In India, the art of Ayurvedic healing is almost as old as the religion of Hinduism itself. It has reached a state of reverence and is classified as one of the Upa-Vedas - a subsection - attached to the Atharva Veda. The Atharva Veda consists of not only the magic spells and the occult sciences but also the Āyurveda which deals with the diseases, injuries, fertility, sanity and health. The secret myths of Ayurvedic of life were revealed even in the first Veda, the Rg Veda. The five elements of creation, the Pancha-maha-bhuta, namely the earth, water, fire, air and ether form the basis and essence of all the life forms. Out of these arise the three doshas, namely Vata, Pitta and Kahpa. These three doshas unfortunately have been crudely translated as air, bile and phlegm. However, the Āyurveda texts, which treat all diseases based on the disequilibrium of these three doshas, have a lot more complexity. The three knowledge aspects of Āyurveda consists as the Tri-Sutras Sutras — reason of illness (etiology), symptomatology of disease process and treatment of disease.

It accumulates all forms of lifestyle in therapy. Therefore, yoga, aroma, meditation, gems, amulets, herbs, diet, astrology, color and surgery etc. are utilized in a comprehensive & consolidated manner in treating the patients. Treating and curing vital and sensitive spots on the body is called Marmas and described both in Āyurveda and in Dhanur Veda (another Upa-Veda dealing with martial arts and military science). Massages, exercises and yoga are recommendable.

The esteemed state of the technique of healing was enhanced by the myths and the legends of the gods of healing, Divodasa Dhanvantari, a patron deity of medicine. The science of medicine was believed to be taught to the sages by Divodasa Dhanvantari, who later had written them down in the text of Āyurveda. According to another historical data or legend the knowledge of healing originated from the creator of the world Brahma himself, who taught it to Daksha (protector of all beings), who in turn passed on the knowledge to Indra. When diseases and death became stagnant, a gathering of the great sages was held in the Himalayas. Sage Bharadvaja volunteered to study the craft from Indra. He then taught the science to his pupil Ātreya, a legendary healer, who then processed all these knowledge through his disciples. Collections of this knowledge are called the Ayurveda. Other patron saints of medicine were twins that were called Ashvins, who were disciples of eyesight and were physicians that treated the gods themselves.

Atreya, amongst his six disciples (Agnivesha, Bhela, Jatokarna, Parashara, Harta, and Ksharapani) held a competition. Each had established a school of his own and taught the traditions of Ayurveda. Agnivesha Samhita was the most comprehensible.

Compilations of Ātreya and Agnivesha are missing. The knowledge which we now have is by three surviving texts of Charaka, Sushruta and Vaghbata. Charaka (1st century A.D.) based his Samhita on Agnivesha Samhita. Sushruta (4th century A.D.) based his Samhita on the Dhanvantari School of Āyurveda. Vaghbata (5th century A.D.) compiled the third set of major texts called Ashtanga Hridaya and Ashtanga Sangraha. The former is more succinct and is based on both Ātreya and Dhanvantari schools than the latter. The basic school of Āyurved- Ātreya’s School of Physicians and Dhanvantari’s School of Surgeons were arranging for a systematic classification of branches of medicine and surgery.

There are Sixteen major supplements (Nighantus) were written in the ensuing years – Dhanvantari Bahavaprakasha, Raja and Shaligrama to name a few – which helped refine the practice of Āyurveda. New drugs had been added and ineffective ones were discarded. Expansion of application, identification of new illnesses and finding other alternative treatments seemed to have been an evolving process. There were close to 2000 plants that were being newly generated for healing diseases and abating symptoms were identified in these supplements.

Dridhabala in the 4th century revised the Charaka Samhita. The texts of Sushruta Samhita were revised and updated by Nagarjuna in the 6th century in a treatise called Upa-hridaya. In eight branches/divisions, Ayurveda was being developed.

1. Kaya-chikitsa (Internal Medicine)
2. Shalakya Tantra (surgery and treatment of head and neck, Ophthalmology and Otolaryngology)
3. Shalya Tantra (Surgery)
4. Agada Tantra (Toxicology)
5. Bhuta Vidya (Psychiatry)
6. Kaumara bhritya (Pediatrics)
7. Rasayana (science of rejuvenation or anti-aging)
8. Vajikarana (the science of fertility).

The author’s dates are still very controversial. Some historians place the lifetimes of Ātreya, Charaka and Sushruta in the Vedic period, around 600 B.C. These are the references to the authors that based to have surfaced in earlier texts than the proposed dates given in this article. When the history is completely rewritten and there is no more controversy, everyone hopefully can agree upon a constant date. There is no need to worry about the timeline and only admire the scientific approach to these ancient authors followed, striving to perfect the art of healing that could create a rivalry for the  modern scientific research.

Modern medications were derived from plants alluded to in Āyurveda texts. The oft cited example is that of Rauwolfia serpentina that was used to treat headache, anxiety and snakebite. Its derivative is used in treating blood pressure today.

Two areas of contributions of Indian physicians were in treating snakebite and prevention of small pox. Detailed account of steps to be followed after a poisonous snake bite including application of tourniquet and lancing the site by connecting the two fang marks and sucking the poison out is described. The next step is to apply a decoction of the medicinal plant Rauwolfia serpentina to the wound.

Initially a form of vaccination for small pox was commonly practiced in India, before the West discovered the method. A small dose of pus from the pustule of small pox lesion was inoculated to have resistance. Such methods of building immunity were practiced in other fields as well, against other diseases in order to develop antibodies against the infecting organism or a poison.

Charaka was said to have been in the court of the Kushana king, Kanishka during the 1st century A. D. Some authors dated him as far back as the 6th century B.C. during Buddha period. The holy trust between physician and patient was held in high esteem by Charaka and patient confidentiality, similar to the Hippocratic Oath, was deemed the proper conduct for a practicing physician. Charaka also told us that the word Āyurveda came from Āyus, meaning life and Veda. However, according to Charaka the word Āyus connotes more than just life. Apart from that, it denotes a combination of the body, sense organs, mind and soul.

The principles of treatment in Charaka’s teachings took a holistic approach that treated not just the symptoms of the disease but the body, mind and soul as single entity.Charaka in the form of discussions and symposiums held by many scholars, Charaka Samhita is the most ancient and authoritative text that has still being survived. Written in Sanskrit in verse form, it has 8400 metrical verses. Following the Ātreya School of Physicians, the Samhita deals mainly with the diagnosis and treatment of disease process through internal and external application of medicine.

Kaya-chikitsa (internal medicine) aims at treating both the body and the spirit and to strike a balance between the two. Following diagnosis, a series of methods to purify both the body and spirit with purgation and detoxification, blood letting and emesis as well as enema (known as Pancha-karma) are utilized. It is to cure diseases in the initial stage or in a preventative manner before the first symptoms appear.The diagnosis and treatment is traditionally divided into eight branches (sthanas) based on some approaches of a physician towards a disease process. Charaka described as follows;

1. sūtra-sthāna, general principles
2. nidāna-sthāna, pathology
3. vimāna-sthāna, diagnostics
4. sharīra-sthāna, physiology and anatomy
5. indriya-sthāna, prognosis
6. chikitsā-sthāna, therapeutics
7. kalpa-sthāna, pharmaceutics
8. siddhi-sthāna, successful treatment.

Details of various methods of diagnosis, study of various stages of symptoms and the comprehensive management of debilitating diseases like diabetes mellitus, tuberculosis, asthma and arthritic conditions are to be found in the Charaka Samhita. Even there is a detailed account of fetal development in the mother’s womb, which can create some rivalry descriptions of modern medical text books. Charaka lists more than 500 remedies in his Samhita.

It was explained about building a hospital and a good hospital should be located in a breezy spot free of smoke and objectionable smells and noises. Even the equipment needed including the brooms and brushes are detailed. The employees are clean and well behaved. Details about the rooms, cooking area and the privies are given. Conversation, recitations and entertainment of the patient were encouraged and said to aid in healing the ailing patient.

In the 4th century A.D, Sushruta was a surgeon in the Gupta courts. He followed Dhanvantari School of Surgery and is one of the earliest surgeons of recorded history. Though Indian mythology is full of accounts of healing through transplantation of head and limbs as well as eye balls, Sushruta Samhita is the first authentic text to describe methodology of plastic surgery, cosmetic and prosthetic surgery, Cesarean section and setting of compound fractures. Sushruta had in his possession an armamentarium of 125 surgical instruments made of stone, metal and wood. Forceps, scalpels, trocars, catheters, syringes, saws, needles and scissors were all available to the surgeon. Rhinoplasty (plastic surgery of the nose) was first suggested to the world medical community by Sushruta in his Samhita, where a detailed method of transposition of a forehead flap to rebuild a severed nose is given. Severed noses were a kind of common punishment.

Due to heavy jewelry worn on ear lobes, Torn ear lobes also were found. Sushruta described a method of repair of the torn ear lobes. Fitting of prosthetics for severed limbs were also commonly performed feats. It is the “Only the union of medicine and surgery constitutes the complete doctor. The doctor who lacks knowledge of one of these branches is like a bird with only one wing.” While Charaka concentrated on the kaya-chikitsa (internal medicine), Sushruta’s work mainly expounded on the Shalya Tantra (surgery).

It contains mostly poetry verses but also has some details in prose. 72 different ophthalmic diseases and their treatment are mentioned in great detail. Pterygium, glaucoma and treatment of conjunctivitis were popular among the Sushruta. Removal of cataract by a method called couching, wherein the opaque lens is pushed to a side to improve vision was practiced routinely. Techniques of suturing and many different kinds of bandaging, puncturing and probing, drainage and extraction are detailed in the manuscript. More than 700 herbal medicines are being included in the Sushruta lists.

Vaghbata in the 5th century gathers two sets of texts called Ashtanga Sangraha and Ashtanga Hridaya. The latter of the two combines both the Ātreya and Dhanvantari schools. It has details of the Kaya-chikitsa of Charaka Samhita and the various surgical procedures of Sushruta Samhita. Exhaustive descriptions of kapha, vayu and pitta are given. However, the pressure is more on the physiological rather than the spiritual aspects of the disease processes. Ashtanga Hridaya is written in prose whereas the Ashtanga Sangraha is in poetry form.

Originally only Brahmins were practicing physicians. Later people from other castes became well versed in the art of healing and a term Vaidya came to be applies to the practitioners. The physicians gained high social status regardless of their caste of birth, merely by their art and knowledge. The court physician was of political importance and sat on the right side of the throne, an important symbolic place. Though the physician, patient, the nurse and the medicine were all necessary in curing a disease, the people thought that the physician was the most important and valuable person in life.

The codes of conduct for physicians and medical students were laid down by the texts of Laws of Manu. The poor and downtrodden were to be cured free of cost. Others were charged according to their ability to pay.

The physician was expected to behave in an exemplary manner, conforming to the highest ideals of both professional and personal life. His dress, manner and speech were expected to be beyond reproach. Medical education was arduous, consisting of many years of sacrifice learning the art of healing. Visiting the sick, collecting herbs and preparations of drugs, memorizing the Vedic texts of Āyurveda, performing procedures on dead animals, melons, and leather bottles and bladders were part of the training. These helped to refine both practical and theoretical training of the student. When finally the student is deemed ready to practice on his own, he is certified by the ruler. The system resembles closely that of the Hippocratic Oath of Greece.

The influence of Greece had on Indian medicines has being tremendous. We know that astrology and astronomy were both greatly influenced by the Greeks (solar calendar, for example). Most of the texts known to all were written after the Greeks made their appearance (Alexander in 3rd century B.C.) and stayed in the Northwest India for several generations. How much the Indian physician learned from the Greek counterpart and vice versa is a question not answered