Ayurvedic Theories in the Contemporary World
Last week I came across an opinion essay by Kishor Patwardhan, a Professor of Ayurveda. I liked reading it, and was particularly impressed by the courage Patwardhan displayed in saying that there were some ideas and beliefs which he held to dearly in the past, and that over time he had realized that those beliefs lacked strong evidence, and that he was thus changing his own outlook. One wishes more of us possessed both the levelheadedness and the courage needed to, like Patwardhan, modify and recalibrate our attitude and convictions depending upon new evidence (or the lack of it). His article received a lot of traction within the biomedical and general modern scientific establishment, but unsurprisingly he received much flak within the Ayurvedic community. (I must say, however, that there are many beliefs and attitudes within the mainstream biomedical community which also need similar introspection and serious reckoning, but which continue to be ignored.)
In his article, Patwardhan talked about the dominant dogma in contemporary Ayurveda that older Ayurvedic texts contain knowledge and practices which can be easily superimposed on modern scientific knowledge and practices. In his words, this dogma means that “Ayurveda physiology and current physiology are not inherently distinct and they can be merged effortlessly.” In the past, he made
every effort to legitimise ancient [Ayurvedic] literature using a strategy of “strained interpretation” (drawing unintended but convenient meanings of certain words and phrases using cherry-picked references from commentaries)… to make it sound modern and relevant… However, Covid-19-related restrictions offered me a chance to read a few interesting articles and books, and sufficient time to introspect on certain points, which probably wouldn’t have occurred to me otherwise. This reading and introspection changed my perspectives so dramatically that I decided to write about it knowing very well that this might put my entire career at risk. But the truth must be told — and the earlier the better.
Patwardhan now believes that “it is not in the true scientific spirit to superimpose modern science over classical reference.”
As a historian, I have a strong interest in the attempts by generations of Ayurveda practitioners to claim parallels between premodern texts and modern medical knowledge. During the early period of COVID-19 — when so many outrageous claims about the ostensible superiority of Ayurveda over biomedicine (and over all other medical knowledge-systems of the world) were being made — I was able to read some historical work on ideas about epidemic and contagious diseases in Ayurvedic texts. These ideas, and their analysis by historians, offer a good anchor to think about the main issues raised by Ayurveda dissenters like Patwardhan.
It is difficult indeed to get into the shoes of people from around the turn of the millennium and imagine a world where the concept of germs (in the air, water and surfaces) was not a part of everyday understanding. Nevertheless, historians have done a great job of detailing such past societies, and in this write-up I will mention the work of some such scholars who’ve worked on the history of pre-modern South Asia. I read some of their essays published in the book ‘Contagion: Perspectives from Pre-modern Societies’ (2000), which is an edited volume compiled by Lawrence I Conrad and Dominik Wujastyk. The editors provide a helpful overview in their introduction:
That certain diseases are readily transmitted from an ill person to a healthy one is something that one might expect that all pre-modern societies would have noticed and explained in some way. As several papers in this volume show, the phenomenon of contagion was recognised by society at large, and was especially clear to pastoralists and those charged with the care of animals who did not need great epidemics to observe the spread of disease among their herds… Chinese and Indian doctors posed the question of why many people should all fall prey to a single disease at a single time and place.
There are two chapters in this book which deal with India/South Asia. The one by Rahul Peter Das is titled Notions of “contagion” in classical Indian medical texts (Das is a professor at the Martin Luther University Halle-Wittenberg). His arguments are based on a detailed examination of four Sanskrit Ayurvedic texts: Ashtangahrudaya-samhita, Ashtanga-sangraha, Charaka-samhita, and Sushruta-samhita. As we saw in the earlier paragraph, it won’t be difficult to find references in the past (anywhere in the world — not just in South Asia) to an understanding that ailments sometimes spread from one person to another; and Das too finds several mentions of such a transference/transmission of diseases in Ayurvedic texts.
What is of interest to scholars, however, is not the presence of random references to disease transference, but the prevalent systematic understanding of what these terms and concepts actually meant for people and societies. Simply the existence of a similar word in a past vocabulary doesn’t mean that people in the past used the word to mean the same things as we do today. For example, as Das mentions, the Sanskrit word ‘papa’ (पाप), which in the modern sense refers to ‘sin,’ had a more subdued meaning when it was used by Ayurvedic writers of the past: it simply denoted badness, or something harmful or unwanted. Similarly, the word ‘infection’ was present even in English writings from the 1500s, but it did not refer to microbial/germ infections then as it began to mainly in the 1900s.
Through a study of Sanskrit Ayurvedic texts for references to transmission/transference of ailments, Das finds that when terms denoting what we today would call contagion — terms like sanchara, sankrama, etc. — were used by Ayurvedic writers, they were referring to a number of different ideas, and not a single uniform concept of disease transmission through contact as we would today. There even is one passage which implies that perhaps all diseases are transferable. All of this indicates that what Ayurvedic practitioners thought when they said a disease is ‘transferable’ from one person to another, was very different from what we mean today when discussing such an idea.
So what exactly was their understanding? In Das’s view, this can be explained by the general worldview of people living in those times, characterized prominently by what many scholars call the “magico-religious” approach. For example, historian Dominik Wujastyk shows in ‘The Roots of Ayurveda’ that the Sushrutasamhita mentions three types of medical therapy: that which depends upon the sacred, that which depends upon reasoning, and that which triumphs through good character. “The one which depends on the sacred includes the use of mantras, herbs, jewels, good luck ceremonies, food offerings to the gods, presents to the gods, oblations, pledges, penances, fasts, benedictions, prostrations, and pilgrimage.”
Das finds that very often for the Ayurvedic writers, occurrence of disease meant that supernatural powers were manifesting themselves in humans. These powers encompassed divine as well as demonic entities, and their actions were manifold. Words and deeds by humans could cause disturbances in the balance and the relative influence of these powers. Besides, disease was just one of the many ways in which the powers acted on humans (other ways could be something like falling off a cliff or drowning). As Das puts it, there was a “non-differentiation of diseases and other adverse things” in the worldview followed by the writers of these texts.
Contrast that with people today for whom, for example, an attack by a shark on the beach does not share common, overlapping causes with the appearance of a rash on the face: in our worldview the causes of these events are completely differentiated.
It seems that what we [today] term “contagion” is in the ancient Indian context actually part of a complex of notions ultimately going back to the “magical mode of looking at the world”. Diseases are only one of the various means by which the powers that make up the world may manifest themselves in humans after they have overpowered or penetrated them. The modes of overpowering or penetration are various, and include physical contact either directly or indirectly, but also other means, such as looking or hearing… that all or almost all diseases pass from one person to another is quite consistent with this belief… Since not all powers are equally mighty, some diseases may be transmitted more than others.
Whenever we analyze the past, it is extremely important to first put aside our contemporary modes of thinking and assumed knowledge, and to appreciate the ideas and beliefs that might have been prevalent in the times we are analyzing. The texts that Das has analyzed belong mainly to the first millennium CE. People then indeed saw and realized that there are times when a disease occurs in one person, and then in another person who they interacted with, and then yet another. If people today came across such a disease, they would mostly attribute it to microbial spread, whether through physical contact or through droplets or air. That is our worldview: we think of diseases as specific entities with specific causes and modes of spread (in this case, a microbial cause).
But for people living centuries ago (like the writer of Ayurvedic texts), diseases were not such a separate, exclusive, differentiated entity: illness and disease were considered to belong to a motley group of all kinds of adverse events that could affect an individual. And the causes of any of these multitude of adverse events were almost always what we today would call supernatural: being overpowered or penetrated by some kind of invisible power. This same kind of overpowering could cause, for example, epileptic fits in one person, blood-stained vomiting in another, and attack by a snake for a third one. And then some adverse events, like diarrhea, would have been observed to spread from one person to the next. Such a spread possibly resulted from, in their minds, the transference of the “harmful powers” from one person to the next through touch or even just seeing or hearing.
Das tells us that for Ayurvedic writers, “the best way to avoid not only disease, but any thing unpleasant, is to constantly guard against doing something which would bring about disharmony amongst the various mutually balanced powers.” That is, to avoid doing what were considered morally and ethically wrong things.
In his essay Patwardhan — the Ayurveda professor I mentioned at the beginning — says that contemporary Ayurveda theorists and practitioners often employ “strained interpretation” to claim equality between the ideas in Ayurvedic texts and modern ideas. In this case, for example one can imagine that the presence of the terms sanchara and sankraman in older Ayurvedic texts, and the mention of diseases which spread from one person to another, could very well be used by many present-day people to claim that Ayurvedic texts “contain knowledge about germs and microbes” and that ancient Hindus “already knew about the workings of epidemics and pandemics”.
Clearly, as Patwardhan noted in his essay, such claims simply involve a “cherry-picking” of words and concepts taken completely out of their historical and social context.
