Āyurveda

“The knowledge of life”: a two-thousand-year-old medical science with its own books, theory and surgery — and, alongside it, Tamil Siddha medicine. What the tradition teaches, how it is regulated today, and what modern evidence does and does not show.

Please read first

This page describes a tradition; it is not medical advice. If you are unwell, see a registered doctor. If you choose Āyurvedic or Siddha care, use a registered practitioner, tell your doctor what you take, and never stop a prescribed medicine on a traditional practitioner’s say-so. See Evidence and safety below.

Many Malaysian Hindu homes keep some Āyurveda without naming it: turmeric in milk for a cold, an oil bath before Deepavali, a grandmother’s rule against curd at night. Behind these habits stands a learned śāstra with root texts, technical vocabulary, commentaries and a theory of the body. This page explains that tradition on its own terms, then asks the questions a careful modern reader should ask.

The knowledge of life

The classic definition opens the Caraka Saṃhitā:

हिताहितं सुखं दुःखमायुस्तस्य हिताहितम् ।
मानं च तच्च यत्रोक्तमायुर्वेदः स उच्यते ॥ hitāhitaṃ sukhaṃ duḥkham āyus tasya hitāhitam,
mānaṃ ca tac ca yatroktam āyurvedaḥ sa ucyate Life that is wholesome or unwholesome, happy or unhappy; what is good and bad for it; its measure; and life itself — that in which these are taught is called Āyurveda. Caraka Saṃhitā, Sūtrasthāna 1.41

Its two aims, Caraka says, are to protect the health of the healthy and to relieve the illness of the sick — prevention first.

Tradition’s view Āyurveda is an upaveda, a “secondary Veda”, usually linked to the Atharvaveda. Caraka tells how the knowledge passed from Brahmā to Prajāpati, the Aśvins and Indra, and from Indra to the sage Bharadvāja, who brought it to suffering humanity; Suśruta learns surgery from Dhanvantari, incarnate as King Divodāsa of Kāśī. Historians trace healing charms back to the Atharvaveda, but find systematic medicine — with its humoral theory and rational method — appearing later. Kenneth Zysk has argued that it grew among wandering ascetics, including Buddhist monks, before being brought into the Brahmanical fold. That thesis is debated, but all agree the classical texts reached their present form in the early centuries CE.

The great three books

Later physicians called three works the Bṛhattrayī, “the great three”. Tap each:

चरकCaraka SaṃhitāInternal medicine

A teaching of the sage Agniveśa, revised by Caraka (perhaps 1st–2nd century CE) and completed, with about a third of it supplied, by Dṛḍhabala of Kashmir (c. 4th–5th century). Eight sections cover principles, diagnosis, the body, prognosis, therapy and pharmacy. It is strikingly rational: it weighs evidence, sets rules for debate between physicians, and insists on examining the patient. See Vāda for its debate rules.

सुश्रुतSuśruta SaṃhitāSurgery

Attributed to Suśruta, pupil of Dhanvantari; its core is probably early centuries CE, with a long supplementary “Later Book” (Uttaratantra) added afterwards. It describes over a hundred instruments, training on gourds and leather bags, dissection, the setting of fractures, removal of bladder stones, cataract couching and reconstruction of the nose.

वाग्भटAṣṭāṅgahṛdayaThe synthesis

Vāgbhaṭa’s “Heart of the Eight Branches” (c. 600 CE) fused Caraka and Suśruta into elegant verse. Its author was very probably a Buddhist from Sindh. It became the most-used textbook of all, above all in Kerala, and was translated into Tibetan and Arabic.

Later works added what the old books lack. Mādhava’s Nidāna (c. 700) systematised diagnosis; pulse-reading (nāḍī-parīkṣā), now thought of as quintessentially Āyurvedic, first appears in the 13th–14th-century Śārṅgadhara Saṃhitā. And from about the 8th–10th centuries a new science of mercury and metals, rasaśāstra, entered the pharmacy — a point that matters for safety today.

The body in balance

Āyurveda explains health as balance among three doṣas. The word means “fault” or “that which goes wrong”: each is necessary, but each causes disease when it grows or wanes too far. Tap each:

The doṣas move through seven dhātus, the tissues built one from another: rasa (nutrient fluid), rakta (blood), māṃsa (flesh), medas (fat), asthi (bone), majjā (marrow) and śukra (reproductive essence). Waste products (mala) — urine, faeces, sweat — must flow out properly. Governing it all is agni, the digestive fire: food that is not well “cooked” leaves āma, undigested residue, the root of much disease. The refined essence of all the tissues is ojas, vigour and immunity. Each person is born with a characteristic mix of doṣas, their constitution (prakṛti), so treatment is individual. Suśruta sums up health in a verse:

समदोषः समाग्निश्च समधातुमलक्रियः ।
प्रसन्नात्मेन्द्रियमनाः स्वस्थ इत्यभिधीयते ॥ sama-doṣaḥ samāgniś ca sama-dhātu-mala-kriyaḥ,
prasannātmendriya-manāḥ svastha ity abhidhīyate One whose doṣas are balanced, whose digestive fire is even, whose tissues and wastes function well, and whose self, senses and mind are clear and content — that person is called healthy. Suśruta Saṃhitā, Sūtrasthāna 15

The Tamil tradition knew the same three. In the Tirukkuṟaḷ’s chapter on medicine:

மிகினும் குறையினும் நோய்செய்யும் நூலோர்
வளிமுதலா எண்ணிய மூன்று. mikiṉum kuṟaiyiṉum nōy ceyyum nūlōr
vaḷi mutalā eṇṇiya mūṉṟu The three that the learned of books reckon, beginning with wind, cause disease whether they grow too great or too small. Tirukkuṟaḷ 941

For Caraka and Suśruta, the doṣas are real constituents of the body, built from the five elements (mahābhūtas): vāta from air and space, pitta from fire (and water), kapha from water and earth. Diagnosis reads their state; treatment, by diet, regimen, herbs and procedures, restores their balance using opposite qualities — hot against cold, dry against oily.

Eight branches

The classical texts divide medicine into eight limbs, which is why Vāgbhaṭa’s book is “of the eight branches” (aṣṭāṅga):

  1. Kāya-cikitsā — internal medicine.
  2. Kaumārabhṛtya — care of children, with pregnancy and childbirth.
  3. Graha- or bhūta-vidyā — disorders attributed to possessing spirits; today often read as mental illness.
  4. Śālākya — diseases above the collarbone: eye, ear, nose, throat, head.
  5. Śalya — surgery and the removal of foreign bodies.
  6. Agada-tantra — toxicology: snakebite, poisons.
  7. Rasāyana — rejuvenation and longevity.
  8. Vājīkaraṇa — virility and fertility.

Living by the day and the season

Much of Āyurveda is not treatment at all but regimen. Caraka devotes a chapter to dinacaryā, the daily routine — rising early, cleaning the teeth with twigs, scraping the tongue, eye salve, oil in the nose, oil massage, exercise to half one’s strength, bathing, eating moderately — and the next to ṛtucaryā, adjusting food and habits to each of the six seasons. The texts add “codes of good conduct” on speech, sleep and sexual life. A Malaysian reader will notice that the six-season scheme was made for north India, not a tropical climate of rain and heat; practitioners adapt it.

Some of this advice — moderate eating, exercise, regular sleep, oral hygiene — sits comfortably with modern public health. Other parts rest on doṣa theory alone. The tradition also links health to ethics: the yamas and niyamas and a calm mind count as medicine too.

Suśruta’s surgery

The Suśruta Saṃhitā is one of the ancient world’s great surgical texts. Students practised incisions on gourds and cucumbers, punctures on the veins of leaves, and suturing on cloth and leather before touching a patient. To learn anatomy, it describes softening a body in a river for a week and then exposing its layers by gently brushing — a method of dissection that avoided cutting the dead.

Its best-known procedure rebuilds a nose lost to injury or to punishment (cutting off the nose was a penalty in ancient law) using a living flap of skin from the cheek. Indian practitioners kept such techniques alive. In 1794 a London magazine reported a nose rebuilt with a forehead flap near Pune, on a man named Cowasjee, by a practitioner of a craft caste; the English surgeon Joseph Carpue tried the “Indian method” and published his results in 1816. Modern plastic surgery honours this lineage — but it is a story of continuous craft skill as much as of one ancient book.

Two cautions keep the picture honest. Āyurvedic surgery declined over the medieval centuries, and the cataract operation of the texts (couching, pushing the lens aside) is not modern cataract surgery. And the classical schools, as written, admitted students by birth: the texts speak of teaching the three upper varṇas, with Suśruta permitting a Śūdra of good family to be taught without the Vedic mantras. Women appear as patients, mothers and midwives, not as authors. These limits should be stated plainly, as should the fact that women and men of every background teach and practise these systems today.

Siddha and Unani

Siddha medicine (cittha vaittiyam) is the Tamil counterpart. Tradition’s view It traces itself to the sage Agastya and the eighteen Siddhars, yogis who mastered body and mind. Historians date most of its Tamil medical verse to the late medieval and early modern centuries, and note that “Siddha” as a distinct, named system was consolidated in the 20th century, partly as a mark of Tamil identity. It shares the three humours — vaḷi, aḻal, aiyam — but has its own eight-fold examination (pulse, tongue, colour, speech, eyes, touch, stool, urine), a strong emphasis on mineral and metal preparations (paṟpam, centūram), and the martial-therapeutic art of varmam, the vital points. The National Institute of Siddha in Chennai trains practitioners, and Siddha is taught and practised in Malaysia too.

Unani (“Greek”) medicine is the Greco-Arabic tradition of Galen and Ibn Sīnā, with four humours, brought to India with the Delhi Sultanate and the Mughals and cultivated by families of Muslim hakīms. It is not a Hindu tradition, but it shared bazaars, patients and ideas with Āyurveda for centuries, and India regulates it alongside them.

Āyurveda today

In India these systems are state-recognised. A Ministry of AYUSH (Āyurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-Rigpa and Homoeopathy) has existed since 2014, and the National Commission for Indian System of Medicine Act of 2020 governs education and registration. Degrees (BAMS for Āyurveda, BSMS for Siddha) take five and a half years. Integration is contested: a 2020 notification allowing postgraduate Āyurveda surgeons to perform listed operations drew strong protest from India’s medical association. The World Health Organization opened a Global Centre for Traditional Medicine at Jamnagar, Gujarat, in 2022, and since 2025 India has kept a National Ayurveda Day on 23 September.

In Malaysia, the Traditional and Complementary Medicine Act 2016 (Act 775) set up a T&CM Council and a register of practitioners in recognised practice areas, one of which is traditional Indian medicine. Registration opened in 2021, and since March 2025 practising in a recognised area without registration has been an offence. Traditional medicine products are separately regulated: a product sold legally in Malaysia should carry a registration number from the National Pharmaceutical Regulatory Agency. Checking both is simple and worth doing. Kerala-style Āyurvedic centres, Siddha clinics run by Tamil practitioners and Āyurvedic oils in Indian shops are part of Malaysian Hindu life; see Malaysia & the Diaspora.

Evidence and safety

What does modern research show? The honest answer is mixed, and mostly thin. There are many small trials, few large rigorous ones, and the whole-system individual treatment Āyurveda prescribes is hard to test. A few examples show the range:

A health caution

Nothing on this page is medical advice. Consult a registered medical doctor for diagnosis, and a registered practitioner if you choose traditional care. Tell your doctor about every herbal or traditional product you use, avoid unregistered products and metal-based preparations unless you understand the risk, and take special care in pregnancy, with children and alongside treatment for serious illness. No tradition’s reverence for a remedy is a substitute for testing it.

None of this cancels the tradition’s value as a body of thought: a careful, observant, ethically serious attempt to understand health as balance, and a reminder that prevention, diet and daily habit matter. Respecting it means describing it accurately — including where it has not held up.

Questions

Is Āyurveda part of the Veda?

In the tradition’s own classification it is an upaveda, a “secondary Veda” linked to the Atharvaveda, and Caraka gives it a divine lineage. Historically the Atharvaveda contains healing charms, but Āyurveda’s systematic theory comes from later, independent medical texts. See The Four Vedas.

Should I find out my doṣa type?

Many people find the language of constitution a helpful way to think about habits. But online doṣa quizzes are not diagnosis, and constitution types are not established by modern research. Any real health concern needs a qualified professional.

How is Siddha different from Āyurveda?

They share much theory, including the three humours. Siddha is Tamil-language, traces itself to Agastya and the Siddhars, uses its own eight-fold examination, and relies more heavily on mineral and metal preparations — which makes the safety point above especially relevant.

Check your knowledge:

Quick check

Which text is the classic of Āyurvedic surgery?

Suśruta’s text describes instruments, training, dissection and reconstruction of the nose.

Which doṣa is the principle of transformation and heat?

Pitta governs digestion and metabolism; vāta is movement, kapha structure.

In Malaysia, traditional Indian medicine practitioners are registered under…

Act 775 created the T&CM Council and the practitioner register.

Why do some rasa preparations raise safety concerns?

Studies have found heavy metals, sometimes above safety limits, in metal-based products.

॥ Pause and reflect

  1. Which of the household health customs you grew up with came from this tradition? Which would you keep, and why?
  2. Caraka set “protect the health of the healthy” before curing the sick. What would that look like in your week?
  3. How do you hold reverence for a tradition together with the demand that its remedies be tested?

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Key terms on this page

Sources & further reading