The blending of healing and pedagogy in Āyurveda
P. Ram Manohar
The medical tradition of Āyurveda has preserved a rather unique concept of education that blends principles of healing with those of pedagogy. With its intense focus on the promotion of positive health and higher states of well-being, Āyurveda has discovered that elevated states of health can be achieved only through a subtle transformation of the inner personality. Diseases can be cured, managed or prevented by medical intervention and other such physical means. However, higher states of health can be achieved only through self-awakening. The process of self-awakening is essentially an educative development, a psycho-spiritual transformation that enables the individual to not only live with awareness, but also with health. The meeting point of the most refined methods of pedagogy and healing gave birth to the notion of the physician par excellence as the vaidya, the one who knows the essentials and educates the individual, enabling him to reach a state of heightened awareness most conducive to knowledge acquisition and a healthy existence.
Healing the sick to cure and the healthy to liberate
The Caraka Saṃhitā, the celebrated medical textbook on Āyurveda that dates back to a few centuries before the Common Era, opens the section on the medical treatment of diseases with chapters on rasāyana (rejuvenation) and vājīkaraṇa (reproductive medicine and eugenics).1 At the first instance, the reader would find it appealing that the ancient masters emphasize the importance of prevention over the cure of diseases. But on a closer look, it becomes evident that there is a more profound message in this clever arrangement of topics in the medical treatise. The message is that even the so-called healthy individual needs further treatment—‘svastho’pi cikitsyaḥ’. Health according to Āyurveda is definitely not the mere absence of disease. Āyurveda does not encourage the individual to remain complacent by eliminating the physical or mental discomfort caused by illness. It is not enough to adopt a conservative and defensive approach to life in order to prevent disease. The focus is on empowering the individual to evolve to elevated levels of health and fulfil the higher goals of human evolution. Health becomes synonymous with an awakening of the mind in an invigorated body and with a life lived with an awareness of the spiritual self. The target of Āyurvedic knowledge is the ‘karma puruṣa’, also known as the ‘rāśi puruṣa’, the acting individual, who has to participate actively and consciously in this programme to soar into the realm of positive health and well-being.2 Terms that mean diseased—such as rogī, ātura, vyādhita and so on—are only used in the context of grave diseases where external help from the physician is more important.3 Since the overall goal of Āyurveda is to be a holistic system of healthy living, these passive terms have been replaced by the term ‘karma puruṣa’.
Central to Āyurvedic healing is the notion of the human persona as a three-dimensional composite of body, mind and self.4 Āyurveda aims to empower the body to invigorate the mind and, consequently, to use the invigorated mind to generate self-awareness. The conscious self shines through every individual, but in different degrees, depending on the stage of evolution of her/his psycho-spiritual apparatus. The ultimate healing, according to Āyurveda, involves a subtle manoeuvre that enables the physical hardware and the psychic software of the human personality to upgrade itself to become capable of manifesting the true nature of the self in all its glory and completeness. This is the true disease-free state that Āyurveda aims to guide each human being to gradually evolve to.5
The chapters on rejuvenation and eugenics have been placed before the discussion on the treatment of physical and psychic ailments for the simple reason that Āyurveda considers every individual to be an incomplete and vulnerable entity till the full potential of the inner being has been awakened to perfection through a process of psycho-spiritual transformation.
Āyurveda stresses the importance of begetting progeny by choice rather than by chance, and emphasizes that only individuals enjoying higher states of health should reproduce to ensure that humanity can collectively raise itself to the sublime levels of spiritual awareness. The purpose of rasāyana (rejuvenation) is to tone up and empower the physical body as well as invigorate the mind. Eugenics and reproductive medicine are mentioned after rejuvenation in order to indicate that one should plan for progeny only after rejuvenating one’s physical and psychic being.
It is very interesting to note that only these two chapters have been divided into quartets (pādas), thus partitioning each chapter into four subsections. No other chapter in the treatise shares this feature. Each section represents one of the four Vedic goals of human life —the puruṣārthas. Rejuvenation and eugenics have been placed on the four pillars of the puruṣārthas to indicate that their purpose is to realize the four major goals of life, viz., dharma, artha, kāma and mokṣa.6
One verse in the section on rasāyana explicitly states that the purpose of this modality of treatment is not cure of disease or a long life. One who adopts this regimen is able to follow the path of self-evolution attained by the great sages and becomes one with the supreme Brahman.7
Psycho-spiritual transformation of the healthy leads to liberation
According to Āyurveda, the conscious self is the immutable awareness8 upon which no medicine can act. It is entrapped in matter and masked by the delimiting nature of the material plane of existence. The liberation of awareness comes by the transformation and transmutation of matter and not merely by cultivating intellectual thoughts and ideas. Therefore, Āyurveda gives emphasis to physical medicines and physical procedures that aim to transform the material body so that the mind becomes powerful and capable of reflecting the true nature of the conscious self. Mind is not different from matter but is the other side of the material continuum, a finer state of matter itself. By definition, rasāyana is the means to clear the path for the smooth transformation of the life sap (rasa).9 The manifestation of consciousness in the relative world of experiences is very much a matter-bound phenomenon; the qualitative state of matter determines the degree of expression of consciousness in living beings. On the other hand, when consciousness manifests itself fully by liberating itself from the clutches of matter, it exerts a direct and transforming influence on the states of matter that delimit it in the first place.
This process of transformation cannot be started by external means. It has to happen from within. Physical illness can be healed, to some extent, with external medical help but to attain higher states of health, there has to be a conscious effort by the individual. The ideal Āyurvedic physician, therefore, has a dual role to play in the realm of healing. He has to first become a healer of diseases—in Āyurvedic terms, a bhiṣak, or one who drives away the fear of disease.10 Second, and most importantly, he has to become a healer of the personality, the knowledgeable vaidya who can facilitate self-transformation and impart knowledge of the self.11
The dictum ‘Physician, heal thyself’ underpins the approach to the formal training that the Āyurvedic physician had to undergo in ancient days. Texts such as the Caraka Saṃhitā point out that apart from learning about diseases, medicines and treatment, the physician himself has to effect an inner transformation and become the ideal of the healthy existence that he will attempt to invoke in all those who approach him for solace and relief from suffering.
We do come across a method of training of the physician that culminates in the transmutation of the personality and the awakening of a higher awareness, comparable to a second birth of the fully trained doctor who now becomes fit to go out into the world as a healer.12 It is very pertinent to note that this discussion falls within the quartet on rasāyana, an indication that sophisticated modalities of treatment like rasāyana should be done by a physician who has transformed himself into higher states of health and well-being.
Healing the healthy is education of the self
We see in the exposition of Āyurveda the emergence of a context where the principles of healing and pedagogy blend naturally to create an approach to self-transformation that transcends the scope of both healing and education as they are popularly understood.
This higher modality of healing in Āyurveda is truly ‘self-education’, which can mean educating oneself on the true nature of the higher self as well as education that has to be self-initiated and self-completed.
In Āyurveda, we can see a continuum being formed by healing and education, beginning with education about healing and culminating with education becoming a process of healing. The physician par excellence, or apūrva vaidya, in Āyurveda is one who eliminates the six faults of the mind and thereby roots out the seeds of disease once and for all.13 Thus, the true physician is one who can balance the two roles of healing and teaching, who can offer a helping hand to a sick person sinking in the swamp of illness and uplift him to the highest level of healthy existence by facilitating an inner transformation. That is why in ancient days, the physician was considered a manifestation of the Lord himself—‘vaidyo nārāyaṇo hariḥ’. In due course of time, this higher role of the physician was neglected, even forgotten. The noble vocation of healing became a means of livelihood, a business, a lucrative profession. The vaidya who was Nārāyaṇa himself became the brother of the Lord of Death—Yama—who takes away both the wealth and life of the sick people who approach him.14 The Caraka Saṃhitā says that in the long term interests of humanity, such individuals deserve to be punished by molten metals being poured down their throats!15
The section of the Caraka Saṃhitā that deals with nature of the physical body, including anatomical considerations, devotes a full chapter to discussing the psycho-spiritual nature of the individual. It is in this context that serious questions are raised regarding the outcome of healing. Can healing eliminate sickness forever? What is the means to attain a disease-free state in which one is not afflicted by sorrow of any kind?16
The answer is yoga, the text declares. One can transcend the limitations of relative existence and go beyond disease and sorrow only through the practice of yoga. In yoga and mokṣa, there is freedom from pain. In mokṣa, which is the end result of the practice of yoga, there is complete cessation of sorrow and freedom from all limitations.17
Pain and pleasure are two sides of the same coin and cannot be avoided by living beings. In Āyurveda, both are together referred to by the technical term ‘vedanā’.18 The practice of yoga enables the individual to rise above them and attain equanimity of mind, which eventually leads to self-awakening and liberation. In that state, the individual identity dissolves completely; the individual becomes one with existence and evolves into a cosmic individuality characterized by the experience that he is one with the universe and the universe one with him.19
It can, thus, be seen that the higher aspects of Āyurvedic healing aim to take the individual on the path of yoga, the path of self-transformation. Interestingly enough, there is no single textbook on Āyurveda that deals with the eightfold path of yoga. There is not a single reference in any Āyurvedic textbook recommending physical postures or breath regulation as a means to heal disease or improve health. Not that they are not useful for these purposes, but Āyurveda seems to have understood yoga as a process of the psycho-spiritual transformation that leads to union with the higher self.20 This goal cannot be achieved by practicing āsanas or prāṇāyāma alone.
Suffice it to say that yoga in Āyurveda is, then, the means to psychic transmutation that leads to mental stillness (sattvasamādhāna) and, eventually, to complete self-awareness.21
Āyurveda advises the physician to become a parent to the sick and to treat the ailing person as one would one’s own child.22 In other words, Āyurveda beseeches the physician to take up the responsibility to facilitate the physical, psychic and spiritual growth of those who approach him for succour.
The twin goals of healing and education
Āyurveda is made an example here to demonstrate the compact manner in which all knowledge systems in the Vedic tradition have been organized to serve the dual purpose of material prosperity (abhyudayaḥ) and spiritual uplift (niśreyas). Āyurveda fulfils the dual purpose of aparā vidyā (mundane knowledge) and parā vidyā (spiritual knowledge) by defining two modalities of treatment. The lower level of healing diseases is called cikitsā, which corresponds to the realm of aparā vidyā in the Upaniṣads. The higher level of healing is called naiṣṭhikī cikitsā, and it corresponds to the realm of parā vidyā.23 Āyurveda thus fulfils the Vedic ideal of embracing both the physical and the spiritual in an act of balance, and to guide physical evolution to reach out to the higher realms of spiritual evolution.
The Āyurvedic example also demonstrates the need to complement vocational training with self-transforming education, and conveys the powerful message that any branch of human learning must blend the lower vocational component with a higher self-transforming programme of education. Training in any knowledge system was designed to develop vocational skills as well as facilitate the self-evolution of the student. In the context of Āyurveda, however, the physician is himself expected to become a powerful catalyst of self-awakening.
The principles of higher education in Āyurveda
The Āyurveda accounts that reveal the system of education through which students of Āyurveda were trained to become physicians give very valuable insights into techniques and methodologies that aimed to facilitate psycho-spiritual evolution and the balanced development of the personality.
The main principles of the Āyurvedic approach to education can be summarized in the following points:
- Right parenting: The education of parents, the pre-conception behaviour of expectant couples and the proper upbringing of the child.
- Right nutrition: The nutritional requirements of the child have to be properly met because growth and development of mental functions are dependent on the physical body, which works as a hardware for the mind.
- Right medical care: Higher mental functions can be awakened by appropriate medical care, and defective development rectified to a great extent by suitable medical intervention.
- Right teacher: The teacher makes all the difference between knowledge and ignorance. The true teacher is a facilitator of learning and not a mere transmitter of information.
- Right teaching: For a harmonious unfolding of the inner potential, it is essential to strike a balance between acquisition of professional skills and personality development, and teaching must give equal emphasis to both these aspects.
- Right student: The student should be endowed with the necessary qualities to be able to imbibe the teaching completely and effectively. Preparing the student to receive knowledge is a key factor in education.
- Right environment: Learning has to take place in an environment conducive to the acquisition of knowledge as well as self-development. Most importantly, the environment must nurture the process of learning in a natural and effortless way.
- Right learning process to suit needs of a student: Each individual is unique. The ideal teaching programme should recognize individual differences and customize the teaching to suit the specific requirements of an individual.
A more detailed discussion on these points will provide better insight into the method of education for self-development advocated by Āyurveda.
The foundation for the complete education of the child begins before its conception. Educating the child begins through the education of the parents. Being born with a healthy physique gives a natural advantage to the individual in the effective pursuit of learning. Āyurveda advises a couple to rejuvenate itself physically and mentally, and to improve the quality of reproductive tissue with special treatments (rasāyana and vājīkaraṇa). The quality of parental tissues will reflect upon the quality of the reproductive tissues and, consequently, on the child that will be born to them. Āyurveda emphasizes that major developmental handicaps can be averted by proper planning and intervention. Āyurveda has also discovered that neurological development can be influenced by behavioural regimens adopted by the expectant mother during gestation. The pregnant woman is advised to mentally visualize the qualities she desires the child to be born with.24
Two legends in the tradition give an indication that the influence of gestational behaviour on the developing personality of the child was a widely accepted principle in ancient times. One is the story of Prahlāda, the devout child of the asura king, Hiraṇyakaśipu, who rebelled against his father and was able to invoke the blessings of Lord Viṣṇu in the ferocious form of the man-lion. Prahlāda, it is said, did not develop asuric traits like his father because he was influenced by spiritual discourses delivered by the sage Nārada when his mother was pregnant. Another is the story of Abhimanyu, the son of Arjuna, who learnt the technique of piercing through the padmavyūha formation in warfare when he was in his mother’s womb. A story from the epics depicts a couple praying to Lord Śiva for a child and facing the predicament of having to choose between a long-lived dullard and a short-lived but intelligent child—they ask for the latter. The role of right parenting in laying the foundation for proper education of the child has been well expounded in the Āyurvedic classics and also finds parallels in the popular culture.
Āyurveda has discovered the relationship between proper nutrition and balanced growth of the mind. Without being provided with the right nutrition, mental alertness can be hampered and during gestation and early childhood, this could lead to permanent mental disability. A story from the Upaniṣads demonstrates the importance of nourishment for the proper functioning of the intellect and the mind. One day, after a teaching session, a teacher advises the students to go on a fast and return with empty stomachs. In the fasting state, the students are unable to remember their lessons. They regain their memories after eating. This was an ingenious way in which the teacher of the Upaniṣads impressed upon children that the mind was a product of food—‘annamayaṃ hi soumya manaḥ’.
Right medical care
Āyurveda recommends medications to enhance the higher mental functions of the growing child so as to facilitate the process of learning. Āyurvedic textbooks abound with lists of formulations for improving mental functions.25 There is specific reference to the awakening of a faculty called ‘medhā’, which is, according to one definition, the enhanced ability to read and understand books, and, according to another, the capacity for constant remembrance and the application of acquired knowledge.26 There is also reference to the ability of herbal formulations to improve ‘smṛti’, or ability to store and recall acquired knowledge.27 Āyurveda has understood that mental functions have a physical basis and that the mind is but a finer form of matter. Only the conscious self transcends the realm of matter and mind and remains unaffected by the changes that take place in the material plane. Medicines can change the quality of physical matter, including the mind, and make it fit to reflect consciousness in a profound and intense manner.
It is very interesting to note that the ideal teacher described in the Āyurvedic texts is a facilitator of learning rather than one who drills information into the minds of his disciples. The teacher is compared to the timely rain that falls on fertile land sown with viable seeds.28 In other words, the true teacher helps the student to unfold his inner potential. The relationship between the teacher and student was characterized by the sentiment of vātsalya, or deep affection. According to the commentator, vātsalya is the intense feeling of affection that a cow feels spontaneously for her newborn calf.29 The main role of the teacher was to mould the character of the student, much like preparing a vessel to hold water. Knowledge is compared to water and the mind of the student to the vessel.30 It is easier to transfer knowledge than to organize a student’s mind to use it in a benevolent way. The teacher was, therefore, one who was vested with the responsibility of ensuring that knowledge was passed on to only deserving candidates. The quality of a teacher was measured not merely by his ability to bestow knowledge and skills but also by his ability to build character. A student was given the right to examine a teacher before accepting him, just as a teacher would examine a student before enrolling him for study.31
Contrary to popular belief, the student enjoyed great freedom in the learning process. We find in the Caraka Saṃhitā, for instance, that teaching begins only when disciples raise questions.32 In many sections, the teaching is in the form of dialogues between the teacher and the pupil. According to tradition, even a teacher’s mind is awakened by a student’s stimulating question that is asked with the right attitude.33
The vidyārambha ceremony, which is a very popular event (albeit nowadays only an occasion for celebration), symbolizes the role of the teacher in the Indian approach to education. The navarātri festival, which culminates in the vidyārambha, or the initiation into the learning process, lasts for nine nights and ten days. During the first three days, devotees worship the Goddess Kālī, the next three days, the Goddess Lakṣmī, and the last three days, the Goddess Sarasvatī. This festival represents the gradual victory over the lower tendencies of the human mind that manifest when tāmasic and rājasic qualities predominate. Kālī is the fierce aspect of the divine that overpowers the tāmasic tendencies of the human mind, Lakṣmī is the dynamic aspect of the divine that conquers the rājasic tendencies and equips the individual with the resources of nature. And, finally, Sarasvatī indicates the awakening of the sātvic tendencies of the human mind, indicating the maturity of the individual to receive knowledge. The grand finale is on the tenth day, which celebrates the victory of the higher nature over the lower, and represents the rebirth of the individual as a new person. It is no coincidence that these ten days correspond to the ten months of gestation in human beings. Āyurveda refers to rajas and tamas as the two faults of the mind, and spiritual education as the means to rectify them.34
Since true education leads to the mental rebirth of the individual, the teacher became more sacred than one’s biological parents and the teaching became sacrosanct. While the biological parents bring forth the physical body of the individual, the teacher brings forth the inner personality to complete the manifestation.
The function of the teacher as a source of information is slowly becoming redundant in this age of information technology and virtual reality. But the role of the teacher as a humanizing and catalyzing influence to facilitate the inner growth of the individual is assuming significance as never before.
The teaching should be appropriate and effective. It should strike a balance between theory and practice. As an Āyurvedic text says, one who is grounded only in theory will become like a soldier who will run away from the battlefield at the mere sight of the enemy; and one who has only practical training will falter in complex situations. Theory and practice are like the two wings of knowledge. A very important concept regarding appropriateness of teaching is adhikāra. It is not easy to translate this word, but it would roughly mean eligibility or preparedness. The right teaching is like a potent seed that sprouts spontaneously when it is sown in the fertile mind of the disciple. Teaching becomes effective only when the mind of the student has been ploughed and made fertile. When the sage Bharadvāja approached Indra to get knowledge of Āyurveda, Indra explained Āyurveda in a very brief and suggestive exposition, knowing the powerful and receptive state of his disciple.35
The Caraka Saṃhitā mentions in one place that the sage Ātreya had six disciples and that he taught all of them in the same manner, without favouritism. However, Agniveśa, his most brilliant disciple, got an edge over the others and became the first to systematically expound on Āyurveda.36 There are three types of teachers and, likewise, three types of students—superior, mediocre and inferior. When a superior teacher meets a superior student, the best possible outcome can be expected. The worst scenario is when an inferior teacher meets an inferior student. Yet, a superior teacher can salvage something from an inferior student. The importance of the student putting in the effort to inculcate the necessary qualities to imbibe knowledge cannot be underestimated. Examination of a student was compulsorily carried out before initiation and was known as śiṣyaparīkṣā.37
True learning occurs spontaneously in the right circumstances. Creating the right environment for education alone can bring success. In the ancient Indian tradition, it was customary to send students out on specific tasks without giving them any formal lessons; the students would learn automatically from the situations that they found themselves in. Two stories in the Āyurvedic tradition exemplify how the ancient masters would cultivate professional skills and nurture personality development. Bhikṣu Ātreya told his students to roam around and find a plant that had no medicinal value. Only one of his disciples, Jīvaka, came back empty-handed, declaring that he could not find any plant that did not have medicinal value. Bhikṣu Ātreya announced Jīvaka as the only student of his who had qualified to be a physician. In another story, Nāgārjuna, the famous alchemist, asked two of his students on probation to prepare medicinal linctus. Both returned the following day: one had prepared the medicine while the other one came empty-handed. Nāgārjuna asked his second disciple why he had not followed the instructions. The disciple explained that on his way to collect herbs, he had met an old, ailing man calling for help. He could not ignore the old man’s pathetic calls and attended to his needs and, therefore, could not make the medicine. The other disciple confessed that he had ignored the old man, fearing his teacher’s wrath, and went on to make the medicine. Nāgārjuna explained to them that compassion and not just the skill of making medicines was the more important quality that a physician must cultivate. He chose his compassionate disciple as his successor and forsook the more skilled one. Nāgārjuna clarified that it was easy to teach the skill of pharmacy but very difficult to nurture the value of compassion.
Right learning process to suit the needs of a student
The teaching most appropriate to an individual’s temperament and potential has to be imparted. In other words, teaching has to be individualized. Mass education and uniform standards were not the salient features of the ancient method of learning and teaching. The Upaniṣadic tradition itself reminds us of the importance of personalized teaching based on a very close and intimate relationship between the teacher and the student. Āyurvedic texts explain that the teaching should be modified according to three levels of intelligence of the students—the brilliant, the mediocre and the dullard.38 Teaching should be suggestive to the brilliant, elucidative to the mediocre and instructive to the dullard.39 The dullard student’s training is application-oriented, the mediocre student’s training theory-oriented, and the brilliant student’s training discovery and innovation-oriented. These three levels correspond to the three-tier structure of a knowledge system dealing with the practice, theory and principles of a particular subject. Further, the Āyurvedic texts proclaim that one who has the qualities of a brāhmaṇa can study Āyurveda to teach and propagate science; one who has a kṣatriya disposition can learn it to become a health administrator; one who has a vaiśya character can learn it to practice and make a livelihood; and everybody can learn it for self-protection and to help the suffering.40 Once again, the purpose of learning is differentiated on the basis of the inner qualities of the student.
In its approach to the training of a prospective student, the classical tradition of Āyurveda has captured the essence of the Indian approach to education in a vivid and clear manner. The goal of psycho-spiritual metamorphosis and the balance between professional skills and personality development constitutes the core of this method.
Both education and healing have two aspects—higher and lower. The lower aspect of education deals with vocational training and the imparting of professional skills with which one is able to serve society and make a living; this is the breadwinning education that we are quite familiar with. The higher aspect of education, however, deals with personality development that eventually leads to self-realization; it is an education that transforms the human personality and transmutes the beast into the human and the human into the divine. The lower aspect of Āyurveda is to prevent and cure disease; this is the profession of medicine, the so-called noble profession that helps humanity to free itself from the clutches of disease and discover the health of the body and the mind. The higher aspect of Āyurveda is no different from the higher aspect of education in general. Knowledge systems in India used this two-fold approach with a view to impart professional skills and transform personality so as to achieve deeper self-awareness to ensure that the acquired knowledge would be applied for the welfare of humanity and the world at large. In Āyurvedic learning, we have a powerful and suggestive representation of this ancient wisdom.
True education heals. It is not a mere acquisition of information but an unfolding of the personality to actualize inner potential. It is, therefore, hardly a wonder that Āyurveda discovered that the higher forms of healing were synonymous with the process of education itself. In the Indian tradition, the undeveloped state of the inner self has long been considered a disease in itself, even outside the medical tradition. This disease is known as bhavaroga, or the disease of relative existence. The one who removes this disease and helps self-evolution is a physician, even if he is not trained in the medical sciences. In this sense, all spiritually awakened individuals become physicians in India. For this reason, even the Buddha came to be known as the ‘bhaiṣajya guru’, or the preceptor of physicians, and came to be revered in some traditions of Āyurveda. Both Āyurveda, in particular, and the Indian cultural process, in general, bear testimony to the fact that at the higher levels of expression, education and healing become synonymous in facilitating a profound psycho-spiritual transformation of the embodied being.
Abbreviations of classical Indian texts used
Damodar, Athvale Ananth (Ed.) (1980). Aṣṭāṅga saṅgraha. Poona: Mahesh Anand Athvale.
Sastri, Paradakara Hari Sadasiva (Ed.) (1994). Aṣṭāṅga hṛdayam. Varanasi: Chaukhambha Surabharati.
Trikamji, Acharya Yadavji (Ed.) (1994). Suśruta samhitā. Varanasi: Chaukhambha Surabharati.
Trikamji, Acharya Yadavji (Ed.) (2002). Caraka samhitā. Varanasi: Chaukhambha Surabharati.