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Ayurveda - Traditional Indian Medicine: More than a wellness trend

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Ayurveda is steeped in salutogenic basic principles in its approach and is therefore extremely modern despite its millennia-old tradition.

Traditional Indian Medicine (TIM), Ayurveda, has become increasingly popular in Germany in recent years. The word Ayurveda is derived from the ancient Indian Sanskrit language and literally means "the knowledge of life". Due to its initial spread in the area of ​​wellness and tourism, especially since the 1990s, the erroneous impression arose that Ayurveda was primarily about (expensive) manual applications, forehead pourings and oil massages. Ayurveda, on the other hand, is a complete diagnosis and therapy system and has a remarkable wealth of empirical healing knowledge. Ayurveda has been folk medicine in South Asia for over 2,000 years, making it one of the oldest naturopathic systems known to mankind.

"The knowledge of life"

In India and neighboring South Asian countries, Ayurveda is officially recognized, has the same legal status as conventional medicine and is used as a popular medicine in a metropolitan area with more than 1.4 billion people. Analogous to Traditional Chinese Medicine, Ayurveda is recognized as a medical science by the World Health Organization. The importance of Ayurveda in modern Indian health care is reflected in the following figures: In India alone, more than 400,000 Ayurvedic doctors are registered, and Ayurvedic medicine is systematically taught, practiced and by the state at more than 250 universities and technical colleges recognized by the Indian government promoted.

In Germany and across Europe, Ayurvedic medicine is currently experiencing a remarkable boom in the context of naturopathy and complementary medicine, often in conjunction with other TIM systems such as yoga and meditation procedures. The demand for Ayurveda is increasing continuously, especially for patients with chronic and lifestyle or stress-related diseases, who generally often make use of natural healing methods, as well as in preventive medicine - not least because TIM systems are interwoven with basic preventive principles in their therapeutic concepts . There is no end in sight to this development for the time being.

Pindas herbal sachets (above) are used for massage. Spices (below) play an important role in Ayurveda.

In terms of content, this process can definitely be compared with the first big wave of traditional Chinese medicine in the 1980s, but only to a limited extent in terms of form and dynamics: In the multimedia postmodern era, the cultural translation of Ayurveda into European contexts seems to take place much more quickly. In everyday medical practice, this is reflected in the almost unmanageable number of medical Ayurveda offers, Ayurvedic constitution type provisions according to Vata, Pitta and Kapha, Ayurveda cures as well as an increasing flood of media and increasing patient demand.

Ayurveda is now of considerable importance in connection with medical tourism. Quite a few doctors are confronted with the fact that, for example, patients report on a trip to India with extensive Ayurvedic therapies. This is problematic insofar as the reception, use and dissemination of Ayurveda / TIM in Germany and Europe have so far been almost completely unregulated and have only been perceived peripherally by decision-makers in medical care.

When Ayurveda comes up in collegial discussions, one moves in a field of tension between esotericism, wellness, IGeL performance on the one hand and prevention, medical history, science on the other. Exaggerated skepticism or euphoric expectations are usually the rule, but medical realism is seldom. In recent years, conventional medicine and clinical science have discovered that Ayurveda is also a system of health care and disease treatment that is thousands of years old, with a focus on lifestyle modification.

Urgent evidence

Questions about the location, definition, indication, quality assurance and good Ayurvedic practice from a medical point of view are of central importance for patients. A research platform of the endowed professorship for clinical naturopathy of the Charité - Universitätsmedizin Berlin and the Center for Naturopathy at the Immanuel Hospital Berlin therefore wants to formulate answers from a European perspective and make a constructive contribution to the connection between science, medical practice, health policy discourse and economic aspects. In addition to the Germany-wide research network, there is also a direct exchange with renowned Indian Ayurveda universities, the department responsible for Ayurveda at the Indian Ministry of Health and innovative projects such as the recently initiated scientific online Ayurveda database DHARA.

The focus is also on therapy safety for patients, especially in complex Ayurvedic phytotherapy, and the professionalization of medical Ayurveda training in this country. This should also form a cornerstone for the serious development and a better understanding of doctor-led Ayurvedic medicine in Germany. The activities of the German Medical Association for Ayurvedic Medicine (DÄGAM) are noteworthy here.

The review of Ayurveda using EbM tools is still in the pioneering phase despite numerous experimental and mostly smaller, preliminary clinical studies. However, the first published data are promising, and numerous scientific working groups are currently active around the world to provide the urgently needed evidence through comparative randomized therapy studies for common chronic diseases. However, the legal classifications of numerous important Ayurvedic foods and medicinal herbs by the European and national authorities (EMA, BfArM) are problematic here.

In addition, there are hardly any studies worldwide in which the complex and polydimensional diagnostic and therapeutic approaches of Ayurvedic medicine have been analyzed. For a knowledge-based Ayurveda of the 21st century, it is important not to approach this scientific review in a reductionist manner, but to preserve the therapeutic complexity in the scientific review; even a traditional medical system such as Ayurveda, which has generated and legitimized its knowledge over the past 2,000 years primarily from empirical values, should and must develop further on a science-based basis.

Individual therapy

Ayurveda is steeped in salutogenic basic principles and therefore surprisingly modern despite its age-old tradition: primary, secondary and tertiary prevention, as well as patient empowerment and self-efficacy play decisive roles. Ayurveda also has strongly individual-related therapeutic approaches that could possibly be incorporated into Western health systems in the sense of integrative approaches. Above all, however, it seems important to convey to doctors in this country that effective Ayurvedic medicine has very little to do with the wellness treatment that is offered to you when you next stay at a hotel.

Dr. med. Christian S. Keßler,

Prof. Dr. med. Andreas Michalsen

Endowed professorship for clinical naturopathy at the Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin and Department of Naturopathy, Clinic for Internal Medicine, Immanuel Hospital Berlin

@Literature on the Internet:
www.aerzteblatt.de/lit3713

Therapy methods

1. Prevention: avoidance of causes and patient self-efficacy

2. "Compensatory" procedures

  • Nutritional therapy and nutritional supplements
  • Order therapy
  • Phytotherapy

3. "Diverting" procedures

- Manual therapy procedures

- Oil massages, dry rubs, casts

- Diaphoresis and thermotherapy

- packs

  • Internal rejection (pancakarma)

- Therapeutic purge

- Decoction enemas

- Medicated oil enemas

- Nasal applications

- blood withdrawal (especially leeches)

4. Psychotherapy, yoga, meditation, spiritual aspects

Association of Ayurvedic Physicians of India (AAPI). Homepage: http://aapiindia.org, 2013.
Central Council for Research in Ayurvedic Science, Department of AYUSH, Ministry of Health and Family Welfare, Govt. of India. Homepage. www.ccras.nic.in. 2013.
Charité University Outpatient Clinic for Naturopathy at the Immanuel Hospital Berlin. Homepage: www.naturheilkunde.immanuel.de, 2013.
German Medical Association for Ayurvedic Medicine (DÄGAM). Homepage: www.daegam.de, 2013.
Digital Helpline for Ayurveda Research Articles (DHARA). Homepage: www.dharaonline.org, 2013.
Follath E, Rao P: India. Between Gandhi and Gates. In: Der Spiegel. 34; 2012, www.spiegel.de/spiegel/print/d-87818614.html
Furst DE, Venkatraman MM, McGann M, Manohar PR, Booth-LaForce C, Sarin R, Sekar PG, Raveendran KG, Mahapatra A, Gopinath J, Kumar PR: Double-blind, randomized, controlled, pilot study comparing classic ayurvedic medicine, methotrexate, and their combination in rheumatoid arthritis. J Clin Rheumatol. 2011; 17 (4): 185-92. CrossRefMEDLINE
Kessler C: Effectiveness of Ayurveda in chronic diseases. Systematic analysis of clinical Ayurveda studies. Essen: KVC-Verlag, 2007.
Kessler C, Michalsen A: The role of whole medical systems in global medicine. Forsch Komplementmed 2012; 19: 65-6. CrossRef
Kirschner M, Schwertfeger B: The Ayurveda boom. Cologne: Vgs-Verlagsgesellschaft, 2004.
Stollberg G, Frank R: Conceptualizing Hybridization — on the Diffusion of Asian Medical Knowledge to Germany. In: International Sociology 2004; 19: 71-88. CrossRef
Witt CM, Michalsen A, Roll S, Morandi A, Gupta S, Rosenberg M, Kronpaß L, Stapelfeldt E, Hissar S, Müller M, Kessler C: Comparative effectiveness of a complex Ayurvedic treatment and conventional standard care in osteoarthritis of the knee - study protocol for a randomized controlled trial. Trials. 2013; 14 (1): 149. (Epub ahead of print) CrossRefMEDLINEPubMed Central
World Health Organization: Traditional Medicine. 2003; Report by the Secretariat. A 56/18.
1.Association of Ayurvedic Physicians of India (AAPI). Homepage: http://aapiindia.org, 2013.
2.Central Council for Research in Ayurvedic Science, Department of AYUSH, Ministry of Health and Family Welfare, Govt. of India. Homepage. www.ccras.nic.in. 2013.
3.Charité University Outpatient Clinic for Naturopathy at the Immanuel Hospital Berlin. Homepage: www.naturheilkunde.immanuel.de, 2013.
4.German Medical Association for Ayurvedic Medicine (DÄGAM). Homepage: www.daegam.de, 2013.
5.Digital Helpline for Ayurveda Research Articles (DHARA). Homepage: www.dharaonline.org, 2013.
6.Follath E, Rao P: India. Between Gandhi and Gates. In: Der Spiegel. 34; 2012, www.spiegel.de/spiegel/print/d-87818614.html
7.Furst DE, Venkatraman MM, McGann M, Manohar PR, Booth-LaForce C, Sarin R, Sekar PG, Raveendran KG, Mahapatra A, Gopinath J, Kumar PR: Double-blind, randomized, controlled, pilot study comparing classic ayurvedic medicine, methotrexate, and their combination in rheumatoid arthritis. J Clin Rheumatol. 2011; 17 (4): 185-92. CrossRefMEDLINE
8.Kessler C: Effectiveness of Ayurveda in chronic diseases. Systematic analysis of clinical Ayurveda studies. Essen: KVC-Verlag, 2007.
9.Kessler C, Michalsen A: The role of whole medical systems in global medicine. Forsch Komplementmed 2012; 19: 65-6. CrossRef
10.Kirschner M, Schwertfeger B: The Ayurveda boom. Cologne: Vgs-Verlagsgesellschaft, 2004.
11.Stollberg G, Frank R: Conceptualizing Hybridization — on the Diffusion of Asian Medical Knowledge to Germany. In: International Sociology 2004; 19: 71-88. CrossRef
12.Witt CM, Michalsen A, Roll S, Morandi A, Gupta S, Rosenberg M, Kronpaß L, Stapelfeldt E, Hissar S, Müller M, Kessler C: Comparative effectiveness of a complex Ayurvedic treatment and conventional standard care in osteoarthritis of the knee - study protocol for a randomized controlled trial. Trials. 2013; 14 (1): 149. (Epub ahead of print) CrossRefMEDLINEPubMed Central
13.World Health Organization: Traditional Medicine. 2003; Report by the Secretariat. A 56/18.
Ayurveda - Traditional Indian Medicine: More than a wellness trend

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