亞洲的兩種傳統醫學基本原理比較：中醫學和阿育吠陀

Introduction

Ayurveda is a kind of traditional medicine relating to India. In Sanskrit language, the word Ayurveda is composed of ayus, meaning life, and veda, meaning science. So Ayurveda, the traditional Indian medicine, is often translated as the science of life. In other words, Ayurveda is an instruction for improving life. Ayurvedic medicine has some similarities to traditional Chinese medicine (TCM). Both systems are philosophical, rather than scientific, and are basically aimed at enhancing life.

Approximately half of the herbs which are most commonly-used in each of these two Asian traditional medicines are similar and explained in somewhat including common characteristics terms. For instance, in both of these two systems, herbs are described according to warm or cold nature, the symptoms they can cure, and their influence on the body fluids. TCM has a strong association to the Yin and Yang theory, Five Elements theory, Qi concept, internal organ systems (Zang Fu organs), and other vitals as blood, essence, and fluids[1]. In Ayurvedic medicine the whole structure is quite complex, there is supremacy of the three Dosha (tridosha) systems: These three concepts including: Kapha, Pitta, Vata. In fact these three items are explained as stages of transformation (following food transformation and transportation) not as a physical structures or functional organs[5].

I think TCM made a break out from its philosophical domain through focusing on modern scientific researches, techniques and investigations. On the contrary Ayurvedic medicine has not done this transformation, and consequently it struggles with some discrepancies between Ayurvedic medicine and Modern medicine and it comes back to ancient times and Indian philosophy. For instance, in recent times herbal formulas are developing depend on indications in modern medicine, and some of these herbal formulas or herbs have been recently approved in modern medicine for prevention and treatment of some alimentations.

FundamentalResources

TCM and Ayurveda each depend on traditional fundamental philosophy.In TCM there are two famous texts named the Suwen (Basic Questions，素問) and Lingshu (Spiritual Pivot，靈樞), which collectively form the Huangdi Neijing (Yellow Emperor's Classic of Internal Medicine，黃帝內經), written around 100 B.C[2]. Both of these books are reference books and many authors have written their works based on these classics. The Suwen is considered the main text, describing such basic theories as five elements, acupuncture, etiology and course of diseases.

In Ayurveda, the two famous treaties are The Sushruta Samhita(妙聞集)and the Charaka Samhita(遮羅迦集)[5]. The Charaka Samhita by Sage Charaka and the Sushruta Samhita by Sage Sushruta were influential works on traditional medicin which are estimated to have been written around 100 A.D. These books are many times huger than Huangdineijing. The Sushruta Samhita is mainly recognized as a text on surgery and surgical procedures; but the Charaka Samhita, is a primary source for basics theory, herbal medicine, prevention and treatment of diseases. Therefore, in this view it may be similar to Suwen of the TCM.

Suwen from TCM and Charaka Samhita from Ayurveda both engage in promoting human daily health; they also describe causes of diseases, particular ailments and disease progression, and present therapeutic procedures. Because Suwen refers to acupuncture for the treatment of the disease and Charaka mainly refers to herbal medicine, massage, and enemas, so Charaka can also be comparable to the other text books in TCM as Shanghanlun and Jinguiyaolu which specify in herbal medicine[6]. In Ayurvedic treatments the usage of medical massage together with oils, and also applying of enema with specific oils is fundamentals.

Terminology

As I mentioned, the basics of Ayurvedic medicine are three dosha as: Kapha, Pitta, Vata (or Vayu). Like TCM terms these items also can not be explained in some pages here, moreover there would be concerns about translation of Tridosha terms to English.

Pitta indicates bile in Ayurveda and subdivided into yellow and black one, and its nature is burning sensation, ascending, and exciting condition. In TCM the best suitable term for description of Pitta is fire (Huo，火). Morever there is a subtype of Pitta named Agni which refers to digestive fire, so in TCM we can call it stomach Huo. Finally I should add that the term Pitta can match comparatively closely with the Chinese theory of Qi (especially stomach Qi) and fire, because it has warming, enhancing, and dispersing qualities as Qi in TCM[5].

Kapha in Ayurveda has characteristics of phlegm (Tan，痰) in TCM as its definition and specifications are nearly the same as phlegm.

Vata (or Vayu) in Charaka Samhita textbook is described as below:

When moving in the world Vata achieves the following functions: It breaks the summit of mountains. It moves on trees. It stirs up seas. It makes the earth shake. It pushes for the clouds. It causes frostiness, storm, dust, sand, fish, frogs, snakes, ashes, and lightning. It causes failure of crops. It can produce diseases…in our body: Vata makes pain the body with various aspects. It destroys and injures strength, complexion, happiness, and duration of life. It causes sorrow, fear, frightened, confusion, cheerlessness, and psychosis.

I think this description for Vata in Ayurveda is similar to wind (Feng，風)in TCM; the term wind in TCM is a confused subject, likewise the term Vata is questionable. Some scholars believe we can assume wind (Feng or Vata) as nervous system (central) in modern medicine because many manifestations of wind problems is similar to central nervous system disorders like seizures, tremor, etc. Vata, unlike Pitta and Kapha, has two specific chapters in the Charaka Samhita and this signifies the complexity of this concept in Ayureveda.

Acomparativeexample

According to Ayurvedic medicine, the harmony and balance of the Doshas (three Dosha) depends on the strength or weakness of the digestive fire. So man should always be careful about the digestive fire and try to save it[6]. The stomach fire regards as normal when there is normal desire for eating, no heaviness or flatulence, no discomfort during or after digestion. It becomes weak as a result of: overuse of cold and liquid substances like cold water, overeating or less eating, overconsumption of heavy food such as meat, eating while there is undigested food in our stomach, and finally emotional problems as anger, sad, fear, anxiety, greed, sorrow, and worry.

Similarly TCM believes that cold foods or water can result in weakening of the spleen and kidney yang, or dampness can cause spleen damage (digestive damage), or diminishing essence and emotions by excessive sexual activity has a significant role in making disease and body disharmony[1].

Additionally, According to Chinese medicine, if we have a normal digestion after consumption of healthy food, it will produce normal Qi (called Gu Qi) which can produce blood and promote health. In the Ayurveda medicine healthy food and good digestion can produce Rasa, which has the same function as Gu Qi, helping to make healthy blood.

Diseaseprogression

TCM initially believed the cold pathogenic factors can influence the body through six stages named Taiyang, Shaoyang, Yangming, Taiyin, Shaoyin, and Jueyin,[3]then later the idea of warm pathogenic factors was added to TCM as Wei, Qi, Ying, Xue (Wenbing theory),which are four levels of disease associated with warm pathogenic factors[4].

In the Ayurvedic medicine the notion of disease-development is fairly different. Rob Svoboda[6]says: “Weakness of the digestive fire is the root cause of all diseases; Vata is the chief cause of the development of all diseases.”Ayurveda considers three stages for disease development as accumulation, aggravation, and overflow.

Accumulation: causative factors impact the body, and then related Doshas accumulates in specific body parts.

Aggravation: In this stage, the Doshas persist to increase and amplify and put pressure on their reservoir, intensifying the symptoms they have produced.

Overflow: If aggravation is allowed to progress unchecked, the Doshas flee their homes, wandering about the body, looking for a place to lodge.

Key note: In the practice of TCM there is a central concern about blood stasis and treatment of this condition by blood promotion, while in Ayurveda, treatment of blood stasis by stimulation of blood circulation does not consider as a major concern of internal medicine, so the emphasis seen in TCM to treat static blood is not a main concern in the Ayurveda.

Globalization

During the past twenty-five years, many schools of Chinese medicine have opened all around the World, and there has been a great movement to get this type of medical therapy accepted. I think some factors made this development possible for TCM:

1, The first thing that was introduced to West was acupuncture; a kind of therapy completely different from anything in Western medicine yet effective in management of various diseases; consequently there was less resistance to its development than might with other methods, like herbal medicine, and then gradually some of these acupuncturists prescribed herbal formulas for their patients as an adjuvant for treatment, as a result Chinese medicine was increasingly developed.

2, Additionally, in some developed countries like US, Canada, Australia, etc, there are Chinese doctors who serve TCM healing to Chinese communities and this phenomenon has helped for spreading of Chinese medicine in these countries. Besides, China is keen to export Chinese medicine, and also has a programmed policy for this purpose, and many visitors come yearly to China to study Chinese medicine.

I think these situations have not happened for Ayurvedic medicine. The foremost part of the Ayurveda that is recognized as a medical practice is herbal medicine, and although there are numerous books and many classes about Ayurvedic foods and diets, they can not consider as a medical practice by other medical systems. Ayurvedic teachers are so fewer than TCM doctors and there is no official licensing for practice Ayurveda in the West, and there are not many colleges that educate this subject, and also compared to many Chinese herbs that are now exported to west through China , Ayurvedic herbs are relatively traded in small amounts.

志謝感謝北京中醫藥大學東直門醫院博士研究生石鳳芹在本文寫作和投稿交流中給予的幫助。

[1]Jia xu chen, Mohammad Hashemipour.Chinese Medicine Study Guide Diagnostics[M].Beijing:People's Medical Publishing House(PMPH),2007:100-118,104.

[2]Zhu ming.The Medical Classic of the Yellow Emperor[M].Beijing:Foreign Language Press,2001.

[3]Craig Mitchell, Feng Ye,Nigel wiseman.Shang Han Lun (On Cold Damage): Translation & Commentaries[M]. Paradigm Publications,1999:10-12.

[4]Liu Guohui, Warm Diseases:A clinical Guide[M].Seattle WA:Eastland Press,2001:3-18.

[5]Svoboda R, and Lade A.Tao and Dharma:Chinese Medicine and Ayurveda[M].Lotus Press,1995:40-50.

[6]Robert E. Svoboda, Ayurveda.life health and longevity[M]. The Ayurvedic Press,2004:75-80.