World Mental Health Day - October 10 :

Psychiatric aspects of traditional medicine

by Ayur. Dr. Saman S.Hettige

The overall perception of health in Ayurveda depends on three factors. Waa, Pith, Sem. (the three bioentities, Vata, Pitta and Kapha, generally more related to shareera or body). If imbalance is caused within these forces it can either create a disorder in one’s physical health or create an imbalance in Mano dhosa. Mano dhosa consists of three elements of power which controlled the activities of the brain and one’s behaviour, cognition and thoughts and perception.

Management of mental disorders or psychological medicine was an area of specialization even during Charaka’s time (500 B.C.) Charaka is a famous Wrishi physician who revised a world famous ayurveda classical text ‘charaka samhitha’ or Compendium of Charaka. Charaka suggests that, treatment for mental illnesses should be sought through an expert in the field of mental illnesses.

It is a fact that various mental disorders have been treated for centuries over by traditional physicians and Ayurvedistis, with the help of available medicines at that time and different unique techniques endemic to their traditions or guru kulas.

The great chronicle of Sri Lankan history ‘Mahavansa’ describes how king Buddadasa, one of the best king physicians and psychiatrists in Sri Lankan history treated and managed psychiatric patients.

There was evidence that the hela had attained an extraordinary level of knowledge in agriculture, irrigation, and had also developed an effective system of herbal medicine, known as Hela-Veda, endemic to these tribes, and the originator or founder of this system was Rishi king Pulasthi.

It is believed that this system of healing is older than the Indian ayurveda system. Factual evidence proves that King Pulasthi was regionally very popular at that time and he was invited for the first ever recorded medical congress hosted in Himalaya province 5,000 years ago, under the patronage of high level Indian royal physicians and delegates.

Concept of Mental Health in Buddhism

According to Buddhist literature there are three key factors known as akusala moola (sinful thoughts) which drives a person into insane state. That is, Loba (greed), Devesha (Hatred), Moha (Delusion). These akusala moola or sinful thoughts are generated in the human mind with other regular thoughts.

But these thoughts are not like regular thoughts because they have been outlined as negative emotional toxins which have a direct and indirect impact to one’s mental health deterioration and behaviour.

These thoughts are found in the middle of a regular thought sequence, amalgamated with every ones personality. But some personalities are predisposed to these kinds of thoughts more than others. According to Buddhism there are three psychological drives necessary for the existence of a human being. That is, kemetta or anuna (like) and akametta or pateegha (dislike).

They are considered as normal thoughts generated within one’s personality so long as they are not developed up to Loba, Dwesha and moha states.

When these regular thoughts develop into an unpleasant toxic stage it is devastating to both mental and physical health and when a person’s mind gets infected by these Akusala moolas, it is the starting point of a mental illness according to Buddhism. We are born with these evil thoughts. But their intensity varies according to the Karma we committed in our previous lives.

Concept of mind and its location in Ayurveda

According to Charaka, ‘the entity responsible for thinking is known as manas’. It is said to have been inherited from the previous birth and evolved from the combination of vaikarika and tejasa ahankara).

It is connected to both jananendriya (sensory centres) and karmendriya (motor centres). That is why it is called Ubhayatmaka (combined psychomotor entity).

Manas has two basic qualities, anutva (atomic nature) and ekatva (unitary nature). But it is difficult to understand these qualities clearly.

Therefore, manas is said to be constituted of 3 more operational qualities, stave, rajas and tamas. In ayurveda, personality traits are classified and identified upon the characteristics of the above mentioned manoguna, while in Buddhism, personality traits are classified according to Raga, Dvesha and Moha.

It has been well defined in one of the oldest Buddhist classical texts, Visuddhi marga written by Buddhagosa himi, during the Anuradhapura era. In fact it was his research thesis which he had to present to his senior monks to exhibit his intellectuality.

Manasthana or location of mind is described in ayurvedic classical texts as follows: Manas is considered as matter.

It’s a nano state matter. Manas is said to be active and in a movable state throughout the body except nail ends, hairs, and such other structures. Its seat of control is said to be between siras (head) and talu (hard palate) ‘Sirasak thaalvanthara gathak manak’ - Hritha samhitha.

Also, it is said, siras is the seat of all senses. Since the senses are controlled by manas, it is necessary to consider siras in understanding manas. Similiarly, Hrdaya (heart) is also said to be the seat of chetana or atma - Hardaym chethanasthanam. Since manas is associated with atma, different emotions influence blood circulation, and consideration of hridaya will also be important while studying manas.

Classical texts describe manas act as a thread which makes a strong bond between body and aatma allowing aatma not to leave the body –“Sathwathma sareerancha” – Bhela samhitha. aatma will permanently leave the body upon one’s death.

It is like an inbuilt data chip which has the genetic imprints of human being. Once it is being released upon death this aatma or life force will seek unborn creatures, human or non human to deposit.

Once it has been deposited it can begin a new life journey as programmed by sansara sankalpa in Buddhism. This complicated phenomena has been extensively discussed in Karma sankalpaya in Buddhism.

Prevention is better than cure

This is called Manasavikaranutpadana in ayurveda (prevention of mental disorders).

In support of its concepts on preservation and promotion of health and prevention of illnesses, ayurveda lays due stress on various measures to be adopted to promote mental health and prevention of mental disorders.

These measures find lucid descriptions in the chapters devoted to dinacarya (daily regimen) ritucarya (seasonal regimen), sadvrtta (code of virtues), roganutpadana (prevention of diseases) and annapanavidhi (rules pertaining to food and drinks), in the classics of ayurveda.

To be free from mental disorders Ayurveda prescribes that one should not allow oneself to become a victim of impulses such as greed, grief, fear, anger, jealousy, impudence, vanity etc. Further, it declares that, one who speaks truth, refrains from over indulgence in alcohol and meat, hurts none, avoids overstrain, is fair spoken, always compassionate and given to wholesome eating, would enjoy the benefits of sound mental health.

It would only be appropriate to consider the Ayurvedic view points in this regard as a ‘socio-moral value system’ which if adopted with modifications to suit our needs without digressing from the core of these concepts, would be of great aid in warding off many a mental disorder, and promote the mental potentialities of mankind.

It would also contribute in preventing and, treating many psychosomatic conditions like peptic ulcer, bronchitis, blood pressure, eczema, diabetes, etc.