Dr. K. T. Jayakrishnan
Medical Superintendent
SJS Ayurveda College Chennai
Learning methodologies
The basic duty of teachers – ways to convince the students
Ayurveda is a medical stream which is highlypopular in Kerala. This, being popular among publics and medicines being very familiar to all, thereis the need to learn basic modalities in Ayurveda when one joins an Ayurveda college, even though these may not be practiced. However, the setback occurs when one starts learning. Generally, the perception is that science is the one aid to understand the intricacies of the world but through Ayurveda such an approach seems unclear and we suffer intellectually.
The basic education of science needs extra clarity in teaching. For example,in the case of PadarthaVijnana inthe first year. This may not seem reasonable to many- to learn something bluntly. The students are not convinced about theories of Ayurveda right from RagadiRoga. However to convince them, we as teachersneed to be convinced by ourselves. Unless we are convinced, we cannot teach Ayurveda to students.
Many students and teachers will havethis issue. In every batch, around 10% intellectual students will be present, who are not easily convinced. They will not be relaxed to receive these subjects. So we, as teachers, needto evaluate ourselves as to how far we have been able to convince them. The highestlevel of sharing to the studentsshould be the way we have learnt a subject- instead of puttingthe books in front of students, we need to present the subject in the way we have understood it and this should be teaching basisfor Ayurveda.
We need to realize that Ayurveda is a Shastra and differs slightly from science. Both Shastra and science, are trying to understand the intricacies of the universe to which we, human beings,belong. It hastried to understand the universe from physical plane to the subtlest basic nature of science. Herethere is the need for repeated evidence to understand each level such evidences which may be directly visible, such as, while teaching anatomy, physiology or pathology. Such visible convincing proof is enough to say that something is working.
Shastra defers, on the other hand. Here the same matter is explored through the plane of mind and not through the physical plane. In such circumstances, direct visualisation may not be possible. We need guidance from experienced people to explore using the mind. Also, knowledge collected mustbe much deeper than expected. So here, the physical mode continues but with more disciplined atmosphere of learning for such intellectual sciences. It is becauseof this, that in olden days we had Gurukula system of learning. Through such an approach there could be complete focus on the teachings. The students being closelyassociated with guru would build an intimacy, through which they could understand the guru’s thought process easily. They would, thus, be able to grasp the method of thinking of teacher and not merely the subject and along with this, also create their own thought process.
Today, even in western teachings we find the need to stay withthe teacher in higher levels of learning like PhDs. The scholars imbibe the waytheir teachers think- in the mental plane. Here,more than that in the physical plane,it requires logic and reasoning to convince a subject matter.This can be likened to mathematics, also accepted as “natural science”.The questions like “why”, “when” and“what” are permissible whereas the physical science is based on a setof norms and need to be accepted as such. In a natural science we can ask and get a reply as to why, by using logic and reasoning. Herewe target the mental plane or the metaphysical plane. We could say, sense organs are physical entities of individual which helps to get in touch with external world but sense organs work only when the mind is connected to them. So, deeper understanding or conte- mplation happens in the plane of the mind and when we learn from that plane we learn deeperlevels of the subject matter.This is the first and foremost fact about Ayurveda. Ayurveda belongs to Shastrawhich is slightly differentfrom science as it is a natural science and needs deeper understanding.
The next fact is that with majorityof students joinany medical course to become physicians and treat diseases. Thereis no doubt that through cure the physicians and the suffering patients derive happiness and satisfaction beyondwords. So, it is considered as a respected course- “Hasthalambobhishakjitham”-In our science also we see that disease is considered as big suffering – SukhaSamjnakamArogyam, Vikaro Dukhameva Cha. So, as an impact to entire planes of the individual, this is a negative experience andif we can take it to the positive side, it is a great effort. We know the synonym of disease as Paapma reflecting thetotal negativity in individual forms and whenwe help to get out of disease,it is not only in the physical plane but the entire individual is taken to positive side. So most students would want to be a physician, even though many more options are available to them today. So, thereis the need to focus more here.
Any medical course is planned to teach in the initialstages the normalcy of body and functions of normal body. Once this is convinced to the students, next how this normalcy is disturbed or deviated is taught.This is knownas a disease. A disease can be understood only if we are convinced about normalcy. Then, how to manage the disease is seen in the third stage. Ayurveda also has the same ways but our problemis that we all comefrom a background of science and a scientific way of understanding. Having no other method of understanding our science is a drawback. So, thereis a tendency to try explain the Tridoshaand so on in physical plane like Vata isnervous system, Acetylecholine, Pitta is endocrinology and Kapha is lymphatics. This seems attractive and reasonable and maybe even convincing at times but when we c o n s i d e r a m e d i c a t i o n l i k e Sahacharadi Thaila or Dhanwa- ntaramThailam, this theory cannot be interpreted or it becomesuseless. Our issue is to know what is the need for SahacharadiThaila or DhanwantaramThailamis and we find that such theories do not takeus anywhere.
Usually the students become very alert as to how to practice Ayurveda only when they reach the final year and till then, it is merely for the exams. The first year, to them, does not seem connected in anyway to clinical practice. So, the fundamentals are not strong and whenwe begin Nidana,none of the diseases become convincing to them. It can becomes convincing to them only through supplementary knowledge of the westernscience. However, in the final year they become alert as they would need to go out and start treating.So they try to study mostly the medicines, treatment modalities and Pancha- karma in the field, in an attemptto utilize the subjectmatter in a sensible way to create a positive result.
The students need to be guided through the rightful exercise when they treat a patient.Before we get into any subject matter,we need an introduction to the subject. Ayurveda is rarely introduced. As compared to anatomy and physiology, where we can justenter into the subjects, as we are familiar to that methodology of learning from our younger years itself. When we learn a direct science we feel we have understood all areas but, here also,the fact remainsthat here too, we may have many areas still unclear to us such as for examplethe anatomy and functions of the brain which is understood to today’s science only by 40%.
However, in our science as part of initiatives to understand, Padartha Vijnanaa n d o t h e r philosophies are introduced initially itself but that becomes a great burden to the students as all are started together-learning Sanskrit, learning the different philosophies and also Ayurveda. This would be similar to entering into anatomy and physiology without havingthe basic understanding of physics and chemistry. The introduction to Ayurveda is not in a systematic way. This is the areawhere the teachers need to be clearerand spend more time to convince ourselves firstly and thenspeak to the students.
The methodology to observe the universe is spoken through Vedic philosophy. Even in Physics, where we say thatsolids, liquids and gases make up whole universe; through this physicsand chemistry, we prove that movementof protons is influenced by consciousness or awareness. If we go deeper, for example, to the black hole theory, where we talk about ourselves, we are trying to know whatis present in the essential plane of matter and when we feel the deepest levelof this plane,where we feel, we have experienced the knowledge our- selves, we become one and the same. Thisis well connected to the Vedic way of understanding. We think too deeply about a matterand ultimately the knowledge of the matter is registered in the deepest planeof ourselves which is nothing but the knowledge itself. So in Veda, it is said about Prajnyanam Brahma. It is the plane where knowledge is registered whenever we indulge in any activity. In thisplane we feel and experience the knowledge. From this ultimatelevel where one can go and from there come downto physical plane,is the i d e o l o g i e s o f t h e S a m k h y a philosophy.So we have a maximum limit already explained in the pursuit of knowledge and if we want to know, further 100% about a matter, we need to go the deepest level of the matter through contemplation of the mind and the deepest level of the matter will be equal to what is at our deepest level. Where we stand is the absolute plane or Aham or myself. This is not directly visibleand so is considered as Mithya or unreal,but this is actually real. So, two things are to be considered, first, the absolute and how to conceive this absolute and second, how we drain back to this one point and then come downback. How we can connect this to look at this world and to explain the physical world, this is our concern.
The basic concept of Samkhya is that everybody wants to know everything and once we know we can utilizeit to achieve happiness. We have to be aware of our body,so that, we can deal withit in such a way that it does not harm us and achieve happiness also.
The five sense organs or Panchendriya, connected to the mind provides us five outlets to connect with external world and the knowledge created will be of five basic varieties. Thesefive varieties of knowledge regarding constitution of universe is known as Pancha Mahabhuta.T h e y f o r m t h e constitutional identities of the physical world and they are the constitutional identities of the body also. They are not limitations so, each sense organ can have an extended experience of what is similar to that. This is Pancha Mahabhutaand it is not an element. It is something which is created and here, it depicts creation of the knowledge of the element and the knowledge lies within ourselves. We create knowledge each and every second of our lives and this knowledge lies deeply within ourselves. So throughPancha Mahabhuta, it is knowledge with which we can say a matteris Prthvi, or this is Jala, Agni,Vayu or Akasham. The 5 Bhuta makeup the body, they make up the universe. Even though this is not used in practice, awareness needs to be made about how this theorycame into practice to makethe concepts of Vata Pitta and Kapha. We are concerned is not to the structural aspect of a Bhuta, rather, what happens to these Bhuta after many years or what is happeningto this PanchaMahabhuta– structured body. This is in the functional plane. We are concerned with what happens to the PanchaMahabhuta– structured body through its lifespan. This is structural understanding of PanchaMahabhuta in the functional plane. Here, we are dealing with initial, age of growth followedby age of maintenance and age of disintegration and it is inevitable to every being in the universe. This is what is meantby saying, the world is always changing.
In the initial stages,the size increases and we find Prithvi and Jala increasing as they aregross or Sthula. Later, when Vayu and Akasha increase, the size will decrease and in the middle we have Agni prominent with Jala.In every second of life, we find these occurring. We observe what changes are occurring in the body and how thesechanges can be made smooth. It is inevitable. However when degeneration occurs at an earlier phase, it could lead to damage of a structure very easily and the subsequent reaction is called a disease. This beingAsatmya to us, we react and we try to restrict and come out of the phaseand put it back into its normal way of disintegration. So we need to understand these 3 phases and that thisoccurs to the Pancha Mahabhuta. Similar to howin physics we understand the characters and properties reflected by matter and claim thematter is so, PanchaMahabhuta is tried to be understood through the properties which intermingle with each other.
When properties of Prithviand JalaMahabuta is reflected, we call it KaphaDosha. Similarly, Vayu and Akasha is called Vataand Agni with Jala is c a l l e d Pitta . S o t h e Doshaconcept is more functional.
So we need to clear the concept of normalcyand phase of disintegration or diseasephase and how the change occurs when we treat. Learning about anything is not a problem if we can achieve clarity. We need clarity of mind and Indriya. Clarity of thought is the clarity of mind. When clarity of mind and sense organs is achieved we gain PrasannaAtmenderiyaManas which is the state of Swastha.
Thus, if approached through clarity, TridoshaSidhantacan be said to be reasonable and most intellectual. It is a theory which cannot be altered and so, it is realistic and truthful.
We need to convincestudents that thisis something theywill work with- to study the body, the disease and medicine and method of treatment. Once this has been effectively introduced, then the further teaching of disease, medicine as well as Dravyacan be done. Learning of any subjectcan be done provided it is clear and not leading to an intellectual blockade. Similar to how clearlywe can study anatomy and physiology, our theories alsoneed to be thought with clarity to be studiedeffectively.
Unnecessary mixing of both medical knowledge is not advisable. An example, to bring clarity, would be the degenerative disc disorders. Similar to modernconcept of disc dehydration leading to symptoms of radiating pain along the sciatic or femoral nerves, we consider this as an activity of increased Vata. Similar to the changesin the disc,we can assume the Rookshatvam ofVata causing symptoms of VataVyadhi. Now, in our concept, a mere application of Snigdhamedicines along the low back would not be feasible as, according to our concepts, we consider Twakas VataSthana; Twakbeing porous, it is
associated with Vata andso, according to ourconcepts, we needto apply Snigdhaoil all over the Twakand not only over the back. Then, the next Vata Sthana is Pakvashaya, where food after digestion and absorption of Snigdhtavamreaches Pakvasaya, being in a drierform. So we need to apply Snigdhtvamhere, throughuse of Vasthi. Snigdha and Ushna medicine willlead to decreased Vata. Also, in selection of internal medications we need to select Snigdha and Snigdha and Ushna medicines.
There maybe a question among students, as to, why a whole body treatment is needed when a localized approachsuch as Pichuor Kati Vasthimay be felt enough.It is here, we need to make them understand that such a treatment modality ideacomes from the view of anatomical knowledge. So we need to make them understand that the back pain is result of the changes occurring all over the body.
Along with this, we need to understand the other background atmosphere which we call disease such as Pandu, Arshasand the syndromes which cause continuous weakness of Dhatussuch as in Maharogalike Grahani.
The students need to be approachedwith an intention to make an impression to them that all of these are a continuous knowledge. The years of learning are not separate. The issue is that the departmentalization further makes it appear that all of these are separated. Similarly, the teachers also have a tendency to reply to questions asked by students that they will be learningit in later year classes. So we need to remember that it is a continuous process and not separate. It is after all, a single book that we are tryingto explain.
This world is a world of uncertainties and we cannot understand everything. We need to comprehend a matter to our level of understanding and expand it as and when needed. Similar to mathematics, where we can bring it to lower levels like5 plus 5 is 10 and apply the same concept to higher levels like 5 lakhsplus 5 lakhs is 10 lakhs. Hence we can see the 1stsloka of 1st chapter of Sutra Sthana reflects what the essence of Ayurvedais and all the aspects are being touched. Sutra Sthanaalso reflects the entire Ayurveda and the smallparts in it, such as Vata Upakramais elaborated later in Chikitsa Sthana as VataVyadhi. There is no contradiction and is only an elaboration of earlier mentioned points.
So we, as teachers and doctors, need to ensure we are giving a coordinated knowledge whether dealing with fundamental knowledge or Nidana or Chikitsa. This is something which lacks in college as it is departmentalized. Teachers need to give a connected knowledge so the students will also feel that they are working with something of intellect through calculated moves and processes, and not bluntlystudying a subject.
Also, while dealing with Sanskrit we need to not restrict ourselves to Sabdharthaor meaning but deal with the Bhavarthaor try to understand what the author may have meant to convey. Through the language, we need to try reach the meaning the author wanted to convey. We need the direct and implied meaning to get the correct idea about the Shastra.
We need to develop continuous contactswith the studentsand build intimacy with students so that we can effectively convey this message.
In the olden days, reverse methodology of learning has been seen to be used, where the students were first introduced to treatments and then the medicines followed by the diseases and then finally, the theories. This helps to convince the students about the effectiveness of the methodology. They see the results and once they are convinced about the effectiveness, they are gradually introduced to the workings of the approach.
Sri. Poomully Neelakanthan Namboothirippad, popularly known as Aramthamburan, had once stated that it requires 12 years to learn CharakaSamhitha. It is not about reading but learning or understanding. So the studentslearning all the Samhithas, that too, in the specified periodof time, would only overburden them. So, if we could stick to just one Samhitha it would be much easierand fruitful.
To conclude, the most responsible duty of a teacher of Ayurveda is to first and foremost convince oneselfto be able to make the students convinced about the philosophies of Ayurveda. To convince ourselves we have to contemplate the subject matter through mind and reach to the depths of the meaning.When we get deeper and deeper into the matter, we can experience the concepts and the concepts become a part of us. Whenwe find we are one with the subject matter,we can reduce and expand the ideas as and when the needarises.
The basic ideology of Ayurveda should be introduced to the studentsin such a way so that they can imbibe the sense of Ayurvedic philosophy and understand Ayurveda is to berecognized through the mental plane, through logic and reasoning.
The subject matter of Ayurveda is one and continuous, even though it has beendivided into years and departmentalization is present. So the fundamentals taught in first year is to be carried throughout the yearsof study.
The ultimate aim of the teacher is to differentiate the direct science from the Shastra as the former workson the physical plane, relying on direct visualizations and repeated evidences or proofs while Shastraworks in the mental plane, relying on the absolute matter, which is unchanging but needs contemplation to be understood.
Article Prepared by
Vaidya Jyotsna Govindan
Assistant professor
Dept of Shalyatantra