TEACHING METHODOLOGY IN AYURVEDA
Former DAM & Former Principal Govt. Ayurveda College Thiruvananthapuram
“Not what you eat, but what you digest,
Not what you earn, but what you save,
Not what you read, but what you recollect
Is all that matters in life.”
This is a principle that is applicable not just to life, but to the study of any science. The information you recollect from what you have learned during graduation or post-graduation study is what matter in a science or profession.
Our science explains about saastrapariksha, acharyapareeksha&sishyapariksha- how a science, teacher and student should be selected. This is given in detail in charakasamhitavimanasthana 8thchapter. Moreover, upayas (methods for learning) such as adhyayana(studying), adhyapana(teaching), and tadvidyasambhasha(debate/discussion) are also mentioned. All of these methods cannot be taken as such, since the circumstances have changed. But many things are very relevant even now. Adhyayana, adhyapana, sishyaparikshaetc are among these. Saririkabhava(physical features), manasikabhava(mental features) and aacharas(routine) of sishya are mentioned in detail in our science. How a student can be inducted into the course- (sishyopanayaneeya), dos and donts for a student (regime of a student) etc. are also explained. It is a chapter which should be read by all teachers at least once, so as to know the method of teaching as explained in our science.
It is very difficult to introduce our science to a new student, since its methods are very unique and different from other concurrent branches of medical science like modern medicine. But yet stays very relevant too. It can be clearly seen now, as the covid19 disease is spreading and all the medical branches are scared about its management, except Ayurveda. Ayurveda has a clear strategy as to how it can be managed. Even the newly graduateddoctors will be ready to treat covid since they are well versed with the basic theory of vatakaphajwara. And not only treatment, but even the preventive measures are well explained in Ayurveda, including Rasayana. Therefore Ayurveda becomes useful in the management of even the most recent disease outbreak, as it was centuries ago and that makes the science very relevant.
One of the most important and most difficult aspect of teaching method is familiarizing the science to a new student. A student who is coming from normal school education, has no idea about the basic principles of Ayurveda like Vata, Pitha etc. So the teachers can’t directly go into the Ayurvedic principles, and instead other introductory classes about the medical system should be done for one-two weeks initially before moving on to the syllabus. This would help them to gain confidence in the subject and become successful in the industry.
There are many hurdles in this field. Language is the first and foremost one. Very few of the students joining the course know the basics of Sanskrit, the language in which Ayurveda is taught in. Most of the texts are in Sanskrit and without any knowledge of the language, it becomes really difficult to digest the principles of Ayurveda. In first year there are some basic texts and a paper in Sanskrit to help learn the language. But initially for a fresher, the language is surely the biggest hurdle.
Second is the unfamiliarity to the basic principles of the science. From primary school itself we have basics of anatomy and physiology in the curriculum. Eg. Chambers of heart, liver, 206 bones etc. have already been introduced early. But none of the basic principles of Ayurveda is taught in school and therefore is completely new to the student.
Another thing is lack of confidence. Most of the teachers are unable to bring confidence to students, since the general atmosphere doesn’t support Ayurveda. Even though covid is managed through Ayurvedic medicines, the modern medicine field is not ready to accept it. Government is also supporting modern medcine. Hence Ayurveda is lagging behind due to this scenario. Being treated as a second grade doctor is really difficult to a doctor who is entering the profession and thus destroys his confidence.
Next factor is lack of guidance. Formerly there were role model teachers like Sri RaghavanTirumulpad sir and Sri Rajagopalan Sir, who were highly qualified, and were good motivators and writers. So the presence of such people would create an ambition in students to be like them.
Another hurdle is lack of goal oriented consistent hard work. Most ayurvedic doctors don’t work hard at all. If they do, they can excel in the field. Despite the good IQ, due to lack of hard work they lag behind.
Another point to mention is scattered knowledge. Even inAshtangahridayam, the most concise text, the knowledge is scattered and is very difficult to gather and associate. A good teacher alone can do that. Eg.Physiology of sneha and sweda is mentioned in sutrasthana first part- “vyayamatooshmanahtaikshnyat…“, while the explanation of sneha and sweda comes later in the 16th and 17th chapters. Only a good teachers gathers this scattered knowledge and point out the association. It is only in this way that theapplication of basic principles can be properly understood.
Support should be given to match expectation with reality. Maximum effort should be made to grasp the basics thoroughly, since it is the backbone of our science. And understanding alone is not enough either. Practical application is equally important. There are some know Samhitha very well, but don’t treat patients. So confidence can be gained only if the principles are merging into practice.
Ayurvedic teachers are given no training in teaching methodology of Ayurveda. All the teachers should be given training after recruitment. Even if the teachers have good caliber, if teaching skills are not developed they might find it difficult to convey what they know to students. In medical college there is a cell for giving training to the new teachers. They are sent to class only after an initial training. In Ayurveda colleges that system has not begun yet. So such innovations should be started soon. One can’t blame the teachers if they are not teaching well, since they completely lack training in the field. Even school teachers have courses to orient them to teaching profession like TTC. In-service courses are also there, to re-orient their skill in teaching. But Ayurveda is lacking in this field.
What is in it for me?
That is a question every student will ask himself before entering the class. He should be gaining something from any class he attend. Compulsion is less fruitful, and it only increases stress. But if we can motivate our students to learn, then definitely, it is the best way.
Importance of reasoning
All the students should be inspired through questions like how, why etc which induce the tendency of reasoning in them. Eg. In greeshmaritu,lavana, amla and katu are contraindicated. In the ritusleshma decreases and vayu increases. So question arises as to why lavana and amla is contraindicated, when it alleviates vata and increases kapha. Answer is that all those three rasas contain agni, which is the major factor in the ritu- “teekshnamsu….” So asking such questions and inducing that reasoning tendency will help the students understand the science better, and make them interested in it too.
Fundamental aspects like satmyatva can be taken as another example. Seetarooksha and seetasnigdha are satmya to body, while ushnasnigdha is considered asatmya. Any dravya with these properties like-dadhi, matsya, mashaetc are asatmya. It can be used for medical purpose, but for daily use it should be avoided. But how divaswapna becomes abhishyanti? Sleep is always snigdha. Night is seeta and day is ushna. “seetamsukledayatyurvimvivasvaansoshayatyapi.”Sleeping at night is seeta-snigdha, while daysleep becomes ushna-snigdha. Therefore daysleep becomes abhishyanti, like the abhishyantidravyas mentioned before. Ratrijagarana is rooksha. Since sleep is snigdha, lack of sleep is definitely rooksha, and since night is seeta, ratrijagarana becomes seetarooksha, which is vatakopana. These are basic fundamental aspects, if conveyed to the students, will spark their interest and develop their confidence in the subject. They will be able to understand the science like a higher level mathematics, and that more effort has to be put in for its understanding. Only a good teacher can produce this effect.
Harithaki is ushna and rooksha. All the drugs which are ushnarooksha produces soshana and therefore haritaki too does the same. There is a rithu with the same properties, ie, greeshmarithu with ushnarookshaguna, which produces soshana. These gunas also produce vatapitha diseases and hence all the vatapitha diseases can be treated with greeshmarithucharya. So, when we explain haritaki or greeshmarithucharya all these interrelations can be explained.
Dravyaguna karma relation can be explained with samanyavisesha principle. Eg. “Nakraretovrishyanamsreshta” isdravyasamanya. Sukravridhi through ksheera is gunasamanya, since ksheera and sukra has the same gunas. Increase of kapha by divaswapna is karmasamanya, since divaswapna is a karma which has the same properties as kapha and thereby causes its vridhi. These examples make it easier to understand.
Mudga is sadaapathya. But it is contraindicated in gulma, since it is vishtambhajanana. Instead kulatha is indicated. Another example is lasuna. “pitharakthavinirmuktho….”. In all avarana, except in pitharaktha, lasuna is indicated. So even though an avarana condition, in vatarakta,lasuna is contraindicated, due to rakta involvement.
Substantiation through evidence:
Based on recent research findings if we can substantiate scientific data with clinical evidence, it will enhance the interest to learn. It will be highly convincing to any learner. “drushtakarmatanissamsayakaranaam”. Eg. In a dravyaguna research study, proportion of guggulu in guggulutikthakaghrita was 5 palas in 1 prastha of ghee. It was experimentally proven that the solubility of guggulu in ghrita was exactly the same. Beyond 5 palas, adding any extra amount is not possible since, ghrita becomes saturated with guggulu. So it is indeed extra ordinary that Acharya knew the exact quantity of guggulu to be added so that maximum saturation can be obtained. (“iyamagamasidhatvathpratyakshaphaladarsanatmantravatsamprayoktavyam”). So these are not fables, but facts which can be absorbed with zero wastage.
More examples of scientific evidences:
1. Godhooma is medicated with triphala overnight and is used for food preparation in prameha diet: it was found out in a study that gluten content was nil in godhooma after this process, but all the nutrient contents were retained. Hypoglycemic activity was also maintained as such.
2. Similarity of ativisha and mustha: ativisha is very costly, about 10000 rs per kilo, while mustha is only 50 rs per kilo. Mustha is the abhava drug of ativisha. A study proves that these two drugs are totally similar in cellular structure, when observed in high power chromatography(SPTLC). While ativisha is available only in north India, mustha is highly available in south India. So definitely the Acharya must have possessed some higher level of wisdom, to associate the two.
3. Purification of water with copper: in a study, it was found that when contaminated water was kept for 12 hours in copper vessel, it was found that the water becomes totally purified (99.9%). Even dangerous bacteria like e-coli were eliminated. This knowledge was adopted from Ayurveda. In food toxicity cases, (tayorvantaviriktasya….) patient is given tamraraja with honey after sodhana. Even leenavisha is eliminated by tamra. So this principle was adopted in the study.
4. Difference of curcumin content in haridra with respect to its natural habitat: if haridra is cultivated in Ernakulam, the curcumin content of haridra is only 2%. But the same when cultivated in Wayanad, the content becomes 8%. So it proves that every drug has a natural habitat, and it should be collected from that place itself for optimum properties.
All these details effectively substantiate Ayurvedic theory, as it can be clearly seen. So through research and sharing of these details with students, their interest can be increased in the subject.
All the verses in Ayurvedic texts are given in a coded form or sutraroopa (alpaksharamasandigdham…). So the decoding of the code is essential for its understanding. Eg. Jwaranidana is told in nidanasthana and chikitsasthana. But when explaining chikitsa, only that part ofsamprapthi(amasayasthohatvagnim…..) is mentioned in chikitsasthana, which is relevant in treatment.
In yogas, yoga and phalasruti can be separated and studied. eg. agasthyarasayana (dasamoolabalamustha….) this can be chanted and repeated, for making it by heart. Such techniques should be shared with the student, so as to help him in study.
See this example-(alpadushtakshinavisushkaretasam….). how a vajikarana act on body is clearly explained in this sloka. It also gives a comprehensive idea of vajikaranachikitsa. For alparetas it does apyayana=nourish, dushta- prasadana=purification, etc. so the words in sloka is being decoded and understood in different aspects.
In udara there is excessive accumulation of doshas, so virechana should be done daily. (doshaatimatropachayat…). Ksheera along with medicated castor oil can be given.
Another context is srotorodha and dhatukshaya in rajayakshma. The most important disease in Ayurveda were immunity power is totally lessened is rajayakshma. (anekaroganugathobahurogapurogama..). samprapti is “srotasaamsannirodhat charaktadeenam cha samkshayat…”. Therefore shadpalaghrita is mentioned in chikitsa which is srotosodhana.
Presume pathogenesis from treatment. Eg. Vamana in pandu (snehitamvamayetteekshnai…). If teekshnavamana is indicated as the first line of treatment, then it would be a kaphaja disorder. “Pandvamayasonitagakapha..” so through the treatment principle the importance of kaphadosha in samprapti is highlighted, even through direct importance was attributed to pitha.
Eg. Shatpalaghrita in rajayakshma is another example. It indicates srotorodha since the ghrita mentioned here is srotosodhana.
Techniques of learning:
There are different techniques of learning like reading, hearing, loud reading etc. which uses different senses for learning. Eg. Reading-visual, hearing- auditory, loud reading- visual and auditory, use of teaching aids- visual and auditory. For learning yogas, loud reading is the best method. Data collection and periodic presentation also helps to improve the standards in academics. Frequent presentation and data collection from the society for research works and clinics increases their confidence and helps them to understand how to deal with the society. In the first year itself, students should be posted in the OP, even though they don’t know the basics because they can watch the patients and observe how the doctors deal with them. It is important since it provides the students with the courage to manage the patient.
How to understand the meaning of text is important. Because from one sentence itself we can find different meanings. Eg. Vasco da gama came to india in 1452. From this sentence there is a direct knowledge which is same for every person, obtained clearly from the sentence. The implied meaning is that it might have taken him months to reach here from Portugal, since the Zeus canal wasn’t built then, so he had to travel around the African continent to reach India. The inference is different for different people. Some might think that the coming of foreigners helped in development of country, in its educational and economic aspects. Some others may think that the foreigners are enemies which destroyed our country. So it differs from perceiver to perceiver. So the interpretation is also very important.
Sincere and intelligent doubt of a student increases the wisdom of a teacher. It makes the teacher think further and thus expand his own knowledge. Guru tries to find out the answer and find out as many substantiating points as possible. Eg. No rasa acts against vata and kapha together. (tatradyamarutam…)no disease is caused by a single dosha alone. Most diseases are dvandvaja or sannipatika. “Bhishakkartha, karanam rasa, doshasthukaaranam, karyamarogyam”. Rasa is the karanam or tool for bhishak. So when we consider rasas for treatment, there are rasas for alleviation of other two dwandvas, but not for vatakapha. So they become yapya or difficult to treat. This is a basic principle which can be taught in the first year itself.First main dvandva disease mentioned is tamaka, which is yapya.Eg. When prakruti examination was done in patients of RCC, about 70% of patients were vatakaphaprakruti, irrespective of the type of cancer. So it was concluded that vatakaphaprakruti individuals are susceptible to many chronic diseases including cancer. Almost all of the neuro degenerative diseases like MND, Alzheimers are having vatakapha predominance.
Learn step by step:
In first year we learn that the paramoushadhas mentioned for pitha is ghrita, and vata is taila. But when we reach chikitsasthanaa, ghrita is mentioned for vatapitha, while taila is for vatakapha. So the knowledge is being upgraded. This is an example for step by step knowledge. First a broader aspect is given, and later we move into specifics.
How to revise:
The best method is to revise thrice within 24 hours. Short period of regular study is better than long period of study with long gaps. Repeat even after thorough learning. Satatam learning is advised by acharyas too. “abhiyuktamtusatatam…”. When we dopanchakarma especially we may face with different challenges (vyapat), and the clear knowledge in text will help us get through those. So thorough learning of text is necessary.
Drugs which act on brain also act on heart. Ghee preparations have affinity to both heart and brain. That is the reason dyslipidemia causes brain attack and heart attack. Similarly alcohol also crosses blood brain barrier. Hence ghritas and arishtas are generally used in psychiatric disorders.
Ghee along with triphala is used in nethrarogas, with brahmi used as medhya and reaches brain, with arjuna for hridaya, i.e. to heart as cardio tonic. We can also see that ghee with brihathyadigana acts in the moothravahasrotas, while with panchakola it acts in GIT. So in all these cases ghee acts as a medicine and a vehicle. Ghee can be used as medicine for reaching organs like nethra, hridaya, brain etc.
Attitude is everything:
We know the iceberg phenomenon. Only 10% is visible, remaining 90% is below sea level. This is applicable also to human beings. Knowledge and skills known to others may be only 10 %. The unknown part is 90%, which is that person’s attitude. Thus attitude is everything.
What makes your life 100%?
See the simple trick which assigns numerical value to letters. In that scale, skill is only 82%, knowledge is 96%, hard work is 98%, but attitude is 100%. This is simply an example, but it is the duty of the teachers to create the right attitude in students. Each teacher should be a good motivator.
Need of complete knowledge:
“na hi jnanavayavenakrusnejneyojnanamutpadyate” ch.vi.4
Understanding of the total nature of a thing does not arise from the fragmentary knowledge of it.
Constant study, mutual discussion, learning other disciplines, serving the preceptor, these factors endow one with intelligence and memory. No medhya medicines like brahmi or sankhupushpi are told here. A teacher should always carry out these basic methods to keep his intelligence updated.
“krusno hi lokobudhimatham Acharyasathruschaabudhimatham” ch.vi.8
The entire world is the teacher to intelligent, and an enemy to the unintelligent.
An Ayuvredic teacher should be a clinician and researcher too. Research is constantly going on in our mind. Previously the vaidyasalas itself were the research centers. Even though kayasekaetc are not explained in our classical texts in detail, the old physicians developed its methodology, without sacrificing the basic principles of Ayurveda. Every procedure or treatment given was scrutinized and further developed. That should be the method followed now too. Even if it is not published as a paper, it will be an updation of knowledge for the observer and an asset for future. Eg. A discussion of Nisakatakadikashayam, pointed out that even though it is not as much effective in inducing hypoglycemia, it is highly effective in preventing complications of diabetes, if given along with modern medicine. So if the modern medicine field also agrees with the fact, it could be adopted generally in population to prevent the diabetic complications. So such an observing mentality should be present in every teacher.
“A bad teacher dictates notes. Good teacher gives lectures. Best teacher inspires.”
Remember, excellent teaching is a great art. Because it’s a divine profession. Consistent hard work, love and affection towards thescience is highly essential. Laziness is a teacher’s enemy. The greatest enemy of knowledge is not ignorance. It is the illusion of knowledge.
-Take home message-
1. Chikitsa is the applied aspect of basic principles.
2. In addition to basic sciences like anatomy and physiology, Adisthanasiddhanta, Dravyaguna and Nidana are also equally important in chikitsa.
3. Apart from imparting knowledge, try to create good attitude towards this great science.
4. Read Ashtangahridaya everyday
5. There is no short cut to become a great teacher.
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