Indigenous Medicine

Sri Lanka has its own indigenous system of traditional medicine which has been practiced for over five thousand years. Sri Lanka’s indigenous system of traditional medicine is known as Desheeya Chikitsa and has been influenced by Ayurveda and Siddha of India and Unani medicine of Greece.

What is Ayurveda?

Considered by many scholars to be the oldest healing science, Ayurveda is a holistic approach to health that is designed to help people live long, healthy, and well balanced lives. The term Ayurveda is taken from the Sanskrit words 'Ayu' meaning life or lifespan, and 'Veda' meaning knowledge. It has been practiced in Sri Lanka and India for at least 5,000 years and has recently become popular in Western cultures. The basic principle of Ayurveda is to prevent and treat illness by maintaining balance in the body, mind, and consciousness through proper drinking, diet, and lifestyle and herbal remedies.

The main type of Ayurveda is traditional. This Ayurveda is based on translations from the classical texts. Ayurvedic practitioners prescribe herbs, believe that disease results from an imbalance in the Doshas (see below), and use many of the same remedies for treating illness. Ayurveda, however, stresses the role of supreme awareness in maintaining good health, and promotes meditation as a way to experience the pure consciousness of the universe. It also highlights the expression of positive emotions and the need to adjust your life to the natural rhythms of the body.

Just as everyone has a unique fingerprint, according to Ayurveda, each person has a distinct pattern of energy - a specific combination of physical, mental, and emotional characteristics. It is also believed that there are three basic energy types called Doshas, present in every person.

Everyone has Vata, Pitta, and Kapha, but usually one or two are dominant in a particular person. Many things can disturb the energy balance, such as stress, an unhealthy diet, the weather, and strained family relationships. The disturbance shows up as disease. Ayurvedic practitioners prescribe treatments to bring the Doshas back into balance.

From a Western medical viewpoint, stress relief seems to be one of the ways Ayurveda works to help fight illness. For example, studies have found that meditation, a part of Ayurveda, lowers anxiety and that Ayurveda lowers blood pressure and cholesterol, slows the aging process, and speeds recovery from illness.

Many herbs used in Ayurvedic medicine have antioxidant effects, which mean that they help to protect long term illnesses such, as heart disease and arthritis. Many Ayurvedic practitioners also recommend a vegetarian diet, which is believed to be better for your heart than diets containing red meat.

What is Dheshiya Chikitsa?

Even before Ayurveda existed, Dheshiya Chikitsa - the indigenous medical system - existed in Sri Lanka. The statue of Rishi Pulasthi 'the Father of Ayurveda' at Pulasthipura proves that there existed a very developed way of treating the sick, long before Ayurveda travelled from India to Sri Lanka and mixed with Dheshiya Chikitsa. Since then it had been preserved continuously in its tradition and is still used to date. Historical scripts confirm the exchange of information between India and Sri Lanka long before its 'official' introduction. Valmiki's Ramayana details few examples for it.

The concept of the Ayurveda is as old as the civilization of mankind. This had taken many turns inherited many ideologies along the passage of time, getting refined into a fine art. The word 'Ayurveda' is made of two syllables. The first part 'Ayur' means long life, 'Veda' means science. The basic rule or the law is to live among and to take care of oneself with nature. The creatures living on the surface cannot live under water and those that live under water cannot live on surface. Nature is considered the mother of all beings, and all living creatures are dependent on the nature for their survival i.e. everything revolves around nature and nature itself brings up, preserves its creations. Ayurveda strictly follows the rules of nature, as it points out: what, when, why, how, how, much: to eat, work, rest, wash, bathe, which, help us to lead a perfectly healthy life. There are two divisions in Ayurvedic treatment. Ayurveda treatment besides healing also aims at rejuvenating the body.

Over the time the word Ayurveda was added to Dheshiya Chikitsa which absorbed many Ayurvedic ways of which prime time goes back to many thousands of years. The knowledge of this complex art of healing was originally passed only on verbally. The first notes were written down in Sanskrit and dating back to more than 5000 years. Opposing to our present health system, Ayurveda is a holistic life concept. It teaches how to keep healthy, maintain your vitality and joy of life right into old age.

Ayu means 'life' and Veda is the 'knowledge', the science, meaning, you can translate Ayurveda as 'science of life'. It is however not just all about passing on theoretical knowledge, but the practical rules are there to help manage everyday life, to restore and maintain the unity of body, soul and spirit. Ayurveda acknowledges three levels of a primary healing:

1. Treating the illness

2. Avoiding the illness and encouraging the wellbeing

3. Developing self-awareness and the balance of the body, soul and spirit.

Most of us think about medicine only, when we are ill and look for being healed. The medicine we subsequently take is to repair what is wrong. Western medicine treats illnesses with forceful therapies and medicaments or operations that could have side effects. In order to treat an illness and restore the balance, Ayurveda uses natural products for preparing medicines. This aspect of Ayurveda is called Shamana Chikitsa.

But Ayurveda is also able to prevent illnesses and heal before the symptoms manifest themselves. To this end lifestyle, surroundings, working conditions and psychological circumstances must be considered. Those factors that incline our body to become vulnerable to illnesses should be removed from our life. Striving to be healthy will become a continuous adapting and achieve a balanced lifestyle.

Medical Feats of Ancient Sinhalese

Sinhala medical traditions date back to the pre-history. A number of medical discoveries are only now being known by western medicine, but the ancient Sinhalese introduced the concept of hospitals to the world. According to the Mahawamsa, the ancient chronicle of Sinhalese royalty, written in the 6th century AD, King Pandukabhaya (4th century BCE) had lyingin- homes and hospitals (Sivikasotthi-Sala) built in various parts of the country after having fortified his capital at Anuradhapura. This is the earliest literary evidence we have of the concept of hospitals (i.e. a special centre where a number of patients could be collectively housed and treated until they recovered) anywhere in the world.

Prof. Arjuna Aluvihare ("Rohal Kramaya Lovata Dhayadha Kale Sri Lankikayo" in the Vidhusara Science Magazine, Nov. 1993) says that there is no evidence, literary or otherwise, to show that hospitals were known elsewhere before the time of King Pandukabhaya. According to Prof. Aluvihare, the oldest archaeological evidence we have so far of a hospital is the ruins of Mihintale, where the remains of a hospital built in the ninth century could still be seen. The layout of the building and the discovery of a medicinal trough and surgical instruments prove this beyond doubt. Heinz E Muller-Dietz (Historia Hospitalium 1975) describes Mihintale Hospital as the oldest in the world. All medieval Sinhalese hospitals so far discovered appear to have comprised of a central courtyard surrounded by cells for the treatment and an adjoining second courtyard with surrounding rooms which were used for the storage and preparation of medicines, besides other purposes.

It should be noted that ancient and medieval Sri Lanka, had a corporate social organization where the state provided welfare services to the people in return for the labour provided by masses to build irrigation works, palaces and religious edifices. As such the state provided free medical care to all its citizens regardless of race, caste, sex, religion or status. Although traditional Sinhalese medicine has a number of distinctive features, it is primarily based on the science of Ayurveda (a Sanskrit term meaning "science of life") an essentially herbal system set forth in the medicinal texts (Samhitas).

Ancient Sri Lankans had extremely cordial relations with Mauryans India who would have considerably helped facilitate the spreading of the great Indian medicinal tradition amongst the local population. King Asoka's (3rd century BCE) Girinar rock edict states that he provided medicines and medical aid 86 | Ayurveda of Sri Lanka S LT RAINBOW PAGES for both men and animals as far as Tambapanni (The old Indian name for Sri Lanka).

However, in spite of the profound Indian influence, Sinhalese medical knowledge has developed on its own with the passage of time and we note a number of distinctive features, which mark it out from other medical systems. We come across a number of references to medicines and medical treatment in the ancient Sinhalese chronicles. According to the Mahawamsa, prior to the birth of Dutugemunu, Queen Viharamahadevi gifted medicines to the Buddhist clergy in order that she may conceive. The same work alludes to King Dutugemunu having donated food and medicine to the sick.

King Buddhadasa (340-368 AD) the country's renowned physician-king was an expert in general medicine, surgery, midwifery and veterinary science. The King's surgical operation on an outcaste (Chandala) woman in order to deliver her child and the surgical removal of a lump in the belly of a cobra is some of the feats narrated of this remarkable monarch in the sequel to the Mahawamsa and Chulavansa. The chronicle states that the king constantly carried a set of surgical instruments with him on his journeys. It speaks well for the nobility of this king who cast aside ancient prejudices "unimaginable in those caste-ridden days to have attended on an outcaste. This in itself shows that the Sinhalese medical establishment of yore considered service to humanity to be such a sacred and estimable duty as to even transcend caste barriers, which were otherwise strictly observed at the time. The king's surgical feats on a helpless serpent also show that not only humans, but also other creatures benefited from the medical skills acquired by the ancients. The king is also stated to have given medical professionals due remuneration for their services to the people. The Chulavansa states that the king "gave the physicians the produce often fields as livelihood."

The compilation of the "Sarartha Sangraha", a comprehensive medical treatise in Sanskrit is also credited to King Buddhadasa. Although this work is similar in arrangement to the Samhita of Shushruta, it contains much original information as well. The work deals with the preparation of drugs, clinical diagnosis, surgical instruments and operations, ear, nose and throat diseases, eye diseases, tuberculosis, insanity, epilepsy and obstetrics, besides a number of other subjects of medical importance. King Agrabodhi VII (766-772 AD) even went to the extent of undertaking fresh research pertaining to medicinal substances. According to the Chulavansa, the king "studied the medicinal plants over the entire Island of Sri Lanka to ascertain whether they were wholesome or harmful to the sick." King Mahinda IV (956-972 AD) had distributed beds and medicines to all the hospitals of his realm.

King Parakramabahu I (1153-1186 AD) who was also wellversed in medicine helped qualified physicians practise their skills by providing them with due maintenance. It is thought to be necessary to give a more detailed explanation of the Sinhala Hospital tradition in order to provide an idea the extent to which the Sinhalese had advanced in hospital care. The ninth century Mihintale hospital which has the distinction of being the oldest hospital yet discovered in any part of the world as seen earlier, was quite a complex structure. The hospital is believed to have been founded by King Sena II (851-885 AD) on the basis of evidence in the Chulavamsa. As shown by recent archaeological excavations the hospital complex comprised of an outer and inner court. The rooms used for the preparation and storage of medicines and the hot water bath were situated in the outer court. The discovery of stone querns used in the grinding of herbs in the outer court area suggests that the preparation of medicines took place thereabouts.


The inner court in common with later hospitals was surrounded by a number of cells where the patients appear to have been treated. A slab inscription of King Mahinda IV (956-972 AD) near the hospital alludes to physicians; physicians who apply leeches and dispensers of medicine. Other hospitals of the medieval period which have been excavated are the Medirigiriya and Polonnaruwa hospitals.

Excavations at Medirigiriya, where a hospital is believed to have flourished in the ninth century, have revealed a stone medicine trough and querns for grinding medicine. Excavations at the Polonnaruwa hospital site have revealed medicine grinders, a pair of scissors, ceramic jars for the storage of medicines and a hooked copper instrument which was probably used for incising abscesses.

The construction of the hospital is assigned to King Parakramabahu I (12th century). Literary and epigraphic evidence however indicates there were many more hospitals and other institutions for the handicapped in existence in ancient and medieval Sri Lanka.

According to the Chulavamsa, the kings Buddhadasa and Upatissa II built institutions for cripples and hospitals for the blind. Upatissa II was probably also responsible for building the country's first ever maternity home, while Kassapa IV had specialized hospitals built in Anuradhapura and Polonnaruwa to combat Upasagga, which is believed to have been an epidemic disease.

An inscription attributed to King Kassapa V (914-923 AD) records the establishment of "medical halls" in Anuradhapura. As borne out by the Kiribath Vehera pillar inscription attributed to King Kassapa IV (896-913 AD), the dispensary was such a hallowed institution that it had the privilege of affording sanctuary to offenders.

As Dr. C. G. Uragoda (A History of Medicine in Sri Lanka,1987) notes: "This is indeed a privilege of a high order if one considers other institutions which have enjoyed similar time honoured positions, namely churches in medieval Europe Tourist Directory 2015 Ayurveda of Sri Lanka | 87 and embassies." As for the efficacy of local medicine this is borne out by a number of western authorities right down from the Portuguese colonial period (16th-17th centuries).

Joao Ribeiro, the famous Portuguese soldier-historian who served in Sri Lanka from 1641-1658 has written in his reputed work "Fat alidade Historia de Ceilao": "They are great herbalists, and in case of wounds, tumours, broken arms and legs they affect a cure in a few days with great ease. As for cancer, which is a loathsome and incurable disease among us, they can cure it in eight days, removing all viscosity from the scab without so much as leaving a mark anywhere to show that the disease had been there. I have seen a large number of soldiers and captains cured during my residence in the country, and the ease with which this was done was marvellous.

In truth the land is full of medicinal herbs and many antidotes to poison, which I have myself tried to learn as a remedy against snake-bites."

Dr C.G. Uragoda ("A scientific basis for some traditional beliefs and practices in Sri Lanka". JRAS SL. 1989/1990) has shown that a good deal of traditional Sinhalese medical concepts, practices and drugs have a sound scientific basis. The concept of heaty (giniyam) and cooling (sitala) foods is one such example. Dr Uragoda has shown that a variety of fish such as skipjack (Balaya) and tuna (Kelavalla) which are usually regarded as heaty, have high histamine content, a substance which causes allergic reactions amongst some people. He has also shown that olden day Sinhalese folk knew that the malaria parasite was transmitted by the mosquito long before 1884 before Sir Patrick Manson propounded the theory that the malaria parasite was transmitted through mosquitoes. As evidence he has cited an interesting passage in Sir Emerson Tenant's Ceylon (1859) which alludes to the Sinhalese of the time employing mosquito curtains as a precaution against malaria. This would indicate that the Sinhalese knew that the mosquito was the vector of malaria at least 25 years before Manson advanced his famous Mosquito-Malaria theory and some of the traditional remedies cited by Dr Uragoda which have a sound scientific base are smoking of Adhatoda Vasica as treatment for excessive phlegm and use of Coscinium fenestratum (Venivel) for tetanus.

In Ayurveda we should never forget our pre-historical Emperor Rawana. His superior acquaintance in Sanskrit can be evaluated from Sivathandawa Sthothra and he was a proficient Ayurvedic Physician. The art of distilling of Arka and the preparation of Asawa was his invention states Ayurvedic history. He invented the 'Varuni' machine to brew Arka. Rawana was the founder of Sindhuram medicine. These medicines cured wounds instantly. He was a divine pharmacologist and a Dhayana yogi.