Ayurvedam

Ayurveda literally means the "Science of Life”. Etymologically, the word "Ayurveda" is derived from two words viz. Ayu-which means “Life” and Veda-which means “knowledge or science”. Hence Ayurveda indicates the science by which life in its totality is understood. It is a way of life that describes the diet medicine and behavior that are benefical or harmful for life. Ayurveda thus means "the science of life and longevity".



Coming to the definition "Ayurveda", it has been described by ancient and great physician CHARAK also known as father of Ay. Medicine as "The science that indicates the appropriate and the inappropriate, happy or sorrowful conditions of living, what is auspicious or inauspicious for longevity as well as the measure or the span of life itself is called as Ayurveda."

The history of ayurveda Starts with the evolution of human life. "According to astronomical records in ancient Vedic texts, the Vedic system, including Ayurveda, was in practice since antiquity. This time proven system of medicine has its origins in Himalayan Kingdom and is still being practiced today in many parts of the world with proven results. Ayurveda is the healing gift, which originated from the ancient enlightened Vedic culture, which goes back to 5000 B.C. Thus, it can be concluded that the tradition of Ayurveda extends back over more than 5000 years of continuous daily practice, from ancient times to the present day. According to philosopher, ayurveda was originated from BRAHMA, the creator of Universe. From Brahma the knowledge of ayurveda was transmitted to mankind thorough subsequent generation. The ancient ayurvedic persons are Charka, Shusrut, Dhanwantari, Bhardwaj, Kasayap etc, who have done lot on ayurveda for its development.

The aims and objectives of this science are to maintain the health of a healthy person and to cure the diseases of an unhealthy person. Unlike Modern system of medicine, it deals not only with the symptoms but also with the individual as a whole. As a science of self healing, Ayurveda encompasses diet and nutrition, lifestyle, meditation, breathing exercises, rest and relaxation, medicinal herbs, minerals along with cleansing and rejuvenation programs for healing body, mind and spirit. It can be concluded that it is the art of daily living in harmony with the laws of nature.

Along with the physical diseases, it also insists on the spiritual and ethical discipline for mental health and normal development of personality. It provides rational means for the treatment of many internal diseases, which are considered to be obstinate and incurable in other systems of medicine.

Ayurveda deals not only with human beings, but also in specialized subjects like Ashva-ayurveda (For the treatment of horses), Gaja-ayurveda (For the treatment of elephants), Go-ayurveda (For the treatment of cows) and Vriksha-ayurveda (For the treatment of diseases of plants).

Ayurveda has gone through several stages of development in its long run. Today, it, is in yet another stage of development, is undergoing readaptation to the Western world and modern conditions, Ayurveda is coming up with answers to many problems, which have eluded modern medicine. For making it easier to study, this vast ocean of knowledge has been divided into 8 principal branches.

Shalya tantra (Surgery) --- The word “Shalya” denotes something that causes discomfort to the body and/or mind. This branch deals with the removal of Shalya and includes the surgical procedures like incision, excision, suturing, rhinoplasty, treatment of the dislocation of the bones, etc.
In ayurveda, Shusurut describes surgery as the first and foremost specialty of system. He describes various surgical procedure including abdominal operation .bladder stone .He was the one who gives the concept of plastic surgery and the surgery of cataract. Ksharasutra chikitsa in ano rectal disease was his wonderful practice which is proved more advantageous and efficacious than modern surgical procedure.

Shalakya Tantra (E.N.T & Ophthalmology) --- This branch deals with the use of a rod (Shalaka) for the treatment of the diseases of the organs above the clavicle bone, hence the name Shalakya Tantra. In other words it deals with the diseases related to Ear, Nose, Throat and Eyes.

Kaya Chikitsa (General Medicine)---Here the word “Kaya” means “Agni” (Digestive power) and also “Body” & “Chikitsa” means “Treatment”. This branch includes the diagnosis and the treatment of the systemic disorders without surgical intervention. It also describes general introduction to health and medicine, longevity, general hygiene, preventive medicine and personal health, dietetics and instructions against the suppression of the natural urges. The popularly known PanchKarma is also described under this branch.

Kaumar Bhritya (Gynecology, obstetrics and Pediatrics)- This branch deals with the diagnosis and the treatment of the diseases related to mother before conception, during pregnancy, delivery, post-delivery and with the disease of children. Ayurveda describes method of conceiving of the desired sex, intelligence and constitution.

Bhootvidya (Psychiatry or Demonology) ---This branch deals with the mental diseases. These sorts of diseases can be correlated to as idiopathic disorders, in Allopathic system of medicine. According to Ayurveda, it has been assumed that these diseases are caused by affliction due to evil spirits.

Agad Tantra (Toxicology)---This branch deals with the forensic aspect. Diagnosis and the treatment of the diseases caused by various types of organic and inorganic poisons have been described under this heading.

Rasayan Tantra (Geriatrics)---The main objective of Ayurveda is to maintain health is carried out through this branch. It deals with various aspects of preventive health care. It includes details concerning rejuvenation and emphasizes a person to look younger.

Vajikarna (aphrodisiacs) ---This aphrodisiacs branch focuses on the sexual aspect of life. It deals with the disorders of reproduction and sexual life and includes administration of medicines which are aphrodisiacs and which not only help in spermatogenesis but also improves the quality of sperms.

What exactly is Ayurveda?
A distinguishing feature which sets Ayurveda apart from other alternative systems of medicine is the fact that Ayurvedic treatment treats patient as a "whole" i.e. a combination of the body, the mind and the soul (Ranade,S.1991) . This Vedic system of medicine repeatedly emphasizes the common origin of mankind and the universe. Our relationship with our environment is intrinsic. The elements which compose the universe also constitute the human body and therefore the laws which govern the universal elements also govern the human realm. These profound concepts based upon an astute understanding of the universal laws and practical observations about the world around give us the indication about the holistic approach of Ayurveda and its potential in alleviating many health related problems afflicting the whole of humanity. Health is essential for enjoyment of all the worldly pleasures in a righteous manner. Ayurveda goes much beyond the realms of ordinary medicine and gives practical measures on how to maintain and protect one's health and well -being and promote longevity of life. Ayurveda is thus not just a system of medicine; rather it's a way of life! According to Ayurveda illness is a condition of imbalance which originates from some fundamental deficiency and something more than symptomatic relief is needed for its cure.


AYURVEDIC MEDICINE
Ayurvedic medicines are derived from the mineral, plant, and animal. A number of minerals and metals are used, but they are subject to various and complex process of purification and oxidation before becoming suitable for internal usage. Sankha ,praval (muga). Sipi,iron, gold, moti, tama, zinc, mercury etc are used to prepare ayurvedic medicine from minerals. Some examples are Sankha Bhasma ,Praval Bhasma,Swarna Bhasma, Rhumayog gold, Tribhuvan kirti ras etc. Some of the ayurvedic medicine is derived from animal origin like Kasturi (kastoori bhusan, mrigamadasab), mayor (mayurpuchha bhasma), elephant teeth (hasti danta masi), pitta of fish, etc. Some drug may need cow’s milk and urine for purification too.

Mostly plants are used to prepare medicine. Nepal is very rich in plant diversity. More than 3000 medicinal plants are available here. Due to the different altitude different type of flora are available. Yarchagumba, Panch aaule ,padamchal ,Kutki, lauthsalla ,sugandhawal. Jatamasi, Bikhma and number of other plant are having high medicinal value. These are abundant in our nation and are of high demand in international market.
Ayurvedic medicines predominantly being plant based are in close harmony with nature and hence easily assimilate by the human body. Ayurveda thus helps maintain the integrity of the unique elemental balance in each individual and treats the ailment at its root cause. Some ayurvedic drugs consisting plant ingredients are Trifala Churna, aabhipattikar churna , Sitopaladi churna.

It is unwise to say ayurvedic medicines are always safe. Usually medicine containing ingredients of toxic plant and minerals in high dose are not safe to take and are fatal too. Ayurvedic medicines are prescribed to take with cold water. Some with hot water some with honey, these are called Anupan and Sahapan and they said to be act as a catalyst. Anupan and sahapan should strictly being followed while taking medicine. Indication and contraindication of diet according to diseases is highly emphasized in Ayurveda. A Nurse working in Ayurveda Hospital should have prompt Knowledge regarding methods of administration of drugs and dosage.

Ayurvedic medicine are made from mixing number of medicinal plant, minerals etc in different amount to prepare. One to hundred of ingredient may contain in ayurvedic medicine. So it is hard to examine quality of the drug by laboratory examination, but some drug may constitute single medicinal plant too.

Form of medicine- Powder, tablet, capsule, syrup, ointment, oil, juice, paste, decoction, injection, granules, Ash etc.

There are two type of ayurvedic medicine available in market. Patent medicine and generic medicine.

Patent Medicine- Liv 52, Neo, newlivfit, cystone, Opthacare, Gastrx, Gasex, R. Pyrin, Neeri, calcury, Septillin, ojus, Himcocid, Livex, Ovarin, Eve care, M2 tone, Amycordial etc

Generic medicine- Chywan prash, Ashokarista ,Dashamularista, Trifala churna, Aabhipattikar churna.Sankha bhasma etc..

Ayurveda says medicinal plants of specific area are more appropriate for the patient of same area that means Ayurvedic drugs prepared from the Nepal are more suits to Nepalese Residence than the patient residing in Europe.


AYURVEDA : PROSPECTS IN NEPAL
Ayurveda is now becoming known and even respectable in the developed countries. Nepal is rich in Ayurvedic tradition. About 2/3 rd population is relying on ayurveda directly or indirectly. Ayurvedic medicines are natural, easy to find, cheap and safe to use. Peoples have lot of trust on ayurveda. Besides the living tradition its National Archives have many Ayurvedic manuscripts which are only available here and are yet to be published. Many western scholars and agencies are coming to Nepal to record this heritage of ours. Nowadays; Ayurvedists of Nepal are having more western patients or students and are also going to developed countries of the west or east. It is high time that this country should make a systematic effort to exploit this potential.AYURVEDA.
Existing situation There are number of government and non government organization working in ayurvedic field.
Nepal Ayurveda Medical Council NAMC functions on the registration of different ayurvedic manpower. Deals with the right of practitioners, controls quality in service and education. Altogether there are around 200 ayurvedic doctors registered in this council. Ayurveda Doctor only can do a practice after being registered in this council.
Ministry of Health-There is an ayurveda and alternative medicine unit in ministry of health. It contributes in policy making area.
Department of Ayurveda This is the apex body for Ayurveda in the country directly under the Ministry of Health HMG and is responsible for formulating implementation and overall supervision of other Units as following
1. Naradevi Ayurveda hospital of 100 beds -1
2. Regional hospital, Dang of 30 beds(50 running)-1
3. Zonal Ayurveda hospital-14
4. District Ayurveda health center -61
5. Ayurvedic Aushadhalaya (Primary dispensaries) -214
At now there is an ayurvedic Network in all 75 district by altogether 291 service providing center from different level of Manpower.
Regional Health Directorate there is an ayurvedic unit to monitor and supervisee the ayurvedic health center.
Singha Durbar Vaidyakhana .This is the manufacturing unit for the Ayurvedic drugs. Till recently this was under the general administrative control of Department of Ayurveda. Now it has been made an autonomous unit and the aim is to make it a self sustaining organization,
Naradevi Ayurveda CampusThis is constituent campus of the Institute of medicine under Tribubhan University and is responsible for the production Ayurvedic manpower. Till recently this institution was running graduate course (BAMS, Bachelor of Ayurvedic Medicine and Surgery) is being conducted with 15 admission per year.
Private Sector
Practitioners with Institutional and Academic Training:
Those with academic training either had their education in the Ayurvedic colleges in foreign countries or in Nepal. Numbers of them are profound scholars of Ayurveda and clinicians of great repute. Furthermore with their long experience they have the knowledge of local herbs and their uses hence they should be regarded as valuable resources persons.
Traditional Ayurvedic Practitioners
There are significant numbers of Ayurvedic practitioners who have a family tradition of several generations. They may not have formal academic training but had sufficient theoretical and some are very erudite also. Moreover in these families there are records of the recipes they have been suing for generations as well as old manuscripts. Due to the pressure of modernization the children of these families are reluctant to follow the tradition and the manuscripts as well the recipes they have been suing are being lost. There is an urgent need of taking some steps to preserve them.
Traditional healers
They are not Ayurvedic practitioners in the conventional sense however the tradition and even the herbs they use have Ayurvedic background. Mostly located in the remote villages they are the most often the first and only health personnel available to the community and the herbs they use in their have real medicinal value. Their large number have been brought in several studies and if mobilized could greatly contribute in the health care system of the country.
Pharmaceutical Sector
Nepal at present imports Ayurvedic drugs of more than 150 cores rupees and it is increasing 25% each year. About two hundred different brands of Ayurvedic drugs are produced in Nepal by more than 30 private companies. More than 150 Indian Ayurvedic drug companies are currently supplying Ayurvedic medicines to Nepal. There is no doubt that significant amount if not all raw materials of these Ayurvedic drugs have their origin in Nepal. There is thus immense potential for these herbs for the manufacture of Ayurvedic drugs not only for the domestic purposes but also for the export to India where most Ayurvedic companies claim to manufacture their medicines from "genuine" Himalayan herbs

Naradevi Ayurveda Hospital in the field of Ayurveda

Naradevi Ayurveda Hospital was established in Baishakh Shucla Akshya Tritiya' in 1974 BS. The formal education of Ayurveda which is also the first technical education in Nepal was also started in its boundary after ten years. At present, the Ayurveda education is under Tribhuwan University and the Ayurveda Hospital in under His Majesty Government of Nepal. But these two are situated in the same compound.

Present world has begun to discuss the usefulness of Ayurveda treatment. This discussion is due to two facts:
One – due to its inability to address the health problems of the people despite the large scale investment of money and manpower in modern medicine and

The next is – Ayurveda treatment system is less invasive to the host, that is, than modern one.

In this way, Ayurveda has proved its existence in a distinct form in the modern world. The world health organization which is in fact of and by the world modern health workers, has also taken interest to protect and promote the Ayurveda and other traditional treatment system. Here, one thing very notifiable is that the treatment system, practiced innately by Nepali, is trying to be categorized as an alternative treatment system. It is quite obvious to say that Ayurveda is an alternative medicine in the context of America and Europe because it was imported to these regions from our sides. But how the system that was imported from western world and is not our own be the principal treatment system in Nepal; how our fundamental and innate system be an alternative treatment System? The foreign advisors and donor agencies in Nepal are advising keeping ayurveda as an alternative medicine as in their countries. If we get convinced and said our system as above, its shame to say own mother as a foster mother.

The organizational development of Ayurveda is very old. The establishment of 'Simhadarbar Vaidyakhana' was in Malla era. The history of Ayurveda hospital is as old as nine decades and that of Ayurveda education is eight decades. How the system having quite long history is now in such a piteous condition? It is a matter of discussion. I like to say something about the Naradevi Ayurveda Hospital: - one of the ancient organizations established with four beds has only hundred beds till today. The organization much newer has already got its advanced forms. But its development is quite slower. Hospital and education are being conducted simultaneously (either in separate form or in the united form) but these organizations are always encountering difficulties. Their forms/patterns may be different but the problems are rising continuously instead of fading away. Having a problem is not a problem. Where there is organization, there are problems. Without problems development is impossible. For the development, identification of the problems are important. So, in many view, we could not identify our problems. The solutions will come immediately after the identification of problems. Yes, one should not raise the problems anywhere or anytime but analytic and reasonable idea or problems should be put forward. We could not identify our problems and make them distinct so they are remaining as burning coals inside the ash. Planning is needed to get ride of the problems. Planning should be done according to the policy. What are the planning and policy of Ayurveda for its proper conductance? What is its source? How can it be generated/gathered? We do not discuss regarding these facts. Ayurveda health pilicy was made in 2052 BS. It has declared; to make Naradevi Ayurveda Hospital 100 bedded, to form its management committee and to provide specialized service through the establishment of different departments. What are the services that we have said specialized services? How can we provide these services?; and What is the technology that we want to introduce? We could not identify these facts which are responsible for hindering the speed of development of Ayurveda hospital.

We made policy. We copied it from others or developed it standing on our realistic ground? This planning is written in this way: "...... many days, months, or years will need to complete this Programme........" Had we made any concrete mentality for these? What is our financial status? In Ten years we can not express our commitment towards its implementation.

Now, the work we have to do for fulfilling the commitment toward policy is to establish different department and to provide specialized services. The others have already been completed. Considering the departments of the hospital, we have to think from two sides. One- the role of teaching hospital it has been providing and the other is the role of providing health facilities through Ayurveda treatment center HMG Nepal. For teaching-learning basis, priority should be provided by establishing different branches of different departments. For example, we can provide special services like "KAMALA", "VATVYADHI", "PANCHAKARMA" etc. in KAYACHIKITSA. So we have to establish the departments through proper coordination to achieve bilateral goals of service and education. The next problem is how to manage the manpower needed for the department. It's a misfortune that the organization having such a long ration (Hospital + Campus) could not do any coordination for the development of required manpower till now. The hospital needs specialized doctors but the campus can not produce such manpower. If we analyze the policy, there is a concept of independent Educational Academy. For raising this, as said above, whether it is a copy or our own matter? Who implements it? Who initiates for its establishment? Why can not we identify the problem and go for its solution?

There is a urgent need of high level manpower for the betterment of present status of the hospital so as to provide better service and place for teaching hospital. What is the number and what will be the subject of specialization may yet be the matters of discussion. But, we should not let our philosophy, treatment system and policy die as by the fool helmsman who sank the village on discussion. So at present we can provide at least some facilities of KAYA-CHIKITSA (Internal medicine), SHALYA-SHALAKYA (ENT, Eye etc), BAAL and STREE (Paediatrics and Gynaecology & obstetrics) with specialized services. This can be said with reference to our neighbouring country. That's why current planning needs specialized (degree holder) manpower to complete the goal. The manpower needed as above can not be prepared immediately in our country. So some (eighteen) seats in KAYA-CHIKITSA, SHALYA-SHALAKYA, BAAL and STREE Roga and Acupuncture are required to the Ayurveda Department and MOH to provide for the scholarship. Ministry of Health has asked to the department of Ayurveda to assess the number of required manpower at Naradevi Hospital as well as in other Ayurveda Health organizations. Considering these events and taking quick steps, Department of Ayurveda if manages for higher study from bachelor level manpower, Ayurveda Hospital will definitely achieve some remarkable speed in its service. If not so, its development will be slower than that in the history. Our system will curse if we can not understand the speed of modern competitive age of advanced technology and information and speed up accordingly. So we must struggle to give a positive direction to this turning history and it's my desire.

Ayurveda: Its Context and Propects In Nepal

Ayurveda is the age old traditional system of medicine of the Indian subcontinent including Nepal. In spite of its antiquity going back to the Vedic period much before the Christian era, it is still in extensive practice and is also an officially recognized system of medicine in Nepal, India and Sri Lanka. It is also claimed that majority of the population in these countries is served by Ayurveda or that its practitioners are the first port of call for the health problems of the population. Emotional appeal for the promotion of Ayurveda is favorite topic in all public forums

of the subcontinent and claims made by its practitioners range from probable to incredible. Its medicines are said to be cheap, without any toxic side effects and capable of radical cure of the diseases not treatable by modern medicine. Further it is often equated with herbal medicines and Nepal being rich in medicinal herbs. Ayurveda is claimed to eminently suitable for this country for utilizing its herbal resources towards self sufficiency in health care. Besides, there is increasing awareness about Ayurveda in the developed countries of the west and Japan for its concepts and as a valuable resource material of knowledge about the medicinal plants used in this system. In various aspects of oriental learning as Yoga, meditation, Zen are becoming more popular in the west than in the countries of their origin.

Today because of communication explosion world has become small an no information or knowledge however obscure it may be, wherever it may be, can remain confined to a particular region or particular people. The dissemination of information is more rapid and universal today than ever before and is further going to increase. Thus if Ayurveda is valid and relevant to Nepal or India it is not going to be limited to these countries only and will be accepted and promoted in other countries of the world. There are infact indications that Ayurveda is going to be more universal in the coming days.
Where as the intellectuals of the undeveloped and developing countries are concentrating or catching up the technological developments of the west, their counterparts in the west are turning their attention to the ancient sciences of the orient hoping to find solutions for the problems of the society created by the technological development. It is realized that capacity to land in the moon surface does not necessarily improve the quality of life, or that unlimited exploitation of the nature ............ Thus while" back to nature " is becoming popular in the developed west, preservation of ecological balance, preservation of environmental pollution are the prime concerns, scant regard or attention is paid to them in the developing countries because of the population pressure, imperatives of existence at eh basic level or else or else because of the irresistible lure of quick returns whatever the means or effects may boon man and nature. This obsession to the western model of modernization and development and aping it may bring about spectacular short tem achievements but long term effects of indiscriminate harnessing natural resources is bound to be detrimental.

Emphasis on the inner quality of life, to live in optimal terms within oneself and without, is the central theme of Ayurveda, which the west having reached almost the limits of objective analysis of man and nature are finding relevant. According to Ayurveda life or life processes is not only a combination of physical and chemical processes but an integral union of physical body with consciousness represented by mind and soul. Similarly health is not only an absence of disease but a state of harmony and equilibrium within oneself and the environment and a state of joy and clarity of our sense faculties, harmony or equilibrium is recurrent theme and also the objectives to be attained in Ayurveda. Whereas harmony is health, disharmony is disease. Therapy in Ayurveda is aimed to bringing back the equilibrium rather than specifically directed towards an organ or an organism, participation of consciousness involving mind and spirit in all life processes of health and diseases is fundamental in the conceptual framework of Ayurveda which is being appreciated now in the west now.

Newtonian model of mechanistic universe was challenged by relativistic model Einstein, now. 'God does not play dice' is being questioned by the 'uncertainty principle' of Heisenberg in the physical sciences 'Objectivity' insisted upon and the sacrosanct creed of modern science may ultimately depend upon the 'observer' and the 'observed' is accepted now Evolution be it from 'Bang' to molecules or from molecules to living protoplasm or from protoplasmic particles to human form is not evolution in the structure of the molecules or composition of protoplasm, but of organization and awareness which in absence of terminology can only be approximated to 'consciousness'. If human beings are most evolved it is not because they different kind of protoplasm than amoebae or better kidneys, liver or other organs of the body but because they have better brains, the seat of consciousness and they have most advanced mental capacity. Whether mind is a product of matter or vice versa may be a subject of debate for scientists and philosophers but mind, consciousness, sprit, soul or whatever name you give it, play a vital role in our life, health and disease is certain, modern medicine has been primarily concerned with the somatic aspects of our body so far. It was hoped that physics and chemistry can explain all our body functions. Valid to an extent it is now apparent that neither life nor health can be measure in terms of sodium, potassium or other chemicals we contain nor by the exact size and shape of our body and organs. Recently modern medicine is taking cognizance of 'Psyche', the day is not very far when it will take into account soma, psyche and sprit as well which according to Ayurveda are integral components of life.

Another aspect of oriental learning including Ayurveda, which is arousing interest is its synthetic, perceptive and experiential mode of comprehending reality. The emphasis of the western thought process so called 'scientific' has been on analysis and objectivity where as our ancient seers were concerned with synthetic experience. Objective details for them were only the means or steps to knowledge and experience of the ultimate not the goal itself. They were aware that analysis could give us the knowledge of the parts, could prepare us for an experience, but can never be the experience itself nor without synthesis we can have a picture of the whole. Knowledge and concepts are necessarily intellectual and rational, but experience can be purely intuitive, never the less a definite reality. No amount of intellectual exercise can substitute for real experience. A professor may write volumes on hydrodynamics, but not know how to swim. It is this fundamental difference in the modern analytical scientific methodology and eastern so called mystical experiential approach which seem contradictory and confusing although both ways one tries to seek the ultimate truth. Reality can not b4e compartmentalized as objective or subjective is becoming evident now. 'Objectivity of modern science is in a way illusion because ultimately it depends upon the subjective perception and ability of different persons to agree upon observed phenomena and processes of thought. Science is ultimately as subjective as all other human knowledge since it resides in the mind and senses of the individuals. It is constrained by the present evolutionary state of man, by the limitations of his senses and even more significant by the power of his reason. All that can be4 claimed for science is that it focuses upon observations about which most human observers agree and proposes concepts that satisfies all requirements of a phenomena and leads to successful predictions.

Ayurvedic philosophical system which form the foundation of Ayurvedic concepts represent the comprehension and understanding of the phenomenal universe encompassing so called ' objective and subjective' sciences of today. Essentially it is a experiential and cognitive or perceptive conceptualization of the phenomenal world and participation of consciousness is primary basis. Reality thus is not objective or subjective but cognitive experiences, either a product of subject- object interaction or transcending them. Consequently objective realities as understand today as well as psychic entities are integral parts of reality. West may not have been converted to this view but there is serous inquisitiveness and inquiry is beyond doubt.

Bedsides these the critical concepts there are other practical considerations which are of interest to the west. Advances made in medicine in recent decades are truly phenomenal. We have now recognized most of microbes causing disease and potent antibiotics to eliminate them. We also have developed more potent means of diagnosis and treatment than ever before. Number of bacterial diseases have been brought under central, but there are several metabolic chronic autoimmune, stress related disease or cancers probably increasing because of environmental changes within or without have defied satisfactory treatment. Modern conventional treatment in a number of theses diseases is also hazardous and uncertain. Western scientists are actively in search of any alternative mode of therapy including Ayurveda, or in the rich herbal repertoire it has. Synthetic chemicals were in vague for some decades for new drugs but now all multinational pharmaceutical companies are again looking into the plant kingdom for new drugs relising the limitations of chemical synthetic approach. Ayurvedic classics mention more than 700 plants of medicinal value besides the use of several hundreds of other plants used by traditional parishioners. Many of these plants used by provide effective drugs is now being recognized . Gugglu is a very common drug used in Ayurveda has been proved to be a good hypocholesteraemic drug used in Ayurveda has been proved to be a good hypocholesteraemic drug. Isolation of reserpine a antihypertensive drug from Rauwolfia serpentina another commonly used Ayurvedic drug is a old story now. There are indications that Tas baccata another plant used in Ayurveda may have anticancer compound. Thus intense enquiry in the plant kingdom has become a part of their activity with leading pharmaceutical concerns. Billions are being invested for the purpose and tons of raw herbs are being consumed from wherever they are. Massive resources available at their disposal it an added advantage to them and it is possible it will make critical difference in the very existence of several species of plants.

May be, because of serious enquiry, genuine benefits or the lure of exotic, it is certain that Ayurveda is no longer limited or specific prerogative of the countries of the Indian subcontinent. There are Ayurvedic societies, institutions in most countries of the west and Japan, increasing number of publications and import of Ayurvedic drug. Ayurveda or Ayurvedic drugs may nit have official approval of the state in these countries, but they are certainly being imported as herbal teas, health foods etc. Ayurvedic scholars are in increasing demand in these countries. Ayurvedic drug companies have set their eyes on this potential market and are extending their operations abroad. Even our nascent Gorkha Ayurveda Company have exported a considerable quantity of herbal Guduchi tea to several countries in the west so much so that this tea is proving to be their main product of sustenance. World Health Organization's support to traditional medicine including Ayurveda has also been a factor in the regard whatever their objectives or methodology may be. Increasing cost of the modern health care is a matter of concern even in the developed country as USA.

With the above background although Ayurveda is gaining recognition at large, there is always a question mark on the rational of promoting Ayurveda amongst the health planners of the underdeveloped countries, because Ayurveda is not 'scientific' and not approved by the reputed medical journals of west. As a result inspite of profuse eulegy Ayurveda receives in these countries in all public forums by politicians, ministers, government officials and well meaning social workers their intentions and public pronouncements are hardly ever translated into implementation and coherent action.
It is true neither antiquity nor extensive practice should be taken as a proof of the validity of Ayurveda nor it should be promoted because it is part of our culture and heritage. Further if Ayurveda can only provide second grade medical care there is no justification for its promotion. Only justification for its promotion should be that Ayurvedic therapy is effective and can answer the problems of today, human life be it in the city or in the village, rich or poor is equally precious and it is not justified to assume that Ayurveda is suitable for villages and poor people or poor countries.

Although it is ridiculous on the part of the Ayurvedists to claim that they can cure all disease on earth or diseases not treatable by modern medicines with all its advancements, it is equally preposterous and unjustified to dismiss Ayurveda as unscientific. If it is assumed the truth is limited to what ancient has proves, it will not only be an afferent to nature itself but also very antithesis of science. Science is not a religious dogma neither it is ever dogmatic, it is basically observation, systemization. Experimentation and verification of facts however bizarre they may be. Enquiry with an open mind is the essence of scientific temper. Mother's milk is the best for the child was not first tested scientifically. Neither we have started eating bread after it was put to scientific scrutiny.

Ayurveda represents a corpus of human knowledge and experience which has been in practice long before modern 'scientific' methodology was evolved. The primary objective should be to see whether Ayurvedic concepts and practices have any factual basis. If it is proved without as shade of doubt that the patients get relief, even if not rationally explained will in due course of time will be explained. It is a medical knowledge that works no matter how scientific its origins is a treasure that can not ignored.

Prospects in Nepal:
Nepal is one of most underdeveloped countries, its per capita income among the lowest in the world. Resources are also limited. There are no known deposits of oil or minerals and its economy is based on mainly agriculture, and trade in the natural products of the hills and the forests of Tarai. Majority of the population being below the poverty line are more concerned with providing themselves with the bare daily necessities of survival and have little time or energy or awareness beyond their immediate requirements. These at the helm of the affairs of the country - who should know, should have had the vision, or wisdom in the long term interest of the country are obsessed with gaining quick popularity and returns for their own survival. Whatever the ground realities may be selling attractive dreams of modernization, development comparable to Switzarland or Singapore, taking the country to 21st century is the popular theme than reminding the population of the hard work and discipline the development process involves. In the field of Ayurveda also we are not short of verbal elequenoe and pious intentions, but how much of it is feasible, practical or every attempted to be implemented is quite another matter. Ad hoc decisions or adhocism has been a rule rather exception. Decisions are taken not on merits of any issue, policy or program but on the immediate returns or benefitser else even on the whims or prejudices of the authorities concerned.

Inspite of all the praises it receives, till late there has never been a consistent policy about Ayurveda in the country. Long term health plan promulgated in BS 2033 has only one sentence for Ayurveda in its objectives "To study the effectiveness of Ayurvedic drugs, to increases their production and to utilize the Ayurvedic manpower in preventive and family planning activities." Some plans and programme were spelled out in subsequent plan periods but with the advent of multiparty democracy government policy after some turns has developed a positive attitude. Organizational set ups, few as they are have little changed either in their status or their functioning for the last several decades. Singha Darbur Vaidya Khana, Nardadevi Ayurvedic hospital and Vidyalaya were established during discredited Rana regime and the Department of Ayurveda was formed in Panchayat period but all of them have little change in comparison to other areas of health and education. Basic reason for this sorry state besides government lack of coherent policy in the past and the poor quality of manpower and infrastructure.
Qualified, competent and trained manpower is a primary prerequisite for any institutional development, formulation, implementation and success of any program as well s the social acceptance or status of any branch of knowledge. No science can survive without the input of competent manpower. Unfortunately Ayurvedic education has received the lowest priority in this country. Although Ayurvedic education has only the technical education provided in this country. Although Ayurvedic education was the only technical education provided in this country even during Rana regime. It was closed with the introduction of New Education plan. Whereas earlier all levels of Ayurvedists were being produced in Naradevi Ayurvdeda Vidyalaya only middle level health of certificate standard were produced after the take over of Vidyalaya as Ayurveda campus by Tribhubhan University since BS 2029. Earlier students were also sent to India for Ayurvedic studies. However ever since these changes it was stopped. As a result not a single graduate in Ayurveda has been produced in this country for the last twenty years and only a about a dozen have been able to complete their graduation-most of them at their own initiative and expenses from India in the last three years. Only two post graduates have come back this year. Production of just twelve gradates in twenty years is indeed a record in the 'promotion of Ayurveda'. Furthermore all admissions in all courses running in the existing Naradevi Ayurvedic Campus have been suspended or stopped since 2049. Thus few as they are there is little hope of any increase of qualified Ayurvedic manpower.

WHO including UNDP have been active in promoting Ayurveda after the Alma Ata declaration of Health for All by 2000 AD. In Nepal they have invested several millions through their projects dealing with primary health care, however the net outcome of these projects has been several visits of short term or long term consultants their voluminous recommendations, holding of workshops and seminars, WHO fellowships for the national to travel abroad, obtaining supplies and equipments most of which have never been put to use because of our incompetency of they were not appropriate. A s0pecific project for Ayurveda has been going on for several years with an annual budget of more than $ 40000. Obviously if our priorities are limited to somehow spend the aid money without any long term policy and programme no amount of external aid will have any results. In Ayurveda lack of infrastructure and trained manpower have been main constraints.

Much is talked about Himalayan herbal wealth. Ultimately resource of Nepal is the Himalayas, its rivers and its flora. Almost all Ayurvedic drugs are based on herbs of which Himalayan herbs are put at a premium. All Ayurvedic drug companies of India claim to prepare their products from 'genuine' Himalayan herbs, have their name as Himalaya drug Company. Quite a number of these companies have a turnover in billions. There is no doubts significant if not all their requirements of raw herbs have its origin in Nepal and their demands are increasing with their expanding trade. It is estimated that the import of Ayurvedic drugs is increasing and has reached to the value of 40 cores. As a corollary export of raw herbs from Nepal must be increasing. It is admitted that herbs beings exploited indiscriminately and exported legally or illegally so much so that numerous species have either become extinct or endangered with the growing interest of multinational drug companies and cosmetic industries. The situation is further going to be deteriorate is certain. Development of Ayurvedic manpower it can not be possible. At present in the absence of any awareness in the population or beaurocracy of their values except making quick money, we are complacently content by passing some laws and establishing some processing plants.

Nepal is also known for fits for its cultural heritage. In fact the tourist industry a major mainstay of Nepalese economy is based on Himalayas and its cultural heritage. Ayurveda is an integral part of this heritage and little people know that old manuscripts of Ayurveda which has been destroyed in India during its long history of foreign rule are still available here in the National Archives or in the private homes. They may be just relics of our past glory about which we, obsessed with 'Modern', many not be interested are valuable resource material of medical knowledge and it is the western scholars who are seeking them out. Kashyapa Samhita published for Indai and Siddha Sara Sangraha recently published from Europe were based on the manuscripts of our National Achieves. There are certainly many more which are yet to see light of the day. We may not be able or interested to publish them but even we prevent them being destroyed or being sold as trinkets in markets of Basantpur or Themal to tourists, we will be doing a great favor to mankind in general.

The purpose of this tresentatun will be served if it is bought home that Ayurveda has a potential and future perse in the universal context or in the developed countries with or without out efforts. Therefore instead of spreading volumes of eulogy of promoting Ayurveda or saving it, it will be better and more rational if we can make a coherent plan and programmes if this country concentrate on creating compent manpower in Ayurveda there is some hope of preserving out natural as well as cultural resources.

Traditional Chinese Medicine and popular Herbs in Thiland

Traditional Chinese Medicine is a medical system developed from the experience of Chinese people over thousand of year in their struggle against diseases. It is developed as early as 4000 yrs ago. The essential characteristics of Traditional Chinese medicines are concept of wholism and treatment determination based on syndrome differentiation.

Traditional Chinese medicine recognizes two key elements to health and well being. The flow of vital energy known as qi and the basic harmony between the forces of yin and yang in the body. The ancient Chinese believed that 'They are born with a certain amount of qi the dynamic force that animates us and our lives. The qi is universal; it exists and manifests itself all throughout nature. The energy is capture (Primarily through the foods we eat and the air we breathe) and circulated in our bodies through invisible channels called meridians. The qi flows form one meridian into the other and is seen as body movements. The body may also store some of the energy for future use. The amount and quality of this life force is determined by heredity but is influenced by the way we liver our lives. We add to our eating the right food, supporting it with proper exercise and breathing clean air. On the other hand, we can deplete our qi by inappropriate habits and life styles. The stresses and excesses that can block the flow of qi are: the six excesses: wind, cold, heat dampness, dryness and fire; The seven moods; joy, anger, anxiety, obsession, fear, horror, and sorrow, intemperance in eating and drinking, too little or too much sexual activity: too little or too much exercise, work and contemplation. Energy varies not only in quantity but also in quality. For everything in the universe contains within itself. The seed of its opposite and everything is governed by the opposite yet complimentary forces of yin and yang. These two principles of nature define each other and constantly transform into the other in a mutually controlling and mutually dependent interplay which is the very force of all life. Yin is nurturing, feminine and dark, cool, quiet and passive like the night, Yang is motivating, masculine and bright, warm, noisy and active like the day. Yin and yang coexist in a fluctuating harmony, one flowing into the other as night into day into night. In traditional Chinese medicine, therefore, illness is an energy imbalance, and excess or deficiency in the elemental energies, the qi in the body. Death is the absence of total depletion of this energy. Illness also results when the basic harmony between the forces of yin and yang is distributed. Our health is a reflection of our relationship to these universal energies and the natural elements of life. From a philosophy of nature, traditional Chinese medicine has evolved into a complex system of examination and diagnosis of health and diseases. Its courses of treatment include herbal preparations, food therapy, breathing and physical exercises, massage (Tuina manupulation) as well as Acupressure, Acupuncture, Moxibuston and Cupping therapy. Basically traditional Chinese medicine is preventive and health promotive medicine using a wholistic approach to health.

In Thailand, practise of herbal medicine is widely using as preventive, promotive, curative as well as in food products. BAY-sweet Laurus nobilis, CATNIP- Nepeta cataria, BUABUK (Cenetella asiatsica), Pennywort, CHA-PLU (Piper sarmentosum) as expectorant and carminative, CURRY (helichrysum angustifolium), GUICHAI ( Allium tuberosum), GANG DANG/GANG KHEO (Whan) in soap, GA-PRAO (Ocimum sanctum) as carminative, antidiarrhoeal, antihelmetic, HORAPAH (Ocimim basilium) as antispasodic useful in gastritis, indigestion and constipation, KHAMI KHAO (Curcuma petiolata) as antidiarrhoeal, antiemetic and antipyretic, KHA ( Languas galanga) in anorexia and indigestion, LEMONBALM (Melissa officinalis) as aromatic and cosmetic, LAMB'S EAR (Stachys) byzatina) as herbal art, MARJORAM (Sweet Origanum marjorna) as aromatic, cosmetic and decorative, MANGLUK (Ocimum basilicum) as laxative and carminative, MERIGOLD MINT/TEX. As (Tagetes lucidia) as culinary, medicinal and ornamental, carminative, antiflatulent and locally application in headache and sprain. PAKSHEE (coriandrum sativum) as aromatic, decorative & medicinal value, OREGANO (Origanum) as health food item, PRIKKEENOOH (calsicum fritescens) Thai pepper as expectorant, antihelmenthics, carminative, counter-irritant and antipyretic, PINEAPPLE SAGE (Saliva elegan rutilans) as decorative and culinary, ROSEMARY (Rosemerinus officinalis) as aromatic, cosmetics, culinary, decorative and medical value mixed with soap and perfumes, SORREL (Rumwl acetosa) as food items, TOEY (Pandanus) as aromatic leaves, TAKRAI (Lemon grass, Cymbopogon citratus) as carminative, diuretic, THYME (Thymus vulgaris) as antiseptic, TUM-LEUNG (Coccinia grandis) locally use as antipyretic, anti-inflamatory and antidiabetic, MAKUE (Thai egg plant) using in the Thai curry and dishes etc. Specially in Thailand, herbal medicines are popular for health food, drink and in cosmetic items. In Thailand, traditional medicine specially herbal medicine is practising since ancient period.

Situation of Ayurveda in Nepal

The first health service organization and medical institution established in the country were Ayurveda Hospital and Ayurveda College, respectively. Now the country has dozens of modern hospitals and teaching institutions related to medicine. However, the central level Ayurveda hospital is the only one institution of its kind that has produced hundreds of graduates since its establishment in 1933.



It is believed that several kinds of treatments - some of which are still beyond the scope of modern science - are possible in Ayurveda for a healthy life. Unfortunately, our Ayurvedic health organizations are remembered only for certain common ailments. Besides, Nepali Ayurvedic Doctors (local products) suffer from a trememndous identity crisis. They are not even eligible to do MD in India since none of the University has recognized the Ayurveda College.

There has not been much development of Ayurvedic science for long.. Although ayurvedic science has tremendous potentials, no clinical researches have been conducted in this regard. Most of the ethno-botanical researches, researches on indigenous knowledge etc are conducted by either botanist or anthropologist. For the sake of development of the Ayurvedic science and procurement of efficient manpower, Ayurveda Health Policy (AHP) has emphasized the establishment of specific institutions. It has proposed the establishment of a National Ayurveda Study Center for quality service, management of manpower, research on Ayurveda and resource management etc. However even after a decade of policy promulgation, there has been no significant progress in this regard.
The county has only one central level Ayurveda hospital in Kathmandu with 100 beds and one regional hospital with 30 beds in Dang. Besides this, 14 zonal Ayurveda Ausadhalaya, 55 District Ayurveda Health Center and 216 Ayurveda Ausadhalaya (dispensaries) are in operation.. There is no significant difference between Zonal Ayurveda Aushadhalaya and District Ayurveda Health Center. Humla, Mugu, Dolpa, Rukum and Kalikot have only one state-run Ayurveda Ausadhalaya. Similarly, eighteen districts (almost of remote region) have only two and sixteen have three Ausadhalaya.

Besides Ayurveda College, seven institutions (under Nepal Sanskrit University/former Mahendra Sankrit University) that produce certificate level (or equivalent) technicians and three institutions (under CTEVT) for 15-month-training program are running legally. Out of eleven educational institutions, seven are in Eastern Region; one doctor-level (BAMS) college is in Kathmandu, two (AHA level) in Western region, and two in Mid-Western (both are in Dang) but not in Far-Western region. Ayurveda education is wide spread in Eastern part comparatively in Western part of the nation. People of Western region have no easy access to Ayurvedic science.

If we do study on the number of Ayurveda technicians based on their birth place, thirty-one districts have no Ayurvedic Doctors, twenty-five districts have no AHA (Ayurveda Health Assistant), and thirty-three districts have no AHW (Ayurveda Health Worker). Baitadi, Achham, Dolpa, Kalikot, Jumla, Humla, Jajarkot, Manag, Rasuwa, Tehrathum, Dhankuta and Taplejung districts have no Ayurvedic technicians. Panchthar, Sindhupalchok, Sankhuwashava and Bajura districts have only one AHW and no Doctors and AHA.

Darchula, Dadeldhura, Dailekh, Bardia, Rolpa and Ramechhap districts have only some AHA (maximum 4) and no Doctors and AHW. Makawanpur has only one Doctor and no AHA and AHW. Sad to say, Mahakali and Karnali Zones have no Ayurvedic Doctors. Among the five districts of Karnali Zone, only Mugu District has one AHA and one AHW. Janakpur is the richest in Ayurvedic technicians while Karnali is the poorest zone to have Ayurveda technicians including all levels. Similarly, nearly 49% of total Ayurvedic technicians are from Central Development Region and Far-Western Region represents just about 0.012%.

Those areas which are rich in medicinal plants have neither adequate Ayurvedic research institutions nor health centers. The regions, which are famous for valuable medicinal and aromatic plants are devoid of trained Ayurvedic technicians to use locally available resources. Transferring skills to the locals and helping them use their own local resources is the only way to improve the health status and the socio-economic status of the community people.

Ayurveda dispensaries are significantly increasing in the country but effectiveness of the service is yet to be improved. Centralized system of drug distribution, insufficient budget for drugs and poor-performance of the employees are hindering the effectiveness of the health service. Higher and middle level officers seldom attend offices in remote areas and in most cases, there are no adequate drugs to distribute.

To sum up, excessive reliance on modern medicine is not an adequate way to improve the health status of people - especially in developing countries. Therefore, the state should integrate traditional medicine into national health system and work towards the development of Ayurvedic sector in the remote areas that are rich in natural resources.

Discovering Cordyceps sinensis in Ayurveda

Cordyceps sinensis, locally known as Yarsagumba in Nepali is found in alpine meadows of Himalaya above 3600m from the sea level. Yarsagumba develops when a type of fungus parasites the larvae of a moth and forms a fungus composite body. The larva forms a cocoon in the winter and hibernates in the ground. Because the fruiting body of the fungus emerges from the head of the larva in the summer trembling a grass sprout, it's local name means roughly Yarsa(winter bug) and gumba(summer grass).

This plant is mainly used to treat low energy following serious illness and as a strengthening tonic. It resembles all the properties of Rasayana and Vajikarana dravyas mentioned in Ayurveda. It's medicinal value is rooted in Tibetan indigenous medicine and at present is traded at the rate of about $4,000 per kg. Though Himalaya has always been the best place for qualitative herbs, there is not any clear proof of the ancient Ayurvedic literatures mentioning about it. However, one cannot deny the possibility of this drug being used in past with name other than it possesses today. Though it needs a lot of research and authenticity, this paper attempts to provide an Ayurvedic lens to this unique and important natural gift.

Keywords:
Yarsagumba, Rasayana, Vajikarana dravya, Yarsagumba collection


Introduction

Botanical Classification:
Kingdom: Fungi
Phylum: Ascomycota
Subphylum: Ascomycotina
Class: Ascomycetes/ Pyrenomycetes
Order: Hypocreales/ Clavicipitales
Family: Clavipripataceae
Genus: Cordyceps
Species: Cordyceps sinensis(Brek.) Sacc.


Vernaculars:
Nepali: Yarsagumba, Jeebanbuti, Sanjivani, Kiraghans
Tibetian: Yarchakunbu
Chinese: Dong chong xia cao
Japanese: Tochukaso


Description of name:
In Tibetan, it is called Yarchakunbu, which literally means 'Yar' for rain; 'Cha' for plant; 'Kun' for winter; and 'Bu' for insect. So, the literal meaning of Yarchakunbu becomes summer plant winter insect.
Tibetan people consider it as a 'Bu', which means living insect. In Buddhism, the collection of 'Bu' is considered as a sin act, which may be the reason of Yarsagumba being protected in the Himalayas for thousands of years.
The botanical name of Yarsagumba comes from a latin word 'Cord'and 'Ceps' which mean club and head respectively. So, the meaning derived from its Latin name is an insect with its head in a horse's tail like body. (NEHHPA 2006)

Biological Description of Cordyceps sinensis:

Habit and habitat:
Cordyceps sinensis is a caterpillar larva of an insect parasitizing fungus of the Hypocreaceae family, found at alpine meadows above 3600 m from the sea level. This fungus lives primarily in the larvae of one particular species of moth, Hepialus armoricanus. It is found that this larva is a voracious eater of leaves of plant Bistorta macrophylla. It is occasionally found growing on other moth species as well.

Morphology:
It is 5-15 cm long and 0.14 to 0.4 cm thick and resembles a caterpillar in shape and colour. It has a black or brown stem about 2-5cm long. Based on colour, it has 2 types. The whitish yellow is larger and good in quality. The other type is of copper colour and is smaller as well as qualitatively compromised.
There are 310 types of fungus of this genus but three of them are found to have medicinal value. Among these three, the Cordyceps sinensis is found to have the best quality.
Two other species of Cordyceps that are used as medicines are Cordyceps millitaris and Cordyceps barnesii, found in Korea.

Historical Background of Cordyceps sinensis:
Cordyceps sinensis, known to the Chinese as "DongChongXiaCao" and to the Japanese as "Tochukaso" has been used in medicine for a very long time. The first known written record of this herbal medicine was in the Ben-Cao-Cong-Xin (New Compilation of Materia Medica) by the author Wu-Yiluo. Written around the year 1757 AD during the Qing Dynasty, this early medical text lists the traditional usage of Cordyceps as a "Lung Protectorate", for "Kidney Improvement" and as a "Yin/Yang double invigorant". (Holliday et al.)
However, in Ayurveda there isn't any documented proof of this product being used as the same name. But it is believed that the 'Sanjivani' brought by Hanumaan from the Himalayas in Ramayana is the same plant which was used for Lakshman.
During the 13th century, Ming Dynasty from China popularized the use of Yarsagumba collected from the Himalayan belt, most probably Nepal. They used to give a big surprise award to those who used to take pains to bring Yarsagumba from Nepal (Rawal). The vegetable worm first became widely publicized during the 1994 Asian Games in Hiroshima, when two female Chinese athletes,and attributed their display of phenomenal power and beat the world records for 1,500, 3000 and 10,000 meters. Later it was learned that they used it at the recommendation of their coach, which has been known for 2,000 years as a folk medicine that gives immense power and lengthen life (Rawal and Wikipedia).

Nepal and Yarsagumba :

Distribution of Yarsagumba in Nepal
Located at central part of the great Himalayan range, Nepal provides habitat to wider varieties of flora and fauna. These floras contain many west Himalayan elements and that of east Himalaya too, with many Sino-Japanese elements. Northern part of Nepal provides habitat to the plants of the Tibetan plateau, especially in the trans-Himalayan regions (Bhattrai N. 1989-1993). Over 1,000 species of Himalayan plants have been discovered and described from the Nepalese Flora (Bajracharya et al., 1988). Some 370 plant species are endemic to Nepal (Joshi and Joshi, 1991) of which 252 are found in high altitude (Bajracharya et al., 1988). Amongst these Cordyceps sinensis has received higher attention these days. In Nepal Polunin and Williams first collected it in 1952 from Chakure Lek of Jumla district (NEHHPA 2006). Dolpa district is one of the major areas producing Yarsagumba in Nepal. Besides, it is also found in many other places like Darchula, Humla, Lamjung, Bajura, Bajhang, Mugu, Jumla, Gorkha and Rasuwa (Gyawali 2006).

Collection:
This product is collected during the spring and early summer when the snow melts and fungus sprouts out on the hills (Gyawali 2006). Crowd of thousand of local people gather in Nepal Himalaya's alpine meadows in the season.


Cultivation of Cordyceps sinensis:
Since native Cordyceps (wild Cordyceps sinensis) is rare and very expensive, countries like China and Korea have been investing a great effort in research for cultivation of this fungus. However, the exact method of cultivation of this fungus has not still known in Nepal. Some individuals and business organization are working on in this aspect. In 1982, Institute of Materia Medica, Chinese Academy of Medical Sciences isolated the commercial strains of Cordyceps for the first time. This strain named CS-4 was fermented in aseptic environment to develop a mycelium, which underwent extensive human testing, and clinical trials during the 1980's. In this way, commercial production of Yarsagumba begun from China in the name of JinShuiBao capsules. A wide range of population was encouraged to use it as a clinical trial in order to establish its chemical composition, therapeutic activity, toxicity and many other facts. (Bau, 1995)

Rasayana in Ayurveda :
Acharya Dalhana says
Bhesajashritaanam rasaviryavipaakaprabhavaparamaayurbalaviryaanaam vaya sthyairyakaranaamayanam laabhaopaayo rasaayanam Su. Su. 1/15

Those dravyas, which are capable of utilizing all the rasas, gunas, virya, vipaak and prabhava to strengthen the body and develop immune mechanism increasing the lifespan, are known as Rasayana. Rasayanas increase a healthy person's mental and physical capabilities. Rasayanas or vitalizers replenish the vital fluids of our body, thus keeping us away from diseases. Rasayana is actually that which increases the essence of each dhatu, starting with rasa. Literally, Rasayana is a sanskrit word comprising of Rasa & Ayana.
Rasa means the nutrient portion derived after the proper digestion of the food and Ayana means proper chanalisation of such nutrients. Hence Rasayana therapy provides good nutrition to different tissues of our body and maintains health leading to long healthy lifespan. It can be effectively used in treating geriatric disorder as they are also known as vayasthapak.
Various merits of Rasayana therapy have been highlighted in the texts of Ayurveda as Charaka has mentioned in the following shloka

Dirghamaayu smritimedhamaarogyam tarunam vaya.
Prabha warna swaraudaaryam dehendriyam balam param.
Waaksiddhimpranatimkaantilavate na rasayaanat
Labho paayo hi sastaanaam rasaadinaam rasayanam. Ch. Chi. 1/8
Dirghamaayu (Long life).
Smritimedha (Memory and intelligence)
Arogya (Good health)
Tarunam vaya. (Youthful age)
Prabha varna. (Glowing skin)
Sworaudaaryam. (Modulated voice)
Dehendriya balam param (Optimum strength of physique and sense organs)

However the Rasayana dravyas are considered useful as remedies of various ailments especially the Auto-immune conditions and other psychosomatic disorders.

It is also said as:

Rasayanancha tajjgeyam yajjaravyadhinaashanam. Ch. Chi. 1/5

Hence, Rasayanas deal with the methods to maintain youth, increase longevity, intellectual capacity and strength and keep the patients free from diseases.


Vajikarana in Ayurveda :
Vaaja is the word synonymus to Vega of Sukra (semen). Person with vaaja is called Vaaji and lacking it is called Avaaji. So, vajikarana is the process of changing an avaaji purush to a vaaji purush. As per some definitions those dravays which enables a male to enjoy sex for a longer time are known as vajikarana dravya.
Vajikarana is defined as

Yena naarisusamarthyam vaajiballavate nara.
Brajechhavyadikam yena vaajikaranameva tatt.Ch. Chi. 2/4/51
Vajikarana in Ayurveda explains the art of producing healthy progeny for the creation of a better society. Vajikarana therapy is recommended to treat various diseases like infertility and conditions relating to weak shukra dhatu resulting in male impotence (napunsakata). Ayurveda has laid much importance on a male's potency. Charaka states the use of aphrodisiacs as mentioned in ayurvedic therapies (Vajikarana therapies) enhances one's potency. These medicines are said to give one the strength and potency of a horse by increasing the quantity and quality of semen. It helps increase the will power, intellect and memory in addition to a healthy body. Shukra dhatu is the final product of all the dhatus and a precursor of Oja, the immunity of the body also known as the eighth dhatu. Hence, vajikarana dravyas help people to renew the sukra dhatu ultimately strengthening the immune system. For this purpose various aphrodisiacs and tonic preparations are prescribed for enhancing the vigor and reproductive capabilities of men. These not only serve as sukrabardhak(precursor of sukra) but also strengthen other dhatus like Rakta, Mamsha, Meda and Asthi. They are said to increase quantity and quality of semen, sperm count and sperm motility and nourish the body of the person.


Pharmacology:
Important components of Cordyceps sinensis
Sn Component Unit Value
1 D-mannitol mg/g 76.81
2 Polysaccharide % 11.2
3 Protein % 25.44
4 Viatamin A mg/g 0.315
5 Viatamin B12 mg/g 0.02
6 Zinc Ppm/g 13.9
7 Copper Ppm/g 2.8



Source: China Science Institute Shimyang Edible Center




Chemical composition of Cordyceps sinensis


S.N. Component Unit
1. Water 10.84%
2. Fat 8.4%
3. Coarse protein 25.32%
4. Coarse fiber 18.53%
5. Carbohydrate 28.9%


There are a number of components like deoxy-nucleosides produced by Cordyceps sinensis, such as the compounds 2', 3' deoxyadenosine which is marketed in the United States as a drug for the treatment of AIDS under the trade name "Didanosine" (Holliday et al.). Similarly Quinic acid derived from Cordycepin (3' deoxyadenosine) present in Cordyceps is found to have anti viral and antibacterial property (NEHHPA 2006).
Medicinal value of Cordyceps sinensis:
Traditional Chinese Medicine (TCM) suggests use of Cordyceps sinensis by cooking the whole fruit body in chicken or duck soup. People use it this way for the treatment of many conditions, such as respiratory diseases, renal dysfunction, hyperlipidemia and hyperglycemia.(Zhou, Halpern and Jones, 1998). Clinical research has shown 'Yarsagumba' to be very effective in treatment of Arrhythmia, Chronic kidney failures and hypercholesteraemia. It helps to strengthen the immune system of patients receiving chemotherapy, Anti tubercular drugs and various surgeries. The Host Defence Potentiators (HDP) present in Yarsagumba defends the host (patient) from foreign invasion by bacteria, cancer cells, and virus and thereby boosts the immunity. It also stimulates the hormone production giving it an anti aging property. (Rawal). Researches show that it may be useful in the treatment of cardiac arrhythmia, angina pectoris, liver disease, and even cancer. It is a building block for gene repair in cell replication and plays an important role in ATP metabolism.


Mode of use varies from place to place
In Nepal Yarsagumba is believed to act as an aphrodisiac and as a tonic when 1-3 pieces are taken regularly mixed with either milk or Shilajatu.
Balfour-Browne (1955) mentioned that Bhutanese use it for impotence caused by typhoid and other permanent diseases (Rawal).
Chinese believe that it boosts Yang, strengthens kidneys, reduces phlegm, and stops bleeding (Holliday et al.)
Including Holiday et al, many literatures have been found to be describing Yarsagumba for following uses.


Hriddya (Cardiac Tonic)
It has been found to have good effects in various Hriadaya rogas (Cardiac diseases). Studies have shown that over 84% of the patients with Hridaya roga esp. cardiac arrhythmia improved following treatment with Yarsagumba.

Raktasodhak(Blood purifier)
Yarsagumba reduces the amount of LDL Cholesterol and increases the amount of HDL Cholesterol thus thereby works as a blood purifier. It is found to have lowered total cholesterol levels by over 17% in a clincal trial.

Yakrit Balya (Liver Tonic)
Yarsagumba is found capable of curing some liver diseases. Clinical trials have shown that treatment with Yarsagumba improved symptoms of liver cirrhosis following hepatitis. The extract of Yarsagumba is considered to relax contractions in the liver blood vessel system and to increase hepatic blood flow, causing liver ATP levels to increase. Such hepatic ATP augmentation may contribute to the acceleration of recovery and improvement of liver function in patients with anaemia.(Manabe et al. 1999)

Used in Vrikka roga (Kidney Diseases)
In TCM Yarsagumba's main use is in the treatment of Kidney disorders. It is believed that it improves kidney function. In kidney transplanted patients it was shown to return levels of infection fighting T cells to normal.

Balakarak (Strengethening tonic)
Cordyceps Sinensis is an excellent strengthening tonic for convalescing patients, and patients with reduced appetite, weak blood, weakened resistance of respiratory tract and susceptibility to colds or flu can take this product orally to strengthen resistance. Cordyceps has an ancient reputation as an effective sex stimulant for male. At present day, this property has made it so expensive and important. It has been termed as 'Himalayan Viagra' or 'Herbal viagra' by the western world nowadays.

Used in Swas roga (Respiratory Disorders)
A preliminary study found that middle aged and elderly patients who took Cordyceps for COPD showed notable improvements. During it's intake by the patients with respiratory disorders it has found to improve coughing, reduction in quantity of sputum, and gradual decrease in shortness of breath. I has also good results in curing prolonged chronic bronchitis (both asthmatic and ordinary type), particularly ordinary type.

Ojobardhak (Immunomodulator)
Yarsagumba appears to be one of the most adaptive immune modulators. The mushroom was found to quiet immune cells in patient with abnormally overactive immune systems, and to raise immune system functions in patients with low or compromised immunological activity. These include a cure for tuberculosis and a restorative action after various diseases (Chatterjee et al. 1957)


Adverse effects:
This medicine may cause the following reactions to the user allergic to it
Breathing problems or tightness chest; chest pain, skin rashes, itchy or swollen skin.
Studies have shown following two major side effects in some cases:
Low blood sugar (hypoglycemia) and upset stomach and dry mouth (Halpern GM et. al 1998)


Economic value:
From Nepal, Yarsagumba is mostly illegally traded to China or Tibet in bulk quantity of 3-5 tons per year worth NRs. 1-1.5 billion. Its price varies from NRs 140,000 to 3, 00,000 per kg in Nepal. In 2004, only two villages (Majhphal and Sun) of Dolpa district in Nepal sold around 600kg of Yarsagumba, most to Tibet. It is estimated that 1 kg of Yarsagumba contains 2,700-4,500 pieces. Government's rate of royalty is NRs. 10,000 per kg. In addition, Maoist rebels collect tax of NRs 5,000 to NRs 27,000 per Kg (Gyawali 2006). Local people of Himalaya are much dependent on this resource, more economically than medicinally.

Conclusion
The Ayurvedic medicine is rich in natural herbs and the rejuvenator group of herbs termed as ' Rasayana ' has micronutrients, which improve health, immunity, vigor, vitality, and give longevity as well as protection against stress. All these actions of certain Rasayana dravyas have now been scientifically proved through experimental as well as clinical studies. Rasayana dravyas prevent the process of aging and keep the individual free from disease even at an advanced age. In this context, we need to introduce a new Rasayana dravya, Yarsagumba, in Ayurveda. Like all the other Rasayana formulations eg. Chyavanaprasha, Triphala rasayana, Pippali rasayana , Shilajatu , Haritaki rasayana,etc. Yarsagumba Rasayana is too serving the people in many aspects. In addition to enriching Ayurveda with a new ingredient, local economy will be improved ensuring sustainable incomes to poor peoples of Himalayas. Thus, it becomes the responsibility of entire Ayurveda world to encourage its use and help people lead a healthier and happier life without itself being destroyed.


References:

Bajracharya, D.M., Joshi, R.M., Rajbhandari, K.R., Shakya, P.R. & Shrestha, T.B. 1988: Endemism in Nepal flora. In: Proceedings of the National Conference on Science and Technology. Kathmandu, Nepal; Royal Nepal Academy of Science and Technology. pp. 73-76

Balfour-Browne(1955): Citation made from unpublished article "Nepal's Pride Yarsagumba" by Dr. Rana B. Rawal

Bau TT, 1995. Further Study of Pharmacological Functions of JinShuiBao. Journal of Administartion Traditional Chinese Med 1995;5 (suupl):6

Bhattrai N. 1989-1993: Articles on Regional Aspects of Medicinal Plants Use, Biodiversity - People Interface in Nepal

Charaka Samhita

China Science Institute Shimyang Edible Center: Citation made from unpublished article "Nepal's Pride Yarsagumba" by Dr. Rana B. Rawal Gyawali 2006: Article titled "Himali Money - Yarsagumba", Himal Magizine, Issue 174, July 2006

Halpern GM, Zhu JS, & Jones K: The scientific rediscovery of a precious ancient chinese herbal regime: Cordyceps sinensis, part II. J Alt Complement Med 1998; 4(4):429-457.

John C. Holliday, Phillip Cleaver, Megan Loomis, Dinesh Patel: The hybridization of Cordyceps sinensis strains and the modifications of their culture parameters, in order to optimize the production of target medicinal compounds

Ayurveda And Nepal

How long is the relation of Ayurveda & Nepal?
The relation of Nepal & Ayurveda is as long as the 'Rig-Veda' which is the eldest book of this subcontinent. The proofs of this fact are ' Rig-Veda' & the ancient book of Ayurveda themselves. In 'Regveda' the founder of Ayurveda i.e. Ashwini Kumar, Bhardwag, Aatraya etc are stated in many places and since the date they had their intimacy to Nepal. Ayurveda itself is related to Rigveda. In Charak Samhita, which is a famous ancient book of Ayurveda, it is motioned that for the search & development of Ayurveda there held a conference on the side of Himalaya where different famous ancient Seer were present. ( Sutrasthan 6-13).

Ashwin kumar, Bhardwaj, Astraya etc were present in that conference. Not only this, the above statement of Charak Samhita also declares that the persons famous in Regveda like Bashista, Bishwamitra, Gautam, Agastya etc were also participated that search conference.

These two facts prove that the relation of Nepal & Ayurveda dated at least 4,000 years back. Furthermore, these two statements also prove that the foundation, search & development of Ayurveda were started on this Himalayan belt.

In Vedic literature and ancient religious books like 'Purans', the region of present Nepal was called Himalayan region or 'Himwat Khanda'. Since that time, Himal, Ayiurveda, and Nepal has been related strongly to one another.

The continuation of this tradition:
The relation from Rigveada era & its continuation in also proved by the descriptions of the Buddha & the Kaytilya. The deported ancestors of Buddha by a North Indian King Okkar came and settled down on northern side of the Kapilvastu, before many generation of Buddha's time. This is a famous story on history. Among these deported, the eldest daughter named Piya ( Amrita) was suffered from leprosy. At the same time, a king of Kashi was also suffered form this disease and handed over his duty to his son & went to the isolated areas of Kapilvastu. Both of these were cured of the diseases by a herbal medicine 'Kol'. Both became healthy & beautiful; they got married. They cut down the jungle of Kol and cultivated the area. The offspring were become famous as "Kolia Kabila". (Aarthakatha: Mahakavi Buddhaghosh).

Gautam Buddha himself was a reputed doctor of Ayurveda. There are many descriptions found that wherever he went he treated the patients by the local herbal medicine.

'Kautilya Arthasastra' of third century B.C. also describes the herbal remedies that had been imported to India through Nepal. In third century BC, the Jain Sage Bhadrabahu also came to Nepal for Yoga in the cave on the side of Himalya and he used his efficiency in researching herbal medicines. At that time, about 500 Sages and other personnel of Jain society came to Nepal and they carried off a number of medicines that had been founded out by Bhadrabahu. This is a famous story of Jain literature.

That tradition of Ayurveda medicine has been going on in Nepal. There are many proofs that the system was quite famous in Malla & Lichhibi era of Nepalese history. The history of Shimhadurbar Vaidhyakhana extends back to King Pratap Malla (1642-75 AD) of Malla Era. This system of tradition has been extended to many generations till now.


The 'Chandra Nighantu' that covers the wide range of Ayurveda knowledge in its large 10 texts- present in Shimhadurbar Vaidhyakhana today- is also a milestone to explain the depth and longevity of the relation of Nepal to Ayurveda.


Ayurveda is not only a 'knowledgeable resource' but also an 'economic resource'.
The reason why Nepalese people are under poverty and why should they go to the foreign country for their livings is due to their inability to develop their traditional knowledge given by their ancestors and inability to utilize their valuable resources. Agriculture, water resources, tourism, minerals etc are the possibilities of Nepal to its development. But there is a need of modernized knowledge, research and a much stronger economy for their development. But, a notifiable fact is that, we have Ayurveda, herbal plants and the medicine system based on long practised since thousand of years with more than thousand years study, use and experiment. With the best efforts of government, industrialists and concerned experts, we can develop it worldwide with lesser investment and shorter time duration.

Our water resources are mainly related to Nepal, India and Bangladesh. Though we can export our drinking water to many other countries, hydro-electricity can be distributed not more than that of India, China, Bangladesh and Pakistan. Tourism, in fact, is a business from exterior. There is lack of mineral resources so as to develop and export them worldwide. In addition Agricultural and veterinary resources to export in significant amount are also impracticable in Nepal. So the resource that is present in large amount and will never finish exporting worldwide even in future generation is the knowledge of Ayurveda and herbal medicine.

Though Nepal is a small country, it is a motherland of different people of different cast, tradition, religion etc. it is also rich in geographical diversity. It has extending from east to west, Himalayas, Mahabharata range, Cure range and Terai with diversified climate and soil. So, it possesses wide variety of knowledge and practice regarding herbal medicine. The various branches of Arya, Mongol, Astrick (Nigro) and Dravid roots comprising various casts, sub-casts etc are in Nepal from all four continents of the world. Moreover, all these varieties of human population have gathered a significant amount of knowledge about herbal medicine and related therapy in Nepal. It will be very difficult not to meet a person in any corner of Nepal who can not say a herbal medicine and a disease that can be cured by that herb. There are still thousands of traditional 'Vaidhya' and 'Aamchi' in Nepal who can recognize thirty/fifty or more herbal remedies and some diseases they can cure.

Nepalese People have more knowledge than the classical Ayurveda Textbooks.
After visiting the different 'Vaidyas' in different parts of the country, it seemed that the traditional 'Vaidyas' are being using and practicing more herbs than those text books of Ayurveda.

The knowledge acquired by the research, use and thousands of years practice after the origin of classical books of Ayurveda; if used collectively with wide research, will seem to be a praiseworthy contribution for the development of Ayurveda in Nepal.

If we enter into the world market by analyzing and relating with modern technology, manufacturing and management, it will be the largest industrial region for Nepal and will raise its glory like Mount Everest.

Why to use expensive Treatment system.
Any person who is suffering form chronic sinusitis or Gastritis has to go hospital, nursing home or private clinics for many tests and findings for months or years and spending thousands of rupees. Moreover, he has to take many dangerous medicines for months, years or more. Nowadays, the Allopathic treatment system is so expensive that one has to sell his buffalo or ox or a peice of land to be cured of his disease. But, on the other hand, thousands of valuable herbs are being wasting everyday, every season. They germinate, grow up, dry off and decay every year. If we go to the green jungle and look around our hundred steps, there will be definitely 20-30 herbs.

I have got some opportunities while on journey form Kathmandu to Narayanghat to share my knowledge about medicinal herbs present on the side of the road on traffic jam. If you have got an opportunity to walk with Late Narahari Nath, he would have identified you more or less hundred medicinal herbs within one kilometer range.

There are many herbs capable of curing any kind of disease in our country. It is obvious that proper treatment of the diseases like Cancer, AIDS etc and those need surgery in not possible by this traditional knowledge but almost 90% of diseases can be cured by the doctors or practitioner of Ayurveda with the locally available, fresh, cheap and affordable medicinal herbs present here and there in our country. If the government pays some special attention and support; University, Ayurveda Hospital, Ayurveda doctors and traditional practitioner develop a champion for the development of Ayurveda, 50,000 trained middle health manpower can be prepared. There will be 12 herbalists for each Village Development Committee. They will grow herbs in their own farm and will collect herbs form their own forest. People will take advantage of the fresh, cheap and locally available herbs in any ailment; furthermore, they can cultivate the herbs in large amount to export internationally.

How much to increase foreign debt?
Nepal, at present, is spending billions of rupees to import expensive allopathic medicine and much expensive equipments and technology. In addition, billion of rupees need to prepare such manpower and the ratio of expenditure in increasing yearly. The foreign debt is also piled up day by day. It is obvious that for the diseases that can not be cured by our own technology and manpower (e.g. Incurable by our own treatment system, those that need complicated surgical procedure etc.), for the study, research, and experiments of severe disease; investment must be done by the country. In spite of the possibilities of production of affordable, locally available medicine by our own technology by our own manpower, our master-plan gives emphasis only on the expensive exported system. They not only ignore all these possibilities, but also say "Ayurveda is a bullock-cart and Allopathy is a rocket". This quotation is not said by other than so called reputed health minister of our country. It is the sentence of evaluation; how farsighted is our leadership?

They not only ignore the manpower that are serving the nation with their full effort by local herbs but also ignore the production of qualitative Ayurveda exports and establishment of industrialize plants relating Ayurveda. Theses all are in the opposite of welfare of both nation and people. This creates a vast gap between wealthy and poor people; this type of policy, on one hand provides the service only for the 'well-to-do' and expels the poor for death and on other hand forces the nation to submerge the lake of debt. That is why changes should be done in the 'Health Policy' that ignores the problem of most people and forces the nation in debt.

The Himalayan herbs or the things of world's attraction:
How people are attracted by the herbs of the Himalaya rather than the herbs of India or Terai region of Nepal ? Why the seer like Balmiki, Vedvays, and great poet Kalidas wrote the Himalaya as the resource of great medicine? Why European researcher concluded that the Himalayan herbs are more potent? Why the herbal companies give emphasis on "Himali herb" while giving an advertisement? What is the specific quality that is related to the 'Himalayan herbs'?

These questions are really important and draw our attention on an extraordinary quality of herbs of Nepal. According to Ayurveda,-" The medicine of that place is the best where the patient has born (is living)". The health related personnel of all specificity accept in one voice that the Himalayan drugs possess especial potency or quality. There is specific logic for that. Any person dealing with ' Apple business' says the apples from Jumla, Kashmir or Marpha (Mustang) are more preferable. This is an example of the geographical and climatic impacts on the potency of the products where they originate. Our Himalayan range is the highest of all in the world and it faces to the south so that it receives plenty of sunlight. These two facts impact on quality of the Himalayan herbs and are famous for their potency from ancient period.

If the Himalayan region and the nearby hilly regions are cultivated profoundly with the herbal medicine and thus grown products are marketed worldwide in their different shapes and forms, our nation and the people of the world will be benefited.