INTERNATIONAL

AYURVEDIC
MEDICAL JOURNAL
Review Article ISSN: 2320 5091 Impact Factor: 4.018

CONTRIBUTION OF KERALA TO AYURVEDIC LITERATURE - A COMPARATIVE

CRITIQUE

Bindu K. K1, Mrudula Vinayak Joshi2

1
Professor, Vaidyaratnam P. S. Varier Ayurveda College, Edarikode P.O., Kottakkal, Malappuram 676501,
Kerala, India
(PhD scholar, Dept., Of Ayurveda, Tilak Maharashtra Vidyapeeth, Pune, Maharashtra, India)
India
2
Professor and HOD, Department of Samhita, Sidhantha and Sanskrit, Dr D.Y Patil College of Ayurveda and
Research Centre, Pune, Maharashtra, India
India)
(Research Guide, Dept. Of Ayurveda, Ti Tilak
lak Maharashtra Vidyapeeth, Pune, Maharashtra, India

Email: [email protected]

Published online: January, 2019

© International Ayurvedic Medical Journal, India 2019

ABSTRACT
Kerala has a glorious tradition of health care system dating back to several centuries. The traditional medical
knowledge, gained from years of critical observations and clinical experiences, has been documented by the great
Physicians. Kerala has made significant cont
contribution
ribution to Ayurvedic literature. Medical literature of Kerala consists
of commentaries on classical text books, books on specialized disciplines of Ayurveda, compendium of formula-
formul
tions and treatment methods and practices prevalent in traditional Vaidya families. Critical analysis of these litera-
liter
ture representing regional traditions and its comparison with the text books of classical tradition is essential to
explore the true worth of these text books.

Keywords: Medical literature, Kerala Ayurveda, Regi

Regional tradition

INTRODUCTION
India has a rich tradition of intellectual inquiry and a The most remarkable
emarkable fact about Indian medical tradi-
trad
textual heritage that goes back to several hundreds of tion is that it prevails at two different group levels,
years1. This has been reflected in medical science and namely the classical tradition and
a the regional tradi-
its literature too. The history of Ayurveda reveals the tion2. The vast amount of medical knowledge that has
evolution of a vibrant and dynamic medical tradition come down to modern times is the result of long evo-
ev
with compendia, medical lexicons, pharmacopoeia, lution through trial and error and exchange of know-
know
handbooks and manuals of treatment. how between diverse communities and regions.
regions The
classical tradition has been modified according to the
 Bindu K. K & Mrudula Vinayak Joshi: Contribution Of Kerala To Ayurvedic Literature - A Comparative Critique
environmental and cultural background of the people Among them, the Ashtavaidyan of Kerala belonging
dwelling in different regions of the country. So it can to 8 Namboothiri families are hereditary physicians of
be said that any enquiry into the regional variations in repute. In addition to that some ezhava families and
the learning, understanding, practice and propagation such other sets of people studied Ashtangahridaya
of Ayurveda will surely throw light to the develop- thoroughly and practiced the system as their heredi-
ment of these dual traditions. The literature of classi- tary occupation5. The physicians were drawn from
cal health traditions are highly organized, classified different strata of the society. It was never a monopoly
and codified with a theoretical and conceptual founda- of a specific community. Often the treatments were
tion, having philosophical and scientific backgrounds. mixed up with different rituals and religious worships.
They were written in Sanskrit language. Charaka Temples, churches and mosques were centers of ther-
samhitha, Susruta samhitha, Astanga Sangraha and apeutic practices for specific diseases and are consid-
Ashtangahridaya are the major representatives of the ered as divine centers giving protection from evil spir-
classical tradition in Ayurveda. But in the regional its and mental and physical ailments6.
literature the knowledge gained from innumerable The contributions of these eminent physicians were
number of clinical experiences which has been passed not limited to application of Ayurvedic principles in
on from generation to generation are documented in treatment, but many of them have also been great con-
regional languages. They are very rich and diverse but tributors to Ayurvedic literature. These literature need
not organized or classified. No proper efforts were not be counted as contribution of a person (author) but
made critically to study the literature representing re- can be considered as a collective contribution of a
gional traditions and practices. These literatures may great tradition as such. Most of the textbooks are
be critically analysed and incorporated into classical anonymous in authorship and found to be edited and
traditions. Such a research on regional literature will supplemented through different generations. These
definitely enrich the literary data base of the Ayurve- texts have an important role in keeping the Kerala tra-
da. dition of Ayurveda alive and most of them are still
History of medical system in Kerala considered as hand books in day-to-day clinical prac-
Kerala is immensely blessed with rich biological and tice.
cultural heritage. The natural resource base is com- These valuable contributions include commentaries
plimented with an equally rich and diverse cultural and translations of classical texts, medical dictionar-
heritage and traditional knowledge system3. Historians ies, compilations of prescriptions of medicines and
have noted that some indigenous system of healing their practical applications, texts incorporating mod-
existed in Kerala even before the advent of Aryans ern scientific knowledge, independent books related to
and Sanskrit language4. As in any other society, medi- the eight branches of Ayurveda and allied sciences
cal practice started in Kerala in crude format by the like Vrikshayurveda and Hasthyaurveda
natives then existed, and the Ayurvedic system and
Sanskrit literary works that came later refined this sys- Literature of Kerala
tem and flourished into new form and content. Books on panchakarma
Ayurvedic practices in Kerala are unique in the sense Panchakarma (five purificatory procedures) is consid-
that they comprise several special methods of treat- ered as the hallmark of Ayurvedic treatment. Kerala,
ments such as innovations in panchakarma therapies, in particular has achieved a place of pride in the glob-
specialised formulations which are not seen anywhere al arena due to the development and nurturing of in-
in classical texts, single drug usage, development of novative techniques which have enriched Ayurveda as
treatment modalities for toxicity, small pox etc. a whole and Panchakarma in particular. The litera-
The foundation stone for such a system was laid down tures on panchakarma not only describe the
by numerous physicians and scholars who had sound kriyakrama which were developed and popularized in
academic knowledge and great clinical acumen. Kerala, but they also contain elaborate and practical

IAMJ: Volume 3, Issue 2, December, 2018 – January, 2019 (www.iamj.in) Page 1558
 Bindu K. K & Mrudula Vinayak Joshi: Contribution Of Kerala To Ayurvedic Literature - A Comparative Critique
descriptions of kriyakarma described in classics. The- Panchakarma procedures and medicines12. The physi-
se books became very popular owing to the simplicity cians of the yester years were not only instrumental in
of presentation and gravity of contents. Some of the reviving the sodhana (purificatory) treatment, but they
important books in this genre are listed below. also provided us with a legacy of books which even
Vasthipradeepa is a book written in Malayalam lan- now serve as guides in the practical application of the-
guage by Panavalli Krishnan Vaidyar and published in se procedures. It can be said that it is due to the efforts
19327. As the name suggests, this book describes vasti of these physicians that Kerala has turned into a global
with importance. But it also gives a detailed account hub of Panchakarma.
of other treatment procedures. Panchakarmam athava Books on drugs / medicinal plants/formulations
sodhanachikitsa is another book in Malayalam by The flora and other natural resources systems lead to
Manakkodam Kesavan Vaidyar8. It is one of the most the development of the unique Ayurvedic formulary
authoritative and comprehensive books in this subject. of Kerala. Ayurvediya Ausadha Nighantu by Tayyil
This book has described all Panchakarma including Kumaran Vaidyan contains Sanskrit and Malayalam
siravedha and preparatory procedures snehapana synonyms, the therapeutic values and the parts used of
(oleation) and swedana (sudation). The description is almost all the medicinal herbs commonly used in Ker-
in the form of case discussions. He has also mentioned ala13. Hortus malabaricus is a comprehensive treatise
the doubts that may arise during the performance of on the floral wealth of Malabar published in Latin14. It
the procedure and also given the clarification then and is an authentic documentation about the ethno-medical
there. ‘Ayurvedic treatments of Kerala’ is an English knowledge of Malabar and reflects the cultural, social,
book written by Vayakara N S Mooss9. It elaborates political and linguistic history of 17th century of Kera-
the Keraleeya Panchakarma procedures like la. It was the brain child of Hendrik Adriaan van
Pindasweda (sudation using medicated cloth bag), Rheede, the then Dutch Governor of Cochin. A team
Annalepanam (application of medicated rice paste on of more than 150 experts in various fields like botany,
body), Kayasekam (medicated oil massage by squeez- medicine and art worked under his leadership to com-
ing oil from cloth), sirovasthi (retention of medicated plete this mammoth work. Itty Achuthan, a renowned
oil on head), sirosekam (pouring medicated oil on physician belonging to a famous traditional ezhava
head) and sirolepanam (application of medicated vaidya family, is one of the key figures behind the
paste on head). Dharaakalpam is another book written compilation of Hortus Malabaricus. 3 Konkani Brah-
by physician of Kerala, but the exact authorship is min physicians – Ranga Bhatt, Vinayak Pandit, and
unknown. Sri N V K Varier has mentioned in his book Appu Bhatt also lent their expertise to this study. It
Ayurvedacharitham that Yadav Sharma has published can be considered as a contribution of Kerala in view
this book along with the text Rajamarthanda from of the contents and persons participated in the
Mumbai10. This is also seen as an appendix in other works15. This work has been translated to English by
books like Sahasrayogam. Written by Putiyedath Ra- Dr K.S. Manilal.
man Menon in 1929, Sirassekaadi vidhi, is a book Sahasrayogam is a compendium containing around
along with Bhaavaprabodhini commentary11. It nar- 1000 formulations and has been used by the practi-
rates the five procedures of Takradhara (pouring med- tioners of Kerala as a hand book for day to day clini-
icated buttermilk), Pizhichil(medicated oil massage by cal practice16. There are many editions for this book
squeezing oil from cloth), Njavarakizhi (sudation us- and Central Council for Research in Ayurveda and
ing medicated cloth bag) Njavarateppu (application of Sidha recently published this book.
medicated rice paste) and Talapothichil (application Alathur Manipravala is a traditional medical treatise
of medicated paste on head). Chikitsasangraham is a of formulations which has linguistic as well as histori-
book written by the great visionary and founder of cal importance17. The manuscripts of this work were
Kottakkal Arya Vaidyasala ,Vaidyaratnam P S Varier believed to be composed 600 years back and consid-
and published in 1905 which contains collection of ered as the oldest Manipravala work related to medi-

IAMJ: Volume 3, Issue 2, December, 2018 – January, 2019 (www.iamj.in) Page 1559
 Bindu K. K & Mrudula Vinayak Joshi: Contribution Of Kerala To Ayurvedic Literature - A Comparative Critique
cal science. This book describes formulations for var- Ulpala, Mekhala, Kalavachana and Lakshanamrita.
ious diseases. Other important available works are Vishajyotsnika
Sindooramanjari (Thrissur thaikkattu Narayanan by Karat Namboodiri, Prayogasamuchaya by
Mooss) and Rasopanishat consist of medicinal appli- Kochunni Thampuran and Sarvagarala Pramochana by
cations of minerals and metals18 Kuttamath Cheriya Rama Kurup24.
Books on treatment for general disease Books on fundamental principles
Yogamritam19 and Chikitsamanjari20, which explicate Brihat Sareera (1942) & Astanga sareera (1926) are
the simple and practical treatments for general diseas- the two books describing Ayurvedic Anatomy and
es throw light on the treatment practices prevalent in Physiology 25, written by Vaidyaratnam P.S. Warrier
the reputed traditional vaidya families of Kerala. in Sanskrit. This book co-ordinate Ayurveda with
Chikitsanool and Vaidyamanorama, modern science by analyzing the basic concepts of
Sarvarogachikitsaratnam are the other notable works Ayurvedic in the light of modern medical science. The
in this category21. book Rasavaisheshika sutra, with 486 sutra in 4 chap-
Books on Paediatrics ters, describes the physiological and therapeutic val-
The traditional literatures are rich source on ues of the medicinal and dietic articles. It also relates
Ayurvedic paediatric care. The most authentic book the existing 6 rasa and 3 dosha. It was first published
representing balachikitsa tradition of Kerala is in 192826.
Arogyakalpadruma written by Kaikulangara Commentaries
22
Ramavarier. It contains exceptional information re- There were many commentaries on classical texts but
garding the diseases affecting children, their patho- some of them are not available now. Indu, the com-
genesis and management. Many innovative treatment mentator of Sasilekha commentary of
27.
procedures and effective formulations are mentioned Astangasamgraha belonged to Kerala Pathya is
in this book. A topic of special citation is prakara yo- one of the most accepted commentary. Kairali com-
ga i.e. explanation of different immunomodulatory mentary authored by Pulamanthol mooss,
recipes and procedures to be adopted right from the Vakyapradeepika by Parameswaran Namputhiri,
day after delivery. Arogyacintamani’ is a paediatric Sararthadarpanam by Kaikkulangara Rama varier,
text written in Malayalam based on Bhaskara commentary by Uppottu Kannan vaidyan,
‘Arogyakalpadrumam’ by Mahakavi Vallattol(one of Arunodayam written by Govindan Vaidyar are some
the triumvirate poets of Malayalam literature) who of the notable commentaries on Ashtanga hridaya.
had also a sound knowledge of Ayurvedic system of Other works
medicine. The book namely ‘Mahasara’ published by Hridayapriya(1865 AD) and Sukha
the Manuscript Library, Madras, contains a lot of in- sadhakam(1882AD) are the works by Vaikkom
formation on paediatrics in Malayalam23. Other fa- Pachumuthathu, based on Ashtangahridaya28. He was
mous works are Karappan by Kodungallur a great scholar and kottaram vaidya of Travan-
Kunjikuttan Thampuran, Vaidyatharakam by core(official Ayurvedic physician) and also estab-
Vaidyakalanidhi N Narayan, Balarogachikitsamanjari lished the first institution for learning Ayurveda in
by Panachirethu Krishnapillai. Kerala in 19th century.
Kushtarogachikilsadarpanam by K V Krishnan
Books on Toxicology Vaidyar, Ottaparuvinteyum ottamasooriyudeym
Kerala has provided many significant contributions in chikilsa by Vaidyan K V Aipu K, Oushadhacharthu
the field of toxicology. There were expert physicians or kudumbavaidyan by Panachireth Krishnapillai,
who can identify the minute differences among poi- Sarvasaadhaarana Chikilsa by T Chandrasekhar,
sonous creatures, and had specific remedies for each Sarvaroga Chikilsanool by John Alexander,
varied poisons. Literatures on toxicology are based on Vaidyaratnamala by R Parameswaran Pillai,
some scientific works namely Narayaniya, Uddisa, Santhanachinthamani (Vajeekaranam) by M K

IAMJ: Volume 3, Issue 2, December, 2018 – January, 2019 (www.iamj.in) Page 1560
 Bindu K. K & Mrudula Vinayak Joshi: Contribution Of Kerala To Ayurvedic Literature - A Comparative Critique
Kunhiraman Vaidyar, Vishoochikasudarsanam by 14th century AD in the initial periods of the
Cholayil Kunhimami Vaidyar, Ayurveda Prakasika & manipravalam movement.
Prameharahasya Chikilsa by T N Nanupilli Asaan, A classical text in Sanskrit uses Devanagiri script,
Aarya Vaidya Chikilsa Margam by P V Ramavarier, whereas regional textbooks of Kerala use Malayalam
Mahasaaram by Dr M K Vaidyar (Ed) are some of the script. Malayalam script was first printed in the book
later works . Hortus malabaricus.
In contrast to the classical texts having a well-
Comparison between literature of classical health structured theoretical platform, the medieval text-
tradition and local health tradition books are practical oriented and not necessarily well-
Literature in classical and local health tradition may structured. The arrangement of chapters in regional
be compared based on the domains like period, au- textbooks is often different from classical books. The
thorship, language, structure and orientation of the diseases may be arranged in terms of its incidence,
text and content. regional prevalence, similarity in clinical presentation
Major classical textbooks like Charaka Samhitha and or treatment and its prognosis. To cite an example, the
Susritha samhitha have been formulated during chapter on Raktapradara (abnormal uterine bleeding)
Samhitha period (500 BC – 600 AD). Majority of the is elucidated after Raktapitta (bleeding disorders) in
regional texts are thought to be composed during the regional texts, whereas in classical texts, it is consid-
medieval period or the ‘age of compilations’ or the ered under the domain of gynaecological disorders.
Sangraha kala (7th – 17th century) 29. Since exchange of The contents of most classical texts include all the
knowledge can be well identified among these region- eight branches of Ayurveda while the regional texts
al texts, it is difficult to identify the chronological or- focus more on specific branches. The socio-cultural
der in which they were written. and geographical peculiarities of Kerala might have
Most of the classical textbooks have known author- influenced the development of specific disciplines like
ship (Ashtangahridaya written by Vagbhata,) while Marma chikitsa, Visha chikitsa (toxicology) etc. e.g;
most of the regional textbooks of the medieval period The massage therapy owes much to the practice of
are of anonymous or controversial authorship. These Kalarippayattu (a traditional form of martial art) of
are seen as factual documentations compiling the tra- Kerala. Knowledge of vital points in the body, com-
ditional practices running in a family (astavaidyans plications of injuries to them and methods of correc-
for instance) or specific to a region (keraleeya tion were taught along with practice of
panchakarmas), keenly subjected to additions and Kalarippayattu. This knowledge was later developed
updates with each passing generation as Kalarichikitsa (Kalari means battle field)
Classical texts on Ayurveda were mostly written in Kathakali, the dance-drama of Kerala, also demands
Sanskrit language. The regional textbooks of Kerala physical fitness and flexibility of body. These practic-
were written in Malayalam, Sanskrit and Manipravala es might have led to the development of Marma
(judicious mixture of Malayalam and Sanskrit) style. Chikitsa as a separate branch of treatment30. Other
Some of the texts show vivid influence of Sidha sys- peculiarities of the contents of the regional texts in-
tem of medicine and they are written in Tamil – Mal- clude the use of locally available drugs such as coco-
ayalam combination. Every regional language has its nut tree products, innovations in medicinal prepara-
own variants, few of which are made by mixing dif- tions and formulations like mukkudi (a takra based
ferent languages e.g; Manipravala, the widely used preparation) and development of treatment modalities
style during medieval period in Kerala, is an intricate like modified swedana (sudation) procedures, and
combination of Sanskrit and Malayalam. Many popu- urovasti (keeping medicated oil over chest).
lar texts like Alathur Manipravala, Chikitsamanjari The contents of these literatures are to be subjected to
and Yogamritam were written in this dialect. Alathur keen examination at multiple levels- the quality, cred-
Manipravalam is believed to be composed during the

IAMJ: Volume 3, Issue 2, December, 2018 – January, 2019 (www.iamj.in) Page 1561
 Bindu K. K & Mrudula Vinayak Joshi: Contribution Of Kerala To Ayurvedic Literature - A Comparative Critique
ibility, feasibility, systematic arrangement, and specif- 10. Krishnankutty Varier NV. Ayurveda in Kerala. History
ic regional variations if any. of Ayurveda. 1st ed. Kottakkal: Department of Publica-
tions, Arya Vaidya Sala; 2005.p.316
11. Puthiyedath Raman Menon. Sirasekadividhi – A Hand-
CONCLUSION
book on the Principles and Practice of Keraleeya
The traditional regional literature are to be scrutinized
Panchakarma with Malayalam commentary
with respect to the quality of its contents, the unique- Bhavaprabodhini by the author and English Annota-
ness of its features which makes it superior to the ex- tions by the editor. Prasad. M, (editor). 1st ed.Thrissur:
isting textbooks and the specific contributions made Vaidyabhushanam Raghavan Thirumulpad Foundation
by the work to the medical community. Critical com- for Ayurvedic studies;2009
parison of the therapeutic aspects of the two traditions 12. Varier PS. Chikitsasamgraham. 9th ed. Kottakkal: Arya
is essential to understand the true worth of these text- Vaidya Sala Dept of Publications; 2011
books. 13. Kumaran Krishnan Thayyil. Ayurvedeeya
Oshadhinighantu, 2nd ed. Thiruvananthapuram: Publi-
cation Division, Govt Ayurveda College;1979/2000
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