Ayurved Medicine in Nepal with brief Introduction to Principles and Practices of Ayurveda

Ayurveda Medicine in Nepal
Prof. Dr. D. B. Roka, BAMS, MD
The then Chief of Ayurveda Campus,
Institute of Medicine, Tribhuvan University,
Kathmandu, Nepal
Dr. Shiva, & Dr. Aseem
नमस्कार ! 你好你好
नन हाउ nǐ hǎo
Hello, Good Morning!

Prayer
• ॐ सर्वे भर्वन्तु सुखिनः सर्वे सन्तु ननरामयः।
सर्वे भद्रनिपश्यन्तु मा कनिददुःि भाग भर्वेत॥
• May all be happy. May all enjoy health and freedom from disease.
May all have prosperity and good luck. May no one suffer.
(Bṛhadāraṇyaka Upanishad 1.4.14)
• अस्तो मा सद गमय। तमसो मा ज्योनतगगमय। मृत्योमाग अमृतं गमय। ॐ
शाखन्त शाखन्त शाखन्त ।
• O Lord, Lead Us From Untruth To Truth, Lead Us From Darkness To
Light, Lead Us From Death To Immortality. (Bṛhadāraṇyaka
Upaniṣad 1.3.28)
Ayurveda Medicine in Nepal 2

Outline of presentation
• Nepal
• Nepal China Friendship
• Introduction to Ayurveda Medicine
• Basic Principles of Ayurveda Medicine
• Ayurveda & TCM
• Ayurvedic Health Services in Nepal
• Ayurveda Education in Nepal
• Traditional Medicine in Today’s Context

Nepal
A South Asian country
In between China and India

Nepal
 Geographical diversity: mountains, hills, terai (plain)
 Cultural diversity

Nepalese Cultures
•Different god and goddesses
Including living goddesses Kumari
•Different festivals

Nepal is famous for having
• Birth place of Lord Buddha
• Largest mountains of Himalayas: including Everest
(Sagarmatha, Jhomolongma)
• Ancient temples and caves

Facts of Nepal
• Land Area: 147,181 sq. km
• Population: 2,64,94,504 (Census, CBS, 2011)
• Life expectancy: 70 years
• Infant mortality: 32/1000 live births (NDHS 2016)
• Major economic sources: Agriculture, Tourism, Remittance, … Others

Nepal China
Friendship

Nepal China Friendship
Araniko designed white pagoda in
Beijing 700 years ago

China Nepal Friendship
• China has been development partner for long
• Support area include: infrastructure, health,
education etc.

China Nepal Friendship

Introduction to
Ayurveda Medicine

Traditional medicine
Ayurveda Medicine
Traditional medicines (TMs), which developed along the human civilizations, are
protecting people since ancient times, which are also the source of different modern
medicines. Predominantly practiced in Asia, Africa and other continents, they are
instrumental to the health of people worldwide.
Such glorious medical practices include Traditional Chinese Medicine (TCM),
Ayurveda, and others . Somewhere they are considered Complementary and
Alternative Medicine (CAM). Now in many countries such medical practices are
practice d along with modern western medicine and called as Integrative Medicine
(IM).
In Nepal, Ayurveda is in practice since long time. Other medical practices include:
aamchi, acupuncture/TCM, allopathy (western medicine), homeopathy, naturopathy,
unani, yoga etc.

Ayurveda
• One of the oldest medical systems - human being first attempted for health
and happiness in the ancient times through Ayurveda and similar practices.
Ayurveda developed in South Asian region.
• History dates back to time immemorial, assumed to be around 6000 BC.
• Aspects: Food and Life Style, Good conduct, Yoga and Meditation, Education,
Herbs, Minerals, Medicines, Relaxation, Detoxification therapy, Rejuvenation,
Surgery, etc.

Special Features of Ayurveda
• Time tested medicine: knowledge/skills/practices based on
tradition of observation and experiences of many generations
• Source of many modern medicine/drugs/ procedure
• Meeting point of many systems of medicine: Yoga, Naturopathy,
Evidence based medical systems etc.
• Culturally accepted
• Concerned with everyday life: health, environment, employment,
biological and health Sciences
• Growing interest of all type of people

Ancient Ayurvedic Literatures
•Among many others two essential groups of
literatures are:
Long Triad: Charak, Sushruta, Vagbhat
Small Triad: Madhav, Sharangdhar,
Bhavprakash

Some Important Classical Texts
Text Specially deals with
Charak Sahmita Internal Medicine
Sushruta Sahmita Surgery
Astanga Hridaya (Vagbhat) Medicine, Surgery
Madhav Nidan Diagnostics
Sharangadhar Sahmita Pharmacology
Bhav Prakash Nighantu Materia medica
Kashyap Sahmita Pediatrics, Gynecology, Obstetrics

Classical Branches of Ayurveda
Branches (8) Deals with Main Text
Kaya Chikitsa Internal Medicine Charak Sahmita
Kaumar Bhritya Pediatrics, Obstetrics and Gynaecology Kasyap Sahmita
Shalya Bigyan Surgery Sushruta Sahmita
Shalakya Tantra ENT, Dentistry, Opthalmology Bhel Sahmita, Sushruta
Agad Tantra Toxicology, Forensic Medicine Charak, Sushruta
Graha Bigyan Psychiatry, Demonology Charak, Sushruta
Jara Bigyan Geriatrics Charak, Sushruta
Vrisha Bigyan Rejuvenation and Aphrodisiac Charak, Sushruta

Charak Samhita
Section (8) Deals with Chapters (120)
Sutra Sthan General Principles 30
Nidan Sthan Pathology 8
Viman Sthan Diagnostics 8
Shaarir Sthan Anatomy and Physiology 8
Indriya Sthan Prognostics 12
Chikitsa Sthan Therapeutics 30
Kalpa Sthan Pharmaceutics 12
Siddhi Sthan Successful Treatments 12
http://www.carakasamhitaonline.com/mediawiki-1.28.2/index.php?title=Adhyaya(chapters)

Sushruta & Surgery
• Father of Surgery, Father of plastic surgery
• His contributions are in - Clinical training,
Medical ethics, Dissection, Preservation of
dead body, Fracture management, Wound
closure, Prosthetics, Enema, Catheterization,
Cataract extraction, Fetoscope, CS to deliver
babies, .. etc.
• Surgery is not the modern development that
happened overnight.

Sushruta teaching anatomy and conducting operation
Davis JS. Address of the president: the story of plastic surgery. Annals of surgery. 1941
May;113(5):641. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1385923/pdf/annsurg00385-0023.pdf
thamburaj.com/susrutha.ppt

Classical Ayurvedic Surgical Instruments
• Yantra: Blunt instrument: Total 101 in number
• Shastra: Sharp instrument: Total 20 in number
• Ayurveda centers have to be strengthened to provide all range of
services (preventive, medical, surgical, rehabilitative, and more) to
address all sorts of problems of health and life.
• Today, in Nepal only some basic surgery and anorectal surgeries are
carried out in Ayurvedic centers. While in some of the Ayurveda
centers in India they have strengthened the service as comparable to
hospitals of western medicine.

Literatures found in Nepal
• Many literatures are found in Nepal: Kashyap Samhita,
Saushrut nighantu and many others …
• Photo of Chandra Nighantu

Basic Principles of
Ayurveda Medicine

Definition of Ayurveda
आयुर्वेद Ayurveda: Sanskrit: Ayu= Life, life-span; Veda = Knowledge, wisdom,
Science. The science, knowledge and technology that deals with the betterment
and prolongation of life. Concerned with what is conducive to life, types of life,
and life span.
 नहतानहतं सुिं दुःिमायुस्तस्य नहतानहतम | मानं च तच्च यत्रोक्तमायुर्वेदः स उच्यते||४१||
 hitāhitaṁ sukhaṁ duḥkhamāyustasya hitāhitam| mānaṁ ca tacca
yatrōktamāyurvēdaḥ sa ucyatē
 Ayurveda is that which deals with good, bad, blissful and sorrowful life, and
with (what is) wholesome and unwholesome for it, longevity, and about
what Ayu (life) is in itself. [Charak Samhita, Sutra Sthan 1/41]
• http://www.carakasamhitaonline.com/mediawiki-
1.28.2/index.php?title=Deerghanjiviteeya_Adhyaya

Definition of Swasthya/Health
स्वास्थ्य Swasthya: Health
समदोषः समानिि समधातुमलनियाः। प्रसन्नात्मेखियमनः स्वस्थ इत्यनभधीयते ॥
सुश्रुतसंनहता, सूत्रस्थानम १५ /४१
Sama dosa samagnischa samadhatu malakriya | Prasannatmendriya
manah swastha itya bhidhiyat- Sushruta Sutra sthan 15/41
Balance of energies/doshas/ humors
Normal functioning of all metabolic activity, normal intake of food and
nutrition, normal excretion of byproducts (physiological)
Balance of all physical and mental aspects (structural)
Happy/Sound soul, mind and senses

Definition of Health by WHO
•Health is a state of complete physical, mental
and social well-being and not merely an
absence of disease or infirmity.” (WHO,1948)
•Any difference ?

Objectives of Ayurveda
• प्रयोजनं चास्य स्वस्थस्य स्वास्थ्यरक्षिमातुरस्य नर्वकारप्रशमनं च||२६||
Charak sutra sthan 30/26
• prayōjanaṁ cāsya svasthasya svāsthyarakṣaṇamāturasya
vikārapraśamanaṁ ca||26||
• The purpose of this science is to preserve the health of the
healthy and cure/control the disease of the unhealthy. [26]
Alleviating (reducing) the disease of the ailing / Restore the health of
unhealthy
Preserving the health of the healthy individual / Preventing risk and
hazard, Promoting healthy life

Objectives of Ayurveda …
• तदायुर्वेदयतीत्यायुर्वेदः; कथनमनत चेत? उच्यते-स्वलक्षितः सुिासुितो नहतानहततः
प्रमािाप्रमािति;यतिायुष्याण्यनायुष्यानि च द्रव्यगुिकमागनि र्वेदयत्यतोऽप्यायुर्वेदः| तत्रायुष्याण्यनायुष्यानि च
द्रव्यगुिकमागनि क
े र्वलेनोपदेक्ष्यन्ते तन्त्रेि||२३||
• tadāyurvēdayatītyāyurvēdah; kathamiti cēt? ucyatē-svalakṣaṇataḥ sukhāsukhatō
hitāhitataḥpramāṇāpramāṇataśca; yataścāyuṣyāṇyanāyuṣyāṇi ca dravyaguṇakarmāṇi
vēdayatyatō'pyāyurvēdaḥ| tatrāyuṣyāṇyanāyuṣyāṇi ca dravyaguṇakarmāṇi kēvalēnōpadēkṣyantē
tantrēṇa||23||
• Ayurveda is that source of knowledge which teaches about or deals with Ayu. How so? By its
characteristics, it imparts the knowledge of joy and suffering, benefit and harm, and
authentic/authoritative and unauthentic/unreliable (sources of information). It is also that which
informs us about the span of life and substances with properties and actions that result in the
same. This will be dealt with in the entire text at various appropriate contexts. [Charak Samhita
sutra sthan 30/23]
1.28.2/index.php?title=Arthedashmahamooliya_Adhyaya

Basic Principles of Ayurveda
• Panchamahabhoota (Five Great Elements): Aakash Ether,
Vayu Air, Tej Fire, Jala Water, Prithvi Earth
Similar concept as TCM
As the universe so is the individual body made up of
these five great elements

The Five Great Elements …
• Ether: space, Air: gases including oxygen, Fire: heat, Water:
fluid, Earth: solid
• अग्रे तु तार्वदद्रव्यभेदमनभप्रेत्य नकनिदनभधास्यामः| सर्वं द्रव्यं पािभौनतकमखिन्नथे; तच्चेतनार्वदचेतनं च, तस्य गुिाः
शब्दादयो गुर्वागदयि द्रर्वान्ताः, कमग पिनर्वधमुक्तं र्वमनानद||१०||
• agrē tu tāvaddravyabhēdamabhiprētya kiñcidabhidhāsyāmaḥ| sarvaṁ dravyaṁ
pāñcabhautikamasminnarthē ; taccētanāvadacētanaṁ ca, tasya guṇāḥ śabdādayō gurvādayaśca
dravāntāḥ, karma pañcavidhamuktaṁ vamanādi||10||
• “First of all, I will tell something about the drugs. In this context, a drug constitutes of
five bhutas: prithvi, apa, tejas, vayu and akasha. It is (of two types) sentient and insentient. Its
properties are shabda etc. and those from guru to drava, and its action are said to be five-fold-
vamana etc”. [Charak Sutra 26/10]
1.28.2/index.php?title=Atreyabhadrakapyiya_Adhyaya

Basic Principles … Pramanas/Evidences/test/experience
Yukti (rational practice): Logical reasoning / rationale practice is advocated
in Ayurveda. Ayurveda has encouraged evidence based practice depending on
different schools of thought:
Stages of Evidences:
• Charvak - (a) Pratyksha (Direct observation/perception: experiments, RTCs)
• Vaisheshik - (a) Pratyksha, (b) Anumana (Inference: statistical inferences,
meta-analysis)
• Sankhya /Yoga/Vedanta - (a) Pratyksha, (b) Anumana, (c) Shabda /
Aptopadesha (testimony of scholars of past and present, Authoritative
statement/word)
• Nyaya - (a) Pratyksha, (b) Anuman, (c) Shabda, (d) Upaman (Comparison
and analogy)
• Others: Arthapatti (postulation, presumption), …..

Basic Principles of Ayurveda …
•kaarana  Kaarya :: Cause (factor)  effect
• तत्रकारिंनामतद्यत्करोनत, सएर्वहेतुः, सकताग||६९||
• tatra kāraṇaṁ nāma tad yat karōti, sa ēva hētuḥ, sa kartā||69||
• Kaarana is defined as the one who does the action, is the cause and
doer.[69]
• [Charak Samhita, Viman Sthan, Chapter 8/Verse 69]
1.28.2/index.php?title=Rogabhishagjitiya_Vimana

• Purusha: Any person with consciousness is purusha (has
aatma/soul, sharir/body, indriyas/senses, sattva/mind)
• Tridosha: Three bio-regulatory principles (set of qualities or
humors or energies): Vata, Pitta, Kapha
• (Imbalance in natural status of dosha results into disease)
• (Similar concept of humors as in Greek medicine)
• Tri-guna: Three manasik (Mental) Properties: Sattva, Raja,
Tama

Basic Principles in Ayurveda …
• Dhatus (Tissue Components): 1) Rasa: Fluid, Lymph, 2) Rakta : Blood, 3)
Mamsha: Muscles, 4) Meda: Adipose, 5) Asthi: Bones, 6) Majja: Marrow, 7)
Shukra aartav: reproductive tissue (Semen, ovum)
• Oja/ojus: essence/vitality/immunity
• Bala: strength/immunity
• Mala (Excretory Products): 1) Mutra: Urine, 2) Purisha: Stool, 3) Sveda: Sweat
• Agni (Fire): 13 agnis are there, among them jatharagni (digestive of stomach)
is main
• Prana: breath of life
• Nadis: energy channels
• Chakra: center of special energy / power; plexuses, wheel
• Marma: vital spot/organ
• Roga: disease

• Tri Sutra (three threads/formulae): Hetu (cause), Linga
(symptoms/signs), Aushad (Medicine)
• Tri sthamba (three pillars): (tri-dosha): vata, pitta, kapha
• Tri upa-stambha (three supporting pillars): Aahar (food - Food
according to prakriti/prakruti, age, sex, work…), Nidra (sleep-
Adequate sleep, timely sleep), Bramhacharya (regulated and
disciplined life- Good conduct on family, friends and relationship,
especially related with use of senses for basic needs)
• Panchanidan (Stages of diagnosis): nidan (cause), purva rupa
(prodormal symptoms), rupa/lakshan (signs), upashaya
(therapeutic tests/diagnosis), samprapti (pathogenesis)

• Dinacharya (daily healthy life style)
- Daily Regulated Activities
- Get up, cleansing, moderate yoga/exercise, proper breakfast, work, food, rest, sleep
• Ritucharya (healthy life style according to seasons)
- Harmonious living according with seasonal variation in environment
• Aahar vidhi (food conduct): proper preparation and consumption
• Avoid viruddha aahar (wrong food combination)
• Aachar-Vichar: (Conduct)
- Proper behavior/conduct, Positive attitude
• Janapadodhvamsa (epidemics) – when large number of people affected by fault in
activities/time/season..

अधारणीय र्वेग Adharaneeya Vega – Natural urges that should
not be suppressed
• र्वेगान्न धारयेत र्वातनर्वण्मुत्रक्षर्वतृट्कक्षुधाम । ननद्राकासश्रम श्वास जृम्भाश्रुच्छदी
रेतसाम ।। [Astanga hridayam sutra sthan 4/1]
• 1. Adhovata – flatus (fart), 2. Vit – feces, 3. Mutra – urine, 4. Kshavatu
– sneeze, 5. Trut – thirst, 6. Kshudha – hunger, 7. Nidra – sleep, 8.
Kasa – cough, 9. Shramashvasa – breathing on exertion, 10. Jrumbha
– Yawning, 11. Ashru – tears, weeping, 12. Chardi – vomiting, 13.
Retas – semen/reproductive

• Yoga (association) of time/objects/activities can lead to
health or disease:
• Hina (inadequate), mithya (faulty/perverse) and ati (excess) lead to
disease
• Samyak (proper) bestows health
• Causes Of Diseases:
• Asatma indriyartha samyog: unfavorable contact of senses and sense
objects
• Prgyapradha: acts against knowledge, memory, intellect (e.g. use of
tobacco knowing that it harms)
• Parinam: conduct against time and space/environment (e.g. cold
drinks in winter)

• Sad Kriya kala: stages of pathogenesis
• Sanchaya: Accumulation of vitiated factor
• Prakop: Aggravation of vitiated dosha
• Prasar: Propagation
• Sthansamshraya: localization
• Vyakti: Manifestation
• Bheda: Complication
• So, earlier the prevention or appropriate intervention better is the
prognosis.

• Sroto dusti (pathological changes of channels):
• Ati pravriti: excess production/flow/ collection /growth
• Sanga: accumulation/obstruction /stricture/block
• Sira granthi: stasis /thrombosis/ nodules/ swelling
• Vimarga gaman: flow in wrong channel/direction,
embolism

Properties of food or medicinal substances
How do medicines work?
According to Ayurveda:
1. Rasa : Taste of the herb/drug/medicinal/nutritional substance, there are 6, each suggestive of the
composition, properties and biological activity of the substance. Shad Rasa (Six rasas) are: Madhur
(sweet), Amla (sour), Lavan (salty), Katu (pungent), Tikta (bitter), Kashaya (astringent)
2. Guna : Qualities possessed by matters which are incapable of independent actions. E.g. guru
(heavy), laghu (light), …etc.
3. Virya : The potency of a substance immediately after ingestion.
4. Vipaka : The post-digestion state of a substance/Drug
5. Prabhava : Unique biological activity (specific effect) of a substance
http://www.carakasamhitaonline.com/mediawiki-1.28.2/index.php?title=Deerghanjiviteeya_Adhyaya
According to western modern science:
- Any substance has certain physical properties and chemical properties
- which undergoes certain changes in the body that exerts effects

Examination of Patient and Disease
• Trivid (major 3): 1) Darsan: Inspection, 2) Sparsan: Palpation, 3) Prasna:
Question
• Asthavid: 1) Nadi: Pulse, 2) Mala: stool, 3) Mutra : urine, 4) Jiwaha: tongue, 5)
Shabda: sound/auscultation, 6) Sparsha: Touch/palpation, 7) Drik :
Inspection/seeing, 8) Akriti: Appearance
Probably these ancient scholars were the first to
learn and explore science of health and well-being,
first to detect heart beat/pulse and use it in
medical practice. They are
remembered/acknowledged for their contribution
in science of life, health and well-being.

Examination of Patient and Disease …
Dashvid Pariksha:
1) Prakriti/Prakruti: Body mind constitution/nature/dosha type
2) Vikriti: Morbid factor,
3) Saar: Prominence of body component,
4) Samhanan: General body built,
5) Satmya: Adaptability ,
6) Sattva: Mental status,
7) Vaya: Age factor,
8) Aaharshakti: Digestive power,
9) Vyam shakti: Physical strength,
10) Pariman: Measurement e.g. height, weight etc.

Treatment in Ayurveda
Three modes of treatment (chikitsa):
1) Yukti vyapashraya chikitsa (Rational healing)
- Using specific ideas, knowledge, skills
- Use of proven techniques and medicines
A) Shaman/Samshaman (pacification), and
B) Shodhan (purification/detoxification - panchakarma)
- (Medicines, procedures, surgery etc: e.g. herbal, herbo-mineral; Panchakarma,
Yoga and Meditation, Proper food and habits)
2) Satvavajaya Chikitsa (Psychological healing) - Psychological support,
psychosocial support, therapy, counseling
3) Daiva vyapashraya chikitsa (Divine/occult healing)- mantra, yagya, japa
Shirodhara

Treatment …
• Samshaman (pacification): diets, life style, herbs, medicines/drugs
to bring doshas into balance
• Apatarpana : Langhana, Ruksana and Svedana
• Santarpana: Brhmana, Snehana and Stambhana
• Pathyas Apathya: (Do’s and Don’t’s/ Conducive or Unconducive)
• Shodhan (purification/detoxification procedures; Panchakarma)
• Snehan (oleation), Abhyanga (massage), Svedan (sweating)
• 1) Vaman (emesis)
• 2) Virechan (laxation)
• 3) Vasti: Anuvasan, Asthapan (enema)
• 4) Nasya (medication through nasal route)
• 5) Rakta Mokshan (detoxification through blood, e.g. blood letting)
Honey
Ghee
Oil

Treatment …
• Surgery (operative procedure) may use:
• Kshar karma (Caustic; herbal caustic thread is popular as kshar sutra),
• Agni karma (Cautery),
• Shastra karma (involving sharp instruments)
• Yantras (use of blunt instruments)
• Anu shastra (use of supportive devices like fingers)
• Shamana and Shodhana (pacifying, purifying)
• Asthavid shastra karma (8 types of surgical procedures): Chhedan
(excision), Bhedan (incision), Vedhan (puncturing/tapping), Lekhan
(scraping), eshan (probing), aaharan (extraction), vishravan (letting out),
sivan (suturing)

Treatment …
Chikitsa chatuspaad (four limbs of service):
i. bhishag (physician), ii. dravya (medicine),
iii. upatha (nurse/ attendant), iv. rogi (patient)
Treatment in short:
• Counseling:
• Swosthavrit: Adopt of appropriate food and life style for healthful living
• Nidan Parivarjan: Avoid causative factors of disease/injury/disorder/imbalance
• Use of Proper medicine (Herbal, Mineral, etc.)
• Detoxification, Rejuvenation
• Yoga, Meditation etc.
• Surgery

Theory of similarity and dissimilarity
• Samanya vishesh siddhant
• सर्वगदा सर्वगभार्वानां सामान्यं र्वृखिकारिम| ह्रासहेतुनर्वगशेषि, प्रर्वृनिरुभयस्य तु||४४||
• sarvadā sarvabhāvānāṁ sāmānyaṁ vr̥ddhikāraṇam|hrāsahēturviśēṣaśca,
pravr̥ttirubhayasya tu||44||
• Like increases like: hence adopt behavior for healthy/balanced living
• The principle samanya causes increase and the principle vishesha causes
decrease of all the existing elements at all times, both these effects are
produced by their application in the body. [Charak Samhita, Sutra Sthan,
1/44]
1.28.2/index.php?title=Deerghanjiviteeya_Adhyaya

Ayurveda and Herbs
यासागगुम्बा
Cordyceps
अडेर
Castor
हृदपत्री
Digitalis
बेसार
Turmeric
Often synonymous
तुलसी
Oscimum
ब्राम्ही
Centella
asiatica

• Locally available and instantly prepared medicines are more
powerful and beneficial…. (Bhav Prakash, Section I, Chapter 5,
Verse 10)
• यस्य देशास्य यो जन्तुस्तज्जं तस्यौषधं नहतम। देशादन्यत्र
र्वसतस्तिुल्यगुिमौषधम ।। (भार्वप्रकाश, प्रथम िण्ड, अध्याय ५,
श्लोक १०)
Shilajit

• सममांसप्रमािस्तु समसंहननो नरः| दृढेखियो नर्वकारािां न बलेनानभभूयते||१८||
• क्षुखिपासातपसहः शीतव्यायामसंसहः| समपक्ता समजरः सममांसचयो मतः||१९|| चरक सुत्र स्थान
२१/१८-१९
• samamāṁsapramāṇastu samasaṁhananō naraḥ| dr̥ḍhēndriyō vikārāṇāṁ na
balēnābhibhūyatē||18||
• kṣutpipāsātapasahaḥ śītavyāyāmasaṁsahaḥ| samapaktā samajaraḥ samamāṁsacayō
mataḥ||19||
• A person with a balanced proportion of muscles and compactness of the body and
firmness in sense organs is not overcome by the onslaught of disorders. Such people can
tolerate hunger, thirst, the heat of the sun, cold and physical exercise. Their digestion,
assimilation of food and muscle metabolism is in a state of equilibrium. Charak Sutra
sthan 21/18-19
1.28.2/index.php?title=Ashtauninditiya_Adhyaya

Ayurveda & TCM
Many similar concepts and practices

Ayurveda and TCM
•Five Elements

Ayurveda and TCM …
•Marma & Pressure points

•Yoga & Tai chi

•Therapies

•Use of Herbs & Food and Life style

Ayurvedic Health
Services in Nepal

History of some formal events
• According to UNESCO report, first official Technical Education
starts from Ayurveda in Nepal.
• First Ayurveda School in 1985 BS
• Nardevi Ayurveda Hospital in 1974 BS
• Nepal Ayurveda Medical council in 2054 BS

Ayurveda Health Policy 2052 BS
•There shall be 1 Ayurveda Rural Dispensary in the
mid of 5 VDCs.
(If so we need about 700 more rural health centers)
•There shall be 4 regional hospitals.
•There shall be herbs processing and medicine
manufacturing centers in each regions.
# Yet to be completely implemented.

Government’s Plan on Ayurveda
There is a policy to take Ayurveda Hospitals up to the
village level and accordingly there is a plan to establish
100 dispensaries, 50 health centers, 3 regional
hospitals, 5 regional directorate, 1 training center and
5 herbal garden one in each region.
http://www.mohp.gov.np/english/function/dept_ayurveda.php (Link cited in 2011)
In the changed context, better planning and
implementation is expected for the health and well-
being of everyone in the country.

Ayurveda Practitioners
Two groups:
1. Traditional - Those who learned it informally from their
family background/profession from generation to
generation
2. Formal Education – Those who got academic courses of
different level
 Paramedical Courses: AAHW/TSLC, AHA etc.
 Medical Courses: BAMS, MD, MS, etc.
 Researches and others: PhD etc.

Ayurveda : concern of 7 major sectors
1. Education:
>> training, development of human resource, awareness, awakening
2. Health and Health Service:
>> medical consultation, treatment, disease control/elimination etc.
3. Herbs cultivation, Collection of Raw materials
>> farming, care to plants, harvesting, collect, store, transport
4. Medicine/Drug Production:
>> processing, quality control, distribution
5. Food Security, Nutrition, Food, Beverage, Culture
6. Rules and Regulation, Economy, Employment, Empowerment,
Intellectual Property Rights, Research, Innovation, Development
7. Biodiversity (species, seeds) Conservation/ Environment/ Climate

Models of ownership and management
1. Government (federal, provincial, or local)
2. Private/personal/family/company
3. Community

Central Regulation of Service
Ministry of Health and Population
Department of Ayurveda and Alternative Medicine
Department of Drug Administration
Nepal Ayurveda Medical Council

Health care Services

Health facilities
Government Private Community
Ayurveda Hospital 2
(Central and Regional)
4+ -
Medical College
Hospital
2 2+ -
Clinics 75
(District and Zonal)
100* -
Dispensaries 305 500* -
Traditional clinics - 19* -
Ayurvedic spas - - -
* There can be more than formally reported , - Exact data not formally reported

Ayurvedic Drugs/Medicine
• Can be either classical (based on ancient texts) or patent (new formulations)
• Forms: tablet, syrups, powder, paste, decoction, oil etc.
• (important lacking is injectable form of medicine; can be a concern to
researchers)
• Use of animal products, herbal products, minerals
• Wide classification of food and behavioral aspects
• Very useful in prevention and treatment
• Range from herbal tea, home remedies and first aid to specific
treatment

Ayurvedic Drugs/Medicine …
Examples of types of Ayurvedic medicine :
Herbs/plant based medicines:
• Churna (Powder), e.g. Trifala
• Vati (Tablet), e.g. Sankha vati
• Ashava/Arista (Alcoholic), e.g. Ashokarista
• Avaleha (Paste), e.g. Vasaabaleha
• Sworasa (Expressed Juices), e.g. Like Aloe vera juice
• Kwath (Decoction), e.g. Dashmool kwath
Mineral /metal based preparations (Rasa Aushadhi)
• Dhatri lauha (contains Iron), Sutshekhar ras, prabal pisti, swarna
bhasma, rasa sindur, laxmi vilas ras, tamra bhasma .…

Ayurvedic Drugs/Medicine …
Some Examples … (properties and uses of Ayurvedic drugs)
1. Avipattikar = balances pitta, virechak, useful in gastritis,
2. Shitopaladi = kapha vata samak, useful in cold and cough
3. Drakshav = improves appetite, useful for digestion
4. Ashokarista = regulation of menstruation
5. Chyavanpras = rejuvenation, useful in respiratory infections
6. Ashogandha = vata samak, aphrodisiac, useful in insomnia
7. Tirfala = tridosha samak, useful in constipation,
8. Chandraprabha vati = useful in urinary tract infection
9. Guggulu = hypolipidemic

Producers of Ayurvedic Medicines/drugs
• Pharmaceuticals: Many national and South Asian (mostly
Indian) multinational companies compete in the market,
mostly private companies
•Herbal farms
•Hospitals
•Dispensaries

Singha Durbar Vaidyakhana

Singha Durbar Vaidyakhana
• Established by King Pratap Malla (1641-1674 CE)
• One of the oldest of its kind in South Asia
• Comes under a few government companies that are in
profit
• Trusted and oldest pharmaceutical company
• Now it is able to supply only about 20% of its demand

Health Service Centers managed by Government
Service Centre Main Manpower Total in
the
country
Main Service Location
Ayurveda Aushadhlaya
(Dispensary)
AAHW, AHA 305 Preventive, Diagnostic, Curative,
Health promotive
Municipality/
ward
Jilla Ayurveda Swasthya
Kendra (Clinic)
BAMS, AHA, AAHW 61 Preventive, Diagnostic, Curative,
Health promotive
District
Anchal Ayurveda
Aushadhalaya (Clinic)
BAMS, AHA, AAHW 14 Preventive, Diagnostic, Curative,
Health promotive
Zonal
Chikitsalaya (Hospital) MD, MS, BAMS,
Nursing Staff, AHA,
AAHW/TSLC
2 Specialization,
Preventive, Diagnostic, Curative,
Health promotive
Regional and
Central

Registered human resources in Ayurveda
Type or Level Number
Traditional Practitioners 19 (Many are not listed in the Council)
AAHW/TSLC 1277+
AHA 1356+
BAMS 485+
MD/MS, PhD 46+
(Foreigners registered in NAMC) (4)
[Update as of 2017; Keep updating]

Top 10 Problems/Disease treated in
Government Ayurveda Health Centre
1. Amlapitta: (Gastritis including peptic ulcer)
2. Kamala: (Hepatitis, jaundice)
3. Prabahika: (Acute and Chronic Dysentry)
4. Vatavyadhi: (Neurological, and Musculo skeletal problems)
5. Pinas: (Sinusitis)
6. Pachan janya Vikar: (Disorders related to digestion)
7. Pradar: (Discharges, PID, DUB in females)
8. Bibandha:(Constipation)
9. Asmari: (Calculi)
10. Jwar: (Different febrile illness)

Most Common Health Problems of people visiting
Ayurveda Health Centers
• APD
• Hemorrhoids, Fistula, Fissure etc.
• Constipation, Indigestion
• Sinusitis
• HTN, DM, COPD, CVA
• Febrile illness
• Stress, Insomnia, Anxiety,
Depression, Psychosis
• Arthritis of various type (RA, OA)
• UTI, Calculi
• DUB, PID
• Infertility, Sexual dysfunction
• Maternal and Child health
problems
• Geriatric problems
• Skin problems,
• Over weight, obesity
• Hepatitis
• …..etc.

What does a Government Ayurvedic Health center do?
• Check ups, Treatment, Counseling, Referral etc.
• Government service of checkups and most of
medicines/drugs are free.
• Conservation of natural resources, Collection of herbs,
Medicine/Drug production
• Preventive/ Promotive: Health Awareness, School and
Community health programs, Elderly, Pregnant and mothers
• Collaboration with other units of government and non-
government sectors, Medical schools and research institutions
• Regulations and controls, Researches, Trainings
• Planning, Budgeting, Monitoring, Evaluation, Reporting

Ayurveda Education
in Nepal

Central Regulation of Education
Ministry of Education,
Nepal Ayurveda Medical Council
Universities (TU, NSU)
Boards : CTEVT

Ayurvedic Education in Nepal
• Paramedical courses: TSLC/AAHW, AHA
• Medical Course: BAMS, MD
• Lacking / Trying for
• Most of Specializations in Post Graduation MD/MS, and further
(Nepal still depends on India and China)
• Training, researches, service in wide range

Ayurvedic Education in Nepal

Tribuvan University (TU),
Institute of Medicine, Ayurveda Campus
• One of the oldest schools,
• Now conducting Bachelor and Master programs

Nepal Sanskrit University, Institute of Ayurveda
• Nepal Sanskrit University, Institute of Ayurveda
• Conducting Assistant and Bachelor level courses

Educational Centers in Nepal
College Board / University /
colleges
Total
colleges
Courses Seats
available
Colleges for Paramedical
Courses
CTEVT, NSU 6 AAHW/TSLC, AHA
Bachelor level colleges TU, IOM
(in Kathmandu and
Birgunj)
2 + 1* BAMS 30 + 40*
NSU
(in Dang, Janakpur, and
Dhulikhel)
3 BAMS 40 + 40 + 40
Master/Post graduate TU, IOM, Ayurveda Campus
(Kathmandu)
1 MD 2 ?
*Affiliation concealed

BAMS: Bachelor of Ayurvedic Medicine and Surgery
Note: Every subject is taught in terms of both Ayurvedic and Western Sciences. If
it is not possible to correlate some distinct ideas, they are taught separately.
Phase
/Professional
Duration Deals with
First Phase 1 ½ years Basic Science
Second Phase 1 ½ years Pre-clinical Sciences
Third Phase 1 ½ years Clinical Sciences
Internship 1 year Hospital based practice under
guidance of experts
Indian colleges have modified BAMS curriculum into 4 phases, total
duration remaining five and half years

Bachelor curriculum (BAMS)
Basic Phase
• Anatomy
• Physiology
• Sanskrit
language
• Padartha
vigyan
• Ancient
Texts
Pre-Clinical
• Forensic
Medicine
• Toxicology
• Pathology
• Pharmacognosy
and
pharmacology
• Social Preventive
medicine
• Yoga
• Naturopathy
• Ancient Texts
Clinical Phase
• Medicine
• Surgery
• Pediatrics
• Gynecology and
Obstetrics
• Panchakarma
(detoxification
and
rejuvenation)
• ENT, Eye,
Dentistry
• Psychiatry
• Ancient Texts
I
N
T
U
R
N
S
H
I
P

Subjects – BAMS First Phase
Subject Theory
Lecture
1 hours
Practical
/Demonstration 1 ½
hours
Deals with
Sanskrit 150 Sanskrit Language
Itihas 60 History
Padartha Vigyan 150 30 Basic Principles
Shareer Rachana 210 210 Human Anatomy,
Embryology
Shareer Kriya 210 90 Human Physiology,
Biochemistry
Astanga Sangraha 60 Principles and Practice
of Ayurveda

Subjects – BAMS Second Phase
Subject Theory
Lecture
1 hours
Practical
/Demonstration 1
½ hours
Deals with
Swasthavrit 180 50 Preventive and Community
Medicine, Epidemiology, Yoga,
Naturopathy
Rog tatha Vikriti Vigyan 180 90 Clinical Medicine,
Microbiology, Pathology
Rasashastra tatha
Bhaishajya Kalpana
180 90 Alchemy, Pharmacy
Dravya Guna Vigyan 180 90 Pharmacognosy, Materia medica,
Pharmacology
Charak Sahmita
Purwardha
100 Principles and Practice of Medicine
Agad Tantra tatha
Vyabahar Ayurveda
100 50 Toxicology, Forensic Medicine

Subjects – BAMS Third Phase
Subject Lecture
hours
Hospital
Training
Months
Deals with
Kaya Chikitsa and
Panchakarma
300 + 100 9 + 3 Internal Medicine, Psychiatry,
Detoxification and Rejuvenation
Shalya Vigyan 210 6 General Surgery
Shalakya Tantra 210 4 Oto-rhino-laryngology, Dentistry,
Ophthalmology
Bal Rog 90 1 Pediatrics
Stri Rog and Prasuti
Tantra
150 3 Obstetrics, Gynecology
Charak Sahmita
Uttarardwha
100 Principles and Practice of Medicine

Surgical treatment
going on in TUATH

Vocational Training Education
• NSU: 1 college
• CTEVT: 7 colleges
• Other regular/technical schools
• Programs:
• AHA 3 years
• AAHW/TSLC 18 months

Traditional Medicine
in Today’s Context

Who prescribe and use Ayurvedic medicines ?
• Ayurvedic doctors and health assistants
• Doctors of western (allopathic) medicines and health
assistants
• Over the counter drugs by anyone
• Home remedies by anyone

Who prefer Ayurvedic products?
• Almost all people, people from all walks of life
• They want to use, learn, help people live better
utilizing safe Ayurvedic medicines
• Everyone wants to see better development in
coming days

Ayurveda in the market:
Besides preventive and curative services, Ayurveda
offers more for daily life:
• Sanitation: Soaps, Shampoos
• Cosmetics
• Health-food supplements
• Herbal tea
• Oils and perfumes
• Organic fruits and vegetables
• Health clubs: Yoga, Massage, Shirodhara, Spa etc.

WHO on Traditional medicine
• In some Asian and African countries, 80% of the population depend on traditional
medicine for primary health care.
• Herbal medicines are the most lucrative form of traditional medicine, generating
billions of dollars in revenue.
• Traditional medicine can treat various infectious and chronic conditions: new
antimalarial drugs were developed from the discovery and isolation of artemisinin
from Artemisia annua L., a plant used in China for almost 2000 years.
• Counterfeit, poor quality, or adulterated herbal products in international markets are
serious patient safety threats.
• More than 100 countries have regulations for herbal medicines.
• http://www.who.int/mediacentre/factsheets/fs134/en/ (Link cited in 2011)

Doctor vs Disease in Nepal
• Simultaneous Prevalence of both
• Communicable diseases and
• Non-communicable diseases
• Low availability of human resource/doctors
Place Doctors/Population
Kathmandu 98/100,000
Rural area 2.5/100,000
Some Villages No doctor
Source: (Nick Simon’s Institute)
http://nsi.edu.np/nsi/page.php?page=nepal_health_situation
(Data and Link cited in 2011)
Different health services should be made available to people of all walks of life in all parts of the country.

Lets not destroy heritage in the name of
development
On third world development, this book serves as a voice to
the voiceless, the silent victims of development.
In the name of development, the traditional knowledge
and skills should not be humiliated and abolished by
imported things, native knowledge should be developed.
It highlights real life stories rather than lifeless data as
indices of development.
https://www.abebooks.com/servlet/BookDetailsPL?bi=7
225899946
Nanda
Shrestha

WHO says
• WHO and its Member States cooperate to promote the use of
traditional medicine for health care. The collaboration aims to:
support and integrate traditional medicine into national health
systems in combination with national policy and regulation for
products, practices and providers to ensure safety and quality;
ensure the use of safe, effective and quality products and practices,
based on available evidence;
acknowledge traditional medicine as part of primary health care, to
increase access to care and preserve knowledge and resources; and
ensure patient safety by upgrading the skills and knowledge of
traditional medicine providers.
• http://www.who.int/mediacentre/factsheets/fs134/en/(Link
cited in 2011)

Some Modern Drugs of Botanical Origin
Modern Medicinal
Compound
Plant origin
(botanical nme)
Action
Atropine Atropa bellodena Anticholinergic
Codeine Papaver somniferum Analgesic, antitussive, antidiarrheal
Colchine Colchium autumnale Antitumor agent, antigout
Digoxin Digitalis purpurea Cardiotonic
Ephedrine Ephedra distachy Sympathomimetic, antihistamine
Reserpine Rauwolfia serpentina Antihypertensive, tranquilizer
Salicylic acid Salix spp Anti-inflammatory
Taxol/Paclitaxel Taxus brevifolia Antitumor agent
L-Dopa Mucuna pruriens Aniparkinsonism
Quinine Cinchona ledgeriana Antimalarial, anti-inflammatory, analgesic

Benefits of Herbs to Nepalese people
1. Health: Anyone can learn, use and benefit.
2. Economy: Cultivation and conservation of plants has provided a lot
of support. It has made possible to send many children to school,
and provided money for food, clothing, health service etc. Many
people get employed. Helps to achieve Sustainable Development
Goals (SDGs). Nepal can also serve people and earn through Medical
tourism.
3. Environment Protection: Protecting plants for medicinal purpose
also protects the source of Oxygen, help balance ecosystem,
conservation of water resources. But over harvesting may create
problems.

Scholars encourage scientific studies
• Its not the allopathy or Ayurveda who should decide
which works and which not
Dr. R D Lele, MBBS,
MD, FRCP
L C Mishra,
Ph. D.

Research Activities: NARTC
National Ayurveda Research and Training Center
• China has gifted a construction of Research center
• First of its kind in Nepal.
• Largest setup of its kind.
• Shall develop ground for development through researches and
trainings.
• Opportunity to : Doctors of different systems of medicine, Ayurvedic
doctors, biochemists, pathologists, statisticians, nutritionist,
pharmacist, microbiologists, botanists…. etc.
• Studies/researches shall eliminate unproven blames/claims.
• Trainings shall strengthen the quality of service

Health is the Goal
Medical Systems are the means
•Keep learning, researching, sharing. from each other

Daily care can be adopted based on traditional medicine
• Handbook of Domestic
medicine and Common
Ayurvedic Remedies
•http://niimh.nic.in

Primary health care can be strengthened using some Safe
Herbal Remedies
• Some official guidelines are available on using safe and effective
traditional/ herbal medicine
• Health service providers of different stream can also learn these things
and Use

Simplified books based on Ayurveda are available for modern learners
• MS Valiathan https://en.wikipedia.org/wiki/M._S._Valiathan
• Prof. Dr. Ram Harsh Singh
https://en.wikipedia.org/wiki/Ram_Harsh_Singh
• Deepak Chopra https://en.wikipedia.org/wiki/Deepak_Chopra

Buddha बुध्द
•“If there is problem, it has
cause and remedy.”
धन्यर्वाद! 谢谢謝謝
से से xiè xie
Thank you!

Annex

Bibliographies
• Ayurved ko vrihad Itihas (Nepali): (Comprehensive History of Ayurveda),
Prof. Dr. Chadra Raj Sapkota Ayurveda
• Darshanko Ruprekha (Nepali), Dr. Kashi Raj Sharma Subedi
• Ashtanga Sangraha (Sanskrit, Nepali and English), Prof. Dr. Shyam Mani
Adhikari
• Annual Report 2015/2016, Department of Health Services
• http://www.mohp.gov.np
• http://niimh.nic.in
• http://www.who.int

Relevant literature on
Traditional Medicine and Ayurveda
• The promotion and development of traditional medicine: report of a WHO (World Health
Organization) meeting [held in Geneva from 28 November to 2 December 1977]. 1978.
• National Ayurveda Health Policy 2052 BS. Kathmandu: Ministry of Health; 1996.
http://www.lawcommission.gov.np/en/wp-content/uploads/2018/09/national-ayurveda-
health-policy-2052-1996.pdf
• General guidelines for methodologies on research and evaluation of traditional medicine.
Geneva: World Health Organization, 2000.
• Koirala RR, Khaniya BN. Present Status of Traditional Medicines and Medicinal and
Aromatic Plants Related Resources and Organizations in Nepal. 2009.
• WHO traditional medicine strategy 2014–2023. World Health Organization. 2013.
• National Health Policy 2014. Kathmandu: Ministry of Health; 2014.
• Aryal KK, Dhimal M, Pandey A, Pandey AR, Dhungana R, Khaniya BN, et al. Knowledge
diversity and healing practices of traditional medicine in Nepal. Nepal Health Research
Council, 2016.

Relevant links on Sushruta Samhita
• https://archive.org/search.php?query=sushruta
• https://archive.org/details/englishtranslati00susruoft/page/n3
• https://www.rarebooksocietyofindia.org/book_archive/196174216674_10154370772
061675.pdf
• Davis JS. Address of the president: the story of plastic surgery. Annals of surgery. 1941
May;113(5):641.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1385923/pdf/annsurg00385-0023.pdf
• https://www.youtube.com/watch?v=-e8h4G_1wEQ
• https://www.youtube.com/watch?v=wOu0RTWjKJk
• https://www.youtube.com/watch?v=uVdx3-2DF3c
• thamburaj.com/susrutha.ppt

Relevant links on Charak Samhita
• https://archive.org/search.php?query=charak
1.28.2/index.php?title=Adhyaya(chapters)
• Dina charya http://www.carakasamhitaonline.com/mediawiki-
1.28.2/index.php?title=Matrashiteeya_Adhyaya
• Annapana vidhi http://www.carakasamhitaonline.com/mediawiki-
1.28.2/index.php?title=Annapanavidhi_Adhyaya
• Ritucharya http://www.carakasamhitaonline.com/mediawiki-
1.28.2/index.php?title=Tasyashiteeya_Adhyaya
• Jana padadodhwamsha http://www.carakasamhitaonline.com/mediawiki-
1.28.2/index.php?title=Janapadodhvansaniya_Vimana

Others Relevant Links
• Astanga hridayam sutra sthan
https://ayurinfo.files.wordpress.com/2011/09/astanga-hridaya-
sutrasthan-handbook-pdf.pdf
• Many scientists of modern medical science also advocate use of
Ayurveda. Dr. B M Hegde
http://www.bmhegde.com/corrected_ayurv.htm
• Dr. Sudha Prathikanti
https://www.youtube.com/watch?v=iTOJ8c__rk8
• Dr. David Frawley https://www.youtube.com/watch?v=3d5dsL5AYCs
• Some others https://www.youtube.com/watch?v=Ld-YxNdaiJ4,
https://www.youtube.com/watch?v=27Q_bJFI3Mw

Keep learning
• नानौषनधभूतमं जगत .. Every dravya (substance/material) is a useful medicine by
proper Yukti
• ओषधीनागमरूपाभ्ां जानते ह्यजपा र्वने| अनर्वपािैर्व गोपाि ये चान्ये र्वनर्वानसनः||१२०||
• ōṣadhīrnāmarūpābhyāṁ jānatē hyajapā vanē| avipāścaiva gōpāśca yē cānyē
vanavāsinaḥ|| Charak, Sutra 1/120 ||
• Goat-herders, sheep-herders, cowherders and forest-dwellers are acquainted with
names and forms/identification of various medicinal herbs and the plants [Charak,
Sutra 1/120]

Ayurveda of all, for all, by all
• There are many similarities between Ayurveda and other medical system.
• Some people regard Ayurveda to be Hindu system of Medicine. In reality it is the
medicine of people of any religion, and also those of no-religion.
• Many luminaries/Acharyas like Bagbhatta and Nagarjuna, who hold highly respectable
position in history of Ayurveda, were Buddhist.
• Ayurveda is a dynamic tradition. There was exchange of knowledge with Arab and Tibet,
and then to Europe and Africa. For example Unani medicine ‘hajrul yahud bhasma’ is
used by Ayurvedic practitioners.
• In modern days, many people of different religious background learn, use, practice, and
play role to develop Ayurveda, with an aim of improving human health, enhance human
sphere of knowledge etc. It is meeting point of all.
• So Ayurveda is not bound to certain religion. Now it must be clear to all that it is an
attempt to keep life better, keep environment better, and respect all types of civilizations.
Everyone can benefit from it, and can contribute for its development.

For overall health
Health in different level has to be supported by well functioning:
• Law/policy, responsibility, social responsibility, human resource, leaders
• Health services, education, communication, opportunities, medicines/ treatment
• Proper conduct/lifestyle: food, work, sleep, recreation, games, water, air, sanitation
• Values, ethics, social support, goods/equipment/supply
• Research, innovation, development, record, review/evaluation, feedback
• National and international collaboration and cooperation etc.
All blocks of the system of health system should be
healthy/strong: Governance/Leadership, Health Work Force,
Health Information System, Logistics/Drugs/ Equipment,
Health Financing, Service Delivery, (WHO: Building Blocks of
Health System)
https://www.who.int/healthsystems/EN_HSSkeycomponents
.pdf?ua=1
To assure Universal Health care/coverage (UHC) and achieve
Sustainable Development Goals (SDG)

To Reduce Poverty and Climate Change: https://stories.undp.org/medicinal-plants-and-poverty-reduction-in-a-changing-climate
To Achieve Sustainable development Goals: https://sustainabledevelopment.un.org/?menu=1300

• Prepared for symposium: CHINA-NEPAL COOPERATION IN HEALTH AND HEALING: Integrative
Medicine: Opportunities and Challenges for Research and Development Cooperation towards a New
Global Health Paradigm
• First presented: 2068 Kartik 29 BS / 15th November 2011 CE; Some update: February 2019
• Acknowledgement: Dr. Amrita Bhattrai, Dr. Ashok K Mahato, Dr. Bidur Shrestha, Dr. Chandra Karki,
Dr. Cyrus Neupane, Dr. Pushpa Raj Poudel, Dr. Sangita Maharjan, Dr. Shree Ram Phuyal, Dr. Subhadra
Karki, Dr. Surya Upadhyay, Dr. Vijay Bhurtel
• For feedback or query:
• Email: ayurinfo11@gmail.com ,
• Dr Aseem Baidya: aseemunlimited.asm@gmail.com,
• Dr Shiva
http://ourayurinfo.blogspot.com/ , https://ayurinfo.wordpress.com/ , https://twitter.com/AyurvedaNepal ,
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Ayurved Medicine in Nepal with brief Introduction to Principles and Practices of Ayurveda

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