Background

Ayurveda, also known as the “Science of Life,” is an ancient system of medicine that originated in India over 5000 years ago. It is contemplated one of the oldest healthcare classifications in the world and has been practiced continuously throughout history (Lohiya et al. 2016). Ayurveda encompasses a holistic approach to health and well-being, focusing on the balance between mind, body, and spirit. Ayurveda, an ancient healing system originating in India, has an opulent history spanning thousands of years. Its roots can be traced back to Vedic scriptures, including the Atharva Veda, Rig Veda, and Yajur Veda. Ayurvedic texts, such as the Charaka Samhita and the Sushruta Samhita, compiled between 1000 and 500 BCE, serve as foundational sources for this traditional medical system (Narayana and Durg 2021; Singh and Agarwal 2022). These texts provide a comprehensive understanding of human anatomy, physiology, pathology, and therapeutic interventions. Ayurveda adopts a holistic approach to health and well-being, considering the physical, mental, and spiritual aspects of an individual. It emphasizes the dynamic balance between doshas (bio-energies), dhatus (body tissues), and malas (waste products) in maintaining health. Ayurvedic practitioners aim to restore this balance through various therapeutic modalities and lifestyle adjustments (Singh et al. 2021).

Fundamental principles

Panchakarma

Panchakarma is a central tenet of Ayurveda that involves a series of detoxification procedures to cleanse the body and mind. A holistic medical regimen called panchakarma purifies and revitalises the body, mind, as well as consciousness. It is founded on Ayurvedic principles, according to which each human is a unique phenomenon that is expressed through one of the five elements: Earth, Air, Fire, Water, and Ether. Each person has a different balance of the three doshas (tridosha) that are formed by these elements: Pitta, Kapha, and Vata. Disturbances in this doshic balance give rise to chaos and, ultimately, disease. Panchakarma is individualized for each individual founded on their unique constitution and disease, necessitating careful monitoring and oversight. It includes cleansing techniques (Shodanas) after pre-purification steps like Snehan and Svedana. It comprises five primary therapies, which are briefly described in Fig. 1.

Fig. 1
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Showing the fundamental principles of panchakarma for treating an infected individual

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Tridosha theory

One fundamental idea in Ayurveda that reflects a straightforward yet profound perspective on health is the Tridosha hypothesis. It asserts that the three basic energies—Pitta, Kapha, and Vata—that regulate all physiological processes are known as doshas. The various doshas that each person possesses in different amounts are what give humans their unique physical characteristics, personalities, and susceptibilities to illness. Ayurveda offers a variety of methods for balancing the doshas, such as Panchakarma, herbal remedies, dietary adjustments, and lifestyle changes (Fig. 2).

Fig. 2
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A systematic depiction of tridosha theory in Ayurveda. Ayurvedic practitioners assess an individual's unique dosha constitution and offer treatment plans accordingly (Ibáñez et al. 2023; Kumar et al. 2021)

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Therapeutic modalities

Ayurvedic medicine utilizes a vast array of herbs, spices, and plant extracts for therapeutic purposes. These herbal remedies are formulated into various preparations, including decoctions, infusions, pills, powders, and oils. Common herbs used in Ayurveda include turmeric, ginger, holy basil, neem and ashwagandha (Singh et al. 2022a, b, c, d; Wu et al. 2021). A few well-known Indian medicinal plants and their applications are included in Table 1.

Table 1 List of Indian medicinal plants and its applications
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Ayurvedic dietary guidelines are based on the principle of Ahara (proper nourishment). A balanced diet is essential for maintaining optimal health. Specific dietary recommendations are made according to an individual's dosha constitution and health condition. Ayurvedic massage, known as Abhyanga, involves massaging the body with medicated oils (Al Mahmud et al. 2023). It helps improve circulation, ease muscle tension, and promote relaxation. Specialized massage techniques, such as Shirodhara (pouring oil on the forehead), are also employed for specific health concerns. Ayurveda emphasizes the integration of yoga and meditation practices to enhance overall well-being. Yoga postures, breathing exercises, and meditation techniques are recommended to balance doshas, promote mental clarity, and reduce stress (Kakodkar et al. 2021). Ayurveda advocates for a harmonious lifestyle that aligns with the rhythms of nature. Regular exercise, adequate sleep, and stress management are essential components of Ayurvedic health maintenance. Ayurveda has gained global recognition for its holistic approach to health and well-being. It offers a comprehensive system that addresses the root causes of imbalances rather than merely treating them (Singh et al. 2022b; Verma et al. 2024).

Historical development

The origins of Ayurveda could be trailed back to the Vedic period in ancient India when sages and seers documented their knowledge of health and healing in sacred texts called Vedas. These texts, particularly the Atharva Veda, contain detailed descriptions of various diseases, their causes, symptoms, and treatments (Sharma et al. 2022). Over time, Ayurveda evolved and expanded its scope through the contributions of renowned scholars such as Charaka and Sushruta. Sushruta Samhita and Charaka Samhita are two seminal texts that provide comprehensive guidelines for diagnosis, treatment, and prevention of diseases (Singh et al. 2022e). Ayurveda, a Sanskrit term meaning “science of life,” is a holistic system of medicine with its roots in ancient India. Ayurveda accentuates the equilibrium between body, spirit, and mind and uses natural herbs, diet, and lifestyle changes to promote health and prevent disease. Here is a detailed historical timeline of Ayurveda's development in India:

Early Vedic period (1500–1000 BCE)

The earliest evidence of Ayurvedic practices can be found in the ancient Vedic texts, such as the Rigveda, Atharvaveda, and Yajurveda. These texts mention medicinal herbs, surgical procedures, and guidelines for healthy living. Ayurveda was closely associated with religion and spirituality, with many healing rituals performed by priests and healers in temples.

Classical period (1000–500 BCE)

During this period, Ayurveda experienced significant advancements, and several influential texts were composed. The most important of these texts are the Charaka Samhita, Sushruta Samhita, and Ashtanga Hridaya. These texts provided a comprehensive framework for Ayurvedic medicine, covering topics such as anatomy, physiology, pathology, diagnosis, and treatment. The Sushruta Samhita, in particular, is acknowledged for its contributions to surgery, including descriptions of over 120 surgical instruments and procedures(Pandey et al. 2013; Shi et al. 2021).

Pre-classical period (500–300 BCE)

This period saw the emergence of various schools of Ayurvedic thought, each with its own unique methodology for treatment and diagnosis. The most prominent schools were the Charaka School, the Sushruta School, and the Vagbhata School. Despite their differences, these schools shared a common belief in the importance of a balanced diet, herbal remedies, and lifestyle changes for maintaining health (Jaiswal and Williams 2016).

Golden age of Ayurveda (300–1000 CE)

This period marked the pinnacle of Ayurvedic development, with significant contributions from renowned physicians and scholars. Notable figures during this time include Nagarjuna, Charaka, and Sushruta. Ayurveda was widely practiced throughout India, and Ayurvedic texts were translated into several languages, including Arabic and Persian. Ayurvedic practitioners also began to establish medical schools, hospitals, and dispensaries(Honwad 2017).

Decline of Ayurveda (1000–1500 CE)

The rise of allopathic medicine and the influence of foreign invaders led to a decline in the popularity of Ayurveda. Allopathic medicine, with its emphasis on scientific experimentation and modern drugs, gained favor among the educated elite. Ayurveda was often viewed as outdated and unscientific, and its practice declined significantly (Li et al. 2022).

Revival of Ayurveda (1500–present)

In the nineteenth century, there was a renewed interest in Ayurveda, thanks to the efforts of Indian nationalists and scholars. Figures like Mahatma Gandhi and Swami Vivekananda advocated for the revival of Indian traditional medicine. In the twentieth century, several Ayurvedic colleges were established, and the government began to promote Ayurvedic education and research. Today, Ayurveda is documented as a legitimate system of medicine in India in addition to is widely practiced alongside allopathic medicine. Ayurveda has an opulent and complex history that spans several millennia. Despite facing challenges and periods of decline, Ayurveda has survived and continues to thrive in India today. Its holistic methodology to health, with its emphasis on natural therapies, has made it an increasingly popular choice for those seeking alternative or complementary healthcare options (Singh and Reddy 2020).

Ideologies of Ayurveda

Ayurveda, the ancient Indian system of medicine, is founded on the belief that health is a state of balance between the mind, body, and spirit. According to Ayurveda, imbalances in these three elements can lead to disease. The fundamental principles of Ayurveda are listed in Table 2.

Table 2 Shows the fundamental principles of Ayurveda
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These principles form the foundation of Ayurvedic medicine along with guide the diagnosis, treatment, and prevention of disease. Ayurvedic practitioners practice countless techniques, comprising herbal remedies, diet, lifestyle changes, and yoga, to restore balance to the doshas and promote overall health and well-being (Pandurangi et al. 2017).

Diagnosis in Ayurveda

Ayurvedic diagnosis is a holistic process that aims to understand the root cause of an individual's imbalance and disease. It involves a comprehensive assessment of the patient's physical, mental, and emotional state, over and above their lifestyle and diet (Kataria et al. 2022). The following are key components of Ayurvedic diagnosis shown in Table 3.

Table 3 List of the important components of Ayurvedic diagnosis
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Based on the information gathered from these diagnostic techniques, the Ayurvedic practitioner determines the patient's prakruti and vikruti. This information guides the appropriate selection of treatment strategies, including herbal remedies, diet, lifestyle changes, and yoga (Raynaud et al. 2021).

Treatment modalities

Ayurveda deals with an extensive range of treatment modalities to address various imbalances and diseases. These modalities aim to restore balance to the doshas, promote self-healing, and support the body's natural detoxification processes (Singh et al. 2024b). Here some significant Ayurvedic treatment modalities are: Herbal Remedies i.e., Ayurveda utilizes a vast array of herbs and herbal formulations to treat various ailments (Singh et al. 2022a, b). These herbs are believed to possess specific medicinal properties that can balance the doshas, alleviate symptoms, and promote healing. Ayurvedic herbal remedies are typically prepared using whole herbs or standardized extracts (Amegbor and Rosenberg 2020). A few medications or chemicals that have been produced from natural ingredients are included in Table 4.

Table 4 Lists several medications or substances that have been created or separated from natural materials
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Diet and nutrition

Ayurveda places prodigious prominence on diet and nutrition as a foundation for good health. Ayurvedic practitioners vouch for a sattvic diet, which is predominantly vegetarian, fresh, and wholesome. The diet is personalized to the individual's unique constitution and current state of imbalance. Specific foods and spices are recommended to poise the doshas and promote healing.

Panchakarma

It is a comprehensive detoxification and rejuvenation program that is considered the cornerstone of Ayurvedic treatment. It involves five main procedures: Nasya (nasal administration of herbal oils or powders), Vamana (therapeutic emesis), Basti (medicated enemas), virechana (therapeutic purgation), and raktamokshana (bloodletting). Panchakarma is typically conducted under the supervision of an authorized Ayurvedic practitioner.

Yoga and meditation

It’s an integral part of Ayurvedic treatment. Specific yoga postures, breathing exercises, and meditation techniques are recommended to poise the doshas, promote relaxation, and enhance overall well-being.

Ayurvedic massage

Ayurvedic massage, known as abhyanga, a therapeutic massage technique that uses herbal oils or ghee. Abhyanga is believed to improve circulation, promote relaxation, as well as balance the doshas. It can also be used to relieve muscle pain and stiffness.

Shirodhara

Shirodhara is a specialized Ayurvedic treatment that includes pouring a continuous stream of warm oil or medicated liquid onto the forehead. Shirodhara is believed to relax the mind, relieve stress and anxiety, and promote deep relaxation.

Ayurvedic facials and body treatments

Ayurvedic facials and body treatments use herbal pastes, oils, and powders to cleanse, nourish, and rejuvenate the skin. These treatments are believed to improve skin health, promote relaxation, along with balance the doshas (Evans et al. 2008; Ladas et al. 2015; Misawa et al. 2019). It’s imperative to note that Ayurvedic treatment modalities should be administered by qualified Ayurvedic practitioners who have undergone proper training and education. Ayurveda is a complete medicine system, and the selection of apposite treatment modalities depends on the individual's unique constitution, current state of imbalance, and specific health concerns (Nlooto and Naidoo 2016).

Contemporary relevance

Ayurveda, the ancient Indian medicine system, is gaining increasing recognition and relevance in contemporary healthcare due to its wide-ranging methodology for health and well-being. Here are some vital aspects highlighting the contemporary relevance of Ayurveda.

Focus on prevention and personalized care

Ayurveda emphasizes preventive healthcare and takes a holistic approach to patient care. Ayurvedic practitioners consider the individual's unique constitution, lifestyle, and environment when making treatment recommendations. This personalized approach can help identify and address imbalances before they manifest as full-blown diseases (Pushpa 2024).

Treatment for rheumatoid arthritis

Studies have demonstrated that by identifying particular Prakriti-based subgroups, Ayurvedic medicines can aid in the treatment of complex diseases, including rheumatoid arthritis. Personalized diets, lifestyle modifications, and herbal therapies are prescribed by Ayurvedic doctors based on each patient's distinct Prakriti (constitutional type) and symptoms.

Prakriti-based stratification of healthy individuals

By combining contemporary genomics with Ayurveda's Prakriti stratification techniques, the molecular and genomic underpinnings of the Dosha Prakriti idea have been discovered. Researchers discovered that healthy people with different Prakriti types (Pitta, Kapha, and Vata) had unique molecular signatures. By utilizing genomes and molecular phenotyping, this Ayurgenomics method allows for the methodical investigation of Ayurvedic principles.

Integration with modern medicine

Ayurveda is increasingly being integrated with modern medicine to provide an inclusive approach to healthcare. Ayurvedic principles and practices are being studied and incorporated into mainstream medical care, particularly in areas such as chronic diseases, stress management, and mental health (Sharma and Prajapati 2020).

The conflict between the traditional way of Ayurveda and the modern medical practice

The ancient Ayurvedic approach and contemporary medical treatment disagree on a number of important points: Lack of Standardization: Ayurvedic medications are created using natural components, which can vary in quality and potency, resulting to inconsistent effectiveness. This is in contrast to modern medicine, where drugs are synthesized in a lab under tight restrictions. Standard Operating Procedures (SOPs) versus Customization: Ayurvedic clinical practice is centered around customization, whereas modern medicine requires standard operating procedures (SOPs). A significant disagreement arises between the two systems as a result (Singh et al. 2024c). Evidence-based Practice: The majority of Ayurvedic treatments lack rigorous scientific study and evidence-based validation, which makes it challenging for Ayurveda to be incorporated into mainstream medicine. Integration Challenges: Lack of trust, technical incompatibilities, difficulties with operational coordination, and regulatory obstacles are some of the obstacles that stand in the way of integrating Ayurveda with contemporary medicine. Reductionist Approach: Ayurveda treats the patient holistically, whereas modern medicine takes a reductionist approach. When creating an interface between Ayurveda and modern medicine, caution must be taken to avoid unduly reductionist treatment of Ayurveda. Safety Myths: People frequently believe that Ayurvedic medications are safe and have no adverse effects, which can result in self-medication and even injury. It is essential for the successful integration of Ayurveda and contemporary medicine to resolve these tensions through standardization, evidence-based research, and a cooperative approach in order to deliver safe and efficient patient treatment (Chopra and Doiphode 2002).

Scientific research and validation

An emergent body of scientific research supports the efficacy of Ayurvedic herbs, therapies, and formulations. Clinical studies have demonstrated the effectiveness of Ayurveda in managing various conditions, including arthritis, diabetes, hypertension, and anxiety (Gupta 2024).

Integrative and complementary medicine

Ayurveda is gaining acceptance as a integrative and complementary medicine system that can be used alongside conventional medicine to enhance treatment outcomes and improve overall well-being (Olbara et al. 2018). Table 5 Ayurvedic therapies can help reduce the conventional treatments' side effects and promote a faster recovery.

Table 5 Lists several significant herbal formulas that are commonly employed in India's traditional Ayurvedic system
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Lifestyle and wellness

Ayurvedic principles and practices, for instance, meditation, yoga, and a sattvic diet, are becoming popular in modern lifestyle and wellness trends. These practices are recognized for their ability to promote mental and physical well-being, diminish stress as well as enhance overall quality of life (Palileo-Villanueva et al. 2022).

Herbal medicine and nutraceuticals

Ayurvedic herbs and formulations are increasingly being used as nutraceuticals and dietary supplements to support complete health and well-being Table 6. The demand for standardized Ayurvedic herbal extracts and formulations is growing globally.

Table 6 Lists a few common medicinal plants with potential as nutraceuticals, along with their main application in conventional medicine
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An organized display of medicinal plants, their corresponding products, potential interactions between drugs and herbs, and an analysis of their effectiveness is shown in Fig. 3.

Fig. 3
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A systematic representation of medicinal plant, their available products, possible mechanism of drug-herbal interaction and their efficacy analysis

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Ayurvedic spas and wellness retreats

Ayurvedic spas and wellness retreats are becoming popular destinations for individuals seeking rejuvenation, relaxation, and healing. These retreats offer a range of Ayurvedic therapies, treatments, and lifestyle interventions to promote mental, emotional, and physical well-being (Peltzer and Pengpid 2019).

The challenge of standardizing Ayurvedic practice

Creating integrative treatment guidelines based on evidence could be one way to solve the issue of standardization in Ayurveda. The integration of contemporary scientific research methodology with Ayurvedic principles may facilitate the development of standardized yet customized treatment regimens that capitalize on the advantages of both systems. This may entail locating essential Ayurvedic medicines, formulas, and techniques that have shown effective in clinical trials and incorporating them into all-encompassing, patient-focused treatment plans. Furthermore, putting in place regulatory frameworks and quality control procedures for Ayurvedic treatments and products could help guarantee consistency and safety, opening the door for Ayurveda to be more widely accepted and integrated into mainstream healthcare. Even though there are still difficulties, this integrated method may offer more concrete answers that close the knowledge gap between conventional medicine and Ayurvedic medicine.

Challenges associated with the use of AYUSH

When applied to modern medicine, Ayurveda, Yoga, Unani, Siddha, and Homoeopathy (AYUSH) presents several challenges: Absence of Scientific Confirmation Scientists haven't looked into the effectiveness of many AYUSH therapies in great detail, and the evidence for this is weak. The marketing of Ayurvedic procedures and items in the West has led to cultural appropriation and the loss of integrity and cultural identity. Safety and Quality Control Issues: There are concerns regarding the safety and quality of Ayurvedic products because they are not governed by many countries. Various goods have been found to contain hazardous compounds, such as heavy metals.

Integration with Modern Medicine: The primary barriers to the integration of AYUSH with modern medication are a lack of solid scientific research and the need for evidence-based validation. Misconceptions and Self-Medication: The common misconception that AYUSH drugs have no side effects may lead to self-medication and potential harm. Challenges with Education and Regulation: AYUSH practice and education are not subject to the same stringent standards and regulations as modern medicine, which makes it challenging to ensure the efficacy as well as safety of AYUSH therapies. The security and efficacy of herbal treatments While Ayurvedic medicines have long been considered safe, their effectiveness is sometimes only moderate, thus further research is needed to find out how efficient they are in treating certain conditions. These problems must be fixed in order to ensure the efficacy and safety of AYUSH treatments and to facilitate the seamless integration of AYUSH with modern medicine (Chandola 2012; Ghate and Wele 2022).

Global acknowledgement and acceptance

Ayurveda’s growing recognition and acceptance worldwide as a legitimate system of medicine. Several countries have incorporated Ayurveda into their national healthcare systems, and Ayurvedic practitioners are increasingly being recognized as healthcare professionals. Overall, Ayurveda's contemporary relevance lies in its holistic approach toward health, its focus on prevention and personalized care, and its growing scientific validation. The amalgamation of modern medicine with Ayurveda and its increasing popularity in lifestyle and wellness trends further contribute to its relevance in the twenty-first century (Kumar et al. 2022a; Peltzer et al. 2008; Ramakrishnan et al. 2014).

Conclusions

Ayurveda, the ancient Indian system of medicine, has a rich and complex history spanning over several millennia. Its principles and practices are established on the credence that health is a state of balance between the mind, body, and spirit. Ayurveda emphasizes prevention and personalized care, besides the natural therapies use to promote healing and well-being. Despite its long history and contributions to healthcare, Ayurveda faced challenges and periods of decline, particularly during the colonial era. However, in recent decades, there has been a renewed interest in Ayurveda, both in India and globally. This revival is driven by several factors. There is growing recognition of the limitations of conventional medicine in addressing chronic diseases and lifestyle-related disorders—increased awareness of the holistic and preventive approach of Ayurveda. Scientific research supporting the safety and efficacy of Ayurvedic herbs and therapies. Integration of Ayurveda with modern medicine and healthcare systems. Ayurveda's contemporary relevance lies in its focus on personalized care, its emphasis on prevention and lifestyle management, and its potential role in addressing chronic diseases and promoting mental and emotional well-being. The amalgamation of Ayurveda with modern medicine and the growing body of scientific research supporting its efficacy is further contributing to its acceptance and recognition worldwide. As we move forward, it’s crucial to continue to study and validate Ayurvedic principles and practices through rigorous scientific research. This will help to establish Ayurveda as a credible and evidence-based system of medicine, further enhancing its relevance and integration into modern healthcare systems. In summary, Ayurveda, with its rich history, holistic approach, and growing scientific validation, is a valuable resource for promoting health and well-being in the twenty-first century. Its principles and practices can complement and enhance conventional medicine, providing individuals with a wide-ranging and personalized methodology for healthcare.