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A review of traditional medicine in Sri Lanka

  • couchpotato708
  • Jan 27, 2023
  • 5 min read

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Sri Lankan traditional medicine is rich in diversity much thanks to the combination of indigenous medicine of the country (Deshiya chikista) and Āyurveda medicine, received from India. Sri Lankan traditional medicine also draws up on the Siddha medicine, from South India, and Unani, from the Greeks and the Arabs. These 4 different systems came together to form the Sri Lankan traditional medicine whilst maintaining their own individual identity.

Much of the allopathic medicine used worldwide is based on Western medicine which uses the idea of subatomic particles that form atoms that arrange themselves in different patterns to form organic molecules to create life as we know today. In Vedic medicine, an influencer of Sri Lankan medicine, the material form is described by five attributes known as the Pañcamahābhūta (De Zoysa and Palitharathne, 2008). These attributes four substances: Akasha/Vayo (air/ether), Apo (water), Pruthuvi (earth) and Thejo (fire) to understand materiality and form the foundation of Āyurveda. In Vedic medicine, health is described as a balance between three metaphoric properties (known as tridosa) called Vata, Pitta and Kapha with each dosa corresponding to air, bile and phlegm. This is based on the idea that wind, sun and moon work together to keep balance in the universe. Any imbalances in these metaphors mean that there is an imbalance in the natural environment, age and disease (De Zoysa and Palitharatne, 2008).

Āyurveda medicine further focuses disease on four reasons: Aganthuka (external factors such as injuries), Sharirika (physical reasons), Manasika (mental reasons), and Swabhavika (natural, such as old age, hunger, thirst) (De Zoysa and Palitharathne, 2008). As such, Āyurveda seeks to understand the physical and spiritual aspects of the body in order to provide treatments. Āyurveda recognizes the existence of microorganisms, however, the main causative factor lies in an imbalance within the human body. As such, South Asian traditional medicine places emphasis on the health and not the disease.

As mentioned, Āyurveda uses theories and principles to help understand the human body. Alongside Āyurveda, the three indigenous medicines mentioned above: Siddha, Unani and Deshiya, form the sources of practical medical wisdom in modern day Sri Lanka. They contain recipes or guidelines that have been memorised and passed down from generations to generations, often written on ola leaf manuscripts. An example of such manuscripts can be seen below. Āyurveda has unique treatment plans based on examination and diagnosis to find the underlying causes of illness that has arisen. The following three main examination methods can be followed: Trividha Pariksha (Three methods), Ashtavidha Pariksha (Eight methods) and Dashavidha Pariksha (Ten methods) in order to create these plans.

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Image 1 - an ola leaf manuscript written in Sinhala, one of the main languages of Sri Lanka

The longevity of these manuscripts were sustained by the ancient kings, such as King Buddhadasa, a prominent and influential physician king of the Lambakanna dynasty who ruled Anuradhapura in central Sri Lanka, who started making medicines based on ancient traditions. These traditions used plant and herbal preparations for traditions with the Āyurveda system using around 2000 plant species and the Deshiya Chikitsa using 500 or so plant species. These ancient traditions still continue to cater around 60 to 70% of the rural populations’ primary health care needs (Kankanamalage, Dharmadasa, Abeysinghe and Wijesekara, 2014). For example, the Sesbania grandiflora (Katuru murunga) flowers have shown anticancer properties against various cell models whereas some flowers have shown antispermatogenic properties. Flowers of Woodfordia floribunda (Militta) are added as fermenting agents in the preparation of Arishtas in Ayurveda. Also, the most popular Clove oil is obtained from the flower buds of Syzygium aromaticum (Karabu-neti) is used to treat toothaches since it has antibiotic and antiseptic properties. Sri Lankan traditional medicine has also been shown to help heal fractures of the humerus following allopathic treatment (Attanayake, De Silva, Jayaweera and Perera, 2018). In this report, the patient had applications of herbal oil and paste made using the oil of Seethodaka, prepared according to the classical text of Ayurveda Pharmacopeia, and oils of Pinda and Narayana were prepared according to the methods given in the classical text Bhaishajya Ratnavali. Preparation of paste of Katakaladi and paste of Ashwagandada were done according to the methods mentioned by the eminent Sri Lankan traditional physician “Arangala Veda Parapura”(Attanayake, De Silva, Jayaweera and Perera, 2018). Applications of these pasts and oils over the course of six months showed complete improvement of the bone.

Sri Lanka also claims to be the first country in the world to have dedicated hospitals and the Buddhist pilgrimage site of Mihintale in the northern central province still boasts the remains of such hospitals, as seen in the image below. The bathtub in the lower left was used as a spa treatment where herbal oils were used to treat ailments such as headaches or even for a scalp/body massage (Bhavani, 2021).

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Image 2 - remnants of a hospital in Mihintale

The conquering colonial conquests, starting with the Portuguese in 1505, The Dutch in the 17th century and British colonisation of Sri Lanka between 1796 to 1948 introduced Western medicine. It established a dominant position in Sri Lanka and Āyurveda and traditional medicines were generally discouraged under British rule and the colonials learnt little from it. Notable exceptions such as Sir Henry Blake, a British governor of Sri Lanka, translated parts of the Suśrutasaṃhitā using Buddhist scholars and he claimed that malaria was recognized as a vector borne disease (De Zoysa and Palitharathne, 2008). But these were rebuked and mocked due to the mentality that European powers were better than other civilisations. Nonetheless, many people, including the urbanized middle classes who are westernised in outlook, continue to practice traditional medicines. After all, if they worked for thousands of years, why should they not continue to work now?

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