Charak Samhita Online Edition- A step towards globalization of Ayurveda

Medical education has been an everchanging field due to research updates, discoveries, diagnostic and therapeutic inventions. The medical education field faces challenges in matching pace with the rapidly changing healthcare needs of the population worldwide [1]. Medical education requires dynamic status to update its core knowledge base and can never be a static form. Medical publishers continuously evolve and update the editions of textbooks with the latest research. For example, Harrison's Principles of Internal Medicine was published first in 1950, and now its twenty-first edition was released in 2022. The latest edition is available with significant changes in the content, presentation, and updates observed in the last seventy years [2]. In Ayurveda, Vagbhata also emphasized the importance of updating the knowledge base with references in the contemporary era [3]. The National Commission for Indian Systems of Medicine (N.C.I.S.M.) has been taking initiatives to upgrade the quality of Ayurveda education. One of the objectives is to encourage competent medical professionals to adopt the latest medical research and contribute to research [4]. However, there is a serious lag in the availability of upgraded and updated publications in the field of Ayurveda. An exploratory study on the quality of books listed in the curriculum of the Ayurveda education field revealed that none of the books contained recent advances in the form of references to research papers and other concerned books. The study suggested that there is much scope for improvement in the quality of the content of these textbooks [5]. Updated text with recent research advances and comprehensive and dynamic editions are fundamental requirements of the Ayurvedic field to improve the quality of education and, indeed, the quality of healthcare professionals.

1. Digital tools to propagate knowledge of Ayurveda

In the era of education technology, there are many digital tools that can be utilized to propagate knowledge of Ayurveda. Online course platforms, virtual classrooms, digital textbooks, learning management systems, and digital assessment tools for special education students are utilized in teaching and learning. However, the core knowledge database that serves as a reference source is Ayurveda Samhita, documented thousands of years ago. Charak Samhita, initially written by Agnivesha (∼1000 BCE), redacted by Charak (∼800BCE) and further completed by Dridhabala (300 CE) is available in the form of Sanskrit text. It is one of the resources referred by Ayurveda scholars and physicians [6]. Very few fundamental resources are found to cater to the needs of online teaching-learning platforms. Considering this demand, Charak Samhita Online Edition Project was initiated with the objective of providing comprehensive, dynamic, easily accessible text with the latest research updates.

2. Digital edition of Charak Samhita

Digitization of Ayurveda classical texts and their translation using information technology is a longstanding demand of the modern era [7]. Charak Samhita is the age-old most referred Sanskrit text of Ayurveda. It is the fundamental text used in Ayurveda's curriculum. An overview shows that five English translations of Charak Samhita are available today in printed form. However, the available translations are focused only on verse-to-verse translation. The following Table 1 gives a brief about these books.

Table 1.

Details of English translations of Charak Samhita available in print form.

Sr. No.	Name of book	Author, Editors,& Publisher	Publishing year and current edition/reprint	Volumes/Parts & Price in INR	Features
1	Charak Samhita	Gulabkunwarba Ayurvedic Society, Jamnagar	1949, Gulabkunwarba Ayurvedic Society, Jamnagar Reprinted by Chaukhambha Publications, Varanasi	Six Volumes, Rs.9000	Sanskrit, English, Gujarathi translation is available. Index of herbs and minerals in Charak Samhita given.
2.	Caraka Samhita – Volume 1-7	Sharma Priyavrat	1981–1994, Fourth edition 1998, Chaukhambha Orientalia, Varanasi	Seven Volumes, Rs.2950	English translation of Charak Samhita is available.
3.	Caraka Samhita: Text With English Translation & Critical Exposition Based on Cakrapani Datta's Ayurveda Dipika (7 vol Set)	Sharma & Das	2009, Chowkhamba Sanskrit Series, Varanasi	Five volumes, Rs.3550	English translation of Charak Samhita and Chakrapanidatta commentary is available.
4.	Caraka Samhita Purvardha and Uttarardha	Tiwari Premavati	2018, Chaukhambha Vishvabharati, Varanasi	Two volumes, Rs.2490	English translation of Charak Samhita and author's commentary is available.
5.	Charaka-Samhita, translated into English	Caraka, Avinash Chunder Kaviratna	1896–1913 G.C. Chakravarti, Calcutta	Four parts. Rarely available in libraries now.	English translation is available.
6.	Charak Samhita Sanskrit Text with English Translation	Bargale Sushant Sukumar and Shashirekha H. K., Chaukhambha Publishers, New Delhi	2017, First Edition	Two volumes: Volume I: Sutra Sthana and Volume II: Nidana Sthana, Vimana Sthana, Sharira Sthana and Indriya Sthana Rs.1600	English translation is available.

Chaukhambha Publications recently published two more English translations of Charak Samhita. A translation by R. Vidyanath (published up to Indriya Sthana only) and a translation by Prof. S.N. Gupta (published up to Sutra Sthana only) are incomplete at present.

3. Availability of Charak Samhita in electronic forms

A search of electronic forms of Charak Samhita revealed that there are two electronic copies of Charak Samhita are available.

• 1.E-Carak Samhita is developed by the National Institute of Indian Medical Heritage, C.C.R.A.S., Hyderabad, India. In this resource, Sanskrit Text of Charak Samhita with Chakrapani Commentary in Sanskrit, multilingual output and search feature for Sanskrit inputs are available [8].
• 2.Charak Samhita Translation published by Wisdom Library includes English translation copied from Gulabkunwarba Ayurveda Society's Charak Samhita Book. On this resource, interlinking is done in some places [9].

Some print editions are available in PDF form on internet archives [10,11]. As the first available electronic formats are in Sanskrit only, the present Charak Samhita New Edition becomes the only available resource with English translation and research updates. Other English translations are either too old or available in traditional print formats only. Table 2 shows a comparison of the two formats.

Table 2.

Comparison of Charak Samhita online with traditional formats.

Sr. No.	Parameters	Traditional format	Charak Samhita Online Edition
1.	Accessibility	The print editions are accessible only to book buyers limited to specific regions of trade.	Accessible to all users anywhere in the globe.
2.	Cost effectiveness	The users have to purchase the books. It is additional economic burden to the students particularly in developing countries like India and Asian countries.	Open access make it free to all users without any economic burden.
3.	Updates and additions of research	Updates are not possible in print books unless they are published in new editions. Again, this is a costly and time-consuming effort for publishers.	Easy updates are possible in wiki-based software used in Charak Samhita New Edition.
4.	Searchability	Readers have to search the concepts manually across Charak Samhita. The time is a major concern for searching and collecting data.	Quick and easy search is possible in few seconds to get all references on the topic. Monograph section provides comprehensive information, too.
5.	Interlinking, addition of graphics and multimedia files	Not possible in print form.	Cross-referencing, interlinking, and addition of multi-media files for a better understanding of the concept is always possible.
6.	Multi-lingual translation	It can be published in only one language at a time.	The online edition can be read in multiple languages using translation tools.
7.	Limitation of words and presentation	There is always a limit of words and pages in print form. This may limit the scope of authors' messages in print form.	The electronic form allows to presentation of all information in a comprehensive way.
8.	Number of authors involved	All available translations are written either by a single author or two authors. This limits the views of presentations and experience in the translation.	The online edition involved more than 180 contributors to present their views. Thus, it included experiences and views of various eminent scholars.
8.	Communication with authors	It is difficult to communicate with authors directly.	It is easy to communicate with each author in online edition.
9.	Post publication citation analysis	The analysis of citations of print books and its chapters is difficult.	As each chapter has assigned DOI, it is easy to analyse citations of each chapter. These are useful in observing impact of the publication.
10.	User-friendliness	It is difficult to carry and use the print books in online education platforms.	It is very easy to carry and use the digital edition in online education platforms.

4. Bridging gaps between contemporary and ancient knowledge

Bridging the gaps between contemporary science and Ayurveda and providing a strong evidence base is required for Ayurveda to be more accepted by the scientific community [12]. No tradition is a static entity; modernity results from evolving traditions. The use of modern technologies to make better clinical interpretations of Ayurveda texts is necessary [13]. The evidence maps for Ayurveda can offer specific research summaries and can address more specific issues on the adequate utilization of traditional medicine in the global healthcare system [14]. A resource that can serve as a common link between ancient knowledge and contemporary updates is required in Ayurveda for its better scientific validation. This can be done by creating a platform for scholars of different healthcare systems.

Considering the need to update this ancient text to make it useful, and understandable by new learners of Ayurveda, the idea of the updated edition of Charak Samhita was proposed by Dr. Gopal Basisht. As a result of the pursuit of this idea, the Charak Samhita New Edition project was started in 2013, and the online edition was released publicly in December 2018. The online Samhita is increasingly popular and accepted by learners of Ayurveda worldwide. The team guided by Dr. Gopal Basisht, in coordination with Dr. Yogesh Deole and other scholars, has been continuously working on making the online Samhita more user-friendly and easier to understand. As a result of the contribution of articles by scholars from various institutions, the team can provide comprehensive information on important concepts and their contemporary practices. This short communication provides the progress of the website to readers, their acceptance, and the reach of the treasure of Ayurveda knowledge based on Google analytic tools applied from the year 2019.

This Ayurveda book available online might be the only book of its kind that is getting analysed in terms of readers visiting and reaching the Samhita in today's era of technology.

5. Journey of idea and inception of project

After practicing allopathy for fifty years in Orlando, United States of America, Dr. Gopal Basisht found that the allopathic system is limited to a disease care system only and does not include “healthcare” practices. After a thorough review of available concepts of health across medical systems, he found that the best definition of health is described by Sushruta and then he proposed laws of health. It is well described in Ayurvedic classical texts [15]. To learn and know more about Ayurveda, he enquired about the most used text and edition of Ayurveda text and received an answer as ‘Charak Samhita’. However, only one edition originally written in Sanskrit was available. Understanding Sanskrit and its interpretation in today's era is a big challenge for a new learner. Therefore, he discussed with senior Ayurveda scholars about possibility of bringing up a new edition of Charak Samhita. Thus, the project of Charak Samhita New Edition was started in the year April 2013 and eventually involved more than 180 Ayurveda scholars to contribute to this project.

6. Planning and methods

A research article template was designed and given to all contributors. The template included an abstract, keywords, an Introduction, Original Sanskrit Text with English Translation, tattva, and vidhi vimarsha with references. After receiving the draft chapters, they were sent to expert reviewers. This writing phase was completed from April 2013 to November 2014. A blind peer review system was followed for unbiased reviews and fruitful suggestions. After receiving the suggestions, they were communicated to the contributors and asked to revise the manuscripts. The second phase of the review was conducted between November 2014 to October 2015. The modified manuscript was subjected to language and content editing. The final chapters were uploaded online to the website created using MediaWiki software. This phase of editing was carried out between November 2015 to December 2018. After this initial launch, content generation on monographs, concepts, and contemporary practices was started in January 2019 till December 2023.

7. Key features of Charak Samhita online

• □Open access, free for all content registered under Creative Commons Attribution-Non Commercial-Share Alike 4.0 International License
• □Easy to search and navigate through Charak Samhita with keywords
• □Interlinking of concepts links the relevant references across Samhita
• □Uploading media files with graphics, photos of herbs, and clinical presentations is more useful for understanding fundamental principles and its interpretations
• □All information related to the important concept is presented in one place on the separate pages of monographs
• □Tantrayukti i.e. interpretation tools are applied by use of modern technology for better understanding
• □Scientific information and new research can be updated frequently with relevant quotes from Charak Samhita
• □Discussion (sambhasha) can be published on each content page and the conclusion can be added with relevant quotes with recent evidence
• □Using the technical features, the content can be translated from English to any language

The Fig. 1 shows homepage of Charak Samhita Online Edition with important links.

Fig. 1.

Homepage of Charak Samhita Online.

8. Acceptance by users

Graph 1 shows an increasing number of users from the year 2020 till December 2023. The total number of users has increased more than six times from 39K in 2019 to 2.66 Lacs in 2023. New users and the number of sessions of the online Samhita have also increased in the same proportion. Total pageviews have increased more than five times from 2.34 lacs to 9.81 lacs (Graph 1). The average session duration time increased from 1 min in 2020 to 2 min 30 s in 2023. However, the bounce rate of the website is ranging from 50% in 2019 to 67% in 2023.

Graph 1.

Readership of Charak Samhita as per google analytics.

9. Global readership

The Charak Samhita online is widely visited by users across the globe. Fig. 2 shows a readership map from various countries in the year 2023. Till then, readers from more than 188 countries have visited the website. The following table shows the number of users from the top 12 countries visiting the Charak Samhita Online website.

Fig. 2.

Global readership in the year 2023.

Table 3 clearly indicates the increasing popularity of Charak Samhita online in countries other than India. One of the important objectives of the publication of Charak Samhita Online is to propagate Ayurveda knowledge across the globe without considering any boundaries of caste, creed, or religion and to emphasize health propagation. The internet is a wonderful tool for conveying messages and connecting with people across the globe. Charak Samhita Online Edition is an openly, accessible resource available to all online readers irrespective of knowing their caste, creed, or religion. The readers who are interested to learn Charak Samhita on this platform can access it at any time, from anywhere in the globe, without sharing their identity with the website source. Some feedbacks from the international users are listed below.

Table 3.

Country wise readership of Charak Samhita in the years 2019–2023.

Sr.No.	Country/year	2019	2020	2021	2022	2023
1.	India	32187	101094	113569	162823	230981
2.	United States	2972	6180	7876	13531	9790
3.	United Kingdom	212	822	1030	1273	1421
4.	Brazil	253	898	1220	1440	1360
5.	Sri Lanka	247	1121	1997	2427	2395
6.	China	102	191	1335	6507	1220
7.	France	315	505	254	781	831
8.	Canada	242	757	1027	1006	1126
9.	Russia	187	321	482	528	408
10.	Australia	159	530	557	760	855
11.	Nepal	159	560	709	933	1242
12.	Germany	157	554	611	779	804

10. Content generation

The original Charak Samhita is written in Sanskrit and divided in eight sections with 120 chapters. All chapters of Charak Samhita are translated into English language and published. Each chapter is available in a unique format, having an abstract, introduction, English translation, tattva vimarsha (fundamental principles), and vidhi vimarsha (clinical applications). After the publication of all chapters online, the page length of each chapter increased significantly. This might be a technical reason behind the shorter session duration. It was also felt by the team that the important concepts of Charak Samhita need special attention and elaboration to make them more understandable. A new learner cannot understand the core concept until he reads all of Samhita. Therefore, it was decided to create a new section on important concepts and contemporary practices to help new learners. The titles of new pages were listed and developed. The developed titles are linked with the original text across all chapters. Since the year 2022, the team has been working to develop monograph-like chapters on important concepts and practices. Until 2023, a total of 160 new chapters are developed by the team. Digital Object Identification (DOI) are assigned with cross reference for all chapters as well as monographs to preserve the identity of the content.

11. Challenges & opportunities

11.1. During project conduction

There are certain challenges in project planning, conduction, and publication. The involvement of more than 180 authors in a single project and their management has been a great challenge for the coordinator in the initial phases of writing, editing, and reviewing. Though a template was provided to all authors, maintaining uniformity in the submitted chapters by curating the unnecessary text was additional work. The language and presentation of the authors from different parts of India have major differences. These tasks were identified and corrected by the editors in due time to make it uniformly presentable in the online format.

Integration and correlation of Ayurvedic concepts with Allopathic textual knowledge was another challenge faced by the project think tank. It was decided to focus on Ayurvedic texts and make them understandable to non-Ayurvedic readers by bracketing medical terms wherever applicable.

11.2. Technical challenges

After finalizing the project content and uploading it online, the team faced a challenge in finding a technical person in India who was well acquainted with Wikipedia editing and management. Very few wiki-editors were available in India, but they didn't know how to manage MediaWiki software. This was overcome by hiring technical persons from outside India. The project coordinator and the technical person took self-training for the same and learned the fundamentals of managing Wikipedia software and wiki editing. Interlinking of new terms and pages with the main text of Charak Samhita is still a time taking work for the team. Maintaining the website and protecting and sustaining the knowledge database on the available financial resources are other challenges. At present, the website management is objecting to making it self-sustainable by generating funds through the Google advertising platform.

The project team's experience in project management has taught them valuable and rewarding lessons. It has been truly satisfying to contribute to the field of Ayurveda through this platform.

11.3. Future-plans

The advantage of having new pages is that it can provide basic as well as advanced knowledge about the concept and its contemporary practical importance. The section is still under development. It is planned to publish separate pages on herbs listed in Charak Samhita, medicinal formulations, and diet recipes. These pages will be helpful in solving practical questions in understanding and applicability of age-old Charak Samhita in today's era.

11.4. Charak Samhita new edition android application

An offline application for easy reading and searching of Charak Samhita is developed. It contains all 120 chapters of Charak Samhita with a drop-down of subsections. It can be downloaded from the Google Play Store. The IOS application is in process and will be released soon for Apple users.

11.5. Spanish translation

The online edition of Charak Samhita is the single largest source of authentic knowledge of Ayurveda text Charak Samhita. Considering the importance of ancient knowledge, Ayurvastu, an organization in Chile, initiated the process of translation of content available in the Charak Samhita online edition into the Spanish language. Spanish is the second most spoken language in Western countries after English. The team has completed the task of translating the content of Panchakarma concepts into Spanish and published it in the form of a book named ‘Monografias Panchakarma Conceptos Y Practicas en Chikitsa (Spanish Translation)’. The first phase of the Spanish translation of Charak Samhita Online Edition is completed. The first volume, including Sutra Sthana Chapters, is released on National Ayurveda Day’2023. Other volumes are also in process and will be released in the near future.

11.6. Print edition

The text is being continuously updated and is open for public reviews and opinions. Once the text reaches the level of excellence with all comprehensive content, the editorial board will publish it in print form. Repeated editions of Charak Samhita are planned to make it an example of excellent updates in Ayurveda.

11.7. Testimonials and feedback from users

The team receives regular appreciation and user feedback through verbal and email communication. The feedback is highly motivating to the project team. Some users get motivated by the work done and seek permission to use the content for academic purposes. The content is permitted for non-commercial and educational purposes. Some international researchers contacted for the use of content to develop their research-based tools. Such requests are put forward to the editorial board and discussed for the reliability and future perspectives of the persons. Some patients also read and contact us to seek guidance and treatment. This shows the effectiveness of Charak Samhita Online Edition in propagating Ayurveda. Some notable feedbacks are listed below.

• 1.Feedback from students with a request for digital copies and willingness to use the resource in post-graduate studies
• 2.A reader from Westminster, Colorado, United States, wishes to contribute with her knowledge
• 3.Enquiry by a patient suffering from Nephrangiosclerosis residing in Russia, seeking help and guidance for his ailment
• 4.Feedback from a research scientist in the United Kingdom stating that the online Samhita makes the process of redaction much more accessible and softer
• 5.Request from a professional based in the United States of America to use the content for the development of a chatbot

The above feedbacks and testimonials show the impact of online availability and accessibility of Charak Samhita across the globe.

11.8. Scope of improvement

The most remarkable advantage of a dynamic edition of Charak Samhita is the feature of continuous editing and updating. The text can be updated continuously with the advancements in the medical field after proper review. Improving language, adding graphical presentations, videos of clinical cases, and contemporary research to make ancient texts filled with modern wisdom are possible on this platform.

12. Conclusion

Knowledge is limitless, and so is intelligence. The application of these two boons for the welfare of society is highly important, especially in today's healthcare systems. Ayurveda is the most ancient, cost-effective, and preferable healthcare system in the world. However, the treasures are still unexplored. Charak Samhita online is an attempt to provide leads from ancient Indian healthcare wisdom to the new modernized scientific community in an authentic way. This effort can set an example for developing new updated editions of other ancient classical texts like Sushrut Samhita and Ashtanga Hridaya, too.

Author contributions

YSD: Conceptualized, executed and designed the work, drafted the manuscript, managed data collection, analysed and interpreted data, contributed intellectual revisions, revised article as per reviewer comments, and agreed to be accountable for all aspects of the work.

GB: Conceptualized and designed the work, provided intellectual revisions, edited the manuscript, provided final approval for the version to be published and agreed to be accountable for all aspects of the work.

Funding sources

Nil.

Declaration of generative AI in scientific writing

This review article was prepared without generative artificial intelligence (AI) tools. All content, including literature search, data analysis, and manuscript preparation, was conducted by the authors using traditional scholarly research methods without assistance from AI-based software or algorithms.

Conflict of interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Appendix A. Supplementary data

The following is the Supplementary data to this article.