This essay shows that physicians of early Āyurveda adopted a pragmatic approach to the challenges dharma imposed on them. While the concept and its importance is generally accepted in the medical compendia, various passages stress the fact that good health is an indispensable precondition to pursue dharma and other goals of life. In the interests of health it is even tolerable to deceive patients if their religious convictions would get in the way of treatment. From the viewpoint of Āyurveda, following dharma not only means complying with the orthodox Brahminical prescriptions, but also implementing various health-­preserving measures. This merger of ethical and medical ideals is shown in various lists of prescriptions for right conduct. Neglect of these rules constitutes a case of adharma and leads to shortened lifespans, suffering and unfavourable rebirths. The concept of dharma is even employed to explain the otherwise incomprehensible phenomenon of epidemics and the gradual decline of the human lifespan throughout the ages. This employment contains a sophisticated proto-ecological theory explaining the impairment of nature through human deeds and its consequences for the affected people.