Ayurvedic Medicine

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   C H A P T E R 10 A YURVEDIC  M EDICINE Shri K. Mishra, MD, MS, Bharathi Ravi, BAMS and Sivaramaprasad Vinjamury, MD Introduction   Ayurveda is a natural system of medicine that has been pracced in India for more than 5,000 years. It was developed by seers (rishis) through centuries of observaon, experimentaon, discussion, and meditaon . The srcins of Ayurvedic medi - cine are recorded in the Atharva Veda, one of the four Vedic scriptures. 1  For several thousand years, Ayurvedic teachings were passed down orally from teacher to student. The rst summary of these teachings was put into wring around 1500 B.C. The main sources of knowledge are the three Vedic classics Charaka Samhita, Susruta Samhita, and Ashtanga Hridaya. 2   Ayurveda is a Sanskrit word made up of two components, ayush meaning life, and veda meaning knowledge or science. Hence, Ayurveda is the “science of life.” The teachings of this ancient system of medicine are wrien in Sanskrit, the ancient language of India and Hinduism. It is based on Indian (Vedic) philosophy. Ayurveda was the rst holisc system of diagnosis and treatment integrang nutrion, hygiene, rejuvenaon, and herbal medicine. Ayurvedic medicine considers the human body to be in balance with nature. The body is believed to be a dynamic and resilient system that can cope with all stresses from its environment while maintaining the ability to heal itself. 3, 4   The main objecves of Ayurveda are:to maintain and promote health by preventing physical, mental, and spiritual ailments y to y  cure  disease through natural medicine, diet, and a regulated lifestyleAyurveda tries to help us live a long and healthy life, achieve our fullest potenal, and express our true inner nature on a daily basis. 4  The Ayurvedic classic Charaka Samhita denes Ayurveda as, “the knowledge that indicates the appropriate and inappropriate, happy or sorrowful condions of living, what is auspicious or inauspicious for longevity, as well as the measure of life itself.” 5   Basic Concepts of Ayurveda   It will be helpful to understand a few important concepts and some Ayurvedic terminology before deciding whether you want to include Ayurveda in your hepas C   treatment plan. The next few pages provide a brief overview of Ayurvedic concepts on which the diagnosis and treatment of all ailments are based.   Pancha-Maha-Bhoota Theory   According to Ayurvedic philosophy, the enre cosmos is made up of the energies of ve elements: earth, water, re, air, and ether (space). Even the human body and herbs are made up of these elements. Collecvely, these elements are called pancha-maha-bhootas or material parcles. The material parcles and the an-material parcles (the spirit) form the cognive aspect of a living being.   The predominance of a parcular element(s) determines the characteriscs of a thing, whether it is an animal, a person, or an herb. The medicinal properes of a drug or an herb are determined by the characteriscs it exhibits. Similarly, depending upon the relave amounts of the elements, each of us exhibits a unique set of physical and mental characteriscs. A disease state changes these characteriscs. This change is the basis for the diagnosis and treatment of Copyright © 2008, Caring Ambassadors Program, Inc.  Caring Ambassadors Hepatitis C Choices: 4th Edition 154 disease. In prescribing a remedy, the doctor chooses a treatment with the opposite characteriscs of the disease to counteract the symptom s. Tri-Dosha Theory   According to Ayurvedic theory, there are three humors in the body called doshas. These determine the constuon of a person and also the life processes of growth and decay. The doshas are genecally determined. The three doshas are vata, pia, and kapha. Each dosha is made up of the ve fundamental elements. Each dosha is responsible for several body funcons. When the doshas are healthy and balanced, this is the state of good health. Imbalances cause disease. Ayurveda recognizes that dierent foods, tastes, colors, and sounds aect the doshas in dierent ways. For example, very hot and pungent spices aggravate pia. Cold, light foods such as salads calm it down. This ability to aect the doshas is the underlying basis for Ayurvedic pracces and therapies. VATA Vata is composed of space and air. It is the subtle energy associated with all voluntary and involuntary movement in the human body. It governs breathing, blinking, muscle and ssue movement, and the heartbeat. It is also responsible for all urges. Creavity, exibility, and the ability to iniate things are seen when vata is in balance. Indecision, restlessness, anxiety, and fear occur when vata is out of balance. Vata is the movang force behind the other two humors. In modern medicine, the  physiological   role of vata is in the central and peripheral nervous systems. 6-8 Vata has a tendency to expand indenitely and to disturb the nervous acvity or the vital forces in the body.   PITTA   Pia is composed of re and water. It is responsible for all digesve and metabolic acvies. It governs body temperature, complexion, visual percepon, hunger, and thirst. In a balanced state, pia promotes intelligence, understanding, and courage. Out of balance, pia produces insomnia, burning sensaons, inammaon , infecon, anger, and hatred. Pia is the humor involved in liver disorders. 6-8  Pia has a tendency to become more liquid and to weaken the digesve and biochemical processes in the body. KAPHA   Kapha is composed of water and earth. It provides the strength and stability for holding body ssues together. Kapha i s the watery aspect of the body. It provides lubricants at the various points of fricon in the body. In balance, kapha is responsible for wisdom, paence, and memory. Out of balance, kapha causes looseness of the limbs, lethargy  , greed, and generalized sluggishness or hypoacvity  . This dosha maintains body resistance to disease. 6-8 Kapha has a tendency to thicken and obstruct the passages of the body and damage the process of lubricaon.   Sapta-Dhatu Theory   Ayurvedic theory states the human body is composed of seven ssues called dhatus. plasma and y interstitial   fluids (rasa) blood (rakta) y muscle (mamsa) y fat or adipose tissue (medas) y bone (asthi) y bone marrow (majja) y reproductive tissue (sukra) y Kapha is specically responsible for plasma, muscle, fat, marrow, and semen. Pia creates blood. Vata creates bone. Diseases of the humors are usually reected in the ssues they govern. When out of balance, the humors can enter any Copyright © 2008, Caring Ambassadors Program, Inc.  Chapter 10: Ayurvedic Medicine 155 ssue and cause disease. 6-8 MALAS   The quanes and qualies of the three excreta from the body, sweat (sweda), feces (mala), and urine (mutra), and other body waste products play an important role in the diagnosis and treatment of disease. The Sanskrit word for these waste products is malas.  6-8 TRIPOD   Tripod includes the doshas, dhatus, and malas. They maintain health when they are in equilibrium and produce disease when they are not. SROTAS The human body has numerous channels to allow the ow of energy, nutrients, and waste products. These channels are called srotas. Some of the srotas such as the alimentary canal (the digesve channel that runs from the mouth to the anus) are very large. Some are small such as arteries and veins. Others are very minute such as the capillaries, nerve terminals, and the lymphacs. Some srotas carry nutrional materials to the ssues of the body. Other srotas carry waste materials out of the body. The three doshas are present in every part of the body and move through every srota. Blockage or improper ow within the srotas produces ailments. The physical channels are similar to the dierent systems of western medicine such as the digesve, respiratory, and cardiovascular   systems. Diseases are classied according to the systems they involve. 9   AGNI AND AAMA   Poor funconing of the digesve system leads to many diseases. The digesve re or agni controls the acvies of digeson. According to Ayurveda, digeson is the cornerstone of good health. Good digeson nourishes the body. Eang the correct foods makes a big dierence in your well-being. Agni helps the body produce secreons and generates the metabolic processes necessary to create energy, and maintain and repair the body. 10  Agni is also part of the immune system  since its heat destroys harmful organisms and toxins. There are 13 agnis. The acvity of agni varies throughout the day. A natural ebb and ow of your digesve re is necessary for good digeson and immune funcon, and resistance to disease. 11   The opposite of this process is aama. Aama is dened as imperfectly metabolized food or drugs. In other words, an aama is a toxin that needs to be eliminated from the body. Aama is usually generated in the body because of weak digesve re or jatharagni. 12  It is also believed that aama is produced by out of balance doshas. Aama is mixed up with the ssues and causes disease by clogging the channels. Out of balance pia, dosha, and poor agni play important roles in the symptoms of liver disorders. OJAS   Ojas is the essenal energy of the immune system. It is a unique concept of Ayurveda that embodies a subtle essence of all the ssues in the body. In other words, ojas is the glue that cements the body, mind, and spirit together, integrang them into a funconing individual. Proper agni is required for proper producon of ojas. Ojas decreases with age. Low ojas levels cause chronic degenerave and immunological diseases. 13  In western medicine, ojas would be similar to immunoglobulins  and other immunomodulators  like cytokines . Abnormalies of ojas lead to decreased immunity  , making a person more vulnerable to infecons including hepas.   PRAKRUTI AND GUNAS   The proporon of the humors varies from person to person. One humor is usually predominant and leaves its mark on a person’s appearance and disposion. Based on the predominant humor, every person is born with a unique mind-body constuon called prakru. Gunas denote a person’s mental make up and are of three types: satva (perfect), rajas (semi-balanced), and tamas (unbalanced). A person’s prakru is determined at the me of concepon. Every person has specic physical, mental, and emoonal characteriscs. These characteriscs are called a person’s constuon. Prakru must be considered in determining natural healing approaches and recommendaons for daily living. 14   Copyright © 2008, Caring Ambassadors Program, Inc.  Caring Ambassadors Hepatitis C Choices: 4th Edition 156 Ayurvedic Denition of Health   Ayurveda denes health as, “the equilibrium of the three biological humors (doshas), the seven body ssues (dhatus), proper digeson, and a state of pleasure or happiness of the soul, senses, and the mind.” 15  This denion dates back to 1500 B.C. and is described in Sushruta Samhita, the surgical compendium of Ayurveda.A balance among the three doshas is necessary for health. Together, the three doshas govern all metabolic acvies. When their acons in our mind-body constuon are balanced, we experience psychological and physical wellness. When they go slightly out of balance, we may feel uneasy. When they are more obviously unbalanced, symptoms of sickness can be observed and experienced. 16, 17 Pathogenesis of Disease Ayurveda asserts that each person is unique, made up of specic characteriscs that are his or her own. This means that in order to protect or preserve your health, you need to follow a diet and lifestyle that create balance with your  constuon or internal environment. Such a lifestyle keeps the humors at normal levels. Aggravang factors such as diet, climate, seasons, emoons, and lifestyle can make the humors go out of balance. Imbalance weakens the digesve re and increases the producon of toxins. The toxins along with the out of balance humor(s) block the channels and disrupt the energy and nutrion ow to that parcular ssue. The result is that the ssue involved in the process becomes diseased. 17  This happens in six stages : accumulaon, aggravaon, overow, relocaon, manifestaon, and diversicaon. 18   Claca f Da   Various diseases are produced by imbalances of specic humors in specic ssues. Diseases are classied as vata, pia, or kapha disorders, and combinaons of these three. Based on the predominant humor, 80 vata, 40 pia, and 20 kapha disorders have been idened. There is further classicaon of the disorders based on the physiological systems or srotas involved. Most diseases of the organ systems are further sub-classied and are named aer the predominant humor, ssue, or organ involved in the disease process. 19 Diagnosis of Disease   Diagnosis in Ayurveda is done in eight parts. Disease is diagnosed by taking a detailed history of the causave factors,  prodromal symptoms , cardinal signs and symptoms, and the aggravang and relieving factors. 20  The aected humor and ssue are idened for treatment. Various methods are used to help acquire informaon during an assessment. These methods are very similar to other medical disciplines and include quesoning, observaon,  palpaon , direct percepon, and inference . Tech - niques such as taking the pulse, observing the tongue and eyes, nong physical symptoms, and examinaons of urine and stool are employed during an assessment. 21  The pulse is one of the important tools in diagnosing the constuon of an individual and the humors involved in a disease. In some cases, the pulse can idenfy the stage of the disease. Pulse diagnosis gets more accurate as the Ayurvedic praconer gains experience. 22 Prognosis of Diseases  Ayurveda is not a cure  for all ailments and all stages of disease. Diseases are classied based on their  prognosis . Easily curable: recent onset, one humor involved y example - digestive disorders − Difficult to cure: chronic, one or two humors involved y example - most skin disorders − Copyright © 2008, Caring Ambassadors Program, Inc.
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