Ayurveda Articles

In this section you can find several Ayurveda articles written by Dr. Marc Halpern, as well as numerous student research papers.

Important Herbs in Ayurvedic Medicine

Ginger: An Ancient Panacea for Modern Times ( By Brenda Castro)

 INTRODUCTION

Known as vishwabheshaja, “the universal medicine”, ginger (zingiber officinale) has been a panacea for digestive, respiratory, and circulatory disorders for thousands of years.1,2  Ginger’s versatility is found in ancient Ayurvedic texts, international cuisine, and a broad spectrum of home remedies. With today’s advent of scientific research, ginger’s therapeutic constituents are being isolated and tested against some of the most common diseases. Not only has it been scientifically proven to aid in digestion, ginger has also shown anti-inflammatory, anti-carcinogenic, and anti-oxidant properties. This paper gives a brief background of ginger, its traditional Ayurvedic use, and its effectiveness in clinical trials.

HISTORY

Ginger is a perennial lily, indigenous to tropical Asia, though it has never been found growing in the wild. Even though its exact botanical origins are unknown, it plays a large role in the ancient traditions of Ayurveda, Unani, and Chinese Medicine. The flowering plant reaches heights “of 3 to 4 feet, *with+ leaves growing 6 to

12 inches long…[Its] flowers are white with purple streaks and grow in spikes.” 3  The medicinal portion used is the rhizome, or horizontal, underground stem. This fleshy, aromatic, firm, fibrous, and plump portion of the plant is how it

propagates itself, through its many knobby portions, and not through its sterile flowers. Today it grows throughout the world in tropical

Botanical Drawing of Zingiber officinale

A Modern Herbal, Mrs. M. Grieve, Ginger.  http://www.botanical.com/botanical/mgmh/g/ginger13.htm

climates, its unique flavor finding its way into signature dishes worldwide. 4 ,5,6

Whereas Indian, Chinese, and other Asian cuisines have used ginger for thousands of years, its unique qualities made it attractive to Europeans more recently, as an important ingredient along the spice trade routes. Ginger ale was popular in 19th century pubs, while ginger’s use in everything from baked goods, to salad dressings,

to exotic dishes continues in the western world.7,8  As KP Khalsa says, in the Way of Ayurvedic Herbs, “*g+inger is a

multi-purpose spice, equally delicious in both sweet and savory dishes.” He also mentions that, though “*h+erbs and spices are typically not significant sources of nutrients in the diet…ginger has [a] relatively high calcium and iron content.”9  Its addition to meals may therefore not only add flavor and medicinal properties, but valuable nutrients too.

AYURVEDIC INTERPRETATION

In Ayurveda, ginger’s rasa (taste) is pungent and sweet, its virya (energy) heating, and its vipāka, (post- digestive effect) sweet. Even though it has a pungent and heating, it is tonifying, as a sweet vipāka implies. As Pole explains in Ayurvedic Medicine, this sweet vipāka leaves a cooling, lasting effect. Through its warm virya, it subdues vāta and kāpha, while increasing pitta, though it is often found counter-balanced in pitta-reducing

remedies. As the “universal medicine,” it affects all dhātus (tissues) and specifically the digestive, respiratory, and circulatory srotas (channels). 10,11,12, 13

The Ayurvedic actions of ginger, as described by Pole include: Āmanāśaka (Destroys toxins), Pācana (Digestive), Chardinigrahaṇa (Prevents nausea), Hikkānigrahaṇa (Stops hiccups), Agni dῑpana (Enkindles the digestive fire), Grāhῑ (Absorbs fluids from the intestines), Arśoghna (Removes piles), Śitapraśamana (Reduces feelings of cold), Rasāyana (Rejuvenative), Kāsaśvāsahara (Alleviates cough and breathing difficulties), and Vedanāsthāpana (Alleviates pain).14  Its therapeutic uses are also found throughout the Materia Medica of Ayurveda and the Sushrut Samhita, mostly in formulas treating varying complaints.

WESTERN INTERPRETATION

In western herbal terminology, it is described as a stimulant, diaphoretic, expectorant, carminative, anti- emetic, analgesic, sialagogue, appetizer, anti-flatulent, anti-tussive, antimicrobial, hypolipidemic, anti-oxidant, anti-spasmodic, anti-atherosclerotic, cardiotonic, circulatory stimulant, and emmenagogue. Its indications include

digestive upset of all kinds, including nausea, indigestion, vomiting, belching, abdominal pain, gas, colic, and motion sickness. It can also be used for respiratory conditions, rheumatism, osteoporosis, gout, colds, flu, laryngitis, arthritis, hemorrhoids, headaches, heart disease, gas, “cramps in the abdomen, including menstrual cramps due to cold”15, migraines, lumbago, fever, and its fresh juice can even be used for burns. 16,17,18,19,20  With such a long list of actions and indications, it is no wonder it is referred to as “the universal medicine”.

ĀRDRAKA & ŚUṆṬHI

Ginger has many names across cultures, and even within Ayurveda. Most commonly, the fresh form is recognized as ārdraka (moist), and the dry rhizome as either śuṇṭhi or nagara, meaning “dry.” 21  Traditional Chinese Medicine also creates a distinction between these two forms of the rhizome, calling fresh ginger shen   jiang and dry ginger gan jiang.22,23  Scientific research confirms the difference between the properties of fresh and dried ginger. As the “volatile and diaphoretic essential oils β-sesquipphellandrene and zingiberene decompose on drying…*t+he warming gingerol principle transforms into shogoals…making it more centrally heating”. 24  “Gingerols have been reported to be responsible for the characteristic taste” of ginger. 25    “The gingerols have analgesic, sedative, antipyretic, antibacterial and gastrointestinal tract motility effects.26  As the most numerous chemical constituents of ginger, both gingerols and shogoals are some of the most researched compounds of ginger.

In The Yoga of Herbs, authors Frawley and Lad mention that “*f+resh ginger is a better diaphoretic, better for colds, cough, vomiting and for deranged Vāta.”27  In both the Materia Medica of Ayurveda and the Sushrut Samhita, ārdraka is touted for promoting a “good voice,” curing vibandha (constipation), ānāha (obstruction to the movement of wind in the stomach), and śúla (colic pain). It is said to be an effective “appetizer, aphrodisiac and cardiac tonic.”28,29 It is also found as part of a treatment for acute conditions, such as earache. 30

Frawley and Lad also state that the drying action and increased heat of dry ginger makes it “a better stimulant and expectorant for reducing Kapha and increasing Agni.” Śunthi is found in many kapha-reducing remedies throughout the Materia Medica, often combined with marica (black pepper) and pippalῑ (long pepper).31 Together the three herbs, combined into powder in equal portions, are commonly called Trikaṭu Cūrṇa, a heating,

stimulating, and toxin-reducing rasāyana for Kapha.32

APPLICATIONS & RESEARCH

DIGESTIVE SYSTEM

Ginger “warms the digestive system, [and] increases agni and the secretion of digestive enzymes. Fresh ginger especially benefits rasadhātvagni (agni of the rasa dhatu) while dry ginger clears āma and is better for kledaka kapha aggravations.”33  As Pole suggests, the two forms of ginger play different roles in digestion, but both help to warm and stimulate the process. Many randomized controlled trials (RCT) were performed on people to examine ginger’s effect on digestion. It is said that “*a+bout 40% of patients with functional dyspepsia have abnormally delayed gastric emptying.” 34  Therefore, two RCTs were done to “evaluate the effects of ginger on gastric motility and emptying, abdominal symptoms, and hormones that influence motility in dyspepsia”. 35

Patients who suffered from functional dyspepsia ingested either three ginger capsules totaling 1.2g, or a placebo. Gastric emptying was more rapid and antral contractions were more numerous in the experimental group, but the ginger “had no impact on gastrointestinal symptoms or gut peptides.” 36  The same study was done previously on healthy, asymptomatic volunteers to test the gastrointestinal effects of ginger. Again, the 1.2g of ginger accelerated gastric emptying while stimulating antral contractions. 37  In another RCT, adult respiratory distress syndrome (ARDS) patients, who were dependent on mechanical ventilation and fed via nasogastric tube, “showed that gastric feed supplementation with [120mg] ginger extract might reduce delayed gastric emptying and help reduce the incidence of ventilator-associated pneumonia in ARDS.” 38

Pole also mentions ginger’s effectiveness in nausea for motion sickness, morning sickness in pregnancy, and post-operative nausea.39 Ginger as a remedy for motion sickness was evaluated in an RCT, where the experimental group was pre-treated with ginger at 1g and 2g before being subject to circular vection. The study showed that “ginger reduces nausea, tachygastric activity, and vasopressin release induced by circular vection,” while delaying their onset and shortening the recovery time afterwards.40 Another RCT, evaluating the effectiveness of ginger on motion sickness, was performed on “eighty naval cadets, unaccustomed to sailing in heavy seas”. 1g of “ginger root reduced the tendency to vomiting and cold sweating significantly better than placebo” and ingestion gave “remarkably fewer symptoms of nausea and vertigo,” though the latter “was not statistically significant.”41  One article explained that, “gingerols have been reported to be responsible for…many pharmacological activities including motion sickness”. They are thought to work directly “on the gastrointestinal tract rather than…on the central nervous system.”42

Studies show that ginger’s anti-emetic properties can benefit patients in a variety of circumstances. In a guide for pre-natal care from London, the authors referred to three RCTs that demonstrate the alleviation of  nausea and vomiting in pregnancy with the use of ginger. After taking 250 mg of ginger, four times a day, pregnant women displayed less severe nausea and fewer instances of vomiting over those in the control group. In another RCT mentioned in the report, patients ingesting 1 tbsp. of ginger syrup in 4 to 8 fluid oz., four times a day, showed a relief in nausea and less vomiting than those in the placebo group. 43 Ginger was also found to be effective in a review of RCTs concerning post-operative nausea and vomiting. The analysis demonstrated “that a fixed dose *of+ at least 1 g of ginger is more effective than placebo for the prevention of [24-hour] postoperative nausea and vomiting *PONV+.”44  In clinical trials for patients with Chemotherapy-induced nausea and vomiting (CINV), ginger again proved to be a valuable anti-emetic. “Ginger root powder was effective in reducing severity of acute and delayed CINV as additional therapy to ondensetron and dexamethasone in patients receiving high emetogenic chemotherapy”. 45  Thus, the ancient tradition of using ginger to reduce nausea by stimulating digestion has been proven successful in clinical trials.

In addition to aiding in the general digestive process, it exhibits cholagogic effects, with its chief pungent principles, [6]-gingerol and [10]-gingerol, being most responsible. 46  While ginger stimulates bile production, it is also hepato-protective. A study using an aqueous ethanol extract of ginger concluded that it works either by preventing the decline of hepatic antioxidant status or due to its direct radical scavenging capacity.47  Another experiment compared the hepato-protective property of 6-gingerol against the standard drug silymarin, and found them to by comparable.48

Even though it is heating in virya, ginger has even been shown to be beneficial in the treatment of experimental ulcers. It stimulates defensive mucin (a constituent of mucous) production slightly more than the offensive acid-pepsin secretions. The isolated compound 6- gingesulphonic acid proved more effective in anti- ulcer activity than 6- gingerol and 6-shogaol, perhaps due to weaker pungency.49  A study on ulcer-induced rats “clearly demonstrated that aqueous extract of ginger was able to protect the gastric mucosa from stress-induced mucosal lesions and inhibits gastric acid secretion probably by blocking H+, K+-ATPase action, inhibiting growth of H. pylori and offering anti-oxidant protection against oxidative stress-induced gastric damage.” 50  Ginger also assists in the treatment of ulcers through antibacterial actions, as found by a Nigerian study:

Ginger’s antibacterial ‘power' is effective against preventing numerous intestinal problems that take place as a result of the alteration of the intestinal flora. This is ideal to avoid the formation of ulcers by eliminating the Helicobacter pylori, a bacterium whose secretions of ammonia are responsible for many ulcers, especially those of the duodene, and for other stomach problems like gastritis, since the plant is able to neutralize the excess of gastric acid that is another of the causes that favours the formation of ulcers.51

ANTI-MICROBIAL

“Its gingerol-related components have been reported to possess antimicrobial and antifungal properties, as well as several pharmaceutical properties.” 52    The aforementioned Nigerian study demonstrated the effectiveness of the anti-bacterial properties of ginger against digestive pathogens. Various extracts, ranging from ethanolic to raw juice, to hot and cold water, exhibited varying effectiveness at different concentrations.  “*T+he cold-water extract of ginger inhibited both Escherichia coli and Salmonella typhi at all concentrations,” while the “ethanolic extract of ginger gave the widest zone of inhibition” against Salmonella typhi. In other studies referenced by the authors, “ginger extract and its pungent compounds demonstrated greater [than those of onion] antibacterial activity against a variety of bacterial species including Helicobacter pylori, Staphylococcus aureus, Pseudomonasaeruginosa and Escherichia coli, although mixed result is attributed to different ginger preparations and varying strength.”53 Pole confirms ginger’s antibacterial actions against Escherichia coli and adds its effectiveness against Shigella bacillus.54 

Ginger’s antimicrobial actions go beyond digestive pathogens. As some bacteria grow resistant to pharmaceuticals, such as Acinetobacter baumannii (XDRAB) has, scientific studies turn to ginger as a potential aid. When combined with tetracycline, four components of ginger, [6]-dehydrogingerdione, [10]-gingerol, [6]-shogaol and [6]-gingerol, exhibited antibacterial actions against XDRAB, and modulated resistance to the drug. Results of the experiment also showed that antioxidants within the compounds aided the antimicrobial actions. 55A research article in Phytotherapy Research sought to explore the anti-bacterial actions of ginger, and its isolated components, on oral pathogens related to periodontitis. Ethanol and n-hexane extracts of ginger showed anti- bacterial actions, while the isolated constituents [10]-gingerol and [12]-gingerol, also inhibited the growth of, and killed the three strains of bacteria in the experiment.56

ANTI-INFLAMMATORY

Ginger is gaining more and more recognition for its anti-inflammatory actions. While Ayurveda has long- touted its benefits, contemporary research studies are now proving which constituents are most responsible, and how they work.  From an Ayurvedic perspective, Pole states, “*d+ry ginger is used as an āma-clearing, śleṣaka kapha-reducing, toxin-digesting, anti-inflammatory in arthritis (āma-vāta) in many traditional ayurvedic formulas, e.g. triphala guggul, yograj guggul.” He goes on to mention that, “despite its ‘warm’ energy it also inhibits the activity of inflammatory prostaglandins.” 57

As a relative of turmeric, ginger shares many of its functions. One study found ginger’s active constituents to act much like turmeric’s in affecting inflammation, oxidative damage, and “fighting the ravages of aging and degenerative diseases.” It did so by influencing:

some endocrine gland functions, and signal pathways involved to mediate their actions. With some systems and adipose tissue, ginger and turmeric exert their actions through some/all of the following signals or molecular mechanisms: (1) through reduction of high levels of some hormones (as: T4, leptin) or interaction with hormone receptors; (2) by inhibition of cytokines/adipokine expression; (3) acting as a potent inhibitor of reactive oxygen species (ROS)- generating enzymes, which play an essential role between inflammation and progression of diseases; (4) mediation of their effects through the inhibition of signaling transcription factors; and/or (5) decrease the proliferative potent by down-regulation of antiapoptotic genes, which may suppress tumor promotion by blocking signal transduction pathways in the target cells. 58

Today, scientists look to some of the key enzymes within the body to understand the mechanism behind ginger’s anti-inflammatory properties. Actions from Cyclooxygenase-1 (COX-1) enzymes produce hormone-like prostaglandins that protect the digestive tract from acids and assist in essential blood clotting.  COX-2 enzymes play a direct role in the production of prostaglandins that protect the body after injury, creating inflammation.

Non-steroidal anti-inflammatory drugs (NSAIDS), such as aspirin and ibuprofen, are often used to both reduce inflammation, and the associated pain. By acting on COX-2 and often COX-1 enzymes, NSAIDS reduce the prostaglandins produced, and “may irritate the stomach’s lining and cause digestive upset, peptic ulcers, and bleeding in the digestive tract.” 59  One research paper summarized research on ginger, and what the findings have meant for pharmacology:

The original discovery of ginger's inhibitory effects on prostaglandin biosynthesis in the early 1970s has been repeatedly confirmed. This discovery identified ginger as an herbal medicinal product that shares pharmacological properties with non-steroidal anti-inflammatory drugs. Ginger suppresses prostaglandin synthesis through inhibition of cyclooxygenase- 1 and cyclooxygenase-2. An important extension of this early work was the observation that ginger also suppresses leukotriene biosynthesis by inhibiting 5-lipoxygenase. This pharmacological property distinguishes ginger from nonsteroidal anti-inflammatory drugs. This discovery preceded the observation that dual inhibitors of cyclooxygenase and 5-lipoxygenase may have a better therapeutic profile and have fewer side effects than non-steroidal anti-inflammatory drugs. The characterization of the pharmacological properties of ginger entered a new phase with the discovery that a ginger extract (EV.EXT.77) derived from Zingiber officinale (family Zingiberaceae) and Alpina galanga (family Zingiberaceae) inhibits the induction of several genes involved in the inflammatory response. These include genes encoding cytokines, chemokines, and the inducible enzyme cyclooxygenase-2. This discovery provided the first evidence that ginger modulates biochemical pathways activated in chronic inflammation. Identification of the molecular targets of individual ginger constituents provides an opportunity to optimize and standardize ginger products with respect to their effects on specific biomarkers of inflammation.60

Many studies have since been done on the various components in ginger, examining the effectiveness on inflammation. In an in-vitro study of 6-shogaol, and 6-, 8-, and 10-gingerols, the compounds were evaluated for their antioxidant and anti-inflammatory efficacy. “6-Shogaol has exhibited the most potent antioxidant and anti- inflammatory properties which can be attributed to the presence of alpha,beta-unsaturated ketone moiety. The carbon chain length has also played a significant role in making 10-gingerol as the most potent among all the gingerols.”61  As some of the most-studied components of ginger, shogaols and gingerols do not act alone. A scientific study compared a “crude dichloromethane ginger extract, which also contained essential oils and more polar compounds”, to a compound containing only gingerols and their derivatives. The crude extract had significantly more anti-arthritic effects on arthritis-induced rats, reducing both joint inflammation and destruction. This research revealed that gingerols are more effective in treating arthritis when working synergistically with other components naturally found in ginger.62

Another scientific study used methanol extracts of ginger roots, to isolate the components, 10-gingerol, 8- shogaol and 10-shogaol. They inhibited cyclooxygenase-2, COX-2, but not COX-1. The report reiterates that the “inhibition of COX-1 is associated with gastrointestinal irritation,” and goes on to explain that “selective inhibition of COX-2 should help minimize this side effect.” 63  Thus, ginger’s use over common NSAIDS may have less side effects in the digestive tract.  The study involving the “standardized and highly concentrated extract of 2 ginger species, Zingiber officinale and Alpinia galanga (EV.EXT 77),” showed a “statistically significant” reduction of symptoms in patients with osteoarthritis (OA) of the knee. Since only “mild GI adverse events *occurred+ in the ginger extract group, it was concluded to have a “good safety profile.”64  In a smaller experiment, a limited number of patients used ginger compresses on their kidneys to manage the symptoms of osteoarthritis. They explained that “warmth penetrated through the entire self, activating deep relaxation, [and that] total relaxation of the self enabled release of tension and improved receptivity towards others. Additionally, interest in the outer world increased as the self felt more mobile and energized.” This alternative treatment to arthritis enabled them to overcome some of the other symptoms that many arthritis patients face, such as “psychological distress, social isolation and general inability to cope” as well as pain.65  In one study, 6-shogaol expressed its usual anti- inflammatory capabilities, but the study examined them within cells of the central nervous system. By mediating microglial activation, which results in neuronal cell death, “6-shogaol is an effective therapeutic agent for treating *and possibly preventing+ neurodegenerative diseases.”66  Ginger exhibits actions across a widespread spectrum of inflammatory conditions.

RESPIRATORY SYSTEM

Though not as many clinical research studies have examined ginger’s effects on the respiratory system, its use in Ayurveda for respiratory complaints is well known. As a kāsaśvāsahara, it is known for alleviating cough and breathing difficulties. As Pole also mentions, fresh ginger’s stimulating effects on peripheral circulation, vasodilation, and sweating may contribute to its ability to clear colds.  As the āma clears from the rasa and rakta, kapha-vāta coughs and colds are reduced. Combined with different herbs, ginger’s many actions can be tailored to the symptoms at hand. With cinnamon and lemongrass, it can induce sweating for a cold. For a high kapha-vata cough, vasa and pippali may be more helpful. As part of trikatu, it can also aid kapha respiratory complaints while accelerating slugglish digestion. 67

According to the Merck Manual of Medical Information, asthma is becoming more common, more serious, and is even resulting in more deaths annually. As explained in the Manual, “airways narrow –usually reversibly—in response to certain stimuli”. While one muscle layer spasms, another becomes inflamed, leading to the excessive production of mucous, which may further lead to an obstruction of the airway. 68    Recurring attacks over a long-period of time, may lead to airway remodeling, a “permanent narrowing of the bronchial tubes.”69

Ginger has been proven effective with asthma, as an anti-inflammatory, anti-hypersecretory, and even helping to repair the body after attack. Using an aqueous methanolic crude extract of ginger, one study found it to inhibit airway contraction through its anti-inflammatory properties.70  Perhaps it did this by reducing interleukin-1 secretion, as a German research paper found it to do, in human bronchial epithelial cells. The authors went on to propose “that distinct ginger compounds could be used as anti-inflammatory drugs in respiratory infections,” such as those in asthmatic patients.71  It can also repair the body after harmful inflammation. A Taiwanese study found that “inflammatory cytokines, which are produced by the bronchial epithelium after exposure to phthalate esters [ingredient in many plastics]…contribute to airway remodeling”. The research went on to demonstrate that “ginger reverses phthalate ester-mediated airway remodeling.”72  Research from South Korea proved [6]- Gingerol’s anti-hypersecretory abilities in relation to human airway epithelial cells.73  Thus, ginger can help reduce inflammation, secretions, and even long-term destruction related to asthma, and thus help in many stages of the disease.

ANTI-CARCINOGENIC

In cultured cell studies and experiments with animals, ginger’s pungent principles (gingerols, shogaols, paradols, and zingerone) have proven to possess anti-carcinogenic properties that may be both chemopreventive and chemotherapeutic. 74  These “cancer preventive activities are supposed to be mainly due to free radical scavenging, antioxidant pathways, alteration of gene expressions, and induction of apoptosis, all of which contribute towards decrease in tumor initiation, promotion, and progression.”75  6-Gingerol assisted the apoptic pathway in gastric cancer cells by enhancing the TRAIL-induced viability reduction of the cells. 6-Shogaol damaged microtubules of the cancer cells, halting their reproduction and thus reducing their ability to reproduce. 76 In breast cancer cells, 6-gingerol has been found to inhibit “cell adhesion, invasion, motility and activities”.

The rate of inhibition was dose-dependent, increasing as the concentration of ginger compounds increased.77  In  an experiment from the National University of Singapore, the isolated constituents, 6-, 8- and 10-shogaol, were shown to “have an inhibitory effect on induced breast cancer cell invasion,” without creating cytotoxic  conditions.78  One study explained the method by which ginger reduced the incidence of liver neoplasms and “the risk of subsequent carcinoma”. In liver cancer cells, NF-κB is constitutively activated and…blocking NFκB activation with ginger resulted in suppressed production of *inflammatory markers+ NFκB and TNF-α. This is in line with findings that many of the pathways that mediate adaptive survival strategies in cancer cells are under the transcriptional control of NFκB. Thus, the ginger extract may have a chemotherapeutic effect in the treatment of liver cancer. 79

Researchers from the University of Minnesota referenced many experiments comparing the effectiveness of gingerols and shogaols in cancer inhibition. As the two constituents are those most prevalent in ginger, they were predominantly examined, although other components were also evaluated. With effectiveness varying with the compound, the constituents were successful against a broad spectrum of cancer cells, including human lung, leukemia, skin, ovarian, and colon cancer cells, as well as mouse skin and lung cancer cells.80

CARDIOVASCULAR SYSTEM

Ginger’s many actions show widespread potential in cardiovascular disease as well. In one study, ginger’s ability to increase body temperature was scientifically examined. It was found that gingerols and shogaols activated transient receptor potential vanilloid subtype 1 (TRPV1), which detects and regulates body temperature. The pungent constituents also increased adrenaline secretion, which heats the body.81  Describing it as a śitapraśamana, Ayurveda has known of its ability to reduce feelings of cold. Pole explains that, Ayurvedically, “*d+ry ginger may be of benefit in cardiac disorders due to increasing circulation and potential blood-thinning properties when used at a high dosage”.82  In combination with the herbs arjuna and guggulu, it treats congestive heart conditions and poor circulation.83

An article from the International Journal of Cardiology, explains, “*h+uman trials have been few and generally used a low dose with inconclusive results, however dosages of 5g or more demonstrated significant anti- platelet activity…Should *more human trials+…prove positive, ginger has the potential to offer not only a cheaper natural alternative to conventional agents but one with significantly lower side effects.”84  In an in-vitro  experiment comparing synthetic gingerols with aspirin, the gingerols and related analogues inhibited human platelet activation at the same potency, or greater than that of aspirin, depending on the analogue.85

Using an orally-administered, aqueous extract of ginger with rats, high doses of the extract (500mg/kg) lowered prostaglandin, thromboxane (blood-clotting substances), and cholesterol levels. “These results suggest that ginger could be used as a cholesterol-lowering, antithrombotic and anti-inflammatory agent.”86  In another study, test rabbits were fed cholesterol for 75 days, and thus were induced with atherosclerosis. After ingesting experimental doses of air dried ginger powder, at 0.1g/kg of body weight, for 75 days, atheroma was reduced by half. Evidence of anti-oxidation was evident in decreased lipid peroxidation, and an increase in fibrinolytic activity meant that wound-healing capabilities also increased. “However, ginger did not lower blood lipids to any significant extent. This distinct protection from the development of atherosclerosis by ginger is probably because of its free radical scavenging, prostaglandin inhibitory and fibri properties.”87

DOSAGES

Author or Research Study Dosage
ARDS, Gastric Emptying RCT 120 mg, gastric feed supplementation with ginger extract88
Lad & Frawley 250 to 500mg powder89
Morning Sickness RCT 250mg, 4 times a day90,
Seasickness RCT 1gm91
Post-Operative Nausea & Vomiting RCT 1gm92
Circular Vection RCT 1-2gm 93
Lust ½ tsp., or about 2.2gm, powdered root, as tea94
Gastric Emptying, RCT 1.2gm total, in 3 capsules95
Pole 1.5-5gm per day (fresh) 1-2gm per day (dry)96
Khalsa 500mg per day, capsule, tea, juice or in food97 As desired, in food, or up to 3gm per day, in capsules 1tsp., chopped fresh root, as tea, 3 times per day98
Reid 3-8gm99
Tierra 3-9gm dried, 2-6 slices of fresh root as tea100
Landis 2 to 5 capsules per day, or about 1.5 to 3.7gm101
Anti-Platelet Studies  5gm or more102

CONCLUSION

Ginger’s versatility expands in all directions. As a seasoning, it spans continents, finding its way through Thai, Indian, Chinese, and other Asian cuisines, and into western baked goods, ales, and sauces. As a supplement, it provides valuable minerals, bridging the gap between diet and medicine. Therapeutically, it works on many conditions, operating synergistically to bring balance through various modalities. Many of the Ayurvedic uses and terms associated with ginger are being proven in today’s laboratories and clinical trials.

Its aid in digestion is widespread, working to initiate (agni dῑpana) and stimulate (pācana) the process, prevent nausea and vomiting (chardinigrahaṇa), treat ulcers, and inhibit harmful bacteria and fungi. It does all this while stimulating, and protecting the liver. It also simultaneously aids in inflammatory and cancerous conditions.  By affecting hormone processes, and other biochemical pathways, harmful gene expression, reactive oxygen species, and free-radical scavenging (āmanāśaka), it reduces inflammation and carcinogenic activity at the same time.

This simultaneously allows it to be a preventative, pain reliever (vedanāsthāpana), and rasāyana to damaged tissues. The remarkable thing about ginger is that these tissues can range from an arthritic and degenerated joint, to an obstructed airway, to an organ recovering from cancer. As if that was not enough, ginger also enhances cardiovascular health. In a modern-day, mostly sedentary society, with more and more high cholesterol and heart related diseases, ginger’s assistance is more than welcome. As a food with a long-history of use throughout the world, its harmful side effects are minimal, especially when compared to many pharmaceuticals. In a gavage safety assessment of ginger, rats were given excessive amounts of ginger, (2000mg/kg), but displayed no harmful abnormalities or mortalities, except for a slight decrease in weight of the testes.103  Though its dosage varies according to use, author, mode of extraction, and research study, it is still relatively safe, even if taken in excess.

Thus, ginger has proven to be the vishwabheshaja, “the universal medicine”, not only through time in ancient medical systems, but also through modern-day clinical and experimental research for some of today’s most common diseases.

ABSTRACTS OF ARTICLES CITED 

(in order of citation)

R.K. Goel, and K. Sairam. “Anti-Ulcer Drugs from Indigenous Sources with Emphasis on Musa Sapientum, Tamrabhasma, Asparagus Racemosus, and Zingiber Officinale,” Indian Journal of Pharmacology 34 (2002): 100-110.

Sula, Parinamasula and Amlapitta are clinical entities recognized by ayurveda, akin to peptic ulcer and functional dyspepsia. Many indigenous drugs have been advocated in ayurveda for treatment of dyspepsia. Our laboratory has been engaged in screening of various indigenous herbal and metallic drugs for their potential use in peptic ulcer diseases, taking lead from Ayurveda and have reported anti-ulcer and ulcerhealing properties of Tectona grandis (lapachol), Rhamnus procumbens (kaempferol), Rhamnus triquerta (emodin), Withania somnifera (acylsteryl glycoside), Shilajit (fulvic acid and carboxymethoxybiphenyl), Datura fastuosa (withafastuosin E), Fluggea microcarpa and Aegle marmelos (pyrano- and iso- coumarins) etc., along with their mechanism of action. The present article includes the detailed exploration of ulcer protective and healing effects of unripe plantain banana, tambrabhasma and Asparagus racemosus on various models of experimental gastroduodenal ulceration and patients with peptic ulcer. Their effects on mucin secretion, mucosal cell shedding, cell proliferation, anti-oxidant activity, glycoproteins, and PG synthesis have been reported. Clinical trials of these drugs for evaluating their potential ulcer healing effects in peptic ulcer patients have been done. Their potential ulcer protective effects both, experimental and clinical seemed to be due to their predominant effects on various mucosal defensive factors rather than on the offensive acid-pepsin secretion. Thus, the above herbal / herbo-mineral drugs do have potential usefulness for treatment of peptic ulcer diseases.

NC Azu, and RA Onyeagba, “Antimicrobial Properties Of Extracts Of Allium cepa (Onions) And Zingiber officinale (Ginger) On Escherichia coli, Salmonella typhi And Bacillus subtilis.” The Internet Journal of Tropical Medicine 3.2 (2007). http://www.ispub.com/journal/the-internet-journal-of-tropical-medicine/v... number-2/antimicrobial-properties-of-extracts-of-allium-cepa-onions-and-zingiber-officinale-ginger-on- escherichia-coli-salmonella-typhi-and-bacillus-subtilis.html

The antimicrobial properties of various extracts of Allium cepa (onions) and Zingiber officinale (ginger) against Escherichia coli, Salmonella typhi and Bacillus subtilis that are common cause of gastrointestinal tract infections were investigated using the cup-plate diffusion method. The result obtained revealed that ethanolic extract of ginger gave the widest zone of inhibition against two out of the three test organisms at the concentration of 0.8gml-1. However, Escherichia coli and Salmonella typhi were more sensitive to the extract of onion bulbs compared to Bacillus subtilis which was predominantly resistant. It was also observed that the solvent of extraction and its varying concentrations affected the sensitivity of two of the test organisms to the plant materials. The minimum inhibitory concentration (MIC) of ginger extracts on the test organisms ranged from 0.1gml-1 - 0.2gml-1, showing that ginger was more effective and produced remarkable inhibitory effect on the two out of the three test organisms when compared to the onion extracts. This investigation indicates that, though both plants had antimicrobial activities on the two gram negative test organisms but not effective on the gram positive test organism, ginger had more inhibitory effect thus confirming their use in folk medicine.

Seng-Kee Chuau, et.al, “Effect of Ginger on Gastric Motility and Symptoms of Functional Dyspepsia,” World Journal of Gastroenterology 17.1 (2011):105-110.

AIM: To evaluate the effects of ginger on gastric motility and emptying, abdominal symptoms, and hormones that influence motility in dyspepsia.

METHODS: Eleven patients with functional dyspepsia were studied twice in a randomized double-blind manner. After an 8-h fast, the patients ingested three capsules that contained ginger (total 1.2 g) or placebo, followed after 1 h by 500 mL low-nutrient soup. Antral area, fundus area and diameter, and the frequency of antral contractions were measured using ultrasound at frequent intervals, and the gastric half-emptying time was calculated from the change in antral area. Gastrointestinal sensations and appetite were scored using visual analog questionnaires, and blood was taken for measurement of plasma glucagon-like peptide-1 (GLP-1), motilin and ghrelin concentrations, at intervals throughout the study.

RESULTS: Gastric emptying was more rapid after ginger than placebo [median (range) half-emptying time 12.3 (8.5- 17.0) min after ginger, 16.1 (8.3-22.6) min after placebo, P ≤ 0.05+. There was a trend for more antral contractions (P = 0.06), but fundus dimensions and gastrointestinal symptoms did not differ, nor did serum concentrations of GLP-1, motilin and ghrelin.

CONCLUSION: Ginger stimulated gastric emptying and antral contractions in patients with functional dyspepsia, but had no impact on gastrointestinal symptoms or gut peptides.

SK Chuau, et al., “Effect of Ginger on Gastric Emptying and Motility in Healthy Humans,” European Journal of Gastroenterology and Hepatology 20.5 (2008):436-440.

OBJECTIVE:

Ginger has been reported to improve upper gastrointestinal symptoms. Little information about the effects of ginger on gastric motor function, exists, however. Our aim was to investigate the effects of ginger on gastric emptying, antral motility, proximal gastric dimensions, and postprandial symptoms.

METHODS:

Twenty-four healthy volunteers were studied twice in a randomized double-blind manner. After an 8 h fast, the volunteers ingested three ginger capsules (total 1200 mg) or placebo, followed after 1 h by 500 ml low-nutrient soup. Antral area, fundus area and diameter, and the frequency of antral contractions were measured using ultrasound at frequent intervals over 90 min, and the gastric half-emptying time was calculated from the change in antral area. Gastrointestinal sensations and appetite were scored using visual analog questionnaires. Data are expressed in terms of mean+/-standard error.

RESULTS:

Antral area decreased more rapidly (P<0.001) and the gastric half-emptying time was less after ginger than placebo ingestion (13.1+/-1.1 vs. 26.7+/-3.1 min, P<0.01), whereas the frequency of antral contractions was greater (P<0.005). Fundus dimensions did not differ, and there was no significant difference in any gastrointestinal symptoms.

CONCLUSION:

Ginger accelerates gastric emptying and stimulates antral contractions in healthy volunteers. These effects could potentially be beneficial in symptomatic patient groups.

M. Mokhtari, et al., “Ginger extract reduces delayed gastric emptying and nosocomial pneumonia in adult respiratory distress syndrome patients hospitalized in an intensive care unit,” Journal of Critical Care 25.4 (2010):647-650.

PURPOSE:

The purpose of this study was to evaluate the effect of ginger extract on delayed gastric emptying, developing ventilator-associated pneumonia, and clinical outcomes in adult respiratory distress syndrome (ARDS).

MATERIALS AND METHODS:

Thirty-two ARDS patients who were dependent on mechanical ventilation and fed via nasogastric tube were studied. After enrollment, patients were randomized to 2 groups. The control group received 1 g of coconut oil as placebo, and the study group received 120 mg of ginger extract. The amount of feeding tolerated at the first 48 hours of feeding, amount of feeding tolerated during the entire study period, nosocomial pneumonia, number of intensive care unit (ICU)-free days, number of ventilator-free days, and mortality were evaluated during 21 days of intervention.

RESULTS:

There was a significant difference between the ginger group and the control group in the amount of feeding tolerated at the first 48 hours of enteral feeding (51% vs 57%, P < .005). There was a trend toward a decrease in pneumonia in the ginger group (P = .07). The overall in-ICU mortality was 15.6%, with no significant difference in the 2 groups. The number of ventilator-free days and that of ICU-free days were lower in the control group compared with the ginger group (P = .04 and P = .02).

CONCLUSION:

This study showed that gastric feed supplementation with ginger extract might reduce delayed gastric emptying and help reduce the incidence of ventilator-associated pneumonia in ARDS.

Owyang Chung, et al., “Effects of ginger on motion sickness and gastric slow-wave dysrhytmias induced by circular vection,” American Journal of Physiology 284.3 (2003):G481-G489.

Ginger has long been used as an alternative medication to prevent motion sickness. The mechanism of its action, however, is unknown. We hypothesize that ginger ameliorates the nausea associated with motion sickness by preventing the development of gastric dysrhythmias and the elevation of plasma vasopressin. Thirteen volunteers with a history of motion sickness underwent circular vection, during which nausea (scored 0–3, i.e., none to severe), electrogastrographic recordings, and plasma vasopressin levels were assessed with or without ginger pretreatment in a crossover-design, double-blind, randomized placebo-controlled study. Circular vection induced a maximal nausea score of 2.5 ± 0.2 and increased tachygastric activity and plasma vasopressin. Pretreatment with ginger (1,000 and 2,000 mg) reduced the nausea, tachygastria, and plasma vasopressin. Ginger also prolonged the latency before nausea onset and shortened the recovery time after vection cessation. Intravenous vasopressin infusion at 0.1 and 0.2 U/min induced nausea and increased bradygastric activity; ginger pretreatment (2,000 mg) affected neither. Ginger effectively reduces nausea, tachygastric activity, and vasopressin release induced by  circular vection. In this manner, ginger may act as a novel agent in the prevention and treatment of motion sickness.

Torben Brask, et al., “Ginger Root Against Seasickness: A Conctrolled Trial on the Open Sea,” Acta Oto- laryngologica 105.1-2 (1988):45-49.

In a double-blind randomized placebo trial, the effect of the powdered rhizome of ginger (Zingiber officinale) was tested on seasickness. Eighty naval cadets, unaccustomed to sailing in heavy seas reported during voyages on the high seas, symptoms of seasickness every hour for 4 consecutive hours after ingestion of 1 g of the drug or placebo. Ginger root reduced the tendency to vomiting and cold sweating significantly better than placebo did (p<0.05). With regard to vomiting, a modified Protection Index (PI)=72% was calculated. Remarkably fewer symptoms of nausea and vertigo were reported after ginger root ingestion, but the difference was not statistically significant. For all symptom categories, PI=38% was calculated.

N Chaiyakunapruk, et al., “The efficacy of ginger for the prevention of postoperative nausea and vomiting: a meta- analysis,” American Journal of Obstetrics and Gynecology 194.1 (2006):95-99.

OBJECTIVE: The aim of this study was to specifically determine the impact of a fixed dose of ginger administration, compared with placebo, on the 24-hour postoperative nausea and vomiting.

STUDY DESIGN: The design was a systematic review and metaanalysis of trials revealed by searches. Randomized controlled trials comparing ginger with placebo to prevent postoperative nausea and vomiting and postoperative vomiting from Medline, IPA, CINAHL, Cochrane CENTRAL, HealthStar, Current Contents, bibliographies of retrieved articles, contact of authors, and experts in the field. Two reviewers selected studies for inclusion and independently extracted data.

RESULTS: Five randomized trials including a total of 363 patients were pooled for analysis of preventing postoperative nausea and vomiting and postoperative vomiting. The summary relative risks of ginger for postoperative nausea and vomiting and postoperative vomiting were 0.69 (95% confidence interval 0.54 to 0.89) and 0.61 (95% confidence interval 0.45 to 0.84), respectively. Only one side effect, abdominal discomfort, was reported.

CONCLUSIONS: This meta-analysis demonstrates that a fixed dose at least 1 g of ginger is more effective than placebo for the prevention of postoperative nausea and vomiting and postoperative vomiting. Use of ginger is an effective means for reducing postoperative nausea and vomiting.

Y.K. Gupta, et al., “Anti-emetic effect of ginger powder versus placebo as an add-on therapy in children and young adults receiving high emetogenic chemotherapy,” Pediatric Blood & Cancer 56.2 (2011):234-238.

PURPOSE:

Chemotherapy-induced nausea and vomiting (CINV) are major adverse effects of chemotherapy. Ginger has been used in postoperative and pregnancy-induced nausea and vomiting. Data on its utility in reducing CINV in children and young adults are lacking.

PATIENTS AND METHODS:

Sixty chemotherapy cycles of cisplatin/doxorubicin in bone sarcoma patients were randomized to ginger root powder capsules or placebo capsules as an additional antiemetic to ondensetron and dexamethasone in a double- blind design. Acute CINV was defined as nausea and vomiting occurring within 24 hr of start of chemotherapy (days 1-4) and delayed CINV  as that occurring  after 24 hr of completion of chemotherapy (days 5-10). CINV was evaluated as per Edmonton's Symptom Assessment Scale and National Cancer Institute criteria respectively.

RESULTS:

Acute moderate to severe nausea was observed in 28/30 (93.3%) cycles in control group as compared to 15/27 (55.6%) cycles in experimental group (P = 0.003). Acute moderate to severe vomiting was significantly more in the control group compared to the experimental group [23/30 (76.7%) vs. 9/27 (33.33%) respectively (P= 0.002)]. Delayed moderate to severe nausea was observed in 22/30 (73.3%) cycles in the control group as compared to 7/27 (25.9%) in the experimental group (P < 0.001). Delayed moderate to severe vomiting was significantly more in the control group compared to the experimental group [14/30 (46.67%) vs. 4/27 (14.81%) (P = 0.022)].

CONCLUSION:

Ginger root powder was effective in reducing severity of acute and delayed CINV as additional therapy to ondensetron and dexamethasone in patients receiving high emetogenic chemotherapy.

T Chisaka, et al., “Cholagogic effect of ginger and its active constituents,” Journal of ethnopharmacology 13.2 (1985):217-25.

The effect of bile secretion in rats was examined in order to clarify the stomachic action of ginger and also to investigate its active constituents. The results showed that mainly the acetone extracts of ginger, which contain essential oils and pungent principles, caused an increase in the bile secretion. Further analyses for the active constituents of the acetone extracts through column chromatography indicated that [6]-gingerol and [10]-gingerol, which are the pungent principles, are mainly responsible for the cholagogic effect of ginger.

T.A. Ajith, et al., “Zingiber officinale Roscoe prevents acetaminophen-induced acute hepatotoxicity by enhancing hepatic antioxidant status,” Food and Chemical Toxicology 45.11 (2007): 2267-2272.

A large number of  xenobiotics are reported to be potentially hepatotoxic. Free radicals generated from the xenobiotic metabolism can induce lesions of the liver and react with the basic cellular constituents – proteins, lipids, RNA and DNA. Hepatoprotective activity of aqueous ethanol extract of Zingiber officinale was evaluated against single dose of acetaminophen-induced (3 g/kg, p.o.) acute hepatotoxicity in rat. Aqueous extract of Z. officinale significantly protected the hepatotoxicity as evident from the activities of serum transaminase and alkaline phosphatase (ALP). Serum glutamate pyruvate transaminase (SGPT), serum glutamate oxaloacetate transaminase (SGOT) and ALP activities were significantly (p < 0.01) elevated in the acetaminophen alone treated animals. Antioxidant status in liver such as activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase and glutathione-S-transferase (GST), a phase II enzyme, and levels of reduced glutathione (GSH) were declined significantly (p < 0.01) in the acetaminophen alone treated animals (control group). Hepatic lipid peroxidation was enhanced significantly (p < 0.01) in the control group. Administration of single dose of aqueous extract of Z. officinale (200 and 400 mg/kg, p.o.) prior to acetaminophen significantly declines the activities of serum transaminases and ALP. Further the hepatic antioxidant status was enhanced in the Z. officinale plus acetaminophen treated group than the control group. The results of the present study concluded that the hepatoprotective effect of aqueous ethanol extract of Z. officinale against acetaminophen-induced acute toxicity is mediated either by preventing the decline of hepatic antioxidant status or due to its direct radical scavenging capacity.

Suresh Kumar, et al., “6-gingerol, an active ingredient of ginger, protects acetaminophen-induced hepatotoxicity in mice,” Journal of Chinese integrative medicine 9.11 (2011):1264-1269.

To investigate the hepatoprotective efficacy of 6-gingerol against acetaminophen-induced hepatotoxicity in mice. Mice were injected with a single dose of acetaminophen (900 mg/kg) to induce hepatotoxicity, while 6-gingerol (30 mg/kg) or the standard drug silymarin (25 mg/kg) was given 30 min after the acetaminophen administration. The mice were sacrificed 4 h after acetaminophen injection to determine the activities of liver marker enzymes such as aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP), total bilirubin in serum, and lipid peroxidation and antioxidant status (superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase, glutathione transferase and glutathione) in liver homogenate. The treatment of 6-gingerol and silymarin to acetaminophen-induced hepatotoxicity showed significant hepatoprotective effect by lowering the hepatic marker enzymes (AST, ALT, and ALP) and total bilirubin in serum (P<0.05). In addition, 6-gingerol and silymarin treatment prevented the elevation of hepatic malondialdehyde formation and the depletion of antioxidant status in the liver of acetaminophen-intoxicated mice (P<0.05). The results evidently demonstrate that 6-gingerol has promising hepatoprotective effect which is comparable to the standard drug silymarin.

Harish Nayaka Mysore Annaiah, et al., “Gastroprotective Effect of Ginger Rhizome (Zingiber Officinale) Extract:   Role of Gallic Acid and Cinnamic Acid in H+, K+-ATPase/H. pylori Inhibition and Anti-Oxidative Mechanism,” Evidence –Based Complementary and Alternative Medicine 2011. (2011): 249487.

Zinger officinale has been used as a traditional source against gastric disturbances from time immemorial. The ulcer-preventive properties of aqueous extract of ginger rhizome (GRAE) belonging to the family Zingiberaceae is reported in the present study. GRAE at 200 mg kg−1 b.w. protected up to 86% and 77% for the swim stress-/ethanol stress-induced ulcers with an ulcer index (UI) of 50 ± 4.0/46 ± 4.0, respectively, similar to that of lansoprazole (80%) at 30 mg kg−1 b.w. Increased H+,  K+-ATPase activity  and thiobarbituric acid reactive substances (TBARS) were observed in ulcer-induced rats, while GRAE fed rats showed normalized levels and GRAE also normalized depleted/amplified anti-oxidant enzymes in swim stress and ethanol stress-induced animals. Gastric mucin damage was recovered up to 77% and 74% in swim stress and ethanol stress, respectively after GRAE treatment. GRAE also inhibited the growth  of  H.  pylori  with MIC  of 300 ±  38 μg and also possessed  reducing  power, free radical −1 scavenging ability with an IC50 of 6.8 ± 0.4 μg mL gallic acid equivalent (GAE). DNA protection up to 90% at 0.4 μg was also observed. Toxicity studies indicated no lethal effects in rats fed up to 5 g kg−1 b.w. Compositional analysis favored by determination of the efficacy of individual phenolic acids towards their potential ulcer-preventive ability revealed that between cinnamic (50%) and gallic (46%) phenolic acids, cinnamic acid appear to contribute to better H+, K+-ATPase and Helicobacter pylori inhibitory activity, while gallic acid contributes significantly to anti-oxidant activity.

M Park, et al., “Antibacterial activity of *10+-gingerol and [12]-gingerol isolated from ginger rhizome against periodontal bacteria,” Phytotherapy Research 22. (2008): 1446–1449.

Ginger (Zingiber officinale Roscoe) has been used widely as a food spice and an herbal medicine. In particular, its gingerol-related components have been reported to possess antimicrobial and antifungal properties, as well as several pharmaceutical properties. However, the effective ginger constituents that inhibit the growth of oral bacteria associated with periodontitis in the human oral cavity have not been elucidated. This study revealed that the ethanol and n-hexane extracts of ginger exhibited antibacterial activities against three anaerobic Gram- negative bacteria, Porphyromonas gingivalis ATCC 53978, Porphyromonas endodontalis ATCC 35406 and Prevotella intermedia ATCC 25611, causing periodontal diseases. Thereafter, five ginger constituents were isolated by a preparative high-performance liquid chromatographic method from the active silica-gel column chromatography fractions, elucidated their structures by nuclear magnetic resonance spectroscopy and electrospray ionization mass spectrometry and their antibacterial activity evaluated. In conclusion, two highly alkylated gingerols, [10]-gingerol and [12]-gingerol effectively inhibited the growth of these oral pathogens at a minimum inhibitory concentration (MIC) range of 6–30 µg/mL. These ginger compounds also killed the oral pathogens at a minimum bactericidal concentration (MBC) range of 4–20 µg/mL, but not the other ginger compounds 5-acetoxy-[6]-gingerol, 3,5- diacetoxy-[6]-gingerdiol and galanolactone.

CY Chen, et al., “Zingiber officinale (ginger) compounds have tetracycline-resistance modifying effects against clinical extensively drug-resistant Acinetobacter baumannii,” Phytotherapy Research 24.12 (2010):1825- 30.

Extensively drug-resistant Acinetobacter baumannii (XDRAB) is a growing and serious nosocomial infection worldwide, such that developing new agents against it is critical. The antimicrobial activities of the rhizomes from Zingiber officinale, known as ginger, have not been proven in clinical bacterial isolates with extensive drug- resistance. This study aimed to investigate the effects of four known components of ginger, [6]- dehydrogingerdione, [10]-gingerol, [6]-shogaol and [6]-gingerol, against clinical XDRAB.  All these compounds showed antibacterial effects against XDRAB. Combined with tetracycline, they showed good resistance modifying effects to modulate tetracycline resistance. Using the 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging method, these four ginger compounds demonstrated antioxidant properties, which were inhibited by MnO₂, an oxidant without antibacterial effects. After the antioxidant property was blocked, their antimicrobial effects were abolished significantly. These results indicate that ginger compounds have antioxidant effects that partially contribute to their antimicrobial activity and are candidates for use in the treatment of infections with XDRAB.

RA Al-Essa RA, et al., “Physiological and therapeutical roles of ginger and turmeric on endocrine functions,” The American Journal of Chinese Medicine 39.2 (2011): 215-31.

The natural product ginger (Zingiber officinale) has active constituents gingerol, Shogaol and Zerumbone, while turmeric (Curcuma longa) contains three active major curcuminoids, namely, curcumin, demethoxycurcumin, and bisdemethoxycurcumin. They have the same scientific classification and are reported to have anti-inflammatory and many therapeutic effects. This article reviews the physiological and therapeutic effects of ginger and turm eric on some endocrine gland functions, and signal pathways involved to mediate their actions. With some systems and adipose tissue, ginger and turmeric exert their actions through some/all of the following signals or molecular mechanisms: (1) through reduction of high levels of some hormones (as: T4, leptin) or interaction with hormone receptors; (2) by inhibition of cytokines/adipokine expression; (3) acting as a potent inhibitor of reactive oxygen species (ROS)-generating enzymes, which play an essential role between inflammation and progression of diseases;

(4) mediation of their effects through the inhibition of signaling transcription factors; and/or (5) decrease the proliferative potent by down-regulation of antiapoptotic genes, which may suppress tumor promotion by blocking signal transduction pathways in the target cells. These multiple mechanisms of protection against inflammation and oxidative damage make ginger and curcumin particularly promising natural agents in fighting the ravages of aging and degenerative diseases, and need to be paid more attention by studies.

Carmelita G. Frondoza, et al., “Ginger—An Herbal Medicinal Product with Broad Anti-Inflammatory Actions,”

Journal of Medicinal Food 8.2 (2005):125-132.

The anti-inflammatory properties of ginger have been known and valued for centuries. During the past 25 years, many laboratories have provided scientific support for the long-held belief that ginger contains constituents with antiinflammatory properties. The original discovery of ginger's inhibitory effects on prostaglandin biosynthesis in the early 1970s has been repeatedly confirmed. This discovery identified ginger as an herbal medicinal product that shares pharmacological properties with non-steroidal anti-inflammatory drugs. Ginger suppresses prostaglandin synthesis through inhibition of cyclooxygenase- 1 and cyclooxygenase-2. An important extension of this early work was the observation that ginger also suppresses leukotriene biosynthesis by inhibiting 5-lipoxygenase. This pharmacological property distinguishes ginger from nonsteroidal anti-inflammatory drugs. This discovery preceded the observation that dual inhibitors of cyclooxygenase and 5-lipoxygenase may have a better therapeutic profile and have fewer side effects than non-steroidal anti-inflammatory drugs. The characterization of the pharmacological properties of ginger entered a new phase with the discovery that a ginger extract (EV.EXT.77) derived from Zingiber officinale (family Zingiberaceae) and Alpina galanga (family Zingiberaceae) inhibits the induction of several genes involved in the inflammatory response. These include genes encoding cytokines, chemokines, and the inducible enzyme cyclooxygenase-2. This discovery provided the first evidence that ginger modulates biochemical pathways activated in chronic inflammation. Identification of the molecular targets of individual ginger constituents provides an opportunity to optimize and standardize ginger products with respect to their effects on specific biomarkers of inflammation. Such preparations will be useful for studies in experimental animals and humans.

MK Balijepalli, et al., “Comparative antioxidant and anti-inflammatory effects of [6]-gingerol, [8]-gingerol, [10]- gingerol and [6]-shogaol,” Journal of ethnopharmacology 127.2 (2010): 515-20.

ETHNOPHARMACOLOGICAL    RELEVANCE:

Zingiber officinale Rosc. (Zingiberaceae) has been traditionally used in Ayurvedic, Chinese and Tibb-Unani herbal medicines for the treatment of various illnesses that involve inflammation and which are caused by oxidative stress. Although gingerols and shogaols are the major bioactive compounds present in Zingiber officinale, their molecular mechanisms of actions and the relationship between their structural features and the activity have not been well studied.

AIM OF THE STUDY:

The aim of the present study was to examine and compare the antioxidant and anti-inflammatory activities of gingerols and their natural analogues to determine their structure-activity relationship and molecular mechanisms. MATERIALS AND METHODS:

The in vitro activities of the compounds [6]-gingerol, [8]-gingerol, [10]-gingerol and [6]-shogaol were evaluated for scavenging of 1,1-diphenyl-2-picyrlhydrazyl (DPPH), superoxide and hydroxyl radicals, inhibition of N-formyl- methionyl-leucyl-phenylalanine (f-MLP) induced reactive oxygen species (ROS) production in human polymorphonuclear neutrophils (PMN), inhibition of lipopolysaccharide induced nitrite and prostaglandin E(2) production in RAW 264.7 cells.

RESULTS:

In the antioxidant activity assay, [6]-gingerol, [8]-gingerol, [10]-gingerol and [6]-shogaol exhibited substantial scavenging activities with IC(50) values of 26.3, 19.47, 10.47 and 8.05 microM against DPPH radical, IC(50) values of 4.05, 2.5, 1.68 and 0.85 microM against superoxide radical and IC(50) values of 4.62, 1.97, 1.35 and 0.72 microM against hydroxyl radical, respectively. The free radical scavenging activity of these compounds also enhanced with increasing concentration (P<0.05). On the other hand, all the compounds at a concentration of 6 microM have significantly inhibited (P<0.05) f-MLP-stimulated oxidative burst in PMN. In addition, production of inflammatory mediators (NO and PGE(2)) has been inhibited significantly (P<0.05) and dose-dependently.

CONCLUSIONS:

6-Shogaol has exhibited the most potent antioxidant and anti-inflammatory properties which can be attributed to the presence of alpha,beta-unsaturated ketone moiety. The carbon chain length has also played a significant role in making 10-gingerol as the most potent among all the gingerols. This study justifies the use of dry ginger in traditional systems of medicine.

Jennifer B. Frye, et al., “Comparative Effects of Two Gingerol-Containing Zingiber officinale Extracts on Experimental Rheumatoid Arthritis,” Journal of Natural Products 72.3 (2009): 403-407.

Ginger (Zingiber officinale) supplements are being promoted for arthritis treatment in western societies based on ginger’s traditional use as an anti-inflammatory in Chinese and Ayurvedic medicine. However, scientific evidence of ginger’s antiarthritic effects is sparse, and its bioactive joint-protective components have not been identified. Therefore, the ability of a well-characterized crude ginger extract to inhibit joint swelling in an animal model of rheumatoid arthritis, streptococcal cell wall (SCW)-induced arthritis, was compared to that of a fraction containing only gingerols and their derivatives. Both extracts were efficacious in preventing joint inflammation. However, the crude dichloromethane extract, which also contained essential oils and more polar compounds, was more efficacious (when normalized to gingerol content) in preventing both joint inflammation and destruction. In conclusion, these data document a very significant joint-protective effect of these ginger samples, and suggest that non-gingerol components are bioactive and can enhance the antiarthritic effects of the more widely studied gingerols.

Wenkui Li, et al. “Cyclooxygenase-2 inhibitors in ginger (Zingiber officinale),” Fitoterapia 82.1 (2011):38-43.

Ginger roots have been used to treat inflammation and have been reported to inhibit cyclooxygenase (COX). Ultrafiltration liquid chromatography mass spectrometry was used to screen a chloroform partition of a methanol extract of ginger roots for COX-2 ligands, and 10-gingerol, 12-gingerol, 8-shogaol, 10-shogaol, 6-gingerdione, 8- gingerdione, 10-gingerdione, 6-dehydro-10-gingerol, 6-paradol, and 8-paradol bound to the enzyme active site. Purified 10-gingerol, 8-shogaol and 10-shogaol inhibited COX-2 with IC50 values of 32 μM, 17.5 μM and 7.5 μM, respectively. No inhibition of COX-1 was detected. Therefore, 10-gingerol, 8-shogaol and 10-shogaol inhibit COX-2 but not COX-1, which can explain, in part, anti-inflammatory properties of ginger.

RD Altman, et al. “Effects of a ginger extract on knee pain in patients with osteoarthritis,” Arthritis and rheumatism

44.11 (2001): 2531-8.

OBJECTIVE:

To evaluate the efficacy and safety of a standardized and highly concentrated extract of 2 ginger species, Zingiber officinale and Alpinia galanga (EV.EXT 77), in patients with osteoarthritis (OA) of the knee.

METHODS:

Two hundred sixty-one patients with OA of the knee and moderate-to-severe pain were enrolled in a randomized, double-blind, placebo-controlled, multicenter, parallel-group, 6-week study. After washout, patients received ginger extract or placebo twice daily, with acetaminophen allowed as rescue medication. The primary efficacy variable was the proportion of responders experiencing a reduction in "knee pain on standing," using an intent-to-treat analysis. A responder was defined by a reduction in pain of > or = 15 mm on a visual analog scale.

RESULTS:

In the 247 evaluable patients, the percentage of responders experiencing a reduction in knee pain on standing was superior in the ginger extract group compared with the control group (63% versus 50%; P = 0.048). Analysis of the secondary efficacy variables revealed a consistently greater response in the ginger extract group compared with the control group, when analyzing mean values: reduction in knee pain on standing (24.5 mm versus 16.4 mm; P = 0.005), reduction in knee pain after walking 50 feet (15.1 mm versus 8.7 mm; P = 0.016), and reduction in the Western Ontario and McMaster Universities osteoarthritis composite index (12.9 mm versus 9.0 mm; P = 0.087). Change in global status and reduction in intake of rescue medication were numerically greater in the ginger extract group. Change in quality of life was equal in the 2 groups. Patients receiving ginger extract experienced more gastrointestinal (GI) adverse events than did the placebo group (59 patients versus 21 patients). GI adverse events were mostly mild.

CONCLUSION:

A highly purified and standardized ginger extract had a statistically significant effect on reducing symptoms of OA of the knee. This effect was moderate. There was a good safety profile, with mostly mild GI adverse events in the ginger extract group.

T. Therkleson, “Ginger compress therapy for adults with osteoarthritis,” Journal of Advanced Nursing 66. (2010): 2225–2233.

AIM:

This paper is a report of a study to explicate the phenomenon of ginger compresses for people with osteoarthritis. BACKGROUND:

Osteoarthritis is claimed to be the leading cause of musculoskeletal pain and disability in Western society. Management ideally  combines  non-pharmacological  strategies,  including complementary therapies  and  pain- relieving medication. Ginger has been applied externally for over a thousand years in China to manage arthritis symptoms.

METHOD:

Husserlian phenomenological methodology was used and the data were collected in 2007. Ten purposively selected adults who had suffered osteoarthritis for at least a year kept daily diaries and made drawings, and follow-up interviews and telephone conversations were conducted.

FINDINGS:

Seven themes were identified in the data: (1) Meditative-like stillness and relaxation of thoughts; (2) Constant penetrating warmth throughout the body; (3) Positive change in outlook; (4) Increased energy and interest in the world; (5) Deeply relaxed state that progressed to a gradual shift in pain and increased interest in others; (6) Increased suppleness within the body and (7) More comfortable, flexible joint mobility. The essential experience of ginger compresses exposed the unique qualities of heat, stimulation, anti-inflammation and analgesia.

CONCLUSION:

Nurses could consider this therapy as part of a holistic treatment for people with osteoarthritis symptoms. Controlled research is needed with larger numbers of older people to explore further the effects of the ginger compress therapy.

SY Kim, et al. “6-Shogaol, a ginger product, modulates neuroinflammation: A new approach to neuroprotection,”

Neuropharmacology 63.2 (2012): 211-23.

Inflammatory processes in the central nervous system play an important role in a number of neurodegenerative diseases mediated by microglial activation, which results in neuronal cell death. Microglia act in immune surveillance and host defense while resting. When activated, they can be deleterious to neurons, even resulting in neurodegeneration. Therefore, the inhibition of microglial activation is considered a useful strategy in searching for neuroprotective agents. In this study, we investigated the effects of 6-shogaol, a pungent agent from Zingiber officinale Roscoe, on microglia activation in BV-2 and primary microglial cell cultures. 6-Shogaol significantly inhibited the release of nitric oxide (NO) and the expression of inducible nitric oxide synthase (iNOS) induced by lipopolysaccharide (LPS). The effect was better than that of 6-gingerol, wogonin, or N-monomethyl-l-arginine, agents previously reported to inhibit nitric oxide. 6-Shogaol exerted its anti-inflammatory effects by inhibiting the production of prostaglandin E(2) (PGE(2)) and proinflammatory cytokines, such as interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α), and by downregulating cyclooxygenase-2 (COX-2), p38 mitogen-activated protein kinase (MAPK), and nuclear factor kappa B (NF-κB) expression. In addition, 6-shogaol suppressed the microglial activation induced by LPS both in primary cortical neuron-glia culture and in an in vivo neuroinflammatory model. Moreover, 6-shogaol showed significant neuroprotective effects in vivo in transient global ischemia via the inhibition of microglia. These results suggest that 6-shogaol is an effective therapeutic agent for treating neurodegenerative diseases.

MN Ghayur, et al. “Ginger attenuates acetylcholine-induced contraction and Ca2+ signalling in murine airway smooth muscle cells,” Canadian Journal of Physiology and Pharmacology 86.5 (2008):264-71.

Asthma is a chronic disease characterized by inflammation and hypersensitivity of airway smooth muscle cells (ASMCs) to different spasmogens. The past decade has seen increased use of herbal treatments for many chronic illnesses. Ginger (Zingiber officinale) is a common food plant that has been used for centuries in treating respiratory illnesses. In this study, we report the effect of its 70% aqueous methanolic crude extract (Zo.Cr) on acetylcholine (ACh)-induced airway contraction and Ca(2+) signalling in ASMCs using mouse lung slices. Airway contraction and Ca(2+) signalling, recorded via confocal microscopy, were induced with ACh, either alone or after pretreatment of slices with Zo.Cr and (or) verapamil, a standard Ca(2+) channel blocker. ACh (10 micromol/L) stimulated airway contraction, seen as decreased airway diameter, and also stimulated Ca(2+) transients (sharp rise in [Ca(2+)]i) and oscillations in ASMCs, seen as increased fluo-4-induced fluorescence intensity. When Zo.Cr (0.3-1.0 mg/mL) was given 30 min before ACh administration, the ACh-induced airway contraction and Ca(2+) signalling were significantly reduced. Similarly, verapamil (1 micromol/L) also inhibited agonist-induced airway contraction and Ca(2+) signalling,  indicating  a  similarity  in  the  modes  of  action.  When  Zo.Cr (0.3  mg/mL)  and verapamil  (1 micromol/L) were given together before ACh, the degree of inhibition was the same as that observed when each of these blockers was given alone, indicating absence of any additional inhibitory mechanism in the extract. In Ca(2+) - free solution, both Zo.Cr and verapamil, when given separately, inhibited Ca(2+) (10 mmol/L)-induced increase in fluorescence and airway contraction. This shows that ginger inhibits airway contraction and associated Ca(2+) signalling, possibly via blockade of plasma membrane Ca(2+) channels, thus reiterating the effectiveness of this age-old herb in treating respiratory illnesses.

JA Podlogar, and EJ Verspohl. “Antiinflammatory effects of ginger and some of its components in human bronchial epithelial (BEAS-2B) cells,” Phytotherapy Research 26.3 (2012): 333-6.

The proinflammatory chemokine interleukin-8 is increased in asthmatic patients. Traditionally, ginger is used as an antiinflammatory drug. An extract and several compounds of Zingiber officinale (ginger) were tested in human bronchial epithelial cells (BEAS-2B cells) with respect to their effect on lipopolysaccharide (LPS)-induced secretion of the proinflammatory chemokine interleukin 8 (IL-8) and RANTES (regulated upon activation, normal T-cell expressed and secreted). An oily extract of ginger rhizome with > 25% total pungent compounds, ginger volatile oil, ar-curcumene and α-pinene reduced the LPS-induced IL-8 secretion (measured by a specific enzyme-linked immunosorbent assay), whereas a spissum extract, the pungents [6]-gingerol and its metabolite [6]-shogaol, and the terpenoids citral and β-phellandrene showed no effect. The LPS-induced slight increase of RANTES was reduced by volatile oil, ar-curcumene and α-pinene. There was no effect of LPS on TNF-α. Our results suggest that distinct ginger compounds could be used as antiinflammatory drugs in respiratory infections.

MS Huang, et al. “Ginger suppresses phthalate ester-induced airway remodeling,” Journal of Agricultural and Food Chemistry 59.7 (2011) 3429-38.

This study has two novel findings: it is not only the first to demonstrate inflammatory cytokines, which are produced by the bronchial epithelium after exposure to phthalate esters and contribute to airway remodeling by increasing human bronchial smooth muscle cells (BSMC) migration and proliferation, but it is also the first to reveal that ginger reverses phthalate ester-mediated airway remodeling. Human bronchial epithelial cell lines BEAS-2B and HBE135-E6E7 (HBE) were treated with butylbenzyl phthalate (BBP), bis(2-ethylhexyl) phthalate (BEHP), dibutyl phthalate (DBP), and diethyl phthalate (DEP), and the conditioned medium (CM) was harvested and then added to BSMC. Cultures of BSMC with BBP-, BEHP-, DBP-, and DEP-BEAS-2B-CM and DEP-HBE-CM increased BSMC proliferation and migration, which are major features in asthma remodeling. Exposure of BEAS-2B and HBE to DBP caused epithelial cells to produce inflammatory cytokines IL-8 and RANTES, which subsequently induced BSMC proliferation and migration. Depleting both IL-8 and RANTES completely reversed the effect of DBP-BEAS-2B-CM and DBP-HBE-CM-mediated BSMC proliferation and migration, suggesting this effect is a synergistic influence of IL- 8 and RANTES. Moreover, [6]-shogaol, [6]-gingerol, [8]-gingerol, and [10]-gingerol, which are major bioactive compounds present in Zingiber officinale , suppress phthalate ester-mediated airway remodeling. This study suggests that ginger is capable of preventing phthalate ester-associated asthma.

JH Bae, et al., “*6+-Gingerol suppresses interleukin-1 beta-induced MUC5AC gene expression in human airway epithelial cells,” American Journal of Rhinology & Allergy 23.4 (2009): 385-91.

BACKGROUND:

[6]-Gingerol is a major  active component of ginger and a natural polyphenol compound. The present study investigated whether [6]-gingerol suppresses interleukin (IL)-1 beta-induced MUC5AC gene expression in human airway epithelial cells and, if so, examined whether the suppression of MUC5AC gene expression is mediated via the mitogen-activated protein kinase (MAPK) signal transduction pathway.

METHODS:

MUC5AC mRNA and protein were measured using reverse transcription-polymerase chain reaction (PCR), real-time PCR, and Western blot analysis in cultured NCI-H292 human airway epithelial cells. Extracellular signal-regulated kinase (ERK) and p38 MAPK protein levels were analyzed by Western blot.

RESULTS:

Expression of MUC5AC mRNA increased in NCI-H292 cells upon treatment with 10 ng/mL of IL-1 beta for 24 hours. When the cells were pretreated with 10 microM of [6]-gingerol, expression of IL-1 beta-induced MUC5AC mRNA and protein was significantly suppressed. Suppression of IL-1 beta-induced MUC5AC mRNA was also observed in cells pretreated with ERK- or p38 MAPK-specific inhibitors, suggesting that [6]-gingerol-mediated suppression of IL- 1 beta-induced MUC5AC mRNA operated via the ERK- and p38 MAPK-dependent pathways.

CONCLUSIONS:

[6]-Gingerol suppresses IL-1 beta -induced MUC5AC gene expression in human airway epithelial cells via the ERK- and p38 MAPK-dependent pathways; therefore, [6]-gingerol may be considered a possible anti-hypersecretory agent.

JK Kundu, et al., “Ginger-derived phenolic substances with cancer preventive and therapeutic potential,” Forum of Nutrition 61. (2009): 182-92.

Ginger, the rhizomes of Zingiber officinale Roscoe (Zingiberaceae), has widely been used as a spice and condiment in different societies. Besides its food-additive functions, ginger has a long history of medicinal use for  the treatment of a variety of human ailments including common colds, fever, rheumatic disorders, gastrointestinal complications, motion sickness, diabetes, cancer, etc. Ginger contains several nonvolatile pungent principles viz. gingerols, shogaols, paradols and zingerone, which account for many of its health beneficial effects. Studies conducted in cultured cells as well as in experimental animals revealed that these pungent phenolics possess anticarcinogenic properties. This chapter summarizes updated information on chemopreventive and chemotherapeutic effects of ginger-derived phenolic substances and their underlying mechanisms.

MS Baliga, et al., “Update on the chemopreventive effects of ginger and its phytochemicals,” Critical Reviews in Food Science and Nutrition 51.6 (2011): 499-523.

The rhizomes of Zingiber officinale Roscoe (Zingiberaceae), commonly known as ginger, is one of the most widely used spice and condiment. It is also an integral part of many traditional medicines and has been extensively used in Chinese, Ayurvedic, Tibb-Unani, Srilankan, Arabic, and African traditional medicines, since antiquity, for many unrelated human ailments including common colds, fever, sore throats, vomiting, motion sickness, gastrointestinal complications, indigestion, constipation, arthritis, rheumatism, sprains, muscular aches, pains, cramps, hypertension, dementia, fever, infectious diseases, and helminthiasis. The putative active compounds are nonvolatile pungent principles, namely gingerols, shogaols, paradols, and zingerone. These compounds are some of the extensively studied phytochemicals and account for the antioxidant, anti-inflammatory, antiemetic, and gastroprotective activities. A number of preclinical investigations with a wide variety of assay systems and carcinogens have shown that ginger and its compounds possess chemopreventive and antineoplastic effects. A number of mechanisms have been observed to be involved in the chemopreventive effects of ginger. The cancer preventive activities of ginger are supposed to be mainly due to free radical scavenging, antioxidant pathways, alteration of gene expressions, and induction of apoptosis, all of which contribute towards decrease in tumor initiation, promotion, and progression. This review provides concise information from preclinical studies with both cell culture models and relevant animal studies by focusing on the mechanisms responsible for the chemopreventive action. The conclusion describes directions for future research to establish its activity and utility as a human cancer preventive and therapeutic drug. The above-mentioned mechanisms of ginger seem to be promising for cancer prevention; however, further clinical studies are warranted to assess the efficacy and safety of ginger.

T Ando, et al., “Ginger ingredients reduce viability of gastric cancer cells via distinct mechanisms,” Biochemical and Biophysical Chemical Research Communications 362.1 (2007):218-23.

Ginger has been used throughout the world as spice, food and traditional herb. We found that 6-gingerol, a phenolic alkanone isolated from ginger, enhanced the TRAIL-induced viability reduction of gastric cancer cells while 6-gingerol alone affected viability only slightly. 6-Gingerol facilitated TRAIL-induced apoptosis by increasing TRAIL- induced caspase-3/7 activation. 6-Gingerol was shown to down-regulate the expression of cIAP1, which suppresses caspase-3/7 activity, by inhibiting TRAIL-induced NF-kappaB activation. As 6-shogaol has a chemical structure similar to 6-gingerol, we also assessed the effect of 6-shogaol on the viability of gastric cancer cells. Unlike 6- gingerol, 6-shogaol alone reduced the viability of gastric cancer cells. 6-Shogaol was shown to damage microtubules and induce mitotic arrest. These findings indicate for the first time that in gastric cancer cells, 6- gingerol enhances TRAIL-induced viability reduction by inhibiting TRAIL-induced NF-kappaB activation while 6- shogaol alone reduces viability by damaging microtubules.

Nam E Kang, et al., “[6]-Gingerol inhibits metastasis of MDA-MB-231 human breast cancer cells,” The Journal of Nutritional Biochemistry 19.5 (2008): 313-319.

Gingerol (Zingiber officinale Roscoe, Zingiberaceae) is one of the most frequently and heavily consumed dietary condiments throughout the world. The oleoresin from rhizomes of ginger contains [6]-gingerol (1-*4′-hydroxy-3′- methoxyphenyl]-5-hydroxy-3-decanone) and its homologs which are pungent ingredients that have been found to possess many interesting pharmacological and physiological activities, such as anti-inflammatory, antihepatotoxic and cardiotonic effects. However, the effects of [6]-gingerol on metastatic processes in breast cancer cells are not currently well known. Therefore, in this study, we examined the effects of [6]-gingerol on adhesion, invasion, motility, activity and the amount of MMP-2 or -9 in the MDA-MB-231 human breast cancer cell line. We cultured MDA-MB-231 cells in the presence of various concentrations of [6]-gingerol (0, 2.5, 5 and 10 μM). *6+-Gingerol had no effect on cell adhesion up to 5 μM, but resulted in a 16% reduction at 10 μM. Treatment of MDA-MB-231 cells with increasing concentrations of [6]-gingerol led to a concentration-dependent decrease in cell migration and motility. The activities of MMP-2 or MMP-9 in MDA-MB-231 cells were decreased by treatment with [6]-gingerol and occurred in a dose-dependent manner. The amount of MMP-2 protein was decreased in a dose-dependent manner, although there was no change in the MMP-9 protein levels following treatment with [6]-gingerol. MMP-2 and MMP-9 mRNA expression were decreased by [6]-gingerol treatment. In conclusion, we have shown that [6]- gingerol inhibits cell adhesion, invasion, motility and activities of MMP-2 and MMP-9 in MDA-MB-231 human breast cancer cell lines.

E-H Chew, et al., "6-Shogaol, an active constituent of ginger, inhibits breast cancer cell invasion by reducing matrix metalloproteinase-9 expression via blockade of nuclear factor-κB activation,” British Journal of Pharmacology 161.8 (2010):1763-1777.

BACKGROUND AND PURPOSE

Shogaols are reported to possess anti-inflammatory and anticancer activities. However, the antimetastatic potential of shogaols remains unexplored. This study was performed to assess the effects of shogaols against breast cancer cell invasion and to investigate the underlying mechanisms.

EXPERIMENTAL APPROACH

The anti-invasive effect of a series of shogaols was initially evaluated on MDA-MB-231 breast cancer cells using the matrigel invasion assay. The suppressive effects of 6-shogaol on phorbol 12-myristate 13-acetate (PMA)-induced matrix metalloproteinase-9 (MMP-9) gelatinolytic activity and nuclear factor-κB (NF-κB) activation were further determined.

KEY RESULTS

Shogaols (6-, 8- and 10-shogaol) inhibited PMA-stimulated MDA-MB-231 cell invasion with an accompanying decrease in MMP-9 secretion. 6-Shogaol was identified to display the greatest anti-invasive effect in association with a dose-dependent reduction in MMP-9 gene activation, protein expression and secretion. The NF-κB transcriptional activity was decreased by 6-shogaol; an effect mediated by inhibition of IκB phosphorylation and degradation that subsequently led to suppression of NF-κB p65 phosphorylation and nuclear translocation. In addition, 6-shogaol was found to inhibit JNK activation with no resulting reduction in activator protein-1 transcriptional activity. By using specific inhibitors, it was demonstrated that ERK and NF-κB signalling, but not JNK and p38 signalling, were involved in PMA-stimulated MMP-9 activation.

CONCLUSIONS AND IMPLICATIONS

6-Shogaol is a potent inhibitor of MDA-MB-231 cell invasion, and the molecular mechanism involves at least in part the down-regulation of MMP-9 transcription by targeting the NF-κB activation cascade. This class of naturally occurring small molecules thus have potential for clinical use as antimetastatic treatments.

Srijit Das, et al., “Ginger Extract (Zingiber Officinale) has Anti-Cancer and Anti-Inflammatory Effects on Ethionine- Induced Hepatoma Rats,” Clinics 63.6 (2008):807-813.

OBJECTIVE

To evaluate the effect of ginger extract on the expression of NFκB and TNF-α in liver cancer-induced rats. METHODS

Male Wistar rats were randomly divided into 5 groups based on diet: i) control (given normal rat chow), ii) olive oil,

iii) ginger extract (100mg/kg body weight), iv) choline-deficient diet + 0.1% ethionine to induce liver cancer and v) choline-deficient diet + ginger extract (100mg/kg body weight). Tissue samples obtained at eight weeks were fixed with formalin and embedded in paraffin wax, followed by immunohistochemistry staining for NFκB and TNF-α. RESULTS

The expression of NFκB was detected in the choline-deficient diet group, with 88.3 ± 1.83% of samples showing positive staining, while in the choline-deficient diet supplemented with ginger group, the expression of NFκB was significantly reduced, to 32.35 ± 1.34% (p<0.05). In the choline-deficient diet group, 83.3 ± 4.52% of samples showed positive staining of TNF-α, which was significantly reduced to 7.94 ± 1.32% (p<0.05) when treated with ginger. There was a significant correlation demonstrated between NFκB and TNF-α in the choline-deficient diet group but not in the choline-deficient diet treated with ginger extract group.

CONCLUSION

In conclusion, ginger extract significantly reduced the elevated expression of NFκB and TNF-α in rats with liver cancer. Ginger may act as an anti-cancer and anti-inflammatory agent by inactivating NFκB through the suppression of the pro-inflammatory TNF-α.

Ann M. Bode, et al. “[6]-Gingerol Suppresses Colon Cancer Growth by Targeting Leukotriene A4 Hydrolase,” Cancer Research 69.13 (2009):5584-91.

[6]-Gingerol, a natural component of ginger, exhibits anti-inflammatory and antitumorigenic activities. Despite its potential efficacy in cancer, the mechanism by which [6]-gingerol exerts its chemopreventive effects remains elusive. The leukotriene A4 hydrolase (LTA4H) protein is regarded as a relevant target for cancer therapy. Our in silico prediction using a reverse-docking approach revealed that LTA4H might be a potential target of [6]-gingerol. We supported our prediction by showing that [6]-gingerol suppresses anchorage-independent cancer cell growth by inhibiting LTA4H activity in HCT116 colorectal cancer cells. We showed that [6]-gingerol effectively suppressed tumor growth in vivo in nude mice, an effect that was mediated by inhibition of LTA4H activity. Collectively, these findings indicate a crucial role of LTA4H in cancer and also support the anticancer efficacy of [6]-gingerol targeting of LTA4H for the prevention of colorectal cancer.

K. Kobata, “A nonpungent component of steamed ginger--[10]-shogaol--increases adrenaline secretion via the activation of TRPV1,” Nutritional Neuroscience 9.3-4 (2006):169-78.

We investigated the components of ginger that are involved in increasing body temperature. Gingerols ([6,8,10]- gingerols) and shogaols ([6,8,10]-shogaols) having different alkyl carbon chain lengths were targeted. All the gingerols and shogaols increased intracellular calcium concentration in rat transient receptor potential vanilloid subtype 1 (TRPV1)-expressing HEK293 cells via TRPV1. In this regard, the shogaols were more potent than the gingerols. Aversive responses were induced by [6]-, [10]-gingerol, and [6]-shogaol (5 mmol/l) in rats when these compounds were applied to the eye; however, no response was observed in response to [10]-shogaol (5 and 10 mmol/l). [10]-Shogaol induced nociceptive responses via TRPV1 in rats following its subcutaneous injection into the hindpaw; the pungent compound capsaicin (CAP) and [6]-shogaol were observed to have similar effects. Moreover, adrenal catecholamine secretion, which influences energy consumption, was promoted in rats in response to [6]- and [10]-gingerols and [6]- and [10]-shogaols (1.6 micromol/kg, i.v.). [10]-Shogaol-induced adrenaline secretion was inhibited by administration of capsazepine, a TRPV1 antagonist. In conclusion, gingerols and shogaols activated TRPV1 and increased adrenaline secretion. Interestingly, [10]-shogaol is the only nonpungent compound among the gingerols and shogaols, suggesting its usefulness as a functional ingredient in food.

MY Henein, and R. Nicoll, “Ginger (Zingiber officinale Roscoe): a hot remedy for cardiovascular disease?”

International Journal of Cardiology 131.3 (2009):408-9.

Ginger is now exciting considerable interest for its potential to treat many aspects of cardiovascular disease. This letter reviews the more recent trials, which suggest that ginger shows considerable anti-inflammatory, antioxidant, anti-platelet, hypotensive and hypolipidemic effect in in vitro and animal studies. Human trials have been few and generally used a low dose with inconclusive results, however dosages of 5 g or more demonstrated significant anti- platelet activity. More human trials are needed using an appropriate dosage of a standardised extract. Should these prove positive, ginger has the potential to offer not only a cheaper natural alternative to conventional agents but one with significantly lower side effects.

AJ Ammit, et al. “Gingerols and related analogues inhibit arachidonic acid-induced human platelet serotonin release and aggregation,” Thrombosis Research 103.5 (2001):387-97.

Gingerols, the active components of ginger (the rhizome of Zingiber officinale, Roscoe), represent a potential new class of platelet activation inhibitors. In this study, we examined the ability of a series of synthetic gingerols and related phenylalkanol analogues (G1-G7) to inhibit human platelet activation, compared to aspirin, by measuring their effects on arachidonic acid (AA)-induced platelet serotonin release and aggregation in vitro. The IC(50) for inhibition of AA-induced (at EC(50)=0.75 mM) serotonin release by aspirin was 23.4+/-3.6 microM. Gingerols and related analogues (G1-G7) inhibited the AA-induced platelet release reaction in a similar dose range as aspirin, with IC(50) values between 45.3 and 82.6 microM. G1-G7 were also effective inhibitors of AA-induced human platelet aggregation. Maximum inhibitory (IC(max)) values of 10.5+/-3.9 and 10.4+/-3.2 microM for G3 and G4, respectively, were approximately 2-fold greater than aspirin (IC(max)=6.0+/-1.0 microM). The remaining gingerols and related analogues maximally inhibited AA-induced platelet aggregation at approximately 20-25 microM. The mechanism underlying inhibition of the AA-induced platelet release reaction and aggregation by G1-G7 may be via an effect on cyclooxygenase (COX) activity in platelets because representative gingerols and related analogues (G3- G6) potently inhibited COX activity in rat basophilic leukemia (RBL-2H3) cells. These results provide a basis for the design of more potent synthetic gingerol analogues, with similar potencies to aspirin, as platelet  activation inhibitors with potential value in cardiovascular disease.

KK Al-Qattan, et al., “The use of ginger (Zingiber officinale Rosc.) as a potential anti-inflammatory and antithrombotic agent,” Prostaglandins, Leukotrienes, and Essential Fatty Acids 67.6 (2002):475-8.

The effect of an aqueous extract of ginger (Zingiber officinale) on serum cholesterol and triglyceride levels as well as platelet thromboxane-B(2) and prostaglandin-E(2) production was examined. A raw aqueous extract of ginger was administered daily for a period of 4 weeks, either orally or intraperitoneally (IP) to rats. Fasting blood serum was investigated for thromboxane-B(2), prostaglandin-E(2), cholesterol and triglycerides. A low dose of ginger (50 mg/kg) administered either orally or IP did not produce any significant reduction in the serum thromboxane-B(2) levels when compared to saline-treated animals. However, ginger administered orally caused significant changes in the serum PGE(2) at this dose. High doses of ginger (500 mg/kg) were significantly effective in lowering serum PGE(2) when given either orally or IP. However, TXB(2) levels were significantly lower in rats given 500 mg/kg ginger orally but not IP. A significant reduction in serum cholesterol was observed when a higher dose of ginger (500 mg/kg) was administered. At a low dose of ginger (50 mg/kg), a significant reduction in the serum cholesterol was observed only when ginger was administered IP. No significant changes in serum triglyceride levels were observed upon administration of either the low or high dose of ginger. These results suggest that ginger could be used as an cholesterol-lowering, antithrombotic and anti-inflammatory agent.

A. Bordia, et al., “Protective effect of ginger, Zingiber officinale Rosc on experimental atherosclerosis in rabbits,”

Indian Journal of Experimental Biology 42.7 (2004):736-8.

The effects of air dried ginger powder (0.1g/kg body weight, po, for 75 days) were studied on experimentally induced atherosclerosis in rabbits by cholesterol feeding (0.3g/kg body weight, po). Cholesterol feeding for 75 days lead to distinct development of atheroma in the aorta and coronary arteriesof the rabbits and this was significantly inhibited by about 50% following ginger administration. There was distinct decrease in lipid peroxidation and enhancement of fibrinolytic activity in ginger treated animals. However, ginger did not lower blood lipidsto any significant extent. This distinct protection from the development of atherosclerosis by ginger is probably because of its free radical scavanging, prostaglandin inhibitory and fibri properties.

Yuhao Li, et al., “A 35-day gavage safety assessment of ginger in rats.” Regulatory Toxicology and Pharmacology 54.2 (2009):118-123.

Ginger (Zingiber officinale Roscoe, Zingiberacae) is one of the most commonly used spices around the world and a traditional medicinal plant that has been widely used in Chinese, Ayurvedic and Unani-Tibb medicines for several thousand years. However, there was still lack of systemic safety evaluation. We conducted a 35-day toxicity study on ginger in rats. Both male and female rats were daily treated with ginger powder at the dosages of 500, 1000 and 2000 mg/kg body weight by a gavage method for 35 days. The results demonstrated that this chronic administration of ginger was not associated with any mortalities and abnormalities in general conditions, behavior, growth, and food and water consumption. Except for dose-related decrease in serum lactate dehydrogenase activity in males, ginger treatment induced similar hematological and blood biochemical parameters to those of controlled animals. In general, ginger treatment caused no overt organ abnormality. Only at a very high dose (2000 mg/kg), ginger led to slightly reduced absolute and relative weights of testes (by 14.4% and 11.5%, respectively). This study provides a new understanding of the toxicological properties of ginger.

ENDNOTES

1 Sebastian Pole, Ayurvedic Medicine (Philadelphia, PA: Elsevier, 2006) 183.

2 David Frawley, and Vasant Lad, The Yoga of Herbs (Twin Lakes, WI: Lotus Press, 1992) 122.

3 John Lust, The Herb Book (New York: Benedict Lust Publications, 2005) 205, 514.

4 Ibid, p205, 514.

5 Karta Purkh Singh Khalsa, and Michael Tierra The Way of Ayurvedic Herbs (Twin Lakes, WI: Lotus Press, 2008) 136, 138.

6 R.K. Goel and K. Sairam. “Anti-Ulcer Drugs from Indigenous Sources with Emphasis on Musa Sapientum, Tamrabhasma, Asparagus Racemosus, and Zingiber Officinale,” Indian Journal of Pharmacology 34 (2002): 100-

110.

7 Karta Purkh Singh Khalsa, and Michael Tierra The Way of Ayurvedic Herbs (Twin Lakes, WI: Lotus Press, 2008) 136, 138.

8 John Lust, The Herb Book (New York: Benedict Lust Publications, 2005) 514-515.

9 Karta Purkh Singh Khalsa and Michael Tierra, The Way of Ayurvedic Herbs (Twin Lakes, WI: Lotus Press, 2008) 138.

10 Sebastian Pole, Ayurvedic Medicine (Philadelphia, PA: Elsevier, 2006) 183.

11 David Frawley, and Vasant Lad, The Yoga of Herbs (Twin Lakes, WI: Lotus Press, 1992) 121.

12 Vaidya Bhagwan Dash, Materia Medica of Ayurveda (New Delhi: Concept Publishing, 1980) 35, ch.2, v.54.

13Kaviraj Kunia Lal Bhishagratna, ed. The Sushruta Samhita. Vol.I (Calcutta, self, 1907) 510, ch. XLVI.

14 Sebastian Pole, Ayurvedic Medicine (Philadelphia, PA: Elsevier, 2006) 183.

15 David Frawley, and Vasant Lad, The Yoga of Herbs (Twin Lakes, WI: Lotus Press, 1992) 122.

16 Karta Purkh Singh Khalsa and Michael Tierra, The Way of Ayurvedic Herbs (Twin Lakes, WI: Lotus Press, 2008) 136.

17 Michael Tierra, The Way of Herbs (Santa Cruz, CA: Unity Press, 1980) 70.

18 David Frawley and Vasant Lad, The Yoga of Herbs (Twin Lakes, WI: Lotus Press, 1992) 121-122.

19 Daniel P. Reid, Chinese Herbal Medicine (Boston: Shambhala Publications, Inc., 1986) 116.

20 Victoria Zak, 20,000 Secrets of Tea (New York: Dell Publishing, 1999) 131-132.

21 David Frawley and Vasant Lad, The Yoga of Herbs (Twin Lakes, WI: Lotus Press, 1992) 121. 22 Daniel P. Reid, Chinese Herbal Medicine (Boston: Shambhala Publications, Inc., 1986) 116. 23 David Frawley and Vasant Lad, The Yoga of Herbs (Twin Lakes, WI: Lotus Press, 1992) 121. 24 Sebastian Pole, Ayurvedic Medicine (Philadelphia, PA: Elsevier, 2006) 183.

25 R.K. Goel and K. Sairam. “Anti-Ulcer Drugs from Indigenous Sources with Emphasis on Musa Sapientum, Tamrabhasma, Asparagus Racemosus, and Zingiber Officinale,” Indian Journal of Pharmacology 34 (2002): 100- 110.

26NC Azu and RA Onyeagba, “Antimicrobial Properties Of Extracts Of Allium cepa (Onions) And Zingiber officinale

(Ginger) On Escherichia coli, Salmonella typhi And Bacillus subtilis.” The Internet Journal of Tropical Medicine 3.2 (2007).        http://www.ispub.com/journal/the-internet-journal-of-tropical-medicine/volume-3-number- 2/antimicrobial-properties-of-extracts-of-allium-cepa-onions-and-zingiber-officinale-ginger-on-escherichia-coli- salmonella-typhi-and-bacillus-subtilis.html

27 David Frawley and Vasant Lad, The Yoga of Herbs (Twin Lakes, WI: Lotus Press, 1992) 122.

28 Vaidya Bhagwan Dash, Materia Medica of Ayurveda (New Delhi: Concept Publishing, 1980) ch.2, v.54.

29 Kaviraj Kunia Lal Bhishagratna, ed. Sushruta Samhita, vol.II, 311, ch.V, verse 34.

30 Ibid, vol.II, 311, ch.V, verse 34.

31 Vaidya Bhagwan Dash, Materia Medica of Ayurveda (New Delhi: Concept Publishing, 1980) ch.2, v.63; ch.8, v.9; ch.27, v.11-13.

32 Sebastian Pole, Ayurvedic Medicine (Philadelphia, PA: Elsevier, 2006) 302.

33 Ibid p183.

34 Seng-Kee Chuau, et.al, “Effect of Ginger on Gastric Motility and Symptoms of Functional Dyspepsia,” World Journal of Gastroenterology 17.1 (2011):105-110.

35 Ibid p105-110.

36 Ibid p105-110.

37 SK Chuau, et al., “Effect of Ginger on Gastric Emptying and Motility in Healthy Humans,” European Journal of Gastroenterology and Hepatology 20.5 (2008):436-440.

38 M. Mokhtari, et al., “Ginger extract reduces delayed gastric emptying and nosocomial pneumonia in adult

respiratory distress syndrome patients hospitalized in an intensive care unit,” Journal of Critical Care 25.4 (2010):647-650.

39 Sebastian Pole, Ayurvedic Medicine (Philadelphia, PA: Elsevier, 2006) 183.

40 Owyang Chung, et al., “Effects of ginger on motion sickness and gastric slow-wave dysrhytmias induced by circular vection,” American Journal of Physiology 284.3 (2003):G481-G489.

41 Torben Brask, et al., “Ginger Root Against Seasickness: A Conctrolled Trial on the Open Sea,” Acta Oto-

laryngologica 105.1-2 (1988):45-49.

42 R.K. Goel and K. Sairam. “Anti-Ulcer Drugs from Indigenous Sources with Emphasis on Musa Sapientum,

Tamrabhasma, Asparagus Racemosus, and Zingiber Officinale,” Indian Journal of Pharmacology 34 (2002): 100- 110.

43“NICE Clinical Guidelines, No. 62,” Antenatal Care: Routine Care for the Healthy Pregnant Woman. London:

National Collaborating Centre for Women’s and Children’s Health (UK), RCOG Press, 2008.

44 N Chaiyakunapruk, et al., “The efficacy of ginger for the prevention of postoperative nausea and vomiting: a meta-analysis,” American Journal of Obstetrics and Gynecology 194.1 (2006):95-99.

45 Y.K. Gupta, et al., “Anti-emetic effect of ginger powder versus placebo as an add-on therapy in children and young adults receiving high emetogenic chemotherapy,” Pediatric Blood & Cancer 56.2 (2011):234-238.

46 T Chisaka, et al., “Cholagogic effect of ginger and its active constituents,” Journal of ethnopharmacology 13.2

(1985):217-25.

47 T.A. Ajith, et al., “Zingiber officinale Roscoe prevents acetaminophen-induced acute hepatotoxicity by enhancing hepatic antioxidant status,” Food and Chemical Toxicology 45.11 (2007): 2267-2272.

48 Suresh Kumar, et al., “6-gingerol, an active ingredient of ginger, protects acetaminophen-induced hepatotoxicity in mice,” Journal of Chinese integrative medicine 9.11 (2011):1264-1269.

49 R.K. Goel, and K. Sairam. “Anti-Ulcer Drugs from Indigenous Sources with Emphasis on Musa Sapientum,

Tamrabhasma, Asparagus Racemosus, and Zingiber Officinale,” Indian Journal of Pharmacology 34 (2002): 100- 110.

50 Harish Nayaka Mysore Annaiah, et al., “Gastroprotective Effect of Ginger Rhizome (Zingiber Officinale) Extract: Role of Gallic Acid and Cinnamic Acid in H+, K+-ATPase/H. pylori Inhibition and Anti-Oxidative Mechanism,”

Evidence –Based Complementary and Alternative Medicine 2011. (2011): 249487.

51 NC Azu and RA Onyeagba, “Antimicrobial Properties Of Extracts Of Allium cepa (Onions) And Zingiber officinale

(Ginger) On Escherichia coli, Salmonella typhi And Bacillus subtilis.” The Internet Journal of Tropical Medicine 3.2 (2007).        http://www.ispub.com/journal/the-internet-journal-of-tropical-medicine/volume-3-number- 2/antimicrobial-properties-of-extracts-of-allium-cepa-onions-and-zingiber-officinale-ginger-on-escherichia-coli- salmonella-typhi-and-bacillus-subtilis.html

52 M Park, et al., “Antibacterial activity of *10+-gingerol and [12]-gingerol isolated from ginger rhizome against

periodontal bacteria,” Phytotherapy Research 22. (2008): 1446–1449.

53 NC Azu and RA Onyeagba, “Antimicrobial Properties Of Extracts Of Allium cepa (Onions) And Zingiber officinale

(Ginger) On Escherichia coli, Salmonella typhi And Bacillus subtilis.” The Internet Journal of Tropical Medicine 3.2 (2007).        http://www.ispub.com/journal/the-internet-journal-of-tropical-medicine/volume-3-number- 2/antimicrobial-properties-of-extracts-of-allium-cepa-onions-and-zingiber-officinale-ginger-on-escherichia-coli- salmonella-typhi-and-bacillus-subtilis.html

54 Sebastian Pole, Ayurvedic Medicine (Philadelphia, PA: Elsevier, 2006) 183.

55 CY Chen, et al., “Zingiber officinale (ginger) compounds have tetracycline-resistance modifying effects against clinical extensively drug-resistant Acinetobacter baumannii,” Phytotherapy Research 24.12 (2010):1825-30.

56 M Park, et al., “Antibacterial activity of *10+-gingerol and [12]-gingerol isolated from ginger rhizome against periodontal bacteria,” Phytotherapy Research 22. (2008): 1446–1449.

57 Sebastian Pole, Ayurvedic Medicine (Philadelphia, PA: Elsevier, 2006) 183-184.

58 RA Al-Essa, et al., “Physiological and therapeutical roles of ginger and turmeric on endocrine functions,” The American Journal of Chinese Medicine 39.2 (2011): 215-31.

59 Mark H. Beers, ed., et al, The Merck Manual of Medical Information 2003. 2nd edition. (New York: Pocket Books,

2004) 408-409.

60 Carmelita G. Frondoza, et al., “Ginger—An Herbal Medicinal Product with Broad Anti-Inflammatory Actions,”

Journal of Medicinal Food 8.2 (2005):125-132.

61MK Balijepalli, et al., “Comparative antioxidant and anti-inflammatory effects of [6]-gingerol, [8]-gingerol, [10]- gingerol and [6]-shogaol,” Journal of ethnopharmacology 127.2 (2010): 515-20.

62 Jennifer B. Frye, et al., “Comparative Effects of Two Gingerol-Containing Zingiber officinale Extracts on Experimental Rheumatoid Arthritis,” Journal of Natural Products 72.3 (2009): 403-407.

63Wenkui Li, et al. “Cyclooxygenase-2 inhibitors in ginger (Zingiber officinale),” Fitoterapia 82.1 (2011):38-43.

64 RD Altman, et al. “Effects of a ginger extract on knee pain in patients with osteoarthritis,” Arthritis and rheumatism 44.11 (2001): 2531-8.

65T. Therkleson, “Ginger compress therapy for adults with osteoarthritis,” Journal of Advanced Nursing 66. (2010):

2225–2233.

66SY Kim, et al. “6-Shogaol, a ginger product, modulates neuroinflammation: A new approach to neuroprotection,”

Neuropharmacology 63.2 (2012): 211-23.

67 Sebastian Pole, Ayurvedic Medicine (Philadelphia, PA: Elsevier, 2006) 183.

68 Mark H. Beers, ed., et al, The Merck Manual of Medical Information 2003. 2nd edition. (New York: Pocket Books, 2004) 236.

69 Mayo Clinic, Mayo Clinic Staff, Asthma.

http://www.mayoclinic.com/health/asthma/DS00021/DSECTION=complications

70 MN Ghayur, et al. “Ginger attenuates acetylcholine-induced contraction and Ca2+ signalling in murine airway smooth muscle cells,” Canadian Journal of Physiology and Pharmacology 86.5 (2008):264-71.

71 JA Podlogar and EJ Verspohl. “Antiinflammatory effects of ginger and some of its components in human bronchial epithelial (BEAS-2B) cells,” Phytotherapy Research 26.3 (2012): 333-6.

72 MS Huang, et al. “Ginger suppresses phthalate ester-induced airway remodeling,” Journal of Agricultural and

Food Chemistry 59.7 (2011) 3429-38.

73 JH Bae, et al., “*6+-Gingerol suppresses interleukin-1 beta-induced MUC5AC gene expression in human airway epithelial cells,” American Journal of Rhinology & Allergy 23.4 (2009): 385-91.

74 JK Kundu, et al., “Ginger-derived phenolic substances with cancer preventive and therapeutic potential,” Forum

of Nutrition 61. (2009): 182-92.

75 MS Baliga, et al., “Update on the chemopreventive effects of ginger and its phytochemicals,” Critical Reviews in Food Science and Nutrition 51.6 (2011): 499-523.

76 T Ando, et al., “Ginger ingredients reduce viability of gastric cancer cells via distinct mechanisms,” Biochemical

and Biophysical Chemical Research Communications 362.1 (2007):218-23.

77 Nam E Kang, et al., “[6]-Gingerol inhibits metastasis of MDA-MB-231 human breast cancer cells,” The Journal of Nutritional Biochemistry 19.5 (2008): 313-319.

78 E-H Chew, et al., "6-Shogaol, an active constituent of ginger, inhibits breast cancer cell invasion by reducing matrix metalloproteinase-9 expression via blockade of nuclear factor-κB activation,” British Journal of Pharmacology 161.8 (2010):1763-1777.

79Srijit Das, et al., “Ginger Extract (Zingiber Officinale) has Anti-Cancer and Anti-Inflammatory Effects on Ethionine-

Induced Hepatoma Rats,” Clinics 63.6 (2008):807-813.

80 Ann M. Bode, et al. “[6]-Gingerol Suppresses Colon Cancer Growth by Targeting Leukotriene A

Cancer Research 69.13 (2009):5584-91. Hydrolase,”

81K. Kobata, “A nonpungent component of steamed ginger--[10]-shogaol--increases adrenaline secretion via the activation of TRPV1,” Nutritional Neuroscience 9.3-4 (2006):169-78.

82 Sebastian Pole, Ayurvedic Medicine (Philadelphia, PA: Elsevier, 2006) 183.

83 Sebastian Pole, Ayurvedic Medicine (Philadelphia, PA: Elsevier, 2006) 184.

84 MY Henein and R. Nicoll, “Ginger (Zingiber officinale Roscoe): a hot remedy for cardiovascular disease?”

International Journal of Cardiology 131.3 (2009):408-9.

85AJ Ammit, et al. “Gingerols and related analogues inhibit arachidonic acid-induced human platelet serotonin release and aggregation,” Thrombosis Research 103.5 (2001):387-97.

86KK Al-Qattan, et al., “The use of ginger (Zingiber officinale Rosc.) as a potential anti-inflammatory and antithrombotic agent,” Prostaglandins, Leukotrienes, and Essential Fatty Acids 67.6 (2002):475-8.

87A. Bordia, et al., “Protective effect of ginger, Zingiber officinale Rosc on experimental atherosclerosis in rabbits,” Indian Journal of Experimental Biology 42.7 (2004):736-8.

88 M. Mokhtari, et al., “Ginger extract reduces delayed gastric emptying and nosocomial pneumonia in adult respiratory distress syndrome patients hospitalized in an intensive care unit,” Journal of Critical Care 25.4 (2010):647-650.

89 David Frawley and Vasant Lad, The Yoga of Herbs (Twin Lakes, WI: Lotus Press, 1992) 121.

90 “NICE Clinical Guidelines, No. 62,” Antenatal Care: Routine Care for the Healthy Pregnant Woman. London: National Collaborating Centre for Women’s and Children’s Health (UK), RCOG Press, 2008.

91 Torben Brask, et al., “Ginger Root Against Seasickness: A Conctrolled Trial on the Open Sea,” Acta Oto- laryngologica 105.1-2 (1988):45-49.

92 N Chaiyakunapruk, et al., “The efficacy of ginger for the prevention of postoperative nausea and vomiting: a meta-analysis,” American Journal of Obstetrics and Gynecology 194.1 (2006):95-99.

93 Owyang Chung, et al., “Effects of ginger on motion sickness and gastric slow-wave dysrhytmias induced by circular vection,” American Journal of Physiology 284.3 (2003):G481-G489.

94 John Lust, The Herb Book (New York: Benedict Lust Publications, 2005) 206.

95 SK Chuau, et al., “Effect of Ginger on Gastric Emptying and Motility in Healthy Humans,” European Journal of Gastroenterology and Hepatology 20.5 (2008): 436-440.

96 Sebastian Pole, Ayurvedic Medicine (Philadelphia, PA: Elsevier, 2006) 184.

97 Karta Purkh Singh Khalsa and Michael Tierra, The Way of Ayurvedic Herbs (Twin Lakes, WI: Lotus Press, 2008) 136.

98 Karta Purkh Singh Khalsa and Michael Tierra, The Way of Ayurvedic Herbs (Twin Lakes, WI: Lotus Press, 2008)

138.

99 Daniel P. Reid, Chinese Herbal Medicine (Boston: Shambhala Publications, Inc., 1986) 116.

100 Michael Tierra, Planetary Herbology (Santa Fe, NM: Lotus Press, 1988) 154, 244.

101 Robyn Landis with Karta Purkh Singh Khalsa, Herbal Defense (New York: Warner Books, 1997) 302.

102 MY Henein, and R. Nicoll, “Ginger (Zingiber officinale Roscoe): a hot remedy for cardiovascular disease?”

International Journal of Cardiology 131.3 (2009):408-9.

103 Yuhao Li, et al., “A 35-day gavage safety assessment of ginger in rats.” Regulatory Toxicology and Pharmacology

 
 
 
 
 
 
 
 
 
 
 

 

Coriander The Wealthy One (By Dr. Khaled Haidari DDS)

1. Introduction
2. Botanical description
3. Ayurvedic description
4. Uses
5. Herbal Combinations
6. Contraindications and interactions with drugs and minerals
7. Conclusion
8. End notes
9. Abstracts
 

1. Introduction

   Coriander is an amazing herb that is used for culinary and medicinal purposes. From the oldest times it is known in the Mediterranean region, Africa and the Middle East, central Asia, India and China.1 The old Greeks, Egyptians and Romans were familiar with it. Pliny (Plinius), the famous Roman historian, tells us that “the best coriander came from Egypt’”.2 It is also very popular in Latin America, and it is getting more appreciated in the West. It appears under many names because of its use in many places and times. From the old Sanskrit name kustambari, many modern versions are derived such as the Indonesian kutumbar and the Tamil kotamali. There is another reference from the Persian geshniz being the basis for the central Asian names. In Arabic it is known as kzbara. Most of the European names originate from the Latin coriandrum or the Greek corianon. In English coriander leaves are often referred to as cilantro and the fruits as coriander. The fruits are also known as seeds. Coriander is also found under the names Indian parsley or Chinese parsley because of the close resemblance to its cousin parsley.1
   
   In India it is known as dhanya or dhanyaka, which means “the rich one”.3 It deserves its name because of its many
culinary and medicinal uses.
   
   For culinary purposes, some regions prefer the fruit and others, the leaf. Most of the people like the taste of the fruit and would describe it as warm, nutty and spicy. Some even find an orange-like quality. The leaves are appreciated by almost everyone in Asia and Latin America, and they are described as fresh, green, tangy and even citrusy. Central and Northern Europeans are on average not very fond of the taste and would describe it as soapy, like burnt rubber, or even like crushed bed bugs. Coriander is very good in bringing together the aromas of different spices. That is the reason why it is found in spice mixes even in regions where it is not used separately.1 It is less known that a very deep knowledge was used in designing the curry and spice blends in which coriander is an important component. The intention was to balance and heal.4 Using food as medicine is an important idea of Ayurveda and other systems that developed from it. Another use is in preparing medicines for an amazing variety of health problems with studies confirming the old knowledge and opening new possibilities. The treasure of the “rich one” is immense, and it is very exciting to explore it.
 

2. Botanical description

   The botanical name is Coriandrum sativum. It is classified in the family Apiaeceae, formerly known as Umbeliferaeae.5 This family is also known as the carrot family and has many important members, such as anise, asafetida, caraway, celery, dill, fennel, and parsley.60
 
-Parts used – Fruit and fresh leaves.
-Description: Coriander is an annual with erect stems, 1-3 feet high, slender and branched. The lowest leaves are stalked and pinnate, the leaflets roundish or oval, slightly lobed. The segments of the uppermost leaves are linear and more divided. The flowers are in shortly-stalked umbels, five to ten rays, pale mauve, almost white, delicately pretty. The seed clusters are very symmetrical, and the seeds fall as soon as they are ripe. They are quite round like tiny balls. They lose their disagreeable scent on drying and become fragrant. The plant is bright green, shining, glabrous and intensely fetid. Gerard describes it as follows:
   
   “The common kind of Coriander is a very striking herb. It has a round stalk full of branches, two feet long. The leaves are almost like the leaves of the parsley, but later on become jagged, almost like the leaves of Fumitorie, but a great deal smaller and more tender. The flowers are white and grow in round tassels like Dill.”
Cultivation: “Coriander likes a warm, dry, light soil, though it also does well in a somewhat heavy soil… It is sown in mild, dry weather in April, or in the wormer month of March.”
 
     “As the seeds ripen, about August, the disagreeable odor gives place to a pleasant aroma and the plant is then cut down with sickles and when dry the fruit is threshed out.”
 
   The parts used are: the fruit and sometimes the fresh leaves for salads and soups. The fruit (so-called seeds) are of globular form, beaked, finely ribbed, yellowish brown, 1/5 inch in diameter, with five longitudinal ridges, separable into two halves (the mericarps), each of which is concave internally and shows the broad, longitudinal oil cells (vittae). The seeds have an aromatic taste and when crushed, a characteristic odor.2
 
   This plant is a native of the Mediterranean region and is intensively grown in India. It is cultivated in all the states and is an important subsidiary crop in the black cotton soils of the Deccan and south India and is also important in North India.6 “The coriander grown in Russia and central Europe (var. microparcum) has smaller fruits less, than 3 mm, and contains more essential oil than the oriental variety ( var.vulgare), which is greater than 3 mm and is cultivated for fruits and leaves.” 1
Constituents- Coriander fruit contains about 1 percent of volatile oil, which is the active ingredient. It is pale yellow or colorless, and has the odor of Coriander and a mild aromatic taste.2 Terpene alcohols are the main component and up to 80 % goes to linalool. 7 Its essential oil consists of linalool called coriandrol (60-70 %), geraniol and borneol .8 The volatile oil also has anethole, camphor and limonen. Coriander essential oil has flavonoids: rutin, quercetin, apigenin, coumarins: psoralen, angelcin, umbeliferone, phenolic acids and phtalides (Williamson 2003) 3. The fruit yields about 5 percent of  ash and also contains malic acid, tannin and some fatty mater.”2 Some more components are Beta-sitosteral, D-mannital, flavonoid, glycosides, L-pinene, beta-phellandrene, 1,8-cineole,beta-caryophyllene, aflatocsins B1 and B2.6
 

3. Ayurvedic description

   According to Drayaguna Vijnana, the Gana or classification of coriander according to Ayrveda is Shitprashmana (Refrigerant) and Trishnanigrheneya (Thirst depressant). Synonyms are Dhania (Hindi), Dhanya, Dhanyaka, Kustumburu, Vitnnaka (Sanskrit), Coriander (English). Habitat: it is found in India. Rasa (taste): madhura (sweet), katu (pungent), tikta (bitter) and kshaya (astringent). Guna (physical property) is laghu (light) and snigadha. Virya (potency) is ushana (hot). Vipaka (post digestion effect) is madhura (sweet). Pacifying Vata, Pitta and Kapha dosha. Karma (action) is  trishnanigrhena (thirst depressant) It is used in fevers, loss of appetite and indegestion. Parts used are fruits and oil. Dose
1-3 g. 9
   
   Formulations based on Dnayaka are Dhanyapanchaka kwatha and Dhanyakadi hima (Coriander water). (drayaguna vijnana). Dhanyapanchaka Kwatha churna, Satamolyadi Lauha, Ernada Paka, Dhanyadi Lima, Bhaskar Lavana Curna. 10
In the Indian Materia Medica we will find that “Dhanyaka is astringent, bitter and sweet in taste, cardiac tonic, digestive stimulant and carminative. It cures casa (coughing), trt (morbid thirst) and chardi (vomiting). It is useful for the eyes. Green kustumbari (dhanyaka), when used in different ways, imparts good taste, fragrance and cardiac tonic property to various excellent types of vegetables. The dried kustumbari is sweet in vipaka and unctuous. It cures trt (morbid thirst), daha (burning) and aggravated doshas. It is slightly pungent and bitter. It cleanses the channels of
circulation.” 11
 
   It belongs to the group of herbs known as Guducuyadi gana which according to Arogya cintamani also consists of guduci, nimba, padmaka and rakta candana. The Dravaguna Vijnana gives information from Susruta according to whom drugs belonging to this group cure trsna (morbid thirst), daha (burning syndrome), aruci (anorexia), chardi (vomiting) and jvara (fever). They also stimulate the power of digestion.12
   
   It is also an alterative, diaphoretic, diuretic and carminative according to “The Yoga of Herbs” by Dr. Frawley and Dr. Lad.13
   
   In Dr. Tierra’s “Planetary Herbology” the seeds of Coriander have a neutral energy, and the leaves are cooling.
Benefitted organs are the bladder and stomach. It is carminative, aromatic and diuretic.8
   
   According to Sebastian Pole, the virya (energy) is cooling (leaves) and warming (seed). Its Ayurvedic actions are dipana (appetite stimulant), amapacana (toxin digester), sulaprasamana (alleviates intestinal spasms), dahaghna (alleviates burning in the body), agmimandyanasaka (aleviates sluggish appetite), trshaghna (alleviates thirst), hrdaya (lifts the spirits), krmighna (warm killer), mutrala (diuretic), kusthaghna (alleviates hot skin conditions).3
   
   Dr. Kurt Schaubelt states, “Because of the high linalool content, this oil is tonifying and strengthening. In addition, a series of coumarin compounds together with linalool provide a mild euphoric effect.” 7
 

4. Uses

   “Coriander seeds are a good household remedy for many pitta disorders, particularly those of the digestive tract or urinary system.” 13    They can be used together with burdock seeds, which have similar indications.14
   “This popular Indian curry ingredient is also an invaluable medicine; it soothes an irritated digestive system and cools any burning sensations in the body. Its sweet aroma subtly lifts the spirits. Dhanyaka is a proper noun also meaning rich.” It is used in dosages 1-30 g/day or 3-15 ml/day of a 1: 3@45 % tincture. It is often used with sugar to increase the anti-pitta effect. 3
 
 
Digestion. Coriander seed is an excellent remedy for promoting Pitta digestion as it enkindles agni but does not aggravate acidity. It is safe to use when there is an inflammation in the digestive system and agni needs strengthening. It is prescribed in IBS (irritative bowel syndrome) and colic. Both the leaf and the seed are used to clear flatulence, gripping and bloating.3 For gas and indigestion a tea can be prepared: an infusion with the seeds.15
 
   It is an effective digestive agent for Pitta conditions in which most spices are contraindicated or used with caution. Often used together with fennel and cumin which are related plants with similar properties for digestive disorders, mainly owing to high Pitta, and are also used together in various formulations to promote the assimilation of the other herbs.13
 
    Coriander can be used roasted alone or with fennel and cumin, one teaspoon after meals for cramping and flatulence.16
  For pitta type bloating where symptoms of high pitta such as hyperacidity, diarrhea, heartburn and irritability appear along with gas, cool carminatives -- among which is coriander -- should be combined with bitters (gentian, barberry, goldenseal, katuka). Coriander, fennel and cumin should be taken in equal parts, ¼ teaspoon before meals.17
 
   It is also useful for vata and kapha because of its digestion enhancing quality, although in small amounts. It is useful for flatulence and indigestion.6
 
“ The curry powder characteristic of the Indian cooking was originally a therapeutic blend of spices. It included turmeric, cumin seed, coriander, ginger, asafetida and chili pepper along with garlic and onions sautéed in ghee (clarified butter).4 The basis of Indian curry is three important spices: cumin seed which is heating, carminative and with a strong spicy flavor; coriander seed which is cooler and has a milder spicy flavor and turmeric root, pleasantly bitter and only slightly spicy tasting, imparts a golden color to the food. It has liver detoxifying, blood moving and digestive properties. These three spices used together are balanced within themselves and are most important in promoting optimal digestion and assimilation of complex carbohydrates.”18
 
Urinary tract.For urinary tract infections, burning urethra and cystitis. It is a cooling diuretic.19 It combines well with fennel.16
 
   It is specific for strengthening of the urinary tract. The seeds and the leaves can both be used as an infusion for infections of the urinary tract.8
 
   A cold infusion of the seeds is used for draining heat out of the urinary system. Useful in cystitis, dysuria and cloudy urine (bhavaprakasa). 3 Warm infusion is also advised for burning on urination. This tea makes the urine more alkaline.15    One formula for urinary tract infections with burning urination is: coriander, pipsissewa, plantain, Marshmallow, lemon grass and gotu kola in equal parts, 1-2 teaspoons of cut and sifted herbs in 1 cup of hot water every few hours.20
 
   Kidney flash procedure done after one day of fasting consists of drinking one or two quarts of water with a small amount of mild diuretic herbs, like coriander, parsley and lemon grass the following morning.21
 
Edema. Cilantro is used as a mild diuretic which is good in order not to over stimulate the kidneys.22 ”Excess moisture of the body is dried out by coriander.” 23 Used as a decoction, it is useful for treating the swelling during pregnancy starting from the fifth month.24
 
High blood pressure. Here, its property of being a good diuretic is used.53
 
Burns 13
 
Allergies, hay fever, skin rushes, urticaria. The fresh juice of the herb is effective internally, but it can also be used externally for itch and inflammation. One teaspoon three times a day.13    Skin rash is treated with an application of the pulp of cilantro leaf directly or by taking coriander tea, 1 tsp. to 1 cup of water.26 “Coriander may be used internally for allergic rhinitis of pitta origin (Frawley & Lad 1994).” 3    When used internally it helps purify the blood and externally relieves the burning sensation. It is also applied for dermatitis. 15
 
Coriander is used to increase digestive fire and regulate digestive function in pitta patients with allergies. 25
 
Food poisoning/radiation: In 1 cup of miso soup add 1 tsp. of ghee and ½ tsp each of coriander and cumin powder.27 A Romanian study shows coriander being an excellent antibacterial and antifungal, effective against staphylococcus, streptococcus, E. coli, salmonella and Candida albicans. The study suggests industrial use for coriander as a food preserver.54
 
Vomiting 11’12 Warm infusion of the seeds is used and also helps with nausea.15
 
Temporal headache: that indicates excess pitta in the stomach. That can be relieved by drinking a tea of cumin and coriander seeds, ½ tsp each in one cup of hot water. This goes with an application of sandalwood oil or paste to the temples.28
 
 
Poison bites and stings: drink cilantro juice.26
 
Parasites. The powder of the seed is used for worms in children. 3    A decoction of the seeds is used effectively.29
 
Eye infections. Eyes are rinsed with a cooled decoction of the seeds.24
 
Diabetes. Coriander is beneficial in the hot, pitta type diabetes (pittaja prameha).3  This herb has a hypoglycemic effect; it lowers the glucose level in the blood.43
 
Hot flashes 3
 
Respiratory system. It is used for sore throat 13. It is useful for coughs 11 when combined with licorice and pippali 3. Another way is ground coriander seeds mixed with honey in the 1:2 ratio. 24
 
For pitta-type asthma coriander is applied in the anti-pitta diet. 31
 
Coriander helps clean mucus from the lungs with its antispasmodic and expectorant properties. (Paranpje 2001) 3
 
Detoxifying herb. Coriander helps to clean the body from the cell up 6. The leaf is used to facilitate the safe excretion of heavy metals and other environmental toxins such as lead, arsenic and mercury. It must be used in drop-by-drop doses accompanied by chlorella, an intestinal heavy metal toxin agent.3
 
Fever. Resolves fevers. 23 The seeds are a mild diaphoretic and they can help alleviate a fever by allowing the displaced agni, pitta and ama to be released through the skin and urine. 3 It is also a cooling diuretic. 19’12
 
Measles.32
 
Small pox. It was used for treating of this horrible and now extant disease.33
 
Colds. Coriander is “particularly useful when a person has a cold.” 23    The essential oil applied externally helps alleviate the body aches.29
 
Morbid thirst. 11’12 A cold infusion is used with some honey.24
 
Anorexia. 12
 
Liver, hepatitis. Coriander is a mild spice that helps promote liver energy and improve the appetite when the liver is sluggish or congested. It is used as a spice for cooking or tea, before or after meals.34 During the treatment of hepatitis, after a mono diet of mung beans for 1-2 weeks, basmati rice can be added to make kicharee, along with coriander, turmeric and other liver cleansing spices. Mainly bitter herbs are indicated with bile clearing, blood cleansing and mild purgative action. Here aloe vera is used with small amounts of turmeric and coriander, 1-2 teaspoons before meals.35
 
   For milder cases of gall stones, corn silk tea, 1 ounce per pint of water with 1 teaspoon of coriander, taken daily is effective. Most herbs for urinary stones help clear gall stones as well when combined with coriander to conduct the action to the liver area. One formula is coriander, turmeric, barberry, gravel root and corn silk in equal parts. 36
 
   It has a hepato-protective effect, reducing the liver weight and clearing the fat and necrosis. 55
 
Epistaxis or nose bleeds. Coriander tea is used in this case. 37 Also, a paste of green coriander leaves can be applied on the forehead, and the patient should inhale the aroma of fresh coriander leaves.38
 
Cleansing of the channels of circulation. 11 ”It opens the subtlest networks of the veins.” 23
 
Weakened immunity. Therapy for weakened immunity (according to Franchomme) starts with two days of intense treatment with essential oils containing phenol (oregano or thyme) and then starts with steadily decreasing them and introducing oils that contain terpene alcohol (coriander, eucalyptus, tea tree, thyme etc.) that are to be applied alternately.39
 
AIDS. Equal parts coriander, gotu kola, sarsaparilla, ashwaghandha, shatavari, gokshura and sandalwood.30
 
Increasing of the milk flow.23
Increasing of the menstrual flow.23
Excessive menstrual bleeding Take coriander with rice water and fresh cilantro leaves.24
 
Boldness, scalp problems and prevention of grey hair. The oil is used 23 or fresh juice made of the leaves.24
 
Insect repellant. The smoke of the burning seed is an effective insect repellant.23
 
Arthritis. Coriander is traditionally used for arthritis, and a study shows that its swelling-decreasing action is based on the anti-inflammatory property.56    Linalool has an anti-inflammatory action.40    The essential oil is applied by massaging the painful joint.29 If no oil is available, a decoction of crushed seeds is used to soak a cloth and place it on the joint. The cloth has to be warm. (anecdotal)
 
Halitosis (bad breath). Chewing of a few seeds as needed takes care of the problem.24
 
Antifungal. A study on the effect of coriander essential oil on Candida albicans isolated from the oral bio film of patients with periodontal disease shows that it has a strong antifungal activity which gives it a good potential to be used in a new antifungal preparation. 57 ’54
 
Anti-anxiety. Its extract applied in certain doses on mice has an anti-anxiety effect comparable to diazepam, according to a study. 58 It is believed the effect is due to the linalool.40
Insomnia. A paste made of the green leaves is placed on the forehead or is taken orally as a juice of the leaves or by chewing the leaves.24 Linolool is proven to induce sleep.40  For this purpose in the Unani Tibb system the seeds are used as an infusion.41
Stress. It is relaxing because of the linalool component. 40
Promotes good memory. 29
Cholesterol and triglyceride lowering. It is proven by a study that coriander seeds significantly reduce the level of cholesterol and triglycerides after a diet high in fats. HDL is increased. It is believed that this is due to the enhanced hepatic bile acid synthesis and increased degradation of cholesterol to fecal bile acids and neutral sterols. 59
Diarrhea. Chewing coriander seeds is recommended. 42
 

6. Herbal Combinations

- With fennel, cumin and cardamom for digestive upsets 3 and with fennel for urinary problems. 19
- Gokshura, manjishta and punarnava for urinary problems, especially stones and burning. 3
- Sariva and pit shirisha for skin allergies.
- With vasa for respiratory allergies.3
- Licorice and pippali for cough 3
- Fresh ginger for fever. 3
- Coriander seeds work well together with burdock seeds, which have similar indications. 14
- Together with betel leaves, it is used to flavor food, as a purgative and to prevent gripping (with meals) 6
 

7. Contraindications and interactions with drugs and minerals

   According to Pole, “There are no known contraindications and drug-herb interactions for Coriander. The herb is very safe.” 3. Dr. Schnaubelt also states that there are no known contraindications. 7    So coriander is considered to be a very safe herb, but there is some advice on avoiding the coriander essential oil in the first three months of pregnancy due to its mildly stimulating effect. 40
   Many members of the Apiaecae family, formerly known as Umbelliferae (or the carrot family), are more prone than other species to causing allergic reactions. Among them is contact dermatitis due to handling or local application. This can sensitize to other members of the family. Aside from coriander, members of this family are anise seed (Pimpinella anisum), asafetida (Ferula spp.), caraway (Carum carvi), celery seeds, root or stalks (Apium graveolens), dill
(Anethum graveolens), fennel (Foeniculum vulgare), parsley leaves (Petroselinum sativum) and Queen Anne’s lace (Daucus carota).44
   In some cases there is interaction between vitamin supplements taken in high doses and drugs or minerals. That interaction can work in two ways. Drugs and minerals can lower the vitamin absorption and reduce its serum levels, or increase its metabolism and excretion. In those cases it is good using plants that contain the vitamin that is deficient.45 Another way of interaction is when the vitamin or mineral can raise the drug or mineral serum levels or reduce their effect.
   Many people take mineral supplements, and interactions with drugs are documented. Consumption of herb sources that contain the mineral is not going to cause the same effect, but it has the potential of exacerbating it (when a supplement is used). Herbs are an adequate source of minerals when high potency mineral supplements cannot be used due to drug interactions. Mineral elements have a toxic potential when used in excessive quantities. This is a point that goes in favor of using natural sources of mineral ingredients instead of high concentrations of mineral inorganic
supplements. 46
   Cilantro leaves are rich in calcium. 47 Calcium as carbonate has interactions with some drugs and minerals.
Documented in human studies, cilantro lowers the serum level or effects of levothyroxine, and in the case of tetracycline leads to insufficiency. Drugs that lower the calcium serum level leading to insufficiency are corticosteroids, gentamicin, phenobarbital, phenolphthalein, phenytoin, tetracycline and viomycin. 48
   The leaves of this beautiful herb are also rich in iron. 49    It is documented in human studies that iron lowers the
serum level or effects of doxycycline, levodopa, methacycline, methyldopa, minocyclyne, oxytetracycline and thyroxine, causing an insufficient effect. It lowers trientine without causing insufficiency. Drugs that lower the serum iron levels leading to insufficiency are caffeine, calcium carbonate, chloramphenicol, tetracycline, trientine and vitamine E. 50
   Cilantro leaves are rich with magnesium. Digoxin, gentamicin and viomycin lower the magnesium, causing insufficiency, as proven by studies in humans. 51
    It is also a source of potassium. Acetazolamide, carbenicillin, carbenoxolone, cephalothin, clindamycin, gentamicin and penicillin lower its serum levels or efficiency, causing insufficiency. Spironolactone causes an increase to toxic levels.52
   This herb has a hypoglycemic effect. It lowers the glucose level in the blood. Insulin-dependent diabetics (type I) who take coriander have to monitor their blood glucose level not only because of the need to prevent high glucose level, but also to be able to avoid hypoglycemic episodes. It is possible to have insulin shock as a result of the combined actions of the insulin and the hypoglycemic herb.43
 

8. Conclusion

   Coriander is a herb well known since ancient times in vast parts of the world from the Mediterranean basin to   India and China. Both its dried fruits and the fresh leaves with the stem known as coriander and cilantro, respectively, are used for culinary and medicinal purposes. Even the culinary applications have a medicinal background. They were originally designed to balance the food and facilitate digestion. As part of the food, the herb is also useful for controlling bad breath and is a source of vitamin C, magnesium, potassium, calcium and iron. Different cultures have different preferences between the seeds and the leaf, and the number of applications is huge.
   The purely medicinal use is also very developed with a big variety of problems that are treated and many different formulas and ways of preparations. Corainder is considered to be very safe. The most widely-known use is for digestive problems where it improves the digestion, stokes the agni (digestive fire) without aggravating pitta and increasing acidity. It is very useful for flatulence, gripping and bloating.
   Another well known use of coriander is for urinary tract problems that are connected with burning urination and infections. It is a mild diuretic, great for the task because it will not overwhelm the kidneys with excessive activity. It is also strengthening to the urinary system. Kidney stones are prevented with a kidney flush with coriander. Its diuretic property will be useful in treating edema and high blood pressure.
 
   Coriander has a detoxifying action for various toxins, which, interestingly, is used for poisoning with metals. It is also cleansing to the liver and cleans the fat and necrosis in it. Coriander is effective in simple cases of gall stones. Most herbs that act on urinary tract stones will have an effect on gall stones when coriander is used as a carrier to conduct their action to the liver.
   Studies are proving its great ability in treating bacterial and fungal infections and parasites. The traditional use is in eye infections, colds, food preserving and parasites in children.
   Coriander has hypoglycemic action (reducing blood glucose), which makes it very useful in diabetes. It is proven to lower the “bad” cholesterol and triglycerides. In the long list, coriander also helps with excessive or insufficient menstruation, allergies, skin problems, burns, baldness, measles, nose bleed, increasing blood flow, treating thirst and working as an insect repellant.
   When we consider coriander’s proven uses, the studies opening new avenues for applications, as well as its safety, the inevitable conclusion is that this formidable herb, coriander, rightfully deserves its name dhanyaka, which means “rich” or “wealthy”. It can also be said that we are immensely enriched by it.
 

 9. End Notes

1. Gernot Katzer’s Spice Pages, Gernot Katzer, Coriander seeds and cilantro herb.  http://www.uni-   graz.at/~katzer/engl/Cori_sat.html#disc
2. Botanical.com, M. Grieve, Coriander. http://www.botanical.com/botanical/mgmh/c/corian99.html
3. Sebastian Pole,: Ayurvedic Medicine, Principles of Traditional Practice (Philadelphia, Pa: Elsevier Ltd. 2006) 165
4. Michael Tierra, C.A., N.D.,O.M.D., Planetary Herbology, an Integration of Western Herbs Into The Traditional Chinese and Ayurvedic Systems (Twin Lakes, Wi: Lotus Press, 1988) 100
5. Francis Brinker, N.D.; Herb Contraindications and Drug Interactions (Sandy, Or: Eclectic Medical Publications, 2001) 209,210
6. Charu Mahawar;Alka Agarwal,“Ayurveda Wonder Foods-Spices”,Light on Ayurveda Journal,Vol. VIII,Issue 1,(Fall 2009):39
7. Kurt Schaubelt, Ph.D.; Advanced Aromatherapy, The Science of Essential Oil Therapy (Rochester, Ve: Healing Arts Press, 1998) 66
8. Michael Tierra, C.A., N.D., O.M.D.; Planetary Herbology, an Integration of Western Herbs Into The Traditional Chinese and Ayurvedic systems (Twin Lakes, Wi: Lotus Press, 1988) 219
9. Dr. Amritpal Singh, Drayaguna Vijnana ( Delhi:Chaukhambha Orientalia, 2005) 115
10. Charu Mahawar;Alka Agarwal,“Ayurveda Wonder Foods-Spices”, Light on Ayurveda Journal, Vol. VIII, Issue 1,(Fall 2009)40
11. Vaidya Bhagwan Dash & Vaidya Lalitesh Kashyap, Materia Medica of Ayurveda Based on Ayurveda Saukham of Todarananda (New Delhi, Naurang Rai, Concept publishing company, 1979) 41,42
12. Vaidya Bhagwan Dash & Vaidya Lalitesh Kashyap,  Materia Medica of Ayurveda Based on Ayurveda Saukham of Todarananda (New Delhi, Naurang Rai, Concept publishing company, 1979) 420
13. Dr. David Frawley and Dr. Vasant Lad, The Yoga of Herbs, an Ayurvedic Guide to Herbal Medicine (Twin Lakes, Wi: Lotus press, 1986), 114
14. Dr. David Frawley and Dr. Vasant Lad, The Yoga of Herbs, an Ayurvedic Guide to Herbal Medicine (Twin Lakes, Wi: Lotus press, 1986) 106
15. Dr. Vasant Lad, Ayurveda The Science of Self Healing (Twin Lakes, Wi: Lotus press, 1984) 134
16. Dr. David Frawley and Dr. Vasant Lad, The Yoga of Herbs, an Ayurvedic Guide to Herbal Medicine (Twin Lakes, Wi: Lotus press, 1986), 117
17. Dr. David Frawley, Ayurvedic Healing, a Comprehensive Guide (Twin Lakes, Wi: Lotus press, 2000) 183,184
18. Michael Tierra, C.A., N.D., O.M.D., Planetary Herbology, an Integration of Western Herbs Into The Traditional Chinese and Ayurvedic Systems (Twin Lakes, Wi: Lotus Press, 1988)422
19. Dr. David Frawley and Dr. Vasant Lad, The Yoga of Herbs, an Ayurvedic Guide to Herbal Medicine (Twin Lakes, Wi: Lotus press, 1986) 61
20. Dr. David Frawley, Ayurvedic Healing, a Comprehensive Guide (Twin Lakes, Wi: Lotus press, 2000) 233
21. Dr. David Frawley, Ayurvedic Healing, a Comprehensive Guide (Twin Lakes, Wi: Lotus press, 2000) 229
22. Dr. David Frawley, Ayurvedic Healing, a Comprehensive Guide (Twin Lakes, Wi: Lotus press, 2000) 232
23. Shaykh Hakim Moinuddin Chishti, The Book of Sufi Healing (Rochester, Ve: Inner Traditions International, 1991) 57
24. Online-health-care.com, Health Care Staff, Coriander (Dhaniya) uses and benefits. http://www.online-health-   care.com/herbal-medicines/coriander.htm
25. Dr. David Frawley; Ayurvedic Healing, a Comprehensive Guide (Twin Lakes, Wi: Lotus press, 2000) 158
26. Dr. David Frawley and Dr. Vasant Lad, The Yoga of Herbs, an Ayurvedic Guide to Herbal Medicine (Twin Lakes, Wi: Lotus press, 1986), 227
27. Dr. David Frawley and Dr. Vasant Lad, The Yoga of Herbs, an Ayurvedic Guide to Herbal Medicine (Twin Lakes, Wi: Lotus press, 1986) 225
28. Dr. David Frawley and Dr. Vasant Lad, The Yoga of Herbs, an Ayurvedic Guide to Herbal Medicine (Twin Lakes, Wi: Lotus press, 1986) 226
29. Naturaltherapypages.com, Natural Therapy Pages Staff, Coriander.  http://www.naturaltherapypages.com.au/article/coriander
30. Dr. David Frawley; Ayurvedic Healing, a Comprehensive Guide(Twin Lakes, Wi: Lotus press, 2000) 266
31. Dr. David Frawley; Ayurvedic Healing, a Comprehensive Guide (Twin Lakes, Wi: Lotus press, 2000) 206
32. Medicinal and Aromatic Plant Home Page, Medicinal and Aromatic Plant Home Page Staff, Coriander.  http://www.hort.purdue.edu/newcrop/med-aro/factsheets/CORIANDER.html
33. Organic facts.net, Apurup Mukherjee, Health Benefits of Coriander. http://www.organicfacts.net/health-benefits/herbs-   and-spices/health-benefits-of-coriander.html
34. Dr. David Frawley; Ayurvedic Healing, a Comprehensive Guide (Twin Lakes, Wi: Lotus press, 2000) 153
35. Dr. David Frawley; Ayurvedic Healing, a Comprehensive Guide (Twin Lakes, Wi: Lotus press, 2000) 154
36. Dr. David Frawley; Ayurvedic Healing, a Comprehensive Guide (Twin Lakes, Wi: Lotus press, 2000) 156
37. Dr. David Frawley; Ayurvedic Healing, a Comprehensive Guide (Twin Lakes, Wi: Lotus press, 2000) 221
38. Usefulhomeremedies.com, Usefulhomeremedies.com Staff, Nose Bleeding and Epistaxis,   http://usefulhomeremedies.com/nosebleeding.html
39. Kurt Schaubelt, Ph.D.; Advanced Aromatherapy, The Science of Essential Oil Therapy (Rochester, Ve: Healing Arts Press, 1998)121
40. Ezinearticles.com, K.G. Stiles, Research Linalool Properties-Immune Stimulant, Reduce Stress & Depression, Stimulant.   http://ezinearticles.com/?Coriander-Essential-Oil-Research-Linalool-Properties---Immune-Stimulant,-Reduces-Stress-and-   Depression&id=2923180
41. Liveandfeel.com, Live and Feel Staff, Benefits of Coriander Plant. http://www.liveandfeel.com/medicinalplants/coriander.html
42. Anxietydisorderpro.com, Anxietydisorderpro.com Staff, Coriander Herb-An Excellent Herb For Nourishment, Digestive Problems and Minimizing Bad Cholesterol. http://www.anxietydisorderpro.com/coriander-herb-an-excellent-herb-for-   nourishment-digestive-problems-and-minimizing-bad-cholesterol/
43. Francis Brinker, N.D., Herb Contraindications and Drug Interactions (Sandy, Or: Eclectic Medical Publications, 2001) 237,238,239
44. Francis Brinker, N.D., Herb Contraindications and Drug Interactions (Sandy, Or: Eclectic Medical Publications, 2001) 209,210
45. Francis Brinker, N.D., Herb Contraindications and Drug Interactions (Sandy, Or: Eclectic Medical Publications, 2001) 285,286
46. Francis Brinker, N.D., Herb Contraindications and Drug Interactions (Sandy, Or: Eclectic Medical Publications, 2001) 296, 297
47. Francis Brinker, N.D., Herb Contraindications and Drug Interactions (Sandy, Or: Eclectic Medical Publications, 2001) 301,
48. Francis Brinker, N.D.. Herb Contraindications and Drug Interactions (Sandy, Or: Eclectic Medical Publications, 2001) 299, 300, 301
49. Francis Brinker, N.D., Herb Contraindications and Drug Interactions (Sandy, Or: Eclectic Medical Publications, 2001) 303
50. Francis Brinker, N.D., Herb Contraindications and Drug Interactions (Sandy, Or: Eclectic Medical Publications, 2001) 302,303
51. Francis Brinker, N.D., Herb Contraindications and Drug Interactions (Sandy, Or: Eclectic Medical Publications, 2001) 304,305
52. Francis Brinker, N.D., Herb contraindications and Drug Interactions (Sandy, Or: Eclectic Medical Publications, 2001) 306,307
53. Healthy-ojas.com, Healthy-ojas.com Staff, Hypertension Herbs. http://healthy-ojas.com/pressure/hypertension-   herbs.html
54. BE Lixandru, NO Dracea, CC Dragomirescu, EC Dragulescu, IL Coldea, L Anton. E Dobre, C Rovinaru, I Codita, “Antimicrobial Activity of Plant Essential Oil Against Bacterial and Fungal Species Involved in Food Poisoning and/or Food Decay”, Romanian Archive of Microbiology and Immunology, 69(4)(October-December 2010):2   http://www.ncbi.nlm.nih.gov/pubmed/21462837
55. A Pandey, P Bigonya, V Raj, KK Patel, “Pharmacological Screening of Coriandrum Sativum Linn. For Hepatoprotective Activity “, Journal of Pharmacy and Bioallied Sciences,3(3)(July 2011): 435-41  http://www.ncbi.nlm.nih.gov/pubmed/21966166
56. V Nair, S Singh, YK Gupta, “Evaluation of Disease Modifying Activity of Coriandrum sativum in Experimental Models,”
Indian Journal of Medical Research 135(2) (February 2012): 240-245. http://www.ncbi.nlm.nih.gov/pubmed
57. VF Furletti, IP Teixeira, G. Obando-Pereda, RC Mardegan, A Sartoratto, GM Figueira, RM Duarte, VL Rehder, MC Duarte, JF Hofling, “Action of Coriandrum Sativum L. Essential Oil Upon Oral Candida Albicans Biofilm Formation.”, Evidence Based Complementary and Alternative Medicine, Epub (May 21, 2011) 985832  http://www.ncbi.nlm.nih.gov/pubmed/21660258
58. P Mahendra, S Bisht, “Anti-anxiety Activity of Coriandrum Sativum Assesed Using Different Experimental Anxiety   Models”, Indian Journal of Pharmacology,43(5)(September 2011):574-7 http://www.ncbi.nlm.nih.gov/pubmed/22022003
59. V Chitra, S Leelamma, “Hypolipidemic  Effect  of Corriander Seeds (Coriandrum Sativum): Mechanism of Action”, Plant Foods For Human Nutrition, 51(2)(1997):167-72 http://www.ncbi.nlm.nih.gov/pubmed/9527351
60. Francis Brinker, N.D., Herb Contraindications and Drug Interactions (Sandy, Or: Eclectic Medical Publications, 2001) 210
 

 10. Abstracts

These are the abstracts of the studies referred to in the paper.
 
Indian J Med Res. 2012 Feb;135(2):240-5.
 

Evaluation of disease modifying activity of Coriandrum sativum in experimental models.

Nair V, Singh S, Gupta YK.
Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India.
 

Abstract

Background & objectives: Coriandrum sativum (CS), has been widely used in traditional systems of medicine for treatment of rheumatoid arthritis. However, the mechanism of action for its antiarthritic effects is not clearly known. Therefore, the present study was carried out to evaluate the antiarthritic activity of CS in rats in two experimental models. Methods: The antiarthritic activity of CS seed hydroalcoholic extract (CSHE) was evaluated in adult Wistar rats by using two experimental models, viz. formaldehyde and Complete Freund's adjuvant (CFA) induced arthritis. The expression of pro- inflammatory cytokines (predominantly contributed by macrophages) was also evaluated. TNF- α level was estimated in serum by ELISA method. TNF-R1, IL-1 β and IL-6 expression in the synovium was analysed by immunohistochemistry. Results: CSHE produced a dose dependent inhibition of joint swelling as compared to control animals in both, formaldehyde and CFA induced arthritis. Although there was a dose dependent increase in serum TNF-α levels in the CSHE treated groups as compared to control, the synovial expression of macrophage derived pro-inflammatory cytokines/cytokine receptor was found to be lower in the CSHE treated groups as compared to control. Interpretation & conclusions: Our results demonstrate that the antiarthritic activity of CSHE may be attributed to the modulation of pro- inflammatory cytokines in the synovium. In further studies CSHE could be explored to be developed as a disease modifying agent in the treatment of RA.
 
Evid Based Complement Alternat Med. 2011;2011:985832. Epub 2011 May 21.
 

Action of Coriandrum sativum L. Essential Oil upon Oral Candida albicans Biofilm Formation.

 
Department of Microbiology and Immunology, Dental School of Piracicaba, University of Campinas-UNICAMP, 13414- 903 Piracicaba, SP, Brazil.
 

Abstract

The efficacy of extracts and essential oils from Allium tuberosum, Coriandrum sativum, Cymbopogon martini, Cymbopogon winterianus, and Santolina chamaecyparissus was evaluated against Candida spp. isolates from the oral cavity of patients with periodontal disease. The most active oil was fractionated and tested against C. albicans biofilm formation. The oils were obtained by water-distillation and the extracts were prepared with macerated dried plant material. The Minimal Inhibitory Concentration-MIC was determined by the microdilution method. Chemical characterization of oil constituents was performed using Gas Chromatography and Mass Spectrometry (GC-MS). C. sativum activity oil upon cell and biofilm morphology was evaluated by Scanning Electron Microscopy (SEM). The best activities against planktonic Candida spp. were observed for the essential oil and the grouped F(8-10) fractions from C. sativum. The crude oil also affected the biofilm formation in C. albicans causing a decrease in the biofilm growth. Chemical analysis of the F(8-10) fractions detected as major active compounds, 2-hexen-1-ol, 3-hexen-1-ol and cyclodecane. Standards of these compounds tested grouped provided a stronger activity than the oil suggesting a synergistic action from the major oil constituents. The activity of C. sativum oil demonstrates its potential for a new natural antifungal formulation.
 
Roum Arch Microbiol Immunol. 2010 Oct-Dec;69(4):224-30.
 

Antimicrobial activity of plant essential oils against bacterial and fungal species involved in food poisoning and/or food decay.

 
Cantacuzino" National Institute of Research-Development for Microbiology and Immunology, Bucharest, România.
 

Abstract:

The currative properties of aromatic and medicinal plants have been recognized since ancient times and, more recently, the antimicrobial activity of plant essential oils has been used in several applications, including food preservation. The purpose of this study was to create directly comparable, quantitative data on the antimicrobial activity of some plant essential oils prepared in the National Institute of Research-Development for Chemistry and Petrochemistry, Bucharest to be used for the further development of food packaging technology, based on their antibacterial and antifungal activity. The essential oils extracted from thyme (Thymus vulgaris L.), basil (Ocimum basilicum L.), coriander (Coriandrum sativum L.), rosemary (Rosmarinus officinalis L.), sage (Salvia officinalis L.), fennel (Foeniculum vulgare L.), spearmint (Mentha spicata L.) and carraway (Carum carvi L.) were investigated for their antimicrobial activity against eleven different bacterial and three fungal strains belonging to species reported to be involved in food poisoning and/or food decay: S. aureus ATCC 25923, S. aureus ATCC 6538, S. aureus ATCC 25913, E. coli ATCC 25922, E. coli ATCC 35218, Salmonella enterica serovar Enteritidis Cantacuzino Institute Culture Collection (CICC) 10878, Listeria monocytogenes ATCC 19112, Bacillus cereus CIP 5127, Bacillus cereus ATCC 11778, Candida albicans ATCC 10231, Aspergillus niger ATCC 16404, Penicillium spp. CICC 251 and two E. coli and Salmonella enterica serovar Enteritidis clinical isolates. The majority of the tested essential oils exibited considerable inhibitory capacity against all the organisms tested, as supported by growth inhibition zone diameters, MICs and MBC's. Thyme, coriander and basil oils proved the best antibacterial activity, while thyme and spearmint oils better inhibited the fungal species.
 
PMID: 21462837
[PubMed - indexed for MEDLINE]
 
Indian J Pharmacol. 2011 Sep;43(5):574-7.
 

Anti-anxiety activity of Coriandrum sativum assessed using different experimental anxiety models.

 
Department of Pharmacology, School of Pharmacy, Suresh Gyan Vihar University, Jaipur - 302 004, India.
 
 

Abstract

Interest in alternative medicine and plant-derived medications that affect the "mind" is growing. The aim of present study was to explore the anti-anxiety activity of hydroalcoholic extract of Coriandrum sativum (Linn.) using different animal models (elevated plus maze, open field test, light and dark test and social interaction test) of anxiety in mice. Diazepam (0.5 mg/kg) was used as the standard and dose of hydroalcoholic extract of C. sativum fruit (50, 100 and 200 mg/kg) was selected as per OECD guidelines. Results suggested that extract of C. sativum at 100 and 200 mg/kg dose produced anti- anxiety effects almost similar to diazepam, and at 50 mg/kg dose did not produce anti-anxiety activity on any of the paradigm used. Further studies are needed to identify the anxiolytic mechanism(s) and the phytoconstituents responsible for the observed central effects of the hydroalcoholic extract of C. sativum.
 
J Pharm Bioallied Sci. 2011 Jul;3(3):435-41.
 

Pharmacological screening of Coriandrum sativum Linn. for hepatoprotective activity.

 
Department of Pharmacology, Radharaman College of Pharmacy, Ratibad, Bhopal, Madhya Pradesh, India.
 
 

Abstract

OBJECTIVE: Coriandrum sativum (Linn.), a glabrous, aromatic, herbaceous annual plant, is well known for its use in jaundice. Essential oil, flavonoids, fatty acids, and sterols have been isolated from different parts of C. sativum. The plant has a very effective antioxidant profile showing 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity, lipoxygenase inhibition, phospholipid peroxidation inhibition, iron chelating activity, hydroxyl radical scavenging activity, superoxide dismutation, glutathione reduction and antilipid peroxidation due to its high total phenolic content with the presence of constituents like pyrogallol, caffeic acid, glycitin, etc.
 
MATERIALS AND METHODS: This study was aimed at investigating the hepatoprotective activity of C. sativum against carbon tetrachloride (CCl4), with estimation of serum serum glutamyl oxaloacetic acid transaminase (SGOT), serum glutamyl pyruvate transaminase (SGPT), alkaine phosphatase (ALP) and bilirubin, and with liver histopathology.
 
RESULTS: Ethanolic extract was found to be rich in alkaloids, phenolic compounds and flavonoids, and high performance liquid chromatography (HPLC) fingerprinting showed the presence of iso-quercetin and quercetin. C. sativum signifies hepatoprotection by reducing the liver weight, activities of SGOT, SGPT, and ALP, and direct bilirubin of CCl(4) intoxicated animals. Administration of C. sativum extract at 300 mg/kg dose resulted in disappearance of fatty deposit, ballooning degeneration and necrosis, indicating antihepatotoxic activity.
 
CONCLUSION The results of this study have led to the conclusion that ethanolic extract of C. sativum possesses hepatoprotective activity which may be due to the antioxidant potential of phenolic compounds.
 
PMID:
 
21966166
 
[PubMed]
 
Plant Foods Hum Nutr. 1997;51(2):167-72.
 

Hypolipidemic effect of coriander seeds (Coriandrum sativum): mechanism of action.

 
Department of Biochemistry, University of Kerala, Kariavattom, India.
 
 

Abstract

The effect of the administration of coriander seeds (Coriandrum sativum) on the metabolism of lipids was studied in rats fed a high fat diet with added cholesterol. The spice had a significant hypolipidemic action. The levels of total cholesterol and triglycerides decreased significantly in the tissues of the animals of the experimental group which received coriander seeds. Significant increases in beta-hydroxy, beta-methyl glutaryl CoA reductase and plasma lecithin cholesterol acyl transferase activity were noted in the experimental group. The level of LDL + VLDL cholesterol decreased while that of
 
HDL cholesterol increased in the experimental group compared to the control group. The increased activity of plasma LCAT, enhanced hepatic bile acid synthesis and the increased degradation of cholesterol to fecal bile acids and neutral sterols appeared to account for its hypocholesterolemic effect.
 
PMID: 9527351
[PubMed - indexed for MEDLINE]
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

Guduchi: The one who protects the body

By Carla Kennedy
December 2009

 

Guduchi is one of the most highly valued and common herbs in Ayurvedic medicine.  It has a rich history in the Indian sub-continent where it has been used and written about for thousands of years.   It is considered one of the best rasayanas (adaptogens) and is unusual in its potent versatility.   In recent years, significant progress has been attained regarding its biological activity and medicinal applications. 

    Guduchi, as it is most commonly called, has been described as “one which protects the body”. (Pole 189)  The Sanskrit and Hindi name Amrita is derived from ancient Hindu scriptures where Amrita was used to bring the dead back to life and keep gods from growing ill and old.  It is no wonder that it is also referred to as “nectar of immortality” and “heavenly elixir”.  Its scientific name is Tinospora cordifolia and is in the Family Menispermaceae.  Common names include: Guduchi, amrita (Sanskrit), giloya, amrita (Hindi), giloe, gulancha (Bengali), gado, galo (Gujarati), duyutige, teppatige (Telugu), heartleaf moonseed, Tinospora (English). (1, 2, 9, 11)

    It is a woody climbing shrub that is deciduous and perennial.  This herbaceous vine grows on hedges and trees.  It is often seen growing up mango or neem trees.  Herbalist Sebastian Pole writes that “those growing up neem trees are said to be the best as the synergy between these two bitter plants enhances guduchi’s efficacy.”  It is indigenous to areas of India, Myanmar, and Sri Lanka.  Guduchi typically grows in deciduous and dry forests at elevations up to 1000 ft.  Its flowers bloom in summer.  The male flower is small, yellow or green in color, and occurs in clusters.  Female flowers are usually solitary and are green.  The fruits are the size and shape of a large pea and turn from green to red when ripe in winter.  The leaves are heart shaped (giving the name cordifolia to the plant) and mucilaginous.  Its stems, when fresh, have a green succulent bark covered by a thin brown bark and are studded with warty lenticels.  When dry, the stem shrinks and the bark separate from the wood.  The roots are long narrow aerial roots that arise from the branches.  The stems, leaves, and roots are used in medicine.  All three parts should be collected in the summer when the bitter qualities are most abundant and, if not used fresh, dried in the shade.   Guduchi grows well without fertilizer or pesticide making it simple to grow.  It is easy to recognize and can be propagated by cuttings. (1, 2, 3, 4, 6)

Ayurvedic Qualities
    Guduchi has always been a very important herb in Ayurvedic medicine.  Ayurvedic herbalists generally describe it as having these qualities: (1) Rasa (taste): bitter and astringent, (2) Guna (quality): light and unctuous, (3) Virya (potency): heating, (4) Vipaka (post-digestive effect): sweet, (5) Prabhava (special action): destroys toxins both internally and externally, (6) Doshakarma (energetics): Tridoshic, VPK=.   Tridoshic in nature, its bitter and astringent properties and sweet post-digestive effect reduces pitta.  The bitter, astringent, and heating qualities reduce kapha.   Vata is reduced by its heat and sweet post-digestive qualities.  Its heat burns up ama yet doesn’t aggravate pitta and its sweet post-digestive effect gives it a nourishing rejuevenative quality.  (1, 2, 7, 9)

Actions and Indications
    Unusual in its qualities, Guduchi has a large variety of actions and is indicated in the treatment of many ailments.  Ayurveda traditionally describes the following actions: Increases appetite, quenches thirst, increases strength, promotes life, increases life span, aphrodisiac, increases sexual potency, purifier of sperm, cleans the blood, relieves gout, relieves arthritis, alleviates skin disorders, destroys toxins, reduces burning sensations, reduces fevers, nerve tonic, bitter tonic, causes constipation, and rejuvenative.  It is described in more modern and Western terms as having similar actions: Febrifuge, anti-periodic, alterative, diuretic, aphrodisiac, cholagogue, anti-inflammatory, anthelmintic, nerve tonic, bitter tonic, anti-rheumatic, and de-toxicant. (1, 2, 7, 9, 13)

    Guduchi is incredibly versatile and is indicated for potential use in the following conditions: Fever, hepatitis, liver damage, jaundice, diabetes, heart disease, tuberculosis, arthritis, gout, hemorrhoids, eczema, psoriasis, lupus, inflammatory skin conditions, autoimmune disease causing inflammation, urinary disease, secondary syphilis, bronchitis, chronic diseases of diarrhea and dysentery, seminal weakness, dyspepsia, general debility, leprosy, anemia, colic, worms, senile diseases, hyperacidity, and snake bite. (2, 7, 9)

Traditional Ayurvedic Preparations
    A potent classical herb, Guduchi is used as an important ingredient in a number of Ayurvedic formulations.  While the dried stem forms the raw material for many herbal preparations, the roots and leaves are also important.  The fresh plant is said to be more effective than the dry one.  However, it is traditionally dried and made into a starchy extract called Guduchi Sattva.   Dr. Gyanendra Pandey writes that Guduchi Sattva “is highly valued for many ailments.  Fevers, chronic diarrhea, chronic dysentery, burning sensation, secondary syphilis, chronic gonorrhea, leucorrhoea, jaundice, rheumatism, urinary disorders, and some other ailments”.  Dr. K.M. Nadkarni describes how it is made “The watery extract is prepared by powdering the stem and washing out the starch with water and drying the sediment.  Pandit Jayakrshna says “that as the deposit settles the sooner it is dried the better.  It is similar to arrow-root in appearance.”  Another common preparation is a watery extract, often called Indian quinine, which is used in malaria, leprosy, and common fevers due to cold or indigestion.  In the ancient text Caraka Samhita 50 great extract categories are described and Guduchi is included in two: Anti-saturative and refrigerant. (1, 2, 5)

Formulas from Caraka-an ancient physician
    The Caraka Samhita (written by Caraka between 1500BCE and 500BCE) is the oldest and perhaps the greatest classical text of Ayurveda.  It contains a vast amount of information on classical Ayurvedic herbal formulas.  Among them Chyavanprash is the most popular rasayana (rejuvenative tonic) formula in India today.  Like all traditional Ayurvedic formulas, the exact herbal combination can differ but most ingredients are the same.  At the end of Caraka’s description of the formula and how it is made he states “This is the famous “cyavanaprasa, an excellent rasayana.  Particularly it alleviates cough and dyspnoea, is useful for the wasted, injured and old people and promotes development of children.  It alleviates hoarseness of voice, chest diseases, heart disease, vatarakta, thirst and disorders of urine and semen.  It should be taken in the dose which does not interfere with the food (intake and digestion).  By using this (rasayana) the extremely old Cyavana regained youthful age.  If this rasayana is used by the indoor method, even the old attains intellect, memory, luster, freedom from diseases, longevity, strength of senses, sexual vigour, increased agni (digestion and metabolism), fairness of complexion and carmination of wind.  One, shedding the form of the old age, puts on that of the fresh youth.”(5)

     Charaka described over two dozen poly-herbal formulas that include Guduchi and that are used for a wide variety of ailments.  One un-named rasayana formulation is  stated  “If this formulation is used regularly for three years, the person attains a life-span of hundred years free from old age, acquires knowledge, his diseases are alleviated, poison becomes ineffective in his body which is rendered firm as stone and he becomes invincible foe the organisms.  Another was described as an “intellect-promoting rasayana drug”.  He states “…these rasayana drugs are life-promoting, disease-alleviating, promoters of strength, agni, complexion, voice and are intellect-promoting.” (5)

    He described a number of anti-pyretic formulas.  For chronic fevers, cold fevers, relapsing fevers and “certain fevers”.  One anti-pyretic formulation has these stated qualities “These extracts are antipyretic appetizer, digestive for dosa and alleviate thirst, anorexia and distaste of mouth.”  Two were to be used specifically for all types of prameha. There was also one for edema in vata combined with pitta. (5)

    A formulation Caraka called fifth alkali, “taken by those suffering from piles caused by kapha and vata, grahani disorder and anemia.  This alkali is an excellent promoter of agni and alleviates splenomegaly, retention of urine, dyspnoea, hiccup, cough, worms, fever, wasting, diarrhea, edema, prameha, hardness in bowels, cardiac pain and all kinds of poison.  After the drug is digested, the patient should eat with sweet meat-soups or milk.” (5)

     A medicated ghee called Guducyadi ghrta “alleviates gulma, dyspnoea, wasting and cough.  Guducyadi ghrta is mentioned in the Susruta Samhita where Susruta states “…would be attended by good results in cases of consumption, asthma, cough and chronic fever”.  One un-named formulation  “kept for whole night in water should be given to alleviate thirst and erysipelas”.   He also described one for disorders of the female genital tract and another for kaphaja vomiting.  And yet another formula for “vata vitiated … trembling of head” (5)
    The formula Amrta taila lists Guduchi as the main herb.  Caraka writes “This oil known as”amrta taila”is one of the best oils” “It brings back to normalcy the persons with diminished energy, agni and strength and confused mind and suffering from insanity, restlessness and epilepsy.  It is an excellent alleviator of vatika disorders.”  “This is delivered by the teacher Krsnatreya and is honoured by physicians.”   For Vrsamuladi taila he states “this oil should be used in patients broken and shattered by (disorders of) vata.”  Another oil has different qualities “This known as “Mulaka taila” (oil prepared with roots) alleviates spleen enlargement, retention of urine, dyspnoea, cough and vatika disorders and promotes complexion, life span and strength.” (5)
    Caraka thinks highly of Amrtadya taila.  “This oil when prepared is useful in all ways in vatarakta, wasting due to chest wound, afflicition by overload, deficiency of semen, trembling, convulsions, fractures and diseases generalized or localized.  This known as “Amrta” is the best among oil and alleviates diseases of female genital track, epilepsy, insanity, limping and lameness and makes delivery of fetus easy.” (5)

    Lastly, Caraka described a number of formulas for unctuous and non-unctuous enemas.  For one called Erandabasti  he states “Is appetizer and reducing and alleviates pain in shanks, thighs, feet, sacrum and back; covering by kapha, obstruction of vayu, retention of feces, urine and flatus, colic pain, tympanitis, calculus, gravels, harness of bowels, piles and disorders of grahani.”  Another un-named enema is stated “This oil used in forms of intake, massage and unctuous enema alleviates quickly the disorders of skin, worms, prameha, piles, disorders of grahani, impotency, irregularity of digestive fire, excrement and three dosas.  This unctuous enema provides strength to those wasted due to disease, physical exercise, evacuative measures and wayfaring, debilitated, devoid of ojas and having diminished semen.  Moreover, it gives good firmness to feet, shanks, thighs, back, shoulder and waist and virility to sterile women and men.”  One un-named formula is described as “for heart, bladder, head…used as urethral douche or non-unctuous enema in a person evacuated, uncted and fomented alleviates pain in bladder and other urinary disorders.” (5)

    Caraka’s last un-named unctuous preparation is described as an excellent aphrodisiac   “This is excellently beneficial for man enjoying women excessively having diminished semen, suffering from chest would, wasting and intermittent fever and for women having disorders of genital track, sterility, accumulation of menstrual blood, dead progeny and amenorrhea and for those having deficiency of muscle and blood.  It is excellent rasayana and destroyer of wrinkles and graying of hairs.” (5)

Modern Research
    While a lot of preliminary research has been done, science has just scratched the surface on the potential effects of Tinospora cordifolia in the human body.  Most research has been done in test tubes (in vitro) or in animals (in vivo) and has yielded some impressive results.  A large variety of chemical constituents have now been isolated from Tinospora cordifolia.  The major isolated compounds belong to a variety of classes such as alkaloids, diterpenoids lactones, glycosides, steroids, sesquiterpenoids, phenolics, aliphatic compounds, and polysaccharides.  The leaves have also been found to be abundant in protein and fairly high in calcium and phosphorous. (3, 4, 6, 8, 11, 13)

    The usefulness of Tinospora cordifolia as a cognitive enhancer has been substantiated by some research.  For example, healthy volunteers were given an aqueous extract for three weeks in a double blind study.  They were found to have a significant increase in test scores for logical memory and verbal memory.  A study gave aqueous and alcoholic extracts to normal and cyclosporine induced cognition deficient rats.  Tinospora cordifolia not only enhanced the cognition in normal rats but also in the rats treated with cyclosporine. (4, 14, 15)

Guduchi has been studied for its hypoglycemic actions.  Crude ethyl acetate, dichloromethane (CDM), chloroform and hexane stem extracts of Tinospora cordifolia was studied for inhibition of the alpha glucosidase enzyme.  The enzyme was inhibited by Tinospora and the hyperglycemic increase was decreased by 50% in normal animals and 58% in diabetic animals.  Another study used an aqueous extract of Tinospora cordifolia to test insulin resistance and oxidative stress in rats.  Tinospora cordifolia treatment prevented the increase in glucose by 21.3%, insulin by 51.5%, triglycerides by 54.12%, and glucose-insulin index by 59.8 of the rats fed fructose without the addition of Tinospora extract.  Also, Tinospora cordifolia treatment was effective in preventing the fructose-induced abnormalities in the liver involving lipid peroxidation, protein carbonyl groups, GSH levels, and enzymatic antioxidants.  (4, 21, 22)

    Tinospora supplies protection against gamma irradiation in mice.  Administration of an alcohol stem extract to mice 1 hour before whole body gamma irradiation was shown to increase survival, prevent body weight loss, increase the number of colony forming unit counts in the spleen, restore total lymphocyte counts, increase impaired S-phase cell population and decrease irradiation induced micronuclei.  In another study an aqueous extract was used on mice before being exposed to gamma radiation.  The results showed various amounts of protection against the radiation through increased survival time and signs and symptoms of radiation sickness. (4, 11, 16, 17)

    Looking into the immune system’s response to tumors one study showed the activation of tumor associated macrophages in Dalton’s lymphoma, a spontaneous transplantable T cell lymphoma, in response to an alcohol extract of Tinospora cordifolia.  Another study by the same authors again found an increase in the count of tumor associated macrophages. The researches also found an increase in the number and myeloid differentiation of bone marrow hematopoietic precursor cells in mice bearing Dalton’s lymphoma.  Further research on it’s anti-tumor activities used  a methanol extract found that it increased the white blood cell count, maturation of bone marrow stem cells, and increased immune response as seen in macrophage activation, and plaque-forming spleen cells.  The reduction in solid tumor growth was significant. (4, 18, 19, 20)

Guduchi has been one of the most versatile and important herbs in the Indian sub-continent since ancient times.  An enormous amount of knowledge has been accumulated by thousands of years of direct observation and trial and error.  In our modern era, impressive research has been done on the biological activity and possible application of Guduchi and its chemical constituents.  Guduchi may have been favorably used for thousands of years but modern herbal pharmacology appears to have just begun to appreciate “the one who protects the body”.

 

Works Cited
1.    Nadkarni K. M., Nadkarni A.K. (Eds) Indian Materia Medica (3rd ed) Vol. 1. Mumbai:Popular Prakashan Private Limited  pp. 356-365, 1220-1221
2.    Pandey G. (2002) Dravyaguna Vijnana (2nd ed) Vol. 1. Varuanasi: Krishnadas Academy pp. Vol. 1 pp.697-710
3.    Tinopsora.  http://www.drugs.com/npp/tinospora.html
4.    Krishna K., Jigar B., Jagruti P. (2009) Guduchi (Tinospora cordifolia): Biological and Medicinal properties, a review. The Internet Journal of Alternative Medicine Vol.6 Num.2 pp.1-10
5.    Caraka (2008) Caraka Samhita (Sharma P. Ed. and Trans.) Varanasi: Chaukhambha Orientalia Vol.1 pp. 9-11, 23, 71-73, 79, 85, 120, 121, 191, 266, 267, 316, 339, 427, 431, 449, 464, 477, 478, 496, 607, 610, 615, 616, 678. Vol. 2 pp.15, 21, 26, 28, 29
6.    Premila M.S. (2006) Ayurvedic Herbs: A clinical Guide to the Healing Plants of Traditional Indian Medicine. New York: Haworth Press  pp. 69-76, 175, 176
7.    Frawley D., Lad V. (2001) The Yoga of Herbs. Wisconsin: Lotus Press.  Pp. 242-243
8.    Williamson E. M. (Ed) (2002) Major Herbs of Ayurveda. London: Elsevier Science Limited  pp. 302-305
9.    Pole S. (2006) Ayurvedic Medicine: The Principles of Traditional Practice.  Philadelphia: Churchill Livingstone  pp.189-190
10.    Frawley D. (2000) Ayurvedic Healing. Wisconsin: Lotus Press pp.154, 158, 168, 266, 270, 282, 286
11.     Evaluation of a New Class 1 Substance, Tinospora cordifolia (Guduchi) (2006 September) IJEACCM 03 Item 3.2.4
12.      Ghishagratna K. K. (2003) Susruta Samhita (Dwivedi L. Ed.) Varanasi:Chowkhamba Sanskrit series Office.  pp.360
13.    Singh S. S., Pandey S.C., Srivastava S., Gupta V.S., Patro B., Ghosh A.C. (2003) Chemistry and Medicinal Properties of Tinospora Cordifolia (Guduchi). Indian Journal of Pharmacology .  pp.83-91
14.     Bairy K.L., Rao Y., Kumar K.B. (2004) Efficacy of Tinospora cordifolia on Learning and Memory in Healthy Volunteers: A Double-Blind, Randomized, Placebo Controlled Study. Iranian Journal of Pharmacology and Therapeutics. July Vol.3, No.2. pp.57-60
15.    Agarwal A., Malini S., Bairy K.L., Rao M.S. (2002) Effect of Tinospora cordifolia on Learning and Memory in Normal and Memory Deficit Rats. Indian Journal of Pharmacology. Pp.339-349
16.    Goel H.C., et al. (2004) Radioprotective Potential of an Herbal Extract of Tinospora cordifolia. Journal of Radiation Research. Vol.45 No.1. pp.61-68
17.    Pahadiya S., Sharma J. (2003) Alteration of lethal effects of gamma rays in Swill albino mice by Tinospora cordifolia. PubMed
18.    Singh S.M., Singh N., Shrivastava P. (2006) Effect of alcoholic extract of Ayurvedic herb Tinospora cordifolia on the Proliferation and Myeloid Differentiation of Bone Marrow Cells in a Tumor-bearing Host.  Fitoterapia. Vol.77 Issue 1. pp.1-11
19.    Singh N., Singh M.S., Shrivastava P. (2005) Immunomodulatory and Antitumor Actions of Medicinal Plant Tinospora cordifolia are Mediated Through Activation of Tumor-Associated Macrphages. Immunopharmacology and immunotoxicology, Vol. 26 pp.145-162
20.    Mathew S., Kuttan G. (1999) Immunomodulatory and antitumor activities of Tinospora cordifolia. Fitoterapia. Vol.70 Issue1 pp.35-43
21.    Chougale A.D., Ghadyale V.A., Panaskar S.N., Arvindekar A. U. (2009) Alpha glucosidase inhibition by stem extract of Tinospora cordifolia. Journal of Enzyme Inhibition and Medicinal Chemistry Vol. 24 PP.998-1001
22.    Reddy S.S., Ramatholisamma P., Karuna R., Saralakumari D. (2009) Preventive effect of Tinospora cordifolia against high-fructose diet-induced insulin resistance and oxidative stress in male Wistar rats. Food Chem Toxicology 47(9) pp.2224-2229

 

Triphala: Ayurvedic Formula for the Modern World (by Rodrigo M. Pocius C.A.S)

See PDF document.

Turmeric: “The Golden Goddess” (by Lisa Gallant C.A.S)

Introduction

Within the cornucopia of medicinal plants, few possess such a wide spectrum of qualities and medicinal uses as turmeric. For countless centuries, many different cultures have used this wonderful, versatile herb to treat a myriad of diseases and ailments. The most well known medicinal action of turmeric is its use as a powerful anti-inflammatory, the effectiveness of which is comparable to pharmaceutical medicines. However, it also acts as an alterative, analgesic, antibacterial, anti-inflammatory, anti-tumor, anti-allergic, anti-oxidant, antiseptic, antispasmodic, astringent, carminative, cholagogue, digestive, diuretic, stimulant, and vulnerary 6,8,10 . Modern science is beginning to recognize and understand the amazing healing qualities of turmeric and much research is currently being conducted.

Turmeric has been proven effective in treating some of the most intense ailments afflicting the world today including: Arthritis, Cancer, Alzheimer's Disease, Diabetes, Multiple Sclerosis, Atherosclerosis, HIV/AIDS, Sexually Transmitted Diseases (Hepatitis-C, Genital Herpes) , Irritable Bowel Syndrome, Indigestion, Inflammation, Acne, Urinary Tract Infections, Kidney Infections, Gallstones, Anemia, Hemorrhoids, Liver Disease, Leprosy, Amenorrhea, Edema, Bronchitis, Common Cold, Headaches, Conjunctivitis, Bursitis, food poisoning, parasites, fever, diarrhea, poor circulation, lower back and abdominal pain. It can also be used as a mosquito repellent, wound healer, and immediate cure for scorpion stings. Turmeric helps balance the female reproductive and lactation systems, and in men it purifies and improves the health of semen. It is used to treat external ulcers that would not respond to other treatment 6,8,10 . Due to its vast array of medicinal purposes and versatility, turmeric is one of the most important herbs in any natural medicine cabinet.

The Latin name for turmeric is “Curcuma Longa”, which comes from the Arabic name for the plant, “Kurkum.” 10 It comes from the Zingiberaceae family (same as ginger) and in Sanskrit is called “Haridra”(“The Yellow One”), “Gauri” (“The One Whose Face is Light and Shining”),“Kanchani” (“Golden Goddess”) , and Aushadhi (“Herb”). It is called “Jiang Huang” in Chinese, and “Haldi” (“Yellow”) in Hindi, the most common name in India 6 . The healing properties of turmeric lie in the golden fingerlike stalk, or rhizome, the same part that is used to flavor, color, and preserve food. Turmeric is commonly found in Indian curries, giving the food a golden orange color. Turmeric has also been used as a dye for mustards, canned chicken broth, and pickles. It has been coded as food additive “E100” in canned beverages, baked products, dairy, ice cream, yogurts, yellow cakes, biscuits, popcorn, sweets, cake icing, cereal, sauces, gelatins, and also direct compression tablets. In combination with annatto, turmeric is used to color cheese, dry mixes, salad dressing, butter and margarine 3 . The brilliant color has also been used for dyeing silk and wool; the robes of Buddhist monks were traditionally dyed with turmeric 10 .

Turmeric is a native to South Asia , particularly India , but is cultivated in many warm regions of the world. It can be found growing extensively in all of India , but does especially well in the regions of Tamil Nadu, West Bengal , and Maharashtra 10 . It is also cultivated in Sri Lanka , Indonesia , China , Taiwan , Indochina , Peru , Haiti , and Jamacia. India is the largest producer in the world; Jamacia and Peru are the chief exporters, and Iran the largest importer. Other large importers are the United Kingdom , Japan , Canada , Sri Lanka , Singapore , and the Middle East 9 .

There are two main varieties of turmeric: one with hard, rich colored, oval rhizomes, called “Lokahandi Halad” that is used mostly for dying, and a variety that is softer, larger, lighter colored with long rhizomes used mostly for eating 8 . Turmeric became valuable to humans when it was discovered that the powdered rhizome preserved the freshness and nutritive value of foods. It was originally used in curries and other food to improve storage conditions, palatability, and preservation. Because of its preservation properties, turmeric played a vital role in survival and sustainability in South Asia , and was valued more than gold and precious stones 7 . However, turmeric was eventually replaced by cheaper, synthetic preservatives.

Turmeric was used much more extensively by the natives of India than today. Turmeric was highly valued by the ancient Indo-European people not only for its preservation properties, but for its energetic and spiritual qualities as well. The Arya culture was a group of people who worshipped the solar system and the sun as a deity. Turmeric was very sacred to them, due to its golden yellow color (like sunlight) and they believed it had special protective properties 7 . Remnants of this belief still exist today, particularly in South India , where some people wear a dried turmeric rhizome bead the size of a large grape around their neck or arm. This is an ancient talisman tradition used to ward off evil and grant to the wearer healing and protection 16 . People of ancient India believed that turmeric contained the energy of the Divine Mother, helped to grant prosperity, cleanse the chakras (energy centers in the body), and purify the channels of the subtle body 6 . Even today, Hindu people consider turmeric to have auspicious qualities, and use it in many sacred ceremonies. It is commonly made into a paste and applied to the forehead (ajna chakra or third eye) during pujas (devotional ceremonies) and weddings. During a traditional Indian wedding ceremony, the bridge and groom apply a paste of turmeric and sandalwood powder on each other's foreheads. Some women use it as a cosmetic, called “Kappumanjal” or rub it over their bodies as a detergent 8 . Traditionally, turmeric was also used to dye the marriage clothing. It was believed that any clothing dyed with turmeric was protection from fever. New clothes would sometimes be stained with a paste of turmeric, lime, and water. Today, magenta dye has become more popular 9 .

Turmeric and Ayurveda

Turmeric has been used for centuries in Ayurveda, the 5,000 year old natural healing system of India . It is called by 46 different synonyms, including: “pitta” (yellow), “gauri” (brilliant), and all words that indicate “night” 10 . This comes from a tradition of married women applying turmeric to their cheeks in the evening in preparation for a visit from Lakshmi (The Goddess of Prosperity) 7 . In Ayurveda, turmeric is believed to balance the three doshas (vata, pitta, and kapha). It has been used by Ayurvedic healers as medicine taken internally in the form of fresh juice, boiled tea, tinctures, or powder, and topically as creams, lotions, pastes, and ointments 1 . There are many ancient Ayurvedic formulas utilizing turmeric. Milk boiled with turmeric and sugar was a popular cold remedy and turmeric juice was used to help heal wounds, bruises, and leech bites. A paste made from turmeric, lime, and salt was commonly applied to sprains and inflamed joints 8 . Smoke made by sprinkling turmeric over burnt charcoal was used to relieve scorpion stings within a few minutes that the affected area is exposed to smoke. Inhaling the fumes of burning turmeric was also used commonly to release copious amounts of mucous and provide instant relief from congestion. The fumes also were believed to help in hysteric fits 8 . A pinch of turmeric was also used as an insect repellent in the kitchen 9 . A paste made of turmeric alone or with neem leaves was used for ringworm, itching, eczema, and any other parasitic skin condition 8 . The Charakra Samhita section on Therapeutics states that turmeric, black pepper, long pepper, and ox bile was a common remedy for consumed poison or snake bites, up until the last stage 15 . The Charakra Samhita also provides a traditional remedy for jaundice: turmeric, triphala, neem bark, bala, licorice cooked in milk and ghee of buffalo. If this did not work and there is “found residue of morbidity still lodged in the body”, inhalation therapy was indicated. Cigars were made from turmeric paste, cinnamon, castor plant root, lac, red arsenic, deodar, yellow orpiment, and nardus, smeared with ghee and smoked. Inhalation of the fumes of barley paste with ghee was also a treatment for jaundice 15 . Hemorrhoids (piles) were treated with an ointment of turmeric, hemp leaves, onions, and warm mustard oil or linseed oil, applied externally when the hemorrhoids are painful and protruding 8 . Pastes of turmeric were used for smallpox, chickenpox, shingles, ulcers, conjunctivitis, skin blemishes, malaria, and applied to the cut placenta after the birth of a child 8 .

Turmeric has hundreds of molecular constituents, each with a variety of biological activities. There are at least 20 molecules that are anti-biotic, 14 that are known cancer preventatives, 12 that are anti-tumor, 12 are anti-inflammatory and there are at least 10 different anti-oxidants 7 . One database presented over 326 known biological activities of turmeric 12 . The rhizome is 70% carbohydrates, 7% protein, 4% minerals, and at least 4% essential oils. It also has vitamins, other alkaloids, and is about 1% resin 7 . The active ingredient in turmeric is called “curcumin”, although in its raw state turmeric only contains 2-5% curcumin 4 . Curcumin is the substance that is responsible for the biological activity of turmeric. Combined with black pepper, curcumin becomes 2000 times more potent 4 . Curcumin is now extracted from turmeric, sold as supplements, and is the basis of most scientific research.

The active properties of curcumin are best called “protective properties”. The same components that prevent deterioration of food protect living tissue from degenerating, possibly extending the life span of our bodies 7 . Clinical and laboratory research indicates that diets that include turmeric or curcumin “stabilize and protect biomolecules in the body at the molecular level”, which is shown in its anti-oxidant, anti- mutagenic, and anti-carcinogenic action 7 . These components may work by protecting a person directly, by shielding the biomolecules, or indirectly, by stimulating the natural detoxification and defense mechanisms of the body: helping the body to heal and preserve itself naturally 7 . Current statistics show that 98% of all diseases are controlled by a molecule called NF-Kappa B, a powerful protein that promotes abnormal inflammatory response in the body. Excess of NF-Kappa B can lead to Cancer, Arthritis, and a wide range of other diseases. Studies show that curcumin subdues NF-Kappa B, meaning that it may work to prevent nearly all diseases afflicting our world today 4 .

Science and Turmeric

Scientists are beginning to realize the importance of turmeric/curcumin in treating modern disease. Much research has been conducted on the various effects of curcumin in the body; the most widely researched is that of its effects on Cancer. In both India and Pakistan , where curry/turmeric is a dietary staple, boast much lower incidence of cancer than in other countries where turmeric is not regularly consumed 2 . Turmeric is considered to fight Cancer in three ways: It neutralizes those substances and conditions which can cause cancer; It directly helps a cell retain its integrity if threatened by carcinogens (a substance showing significant evidence of causing cancer or growth of cancer cells); If a tumor does grow the curcumins can often destroy it 13 . There are many reasons why turmeric helps to destroy Cancer. One of the keys to this activity is the ability of curcumin to inhibit the enzyme Topoisomerase, which is required for the replication of cancer cells. “Topoisomerase works within the nucleus of the cell, where it first binds to supercoiled DNA and then catalyzes the passage of one DNA helix through another via a transient double-stranded break. This splits the DNA and thus allows cell replication to occur. Stopping Topoisomerase stops replication which stops the spread of the problem 13 .”

Curcumin is also one of the most studied natural COX-2 inhibitors, which block an enzyme called cyclooxygenase-2. This is beneficial because the COX-2 enzyme helps make carcinogens more active in the body and allows cancerous cells to survive by growing new blood vessels 2 . In essence, curcumin completely blocks the formation of cancer causing enzymes, decreasing the likelihood of cancerous cell formation or growth. Curcumin is also rich in antioxidants, which are important disease fighting substances that help to clean up unstable oxygen molecules (free radicals) that can damage cells and cause diseases such as Cancer. Other antioxidants and COX-2 inhibitors are red grapes, green tea, rosemary, and bee propolis 2 .

Even when using more allopathic methods to treat cancer, turmeric/curcumin still helps to increase the effectiveness and decrease some of the side effects of cancer treatments. Current research suggests that including curcumin in the diet during the “initiation and or post initiation periods” of cancer significantly suppresses the development of chemically induced tumors 13 . In summary, research is showing that curcumin may be more effective treatment for cancer in the beginning phases of the disease, as well as preventative treatment throughout life before cancer even emerges. A study performed in 1992 on 16 cigarette smokers who took 1.5 g of turmeric a day for 30 days had much lower mutagenic levels in their urine than those who did not include turmeric in their diet 1 . Mutagens are substances that cause cell mutation and increase the occurrence of cancer. There is, however, some new research suggesting that taking curcumin may counteract the effectiveness of chemotherapy. Thus, many cancer treatment programs are developing a periodic schedule of use to avoid any issues 13 .

“We have not found a single cancer on which curcumin does not work”, states Dr. Bharat Aggarwal, who conducts cancer research at the Jawaharlal Nehru Centre for Advanced Scientific Research in Bangalore , India 4 . Ayurveda especially recommends turmeric for cancers of the female reproductive system, specifically breast and uterine cancer, and to treat benign tumors as well 11 . Although the current research looks promising, there have been very few long term tests performed on large quantities of humans. Turmeric was recently nominated by the National Cancer Institute for more study so we can look forward to many more research findings in the future.

Turmeric is also a powerful anti-inflammatory herb. It has been shown to be helpful in the treatment of Arthritis, Rheumatoid Arthritis, Osteoarthritis, injuries, trauma, and stiffness from both under activity and over activity 10 . It is also helpful after surgery to decrease pain, inflammation and accelerate healing. One study conducted in 1986 showed that a dosage of 1200 mg of curcumin a day was more effective in reducing post-surgical inflammation than either the placebo group or anti-inflammatory medication normally prescribed 5 . In India , turmeric is considered the standard anti-inflammatory, and yogis use it to help keep their tendons and ligaments free from injury and to assist in their asana practice 6 . In the same way, it minimizes pain and inflammation related to any kind of exercise or strenuous activity. Majeed states: “Perhaps Turmeric's most important anti-inflammatory mechanism centers on its effects on the Prostaglandins (PGs), a large family of potent lipids produced by the body. PG1 and PG3 calm the body while PG2 inflames the body. Turmeric is a potent inhibitor of cyclooxygenase 5-lipoxygenase and also 5-HETE production in neutrophils. Reducing these enzymes means less arachidonic acid metabolism, which means less PG2, which means less pain and inflammation 7 .” Some sources suggest that turmeric/curcumin is most effective for acute inflammation, and not for chronic 1 . Many sources recommend turmeric for Arthritis but the scientific evidence is still unclear and much more research is underway.

Turmeric also has a special action to purify and nourish the blood and skin. External application stops pain and swelling, heals wounds rapidly, and treats many skin diseases ranging from acne to leprosy. The classic way to apply turmeric topically is as an “Ubtan”: a blend of turmeric, chick-pea flour, sesame or almond oil, a little fresh cream and honey. This will clear up skin blemishes, and increase the natural glow and radiance of the skin 16 . Turmeric essential oil works wonderfully as an external antibiotic to prevent infections in wounds. A nice formula for a wound healing salve is a mixture of olive oil, beeswax, tea tree oil, aloe, turmeric, arnica, slippery elm, red clover, thyme oil, and vitamin E 9 . Since turmeric is bitter and anti-inflammatory, it is excellent for hot skin diseases, red rashes, and especially wet eczema 16 . Turmeric essential oil, mixed with citronella, tulsi, and vanillin, works as a powerful insect repellent, and is a natural alternative to D.E.E.T, the most common chemical insect repellent commercially available. Studies show that D.E.E.T. is extremely toxic, hazardous to the environment, and actually kills plant and insect life that it contacts 3 .

Turmeric also protects the liver from toxins and pathogens. It is known to both destroy m toxins in the liver, and to rebuild the liver after a toxic attack 16 . Turmeric increases the secretion and movement of bile, and may prevent all forms of liver disease. Excessive use of drugs and/or alcohol can tax the liver and lead to liver diseases 16 . One study shows that curcumin blocks some of the harmful side effects of cigarette smoke, and prevents dangerous chemical formation after eating processed food 11 . It is also helpful in treating food poisoning. Traditionally, about 5 grams of Turmeric is taken with a glass of whey, morning and evening, for a month to activate and rebuild a liver 8 . Another good liver remedy could be based on Turmeric, Kutki root, and Milk Thistle seeds. In essence, turmeric helps keep the liver healthy so it can do its job of keeping the body detoxified.

Ayurveda uses turmeric to purify and move the blood, as it is a wonderful alterative. It helps to remove stagnant blood while stimulating the formation of new blood tissue 6 . Turmeric regulates menses, and decreases the intensity and pain of menstrual periods, and of uterine tumors. Turmeric is a mild and supportive uterine stimulant and its many actions on the liver suggest that it may assist in balancing hormone levels as well 16 .

Turmeric also plays a role in pregnancy and birthing in India . Traditionally, it is said that taking turmeric when pregnant will ensure that the child will always have beautiful skin 16 . (However, turmeric is a mild uterine stimulant, so there is a chance of over stimulation; it is essential to consult a healthcare practitioner before taking any herbs during pregnancy.) Turmeric taken in the last two weeks of pregnancy in warm, organic milk helps to expedite a simple birth, while increasing the health of the mother and child as well. Turmeric is also an analgesic (pain reliever) and is sometimes used in natural childbirth to decrease pain 16 .

Turmeric also has a special action to help the entire Gastro-Intestinal system by increasing intestinal flora and generate healthy digestion 6 . It is traditionally used for weak stomachs, poor digestion, dyspepsia, parasites, abdominal cramps, to normalize metabolism, to help digest protein and breakdown of fats, to increase absorption, and the ability of the stomach to withstand digestive acids 6 . Turmeric is also a carminative: it helps to decrease gas and distention. According to Ayurveda, plants that treat digestion are often the most important herbs of all since digestion is the basis of mental and physical health. Prashanti de Jager states, “Turmeric is one of the best carminatives because though it leans towards being heating-pungent, it is very balanced and does not aggravate any of the doshas if taken in normal amounts, a few grams per day 16 .” As a vulnerary it also helps to nurture and heal mucous membranes; it has a strong protective effect against food and materials that are corrosive to the stomach and intestines as from food poisoning. In a 1989 double blind study (the participants and researches did not know which groups were taking the herb or the placebo) conducted in Thailand , 500mg capsules of curcumin were given to 116 adults suffering from indigestion at six different hospitals. Stunning results showed that 90% of those taking the curcumin felt full or partial relief after seven days, while 53% of the placebo group felt relief 1 .

Another major use of turmeric is support of the respiratory system. As an anti-oxidant it protects the lungs from pollution and toxins. It also helps the oxygen transfer from the lungs to the blood. Turmeric with ghee is traditionally used to get rid of cough and to treat asthma 8 . It also supports the heart in many ways. A study conducted in 1992 shows that turmeric may assist in lowering cholesterol and prevent Atherosclerosis (blockage of arteries that can cause heart attack and/or stroke) 12 . Animal studies have shown that turmeric lowers cholesterol levels and inhibits the oxidation of LDL (“bad cholesterol”, responsible for clogging of arteries). When LDL becomes oxidized, it creates deposits in the walls of blood vessels and contributes to the formation of arteriosclerosis. Turmeric may also prevent platelet buildup along the walls of injured blood vessels, another common cause of blood clots and artery blockage that can result in heart attacks and strokes 12 .

Studies are also underway regarding turmeric's believed effects in treating and preventing neurological diseases such as Multiple Sclerosis and Alzheimer's Disease. This belief generates from the realization that elderly Indian people who eat turmeric on a regular basis are far less likely to develop these ailments than those who do not eat turmeric. In fact, Alzheimer's Disease is 4.4 times less common among older adults in India than in the United States 4 . It has been noted that people taking anti-inflammatory medication for Arthritis are less likely to develop Alzheimer's Disease 1 . Since turmeric possesses such a powerful anti-inflammatory action, scientists speculate that it most likely will have a preventative effect on such disorders. More research is needed in this area to prove such theories.

New research also suggests that turmeric may play a vital role in fighting HIV/AIDS, particularly HIV, Type 1 10 . In a recent study at the Jawaharlal Nehru Centre for Advanced Scientific Research in Bangalore , India , when scientists 'fed' curcumin to HIV-infected cells in the laboratory, the virus stopped replicating 17 . Several studies have shown that people who have HIV and AIDS are deficient in many antioxidant vitamins and minerals, and it is believed that it is the powerful antioxidant properties of turmeric that combat the disease 17 . "Curcumin's antioxidant properties will protect your DNA from the ravages of the virus. It's also antimicrobial, so it will help prevent the many opportunistic illnesses associated with HIV and AIDS," says Dr. Susan Kowalsky, N.D., a naturopathic doctor in Norwich , Vermont 18 . In a study at Harvard Medical School , research showed that curcumin prevented the reproduction of HIV by blocking a specific gene that activates the virus and causes it to spread. Another study showed that it may help decrease the reproduction of HIV 18 . This is a currently major topic of research, so we can look forward to updates in the near future.

Turmeric can obviously stand the test of time. It has been worshipped, reveled and revered by people for centuries, and still today it is one of the most significant players in the prevention of serious disease as well as the general afflictions of living. Much more research is underway to prove scientifically what the ancient people of India have known for centuries: that turmeric is one of the most powerful plants on the planet. Whether suffering from an acute or chronic disease, aches and pains, bumps and bruises, or as preventative maintenance, turmeric can and should be utilized by everyone on a regular basis. In the words of David Frawley: “If I had only a single herb to depend upon for all possible health and dietary needs, I would without much hesitation choose the Indian spice turmeric 16 .” Without a doubt, this writer feels exactly the same.

References

1. Whole Health MD.com , Article: “Turmeric”.

http://www.wholehealthmd.com/refshelf/substances_view/1,1525,10062,00.html

2. Whole Health MD.com , Article: “Cancer Fighters in Your Spice Rack,” 3/21/2001 .

http://www.wholehealthmd.com/news/viewarticle/1,1513,844,00.html

3. The Wikipedia Encyclopeida

http://en.wikipedia.org/wiki/Turmeric

4. Sundaram, Viji. Article: “Don't Go Easy on Turmeric: It Prevents and Cures Cancer”: India-West , 2005

5. HealthNotes , Article: “Turmeric”, 2002.

http://www.drugstore.com/templates/hnotes/default.asp?catid=41779&aid=33...

6. Frawley, David & Vasant Lad, The Yoga of Herbs . Lotus Light Publications, 1993.

7. Majeed, Muhammed; Vladimir Badmaev; Uma Shivakumar; R.Rajendran, eds., Curcuminoids ; antioxidant phytonutrients. NutriScience Publishers, Inc, 1995.

8. Nadkarni, K.M., The Indian Materia Medica. Bombay Popular Prakashan, 1976.

9. Kaushik, Purshotam, Haridra (Turmeric): Antibacterial Potential . Chowkhamba Sanskrit Series Office, Varanasi , 2003.

10. Williamson, Elizabeth , ed., Major Herbs of Ayurveda. Churchill Livingstone, 2002.

11. Pook, Sally, “ Curries May Help to Combat Cancer”. Article: news.telegraph.co.uk

12. University of Maryland Medical Center , Article: “Turmeric”.

http://www.umm.edu/altmed/ConsHerbs/Turmericch.html
13. Cancer Research , Article: “Chemopreventive Effect of Curcumin , a Naturally Occurring Anti-Inflammatory Agent, during the Promotion/Progression Stages of Colon Cancer ” Cancer Research 59, 597-601, February 1, 1999 .

14. Cole GM , Lim GP , Yang F , Teter B , Begum A , Ma Q , Harris-White ME , Frautschy SA . “Prevention of Alzheimer's disease: Omega-3 fatty acid and phenolic anti-oxidant interventions.” Neurobiol Aging. October 30, 2005 .

15. Dash, Bhagwan and R.K. Sharma, Caraka Samhita . Chowkhamba Sanskrit Series Office, Varanasi ,India , 2001.

16. Prashanti de Jager, Article: “Turmeric: The Ayurvedic Spice of Life”, 2003.
17. SciDev.net , Article: “Turmeric can Combat malaria, Cancer Virus, and HIV”. March 6, 2006 .

http://www.scidev.net/news/index.cfm?fuseaction=printarticle&itemid=1987...

18. Mother Nature.com, Article: “HIV and AIDS”. http://www.mothernature.com/Library/Bookshelf/Books/23/102.cfm

19. Pub-Med, Article: “In Vitro and in Vivo Anti-Tumoral Effect of Curcumin Against Melanoma Cells.” http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dop...

Better Known as Turmeric By: Ivy Cannon

Ayurvedic nutrition and diet: an ancient traditional perspective

Healthy Digestion - Healthy Body!

According to Ayurveda, the traditional medicine of India, the digestive system is the physical root of most diseases in the body. In other words, as disease develops, its early signs are often seen as digestive problems. Gas, constipation, diarrhea, indigestion and bloating are all considered to be warning signs of future problems that are more serious. If the digestive system is properly cared for many diseases can be averted and diseases that are present have a better chance of healing. Ayurveda places a lot of emphasis of the care of the digestive system. In doing so, Ayurveda addresses not only what food is best for an individual but how food is eaten and how it is combined. If proper food is taken and it is taken in the proper manner most digestive problems go away. For those that do not, Ayurveda utilizes herbs to normalize the function of the digestive system. How do you know if you have digestive problems that may cause future challenges? Most of the signs are obvious. If you have gas, bloating, constipation, diarrhea or cramping you have mild but important signs of imbalance. If you have been diagnosed with irritable bowel syndrome, ulcers, ulcerative colitis, diverticulitis or GIRD (gastrointestinal reflux disorder), your challenges are more serious but can still be helped. The knowledge of Ayurveda is important to the correction all digestive imbalances. Proper digestion begins not with what you eat but how you eat! Here are five simple but important guidelines to assure that your digestion is optimal. 1. Begin meals with a moment of relaxation or grace: When the body is relaxed and focused on the food, digestive enzyme secretion is maximized. 2. Eat in a calm environment: When the mind is involved in drama and emotion, digestion is disturbed. Turn off the TV, don't discuss intense issues at the dinner table and avoid eating while driving in the car. 3. Chew your food well: Digestion begins with chewing. Proper chewing allows enzymes in the saliva to begin the digestive process. Food should be chewed until it is an even consistency. 4. Eat until you are satisfied, not till you are full: Overeating is one of the major causes of digestive upset and subsequent disease in Western countries. The surest way to extend life for most people is to eat less! It is important to learn the difference between genuine hunger and the desire for pleasure through taste. 5. Rest before going on to the next activity: For optimal digestion, it is important to rest after eating. Failure to rest means that the body's physiology will switch away from digestion and toward the activity of the muscles of the body. This leaves poorly digested food in the digestive system. It is best to wait at least 20 minutes before going on to the next activity. Simply eating food properly will alleviate a lot of chronic digestive problems there by preventing more serious disease. When this is combined with a healthy diet, the effect is even more dramatic and almost all digestive problems disappear. Ayurveda teaches that the best diet is the one that is proper for a person's constitution, or unique balance of body energies. People with a more vata nature or those who suffer from constipation and gas tend to need more cooked foods taken with some oil and spices, including salt. It may come as a surprise to find that raw salads can cause more gas. Those with a more pitta nature or those who suffer from burning indigestion and loose stools need to eat more raw foods and take food that is less spicy and less oily. Deep fried foods are the worst food for people with pitta imbalances. Those with a kapha nature or those who tend to feel heavy and sluggish and sometimes get nauseous after eating require food that is dry, light and spicy. People with a kapha nature thrive as vegetarians. What food should you eat? Ayurveda teaches that everyone is a unique individual. Nothing is right for everyone but everything is right for someone. Ayurveda is a path of finding out what is right for you. For the best personalized dietary plan, consult a Clinical Ayurvedic Specialist. In addition to supporting dietary and lifestyle changes, your Clinical Ayurvedic Specialist may design individualized herbal formulas to give your digestive system and the rest of your body its best chance of getting well.

The Annavaha Srota - A Closer Look

Please see Attachment

Principles of Ayurvedic Nutrition

Ayurveda is based on the belief that nothing is right for everyone and everything is right for someone. This belief comes from an understanding that each of us is unique. Simply put, each of us is biochemically different with different hormonal, enzyme levels and neurotransmitter levels. Each person reacts to the world in different ways. If we are all different, why would we even consider the idea that there must be one program of nutrition that is best for everyone? Where did the idea come from?

The United States Department of Agriculture publishes daily recommended allowances of vitamins and minerals. For decades people have taken these guidelines as the “bible” and carefully read food labels to understand how much of each nutrient they are getting. The American Heart Association also publishes recommendations for the amount of fruits, vegetables, grains and dairy people should consume. People routinely use these guidelines to see how they measure up. These guidelines are based upon statistical models of the “average American” and research based in “current science.”

The problem with statistical models is that the average American is a myth found only in statistical research papers. In real life, individual needs can vary significantly. Meanwhile, current science is simply the best conclusion that can be made given available data. The problem with “current science” is that it is quickly outdated and never complete as new information is constantly being gathered. What is accepted as the truth today is often found to be wrong tomorrow. A good case in point is the intake of cholesterol. While America has become obsessed with lowering cholesterol intake, studies published over the last couple of years in the prestigious British Medical Journal reveal that low cholesterol numbers, while protecting against cardiovascular disease, seem to increase the risk of certain cancers. In addition, supplements and herbs once thought to be “quackery” are now observed to have complex biochemical interactions beneficial in a wide variety of conditions.

What should a person do? There are many ideas on the bookshelves about how to eat and stay healthy. There are diets named after the people who wrote the books, diets named after the foods eaten, diets named after blood types and diets that promise to keep you in the “zone”. New books and ideas are published every month. Ayurveda is a 5000 year old science that aims to help a person understand what is right for them as a unique individual. By evaluating how a person’s digestive system, nervous system and other systems of the body function and by evaluating a person’s body structure, a Clinical Ayurvedic Specialist designs a diet specific to clients needs.

Ayurvedic Medicine teaches that people who have a “vata” nature, or those people who are thin, dry and often feel cold, need more grains, oils, salt and a little spice in their diet. Those who do not receive enough are prone to anxiety, constipation and sleeplessness among many other conditions. They need nourishing foods and often have difficulty maintaining a vegetarian diet. People of vata nature should avoid too many salads and fruits as well as beans and take in more grains, dairy and nuts.

People of “pitta” nature, or those who tend to be warm and have a more intense and highly focused nature, are understood to need more raw vegetables and food which are only mildly spiced. Hot, spicy food is believed to lead to a greater incidence of skin rashes, liver weakness and anger. Large salads are wonderful.

People of “kapha” nature, or those who tend to be overweight or stocky and often move and speak very slowly, benefit from lighter foods such as vegetables and salads and thrive on hot, spicy foods. If sweet, heavy, oily foods are taken in too great of a quantity it can lead to greater mucous accumulation as well as further weight gain and diabetes mellitus. People with a kapha nature should avoid all sweets, dairy and nuts and most grains such as wheat and rice. However, grains such as quinoa and millet can be taken.

Nothing is right for everyone, everything is right for someone. Ayurveda avoids the “everybody must” dogma in favor individually tailored food programs to meet the needs of individuals. With a proper diet and lifestyle, Ayurveda’s goal is to help each person reach their maximum potential, physically, emotionally and spiritually.

Simple Ayurvedic Food Tips for Each Dosha

 

Vata

Pitta

Kapha

Best Foods

Cooked grains, butter, dairy, nuts, cooked vegetables

Raw Salads, cooked grains, milk, seeds

Salads, cooked vegetables, spicy foods, quinoa, millet, corn flour and buckwheat

Worst Foods

Raw salads, fruits, beans

Hot, Spicy foods, sour foods, deep
fried foods, fermented foods such as yogurt and vinegar.

Dairy, meat, cheese, nuts, wheat and rice

Fats and Oils - Has Science Gone Astray?

Fats, the long time enemy of those who want to prevent heart disease, is getting a second look in light of new evidence that reveals that fats may play an important role in the prevention of some cancers. Recent research published in the British Medical Journal has revealed that while low levels of fats protect us against heart disease, they may also increase our susceptibility to certain kinds of cancers. Another study revealed that milk fats contain substances protective toward our bodies which prevent some cancers from forming. In light of this new research, it is important that each person reassess their attitudes toward fats and oils.

Cardiovascular disease (CVD: heart disease and strokes) is the number one killer in the United States. Each year it kills more than twice the number of people as all cancers combined. Modern methods of nutrition have focused on the prevention of this group of diseases though diet and exercise. A diet low in saturated fats and cholesterol has been the cornerstone of prevention. Repeated studies have concluded that lower blood cholesterol levels and trygylcerides (circulating fats) reduce the incidence of these conditions. In addition, it has been shown that exercise also lowers their incidence in part through raising HDL and Lowering LDL. (HDL and LDL are often called good and bad fats; they are proteins that carry fat within the body).

The new research showing that lower fat levels may increase the incidence of some cancers should not come as a great surprise. Fat has always been known to play an important role in the body, particularly in the production of all cell membranes, many hormones, the sheaths that surround nerves, and the oils that keep our skin healthy. Those who receive too little fat in their diet are more likely to suffer from a multitude of conditions including hormonal imbalances, brittle hair and nails, dry skin and Raynaud's disease (cold, painful sensations in the fingers, toes, ears and nose due to vasospasm of the small vessels.).

It would be wrong to conclude that fat is either absolutely good for us or absolutely bad for us. Perhaps this is why there has been so much confusion and disagreement among the experts. Effective arguments can be made for either point of view. Dean Ornate, MD, well received as an expert in nutrition, advocates very low fat diets as being optimal for preventing and reversing, heart disease. Another recognized expert, Robert Atkins, MD, blames heart disease on high carbohydrate diets and advocates low carbohydrate, high protein diets. He does not recommend restricting fat. Could both experts be right? Perhaps, future research will try to answer an as yet, unasked question. Could higher levels of fat be good for some people and harmful for others? If so, who would fall into each category?

Ayurvedai, the traditional healing system from India, is based upon the understanding that each person is an individual with unique nutritional needs. Ayurveda teaches that those people of vata nature, who are lighter, thin boned, have narrow faces and thin, scanty hair, dry skin and a nervous or anxious nature benefit from extra fats and oils in their diet. In fact, according to Ayurveda, the oils reduce their risk of cardiovascular disease. Meanwhile, those of a more pitta nature, who have a moderate build, focused, intense, deep set eyes and early graying of the hair and those of kapha nature (stocky, dense bones, short necks, round faces, generally calm and relaxed) become unhealthy when exposed to too much fat. Those of a kapha nature are understood to be the most susceptible to traditional risk factors of cardiovascular disease. Increased body weight is a known risk factor of CVD and kapha individuals having a slower metabolism are often overweight.

With all of this conflicting information, what is a person to do? I am reminded of the wise words of the great rishi (mystic) Patanjali in the Yoga Sutras. In summary he says, "...take only those foods which are pure and produce a clear mind. Take them all in moderation." Moderation is the best choice for the general community.

If you are very thin, do not fear fats, they are your friend. As Ayurveda teaches, they may reduce your risk of CVD and also of other conditions such as anxiety. It is best to take healthy fats from naturally occurring sources such as vegetable oils, nuts, milk and eggs. Oils such as olive, sesame and ghee are the best as they are somewhat heavy oils. They have a moderate percentage of saturated fats and are high in mono-unsaturated fats. If you are heavy, reduce your intake of fats. Not only will they increase your risk of CVD but also of diabetes. If you do take oils, use polyunsaturated oils such as safflower, they are lighter. Everyone should avoid excessive un-natural fats such as those from deep fried foods and oils which are old and rancid. For specific individualized dietary plans, see a Clinical Ayurvedic Specialist. And, remember, to further reduce your risk of cardiovascular, avoid smoking, exercise regularly, relax often and have your blood pressure checked regularly.

Beware of modern science. There is a tendency to leap into the current theories being promoted as though they express the whole truth. Modern science is outdated every ten years, replaced by newer, still incomplete information. It was, after all, "modern science" that once told us that babies would thrive more on bottled milk than on breast milk, that the chemical DES was safe for pregnant woman, that marijuana has no useful medical value and that you can safely loose weight by taking the drug phen - phen. Modern science still tells us that pesticides in reasonable doses are safe.

Use common sense and intuition. All great traditional healing sciences (Native American, Ayurvedic, Chinese) focus on principles of truth, based in spirit, tested though time and which stand eternal. Moderation is the safest approach unless a person is guided by an expert in the field.

Ayurveda and the mind: a new perspective in the management of mental illness

Insanity: Ayurvedic vs. Western Medicine Perspectives

By: Alexandra Compson

November 4, 2010

INTRODUCTION

    The condition of “insanity,” better known to the modern world as “psychosis,” is an illness of the mind that has been recognized throughout history within every known society. Today, insanity is characterized by the adherence to fixed, delusional beliefs existing outside the normal range of one’s subculture, including hallucinatory experiences and thought disorders in which the mind does not follow any rational line of thinking[1].
    Within the field of Western medicine, psychosis is viewed as a complex of visible symptoms and effects rather than as an indicator of a simple root cause. From this view, it appears that the primary threat posed by the condition is its potent ability to “prevent people from functioning normally and caring for themselves. If the condition is left untreated, people can sometimes harm themselves or others.”[2] The main goals of Western medicine in the treatment of psychosis includes the reduction of both positive and negative symptoms produced by the illness, maintaining or increasing cognitive abilities, minimizing side effects, reducing secondary diseases, preventing relapse, and enhancing the sufferer’s quality of life.
    In contrast, the Ayurvedic approach to insanity rests on the premise that, “All mental disease originates in a lack of clarity (sattva) within the mind.”[3] Halpern, p. 332. Thus, Ayurveda’s primary goal of treatment is the cultivation of sattva, a state of mind that, according to basic Ayurvedic tenets, can be attained through proper diet and lifestyle. Very little information can be found in Western medicine advocating either diet or lifestyle as a foundation of mental clarity or a cure for mental illness.
    In order to compare the Western and Ayurvedic approaches to insanity, we must first explore what “insanity” means within each world-view. How does the Western world’s understanding of insanity differ from that of Ayurveda’s? What sorts of treatment methods are utilized by these two medical sciences in its management? The objective of this paper is aimed towards the exploration of and answers to these questions.

WESTERN MEDICINE’S VIEW OF INSANITY

A Brief History
    As mentioned previously, “Madness, the non-legal word for insanity, has been recognized throughout history in every known society.”[4] It is known that primitive cultures turned to witch doctors or shamans to apply magic, herbal mixtures, or folk medicine to rid deranged persons of evil spirits or bizarre behavior[4]. However, it was the relatively recent years of the 18th century that saw the seeds of modern psychiatry begin to sprout. Though the Ancient Greeks and Romans had progressive ideas regarding mental illness, the Middle Ages witnessed the end of such revelations. It wasn’t until the 1700s that this tide again began to turn, as the French and British introduced humane treatment of the clinically insane[5]. The late 19th century advent of psychoanalysis led to increasingly enlightened exploration and treatment of mental illness. In retrospect, it seems inevitable that psychiatrists and their counterparts in the psychoanalytic field would soon begin to feel uncomfortable with the term “insanity” and its obscure definition within the realm of scientific medicine[6]. By the mid-20th century, insane asylums were outdated, and “Increasing disillusionment with and desire to distance theory and practice from the field’s asylum-dominated past provided further impetus for physicaians to leave the 19th century traditions behind…”[6]. Being able to define the difference between “normalcy” and insanity is part of what moved psychiatry and the psychoanalytic field to where it is today[5]. Insanity is no longer considered a medical diagnosis in the United States, although it is still a legal term[6]. “Psychosis” has become the modern medical equivalent of the term “insanity.”[4][5][6]

Insanity Defined from a Western Medical and Psychological Perspective
    According to the American Medical Association, psychosis is a mental condition defined as:
“A severe mental illness in which a person loses touch with reality, experiences unusual perceptions (hallucinations), and holds false beliefs called delusions. Psychotic disorders include schizophrenia (an illness involving delusions, hallucinations, abnormal speech, and strange behavior) and delusional disorder (in which a person has a persistent belief that seems very real to him or her but is not shared by others.”[3] pp. 575-576

Understanding Insanity from a Western Medical and Psychological Perspective
    The understanding of factors that define mental pathology and those that define “normalcy” are largely prescribed by one’s society and culture. For example, a behavior that may be seen as problematic in our society may be seen as normal within another society[8]. In Western medicine the mental illness known as “psychosis” is a syndrome classified as either “organic” (non-psychological) or “functional” (psychological). Psychosis arising from “organic” conditions are associated with numerous medical or pathophysiological diseases including electrolyte disorders [9], multiple sclerosis10] and syphilis[11], whereas “functional” psychosis can be caused by a variety of dysfunctions such as biochemical changes within the brain or differences in the brain’s ability to function and process information[8].

Western Medical Etiology
    In Western medical thinking, insanity, or psychosis, is largely known to be caused by various medical conditions and organic disorders (e.g. thyroid abnormalities[1]). In addition, the introduction of foreign chemicals into the body (e.g. alcohol, cocaine, various prescription drugs) may also disturb normal neurological processes. In Western medicine the above pathologies are known to cause structural defects and/or physiologic brain dysfunction, which, in turn, can lead to the onset of psychosis within the affected individual[1].

Signs and Symptoms
    Symptoms of psychosis may include disordered thought and speech[2], false beliefs that are not based in reality (delusions)[2], hearing, seeing, and/or feeling things that are not there (hallucinations)[2], thoughts that “jump” between unrelated topics (disordered thinking)[2], and what is known as “disturbance of affect”[1] in which a person’s apparent emotions are not consistent with their thoughts or fluctuate rapidly[1].

Western Medical Treatment
    Various treatment methods are available in the management of psychosis, though treatment depends largely upon the cause, diagnosis or diagnoses of the psychosis. Most treatment methods, however, typically begin with the administration of antipsychotic medication as the first line of treatment, while hospitalization is often required to ensure the patient’s safety. Cognitive behavioral therapy[12], family therapy[13] and animal-assisted therapy[14] is supported by growing evidence in the management of symptoms and for the patient’s general long term well-being. Electroconvulsive therapy (also known as electric shock treatment) may be applied if all other treatments prove ineffective.
    Additional treatment methods include early intervention in psychosis, a relatively new but effective concept based upon the observation that identifying and treating a person in the early stages of psychosis can significantly improve their long-term outcome[15]. This approach advocates use of intensive multi-disciplinary techniques during the “critical period” – the period when intervention is seen as critical to the outcome of the patient’s condition – and prevents long-term morbidity associated with chronic psychotic illness. Cognitive behavioral therapy during this “critical period” can aid further in the delay or prevention of psychosis[16].

AYURVEDIC VIEW OF INSANITY

Insanity Defined from an Ayurvedic Medical and Psychological Perspective
    According to the Ayurvedic text Ashtanga Hridayam, “Unmada (insanity) is of six kinds, by each dosa separately, by the combination of all of them, by sins and by poison. Unmada is mada (toxicity, disorder) of the manas (mind) produced by the dosas (vata, etc.) moving in the wrong paths (because of their increase).”[17] Murthy, p. 56. Similarly, the Ayurvedic text Charaka Samhita defines insanity as the perversion of the mind, intellect, consciousness, knowledge, memory, desire, manners, behavior, and conduct[18].

Understanding Insanity from an Ayurvedic Medical and Psychological Perspective
    Ayurveda views mental disease as the result of a lack of clarity (sattva) within the mind[4]. As the quality of sattva becomes diminished within the mind, it is only a matter of time before imbalances appear within the three biological humors: vata, pitta and kapha[19]. In his book, Ayurveda and the Mind: The Healing of Consciousness, Dr. David Frawley states, “Health problems, whether physical or mental, are not merely personal problems, but energetic problems in the mind-body complex. They are not so much personal or moral failings as an inability to harmonize the forces within us.”[19]
Within the classical texts, six types of unmada (insanity) are described. These include one for each dosha (Vatonmada, Pittonmada, Kaphonmada), one for a combination of all three doshas (Sannipatonmada), one due to mental shock (Citta Ghataja Unmada) and one caused by poisons (Visaja Unmada)[17].
    According to Ayurveda, the mind, or manas as it is known in Sanskrit, is composed primarily of the air and ether elements[19]. Thus, of the three doshas vata is commonly behind most psychological disorders[19]. Excess air within the mind causes mental instability and agitation, which leads to excessive thinking, worrying, and ultimately the perception that our problems are much worse than they really are[19]. “The mind becomes overly sensitive, excessively reactive, and we take things too personally. We are prone to premature or inappropriate action that may aggravate our problems.”[19] Frawley, pp.154-155.
    Pitta-type psychological disturbances occur moderately, as pitta tends to have strong self-control[19]. However, pitta’s tendency to be self-centered and anti-social can lead to problems, while its fire and heat often creates a narrow, quarrelsome mind[19]. Excess aggression and hostility are the root cause behind most pitta-type psychological disorders[19]. “Typical Pitta is the overly critical type who finds fault with everyone, blames other people for everything, sees enemies everywhere, is always on guard and ready for a fight.”[19] Frawley, pp. 155-156
    Psychological disorders due to kapha dosha are least common to occur due to the dosha’s inherently strong, stable nature. Problems can arise, however, when vitiated kapha produces blocked channels and clouded senses[19]. Excess kapha within the mind causes mental dullness, congestion and poor perception[19].
    According to Frawley, Ayurveda sees the deluded mind as a condition dominated by the quality of tamas or darkness[19]. The mind is absorbed in a blank state in which consciousness of the body is obscured or lost[19]; it is a mindless, non-feeling state of inertia: “…like a drunk lost in a drunken stupor lying half-conscious on the floor.”[19] pp. 294-295.
    The quality of tamas generally dominates within the schizophrenic mind as well[19]. In this condition, a person goes into trances, sees hallucinations, hears voices, etc.; the mind is absorbed in its own fantasies and the patient loses conscious control over their own mind[19]. Frawley states, “All these are not merely aberrations in the brain. They may include psychic abilities or psychic sensitivities but are beyond the control of the person. The person may connect up to the astral plane and lose contact with physical realities. In these cases, the mind goes into an absorption of the dull or blank type and sometimes an astral entity comes in to use the mind.”[19] p. 297. Interestingly, according to Frawley all severe mental derangement involves some type of astral entity possession or influence[19].

Ayurvedic Etiology
    The Charaka Samhita states, “One of the criteria for the disease process to rapidly manifest, occurs in these circumstances: when his mind is afflicted over and over again by passion, greed, excitement, fear, attachment, exertion, and grief. In the circumstances…the mind gets seriously affected and the intellect loses its balance. So the doshas aggravated and vitiated enter the cardiac region, obstruct the channels of the mind resulting in insanity.”[20] p. 89. Furthermore, the text cautions against the disharmonious acts of Prajnaparadha (intellectual blasphemy, the failure of the intellect, or crimes against wisdom[21] p. 7) and its ability to provoke the  gods who in term cause the insanity.
Within Ashtanga Hridayam, Vagbhata relates, “Indulgence in unsuitable (unhealthy) foods and drinks, foods which are spoilt, unaccustomed, containing dirt (contaminated) and using (foods, and drinks) in improper manner; those who are dejected (due to worry, grief, etc.), who are of weak mind, by the effect of sudden increase of diseases, emaciated persons indulging in activities in improper ways, committing mistakes in the procedure of worship of the worshipful, by committing sinful acts, loss of balance of mind, by the effect of strong poisons or weak poisons -- by these causes the doshas getting increased in the heart (mind) in persons of feeble mind, produce vitiation of the mind, and destroying (invading) the manovaha srotas (channels of the mind) cause unmada (insanity); dhi (discriminating/deciding capacity) vijnana (capacity of special knowledge to understand the science, arts etc.) and smriti (power of remembrance of earlier happenings) having become abnormal (lost or impaired) make the body lose the feeling of happiness and unhappiness and like a chariot devoid of a charioteer, the person begins to resort to activities without any thinking.”[17] pp. 56-57.
    In Ayurveda two types of insanity are described: According to B.S. Venkataram in his article “Ayurvedic Definitions and Classification of Manovikara,” nija rogas, or insanity due to endogenous conditions are, “…caused by irregular food habits and psycho behavioral excess resulting in the impairment of the Sarira [body] dosha physical element.” [22] p. 60. Falling under the category of nija roga, manasa (psychological) rogas occur due to the gain of undesired objects or losing the desired object/cherished ones, resulting in the impairment of the Manodosha (mental elements)[22].
    Insanity due to exogenous conditions are caused by injuries, poison, fire, and wind[22]. The Charaka Samhita adds that exogenous insanity may be caused by the “…effects of sinful activities in a past life. Lord Punarvasu Atreya considers intellectual blasphemy as the Nidana (causative factors) of this condition.”[20] p. 93.
    As the dominant dosha within the mind, vata-type psychological disturbances occur most commonly. Fasting, irregular eating habits or insufficient food, and the excessive intake of dry, cold foods easily weaken and upset the vata-dominated mind[19]. “…Disturbing sensations are hard for Vatas to handle, particularly too much exposure to mass media, loud music or noise. Drugs and stimulants easily derange them…Excessive or unnatural sexual activity quickly drains their often low energy. Stress, fear and anxiety affect them emotionally because they lack calm and endurance. Violence and trauma leaves them hurt and withdrawn. Neglect or abuse as a child creates a predisposition for a Vata-deranged psychology.”[19] Frawley, p. 155
    Pitta-type psychological disorders occur due to conditions of excess heat[19]. Overly hot, spicy foods easily disturb the pitta mind[19]. Strong, bright colors and sensations irritate their senses[19]. Exposure to violence and aggression increase similar attitudes within them[19]. Sexual frustration, excessive anger and ambition often cause problems as well. Frawley expounds, “Too competitive an education or too much conflict in childhood are additional factors.”[19] p. 156
     The basis of kapha-type psychological disorders lies within the consumption of excess sugar and oily foods. Excess pleasure, enjoyment, attachment, too much sleep, sleep during the day, and lack of exercise add to the potential of a psychological disturbance within the kapha-type individual[19]. In addition, “Emotional problems combine with Kapha physical conditions like over-weight congestion. Educational factors include being overly indulged as a child or emotionally smothered by parents.”[19] Frawley, p. 157.

Signs and Symptoms
     “In unmada (insanity) produced by (increased) vata, the body is emaciated the person weeps becomes angry, laughs, smiles, dances, sings, plays musical notes, speaks, does movements of the different parts of the body, and makes loud sound – all these at improper time and place; imitates the sound of the flute, vina (lute) etc. violently and often; froth exudes from the mouth, roams about constantly, speaks too much, decorates himself with non-decorating things, attempts to travel on things which are not vehicles; desires foods but abuses them after obtaining, the eyes protruding and red in color and the disease (symptoms) appearing after the food is digested.”[17] Murthy, pp. 57-58. Excess vata within the mind causes the individual to become ungrounded and unrealistic, producing overactive and wrong imaginations, hallucinations and delusions[19]. Over activity of the mind results in dispersed life-force energy (prana), leaving the afflicted weak, with a diminished connection to the physical body and physical reality. Vata-type psychological disorders are behind feelings of fear, alienation, anxiety, and nervous breakdowns[19]. Insomnia, tremors, palpitations, unrest, and rapid shifts in mood are due to vata as well. Frawley adds, “Insanity of the manic-depressive type, or schizophrenia, is an extreme Vata imbalance.”[19] p.155
     “In unmada (insanity) caused by pitta, the patient threatens others, becomes angry, attacks others with the fist, stones etc. desires cool shade and cold water, remains naked, has yellow color (of the skin etc.) sees fire, flames, stars and lamp which are not actually present.”[17] Murthy, p. 58. Excess pitta (heat) within the mind produces agitation, irritation, anger, and possible violence[19]. “The overheated body and mind seek release in venting the built-up tension. Pitta types can become domineering, authoritarian or fanatic. When disturbed they may have paranoid delusions, delusions of grandeur, or can becomes psychotic.”[19] Frawley, p. 156.
     “In unmada (insanity) caused by kapha, the person has loss of appetite, vomiting, very little of desires, foods and talk; desire for the woman (sex) and solitude, copious saliva and nasal secretions flowing, terrifying activities, hatredness to cleanliness, sleep, swelling of the face, symptoms strong during nights and soon after taking food.”[17] Murthy, p. 58. Excess kapha in the mind results in over-attachment and lack in motivation and mental drive that often leads to depression, sorrow, and excessive clinging. A person becomes passive and dependent; “We want to remain a child and be taken care of…Such people often end up being taken care of by others and are unable to function on their own.”[19] Frawley, pp. 156-157. Stronger kapha types may find themselves suffering from greed and possessiveness, which renders the mind heavy, dull and depressed[19]. They want to own and control everything, but when control and ownership are lost psychological instability results[19].
In Sannipatonmada (insanity caused by the combination of all three doshas[17]), the Ashtanga Hridayam notes that symptoms attributed to all of the doshas appear simultaneously. The text cautions against the treatment of these patients, as this type of insanity is often too difficult to cure[17].
    In Citta Ghataja Unmada (or insanity due to mental shock[17]), “Loss of money, wife etc. which is unbearable, which persists for long time leads to insanity. The person becomes pale, timid, faints often, weeps making sounds such ha, ha etc. (alas, that is lost, alas, that is gone, etc.) weeps without any (other) reason; dies (loses consciousness), praises the qualities of the things lost, with the mind suffering from grief he worries much, keeps awake without sleep and does unusual acts.”[17] Murthy, p. 59.
    Visaja Unmada is insanity caused by poisons. In this type of insanity it is said that the face turns blue, the eyes become red, there is a loss of healthy complexion, strength, physical senses, and the mind is unstable even throughout the different stages of poisoning[17]. Again, the patient who presents with this condition is seen as too difficult to cure and should be rejected by the physician[17].

Ayurvedic Treatment (Chikitsa)
    In his book The Roots of Ayurveda, Dominik Wujastyk states, “Any deficiency or excess of either Doshas or Dhatus or Malas may induce disease and Ayurveda always aims at keeping an equilibrium in the level of these things. Physical diseases and mental diseases are caused by the irrevelevent contacts, intellectual blaspheme and suppression of natural urges.”[23] p. 20.
    In Ayurveda the primary treatment goal of all psychological illness is the cultivation of sattva[3], as this is the quality that brings balance to body and clarity to the mind. The principles of treating mental disease emphasize sattvic activities that bring peace and stability into one’s life. Sattvic activities include spending more time in nature, meditation, yoga, avoiding the influence of the media, and the consumption of a sattvic diet.
    Internal and external oleation therapies are the cornerstone of treatment in vata-type insanity. Should the moist, heavy qualities inherent within the oil induce channel obstruction, Vagbhata recommends mixing mild purgatives with the therapeutic oils being used[17]. Numerous vata-reducing impressions may be applied, as they help bring peace and stability to the vata-deranged mind. Such impressions include sitting or walking quietly and peacefully in a garden, listening to calming music, and gentle exercise such as Hatha Yoga or Tai Chi[19].
    For pitta-type insanity, emesis, purgation, and enema therapies administered after oleation and sudation should be administered[17]. Purgative therapy for the head is also recommended[17]. Pitta-reducing impressions include the use of cooling colors (blue, white, silver), cool, sweet fragrances like rose and sandalwood, and the use of pitta-pacifying mantras such as Shrim and Sham[19].
Similar to the treatment of pitta-type insanity, kapha-type insanity also calls for emesis, purgation, and enema therapies administered after oleation and sudation, including purgative therapy for the head[17]. Kapha benefits immensely from strong aerobic exercise, cultivating of detachment, and meditation on active, wrathful deities like Kali or Rudra.
    In the treatment of insanity due to lust, grief, fear, anger, joy, jealousy, and greed (i.e. Citta Ghataja Unmada), the patient should be exposed to the condition’s opposite qualities[17]. Lust should be met with dislike, grief with delight, fear with faith, etc.
    Patients suffering from insanity due to loss should be given that which is identical to what was bereaved, along with assurances and consoling words.
    Should the above therapies prove ineffective, alternate recommendations are described in the Ashtanga Hridayam that, while outdated, are interesting to take note of. In this section of the text Vagbhata suggests that the physician treat the patient by“…making him happy, assuring him, threatening, causing fear, beating and terrorizing him should be resorted to, oil massage, dry massage, anointing with paste, fumigation, drinking of medicated ghee should be administered; purified by these the mind becomes normal.”[17] Murthy, p. 60. Vagbhata also recommends beating the patient with lashes, binding the patient, throwing the patient into a ravine, and confining the patient in a dark room free from weapons, stones, and men[17]. The result of such therapies, he says, is the notion that the fear of death is more powerful than the troubles of the body, thus the disturbed mind becomes free of its abnormalities[17].
    According to the Charaka Samhita, “Purity of the sense organs, their objects, intellect, soul and mind and normalcy of the tissues of the body are the features of (the person) cured of insanity.”[20] Dash, and Sharma, p. 66

CONCLUSION

The mental condition known insanity is well known to describe a mentally unstable person. Though the term “insanity” may no longer exist as accepted medical terminology, the mental conditions that the word once described most certainly do.
    Insanity is a disease that has been common throughout history within every culture of the world, invoking diverse views of understanding and the development of numerous treatment methods. The Western approach to mental illness appears to be primarily concerned with the complicated, minute details of brain chemistry in its quest to understand the logistics of mental disease. The Western tendency is to concentrate on specific aspects of sensory impressions and brain lobes and the effect of various forms of multiple neurotransmitters and hormones within the body. On the other hand, the condition of mental illness is a much more accepted, explored, and understood concept within Ayurveda and Eastern medicine in general. Whereas Western medicine scrutinizes the minute, Ayurveda is much more concerned with the bigger, simpler picture of humoral and energetic imbalances, which it sees as a physical manifestation of karma that allows for the teaching of spiritual lessons.
    Charaka, perhaps, speculates that the avoidance of disease and conservation of health is even more simple: “The person of a strong mind who does not indulge in meat and wine; who eats only healthy food, remains clean (both physically and mentally) does not become affected by either nija or agantu unmada (endogenous or exogenous insanity).”[20] Dash, and Sharma, pp. 65-66.

References

1.    “Health Encyclopedia – Diseases and Conditions: Psychoses.” healthscout. The HealthCentralNetwork, Inc., n.d. Web. 11 Oct 2010. <http://www.healthscout.com/ency/68/77/main.html>.

2.    “Psychosis.” National Library of Medicine, National Institutes of Health. U.S. National Library of Medicine, 7 Feb 2010. Web. 20 Sept 2010. <http://www.nlm.nih.gov/medlineplus/ency/article/001553.htm>.

3.    Halpern, Marc. Principles of Ayurvedic Medicine. 9. 2. Grass Valley: California College of Ayurveda, 2007. Print.

4.    Weinstein, Raymond M. “Madness.” The Blackwell Encyclopedia of Sociology. Blackwell Publishing 2007. Print.

5.    “Conquering Depression: Historical Background.” SEARO. WHO Regional Office for South-East Asia, 18 Aug 2006. Web. 16 Sept 2010. <http://www.searo.who.int/en/Section1174/Section1199/Section1567/Section1826_8097.htm>.

6.    Tighe, Janet A. “‘What’s in a Name?” A Brief Foray into the History of Insanity in England and the United States.’” Journal of the American Academy of Psychiatry and the Law Online. American Academy of Psychiatry and the Law, 2005. Web. 15 Sept 2010. <http://www.jaapl.org/cgi/content/full/33/2/252>.

7.    American Medical Association: Concise Medical Encyclopedia. Ed. Martin S. Lipsky, MD. Random House, 2003. Print.

8.    Merlino, Dr. Joseph. Wikinews. Interview by David Shankbone, 5 October 2007. Web. 13 Oct 2010. <http://en.wikinews.org/wiki/Dr._Joseph_Merlino_on_sexuality,_insanity,_Freud,_fetishes_and_apathuy>.

9.    Rossman, Philip L., and Robert M. Vock. “Postpartum Tetany and Psychosis Due to Hypocalcemia.” California Medicine 85.3. 1956: 190–93. eBook.

10.    Rodriguez Gomez, Diego, Elvira Gonzalez, and Oscar Perez Carral. “Acute Psychosis as the Presenting Symptom of Multiple Sclerosis.” Revista de Neurologia 41. 4. 2005: 255-56. eBook.

11.    Karaizou, E, C Mitsonis, N Dimopoulos, K Gkiatas, I Markou, N Kalfakis. “Psychosis or Simply a New Manifestation of Neurosyphilis?” J. Int. Med. Res. 34. 3. 2006: 335-37. eBook.

12.    Birchwood, M, and P Trower. "The Future of Cognitive-Behavioural Therapy for Psychosis: Not a Quasi-Narcoleptic." British Journal of Psychiatry. 188. 2006. 108. eBook.

13.    Haddock, G and S Lewis. "Psychological Interventions in Early Psychosis." Schizophrenia Bulletin. 31. 3. 2005. 697–704. eBook.

14.    Nathans-Barel, I, P Feldman, B Berger, I Modai, and H Silver. "Animal-Assisted Therapy Ameliorates Anhedonia in Schizophrenia Patients." Psychotherapy and Psychosomatics. 74. 1. 2005. 31–35. eBook.

15.    Birchwood, M, P Todd, and C Jackson. "Early Intervention in Psychosis: The Critical Period Hypothesis". British Journal of Psychiatry. 172. 33. 1998. 53–59. eBook.

16.    French, Paul, Anthony Morrison. Early Detection and Cognitive Therapy for People at High Risk of Developing Psychosis. Chichester: John Wiley and Sons, 2004. eBook.

17.    Murthy, Prof. KR Srikantha. Vagbhata’s Ashtanga Hridayam. 3. Varanasi, India: Chowkhamba Sanskrit Series Office, 2008. Print.

18.    Swami Sada Shiva Tirtha. The Ayurveda Encyclopedia: Natural Secrets to Healing, Prevention & Longevity. 1. Bayville: Ayurveda Holistic Center Press, 1998. Print.

19.    Frawley, Dr. David. Ayurveda and the Mind: The Healing of Consciousness. Twin Lakes: Lotus Press, 1996. Print.

20.    Dash, Bhagwan and RK Sharma. Caraka Samhita. Varanasi, India: Chowkhamba Sanskrit Series Office, 2001. Print.

21.    Halpern, Marc. Principles of Ayurvedic Medicine. 9. 1. Grass Valley: California College of Ayurveda, 2007. Print.

22.    Venkataram, BS. “Ayurvedic Definitions and Classification of Manovikara”. Ayurvedic and Allopathic Medicine and Mental Health: Proceedings of Indo-US workshop on Traditional Medicine and Mental Health. Bhavan’s Book University, 2003. Print.

23.    Wujastyk, Dominik. The Roots of Ayurveda. London: Penguin Books, 1998. Print.

 

An Ayurvedic and Yogic Perspective of Mental Illness (by Gauri Eleanora Trainor C.A.S)

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Ayurvedic & Western approaches to the treatment of Schizophrenia (by Rubén Vega, MA)

Overview

Ayurvedic medicine is one of the world’s oldest and most complete systems of natural healing which offers comprehensive and holistic treatment for physical and mental disorders. It promotes physical health and healing of the mind through diverse methods focused on treating all the physical, psychological, and spiritual aspects of each individual affected with physical and mental disorders. In a review Of the literature from the classical Ayurvedic texts to current Ayurvedic literature  As well as the most current Western Psychological / Psychiatric  Approaches to the treatment of schizophrenia. I will research the causes,  theories, and treatment methods utilized by these two divergent approaches in the treatment of schizophrenia and other mental disorders.  In addition, I will also briefly describe some of the Ayurvedic’s spiritual therapies and factors to the treatment of mental disorders.

Introduction

According to the National Institute of Mental Health, approximately 2.4 million American adults, or about 1.1 percent of the population age 18 and older in a given year have schizophrenia.  Schizophrenia is found all over the world, in all races, cultures and social classes. It affects 1 out of 100 people worldwide.  “More than two million Americans are affected by schizophrenia and approximately 1 percent of the population develops schizophrenia during their lifetime. More than 2 million Americans suffer from the illness in a given year and one out of every 10 people with schizophrenia commits suicide.” 1. (www.nimh.nih.gov).  “Approximately 10 percent of people with schizophrenia (especially younger adult males) commit suicide.”(2). (www.nimh.nih.gov). “It is generally assumed that suicide is a problem only for those with major depression.  This assumption is, unfortunately, not true. Suicide rates among people with schizophrenia are alarmingly high; in fact, suicide is the number one cause of premature death. Ten to thirteen percent kill themselves, and close to fifty percent attempt suicide at some point in their lives.”
(3). Keefe, H arvey, (1994). Number the citation+ give the page number from where you took quote.
Schizophrenia has been considered one of the most chronic, disabling, and difficult to understand of the mental disorders since ancient times.  People with this illness suffer with a loss of individual potential and personal anguish, resulting in significant psychological and social consequences.  People with schizophrenia suffer terrifying symptoms such as hallucinations, delusions, and distorted perceptions of reality, disordered thinking, lack of emotional expression and communication problems.

This often leaves them fearful, anxious, confused, and withdrawn for the rest of their lives.  A wide range of reason or events can and might lead some people to run a risk for suicide, although this risk may be higher for individuals with schizophrenia.  The underlying causes are the same for those who are afflicted with this disease. Some of the causes can be depression, feelings of hopelessness, being unemployed, being unmarried, experiencing deteriorating health and recent traumatic experiences and/or stress.

 Due to those reasons listed above, schizophrenia is considered a devastating disorder like no other, causing pervasive and profound social, economic and personal impact on those afflicted. Most of the people with schizophrenia continue to suffer chronically or episodically throughout their lives.  It has been estimated that no more than one in five individuals recover completely.

What is schizophrenia?  Why is schizophrenia still considered one of the most fearsome and disabling mental disorders?   What are the Western Psychiatric/psychological theories of Schizophrenia? What is the Ayurvedic interpretation of schizophrenia and mental illness?  What are the treatment methods utilized by psychiatric/Psychological approaches and Ayurvedic medicine in the treatment of schizophrenia and other psychotic disorders?   And, what Ayurvedic treatments are available for people suffering with mental illness? These are just a few questions that will be answered in the following pages.      

Western definition of Schizophrenia

According to Western Psychiatry, Schizophrenia is not a split personality condition, but a chronic relapsing psychotic disorder that primarily affects thought and behavior.  According to DSM-V, schizophrenia is described as  “ a disturbance that lasts for at least six months and includes at least one month of active-phase symptoms (i.e., two (or more) of the following: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms)”.   DSM-IV criteria identify five subtypes of schizophrenia: Paranoid type, disorganized type, Catatonic type, undifferentiated type, and Residual type. All of these vary by their degree of severity and symptomatology.  

Ayurevedic Interpretation of Schizophrenia and other Psychotic Disorders

As noted by Dr. Halpern, Ayurvedic medicine offers the opportunity to understand the nature of the mind in a way that is completely unique and quite different from the variety of the Western Psychological and Psychiatric medicine models. “Ayurvedic medicine views psychotic disorders (schizophrenia) as the imbalance of energies on an inner level. According to Ayurveda and occult science, behind the gross physical is a subtle or astral body composed of the life-force, emotions and thoughts. The astral is a subtle form or underlying energy pattern of the physical, from which the physical is produced (3). Frawley (1989).
In the ancient texts of Ayurveda, there are detailed descriptions of mental disorders known as “Unmada”, and schizophrenia can be correlated with many of the types of “Unmada.  Ayurvedic’s physicians describe schizophrenia as a disorder of the mind caused by the doshas (vata, kapha, and vata.)  Moving in the wrong paths due to increased toxicity.  According to the classical Ayurvedic texts, the Charaka Samhita, insanity is defined as, “the perversion of the mind, intellect, consciousness, knowledge, memory, desire, manners, behavior, and conduct”.  It is denominated as insanity (umada) because it is madness (mada) of the mind caused by a deviation (unmarga) of the humors”.  Swami Sada Shiva Tirtha, (1998).

Western theories of the causes of Schizophrenia

The real causes of schizophrenia are unfortunately not known, however, there are several theories and hypotheses of the etiology of schizophrenia.  Western scientists and psychologists do not yet understand all the factors that produce schizophrenia.  An interaction of sociological, biological, and psychological factors seems to contribute to the condition. Schizophrenia also may result from various factors such as drug abuse, aging, and/or brain injuries and diseases. 

One of the more influential views of the origins of schizophrenia is the theory of biochemical and brain dysfunction.  This view attempts to “identify the biological abnormalities that are inherited or developed by persons with schizophrenia.  The two most likely candidates are biochemical abnormalities and abnormal brain structure.  It also involves disturbances of the brain’s chemistry, anatomy, and physiology, which in turn distort perceptions and subjective experiences.  This hypothesis revolves around the idea that schizophrenic symptoms might be the result of overactivity of a neurotransmitter called dopamine.” Maxmen, J. & Ward, N. (1995).   This theory is supported by the fact that drugs, which increase dopamine activity, can bring about a worsening of psychotic symptoms.

The treatment methods for schizophrenia with this biological view are based on clinical research and experience. (1)Antipsychotic medications treat the symptoms of the disorder, but do not cure schizophrenia.  “These medications reduce the psychotic symptoms of schizophrenia and usually allow the patient to function more effectively and appropriately.  Antipsychotic drugs appear to be the best treatment now available, but they do not cure schizophrenia or ensure that there will be no further psychotic episodes. The antipsychotic drugs include two major classes: dopamine receptor antagonists (for example: Chlorpromazine (Thorazine), haloperidol (Haldol), sulpiride) and serotonin-dopamine antagonists’ drugs (per example, risperidone (Risperdal) and clozapine (Clozaril)). Kaplan, S. & Sadock, B. (1998)

Genetic theories state that biology produces schizophrenia and environment alters its course.  More specifically, genetic and other biological factors create various degrees of vulnerability to schizophrenia.  Whether, and how severely, the predisposed individual Becomes schizophrenic depends on a mix of biological factors (e.g., severity of heredity, prenatal complications, or slow viruses).  Genetic scientists believe that “some people inherit a biological predisposition to schizophrenia and, in accordance with a diathesis-stress model, come to develop the disorder when they are confronted by extreme stress, usually during early adulthood.” (Gottesman, 1991).  Since schizophrenia tends to be familial, but does not follow a classical pattern of inheritance, the study of genetic factors in this disorder has been complicated.  It is extremely unlikely that a single gene will ever be found that is responsible for all cases of schizophrenia in the population.

Another theory is based on psychosocial influences.  The psychological view is based on the principle that “psychological factors are critical in the development of schizophrenia, (traumatic childhood experiences, intense negative intrafamiliar communication) substantially affect the extent of recovery; probability of relapse, overall quality of life, and the symbolic meaning attributed to the disorder.” Maxmen & Ward, (1995).  The leading psychological explanations have come from the psychodynamic, behavioral, family, existential, and cognitive perspectives.

Causes of Insanity from an Ayurvedic perspective.

From the writings extracted from the classical text: the Caraka Samhita by R. K. Sharma and Bhagwan Dash, the causes of inanity are due to  “having unhealthy foods which area spoiled, unaccustomed, contamined and using (food and drinks) improper manner; those who are dejected due to worry, grief, etc.), who are weak mind due to the effect of sudden increase of disease, emaciated persons indulging in activities in improper ways, doing mistakes in the method of worship, by doing sinful acts, loss of balance of mind, by the effects of strong poisons or weak poisons due to these reasons the doshas getting increased in the mind in persons of feeble mind, produces vitiation of the mind, and invading the manovaha shrotas channels of the mind / caused insanity”. Asthanga-Hrdaya of Vagbhta: the book eight branches of Ayurveda, (1994).
     In current literatures, Dr. David Frawley describes that, “mental disorders are caused by emotional stress, poor upbringing, repressive religion, coming under the influence of disturbed individuals, sexual abuse or perversion, and taking drugs”. Frawley, (1989).   Dr. Frawley further adds that metal illness are also caused by excess thinking or by the strain in yogic or meditation practices naively opening up to the influences the astral plane, and through occult methods”. He also states that “mental disorders, including schizophrenia are caused by a vitiation of sattva; that is, by a disturbance of the inherent clear quality of the mind. This occurs though excess rajas and tamas turbulence and darkness in the mind. Too much rajas involves excess of anger, hatred and fear, excessive nervousness, worry, and anxiety. Too much tamas involves excess sleep, dullness, apathy, inertia and the inability to perceive things as they are”. Frawley, (1996).

According to the Asthanga-Hydaya of Vagbhata insanity is a toxicity / disorder to the mind caused by dohas (vata, etc.) moving in the wrong paths due to their increase”. It also said that having unhealthy foods which are spoiled, unaccustomed, contamined and using (food and drinks) improper manner, those who are dejected due to worry, grief, etc.), who is weak mind due to the effect of sudden increase of disease, emaciated persons indulging in activities in improper ways, doing mistakes in the method of
worship, by doing sinful acts, loss of balance of mind, by the effects of strong poisons or weak poisons due to these reasons the doshas getting increased in the mind in persons of  Feeble mind produces vitiation of the mind, and invading the manovaha shrotas channels  Of the mind/ caused insanity”. All these corruptions causes the intelligence, understanding, and memory to go astray.  Because of that, the body loses any sense of joy or sorrow, and wanders about purposelessly like a chariot which has lost its driver”.

According to ancient medical texts written by the first Ayurvedic physicians, There are six kinds of insanity that arise from each of the humors, from a conjunction of them, from mental anguish, and from poisoning. Regarding the development of mental illness, Ayurvedic physician’s states that “The corruption of certain mental and physical things can cause the inflammation of the humors in the heart of someone whose mental faculty is weakened. Next, it causes defilement of the intelligence, destruction of the pathways along which mind flows and, finally, insanity. Wujastyk, (1998).

Types of insanity (unmada)

Wind insanity: (vayu)
“Wind gives rise to the following: an emaciated body; inappropriate lamenting,
shouting, laughing, and smiling, as well as dancing, singing, playing music, talking,
posturing, bursting out; repeatedly and tunelessly imitating the sound of a flute, veena, or other instrument; frothing at the mouth; constantly wandering about; ceaseless talking; using things which are not ornaments as decoration; trying to travel on things which are not vehicles; being greedy for food, but spurning it once it has been obtained; bulging, Bloodshot eyes, and illness after foods had been digested.” Wajastic, (1998). Swami Sada Shiv Tirtha notes, “Vayu insanity is also caused by fasting or an excessive intake of dry or cold foods. This affects the heart and mind with worry, passion, and anger which results in distortion of memory and perceptions.” Swami Sada Shiv Tirtha, (1998). 

 Frawley states that when high vata, as excess ether, makes us ungrounded, spaced-out and unrealistic. We may have various wrong imaginations, hallucinations or delusions, like hearing voices. High vata in the mind manifests as fear, alienation, anxiety and possible nervous breakdown. There is insomnia, tremors, palpitations, unrest and rapid shifts of mood. Insanity of the manic depressive type or schizophrenia is an extreme vata imbalance”. Frawley, (1996).

Choleric Insanity: (pitta)

Choler gives rise to threatening behavior, fury, and charging at people with fists stones,
and the like. The patient craves coolness shade, and water. He goes naked, and has a
yellow color. He sees thing which are not there, such as ire, flames, stars, and lamps.
Pitta insanity results from indigestion, excess of hot, pungent, sour, or burning foods and
liquids, excesses pitta afflict the heart of the person lacking self-control. Wajastic (1988).
Frawley notes that the “fire and heat of pitta cause the mind to be narrowed and contentious, fighting either with others or with themselves. High pitta in the mind causes agitation, irritation, anger, and possible violence. The overheated body and mind seek release in venting the build-up tension. Pitta types can become domineering, authoritarian or fanatic. When disturbed they many have paranoid delusions, delusion of grandeur or can become psychotic.” Frawley, (1996).

Phlegmatic Insanity: (kapha)

Phlegm causes the patient to lose any desire for food. It causes vomiting, and a reduction
in motivation, appetite, and conversation. It causes a lust for women. It causes the patient
to enjoy solitude. He dribbles mucus and snot, and is very frightening. He hates being
clean. He sleeps, and has puffy face. This insanity is stronger at night, and just after
eating. This is caused by the overeating and excessive use of oily foods. This is
aggravated kapha afflicts the heart, troubling the mind and memory.  Wajastic, (1988)
Frawey stated that kapha type evolves attachment and lack of motivation lading to depression, sorrow, and clinging. The mind may be incapable of abstract, objective or impersonal thinking. There is lack of drive and motivation along with passivity and dependency”. Frawley (1996).

Conjunctive Insanity: (trisdosha)

When there is a conjunction of all the sources of disease, and symptoms, then the
resulting insanity is dreadful. A physician should stay away from such a patient.
This caused by the excessed condition of all thee doshas. It is considered serious because
the therapies will aggravate one or more of the doshas. Therefore, this condition is
incurable. Wajastic, (1988).

Insanity cause by loss:
A person crushed by the unbearable loss of his possessions or of a loved one becomes
pale, depressed, and swoons frequently. “oh, oh” he groans. He wails for no reason. He
loses consciousness. He thinks a lot about the qualities of what he has lost. His mind is
Distraught with grief and he cannot sleep for worrying. He thrashes about. Wajastc, (1988).

Insanity caused by poison:
Poison makes the face dark the complexion, strength, and senses are all ruined. The
Patient is delirious even in between fits, and has bloodshot eyes. He should be avoided. Wajastic, (1988).

Western Psychiatric and Psychological Treatment for Schizophrenia

The primary method of treatment for these patients is the use of psychotropic medications, which aim to mitigate symptomology such as visual and auditory hallucinations, suicidal ideation, anxiety and depression.  The proper treatment of schizophrenia may include a combination of different techniques.
 Generally, medications for treating psychotic symptoms of schizophrenia are referred to as antipsychotic, or sometimes neuroleptics.  Examples of standard antipsycotics include Thorazine, Mellaril, Modecate, Prolixin, Navane, Stelazine and Haldol.  The newer antipsychotic drugs are called atypical antipsychotic medications are being used more and more frequently.  They are called “atypical” because they do not have the same chemical profiles as standard medication and seem to work in a different way causing fewer side effects while helping patients to stabilize.  Examples include Risperdone, Clozaril, Zyprexa and Seroquel.   Most patients have to take medication regularly to keep their illness under control. It is not possible to know in advance which medication will work best for an individual.  Many medication adjustments may be required.  This period of trial and error can be very difficult for everyone involved. Some medications have unpleasant side effects such as dry mouth, drowsiness, stiffness, restlessness, muscle spasms, tremor, and blurring vision.

I have also observed that even patients who respond well to psychotropic medication continue to have secondary symptoms such as lethargy, disinterest, excessive sleep, lack of spontaneous emotions and other symptoms of relapse. In addition, patients often develop multiple medication adverse effect, but these can be corrected by lowering the dosage or controlled by other medications.  Different patients have different treatment responses and side effects to various antipsychotic drugs.
“Other biological therapies such as electroconvulsive therapy, although less effective than antipsychotic drugs, may be indicated for catatonic patients and for patients who for some reason cannot take antipyshcoitc drugs.  In the past, schizophrenia was treated with insulin and barbirute-induced coma, but these treatments are no longer used because of the associated hazards.  Psychosurgery, particularly frontal lobotomy, was used from 1935 to 1955, and is no longer considered an appropriate treatment.”
Kaplan, S. (1998).

Although antipsychotic medications are the mainstay of the treatment for schizophrenia, research has found that psychosocial interventions can increase the clinical status.  One of the main modalities used in psychosocial therapies is behavioral therapy.  This therapy uses techniques such as token economies and social skills training to increase social abilities, self-sufficiency, practical skills, and interpersonal communication.  Skills-based programs can lead to an improvement in life functioning and the subsequent discharge of people with schizophrenia who have had long-term stays in psychiatric facilities. 

Cognitive therapy is used to improve cognitive distortions, reduce distractibility, and correct errors in judgment.  Group therapy focuses on real life plans, problems, and relationships.  “Because patients with schizophrenia frequently become ill during the critical career forming years of life (e.g., ages 18 to 35), they are less likely to complete the training required for skilled work.  As a result, many suffer with lack of social and work skills and experience as well.” (www.nimh.gov).  Rehabilitation programs emphasize social and vocational training to help patients and former patients to overcome difficulties in these areas.  These programs include vocational counseling, job training, problem solving, money management skills, use of transportation, and social/communication skills training.

Although schizophrenia is not yet a “curable” disease, the treatment for this illness is more effective today than ever before, largely because of the careful thinking and research that has gone into it.  The most successful treatment programs are the ones that use a multimodal approach.  They use the proper treatment of schizophrenia that includes the following: medication, education, family counseling, residential and rehabilitation programs, self-help groups, nutrition, rest and exercise. 

  Ayurvedic Medicine Treatment methods of Schizophrenia

 Ayurvedic medicine is a holistic system of medicine that treats mental disorders from mild stress to severe condition, including insanity (psychosis). “Ayurveda employs whole series of yogi and spiritual therapies, including meditation, pranayama, mantra, prayers, visualizations, and rituals called “spiritual therapy” (daiva cikitsa).’ Frawley, (1998).

Ayurvedic’s treatments methods first works on balancing the biological humors through appropriate physical remedial methods of diet, herbs, and exercise. One of the best Ayurvedic’s treatment for schizophrenia includes panchakarma chikitsa. Some Ayurvedic formulations are Mahakalyanak ghrita, Vachadi churna, Purana ghrita, and Saraswatharistha. According to Frawley, all psychological disorders, including psychotic disorders reflect imbalances of the three biological humors. He says, “Health problems, whether physical or mental, are not merely personal problems, but energetic problems in the mind-body complex. They are not so much personal or moral failings as an inability to harmonize the forces within us” Frawley (1996). The imbalances caused by the lack or harmony in our lives weaken the doshas that afflict the heart where there is less sattwa in ones’s life and the mind. The disease develops through the  manovaha srota that sends psychic energy to the mind”

Treatment differentiation: Vata, pitta, and kapha type insanity

Frawley reports that for mental disorders, including schizophrenia treatments are similar that neurosis type and  Pancha karma treatment is recommended as a stronger method.

Vata type insanity: Dr. Frawley states that nourishing and sedating herbs are required, especially ashwagandha and its various preparations. Sarpagandha, rauwolfia serpentine, is an important ayurvedic herb for mental disorders. Other good herbs include valerian, guggul, jatamansi and calamus. Other therapies recommended are oil and ghee therapies, including oil enemas. Oil and ghee if the air passages are not blocked and laxatives which are given with the oils and ghee to remove the blocks.

Pitta type Insanity:  purgation is recommended, even with strong purgatives, is often helpful. The more violent type, the more purgation is required. Good herbs for this include rhubarb root, senna and aloe. Gotu kola is generally the best herb others are bhringaraj, sandalwood and passion flower. Shatavari is good for promoting a sense of love and compassion and is better for weaker pitta types. Also, oleation and fomentation therapies are recommended, then purgatives, followed by emetics. Also, medicated enemas evacuation from the head with jatamashi and gotu kola.

Kaph type insanity:  is recommended spicy brain-stimulating herbs. The treatment is mainly expectorant, to clear phlegm from blocking the channels and obstructing mental functioning. Important herbs are calamus, basil, bayberry, sage, myrrh, and guggul, which have good expectorant action. Other formulas include trikatu with ghee or calams ghee.

Other important miscellaneous therapies:

Other miscellaneous therapies describe in current Ayurvedic texts include, Abhyanga, shirodhara, shirobasti, ghee to stimulate the mind, intellect, memory and consciousness; and applying thick ointments. In addition, other Ayurvedic treatments recommend different kinds of nasal medicines mixed with mustard and oil. It is also recommended face and head massage with mustard oil and the inhalation of mustard powder. Other more intrusive treatments recommended were bloodletting and shock treatment. Some alternative treatments recommended for the insanity by the first Ayurvedic physicians were to help the patient’s mind to become still by throwing the patient into a dry well and keep him hungry until he/she is emaciated; send a policemen to grab the patient and take the patient outside and intimidate him/her with corporal punishment, and threatening him/her in the name of the king; terrify the patient with name lions, elephants or snakes whose fangs have been drawn or with knives in one’s hands or with tribesman, enemies, or robbers; tie the patient up, flog him and then cast him/her into a pit or into a completely dark room which has no knives, stones, or people in it; and to  friend may comfort the patient with conversations that inculcated virtue and profits; “  Wujastic, (1998).

Ancient ayurvedic herbal formulations for any mental disorders.

1. brahmi ghee-( 4 days worth).
Ingredients: Brahmi- 50 mgs., shankha pushpin-50 mgs., Ashwagandha-50 mgs.,  jatamanshi 50 mgs., and Ghee -100 mgs. Dose: 1 tsp. 2 times daily.
Preparation: make a paste from the herbs and roll into a ball, boil the ghee and add the paste and cook for1/2 hour, and filter. Swami Sada Shiva irtha (1998).
2. Cow’s urine potion:
“Cow’s urine is cooked in about three kilograms of ghee, together with about 200 grams of asofoetida, dark salt, and a mixture of black pepper, long pepper and dried ginger this is the best thing for banishing insanity” Wajastic, (1998 ).

The principles of treating mental disease

In the current body of literature, Dr. Marc Halpern writes, “All mental disease originates in a lack of clarity (sattwa) within the mind”. He adds, “The primary goal of spiritual healing is the cultivation of sattwa through proper lifestyle and through all five senses”. In addition, Dr. Halpern points out that some general principles are needed to heal the mind, including spending more time in nature, mediation practices, and yoga (8 limbs). He also adds that avoiding the influence of the media and eating a sattvic diet helps to restore the mind. Finally, it is also recommended to increase ojas and balance prana, tejas.

Summary

As noted by Psychiatric professionals, schizophrenia is not yet a “curable” disease, but the treatment for this illness is more effective today than ever before, largely because of the careful thinking and research that has gone into its main treatment method,  antipsychotic medication.  However, it is well known the multiple short and long-term mental and physical side effects caused by anti-psychotic medication.  Some of the of the “less serious” side effects include dry mouth, diarrhea, constipation, cough, and blurry vision. And some of the more serious long term side effects include, tardive dyskinesia, low white blood cell count, neuroleptic malignant syndrome, memory loss, uncontrollable body movements, unexplained muscle weakness, suicidal thoughts, liver failure, diabetes, weight gain, digestive problems, heart disease, sexual dysfunction,  degenerative disorders, among others. I believe the most successful treatment approaches are the ones that use a multimodal and holistic approach.

Ayurvedic medicine can be of great assistance to the treatment of people suffering from schizophrenia and other psychotic disorders. In addition to all the therapies described above, Ayurvedic Medicine employs a whole series of Yogic and spiritual therapies not yet explored by Western approaches for the treatment of mental illness. Some of these spiritual therapies include meditation, pranayanma, mantra, prayer, and visualizations besides its regular physical healing means and modalities to treat mental conditions such as herbal medicine, education, yoga, diet/nutrition, aromatherapy, and color therapy.
Unfortunately, Ayurvedic medicine is not totally yet incorporated as a complementary therapy to the treatment of mental disorder by Western Medical establishment. Although Western treatment methods for the treatment of schizophrenia are more effective today, still there is no cure and not a single effective Western treatment method for schizophrenia. Most of the western methods are more focused on improving their quality of life, minimize symptoms, prevent suicide, avert relapses, enhance the patient’s self- esteem, and to improve social and occupational functioning.  In addition, Psychiatric treatment methods are to stabilize the patient’s symptoms, reduce the need for psychiatric hospitalizations and to increase the patient’s social and independent living skills.  Unfortunately there is no scientific research done on Ayurvedic treatment for schizophrenia that can validate the effectiveness of its treatment methods. Finally, Ayurvedic medicine offers a great hope for people with psychotic disorders that can help them to live a more balanced life. As noted by Frawley, “Ayurveda teaches harmony with nature, simplicity and contentment as the keys to well being. Ayurveda shows us how to live in a state of balance in which fulfillment in a matter of being, not becoming. It connects us with the wellsprings of creativity and happiness within our own consciousness, so that we can permanently overcome our psychological problems”. Frawley, (1998).

References

Keefe, R., and Harvey, P. (1994).  Understanding schizophrenia: A guide to the new research on causes and treatment. New York: The Free Press.
Manxmen, J., and Ward, N., (1995). Essential psychopathology and its treatment. New York: Norton.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders. (4th ed.). Washington, DC: Author.
Liberman, R. (1988). Psychiatric rehabilitation of chronic mental patients. Washington, DC: American Psychology Association.
Comer, R. (1992). Abnormal Psychology. New York: Freeman and company.
Kaplan, H., and Sadock, B. (1998). Synopsis of Psychiatry: Behavioral Science / Clinical Psychiatry. Pa: Rose Tree Corporate Center.
British Columbia Schizophrenia Society. (2001, April). Basic facts about schizophrenia: National Institute of Mental Health. (1999, June 1). Schizophrenia. Retrieved from http:www.nimh.gov/publicat/schizoh.htm
A Review of Schizophrenia by Dr. B. Green, consultant Psychiatrist, UK. (1995). Schizophrenia an independent review article in Psychiatry on-line. Retrieved from http://www.pol-it.org//schizo.htm
Schizophrenia Research at the National Institute of Mental Health. (1999, April 14). Schizophrenia research. Retrieved from http://nimh.gov/publicat/schizresfact.htm

American Institute of Vedic Studies
Frawley, (2004) Ayurvedic Healing Course for Health Care Professionals Part IV
Santa Fe, N.American Institute of Vedic Studies.
.Frawley, (1989). Ayurveda and the Mind the healing of Consciousness
Salt Lake City, Utah. Passage Press
Wujasty, (1998). The Roots of Ayurveda.  London. Penguin books
Halpern. (2005)  Principles of Ayurvedic Medicine.  8th edition.
Grass Valley CA. California College of Ayurveda.
Swami Sada Shiva Tirtha. (1998). The Ayurveda Encyclopedia. Natural Secrets to Healing, Prevention, & Longevity. First edition. Bayville. NY. Ayurveda Holistic Center Press.

Ayurvedic Approaches to the Treatment of Depression: By Laura Perlin

Ayurvedic Management of Bipolar Disorder

By: Josh Greene

Introduction
    Bipolar disorder is a Western psychological diagnosis, characterized by mood swings between elation or mania and depression. It has an extensive amount of symptoms and manifestations that can vary greatly depending on the constitution, environment and imbalances of the individual. In susceptible individuals, bipolar disorder is primarily amplified by low ojas (immunity, strength, contentment, ability to cope) and high vata (biological principle of movement and dryness) in the mind and nervous system. As we shall discover, Ayurveda offers a multitude of holistic tools and ways of approaching this disease that can restore health so as to not rely as heavily on conventional treatments.

Western Definition
    “Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Symptoms of bipolar disorder are severe. They are different from the normal ups and downs that everyone goes through from time to time.”   Modern psychology defines several subcategories of bipolar disorder that make up a spectrum of possible manifestations. All of these types are characterized by extreme mood swings that alternate between mania, hypomania (elevated, euphoric, hyperactive or irritable mood) and depression or can exist in a variety of combinations simultaneously. Bipolar I disorder involves episodes of the most severe high and low mood swings and is your classic manic to depressed presentation.  It is defined as: “One or more manic episodes.”   Bipolar II disorder is a milder form, involving episodes of hypomania that alternate with depression. It is defined as: “No manic episodes, but one or more hypomanic episodes and one or more major depressive episode.”   Cyclothymic disorder describes even milder mood changes. It is defined as: “A history of hypomanic episodes with periods of depression that do not meet criteria for major depressive episodes.”   When the episodes do not fall into the previous three subcategories, the term Bipolar Disorder NOS (Not Otherwise Specified) is used and defined as: “A catchall category, diagnosed when the disorder does not fall within a specific subtype.”   Another subcategory is “rapid cycling,” which can pertain to any of the aforementioned subtypes. It is characterized by frequency and is defined as: “A patient who presents with more than four or five episodes in 1 year.”    This disease is quite different from normal mood states of happiness and sadness that everyone experiences, symptoms of bipolar disorder can be quite severe and potentially life threatening.

Ayurvedic Definition
    Traditional Ayurveda has no specific equivalent disease for the diagnosis of bipolar disorder written in the classical Ayurvedic texts. One of the main ancient treatises on Ayurveda is the Charaka Samhita. It uses the term “Unmada” as a very general term for insanity. Insanity according to the author Charak is “wandering about of mind, intellect, consciousness, knowledge, memory, inclination, manners, activities and conduct.”   Charak goes on to describe five different types of insanity. While none of these perfectly correlate to the western description of bipolar disorder, some of the descriptions and symptoms are similar and some parallels can be drawn. Fitting a set of symptoms into the diagnosis of a particular disease is not a prerequisite to treating it using Ayurvedic methods.  Bipolar disorder manifests due to imbalances in the three fundamental biological qualities that govern the body and mind; vata, pitta and kapha; and the mental principles of sattva, rajas and tamas, which are the “qualities of consciousness.”  
    Some modern Ayurvedic practitioners liken bipolar disorder to being a lack of stability or ojas, which leads to difficulty sustaining emotional responses.   Ojas is defined to “maintain immunity, strength, integrity, and vitality.”   It acts as the container that holds the other two energies in the body: tejas, the energy of intelligence and discrimination; and prana, the body’s life energy. These three subtle energies are the forces that govern the functioning of the mind.  During the elated or manic phase, prana and tejas are high and during the depressive state, prana will be low and tejas can be either high or low.

Signs and Symptoms (Rupa and Laksana)
    Bipolar disorder is a disease in which individuals experience periods of elation, either manic or hypomanic and periods of abnormal depression that interfere with functioning in daily life.  In general, men tend to have more frequent elated or manic episodes, while women more often depressive episodes. The peak age of onset is in the early thirties. 
The elated and vata symptoms of bipolar disorder include talkativeness, excessiveness, racing thoughts, hyper-sexuality, euphoria and impulsive over-spending (of money, time, energy). Some other manic and more pitta type symptoms include over-confidence, irritability, aggression or anger directed outwardly against other people, under-sleeping and hyperactivity. On the other side of the coin are the depressive (more kaphic) symptoms of bipolar disorder, including feelings of sadness, lethargy, lack of enthusiasm, apathy, lack of appetite, lack of sexual interest, over-sleeping and hypoactivity. It should be noted that while there are typical vata, pitta and kapha symptoms, you could have for example a depression that is primarily governed by vata, pitta or kapha. “There are many people who say, "well if anxiety is due to vata then depression must be due to kapha, because it is heavy." Well, that’s sometimes true, but not always true in fact severe depression tends to be more of a vata condition.”   Emptiness, hopelessness, difficulty concentrating or making decisions, insomnia, restlessness, memory problems, uncontrollable crying, weight loss, despair and even suicidal thoughts are also all symptoms of depression that are chiefly vata symptoms.  All of these listed symptoms can manifest in the short term as well as the long term and can appear in countless combinations, making each patient a unique case.

Etiology and Pathology (Nidana and Samprapati)
    In western medicine the exact cause of bipolar disorder is unknown. Genetics are a substantial factor in the disease manifestation, but it rarely appears without environmental circumstances such as traumatic life events or extreme social stressors. It is found to be more common among individuals who are affluent, extroverted, achievement-oriented and use activity to combat depression.  Outwardly, bipolar disorder is seemingly two opposing high and low conditions that have a pendulum type correlation to each other. However there can be aspects of anxiety, elation or mania even during depressive states and vise versa.  While multiple doshas will likely be involved in the oscillations of bipolar disorder, the very changeability of this disease points to an underlying variable vata imbalance as the principal doshic disturbance. “High Vata in the mind manifests as fear, alienation, anxiety and possible nervous breakdown. There is insomnia, tremors, palpitations, unrest and rapid shifts in mood. Insanity, of the manic depressive type or schizophrenia, is an extreme Vata imbalance.”   More specifically, the cause is primarily samana vayu (vayu is another word for vata).   Dr David Frawley refers to samana vayu as “the equalizing life energy.”   Samana vayu literally means, “balancing air.” “In the mind, the role of samana vayu is to balance and stabilize the other vayus. When it is healthy, the other vayus find greater stability. When it is disrupted, a person loses control of his thoughts and feelings. Samana vayu is also responsible for absorbing sensory impressions into the workings of the brain and mind.”   The other two vayus that play an essential role in this disorder are prana and vyana. When prana vayu is disturbed it affects our thoughts and emotions. Prana is also responsible for the intake of impressions into the brain and mind as well as movement of neurotransmitters through the nervous system. Vyana is also responsible for movement in the nervous system and circulation of thoughts and emotions.  Aggravated pitta pushed by vata leads to the mental principle of rajas, which may result in mania. Rajas is defined as “quality of consciousness; the principle of kinetic energy; active, mobile.”   It is responsible for all movements, changes and excitability. Aggravated kapha pushed by vata leads to the mental principle of tamas, which may result in depression. Tamas is defined as “quality of consciousness; inertia.” and is responsible for sleep, heaviness, dullness and depression.   These two principles of the three basic mental states are destructive. The third being sattva which brings balance, light and purpose. The higher the air element in the vata, the faster the individual moves through the different cycles.
    Regardless of the doshic imbalance, all patients suffering from bipolar disorder are likely to have low ojas (contentment, ability to cope, vitality and immunity). This low ojas is the instability that is allowing the vata movement from one mood state to another. The patient will also be more susceptible to vata changes in mood when they are under stress. It is this stress that wears down the “container of ojas.”    As was mentioned previously, bipolar disorder usually doesn’t manifest until one’s twenties or thirties.  It is possible that as the patient moves out of the kapha phase of life into the busier more stressful pitta time of life, they lose the grounding of the water and earth elements and become more susceptible to the heat of pitta, which in turn contributes to the drying of vata. Changes in the underlying emotions are brought on by vata-provoking qualities in the individual’s lifestyle, habits, foods and activities. These qualities are dry, rough, light, cold, subtle and mobile.  Some specific etiologies include: Eating while anxious or depressed, eating on the run, taking in stimulants such as coffee or cigarettes, using intoxicants such as alcohol or recreational drugs, following irregular routines, traveling frequently, going to bed late, loud music or noise, engaging in excessive physical or sexual activity, failing to change with the seasons (especially autumn), overloading on stimulation such as TV, mass media, suppressing inner creativity and emotional sensitivity.  Bipolar disorder affects as many as 5.7 million American adults, which is about 2.6 percent of the population over the age of eighteen.  The disease is also quickly on the rise especially in children; one study showed as high as a 40-fold increase between 1995 and 2002.  One of the reasons for this could be the increasingly vatagenic environment to which today’s children are exposed.  “The fact that we have more of these problems is because our culture is over stimulating people.” “Wherever there is excess stimulation, the natural consequence is long term depression once the stimuli gets removed.”  
    The pathology path of vata’s movement through the body begins when vata accumulates and becomes aggravated in the purishavaha srota (colon). From there it overflows into the rasa dhatu (plasma tissue), and rakta dhatu (blood tissue). If the bodies’ tissues and pathways have preexisting weaknesses due to genetics or in the case of the brain and mind, emotional trauma, then under the right conditions repeated doshic disturbances will relocate to those sites. In the case of bipolar disorder, vata moves from the plasma and blood and relocates to the mano vaha srota (pathway of the mind) resulting in loss of awareness of one’s situation and fluctuations in emotional states. It also secondarily relocates into the majja dhatu (nervous tissue) and majja vaha srota (pathway of the nervous system), resulting in biochemical changes to the neurotransmitters being released effecting our thoughts.  Once vata has taken root in these tissues and pathways, it starts to manifest the myriad of signs and symptoms of bipolar disorder.

Diagnosis (Nidanam)
    The Western diagnosis of bipolar disorder is based on symptoms and how they change and progress, as well as life and family history. There is no definitive biological test and diagnosis can be difficult even for an experienced psychologist or psychiatrist. The diagnosis is primarily based on the self history as well as what is reported by friends, family and co-workers “using the criteria for both manic and major depressive episodes.”   Both of these must have been present, and the subtype of bipolar disorder will depend on the frequency, severity and duration of the episodes.
    In Ayurvedic medicine the label of bipolar is not really relevant to treatment. Diagnosis is based on the patient’s prakruti (underlying constitution) and the past and present history of vikruti (short-term symptoms and doshic imbalances).  The practitioner must consider the long- and short-term state of doshas and subdoshas; the patient’s levels of ojas, tejas and prana; as well as the state of mental principles, sattva, rajas and tamas.  Ayurvedic practitioners must also identify the major stressors that are pushing the patient’s mental states to opposite poles. 

Western Medical Treatment
    There is no known cure for bipolar disorder. The two main Western methods for treatment are medications and psychotherapy. When used in conjunction, they have shown to be effective at preventing relapses and reducing the severity of the patient’s symptoms.  As Dr David Frawley states: “Modern Medicine attempts to change the consciousness through altering the chemistry of the brain.” 
    The main medications used are mood stabilizers such as lithium, valproic acid (Depakote) and lamotrigine (Lamictal); antipsychotics such as olanzapine (Zyprexa), quetiapine (Seroquel) and aripiprazole (Abilify); and lastly, antidepressants such as fluoxetine (Prozac), paroxetine (Paxil) and bupropion (Wellbutrin).  These medications are an amazing product of modern science. They have a strong effect on brain chemistry and are often very useful for managing this disease and improving the lives of individuals. Any medical doctor can prescribe these medications, but typically a psychiatrist, rather than a family practice or other specialty physician, would manage bipolar disorder. The downsides to these medications include countless known side effects and imperfect research as to how they affect the body and mind in other ways especially long term. From an Ayurvedic perspective, these medications do not treat the deep doshic root causes of the disease, but rather they balance and suppress the manifesting symptoms. “One of the main problems with modern medicine is that acute care has become the primary care both for the physical and the psychological medicine, which often causes more trouble with the chronic diseases.”   It is also very possible that these medicines simply move the doshas into other parts of the body, only to negatively affect the health of the individual in other ways. For example, vata being pushed into the medas or asthi dhatu could cause wasting, osteoporosis, or arthritis; vata staying in the majja dhatu could lead to other types of brain problems, such as Parkinson’s or Alzheimer’s; vata entering the shukra dhatu could cause sterility or low libido. 
    The other main Western treatment is psychotherapy or “talk” therapy.  Some common psychotherapy treatments that have been used to treat bipolar disorder are:
    “Cognitive behavioral therapy, helps people with bipolar disorder learn to change harmful or negative thought patterns and behaviors.  Family-focused therapy includes family members. It helps enhance family coping strategies, such as recognizing new episodes early and helping their loved one. Interpersonal and social rhythm therapy helps people with bipolar disorder improve their relationships with others and manage their daily routines. Regular daily routines and sleep schedules may help protect against manic episodes. Psychoeducation teaches people with bipolar disorder about the illness and its treatment. This treatment helps people recognize signs of relapse so they can seek treatment early, before a full-blown episode occurs.”  
    Usually a licensed psychologist, social worker, or counselor provides these therapies. The efficacy of therapy and medications was highlighted in the largest treatment study ever conducted for bipolar disorder. Researchers compared people in two treatment groups: the first was treated with three psychoeducation sessions over six weeks, while the second was treated with medication and thirty of the above mentioned types of intensive psychotherapy sessions over nine months. The results showed that group two individuals were more likely to get well faster and stay well longer with fewer relapses, lower hospitalization rates, and greater adherence to their treatment plans.   Some other Western treatment methods include electroconvulsive therapy (ECT), sleeping medications, increased omega 3 fatty acid intake, ketogenic diets and canabanoids. All of these have mixed results or insufficient data to show significant usefulness.

Ayurvedic Treatment (Chikitsa)
    In management of any psychological disease, Ayurveda works to change the energetics of the mind.  The two main Ayurvedic treatments for managing bipolar disorder center on increasing our ojas and reducing our stressors. The stronger our ability to cope and withstand the stressors of the world, the less likely our moods will fluctuate between highs and lows. When ojas is strong  we are less likely to be buffeted by the doshas.  The more we identify our stressors and reduce them, the less ojas will be worn down.  The patient’s therapist and family are good allies in helping the patient identify these stressors. The main tools used in managing the mind are “diet and herbs on a physical level, prana and the senses working at a more subtle level, and mantra and meditation working more at the level of the mind itself.” 
    In dealing with the doshas, vata must be balanced first even if there are other current imbalances. The practitioner does not want simply to treat the current vikruti, only to drive the movement from one mood to another. It is no coincidence that many of the treatments for vata will also build ojas.  The main thing that helps both is to develop regular solid routines and stability. This includes: waking and sleeping times, eating times and food choices, work schedules and one’s general activities throughout the day.  Irregular patterns place stress on our body’s ability to function at its best. Some examples of this are regular mealtimes and bedtimes. When our body’s biological clock can anticipate meal or sleep times, it will release chemicals such as amylase, pepsin and acid needed to digest food in the former and chemicals such as melatonin needed to sleep in the latter. When the body is subject to irregularity, we will be prone to problems like indigestion and insomnia that put great stress on our bodies and reduce ojas. This is especially true of digestion, since we identified samana vayu as being the main causative factor in changes from one mood to another and the digestive tract as being the primary site of all doshic disturbances in the body.  Sleeping times are also important. Going to bed around 10:00pm and awakening near sunrise will help the body change mental states in the kapha times of day when it is more stable. The morning should be devoted to steady and healthy morning routines, including meditation and exercise.   Since vata has the qualities of: “cold, light, mobile, dry and piercing, and follows a transverse course,”  it is necessary to implement the opposite qualities in any treatment. Regardless of the type of treatment, an emphasis on warm, heavy, stable, moist, oily and dull qualities should be made.
    The best place to start in dealing with bipolar disorder is to identify and minimize stressors that trigger changes in the mood states. Family and friends may be useful in helping to identify what these are as patients may have some denial about this. Our society is largely work driven and it may be necessary for patients to reduce their workload in order to reduce stress and focus on their health. Prioritization of all the things one wants to do in order to create a more laid back and relaxed schedule can often be difficult. The patient’s surroundings at home can also be a major source of stress. Keeping the home tidy, free of clutter and clean helps to cultivate a more sattvic and stress free environment. Time in nature is also an excellent method for reducing stress, building ojas and pacifying vata.
    The most important factor concerning meals is eating at regular times each day and also making sure not to go without eating. Food pacifies vata and diet should emphasize whole grains, cooked vegetables, mung beans, meats, fresh dairy, nuts and oils in order to ground the patient and build up ojas. Generally, sweet, sour and salty tastes should be emphasized, as well as the qualities of warm, moist and heavy foods. When one is having a pitta manic phase, then cooler and blander foods may be useful, and during depressive states, spicier foods can be used. Canned, frozen, old, processed, microwaved and rancid foods should be avoided.   It is also important to stabilize blood sugar.  Increasing the ratio of fats and proteins in relation to carbohydrates and keeping simple carbohydrates to a minimum will help with this.  Coffee and other stimulants should be avoided since they will only serve to keep someone going artificially without getting true rest and will lead to more vata imbalance. Lunchtime should be the main meal of the day. It should last at least one hour and be taken at the same time, everyday while seated in a peaceful, distraction free environment in order to let food settle and digest before moving on to other activities. Some form of grace and blessing should be given before eating in order to help center ones mind. 
    When treating bipolar disorder with herbal therapies, nervine tonics become the most important for building stability and mental ojas. Nervine sedatives may be useful for elated or manic episodes and nervine stimulants may be useful for depressive states; however, the intent is not to force the brain out of a particular episode by providing herbal uppers or downers. While having sedatives and stimulants on hand is okay, the goal should be to balance the doshas and normalize the production of neurotransmitters using tonics.  A specific formula should depend on the particular constitution and state of the patient. Some generally good herb choices for tonics are ashwagandha, brahmi, shatavari, ginseng, shanka pushpi, nutmeg, skull cap, kappikacchu, haritaki and bhringaraj.  Also, jyotishmati, ginkgo, jatamamsi, oat straw, valerian root, St. John’s wort and Gotu Kola may be useful in some patients.   Brahmi is a great choice for any mood state since it can both act as a mild stimulant and sedative depending on what mood state needs to be balanced. Ashwagandha is very useful for building ojas and pacifying vata in the nervous system and mind. All of these herbs should be taken with herbs that aid in their digestion and absorption.  Triphala is a useful combination of three fruits that not only strongly reduces vata in the intestines, but also helps with the absorption of the other herbs and foods that are being taken and will exponentially multiply their effects. Since bipolar disorder is partially rooted in the nervous system, medicated ghees are an ideal medium for enabling these herbs to penetrate deeply into these tissues.
    The five sense therapies (vision, sound, taste, touch and smell) can be used to place the patient in balancing and restorative surroundings. Color therapy may be useful for the visual sense. Yellow, green, gold, blue, white, violet, and pastels in general are considered sattvic colors; gold and brown are considered to raise ojas; and yellow, green, gold, brown and purple are considered to decrease vata.   Colors can be applied to clothing, home décor, meditation and flowers. Music that the patient finds enjoyable or mantra therapy may be beneficial sound therapy. Since vata is rough, dry cold and sharp, touch therapy should have the opposite qualities. Clothing worn and bedding should be soft and warm. Regular, gentle and steady massage with lots of oil is also an excellent therapy for the touch sense. While professional massage is also excellent, daily self-massage with sesame oil is more affordable, easier to implement and offers the added benefit of self-love needed for more insecure vata type individuals. Aromas that may be useful to calm the mind during elation include sandalwood, chamomile, clary sage and jatamamsi.  For depression, rosemary, cinnamon, thyme, mint and eucalyptus may be useful to help get moving. Rose, basil and lavender may add balance to bipolar disorder.   They can be taken in the form of essential oils with an infuser, or by adding a few drops to a warm bath.
    Exercise can also be an important factor in managing the doshas, as well as helping one relax and sleep well. It is; however, important not to over exert oneself since that can deplete ojas. Generally, working out to half of one’s capacity is advised. Calming exercises like Yoga, Qi Gong, Pilates and Tai Chi are generally wise choices for all three doshas. Aikido, gardening, walking and gentle hiking are also good activities. When the patient is experiencing more pitta manic symptoms, then slow and cooling exercises are best like a cool walk in nature or slow swimming.  When the patient is in a more depressive state, mild running, team sports or Bikram Yoga may be of use.
    Panchakarma (“the five actions”) is the main Ayurvedic method for purification. “Owing to the subtle nature of its processes, it penetrates deep into the nervous system. It is useful for psychological problems caused by excess of the three doshas. Yet it can also be helpful for psychological problems caused by internal factors, emotions and karma.”     The practitioner must of course evaluate the state of the patient’s ama (toxins) and strength of ojas, before deciding on a plan for how aggressively to pursue panchakarma. Since the patient is likely to be low ojas, a slower palliative plan that focuses on strengthening the patient during purification is more likely to be useful. Since the primary problem is vata imbalance, a program with an emphasis on bastis (therapeutic enemas) should be adopted. If the patient is in a manic phase, virechana (therapeutic purgation) may be used and if the patient is in a depressed state, vamana (therapeutic emesis) may be an option. Oleation with medicated oils through abhyanga (Ayurvedic massage) is also a key therapy in palliation, as well as for managing vata whether or not it is a part of panchakarma. Shirodhara (flowing oil on the forehead) and shirobasti (oil in a crown on the head) are also highly recommended for their direct action on the brain, mind and subtle energy fields.
    In Ayurveda sleep is considered one of the great pillars of health. Sleep builds ojas and pacifies vata. Its importance for treatment of bipolar disorder cannot be understated. “There is also a connection between mental health and deep sleep.” “It is the state of deep sleep that allows the mind to renew itself.”   Sleep allows the body and mind to naturally rest and heal. Many of the other therapies, foods and herbs listed here help to regulate the body so that it can get enough quality sleep. Most sleeping pills are a class of drugs called “hypnotics” that put the body into trance-like states that do not go through the normal sleep stages. They do not provide the same quality of sleep as a natural, healthy sleep cycle.
    Meditation, breath, pranayama, as well as other yogic practices, are also of great importance in managing bipolar disorder. They have the ability to cultivate a sattvic mind, as well as to teach the patient how to manage the internal channels and energy moving through their body and mind. Meditation brings us back to a state of awareness that allows us to see the transient nature of things including our own moods and emotional states. Repetition of these practices actually has the ability to change our internal biochemistry, lessening the large fluctuations in our minds. While diet, herbs and lifestyle practices can do much on an outer level to pacify doshas and prevent disease, practices like meditation work on a much deeper and more fundamental level to change the subtle energies in our consciousness.
    Since Ayurveda is not a quick process and relies on the development of healthy routines and habits over a lifetime, it is important for a patient already diagnosed as bipolar to continue with the treatments laid out by his or her physician. If the patient has not received a formal diagnosis and the Ayurvedic practitioner, patient, or a patient’s family has concerns about a severe mood disorder, the patient should be referred to a primary care physician for evaluation.  Even if a patient currently seems stable, if there is a history of severe mood states and he or she falls back into them, then the patient will likely be unable to follow an Ayurvedic lifestyle. Western pharmacology can often provide the acute stability needed for the individual to work on developing long-term habits and routines.  A year on an Ayurvedic treatment plan would be a reasonable minimal timeframe for a patient to follow before talking with his or her physician about coming off medications. 

Conclusion
    Bipolar disorder is a multi-faceted disease consisting of periods of elation and depression. It is a condition of low ojas and high vata in the mind and nervous system. A regimen of Ayurvedic treatments to tonify, develop regularity and reduce stressors can help to build ojas and pacify the vayus. Ayurveda is useful for managing bipolar disorder because it is a holistic approach that looks at the constitution, the state of current imbalances, and the whole environment of an individual before deciding what is the best regimen to bring him or her into a balanced state.  It provides a complete package of useful everyday tools such as lifestyle, diet, herbs, purification and meditation that best suits the specific individual. This is contrasted with Western medicine, which has the tendency to put everyone with similar symptoms into the same box and provide them with pharmacological solutions that suppress symptoms but don’t solve the underlying problem. Ayurveda not only has the ability to treat symptoms of a psychological disease like bipolar disorder, but it can also move past the disease to identify its root causes and the underlying patterns affecting the individual. Combined with meditation and other yogic practices, Ayurveda works on the subtle aspects of mind to heal consciousness and release individuals from disease.

References

  "NIMH • Bipolar Disorder." NIMH • Home. U.S. Department of Health and Human Services, 06 Oct. 2009. Web. 02 June 2010. <http://www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml>.

  American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th, text revision (DSM-IV-TR) ed. 2000. ISBN 0-89042-025-4. Bipolar Disorder.  DSM-IV-TR. Bipolar I Disorder.

  ^ DSM-IV-TR. Diagnostic criteria for 296.89 Bipolar II Disorder.

  ^ DSM-IV-TR. Diagnostic criteria for 301.13 Cyclothymic Disorder.

  ^ DSM-IV-TR. Not Otherwise Specified (NOS)

  Judd, Lewis L., and Leighton Y. Huey. "Part Thirteen Psychiatry." Harrison's Principles of Internal Medicine. By Eugene Braunwald. 11th ed. New York [etc.: McGraw-Hill, 1987. 2085-087. Print.

  Charaka. Charaka Samhita Handbook on Ayurveda. Ed. Gabriel Van Loon. Vol. 2. Chaukhambha Orientalia, 2002.  1100. Print.

  Lad, Vasant. Textbook of Ayurveda: Fundamental Principles of Ayurveda. Albuquerque, NM: Ayurvedic, 2002. 308. Print. 

  Thompson, Mary. "The Nervous System." AHP Level 2 Class. California College of Ayurveda, Grass Valley. 16 Sept. 2010. Lecture.

  Ibid Textbook of Ayurveda: Fundamental Principles of Ayurveda. 306.

  Halpern, Marc. Principles of Ayurvedic Medicine. 9th ed. Vol. 2. Grass Valley: California College of Ayurveda, 2007. Print. Textbook.

  Frawley, David, and Marc Halpern. Ayurvedic Psychology: Anxiety and Depression. Rec. 18 Nov. 2006. California College of Ayurveda, 2006. CD.

   Ibid Harrison's Principles of Internal Medicine. 2086.

  Ibid Ayurvedic Psychology: Anxiety and Depression. Disc 4 “Anxiety and Depression”

  ^Ayurvedic Psychology: Anxiety and Depression. Disc 4 “Anxiety and Depression”

  ^Ayurvedic Psychology: Anxiety and Depression. Disc 4 “Anxiety and Depression”

  Frawley, David. Ayurveda and the Mind: the Healing of Consciousness. Twin Lakes, WI: Lotus, 1997. 155. Print.

  Ibid "The Nervous System."

  Ibid Ayurveda and the Mind. 316.

  Halpern, Marc. Principles of Ayurvedic Medicine. 9th ed. Vol. 1. Grass Valley: California College of Ayurveda, 2007. Print. 81. Textbook.

  Ibid Principles of Ayurvedic Medicine. 9th ed. Vol. 1. 78-83.

  Ibid Textbook of Ayurveda: Fundamental Principles of Ayurveda. 308.

  Ibid Textbook of Ayurveda: Fundamental Principles of Ayurveda. 8.

  Ibid "The Nervous System."

  Yarema, Thomas, Daniel Rhoda, and Johnny Branningan. Eat-taste-heal: an Ayurvedic Cookbook of Modern Living. Kapaa, HI: Five Elements, 2006. 28-31 Print.

  ^ Eat-taste-heal: an Ayurvedic Cookbook of Modern Living. 31.

  Moreno, C., G. Laje, C. Blanco, H. Jiang, A. B. Schmidt, and M. Olfson. "National Trends in the Outpatient Diagnosis and Treatment of Bipolar Disorder in Youth." Archives of General Psychiatry 64.9 (2007): 1032-039. Print.

  ^ “National Trends in the Outpatient Diagnosis and Treatment of Bipolar Disorder in Youth.”

  Ibid Ayurvedic Psychology: Anxiety and Depression

  Ibid Ayurvedic Psychology: Anxiety and Depression.

  Ibid Harrison's Principles of Internal Medicine. 11th ed. 2086.

  Ibid "NIMH • Bipolar Disorder." How is bipolar disorder treated?

  Ibid Ayurvedic Psychology: Anxiety and Depression.

  Ibid "NIMH • Bipolar Disorder." Medications.

  Ibid Ayurvedic Psychology: Anxiety and Depression.

  Ibid Textbook of Ayurveda: Fundamental Principles of Ayurveda. Chapter 6.

  Ibid "NIMH • Bipolar Disorder." Psychotherapy.

  Miklowitz DJ, Otto MW, Frank E, Reilly-Harrington NA, Wisniewski SR, Kogan JN, Nierenberg AA, Calabrese JR, Marangell LB, Gyulai L, Araga M, Gonzalez JM, Shirley ER, Thase ME, Sachs GS. Psychosocial treatments for bipolar depression: a 1-year randomized trial from the Systematic Treatment Enhancement Program (STEP). Arch Gen Psychiatry. 2007 Apr;64(4):419-426.

  Ibid "NIMH • Bipolar Disorder." Other treatments.

  Ibid Ayurvedic Psychology: Anxiety and Depression.

  Ibid "The Nervous System."

  Ibid Ayurvedic Psychology: Anxiety and Depression.

  Ibid "The Nervous System."

  Ibid Ayurvedic Psychology: Anxiety and Depression.

  Bhishagratna, Kaviraj Kunjalal. An English Translation of Sushruta Samhitá: Based on Original Sanskrit Text with a Full Comprehensive Introduction, Additional Texts, Different Readings, Notes, Comparative Views, Index, Glossary and Plates. Varansi: Chowkhamba Sanskrit Series Office, 1981. Chapter 1. Print.

  Ibid Ayurvedic Psychology: Anxiety and Depression.

  Ibid Psychology of Ayurveda: Treatment of Psychological Conditions.

  Ibid "The Nervous System."

  Ibid Ayurvedic Psychology: Anxiety and Depression.

  Ibid "The Nervous System."

  Frawley, David, and Vasant Lad. The Yoga of Herbs: an Ayurvedic Guide to Herbal Medicine. Twin Lakes, WI: Lotus, 2001. Print.

  Halpern, Marc. Psychology of Ayurveda: Treatment of Psychological Conditions. Grass Valley: California College of Ayurveda, 2006. Print.

  Ibid Principles of Ayurvedic Medicine. 9th ed. Vol. 2. 442.

  Ibid Psychology of Ayurveda: Treatment of Psychological Conditions.

  Ibid Ayurveda and the Mind. 203.

  Ibid Ayurvedic Psychology: Anxiety and Depression. Disc 3. “Prana, Tejas and Ojas”. Track 4.

Bipolar Disorder: from Western Medicine and Chronobiology to Ayurveda By: Lucia Pagani

Ayurveda Research Papers (CCA Student papers)

The selected papers published on our website have been written by students of the California College of Ayurveda as a part of their required work toward graduation.

An Ayurvedic Approach to the Treatment of Secondary Amenorrhea By: Zoe Middlebrooks

AN AYURVEDIC APPROACH TO AMENORRHEA 

Overview of Women’s Reproductive Cycle

The glands of the endocrine system that regulate a women’s menstrual cycle are the hypothalamus, pituitary gland, and the ovaries. The hypothalamus is the master gland of the system; it secretes Luteinizing Hormone Releasing Hormones (LHRH) and stimulates the pituitary gland to release Luteinizing Hormone (LH) and Follicle-­‐Stimulating Hormone (FSH). As the pituitary gland secretes LH and FSH, these hormones act on the follicle in the ovary and stimulate its maturation. At the ovary, estrogen and progesterone are released. As the follicle matures, estrogen affects the development of a woman’s body and maturing egg. At the same time, progesterone affects the development of the endometrium and the breast tissue. The hormonal flow between the three glands is a negative feedback system; if the body has enough estrogen then no LHRH is produced, however, if estrogen levels are running low, than the hypothalamus secretes LHRH. A healthy menstrual cycle is dependent on functioning of the endocrine system.1
 
Every month an egg matures and a woman’s body and uterus prepare for pregnancy. If pregnancy does not occur, than the endometrial lining is released. Following menstruation, the endometrial lining of the uterus builds again as the uterus prepares for a fertilized egg. During this time there is an increase in arterial and venous blood flow. This is called the proliferative phase of the  uterine (menstrual) cycle. Then, during the secretory phase, the tissue leftover after the egg is released, known as the corpus luteum, secretes estrogen and progesterone to act on the uterus and body. At this point in the cycle, if fertilization has occurred, estrogen and progesterone remain high and there is no need for the hypothalamus to secrete LHRH. However, if the egg was not fertilized then production of estrogen and progesterone drops, triggering the shedding of the endometrium-­‐ the start of another menstrual cycle.2  This monthly release is the motion of apana vayu. The subdosha of vata associated with downward movement.
 

  • 1  

    Halpern, Clinical Ayurvedic Medicine, 6th Ed. (Grass Valley: California College of Ayurveda 2012)


    2  

    American Medical Woman’s Association, Inc., The Women’s Complete Healthbook: Up-­‐to-­‐the-­‐Minute Medical Information on the Issues that Concern Women Most (New York: Delacorte Press,1995) p.213

Menarche & Menstruation

The onset of menses in a young woman is called menarche, according to the American Medical Women’s Association, this occurs “between the ages of 10 and 14, when the ovaries begin producing the hormone estrogen.  This causes the hips to widen, breasts to develop, and body hair to grow.  It also triggers menstruation, the monthly cycle of bleeding that is a key part of a woman’s fertility.”3  On average, menstruation lasts 3-­‐5 days.   Women’s menstrual cycles can range in length from 21 to 35.  A 28-­‐day cycle is the average and is thought to be the healthiest length for a woman.  Health complications become more common the farther away from 28 days a women’s cycle gets.
 
The classical Ayurvedic description of menses was more specific; according to the Astanga Hrdayamis, “in women, the rajas (menstrual blood) which is the product of rasa (the first dhatu), flows out of the body for three days, every month, after the age of twelve years and undergoes diminision by the age of fifty years.”4
 
There are many Sanskrit terms that refer to the menstrual cycle. In Sanskrit, “the menstrual cycle of a woman is called rajodarshana. The root raja means ‘blood’ while dharshana means ‘to see.’ Thus rajodharshana is the ‘seeing of blood.’”5  Other Sanskrit terms include rutukala, or “woman’s season,”6 arajaska from the Charaka Samhita.7
 
Amenorrhea
 
Amenorrhea is a condition in which there is an absence of menstruation. “This absence is normal before puberty, after menopause, and during pregnancy [& lactation].”8  Amenorrhea can be a primary or secondary condition. “Primary amenorrhea occurs when a woman reaches the age of 18 and has never had a period. It is usually caused by a problem in the endocrine system that regulates hormones.”9  Reasons a woman could experience primary amenorrhea include “ovarian failure,” “problems in the nervous system or the pituitary gland in the endocrine system that affect maturation at
 
  • Ibid. p.210

    4 Astanga Hrdayam 1:360

    5 Halpern, Clinical Ayurvedic Medicine, 6th Ed. (Grass Valley: California College of Ayurveda 2012) p.5-­‐4 6 Ibid.

    7 Dash & Sharma, Charaka Samhita: Text With Translation & Critical Exposition Based on Cakrapani Datta’s Ayurveda Dipika 4th Ed. (Varanasi: Chowkhamba Sanskrit Series), Volume 5 p.155, XXX:17

    8 American Medical Woman’s Association, Inc., The Women’s Complete Healthbook: Up-­‐to-­‐the-­‐Minute Medical

    Information on the Issues that Concern Women Most (New York: Delacorte Press,1995) p.232

    9 Ibid.

puberty,” or “birth defects in which the reproductive structures do not develop properly.”10 The Sanskrit term for amenorrhea from the Charaka Samhita is and nashta-­‐rakta with nashta meaning lost, destroyed or missing, and rakta meaning blood.11
 
“Secondary amenorrhea is an absence of menstruation for greater than or equal to three months.”12  Secondary amenorrhea can be triggered by “problems that affect estrogen levels, such as stress, weight loss, exercise, or illness;” “problems affecting the pituitary, thyroid, or adrenal gland;” or “ovarian tumors or surgical removal of the ovaries.”13  Stress, whether physical or emotional, “causes   low levels of FSH and LH along with low estrogen levels.”14  Another common cause is coming off of birth control. According to Rosemary Gladstar, “many women have waited for months, even years, for their menstrual cycle to return after having been on birth control pills for an extended period of time.”15
 
A woman experiencing Amenorrhea should consult a western doctor or other diagnostician in order to identify any obvious reasons for her lack of menses. Common diagnostic tools are blood tests for thyroid function, female and male hormone, and possible ultrasound imaging to view the reproductive organs.16  This paper will focus on the pathology and treatment of secondary amenorrhea.
 
Pathology of Amenorrhea
 
According to Charaka, “a woman never suffers from gynecic diseases except as a result of affliction by the aggravated vayu. Therefore, first of all, the aggravated vayu should be alleviated, and only thereafter, therapies should be administered for the alleviation of other doshas.”17  Dr. Frawley has  a similar claim, stating that “as a long-­‐term or frequent condition [amenorrhea] is mainly a deficiency disease due to Vata. But other doshas can cause it as well.”18  While both pitta and vata can play a role in amenorrhea they are uncommon, and in most cases, vata is the primary vitiated dosha. The nidana, or etiology of this condition is caused by vata-­‐provoking lifestyle regimens that lead to depletion. The
 
  • 10 Ibid.

    11 Halpern, Clinical Ayurvedic Medicine, 6th Ed. (Grass Valley: California College of Ayurveda 2012) p.5-­‐100      12 Halpern, Clinical Ayurvedic Medicine, 6th Ed. (Grass Valley: California College of Ayurveda 2012) p.5-­‐100      13 American Medical Woman’s Association, Inc., The Women’s Complete Healthbook: Up-­‐to-­‐the-­‐Minute Medical

    Information on the Issues that Concern Women Most (New York: Delacorte Press,1995) p.232

    14 Halpern, Clinical Ayurvedic Medicine, 6th Ed. (Grass Valley: California College of Ayurveda 2012) p.5-­‐100

    15 Gladstar, Herbal Healing for Women: Simple Home Remedies for Women of All Ages (New York: Fireside 1993)

    p.122

    16 Mayo Clinic, Mayo Clinic Staff, Amenorrhea, http://www.mayoclinic.com/health/amenorrhea/DS00581

    17 Dash & Sharma, Charaka Samhita: Text With Translation & Critical Exposition Based on Cakrapani Datta’s Ayurveda

    Dipika 4th Ed. (Varanasi: Chowkhamba Sanskrit Series) Volume 5 p.159, XXX:114.5-­‐116.5

    18 Frawley, Ayurvedic Healing: A Comprehensive Guide 2nd Ed. (Twin Lakes, WI: Lotus Press 2000) p.248

 

consumption of old, dry and light foods that lead to malnourishment is a very important contributing factor. So too is excessive motion such as a fast paced lifestyle filled with travel, stress and overwhelm. Physically, excessive exercise provokes vata.
 
Symptoms accompanying amenorrhea can include other symptoms of depletion and dryness including “constipation, dry skin, dry hair, weight loss, worry and anxiety.”19  As all these symptoms are those of vata dosha, the samprapti of amenorrhea will be primarily vata associated. In Dr. Halpern’s Clinical Ayurvedic Medicine, he concisely describes the six stages of disease of amenorrhea as the vitiation of vata travels through accumulation, aggravation, overflow, relocation, manifestation, and diversification.
 
  • “Vata accumulates and becomes aggravated in the purishavaha srota. It overflows to the rasa and rakta vaha srotas and relocates deeper into the rasa dhatu as well as into the medas and shukra dhatus. Relocation to the rasa dhatu leads to dryness throughout the body and a decrease in the production of menstrual fluid. Relocation to the medas dhatu results in weight loss and further drying of the body. Relocation to the shukra dhatu inhibits ovulation. Relocation to the mind results in anxiety and overwhelm  along with other vata emotions. “ 20
In addition, after accumulation and aggravation in the purishavaha srota, apana vayu could relocate in the purishavaha srota with a decrease in rasa dhatu leading to a possible and likely symptom of constipation.
 
Western Approach to Treatment
 
According to the Mayo Clinic staff, depending on the nidana of the amenorrhea, treatments include contraceptive pills to jumpstart the menstrual cycle, medications to treat possible thyroid or pituitary disorders or surgery in the case of tumors or structural blockages. In addition, they also mention “lifestyle and home remedies” a woman can work with, including a recommendation to “strive for balance in work, recreation and rest. Assess areas of stress and conflict in your life.”21  The American Medical Women’s Association notes that patients are often asked to record their basal body
 
temperatures in order to help detect whether or not a woman is ovulating.22  Taking ones basal body temperature daily is also useful in bringing awareness and mindfulness to a woman’s monthly cycle and accompanying  patterns.
 
Ayurvedic  Treatment
 
As a holistic health, in treating an absence of menses ayurvedically, a practitioner would treat the patient through their mind, body, and spirit. Their treatment plan would include dietary and lifestyle changes in addition to herbal and five sense therapies.
 
Dietary Recommendations
 
As a condition of vata vitiation, women with amenorrhea will likely experience an increase in the qualities of dry, cold, light and mobile. To counteract these qualities they should alter their diet to concentrate on warm, moist and heavy foods. The most beneficial tastes for them at this time are sweet, in addition to salty and sour. The spicing of foods with dipanas is important to ensure that samana and apana vayu are functioning, as absorption and elimination of nutrients is key. Classical Ayurvedic  dietary recommendations from the Susruta Samhita include taking “fish, Kulattha pulse, Masa pulse, Kanjika (fermented sour gruel etc.), Tila, wine (Sura), cow’s urine, whey, half diluted Takra, curd and Sukta.”23  These suggestions include the sweet, sour and salty tastes as well as heavy and oily foods to nourish vata. A woman with amenorrhea should increase her consumption of whole grains, root vegetables, nuts, dairy and oil. The addition of oils to the diet will be very nourishing and help to keep moisture in the body. It is also important to consider a woman’s daily caloric intake and make sure that it is adequate especially in cases of amenorrhea and vata vitiation due to anorexia nervosa or excessive exercise.
 
For some women, taking daily supplements will help them to get any vitamins or minerals that their diet is lacking.  According to the University of Maryland Medical Center, for women lacking menstruation, it may be beneficial to supplement the diet with calcium, magnesium, vitamin D, vitamin K, boron, Vitamin B-­‐6, and essential fatty oils.  “Women who don’t have periods are at higher risk of
 

  • 22 American Medical Woman’s Association, Inc., The Women’s Complete Healthbook: Up-­‐to-­‐the-­‐Minute Medical

    Information on the Issues that Concern Women Most (New York: Delacorte Press,1995) p.232/233

    23 Bhishagratna, Susruta Samhita(Varanasi: Chowkhamba Sanskrit Series 2002) p. 146, II:22-­‐23

osteoporosis”, calcium, magnesium, vitamin D, vitamin K, and boron “may help keep bones strong.”24 Vitamin B-­‐6 is recommended because it may help reduce high prolactin levels.  “Prolactin is a hormone released by the pituitary gland, and women with amenorrhea often have higher levels of prolactin.”25 Essential fatty acids are important to supplement into the diet, as the human body is not able to synthesize these fats.  A couple examples of oils containing omega 3 and 6 fatty acids are flaxseed oil and cod liver oil.
 
Herbs for Amenorrhea
 
Herbal treatments for amenorrhea can be very effective when taken in addition to dietary and lifestyle changes. The suggested herbal treatment for amenorrhea in the Charaka Samhita is to “drink  the blood of deer, goat, sheep and pig mixed with yoghurt, juice of sour fruits and ghee. She may also  take the milk boiled with drugs belonging to Jivaniya group (jivaka, rasabhaka, meda, maha-­‐meda, kakoli, ksira-­‐kakoli, mudga-­‐parni, masa-­‐parni, jivanti and madhuka).”26  Only some of these classical recommendations can be utilized in the twenty-­‐first century as few women will agree to drinking the blood of animals and many of the suggested herbs are no longer available. “The first six herbs listed in Jivaniya are listed in a group of herbs known as Ashtvarga-­‐ eight herbs. These eight herbs became  extinct 500 years ago.”27  Bhavamisra the author of Bhavaprakasa Nighantu has made some suggested substitutions for the extinct herbs; these include replacing meda and mahameda with shatavari, and jivaka and rasabhaka with vidari kand.28
 
In Dr. Halpern’s text he writes “herbs that are nutritive tonics should be taken along with spices to improve digestion. Most nutritive female reproductive tonics are demulcents and build the rasa dhatu supporting the production of menstrual flow.”29 Therefore, reproductive tonics, demulcents, nervine tonics, and tonifying emmenogogues are herbal categories that should be concentrated on. Most herbal treatments must be continued for several months before the menses returns as rebuilding the health    and tone of the reproductive system takes time. While a woman may be tempted to work with
 
  • 24 University of Maryland Medical Center, http://umm.edu/health/medical/altmed/condition/amenorrhea 25 Ibid.

    26 Dash & Sharma, Charaka Samhita: Text With Translation & Critical Exposition Based on Cakrapani Datta’s Ayurveda Dipika 4th Ed. (Varanasi: Chowkhamba Sanskrit Series) Volume 5 p.155, XXX:101.5-­‐102.5

    27 Skudder, Vitalizing Herbs-­‐Jivaniya, http://www.atreya.com/ayurveda/Vitalizing-­‐Herbs-­‐Jivaniya.html 28 Ibid.

    29 Halpern, Clinical Ayurvedic Medicine, 6th Ed. (Grass Valley: California College of Ayurveda 2012) p.5-­‐101

emmenogogues, “purifying emmenogogues…while stimulating menstrual bleeding, should not be taken as they are drying to the body and lead to greater depletion.”30
 
The Jivaniya herbal substitutes of shatavari and vidari kand in addition to wild yam are nutritive female reproductive tonics that will benefit women with amenorrhea. These are the reproductive tonics are also recommended in the Dr. Halpern’s Clinical Ayurvedic Medicine text. Dong quai is another suggested herb because of its actions as a tonifying emmenogogue. The roots of these four herbs are the part of the plant used medicinally as tonics. All of them are considered to have a sweet rasa (taste). The sweet taste in Ayurveda is composed of the earth and water elements. According to Michael Tierra “it is cooling, nutritive, pleasant and softening…the essence of nourishment.”31
 
Shatavari
 
Asparagus racemosus is the variety of asparagus root used medicinally in Ayurveda, known as Shatavari. The translation of Shatavari is one “’who possesses a hundred husbands,’ as its tonic and rejuvenative action on the female reproductive organs is said to give the capacity to have a hundred husbands”32  Shatavari is an heavy and oily tonic used often in Ayurveda “for gynecological purposes and to strengthen female hormones.”33  Its demulcent quality helps to nurture the mucous membranes. “It both nourishes and cleanses the blood and the female reproductive organs.”34
 
Vidari Kand
 
Vidari Kand, or Ipomea digitati, falls into the herbal categories of rasayana and demulcent, as well as many others. This sweet root is related to the sweet potato. Studies have shown that vidari kand has “significant oestrogenic and progesteronogenic activities with no toxicity.“35  In addition, patients have responded positively when taking vidari kand as a replacement for routine hormonal therapies.36
 

  • 30 Ibid.

    31 Tierra, Plantetary Herbology: An Integration of Western Herbs into the Traditional Chinese and Ayurvedic Systems

    (Twin Lakes, WI: Lotus Press 1988) p.41

    32 Frawley & Lad, The Yoga of Herbs: An Ayurvedic Guide to Herbal Medicine, 2nd Ed. (Twin Lakes, WI: Lotus Press, 2008) p.183

    33 Tierra, Plantetary Herbology: An Integration of Western Herbs into the Traditional Chinese and Ayurvedic Systems

    (Twin Lakes, WI: Lotus Press 1988) p.321

    34 Frawley & Lad, The Yoga of Herbs: An Ayurvedic Guide to Herbal Medicine, 2nd Ed. (Twin Lakes, WI: Lotus Press, 2008) p.184

    35 Puri, Rasayana: Ayurvedic Herbs for Longevity and Rejuvenation (Traditional Herbal Medicines for Modern

    Times)(London: Taylor & Francis 2002) p.306

    36 Ibid.

Wild Yam

Deioscorea villosa also known as wild yam is a sweet herb that “contains hormones and is an effective tonic for the female reproductive system.”37  The phytoprogesterones contained in wild yam help “to regulate the ratio of progesterone to estrogen in the system,” making wild yam beneficial to both the herbal and scientific communities.38   When treating disorders of the women’s reproductive system it is important to consider the liver. The liver is a detoxifier, filtering toxins from the bloodstream. It also plays a major role in the balance of hormones.39  When there is stagnation in the liver, these processes slow. Wild yam is a recommended herb to use in this case, in addition to working on the reproductive system. Wild yam is a great liver tonic, as it “activates and stimulates liver activity.”40
 
Dong quai
 
Dong quai, or Angelica sinensis is another sweet root that “can be used to treat almost every gynecological imbalance because of its strengthening and building qualities…Though dong quai has no specific hormonal action, it exerts a regulating and normalizing influence on hormonal production through its positive action on the liver and endocrine system.”41  It can be used in all complaints of the female reproductive system. In addition, don quai is also a mild nervine tonic, helping to lower stress by calming and relaxing the nervous system.
 
Dipanas
 
Shatavari, vidari kand, wild yam, and dong quai are all heavy and cooling herbs, therefore they turmeric. Cinnamon (Cinnamomum cassia) is a good choice because of its demulcent and stimulating properties. Dried ginger (Zingiberis officinale) would be a useful carrier herb in a formula because it is also considered an emmenogogue. Turmeric (Curcumae longa) is less stimulating than cinnamon and ginger, but it helps to regulate menses by decongesting the liver.42
 

  • 37 Frawley & Lad, The Yoga of Herbs: An Ayurvedic Guide to Herbal Medicine, 2nd Ed. (Twin Lakes, WI: Lotus Press, 2008) p.186

    38 Gladstar, Herbal Healing for Women: Simple Home Remedies for Women of All Ages (New York: Fireside 1993) p.258

    39 Ibid. p.78-­‐79 40 Ibid. p.259  41 Ibid. p.241

    42 Ibid. p.244-­‐245, 274

Anupanas

When considering the appropriate anupana for these herbs in pacifying vata, it would be best to cook a formulation of these herbs into a medicated ghee or oil. A teaspoon of this ghee would be taken an hour away from food in the morning and evening. As long as there are appropriate dipanas in the medicated ghee then it could be melted into warm milk, another option is to take it with ginger tea. This treatment will need to be continued for several months in order to give the uterus and reproductive system time to rebuild itself.
 
Chyawanprash
 
Chyawanprash is another beneficial herbal supplement, recommended for its nutritional value and general tonifying effects.  In Parle & Bansal’s review of the herbal formula it is said that it “streamlines menstrual cycles in females.”43    Comprised of around fifty herbs, Chyawanprash is a comprehensive tonic, great for maintaining homeostasis.  As the carrier, the honey in formula helps drive the herbs deep into the body’s tissues.44   In the case of amenorrhea this is useful for the honey’s action of driving the tonifying herbs into the tissues of the uterus.  It is also commonly used in the reduction of stress.  As a daily tonic, a woman can take 1-­‐2 teaspoons of Chyawanprash morning and evening; taking it with warm milk will enhance the tonifying effect.45
 
Rejuvenative  Therapies
 
Women with amenorrhea should consider treating themselves to a series of Ayurvedic body therapies. A Bliss therapy consisting of abhyanga, shirodhara, and svedana treatments would be beneficial as these treatments are pacifying to vata and very nourishing to the system. In addition to the Bliss therapy, anuvasana and uttara bastis would help to encourage healthy downward movement and svadhisthana basti would localize energy and release to the 2nd chakra. These treatments would be most helpful if the woman repeated them every month several times until menstruation returned.46
 

  • 43 Parle, & Bansal, “Traditional medicinal formulation, Chyawanprash-­‐ A Review,” Indian Journal of Traditional Knowledge 5(4)(October 2006)487

    44 Ibid. p.484

    45 Frawley, Ayurvedic Healing: A Comprehensive Guide 2nd Ed. (Twin Lakes, WI: Lotus Press 2000) p.116    46 Halpern, Clinical Ayurvedic Medicine, 6th Ed. (Grass Valley: California College of Ayurveda 2012) p.5-­‐101

Lifestyle Changes

Lifestyle and yoga therapies are very important for women experiencing amenorrhea. They need to partake in vata pacifying behaviors and therapies. Most importantly this includes rest and minimizing the amount of things or stressors that are apart of their everyday lives. In addition, women can look toward the support of other women, Yoga Nidra, daily movement, and releasing pranayama practices.
 
Sharing  Pheromones
 
In Herbal Healing for Women it is recommended for women experiencing amenorrhea to spend extra time surrounded by menstruating women. She states, “menstruating women secrete a chemical called pheromone. This enzyme triggers a hormonal reaction in other women which can stimulate the menstrual cycle.”47  In 1998 at the University of Chicago a study was done that demonstrates “the existence of human pheromones and identify[ing] a potential pheromonal mechanism for menstrual synchrony, as well as for other forms of social regulation of ovulation.”48
 
Yoga Nidra
 
A six-­‐month trial study with women experiencing menstrual disorders suggested, “in patients with menstrual irregularities, Yoga Nidra not only has utility as a possible therapeutic strategy, but also may be a method for improving headache, giddiness, nervousness and irritability.49  In the study, amenorrhea was included in the various menstrual symptoms whose changes were tracked in both the intervention (Yoga Nidra & medication) and control (medication only) groups. In the group of women that experienced Yoga Nidra for 35 minutes five days a week for six months there was a larger decrease in the occurrence of amenorrhea than in the control group. 50
 
Daily Movement
 
When excessive exercise is not the cause of amenorrhea, it is recommended to incorporate 30 minutes of movement daily. This exercise should be gentle and can include walking in nature or a
 

  • 47 Gladstar, Herbal Healing for Women: Simple Home Remedies for Women of All Ages (New York: Fireside 1993)

    p.123

    48 Stern & McClintock, “Regulation of ovulation by human pheromones,” Nature 392 (March 1998) 177-­‐179

    49 Rani, Tiwar, Singh, Agrawai, “Six-­‐month trial of Yoga Nidra in menstrual disorder patients: Effects on somatoform

    symptoms,” Industrial Psychiatry Journal 20(2) (July-­‐December 2011) 97-­‐102

    50 Ibid.

restorative yoga asana practice and should only be preformed if the woman is strong enough. Yoga is beneficial when trying to bring back the menstrual cycle because when done consistently it to reduce stress and brings balance to the endocrine system. A balanced practice would include a full range of motion, focusing on inversions, twists, and backbends. “Inversions increase blood circulation, and balance your endocrine system, backbends tone your liver, and twists massage your internal organs.”51 A suggested sequence for healthy menstruation could include supta baddha konasana, adho mukha virasana, jahu sirsasana, triang mukhaikapada paschimottanasana, paschimottanasana, upavistha konasana I, parsva upavistha konasana, upavistha konasana II, viparita dandasana, setu bandha sarvangasana,  savasana.52
 
Conclusion
 
Western medicine and Ayurveda both offer options for the treatment of amenorrhea. In most cases, Western medicine encourages the return of menses through the use of artificial hormone therapy. Ayuveda offers more options and avenues for treatment that allow women to bring awareness to their own cycles and lives. Taking charge of their own treatment by making positive lifestyle changes and utilizing the natural but effective medicine of herbs.
 

  • 51 Sparrowe & Walden, Yoga for a healthy menstrual cycle (Boston: Shambhala Publications, Inc 2004) p.29

  • 52 Ibid. p.11


Sources Cited

  • American Medical Woman’s Association, Inc., The Women’s Complete Healthbook: Up-­‐to-­‐the-­‐ Minute Medical Information on the Issues that Concern Women Most (New York: Delacorte Press,1995)
  • Bhishagratna, Susruta Samhita(Varanasi: Chowkhamba Sanskrit Series 2002)
  • Dash & Sharma, Charaka Samhita: Text With Translation & Critical Exposition Based on Cakrapani Datta’s Ayurveda Dipika 4th Ed. (Varanasi: Chowkhamba Sanskrit Series)
  • de la Foret, Herbal Remedies Advice, Female Reproductive System,  http://www.herbalremediesadvice.org/female-­‐reproductive-­‐system.html
  • Frawley, Ayurvedic Healing: A Comprehensive Guide 2nd Ed. (Twin Lakes, WI: Lotus Press 2000)
  • Frawley & Lad, The Yoga of Herbs: An Ayurvedic Guide to Herbal Medicine, 2nd Ed. (Twin Lakes, WI: Lotus Press, 2008)
  • Gladstar, Herbal Healing for Women: Simple Home Remedies for Women of All Ages (New York: Fireside 1993)
  • Halpern, Clinical Ayurvedic Medicine, 6th Ed. (Grass Valley: California College of Ayurveda 2012)
  • Mayo Clinic, Mayo Clinic Staff, Amenorrhea,  http://www.mayoclinic.com/health/amenorrhea/DS00581
  • Parle, & Bansal, “Traditional medicinal formulation, Chyawanprash-­‐ A Review,” Indian Journal of Traditional Knowledge 5(4)(October 2006)484-­‐488
 
ABSTRACT
 
Pheromones are airborne chemical signals that are released by an individual into the environment and which affect the physiology or behaviour of other members of the same species1. The idea that humans produce pheromones has excited the imagination of scientists and the public, leading to widespread claims for their existence, which, however, has remained unproven. Here we investigate whether humans produce compounds that regulate a specific neuroendocrine mechanism in other people without being consciously detected as odours (thereby fulfilling the classic definition of a pheromone). We found that odourless compounds from the armpits of women in the late follicular phase of their menstrual cycles accelerated the preovulatory surge of luteinizing hormone of recipient women and shortened their menstrual cycles. Axillary (underarm) compounds from the same donors which were collected later in the menstrual cycle (at ovulation) had the opposite effect: they delayed the luteinizing-­‐hormone surge of the recipients and lengthened their menstrual cycles. By showing in a fully controlled experiment that the timing of ovulation can be manipulated, this study provides definitive evidence of human pheromones.
  • Puri, Rasayana: Ayurvedic Herbs for Longevity and Rejuvenation (Traditional Herbal Medicines for Modern Times)(London: Taylor & Francis 2002)
  • Rani, Tiwar, Singh, Agrawai, “Six-­‐month trial of Yoga Nidra in menstrual disorder patients: Effects on somatoform symptoms,” Industrial Psychiatry Journal 20(2) (July-­‐December 2011) 97-­‐102
 
ABSTRACT
 
Background:
Emotional insecurity, stress, depressive or/and anxiety symptoms are common with variable severity among patients with menstrual disorder. Yogic relaxation therapy (Yoga Nidra) leads to conscious and subconscious recognition of these underlying psychological factors and helps releasing of suppressed conflicts.
Objective:
To evaluate the effect of Yoga Nidra on anxiety and depressive symptoms in patients with menstrual  disorders.
Materials and Methods:
Subjects were recruited from the Department of Obstetrics and Gynecology, C.S.M. Medical University (erstwhile KGMU), Lucknow Uttar Pradesh, India. The subjects were randomly divided in to two groups: Intervention group (with yogic intervention) and control group (without yogic intervention). Assessments of all subjects were carried out by administering Hamilton anxiety scale (HAM-­‐A) and Hamilton rating scale for depression (HAM-­‐D) at baseline and after six months.
Results:
The mean age with S.D of the intervention group was 27.67 ± 7.85 years, and for control group was 26.58 ± 6.87 years (among completed intervention group nn = 65 and control group nn = 61). There was significant reduction of scores in HAM-­‐A (P<0.003) and HAM-­‐D (P<0.02) respectively in subjects with mild to moderate anxiety and depressive symptoms after six months of yoga therapy (Yoga Nidra) in intervention group in comparison to control group.
Conclusion:
The patients with mild to moderate anxiety and depressive symptoms improve significantly with ‘Yoga Nidra’ intervention. There is no significant improvement in the patients with severe anxiety and depressive symptoms.
 
ABSTRACT
 
Pheromones are airborne chemical signals that are released by an individual into the environment and which affect the physiology or behaviour of other members of the same species1. The idea that humans produce pheromones has excited the imagination of scientists and the public, leading to widespread claims for their existence, which, however, has remained unproven. Here we investigate whether humans produce compounds that regulate a specific neuroendocrine mechanism in other people without being consciously detected as odours (thereby fulfilling the classic definition of a pheromone). We found that odourless compounds from the armpits of women in the late follicular phase of their menstrual cycles accelerated the preovulatory surge of luteinizing hormone of recipient women and shortened their menstrual cycles. Axillary (underarm) compounds from the same donors which were collected later in the menstrual cycle (at ovulation) had the opposite effect: they delayed the luteinizing-­‐hormone surge of the recipients and lengthened their menstrual cycles. By showing in a fully controlled experiment that the timing of ovulation can be manipulated, this study provides definitive evidence of human pheromones.
 

BUILDING OJAS: The road back to health from Chemotherapy By: Jill Talve

 Introduction

Cancer is characterized by the spread of abnormal cells in the body. Mutated cell growth is often uncontrollable and can cause death in the individual by eventually compromising the body’s vital functions. The existence of cancer and its manifestations go back thousands of years as described in the classical texts of Ayurveda. While modern research has linked numerous causes to the proliferation of cancer cells within the body, malignant cancer cells are produced in all bodies. The general difference between a detectable cancer and that which does not develop further is the body’s immune system and its many functions. From an ayurvedic perspective, Ojas, a Vedic concept that contains the body’s defense against such pathogens , is disempowered at a time when cancer cells begin to populate. In today’s world, the abundant use of chemotherapy to eradicate many cancers can leave the body in a severely weakened state. The success of chemotherapy is often a matter of ridding the body of more malignant cells before too many healthy cells are compromised. When the body has reached this point and the chemotherapy has ceased, the body’s immune system, already  compromised as evidenced by the high volume of cancer cells, is further impaired. In order for the body to continue to survive, immunity must be restored. In Ayurveda, the practice of restoring immunity is referred to as building Ojas. The cultivation of Soma, Rasayana or Rejuvenation therapies, including physical, mental , and spiritual practices must all be employed so that the body can fully recover and defend itself against future assaults.
 

Cancer and the use of Chemotherapy

Chemotherapy is the use of certain chemicals that are introduced to the body for the purpose of destroying disease. Antineoplastic (anti-cancer) therapy and Cytotoxic (cell-killing) therapy are specific to treating cancer.   In the article Chemotherapy and the war on cancer, a historical account of the development of chemotherapy  explains that during WWII an event causing exposure to mustard gas led to a decrease in white blood cells among those who were in contact with the gas. Continued research in the 1940’s led to the experimental treatment of non-hodgkins lymphoma with nitrogen mustard. The mustard gas derivative caused a temporary regression of the mediastinal and lymphatic masses. By the late 1940’s, compounds identified as antifolates were the first drugs to induce remission in cases of acute lymphoblastic leukemia. More stabilized versions of these drugs diminished tumors successfully in Breast, ovarian, bladder, and head and neck cancers. Clinical trials continued through the 1950’s and 60’s as natural and synthetic compounds were combined and tested on tumor cells at various stages. Chemotherapy was considered as constructive adjuvant therapy following the surgical removal of tumors. Although there has been tremendous support for the development of chemotherapy since the early stages of research, there exists a parallel concern around the “Acute and long-term toxicities of chemotherapies, which affects virtually every organ in the body”.  Oncologists have accepted this fact as the price for controlling such a fatal disease. In patients who are treated yearly with chemotherapy, approximately 20% are cured and another 20% experience a significant extension of life.  The remaining 60% of patients experience minimum benefit from cytostatic treatment and suffer from the effects. Common side effects resulting from the administration of chemotherapy drugs include: Decrease in blood cell counts, hair loss (reversible), confusion, nausea, vomiting, ringing in ears, hearing loss, kidney damage, bladder damage, fertility impairment, lung and heart damage, mouth ulcers, decreased appetite, liver damage, photosensitivity, skin rash, seizures, loss of reflexes, and weakness.  As several rounds of treatment are often dispensed over a period of time, the patient can develop psychological disturbances in anticipation of subsequent rounds. Although many of these conditions subside once the chemotherapy is over; the long-term effects force the patients to discontinue treatments and leave the person in a deeply weakened state with low quality of life.
 

Ayurveda and Cancer 

Cancer is described in the classical texts as inflammatory or non-inflammatory swelling and described as Granthi (minor neoplasm) or Arbuda (major neoplasm).  Granthi is the term most commonly used to describe benign tumors and is visible from the surface. Arbuda is the term that specifies a malignancy.  Other terms from the texts include Gulma, which describes any palpable mass in the abdominal area; and Dwirarbuda, which refers to the spread of the malignant cells from its origin throughout the body.  Malignant tumors (Tridosaja) are the result of all three doshas deeply out of balance and unable to inhibit tissue damage.   According to the sushruta samhita, it is the vitiation of all three doshas that ultimately lead to the manifestation of tumors.  Dr. Marc Halpern  explains the evolution of a tumor to be a function of Vata ( faulty division of cells) pushing Kapha (tissue growth) and the excess of pitta creates malignancy making it sannipatika in nature . Cancer manifests differently in each individual according to their distinct exposure to pathogens and their unique constitutional makeup.  Not only is the spread of cancer due to the vitiation of the Vata, Pitta and Kapha doshas, but disturbances deeply rooted in the Rakta, Mamsa and Medas dhatus.
 

Ayurveda and Chemotherapy

Visha Dravya is a Sanskrit  term that refers to poisonous drugs. Chemotherapeutic agents belong in this classification, as they all possess a hot potency. While working to destroy cancerous cells, they inadvertently destroy healthy cells within the GI tract, mucous membrane, skin, hair root, and other organs. Chemotherapy drugs embody properties that directly oppose the Rasa, Kapha and Ojas in an individual, thereby creating vitiation in the vata and pitta doshas while depleting the Kapha dosha, leading to the depletion of the rasa and Rakta dhatus and resulting in the depletion of Ojas.
 

Life after Chemo

When the round(s) of chemotherapy end(s), many of the acute symptoms end too. However there are long-term effects that are now a part of a persons’ physical landscape. Common long –term (1 year and beyond) complaints include fatigue, anemia, neuropathy or numbness (due to injured nerves), lymphedema (arm or leg swelling), dry mouth, teeth problems, loss of taste, painful mouth and gums, jaw stiffness or jawbone changes, weight gain, weight loss, trouble swallowing, hormone depletion and lack of libido. Many of these conditions can develop months or years after the treatment has ended.   There is also a large psychological component , where the entire paradigm of a healthy life is transformed. Even if the cancer is in remission, a cancer survivor can experience deep fear from the possibility of recurrence and as a result have difficulty making life decisions, such as career path or marriage. Values and goals may be altered, reflecting deeper inquiry into spiritual and existential  concerns over death and dying. The psychological path of a cancer patient is constantly changing, with transitions being particularly stressful, such as the “Transition from treatment to long-term follow up.” 
 

The Heart of Healing: Ojas

“Disease always forces us to confront our attachments. All attachments are temporary and are dissolved by Nature when She feels it is time to broaden our personalities. Disease is always an opportunity to learn from our mistakes, an opportunity that nature provides us out of Her maternal magnanimity. She hopes  we will learn enough so we will never be sick. She can even teach us how to overcome death ….Rejuvenation is the first step in the direction of immortality”.   –Dr. Robert Svoboda
 
To understand the ayurvedic concept of Rasayana and its protocols, it is necessary to understand the concept of Ojas . It is defined poetically in verse from the Caraka Samhita:
Ojas:
It maintains the living beings by its saturation;
Without ojas no life of creatures exists,
It is the initial essence of embryo and also the essence of the embryo’s nourishing material,
It enters into the cardiac cycle first,
If it is destroyed, it leads to destruction of that person,
It is the sustainer
It is located in the heart,
It is the cream of the nutrient fluid in the body,
It is where vital factors are established,
It is the fruit of them or they produce various types of fruits. 
 In the Astanga Hrdayam, Ojas is seated in the hrdaya (Heart); although it is the essence of all the dhatus. It is what regulates the body and even has a texture( viscous) and color (reddish yellow). The loss of ojas leads to a loss of life.  According to Dr. Robert Svoboda , the definition of Ojas is “A hormone –like substance which is derived from Shukra. Ojas produces the aura, transmits energy from mind to body, and controls immunity.”  Dr. David Frawley contends that Ojas is the is the foundation of the development of all other faculties: “ The internalized essence of digested food,water,air, impressions and thought, the basis for patience, control of the senses and mental endurance.”  Many causes of the loss of Ojas are listed in the classical text and in the notes given by Professor K.R.Srikantha Murthy, who  references  many additional factors from other classical sources including Abhisanga (assault by evil spirits; micro-organisms such as bacteria, virus, etc.) and Visa, ingestion of poisonous substances. Dr. Marc Halpern cites in The Principles of Ayurvedic Medicine that Ojas can be defined as  the “force of contentment and stability.”  Dr. Halpern connects the condition of low ojas with the presence of cancer in the affected tissue; and as the disease progresses, for the systemic Ojas to become lower and lower.  In order for long term healing to occur, one’s Ojas needs to be rebuilt. The Astanga Hrdayam plainly states that the increase of Ojas creates “Contentment, nourishment of the body and increase of strength”.  
 

An Ayurvedic Solution

“Ayurvedic Herbology reaches its culmination in the science of rejuvenation .Aimed at the renewal of both body and mind, Ayurvedic herbology does not seek simply longevity, but moves towards a life of pure awareness, natural creativity, spontaneous delight.” –Dr. David Frawley and Dr. Vasant Lad, The Yoga of Herbs
 
Rasayana, or Rejuvenation therapy, provides multi-dimensional relief to the many residual issues imposed on a person who has undergone chemotherapy. The general effects of rasayana therapy include Vayahsthapana (anti-aging), Balya (restoring power),  and Jeevaniya (improving vitality).   Rasayana literally means “The path of Rasa.” This implies a journey back to health. Dr. Svoboda impresses the importance of the health of the Rasa dhatu, which is the substance by which other dhatus are formed. He continues to describe healthy Rasa as the primary element in creating healthy shukra, where ojas are produced.  Bri Maya Tiwari describes rasa as “The mother essence of healing.”  She continues to define Rasa as the taste we have for all things, not only with our mouths to taste food, but through sensory impressions as well. The path to healing includes all forms of Rasa, and in choosing the appropriate foods and rituals (sadhanas) in one’s daily life, one can engage in the inherent intelligence of acting in accord with their surroundings, thereby forging a clear path to health.   Nourishing the Rasa requires the physical consumption of the sweet taste. Made up of the elements water and earth, it is the perfect foil to the hot, sharp qualities of Chemotherapy. Dr. Svoboda defines honey and its origins, pollen , which is referred to as the sperm of plants, as plant shukra, which increases human shukra and thereby nourishing Rasa.  In this way honey is a primary food in rasayana therapy. The Sanskrit term for honey, Madhu , appears in numerous classical rejuvanative formulas. One such formula that is very popular is Chyavanprash, a spicy sweet  amla based jam consisting of 5 of the 6 tastes(excludes salty). Other foods which provide the sweet taste include Whole Grains, root vegetables, fruits and milk. Foods that have the sweet taste have a cool potency(virya) and a sweet  post digestive effect (vipaka). Each dhatu benefits from the sweet taste; Foods that increase the Rasa Dhatu include some dairy products, fruits and oils; Molasses, black grapes, carrots and beets enrich the rakta dhatu; Meat, grains and nuts build mamsa dhatu; Oils, dairy, wheat and nuts replenish the medas dhatu; Bone soups will aid the Asthi dhatu; Ghee , butter and nuts protect the majja dhatu;  Milk, ghee, almonds and sesame seeds enliven the shukra dhatu.  A balanced amount of sweet taste in accordance with one’s constitution will help the recovering patient to rebuild healthy tissue. It is also essential to eat seasonally and locally. In Maya Tiwari’s Living Ahimsa Diet, she makes a strong case for the effectiveness of honoring the cycles of nature. The presence of foods as they appear in order out of the ground is not coincidence; but rather an ancient agreement between all living things to feed and be fed at the appropriate time. Since us as humans are created from the same elements that have created the seasons, we share this inherent rhythm with nature. “Only the rhythms of the seasons have the power to fully restore our vital tissues and their innate memories that guide their form and function to perfect health”.  Another important component of restoring health to a body ravaged by cancer and its treatments are the plant-based medicines utilized in Rasayana therapy. In the article published by AYU :An international Quarterly Journal of Research in Ayurveda,  A trial involving a total of 36 cancer patients were divided into two control groups where one group received chemotherapy and radiotherapy and another group received the same cancer treatments along with an ayurvedic formulation Rasayana Avaleha. The results showed a clear indication that the formula helped to protect patients from the adverse effects while going through treatment.  The herbs used in this formula are ones that are used in many classical rejuvenative formulas and continue to be the subject of many clinical studies.  The formula contains Amalaki, Ashwaganda, Gaduchi, Yastimadhu, Jivanti, Tulasi and Pippali. Amalaki (Emblica Officinialis)or Dhatri(the nurse) is one of the strongest rejuvenatives in ayurveda. It is a premium source of vitamin C, rebuilds and retains new tissues and increases red blood cell count, and is also a major component in the rejuvanative  Chyavanprash .  Ashwaganda (Withania Somnifera)  is considered among one of the best rejuvenative herbs  for the muscles, marrow , semen and vata constitution, especially in cases where tissues are debilitated as a result of chronic disease.  Guduchi (Tinospora Cordifolia) is a potent anti-inflammatory and excellent tonic for the immune system.  Yashtimadhu(Glycirrhiza glabra) Otherwise known as Licorice, is an effective expectorant, demulcent, emetic, Kapha-cleansing agent, laxative, restorative, rejuvenative agent. , Jivanti (Leptadinia reticulate) is a natural source of Quercitin.   Tulasi (Ocimum sanctum)or Holy Basil, is the most sacred plant in India, as it opens the heart and mind, clears the aura and strengthens immunity.  Pippali (piper Longum), also known as long pepper is a stimulant ,expectorant  and revives weakened organic functions.  Flavonids as potent antioxidants are vital for protection against disease and are present in Guduchi, Ashwaganda, Amalaki, Pippali, and Tulasi.  Many of these herbs have a sweet rasa, cool virya and sweet vipaka, which aid in nourishing Kapha dosha, depleted by cytotoxic chemicals. As a result these herbs serve to offset the cancer anorexia-cahexia syndrome, a source of malnutrition in cancer patients. Gaduchi, Ashwaganda and Jivanti are also known adaptogens, correcting imbalances without negative side-effects.  To combat the psychological conditions that occur post-treatment, Dr. David Frawley, In his book Ayurveda and the Mind, highlights key rejuvenating herbs for the mind. Calamus,(acorus calamus)  is a rejuvenative for the brain and nervous system, and used by the ancient Vedic seers. Calamus is currently restricted for internal use by the FDA.   Gotu Kola (Centella asiatica),is a rejuvenative that increases intelligence and memory, as well as fortifies the immune system;   And  Shanka pushpi (Canscora desuccata).  Brahmi, or Mandukaparni, (Hydrocotyle asiatica, Umbellifera, Bacopa monniera, Scrophulariaceae) is considered one of the most important nervine herbs in Ayurveda. In The Yoga of Herbs by Drs. David Frawley and Vasant Lad, Brahmi is a great rejuvenative when combined with ghee, as it revitalizes brain cells and purifies the nervous system.  The Caraka Samhita has many Rasayana formulas containing the aforementioned herbs. One such formula promises that if used every day for three years a person will live a vital 100 years disease-free, will be physically strong and solid and untouchable by poison. It begins with the herbs haritaki, amalaka, bibhitaka, haridra, salaparni, bala, vidanga, guduchi, sunthi, madhuka, pippali and katphala cooked into ghee; then amalaka powder (which has been impregnated 100 times with amalaka juice) mixed with ¼ quantity of iron powder(iron Bhasma) , combined with the herbal ghee mixture and some extra honey and sugar. 10gm of the formulation is to be taken every morning and a diet of Sali and swastika rice with ghee along with green gram or milk taken at night.   If required, rasayana herbs can add bulk and increase tissue where need, but more importantly these substances will add quality tissue to the body, thereby promoting longevity and the quality of life. 
 

Yoga

According to David Frawley in his book “Ayurveda and the Mind”, Dr. Frawley defines Yoga  as a means to gain awareness around the “original impetus of life”. It is the human experience to move towards integration, consciously or unconsciously, with universal wholeness and peace. This greater system of yoga can reverse  psychological distress by reuniting the mind back into pure consciousness, which “resides in perfect peace.”   Where the protocols of Ayurveda heal the body in a physical and subtle way, it also prepares the body for Yoga, an inner pathway that ultimately merges the mind which the “Cyclical nature of the cosmos”. Embodied in the classical eight limbs of yoga lie a treasure of healing practices for the cancer survivor.  The use of asana, pranayama, mantra and meditation are invaluable tools to aid in the whole Ayurvedic  healing process. Asana includes all postures, either seated of moving, that when done correctly with the right intention, can open up and loosen stagnant energies that may have played a part in causing illness.  Pranayama is a method that develops and expands the energy of the life-force (prana) beyond its ordinary limitations . Conclusions to a pilot study showed that pranayama may improve sleep disturbance, anxiety and other chemotherapy associated symptoms.  According to Dr. David Frawley, Mantra is the most important healing sound therapy in Ayurveda. The word mantra is a word that combines Trayati, that which saves, and Manas, the mind. He explains that mantra can heal emotional patterns by re-patterning them where counseling or analysis cannot. The more repetition of the mantra, the more effective it is for the individual.  Dr. Vasant Lad instructs that mantra should first be spoken aloud so that the sound is heard by the heart. Ultimately the vibrations of the mantra infiltrate the heart and no external sound is necessary, allowing the deepest resonance within, creating a powerful healing energy. Each person chooses their own mantra; as it is as unique as one’s own constitution.  Meditation is another powerful self-healing tool.  A controlled study of ninety cancer patients showed a significant decrease in those who did mindfulness meditation for 7 weeks.  31% had fewer symptoms of stress and 65% had fewer episodes of mood disturbance than those who did not meditate.    According to the American Cancer society, Some studies have also suggested that more meditation improves the chance of a positive outcome.  Deepak Chopra describes the effectiveness of meditation and healing as follows: ”  Rather than considering it a relaxation response, consider it as a heightened awareness or a restful alertness response. We meditate to experience an inner wakefulness, an inner knowingness that gives us a sense of control over the processes inside our body, as well as over our life experiences. In the silence of meditation there is alertness, flexibility, creativity, sensitivity, freshness, aliveness and renewal. There is pure consciousness, no contamination of experiences in the past, by memories or by cravings---awareness remain pure, full of energy, full of clarity.”  Additional holistic therapies that will help an individual back to health and strengthen ojas include aromatherapy and Chromotherapy . Aromatherapy enlists the sense of smell to take in the environment . Certain plants provide energetics through their oils that are extracted from the various parts, depending on the plant. If the scent is in accordance with one’s nature, the effects can be extremely beneficial to the mind, body and consciousness.  Chromotherapy, or the use of color to improve overall health, is a broad field that covers  everything from decorating the home in a color scheme that is according to one’s prakriti to using colored lights to treat different parts of the body. Understanding the elemental quality of color and how it relates to nature is another way of bringing a sense of harmony to one’s environment, setting the stage for effective healing.
 

Soma and the quality of Life

For a cancer survivor, mortality is no longer a distant concept. Many survivors do not consider themselves healthy; There is always a chance of recurrence of the disease. However, many survivors find that their life takes on new meaning after cancer. Life and living take on greater value. This attitude often leads the survivor to a more thoughtful position on spirituality.  As with any crisis, a space is created where new paradigms are forged in seeking  the greater meaning to life. According to David Frawley in his book Soma in yoga and ayurveda,  greater longevity is only a benefit if we connect to meaning, consciousness and creativity, and doing so requires” An ability to connect with the immortal essence of our being.”  This is only one aspect of Soma. Dr. Frawley interprets, through his lifelong study of the Vedic texts, a vast concept that encompasses physical and non-physical , inner and outer manifestations of lasting bliss, resulting in the infinite quest for immortality. Soma, both material and otherwise, is rooted in the field of rejuvenation. Through traditional ayurveda therapies, diet and lifestyle , internal soma will unfold, revealing the potential for “immortality of spirit”. In exploring this inner immortality, the physical body is no longer the object of greater longevity, but rather a desire to achieve a “Greater existence in consciousness itself” provides a true prolonged existence.
 

Conclusion

In Maya Tiwari’s The path of Practice, an autobiographical account of her victory over incurable ovarian cancer, she is summoned into healing through spiritual reckoning, after being told that nothing else could be done to save her. Her journey back to perfect health is a testament to the value of the wisdom of Ayurveda and its protocols. Along with her devotion to her daily practices(sadhanas), Tiwari simultaneously engaged deeply into an agreement with the sea of souls before her;  And to connect to the supreme consciousness that provides an everlasting awareness, or pure love.  For the cancer survivor, it is a long road back to health.  With the use of proper diet, herbs, sensory therapies and lifestyle choices, Ojas can be strengthened. However, if the person continues to explore the relationship between their own receptivity to the healing practices and the healing practices themselves, and they make their journey about this, with an open mind and an open heart…Oja s can be restored.
 
  Bruce A. Chabner and Thomas G. Roberts. (2005). Chemotherapy and the war on cancer. Nature Reviews Cancer. doi:10.1038/nrc1529
  Purvi Vyas,A.B. Thakar, M.S. Baghel, Arvind Sisodia, Yogesh Deole, Efficacy of Rasayana Aveleha as adjuvant to radiotherapy and chemotherapy in reducingadverseffects.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202271
  The Medical and Psychological Concerns of Cancer Survivors After Treatment ." From Cancer Patient to Cancer Survivor: Lost in Transition. Washington, DC: The National Academies Press, 2005 .
  Premalatha balachandran, Rajgopal Govindarajan, Cancer-an ayurvedic perspective.http://www.elsevier.com
  Dr. Marc Halpern, Clinical Ayurvedic Medicine (Dr. Marc Halpern and the California College of Ayurveda 1995-2012) Appendix C: Managing Cancer pg.A-33.
  Premalatha balachandran, Rajgopal Govindarajan, Cancer-an ayurvedic  perspective. http://www.elsevier.com
  Bhishagratha KL. Sushruta samhita (Varanasi:choukhamba Orientalia,1991)
  Dr. Marc Halpern, Clinical Ayurvedic Medicine (Dr. Marc Halpern and the California College of Ayurveda 1995-2012) Appendix C: Managing Cancer pg.A-33.
  Purvi Vyas,A.B. Thakar, M.S. Baghel, Arvind Sisodia, Yogesh Deole, Efficacy of Rasayana Aveleha as adjuvant to radiotherapy and chemotherapy in reducingadverseffects.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202271
  Premalatha balachandran, Rajgopal Govindarajan, Cancer-an ayurvedic  perspective. http://www.elsevier.com
  Purvi Vyas,A.B. Thakar, M.S. Baghel, Arvind Sisodia, Yogesh Deole, Efficacy of Rasayana Aveleha as adjuvant to radiotherapy and chemotherapy in reducingadverseffects.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202271
  The Medical and Psychological Concerns of Cancer Survivors After Treatment ." From Cancer Patient to Cancer Survivor: Lost in Transition. Washington, DC: The National Academies Press, 2005 .
  Dr. Robert E. Svoboda, Prakriti: Your Ayurvedic constitution (Twin Lakes, WI: Lotus Press, 11/98)p.161.
  Sharma PV, Caraka Samhita ,(Varanasi: Chaukhambha Orientalia;1981) Su30#9-11
    Vagbhata, Astanga Hrdayam Eighth edition , translated by Prof. K.R. Srikantha Murthy (Chowkhamba Krishnadas Academy, Varanasi  2011.) 
 
  Dr. Robert E. Svoboda, Prakriti: Your Ayurvedic constitution (Twin Lakes, WI: Lotus Press, 11/98) 197-198.
 
  Dr. David Frawley, Ayurvedic Healing For Healthcare Professionals (California College of Ayurveda, Copyright 1988-2011)pg.264.
  Vagbhata, Astanga Hrdayam Eighth edition , translated by Prof. K.R. Srikantha Murthy (Chowkhamba Krishnadas Academy, Varanasi  2011.) p.163-164.
  Dr. Marc Halpern, Principles of Ayurvedic Medicine: Tenth Edition (September 2010)p.238.
  Dr. Marc Halpern, Clinical Ayurvedic Medicine (Dr. Marc Halpern and the California College of Ayurveda 1995-2012) Appendix C: Managing Cancer pg.A-34.
  Vagbhata, Astanga Hrdayam Eighth edition , translated by Prof. K.R. Srikantha Murthy (Chowkhamba Krishnadas Academy, Varanasi  2011.) p.164.
  Purvi Vyas,A.B. Thakar, M.S. Baghel, Arvind Sisodia, Yogesh Deole, Efficacy of Rasayana Aveleha as adjuvant to radiotherapy and chemotherapy in reducingadverseffects.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202271
  Dr. Robert E. Svoboda, Prakriti: Your Ayurvedic constitution (Twin Lakes, WI: Lotus Press, 11/98)p.161.
  Maya Tiwari, The Path of Practice (Ballantine Publishing, November 2000.)p. 274.
  Ibid.
  Dr. Robert E. Svoboda, Prakriti: Your Ayurvedic constitution (Twin Lakes, WI: Lotus Press, 11/98)p.161.
  Dr. Marc Halpern, Principles of Ayurvedic Medicine: Tenth Edition (September 2010)p.277.
  Maya Tiwari, Living Ahimsa Diet,(Mother Om Media,2011) p.80-81
  Purvi Vyas,A.B. Thakar, M.S. Baghel, Arvind Sisodia, Yogesh Deole, Efficacy of Rasayana Aveleha as adjuvant to radiotherapy and chemotherapy in reducingadverseffects.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202271
 
  Dr. David Frawley and Dr. Vasant Lad, The Yoga of Herbs, Second revised and enlarged edition, (Twin Lakes, WI: Lotus Press 2001)p.161
    Dr. David Frawley and Dr. Vasant Lad, The Yoga of Herbs, Second revised and enlarged edition, (Twin Lakes,   WI: Lotus Press 2001)p.242,243
  Ibid,p.127-128
 
   Pal A, Sharma PP, Pandya TN, Acharya R, Patel BR, Shukla VJ, Ravishankar B.
 Phyto-chemical evaluation of dried aqueous extract of Jivanti [Leptadenia reticulata (Retz.) Wt. et Arn].
Ayu. 2012 Oct;33(4):557-60. doi: 10.4103/0974-8520.110525.
 
 
   Dr. David Frawley and Dr. Vasant Lad, The Yoga of Herbs, Second revised and enlarged edition, (Twin Lakes, WI: Lotus Press 2001)p.102,103
  Dr. David Frawley and Dr. Vasant Lad, The Yoga of Herbs, Second revised and enlarged edition, (Twin Lakes, WI: Lotus Press 2001)p.180
  Purvi Vyas,A.B. Thakar, M.S. Baghel, Arvind Sisodia, Yogesh Deole, Efficacy of Rasayana Aveleha as adjuvant to radiotherapy and chemotherapy inreducingadverseffects.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202271
  Purvi Vyas,A.B. Thakar, M.S. Baghel, Arvind Sisodia, Yogesh Deole, Efficacy of Rasayana Aveleha as adjuvant to radiotherapy and chemotherapy inreducingadverseffects.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202271
  Dr. David Frawley and Dr. Vasant Lad, The Yoga of Herbs, Second revised and enlarged edition, (Twin Lakes, WI: Lotus Press 2001)p.106,107
 
  Dr. David Frawley and Dr. Vasant Lad, The Yoga of Herbs, Second revised and enlarged edition, (Twin Lakes,   WI: Lotus Press 2001)p.171
  Dr. David Frawley, Ayurveda and the Mind: the healing of consciousness, (Twin Lakes, WI: Lotus Press 1996)pg.199
  Dr. David Frawley and Dr. Vasant Lad, The Yoga of Herbs, Second revised and enlarged edition, (Twin Lakes,   WI: Lotus Press 2001)p.240-241
  Sharma PV, Caraka Samhita ,(Varanasi: Chaukhambha Orientalia;1981) Ci 1.1 #77
  Dr. David Frawley and Dr. Vasant Lad, The Yoga of Herbs, Second revised and enlarged edition, (Twin Lakes,   WI: Lotus Press 2001)p.72
  Dr. David Frawley, Ayurveda and the Mind: the healing of consciousness, (Twin Lakes, WI: Lotus Press 1996)p.259
  Maya Tiwari, The Path of Practice (Ballantine Publishing, November 2000.)p. 72.
  Dr. Vasant Lad, Ayurveda: the science of Self-healing, A practical guide ( twin Lakes, WI: Lotus Press 2004)p.113
  Dr. David Frawley, Ayurveda and the Mind: the healing of consciousness, (Twin Lakes, WI: Lotus Press 1996)p271
  Anand Dhruva,MD,Christine Miaskowski,PhD, Donald Abrams, MD, Michael Acree PhD, Bruce Cooper, PhD, Steffanie goodman,MPH, and Freerick M Hecht,MD, Yoga Breathing for Cancer Chemotherapy-Associated Symptoms and Quality of Life: Results of a Pilot Randomized Controlled Trial (The journal of Alternative and Complementary medicine, Volume 18, Number 5,2012) pp473-479
    Dr. David Frawley, Ayurveda and the Mind: the healing of consciousness, (Twin Lakes, WI: Lotus Press 1996)
  Dr. Vasant Lad, Ayurveda: the science of Self-healing, A practical guide ( twin Lakes, WI: Lotus Press 2004)p.125
  Speca M, Carlson LE, Goodey E, Angen M. A randomized, wait-list controlled clinical trial: the effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosom Med. 2000;62:613-622.
  www.AmericanCancer society.com
  Transcribed from an interview with Deepak Chopra, the Oprah Winfrey show, 2013
  Dr. Marc Halpern, Principles of Ayurvedic Medicine: Tenth Edition (September 2010)p.325.
  Dr. Marc Halpern, Principles of Ayurvedic Medicine: Tenth Edition (September 2010)p.332-334.
  David Frawley, Soma in Yoga and Ayurveda: The power of rejuvenation (Twin Lakes, WI: Lotus Press 2012)  Author’s Preface.
  Ibid.
  Maya Tiwari, The Path of Practice (Ballantine Publishing, November 2000.)
 
 
 

 

Brahmi: “Herb of Grace”

Abstract

   The uses of alternative medicines have increased significantly around the world. The search for effective and safe medicines is always on as well as new uses of old medicines are being looked into. Brahmi is an Ayurvedic medicinal herb which has been used for centuries. Certain neurological disorders have limited therapeutic options in Western medicine and hospitals and research institutes across the globe are increasingly looking into Ayurvedic science for effective and safer alternatives. Brahmi is a well-known nootropic herb and its uses in neurological and psychiatric disorders are well recognized. Its efficacy and safety is supported by research and thousands of years of knowledge and experience. Despite being such an old medicine, its new benefits are constantly being studied. Brahmi is one of the most sattvic herbs known in Ayurvedic pharmacopeia since Vedic times. Here, we will delve deep into the Brahmi plant, its science, its Ayurvedic uses and much more. 

Introduction 

   In recent times, the use of herbal products has increased significantly in the western world as well as in the developing countries. Brahmi is an important medicinal plant that has been widely used therapeutically in the orient and is becoming increasingly popular in the west 6. Brahmi is a Sanskrit word derived from “Lord Brahma” or “Brahman”. Lord Brahma is the divinity responsible for all of the creative forces in the world and Brahman is the Hindu name given to the universal consciousness. Brahmi literally means the energy (or “Shakti”) of Brahma 8, 9, 10. Thus, Brahmi has a lot to offer to the medical world 9.

   The ancient Ayurvedic sages, who were also great physicians, revealed Brahmi’s role in promoting Medhya (intellect), Ayushya (longevity), Rasayana (rejuvenation), Prajnasaktivardhana (intellectual power), Hrdaya (Heart), Majjadhaty Rasayana (nervous system rejuvenation), Balya (strength, especially mind), Jivaniya (life energy), Nidrajanana (sleep), Dhana (wealth), Svara (voice), Varna (complexion) and Anuloma (redirecting the flow of vata downwards). Over the centuries, the role of Brahmi in the treatment of Kustha (leprosy/skin disorder), Pandu (anemia), Meha (diabetes), Asra Vikara (blood disorders), Kasa (cough), Visa (poison), Sopha (edema), Jwara (fever), Vatahara (vata), Unmadahara (mental illness), Unmada (insanity), Alaksmi (inauspiciousness), Apasmara (epilepsy), Papa (evil deeds), Krtya (black magic), Ruk (pain) and Manasavikara (mental disorders) has been well described 3, 5, 9, 19.

   Scientifically, Brahmi is known as Bacopa Monnieri L. Pennell; some of the other names it is also known as are Bacopa monniera, Indian Pennywort L. Pennell, Bramia monnieri L. Pennell, Gratiola monnieria L, Herpestes monnieria L. Kunth, Herpestis fauriei H. Lev, Herpestis monniera, Herpestris monnieria, Lysimachia monnieri L. and Moniera euneifolia 4. The herb comes from the family of Plantaginaceae; it can also be placed under families of Scrophulariaceae, Gratiolaceae, or Veronicaceae 2, 4. It commonly grows in marshy areas throughout India, Nepal, Sri Lanka, Pakistan, China, Taiwan, Vietnam & USA. In the USA, it is grown in Florida, Hawaii and other southern states 4. It is widely distributed across most regions of the world including China, India, Canada, USA, Brazil, Australia, Argentina, Nigeria, South Africa, etc. 2

   Due to Brahmi’s widespread availability across the globe, it is often recognized by different names in different regions and languages. In Sanskrit, it is called Saraswati (Goddess of learning, knowledge and wisdom or the essence of the self), Somavati (containing soma or nectar), Indravalli (energy of Lord Indra), Brahmi (knowledge of Brahma or supreme reality), Adha-birni 2, Jala-Brahmi, or Svetakamini 7. In Hindi, it is known as Brambhi, Safed kami (white Lord) 7, Brahmi, Jaributi (herb), Nirbrahmi, or Jalneem. In Gujarati, it is known as Jalanevari or Kadavi luni (the better herb). In English, it is called herb-of-grace, Bacopa, Thyme leaved Gratiola, or Waterhyssop. It is known as Farfakh (the hottest tree) in Arabic, Jia ma chi xian in Chinese, Kleines Fettblatt, or Wasserysop in German, Medha giree (mountain of wisdom) in Nepalese, Litet tjockblad in Swedish and many more 2, 7. 

The plant

   Brahmi is a small creeping perennial with numerous branches and small, oblong, relatively thick leaves which are arranged opposite to each other on the stem. Flowers are small and light purple or white with four to five petals. It can grow naturally in wetland, shallow water, damp and muddy shores. Its ability to grow in water makes it a popular aquarium plant; it can also grow in slightly brackish conditions 4, 11. What makes Brahmi a unique plant is that even though it is an aquatic plant, it can easily be cultivated in pots, in a garden under a shade or even under full sun when provided ample water 13. 

   The whole plant can be used for medicinal purposes. It has bitter and sweet taste (Rasa), cooling energy (Virya) and sweet post-digestive effect (Vipaka). It normalizes all three Doshas and all Dhatus (tissues), especially nerve, blood and plasma. It has an effect on numerous Srotas (system); like circulatory, digestive, nervous, excretory, muscular and reproductive 8, 9.

Mandukaparni and Brahmi

   Since the 3rd century, ancient Ayurvedic authors like Charaka, Sushruta and Vagbhatta treated Brahmi and Mandukaparni as two different herbs 15. Later, confusion was created in the 16th century when Bhavaprakasha and Hemadri equated Brahmi with Mandukaparni 4, 15. Since then, Centella Asiatica (Gotu Kola or Mandukaparni) has been known as Brahmi, particularly in North India and Kerala 4. However, according to The Ayurvedic Formulary of India, Bacopa monnieri is Brahmi and Centella Asiatica is Mandukaparni 9. A critical study of comparative photochemistry, pharmacology and therapeutic properties of these two drugs has proven that they are distinct 15. Brahmi was used specifically in mental diseases like insanity and epilepsy, while Mandukaparni was used as a general brain tonic. Another study published in 2012 proved that these two herbs exhibited significant differences in their antioxidant values too. The study concludes that regular use of Brahmi as a supplement could be more helpful compared to Gotu Kola in the treatment of neurological disorders caused by free radical damage 14. Brahmi promotes fertility and sustains implantation; while Mandukaparni is abortifacient. Both are used for skin diseases but their therapeutic effects are different 15. Also, unlike Brahmi, Mandukaparni is a stronger diuretic 8.  Hence, these two are entirely different herbs.

Brahmi and Ayurveda

   In India, Brahmi is largely treasured as a revitalizing herb used by Ayurvedic medical practitioners for almost 3000 years. The herb has been mentioned in several Ayurvedic treatises including Charaka Samhita and Sushruta Samhita in the 3rd century AD 11. In addition to being a well-known Nootropic herb for centuries, it has also been used as an antispasmodic, alterative, astringent, cardio tonic, diuretic, anticonvulsant, anti-inflammatory, analgesic, antipyretic and antiepileptic agent 8, 9, 10.

   Brahmi is one of the best herbs for balancing and rejuvenating Pitta, while at the same time strongly reducing Kapha 8. It enhances the quality of Sadhaka pitta which directly influences the nature of consciousness 9. It can balance Vata if taken in proper doses or with other anti-vata herbs 8. It aids in the recovery from exhaustion, stress, debility and aggravation of vata. It helps in all conditions with a deficient Majja dhatu; hence it is used in Parkinson’s disease, Alzheimer’s disease, dementia, ADHD, Asperger’s syndrome, autism, insomnia and depression 9. It reveals its sattvic quality by helping to give up bad habits and all types of addictions. It aids in recovery from alcoholism or drug abuse, and also helps to kick the sugar habit. For this reason it is added to many Ayurvedic formulas as a nervine agent 8. As a purifier, it is a first rate herb to cleanse the system by eliminating all sorts of poisons. It is therefore very useful in leprosy, syphilitic and scrofulous ulceration, obstinate eczema, cutaneous affections and psoriasis 12. According to Bhavaprakasha, Brahmi is useful in skin conditions with underlying nervous imbalance. In addition to a blood purifier, it strengthens the immune system, allays excess sexual desire, and is beneficial in venereal diseases, including AIDS. It also cleanses the kidneys, while calming and soothing the liver. It calms the heart and helps guard against heart attacks 8. It is beneficial in relieving tension throughout the system and helps to ease constipation from stress, relaxes muscles and alleviates menstrual pain and disorders. It has a cooling effect on Mutravaha srota (urinary system) and it cools the heat of cystitis and pain of dysuria by guiding pitta out of the system 9. 

Brahmi Rasayana

   Ancient Ayurvedic texts describe a remedy called Brahmi Rasayana which is a molecular nutrient and nutrition enhancing agent. According to Acharya Charaka, Rasayana therapy improves the nutritional status of the body, leading to the formation of better qualities of cells and tissues which can sustain aging and stress 18. Sage Sushruta explains Brahmi Rasayana as an elixir and remedial agent which improves memory and invigorate mental faculties, as well as increasing the duration of human life. After proper cleansing of the body, Sushruta describes the treatment with fresh juice of Brahmi and an extremely light diet at a specific time of the day for 21 days. It improves memory and intellectual power every week of the treatment. The complete 21-day treatment removes all inauspicious features of the body and the mind. The Goddess of learning appears in an embodied form in the mind of the user and the mind gains different kinds of knowledge. It also enables the person to live for five hundred years 17. As a heart rejuvenator, it is recommended in the treatment of heart diseases 30. Acharya Charaka also used Brahmi as one of the herbs in preparation of Aindra Rasayana to treat Svitra (leucoderma), kustha (skin diseases including leprosy), Jathara (abdominal diseases including ascites), Gulma (phantom tumor), Purana pliha (chronic splenic disorders), Visama jvara (irregular fever); and in Indrokta Rasayana to improve longevity, youth, voice, complexion, nourishment, intellect, memory and strength and be disease free 5. 

   The Rasayana specific to the brain called Medhya Rasayana slows the brain aging process and helps in regeneration of neural tissues besides producing anti-stress, adaptable and memory enhancing effects 18. The soothing effects on the nervous system as well as its mind enhancing capability are legendary. According to Dr. Frawely, it is the most important Nervine herb used in Ayurvedic medicine; it improves memory and aids in concentration. It revitalizes the brain cells by removing toxins and blockages within the nervous system, while at the same time having a nurturing effect. Brahmi, which grows in the Himalayas, is an important food for yogis practicing meditation. A small amount of its fresh leaves are eaten daily for rejuvenating the mind and to improve meditation. Brahmi helps awaken the crown chakra (Sahastrara; the seventh spiritual chakra in head) and balances the right and left hemispheres of the brain 8, 9. Brahmi has been used as Medhya Rasayana since Vedic times and it is still well-researched in today’s medical world.

Usage forms

   The Ayurvedic pharmacopoeia of India mentions important formulas of Brahmi as Sarasvataristha, Brahmi Ghrita, Ratnagiri Rasa, Brahmi Vati, Sarasvata Curna and Smrtisagara Rasa 19. The herb can be taken as ghrita (medicated Ghee), medicated oil, churna (powder), svarasa (fresh juice), infusion, decoction, tincture (fermented beverage), syrup, tea, lepa (paste), pill or eaten fresh (leaves).  As a milk decoction, Brahmi is a good brain tonic, particularly if combined with Aswagandha 8. Sarasvataristha is a fermented beverage (tincture) in which Brahmi is the major constituent, used in the treatment of infertility, epilepsy and mental disorders 20. As a medicated oil, it helps relieve joint pain, headache and to clear the mind. When massaged on the skull, it works as a brain tonic to strengthen memory and encourage hair growth 9. Brahmi paste applied to the neck is very useful in cough and pneumonia, especially in children 12. Topical use also treats diaper rash in infants 30. Brahmi lepa (paste) helps to reduce swellings. A poultice made of boiled plant is placed on the chest in acute bronchitis and other coughs in children. Its leaves are fried in ghee (purified butter) and consumed to relieve hoarseness. Juice of its leaves is given to relieve diarrhea in children. Brahmi juice mixed with petroleum can improve symptoms when applied in rheumatism 7. As neti, Brahmi is one of the best herbs to normalize the absorption of prana through the sinus 30. A cup of fresh Brahmi tea taken with honey before meditation is also a great aid in its practice 8. 

   When combined with ghee (purified butter) or milk, Brahmi has a tonifying, nerve nourishing and pitta cooling effect 9. Brahmi Ghrita or Ghrta (Brahmi medicated ghee) is a popular formula referenced in classical Ayurvedic texts. Charaka described the recipe of Brahmi Ghrita as one part old cow’s ghee cooked with four parts Brahmi juice and 1/4th part in total of the paste of vaca, kustha and sankhapuspi. This medicated ghee cures insanity, inauspiciousness, epilepsy and effects of evil deeds 5. In Astanga Hrdayam, Brahmi Ghrta is mentioned with herbs like vyosa, syama, trivit, danti, sankhapuspi, nrpadruma, saptala and krmihara for the treatment of insanity, leprosy and epilepsy, and to improve speech, voice, memory, intelligence and to bestow sons to barren women 6. Classical texts also mention the use of Brahmi along with other herbs in the preparation of other Ghrtas. For example: Maha paisacika Ghrta to treat insanity 6 and Tryusanadya Ghrta to cure fever, gulma (phantom tumor), anorexia, splenic disorders, headache, chest and cardiac pain, jaundice, piles, vatika type of asthila (hard tumor), phthisis and tuberculosis 5. Brahmi Ghrita can be applied as nasya in doses of five drops per nostril in the treatment of mental disorders. Brahmi Ghrita prepared with sesame or coconut oil can be massaged on the feet, large joints and ears before sleep in the treatment of anxiety and depression 20. According to Dr. Frawely, “Brahmi Ghrita is the best rejuvenative for the mind and the heart which should be kept in every home” 8.

With other herbs

   When Brahmi is combined with other herbs, its medicated qualities are expanded even further. Taken with basil and a little black pepper, Brahmi is good for all kinds of fevers 8. When used with neem, manjishtha and turmeric, it helps in skin conditions with pitta imbalance 9. According to Dr. Halpern, a popular remedy for acne is to combine Brahmi and turmeric in equal amounts, add 1 tsp. (4oz.) of warm cow milk and ½ tsp. of ghee and taken twice a day for several months. This remedy reduces Bhrajaka pitta on the skin (acne) and makes the skin lustrous 30. Brahmi and vacha stimulate the mind with a high kapha condition, whereas; gotu kola, jatamansi and tagarah bring out its sedative effect. Brahmi combined with aswagandha, kushta, kappikacchu, shankhapushpi and bala works as a nerve tonic. Brahmi Rasayana, with ten parts Brahmi, forty parts sugar, two parts clove and one part each of cardamom and pippali, works as an anti-inflammatory and nerve tonic agent. When combined with digestive stimulants like ginger and cardamom, it suppresses the appetite; with cumin, fennel and ajwan it relaxes the intestines 9.  

Kaya Kalpa

   Swami Sivananda described a very remarkable treatment called Brahmi Kalpa treatment in his book – ‘The Practice of Ayurveda’. It is a treatment of ‘Kaya Kalpa’, where ‘Kaya’ means the body and ‘Kalpa’ means transformation or rejuvenation. After going through pancha karma, he explains Kaya Kalpa treatment with fresh Brahmi leaves’ juice and fresh cow milk for 45 days. The treatment restores the aged and debilitated body to its pristine youth and vigor, re-establishes the full potential of the senses and imparts good health. It prolongs as well as improves the quality of life. It restores the natural balance of all three doshas, brings the function of sapta (seven) dhatus to a normal condition and cures many incurable diseases 12.

Brahmi and Science

   Over the last few decades, Brahmi has been researched extensively for its chemical constitution and identification of its therapeutic role. Compounds responsible for the pharmacologic effects of Brahmi include alkaloids, saponins, and sterols 21. Detailed investigation first reported the isolation of the alkaloid ‘brahmine’ from Brahmi 11. Later, numerous compounds have been isolated including nicotine, herpestine, betulic acid, stigmastarol, beta-sitosterol, as well as numerous bacosides and bacopasaponins 21. Extensive investigation on the plant extract and isolated bacosides, especially bacosides A and B, confirm their nootropic (Medhya Rasayana) action 23. Brahmi enhances the three basic components of mind: power of learning (Dhi), power of retention (Dhuti) and power of recall (Smriti) 21. 

   Since 1993, Central Drug Research of India has been doing extensive research with Brahmi on human volunteers 13. Triterpenoid saponins and their bacosides are responsible for Brahmi’s ability to enhance nerve impulse transmission. The bacosides aid in repair of damaged neurons by enhancing kinase activity, neuronal synthesis, and restoration of synaptic activity, and ultimately nerve impulse transmission 22. A research on adults indicated that Brahmi had a significant effect upon retention of new information; improved the speed of visual information processing, learning rate and memory consolidation within 12 weeks of treatment 20. A 2012 research study on the elderly clearly demonstrated that B. monnieri suppresses AChE activity resulting in enhanced cholinergic function, which in turn enhances attention and memory processing and increases working memory 24. In children, a 12 week Brahmi treatment revealed significant benefits with improvement in sentence repetition, logical memory, and paired associate learning tasks 22.

   Brahmi helps in coping with combined hypoxic, hypothermic and immobilization stress that could lead to the onslaught of ‘free radicals’ (highly reactive oxygen species). Brahmi extract exhibits interesting antioxidant properties, expressed by its capacity to scavenge superoxide anion and hydroxyl radical, and to reduce H2O2 induced cytotoxicity and DNA damage in human fibroblast cells. An animal study showed its antioxidant activity in the hippocampus, frontal cortex and striatum. Brahmi extract has shown neuroprotective effect against aluminum-induced oxidative stress in rat brain; and reduced nicotine-induced lipid peroxidation and geno protection in mice. It reduces amyloid levels and can be used in the therapy of Alzheimer’s disease 11. Since mild cognitive impairment (MCI) and early phase Alzheimer's disease occur due to cholinergic degeneration and oxidative stress, Brahmi extract provides a benefit in terms of decreasing memory impairment in these two diseases and even in attention deficit disorder 24. A study has shown a protective role of bacoside A against chronic cigarette-induced oxidative damage in rat brain 11. In the management of stress related study, Brahmi extract was found not only to induce the expression of heat shock protein (HSP 70) but also of CYP 450 enzymes in all regions of the brain. Brahmi primes the brain for stress by stockpiling and modulating the activities of useful enzymes like HSP 70, CYP 450 and SOD even before the onset of the stressful condition 11. In paranoid schizophrenia, adding Brahmi to olanzapine resulted in improvement in psychopathology as evidenced by reduction in PANSS and BPRS scores, without any treatment associated adverse effects 25. 

   Brahmi extract has been found comparable to standard anti-depressant drug imipramine in anti-depressant activity in rodent animals. The same study has postulated its role on serotonin and GABA (gamma amino butyric acid) receptors in the mechanism of action for its anti-depressant and anti-anxiety activity 11. Early research in India demonstrated that hersaponin (an active constituent of Brahmi) exhibited protection against seizures in mice; whereas another study examined the anticonvulsant properties of Brahmi extract at higher doses by its mechanism on GABA receptors 11. 

   Animal and human studies have investigated the effect of Brahmi extract on the gastrointestinal tract. An in-vitro study has demonstrated its direct spasmolytic activity on intestinal smooth muscles, via inhibition of calcium influx across cell membrane channels; suggesting its benefit in intestinal spasm such as irritable bowel syndrome. Brahmi also has a protective and curative effect on gastric ulcer. A study showed that Brahmi extract significantly healed penetrating ulcers induced by acetic acid, significantly strengthened the mucosal barrier and decreased mucosal exfoliation. A methanolic extract of Brahmi given for 5 days demonstrated a dose-dependent anti-ulcerogenic on various gastric ulcer models induced by ethanol, aspirin, two hour cold stress and four hour pylorus ligation 20. The extract also alleviated stress-induced ulcers as observed by significant reduction in LPO in rat gastric mucosa 11. Diethyl ether and ethyl acetate extract of Brahmi have slight anti-fungal activity but have a broad spectrum of antibacterial activity 10. Another in vitro study demonstrated its specific anti-microbial activity against Helicobacter pylori, a bacterium associated with chronic gastric ulcers 11. 

   A recent 2013 study revealed Brahmi’s wound healing properties. Brahmi showed antimicrobial activity against skin pathogens, enhanced wound breaking strength, rate of contraction, skin collagen tissue formation, and early epithelization period with low scar area by decreasing myeloperoxidase and free radical generated tissue damage 32.  Brahmi possesses anti-inflammatory activity that has shown 82% edema inhibition when compared to indomethacin. It also significantly inhibited 5-lipoxygenase (5-LOX), 15-LOX and cyclooxygenase-2 (COX-2) activity. Another paper supported its anti-inflammatory activity via inhibition of prostaglandin synthesis and lysosomal membrane stabilization 10, 11. 

   Brahmi extract has the potential usefulness in bronchoconstrictive and allergic conditions. Animal studies have demonstrated that it has a relaxant effect on chemically-induced bronchoconstriction, probably via inhibition of calcium influx into cell membranes. In vitro research using rabbit and pig aortas and pulmonary arteries has demonstrated that Brahmi exerts a vasodilatory effect on calcium chloride-induced contraction in both tissues via interference with calcium channel flux in tissue cells. Nearly all of the Brahmi extract subfractions inhibited carbachol-induced bronchoconstriction, hypotension and bradycardia in this animal model. Another study demonstrated that a methanol extract of Brahmi possessed potent mast cell stabilizing activity comparable to disodium cromoglycate, a commonly used allergy medication 11.

   Recently, some studies have demonstrated Brahmi’s anti-cancer activity. A study on rats found that Brahmi extract promotes antioxidant status, reduces the rate of lipid peroxidation and markers of tumor progression in fibro sarcoma 10. The anticancer effect of Brahmi extracts may be due to inhibition of DNA replication in cancer cell lines 11. A study on rats revealed that pretreatment of bacoside A prevents the elevation of lipid peroxidase activity of serum marker enzymes and maintains the antioxidant system and thus protects the rats from Diethyl nitrosamine-induced hepatocellular carcinoma 10. Brahmi protects human lymphocytes against various clastogens with its high anti-oxidant activity since clastogens are known to induce their clastogenic effects via the production of oxidative radicals 10. More research is needed to support Brahmi’s anticancer ability.

   A study on rats showed Brahmi’s protective effect against morphine-induced liver and kidney toxicity 10. Simultaneous administration of morphine and alcohol extract of Brahmi significantly decreased lipid peroxidation and increased liver antioxidant enzyme level, thereby protecting the liver against morphine 28. In mice, Brahmi administration with phenytoin reversed phenytoin-induced cognitive impairment, and improved acquisition and retention of memory 22. 

   An animal study showed that high doses of Brahmi extract increased the thyroid hormone, T4. However, T3 levels remained unchanged. Based on this study, Brahmi may have a potential use in hypothyroidism, however, the doses used in this study were very high and this effect has not yet been studied in humans 26. The antifertility potential of Brahmi was studied in male mice. According to a 2009 study, Brahmi caused reversible suppression of spermatogenesis and fertility, without producing apparent toxic effects; and 56 days after treatment cessation, the parameters returned to baseline 27. According to classical texts, Brahmi can safely be used during pregnancy to help both the mother and the fetus to be strong and sattvic. Also following delivery, the child may be given a honey-sweetened confection prepared with Brahmi to promote intellect 30. 

   In addition to its beneficial effect on humans and animals, Brahmi has a favorable effect on the environment. Brahmi is a known hyper accumulator of cadmium, chromium, lead and mercury and can be used for phytoremediation 10. A 2011study reported that substantial amount of arsenate were found accumulated in the Brahmi plant, thus aiding in phytoremediation 29. 

   Brahmi growing in contaminated areas may be toxic to health when consumed by humans 29. According to Swami Sivananda, Brahmi should not be collected from impure and unholy places; instead it should be collected from clean places with "fresh airy regions" 12.

A Final Thought

   Brahmi is one of the rare Ayurvedic herbs which can be grown almost anywhere when provided ample hydration and is widely available. It has been used for centuries in various forms and its advantages are supported by a vast body of literature and experience. Interestingly, the whole plant can be used for medicinal purposes. Ayurveda is the complete knowledge of life. Brahmi helps to achieve the primary goal of Ayurveda which is to prevent and treat illnesses and enhance lifespan by maintaining proper balance between the body, mind and the soul. Its therapeutic range is wide, and can be used in prevention as well as cure of a variety of disorders. It is a sattvic herb which comes from the same root as Brahman whose nature is Sat-Chit-Ananda 16. Its sattvic quality can help build strong ojas and reduce bad habits and treat addictions. It balances all doshas, dhatus and has an effect on almost all the Srotas of the human system and, based on the studies, animals, too. Being a nervine agent, it is beneficial in many neurologic and psychiatric disorders. This unusual herb has tonic, sedative and at the same time stimulant nervine effects. As a purifier, it is helpful in debilitating skin conditions. It strengthens the immune system and improves nutritional status, memory, intellect and longevity. It can help to achieve higher consciousness and improve meditation skills. By helping to open the crown chakra, it helps to achieve the highest goal of human life which is self-realization. Its ability to be used in different forms as well as in combination with other herbs makes it a popular medicinal plant. Finally, we have to agree with Swami Sivananda, “Rarely is it possible to come across an herb of such great worth.” 

References

1. USDA, plants profile: ‘Bacopa Monnieri (L.) Pennell http://plants.usda.gov/java/profile?symbol=BAMO
2. USDA, Bacopa Monnieri information from NPGS/GRIN http://www.ars.grin.gov/cgi-bin/npgs/html/taxon.pl?102292
3. National R & D Facility for Rasayana of Indian System of Medicine, Brahmi http://www.frlht.org/rasayana/node/47
4. The Wikipedia Encyclopedia http://en.wikipedia.org/wiki/Bacopa_monnieri
5. R. K. Sharma & Bhagwan Dash, Charaka Samhita. Chowkhamba Sanskrit Series Office 2009, Vol III, pp. 45, 58, 447, 456; Vol IV, pp. 167-68
6. K. R. Srikantha Murthy, Astanga Hrdayam. Chowkhamba Krishnadas Academy, 2012, vol 3, pp. 60, 62
7. A. K. Nadkarni, Dr. K. M. Nadkarni’s INDIAN MATERIA MEDICA. Popular Prakashan 2010, Vol I, pp. 624-25
8. Dr. David Frawley & Dr. Vasant Lad, Yoga of Herbs. Lotus press 2001, 239-241
9. Sebastian Pole, Ayurvedic Medicine- The principles of traditional practice. Singing dragon 2013, 149-150
10. D. sudharani, K. L. Krishna, K. Deval, A.K.Safia and Priya, “Pharmacological profiles of Bacopa monnieri: a review,” International Journal of Pharmaceutics, vol 1, no. 1, 2011, pp. 15-23
11. Kashmira J. Gohil & Jagruti A. Patel, “A review on Bacopa monnieri: Current research and future prospects,” International journal of green pharmacy, Vol 4, Issue:1, 2010, pp. 1-9
12. Swami Sivananda, Practice of Ayurveda. A divine life society 2006, 121, 205-207
13. Shipard, Isabell, How can I use HERBS in my daily life? 5th edition, 2007
14. Harsahay Meena, Hemant Kumar Pandey, Pankaj Pandey, Mahesh Chand Arya and Zakwan Ahmed, “ Evaluation of antioxidant activity of two important memory enhancing medicinal plants Bacopa Monnieri and Centella Asiatica,” Indian Journal of Pharmacology, 2012 Jan-Feb; 44(1): 114–117. doi: 10.4103/0253-7613.91880, PMCID: PMC3271514
15. Khare, C. P. (2003). Indian Herbal Remedies: Rational Western Therapy, Ayurvedic, and Other Traditional Usage, Botany. Springer. p. 89. ISBN 978-3-540-01026-5.
16. Sarasvati Buhrman, Ph.D., “ Ayurvedic Psychology and Psychiatric Approaches to the Treatment of Common Affective Disorders,” Protocol Journal of Botanical Medicine II: 1, 1-8
17. Kaviraj Kunja Lal Bhishagratna, An English Translation of The SUSHRUTA SAMHITA. Bharat Mihir Press 1911, Vol II, 522-26  http://archive.org/details/englishtranslati00susruoft
18. Singh RH, Narsimhamurthy K, Singh G., “Neuronutrient impact of Ayurvedic Rasayana therapy in brain aging,” Biogerontology 2008 Dec; 9(6):369-74. doi: 10.1007/s10522-008-9185-z. Epub 2008 Oct 18.
19. Government of India Ministry of Health and Family Welfare Department of Ayush, THE AYURVEDIC PHARMACOPOEIA OF INDIA, Part- I, Volume – II, pp. 25-27 http://www.ayurveda.hu/api/API-Vol-2.pdf
20. Caldecott, T. "Brahmi". Ayurveda: The Divine Science of Life. Elsevier / Mosby. ISBN 0-7234-3410-7. http://www.toddcaldecott.com/index.php/herbs/learning-herbs/384-brahmi
21. Wendy Weissner, article: “Brahmi and Cognition: Nature’s Brainpower Enhancer”               http://ayurveda-nama.org/pdf/resources/NAMA_Brahmi_Weissner.pdf
22. Monograph: Bacopa monnieri. Alternative Medicine Review, Vol 9 (1), 2004, pp. 79-85                http://www.thorne.com/altmedrev/.fulltext/9/1/79.pdf
23. Russo A, Borrelli F., “Bacopa monniera, a reputed nootropic plant: an overview,” Phytomedicine. 2005 Apr; 12(4):305-17. 
24. Tatimah Peth-Nui, Jintanaporn Wattanathorn, Supaporn Muchimapura, Terdthai Tong-Un, Nawanant Piyavhatkul, Poonsri Rangseekajee, Kornkanok Ingkaninan, Sakchai Vittaya-areekul, “Effects of 12-Week Bacopa monnieri Consumption on Attention, Cognitive Processing, Working Memory, and Functions of Both Cholinergic and Monoaminergic Systems in Healthy Elderly Volunteers,” Evid Based Complement Alternat Med. 2012: 606424, doi: 10.1155/2012/606424, PMCID: PMC3537209
25. Sukanto Sarkar, Biswa Ranjan Mishra, Samir Kumar Praharaj, S. Haque Nizamie, “Add-on effect of Brahmi in the management of schizophrenia,” J Ayurveda Integr Med. 2012 Oct-Dec; 3(4): 223–225. doi: 10.4103/0975-9476.104448, PMCID: PMC3545244
26. Kar A, Panda S, Bharti S., “Relative efficacy of three medicinal plant extracts in the alteration of thyroid hormone concentrations in male mice,” J Ethnopharmacol. 2002 Jul; 81(2):281-5.
27. Singh, A., Singh, S. K. (2009). "Evaluation of antifertility potential of Brahmi in male mouse". Contraception 79 (1): 71–79. doi:10.1016/j.contraception.2008.07.023. PMID 19041444
28. Sumathy T, Subramanian S, Govindasamy S, Balakrishna K, Veluchamy G., “Protective role of Bacopa monniera on morphine induced hepatotoxicity in rats,” Phytother Res. 2001 Nov;15(7):643-5.
29. Mishra S, Srivastava S, Dwivedi S, Tripathi RD., “Investigation of biochemical responses of Bacopa monnieri L. upon exposure to arsenate,” Environ Toxicol. 2013 Aug; 28(8):419-30. doi: 10.1002/tox.20733. Epub 2011 Jun 7.
30. Dr. Marc Halpern, Clinical Ayurvedic Medicine. California College of Ayurveda, sixth edition, September 2012, pp. 2-47; 5-25, 33,88
31. Dr. Marc Halpern, Principles of Ayurvedic Medicine. California College of Ayurveda, tenth edition, September 2010, pp. 295
32. Murthy S, Gautam MK, Goel S, Purohit V, Sharma H, Goel RK. “Evaluation of In Vivo Wound Healing Activity of Bacopa monniera on Different Wound Model in Rats,” Biomed Res Int. 2013; 2013:972028. doi: 10.1155/2013/972028. Epub 2013 Jul 29.

 

The Magical Moringa By: Vanita Agarwal

Introduction

Growing up in India this humble tree grew in our backyard and it never caught my attention, though I always loved the vegetable that grew on it. As I  entered into the world of Ayurveda I learnt about  this most  nutritious  tree  in the world called Moringa  only to realize that this tree was a childhood friend that I had loved and this world famous Moringa was my backyard fried the drumstick tree or Sajana as we used to call it.

In this paper I will attempt to cover:

  • 1. What is Moringa?
  • 2. The Nutritional value of Moringa
  • 3. Johns Hopkins University research on Moringa
  • 4. Health benefits of Moringa
  • 5. The qualities of Moringa from an Ayurvedic perspective

1. What is Moringa?

According to Wikipedia Moringa, a native to parts of Africa and Asia, is the sole genus in the flowering plant family Moringaceae. The name is derived from the Tamil word Murungai (முருங்கை) [1]. 

It contains 13 species from tropical and subtropical climates that range in size from tiny herbs to massive trees. The most widely cultivated species is Moringa oleifera, a multipurpose tree native to the foothills of the Himalayas in northwestern India and cultivated throughout the tropics. M. stenopetala, an African species, is also widely grown, but to a much lesser extent than M. oleifera.

As Moringa spread from India to other tropical and subtropical areas, it adapted to local conditions. Over time, these thirteen distinct species of Moringa developed.

Scientific Classification of Moringa [1]:

Kingdom:         Plantae
(un-ranked): Angiosperms
(un-ranked): Eudicots
(un-ranked): Rosids
Order: Brassicales
Family: Moringaceae
Genus: Moringa

Scientific Names of the 13 different species of Moringa found in the world today [1] 

1. M. oleifera (Northwestern India)
2. M. arborea (Kenya)
3. M. borziana
4. M. concanensis
5. M. drouhardii (Southwestern Madagascar)
6. M. hildebrandtii
7. M. longituba
8. M. ovalifolia
9. M. peregrine
10. M. pygmaea
11. M. rivae
12. M. ruspoliana
13. M. stenopetala

Common Names of Moringa:

While native to the Indian sub-continent, Moringa has spread throughout the tropical and sub-tropical regions of the world. There are over 400 names of Moringa around different parts of the world. Here are some of the many common names of Moringa: [3]

English Drumstick tree, Horseradish tree, Mother's Best Friend, Radish tree, West Indian ben
French Bèn ailé, Benzolive, Moringa, Ben oléifère, Arbre radis du cheval
German Behenbaum, Behenussbaum, Flügelsaniger Bennussbaum, Pferderettichbaum
Italian Sàndalo ceruleo
Portuguese Acácia branca, Cedra (Brazil), Marungo, Moringuiero, Muringa
Spanish  Árbol del ben, Ben, Morango, Moringa

Africa

Benin: Patima, Ewé ilé
Burkina Faso: Argentiga
Cameroon: Paizlava, Djihiré
Chad: Kag n’dongue
Ethiopia: Aleko, Haleko
Ghana: Yevu-ti, Zingerindende
Kenya: Mronge
Malawi: Cham’mwanba
Mali: Névrédé
Niger: Zôgla gandi
Nigeria: Ewe ile, Bagaruwar maka
Senegal: Neverday, Sap-Sap
Somalia: Dangap
Sudan: Ruwag
Tanzania: Mlonge
Togo: Baganlua, Yovovoti
Zimbabwe: Mupulanga

Asia

Bangladesh: Sajina
Burma: Dandalonbin
Cambodia: Ben ailé
India: Sahjan, Murunga, Moonga; 
Hindi: Sahijan, Munaga, Sajana, 
Sindhi: Swanjera
Tamil: Murungai, Murunkak-kai, Morunga
Telegu: Tella-Munaga, Mulaga, Sajana
Kannada: Nugge mara, Nugge kayi; 
Oriya: Munigha, Sajina
Punjabi: Sanjina, Soanjana
Rajasthani: Lal Sahinjano
Sanskrit: Sigru Shobhanjan, Sobhan jana, Shobanjana
Konkani/Goa: Moosing, Mosing
Malayalam: Sigru, Moringa, Muringa, Murinna, Morunna
Marathi: Sujna, Shevga, Shivga

Indonesia: Kalor

Pakistan: Suhanjna
Philippines: Mulangai
Sri Lanka: Murunga
Taiwan: La Mu
Thailand: Marum
Vietnam: Chùm Ngây

South and Central America, Caribbean

Brazil: Cedro
Colombia: Angela
Costa Rica: Marango
Cuba: Palo Jeringa
Dominican Republic: Palo de aceiti
El Salvador: Teberinto
French Guiana: Saijhan
Guadeloupe: Moloko
Guatemala: Perlas
Haiti: Benzolive
Honduras: Maranga calalu
Nicaragua: Marango
Panama: Jacinto
Puerto Rico: Resada
Suriname: Kelor
Trinidad: Saijan

Oceania

Fiji: Sajina
Guam: Katdes
Palau: Malungkai

2. The Nutritional value of Moringa

The tree is often referred to as "The Miracle Tree" and "Mother’s Best Friend", which is understandable when you learn that Moringa contains a unique combination of vitamins, minerals and amino acids that make it one of the most nutritious plants ever discovered. Much of the plant is edible by humans or by farm animals.

Moringa leaves
Moringa leaves are exceptionally nutritious. When fresh, they are rich in vitamin C. When carefully dried, gram for gram Moringa leaves contain 24 times the iron of spinach, 16 times the calcium of milk, 9 times the vitamin A of carrots, many times the potassium of bananas, and every essential amino acid your body needs.
The leaves are rich in protein, vitamin A, vitamin B, vitamin C and minerals [4]. 100g of fresh Moringa leaves have 8.3 g protein, 434 mg calcium, 404 mg potassium, 738 μg vitamin A, and 164 mg vitamin C [5].
 
Antioxidants
Moringa contains 46 powerful antioxidants - compounds that protect the body against the destructive effects of free radicals by neutralizing them before they can cause cellular damage and disease [6].
 
Vitamins
Vitamin A (Alpha & Beta-Carotene), B, B1, B2, B3, B5, B6, B12, C, D, E, K, Folate (Folic Acid), Biotin [6]
 
Minerals
Calcium, Chromium, Copper, Fluorine, Iron, Manganese, Magnesium, Molybdenum, Phosphorus, Potassium, Sodium, Selenium, Sulphur, Zinc [6] .
 
Essential Amino acids
Isoleucine, Leucine, Lysine, Methionine, Phenylalanine, Threonine, Tryptophan, Valine [6]. 
 
Non-essential Amino Acids
Alanine, Arginine, Aspartic Acid, Cystine, Glutamine, Gl ycine, Histidine, Proline, Serine, Tyrosine [6]

Vitamin & Mineral Content of Moringa: [9]

All values are per 100 grams of edible portion.

  Fresh Leaves Dried Leaves
Carotene (Vit. A)* 6.78 mg  18.9 mg
Thiamin (B1) 0.06 mg 2.64 mg
Riboflavin (B2) 0.05 mg 20.5 mg 
Niacin (B3) 0.8 mg  8.2 mg
Vitamin C  220 mg 17.3 mg
Calcium  440 mg 2,003 mg
Calories  92 cal 205 cal
Carbohydrates  12.5 g  38.2 g
Copper 0.07 mg 0.57 mg
Fat   1.70 g  2.3 g
Fiber  0.90 g 19.2 g
Iron  0.85 mg 28.2 mg
Magnesium 42 mg  368 mg
Phosphorus  70 mg 204 mg
Potassium  259 mg 1,324 mg
Protein  6.70 g 27.1g
Zinc  0.16 mg  3.29 mg

Amino Acid Content of Moringa [9]:

All values are per 100 grams of edible portion.

  Fresh Leaves Dried Leaves
Arginine  406.6 mg  1,325 mg
Histidine  149.8 mg 613 mg
Isoleucine  299.6 mg  825 mg
Leucine  492.2 mg  1,950 mg
Lysine  342.4 mg  1,325 mg
Methionine  117.7 mg 350 mg
Phenylalinine  310.3 mg 1,388 mg
Threonine  117.7 mg  1,188 mg
Tryptophan  107 mg  425 mg
Valine  374.5 mg 1,063 mg

3. Johns Hopkins University research on Moringa [10] :

Jed W. Fahey, Sc.D. , Johns Hopkins School of Medicine, Department of Pharmacology and Molecular Sciences produced a very important research paper titled: “Moringa oleifera: A Review of the Medical Evidence for Its Nutritional, Therapeutic, and Prophylactic Properties. Part 1.” In this seminal work, they began the process of sifting through the scientific work on Moringa, as well as the traditional, as well as anecdotal evidence for Moringa’s nutritional, therapeutic and prophylactic. In doing this, they found that much of the scientific evidence is beginning to support much of the traditional and anecdotal information.

4. Health Benefits of Moringa

Moringa preparations have been cited in the scientific literature as having antibiotic, antitrypanosomal, hypotensive, antispasmodic, antiulcer, anti-inflammatory, hypo-cholesterolemic, and hypoglycemic activities, as well as having considerable efficacy in water purification by flocculation, sedimentation, antibiosis and even reduction of Schistosome cercariae titer. 

Antibiotic Activity: This is clearly the area in which the preponderance evidence—both classical scientific and extensive anecdotal evidence—is overwhelming. The scientific evidence has now been available for over 50 years, although much of it is completely unknown to western scientists [10].

Phytochemicals and 6 Carbon Sugar Rhamnose: An examination of the phytochemicals of Moringa species affords the opportunity to examine a range of fairly unique compounds. In particular, this plant family is rich in compounds containing the simple sugar, rhamnose, and it is rich in a fairly unique group of compounds called glucosinolates and isothiocyanates. For example, specific components of Moringa preparations that have been reported to have hypotensive, anticancer, and antibacterial activity [10].

Antibacterial and Antifungal:

Subsequent elegant and very thorough work, published in 1964 as a PhD thesis by Bennie Badgett (a student of the well-known chemist Martin Ettlinger), identified a number of glycosylated derivatives of benzyl isothiocyanate [5] (e.g. compounds containing the 6-carbon simple sugar, rhamnose) (8). The identity of these compounds was not available in the refereed scientific literature until “re-discovered” 15 years later by Kjaer and co-workers (73). Seminal reports on the antibiotic activity of the primary rhamnosylated compound then followed, from U Eilert and colleagues in Braunschweig, Germany (33, 34). They re-isolated and confirmed the identity of 4-(α-L-rhamnopy-ranosyloxy)benzyl glucosinolate [6] and its cognate isothiocyanate [2] and verified the activity of the latter compound against a wide range of bacteria and fungi. (Jed W. Fahey, 2005) This is clearly the area in which the preponderance of evidence—both classical scientific and extensive anecdotal evidence—is overwhelming. The scientific evidence has now been available for over 50 years, although much of it is completely unknown to western scientists [10].

ANTIBACTERIAL PROPERTIES OF MORINGA STENOPETALA [12] 

The main objective of this study was to isolate compounds from root wood of Moringa stenopetala and evaluate antibacterial activities of the isolated compounds. Three of the compounds namely cholest-5-en-3-ol, palmitic acid and oleic acid showed highest activity against E. coli. The observed antibacterial activities of the crude extract and the isolated compounds could justify the traditional use of the plant for the treatment of different bacterial infections [12].

H. pylori is an omnipresent pathogen of human beings in medically underserved areas of the world, and amongst the poorest of poor populations worldwide. It is a major cause of gastritis, and of gastric and duodenal ulcers, and it is a major risk factor for gastric cancer (having been classified as a carcinogen by the W.H.O. in 1993). Cultures of H. pylori, it turned out, were extraordinarily susceptible to [2], and to a number of other isothiocyanates (37, 60). These compounds had antibiotic activity against H. pylori at concentrations up to 1000-fold lower than those which had been used in earlier studies against a wide range of bacteria and fungi. The extension of this finding to human H. pylori infection is now being pursued in the clinic, and the prototypical isothiocyanate has already demonstrated some efficacy in pilot studies [10].

Cancer Prevention:

Since Moringa species have long been recognized by folk medicine practitioners as having value in tumor therapy, we examined compounds for their cancer preventive potential. Recently, these compounds were shown to be potent inhibitors of phorbol ester (TPA)-induced Epstein-Barr virus early antigen activation in lymphoblastoid (Burkitt’s lymphoma) cells [10].

In one of these studies, they also inhibited tumor promotion in a mouse two-stage DMBA-TPA tumor model. In an even more recent study, Bharali and colleagues have examined skin tumor prevention following ingestion of drumstick (Moringa seedpod) extracts. In this mouse model, which included appropriate positive and negative controls, a dramatic reduction in skin papillomas was demonstrated. Thus, traditional practice has long suggested that cancer prevention and therapy may be achievable with native plants.

Role of Moringa on Gastric Ulcer and its use as Antacid

  • A study on Moringa leaf extract to determine its effect on experimental gastric ulceration concluded that the leaf extract can be beneficially used in the management of gastric ulcer in contrast to the classical antacid, antihistamine or surgical treatment [13].
  • Two weeks of treatment with Moringa Oleifera healed gastric ulcer damage [14].

Role of Moringa on Muscle cramps and Sleep

  • • Moringa is found to significantly reduces muscle cramps, decreases body temperature, and enhances sleep [15].

Benefits to Heart, Cholesterol, Triglycerides, Atherosclerotic Plaques:

  • Moringa has been found to have significant benefits to heart [16]. Water extract of Moringa Oleifera leaves possesses strong antioxidant activities. The prevention of artherosclerotic plaque formation in artery as well as the lipid lowering activity of the extract has been shown in rabbit fed with high cholesterol diet. M. Oleifera has high therapeutic potential for the prevention of cardiovascular diseases.
  • It works as well as Simvastatin in decreasing cholesterol, triglycerides, and inhibiting the formation of atherosclerotic plaques. [17]
  • Moringa strengthens heart function : Prevented structural damage and prevented increases in lipid peroxidation in the myocardium [8]

Anti-fungal 

  • • Moringa seeds have shown anti-fungal ability and effectiveness against athlete’s foot [18].

Prevention of Kidney stone 

  • • Moringa water extract has shown to prevent kidney stone formation and dissolve already performed stones [19]. 

Liver fibrosis 

Oral administration of Moringa seed extract in rats reduced liver damage as well as symptoms of liver fibrosis. Moringa seed extract can act against CCl(4)-induced liver injury and fibrosis in rats by a mechanism related to its antioxidant properties, anti-inflammatory effect and its ability to attenuate the hepatic stellate cells activation. [20]

Cancer/Chemo preventative property of Moringa 

  • • A study was conducted to find out the Chemomodulatory effect of hydro-alcoholic extract of Moringa oleifera, Lam, on hepatic carcinogen metabolizing enzymes, antioxidant parameters and skin papillomagenesis in mice. The findings are suggestive of a possible chemo preventive potential of Moringa oliefera drumstick extract against chemical carcinogenesis [21]

Blood glucose level and Diabetes

  • • Variable doses of M. oleifera leaves aqueous extract administered orally to test the glycemic control, haemoglobin, total protein, urine sugar, urine protein and body weight. The dose of 200 mg kg(-1) decreases blood glucose level (BGL) of normal animals by 26.7 and 29.9% during FBG and OGTT studies respectively. In sub and mild diabetic animals the same dose produced a maximum fall of 31.1 and 32.8% respectively, during OGTT. In case of severely diabetic animals FBG and PPG levels were reduced by 69.2 and 51.2% whereas, total protein, body weight and haemoglobin were increased by 11.3, 10.5 and 10.9% respectively after 21 days of treatment. Significant reduction was found in urine sugar and urine protein levels from +4 and +2 to nil and trace, respectively. The test result concluded that the study validates scientifically the widely claimed use of M. oleifera as an ethnomedicine to treat diabetes mellitus. [22]

5.  Ayurvedic Perspective on Moringa 

According to Vaidya Mishra [23] , an Ayurvedic expert from the Shankha Vamsa lineage, Moringa is  both a  detoxifier as well as a tonic. Whenever we detox we also use a tonic, Moringa does both. It purifies and nourishes the blood and muscle tissues, the bone marrow and the fat tissues of any toxins at the same time nourishing it.

Ayurvedic Properties/Guna of Moringa

Taste (rasa) Pungent/katu, tikta/bitter 
Virya Heating/ushna 
Post  Digestive metabolic state (vipak): pungent/katu 
Guna Light/laghu, dry/ruksha, sharp/tikshana, fluid/sara
Prabhava Liver cleanser (yakrit sodhana)
Purifies Blood (rakta sodhaka)
enhances spleen/pliha 
Removes worms (krmi), acidic toxins from the blood (amavishagni)
Relieves from tumor (gulma)
Strengthens heart/ hridya, fat metabolism and weight loss/Medovishahara and regulates cholesterol. 

In Bhava Prakash (16 Century canonical textbook of Ayurveda), part one, authored by Bhav Mishra and Rajnigantu, Moringa is called sigru, or “it moves like an arrow” in the body because it rapidly penetrates the tissues and has deep absorption and detoxification ability, making its effect on the deep bone marrow tissue swift and effective. 

The Nature and Qualities of Moringa: 

  • Hot and sharp, but also bitter and pungent 
  • Pacifies vata and kapha (vatakaphapaha) 
  • Pacifies kledaka kapha and increases appetite 
  • Reduces stiffness in the jaw, relaxes the jaw and thus helps in opening the mouth (mukhajadyahar) 
  • It is appetizing (rucyo) 
  • Increases digestive flame (dipano)
  • It cleans and clears the ulcers (vranadosanut). Vrana means ulcer.
  • Bitter (Sigrustiktah) 
  • Pungent and heating (Katuscosnah) 
  • Reduces kapha-predominant swelling and water retention, which can also lead to vata imbalance. Swollen ankles are a common complication of excess weight. Three-four drumstick pods per meal begin to reintroduce the intelligence so the body does not accumulate toxins in the lower extremities. Over time, little by little, the swelling will go down and not return. (Kaphasophasamirajit) 
  • Creates an unfriendly environment for the growth of tumors 
  • Destroys krimi and amavisha (Krgyamvisa) 
  • By binding the toxins in the blood, and cleaning the blood (due to its hot potency and pungent taste and post digestive taste), it relieves long term burning in the skin and stomach. 
  • Prevents and rids the tumors. When the clean blood circulates, growth of tumors are prevented and also if tumors are present, gets rid of the tumors (gulmanut). 
  • The Ayurvedic verse on Moringa by Bhav prakash of Bhav Mishra cites Moringa as removing acidic toxins from the blood, cleansing the blood. This in turn lowers bad cholesterol and improves cholesterol metabolism. This correlates the power of Moringa in lowering bad cholesterol and improving cholesterol metabolism. 
  • Kidney Stones: Ushna/hot and thikshana/pungent quality of Moringa stimulates the kidneys, dysuria, increases quantity of urine, removes excess acidity in urine and calculi. 

Dr. JV Hebbar, summarizes several interesting facts about Moringa in his blog [24].

Sanskrit Synonyms:

  • Shobhanjana – Very auspicious tree
  • Shigru – has strong, piercing qualities
  • Teekshnagandha – Strong and pungent odor
  • Aksheeva – relieves intoxication
  • Mochaka – helps to cure diseases

Classical categorization:

  • According to Charaka Samhita – 
  • Krimighna – group of herbs that are used to treat worm infestation.
  • Svedopaga – group of herbs that are used in Svedana (preparatory procedure for Panchakarma)
  • Shirovirechanopaga – group of herbs that are used in Nasya Panchakarma treatment
  • Katuka Skandha – group of herbs that have pungent taste.
  • According to Sushruta and Vagbhata – Varunadi Group of herbs. (Hence it is an ingredient of a famous Ayurvedic medicine – Varanadi kashayam)

Medicinal Qualities of drumstick tree:

  • Rasa(taste) – Katu (Pungent), Tikta (bitter)
  • Guna(qualities) – Laghu (light to digest), Rooksha (dryness), Teekshna (strong, piercing)
  • Vipaka – katu (Moringa undergoes pungent taste conversion after digestion.)
  • Veerya – Ushna – hot potency.
  • Effect on Tridosha – Balances Kapha and Vata

Varieties of Moringa:

There are three varieties of Moringa explained in Ayurvedic text books.

1. Shyama – black variety
2. Shveta – white variety and
3. Rakta – red variety. It is also called as Madhu shigru.

Black variety of drumstick tree is the most common. Its qualities are:

Katu – pungent,
Teekshna – piercing, sharp, strong
Ushna – hot in potency
Madhura – slightly sweetish
Laghu – light to digest
Deepana – improves digestion
Rochana – Improves taste,
Rooksha – dry
Kshara – Has alkaline properties
Tikta – Bitter
Vidaahakrit – causes burning sensation
Sangrahi – Useful to check diarrhoea
Shukrala – Improves semen quantity and sperm count
Hrudya – Good for heart. Cardiac tonic
Pittarakta prakopana: Increases Pitta and vitiates blood. Hence, drumstick should not be consumed during bleeding disorders, duriner menstruation and for people with pimples and Pitta related skin diseases.
Chakshushya – Improves vision, good for eyes.
Kaphavataghna – Decreases imbalanced Kapha and Vata
Vidradhi – Useful in abscess. It helps in quick wound healing of abscess, upon oral intake and external application as paste.
Shvayathu – It is a good anti inflammatory herb.
Krimi – useful in worm infestation in stomach and in wounds.
Meda – helpful to decrease fat and obesity.
Apachi – Useful in relieving carbuncles.
Visha – Anti toxic. Has detoxifying action.
Pleeha – Useful in spleen related diseases
Gulma – Useful in abdominal bloating and tumors
Ganda Vrana – Useful in lymphadenitis

White variety Moringa Properties: It is quite similar to the black variety.

Dahakrut – causes burning sensation
pleehaanaam vidradhim hanti – useful in splenic abscess
VraNaghna – helps in quick wound healing
Pittaraktakrut – Increases Pitta and vitiates blood.
 
The Red Variety, called as Madhushigru 
Deepana – Increases digestion power.
Sara – promotes proper bowel movements.

Moringa Leaves and Bark

The juice extract of drumstick leaves and bark are very useful in relieving pain. They act as natural analgesic. They are used both for oral intake and also for external application as paste.

In Indian household, the leaves are used to prepare Chutney and Sambar (a south-indian soup).

Moringa seeds uses: Moringa seeds are called as Shweta Maricha
Chakshushya – good for eyes
Vishanashana – anti toxic
Avrushya – do not have aphrodisiac qualities
Nasyena Shiro Artinut – When used for Nasya (in the form of powder or oil), it helps to relieve headache.
 

Moringa for Headaches:

Moringa leaves paste applied externally, or used as vegetable helps to relieve headache.
Its seed powder, in the form of nasya treatment cures headache.
 

Moringa for Diabetes: Many studies have been conducted to prove the anti-diabetic and anti-oxidant effect of Moringa.

Oil prepared with Moringa is useful to relieve headache, pungent, useful in skin diseases and diabetes.

Moringa flowers are useful in intestinal worms. It balances Pitta and kapha.

Moringa Side Effects:

As explained above, it causes increase in burning sensation and is pungent. Hence, people with gastritis or sensitive stomach should use this vegetable carefully.
It is not ideal to be taken during periods, since it increases Pitta and vitiates blood.
It is also not ideal to be taken during bleeding disorders.
 

Moringa during pregnancy and lactation:

Moringa fruit is rich in protein, vitamins, minerals and anti-oxidants. Hence it can be used during pregnancy. But Moringa leaves, root bark and flowers are not indicated during pregnancy.
 

Conclusion:

Thus we can see that this humble tree is loaded with wonderful qualities that can be used for healing by an Ayurvedic practitioner. Several scientific studies have documented its great properties of healing like anti-bacterial, anti-cancer, anti-inflammatory, anti-fungal etc. and has been used successfully for hundreds of years. 
 

Bibliography/References:

1. Moringa, Wikipedia. http://en.wikipedia.org/wiki/Moringa.
3. Trees for Life International, Moringa Tree. http://www.treesforlife.org/our-work/our-initiatives/Moringa.
4. Janick, Jules, Robert E. Paull, The Encyclopedia of Fruit & Nuts. (CABI, 2008): 509-510.
5. Food and Agriculture Organization of the United Nations, Barbara Stadlmayr, U Ruth Charrondiere, et. al, West African Food Composition Table,   http://www.fao.org/docrep/015/i2698b/i2698b00.pdf
6. Moringa Tree Foundation, Seeds of Hope, www.Moringatreefoundation.org 
7. Trees for Life International, Moringa Tree. http://www.treesforlife.org/our-work/our-initiatives/Moringa
8. Fuglie LJ, The Miracle Tree: Moringa oleifera: Natural Nutrition for the Tropics (Church World Service, Dakar 1999),   68.; revised in 2001 and published as The Miracle Tree: The Multiple Attributes of Moringa,  172
9. All Things Moringa, H. Hiawatha Bey, www.allthingsmoringa.com
10. Jed W. Fahey, S., “Moringa Oleifera: A Review of the Medical Evidence for Its Nutritional, Therapeutic, and Prophylactic Properties. Part 1.” (Vols. Copyright: ©2005 Jed W. Fahey. Baltimore, Maryland: Johns Hopkins School of Medicine, Department of Pharmacology and Molecular Sciences, Lewis B. and Dorothy Cullman Cancer Chemoprotection Center, 725 N. Wolfe Street, 406 WBSB, Baltimore, Maryland, USA 21205-2185.]
12. Mulugeta Tesemma, Legesse Adane, Yinebeb Tariku, Diriba Muleta and Shiferaw Demise. “Isolation of Compounds from Acetone Extract of Root Wood of Moringa stenopetala and Evaluation of their Antibacterial Activities” Research Journal of Medicinal Plant, 7(1) (2013):  32-47
13. Debnath S, Biswas D, Ray K, Guha D., “Moringa oleifera induced potentiation of serotonin release by 5-HT(3) receptors in experimental ulcer model”,  Phytomedicine, 18(2-3) (2011-Jan-15):  91-95
14. Debnath, S., & Guha, D., “Role of Moringa oleifera on enterochromaffin cell count and serotonin content of experimental ulcer model,” Indian Journal of Exp Biol, 45(8), (2007):   726-731. 
15. Pal, S., Mukherjee, P., Saha, K., M., P., & Saha, B. “Studies on some psychopharmacological actions of Moringa oleifera Lam.”, Phototherapy Research, 10(5), (1996):  402-405. 
16. Chumark, Khunawat et. al, “The in vitro and ex vivo antioxidant properties, hypolipidaemic and antiatherosclerotic activities of water extract of Moringa oleifera Lam. leaves,” Journal of Ethno-Pharmocology 116(3) (2008 Mar 28):  439-446.
17. Jain, Pankaj G. et al., “Hypolipidemic activity of Moringa oleifera Lam., Moringaceae, on high fat diet induced hyperlipidemia in albino rats,” Rev. bras. farmacogn., 20(6) (Dec 2010):  969-973.
18. Chuang, P. H., Lee, C.W., Chou, J. Y., Murugan, M., Shieh, B.J., & Chen, H. M. “Anti-fungal activity of crude extracts and essential oil of Moringa oleifera Lam.”, Bioresour Technol, 98(1), (2007):  232-236. 
19. Karadi, R. V., Gadge, N. B., Alagawadi, K. R., & Savadi, R. V., “Effect of Moringa oleifera Lam. root-wood on ethylene glycol induced urolithiasis in rats.” J Enthnopharmacol, 105(1-2), (2006): 306-311. 
20. Hamza AA, “Ameliorative effects of Moringa oleifera Lam seed extract on liver fibrosis in rats.” 
Food Chem Toxicol. 48(1), (2010 Jan):  345-355.
21. Bharali R, Tabassum J, Azad MR, “Chemomodulatory effect of Moringa oleifera, Lam, on hepatic carcinogen metabolising enzymes, antioxidant parameters and skin papillomagenesis in mice.”  Asian Pacific Journal of Cancer Prevention, 4(2) (2003 Apr-Jun): 131-139.
22. Jaiswal D, Kumar Rai P, Kumar A, Mehta S, Watal G, “Effect of Moringa oleifera Lam. leaves aqueous extract therapy on hyperglycemic rats,” Journal of Ethnopharmacology, 123(3) (2009 Jun 25): 392-396.
23. Adhishakti LLC, Vaidya Mishra,  “Moringa Super Veggie”, http://issuu.com/vaidyamishra/docs/moringa_super_veggie
24. Dr JV Hebbar, Moringa Benefits, Medicinal Usage and Complete Ayurveda Details, http://easyayurveda.com/2012/12/06/moringa-benefits-medicinal-usage-complete-ayurveda-details/ 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

The Skinny: Western and Ayurvedic Treatment Approach To Anorexia Nervosa. By: Leah Kaplan

   Anorexia Nervosa, the mental disorder in which individuals consciously starve themselves, remains one of the most complicated mental illnesses present today. From its first appearance in Medieval Europe to its current form, anorexia nervosa continues to baffle those who study it and destroy the lives of those stricken with it. It remains so elusive for a few reasons. One, there is no reliable source as to what causes the disease. Research shows some genetic link, and trauma seems to be involved somehow, but evidence remains loose as to how exactly those factors affect the development. The public is inclined to lay blame on the media and current ideals of female thinness, but if this were the cause the entire population would be struggling, as we are all exposed to those images and messages. Secondly, while the three medical criteria discussed in this paper, a body weight of 85% below the ideal, an intense fear of gaining weight, and amenorrhea, are consistent amongst anorexic patients, all other symptoms and signs are variable. Some patients will present with depression and apathy, while others will struggle with excessive exercise and OCD behaviors. One woman might show signs of developing osteoporosis, while another has no symptoms of this at all. As many individuals as contract anorexia, that is how many expressions of the disease there will be. This fact lends itself to Ayurveda, India’s ancient system of wellness, which views each individual as completely unique and in need of a unique healing recommendation to match. Finally, while anorexia is very much a mental disorder, the physical symptoms cannot be ignored or put on the back-burner while the mental body is attended to because of the dangerous nature of the disease. It is the most deadly amongst mental disorders and must be handled with a level of seriousness to match. For this reason, Western medical science, with its abundance of research, seems more trustworthy and capable of handling treatment. By examining what both Western medicine and Ayurveda have to offer, one can develop strategies across modalities to increase healing and well-being for these patients and form a more complete picture of all that is needed to take care of an anorexic patient. 

   Anorexia Nervosa (AN) is defined in the DSM-V, the American Psychiatric Association’s (APA) classification and diagnostic manual, as having three criteria:

  • 1. Restriction of energy intake relative to requirements leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health; 2. Intense fear of gaining weight or becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight; 3. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.  

   As one can discern from this lengthy and somewhat objective criteria, anorexia nervosa is a complex and complicated disease, both to diagnose and to treat. This becomes even clearer when one considers that the origin of this disease is psychological in nature, but unlike other common psychological disorders, becomes visible primarily because of physical habits and changes. These physical changes then perpetuate the psychological changes. In their guide, Eating Disorders: Everything You Need to Know, Jim Kirkpatrick and Paul Caldwell sum up this vicious cycle, “the psychological and emotional changes initiate the physical ones, but then the physical changes reinforce the negative psychological changes.”  The complexity of this cannot be overstated. From a treatment perspective, the question then becomes which do you consider first? Whatever therapies are administered to heal physical ailments as a result of starvation must also concern themselves with their psychological effects on the anoretic. And although the disease needs to be eradicated at the level of the mind, the physical body needs to be re-fed in a most literal way, as soon as possible; according to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), “20% of people suffering from anorexia nervosa will prematurely die from complications relating to their eating disorder,” making eating disorders the most fatal of any mental disorder.   But treatments that might prove extremely effective for the physical symptoms of anorexia nervosa (such as severe weight loss and amenorrhea) might be useless here due to non-compliance on the part of the anoretic. Physical treatments cannot wait for the slower, more gradual process of psychological rehabilitation, which can take years, however: the re-feeding process must occur simultaneously to the psychological treatment for both bodily and mental health. As this paper proceeds to examine the Western and Ayurvedic treatments for the three medical criteria necessary for a diagnosis, this point of view will be considered for all possible therapies. 

   Classical Ayurveda does not mention anorexia nervosa, as we understand it today, as a disease condition. The origins of anorexia nervosa can be traced back to religious fasting in Medieval Europe and the reported starvation of female saints, the most famous being Catherine of Siena (1347-1380), who “claimed to be incapable of eating normal earthly fare.”  And the first medical reports of anorexia nervosa did not appear until 1689 in Thomas Morton’s “Wasting Disease of Nervous Origins.”  Considering that the Classical Ayurvedic texts were written between 500 and 1500 BC,  it becomes obvious why it was never mentioned: it probably did not exist. Anorexia nervosa seems to appear only after food becomes abundant and eating becomes less about survival and more about a social obligation or sensory pleasure. As Joan Jacobs Brumberg, the author of Fasting Girls: A History of Anorexia Nervosa comments in a New York Times article entitled “Anorexia: It’s Not a New Disease,”  “Anorexia nervosa emerges in cultures that are food-abundant…You don’t have anorexia nervosa in the third world: what you don’t eat, someone else will.”  While the specific disease anorexia nervosa is not mentioned in the Classical Ayurvedic texts, anorexia nervosa would be classified as manasika arocaka or “loss of appetite due to factors of the mind”  and for management of anorexia due to psychic origin, the Cakradatta recommends that “the patient is managed with pleasing and agreeable items.”  It is important to note the significant difference between anorexia, meaning loss of appetite, and anorexia nervosa, the disease described above. While this paper will address loss of appetite as it appears as a symptom in advanced stages of anorexia nervosa, it is a deep misunderstanding to think that the anoretic has lost her appetite or does not desire to eat. “Individuals with anorexia nervosa may eventually develop a true lack of appetite, but for the most part it is not a loss of appetite but rather a strong desire to control it that is a cardinal feature. Rather than lose their desire to eat, anorexics, while suffering from the disorder, deny their bodies even when driven by hunger pangs…”  writes Carolyn Costin in her reference manual, The Eating Disorder Sourcebook. Thus, loss of appetite will be considered as a late-stage symptom and not a causative factor. 

   In fact, the etiology of anorexia nervosa is still very much debated. It is beyond the scope of this paper to thoroughly investigate this topic, but trauma, genetics, a perfectionistic, self-critical personality, the influence of the media, and participation in competitive activities that have an ideal weight have all been found to be contributing factors.  Due to the size and scope of this paper, descriptions and treatments will focus only on post-menarche females, who account for 85-95% of all cases.  This is not to suggest that anorexia nervosa does not also affect males and older women. Additionally, there are as many symptoms and expressions of AN as there are patients. While this paper will only focus on three of them, it is worth noting that other symptoms will be present and can frequently include: dry skin and hair, the development of lanugo (fine hairs on the body to conserve heat), insomnia, fluid retention, decreased ability to concentrate, dullness in the mind, depression, social withdrawal, and apathy.   

   The first medical criteria required for a diagnosis of AN, as determined by the APA, is a “refusal to maintain body weight at or above a minimally normal weight for age and height…leading to body weight less than 85% of that expected.”  It is reasonable to say that all other symptoms are a cascade that originate from this one source. The refusal to maintain body weight is not due to lack of hunger, as previously noted, “but, rather, due to strict denial of that most basic of body instincts: hunger.”  So, while symptomatic relief is available and will be discussed for other medical complications, to treat the physical root of anorexia nervosa is to begin a process known as re-feeding. Re-feeding can happen either through working with a nutritionist and team of doctors while the patient lives at home or at an in-patient clinic, either at a private institution or in the psychiatric wing of a hospital. Throughout this process, Western treatment places primary importance on the calorie level and number of exchanges (measures of carbohydrate, fat, and protein content) present in the patient’s diet. A 2013 study conducted by the University of California, San Francisco, examined caloric intakes for adolescent anoretics: “Current recommendations for re-feeding in anorexia nervosa (AN) are conservative, beginning around 1,200 calories to avoid re-feeding syndrome.”  Re-feeding syndrome is “the potentially fatal shifts in fluids and electrolytes that may occur in malnourished patients receiving artificial refeeding (whether enterally or parenterally).”  So one can see that there is a standardized caloric starting point for all anorexic patients. As Erin Naimi, R.D., eating disorders specialist and nutrition therapist commented in an interview for this paper, “things are pretty non-individualized in terms of how much [food]” is given to anorexic patients in treatment. This recent study completed by UCSF concluded that higher calorie diets with phosphate supplementation actually reduced hospital stays and resulted in faster weight gain with no incidents of refeeding syndrome.  This is very much against the current model of refeeding at Western treatment centers, who use “the strategy called ‘start low, advance slow.’”  Calorie increases from the baseline are dependent upon how quickly the anoretic gains weight. In a hospital setting, “there is a baseline meal plan which is the same…someone who needs to gain more weight would increase to a more rigorous meal plan,” says Ms. Naimi. But while immediately beginning with a higher calorie level might have physical benefits, like faster weight gain, there are psychological factors to consider; in the New York Times article, “Protocol to Treat Anorexia Is Faulted,” a patient who underwent rapid weight gain during her first hospital stay was so traumatized by it that she immediately lost all the weight as soon as she got out. When she was re-hospitalized two years later, she stayed for a longer period with slower weight gain and no such ramifications in the future.  Complicating matters further, anorexics will frequently experience hypermetabolism during the refeeding process. A 2012 study found consistent “evidence of a hypermetabolic state in patients with AN during refeeding which cannot be attributed to increased body mass alone…This is a phenomenon which appears to be unique to AN patients.”  This phenomenon requires caloric levels to increase rapidly and dramatically if the patient is to keep gaining weight. Increase levels too fast, however, and patients may experience “digestive disorders like constipation, diarrhea, and reflux disease. They may vomit involuntarily because the stomach and digestive capacity is diminished.”  The refeeding process shows exactly why treating AN remains a delicate matter; quantity of food must be balanced with rate of weight gain and digestive capability in equal measure, with the focus also being shared by the mental health of the patient. 

   Food choices in an inpatient program will vary from program to program, Ms. Naimi, the eating disorders specialist in Los Angeles, reports, but generally are not seen as important as caloric levels. In a strict hospital setting, the food provided for eating disorder patients is of the same quality as the food provided for all the other patients in the hospital. This usually means conventionally grown, highly processed, low quality ingredients. Foods are simple, bland, and dense, with the emphasis on the quantity of calories and number of exchanges rather than the specific foods used to deliver those measures. The strictest eating disorder programs will not even make accommodations for food allergies or vegetarianism. Other privately-run programs offer patients “up to three likes or dislikes, but draw the line around veganism, generally,” says Ms. Naimi. The ability to select foods from a menu is sometimes given as a privilege after the patient has gained a certain amount of weight and can be trusted to make her own meal choices. Upon arrival to an in-patient program, the anoretic does not possess the mental capacity to choose foods that are healthful for her and even more than that, cannot be trusted to make food choices that are not the direct result of the disease. This is the thinking behind stripping away any and all “preferences,” which might just be a thin veil for her disorder to control her food choices.  More than anything, the lack of information available on this specific subtopic speaks volumes as to how little attention is paid to food choices for the recovering anoretic. 

   In terms of food habits, the recovering anoretic’s entire day is structured around mealtimes and snack times. Interestingly, routine is of primary importance; breakfast, lunch and dinner are served at the same time everyday in in-patient programs. In Ms. Naimi’s experience, meals are timed so that patients finish their meals in a “normal” amount of time, with consequences if they are unable to do so. This usually means 30 minutes for each meal and 15 minutes for each snack. Ms. Naimi has never encountered a program that incorporates spiritual practices such as prayer into their mealtime routines, especially at larger, hospital in-patient centers. She says that smaller, private institutions will offer more spiritual practices, but not necessarily around mealtimes. The patients will always be monitored during meals and snacks, either by a nursing staff or by their own private therapists. These practices vary from program to program. The idea is two-fold: one, anoretics, especially at the beginning, are essentially at the mercy of their disease and will try anything to not eat, so monitoring prevents them from getting out of eating; and two, especially with a therapist, the mealtime becomes a sort of therapy session, where the doctor can see the patient interact with her meal and help her deal with the thoughts and behaviors surrounding it as they arise. Following mealtime, patients will typically have some form of therapy to help them process anything that came up during the meal or quiet time to relax, journal and practice stillness after eating.  

   From an Ayurvedic perspective, as explained in the Astanga Hrdayam, “consuming of insufficient quantity of food does not help improvement of strength, growth, and vigour, it becomes a cause for all diseases of vata origin.”  Thus, the first symptom of AN, weight loss resulting in a body weight of 85% of the ideal, is an invitation for vata vitiation, and treatment would therefore be centered around vata pacification: 

  • The treatment of (increased) vata are – oleation (internal and external), sudation (diaphoresis), mild purifactory therapies (emesis and purgation), ingestion of foods which are of sweet, sour, and salt taste; warm-oil bath massage of the body, wrapping the body with cloth, threatning (frightening), bath (pouring of medicinal decoctions, water, etc on the body), wine prepared from cornflour and jaggery (molasses), enema therapy with fat (oil), and drugs of hot potency, adherence to regimen of enema therapy, comfortable activities, medicated fats of different kinds (sources) prepared with drugs causing increase of hunger and improving digestion; especially anuvasana basti (oleation enema) prepared from the juice of fatty meat and oil.

   We have concluded that weight loss due to insufficient food qualifies as a vata imbalance and as noted above, the Astanga Hrdayama indicates the sweet, sour, and salty tastes as best for pacifying vata. So, a diet rich in these three tastes should be best for the recovering anoretic. Other qualities known to pacify vata are heavy, moist, oily, and warm foods. Refeeding according to Ayurveda follows samsarjana karma and recommends that the anoretic begins eating “the heaviest food that is well digested.”   In stark contrast to the non-individualized Western treatment approach, Ayurveda begins by tailoring the amount of food taken in to the specific digestive ability of the patient. If the patient is found to have deficient digestion, the Cakradatta recommends taking “hot rice-scum mixed with hingu and sauvarcala. By this the irregular fire becomes regular and the mild one is intensified. The rice-scum has eight properties – it increases appetite, cleans urinary bladder, gives energy, promotes blood, alleviates fever and pacifies kapha, pitta, and vata.”  Other foods like rice water, thin rice gruel, and rice porridge are also recommended as starting points to assess digestion by. Ghee and oils are added in small amounts to the food, beginning when the patient can properly digest rice, and then increased as digestion can tolerate.  Warming dipanas and appetite increasers, like Ginger, Pippali, Amalaki, and Chitrak should be taken with all meals, as well.  Ginger is especially recommended for low agni in the Cakradatta, “(In case of mildness of fire) taking pieces of fresh ginger with salt in the beginning of the meal is always wholsome [sic]. It stimulates digestive fire, cleanses tongue and throat and is pleasant.” In addition to dipanas, herbs can be used to help increase weight and improve appetite, while improving the psychiatric condition of the patient. Dr. A. A. Mundewadi, Chief Ayurvedic Physician at Mundewadi Ayurvedic Clinic in Maharashtra, India, recommends Ashwagandha, Shatavari, Samudrashosh, Jayphal, and Khurasani Ova for this purpose.  In addition, he, along with other sources, recommends the jam Chyawanprash to help with weight gain. No references to specific caloric levels can be found in modern Ayurvedic treatment plans for AN, an indication that the health of the digestion and pacification of vata are to be given more attention than the caloric level. While the goal of treatment is the same (weight gain), Ayurveda seems to prioritize healthy digestion above the speed with which weight is put on.

   Following principles of Ayurveda, more important than even the choice of foods that the anoretic is eating would be the way in which they are prepared and the way in which she is eating them. In the context of AN, these food habits become even more critical to counteract the anxiety that peaks with mealtimes. According to the Charaka Samhita, “food should be taken mindfully…food should not be taken when afflicted with grief, anxiety, confusion, fear, anger, passion or greed…Food should be taken under conducive and pleasant environment. The individual should be relaxed and happy.”  Ayurvedic treatment would extend off the plate and into the very room in which meals are being held, encouraging the use of all five senses to make eating a more pleasant experience. Aromatherapy may be administered before a meal, to stimulate digestion, during a meal to calm anxiety, and after a meal to promote relaxation in the mind and reduce digestive upset. Ginger, Mandarin, and Lavender, respectively, are all indicated. Color therapy on the walls of the dining-room or as a light source can also be recruited to aid the healing process. Sattvic colors like gold, green, and blue are all indicated. In addition to these recommendations, “food should be taken when hunger is felt and not delayed or taken in a hurry or very slow.”  While hunger cues are guaranteed to be distrusted at the beginning, meals can certainly not be taken in a hurry or very slowly. This seems particularly applicable to anoretics who will want to rush mealtimes to get them over with or draw them out to avoid eating. Taking an appropriate amount of time encourages mindfulness and connection of the mind to the body. 

   In addition to maintaining a body weight that is less than 85% of the ideal, a patient must display an “intense fear of gaining weight or becoming fat…and a disturbance in the way one’s body weight or shape are experienced, undue influence of body weight or shape on self evaluation, or denial of the seriousness of the current low body weight.”  This symptom moves the disease from the physical body into the deeper layers of the mental and emotional bodies, what would be considered the manomaya kosha and vijnanamaya kosha in Ayurveda. Western treatment for this fear, anxiety, and misperception incorporates psychotherapy and, to a lesser extent, medications. The use of medications is solely focused on symptomatic relief of psychological symptoms, such as anxiety, and not on the root cause of the disease. As reported by the Mayo Clinic, “there are no medications specifically designed to treat anorexia because they haven’t been found to work very well. However, antidepressants or other psychiatric medications can help treat other mental disorders you may also have, such as depression or anxiety.”  The most common medications used to treat mental symptoms stemming from AN are anti-depressants, specifically Selective Serotonin Reuptake Inhibitors and anti-anxiety medications, like benzodiazepines. Research shows that the time of administration significantly alters the effectiveness of SSRI’s. Fluoxetine (Prozac), an SSRI, for example, has been shown to prevent relapse in anoretics, but only when given after weight restoration.  Benzodiazepines, on the other hand, are best administered “when therapeutic efforts are made to counteract the pursuit of thinness and ritualistic behaviours [sic] around eating,”  it was reported in a study published in The Journal of Psychiatry and Neuroscience. Further, from the same study, “despite their merits in the acute treatment of anorexia nervosa, benzodiazepines are used sparingly in clinical settings. This may be because psychotherapy, accompanied by nutritional and behavioural approaches to healthy eating and weight gain, is considered the most promising treatment.” We can conclude, therefore, that while appropriately administered drugs can be helpful in reducing relapse, the initial healing is not accomplished through pharmaceuticals. Nutritional and behavioral approaches are administered in the form of therapy, both personal and group, and through nutrition therapy and education. As far as therapeutic approaches go, cognitive behavioral therapy has been found to be most effective, generally, and even more effective than nutrition counseling. A 2003 study published in The American Journal of Psychiatry found that “cognitive behavior therapy was significantly more effective than nutritional counseling in improving outcome and preventing relapse.”  This can be attributed to the fact that it is not lack of knowledge about nutrition that is causing the anoretic to starve (on the contrary, eating disorder patients frequently display an encyclopedic knowledge of caloric contents and dietary facts), but the mental disturbances caused by the disease. 

   Fear and anxiety like the kind displayed by anoretics would, from an Ayurvedic perspective, fall squarely under the category of vata vitiation. Specifically, prana, vyana, and samana vayu would all be vitiated in the manovaha srota. To treat this vitiation in the mind, Ayurveda provides a great variety of body therapies, lifestyle practices and herbs. As cited earlier in the Astanga Hrdayam, both external and internal oleation are strongly indicated to pacify vata in the body, as well as in the mind. In his text, Ayurvedic Healing, Dr. David Frawley recommends sesame oil massage for anorexia, with emphasis on the head and feet of the patient, as well as the administration of sandalwood oil to the head.  Even though he is referring to anorexia meaning loss of appetite, the remedies are applicable, as they are designed to pacify vata. This external oleation will pacify vyana vayu as well as slow the rate of absorption of prana vayu, decreasing the speed at which thought flows through the mind and thus calming anxiety. In addition to this therapy, shirodhara, known for its effectiveness in reducing anxiety, insomnia, and nervousness would be of huge benefit to the anoretic, too. This external oleation would be best complemented by internal oleation as well, however, this brings up some of the complexities that are inherent in this most complicated disease. Firstly, agni in the advanced stage will be low, perhaps too low to digest oils without creating ama (as explored previously in this paper). Secondly, the anoretic is almost guaranteed to strongly resist taking in pure oil, which she sees as pure fat, to the point that it creates more anxiety than it is worth. Anuvasana basti, as previously recommended in the Astanga Hrdayama, would be an excellent way to apply oil internally in order to pacify vata at its root, the colon. And because it would not need to be ingested through the mouth, this internal oil application might be easier for the anoretic to swallow, as well as being of excellent benefit. Additionally, lifestyle practices that would be recommended include yoga, meditation, and time in nature. Yoga is of particular importance for several reasons. As Patricia Walden, yoga teacher, writes in the book The Woman’s Book of Yoga and Health, “besides offering emotional and spiritual support, yoga provides physiological help to reverse or minimize the long-lasting effects of starving.”  Physically, yoga postures can balance the endocrine system and blood pressure, calm the adrenal glands, and even jumpstart menstruation.  Almost more importantly, though, yoga can arrest the sympathetic nervous system response, a fight-or-flight mechanism that will frequently kick in for an anoretic during and right after mealtimes, when anxiety is highest. Gentle, slow, flowing sequences that are designed to pacify vata by including lots of poses that encourage compression of the solar plexus will have the additional benefit of providing a new habit that, hopefully, in time, will replace the old starvation patterns. A 2010 study completed by the Department of Adolescent Medicine at Seattle Children’s Hospital shows very promising results; the authors of the study concluded that individualized yoga sessions decreased Eating Disorder Examination scores after 12 weeks of practice and also significantly reduced food preoccupation immediately after the practice.  Finally, herbal remedies are available to treat anxiety; nervine sedatives will calm vata in the mind, while nervine tonics will build the strength of the nervous system. Dr. A. A. Mundewadi recommends “Jatamansi, Shankpushpi, Vacha, Kushmand, Brahmi, and Sarpagandgha [to treat the psychological component of anorexia nervosa].”  

   The final symptom that will be examined in this paper is amenorrhea. This criteria was recently removed from the DSM-V, the most recent version of the APA’s manual, but because of the large number of anoretics who experience amenorrhea and because of the seriousness of such a symptom, I have chosen to include it in this report. Amenorrhea is defined by the Mayo Clinic as “the absence of menstruation – one or more missed menstrual periods. Women who have missed at least three menstrual periods in a row have amenorrhea.”  “From a traditional Western medical perspective, the loss of menses due to AN is viewed as a result of low hormone levels, specifically a lack of luteinizing hormone and follicular-stimulating hormone precipitated by inadequate body fat or low weight which causes corticotropin-releasing hormone to be suppressed.  But, recent studies, like the one from the Department of Pediatrics at the Schneider Children’s Hospital at the Long Island Jewish Medical Center are finding that “resumption of menses require[s] restoration of hypothalamic-pituitary-ovarian function, which [does] not depend on the amount of body fat.”  And a 2006 study by the University Tor Vergata in Rome, Italy, found that “an adequate body composition and a well represented fat mass are certainly a necessary but not sufficient condition for the return of the menstrual cycle.”  Very few studies have been conducted around treating the hypothalamic disturbance that seems to be at the root of the persistent amenorrhea. A 1976 study entitled “Amenorrhea in Anorexia Nervosa: Assessment and Treatment with Clomiphene Citrate” concludes that in patients who were still amenorrhoeic following the finding of normal LH levels, “that they have a persistent hypothalamic disorder whereby the normal midcycle peak of LH secretion does not occur. A hypothalamic disturbance has long been postulated as the cause of pituitary hypofunction in anorexia nervosa, but definite evidence has been lacking.”  Due to this lack of research, Western medical treatment focuses on hormone replacement as the answer to amenorrhea, if menses has not resumed following adequate weight gain. It is recommended that patients who present with amenorrhea be placed on oral contraceptives for the health of their bones, which are already under duress from malnutrition. Osteoporosis is one of the major health concerns facing anoretics because bone density loss is believed to be irreversible and amenorrhea is seen as a major causative factor in osteoporosis. Thus it is of primary importance to replace the hormones artificially to protect the health of the bones. The common treatment plan is to keep the patient on oral contraceptives until weight is restored and then observe if menses returns. If it does not, then the patient would be placed back on oral contraceptives. As the lack of research in this area shows, the priority for AN patients is to get hormones back into the body as quickly as possible to protect the stability of the bones; amenorrhea is really only viewed as an issue if the woman wants to get pregnant, at which time they will provide medications to stimulate ovulation. 

   Following in line with all the other symptoms before it, from an Ayurvedic perspective, secondary amenorrhea of this sort is considered a vitiation of vata in the rasa and shukra dhatus of the artavavaha srota. The shukra dhatu is the deepest dhatu of the body, so nutrition must be digested first by all six other dhatus before it can reach and nourish the shukra dhatu. Thus the treatment of amenorrhea begins with the treatment of dhatu agnis and regulation of the digestive system of a patient. Ayurveda understands that even if adequate nutrition is being taken in, the tissue being produced could be of low quality if there is disturbance in the dhatu agnis. The Cakradatta suggests a “suppository made of iksvaku (seeds), danti, pippali, jaggery, madana, yeast, madhuyasti and snuhi latex and kept in vagina” to induce menstruation.   If not this, then another alternative remedy is suggested, “Japa flower mixed with sour gruel or jyotismati leaves, both fried, and rice-cake of durva – woman taking any of these gains menstruation.”  As Dr. Frawley notes for treatment of amenorrhea, “an anti-vata or tonifying diet is primarily indicated using dairy, nuts, oils, whole grains and other nourishing foods.”  This is right in line with the diet discussed previously to restore the weight of the anoretic. Dipana herbs to regulate any digestive disturbances would also be indicated here. Herbs may also be used to promote menstruation, if necessary. Reproductive tonics like Shatavari, Ashwagandha, Vidari Kand, and Wild Yam are all indicated. Chyawanprash, as mentioned before, would be an excellent herbal supplement for amenorrhea. Ayurveda also recognizes the role that stress plays in amenorrhea. “Excessive motion such as a fast-paced lifestyle filled with travel, stress and overwhelm is a key contributing factor [to amenorrhea],” as is excessive exercise.  Other vata-pacifying therapies like abhyangha, shirodhara, and appropriate yoga (as previously discussed) would also come into play as treatments for stress-related amenorrhea. Restorative yoga as well as Yoga Nidra would be the preferred types of yoga. Even sleeping during the day should be considered as a remedy, as suggested in the Cakradatta, “sleeping during the day is recommended in the following conditions – those who are exhausted by exercise…patients suffering from diarrhea [sic], abdominal pain, dyspnea, thirst, hiccough, and vatika disorders; those who are emaciated…”  The other aspect of amenorrhea that cannot be denied is in the mind of the patient. If the eating disorder serves the function of keeping maturation and adulthood at bay, then the patient will actually desire to lose her menses. This must be dealt with on a psychological and spiritual level through therapy and self-study.

   In summary, I believe that neither Western nor Ayurvedic remedies provide the entire answer to this mysterious and dangerous illness. Rather, it seems that a treatment plan which encompasses the best of Western science along with the holistic, individualized healing therapies of Ayurveda would provide the most well-rounded and complete approach with the best possible chances of achieving recovery. Due to the severity of advanced cases of anorexia, it would be irresponsible to depend purely on Ayurveda as a healing modality; there is much more evidenced-based research around a Western refeeding model to support its use in providing nutrition to malnourished individuals safely. But for healing not just the body, but also the mind and the spirit, Ayurveda can absolutely supplement Western prescriptions. Since medications have been found so ineffective in treating AN, perhaps both providers and patients will feel more open to alternatives like herbal treatments and body therapies. And as the trend towards more conscious eating keep moving forward, one can only hope that eating disorder programs will pay more attention to not just how much, but what they are feeding their patients. Ayurveda, I believe, can be especially helpful in the treatment of amenorrhea, since the condition seems to still baffle Western medicine and appears to have so much to do with lifestyle and stress reduction. Imagine a hospital program that offered regular yoga instruction, had a meditation space, offered abhyanga and shirodhara, and encouraged reverence, rather than rigidity, around mealtimes: such a place would encourage not only the healing of bodily tissues, but the mending of the very soul itself, which can be just as starved for attention as the body it inhabits. Ms. Naimi has already seen a trend towards bringing in spiritual practices in smaller, private residential treatment centers and in private practices, so maybe the larger inpatient centers will follow suit. This would require a rethinking of the anoretic as an individual with a disease, rather than as a disease that has taken over an individual. And that can only result in deeper levels of healing and understanding of this still elusive and devastating disorder.

Body Matters Australasia, Body Matters Staff, DSM-V Proposed Diagnostic Criteria For Eating Disorders. http://bodymatters.com.au/wp-content/uploads/2010/11/DSM-VproposalsED.pdf
Kirkpatrick, Jim and Paul Caldwell, Eating Disorders: Everything You Need to Know (Buffalo: Firefly Press, 2004) 17. 
National Associate of Anorexia Nervosa and Associated Disorders, ANAD Staff, Eating Disorders Statistics. http://www.anad.org/get-information/about-eating-disorders/eating-disorders-statistics/
Brumberg, Joan Jacobs, Fasting Girls: The History of Anorexia Nervosa (New York: Vintage Books, 2000), 43. 
Kirkpatrick, Jim and Paul Caldwell, Eating Disorders: Everything You Need to Know (Buffalo: Firefly Press, 2004), 26.
Halpern, Dr. Marc, Principles of Ayurvedic Medicine (California College of Ayurveda, 2010), 13.
Lawson, Carol, “Anorexia: It’s Not a New Disease,” The New York Times (December 1985). http://www.nytimes.com/1985/12/08/style/anorexia-it-s-not-a-new-disease.html
Halpern, Dr. Marc, Clinical Ayurvedic Medicine (California College of Ayurveda, 2012), 2-19. 
Sharma, P.V. Cakradatta: A Treatise on Principles and Practices of Ayurvedic Medicine (Varanasi: Chaukhambha, 2002) page 153, Chapter XIV, Verse 1
Costin, Carolyn, The Eating Disorder Sourcebook (Los Angeles: Lowell House, 1999), 6. 
Mayo Clinic, Mayo Clinic Staff, Anorexia Nervosa: Risk Factors. http://www.mayoclinic.com/health/anorexia/DS00606/DSECTION=risk-factors
National Association of Anorexia Nervosa and Associated Disorders, ANAD Staff, Eating Disorder Statistics. http://www.anad.org/get-information/about-eating-disorders/eating-disorders-statistics/.
Kirkpatrick, Jim and Paul Caldwell, Eating Disorders: Everything You Need to Know (Buffalo: Firefly Press, 2004), 31-34. 
Kirkpatrick, Jim and Paul Caldwell, Eating Disorders: Everything You Need to Know (Buffalo: Firefly Press, 2004), 25.
Garber AK, Mauldin K, Michihata N, Buckelew SM, Shafer MA, Mosicicki AB. Higher Calorie Diets Increase Rate of Weight Gain and Shorten Hospital Stay in Hospitalized Adolescents With Anorexia Nervosa. J Adolesc Health 2013 Sep 17; PubMed PMID: 24054812. http://www.ncbi.nlm.nih.gov/pubmed/24054812.
Mehanna Hisham M, Jamil Moledina, Jane Travis. Refeeding Syndrome: what it is, and how to prevent and treat it. BMJ 2008 June 28. 336(7659): 1495-1498. PMC2440847.  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440847/
Garber AK, Mauldin K, Michihata N, Buckelew SM, Shafer MA, Mosicicki AB. Higher Calorie Diets Increase Rate of Weight Gain and Shorten Hospital Stay in Hospitalized Adolescents With Anorexia Nervosa. J Adolesc Health 2013 Sep 17; PubMed PMID: 24054812. http://www.ncbi.nlm.nih.gov/pubmed/24054812.
Rabin, Roni Caryn. “Protocol to Treat Anorexia Is Faulted.” The New York Times (January 2, 2012) http://www.nytimes.com/2012/01/03/health/research/anorexic-patients-can-be-fed-more-aggressively-study-says.html
Rabin, Roni Caryn. “Protocol to Treat Anorexia Is Faulted.” The New York Times (January 2, 2012) http://www.nytimes.com/2012/01/03/health/research/anorexic-patients-can-be-fed-more-aggressively-study-says.html
Curran, Hannah. Hypermetabolism during refeeding in patients with anorexia nervosa. Undergraduate Awards Competition. 2012. http://www.scribd.com/doc/104433299/Hypermetabolism-during-refeeding-in-patients-with-anorexia-nervosa
Rabin, Roni Caryn. “Protocol to Treat Anorexia Is Faulted.” The New York Times (January 2, 2012) http://www.nytimes.com/2012/01/03/health/research/anorexic-patients-can-be-fed-more-aggressively-study-says.html
Eating Recovery Center, Eating Recovery Center Staff, “A Day in the Life of An Eating Disorder Treatment Patient.” http://www.eatingrecoverycenter.com/patient-eating-disorder-treatment/a-day-in-the-life/
Murthy, Prof. K. R. Srikantha, Vagbhatta’s Astanga Hrdayama: Volume 1: Sutra, Sthana, and Sarira Sthana (Varanasi: Krishnadas Academy, 1991), 124, Chapter 8, Verse 3-3.5. 
Murthy, Prof K.R. Srikantha. Vagbhatta’s Astanga Hrdayama: Volume I: Sutra, Sthana, and Sarira Sthana (Varanasi: Krishnadas Academy, 1991), 183, Chapter 13, Verse 1-3.  
Halpern, Dr. Marc. Clinical Ayurvedic Medicine (California College of Ayurveda, 2012), 2-19. 
Sharma, Cakradatta: A Treatise on Principles and Practices of Ayurvedic Medicine (Varanasi: Chaukhambha, 2002), 91. 
Halpern, Dr. Marc. Clinical Ayurvedic Medicine (California College of Ayurveda, 2012), 2-19.
Mundewadi, A. Anorexia Nervosa - Ayurvedic Herbal Treatment (2009, February 12).  http://ezinearticles.com/?Anorexia-¬Nervosa-¬-¬-¬Ayurvedic-¬Herbal-¬Treatment&id=1986631
Mundewadi, A. Anorexia Nervosa - Ayurvedic Herbal Treatment (2009, February 12).  http://ezinearticles.com/?Anorexia-¬Nervosa-¬-¬-¬Ayurvedic-¬Herbal-¬Treatment&id=1986631
Arunachalan, Srikantha. Treatise On Ayurveda (New Delhi: The Book Factory, 2005), 59-60, referencing The Charaka Samhita, Vimana Sthana 1 & 2 and Chikitsa Sthana 15. 
Arunachalan, Srikantha. Treatise On Ayurveda (New Delhi: The Book Factory, 2005), 60, referencing The Charaka Samhita, Vimana Sthana 1 & 2 and Chikitsa Sthana 15.
Mayo Clinic, Mayo Clinic Staff, Anorexia Nervosa: Treatments and Drugs. http://www.mayoclinic.com/health/anorexia/DS00606/DSECTION=treatments-and-drugs
Costin, Carolyn, The Eating Disorder Sourcebook (Los Angeles: Lowell House, 1999), 222.
Kruger, S and SH Kennedy, “Psychopharmacotherapy of anorexia nervosa, bulimia nervosa, and binge-eating disorder,” The Journal of Psychiatry and Neuroscience (November 2000) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1408011/?page=3
Pike, Kathleen et al. “Cognitive Behavior Therapy in Posthospitilization Treatment of Anorexia Nervosa,” The American Journal of Psychiatry  (November 2003) http://ajp.psychiatryonline.org/article.aspx?articleID=176504
Frawley, Dr. David, Ayurvedic Healing: A Comprehensive Guide (Twin Lakes: Lotus Press, 2000), 170. 
Sparrowe, Linda and Patricia Walden, The Woman’s Book of Yoga & Health (Boston: Shambhala Publications, 2002), 65
Sparrowe, Linda and Patricia Walden, The Woman’s Book of Yoga & Health (Boston: Shambhala Publications, 2002), 65
Carei TR, Fyfe-Johnson AL, Breuner CC, Brown MA. Randomized controlled clinical trial of yoga in the treatment of eating disorders. J Adolesc Health. 2010 Apr;46(4):346-51. PubMed [indexed for Medline] PMID: 20307823. http://www.ncbi.nlm.nih.gov/pubmed/20307823
Mundewadi, A. Anorexia Nervosa - Ayurvedic Herbal Treatment (2009, February 12).  http://ezinearticles.com/?Anorexia-¬Nervosa-¬-¬-¬Ayurvedic-¬Herbal-¬Treatment&id=1986631
Mayo Clinic, Mayo Clinic Staff, Amenorrhea: Definition. http://www.mayoclinic.com/health/amenorrhea/DS00581
University of Washington, University of Washington staff, What is the mechanism of amenorrhea in anorexia nervosa? http://depts.washington.edu/osteoed/faqs.php?faqID=93
Golden NH, Jacobson MS, Schebendach J, Solanto MV, Hertz SM, Shenker IR. Resumption of menses in anorexia nervosa. Arch Pediatr Adolesc Med 1997 Jan;151(1):16-21. PubMed [indexed for Medline] PMID: 9006523 http://www.ncbi.nlm.nih.gov/pubmed/9006523
Jacoangeli F, Masala S, Staar Mezzasalma F, Fiori R, Martinetti A, Ficoneri C, Novi B, Pierangeli S, Marchetti G, Simonetti G, Bollea MR. Amenorrhea after weight recover in anorexia nervosa: role of body composition and endocrine abnormalities. Eat Weight Disord. 2006 Mar;11(1):e20-6. PubMed [indexed for Medline] PMID: 16801735. http://www.ncbi.nlm.nih.gov/pubmed/16801735
Marshall J.C., Fraser T. Russell. Amenorrhea in Anorexia Nervosa: Assessment and Treatment with Clomiphene Citrate. Br Med J. 1971 December 4; 4(5787): 590-592. PubMed PMCID: PMC1799887. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1799887/
Sharma, P.V. Cakradatta: A Treatise on Principles and Practices of Ayurvedic Medicine (Varanasi: Chaukhambha, 2002), 531, Chapter LXII, Verse 24
Sharma, P.V. Cakradatta: A Treatise on Principles and Practices of Ayurvedic Medicine (Varanasi: Chaukhambha, 2002), 531, Chapter LXII, Verse 25
Frawley, Dr. David. Ayurvedic Healing (Twin Lakes: Lotus Press, 2000), 248. 
Halpern, Dr. Marc. Clinical Ayurvedic Medicine (California College of Ayurveda, 2012), 5-101. 
Sharma, Cakradatta: A Treatise on Principles and Practices of Ayurvedic Medicine (Varanasi: Chaukhambha, 2002), 99, Chapter VI, Verse 78. 
 
 
 
 
 

 

The Use of Sound in Healing—An Ayurvedic and Western Perspective By Parthena Rodriguez

Abstract 

It has long been noted that particular sounds have a direct effect on the body’s ability to heal from various disharmonious states or dis-ease.  From imbalances associated with anxiety to nerve disorders and cancer, recent advances in western medicine show how sound affects us on the cellular level and can have broad, physiological healing results.  Modalities shown to have beneficial effects include listening to music, toning, humming, chanting and giving one’s attention to the sounds of various instruments.

This paper compares recent advances in western medicine’s ability to analyze what the ancient rishis knew long ago:  that we are part of a common vibratory experience which begins with what has been known as The Word (Om) and that unhealthy or negative patterns in the body could be eliminated and health restored or helped by repeating mantra, listening to music or patterned sound, and/or becoming attuned to various rhythms or harmonies, external as well as internal.  Though this knowledge is inherent and was passed down through the millennia, recent examples of specific healing effects from sound therapies are studied and documented by scientists, doctors, physicists, musicians, and modern day yogis. 

As western attitudes broaden, eastern teachings are being integrated and are seen as complementary, leading to a convergence of the ancient and the modern methods of healing, mind, and spirit.

The Use of Sound in Healing—An Ayurvedic and Western Perspective By Parthena Rodriguez

“In the beginning was the Word and the Word was with God,” is stated in St. John’s Gospel. Johannes Kepler, the great German mathematician and astrologer writes in his Music of the Spheres,   “The earth hums a tune,” and the ancient rishis uttered secret syllables before administering life saving treatments and medicine.    Edgar Cayce, the great modern day mystic called sound ‘The Medicine of the Future’ and the benefits of ultrasound in modern medicine are duly noted for a number of things, including the use in healing muscles that are affected by pain.  

Actually, the word heal, in old English, means “to return to a sound state”’   

to “make whole, sound and well. “ 

The Sanskrit word svanah, meaning sound or tone, generally refers to a type of synchronization.   

There is no doubt that human beings along with all sentient beings are a part of  a vibratory experience which began with creation, ever permeating prakruti and that sound, being  of that experience,  plays a vital role in our emotional, physical, mental,  and spiritual existence and  well being.   Assuming that the reader understands that sounds or vibratory patterns have an effect, this paper will delve into some of the physics of what sound is, cite examples of Western studies and Ayurvedic views as related to sound used in healing, and explore the Om sound and its vibratory significance on humankind’s fit in this universe.

Sound   

All sounds are waves and are produced by the vibrations of material objects.      These vibrations are transmitted through air or other mediums such as solid, liquid, gas or plasma.   When vibrations reach the ear they are converted to electrical impulses in the brain, which we interpret as sound.  However, lower frequency vibrations can also be felt by the body.   Sound also has a speed at which it travels and is dependent on subtle atmospheric changes like temperature and humidity.    

Because sound travels in waves, it can move over very large distances.   However, the linear concept of how sound travels can go quite beyond that sounds are simply waves.   Paul in his book, The Yoga of Sound states that “sound is infused with intelligence—an organizing principle that shapes the forms we perceive [even] through our eyes. “    That organizing principle has been shown to affect everything down to our DNA, permeating every cell within our bodies.  In other words, sound effects form, as it was proposed that sound came first, before form.  This connection of sound to form was summed up when Plato said that ‘a stone is frozen music’.   

It is interesting to note that sound waves bend and take little energy to produce.  The conceptual physicist Paul Hewitt states that “10,000,000 people talking at the same time would produce sound energy equal only to the energy of an ordinary incandescent lamp. “  Yet our sense of hearing is subtle and we are only able to hear because of our ears’ remarkable sensitivity.     Medical science has even proven that our ears are “the first organ to develop in the fetus and the last organ to stop function during the process of death.”     

Sound has loudness which depends on the amplitude of the wave.   We gauge loudness in decibels which measure common noise levels found in our environment and are registered by the human ear beginning at about 10 decibels with painful sounds beginning at about 125 db.  The frequency of sound is measured in Hz, or cycles per second.  Humans can hear from around 20 Hz to 20,000 Hz.     However, it has also been suggested that “music or audible sounds could modulate physiological and pathophysiological processes” and that “cell types other than auditory hair cells could respond to audible sound [as] vibrotactile sensations… in the chest and throat.”  

Sounds, simply, have waves, patterns, and frequencies; yet, affect us in ways that are both subtle and remarkable.

Pitch and quality are also ways to describe frequency and sound characteristics.  For example, low pitch notes have a lower frequency of vibration than high notes--the higher the pitch, the faster the vibration and the lower the pitch, the slower.   A musically pure note is one frequency, though most sounds that we experience have many different frequencies combined. 

Resonance is an important factor when examining sound and its quality because “when the frequency of forced vibrations on a body matches the body’s natural frequency, a dramatic increase in amplitude occurs.”    This brings in the idea of a principle called prime resonance.  This means that our organs and systems have their own innate frequencies.  These frequencies determine how the cells and systems absorb sound or to what extent they can be re-harmonized by various outside healing frequencies.  And we know that our cells, organs, and systems are susceptible to a variety of environmental and emotional traumas which can de-harmonize them and vice versa.  For example, long term exposure to noise can contribute to the dis-harmony of the cells and systems in our bodies.    Studies conclude that each organ as well as each cell vibrates its own frequency since cells emit sounds as a part of their metabolic processes as they interact with the frequencies in their environment.    

Rhythm

We know that before birth, the fetus is not only encompassed in the mother’s rhythms, but is also able to hear noises outside of the womb as early as four months.      Caraka notes that around the third or fourth months, the fetus begins to manifest consciousness.  This is when ether or akasha, the most subtle of the five elements, becomes evident.  Ether, according to Ayurveda, is responsible or associated with the sound of hearing.   And from birth on, we are surrounded by rhythms and sounds that make up the vibratory experience of pattern all around us.  These rhythms are noted in our immediate environment—in the seasons and in the passing of different times of day, the cycles of the moon and our patterned breathing.  Even the rhythmic beats of our hearts are mirrored in great poetry and in Shakespearean plays in the form of iambic pentameter.      This makes us an obvious reflection of these patterned rhythmic experiences of which even our “Milky Way Galaxy turns like a Ferris wheel” every 10 million years.    Nothing in the universe escapes movement and rhythmic patterns.   So sound has to be a part of a rhythmic structure that affects the cadence of our experience.  The more we are in tune with waves of varying worth may determine the quality of our bodily existence in the greater scheme of life’s rhythms.  

Western studies and stories on the effects of sound on healing

Not surprisingly, there have been numerous studies on the effects of sound on health.

In Masaru Emoto’s book on water crystal healing, he is able to show how organized sound in the form of music affects the formation of patterns in water crystals which are frozen in Petri dishes under a light microscope.  Through photographs, he demonstrates how water takes on expressions of sound.   He also likens our body’s systems to a symphony that is healthy when it is harmoniously vibrating.  As with all energy, sound moves in waves outwards, though they may affect patterns beyond ‘normal’ perception. 

Emoto reveals how one vibration influences another as in prime resonance.  First, he shows that diseases have a measurable wave or vibration.  That vibration is something termed hado and is measured using a device called a Magnetic Resonance Analyzer.  The MRA measures the characteristic of the wave produced by the vibration inherent in the diseased organ.    He then shows how music formulates patterned crystals when exposed to various classical musical pieces.  Dr. Emoto claims that upon drinking the water that was exposed to healing music prescriptive to that patient and his disease that healing and balancing is able to take effect, correcting the energy disturbance.    

From analysis of each piece of music’s hado, he is able to suggest that by listening to various melodic pieces, one can be relieved from a variety of imbalances which include irritability, suppression of emotions, relationship problems, stuck thought patterns, self- pity, hopelessness, deep sorrow, stubbornness, and depression. 

In The Mozart Effect, Campbell, a classically trained musician, begins by telling how he healed himself from a potentially deadly blood clot in the brain through internal visualization and by humming a sound which he felt helped his cells resonate a healthy pattern throughout his system.  

In humming a tone, I sensed the power of a sound that had warmth, brightness, and clarity.  I envisioned the sound as a vibrating hand coming into my skull on the right side, simply holding the energy within.  I imagined a vowel sound coming into my left hand, traveling through my heart and body, up to my right hand, and then back into my head, heart, and down through my feet.  Each tone made a circuit through my body.   

Undergoing a series of medical tests three weeks later, the results showed that the clot had decreased from more than an inch to less than an eighth of an inch, astounding the doctor who pronounced him out of mortal danger.   

Most people would agree that ‘music masks unpleasant sounds and feelings’, but music, patterned sound, is also demonstrated to slow down and equalize brain waves.    Campbell reminds us that varying states of consciousness are associated with different types of waves such as beta, delta, and theta and it has been proven that the slower the brain waves, the more relaxed and peaceful we feel.

Respiration, heartbeat, pulse rate, as well as blood pressure have all been proven to be affected by various types of music.   Campbell cites a study by researchers at Temple University who found that when our heart rates are increased, our resistance to disease is decreased.  They also found that rock music increased the heart rate more than other types of music and that some forms of rock music were responsible for reducing skin resistance to stimuli.   

Campbell, inspired by his own healing with the help of sound, was able to show how attributes of various types of music resulted in specifically desired effects.  As with prime resonance, how the listener responded to various patterned sound or music was important, so the healing effects varied “according to the composition, the performer, the listener, the posture assumed in listening, and other factors.”      

It is interesting to note how various musical genres have a range of effects on most listeners, again this is due to individual perception and experience.   For example, chants were noted to create a sense of relaxed spaciousness, classical music with improved concentration and memory, jazz can elicit feelings that inspire and uplift, and salsa may simultaneously soothe and awaken the senses.  Even heavy metal, “with its dynamic and disturbing consequence of exciting the nervous system, can help modern day adolescents release their inner rage and turmoil.”   

In Empower for Your Health magazine, Dr. Mark Harrell, an endocrinologist, after explaining how our biology demands rhythm, discusses how music therapy can help stroke victims and patients with Parkinson’s disease.  

Scientists believe that music triggers undamaged networks of nerve cells that allow translation of the beat into organized body movement.  Dr. Concetta Tomaino, co-founder of the New York City Institute for Music and Neurologic Function, notes that ‘someone who is frozen (from Parkinson’s or stroke) can immediately release and begin walking.  They can co-ordinate their steps to synchronize with the music.’ 

Music affects health as it influences digestion, endurance, productivity, and feelings of romance.   Used along with other healing modalities, mainstream or otherwise, certain types of music are seen as helpful and prescriptive sources.  

In one single-blind controlled scientific study, patients who had experienced cerebral artery strokes were shown as benefiting simply from listening to music for two months. 

Fifty-four patients completed the study.  Results showed that recovery in the domains of verbal memory and focused attention improved significantly more in the music group than in the language and control groups. The music group also experienced less depressed and confused moods than the control group. 

Those findings also demonstrate “that music listening during the early post-stroke stage can enhance cognitive recovery and prevent negative mood.”  

Using just sound waves themselves have been shown to have an effect on the human body.  An example is proven in yet another single-blind study done in Finland several years ago involving forty-nine volunteers in two senior citizen centers.  The effect of low-frequency sound wave therapy was shown to have a positive effect on blood pressure, mobility, as well as bone density on frail elderly subjects.   

In one researcher’s postlude, there are numerous examples given of people who have helped to heal or soothe themselves from varying degrees of dis-harmony.   For example humming helped minor abrasions, listening to Mozart helped to relieve acute pain, enjoying grounding music with strong beats helped folks with anxiety, and the harp helped to relieve back pain.  Music may be one of the keys to “transcending the pains of the moment…from Zen monasteries to intensive care units, accounts abound of [those] who experienced the remission of a disease or disorder as the result of some sound or melody.”     

Toning and humming

The book Toning: The Creative Power of the Voice, Laurel Elizabeth Keys articulates stories about people who were healed with toning or relaxing into their voices.  “Toning can release psychological stress before surgery, lower the blood pressure and respiratory rate of cardiac patients, and reduce tension in those undergoing MRIs and CAT scans.”   Sounds seem to trigger endorphin release, thus masking pain which may help the body to heal more effectively.    

In Campbell’s book he, as a listening therapist, was able to detect through a patient’s voice, long dormant emotions.  A forty-seven year old woman had a cyst on the right side of her right breast and Campbell heard a break in her voice when he stood on her right side.  After she was able to express a long held repressed memory, she was then able to release the memory through humming.    The woman’s cyst had completely disappeared within three months.   

Campbell also noted that humming was more helpful than singing in helping schizophrenia patients positively modify their behavior. 

Some people, with guidance, are able to find their own sound or resonance in order to help release unresolved emotions and pain.  

There is also evidence that toning and humming helped to alleviate various ailments including headaches and menopausal hot flashes.  

In essence, every person is seen to have a tune, a song, a hum, a string of syllables or rhythmic sounds that “resonates with his or her essence” creating “harmonious thoughts and feelings.”    

Jack Kornfield in his book, A Path with Heart, reminds us of the story of Siddhartha, finding his song as he sits alone by the river, taking everything in as Himself.  During deep contemplation is where “we [can] experience more deeply both the beauty and the sorrow of life [listening] deeply, the great song moves through each of our lives.”    

Tibetan singing bowls

Dr. Mitchell L. Gaynor in his book Sounds of Healing discusses his discovery of Tibetan singing bowls in helping cancer patients.  As a scientist, he communicates the importance of vibrational healing through sound and how “we can order our molecular structure though sound and heal physical and emotional imbalances.”    He gives one example of a woman with a tumor in her thymus gland and how singing bowls helped her to relax and reflect upon internal stresses that were the cause of the blockages in her body.   By listening to “the vibration of the crystal bowl and visualizing the shape of her fears” she was able to see where the fear was stuck in her physical body, in this case, the throat.    He points out that her story is not unique as most people are in so much of a rush that they don’t stop to consider what is important or missing in life, getting ‘out of tune’ with the world around them.  This dis-harmony is usually reflected in disease or imbalance.  Getting ‘back in tune’ helps us to release tensions that we are many times not even aware of.  

Entrainment

How sound can affect us can be explained by what is termed as entrainment.  Entrainment is defined as the process by which the powerful rhythmic vibrations of one object with a similar frequency causes an object to vibrate in resonance with the first object.     We are not, of course, referring to our bodies as inanimate objects since human beings possess amazing complexity that complements their ability to harmonize and to adapt to the environment.   Entrainment is based in rhythm and when a vibration is perceived through the auditory senses, then the combined synergy creates profound synchronicity.   

It has been studied then postulated that everything rhythmical is subject to entrainment, and that even people’s bodies respond to the talk of another.  Dr. William S. Condon from the Boston University School of Medicine closely observed the body language of people as they listened to another person speak.    “Listeners were observed to move in precise shared synchrony with a speaker’s speech.”    He also noted that there was “no discernible lag even at 1/48 of a second.”  An analysis of this data shows the power of entrainment works whether or not we are conscious of it.    

The idea that “the human organism is not only constructed according to harmonic principles, but also functions within them” is suggested by physiologist Gunther Hildebrandt.    He helps us to understand the notion of entrainment since everything vibrates in a certain resonance with what is around it and that we are deeply entrenched in a great synchronized scheme.  

Ayurvedic examples on effects of sound.

The Rishis

Ayurveda, or the knowledge of the ancient rishis, is deeply rooted in the idea of entrainment and of the greater vibratory experience for which we are all striving.   The rishis were also attuned to the primordial sounds and understood that everything was held together by things that we could not see.   Deepak Chopra explains that “Ayurveda tells us to apply a specifically chosen primordial sound like a mold or template slipped over the disturbed cells pushing them back into line, not physically, but by repairing the sequence of sound at the heart of every cell.”  

In the Vedas, sound was understood to have a healing effect on its listener and, not surprisingly, various instruments were used to enable particular vibrations of sounds to prevent increases in particular doshas.

On Healing Sounds of Ayurveda site, a musician offers a variety of melodies played by specific instruments in order to pacify doshic imbalances.  The melodies attributed to these instruments’ sounds seem to counterbalance the effects of an imbalance.

For example, the instrumental sounds of the bamboo flute are thought to prevent the increase of vata.  The bamboo flute emits soft notes and has a soothing effect on its listener.  This is also the flute from which Lord Krishna played his soulful calming melodies alone on a calm river. 

Pitta needs a strong quality to catch its attention and the sitar is believed to possess that with its nasal overtones and rich sound.

The sarod is a classical Indian lute-like instrument and, with its deep and ‘awakening’ sound and clear tones, is said to help balance and enliven the kapha dosha.  The sarod is not as sweet as the sitar, nor as soothing as the bamboo flute.   

Nadis, chanting, and mantra  

In The Yoga of Sound, Paul states that sound essentially “works with the transformation, restoration, and reconstitution of the energies of the soul through channels known as nadis…subtle channels of the chakra system related to the soul’s infrastructure.”   In other words   “sound optimizes the performance of energy vortexes or chakras which govern our emotional, psychic and spiritual states of consciousness.”  

Mantras, or hymns, became interwoven with all actions related to healing.  Mantras, as sacred sounds, are known to affect our vibratory being and consciousness as the word mantra itself means both protection and instrument.   

In the Ashtanga Samgraha, chants are noted as playing a vital role in the overall healing process.    From the very start of life, chants are indicated.  For example, the attendant present at the birth of a child is instructed to chant a hymn into the baby’s ear right away.  

Mantras are also alleged to have the power to rid a child of evil demons.   It was seen important that those evil spirits are won over by the chanting of certain sacred sounds or hymns.   

The Vedas themselves are a series of mantras, as both words and sounds awaken memory and the deep knowledge encoded in our DNA and cells. This deep encoding is linked to the primordial sound of creation and to the source from which we emanate and are deeply a part.   However, it also understood that the emanator of the sound must, as stated in the Ashtanga Samgraha, be fully conscious in order to achieve the highest level of effect.   As Paul reminds us, “The vibratory effects of our tones…find their way into the psyche. Let us be mindful about these tones and use our voices to heal.”  

The experience of mantra and chanting are best when accompanied by ritual.  Ritual, in the very way that it is performed --the same time each day, also mirrors the rhythmic quality of mantra or the universe’s ebbs and flows.  Paul states that without sound encompassed in ritual that it is difficult to “release the accumulation of psychic toxicity in our spiritual system.”    It also “allows us to experience the deep and the high, much like sound.”   

In a translation of the Yoga aphorisms of Patanjali, it is noted that the “repetition of sacred words or mantras is…an invaluable aid to spiritual progress.”    Tapping in to our true nature, the definition of health being not forgetting who we are, is where true health lies.   Any disengagement from our spiritual nature is a disconnection from the source; and overall good health is more possible when we are encompassed by our connection and in tune with our greater nature, all of which is helped by sacred sound.

The rishis in Ayurveda also addressed other ways to fall ill besides disconnecting with one’s true nature.  Poison is a reality of our world and the ancients understood that being poisoned or otherwise harmed by the external environment posed a very real harm to the human body.  Toxins from snakes, animals and plants were believed to have possessed a fire that would severely harm one’s well-being.   One of the suggested antidotes to poison was the use of sound.  The Ashtanga Samgraha states that “Poison is full of tejas…it does not get warded off by the administration of drugs as quickly as by the use of mantras, full of satya, brahmacarya and tapas of the priest.”   The physician would have to be proficient with the hymn, however  as part of ‘sacred hymn’ therapy in helping the patient.   

Interestingly, in Traveling the Sacred Sound Current, Debroah Van Dyke notes that “sound is [also] fire…the agent of purification.”  Sound, therefore has “an inherent role in the transformation of our consciousness because it is the very vibrational nature of our soul.”   The creative organizing force of sound on our biology cannot be denied as sound’s power is evidenced to organize matter itself.   

An interpretation of the Yoga Sutras notes a sort of transcending effect of sound, one that goes beyond simply healing the body.  “By making samyama [when the true nature of an object is known] on the sound of a word, one’s perception of its meaning and one’s reaction to it…one obtains understanding of all sounds uttered by living beings.” This understanding translates into one being able to “attain supernatural powers of hearing” and achieving various levels of samadhi, complete absorption.  

Chakras and bija mantras

Chakras, the energy wheels in our subtle body, are also directed by sound.   Chakras represent their own dimension as they act as a “superhighway system in which our energies travel.”  Roadblocks through this highway system can be unblocked not only by visualization and physical exercises, but also by using sounds, specifically mantras, something that was known during the Vedic era.  

Chanting bija mantras or what are known as ‘seed sounds’ increase the rotation or the frequency of prana moving through a chakra. If the function of a chakra increases, then there is heightened awareness and change in the chakra, with the quality of that dependent upon intent and the level of the practitioner.  

Mantras in themselves have long been a part of Hindu cosmology.  The intelligence inherent in each syllable, vowel or consonant when uttered, has very specific connections to our total spiritual being.

The following is a breakdown of how bija mantras work within the body, utilizing all five elements.

The bija mantra of the first chakra, Lam, helps to increase the earth element in the body.  The second chakra’s bija mantra, Vam, helps to increase the water element in the body.  The third, Ram, is believed to increase the fire element in both the body and the mind as the fourth chakra, Yam, increases the air element in both the body and mind.  The fifth bija mantra for the throat is Ham and influences the either element, again working with the mind and body.   The bija mantra Ksham influences the ether element, but goes beyond the physical and affects the astral body as well.  And the crown chakra’s bija mantra, Om, influences the physical, subtle, as well as the causal body.   

One may also note the consonant and vowel sounds in each of these mantras, as their vibratory effects are connected back to the source of the universe and well as to the duality inherent in our current state of being.

The M in each of these sounds is said to represent the maternal and material aspect of the universe.  The A sound in turn represents the Father, the nonmaterial, the action of the Alpha.  L (lam, earth) is a heavy, closing sound, while H in HAM (ether) is light, airy, ethereal sound, and R (ram, fire) is an energetic, fiery sound.   Typically, consonants have come to reflect the hard, material aspects of the world, while vowels represent the spiritual or etheric aspects.    

Paul states that the movement of various appropriate tones for the individual using Vedic mantras helps to “sustain the wavelength of sound frequencies generated by our brain [and] streamlines our mental processes toward the intention of the mantra.”   Focus lends itself to practice of the seventh limb in yoga, dhyana, and is the precursor to the ultimate state of consciousness, samadhi.

OM

One of the most interesting aspects of the Vedic mantra Om is that its uttering and meditating upon it connects us to a higher vibratory rate, linking us to the origin of Prakruti.

It is, in other words, “the sound of all sounds together.”  

If we are to assume that the ancients were in resonance with the creation of the universe itself, then we must examine some of the theories of creation.

One of those theories is that the universe was created by the ‘big bang.’  

The word ‘bang’ connotes loud sound.  Interestingly enough, scientists theorize that the big bang wasn’t an explosion at all.  Stephen Hawking in his book The Universe in a Nutshell puts forth a multiple of theories by great physicists, most notably, Einstein.   Space, so it seems, originated as a point of density when “density would have been very large.”   

Through Einstein’s theories and the invention of the modern telescope, Hawkins reveals that galaxies are spreading apart and that the universe “is not a cosmological constant.”  

The ‘primeval atom’ or big bang points to the scientific fact that our universe is expanding and that both space and time had a beginning.   The expansion of the universe can be likened to our ever expanding consciousness.  And the sound of Om is in resonance with this expansion as well as our consciousness which is ever changing and growing.

The sound of the big bang was mathematically construed by University of Washington physicist John G. Cramer. One can listen to the sound of this expansion on audio.   It is of interest to compare a modern day scientist’s rendition of ‘the big bang’ to the rishis mantra Om. The listener will notice that the ‘big bang’ is actually a hum, and is very much “what the ancient Rishis perceived in their deepest meditations. “   This hums signals an expansion, not just in matter, but also in consciousness itself. 

The ancients harmonized in resonance with the expansion of what we perceive as time and space as Om can be said to mirror the space time continuum.  

“Om is the single most important sound that can, by itself, configure the human body optimally for maximum resonance and is noted to have the ability to generate overtones or additional frequencies that occur over and above a tone.”    Paul quotes a passage from the Upanishads which helps us to contemplate the depth of Om’s meaning.

There are two ways of contemplation of Brahman:  in sound and in silence.  By sound we go to silence.  The sound of Brahman is Om. With Om we go to the End; the silence of Brahman.  The End is immortality, union, and peace.  

Even as a spider reaches the liberty of space by means of its own thread, the [person] of contemplation by means of Om reaches freedom. 

In other words Om “represents… the totality of all that is and all that is not.”   And chanting it connects us to the Divine expansion, offering us the awareness that we are a part of everything that is and was.   This glimpse of wholeness and of both surpassing and encompassing duality is offered if we simply tune into it.

Summary

Through these examples we can see that the Ayurvedic understanding of sound is ancient and intuitive, with deep involvement in our spiritual being and the bodies we occupy.  The western interpretation includes analytical understanding of the physical nature of sound.  But as the effects of sound on the body and psyche are steadily investigated, the convergence of western and Ayurvedic perspectives become more integrated. 

The good news is that western medicine and what we once called ‘alternative medicine’ are beginning to work together.  The science of the spirit is becoming more understood as we progress on the path of the best ways to get well, stay well, and feel connected. Therefore, healing modalities become complementary, eliminating the need for isolation. 

Fewer and fewer western medical doctors are separating their practices from what is becoming more and more evident—that we are energetic beings and not simply made up of parts.  And much is being scientifically noted about how stress and outside influences affect our well-being and can even be the cause of dis-ease in the body.   The connection to what we hear, as well as see, has a lot to do with how we feel.  Any wellness professional, who is truly into his patient feeling whole, connected, and empowered, will be able to address that in his or her practice.

At the beginning of last century, Edgar Cayce called sound “The Medicine of the Future.”  Perhaps this is the future to which he was referring.

  Ashtanga Samgraha: Prof. KR Srikanta Murthy, Chowkumbha Orientalia, Varanasi, India   (Vol 1, xiii).  

  Mayo Clinic, Mayo Clinic Staff, Myofascial pain syndrome. http://www.mayoclinic.com/health/myofascial-pain-syndrome/DS01042/DSECTION=treatments-and-drugs

  Don Campbell, The Mozart Effect: Tapping the Power of Music to Heal the Body, Strengthen the Mind, and Unlock the Creative Spirit (New York: Avon Books, 1997), 10. 

  Online Etymology Dictionary, health. http://www.etymonline.com/index.php?term=heal.

  Ibid.

 .Paul G. Hewitt, Conceptual Physics—A New Introduction to Your Environment (Boston: Little, Brown and Company, 1977), 288.

  Ibid 291

  Russill Paul, The Yoga of Sound: Tapping the Hidden Power of Music and Chant (Novato California: New World Library, 2004), 12.

  Ibid, 11.  

  Ibid. 5, 293.

  Ibid, 14.

  Ibid 5, 302.

  Masaru Emoto, Water Crystal Healing: Music & Images To Restore Your Well-Being (New York: Atria Books, 2006), vii.  

  Lestard Nd, Valente RC, Lopes AG, Capells MA. Direct effects of music in non-auditory cells in culture. Noise Health 2013; 15:307-14.

  Ibid 2, 32.

  Ibid 5, 293.

  Cymascope, Sound Made Visible. http://cymascope.com/cyma_research/soundhealinghtml.

  Ibid.

  Mayo Clinic, Mayo Clinic staff, Pregnancy week by week. http://www.mayoclinic.com/health/fetal-development/PR00113.

  Ibid. 2, 68.   

  Jack Kornfield, A Path with Heart—A Guide Through the Perils and Promises of Spiritual Life (New York: Bantam Books, 1993),  323.  

  Ibid 13,vii- xii.

  Ibid 13, x, xi.

  Ibid 13, 2-50.

  Ibid 2, 7.

  Ibid 2, 65.

  Ibid 2, 67.

  Ibid 2, 221.

  Ibid 2, 80.

  Empower Your Health Magazine, Mack Harrell, MD, FACP, FACE,ECNU, Music For Your Health. http://www.empoweryourhealth.org/magazine/vol2_issue3/music-for-your-health.

  Teppo Sarkamo, et al., “Music Listening Enhances Cognitive Recovery and Mood After Middle Cerebral Artery Stroke,” Brain (2008) 131 (3): 866-876.  http://brain.oxfordjournals.org/content/131/3/866.full.

  Ibid 32.

  Zheng A. et al., “Effects of a Low-frequency Sound Wave Therapy Programme on Functional Capacity, Blood Circulation and Bone Metabolism in Frail Old Men and Women.” Clinical Rehabilitation, 2009 Oct; 23 (10): 897-908.  http://www.ncbi.nlm.nih.gov/pubmed/19717506.

  Ibid 2, 64.

  Ibid 2, 92-94.

  Ibid 2, 99.

  Ibid 2, 272.

  Ibid 2, 221- 283.

  Mitchell L. Gaynor, M.D., Sounds of Healing: A Physician Reveals the Therapeutic Power of Sound, Voice, and Music (New York: Random House, Inc., 1993), 19.  

  Ibid 20, 322.

  Ibid 33, 19.

  Ibid 33, 46 47.     

  Ibid 33, 64).  

  Ibid 7, Paul 135.

  Anodea Judith, Wheels of Life—A User’s Guide to the Chakra System (St Paul, Minnesota: Llewellyn Publications, 1998),  287.  

  Ibid 33,  68.   

  Ibid 2, 158.

  Healing Sounds of Ayurveda, Markus Frerichs.  http://www.ayurveda-music.com

  Ibid 7, Paul 24.

  Ibid 40, 279.

  Ibid 1, 258.

  Ashtanga Samgraha: Prof. KR Srikanta Murthy, Chowkumbha Orientalia, Varanasi, India   (Vol 3, 2).  

  Ibid, 58 – 61.

  Ibid 48, 80

  Ibid 7, 68- 79.

  Ibid 7, 111.

  Swami Prabhavananda and Christopher Isherwood, How to Know God: The Yoga Aphorisms of Patanjali (Hollywood CA: Vedanta Press, 1981), 203.

  Ibid 48, 371.

 Ibid 48, 451.

  Ibid 48, 371

  Deborah Van Dyke, Travelling the Sacred Sound Current: Keys for Conscious Evolution (Brown Island B.C. Canada: Sound Current Music), 21.

  Ibid, 23.

  Ibid 52, 182.    

  Ibid 40, 16.    

  Marc Halpern, Principles of Ayurvedic Medicine10th ed. (California College of Ayurveda, 2010),  218.  

  Ibid 58, 218-232.    

  Ibid 40.

  Ibid 7, 79.  

  Ibid 40.

  Stephen Hawking, The Universe in a Nutshell: A Brief History of Time, Black Holes and Baby Universes and Other Essays (New York: Bantam Books, 2001), 22.

  Ibid, 21 – 23. 

  John G. Cramer, “Sound of the Big Bang,” November 10, 2003, http://faculty.washington.edu/jcramer/BBSound.html

  Ibid. 

  Ibid 7, 73

  Ibid 7, 175.  

  Ibid 7, 219.

  Ibid 7, 179- 181.

 
 
 

A Perspective of the Ayurvedic Application to HIV (By Lance Roehrig)

Abstract

   The role of traditional, complimentary and alternative health care is rapidly changing in the world climate. A greater emphasis on complimentary and alternative health care, and its practitioners, is developing in the wake of economic downturns. Healthcare and Health Insurance prioritized as a moneymaking industry rather than the greater seva, act of service, to heal and promote longevity is unsustainable. Although the care received in hospitals and by Doctors is beneficial for the most part; when the bottom line speaks louder than the individual that lies ill, great tides of change can and must occur. Communities have taken into their own hands the motto, “I am my primary care physician.” By integrating alternative health care practitioners as a tool in educated themselves in preventative and natural care, individuals empower themselves to take their health into their own hands, thus creating a truly holistic approach to health which is the very core of Ayurveda.

   The goal of this paper is not to prove viability of one herb, approach or method as a viable healing agent of HIV. Rather, the goal of this paper, like Ayurveda, is to show the extensive tools available to the HIV individual and in fact all individuals managing chronic disease. The important term here is managing. The goal of this paper is to show that with the use of an Ayurvedic framework; or roadmap, one can use allopathic technology in addition to the abundant tools available, thus taking back the power of healing from the healthcare industry and its beneficiaries and placing it back into the hands of each and every one of us.

Introduction to Ayurveda

“Forgetting our true nature as spirit is the primordial cause of disease.” – Dr. Marc Halpern

   Ayurveda is the ancient science of life and the world’s oldest holistic medical system.  It is said to be as old as humanity itself, but scholars place the age between five and 10,000 years.[1]   The term Ayurveda is derived from the two sanskrit root words “Ayus” meaning life and “veda,” meaning knowledge, “The science of life.”  Ayurveda takes its origins from the spiritual texts of India known as the Vedas. The Vedas are the oldest known written text with subjects as vast as grammar, phonetics, astrology, ritual, etymology and prosody (metric verse). [2] There are four Vedas, The Rig Veda, Atharva Veda, Yajur Veda and Sama Veda. Ayurveda is a gathering of knowledge from all four texts.
Vedic knowledge was perceived by merging ones consciousness with the subject of inquiry. Tajjayat Prajnalokah, “By the mastery of [one pointed focus and meditation] comes the light of knowledge.” [3] From this practice true wisdom was received as gifts from the Devas (Gods). Dr. David Frawley writes in his book Ayurveda – Natures Medicine, “[Ayurveda] is not merely a kind of antiquated folk medicine as it is sometimes considered to be.”  [4] Many discoveries in modern sciences and technology can often be linked with parallel wisdom in the Vedas.  “Today, quantum physicists have become the torchbearers in the realm of the ‘tinier than tiny.’ Ten million to one hundred million times smaller than the sub- atom lies the level of the quanta, the new frontier of min-body research. The source of this quantum level is a field of pure energy, which serves as the underlying intelligence and glue of the entire universe. 65 years ago, quantum physicists labeled this the Unified Field. Nearly six millennia ago, Ayuvedic sages called it the Cosmic Life Force or Field of Pure Consciousness. While modern science is only beginning to understand implications of this discovery, Ayurveda has been steeped in quantum theory for a millennia.” [5]
   Unlike our modern age where our focused intent is outward, ancient Rishis chose to place their eye on the internal universe and in doing so they discovered this Unified Field as modern scientist call it; “[Is a,] field of consciousness, which connects every thought, wave pattern and particle of our being.” [6] It is here where we discover infinite potentiality as well as the understanding that what is in the microcosm is in the macrocosm and what is in the macrocosm is in the microcosm. Our ability to heal can be attained by simply watching the rhythms of the universe … or better yet, our own backyard.
   The philosophies, principles and techniques in Ayurveda, the Vedas, Tantra, Yoga; these are all part of an ancient wisdom known as Sanatana Dharma (now known as Hinduism) roughly translated as the eternal truth.  As the same sun is called by different names in different countries at different times, these truths are universal and cannot be defined by time nor are written by, or for; the benefit of one man, one nation or one race. These truths have been written and passed chest –chest for the benefit of humanity.
   “… great rishis sat together on the slopes of the Himalayan Mountain. They discussed the occurrence of great diseases that had arisen and how to deal with them … They decided that they should ask the Gods how to stay well and avoid disease as well as how to heal those who are sick … (The rishi ) Bharadvaja was selected … as he was best suited for the mission. Bowing before Indra, he explained the reason he needed an audience before such a great God. Bharadvaja was successful and Indra taught him the knowledge of Ayurveda…” [7]
   Bharadvaja went on to teach many great rishis and sages the science of Ayurveda. One of the great sages was Atreya, who passed on the knowledge to Agnivesa. Agnivesa later wrote the Agnivesa Tantra, which became the Caraka Samhita after Caraka revised it. [8] The Caraka Samhita is one of the primary Ayurvedic text that many practitioners gather their information from. In it myth and history are woven revealing the secrets of Ayurveda.
   “Forgetting our true nature as spirit is the primordial cause of disease.” Writes Dr. Halpern. When we forget our true nature as spirit we become dominated by the ego. We are wrapped up and consumed in vrittis, the dramas of everyday life. Yogas citta-vritti-nirodah, Yoga is the cessation of the mind or settling of the mind into silence. [9] When we connect our physiology with the dramas of everyday life, time seems to increase and our reality becomes further attached to maya, illusion. By connecting to our ego; my car, my house, my job, my safety, my money, my family, my society, my government; and defining these transient things as I, simply, we forget. We forget our true and timeless nature is here in this infinitesimal moment of the now. It is here where the deepest secrets unravel and one can capture a glimpse into the internal pharmacy where anything is possible.
Ayurveda uses the language of nature to describe the rhythms and cycles of the macrocosm and shows the similarities within the microcosm. It relates and shows how the five elements of earth, water, fire, air and ether are intrinsically connected in this beautiful lila or cosmic play, in the outer world, and how they are part of the body - and the internal world. It uses the language of 10 sets of opposite characteristics: hot/cold, moist/ dry, heavy/ light, gross/ subtle, dull/ sharp, soft/ hard, smooth/ rough, cloudy/clear… to further describe and relate the harmony and the imbalance in the individual.  These principles are used to describe the body, the disease and ultimately the path of healing. For example, if one were to present constipation (cold/ dry) Ayurveda recommends opposite therapy, so in said example one would employ warm, moist and nourishing qualities as an anecdote.
    The three causes of disease in Ayurveda outlined in the Caraka Samhita, are: 1) The unwholesome conjunction of the senses with the objects of their affection (“Having forgotten its true nature as spirit, mankind understands itself to exist only as its senses, its body and its mind … the meaning of life becomes the simple pursuit of pleasure.” 2)Intellectual blasphemy, the failure of the intellect or crimes against wisdom (“When we listen deeply inside ourselves, we find that we know how to act in ways that would bring us toward health … Yet, we often do not follow what we know to be true.”) 3)Transformation or decay due to time and motion. (There are two kinds of time: Linear time, which is static. Then there is biological time, which changes in response to motion. The faster our pace of life, biological time increases, gross motions such as air and automobile travel exacerbate this. More important than gross motions is the motion of the mind. The faster the rate of our thoughts time seems to increase and so does our biology. When the mind slows down such as in meditation or yogasana the biology also slows down.) [10]
   When we look at the three causes of disease we can see how the nidana or cause of HIV falls into the first two categories and the treatment and rate of action on the body falls into this third cause. Hope lies in reconnecting the individual to the eternal. We are more than our senses perceive. The path of healing lies in the ability to turn on the innate intelligence that resides within.  Understanding that how we move through life and that how we perceive to move through life are two very different things and can be altered.

The History of HIV

“Due to funding constraints AVERT is unfortunately not able to fund any new projects, or accept project proposals until at least April 2012. Please do not send in any applications for funding until that date.” [11]

   1981 was the year AIDS was first reported in the U.S. Scientists scrambled through much confusion in the first few years surrounding the illness, attempting to pin down transmission of the virus and treatment of those infected. Advancements in the 1990s with new classifications of drugs have greatly changed the landscape of treatments. [12]
   The genetic research places the origins of HIV in West-central Africa. The Mayo Clinic states, “Scientists believe a virus similar to HIV first occurred in some populations of chimps and monkeys in Africa, where they’re hunted for food. Contact with an infected monkey’s blood during butchering or cooking may have allowed the virus to cross into humans and become HIV”[13]

Before 1970s
1    HIV (the virus that causes AIDS) probably transfers to humans in Africa between 1884 and 1924.
2    HIV probably enters Haiti around 1966.
1970s
1    HIV probably enters the United States around 1970.
2    African doctors see a rise in opportunistic infections and wasting.
3    Western scientists and doctors remain ignorant of the growing epidemic.
1981
1    AIDS is detected in California and New York.
2    The first cases are among gay men, then injecting drug users.
1982
1    AIDS is reported among haemophiliacs and Haitians in the USA.
2    AIDS is reported in several European countries.
3    The name “AIDS” – Acquired Immune Deficiency Syndrome – is created.
4    Community organisations in the UK and USA promote safer sex among gay men.
1983
1    AIDS is reported among non-drug using women and children.
2    Experts become more confident that the cause of AIDS is infectious.
3    Three thousand AIDS cases have been reported in the USA; one thousand have died.
1984
1    Scientists identify HIV (initially called HTLV-III or LAV) as the cause of AIDS.
2    Western scientists become aware that AIDS is widespread in parts of Africa
3    The world's first needle exchange program is set up in Amsterdam, the Netherlands.
1985
1    An HIV test is licensed for screening blood supplies.
2    AIDS is found in China, and has therefore been seen in all regions of the world.
1986
1    More than 38,000 cases of AIDS have been reported from 85 countries.
2    Uganda begins promoting sexual behaviour change in response to AIDS.
1987
1    AZT is the first drug approved for treating AIDS.
2    The UK and other countries act to raise awareness of AIDS.

1988
1    The American government conducts a national AIDS education campaign.
2    Health ministers meet to discuss AIDS and establish a World Aids Day
1990
1    Around 8 million people are living with HIV worldwide, according to estimates made later.
1991
1    Thailand launches Asia’s most extensive HIV prevention program.
1993
1    AZT is shown to be of no benefit to those in the early stages of HIV infection.
1994
1    AZT is shown to reduce the risk of Mother to child transmission.
2    Infant HIV infections begin to fall in developed countries, due to use of AZT.
1995
1    The Joint United Nations Programme on AIDS (UNAIDS) is established.
1996
1     Combination antiretroviral therapy shown to be highly effective against HIV.
1    In developed countries, many people begin taking the new treatment.
2    Annual global spending on AIDS in low- and middle-income countries is $300 million.
1997
1    AIDS deaths begin to decline in developed countries, due to the new drugs.
2    Brazil is the first developing country to begin providing free combination treatment.
3    In other developing countries, only a tiny minority can access treatment for HIV.
4    Around 22 million people are living with HIV worldwide, according to estimates made later.
2000
1    President Thabo Mbeki of South Africa voices support for Aids dissidents
2001
1    At a UN Special Session, world leaders set long-term targets on HIV/AIDS.
2002
1    The Global Fund established to boost the response to AIDS, TB and malaria.
2    Botswana begins Africa’s first national AIDS treatment programme.
2003
1    AIDS drugs become more affordable for developing countries.
2    The “3 by 5” campaign is launched to widen access to AIDS treatments.
3    The first HIV vaccine candidate to undergo a major trial is found to be ineffective.
2004
1    America launches a major initiative called PEPFAR to combat AIDS worldwide.
2    After much hesitancy, South Africa begins to provide free antiretroviral treatment.
2006
1      Circumcision is shown to reduce HIV infection among heterosexual men.
1    28% of people in developing countries who need treatment for HIV are receiving it.
2    Annual global spending on AIDS in low- and middle-income countries is $8.9 billion.
3    It is estimated that $14.9 billion would be needed for a truly effective response.
2007
1    Around 33 million people are living with HIV, according to revised estimates.
2    Another major HIV vaccine trial is halted after preliminary results show no benefit.
2008
1    A controversial Swiss study claims people adhering to ARVs have a "negligibly small" risk of transmitting HIV through unprotected sex.
2    PEPFAR is reauthorized, committing $48 billion for the next five years.
3    Michel Sidibé is named as new head of UNAIDS as Peter Piot steps down.
2009
1    President Obama announces the removal of the travel ban that prevents HIV-positive people from entering the US.
2    4 million people in developing and transitional countries are receiving treatment for HIV; 9.5 million are still in immediate need of treatment.
2010
1    The United States, South Korea, China and Namibia lift their travel bans for people living with HIV.
2    The CAPRISA 004 microbicide trial is hailed a success after results show the gel reduced the risk of HIV infection by 40%.
3    Results from the iPrEx trial show a reduction in HIV acquisition among men who have sex with men taking PREP [14]

What is HIV?

Western Interpretation

Definition

   HIV (Human immunodeficiency virus): A disease of the human immune system that attacks white blood cells reducing the body’s ability to fight off illness. This condition progressively reduces the effectiveness of the immune system. Left untreated individuals become susceptible to opportunistic infections or tumors that usually are handled by a strong immune system. At this stage HIV has manifested into AIDS (Acquired immunodeficiency syndrome). [15]

Etiology

   HIV is transmitted with direct contact with a mucous membrane or bloodstream with a body fluid containing the virus such as infected blood, semen, vaginal secretions, preseminal fluid and breast milk. Infection cannot take place via hugging, kissing, dancing or shaking hands. HIV is temperamental and cannot live long outside of the body. It cannot be transmitted by air, insect bite or water. [16]

Signs and Symptoms

    Initially there is brief flu like systems presented two to four weeks after infection that dissipate and generally go away. Symptoms are fever, headache, sore throat, swollen glands and rash. Years later as the condition progresses some may develop mild infections or chronic conditions such as swollen lymph nodes (often a first sign) diarrhea, weight loss, fever, cough and shortness of breath. If the condition progresses and the HIV infection is not treated the disease typically progresses to AIDS. At this stage the symptoms include: soaking night sweats, shaking chills or fever, cough and shortness of breath, persistent white spots and unusual lesions on the tongue or in the mouth, headache, persistent fatigue, blurred and distorted vision, weight loss, skin rashes. [17]

Complications

   Complications can be as individual as the person infected with HIV. From the Avert website here is a partial list of some of the most common: “Bacterial diseases such as tuberculosis, bacterial pneumonia and septicaemia (blood poisoning) Protozoal diseases such as toxoplasmosis, microsporidiosis, cryptosporidiosis, isopsoriasis and leishmaniasis.  Fungal diseases such as PCP, candidiasis, cryptococcosis and penicilliosis. Viral diseases such as those caused by cytomegalovirus, herpes simplex and herpes zoster virus.  HIV-associated malignancies such as Kaposi's sarcoma, lymphoma and squamous cell carcinoma.”
   Complications also arise in the treatment of HIV with the side effects from the antiretroviral therapies. Some common side effects are: Hepatoxicity (liver damage), Hyperglycemia (elevated blood sugar), lipodystrophy (fat redistribution) and skin rash. [8]

Test and Diagnosis

   The ELISA (enzyme-linked immunoabsorbant) is the most common test for routine diagnosis of HIV among adults. There is however a window period after HIV infection from weeks up to 6 months where the antibodies are not produced after infection.  During this time an antibody test can give a false negative. To avoid a false negative it is recommended that a second test be done three months after possible exposure. [19]

Blood Tests and Treatments

   An HIV positive result will result with the patient being referred to an Infectious Disease Specialist (I.D. Dr.). This specialist will work with the patient and come up with a selection of drugs to treat the virus. In some cases with the advancement in research only 1 pill, once day that is a cocktail of multiple drugs is used, such as Atripla. It is imperative that the patient takes the medication as directed to curb side effects as well as drug resistance.  The Mayo Clinic lists on their website the classifications of drugs for the treatment of HIV:
        “Non-nucleoside reverse transcriptase inhibitors (NNRTIs). NNRTIs disable a protein needed by HIV to make copies of itself. Examples include efavirenz (Sustiva), etravirine (Intelence) and nevirapine (Viramune).
        Nucleoside reverse transcriptase inhibitors (NRTIs). NRTIs are faulty versions of building blocks that HIV needs to make copies of itself. Examples include Abacavir (Ziagen), and the combination drugs emtricitabine and tenofovir (Truvada), and lamivudine and zidovudine (Combivir).
        Protease inhibitors (PIs). PIs disable protease, another protein that HIV needs to make copies of itself. Examples include atazanavir (Reyataz), darunavir (Prezista), fosamprenavir (Lexiva) and ritonavir (Norvir).
        Entry or fusion inhibitors. These drugs block HIV's entry into CD4 cells. Examples include enfuvirtide (Fuzeon) and maraviroc (Selzentry).
        Integrase inhibitors. Raltegravir (Isentress) works by disabling integrase, protein that HIV uses to insert its genetic material into CD4 cells.” [20]

    Some of the blood tests that the I.D. Dr. will use to determine which medication to use as well as its effectiveness and the management of possible side effects are: CBC (Complete Blood Count), this will tell the I.D. Dr. the kinds and numbers red and white blood cells along with platelets; Liver Function panel to assess the function of the liver and avoid toxicity; CD4 (T- Cell) count tells the I.D. Dr. how the immune system is functioning – with the standard range being between 290-2077 and Viral Load. This Test measures how many counts of HIV are in the blood. Today, with increasingly newer technology, an undetectable viral load is becoming more common. [21]

Ayurvedic Interpretation

“Remember that no disease can harm you if agni is balance, ojas is strong and you are living a sattvic lifestyle.” – Dr. Marc Halpern

   No, disease can harm you if agni is balance and ojas is strong. These words written in an email by Dr. Halpern inspired the approach of this paper. How does one address Ayurveda’s message to HIV? - Hope.
   Underlying the message of Ayurveda is a deeper wisdom of spiritual connection that can get lost in the interpretation of Ayurveda. As western-minded individuals it is easy to struggle with the tendency to take Ayurveda out of its context and westernize its procedures and treatments, thus losing the very heart that differentiates Ayurveda from allopathic medicine.  By simply treating the symptoms and not uprooting the entire tree of dis-harmony we lose the opportunity Ayurveda presents to create a deeper change within. It is the deeper meanings beyond what we see with our eyes that Ayurveda has so eloquently conveyed. Yogi Baba Prem wrote, “…one must learn to look at eastern teachings through eastern eyes. The literalist tradition, common in the west and relevant in the east, does not afford much opportunity to unlock the vast secrets held within the eastern traditions and the more familiar system of yoga.” [22] We must understand this in order to facilitate a deeper awareness within ourselves when we venture into these ancient traditions for healing. When we blend the modern treatments of western allopathic medicine with the wisdom from the east we truly discover a holistic approach to healing. “Whether animal, herb or pharmaceutical everything is medicine when given to the right person, at the right time, for the right reason. Whether animal, herb or pharmaceutical everything is poison when given to the wrong person, at the wrong time, for the wrong reason.” [23] It is by accessing these internal secrets that each one of us is gifted with; will we have the capability to surpass great odds and learn great lessons.
   When we step into an Ayurvedic mind, we realize that Ayurveda includes all forms of medicine as treatment and the need to battle or pit one group against another just isn’t there. Shanti, Peace. In the fullness of a harmonious and global, community mind - adversity does not have a place to function. What we discover is that this subtle wisdom is the very philosophy that is capable of powerful treatment in chronic disease. When the mind, body and spirit create a harmonious community within, adversity melts and naturally the route of healing and the ability to access the internal pharmacy becomes alive. And, even in the face of chronic conditions such as HIV, one can find Shanti.

*    *    *

    According to Ayurveda, HIV can be correlated to Ksaya  or  OjaKsaya, the loss and consumption of vital energy. “Ksaya,” is most commonly associated with tuberculosis, it is characterized as an end stage respiratory condition with all three doshas vitiated. Any disease that is not properly treated can result in this condition and is considered, rajayaksmadi, “king of diseases.” [24] In The Ayurvedic Encyclopedia, Swami Sadashiva Tirtha writes,” In an ancient Ayurvedic text, Madhava Nidan, written around 700 A.D., the author, Madhavakara foretells a disease that will come to India. From its description, we know it as HIV/ AIDS. Its cure was said to be shilajit.” [26]

Nidana (Cause)

   HIV is a tridoshic viral infection affecting the strength and ability of the immune system to function.  It causes a deficiency in life-sap, ojas.  When ojas is strong the HIV virus cannot develop. Ojas is lost or diminished by excess sex, improper food, improper routine, worry and insomnia.  The HIV virus uses the body’s immune cells to replicate itself.  Much like a ghost, this virus does not have a body of its own and uses its host’s cells and body to function and survive. Dr. Marc Halpern, director of the California College of Ayurveda wrote on Ksaya “A lifestyle that reduces ojas leads to individual susceptibility to the condition. A lifestyle that results in a loss of shukra (vital fluid) is considered to increase the risk of developing the condition. In addition, a person is weakened by the suppression of natural urges and the intake of foods and drinks that are disharmonious.” [26]

Purva Rupa (Premonitory Symptoms)

   According to the Ashtanga Hrydayam, the following is a list of premonitory symptoms that often precede the onset of the disease. [27]

•    Nasal catarrh
•    Increased salivation
•    Sweet taste in the mouth
•    Weak agni
•    Increased desire for sex and wine
•    Swelling of the feet and face
•    Dreams of being defeated by animals
•    Visions of dirt in foods
•    Denial of emaciation

Rupa (Symptoms)

   Vata and Pitta are primary factors, however Kapha may present symptoms of congestion and lung disorders as the virus manifests. Fever, chills, headaches, tiredness, enlarged lymph nodes and general flu like symptoms in the first stages of infection. Symptoms of vata vitiation include: Fatigue, nerve disorders, cough, pain, change in voice and emaciation. Pitta symptoms include:  fever, low energy-burnout, yellow, green or red foul smelling sputum. Symptoms due to kapha vitiation are loss of appetite, congestion, oral candida, vomiting and dyspnea. [28]

Samprapti (Pathogenesis)

   The symptoms that develop from HIV have one major factor in common – movement. The symptoms seem to manifest throughout the various dhatus and strotas (tissues and channels) throughout the entire body, affecting all dhatus. Because HIV affects the white blood cells, the actual infection is located in the rasa dhatu of the rasavaha strota. Dr. Marc Halpern of the California College of Ayurveda states, “It is a constituent of rasa. (lymph)”   According to the Madhava Nidanam, Vata then becomes the primary vitiated dosha in the pathogenesis. Vata vitiation then leads to pushing pitta and kapha. From this we can see the condition is sannipattika (tridoshic) with vata at the root, overflowing into the rasa dhatu and the rasavaha strota and relocating to various sites through out the body creating the classic symptoms of early HIV infection as well as later stages. [29]

Stage Evidence Dosha Subdosha Dhatu Incr/Decr Srota Herb Categories Herb Examples
rmd HIV Infection/ low ojas/ reduced immuntiy V vyana Rasa decr Rasa-vaha Strota Rasayana Chywanprash
AshwagandhaShatvari
Shillajit
rmd Ema-ciation V apana

Medas
Mam-sa
 

decr Medo-vaha Strota Fat tonics
Muscle tonics
Shatavari, licorice
Amalaki ashwagandha
rmd anxiety V prana n/a decr Mano-vaha Strota Nervine sedadtive
Nervine tonic
Jatamamsi/ shankha pushpi
Brahmi
ashwagandha
rmd Fatigue V vyana rakta decr Rakta-vaha Strota Blood tonics Amalaki/ turmeric
rmd HIV Infection / Fever
 
P n/a rakta decr Rakt-vaha Strota Anti-microbials Turmeric/ neem/ goldenseal
rmd Fatigue P n/a rakta decr Rakta-vaha Strota Blood Tonics Amalaki/ Turmeric
rmd HIV Infection
Swollen lymph nodes
K n/a rasa incr Rasa-vaha Strota Channel clearing
Anti-Microbial
Turmeric/ Garlic
rmd Loss of appetite K kledaka rasa incr Anna-vaha Strota dipana Trikatu/ Ginger
rmd Oral candida K Bodhaka rasa incr Anna-vaha Strota Anti-Microbials
Anthelmintic
Musta, Pau d’arco
Asofatida
vidanga
rmd Depression K tarpaka n/a incr Mano-vaha Strota Nervine stimulant Brahmi/ Calamus

Chikitsa (Treatment)

   Ayurveda gives the patient the framework to lead a harmonious life and build ojas. This is key in preventing the infection form further manifesting as well as managing the possible side affects associated with the pharmaceuticals employed to treat HIV.  Along with numerous others, all HIV allopathic medications list possible digestive imbalances and anxiety/ depression, as common side affects that may subside as treatment continues. Little is known as to whether the psychological disturbances are caused by the disease, the medication, the outlook of the patient or a combination.  These side affects in treating HIV from an Ayurvedic perspective will be taken into account below.

   Because Vata vitiation is of concern, a treatment for general vata imbalance is employed. Nourishing foods that are vata pacifying are consumed being aware that vata in HIV individuals can very quickly push pitta and kapha out of balance. (As HIV is tridoshic in nature. See samprapti above.) The diet will often need to be adjusted to compensate. It is interesting to note specifically the use of goat meat in soups as well as fried in ghee in Caraka Samhita.  Many recipes included goat milk along with all the recipes employ ghee, cows milk, sugar and honey for their nourishing nature on vata and rasa dhatu (lymph). [30] Because HIV affects the nourishment of the tissues, regulating samana vayu ( the ability to absorb nutrients) is considered a primary focus when it comes to nutrition as well as daily routines. The annamaya kosha (food sheath or physical body) is nourished by the right foods at the right time, thus creating ojas, immunity. The daily routines are vital in treatment of HIV, keeping patterns and routine grounds samana vayu. Daily routines consist of regular bowel movements, self-abhyanga (daily oil massage), yoga, pranayama, and the routines around meals such as prayer and the routines around sleep. Tongue scraping and neti, nasal irrigation, help remove toxins and dead cellular debris from the tongue and sinus cavity. Abhyanga increases lymphatic flow from the heat it generates and can promote the detoxification of pharmaceuticals as well as the removal of the virus from the body.

   Considering what sort of mental impressions are being digested is a factor in healing and creating strength in the mind, nerves and musculoskeletal system. On the lecture Ayurvedic Psychology, Dr. David Frawley, comments how “…we let people into our minds that we wouldn’t let into our houses.” [31] Allowing the junk impressions into the mind is akin to eating junk food. Ojas is depleted and the body, mind and spirit must digest these junk impressions. Therefore it is paramount for the psychology and treatment of majjavaha strota and manovaha strota or the mind and nervous systems, to begin to build and nourish the environment from which one lives and functions.

   Auditing ones life and evaluating how nourishing each situation is within the home, career and self is extremely beneficial. How nourishing is the quality of the mind and heart? Systematically moving through each segment of the day one can audit and discover how nourishing and ojas building is each segment of the day is.  Break these segments into drying, heating, cooling, astringent etc. and one can begin to see the picture and quality of the course of the day. What aspects can be nourished?  Meditation can significantly effect the quality of these segments as the more one meditates and reconnects to Self, the more the various circumstance seem less important or less attachment is placed on them.  Color therapies play an important role in this segment. Gold is the most healing and nourishing, an abundance of this color in the form of flowers can uplift and tonify any environment.

   The use of herbal Anti-microbial herbs to treat the infection and rasayana (longevity/ ojas building therapies), to increase immunity is the corner stone of the treatment for HIV. Nervine sedatives and tonics help treat anxiety while fat and muscle tonics help in weight loss. Blood tonics are used for fatigue and oil massage and nasya with herbs like ashwagandha and brahmi. The gold ash formula, Survana Vasant Malti  is revered as being excellent for all immune disorders. [32]

   Essential oils are the rasa of the trees and plant kingdom. They prove very effective in healing and rebuilding the rasa of the human organism. Vata pacifying essential oils are highly effective in treating vata imbalance as they can be applied via Abhyanga.  They are applied through the pathways of the skin, nasal passages, lungs and gastro-intestinal tract. Once absorbed, essential oils quickly penetrate into the rasa and rakta (lymphatic and blood systems). As the oils circulate through the circulatory system, tissues and organs may choose any portion of the essential oil it wishes to use in the metabolic process, receiving the stimulating, sedating or beneficial property of the oil. [33] Essential oils are diluted in base oils that are constitutionally appropriate. A general accepted ratio of essential oil to base oil is about 25ml (12-13) drops: 1oz base oil. See the table below for doshic appropriate base oils. [34] Essential oils can be applied to the main marma point that balances each dosha: Vata, third eye; Pitta, Heart chakra; Kapha, between the navel and pubic bone.

Vata……………………...Sesame
Pitta…………Coconut/Sunflower
Kapha …………Canola/ Mustard

   Essential oils can be used as misting bottles with either healing oils or anti-microbial/ anti-viral/ anti-bacterial oils which are great for the rooms, bedding and the space in which the HIV patient resides. The general rule is one drop per 2 oz of water. [35] Shirodhara is effective in calming the mind, relaxing the nerves and immune system, providing individuals with a profound state of rest. Deep-seated stressors can be released via this treatment. [36]
   Mantra is sacred sound. On an esoteric level it is the sound or vibration pattern behind the universe itself. [37] Connecting to this sound vibration puts one in harmony with the universe and unlimited potentiality. It connects the individual with the sound vibrations available to awaken the internal pharmacy of healing. On a practical level it has gained wide recognition for its use in affirmations of healing. “According to the researchers, … repeating a mantram may help HIV-positive individuals examine stressful situations in a more nonjudgmental and accepting way…” [38]
   Gemstones can also be used as they speak to the body via outside the realm of the five senses. Stones are grounding representing the earth element however; gemstones like all of nature are composed of all of the five elements.  When wearing the gemstone the qualities of the gemstone interact with the qualities of the person. Gem infusions are made by soaking the gem in a glass of water in the moon or sunlight. [39] Time moves slower as mass increases; so time moves faster in the atmosphere above earth than it does on earth. This can be noted that by large structures such as mountains and even the great pyramids in Egypt, its hypothesized time moves at an infinitesimally slower rate. [40] Pondering this opens the attitude that there is more to life than what can be understood by the five senses.

Ayurvedic Treatments for HIV

Pancha Karma

   Pancha Karma is the process of removing ama and excess doshas from the body and mind and then rebuilding the internal strength and ojas, immunity. The state of ojas is important to determine whether or not the individual is ready for pancha karma.  Birmhana Chikitsa , tonification therapy may need to be performed prior to beginning a pancha karma routine. During the first stage, Purva Karma, a palliative doshic appropriate diet is indicated. During this time the built up toxins in the body from medications as well as viral debris can be thought of as moving towards the organs of elimination. Abhyanga  is performed as well as color, mantra, and pranayama. The duration for this initial phase is determined by doshic imbalance. As HIV is primarly vata, then tridhoshic, balancing vata and taking care not to cause vata imbalance is key to the success of the treatment.
   Pancha Karma literally means the five actions. Vamana (Therapeutic vomiting), Virechana (Purgation), Basti (Enema), Nasya ( Nasal Purgation), Rakta Mokshana (Bloodletting). Therapies like anuvasana basti, tonifying enema, are employed to heal and calm vata at its root site. These therapies performed by a skilled Pancha Karma specialist help to alleviate excess doshas and bring balance to the HIV individual as well as prepare the body to receive the tonification therapies of the third step, Praschat Karma.  These therapies are the tonifying and rasayana portion of the treatment and is the key in building immunity, ojas, as well as strengthen agni, the fire of digestion. The fire of agni is key in the overall health of the HIV individual. If the fire of agni burns to low, ama is left behind; if the fire of agni burns to hot, it smokes and burns and metabolizes the individual. When in balance agni burns clean and clear with no residues left. This is the goal of Pancha Karma.[41]

Amalaki

   The amalaki fruit is also known as Dhatri, the nurse, as it is like a nurse or mother in its healing properties.  It has a sweet, sour, astringent, pungent and bitter rasa, a cool virya, and sweet vipaka. It is part of the revered preparations, Chyawanprash and Triphala.  It is one of the best herbs for pitta and considered a rasayana for pitta type vitiation. The amla fruit contains the equivalent of nine oranges of vitamin C, as well as studies confirmed the bioavailability of the vitamin C in amla is better than that from synthetic ascorbic acid. It has anti-microbial properties and was shown to have inhibitory effects on HIV. [42] Increased cholesterol is a common side effect in many HIV medications. Studies have shown it to reduce cholesterol. Amalaki shows anti-oxidant properties against oxidative stressors. [43] It is considered the best among rasayana as well as it clears all three doshas from the body. When vitality is low amla with ashwagandha, ghee and honey is restorative and invigorating. [44], [45], [46]

Ashwagandha *

   Ashwagandha has a sweet, astringent and bitter rasa, warm virya and sweet vipaka. Its qualities are light and oily. is used in general debility and is the best rejuvenation herb for muscle, marrow and semen and for Vata constitution. [47] It is adaptagenic and increases the bodies ability to handle stressors. It is used in weakness, consumption and debility.  [48] It is a nervine sedative and nervine tonic and is known to treat anxiety, arthritis, insomnia and stress as well as an antioxidant. [49] Because Vata vitiation is paramount in the treatment of HIV Ashwagandha becomes an herbal ally in treating the stressors on the nervous system from the virus and/or the medications. Ashwagandha has been shown to increase body weight and total protein content.  It has been shown to have anti-cancerous activity and has shown to be effective against hepatotoxicity, chemical driven liver damage. [50]  (*See Appendix I For related research)

Shilajit

   A unique ayurvedic panacea or cure all.  Its rasa is pungent, bitter, and salty. It’s Virya is warm and its vipaka  is pungent. It is not actually an herb but a mineral pitch.  “It is an exudate that oozes out from ceratain rocks in the Himalayas, as they become warm.” [51] “Shilajit is renowned as a rejuvinative tonic with specific action on the urinary, reproductive, and endocrine systems. According to Caraka, almost all diseases can be controlled or cured with the use of this substance.” [52] In a comparative study of shilajit and 2 other herbs and AZT in 2006, shilajit performed 80%-90% effective against an enzyme found in HIV necessary for its multiplication. AZT was 70% effective. [53]

Turmeric*

   “When a virus replicates the ‘long terminal repeat’(LTR) sequence is activated. Without this activation there can be no replication of a virus like HIV. Published laboratory tests, completed by researchers at Harvard Medical School in 1993, indicated three inhibitors of HIV LTR. Curcumin is one of them…”  [54] Curcumin is what gives turmeric its yellow color. Turmeric works on all the tissues of the body. It has a bitter rasa warm virya and pungent vipaka. It is an anti-microbial, good for indigestion, poor circulation, cough, skin disorders, diabetes, arthritis, anemia, wounds and bruises. It helps to improve intestinal flora and is good antibacterial for those chronically weak or ill. It purifies the blood and warms and stimulates the formation of new blood tissue. It helps in digestion of protein as well as promotes proper metabolism in the body, correcting both excess and deficiencies. On an energetic level it gives the Shakti of the Divine Mother and is effective in cleansing the chakras (nadi-shodhana)  purification of the channels of the subtle body. [55] It seems to be slightly controversial as to whether or not Turmeric is Vata/ Pitta aggravating or tridoshic. As a satvic herb Tumeric has the ability to clear the intensity, anger and heat in the blood from excess Pitta. According to Prashanti de Jager, Turmeric is tridoshic because of its herbal actions and high carbohydrate percentage (70%) – the sweet taste. [56] (*See Appendix I For related research)

Triphala*

   Triphala, perhaps the most famous combination of herbs in the Ayurveda, Triphala is made of the three herbs amalaki, bibhitaki and haritaki. Considered a panacea for digestive disorders and is useful in almost every condition of the intestines. Triphala tones the intestinal muscles, creates regularity and dispels gas.  “Triphala’s actions extend beyond the digestive system. Each herb in Triphala is itself a rasayana for one dosha… Hence, this formulation builds internal strength and ojas.”  [57] Unlike over-the-counter laxative and laxatives in general Triphala is not dependency forming; in fact it is a remedy for this sort of dependency. Triphala becomes and ally in the treatment of digestive imbalance occurring form the virus as well as the pharmaceuticals employed to treat HIV. The individual’s ability to digest and absorb foods properly increases when the doshas are brought into balance and removed when in excess from their sites of origin. (*See Appendix I For related research)

Chyawanprash*

   This famed rasayana is considered the supreme rasayana of Ayurveda. It is a tasty dietary supplement that strengthens the organs under the ribs. It is very effective in the convalescence of the weak. It is made from amalaki (see below) and is the premier builder of ojas. It is heavy, sweet, sour and pungent in taste. Its vipaka is sweet.  It is said to dispel drowsiness, fatigue and preserve the harmony of all three doshas. It inhibits aging, rejuvenates depleted bodies, increases all dhatus and builds ojas. Chyawanprash becomes a strong ally in the treatment of individuals with HIV in maintain tissue strength and tone and helps bring balance into Vata dosha. Note that some are heating and others are more tridoshic as well as it is heavy. Those who have ama should undergo purifaction by Pancha Karma for its most beneficial effects.
    Legend has it that the sage Chayavan was an old man. He was destined to marry a very young woman from his village. Fearing that he could not satisfy this young woman and produce healthy progeny, he sought the counsel of the Gods. In meditation, he was instructed in the preparation of the now famous confection. Upon eating it, he became young and virile again. Hence, chywanprash is used by those who wish to remain young for many years.  [58] (*See Appendix I For related research)

Gemstomes

   Gemstones can be worn as jewelry such as a ring or pendant. The effect is greatest when the setting is designed for allowing contact to the skin. Gold is warming and tonifying as well as tridoshic and is best for Vata. Silver is cooling and purifying and is best for Pitta. Infusions can be made by soaking the gem in water in the sunlight for Vata and Kapha, and the moonlight for Pitta. Emerald/ Jade builds ojas is a nervine sedative and is good for degenerative diseases such as HIV. Pearl/ Moonstone, increases ojas is a tonic and is calming. It reduces hyperacidity  and ails the liver and kidney. Yellow Sapphire/ Yellow Topaz/ Citrine, increases ojas as well as discrimination, tejas. Reduces fear, nervousness and anxiety and is good in wasting conditions and regulates the hormonal system. [59]

Aromatherapy

   Aromatherapy speaks to the subtle channels as well as the mind. The mind has the ability to choose to attach to healing or sorrow, in this regard Aromatics become useful in the overall well being and healing of the individual. Rose increases love, compassion, has a prabhava of reducing anger and increasing immunity. It is a anti-microbial and cools the eyes (what the body digests via the eyes.) In this manner it is used as rose water. Rose increases ojas. Sandalwood is calming to the mind, is a nervine sedative and tonic and is useful in nourishing the heart. It increases ojas and has a prabhava for reducing anxiety and fear. Lotus is tonifying on the immune system and helps build ojas. Saffron increases faith which is the antidote for Vata. It is a rasayana, builds ojas, and is considered useful in cancer and HIV. [60]

Mantra

   Utilizing the Sanskrit language mantra is a powerful tool for healing. The Sanskrit alphabet is based on the cosmic sounds of creation and as such resonates deep within our beings. On a subtle level each letter resonates in the petals of different chakras, wheels of energy. When we use healing mantras they resonate on our physical, psychological and spiritual selves. However mantra does not need to be specifically in Sanskrit, although powerful; affirmations in ones own language can and should be considered equally as healing. In an article that Yogi Baba Prem, wrote,

“Within the Atharva Veda, one can find teachings of modern day visualization and affirmation tools; with such quotes as, ‘My mind stands against disease.’ Or from the Yajur Veda (Sukla version).



Preserve my life.


Assist/Preserve my prana (life-force).


Assist/preserve my vyana (circulating life-force).
Assist/preserve my sight.


Assist/preserve my ears [hearing].


Assist/preserve my speech, let it abound.


Be active in my mind.


Keep my soul.

[Keep] my light pure. 


Yajur Veda XIV.17



This is a powerful affirmation for health and wellness.” [61]
   Maha Mritunjaya Mantra is found in the Rig Veda. It is dedicated to Shiva and is considered the Death- Conquering mantra. Along with the Gayatri Mantra it is hailed as the heart of the Vedas. It is used for contemplation and meditation and is considered a nourishing mantra.  Swami Satyananda Saraswati of the Devi Mandir (www.shreemaa.org) says that by reciting this mantra 108 times one receives the blessings of Lord Shiva.

OM. Tryambakam yajamahe
Sugandhim pushtivardhanam
Urvarukamiva bandhanan
Mrityor mukshiya mamritat

We worship the Father of the three worlds, of excellent fame, grantor of increase. As a cucumber is released from bondage to the stem, so may we be freed from death to dewll in immortality.  (www.shreemaa.org)

   The practice of mantra should be approached with care in the HIV positive individual as to fully integrate the healing benefits and to not cause undue stress and imbalance. Intense emotions, tiredness or fatigue are signs of pressing too hard into the practice of mantra.  Creating routine and allowing the practice to unfold is the key to the success of mantra japa. So-Hum mantra is a wonderful mantra to begin with, as it is the natural mantra of the breath. With each inhalation and each exhalation the breath naturally repeats this powerful mantra. In the text supplement to the California College of Ayurveda, Dr. Marc Halpern guides the so-hum meditation in this fashion: “Allow your mind to become completely present. Bring your awareness within and follow the flow of your breath as it moves in and out of your body. (Pause) Do not control your breath, just be the witness as it moves in and out. (Pause) And now, with each inhalation I want you to listen within the breath for the sounds soooooo as you inhale and huuuuuuuum as you exhale. Let your breath and your mantra be your point of focus. If, at any time, your mind begins to wander, gently bring it back to your breath and your mantra.”  This is the secret in this meditation, find the mantra naturally within the breath rather than verbally repeating “So-Hum.”  Another mantra practice is reciting the Sanskrit name of the herbs that are being consumed. The names themselves are mantras and often times are broken into stories and legends that give keys into how they are used and employed as well as the energetics behind them. The act of story in this fashion speaks to the more subtle nature of the individual and works on the subconscious to heal from within.

Meditation

   In 2008 UCLA did a study on mindfulness meditation and its effect on the CD4 count of the individual. “This study provides the first indication that mindfulness meditation stress-management training can have a direct impact on slowing HIV disease progression," said lead study author David Creswell, a research scientist at the Cousins Center for Psychoneuroimmunology at UCLA. [62] The benefits of meditation on the immune system and stress are numerous. When given the opportunity to quiet the mind and let go of the attachments of the day - the mind, body and spirit are afforded an opportunity to heal. Meditation however is a challenging prospect for many and “to get there” is often a struggle. One must first understand that meditation cannot be taught. Meditation must be experienced. Only the technique to experience meditation can be taught. Some of the techniques noted above in the mantra section are useful as well as the use of breathing techniques such as alternate nostril breathing and observing the movement of the breath. Trataka, gazing at the flame of a lit candle or ghee lamp is another technique employed to help with meditation. One observes the candle without blinking and allows the initial tears to come and pass. Upon closing the eyes, the flame will still be able to be seen. Keep the gaze at this point until it is no longer there.  In Oshos translation of the Vigyam Bhairav Tantra, he writes, “Shiva proposes one hundred and twelve methods (for meditation). These are all the methods possible. … these one hundred and twelve methods are for the whole of humanity – for all the ages that have passed and for all the ages that have yet to come. In no time has there ever been a single man, and there will never be one, who can not say ‘ These one hundred twelve methods are all useless for me.’”  [63]
   When one is guided with a few techniques the inner light turns on and the remaining journey is lead from within. In the Yoga Sutras, sutra 1:4-6 refers to the waves and motions of the mind.  In any given 24 hour period the mind is attached and wrapped up within five states: right knowledge, wrong knowledge, memory, sleep and the stories that we imagine due to something we see, hear, smell etc [64] When one quiets the mind beyond these five states equilibrium is created; a certain detachment is cultivated and a deep awareness and connection with spirit is rekindled. In the practice of meditation one has the opportunity to connect with Self, consciousness or God. Experiencing this aspect of the divine instills faith, the most healing emotion to vata dosha and HIV.

Hatha Yoga

   Hatha Yoga, here referred as the general asana, posture, practice that all the styles in the west branch from. Since yogasana can increase the effectiveness of the immune system it has the potential to limit the damage the HIV virus can create. “The practice of yoga appears to improve the immune function in part by lowering levels of the stress hormone cortisol and yoga asana may boost immunity by improving the circulation of lymph, a fluid rich in disease-fighting white blood cells like lymphocytes.” When in states of secondary disease or fatigue long restorative postures such as child’s pose and savasana during a practice is very therapeutic. Grounding poses such as those were both feet are firmly on the ground help ground vata, in addition to hip compression and forward folds. Side lateral extensions and twists move the lymph and reduce pitta dosha. Back bends clear kapha and should be approached with care as they invigorate the nervous system. To stimulate the thymus, Pandit Rajmani Tigunait, PhD. Recommends two pranayama, breath techniques: Ujjayi and Bhramari. He also suggests meditating on the hollow of the throat.
   When one steps onto a yoga mat it is a different moment each and every time, those living with HIV need to pay particular attention to their bodies and ask “How am I feeling in this posture today?” Those that are feeling good are encouraged to do a normal, energetic yoganasana practiced balanced with plenty of restorative work. Iyengar methodology for HIV insists that one not strain during any pose or practice as well as supported inversions and restorative postures are prescribed.  [65]


Conclusion

   In the article, “Conversations With My Virus,” Shana Cozad writes a heroic journey of acceptance of her virus and how she transforms and spiritualizes her journey. “This disease is simply remarkable at bringing out the raw and emotional and scariest aspects of Life, or Death, and often at the same time. Our culture doesn't prepare us how to deal with death very well, and as far as I am concerned, our culture has haphazard way of preparing us for life anyway.” [66]
    Ayurveda guides one on the journey toward equanimity and harmony. The two goals of Ayurveda are: to keep the body in a state of health and free from disease, and, To show us how to use health as a basis of, or as a part of, the path to enlightenment. [67] As noted earlier Sanskrit, the language of the Vedas, has the uncanny ability, like modern URL’s, to guide us further and deeper into stories and secrets. Ayus = life. Veda = knowledge. Ayurveda - the knowledge of life. But when one meditates on this further, the question arises; what sort of knowledge? And what and how is life defined?  The knowledge gifted to us by Ayurveda asks us to look deep within and find the Sadguru, the teacher within; to spiritualize our circumstances and to learn from them. When, as Shana Cozad demonstrates so heroically, we transform ill fortuned circumstances and diseases like HIV into spiritual teachers, we can then see the knowledge Ayurveda may be hoping to impart.

Hatha Yoga Prayer

I offer this practice to the Sadguru, the Teacher within all things,
The Teacher that is the Prana (life) from which my body emerged,
The Teacher that sustains and nourishes me with each breath,
The Teacher whose lessons are in every life experience – even pain and death.
May this practice open me to the wisdom of the Sadguru,
That my mind may know peace,
That my heart may know compassion
And my life may offer peace and compassion to all beings.
Om Shanti, Om Peace
- Darren Main[68]

Appendix I

Related Studies on the Effects of Herbs in Anti-Viral Therapies

   The role of traditional, complimentary and alternative health care is rapidly changing in the world climate. A greater emphasis on complimentary and alternative health care, and its practitioners, is developing in the wake of economic downturns. Healthcare and Health Insurance prioritized as a moneymaking industry rather than the greater seva, act of service, to heal and promote longevity is unsustainable. Although the care received in hospitals and by Doctors is beneficial for the most part; when the bottom line speaks louder than the individual that lies ill, great tides of change can and must occur. Communities have taken into their own hands the motto, “I am my primary care physician.” By integrating alternative health care practitioners as a tool in educated themselves in preventative and natural care, individuals empower themselves to take their health into their own hands, thus creating a truly holistic approach to health which is the very core of Ayurveda.

   “Traditional, complementary and alternative medicine (TCAM), drawn from indigenous medical and/or healing knowledge systems from around the world, has for the last 30 years been recognized by the World Health Organization (WHO) as providing culturally acceptable, affordable and sustainable primary healthcare. TCAM knowledge has been known for some time to assist with birthing practices, acute injuries, infectious diseases and parasites.” “Specific examples include the use of TCAM practitioners for HIV/AIDS prevention awareness and direct treatment of AIDS-related symptoms; the use of TCAM herbs for the treatment of malaria and the use of home herbal gardens for health maintenance.”  (69)

   Below is a listing of articles and abstracts that contributed to the research of this paper.

Bombay Hospital Journal
   
    Dr. A.A. Mundewadi has been practicing Ayurvedic medicine for 25 years and has several published clinical works including one study on HIV. The results of his study showed Ayurveda to be effective anti-viral and immuno-stimulant as well as safe for long-term use. (70)    (www.ayurvedaphysician.com/)

   This study also brought forth some interesting results. One patient who subsequently died, had severe demyelinating disease of the brain (as diagnosed in a major hospital), and had lost most of his motor control and sensory senses, since several months. After being given Ayurvedic treatment for about 11/2 months he became alert, and could speak clearly, albeit temporarily, for 1 week. Another patient with Nephrotic syndrome resulting in long-standing generalized oedema (2 years) had complete regression of the oedema after 2 months of Ayurvedic treatment without any other treatment. One HIV positive patient with suspected malignancy of lung in the right upper lobe was steadily losing weight. After starting Ayurvedic treatment, he started putting on weight. This patient later underwent a CT-guided FNAC, the results of which are awaited. Another patient with history suggestive of HIV Encephalopathy was semi-conscious at presentation. He was passively fed on liquid diet and a combination of both modern drugs and Ayurvedic treatment. This patient became ambulatory within 2 weeks, and after 2 months of treatment he is faring well, even with a CD4 count of just 6.The above 4 instances indicate that the Ayurvedic medicines may have multi-faceted properties and need further evaluation.
Conclusion
   The retrospective study of 55 HIV positive adult patients treated with an Ayurvedic Herbal combination from April 1999 to November 2004 proved the Ayurvedic medicines to be considerably effective as anti-viral and immuno-stimulant,and safe on long-term use. A nutritious diet, Ayurvedic baseline therapy, timely allopathic treatment of Opportunistic Infections and regular counselling support appears to be an ideal combination in the management of HIV/ AIDS patients.
Acknowledgement
   The medicines used in this study were purchased from Chaitanya Pharmaceuticals, Nasik and Nahar Pharmaceuticals, Gujarat.
References
1    UNAIDS. Global Summary of the AIDS Epidemic. Update. December 2004.
2    UNAIDS. Epidemiological Fact Sheets on HIV/AIDS. India. Page 2. 1/9/2004.
3    Foundation for Integrative AIDS Research. Potential Anti-HIV Herbs. 15/9/2002.
4    Sharma PV. Vegetable Drugs. IV Edition. Chaukhamba Publications.1978:2.
5    Dahanukar S A, Kulkarni RA, Rege NN. Pharmacology of Medicinal Plants and Natural Products. Indian J Pharmacology 2000; 32 : S81 - S118.
 

*Ayurvedic Physician, T.M.C. Office Bldg., 1st Floor, Mumbra, Thane 400612.
(71)

 

 

 

 

Allopathic and Ayurvedic Approaches to Hypothalamic Amenorrhea (by Sharyn Galindo A.H.P)

See PDF document.

Allopathic and Ayurvedic Approaches to Leucoderma (by Rama D. Napolitani C.A.S)

Introduction

Leucoderma, also known as vitiligo is a skin disorder that affects nearly 2% of the world population. [1] Allopathy, the system of medicine in widespread practice today offers palliative measures, but no cure. By contrast, the Charaka Samhita , a two thousand-year-old Indian Ayurvedic text [2] , provides a description of leucoderma with recommendations for treatment . In this paper, the modern medical understanding and treatment of leucoderma will be discussed. Then, a detailed Ayurvedic analysis and approach to management will be presented.

Modern Medicine and Leucoderma

Leucoderma, a Latin word, meaning ‘white skin' is caused by the destruction of melanocytes; the cells responsible for skin color. There are many theories as to what may be responsible for causing leucoderma. Researchers have suggested an auto-immunological, neurological or auto-cytotoxic origin. None of these have been proven definitive. [3] The disorder is said to affect all races and genders equally and in 95% of cases, leucoderma manifests before age 40. [4] As for a possible hereditary link, approximately one third of cases report a family history. The most commonly afflicted areas of the body are the sun-exposed tops of hands and faces, and hyper-pigmented areas of the body, such as the groin, nipples, genitalia and axilla. [5] The disorder is not infectious, nor does it cause pathological harm. However, leucoderma does leave the skin aesthetically disfigured, often causing psychological and emotional stress.

In consideration of no known medical cure, allopathic treatment of leucoderma offers two approaches to the management of this disorder: protection of depigmented patches and repigmentation therapies. Due to the absence of melanocytes in depigmented skin, the body is unable to provide adequate UV light shielding from the harmful rays of the sun; thus protection of depigmented patches is of paramount importance. To minimize exposure to UV concentrated light, protective measures are encouraged, such as the application of Sunscreen 15-30 SPF or the use of protective clothing. 5 In addition to protecting leucodermic patches, many cosmetic products are available that act to camouflage the affected skin.

The second approach to the management of leucoderma focuses on repigmentation therapies. Common therapies are of three types: The topical application of potent corticosteroids, (PUVA) psoralen photochemotherapy and surgical therapies. Of these interventions PUVA is considered the most effective treatment available in the United States, however the treatments are time-consuming, side effects can be severe, 4 and complete repigmentation only occurs in 15-20%. 5 Interestingly, psoralens used with photochemotherapy are obtained from the ancient Ayurvedic herb known as Vakuchi (psoralea corylifolia). [6]

Ayurveda and Leucoderma

Ayurveda, a Sanskrit term meaning ‘science of life', is said to be the most ancient system of medicine in widespread practice today. In fact, the archeological findings of the ‘Bower Manuscripts' support the notion that Ayurveda has been in continuous practice for more than two millennia. [7] The practice of Ayurveda finds its roots in a body of knowledge and principles that were systematized in the Charaka Samhita , a treatise written more than two thousand years ago. In this ancient text a description and treatment for leucoderma is discussed. However, the basic theory, principles and objectives of Ayurveda will first be presented.

Ayurveda, an ancient healing system and a medical science, first seeks to restore, then maintain Svastha of the body and mind. S vastha, meaning health in English, has a definition in Ayurveda that, when fully understood, sheds much light on the objective of this system of medicine. Health is defined “as physical and mental well-being; freedom from disease, pain, or defect; normalcy of physical and mental functions; soundness.” [8] Ayurveda, defines Svastha in Sanskrit as:

“sama dosah samagnis ca sama dhatu mala kriyah prasannatmendriya manah svastha ityabhihiyate (Sushruta Samhita, 15.38)

One who is established in Self, who has balanced doshas, balanced agni, properly formed dhatus, proper elimination of malas, well functioning bodily processes, and whose mind, soul, and senses are full of bliss, is called a healthy person .” [9]

In this Ayurvedic definition of health, not only is the western concept of health encompassed, but there are other layers, that of the doshas, agni, dhatus, and malas. Hence, Ayurveda views health as a balance of the doshas which are vata, pitta, kapha (in consideration of one's prakruti), properly formed/functioning dhatus (seven tissues of the body), and proper elimination of malas (waste products). Thus, when Ayurveda looks at a disease such as leucoderma, invariably, these aforementioned factors are taken into account and discussed. Unique to Ayurveda, is its understanding and articulation of disease.

In western medicine when a disease or a group of symptoms is examined, analyzed, then given a name, the disease has been ‘diagnosed'. In contrast, the Ayurvedic approach to disease diagnosis seeks first to define its' root, or its' roganam mulakaranani; [10] it is considered as important to define the root of a disease as it is to name a disease.

In Ayurvedic medicine, the process by which a disease is understood and diagnosed is called s arvaroga nidanam and is composed of five parts: nidanam (causative factors or etiology), purvarupa (earliest signs/symptoms), rupa (clinical signs/symptoms), samprapti (pathogenesis of the condition), and upasaya (diagnostic tests). [11] Traditionally, when a disease is being discussed, the five parts of the sarvaroga nidanam will be presented. Indeed, the ancient Ayurvedic text, Charaka Samhita , presents skin disease (kustha) following this format.

Classical Ayurveda and Svitra

In Ayurvedic classical literature, such as the Charaka Samhita , leucoderma also known as ‘white leprosy‘ is called svitra or kilasa. [12] It is within volume III, chapter VII of this aforementioned text where “ kustha (obstinate skin diseases) and leucoderma are discussed. The sarvaroga nidanam of kustha and svitra share many common threads as will now be presented. [13]

Nidanam

The development of leucoderma in an individual is said to be caused by the incorporation of the following unwholesome regimes into their life:

• “Intake of mutually contradictory food, and drinks which are liquid, unctuous and heavy;

• Suppression of natural urges;

• Performance of physical exercise in excessive heat and after taking very heavy meals;

• Transgression of the prescribed order of the intake of food and with reference to heat and cold, as well as fasting;

• Use of cold water immediately after exposure to scorching sun, exertion, or exposure to frightening situations;

• Intake of uncooked food and/or intake of food, before the previous meal is digested;

• Excessive intake of food prepared of freshly harvested grains, curd, fish, salt, and sour substances.

• Untruthfulness, ungratefulness…insult of preceptors, sinful acts… misdeeds of past lives.

Purvarupa (earliest signs/symptoms)

• Excessive or absence of perspiration;

• Discoloration of patches on the skin;

• Horripilation, itching, pricking pain, physical exhaustion, mental fatigue

Rupa (clinical signs/symptoms)

• Daruna- when dosha (chiefly) vitiates the rakta or the blood, the patches will be red in color.

• Caruna- when dosha (chiefly) vitiates the mamsa or the muscle tissue, the patches will be coppery in color.

• Kilasa- when dosha (chiefly) vitiates the medas or the fat, the patches will be white in color.” [This is the most common rupa (clinical presentation) of svitra hence leucoderma is often called kilas]

Samprapti (pathogenesis of the condition)

In the Charaka it says the three vitiated dosha mix with the dhatus, namely the rasa, rakta, mamsa, medas, and result in the white patches. “Ayurveda maintains that leucoderma is caused by some morbidity of the liver” which is a vitiation of pitta. [14]

Below in table 1, is the authors' rendition of a samprapti for leucoderma. The format used for presentation was designed and created by Dr. M. Halpern as a tool to articulate a disease process.

Table 1 :     Samprapti and Herbal Chikitsa Summary –Vata-Pitta type Leucoderma

{vata pushing pitta, or primary pitta vitiation}

 

Stage

Evidence

Dosha

Sub-dosha

Dhatu

Srota

Category

A/A

Possible constipation and gas

Vata

Apana

Rasa

Purishavaha srota

Laxatives

Demulcents

Carminative

O

Mild, transient systemic dryness

Vata

Vyana

Rasa

Rasavaha srota

Demulcents

O

Mild transient feeling of cold

Vata

Vyana

Rakta

Raktavaha srota

Circulatory Stimulants

RMD

White skin patches with irregular edges, asymmetry

Vata

N/A

Rasa, Rakta, Mamsa, Medas,

Rasa, Rakta, Mamsa and Medo vaha srota

Skin tonics,

Liver tonics

RMD

Decreased Sweat

Vata

Vyana

Rasa

Rasavaha srota

Svedavaha srota

Demulcents

RMD

Worry/anxiety

Vata

Vyana

N/a

Manovaha srota

Nervine Tonics

Nervine sedatives

A/A

Possible loose stool, burning indigestion

Pitta

Pachaka

Rasa

Annavaha srota

Demulcents

Cool dipanas

O

Transient mild burning mucus membranes

Pitta

N/A

Rasa

Rasavaha srota

Demulcents

O

Transient mild feelings of warmth

Pitta

Ranjaka

Rakta

Raktavaha srota

Alteratives

RMD

White symmetrical skin patches

Pitta

Bhrajaka

Rasa

Mamsavaha srota, medovaha srota

Liver tonics,

Skin tonics

RMD

Excessive sweating

Pitta

N/A

Rasa

Rasavaha srota

Svedavaha srota

Alteratives

RMD

Anger, criticism

Pitta

Sadhaka

N/A

Manovaha srota

Nervine Tonics

Nervine sedatives

In the above samprapti, it is indicated that vata dosha accumulates in the purishvaha srota resulting in poor elimination, then overflows into the rasa and rakta dhatu. When vata relocates to the rasa and rakta dhatu it results in deficient flow through the rasa and raktavaha srota. Coupled with pitta vitiation, in due course, an altered functioning of the liver¹ 6 occurs, which in turn contributes to impaired elimination/management of impurities in the body. It is understood in Ayurveda, that deficient flow through the raktavaha srota vitiates posaka rakta (the building blocks of the mamsa dhatu). [15] Since the mamsa dhatu is responsible for healthy skin, it stands to reason that an impairment of the skin may result. In essence, an accumulation of vata and pitta dosha and ama (toxins) in the srotas and dhatus is resulting in impaired function, as well as inferior production, of tissue. Consequently, one can understand why the Charaka says, “The patient of svitra should (first) be cleansed by the administration of elimination therapies and thereafter” [16] employ other measures. Thus it is essential that ama and excess dosha be expelled from the body, only then can the restoration of healthy tissue commence. Next, Ayurvedic treatments (chikitsa) for leucoderma will be discussed.

Chikitsa (Overview)

An Ayurvedic treatment plan starts with measures to arrest the ongoing aggravation of dosha in the body. The digestive track is targeted first with the implementation of a dosha appropriate diet. For example, if pitta-dosha aggravation were present, then a pitta pacifying diet would be implemented. Salt intake should be minimized and restricted to rock salt only, as this will further expedite recovery from kilas. [17] Concomitantly, lifestyle would be closely evaluated for possible nidanam (causative factors), and these would be corrected. Once all correctable causative factors such as lifestyle and diet have been addressed, proper eliminative measure would be taken to facilitate the removal of ama (toxins) and excess dosha from the body. Eliminative measures must initially be employed, taking into consideration a patients' agni and level of ojas, then might herbal remedies prove effective. Purification kriyas such as oleation (application of oil), svedana (fomentation or heat therapy) and vrechana (purgation) are employed to (1) “loosen and liquefy ama” and excess dosha from the various sites of accumulation in the tissue, (2) mobilize ama and excess dosha, (3) facilitate removal of ama and excess dosha from the body. [18] An additional manner of purification often mentioned with leucoderma is called rakatamoksha (therapeutic bloodletting). In this treatment, excess pitta dosha in the rakta dhatu is being removed via one of the following methods:

• Removal of 300cc of blood via venipuncture (performed following oleation and svedana) [19]

• Topical application of leeches to affected areas.

A case study published in 2004 demonstrated complete resolution of vitiligo in a six year old boy whom had incorporated raktamoksha (per topical application of leeches) in his Ayurvedic treatment plan, “There was a marked difference in the skin color after the first (application). The skin started to appear pink. After a period of 2 ½ weeks leeches were applied again, the client continued with herbs and the local application of Bakuchi oil. Gradually the skin started getting back it's brownish hue, the hair on the scalp that had turned white at the patch started turning black again…patches regained their color fully after a period of two months” [20] With proper elimination of excess dosha and ama, then herbal remedies may prove effective.

Herbal Chikitsa

An abundance of herbs are mentioned in the Ayurvedic texts, many of which are readily available today. Several of these herbs have been studied in Indian laboratories. Interestingly, properties identified in the lab often support the Ayurvedically identified properties. For example, Khadira (acacia catechu), as a decoction, is recommended for treatment of leucoderma.¹ 6 The rasa of Khadira is bitter and astringent. Its' virya is cold, and its vipaka is pungent. It is said to balance both Pitta and kapha dosha. Laboratory studies have identified constituents shown to regenerate liver cells, as well as providing anti-fungal and anti-inflammatory effects. [21] A decoction of khadira and amla is recommended as a two-ounce dose every morning.¹ 7

Another herb, Vernonia anthelmintica (somaraja/kattu-shiragam/purple fleabane), is also reported to be an effective remedy for vitiligo. The rasa is bitter, virya is warm and the vipaka is pungent. In the Indian Materia Medica a few remedies with this herb are mentioned: (1) The powdered seeds of this herb taken with a decoction of emblic myrobalans (amalaki or nellikkai) and catechu. (2) The powdered seeds taken alone (1 tsp.) (3) The powdered seeds taken with black pepper or black sesame seeds in equal parts, daily in the morning, with warm water, just after perspiring. It is indicated that if one of the above methods is followed for one year, resolution of vitiligo will occur. [22]

However, the one herb most often mentioned with leucodermic treatment is Vakuchi (psoralea corylifolia Linn). This herb is recognized as being helpful for treatment by all the major medical disciplines, Ayurvedic, Chinese, Unani, as well as Western medicine. Vakuchi, also called Bakuchi or karpkarishi has a pungent and bitter rasa, a warm virya, and a pungent vipaka. [23] Most sources suggest taking vakuchi internally as well as topically. The seeds, as a powder (churna), are recommended for internal use. The parts of the plant used for topical applications are the essential oil extracted from the seeds, or a medicated oil prepared from the seeds. As a diluted essential oil, when topically applied to white depigmented patches, it is reported to act “on both the Rouget's cells and the melanoblastic cells of the skin…stimulation (of these cells) by the oil leads them to form and exude pigment which gradually diffuses into the decolorized areas.” [24] Other methods of preparation and administration of this herb are as follows:

• The paste of the seeds made with milk is rubbed into the affected parts of the skin. However if continuous application irritates the skin, the treatment should be discontinued for some time.² 5

• Equal parts of the seeds of Vakuchi, seeds of chakramarda (cassia tora), and the wood of Mahanimba (melia azdarach or persian lilac) made into a paste with rose water is applied over the white patches. The persian lilac can be substituted with Nimba (Indian lilac or neem) berries. [25]

• Another formulation including vakuchi, Pancha-nimba gutica or Pancha-amrita is recommended in daily doses of 4 drachms (this is equal 1 tablespoon). To prepare, take the five different portions of the neem tree, namely the flowers, fruits, leaves, bark, and roots 15 parts each powdered to 1 part each of the following substances: iron oxide, chebulic myrobalans, seeds of cassia tora, triphala, fruit of Semecarpus anacardium, embelia ribes, sugar, emblic seeds, curcuma longa, long pepper, black pepper, dry ginger, seeds of psoralea corylifolia, pods of cassia fistula and tribulus terrestris all powdered. Mix all together and make into paste in the juice of eclipta erecta. Then mix with the decoction (1 in 8) of the bark of acacia catechu. [26]

A final area of treatment comes into focus when considering the last nidanam (causative factor) of this disorder which is, “untruthfulness, ungratefulness…insult of preceptors, sinful acts… misdeeds of past lives.” This nidanam has its' roots in the concept of karma. The law of cause and effect can be seen manifesting in many diseases afflicting our society. A person smoking daily for the past 30 years, who is discovered to have lung cancer, illustrates the concept of karma in action. Lung cancer is the effect. Smoking a known carcinogen, daily for 30 years, is the cause. This is a simplified example of karma. A more complex example is the all too often 60-year-old obese male with elevated cholesterol complaining of severe sudden chest pain. After presenting to the hospital with elevated troponin levels and tombstone t-wave elevations per EKG, he is informed he is having a massive heart attack. When cardiac cathaterization reveals that some of the arteries leading to his heart are severely occluded, he is told that the cause of his heart attack is the severe arterial sclerosis, which was caused by his elevated cholesterol. He might then be told that the poor diet and absence of exercise that he reports caused his elevated cholesterol. In essence this is karma in action. The cause is a life long poor diet, coupled with the absence of exercise, resulting in elevated lipid levels, ultimately leading to the massive heart attack. While many behaviors are clear causes of disease, others are much subtler. Ayurveda encourages a regular practice of self-introspection such as meditation, by which an awareness and clarity of judgement develops. People shower and brush their teeth often to maintain cleanliness of body and mouth. A regular practice of meditation can provide a similar cleansing, of the mind and thoughts. Clarity of mind produces balanced judgment and right decisions which in turn promote right actions, hence healthy results.

“Character is nurtured midst the tempests of the world" -Goethe

Having once been rough and jagged, the weather worn surface of an ocean cliff is only now smooth and beautiful due to the indiscriminant sculpturing of powerful ocean waves. So too do the trials and tribulations of life have mysterious ways of sculpting beauty out of humanity. Perhaps disease is a method nature uses to sculpt and refine creation. Vitiligo like any other ailment affecting humanity is a manifestation of disease. In this paper its roots have been articulated, and Ayurvedic remedies presented. In Western medicine, reduction of symptoms alone is all too often the result. However, leucoderma stubbornly refuses to be cured by allopathic methods. On the other hand, many cases of leucoderma have been resolved with Ayurveda. The key to successfully treating disease is a comprehensive approach. Ayurveda offers this. The key to resolving Disease is to treat the root. Ayurveda offers this. Finally, the key to restoring health is to address the individual as a WHOLE. Ayurveda achi

References

[1] Zhang XJ, Liu JB, Gui JP, et al. Characteristics of genetic epidemiology and genetic model for vitiligo. J Am Acad Dermatol.2004, 51 (3): 383-90.

[2] Pillai, Kandaswamy. History of Siddha Medicine, Government of Tamil Nadu Manorama Press 1979 1 st Edition: pp. 192.

[3] Yu, Dr. Hsin-Su. Melanocyte Destruction and Repigmentation in Vitiligo: A Model for Nerve Cell Damage and Regrowth, J Biomedical Science 2002;9:564

[4] Moshell, Alan. Et al. National Institute of Health Pub No. 01-4909. May 2001

[5] Dr Su, R. Handbook of Dermatology & Venereology 2 nd Edition: www.hkmj.org.hk/skin/vitiligo/html

[6] Electronic Textbook of Dermatology—Botanical Dermatology, Phytophotodermatitis, www.telemedicine.org/botanica/bot5.htm . 01/06: pg. 1

[7] Pillai, Kandaswamy. History of Siddha Medicine, Government of Tamil Nadu Manorama Press 1979 1 st Edition: pp. 186-92.

[8] Webster's New World Dictionary, Simon & Schuster, Inc. 1988 3 rd College Edition: pg. 621

[9] Lad, Vasant D. Text Book of Ayurveda, The Ayurvedic Press 2002 1 st Edition: pg. 279

[10] Athavale, Dr. V.B. Pathogenesis in Ayurveda, Chaukhamba Sanskrit Pratishthan, Delhi , 2001, 2 nd Edition: pg. 141

[11] Halpern, Dr. Marc. Clinical Ayurvedic Medicine , California College of Ayurveda, 2005, 4 th Edition: pg. viii

[12] Dash, Bhagwan et al. Charaka Samhita, Chowkhamba Sanskrit Series Office, Varanasi-1, 2003: Vol. III, pp. 359-63.

[13] Dash, Bhagwan et al. Charaka Samhita, Chowkhamba Sanskrit Series Office, Varanasi-1, 2003: Vol. III, pg. 318-63

[14] Murthy, Dr.N et al. Ayurvedic Cures for Common Diseases, Orient Paperbacks, Delhi , 1995: pg. 94

[15] Halpern, Dr. Marc. Principles of Ayurvedic Medicine , California College of Ayurveda , 2003, 5 th Edition: pg. 3.19-20

[16] Dash, Bhagwan et al. Charaka Samhita, Chowkhamba Sanskrit Series Office, Varanasi-1, 2003: Vol. III, pg. 359-363

[17] Murthy, Dr.N et al. Ayurvedic Cures for Common Diseases, Orient Paperbacks, Delhi , 1995: pg. 95

[18] Halpern, Dr. Marc. Principles of Ayurvedic Medicine , California College of Ayurveda , 2003, 5 th Edition: pg. 8.19, 8-28, 8.39-41

[19] Ranade, Dr.Subhash, Natural Healing Through Ayurveda, Motilal Banarsidass, Delhi , 1999: pg.159

[20] Kelkar, Dr. Rucha: Vitiligo and Blood Letting- A Novel Approach: Compilation of Papers Presented at the National Ayurvedic Medical Association Conference 10/21-24, 2004: pp. 63-65

[21] Williamson, E. Major Herbs of Ayurveda, Churchill Livingstone 2002: pp. 13-15.

[22] Nadkarni, Dr.K. Indian Materia Medica, Popular Prakashan LTD Reprinted 2002, Volume 1: pg. 1269

[23] Gogte, Vaidya V.M. Ayurvedic Pharmacology & Therapeutic Uses of Medicinal Plants (Dravyagunavignyan), Bhavan's Book University 2000: pp.436.

[24] Nadkarni, Dr.K. Indian Materia Medica, Popular Prakashan LTD Reprinted 2002, Vol. 1: pg. 1021

[25] Dastur,J.F. Everybody's Guide to Ayurvedic Medicine- a Repository of Therapeutic Prescriptions Based on the Indigenous Systems of India, Taraporevala Sons & CO. Bombay-1, 1960: Pg. 209

[26] Nadkarni, Dr.K. Indian Materia Medica, Popular Prakashan LTD Reprinted 2002, Volume 1: pg. 783

[1] Zhang XJ, Liu JB, Gui JP, et al. Characteristics of genetic epidemiology and genetic model for vitiligo. J Am Acad Dermatol.2004, 51 (3): 383-90.

[2] Pillai, Kandaswamy. History of Siddha Medicine, Government of Tamil Nadu Manorama Press 1979 1 st Edition: pp. 192.

[3] Yu, Dr. Hsin-Su. Melanocyte Destruction and Repigmentation in Vitiligo: A Model for Nerve Cell Damage and Regrowth, J Biomedical Science 2002;9:564

[4] Moshell, Alan. Et al. National Institute of Health Pub No. 01-4909. May 2001

[5] Dr Su, R. Handbook of Dermatology & Venereology 2 nd Edition: www.hkmj.org.hk/skin/vitiligo/html

[6] Electronic Textbook of Dermatology—Botanical Dermatology, Phytophotodermatitis, www.telemedicine.org/botanica/bot5.htm . 01/06: pg. 1

[7] Pillai, Kandaswamy. History of Siddha Medicine, Government of Tamil Nadu Manorama Press 1979 1 st Edition: pp. 186-92.

[8] Webster's New World Dictionary, Simon & Schuster, Inc. 1988 3 rd College Edition: pg. 621

[9] Lad, Vasant D. Text Book of Ayurveda, The Ayurvedic Press 2002 1 st Edition: pg. 279

[10] Athavale, Dr. V.B. Pathogenesis in Ayurveda, Chaukhamba Sanskrit Pratishthan, Delhi , 2001, 2 nd Edition: pg. 141

[11] Halpern, Dr. Marc. Clinical Ayurvedic Medicine , California College of Ayurveda, 2005, 4 th Edition: pg. viii

[12] Dash, Bhagwan et al. Charaka Samhita, Chowkhamba Sanskrit Series Office, Varanasi-1, 2003: Vol. III, pp. 359-63.

[13] Dash, Bhagwan et al. Charaka Samhita, Chowkhamba Sanskrit Series Office, Varanasi-1, 2003: Vol. III, pg. 318-63

[14] Murthy, Dr.N et al. Ayurvedic Cures for Common Diseases, Orient Paperbacks, Delhi , 1995: pg. 94

[15] Halpern, Dr. Marc. Principles of Ayurvedic Medicine , California College of Ayurveda , 2003, 5 th Edition: pg. 3.19-20

[16] Dash, Bhagwan et al. Charaka Samhita, Chowkhamba Sanskrit Series Office, Varanasi-1, 2003: Vol. III, pg. 359-363

[17] Murthy, Dr.N et al. Ayurvedic Cures for Common Diseases, Orient Paperbacks, Delhi , 1995: pg. 95

[18] Halpern, Dr. Marc. Principles of Ayurvedic Medicine , California College of Ayurveda , 2003, 5 th Edition: pg. 8.19, 8-28, 8.39-41

[19] Ranade, Dr.Subhash, Natural Healing Through Ayurveda, Motilal Banarsidass, Delhi , 1999: pg.159

[20] Kelkar, Dr. Rucha: Vitiligo and Blood Letting- A Novel Approach: Compilation of Papers Presented at the National Ayurvedic Medical Association Conference 10/21-24 , 2004: pp. 63-65

[21] Williamson, E. Major Herbs of Ayurveda, Churchill Livingstone 2002: pp. 13-15.

[22] Nadkarni, Dr.K. Indian Materia Medica, Popular Prakashan LTD Reprinted 2002, Volume 1: pg. 1269

[23] Gogte, Vaidya V.M. Ayurvedic Pharmacology & Therapeutic Uses of Medicinal Plants (Dravyagunavignyan), Bhavan's Book University 2000: pp.436.

[24] Nadkarni, Dr.K. Indian Materia Medica, Popular Prakashan LTD Reprinted 2002, Vol. 1: pg. 1021

[25] Dastur,J.F. Everybody's Guide to Ayurvedic Medicine- a Repository of Therapeutic Prescriptions Based on the Indigenous Systems of India, Taraporevala Sons & CO. Bombay-1, 1960: Pg. 209

[26] Nadkarni, Dr.K. Indian Materia Medica, Popular Prakashan LTD Reprinted 2002, Volume 1: pg. 783

Applying The Knowledge of Ayurveda to Appraise the US Nutritional Paradigm

By Mrunalini R. Patel, BSc.

Ayurveda and the Treatment of Attention Deficit Dissorder: (By Ryan Strong)

     Ayurveda  is the worlds oldest and most complete holistic healing modality.  Although Ayurveda appears in the Rig Veda, dating back over 3000 years, it is widely believed to be  thousands of years older.  Ayurveda in relative terms is ancient, yet it is not a relic of the past.  Rooted deep in timeless wisdom, Ayurveda is ageless.  It has been continually practiced for millennium, passed down from generation to generation,  Ayurvedic medicine remains alive, enlightening and healing.

     Ayurveda recognizes life as one unified spirit that contains and connects the energy of the universe to the individual soul.  Ayurveda sees every life form as a unique combination of matter, spirit and mind.  It approaches healing by balancing the elemental forces that make up the physical and spiritual construct of our universe.  Ayurveda is the knowledge of how to live, this knowledge brings awareness of our situation here on earth, it is very practical and yet it is profound.   Awareness and understanding of our true selves, the environment, and how the two interact.  Ayurveda looks at the qualities inherent in all matter, to the energy that pulses through all life.

     According Ayurvedic theory, there are three main constitutions make up the body.  These constitutions are often referred to as doshas or humors.  Every person has a unique dosha, with different combinations of ether, air, fire, water, and  earth.  These elements combine to make up Vata, Pitta, and Kapha.  Vata dosha having more air and ether, with pitta being more so fire.   Earth and water make up Kapha dosha.  Ayurvedic medicine seeks to recognize the dosha in each person in order to understand any imbalances that may cause disease.  By examining the doshic qualities of modern diseases, Ayurveda can balance and heal them.

     One such ailment that widely affects people today is Attention Deficit Disorder (ADD).  This disorder was known and treated by Ayurvedic doctors in ancient times, and continues to be treated by Ayurvedic doctors today.  By looking at modern and classical Ayurvedic writings to shed light on the causes, we can learn holistic treatments that   can heal this disorder. This disorder considered benign by some, is very serious. Millions of people struggle with ADD, and the numbers continue to rise.

     ADD is defined by the Diagnostic and Statical Manual of Mental Disorders  as “ inattention, compulsive behavior, and hyperactivity.”[1]  According to the Attention Deficit Disorder  Association www.adda.org , over eight million adults, and two million children have a form of this disorder.[2]  People who suffer from ADD will have varying degrees of symptom intensity.  ADD may also be referred to as ADHA (Attention Deficit /Hyperactivity Disorder).  ADHD presents with more hyperactivity.   ADD is further classified as Adult ADD or Child ADD. This only indicates the age of the person who has ADD and is not a differential diagnosis.  ADD was recognized but not defined by the psychiatric world until the mid 1970's.  Up until the last couple years, some children diagnosed with ADD were thought to grow out of the condition as they got older.  It is now thought that children whose ADD symptoms disappeared as they grew up, were in fact wrongly diagnosed.  It is now believed by western medicine that ADD is a life long affliction.

     Most people can relate to feeling unfocused, and we all have made impulsive decisions. Certainly most people at one time or another have felt hyper.  So, what are the differences between common experiences, and what is experienced by people who have Attention Deficit Disorder?  This question makes it hard for doctors to diagnose ADD.   ADD is defined as having one or more of  three main symptoms; inattention, compulsive behavior, and hyperactivity.  In addition, there are nine defining secondary symptoms associated with ADD used to diagnose the condition.  The most common are insomnia, learning disabilities, and delayed language development.  The majority of people with ADD have two if not three of these secondary symptoms.

     A person suffering from this ailment will find it hard to complete tasks, meet deadlines, and manage their time.  Dr. Thomas Brown author of Attention Deficit Disorder, suggests ADD effects the executive functions of the brain, “ getting started, shifting focus, making an effort, being persistent, being organized, managing time, managing frustration, and retrieving things from memory”, can all be compromised when suffering from ADD.[3]    According to Dr. Russell Barkley www.russellbarkley.org, people who suffer from ADD have “impaired response, impulse control, poor sustained attention, remembering to do things, delayed development of language, poor rule following, and regulation of emotion.”[4]

     Any one symptom of ADD can pose a problem, but combined, these symptoms can create real life challenges to work, school, relationships, and just about every facet of life.   People who suffer from ADD will be plagued with many difficulties.  Dr. Russell Barkley lists that ,  “up to 36% of people with ADD will drop out of high school,  up to 40% suffer from low self-esteem, up 25% will suffer from clinical depression, and up to 25% will suffer from long term addiction to drugs and or alcohol.”[5]

     According to Kenneth Appelbaum in The American Journal of psychiatry, up to 45% percent of American inmates may suffer from ADD.[6]   Although there has never been a widespread study on  American inmates, a study published by the  Norwegian  University of Science and Technology, suggests that ADD is very prevalent in the inmate population in Norway.[7]   The Suicide and Mental Health Association International, http://suicedandmentalhealthassociationinternational.org, website, Lists higher rates of  “failed marriages, motor vehicle accidents, teen pregnancy, and increased rates of suicide by ADHD sufferers.”[8]   In the book Driven To Distraction by Dr. Edward M. Hallowell and  Dr. John J. Rately, they suggest that men and women who have ADD will seek out stimulation, negative or positive, from drugs, sex, and  excess eating.  A study published by the a Nutritional Disorder Clinic in Toronto Canada, suggests a link between obesity and ADD.[9]  It suggests  that  treating ADD may became an affective tool in fighting obesity.

     ADD can damage the health of the person who has it.  The inability to focus and to be able manage ones time, actions, and thoughts can create real hardships in all aspects of life.  Failure can strongly weigh upon a person with ADD, when they are unable to meet goals necessary to move forward in life.  This syndrome does not just effect the individual, but also affects the society as a whole.

     Author and Psychologist Dr. Edward M. Hallowell states that,” ADD is almost always accompanying problems such as a learning disabilities and or low self-esteem,” and that if left untreated, “it leaves millions of children and adults misunderstood and unnecessarily floundering and even incapacitated.”[10]

     Western medicine does not know the cause of ADD.  There are several theories that underline possible causes of ADD, but nothing has been proven.  Some believe exposure to environmental toxins while in the womb may have caused ADD.   Others blame sensitivities to sugar, and synthetic food additives.  The increased exposure to television and the internet is a popular theory.  Many authors will site the combination of all three of these.  However, there is no consensus, or solid evidence supporting  them.  Currently the most accepted theory is that ADD is a genetic disorder, and that is hereditary.

     Scientists have compared brain function and activity of  a person with ADD to that of a person without it, using various tests that take images of the brain.  According to the Dana Foundation www.dana.org, an organization dedicated to the study of brain science,  “people with ADHD have differences in brain structure and function, especially in chemical regulation of dopamine and norepinephrine.”[11] , suggesting that lower levels of these neurotransmitters may cause ADD symptoms.  Dopamine and norepinephrine have critically important roles in our brains, both are key for stimulating many different areas of the brain in order for us to function properly, and especially in stimulating our brains in order for us to focus.  Current research indicates the frontal lobe, basal ganglia, caudate nucleus, cerebellum, as well as other area of the brain, play a significant role in ADHD (ADD) because they are involved in complex process that regulate behavior.”[12]  The role of dopamine and norepinephrine regulation in patients with ADD is considered the most important in treatment, from a western science view point.

      The treatment for ADD consists of medication, counseling, and cognitive  behavioral therapies, with the main focus being pharmaceutical medications.  The most commonly prescribed medications are central nervous system stimulants like Ritalin and Adderal.  Both theses medication speed up the release of dopamine and norepinephine,  increasing brain function.  Anti depressant drugs and other non-stimulant drugs are also used.  It is thought that anti depressant medications will increase up take and absorption of neurotransmitters in the brain, thus increasing brain activity.

     Both types of medication are prescribed to children and adults. These medications do not cure ADD.  The symptoms associated with ADD cease only for the time the medication is active within the body.  When the medication wears off, the symptoms return.  A patient taking these medications are to continue taking them throughout their life.

     In order for an  Ayurvedic treatment of ADD, the disorder must be seen from a Ayurvedic perspective. The doshic imbalances that cause the symptoms of ADD must be recognized in order to balance them.  Looking for references in the Caraka Samhita in regards to ADD, we can interpret what ADD would have been classified by Ayurvedic doctors during ancient times.  Although the western classification will not be identical, the symptom picture will remain the same. We can find passages in the Caraka Samhita that sight symptoms associated with inattention, hyperactivity and compulsive behavior.

     The inability to keep a steady thought stream or focus, is described in the Caraka Samhita as one of twenty main blocks of Vata in the body.  In chapter  XXVIII  verse 198, The Caraka Samhita states, “ If vyana-vayu is occluded by prana-vayu, then there will be loss of all the senses, and there will loss of memory as well as strength.”

     The Vata dosha is a combination of ether and air.  The qualities of Vata are light, cold, rough, and subtle. Because of these qualities, it is the most changeable and moveable. Being that it is the most moveable, it can easily become imbalanced, and cause imbalances in the other doshas, Kapha, and Pitta.  Vata plays many roles within our bodies and minds.  Vata dosha being in balance is vital to the health of our bodies and mind.  Vata, although one dosha, is divided up into five sub-categories, classifying the different actions and movements of Vata into and out of our body.

     The two sub-categories referred to in the cited quote from the Caraka Samhita refer to Prana and Vyana.  Prana Vata is responsible for bringing in  all of the sensory perceptions of the environment outside of us.  Prana Vata relays information we experience from the world around us to the mind through the nervous system.   According to Ayurveda the nervous system and Prana Vata are intricately connected.  Proper function of Prana Vata is key for proper neurological function.

     Vyana is the circulation and movement of the Prana once it is in the body and mind.  Because of the world around us, the Prana we take in may in a sense become toxic.  These sensory impressions may be considered toxic for the following reasons: they may not be harmonious, they may be become too much, and over load or overwhelm the neurological system.  Prana can obstruct Vyana, and because of this, Vata dosha in the mind and body may become disturbed.  This disturbance is an over stimulation of Prana Vata.  According to Ayurveda too much stimulation can increase the prana of the mind.  This excessive movement of the mind due to an over stimulation of the neurological system deranges the mind, and upsets the balance of our bodily system as a whole. The high Vata in the mind will not only cause emotional and behavioral symptoms but will also manifest as bodily distress as well.  Vata can cause numerous symptoms that include weight loss, weight gain, constipation, hyperactivity, insomnia, disorientation, confused speech, light headed, confusion and depression.  Dr. David Frawely states that, “ Vata is aggravated by excess and wasteful mental activity like worry and too much calculation about things,” he goes on to say that, “ Vata people should not read too many newspapers or magazines, or watch several television programs at the same time, as these agitate Vata and the mind.”[14]

     To look at another cause of ADD we may examine the description of mental illness in the Caraka Samhita,  Ch IX, verse [6-7], it describes that “unmada (mental illness) is a wandering mind, intellect, consciousness, knowledge, memory, inclination, manners, activities and conduct.”[15]   Describing the possible causes for imbalances, it says that any one or all of the three doshas, Vata, Kapha, Pitta, may cause mental illness, or mental illness may be due to outside factors.

     The outside factors that may cause, what Ayurveda deems “a wandering mind”, may be  the environmental pollutions of the modern world.  An exogenous factor causing ADD may be the vast  amount of  information we are exposed to through our eyes and ears. With the inventions of modern transportation, film, TV, internet, cell phones, video games, and so forth.  These images may be too much for some brains to process.  They may disturb the flow of Vata, and damage the nervous system.  Not only is the mind subjected to fast moving images and sounds, but it has to deal with the consequence of  their qualities.  Many images are in fact negative, and can also cause disturbances in Vata.  Mass media may be considered to be harmful because of it's over stimulation.  This over stimulation  is also often accompanied by negative subtle forms of advertising, that among many things: subjugates women, propagandizes violence, war, and greed.   According to the Nielson report, a company that tracks advertising and programing, “the average person is exposed to 1600 advertising messages a day,  has their TV on for 7.5 hours and watches about 4.5 hours daily.”[16]

     Prana is not just the images we see, but it is also the smells, textures, tastes and sounds.  It is the food and water we consume.  Exposure to harmful toxins in our food and water may be other exogenous factors.  Fluoride, a chemical found to lower cavities, is added to the water supplies across the United States.  In fact, according to a study done in Brazil at the University Federal de Parana, fluoride even in small quantities may cause “memory impairment” and is considered harmful to neurological function.[17] Other factors may include the standard American diet.   According to the American Heart Association,  “The average American consumes 22 teaspoons of sugar a day.”[18] Many people eat processed foods that contain additives like MSG and caffeine.  The outer environment for many humans is harmful, sometimes deadly.  Many cities and towns are polluted exposing humans to harmful pathogens, chemicals, and air pollutants.

     Attention Deficit Disorder may be a result of too much exposure to the harmful substances in our environments, of too much Prana flowing into our nervous systems. The over stimulation of our  day to day lives, may increases the flow of Prana Vata until it is too much for the body to handle.  Vedic scholar  Dr. David Frawely describes it as  ''Vata (high air) is damaged by too many stimulating impressions, particularly those of an artificial nature.”[19]

     Vata is a combination of air and ether.  According to Dr. Marc Halpern a leading Ayurvedic healer and educator, “ In the case of hyperactivity and attention deficit disorder there is an excess in the qualities of air and ether and deficiency in the qualities of earth.  Hence, from the perspective of Ayurveda, ADD and ADHD are conditions of increased expansive and creative energies and decreased in stability.”[20]  To treat the symptoms of ADD,  Ayurveda seeks to counterbalance the unstable elemental forces of ether and air by increasing the grounding element of earth.

     In treating ADD, Ayurveda approaches the symptoms and the underlying causes by working with many treatments, including diet and lifestyle changes and specific herbs that  improve cognitive function.  These treatments include cleansing possible toxins known in Sanskrit as Ama, that have built up in the body and even the mind.  To treat ADD,  Ayurveda looks at each individual case, and does not prescribe one treatment, nor does it view any one protocol to be appropriate for any one person.  Everyone has a unique make up of doshic qualities, with varying degrees of elemental make up.  Each person has a different level of strength, or vital energy.  Vital energy in Ayurveda is known as Ojas.  Determining the level of the ojas is key in any treatment plan of ADD.  If  the cause of the doshic imbalance is deemed that of exogenous factors, treatment may include cleansing toxins from the body and mind.  However, if the ojas in the individual is low, cleansing is contraindicated, because cleansing may increase depletion of Ojas.    

     ADD is a Vata disorder, that has increased elements of air and ether, this causing too much movement in the mind and body.  To balance Vata, actions, food, and herbs of apposing qualities of ether and air are administered.  The increased Prana causes agitation to the nervous system. This flow must be slowed, grounded and stabilized.  Herbal medicines, routines, and foods that are slow, heavy and sweet have the elemental qualities of earth. They generally build tissues and ojas, which will nourish and calm Vata. 

     To fully treat ADD Ayurveda seeks to reverse the cause of the imbalance.  This is paramount and must be looked at and dealt with for healing inattention, compulsive behavior, and hyperactivity.  To reverse the cause of ADD, a lifestyle that is first and foremost regular must be experienced.  Regularity of sleep patterns, eating patterns, and avoiding anything that disrupts, or over stimulates the senses.  Steady routines stabilize Vata and negate the ill effects that irregularity causes. Individuals with ADD also must limit activities like TV, internet, and travel. They must avoid stimulants like refined sugar and caffeine.  The relief an individual may experience by using stimulates to see through the fog of inattention is momentary.  The use of stimulants will increase the disturbance to Vata, and will  weaken the nervous system, and lower ojas.  Over stimulation of any kind must be completely avoided, and is vital for successful long term treatment.  Building Ojas is key to having and maintaining healthy minds, nervous systems, and bodies.  Healthy levels of Ojas will help stabilize the mind and counter the symptoms of inattention, compulsive behavior, and hyperactivity. Ojas will also protect people from substances or environmental factors that cause Vata disturbances.   Creating consistent patterns in our life, avoiding mass media, building Ojas, and clearing Ama in the the mind and body will heal ADD.

     Ayurveda utilizes a large spectrum of herbal remedies to address neurological disorders caused by doshic imbalances.  Holistic Ayurvedic herbal medicine seeks to bring balance to the entire body system. For example, if a person is suffering from symptoms like inattention, hyperactivity, or compulsive behavior, Ayurvedic medicine will employ herbal remedies that both seek to give symptomatic relief, and repair and rebuild healthy tissues in the entire body.

     Rasayana therapies that include herbal preparations are useful tools in treating the nervous system and mind of a person suffering from ADD.  Rasayana is defined as rejuvenation.  Ayurvedic rejuvenation therapies that will treat both the Vata in the mind and nervous system, according to The Ayurvedic Encyclopedia are, “oil and ghee therapies are given to remove block.”[21] The Ayurvedic Encyclopedia also includes “abhyanga, ingestion of ghee to stimulate the mind, intellect, memory, and consciousness.”[22] The Ayurvedic Encyclopedia also sites the use of the herb Brahmi with ghee.[23]

     In the case of ADD a herbal medicine prepared with the herb Bramhi (bacopa monniera) would be administered.  A study done in Australia by the Brain Sciences Institute at Swinborne University in Victoria, studied the effects of Bramhi on people. The study revealed to modern scientists what Ayurveda has known for centuries,    noting; “cognitive enhancing effects in healthy humans after 90 day administration of the bocapa monniera extract.”   Other therapies to improve the mind and nervous system include nasya, mana shuddi, and pratyahara.

     Nasya is medicated oil administered into sinuses through the noise. Nasya medicated with herbs that ground Vata, and clear the mind will be very helpful in the treatment of  Vata symptoms associated with  ADD.  According Vedic scholar Dr. David Frawley, “ Nasya and neti are important treatments of Vata conditions in the nervous system and mind”... “They help restore the organic equilibrium of the mind and body and hormonal secretions that hormonal secretions that are ruled by Prana.”[25]

     Mana Shuddi is mental cleansing. This can be achieved by pratyahara, which is fasting from one or more of the senses.  Resting our senses by withdrawing from hearing, seeing, touch, tastes and smell, we rest the nervous system and also cleanse the mind. Both of these practices help build Ojas and increase the stability of the mind. According to The Ayurvedic Encyclopedia the yoga posture Shavasana, also known as corpse pose is a good way to practice Pratyahara.[26]

     The Ayurvedic approach is to balance elemental qualities by determining the underlying doshic imbalance, state of ojas, and toxin (ama) build up.  Attention Deficit Disorder can be fully treated by Ayurveda.  The combination of symptoms may be the result of a combination of causative factors.  Regardless of the causes western medicine may discover for ADD, be it genetic, environmental, dietary, or a combination of all three, the Ayurvedic treatments will remain the same, and stand the test of time. The treatment will remain as effective today as it was 3000 years ago.  However it is clear from the research that ADD is serious, for the individual suffering from it, and the effects on the society as a whole. The modern day world is over stimulating  to the senses, and toxic to the mind and body. To combat ADD and to reverse the causes, we must reduce the speed and volume of modern life.  We must live in the natural rhythms of day and night.  The food we eat need to be appropriate for our needs, organic and fresh. The air we breath must be clean, and the water we drink and give to our children must be pure.

     Vata is the most sensitive dosha, exhibiting symptoms of imbalances much Quicker than the other doshas.  Perhaps it might be wise to view ADD, as an early warning.  Maybe those suffering from these Vata imbalances or “ADD”, are the metaphoric canary in the mines.  An alarm, warning us of the deeper issues that may come to manifest.  The rising ADD population may represent pending issues the world faces.  The human species is living out of balance from nature and because of that, the planet as a whole is suffering.   Using Ayurveda as a lens to perceive the world, we can both heal much of what has been done, and we can see the causes for the issues.  Ayurveda works both to minimize and end suffering, but more importantly, it seeks to reverse the cause.   Ayurs is the root sanskrit word meaning “to align”.  It is this aim of aligning with spirit, mind and body that Ayurveda seeks to attain.  It is the truth of our reality that we must align ourselves with, to live in, and to abide in.  The pure radiance of health and happiness is our birth right.  Living in balance and harmony is not some idealistic dream,  but a life style we can fully realize.  It is not a foreign science we must adopt, but is the unnatural lifestyle of most modern cultures we must un-adopt.  Living in balance is moving through  life with our hearts fully open, and hearing life by listening to our soul.  Only then can we live in alignment, to be in tune with our higher self.  From our higher-self we know and make right choices. This is what it means to live righteously.  To make the right choices, from the foods we choice to eat, from  how we eat them, and for all the other millions of decisions we make. In ayurs, in alignment we simply  live right.  This is Ayurveda, this is knowledge of life.

 

References 

1.  The American Psychiatric Association, The Diagnostics and Statistical Manual of Mental Disorders 4th Edition: (Washington D.C.: The American Psychiatric Association, 1994) 85.
2.  The Attention Deficit Disorder Association.  Www.add.org.mc/page?citepageid=92501eorgid=atdda. “Over eight million people”  (1996-2009)  11/25/09
3.  Brown, E. Thomas,  The Unfocused Mind in Children and Adults: (New York: Integrated Publishing Solutions, 2005) 21.
4.  Russel, A. Barkley PhD. D. The Official Site www.russelbarkley.org/adhd.fucthtm.  “Up to 36% of people with ADD.” (2006) 11/15/09  “Getting started, shifting focus.”  (2009)  11/15/09
5.  Russel, A. Barkley PhD. D. The Official Site www.russelbarkley.org/adhd.fucthtm.  “Up to 36% of people with ADD.” (2006) 11/15/09  “Getting started, shifting focus.”  (2009)  11/15/09
6.  Kenneth L. Appellbaum, M.D., “Assessment and treatment of correctional inmate with ADHD,” The American Journal of Psychiatry 165( December 2008):1520 
11/25/09  Http://ajp.psychiatryonline.org
7.  U.S. National Library of Medicine.  Www.pubmed.gov.ncbi.nlm.nih.gov/sites/entrez.  “prison ADD”  Rassmusen K. Alvmikr. J am acad psychiatry law. (2001) Pmid 29 (2) : 186-93. 11/25/09
8.  The Suicide and Mental Health Association International.  Www.suicideandmentalhealthassociationinternational.org/adhsui.html.  “Failed marriages, motor vehicle accidents”  (2004-2006)  11/25/09
9.  Fleming, Levy.  Nutritional Disorder Clinic.  Http://www.ncbi.nih.gov/pubmed//9223848?itool
“Obesity and ADD.”  Pmid: 19223848 : Canada (2009) 11/25/09
10.  Hallowell, M. Edward; Ratey, J. John, Driven to Distraction : (New York:  Simon and Shuster, 1995)Preface xi.
11.  The Dana Foundation.  Www.dana.org/news/brainnews/detail.aspx?id=10398.  “People with ADHD have differences in brain.”  Mchann, Guy MD.  (2007) 11/25/09
12.  The Dana Foundation.  Www.dana.org/news/brainnews/detail.aspx?id=10398.  “People with ADHD have differences in brain.”  Mchann, Guy MD.  (2007) 11/25/09
13.  Sharman P. V. , Charaka Samhita : (Varanasi: Chaukambha Orientalia, 2003) 481.
14.  David Frawely, AYURVEDIC HEALING FOR HEALTHCARE PROFESSIONALS PART IV :(New Mexico:NorthAmerican Institute for Vedic Studies, 2006)66.                                        
15.  Sharman P. V., Charaka Samhita : (Varanasi: Chaukambha Orientalia, 2003)160.
16.  The Neilson Company.  Http://blogneilson.com/neilsonwire/online-mobile/americans.  “The average person is exposed to.”  (2009) 11/25/09
17.  U.S National Library of Medicine.  Www.ncbi.nlm.nih.gov/pubmed/19957215?itool.  “Memory impairment”  Pereira Dombrowski.  Sector de ciencias biologicals. Brazil. Pmid: 19957215 (2009) 11/25/09
18.  American Heart Association.  Www.circ.ahajurnals.org.  “The average American consumes.”  R.K.
Johnson  (2002)  11/25/09
19.  David Frawley, Ayurvedic Healing for Healthcare Professionals Part IV : (New Mexico: North American Institute for Vedic Studies,2006)62.
20.  California College of Ayurveda.  Www.ayurvedacollege.com/articles/drhalpern/clinic/hyperactivity-add.  “In the case of hyperactivity and attention deficit.”  (2009)  11/25/09
21.  Tirtha, Swami Sada Shiva, The Ayurvedic Encyclopedia: (New York: Ayurvedic Holistic Center Press, 1998)466. 
22. Tirtha, Swami Sada Shiva, The Ayurvedic Encyclopedia: (New York: Ayurvedic Holistic Center Press, 1998)467.
23.  Tirtha, Swami Sada Shiva, The Ayurvedic Encyclopedia: (New York: Ayurvedic Holistic Center Press, 1998)468.
24.  U.S. National Library of Medicine.  Www.ncbi.nlm.nih.gov/pubmed/18683852?itool.  “Cognitive enhancing effects in healthy.”  Stough C. Downy: Brain and Science Institute. Australia. Pmid: 18683852.  (2008)  11/25/09
25.  David Frawley, Neti, Healing Secrets of Yoga and Ayurveda: (Wisconsin: Lotus Press,2005)54.
26.  Tirtha, Swami Sada Shiva, The Ayurvedic Encyclopedia: (New York: Ayurvedic Holistic Center Press, 1998)280.

 

Ayurveda – An ancient healing system’s gifts to the Modern Woman

Ayurvedic Approach to Age-Associated Macular Degeneration (by Rammohan V Rao PhD,C.A.S)

Abstract

Macular degeneration also called as Age related macular degeneration (ARMD) is an age
associated chronic eye disease and is a very common cause of reduced vision among
older individuals over the age of55 years. The condition is characterized by degeneration
of light-sensing cells of the central region of the retina - the rnacula which malfunction
and eventually die, resuhing in a gradual decline and loss of central vision, while
peripheral vision is retained. MD is the main cause of blindness in the United States and
accounts for blindness in approximately 80 percent of people who are 75 or older. The
condition affects more than 10 million Americans and this number is predicted to
increase as the ''baby boomers" age.

Eyes, Vision and Macular Degeneration

The retina, which is situated at the back of the eye, contains an extraordinary
photosensitive array ofcells that line the back ofthe eye. The light fulling onto these cells
in the retina is transfurmed into electrical signals which arc transmitted to the brain
centers !bat process and interpret them. The retina has two main parts - the macula and
the peripheral retina 1-3.
The rnacula is the part of the retina that is responsible fur seeing line detail (see fig
below), such as reading, seeing fueial features and interpreting different colors. The
macula is made up of densely packed light-sensitive cells called cones and rods. These
cells, particularly the cones, are essential for central vision. The cones are responsible for
color vision, and the rods enable the individual to see shades ofgray 1-3

The choroid is an underlying layer of blood vessels that noutishes the cones and rods of
the retina. A layer of tissue furming the outermost surfuce of the retina is callcd the
retinal pigment epithelium (RPE). The RPE is a eritical passageway fur nutrients from the
choroid to the rerina and helps remove waste products from the retina to the choroid. It is
this part of the retina that is affected by age-related macular degeneration and results in
debilitating loss ofvital central or detail vision 1-3.

Types of Macular Degeneration

Read Full Article

Ayurvedic Approach to Down Syndrome (by Vidya Venkatesh A.H.P.)

See PDF document.

Ayurvedic Approach to Stress (by Jeff Mortlock C.A.S)

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Ayurvedic and Allopathic Approaches to Migraine Headaches (by Patricia J. Brinkmann B.S., A.H.P)

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A Survey of Marmani Chikitsa By: Emily Laine Levoy

Introduction

   Ayurveda, the knowledge of life, is India’s most ancient system of healing.  Its fundamental aim is to bring each and every one of us into alignment with our true nature as Spirit, and thus allow us to be our best, healthiest, Selves.  Through the application of myriad therapies using herbs, colors, aromas, foods, breath, movement, meditation, oil, massage and more, Ayurveda prescribes a unique program to balance the unique constitution of each unique individual that exists in the world. 
 
   Ayurveda’s origins are in Samkhya philosophy, which teaches that in the beginning there existed only Purusha, the potential for pure consciousness, and Prakriti, the potential for pure matter.  Purusha desired to know itself and merged with Prakriti in the act that was the beginning of the world as we know it.  From this merging the cosmic vibration of Aum emerged, the qualities of Sattva (clarity or mind), Rajas (motion or life), and Tamas (inertia or matter) were produced, and the five basic elements of earth, water, fire, air, and ether were created.  The elements are the building blocks for all that exists, and their physical and subtle forms are the basis for Vata (physical air and ether), Pitta (physical fire and water), and Kapha (physical water and earth), and for Prana (subtle air and ether), Tejas (subtle fire and water), and Ojas (subtle water and earth).  It is with these six elemental combinations that Ayurveda diagnoses and treats it’s patients.   
 
   Under the umbrella of Ayurvedic treatments falls Marma Therapy, also called Marmani Chikitsa, which involves the stimulation of sensitive points to promote healing in the physical, mental, and energetic planes by affecting the flow of prana.  Marma points can be found all over the body from the hands and feet to the trunk and head, and when manipulated via massage, pranic healing, oil and herb application, heat, or pressure, can “alter both the organic functions and structural conditions of the body” (Muley).  Since all was created from Purusha and Prakriti, all matter is fundamentally the same.  While it may be difficult to perceive this oneness of all, marma points provide a super sensitive entry point into these more subtle realms of the physical-energetic connection that resides in all of us.  In the words of Dr. Vasant Lad, “Like quantum mechanics, Ayurveda holds that a human being is not a solid, stable material structure but an ever-changing, dynamic collection of energy and intelligence in the larger field of energy and intelligence that is the universe.” (Lad, 19)   Marma points are vortexes of prana, the life force that can be used as a gateway into this dynamic field.
 
   The purpose of this exposition is to provide a general overview of the origins and classical uses of marma, as well as a survey of the application of marma therapy in the modern age.  For in depth information on any specific marma point, therapy, or Ayurvedic concept please refer to the copious information available in the sources cited at the end of this paper.

History and Evolution:

   The aim of marma therapy in the modern day is to promote healing, however as vital points of life marma have also been used for harm.  In his course on marma therapy, Dr. Marc Halpern said, “any area of the body that can be harmed with a forceful blow can be healed with a therapeutic touch,” and it is this dichotomy that can be seen in the history and evolution of marma.  An important part of Ayurveda, Yoga, and the martial arts of Southern India, marma originated in the most ancient of Indian civilizations known as the Indus-Sarasvati culture (3500 - 1700 BCE) which was located in the north of India and evolved along with other Vedic disciplines from this time.2 Emphasized as a means to inflict injury on an opponent, as guidelines for healing wounds,4 and as a map for the use of body armor in combat, marma points were an integral part of South Indian martial arts and “the path of the warrior who learned to master his Prana for both defensive and offensive purposes”(Frawley, 8).  Wartime surgeons in classical times were versed in the energetics of marma points in order to provide the best possible care on the battlefield.8  References to marma points can be found in a wide variety of ancient texts including the Rig Veda, Mahabharata, Charaka Samhita, Sushruta Samhita, and classical yogic texts where marmas are incorporated with asana, pranayama, and the nadis.2
 
   A noted Ayurvedic surgeon, Sushruta is recognized as the leading contributor to the classical study of marma.  His text, the Sushruta Samhita, defines marma as fatal spots8 and contains details for manipulating marmas through surgical techniques and in the treatments of acute conditions.  In the section of his text on anatomy there exists documentation on the location and effects of each marma point (detailed below) and this knowledge has evolved with each generation of practitioner.4 
 
   Interestingly, in his commentary of the Sushruta Samhita, Prof K.R. Krikantha Murthy specifically comments on the use of marma for therapeutic effect as is common in modern day.  “
  • A recent trend among some Ayurveda scholars is an attempt to equate and correlate knowledge of Marma with the ancient Chinese method of treatment known as Acupuncture.  Though recognition of special spots on the body is common to both, the aim of approach of each one is thoroughly opposite of the other.  While Ayurveda describes the ‘Marma’ as seats of prana… the descriptions are mainly intended to warn the surgeon not to cause injury [where as] Acupuncture… spots are considered centers of ‘vital energy’ that when stimulated by sharp needles… brings about cure of many diseases.  Nowhere in Ayurvedic texts is there any suggestion of meddling with the Marma for either relief of pain or for cure of diseases” (Murthy, 115). 
   Dr. Frank Ros, however, states that errors were made in earlier translations of the Sushruta Samhita, and upon further review, “evidence was found showing that the marmas correspond precisely with traditional acupuncture points used to treat the vital organs in the flow of qi” (Frawley, 215).  The terms dhamanis and siras were previously misinterpreted to mean arteries and veins, when actually they correspond to the channels, which control the flow of prana (or qi).  Many prominent Ayurvedic scholars agree with Dr. Ros’s statement, including Dr. Vasant Lad whose entire book, Marma Points of Ayurveda, is a comparison of Marma and Acupuncture 
Whether marma were classically used for healing or not, it is nonetheless now commonly used as such in Ayurvedic clinics and schools around the world.

Locations, and Categorizations:

   According to Sushruta and Dr. David Frawley there are 107 marma, though others including Vagbhata and Dr. Vasant Lad indicate there to be 116 or 117.  Vagbhata says that “structures which show irregular pulsation and where the pain on pressure persists can be labeled as Marmasthana” (Muley).  Sushruta categorizes marma according to the following tissue types: Mamsa (Muscular) Marma, Sira (Venous) Marma, Snayu (Ligament) Marma, Asthi (Bony) Marma, and Sandhi (Joint) Marma.8   Some say marma may contain all five tissue types, and some may contain only two.  Marma can be measured by the unit angula, which are defined as “the width of the patient’s middle finger measured across the proximal interphalangeal joint” (Lad, 316).  
   
   The following table and diagram of marma points with their location and size is composed of the 107 marma according to Sushruta.  While there are descriptions available as to the locations of marma points on the physical body, every body is different, thus is may take a trained marma therapist to locate the specific points.
 
Marma Location Size Number of Points
Adhipati Crown Chakra ½ angula 1
Amsa Shoulder ½ angula 2
Amsaphalaka Shoulder blade ½ angula 2
Ani Lower region of upper arm and upper leg ½ angula 4
Apalapa Armpits ½ angula 2
Apanga Outer corner of each eye ½ angula 2
Apastamba Medial and inferior to nipples on abdomen ½ angula 2
Avarta Midpoint above each eyebrow ½ angula 2
Bhavi Inside of upper arm 1 angula 2
Basti Lower abdomen/ bladder 4 angula 1
Brihati Broad region of upper back ½ angula 2
Guda Rectum 4 angula 1
Gulpha Ankle 2 angula 2
Hrdaya Heart 4 angula 1
Indrabasti Center of forearm and lower leg ½ angula 4
Janu Knee 3 angula 2
Kakshadhara Coracoid Process 1 angula 2
Katika Taruna Hip joint ½ angula 2
Krikatika Neck joint ½ angula 2
Kshipra Between thumb and index finger and between big toe and second toe ½ angula 4
Kukundara Sides of the lower iliac spine ½ angula 2
Kupara Elbow joint 3 angula 2
Kurcha Bottom of thumb and big toe 4 angula 4
Kurchashira Base of thumb joint and base of big toe joint 1 angula 4
Lohitaksha Lower frontal end of shoulder and hip joint ½ angula 4
Manibandha Wrist 2 angula 2
Manya Side of the neck 4 angula 2
Nabhi Naval 4 angula 1
Nila Base of the throat 4 angula 2
Nitamba Upper buttock ½ angula 2
Parshva Sandhi Upper hip ½ angula 2
Phana Side of each nostril ½ angula 2
Shankha Temple ½ angula 2
Shringataka Just below each cheek bone 4 angula 4
Simanta Sagittal Suture of skull 4 angula 5
Sira Matrika Base of the neck 4 angula 8
Stanamula Nipples 2 angula 2
Stanarohita Superior and medial to nipples ½ angula 2
Sthapani Third eye center ½ angula 1
Talahrdaya Center of palm of hand and sole of foot ½ angula 4
Utkshepa Above ears ½ angula 2
Urvi Mid-region of upper thigh 1 angula 2
Vidhura Behind and below ears ½ angula 2
Vitapa Perineum 1 angula 2
 
   As their origins lie in combat, five types according to the result of injury additionally categorize marma points.  The following information comes from Prof K.R. Krikantha Murthy’s translation of the Sushruta Samhita:
  • Sadya Pranahara:  Immediately causing death
  • The marma of this type are Shringataka (four points), Adhipati (one point), Shankha (two points), Kanthasira/ matrika (eight points), Guda (one point), Hrdaya (one point), Basti (one point), Kshipra (four points), and Nabhi (one point).  According to Sushruta, Sadya Pranahara points have the qualities of fire, and this is why they quickly cause death.  Some classical physicians said that Sadya Pranahara points are those containing all five tissue types (Mamsa, Sira, Snayu, Asthi, and Sandhi).  Sushruta disagrees and says that all five tissue types are present in the below four types of marma.
  • Kalantara Pranahara: Causing death after some time
  • Kalantara Pranahara have the qualities of water and fire, thus with their hot/fiery qualities kill debilitated people quickly, and with their cold/watery qualities kill others after some time.  Sushruta designates the following marma as Kalantara Pranahara:  Stanamula (two points), Stanarohita (two points), Apalapa (two points), Apastamba (two points), Simanta (five points), Tala (four points), Indrabasti (four points), Katika Taruna (two points), Brihati (two points), and Nitamba (two points).  
  • Visalya Pranahara:  Fatal if pierced
  • Visalya Pranahara points have the quality of air, thus are fatal if the air residing in the marma is disturbed.  If pierced, the air will remain undisturbed if the foreign object is not removed, but upon removal of the foreign object air will be allowed to escape from the marma and thus cause death.  Marma of this type are Utkshepa (two points) and Sthapani (one point).
  • Vaikalyakara:  Disability causing
  • Sushruta describes Vaikalyakara marma as “possessing qualities of the moon/water” and explains that the corresponding stable and cold qualities help with the sustenance of life when these points are injured.  Thus, only disability is caused.  Points of Vaikalyakara nature are Lohitaksha (four points), Ani (four points), Janu (two points), Urvi (four points), Kurcha (four points), Vitapa (two points), Kupara (two points), Kukundara (two points), Kakshadhara (two points), Vidhura (two points), Krikatika (two points), Amsa (two points), Amsaphalaka (two points), Apanga (two points), Nila (two points), Manya (two points), Phana (two points), and Avarta (two points).
  • Rujakara:  Pain causing
  • o The final categorization of marma point is Rujakara, which designates points composed of the qualities of fire and air, which produce pain.  These marma are Gulpha (two points), Manibandha (two points), and Kurcha Sira (four points).  
 

Relations to Ayurveda & Diagnosis

   Ayurveda bases its diagnoses on the fundamentals of the three doshas:  Vata, Pitta, and Kapha.  As already explained, each dosha is a combination of two elements, and it is the qualities of these elemental combinations that provide clues as to the nature of a given imbalance.  Treatment is then accomplished using the opposite qualities to those of the condition .  Conditions of Vata nature will present with qualities such as cold or dry, and they may have decreased tissues, energy, pain, or insomnia.  Sensitivity upon light pressure of a marma would be indicative of Vata.  Pitta conditions will display warm or hot qualities such as fever, anger, or bleeding, and would be indicated by sensitivity to moderate pressure on a marma.  Kapha conditions will be those of heaviness such as water retention, excess weight, tissue, mucus or swelling.  Heavy pressure causing sensitivity would indicate a Kapha imbalance at the site of a marma.  Any of the qualities of a specific dosha can be observed at the site of a marma to provide clues to determine the best course of treatment.  
   
   Different marma points also relate specifically to different doshas and body systems, and can be used both to indicate an imbalance, and in the treatment.  These relationships are detailed in the tables below:
 
Relationship of Doshas, Subdoshas, and Marma Points
Vata
                                      Pitta                                   Kapha
Prana Vayu Adhipati Sadhaka Pitta Adhipati Tarpaka Kapha Adhipati
  Sthapani   Simanta   Simanta
  Phana   Hrdaya   Hrdaya
  Vidhura Alochaka Pitta Kurcha   Shringataka
  Kshipra   Kurchashira   Krikatika
  Talahrdaya   Sthapani Bodhaka Kapha Shringataka
Udana Vayu Nila   Apanga   Manya
  Manya Bhrajaka Pitta Nila   Phana
  Krikatika   Manya Avalambaka Kapha Hrdaya
  Amsa   Talahrdaya   Stanamula
Vyana Vayu Hrdaya   Amsa   Talahrdaya
  Brihati   Katika Taruna Kledaka Kapha Nabhi
  Amsaphalaka Pachaka Pitta Nabhi   Apastamba
  Talahrdaya   Apastamba   Kurchashira
  Kshipra   Kurchashira Sleshaka Kapha Janu
Samana Vayu Nabhi   Indrabasti   Kupara
  Apastamba Ranjaka Pitta Nabhi   Manibandha
  Kurchashira   Kupara   Gulpha
Apana     Basti   Janu   Katika Taruna
  Guda   Kukundara    
  Vitapa        
  Talahrdaya (feet)        
  Lohitaksha (Legs)        
  Utkshepa        
 
Relationship of Body Systems and Marma Points
Circulatory System Hrdaya, Nabhi, Kupara, Brihati, Janu, Lohitaksha, Sira Matrika
Digestive System Nabhi, Indrabasti, Kurchashira, Parshvasandhi, Shankha
Female Reproductive Guda, Vitapa, Gulpha, Basti
Lymphatic System Hrdaya, Kshipra, Stanamula, Lohitaksha, Amsaphalaka, Nila
Muscular System Kurchashira, Kakshadhara, Stanamula, Stanarohita, Guda
Nervous System Adhipati, Simanta, Sthapani, Apalapa, Apastambha, Shringataka
Respiratory System Talahridaya, Kshipra, Hridaya, Phana, Sthapani
Skeletal System Kukundara, Katikataruna, Janu, Manibandha, Simanta
Urinary System Basti, Guda, Kukundara
 

Methods of healing through Marma

There are many methods through which healing such as massage, oils, heat, herbs, and pranic healing which a trained therapist whilst interacting with marma points may employ.  There are other therapies such as yoga postures and meditation, which a person can use to independently affect their marma points and with the right knowledge affect the flow of their own prana.  Below some of these techniques are described. 
 
Massage/ Therapeutic Touch
   One of the most basic treatments in Ayurvedic Medicine is Abhyanga, the Ayurvedic Oil Massage.  A rejuvenating therapy with strokes coordinated with the five Vayus, or directions of Vata dosha, Abhyanga affects marma points through therapeutic touch, and through the healing qualities of the oils and any herbs or aromas that are used.  Specific attention to marma points may be included in the massage, but marma points are affected simply through the flow of Abhyanga strokes without specific concentration,
   
   Acupressure (also called Mardana by Dr. Frawley) is another form of therapeutic touch where firm pressure is held on a specific marma or collection of marmas until associated tension or pain is reduced or released.  The pressure used should be quite firm for Kapha conditions, moderate for conditions of Pitta, and light for those of Vata nature.

Herbs

   Ayurveda uses a vast breadth of herbs and formulations for internal and external healing.  The topical application of herbal medicated oils, pastes, and powders may be used to elicit a desired effect from a specific marma.  Dr. Frawley recommends Guggul as the most well rounded herb for marma therapy, citing it’s clearing properties and it’s affinity for reducing pain and promoting the flow of energy.  For healing of a specific condition an herbal formula with properties specifically targeted toward the desired result should be used. 

Oleation
   Most commonly used as part of the Abhyanga massage, the application of oils is deeply therapeutic most especially for conditions of Vata nature but can be therapeutic for imbalances of all doshas.  Warm sesame oil is best for the treatment of Vata, and the essential oil of sandalwood, calamus, or cinnamon can be added.  For pitta coconut or sunflower oils are best, potentially mixed with the essential oils of sandalwood or rose.  For Kapha, oil is generally contraindicated however sesame and mustard oil mixed together with the essential oils of camphor, menthol, or wintergreen would be balancing.2

 
   Another technique would be applying oil locally to the specific marma points that are being used for healing, rather than applying oil to the whole body as in Abhyanga,
 
Pranic Healing
   Pranic Healing involves transmitting energy from the healer to the client and can be accomplished by placing one’s hands above the specific area of the body (or in this case the marma point) that is the target of the healing.  In Ayurvedic terms marma points are part of the Majja dhatu, or nervous system, which is governed by prana.  Pranic healing can assist in the harmonious interaction of prana vayu (the flow of cellular intelligence), sadhaka pitta (present especially in the gray matter of the brain) and tarpaka kapha (the white matter covering the brain), to promote grea