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.)
 
 
 

 

Better Known as Turmeric (By: Ivy Cannon A.H.E.)

 Introduction

   Over thousands of years, turmeric has served many purposes. This versatile root's bright yellow color has always been used for paints and dyes. Far superior to its use for color are its many culinary applications and medicinal purposes. Because of its widespread use, this wonderful root has nearly as many names as uses.
 
   Numerous are the names given to this amazing root but it is most commonly known as Turmeric (Curcuma longa). "Curcuma is Latinization of Arabic al-kurkum [rfi..SJI], which originally means saffron but is now used for turmeric only." [1] Turmeric is sometimes called indian saffron, golden goddess, haridra, haldi, jiang huang, curcuma longa, kha
min chan by the Thai, kunir in Indonesia, kurkuma by the Germans and Terre-merite in France. In almost every language it means "yellow root." In India alone it has over 10 different names: halad, haradi, nisa, kancani, pasupu, makhal, halud, ladir, pivari and yositpriya.
 
   Haradi is a plant native to southern India and Asia, and it is closely related to ginger. 'Turmeric (Curcuma longa) is a rhizomatous herbaceous perennial plant of the ginger family, Zingiberaceae." [2] "A tall herb, rootstock large, avoid, with sessile cylindric tubers orange-colored inside. Leaves very large, in tufts up to 1.2 meters long, including the petiole which is as long as the blade, oblong-lanceolate, tapering to the base. Flowering in autumn, spikes 10-15 cm long; peduncle 15 cm or more, concealed by the sheathing petiole; flowering bracts pale green; bracts of coma tinged with pink." [3] The root looks much like ginger with a more orange skin that is thinner. The inside of risa is a yellowish-orange color. Another variation is known as kunkum. Kunkum is red on the inside and considered sacred thus not used for cooking. Only the yellow haridra is eaten, and it is essential in most Indian cooking. Aside from being such a great herb for cooking, nisa is one of the most important herbs for both internal and external medicinal use.
 
   Understanding the chemical components of ladir is necessary when learning how to use the root effectively. A closer look at curcumin through the lense of science reveals it's healing essence. "Turmeric contains up to 5% essential oils and up to 5% curcumin, a polyphenol." [5] "An active principle curcumin, yellow coloring matter and turmeric oil (or turmeriol) of specific odor and taste, and yellow color." [6] "Curcumin is the active substance of turmeric and curcumin is known as C.I. 75300, or Natural Yellow 3. The systematic chemical name is
(1E,6E)-1,7-bis(4-hydroxy-3-methoxyphenyl)-1,6-heptadiene-3,5-dione." [5] "Fresh rhizomes yield 0.24% oil, containing zingiberene." [6] The plant kingdom classification of turmeric shows its close relation to ginger.
  • Kingdom: Plantae - Plants
  • Subkingdom: Tracheobionta - Vascular plants
  • Superdivision: Spermatophyta - Seed plants
  • Division: Magnoliophyta - Flowering plants
  • Class: Liliopsida - Monocotyledons,
  • Subclass: Zingiberidae
  • Order: Zingiberales
  • Family: Zingiberaceae - Ginger family 
  • Genus: Curcuma L. - curcuma
  • Species: Curcuma longa L. - common turmeric [4]

Traditional Uses

   Traditionally the active principle curcumin, which gives turmeric its bright yellow color, was used as a fabric dye. It's use in this application has varying results and ultimately the color it produces fades fast. "Essentially turmeric makes a poor fabric dye, as it is not very light fast. However, turmeric is commonly used in Indian and Bangladeshi clothing, such as saris and Buddhist monks' robes." [7] Even though we now have superior synthetic dyes this root is still used by many cultures as a coloring agent.
 
   We may be able to easily replace kunir with a synthetic dye, but we can not employ a different herb to replace it's numerous culinary and medicinal applications. Probably best known for its classic application as a fundamental spice in the curry armamentarium, turmeric is a significant ingredient in most commercial curry powders. Its bright gold color gives curries their characteristic hue and adds an attractive tone, especially to vegetable combinations. Jiang Huang is mostly used in savory dishes, as well as some sweet dishes such as the cake sfouf. "Although most usage of turmeric is in the form of rhizome powder, in some regions leaves of turmeric are used to wrap and cook food. In Goa and Dakshina Kannada (Karnataka state, India), turmeric plant leaf is used to prepare special sweet dishes, patoleo, by layering rice flour and coconut-jaggery mixture on the leaf, and then closing and steaming it in a special copper steamer (goa)." [8] Indian saffron is used in so many indian culinary delicacies it's a shame one can't list them all. Some applications include dishes such as dal soup, kitchadi, bhaji, subji, rice khir, raitas, chutneys and pickling. In a more modern culinary application, "Turmeric (coded as E100 when used as a food additive, indicating how it is used as a food coloring since it normally gives food slightly yellow color) is used to protect food products from sunlight."[9] This commonly found food additive has also been proven beneficial to your health.
 
   For many thousands of years kunir has been used in a laundry list of applications with effects on all the tissues of body and several body systems. "Turmeric is the best medicine in Ayurveda. It cures the whole person. Turmeric's rasa (taste) is pungent, bitter, astringent, the virya (effect on digestion) is heating with a pungent vipaka (post digestive effect). Turmeric can be used by all doshas (body types). Turmeric helps digestion, maintains the flora of the intestine, reduces gas, has tonic properties and is an antibiotic. Turmeric can be used for cough, sty, diabetes, hemorrhoids, cuts, wounds, burns and skin problems. It helps reduce anxiety and stress." [10] Its herbal actions include a digestive stimulant, carminative (dispel gas), alterative (cleanses circulatory system), vulnerary (heals the skin), hemostat (stops bleeding), antibacterial, purification of tissue while supporting tonification (increase tissue) and emmenagogues (action on female reproductive system). "Its use is indicated when indigestion, poor circulation, cough, amenorrhea, pharyngitis,
skin disorders, diabetes, arthritis, anemia, wounds, or bruises are present." [11] Over the centuries it has been used for the treatment of snake bites and scorpion stings. Even now when western medicine is unavailable to those living in more isolated areas, halad is an effective treatment. "The smoke produced by sprinkling powder of turmeric rhizome over burning charcoal will relieve scorpion sting when the part affected is exposed to the smoke for a few minutes." [12] More uses for this wonderful herb include:
  • for anemia, take a bowl of yogurt with 1 tsp turmeric. Eat on empty stomach morning and evening. Do not eat after dark.
  • for cuts, wound and fungal nail infections, apply mixture of Yz tsp turmeric & 1 tsp aloe vera gel to affected area.
  • for external hemorrhoids, apply a mixture of Yz tsp of turmeric and 1 tsp of ghee locally at bedtime. [10]

Effects on Body Tissues

   From an Ayurvedic perspective, we can look at each tissue of the body and see how turmeric plays a role in the health of that tissue (dhatu). Here are a few ways haridra works on each tissue of the body, although it is not limited to these actions. In the lymphatic system, known as the rasa dhatu, turmeric purifies the lymphatic fluid, removes stagnation, reduces excess heat associated with low intermittent fever and reduces inflammation of mucous membranes.
 
   In the circulatory system, the rakta (blood) benefits greatly from turmerics effects. Some of these include: stimulation of blood tissue development, regulation of blood glucose levels, removal of stagnation in the liver, antimicrobial properties that fight bacterial and viral infections as well as inflammatory conditions and a hemostatic property which acts as a coagulant. It's effectiveness as a hemostat makes it useful for mild internal bleeding due to diseases such as ulcerative colitis. The leaves of kunir also have an antipyretic (cools blood & liver) effect.
 
   In the mamsa dhatu or muscle tissue, one may notice benefits for complexion. A paste made of flour and halad is used for treatment of ringworm or other parasitic skin conditions. For a heated skin condition such as herpes simplex virus, one could apply ladir in aloe vera gel to the affected area. The same mixture of turmeric and aloe vera gel taken internally, is used to combat the systemic heat and viral infection associated with a herpes flare up. A haridra and salt paste may be applied to bruises or traumatic injuries where swelling has occurred to not only reduce the swelling, but alleviate some of the pain as well. Nisa may also be used for acne in conjunction with sandalwood.
 
   Fat tissue, also known as the medas dhatu, is affected in many ways by jiang huang. Through its purification and clearing stagnation in the liver, it increases function of gallbladder and bile production. This stimulates digestion of fats while also having the ability to aid in the digestion of protein through assisting the pancreas in its digestive functions. All of these factors lead to the maintenance of a healthy body weight.
 
   Turmeric stimulates flow through the circulatory system by promoting removal of old red blood cells and production of new red blood cells. The asthi dhatu, or bones, are the site of production for new red blood cells. Golden Goddess has an alkalizing effect on the blood which promotes healthy bones. When the blood ph is low and the body is highly acidic, the blood borrows minerals such as calcium from the bones to bring its ph to a more alkalized environment. This borrowing from the bones leads to a weakening. Over time this can lead to the disease osteoporosis. Through its antimicrobial properties and stimulation of healthy red blood cells, risa can prevent infections of the bones such as osteomyelitis.
 
   Indian Saffron is known as a protector against stress and anxiety. It purifies the plasma which is the vital spinal fluid that feeds the brain. With healthy pure rasa (lymph) feeding brain function the entire nervous system is supported. In a recent study on alzheimer's disease haldi was proven to be therapeutically beneficial. "Alzheimer's disease (AD) is a neurodegenerative disorder and the most common form of dementia, affecting more than 5.4 million people in the USA. Some natural products may be used as AD therapeutics from a variety of biological sources, including the anti-amyloid agent curcumin, isolated from turmeric." [21]
 
   While pivari has a purifying effect, lets not forget its support in tonification (building) of tissue. Mostly associated with use for the female reproductive system it is used as a general tonic and stimulant. Safe for use during later trimesters of pregnancy, its stimulating effect can promote menstruation and thus should be avoided during early conception. While its tonifying and purifying effects maintain healthy reproductive tissue, it's antimicrobial properties make it useful in the treatment of sexually transmitted diseases such as gonorrhea.

Effects on Body Systems

   There are specific body systems that the golden goddess has more of an effect on than others. One of these is the circulatory system. "The rhizome is used as a stimulant; and is externally applied to bruises, cuts, ulcers, sprains and pain. It is orally given in blood diseases. Employed in intermittent fevers. Its used externally on bruises and snake bites." [13] In the event of a sprain or pain one can employ various applications of turmeric rhizome. "For general muscle strain, apply warm ginger paste with turmeric (one tsp ginger with Yz tsp turmeric) to the affected area twice a day. Wrap the affected area in a piece of gauze or cotton cloth. A warm compress may be applied for further relief of pain." [14] Healing time for this kind of injury can be increased by daily internal use. "A good antibacterial for those chronically weak or ill. It not only purifies the blood, but also warms it and stimulates formation of new blood tissue. Golden Goddess gives the energy of the Divine Mother and grants prosperity. It is effective for cleansing and purifying the channels of the subtle body." [11] Long term use of ladir has been proven to be an essential part of preventative and holistic medicine.
 
   In the digestive system indian saffron is best known for its treatment of inflammation and indigestion with flatus. Although this herb is warm and stimulating, it does not create heat in the liver and actually moves stagnant heat out of the liver and small intestine. For this reason it is sometimes given during bouts of diarrhea. Kunir may be added to high protein food to assist digestion and prevent the formation of gas. It is effectively used to maintain the flora of the large intestine and prevent the formation of toxins. Best taken in a portion of 1-3 grams of powder with food. In one western study scientist looked at the effects of turmeric as an anti-inflammatory in the colons of mice. "The biological activity of Curcuma extract was evaluated against Carbachol induced contraction in isolated mice intestine." [19] Alternating administration of either curcuma longa or a placebo, observations were held for a period of two weeks. In conclusion the study demonstrated, "Curcuma extract has a direct and indirect myorelaxant effect on mouse ileum and colon, independent of the anti-inflammatory effect. The indirect effect is reversible and non-competitive with the cholinergic agent. These results suggest the use of curcuma extract as a spasmolytic agent." [19] Ultimately this study confirms the anti-inflammatory and bowel tonic effect nisa has on the digestive system.
 
   Golden Goddess is said to assist in the digestion of proteins which in turn assists the pancreas in its activities. These effects are not limited to the pancreas' exocrine functions. For reasons that are still being studied turmeric helps support blood glucose levels. "Health benefits of curcuminoids from C. longa as antioxidants, anti-cancer and anti-inflammatory molecules have been well documented. We report here for the first time that Bisdemethoxycurcumin (BDMC) from C. longa, acts as an inhibitor to inactivate human pancreatic a-amylase, a therapeutic target for oral hypoglycemic agents in type-2 diabetes." [20] "For the treatment of diabetes, turmeric is also useful. Take four to five 00 capsules after each meal to return the blood sugar levels to normal." [15] Certainly halads promotion of a healthy liver aids in the storage of glycogen and regulation of glucose. This storage and regulation allows the pancreas to function optimally.
 
   In the respiratory system haridra is good for fighting infections such as bronchitis. A common treatment for a cold is; "Fresh juice (10-20 gms) of turmeric or drink 1 cup milk boiled for 3 minutes with 1 tsp turmeric before bed." [16] To combat cough, sore throat and relieve inflammation in the throat, prepare a turmeric and salt gargle (2 pinch : 2 pinch) in one cup hot water. A "milk turmeric decoction is said to be beneficial for cold, diarrhea, intermittent fever, dropsy, jaundice, liver disorders, urinary diseases, worms (add sugar follow with purgation & enema), trauma and fracture." [17] For sinus inflammation add a pinch of risa to your neti pot or make a medicated oil. The kunir oil may be added to a neti pot or a few drops inserted directly into each nostril.

Western Studies

There have been many studies held on the effects of jiang huang as an anti-inflammatory for the bowels, an antimicrobial for the blood and a blood sugar regulator. More recent studies are showing the effects of halad on cancer cells. One thing we know from collective research is that it reduces heat in the liver by balancing or alkalizing the blood ph. In many cases cancer patients have a low ph. Here are two studies that support the theory of turmeric's benefits for cancer patients.
  • Study 1 "Animal and laboratory studies have found that curcumin, an antioxidant that is an active ingredient in turmeric, demonstrated some anticancer effects.  Antioxidants are compounds that can protect the body's cells from damage caused by activated oxygen molecules known as free radicals. However, clinical research is needed to determine curcumin's role in cancer prevention and treatment in humans. Several types of cancer cells are inhibited by curcumin in the laboratory, and curcumin slows the spread of some cancers in some animal studies." [22]
  • Study 2 "Curcumin (diferuloylmethane), the yellow pigment in Indian saffron (Curcuma longa; also called turmeric, haldi, or haridara in the East and curry powder in the West), has been consumed by people for centuries as a dietary component and for a variety of proinflammatory ailments. Extensive research within the last decade in cell culture and in rodents has revealed that curcumin can sensitize tumors to different chemotherapeutic agents. Chemosensitization has been observed in cancers of the breast, colon, pancreas, gastric, liver, blood, lung, prostate, bladder, cervix, ovary, head and neck, and brain and in multiple myeloma, leukemia, and lymphoma. Similar studies have also revealed that this agent can sensitize a variety of tumors to gamma radiation including glioma, neuroblastoma, cervical carcinoma, epidermal carcinoma, prostate cancer, and colon cancer. Although it acts as a chemosensitizer and radiosensitizer for tumors in some cases, curcumin has also been shown to protect normal organs such as liver, kidney, oral mucosa, and heart from chemotherapy and radiotherapy-induced toxicity. These preclinical studies are expected to lead to clinical trials to prove the potential of this age-old golden spice for treating cancer patients." [23]

   While there are many theories to support kunir's versatile uses, some studies suggest otherwise. "Curcumin (CUR) is the major orange pigment of turmeric and believed to exert beneficial health effects in the gastrointestinal tract and numerous other organs after oral intake. However, an increasing number of animal and clinical studies show that the concentrations of CUR in blood plasma, urine, and peripheral tissues, if at all detectable, are extremely low even after large doses. In view of the very low intestinal bioavailability, it is difficult to attribute the putative effects observed in peripheral organs to CUR. Without testing the fecal matter for concentrations of CUR it can't be said that turmeric has, poor permeation from the intestinal lumen to the portal blood." [18] Just because haridra hasn't shown up in the urine, blood or plasma, doesn't mean it's confined to the intestine. Perhaps once in systemic circulation the compound changes or is picked up by different organs resulting in a low concentration of CUR in the blood, plasma and urine. It would be helpful to conduct a study that could confirm the concentration of CUR in the intestine and fecal matter after high dosages. With the growing trend of turmeric studies, we will soon gain a deeper understanding of the many benefits of this amazing herb.

   Even with all the recent studies, thousands of years of use are evidence that turmeric is a priceless resource. It is an essential part of everyone's health. Used in preventative measures and ongoing treatment, it has countless uses and applications. Its is no wonder that nisa has been so prized for so long in India and other eastern cultures. Through it's culinary applications and medicinal uses, golden goddess has become an integral part of the survival of human health. Now readily available around the world, it is being used more and more. The bright orange color of turmeric can be spotted wherever you go even when you may not recognize it by name.

Bibliography

1/3. Dr. Gyanendra Pandey. "Chowkhamba Krishnadas Academy." Krishnadas Ayurveda (K.A.S.) Series48. "Dravyaguna Vijnana." Part - 1. Page 737-745. "Haridra." Chowkhamba Press, Varanasi. Oriental Publishers & Distributors. 2005
 
2. Chan, E.W.C. et al.; Lim, Y; Wong, S; Lim, K; Tan, S; Lianto, F; Yong, M (2009). "Effects of different drying methods on the antioxidant properties of leaves and tea of ginger species". Food Chemistry 113 (1): 166-172.doi:10.1016/j.foodchem.2008.07.090.
 
Plants. USDA. Plant Profile. Curcuma Longa L. common turmeric
 
article. turmeric. (2)composition
 
6. Gernot Katzer's Spice Pages. "Turmeric". Etymology. Last Modification - 19 Mar. 1999 Web. 24 Sept. 2012 <http://www.uni-graz.at/-katzer/engl/Curc_lon.html>
 
7. [www.wikipedia.org] article. turmeric. (1.5) dye
 
article. turmeric. (1.1) culinary uses
 
10. Usha Lad & Dr. Vasant Lad. Ayurvedic Cooking for Self-Healing. Second Edition. Page 215-216. The Ayurvedic Press, Albuquerque 87112. Copyright 1994, 2009
 
11. Dr. David Frawley and Dr. Vasant Lad. The Yoga of Herbs. Second Edition. Page 149. Lotus Press Twin Lakes, Wisconsin. Copyright 1986, 2001
 
12. Dr. Gyanendra Pandey. "Chowkhamba Krishnadas Academy." Krishnadas Ayurveda (K.A.S.) Series48. "Dravyaguna Vijnana." Part - 1. Page 737-745. "Haridra." Chowkhamba Press, Varanasi. Oriental Publishers & Distributors. 2005
 
13. Dr. Gyanendra Pandey. "Chowkhamba Krishnadas Academy." Krishnadas Ayurveda (K.A.S.) Series48. "Dravyaguna Vijnana." Part - 1. Page 737-745. "Haridra." Chowkhamba Press, Varanasi. Oriental Publishers & Distributors. 2005
 
14. Dr. Vasant Lad. "Ayurveda The Science of Self-Healing." Page 160. "Muscle Strain & Pain." Lotus Press Twin Lakes, Wisconsin.
 
15. Dr. Vasant Lad. "Ayurveda The Science of Self-Healing." Page 141. "Turmeric." Lotus Press Twin Lakes, Wisconsin.
 
16. Usha Lad & Dr. Vasant Lad. Ayurvedic Cooking for Self-Healing. Second Edition. Page 215-216. The Ayurvedic Press, Albuquerque 87112. Copyright 1994, 2009
 
17. Dr. Gyanendra Pandey. "Chowkhamba Krishnadas Academy." Krishnadas Ayurveda (K.A.S.) Series48. "Dravyaguna Vijnana." Part - 1. Page 737-745. "Haridra." Chowkhamba Press, Varanasi. Oriental Publishers & Distributors. 2005
 
18. [Pub.Med.gov - US National Library of Medicine - National Institutes of Health]  Biofactors. 2012 Sep 20. doi: 10.1002/biof.1042. [Epub ahead of print]
"Curcumin uptake and metabolism."
Metzler M, Pfeiffer E, Schulz SI, Dempe JS. Source
Department of Chemistry and Biosciences, Chair of Food Chemistry, Karlsruhe Institute of Technology (KIT), Adenauerring 20a, D-76131 Karlsruhe, Germany.
Manfred.metzler@kit.edu.
 
19. [Pub.Med.gov - US National Library of Medicine - National Institutes of Health]  PLoS One. 2012;7(9):e44650. Epub 2012 Sep 12.
"Curcuma longa Extract Exerts a Myorelaxant Effect on the Ileum and Colon in a Mouse Experimental Colitis Model, Independent of the Anti-Inflammatory Effect."
Aldini R, Budriesi R, Roda G, Micucci M, Ioan P, D'Errico-Grigioni A, Sartini A, Guidetti E,  Marocchi M, Cevenini M, Rosini F, Montagnani M, Chiarini A, Mazzella G.
Source
Ospedale Policlinico S.Orsola and Dipartimento di Scienza dei Metalli, Elettrochimica e Tecniche Chimiche, Universita degli Studi di Bologna, Bologna, Italy.
 
20. [Pub.Med.gov - US National Library of Medicine - National Institutes of Health]
Food Chem. 2012 Dec 15;135(4):2638-42. doi: 10.1016/j.foodchem.2012.06.110. Epub 2012 Jul 13.
"Discovering Bisdemethoxycurcumin from Curcuma longa rhizome as a potent small molecule inhibitor of human pancreatic a-amylase, a target for type-2 diabetes."  Ponnusamy S, Zinjarde S, Bhargava S, Rajamohanan PR, Ravikumar A.
Source
Institute of Bioinformatics and Biotechnology, University of Pune, Pune 411 007, Maharashtra, India.
 
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Future Med Chem. 2012 Sep;4(13):1751-61.
"Natural products as a rich source of tau-targeting drugs for Alzheimer's disease."  Calcul L, Zhang B, Jinwal UK, Dickey CA, Baker BJ.
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22. [www.cancer.org - Find Support & Treatment - Treatments and Side Effects - Complementary and Alternative Medicine - Herbs, Vitamins, and Minerals] "Turmeric"
Last Medical Review: 11/28/2008 _ Last Revised: 11/28/2008 Web. 24 Sept. 2012
 
23. [Pub.Med.gov - US National Library of Medicine - National Institutes of Health]  Nutr Cancer. 2010;62(7):919-30.
"Curcumin, the golden spice from Indian saffron, is a chemosensitizer and radiosensitizer for tumors and chemoprotector and radioprotector for normal organs."
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Department of Internal Medicine, Baylor University Medical Center, Dallas, Texas, USA. Web. 25 Sept. 2012 <http://www.ncbi.nlm.nih.gov/pubmed/20924967
 
 

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.

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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 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.)

Acknowledgments

My obeisance to The Divine for leading me through life and bestowing me the opportunity to follow my life’s interest for the knowledge of Ayurveda. 
 
This paper would not be possible without the founder of CCA, Dr. Marc Halpern and the staff that are supporting the work. I thank Dr. Halpern for bringing the opportunity of learning Ayurveda in America with such clarity. He has been a part in helping me choose an appropriate title for this research paper, and is always ready to be of assistance. I thank my mentor teacher, Marisa Lauren for her guidance in the course work for the AHE and AHP programs, her encouragement has meant much. 
 
I would like to thank my unforeseen early teachers in helping me discover many Ayurvedic principles in cooking and the fine art of living. I am grateful for the occasions of being able to observe and experience life’s learning moments. I thank them for their continuous guidance: my parents, Kapurchand Shah, my academic teachers, friends and family members. 
 
Thanks also to The Aryavaida Chikitsalayam and Research Institute, Coimbatore, India for two months of wonderful insights and treatment. 
 
My deep appreciation to my husband, Sanjay, and daughter, Ravenna, for their continuous support, sense of humor and critiquing that has benefited me along the way. 
 
Finally a heart felt gratitude to the Sri Aurobindo Ashram friends in Pondicherry, India for their warmness and support. My mentor and guru Vishwajit.da Talukdar, has persevered in guiding and loving me through the most difficult of times. This paper is dedicated to The Mother and Sri Aurobindo. 
 
Om Shanti

Abstract

Eating habits in affluent Westernized countries have changed rapidly with lifestyle change and the Eastern countries are following. A diet high in saturated fats, refined sugar, meat, and commercially processed foods has overtaken the use of fresh fruits and vegetables. With the rich, heavy, sweet foods that satiate the majority of stomachs, there is very little nutrient value, leading to nutritional deficiencies and health problems. To overcome the nutritional aspects, a ruinous diet and chemical supplements have become the solution. 
 
Food value goes beyond calorie and biochemical content. The subtle aspects contained within fresh naturally grown foods that provide all living beings with a powerful life force, is lost in a fast paced commercially driven mode of living. Diet means “a way of eating”, stemming from the Greek word diaita meaning “a way of life”. 
 
“Let food be thy medicine and medicine be thy food.” - Hippocrates, the father of Greek medicine. How true these words are, yet society has forgotten to live by them. 
 
In the USDA food guidelines, all calorie intake is based on body mass index, gender, stage of life, and whether one is sedentary or active. (See Fig. 5.6 in the MyPyramid section). Active means at least 30mins of exercise on most days of the week and 60-90mins per day to sustain weight loss. The amount of portions for each individual, from the same food group is in proportion to the amount of calories calculated for a particular group; therefore, the ratios of portions are the same e.g. a female requires less calories than a male, so the quantity is lower, however, the ratio of portions for each food group is the same as is shown for all individuals on the “MyPyramid”. The same applies for a 2-year-old vs. a 12-year-old; quantity is increased, however, the ratio of each food group to be consumed remains the same. The only factor that varies is the amount or quantity of portions. The guidelines provide a complete list of foods containing potassium, sodium, vitamin E, iron, non-dairy calcium food, calcium, vitamin A, magnesium, dietary fiber, and vitamin C, which have been shown to be of concern amongst various population groups. The amount of these substances required for each group of calories is also provided. Each section addresses the importance of getting the required amounts of nutrients for particular age groups, groups of concern (i.e., those with health issues), and pregnant women. The guidelines do not specify the reason for the substance and its utilization within the body. In some cases the guidelines do mention the cause of some diseases through excess intake, such as sodium causing high blood pressure. 
 
There is no discretion or consideration given to what type of vegetable, fruit, oil etc. to be consumed for each individual person; the choice is left upon preference. Food groups are shown to provide the necessary fats, proteins, carbohydrates, vitamins, minerals, and sugars, which are all required for proper function of the body. There are no precautions provided on livestock meat and dairy, which may contain antibiotics and hormones, which are unnaturally fed, and the harm it may cause to individuals. Some hygiene and cooking procedures are outlined so that meats are well cooked and cross contamination is reduced. 
 
Since the current state within the US (and most western fast paced countries) faces the challenge of high obesity and related diseases, the USDA report and dietary guidelines have mainly focused attention on concern areas. For this reason, the current version of the Food Pyramid includes and emphasizes exercise and moderation of intake of fats and sugars. 
 
In Ayurvedic philosophy, the food groupings are similar to those of USDA. However, unlike the USDA, Ayurveda gives consideration to cooking preparation, storage, times, seasons, prakrīti, vikruti, stage of life, environment, lifestyle, food habits e.g. sequence of eating and pleasant eating atmosphere, where food is grown, and energetics (rasa, virya, vipaka) of food are additional factors, that govern an individual’s diet. Ideally there are factors such as when to pick fruits and vegetables, how and where to best grow them, amongst other factors, which do not require the need to delve into in this paper. Many inter-layered factors are given due consideration for a diet plan to be derived at for a particular individual. All of this may sound complex, however, there is a science behind the system that renders a commonsense approach. Food charts that list each food item for the basic prakrītis/constitutions are available, and with additional factors the charts can easily be modified by an Ayurvedic practitioner. To follow the diet prescribed by Ayurveda involves some discipline and self-control however, it involves a lifestyle change that leads to optimal health and longevity. 
 
“The four aims of life, dharma/to fulfill ones duty in life, artha/to attain wealth or livelihood, kāma/to attain ones desires, and moksha/liberation, are to be reached through health only” [1] “Good health stands at the very root of attaining aims in life, so it is only desirable for all” [2] 
 
There are seven types of prakrīti that can have infinite combinations based on the percentage of each dosha’s presence. Any, vikruti factors will also be taken into account, this establishes an individualistic and thorough diet plan. Each person is seen as a unique entity that has his/her own body constitution, whether that may be in the varying levels of hormones, agni/metabolism, or even neurotransmitters. This means each individual has an exclusive biochemical world that influences how it functions, thinks reacts, senses, talks, lives etc. The living biochemical bodies require a safe and nurturing environment and top grade ‘fuel’ that maintains harmony and equilibrium. What may be nurturing and advantageous to one may not be to another, if we consider the various factors that account for an individual’s diet plan, based on Ayurvedic principles. This would literally mean an individual Food Pyramid for each person. Within the subgroups of food lists, there would be preference provided according to the fresh seasonal foods available. Quantity is not based on calories but on the power of digestion and fullness of the stomach, being able to gauge what 75% full means or stopping at the first burp with the second being past the red light signal. Bringing awareness to the body whilst eating has endless benefits of increasing one’s consciousness for a harmonious life. Being aware of all the senses as we eat brings joy and increases intuitive perception, as well as showing respect, for the food and the action of taking in Earth’s bounty.  
 
Lastly, in Ayurveda, ahara/diet is not separated from lifestyle. Lifestyle that balances each individual constitution is important in maintaining balance of the subtle energies within. By subtle, it is meant to be the health that leads us to purity and sattva/equilibrium for a transformational consciousness. Only when there is balance in the mind, can the right choices be made, and when the physical body is at its optimal working level, the mind is also predisposed to attaining the best possible limits. Ayurveda looks at health as the whole body in terms of physical, mental and subtle aspects.
 

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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 By Sandhiya Ramaswamy

 ||        Dhanvantari Stotram     ||

Om Sankham Chakram Jaloukaam

Dadhadamruta GhatamChaaru Dorbhicchaturbhihi

Sookshma Swacchati Hrudayaamsuka

Parivilasan Moulim Amboja Netram

Kaalaambodojvalaangam Katitata Vilasat

Chaaru Peetaambaraadyam

Vandey Dhanvantarim Tam

Nikhila Gada Vana Proudda Daavaagni Leelam 

Salutations to him, Lord Dhanvantari, who is holding in his four hands a Conch, a Disc .a Leech and a pot of celestial ambrosia

in whose heart shines a very clear, gentle and pleasing blaze of light, which also shines all around HIS head and lotus eyes.

On the dark blue/black water his body is luminous and splendid.

His waist and thighs are covered in yellow cloth and who by his mere play destroys all diseases like a huge forest fire.

||                     Mahalakshmi Gayatri               ||

Om Mahalakshmyai cha vidmahe

Vishnu patnyai cha dhimahi

Tanno Lakshmihi prachodayat

Om. Let us meditate on the Great Goddess Sri Lakshmi, the consort of Sri Maha Vishnu. May that effulgent Maha Lakshmi Devi inspire and illumine our mind and understanding.

Acknowledgements

I would like to offer my sincere thanks to my teachers at the California College of Ayurveda – Rob Talbert, Hema Ravikumar, Marisa Larsen, Mary Alice Quinn who have inspired me every step of the way.  My thanks to Dr. Marc Halpern, who has put together such an amazing course of Ayurvedic study.   I also offer my thanks to my wonderful class-mates at CCA, my friends and members of my family who have encouraged me along the way and offered me their unconditional support.  Most of all, I thank Lord Dhanvantari, the God of Ayurveda, who has offered me divine guidance, illuminating my path every step of the way.

See PDF Article

 

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

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 greater healing in the physical, mental, and emotional bodies. 
When contemplating the manipulation of the emotions, energetic body, or physical points remote to a specific marma it is interesting to note the correlation with modern superstring theory which considers all particles to be made of “infinitesimally small vibrating strings”5 which are the foundation of all energy. 
  • The oneness of mindbody and how it may be bundled as vibrating energy that is interconnected to everything else in the universe, is the basis of what may be called the "Cosmic Connection". Furthermore, vibrating bundles of energy (i.e., vibrating strings of mutual harmonic resonance that have coalesced to form an electromagnetic field operating at a given frequency -- not unlike a frequency for a radio station, for instance) create fields of influence around their physical selves.  A physical manifestation of the energy of thoughts is the instincts and/or emotions as they elicit as a response to a specific stimulus.7
   Since all matter, all emotions, and all thoughts are considered to be energy, and since all energy is thought to be made up of the same fundamental component, it becomes clear how the manipulation of certain points on the body could promote healing elsewhere.  According to Dr. Deepak Chopra, “Once you strip off its physical mask, a cell is really a junction point between matter and consciousness, a station where the quantum mechanical body and the outside world intersect.” (Chopra, 178) 

Yoga Asana
   Yoga is known to increase general pranic levels  and also directly affects marma points through compression in certain poses.11  For example, Janu Sirsasana (seated forehead to knee pose) compresses Nabhi, Janu, and Sthapani marma as the third eye connects with the knee, and the abdomen is contracted.  Sirsasana (headstand) stimulates Adhipati through the connection of the crown chakra with the earth.  Halasana (shoulder stand) affects Hrdaya, Nila, and Nabhi as the frontal plane of the body is contracted and may also affect Brihati and Krikatika on the posterior plane.  With a thorough knowledge of marma points and yoga postures, a great variety of therapeutic applications may be derived. 

Meditation 
   Healing may be brought on by meditation upon a specific marma point, or set of points, to promote the free flow of prana independently of a therapist.  Simply concentrating one’s energy on the specific point(s), or by following the flow of energy within the body to or from a specific point, or by performing a complete rotation of consciousness around all the marma points of the body, awareness and healing may be achieved. 
   

Conclusion

The subject of Marma Therapy is vast and complex, with varying opinions from many prominent Ayurvedic physicians and scholars.  All seem to agree on at least one thing:  that marma points are regions on the body powerful enough that they can be used for harm or healing.  The experience of the author in the realm of using marma points for healing has been quite potent, through meditation, yoga postures, massage, and pranic healing techniques used on her self and in the use of therapeutic touch and pranic healing transmitted to others, and this experience was her motivation for embarking upon this research.
 

Bibliography:

1.    Bhishagratna, Kaviraj Kunja Lal.  An English Translation of the Sushruta Samhita.  Calcutta:  Published by Author, 1911
2.    Frawley, Dr. David.  Ayurveda and Marma Therapy.  Wisconsin: Lotus Press, 2003
3.    Halpern, Marc, The Importance of Marma Therapy in Ayurvedic Practice:  http://www.ayurvedacollege.com/importance-marma-therapy-ayurvedic-practice
4.    Lad, Vasant.  Marma Points of Ayurveda.  Albequerque: The Ayurvedic Press, 2008
5.    Smith, William L.  The Human Electromagnetic Energy Field:  It’s Relationship to Interpersonal Communication:  http://www.journaloftheoretics.com/articles/4-2/Smith.htm
6.    Swami Vivekananda Yoga Anusamdana Samsthana, Bangalore, India, Effects Of Yoga Practice on Acumeridian Energies: Variance Reduction Implies Benefits for Regulation: http://www.ncbi.nlm.nih.gov/pubmed/23439630
7.    Halpern, Marc. Ayurvedic Marma Therapy.  Course Supplement, 2004 - 2012.
8.    Murthy, Prof. K. R. Srikantha. Illustrated Sushruta Samhita, Vol 1,2,3.  Varanasi, Uttar Pradesh, India: Chaukhambha Orientalia, 2010.
9.    Chopra, Deepak. Perfect Health. New York: Three Rivers Press, 1991
10.    Muley, SK, Associate Professor and Head, Department of Sharira Rachana, Government Ayurved College, Nanded, Maharashtra, India, Study of Vaikalyakara Marma with special reference to Kurpara Marma: http://www.ncbi.nlm.nih.gov/pubmed/22661839
11.    Niharika Nagilla, Swami Vivekananda Yoga Anusamdana Samsthana (S-VYASA), Bangalore, India, Effects of yoga practice on acumeridian energies: Variance reduction implies benefits for regulation: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573545.
12.    Caraka.  Caraka Samhita.  R.K. Sharma and Bhagwan Dash translation.  Varanasi, India:  Chowkhamba Sanskrit Series Office, 1976.
 
 

Allopathic and Ayurvedic Approaches to Hypothalamic Amenorrhea By Sharyn Galindo

   There are two kinds of Hypothalamic Amenorrhea, primary and secondary. Primary refers to females that have not yet had their periods by the age of sixteen. Secondary, is when a woman who previously had normal periods, temporarily or permanently stops menstruating. While many women skip an occasional period, amenorrhea is diagnosed if a woman has missed three or more in a row. This secondary amenorrhea, also known as “Functional” amenorrhea is what will be addressed in this paper. Hence, "Hypothalamic amenorrhea" can technically be defined as the cessation of menstruation due to a dysfunction of hypothalamic signals to the pituitary gland resulting in a failure of ovulation or stimulation of ovulation. Typically, young women who are affected by the condition have no obvious structural abnormalities of the hypothalamus or the rest of the brain, pituitary gland, or ovaries. This common type of functional amenorrhea is a diagnosis of exclusion. Hyperprolactinemia, primary deficiency of gonadotropin-releasing hormone, and other hormonal and electrolyte abnormalities must be ruled out. Affected women are reportedly more likely to be underweight, athletic, engaged in "intellectual" professions, or exposed to social stress than women without the disorder.1
 
   In addition, hypothalamic amenorrhea may be preceded by a history of irregular menses and may last several months to years. When it occurs in association with weight loss or intense exercise, hypothalamic amenorrhea is considered to result from energy deficiency. Deficits in nutrients, hormonal perturbations, or both may signal to the brain, leading to the disruption of the pulsatile secretion of gonadotropin-releasing hormone and luteinizing hormone as well as disruption of the menstrual cycle. On the other hand, hypothalamic amenorrhea has also been described in nonathletic women of normal weight -- a variant that may be associated with psychogenic factors such as stressful life events or adverse childhood experiences.2 An association between menstrual aberrations and stressful situations has long been recognized. For example, women frequently start their menstrual periods on their wedding days or when their husbands return home from military service. Women hospitalized for depression are commonly reported to have amenorrhea. Fifty percent of women in concentration camps developed amenorrhea which persisted throughout their detention. In addition, it has been repeatedly demonstrated that a considerable number of women develop menstrual aberrations, and as high as 20% develop amenorrhea when undergoing the stress of separation.3 There are examples of it happening at the time of breaking up with a significant other/life partner, desertion by a parent, and leaving home. Moreover, psychogenic amenorrhea, like exercise-related amenorrhea, has been associated with subtle deficits in calorie and macronutrient intake, as well as with neuroendocrine abnormalities. Thus, a central signal related to energy deficit may be the common factor underlying the two forms of hypothalamic amenorrhea.4

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An Ayurvedic Approach to the use of Cannabis to treat Anxiety By: Danielle Bertoia

At (approximately) nearly 5000 years old, Ayurveda is touted as being one of, if not the oldest healing modality on the planet. The word Ayurveda translates from Sanskrit to “The Science of Life” and is based on the theory that each of us are a unique blend of the 5 elements that make up the known Universe and our planet. Earth, air, fire, water and ether all combine together to create our physical form. When living in harmony with the rhythms of nature and in accordance to our unique constitution, health prevails. When we step outside of our nature by eating foods that are not appropriate, exposing ourselves to outside stressors, and by ignoring the power of our internal knowing, we then leave ourselves vulnerable to dis-ease.

Doshic theory reveals to us that these 5 elements then combine with one another to create 3 Doshas. Air and Ether come together to create Vata, Fire and Water to create Pitta and Earth and Water to create Kapha. As we take our first breath upon birth, we settle into our Primary, Secondary and Tertiary doshas, also known as our Prakruti. This becomes our initial blueprint, our Health Touchstone if you will, which we will spend our lifetimes endeavoring to preserve. As time and experience march on, we may begin to experience a distancing from this initial blueprint, a disconnect from our true health, also known as our Vikruti. Outside stress, incorrect food choices, our personal karma and incorrect seasonal diet can all contribute to an imbalanced state within the doshas. By then looking to the qualities of the imbalance we can apply opposing qualities to draw the doshas back into harmony.

When looking specifically to Anxiety and seeking to treat it medicinally with Cannabis, we must first understand the nature of Vata dosha, as well as it’s 5 vayus. Vata dosha is comprised of Air and Ether, is cold, light, dry, mobile, rough, subtle and clear. Vata is responsible for movement, motor function, circulation, respiration and sensory function. Each of these functions are assigned to a particular Vayu, or sub-dosha of Vata. To understand Anxiety more clearly from an Ayurvedic perspective, we examine both Vyana and Prana vayu for disturbances.

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An Ayurvedic Perspective on The Lunar Effect By Arlini Singh

 ya esa sodasa-kalah puroso bhagavan manomayo ‘nnamayo “mrtamayo deva-pitr-manusya-bhuta-pasu-paksi-sarispavirudham pranapy ayana-silavat sarvamaya iti varnayanti

Translation

Because the moon is full of all potentialities, it represents the influence of the Supreme Personality of Godhead. The moon is the predominating deity of everyone’s mind, and therefore the moon-god is called Manomaya. He is also called Annamaya because he gives potency to all herbs and plants, and he is called Amrtamaya because he is the source of life for all living entities. The moon pleases the demigods, inhabitants of Pitrloka, animals, birds, reptiles, trees, plants and all other living entities. Everyone is satisfied by the presence of the moon. Therefore the moon is also called Sarvamaya ( all pervading) ( Srimad - Bhagavatam 5.22.10)1.

Introduction

For centuries, Man has looked up and gazed at the wonder and splendour of the Moon. Therefore, it is not surprising that the Moon has played such a vital role in the traditions of every culture, as Man has appreciated and respected the Moon, not only for it’s beauty, but also for his survival.

Johanna Paungger and Thomas Poppe in their book, Guided by the Moon, states that Man discovered:

“ - that numerous natural phenomena - the tides, birth, meteorological events, women’s menstrual cycle, and much more - are related to the movements of the moon

 - that the behaviour of many animals depends on the position of the moon; that birds, for example, always gather their nest material at particular times, so that the nests dry our rapidly after a rainfall

- that the effect and success of both countless everyday activities and others that are less everyday - cutting wood, cooking, eating, cutting hair, gardening, putting down fertilizer, doing laundry, using medicines, performing surgical operations, and many other things - are subject to rhythms in nature

- that sometimes operations and doses of medicine administered on certain days can be helpful, while on other days they can be useless or even harmful - often regardless of the amount and quality of the medication or the skill of the doctor

- that plants and their component parts are exposed to different energies from day to day - a knowledge of which is crucial for successful cultivation, tending and harvesting of crops - and that herbs gathered at certain times contain incomparably more active agents that at other.

In other words, the success of an intention depends not only on the availability of the necessary skills and resources, but also decisively on the timing of the action.”2

The moon is the Earth’s only natural satellite and the average distance between ourselves and moon is about 384,400 km. Currently, it takes the moon 27.3 days to orbit the Earth. However, the moon is moving away from Earth at approximately 3.78 cm every year, causing the rotation of Earth to slow down. “Just like keeping a plate spinning on a stick, the key is to have the plate spinning fast, as if it slows down it crashes to the floor. In a similar way, as the Earth's rotation slows down, our whole planet may start to slowly wobble and this will have a devastating effect on our seasons.” BBC News, 1 February 2011.3

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Ashwagandha the World’s Healer By: Katlyn Bosnich

The desire for and use of more natural ways to bring health into the body as well as heal or help aid in the healing of current ailments are on  the rise. With people wanting more and more to do things the “natural” or “organic” way it is no surprise that more and more research is being done on the validity of these herbs that claim to heal and promote health. The medical world or maybe it is the mass’s that are coming full circle into a life that is a more in tune with nature and ultimately with the human body. Researchers are diving head first into studies that prove the validity and strength of some of these ancient herbs. Ashwagandha is one of many herbs that numerous studies are being conducted around to prove what has been written for hundreds of years in the ancient texts about herbs such as this. Ashwagandha is one of the most recognizable herbs in Ayurvedic Medicine and Ayurveda itself. Ayurved is said to be “as old as humanity” according to Dr. Halpern in his book The Principles of Ayurveda, he also follows this up with saying that historians place the age of Ayurveda anywhere from 5000-10,000 years old. Ashwagandha being one of the most respected rasayana herbs of Ayurvedic Medicine means that this herb has been around as long as the science has as well. 4 We believe this because it is frequently referenced in the Caraka Samhita as well as the Sushruta Samhita. 5,6

Ashwagandha’s botanical name is Withania Somnifer; meaning winter cherry. Ashwagandha also has many other names such as Ajagandha, Amangura, Amukkirag, Asan, Asana, Asgand, Asgandh, Asgandha, Ashagandha, Ashvagandha, Ashwaganda, Ashwanga, Asoda, Asundha, Asvagandha, Aswagandha, Avarada, Ayurvedic Ginseng, Cerise d'Hiver, Clustered Wintercherry, Ghoda Asoda, Ginseng Ayurvédique, Ginseng Indien, Hayahvaya, Indian Ginseng, Kanaje Hindi, Kuthmithi, Orovale, Peyette, Physalis somnifera, Samm Al Ferakh, Samm Al Rerakh, Sogade-Beru, Strychnos, Turangi-Ghanda, Vajigandha, Winter Cherry, and Withania, As a result of this plants various applications its popularity has spread to all over the world and so many names have been created to interpret the name Ashwagandha to fit into other cultures and laguages.   These multiple different languages only makes it more obvious of how highly diverse and widely accepted this herb is. Ashwagandha is a shrub like plant that is common in hot temperatures and places like Bombay and west India; the parts of the plant that are commonly used are the roots and leaves although all parts of the plant have been known to be used in various different formulas. 1

As a rasayana; Ashwagandha promotes youth and mental health, and is said to expand happiness. Among rasayanas Ashwagandha holds the most prominent place for its adaptive properties and many applications in promoting health and wellness in all ages and all ailments, particularly for weakness and tissue deficiency. But is also beneficial for those who are overworked and have a lack of sleep. Ashwagandha is also an aphrodisiac, adaptogen, nervine tonic, sedative, and an astringent. Its many actions are one of the many reasons it is such a revered herb. 2

The dosic effects and properties of Ashwagandha are that its taste is bitter and astringent its energy is heating but has a sweet effect. Its doshic effect is pacifying to vata and kapha but can be aggravating to pitta in excess when ama is present. The tissue it acts upon is muscle, fat, bone, bone marrow, nerve and the reproductive organs. The systems that Ashwagandha works on are mostly the reproductive, nervous, and respiratory. The actions of Ashwagandha are tonic, rejuvenative, aphrodisiac, nervine, sedative, and astringent. It is indicated for use for general disability including sexual disabilities, excessive exhaustion, emaciation, old age, memory loss, muscle loss, paralysis, multiple sclerosis, skin diseases, difficulty breathing, infertility and many more ailments that take away from the tissues of the body. Some precautions when using this herb are when ama is high or with severe congestion as it can aggravate the problem. Ama must be cleared first and then Ashwagandha can be beneficial without cleaing the channels first the weight of Ashwagandha would only be stacked on top of the present ama, causing more problems than help. 2 This is why it is important to be informed on your condition and to consult with an Ayurvedic Specialist before jumping into taking any herb before understanding all of its possible effects on the body.

Rasayana’s and rejuvenation therapy is referenced many times in the Carka Samhita writing that “A person undergoing rejuvenation therapy attains longevity, memory, intellect, freedom from disease, youth, excellence of lustier complexion and voice, excellent potentiality of the body and the sense organs, (i.e. What he says comes true), respect and brilliance.” Caraka Samhita VOL.III pg.8. The long list of amazing benefits of rejuvenative techniques are exactly the same benefits that Ashwagandha has and by this proving that when Ashwagandha is integrated into the diet combined with a healthy lifestyle it proves to bring health and wellness to the body and mind. As a rasayana herb it is a vital part of many rejuvenative therapies and brining health and wellness back to a body that has been depleted by purification, disease or any form of over work or stress. This herb along with rejuvenation therapies can also help prevent disease and the effects of aging.  The Caraka Samhita gives more specific qualifications to rasayana’s saying that “The term rasayana… connotes a specific meaning…drugs, diet and regiments, which promote longevity by preventing aging and disease.” Caraka Samhita VOL.III pg.3 Giving clear distinction that rasayana type herbs combined with diet and lifestyle is what leads the body and mind to overall health and wellness. The integration of this herb into daily life can also facilitate a clearer mind in order to make better more healthful decisions, so that one may have a youthful, disease free life.

Not only is Ashwagandha used as a rasayana for rejuvanative techniques but also as hypnotic in alcoholism and emphysematous dyspnea. According to the India Materia Medica the roots and bitter leaves are used as a hypnotic in the treatment of alcoholism. 1 While Ashwagandha has many rasayana properties it is also a nervine tonic and sedative. The diversity of this herb and its ability to be applied to many types of ailments is why it is so useful in so many different healing methods and herbal formulas. Its applications run from fatigue to stress, from overwork to recovery from disease or surgery, it is even used in cases of extreme loss or sadness. 2 Ashwagandha’s many applications is why it is so well known and widely used within Ayurvedic Medicine as well as beyond.  As a widely accepted and diverse herb, it is used in many fashions; again in the India Materia Medica references another way to use Ashwagandha beyond internally as a tea or capsule but also the leaves maybe used topically in the treatment of carbuncles. “A carbuncle is a skin infection that often involves a group of hair follicles. The infected material forms a lump, which occurs deep in the skin and may contain pus” as defined by Medline Plus with the U.S. National Library of Medicine. The leaves being anthelmintic can help calm the intensity and pain of the affected area, again referencing Ashwagandha’s wide scope of application. 1

Another of Ahwagandhs’s many applications is its application towards stress. “Stress is simply a reaction to a stimulus that disturbs our physical or mental equilibrium. A stressful event can trigger a fight or flight response, causing hormones such as adrenaline and cortisol to surge through the body. ” PsycologyToday.com As stress rises more and more in our culture it is no wonder people are turning to all sorts of different techniques and drugs in order to help control the constant pressure and stressors of life. Ashwagandha has had many studies done to prove it’s effectiveness for combating stress and lowering cortisol levels. In a study published on PubMed a double blind random study was done on 64 individuals with a history of chronic stress. They were split into two groups one given a placebo and one given a high concentrate full spectrum Ashwagandha capsule for sixty days. The group who took the Ashwagandha experienced significant and measurable reduction in all stress assessments and cortisol levels were sustainably reduced as well. The study concluded that Ashwagandha root extract proves to be effective in improving ones resistance to stress and improves overall quality of life as a result.  14

In an another study found on Pub Med Ashwagandha’s adaptogenic properties were studied and it was found showing increased stamina and the ability to keep ascorbic acid and cortisol levels low even during the high stress of swimming, the experiment; done on rats showed significant protection from high levels of stress. As well as showing protection from stress induced gastric ulcers. 7

Disease can be described as anything causing a lack of ease therefore stress can be considered a huge disease affecting the western world. With a life that is in a constant state of movement and is always in need of being faster and more productive it is no wonder people are turning to anything that can help them combat the stress. While lifestyle is a huge reason for stress there are many herbs that can help combat these stressors of daily life. With Ashwagandhas adaptogenic properties it is no wonder that people are doing so many studies on herbs such as these. Ashwagandha has such amazing effects on keeping the body healthy and healing it from diseases as well as its stress fighting attributes. The adaptogenic properties give the body room to process stress and worry and to let go of it much more easily. 3

With further study of this herb material was found to prove its effectiveness in and around cancer, tumors and their treatment. In the medical journal called “Cancer Letters” a study was done on the components of selective cancer killing properties of Ashwagandha leaf extract. Their research found that the leaf extract of Ashwagandha had cancer inhibitory factors and has at least seven components that could kill cancer safely; in this study it was also shown to be non-toxic to the body and also have anti tumorigenic in studies done on mice. They also took on a gene silencing and pathway analysis and found that the extract and the components within it kill cancer cells by at very least five different pathways. Making the leaf extract of Ashwagandha highly effective in the treatment of cancer. 13

Cancer is described as abnormal cells dividing uncontrollably and destroying body tissue. According to the American Cancer Society the estimation for new cases of cancer this year alone is 1,658,370 and the estimated deaths from cancer this year alone are 589,430. Thankfully Ashwagandha’s effects have even been tested on and in relation to cancer and chemotherapy. Showing significant antitumor effects in experiments without causing any systemic toxicity. According to Euro PubMed and then Indian Journal of Experimental Biology these tests were conducted and came back to prove that Ashwagandha could be a great resource of natural treatment for cancer and other autoimmune diseases. 12 In another study done on an adult mouse with a tumor there was significant response from the tumor with the addition of Ashwagandha in tincture form. The combination of Ashwagandha and hyperthermia at 43 degrees Celsius proved to be just as effective as radiation therapy on the tumor. Again proving to be a healthy alternative to traditional radiation techniques in regards to tumors and or cancer. The research says, “It is concluded that Ashwagandha in addition to having a tumor inhibitory effect, also acts as a radio-sensitizer and heat enhances these effects.” 11

In the book The Yoga of Herbs Dr. Frawley and Dr. Lad describe Ashwagandha as having the smell of a horse and giving the vitality and sexual energy of a horse. Another of Ashwagandha’s many qualities and functions is its work as an aphrodisiac; an aphrodisiac according to Webster Dictionary is a food, drink, or drug that stimulates sexual desire. While Ashwagandha has been shown to improve sexual desire it has also been proven to promote men’s reproductive health and even increase sperm count in men with infertility. As many as 50% of men deal with infertility and low sperm count, while the exact cause of this is unknown there have been studies to show the benefits of Ashwagandha and improved health in men’s reproduction. In a random blind study of forty six men with oligospermia or low sperm count they were give full spectrum root extract of Ashwagandha for ninety days and on the final day there was 167% increase in the sperm count, a 53% increase in volume and a 57% increase in the motility of the sperm of those who were given the root extract compared to those given the placebo. These results show a significant benefit in regards to men’s reproductive health. 10

Ashwagandha has also been shown to be active towards bacteria, and as an anti-bacterial and anti-fungal herb its effectiveness has been tested against multiple pathogenic bacteria, the properties of these traits have been revealed by a study done in 2005, testing Ashwagandha’s ability to protect various mice that had been treated with many different strains of bacteria one in particular being the bacteria Salmonella typhimurium. The study revealed that the mice that were administered Ashwagandha extract in tincture form orally had not only a higher survival rate but also had lower bacterial load found in their system and in their various vital organs.  9

A fungus is described as “any of a diverse group of eukaryotic single-celled or multinucleate organisms that live by decomposing and absorbing the organic material in which they grow…” by dictionary.com. The fungus A.niger is one of the most common fungi and is described by the EPA “Aspergillus niger is a member of the genus Aspergillus which includes a set of fungi that are generally considered asexual, although perfect forms (forms that reproduce sexually) have been found. Aspergilli are ubiquitous in nature. They are geographically widely distributed, and have been observed in a broad range of habitats because they can colonize a wide variety of substrates. A. niger is commonly found as a saprophyte growing on dead leaves, stored grain, compost piles, and other decaying vegetation. The spores are widespread, and are often associated with organic materials and soil”. A study done with Ashwagandha and its effectiveness against such fungi as A. niger were done, in this study the plant extract was tested from multiple different solvents. The study showed that Ashwagandha had effectiveness using any solvent but was the most effective when the extract was done in methanol. Proving Ashwagandha’s effectiveness even against fungi, really showing a large scope of productivity as an herb. 8

As a result of Ashwagandha’s many applications it is no wonder why there are so many different ways to prepare this herb for use. Each aliment or need easily has it’s own method of preparation. Looking at India Materia Medica and The book The Yoga of Herbs a long list of preparations for specific and non-specific ailments were found. The most common preparations for Ashwagandha are a decoction in either milk or water, but also can be made into a paste or medicated ghee or oil. 2 Also because of its many applications the modes in which it is administered varies on the application needed for the aliment involved. The Indian Materia Medica has a long list of formulas and recommendations for some general and specific aliments. I have included a few interesting ones found with in the book. The fruits and seeds can be used as a diuretic and to coagulate milk. The root is used in the application of obstinate ulcers and rheumatic swelling. The dosage is approximately 30 grains in the treatment of consumption, emaciation of children, senile debility, and in any case of general debility or exhaustion. Powdered Ashwagandha mixed with ghee and honey in equal parts is recommended for impotence or any problems with seminal fluid. For women who are pregnant or are in an older stage of life it is recommended to drink a decoction made from the powder or to mix the powder in milk. A formula given to sterile women is a decoction made from milk that ghee is added to, it is given as a cure for the these women. A formula for weak children would be a decoction of the root boiled down to a paste and is then is placed in warm milk and mixed with ghee. For skin diseases or irritations Ashwagandha powder can be mixed with oil and applied topically. Ashwagandha is also recommended for improving eyesight; a classical formula for this is a mixture of the root powder mixed with licorice root powder and taken with the juice of Indian gooseberry or amla. 1

Most commonly Ashwagandha is found in capsule form in recent years according to Swanson’s Vitamins but there are many other ways to receive the herb. It is also available in powder form as well as tincture or extracts in liquid form or in a “cut a sifted” option, giving the herb a longer shelf life and more versatility to the individual who is using the herb. Allowing the individual the option to grind the root into powder or to  make it into a decoction or medicated oil or ghee and even placing your own formula into a capsule as well. Each modality the herb is in is dependent on the body system or tissue that needs to be affected. For example if the issue is stress then the use of a tincture is helpful because as stated earlier stress triggers hormones like cortisol and hormones get processed in the liver. With a tincture or extract made in alcohol it causes its direct action to go straight to the liver because alcohol is something else that the liver needs to process solely.

Ashwagandha is considered one of the most respected herbs in Ayurvedic Medicine and as an herb that pacifies all three doshas meaning it works well with all types of people, it is no wonder that it has such wide scope of application. 4 As discussed in this review of literature the vast uses of Ashwagandha and its ability to work with many different body systems and tissues as well as fight against many different ailments it is no wonder that this herb is one of the most respected. Although many think of this herb as only a tonic for men’s reproductive system as covered above the range of application is far beyond a higher sperm count. The scope of this herb ranges from building up tissue that has been depleted as a result of purification or emaciation do to illness to fighting against abnormal tissue that is attacking the body the way cancer does, from being antibacterial and antifungal to calming the mind, clearing stress and lowering cortisol levels to even as far as shrinking tumors and aiding in safer forms of chemotherapy like treatment. This herbs vast wealth of healing properties is why people are continuing to run studies and research programs to make sure this herb is all that it claims to be. A truly magical healer when it is combined with diet and lifestyle, this honored rasayana really does bring freedom from disease, as well as bring youth back to the body, promote longevity, memory function and expand happiness. How could one not be happy if their bodies and mind’s are free from disease and even aging is prevented? This herb like Ayurveda promotes immortality, something all people are looking for. 3 With the various benefits of Ashwagandha this herb is surely something to be integrating into all of our daily lives and diets in order to promote youth and expand happiness in not only ourselves but the world as well, creating a world free from disease would ultimately cause a happier more peaceful world because not only would health no longer be an issue or source of worry as healthier people, individuals would feel more happy and alive; spreading that good feeling everywhere they went.

End Notes

1. A. K. Nadkarni, Dr. K. M. Nadkarni’s INDIAN MATERIA MEDICA. Popular Prakashan 2010, - Volume I. 1976 1292-1293

2. Dr. David Frawley & Dr. Vasant Lad, Yoga of Herbs. Lotus press 2001 160-161

3. Dr. Marc Halpern, Principles of Ayurvedic Medicine. California College of Ayurveda, tenth edition, September 2010 - 1, 4

4. Dr. Marc Halpern, Clinical Ayurvedic Medicine. California College of Ayurveda, sixth edition, September 2012, - 7-39

5. R. K. Sharma & Bhagwan Dash, Charaka Samhita. Chowkhamba Sanskrit Series Office 2009 VolumeIII-3,8

6. Kaviraj Kunja Lal Bhishagratna M.R.A.S The Shushruta Samhita 1911 Volume II 348, 354,365,376,697

7. African Journal Traditional Complementary and Alternative Med. 2011; 8(5 Suppl): An Overwiew on Ashwagandha: A Rasayana Rejuvenator of Ayurveda 208–213. Published online 2011 Jul 3. doi:  10.4314/ajtcam.v8i5S.9

8. Babeet Singh Tanwer. Et al. /International Journal of Biopharmaceutics “Antifungal Potential of Ashwagandha against some Pathogenic Fungi” http://www.ijbonline.com/article/72-74.pdf

9. M. Owais, K.S. Sharad, A. Shehbaz, M. Saleemuddin, Elsevier Phytomedicine  “Antibacterial efficacy of Withania somnifera and indigenous medicinal plant against experimental murine salmonellsis Volume 12, Issue 3, 22 March 2005-229-235 http://www.sciencedirect.com/science/article/pii/S0944711304000789 

10. Vijay R. Ambiye et al, Hinwadi Publishing Corporation Volume 2013 “Clinical Evaluation of the Spermatogenic Activity of the Root extract of Ashwagandha in Oligospermic Males” http://www.hindawi.com/journals/ecam/2013/571420/ 

11. Devi PU, Sharada AC, Solomon FE Indian Journal of Experimental Biology Antitumor and radio-sensitizing effects of Withania somnifera(Ashwagandha) on a transplantable mouse tumor. 1993, 31(7): 607-611 http://europepmc.org/abstract/med/8225418 

12. Devi PU, Indian Journal of Experimental Biology Withania Somnifera Dunal (Ashwagandha); Potential plant source of promising drug for cancer chemotherapy and radio-sensitization. 1996, 34 (10): 927-932 http://europepmc.org/abstract/med/9055640 

13. Nashi Widodo, Yasuomi Takagi, Bhupal G. Shrestha, Tetsuro Ishii, Sunil C. Kaul, Renu Wadhwa. “Selective killing of cancer cells by leaf extract of Ashwagandha: Components, activity and pathway analyses. “Cancer Letters” Volume 262, Issue 1, April 8, 2008- 37-47 http://www.sciencedirect.com/science/article/pii/S0304383507005848 

14. K. Chandrasekhar, Jyoti Kapoor, and Sridhar Anishetty  “A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of Ashwagandha root in reducing stress and anxiety in adults” Indian Journal Psychological Medicine. 2012 Jul-Sep; 34(3): 255–262. doi:  10.4103/0253-7176.106022

 
 

Ayurveda and Application of Cannabis in Abnormal Tissue Development By: Brian G. Zeck

Ayurveda is an ancient healing system from India that translates to be the “Science of Life”.  Its origins date back somewhere between 5 and 10 thousand years ago, although it has been described as being as old as Humanity itself.  Abnormal tissue development or cancerous tissue in the human body has been a topic discussed throughout the ages in both Ayurveda and today in Modern Science.  Even today many questions are being explored as the best approach to healing the many forms in which this disease manifests.  As there are many different types of tissues in the body, any of these can develop abnormally.  The herb Cannabis Sativa has gained popularity in mainstream media often times debating its application and possible health benefits when dealing with patients who have become ill due to cancerous tissue. The exploration of Abnormal Tissue Development and the use of Cannabis Sativa in Ancient and Modern Times will provide a look into the viable possibilities of dealing with a modern day epidemic.
 
The Science of Ayurveda provides a holistic approach to well-being and is founded through the Ancient Vedas of India considered the oldest writings in the world.  The Ayurvedic Texts provide the largest compiled knowledge on the subject of health and healing and date back to 500 and 1500 BC.   Exploring these writings will allow for an in depth look into practical application of Ayurveda and the use of Cannabis Sativa to promote healing and well-being to patients suffering due to abnormalities in tissue development.
 
The foundation of Ayurveda is built upon the “Three Pillars”.  “The Charaka Samhita states that one who manages these Three Pillars properly is guaranteed a full span of life that is not cut short by  disease”.11 The three pillars are food, sleep, and observance of brahmacharya.  Food refers to proper digestion which sustains the proper development of tissue and energy in the body.  If inappropriate food is taken then the result is disturbance in the development of tissue and toxins increase in the body leading to disease.  Sleep is utilized to rest and repair the body and if adequate sleep is not received then the body breaks down.  Too much or too little sleep determines the quality of tissue development.  Too little sleep builds weak tissue whereas too much sleep develops excessive tissue.  Management of sexual energy is crucial due to the concept of optimal tissue development, development of intellect, and cultivation of the life sustaining force in Ayurveda called Ojas.  When all three of these concepts are followed health and well-being is ensured according to this system.
 
The Ayurvedic System works in accordance with the three pillars of life through the Doshas, Dhatus, and Srotas.  “Dosha literally means faulty or to cause harm”, yet when in balance maintain harmonious health of the normal body processes. 11 The Three Doshas are the forces that determine their embodiment of the five elements earth, water, fire, air, and ether.  The three Doshas are Vata, Pitta, and Kapha.  Vata being air and ether breaks down tissue and generates movement throughout the body, pitta being fire and water maintains metabolic activity, and kapha being water and earth builds new tissues.  The Dhatus are the tissues and there are seven of them Rasa the plasma, Rakta the blood, Mamsa the muscle, Medas the fat, Asthi the bone, Majja the nerves, Shukra the reproductive.  The Srotas are the channels that allow the bodily systems to flow providing nourishment to tissue and removing wastes keeping tissues clean.  The Srotas allow a person to eat, digest, deficate, breathe, and procreate, the basic functions of being a human and maintaining a body.  
 
Abnormal tissue or overgrown tissue is always a Kapha imbalance.  This Kaphagenic lifestyle can lead to overgrown tissue, abscesses, tumors, cancer and overall stagnicity in the body causing blockages and excess fluid.  The Sushruta Samhita mentions “A swelling, no matter whether limited or extensive, spontaneously runs on to suppuration, if not medically treated, or left to nature.  The base of such a swelling goes on extending.  It becomes unequally supporated and reaches an unequal elevation, thus affecting the deeper tissues of the part and swiftly running into one of an incurable type”.12 It was known through the ancient scripts that it is rare for an over development of tissue to reduce naturally and if left untreated would lead to an incurable disease.   
 
In Ayurveda the physician would use their wisdom of the properties of each dosha to work to bring the kapha dosha back into balance. Keeping in mind that any of the doshas out of balance can push Kapha to develop abnormal tissue. Certain Herbs or herb blends would be used to shock the dosha back into balance.  In regards to the Ayurvedic Physician, in the chapter of the Susruta Samhita which deals with the mode of distinguishing between supporating and non-supporating swellings known as Ama-pakvaisaniya adhyaya, the Authorative verse is as follows, “They Physician (surgeon) who opens an unsuppurated or unripe swelling out of ignorance, as well as the man who neglects a fully supporated one, should be looked upon as the vilest canda’la for his wrong or incorrect diagnosis”.12  This statement expresses the utmost importance of proper diagnosis when dealing with abnormal tissue growth.  The Sushruta Samhita is a reference literature based in Surgery in the ancient time of Ayurveda, whereas describes surgery to a patient with a tumor.    
 
Proper treatment of benign and malignant tumors is explained in the chapter Granthi-Arbuda-Slipada-Apaci-Nadi-Pratisedha of the Ashtanga Hrdaya of Vagbhata, The Book of Eight Branches of Ayurveda.  “For benign tumors which is unripe, the treatment is the same as of any swelling. The patient requiring purificatory therapies should be given oleation therapy first with ghee made with brhati, citraka, vyaghri, and kana; when he gets purified, application of paste of drugs of penetrating action should be done (on the tumor); the tumor should be fomented many a times and squeezed (by hands) again and again.”.8 For malignant tumors the same treatment is prescribed.   Note, the application of paste of drugs of penetrating action.  The Ashtanga Hrdaya states, “inspite of all the treatments, should be cut and when bleeding stops it should be burnt by fire (thermal cautery) leaving no residue/remnant, because such as residue/remnant is sure to develop again into a tumour”.8 Even to this day we use a very similar approach to cutting out a tumor and getting out the residual of cancerous tissue in hopes the tumor will not come back.  Modern Technology offers abundant applications to work to make this tumor method removal more successful.
 
The purpose of this research is to assess if the principles of Ayurveda can actually prevent the need to perform open surgery using the principles to reduce the abnormal tissue growth before it becomes ripe, along with beneficial application of medicine for those which are ripe.  This would imply getting to the root cause of the symptom.  Through the Ayurvedic approaches of creating balance within the systems of the body, generating abnormal tissue growth can be reverted.  The Herb Cannabis Sativa has been used throughout the ages as a medicine to subdue many ailments.  In Sanskrit, the language of Ayurveda, Cannabis is known by many names including bhanga and indrasana. The properties of Cannabis Sativa include Rasa a bitter taste, Guna qualities are light, strong or fast and penetrating, and dry, Vipaka has a pungent taste after digestion, Veerya has a hot potency, Its Prabhav is intoxicating, and it balances the Vata and Kapha Dosha. It also increases heat in the body referred to as ushna property.10 
 
There are many preparations of bhanga and when spoken about within ancient texts it is implied that it is never administered without careful preparation most often administer mixed with various other herbs.  According to the Dravyaguna Vijnana there are three important preparations.  They are jatiphaladi curna, indrasana-rasayana, and madananada modaka.  Jatiphaladi curna is mainly used in treatment of digestive and respiratory conditions by calming Vata and Kapha Dosha.  Indrasana-rasayana is a paste of the leaves, honey, sugar-candy, and ghee which is extremely useful in all skin diseases and implies tonification therapy.  Madananada Modaka is considered to cure all diseases and balances the Kapha Dosha.  These three herbal concoctions applied to create balance of the doshas in the body can provide immense amount of support in what is called tridoshic therapy in Ayurveda.  The Purpose in the Ayurvedic System is to create balance and this balance is tridoshic.  These three herbal formulas with proper adjustments in lifestyle cover the goal of curing disease in the body by regulating Agni or the digestive fire, removing Ama or toxins, and supporting the liver and building rasa the initial dhatu (tissue) that supports all other dhatus in the body.  The body’s immune system has a mechanism to regulate mutated cells in the body.  To support this mechanism is to sustain optimal tissue development.  When this is achieved then reducing abnormal tissue development may be possible.
 
Modern science has developed technology which allows us to study the development of tissue in the body down to the cell level and beyond.  In order to gain an understanding of how abnormal tissue develops in the body, the biology of the cell must be understood.  In Cancer, a tumor cell proliferates without control since the capacity to recognize apoptotic signals has been lost.   Endoplasmic reticulum (cell membrane) stress sending a messenger to the mitochondria (central control) of the cell through the depolarization by the dependent mineral calcium regulates the many functions of the cell such as proliferation, differentiation, and apoptosis.  Since the cell has lost control of its signaling function behaving abnormally, the abnormal cell rapidly reproduces itself with the same abnormality or genetic mutation.  These cells are faster growing and much more porous than the normal cells with proper genetics.  Tumor formation arises from the imbalance between cell death and cell survival.
 
Ceramide resides on the cytosolic (inner fluid of cell) side of the endoplasmic reticulum serving as a precursor for the biosynthesis of Sphingolipids in the Golgi (prepares amino acids for cell development).  Sphingolipids are responsible for determining the life or death of the cell.  Ceramide promotes programmed cell death, whereas Sphingosine promotes cell survival.  Ceramide influences apoptotic events such as cell death receptor in the plasma membrane and pore formation at the mitochondria solely in mutated cells.  Due to the influence of ceramide on cell apoptosis, to promote ceramide production could offer promising solutions to anti-tumor therapies.
 
Medicinal properties of extracts from Cannabis Sativa have been used since ancient times, yet it was not until the 90’s that endogenous ligands for the cannabinoid receptors were identified.  “The term ‘Endocannabinoid System’ was coined to indicate the complex signaling system of cannabinoid receptors, endogenous ligands, and the enzymes responsible for their biosynthesis and inactivation”.3  The ‘endocannabinoid system’ influences many functions in many pathological conditions.
 
The main active ingredient of cannabis, tetrahydrocannabinol (THC), produces its effects through activation of CB(1) and CB(2) receptors.  “CB(1) receptors are expressed at high levels in the central nervous system (CNS), whereas CB(2) receptors are concentrated predominantly, although not exclusively, in cells of the immune system”.5  The important function of endocannabinoids in relation to cancer or abnormal tissue development, is the regulation of cell cycle and survival pathways.  “CB(1) receptors are found throughout the brain, spleen, eye, testis, and uterus, whereas CB(2) receptors are associated with the cells and organs of the immune system as well as tumor cells”2 Cannabanoids do not show selectivity between CB(1) and CB(2) binding, although synthetic cannabinoids are now available that allow for experimental delineation  of CB(1) versus CB(2) effects with an intention that CB(1) binding is responsible for the psychoactive properties of cannabinoid action, whereas CB(2) binding mediates immune effects.2  The way cannabinoids are acting as modulators of the immune system is becoming more apparent.  “CB(1) receptors are located on T lymphocytes, whereas CB(2) receptors, historically associated with immune function, are located in human B cells, natural killer cells, monocytes, polymorph nuclear neutrophils, and T cells.”2 It is apparent that understanding how this system works in the body is essential in understanding how non-invasive and non-toxic approaches to cancer therapy may be most effective.
 
Since the discovery of the endocannibinoidal system scientific evaluation of medical cannabis in humans is still in its infancy.   “In particular, cannabinoids offer potential applications as anti-tumor drugs, based on the ability of some members of this class of compounds to limit cell proliferation and to induce tumor-selective cell death”.13  Cannabinoids may induce proliferation, growth arrest, or apoptosis in a number of cells, including neurons, lymphocytes, and various transformed neural and non-neural cells.  The application of cannabinoids and its effects may depend on many factors such as concentration, timing of delivery, and type of target cell.13
According to the studies, the synthetic cannabinoids have shown to induce abnormal tissue growth in some cases as well as natural cannabinoid concentrates in other studies.  The question still exists as to proper application of these cannabinoids, knowing that there is some direct correlation between the plant cannabis sativa and the CB(1) and CB(2) receptors within the human body.
 
Cannabinoids have not yet been approved for the treatment of tumor progression, yet it is known that they have shown significant results in their antitumorigenic effects.  Supported by the finding that the ‘endocannabinoid system’ may be altered during disease states, “Significant levels of the cannabinoid receptor are found in prostate, breast, leukemia, melanoma, and thyroid cell lines, as well as colorectal and hepatocellular carcinoma tissue”.2 This article leads to the suggestion that cannabinoids may inhibit the growth or development of tumor blood vessels which would prove the key to the success as a clinical therapy.
 
Current Studies are in progress to discover the actual benefits of Cannabis Sativa, as it has been notably used and prescribed around the world in folk medicine, by physicians, and other authoritative figures since ancient times.  At the turn of the 19th century our country utilized with more understanding   the cannabis plant as medicine, than our country currently issues.  Although this is changing rapidly as modern scientific research is drawing immense clues to the value of this plant and its many different medicinal applications.   The many illnesses and diseases that Medical Marijuana has been recognized as providing beneficial treatments include the severe nausea and vomiting of cancer chemotherapy, glaucoma, epilepsy, multiple sclerosis, the spasm and pain of paraplegia and quadriplegia, AIDS, chronic pain, migraine, rheumatic disease, premenstrual syndrome, menstrual cramps, labor pains, ulcerative colitis, crohn’s disease, phantom limb pain, depression, hyperemensis gravidarum.  For the purpose of this research paper the focus is on the role of cannabinoids in cancer management.
 
Cancer treatment in Modern Medicine has utilized Radiation and Chemo Therapeutics to treat this abnormal tissue development, even though, cancers are becoming resistant to this treatment and metastasis (spread) is making this disease even harder to treat.  The spread of the cancer developments is often observed after chemotherapy.  Modern Medicine is in need of more effective cancer treatment.  “Using drug-cocktails that combine multiple anti-cancer agents working in different mechanisms has been a standard treatment of cancers to overcome the drug resistance problem.”4 Also, patients are arriving to high levels of pharmaceutical toxicity, which weakens the immune system and taxes the liver.  Modern Medicine is still in the process of understanding cancer treatment and looking into new models of cancer therapy.
 
There are many different active ingredients found in the plant Cannabis Sativa and different uses of the plant parts have different therapeutic interests.   “Primary active ingredients may be enhanced by secondary compounds, which act in beneficial synergy.”1 Ayurveda blends different herbs which may enhance or alleviate side effects from main active ingredients.  “Herbalist contend that polypharmaceutical herbs provide two advantages over single ingredient synthetic drugs: (1) therapeutic effects of the primary active ingredients in herbs may be synergized by other compounds, and (2) side effects of the primary active ingredients may be mitigated by other compounds.”1 It is implied cannabis works in synergy, whereas its synthetic form Marinol, currently prescribed through the current health system, is a single ingredient may be less effective.1 Terpenoids and flavonoids are two categories of a number of other compounds found in the plant Cannabis Sativa.  It is suggested that “monoterpenes such as those in cannabis resin have been suggested to: (1) inhibit cholesterol synthesis, (2) promote hepatic enzyme activity to detoxify carcinogens, (3) stimulate apoptosis in cells with damaged DNA, and (4) inhibit protein isoprenylation implicated in malignant deterioration".1  The Terpine of interest is Limonene which is currently under clinical trials which is said to block carcinogenisis by multiple mechanisms.1 It’s suggested to protect against breast lung, liver, colon, pancreas, and skin cancers.1    “Reducing anxiety and depression will improve immune function via the neuroendocrine system, by damping down the hypothalamic-pituitary-adrenal axis.”1 This means inhalation of terpenes reduces the secretion of stress hormones, relaxing the adrenals and allowing to optimize the immune function.  The Flavonoid “quercetin hinders carcinogenesis and inflammatory disease”.1 These compounds offer an approach to clinical research and cancer therapy. Ayurveda’s whole system approach to therapy may very well offer some therapeutic solutions to future cancer patients and to the dilemma of Chemo resistance.
 
It is apparent through cannabis application in Ayurveda that it is often blended with different herbs to have multiple effects on the body depending on the disease of focus.   Since cancerous tissue is genetic, the possibility with plant genetics having healing capabilities beyond our scientific knowledge and testing may be apparent.  Genetics are a cellular intelligence in which is common in both plants and humans.  Just as the human species has evolved through the ages, the plant kingdom has also evolved alongside.  There is a very good possibility that the genetics of plants and humans are synergistic way beyond our scientific proof.   Ayurveda is a science that uses a system which understands the direct impact of these types of conditions on health offering a multitude of remedies that may allow this singular plant to be more effective in its healing capabilities.   
 
Upon discovering the ancient use of Cannabis through the System of Ayurveda and our Modern Health System, there are very important points to be discussed.  When it comes to application of Cannabis or medicine in general, it is understood that there are two different approaches to healing.  Ayurveda expresses its holistic approach to application of medicine, whereas in modern medicine an approach to emphasize a specific target.  This is where the two systems may be able to benefit from each other.  Modern Medicine has a very direct approach to dealing with disease and Ayurveda approaches disease in the form of balance in the body through lifestyle and habit.  It has been shown through Ayurveda that changes in habits and lifestyle bear results, which can change the state of disease.  Through application of medicine to balance the bodies system and maintaining equilibrium is the goal of Ayurveda and in this case the body balance has the proper mechanisms in place to heal itself.  This very concept can become a supportive measure in Modern Medicine.  As research continues to develop an understanding of cancer treatment, the cannabinoidal system, and application of medicine there could be a merge in integrating the ancient Ayurvedic wisdom with modern findings to support health and well-being.     
 
The limited research on this subject is mainly due to the world-wide suppression and legal controls of this plant.   Even though, it was utilized and became a well reputable medicine in the 19th century, in the 20th century many legal controls were established.  It has been outlawed and banned in the United States to possess, grow, manufacture, and/or distribute and still remains a Federal Criminal Offense.  This has left Cannabis to the black markets ever since, and with its availability has allowed for many to access it illegally.  Those who have sought the benefits of this plant for recreational or medicinal reasons continued the legacy of this plant through demand and upholding the understanding of its healing properties.  Human research has been forbidden and for the most part unsupported.  A new paradigm is arising around the benefits of this plant and its medicinal application.  Since the discovery of the ‘Endocannibinoid System’, there is a rapid enthusiasm in scientific research.  Due to this recent find, cannabis based medicines are gaining more and more attention. As many states in The USA and some other regions of the world have alleviated the strict measures surrounding this plant, more information about its medicinal application is becoming available, as we should see more data on Human Research available.  As this continues to be the case the true benefits of the Cannabis Sativa plant will be known.  Due to the current blocks in Modern Medicines approach to therapy to those suffering from abnormal tissue growth and cancer, the merging of the ancient medicine ways of Ayurveda may offer necessary support for the evolution of modern therapeutics.

Endnotes:

1. John M. McPartland and Ethan B. Russo, “Cannabis and Cannabis Extracts: Greater Than the Sum of Their Parts?” Journal of Cannabis Therapeutics Vol. 1, No ¾ (2001): pp. 103-132 

2. PubMed, Belinda J Cridge and Rhonda J Rosengren, Critical Appraisal of the Potential use of Cannabinoids in Cancer Management.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3770515

3. PubMed, Bifulco M, Laezza C, Gazzerro P, Pentimalli F., Endocannabinoids as Emerging Suppressors of Angiogenesis and Tumor Invasion.

http://www.ncbi.nlm.nih.gov/pubmed/17342320

4. PubMed, Lin JH., Structure- and dynamics-based computational design of anticancer drugs.

http://www.ncbi.nlm.nih.gov/pubmed/26385494

5. PubMed, Guindon J, Hohmann AG., The endocannabinoid system and cancer: therapeutic implication.  http://www.ncbi.nlm.nih.gov/pubmed/21410463

6. PubMed, Guzmán M, Sánchez C, Galve-Roperh I., Control of the cell survival/death decision by cannabinoids.  http://www.ncbi.nlm.nih.gov/pubmed/11269508

7. PubMed, Flygare J, Sander B., The endocannabinoid system in cancer-potential therapeutic target?  http://www.ncbi.nlm.nih.gov/pubmed/18249558

8. A Board of Scholars, Astanga Hrdaya of Vagbhata, The Book of Eight Branches of Ayurveda Vol. III (Delhi: Sri SatGuru Publications, 1999) 237 – 243

9. Dr. J.L.N. Sastry, Dravyaguna Vijnana, Study of the Essential Medicinal Plants in Ayurveda (Varanasi: Chaukhambha Orientalia, 2010) 503 – 506

10. Vaidya V.M. Gogte, Ayurvedic Pharmacology & Therapeutic Uses of Medicinal Plants, Dravyagunavignyan (New Delhi: Chaukambha Publications. 2012)

11. Dr. Halpern and the California College of Ayurveda, Principles of Ayurvedic Medicine Tenth Edition (California College of Ayurveda. 2012) 41 – 42

12. Kaviraj Kunjalal Bhishagratna, Sushruta Samhita Vol. 1, Sutra-sthana (Varanasi: Chowkhumba Krishnadas Academy Oriental Publishers & Distributors. 2005) 151 – 152

13. PubMed, Pisanti S1, Malfitano AM, Grimaldi C, Santoro A, Gazzerro P, Laezza C, Bifulco M., Use of cannabinoid receptor agonists in cancer therapy as palliative and curative agents.

http://www.ncbi.nlm.nih.gov/pubmed/?term=19285265

14. John M. McPartland and Ethan B. Russo, “Cannabis and Cannabis Extracts: Greater Than the Sum of Their Parts?” Journal of Cannabis Therapeutics Vol. 1, No ¾ (2001): pp. 103-132 

15. PubMed, Belinda J Cridge and Rhonda J Rosengren, Critical Appraisal of the Potential use of Cannabinoids in Cancer Management.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3770515

16. PubMed, Bifulco M, Laezza C, Gazzerro P, Pentimalli F., Endocannabinoids as Emerging Suppressors of Angiogenesis and Tumor Invasion.

http://www.ncbi.nlm.nih.gov/pubmed/17342320

17. PubMed, Lin JH., Structure- and dynamics-based computational design of anticancer drugs.

http://www.ncbi.nlm.nih.gov/pubmed/26385494

18. PubMed, Guindon J, Hohmann AG., The endocannabinoid system and cancer: therapeutic implication.  http://www.ncbi.nlm.nih.gov/pubmed/21410463

19. PubMed, Guzmán M, Sánchez C, Galve-Roperh I., Control of the cell survival/death decision by cannabinoids.  http://www.ncbi.nlm.nih.gov/pubmed/11269508

20. PubMed, Flygare J, Sander B., The endocannabinoid system in cancer-potential therapeutic target?  http://www.ncbi.nlm.nih.gov/pubmed/18249558

21. A Board of Scholars, Astanga Hrdaya of Vagbhata, The Book of Eight Branches of Ayurveda Vol. III (Delhi: Sri SatGuru Publications, 1999) 237 – 243

22. Dr. J.L.N. Sastry, Dravyaguna Vijnana, Study of the Essential Medicinal Plants in Ayurveda (Varanasi: Chaukhambha Orientalia, 2010) 503 – 506

23. Vaidya V.M. Gogte, Ayurvedic Pharmacology & Therapeutic Uses of Medicinal Plants, Dravyagunavignyan (New Delhi: Chaukambha Publications. 2012)

24. Dr. Halpern and the California College of Ayurveda, Principles of Ayurvedic Medicine Tenth Edition (California College of Ayurveda. 2012) 41 – 42

25. Kaviraj Kunjalal Bhishagratna, Sushruta Samhita Vol. 1, Sutra-sthana (Varanasi: Chowkhumba Krishnadas Academy Oriental Publishers & Distributors. 2005) 151 – 152

26. PubMed, Pisanti S1, Malfitano AM, Grimaldi C, Santoro A, Gazzerro P, Laezza C, Bifulco M., Use of cannabinoid receptor agonists in cancer therapy as palliative and curative agents.

http://www.ncbi.nlm.nih.gov/pubmed/?term=19285265

 

 

 

Ayurveda, Death & Dying by Renee Traub

 Introduction:

The intent of this research paper is to look at death and dying from an Ayurvedic perspective, specifically to assist those in the hospice and end­of­life caregiving field in learning to spiritualize the death process for themselves, their patients and patient families.  This paper will utilize Ayurvedic principles and introduce practices that caregivers, professionals and families can implement with patients in the process of dying.  My intention is to expand Ayurvedic practice into a field where it can be used to open the door to mindful, aware and compassionate dying. My interest in this topic stems from my professional experience as a neonatal ICU nurse for 28
years and a hospice nurse for 3 years, as well as my experience last year around my mother’s passing.  Oftentimes I have felt like a midwife to the soul.  I have experienced the sacredness of death and this is what I would like to share with the public. Research sources include ancient and modern Ayurvedic texts, allopathic medical journals, and alternative and complementary
texts relating to the topic.  To echo the work of Dr. Mits Aoki, I would like to “make death a work of art, a great achievement for the patient and a time of growth, understanding and closeness for family members.1 ”

Principles of Ayurveda

Ayurveda is a traditional Indian medical system with a scientific basis. It incorporates mind, body, and spirit in its understanding of the human being. Ayurvedic medicine complements Western medicine by focusing more on root causes rather than symptomatic treatment. Self­care practices are foundational for a healthy life. Examples of Ayurvedic practices are meditation and breathing techniques. Preventative medicine is emphasized as it is easier to put into effect than treating disease that has already manifested. Prevention means empowering patients to make positive lifestyle changes and behavior changes by educating and incorporating diet, spirituality, psychology, herbal medicine, and detoxification (known as pancha karma). Ayurveda reminds us that our true nature as human beings is spirit, and to connect to something greater than ourselves.
 
Ayurveda means “science of life.” It is a science because it contains systematically applied knowledge that has been proven in its effectiveness over thousands of years of continual application.  Ayurveda supports balance in all aspects of life ­ physical, mental and spiritual.  In the words of doctor and author Vivek Shanbhag, Ayurveda “respects the uniqueness of the individual, considers all the levels of the individual, emphasizes prevention, [and] empowers everyone to take responsibility for their own well­being.2 ”
  • 1 Aoki, Dr. Mitsuo.  www.livingyourdying.com “Helping Others Live with Dying.”
  • 2 Shanbhag, Vivek. A Beginner’s Introduction to Ayurvedic Medicine: The Science of Natural Healing and Prevention Through Individualized Therapies. Keats Publishing, Inc: CN, 1994. p. 9
According to Ayurveda, doshas are forces of nature that combine into the tapestry of life.  The human body is composed of the three doshas and operates based on their functioning,  If the doshas are out of balance with one another, there will be a disturbance in the function of the body and/or mind.  Often health or disease is discussed in terms of the balance existing
between the three doshas.  The three doshas are vata, pitta, and kapha.  On a cosmic level, one can say that vata relates to wind, pitta relates to the sun, and kapha relates to the moon and the earth.3 In short, doshas are forces that govern the physiology of the human being.4
 
Ayurveda “recognizes that each person is made up of a unique body type and a unique psychological personality.5 ”  We all have our own individual doshic combination from the moment of conception, and this is what accounts for our differences as people.  Vata dosha represents the forces of movement.  Vata is active and dynamic, like the wind.  Vata makes things happen in the body and mind, and is responsible for all movement, including the breath, the circulation, and movement of thoughts.  People who have a lot of vata can be energetic, vivacious social butterflies.  They can be very vibrant, enthusiastic and creative.  Every dosha has its balanced side, as well as its out of balance side.  When vata is out of balance, a person may be flighty, fickle, fearful and insecure.  Excess vata can manifest in worrying, a fragile nervous system, anxiety and exhaustion.  In order to heal, patients with vata imbalances will need a lot of hand holding, support, nurturing and a deep sense of connection with others.
 
The force of vata dosha is inherently dry, cold and light.  It is the dosha that governs depletion, destruction, decay, necrosis, debility, dissolution, and the process of wasting away and shutting down.  For these reasons it is especially correlated with the active dying process.  Signs of impending death such as a change in smell, bodily organs shutting down, core temperature instability, gurgling breathing (death rattle) and the mottling of the skin are all vata symptoms.
Terminal agitation, a dying patient’s behavior of responding unpredictably, is also linked to vata, and may include speaking to those who have already passed on, being spaced out or not present, non­responsiveness, outbursts of tears or yelling, and other behaviors displaying the movement and rapid dynamism of vata.  Vata dosha benefits especially from therapies involving calming, grounding and peaceful touch and sound.
 
Pitta dosha represents the forces of transformation and metabolism in the body and mind.  It is very active in the digestive system, the liver, eyes, and the rational aspect of the intellect.  Pitta dosha allows food to transform into energy and experiences to transform into opinions, analysis and evaluations.  Pitta is hot and fiery, and has rough, sharp, and clear qualities.  Individuals with a lot of pitta in their unique doshic combination can often be confident, organized, driven, bright, passionate and disciplined.  However, like fire, pitta can easily become uncontained.  This creates an excess of heat in body and mind, expressing itself in outbursts, anger, tantrums, criticism, resentment, jealousy and rage.
  • 3 Heyn, Birgit. Ayurvedic Medicine: The Gentle Strength of Indian Healing. Thorsons Publishing Group: Vermont, 1987. p. 13.
  • 4 Halpern, Dr. Marc. Principles of Ayurvedic Medicine. California College of Ayurveda: California, 1995. p. 53
  • 5 Shanbhag. p. 10.
 The process of dying is neither controlled nor precise.  This can be a challenge for pitta individuals who can be over­controlling and demanding, especially in times of stress. Strong­willed people who are used to being leaders and making things happen find that they have no control over the dying process, and this is difficult for pitta.  Sometimes pitta patients and/or family members are very direct and intense, and communicate in a way that is explosive and sharp due to their feelings of helplessness and powerlessness.  Strategies to support pitta patients and families in the dying process include cooling, relaxing and stress­diffusing forms of aromatherapy, breathing practices, yoga nidra and guided meditation.
 
Kapha dosha represents the forces of stability and structure in the body and mind.  It is the container for vata and pitta doshas.  Kapha dosha provides the physical form and material structure of the body.  Linked with the qualities of earth and water, kapha is wet, dense, heavy, slow and steady.  In the mind, kapha dosha describes qualities of gentleness, calm, consistency, and dependability.  Individuals with a lot of kapha in their unique doshic combination can often be nurturing, affectionate, compassionate and loyal.  However, when kapha is out of balance, these same qualities can become stubbornness, lethargy, withdrawal, depression, and issues of attachment and possessiveness.  Kaphic individuals, unlike vata and pitta, are slow to change, but once change is implemented, they are steady and enduring in new habits.
 
When working with kapha individuals in the death and dying journey, it is important to understand that they may experience a longer grieving process. Watery emotions such as tears may be present. Kaphas can also internalize emotions and not show them, even though they feel very deeply.  Honoring relationships is very important, as is self­care for caregivers and families who have created deep attachments to individuals who have passed on. 
 
In order to understand Ayurvedic psycho­spiritual healing, one must also understand the concept of gunas. Guna is a Sanskrit word meaning attribute or quality.6 It describes a person’s state of mind or state of consciousness.  The three gunas are sattva, rajas and tamas.  Sattva guna describes a state of consciousness that is peaceful, calm and balanced.  Rajas guna describes a state of mind that is full of movement and activity, constantly creating turbulence and drama. Tamas guna describes a state of consciousness that is inactive, dull and stuck.  A colleague has beautifully put this in terms that are understandable:
  • “A person who is a vegetarian, practices yoga daily, meditates daily, is emotionally stable and has a good work/life balance could be described as sattvic; a person working in the corporate field who is highly committed and driven, spends most of their waking hours at work, works hard and plays hard, is a competitive sportsperson, and eats meat every day could be described as rajasic; and a person who sits at home all day every day watching TV, eating microwaved food, and not exercising could be described as tamasic7 ”
  • 6 Klutznick, Karen.  http://www.kkayurveda.com/ayurvedabasics/thegunas.html 
The concept of chakras is important to understand when considering health from a mind/body/spirit perspective.  Chakras are energy centers in the body that “show how the life force...directs and guides the physical body through the nervous system.”8 Chakras are composed of energy that ranges from being more open, flowing and functioning to more closed and blocked.  Because chakras are not in the physical body, they can be worked with through energetic techniques such as meditation, mantra, color therapy and visualization. The seven major chakras correspond with the movement of energy through the spinal cord.
 
This paper will introduce two more concepts in Ayurveda that connect to the subject of death and dying.  These concepts are prana and ojas.  Prana is the lifeforce behind all creation that each person is linked to through the breath.  The process of breathing brings prana into the body. Individuals with healthy prana radiate a strong sense of aliveness, vibrancy, and sparkle.  They are full of life.
 
Ojas relates to the strength of the immune system.  Strong ojas creates physical and mental endurance and the capacity to get things done despite stress.  Individuals with strong ojas are centered and grounded, and less reactive than those with weak ojas.  Weak ojas creates hypersensitivity to the environment, as well as sensory overload and decreased immune system function.  Individuals with depleted ojas are often exhausted physically and emotionally.

Introduction to Hospice

Hospice is a care model that provides palliative care to individuals who are in the process of dying.  Hospice is a way to deal realistically and honestly with terminal disease.  It offers hope of dignity and comfort for patients and families.9 This model of care, focused on palliation rather than curative therapies, neither hastens nor prolongs death, allowing nature to take its course.10 Hospice care can take place at a dedicated hospice facility, nursing home, hospital, or at the patient’s home.  Patients are generally put on hospice towards the very end of life, generally no longer than six months.  The current model of hospice care centers around making the patient comfortable, managing patient pain, educating family members on the death and dying process, and helping the family organize and prepare for their loved one’s death.  Hospice describes an interdisciplinary team which may include doctors, nurses, social workers, assistants, chaplains and grief counselors.
Individuals in the process of dying undergo many changes physically, mentally and spiritually. Often they become drawn inward, sleeping more and showing disinterest in food, guests and other activities.  The body weakens, and the mind may become agitated and confused.  Fear and sadness may arise, as well as feelings of not wanting to be a burden.  The patient may wish to talk about the past and review her/his life.  Elizabeth Kubler­Ross, pioneer in the field of near­death studies, identified five stages of grieving for the imminent loss of one’s life: denial, anger, bargaining, depression and acceptance,11 The process of death has been studied forthousands of years, and is described in ancient texts in similar terms as today:
  • While approaching death, the process of destruction is initiated in the body.  Functions of various limbs and organs of the body get disturbed….drainage of strength from limbs, cessation of movement, destruction of sensory/tactile, impairment of consciousness, restlessness in the mind, affliction of the mind with fear, deprivation of memory and intellect….radical change in the conduct...wasting of muscle tissue and blood….morbid changes in the smell of the body...discoloration of the body, dryness in the orifices of the body.12
In my experience, hospice is all about being present with what is.  The practice of being unconditionally present and just listening, without having one’s own agenda, can be incredibly profound.  Caring for the dying can be a deep spiritual calling where one is open to whatever comes up, and willing to give whatever is needed.  In the words of spiritual teacher Ram Dass:
  • Whenever I tried to impose my model of a good death on a situation, or been attached to a particular outcome, it has backfired.  But when I meet the person with love, without wanting anything, I become a safe haven.  When I could remain conscious, aware of my own thoughts and feelings, waves of sadness or pity, aversion or fear, as well as my own temptation to react, I could bring soul quietness and a feeling that what was happening was alright.  This inner calm seemed rock­like it its stability.13
Hospice creates an attitude of service to the body, mind and spirit of the patient. Hospice has really made a difference in the lives and deaths of those it has touched, and by adding complementary Ayurvedic practices, opportunities are created to deepen compassion, mindfulness and integration.

Timeline of Hospice Care14

1948: The term hospice, from the same linguistic root as hospitality, is first applied to specialized care for dying patients by physician Dame Cicely Saunders of the UK.
1963: The concept of hospice is introduced to the medical community of the US by Saunders.
1967: Saunders opens the first modern dedicated hospice facility in the UK.
  • 11 Kubler-Ross, Elizabeth. On Death and Dying. Scribner: New York, 1969.
  • 12 Caraka Samhita. Vol 2. Chapter 5. v. 90-91.
  • 13 Dass, Ram. Still Here: Embracing Aging, Changing and Dying. Berkeley Publishing Group: New York, 2000. p. 178.
  • 14 timeline information courtesy of National Hospice and Palliative Care Organization, Alexandria, VA.
1969: Elizabeth Kubler­Ross publishes On Death and Dying, a controversial book which sparks widespread public conversation on death and dying care in the US.
1974: Florence Wald of Yale University opens first hospice care facility in the US.
1982: Medicare begins to cover hospice benefits.
1984: Standardized hospice accreditation is initiated through the Joint Commission on Accreditation of Healthcare Organizations.
1986: Medicare hospice benefits are expanded and made permanent by US Congress.
2002: Department of Veterans Affairs launches program expanding hospice services to veterans and also providing continuing education in hospice and palliative care to clinicians.
2006: American Board of Medical Specialties recognizes hospice and palliative medicine as a medical specialty.
 
In recent years, research and policy work has been done in areas of hospice for HIV/AIDS patients in sub­Saharan Africa, pediatric hospice, expansion of hospice services for veterans and provision of hospice to individuals who are incarcerated.

Ayurvedic Aromatherapy

Aromatherapy is the use of the sense of smell for healing.  High quality essential oils distilled from plant sources can affect moods, balance the nervous system, and help calm and refresh the body and mind.  Aromatherapy works powerfully on the mind, and helps create sattva, allowing for greater peace and serenity in the final stages of life.15 The sense of smell is perceived through the evolutionarily oldest part of the brain, the limbic system, which responds to stimuli instantly, without thought.16  Scents have the ability to penetrate deeply into the brain, and chemically alter the functioning of the nervous and endocrine systems.  Studies have found that aromatherapy massage decreases anxiety, promotes relaxation, and stimulates autonomic nervous system function, especially in instances of palliative care.17
 
The application of aromatherapy in a hospice care setting can take many forms, all of which are user­friendly.  Essential oils can be purchased in health food stores or online, and many of the oils suggested here are inexpensive.  It is important that essential oils are pure and of good quality. “Fragrance oils” aren’t true essential oils ­ be aware of synthetic and adulterated oils used in the cosmetic and food industry. They do not have the therapeutic value of natural oils.18 Essential oils can be added to a tub of warm water for a foot or hand soak, added to a massage oil, or dripped into a spray bottle full of water.  Bear in mind that essential oils should generally not be placed directly on the skin.  One drop of an oil can be placed on a cotton ball to scent a room.  A spray bottle of rose water hydrosol can be used instead of rose essential oil, which is more cost effective.19
  • 15 Sushruta Samhita. Section 8, verse 10.
  • 16 Wall, Carly. Setting the Mood With: Aromatherapy. Sterling Publishing Company: New York, 1998. p. 12.
  • 17 American Journal of Hospice and Palliative Care. “The role of aromatherapy massage in reducing anxiety in patients with malignant brain tumours.” Downey et al. Aug/Sep 2009. 
 Excellent oils for reducing anxiety, stress and worry are lavender, chamomile, clary sage, lemon balm, rose geranium, rosemary and sandalwood.  Lavender creates a calm and positive attitude and stimulates brain secretions of serotonin, as well as calming and soothing the nervous system.20 21  Lemon balm, also known as melissa, is an excellent restorative of the nervous system.22 Rosemary is known to ease emotional tension.23 Sandalwood is known to relieve irritability that stems from anxiety.24 Chamomile is a nervine sedative specific to anxiety and stress.25 Clary sage is useful in cases of despair stemming from anxiety and stress.26 Feel free to make your own oil blends and remember that one drop goes a long way; only a few drops are needed in a foot bath or 4 oz spray bottle.
 
Many oils are helpful in aiding relaxation and supporting restful sleep.  This allows patients to respond to the stresses of living and dying from a more peaceful place.  Oils specific to this purpose are lavender, chamomile, frankincense, jatamamsi, lily, nutmeg, rose and sandalwood. Lily soothes the nerves and relieves irritability.27 Many of the oils listed in for anxiety, stress and worry are also helpful with stress relief and relaxation.
 
Anger and resentment can arise at different stages of the dying process, especially in patients with high pitta.  Resistance to the dying process, asking “why me?”, loss of control over the body and one’s life, and family­ related dramas that come up during difficult times can all cause pitta to rise.  Spearmint, lemongrass, fir and cedar can all rebalance the body and cool hot feelings.28 Lavender, rose and sandalwood are excellent oils for relaxing and purifying a heated pitta mind. Rose increases love and compassion.29 Sandalwood deeply nourishes the heart.30 Jasmine is great for releasing anger, and purifying the mind and emotions.31 32 Lily calms the heart and soothes the nerves, reducing irritability and increasing faith and devotion.33
  • 18 Wall, Carly. p. 16.
  • 19 Edgar Cayce Rosewater is highly recommended and inexpensive.  Reputable brands of essential are Floracopeia, Simplers, Mountain Rose, Young Living and Doterra.
  • 20 Wall, Carly. Setting the Mood With: Aromatherapy.  
  • 21 Frawley, David. Ayurvedic Healing for Healthcare Professionals.
  • 22 Wall, Carly. Setting the Mood With: Aromatherapy.
  • 23 Frawley, David. Ayurvedic Healing for Healthcare Professionals.
  • 24 Ibid.
  • 25 Page, Linda. Healthy Healing. Quality Books Inc: 1985.
  • 26 Young, Gary. Aromatherapy: The Essential Beginnings. Essential Press Publishing, Salt Lake City,1996.
  • 27 Frawley, David. Ayurvedic Healing for Healthcare Professionals.
  • 28 Wall, Carly. Setting the Mood With: Aromatherapy.
  • 29 Frawley, David. Ayurvedic Healing for Healthcare Professionals.
  • 30 Ibid.
 Loss, sadness, depression and grief are often present in the dying process.  Patients may have regrets from the past, sadness at not being able to accomplish things they want to, and grief at saying goodbye to loved ones.  Gently uplifting oils can be beneficial in shifting the mind and increasing movement towards acceptance.  Coriander, pine and helichrysum are great for softening the grief process.34 Rose is a wonderful soothing oil for the mind and an anti­depressant, allowing for greater experience of love and increased self esteem.35 Rosemary, tulsi (holy basil), patchouli, cardamom and wintergreen also help alleviate depression.36 37 Citrus oils such as bergamot, lemon and orange are very uplifting.38 break through despondency.39 Cypress and eucalyptus can help break through despondency.39
 
Aromatherapy can bring about a sattvic state of consciousness, spiritualizing the death process and awakening higher awareness.  Scent has the power to bring us back into alignment with our authentic self.  Oils that have this property have been used in many of the world’s spiritual traditions.  Frankincense creates a space of purity in which higher virtues can come forth.40 Sandalwood and rose are other herbs that possess this sacred quality.  Essential oils can be selected for their therapeutic purposes and used not only in aromatherapy, but also in touch therapy or massage.

Massage and Gentle Touch

Massage has a long history as an integrative part of many healing traditions, including Ayurveda. Ayurvedic massage can feed the senses and nourish the body and mind through the application of therapeutic touch. It supports restful sleep and a calm, happy mind.41 A recent study of complementary practices in a hospice setting found that massage was not only beneficial to patient care, but reported by patients themselves as the most beneficial treatment they received. 42 Sharing massage with a patient or loved one can be a deep expression of love, care and compassion.  Especially while caring for those in hospice, it is important to maintain a sattvic touch, which is light, mild, gentle, balancing, harmonizing, warm, pleasant, sweet and nourishing.43 When massage is done with love, care, gentleness and sensitivity, it will increase sattva in the patient.  The massager must also have a sattvic quality in their attitude and manner of application.44 Healing benefits of massage and application of oils build up over time, and are also immediately beneficial to skin, muscles and the nervous system.45
  • 31 Halpern, Dr. Marc. p. 324.
  • 32 Frawley, David. Ayurvedic Healing for Healthcare Professionals.
  • 33 Ibid.
  • 34 Worwood, Valerie Ann. The Complete Book of Essential Oils and Aromatherapy. New World Library: San Rafael, CA, 1991.
  • 35 Wall, Carly. Setting the Mood With: Aromatherapy.
  • 36 Halpern, Dr. Marc.. p. 324.
  • 37 Frawley, David. Ayurvedic Healing for Healthcare Professionals.
  • 38 Page, Linda. Healthy Healing. Quality Books Inc: 1985.
  • 39 Young, Gary. Aromatherapy: The Essential Beginnings.
  • 40 Frawley, David. Ayurvedic Healing for Healthcare Professionals.
  • 41 Lad, Vasant. Complete Book of Ayurvedic Home Remedies. Three Rivers Press: New York, 1998. p. 60.
  • 42 American Journal of Hospice and Palliative Care. “Three lessons from a randomized trial of massage and meditation at end of life: patient benefit, outcome measure selection, and design of trials with terminally ill patients.” Downey, et al. Aug 2009.
 Massage is recommended for patients with high vata, pain and hypersensitivity, as well as any disturbance of the mind, emotions and nerves.46 Sesame oil and almond oil are recommended as they are softening to the tissues of the body.  Mild and sweet essential oils such as sandalwood, rose and lavender can be added.47 Incorporating aromatherapy into massage helps the mind and body prepare for a deeper opening.  Gentle massage of patients is recommended three times a week, or even daily.  Frequency of this practice allows oils and herbs to penetrate deep into the skin, creating permanent changes.48
 
Techniques and supplies for this practice are very simple.  Purchase cold pressed, organic sesame or almond oil at a health food store.  Pour some oil into a bottle and store the rest in a cool, dark place.  Add essential oils according to patient needs. Warm oil prior to application in a hot water bath in a sink or a pan.  Test temperature on wrist before use.  Pour oil in hand liberally, and use both hands to spread oil along body part.  Use long strokes for long parts, such as arms, legs, and torso, and use circular strokes around joints.  Rub the oil in and allow the body to soak it up.  Maximum absorption is important and may take 20 minutes or more.  Stress reducing or mindfulness practices such as meditation may be done while the oil is absorbing. After absorption, pat off excess with a cloth, and if necessary, some warm water.  Removing oil with soap is not recommended.49
 
If massaging the whole body is not available, a simple foot and scalp massage will have many of the same therapeutic benefits, and will assist in relieving sleeplessness and fatigue.50 Head massage can relax the entire body by relaxing the nervous system and relieving mental strain and stress.51 and scalp.52 Brahmi oil, available online, is especially recommended for the soles of the feet and scalp. 52

Altars and Color Therapy

  • 43 Frawley, David. p. 502.
  • 44 Ibid.
  • 45 Halpern, Dr. Marc. Principles of Ayurvedic Medicine. p. 167.
  • 46 Sushruta Samhita. Section 5, verses 90-91
  • 47 Frawley, David. p. 506
  • 48  Ibid.
  • 49 massage technique from Halpern, Dr. Marc. Principles of Ayurvedic Medicine. p. 168.
  • 50 Johari, Harish. Ayurvedic Massage: Traditional Indian Techniques for Balancing Body and Mind. Healing Arts Press: Vermont, 1996. p. 4-5.
  • 51 Charaka Samhita.Vol 1. Section 5, verse 81-83.
  • 52 Lad, Vasant.p. 260.
The visual images that we take in through our sense of sight can bring pleasure or pain. The sense of sight can trigger memories, feelings and thoughts that are sattvic, rajasic or tamasic. The skillful use of color can add psychological harmony and peace of mind, and contribute positively to a patient’s emotional well­being during the dying process.53 This happens on a very subtle level and the psychological effects of color are not always consciously apparent to the viewer.  Color is vibrational energy that enters the eye and goes directly to the brain and mind.54
 
Color therapy can be applied in many ways.  Various methods include surrounding ourselves in therapeutic color choices through clothing, linens, window coverings, paint choices, colored light bulbs, flowers, candles, artwork and nature imagery.  Soft lights can be used instead of fluorescent or neon, and full spectrum light bulbs can be used in winter.55 Choosing decor with awareness of the specific effects of different colors can calm the mind and increase sattva.
 
The color gold is especially powerful in harmonizing the mind, strengthening the heart, and supporting ojas and immune and endocrine system health.56 Gold also provides stability, relieves anxiety, uplifts the spirit, and supports greater awareness and transformation of consciousness.57 For these reasons, gold is highly beneficial in hospice care settings.
 
The colors white and blue can also be used therapeutically.  White invokes purity, virtue and spirituality, and calms the heart, mind, nerves and emotions.58 It promotes meditation and spiritual awareness, and supports a state of mind that is expansive, flowing, clear and effortless. 59 Although these aspects are beneficial, white can increase vata and is not recommended in
excess.  Blue spiritualizes anger, antidotes the critical mind and reduces attachment and pitta, however, blue is very cold, light and dry and in excess, can increase vata.60
 
Another way to experience color is through creating an altar.  An altar creates a physical and tangible sacred space to facilitate mental and spiritual peace.61 Co­creating an altar with a patient allows for intimacy, connection, grounding and creativity.  Any objects can be used that have meaning and provide inspiration.

Mantras, Music and Affirmations

  • 53 Tirtha, Swami Sadashiva. Ayurvedic Encyclopedia: Natural Secrets to Healing, Prevention and Longevity. Ayurveda Holistic Center Press: New York, 1998. p. 319.
  • 54 Halpern, Dr. Marc. Healing Your Life: Lessons on the Path of Ayurveda. Lotus Press: Wisconsin, 2011. p. 126.
  • 55 Tirtha, Swami Sadashiva. p. 319.
  • 56 Ibid. p. 320.
  • 57 Halpern, Dr. Marc. Healing Your Life: Lessons on the Path of Ayurveda. p. 126.
  • 58 Tirtha, Swami Sadashiva. p. 321.
  • 59 Halpern, Dr. Marc. Healing Your Life: Lessons on the Path of Ayurveda. p. 126.
  • 60 Ibid.
  • 61 Simpson, Liz. The Book of Chakra Healing. Sterling Publishing Co: New York, 1999. p. 24.
The sense of hearing, like the sense of sight, can be used in ways that create harmony and peace, or in ways that agitate and disrupt the mind and body.  Hearing is the first sense that develops in utero.  The fetus reacts to its mother’s voice and external sounds as early as 4 ½ months.62  Hearing is the last sense to go as people transition into death.  Even unresponsive patients can often hear what is said to them.  Relaxing music, uplifting mantras such as ‘om,’ and affirmations are all sattvic tools that can be incorporated into patient care.
 
An affirmation is a positive, personally inspiring phrase that is a powerful tool to focus positive intention and counteract previous negative conditioning.63 Affirmations can be used to shift awareness and belief.  They can be played in the background, repeated aloud by patient or caregiver, written and placed around the space, or repeatedly mentally.  Patients and caregivers can develop their own affirmations, or use existing ones such as: May I be free from suffering, May I be at peace, May my heart flower.64 Other helpful affirmations are: I am at peace in this moment.  I release control; I embrace the unknown.65 Repeating affirmations creates the openness in mind and heart to receive what is longed for. If possible, repeat affirmations, or have them playing in the background, throughout the day.
 
Mantras are sound forms that create a shift in consciousness. Like affirmations, they can be chanted aloud or internally, or listened to in music.  To pacify vata, and create sattva, mantras need to be soft, warm, soothing, and calming.66 Patients should only chant out loud briefly, if at all, as this can deplete energy.  The mantra ‘om’ (rhymes with ‘home’) balances mind, body and spirit, promotes awareness, harmonizes the nervous system and clears the energy.67 The mantra ‘lum’ (rhymes with ‘chewing gum’) can be used to stabilize, ground, calm, and bring joy, happiness and contentment, and is especially useful when vata is high.68 Mantras resonate with the chakras and help to spiritualize the awareness on a subtle level.
 
Music can support the dying process in ways ranging from stress relief, to bedside support, to grief recovery.  Because music reaches a deep, non­rational part of the mind, it is ideally suited to shift feelings such as grief, fear, anxiety, sadness and anger that create rajas in the mind. Music can release blocked or painful feelings and can stimulate positive ones such as hope, love and gratitude. Sharing music together can lead to sharing of the emotions that the music brings up.69 70
  • 62 Gass, Robert. Chanting: Discovering Spirit and Sound. Broadway Books: New York, 1999. p. 23
  • 63 Simpson, Liz. p. 138.
  • 64 Levine, Stephan. Healing Into Life and Death.  Doubleday: New York, 1987. p. 23-24.
  • 65 Ibid. p. 27.
  • 66 Tirtha, Swami Sadashiva. p. 314.
  • 67 Ibid. p. 312.
  • 68 Ibid. p. 313.
  • 69 Levine, Stephan.. p. 25.
  • 70 http://www.growthhouse.org/music.html This website streams music that is intended to support the death process and patients in hospice and palliative care settings.
 Sound is a nutrient for the spirit as well as for the body.71 When the moment of transition into death arises, chants can be used to say goodbye. Stephan Levine suggests: Go in beauty. Peace be with you.  Til we meet again in the light.72 Another chant, made famous in Kundalini Yoga circles, that can be used comes from a popular song from the 1960s:
 
May the longtime sun shine upon you, May all love surround you,
And the pure light within you guide your way home.73

Meditation Practices for Hospice and Palliative Care

Meditation is a journey to the center of our own being.74 Meditation can be done anywhere, at any time, sitting, lying down, or walking.75 One can meditate with a mantra, a thought or feeling, by looking at nature, thinking about God, feeling pure love, or with any technique that doesn’t cause strain, anger or worry that one is not doing it properly.76  There are countless techniques for meditation, and they are all valid.  The technique introduced here is simple to learn and to practice.  Any other techniques can also be used.  The most important aspects to practice are devotion and sincerity.77
 
Meditation is an art of bringing harmony to body, mind and consciousness.78 It has been shown to be clinically beneficial in healing body and mind.79 It gives us a respite from the pressures of life.  As we relax, the heart beats more slowly and the blood pressure lowers. Meditation helps retrain response mechanisms so we don’t react as strongly or as negatively to adverse situations. It gives us the ability to be more centered, and more in control of our reactions.80 Meditation allows the mind to be healthy and sattvic, alert, positive and calm.81 When we meditate, we release rajasic mental states such as fear, worry and anger and replace them with positive attitudes.82 By practicing meditation as regularly as possible, we gradually gain control over the flow of our emotions and movement of our minds.  This allows us to turn awareness inward.83
  • 71 Levine, Stephan.. p. 25.
  • 72 Ibid. p. 27.
  • 73 lyrics written by Incredible String Band.
  • 74 Novak, John. Ananda Course in Self-Realization: Part 1: Lessons in Meditation. Ananda Church: USA, 1997. p. 13.
  • 75 Tirtha, Swami Sadashiva.. p. 595.
  • 76 Ibid.
  • 77 Ibid.
  • 78 Lad, Vasant..p. 76.
  • 79 International Journal of Palliative Nursing. “Mindfulness Based Cognitive Therapy.” Kabat-Zinn, Dr. Jon. June 2001.
  • 80 Novak, John. p. 15.
  • 81 Ibid.
  • 82 Ibid. p. 16.
  • 83 Ibid.
 One advantage of the form of meditation outlined below as a treatment method is that it is very safe, has no side effects, and is easy to teach and share.84 This form of practice creates the ability to look within and contact the deeper aspects of consciousness. In So Hum meditation we sit quietly and watch our breath.85 Patients can be in supine position or seated.  Keeping the spine straight is helpful. Patients can be supported with pillows to suit their comfort. Begin by allowing the mind to be present. Let go of stories in the mind and thoughts about what’s going on elsewhere.  Relax and be comfortable.  Take a few deep breaths in, if possible.  Inhale and
exhale through the nose, if possible.  As you inhale, mentally think ‘so’ (rhymes with ‘no’).  As you exhale, mentally think ‘hum’ (rhymes with ‘chewing gum’).  Continue this pattern of repeating ‘so­hum’ with the breath.  The syllable ‘so’ represents the life force entering the body through inhalation, and the syllable ‘hum’ represents the release of limitations through the exhalation.86 If the mind starts to wander, just bring it back to focus on the mantra and the breath.87 Breathe through whatever comes up.  In this practice, for most people, the breath naturally deepens.  You will very likely become distracted, just bring the mind back to focus on the breath and mantra, be gentle with yourself, and keep going.  When beginning this practice, 2­3 minutes of practice is suggested.  Practicing consistently brings benefit.  After the practice is finished, allow a few moments to bring the mind back to normal awareness.88
 
Another practice that supports deep relaxation and spiritualizing one’s awareness is yoga nidra. Yoga nidra begins with the patient in a supine position, supported with pillows for comfort.  This practice is guided by a soothing voice, and many good recordings are available.89 Yoga nidra takes the body through a total relaxation process, calms the mind and releases tension and stress.  Yoga nidra brings the mind to focus on different parts of the body, feeling them distinctly, and then fully relaxing.  It brings the mind to focus and creates intention.  Although it is not intended to cause one to fall asleep, one will receive benefit even if one is asleep.  If possible, keep the mind alert and focused.  When practiced effectively, this technique is as restorative as sleep.90

Breathing Practices for Hospice and Palliative Care

The breath is the primordial life force governing mental and physical function.  One’s breath is the essence of one’s life.  The first breath is taken shortly after arriving in the world, even before the umbilical cord is cut.  The breath continues, unbroken, until death. Breathing does not require conscious attention, but by choosing to bring awareness to the breath, one can influence the body and mind. Mindful breathing clears the mind, brings calm and allows individuals to connect their personal energy with the universal energy.91 
  • 84 Frawley, David. p. 517.
  • 85 Lad, Vasant..p. 79.
  • 86 Ibid.
  • 87 Chopra, Deepak and David Simon. The Seven Spiritual Laws of Yoga: A Practical Guide to Healing Body, Mind, and Spirit. John Wiley & Sons, Inc: New Jersey, 2004. p. 90-91.
  • 88 For different meditation techniques, consult the many books of Pema Chodron, as well as titles by Stephan Levine Who Dies? and Healing into Life and Death.
  • 89 Yoga nidra recordings are widely available on CD, iTunes and YouTube.  The recording of Dr. Marc Halpern guiding Yoga nidra is recommended.
  • 90 Feuerstein, Georg and Larry Payne. Yoga for Dummies. IDG Books Worldwide, Inc: California, 1999. p. 61.

To practice mindful breathing, sit or lie in a comfortable position.  Relax the shoulders.  Breathe deeply and slowly, allowing the breath to come from the abdomen.  Imagine that the belly is breathing, rather than the chest.  If possible, have the entire breathing movement come from the diaphragm.   After a few minutes, observe the effects of this practice on the body and mind.

Support for Caregivers

Caregivers for the dying often become distressed, depressed and drained of energy.  They often become the second patient.93 In times of stress it is easy to focus one’s attention outward, and forget one’s own needs.  There may seem to be no time for caregivers to focus on their own needs such as nourishing and healthy food, sleep, quiet time or meditation and time to unwind in nature or with loved ones.  For those who devote their time to caring for the ill and dying, it is especially important to prioritize self­care, ask for help and delegate responsibility to others.
Studies have shown that caregivers experience a rise in anxiety, depression and salivary cortisol, and that regular practice of yoga and meditation reduces all three of these symptoms.94 Caregivers can use all five of their senses to create harmony, peace and balance.95 The recommendations outlined in this paper can also apply to caregivers.  Massage nourishes the sense of touch, aromatherapy can influence the mind through the sense of smell, relaxing music and healing mantras can serve as sound therapy and color therapy can be applied through flowers and pleasant visual impressions.  Caregivers need to bring their attention to keeping ojas high, therefore, ojas building foods are recommended, such as nourishing soups, dates, almonds, and hearty grains such as basmati rice, quinoa and oatmeal with warming spices.
Helping others have a peaceful and dignified death, either as a professional or familial caregiver, is heart­centered work.  Caregivers in hospice situations extend themselves above and beyond usual boundaries.  Having a “good death” is important to people, and contributing to that end is a deep calling and not something that everyone is called to do.96 In order to be able to continue to give, one must avoid draining one’s self.  Ayurveda has profound wisdom to offer in this capacity.
 
Conclusion
  • 91 Chopra, Deepak and David Simon. p. 99-104
  • 92 Ibid.
  • 93 Berman, Claire. Caring for Yourself While Caring for Your Aging Parent: How to Help, How to Survive. Henry Holt: New York, 1996. p. 34.
  • 94 Evidence Based Complementary and Alternative Medicine. “A yoga and compassion meditation program reduces stress in familial caregivers of Alzheimer's disease patients.” Danucalov et al. April 2013.
  • 95 Sushruta Samhita. Section 8, verse 10.
  • 96 Sneesby and Mater. “Home is Where I Want to Die: Kelly’s Journey.” Contemporary Nurse. Aug 2013.
Ayurveda is an ancient system that can be used to offer ease and comfort to patients in hospice care settings, as well as their family and caregivers.  Techniques explored in this paper help support relaxation, manage stress and anxiety, and create feelings of peacefulness and upliftment.  These practices assist all who are involved in experiencing and being present to the sacredness of dying.  Through Ayurveda, we can explore the dimension of spirituality within us, unlocking greater capacity to love, care and be compassionate.

Bibliography

Berman, Claire. Caring for Yourself While Caring for Your Aging Parent: How to Help, How to Survive. Henry Holt: New York, 1996.
Charaka Samhita.
Chopra, Deepak and David Simon. The Seven Spiritual Laws of Yoga: A Practical Guide to Healing Body, Mind, and Spirit. John Wiley & Sons, Inc: New Jersey, 2004.
Danucalov et al. “A yoga and compassion meditation program reduces stress in familial caregivers of Alzheimer's disease patients.” Evidence Based Complementary and Alternative Medicine. April 2013.
Dass, Ram. Still Here: Embracing Aging, Changing and Dying. Berkeley Publishing Group: New York, 2000. Downey, et al.“Three lessons from a randomized trial of massage and meditation at end of life: patient benefit, outcome measure selection, and design of trials with terminally ill patients.” American Journal of Hospice and Palliative Care. Aug 2009.
Feuerstein, Georg and Larry Payne. Yoga for Dummies. IDG Books Worldwide, Inc: California, 1999.
Frawley, David. Ayurvedic Healing for Healthcare Professionals. California College of Ayurveda: Nevada City, CA, 1988.
Gass, Robert. Chanting: Discovering Spirit and Sound. Broadway Books: New York, 1999.
Halpern, Dr. Marc. Healing Your Life: Lessons on the Path of Ayurveda. Lotus Press: Wisconsin, 2011. Halpern, Dr. Marc. Principles of Ayurvedic Medicine. California College of Ayurveda: California, 1995. Heyn, Birgit. Ayurvedic Medicine: The Gentle Strength of Indian Healing. Thorsons Publishing Group: Vermont, 1987.
initiateayurveda.blogspot.com
Johari, Harish. Ayurvedic Massage: Traditional Indian Techniques for Balancing Body and Mind. Healing Arts Press: Vermont, 1996.
Kabat­ Zinn.  “Mindfulness Based Cognitive Therapy.” International Journal of Palliative Nursing. June 2001.
Kubler­Ross, Elizabeth. On Death and Dying. Scribner: New York, 1969.
Lad, Vasant. Complete Book of Ayurvedic Home Remedies. Three Rivers Press: New York, 1998.
Levine, Stephan. Healing Into Life and Death.  Doubleday: New York, 1987 livingyourdying.com
Novak, John. Ananda Course in Self­Realization: Part 1: Lessons in Meditation. Ananda Church: USA, 1997 Page, Linda. Healthy Healing. Quality Books Inc: 1985.
Shanbhag, Vivek. A Beginner’s Introduction to Ayurvedic Medicine: The Science of Natural Healing and Prevention Through Individualized Therapies. Keats Publishing, Inc: CN, 1994.
Simpson, Liz. The Book of Chakra Healing. Sterling Publishing Co: New York, 1999.
Sneesby and Mater. “Home is Where I Want to Die: Kelly’s Journey.” Contemporary Nurse. Aug 2013. Sushruta Samhita.
Tirtha, Swami Sadashiva. Ayurvedic Encyclopedia: Natural Secrets to Healing, Prevention and Longevity. Ayurveda Holistic Center Press: New York, 1998.
Wall, Carly. Setting the Mood With: Aromatherapy. Sterling Publishing Company: New York, 1998.
What Hospice Is, What Hospice is Not. Patient education pamphlet distributed by Vitas Innovative Hospice Care.
Worwood, Valerie Ann. The Complete Book of Essential Oils and Aromatherapy. New World Library: San Rafael, CA, 1991.
Young, Gary. Aromatherapy: The Essential Beginnings. Essential Press Publishing, Salt Lake City,1996.
 

Abstracts

from Contemp Nurse. 2013 Aug 4.
Home is where I want to die: Kelly's Journey.
Sneesby L, Mater C.
 
Abstract
The definition of a "good death" is centred on being peaceful, dignified and pain free. The preferred place of death has also been highlighted as an important concept in defining a good death (Cox, Almack, Pollack & Seymour, 2011) 70% of Australians express the desire to spend their last days at home. In reality only 16 % of people die at home (Preferred place of death, 2008). With 10% of Australians dying in residential aged care facilities and approximately 20% in hospices, the rest die in hospitals (Parish et al., 2006). Family support and the family's care giving ability play a major role in determining whether a person is able to die at home. Other factors include the availability of medical and nursing care.
 
from­Evid Based Complement Alternat Med. 2013 Apr 18.
 
A yoga and compassion meditation program reduces stress in familial caregivers of Alzheimer's disease patients.
Danucalov MA, Kozasa EH, Ribas KT, Galduróz JC, Garcia MC, Verreschi IT, Oliveira KC, Romani de Oliveira L, Leite JR.
 
Abstract
Familial caregivers of patients with Alzheimer's disease exhibit reduced quality of life and increased stress levels. The aim of this study was to investigate the effects of an 8­week yoga and compassion meditation program on the perceived stress, anxiety, depression, and salivary cortisol levels in familial caregivers. A total of 46 volunteers were randomly assigned to participate in a stress­reduction program for a 2­month period (yoga and compassion meditation program­YCMP group) (n = 25) or an untreated group for the same period of time (control group) (n = 21). The levels of stress, anxiety, depression, and morning salivary cortisol of the participants were measured before and after intervention. The groups were initially homogeneous; however, after intervention, the groups diverged significantly. The YCMP group exhibited a reduction of the stress (P < 0.05), anxiety (P < 0.000001), and depression (P < 0.00001) levels, as well as a reduction in the concentration of salivary cortisol (P < 0.05). Our study suggests that an 8­week yoga and compassion meditation program may offer an effective intervention for reducing perceived stress, anxiety, depression, and salivary cortisol in familial caregivers.
 
from Am J Hosp Palliat Care. 2009 Aug­Sep
 
Three lessons from a randomized trial of massage and meditation at end of life: patient benefit, outcome measure selection, and design of trials with terminally ill patients.
Downey L, Engelberg RA, Standish LJ, Kozak L, Lafferty WE.
 
Abstract
Improving end­of­life care is a priority in the United States, but assigning priorities for standard care services requires evaluations using appropriate study design and appropriate outcome indicators. A recent randomized controlled trial with terminally ill patients produced no evidence of benefit from massage or guided meditation, when evaluated with measures of global quality of life or pain distress over the course of patient participation. However, reanalysis using a more targeted outcome, surrogates' assessment of patients' benefit from the study intervention, suggested significant gains from massage­the treatment patients gave their highest preassignment preference ratings. The authors conclude that adding a menu of complementary therapies as part of standard end­of­life care may yield significant benefit, that patient preference is an important predictor of outcome, and that modifications in trial design may be appropriate for end­of­life studies.
 
from Am J Hosp Palliat Care. 2009 Aug­Sep
 
Three lessons from a randomized trial of massage and meditation at end of life: patient benefit, outcome measure selection, and design of trials with terminally ill patients.
Downey L, Engelberg RA, Standish LJ, Kozak L, Lafferty WE.
 
Abstract
Research suggests that aromatherapy massage (AM) is increasingly being used by cancer patients, especially in the palliative care setting, although few studies have assessed its effectiveness. I wanted to find out whether AM reduces anxiety in patients with a primary malignant brain tumour attending their first follow­up appointment after radiotherapy. Eight patients were recruited to the study, which comprised three methods of data collection: the measurement of physical parameters; the completion of Hospital Anxiety and Depression Scales (HADS); and semi­structured interviews. The results from HADS did not show any psychological benefit from AM. However, there was a statistically significant reduction in all four physical parameters, which suggests that AM affects the autonomic nervous system, inducing relaxation. This finding was supported by the patients themselves, all of whom stated during interview that they felt 'relaxed' after AM. Since these patients are faced with limited treatment options and a poor prognosis, this intervention appears to be a good way of offering support and improving quality of life.
 
from Int J Palliat Nurs. 2001 Jun;
 
The role of aromatherapy massage in reducing anxiety in patients with malignant brain tumours.
 
Abstract
 
Mindfulness is a lifetime engagement­­not to get somewhere else, but to be where and as we actually are in this very moment, whether the experience is pleasant, unpleasant, or neutral.Mindfulness is a lifetime engagement­­not to get somewhere else, but to be where and as we actually are in this very moment, whether the experience is pleasant, unpleasant, or neutral.

 

Ayurvedic Approach to Down Syndrome by Vidya Venkatesh

 TABLE OF CONTENTS 

ITEM                                                                                                  PAGE 
Acknowledgements……………………………………………………………………………………………….4 
Abstract………...…………………………………………………………………………………………………5 
Chromosomes and Cells………………………………………………………………………………………….5 
Types of Down Syndrome………………………………………………………………………………………..5 
Signs and Symptoms…….……………………………………………………………………………………….6 
Etiology…………………………………………………………………………………………………………..6 
Treatment………………………………………………………………………………………………………...7 
Prevention………………………………………………………………………………………………………..7 
Ayurvedic Interpretation of the Mind……………………………………………………………………………8 
The Five Layers of Human Existence (Koshas)…………………………………………………………………9 
Ayurvedic Interpretation of Karma……………………………………………………………………………...10 
Classical Ayurveda Interpretation of Down syndrome………………………………………………………….10 
Nidhana (Causes)………………………………………………………………………………………………..10 
Rupa (Symptoms)……………………………………………………………………………………………….11 
Samprapti (Pathology)…………………………………………………………………………………………..11 
  • Vata Samprapti…………………………………………………………………………………………......11 
  • Kapha Samprapti…………………………………………………………………………………………...13 
Chikitsa (Treatment)…………………………………………………………………………………………….13 
  • Herbs………………………………………………………………………………………………………..14 
  • Nervous System Treatment and Enhancement……………………………………………………………..15 
  • Meditation…………………………………………………………………………………………………..15 
  • Pranayama………………………………………………………………………………………………….15 
  • Panchakarma……………………………………………………………………………………………….15 
  • Abhyanga, Shirodhara, and Swedhna—Bliss Therapy…………………………………………………….16 
  • Basti………………………………………………………………………………………………………...16 
  • Nasya (with Brahmi Ghee)…………………………………………………………………………………16 
  • Color Therapy………………………………………………………………………………………………17 
  • Marma Therapy……………………………………………………………………………………………..17 
  • G-Therapy…………………………………………………………………………………………………..18 
Rasayana (Rejuvenation) Therapies…………………………………………………………………………….18 
  • Aromatherapy………………………………………………………………………………………………18 
  • Mantra Therapy…………………………………………………………………………………………….18 
  • Diet…………………………………………………………………………………………………………18 
Conclusion………………………………………………………………………………………………………18 
References……………………………………………………………………………………………………….19 
Photo Credits…………………………………………………………………………………………………….20 

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Ayurvedic Approach to Obesity by Sarah Haven Bundy

Obesity Overview

Despite the staggering list of risks associated with obesity, more than 35% of American adults have been diagnosed with this condition1 and that number is rising each year.2  Our modern medical view of treatment for this epidemic condition utilizes diet & exercise, often moving on to weight loss drugs and surgery if patients don’t see results.  This approach could be seen as a two-dimensional view for a multi-dimensional challenge, and often falls short in long term treatment.  There are some major leverage points within the wisdom of Ayurveda on the topic of weight management that could assist in greater success, and bring with them a cascade of accompanying health benefits.  The Ayurvedic view looks at the whole individual and the underlying cause for any imbalance.   It meets those challenges where they are, instead of working on symptoms only and ignoring their root origins.  We are going to look deeply into this ancient science and see how it can work for today’s dilemma of American Obesity.

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Ayurvedic Approach to Stress by Jeff Mortlock

   What is stress, and what does it mean to us as people or more specifically what does it mean to the ayurvedic practitioner? It's one of those words that are much overused, or so casually, or so incorrectly that we actually lose the real meaning of the word and its significance. Stress is also commonly called anxiety, tension, etc.
 
   Stressors which are events that provoke stress are in themselves not a bad thing as one may think by the commonly overused cliches that we often hear. They are a very necessary function of the psyche and the body to deal with different situations, both positive and negative. "Life stressors involve changes in your environment that your central nervous system must adapt to during the course of daily living. Stressors include either positive or negative life events ( e.g . death, divorce, new job, new house, new baby) that require you to adapt to these changes in your life. Stress results when  pressures, challenges, or demands in life exceed your coping abilities. Stress can manifest itself in physical, emotional, or behavioral symptoms." 1
 
   "Stress can come from any situation or thought that makes you feel frustrated, angry, or anxious. What is stressful to one person is not necessarily stressful to another." 2 Stress in everyday life isn't necessarily a bad thing; however, unchecked or negative stress can be a bad thing causing many conditions that we'll look at in this paper. A little stress can be a motivating thing to get your work done on the job for example. It can make you more aware in a situation that requires serious attention. It can also be used as a life saving safety mechanism e.g. in wartime, the soldier runs or just reacts without really thinking.
 
1 ''The Phases of Stress" in The Cleveland Clinic Health and Information Center, Available on the World Wide Web @ www.clevlandclinic.org/health/health­ info/docs/0200/0296.asp?index=5274
2 Christo Hallos, "Medical Encyclopedia: Stress and Anxiety" in Medline Plus, June 17, 2005 , Available on the World Wide Web @ www.nlm.nih.gov/medlineplis/ency/article/00321   l .htm
 
   However, too much stress, or a strong response to stress, is harmful. It can set you up for general poor health as well as specific physical or psychological illness like infection, heart disease, or depression. "Persistent and unrelenting stress often leads to anxiety and unhealthy behaviors like overeating and abuse of alcohol or drugs." 3 Low emotional states or poor health conditions can cause stress as well.
 
"Anxiety is often accompanied by physical symptoms, including:
  • Twitching or trembling Muscle tension, headaches
  • Sweating
  • Dry mouth, difficulty swallowing
  • Abdominal pain (may be the only symptom of stress, especially in a child)" 4
These are some of the multitude of symptoms that can occur:
  • fatigue
  • diarrhea
  • lack of concentration
  • sleeping problems
  • irregular heartbeat
  • Irritability (anger)
   Almost all of these symptoms seem to point to a marked increase or imbalance in the vata dosha. However, all three doshas can play a role. Generally, vata individuals are likely to develop vata-aggravated stress reactions, such as anxiety or fearfulness, even phobias or anxiety neurosis. Pitta individuals increase in pitta during stressful situations and
typically react to stress in the form of anger. They may also suffer from hypertension, peptic ulcer, ulcerative colitis, and other pitta disorders. "Kapha individuals under stress can develop under active thyroid function, slow metabolism, and even increased blood sugar, leading to a prediabetic condition.
3 Ibid.
4 Ibid.
They tend to eat and eat and eat and become chubby." 5
 
   From a physical point of view, ''the human body responds to stressors by activating the nervous system and specific hormones in the endocrine system The hypothalamus signals the adrenal glands to produce more of the hormones adrenaline and cortisol and release them into the blood stream These hormones speed up the heart rate, breathing rate, blood pressure and metabolism Blood vessels open wider to let more blood flow to large muscle groups. Putting our muscles on alert. Pupils dilate to improve vision. The liver releases some of its stored glucose to increase the body's energy. And sweat is produced to cool the body. All of these physical changes prepare a person to react quickly and effectively to handle the pressure of the moment." 6
 
   "Cortisol also curbs functions that would be nonessential or detrimental in a fight-or­ flight situation. It alters immune system responses and suppresses the digestive system, the reproductive system and the growth processes." 7 Sushrut points out in the Sushruta Samhita that "a person with an uniformly healthy digestion, and whose bodily humors are in a state of equilibrium, and in whom the fundamental vital fluids course in their normal state and quantity, accompanied by the normal processes of secretion, organic function, and intellection, is said to be a healthy person." 8
 
''The natural reaction known as the stress response. Working properly, the body's stress response enhances a person's ability to perform well under pressure. But the stress response can also cause problems when it overreacts or fails to turn off and reset itself properly." 9
 
5 Vasant Lad, The Complete Book of Ayurvedic Home Remedies, (New York: Three Rivers Press  1998), 259
6 D'Arcy Lyness, PhD "Stress" in TeensHealth, July 2007 Available on the World Wide Web  @ http://www.kidshealth.org/teen/your _mind/emotions/stress.html
7 Mayo Clinic Staff "Stress: Unhealthy response to the pressures  oflife" September 2006 Available on the World Wide Web @ www.nlm.nih. gov/medlineplus.stree.html
8 Kaviraj Kunjalal Bhishagratna, trans., Sushruta Samhita. 3rd ed. (India: Chowkhamba Sanskrit Series Office, 2005) 131
9 D'Arcy Lyness, PhD "Stress" in TeensHealth, July 2007 Available on the World Wide Web  @ http://www.kidshealth.org/teen/your _mind/emotions/stress.html
 
   There are three phases of stress. PhaseIhas to due with the body's response to stress. Events can trigger this like divorce, finances, accidents, etc. Also, less tangible reasons might include worries, regrets, memories, etc. and how our mind interprets these mental processes.
 
   Phase II is how we interpret the stressors and our ability to cope with them  Our beliefs and values determine how we will likely view these stressors. If we view them as threats or pressures, or we're feeling over attached to things or outcomes then that could compromise our ability to cope.
 
   Phase III "Reaction to stress might create or worsen physical, emotional, or behavioral symptoms.
  • Physical -high blood pressure, heart disease, ulcers,  strokes, rashes, migraine, tension headaches
  • Emotional - anxiety, depression, anger, forgetfulness
  • Behavioral - overeating, poor appetite, drug abuse, excessive smoking, irritability, social withdrawal, insonmia" 10
   As previously mentioned that a little stress can be good in certain situations and then the body resets itself; however, the stress due to physical threats in previous eras doesn't apply to us nearly as much as it once did. The more psychological threats/stress apply to us much more often in the modern day world, especially in the western world, where man maybe more than anywhere seeks happiness and security outside of himself and in artificial ways. The thing about psychologically stressful situations more so than physically stressful situations is that the body tends to stay in the stressed mode for longer and longer periods of time. The stress with physical threats comes and goes rather quickly and the body resets, but the psychological can last for long periods of time. This can really start to breakdown the bodies systems ifstressed for an extended period of time.
 
10 "The Phases of Stress" in The Cleveland Clinic Health and Information Center, Available on the World Wide Web @ www.clevlandclinic.org/health/health­ info/docs/0200/0296.asp?index=5274
 
   Now, focusing on some of the major symptoms, problems, and diseases that stress can have on a person and how the ayurvedic system of medicine approaches these. Along with some of the different treatments, methods, and protocols that ayurveda suggests to help alleviate these problems. Ayurvedic methods of cure are very individualized for each patient so in a general paper regarding a particular topic more generalized methods must suffice.
 
   One of the major problems that occur with too much stress for an extended period of time would be depression. Depression needless to say is a very big problem in our society. Depression may affect most people at some point in their life to a greater or lesser degree, but when it starts to become prolonged, or it starts to affect the ability to act and interact in normal life situations, then it becomes a problem that should be addressed. Depression is more on the emotional level than the physical level and is a very reactionary symptom of stress.
 
   As Dr. David Frawley states, "depression follows stress, overwork, overexertion, and trauma, particularly adrenal fatigue. Itis generally a sign oflow Ojas and weak immune function. Depression is the most common kapha disorder." 11 Kaphas often suffer from low energy, a slower metabolism, weight gain, and attachment. These things can lead to depression. Vatas can also be affected by stress and depression. The vata type is usually more sensitive and may feel hurt more easily. ''Vata type depression is associated with feelings of abandonment, lack of love and nurturing in life. It can become severe or even suicidal" 12 Pitta depression is in large part due to a failure in their plans, a set back. The pitta type could take into consideration a sayingIheard a monk once say "if you want to make God laugh, tell him your plans for the future."
 
11 David Frawley, Ayurvedic Healing, 2 nd ed., (Twin Lakes, WI: Lotus Press, 2000) 324
12 Ibid. 324
 
   With somebody that's so stressed as to fall into depression one of the hardest things is to get the patient to comply with any treatment. Dr. Frawley recommends that the first thing to be done is to initiate change and encourage activity of any kind to help restore some interest in life. A few of the general ayurvedic methods of treatment for depression would be a light stimulating diet that's well spiced with herbs that open the mind e.g. ginger and basil. There should be exposure to positive sights and sounds, like walking in nature.
There should be exposure to stimulating and positive aromas like camphor or tangerine. Exercise and pranayama are very good to bring in new fresh energy and prana. A good herb to take is calamus taken as a tea with ginger and honey. And, as with any good ayurvedic regiment keeping the apana going with a mild laxative e.g . triphala.
 
   Tension is another big symptom of stress. Vagbhata wrote of tension in the Astanga Hridayam and said "that when vata getting inside the arteries/nerves present in the sides of the neck cause their stiffuess and then spreads to all parts of the body, constricts the shoulders, then makes the body bend forwards like a bow; produces bouts of convulsions, loss of movement of the eyes, move of yawnings, grinding of the teeth (rigidity of the jaw or lock jaw) vomiting of kapha (mucus), pain in the flanks, inability of speech, loss of movement of the lower jaw, back and head. This is called Anaryama (inward bending)." 13 This is obviously an extreme example of tension related symptoms; however, many people experience several of these on a regular basis. Headaches and neck stiffuess seem to be ubiquitous. Ayurveda would address tension with looking at a dosha balancing diet as should always be addressed, as well as nerviness sedatives and tonics such as Ashwaganda and jatamamsi and perhaps an analgesic like feverfew. Lifestyle issues are likely going to need to be addressed, what's making the person so tense and stressed, job, marriage, lack of rest, etc. Other of the five sense therapies like massage, shirodhara, and aromatherapy can be very helpful.
 
13 Board of scholars, trans., Astanga Hridayam. Vol 2 first ed. (India: Sri Satguru Publications), 129
 
   Chronic fatigue is something else that is common that can be hrought on by stress. "Fatigue is physical and mental stress." 14 Fatigue is also called shrama and it's a condition of increased vata. An obvious treatment for fatigue would be a lot ofrest. A vata reducing diet one that is tonifing and strengthening. Sense therapies such as daily abhyanga ''removes fatigue and stress from work and life overall." 15 Morning rosemary baths are good as well.
 
   A pitta type person suffering from stress may suffer from ulcerative colitis. This is actually a pitta/vata type condition in that it's a chronic inflammatory disease causing ulcerations. The cause or etiology of this disease is a ''vata- and pitta- vitiating lifestyle and dietary imbalances. Emotionally this condition occurs in individuals who are prone to worry and anxiety combined with intensity and I or anger." 16 The pathology of this disease is that pitta has relocated to the colon, from the small intestine. Vata has relocated from the large intestine to the small intestine and this combination of heat and dryness causes ulcerations in the mucosa! wall The doshas both relocate in the mind as well. This causes the anger and anxiety. Some of the treatments ayurveda would recommend are following a vata/pitta pacifying diet. '"friphala in the form of shita kshaya should be considered for the long-term care of the colon. Takra is also beneficial for normalizing digestion. With nutmeg and licorice added, absorption is improved and both vata and pitta are pacified." 17
 
   Stress can produce sleeping problems and this is a major problem with many, many people. Many things can cause sleeping problems; however, this is just focused on the sleep that is troubled by stress and anxiety. In these cases it's usually a vata disturbance. A vata-vitiated lifestyle often leads to anxiety, worry, and overwhelm which in turn can disturb sleep. "Sleep disturbances are accompanied by fear, worry, and anxiety.
 
14 Vasant Lad, The Complete Book of Ayurvedic Home Remedies, (New York: Three Rivers Press 1998), 177 15 Swami Sada Shiva Tirtha, The Ayurvedic Encyclopedia, (Bayville, NY: Ayurveda Holistic Center Press), 207
16 Marc Halpern, Clinical Ayurveda Medicine, 5 th ed. (Grass valley, CA: California College of Ayurveda)  1-42
17 Ibid, 1-44
Sleep is restless, fitful, and light. Other systemic signs of vata disturbances are likely to be found." 18
 
   Sleeping problems in particular to the vata type that we're discussing here, are really a problem that requires most if not all of the five sense therapies. Lifestyle is important to look at, what may be something that is disturbing or causing anxiety in the person.
Maybe a very disturbing work environment, a tyrannical boss, or an extremely chaotic or loud workplace. Too much coffee or caffeinated drinks. Too much TV before bedtime. A long fierce commute can be very unsettling. These are things to consider along with a myriad of other things in our vata-vitiated  society.
 
   Some of the things that may help a person with sleeping troubles are being quite after dark before bedtime. Rising with the sun and keeping a regular routine is helpful. Turn the TV off early, or never turn it on in the first place. Read a spiritual book to calm the nerves and uplift the soul, bathe in the peaceful vibrations of meditation before bed, or even twice a day if possible. Meditation works on all levels of a person physical, mental, spiritual. It also affects all three bodies physical, astral, and casual. On a practical physical level "p racticing meditation has been shown to induce some changes in the body, such as changes in the body's [fight or flight] response. The system responsible for this response is the autonomic nervous system (sometimes called the involuntary nervous system). It regulates many organs and muscles, including functions such as the heartbeat, sweating, breathing, and digestion, and does so automatically." 19
 
   It's believed to slow the sympathetic nervous system, while boosting the parasympathetic nervous system, which slows the breathing and heart rate. Exercise, preferably a grounding or restorative hatha yoga routine may be helpful. A warm bath before bedtime is relaxing, perhaps with a little jatamamsi  or lavender essential oil. A vata reducing diet needs to be kept.
 
18 Ibid, 6-39
19 National Center for Complementary and Alternative Medicine (NCCAM), Meditation for Health Purposes, Baime , Davidson, et al., February 2006, page 3
 
   "Boiled milk builds ojas, promotes sleep (with warm nervine herbs). Boiled, it reduces Vayu and Kapha." 20 Anger is another problem that stress can produce, especially in the pitta type person. "Anger and hostility are signs of aggravated pitta in the nervous system. Pitta is necessary for right understanding and judgment,  but when it gets disturbed or out of balance, it creates misunderstanding and wrong judgment,  leading to anger and hostility. The aim is to bring pitta back to its normal constitutional function." 21 Many ifnot most people in our society create a tremendous amount of stress on themselves to keep up with everybody else, and even compare themselves to others to see if there up to standards with everybody else. People even create a false sort of desire for what others have; they have a tribal mentality to keep up, because somebody or some advertising has made them believe that they're less than others ifthey're without something. This can really create a lot of stress and anger in a person ifthey're so gullible as to follow this perverted rational Krishna in the Bhagavad Gita says, "brooding on sense objects causes attachment to them. Attachment breeds craving; craving breeds anger. Anger breeds delusion; delusion breeds loss of memory (of the Seit). Loss of right memory causes decay of the discriminating faculty. From decay of the discrimination, annihilation (of the spiritual life) follows." 22 This is a problem that can obviously run very deep, but from an Ayurvedic perspective we can view it as a primary pitta imbalance, as well as a case of prajnaparadha.
 
   Some of the Ayurvedic methods to overcome this stress-induced anger would be to follow a pitta-pacifying diet, lay off the chili peppers, citrus and sour foods. Avoid alcohol and caffeinated drinks.
 
20 Swami Sada Shiva Tirtha, The Ayurvedic Encyclopedia, (Bayville, NY: Ayurveda Holistic Center Press), 146
21 Vasant Lad, The Complete Book of Ayurvedic Home Remedies, (New York: Three Rivers Press 1998), 124
22 Paramahansa Yogananda, trans., The Bhagavad Gita, (Los Angeles, CA: Self­ Realization Fellowship,  1995), 307
"Have a pitta pacifying drink. Into 1 cup of grape juice, add Ya teaspoon cumin, Ya teaspoon fennel, and a Ya teaspoon sandalwood powder. This cooling pitta pacifying drink will help to settle angry feelings and other pitta symptoms such as burning in the stomach." 23
 
   A pitta in a hot climate should try to keep cool ifpossible; hot weather can really stress a pitta. Some lunar pranayama would be good. Avoid overheating exercise routines e.g . jogging at noon or hot yoga. As far as the deeper issues the best thing there is to do for prajnaparadha  is meditation. A person with issues of stress and anger could immensely benefit by disconnecting with ahamkara (ego) little by little. Introspection while being quite is an excellent tool for anyone as well.
 
   Heart disease is another area where stress has been known to cause or be a causative factor. In ayurveda and also "according to Oriental medicine, the heart, not the brain, is the seat of consciousness." 24 Dr. Frawley explains that what we feel in our hearts is who we truly are, not necessarily the passing thoughts that we think in our heads. He goes on to say that "heart diseases reflect deep-seated issues of identity, feeling, and consciousness." 25 Considering this train of thought, it's easy to see why emotions and stress, as well as the obvious physical reasons of overeating, eating the wrong foods, lack of exercise, etc. can cause trouble with the heart.
 
   Allopathic medicine as well as Ayurvedic medicine sees that high stress can be a causative factor inheart disease as reported in the British Medical Journal (BMJ). "Both prevalence and incidence of angina increased with the perceiving of stress...high stress was associated with a
 
23 Vasant Lad, The Complete Book of Ayurvedic Home Remedies, (New York: Tbree Rivers Press 1998), 125
24 David Frawley, Ayurvedic Healing, 2 nd ed., (Twin Lakes, WI: Lotus Press, 2000) 209
25 Ibid, 209
higher rate of admissions related to cardiovascular disease." 26 In the Journal of the American Medical Association (JAMA) an article about stress research states that the authors looked at the behavior and biological mechanisms through which stress contributes to disease and weighed the results to whether stress plays a role is cardiovascular disease as well as others. "Those studies reveal that stress plays a role in triggering or worsening depression and cardiovascular disease." 27
 
   General Ayurvedic treatment would emphasize extended rest. An extended retreat in a natural setting could due wonders, especially if the person has been a stressed out city dweller for a period of time. Meditation is great for calming the mind and emotions. A doshically appropriate diet is always important, but considering the vikruti, getting that under control first, while working toward the primary doshic routine. Certain herbs are great in different combinations, depending on the individual's particular problem and constitution; however, Arjuna is a tridoshic favorite for heart ailments mixed in combination with constitutionally correct herbs.
 
   Stress can play a huge role in our lives, and for many, or even most it plays a role on occasion or even on a daily basis. As we've seen it contributes or even causes disease. It can cause simple things like occasional sleepless nights or chronic insomnia. Can contribute to angina, or to full-blown heart attacks. Stress can lead to ulcers, anger, depression, tension, chronic fatigue, as well as a myriad of other symptoms and diseases.
 
   As we can see Ayurvedic medicine can actually play a major role in mitigating or even eliminating these kinds of problems.
 
26 Macleod, Smith, et al., ''Psychological Stress and Cardiovascular Disease" British Medicine Journal, May 2002 Available on the World Wide Web
27 Cohen, Janicki-Deverts, and Miller, "Study of Relationship Between Chronic Diseases and Stress" Medical News Today, Oct 2007 Article adapted from original press release, Available on the World Wide Web @www.medicalnewstoday.com/printerfriendlynews.php?newsid=85162
To summarize some of the different treatments and approaches that ayurveda would take in an approach to help somebody suffering from too much stress in their life:
  • A constitutional balancing diet is always in the forefront of treatment. What is the person putting into their body three times a day, everyday? Is it correct for that individual?
  • How's the elimination? The apana needs to be moving everyday so toxins don't build up and overflow into the rasa and rakta dhatus and get carried into other weakened parts of the body. This can be easily addressed with herbal formulas as needed, such as mild laxatives like triphala, psyllium, flaxseed, etc.
  • With the proper herbs that are nervine sedatives and tonics like ashwaganda and jatamamsi, these can be of great value.
  • Meditation is a very important treatment, it actually a lifestyle, not so much a treatment, but it could be used as one in the beginning, working with a person new to ayurveda. Disconnecting from the ego, withdrawing from the senses, realizing that your not just this little body, but that you're part of the whole, and that behind all oflife's drama (lila) it's all okay. There's nothing better than this for stress relief.
  • A life routine especially for vatas, and occasionally we may want to be a little spontaneous if kapha gets a little too lazy.
  • Five sense therapies are very beneficial in the relief of stress and anxiety. Of course depending on the persons constitution the treatments will vary to some degree; however, getting out into nature and seeing the trees and sunlight does everybody good. Using some aromatherapy in a warm bath or diffuser is soothing. Paying attention to the environment that your in, is it well kempt or sloppy. Are the colors in your house good
for you, as well as the clothes you wear? Is your environment too noisy or restless? All of these things need to be addressed at some point. Of course taken slowly as to not overwhelm the patient, seeing they're already stressed.
  • Getting the right kind and amount of exercise for your constitution and level of health.
  • Monitor your thinking and introspection.
  • Get plenty ofrest.

All of these things, or depending on the individual a few of these things can and will make a difference to lessen stress.

 

Ayurvedic and Allopathic Approaches to Migraine Headaches By Patricia J. Brinkmann

Table of Contents

CONTENTS                                                                                 Page Number

Abstract                                                                                                3
Western Interpretation of Migraine Headache                                            3
Classic Migraine                                                                                      3
Common Migraine                                                                                   3
Cluster Migraine                                                                                     4
Complicated Migraine                                                                              4
Abdominal Migraine                                                                                 4
Basilar Migraine                                                                                      4
Benign Exertional Migraine                                                                       4
Headache Free Migraine                                                                          4
Hemiplegic Migraine                                                                                4
Menstrual Migraine                                                                                  5
Ocular Migraine                                                                                      5
Opthalmoplegic Migraine                                                                          5
Status Migrainosus                                                                                   5
Non-Food Related Triggers                                                                        6
Food Related Triggers                                                                               7
Allopathic / Pharmaceutical Treatment Options                                           8
Nonsteroidal Anti-Inflammatory Drugs                                                          8
Triptans                                                                                                  9
Ergotamine Tartrate                                                                                 9
Midrin                                                                                                    9
Ayurvedic Interpretation of Migraine Headache                                            9
Diseases of the head                                                                                10
Vata Type Headache                                                                                10
Pitta Type Headache                                                                                12
Kapha Type Headache                                                                              15
Suryavarta Headache                                                                                16
Treatments                                                                                             16
Herbs for Headaches                                                                                16
Biofeedback                                                                                            17
Visualization                                                                                            17
Meditation / Deep Breathing / Progressive Muscle Relaxation                        18
Cervical Correction Device                                                                        18
Reflexology                                                                                             18
Cervical Manipulation and Massage                                                             18
Conclusion                                                                                              18
References                                                                                             19 

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Aśvagandhā By Radhakrishna Gargé

 Table of Contents

Acknowledgements...................................................................................................................................3

Abstract.....................................................................................................................................................4

Introduction..............................................................................................................................................5

Aśvagandhā - The Plant and its Distribution.........................................................................................5

Parts of the plant and their traditional therapeutic uses.........................................................................6

Chemical Constituents of Aśvagandhā..................................................................................................6

Energetics and Ayurvedic properties of Aśvagandhā............................................................................7

Traditional uses of Aśvagandhā in Ayurvedic Medicine.......................................................................7

Aśvagandhā.........................................................................................................................................16

Pharmacological and Clinical Studies....................................................................................................9

Adaptogenic and anti-stress Studies......................................................................................................9

Hepato-protective Studies...................................................................................................................10

Anti-tumoural Property Studies...........................................................................................................11

Anti-inflammatory and anti-bacterial studies......................................................................................13

Neuro-regenerative Potential Studies..................................................................................................14

Infertility and Sexual Dysfunction Studies.........................................................................................16

Toxicity and Safety Studies.................................................................................................................17

Contra-indications of Usage................................................................................................................18

Conclusion...........................................................................................................................................18

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Eczema and Vicharchika: A Review From Western and Ayurvedic Perspectives: A Review of the Literature by Jessica Houghton

Introduction

Eczema is the common name given to Atopic Dermatitis, a chronic inflammatory skin condition that typically begins in the first few years of life.  It is the most widespread skin disease of infancy and childhood1  and is often the initial indication that a child will develop further allergic conditions such as allergic rhinitis and allergic asthmaHthe beginning of the soHcalled “atopic march.”2.   It was once thought of as solely a disease of childhood, but is becoming increasingly prevalent in all age groups.  Although it does sometimes begin and resolve itself during childhood, it can progress into adulthood, or simply have a later onset for some individuals.  There have been many significant scientific discoveries in recent years about the causes of eczema including the discovery of the filaggrin gene and the loss              of barrier function, and also the current understanding of the role of the mast cell in allergic reaction.  In addition, there have been highly credible theories as to what serves as the catalyst for the disease, including the hygiene hypothesis and the misuse of topical steroids.

Atopic dermatitis is characterized cracked or scaly skin, discolored patches, erythema (red skin), papules, exudate (oozing), and intense pruritus (itching), which can secondarily cause insomnia and diminished quality of life. It may present differently, combining any of these symptoms, depending on the age and nature of the patient, as well as the stage of the  disease.  Eczema is usually classified in three distinct stages:  infancy, childhood, and adolescent/adulthood. Beginning in the second or third month of life, it often appears as patches on the cheeks referred to as “milk crust” and later in the flexures of the arms and legs. It is reminiscent of seborrheic dermatitis, also known as “cradle cap.” At this point, the condition may or may not yet have developed into an atopic condition3.

As the disease progresses into childhood, the eczematous lesions can be found on the flexural areas such as the innerHelbow, neck, and wrists.  Even if the disease does resolve itself during adolescence, abnormal dryness and lichenification may remain in the affected areas.  Although about 60% of the childhood cases of eczema will disappear completely4, it frequently persists into adulthood. It can also develop for the first time at this later stage. The areas classically affected during this period are the flexures as well as the orbital and perioral regions of the head and most appear as dry, lichenified plaques5.

The psychological effects of eczema must be considered as well for both children and adults. Living with atopic dermatitis can have a profoundly negative effect on quality of life. Constant itching and scratching, soreness, pain, and discomfort can lead to high stress levels and sleep deprivation.  Lifestyle may be affected, as the patient’s activities might be restricted.  Depression is also a concern as the patient might begin to feel hopelessness, embarrassment, despair due to the chronic nature of the disease6.

The specific definition of atopic dermatitis should be mentioned as the term “eczema” is often separated into two separate categories:   atopic (extrinsic) dermatitis and atopiform (intrinsic) dermatitis; or in other words, allergic eczema and nonHallergic eczema, respectively.  According to the World Allergy Organization (WAO), atopy and atopic conditions are defined only in association with IgEHmediated pathophysiology7.  This pertains to the body’s ability to create the allergic antibody in response to an antigen. By exclusion, this would signify that only atopic dermatitis is specifically allergyHinduced eczema.  There is some debate over whether there are indeed two distinct forms; it is postulated by some that non IgEHassociated eczema may represent a transitional phase of the IgEHassociated form in infancy8. At the stage when an infant or child contacts the earliest signs of eczema, in about half the cases, there is no evidence of IgEHmediated sensitization9. These patients are not yet technically considered “atopic” but could progress into allergic sensitization.

What provokes the disease to progress from a nonHallergic condition to an allergic one and potentially pushes the patient to develop other atopic diseases such as asthma and hay fever?  The etiology of eczema isn’t entirely clear.  However, there is considerable research as to what causes it to manifest and several theories have been produced as a result.  Most certainly, it is a multifactorial condition that occurs due to both genetic and environmental factors10.

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Eczema: Cause and Treatment in Ayurvedic Perspective By Naomi Ikuma

Big interest in eczema treatment is found all over the world due to the high percent of people affected by this disease. According to WebMD, Eczema is a skin condition caused by inflammation of the skin.(1) Roughly 40% of the population worldwide has eczema, nowadays, and this number is constantly growing. The skin has a functional relationship with the internal organs and the glands of internal secretion. Therefore, any impairment of those functions contributes to the development of eczema and dermatitis. Since eczema has such a broad definition, it subdivides into multiple types and can be mild, moderate or severe. It is common for eczema to become chronic. Important to know that eczema is not contagious, and western medicine can not fully cure it. 

Itching is surely the primary symptom in patients suffering from eczema. Indeed, more often than not itching comes before the rash appears on the skin.(1) Eczema is characterized by dry, itchy patches on the skin that usually appear on the hands, neck, face and legs, even though they can be found in any part of the body. Severe itching causes constant scratching that leads to skin bleeding, Therefore making the skin vulnerable to further inflammation. This is known as "itch-scratch cycle."(2)  Eczema is usually diagnosed in childhood and it becomes less severe in adulthood. Infants get eczema on their faces, cheeks, or necks. At times, Eczema can start in adulthood. It also goes through remission cycles that can sometimes last for several years. Eczema can not be cured, yet the symptoms can be successfully treated. 

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Epigenetics – What Ayurveda Already Knows By Gwen Diaz

 We have all contemplated the argument of nature vs nurture. Somewhere along the line we have all responded to a problem with, “that’s just a part of my genes!”  Whether it is through a diagnosis of high cholesterol or an emotional outburst that leads to a bit of embarrassment and shame, we have all used this tactic to avoid responsibility from our actions. So can our choices really affect our outcomes? The answer in both modern science and Ayurveda is overwhelmingly yes. In this paper we will discuss the similarities of what modern science is discovering and what Ayurveda has been teaching and practicing for millennium. The science is called Epigenetics. We will learn about the three types of epigenetic categories – DNA Methylation, Histone Modification and RNA Alteration.  We will also discuss three topics in Ayurveda and relate to the science of epigenetics – Prakruti vs. Vikruiti, Dinacharya, and the Three Causes Disease – Prajnaparadha, Asatmendriyartha Samyoga, and Parinama.

Epigenetics

In order to understand epigenetics we must first talk a bit about genetics.  Genetics is the study of heredity and heredity is the science by which we pass certain genes to our offspring. Every child inherits a set of chromosomes from both the mother and the father that predetermines us to a certain set of physical traits and also tendencies to develop certain disorders and disease. These chromosomes carry thousands of important genes that make us each a unique individual. Genes comprise about 29% of the human genome. The human genome contains roughly 20,000 to 25,000 genes. 1 Each cell contains a complete DNA but the genes differ in cells to be able to perform different functions. Genes can also be activated and/or altered by external stimuli such as infection or stress. This leads to the study of epigenetics.
 
Genetics vs epigenetics is like writing a good book vs reading a good book. When you write a book, it is on paper. It is published and those words hold true no matter how many copies are distributed. Reading a good book on the other hand is quite different. Determining the merit of a good book is completely subjective after the basics of good writing are employed. A good book is based on the perspective of the reader – their physical state, emotional tendencies and even where they grew up will have an effect on whether that person will consider it to be a good book. That’s epigenetics – everything that can be altered in a person’s environment can alter the experience and modify the outcome. Bruce Lipton, an international leader in stem cell biology described the difference like this. “The fundamental difference between the old DNA genetic code and the new epigenetics is that the former notion endorses genetic determinism--the belief that genes predetermine and control our physiological and behavioral traits--while epigenetics recognizes that our perceptions of the environment, including our consciousness, actively control our genes.” 2
 
Epigenetics literally means Epi - “above” and genetic - “origin”. Above the origin.  So epigenetics is the study of the process by which genetic information is translated into the substance and behavior of an organism: specifically, the study of the way in which the expression of heritable traits is modified by environmental influences or other mechanisms without a change to the DNA sequence. 3 To explain this simply it means that the cells of our body can behave and respond differently based on particular environmental factors.  The cells in our body each have a certain function. Some are designed to produce tissue. Other are designed to create enzymes. Others are there to clean up waste that has been produced. Whatever the function of the cell there is a surface receptor that bonds with an extracellular molecule to trigger the cell into behaving a certain way. For example, there are receptors for insulin to bind to a cell. If the receptor sites are not working properly and the extracellular molecule can’t bind with that particular cell then our body malfunctions. This would happen in the case of the hormone insulin not binding with the cell which creates a deficiency of insulin being produced, thus Type 2 Diabetes Mellitus. 
 
So why does this happen? This is the study of epigenetics. There are infinite reasons we can postulate as to why a certain cell behaves or doesn’t behave. What science is teaching us is that our environment has a huge role in this. Everything we bring into our body from our five senses plays an integral part in how our body responds. It makes sense if a person listens over and over again to very loud music they can damage the tissues in the ears and thus cause hearing problems. The same principle applies to what physical substances go into our bodies. If we are exposed to lead based paint it seems logical that lead will enter the body and thus create a lead toxicity that our body does not know how to respond to.  Here are four key things to know about Epigenetics: 
  • Epigenetics Controls Genes. Certain factors in life can cause genes to be turned on or off.  Genes may lie dormant in the body or become altered by epigenetic factors that will cause genes to express in a certain way.
  • Epigenetics Is Everywhere. Everything you eat, touch, smell, hear, or feel can cause chemical modification in your body altering your genes. Even how you sleep, how you exercise and how you age will affect how your body transcribes the genes. Certain diseases are brought on by a malfunction of genes from a healthy state to a disease state.
  • Epigenetics Makes Us Unique. Epigenetic factors can be passed down from generation to generation but also, epigenetics is responsible for the little things that make us all unique. Why do some of us dislike the taste of olives? Why are some of us better listeners? This all has to do with epigenetics.
  • Epigenetics Is Reversible.  With over 20,000 genes in our body the different combinations are enormous. With the science of epigenetics we can begin to map out genes that keep us in a healthy state and eliminate those bad genes that have been plaguing humans over the course of time. There is real possibility to map cures for certain cancers, autoimmune disorders, and many other debilitating diseases.
Our body is constantly reacting to the external ingredients of our life. Many times, our body does an amazing job of handling substances that it does not recognize. The smooth endoplasmic reticulum of the liver is responsible for metabolizing and processing foreign substances to be excreted from the body. The liver processes both the endogenous chemicals such as cholesterol, hormones, fatty acids as well as the exogenous substances we put into our bodies including drugs, alcohol, and food additives.  If we overwhelm our bodies with foreign substances then we will naturally tire out the forces of the body trying to metabolize and excrete these substances. Thus, our body will eventually stop responding to certain actions which will in turn lead to disease. In epigenetic research, scientists are researching how different factors are changing the potential for disease states without changing DNA sequencing. Three main mechanisms are DNA methylation, histone modification and RNA alteration.  These changes are all potentially reversible. Modern science is proving that the path of personalized therapy can affect disease screening and prevention strategies. 

DNA Methylation

Epi¬gen¬et¬i¬cists study mo¬lecu¬lar changes in¬clud¬ing DNA methyl¬a¬tion.  This is a chemical process that adds a methyl group to DNA. This is a fancy way for explaining that our en¬vir¬on¬ment and ex¬per¬i¬ences can subtly al¬ter our gene activ¬ity. Genes turn “on” and turn “off” when we are ex¬posed to cer¬tain chem¬ic-als, man-made pois¬ons, and — per¬haps most sur¬pris¬ingly — emo¬tion¬al ex¬per¬i¬ences, which can make us more or less sus¬cept¬ible to par¬tic¬u¬lar health prob¬lems. 4 When these methyl groups attach to certain DNA it affects the way the DNA acts thus changing the outcome of cellular functioning.  Mi¬chael K. Skin¬ner, a pro¬fess¬or at Wash¬ing¬ton State Uni¬versity and the found¬ing dir¬ect¬or of the Cen¬ter for Re-pro¬duct¬ive Bio¬logy in the School of Bio¬lo¬gic¬al Sci¬ences states, “Ge¬net¬ics is part of the story, an im¬port-ant part of the hu¬man story,” says Skin¬ner. “But epi¬gen¬et¬ics, that is the oth¬er half of the equa¬tion.”  5 Dr Skinner’s work has been notable in the world of epigenetics. One of his most notable studies was on the chemical compound DDT (dichlorodiphenyltrichloroethane). DDT was first developed as an insecticide and used widely in WWII to control outbreaks of malaria and typhoid. Post WWII it was used as a pesticide on agricultural crops. Years later genetic and epigenetic research has found a host of health problems associated with the use of DDT and DDT was finally banned in 1974. His study on rats being exposed to DDT showed that the initial group of rats exposed had elevated levels of certain diseases but by the time the grandchildren of these rats came around there was a 90% chance that these rats would experience obesity, have low sperm counts and even more serious health problems. 6 In the US after WWII, DDT was used widely as a chemical sprayed on crops to reduce insect infestation.  The substance was banned in the early 1970’s but three generations later there is a noted increase in many of the associated health problems including cancer, low sperm counts and human obesity.  

Histone Modification

Histones are primary proteins of chromatin and they combine with DNA to make chromosomes.  Histones are wrapped around the DNA. They essentially organize the DNA in the cell.  If the histones are modified from any outside influence, they can influence how a chromatin is arranged and thus change the way the DNA will be transcribed. 7 This tells us that our DNA can essentially either work or not work depending on the protein modification happening in the body. These alterations are then passed down from generation to generation. These changes in our modification levels can be seen with research which correlates to heightened levels of breast cancer, prostate cancer and pancreatic cancer. Research is being done to study the predetermined risks associated with these types of cancers. Epigenetics not only has the ability to work with diseases such as cancer, scientists are also using epigenetics to study autoimmune disorders, neuropsychiatric disorders and pediatric syndromes. These diseases all have roots in the DNA but have experienced changes within the epigenetic layer that produces faulty cellular functioning. 

RNA Alteration

RNA, particularly microRNA’s, has its roots at the post transcriptional level. Micro RNA’s are non-coding RNA that regulates gene expression. Theses microRNA’s are primarily responsible for normalizing cell function. They are a “blueprint” for the cell to form in a certain way. MicroRNA can also be affected by environmental factors that can alter the blueprint for the cell thus making it behave differently than intended.  These RNA have the ability to turn on and off their DNA making them functional or dormant depending on the signals. 8

Ayurveda

So what does this have to do with Ayurveda? Everything.  Ayurveda is the study of life science.  Ayu – meaning life and Veda – meaning science or knowledge.  This science has been witnessed and practiced for 5000 years since the ancient Vedas were written. Ayurveda believes that the origin of disease is rooted in one key phrase, “Forgetting our true nature as spirit.” This can be further explained by understanding a little bit of Sankhya philosophy. Purusha desires to know its own nature and merges with Prakriti. What unfolds is the creation of the individual soul. It is believed that disease unfolds when a person forgets their true nature as spirit. This happens at every incarnation. At each incarnation there is a storehouse of karma that is stored in the causal body. When incarnation occurs the ahamkara takes form into an astral body where disturbance originates. These disturbances of the mind called vrittis upset the balance of a person which then manifests into the physical body as disease states. 9 In one of the most classically cited books on Ayurveda, the Caraka Samhita states, “The soul is essentially devoid of all pathogenecity…” 10 once we forget our true nature as spirit we then can start manifesting disease in the astral body. These disturbances that begin in the mind then start affect the physical body creating imbalance to the doshas.  
 
Conventional medicine has relied on symptomatic treatment of disease where Ayurveda looks deeper to the root of the problem.  It is well established that western allopathic medicine is excellent at handling acute medical crisis. They can reattach limbs, replace joints, put in stints, etc. Conventional medicine has its weakness though in terms of managing chronic conditions related to diet and lifestyle such as high blood pressure, cardiovascular disease and obesity. They are aware there needs to be improvement in public health and affordable primary care functions.   Ayurveda has successfully shown how to manage chronic disorders that affect so much of our modern culture. Ayurveda’s holistic approach to treating the mind, body and soul as a complete person has the potential to solve some of the world’s most pressing health problems. Modern medicine has seen this need for personalized medicine and Ayurveda offers the path which plays a key role towards disease prevention through diet and lifestyle. By taking the knowledge of modern science and combining it with the roots of Ayurveda, there is an opportunity to change the course of some of the most plaguing disorders of the modern world today. 

Prakruti vs. Vikruti

We are born into this world with a predetermined set of tendencies. Our Prakruti in Ayurveda roughly resembles our DNA, or our genes, in western medicine.  Each us of is born with a unique constitutional balance.  This is known as our prakruti.  In Ayurveda the individual constitution, or Prakruti, is based on physical and psychological characteristics. “Prakriti is a corollary of the comparative proportion of three entities, i.e., Tridoshas, namely, Vata, Pitta, and Kapha. This is not only genetically determined (Shukra Shonita), but also influenced by environment (Mahabhuta Vikara), chiefly by maternal diet and lifestyle (Matura Ahara Vihara), and the age of the parents (Kala Garbhashaya). Ethnicity (Jati), familial characteristics (Satmya), as well as place of origin of an individual (Desha) are also considered to influence the development of Prakriti...” 11 Prakruti is determined by our parents’ nature, as well as the circumstances of our birth.  Our mother’s emotional and physical state, the season, and location of our birthplace are all determining factors in our prakruti.  According to Ayurveda this happen at the moment of conception and the lifestyle of our mother will play a role in the development of the offspring but the seeds of karma are also a factor in determining the tendency of the offspring. 12 
 
So if our Prakruti is roughly related to our genes then our Vikruti is roughly related to our phenotype in Epigenetics. 13 Our Vikruiti is defined as the nature of the imbalance. It is our current state. Prakruti is determined at the moment of conception and our Vikruti is the present state of the person. To get from point A (Prakruti) to point B (Vikruti) there can be any number of changes and those changes relate to epigenetic factors that include sensory input from the outside world. This includes diet, lifestyle, visual input, sensory stimulation, emotions, as well as many other environmental factors.  According to Ayurveda, any state that is not at Prakruti is a state of dis-ease and in order to treat this one must know the nature of the patient, the nature of the disease and the nature of the remedy. 14 Dis means having a negative or reversing force. Ease means free from difficulty, effort, or trouble. Dis-ease, therefore, is a negative reversal of the flow of ease.15 
 
Western science looks at this a little differently. Western science believes that the offspring is a combination of the genes of the mother and the genes of the father. This creates a unique DNA of a child that will be different than any other person on the planet, the only exception being genetic twins. This has been the basis for Personalized Preventative Medicine (PPM) in the modern world. Ayurveda is filling the gap for personalized medicine as it relates to the individual in accordance with diet and lifestyle, season, time of life, and individual tendencies. Personalized Preventative Medicine PPM has been at the forefront of study in recent times. Modern science is realizing that epigenetic factors (i.e. diet, lifestyle, season, time of life, and individual tendencies) are directly influencing drug response.  Ayurveda commonly describes its medicine in terms of its rasa, virya, vipaka, and prabhav. This will have a unique effect for each person as it relates to their prakruti or individual constitution. As modern science is learning drug reactions are found on an individual basis independent from that of any ethnic, racial or geographic grouping. 16
 
Western medicine is extremely good at treating acute issues and highly technological support such as joint replacement. But the leading causes of mortality in the world are directly related to issues of non-harmonious lifestyle, poor nutrition and stress. Modern medicine treats the symptom of the underlying ailment whereas Ayurveda is treating the root of the imbalance. Ayurveda analyzes the person with relation to their mind as well as their physical body to determine the correct treatment of the imbalance. This imbalance is not a factor of changing DNA rather an epigenetic factor that can be modified in relation to the patient’s actions and environment. The Caraka Samhita states that disease starts in the mind. ”The body and the mind cause a substrata of disease and happiness (i.e. positive health). Balanced utilization (time, mental faculties, and object of sense organs) is the cause of happiness.” 17 
 
We can look at a study on the traits of twins to understand a few things about epigenetics in relation to Ayurveda. This study revealed that identical twins – with the exact same DNA – will not only have different physical traits as they age, but they will also carry different emotional temperaments and be prone to different disease states throughout their lives. A very famous epigenetic study on genetic twins found that 35% of twin pairs had significant differences in DNA methylation and histone modification profiles. 18 DNA methylation patterns can be affected by genetic variation, environmental changes, heritable and non-heritable changes in other epigenetic processes. Over the course of their lives, their bodies have played out differing roles which have created different expressions and manifestation of certain traits among them. This indicates that even if you have identical DNA the choices you make in the world can affect how your body responds to the stimuli.  We are responsible for our choices. Our choices affect our outcomes.  There is far more to health than just our genes. So how do we know how to adjust for this to live a life free of disease? Ayurveda has some very intuitive answers. 

Dinacharya

In Sanskrit Dina means “daily” and Charya means “following or moving”. Ayurveda recommends that in order to be in an optimal state of health we should tune our bodies into the cycle of nature which in turn regulates the various other rhythms of our body.  As modern society has taken hold of our lifestyle, our ability to live within the rhythms of nature has become increasingly difficult. We have artificial light everywhere we look. We have manmade sounds that keep our body stimulated far beyond the evening when our body naturally wants to find a quieter space for itself.  We have technology that keeps us attached to screen for many hours of our waking day. There are so many factors in our world today that keep us from truly being in touch with nature and our natural rhythms.  The longer we deny ourselves the opportunity to live by the rhythms of the natural world, the deeper we leave a state of balance and fall into a place of ill health.  
 
Ayurveda suggests that we live by the light of the sun. It is best to wake up in the dawn hours. Depending on our doshic tendencies we should wake anywhere from 3 to 6 am. It is best to take this time to eliminate and cleanse the body, perform self care including abhyanga, do physical exercise to further cleanse the body, take time for proper meditation and take nourishment of proper foods. All of these tasks shall keep a body free of disease. 19 In the evening, there should be a lighter meal taken at least two hours prior to sleep to let all food empty from the stomach for proper digestions to occur. The time after dinner should be of relaxing nature and bedtime should not be later than 10pm. If these natural rhythms are allowed to fall by the wayside, change in our body chemistry can be seen.   Take, for example, a study done on shift workers and their circadian rhythm disruption and its link with breast cancer.  This study pointed out that as our circadian rhythms get more and more out of kilter with nature, there is an increasing likelihood that certain genes will have the ability to mutate into cancer causing cells. 20 So even if a person is getting enough sleep if they are not sleeping at the proper times their body will react in a way that manifests disease. This study reflects Ayurveda’s message about living within the cycles of nature. It is not natural to sleep during the sun. Our bodies are proving this by manifesting irregular cellular functioning which leads to damaging outcomes. 

Three Causes of Disease

Ayurveda believes that the three cause of disease have a direct correlation with our influence from our personal choices and our environment. These three causes – Prajnaparadha, Asatmendriyartha Samyoga, and Parinama are three factors that, when not taken into consideration, will be the cause for dis-ease in life.  According to Ayurveda treatment of the disease does not treat the symptoms but brings the person back to their true nature. The body will then be able to rid itself of the disease.  The Caraka Samhita states, “So the unwholesome conjunction of the sense organs with their objects, intellectual blasphemy (prajnaparadha) and transformation (parinama) – these are the threefold cause of diseases. Proper utilization of the objects, action and time is beneficial to the maintenance of normal health.” 21 

Prajnaparadha  

Prajnaparadha is translated to mean – “intellectual blasphemy.”  In short, we know that when we truly listen to our inner self, we can make decisions that reflect a state of balance. When our ego gets in the way we can potentially make choices that go against the health of our entire being.  When we ignore our inner voice we are knowingly making choices that lead us astray. It could be a choice that we may think has minor consequences such as feeling heavy and lethargic after too large of a meal. This feeling may not last long but if we choose this route over and over again it will lead to long term consequences. The challenge of prajnaparadha is the gradual erosion of willpower and self esteem. The choices we make every day that lead us away from a state of good health will give us the idea that we somehow lack the control over bigger choices in our life. If we “give in” too often to our ego’s desire we then develop a path that makes it harder and harder to choose the more beneficial long term outcome. In ancient times this act is referenced in both present choices and choices from our past lives. “Hence, all seen (known and understood) causes are those of the present life, the opposite (unseen causes) and those of Davia providential divine origin; those causes which are trivial (mild, insignificant, weak) in nature but cause dreadful disease are a mixture of both (activities of the present life and past lives). 22 The recognition of choosing our action in response to our well being will lead us to a place of Sattva. When we succumb to the desire of our ego state, we are acting in a position of Rajas.
 
This idea of prajanparadha (intellectual blasphemy) can be seen through the lens of epigenetics. If our choices of the present moment are carried with us as we age it’s fair to say that, epigenetically speaking, we are also passing down those choices to our offspring. Here are two studies that show how small insignificant choices can have dreadful long term results, not only for us but our offspring as well.
 
The first study, and probably one of the most significant studies on epigenetics, relates the choices of the mother agouti mouse directly to the health of her offspring. This study used mice that carried the particular agouti gene scientists could track to see if they could change the genetic legacy of the offspring. When agouti mice breed the offspring are identical to the parents. These yellow fat mice look different than other mice because they carry this agouti gene that makes the rodent’s appetite enormous and renders them prone to cancer and diabetes. The experiment was simple – they changed the mother’s diet. In one generation – the mother’s offspring were small, slender, brown, normal looking mice. All they did was change the mom’s diet. The diet was rich in methyl donors which are found in many healthy foods including onions, garlic and beets. These “good” methyl clusters attached to the agouti gene essentially turning it off so that the developing embryos did not have an open methyl to activate the agouti gene. These offspring did not display susceptibility to cancer and diabetes and lived to a very old age. The DNA of the offspring was not altered and the effects of the agouti gene had virtually been eradicated. 23 This study is remarkable in many ways. Not only does it show that epigenetically we have a great deal of influence over our lives and the lives of our offspring, it also shows that our small, somewhat insignificant everyday choices (i.e. what we eat) have an enormous impact on our well being and the health of our progeny. These choices are all about prajnaparadha.  The majority of humans today have at least some idea of good food choices. We are educated at a young age about long term health and the effects of poor food choices. We then must cope with our own intellectual blasphemy when we are faced everyday with choices which will affect us as well as our children. 
 
The next topic leans toward prajnaparadha of the mind. Our choices are not just having an effect on the physical body. Epigenetic studies have correlated their findings to that of the brain – primarily in relation to stress.  Many studies have shown that stress in early life experiences can alter the neuroendocrine system. These alterations can impact the response to stress a person carries throughout life. Studies in both rats and people have shown that early life stressors to infants will cause DNA methylation thereby affecting oxytocin receptor expression as well as anxiety responsivity.  “The fetal and early postnatal periods are times of dynamic physiologic change and developing organs and tissues are extraordinarily vulnerable to environmental influences. During sensitive periods of development adverse events such as stress or maltreatment can more readily trigger epigenetic alterations which can adversely affect physiological function and behavior through adulthood.” 24 Cognitive and physiological response to stressors are highly influenced by genetics, early-life environment and trauma. “Responses to stress are ultimately based on the predispositions of the organism. The magnitude, duration and pathological consequences of physiological ‘stress responses’ differ markedly between individuals, based on stress history, genetic background, and early-life programming. Thus, resilience and susceptibility to stress are dictated by a variety of factors that ultimately determine whether neuroplastic adaptations can effectively promote coping or lead to loss of appropriate stress control and perhaps pathology.” 25 The vast evidence shows that epigenetic modifications within relevant brain regions will influence behavior, physiological outcomes and disease risk.
 
The human race is fragile. We are not only susceptible to environmental factors on a physical level, we are susceptible on a mental/emotional level as well. As these studies point out, our choices not only have great impact on us but on those around us. We have such huge influence over our offspring. Prajnaparadha comes down to promoting the human race. Evolution of our ability to advance into beings of a higher kind then must start at the basic level of taking a more mindful approach to our lives, not only for ourselves but for generations to come.

Asatmendriyartha Samyoga

Astmaya means "improper", indriya means "sense organs", artha is "the objects of the senses" and samyoga means "to combine" or "to link". Asatmendriyartha Samyoga means improper use of the senses. Our five senses carry a delicate balance between delight and damage. Whether it be through sight, sound, touch, taste or smell, our senses give us extraordinary pleasure.  As humans we naturally feel that if something is pleasurable that more of the same stimulation will be even more pleasurable. That is ever so far from the truth. When we repeatedly hyperstimulate our senses we can damage our senses.  This can lead to confusion and blocked flow of consciousness. Damage to our senses can then destroy consciousness. Our job is to stay mindful of the balance and respond to the needs of our bodies appropriately.
 
Ayurveda uses five sense therapies in order to bring the body back to its natural state of balance. Taste therapy comes in through what we ingest into our bodies. Food, herbs and liquids all have a very direct effect on our health.  Ayurveda categorizes food into six tastes - sweet, sour, salty, pungent, bitter and astringent. These tastes have a unique physiological response for every individual. Good food choices differ greatly from person to person in terms of what would be considered constitutionally appropriate.  Visual impressions have a profound effect on the body. Violent movies create stress in the body and beautiful sunsets release a surge of peaceful neurochemicals in the body. Everything we take in visually will stay with us.  Different colors have varying energetics and Ayurveda uses these to subtly adjust the balance in the body. Color therapy is used to heal that which the eyes bring in. Ayurveda also uses touch therapies to promote balance in the body.  Abhyanga is one of the most popular Ayurvedic therapies that is used daily to promote health.  It improves immune function, nerve stabilization, improves circulation and promotes restful sleep. Every sound has a physiological effect. Ayurveda incorporates the use of mantra to achieve healthy balance via our sense for hearing. Our sense of smell is the most primitive of our senses and connects us with our emotions, instincts and memories. Ayurveda incorporates aromatherapy to alleviate imbalance in the mind and body through our sense of smell. With every breath we are exchanging our personal energy with that energy from the universe. 
 
Epigeneticists are researching the misuse of the senses on a molecular level. They are finding that epigenetic factors are proving to be instrumental in the spread of common diseases.  It has been stated many times throughout the medical world that 95% of disease are not inherited. This means the lifestyle choices people make everyday have a direct impact on the susceptibility to disease.  For example, one study shows that mice that are predisposed genetically to cardiac and diabetic disorders can give off normal offspring when they are fed the proper diet. In short, epigenetic factors, proper use of the senses, can supersede genetic factors. 26 This is extraordinary. This proves that the Vedas were right. Asatmendriyartha Samyoga is essential to health and longevity.  According S.L. Martin, ”genes regulate 25% of longevity, whereas 75% is determined by lifestyle factors such as sleep habits, alcohol beverage consumption, stress levels, exercise, and diet. Furthermore, studies have indicated that vegetarian dietary patterns of the Seventh Day Adventists play a role in extending the life-span of humans, as well as lowering the risk of developing metabolic syndrome, and has been determined to exert beneficial effects on aging.” 27 As humans have evolved, lifespan has been increasing with the eradication of certain disease, with advancement in sanitary conditions as well as acute trauma medicine. Many epigenetic studies have also focused on whether becoming a centenarian is strictly nature or nurture. The increased human lifespan of centenarian individuals compared to people with average lifespan is directly related to vastly different diets.  The average centenarian diet focuses on plant proteins, whole grains, monounsaturated fats and very little red meat, simple sugars and refined grains. 28
 
In the Astanga Hrdayam, it talks directly about the use of the senses in relation to disease. “He, who indulges daily in healthy food and activities, who discriminates (the good and bad of everything and then act wisely), who is not attached (too much), to the objects of the senses, who develops the habit of charity, of considering all as equal (regarding kindness), of truthfulness, of pardoning and keeping company of good persons only, becomes free from all diseases.”29 This quote sums up the idea of Asatmendriyartha Samyoga. All good things in moderation and giving of oneself for the benefit of the greater good seems to be an everlasting truth to the endurance of humanity. 

Parinama

Parinama in Sanskrit means “evolution over time”.  This third cause of disease is a fatal one. By the end of a long life everyone will see the affects of parinama but the key to health is learning to flow within the natural rhythms of life.  The Caraka Samhita said that a person’s inability to cope with the changing cycles of life will lead to various stages of disease. 30 Diseases tend to come on with change – whether it’s the change in the season and immunity is down or whether there is increased sexual desire from the changes in a woman’s moon cycle – these are both examples of the natural ebb and flow of the body.
 
According to The Principles of Ayurvedic Medicine, there are two types of time – one being linear and the other being biological. 31 Linear time is static. Biological time can be manipulated based on the movement of our bodies and our minds.  The famous author Eckhart Tolle explained time like this, “Time is what keeps the light from reaching us. There is no greater obstacle to God than time: and not only time but temporalities, not only temporal things but temporal affections, not only temporal affections but the very taint and smell of time.”  Being in the present moment is the key to spiritual awakening. When our bodies are in constant motion and our mind is in constant thought, time will speed along until disease sets in. When we consciously slow down our motion (Vata) we can begin to understand the concept of parinama. In Ayurveda Vata is motion. If we exacerbate our motion both on a physical as well as a mental level and never calm the body or the mind down, we will literally wear it out at a much faster pace. Over 80 diseases are a manifestation of the Vata dosha. 32 
 
In the book Yoga Sutras of Patanjali there is an eightfold path to quiet the mind. This path is the key to enlightenment. Part of this path is learning to quiet the vrittis of the mind. This requires the focused attention called Dharana. It is the first aspect of meditation. It is the ability to pick a point of focus for the mind and refer to it as the mind begins to wander during meditation.  Dharana is “concentration of the mind” in Sanskrit. Once we learn to focus the mind we can then train the mind to sustain focus and concentration for longer periods of time. Dhyana is the actual practice of mediation. It is the sustained focus of one’s mind in order to fully be present with the object of focus. 33 These two concepts – Dharana and Dhyana – are essential to parinama and slowing down biological time. If we can consistently practice concentrating our minds we can hinder the encumbrances of aging.  Sri Desikachar, one of the most influential yogis of the modern age, talked about the relation to time like this, “the mind is capable of 2 states based on 2 different tendencies. These are distraction and attention. However at any one moment only one state prevails and this state influences the individual’s behavior attitudes and expression.”  
 
Epigenetic research is studying the effect of parinama through the study of applied consciousness. In a study of expert meditators, there was a reduced expression of histone deacetylase genes, alteration in global modification of histones and decreased expression of pro-inflammatory genes in meditators compared with a control group. 34 This basically states that the meditator group showed significant reduction in inflammation – which is a precursor to a host of diseases including Alzheimer’s, depression, cancer and obesity. The membrane of every cell plays a vital role in determining the input from the cell itself. There are two types of proteins in cell membranes – sensor proteins and effector proteins. Sensor proteins respond to a variety of extracellular signals that may be biochemical, vibratory or electromagnetic.  Hence, the response of the body may be based on non-physical inputs such as movement (i.e. yoga asana) and thought (i.e. meditation). 35
 
The total number of altered methylation sites, where the sensor proteins latch onto, increase as we age. Methylation changes can then lead to altered gene expression which contributes to the delayed onset of age related diseases 36 As more of the population is living longer, there has been an increase in age related diseases. Environmental variables in the epigenetic processes that involve alterations of gene expression without a change in DNA sequence can determine different aspects of aging, as well as pathogenesis of age-related diseases. Epigenetics plays a role in the aging processes and healthy life extension. 
 
Another study on epigenetics and meditation showed that two psychological states in contrast to each other – threat cognition and mindfulness – had an effect on cellular aging. Threats in terms of ruminative thoughts can lead to prolong states of reactivity whereas mindfulness reduced the ruminative thoughts and reduced stress arousal. 37 These studies show the effect of applied consciousness going far beyond that of a person’s current state.  Meditation has long term benefits for the body, mind and spirit. As we learn to quiet our minds our body follows suit. This is a place where our body can rejuvenate and heal itself.  As a result of epigenetic investigations, we now understand how negative, fearful thoughts can cause DNA strands to constrict and become entangled.  Conversely, we’ve learned that positive, appreciative, and loving thoughts can result in lengthened and relaxed DNA strands. 38
 
The time for the body to relax is essential for repair so the body will continue to last well into the Vata time of life.  As we flow into the Vata time of life, our body naturally begins to break down.  If one is conscious of this we can work to alleviate the dosha with diet and lifestyle practices thereby promoting a greater likelihood of good health as we age. Parinama can then help us mindfully flow into the golden years of our lives.

Conclusion

In this paper we have seen many similarities between Ayurveda and Epigenetics. We gave a basic overview of epigenetics and the three main types of epigenetic modifications.  We then discussed how Ayurveda relates to the concept of epigenetics in five distinct ways. The first way relates the Ayurvedic concept of Prakruti vs. Vikruiti with that of genetics vs epigenetics.  We saw striking similarities between the two concepts. Next we discussed the role of nature and lifestyle routines in relation to epigenetic research. We found that not only what you eat but everything we take in through the five senses affects our health and our susceptibility to disease. We then talked more in detail about the three main causes of disease according to Ayurveda.  We correlated how Prajnaparadha directly impacts our health and longevity. We saw that Asatmendriyartha Samyoga was essential for health and well being and finally we showed that Parinama has a direct impact on our ability to age gracefully. Both Epigenetics and Ayurveda have shown that a person’s experience at the physical, mental and cellular level can directly affect the quality of that person’s life experience. We can also see that those experiences are easily transferred down from generation to generation. 
 
The purpose of Ayurveda is health, happiness, and liberation on the journey to enlightenment. Ayurveda simply offers direction in terms of nutrition, physical activity, and rest. Ego, ignorance, greed, and attachment cause great angst because the idea of possession creates stress. The awareness of being is the reality in which truth is embodied and silence is enjoyed.  The wrong perception is the Maya, or illusion, that often perceives stress. This directs the individual away from the truth. A proper perception transcends all, while a faulty one generates suffering and illness.
 
Epigenetics has been around 20 years. Ayurveda has been around 5000 years. Both have come to very similar conclusions. Epigenetic research confirms traditional ancient knowledge that diet, lifestyle and mindfulness can all be used to fight disease and promote health. We are here on this planet to optimize the expression of our genes in a way that supports evolution and growth both individually and collectively. “Expression” is the operative word in epigenetic possibility. Genes will take multiple generations before any minor mutations can take place but the expression of our genes can change almost daily. Our health is a vast spectrum of possibility. Our choices affect our outcomes. We are what we eat. We are not a product of circumstance by which we sit around and watch while our health and happiness deteriorate as we age. We are truly masters of our own demise.  The great English poet William Henley summed things up quiet perfectly in his final stanza from his famous poem Invictus;
  • It matters not how strait the gate,
  • How charged with punishments the scroll,
  • I am the master of my fate:
  • I am the captain of my soul.

Endnotes

1. Genetic Alliance, Genetic Alliance Staff, Understanding Genetics: A Guide for Patients and Health Professionals. http://www.geneticalliance.org/publications/understandinggenetics
 
2. Bruce H. Lipton, “Embracing the Immaterial Universe, Shift: At The Frontiers of Consciousness” No. 9, p. 12, December 2005--February 2006.http://www.ozarkresearch.org/Site/epigenetics.html
 
3. Chicago Manual Style (CMS): epigenetics. Dictionary.com. Dictionary.com Unabridged. Random House, Inc. http://dictionary.reference.com/browse/epigenetics
 
4. Danielle Sinnmons, PhD Epigenetic Influences and Disease. http://www.nature.com/scitable/topicpage/Epigenetic-Influences-and-Disease-895
 
5. Michael Skinner, "Epigenetic Ancestral DDT exposure promotes epigenetic transgenerational inheritance of obesity," BCM Medicine 2013. 11:228. 
 
6. Ibid 5.
 
7. Ibid 4.
 
8. Ibid 4.
 
9. Dr. Marc Haplern, Principles of Ayurvedic Medicine (Tenth Edition September 2012), 202.
 
10. R.K. Sharma and Bhagwan Dash, Caraka Samhita (Chaukamba Sanskrit Series Office, Varanasi, India, 1992), 41.
 
11. Subhadip Banerjee, Parikshit Debnath, and Pratip Kumar Debnath, “Ayurnutrigenomics: Ayurveda-inspired Personalized Nutrition from Inception to Evidence” Journal of Traditional Complementary Medicine 2015 Oct; 5(4): 228-233. PMCID: PMC4624353
 
12. Yogita Ghodke,  Kalpana Joshi,  and Bhushan Patwardhan, “Traditional Medicine to Modern Pharmacogenomics: Ayurveda Prakriti Type and CYP2C19 Gene Polymorphism Associated with the Metabolic Variability,” Evidence Based Complementary Alternative Medicine 2011;249528 PMCID: PMC3135904
 
13. Ibid 11
 
14. Ibid 9
 
15. Prof K. R Srikanthu Murthy, Astanga Hrdayam: (Government College of Indian Medicine, Bangalore, India), 12.  
 
16. Bijoya Chatterjee and Jigisha Pancholi, “Prakriti-based medicine: A step towards personalized medicine”, Ayu. 2011 Apr-Jun; 32 (2): 141-146. PMCID: PMC3296331
 
17. Ibid 9, 40
 
18. Jordana T. Bell and Tim D. Spector, “A twin approach to unraveling epigenetics”, Trends Genetics. 2011 Mar; 27 (3): 116-125. PMCID: PMC3063335
 
19. Ibid 14, Sutra 2: 1-18
 
20. Hoffman AE, Yi CH, Zheng T, Stevens RG, Leaderer D, Zhang Y, Holford TR, Hansen J, Paulson J, Zhu Y., “CLOCK in breast tumorigenesis: genetic, epigenetic and transcriptional profiling analyses”, Cancer Research 2010 Feb 15:70 (4): 1459-68 PMCID:PMC3188957
 
21. Ibid 9, 43
 
22. Prof. K.R. Srikantha Murthy, Astanga Samgraha: (Chaukhambha Orientalia, Varanasi), 396. 
 
23. Dana C Dolinoy, “The agouti mouse model: an epigenetic biosensor for nutritional and environmental alterations on the fetal epigenome.” Nutritional Review 2008 Aug; 66 (Suppl1): S7-11. PMCID:PMC2822875
 
24. Herbert L. Mathews and Linda Witek Janusek, “Epigenetics and Psychoneuroimmunology: Mechanisms and Models” Brain Behavior Immun. 2011 Jan; 25(1): 25–39. PMCID:PMC2991515
 
25. Jason J. Radley, Mohamed Kabbaj,  Lauren Jacobson, Willem Heydendael, Rachel Yehuda,  and James P. Herman, “Stress risk factors and stress related pathology: neuroplasticity, epigenetics and endophenotypes”, Stress 2011 Sep; 14(5): 481-497. PMCID:PMC3641164
 
26. Thaiyar M Srinivasan, “Genetic, epigenetics and pregenetics”, International Journal of Yoga. 2011 Jul-Dec; 4(2): 47-48. PMCID:PMC3193653.
 
27. S.L. Martin, T.M. Hardy, and T.O. Tollefsbol, “Medicinal Chemistry of the Epigenetic Diet and Caloric Restriction”, Current Med Chemistry 2013; 20(32): 4050-4059. PMCID:PMC3873820.
 
28. Ibid 26
 
29. Ibid 14 
 
30. Ibid 9, 226
 
31. Ibid 8   
 
32. Ibid 21, 373
 
33. Sri Swami Satchitananda, The Yoga Sutras of Patanjali (Integral Yoga Publications, Yogaville, Virginia), 1999.
 
34. Perla Kaliman, María Jesús Álvarez-López, Marta Cosín-Tomás, Melissa A. Rosenkranz, Antoine Lutz, Richard J. Davidson, “Rapid changes in histone deacetylases and inflammatory gene expression in expert meditators” Psychoneuroendocrinology. 2014 Feb; 40: 96–107. PMCID: PMC4039194.
 
35. Ibid 25
 
36. Elissa Epel, Jennifer Daubenmier, Judith Tedlie Moskowitz, Susan Folkman and Elizabeth Blackburn, “Can Meditation Slow Rate of Cellular Aging? Cognitive Stress, Mindfulness, and Telomeres” Annals of the New York Academy of Sciences 2009 Aug; Vol 1172: 34-53. PMCID: PMC3057175
 
37. Danny Ben-Avraham, Radhika H Muzumdar, and Gil Atzmon, “Epigenetic genome wide association methylation in aging and longevity”, Epigenomics. 2012 Oct; 4(5): 503-509. PMCID: PMC4123813.
 
38. Jim Walden, Ed.D., R.Hy., “Epigenetics: Using Applied Consciousness to Achieve Wellness and Well-being.” http://www.ozarkresearch.org/Site/epigenetics.html
 

Guduchi: The Amrit of Ayurveda by Neeshee Pandit

 I. Introduction 

Ayurveda is a 5,000-year-old system of medicine, rooted in the ancient Indian scriptures known as The Vedas. According to the Vedas, the entire universe is a manifestation of five elements: space, air, fire, water, and earth. The human being, a non-separate manifestation born of the universe, is also comprised of these very elements. Thus, living in harmony with the external universe and balancing the flow of the five elements in the human physiology maintains health and well-being. What we take into our body affects this cosmic dynamism more than anything else, and this is where the significance of plant medicines comes to light. Dr. Vasant Lad and Dr. David Frawley write poetically about the role of plants in Ayurvedic medicine: 

"Plants bring us love, the nourishing power of the sun, which is the same energy of all the stars, of all light. These cosmic energies emanated by plants thus nourish, sustain and make grow our own astral body. In this way the existence of plants is a great offering, a sacrifice. They offer us not only their own nutritive value but the very light and love from the stars, from the cosmos whose messengers they are. They bring us the universal light so that we can enter the universal life. They exist for psychological, as well as physical nourishment...The Sanskrit word for the plant osadhi means literally a receptacle or mind, dhi, in which there is burning transformation, osa."1

Guduchi (Tinospora cordifolia) is one such plant and among the most highly revered herbs of Ayurvedic medicine. Known universally as "Guduchi" (the one who protects), the herb is also known by different names across the sub-continent of India: "Tippa-teega" (Telugu), "Shindilakodi" (Tamil), "Arutha balli" (Kannada), "Rasakinda" (Sinhala), "Giloy" (Hindi), "Garo" (Gujarati), "Amrit" (Sanskrit), "Guduchi" (Marathi), and "Guluchi" (Oriya).2

Originating in India, guduchi is a tropical climbing herb that belongs to the Mernispermaccae family. It is now found not only in the tropical areas of India but also in Sri Lanka and Burma.2 The guduchi vine grows wild and does not require much cultivation. In the Indian city of Ahmedabad, for example, guduchi grows wild on hedges. Guduchi is often found in the dry forests of India growing on large trees, particularly neem and mango trees. One of the defining characteristics of the plant is its green heart-shaped leaf.3

The sacred origin of guduchi is described in the Indian epic, The Ramayana and the sacred text of the Durga Saptshati. Vaidya Ramakant Mishra recounts the myth of guduchi from The Ramayana saying that guduchi began growing on Earth from the hands of Lord Indra. Lord Rama made a special prayer to Lord Indra asking Indra to resurrect all the monkeys and bears from his army that had died during the war with the rakshasa (demon), Ravana. Upon hearing the wish from Rama, Lord Indra granted Rama the boon and sprinkled nectar from the heavens to resurrect the animals. As the nectarous drops fell upon the bodies of the dead monkeys and bears, they suddenly came back to life. The nectarous drops that fell on the Earth formed the sacred guduchi plant.4

Guduchi is highly valued in Ayurveda for its detoxifying, rejuvenating, immune-boosting, and anti-rheumatic properties. It is now being studied and utilized in modern medicine for cold and flu prevention, immune support, skin disorders, arthritis, liver disorders, gout (and rheumatic disorders), and most recently to mitigate the negative effects of chemotherapy.5 Guduchi is clearly an herb with a myriad of potent medicinal qualities, qualities that were recognized by the ancient rishis in Vedic times, long before modern scientific technology. Through spiritual means, the rishis were able to understand guduchi (and other herbs) in a profound manner and now modern science is able to evaluate and recognize many of the medicinal properties of guduchi.

II. General Classifications

In Ayurvedic medicine, guduchi is considered to be one of three amrit plants. The Sanskrit term "amrit" literally means "nectar" or "ambrosia". In the context of Ayurvedic medicine, "amrit" is understood to be the nectar of the gods. The three plants which contain this heavenly nectar (or amrit) are guduchi, garlic, and haritaki. Interestingly, the Sanskrit name for guduchi is "amritavalli", literally meaning "creeper with amrit"--creeper being a reference to its climbing nature. The classification of guduchi as "amrit" alone indicates the elevated status of this herb in Ayurveda.4 

Dr. Vasant Lad and Dr. David Frawley give further comment to the reverence with which one views herbs and why they are considered sacred: 

"The proper usage of a plant or herb, during which its true power is released, implies a communion with it. The plant, when we are one with it, will vitalize our nervous system and invigorate our perception. This means giving value to a plant as something sacred, as a means of communion with all nature. Each plant, then, like a mantra, will help to actualize the potential of cosmic life of which it is a representative."1

In that spirit, Vaidya Ramakant Mishra's "Shaka Vansiya" family lineage has emphasized the therapeutic properties of guduchi and the many ways to use it. Mishra considers guduchi to be "the most divine herb in Ayurveda" and refers to it as "divya aushadhi" (divine plant) and as "the best rasayana". Such a classification should make it clear that guduchi enjoys a status in Ayurvedic medicine that extends far beyond that of a useful or highly medicinal herb, but that of a sacred herb that gives the body and mind the very nectar of life. Indeed, Vaidya Mishra has described guduchi as "jivanti" (or life-giving), as illustrated by the mythological story of the monkeys coming back to life.4

The 16th century Ayurvedic treatise, Bhav Prakash by Bhav Mishra, gives a further analysis of the spiritual nature of guduchi by naming it "chinnodbhava" (able to grow even if cut). Vaidya Mishra elaborates on the significance of this quality, pointing out that it indicates guduchi's ability to live on air. According to Mishra, guduchi "...is so full of life that is can grow without any soil or water". Mishra draws a profound comparison to the great yogis who were able to live without food or water, subsisting purely on the pranic energy in the air. Mishra says that guduchi possesses "amrit siddhi", or capability to live entirely on the pranic energy available in the air without the need for grosser levels of sustenance, and indicates that it is an herb uniquely full with life- energy.4

In terms of its medicinal actions, guduchi is classified as a bitter tonic, febrifuge, alterative, diuretic, aphrodisiac, rejuvenative, and anti-rheumatic.1 In Nadkarni's Indian Materia Medica, guduchi is described as a stomachic, bitter tonic, alterative, aphrodisiac, hepatic stimulant, antiperiodic, mild diuretic, and demulcent.3 Guduchi brings nourishment to all seven tissues (or dhatus) of the body, making it a powerful nutritive tonic. The ability of this herb to detoxify the body while simultaneously rejuvenating it makes it a deeply effective herbal medicine for all constitutional types.4 

III. Dravya Guna: Rasa, Virya, Vipaka, and Prabhava

"Dravya" means "substance" or "material" and "guna" means "quality". In Ayurvedic medicine, "dravya guna" is the study of herbal medicine via the specific qualities of each herb. Based on these qualities, Ayurveda classifies herbs according to four categories: 

  • rasa (or "taste")
  • virya (or "potency") 
  • vipaka (or "post-digestive effect")
  • prabhava (or "special action").6 

The "rasa" of an herb indicates which tastes are predominant and allow one to evaluate the effect of the herb on the three doshas. The "virya" of an herb indicate the energetic quality of the herb--whether it is heating or cooling. "Vipaka" is a classification unique to Ayurveda and describes the ultimate effect of the herb once it has been digested. "Prabhava" is another unique classification that describes the mysterious and often contradictory effects of an herb, such as the ability of a heating herb such as ginger to function as a powerful anti-inflammatory.6 

Guduchi has a rasa that is bitter and astringent. Bitter taste reduces Pitta and Kapha doshas, while increasing Vata dosha. Astringent taste decreases Pitta and Kapha doshas, while increasing Vata dosha. 

Guduchi is considered to have an ushna (or heating) virya, yet it does not aggravate Pitta dosha. Ginger also has ushna virya which typically increases Pitta dosha, making this effect unique to guduchi, an example of prabhava. Vaidya Mishra's family tradition describes guduchi as the only herb that is able to bind and safely remove acidic and environmental toxins from the body without aggravating Pitta dosha while also healing the damage caused by local toxins.4 

The vipaka (or post-digestive effect) of guduchi is sweet, meaning that in the long-term it will decrease Vata and Pitta doshas while providing a nourishing quality to the body. Altogether, the effect of guduchi is that of reducing all three doshas. 

In terms of guna (or quality), guduchi is described as:

  • laghu (light)
  • deepanam (kindles digestive fire)
  • chakshushyam (good for the eyes)
  • dhatukrit (builds the seven bodily tissues)
  • medhayam (rejuvenating for the mind)
  • bayasthaapankarakam (maintains youthfulness and longevity).3

According to Mishra, guduchi's light quality coupled with its heating action allows it to penetrate the dhatus while the astringent quality enhances absorption in the dhatus.4 

The Caraka Samhita also describes guduchi as having the qualities of "guru" (or heaviness) and "snigdha" (or untuousness).7 Heavy and unctuous qualities reduce Vata and Pitta doshas while increasing Kapha dosha. Guduchi is considered to be tridoshic because the comprehensive effect of the herb, the sum total of all its parts and qualities, reduces all three doshas, detoxifies the deepest dhatu (shukra), and rejuvenates the entire body. Thus, guduchi is also able to build ojas of good quality and quantity, explaining its actions as an immune-booster. Guduchi is also described as being "pathyam", meaning that it keeps one on the path of health by agreeing with one's physiology. As such, it is documented to have good effect for convalescents.4

Guduchi's most powerful effects come to light in examining its "prabhava" (or special properties). The Caraka Samhita gives the following definition of prabhava: 

"In cases, where inspite of similarity in rasa, virya, and vipaka, there is difference in action, this (difference) is said to be due to prabhava (specific potency)."7 

Vaghbata defines prabhava in the Astanga Hrdayam as:

"The special action (of a substances) seen, when the rasa and others (present in it) are of equal strength, that action is said to be arisen from prabhava. . ."8 

One such special action of guduchi is that of "vakshagni dipani", literally "that which strengthens the flame of the heart". "Vaksha" means "heart" and "dipani" refers to the ability of guduchi to increase the agni of the heart. When the flame of the heart is strong, one is able to endure emotional challenges without becoming emotionally imbalanced. Mishra goes on to state that by way of strengthening the heart, guduchi is able to function as a "medhya rasayana" (rejuvenative for the mind).4 

A comparative study was conducted to examine the effects of medhya rasayanas including guduchi alongside gotu kola, licorice, and shankapushpi. The study found that consumption of these herbs (alongside yogic practices such as meditation) increased the short-term memory capacity of young children. The study concluded that medhya rasayanas were actually more effective and efficient in improving memory than yogic practices.11 Guduchi also has "vyasthapana prabhava" (or the ability to retain youthfulness".4 Another prabhava of guduchi is that of "vishaghna" which means "anti-toxic" and accounts for its potent detoxifying effects.25

In their treatise on Ayurvedic herbs, Dr. Vasant Lad and Dr. David Frawley note that the primary actions of guduchi are on the blood, fat, and reproductive tissues of the body (or the rakta, medas, and shukra dhatus).1 

IV. Ayurvedic Pharmacodynamics, Uses, and Formulations

The roots, stems, and leaves of the guduchi plant are all used medicinally in Ayurveda, although it is primarily the bitter starch of the plant (known as "Giloy Sattva") that is prized.1 The leaves are described as being mucilaginous while consuming large doses of the root gives a strong emetic effect. The stem is regarded to have anti-purgative effects.3 One research study conducted an elemental analysis of the guduchi stem, concluding that guduchi stems are "a potential source of nutrition and minerals for man as well as animals".9

In the Caraka Samhita, guduchi is listed as having the following actions:

  • vatahara (alleviates vata)
  • kaphahara (alleviates kapha)
  • deepana (promotes digestion by increasing agni)
  • raktapittahara (alleviates bleeding disorders)
  • vayaha sthapana (anti-aging)
  • stanyashodhana (detoxifies breast milk)
  • trushna nigrahana (alleviates thirst)
  • daha prashamana (alleviates burning)
  • jwaraghna (alleviates fever)
  • vivandhahara (alleviates constipation).7

In the Bhav Prakash, guduchi is listed as being useful for the following conditions: 

  • daha (burning) 
  • meha (urinary conditions) 
  • kasa (cough) 
  • pandutam (anemia) 
  • kamala (chronic jaundice)
  • kushta (skin diseases)
  • vatasrajwara (vata-type fever) 
  • krimi (parasites) 
  • vamimharet (vomiting due to toxicity) 
  • heart conditions that are difficult to treat (krichahridaroga).4,24

In Chapter Four, verse 40 of Sutrasthana, Caraka classifies guduchi "among astringents, vata-alleviators, appetisers, and pacifiers of kapha, rakta and constipation". Caraka mentions guduchi in a list of other herbs saying, "these may be used for non-unctuous enema in udavarta [bloating] and constipation. With this very group of drugs may be prepared unctuous enema for alleviation of vata." Caraka also lists guduchi as an ingredient in a paste prepared for treating skin disorders, saying, "These six formulations...impregnated with ox-bile, ground again and prepared with mustard oil and then used externally by physicians along with the powder...thus administered they destroy in no time obstinate skin disease, acute leucoderma, alopecia, kitibha (a skin disease), ringworm, fistula-in-ano, piles, scrofula and papular eruptions in human beings." Guduchi is also featured in a formula for gout which states that "Ghee prepared with rasna, guduchi, madhuyasti, both (types of) bala, jivaka, rsabhaka along with milk and added with bee-wax is used as paste for alleviating discomfort in raktavata [gout]."7

In a discussion concerning the use of rasayana herbs, the Caraka Samhita describes a formula that includes guduchi, stating that "these rasayana drugs are life-promoting, disease-alleviating, promoters of strength, agni, complexion, voice and are intellect-promoting". Guduchi is classified in the Caraka Samhita under the category of "Jeevaneeya Gana" which means "Enlivening and Anti-Aging Herbs". In this context it is mentioned with a group of herbs for "stanyashodhana", or the detoxification of breast milk. Guduchi is also mentioned in the treatment of fever, "Guduchi, amalaka and musta--these five (formulations for) decoctions ending in half verses alleviate five types of fever such as remittent, double quitoidian, quitidian, tertian and quartan". Guduchi is listed in another formulation that is considered "efficacious in chronic fever".  It is also classified by Caraka to be an anti-dyspic.7

Caraka lists guduchi as the main ingredient in a taila formulation known as "Amrta taila". He describes it as, ". . .one of the best oils. It brings back to normalcy 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".7  A study published in The Journal of Ethnopharmacology examined a 6th Century medical treatise written by Buddhist monks on birch paper known as the "Bower Manuscript". In this manuscript, a recipe for Amrita Oil and an Amrita Ghee were given with guduchi as the main ingredient alongside other rasayana herbs. The study sought to identify the prized "soma" plant of the Rig Veda and concluded that the soma plant is likely a combination of guduchi with tryptamine extract.12 In another study, the Amrita Taila and Amrita Ghrita featuring guduchi were examined for their pharmacological effects. The authors of the study describe guduchi as a "drug that has properties like Rasayana (rejuvenating property), Krimighna (anthelmintics), and Kushtghna (skin disorders)." The study found that the taila in particular had more of an immunostimulating activity, while the ghrita "exhibited an anti-stress effect with an immunosupressing activity."13

Guduchi is also used in the treatment of convalescence, hyperacidity, hepatitis, diabetes, tuberculosis, arthritis, gout, and hermorrhoids. In Traditional Chinese Medicine, guduchi is known as "Kuan Jin Teng" and is used primarily for treating swelling from arthritis or injury.1

Vaghbata lists guduchi in two herb categories in the Astanga Hrdayam: 

1. Patoladi gana:  a group of herbs that "...subjugate kapha and pitta and cure leprosy (and other skin diseases), fevers, poison, vomiting, anorexia and jaundice."

2. Guduchyadi gana: a group of herbs that "mitigate pitta and kapha, cure fever, vomiting, burning sensation, thirst and improves digestion."8

The Astanga Hrdayam gives two recipes featuring guduchi used in the treatment of vata-type fever.8 One such formula is Patolakaturohinyadi Kashayam, a traditional formula used in the treatment of liver disorders and skin diseases. Guduchi is one of six herbs in this formula that is used primarily to treat skin and liver disorders of Pitta-Kapha origin. It purifies the blood and liver, removes cellular toxicity, and rejuvenates the cellular system when it has been affected by disease.10

In Yoga and Ayurveda, Dr. David Frawley highlights the ability of guduchi to cool the body and mind, echoing sentiments similar to Vaidya Mishra in describing it as a "rejuvenative for Pitta". According to Dr. Frawley, guduchi not only reduces fevers but can counter viral infections such as Eptstein-Barre virus and AIDS. As a rasayana, guduchi also improves energy levels especially in the context of chronic fatigue syndrome.14 

V. Modern Medical Research

Guduchi is not only well-documented in classical texts and modern Ayurvedic literature. Scientists and doctors are now able to evaluate confirm the insight of the ancient rishis in the context of research studies that examine the effects of the herb.

One study published in the Journal of Ethnopharmacology concluded that guduchi had immunomodulatory effects, confirming the Ayurvedic view of guduchi as a rasayana and immune-booster.15 Another study compared the anti-stress effects of guduchi and gotu kola in comparison to diazepam. Ethanol extracts of guduchi and gotu kola showed "significant anti-stress activity", especially in comparison to the pharmaceutical, diazepam.16 In a study published in Immunopharmacology and Immunotoxicology, guduchi was found to have anti-tumor properties. According to the study, an alcohol extraction of guduchi was shown to activate tumor-associated macrophages (white blood cells that eat cancer cells).17

Ayurveda describes guduchi as being useful in conditions of hepatitis and jaundice due to its ability to detoxify the liver. In a clinical trial, liver toxicity was induced in rats, followed by the administration of an alcohol extract of guduchi. The extract protected the livers of the rats, showing that guduchi has clinically significant hepatoprotective properties.18

Guduchi was found to be useful in the treatment of allergic rhinitis, an allergic condition characterized by sneezing, mucus discharge from the nose, sinus congestion, and related symptoms. The study showed that guduchi gave significant relief to the allergic symptoms.19

A study published in the Journal of Ethnopharmacology showed the efficacy of guduchi in treating diabetes mellitus by lowering blood glucose levels and brain lipids in diabetic rats, concluding that guduchi extract has hypoglycaemic and hypolipidaemic effects.20

Another study tested the rejuvenative potential of guduchi, examining the ability of guduchi (and ashwagandha) to reduce oxidative stress in human volunteers. The results of the study showed that both herbs are potent antioxidants that may also prevent premature aging.21

Modern research has found that guduchi also has gastroprotective properties. Epoxy clerodane diterpene, a compound in guduchi, was isolated and given to rats with gastric ulcer. The compound reduced the gastic ulcer "by reinforcement of defensive elements and diminishing the offensive elements."22

Guduchi is also being studied for its positive effects on emotional and psychological health. In one study, rats were administered a "Rasayana Ghana tablet" comprised of guduchi, amalaki, and gokshura. The tablet was found to have anxiolytic and anti-depressive effects on the rats.23 

A comprehensive and summary study was conducted to examine and validate the many pharmacological effects of guduchi described in the Ayurvedic texts. The study examined and confirmed the following effects, actions, and uses of guduchi:

learning and memory enhancer (medhya rasayana)

  • anti-inflammatory
  • anti-arthritic
  • anti-osteoporitic
  • anti-allergic
  • antioxidant
  • antineoplastic 
  • radio-protective
  • anti-pyretic 
  • anti-infective
  • hepato-protective
  • immunomodulatory
  • diuretic
  • cardio-protective
  • anti-leprotic
  • anti-ulcer
  • osteo-protective

The conclusion of the study states that the "pharmacological actions attributed to Tinospora cordifolia in Ayurvedic texts have been validated by a remarkable body of modern evidence suggesting that this drug has immense potential in modern pharmacotherapeutics."25

VI. Conclusion

Guduchi has been revered in nearly all of the ancient Ayurvedic texts and modern treatises: Caraka Samhita, Astanga Hrdayam, Astanga Samgraha, Sushruta Samhita, Bhav Prakash, and Indian Materia Medica to name a few. In modern medical research, there is an abundance of studies and scientific evaluation on the astoundingly diverse pharmacological effects of this sacred herb. Guduchi appears to be experiencing a modern renaissance, as Western medicine begins to recognize its vast potential in both preventive and clinical medicine. Truly, guduchi is the amrit of Ayurveda, the medicinal nectar that is deeply needed and most relevant in these modern times. 

References

1. Dr. David Frawley, Dr. Vasant Lad, The Yoga of Herbs: An Ayurvedic Guide To Herbal Medicine (Twin Lakes, WI: Lotus Press, 2001), pp. 4-5, 242-243.

2. Giloy Herb: The Wonder Plant, Giloy: The origin and uses, http://giloyherb.com/index.php/articles/the-origin

3. K.M. Nadkarni, Indian Materia Medica (Bombay: Popular Prakashan, 1908), pp. 356-357.

4. SVAyurveda: From Sutra to Science, Vaidya Mishra, "Guduchi--Learn About The Most Divine Herb In Ayurveda", https://vaidyamishra.com/shop/media/dravya-guna-vigyan-ayurvedic-pharmacopoeia/guduchi-learn-about-the-most-divine-herb-in-ayurveda.html.

5. The Chopra Center, Deepak Chopra, "Guduchi", https://www.chopra.com/guduchi

6. Dr. Marc Halpern, D.C., C.A.S., P.K.S., Principles of Ayurvedic Medicine: Textbook for the Ayurvedic Profession, Tenth Edition (Nevada City, CA: California College of Ayurveda, 2012), pp. 249-250.

7. Prof. Priyavrat Sharma (Editor-Translator), Caraka-Samhita: Agnivesa's treatise refined and annotated by Caraka and redacted by Drbhabala (Varanasi: Chaukambha Orientalia, 2014), Vol. I. Ch. II [verses 11-14], Ch. III [verses 1-7, 22], Ch. IV [verses 18-19, 29, 41], Ch. XXV [verse 40], Ch. XXVI [verse 67], Vol. II, Ch. I [verses 30-31], Ch III [verses 200-203, 222-223], Ch XXVIII [verses 157-164] 

8. Vagbhata's Astanga Hrdayam, translated by Prof. K. R.. Srikantha Murthy (Varanasi: Chowkhamba Krishnadas Academy, 2014), Vol. 1, Ch. I [verses 48-51b], Ch. IX [verse 26], Ch. XXV {verses 15-16].

9. Mahima, Rahal A, Prakash A, Verma AK, Kumar V, Roy D., "Proximate and elemental analyses of Tinospora cordifolia stem," Pakistan Journal of Biological Sciences, 17 (May 2014): 744-7.

10. All About Ayurveda, Patolakaturohinyadi Kashayam – An effective medicine in Skin and Liver diseases, Dr. Raghuram Y.S., https://drraghuramys.wordpress.com/2015/01/01/patolakaturohinyadi-kashayam-an-effective-medicine-in-skin-and-liver-diseases/.

11. Sarokte, Shankar Atul and Rao, Mangaloagowri V., "Effects of Medhya Rasayana and Yogic practices in improvement of short-term memory among school-going children," AYU An International Quarterly Journal of Research in Ayurveda, 34 (Oct-Dec 2013): 383-389.

12. Leonti M, Casu L., "Soma, food of the immortals according to the Bower Manuscript (Kashmir, 6th century A.D.)," Journal of Ethnopharmacology, 155 (August 2014): 373-86.

13. Vaghamshi R., Jaiswal M., Patgiri B.J., Prajapati P.K., Ravishankar B., Shukla V.J., "A comparative pharmacological evaluation of Taila (oil) and Ghrita (ghee) prepared with Guduchi (Tinospora cordifolia)," AYU An International Quarterly Journal of Research in Ayurveda, 31 (October 2010): 504-8.

14. Dr. David Frawley, Yoga and Ayurveda: Self-Healing and Self-Realization, (Twin Lakes, WI: Lotus Press, 1999), pp. 196-197).

15. Kapil, A., Sharma, S., "Immunopotentiating compounds from Tinospora cordifolia," Journal of Ethnopharmacology, 58 (October 1997): 89-95.

16. Sarma, D.N.K., Khosa, R.L., Chansauria, J.P.N., Sahai, M., "Antistress Activity of Tinospora cordifolia and Centella asiatica Extracts," Phytotherapy Research, 10 (December 1996): 181-183.

17. Singh, Nisha; Singh, Mahendra Sukh; Srivastava, Pratima, "Immunomodulatory and Antitumor Actions of Medicinal Plant Tinospora cordifolia Are Mediated Through Activation of Tumor‐Associated Macrophages,",Immunopharmacology and Immunotoxicology, 26 (February 2004): 145-62. 

18. Bishayi B., Roychowdhury S., Ghosh S., Sengupta M., "Hepatoprotective and immunomodulatory properties of Tinospora cordifolia in CCl4 intoxicated mature albino rats," The Journal of Toxicological Sciences, 27 (August 2002): 139-46. 

19. Badar V.A., Thawani V.R., Wakode P.T., Shrivastava M.P., Gharpure K.J., Hingorani L.L., Khiyani R.M., "Efficacy of Tinospora cordifolia in allergic rhinitis," Journal of Ethnopharmacology, 96 (January 2005): 445-9.

20. Stanely P., Prince M., Menon V.P., "Hypoglycaemic and other related actions of Tinospora cordifolia roots in alloxan-induced diabetic rats," Journal of Ethnopharmacology, 70 (April 2000): 9-15. 

21. Kuchewar V.V., Borkar M.A., Nisargandha M.A., "Evaluation of antioxidant potential of Rasayana drugs in healthy human volunteers," AYU An International Quarterly Journal of Research in Ayurveda, 35 (January 2014): 46-9.

22. Antonisamy P., Dhanasekaran M., Ignacimuthu S., Duraipandiyan V., Balthazar J.D., Agastian P., Kim J.H., "Gastroprotective effect of epoxy clerodane diterpene isolated from Tinospora cordifolia Miers (Guduchi) on indomethacin-induced gastric ulcer in rats," Phytomedicine, 21 (June 2014): 966-9.

23. Deole Y.S., Chavan S.S., Ashok B.K., Ravishankar B., Thakar A.B., Chandola H.M., "Evaluation of anti-depressant and anxiolytic activity of Rasayana Ghana Tablet (A compound Ayurvedic formulation) in albino mice," AYU An International Quarterly Journal of Research in Ayurveda, 32 (July 2011): 375-9.

24. Chunekar K.C., Pandey G.S., Bhavprakash Nighantu,  (Varanasi: Chaukhambha Bharati Academy, 2006), Ch. 8 [verse 10].

25. Upadhyay, Avnish K., Kumar, Kaushal, Mishra, Hari S., "Tinospora cordifolia (Willd.) Hook. f. and Thoms. (Guduchi) – validation of the Ayurvedic pharmacology through experimental and clinical studies," International Journal of Ayurveda Research, 1 (April-June 2010): 112-121.

Healthy Breast Milk By: Jessica Skandunas

Softly…. quietly….. gently we begin, “It’s time to nurse, my baby,” I sing. Your mouth opens wide, I soon hear you swallow, You’re drifting to dreamland, I’m tempted to follow. Blissfully we sit, wrapped up in each other, Connected, in sync; baby and mother….

   Breast feeding is intended to be a joyful loving connection, a graceful welcoming and comfort of a soul into a new body. The mothers breast being located in the Anahata chakra (heart center) of the body signifies that the breast are an instrument of love, and nurturing, meant to give love outwardly through breast milk and to connect in an intimate way. It is a silent language of love. In an optimal setting breast milk is amrita, nectar, for the growing child. In Ayurveda it is known as the essence (upadhatu) of the rasa dhatu.

   “In fetal life, the baby receives nourishment from the mother through the placenta. After birth, the baby continues to receive all its nutrients from the mother through breast milk.” [1] The health of the mother is of huge importance in Ayurveda through all phases of bearing a child. In an optimal scenario the mother will have gone through a purification therapy (pancha karma) prior to becoming pregnant and then during pregnancy maintained herself in a healthful & harmonious way according to her dosha. Once labor has commenced the breast begin their job. The hormone prolactin is responsible for the secretion of the milk. It first flows in the form of colostrum.  “This special milk is yellow to orange in color and thick and sticky. It is low in fat, and high in carbohydrates, protein, and antibodies to keep your baby healthy. Colostrum is extremely easy to digest…it is low in volume (measurable in teaspoons rather than in ounces), but high in concentrated nutrition for the newborn. Colostrum has a laxative effect on the baby, helping him pass his early stools, which aids in the excretion of excess bilirubin and helps prevent jaundice.” [2] This type of pre milk substance flows for about 2-4 days before the letdown of the actual milk. 

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Implementing Ayurvedic Practices and Philosophy in Pregnancy By: Kelly Stoinski

Every thought, action, and decision a pregnant mother makes is directly correlated to the health, vitality, and essentially, the life potential of the child. She must be mindful that every element, food article, aroma, sight, and sound entering or surrounding her body impacts the fetus, directing the dependent soul to a greater state or to a more weakened state of health. Holistic care relating to pregnancy becomes essential as soon as the mother and father even decide to embark on the journey of parenthood—before conception even takes place. Ayurvedic practices and principles applied to the pregnant mother and her pending child provide a sincere potential for an enriched pregnancy and birthing experience, contributing to greater mental, emotional, spiritual, and physical health of the mother, child, and father. How can the modern, western-born mother implement the ancient teachings of Ayurveda as she embarks on the journey to bring a vital new life into this world? This review of literature will offer an array of insight shedding light on how the three pillars of life, herbal treatments, five sense therapies, and spiritual practices can be incorporated and utilized throughout the pregnancy experience.

THE THREE PILLARS OF LIFE

As much as her lifestyle allows, the pregnant mother would greatly profit adhering to the Ayurvedic principles encompassing the three pillars of life. Proper routines around food, sleep, and sexual practices will establish a foundation for an ameliorated and more harmonious pregnancy. Considering that all food ingested by the mother supplies the fetus with the building blocks of development, the highest quality and ideal quantities of foods should be consumed. The foundation of an expecting mother should emphasize a balanced kapha increasing food regimen, accentuating the sweet and salty tastes and limiting the bitter and pungent tastes.

Chopra, in his holistic pregnancy book, Magical Beginnings and Enchanted Lives, infuses Ayurvedic concepts when dealing with western pregnancies. He mentions that even though the mother will tend toward “sweet foods” (meat, dairy, grains, nuts, etc), all six tastes—sweet, salty, sour, pungent, butter, and astringent— play an essential role in optimizing the nutrition available to the mother and her baby. Sweet tastes impart nourishing and tonifying attributes that encourage healthy tissue formation. Sour foods, such as citrus fruits, berries, and fermented foods, aid in digestion and stimulate the appetite; sour fruits specifically provide adequate amounts of vitamin C and flavonoids—which contribute to healthy cell development and immune function. Salty tastes, when naturally integrated in foods, support water-absorption, enhance digestion, and can be sedating. These include seaweed, seafood, and the natural mineral salts found in fruits and vegetables. Pungent tastes, such as common culinary spices like garlic, chili peppers, onion, clove, cayenne, cinnamon, ginger, etc., help to stimulate and support digestion and metabolism, relieve nausea, and cleanse the sinuses and respiratory system. Bitter tastes are found in an array of green and yellow vegetables that contain important phytochemicals that support immune function, promote healthy growth, and often encourage cleansing and detoxification of the body. The last taste, astringent, initiates a drying response on the mucosa and creates a “puckering effect” throughout the body. Astringents include cranberries, pomegranates, asparagus, and many beans and legumes—which contribute complete and abundant sources of valuable proteins and complex carbohydrates1.

So what does a mother want to achieve during pregnancy in regards to her dhatus (tissues) and body? The mother wants to foster a nourishing home and foundation for the developing fetus; without getting too absorbed by calories, meal sizes, and “pregnancy diets”, the mother will achieve balanced nourishment by simply emphasizing sweet, salty, and sour tastes that primarily tonify and fashion healthy tissue formation. Albeit, elevated intake of pungent, astringent, and bitter tastes deplete, dry-out, and exasperate purification of the mother’s body. All six tastes are vital, yet concocting the ideal balance of all the tastes in each meal is the ultimate—and, yes, obtainable—goal of the mother.

The Sushruta supports that, “the food should by amply sweet, palatable (ojas producing food), well-cooked, prepared with appetizing drugs and abounding in fluid substances2;” overall, highlighting sweet, cool, and moist qualities. The Charaka Samhita and Sushruta Samhita describe similar “special pregnancy” dietary regimens: in the first month, according to the Charaka, the mother is to consume large quantities of cold, unprocessed milk; in the second month, “only milk prepared with sweet drugs;” milk with ghee (clarified butter) and honey added in the third month; ten grams daily of milk butter in the fourth month; in the fifth month, she is suggested to take ghee; ghee with sweet herbs should be taken in the sixth and seventh months; and, for the final months leading up to delivery, the mother should include milk gruel cooked with ghee into her diet3. This tonifying regimen is encouraged to be included in conjunction with a nutritious, balanced, and complete diet. The Sushruta recommends nearly identical additions of milk and/or ghee at the progressing stages of pregnancy, but also encourages the intake of shashtika rice with milk in the third month, with curd in the fourth, with milk in

the fifth, and with clarified butter in the sixth month of pregnancy. The addition of animal flesh soups to her diet along with including abundant emollient fatty substances is also noted as supportive to the mother especially in her later months of pregnancy4. The Sushruta is adamant that, “if treated on these lines, the enceinte [fetus] remains healthy and strong, and parturition becomes easy and unattended with evils5.”

Ramesh Nanal, a practicing Ayurvedic practitioner for over 35 years, incorporates useful pregnancy-related nutrition and specific food advice in his research; he succeeds in amplifying the clarity of the valuable information offered in the Caraka. He supports that stabilization of the fetus in the first trimester is essential—hence the importance of consuming sweet, cooling, and liquid food as suggested by the Sushruta. Garghasthapan foods (stabilizing to the fetus) help to anchor the placenta, and Nanal provides the example of supplementing with one tablespoon of Water Chestnut powder (Singhoda) decocted in a cup of warm milk with ghee, taking up to four cups a day. When the heart becomes active around the fourth month, “more pure kapha and rakta is essential for the fetus here6,” and thus, a higher quantity of milk curds with rice and ghee should be consumed during breakfast and lunch. In the fifth month, the mana (mind) of the fetus becomes active, and the buddhi (the intellect) enters the fetus at month sixth; Hyridra foods (ojas/immune building foods) become highly important, Nanal recommending an increased intake of milk (milk being described as “boon to the making of mind7”) along with ghee and rice. As the last trimester nears and the fetus’s organs and systems become more developed, Nanal merely states that the mother now “requires a specific prescription for each individual body constitution8” that also acknowledges her overall health and any lingering symptoms. Nanal goes on to introduce a few specific food-based supplements to deliver additional support and nourishment to the expecting mother:

  • • Garden cress seeds roasted in ghee and mixed with milk and sugar taken in the last months help with tonification, general debility, and pregnancy anemia.
  • • Crab, corn, and egg soup or soy milk with egg yolks consumed after the second trimester is noted to assist with strong bone formation in the fetus.
  • • Spinach soup with onions and carrots also support bone health of both mother and child, along with helping with pregnancy anemia.
  • • Apricots—naturally very high in vitamin A—with honey is depicted as a very effective nervine tonic, yet also assisting with constipation, preventing infections, increasing healthy blood formation, and reducing the chances of cellular degeneration.
  • • Banana with dates, figs, and ghee taken every day in pregnancy is said to be a superior overall tonic that also improves and increases blood, preventing anemia to a great extent.
  • • When soaked and ground in water, black currents can be helpful in all urine disorders while also helping to alkalize the body and tone the large intestine.
  • • Dates soaked in milk overnight, ground in the morning, and mixed with cardamom and honey assists in healthy blood and bone formation in the fetus.
  • • Mango juice with ghee and milk taken two times daily may prevent fetal abnormalities, increase fetus’s defense against infections, aid in proper development, ease delivery, and prevent post-partum complications.9

Supplementing an already nutritious, abundant, and whole diet with balanced, nutrient-dense foods compared to supplementing with bottled, store bought vitamins will do more to holistically support and nourish the mother and child. The Charaka notes that, “the entities derived from nutrition are these such as– formation of the body, growth, continuance of vital breath, contentment, corpulence and vigor,10” portraying the special importance of a proper and complete diet for a mother-to-be.

Ayurveda principles strongly support that the foods one consumes is only a component of achieving a healthy and complete diet; the proper routines and practices around eating contribute immeasurably to the inclusiveness of one’s diet. To benefit more fully from her meals, the mother should eat her meals in a peaceful and beautiful environment, eliminate alcohol, nicotine, and nonprescription drugs from her life, eliminate caffeine if possible, honor her appetite (eating only when she feels hungry and stopping when satisfied), refraining from overeating by paying attention to when her stomach is 2/3rds full, eat freshly prepared foods, reduce ice-cold foods and beverages, drink plenty of pure, room-temperature water every day, sit quietly for a few minutes following each meal, and honor any cravings that arise, yet indulging with awareness.11 In regards to cravings, both the Sushruta and Charaka agree that desires shouldn’t be ignored. The Sushruta averring: “A physician should cause the longings of a pregnant woman to be gratified inasmuch as such gratifications would alleviate the discomforts of gestation; her desires being full-filled ensure the birth of a strong, long-lived, and virtuous son. A non-fulfilment of her desires during pregnancy proves injurious both to her child and her ownself12,” and the Charaka agreeing that “whatever she wants should be provided to her except those which damage the fetus13.”

The other two pillars are considerably more direct. Regarding sleep, the mother should get a full night of sleep, avoid day sleep, avoid sleeping on her stomach and back (unless properly supported with an incline), and shouldn’t oversleep to prevent lethargy in herself and in birthing a lethargic and lazy child. The Sushruta supports that sexual intercourse should be avoided because of fear of harm to the child14 and the Caraka compromised with sexual activity being acceptable one time each month. However, with current research regarding sex and pregnancy, experts support that, “sex during pregnancy is extremely safe for most women with uncomplicated, low-risk pregnancies15.” Each pregnancy is unique and sexual desire can vary with each women, thus the mother should remain present with what feels appropriate and appealing to her, simply using her desires as her best guide. In general, however, it should be acknowledged that sexual intercourse in excess is depleting to both partners and that special care, more gentle practices, increased mindfulness, and emphasizing the sacredness around sexual union becomes valuable and supportive to the pregnant couple. Ayurveda is all about balance and catering to the uniqueness of all individuals, so regarding the pillars of life and all other practices falling under the Ayurvedic umbrella, always looking at what will best support the unique mother at the present is fundamental.

HERBS AND PREGNANCY

Herbs are quite a controversial topic when it comes to their consumption during pregnancy, especially when considering that medicinal quantities of any herb can have unpredictable consequences on individuals. However, herbal practices have boomed immensely in the west, steering more mothers toward herbal consumption during pregnancy. Inexorably, this has led to expanded knowledge of how herbs affect pregnant woman and their babies. In Aviva Romm’s research and time in practice as a midwife and herbalist, she summarizes herbs repeatedly observed to be safe and effective, those commonly used but may be harmful, and herbs to avoid all together during pregnancy. Romm acknowledges: “Overall, most herbs are safe, with little evidence of harm. Few reported adverse events have occurred, and those that have been reported typically involve the consumption of known toxic herbs, adulterants such as unsafe herbs or even pharmaceuticals additives, or inappropriate use or dosage of botanical therapies16.” Caution should always be taken, of course, and Romm and other sources state that, if anything, the majority of herbs should be avoided all together in the first trimester17.

Through scientific evaluation and clinical trials, Romm lists a handful of herbs seen repeatedly to be safe during pregnancy. Red raspberry leaf was found to be a mineral-rich, nutritive uterine tonic that, with long-term, low-dose (1.5-5 gm in tea/infusion) use leading up to parturition, can promote an expedient labor with minimal bleeding. To reduce the duration or occurrence of upper respiratory symptoms, intermittent use of Echinacea (as tincture) has been deemed safe. Chamomile tea in

moderate amounts can assist in relaxation, insomnia, and flatulence during pregnancy. In the case of a urinary tract infection, concentrated, pure cranberry juice (taking up to 32oz/day) is the ideal, non-anti-bacterial treatment that is safe and effective for pregnant women. Ginger, mentioned in many texts and research, is commonly recommended as a safe treatment for nausea, vomiting, and general morning sickness as long as the daily dose doesn’t exceed one gram of dried ginger powder18. Even the Natural Medicine Comprehensive Database, an extensive, online resource providing “Unbiased, Scientific clinical Information in Complementary, Alternative, and Integrative Therapies,” remarks ginger as one of the best known herbal treatments for morning sickness in pregnancy, stating: “Clinical research in pregnant woman suggests that ginger can be used safely for morning sickness without harm to the fetus19.” Other herbs, like Nettle to reverse iron-deficiency, cramp bark for irritable uterus relief, licorice (only for short-term use not exceeding a week) utilized for sore throat symptoms, motherwort for labor pain, black and blue cohosh and castor oil to simulate labor, and the external application of tea tree oil, garlic, and calendula oil for vaginal yeast infections are also notable treatments, yet less scientific research has been conducted to back up their safety—only traditional usage and empirical evidence is available20. So, what herbs should soon-to-be mothers avoid all together? The American Pregnancy Association lists saw palmetto, goldenseal, dong quai, ephedra, yohimbe, pau d’arco (in large doses), passion flower, black and blue cohosh (for women who are not at term), roman chamomile, and pennyroyal as herbs that are likely unsafe or unsafe for oral consumption during pregnancy. Possibly unsafe herbs may include aloe, ginseng, feverfew, kava kava, and senna, but like with most herbs, adequate research is limited21. Generally noted from the Caraka, “the diseases of the pregnant women should be managed with diet and drugs consisting mostly of soft, sweet, cold, pleasant and delicate things22.” While this is quite vague, the idea of judging herbal effects based on their gentler qualities could be of use for the pregnant mother trying to avoid harm.

Throughout the Vedas, while herbal recommendation (usually via external application) are noted for use in regards to serious pregnancy complaints and disorders, little is to be found mentioning common herbal use safety during pregnancy. The Sushruta, pertaining to the overall health benefits for mother and fetus, does however include that, “the growth, memory, strength and intellect of a child are improved by the use of four following medicinal compounds, used as linctus (pras’a): 1) well-powdered gold, kushtha, honey, clarified butter and vacha; 2) brahmi, shanka pushpi, powdered gold, clarified butter, and honey; 3) shanka pushpi, honey, clarified butter, powdered gold and vacha; and 4) powdered gold, maha nimba, white vacha, clarified butter and honey23.” As the mother progresses through her final term, bastis (enemas) are commonly employed to balance vata, particularly apana vayu—which is the vayu governing the decent of the child through the birth canal. A specific basti formulation the Sushruta suggests to help “restore vayu in her body (nervous system) to normal and to cleanse bowels, [is an] anuvasana basti(enema) with bala, atibala, shatapushpa, palala (flesh), milk, cream, oil, salt, madana fruit, honey and clarified butter.” It was then stated to follow with a basti made with milk and a decoction of Madhuradi-gana24. While the Charaka was vaguer, stating simply to “give unctuous enema with the oil cooked with sweet drugs25,” they can both be interpreted to support that tonifying, oil-based enemas with nourishing herbs, and maybe even nervines, would be beneficial to the mother during the eighth and ninth months of pregnancy. While ancient Ayurvedic remedies may be difficult to apply, utilizing Ayuverdic principles with the available herbs can benefit the western mother.

While taking caution and/or seeking herbal advice from an expert is never a bad idea in the case of including herbs during pregnancy, the moderate use of herbal nutritive teas and cooking spices are generally considered safe to be used freely. And, again referencing Romm, a final general list of safe herbs to use for mild pregnancy complaints—having only slight variation in the medical research she gathered—include: Echinacea, St. John’s wort, peppermint, spearmint, ginger root, fennel wild yam, meadowsweet, blue and black cohosh, red raspberry leaf, evening primrose, garlic, aloe, chamomile, pumpkin seeds, and ginseng26. Herbs, however, aren’t paramount to a healthful, joyous, and symptom-free pregnancy. Through diet, including proper daily routines and practices, and managing overall stress of the mind and body, an expecting woman may find she has no need to reach in the herbal cabinet for symptomatic relief.

DAILY ROUTINES AND PRACTICES

The ancient Vedic practioners are adamant about implementing more sattvic routines and rituals in daily life. The Sushruta claims: “Those women who are devout in their worship of the gods and the Brahmins and cherish a clean soul in a clean body during pregnancy are sure to be blest with good, virtuous and generous children; whereas a contrary conduct during the period is sure to be attended with contrary fruits2.” Today, we may not be as devout in our thinking, but promoting and conducting practices that support spiritual growth, keep the body clean and healthy, and keep the mind calm and joyous can support and enhance the experience leading up to and following parturition. Before uncovering the practices most beneficial to the mother-to-be, the Sushruta obstinately remarks on actions prohibited during pregnancy:

“A woman should avoid all kinds of physical labor, sexual intercourse, fasting, causes of emaciation of the body, day-sleep, keeping of ate hours, indulgence in grief, fright, journey by

carriage or in any kind of conveyance, sitting on her haunches, excessive application of Sneha (oil) karmas and venesection a the improper time (after the eight month of gestation), and voluntary retention of any natural urging of the body28.”

Even with these “don’ts” having been recorded in texts thousands of years ago, these simple examples still can provide a baseline of actions to avoid during pregnancy in the modern day. Implementing yoga (encompassing meditation and breathing), increased overall mindfulness, and five sense therapies as routine practices during pregnancy is supported by the ancient texts, and all can be safely and conveniently integrated into an expecting mother’s day.

While strenuous exercise is almost always prohibited during pregnancy, conducting some form of exercise can be beneficial in maintaining the strength of a pregnant woman’s body—especially as the fetus grows and her energy and physical demands increase. To maintain bone strength, muscle tone (of all organs), heart endurance, and to keep her mind at ease, mild to moderate (depending on previous fitness and exercise routine before pregnancy) exercise should be adhered to daily starting at around the second trimester—because of the instability of the fetus in the first trimester, much more caution should be taken during that time. Brisk walks in nature, swimming, tai chi, and yoga are just a few examples of exercise options that will holistically sustain the mother. Yoga, the sister science of Ayurveda, is not only ideal because of its physical benefits, but yoga helps to calm the mind, alleviate stresses, and as Chopra puts it, “yoga awakens mind/body harmony, making it easier for you to make choices that are good for you both physically and emotionally29.” Because prenatal depression has been noted to be a progressively prevalent factor, recorded to affect as many as 49% of pregnant women, and being observed to be “a risk factor for prematurity, for developmental delays, and for later behavior problems in childhood and adolescence30,” safe and non-invasive measures to mitigate depression in pregnant women should be encouraged. In Tiffany Field’s study utilizing yoga and tai chi as a complementary therapy for prenatal depression, anxiety, and sleep disturbances, she found that women who participated in tai chi/yoga sessions for 20 minutes daily for 12 weeks while in their second and third trimester (weeks 22 to 34 of pregnancy) depicted greater decreases in all three areas she observed. They utilized the Center for Epidemiological Studies-Depression Scale (CES-D), which is a self-report assessing the frequency of present depressive symptoms including: “depressed mood, feelings of guilt and worthlessness, feelings of helplessness and hopelessness, loss of energy, and disturbances of sleep and appetite31.” With only positive results recorded, this study supports that yoga and/or tai chi is a cost-effective, safe, and convenient way to successfully reduce depression and associated symptoms during pregnancy.

Yoga can be modified for all levels, and yoga encompasses not just asana (the physical practice) but also breathing techniques, mindfulness, and meditation, making it accessible to everyone in some form. In a comprehensive literature review conducted by Kathryn Curtis, Aliza Weinrib, and Joel Katz on implementing yoga and its subsequent effects on pregnancy and the labor/delivery experience, they concluded that yoga is indicated during pregnancy having supportive psychological, physiological, neuromuscular, and immunological impacts on the mother throughout term and through and following parturition32. One of the studies they examined was a monitored yoga program lasting 12-14 weeks which compared pregnancy-related discomfort in women who completed the program to those receiving standard hospital care. The findings support that a “prenatal yoga program is safe for pregnant women and can reduce the discomforts of pregnancy and increase maternal self-efficacy and self-confidence33.” A second note-worthy study mentioned in the review described a holistic 16 week long (week 20 to 36 of pregnancy) program including asana, breathing techniques, lectures, and deep relaxation techniques. Not only did the yoga group show significantly greater improvements in physical, psychological, environmental, and social domains tested, but the author pronounced yoga as “a noninvasive and cost-effective way of improving quality of life and interpersonal relationships during pregnancy34.” With this last study, the experience of the mother throughout and following labor was examined. After a 10 to 12 week yoga program (throughout week 26-28 to week 37-38) was followed, maternal comfort, objective and subjective pain, length, augmentation, and the use of medication all in relation to labor, along with the overall birth outcome, was recorded. For the mothers who followed the yoga regimen, the first stage and the total duration of labor was significantly shorter, self-reported and observed pain scores were drastically lower, and evidence supports that maternal comfort at four different assessment points during and following la