Scientific Basis for Ayurvedic Therapies -3

Scientific Basis for

Ayurvedic Therapies 

edited by

Brahmasree Lakshmi Chandra Mishra

References

1. Shastri Ambika Dutta,

Sushrut Samhita

, 8th ed., Chowkhembha Sanskrit Samsthan, Varanasi,

1982, 64 (or Chap. 15, Verse 48).

2.

Jabalpur, India, 1983, p. 12.

3.

4. Anon., South-East Asia Progress Towards Health for All 1977–2000, World Health Organization,

New Delhi, 2000.

5. CD: Information Gateway on Ayurveda, prepared by ISM & H, Government of India.

6. Satyavati, G.V., An overview of pharmacological studies in India on medicinal plants and

natural products (1975–1982), A sequel to the chapter Pharmacology of medicinal plants

and natural products, in

Current Research in Pharmacology in India (1975–1982)

, Indian National

Science

Academy, New Delhi, 1984.

7. Narayana, D.B.A., Forensic Ayurveda and GMPs, in

Proceedings National Workshop on Internationally

Acceptable Standards for Ayurvedic Formulations,

Ravishankar, B., Ed., July 20–21,

Institute of PG Teaching and Research in Ayurveda, Gujarat Ayurved University, Jamnagar,

India, 2000, p. 36.

8. Jain, N.K.,

A Textbook of Forensic Pharmacy

, Vallabh Prakashan, Delhi, 2001.

9. Dahanukar, S.A., Kulkarni, R.A., and Rege, N.N., Pharmacology of medicinal plants and

natural products,

Indian J. Pharmacol.

, 32, S81, 2000.

2.1 Introduction

In Ayurveda, health is defined as the state where physical body, senses, and psyche are

in original or natural state with respect to body and function. Although the genetic makeup

of an individual determines the basic body constitution with respect to

dosas

(biomaterials)

and

psychological factors

,

total health is determined by physical and psychological environment.

It is currently believed that the expression of genes largely depends on environmental

factors. Consistent with this belief, Ayurveda emphasizes the role of environmental

factors, daily routine, seasonal changes, lifestyle, diet, regular exercise, and body tonics

(

rasayana

) in maintaining health. It also emphasizes that all needs of the body and senses

must be in balance in order to avoid illness and maintain good health — a scientifically

valid concept.

1

Scientific Basis for Ayurvedic Therapies

The founding fathers of Ayurveda believed that the world is made up of five elements

called

Panch-mahabhuta

. Their criterion was that an element must not be “divisible into”

a new material. They determined that earth, water, fire, air, and space are indivisible and

therefore designated them as the five basic elements (

Panchmahabhuta

). The human body

in Ayurveda was also believed to be made up of these five elements. In order to understand

the whole body physiology, Ayurveda postulates three main factors called

tridosa

, which

are also called biomaterials, biofactors, or bioenergies. These

tridosas

or biomaterials are

vata

,

pitta

, and

kapha

. The primary dominant elements in

vata

,

pitta

, and

kapha

are air, fire,

and earth, respectively. According to the

tridosa

theory the total human body consists of

an intensive interplay of a solid material substrate referred to as

kapha

, chemical activity

(biofire) referred as

pitta

, and an energy pool of motion and movement referred to as

vata

.

These three

dosas

coexist in a predetermined proportion and function in a complementary

manner to overall function of the total organism in spite of their opposite properties and

functions. The existence of the

dosas

can be understood at both the macromolecular and

micromolecular levels. A balance in the activity of these

dosas

is necessary for health.

The human body according to Ayurveda is made up of somatic

dosas

(

vata

,

pitta

, and

kapha

) and psychic components (

dosas

),

body tissues

(

dhatus

), and

waste products

(

malas

).

The three psychological components are

satogun

,

rajogun

, and

tamogun

. A close interdependence

among the somatic and psychological components exists; if one component is

out of balance, the others are also out of balance. The imbalance or vitiation of

vata

,

pitta

,

or

kapha

is considered the major factor in the causation of a disease.

1

Ayurveda has a concept of

agni

(fire) for all digestive and metabolic activities. Use of

the word “fire” can be rationalized based on the fact that fire generates carbon dioxide as

a result of burning carbon-based materials, and metabolism of carbon-based nutrients in

the body also generates carbon dioxide. Digestion and absorption processes are called

digestive fire (

pakwagni

)

and the enzymic action causing transformation of nutrients into

various tissue materials is called tissue fire (

dhatwagni

). Food must not only be digested

and absorbed from the intestine and circulate in the blood plasma, but also must be

absorbed by the tissue cells in order to be assimilated by the body. There are seven primary

supportive tissues (

dhatus

) in the body: (1) plasma, (2) blood, (3) muscular tissue, (4)

osseous tissue, (5) adipose tissue, (6) marrow and myeloid tissue, and (7) reproductive

tissue. All tissues are made up of cells with different structures and functions connected

with other cells through minute channels or pores (

suksma srotas

) to receive and distribute

nutrients and excrete metabolic waste products. This description of cellular communication

in Ayurveda is consistent with the modern understanding of intercellular uptake and

release of substrates and metabolites. All tissues have a material called activator, essence,

or hormone (

ojas

) which has specific properties and functions that are perceived to produce

a healthy essence. The properties and balance of excretory products (stool and urine) and

breakdown products of tissues (nitrogenous products) are also important factors in determining

health and disease.

1

2.2

Tridosas

1

2.2.1

Vata

Vata

literally means “air.” The description of

vata

in Ayurveda includes the following: dry,

cold, light, penetrating, mobile, transparent, and rough-like air and responsible for all

kinds of movements in the body, speed, impulse, and odor.

Vata

is a part of every cell;

however, the major sites of

vata

are believed to be the colon, lower back, calf muscle, ear,

bones, and joints. Some organs of the body also have a higher level of

vata

biofactor than

other organs, such as the brain, spinal cord, autonomic nervous systems, and motor and

sensory systems.

Vata

biofactor is responsible for functions of the central, autonomic, and

peripheral nervous systems.

Vata

controls the respiratory, blood, lymphatic, excretory, and

reproductive systems, as well as all types of movements. It is also responsible for the

cognitive and neocognitive function of the brain, and secretion of various chemical neurotransmitters

and hormones. This description of

vata

resembles the functions of central,

peripheral, and autonomic nervous systems. The following six main

chakras

(extrasensory

channels) of

vata

correspond to modern autonomic nervous system plexuses, further

substantiating that

vata

, in fact, resembles the nervous system:

1. Agya chakra –

nasociliary extension of the cavernous plexus of the sympathetic

nervous system

2. Vishuddha chakra

– pharyngeal plexus of the sympathetic nervous system

3. Anahat chakra

– cardiac plexus of the sympathetic nervous system

4. Manipur chakra –

plexus of the cholinergic

5. Swadhistan chakra

– hypogastric plexus

6.

Muladhar chakra

– pelvic plexus

Among

tridosas

,

vata

is more critical because it controls p

itta

and

kapha

in order to

accomplish various physiological functions.

Vata

is classified into five types based on the

organ site and function as shown in Table 2.1.

TABLE 2.1

Classification of

Vata

Vata

Location Function

Prana

Central nervous system and some vital

centers of the brain

Controls the action of other

vatas

Apana

Lumbo-sacral, gluteal, genito-urinary,

inguinal, and visceral regions

Regulates discharge of seminal fluid, menstrual

fluid, feces, urine, and aids in childbirth

Vyana

The heart (the fluid pumping system),

nonconscious reflexes produced along the

spinal cord (corresponds to autonomic

nervous system)

Controls contraction and relaxation of muscles,

blood circulation, lymph circulation, sweating,

and other secretions of the body through the

stimulation of nerves

Udana

The chest, umbilical area, nasal and

pharyngeal passages

Controls speech, respiration, energy, body luster,

and consciousness and also influences the

respective centers in the brain

Samana

The entire abdomen Controls digestion and assimilation of food, as

well as excretion of waste products

Signs and symptoms of deranged vata are indicative of neurological problems

Causes of Deranged

Vata

Symptoms of Deranged

Vata

Overworking, grief, worry, lack of sleep, intentional

retention of bodily waste, excess exercise or sexual

indulgence, and ingestion of bitter, pungent, astringent,

or dry foods

Irregular movement of the limbs, tearing pain,

throbbing suppression of secretions, contraction

of muscles (spasms), roughness of the skin,

formation of bone cavities, suspension of bowel

movements, and an astringent taste in the

mouth

2.2.2

Pitta

The second

dosa

is

pitta

, which indicates

agni

(fire, heat energy), and the description in

Ayurvedic texts includes heat, sharpness, sourness, and moisture. It is responsible for

appetite, thirst, digestion, metabolism, body heat, normal eyesight, softness of the body,

luster, mental calmness, and intelligence. This description of

pitta

resembles that of digestion,

metabolism, oxidation, conjugation, reduction, phosphorylation, enzymes, and hormones.

Although

pitta

is present in every cell in the body, it is classified based on five

major anatomical locations shown in Table 2.2. Although

pitta

, like

vata

, exists in every

cell of the body

,

the major sites of

pitta

are believed to be the stomach, duodenum, liver,

spleen, pancreas, heart, eyes, and skin.

2.2.3

Kapha

The third

dosa

is

kapha

, which is described in Ayurveda as moist, steady, cool, heavy, soft,

and slimy materials.

Kapha

is responsible for the normal body moisture, stability of the

joints, firmness of the body, a proportionate bulk, weight, strength, endurance, and courage.

The description of

kapha

resembles those of the lymphatic system, immune system,

body fat, and mucous and mucoid systems.

Kapha

balances

pitta

in functions by providing

basic materials for conversion into body tissues by enzymes, a kind of biochemical feedback

mechanism.

Pitta

generates heat from the enzymatic activities, while

kapha

provides

ways to eliminate the heat through the skin, lungs, urine, and feces via fat and moisture.

Although

kapha

is basically the same in all cells of the body, it is classified into five types

present in every cell of the body and its major sites are believed to be the chest, stomach,

brain, tongue, and synovial membrane of bone joints.

TABLE 2.2

Classification of Pitta

Pitta Location Function

Pachak Stomach and small intestine Controls bile and pancreatic juices

Ranjaka Stomach, duodenum, liver, spleen,

and pancreas

Enzymes responsible for digestion and metabolism;

provide nutrients, blood constituents, and the

formation of the blood cells in the spleen

Sadhak Heart Responsible for life span, complexion, energy, body

temperature, body luster

Bhrajak Eye Responsible for vision

Alochak Skin Responsible for the heat, moisture, and health of the

skin, as well as the vasomotor mechanism and

adaptation to the surrounding environment

Signs and symptoms of deranged pitta are indicative of digestive, metabolic, and enzymatic problems

Causes of Deranged Pitta Symptoms of Deranged Pitta

Pitta may be deranged by ingestion of salty, hot,

irritating, or sharp-tasting foods, as well as by anger

Burning sensation in the stomach, redness, digestive

system disturbances, excessive sweating, fainting,

symptoms of intoxication, pungent and sour taste,

and inability to see white and dark red color

based on location and functions as shown in Table 2.3. Again, like vata and pitta, kapha is

2.3 Body Constitution (Prakriti) 1

Although all biomaterials are natural elements of the body, people may have the predominance

of one or a combination of two of the biomaterials that determine general physical

and psychological characteristics and the tendency (susceptibility) to develop certain

nance of biomaterials and tendency to develop certain diseases.

2.4 Mental Components (Mano Guna)

Charak describes attributes of mental components as desire for pleasure, aversion to pain

or misery, intelligence, mind, will power, logical faculty (vicarna), memory, knowledge

gained from experience (vijnana), ability, and perception. Based on these attributes, mental

components are divided into three classes: godly (satogun), kingly (rajogun), and evil

(tamogun). Manifestations of these classes of mental components and characteristic con-

1

2.5 Health Care

Health care in Ayurveda is essentially aimed at balancing the dosas and gunas, bringing

them into equilibrium. With this goal in mind, management of a disease is designed to

TABLE 2.3

Classification of Kapha

Kapha Location Function

Avalambak Chest Enables other dosas to perform their function by

supplying humidity and body water, blood, fluid

Kledak Stomach It is liquid, mucoid, sweet, cooling in nature, and

moistens the bolus

Bodhak Tongue Controls saliva and other juices that moisten the

mouth, helps the bolus descend, and creates taste

Tarpak Brain Controls vision, hearing, smell, taste, and touch

Shleshaka Synovial areas of bone joints Provides lubrication

Signs and symptoms of deranged kapha are indicative of lipid metabolism and mucus-secreting system

Causes of Deranged Kapha Symptoms of Deranged Kapha

Overexposure to cold weather; excessive sleep; day

sleeping; excessive, sweet, fatty, and oily food; low

level of physical activity

Excess of moisture, hardness of tissues, itching,

feeling cold or heavy, low secretary activity, mucous

membranes heavily coated with mucous, reduced

activity of limbs, swelling, weak digestive power,

sleepiness, pale skin, salty taste, and slow recovery

after an illness

diseases. Table 2.4 shows the characteristics of body constitutions according to predomistitutions

are shown in Tables 2.5 and 2.6, respectively.

Characteristics of Dosha Constitutions

Vata Constitution Pitta Constitution Kapha Constitution

Characteristics

Low body weight, light bone

structure, fast to act, forgetful,

artistic, loves esoteric material, is

shy and sensitive, enthusiastic

Healthy body, well-developed

muscles, well-functioning

metabolism, an urge for physical

activities, an interest in science and

technical subjects, good speaking

ability, aggressiveness, hostile

tendency, impatience, tendency to

baldness, good mental ability,

excellent memory, loves intellectual

activities

Heavy body weight, solid body

structure, strength, endurance,

secure feeling, self-confident, not

easily rattled, somewhat lethargic,

patient, polite, generous,

materialistic tendency, greedy,

passive, tendency to sleep too

much

Diseases Prone To

Rheumatism, nervous disorders,

sciatica, insomnia, dry skin,

constipation, receding gums,

weak bones, infertility,

impotence, colic, flatulence,

stuttering, ringing in the ears,

irregular menstruation with

cramps, varicose veins, paralysis,

blood clotting, anorexia, shivering

fits, poor blood circulation

Stress-related diseases; high blood

pressure; coronary diseases;

thrombosis; ulcers; cancer of the

stomach, intestine, and skin;

psoriasis; inflammation of the

lymph system; infectious diseases;

inflammation of the spleen;

hepatitis, urinary tract infection;

heartburn

Nausea, colds, bronchitis, asthma,

kidney stones, swollen lymph

nodes, benign tumors, dropsy,

goiter, lung and breast cancer,

fungal infections, digestive system

problems, obesity

TABLE 2.5

Characteristics of Mental Components

Godly (Satogun) Kingly (Rajogun) Evil (Tamogun)

Compassion, self-control,

forbearance, devotion to truth,

proper conduct, faith in god,

knowledge gained from selfrealization

(Jnana), intelligence,

resolution, comprehension,

nonattachment

Sensitivity to pain, restlessness of

mind, lack of true understanding,

egoism, lack of honesty, lack of

compassion, false pride,

overconfidence, buoyancy of

spirit, strong desires, anger

Despondency, agnosticism and

atheism, tendency to evil conduct

(adharma), dull intellect, lack of

knowledge and insight,

perverted mind, physical and

mental inertia, somnolence

TABLE 2.6

Characteristics of Mental Constitutions (Manasik Prakriti)

Godly (Satvik) Kingly (Rajsik) Evil (Tamsik)

Pure-minded, compassionate,

loving, and righteous person who

is capable of enduring all degrees

of hardship and pain through

willpower

Egotistic, ambitious, proud,

competitive, controlling, and

power-hungry person who may

be made to submit to pain and

unpleasant medical treatment

through persuasion and logic

Lazy, sleepy, depressed, greedy,

irritable, irresponsible, and

selfish person with a large

appetite who is horrified at the

prospect of bodily pain

TABLE 2.4

diagnose which biomaterials and components are in excess or not and how they can be

brought into balance.2

2.5.1 Diagnosis

Diagnosis of a disease in Ayurveda is essentially done by inspection, palpation, and

interrogation. The specific examination includes the standard eight-point examination: (1)

pulse, (2) urine, (3) stool, (4) tongue, (5) eye, (6) skin, (7) speech and voice, and (8) general

appearance (Table 2.7). Additional examinations are made to assess digestive capacity,

personal habits, body appearance, and patient’s resilience. The other elements of diagnosis

are the most recent reason for the illness, warning symptoms, clear symptoms, various

diagnostic tests, and pathogenesis.

Management of an illness considers elimination of causes of the imbalance of dosas,

administration of various herbal formulas, dietary and lifestyle interventions to bring dosas

back into balance, elimination of chinta (serious worry), and nurturing the soul to regain

spiritual health (Samana).

2.5.2 Disease Management

Charak Samhita describes four components of a disease management scheme: (1) the physician,

(2) the drug, (3) the patient, and (4) the attendant. A physician must have proper

training, knowledge, and experience. A remedy must be abundantly available, effective,

and relatively safe. A patient must provide all information to the physician about the

disorder and be compliant. An attendant (a nurse) must have the knowledge of patient

care, dexterity, loyalty, and cleanliness.

Management of illness primarily consists of four procedures: (1) cleansing (samsodhan),

(2) palliation (samsaman), (3) rejuvenation (kaya kalp), and (4) mental and spiritual healing

(sattvavajaya, or psychotherapy). The management of an illness starts with cleansing and

TABLE 2.7

Eight-Point Diagnosis

Examination Vata Pitta Kapha

1. Pulse Thread-like, feeble,

snake-like motion

Moderately heavy, and

jumps like a frog

Heavy, slow, flows

like swan

2. Urine

Drop of sesame oil

spreads on the surface

of urine gives:

Black–brown color

Wave-like movement

Dark brown color

Multiple colors, like

rainbow

Cloudy appearance

Pearl-like droplets

3. Stool Uniform, dark color Yellowish color Bulky foul smell

4. Tongue Black to brown, dry,

coarse, furred,

pigmented

Red, yellow, or green,

soft, sharp, moist

Whitish color, pale

coated, big, soft, flabby

5. Eye Small, conjunctiva,

muddy, iris is dark

gray or brown

Moderate size, sharp,

more sensitive to light

Large, moist, oily,

conjunctiva is white

6. Skin Dry, coarse, wrinkled,

dusky

Wheat color, copper-like

color, shiny, moist

Soft, off-white,

smooth, moist

7. Speech and voice Coarse and dry Sharp Heavy

8. General appearance Mental disorders, anxiety, distress, pain, weakness, and strength are important

factors in diagnosis

includes five procedures called panchakarma, all of which are not necessarily done at the

Panchakarma is a major therapeutic procedure in Ayurveda known to be useful for all

diseases of all the body organs and functions because the elimination of toxic products,

endogenous or exogenous, can contribute to overall management of an ailment. It is

toxic symptoms will develop over a period of time. The major cause of body ailments is

the toxic products produced by body metabolism, microorganisms, synthetic chemicals,

Palliation essentially consists of compound preparations of herbs and minerals for diet

and lifestyle interventions. Ayurvedic texts describe seven types of palliation: (1) digestive

yoga exercise, (6) lying in the sunlight or sunbathing, and (7) breathing exercise and

meditation. A variety of formulas are used to improve digestion, eliminate ama, and

balance dosas. Examples of herbs used to subdue deranged or vitiated dosas are shown in

acute fever.

2.5.2.1 An Example of Ayurvedic Case Management

To illustrate a typical Ayurvedic therapy, the management of Ama-vata (rheumatoid arthritis)

is given below. It includes biopurification and detoxification by dietary interventions

and necessary panchakarma procedures and administration of herbal formulas. The first

step is elimination of ama (the incompletely digested food material in the intestine, collagen

materials, allergens, mucus, mucoid materials, crystals like uric acid) by reducing the diet

to near or total fasting if possible. The diet consists of very small quantities of doubleboiled

rice and watery mung dal (lentils) for the first 5 days, with the addition of small

amounts of vegetables for the next 5 days, and then one piece of bread (roti) for an

TABLE 2.8

Group of Herbs Used To Mitigate Vata3

Medicinal Plant Botanical Name Medicinal Plant Botanical Name

Bhadradaru Vrsciva Boerhavia diffusa

Nata Caesalpinia bonduc (L.) Devahvaya Cedrus deodru

Kustha Saussurea lappa cob Two Salpaparni

Dashmula Kandukari Mueuna pruriens

Two Bala Sida cordifolia Linn. Abhiru Asparagus racemoses

Vellantara Vativera zizanoides Vira Roscoea procera

Aranika Premna integrefolia Linn. Jivanti Leptadenia reticulata

Buka Osmanthus fragrans Rsbhaka Microstullus wallachi Lindl

Vrsa Addhatoda vasica Nees Brihatee Solanum anguivi Lam.

Asmabheda Bergenia ligulala wall Kantakaree Solanum surattense Burm. F.

Gokantaka Tribulus teriatris Saliparni Desmodium gangeticum

Itkata Sesbania bispinosa Prasniparni Uraria picta

Sahacara Baeleria prionitis Linn. Goksuraka Tribulus terristris

Bana Bareleria stringosa Hansapadi-Adiantum

Lunilatum-Burm

Podophyllum hexandrum royle

Gundra Typha elephantia Roxb Kasa Saccharum spontaneum Linn

Bhalluka Oroxylum indicum Vent. Vrksadani Loranthus longifolius

Karambha Pergularia extensa Nala Arundo donax Linn

Partha Gynandropsis pentaphylla Two Kusa Desmostachya bipinnata

Vrscikali Pergularia extensa Guntha Typha angustata

Tables 2.8 through 2.10. Fasting also helps in acute indigestion, dysentery, diarrhea, and

same time or to all patients. This topic is described in detail in Chapter 4.

understandable that if the body organs are not eliminating toxic products from the body,

power enhancement, (2) toxic waste (ama) elimination, (3) fasting, (4) observing thirst, (5)

xenobiotics, or drugs. Panchakarma is discussed in detail in Chapter 4.

© 2004 by CRC Press LLC

Health Care and Disease Management 23

additional 5 days. This treatment is generally given for a minimum of 1 month. During

this period, hot fomentations are applied and no ghee (dehydrated milk fat), vegetable

oil, meat, or animal fat is given. It is believed that this treatment increases the metabolic

power of the body, resulting in breakdown and excretion of the disease-producing vitiated

materials (ama), collagen, uric acid, sugar, urea, fat, etc. To augment the process of cleansing,

ginger juice or dry ginger is given daily in the early morning on an empty stomach.

Chirata or Swertia chirayita, a bitter herb, is also given to improve digestion.

After 1 month of this treatment, ghee (dehydrated butter) may be given to help in

removing fat-soluble materials from the body. A medicated enema (basti) containing sesame

(til) oil may be started and continued for 1 month for this purpose. At this point the

treatment is stopped for 4 to 8 weeks and the reduced diet treatment is resumed. Once

the acute phase has subsided, the patient is asked to exercise, first with passive movements

and then with active movements (yoga exercises using various body positions). Yoga

instructions are recommended to help the patients do these exercises correctly.

This treatment is often accompanied by an oral administration of Ayurvedic herbal

formulas two to three times per day. The formulas often used are Yograj-guggul or

Mahayograj-guggul (formulas from Ayurvedic text) with gold bhasma (gold formula made

by oxidizing gold with heat using herbs). A physician must carefully examine the patient

for other illnesses and organ disorders to determine a suitable antiarthritis formula,

depending on accompanying health conditions.

TABLE 2.9

Herbs Used To Mitigate Pitta3

Herb Botanical Name Herb Botanical Name

Durva Cynodon dactylon Abhiru Asparagus racemoses

Ananta Alhagi camelorum Sitapaki Abrus precatorius

Nimba Azadirachta indica A. Priyangu Setaria italica Beauv

Vasa Litesa glutinosa Two Sthira Desmodium gangeticum

Atmagupta Mueuna pruriens Padmak Prunus cerasoides

Gundra Typha elephantine Roxb Vanya Cyperus rotundus Linn.

Nyagrodhadi group

Nyagrodha Ficus vengakensis Linn. Two Meda (fat) Litsea monpetala

Tuga Bamboo mann Mudgaparni Vigna trilobata

Rddhi Sphaeranthus inducus Mashaparni Teramnus labialis

Shringee Pistacia chinensis Bunge Rsabhaka Microstullus wallachi

Amrita Tinospora cordifolia Jivaka Microstyllus wallachi Lindl

Jivanti Leptadenia reticulata Madhuka Sapotaceae

Two Kakoli Roscoea procera

Sarivadi group (used to treat burning sensation, bleeding disease, thirst, and fever)

Pippala Piper longum Linn. Usira Vativeria zizanoides

Sadaphala Ficus glomerata Kasmarda Cassia sophera

Two Rodhra Symplocos racemosa Roxb Yashti-madhu Glycyrrhiza glabra

Arjun Terminalia arjuna Kadamba Anthocephalus chinensis

Kapitana Thespesia populnea Virala Diospyros tomentosa

Somavalka Acacia suma Kurz Madhuka Sapotaceae

Plaksha Ficus lucescens Blume

Amaara Vitex nigundo Linn.

Padmakadi group (increase breast milk to subjugate vata and pitta)

Padmaka Prunus cerasoides

© 2004 by CRC Press LLC

24 Scientific Basis for Ayurvedic Therapies

2.5.3 Dietary Management and Lifestyle Changes

Dietary and lifestyle interventions are initiated according to the disturbed dosas and

the physical and mental constitution of a person; these interventions are accompanied

by spiritual nurturing, removing serious worry, exercise, and yoga practice. If vata

were disturbed, the diet would include oils, butter, and sweet food. If kapha were

disturbed, the diet would include bitter, sour, vinegary, spicy, dry food. If pitta were

disturbed, the diet would include mild tasting food, grains, lentils, and moderate

amounts of sweets and oils. Patients are given a restricted diet of small quantities of

mung dal (a type of lentil) or yogurt and rice. Depriving the patient of drinking water

helps in ascites, edema, and certain kidney diseases where large amounts of water are

retained in the body.

TABLE 2.10

Group of Herbs To Mitigate Kapha3

Aragvadhadi Group (used to treat vomiting, leprosy, fevers, mitigate kapha, itching,

diabetes, and clean bad wounds)

Medicinal Plant Botanical Name

Aragvadha Cassia fistula

Indrajava Holerrhina antidysenterica wall

Patali Stereospermum colais

Kakatitka Abrus precatorius Linn.

Nimba Azadirachta indica A.

Amrata Tinospora cordifolia Miers

Madhurasa Marsedenia tenacissima

Sruvavrksa Flacourtia indica

Patha Steohania japonica Miers

Bhunimba Andrographis paniculata

Sairyaka Barleria prionitis Linn.

Patala Cydonia oblonga

Two Karanja Pongamia pinnata

Saptacchada Alstonia scholaris R.

Agni Plymbago zeylanica Linn.

Susavi Momoridca chirantia Linn.

Phalsa Grewia subinaequalis DC

Bana Barleria stringosa

Ghonta Acaia catechu Willd badari (Hem), Zyziphus

jujuba Lam.

Arka Calotropis gigantea (L.)

Alarka Calotropis procera

Nagadanti Croton oblongifolius

Visalya Gloriosa superba Linn.

Bharangi Clerodendrum indicum

Rasna Acampe papikkosa

Vrscikali Pergularia extensa

Prakirya Cesalpinia bonducella Fleming

Pratyakpuspi Achyranthes aspera Linn.

Pitataila Abrus precatorius Linn.

Udakirya Pongamia glabra Vent.

Healthy lifestyle is very important to maximize the effect of palliative treatment.

Ayurveda strongly recommends that the patient utilize a regular sleeping schedule, about

8 hours of sleep each night, rising early in the morning; do regular exercise; and eat

breakfast and engage in other dietary recommendations according to seasons. In order to

maximize the effectiveness of palliative treatment, Vyayam (exercise, yoga, stretching),

breathing exercises, and sunbathing are necessary. It is important that some appropriate

form of exercise be done at a maximum tolerated effect (MTE) level during the treatment

period; this may be with the help of a physical fitness trainer. The concept of MTE is

similar to a therapeutic dose of pharmacologic agents to get maximum beneficial effect.

Exercise is likely to create a need for nutrients inside the cells. It is believed to open up

the microchannels (shrotas) in the body cell for nutrients and for medicine to enter. It is

particularly important in maximizing the effectiveness of therapies in management as well

as prevention of chronic musculoskeletal disorders.

TABLE 2.11

Ayurvedic Herbs Known To Have Confirmed Therapeutic Effects

Disease/Symptoms Herb Popular Name

Edema Achyranthes aspera Linn. Apamarga

Mental distress Acorus calamus Linn. Vacha

Bronchiolar constriction Adhatoda zeylanica Medic. Vasa

Intestinal worms Butea monosperma Lam Palasha

Arthritis, inflammation, and

high cholesterol

Commiphora mukul Wightii Guggul

Bone fracture Cissus quadrangularis Linn. Vajravalli

Malaria Alstonia scholaris R. Br. Saptaparna

Liver disorders Andrographis paniculata Nees Bhunimba

Cardiac disorders Artemisia vulgaris Linn. Nimba

Terminalia arjuna Arjuna

Bacterial or virus Azadirachta Indica A. Juss Nimba

Memory problem Bacopa monnieri (Linn.) Pennell Brahmi

Inflammation and

diuretic need

Boerhaavia diffusa Punarnava

Severe constipation Cassia angustifolia Vahl. Rechani

Muscle spasm Cedrus deodara (Roxb.) Devadaaru

Memory problem Celastrus paniculatus Willd. Jyotishmati

Nerve weakness Centella asiatica (Linn.) Urban. Mandukaparni

Malaria and fevers Caesalpinia crista Linn. Natakaranja

Inflammation Curcuma longa Linn. Haridraa

Diabetes Eugenia jambolana Lam. Jamboo

Dysentry Holarrhena antidysenterica Wall. Kutaja

Convulsions Masilea minuta Linn. Sunisannak

Liver toxicity Picrorhiza kurroa Royle. Kutuka

Mild constipation Plantago ovata Forsk Ishadgola

Skin white spot Psoralea corylifolia Linn. Bakuchi

Low breast milk Pueraria tuberosa DC. Vidarikanda

Low muscle mass Sida rhombifolia Linn. Mahabala

Fever Swertia chirata Buch.-Ham. Kairata

Heart weakness Terminalia arjuna W. and A. Arjuna

Mental distress, physical

exhaustion, and inflammation

Withania somnifera Dunal Ashwagandha

2.5.4 Bhasma

The oxidized form of metal and mineral preparations, called bhasma, is also extensively

used in Ayurvedic medicine. Bhasmas are metal or mineral powder formulas made by

specific Ayurvedic text procedures with several herbs and herbal extracts and subjected

to very precise heat treatment. The common metals and minerals used in making bhasmas

for therapeutic use are gold, silver, copper, mercury, iron, zinc, tin, arsenic, gypsum, lime,

alum, borax, silica, diamond, ruby, emerald, saphire, jade, moonstone, sunstone, turquoise,

and mica.

Procedures to make bhasmas are very complicated and involve dozens of steps and many

herbs and herbal extracts. These procedures detoxify toxic metals like mercury. If any of

the steps in the procedure are either omitted or not properly carried out, then safety is

compromised. The pure metal salts do not account for unique pharmacological properties

of their bhasmas. For example, pure mercury salts do not account for the antiarthritic

The science and art of bhasmas, a separate branch of pharmacy known as Rasa Shastra, is

2.5.5 Rasayana

The word rasayana is made up of two Sanskrit words, rasa (nutrition) and ayana (transportation

in the body). Thus, rasayana refers to compound preparations containing multiple

herbs and minerals that improve transportation of nutritional materials to body

tissues. The fundamental underlying theme of rasayanas is nutrition. They are part of the

overall balanced diet. Rasayanas are claimed to improve vitality, rejuvenate body tissues,

improve immunity, and prevent aging. Rasayanas may act in a variety of ways by improving

the nutritional value of the food, digestion and absorption of nutrients, transportation

of nutrients to tissues, bioavailability of nutrients, metabolism of nutrients in tissues,

immunity, and by cleaning the srotas (microcirculatory channels or pores) which improve

uptake of micronutrients. Basically, rasayanas are classified into three categories: (1) Ajasrika

rasayana (nutrition, dietary) is taken regularly with food as nutrition; (2) Kamya rasayana

(normal health promoter) is indicated to improve vigor, vitality, and to make a healthy

person feel better; and (3) Naimittika rasayana is indicated to promote vitality in a particular

disease. Kamya rasayana is further classified into three categories: (1) Pranakamya rasayana

(promoter of life vitality and longevity); (2) Medhakamya rasayana (promoter of intellect);

and (3) Srikamya rasayana (promoter of skin complexion and luster). Ayurvedic physicians

should be consulted to determine the appropriate rasayana required depending upon the

health needs.

Rasayanas are the Ayurvedic equivalent to modern dietary supplements. It is understandable

that vitamins, minerals, and biologically active steroids, alkaloids, glycosides,

tannins, and a variety of antioxidants present in rasayanas would be a good source in

providing necessary nutrients to the body. Sometimes an overdose of pure vitamins in

modern dietary supplements can cause serious side effects. There is virtually no possibility

of an overdose of any specific vitamin or mineral from a rasayana.

2.5.6 Formulas

The drug treatment in Ayurveda primarily consists of herbal formulas, bhasmas, rasas

(mercury is always an ingredient of rasas), and medicated oils and ghee (for topical

described in Chapter 6.

activity of mercury bhasma. There are several hundred metal bhasmas described in texts.

application, nasal drops, and enemas). A single herb is rarely administered to a patient

in Ayurveda; generally a formula made up of several herbs is used. They are always given

with other foods or herbal items, e.g., honey, ghee, ginger, etc., which help mitigate toxicity

and may increase absorption of certain ingredients, thus obtaining the desired therapeutic

effect. Herbal formulas are favored in Ayurveda because the founders of Ayurveda recognized

the possible synergistic and counterbalancing effects of herbs.

Sometimes none of the herbs in a formula exhibit therapeutic effects individually, but

the formula could nevertheless be effective. Recently, a formula (Trasina) made up of

Withania somnifera, Tinospora cordifolia (Wild) Miers, Eclipt alba Hassk, Ocimum sanctum

Linn, Picrorrhiza kurroa Royal ex Benth, and Shilajit (rock sweat, collected from rocks)

showed beneficial activity in diabetic rats, whereas no such effect was seen with individual

herbs.4 This example illustrates the fact that a rapid screening program to assess biologic

activity of single herbs or purified constituents of a herb may not necessarily confirm or

disprove a health claim because of possible synergistic effects of the combination of drugs

or adjuvant. Ayurvedic formulas are analogous to vegetarian food where an experienced

cook makes the difference in taste and benefits. All the chemical constituents of milk

consumed individually are not likely to give benefits equal to that of an equivalent amount

of whole milk consumed. It is therefore important that Ayurvedic formulas as described

in Ayurvedic texts be evaluated for therapeutic benefits along with the individual active

herbs.

There are several thousand formulas described in Ayurvedic texts that are recommended

for over 200 well-identified diseases. In the 1970s, a panel of Ayurvedic experts was

appointed by the government of India to evaluate the formulas in Ayurvedic texts. The

panel compiled an “Ayurvedic Formulary of India.”5 It has over 560 evaluated formulas

including 22 bhasmas and 55 rasas and yogas (preparations containing mineral drugs as

main ingredients). Some formulas have dozens of herbs; for example, Jirakadi Modaka has

46 herbs and Shiva Gutika has 49 herbs.

Individual plants and plant constituents have been studied for therapeutic activity in

recent scientific studies. Therapeutic effects have been confirmed by clinical and biological

2.5.7 Yoga

Yoga is used not only as a therapy, but also to improve general health and vitality. Yoga

is defined as the inhibition of fluctuations of consciousness.6 In effect, it restrains mental

the means by which the mind is controlled and redirected into constructive channels.

Pantanjali, a famous sage, advocated two methods to control the mind: constant practice

and detachment. Although Yoga is conceived today as a combination of physical postures

and breathing exercises, Ayurvedic texts actually describe several components of Yoga

such as ethical practices, punctuality of daily routine, physical-posture exercises, breathing

exercise, sensorial practices, and meditation practices. Today, breathing and physicalposture

exercises are collectively known as Yoga. The practice of Yoga alone or in combination

with other Ayurvedic therapies has been noted in Ayurvedic texts as beneficial in

certain diseases, such as hypertension, bronchial asthma, anxiety, neurosis, gastrointestinal

disorders, headache, insomnia, obesity, anxiety, and depression. It is suggested that the

autonomic nervous system is improved by Yoga, resulting in a relatively hypometabolic

state, thereby lessening the energy demands on the body. The efficiency of the cardiovascular

and respiratory systems is also significantly enhanced by Yoga.

testing for many of them. A few examples are given in Table 2.11.

activity. Mind in total is composed of three faculties: brain, intellect, and ego. Yoga teaches

2.5.8 Massage

Vital points exist where muscle, cartilage, nerves, and bones join each other. The life

energies are believed to be concentrated at these points. There are 22 vital points on the

upper extremities, 22 on the lower extremities, 12 in the abdominal areas, 14 in the back,

and 37 in the neck and head. Manipulation and massage of these points has been used in

Ayurveda to treat diseases and strengthen the body. Ayurvedic massage is the combination

of massage with medicinal oils and acupressure. Because lipophilic materials can be easily

absorbed through skin, medicated oil massage can be a very effective therapy. Specific

medicated oils and types of strokes are chosen based on the disturbed dosas, body constitution,

injury, and disease condition.

The basic strokes of massage include (1) friction where pressure is applied by thumb

and finger tips more on muscular part, and gentle pressure on bony parts; (2) kneading,

deep or superficial; (3) rounding; (4) wringing or twisting; (5) chucking; (6) stroking; (7)

percussion; (8) vibrations; (9) joint movement; and (10) soft, gentle massage with thumbs

and palm. Ayurvedic massage is useful for general weakness, fatigue, arthritis, musculoskeletal

disorders, tennis elbow, lumbago, frozen shoulder, backache sprains, and aches.

Massage is also found useful for nervous system disorders, psychosis, drug addiction,

gynecological disorders, menopausal syndrome, postdelivery recovery, myocardial infarction,

ischemic heart disease, functional heart disease, cold hands and feet due to bad

circulation, varicose veins, psychological problems, obesity, loss of weight, stamina, and

disturbed digestive system.7 Contraindications for massage therapy are fever, indigestion,

and patients undergoing cleansing processes.

Massage is also advised for healthy people to maintain their health and relieve muscular

fatigue after a heavy physical activity or exercise.

2.6 Summary

Basically, Ayurvedic health care is based on the principle that body, mind, and soul must

be in harmony for health and happiness. Each of these has to be nurtured for an individual

to create health. Ayurveda recommends daily activities in detail, e.g., getting up before

sunrise, routine physical exercise, meditation, and diet according to the body constitution

with seasonal adjustments in lifestyle and sexual activities to maintain an optimum balance

of dosas to prevent illness. Unhealthy lifestyles, exposure to various physical, chemical,

and biological agents, extreme weather conditions, unhealthy diets, and overexertion from

physical or mental activities are considered the major causes of imbalance of dosas. Cleansing

of the body from waste products of the illness is necessary to eradicate an illness and

prevent its recurrence. Finally, management of an illness essentially consists of elimination

of causes of the imbalance of dosas, administration of various Ayurvedic formulas, dietary

changes to bring dosas back into balance, elimination of serious worry, and nurturing the

soul to regain spiritual health.

Research activity on Indian medicinal plants over the past 50 years has been extensive.

Data on more than 5000 Indian medicinal plants have been complied in the Compendium

of Indian Medicinal Plants by Rastogi and Mehrotra.8 The data include research studies on

pharmacological and therapeutic activity, pharmacognosy, plant chemistry, and established

chemical structures of chemical constituents. Research on more than 500 popular

Indian medicinal plants are similarly described in The Treatise of Indian Medicinal Plants by

Chatterjee and Pakarashi.9 Data on several hundred selected medicinal plants are also

compiled in other books.

Ayurveda, the traditional health-care system of India, is a complete and holistic healthcare

system that contains both preventive and therapeutic aspects. It has a defined diagnostic

system covering all physiological functions and organs, as well as specific treatments

and management techniques for each disease. Although Ayurveda is thousands of years

old, many of its core principles are consistent with modern medicine. Ayurvedic medicine

offers a wealth of relatively effective, safe, and economic health-care therapies. Its therapies

provide relief for many chronic illnesses such as musculoskeletal disorders, rheumatoid

arthritis, osteoarthritis, diabetes, obesity, nervous disorders, etc. Ayurvedic medicine has

been successfully integrated with allopathic medicine in India. Certainly, a great potential

exists for its integration into the health-care system in the U.S.

References

1. Mishra, L., Singh, B.B., and Dagenais, S., Ayurveda: a historical perspective and principles of

the traditional healthcare system in India, Altern. Ther. Health Med., 7(2), 36–42, 2001a.

2. Mishra, L., Singh, B.B., and Dagenais, S., Healthcare and disease management in Ayurveda,

Altern. Ther. Health Med., 7(2), 44–50, 2001b.

3. Shikantha Murthy, K.R. (translator), Sodhanadigana Samgraha, in Vagbhatt’s Ashtanghradaya,

Vol.1, Krishnadas Academy, Varanasi, UP, India, 1999, chap. 15.

4. Bhattacharya, S.K., Satyan, K., and Chakrabaarti, A., Effect of Trasina, an Ayurvedic herbal

formulation, on pancreatic islet superoxide dismutase activity in hyperglycemic rats, Indian J.

Exp. Biol., 35, 297–299, 1997.

5. Ayurvedic Formulary of India, 1st ed., Government of India, Ministry of Health and Family

Planning, Department of Health, Government of India Press, Delhi, 1978.

6. Murthy, A.R.Y., Ayurveda and yoga, in Principles of Ayurvedic Therapeutics, Vinaya Kumaar,

A., Ed., Shri Satguru Publications, New Delhi, India, 1995.

7. Ranade, S. and Rawat, R., Healing Touch: Ayurvedic Message, Chaukhambe Sanskrit Pratisthan,

Delhi, India, 2000.

8. Rastogi, R.P. and Mehrotra, B.N., Compendium of Indian Medicinal Plants, Central Drug Research

Institute, Lucknow, and National Institute of Science Communication, New Delhi, printed at

Publication and Information Directorate of Council of Scientific and Industrial Research, New

Delhi, India, Vol. 1, 1990; Vol. 2, 1991; Vol. 3, 1993; Vol. 4, 1995; Vol. 5, 1998.

9. Chatterjee, A. and Pakrashi, S.C., The Treatise of Indian Medicinal Plants, Publication and Information

Directorate, New Delhi, National Institute of Science Communication (CSIR), Dr.

Krishnan Marg, New Delhi, India, Vol. 1, 1991; Vol. 2, 1992; Vol. 3, 1994; Vol. 4, 1995; Vol. 5, 1997.

Clinical Research Design: Limited Systematic

Review of Five Diagnostic Categories

Betsy B. Singh, Sivarama P. Vinjamury, and Vijay John Singh

Om Tat Sat

                                                        

(Continued...) 

(My humble salutations to H H Maharshi ji,  Brahmasri Sreeman Lakshmi Chandra Mishra ji and other eminent medical scholars and doctors   for the collection)