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)
