Positive Health Online

Introduction

Ayurveda is appearing everywhere in the general media: little snippets about which famous star is using which treatment, what oil is good for you, which foods you should eat. What is this really telling us? That Ayurveda is growing? That people are more interested in their own well-being? That we don't know enough about what the food we eat is doing to us? A bit of all of these things, but not much about the real specifics of Ayurveda. This ancient medical-lifestyle system is being presented as something exotic or an esoteric enigma from the East. In fact, it is just the opposite. Ayurveda is utterly simple and grounded. It is not just one big detox, it is much more detailed and specific.

Ayurveda is a pregnant word; literally translated as 'science of longevity', it can also be described as 'the way of living with insight and balance'. As Charaka, the earliest written source on Ayurveda, says, "It is called 'ayurveda' because it tells us which substances, qualities, and actions are life-enhancing and which are not." It is more than just a medical system. It also includes philosophy, mythology, diet, yoga, mental refinement as well as techniques for gaining insights into how to live in total balance with nature. Ayurveda offers guidance to optimize healthy living. What makes Ayurveda so attractive is the fact that its lofty philosophical theories are so universal and that they do not stay as theories as they do in Western philosophy – the keystones to Ayurveda's effectiveness are rooted in the goal to inspire personal growth and freedom; the theories are for implementing, experiencing and rejuvenating us.

Interacting with Nature

Ayurveda grew up within an agrarian civilization among people living in direct contact with nature; their every movement and activity presented a challenge. How could they interact with this all-pervading natural force? They began to see an interrelated universe within which each individual was unique and yet a part of this whole. The now well-known concept of the macrocosm/microcosm became a part of their everyday experience. They experienced themselves as a part of the larger whole, and vice versa. They learnt to adjust their life to the changing seasons, changing weather as well as the different seasonal foods. It feels as though we are a culture having to relearn this fundamental truth about living in balance with the cosmic rhythms of growth and decline, day and night, youth and adulthood.

This challenge to maintain balance needed a vocabulary so that it could be explained. Nature saved the day again. Ayurveda is full of natural metaphors – heavy, light, wet, dry, hot, cold, rough, smooth, red, brown, pale, etc. – that are used to describe various qualities in the body, of diseases, in foods, in herbs. The digestive system is described as a fire, nervous system disorders are related to the erratic nature of the wind, and ginger root is described as being pungent, hot, dry and light. It is a system that brings nature back to us.

The Elemental Structures

The whole material universe is built from elemental structures or tattwa – space, air, fire, water and earth. These combine to form the individual constitutional supports – the doshas: vata, pitta and kapha. Your dosha can be your friend or your enemy. Dosha literally means enemy because of the observation that people with a certain constitutional disposition also had the tendency to accumulate more of that disposition. A water constitution tends to have problems with accumulating water (catarrh, oedema, etc.). This tendency could tip the balance between health and disease; as we all know it is quite a fine balance. If the doshas do not move out of you then they accumulate and this heralds disaster.

The tattwa also combine to make the seven tissues or dhatu (plasma, blood. muscle, lipid, bone, nervous and reproductive) that give structure to the body. These tissues give the framework for the channels or srotas (e.g. food channel, menstrual channel, etc.) to carry nutrition, fluids and impressions into the body and wastes (mala) and doshas out of the body. The elements also combine to make up the different tastes of sweet, salty, sour, pungent, bitter and astringent. These taste classifications are the tools of the herbalist's trade – they allow the practitioner to differentiate which herbs will be used in what proportion for which person. It is very specific. What the ancient Ayurvedic doctors learnt is that there is never an always – there is no hard and fast rule. Every diagnosis must be state specific. The disease is never treated, but only the person carrying the imbalance. They learnt that if your mini-universe can be put back in order then there will be no conflict with the larger universe.

Treatment Strategy

Panch Karma – Reducing Therapy

Ayurvedic physicians implement a treatment strategy, a chikitsa, to bring about a harmonious balance between the constitution (dosha), body tissues (dhatu) and the mind. This is simply to tonify (brimhana) where there is deficiency or reduce (langhana) where there is excess. Reducing therapy consists of cleansing the system. This is done in depth by the practice of panch karma – therapeutic emesis, purgation, enemas (two types) and nasal cleansing therapy)- the five activities that guide toxins into the digestive tract and rapidly out! But it does not stop there. And this is where Ayurveda differs from the Western naturopathic tradition and the popular fads for perpetual juicing, repetitive colonics and raw foods. Ayurveda does not just leave a clean ground, it nourishes and nurtures it to full strength. Following a good panch karma should always come a period of rebuilding and rejuvenation. This means tonic herbs and easily digestible food.

Shamana – Purification

Where panch karma is inappropriate (due to the strength of the patient, season, etc.) or unavailable, simple maintenance can be carried out. This is known as purification or shamana and results in the pacification of the disrupted dosha. It is the best prescription for health that I have ever heard of. Anyone can incorporate it into their life as it is both a medical treatment as well as an excellent preventative. The different parts of shamana can be included as a general way of life or just for a few days as and when required. It involves:

* deepana – enkindling the digestive fire;
* amapachana – removing toxins by burning them up;
* kshud nigraha – fasting;
* trut nigraha – abstaining from liquids;
* vyayama – exercise, yoga;
* atapa seva – sitting in the sunshine and heating up;
* maruta seva – sitting in the wind, doing breathing exercises.

Deepana – Enkindling the Digestive Fire

You enkindle the digestive fire like you build a fire – by laying little bits of well-prepared wood onto the flames: a big, damp log will put the fire out; light sticks will help the flames to burn. One of Ayurveda's central tenets is that 'like increases like'. Fire is increased by fire, and so, in order build the strength of the digestion, pungent spices such as dry ginger and long pepper are taken before meals. These pyro-herbs must be used constitutionally: ginger for vata, long pepper for kapha and the warming but not excessively hot coriander for pitta.

Then follow a sensible diet to optimize healthy flames!:

1. Avoid – cold things, ice, too much refrigerated water, salads in winter, eating without hunger;
2. Increase – light eating, warm meals, hot water, eating a small piece of ginger before a meal, having a short walk before you eat.

Amapachana – Removing Toxins

Whenever there is low digestive fire there is the accumulation of a substance known as ama. It is a sticky, thick, wet substance that blocks the channels of circulation (nutritional, nervous and mental); it lowers immunity and creates low energy and a foggy mind. This is an Ayurvedic toxin. We all have some in varying degrees. Modern examples may be high cholesterol, chronic fatigue syndrome, allergies, gallstones, arthritis, tumours and unstable blood counts. Ayurveda is very concerned about low digestive capacity. You should be as well! Ayurveda says 'sarvepi roga mandagni' – all diseases are caused by an underactive digestive system.

Amapachana uses many of the same herbs as deepana, but instead of taking them before a meal they are taken after and usually at double the dose. These hot herbs literally burn the ama. The indication for using pachana is when there is hunger but not enough 'fuel' to fan the digestive flames. These spices are the fuel. Of course, when there are already inflammatory conditions, such as ulcers, caution must be taken. Other signs are a tongue coating. Vata mixed with ama affects the colon, causing stagnation in the lower abdomen, constipation and bloating, and may progress to arthritis and sciatica. Pitta mixed with ama upsets the centre of the abdomen and stagnates the liver, gall bladder and small intestine as well as the blood as a whole. As pitta is hot and oily it creates hot and damp inflammatory conditions in these areas and can make people bilious, ulcerated and infected. Kapha mixed with ama stagnates in the stomach, chest, lungs and nasal area. Because the nature of kapha is to be wet, cold and heavy it has these effects in these areas, causing copious mucus, sinus congestion and lymphatic congestion.

Kshut Nigraha – Fasting

Fasting Ayurvedic style is actually quite pleasant (especially if you are quite vata). It is carried out to inspire a healthy hunger – a true need for food taken in a balanced quantity. Kshut nigraha means to 'hold onto your hunger'. Kapha types can do a literal fast. Although this is a great struggle for them as it challenges their tendency to hold onto things, it can quickly return balance to a system that can easily become stagnant. Pitta constitutions can do a liquid fast on fruit juices such as grapes or pomegranates. Vata people can do a short fast on hot liquid soups. Another soothing way to fast is to do a mono-fast. This is very useful if you have to work hard or are depleted in any way. The supreme food – kicharee, the original kedgeree – is specifically pacifying to all three doshas. It is made as follows:

Kicharee: 1/3 cup of mung dal and 2/3 cup of basmati rice (or other grain) simmered in 3-4 cups of water. Add 1/4 teaspoon of organic turmeric, ginger, cumin and coriander. Add seasonal vegetables – spinach, peas, or seaweeds, Shitake mushrooms for an all-round healing, healthy, agni (fire) enkindling meal.

While fasting it can be useful to sip hot drinks. Try spicy teas of black pepper, cinnamon and cardamom to burn ama, clear toxins and relax your contracting stomach.

Trut Nigraha – Fasting from Liquids

This means to fast from liquid intake. Extreme as this may sound, in water disease and kapha imbalance such as oedema, diabetes or kidney problems this can be very beneficial. It reduces the stress on the water channels in the body. It also has the emotional effect of confronting your inner thirst which, when out of balance, can overflow into desire. That grasping and holding onto sensual experience may manifest as a 'thirst' for food, drugs or extreme experiences. Fasting from liquid can help to redress this imbalance.

Vyayama – Exercise

Exercise is good for you. We all know that. But what sort of exercise? The modern phenomenon of sports massage therapists and physiotherapists as well as the steep increase in obesity and lack-of-exercise related diseases suggest that many of us are not taking the correct type of exercise in the appropriate proportion. Ayurveda supports all exercise as long as it is the one for you. A vata type pounding the heavy concrete streets is not approved! Kapha people can do more vigorous exercise and it should be done regularly. Yoga is always going to win from the Ayurvedic perspective – there are postures for everybody: lung expanding, metabolic raising exercises for kapha such as dynamic sun salutation, camel, bellows breath; abdominal focusing and stretching postures for pitta such as cobra, fish and alternate nostril breathing; and pelvic region opening and manipulating poses for vata, such as forward bend, squatting poses and humming bee pranayama.

Atapa Seva – Sunbathing

This practice of sitting in the sun sounds fantastic to us in sunny old Britain. It is also not without its caution sign in this modern age of ozonelessness. In fact, many conditions are specifically improved by sitting in the sun: eczema, psoriasis, arthritis, depression and water retention to name a few. Again, it all comes back to who is doing what, how and when. Pitta types must obviously take care in the sun – apply aloe vera gel.

Maruta Seva – Wind Bathing

This practice of receiving air is wonderful. How often do we just go outside and breathe? It specifically relates to the yogic practice of pranayama – extending the breath, of becoming inherently tuned into deep, slow breathing using a long exhalation. It is about imbibing prana – the life force that surfs on the breath deep into our tissues. Specific problems such as asthma, bronchitis and emphysema greatly benefit from this practice. Also people with a tendency to experience excessive anxiety and fear in their lives benefit from allowing breath into and out of themselves. It balances pranavahasrota – the channel carrying breath around the system. This has a direct effect on the nervous system.

Rejuvenation

After integrating these wise practices, where relevant, into your life you are ready for rejuvenation. In fact, these practices alone will rejuvenate you; they will improve your quality of life and your experience of life and they may well extend it.

Rejuvenation involves brimhana – building therapy – using tonic herbs such as Ashwagandha (Withania somnifera), Shatavari (Asparagus racemosus) and Bala (Sida cordifolia) to nourish all the tissues and build strength and immunity. It also involves building foods like nuts, ghee and dairy products. In Ayurveda, tonics are sweet, heavy and oily. This is in contrast to the Western concept of bitter tonics that are used 15 minutes before a meal to stimulate digestion. In Ayurveda the bitter flavour is considered depleting – it is used to clear infections and inflammation. The sweet flavour increases and builds the quantity and quality of the tissues and especially the immune system. So many of the modern wonder herbs that boost immunity are full of immune enhancing saponins and polysaccharides. Sweet is tonifying.

Case Study

A 32-year-old woman presented with insomnia as her primary complaint. On further enquiry she revealed that she was always bloated by the end of the day, only had a bowel movement every other day and had recently been aware of her heart racing when under pressure. She worked for a legal company working to tight deadlines. Her appetite was good; in fact if she did not eat regularly then she felt weak. Despite her hunger she did not always digest her food well. Her tongue was small and thin with a dry coating. Her pulse was thin and weak, with no depth and a little rapid.

I diagnosed high vata, with ama in the lower abdomen.

The high vata was fanning her digestive flames but not the digestive ability to absorb the food – hence the bloating. Her constipation came from anxiety and tension in the tissues. The primary complaint, her insomnia, was caused by stress and vata rebelling upwards instead of moving down and out.

The treatment strategy was first to normalize her bowel movements and digestion. She took triphala (a combination of amalaki, haritaki and bibhitaki) mixed with psyllium husks – four pills at night with one teaspoon of psyllium and hot water. She started to sip hot ginger water throughout the day and then to take two ginger pills after food. She was asked only to eat warm food and not to eat too much solid food (preferably soups) if she was under stress. To help calm vata she took a mixture of Ashwagandha, Indian valerian, Shatavari and fennel three times a day as a powder.

Her bowels soon normalized. The tight-chested awareness of her heart beat stopped all together. Her sleep was not settling down as quickly as hoped and so we introduced a warm sesame oil foot massage at night and a twice-weekly yoga class. This helped enormously. She has now learnt a simple meditation technique and feels much more in control of her life. In fact, she has taken control.

Final Comment

Ayurveda is about being who you are. It sounds simple. It's the constant adjusting that is so difficult!

Bibliography

Dr Sharma. Charaka Samhita. Chowkhamba Publishers. 1981-96
Murthy Srikantha. Bhavaprakasha. Krishnadas Academy. 2001
Ladd Vasant. The Complete Book of Ayurvedic Home Remedies. Piatkus Books. 1999.