History/Philosophy

Ayurveda is an ancient system of life (ayur) knowledge (veda) arising in India thousands of years ago. Ayurveda theory evolved from a deep understanding of creation. The great rishis or seers of ancient India came to understand creation through deep meditation and other spiritual practices. The rishis sought to reveal the deepest truths of human physiology and health. They observed the fundamentals of life, organized them into an elaborate system, and compiled India’s philosophical and spiritual texts, called Veda of knowledge.

Ayurveda was first recorded in the Veda, the world’s oldest existing literature. The three most important Veda texts containing the original and complete knowledge of Ayurveda, believed to be over 1200 years old, is still in use today. These Ayurvedic teachings were customarily passed on orally from teacher to student for over 1000 years. The wisdom of Ayurveda is recorded in Sanskrit, the ancient language of India that reflects the philosophy behind Ayurveda and the depth within it.

Ayurveda greatly influenced health care practices in the east and the west. By 400 AD Ayurvedic works were translated into Chinese; by 700 AD Chinese scholars were studying medicine in India at Nalanda University. Chinese medicine, herbology and Buddhist philosophy were also impacted by Ayurvedic knowledge. Having passed the test of experience it remains essentially the same now as at its inception, although numerous commentators over the centuries have added insight with their analyses.

The philosophy of Ayurveda teaches a series of conceptual systems characterized by balance and disorder, health and disease. Disease/health results from the interconnectedness between the self, personality, and everything that occurs in the mental, emotional, and spiritual being. To be healthy, harmony must exist between the purpose for healing, thoughts, feelings and physical action.

Ayurveda is a careful integration of six important Indian philosophical systems, many physical/behavioral sciences, and the medical arts. One verse from an ancient authority says Ayurveda deals with what is good life and bad life, happiness and misery, that which supports or destroys, and the measurement of life. It works to heal the sick, to maintain health in the healthy, and to prevent disease in order to promote quality of life and long life. Health is defined as an experience of bliss/happiness in the soul, mind, and senses and balance of the body’s three governing principles, seven tissues, three wastes, digestion, and other processes such as immune functioning. Health is not the absence of symptoms. Ayurveda has objective ways to assess each of these, pulse assessment being the primary means.

Its central tenet is that life is a combination of body, mind, senses, and spirit (more than a mind-body system). Nothing exists but for the pre-existence of and working of a Supreme Intelligence/Consciousness — an elemental, all-powerful, all-pervading spirit-energy that expresses Itself through and in the creation. Ayurveda seeks to know this aspect of life, the subjective (internal) as well as the objective (outer).

It is central to Ayurveda that the functioning of all creation, the mineral, plant and animal kingdoms, can be understood as the interactions of three fundamental energy complexes (erroneously called doshas). The three energies are vata, pitta and kapha — signifying the dynamic or mobile, energetic, nonmaterial aspect of nature; the transformative, intelligence aspect; and the structural, physical aspect respectively.

Vata governs respiration, circulation, elimination, locomotion, movement, speech, creativity, enthusiasm, and the entire nervous system. Pitta governs transformations such as digestion and metabolism, vision, complexion, body temperature, courage, cheerfulness, intellection and discrimination. Kapha governs growth (anabolic processes), lubrication, fluid secretions, binding, potency, patience, heaviness, fluid balance, compassion, and understanding in the organism. All have physical expressions in the body.

In the human physiology these three energies tend to interact in a harmonious and compensatory way to govern and sustain life. Their relative expression in an individual implies a unique ratio of functioning of these governing principles according to each person’s unique DNA (vta-pitta-kapha ratio) determined at conception. This is body or constitutional typing, called prakruti. There are seven types — vata type, pitta type, kapha type and combinations thereof.

Prakruti yields two important understandings. A person has a permanent or stable nature for the entire life and efforts to maintain or change physiology must keep this balance point in mind. In addition each type will suggest an area tending to go out of balance, a disease tendency, requiring lifelong attention to maintain balance. A vata type naturally tends to constipation, arthritis, anxiety; a pitta type tends towards inflammations, infections, ulcers; and kapha types tend to overweight, diabetes, congestive disorders, etc. The implication of pakruti is that it helps explain why people react differently to the same things. The medical implication for this is that certain people will have a natural predisposition or sensitivity to certain medicines and this can be predicted.

Why does imbalance occur? It occurs because one or more of the energies or elements described above gets increased quantitatively or altered qualitatively. There is no human experience, whether a thought, an emotion, the climate, food, lifestyle, etc. that does not have at least one of the twenty qualities which, by its action, yields an effect in the physiology.

Classically, the nature of the causative factors are the result of mistakes of intellection (failure to perceive things as they are), inappropriate use of the sense organs, and mistakes of time (doing even proper things at the wrong time). While DNA gives the body one set of instructions, the life experiences at every moment are giving the governing principles perhaps another message. Since these three governing principles are nothing but energy themselves, they can be influenced -—increased or decreased — by like or opposite energies. Heat increases pitta, dryness increases vata, and liquid increases kapha, etc. Thus imbalance is the continued experience of some stimulus — mental, emotional, or physical, real or imagined - that overwhelms the body’s ability to maintain its identity, its prakruti or vata-pitta-kahpa ratio. When a stimulus and a system have the same energy the stimulus promotes more of its value in the system. Like increases like which can lead to imbalance even though they are not necessarily unhealthy influences in themselves — properly cooked organic food when taken in excess or at the wrong time promotes imbalance. With time and chronicity and some defective space in the organism (from genes, prior disease, trauma, congenital defect, etc.), disease can develop and manifest in the weak organ or tissue. When disease begins to manifest the governing principles are called doshas, meaning impurities, which can pollute or contaminate the physiology.

Ayurveda has three broad themes of treatment. These are elimination therapies (shodana or Panchakarma), pacification therapies (shamana), and nourishing therapies (bhrimana). Panchakarma includes nasal administration for vata, pitta and kapha, medicated enemas for vata, purgation and blood letting for pitta, and vomiting for kapha. Symptomatic treatment of this type of disease is not effective in bringing a cure. Pacification strategies, or balancing with opposites, include diet, lifestyle, herbs, meditation, yoga, and so on. Nourishing therapies are used when strength or emaciation issues are being treated.

The model of disease development in Ayurveda describes six stages. Knowledge of the symptomotology of each stage for each dosha enables the practitioner to properly diagnose and treat the disease. This knowledge shows how a common cold becoming chronic may become asthma or congestive heart failure; or how multiple sclerosis starts with worry, constipation and the need to control and ends with degenerative changes in challenged nervous tissue. The classification of the western disease scheme manifests in the fourth stage of the development of disease according to Ayurveda. This knowledge enables the Ayurvedic practitioner to prevent the serious diseases indicated in the western classification of disease.

The theory of healing and maintaining balance is based upon the corollary to the law of karma (nature is governed by a universal law of cause and effect, with the physical processes inside the body governed by the same laws operating outside the body). Opposite qualities coming together in a system reduces the quantitative and qualitative expression of each factor in that system. Hence, when there is excess heat in a system, the system will become cooler by adding cold entities. This is important for inflammatory conditions, for example. If the system is liquid, adding dry substances will make the system less liquid. This is the essential action of diuretics and helps promote weight loss. It is almost always suitable to apply this strategy, whether the imbalance involves systemic or local changes in the doshas, debility, toxicity/poisoning, etc.

As a general rule, however, quantitative systemic increases of the doshas, such as gas, hormones, mucus, and calcifications, are treated with elimination therapies (Panchakarma). When there is excessive material present in one or more of the three governing factors (vata, pitta or kapha), Panchakarma eliminates these factors directly. A metaphor for how and why this works has been offered in the ancient classics: by eliminating these excess substances from their sites of production and accumulation, an emptiness in the home site is created and the body is able to naturally rebalance itself. A new physiology is prompted and supported by these elimination therapies.

Qualitative changes, localized changes of the doshas such as a sprained ankle or carpal tunnel syndrome, are treated by applying opposites (pacification) from diet, lifestyle, herbs, etc. The general role of pacification is subordinate to the elimination therapies in Panchakarma but it is still necessary for physiological balance to be achieved. Panchakarma utilizes both strategies simultaneously.

In the case of toxicity, detoxifiers and digestives are employed. Disorders of the mind and spirit require mental and spiritual specific medicines in addition to bodily specific medicines. These include mantras, pujas (rituals and recitation), and other spiritual practices. Be in the company of the wise is one such behavioral prescription. These techniques operate directly on the soul/consciousness itself; hence they are effective for this purpose.

When to use it

The field of expertise of Ayurveda is broad and deep, as is its pharmacopoeia. It is valid for the chronic, sub-acute, acute, symptomatic and asymptomatic. The central premise that no disease occurs except through the operation of the governing principles (vata, pitta, kapha), and that each can be manipulated by even diet only, makes all diseases amenable to successful treatment by Ayurveda. This does not imply that Ayurveda can cure all disease in all stages of progression. Some diseases may be managed only, such as congenital defects, dormant poliomyelitis, etc. The science of drugs is complex but extensive. This field embraces the mineral, plant and animal kingdoms. The most potent of Ayurvedic drugs are not permitted for use here in the U.S.

Training

There are definite academic standards in India. BAMS (Bachelor of Ayurvedic Medicine and Surgery), MASc, etc. In the U.S., however, those who "practice" Ayurveda have often only attended weekend workshops. Presently, the following are the main groups offering coursework in some form of Ayurveda: The Ayurvedic Institute offers an eight-month Academic Studies Program, Gurukula (open-ended study) and Summer Intensives; Maharishi Ayurveda offers a Physician Training Program and other degree/non-degree studies; the California College of Ayurveda; National Institute of Ayurvedic Medicine; International Ayurvedic Institute; and Banaras Hindu University in Florida. None of these offerings presently meets the minimum criteria for a BAMS degree in India.

Ayurveda itself is not recognized in the U.S. and in every medical modality there are rules of practice. While the knowledge of Ayurveda has stood the test of time and use for thousands of years, there is at present very little "objective scientific" verification of its effectiveness. This remains a hindrance to its integration into the health care system in the United States.

References:

Bhishagratna, Kaviraj Kunjalal, editor-translator. Sushruta Samhita. 4^th ed., Chowkhamba Sanskrit Series Office: Varanasi, India, 1991.

Dahanukar, Sharadini and Thatte Urmila. Ayurveda Revisited-Ayuraveda in the Light of Contemporary Medicine. Popular Prakashan Private Litd, Bombay, India, 1989.

Murthy, K.R. Srikantha, translator. Sharngadhara Samhita: A Treatise on Ayurveda. Chaukhambha Orientalia: Varanasi, India, 1984.

Sharma, Priyavrat V., editor-translator. Caraka Samhita. Chowkhamba Sanskrit Series Office: Varanasi, India, 1981-1994.

Vagbhata. Ashtanga Hridayam. Translated by K.R. Srikantha Murthy. Krishnadas Academy: Varanasi, India, 1991-1992.