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INTRODUCTION TO AYURVEDA

Ayurveda is the most ancient codified system of medicine based on its

own unique holistic principles with due scientific temper. It has an unbroken tradition of

practice in India for several thousand years. Its origin goes back to the vedic ages. It is

considered as the Upveda of Atharveda. It has holistic approach in the management of

disease and promotion of health. It is the only Science which lays more emphasis on

preventive and promotive health, then comes the curative aspect. The Ayurveda is derived

from two words 'AYU' and 'VEDA'. Ayu means life (bio-fire) and Veda mean science or

knowledge. Thus Ayurveda means that science that deals with the life. The main goal of

Ayurveda is to make a healthy society. According to Ayurveda the health is a state of

equilibrium of Dosas, Agnis, Dhatus, Malas and body functions along with spiritual,

sensorial and mental wellbeing.

Presently it is an official system of medicine with great acceptability

among the masses having a huge infrastructure in the research. Recent attempts of

developing scientific evidence for the efficacy and safety of its medications have been

encouraging. So there is a need of active attempt of mainstreaming and maximization of

its utilization at global level.

Ayurveda divided into 8 major clinical specialties as-

1. Kayachikitsa (Internal Medicine)

2. Salyatantra (Surgery)

3. Salakyatantra (Eye and E.N.T. diseases)

4. Kaumarbhritya (Pediatrics, Obstetrics and Gynecology)

5. Agadatantra (Toxicology)

6. Bhutavidhya (Psychiatry)

7. Rasayantantra (Nutrition and geriatrics)

8. Vajikarana (Sexology and Reproduction)

Ayurveda follows a comprehensive holistic approach considering life as a three

dimensional bio-unit integrally linked inside with the three system of energy and

externally with three master ecological factors adopting a tri-triangular model as depicted

below.

SUN

PITTA

TEJA

OJA PRAN

KAPHA VATA

WATER AIR

According to Ayurveda, the living body is composed of five basic elemental substances

named as- (1) Akasa (Ether)

(2) Vayu (Air)

(3) Teja (Fire)

(4) Jala (Water)

(5) Prthvi (Earth).

These five physical elements constitute the three essential Bio-components of the

living body which are termed as the Tridosas viz., Vata, Pitta and Kapha. It may be

approximately understood that the gross structure of the body (solid and liquid) is

constituted by the Kaphaja fraction of the Tridosa factor in the total body composition.

The entire physico-chemical phenomenon including the biochemical and metabolic

activities as well as the endocrine functions are the attributes of Pitta. And Vata is

responsible for the physical activity or the motion in the organism.

These three Dosas have contradictory physical and physiological characters and

so they are capable of antagonizing the activities of each other, thus maintaining an

inherent equilibrium. The total spectrum of their physical and physiological characters is

reflected in the final constitutional set-up of a man, which is known as Dosic Prakriti or

the psychosomatic constitution of a particular individual. According to the predominance

of one or the other of the three Dosas in the body composition, the Prakriti may be

predominently of three types viz., Vatika, Paittika and Kaphaja. Thus Ayurveda

recognizes three basic human types in which the total living population can be classified.

The Ayurvedic classics have put a great emphasis on this classification of human types

because each of these types requires a different type of handling, specific to each Dosic

Prakriti, in the preservation of health, prevention and treatment of diseases.

A further development of the compositional concept of living body is the re-

categorization of the morphophysiological structure of the body into seven Dhatus or the

seven basic tissues which are named as Rasa (Plasma), Rakta (Blood), Mamsa (Muscle),

Meda (Adepose), Asthi (Bone), Majja (Marrow) and Sukra (Semen). There is a very

interesting concept in Indian system of medicine about the evolution of these seven basic

tissues. Ayurveda believes, that Rasa is the first Dhatu or tissue which is formed in the

body, a part of which when matured gets, transformed into Rakta. Similarly Rakta gets

transformed into Mamsa, and Mamsa into Meda and so on. Sukra is supposed to be the

last Dhatu or tissue to be formed in this sequence. All these tissues receive their nutrition

through their precursor Dhatu or directly from Posaka (nourishing) Rasa. The

quintessence of all the seven body tissues is called Ojas or vital essence. Ojas is a very

specialized vital biomaterial which is responsible for sustenance of life and immunity.

Ojas is the real bio-strength of the body and it represents the immune system. Bala,

immunity has been considered to be of three types:

1. Sahaja Bala or natural immunity

2. Kalaja Bala or the age time specific immunity

3. Yukti krita Bala i.e. artificially induced or acquired immunity.

The Ayurvedic concept of the evolution of a disease is remarkably wide.

According to Ayurveda, Vyadhi or disease has been defined as the state in which both the

body and mind are subjected to pain and misery. Whatever may be the nature of the

exciting causes of the disease the actual factors which become excited and imbalanced

are the three Dosas and thus basically disease process may be correlated with the three

basic constituents of the living body which have been referred to as Vata, Pitta and

Kapha.

In principle, the Ayurvedic approach to the treatment of a disease consists of two

major procedures-(1) Sansodhana Chikitsa (Purificatory Therapy)

(2) Sansamana Chikitsa (Pacificatory therapy).

Sansodhana Chikitsa is the radical treatment of a disease and is supposed to

eradicate or eliminate the vitiated Dosas from the body thus completely preventing or

curing the disease. Sansamana Chikitsa is the conservative treatment which consists of

conservative measures like Langhana (fasting), Pacana (digestion) etc. by administration

of appropriate drugs designed for subsiding or alleviating the vitiated Dosas thus

preventing temporarily or subsiding a disease.

It is believed that the diseases cured by Sansodhana therapy, never relapse while

the diseases cured by, Sansamana treatment may recur. However, the comprehensive

treatment of a disease has to consist of both these types of treatments ie. Sansodhana and

Sansamana at appropriate time.

The Sansodhana treatment consists of a number of physicophysiological

measures advocated in the treatment of a disease. The so-called Panchkarma therapy is a

similar Sansodhana regimen. The Panchkarma Therapy can be divided in three major

parts -

(1) Purva Karma or the preparatory measures like Snehana (oleation) and Swedana

(fomentation) etc.

(2) Pradhana Karma or the main Sansodhana measures like Vamana (emesis), Virechana

(purgation), Anuvasana (oily enemas), Asthapana (medicated enemas) and Sirovirechana

(snuffing) etc.

(3) Paschata Karma consisting of a special post-therapy dietetic regimen known as

Sansarjana Krama. A great importance has been attached to Panchkarma therapy in

Ayurvedic classics. As a matter of fact the indispensable place of Panchkarma measures

in Ayurvedic management of patients is a fundamental character of Ayurvedic system of

medicine. It may not be exaggeration to say that according to the Ayurvedic classics, the

therapeutic measures comprehended by Panchkarma therapy are the sheet anchor in the

Ayurvedic approach to the treatment of the diseases. These measures have also been

indicated to be utilized in the methods calculated to the preservation, maintenance and

conservation of health and promotion of longevity. They also form a part in the regimen

of Swastha Vritta or the preventive medicine as they are indicated as prophylactic

measures in the context of epidemics and pandemics.

"Besides the application of Panchkarma therapy in the treatment of disease stated

as a rule these measures are indicated as preparatory procedures before institution of

surgery and also before the administration of Rasayana or rejuvenation therapy and

Vajlkarana or the therapy for the promotion of virility, sexual stamina and productivity.

Thus Panchkarma therapy has a direct reference to both, the healthy as well as to the

ailing.

It would be seen that in course of time possibly since a thousand years the

Panchkarma therapy in its complete form has ceased to be in practice. Most of the

Ayurvedic practitioners adopt conservative treatment i.e. Sansamana treatment with the

help of various drug therapies. However, even today, there are Ayurvedic practitioners in

certain parts of our country especially in Kerala who are successfully practicing

Panchkarma therapy and claim a major percentage of cure in a number of difficult

diseases like arthritis, paralysis etc. This kind of treatment is now rapidly spreading in the

north too and is becoming popular abroad.

The great emphasis put on the utility of Panchkarma therapy and the successful

practice of these measures by many physicians in certain parts of the country emphasize

the need of instituting an enquiry to evaluate the consequent phenomenon of this therapy

specially in the context of recent developments in the field of physiology, biochemistry,

immunology and physical medicine. This will establish the scientific basis and the

rationale of this therapy by working out the biological events caused by the application of

these measures in the living organism. Such a study will make the Panchkarma therapy

more useful and popular.

Swasth Vritta - Panchkarma has specific application in the care of Tridosika Rhythm of Sadritu i.e. six seasons. Ayurveda describes six seasons round the year and each season is characterised by specific rhythm viz. Sanchaya (accumulation), Prakopa (aggravation) and Prasama (remission) of the three Dosas ie. Vata, Pitta and Kapha. The period of Prakopa (aggravation) of a Dosa warrants Sansodhana/elimination of the aggravated Dosa. In other words Sansodhan (Vaman, Virechana, Basti etc.) are indicated only in Prakopa Kala. The Sanchaya Kala of different Dosas does not warrant Sansodhana Karma. The desired regimen for the Sanchaya Kala should comprise of Deepana, Pacana, and Yukta Ahara-Vihara ie. appropriate life style intervention against the nature of rhythm of a particular Dosa. Similarly Prasama kala or the period of remission too does not need actual Sansodhana Karma. The following table summarizes the Tridosika Rhythm and indication of specific Sansodhana Karmas which may be used as a guideline for Swasthavrittaka Sansodhana Karma i.e. preventive Panchkarma.

Sadritu Six Seasons

Month Sanchaya Prakopa Prasaman Karma Indicated

ADANAKALA

Shishir (Winter)

Magh Phalgun (Jan,Feb)

Kapha

-

Vata

Anti Kapha Ahara, Vihar Dipan, Pachana

Vasant (Spring)

Chaitra Vaisakha (Mar, April)

- Kapha Vata Vamana

Grishma (Summer)

Jayestha Asadha (May, June)

Vata - Kapha Anti Vata Ahara Vihara Samana Karma

VISHARGAKALA Varsha (Rainy)

Shravana Bhadrapada (July, Aug)

Pitta Kapha

Vata

-

Snehana Swedana Basti

Sharada (Autumn)

Aswin Kartika (Sep., Oct.)

- Pitta Kapha

Vata Virechana

Hemanta (Earty Winter)

Agahan Pousha (Nov., Dec.)

Kapha Vata Pitta Basti

Rasayana and Rejuvenation - Rasayana therapy of Ayurveda essentially refers to the process of tissue nourishment and rejuvenation. The Rasayana effect retards ageing and prolongs life. The Rasayana remedies encompass a range of drugs, diets and life style interventions which promote nutritional status of the body. Such an effect cannot succeed unless the channels of the body are clean and hence Panchkarma Therapy is an essential component of Rasayana Therapy. Some of the Rasayanas themselves have biopurifactory effect.

Biopurification, Rasayana and Kayakalpa -

The full Panchkarma therapy followed by appropriate Rasayana Krama

undertaken for the purpose of Vayah Sthapana or rejuvenation is called Kayakalpa. Such

an intensive Rasayana Therapy was called Kutipravesika Rasayana in classical age as

described by the Samhitas of Ayurveda. The classic texts describe a specially designed

Trigarbha kuti or a Tri-spaced therapy chamber for the purpose.

Panchkarma in Chronic Diseases -

Besides Swastha Vritta and Rasayana Karma the next important area, where

Panchkarma therapy is essential, falls into the the realm of a range of chronic diseases.

Chronicity of a disease is an important entity warranting special consideration in the

understanding of the disease and its total management. The central feature of all chronic

long standing diseases is Immunopathology. All pathologies whether they are initially

infection, traumatic, metabolic or psychosomatic; lead in due course of time to an

immunopathological complex. Due to inherent nature of prolonged standing, every

disease turns to immune disorder and immunopathology and there occurs significant Bala

Dosa. Disorders of Oja Bala are of three kinds.

1. Oja Vyapat

2. Oja Visransa

3. Oja Kshaya.

The disorder of Ojabala is to be rectified with the help of Rasayana therapy.

Besides the immunopathology which is the hallmark of chronic diseases, the next

important feature of chronic diseases is Shroto-distortion i.e. distortion of channels of the

body which warrant cleansing therapy to clean the channels so that the nutrients,

medicaments, energy and inpulses may flow freely in the system. For this, Sansodhana

through Panchkarma therapy is indicated. A chronic disease cannot be managed without

the combined consolidated use of Panchkarma and Rasayana. Sansodhana and Rasayana

therapy suitably added to the Samana treatment is expected to afford a cure potential for

chronic disease.

A chronic disease complex with immunopathology is the essential outcome of a

multifaceted reaction of the body to the antigenic material present perpetually in the

system because of a continued ailmant and many other microcosmic and macrocosmic

factors (Individual and Environmental factors). Such a reaction may manifest in three

ways i.e. through any of the three Roga Margas viz.

1. Vahya Marga i.e. skin and circulation such as in cases of chronic skin diseases like

urticaria, eczema and psoriasis etc.

2. Madhya Marga i.e. joints and bones such as in case of Arthritis, Rheumatoid disease

etc.

3. Abhyantara Marga i.e. Visceral Organs such as in case of Bronchial Asthma and

similar other conditions. None of such chronic diseases can be cured by any treatment

belonging to any system of medicine, modern or traditional because of the perpetual

pathology. The routine treatment in such conditions has to be merely palliative and life

long as is often seen in clinical practice. The only hope of cure could be the radical

treatment, through Panchkarma and Rasayana therapy added to appropriate Samana

treatment comprehensively planned utilizing Diet, Drug and Life Style interventions.

So in the view of above facts the Panchkarma therapy is essentially a -

1. Preventive, curative and health promotive therapy.

2. The diseases cured by palliative (Saman) therapy can reoccur but those cured by

biopurificatory Panchkarma therapy seldom reoccur.

3. Palliative treatment (Saman Chikitsa) works better after Sodhan (Panchkarma)

therapy.

4. For promotion and prevention of health, the therapy is carried out according to season,

age, habitat and time. So it has got Immune buster and diseases prevention action and

increases healthy life span.

5. The famous word ' Kaya Kalp' is used for this therapy as, if it done on regular basis,

according to season and age etc., helps to delay the process of ageing, promoting health,

as it cleans every cell and decreases toxins and free radicals in body.

6. Panchkarma is essentially a prepatory procedure for Rasayan and Vajikarma

(Rrejuvenative) therapy. Thus cures infertility, impotency and sterility and enhance

sexual vigor.

7. Its effect is almost permanent on general immunity. As it improves both mental and

physical health, thus makes a person more active, youthful, with high sexual vigor and

good quantity and quality of Semen.

8. It has got Rehabilitative and Physiotherapeutic effect.

9. Cures specific disease by cleaning the Macro-channels (blood vessels, lymphatic etc.)

and Micro-channels of body (Cleans every cell of the body) thus eliminates the free

radicals and Toxins (malas) from the body.

MAJOR SPECIFIC APPLICA TIONS OF SANSODHAN THERAPY-

Panchkarma therapy is an integral part of Ayurvedic treatment and as such has its

role in every therapeutic situation. In principles, Sansodhana is a prerequisite for all

Samana treatments. However the major contemporary specific areas of application of

Panchkarma Therapy are-

1. Promotive and Preventive Health care as a component of Swastha Vritta regime.

2. as an integral pre-requisite of Rasayana Therapy and Kayakalpa.

3. Curative Treatment of Chronic Diseases.

For past 15-20 years the demonstration of the prevalence of cellular immune

deficiencies in Cancer, ageing, autoimmunity, and infectious diseases such as Acquired

Immune Deficiency Syndrome (AIDS) has generated interest in the clinical use of

immunotherapeutic procedure.

Some Immunomodulatry factors are produced by Panchkarma, which can

enhance the immunological responsiveness of an individual by interfering with its

regulatory mechanisms. Thus very effective in:-

Chronic infectious diseases like Rheumatism, Psoriasis, Bronchial asthma,

Eczema, Cancer, particularly disorders involving the lymphatic system.

Immunodeficiency disorders such as Acquired Immune Deficiency Syndrome (AIDS).