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Ayurveda-literally "Science of Life"-is based on the twin principles of wholeness and balance. As a holistic healing tradition, Ayurveda recommends treating the "whole" person-body, mind, senses, emotions and spirit-instead of following the "one-cause-one-cure" principle and focusing on the symptoms of the moment. The premise is that if the roots are nourished and watered, the plant will flourish. Diet, sleep, lifestyle, daily and seasonal routines and internal cleansing are just as, or more, important than herbs and potions in order to maintain good health. And Ayurveda is equally about maintaining or preserving good health as it is about treating disorders - "Swaasthasya Rakshanam" is one of the goals of Ayurveda.
The Five Elements
Ayurveda states that everything in this universe, including the human body is composed of five basic elements.
PRITHVI - Earth
JALA - Water
AGNI - Fire
VAYU - Air
AKASH - Space
These five elements are the basic constituents of everything on Earth. In the human body, space is present where there is an empty, hollow area (nostrils, mouth, ears, throat, lungs, stomach). Air provides movement - such as in the joints, intestine or heart. Fire is present in all metabolic activity; and water in all fluids such as plasma, blood, lymph and saliva. Earth is represented in any solid, heavy part of the body like fat muscles, skin and nails.
Tridosa In humans, the five elements combine to produce three primary life forces, or "biological humors". The Ayurvedic term for these forces is Dosha. Because there are three of them, they are referred to as the tridosa (tri meaning three), Vata, Pitta and Kapha.
Like any other object each dosha is also made of the five elements. However they have predominance of one or more elements as described below:
Vata - air and space
Pitta - fire
Kapha - water and earth.
The doshas can be understood from their qualities and actions in the body. For example, people with a Vata dosha display characteristics and qualities related to the space and air elements - active, restless, mobile. Those with a Kapha dosha (earth and water) are usually very solid, stable and slow.
The Tridosa theory is a basic principle of Ayurveda. All humans have the three doshas, although there is always a predominance of one or more dosha. This predominance of dosha and their unique proportion, in a person, is responsible for her or his unique nature. This unique nature of an individual is called prakriti or constitution. Knowing the constitution assists both in preventing as well as curing diseases.
Other important basic principles of Ayurveda are:
• Dhatus- These are the basic tissues which maintain and nourish the body. There are seven dhatus - plasma, blood, muscle, fat, bone, marrow and reproductive fluid. The quality and quantity of each dhatu and its balanced functioning is very important for good health.
• Mala- These are the waste materials produced as a result of various metabolic activities in the body. The main mala are urine, faeces and sweat. Proper elimination of mala is equally important for good health. Accumulation of mala causes blockages in the body resulting in manifestation of diseases.
• Srota- These are channels which are responsible for transportation of food, dhatus, malas and doshas Proper functioning of srota is necessary for transporting different materials. Blockage of srota causes many diseases.
• Agni- Agni means fire. According to Ayurveda there are 13 types of agni in the body which carry out different metabolic activities. The agni can be compared to different types of enzymes responsible for digestion and metabolic activity.
All these factors should function in a proper balance for good health.
Prakriti Parikshan: Analysis of the constitution & psychosomatic personality. Based on the above factors and their varying presence in each human being, an investigative analysis is done to arrive at the `Prakriti' of each individual. This forms the basis of the treatment especially in chronic diseases or major health problems.
Published with the kind permission of Dr. Sachin Dua
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Text and History of Ayurveda - A Hindu Heritage of Healing
The Origins - The Myths and Legends
Indian art of healing is almost as old as the religion of Hinduism itself. Ayurveda attained a state of reverence and is classified as one of the 'Upa-Vedas' - a subsection - attached to the Atharva Veda. The Atharva Veda contains not only the magic spells and the occult sciences but also the Ayurveda that deals with the diseases, injuries, fertility, sanity and health. However, the secrets of life were revealed even in the first Veda, the Rg Veda. The five elements of creation, the Pancha-maha-bhuta, namely the earth, water, fire, air and ether form the basis and essence of all life forms. Out of these arise the three doshas, namely Vata, Pitta and Kahpa. These three doshas unfortunately have been crudely translated as air, bile and phlegm. But the Ayurveda texts, which treat all diseases based on the disequilibrium of these three doshas, are lot more complex. The knowledge consists of three aspects of A-yurveda known as the Tri-Sutras - cause of illness (etiology), symptomatology of disease process and treatment of disease.
Ayurveda incorporates all forms of lifestyle in therapy. Thus yoga, aroma, meditation, gems, amulets, herbs, diet, astrology, color and surgery etc. are used in a comprehensive manner in treating patients. Treating important and sensitive spots on the body called Marmas is described both in Ayurveda and in Dhanur Veda (another Upa-Veda dealing with martial arts and military science). Massages, exercises and yoga are recommended.
The venerable state of the art of healing was enhanced by the myths and legends of the god of healing, Divodasa Dhanvantari, a patron deity of medicine. The science of medicine was said to have been taught to the sages by Divodasa Dhanvantari, who later wrote them down in the text of Ayurveda. According to another legend, the knowledge of healing originated from the creator Brahma himself, who taught it to Daksha (protector of all beings), who in turn taught it to Indra. When diseases and death became rampant, a gathering of the great sages was held in the Himalayas. Sage Bharadvaja volunteered to learn the craft from Indra. He then taught the science to his pupil Atreya, a legendary healer, who then transmitted this knowledge through his disciples. Compilations of this knowledge are called the Ayurveda. Other patron saints of medicine were the twins called Ashvins, who were patrons of eyesight and were physicians that treated the gods themselves.
Atreya held a competition among his six disciples namely Agnivesha, Bhela, Jatu-karna, Para-shara, Ha-ri-ta, and Ksha-rapa-ni. Each established a school of his own and taught the traditions of Ayurveda.
Texts of Ayurveda
Compilations of Atreya and Agnivesha are lost. The knowledge we now have is by three surviving texts of Charaka, Sushruta and Vaghbata. Charaka (1st century A.D.) based his Samhita on Agnivesha Samhita. Sushruta (4th century A.D.) based his Samhita on the Dhanvantari School of Ayurveda. Vaghbata (5th century A.D.) compiled the third set of major texts called Ashtanga Hridaya and Ashtanga Sangraha. The former is more succinct and is based on both Atreya and Dhanvantari schools. Atreya's School of Physicians and Dhanvantari's School of Surgeons became the basis of Ayurveda and helped organize and systematically classify into branches of medicine and surgery.
Sixteen major supplements (Nighantus) were written in the ensuing years - Dhanvantari Bahavaprakasha, Raja and Shaligrama to name a few - that helped refine the practice of Ayurveda. New drugs were added and ineffective ones were discarded. Expansion of application, identification of new illnesses and finding substitute treatments seemed to have been an evolving process. Close to 2000 plants that were used in healing diseases and abating symptoms were identified in these supplements.
Dridhabala in the 4th century revised the Charaka Samhita. The texts of Sushruta Samhita were revised and supplemented by Nagarjuna in the 6th century in a treatise called Upa-hridaya.
There developed eight branches/divisions of Ayurveda:
1. Kaya-chikitsa (Internal Medicine)
2. Shalakya Tantra (surgery and treatment of head and neck, Ophthalmology and Otolaryngology)
3. Shalya Tantra (Surgery)
4. Agada Tantra (Toxicology)
5. Bhuta Vidya (Psychiatry)
6. Kaumara bhritya (Pediatrics)
7. Rasayana (science of rejuvenation or anti-aging)
8. Vajikarana (the science of fertility).
The dates of the authors are still very controversial. Some historians place the lifetimes of Atreya, Charaka and Sushruta in the Vedic period, around 600 B.C. These are based on the references to the authors that seem to have surfaced in earlier texts than the proposed dates mentioned in this article. When the history is completely rewritten and there is no more controversy, everyone hopefully can agree upon a constant date. Until then we should not worry about the timeline and only admire the scientific approach these ancient authors followed, striving to perfect the art of healing that could rival a modern scientific research.
Many modern medications were derived from plants alluded to in Ayurveda texts. The oft cited example is that of 'Rauwolfia serpentina' that was used to treat headache, anxiety and snakebite. Its derivative is used in treating blood pressure today.
Two areas of contribution of Indian physicians were in treating snakebite and prevention of small pox. Detailed account of steps to be followed after a poisonous snake bite including application of tourniquet and lancing the site by connecting the two fang marks and sucking the poison out is described. A decoction of the medicinal plant Rauwolfia serpentina is next applied to the wound.
A form of vaccination for small pox was commonly practiced in India long before the West discovered the method. A small dose of pus from the pustule of small pox lesion was inoculated to develop resistance. Such methods of building immunity were practiced in other fields as well, against other diseases in order to develop antibodies against the infecting organism or a poison.
Charaka Samhita
Charaka was said to have been in the court of the Kushana king, Kanishka during the 1st century A. D. Some authors date him as far back as the 6th century B.C. during Buddha period. The sacred trust between physician and patient was held in high esteem by Charaka and patient confidentiality, similar to the Hippocratic Oath, was deemed the proper conduct for a practicing physician. Charaka also told us that the word Ayurveda was derived from Ayus, meaning life and Veda. Nevertheless, according to Charaka the word Ayus connotes more than just life. Ayus denotes a combination of the body, sense organs, mind and soul. The principles of treatment in Charaka's teachings took a holistic approach that treated not just the symptoms of the disease but the body, mind and soul as single entity.
 This undated photo released by Prasad Ushus shows Sabine Steiger, 28, an anthropology student from Vienna, left, as she tries the "nasya" treatment at the Athreya Ayurvedic Resort in Kottayam, India. To perform this treatment, which is aimed at clearing the head, the therapist lights a cloth soaked in camphor and other substances, and the patient inhales the smoke. In the West, Ayurveda is perhaps most closely associated with oily spa massages, but a trip to India uncovers Ayurveda's deep roots and diverse techniques. Ayurveda's tools include herbal extractions, a wide range of body treatments, a light vegetarian diet and yoga.AP Photo |
Ayurvedic diagnosis and treatment is traditionally divided into eight branches (sthanas) based on the approach of a physician towards a disease process. Charaka described them thus:
1. su-tra-stha-na, general principles
2. nida-na-stha-na, pathology
3. vima-na-stha-na, diagnostics
4. shari-ra-stha-na, physiology and anatomy
5. indriya-stha-na, prognosis
6. chikitsa--stha-na, therapeutics
7. kalpa-stha-na, pharmaceutics
8. siddhi-stha-na, successful treatment.
Detailed accounts of various methods of diagnosis, study of various stages of symptoms and the comprehensive management of debilitating diseases like diabetes mellitus, tuberculosis, asthma and arthritic conditions are to be found in the Charaka Samhita. There is even a detailed account of fetal development in the mother's womb, which can rival descriptions of modern medical text books. Charaka lists more than 500 remedies in his Samhita.
Charaka also wrote details about building a hospital. A good hospital should be located in a breezy spot free of smoke and objectionable smells and noises. Even the equipment needed including the brooms and brushes are detailed. The personnel should be clean and well behaved. Details about the rooms, cooking area and the privies are given. Conversation, recitations and entertainment of the patient were encouraged and said to aid in healing the ailing patient.
Sushruta Samhita
Sushruta was a surgeon in the Gupta courts in the 4th century A.D. He followed Dhanvantari School of Surgery and is one of the earliest surgeons of recorded history. Though Indian mythology is full of accounts of healing through transplantation of head and limbs as well as eye-balls, Sushruta Samhita is the first authentic text to describe methodology of plastic surgery, cosmetic and prosthetic surgery, Cesarean section and setting of compound fractures. Sushruta had in his possession an armamentarium of 125 surgical instruments made of stone, metal and wood. Forceps, scalpels, trocars, catheters, syringes, saws, needles and scissors were all available to the surgeon. Rhinoplasty (plastic surgery of the nose) was first presented to the world medical community by Sushruta in his Samhita, where a detailed method of transposition of a forehead flap to reconstruct a severed nose is given. Severed noses were common form of punishment. Torn ear lobes also were common due to heavy jewelry worn on ear lobes. Sushruta described a method of repair of the torn ear lobes. Fitting of prosthetics for severed limbs were also commonly performed feats.
Sushruta wrote, 'Only the union of medicine and surgery constitutes the complete doctor. The doctor who lacks knowledge of one of these branches is like a bird with only one wing.' While Charaka concentrated on the kaya-chikitsa (internal medicine), Sushruta's work mainly expounded on the Shalya Tantra (surgery).
The Samhita contains mostly poetry verses but also has some details in prose. 72 different ophthalmic diseases and their treatment are mentioned in great detail. Pterygium, glaucoma and treatment of conjunctivitis were well known to Sushruta. Removal of cataract by a method called couching, wherein the opaque lens is pushed to a side to improve vision was practiced routinely. Techniques of suturing and many varieties of bandaging, puncturing and probing, drainage and extraction are detailed in the manuscript. Sushruta lists more than 700 herbal medicines.
Ashtanga Hridaya
Vaghbata in the 5th century compiled two sets of texts called Ashtanga Sangraha and Ashtanga Hridaya. The latter of the two combines both the Atreya and Dhanvantari schools. It details the Kaya-chikitsa of Charaka Samhita and the various surgical procedures of Sushruta Samhita. Exhaustive descriptions of kapha, vayu and pitta are given. However, the emphasis seems to be more on the physiological rather than the spiritual aspects of the disease processes. Ashtanga Hridaya is written in prose whereas the Ashtanga Sangraha is in poetry form.
The Ancient Indian Physician
Originally only Brahmins were practicing physicians. Later people from other castes became well versed in the art of healing and a term Vaidya came to be applied to the practitioners. Merely by their art and knowledge, the physicians gained high social status regardless of their caste of birth. The court physician was of political importance and sat on the right side of the throne, an important symbolic place. Though the physician, patient, the nurse and the medicine were all important in curing a disease, the physician was thought to be the most important.
The codes of conduct for physicians and medical students were laid down by the texts of 'Laws of Manu'. The poor and downtrodden were to be treated free of charge. Others were charged according to their ability to pay.
The physician was expected to behave in an exemplary manner, conforming to the highest ideals of professional and personal life. His dress, manner and speech were expected to be beyond reproach. Medical education was arduous, consisting of many years of sacrifice learning the art of healing. Visiting the sick, collecting herbs and preparation of drugs, memorizing the Vedic texts of Ayurveda, performing procedures on dead animals, melons, and leather bottles and bladders were part of the training. These exercises helped refine both theoretical and practical training of the student. When finally the student is deemed ready to practice on his own, he is certified by the ruler. The system closely resembles that of the Hippocratic Oath of Greece.
How much influence Greece had on Indian medicine is hard to say. We know that astrology and astronomy were both greatly influenced by the Greeks (solar calendar, for example). Most of the texts available to us were written after the Greeks made their appearance (Alexander in 3rd century B.C.) and stayed in the Northwest India for several decades. How much the Indian physician learned from the Greek counterpart and vice versa is a question not answered.
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Ayurveda Basics - Six Stages of Disease
Vedic wisdom gives us the understanding of the significance of our daily life. Even the slightest discomfort can tune us into a doshic imbalance. Slight doshic changes are pre-pathological conditions. First, the dosha gets impure and deranged and then starts affecting the dhatus (tissues). The word dosha literally translated means that which rots. When the doshas are no longer serving as a physiological function, they become disturbed and create symptoms. In Western medicine these disturbances would be recognized as non-specific in origin. For example, a fever of non-specific origin. But in Ayurveda terminology, one may say “high Pitta in the rakta dhatu (blood tissue)”.
As the doshas start to become rebellious in the system, they go through six stages that can be easily recognized through observation, questioning and also with the use of medical diagnosis.
The six stages of disease are:
1. Sanchaya (Accumulation)
2. Prakopa (Aggravation, provoked)
3. Prasara (Overflow, spread)
4. Sthana samsraya (Relocation, depositing)
5. Vyakti (Manifestation - can be labeled at this point)
6. Bheda (Diversification, complications, damage to organs as in rheumatoid arthritis) Note: the first two stages of disease takes place in the digestive system; Kapha in the stomach, Pitta in the small intestine, and Vata in the colon. Ayurveda says that it is very important to handle the doshic imbalance at its point of origin, the digestive system and try not to let it go beyond the first two stages. Various herbs, enemas, cleansing, awareness of food choices and relationship choices help to keep the dosha from going way out of hand. It should be noted that certain life situations could bring the dosha directly into a later stage of disease. Accidents, ingestion of poisons and so forth, move things rapidly to a more serious and deeper condition.
Vata and the Six Stages
1. Sanchaya: The vata attribute of cold is evident at this stage. Apana vayu is affected which is the downward moving vata responsible for bowel movements, urination, menstruation, child birth, and ejaculation. The person may have some gas or constipation and there will be an aversion to the cause.
2. Prakopa: The attributes of cold, dry, and mobile are involved in the imbalance now. The gas starts to rise and comes to the ascending colon causing abdominal distention, burping, hiccups and breathlessness.
3. Prasara: The vata attributes of mobile, light, agitated and subtle come into play and vata now moves out of the colon, penetrates the mucus membrane, goes through the capillaries and enters the blood. Vata begins moving throughout the body and the person may have some of the following symptoms: cold hands and feet, generalized body aches, irregular appetite, rajasic vata activity (unable to focus the mind), dry hair or nails, cracking joints, stiffness of the muscles, anxiety, insomnia, fear, and low agni which causes discomfort after eating.
4. Sthana samsraya: All the other attributes plus the attributes of rough and dispersing are now present. The dosha now goes to a defective or weak body part. This may be due to trauma (physical or emotional), memory of illness, or genetic factors. All these things make fingerprints in the body and make a place for future disease to occur. Even emotions will accumulate in the tissues and create puddles in which the depositing stage happens. In other words, the dosha lodges in the defective space. The manifested doshic imbalance can also be seen in the tissue.
For example, Vata in the:
* rasa dhatu can show itself as dry eczema * rakta dhatu can be seen as anaemia * meda dhatu can be seen as weight loss, emaciation * mamsa dhatu can be seen as muscle pain * asthi dhatu can be seen as bone pain * majja dhatu can create phobias or tremors. * shukra/artava dhatu can create low sperm count, pain on ovulation.
5. Vyakti: All the attributes of Vata are now in full swing. The condition can now be labeled as epilepsy, Parkinson’s disease, spastic colon, and so forth.
6. Bheda: At this stage the disease begins to cause damage to the organ and body parts. It seems to have a life of its own and projects itself like an entity. There may be, for example, arthritic deformities, loss of function of an organ, atrophy, etc.
Pitta and the Six Stages
1. Sanchaya: The attributes that are first evident are hot and liquid. Pitta is fire and water (hot and damp); hot water can put out our agni as can alcohol, and coffee. These substances can dilute enzymes and hydrochloric acid. The person may feel a little heat in the small intestinal region and will have an aversion to the cause.
2. Prakopa: The next attribute that gets stirred up is sour. This can manifest as acid indigestion, dark urine and dry yellow faeces. Remember, the dosha is still in the digestive system at this stage and can be easily pacified through herbs and other corrective measures.
3. Prasara; The dosha leaves the small intestines and enters the circulation. Now the attributes that are added are light and spreading. The person may experience a rash, acne, burning hands eyes, feet, desire to have cold things, irritation, and the head may be hot (the brain does not tolerate heat very well). Emotionally, this may manifest as being hypercritical, lacking discrimination, engaging in unhealthy competition, expressing jealousy, anger and violence. The normal emotional functions of pitta are quick comprehension, appreciation and sharp intelligence.
4. Sthana samsraya: The attributes of sharp, penetrating qualities are now present and the dosha moves into the dhatu. There may be fever, inflammation, bacterial infection, and inflammation of the stomach wall, (pitta in the mamsa dhatu or muscle of the stomach).
5. Vyakti: All the attributes are now activated and the next stage is the labeling of the disease. Now the dosha has become an entity that is recognized as a specific pathological condition such as hepatitis, encephalitis, or meningitis. The suffix, itis, equates with inflammation or Pitta.
6. Bheda: The disease now starts to cause a breakdown in the system. Pitta being so aggressive can cause perforation, abscesses, coma and aneurysm. My teacher said, “Never fiddle faddle with Pitta!”
Kapha and the Six Stages
1. Sanchaya: The kapha attribute of liquid and heavy begin to accumulate in the stomach. These create a feeling of heaviness after eating, slow digestion and a weighted feeling in the stomach.
2. Prakopa: The attribute of cool now enters the picture and the symptoms will start to increase. There may be poor digestion, excess saliva, mucus diarrhea, or coolness in the stomach region.
3. Prasara: The kapha dosha now leaves the stomach (digestive system) and circulates into the lymph system. The attribute of oily manifests itself and oily fried, greasy foods will cause kapha to increase. Remember kapha in excess creates stagnation and engorgement.
4. Sthana samsraya: The kapha dosha will now find a place to lodge itself. The attributes of dull and stagnant are manifesting. In the Rasa dhatu, kapha may appear as lymph swellings and congestion, sinusitis, and plaque accumulations. Ayurvedically speaking, we can see kapha lodged in the rakta dhatu as purulent discharges such as boils, in the mamsa dhatu as flabby muscles and so forth through the dhatus.
5. Vyakti: All attributes of kapha are in full swing. At this stage the disease can be labeled and we can now identify the disease entity. We may call it pneumonia, polyps, obesity, diabetes, and hypertension due to water retention.
6. Bheda: Now the disease entity begins to cause organ changes and disruption of physiological functions. For example, there may be a tumor in the liver, ascites (an abnormal accumulation of serous fluid in the abdominal cavity indicating a very serious condition), or congestive heart failure.
---------------------Ayurvedic Philosophy, Theory...
Sooner or later, every Ayurvedic preceptor and practitioner must answer inevitable queries from a student or patient regarding extreme medical interventions. Although I have responded often to such questions over two decades of instruction and practice, a recent inquiry from an allopathic medical student has triggered a deeper examination of the ontological and moral underpinnings that inform Ayurvedic ethics.
An Indian student currently in the midst of a rotation as part of her residency in organ transplantation at a leading medical school in Boston recently participated in “harvesting” a working heart from a 12-year-old boy in a persistent and irreversible vegetative state. Her questions were both sober and sobering:
“Does the removal of the live heart constitute hatya (killing, slaying)? What is the Ayurvedic perspective on donating organs after death? What are the implications for the jiva (soul) upon leaving the body, if one or more organs are transplanted and the rest of the body is cremated?
“What are the implications for organ recipients? If the body is so ill that vital organs are beyond repair, should we accept that as an indication to forego the transplant and simply prepare for death?”
The traditional Vedic understanding is that the jiva (soul) resides in the heart (Prasna Upanishad 3.6, Brhad Aranyaka Upanishad 4.3.7). When the jiva departs the heart, that is the actual moment of physical death. There is no mention in the sastra of any other measure or standard for ascertaining physical death (Chandogya Upanishad 6.11.3). So, if the heart is beating, one must conclude that the jiva is animating the body, and harvesting the organ is considered hatya, killing.
Donating organs after death does not involve killing the patient, but does present other problems. The jiva (except in the case of divine personalities, such as paramahamsa sannyasis) is attached to its physical frame, and will hover and linger over it while in a recognizable form, even after physical death. Therefore, cremation is meant to accelerate the process of disintegration of the material form. As a rule, the skull is crushed during cremation, so that the incineration is complete, and the life force together with the senses (traditionally known as the pranas), are properly released. Thus, those who are attached to embodied life should not donate their organs, as their sukshma and karana shariras (subtle and causal bodies) may transfer such attachment to the physical body of the recipient. Conversely, for these same reasons, anyone receiving organ donations is subject to the influence of the donor’s sukshma and karana shariras.
Important as these specific considerations are, the central issue raised by these questions is how much do we resist the natural processes of aging, decay, and death? When do we accept the inevitable? The sastras say clearly, “One who has taken his birth is sure to die.” (Bhagavad-Gita) And that is certainly the uncontroverted experience of all embodied beings throughout history. We do not and cannot “save lives;” we only postpone death –but at what personal and social cost?
Organ transplantation is but one of the medical procedures that unquestionably fall in the category that Srila Bhakti Vinoda Thakura has labeled “extraordinary endeavors to keep body and soul together.” Not only do they constitute bhukti (attachment to and gratification of the physical and subtle bodies), but also should be avoided as ugra karma, a term defined as “difficult action with limited rewards.”
End of Life
The death process follows the following general pattern, although some stages can be abbreviated to the point of imperceptibility, while others can be extended considerably. In the terminally ill, prana (life-force) becomes debilitated and begins to withdraw from the sthula sharira (physical body). In most patients, this gradual retreat of prana is accomplished in an orderly fashion, with the life-force withdrawing in set ways: from the periphery to the center; from less vital to more vital organs; and from the lower torso towards the head. Once prana has retreated from the physical body, the karmendriyas (faculties of action) are inoperative. The second stage consists of the withdrawal of prana into the sukshma sharira, consisting of mind, intelligence, and ego. When prana retreats from the jnanendriyas (faculties of perception), the patient loses awareness of the external environment and sinks into unconsciousness.
In the third stage, prana withdraws into the karana sharira (causal body, consisting of ahankara). Because the sukshma sharira is incapable of exerting its organizing influence over the physical body through the medium of prana, the four elemental states of matter begin to disintegrate. (The fifth state, ether or space, is the field in which the other four states manifest, and thus cannot disintegrate, having no parts.)
Dhatus (bodily tissues) in the solid state lose cohesion, and the patient experiences a corresponding loss of body consciousness. Then the dhatus in the liquid state disperse, causing the mucous membranes to desiccate. As the dhatus in the radiant state disintegrate, the body loses warmth, and rigor starts to set in. Finally, the dhatus in the gaseous state dissolve, and the patient expires. It is at this point that the jiva leaves the heart, and is carried away with the sukshma sharira.
Ayurvedic practitioners aware of this orderly process can be immensely helpful to patients and their families, assuaging their fears and reassuring them of the immortality of the jiva, even in the midst of this experience. Chanting the Lord’s Names, recitation of prayers, scriptural readings, and the performance of other religious rites (according to the faith of the patient), are highly recommended, and constitute an integral part of Ayurvedic care of terminal patients.
Of course, palliative measures can and should be employed whenever possible to mitigate pain and suffering, but the clouding of consciousness through the use of excessive anodyne therapy should be avoided, as a conscious exit from this plane is beneficial for spiritual evolution. Death should be approached as sadhana (spiritual practice) by patients, relatives, and the Ayurvedic practitioner.
Prolongation of Life
Ayurveda classifies disease as either sadhya (remediable) or asadhya (irremediable). Among irremediable diseases, some are yapya (chronic but manageable, such as diabetes), and others are pratyakheya (terminal, such as metastasized cancer). In terminal conditions, Ayurveda considers that only palliative measures are indicated.
DNR Orders
Ayurvedic practitioners accept the natural rhythm of life and death, and do not engage in ugra karma to prolong life (suffering) at great effort and expense. An informed patient with a terminal condition should discuss his or her preferences, and make legal provisions to insure that they will be respected. If the patient has given an explicit Do-Not-Resuscitate order, it is the duty of the Ayurvedic practitioner to assist in its observance.
Removal of Life Support
According to Vedic principles, removal of life support systems is justified when the assistive device is the major impediment to the death process. Ayurveda also allows for suspension of hydration and nourishment at the request of a terminally ill patient who chooses to fast, even if such fasting will accelerate death. Prayopavesha, voluntary fasting unto death for those who are terminally ill, is to be undertaken only under the authority and with the blessings of senior members of the patient’s faith.
Assisted Suicide
Ayurvedic ethics do not condone so-called assisted suicide, deliberately causing the death of a patient at his/her request by any lethal means. If requested by the patient, Ayurvedic practitioners may describe —but not actively recommend— prayopavesha (voluntary fasting unto death) as a viable means to abbreviate prolonged suffering.
Suicide
According to sastra, suicide postpones and intensifies karma. However, as stated above, Ayurvedic ethics allow prayopavesha, voluntary death by fasting. The patient making such a decision must declare it publicly, to distinguish the act from suicide committed privately in traumatic emotional states of anguish and despair, and to allow for family and religious community intervention. Prayopavesha is allowed when the patient is unable to perform normal bodily purification, death appears imminent, and pain and suffering are extreme (such that mitigating them would entail loss of consciousness). Prayopavesha is gradual, and allows the patient to reflect and reconsider his/her decision. After due deliberation, voluntary fasting unto death should be undertaken as sadhana, with the support of a community of faith.
Autopsy, Dissection, Embalming
Invasive procedures performed on the physical body after death distress the departed jiva, unnecessarily postponing final disposition may affect family members negatively. For these reasons, Ayurveda understands that autopsies should be avoided unless required by law, and dissection of cadavers for the advancement of science is also discouraged. Embalming, or replacing the blood with a preservative fluid, is also contra-indicated. In addition to the reasons mentioned above, embalming retards the decomposition of the physical body, promoting lingering attachment of the jiva for its deceased instrument.
Final Disposition
Cremation is the preferred system of disposing of cadavers, and should be performed within 24 hours of death. Due to the accelerated decomposition of the physical body accomplished by fire, cremation thoroughly releases the jiva from any lingering attachment to the physical instrument. Burial is not recommended, except for infant children and divine personalities.
I trust that the discussion of these principles and guidelines will assist all practitioners of Ayurveda to face these unavoidable ethical dilemmas with greater aplomb and certainty. Even those who do not share these Vedic perspectives may gain from the experience, as they will have had an opportunity to consider these issues before confronting them in clinical practice.
I pray that our patients will be better served. For, in the words of Acharya Charaka: “Those who practice Ayurveda while holding compassion for all creatures as the highest duty, have fulfilled their mission. They obtain supreme happiness.”
---------------------Are All Ayurveda Drugs 100 % Safe As Claimed?
Due to the failure of modern medicines to cure diseases like Cancer, Diabetes, and Arthritis, and the yoga gurus like Baba Ramdev, Ayurveda drugs are becoming very popular all over the world. The online purchasing of medicines is a popular way to get rid of physical problems all over the world now. According to official data produced in an international symposium on cancer and Ayurveda at Gujarat cancer research institute in November 2007, information was given that as many as 60 to 70 % of cancer patients rely on herbal medicines as chief or supportive therapy even in Canada or USA.
You might have read the latest issue of JAMA. There is an article entitled "Lead, Mercury, and Arsenic in US and Indian manufactured Ayurvedic Medicines Sold via the Internet" JAMA. 2008;300(8):915-923. It Context that Lead, mercury, and arsenic have been detected in a substantial proportion of Indian-manufactured traditional Ayurvedic medicines. Metals may be present due to the practice of Rasa Shastra (combining herbs with metals, minerals, and gems). Whether toxic metals are present in both US and Indian manufactured Ayurvedic Medicines are unknown.
Luckily this article has not asked for ban of these drugs neither they have been banned yet. But this is the high time to discuss this issue. Are all Ayurveda drugs 100 % safe as claimed?
I would like to draw your kind attention in this regards. The classics of Ayurveda has never ever claimed that all Ayurveda drugs are 100% non toxic. Even the poison of Snake is used as medicine in Ayurveda. This has been a myth that all Ayurveda drugs are 100% safe and can be consumed without any expert guidance or supervision. No wonder, 80% of total sale of Ayurveda drugs is OTC (over the counter) Most of the patients follow the articles published in newspapers or by Babas.
This has created myth for Ayurveda even in scientific fraternity. Many a times patients consumes drugs containing Nag bhasma or Parada i.e. mercury for years and years and when they approach with chronic toxicity of such metals, modern practitioners always defame the science Ayurveda. On the contrary, Ayurveda has always prescribed the drugs with precautions, and cautions. So it is always advised to take even Ayurvedic treatment under medical supervision only.
The definition of TOXICITY or Heavy metals is relative. Toxicity depends upon the body reaction, Prakriti, dose and duration of the drug administered etc.
We all have observed that the NRIs or foreigners, who come to India, can't digest Indian foods or water either and as a result most of the times they rely on Mineral waters only. And on the contrary, almost 80% of Indians are still using that raw water for consumption. And they are comparatively healthy!. Ayurveda has termed it Oksatmya; means which is non-toxic due to practice. We have read the stories of Vishakanyas who were being given Visha i.e. toxins since their childhood and even if they kiss someone, he or she will die due to the Visha. This is the best example of Oksatmya.
The detectable presence of these elements in dietary products and food or water is not the same as toxicity. These elements are present in many of our everyday foods and as shown in this study, Ayurvedic dietary supplements. In the case of foods and herbal products their presence can occur because:
1) they are naturally occurring in the soil, water and air,
2) from pollution as a result of human activity where in both cases theses elements are taken up by the plants,
3) from contamination in the manufacturing process, and
4) these elements are intentionally added.
Toxicity is the result of too much of the specific form of metal being ingested over time. But the most important point is, in Ayurveda or Rasashashtra, any metal is never prescribed as raw or virgin metal. It has always been processed with the procedures like Shodhana, Marana, Jarana, Amritikarana, Bhasmikarana, Satvapatana, Lauhitikarana etc. and most of them are used in sulphide form which is most suitable to the body.
Some times these procedures may need 5 years! Moreover there are many standards or parameters, to check it before consumption like Rekhapurnatva, Unnamatva, desired color etc. But I really doubt how many pharmaceutical companies follow these procedures and the standard protocols even after getting the license of good manufacturing practices, as many a times it happens with the pharmaceutical companies.
So for Indian patients, here are a few tips, when they consume Rasashashtra or Ayurveda products.
* Read the label carefully of the product you are using.
* If there is a drug named as Nag Bhasma, Parada Bhasma or Somala Bhasma, then don't use it for more than 21 days.
* Regular use of Harde or Haritaki is contra-indicated during pregnancy for longer period by Ayurveda.
* Long term use of Drugs containing Bhallataka, Lasun, Karen are contra-indicated for the patients with Pitta Prakriti.
* Long term use of Drugs like Vasa (ardusi), Neem, are contra-indicated for Vaata Prakriti.
* Long term use of Drugs like Shatavari is contraindicated for the patients with chronic cough.
* Long term use of Drugs like shatavari, may cause constipation.
* Long term and much use of Milk of buffalo is contra-indicated in patients with constipation, diabetes, asthma and skin diseases.
* Regular and long term use of Isabgul may cause loss of appetite and digestive problems.
* Long term use of Suvarna patri (sonamukhi) can weaken the intestine's natural movements and may cause a habit. (Many drugs sold in market like Kayamchurna contains such habit forming drugs)
According to the guidance of Government of India, drugs containing following ingredients must be consumed under strict medical supervision of Ayurveda expert.
Drugs of vegetable origin
* Ahipena Papaver somniferurn Linn.
* Arka Colotropis gigantean (linn.) R. Br. Ex. Ait.
* Bhallataka Semecarpus anacardium Linn. f.
* Bhanga Cannabis eativa Linn.
* Danti Baliospermum montanum Mall. Arg.
* Dhattura Datura metal Linn.
* Gunj Abrus
* Jaiphala (Jayapala) Croton tiglium Linn.
* Karaveera Rerium indicum Mill.
* Langali Gloriosa superba Linn.
* Parasilka Yavani Hyocyamus inibar Linn.
* Snuhi Euphorbia neriifolia Linn.
* Vatsanabha Acontium chasmanthum Stapfex Holm.
* Vishmushti Strychnox nuxvolnica Linn.
* Shringivisha Acontium chasmanthum Stapfex Holm.
Drugs of Animal Origin
* Sarpa Visha Snake poison.
Drugs of Mineral Origin
* Gauripashna Arsenic
* Hartala Arseno sulphide
* Manahashila Arseno sulphide
* Parada Mercury
* Rasa Karpura Hydragyri subchloridum
* Tuttha Copper sulphate
* Hingula Cinnabar
* Sindura Red oxide of lead
* Girisindura Red oxide of mercury.
Following list is examples of few popular drugs which are being taken as self-medication by the patients but it must be consumed under medical supervision of a qualified Vaidya:
* Vaat vidhvamsana Rasa
* Aarogyavardhini Rasa
* Yogaraja guggulu
* Mahayograj Guggulu
* Tribhuvan Kirti Rasa
* Bruhad or Laghu Suvarna Vasant Malini Rasa
* Laxmivilas Rasa
* Panchamrita Parpati
* TamraBhasma
* Trivanga Bhasma
* Simhanada Guggulu
* SamirPannaga Rasa
* Chandraprabha vati
* Swasakuthar Rasa
* Makardhwaja Rasa etc.
The patients who are consuming any Bhasma regularly they should analyse the Bhasma before consuming it. Followings are few easy methods to check the qualities of Bhasmas,
Varitarattwa is that specialty in which the Bhasma of some substances floats on the surface of the water and does not sink in the water. According to the Rasa Tantraic concepts, a perfectly prepared Bhasma when sprinkled in a beaker full of water, floats upon the surface and does not sink in the water, it is known as Varitara. According to the Rasa Shastric every metal or other substances are to be converted into Bhasma form. They all are heavy in comparison to water, and when they come into contact of the fire and get converted into Bhasma form, they become light and the heaviness is destroyed. They attain a fine state of division and on account of the surface tension they float on the water. Ideally bhasmas like Suvarna, Rajata, Tamra, Lauha, Nag or Vanga should float on the water. If it sinks in the water, then it is not properly prepared.
Rekhapurnatva: This is one of the important criterions of the examination of the perfectness of the Bhasmas. The filling of the thread grooves of the surfaces of the first finger and the thumb is known as Rekha Purnattwa. When a small quantity of the Bhasma is picked up between the first finger and thumb and on rubbing, if the thready grooves allow penetrating that Bhasma, it is said that the Bhasma is having Rekha Purnattwa.
Unam is also an adjective attached to a perfectly prepared Bhasma Though basically, the test of Unattwa is similar to the test of Varitarattwa, there is a little modification. After examining the Varitarattwa of a Bhasma, when small food grains are delicately placed over the layer of the Bhasma, which is floating over the water level and if the food grains do not sink and continue to float, the Bhasma is supposed to be Una i.e. very less in gravity, and as such it is just an advance test of Varitarattwa and to decide comparatively more Laghuta.
Nirdhumattwa is the next criterion for the assessment of the perfectness of the Bhasma. Nirdhumattwa refers to a special in which anything put on burning fire and non-observance of the smoke thereof. The same meaning is applied in the context of Bhasma Pariksha. A small quantity of the Bhasma to be tested after subjecting to specific number of Putas, is put on the fire and when no smoke of any type is observed, it is inferred that the Bhasma is prepared perfectly. If the Bhasma is not prepared completely, the Apakwa(not fully prepared-Ed) substances will remit yellow or white colored smoke.
Gatarasatva: One of the criteria of assessing the perfect Bhasma has been considered to be the absence of taste in the Bhasma and that will be free from all the side- effects.
Ishtavarnattwa: Ishta Varnattwa means the attainment of an appropriate color. In the context of Bhasmas also the attainment of the specific color corresponding to the basic metals or substances has been considered as a quality of the Bhasma. It has been expounded that whatever method of Bhasma preparation is adopted, with a little modification the Bhasma will have a specific type of colour. In Yoga Ratnakara, the standard colors of the Bhasma have been discussed extensively. It has been stated that the Bhasma of gold attains the color resembling to the Champaka flower; the Bhasma of silver and copper are attaining the black color, while the Bhasma of Naga attains the color resembling to the pigeon neck while Vanga covers into white color if the Bhasma is prepared perfectly and correctly. Generally the Bhasma of iron, or iron containing ores acquires a red colour and as such the Loha Bhasma, Kanta Bhasma and Kashisa Bhasma, Vimala Bhasma or Makshika Bhasma, on account of their iron content, attain the red colour. The Abhraka Bhasma attains brick red color on account of its iron content. Similarly, Swarna Makshika which has about 30% iron component attains the Jamun fruit color. Similarly, other Bhasmas are also having different colors and on account of those colors, their perfection is decided.
Chandrika is the metallic luster and its absence is considered as a criterion for assessing the perfection of a Bhasma. Various Rasa Tantric substances are having a natural luster or shine and after conversion into Bhasma form that luster should go. This absence of natural luster is an indication that the specific metal or the metallic ore has converted into Bhasma form. A small quantity of the Bhasma is taken in between the thumb and the index finger and rubbed vigorously. Then the portion stuck in the grooves of these fingers is exposed to the sunlight and viewed very carefully. If very tiny shining particles are observed on the fingers, it is presumed that the metal or the mineral or the Ore has not converted into the Bhasma form perfectly whereas its absence indicates the perfection of the Bhasma.
Mriduttwa: The softness is denoted by the adjective Mriduttwa. This is perception through the touch sense. All the minerals, metals etc. are Bhoomija or Parthiva Dravyas and the ancient scholars have said that the Parthiva Dravyas contain Guru, Kathin, Khara etc. qualities. When these substances attain a Mrita state or Bhasma form, they lose their physical characteristics and as such the Kharasparsha of metals gets lost and the Bhasmas are felt soft and smooth.
-----------------------------Disclaimer :
Information provided in these article is for the sole purpose of imparting education on Ayurveda and is not intended to diagnose, treat, cure or prevent any disease. If you have a medical condition, please consult your physician.
BIBLIO:
Ayurveda http://www.boloji.com/ayurveda/index.htm
The Five Elements - by Dr. Sachin Dua
Dr. Dua may be emailed at: [email protected]
Copyright © 2008 Dr. Sachin Dua. All rights reserved.
Dr. Dua has a tremendous passion for Ayurveda, believing that it is by far the best preventative health-care system known to man. He holds a B.A.M.S. Degree from M.D. University, Rohtak, Haryana. He is committed to academic excellence and his ongoing goal of providing the highest level of Ayurvedic training outside of India.
He teaches both the public and professionals such as; physicians, chiropractors, osteopaths, psychologists and other professionals in the basic principles and practices of Ayurveda.
Text and History of Ayurveda - A Hindu Heritage of Healing
by Neria Harish Hebbar, MD
http://www.boloji.com/ayurveda/av024.htm
References:
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2. D.P. Agrawal; Sushruta: The Great Surgeon of Yore
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Ayurveda Basics - Six Stages of Disease
by Candis Cantin Packard
http://www.loaj.com/ayurveda_basics.html#six
Candis Cantin Packard has over 25 years of practical experience as a counselor and teacher of wholistic life-style principles. She is a founding member of the American Herbalist Guild, has studied Ayurveda with American Institute of Vedic Studies and with Dr. Vasant Lad. She is the author of Pocket Guide to Ayurvedic Healing is the artist for the Herbology Tarot and has created a new correspondence course for the program she founded and directs, The Evergreen School of Integrative Herbology in Placerville, CA Tel: 530-626-9288.
Ayurvedic Philosophy, Theory...
Ugra Karma: End of Life Ethical Considerations
Suddha Ayurveda:The Lineage of the Bhagavata Kavirajas
Vikriti Vijnana: Ayurvedic Pathology
by Kj. Nimai Nitai Das
http://www.loaj.com/ayurveda_philosophy.html#sa
Kj. Nimai Nitai Das (formerly writing for this journal as Murari Chaitanya dasa) is a Preceptor in the Suddha Ayurveda Vidyalaya, and an Asst. Clinical Professor of Family Medicine & Community Health at Tufts University School of Medicine. He can be reached at [email protected]
Are All Ayurveda Drugs 100 % Safe As Claimed?
by Dr. Joban Modha M.D.(Ph.D.) Ayurveda
http://www.boloji.com/ayurveda/av071.htm