According to Ayurveda, youth ends at 60. Thereafter, if one practices proper measures that slow and prevent the degenerative changes that can accompany aging, one can achieve a long and disease-free old age. These proper measures take two principal forms. The first is known as panchakarma, (literally “five actions," in Sanskrit), which entails sophisticated physical and manipulative massage procedures to open the channels of the body and promote elimination of toxins. The second aspect, aushadi chikitsa, involves use of an array of natural herbal medicines which up-regulate innate physiological cleansing processes in the body.
Here in the West, Ayurveda has become famous for these cleansing methods, which have been dubbed the “detoxification" procedures of Ayurveda. However, Ayurvedic physicians do not agree with the term detoxification, interpreting detoxification as a solution to a problem, which has already occurred. In contrast, the Ayurvedic approach to health utilizes what could be aptly described as “anti-toxification," or a continuous process of internal care and hygiene fueled by appropriate nutrition and carefully selected natural herbal medicines. Anti-toxification is preventative maintenance, which prevents decay and periodically revitalizes one's physiology so that detoxification is never required. Longevity is not equated with merely a long life it means achieving a long life filled with pleasure and meaning and free from disease and misery. It is within every human being's power to maximize his or her own longevity. However, it is necessary to follow some simple measures to preserve the youthful vigor and vitality of the mind and body. The time to act and invest in health is now. One does not begin digging a well upon feeling thirsty.
Except in the arena of acute illness, the modern reductionist approach to disease has little relevance. Most people do not have acute, life threatening diseases they have chronic and debilitating diseases, such as obesity, arthritis, allergies, asthma, depression, anxiety, gastric ulcer, hypertension, sinusitis, asthma, fatigue, irritable bowels, dysmenorrhea, infertility, impotence and diabetes, to name a few. Certainly in the case of certain acute diseases Western medicine is effective in identifying the single cause (i.e. meningococcal bacteria) of a disease (bacterial meningitis) and treating it with an appropriate medicine (penicillin). However, Western medicine does not address the multifactorial root of these much more prevalent chronic conditions and therefore has no theoretical framework for curing them.
The root of these diseases is not a single strain of bacteria or enzyme deficiency. The root of these diseases is found in the whole picture, which is formed by how a person lives his or her life. What we eat, how we digest and assimilate, how we breath, the rate of our metabolism, what we believe, what thoughts dominate our minds, what we feel, remember, and aspire to, what sounds, sensations, sights, smells, tastes we experience--all these things contribute to our state of health. So if we really want to comprehend the root of disease for any individual we have to know how that person lives and what that person experiences on a regular daily basis. Ayurveda counsels us to assess effects of toxins on each individual patient. This requires more than knowing about the purity of the water supply or one's constant exposure to car exhaust, although these too are important. Are there toxic habits, toxic relationships, toxic foods, toxic addictions, toxic thoughts and emotions, toxic speech, toxic lives? Is this person a happy, whole, connected human being or not? Until you can understand how a person thinks, feels, behaves, responds, desires, and dreams you cannot truly understand the origins of his or her disease. And you will not find an antibiotic, antidepressant, or antihistamine that will cure these diseases at best allopathic medicine may succeed in temporarily masking the symptoms.
Basic Principles of Ayurveda
Ayurveda is a holistic medical science, which provides a unique conceptual framework for understanding the nature of disease and offers a variety of treatment modalities to promote recuperation. The concepts of health and disease are based on several fundamental concepts relating to the structure of human beings.
As Above, So Below
Ayurveda is a system of human health care, which is derived from observations about the immutable universal laws of nature. One of its most defining concepts is that of loka-purusha-samya or, literally, the "connection between the individual and the universe". According to Ayurveda, the individual (microcosm) of nature (macrocosm) and falls under the same laws. Both man and the universe are composed of five basic elements:
There is a constant interrelationship between the individual and the universe and a constant co-exchange of elements in order to maintain a normal and balanced state (homeostasis). Furthermore, this exchange of materials reflects the principle of samana-vishesa or similar-dissimilar. This principle reflects the observation that matter of a specific nature increases when acted upon by a substance of a similar composition and will decrease with addition of substances of dissimilar compositions. This exchange between individual and nature proceeds in an appropriate and mutually beneficial manner as we eat, drink, breath, eliminate wastes, and perform our activities of life. Health is maintained provided this interaction is harmonious when the harmony is disrupted disease can arise. The primary object of treatment is to re-establish homeostasis of the five elements within the individual and between the individual and the environment.
Ayurveda understands life to require four requisite dimensions, which occur together in space and time: physical body, mind, five senses, and consciousness. Thus every human being is conceived of as a complete psycho-physiological-spiritual aggregate, which is in a dynamic and constant interrelationship with the universe. The five elements of Ayurvedic doctrine represents nothing less than a primitive energetic theory of physics, which incorporates the five essential attributes of matter (Table 1.):
Table 1. The Five Elements and Modern Physics
Space represents the Unified Field
Air represents to Motion and Acceleration
Fire represents Radiant Energy and Heat
Water represents Cohesive Forces and Gravity
Earth represents Mass
The Three Doshas
In living systems, the five elements become organized into three fundamental biological energies known as the three doshas (pronounced "doshas") or tridosha. Their names are Vata, Pitta, and Kapha.
The elemental composition of the three doshas is depicted as: Vata dosha comes from space and air Pitta dosha from fire and water and Kapha dosha from water and earth.
Vata--which governs motion and activity--is said to be at the basis of all movement in the physiology. It controls functions such as blood circulation and the expansion and contraction of the lungs and heart intestinal peristalsis and elimination activities of the nervous system the contractile process in muscle ionic transport across membranes (such as the sodium pump) cell division and unwinding and pairing of DNA during the processes of transcription and replication. Vata energy is of prime importance in all movements at all levels of structure.
Pitta governs bodily functions concerned with heat and metabolism, and directs all biochemical reactions and the processes of energy exchange. For example, it regulates digestion, the secretions of the exocrine glands and the endocrine hormones, and intracellular metabolic pathways such as glycolysis, the tricarboxylic acid cycle, ATP metabolism, and the respiratory chain.
Kapha governs the structure and cohesion of the organism. It is responsible for physical and biological strength, natural tissue resistance, and proper body structure. Microscopically, it is related to anatomic connections in the cell, such as the intracellular matrix, cell membrane, cellular receptors, integrins, and synapses. It is the energetic principle that holds things together and connects us to the intelligence of Nature.
In the Ayurvedic view, the human being consists of a physical body with mass and density (Kapha) serving as the substratum for a milieu of intricate chemical processes (Pitta), connected by a subtle energetic force of movement and motion (Vata). The three doshas dynamically co-exist in a genetically determined proportion for each individual and function in a harmonious manner for the ultimate benefit of the whole organism. The qualities of the three doshas can be perceived at the gross level of the physical body as a whole (e.g. nervousness or dryness = Vata febrile or inflammatory conditions = Pitta congestion or lethargy = Kapha) as well as at the cellular, molecule and atomic levels.
Thus, a neuron in the CNS might have a higher proportion of Vata energy than the other two doshas, while an HCL-producing gland in the stomach would be predominantly Pitta, and a skeletal muscle cell relatively more Kapha. Similarly, the mass-possessing protons and neutrons of an atom represent Kapha energy, the electrons whipping around in shells represent Vata energy, and the potentially explosive forces within the atom is the Pitta energy.
Constitutional Type (Prakriti)
All people consist of all three of these energies but have differing and unique proportions of the three. According to which one or two of these energies predominate in a particular individual, that individual will display certain physical and psychological characteristics. The one energy, which is most dominant of all, determines a person's body type or prakriti.
Most people find that they have a primary body type and a secondary body type. For instance, a person may be primarily a Pitta (fire) type but also demonstrate many Kapha (water + earth) characteristics as well. Body types refer to a person's physical characteristics as well as their mental and emotional qualities.
Vata Types. Physically, Vata-type individuals are usually thin and angular physiques, love to be on the move, and have curly or frizzy hair. They can be either taller or shorter than average. Their skin has a gray or bluish tone and can have lines around the eyes and mouth. Air people tend to forget things easily, though they are by nature bright and creative. Their flow of energy tends to be unsteady, and they often are attracted to stimulants such as sugar and caffeine, to maintain their energy.
Pitta Types. These individuals are attractive and have medium-sized physiques. Although a redhead definitely has Pitta characteristics, Pitta types may also have blond, light brown, or prematurely gray hair. Pitta types have oily skin and hair. Their skin may have a yellowish or reddish tint to it. Pitta people tend to be ambitious, driven people, comparable to stereotypical Type A personalities of Western psychologists. They tend to be intense and aggressive individuals who are naturally drawn to positions of leadership and responsibility. Indeed, fire types have an affinity for adversity and challenge and often seek it out. They may be prone to abuse alcohol, drugs, and hot spices in an unconscious effort to infuse their lives (and meals) with intensity and flavor.
Kapha Types. Physically, Kapha types tend to have larger and more solid physiques, sometimes with a tendency to be overweight. They often have big eyes and beautiful dark hair. Their skin is generally healthy, with rosy complexions and their teeth are white and straight. Thickly built, water types tend to have a steady supply of energy and an easy-going disposition. Because of a love of food and a tendency towards heaviness, water types benefit from eating lightly and getting plenty of exercise. Unfortunately, water types especially have an affinity for heavy and sweet foods like ice cream, breads and pasta. Kapha types also have a relative aversion to physical exertion, preferring to relax and enjoy life.
Table 2. Characteristics of Vata, Pitta, and Kapha Types
Light, thin physique
Tends toward dry skin
Moves and performs activities quickly
Aversion to cold temperature
Quick to grasp new information, also quick to forget
Tendency toward worry and nervousness
Can experience constipation
Light or interrupted sleep
Irregular eating times and habits
Enjoys being active but can tire easily
Dislikes hot weather
Experiences strong onset of hunger
Cannot miss meals
Tendency toward anger, irritability, and impatience
Ambitious and focused in nature
Excellent speakers and leaders
Prefers cool foods and beverages
Average memory and speed of performing activities
Tendency towards reddish complexion, moles, and freckles
Large, heavier physique
Very muscular and broad
Tendency toward obesity
Slow and methodical in activities
Slightly oily skin
Needs more time to learn, but retains well.
Difficult to irritate, excite, or agitate
Sleeps deeply and for long periods, if undisturbed
Eats relatively small amounts of food
Calm and reliable personality
Hair is thick, dark and abundant
The Ayurvedic tradition offers practical and reliable knowledge about the prevention and treatment of disease, the maintenance of health, and the promotion of longevity. Ayurveda defines health not only in terms of a balanced physiology of the physical body, but also as a state of harmony and contentment in every aspect of life. Thus, not only is it a medical approach to health--Ayurveda can also be the foundation for the spiritual evolution of humankind.
A principle concept in Ayurveda is that of internal hygiene, or preservation of a toxin-free physiology. This is because one of the earliest stages of disease involves the obstruction of the body's various channels (shrotas) by accumulated impurities.
Shrotas, meaning channels or pores, are present throughout the visible body as well as at the subtle level of the cells, molecules, atoms, and subatomic strata. It is through these channels that nutrients and other substances are transported in and out of our physiologies. It is also through these channels that information and intelligence spontaneously flow. When the flow of appropriate nutrients and energies through these channels is unimpeded, there is health when there is excess, deficiency, or blockage in these channels disease can take root. Some shrotas have obvious correlates with western concepts (e.g. both Ayurveda and allopathy recognize the anna vaha shrota, or gastrointestinal channel and the prana vaha shrota, or respiratory passageways. Other shrotas have no western correlate: artava vaha shrota or udaka vaha shrota, carrying the monthly menstrum and the pure water in the body, respectively.
Panchakarma is comprised of five therapies--which promote a clean physiology. These therapies are physical manipulations, such as various massages, enemas, and other procedures described below, which correspond to the body's own natural cleansing functions. Normally, the body can cleanse itself without assistance however these innate functions often become dysfunctional due to modern dietary, environmental, and emotional stresses. Panchakarma therapies are designed to loosen and eliminate accumulated impurities in the shrotas to create a profound internal cleansing.
These treatments are extremely enjoyable and can be described as a cross between a spa treatment and a medical procedure--there are aspects of both. Each individual Panchakarma session requires between two and four hours and patients may be advised to have two, four, eight, or more sessions depending on the individual's state of health.
The therapies are available in two settings. One option is for patients to attend a Panchakarma Retreat at authentic Ayurvedic center. The advantage of retreat-based panchakarma is that the food is specially prepared, yoga and meditation sessions are provided, exercise periods are individualized, and a senior vaidya (i.e. wise physician) is always present for questions and support. The serene and peaceful surroundings reduce stress and promote the emotional aspects of anti-toxification.
The second option for receiving Panchakarma treatments is to do them on an outpatient basis in a qualified physician's fully equipped panchakarma office facility. The treatments one receives in an office are identical to those at the retreat center, with the difference of being able to go home after each session. The patient simply returns the next day to receive the next treatment. Instructions are provided on how to eat, exercise, and rest during the treatment period.
A description of several of the more common Panchakarma therapies follows below. Not all individuals will require all procedures.
Nasya (Application of Herbalized Nasal Medicines)
The application of specially herbalized nasal drops which cleanse the sinuses and removes impurities from the throat, facial, and supraclavicular areas.
Vamana (Controlled Therapeutic Emesis)
The use of emetic herbs to induce a therapeutic vomiting of the stomach contents. Preceded by the consumption of cool water or specific teas to fill the stomach. Excellent in treating all kapha-type conditions including asthma, bronchitis, allergies, depression, and many digestive problems.
A two-part procedure, which involves an initial consumption of an oily or unctuous substance followed by the administration of an herbal laxative. The oleation acts as a solvent and mobilizer for certain toxins in the body and also promotes strength, good complexion, efficient digestion, and proper function of the sense organs. The subsequent laxative therapies eliminates the toxins loosened by the oleation and causes a maximal dilation of the hepatic, biliary, and other channels which allows for the removal of lipid-soluble impurities.
Basti (Herbalized Enemata)
Gentle, herbalized enemas, which cleanse the rectum and lower colon and eliminate excess vata dosha from the physiology.
The removal of a small quantity of blood from the patient using modern sterile techniques traditionally this was accomplished with special jaluka, or leeches. This procedure is valuable if there is toxicity in the blood it also stimulates production of fresh blood cells from the bone marrow.
Abhyanga (Friction Massage)
The body is massaged with warm, herbalized oils by one or more therapists working in perfect unison. This promotes deep relaxation and gently stimulates the marma points leading to a state of mental balance and heightened awareness. This is the renowned “synchronized oil massage" of Ayurveda.
Swedana (Fomentation Therapy)
An herbalized steam treatment promotes perspiration and elimination of toxins from the fatty tissues and nerves via the sweat glands. This treatment also optimizes the circulation and dissolves impurities.
Shirodhara (Pouring Oil Over the Head)
A continuous stream of warm, herbalized oil flows from an overhead vessel through a small aperture onto the forehead. This treatment is said to purify the mind-body, and profoundly relax the nervous system. Individuals experience twilight states of consciousness between waking and dreaming. Most people find it very meditative and pleasurable.
Udvartna (External Poultice Application)
A general term for therapies in which herbal pastes (or muds) are applied to all parts of the body. Patients are wrapped in warm blankets and the paste removed when dry. This treatment exfoliates the skin, penetrates to the muscles and fat tissues, and removes impurities. It is useful in stimulating weight reduction.
Additional specialized therapies are administered when medically indicated.
Normally the body has the natural ability to efficiently process and eliminate toxins and products of metabolism. If one is careful about diet, stress management, and exercise Panchakarma alone can prevent the bioaccumulation of toxins, maintain one's vital energies, and prevent the occurrence of disease. However, many of us are prone to repeated dietary indiscretions, poor exercise patterns, environmental stresses, and modern lifestyles, which upset the homeostasis of the body and result in accumulation of waste products. This situation may be beyond the point of repair by Panchakarma therapies alone. This is when Ayurvedic herbal medicines can often be useful.
There are myriad tissues and organs in the human body, which are important for the removal of toxins: liver, spleen, kidneys, lungs, lymphatics, intestines, skin, and mucous membranes to name a few. Ayurveda recognizes each of these and prescribes an array of plant-derived medicines to assist each in their cleansing function. Because of space, we will limit our discussion to herbs, which support the liver--the master un-toxifier. To appreciate the importance of the liver's role in purifying the body, consider the following modern example.
When one eats an (non-organic) apple containing a toxin, the chemical is absorbed into the bloodstream and eventually arrives at the liver where it undergoes two processes of functionalization and conjugation. These processes convert the toxin from a lipid-soluble to a water-soluble form, which can be eliminated in the urine or feces.
TOXIN INTERMEDIATE END PRODUCT
(Benzene) (Phenol) (Phenyl Sulfate)
HO Hydroxyl O4SO Polar sulfate group
Furthermore, for these important processes to proceed effectively, many specific complex enzymes are required in proper proportion and release sequence, including the mixed oxidase p-450 enzyme system. If the liver is properly nourished and in a clean state, the pesticide will be eliminated from the body before it can exert its neuro- or immunotoxic effect. The ancient vaidyas were not aware of these details, but fully understood the importance of the liver in maintaining health and avoiding premature mortality.
Three herbal medicines in particular were, and still are, found useful in maintaining liver function: Andrographis paniculata, Picrorhiza kurroa, and Phyllanthus niruri.
Andrographis paniculata (Nees) Family: Acanthaceae
The ancient Ayurvedic medical texts describe the use of the leaves of this common and ubiquitous plant in the treatment of jaundice and other liver ailments. The leaves and leaf juice have also been traditionally used as a remedy for flatulence, loss of appetite, children's bowel complaints, dyspepsia, and general debility. The hepatoprotective action of A. paniculata and its active principle, andrographolide, has been studied. These studies show that the leaf water extract significantly reduced the expected liver damage from carbon tetrachloride, a known hepatic toxin. Free radical formation via microsomal lipid peroxidation was also shown to be reduced. A leaf decoction of A. paniculata was studied in twenty patients with viral hepatitis. After twenty-four days complete clinical improvement was observed in 16 patients (80%) and significant improvement in four patients. SGOT, SGPT, and bilirubin returned to normal levels within one month.
Picrorhiza kurroa (Royle ex Benth) Family: Scrophulariaceae
This perennial woody herb with its grayish, irregularly curved roots has been used for centuries as a liver stimulant, laxative, appetite stimulant, febrifuge, and treatment for bronchial asthma and arthritic pain. Recent studies have isolated a bitter glucosidal principle, kutkin, which has demonstrated both protective and therapeutic effects against diverse models of liver damage. The crude root extract has shown hepatoprotective activity against carbon tetrachloride, paracetamol, galactosamine, and alcohol.
The powdered root given in divided dosages of 4 gm/day to fifty-five patients with documented infectious hepatitis for six weeks resulted in complete clinical resolution in fifty patients (91%), satisfactory response in 3 patients, and no response in 2 patients. The conclusion was that P. kurroa root powder appeared to be a useful agent in the treatment of jaundice in infectious hepatitis. This very well-researched herb is useful not only in liver disease, but also in promoting routine liver protection and immunocompetence.
Phyllanthus niruri (Hook f.) Family: Euphorbiaceae
The aerial parts of this plant have been found to contain lignans, which are known to modify the immune system.,4 Five flavonoids with known antioxidant activity have also been isolated including: quercitin, quercitrin, isoquercitrin, astralgin, and rutin. In what has now become a classic and much-quoted collaborative study at the Madras Hospital For Children and the Madras Government General Hospital treated carriers of hepatitis B with extracts of P. niruri for thirty days.5 Three weeks after the herb was discontinued 59% of the patients sero-converted to non-carrier status,i.e., neither the virus itself nor antibodies to it could be found in their serum.
Blumberg et al found that the extract inhibited hepatitis B DNA polymerase and also had a viral-agglutinating activity. Dixit and Achar observed that Phyllanthus niruri was effective in children in treating infectious hepatitis without side effects.
We are in the midst of a global paradigm shift in modern medicine. Quickly emerging into the center of this change is Ayurvedic medicine, a healing system which promotes health using natural, nontoxic substances, places emphasis on detoxification therapies, and which recognizes the important role of the mind and emotions. A paradigm is a model used to explain how and why events happen the way they do. New paradigms emerge due to the evolution of humanity's understanding of the world. The best example of paradigm shifts is in the field of modern physics. The classical Newtonian explanation of the world, which for two hundred years was accepted as reality, has now been replaced by quantum mechanics, superstrings, and field theory. In the old paradigm, every event had a definite cause and every action had an equal and opposite reaction. In the new paradigm, we describe events as possibilities instead of certainties and we recognize now the interconnectedness of all phenomena. The new explanation of the universe is, in a word, more holistic than the old reductionist view of explaining events in terms of separate, unrelated components.
In the same way, the medical paradigm shift, which we are experiencing today, represents a movement toward holism. The old medical paradigm viewed the human being as a machine, with separate systems, organs, and tissues it separated mind and body into distinct categories. The new paradigm acknowledges the mutual interdependence of the physical body, mind, emotions, and the environment in creating health and disease. As physicians living and working to firmly establish this new medical paradigm,
Ayurveda is not a static, cut-and-dry system of rules, which apply to everyone in all circumstances. Rather it is a system, which recognizes the paramount importance of individual differences, and characteristics Ayurveda is a flexible, dynamic framework, which depends on self-adjustment and idiosyncrasies of use. Within every individual there will arise a particular interpretation of each prescription. No two people will perform an identical self-massage, or prepare a spicy kichadi (an Ayurvedic rice and dal recipe), or exercise vigorously in quite the same way. In this sense, Ayurveda is much more of an art than a science.
Ayurveda overcomes the tyranny of western reductionist medical thought, which breaks
everything down into separate parts for isolated analysis: mind and body heart specialists,
lung specialists, kidney specialists, liver specialists, cancer specialists, woman specialists, etc.
In its place, Ayurveda presents a holistic and organic understanding of the human being which
emphasizes the interrelationship of all aspects of the body, mind, spirit, and environment.
This view of humankind can unchain the true intellect and stimulate the creative powers
inherent in all of us by connecting us to the healing power of nature within and around us.
Direct correspondence to:
Scott Gerson, M.D., Ph.D. (Ayu)
The National Institute Of Ayurvedic Medicine
375 Fifth Ave. 5th Fl.
NY, New York 10016
 Govindacharya, TR, et.al. Ind. J. Chem. 7, 306, 1969.
 Roy Chaudhuri, B and Podar, MK. IRCS Med. Sci. 12, 6, 1984.
 Chaturvedi, GN, et.al. A. paniculata in the treatment of infectious hepatitis in twenty patients, Ancient Sci. Life, 2, 208, 1983.
 Pandey, VN and Chaturvedi, GN. Effect of different extracts of P. kurroa on experimentally induced abnormalities in the liver. Ind. J. Med. Res. 57 (3): 503-512, 1969.
 Chaturvedi GN and Singh RH Treatment of jaundice in infectious hepatitis with Picrorhiza kurroa. Curr. Med Pract. 9, 451, 1965.
 Row, LR, Srinivasulu, C, Smith, M, and Subba Rao, GSR, New lignans from Phyllanthus niruri. Tetrahedron Let. No. 24, 1557, 1964.
4 Ajaneyulu, AS, Jaganmohan, RK, Row, LR. Isolation and structural elucidation of three new lignanas from P. niruri leaves. Tetrahedron 29,1291, 1973.
5 Thyagarajan, et.al. Treatment of infectious hepatitis with P. niruri. The Lancet, 764-766 October 1, 1988,
6 Dixit, SP, Achar, MP. Phyllanthus niruri and jaundice in children. J. Natl. Integ. Med. Assoc., 25 (8), 269, 1983.
This article was reprinted with the permission of Scott Gerson, M.D., Ph.D. (Medical Director, National Institute Of Ayurvedic Medicine). This article is the Copyright 2006 of Scott Gerson, M.D., Ph.D and may not be reproduced without prior written permission.
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