Ayurvedic Medicine

Ayurvedic Medicine

In Sanskrit, the primary language of ancient India, Ayurveda means "knowledge of life." Indeed, it is far more than a compendium of medical treatments: It represents a complete philosophy of life and living. Like traditional Chinese medicine, Ayurvedic medicine sees each individual person as an extension of the universe, and health as a state of balance within the body and between the body and the universe. In Ayurveda, as in most holistic forms of health and healing, there is no dividing line between body, mind, and spirit, and disease and pain can be caused by physical, psychological, or spiritual imbalances. Your case of arthritis, in this view, could very well stem from the fact that your life is too filled with stress or that you are unhappy in your relationships with others rather than from misuse or overuse of your joints.

Ayurvedic medicine attempts to treat not just the overt symptoms, but the whole body. It uses a combination of herbal medicine, diet, yoga, and meditation to bring the body back into balance. And as is true in many forms of alternative medicine, the process of diagnosis in Ayurvedic medicine relies far more on a practitioner's powers of observation and questioning than on laboratory tests or imaging techniques.

The Diagnostic Process

If you're like most Americans who are more familiar with Western techniques, it may surprise you that the Ayurvedic practitioner begins by asking you a series of questions about your personal life and habits as well as about your arthritis symptoms in particular. In addition, you may find it strange that he will want to smell and touch your skin during the exam; don't be alarmed, this is a perfectly natural part of the Ayurvedic diagnostic procedure.

The Ayurvedic practitioner will probably begin his examination of you by taking your pulse. In fact, as in Chinese medicine, he will listen to your pulse at twelve separate sites on the wrists—six on the left and six on the right. Measuring the pulses informs the practitioner of the movement of energy—called prana—through the body, as well as the general health of each internal organ.

Another important diagnostic tool used in Ayurvedic medicine, as well as in traditional Chinese medicine, is the examination of the tongue. Ayurvedic tradition divides the tongue into areas which reflect the different organs. The coating on the tongue reflects the amount and type of toxins in the organs. For instance, the rear of the tongue corresponds to the lower back and hip area; thus a practitioner may look there first if you come in complaining of low-back pain or arthritic hips.

The practitioner is likely to ask you a great many questions about your medical history, your present symptoms, and your feelings about your personal life and physical condition. The practitioner will take note of not only what you say, but also the way you say it: The strength and sincerity (or lack of it) of your voice may reflect your willingness to accept responsibility for your own health. Based on the results of these and other examination procedures, an Ayurvedic doctor will attempt to locate your physical and emotional strengths and weaknesses, as delineated by Ayurvedic tenets.

The ABCs of Ayurvedic Philosophy

As you attempt to relate Ayurvedic principles to your arthritis, keep in mind that Ayurveda teaches that all of life—including disease and its symptoms—depends upon learning and developing self-knowledge. In this way, you can look at the pain and limitations arthritis causes you as an opportunity to reexamine your spiritual life and physical state. As you do so, you will learn how to correct any imbalances and thus bring your body back into alignment with the energy of nature and the universe. Later in this chapter, we'll show you some of the ways Ayurvedic therapies may be used to treat arthritis. In the meantime, here is a brief overview of Ayurvedic philosophy.

PRANA (THE LIFE FORCE) AND THE THREE DOSHAS

Known as "qi" in Chinese medicine, the life-providing energy in Ayurveda is called prana. Prana is the animating power of life, providing vitality and endurance to each human being. Prana is also considered to be the power behind the healing process. Indeed, Ayurveda teaches that we each have a Divine Healer within us, nourished by prana, that if properly directed can restore health and balance to the body.

Balance is a particularly important theme in Ayurvedic medicine, as it is in traditional Chinese medicine. In this Indian philosophy, balance and harmony are maintained by what is known as the three doshas, forces of energy that act upon body substances and organs. When the three doshas are balanced, the body functions harmoniously and in health; when they are out of balance, disease results.

The three doshas are called vata, pitta, and kapha. Vata represents movement; pitta, metabolism and heat; and kapha, structure. Within every cell of the body, these three operating principles must exist in proper balance for health to be maintained. A balance between the doshas will allow your physical, emotional, and intellectual qualities to function with vitality and energy.

According to Ayurvedic tenets, each individual has a specific body type based on one of the three doshas. In essence, one of these qualities—movement, heat, or stability—predominates, helping to form your unique personality and physiology. Your Ayurvedic body type is like a blueprint outlining the innate tendencies built into your system. It helps to explain why you are able to consume lots of salt without suffering any ill effects, while your sister's blood pressure soars when she overloads on sodium. Or why eating plants of the nightshade family, such as eggplant, causes a flare-up of arthritis in your friend, but has no adverse consequences for you. Since a prime goal of Ayurvedic medicine is to prevent disease from occurring in the first place, understanding one's own dosha and practicing a lifestyle designed to maintain dosha balance are essential. By accurately identifying your body type, an Ayurvedic practitioner then is able to diagnose and treat your condition more effectively.

Your body shape, your personality, and many other physical and emotional attributes determine your dosha. Here are short descriptions of each type of dosha as it applies to body type:

Vata (pronounced vah-tah) represents the force of movement within your body. It activates the physical system and is responsible for respiration and blood flow through the body. The seats of vata—the places in the body from which it springs—are the large intestine, pelvic cavity, skin, ears, and thighs. Organs associated with vata include the bones, the brain (especially motor activity), the heart, and the lungs. Vata is the dosha most associated with arthritis and other musculoskeletal problems.

If you are predominately a vata body type, you tend to be rather thin, with prominent features and cool, dry skin. You're inclined to speak rapidly and have an active, creative mind. You probably like to keep irregular hours, and may be prone to feel anxious and worried. Vata's season is autumn—a dry, windy season during which vata people often develop arthritis, constipation, and other diseases of the vata organs.

Pitta dosha governs the metabolic processes of cells. Organs associated with pitta include the blood, the brain (especially memory and learning), hormones, liver, small intestine, and spleen. If you're a pitta body type, you tend to have a medium build, thin hair, and warm, ruddy skin. Pittas are organized, work hard, and have very regular sleeping and eating patterns. Although generally warm and loving, a person with a predominately pitta dosha may also display quick bursts of temper. Pittas tend to suffer from acne, hemorrhoids, and ulcers, and may often feel warm and thirsty. The pitta season is summer, when the heat and bright light may aggravate pitta-related disorders, including rashes, diarrhea, and inflammatory conditions. Pitta arthritis is marked by inflammation and helped by cold applications.

Kapha is responsible for physical strength and stability, and is directly linked to arthritis and other joint diseases. Located in the chest, lungs, and spinal fluid, kapha holds together the structure of the body. Organs associated with kapha include the brain (information storage), joints, lymph, and stomach. If you have a predominantly kapha body type, you tend to be heavyset, with cool, oily skin. Kaphas are often very relaxed and tolerant people, who are slow to anger and have a tendency to procrastinate. They sleep for long hours and may not eat for physical reasons but rather for the emotional pleasure that food brings to them. Kapha types are especially prone to obesity as well as to illnesses of the kapha organs, such as allergies and sinus problems. The kapha season is winter, when the respiratory system is particularly susceptible to colds and congestion. Kapha arthritis is swollen, with dull pain and heavy aching, made worse by cold damp weather.

The Ayurvedic Prescription

All treatment for arthritis—indeed, for all illnesses and imbalances—involves the use of diet and nutrition, herbs, yoga exercises, meditation, massage, and breathing exercises. It is important to remember that Ayurvedic medicine does not treat any condition in isolation; thus, the whole body must be brought into balance before a specific symptom, like joint pain and inflammation, can be alleviated.

PANCHAKARMA

The first step in your treatment may involve what is called panchakarma, which is the process of detoxifying your body of impurities or toxins. Detoxification may consist of induced vomiting, enemas, blood cleansing (by bloodletting and using blood-thinning herbs), and nasal douching—all under the strict and careful supervision of the Ayurvedic practitioner. Yoga, chanting, meditation, and lying in the sun for long periods make up another stage in the cleansing process.

A period of tonification, or enhancement, then takes place. During tonification, you'll consume certain herbs and perform particular yoga, meditation, and breathing exercises. At the same time, or perhaps as a next stage in the healing process, you'll spend a great deal of time meditating; this is called satvajaya and has as its goal the reduction of psychological and emotional stress, as well as the release of negative emotions and ideas.

Although the above steps are recommended for anyone desiring to attain proper health and balance, those who suffer from arthritis are likely to be prescribed certain specific dietary guidelines, herbal remedies, and yoga exercises designed to bring your apana vata back into balance. The apana vata is the subdosha most related to the intestinal tract, and thus the prescription for flushing out impurities that otherwise might collect in joint tissue and hence cause pain and inflammation. However, any Ayurvedic prescription will be quite personal and individual; everyone with arthritis does not have the same physical make-up and thus will not respond to the same treatments.

EATING FOR HEALTH

Dietary measures are particularly personal. The Ayurvedic practitioner will devise an eating plan based on your own specific needs and physiology, designed to help restore your health and alleviate arthritis symptoms. In most cases, a diet to pacify or moderate the apana vata subdosha would include increasing the amount of asparagus, cooked onions, garlic, and okra, while avoiding broccoli, cabbage, as well as vegetables of the nightshade family like eggplant and potatoes. Dried fruits, beans, and certain herbs like coriander seed and saffron are among the other foods that an Ayurvedic prescription for arthritis, back pain, and other musculoskeletal disorders might limit or forbid. However, you should work closely with your practitioner to devise an eating plan that works for you. Supervised fasting, either by abstaining from eating all food or by eating just one food, is a frequent first-line treatment for arthritis and other pain-associated conditions. A fast may include consuming herbs which help to cleanse the body.

YOGA

Yoga exercises are meant to stimulate and stretch your muscles and organs, as well as bring your mind and body into a deeper state of relaxation. There are dozens of yoga techniques and exercises and, in fact, several different schools of yoga, each one with a slightly different philosophy and emphasis. Indeed, the study of yoga in its fullest measure and many levels is a lifetime endeavor, one that, Ayurvedic tradition dictates, leads to true harmony and health.

At the same time, however, yoga poses in and of themselves can be quite helpful in alleviating muscle and joint pain related to arthritis. Yoga poses, performed correctly and practiced regularly, will help you keep your body in balance and the muscles and tendons of your body supple and lithe.

In his book, Perfect Health, Deepak Chopra, M.D., describes a three-pronged yoga program that he prescribes to his patients. Called the "Three Dosha Exercises," it starts with an exercise called "The Sun Salutation," which is a complete Ayurvedic exercise that attempts to integrate your whole body, mind, and spirit. It also stretches and strengthens all of the major muscle groups and lubricates the joints while increasing blood flow throughout the body—a perfect tonic for anyone suffering from arthritis.

The Sun Salutation consists of 12 postures that you should perform in a fluid sequence, one following directly after another. It is important that you keep breathing, deeply and regularly, throughout this exercise. If your joints and muscles are particularly stiff, you'll want to perform this exercise very slowly, taking care not to strain or push too hard.

The Sun Salutation (Surya Namaskar)

1. Stand up straight, feet together, the fingers and palms together in front of the chest, the fingers pointing upward and thumbs touching the chest. This is the traditional Indian gesture of respect or homage. If you like, think of the sun suffusing your body with energy.

2. As you inhale, raise your arms high and back, the palms facing forward. Let your head fall back, bending the spine gently backward at the waist.

3. As you exhale, bend forward from the waist and try to touch your hands to the floor beside your feet. Come as close as you can, but do not strain. Keep your knees slightly bent. Try to press your face to your thighs.

4. As you inhale and lift your head, stretch the right leg back and go down on your right knee. The left foot stays in position, and if your hands are not already on the floor, then you you should place them on either side of your left foot.

5. As you hold your breath, straighten the right leg and bring the left leg next to it. Your hands and toes are now supporting your body. From the back of the head to the heels should be a straight line. This looks like the "up" position in a standard push-up.

6. As you exhale, bend your arms and lower your forehead, chest, and knees to the floor. Try to keep your pelvis and calves raised by pulling in your abdominal muscles and gripping your toes tighter.

7. As you inhale, straighten the arms and raise the upper part of your body up and back, keeping the pelvis and legs on the floor. Your back should form a gentle arc, with your chin pointing up. This is known as the Cobra Position.

Step 7 - The Cobra Position This position works to stretch your hamstrings and lower back. Make sure that you inhale as you lift and expand your chest forward and up. Let your upper back widen and lengthen.

8. As you exhale, raise your pelvis and hips and bring your head between your arms. Your feet should stay flat on the floor, your palms should support your upper body, your back should be straight, and your buttocks should form the highest point. In this Wheelbarrow Pose, you may not be able to keep your feet flat on the floor until you develop a good deal of flexibility.

Step 8 - Wheelbarrow Pose As you perform the Wheelbarrow Pose as described in Step 8 of the Sun Salutation, make sure that you lengthen through the backs of your legs during the stretch, while keeping your head and neck relaxed.

9. As you inhale, take a long step forward with the right foot, bringing it in line with the hands. At the same time, lower the left knee to the floor and bring the chest up and forward. (This is the same as Position 4, only kneeling with the left knee instead of the right.)

10. As you exhale, assume Position 3 again by bringing the left foot forward beside the right foot, raising the hips, and straightening or nearly straightening the legs.

11. As you inhale, straighten up from the waist and swing your arms high and back, essentially repeating Position 2.

12. As you exhale, lower your arms to the side and stand up straight.

These twelve postures form the Sun Salutation. Once you've done the exercise a few times, it should come naturally to you. Never bounce, strain, or rush. Breathe deeply, feeling energy rush in every time you inhale and tension flee every time you exhale.

If yoga interests you, you should have no trouble finding a class in the city nearest you. A qualified instructor will be able to guide you to the most beneficial poses for your particular condition; if your hips are troubled by arthritis, he may suggest the "seated twisting pose" (Marichyasana), which involves a gentle stretch of the spine, neck, and upper body in order to refresh and nourish the lower back and hip area.

Another common prescription for people interested in treating their bodies with Indian healing techniques is called balanced breathing, or Pranayama. This exercise involves learning to control and appreciate the act of taking oxygen and prana in and releasing carbon dioxide and other toxins.

To perform a typical exercise, gently close your right nostril with your right thumb, then exhale and inhale once through your left nostril. Now, open the right nostril, and close your left nostril with the middle and fourth fingers and exhale and inhale once with your right nostril. Continue alternating your breath between the two nostrils for five minutes. Remember to remain quiet, begin each breath on the exhale and finish on the inhale. Breathe naturally, do not feel the need to take deep breaths. You are simply learning to quiet your body and soul while bringing nourishment into your body.

Ayurvedic medicine is an ancient, complex, and multilayered system of health and healing. Its goal—to bring the body back into balance and harmony with nature and its natural state—is one that we should all strive to achieve. The closer we come to that ideal, the less likely we'll be to develop such chronic and ultimately destructive diseases as arthritis. If you are interested in pursuing Ayurvedic medicine in more depth, see our list of resources on page 168. In the meantime, we now look to another system of healing, one that looks to the spinal column and the nervous system that springs from it as the wellspring of health and well-being.