Philosophy:



Ayurveda, the science of life, (Ayu=life; vid=science) is a part of the ageless Vedic heritage of India. Speculations about its origin go back thousands of years before Christ. Extensive literature on this subject, dating back to the fourth century BC, has one thing in common that the essence of Ayurveda is to preserve good health, which is every human being’s birthright. Ayurveda prescribes life style changes with emphasis on tranquility of mind that is filled with universal compassion, as an insurance against an occasional illness. In this system disease is only an accident. Just as road accidents are rare if one follows traffic rules, disease would an exception if one follows the life style prescribed in Ayurveda, which is not hard to comply with.



Human body has an inbuilt powerful immune system that could correct most, if not all, ills that man is heir to. In the unlikely event of this mechanism failing, and only then, should doctors interfere to help the system, when possible. In fact, the concept of immune deficiency syndromes had been prevalent there. Immune boosting methods are the mainstay of Ayurvedic therapeutics, the panchakarmas, and the five modalities.



Swasthasya swastha rakshitham

(Keep the well healthy as long as possible is the motto)



This motto would be a great help to modern medicine where a stage has come, what with the an array of scopes and scanners, coupled with our inability to define normality precisely, we end up with having no normal healthy human beings at all.1 Among the many methods of preserving health in Ayurveda, the one that stands out is Sage Patanjali’s Yoga Shashtra, the science of Yoga. Unlike what is sold by the new age gurus, original Yoga had eight wings: rules for day today living including diet, the art and ethics of living, regular exercise menu, the all important breathing method-pranayaama, detached outlook towards life, yogic postures for constant ease to enable one to practice the next steps of dhyaana-concentration, tranquility of mind, and the ultimate realization of the impermanence of life to make man fearless even in the face of death. Thus defined, Yoga becomes a way of life and not just a few contortions of the body for an hour or so daily. Yoga, in its true form, is a way of life.



Another distinct philosophy in Ayurveda is that every disease begins in our thoughts (consciousness) and grows in the body. Genetic contributions are very clearly understood, in addition. The concept is holistic and never reductionist. Man is a part of the Universal consciousness, the environment and even the stars are supposed to have a role to play. Modern medicine is just trying to grapple with the role played by the mind in serious illnesses.2 Science, especially quantum physics, seems to be going into the new realm of human consciousness. Werner Heisenberg’s Uncertainty principle and Ervin Schrodinger’s Cat Hypothesis point in that direction. Recent studies of patients revived after cardiac arrest and those undergoing brain surgeries have pointed to the possibility of human consciousness (mind) outwith the brain in every single human cell.3,4,5 This all-pervasive consciousness has been the hallmark of Ayurvedic thinking.



Effectiveness of Ayurveda:



In the absence of its recognition by the main line science journals, the studies in the field of Ayurveda find it very difficult to get published, but there have been modern scientific enquiries into the effects of Yogic breathing.6 Millions all over the world now practice breathing methods for good health. It has become another big business with all market force trappings. Small pox, the only scourge that we have been able to eradicate so far, was eradicated with the help of vaccination. The authentication for Edward Jenner’s anecdotal experience came from the prospective controlled study observations of a London physician, T.Z.Holwell, FRCP, FRS, who after studying Indian vaccination systems prospectively for twenty long years in The Bengall province of the Raj, reported his findings to the President and Fellows of the London College in 1747. He wrote that the antiquity and the authenticity (ninety percent protection of the vaccinated) could certainly give credibility to Jenner’s method. The graphic descriptions of the Indian method and its efficacy are portrayed in his paper, which could be viewed in the archives of the College library even today. Although slightly damaged by the great London fire of the eighteenth century, the document, providentially, survived the fire to show the original method that eventually led to the eradication of the greatest scourge of mankind.7 Recent evidence also suggests that the mind could initiate the cardiac rhythm and also the arrhythmias.8



Personality Types in Ayurveda:



Ayurveda classifies human beings into three distinct types, vaata, pitta, and kapha with multiple subtypes. This typing takes into account the pheno-typical and geno-typical features, in addition to consciousness. In short, it is a holistic concept, unlike the modern medical method of matching groups for controlled studies based on tiny fractions of the phenotype, like height, weight, age, sex and body mass index with a few of the biochemical and physical characteristics. This kind of science of reductionism has led to doctors predicting the unpredictable.9 An experienced Ayurvedic physician could classify his patients based on these types since the treatment modalities are individualistic and not based on controlled studies as in modern medicine. Each patient needs individual titration of the methods used for him. Since time-evolution, in a dynamic system, depends on the total initial state of the organism, controlled studies could be done using these personality types to match cohorts for better results in future. There are computerized systems to classify people based on this system.



Holistic Concept of Ayurveda:



Ayurveda does not look at the human body as a sum total of the organs. The physiology in Ayurveda takes into account every aspect of man’s existence, including the planetary influence. There is a whole science of Ayurvedic astrology. The various rhythms of the body like the circadian and ultradian were explained by their mode-locking to the most dominant rhythm of breathing. Breathing could control all the systems in the body except the one rhythm that occurs outside twenty-four hour cycle-the menstrual cycle that occurs once in twenty-eight days. This, Ayurveda, claimed is under the gravitational pull of the moon stimulating the human brain!



“Kujendu hetu prathimaasaarthavam”

(Because of the moon the woman menstruates once a month)



This might have looked very odd but for the fact that recent advances in human physiology have shown that the final stimulus for the endocrine orchestra that maintains the infradien rhythm of menstruation comes, from the gravitational effect of the moon on the cortical cells.10





Most of the present day ”so-called” Ayurvedic drugs in the market are reductionist in that they are only the extracts of the active principle in the plant to conform to the modern medical standards of drug sales. Dravyaguna, Ayurvedic pharmacodynamics, does not deal with active principles. It deals with the whole plant extract as envisaged in the ancient texts. This takes into effect even the photodynamicity of the plant. Some plants are to be harvested only after sunset lest their properties should change if harvested while the sun is up. Modern medicine now tells us that extracts might have serious side effects in the long run.11 Vitamin C in large does, over long periods, could encourage cancer growth in the body, but eating tomato daily with lots of vitamin C in it, would not harm the body. There are many unknown chemicals in the whole plant that prevent the active ingredient from harming the patient while, at the same time, potentiating the good effects of the active principle. We will have to standardize the drug delivery methods to conform to the present standards but on the basis of holism only. In fact, herbal medicines are the least important part of Ayurvedic therapeutics. While yoga, panchakarma, and surgery are the main stay, herbal medicines are occasionally used. Ayurvedic surgery was so advanced that the rhinoplasty method used by the Ayurvedic physician, Shushruta, is being used by plastic surgeons even today. His anatomy classes lasted more than two years for students and he had devised most of the important emergency surgical methods.



What should an Ayurvedic doctor do?



His main job is to study his patient in great detail with special reference to his surroundings and classify him. Having done that he should then try and tailor the management strategies. Most of them would need panchakarma methods. Almost all of them would do well with change of mode of living that ayurveda prescribes with special emphasis on diet, yoga, and exercise. Rarely do surgical methods and/or drugs become appropriate. With advances in modern science and technology one cannot ignore the benefits of using modern hi-tech methods for emergency care. This requires the conventional ayurvedic doctor to have a reasonably good knowledge of the modern medical methods to be able to give proper advice to patients. A judicious combination of modern medicine and ayurveda would be an ideal training for a family doctor. More skilled specialists in either system could be used only at the referral point. This would bring down the top-heavy cost of modern medical care remarkably.



More than eighty per cent of the illnesses are either minor or self-correcting. They could easily be helped using ayurvedic methods and a placebo doctor. In addition, Ayurveda could help chronic debilitating diseases to a great extent, at a very small cost to the taxpayer. About ten per cent of the time modern medicine becomes mandatory. Roughly ninety per cent of the unnecessary cost could be reduced for the benefit of all without detriment to public health. Rather, most of the iatrogenic problems could thus be avoided. Iatrogenesis is usually due to the long-term side effects of modern drugs.12 The latter form about fifteen per cent of hospital admissions. Modern medical doctors, who do not have an idea of Ayurveda and how it works, could be baffled when confronted with a patient who has probably taken the wrong advice from unscrupulous ayurvedic practitioners. The whole gamut of these intricacies would have to be thrashed out before changing the system of medical education into a complementary holistic system.



Ayurveda would not be of much use in an emergency. For the management of emergencies we have to follow the modern medical methods. But for all the chronic degenerative and ageing problems Ayurveda is a panacea. The cost is very small in comparison. Modern medical drugs and interventions are good for acute emergencies, but in the long run most of them have run into serious problems.



Bibiliography.





1) Smith R, The Screening Industry. BMJ 2003;

2) Hostility and the heart. BMJ

3) Pimm vL, Ruud vW, Meyers V, & Elfeferich I. Near-death experience in survivors of cardiac arrest: a prospective study in Netherlands. Lancet 2001; 358: 2039-45.

4) Greyson B. Dissociation in people who have near-death experiences: out of their bodies or out of their minds? Lancet 2000; 355: 460-63.

5) Sabom MB. Light and death: one doctor’s fascinating account of near-death experience. Michigan: Zonderyan Publishing House, 1998: 37-52.

6) Bernardi et.al Effect of breathing rate on oxygen saturation and exercise performance in CHF. Lancet; 1997;351:9112.

7) Hegde BM. Vaccination in India. Jr. Assoc. Physi.India

8) Victor S et. Al

9) Firth WJ. Chaos-predicting the unpredictable. BMJ 1991;

10) Cecil’s Textbook of Medicine 2001, page 1202.

11) Long term side effects-negative research. ?BMJ

12) Effect of anti-hypertensive treatment after five years. BMJ.



Extra if needed.



* BHJ 1994; 71: 229-31

*Lancet 1996; 348: 752-53.

*Goleman Daniel. Destructive Emotions, Book. To be discussed in MIT in September.

* Benson Herbert. The Relaxation Response. Mind Body Medical Institute, Boston.

* Lommel Pim von. Lancet 2001

* Blackmore. Dying to Live. (Out of body experience.)

5.Solomon Victor’s study.