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Indian Ayurveda medicine
– Detoxification and Rejuvenation
Prof. Dr. Gangadharan GG, Ayurvedacharya, FAIP
(USA), PhD, MoM (McGill, Canada)
Director, Ramaiah Indic Specialty Ayurveda – Restoration
Hospital, A unit of Gokula Education Foundation (Medical)
New BEL Road, MSR Nagar, Mathikere PO, Bengaluru - 54
Tel: +91-80-22183456, +91-9632128544,
Mob: +91-9448278900
e-mail: [email protected]
Website: http://www.msricaim.com/
Introduction
• Indian knowledge systems (IKS) – foundational unity
despite diverse nature
• Contiguous, interconnected and epistemologically
common identity
• Same thread runs through gamut of activities
including medicine, farming, cooking, grammar,
dance, arts etc.
• Currently, IKS are in a state of transition owing to
external influence
• Distorted promotion and popularization of IKS will
be detrimental to its growth
Traditional medicine
• WHO defines Traditional medicine as the sum total of the
knowledge, skills, and practices based on the theories,
beliefs, and experiences indigenous to different cultures,
whether explicable or not, used in the maintenance of health
as well as in the prevention, diagnosis, improvement or
treatment of physical and mental illness
• These include Ayurveda, Siddha medicine, Unani, ancient
Iranian medicine, Iranian (Persian), Islamic
medicine, traditional Chinese medicine, Kampo (drawn largely
from TCM, in Japan), traditional Korean
medicine, acupuncture, Muti, Ifá, and traditional African
medicine and many many more newer practices
• Very few of such practices are complete knowledge systems
• Ayurveda – a comprehensive system, with holistic approach;
attends to body, mind and spirit
Subjectivity and objectivity
Contemporary science
• Testability
• verifiability
• Reproducibility
• Quantitative
• Evidence based
• Structural
• Generalised
Traditional knowledge systems
• Four-fold approach
• Aptopadesha (Scriptures and
peers)
• Pratyaksha (direct cognition)
• Anumana (Inference)
• Yukti (Rationale)
• Qualitative
• Word of mouth
• Functional
Medical pluralism
• Health behavior is a type of social behavior mainly
influenced by the various socio-cultural issues.
• Understanding a disease/illness is not a medical
subject rather it is mainly reliant on the common
information of the concerned community.
• This has led to prevalence of more than one
system of medicine existing
• Medical Pluralism is an adaptation of more than
one medical system or simultaneous integration
of orthodox medicine with complementary and
alternative medicine (CAM)
Different traditional medical
systems
• Traditional medicines include Ayurveda, Siddha
medicine, Unani, ancient Iranian medicine, Iranian
(Persian), Islamic medicine, traditional Chinese
medicine, Kampo (drawn largely from TCM, in
Japan), traditional Korean
medicine, acupuncture, Muti, Ifá, and traditional
African medicine and many many more newer
practices
• Very few of such practices are complete knowledge
systems
• Ayurveda – a comprehensive system, with holistic
approach; attends to body, mind and spirit
Challenges to traditional medicine
• Major threat is
• trend to negate philosophical moorings
• Discard their interconnectedness
• Promote them as fragmented systems
• Concept of holism, ethics in application and
responsibility to the philosophy is diluted and
disregarded
• Need is
• Explore and adopt ethical modes to
adapt to changing times
Advantage of Ayurveda
A functional framework that can
accommodate any medical
condition one may encounter.
A practical inventory of physical
universe and their effect on the
living system which, when
understood makes everything
around us a potential medicine
Vikaro nama akushalo na
jihriyat kadaachana
Indicative correlates of dosha theory with
biomedical science
Vata
Movement
Governs nervous and musculoskeletal systems
Signaling pathways regulating cell growth, differentiation, and cell death
Pitta
Transformation
Actions of enzymes, growth factors, hormones
Processes such as digestion, metabolism, energy production
Kapha
Anabolism
Maintains body mass, shape, and flexibility
Biosynthesis of macromolecule. coordination of gene and protein function
Sumantran and Tillu, 2012
Elemental tissues (dhatu) – factors affected in
disease pathogenesis
• Rasa
• Fluid component (intra-extra cellular)
Nourishes
• Rakta
• Intravascular component
Gives life
• Mamsa
• Muscular tissue
Covers
• Meda
• Adipose tissue
Lubricates
• Asthi
• Structural component (skeletal)
Supports
• Majja
• Intraosseous material
Completes
• Shukra
• Reproductive material
Reproduces
Image courtesy: ancientsciencesofhealing.blogspot.com
• 52 single nucleotide polymorphisms (p ≤ × −5) were significantly
different between Prakritis, without any confounding effect of
stratification, after 106 permutations
• PGM1 correlated with phenotype of Pitta as described in Caraka
Samhita, suggesting that the phe otypic classificatio of I dia’s traditional medicine has a genetic basis; and its Prakriti-based
practice in vogue for many centuries resonates with personalized
medicine (Govindaraj et al, 2015)
Triphala: An Intelligent Formulation
Cause of disease in ayurveda (AMA)
Aberrant metabolism
Ama - Toxic, pro-inflammatory, waste-product
Blocks micro-channels (Srotas)
Disease
Ayurveda theory of pathogenesis
Nidana
(Cause)
Dosha
(V,P,K)
Dushya
(Dhatu, Agni, Ama)
Disease
Factors involved in disease production
Six stages of progression
Therapeutics is designed to correct Nidana, Dosha and Dushya
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Rogi Pariksha
Disease
Symptoms
Pathogenesis
Affecting factors
Causes
Patient
Constitution
Systems & organs
Age
Season
Strength
Metabolic status
Tolerance
Surroundings
Diet
Precise Diagnosis
Customized Treatment
Diet
Lifestyle
Medicines
Therapies
Counselling
Others
Relief Health
No Symptoms
Homeostasis
Good QoL
Tranquil mind
Well Being
Variables in Ayurveda disease management
Image Courtesy: Tillu G
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Holistic therapeutics
• Focus is on
• Host factors rather than disease factors
• Whole system rather than target tissue
• Multidrug/therapy rather than single
molecule
• Preventive and promotive in addition to
curative
Inherent strengths of Ayurveda 1. Customised intervention that varies according to individual
constitutional frame work (prakriti) and the stage & phase of
disease.
2. Multi-component intervention involving drug, diet, lifestyle,
panchakarma (detox) and yoga.
3. A systemic cleansing of body (shodhana chikitsa) using
techniques of Panchakarma that is unique to Ayurveda
4. A treatment approach that has homeostasis or restoration of
balance as its end point. In this approach, stress is laid on two
things:
a. Apunarbhavatva: Achieving a stable state of homeostasis that
does not relapse to the prior diseased stage (non-recurring).
b. Yonyamanyamudeerayet: Achieving homeostasis without
causing any disturbance to any other systems (without side-
effects).
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Ayurveda principles for healthy life
Dinacharya (Daily regimen)
Ritucharya (Seasonal regimen)
Panchakarma (5 purificatory procedure)
Rasayana (rejuventaion)
Aachara Rasayana – Sadvritta (Behavioral therapeutics)
Ashtanga Yoga (8 steps of Yoga)
Nityam hitaharaviharasevi sameekshakari vishayeshvebhaktah I
Dhata samah satyaparah kshamavanaptopasevi ca bhavatyarogah II
(A.H.Su.4/36)
Aahara - SHADRASA PRADHANATA
Let thy food e thy edi i e a d thy edi i e e thy food Hippocrates
Shadrasa-(Six tastes) - and alleviation of doshas by tastes;
Svadu /Madhura – sweet, Amla – Sour ,Lavana – Salt ,Tikta – Bitter ,Ushna – Katu – Pungent, Kashaya – Astringent are the six types of Rasa(tastes);they are present in the substances, each one is more strengthening (to the body)in their order of precedence.
Rasaha swadvamlalavantiktoshnakashayakah ||
Shad dravyamashritaste ca yathapoorvam balavaha |
tatraadyaa maarutam ghnanti trayastiktaadaya: kapham |
kashaayatiktamadhuraa: pittamanye tu kurvate ||
(As.H.su1/14,15)
Diurnal and seasonal clocks
DINACHARYA
Healthy habits should be included in life-style even in the busy schedule , if a person want to be healthy forever.
Includes-
• Early go to bed and early wake-up.
• Daily physical exercise.
• Daily oil massage including scalp, ear and feet as well as bathing.
• Daily use of oily nasal drops.
• Maintenance of body hygiene.
• Daily prayer and meditation.
• Take nutritious and balanced diet.
• Proper dressing.
• Use of gems and jewellery.
• Use deodorants and perfumes.
• Wear good quality of shoes and sandals.
• Select a job with morals and ethics
RITUCHARYA (SEASONAL REGIMEN)
• Environment influences the resting state of Doshas—Vata,
Pitta, and Kapha
• Good understanding of it is very much essential for early
diagnosis and prognosis of any disease & for adopting
preventive and curative measures.
• Dosha accumulation in cold season - expelled in vasanta/spring
• Dosha accumulation in summer / grishma - expelled in varsha /
rainy season
• Dosha accumulation in varsha - expelled in sarat / autumn
• Key to pre e tio of ost NCD s – a gift of Ayurveda
shiitotdbhavam doshacayam vasante vishodhayan griismajam
abhrakaale I
ghanaatyaye vaarsikamaa su samyak praapnoti rogaan
rtujaanna jaatu
Main categories of therapeutics
Purification (shodhana) Palliation (shamana)
Emesis (Kapha) Enhancing digestion
Purgation (Pitta) Withstanding thirst
Decoction enema (Vata) Withstanding hunger
Nasal medication Exposure to sun
Blood letting Exposure to wind
Physical exercise
shodha aṃ sha a aṃ ceti samaasaat aushadham dvidhaa|
shareerajaanaam doṣaaṇaa kramena para auṣadha ||
basti: vireko va a aṃ tathaa taila ghrutam madhu: |
(A.H.Su.1/25)
Homeostasis with Panchakarma – few
reports
• Twice weekly Panchakarma treatment consisting of snehana
(external oleation), swedana (passive heat therapy),
hrudaydhara (concoction dripping treatment) and basti
(enema) in patients of chronic heart failure significantly
improved metabolic equivalents of task and peak oxygen
uptake (Sane R, et al, 2017)
• Quality of life assessment (Skindex-29) among patients of skin
diseases, showed improvement quality of life domains-
emotions, functioning, and symptoms before and after
Ayurvedic purification therapy (Deshpande H, et al, 2016)
• Ayurveda panchakarma intervention resulted in changes in
metabolites across many pathways such as phospholipid
biosynthesis, choline metabolism, and lipoprotein metabolism
(Peterson CT et al, 2016)
• A combination of Panchakarma purificatory measure
Virechana and multiherbal oral medication has been
demonstrated to be effective in management of Hepatic
Cirrhosis Complicated by Ascites (Patel MV et al, 2015)
• Panchakarma therapy – Vamana showed significant relief in
parameters of psoriasis such as scaling, itching, candle grease
sign and psoriasis area and severity index score
(Bhattacharya N, 2016).
• A therapeutic course of Basti in obese individuals modulated
immune responses by regulating pro-inflammatory cytokines,
immunoglobulins and functional properties of T-cells. These
changes are associated with a reduction in the body weight
which is maintained even after three months of treatment
(Thatte U, 2015)
Salutogenesis – Svasthya rakshana
• The term describes an approach focusing on
factors that support human health and well-being,
rather than on factors that cause disease – Aaron
Antonovsky
• Health is a positive state and it is the outcome of
the adaptive feedback that each being establishes
with the environment
• Health is not merely a biological process, it is also a
cultural one involving knowledge as well as the
interaction with the environment in order to
modify it
Rasayana chikitsa
• Jara - Sequential biological human aging in terms
of sequential loss of certain biological qualities of
life specific to different decades of life
• If these bio-losses are compensated in respective
decades by appropriate life-style, nutrition and
Ayurvedic rejuvenative Rasayana remedies
described for this purpose, the rate of biological
aging may be retarded
• Rasayana are age-specific as they promote
nutrition relevant to the natural bio-losses
occurring at different phases of life span
• Rasayana – Ensure excellence of tissue elements
by
• Deepana, pachana (enhanced metabolism)
• Srotoshodhana (detoxification)
• Poshana (nourishment)
• All these three events singly or jointly lead to
improved nutritional status in the body leading
further to the formation of the best qualities of
cells and tissues which sustain aging and stress
Tridosha and biological clock
• Predominance of Dosha changes with age
• So also propensity for disease caused by a specific
dosha differs across ages; eg. Disease of vata –
degenerative illnesses in old age
• Prophylactic measures to keep the dosha fluctuations
in control helps avoid undue effects
• Age appropriate Rasayana therapy
Decade-wise ageing and prevention
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Rasayana chikitsa – an elixir –
evidence
• Abundant evidence for anti-ageing/healthy ageing/reversal of process benefits of Rasayana
• Few examples
• Amalaki Rasayana (herbal formulation) and Rasa-Sindoor (a mercury-based organo-metallic formulation) suppressed cell death and pathology in fly models of neurodegeneration; contribute to 'healthy ageing (Dwivedi V,
etal, 2015, 2016)
• Curcumin reduces oxidative stress and apoptosis, and increase in the life span of PD model flies (Siddique YH etal, 2014)
• Brahma Rasayana and Chyavanaprash reduce cardiotoxicity (Alsuhailbani etal ,2016)
• Amalaki rasayana in aged individuals showed stable maintenance of DNA strand break repair without toxic effects (Viswanath U etal ,2016)
Genomic Variation Analysis and Gene Expression Profiling
of Human Dosha Prakriti based on Principals of Ayurveda
• Determination of Dosha prakriti of the subjects with Ayusoft software and senior ayurvedic physician (Vaidya)
• Analyis of Genetic variation after isolating DNA from selected subjects.
Results • Kapha prakriti specific CDH22 5′-UTR CpG methylation was also found to be
associated with higher body mass index (BMI) (Nizamuddin S et al, 2015)
• Significant difference in the expression of CD14, CD25 and CD56 markers between three different prakriti is demonstrated. The increased level of CD25 and CD56 in kapha prakriti may indicate ability to elicit better immune response, which is in conformity with textual references in Ayurveda (Rotti H et al, 2014).
• Prakriti may govern functions at cellular, tissue and at system levels maintaining equilibrium determined by genes which in turn are regulated by epigenetic cross talk especially through DNA methylation.
• These may provide basis to explore whether the DNA methylation programmed at the time of birth of an individual that will mimic the prakriti constitutions (Rotti H et al, 2015)
• Approaches to identify the influence of food and
utritio i i di iduals gro th, de elop e t and disease causation
•आहारसम्भवं वस्तु र गाश्चाहारसम्भवााः| हहताहहतववशषेाच्च ववशषेाः सुखदाुःखय ाः||४५|| C.S.Su.28
• Grow local, eat local
• यस्य देशस्य य जनतुाः तज्ज ंतज्ज षधं हहतं ।B.N.5/8
• Scope for Ayurveda based food and beverages
The s ie e of life shall e er attai fi ality. Therefore, humility and relentless industry
should characterize your endeavour and approach to knowledge. The entire world
consists of teachers for the wise. Knowledge conducive to health, longevity, fame, and
excellence, coming even from an unfamiliar source, should be received, assimilated and utilized ith ear est ess. Acharya Charaka
THANK YOU