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 Traditional knowledge systems • Testability • Four-fold approach • verifiability • Aptopadesha (Scriptures and • Reproducibility peers) • Quantitative • Pratyaksha (direct cognition) • Evidence based • Anumana (Inference) • Structural • Yukti (Rationale) • Generalised • 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 Vikaro nama akushalo na jihriyat kadaachana around us a potential medicine Indicative correlates of dosha theory with biomedical science Vata Pitta Kapha Movement Transformation Anabolism Governs nervous Actions of enzymes, Maintains body and musculoskeletal growth factors, mass, shape, and systems hormones flexibility Signaling pathways Processes such as Biosynthesis of regulating cell growth, digestion, macromolecule. differentiation, and cell metabolism, energy coordination of death production gene and protein function Sumantran and Tillu, 2012 Elemental tissues (dhatu) – factors affected in disease pathogenesis • Rasa • Rakta • Mamsa • Meda • Fluid component • Intravascular • Muscular tissue • Adipose tissue (intra-extra component cellular) Nourishes Gives life Covers Lubricates • Asthi • Majja • Shukra • Structural • Intraosseous • Reproductive component material material (skeletal) Supports Completes 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 pheotypic classificatio of Idia’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 Six stages of progression 2017 - 09 - 20 Dushya Nidana Dosha (Dhatu, Agni, Disease (Cause) (V,P,K) Ama) Factors involved in disease production Therapeutics is designed to correct Nidana, Dosha and Dushya Variables in Ayurveda disease management Causes Pathogenesis Disease Symptoms Diet No Symptoms 2017 - 09 Affecting factors Lifestyle - Homeostasis 20 Medicines Good QoL Precise Customized Relief Health Constitution Diagnosis Treatment Therapies Systems & organs Tranquil mind Age Counselling Well Being Season Others Strength Patient Metabolic status Rogi Pariksha Tolerance Surroundings Diet Image Courtesy: Tillu G 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, 2017 - 09 panchakarma (detox) and yoga. - 3. A systemic cleansing of body (shodhana chikitsa) using 20 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). 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 ediie ad thy ediie 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 preetio of ost NCDs – 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 shodhaaṃ shaaaṃ ceti samaasaat aushadham dvidhaa| shareerajaanaam doṣaaṇaa kramena paraauṣadha || basti: vireko vaaaṃ tathaa taila ghrutam madhu: | (A.H.Su.1/25) Homeostasis with Panchakarma – few reports