| Ayurvedic Medicine
Ayurveda is the traditional, natural system of medicine of India, which
has been practiced for more than 5,000 years. Ayurveda provides an integrated
approach to the prevention and treatment of illness through lifestyle
interventions and a wide range of natural therapies. The term Ayurveda
has its origins in the Sanskrit roots ayus, which means "life," and veda,
which means "knowledge." Ayurvedic theory states that all imbalance and
disease in the body begin with imbalance or stress in the awareness, or
consciousness, of the individual. This mental stress leads to unhealthy
lifestyles, which further promote ill health. Therefore, mental techniques
such as meditation are considered essential to the promotion of healing
and to prevention. Ayurveda describes all physical manifestations of disease
as due to the imbalance of three basic physiological principles in the
body, called doshas, which are believed to govern all bodily functions.
Evaluation of these three doshas--vata, pitta, and kapha--is accomplished
~primarily by feeling the patient's pulse at the radial artery, which
is a detailed and systematic technique called nadi vigyan. This evaluation
determines the types of herbs prescribed, and it guides the physician
in the application of all other ayurvedic therapies. Specific lifestyle
interventions are a major preventive and therapeutic approach in Ayurveda
as well. Each patient is prescribed an individualized dietary, eating,
sleeping, and exercise program depending on his or her constitutional
type and the nature of the underlying dosha imbalance at the source of
the illness. The Ayurvedic practitioner uses a variety of precise body
postures, all derived from the age-old discipline of yoga; breathing exercises;
and meditative techniques. These postures are used to create an individualized
self-care program to improve both physical health and personal consciousness.
In addition, herbal preparations are added to the patient's diet for preventive
and rejuvenative purposes as well as for the treatment of specific disorders.
In addition to mental factors, lifestyle, and dosha imbalance, Ayurveda
identifies a fourth major factor in disease: the accumulation of metabolic
byproducts and toxins in the body ~tissues. Ayurvedic physical therapy,
called panchakarma, consists of physical applications, including herbalized
oil massage, herbalized heat treatments, and elimination therapies (e.g.,
therapies to improve bowel movements), which promote internal cleansing
and removal of such toxic metabolic wastes. Certain of the agents used
in panchakarma therapy are proposed to have free-radical scavenging, or
antioxidant, effects (Fields et al., 1990). Free radicals are naturally
occurring atoms or molecules that are highly reactive with anything they
come into contact with. A recently developed theory suggests that free
radicals play important roles in causing a wide range of degenerative
and chronic disorders, including cancer and aging. Thus, substances with
antioxidant properties may be effective in preventing, or even treating,
myriad conditions. (See the "Diet and Nutrition" chapter for more information
on free radicals and antioxidants.) Ayurveda emphasizes the interdependence
of the health of the individual and the quality of societal life. Therefore,
measures to ensure the collective health of society, such as pollution
control, community hygiene, the collective practice of meditation programs,
and appropriate living conditions, are supported.~There are currently
approximately 10 Ayurveda clinics in North America, including one hospital-based
clinic, which together have served an estimated 25,000 patients since
1985 (Lonsdorf, 1993). More than 200 physicians have received training
as Ayurvedic practitioners through the American Association of Ayurvedic
Medicine, have received continuing medical education credit for Ayurvedic
training programs, and have incorporated Ayurveda into their clinical
practices as an adjunct to modern medicine (Lonsdorf, 1993). A modern
revitalization of Ayurveda now being practiced in the United States and
internationally is known as Maharishi Ayurveda. This approach utilizes
a full range of physical and mental therapies from the Ayurvedic tradition.
In India, Ayurvedic practitioners receive State-recognized and-institutionalized
training along with their physician counterparts in the Indian state-supported
systems for conventional Western biomedicine and homeopathic medicine.
A number of these Indian-trained Ayurvedic physicians practice or teach
Ayurveda in the United States. Research base. There have been extensive
studies of the physiological effects of meditative ~techniques and yoga
postures in both the Indian medical literature and the Western psychological
literature (Funderburk, 1977; Murphy, 1992a; Murphy and Donovan, 1988).
For example, students in hatha yoga classes showed improvement in fitness
measures, including flexibility, strength, equilibrium, and stamina (Jharote,
1973). In addition, effects of yogic postures and breathing on finger
blood flow showed consistent changes with various breathing practices,
changes that were more pronounced in trained yogic practitioners (Gopal
et al., 1973). Changes in endocrine hormone measurements also have been
associated with certain Ayurvedic practices (Glaser et al., 1992; Udupa
et al., 1971). Measurement of metabolic rate, oxygen exchange, lung capacity,
and red and white blood cell counts have been found to be associated with
general yogic training and in some cases with specific asanas (posture)
(Gopal et al., 1974). Similar basic research on meditative practices has
led to the development in Western medicine of biofeedback and relaxation
training (see the "Mind-Body Interventions" chapter). Yogic and meditative
practices also have been studied as specific interventions for disease
~states such as asthma and hypertension (Bhole, 1967; Patel, 1973). A
recent pilot study performed in Holland followed a group of patients who
used a combination of Ayurvedic therapies. The study documented improvements
with Ayurvedic therapies in 79 percent of patients who were studied for
a 3-month treatment period with a number of chronic disease conditions,
including rheumatoid arthritis, asthma, chronic bronchitis, eczema, psoriasis,
hypertension, constipation, headaches, chronic sinusitis, and non-insulin-dependent
diabetes mellitus (Janssen, 1989). In addition, published studies have
documented reductions in cardiovascular disease risk factors, including
blood pressure, cholesterol, and reaction to stress, in individuals practicing
Ayurvedic methods (Schneider et al., 1992) and have shown improvement
in overall health care utilization measures among meditators (Orme-Johnson,
1988). The "technology" of meditative practices has been subjected to
studies showing physiological changes of heart rate, blood pressure, brain
cortex activity, metabolism, respiration, muscle tension, lactate level,
skin resistance, salivation, and pain and stress responses ~(improvement),
and both negative and positive behavioral effects (Murphy, 1992a). Further
laboratory and clinical studies on Ayurvedic herbal preparations and other
therapies have shown them to have a wide range of potentially beneficial
effects for the prevention and treatment of certain cancers, including
breast, lung, and colon cancers (Sharma et al., 1990). They have also
been shown effective in the treatment of mental health (Alexander et al.,
1989b) and infectious disease (Thyagarajan et al., 1988), in health promotion
(Schneider et al., 1990), and in treatment of aging (Alexander et al.,
1989a; Glaser et al., 1992). Mechanisms underlying these effects are believed
to include free-radical scavenging effects (Fields et al., 1990), immune
system modulation, brain neurotransmitter modulation, and hormonal effects
(Glaser et al., 1992). The National Cancer Institute (NCI) has included
Ayurvedic compounds on its list of potential chemopreventive agents and
has recently funded a series of in vitro studies on the cancer-preventive
properties of two Ayurvedic herbal compounds, maharadis amrit kalash 4
and 5 (MAK-4 and MAK-5). In preliminary studies, NCI researchers have
demonstrated that MAK-4 and MAK-5 significantly inhibited cancer cell
growth in both human tumor and rat tracheal epithelial cell systems ~(Arnold
et al., 1991). Future research opportunities and priorities. Because of
the potential of ayurvedic therapies for treating conditions for which
modern medicine has few, if any, effective treatments, this area is a
fertile one for research opportunities. For example, when NCI researchers
began testing MAK-4 and MAK-5 for effects against tumor cell growth, they
also found that similar compounds such as ferulic acid, catechin, bioflavonoids,
retinoic acid (vitamin A), ascorbyl palmitate, and glycyrrhetinic acid
also showed chemopreventive activity (Arnold et al., 1991). Known scientific
data on the intrinsic rhythms and laterality (right side vs. left side)
patterns in the autonomic nervous system can provide a model for understanding
how stress disrupts healthy physical function. Certain meditative and
yogic practices have been proposed as noninvasive "technologies" to self-regulate
the neural matrices that couple mind and metabolism in the body (Shannahoff-Khalsa,
1991). Translation of the traditional concepts of yogic medicine into
the language of modern medicine could stimulate creative research in ~the
neurophysiology of stress and adaptation. The following are the research
opportunities as well as the priorities for investigations in this area
of alternative medicine: 1. Performing a critical review of world literature
to identify potentially useful Ayurvedic therapies for various conditions.
2. Conducting long-term health care utilization and cost effectiveness
studies on individuals who use Ayurvedic therapies, lifestyle programs,
and meditation regularly for prevention. 3. Studying the effectiveness
of Ayurvedic therapies and lifestyle for the prevention and treatment
of diseases such as cardiovascular disease, cancer, AIDS, osteoporosis,
autoimmune disorders, Alzheimer's, and aging. ~ 4. Assessing the cost
and treatment effectiveness of Ayurvedic therapies in the treatment of
specific functional or chronic disorders such as chronic fatigue syndrome,
premenstrual syndrome, chronic pain, functional bowel and digestive problems,
insomnia, allergies, and neuromuscular disorders. 5. Identifying the mechanisms
underlying therapeutic effects of herbal therapies, diet, Ayurvedic physical
therapies such as panchakarma, meditation, yogic practices, and other
treatment modalities. 6. Studying the effects of the collective practice
of meditation on community health indices and health care costs in cities,
the Nation, and other social groups.
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