495

IISJCIY
Ayurveda is a holistic system of natural health care that
originated in the ancient Vedic civilization of India.
During centuries of foreign rule in India, beginning in
the fteenth century, Ayurvedic institutions declined or
were suppressed, and much of the Ayurvedic knowledge
was fragmented, misunderstood, and not used in its
totality. Ayurveda has been revived in its completeness,
in accordance with the classical texts, by Maharishi
Mahesh Yogi in collaboration with leading Ayurvedic
scholars and physicians, known as vaidyas. This specic
reformulation of Ayurveda is known as Maharishi
Ayurveda (MAV).
The Sanskrit name Ayurveda is a compound of two
words: Ayus, which means life or life span, and Veda,
which means knowledge, with a connotation of com-
pleteness or wholeness of knowledge. The element of
wholeness in Ayurvedic knowledge has profound clini-
cal signicance: the MAV clinician uses more than 20
treatment approaches that deal with the full range of the
patients life: the body, mind, behavior, environment, and,
most importantly, the patients consciousness, his or her
innermost life. MAV considers consciousness to be of
primary importance in maintaining optimal health and
emphasizes meditation techniques to develop integrated
holistic functioning of the nervous system.
MAV includes a sophisticated theoretical framework
that provides clinical insight into the functioning of both
mind and body. Understanding of the patients mind-
body type is essential to diagnosis and treatment, and
special emphasis is placed on the therapeutic effects of
diet and healthy digestion, as well as techniques to bal-
ance behavior and emotions. An extensive materia medica
describes the therapeutic use of medicinal plants, and
there is a detailed understanding of biological rhythms,
which form the basis for daily and seasonal behavioral
routines to strengthen the immune system and homeo-
static mechanisms.
Ancient Ayurvedic texts typically begin with a thorough
description of strategies of prevention before discussing
modalities for treatment.
32
CONTFMPORARY AYURVFDA
H A R I M . S H A R M A

C H A P T E R
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496 FUNDAMENTALS OF COMPLEMENTARY AND ALTERNATIVE MEDICINE
In addition to preventive techniques, MAV offers a
holistic theory of prevention. Western medical attempts
to develop preventive medical strategies, although laud-
able, conspicuously lack such a theory. As for the elds of
diagnosis and treatment, MAV offers a large body of pro-
cedures and protocols, including a set of noninvasive
diagnostic techniques, and addresses certain deciencies
of Western allopathic medicine. For example, functional
diseases, such as irritable bowel syndrome and poor diges-
tion, account for approximately one third of patient visits
to family practitioners. Western medicine, however, lacks
well-developed theories or methods of treatment for these
disorders.
Another area of concern is iatrogenic (physician-
caused) diseases, which are estimated to be the third lead-
ing cause of death in the United States (Stareld, 2000).
A study of hospitalized patients found that 36% had iat-
rogenic illnesses (Steel et al, 1981). At least one serious
adverse event (another term for iatrogenic occurrence)
resulting from inappropriate care lengthened the hospital
stay of 17.7% of hospital patients (Andrews et al, 1997),
and nearly 14% of the adverse events led to death (Berwick
et al, 1999). A large percentage of iatrogenic illnesses are
the result of side effects from drugs. Adverse drug reac-
tions have now become the fourth leading cause of death
in the United States (Lazarou et al, 1998). To consider one
example, Western approaches to cancer treatment can
have severe side effects, and some antitumor drugs con-
tribute to the development of new cancers. MAV modali-
ties have been effective in reducing the side effects of
several of these treatments (Dwivedi et al, 2005; Misra
et al, 1994; Sharma et al, 1994; Srivastava et al, 2000), and
laboratory research has shown that some MAV herbal
preparations reduce cancer growth directly (Patel et al,
1992; Penza et al, 2007; Prasad et al, 1992, 1993; Sharma
et al, 1990, 1991).
MAV is being practiced in clinics worldwide in India,
Europe, Japan, Africa, Russia, Australia, and South and
North America by specially trained physicians, many of
whom also practice privately. In various ways, MAV directs
its objectives not only to individual patients, but also to
the life of society as a whole.
JICIJICAI bASIS:
A CCSCIC!SSS MCII
CI MIICI
MAVs contribution to patient care and clinical practice
results from the model of health and disease on which it
is based. Whereas Western medicine bases its model for
understanding health and disease on the material of the
body, the MAV model is based on the bodys non material
substrate, which is conceived as a eld of pure intelli-
gence. Western medicines paradigm may seem more sci-
entic, but in certain respects, Ayurvedas may be seen to
presage todays advanced theories of physics.
From the time of Newton until the early twentieth
century, the eld of physics was based on a materialist
approach to the natural world (see Chapter 1 ). The allo-
pathic medical paradigm, developed in the nineteenth
century, is based on this theory of materialism; it views
the body as a complex machine. However, discoveries by
twentieth-century physicists have undermined this mate-
rialist worldview and uncovered a fundamental role for
consciousness in the physical world. Because the nature
and importance of consciousness are not usually consid-
ered in allopathic medicine, twentieth-century physics
provides a useful background for understanding MAV.
According to the materialist theory that dominated
physics until the 1900s, the universe is made up of solid,
discrete bits of matter. These particles affect each other
only through direct interactions. Four basic principles
support this common sense view of reality, as follows:
1. Solid matter. The world is fundamentally made up
of solid material objects, the building blocks of
nature.
2. Strict causality. Change in motion of one object can
be caused only by direct interaction with another
object.
3. Locality. Interactions between particles can occur
only through collisions or through inuences radi-
ated through the electromagnetic or gravitational
elds at the speed of light, or less. No nonlocal
interaction can occur.
4. Reductionism. Large systems in natureincluding, in
principle, the human body and even the entire
universecan be understood completely by under-
standing the properties and local, causal interac-
tions of their smallest discrete components.
In the materialist theory the consciousness of the sci-
entist is considered separate from the material objects
being studied. The knower (consciousness) and the known
T
he Ayurvedic classics include three major texts
( Brihat Trayi ), the Charaka Samhita, Sushruta Sam-
hita, and Ashtanga Hridaya of Vagbhata, and three minor
texts ( Laghu Trayi ), the Sarngadhara Samhita, Bhavaprakash
Samhita, and Madhava Nidanam. Most of these texts have
been translated into English ( Charaka Samhita, 1977;
Madhavakava, 1986; Sarngadhara, 1984; Sushruta Sam-
hita, 1963; Vagbhata, 1982). These texts address eight
main sections of Ayurveda: Shalya surgery in general;
Shalakya head and neck surgery for supraclavicular
diseases; Kaya Chikitsa treatment, diagnosis, and inter-
nal medicine; Kaumarya Birtya pediatrics, obstetrics,
and gynecology; Agad Tantra toxicology and medical
jurisprudence; Bhut Vidya psychosomatic medicine;
Rasayana materia medica to promote vitality, stamina,
resistance to disease, and longevity; and Vajikarana
fertility and potency. (See also Chapter 29 .)
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CHAPTER 32 Contemporar y Ayur veda 497
(object) are thought to exist in completely distinct
domains. This separation is thought to be the basis of
objective science. Throughout the history of science,
however, the separation of consciousness from the appar-
ently material world has led to theoretical difculties. For
example, if consciousness is completely separate from
matter, it is difcult to explain how consciousness could
arise from the purely mechanical interactions of solid
matter within the brain.
In the twentieth century the terms of this discussion
were changed by the fundamental discoveries of quan-
tum physics. Experiments performed in the rst quarter
of the twentieth century indicated that subatomic parti-
cles, the supposed building blocks of nature, did not
appear to be composed of solid matter. In some of these
experiments, particles behaved as if they were waves. In
others, electrons took instantaneous, discontinuous
quantum jumps from one atomic orbit to another, with
no intervening time and no journey through spacean
impossible act for a classic particle. It also was shown
that an individual subatomic particle cannot have both a
precise position and a precise momentum simultane-
ously (the uncertainty principle), another situation
that would not apply to a solid material particle. Finally,
it was found that electrons can, with predictable regular-
ity, tunnel through a solid barrier that, classically, would
be impenetrable.
On the basis of these ndings, the basic principles of
quantum mechanics (often known as the Copenhagen
interpretation ) challenge the materialist worldview, as
follows:
1. No solid matter. This interpretation accepted the
scientic ndings (wave/particle, quantum jumps,
uncertainty, tunneling) that contradict the notion
of solid matter.
2. No strict causality. Precise predictions for individual
subatomic particles are impossible. Quantum me-
chanics thus loses the ability to trace causal relations
among individual particles.
3. No locality. Quantum mechanical equations indicate
that two particles, once they have interacted, are in-
stantaneously connected, even across astronomical
distances. This dees the strictly local connections
allowed in classic materialism.
4. No reductionism. If apparently separate particles ac-
tually are connected nonlocally, a reductionist view
based on isolated particles is untenable.
The Copenhagen interpretation was not put to exper-
imental test for decades, which left some physicists
unconvinced that solidity, causality, locality, and reduc-
tionism had to be abandoned. In the 1980s, however, a
number of different experiments produced results that
consistently contradicted the theories of materialism
(often called local realism ) and consistently conrmed
the predictions of quantum mechanics (Aspect et al,
1981; Rarity et al, 1990). These studies found that once
two particles have interacted, they are instantaneously
correlated nonlocally, over arbitrarily vast distancesan
impossibility in materialism.
These results do not invalidate materialism altogether.
In the everyday world of large objects, the mechanistic
causation of Newtonian physics is approximately correct,
which is why much of medicine has been able to rely on it
without apparently ill consequences. However, at the fun-
damental, subatomic level, materialism conicts both
with theory and with frequently replicated experimental
evidence. This gives rise to a fundamentally different
worldview. Many physicists now argue that nature is com-
posed of probability waves that are a function of intelligence
alone, not of discrete physical particles. The equations of
quantum mechanics thus describe a world made of
abstract patterns of intelligence.
In view of these uniformly idea-like characteristics of
the quantum-physical world, the proper answer to our
question, What sort of world do we live in? would seem to
be this: We live in an idea-like world, not a matter-like
world. There is, in fact, in the quantum universe no natu-
ral place for matter. This conclusion, curiously, is the exact
reverse of the circumstance that in the classic physical uni-
verse there was not a natural place for mind. (Stapp, 1994)
Quantum eld theory, the most accurate version of
quantum mechanics, can be related to the core tenet of
MAVs paradigm. In quantum eld theory the probability
wave for a particle is described as a uctuation in an
underlying, nonmaterial eld (known as a force eld or
matter eld ). Furthermore, in the most recent superunied
theories, physicists have described all the force and matter
elds that make up the universe as modes of vibration of
one underlying, unied eld, sometimes called the super-
eld or superstring eld. All the order and intelligence of the
laws of nature arise from this one fundamental, nonmate-
rial eld, as does all matter. Not only are particles really
just waves, but those waves ultimately are made of an
underlying eld, as ocean waves are made of ocean water.
This eld is one of pure intelligence, having the attributes
that we associate with consciousness. This lends support
to the statement of the quantum mechanical pioneer Max
Planck, who said, I regard consciousness as primary.
I regard matter as derivative from consciousness, and of
Sir Arthur Eddington, the physicist who rst provided
evidence in support of Einsteins general theory of relativ-
ity, who said, The stuff of the world is mind-stuff
(Eddington, 1974).
Unied eld theory may seem worlds away from the
concerns of a clinician. The current allopathic approach
assumes that the body can be explained by material reduc-
tionism, as if it were machinery. MAV, by contrast, has
viewed it as an abstract pattern of intelligence. Because
this latter view appears to be consistent with fundamental
science, it is not unreasonable to consider that it might
contribute to the clinicians capacity to promote health.
Let us examine how MAVs consciousness model is
applied in clinical practice.
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498 FUNDAMENTALS OF COMPLEMENTARY AND ALTERNATIVE MEDICINE
AIIIICAJIC CI JI
CCSCIC!SSS MCII
I MAIAIISII AY!IVIA
JRANSCFNDFNTAL MFDITATION
To understand the most basic application of the con-
sciousness model, we must briey touch on physics again.
Vedic thought discusses a unied eld of pure, nonmate-
rial intelligence and consciousness whose modes of vibra-
tion manifest as the material universe. These modes of
vibration are called Veda . The Vedic description is strik-
ingly similar to that of physics but emphasizes an idea less
often discussed in physics: that the unied eld is the
eld of pure consciousness. The differentiation between
consciousness and matter, between knower and known,
loses its signicance at the level of the unied eld.
eyes-closed rest (Gallois, 1984; Wallace, 1970). Periods of
clear experience of TC have been characterized by suspen-
sion of respiration without oxygen deprivation (Badawi
et al, 1984; Farrow et al, 1982), stabilization of the auto-
nomic nervous system (Orme-Johnson, 1973), and a
decrease in plasma levels of lactate, a chemical marker of
metabolic activity (Jevning et al, 1983) and cortisol levels
(Jevning et al, 1978). Simultaneous with this metabolic
rest, blood ow to the brain increases markedly (Jevning
et al, 1978), and the brain displays a state of restful alert-
ness, characterized by greatly increased coherence
between the EEG patterns of different areas of the brain,
that is, stable phase relations between two EEG signals as
measured by Fourier analyses that attain correlations of
more than 0.95 (Badawi et al, 1984; Levine, 1976).
The state of TC can thus be dened physiologically
and experientially. This corroborates MAVs view of TC as
the fourth major state of human consciousness, in the
sense that the three common states of waking, sleeping,
and dreaming can be dened physiologically as well. MAV
also discusses three higher states of consciousness in
which the full potential of consciousness progressively
unfolds. Long-term TM practitioners have reported that
the experience of TC, which rst occurred only during
their practice of the TM technique, now subjectively coex-
ists with waking and sleeping states. Several studies have
investigated this integrated state, and results show that
the increased EEG coherence that is characteristic of the
TM practice appears to become a stable EEG trait during
computer tasks (Travis et al, 2002). Long-term TM practi-
tioners have signicantly higher levels of frontal EEG
coherence during performance of computer tasks than
subjects who do not practice TM (Travis et al, 2006).
MAV views unfolding consciousness as the most
important strategy of both disease prevention and cure.
Consistent with this theory, data suggest that regular
experience of TC has signicant health benets. Such
research supports the MAV concept that remembering
the unied eld enlivens the orderly patterns that prevail
in a healthy body. For example, TM has been found in
several studies to retard biological aging (Glaser et al,
1992; Wallace et al, 1982). In a Harvard study of elderly
nursing home residents that compared TM with two
other types of meditation and relaxation techniques over
3 years, the TM group had the lowest mortality rate
and the greatest reductions in stress and blood pressure
(Alexander et al, 1989). A follow-up study that evaluated
the long-term effects of TM on mortality in patients with
systemic hypertension showed that TM practice was asso-
ciated with a 23% decrease in all-cause mortality and a
30% decrease in the rate of cardiovascular mortality com-
pared with other behavioral interventions and usual care
(Schneider et al, 2005a). Several studies have found that
TM signicantly reduces high blood pressure (Cooper
et al, 1978; Schneider et al, 1992, 2005b; Wallace et al,
1983). In a randomized controlled trial Schneider et al
(1995) found TM to be approximately twice as effective as
T
hese various modes of vibration known as Veda
are described and written down in the volumi-
nous Vedic literature. The different aspects of Vedic lit-
erature have been found to correspond with specic ar-
eas of the human physiology (Nader, 1993).
In MAV the ultimate basis of disease is losing ones
connection to (or, to use a central Vedic description, ones
memory of) the unied eld, which is the innermost core
of ones own being and experience. This loss is known
technically as pragya-aparadh. The ultimate basis of preven-
tion and cure is restoring ones conscious connection to
(or memory of) this innermost core of ones being and
experience. This reconnection is the basis of an integrated
approach to health care; integration of the different layers
of life begins with reconnecting ones life to the substrate
on which all its layers are based. The innermost core of
ones experience is considered identical to the home of all
the laws of nature that operate throughout the universe.
The body contains, at its basis, the total potential of natu-
ral law, and all of MAVs modalities aim to enable the full
expression of the bodys inner intelligence.
The foremost means for accomplishing this are the
Vedic techniques for developing consciousness, the most
important of which is Transcendental Meditation (TM). The
term transcendental indicates that the mind transcends even
the subtlest impulses of thought and settles down to the
simplest state of awareness (in MAV terms, identical to
the unied eld). This state of awareness is known techni-
cally as Transcendental Consciousness (TC).
Interestingly, a large body of published research has
demonstrated that, during the subjective experience of
TC, the bodys metabolism and electroencephalogram
(EEG) tracings take on a unique pattern of profound
physiological rest and balance, with a metabolic reduction
signicantly deeper than that experienced during sleep or
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CHAPTER 32 Contemporar y Ayur veda 499
progressive muscle relaxation in reducing hypertension in
older African Americans. Barnes et al (2004) studied the
effect of TM on African American adolescents with high
normal blood pressure and found that the TM group had
greater decreases in daytime systolic and diastolic blood
pressure than a control group who received health educa-
tion. A recent meta-analysis of nine randomized con-
trolled trials indicated that the regular practice of TM
is associated with a signicant reduction in systolic
and diastolic blood pressure (Anderson et al, 2008).
A previous meta-analysis of 17 randomized controlled tri-
als indicated that practice of TM was associated with sig-
nicant reductions in blood pressure, whereas simple
biofeedback, relaxation-assisted biofeedback, progressive
muscle relaxation, and stress management training did
not result in statistically signicant reductions (Rainforth
et al, 2007).
A study of adolescents by Barnes et al (2001) found
that TM had a benecial effect on cardiovascular func-
tioning, as measured by blood pressure, heart rate, and
cardiac output. Studies of TM have shown that it signi-
cantly reduces cholesterol level (Cooper et al, 1978, 1979)
and levels of lipid peroxide, fat that has been damaged by
free radicals and can in turn cause damage of its own
(Schneider et al, 1998). A noninvasive method of detect-
ing free radical activity is the measurement of human
ultra-weak photon emission, with lower emission intensi-
ties indicating lower levels of free radical activity. A study
of long-term TM practitioners showed lower emission
intensities in the TM group than in controls who did not
meditate (Van Wijk et al, 2006). A follow-up study showed
that TM practitioners had signicantly lower emission
intensities than practitioners of other meditation tech-
niques and controls who did not practice meditation (Van
Wijk et al, 2008). A study measuring catecholamine levels
in TM practitioners showed that epinephrine and norepi-
nephrine levels were signicantly lower in the TM group
than in the control group, although anxiety levels were
similar in both groups (Infante et al, 2001). This indicates
that the regular practice of TM results in a low hormonal
response to daily stress. Because TM has been shown to
reduce several important risk factors for heart disease
(TM decreases high blood pressure, cholesterol level, and
lipid peroxide level, and modulates the bodys response to
stress), TM should be helpful in the treatment of heart
disease (Barnes et al, 2006). Research has borne this
outpatients with heart disease were challenged by exer-
cising on a bicycle, and those who practiced TM showed
better results on several heart-related parameters (Zamarra
et al, 1996). A randomized controlled clinical trial showed
that practice of TM is associated with a reduction in
atherosclerosishardening of the blood vessels that
can lead to heart attack or stroke (Castillo-Richmond
et al, 2000). A randomized controlled study of African
Americans with congestive heart failure showed that those
practicing TM had signicantly improved functional
capacity as measured by a 6-minute walk test, compared
with the health education control group. The TM group
showed a signicant decrease in depression compared
with controls and had fewer rehospitalizations during the
6-month follow-up period (Jayadevappa et al, 2007).
The metabolic syndrome is regarded as a risk factor
for coronary heart disease. Insulin resistance is considered
a key component of the metabolic syndrome and is associ-
ated with hypertension. A randomized controlled trial of
TM in patients with coronary heart disease showed that
blood pressure and insulin resistance was signicantly
improved in the TM group compared with a health educa-
tion control group (Paul-Labrador et al, 2006). A pilot
study of postmenopausal women showed that TM reduced
cortisol response to a metabolic stressor (Walton et al,
2004). This may play a role in the preventive effects of TM
on cardiovascular disease and coronary heart disease,
because elevated cortisol levels may be involved in produc-
ing the metabolic syndrome.
A meta-analysis of research on meditation and trait
anxiety conducted at the Stanford Research Institute
found that TM is approximately twice as effective as other
meditation techniques in reducing trait anxiety (Eppley
et al, 1989). Orme-Johnson and Walton (1998) conducted
an analysis of meditation and relaxation techniques that
showed TM to be more effective than other approaches in
reducing anxiety, improving psychological health, and
reducing tobacco, alcohol, and drug use. These and similar
studies and meta-analyses (Alexander, Robinson, Orme-
Johnson et al, 1994; Alexander, Robinson, Rainforth,
1994; Alexander et al, 1991) seem to corroborate MAVs
theory, in that relaxation and other types of meditation
appeared to be a less signicant variable compared with
experiencing the fourth state of consciousness (i.e., TC)
via TM. Hundreds of other published studies of TM have
documented a wide range of benets in such areas as
intellectual development and rehabilitation (many of
these studies are reprinted in Chalmers et al, 1989a,
1989b, 1989c; Orme-Johnson et al, 1977; and Wallace
et al, 1989).
Regular practice of TM has also been found to reduce
health care costs signicantly, as measured by insurance
statistics; TM practitioners needed hospitalization for
illness or surgery 80% less often than a matched control
group (Orme-Johnson, 1987). A study of Canadian citi-
zens enrolled in the government health insurance pro-
gram showed that over a 6-year period, practice of the TM
technique reduced government payments to physicians by
13% each year (Herron et al, 2000). A subsequent study of
Canadian citizens over the age of 65 showed even greater
reductions in medical expenditures. Mean physician
payments for the TM group decreased 24% annually com-
pared with those for controls. There was a 5-year cumula-
tive decline of 70% in physician payments compared with
those for controls (Herron et al, 2005). This suggests that
a TM program would be a valuable component of any
comprehensive health care cost containment strategy or
health care system reform effort.
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500 FUNDAMENTALS OF COMPLEMENTARY AND ALTERNATIVE MEDICINE
IRFVFNTION, IATHOGFNFSIS,
AND bALANCF
Viewing the body as a pattern of intelligence is the basis of
a central tenet of MAV: for optimal health, it is necessary
to maintain the bodys natural state of internal balance.
This tenet has applications for strengthening immunity,
as well as for prevention, diagnosis, and treatment. The
natural state of balance is understood in terms of another
important Ayurvedic concept: three principles known as
doshas govern the functioning of the body. The three
doshas are vata, pitta, and kapha. Each has specic qualities
and governs certain physiological activities. The doshas
are not thought of as specically physiological but as
subtle principles that emerge early in the manifestation of
the unied eld. Therefore they are understood to operate
throughout nature.
When the doshas are balanced in their natural states
and bodily locations, they produce health; when aggra-
vated or imbalanced, they produce disease. A balanced
pitta dosha, for example, ensures healthy digestion, but
an aggravated pitta can cause ulcers and acid indigestion.
MAV holds that all disease results from disruption of the
natural balance of the doshas, and immune strength
results from maintaining balance of the doshas. As
Table 32-1 shows, the natural dosha balance can be
thrown off by a wide variety of factors, such as unhealthy
diet, poor digestion, unnatural daily routine, pollutants,
and certain behaviors. The balance is restored by a variety
of dietary and behavioral modalities, as well as other
modalities discussed in this chapter, such as TM and
herbal mixtures.
Each dosha has ve subdivisions that govern different
aspects of the body. For example, bhrajaka pitta, one of the
subdivisions of pitta, relates to the skin. When balanced,
it gives luster to the skin; when aggravated, bhrajaka pitta
results in acne, boils, and rashes.
The concept of doshasunderlying metabolic
principlessimplies the practitioners tasks and
increases his or her effectiveness. The tridosha concept
can help in clarifying the possible side effects of any
treatment, customizing treatments for a specic patient,
predicting risk factors and tendencies toward specic
diseases, and noticing clusters of apparently unrelated
syndromes that may have a similar underlying cause.
Some of these aspects result from the doshas ability
to provide the basis for a more precise description of the
individuals natural state of balance. An individual may
have a natural predominance of one or more doshas.
These doshas need not be present in equal proportion to
ensure physiological balance, but they need to be func-
tioning in harmony with one another. This state is called
prakriti. When the doshas are out of balance, they create
vikriti, which results in disorder and disease. Box 32-1
describes the classic characteristics of vata, pitta, and
kapha prakritis. More common than these are mixed
prakritis, which involve various combinations of the three
classic types, such as vata-pitta, or pitta-kapha. These also
describe the normal state of balance for individuals who
possess them. Treatment in MAV is tailored to the indi-
vidual patient through careful evaluation of both prakriti
and vikriti.
Because MAV views disease as resulting from disrup-
tion of the natural balance of the doshas, the doshas
play a key role in MAVs approach to understanding
pathogenesis. In Western medicine a disease is detected
as a result of its symptoms. The emergence of symp-
toms, however, must be preceded by earlier stages of
imbalance. MAV identies six stages of pathogenesis,
the rst three of which have highly subtle symptoms
with which allopathic medicine is not familiar. These
rst three stages involve aggravation of the normal
functioning of the doshas. A skilled MAV diagnostician
can detect these early pathogenic stages before overt
T
he doshas are considered to be derived from
combinations of still subtler expressions, the
ve mahabhutas, or great elements. The physicist John
Hagelin, a major contributor to grand unication the-
ory, has pointed out that physics also identies ve
basic elements, known as spin types. All the force and
particle elds of physics belong to one of these ve cate-
gories, and the characteristics of the ve spin types cor-
respond closely to those of the ve mahabhutas.
Vata governs ow and motion in the body. It is at the
basis of the activity of the locomotor system. Vata con-
trols functions such as blood circulation, the expansion
and contraction of the lungs and heart, intestinal peristal-
sis and elimination, activities of the nervous system, the
contractile process in muscle, ionic transport across mem-
branes (e.g., the sodium pump), cell division, and the
unwinding of DNA during the process of transcription or
replication. Vata is of prime importance in all homeo-
static mechanisms and controls the other two principles,
pitta and kapha.
Pitta governs bodily functions concerned with heat
and metabolism, and directs all biochemical reactions
and the process of energy exchange. For example, it regu-
lates digestion, functions of the exocrine glands and
endocrine hormones, and intracellular metabolic path-
ways such as glycolysis, the tricarboxylic acid cycle, and
the respiratory chain.
Kapha governs the structure and cohesion of the organ-
ism. It is responsible for biological strength, natural tissue
resistance, and proper body structure. Microscopically, it is
related to anatomical connections in the cell, such as the
intracellular matrix, cell membrane, membranes of organ-
elles, and synapses. On a biochemical level, kapha struc-
tures receptors and the various forms of chemical binding.
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CHAPTER 32 Contemporar y Ayur veda 501
symptoms emerge, using the techniques discussed in
the next section.
IIAGNOSIS
MAV adds a number of diagnostic techniques to the clini-
cians repertoire. All of them are noninvasive and reveal
much information about underlying imbalances and
about specic illnesses. Chief among these techniques is
nadi vigyan (pulse diagnosis), which allows one to retrieve
detailed information about the internal functioning of
the body and its organs through signals present in the
radial pulse. This information involves not only the car-
diovascular system but other bodily systems as well. From
the pulse, the diagnostician gains information about the
functioning of the bodily tissues, the state of the doshas,
and much more. Pulse diagnosis reveals early stages of
imbalance that precede full-blown symptoms. In this and
other MAV diagnostic modalities, perceiving the body as a
pattern of intelligence enables physicians to retrieve enor-
mous amounts of information in a noninvasive manner.
IHARMACOLOGY
Perception of the body in terms of patterns of intelligence
is also demonstrated in MAVs approach to pharmacol-
ogy, which makes sophisticated use of thousands of herbs
and other plants.
Western pharmacology, applying the mechanistic
model of the body, isolates and then synthesizes single
TA B L E 3 2 - 1
The Three Doshas
Dosha Effect of balanced dosha Effect of imbalanced dosha Factors aggravating dosha
Vata Exhilaration Rough skin Excessive exercise
Clear and alert mind Weight loss Wakefulness
Perfect functioning of bowels and
urinary tract
Anxiety, worry Falling, bone fractures
Proper formation of all bodily tissues Restlessness Tuberculosis
Sound sleep Constipation Suppression of natural urges
Excellent vitality and immunity Decreased strength Cold
Arthritis Fear or grief
Hypertension Agitation or anger
Rheumatic disorder Fasting
Cardiac arrhythmia Pungent, astringent, or bitter
foods
Insomnia In USA: Late autumn and winter
Irritable bowel syndrome In India: Summer and rainy
season
Pitta Lustrous complexion Yellowish complexion Anger
Contentment Excessive body heat Strong sunshine
Perfect digestion Insufcient sleep Burning sensations
Softness of body Weak digestion Fasting
Perfectly balanced heat and thirst
mechanisms
Inammation Sesame products, linseed
Balanced intellect Inammatory bowel diseases Yogurt
Skin diseases Wine, vinegar
Heartburn Pungent, sour, or salty foods
Peptic ulcer In USA: Summer and early
autumn
Anger In India: Rainy season and
autumn
Kapha Strength Pale complexion Sleeping during daytime
Normal joints Coldness Heavy food
Stability of mind Laziness, dullness Sweet, sour, or salty foods
Dignity Excessive sleep Milk products
Affectionate, forgiving nature Sinusitis Sugar
Strong and properly proportioned
body
Respiratory diseases, asthma In USA: Spring
Courage Excessive weight gain In India: Late winter and spring
Vitality Loose joints
Depression

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502 FUNDAMENTALS OF COMPLEMENTARY AND ALTERNATIVE MEDICINE
active ingredients from herbs and plants. For example, the
Ayurvedic remedy willow bark was the source of acetyl-
salicylic acid, and the Ayurvedic remedy rauwola was the
source of reserpine. The active ingredient model reects a
weakness of the scientic method: its inability to deal
with complex systems and its requirement that the
researcher radically simplify a process to evaluate it
(Sharma, 1997). In contrast, Ayurvedic pharmacology,
called dravyaguna, uses the synergistic cooperation of sub-
stances as they coexist in natural sources. It uses single
plants or, more often, mixtures of plants whose effects are
complementary. Such synergistic effects are gaining con-
sideration in Western medical research, which is nding,
for example, that combinations of antioxidants may halt
oxidative damage and cancer cell growth more effectively
than the single substances acting alone.
In terms of MAVs consciousness model, the effective-
ness of herbal mixtures relative to active ingredients can
be explained by the idea that plants, especially herbs, are
concentrated repositories of natures intelligence that,
when used properly, can increase the expression of that
intelligence in the body. Research and experience with
MAV herbal mixtures known as rasayanas shows that syn-
ergism enhances the free radicalscavenging properties of
herbs and mitigates the harmful side effects that often
accompany Western drugs (Sharma, 2002).
According to MAV, rasayanas promote longevity,
stamina, immunity, and overall well-being (Sharma, 1993).
Research has shown several rasayanas to have signicant
antioxidant properties (Bondy et al, 1994; Cullen et al,
1997; Dwivedi et al, 1991, 2005; Engineer et al, 1992;
Hanna et al, 1994; Niwa, 1991; Sharma et al, 1995). The
rasayana known as Maharishi Amrit Kalash (MAK) is approx-
imately 1000 times more effective at scavenging free radi-
cals than vitamin C, vitamin E, and a pharmaceutical
antioxidant (Sharma et al, 1992).
MAK has been researched extensively in laboratory,
animal, and clinical settings, and has been found to have
a wide range of signicant benecial properties. MAK
prevented and treated breast cancer (Sharma et al, 1990;
Sharma et al, 1991); prevented metastasis of lung cancer
(Patel et al, 1992); caused nervous system tumor cells
(neuroblastoma) to regain normal cell functioning (Prasad
et al, 1992); enhanced the effect of nerve growth factor in
causing morphological differentiation of nervous system
tumor cells (pheochromocytoma) (Rodella et al, 2004);
inhibited the growth of skin cancer cells (melanoma)
(Prasad et al, 1993); and inhibited liver cancer (Penza et al,
2007). In clinical studies, MAK has been shown to reduce
the side effects of chemotherapy without reducing
the efcacy of the cancer treatment (Misra et al, 1994;
Srivastava et al, 2000).
MAK also reduces several risk factors for heart disease.
It prevented human platelet aggregation (Sharma et al,
1989) and reduced atherosclerosis in laboratory animals
by 53% (Lee et al, 1996). In clinical studies of patients with
heart disease, MAK reduced the frequency of angina,
improved exercise tolerance, and lowered systolic blood
pressure and lipid peroxide levels (Dogra et al, 1994,
2005). A study of hyperlipidemic patients showed that
MAK increases the resistance of low-density lipoprotein
to oxidation, which is important for the prevention of
atherosclerosis (Sundaram et al, 1997).
A strong immune system is vital to the maintenance of
health. Several studies have shown that MAK signicantly
enhances immune functioning (Dileepan et al, 1990,
1993; Inaba et al, 1995, 1996, 1997, 2005). MAK has also
demonstrated antiaging effects. It improved age-related
visual discrimination in older men (Gelderloos et al,
1990) and has been shown to rejuvenate the antioxidant
defense system and protect against mitochondrial deteri-
oration in the aging central nervous system (Vohra et al,
1999, 2001a). In the aging brain, MAK reduced lipid
B OX 3 2 - 1
Classic Characteristics of Vata, Pitta, and Kapha
Prakritis
Vata Prakriti
Light, thin build
Performs activity quickly
Tendency to dry skin
Aversion to cold weather
Irregular hunger and digestion
Quick to grasp new information, also quick to forget
Tendency toward worry
Tendency toward constipation
Tendency toward light and interrupted sleep
Pitta Prakriti
Moderate build
Performs activity with medium speed
Aversion to hot weather
Sharp hunger and digestion
Medium time to grasp new information
Medium memory
Tendency toward irritability and temper
Enterprising and sharp in character
Prefers cold foods and drinks
Cannot skip meals
Good speaker
Tendency toward reddish complexion and hair, moles,
and freckles
Kapha Prakriti
Solid, heavier build
Greater strength and endurance
Slow, methodical in activity
Oily, smooth skin
Tranquil, steady personality
Slow to grasp new information, slow to forget
Slow to become excited or irritated
Sleeps heavily and for long periods
Plentiful hair that tends to be dark in color
Slow digestion, mild hunger
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CHAPTER 32 Contemporar y Ayur veda 503
peroxidation and lipofuscin pigment accumulation,
restored normal oxygen consumption, and enhanced cho-
linergic enzymes (Vohra et al, 2001b, 2001c). It has also
been shown to decrease the number of dark neurons in
the brain, which indicates that MAK protects the neurons
from injury (Vohra et al, 2002).
A modied form of MAK, known as Amrit Nectar tab-
lets, has powerful antioxidant properties. In a study of the
inhibition of lipid peroxidation, an aqueous extract of
Amrit Nectar tablets was 16 times more potent and an
alcoholic extract was 166 times more potent than vitamin
E, a well-known antioxidant. Amrit Nectar tablets also
protected against the toxic side effects of the chemothera-
peutic drugs doxorubicin (Adriamycin) and cisplatin
(Dwivedi et al, 2005).
IIFT
Western medical research is accumulating increasing evi-
dence that diet plays a critical role in the development of
heart disease and cancer. The American Cancer Society
reports that about one third of the cancer deaths that
occur each year in the United States are from cancers for
which diet is a signicant risk factor ( Cancer Facts and
Figures, 2008). Scientists estimate that 60% to 70% of can-
cers could be prevented by simple changes in diet and
lifestyle (Sharma et al, 2002). It is known that a diet rich
in the wrong types of fat creates a higher risk of heart
disease, the number one killer in the United States today
(American Heart Association, 2007; Sharma et al, 1998).
Ayurveda has long considered problems of diet and diges-
tion to be among the central causes of all disease and has
considered improvement of diet and digestion to be cru-
cial to almost any therapeutic regimen. Ayurveda views
faulty diet as not only contributing to specic degenera-
tive diseases, but also throwing off the bodys natural
balance, thus weakening immunity.
MAVs approach to diet rests on the consciousness
model. Food is viewed as providing not only matter and
energy to the body but also intelligence, order, and bal-
ance. This brings to mind the observation of the Nobel
laureate physicist Erwin Schrdinger that food helps
the body resist the second law of thermodynamics,
which normally leads any complex system into chaos
(Schrdinger, 1967). In this view, when we eat, we are eat-
ing not only nutrients but also orderliness. MAV dietet-
ics considers not only the nutritional value and caloric
content of food but also the foods impact on the bodys
underlying state of balance. Food affects the doshas, and
diet must be suited to the individuals vikriti and prakriti.
It must also reect the climate and season, as well as
specic health conditions.
The inuence of food on the doshas is specic to the
food, but can usually be determined by knowing to which
generic categories of taste and qualities the food belongs.
According to MAV, the six categories of taste are sweet,
sour, salty, pungent, bitter, and astringent. The six major
categories of qualities are heavy, light, oily, dry, hot, and
cold. Box 32-2 summarizes how taste and food qualities
affect the doshas, and Box 32-3 gives examples of foods
that possess these various qualities and tastes.
As an example of how this information would be
applied clinically, a patient with kapha syndromes (e.g.,
sinusitis, certain types of obesity) would be advised to
minimize consumption of heavy, oily, and cold foods, as
well as foods with sweet, sour, and salty tastes. It would be
recommended that the patient give predominance to
foods exhibiting the remaining qualities and tastes.
MAV recommends a lactovegetarian diet for optimal
health. Meat is more difcult to digest and has been linked
to numerous diseases, including heart disease, cancer, and
diabetes. MAV also recommends eating fresh fruits and
vegetables. These emphases map well with emerging
Western ndings on diet, which have shown signicant
health benets from a meatless diet and from increased
consumption of fruits and vegetables (Vegetarianism:
addition by subtraction, 2004). A long-term study of veg-
etarians revealed that eating fresh fruit daily results in a
signicant reduction in mortality from ischemic heart
disease, cerebrovascular disease, and all causes combined
B OX 3 2 - 2
Tastes and Food Qualities: Effects on the Doshas
Tastes
Decrease Vata Increase Vata
Sweet Pungent
Sour Bitter
Salty Astringent
Decrease Pitta Increase Pitta
Sweet Pungent
Bitter Sour
Astringent Salty
Decrease Kapha Increase Kapha
Pungent Sweet
Bitter Sour
Astringent Salty
Major Food Qualities
Decrease Vata Increase Vata
Heavy Light
Oily Dry
Hot Cold
Decrease Pitta Increase Pitta
Cold Hot
Heavy Light
Oily Dry
Decrease Kapha Increase Kapha
Light Heavy
Dry Oily
Hot Cold
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504 FUNDAMENTALS OF COMPLEMENTARY AND ALTERNATIVE MEDICINE
(Key et al, 1996). Higher consumption of fruits has also
been associated with lower risks of lung, prostate, and
pancreatic cancers. Vegetarians have lower risks of obesity,
hypertension, diabetes, arthritis, colon cancer, prostate
cancer, fatal ischemic heart disease, and death from all
causes (Fraser, 1999; Kwok et al, 2000). A long-term study
of male Seventh-Day Adventists found that meat eating
correlated positively with all forms of mortality measured
(Snowdon, 1988).
Multiple studies have demonstrated that eating meat
increases the risk of heart disease, whereas a vegetarian
diet affords protection against heart disease. A study of
Seventh-Day Adventists showed a signicant association
between beef consumption and fatal ischemic heart dis-
ease in men, compared with vegetarians. The lifetime risk
of ischemic heart disease was decreased by 37% in male
vegetarians compared with nonvegetarians (Fraser, 1999).
The risk of developing ischemic heart disease is also sig-
nicantly lower in older vegetarian women than in older
nonvegetarian women (Kwok et al, 2000). The Health
Professionals Follow-up Study found consumption of red
meat to be associated with coronary artery disease in men
(Ascherio et al, 1994). Other studies also indicate that veg-
etarians have a signicantly lower incidence of coronary
heart disease (Claude-Chang et al, 1992; Dwyer, 1988;
Slattery et al, 1991). Patients on a vegetarian diet show
reduced frequency, duration, and severity of angina; regres-
sion of atherosclerosis; and improvement in coronary
perfusion (Segasothy et al, 1999). Long-term vegetarians
have a reduced risk of lipid peroxidation (Krajcovicova-
Kudlackova, Simoncic, Babinska et al, 1995; Krajcovicova-
Kudlackova, Simoncic, Bederova et al, 1995) and lower
levels of cholesterol (Key et al, 1999; Kwok et al, 2000).
A vegetarian diet has shown protective effects against
cancer, whereas eating meat has been correlated with the
development of various types of cancer. Nonvegetarians
have a signicantly higher risk of developing colon cancer
and prostate cancer (Fraser, 1999). Women who eat red
meat daily are at twice the risk of developing colon cancer
compared with women who eat red meat less than once a
month (Willett et al, 1990). The association between red
meat and colon cancer was elucidated in a clinical study that
showed increased levels of endogenous N -nitrosation due to
increased nitrogenous residues from red meat (Bingham
et al, 2002). A large prospective study, the National Insti-
tutes of HealthAARP Diet and Health Study, found that
eating red meat was associated with a signicantly elevated
risk of colorectal cancer, lung cancer, esophageal cancer, and
liver cancer. Eating processed meats resulted in a signi-
cantly elevated risk of colorectal cancer and lung cancer
(Cross et al, 2007). A study of vegetarian diet found a 40%
reduction in cancer mortality in nonmeat eaters compared
with meat eaters (Thorogood et al, 1994). Increased con-
sumption of fruit has been associated with lower risks of
lung, prostate, and pancreatic cancers (Fraser, 1999).
Type 2 diabetes mellitus is another chronic disease that
has been associated with meat intake. In a 17-year prospec-
tive study of Adventists, subjects who ate meat at least
weekly had a 74% increase in diabetes risk compared with
those who did not eat meat (Vang et al, 2008). The Nurses
Health Study showed that consumption of red meat and
processed meats were both associated with an increased
risk of diabetes in women (Fung et al, 2004). Processed
meats were also implicated in diabetes in the Nurses
Health Study II, in which increased processed meat con-
sumption was strongly associated with a progressively
higher risk for diabetes in women. This study was also
found that consumption of bacon, hot dogs, sausage,
salami, and bologna were all individually associated with a
higher risk of diabetes (Schulze et al, 2003). Similar results
were seen in the Womens Health Study: higher consump-
tion of total red meat, higher consumption of processed
meat, and higher consumption individually of bacon and
hot dogs were all signicantly associated with increased
risk of diabetes in women (Song et al, 2004). Findings are
comparable for men: the Health Professionals Follow-up
Study showed that frequent consumption of processed
meat was signicantly associated with a higher risk of dia-
betes (van Dam et al, 2002). Eating fruits and vegetables
provides protection against diabetes. A 12-year prospective
study showed that higher fruit and vegetable intake is
associated with a substantially decreased risk of diabetes
(Harding et al, 2008).
A vegetarian diet has proven benecial in other chronic
disorders as well. The prevalence of hypertension was shown
to be lower among long-term vegetarians than among
nonvegetarians in a study of Seventh-Day Adventists
(Brathwaite et al, 2003). Diets rich in fruits and vegetables
signicantly reduced blood pressure in the Dietary
Approaches to Stop Hypertension (DASH) clinical trial
(Appel et al, 1997). This study also found that increasing
fruit and vegetable consumption decreases urinary calcium
excretion, which has positive implications for bone health
B OX 3 2 - 3
Common Examples of the Six Tastes and Major
Food Qualities
Six Tastes and Common Examples
Sweet: sugar, milk, butter, rice, breads
Sour: yogurt, lemon, cheese
Salty: salt
Pungent: spicy foods, peppers, ginger, cumin
Bitter: spinach, other green leafy vegetables
Astringent: beans, pomegranate
Six Major Food Qualities and Common Examples
Heavy: cheese, yogurt, wheat products
Light: barley, corn, spinach, apples
Oily: dairy products, fatty foods, oils
Dry: barley, corn, potato, beans
Hot: hot (temperature) foods and drinks
Cold: cold (temperature) foods and drinks
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CHAPTER 32 Contemporar y Ayur veda 505
(Appel et al, 1997). Several population-based studies have
shown that eating fruits and vegetables is benecial for axial
and peripheral bone mass and bone metabolism in men and
women of all ages (New, 2003). Considering all the benets
of a vegetarian diet, it is not surprising that studies have
shown vegetarians to have a longer life span (Fraser, 1999;
Fraser et al, 2001; Singh et al, 2003). A long-term study
found that vegetarians have a mortality rate that is half that
of the general population (Key et al, 1996).
The hazards of a meat-based diet may be due to char-
acteristics of the meat itself as well as multiple aspects
involved in the production, preservation, processing, and
cooking of meat and meat products (Cross et al, 2007;
Singh et al, 2003). Saturated fat in meat contributes to
atherogenesis and carcinogenesis. Heme iron in meat con-
tributes to higher oxidative stress, which is linked to both
heart disease and cancer. Meat increases the endogenous
formation of N -nitroso compounds, which are carcino-
genic. Processed meats containing nitrite preservatives are
an exogenous source of N -nitroso compounds. Smoked
and salted meats containing N -nitrosodimethylamine are
a carcinogenic risk. Heterocyclic amines and polycyclic
aromatic hydrocarbons are known mutagens that are
formed during high-temperature cooking of meat (e.g.,
grilling). Other hazards of ingesting meat relate to what
the animals themselves have eaten, for example, feed con-
taining herbicides and pesticides that become concen-
trated in the fatty tissues and membranes of the meat.
Cattle feed supplemented with rendered cattle carcasses
has been implicated in the development of the transmis-
sible prion disease known as mad cow disease. Antibiot-
ics administered to livestock may contribute to antibiotic
resistance in those who consume their meat.
The benets of a vegetarian diet relate to lower intake
of saturated fat, cholesterol, and animal protein and
increased intake of complex carbohydrates, dietary ber,
trace minerals, vitamins, and a myriad of biologically
active phytochemicals (Lampe, 1999; Leitzmann, 2005).
Clinical dietary studies of plant foods and their constitu-
ents have shown that fruits and vegetables affect the
human biological system in many benecial ways. They
have antioxidant properties, stimulate the immune sys-
tem, modulate detoxication enzymes, and alter choles-
terol synthesis and hormone metabolism. Many phyto-
chemicals have overlapping mechanisms of action and
can have synergistic or additive effects. It is noteworthy
that the protective effects of fruit and vegetable consump-
tion observed in the epidemiological studies are not seen
with pharmacological doses of the plant foods or their
constituents. The benets were observed when these foods
were eaten as part of the subjects diet (Lampe, 1999).
IIGFSTION
MAV focuses not only on what one eats but also on how
one digests it. The emphasis on digestion contrasts with
Western allopathic medicine, which deals with digestion
only when it is signicantly disrupted. In MAV, excellent
digestion is considered critical to robust health. MAV
contains a number of techniques for improving digestion
and treating digestive disorders. They center on the con-
cept of agni, which literally means re and refers to
metabolic and digestive activities that convert foodstuff
into bodily substances. Ayurveda describes 13 types of
agni in the body. Their importance in Ayurvedic health
care is suggested by the fact that one of the eight branches
of Ayurveda, Kaya Chikitsa (internal medicine), focuses on
the strength or weakness of the agnis. This emphasis on
digestion becomes clearer when we consider the end prod-
uct of poor digestion, which Ayurveda calls ama. Ama
plays a key role in pathogenesis, interacting with aggra-
vated doshas and causing them to stick to areas where
they do not belong. Healthy digestion reduces the amount
of ama produced.
The central role of food and digestion is demon-
strated particularly well by consideration of another
central MAV concept: the importance of a substance
called ojas. Ojas is said to be the nest manifestation of
the unied eld, which serves as a sort of glue to link
consciousness and matter. Ojas maintains the integrity
of the seven bodily tissues (dhatus), which are plasma
(rasa), blood (rakta), muscle (mamsa), fat (meda), bone
(asthi), bone marrow and nervous system (majja), and
sperm and ovum (sukra). The end product of truly
healthy diet and digestion is said to contain signicant
amounts of ojas. According to an MAV expression, Like
a bee that gets honey from the owers, we get ojas from
our food. Most MAV therapies and behavioral advice
are designed to maximize the presence of ojas, and
almost all MAV proscriptions are designed to minimize
the depletion of ojas.
The manner in which food is eaten is considered to
have an effect on healthy digestion. Food should be
eaten in a warm, congenial, and uplifting atmosphere.
Arguing or any other negativity at meals interferes with
digestion, producing ama instead of ojas. Positive, lov-
ing emotions enhance digestion and increase the abun-
dance of ojas.
IACHAKARMA (IURIFICATION
JHFRAPIFS)
To rid the body of accumulated ama, pollutants,
and other pathogenic impurities that disrupt or block the
natural expression of the bodys inner intelligence, MAV
emphasizes the importance of purication therapies.
Foremost among these is Pachakarma (or Panchakarma;
see Chapter 29 ), which literally means ve activities.
Pachakarma includes ve main treatment modalities:
1. Whole-body massage with herbalized oil (abhyanga)
2. Continuous ow of warm herbalized oil on the
forehead (shirodhara)
3. Fomentation of the body with herbalized heat
(swedana)
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506 FUNDAMENTALS OF COMPLEMENTARY AND ALTERNATIVE MEDICINE
4. Special herbalized oil head massage and nasal
administration of herbs (nasya)
5. Sesame oil retention or herbalized eliminative
enemas (basti)
Daily treatments, administered for 2 to 14 days or
longer, are recommended with each change of the sea-
sons. Certain aspects of Pachakarma can also t easily
into a patients daily preventive regimen. Preliminary
research has shown that regular Pachakarma reduces
several cardiovascular risk factors, including cholesterol
(Sharma et al, 1993; Waldschtz, 1988). Sesame oil, which
is used topically and for colonic irrigation in Pacha-
karma, has been shown to inhibit in vitro malignant
melanoma growth (Smith et al, 1992) and human colon
adenocarcinoma cell line growth (Salerno et al, 1991).
Preliminary research on Pachakarma has shown that it
reduces levels of fat-soluble toxicants in humans. Levels of
polychlorinated biphenyls (PCBs) and agrochemicals were
reduced by 50% in subjects who received Pachakarma.
PCBs have been banned for years, but previous exposure
can result in a lingering accumulation of the toxicant in
fat tissue. Lipophilic toxicants have been associated with
hormonal disorders, suppression of the immune system,
reproductive disorders, cancer, and other diseases (Herron
et al, 2002).
bFHAVIOR, MOTIONS, AND THF SFNSFS
MAV regards behavior, speech, and emotions as having a
signicant impact on health. This concept springs natu-
rally from the model that places consciousness at the
basis of the body. Emotions can be understood as ne
uctuations of consciousness (or the unied eld); as
such, their impact on the more expressed physical levels of
the body is immense. Recently, Western medicine has
begun to investigate the effect of emotions on health,
with interesting ndings; Ayurveda has discussed this
eld for millennia. Ayurvedic texts include detailed dis-
cussions of lifestyle and behavior and their impact on
health. Interestingly, traditional virtuessuch as respect
for elders, teachers, loved ones, and family members; par-
doning those who wrong you; practicing nonviolence; and
not speaking ill of othersare understood to promote the
health of the individuals mind and body, as well as of the
community and society.
According to Ayurveda, information entering through
the ve senses (sight, sound, taste, touch, and smell) is
digested and metabolized in its own specic ways, and the
by-products inuence physiology. Thus, sensory input is
considered to have an impact on health. This idea is
applied clinically, not only in terms of behavioral advice
but also in the form of sensory therapies such as aroma-
therapy and sound therapy. The use of sound therapy
includes music (called Gandharva Veda ) and primordial
sounds used for their healing qualities. A study of MAV
primordial sound therapy (specically, Vedic sounds
known as Sama Veda ) found that it reduces human tumor
cell growth signicantly, whereas hard rock music tends
to increase growth signicantly (Sharma et al, 1996) (see
Chapter 31 ).
bIOLOGICAL IHYTHMS
In MAV, attuning the patients lifestyle to natural bio-
rhythms is considered a crucial element of prevention and
treatment. MAV gives a detailed analysis of circadian and
circannual rhythms, with recommendations for daily
and seasonal routines. These include advice such as rising
and retiring early, and eating ones main meal at lunch-
time when the digestive res are strongest. Many other
recommendations are also given; as always, this advice
must be tailored to the individual. Emerging Western
data on biorhythms correlate well with the ancient
Ayurvedic knowledge. Again, the idea of a connection
between patterns of order in nature and in the human
body was obvious to Ayurveda millennia ago.
The three-dosha concept plays a key role in under-
standing these connections. Different times of the day are
associated with different doshas, as are different seasons
and the different stages of the human life cycle ( Box 32-4 ).
For example, the summer is dominated by pitta (the
dosha that governs heat and metabolism), whereas the
spring is dominated by kapha (which has qualities of
coolness and moisture). Childhood is dominated by kapha
(which governs structure, substance, and growth) and old
age by vata. In fact, physicians see a preponderance of
kapha-based disorders, such as colds and respiratory ill-
nesses, in children and an ever-increasing number of vata
disorders, such as constipation and lighter, shorter, and
more frequently interrupted sleep, in elderly patients.
They also see more kapha-type disorders in spring and
B OX 3 2 - 4
Times of Day, Seasons, and Life Cycle Classied
According to the Doshas
Kapha time: Approximately 6 AM (sunrise) to 10 AM and
6 PM to 10 PM
Kapha season: In USA, spring; in India, late winter and
spring
Kapha period in life cycle: Childhood
Pitta time: Approximately 10 AM to 2 PM and 10 PM to
2 AM
Pitta season: In USA, summer and early autumn; in
India, rainy season and autumn
Pitta period in life cycle: Adulthood
Vata time: Approximately 2 AM to 6 AM (sunrise) and
2 PM to 6 PM
Vata season: In USA, late autumn and winter; in India,
summer and rainy season
Vata period in life cycle: Old age
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CHAPTER 32 Contemporar y Ayur veda 507
pitta disorders in summer. Understanding the concept of
doshas is helpful in treating these ailments.
CCIICJIV IAIJI
AI JI VIICMJ
MAV holds great promise in several areas of collective
health. In terms of infectious disease and epidemics, the
Western approach of using antibiotics has an inherent
limitation and risk caused by the process of natural selec-
tion, which produces new, resistant strains of microbes.
As a result, overreliance on antibiotics can foster the
development of serious new infectious diseases. MAVs
focus on strengthening immunity and its techniques for
dealing directly with epidemics offer a more effective and
safer means of ensuring collective health.
In terms of chronic disease, Western medicine has
long recognized that preventing and treating these disor-
ders requires changes in lifestyle, diet, and behavior. How-
ever, allopathic medicine has been at a loss as to how to
effect these changes in patients for a prolonged time.
Research has shown that those who practice TM are better
able to give up harmful habits such as cigarette smoking,
alcohol consumption, and illegal drug use, and incorpo-
rate healthy dietary and lifestyle changes (Alexander et al,
1994b; Gelderloos et al, 1991; Monahan, 1977). MAV
offers other time-tested modalities that benet individual
patients, such as daily routine and purication proce-
dures, which could be useful in large-scale applications.
MAV also offers an overall theory of prevention involving
elements such as the three-dosha concept that could be of
value for research on preventive medicine.
The most signicant public health approach of MAV
deals with larger social disorders and the dangers they
pose. War, crime, and violence are rarely considered sub-
jects of public health policy, but their implications for
health are obvious. As with individual disease, MAV
understands these as originating not in material factors
but ultimately in consciousnessin this case, both indi-
vidual and collective consciousness. Just as an abstract
eld of consciousness underlies the individuals mind and
body, such a eld underlies societal trends. Society reects
the inuence of its members not only in a linear, additive
wayin the sense that a green forest is made of green
treesbut also through a eld effectin the sense that a
gravitational elds inuences are not localized. If the
individual consciousness of a sufcient number of mem-
bers of a society is coherent, harmonious, and life sup-
porting, those inuences spread through the eld of the
collective consciousness of the society, inuencing the
society as a whole.
This idea has been tested in a number of different set-
tings. A study conducted in 1983 during the Lebanon War
found that when a sufciently large group of practitio-
ners of the TM and advanced TM-Sidhi techniques medi-
tated together as a group in Israel, war deaths in Lebanon
were signicantly reduced compared with casualty rates
on days when the number of practitioners meditating
together decreased below a certain threshold (Orme-
Johnson, Alexander et al, 1988). This study was replicated
and extended; the results showed that the group practice
of meditation techniques in a series of seven assemblies
occurring over a 2.25-year period of the Lebanon War had
a signicant benecial impact, including an estimated
48% reduction in conict, 71% reduction in war fatalities,
and 68% reduction in war injuries during the assemblies
(Davies et al, 2005). Studies in other localities have also
shown benecial effects, usually involving reductions in
the rate of violent crime (Dillbeck et al, 1981, 1988; Orme-
Johnson and Gelderloos, 1988). For example, a 1993 study
in Washington, DC, showed that when a large group of
practitioners of the TM and TM-Sidhi programs assem-
bled to meditate during the summer, there was an 18%
reduction in violent crime compared with levels that had
been predicted on the basis of previous years crime levels
and weather trends (Hagelin et al, 1999).
There has been much discussion and debate regarding
these observations and the validity of what has been called
the Maharishi effect. A psychoneuroendocrine mechanism
for the observed societal effects has been investigated in a
prospective time series study. It was found that day-to-day
increases in the size of a group practicing the TM program
were predictive of biochemical changes in nonpractitio-
ners living and working up to 20 miles away from the TM
group. There were changes in the levels of cortisol, a major
stress hormone, and 5-hydroxyindoleacetic acid (5-HIAA),
the main metabolite of serotonin, a widely distributed
neurotransmitter in the brain that is associated with a
sense of well-being. As the size of the TM group increased,
excretion of cortisol decreased, excretion of 5-HIAA
increased, and the ratio of excretion rates of 5-HIAA to
cortisol increased. This preliminary study supports the
hypothesis that group practice of the TM technique
reduces stress and increases well-being on a biochemical
level in individuals who are not in physical contact or in
communication with the meditators (Orme-Johnson,
2005; Walton et al, 2005).
I!J!I IIICJICS
Many central elements of Ayurveda, such as the ideas that
diet and emotions play a crucial role in disease and pre-
vention, were not taken seriously by Western medicine a
generation ago but are now major themes of research.
Other areas of Ayurveda might prove to be of value in
both clinical work and research. Already, study of the TM
technique and herbal preparations have produced bodies
of signicant research ndings whose implications have
yet to be fully explored. Other areas in which research is
just beginning include using a biostatistical approach to
quantify the three doshas (Joshi, 2004); using the scien-
tic framework of systems analysis to establish the three
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508 FUNDAMENTALS OF COMPLEMENTARY AND ALTERNATIVE MEDICINE
doshas as universal properties of all living organisms
(Hankey, 2001, 2005); and identifying a genetic basis for
prakriti (Patwardhan et al, 2005, 2008).
The clinical use of Ayurveda appears to be most dra-
matic when applied to diseases that Western medicine
nds it difcult to treat, such as poor digestion, heart
disease, cancer, and other chronic diseases (Janssen, 1989;
Orme-Johnson, 1987). Its clinical value extends to other
areas not discussed previously, including pediatrics, in
which it has been found to reduce signicantly the inci-
dence of childhood ailments such as frequent colds, and
gynecology, in which it has been shown to reduce the
severity of menstrual and premenstrual disorders.
Ayurveda is a comprehensive system of health care that
uses multiple modalities for the treatment of disorders.
Clinical research trials are generally designed to investi-
gate single treatments for ease of interpretation and char-
acterization of the results; however, this type of investiga-
tion fragments Ayurvedic treatment. A randomized trial
of a whole-system Ayurvedic protocol was conducted in
patients who were newly diagnosed with type 2 diabetes.
The experimental group received instruction in TM
and yoga stretches, dietary instructions in accordance
with Ayurvedic principles, recommendations for daily
routine and exercise, and an Ayurvedic herbal supple-
ment. This preliminary study found statistically signi-
cant improvements in those patients in the Ayurvedic
group who had higher baseline values of glycosylated
hemoglobin (Elder et al, 2006).
Several medical institutions have incorporated
Ayurveda into their teaching curricula. In the future it is
likely that Ayurveda will gain further recognition as an
effective system of natural health care. Its comprehensive
modalities can be used to create health and well-being in
the individual and in society as a whole.

Chapter References can be found on the Evolve website at
http://evolve.elsevier.com/Micozzi/complementary/

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