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Ayurvedic Medicine and Yoga: From Buddha to the Millennium

Ayurveda is India's traditional system of natural medicine. It was first described around 3500 BC in the ancient Hindu texts known as the Vedas, and means "science of life," from the Sanskrit ayur, or life, and veda, or science. An integral part of classical Ayurvedic medicine is the practice of yoga, or "union." In considering this discipline, both Ayurveda and yoga are included, out of respect to this centuries-old tradition.

Ayurveda has been continuously practiced for approximately 5,500 years in India and Asia, and is claimed to be the oldest system of natural healing on earth, the original source of many other medical traditions, and the traditional medicine of Buddha.

With the introduction of Western medicine into India, Ayurveda lost its eminence, but has since made a comeback and is now practiced side by side with Western medicine. It has also aroused increasing interest in Western countries, including the United States. In 1978, the World Health Organization recognized Ayurveda as one of the forms of traditional medicine that could especially help developing nations.

Ayurveda is preeminently a comprehensive approach to healthy living. Its primary goal is preservation and promotion of health, with an emphasis on enhancing immunity. A secondary goal is the treatment of mental and physical illnesses, and the restoration of spiritual peace.

Taking a holistic approach to the individual, Ayurveda believes that all aspects of life contribute to health, including nutrition, hygiene, sleep, weather, and lifestyle, as well as physical, mental, and sexual activities. Emotional factors are also taken into consideration. Anger, fear, anxiety, and unhealthy relationships are believed to contribute to illness. A healthy emotional state is considered the very foundation of physical health.

Because the wider social environment is considered an important contributor to health and disease, Ayurveda is concerned with maintaining a healthful physical, social, and spiritual environment, and uses collective meditation to try to influence society.

Of the major approaches to health, Ayurvedic medicine is one of the least well understood and least researched. This critical review was possible only with the assistance of Dr. Shri K. Mishra, a prominent researcher of Ayurveda, professor of neurology and dean of the school of medicine at the University of Southern California School of Medicine.

According to Dr. Mishra, in Vedic philosophy, each living organism is a microcosm that reflects the macrocosm of the entire cosmos. In Vedic philosophy, all of creation is made up of five "elements": earth, ether, air, fire, and water. These five basic elements represent principles of action and interaction that guide and shape everything that exists, and they form the basis for understanding health and illness.

From the five elements come three essential, overriding qualities that are present in all things. The relative balance of these three qualities in each person determines that person's unique psychophysiological constitution and functional body type. The three qualities, or doshas, are vata, pitta, and kapha. Vata represents air, and is personified by people who are active, changeable, and energetic. Pitta represents fire, or transformative energy, and is personified by people who are aggressive, explosive, and efficient. Kapha is the densest of the three qualities, or humors, and is personified by people who tend to be slow moving, conservative, stable, and sometimes overweight. Each dosha is thought to predominate in particular sites; for instance, vata is concentrated more in the intestines, skin, ears, and thighs.

When these three doshas are balanced within a person, it is conducive to health and longevity. In Ayurvedic medicine, individuals use various interventions, such as diet and exercise, to restore and maintain balance of the three doshas.

Doshas can be increased or decreased by a variety of factors, including food, sleep, lifestyle, and other physical and mental activities. Vata is disturbed by eating raw vegetables, by excessive travel, sleeplessness, exercise, drink, or sexual activity, and is manifested primarily in people with a predominantly vata constitution. Pitta is disturbed by consuming too much hot food, tea, coffee, or alcohol, and by excess exposure to heat and sun. Kapha is deranged by eating excess sweets, or fatty or cold foods (including dairy products), by too much sleep during the daytime, and by an inactive lifestyle.

Doshas are also subject to natural cycles of change, on a daily and seasonal basis, and during the stages of life. Kapha is emphasized in the morning, in winter and early spring, and during youth. Pitta increases at noon, in the autumn and late spring, and in adulthood. Vata predominates in the evening, in summer, and in old age.

Abnormalities in the levels of the doshas lead to abnormalities in the tissues, the excretory system, the digestive system, and enzymatic systems. As bodily humors become agitated, they begin to accumulate in their respective sites in the body - vata in the colon, pitta in the small intestines, and kapha in the stomach. With continued aggravation, the accumulated dosha overflows from its original site and spreads throughout the body, creating lesions in one or more susceptible target tissues, and interfering with metabolism.

In Ayurvedic medicine, it is important that a disease be recognized early in its course, and that its root cause be correctly identified. Otherwise, it may disseminate to other tissues and produce secondary effects on other doshas, which can lead to serious consequences, including possibly death.

Most people have problems associated with their predominate dosha. Vata people are most likely to have vata conditions, such as nervous system problems, arthritis, sciatica, lower back pain, or intestinal gas. Pitta people are more likely to have liver and gallbladder problems, gastritis, hyperacidity, peptic ulcer, inflammatory disease, and skin problems. Kapha people are more likely to have tonsillitis, bronchitis, sinusitis, and lung congestion.

Because the principal focus of Ayurveda is not on disease but on restoring balance, diagnosis is different in Ayurveda. Practitioners try to determine the individual's constitution, and then to rebalance the doshas. Rather than using instruments or laboratory tests to make a diagnosis, the Ayurvedic physician relies on observation, and on questioning of the patient. Clinicians obtain a detailed family, social, personal, and past history, and gain information about environmental and nutritional factors.

Physical examination includes an evaluation of three superficial and three deep pulses on a person's right and left wrists. The three pulses are believed to correspond to the three doshas. The physician also examines the surface of the tongue for discoloration, irregularities, coating, and sensitivity, believing that these characteristics reveal information about the balance of the doshas and the condition of internal organs. In addition, the physician examines urine samples for color and odor.

Following diagnosis, a treatment program is designed, and is likely to include the following procedures:

  • Poorvakarma. This is a three- to seven-day preparatory program that involves toxin-removing massage, sweating, and use of herbs.

  • Pancha karma. This is an intensive, one- to two-week detoxification regimen that includes induced vomiting, purgation with laxatives, herbal enema therapy, herbal cleansing of the nasal cavity, and cleansing of the blood through a form of bloodletting, such as donating blood to a blood bank. Detoxification is also achieved by purification of the diet and lifestyle.

  • Shaman. Also called "palliation," this intervention focuses on the spiritual dimensions of healing. It can include fasting, sunbathing, yoga, and use of herbs.

  • Rasayana. Also known as "rejuvenation," this phase of the treatment comes after detoxification, and employs yoga, breathing exercises, and herbs to restore vitality.

  • Satvajaya. This phase focuses on psychotherapy, and helps reduce stress, employing measures such as the chanting of mantras to change vibratory patterns in the mind.

Of considerable importance in this comprehensive healing regime is the use of herbal medicines. Herbs are added to the diet for preventive and rejuvenative purposes, and also for treating specific disorders.

Ayurvedic herbal preparations generally have no equivalent in Western medicine. Unlike allopathic medicine, Ayurveda uses combined herbal preparations, often including whole plant products, rather than isolated chemicals from plants. Herbal preparations may contain ten to twenty different herbs. The goal of using medicinal compounds is to rebalance the doshas, so herbs are classified according to their action upon the doshas, such as vata-stimulating or vata-reducing. Herbs are also divided into some fifty groups, based on their therapeutic actions, such as vitalizing agents, heart tonics, or pain relievers. Many of the substances used in Ayurvedic herbal preparations have been studied with modern laboratory techniques. Amala, for example, is a rich source of vitamin C, and a potent antioxidant. Bacopa, which is used as a brain tonic, is also a powerful antioxidant, and has been shown in studies to increase intelligence and mental clarity.

Ayurvedic preparations manufactured by herbal companies in India are currently being imported into the United States, but there is a lack of quality control in the manufacture of these products, resulting in questionable standards of purity and sanitation. Many herbal compounds from India are contaminated with biological materials, as well as with heavy metals, such as arsenic, mercury, or lead. However, some common Ayurvedic preparations are now being produced by American companies, and these are much safer. Some Ayurvedic herbs themselves also have potentially harmful side effects, and should not be used without an understanding of the full range of their biological activity, and the advice of a physician.

Typically, Ayurvedic treatment consists of an initial forty-five- to ninety-minute consultation and one or two shorter follow-up consultations several weeks or even months apart. Costs vary greatly. An initial consultation may range from $100 to $200, with follow-up visits being proportionately less. Usually there are few follow-up visits, so Ayurvedic treatment is relatively inexpensive. Herbal remedies may cost from $50 to $100 a month. Insurance coverage is generally limited to licensed health professionals who are covered because of their other qualifications.

Ayurvedic education in the West is limited, in both the availability and extent of training. Ayurveda has the smallest number of practitioners of any medical tradition in the United States, although its popularity is growing. Only a few hundred physicians in the United States have received some degree of training in Ayurvedic medicine. However, Ayurveda is also practiced in the United States by health educators and health consultants who do not have specialized degrees. In addition, a number of graduates of Indian Ayurvedic medical schools have come to this country to practice or teach.

A major stimulus for an expansion of Ayurveda in the United States has been the development by followers of Maharishi Mahesh Yoga of an Ayurvedic approach called Maharishi Ayur-Ved, which incorporates Transcendental Meditation (TM) as part of its array of practices. However, Maharishi Ayur-Ved does not necessarily follow classical Ayurveda, and the scientific papers describing it may be oriented toward commercialism of its products. Today, the College of Maharishi Ayur-Ved, which offers degree and nondegree courses in their form of Ayurveda, has a well-structured academic curriculum that begins at the undergraduate level and culminates in a doctoral degree in clinical Ayurveda.

In addition to Maharishi Ayur-Ved's highly organized approach to Ayurveda, there are many independent Ayurvedic teachers and practitioners who have established practices, institutions, and training programs in this country. A prime mover in the popularization of Ayurveda in the United States is prominent author Dr. Deepak Chopra, an endocrinologist who was formerly chief of staff at New England Memorial Hospital in Stoneham, Massachusetts. Among the other leading figures in Ayurveda in the United States are Dr. Vasant Lad, a former Indian medical school professor who founded the Ayurvedic Institute in Albuquerque, New Mexico, and Dr. David Frawley of the American Institute of Vedic Studies in Santa Fe, New Mexico.

One of the earliest articles to explicate Maharishi Ayur-Ved was published by Dr. Hari M. Sharma, Dr. Brihaspati Dev Triguna, and Dr. Deepak Chopra in the Journal of the American Medical Association in 1991. This important article was eclipsed by a controversy when JAMA editors accused the authors of failing to disclose a potential conflict of interest through affiliations with the marketers of products noted in the article. More recently, the controversy continued with a Newsweek cover story entitled "Spirituality for Sale," with Dr. Chopra's photograph on the cover. There tends to be a fusion and confusion of Ayurvedic medicine with a particular approach to this complex area. There are many significant insights in Dr. Chopra's books, and it is surely premature at best to judge, much less dismiss, the significance of Ayurvedic approaches to health care based on accusations and conjecture.

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Copyright © 2000 by Dr. Kenneth R. Pelletier, Inc.
Reprinted by permission of Simon & Schuster, Inc., New York, New York.

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