Indian Ayurveda medicine

– Detoxification and Rejuvenation

Prof. Dr. Gangadharan GG, Ayurvedacharya, FAIP

(USA), PhD, MoM (McGill, Canada)

Director, Ramaiah Indic Specialty Ayurveda – Restoration

Hospital, A unit of Gokula Education Foundation (Medical)

New BEL Road, MSR Nagar, Mathikere PO, Bengaluru - 54

Tel: +91-80-22183456, +91-9632128544,

Mob: +91-9448278900

e-mail: vaidyaggganga@gmail.com

Website: http://www.msricaim.com/

Introduction

• Indian knowledge systems (IKS) – foundational unity

despite diverse nature

• Contiguous, interconnected and epistemologically

common identity

• Same thread runs through gamut of activities

including medicine, farming, cooking, grammar,

dance, arts etc.

• Currently, IKS are in a state of transition owing to

external influence

• Distorted promotion and popularization of IKS will

be detrimental to its growth

Traditional medicine

• WHO defines Traditional medicine as the sum total of the

knowledge, skills, and practices based on the theories,

beliefs, and experiences indigenous to different cultures,

whether explicable or not, used in the maintenance of health

as well as in the prevention, diagnosis, improvement or

treatment of physical and mental illness

• These include Ayurveda, Siddha medicine, Unani, ancient

Iranian medicine, Iranian (Persian), Islamic

medicine, traditional Chinese medicine, Kampo (drawn largely

from TCM, in Japan), traditional Korean

medicine, acupuncture, Muti, Ifá, and traditional African

medicine and many many more newer practices

• Very few of such practices are complete knowledge systems

• Ayurveda – a comprehensive system, with holistic approach;

attends to body, mind and spirit

Subjectivity and objectivity

Contemporary science

• Testability

• verifiability

• Reproducibility

• Quantitative

• Evidence based

• Structural

• Generalised

Traditional knowledge systems

• Four-fold approach

• Aptopadesha (Scriptures and

peers)

• Pratyaksha (direct cognition)

• Anumana (Inference)

• Yukti (Rationale)

• Qualitative

• Word of mouth

• Functional

Medical pluralism

• Health behavior is a type of social behavior mainly

influenced by the various socio-cultural issues.

• Understanding a disease/illness is not a medical

subject rather it is mainly reliant on the common

information of the concerned community.

• This has led to prevalence of more than one

system of medicine existing

• Medical Pluralism is an adaptation of more than

one medical system or simultaneous integration

of orthodox medicine with complementary and

alternative medicine (CAM)

Different traditional medical

systems

• Traditional medicines include Ayurveda, Siddha

medicine, Unani, ancient Iranian medicine, Iranian

(Persian), Islamic medicine, traditional Chinese

medicine, Kampo (drawn largely from TCM, in

Japan), traditional Korean

medicine, acupuncture, Muti, Ifá, and traditional

African medicine and many many more newer

practices

• Very few of such practices are complete knowledge

systems

• Ayurveda – a comprehensive system, with holistic

approach; attends to body, mind and spirit

Challenges to traditional medicine

• Major threat is

• trend to negate philosophical moorings

• Discard their interconnectedness

• Promote them as fragmented systems

• Concept of holism, ethics in application and

responsibility to the philosophy is diluted and

disregarded

• Need is

• Explore and adopt ethical modes to

adapt to changing times

Advantage of Ayurveda

A functional framework that can

accommodate any medical

condition one may encounter.

A practical inventory of physical

universe and their effect on the

living system which, when

understood makes everything

around us a potential medicine

Vikaro nama akushalo na

jihriyat kadaachana

Indicative correlates of dosha theory with

biomedical science

Vata

Movement

Governs nervous and musculoskeletal systems

Signaling pathways regulating cell growth, differentiation, and cell death

Pitta

Transformation

Actions of enzymes, growth factors, hormones

Processes such as digestion, metabolism, energy production

Kapha

Anabolism

Maintains body mass, shape, and flexibility

Biosynthesis of macromolecule. coordination of gene and protein function

Sumantran and Tillu, 2012

Elemental tissues (dhatu) – factors affected in

disease pathogenesis

• Rasa

• Fluid component (intra-extra cellular)

Nourishes

• Rakta

• Intravascular component

Gives life

• Mamsa

• Muscular tissue

Covers

• Meda

• Adipose tissue

Lubricates

• Asthi

• Structural component (skeletal)

Supports

• Majja

• Intraosseous material

Completes

• Shukra

• Reproductive material

Reproduces

Image courtesy: ancientsciencesofhealing.blogspot.com

• 52 single nucleotide polymorphisms (p ≤   ×  −5) were significantly

different between Prakritis, without any confounding effect of

stratification, after 106 permutations

• PGM1 correlated with phenotype of Pitta as described in Caraka

Samhita, suggesting that the phe otypic classificatio of I dia’s traditional medicine has a genetic basis; and its Prakriti-based

practice in vogue for many centuries resonates with personalized

medicine (Govindaraj et al, 2015)

Triphala: An Intelligent Formulation

Cause of disease in ayurveda (AMA)

Aberrant metabolism

Ama - Toxic, pro-inflammatory, waste-product

Blocks micro-channels (Srotas)

Disease

Ayurveda theory of pathogenesis

Nidana

(Cause)

Dosha

(V,P,K)

Dushya

(Dhatu, Agni, Ama)

Disease

Factors involved in disease production

Six stages of progression

Therapeutics is designed to correct Nidana, Dosha and Dushya

20

-09

-20

17

Rogi Pariksha

Disease

Symptoms

Pathogenesis

Affecting factors

Causes

Patient

Constitution

Systems & organs

Age

Season

Strength

Metabolic status

Tolerance

Surroundings

Diet

Precise Diagnosis

Customized Treatment

Diet

Lifestyle

Medicines

Therapies

Counselling

Others

Relief Health

No Symptoms

Homeostasis

Good QoL

Tranquil mind

Well Being

Variables in Ayurveda disease management

Image Courtesy: Tillu G

20

-09

-20

17

Holistic therapeutics

• Focus is on

• Host factors rather than disease factors

• Whole system rather than target tissue

• Multidrug/therapy rather than single

molecule

• Preventive and promotive in addition to

curative

Inherent strengths of Ayurveda 1. Customised intervention that varies according to individual

constitutional frame work (prakriti) and the stage & phase of

disease.

2. Multi-component intervention involving drug, diet, lifestyle,

panchakarma (detox) and yoga.

3. A systemic cleansing of body (shodhana chikitsa) using

techniques of Panchakarma that is unique to Ayurveda

4. A treatment approach that has homeostasis or restoration of

balance as its end point. In this approach, stress is laid on two

things:

a. Apunarbhavatva: Achieving a stable state of homeostasis that

does not relapse to the prior diseased stage (non-recurring).

b. Yonyamanyamudeerayet: Achieving homeostasis without

causing any disturbance to any other systems (without side-

effects).

20

-09

-20

17

Ayurveda principles for healthy life

Dinacharya (Daily regimen)

Ritucharya (Seasonal regimen)

Panchakarma (5 purificatory procedure)

Rasayana (rejuventaion)

Aachara Rasayana – Sadvritta (Behavioral therapeutics)

Ashtanga Yoga (8 steps of Yoga)

Nityam hitaharaviharasevi sameekshakari vishayeshvebhaktah I

Dhata samah satyaparah kshamavanaptopasevi ca bhavatyarogah II

(A.H.Su.4/36)

Aahara - SHADRASA PRADHANATA

Let thy food e thy edi i e a d thy edi i e e thy food Hippocrates

Shadrasa-(Six tastes) - and alleviation of doshas by tastes;

Svadu /Madhura – sweet, Amla – Sour ,Lavana – Salt ,Tikta – Bitter ,Ushna – Katu – Pungent, Kashaya – Astringent are the six types of Rasa(tastes);they are present in the substances, each one is more strengthening (to the body)in their order of precedence.

Rasaha swadvamlalavantiktoshnakashayakah ||

Shad dravyamashritaste ca yathapoorvam balavaha |

tatraadyaa maarutam ghnanti trayastiktaadaya: kapham |

kashaayatiktamadhuraa: pittamanye tu kurvate ||

(As.H.su1/14,15)

Diurnal and seasonal clocks

DINACHARYA

Healthy habits should be included in life-style even in the busy schedule , if a person want to be healthy forever.

Includes-

• Early go to bed and early wake-up.

• Daily physical exercise.

• Daily oil massage including scalp, ear and feet as well as bathing.

• Daily use of oily nasal drops.

• Maintenance of body hygiene.

• Daily prayer and meditation.

• Take nutritious and balanced diet.

• Proper dressing.

• Use of gems and jewellery.

• Use deodorants and perfumes.

• Wear good quality of shoes and sandals.

• Select a job with morals and ethics

RITUCHARYA (SEASONAL REGIMEN)

• Environment influences the resting state of Doshas—Vata,

Pitta, and Kapha

• Good understanding of it is very much essential for early

diagnosis and prognosis of any disease & for adopting

preventive and curative measures.

• Dosha accumulation in cold season - expelled in vasanta/spring

• Dosha accumulation in summer / grishma - expelled in varsha /

rainy season

• Dosha accumulation in varsha - expelled in sarat / autumn

• Key to pre e tio of ost NCD s – a gift of Ayurveda

shiitotdbhavam doshacayam vasante vishodhayan griismajam

abhrakaale I

ghanaatyaye vaarsikamaa su samyak praapnoti rogaan

rtujaanna jaatu

Main categories of therapeutics

Purification (shodhana) Palliation (shamana)

Emesis (Kapha) Enhancing digestion

Purgation (Pitta) Withstanding thirst

Decoction enema (Vata) Withstanding hunger

Nasal medication Exposure to sun

Blood letting Exposure to wind

Physical exercise

shodha aṃ sha a aṃ ceti samaasaat aushadham dvidhaa|

shareerajaanaam doṣaaṇaa kramena para auṣadha ||

basti: vireko va a aṃ tathaa taila ghrutam madhu: |

(A.H.Su.1/25)

Homeostasis with Panchakarma – few

reports

• Twice weekly Panchakarma treatment consisting of snehana

(external oleation), swedana (passive heat therapy),

hrudaydhara (concoction dripping treatment) and basti

(enema) in patients of chronic heart failure significantly

improved metabolic equivalents of task and peak oxygen

uptake (Sane R, et al, 2017)

• Quality of life assessment (Skindex-29) among patients of skin

diseases, showed improvement quality of life domains-

emotions, functioning, and symptoms before and after

Ayurvedic purification therapy (Deshpande H, et al, 2016)

• Ayurveda panchakarma intervention resulted in changes in

metabolites across many pathways such as phospholipid

biosynthesis, choline metabolism, and lipoprotein metabolism

(Peterson CT et al, 2016)

• A combination of Panchakarma purificatory measure

Virechana and multiherbal oral medication has been

demonstrated to be effective in management of Hepatic

Cirrhosis Complicated by Ascites (Patel MV et al, 2015)

• Panchakarma therapy – Vamana showed significant relief in

parameters of psoriasis such as scaling, itching, candle grease

sign and psoriasis area and severity index score

(Bhattacharya N, 2016).

• A therapeutic course of Basti in obese individuals modulated

immune responses by regulating pro-inflammatory cytokines,

immunoglobulins and functional properties of T-cells. These

changes are associated with a reduction in the body weight

which is maintained even after three months of treatment

(Thatte U, 2015)

Salutogenesis – Svasthya rakshana

• The term describes an approach focusing on

factors that support human health and well-being,

rather than on factors that cause disease – Aaron

Antonovsky

• Health is a positive state and it is the outcome of

the adaptive feedback that each being establishes

with the environment

• Health is not merely a biological process, it is also a

cultural one involving knowledge as well as the

interaction with the environment in order to

modify it

Rasayana chikitsa

• Jara - Sequential biological human aging in terms

of sequential loss of certain biological qualities of

life specific to different decades of life

• If these bio-losses are compensated in respective

decades by appropriate life-style, nutrition and

Ayurvedic rejuvenative Rasayana remedies

described for this purpose, the rate of biological

aging may be retarded

• Rasayana are age-specific as they promote

nutrition relevant to the natural bio-losses

occurring at different phases of life span

• Rasayana – Ensure excellence of tissue elements

by

• Deepana, pachana (enhanced metabolism)

• Srotoshodhana (detoxification)

• Poshana (nourishment)

• All these three events singly or jointly lead to

improved nutritional status in the body leading

further to the formation of the best qualities of

cells and tissues which sustain aging and stress

Tridosha and biological clock

• Predominance of Dosha changes with age

• So also propensity for disease caused by a specific

dosha differs across ages; eg. Disease of vata –

degenerative illnesses in old age

• Prophylactic measures to keep the dosha fluctuations

in control helps avoid undue effects

• Age appropriate Rasayana therapy

Decade-wise ageing and prevention

20

-09

-20

17

Rasayana chikitsa – an elixir –

evidence

• Abundant evidence for anti-ageing/healthy ageing/reversal of process benefits of Rasayana

• Few examples

• Amalaki Rasayana (herbal formulation) and Rasa-Sindoor (a mercury-based organo-metallic formulation) suppressed cell death and pathology in fly models of neurodegeneration; contribute to 'healthy ageing (Dwivedi V,

etal, 2015, 2016)

• Curcumin reduces oxidative stress and apoptosis, and increase in the life span of PD model flies (Siddique YH etal, 2014)

• Brahma Rasayana and Chyavanaprash reduce cardiotoxicity (Alsuhailbani etal ,2016)

• Amalaki rasayana in aged individuals showed stable maintenance of DNA strand break repair without toxic effects (Viswanath U etal ,2016)

Genomic Variation Analysis and Gene Expression Profiling

of Human Dosha Prakriti based on Principals of Ayurveda

• Determination of Dosha prakriti of the subjects with Ayusoft software and senior ayurvedic physician (Vaidya)

• Analyis of Genetic variation after isolating DNA from selected subjects.

Results • Kapha prakriti specific CDH22 5′-UTR CpG methylation was also found to be

associated with higher body mass index (BMI) (Nizamuddin S et al, 2015)

• Significant difference in the expression of CD14, CD25 and CD56 markers between three different prakriti is demonstrated. The increased level of CD25 and CD56 in kapha prakriti may indicate ability to elicit better immune response, which is in conformity with textual references in Ayurveda (Rotti H et al, 2014).

• Prakriti may govern functions at cellular, tissue and at system levels maintaining equilibrium determined by genes which in turn are regulated by epigenetic cross talk especially through DNA methylation.

• These may provide basis to explore whether the DNA methylation programmed at the time of birth of an individual that will mimic the prakriti constitutions (Rotti H et al, 2015)

• Approaches to identify the influence of food and

utritio i i di iduals gro th, de elop e t and disease causation

•आहारसम्भवं वस्तु र गाश्चाहारसम्भवााः| हहताहहतववशषेाच्च ववशषेाः सुखदाुःखय ाः||४५|| C.S.Su.28

• Grow local, eat local

• यस्य देशस्य य जनतुाः तज्ज ंतज्ज षधं हहतं ।B.N.5/8

• Scope for Ayurveda based food and beverages

The s ie e of life shall e er attai fi ality. Therefore, humility and relentless industry

should characterize your endeavour and approach to knowledge. The entire world

consists of teachers for the wise. Knowledge conducive to health, longevity, fame, and

excellence, coming even from an unfamiliar source, should be received, assimilated and utilized ith ear est ess. Acharya Charaka

THANK YOU