16th International - Europäische Akademie für Ayurveda

Transcription

Ganzheit in Gesundheit und Bildung . Society for Holistic Health and Education
Europäische Akademie
für Ayurveda
European Academy
of Ayurveda
16th International
Ayurveda
Symposium2014
Prime Sponsor
Grußworte . Greetings
Mark und Kerstin Rosenberg, Initiatoren und Geschäftsführer der Gesellschaft
für ganzheitliche Gesundheit und Bildung gGmbH
Herzlich willkommen!
Liebe Symposiums-Teilnehmer,
mit unserem diesjährigen 16. Symposium gehen wir einen
neuen Schritt und unterstützen das von einem internationalen
Forscherteam organisierte 1. Internationale Research Seminar für
Ayurveda (IRSA). Damit entsteht eine Plattform, die AyurvedaExperten auf wissenschaftlicher Ebene zusammenbringt. Ziel ist
es, neue Studienergebnisse vorzustellen sowie Empfehlungen für
die zukünftige Richtung der Ayurveda-Forschung zu formulieren.
Gleichzeitig führen wir unser bewährtes Symposiumskonzept fort,
indem wir praxis- und therapiebezogene Vorträge und Workshops
von namhaften Experten anbieten. Es gibt wohl kaum eine andere
Gelegenheit, an der man sich so vielfältig über erfolgreiche ayurvedische Therapiestrategien orientieren kann wie hier in Birstein.
Auch zum 16. Internationalen Ayurveda Symposium erwarten wir
wieder hochkarätige Sprecher aus Indien, Europa und Amerika.
Über 40 Live-Vorträge, Workshops und Expertenrunden können
die Arbeit mit Ayurveda praktisch bereichern und mit fundiertem
Fachwissen untermauern.
"Krankheitsursache & Pathogenese ayurvedisch neu betrachtet"
ist eines unser bedeutsamen Schwerpunkt-Themen. Die genaue
Diagnose unter Berücksichtigung der gesamten Symptomatik, die
ein Patient aufweist, ist eine besondere Stärke des Ayurveda. Sie
ermöglicht, dass Störungen bereits früh erkannt werden können
und damit bessere Heilungs-Chancen eröffnet werden.
Trotz Wohlstand und vielen Sicherheiten nehmen in Europa
psychische Probleme und Schmerzen drastisch zu. Hier kann der
Ayurveda durch seine systemische Betrachtungsweise wertvolle
Hilfe leisten. Das Forum Mental Health mit Dr. Antonio Morandi
(IT), Ram Manohar (IND), Parvathidevi Kirathamoorthy (IND) u.a.
wird ein besonderes Highlight des Symposiums sein.
Auch wenn die Männer oft erst sehr spät Therapie in Anspruch
nehmen, sollten wir uns gerade deshalb intensiv um diese
Zielgruppe kümmern. Spannende Präsentationen sollen Ihnen
hierfür gedankliche Anregungen geben.
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Der Ayurveda wird in seiner Bedeutung international immer mehr
sichtbar. Weltweit wachsen die Bemühungen, ihn in die jeweiligen
Gesundheitssysteme zu integrieren. Hierfür wollen wir mit unserem erweiterten Symposium einen Beitrag leisten und zum Motor
für zukünftige Entwicklungen werden.
Wir freuen uns, dass wir sechs viel versprechenden
Nachwuchsforschern aus Indien die Möglichkeit eröffnen konnten,
sich auf einem internationalen Symposium zu präsentieren. Damit
möchten wir einen ermutigenden Impuls für die Entwicklung des
Forschungssektors in der Heimat des Ayurveda setzen.
Wir danken den herausragenden Ayurveda-Ärzten und Professoren
aus Indien, Europa und anderen Ländern der Welt, die unserer
Einladung gefolgt sind und so unsere Veranstaltung wieder mit
ihrem wertvollen und tiefgehenden Erkenntnissen bereichern.
Außerdem danken wir unseren Ausstellern und Sponsoren, die
nicht nur das Symposium, sondern auch den Ayurveda mit ihren
Produkten und Ideen unterstützen und voranbringen.
Ebenso herzlich begrüßen wir Sie als Gäste, die dieses Wochenende
zur fachlichen Weiterbildung und zum Gedankenaustausch nutzen. Als Kompetenzzentrum für Ayurveda in Europa bieten wir
Ihnen dafür den Raum und wünschen Ihnen viel Freude und interessante Begegnungen mit den anderen Teilnehmern und unseren
Ayurveda-Experten.
Ab 2015 werden wir in vergrößerten Räumlichkeiten noch mehr
Möglichkeiten umsetzen. So können wir dann kontinuierlich
medizinisch fundierte Ayurveda-Kuren in ruhiger und entspannter
Atmosphäre anbieten und gleichzeitig dynamische und inspirierende Seminare durchführen, ohne dass sich beide Bereiche stören.
Darauf freuen wir uns alle.
So hoffen wir, dass wir Sie und viele andere Gäste, die sich vertieft
mit Ayurveda beschäftigen wollen, auch in den nächsten Jahren
wieder hier in Birstein begrüßen können.
Kerstin & Mark Rosenberg
mit Team
2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014
A very warm welcome to you!
Dear symposium's participant,
With this year's 16th Symposium we take another step forward
and support the 1st International Research Seminar on Ayurveda
(IRSA) which was organized by an international team of Ayurveda
researchers. A new platform will develop, bringing together
Ayurveda experts on a scientific level. The aim is to present new
study outcomes as well as drafting advice for the future direction
of research on Ayurveda.
At the same time we continue our established Symposium concept
in presenting practical and therapy-related lectures and workshops
from renowned experts. You will hardly find another opportunity
apart from Birstein to be informed in such a wide range of diversity
about successful Ayurvedic Therapy strategies.
For this 16th International Ayurveda Symposium we expect again
top-class speakers from India, Europe and America. More than 40
live lectures, workshops and expert panels will enrich your practical
work with Ayurveda and profoundly substantiate your expertise.
"Etiology and pathogenesis seen from an Ayurvedic perspective"
is one of the main topics. A precise diagnosis in due consideration
of the complete symptomatology of a patient, is one of the special
strengths of Ayurveda. As dysfunctions can be detected at an earlier stage, better chances of healing are rendered possible.
Despite wealth and many securities psychic problems and pain
are dramatically encreasing in Europe. Here Ayurveda can provide
valuable assistance through its systemic perspective. Our Forum on
Mental Health with Dr. Antonio Morandi (IT), Ram Manohar (IND),
Parvathidevi Kirathamoorthy (IND) and others will therefore be a
special highlight of the Symposium.
Even though men quite often come to therapy at a rather late
state, this is exactly why we should take special care of this target group. Fascinating presentations will give you some clarity of
thought in that matter.
Ayurveda is becoming more visible at an international level. All
over the world, endeavours are made to integrate Ayurveda in the
specific health care systems. The Symposium aims to contribute
to this process and to become a driving force for future developments.
We are happy that we are able to offer six promising young researchers from India the opportunity to present themselves at an
international symposium. Thus we hope to send an encouraging
impulse for the further development of research to the motherland
of Ayurveda.
We thank our out-standing Ayurveda doctors and professors from
India, Europe and other countries of the world for following our
invitation and for enriching our event again with their valuable and
deep knowledge. In addition we thank our sponsors and exhibitors
who do not only support the Symposium but also Ayurveda itself
with their products and ideas.
Equally warm we welcome you as our guests who will use this
weekend for professional further education and exchange of ideas.
Being a competence center for Ayurveda in Europe we offer the
space for this exchange. We wish you lots of joy and interesting
encounters with other participants and our Ayurveda experts.
In 2015 we will realize more ideas in bigger premises. Thus it will
be possible to offer continuously medicine-based Ayurveda treatments in a peaceful and relaxed atmosphere, while at the same
time executing dynamic and inspiring seminars without any interference of the two fields. We are all eagerly looking forward to that.
We hope to see you and many other guests, who wish to dive
deeper into Ayurveda, again in the next years here in Birstein.
Kerstin & Mark Rosenberg
and team
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Inhalt · Content
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Inhalt . Content
16th International Ayurveda Symposium 2014
Abstracts Deutsch
Abstracts German
Abstracts Englisch
Abstracts English
Sponsoren · Aussteller
Sponsors · Exhibitors
Referenten
Speakers
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16
37
38
1st International Research Seminar on Ayurveda (IRSA)
Abstracts IRSA
Abstracts IRSA
Partner
Partners
42
52
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Abstracts · Deutsch
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Abstracts . Deutsch
Abstracts · Deutsch
Seite
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Oliver Becker HP: Mentale Pathogenese und Tonisierung: therapeutische Möglichkeiten von Medhya-Rasayana
9
Dr. med. Hedwig Gupta: Ayurvedische Differenzialdiagnose und -therapie bei Schmerzen im Bewegungsapparat
9
Sascha Kriese BA Hons (Ayu): Der Zweck von Krankheit – ein ganzheitliches Verständnis von Pathogenese
10
Marco Lebbing MD: Adjuvante ayurvedische Behandlung chronischer vs. akuter Schmerzen in der Neurologie
10
L. Mahadevan MD (Ayu): Eine klinische Studie zur Bewertung der Wirksamkeit von Vasti Chikitsa in Verbindung
von Bandscheibenvorfall-Management unter Berücksichtigung der Radikulopathie
11
Prof. Dr. Martin Mittwede PhD: Die Krankheitsspirale durchbrechen – verhaltenstherapeutische Perspektiven des Ayurveda
12
Dr. med. Kalyani Nagersheth: Schmerztherapie mit pflanzlichen Mitteln
12
Dr. Karin Pirc MD PhD: Die multifaktorielle Behandlung von Panikattacken
13Dr. med. Rotraud Scheiderbauer: Krankheitsursache und Pathogenese moderner Krankheiten ayurvedisch neu betrachtet
14
Elmar Stapelfeldt HP: Reizmagen und Reizdarm aus der Sicht der Ayurveda-Medizin
14
Ralph Steuernagel HP: Ayurvedische Anti-Aging Medizin für Männer
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Dr. Dr. med. Bernhard Uehleke PhD: Wissen und Verwendung von ayurvedischen Heilpflanzen in der Klostermedizin
Zusammenfassung der Vorträge in Deutsch
Mit den folgenden Texten möchten wir eine Übersicht der vielschichtigen Erfahrungswerte jener praktizierenden Ayurveda-Ärzte und
-Therapeuten vermitteln, die am Ayurveda-Symposium 2014 mitwirken. Wir bedanken uns bei all unseren Gästen, Referenten und
Mitwirkenden, die diesen Kongress an der Europäischen Akademie für Ayurveda zu einem einzigartigen Ereignis mit vielfältigem
Erfahrungsaustausch möglich machen. Die Artikel sind teilweise nur kurze Zusammenfassungen oder Auszüge aus den Präsentationen
und geben einen Eindruck über das reiche Wissen und die Informationsfülle der eigentlichen Vorträge und Workshops wieder.
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Abstracts . Deutsch
Mentale Pathogenese und Tonisierung:
therapeutische Möglichkeiten von
Medhya-Rasayana
Oliver Becker HP
Die starke Zunahme psychischer Problematiken ist ein typisches
Merkmal der heutigen Zeit. Immer mehr Menschen sind auf
der Suche nach Werkzeugen zur mentalen Tonisierung und
Stressreduktion. Die Ayurveda-Medizin bietet hier simple und
effektive Unterstützungsmöglichkeiten. Der Workshop skizziert
die ayurvedische Sichtweise der mentalen Ätiopathogenese sowie
Grundlagen und praktische Bedeutung der rasayana- und medhya-Konzepte als therapeutische Interventionsmöglichkeiten.
Die effektivsten pflanzlichen medhya-Substanzen sind
Shankhapushpi (Convolvulus pluricaulis), Mandukaparni (Hyrocotyl
asiatica) und Brahmi (Bacopa monniera). Auch Ashvagandha
(Withania somnifera) und Tulasi (Ocimum sanctum) beeinflussen
das mentale Milieu durch ihre adaptogene (die Anpassung des
Organismus an Stress verbessernde) Wirkung positiv. Darüber
hinaus besitzen auch einige Nahrungsmittel (z.B. Kuhmilch und
Ghee) eine medhya-Wirkung.
Weitere einfache und wirkungsvolle Maßnahmen zur mentalen Tonisierung sind eine vegetarische konstitutionsgemäße
Ernährung, eine moralisch hochstehende Lebensweise (sog. acara-rasayana) sowie die regelmäßige Praxis von Yoga-Techniken
(pranayama, Konzentration und Meditation) oder anderen
Entspannungsmethoden.
Gemäß der Caraka-samhita erhält eine vernünftige Verwendung
des Geistes sowie der geistigen Fähigkeiten die mentale Gesundheit,
während eine unvernünftige (ausbleibende, falsche oder exzessive)
Verwendung mentale Störung erzeugt. Rasayana-Maßnahmen,
die primär der Verlangsamung des Alterungsprozesses dienen,
verbessern auch die Arbeitsweise des Geistes. Medhya-Substanzen
ermöglichen eine spezifische mentale Tonisierung.
Dem Phänomen der Alterung kommt hier eine besondere Signifikanz
zu. So beschreibt der ayurvedische Gelehrte Sharngadhara (13.
Jhd.) die schrittweise Beeinträchtigung der kognitiven Fähigkeiten
des Geistes als Teil des natürlichen Alterungsprozesses. In einem
Schema sequenzieller Alterung ordnet er die jeweils betroffenen
Komponenten bestimmten Lebensdekaden des Menschen zu
und empfiehlt gleichzeitig spezifische Substanzen (dravya) zur
frühzeitigen Gegensteuerung. Gemäß diesem Konzept beginnt
der allmähliche geistige Abbau bereits mit Beginn des vierten
Lebensjahrzehnts. Moderne Studien bestätigen dies.
Rasayana-Maßnahmen bezwecken die Optimierung des kontinuierlichen Transformations- und Regenerationsprozesses der essentiellen strukturellen Körperkomponenten (dhatu-parinama). Über
die Verbesserung der Körperebene entfalten sie rückwirkend auch
eine Verbesserung des mentalen Milieus, worin sich der psychosomatische Ansatz des Ayurveda widerspiegelt. Einige der rasayanas
besitzen gleichzeitig eine medhya-Wirkung.
Der Fachterminus „medhya“ entstammt der ayurvedischen
Substanzlehre (dravyaguna-vijnana). Er beinhaltet die pharmakologische Wirkung einer Substanz auf die intellektuelle Komponente
(medha) des Geistes. Medhya-Substanzen verbessern kognitive Funktionen wie Auffassungsgabe, Verständnis, Analyse,
Problemlösen sowie Speicherung und Wiederabrufung von
Informationen. Medhya-Substanzen setzen auf körperlicher Ebene
an. Sie stärken das zentrale Nervensystem als Sitz des Geistes,
beeinflussen den Geist also indirekt. Denn nur in einem gesunden
Körper wohnt und operiert ein gesunder Geist.
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Ayurvedische Differenzialdiagnose
und -therapie bei Schmerzen im
Bewegungsapparat
Der Zweck von Krankheit –
ein ganzheitliches Verständnis von
Pathogenese
Dr. med. Hedwig Gupta
Sascha Kriese BA Hons (Ayu)
Schmerzen sind eine zentrale Grunderfahrung der Menschen.
Diese werden im Ayurveda sehr differenziert untersucht, diagnostiziert und behandelt.
Samkhya und Yoga, zwei grundlegende Philosophien, auf denen
der Ayurveda basiert, postulieren, dass die Schöpfung beginnt,
wenn sich bewusster, passiver Purusha mit unbewusster, dynamischer Prakrti vereinigt, um Selbsterfahrung zu erlangen und sich
in Richtung Erlösung weiterzuentwickeln. Evolution wird hier als
ein bewusster und zielorientierter Prozess gesehen, der laut Caraka
initiiert und erhalten wird von Paramatman, dem Schöpfer und
Bewahrer des Universums. Leben wird daher im Ayurveda nicht als
zufälliges Ereignis oder versehentlicher Unfall der Natur betrachtet.
Caraka geht sogar soweit, den Glauben an Zufall als eine der größten
Sünden zu bezeichnen (Caraka Samhita 1.11.14-15).
Nicht ein Schmerz ist wie der andere. Wenn zwei Menschen aus
moderner Sicht zum Beispiel eine Gonarthrose, eine Arthrose des
Kniegelenkes, haben, kann dies aus Ayurvedischer Sicht nicht nur
von unterschiedlichen Faktoren verursacht sein, sondern es können
völlig verschiedene Krankheitsentitäten vorliegen. Sie bedürfen
dementsprechend einer unterschiedlichen Therapie.
Woran aber kann man differenzialdiagnostisch ableiten, welcher dosha in welchem Gewebe auf welche Art verändert ist?
Wie wirkt sich das aus bei unterschiedlichen Konstitutionen und
Möglichkeiten des Zustandes von agni?
In was für einem Stadium liegt die Erkrankung vor?
Wie werden Schmerzerkrankungen grundsätzlich therapeutisch
angegangen und welche differenzialtherapeutischen Aspekte sind
zu bedenken?
In diesem Vortrag werden diese Fragen durchleuchtet und –
unterbaut von klassischen Zitaten – werden Beispiele für die
Differenzialdiagnose und Differenzialtherapie vom Phänomen des
muskuloskelettalen Schmerzes im Ayurveda gegeben. Wir besprechen mögliche Krankheitsbilder und Wege der Verursachung
sowie die genauen Anzeichen des Schmerzes, die uns differenzialdiagnostisch voranbringen.
Der Vortrag stellt für im Ayurveda schon Fortgeschrittene eine
geeignete Vertiefung der Ayurvedischen Zusammenhänge dar.
Wenn das Leben also einen Zweck hat und frei von Zufällen ist,
dann müssen Gesundheit und Krankheit ebenfalls einen bestimmten
Sinn haben. Das erklärte Ziel des Ayurveda ist die Erhaltung von
Gesundheit als Mittel und Weg zur Erreichung der vier Hauptziele im
Leben: dharma, artha, kama und moksha (Ashtanga Hrdaya 1.1.2).
Gesundheit gilt nicht einfach nur als wünschenswerter Zustand,
sondern als notwendige Voraussetzung für das Erleben von wahrer
Erfüllung und letztendlicher Erlösung. Worin besteht dann der Zweck
von Krankheit im Leben? Laut ayurvedischer Ätiologie führt ein
Ungleichgewicht ausgelöst durch asatmyendriyartha samyoga und
prajnaparadha zu Krankheit (Charaka Samhita 1.1.54). Dies verweist
auf das, was im Ayurveda als Hauptursache von Krankheit angesehen
wird: Individuelle Entscheidungen und darauffolgende Handlungen,
die schädlich und nicht im Einklang mit der wahren Natur (dharma) eines Individuums sind. Mit anderen Worten: Krankheit ist das
Ergebnis eines nicht authentischen Ausdrucks des eigenen Selbst.
Da menschliches Verhalten bestimmt wird von tiefliegenden
Glaubenssätzen darüber, was ein Mensch als ‘richtig’ oder ‘falsch‘
betrachtet, führt jede inkorrekte Annahme über das eigene Ich zu
einem nicht authentischem Selbstausdruck und folglich zu einer
nicht authentischen Erfahrung des eigenen Ich. Wenn dies von einer
Person nicht erkannt und verändert wird, etabliert sich eine sogenannte psycho-emotionale Dynamik im Unterbewusstsein, die die selbe
Erfahrung stetig neu hervorruft. Um mit der Dynamik konstruktiv
umgehen zu können, muss die Person sich dieser zuerst klar bewusst
werden. Und genau hierin liegt der eigentliche Sinn und Zweck von
Krankheit: jede psycho-emotionale Dynamik manifestiert sich mit der
Zeit als spezifische Krankheit, welche einer Person die Möglichkeit
bietet, diese Dynamik bewusst wahrzunehmen. Krankheit dient also
als Einladung dazu, diejenigen Ausdrucksweisen des eigenen Ich
zu erkennen und zu verändern, die nicht authentisch sind und auf
falschen Annahmen aus der Vergangenheit beruhen.
In diesem Vortrag werden die oben genannten Konzepte genauer
erklärt und deren klinische Relevanz und praktische Anwendung an
den Beispielen Krebs und Diabetes mellitus verdeutlicht.
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Abstracts . Deutsch
Adjuvante ayurvedische Behandlung
chronischer vs. akuter Schmerzen in der
Neurologie
Eine klinische Studie zur Bewertung
der Wirksamkeit von Vasti Chikitsa
in Verbindung von BandscheibenvorfallManagement unter Berücksichtigung
der Radikulopathie
Marco Lebbing MD
L. Mahadevan MD (Ayu)
Schmerz wird im Ayurveda ebenso wie neurologische Erkrankungen
durch eine Störung von Vata verursacht. Während akute Schmerzen
meist klar zugeordnet und behandelt werden können, sind chronische Schmerzen oft multifaktoriell bedingt und bedürfen eines
komplexeren Behandlungskonzepts.
Im Gegensatz zu traumatisch bedingten Schmerzen ist eine klare
Ätiopathogenese nicht immer zu erzielen, was eine zufriedenstellende Behandlung zusätzlich erschwert. Dabei gehen gerade neurologisch bedingte Schmerzen oftmals mit diffusen und teilweise
schwer beeinflussbaren Beschwerden einher.
Bandscheibenvorfall ist eine der häufigsten Erkrankungen, die
durch einen Ayurveda-Arzt in der klinischen Praxis beobachtet wird. Die Krankheit zeigt sich durch einen Vata-Anstieg
bedingt durch einen Lebensstil, der akute Rückenschmerzen
mit Taubheitsgefühl, Missempfindungen und Schmerzen in den
Beinen verursacht. Die Patienten nehmen oft Analgetika für
ein paar Tage und erhalten symptomatische Linderung , aber
Schmerzen treten nach dem Absetzen der Medikamente wieder
auf. Die meisten dieser Menschen besuchen Ayurveda Vaidyas
hier in meinem Dorf für eine vollständige Heilung.
Der Vortrag gibt einen Überblick über die verschiedenen Arten von
Schmerz und die Schmerzentstehung. Anhand von primär neurologischen Schmerzerkrankungen erfolgt dann eine Beurteilung nach
ayurvedischen Gesichtspunkten und mögliche Therapieansätze
werden erläutert.
Die Ayurveda-Beurteilung stützt sich auf Prinzipien wie dosha,
dushya, guna vikalpa, srotodushti prakara usw. Diagnose wird
durch Prüfung und Untersuchungen wie SLR , Trendelenburg
Test, Blasenkontrolle, Fußkontrolle, plantare Reflexe und MRT
der Lendenwirbelsäule , sowie Screening der sagittalen Ansicht
bestätigt.
Therapiestrategie (cikitsa) ist vor allem die Redultion von Vata und
Kapha (vatakapha-hara, ushna und vatanulomana und wird in
verschiedenen Stufen durchgeführt. In der ersten Phase können
gandharva hastadi kashaya, vaishvanara curna, abhayarishta usw.
eingesetzt werden.
Die zweite Phase umfasst die Anwendung von nagaradi lepa. Die
dritte Phase umfasst die Anwendung von taila wie kottamchukkadi taila, chinchadi taila usw., wonach ruksha sveda folgt. In der
vierten Phase wird vasti cikitsa wie pippalyadi taila für anuvasana
und eranda muladi niruha für sthula dehi eingesetzt, während für
krusha dehi dhanvantara taila anuvasana angewandt und madhutailika vasti genutzt wird.
Vasti cikitsa kann vom Yoga- oder Karma-vasti-Typ in Abhängigkeit
von dem Durchmesser des Wirbelkanals sein. Auf Vasti cikitsa folgen shamana-aushadhas. Kati vasti ist das letzte Instrument in der
Behandlungsphase Tägliche Bewegung während einer Dauer von
20 Minuten wird empfohlen, bei Lumbalflexion zu vermeiden.
Die Gesamtdauer der Behandlung beträgt 12 Wochen, in den
ersten zwei Wochen stationäre Patientenbehandlung, gefolgt von
shamana-aushadha. Die Wiederherstellung der Gesundheit liegt
bei 99%. Der Referent präsentiert MRT Dokumentationen der
Resorption des Bandscheibenvorfalls nach vasti cikitsa während
des Referats.
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Die Krankheitsspirale durchbrechen –
verhaltenstherapeutische Perspektiven
des Ayurveda
In diesem Sinne lohnt es sich, den Ayurveda im verhaltenstherapeutischen Sinne zu beleuchten; dabei spielen Erklärungsmodelle
zur Funktionsweise der Psyche, aber auch klassische Empfehlungen
zur Lebensführung eine Rolle, weil sie die therapeutische Vision
der alten Ayurveda-Ärzte beleuchten und Auswege aus der
Krankheitsspirale aufzeigen.
Prof. Dr. Martin Mittwede PhD
In dem Vortrag werden wir versuchen, die ayurvedischen Strategien
zur Verhaltensänderung zu begreifen, um sie dann für unsere
eigene Arbeit mit Patienten praktisch nutzbar zu machen.
Der Ayurveda nähert sich der Entstehung von Krankheiten auf
verschiedene Weise und entwickelt Systematiken, um die Prozesse
zu beschreiben und eindeutig diagnostisch zu erfassen. Als ein
komplexes Medizinsystem betrachtet er die ursächlichen Faktoren
in einem Zusammenhang und entwickelt daraus angepasste
Strategien für die Behandlung.
Klassisch bekannt ist das Konzept der zeitlichen Dynamik (kriyakala), in der sich eine Krankheit entwickelt:
1) Samcaya = Stadium der Akkumulation
2) Prakopa = Stadium der Provokation und des weiteren Anstiegs
3) Prasara = Stadium der Ausbreitung und der Einwanderung in
andere Bereiche
4) Sthana-Samshraya = Stadium der Lokalisierung bzw. des
Festsetzens in den Geweben
5) Vyakti= Stadium der Manifestation (volle klinische Symptomatik
vorhanden)
6) Bheda= Stadium der Entstehung von Komplikationen und
Chronizität
Für die Veränderung der Dosha-Dynamik kennt der Ayurveda eine
Vielzahl an Ursachen, wobei das selbst verantwortete Handeln
eine bedeutende Rolle spielt. Das Ungleichgewicht der Doshas ist
also häufig nicht die primäre Ursache der Störung, auch wenn es
in der Literatur oft so dargestellt wird. Tatsache ist jedoch, dass
ursächliche Belastungsfaktoren in der Regel zu einer Veränderung
der Dosha-Situation führen und daher dementsprechend klassifizierbar sind.
Ein entscheidendes Problem ist nun, dass gestörte Doshas
auch auf die Psyche zurückwirken und zu einer Störung des
Unterscheidungsvermögens (buddhi) und der Erkenntnisfähigkeit
(prajna) führen. Gleichzeitig wirken Gewohnheitsmuster mit
hinein, die dazu führen, dass selbst nach einer Balancierung der
Doshas alte, eingeübte Verhaltensweisen wieder auftauchen und
den Therapieerfolg zunichte machen können. Dieses Phänomen
wird u.a. mit dem Begriff Anhaftung (klesha) beschrieben.
Damit sind wir bei einem grundsätzlichen Problem der Prävention
und der Gesundheitsbildung angekommen: Menschen verhalten sich nicht so, wie es für die Verwirklichung und Erhaltung
der Gesundheit wünschenswert wäre. Viele Programme und
Maßnahmen des öffentlichen Gesundheitswesens sind erfolglos,
weil es nicht zu einer nachhaltigen Veränderung des Verhaltens
kommt. Viele Menschen benötigen letztlich therapeutische
Unterstützung, um sich auf den richtigen Weg zu begeben. Und
dafür bedarf es sinnvoller Strategien.
11
Abstracts . Deutsch
Schmerztherapie mit pflanzlichen Mitteln
Die multifaktorielle Behandlung von
Panikattacken
Dr. med. Kalyani Nagersheth
Dr. Karin Pirc MD PhD
Im Vortrag wird ein Schmerzkonzept vorgestellt und dann über
zwei ausgewählte Pflanzen gesprochen, die im Ayurveda bei
Schmerzen Verwendung finden.
Burn-out, Depressionen, Ängste, Schlafstörungen und
Panikattacken zeigen in den letzten Jahrzehnten eine ständig
steigende Tendenz. Statt Beruhigungsmitteln setzt der Ayurveda
auf Ursachenanalyse. Wie ist die Lebenssituation des Betroffenen,
sein Schlaf- und Wachrhythmus, seine Arbeitsbelastung ebenso
wie die familiäre Situation und seine Ernährungsgewohnheiten über welchen Zeitraum und wodurch haben sich die Störungen
eingestellt? Eine solche detaillierte Erhebung der Ursachen ist
immer individuell auf die einzigartige Lebenssituation des Patienten
zugeschnitten und schließt auch eine differenzierte Pulsdiagnose
mit ein.
Boswellia serrata (shallaki, indischer Weihrauch) gehört zu den
ayurvedischen Pflanzen-Substanzen, die in der letzten Zeit sehr
intensiv erforscht worden sind. Es liegen viel versprechende
Erkenntnisse über seine Wirkungen vor. Weihrauch setzt an der
selben Stelle wie Cortison an und findet daher Verwendung bei
überwiegend entzündlich bedingten Schmerzen.
Syzygium aromaticum (lavanga, Gewürznelke) ist ein Klassiker im
ayurvedischen Gewürzregal. Bei Schmerzen findet insbesondere
auch das Nelkenöl Verwendung, welches in der Zahnmedizin
häufig eingesetzt wird. Aber auch in Europa sind die Nelken seit
dem Mittelalter in der Heilkunde bekannt. Sie können vielfältiger
verwendet werden, als heute meist bekannt ist. Nelken wirken auf
die Schmerzrezeptoren und werden besonders bei Schmerzen im
Kopfbereich und bei Zahnschmerzen eingesetzt.
Darauf aufbauend erarbeitet der Ayurveda-Arzt gemeinsam mit dem
Patienten einen in seinen Alltag umsetzbaren Maßnahmenkatalog,
der die gestörten Doshas wieder ins Gleichgewicht zurückführt,
sodass das verloren gegangene Wohlbefinden sich wieder einstellen und auch auf Dauer erhalten bleiben kann.
Je ausgeprägter das Beschwerdebild bereits ist, desto mehr Faktoren
müssen ausgeglichen werden. Als Basis gilt eine Lebensweise, die
im modernen, hektischen Leben oft verloren gegangen ist: - ausreichend Schlaf angepasst an den biologischen Rhythmus, - leicht
verdauliche, lebendige Nahrung, regelmäßig und zur richtigen
Tageszeit genossen, wobei die individuelle Verdauungskraft und
Stoffwechselleistung berücksichtigt werden, - im Alltag einfach
durchzuführende Entgiftungsmaßnahmen, - sportliche Bewegung
und/oder Yoga-Übungen, ebenfalls fein abgestimmt auf die
individuelle Befindlichkeit und Leistungssituation - und vor allem
in diesen Situationen extrem bewährt Meditation, speziell die
Transzendentale Meditation ebenso wie Phytotherapie, die das
Nervensystem stärkt und beruhigt.
Selbst in schweren Fällen hilft eine Pancakarma-Kur, die klassisch
überlieferte und seit Jahrtausenden bewährte Umstimmungs- und
Ausleitungstherapie des Ayurveda. Diese wird unter ärztlicher
Aufsicht individuell auf den Einzelnen abgestimmt. Sie löst mit
vielen verschiedenen Formen von Ölmassagen - die von zwei
Therapeuten mit synchronen Bewegungen durchgeführt werden
- und Ölgüssen systematisch Umweltgifte und körpereigene
Abbauprodukte aus den Zellen. Diese werden anschließend durch
Abführen und sanfte Einläufe systematisch wieder ausgeschieden. Diese Entlastung des Körpers, die eine tiefe Regeneration
einleitet, wird begleitet von gesundheitsfördernder, schmackhafter Ernährung und einem Tagesablauf, der alle Aspekte der
Regeneration weiter vertieft.
12
Krankheitsursache und Pathogenese
moderner Krankheiten ayurvedisch neu
betrachtet
Dr. med. Rotraud Scheiderbauer
In unsere ayurvedische Praxis in Europa kommen Patienten häufig
mit Beschwerden, die entweder bereits schulmedizinisch klassifiziert wurden oder in kein allopathisches Krankheitsbild passen. Die
“moderne“ Medizin unseres Jahrhunderts beschreibt Krankheiten,
die in den ayurvedischen Schriften nicht angeführt sind und für die
es in den alten Texten keine Entsprechungen gibt. Das weite Feld
der Autoimmunerkrankungen sei hier als Beispiel genannt. Sucht
man in der ayurvedischen Pathophysiologie, findet man für AutoAntikörper kein Pendant.
Wie geht man also als Ayurveda Mediziner mit “modernen“
Krankheiten wie z.B. multipler Sklerose, Lupus erythematodes
oder Hashimoto Thyreoiditis um? Bei Sushruta finden wir folgende
Empfehlung:
nasti rogo vina doshair yasmat tasmad vicaksanah
anuktam api doshanam lingair vyadhim upacaret
Da es keine Krankheit ohne (Beteiligung von) doshas gibt, möge
also der Verständige auch nicht genannte Krankheiten nach den
Symptomen der doshas behandeln
Sushruta-Samhita, Su 35.19
tasmad vikaraprakrtir adhisthanantarani ca
samutthanavisheshamsh ca buddhva karma samacaret
Also möge man die Behandlung beginnen, nachdem man die
Natur der Krankheit, die Veränderung der Lokalisation und den
spezifischen Beginn erkannt hat.
Caraka-Samhita, Su. 20-22
Wie kann nun eine Therapie aussehen, die zum Benefit des
Patienten Ayurveda und Schulmedizin vereint? Anhand einer
Fallstudie wird auf diese Frage detailliert im Vortrag eingegangen:
Eine 55-jährige Patientin wurde mir vor 11 Jahren zur internistischen Abklärung rezidivierender Entzündungen im Genitalbereich
überwiesen. Die Bartholinischen Drüsen waren in unregelmäßigen,
immer kürzer werdenden Abständen schmerzhaft geschwollen
und eitrig, sodass eine chirurgische Intervention unumgänglich
war. Begleitend litt sie an Gastritis und nächtlichem Schwitzen
am Kopf. An pathologischen Laborwerten fiel neben akuter
Entzündungsparameter ein deutlich erhöhtes TSH auf, das so gar
nicht zu der äußerst agilen Patientin passte. Sie litt weder unter
Müdigkeit, Energieverlust noch Antriebslosigkeit. Der Verdacht
auf eine Immunthyreoiditis Hashimoto bestätigte sich in weiteren
Untersuchungen und eine Substitutionstherapie mit SchilddrüsenHormonen wurde eingeleitet. Die Beschwerden besserten sich
teilweise. Die als „vegetative“ Symptome bezeichneten NebenErscheinungen blieben allerdings unverändert.
Jetzt, in meiner ayurvedischen Praxis, wurde die allopathische
Therapie durch Ausgleich der aggravierten doshas ergänzt.
In der ayurvedischen Pathogenese (samprapti) werden über 30
mögliche Krankheitsursachen, u.a. abhyantara und bahya (innere
und äußere Ursachen), sama dosha und nirama dosha (dosha mit
und ohne ama) genannt, die zu einer Veränderung der doshas
führen können. Sechs verschiedene Stadien abnormer dosha
Aktivität bieten Gelegenheit zu therapeutischer Intervention.
Schulmedizinisch gesehen ist die Ursache “moderner“ Erkrankungen
häufig unbekannt. Desto wichtiger scheint – gleichwie zum
Ausgleich – eine genaue Klassifizierung und Nomenklatur zu sein.
Im Ayurveda gibt es auch hierzu Hilfe von den Klassikern:
vikaranam akushalo na jihriyat kadacana
na hi sarvavikaranam namato sti dhruva sthitih
Wer den Namen einer Krankheit nicht kennt, der möge sich niemals schämen, denn es sind nicht alle Krankheiten vom Namen
her festgelegt.
sa eva kupito doshah samutthanavisheshatah
sthanantaragatash caiva janayaty amayan bahun
Der erregte dosha aufgrund der Besonderheit seiner Lokalisation
und bei Wechsel der (Körper-)Region erzeugt viele Krankheiten.
13
Abstracts . Deutsch
Reizmagen und Reizdarm aus der Sicht der
Ayurveda-Medizin
Ayurvedische Anti-Aging Medizin für
Männer
Elmar Stapelfeldt HP
Ralph Steuernagel HP
"Das Verständnis und die Therapiemöglichkeiten von funktionellen Erkrankungen des Magen-Darm-Trakts können durch traditionelle Medizinsysteme wie dem Ayurveda bereichert werden."
Anti-Aging ist das Zusammenspiel mehrerer Disziplinen mit dem
Ziel länger, gesünder, schöner, biologisch jünger und glücklicher
zu leben.
Dieser von der Schulmedizin hinsichtlich seiner Ursachen
und
Entstehungsmechanismen
schwer zu
greifende
Beschwerdekomplex lässt sich mithilfe der dynamischen Konzepte
der Ayurveda gut fassen. Traditionell liegt der Fokus des Ayurveda
in vielerlei Hinsicht auf dem Magendarmtrakt und er hat an
großen Populationen umfangreiches Erfahrungswissen bei der
Behandlung funktioneller Verdauungsbeschwerden gesammelt.
Dank seines ganzheitlichen Ansatzes bietet Ayurveda gerade bei
den psychisch beeinflussten Erscheinungsformen vielfältige therapeutische Möglichkeiten.
Das Leben verlängern heißt, es nicht zu verkürzen. Die AntiAging-Medizin beinhaltet Maßnahmen zur Verhinderung vorzeitigen Alterns. Ihre Quelle liegt im alten Indien und wurde vorwiegend in der Lehre von RASAYANA CIKITSA, einer der acht Glieder
klassischer Ayurvedamedizin, verarbeitet.
Übereinstimmend mit den sog. ROM-Klassifikationskriterien,
die funktionelle Magendarm-Beschwerden auf zwei
Hauptbeschwerdebilder
(funktionelle
Dyspepsie
und
Reizdarmsyndrom) reduzieren, finden sich im Ayurveda zwei
wesentliche Kriterien für die Diagnose: 1. das "Verdauungsfeuer"
(agni) für den oberen und 2. die Darmsensibilität (koshtha) für
den unteren Verdauungstrakt. Die jeweiligen Untereinteilungen
dieser beiden Kriterien ermöglichen eine praxisnahe Typisierung.
Zur differenzierten Zuordnung individueller Symptome wird die
dosha-Theorie herangezogen.
Nach der individualisierten Diagnose unter Berücksichtigung
der Patientenkonstitution steht am Anfang der ayurvedischen
Therapie die Ursachenvermeidung. Da im Ayurveda-System
Ernährung, Verhalten und Denkweisen die wichtigsten ursächlichen Felder darstellen, kommen die umfangreiche Diätetik und
Ordnungstherapie des Ayurveda zum Tragen. Mithilfe der ayurvedischen Phytotherapie lassen sich nebenwirkungsarm Impulse auf
individuelle Beschwerden setzen. Im Vordergrund stehen hier die
Korrektur der Verdauungsfunktionen (agni) und die Regulierung
der Darmmotilität (koshtha). Die psychische Komponente wird
mittels harmonisierender Ölanwendungen, Phytotherapeutika
und übender Verfahren wie Yoga und Meditation behandelt.
Sollten genannte Therapiemethoden nicht den gewünschten
Erfolg zeitigen, so werden traditionelle Ausleitungsverfahren zur
Verbesserung von Digestion und Stoffwechsel, zur Darmsanierung
und zur Beseitigung pathogenetischer Schadstoffe durchgeführt.
Läuft die biologische Uhr der chronologischen voraus, lässt sich
diese durch sieben Methoden wieder zurückdrehen in den richtigen Takt der Natur:
• Ernährungsplanung (Ahara)
• Bewegungstraining (Vyayama)
• Lebensstiländerung (Vihara)
• Supplementierung (Aushadha)
• Hormonelle Balance
• Mentale Balance (Sattvavajaya)
• Ästhetisches Anti-Aging (Saundarya)
Für ayurvedisches Anti-Aging gibt es keine Altersbegrenzung –
unser Organismus altert, weil er lebt. Frauen und Männer können
gleichermaßen von den ganzheitlichen Ansätzen des RASAYANA
profitieren.
In diesem Fachvortrag werden u.a. folgende Themen behandelt:
• Ursachen der Alterung aus ayurvedischer Sicht
• Ganzheitliche Maßnahmen zur biologischen Verjüngung von
Organen und Funktionen
• Andropause: Ayurvedische Begleitung der hormonellen
Umstellung bei Männern
• Problemlösungen bei sexuellen Funktionsstörungen
• Prävention von männlicher Demenz und Depression im
Rentenalter
• Verwirklichung männlicher Lebensziele in unterschiedlichen
Lebensphasen
• Die Rolle von Attraktivität in jedem Lebensalter
In diesem Workshop vermittelt Elmar Stapelfeldt seine umfangreiche Praxis-Erfahrung mit diesem weit verbreitetem Krankheitsbild,
das mit Ayurveda gut behandelt werden kann. DiagnoseÜbungen, praktische Tipps und Fallanalysen machen die Inhalte
für die Teilnehmer leicht umsetzbar.
14
Wissen und Verwendung von ayurvedischen
Heilpflanzen in der Klostermedizin
Dr. Dr. med. Bernhard Uehleke PhD
Es gibt eine deutliche Überlappung bei den verwendeten
Heilpflanzen im Ayurveda und in der Traditionellen Europäischen
Medizin bzw. Klostermedizin. Bereits in der frühen Phase (8.-10.
Jh.) der Klostermedizin war bereits Ingwer eine der meist erwähnten Pflanzen überhaupt (bes. 'Lorscher Arzneibuch'), fast ebenso
wichtig war Pfeffer (schwarzer, weißer und langer Pfeffer), daneben Kardamom, Gewürznelke und Zimt.
Die Zuordnung von Qualitäten ist bei diesen Gewürzen ebenso
wie in den asiatischen traditionellen Medizinsystemen übereinstimmend heiß und trocken. Sie werden bei feucht-kalten
Zuständen angewandt – dennoch unterscheiden sich die spezifischen Indikationsangaben nicht unerheblich.
In der 2. Phase: 11.-12. Jh. (erste arabische Rezeption) kamen
hinzu: Muskatnuss und Galgant (beide auch direkt aus China) und
die Zittwer-Wurzel (Curcuma zedoaria). Alle diese Gewürze und
Arzneipflanzen gehörten zu den äußerst beliebten Heilmitteln,
nicht zuletzt auch bei Hildegard von Bingen. Ein genauerer
Vergleich der Indikationsangaben in Abhängigkeit von Zeit und
Raum könnte Hinweise zu vergessenen Indikationen bringen.
15
Abstracts · English
16
Abstracts . English
Abstracts · English
Page
18
Anand Chaudhary MD (Ayu) PhD: Pathogenesis in Ayurveda
18
Matthijs Cornelissen MD: How to develop rigorous subjectivity as a new research methodology for psychology and mental health
19
Prof. Anand Dhruva MD: Developing modern perspectives on the concept of ama
19
Prof. Antonella delle Fave MD: The management of mental health – challenges and solutions
20
Prof. Antonella delle Fave MD: Towards sustainable healthcare: the benefits of an integrated approach
20
Prof. S. N. Gupta MD (Ayu): Etiopathogenesis of diabetes mellitus and its treatment
21
Prof. S. N. Gupta MD (Ayu): Psychological aspects of pain: role of the mind in causation as well as in management of pain
23
Parvathidevi Kirathamoorthy MD (Ayu) MSc: Treatment strategies of unbalanced states of mind due to pitta (
paittikonmada)
24
Nikolaos Kostopoulos MD and Asvin Barot MD (Ayu): Acute and chronic pain managed with agnikarma and the use of a
novel herbal cream
24
Rajesh Kotecha MD (Ayu): Clues on pain management from an Ayurvedic perspective
25
Sascha Kriese BA Hons (Ayu): The purpose of disease – understanding pathogenesis holistically
25
Sascha Kriese BA Hons (Ayu): The sacred masculine
28
Marco Lebbing MD: Adjuvant Ayurvedic treatment of chronic and acute pain in neurology
28
L. Mahadevan MD (Ayu): A clinical study to assess the efficacy of vasti chikitsa in the management of intervertebral disc
prolapse associated with radiculopathy
29
Ram Manohar MD (Ayu): The role of dhatu in etiology and pathogenesis of diseases
29
Ram Manohar MD (Ayu): Reproductive medicine in Ayurveda – the concept of vrishya (fertility) and vajikarana (potency)
30
Prof. Martin Mittwede PhD: Breaking the disease spiral – behavioral perspectives of Ayurveda
31
Antonio Morandi MD: Neuropathic pain after lombotomy for renal cancer resolved with Ayurvedic treatments – a case
report
31
Ashtavaidyan Narayanan Nambi MD (Ayu): Management of prostate disorders and BPH
32
Ashtavaidyan Narayanan Nambi MD (Ayu): Neurological descriptions in classical texts
32
Prof. Tanuja Nesari MD (Ayu) PhD: Medicinal plants for improving dhatvagni and qualities of dhatuin Ayurveda
33
Sukumar Sardeshmukh MD (Ayu): Importance of shukra dhatu in Ayurveda
34
Madan Thangavelu PhD: The agni-ama-srota triad in disease aetiology and pathogenesis
35
Carmen Tosto: External basti in pain management
36
Ramesh Varier MD (Ayu): Ayurvedic treatment of male infertility
36
Ramesh Varier MD (Ayu): Polycystic ovarian syndrome and its management through Ayurveda
Composition of all lectures in English
By the following texts we would like to give you an overview on the manifold experiences of the Ayurvedic doctors and therapists
participating in this year‘s symposium. We would like to thank all our guests, lecturers and contributors who enable this Ayurveic
Congress at the European Academy of Ayurveda to become a unique and qualitative event with lots of exchange of experiences.
The articles are often only short abstracts of the lectures and reflect the deep knowledge and informational richness the lectures and
workshops have.
17
Abstracts . English
Pathogenesis in Ayurveda
How to develop rigorous subjectivity as a
new research methodology for psychology
and mental health
Anand Chaudhary MD (Ayu) PhD
Matthijs Cornelissen MD
The holistic approach of Ayurveda intends to make human life
healthier. The classical and contemporary literature of Ayurveda
has conceptualized the doctrine of origin of diseases and its remedies as per its fundamental philosophy /principles based on core
concepts like Tridosha, Pancamahabhuta, Saptadhatu, DoshaDushya-Sammurcchana, Kha-Vaigunya, Avarana and SampraptiVighattana.
In recent years, a number of health-related disciplines and practices
from India have found widespread acceptance in the emerging
global civilization. But the acceptance is still largely at the margins.
Ayurveda tends to be bracketed as a "complementary and alternative" form of medicine of which the "usefulness and safety" is still
to be established, and hathayoga and mindfulness are accepted
only as neatly packaged but severely simplified and decontextualized auxiliary techniques. The sophisticated underlying knowledge
systems and the well-developed ontologies and epistemologies on
which they are based are ignored.
Ayurveda believe that if basics of body such as Dosha, Agni, Dhatu,
Mala and various physiological factors and procedures are in balanced state and performing with equilibrium, person will maintain
a disease free status. Any disturbances in symmetry of these factors
will lead to pathogenesis of disease. Ayurveda describes how the
etiological factors bring about changes in the structural and functional units of the body, i.e. Vata, Pitta and Kapha, further, how
these structural changes derange the functions of organs and finally
how the deranged functions of one organ lead to derangement of
other organs i.e. complications.
The concept of pathogenesis of diseases in Ayurveda discussed
various stages of commencement of diseases as under
a) Samcaya – Accumulation of Doshas because of action of etiological factors.
b) Prakopa – Further enhancement in imbalance status of Doshas
c) Prasara – Propagation of Doshas at different sites
d) Sthanasamshraya – Collection of Doshas in specific sites
e) Vyakti – Expression of disease
f) Bheda – Differentiation of diseases
Ayurveda defines different varieties of diseases in accordance of
their causative causes, such as diseases of body and mind, diseases
due to internal and external causes (Nijja and Agantuja), diseases
as per number of Doshas involved and their different sets of cross
combination termed as Ekadoshaja (any one Dosha), Dvandvaja
(any two Doshas) and Sannipatika (all three Doshas are involved),
Hereditary diseases (Adibala Pravritta or Sahaja), congenital diseases
(Janmabala Pravritta or Garbhaj), diseases due to environmental
factor (Kalabala Pravritta or Kalaja), diseases arising due to bad luck
or misfortune (Daivabala Pravritta or Prabhavaj) and many more.
In this presentation I will focus on mindfulness where a shift from its
limited present usage to its full potential could have a far-reaching
impact on our collective and individual lives. Mindfulness is increasing accepted as an auxiliary technique in Cognitive Behavioral
Therapy (CBT), because even its present crippled, decontextualized
usage simply works.
But a good understanding of the underlying philosophy, the psychological theories, and the practical know-how on which this
technique is based, could lead to much more. It could not only
lead to more effective usage in counseling, therapy and the maintenance of mental health, but it could also open up the possibility
for the systematic development of what Maslow called the further
reaches of human potential. It could do this by the development of
consciousness-based research methods, which could (finally) offer
psychology the possibility of studying (and influencing) with perfect
rigor and mental rectitude the subtle, yet powerful, innermost
movements of the mind. The issues involved are, however, many
and the whole territory is rather complex. What I'll try to do here is
to give a short outline of the underlying philosophical assumptions,
indicate a few basic techniques, hint at the possibilities their usage
might open up to, and hope that this will lead to discussion and
further studies.
Understanding of pathogenesis of all these kind of diseases as per
principles of Ayurvedic doctrines is necessary to decide root cause
of disease so that instead of symptomatic treatment total cure may
be provided to patient. The classical and contemporary thoughts
of pathogenesis in Ayurveda will be discussed in detail during discourse of symposium.
18
18
Developing modern perspectives on the
concept of ama
The management of mental health –
challenges and solutions
Prof. Anand Dhruva MD
Prof. Antonella delle Fave MD
Given trends in globalization, it is becoming increasingly important
to have productive dialogue among different thought systems.
Biomedicine and Ayurveda are two major systems that interact
in the modern framework. As such, encouraging discussion of
core concepts that may be shared between the two systems is of
importance.
The impressive advancements in pharmacology and medical technology, improvements in diet, hygiene practices, immunization
campaigns, and the inclusion of health in the Human Development
Index increased policymakers’ attention to health-related issues.
Although this positive trend led to a substantial reduction of
infectious and acute diseases, and to a relevant increase of life
expectancy, this success was counterbalanced by the worldwide
increase of chronic and degenerative diseases, mental disorders
and substance abuse, partially derived from massive urbanization
and consequent lifestyle changes.
According to Ayurveda, ama represents partially digested metabolic
toxins that are retained in the body and linked to the formation of
disease. The concept of ama is central to the practice of Ayurveda.
The diagnosis and treatment of ama represents the first step in a
treatment approach.
In this session we will review the textual description of ama;
consider Ayurvedic clinical perspectives on ama; discuss possible
modern correlates of ama; and conclude with a panel discussion on
developing modern perspectives on the traditional concept of ama.
Learning objectives include:
• to consider the importance of dialogue between modern and
traditional medicine
• to understand the traditional textual description of ama
• to recognize key clinical features of ama and
• to consider possible modern correlates of ama
The negative impact of inappropriate dietary regimes, excessive
workload, sedentary style and lack of social connections on physical and mental health are increasingly evident. In order to cope
with these challenges, specific effort is required to identify personal
and social resources that can promote health and prevent disease
onset or progression, over and above medical interventions whose
relevance is anyway limited.
The recent development of health psychology and positive psychology shed light on the psychological and social resources that
can be mobilized and built to promote individuals’ well-being.
However a more systematic approach is required, based on cooperation across disciplines, including traditional medical systems,
such as Ayurveda, that structurally encompass the environmental
and psychological components of health in their view of human
functioning.
19
Abstracts . English
Towards sustainable healthcare: the benefits
of an integrated approach
Etiopathogenesis of diabetes mellitus and its
treatment
Prof. Antonella delle Fave MD
Prof. S. N. Gupta MD (Ayu)
Western scientists have developed different theories and models
of human health and functioning, often proceeding autonomously
and without seeking for connections with other perspectives. This
trend led either to over-generalizations (typically exemplified by the
bio-psycho-social model) or to knowledge fragmentation across
sub-disciplines.
Diabetes mellitus (DM) is one of the diseases which have longest recorded history of its prevalence in human society. Nearly
all ancient scriptures including the oldest ones ‘the vedas’ have
descriptions of this disease. Ancient Ayurvedic scriptures e.g.
Caraka samhita and Sushruta samhita have described this disease
as madhumeha, kshaudrameha or ojomeha, a subtype of prameha. Etiology, pathogenesis, symptomatology, complications and its
treatment are described in detail, these have their relevance even
today in managing this disease.
The binary view contrasting universalism and relativism, quality
and quantity, holistic and reductionist frameworks cannot take
researchers and practitioners very far in their attempts to provide an
exhaustive description of life and health. The complexity of human
behaviour can hardly be captured through simplified paradigms,
and the current state of the art in Western science does not allow
for a unified perspective yet.
Moreover, the attempt to achieve a stable and ultimate description of human functioning does not fit the growing challenge
of resource limitations in welfare societies, calling for healthcare
programs that can be sustainable in the long run. The dynamic
and flexible nature of living systems and groups, highlighted by a
variety of disciplines ranging from psychology to economics, is more
consistent with the person-centred and agentic approach characterizing traditional medical systems, that should be more systematically
integrated in health policy.
Diabetes is very big challenge for medical science. Though invention of insulin and several hypoglycemic drugs have given good
assurance to the sufferers, its complications are still considered
among life threatening conditions. This is the fourth main cause of
death in developed countries. This is an alarming fact that in the
year 2000 150 million people world wide have diabetes and this
is estimated to be doubled by 2010. In Europe itself there are 30
million diabetics.
Classification
Ayurveda classifies DM into two types which are well comparable
with two main types of DM in modern medical science:
• Krisha Pramehi – these are the lean patents, in which the vata
principle is hyperactive due to diminution in dhatus (dhatu kshaya). This type is very well comparable with Type 1 DM in modern
conventional medical classification.
• Sthula Pramehi – these are comparatively overweight patients
having excess of medas and mamsa dhatus in abnormal form,
which block the action path of vata principle (avarana of vata).
This type is very well comparable with Type 2 DM in modern
classification.
Etiopathogenesis in Ayurveda
Krisha Pramehi / Type 1 DM
Causative factors:
• Bija dosha – genetic factors
• Excessive work / work or exercise beyond capacity
• Mal nourishment
• Diseases causing defects in dhatus
Pathogenesis: In this category there is damage to dhatus or the
body tissues resulting into hyperactivity of vata principle; that again
causes further damage to the body tissues. In this way a vicious
cycle is formed which results into more and more damage to the
body tissues. In other words we can say that the beta cells of pancreas are damaged due to above mentioned causes which modern
science explains in terms of autoimmune beta cell destruction. This
results into lack of insulin resulting into metabolic defects and ultimately damage to the body tissues, the dhatus.
20
20
Sthula Pramehi / Type 2 DM
Causative factors:
• Bija dosha – genetic factors
• Lack of physical activities and exercise
• Day time sleep
• Excessive consumption of nutrition
Psychological aspects of pain: role of the
mind in causation as well as in management
of pain
Pathogenesis: These causative factors produce abnormal increase in
medas and mamsa dhatus. These abnormal dhatus block the action
path of vata principle. This is comparable with inhibition of insulin
action, insulin resistance and relatively less production of insulin
and thus DM.
‘Pain’ is originated from the Latin "Poene," which means to punish. When we are in pain, we feel like a punishment. Pain is the
most common and attention-seeking symptom, which interrupts
all other activities. Pain is described in various forms with various
words in Ayurveda, however vata is the principle in every type of
pain which conveys the pain impulse through sanjnavaha srotas
to manah – the mind which is the receiver for all senses including
pain and recognises it in its form, location and severity. Mind is not
only receiver of the impulses but also generator of the impulses.
Ayurveda and other associated sciences in India have recognised
the importance of mind in causation, experiencing and managing
a pain as it can generate the pain but also can generate pleasure.
Treatment strategy based on etiopathogenesis
Krisha Pramehi / Type 1 DM
Since insulin producing cells are non working in this category,
Ayurvedic treatment can not compensate the metabolic functions
of insulin but Ayurveda can help a lot in cases of chronic complications of DM. For this type of DM our strategy shall be
1. improvement of quality of dhatus and ojas nourishing and
anti-vata measures
2. controlling and regulating vata principle
3. supportive Ayurvedic treatment together with modern medicine
(insulin)
4. prevention and treatment of the complications
Sthula Pramehi / Type 2 DM
Ayurveda can help significantly to this type of Diabetics. For this
type of DM our strategy shall be
1. Removal of the factors blocking action vata principle (insulin
inhibiting factors) through shodhana (pañcakarma) procedures.
The factors those interfere with the functions of Beta cells as
well as insulin are eliminated. This results into better functioning
of beta cells and insulin.
2. Weight control: This helps in reduction of abnormal medas and
mamsa dhatus and reduces the requirement of insulin.
3. Prevention and treatment of the complications.
The patients of DM are successfully treated with these measures at
Ayurveda clinics in India and in Europe.
Prof. S. N. Gupta MD (Ayu)
Role of psychic factors in causation of pain, experiencing a pain and
in managing a pain
Causation
Pain is grossly of two origins: physical and psychogenic. A physical
pain may be due to stimulation of pain receptors by substances
produced by damaged tissues (nociceptive pain), or it may be due
to a nerve injury (neuropathic pain). A psychogenic pain is due to
mental factors without any physical cause, in which mind creates
and imagines a pain. Headaches, muscle pains, backache and
abdominal pains are some of the most common types of psychosomatic pain. Whether it is a psychic origin or it is a physical origin,
but in any case, it is not all either in the mind or in the body. It is all
in the mind-brain-body.
Experiencing pain
Pain is a complex process which is a resultant experience influenced
by several factors beginning from the generation of pain impulse
till it reaches to the brain-cortex and perceived by mind. The pain
experience depends on a complex interplay of mind, central and
peripheral nervous systems those process pain signals in their own
way. The pain signals before reaching to brain have to pass through
a ‘gate’ system in spinal cord which is believed to be situated in
substantia gelatinosa of the dorsal horn.
These are events and conditions that may open the pain gates and
cause more suffering include:
• sensory factors such as injury, inactivity, long-term narcotic use,
poor body mechanics
• cognitive factors such as focusing and worrying on the pain,
distractions, negative thoughts, catastrophic thinking’ and hypervigilance to threat
• emotional factors such as depression, anger, anxiety, stress and
frustration
21
Abstracts . English
Opposite to this influences that can close the pain gates and reduce
suffering include:
• sensory factors, such as encouraging activities, short-term use of
analgesics, relaxation training and meditation
• cognitive factors such as outside interests, thoughts helping in
coping with the pain, and distraction from pain
• emotional factors, such as positive attitude
Besides these factors, enkephalins and endorphins present in substantia gelatinosa are likely to act here.
Once a pain signal reaches the brain, a number of things can happen. Certain parts of the brain stem (which connects the brain to
the spinal cord) can inhibit or muffle incoming pain signals by the
producing endorphins that occur naturally in the human body. The
brain can also send signals down the spinal cord to open and close
the Gates
Patients have to be guided to develop insight into the nature of
self-defeating and self-denigrating patterns of thinking and to test
the reality of these patterns of thinking and develop ways of challenging them. With this one can understand the effects of thoughts
upon feelings and feelings upon thoughts.
Education about causes and consequences of pain and positive
information as well as predictability reduces pain. Meditation serves
a purpose to focus the mind away from the pain. Most importantly
meditation shuts down the stress response which intensifies the
pain. For meditation lie down in quiet and comfortable dark room
with closed eyes. Take slow, deep breaths, focus on only inhalation
(through nose) and exhalation (through mouth). Autosuggestions
of painful area being filled with a cooling mist (hypnoanaesthesia),
shifting attention to non-painful part and altering sensation in that
part, imagination of strong painkiller injection at painful site (mental
analgesia) during meditation are beneficial.
A fast pain message reaches the cortex quickly and prompts immediate action to reduce the pain or threat of injury. In contrast,
chronic pain tends to move along a "slow" pathway (C-fiber). Slow
pain tends to be perceived as dull, aching, burning, and cramping.
Initially, the slow pain messages travel along the same pathways
as the fast pain signals through the spinal cord. Once they reach
the brain, however, the slow pain messages take a pathway to the
hypothalamus and limbic system. The hypothalamus is responsible
for the release of certain stress hormones, while the limbic system
is responsible for emotions. This is the reason of association of
stress, depression, and anxiety with chronic pain. The cortex also
controls pain messages by attaching meaning to the personal and
social context in which the pain is experienced. Periaqueductal grey
matter and raphe nuclei in brain stem produce analgesia, and also
inhibit pain inputs at dorsal horn. Personality may also influence the pain intensity. Vatala may feel
more pain while pittala and shleshmala less. People respond differently to pain-inducing stimuli and to attempts at pain management.
Influencing factors besides personality are gender, age and culture.
Chronic pain patients are often disabled and complain of associated
problems. They may become interpersonally isolated and develop
unsatisfactory family responsibilities. They often suffer with depression, phobias, poor concentration and poor memory.
Treatment
Treatment plans are based on above mentioned factors.
To remain active and to believe in the ability to control pain are useful. Often the consequences of pain behaviour are detrimental for
the patient and add to suffering. Avoidance behaviour is the most
common form of reinforcement of pain and disability. These patterns are replaced within cognitive behavior therapy by encouraging
patients to behave time-contingently and to plan for achievable
goals. The sedentary patients may develop symptoms of physical
disuse. Increasing general fitness is thought to reduce fatigue and
reduce the number of fatigue-related somatic symptoms that can
be judged to be pain related. Personal achievement in fitness and
function are common goals for patients.
22
Treatment strategies of unbalanced states
of mind due to pitta (paittikonmada)
Parvathidevi Kirathamoorthy MD (Ayu) MSc
Unmada is one of the major psychiatric disorders elaborately dealt
in Ayurvedic psychiatry (manasarogavijnana). This is considered as
the disordered state of mind in which an individual loses the power
of regulating his conduct and behavior in accordance to norms of
the society.
According to Ashtanga Hridaya, a classic text of Ayurveda, unmada is the unbalanced state of mind produced by morbid doshas
(vata, pitta and kapha along with manasa dosha namely rajas and
tamas). Mainly it is classified into two groups: doshonmada and
bhutonmada. The cause for doshonmada is the vitiation of the
doshas whereas that of bhutonmada is a pure psychological insult.
Doshonmada is again classified into vatika, paittika, kaphaja and
sannipatika.
Among various doshonmada the psychic unbalance caused by
vata (vatonmada) is the one which is more common these days
whereas psychic unbalance caused by pitta (paittikonmada) stands
for the one which is very difficult to manage. We can correlate
the symptoms of paittikonmada to mania with an irritable mood,
the main symptoms being increased anger, irritability, destructive
tendency, increased psychomotoric activity, increased thirst and
sweat, insomnia, increased appetite and the like.
The general treatment for pittadosha includes snehapana, svedana, virecana and shamana measures. Different types of shamana
are food with sweet, bitter and astringent taste, residing in a cool
atmosphere, enjoying pleasant music and the company of good
friends.
This treatment methodology is administered in the treatment of
paittikonmada as well.
The common treatment strategy followed in GARIM (Government
Ayurveda Research Institute for Mental diseases, Kottakkal, India)
for paittikonmada include mriduvirecana followed by talapothichil,
snehapana, svedana, virecana, yogavasti and nasya respectively
Sirolepa with shita virya drugs are advised in treatment of pittadosha. Traditional physicians from Kerala practice lepa on head in
mental disorders. In paittikonmada lepa with dhatriphala curna,
guluchi curna etc. are drugs of choice. Siropichu with specific oils
will help in subsiding the morbid symptoms in paittikonmada.
It is observed that the extreme energy and not wanting sleep or
other relaxing states that are very common symptoms exhibited
in paittikonmada as well as in mania are the target of shodhana
therapy. Through various procedures like snehapana, and virecana
exhaustion is brought about. Further the specific drugs and drug
formulae indicated in this condition as shamana cikitsa, directly
breaks open the aetiopathogenesis and brings forth significant
clinical changes in the patient.
As far as Ayurvedic psychiatry is considered, the most challenging
element is the management of paittikonmada. The patient being
in a very aggressive and agitated state, special care must be taken
while giving medicines and also while undergoing treatment procedures. But among all the other types of unmada, paittikonmada
gets striking results as the change the symptoms will be conspicuous.
Principles of treatment of mental disorders basically do not vary
from that of kayacikitsa, because both are caused by vitiated
doshas. The basic treatment modality specific to doshonmada is
purification (shodhana) and pacification (shaman). On observing
the treatment methodologies prescribed in Ayurvedic treatises we
can understand that the ancient scholars have given prime importance to shodhana than to shamana measures.
Methodologies:
Treatment measures of paittikonmada can be categorized into two
depending upon the involvement of pittadosha:
1. General treatment for pittadosha
2. General treatment for unmada
23
Abstracts . English
Acute and chronic pain managed with agnikarma and the use of a novel herbal cream
Clues on pain management from an
Ayurvedic perspective
Nikolaos Kostopoulos MD and Asvin Barot MD (Ayu)
Rajesh Kotecha MD (Ayu)
Osteoarthritic pain is a challenging and debilitating condition that
undermines the ability of a patient to move, work, rest and enjoy
everyday activities that make life worth living.
Although other contemporary medicines have found cures for
many troubling health problems including some infectious diseases
that cause sickness and premature death on a grand scale, they
have been less successful in combating many chronic and life style
illnesses. Likewise drugs of contemporary medicine offer potent
treatment for several common ailments, but they also carry the high
risk of adverse reactions, which in some cases are powerful and
become distressing. Amid all these deficits of treatment it becomes
mandatory that one should search for medicaments, which can
overcome all these vagaries. In this direction a search in the field of
Ayurveda for medicines, which can fulfill the requirements, is the
need of the hour.
The side effects of anti-inflammatory therapy (NSAIDS) include
gastrointestinal bleeding, for the non-selective ones and possible
cardiovascular toxicity for selective COX-2 inhibitors.
Agnikarma is a procedure described in Ayurveda that is not widely
used because of its main side effect which is the burn and the possible formation of scar. Having done research in Miami University
(deep 2nd degree burns), Benares Hindu University and Civil Hospital in Ahmedabad (treatment of post burn hypertrophic scars)
with a novel herbal cream, we developed a tool to treat and prevent in a fast and pain free way the main side effect and obstacle
in the use of Agnikarma.
In the presentation we will show our data from both fields of our
research.
First the basic and clinical data from the use of the herbal cream
for burns and hypertrophic scars, and then our data from the use
of Agnikarma for the management of pain.
In Ayurvedic texts pain and inflammation have been discussed under
various headings. They have always been a problem of unease to all
clinicians and patients. It is the self-protective reaction of the tissues
towards infection, irritants or foreign substances. Though it is a part
of host defense mechanism when it becomes critical it turns to be
a hopeless condition which causes tissue damage and also do harm
to the body. Hence, taming is always essential.
These two symptoms are always associated with various diseases and musculo-skeletal system is the most affected one in the
form of arthritis. To combat these symptoms, Non-Steroidal AntiInflammatory Drugs (NSAID), immunesuppressants and certain steroids are the routine drugs being used by modern physicians. These
drugs of modern medicine are effective but have an increased risk
of causing adverse reactions like gastric erosion etc. Hence, clues
are being taken from rich Ayurvedic treasure house to find out safe
analgesic and anti-inflammatory drugs. This has given a momentum to search remedies from natural sources, which may tame the
threat of inflammation efficiently.
In addition to these, there is a term called functional pain and it
applies to pains and aches in clinical conditions like Irritable Bowel
Syndrome, Fibromyalgia etc. that hamper quality of life of individuals. There are evidences that some Ayurveda plant based medicines
and therapies are very effective for such types of functional pains.
In current exercise it has been attempted to put forward the basic
concepts of pain in Ayurveda and present clues and evidences
on analgesic and anti-inflammatory activities of certain Ayurveda
drugs.
24
The purpose of disease – understanding
pathogenesis holistically
The sacred masculine
Samkhya and Yoga, two principal philosophies underpinning
Ayurveda, postulate that creation starts when the conscious, passive purusha becomes associated with the unconscious, dynamic
prakrti in order to gain self-experience and evolve towards the
ultimate aim of liberation. Evolution is thus considered as a conscious and goal-oriented process that, according to Caraka, is
initiated and upheld by paramatman, the creator and sustainer of
the universe. Hence, life is not viewed in Ayurveda as meaningless
happenstance or a series of accidents of nature. In fact, Caraka
goes as far as condemning faith in the theory of chance as “the
worst of the sinful” (Caraka Samhita 1.11.14-15).
All humans are born with a unique potential to express themselves
fully and to achieve any goal they desire. Although vast and multifaceted, this potential is only latent when we enter our bodies,
which means that each aspect of it needs some form of activation
before we can make use of it in our lives. If certain parts of our
potential do not get empowered and transformed into dynamic
creative energy, we are unable to authentically and fully express
those parts of ourselves.
If life itself has specific meaning and no aspects of it are coincidental, then health and disease must be purposeful too. Ayurveda’s
stated core aim is the maintenance of health as a pathway towards
achieving four primary goals in life: dharma, artha, kama and moksha (Ashtanga Hrdaya 1.1.2). Health is not simply a desirable state
but considered an essential prerequisite for the experience of true
fulfilment and ultimate liberation. What then is the purpose of illhealth or disease in life?
According to Ayurvedic aetiology, any imbalance that is caused by
asatmyendriyartha samyoga or prajnaparadha will eventually lead
to disease (Caraka Samhita 1.1.54). Stating these as primary reasons for pathology clearly indicates what Ayurveda considers to be
the root causes of disease: decisions and consequent actions that
are unsuitable to and not aligned with an individual’s true nature
or dharma. In other words: ill-health is the result of inauthentic
self-expression.
Since human behaviour is informed and instigated by underlying
belief systems of what an individual considers ‘right’ or ‘wrong’,
every incorrect assumption about the nature of the self leads to
inauthentic expression and consequently to inauthentic experience
of the self. If this is not realised and corrected by an individual,
a so-called psycho-emotional dynamic gets established in the
subconscious that keeps re-creating the same experience over
and over again. In order to be able to constructively deal with the
dynamic, an individual needs to become consciously aware of it.
And herein lies the actual purpose of disease: over time, every
psycho-emotional dynamic manifests as a specific illness that represents an opportunity for the individual to become conscious of it.
Disease therefore serves as an invitation to recognise and change
expressions of the self that are inauthentic and based on incorrect
assumptions from the past.
In this talk the above concepts will be explained in more detail
and their clinical relevance and practical application clarified with
example conditions such as cancer and diabetes mellitus.
Every man and woman embodies a gender-specific combination
of both feminine and masculine energies. Even though men are
the physical manifestation of the masculine principle, they are also
endowed with aspects of the feminine. The same holds true for
women: while representing femininity incarnate, each female has
access to inner masculine parts as well. What then makes a man
a man and a woman a woman? Are we already men and women
from the moment of genetic sex allocation after conception?
The simple truth is: we are born as boys and girls; not men and
women. Neither physical maturity, sexual activity nor the age of
consent are sufficient to make us a man or a woman. For this
we require a deep transformative process of experiential empowerment. Unless we are consciously initiated into our sacred core
energies through rituals facilitated with wisdom and love, we fail
to experience the truth of who we really are: embodiments of the
sacred feminine and masculine.
This keynote lecture offers insights into the causes of symptoms
that many male patients present with today: low self-esteem,
feelings of inferiority among other men, an inability to gain weight
and sexual problems like premature ejaculation. While there
may be associated physiological reasons, such conditions often
develop due to a man’s lack of access to the sacred masculine.
Understanding the subconscious psycho-emotional dynamics as
well as recognising their physical manifestations in these men is
essential for effective treatment and support.
25
Authentic solutions in Ayurve
Somatheeram Ayurveda Group, Chowara P.O South of Kovalam Triv
[email protected], [email protected]
eda and Yoga
Somatheeram has been in the forefront of dispensing authentic solutions for the needy from all around the
world.Its lovely locations, traditional knowledge and first - rate services and performances make it a unique provider of general well-being through Yoga and Ayurveda.Located in Kerala on the South - West coast of India it
has been offering exellent facilities to discering customers for more than 20 years.Explore and discover an ancient world of well-being with all modern conveniences.Welcome to Somatheeram, the land of the spirit !
vandrum, Kerala, India, 695 501
+91 471 2268101, +91 9447755077
n www.soma.in, www.somatheeram.in
Abstracts . English
Adjuvant Ayurvedic treatment of chronic
and acute pain in neurology
A clinical study to assess the efficacy of vasti
chikitsa in the management of intervertebral
disc prolapse associated with radiculopathy
Marco Lebbing MD
L. Mahadevan MD (Ayu)
In Ayurveda pain as well as neurological disorders are due to a
disturbance of vata. Acute pain can often be related to a certain
dysfunction and thus be treated whereas chronic pain often is multifactorial and needs a more complex treatment pattern. In contrast to traumatic pain the etiopathogenesis of chronic pain is not
always clearly understood which hampers a satisfactory treatment.
Especially neurologic pain disorders often go along with diffuse
complaints hard to be influenced. The lecture wants to give an
overview about different kinds and origins of pain. On the basis of
neurological pain disorders an ayurvedic evaluation will be carried
out and suitable therapeutic options will be explained.
Intervertebral disc prolapse is one of the common conditions seen
by an Ayurvedic physcian in clinical practice. The disease is due to
vata increase in lifestyle which causes acute back pain associated
with numbness, paraesthesia and pain in the leg. Patients often
take analgesics for few days and get symptomatic relief but pain
reccurs after stopping the medication. Most of these people visit
Ayurvedic vaidyas here in my village for complete cure.
Ayurvedic assesment is based on principles like dosha, dushya,
guna vikalpa, srotodushti prakara etc. Diagnosis is confirmed by
examination and investigations like SLR, Trendelenburg test, bladder control, foot control, plantar reflexes and MRI of lumbar spine,
screening the saggital view.
Strategy of therapy (cikitsa) is mainly reduktion of Vata and Kapha
(vatakapha-hara, ushna and vatanulomana) and is performed in different stages, in first phase gandharva hastadi kashaya, vaishvanara
curna, abhayarishta etc are employed. Second phase involves the
application of nagaradi lepa. Third phase involves application of
taila’s like kottamchukkadi taila, chinchadi taila etc., followed by
ruksha sveda. In fourth phase vasti cikitsa like pippalyadi taila for
anuvasana and eranda muladi niruha for sthula dehi is employed
whereas for krusha dehi dhanvantara taila anuvasana and madhutailika vasti is utilised.
Vasti cikitsa may be of yoga or karma vasti type depending on the
spinal canal diameter. Vasti cikitsa is followed by shamana-aushadhas. Kati vasti is the last modality in the treatment phase. Daily
exercise for a duration of 20 minutes is advised wherein lumbar
flexion is avoided.
Overall total duration of treatment will be of 12 weeks in which
first two weeks treatment is advocated as an in patient treatment
followed by shamana-aushadha. Recovery will be 99%.
Author will present the MRI documentation of resorption of prolapsed disc after vasti cikitsa during the presentation.
28
The role of dhatu in etiology and
pathogenesis of diseases
Reproductive medicine in Ayurveda –
the concept of vrishya (fertility) and
vajikarana (potency)
Ram Manohar MD (Ayu)
Ram Manohar MD (Ayu)
Nidana (Etiology), dosha and dhatu constitute the trinity that plays
a critical role in the pathogenesis of diseases. Out of these three
components, the doshas are considered to be the most important in initiation of the disease process. Etiological factors cannot
cause diseases as long as the doshas do not get deranged. For this
reason a single exposure to an etiological factor does not always
result in a disease. In some individuals even repeated exposure
to etiological factors do not cause diseases while in other individuals even a single exposure may lead to imbalance and disease.
Indeed the critical factor that makes the difference are the doshas.
Therefore, the doshas are considered to be the primary causative
factors of disease.
Vajikarana is one of the eight branches of Ayurveda. In fact it is the
last of the eight classical specialties of clinical medicine in Ayurveda.
It comes last because reproduction is something that assumes
relevance only when the basic health of the individual has been
established. The first two branches of general medicine (kayacikitsa)
and pediatrics (balacikitsa) help to protect the body in adulthood
and childhood. This is followed by psychiatry (grahacikitsa) and the
branch dealing with the diseases above the neck (shalakya). These
two disciplines take care of the mind and its physical structures.
Then comes surgery shalya) and toxicology (visha) which takes
care of the threats from the outside world in form of injuries and
bites. This is followed by the branch of rejuvenative medicine (rasayana), which seeks to protect the body and mind throughout life
to achieve healthy ageing. Finally comes Vajikarana, which aims to
ensure survival of the species through reproduction.
But what happens in reality? Little do we realise that doshas do
go out of balance more often than we think. Under the influence
of the etiological factors, the doshas are constantly swaying back
and forth across the boundary of normalcy and abnormality. In
the course of the day, in the course of the night, during digestion,
during the seasons, the doshas shift from their state of normalcy
and become almost deranged. When the dosas reach the brink
of the upper limit, beyond which it can cause illness, it retreats
and returns back to its state of normalcy. Therefore it has to be
understood that it is not the imbalance of the v that cause disease,
but rather the inability of the doshas to return back to normalcy,
when it reaches the critical point of imbalance beyond which the
process of pathogenesis is initiated.
The critical factor that enables the doshas to return back to normalcy from the boundaries of abnormality is the innate strength
of the dhatus. According to Caraka, a viewpoint seconded by
Vagbhatta, the strength of the dhatus itself can pacify and bring
the doshas back to balance (balam hyalam doshaharam). In similar
vein it has been mentioned in another context that diseases tend
to be chronic when the weakness of the dhatus has not been
resolved (dehadhatvabalatvac ca jvaro jirno ‘nuvartate).
This paper discusses the etiology and pathogenesis from the viewpoint of the dhatus instead of the doshas and seeks to highlight
the definition of health as proposed in Caraka Samhita as dhatusamya or balance of the dhatus rather than the doshas and disease as dhatuvaisamya or imbalance of the dhatus rather than the
doshas. An attempt will also be made to reconcile this viewpoint
with that of disease as doshavaisamya or imbalance of the doshas.
Vajikarana is often misunderstood as sexual medicine dealing
with aphrodisiacs. While this is one aspect of this discpline, the
major focus of this clinical specialty is fertility, reproductive health
and prevention of diseases that are transmitted through heredity
and factors that operate at the time of conception. The concept
becomes clear when we understand the meaning and implications
of two terms that are used as synonyms of reproductive medicine
in Ayurveda. These terms are Vrishya and Vajikarana. The word
Vrishya denotes fertility. It is derived from a Sanskrit root that means
to irrigate or rain. It denotes sowing, irrigation and thus fertility. For
this reason the bull, which is known as vrisha in Sanskrit, became
the symbol of fertility. We can see the bull in front of the temples
of Lord Shiva, denoting fertility, whereas the Shivalinga itself symbolises creation and reproduction.
On the other hand, Vajikarana means to make one potent like a
horse. This means arousal and sexual vigour. Vajikarana follows
Vrishya. Traditionally sexual potency had meaning only in the
backdrop of fertility. However, in due course of time, this branch
of medicine became a tool to protect and preserve the body from
the deleterious effects of excessive indulgence and also to enhance
sexual pleasure.
There is a need to strike a balance between these two aspects of
reproductive medicine in Ayurveda to reap the full benefits. There is
especially a need to understand the various interventions described
in Ayurvedic texts to enhance fertility in such a manner that not
only does one beget children, but there is also an enhancement of
the quality of the reproductive tissue resulting in progeny that is not
susceptible to hereditary and genetic diseases.
29
Abstracts . English
A very important point to bear in mind is the fact that Vajikarana
becomes effective only when it is preceded by Rasayana treatment. In fact, both these branches go hand in hand in enhancing
the immunity of the body. Every year, Ayurveda advises that the
individual should cleanse the body and then undergo a course of
Rasayana and Vajikarana, which improves the immunity of the body
by creating an abundance of Ojas. Ojas impacts not only the health
of the body but also that of the mind.
This paper seeks to explore the scope of reproductive medicine in
Ayurveda as a systematic approach to enhance fertility, improve the
quality of progeny, boost sexual potency, modulate immunity and
also promote psychological health.
Breaking the disease spiral – behavioral
perspectives of Ayurveda
Prof. Martin Mittwede PhD
Ayurveda approaches the development of diseases in different
ways and develops classifications to describe the processes and to
capture clear diagnostic. As a complex system of medicine he considers the causative factors in a context and develops appropriate
strategies for treatment.
Classically known is the concept of temporal dynamics (kriyakala) in
which a disease unfolds:
1) Samcaya = stage of accumulation
2) Prakopa = stage of provocation and further increase
3) Prasara = stage of propagation and immigration in other areas
4) Sthana-Samshraya = stage of localization or of setting in the
tissues
5) Vyakti = stage of manifestation (full clinical symptoms present)
6) Bheda = stage of development of complications and chronicity
For the change in the dynamics of doshas Ayurveda knows a multitude of causes, the self-responsible action plays an important role.
The imbalance of doshas is therefore often not the primary cause of
the disease, even though it is often presented in the literature. But
the fact is that causal exposure factors usually lead to a change of
dosha situation and are therefore classifiable.
A crucial problem is now that disturbed doshas also affect the
psyche and lead to a disturbance of discrimination (buddhi) and
insight (prajna). At the same time habitual patterns act into it. Old
practiced behaviours may appear again and destroy the therapy
success even after balancing the doshas. This phenomenon is, inter
alia, with the term adhesion (klesha) described.
Thus we have arrived at a fundamental problem of prevention and
health education: people do not behave as would be desirable
for achieving and maintaining good health. Many programs and
public health measures are unsuccessful, because they do not lead
to a sustained change in behaviour. Many people ultimately need
therapeutic support in order to embark on the right path. And this
requires effective strategies.
In this sense, it is worthwhile to examine the Ayurveda in the context of behavioural therapy. Explanations on the functioning of the
psyche, but also classic recommendations of Ayurveda for lifestyle
are essential, because they illuminate the therapeutic vision of the
ancient Ayurvedic physicians and show ways out of the disease
spiral.
In the session, we will try to understand the behaviour change
strategies of Ayurveda, to then make practical use for our own
work with patients.
30
Neuropathic pain after lombotomy for renal
cancer resolved with Ayurvedic treatments:
a case report
Management of prostate disorders and BPH
Antonio Morandi MD
Ashtavaidyan Narayanan Nambi MD (Ayu)
Neuropathic pain is a complex, chronic condition deriving from
damage or alteration of nerve fibers. Conventional medicine is
often ineffective and only a minority of patients may achieve partial
relief. Here we report one case in which the therapeutic approach
with Ayurveda shows promising results for this pathology.
Prostate is a gland seen in male a major participant in the reproductive system. Hence in later half of the reproductive era of a man
disturbance of prostate could be a very common presentation similar to uterus or ovary in females. A male aged above fifty and less
active in sexual life are more prone for Benign Prostate Hypertrophy
(BPH) and not uncommon to have Prostate Carcinoma. Whereas
below fifty aged people with active sexual life often experiences
Prostatitis (an inflammatory condition). As elderly population is
growing all over the world especially in Euro zone, it is interesting
to note that a geriatrician is largely been addressing this problem.
One patient, male, 58 years old, carpenter, diabetic, developed
severe neuropathic pain after lesion of ileo-inguinal nerve during
lombotomy for renal cancer. The pain was continuous and disabling, rating 8-9 (NRS-11 scale), associated with insomnia and
depression. The patient was unable to perform his work and also
the overall quality of his life was very poor.
The patient tried to manage the pain with NSAIDs (nonsteroidal
anti-inflammatory drugs), Morphine, Pregabalin, antidepressants
(Duloxetine, Sertraline) and Benzodiazepines for 6 months treatment without significant results. Only a limited and short time
results (2-3 hours pain reduction) were obtained with Acupuncture.
The patient was then evaluated according to Ayurveda from a
certified ayurvedic doctor, and for a period of 4 months both conventional drugs as well as acupuncture were suspended and the
following ayurvedic therapy has been given:
1. Oral administration of Ashvagandha 500mg t.d., Shilajit 500mg
o.d., Triphala 1500mg o.d.
2. Two sessions a week of Sarvanga Abhyanga using Dhanvantara
Taila alternated with Kati Basti using Kottamchukkadi Taila on
lombotomy site, both treatments were associated with 15’ of
ShiroPichu using Dhanvantara Taila. The treatments where carried out by expert certified ayurvedic therapists.
3. Personalized life style as well as nutritional advices.
The results were quickly evident. After the first week of treatment
the neuropathic pain was significantly reduced, and after 4 months
its intensity was decreased to 2-3 from the initial 8-9 according to
the NRS-11 scale. Some rare peaks of increased pain were still present but for very short time.
The sleep of the patient improved and he was able to resume his
work. On this regard it is worth noting that the patient’s occupation is carpenter, an heavy activity which can be carried out only if
in good health conditions. The treatments continued for one year
with continuous improvement of patient’s clinical situation as well
as his quality of life.
This case provides important evidence of the therapeutical possibilities of the multidimensional approach of Ayurveda to chronic
disabling conditions, such as neuropathic pain, which are difficult
to resolve with conventional means.
If we look into the disease of prostate, the whole issue can be
classified into four:
1. Obstructive symptoms
2. Storage symptoms
3. Complications
4. Psycho-social issues
It is very vital to look from ayurvedic perspective these manifestations
based on abnormal behaviors of Apana. Various disease pathologies
in Ayurveda like Gulma, Prameha, Mutrakruchra also taken in due
consideration for understanding the various expressions of Apana.
Psycho-social issues also need special attention like using diapers in
elderly people when they participate in social gatherings.
Prostate malignancy need to be independently understood or
evaluated as it mostly begins with asymptomatic phase. Many
Ayurvedic interventions are highly effective in the management of
prostate diseases. Ayurvedic management observes the situation in
totality not only to balance apana but also to prevent the progression of manifestation like malignancy. Initial stage largely may be
influenced by medicinal usage to correct the apana which is ruksha
in nature by using ayurvedic products containing Castor Oil. But
later stages need complete protection and preservation of whole
apana zone. Vasti, avagaha sveda are some of the major ayurvedic
therapies, they deeply influence the management. Use of shilajit,
guggulu also has some direct influence.
In the presentation the concept of understanding the prostate with
illustrations and examples is delivered. A detailed discussion will
be given about the samprapti of all prostate diseases and a special
highlight will be given to Benign Prostate Hypertrophy as it is the
most common clinical problem. This presentation also includes
experiences of mostly time-tested formulations successfully utilized
in the management of prostate. Recent research work observations
and some bird’s eye view on other alternative treatments are also
deliberated. An active discussion also will be made at the end with
sharing our own experiences and insights by correcting the life style
and dietary habits.
31
Abstracts . English
Neurological descriptions in classical texts
Medicinal plants for improving dhatvagni
and qualities of dhatuin Ayurveda
Ashtavaidyan Narayanan Nambi MD (Ayu)
Prof. Tanuja Nesari MD (Ayu) PhD
It is believed that the ayurvedic knowledge system looks into very
subtle details of body functioning majorly named as system of tridosha. But when we analyze the subtle details of the descriptions
of tridosha in classics, we are able to derive all so called anatomical
systems described by western bio-medicine, but they are expressed
in a different way. For example, the neurological concepts are
widely diffused and principally been identified in the part of vata
in general. From embryogenesis till the establishment of neural
system all the functional attributes are related in some or the other
way with vata.
Ayurveda is a science of healthy & happy life, which is divided in
eight specialized branches. First and of prime importance branch
is Kayachikitsa (Internal Medicine). Kaya means Agni & Chikitsa
is management. Thus treatment of any disease condition aims at
restoring the normal status of Agni.
Ayurvedic classics describe five sub-types of vata with its habitat
and behavior patterns. The nature and extent of the required
movements for actions and reactions are maintained by any biological (bio-physical, bio-chemical and electromagnetic) entity, but all
these are seen in the vata much more before than the instigation
of gametogenesis and continue till the death. If we analyze these
and try to understand it profoundly, we may be surprised to see that
most neurological expressions are included in the frame.
For example in Caraka Samhita, while explaining the disease named
ardita (cerebrovascular accident / stroke including facial palsy) the
text is able to demonstrate all possible neurological deficits in
all twelve pairs of cranial nerves both in sensory and motor. This
example itself shows ayurvedic acharyas deepest insights in neurology beyond the frame of single system. Caraka explains later the
management of possible treatment measures for correction which
again include neuro-regenerative therapies.
This presentation extensively illustrates all available anatomical entities described in ayurvedic classics especially in the field of neurology. It also comprises elaboration of sites, behaviors and expressions
all five vata from neurological perspective. Later with help of various
clinical cases this presentation demonstrates neuro-pathological
aspects from ayurvedic classics with its management. A detailed discussion will be done at the end with all possible expansions about
its implications in ayurvedic therapies.
32
The human body consists of 3 doshas – vata,pitta and kapha; 7
dhatus i.e. Rasa, Rakta, Mamsa, Medas, Asthi, Majja, Shukra; and
three malas i.e. Purish, Mutra and Sweda. Agni is separate entity
which governs the synthesis & metabolism of these elements. Thus
Agni is defined as unit of bioconversion in the body. Importance
of Agni is described in every classical Ayurveda text (e.g. Charak
samhita, Chi. 15)). In Bhagwad-Geeta, Lord Krishna states that I am
the ‘’Vaishwanar’’ i.e who stay in body in the form of Agni in all
living creatures. This underlines the importance of Agni.
When we talk of Agni, it is assumed as Jaatharagni i.e. which
resides in GI system & responsible for digestion & assimilation of
food with its transformation in bodily suitable substances. The part
which nourishes five basic element (panchbhoota) is known as
Panchbhoutikagni.
Similarly, parts of Jaatharagni, intended for metabolism of each
of specific seven Dhatu is termed as Dhtavagni. (Ref. AshtangHrudaya. Sutrasthana. Ch11. 34/35). Hence functional aspects of
total 13 types of Agni are to be considered in health & disease
management.
Due to wrong diet and lifestyle, Jaatharagni gets vitiated, which
leads to commencement of disease process. Also similarly agni
vitiation can also occur at dhatvagni level, leading to manifestation
of dhatu-specific diseases. For e.g. Rasa vitiation leads to diseases
like Jwara (fever), Pandu (anaemia), where along with Jathar-agni,
ras-agni is also vitiated. Similarly low medoagni manifests in to
Obesity & Prameha (Dibedes Mellites etc.).
Dhatu
Some dhatu specific diseases (e.g.)
Rasa
Jwara (Fever), Shootha (inflammatory
disorder )
Rakt
Kushtha (Skin) diseases, Visarpa
Mamsa
Granthi (Fibroid, Tumors) etc.
Meda
Sthaulya (Obesity) Granthi
Asthi
Adhyasthi, Adhidanta, Asthikshaya
(Osteoporosis)
Majja
Bhrama (Vertigo), Unmad, Apasmar
Shukra
Vandhyatva, Shaandhya (female & male infertility), Arajaskata (Pathological amanorrhoea)
Excess or increase in intensity of dhatvagni (teekshagni) leads to
depletion of specific dhatu. Whereas decrease (low) or vitiation of
dhatvagni (Mandagni) leads to excessive production of dhatu of
substandard quality.
Importance of shukra dhatu in Ayurveda
It is necessary to balance & treat that specific dhatvagni while
curing dhatu specific diseases.
Sukumar Sardeshmukh MD (Ayu)
Panchakarrmas i.e .Bio-purificatory procedures are very useful in
improving state of all agnis.
However in medicinal treatment also, some dhatu specific herbs /
medicines are described in Ayurveda. Some herbs improve dhatvagni & some herbs nourish this dhatu with the help of specific
dhatvagni.
Dhatu
Useful for dhatvagni Useful to nourish
dhatu
Rasa
Guduchi, Haritaki,
Pippali, Vasa
Shatavari, Amalki
Rakt
Manjishtha, Nimba,
Kutki
Sariva, Madoor
Mamsa
Marich, Pippali,
Musta, Triphala
Vidari, Ashwagandha,
Shatavari, Bala, Yashti
Meda
Guduchi, Triphala,
Shunthi, Shilajita,
Vidanga
Vasa, Ghruta (Ghee),
Navneet (Butter)
Asthi
Guduchi, Musta
Asthishrunkhala,
Kukktanda-twakbhasma, shrunga bhasma
Majja
Guduchi, Musta,
Shankhapushpi, Vacha
Majja, Brahmi, Ghruta
Shukra
Shilajit, Karpoor,
Lavanga, Kapikacchu,
Jatiphala
Dugdha, Ghruta,
Ashwagandha,
Shatavari, Kapikacchu
In addition to this, any substance, which is ushna veerya (hot in
potency) generally stimulates for Agni.
Paper highlights the details about therapeutic administration of the
dhatu specific herbs in specific disorders.
Caraka has clearly stated in his Samhita (Ca ina 6.9) that shukra
(Semen) is the final transformation of food taken and one should
always conserve this tissue. The loss of this tissue is responsible for
many disorders and can even cause death in extreme cases.
Human body is composed of 7 dhatu (tissues) and shukra is the
last one. Its main function is the reproduction of healthy progeny.
It is the only tissue in the body that is normally expelled out for this
function but excessive sexual desire and indulgence in sexual activity
creates unnecessary loss of this pure form of tissue. Body has to get
involved again to regenerate this pure tissue from diet which takes
approximately 30 days.
Since the other functions of this tissue are maintaining confidence
level, love and affection towards our mate, body strength and energy level, excessive loss of this dhatu causes imbalance of physical
and mental status of body leading to unhealthy and unhappy life.
On the contrary proper formation or conservation of shukra dhatu
increases the ojas level and contributes to keep body healthy and
happy.
Ayurveda has described three pillars of life viz., ahara (diet), nidra
(sleep) and brahmacarya (celibacy). Celibacy is practiced to get the
benefits of conservation of shukra dhatu that is to achieve healthy
and happy long life. It does not indicate to avoid sex totally but
follow the rules and regulations described in Ayurveda.
“The pure or natural form of Shukra Dhatu is white like Rock crystal, sometimes like oil or honey, liquid and unctuous in consistency
and sweetish.” (Sa saa 2.11)
“The vitiated Shukra Dhatu is not thick, less in quantity, frothy, not
white color, foul smell, very sticky, contain other tissues like blood
and creates considerable energy loss when expelled.” (Ca sa 19.4)
Current problems faced today like oligospermia, infertility, erectile
dysfunction, nocturnal emissions etc. are due to the modern culture
and lifestyle like altered diet and sleep patterns, excessive mental
stress etc. Ayurveda has its own diagnostic methodology and has
described treatments like shaman (pacification) and shodhana (purification). This is accompanied by diet and behavioural management
to overcome these problems.
Hence, it is very important to understand shukra dhatu and its function throughout body. Only Ayurveda has described the importance
of shukra dhatu, and this will be elaborated.
33
Abstracts . English
The agni-ama-srota triad in disease
aetiology and pathogenesis
Madan Thangavelu PhD
Life forms are complex adaptive systems. Life's scales of organisation, structures, functions, integrity and resilience are maintained by
networks of well-ordered and logical sub-systems and processes /
hyperprocesses. Multiple formalisms, mostly similar and sometimes
competing, have been developed over the millennia to understand
and describe this complexity. Ayurveda offers one such formalism.
Ayurveda’s process-based and scale-free rationale can contain
inanimate dynamic processes necessary for pre-Life and the origin
of Life, subsequent ‘complexification’ of life forms and also to
comprehend and describe health and disease. At the heart of this
system is a qualitative, top-down, holistic approach where there are
no separate parts but relationships, where entities are viewed as
fluid and constantly changing and transforming - where "nothing
is, but everything is becoming"! A powerful central metaphor in
this scheme is the agni-ama-srota triad where Agni transforms,
Ama is the partially or incorrectly transformed and Srotas are the
conduits that transport or convey both materials and information,
both material and immaterial.
The predominant contemporary discourses and descriptions of
agni-ama-srota are based mostly on a clinically-biased functional
perspective but form an important first step to appreciate this
triad. However, a rigorous semantic - lexical and logical - analysis
of agni - the transformer offers broader, richer and more sophisticated implications than currently appreciated. Agni, the 'absolute
transformer', implies layers and textures of meaning with a deep
logic and rich grammar. For instance, forms of agni different from
bhutagni of clinical parlance preceded life. Agni implies ama. Agni
is prior to dosha and dhatu. Agni complexifies as system complexify,
agni enables signalling in complex systems, agni evolves to help
systems evolve. This implies radical inseparability of agni from ama
and srota also forces the emergence of higher and ultra-levels of
complexities - with novelty at each level. Such novelty is seen most
certainly in the manifest and perhaps even exists in the unmanifest
Agni-ama-srota, when viewed as such an inextricably intertwined
triad offers the most parsimonious description of the driver of complex system generation. The inextricably interlinked triad enables
the evolution of complex systems having independent but interdependent processes where agni transforms and vayu moves. This
description also offers an invaluable metaphor not only for understanding the grammar of life and how life emerges and evolves
and complexifies but also the earliest errors in the organisation of
cellular logic as the basis for disease aetiology and pathogenesis.
The triad is also an error generation and an error correction unit that
is the basis of agni dipana and ama pacana rationale of Ayurveda.
34
In earlier presentations I have alluded to ama in the context of
intracellular mucin accumulation (1). The ‘triad’ forms a powerful
tool and offers novel ways to dissect aetiology and pathogenesis in
innumerable previously unapproachable problems related to complex human diseases. By drawing on selected examples from contemporary research evidence I will extend this theme by highlight
the agni-ama-srota triad in the context of:
• endothelial cell physiology and dysfunction with reference to
stroke,
• synaptic architecture and neuroplasticity and dynamics in neurological disorders,
• neurodegeneration and anxiety,
• errors in autonomic responses in hypertension and other human
diseases,
• inappropriate interactions between gastrointestinal and skin
microflora and the human immune system in inflammation and
disease like autism and multiple sclerosis, and
• errors in the regulation of mammary epithelial cell fate in development and breast cancer (PMID:25056120).
Ama if viewed as a faulty outcome of a process can readily account
for disease causing DNA and RNA mutations, misfolded proteins,
misorganised cellular and subcellular components - all of which
are now recognized as the predominant aetiological mechanisms
in innumerable human, animal and plant diseases. In this context I
will present briefly the recent observation of - aberrant methylation
of tRNAs and neuro-developmental disorders (PMID: 25063673).
Paving the way for understanding the complex origins of age related conditions like myelodysplastic syndrome with origins in inaccessible locations, namely the bone marrow haematopoetic stem-cell
compartment might be greatly aided by the rational and logic of
such a ‘triad’ – exploited in the rasayana treatments of Ayurveda.
Such an “agni-ama-srota” triad when extended into the unperceivable and the unmanifest can also be exploited to explain the
vyadi (disease) from adhi (anxiety) aspects at the interfaces of
Ayurveda and Yoga. Errors in such triads might also be extendable
to accommodate Yoga's panca kosha theories about human health
and wellness.
External basti in pain management
Carmen Tosto
Kati basti is a peculiar ayurvedic procedure that belongs to the
category of the various external basti and specifically is a procedure
of Bahya sneha that brings together in itself both effects of snehana and svedana or "Snehayukta sveda".
Kati basti is used when one needs to act primarily through ushna
and snigdha qualities. The treatment kati basti involves, in its most
superficial and external expression, the lower back region actually called kati (according to Sadanga Sarira, Kati is the region of
Antaradhi or Madhyasarira, or the area that we call sacro-lumbar)
while the word basti, in this case, has the meaning of "to hold,
to retain". When the basti is held in Kati pradesha, it is called Kati
Basti. Susruta defines the size of the area called Kati to the extent
of 18 anguli.
In this procedure the taila is used as snigdha, and it is also Agni
samyoga since the oil is heated and kept constantly hot. So the
treatment should also be considered for its snigdha sveda nature.
In the classical texts several svedana therapies are mentioned, and
observing the characteristics of Kati Basti it can be considered
belonging to Drava Sveda therapies. During the process of holding
the taila still it can be considered as a variety of Avagaha Sveda,
while, during the procedure of the changing of the oil, in other
words if a leak is present, it can be related to a variety of Parisheka.
It is a relatively simple procedure in its implementation, but it requires an “a priori“ proper prescription as it is necessary to carefully
consider the altered gunas of the underlying condition as well as
the imbalance of the dosa involved.
As is the case for any Ayurvedic treatment, there are strict rules
to be observed as well as specific indications and contraindications. Special attention has to be given to the patient as well as
customized information regarding the type of taila to be used, the
constant temperature to be maintained and the duration of the
treatment is given.
It is important to consider that the region traditionally considered
for the application of Kati basti corresponds exactly at the origin
of the metameric distribution of pain for typical alterations of the
lumbar spine. One of the most typical painful manifestation of this
region is defined by the term Gridhrasi, which can be related to
what modern medicine calls sciatic pain, and is considered to be
Shula Pradhana Vata vyadhi.
In this specific region of the back it is easy to observe disorders
referring to the musculoskeletal apparatus that are called with
different names in modern medicine, actually they mostly refer to
an imbalance of Vata dosa in one of its main site. Unfortunately,
nowadays the activities of man are totally contrary to the regimes
of Svasthavrtta and often even opposite to it. Thus, one of the
main causes of disease is just poor management of one's lifestyle.
The Ayurvedic reading of "pain" phenomenon can have so many
different shades that can be grasped only through direct and
careful observation of the manifested gunas. The pain may in fact
derive from the alteration of various structures involved, and for
each one the manifestation of pain will be specific. Therefore a
correct diagnosis will be of paramount importance in order to prescribe the most adequate treatment as well as the right product (in
this case the most suitable medicated taila). The treatment should
therefore have the gunas opposite to the reported imbalance and
should be synergic with the internal therapy.
The task of the ayurvedic therapist is to perform the treatment in
the best possible way, taking into account the real postural difficulties of the patient and, when necessary, adapting to different
situations.
The local action of basti on the pain depends on the ability to counteract the gunas expressed by the pain itself. From the point of
view of western medicine one can conceive an action at the level of
the nociceptive sensory system beyond the more complex systemic
effects and on the tissues. The basti can in fact be used in typical
neuropathic pain conditions whether resulting from compression
or from lesion of the nerve trunks.
The basic principle is to report the organism in its state of natural
balance which is a process that can take a certain period of time.
The peculiarity of the treatment kati basti is that it gives an almost
immediate effect and real relief to the patient.
35
Abstracts . English
Ayurvedic treatment of male infertility
Polycystic ovarian syndrome and its
management through Ayurveda
Ramesh Varier MD (Ayu)
Ramesh Varier MD (Ayu)
Vajikarana, being one of the eight branches of Ayurveda, includes
the treatment of male infertility; it is considered one of the most
commonly practised disciplines of Ayurveda. Vajikarana is considered as a solution to problems relating to male sexuality and fertility
and is interpreted to have all sorts of actions and is administered
through the use of randomly selected vajikarana combinations.
Polycystic Ovarian Syndrome (PCOS) is one of the most common
endocrine disorders in the females with an incidence of about 6%
in the general population world over. The condition is known to be
genetically inherited, it is characterised by anovulation or hypo-ovulation, hyper-androgenism and hyper-gonadism and is associated with a
high risk of insulin resistance, diabetes, dyslipidaemia and obesity. The
problem presents as menstrual irregularities, an ovulation, infertility,
hirsuitism and acne, endometrial hyperplasia and predisposition to cancer. Conventional medical approaches comprise of weight reduction,
treatment of insulin resistance with drugs like metformin, treatment of
acne and hirsuitism with androgen antagonists and with clomiphene
citrate and or FSH to induce ovulation and achieve conception, for failing
IVF is adviced.
While a few cases do respond to such arbitrary treatment, the overall success rate is not all that great largely due to the lack of proper
diagnosis and differentiation of the aetiology involved.
Ayurvedic classic literature has clearly differentiated different types
of semen related problems and prescribed different approaches
conceptually though not very elaborately. Modern knowledge has
further increased the level of understanding of the underlying issues
and backed by investigations that are now available it helps to arrive
at a more rational prognostic conclusion.
A major part of the population suffering from male infertility suffers
from idiopathic causes of male infertility and so treatment is often
arbitrary. This large section is highly responsive to properly carried
out Ayurvedic intervention. Several other gropus of patients with
clearly identifiable cause also respond positively. There are however
several conditions like genetic abnormalities and irreversible causes
of infertility which do not respond to medical treatment - Ayurvedic
or conventional and some even to surgical intervention. In some
cases modern assisted reproduction techniques hold great promise.
So the first crucial step in treatment of male infertility is to understand the underlying aetiology and pathology and proceed through
the appropriate pathway.
This presentation focusses on the different causes and an Ayurvedic
approach to differentiation and treatment of the treatable causes
of male infertility.
Ayurveda has an established role in the management of several gynaecological disorders. Several Ayurvedic products and therapeutic approaches are described and practised. While different manifestations of
PCOS are described as separate entities there is no single disease entity
in Ayurvedic literature that matches PCOS. The modern understanding
of the patho-physiology of PCOS provides a comprehensive approach
to devising concepts and protocols for the management of PCOS and
associated complications including infertility. Ayurveda recommends
purification (shodhana) to be followed by pacification (shamana cikitsa).
Snehana is the initial step in the treatment of most chronic diseases. This
is particularly relevant in PCOS, as the disease is chronic and is mediated by the central neuro-endocrine axis. Snehapana with ghritas like
Kalyanaka and Maha-Kalyanaka ghrita which are indicated for “Aretasi
& Alpa Rajasi” (amenorrhoea & hypo-menorrhoea) are seen to provide
significant improvement to the hormonal milieu normalising menstruation and ovulation. Vamana and vasti aid the process in several cases.
Shamana cikitsa with different herbal and mineral compounds
like Sukumara Kashaya, ghrita, Saptasara Kashaya, Ashokarishta,
Dhanvantara Taila, Kulathadi kashaya, Rajapravartini Vati and many
more are described and used for menstrual disorders. While many patients respond to the administration of these formulations, there are also
several non-responders. This is largely because of in-adequate sub-classification of the cases and lack of clear understanding of the specificity of
each of these formulations or protocols for different sub-classes.
Treatment is far more effective if patients are categorised into sub-classes and specific shamana protocols developed and fine-tuned for
different sub-classes of patients by observing the associated conditions
by taking into account modern bio-chemical markers for hypo-thyroidism, hyper-insulinaemia, hyper-estrogenism, hyper-androgenism and
hyper-prolactinaemia. Further individualisation could again be based on
Ayurvedic principles. These approaches are detailed in the presentation.
This approach has been observed to provide a much larger percentage
of success in the management of infertility due to PCOS.
36
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Referenten . Speakers
Referenten
Speakers
Asvin Barot MD (Ayu), erfolgreiche 20-jährige Praxistätigkeit in London. Entwickelte einen nahe am Originaltext ausgerichteten und psychologisch orientierten Zugang zum Ayurveda. Internationale Vortragstätigkeit. Intern. Forschungsprojekte.
Asvin Barot MD (Ayu) from Nadiad successful 20-year
practice in London. Developed a psychologically oriented
approach to Ayurveda closely in keeping with original
texts. International lectures. International research projects.
Oliver Becker Heilpraktiker, Diplom-Pädagoge und Ayurveda-Mediziner mit eigener Praxis. Dozent, medizin.
Kurleiter sowie Modulleiter im MSc Studiengang Ayurveda-Medizin an der REAA. Experte für Ayurveda, vedischen Wissenschaften und Sanskrit.
Oliver Becker Master in Paedagogics, practitioner of
Natural Medicine, Ayurveda-Medical-Practitioner in his
own clinic of naturopathy. Lecturer and interpreter within
the Master‘s Training at the REAA. Profound experience
in Ayurveda, vedic sciences and sanskrit.
Dr. med. Jorge Luis Berra, Facharzt für Pädiatrie, Direktor der Fundatión de Salud Ayurveda Prema und des
PG Course in Ayurveda Medicine, Faculty of Medicine,
Buenos Aires University (Argentina)
Jorge Luis Berra MD, pediatrician, director PG Courses
on Ayurvedic Medicine, Faculty of Medicine, Buenos Aires
University, director PG Course on Ayurvedic Phytotherapy,
Great Rosario University Institute (ARG). Director
Fundacion de Salud Ayurveda Prema.
Dr. med. Ashish Bhalla Allgemeinmediziner, medizinischer Ayurveda-Spezialist, ÖAK Diplom Kurortmedizin. Er leitet eine Ayurveda-Praxis, praktiziert als Kurarzt
und unterrichtet Ayurveda-Medizin in Deutschland, Italien und Österreich.
Ashish Bhalla MD, general practitioner, medical
Ayurveda specialist, spa physician (Austrian medical
diploma), teaching ayurvedic medicine in Germany, Italy
and Austria. Medical director for post-gradual studies in
ayurvedic medicine für doctors in Vienna.
Dr. Anand Chaudhary MD (Ayu) PhD, Associate Professor im Department of Rasa Shastra der Banaras Hindu
University, Varanasi. Über 90 wissenschaftliche Veröffentlichungen. Mitglied im Zentralrat für Forschung, Industrie
und Lehre, Department of AYUSH.
Anand Chaudhary MD (Ayu) PhD, associate professor
of the Department of Rasashastra at the Banaras Hindu
University, Varanasi. Over 90 scientific publications.
Member of the Governing Council for Research, industry
and education, Department of AYUSH.
Dr. med. Matthjis Cornelissen Niederländ. Arzt und
Buchautor, lebt seit 1976 in Indien, unterrichtet Integrale
Psychologie am Sri Aurobindo Int'l Centre of Education
in Pondicherry, Direktor des Indian Psychology Institute.
Projekte zu Psychologie aus Sicht indischer Traditionen.
Matthjis Cornelissen MD, physician and author from
the Netherlands, resident of India since 1976, teaches integral psychology at Sri Aurobindo Int'l Centre of Education
in Pondicherry, director of the Indian Psychology Institute.
Projects on psychology from an Indian traditional perspective.
Parvathidevi Kirathamoorthy MD (Ayu) MSc, Stu-dium der Ayurveda-Medizin & Psychologie, Superintendent
des Gvt. Ayurveda Forschungsinstitut für mentale Erkrankungen in Kottakkal. Weltweit führend in der Erforschung ayurv. Behandlung psycho-mentaler Störungen.
Parvathidevi Kirathamoorthy MD (Ayu) MSc, studied
ayurvedic medicine and psychology, superintendent
of the Govt. Ayurveda Research Institute for Mental
Diseases in Kottakkal. Global leader in the research of
the ayurvedic treatment of psycho-mental disorders.
Prof. Dr. med. Anand Dhruva Medizinischer Onkologe, Hämatologe und Internist. Forschung über Komplementärmedizin in der Krebstherapie. Associate Professor
of Medicine an der School of Medicine der University of
California, San Francisco (UCSF).
Prof. Anand Dhruva MD Medical oncologist, hematologist and internist. Researcher specializing in complementary
therapies for cancer symptom management. Associate
Professor of Medicine at the School of Medicine, University
of California, San Francisco (UCSF).
Prof. Dr. Torkel Falkenberg PhD, ist Associate Professor am Karolinska Institutet, Schweden. Er beschäftigt
sich mit Forschung im Bereich integrativer Gesundheitspflege un d war beteiligt an der Erstellung der WHO Direktive zur Traditionellen Medizin (2002).
Prof. Torkel Falkenberg PhD, associate professor at
the Karolinska Institutet, Sweden. Dedicated to research
in the field of integrative health care and was involved in
the creation of the WHO directive for traditional medicine (2002).
Prof. Dr. med. Antonella delle Fave Ärztin mit Spezialisierung auf klinische Psychologie, Professorin für Psychologie an der med. Universität in Mailand, Italien. Präsidentin des European Network of Positive Psychology
(ENPP) & der Int'l Positive Psychology Association (IPPA).
Prof. Antonella delle Fave MD, physician with specialization in clinical psychology and professor for psychology
at the Medical University of Milan, Italy. President of the
European Network of Positive Psychology (ENPP), president of the Int'l Positive Psychology Association (IPPA).
Prof. Dr. med. Olga Golubnitschaja hat Musik, Journalismus, Biotechnologie & Medizin studiert. Pionierin in
der personalisierten Medizin, Expertin in der Molekulardiagnostik, Autorin für integrative Medizin. EPMA-Generalsekretärin. Lehrstuhl an der Universität Bonn.
Prof. Olga Golubnitschaja MD, has studied music,
journalism, biotechnology and medicine. Pioneer in the
area of personalized medicine, an expert in molecular
diagnostics, author for integrative medicine. Secretary
General of EPMA. Professor at the University of Bonn.
38
Referenten
Speakers
Dr. med. Hedwig Gupta Fachärztin für Orthopädie
& Rheumatologie, arbeitet seit 1995 mit Ayurveda und
dem therapeutischen Yoga in eigener Praxis. Vorstandsmitglied Dägam. Ayurvedastudium an der BHU, Indien.
Hedwig Gupta MD Specialist for orthopaedics and
rheumatology, has been working with Ayurveda and
therapeutic yoga in her own practice since 1995.
Studies in Ayurveda at BHU, India.
Prof. S. N. Gupta MD (Ayu), Chefarzt am Ayurveda
Hospital und Professor am Ayurveda-College in Nadiad,
Gujarat (Indien). Seit über 15 Jahren Dozent und Vor
sitzender des akademischen Beirates der Europäischen
Akademie für Ayurveda (REAA).
Prof. S. N. Gupta MD (Ayu) Head of department
and professor at the ayurvedic hospital and college in
Nadiad, Gujarat. For more than 15 years now lecturer
and chairman of the academic advisory board of the
European Academy of Ayurveda.
Dr. med. Nikolaos Kostopoulos ist bekannter Spezialist für Ayurveda und Ganzheitsmedizin. Praktiziert in
Athen. Schwerpunkt seiner Arbeit als Arzt und in eigener Forschung ist die Behandlung psychosomatischer
Beschwerden und Stressmanagement.
Nikolaos Kostopoulous MD, well-known specialist for
Ayurveda and holistic medicine. Practicing in Athens.
Emphasis (of his work as physician and in his research)
is the treatment of psychosomatic disorders and stress
management.
Rajesh Kotecha MD (Ayu), ist Präsident der renommierten Gujarat Ayurved University, Jamnagar. Er leitet
außerdem seine eigene Ayurveda-Klinik in Jaipur. Umfangreiche, langjährige Lehrtätigkeit auch international,
vor allem in Süd- & Nordamerika.
Rajesh Kotecha MD (Ayu), is the president of the
recognized Gujarat Ayurved University, Jamnagar. He
also directs his own Ayurveda clinic in Jaipur. Also
extensive, long-standing international teaching career,
particularly in South and North America.
Sascha Kriese BA Hons (Ayu), Ayurveda-Studium an
der Thames Valley University London, erlernte das Pulslesen in Indien (Mentor Dr. Pankaj Naram), eigene Ayurveda-Praxis in Brighton, Co-Präsident der Ayurvedic
Practitioners Association (APA).
Sascha Kriese BA Hons (Ayu), 3-years-study on
Ayurveda at the Thames Valley University, London.
Learned the art of pulse-diagnosis in India with his
mentor Dr. Pankaj Naram, runs his own practice in
Brighton. VP of the Ayurvedic Practitioners Assoc. (APA).
Dr. med. Ludwig Kronpaß Chefarzt der Klinik für
Frauenheilkunde und Geburtsmedizin in Rotthalmünster
Leiter der AyurSan-Klinik. Medizin. Direktor und Studienleiter der Ärzte-Fortbildungen an der REAA. Stellvertretender Vorsitzender VEAT e.V.
Ludwig Kronpaß MD, Chief physician in the clinic for
gynecology and obstetrics in Rotthalmünster. Director
of the AyurSan clinic, medical director and director of
studies for post-graduate education for doctors at the
REAA. Vice President of the VEAT e.V.
Prof. Dr. Abhimanyu Kumar MD (Ayu) MSc PhD, Direktor des Central Council for Research in Ayurveda des
Ind. Bundesgesundheitsministeriums, Direktor des All India
Institute of Ayurveda. Davor Leiter der Abt. Kinderheilkunde am National Institute of Ayurveda (NIA), Jaipur.
Prof. Abhimanyu Kumar MD (Ayu) MSc PhD, director of the Central Council for Research in Ayurveda of
he Indian Ministry of Health. Director of the All India
Institute of Ayurveda. Was director of the dept. of pediatrics at the National Institute for Ayurveda in Jaipur.
Marco Lebbing MD, Facharzt für Allgemeinmedizin,
studierte Ayurveda-Medizin in Deutschland und Indien
und beschäftigt sich mit klassischen europäischen Naturheilverfahren. Vorstandsmitglied der Deutschen Ärztegesellschaft für Ayurveda-Medizin DÄGAM.
Marco Lebbing MD, Ayurveda Medical Practitioner
with comprehensive training in Germany and India.
Studied traditional European medicine. Board member of the German Doctors Association for Ayurvedic
Medicine (DÄGAM).
L. Mahadevan MD (Ayu) Leitender Arzt am Sri Sarada
Ayurvedic Hospital, weitreichende Unterrichtserfahrung
in der Ärzte-Ausbildung. Intensive Tätigkeit als Sprecher
auf nationalen wie indischen Kongressen sowie als Autor wissenschaftlicher Publikationen.
L. Mahadevan MD (Ayu), senior physician at Sri
Sarada Ayurvedic Hospital, extensive experience in the
training of physicians. Intensive work as speaker at
national as well as Indian congresses as well as author
of scientific publications.
Ram Manohar MD (Ayu), Ayurveda-Arzt und -Pharmakologe, Forschungsdirektor bei Arya Vaidya Pharmacy in Coimbatore. Mitarbeit in Ayurveda-Forschungsprojekten in Europa und den USA, Mitglied des Internat.
Council for Indian Systems of Medicine.
Ram Manohar MD (Ayu) and pharmacist, director of research at AVTAR (Arya Vaidya Pharmacy) in
Coimbatore. Collaboration in Ayurvedic research projects in Europe and the US, member of the International
Council for Indian Systems of Medicine.
Prof. Dr. Martin Mittwede PhD Indologe und Religionswissenschaftler, lehrt an der Universität Frankfurt/
Main. Habilitierte zum Thema Ayurveda. Leiter des Master-Studiengang MSc Ayurveda-Medizin und Dozent an
der Europäischen Akademie für Ayurveda.
Prof. Martin Mittwede PhD Scholar of religion and
indology, teaches at Frankfurt/Main. Postdoctoral thesis on Ayurveda. Director of studies for the Master
Program in Ayurveda Medicine at faculty member of
the European Academy for Ayurveda.
39
Referenten . Speakers
Referenten
Speakers
Dr. med. Antonio Morandi Neurologe und Vaidya (Ayurveda Academy, Pune (Indien) / Joytinat International
College of Ayurveda). Direktor Ayurvedic Point, Mailand,
und Präsident der Wissenschaftlichen Gesellschaft für
Ayurveda Medizin Italien (SSIMA).
Antonio Morandi MD Neurologist and Vaidya
(Ayurveda Academy, Pune / Joytinat International
College of Ayurveda). Director of Ayurvedic Point, Milan
and president of the scientific society for Ayurvedic
medicine (SSIMA).
Vanitha Muralikumar MD (KC), Präsidentin des Central Council of Indian Medicine der indischen Regierung.
Rektorin und Direktorin für klinische Forschung am Sri
Sairam Ayurveda Medical College and Research Centre
in Chennai.
Vanitha Muralikumar MD (KC), President of the
Central Council of Indian Medicine, Government of
India. Principal cum Director Clinical Research at the Sri
Sairam Ayurveda Medical College and Research Centre
in Chennai.
Vijayendra Murthy MS, B.Nat, MPH praktiziert,
forscht und lehrt seit mehr als 20 Jahren Naturheilkunde
mit Schwerpunkt Ayurveda u.a. in Neuseeland, Australien und Großbritannien.
Vijayendra Murthy MS, B.Nat, MPH More than 20
years of experience in Ayurveda practice, research and
teaching, e.g. in New Zealand, Australia and Great
Britain. Runs his own clinic for natural medicine in
London.
Dr. med. Kalyani Nagersheth wirkte als Ärztin der
Ayurveda-Abteilung an der Habichtswald-Klinik, Kassel. Langjährige Erfahrung als Ayurveda-Dozentin. Eigene Praxis in Frankfurt. Eines ihrer Spezialgebiete ist die
westliche und ayurvedische Phythotherapie.
Kalyani Nagersheth MD, practice as managing doctor
of the Ayurveda department at the Habichts-Wald-Klinik,
Kassel (Germany). Longtime experience as lecturer on
Ayurveda (inter-)nationally. One of her areas of expertise
is Western and Ayurvedic.
Ashtavaidyan Narayanan Nambi MD (Ayu), Leiter der
Abteilung Forschung und Lehre am Institute of Ayurveda
S.N.A. Oushadhasla (P) Ltd., Thrissur, Kerala. Er ist Extraordinarius am Vishnu Ayurveda College sowie ein angesehener Dozent in Indien und Italien (AP)
Narayanan Nambi MD (Ayu), Director of the
Department of Research and Teaching at the Institute of
Ayurveda S.N.A. Oushadhasla (P) Ltd., Thrissur, Kerala.
Associate Professor at the Vishnu Ayurveda College and
well-respected Ashtavaidya and lecturer in India.
Prof. Tanuja Nesari MD (Ayu) PhD, Ayurveda-Ärztin,
Professorin, Leiterin der Abtlg. für medizinische Pflanzen und Pharmakologie am Ch. Brahm Prakash Ayurved
Charak Sanstan in Dehli. Erfahrene Didaktin und Forscherin im Bereich ayurv. Pflanzenheilkunde & Diätetik.
Prof. Tanuja Nesari MD (Ayu) PhD, additional director
(academics) and head of department of Dravyaguna
(Dept. of medical plants & pharmacology) at Ch. Brahm
Prakash Ayurved Charak Sanstan, Dehli. Extensive research in herbal medicine & clinical herbal pharmacology.
Dr. med. Karin Pirc PhD, leitende Ärztin und Gründerin der Privatklinik Bad Ems. Spezialistin für Pulsdiagnose und Panchakarma. Buchautorin und Preisträgerin
des Global Hakim Ajmal Khan Award als „Bester Ayurveda-Arzt 2006“.
Karin Pirc MD PhD, leading physician and founder of
the Maharishi Private Clinic Bad Ems. Specialist for puls
diagnosis and pancha karma. Author and laureate of
the Global Hakim Ajmal Khan Award as “Best Ayurvedic
Physician 2006”.
Dr. Hans H. Rhyner MD (AM) PhD, Naturarzt, Autor, seit 30 Jahren Ayurveda-Kur-, Lehr- und Praxistätigkeit vorrangig in der Schweiz, Österreich und Indien. Seit
2012 auch im Parkschlösschen, Traben Trabach aktiv.
Hersteller von Ayurveda-Bio-Produkten.
Hans H. Rhyner MD (AM) PhD, naturopath, author.
working for more than 30 years now internationally in
the fields of treatments, teaching and practice esp. in
Switzerland, Austria and India. Producer of AyurvedaOrganic-Products.
Prof. Dr. med. Paolo Roberti di Sarsina Experte für
komplementäre und alternative Medizin im Rat für Gesundheit im Italien. Gesundheitsministerium. Er leitet
und koordiniert das permanente Kommitte für Konsens
und Koordination in CAM, Italien.
Prof. Paolo Roberti di Sarsina MD Expert for complementary and alternative medicine at the Italian Board of
Health. Ministry of Health. He directs and coordinates
the permanent committee for consensus and coordination in CAM, Italy.
Kerstin Rosenberg Geschäftsführende Gesellschafterin sowie Fachbereichs- und Ausbildungsleiterin der Europäischen Akademie für Ayurveda, bekannte Spezialistin,
Dozentin und Autorin für Ayurveda-Ernährung, Therapie
und Psychologie.
Kerstin Rosenberg Internationally renowned specialist,
lecturer and author on ayurvedic dietetics, therapy and
psychology. Head of department of Education of the
European Academy of Ayurveda.
Mark Rosenberg Direktor REAA und Geschäftsführender Gesellschafter der Rosenberg Ayurveda Unternehmen, 1. Vorsitzender des Verbands Europäischer Ayurveda-Mediziner & Therapeuten, auch als Vastu-Berater
(altindische Architekturwissenschaft) aktiv.
40
Mark Rosenberg Managing Director of the European
Academy of Ayurveda and the Rosenberg Group of
Institutes, President of the European Professional
Association for Ayurvedic Practitioners and Therapists.
Vastu-Shastra Expert.
Referenten
Speakers
Dr. med. Rotraud Scheiderbauer Seit 20 Jahren
Fachärztin für Innere Medizin, davon 16 Jahre in eigener Praxis. PGDip in Ayurveda Medizin, arbeitete 1 Jahr
als Ärztin an der Ayurveda-Abt. der Habichtswaldklinik,
Kassel. Eigene Ayurveda-Praxis in Salzburg.
Rotraud Scheiderbauer MD, specialist in internal
medicine, 16 years in her own practice. PGDip in ayurvedic medicine, physician for one year in the department for Ayurveda at the Habichts-Wald-Klinik, Kassel.
Own Ayurveda practice in Salzburg.
Sukumar Sardeshmukh MD (Ayu) Enkel des ehrwürdigen Parampoojya P. K. Sardeshmukh (Bharatiya Darshan Trust, Pune) und Leiter der Atharva Nature Healthcare. Praktiziert Ayurveda in der dritten Generation. In
Projekten zur Krebsforschung involviert.
Sukumar Sardeshmukh MD (Ayu), grandchild of the
honourable Parampoojya, P. K. Sardeshmukh (Bharatiya
Darshan Trust, Pune) and director of Atharva Nature
Health Care. 3rd generation of practice in Ayurveda.
Involved in cancer research projects.
Elmar Stapelfeldt Heilpraktiker, Magister der Indologie, Buchautor. Wissenschaftlicher Mitarbeiter am Immanuel Krankenhaus, Berlin. Langjähriger Dozent an
der REAA, darunter 5 Jahre als Leiter des Fachbereichs
Ayurveda-Medizin.
Elmar Stapelfeldt HP Practitioner of natural medicine,
Master of Indology, author. Scientific associate at the
Immanuel Hospital in Berlin. Experienced lecturer at the
European Academy of Ayurveda and 5 years as director
of the faculty of Ayurvedic medicine.
Ralph Steuernagel Heilpraktiker, widmet sich seit 18
Jahren der interdisziplinären Zusammenarbeit von westlicher und östlicher Medizin. Leitet eine eigene Ayurveda-Praxis und Akademie in Bad Homburg. Redaktionsleiter des Ayurveda-Journals.
Ralph Steuernagel HP Practitioner of Natural
Medicine, dedicated for 18 years now to the interdisciplinary collaboration of Western and Eastern medicine. Running his own ayurvedic practice & academy in
Germany. Editor of the Ayurveda Journal.
Dr. Madan Thangavelu PhD, Forschungstätigkeit an
der Universität Cambridge in der Krebs-Genomik. Entwickelte neue Ansätze zur Analyse von Gen-Dynamik
und -Variation. Mitglied des Research Advisory Board
der AVP Research Foundation.
Madan Thangavelu PhD, researcher at Cambridge
University in the field of cancer – genomics. He
developed new approaches to the analysis of gen dynamics and variation. Member of the Research Advisory
Board of the AVP Research Foundation.
Carmen Tosto Yogalehrerin und Ayurveda-Therapeutin, Vize-Direktorin Ayurvedic Point, Mailand (Italien),
hält einen Honorary Degree of Ayurveda Acharya vom
Ayurvedic Institute Ashtavaidya Thaikat Moss, Thrissur.
Carmen Tosto Yoga teacher and Ayurveda therapist,
deputy director Ayurvedic Point, Milan, Italy. Holds an
Honorary Ayurveda Acharya Degree from the Ayurvedic
Institute Ashtavaidya Thaikat Moss, Thrissur.
Dr. Dr. med. Bernhard Uehleke PhD Mediziner und
Physiker; forscht, lehrt und arbeitet in der Phytopharmakologie & -therapie. Spezialist für Kneipp-Therapie
und Geschichte der Komplementärmedizin.
Bernhard Uehleke MD PhD in medicine and physics.
Teaches and works primarily in phytoparmacology and
phytotherapy. Specialist for the history of complementary medicine and hydrotherapy. Pubished more the 50
research papers in the field of CAM.
Ramesh Varier MD (Ayu), über 25 Jahre klinische Erfahrung als Ayurveda-Arzt. Beteiligt an der Entwicklung
von Medikamenten und Behandlungskonzepten gegen
chronische Erkrankungen. Managing Director der AVNGroup.
Ramesh Varier MD (Ayu), more than 25 years of
experience as an Ayurvedic doctor. He developed several proprietary formulations for specific ailments from
traditional Ayurvedic preparations. Managing Director
of the AVN group.
41
Abstracts IRSA
Young Research
Parameswarappa Shivappa Byadgi
MD PhD Dept. of Vikriti Vigyan,
Faculty of Ayurveda, Institute of Medical
Sciences, Banaras Hindu University, Varanasi
Sriranjini Jaideep Institute of
Transdisciplinary Health Sciences and
Technology, Jarakabande kaval, Post
Attur, Via Yelahanka, Bangalore
Aparna Wilson Panikkasseril
Department of Roganidana,
Government Ayurveda College, Kannur
Sunil Rapolu Department of Kriya
Sharir, Faculty of Ayurveda, Banaras
Hindu University, Varanasi, Uttar
Pradesh
Dinesh Karayil Subrahmanian
Assistant Professor, Kottakkal Ayurveda
College
Basavaraj Tubaki MD PhD
Department of Kayachikitsa, KLEU
BMK Ayurveda Mahavidyalaya,
Belgaum, Karnataka
42
Abstracts IRSA
Abstracts IRSA
Call for papers
The scientific committee of IRSA called on researchers from India, Europe and other countries to present their works in the field of
Ayurveda medicine on the 1st International Research Seminar on Ayurveda. Interested scientists and students were requested to send an
abstract of their presentation in English to be scrutinized in a multistage blinded peer review process.
The following research works got selected out of a total of 151 abstracts:
Selected for oral presentation
Page
44
Parameswarappa Shivappa Byadgi MD PhD: Kapha and kapha-pittaja type of body constitution and MTHFR 677CC are
strong risks for Type2 diabetes mellitus
45
Sriranjini Jaideep: Effect of Ayurveda on recovery in pakshaghata (stroke) – a clinical and electrophysiological assessment
46
Aparna Wilson Panikkasseril: An observational study to explore the dhatugata-avastha in breast carcinoma
47
Sunil Rapolu: Certain autonomic responses in healthy individuals may have some association with constitutional types
defined in Ayurveda
48
Dinesh Karayil Subrahmanian: Correlation of a gut therapy protocol (ama chikitsa) in changes of ama and behavioral symptoms of autistic babies
49
Basavaraj Tubaki MD PhD: Development and psychometric analysis of Ayurveda assessment scale for anxiety (AAA)
Selected for honorable mention
Page
50
H.T. Eswaran: Formation and validation of questionnaire to assess jatharagni
51
Dr. Naveen Chandran Venkallil: An observational study to explore the Ayurvedic etiopathogenesis of skin diseases prevalent in endosulfan affected areas
43
Abstracts IRSA
Kapha and kapha-pittaja type of body
constitution and MTHFR 677CC are strong
risks for Type2 diabetes mellitus
Parameswarappa Shivappa Byadgi MD PhD
Archana Gupta, MD
Department of Vikriti Vigyan, Faculty of Ayurveda, Institute of
Medical Sciences, Banaras Hindu University, Varanasi
Email: [email protected]
Akhtar Ali, PhD
Center for Genetic Disorders, Faculty of Science, Banaras Hindu
University, Varanasi
Priyadarshini Tewari, MD, PhD
Neeraj Kumar Agrawal, MD
Department of Endocrinology and Metabolism, Institute of Medical
Sciences, Banaras Hindu University, Varanasi
Email: drkavns@ gmail.com
Rashmi Patel, MSc
Center for Genetic Disorders, Faculty of Science, Banaras Hindu
University, Varanasi
Parameswarappa Shivappa Byadgi, MD, PhD
Name and postal address of presenting author
Presenting author: Parameswarappa Shivappa Byadgi, MD, PhD
Assistant Professor
Address: Department of Vikriti Vigyan, Faculty of Ayurveda, Institute
of Medical Sciences, Banaras Hindu University, Varanasi-221005,
Uttar Pradesh, India
Cell phone : +91 9450711759
Email: [email protected]/[email protected]
Background and Purpose
Type 2 diabetes mellitus (T2DM) is a complex, multifactorial disorder
that results from interaction between genetic predisposition and
environmental factors. Ayurveda’s Prakriti concept also has a genetic and environmental element and alludes to links and susceptibilities of individuals to diseases. In the context of diabetes, Prameha/
Madhumeha (Diabetes Mellitus) Kapha Prakriti individuals are said
to be particularly susceptible (Caraka Samhita Vimanasthana 6/15).
Genetic markers, if any, for Prakriti and risk factors for T2DM will
help stratify individuals susceptible to diabetes and can provide a
way for effective intervention – from early recommendation of preventive life style changes to early detection of the disease and thus
help reduce the burden of the disease in the society.
44
5,10-Methylenetetrahydrofolate reductase (MTHFR), an enzyme
involved in the folate-homocysteine metabolic pathway is now
known to be associated with complex diseases like cancers, cardiovascular and neurodegenerative diseases. In this preliminary study
we address whether two well-studied polymorphisms at positions
677 and 1298 of the MTHFR gene are associated with Prakriti and
/or Type 2 diabetes.
Design / methodology / approach
After informed consent, Ayurvedic constitution, MTHFR C677T and
A1298C genotypes were determined and disease assessment was
done for 54 patients with T2DM and 56 normal controls. The polymorphisms were detected by PCR-RFLP. The study was approved
by the institutional ethical committee and work was funded by
Banaras Hindu University from UGC Grant for young Faculty.
Findings
The frequencies of the CC, CT and TT genotypes in patients
were 50, 3 and 1 whereas in controls 43, 13 and 0 respectively.
The number of individuals in the Kapha/Kapha-Pittaja Prakriti in
patients and control groups were 44 and 12 respectively. Kapha/
Kapha-Pittaja Prakriti were found to be associated with T2DM
(x2 = 39.67, p< 0.001) and found to be strong risk factors [odds
ratio (OR) =16.133, 95%CI=6.32-41.20] for T2DM. MTHFR C677T
was associated (x2 = 7.743, p-value=0.02) with T2DM where the
major CC genotype was found to be a risk for T2DM (OR=3.78,
95% CI = 1.14- 12.45). A1298C was not associated with T2DM
(x2 =2.264, p-value=0.322). No correlation was observed between
Prakriti and C677T/A1298C variants. A noticeable higher number
of CT (heterozygotes) was seen in the control group (13 out of 56)
in comparison to the T2DM group (3 out of 54).
Interpretation & Conclusions
A significant correlation was observed between Prakriti (Kapha/
Kapha-Pittaja) and T2DM (p<0.001). This finding corroborates well
with the Ayurvedic understanding that the Kapha Prakriti individuals
are highly susceptible for Prameha/Madhumeha (Diabetes Mellitus).
The study also suggests a basis for the correlation of Prakriti (body
constitutional type) and clinical phenotype. The most common (normal and wild type) genotype individuals with two copies of 677C
(677CC) showed a higher incidence of T2DM. A larger sample size
and individuals from diverse ethnic backgrounds will provide more
information about this observed association. In the absence of such
associations it might seem that the Ayurvedic Prakriti will prove to
be a much better indicator of proclivity to T2DM.
Effect of Ayurveda on recovery in
pakshaghata (stroke) – a clinical and
electrophysiological assessment
Sriranjini Jaideep
Authors: Sriranjini SJ, MD (Ayurveda), PhD*, Nagaraja D, MD, DM1,
Pal PK, MD, DM1, Sudhakara D, MD (Ayurveda)2, Sathyaprabha TN,
MD
Affiliations: Departments of Neurophysiology, 1Neurology,
2Advanced Center for Ayurveda in Mental Health and Neurosciences,
National Institute of Mental Health & Neurosciences (NIMHANS),
Bangalore, India
*Current affiliation: Clinical Research Group, School of Health
Sciences, Institute of Transdisciplinary Health Sciences and
Technology (ITD-HST), #74, Jarakabande kaval, Post Attur, Via
Yelahanka, Bangalore 560106, India; e-mail: drsriranjini@gmail.
com; Ph: +91-80-28567000; Mob: +91-9886492902
Background: Ayurveda describes cerebrovascular diseases as pakshaghata (stroke) and implicates vatadosha in the pathogenesis.
This study intended to assess the effect of Ayurveda treatment on
aspects of aberrant vatadosha including motor recovery, cardiac
autonomic functions and cortical excitability and corticospinal
integrity in patients of pakshaghata.
Statistical analysis was performed using SPSS. Chi-square and
Fisher Exact test was used to find the significance of categorical
data comparison between two groups of patients. 2x2 Repeated
Measures Analysis of Variance (RMANOVA) was used to find the
significance of study parameters within and between the two
groups of patients.
Results: Patients in Group II showed statistically significant improvement in clinical variables [mRS (F=70.970), NIHSS (F=153.422), BI
(F=171.461), PRS (F=134.352), p<0.001]. The improvement was
comparable with patients in Group I. In addition, patients in Group
II showed statistically significant improvement in the cardiac autonomic parameters [standard deviation of normal to normal intervals
(SDNN) (F=8.16, p=0.007), total power (TP) (F=9.73, p=0.004), low
frequency (LF) power (F=13.51, p=0.001)]. The TMS measures did
not show any significant changes in both groups of patients.
Conclusion: We have shown preliminary data that adjuvant
Ayurveda treatment as used in the current study aids motor
recovery and modulates cardiac autonomic activity in pakshaghata
patients. However, further studies in larger sample and with longterm follow-up are warranted.
Methods: The study was conducted at the National Institute of
Mental Health And NeuroScience, Bangalore with ethical approval.
Fifty patients of pakshaghata (ischemic stroke in middle cerebral
artery territory) (mean age 39.26±9.88 years; Male 43, Female 7)
were recruited within one month of ictus with signed informed
consent. All patients received standard allopathic medications as
advised by neurologist.
In addition, patients were randomized to receive conventional
physiotherapy (Group I) or Ayurveda treatment (Group II) consisting
of Abhyanga (methodical massage with Balasvagandhataila) and
Bashpasveda (steam therapy), Matravasti (with Balashvagandhataila)
and oral medicines of Ashtavargakashaya 15ml TID with 15ml
warm water and Kshirabalataila 101, 5 drops BD with 15ml warm
water for 14 days.
All parameters were assessed at baseline and at the end of 14 days.
Clinical parameters assessed were Modified Rankin Scale (mRS),
National Institute of Health Stroke Scale (NIHSS), Barthel index (BI)
and a newly developed Pakshaghata rating scale (PRS). Continuous
15 minute electrocardiogram and finger arterial pressure recordings
were obtained and analyzed offline to obtain cardiac autonomic
parameters. Transcranial magnetic stimulation (TMS) parameters
assessed were resting motor threshold and central motor conduction time.
45
Abstracts IRSA
An observational study to explore the
dhatugata-avastha in breast carcinoma
Aparna Wilson Panikkasseril
Department of Roganidana, Government Ayurveda College,
Kannur, India
[email protected], +91 9447318961
Background:
Cancer ranks first among the developing challenges to the field
of medicine, with an increasing burden of mortality and morbidity
rates. Breast cancer remains the leading cause of death and morbidity in females across the world. With a change in lifestyle and
exposure to environmental carcinogens, the risk factors of breast
cancer increases day by day. Ayurveda, being a socially responsible
medical system, cannot stay back from the emerging challenges in
today’s health care scenario. Ayurveda describes several stana rogas
(diseases of breast) but complete descriptions of breast cancer and
its metastatic stages are not available. Dhatugatavastha (progressive affliction and involvement of the various tissues of the body)
explains the extension of samprapti (pathogenesis) from the initial
site of disease manifestation to the deeper dhatus (tissues, structural elements). The possibility of dhatugatavastha in breast cancer,
which often begins as a localised disease but culminates in systemic
metastases has to be explored.
Methods:
An observational study was conducted among fifty female patients,
diagnosed with breast cancer (all stages of the disease), prior to
administration of any therapeutic interventions at Malabar Cancer
Center, Kannur.
Assessment of dhatu dushti (derangement of tissues, structural
elements) considering the dhatu vriddhi kshaya lakshanas (signs
of increase and decrease of the tissues), 75% of patients had rasa
dushti (derangement of chyle), 74% had rakta dushti (derangement
of blood), 98% had mamsa dushti (derangement of muscle), 88%
had medodushti (derangement of adipose tissue), 20% had asthi
dushti (derangement of bone), 68% had majja dushti (derangement of marrow) and 9.3% had shukra dushti. (derangement of
reproductive tissue).
It was observed that patients were habituated to foods that provoke
secretions, are heavy to digest, pro-inflammatory, incompatible
and extremely unctuous as well as unhealthy life style like lack of
exercise and sleeping during daytime Ojodushti (disturbances of
the vital fluid) like ojovyapat (derangement of vital fluid) and ojokshaya (depletion of vital fluid) was observed among the patients
with advanced stages of the disease. Dhatupaka (suppuration and
wasting of tissues) is an inevitable consequence of breast carcinoma
resulting in symptoms like insomnia, anorexia and loss of strength.
Conclusion:
The progressive affliction and involvement of the tissues in breast
cancer can be studied on the basis of the symptoms of diseases
caused by increase, decrease and derangement of the dhatus. From
this viewpoint, it can be inferred that there is successive involvement of the tissues as the disease progress eventually leading to the
affliction of the bijabhigavayava (genetic material), resulting in the
genetic predisposition of progeny to breast carcinoma. The tissues
and srotas (microchannels) involved in the earlier stages are rasa,
rakta, mamsa and medas, while in the advanced stages asthi, majja,
shukra are also affected. This approach helps to map the progressive and successive involvement of the tissues in breast carcinoma.
Results:
Painless lump over breast, nipple retraction and Peau d’ orange
were amongst the commonest clinical features observed. Loss
of appetite, loss of weight, ulceration and fungus infection were
observed in patients with advanced breast carcinoma. The nature
of dosha dushti (derangement of dosha) was observed to be different among different stages of the progress of the disease. Vata is
invariably present in all the stages of the disease with kapha predominating the initial stage, followed by pitta and ultimately vata
characterized by depletion of the tissues.
The koshthagati (movement in the internal disease pathway) of
the doshas result in the metastasis to the two koshtangas (internal organs), yakrit (liver) and pupphusa (lungs), while shakha gati
(movement in the peripheral disease pathway) of the doshas results
in the metastasis to the asthi dhatu (bone tissue), whereas the
marma asthi-sandhi gati (movement in the central disease pathway)
leads to the metastasis of doshas to siras (head).
46
Certain autonomic responses in healthy
individuals may have some association with
constitutional types defined in Ayurveda
Sunil Rapolu
Authors:
Rapolu SB,1 Kumar M,2 Signh G,3 Patwardhan K.1
Author affiliations:
1Department of Kriya Sharir, Faculty of Ayurveda
2Department of Shalakya Tantra, Faculty of Ayurveda
3Division of Biostatistics, Department of Community Medicine
Banaras Hindu University, Varanasi, Uttar Pradesh, INDIA
Contact Details:
Rapolu Sunil Buchiramulu: [email protected]
Manoj Kumar: [email protected],
Girish Singh: [email protected]
Kishor Patwardhan: [email protected]
in Vata group was found to be relatively higher than that in Kapha
group in cold pressor test. In the tests such as standing-to-lying
ratio and pupil diameter, the sympathetic activity was found to be
relatively higher in Vata and Pitta groups than that in Kapha group.
Pupil cycle time, however, indicated that individuals in Kapha group
had relatively higher sympathetic activity. This could be indicative
of a negative correlation between cardiac parasympathetic activity
and pupillary parasympathetic activity, as has been proposed in a
few earlier studies.
Conclusions:
Certain autonomic function tests related with cardiovascular reactivity and pupillary responses may have an association with the
dominant Dosha expressed in an individual. As a corollary, it may be
useful to explore the possibility of employing these tests to identify
the primary Dosha in an individual. Further, the present model of
grouping people depending on their ‘primary Dosha’ may be a useful option to explore, while investigating various aspects of Prakriti.
Background:
According to Ayurveda, an individual can be grouped into any one
of the seven constitutional types (Prakriti) depending on the dominance of one, two, or three Doshas. A ‘Dosha’ is representative of
those fundamental mechanisms that are responsible for homeostasis, and thus, to health. In the recent years, there have been several
efforts to see whether certain physiological, haematological or biochemical parameters have any association with the constitutional
types or not. The objective of the present study was to see if the
results of certain autonomic function tests vary according to Prakriti
of an individual.
Methods:
We conducted this study in healthy volunteers of both gender
belonging to the age group of 17 to 35 years after obtaining their
written consent. The Prakriti of these volunteers was assessed
on the basis of a validated questionnaire and also by traditional
method of interviewing. After confirming that the primary Dosha
ascertained by both these methods matched, 106 volunteers were
shortlisted and grouped into three (Vata, Pitta and Kapha) on the
basis of primary Dosha and were subjected to various autonomic
function tests such as cold pressor test, standing-to-lying ratio,
Valsalva ratio and pupillary responses such as pupil cycle time and
pupil size measurement in light and dark. The results were analysed
by applying suitable statistical tests.
Results:
The results of several autonomic function tests correlated linearly
with the primary Dosha expressed in an individual. In particular,
people with Kapha as the most dominant Dosha showed a tendency to have higher parasympathetic activity with respect to their
cardiovascular reactivity. More specifically, the sympathetic activity
47
Abstracts IRSA
Correlation of a gut therapy protocol (ama
chikitsa) in changes of ama and behavioral
symptoms of autistic babies
Dinesh Karayil Subrahmanian
Author(s):
Dinesh K S, Jayadevan C V
Assistant Professor, Kottakkal Ayurveda College
Contact details
Email: [email protected], +91 9447698085
Background
The relation between gut problems and behavioral disorders in
autistic babies are being discussed since long, especially after the
publication of Andrew Wakefield's article in Lancet. Ama (defect
in the bioconversion of either food or any biological material in
a metabolism) is a unique concept, which is the root cause of all
diseases as per the principles of Ayurveda. The clinical features
mentioned in Ayurveda texts for ama are common among autistic
babies. Basic reasons behind the manifestation of ama symptoms
in autistic babies are dysbiosis, yeast growth, nutritional deficiency,
enzyme deficiency, essential fatty acid deficiency, Gastro Esophageal
Reflux Disease, indigestion, inflammatory bowel, chronic constipation and their cascades. Leaky gut syndrome is the most discussed
pathogenesis among them. According to Ayurveda behavioral
disorders and other clinical features of autism have conspicuous
connection with gut functions (ama) because both mind and gut
functions are governed by a single physiological entity [Rasa dhatu,
which is often translated as chyle.] The Ayurvedic understanding of
Autism in the backdrop of the connection between mind and gut
functions has not been reported before.
Methods
A retrospective analysis was done on the basis of records of 40
autistic babies who had undergone the treatment at AyuCALM
[Ayurveda Centre for Autism & Learning Disability Managementa functional subset of department of Ayurveda Paediatrics] of
Vaidyaratnam.P.S.Varier Ayurveda College Hospital, Kottakkal, India.
The case sheets of Rett syndrome and Childhood Disintegrative
Disorder were excluded from analysis. In all cases an initial gut therapy for three months were done as a part of autism intervention
protocol. The Ayurvedic gut therapy protocol [AGTP] consists of oral
administration of several polyherbal compound drugs according to
the norms of Ayurveda. AGTP also includes an Ayurveda dietetics
and food regimens to the autistic babies during this period.
cry and disordered sleep] before and after the gut therapy were
done using ‘t’ test. The correlation between the changes in gut
symptoms and behavioral disorders was analysed.
Results
Significant change was observed in most of the gut problems
[abdominal pain <0.001, bloating, constipation and lack of appetite
<0.05] and in a few behavioral problems [stereotypy and crankiness
<0.05]. The correlation coefficient obtained between the changes
in gut disorders and behavioral disorders was +0.898.
Conclusions
AGTP (Ama Cikitsa) may have a significant effect in the behavioral
and gut disorders in autistic babies. The change observed in behavioral and gut disorders after an Ayurveda gut therapy protocol in
autistic babies showed a positive correlation.
Analysis of gut disorders [abdominal pain, diarrhea, bloating, constipation, lack of appetite and increased tiredness] and behavioral
disorders [sensory dysfunction, stereotypy, crankiness, spontaneous
48
Development and psychometric analysis of
Ayurveda assessment scale for anxiety (AAA)
Basavaraj Tubaki MD PhD
Tubaki B R*, Chandrashekar C R, Sudhakar D, Sathya Prabha T N,
Lavekar G.S, Kutty B M.
Basavaraj R Tubaki MD, PhD (NIMHANS), Reader,. Department
of Kayachikitsa, KLEU BMK Ayurveda Mahavidyalaya, Belgaum.
Karnataka. India.
C R Chandrashekar MD, Professor, Department of Psychiatry.
NIMHANS. Bangalore. India.
D. Sudhakar MD (Ayurveda), Assistant Director, Advanced Centre
For Ayurveda in Mental Health and Neuro-Sciences, NIMHANS.
Bangalore. India
T N Sathya Prabha MD, Additional Professor, .Department of
Neurophysiology. NIMHANS. Bangalore. India.
GS Lavekar MD (Ayurveda), Former Director General. Central
Council for research in Ayurveda and Siddha (CCRAS).New Delhi.
Bindu M Kutty PhD, Professor & Head, Department of
Neurophysiology. NIMHANS. Bangalore. India.
* Corresponding Author:
Basavaraj R Tubaki MD, PhD
Reader, .Department of Kayachikitsa, KLEU BMK Ayurveda
Mahavidyalaya, Shahapur, Belgaum. Karnataka. India. 590003
E Mail- [email protected]
Mobile-+919448634660 Fax-+918312424157 Background
Scarcity and poor quality of Complementary Medicine research
including Ayurveda in psychiatry is primarily due to lack of proper
assessment scales that capture the epistemological approaches of
the underlying knowledge systems. Assessment scales based on
Ayurveda guidelines that fulfill the current psychometric parameters
is imperative to take Ayurvedic Psychiatry forward.
Materials and methods
Descriptions of udvega (anxiety), mano dosha (faults of the mind),
vata vikriti (derangement of vata) were thoroughly screened from
Ayurveda treatises. These were compared with manifestations of
Anxiety disorders (GAD and Social Phobia). A Panel of Ayurveda
experts and a psychiatrist thoroughly evaluated each item and an
18 item semi structured scale with the suitable anchor points were
developed. This Ayurveda Assessment scale for Anxiety (AAA) was
subjected to following psychometric evaluations:
1. To assess Reliability & Validity:
Sixty two (62) subjects were recruited in the study. Among which 31
patients of GAD with co morbid generalized social phobia meeting
DSM IV TR criteria, between the age group of 20-55 yrs of either
sex were recruited from Psychiatry OPD, National Institute of Mental
Health and Neurosciences (NIMHANS) Bangalore. Other 31 were
age and sex matched healthy subjects enrolled from NIMHANS
campus, Bangalore. Two independent Ayurveda experts evaluated
both patients and healthy subjects through AAA, Hamilton Anxiety
Rating Scale (HARS) and Becks Anxiety Inventory (BAI). Internal
consistency analysis was through Cronbach’s alpha and split half
tests. Inter rater agreement was assessed through Cohn’s Kappa,
Correlation between the AAA, HARS and BAI was calculated using
Pearson’s correlation coefficient r, set at 5% (p<0.05).
2. To assess Sensitivity to treatment induced change:
Seventy-two (72) patients of 20 to 55 years age of either sex
diagnosed as GAD with co morbid generalized social phobia (DSM
IV TR criteria), participated in the randomized controlled clinical
trial**. They were randomly divided into three treatment groups:
Group I (n = 24) and Group II (n = 24) received Manasamitra Vataka
tablets (100mg twice daily for 30 days). Group II, in addition to
Manasamitra Vataka, underwent Shirodhara (therapy involving
dripping of medicated oil [Brahmi taila] over the forehead) treatment for the first 7 days. Group III (n = 24) received clonazepam
0.75mg daily in divided dose for 30 days. The assessment of the
study was done using the HARS, BAI, Beck Depression Inventory
(BDI), AAA and Clinical Global Impression scales. Assessments were
through Repeated measures ANOVA and effect size calculation.
Results
Reliability assessment showed that Inter rater agreement was good
to very good (Cohn’s kappa >0.60) in most of the items (16 items).
Correlation of AAA with HARS & BAI was significant (p<0.001).
Scales recorded significant difference when compared between
patients and healthy subjects (p<0.001). Internal consistency
assessed with Cronbach’s alpha was 0.74 and split half reliability
of AAA was (Pearson correlation) 0.58 at p=0.001.The Sensitivity
to treatment induced change showed that all three intervention
groups showed significant improvement within their group. HARS,
BAI and AAA showed large effect size (above 0.5) in all the three
groups. Hence AAA could catch the change on 15th and 30th day
of intervention similar to HARS & BAI.
Conclusions
This is the first study to comprehensively develop and evaluate the
psychometric properties of assessment scale on Ayurveda in Anxiety
disorders. Psychometric properties like inter rater reliability, validity
(criteria, convergent, divergent, face) and sensitivity to change were
promising. However it needs further assessments like test re test
reliability and large multi centric studies.
** Basavaraj R Tubaki, C R Chandrashekar, D Sudhakar, T N
Sathya Prabha, G.S Lavekar, Bindu M Kutty. Clinical efficacy of
Ma<<nasamitra vataka (An Ayurveda Medication) on Generalized
Anxiety Disorder with co-morbid Generalized Social phobia: A
Randomized controlled study. The Journal of Alternative and
Complementary Medicine, Vol. 18, No. 6, June 2012: 612-621.
(Data of Ayurveda Assessment scale for Anxiety (AAA) is not published/reported earlier in any of the forums and is being done for
the first time)
49
Abstracts IRSA
Formation and validation of questionnaire
to assess jatharagni
H.T. Eswaran
Eswaran. H.T.,1 Kavita M.B.,2 Tripaty T.B.,3 Shivakumar,4
1PG Scholar, 2Associate Professor, 3Professor, 4Associate Professor
& HOD
Conclusion
The normalcy and changes in Jatharagni are indicative of health or
ill health. The assessment of various statuses of Jatharagni can be
made by specific symptoms related with various systems specially
the digestive system. The internal consistency of the questionnaire
was 0.909 which is indicative of the excellent internal consistency
of questionnaire. The lacuna of tool to assess state of Jatharagni
in Ayurveda is filled by this questionnaire. Hence the validated
and standardized questionnaire for the assessment of state of
Jatharagni will act as useful tool for the clinicians of Ayurveda.
Department of Swasthavritta, SDM College of Ayurveda&
Hospital, Hassan.
1,2,3,4
Corresponding Author: Eswaran.H.T
Address: Sri DharmasthalaManjunatheshwara College of Ayurveda
& Hospital, Thannirhulla, B.M.Road, Hassan – 573201. Karnataka.
E-Mail: [email protected]
Mob: 09591094425
Abstract
Jatharagni (the digestive factor) is of the prime importance in the
maintenance of health as well as causation of diseases. Food which
is consumed by the person shares the major responsibility for being
healthy or manifestation of diseases. The relation between food
and health is mediated by Jatharagni.
There are four different states of Jatharagni viz, Mandagni
(weak digestive capacity), Vishamagni (erratic digestive capacity),
Tikshnagni (strong digestive capacity), and Samagni (normal digestive capacity). Samagni is said to be the normal State and maintains the health of an individual. All the other states are considered
as abnormal.
Objectives
The Study was undertaken to frame and validate a Questionnaire
to assess the state of Jatharagni.
Materials & Methods
A qualitative research that involved interview method and cluster
sampling method. A total of 500 volunteers of either gender in
two groups viz., apparently healthy and unhealthy, were assessed
for the state of their Jatharagni.
Result
The internal consistency of the questionnaire using Cronbach’s
Alpha was 0.916. The internal consistency of Vishamagni domain
was 0.909; Tikshnagni domain was 0.873; Mandagni domain was
0.894; and Samagni domain was 0.876.
50
An observational study to explore the
Ayurvedic etiopathogenesis of skin diseases
prevalent in endosulfan affected areas
Dr. Naveen Chandran Venkallil
Dr. Naveen Chandran Venkallil, Assistant Professor, Department of
Roganidana, Parassinikkadavu Ayurveda Medical College, Kannur,
India
mail [email protected], +91 9447318871
Background
Endosulfan is an organochlorine insecticide and acaricide. Due to
its acute toxicity and potential for bioaccumulation, a global ban
on the manufacture and use of endosulfan was negotiated under
the Stockholm Convention, 2011. Endosulfan was aerially sprayed
in the cashew plantations of Kasaragod district in Kerala since
1983 until it was banned by the Kerala state government in the
year 2000. The district has plantations, which extends to about
5600 acres, spreading through habitations, water bodies and hills
in about 11 villages (Gram Panchayaths). Alarmingly high levels of
neurological, developmental, oncologic, dermatological and psychological disorders are being reported from among people living
here. Study reports on the health hazards of endosulfan are mutually contradictory. For proper Ayurvedic management a detailed
evaluation of the probable aetiopathologic factors is necessary.
Conclusion
People living in the endosulfan-affected areas of Kasaragod district
suffer from abnormally high prevalance of skin diseases, which
accounts for a major source of morbidity. Lesions were chronic in
nature, predominant with secondary lesions. Complaints showed
periodic exacerbations and hot and cold climate were the major
aggravating factors. Majority belonged to Jañgala desa (arid land)
with ushna-ruksha (dry and hot atmosphere) predominance. The
food habits followed more or less a common pattern with predominant use of madhura-amla-lavana-katu rasa (sweet, sour, saline and
pungent taste). No relevant abnormal pattern of food intake was
observed in majority of the population. In the case of people who
are or were labourers and in the case of students, many lifestyle
patterns were found to be relevant.
Majority of the lesions showed the vitiation of vata dosha; either
in isolation, in dual combination or as in combination of all three.
Pitta followed vata dosha in frequency. All cases showed features of
deeper involvement of the tissues or structural elements; in variable
extent, beginning from skin to reproductive tissue. Possible role
of endosulfan as visha (toxin) in the etiopathogenesis in bringing
about these abnormalities needs to be further studied from an
Ayurvedic perspective.
Method
An observational study was conducted in fifty samples with skin
diseases available within the 11 villages in the Kasaragod district
which were identified to be affected by endosulfan.
Results
Majority of the sample (86%) were born or were alive during
the period of aerial spray. The duration of the complaints was
10-29 years in 82%. The occupations of 80% were affected by
their disease. The prominent lesion was pigmentation (94%) and
atrophy (56%). Major aggravating factors were hot climate (28%)
and cold climate (46%). Respiratory system was the most affected
system other than skin (34%). Major food pattern was madhura-amla-lavana-katu ahara (food that has sweet, sour, salty and
pungent taste) (56%). Major vihara (lifestyle factor) was exertion in
extremely hot conditions. (34%). In the lesions, there was an isolated predominance of vata in 36% and a combined increase of vata
pitta in 24%. Raukshya guna (the quality of dryness) of vata was
found to be increased in 76%, with shyava (smoky black) / aruna
(sun red) color in 88%. Major waste product affected was sweat
(decreased in 60%). Dhatugata avasthas (the progressive stages of
involvement of the tissues) from tvak gata (skin involvement) (50%)
to shukra gata avastha (involvement of reproductive tissue) (20%)
was observed.
51
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17th International
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16th International - Europäische Akademie für Ayurveda

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