Is Ayurveda a Natural and Holistic Solution to this Environmental Illness?
Nicole M. Rossi
Submitted to the Interdisciplinary Studies Program
College of Lifelong Learning
Wayne State University
In partial fulfillment of the requirements for the degree of
BACHELOR OF INTERDISCIPLINARY STUDIES
Senior Essay Advisor: Moti Nissani, Ph.D. July 24, 2002
Senior Essay Examiner: Lisa Barno, M.D July 27, 2002
Senior Essay Examiner: Andre Furtado, Ph.D. July 24, 2002
What would happen if you woke up one day and found out that some of your most cherished beliefs were wrong? If you found out that the things that, until now, gave comfort and meaning to your life, lacked integrity? If what you felt to be safe now proved to be dangerous? If the people you counted on for help had no answers?
On July 15, 1995, my life took this desolate turn. I woke up with no feelings in my legs and with a heavy sensation about my waist, as though I were wearing a corset. While my family celebrated my nieces christening, I took myself to the hospitalonly to be informed that they had no answers for me. In the following weeks, my condition kept getting worse. My hands and feet felt like ice and pricked continuously with a pins-and-needles sensation; my bladder hardly worked; and when I moved my neck, an electric-like shock tore down my spine into the heels of both feet. I could hardly stand to be touched by anyone--the brutality of my condition was never so clear as when it physically hurt to hold my daughter, who was just five-years-old. These symptoms, however, could not be seen or felt by anyone else and I could sense doubt, be it real or imagined, among my family members, friends and the medical community.
All preliminary tests were negative except for the nerve conduction studies, which showed only a slightly delayed response in my right tibial nerve. These studies were the only clinical evidence of my deteriorating condition. After a battery of additional tests, by process of elimination, I was at long last, after more than two months, given the diagnosis of Transverse Myelitis with unsatisfactory, even harmful, treatment options and an uncertain prognosis.
As my condition worsened, I learned that the doctors, my faithful doctors for 27 years, could not help me. This was particularly poignant because, I, myself, had naïve ambitions of one day being the type of doctor who could and would help anyone who knocked on my door. The laborious process of diagnosis and the endless arrays of diagnostic tests further discouraged me and deepened my despair.
A profound sense of loss overwhelmed me as though someone close to me had died or was dying. And, although I had seen myself as a logical and practical person and rationally knew I was in no eminent danger, I still somehow felt certain that I was mourning for myself because it was me who was dying. Fear, and even terror, followed my sense of loss as new symptoms appeared or the old ones worsened. It was the beginning of an emotional cycle that continues to this day.
I felt sick with hopelessness. Many people with chronic or terminal illnesses often feel that their world has been turned upside down. They often have to make drastic lifestyle changes in addition to undergoing extensive, long term, and often-uncomfortable treatment. They have to restructure their entire lives, as well as that of their family, and for them the security of the past is lost to the uncertainty of the future. It is also not uncommon for people to question their faith and ask, "Why is this happening to me?" That was my situation too. In addition to questioning a higher power, I also asked myself why modern medicine didnt have any answers for me and if there was anything else out there that could help.
My daughters paternal grandmother, a holistically inclined massage therapist, harangued me for years with stories of Bach Flower Remedies, goldenseal salve, and vegetarianianism. I listened unenthusiastically then, but I now I felt I must listen. I read and learned a great deal. Homeopathy and naturopathy were of interest to me, although I did not lean toward any particular philosophy. Following a major bout of TM in August of 1999 and another in March of 2001, I began exploring the medicine of the Far East. Finally, I found Ayurveda.
The Ayurvedic approach, in turn, hinges on the correct etiology of my condition. It had been almost six years since the onset of my disorder and its causes still remain unknown. My worry was compounded by the possibility that whatever was out there that caused my TM could affect my friends and loved ones. I began contemplating the possibilities and came across a theory regarding Multiple Sclerosis (MS) and environmental factors (what I have come to call "human pollution." Because MS and TM are often seen as interrelated, I hypothesized about the toxicity of my own system and its manifestation as TM. I had been plagued by thyroid disease, headaches, idiopathic stomach disorders, intermittent acne and chronic bronchitis. Could these have been warning signs of the impending illness? Could my current condition be due to toxic human pollution? My next question became: How can such contamination be reversed? Believe it or not, the answer was not so complicatedthe opposite of "contaminated" is "pure." My solution, my answer, was to detoxify my body and return to a lifestyle that emphasized purity.
Because one of Ayurvedas prime health philosophies relates to detoxification of the body, and because there were few other programs, particularly of western origin, that specifically addressed this possibility, I saw Ayurveda as the opportunity to get past my illness (or at least live comfortably with it) and get on with my life. Although I took Ayurvedic therapy one step at a time (it has at least five separate parts besides detoxification), after only three weeks, about 90% of my symptoms had disappeared completely. The only remains of my illness were dysaesthesia (any unpleasant abnormal sensation, usually neurologically linked) in my thumb and index finger of my left hand (presumably the result of permanent damage to the neurons). I was hooked on Ayurveda simply because it appeared to be the answer which eluded medical science and me for six years.
My newfound knowledge also shaped my understanding of how people and the earth are intimately connected and how a healthy life is a matter of balance between them. I have continued my studies because, apart form the health benefits, I feel that Ayurveda helps control my life and my emotions and helps me gain understanding of the lives and emotions of other people.
Human beings are the most adaptable creatures on this earth. We can survive the most inhospitable conditionswhether freezing cold, burning hot, interacting with our in-laws, or coping with a devastating illness. Survival in modern times, as I am learning, begins with the desire to survive it and the belief that there is security, peace and happiness within you. Survival continues with awareness of the world around you. Where and when life ends depends on the quality of the journey. This paper is the written manifestation of what I have learned about my disease, Ayurveda, and myself.
I want to thank Dr. Lisa Barno for not only being my examiner, but also a good friend. Id also like to thank Andre Furtado for being my examiner. Mary Jo deserves credit for opening my eyes to the world of alternative therapies. Thanks to the doctors who listened to me, to Ayurvedic practitioners who gave me something new to listen to, and to my family for putting up with my educational endeavors for what seems like a century. A special thanks also has to go to James for physically putting me into the computer chair at those times when I needed to write. My daughter, as always, has my heart because she has lived with me, suffered with me going through a change of lifestyle, and has remained my best friend throughout. Thank you Alex with all my heart.
TABLE OF CONTENTS
CHAPTER 1 ENVIRONMENTAL CONTAMINATION
Antibiotics and Vaccinations in Human Beings
Antibiotics in Consumable Animals
CHAPTER 2 - THE REALITY OF ENVIRONMENTAL DISEASE
Systemic Lupus Erythematosus
CHAPTER 3 TRANSVERSE MYELITIS
Course of the Disease
Incidence of Transverse Myelitis
CHAPTER 4 - WESTERN TREATMENT MODALITIES OF TM
Treating the Symptoms
Physical, Occupational and Vocational Therapies
Future Treatment Studies
CHAPTER 5- AYURVEDA
Massage and Yoga
Alternative Therapies and their Relation to Ayurveda
Change of LifestyleNew Routines
CHAPTER 6 REJUVENATION AND DETOXIFICATION IN AYURVEDA
CHAPTER 7 - AYURVEDIC TREATMENT OF TMMY STORY
Ayurvedic Treatment of a Neurologic Disorder
My Personal Regimen
CHAPTER 8 AYURVEDA AND OTHER COMPLEMENTARYAND ALTERNATIVE MEDICINES IN THE WEST
What is included in CAM?
Western Medicines Concerns with CAM
Big Business and Proponents of CAM
Appendix A List of Illnesses by Dosha
Appendix B List of Ayurvedic Herbs and Their Uses
Appendix C Dosha Test
Appendix D Various Yoga Positions
CHAPTER 1 ENVIRONMENTAL CONTAMINATION
In this chapter, the shocking reality of environmental contamination will be elucidated. This is an essential part of this paper because (1) the broad spectrum of factors that can affect health is not widely known and (2) without knowing what may be affecting our health, we can do little about it.
For the environmentally aware, there is no need to describe the environmental problems we face today. Literally thousands of books, articles and films have been produced showing that the biosphere has been dramatically disturbed and chemically changed by human activities (Ecology 30). But your average individual may not know that in 1989 alone, more than 1,000,000,000 pounds of chemicals were released into the ground, contaminating our farmlands and drinking waters. Over 188,000,000 pounds of chemicals were also discharged into surface waters such as lakes and rivers. More than 2,400,000,000 pounds of chemicals were pumped into the air we breathe. A grand total of 5,705,670,380 pounds of chemical pollutants were released into the environment which we eat, breathe, and live inall in just one year (Edelson). And by now, the situation is even worse!
Environmental health risks are often linked to job-related illness or injury, where the effects of high concentrations of toxic chemicals can be more easily associated with particular symptoms (Tiscali 2001). However, there is no doubt that environmental factors can, and have, affected the health of individuals not specifically involved in the industries that produce such pollutants. For instance, asthma, respiratory diseases and cancer rates have grown to near-epidemic proportions (EPA-OCHP 2002; Fisher 1998). Any time you hear that someone has an environmental illness, you think of cancer, asbestosis, chemical contamination, and diseases like chronic pulmonary obstructive disease (caused by the long-term inhaling of various dust particles such as gypsum). But in recent years, there have been significant and steep increases in the number of cases of MS, systemic lupus erythematosus, chronic fatigue syndrome (Edelson), fibromyalgia (Goldberg) and adult onset diabetes (ENS 2000). And, not so shockingly, these chronic and often terminal illnesses show up in working and non-working individuals from birth to age 90 or more (Edelson, Goldberg, ENS 2002).
It is, therefore, reasonable to suggest that other illnesses can be linked to environmental factors as well. The environment may also be the cause of illnesses otherwise referred to as idiopathic or "without cause."
What does "Environment" refer too?
It is not difficult for scientists and environmentally active people to discern environmental factors that may affect health. But unless the average person has done personal research or is an avid reader on health concerns, it is difficult for them to pinpoint the factors that may be influencing their health.
Environmental Definitions. Environment is usually defined in an ecological perspective (i.e., how the ecosystem processes interact and affect us on local, regional and world levels). But an equally important perspective is that of the immediate environmentwhether people work in factories, in suburban offices, or on farms, or whether they live in 50-year-old houses in the city, or 2-year-old condominiums in a newly developed subdivision that had been a toxic dumping ground ten years prior.
The New England Journal of Medicine defines environmental influences to include all non-genetic factors (Hoover 2000). Further, Encarta Encyclopedia defines environment as the sum of all external conditions affecting the life, development, and survival of an organism. When we are the organism, everything from the air we breathe, the food we eat, the places we work and live, the clothes we wear, the people we know, the social and political cultures to which we belong, to the school we attend, among many other factors, are elements of our environment. It follows then that any one of these factors may contribute to the state of our health and would be considered an "environmental health factor." Hence, illnesses caused by such things may be considered "environmental illnesses".
Extent of Environmental ContaminationIndoors and Outdoors. This definition is more convincing when it is shown that environmental contamination is all around usin the air we breathe, the products we use every day, the places we visitincluding our own homes. In fact, there is evidence linking indoor pollution to contaminated drinking water, synthetic drugs, antibiotics in medicine and agriculture, genetic manipulation and radiation treatment of foodstuffs, refined sugar, foods high in additives and preservatives, saccharine, aspartame, detergents, emissions from the plastic of computer video monitors, lead paint and pipes, pesticides, formaldehyde, mercury, arsenic, radiation from cellular phones, electromagnetic fields from high power lines (Blaasaas), and air pollutants (e.g., Carbon monoxide, Nitrogen dioxide, Ozone, Lead, PM-10, and Sulfur dioxide [EPA 2001]). There is hardly a place on the globe that you can go to where these things do not existwhere they cannot have an effect on your life or health.
The problem lies in the fact that Americans are so dependent on many of these things, that to even question their worth would be inconceivable. Where would we be without laundry detergent or Diet Coke? How about canned soup or California strawberries? Yes, even strawberries, as well as other "fresh" fruits and vegetables, may actually pose a health risk. Low level radiation is used to preserve the life and "sterilize" produce shipped out of its state of origin. Radiation reduces food value and may in fact alter its genetic structure (IFT 2000). For that matter, such produce may also possess a resistant strain of bacteria. And this is just the beginning; the soil where these good strawberries are grown is contaminated with synthetic fertilizers and the strawberries themselves are coated with toxic pesticides. The retailer selling them may add additives and plastic or wax coatings as well.
These modern practices, applied to the hundreds of thousands of other things on which we are dependent, are a result of popular American culture. We all do things because "its the thing to do," which is often what is most convenient in the rushed American lifestyle. Even health fads, such as diets and medical protocols, are a result of propaganda. The widespread use of antibiotics is the well-known cause of antibiotic-resistant bacteria and the not-so-popular fact that this practice is destroying our immune systems ability to work against these bacteria. Similarly, on the side of alternative medicine, overuse of antioxidants (used to clean up and reduce free radicals) actually can cause more free radicals and may be counterproductive. These are just two examples of how environmental illness can arise from popular culture, showing that everything we do as Americans can also have an effect on our health.
Almost everyone is aware of the problem of industrial environmental pollution. In the US, chemical dumping which pollutes the air, water and ground, although regulated by the EPA, is still permitted and produces an unacceptable level of pollution. Factory exhaust is difficult and expensive to filter. In a world where globalization is the trend, trade organizations control the actions of even superpowers like the US and the "deal with it later" attitude is easier than dealing with trade sanctions. Almost invariably, in a conflict between human health needs and industry, industry wins.
Dioxin. Food contamination is less known, but just as prevalent. A related problem has to do with animals, particularly those used for meat. Dioxinstoxic substances formed by burning of hazardous wastes and the breakdown of heated chlorine productsfind their way into the muscle and fat tissue of large food animals, which are in turn used for human consumption. Dioxin has been found to be one of the most toxic and carcinogenic chemicals ever tested, and has been found to cause cancer, endocrine and immune system damage, birth defects and learning disabilities. Dioxins can also alter glucose tolerance and liver enzyme levels, even with minimal exposure (Chrysalis 3). High dioxin levels are also found in fish and dairy products, including mothers milk, so a nursing baby gets a big dose of what the EPA considers one of the 10 most toxic chemicals in the environment today (EPA 2000). With dioxins are often found furans, of which some are equally toxic. The levels of these substances in animal tissues generally remain constant or increase with time.
The problem is so common that conscientious dairy farmers believe that as long as dioxin continues to be released into the environment, people should be advised to reduce or eliminate the consumption of meat and dairy products from their diets no matter what the source (Chrysalis 1). This is because people are under the impression that family farm grown and organic products DO NOT contain such poisons, but dioxins, as well as other poisons like herbicides and pesticides, are airborne and they often contaminate organic crops and livestock.
Genetic Engineering (GE). Genetic pollution results when wind, rain, birds, bees, and insect pollinators carry genetically altered pollen into adjoining fields, polluting the DNA of crops of organic and non-genetically engineered farms. There is little control for this type of contamination and genetically engineered foods, in general, have a history of causing numerous problems and concernshuman, environmental and economic (Cummins 3).
Monsanto and Aventis are the biggest genetic engineering or life science corporations (a multi-billion dollar industry). Opponents of GE claim that these companies intend to use GE to monopolize global markets for seeds, foods, fibers and medical products (in some areas they already do this). Although these companies claim that their products will make agriculture sustainable, eliminate world hunger, cure disease and vastly improve public health, both experiments and historical usage actually contradict such self-serving claims. Examples of the risks include a synthetic tryptophan supplement that killed 37 Americans and affected more than 5000 others with a potentially fatal blood disorder, eosinophilia myalgia syndrome (EMS). A splicing crossed potatoes with the snowdrop plant and a viral promoter, Cauliflower Mosaic Virus (camv), and turned out to be poisonous to mammals, damaging vital organs in rats and giving them the camv virus (Cummins 2).
You have food allergies you should be concerned because you never know what you may be eating. Highly allergic foods, such as nuts, have been spliced into commonly used foods. Genes of illegal crops (such as certain South and Central American varieties of corn not permitted in the US) have even been used for plants intended for use in this country. In addition, nutritional and health values, such as heart disease fighting and cancer reducing compounds, are sometimes sacrificed in the act of genetic manipulation. Antibiotic genes are spliced into almost every genetically engineered food, which contributes to the growing concern for antibiotic resistance. The environment suffers from the loss of beneficial insects, such as the monarch butterfly and ladybugs to which the GE corn is poisonous. Soil fertility is compromised when soil microorganisms are destroyed, and in contrast to the life science corporations initial statements, superweeds and superpests, resistant to the spliced herbicides and pesticides, also have developed (Cummins 2-3).
Perhaps the biggest concern is the unpredictable aspect of genetically engineered foods. No one knows the long-term effects of consuming such "frankenfoods" and they are all around us. Lab tests indicate that 60-75% of all non-organic supermarket foods test positive for the presence of genetically engineered food.
Steroids in Consumable Animals. In addition to genetic manipulation, companies develop steroids to "improve" animal products. Monsantos Bovine Growth Hormone (rBGH), used to increase milk production in cows, causes concern because the steroidal-type drug is stored in fat tissues and passed on through milk in the form of Insulin-Like Growth Factor (IGF-I), which when consumed by humans is stored in their tissues. Studies have shown that humans with high levels of IGF-I were more likely to get cancer, particularly of the breast, prostate and colon. In addition, rats developed thyroid cysts as well as various cancers. These statistics are so renowned that the United Nations food standards body has refused to certify rBGH as safe.
Steroids, along with antibiotics, have also been used in animals to increase their muscle mass and produce larger animals for greater profit without concern for human safety. This is discussed further below.
Antibiotics and Vaccinations in Human Beings
Each winter, millions of people suffer from the flu, a highly contagious infection. Fluthe short name for influenzais caused by viruses that infect the nose, throat, and lungs. It is usually a mild disease in healthy children, young adults, and middle-aged people, but the flu can be life-threatening to older adults and to people of any age who have chronic illnesses such as diabetes or heart, lung, or kidney diseases. The National Institute on Aging states that some people experience soreness, redness or swelling on the arm where the shot was given and some have moderate side effects such as headache or low grade fever for about a day after the vaccination (NIA 2000). But there are some risks of getting vaccines such as the flu shot, PVC7 or DPT that are not always mentioned by such vaccine advocates. These risks include the development of immunoreactions like Transverse Myelitis (which will be discussed in detail in Chapter 3), and the risk to people having a severe allergy to culture media.
The development of vaccinations, particularly those against childhood illnesses, are arguably one of the most significant medical achievements of the 20th century (Lesperance 1). There are, however, no less than 11 routine vaccinations that are given at various intervals to a majority of American children from birth through high school. Some of these vaccines have been found to contain unsafe amounts of mercury, contained in the preservative thimerosal, and which recently led to "thimerosal-free" vaccines in 2002. Rushed to the market too soon, some vaccines have caused terrible side effects, such as life-threatening bowel obstructions caused by a 2001 rotavirus vaccine (Mitchell 2). Research has also presented evidence that the rise in autism (556% in five years) was related to immune system impairment. And autism is just part of a spectrum of other such illnesses that are on the rise, including allergies, asthma, ADHD, learning disabilities and seizure disorders. Research indicates that the cause of the immune system turning against itself is its bombardment by multiple vaccines that overwhelmed the immature immune system of infants and toddlers. (Mitchell 2-3) This is, of course, only the beginning of problems these children must face, because other autoimmune illnesses with adult onset, like MS and SLE, still lurk in their future.
The overuse of antibiotics presents yet another problem for the immune system. The sheer number of pounds of antibiotics used in the United States alone in both humans and consumable animals is evidence of the concentration and overuse of these drugs. Seven out of ten Americans receive antibiotics when they seek treatment for illnesses such as cold or flu. It is interesting to note that health insurance politics play a major role in this because tests to confirm a bacterial infection, a culture test, often cost more than the antibiotic itself so doctors often prescribe them without a confirmation of such infections. Another problem with antibiotics is that once patients begin to feel better, they often stop taking their medication. When antibiotics have been taken for less then 10 days, the most susceptible bacteria have been killed off and the strong are left to flourish. These remaining bacteria are now resistant and in a 24-hour period one resistant bacterium can produce millions resistant offspring. Over time, this process has left us with bacteria resistant to most prescribed antibiotics (Beam). During 1992, 13,300 hospital patients died from a bacterial infection that resisted the antibiotics doctors fired at them. Some 20% of the nation's Gonorrhea is now resistant to one or more antibiotics. Twenty percent of TB patients now resist the drug Isoniazid, which is commonly used to treat the disease. In parts of the world where antibiotics are not available, people are forced to let their immune system fight off the bacterial infections so the immune systems of these people become resistant and not the bacteria. Interestingly enough, the incidence of environmental illness among such people is lower (Beam).
Antibiotics in Consumable Animals
As mentioned earlier, consumable animals have also contributed to this kind of resistance back in the first world. The Union of Concerned Scientists estimates that 26.6 million pounds of antibiotics are used on animals each year, but only 2 million pounds are used to treat sick animals. It may sound peculiar to use antibiotics therapeutically on animals, but it all goes back to the immunization theory. On factory farms, antibiotics have long been a justifiable means of preventing infection in chickens, as well as enhancing growth. Opponents of such use say that it contributes to the growing public health problem of resistance to disease causing bacteria in humans, but proponents, such as Perdues vice president of technical services Dr. Hank Engster, claim that they are "not using medically important antibiotics nontherapeutically that would be used in human medicine like penicillin, tetracycline and sulfonamides" and that they are in no way "contributing to antibiotic resistance in humans". (Burros) This, however, is a common misconception; the continual use of any antibiotics on bacteria makes them more resistant. Salmonella is perhaps the best example of this; over the past 5 years recent strains of salmonella have proved to be resistant to no less than 5 different antibiotics (Glynn, 1333). There is further concern because some strains are resistant to antibiotics of "last resort," the so-called fluoroquinolones, for which scientists believe there will be no substitute for at least a decade (Grady, A15). Whats more is that farmers searching in desperation for effective antibiotics are using Baytril, which is very similar to Cipro, the treatment for anthrax, an infection in which mortality is an issue. (Burros)
Similar drugs and antibiotics can be found in almost any edible livestock and there is no way for the consumer to know whether the animal has been treated with them, unless it happens to be labeled.
In this chapter, we can see how our environment is slowly deteriorating and that it will take at least as long to clean it up as it took to make it that way. That is, once we all realize to what extent the earth has been affected by our human existence and to what extent our materialistic desires and endless reproductive spiral have boomeranged. Perhaps the rising global concern with health can be paralleled by a similar growing concern with the deterioration of the natural environment. However, that concern is not yet big enough because not enough people have suffered and died to cause those responsible and those in power to launch a significant campaign to correct the misactions of the past.
CHAPTER 2 - THE REALITY OF ENVIRONMENTAL DISEASE
Now that we have learned about what in the environment compromises our health, this chapter will show a sample of the serious illnesses that result, explain why they can be considered environmental illnesses and propose some natural environmental solutions. This is necessary to show how serious a problem environmental illness is and why reversal of the environmental damage is the most logical way to fight it.
There is more than enough evidence to suggest that serious illness and disease arise from environmental factors. New diseases and higher incidences of existing diseases are being linked to ubiquitous pollutants and to the overall decline in environmental quality.
We are seeing serious diseases occurring in younger and younger people. For instance, take the rise in the number of children diagnosed with psychiatric problems, including ADHD and bipolarism. The Journal of the American Medical Association reported that the number of 2-to-4 year old children on Ritalin, antidepressants and other psychoactive drugs has increased dramatically from 1991 through 1995. As startling as that is, it merely illustrates the overall rise in use of powerful psychiatric drugs in children of all ages. (Shute 2000). This is a newer problem that some experts are relating to the environment, especially allergic reactions to food products.
But these startling statistics do not stand alone. Depletion of the ozone layer has been linked to cataracts. Life threatening lung disease, such as asthma, can be found in newborn children. Diseases such as MS and Lupus are striking down people in the prime of their life. Cancers attack the most innocent, those with no say and no ability to prevent or control what is a primary cause of their illness. These statistics are not only pointing to environmental contamination, but also show how our bodies, specifically our immune system, are losing the capacity to deal with such toxins.
Although it may sound drastic, and it may be far in the future, if we do not acknowledge the fact that our environment is deteriorating and do something about it, the future of humankind will likely be one of suffering. Knowing that someone we love could be the next victim, it is important for us who have some power to control our environment, to realize the extent, severity, and difficulty in treating environmentally caused diseases and to focus on lifestyle change on a global basis as our best defense.
The following sections elucidate some of the most prominent threats to our health and suggest some lifestyle changes, difficult as they may be, which may prevent or lessen the effects of these common environmental illnesses. Further prevention could be achieved with many of the commonsense theories of reducing and reversing damage caused by our declining environment.
Each year more than 50 million Americans suffer from allergic diseases (AAAAI 2001). Allergies are also on the rise, and with the increase in genetically altered food, mutated allergens have also come about. For example, peanut or tree nut allergies affect approximately 3 million Americans to cause the most severe food-induced allergic reactions, but genetic engineers do not take this into consideration and splice genes from these nuts into other food products. Experts estimate that food allergy occurs in 8 percent of children 6 years of age or under, and in 1 to 2 percent of adults (Sampson 1162). Approximately 100 Americans, usually children, die each year from food-induced anaphylaxis. (AAAAI 174 ).
Interestingly, food allergies generally arise out of an immune system reaction as well. In the field of immunotoxicology, which studies the adverse effects of occupational, inadvertent, or therapeutic exposure to environmental chemicals and biological materials, including drugs and antibiotics, researchers debate if such toxic agents damage the immune system and, if so, to what extent. Some researchers contend that certain chemicals can affect immunity, significantly increasing an individual's susceptibility to disease, and in some cases causing hypersensitivity reactions, autoimmunity, or immunosuppression. Others scientists dispute this view, arguing that the evidence for immunotoxicity in humans is greatly overstated (Glover-Kerkvliet).
But unknown allergens are not just in food; they are, in fact, everywhere. Another example is latexa synthetic, highly toxic, rubber-like compound found particularly in the healthcare and textile industries. Estimates of allergy to latex products in the general population vary widely, ranging from less than 1 percent to 6 percent. Moreover, individuals with existing allergies are at an increased risk of developing latex allergy (Poley 1054). Approximately 220 cases of anaphylaxis and 3 deaths per year are due to latex allergy (Neugut 16).
Less severe, but just as prevalent, atopic dermatitis is one of the most common skin diseases, particularly in infants and children. The incidence also appears to be increasing (Boguniewicz 1123). Adverse drug reactions account for 5 to 10 percent of all allergic reactions, with skin reaction being the most common form (AAAAI 2001).
Other drug reactions are also common. To use an earlier example, viruses for flu vaccines are grown in eggs and serious reactions may occur in people who are allergic to eggsto potentially prevent a viral infection they could live with, they may die from an allergic reaction. Penicillin is also a common cause of drug allergy. Anaphylactic reactions to penicillin cause 400 deaths annually among Americans, making penicillin allergy a more common cause of death than food allergy (Neugut 17).
Lastly, we hear more and more people complaining about sinuses and hayfever. Not surprisingly, chronic sinusitis is the most commonly reported chronic disease, affecting 12.6 percent of people (approximately 38 million) in the United States in 1996 (CDC 1996). The explanation could be the increasing number of allergens and mutation of allergens in the environment, which the immune system does not recognize, and subsequently overreacts to, causing reactions from mild to severe depending on an individuals predisposition to allergic reactions.
The most common treatment for allergic reactions are shots. Allergy shots, which contain a small amount of a specific allergen, relieve symptoms by helping the body fight the allergen, acting similar to a vaccination. The body makes antibodies to the allergen and these antibodies block its effects the next time you have contact with it. After a long series of shots, there may then be relief from allergy symptoms. However, if you have reactions to many allergens, this may require you may need many shots over many years, so this may not be a pleasant or reasonable solution to your problem. There is also a problem with such shots if your reaction to the allergen is severe, such as an anaphylactic reaction, or when the allergen is unknown; then a shot will not help. In the case of anaphylactic reactions, single or sometimes multiple injections of epinephrine may reduce the chance of death, but they must be administered promptly.
Another common approach is avoidance of highly allergic conditions and foods. For some people, avoidance of a single food appears to cure a majority of allergy symptoms. Wheat and gluten are considered two of the most highly allergic foods. As a matter of fact, immune responses to gluten, the protein found in cereal grains, are a common cause of or contributing factor to disease. When the gluten allergy affects the gastrointestinal tract, it is called celiac disease. And although the gastrointestinal tract is the primary target organ, systemic disease is an important consequence of cereal grain ingestion in many people. Diabetes, thyroid disease, anemia, rheumatoid arthritis, sacroileitis, sarcoidosis, vasculitis, lung disease, myositis, eye inflammation, and schizophrenia, all of which are on the rise, are also linked to gluten allergy. Because in wheat and other grains much genetic manipulation has occurred, the theory of allergy due to unknown or mutated allergens makes a great deal of sense and gives a clue as to why these diseases may be on the rise.
An allergic reaction may also result in an asthmatic attack. Asthma can be a very serious condition in which an acute attack can lead to death in a matter of minutes. Asthma is a chronic lung condition that has two main components: (1) constrictionthe tightening of the muscles surrounding the airways, and (2) inflammationthe swelling and irritation of the airways. Narrowing of the airways caused by an asthma attack may result in symptoms such as wheezing, coughing, chest tightness, or shortness of breath. There is also increasing evidence that, if left untreated, asthma may cause long-term loss of lung function.
Each year, nearly 500,000 Americans are hospitalized and more than 5,000 die from asthma and according to the National Institute on Asthma and Infectious Disease asthma is on the rise (NIAID 2001). One theory behind this rise in asthma is that people today are spending more time indoors where they are exposed to more indoor allergens, such as dust mite allergen. Another reason may be that people today live in cleaner, more sanitary conditions than they did before the industrial revolution, relatively free of disease-causing viruses and bacteria, which affects our immune system, so perhaps our immune systems has lost some of its ability to fight off infections and likewise some of its ability to fight off allergens, as well. Other theories as to factors that may be leading to the increase in asthma include increased levels of air pollutants, a decline in the amount of exercise people get, or rising obesity.
Although asthma afflicts 17 million Americans, including 5 million children (NIAID 2001), American research on asthma and its potential environmental link is fragmented and inadequate for collecting the kind of nationwide data that are needed to truly understand how often, in what locations and why this disease occurs. Without information like this, it is difficult to grasp the magnitude of the problem we face and how to prevent it. Although more research must be done, at this time it is appropriate to take measures to recognize allergens and eliminate them in order to decrease the seriousness and mortality of environmentally triggered asthma.
An Australian report, although it did not elaborate on the evidence that environmental factors were the main causes of asthma in children and adults, did state that certain environmental factors, including allergens, viral infections and some forms of air pollution, had a substantive impact on exacerbation and severity of symptoms in people with asthma. The researchers also compiled evidence and made recommendations regarding effective interventions to prevent or reduce exposure to environmental allergens that are associated with the development of asthma and exacerbation in people with asthma.
The study emphasized that primary prevention was the most important factor halting the onset of the disease and avoiding adverse outcomes in those who have the disease. Primary prevention included: (1) elimination of the house dust mite (HDM) and the conditions which make it proliferate, including dampness, mold and dust (which are also allergens); (2) eliminating indoor pollutants, such as smoke, as neither air filters nor ionizers appear to be effective at substantially reducing such indoor pollutants; and (3) a low salt, low fat diet, abundant with fruits and vegetables (organic preferred) rich in antioxidants is recommended which is generally recommended to boost the immune system. Secondly, like other allergic reactions, allergy shots are also recommended for prevention of future asthma attacks.
The study also emphasized some other important facts. Occupational exposures are important in the etiology of adult-onset asthma and primary prevention requires recognition of occupational allergens and stringent application of industrial safety measures. Exercise-induced asthma, common in both adults and children, may be related to prior exposures and attacks caused by reduced lung capacity in a situation where greater capacity is required.
We can see that there are indications that asthma, like allergic reactions, is the result of a misguided immune system. The logical, and often recommended, treatment for such conditions is removal of allergens from the sufferers immediate environment, a good immune system boosting diet, and allergy shots. Since two of the focal points of treatment relate to the immune system, it is difficult for even doctors to deny that the immune system is the primary cause of allergic reactions.
Cancer develops when cells in some part of the body begin to grow out of control. Although there are many kinds of cancer, they all start because of this unregulated growth of abnormal cells. Where normal cells have a limited life span, cancer cells continue to grow and divide. Instead of dying, they outlive normal cells and continue to form new abnormal cells. These abnormal cells spread and replace normal tissue and sometimes metastasize to other tissues in the body. Cancer cells probably develop because of damage to DNA, which directs the activities of each cell. Most of the time when DNA is damaged the body is able to repair or replace it. In cancer cells, however, the damaged DNA is not repaired.
Generally there are three theories for the etiology of cancer: people can either inherit damaged DNA, which accounts for inherited cancers; or many times a persons DNA becomes damaged by exposure to something in the environment, like smoking or toxic exposure (ACS 2002). There is also a third view, which may be used in conjunction with the other theories, that some people have DNA that is predisposed to damage from the environment.
In the past 15 years, the explosion of molecular genetics has overshadowed environmental explanations for cancer. This is why there is current confusion about environmental and genetic risk factors for cancer. However, a Scandinavian study showed that in general, environmental factors were the dominant determinants of the site-specific risk of cancer. For cancer at four of the five common anatomical sites (lung, prostate/breast, colon, pancreas, lymphnodes), estimates of the proportion of risk due to environmental effects rather than genetic were all 65 percent or greater.
Outside of cigarette smoke, contaminated air and water, and occupational exposure, contaminated foods are probably a common source of such toxic exposure. For example, Aflatoxin is produced by several different molds that grow on food and grains when less than ideal storage occurs. Unfortunately, unsafe food storage and preparation is a problem even in modern times and in technologically advanced countries such as the US. Aflatoxin has been shown to cause 97% incidence of hepatic cancer in Rainbow Trout, even when given in small amounts. (HEAL 2002). Aflatoxin should therefore be treated as a threat to humans, as well as lower animals.
In addition, many pesticides and herbicides have long been known as carcinogenic and yet many people eat fruits and vegetables without washing them first. Wax coatings used to preserve fruit while in transit may actually trap pesticide and herbicide residues on the skins. As mentioned earlier, meat and poultry contain antibiotics, steroids and dioxins, which have either known carcinogenic or untested properties. For further cancer prevention related to diet, more consideration should be given to food treatment and preparation.
Over half a million Americans are expected to die from cancer in 2002, that is more than 1,500 per day, and over 1.3 million new cases are expected to be diagnosed in 2002 (ACS 2002). Cancer is the second leading cause of death in the United States. Half of all men and one-third of all women in the US will develop cancer during their lifetimes (ACS 2001). Most people cannot go through life without cancer affecting them or someone they are close to. But there are ways to lower the incidence of cancer. The Cancer Prevention Coalition, Inc. (CPC), an organization with a mission to fight for a safer environment at home, at work and in the community, is made up of leading independent experts in cancer prevention and public health, together with citizen activists and representatives of organized labor, public interest groups, and environmental and women's health groups. The CPC strives to reduce escalating cancer rates through a comprehensive strategy of outreach, public education, advocacy and public policy initiatives to establish prevention as the nation's foremost cancer policy (CPC 2002). Their belief is that most cases of cancer, even genetically transmitted cancers, are caused by toxic exposures, many of which are preventable.
A healthy lifestyle is the number one way to prevent such disease. Well-washed and properly prepared foods, rich in fruits and vegetables and low in fat, as well as regular exercise, are advocated by most health care professionals. But awareness of all environmental dangers and avoidance of these contaminants are the best ways to prevent exposure diseases such as cancer.
Autoimmune diseases, such as MS and lupus, are also on the rise in the U.S. MS is characterized by weakness, paralysis, tingling or numbness of the limbs, loss of vision from one or both eyes, double vision (both optic neuropathy), imbalance, incoordination, slurred speech, impaired bladder and bowel control, chronic pain, and profound fatigue. Although many other neurologic illnesses have similar symptoms, the tendency of the symptoms to spontaneously disappear (remit) and recur in multiple locations is characteristic of MS. Exercise or increases in body temperature may exacerbate symptoms. This phenomenon, relatively specific for MS, is attributed to interruption of signals at points where nerve fibers are denuded of their myelin-insulation (Riskind 1).
MS is a common neurologic illness, affecting approximately 300,000 Americans. It strikes otherwise healthy young men and women and is the second most common neurologic cause of disability of young adults (after head trauma) in the United States. In 2/3 of patients diagnosis is made between ages 20 and 40 and MS is rarely seen in young children or the elderly (Riskind 1). MS is a disease of civilized man, making its first appearance about 75 years ago, and like many other diseases of our modern age, it is a disease of an overactive and misdirected immune system, wherein the immune system mistakenly recognizes normal brain and spinal cord tissues as "foreign" and attacks them, resulting in inflammation and damage. The specific reasons for this are unclear, but a prominent theory traces the condition to heavy metals like mercury, lead and aluminum as the agents that might replace normal molecules in the myelin sheaths. The immune system now sees this tissue as foreign, because of the replacement of heavy metals, and produces antibodies that attack the myelin, leading to further damage. So, when heavy metals are in body tissues, there is free radical destructive activity going on constantly. Rapid aging and degeneration are the results.
Although there is a variety of indications for MS, when lesions form (clinical deficits such as optic neuritis, myelitis, brainstem (sensory) affection, and others) due to such myelin destruction, generally in multiple locations at different times in the course of the illness, and provided that other causes are excluded, it may then be considered MS. (See images below.)
|CT scan of the brain of an individual with MS. There are lucent (white and airy) areas around the lateral ventricles (large dark areas in the center) representing multiple sclerosis plaques. The normal age range for this disease is young adulthood 20's to 40's, Source: NINDS 2001.|
Note in this image around the ventricles of a normal brain
there are no lucent areas. Source: Siemens/Springfield
Technical Community College, Springfield, MA, 2001
|The sunken grayish areas around the ventricles representing old lesions. Source: NINDS, 2001|
View of normal brain with no lesions. Source: University of Florida College of Medicine, 2001.
The central nervous system (CNS) operates through something like the electrical impulses that control what a computer does. Since MS is a disorder affecting nerve cells, it only makes sense that there may be a connection between MS and heavy metal toxicity causing free radical damage in the CNS. Add this to an already compromised immune system due to other environmental factors and the difficulties in treating this disease become understandable.
Although there are many theories for the etiology of this disease, including the environment, autoimmune deficiency, and heredity, and one would suspect various treatment options, effective treatments are in fact limited. Corticosteroids, Cytoxan and other immunosuppressive drugs all have been used. Beta interferon is presently being used in more acute cases. However, to develop effective treatment, or possibly a cure for MS, scientists believe that large studies are still needed to be evaluated over long periods because of the tendency for the disease to have natural remissions.
Evidence indicates that many people have achieved either a permanent remission or a significant slowdown in disease progress through dietary changes and elimination of hypersensitive foods. The most common foods that result in immune reactions and eventual MS are dairy, cereal grains, eggs, yeast and legumesall foods which have been introduced into the human diet relatively recently and are genetically difficult to tolerate for some individuals. Most of these foods are also, as previously indicated, the most affected by environmental toxins, over-use of antibiotics and genetic engineering.
The focus of the most recent studies are on the "genetic" connection to MS. Although, Multiple Sclerosis is not an inherited disease, it does occur more often in families with a history of it. Research is needed to see if families may share common genes that make the members more likely to get the disease. If there is a connection, the knowledge gained from genetic research will be essential if researchers are to design therapies aimed at controlling the genes that could make people more susceptible to MS. (Sandovnick)
MS running in families could be attributed to environmental conditions as well. Evidence has been found to show that heart disease, gall bladder disease and high blood pressure also run in families and can be linked to diet. It makes sense that families with the same genes and the same diets, living in the same environments are susceptible to the same illnesses. When this is taken into consideration in such situations, there are indications for some of these "idiopathic" illnesses and diseases.
Systemic Lupus Erythematosus
Like MS, Systemic Lupus Erythematosus (SLE) is a chronic, usually life-long, potentially fatal autoimmune disease characterized by unpredictable exacerbations and remissions. Like in MS, in SLE the immune system loses its ability to tell the difference between foreign substances and its own cells and tissues. The immune system then makes antibodies directed against those tissues.
SLE affects many tissues in the body, including the joints, kidneys, heart, lungs, brain, blood, and skin. Patients report such symptoms as achy joints (arthralgia), frequent fevers, arthritis, prolonged or extreme fatigue, skin rashes including butterfly-shaped rash across the cheek and nose, anemia, kidney problems, pleurisy, photosensitivity, hair loss, blood clotting problems, Raynauds syndrome (fingers turning white or blue in the cold), seizures and mouth and nose ulcers. (LFA 2001)
SLE is characterized by immune "dysregulation" resulting in the over-production of antinuclear antibodies (ANA)--antibodies that work against the body. The production of ANA leads to the formation of circulating immune complexesmacromolecules that are deposited in target tissues causing the various initial symptoms of the disease. The body may then recognize this tissue as foreign. Subsequently, a complement system is activated to attack the "foreign tissue," thereby accelerating the disease by destroying connective tissues. Immune complexes can be deposited in glomeruli (parts of the kidneys), skin, lungs, synovium, mesothelium, among other places. Many SLE patients develop renal complications. The most prominent symptom of the disease is recurrent, widespread vascular lesions.
Treatment is based upon the specific needs and symptoms of each person. Because of the significant variance in characteristics and course of lupus among individuals, a thorough medical evaluation and ongoing medical supervision are essential to ensure proper diagnosis and treatment. Depending on the organs involved, and the severity of the condition, patients with lupus may be prescribed a variety of medications: non-steroidal anti-inflammatory drugs (NSAIDs) for inflammation and pain, acetaminophen for pain, corticosteroids for inflammation and organ involvement, anti-malarials (drugs prescribed for malaria) for immunoregulation and blood disorders, and immunomodulating drugs are the most commonly prescribed. (LFA 2001)
Women and minorities are disproportionately affected and SLE is most common in women of child-bearing age, although it has been reported in both extremes of life (i.e., diagnosed in infants and in the tenth decade of life). Its prevalence in the Unites States had been estimated as approximately 500,000 but a recent telephone survey commissioned by the Lupus Foundation of America suggests that it may affect as many as 2,000,000 (LFA 1998). A recent study identified a prevalence of 500 per 100,000 (1:200) in women residing near Birmingham, Alabama. This concentrated incidence again suggests environmental causation.
A correlation between SLE and environmental factors can be found in a recent Russian study which should direct impairment of organs and tissues of SLE patients via a damaged immune system as a result of exposure to chemical pollutants (Ter Arkh 2000). In addition there is proof that lupus may be drug-induced. Lupus occurs after the use of certain prescribed drugs, such as certain hypertension and arrhythmia drugs, the symptoms of which are similar to systemic lupus (LFA 2001). Although a small percentage of individuals using these drugs develop drug-induced lupus, the symptoms usually fade when the medications are discontinued, which indicates that such conditions may be reversed if toxins are removed from the patients system.
MS and Lupus are autoimmune diseasesdiseases caused again by a misdirected immune system. This is an unquestionable fact. When added to allergies, asthma, celiac disease, thyroid disease, diabetes and cancer, a pattern should be obvious that we do have a problem in regard to the breakdown of our immune system and linked to the environment. It is easy to shrug this suggestion off, even after this argument, until tragedy someone you love. Imagine an idiopathic asthma attack in which your young child turns blue, struggling for air and you have mere seconds to save her life. Or imagine that your 20-year-old sister is diagnosed with lupus and given an abbreviated life span. Or your husband goes into anaphylactic shock from eating popcorn which has been genetically spliced with a Brazil nut and he again has only seconds to get an epinephrine injection. Or your 4-year old nephew is diagnosed with leukemia, or a brain tumor or juvenile diabetes and all you can do is ask why?
For each new allergen that enters our body, the immune systems must identify the allergen and make an antibody to fight it. However, for some people, mutated allergens may present a problem for the body and that is why their immune systems become misdirected and causes disease or severe reaction. Avoidance of such allergens, as well as returning to the natural, pure or organic, seems to be the most logical way to avoid and perhaps reverse the damage caused by this attack. What does not seem appropriate is using other synthetic chemicals and drugs to temporarily relieve symptoms temporarily. It appears that the immune system has been debilitated enough and it is time to discard solutions that only further misdirect it. Human beings should be part of the natural environment, but technology has altered that environment so that natural connections are not only broken (such as our ability to consume uncontaminated food), but reconnection can never reoccur or is a long way away. Is it now obvious that humans have disturbed their own ecosystem so that their health is suffering?
CHAPTER 3 TRANSVERSE MYELITIS
This chapter analyzes the symptoms, progression and origin of Transverse Myelitis. This illness has had a significant affect on my life and I know that until one sees first hand the effects of this disorder, it is difficult to comprehend its devastating toll. This chapter also begins to show that western medicine is struggling to treat TM, which in turn demonstrates that alternative treatment modalities may be in order.
Another related disease, Transverse Myelitis (TM), one of 6000 rarest disorders listed by the National Institute of Neurological Disorders and Stroke (NINDS) and one of the few not genetically caused, is a relatively new disorder, with the first cases having been reported in the early fifties. But it has been on the rise since the late 1960s, affecting people of not only every race, gender and age, but of many health backgrounds.
This disorder is strange in itself because there are many ways by which someone may acquire it. MS and SLE have been elaborated on in this paper precisely because both occasionally manifest the disorder TM. But strangely, such a distinct disorder can also be manifested by people who suffer from AIDS, syphilis or cancer, or those who have had the flu shot or other immunizations, chicken pox, rare diseases such as Devics Disease. Some TM patients have no underlying disease or cause at all.
Doctors and researchers often relate TM to immune system dysfunction. But this causation covers a broad range of illnesses with even more underlying causes. I myself have an atypical type of TM with no known underlying cause, nor any indication of immune system dysfunction. Further, no immune system dysfunction drug, including interferon and steroids, has been effective in treating me. It was ultimately my immune system, in combination with systematic detoxification (which will be discussed in a later chapter) that resolved the initial bout and four later recurrences.
TM is a terrible, sometimes devastating disorder, the cause of which eludes doctors to this day. Treatment involves alleviation of symptoms, but to date, there is no cure. It is my theory, however, that TM stems from system toxicity, perhaps more so in predisposed individuals, but is still caused by environmental factors.
Transverse myelitis is a neurological disorder characterized by inflammation across both sides of one level, or segment, of the spinal cord. The term myelitis means an inflammation of the myelin sheath, the fatty insulating substance that covers nerve cell fibers. The spinal cord is a bundle of nerve cells each surrounded by myelin. Myelitis in this respect refers to inflammation of the myelin of the spinal cord; transverse simply describes the position of the inflammation, that is, across the width of the spinal cord (Tabor 1999). Bouts of inflammation can damage or destroy myelin. This scars the nerve tissue thereby interrupting communication between the nerves in the spinal cord and the rest of the body.
Symptoms of transverse myelitis includes a loss of spinal cord function that may evolve over several hours (acute) to several weeks (subacute). Initial symptoms usually include localized lower back pain, sudden paraesthesias (abnormal sensations such as burning, tickling, pricking, or tingling) in the legs, sensory loss, and paraparesis (partial paralysis of the legs). Paraparesis often progresses to paraplegia (paralysis of the legs and lower part of the trunk). This may also occur on one side of the body below the affected area of the spinal cord and is called hemiparesis. Many patients also report experiencing muscle spasms, a general feeling of discomfort, headache, fever, and loss of appetite. Depending on which segment of the spinal cord is involved, some patients may experience respiratory problems as well.
From this wide array of symptoms, four classic features of transverse myelitis emerge that are essentially the symptoms used for diagnosis (particularly for idiopathic cases): (1) weakness of the legs and arms, (2) pain, (3) sensory alteration (dysaethesia), and (4) bowel and bladder dysfunction.
Most patients experience weakness of varying degrees in their legs; some also experience it in their arms. Initially, people with TM may notice that they are stumbling or dragging one foot or that their legs seem heavier than normal. Hand and arm coordination and strength may also be compromised. Over several weeks, the disease often leads to full paralysis of the legs, requiring the use of a wheelchair.
Pain is the primary presenting symptom of transverse myelitis in approximately one-third to one-half of all patients. The pain may be localized in the lower back or may consist of sharp, shooting sensations that radiate down the legs or arms or around the torso. Pain may also be associated with sensory disturbances.
Patients who experience sensory disturbances often use terms such as numbness, tingling, coldness, or burning to describe their symptoms. Up to 80 percent of those with transverse myelitis report areas of heightened sensitivity to the touch of things such as clothing or another person (a condition called allodynia). Many also experience heightened sensitivity to changes in temperature or to extreme heat or cold (NINDS 2000).
Bladder and bowel problems may involve increased frequency of the urge to urinate or have bowel movements, incontinence, difficulty voiding, sensation of incomplete evacuation, and constipation. Over the course of the disease, the majority of people with transverse myelitis will experience one or several of these symptoms.
People living with permanent disability may feel a range of emotions, from fear and sadness to frustration and anger. Many individuals report a profound sense of loss (even those who have not yet had a definite diagnosis), as if someone close has passed away. Such feelings are natural, but they can also jeopardize health and potential for functional recovery. Those with permanent disabilities frequently experience clinical depression (MacQueen 2001). Fortunately, depression is partially treatable, due to the development of a wide range of psychotherapeutic medications.
Course of the Disease
Although some patients recover from bouts of the disease with minor or no residual problems, a majority suffer permanent impairments that affect their ability to perform ordinary tasks of daily living. Most patients will suffer only one episode of transverse myelitis, but a small percentage may have a recurrence, similar to relapsing-recurring MS.
The segment of the spinal cord at which the damage occurs determines which parts of the body are affected. Nerves in the cervical (neck) and the upper thoracic (upper back) regions control signals to the neck, arms, hands, and muscles of breathing (the diaphragm). Nerves in the mid and lower thoracic region relay signals to the torso and some parts of the arms. Nerves at the lumbar (mid-back) level control signals to the hips and legs. Finally, sacral nerves, located within the lowest segment of the spinal cord, relay signals to the groin, toes, and some parts of the legs.
Damage at one segment will affect function at that segment and some segments below it. This occurs because impulses sent from the brain to various parts of the body and vice versa are interrupted by the inflammation, lesions and subsequent scarring. For example, if there is inflammation at the neck, sensory nerves in the hand may not register the heat of a hot pan quickly enough to relay the message to the brain which would in turn cause the hand to move away or off the pan before the tissue is injured. Likewise, if this lack of sensation were at the thigh or the abdomen, the inflammation would be between the sensory area and the brain and cause the same delay in response (or, in some severe cases, no response at all). In most cases of transverse myelitis, demyelination usually occurs at the thoracic level, causing problems with leg movement and bowel and bladder control, which require signals from the lower segments of the spinal cord.
Recovery from transverse myelitis usually begins within 2 to 12 weeks of the onset of symptoms and may continue for up to 2 years. However, if there is no improvement within the first 3 to 6 months, significant recovery is unlikely. About one-third of people affected with transverse myelitis experience good or full recovery from their symptoms, regaining the ability to walk normally and experiencing minimal urinary or bowel effects and parasthesias. Another one-third of patients show fair recovery and is left with significant deficits such as spastic gait, sensory dysfunction, and prominent urinary urgency or incontinence (John Hopkins 2001). The remaining one-third show no recovery at all, remaining wheelchair-bound or bedridden with marked dependence on others for basic functions of daily living. Although making predictions about individual cases is difficult, research has shown that a rapid onset of symptoms generally results in poorer recovery.
The majority of people with this disorder experience only one episode, although in rare cases recurrent or relapsing transverse myelitis does occur. Some patients recover completely, then experience a relapse. Others begin to recover, then suffer worsening of symptoms before recovery continues. In all cases of relapse, physicians will likely investigate possible underlying causes such as MS or SLE since most people who experience relapse, but not all, have an underlying disorder.
Incidence of Transverse Myelitis
TM occurs in adults and children, in both genders, and in all races. It does not appear to have a familial link. New cases appear to occur primarily between the ages of 10 and 19 years and 30 and 39 years. Although only a few studies have examined incidence, it is estimated that about 1,400 new cases of transverse myelitis are diagnosed each year in the United States, and approximately 33,000 Americans have some type of disability resulting from the disorder (NINDS 2000).
Etiology of Transverse Myelitis
Researchers are uncertain of the exact causes of transverse myelitis. The inflammation that causes such extensive damage to myelin and nerve fibers of the spinal cord may result from viral infections, abnormal immune reactions, or insufficient blood flow through the blood vessels located in the spinal cord. Transverse myelitis also may occur as a complication of syphilis, measles, Lyme disease, and some vaccinations, including such common childhood vaccinations as chickenpox and rabies. Transverse Myelitis may also result from a spinal injury or, as in a recent case, subsequent to an epidural or spinal anesthetic given during childbirth. A majority of the cases however, remain idiopathic.
Some verified cases of transverse myelitis result from spinal arteriovenous malformations (abnormalities that alter normal patterns of blood flow) or vascular diseases such as atherosclerosis that cause ischemia, a reduction in normal levels of oxygen in spinal cord tissues. Ischemia can result from bleeding (hemorrhage) within the spinal cord, blood vessel blockage or narrowing, or other less common factors. Blood vessels bring oxygen and nutrients to spinal cord tissues and remove metabolic waste products. When these vessels become narrowed or blocked, they cannot deliver sufficient amounts of oxygen-laden blood to spinal cord tissues. When a specific region of the spinal cord becomes starved of oxygen, or ischemic, nerve cells and fibers may begin to deteriorate relatively quickly. This damage may cause widespread inflammation, sometimes leading to transverse myelitis. Most people who develop the condition as a result of vascular disease are past the age of 50, have cardiac disease, or have recently undergone a chest or abdominal operation.
Transverse myelitis often develops following viral and bacterial infections. The viruses suspected of causing transverse myelitis include varicella zoster (the virus that causes chickenpox and shingles), herpes simplex, cytomegalovirus (CMV), Epstein-Barr, influenza, echovirus, human immunodeficiency (HIV), hepatitis A, and rubella. Bacterial skin infections, middle-ear infections (otitis media) and Mycoplasma pneumoniae (bacterial pneumonia) have also been associated with the condition. (Johns Hopkins 2001). However, a specific viral or bacterial infection is difficult to pinpoint and therefore such etiology in most cases remains unverified.
In post-infectious casesthat is those in which the actual bacteria or virus have been killed off by antibiotics, antiviral agents and the immune system, immune system mechanismsrather than active viral or bacterial infections, appear to play an important role in causing damage to spinal nerves. Although researchers have not yet identified the precise mechanisms of spinal cord injury in these cases, stimulation of the immune system in response to infection indicates that an autoimmune reaction may be responsible. In autoimmune diseases, the immune system, which normally protects the body from foreign organisms, mistakenly attacks the bodys own tissue, causing inflammation and, in some cases, damage to myelin within the spinal cord.
Because some affected individuals also have autoimmune diseases such as systemic lupus erythematosus, Sjogrens syndrome, and sarcoidosis, some scientists suggest that transverse myelitis may also be an autoimmune disorder. In addition, some cancers may trigger an abnormal immune response that may lead to transverse myelitis.
An acute, rapidly progressing form of transverse myelitis sometimes signals the first attack of multiple sclerosis (MS), however, studies indicate that most people who develop transverse myelitis do not go on to develop MS. Patients with transverse myelitis should nonetheless be screened for MS because they require different treatments (Weinshecker 39-40).
Western physicians diagnose transverse myelitis by recording symptoms, taking a medical history and performing a thorough neurological examination. Because there are so many possible causes, pathology of TM is not the same in all patients. In some, the neurons seem to be normal in appearance and number, while the supporting cells that myelinate these nerves are damaged. In others, there is widespread damage and necrosis (death) of all the cells within the area of injury. And, because it is often difficult to distinguish between a patient with an idiopathic form of transverse myelitis and one who has a known underlying condition, physicians must first eliminate potentially treatable causes of the condition. If a spinal cord injury is suspected, physicians seek first to rule out lesions (damaged or abnormally functioning areas) that could cause spinal cord compression. Such potential lesions include tumors, herniated or slipped discs, stenosis (narrowing of the canal that holds the spinal cord), and abscesses. To rule out such lesions and check for inflammation of the spinal cord, patients often undergo magnetic resonance imaging (MRI), a procedure that provides a picture of the brain and spinal cord. Physicians also may perform myelography, which involves injecting a dye into the sac that surrounds the spinal cord. The patient is then tilted up and down to let the dye flow around and outline the spinal cord while X-rays are taken to visualize any abnormalities such as slipped disks or stenosis.
Blood tests may be performed to rule out various disorders such as SLE, HIV infection, syphilis and vitamin B12 deficiency. In some patients with transverse myelitis, the cerebrospinal fluid that bathes the spinal cord and brain contains more protein than usual and an increased number of leukocytes (white blood cells), indicating possible infection. A spinal tap may be performed to obtain fluid to study these factors.
If none of these tests suggests a specific cause, the patient is presumed to have idiopathic transverse myelitis. For such a patient, there are always questions. Why do I have TM? Why arent there more treatment options? And, will there ever be any answers for me? For this patient, there may be no hope unless physicians start looking to the natural world for answers.
From this chapter, we can see the devastating toll TM can have on lives of individuals. Because TM is often a side effect of diseases like Lupus and MS, it stands to reason that if they are often triggered by environmental factors, so is TM. Further, because TM regularly occurs in adults and children, in both genders, and in all races, it is different from MS and SLE, which is a good indication that there is some gross factor that is causing it. At this point, we are well aware that the immune system has been compromised through environmental contamination, and this leaves the general population at a great risk for advantageous infections and diseases. Because TM has been steadily on the rise, this would make it even more probable that environmental factors play a part in the increase in frequency of this disorder. However, very little research has been done in this area with regard to TM. Prevention and a cure, therefore, may elude scientists until they view the environment as a serious propagator of transverse myelitis.
CHAPTER 4 - WESTERN TREATMENT MODALITIES OF TM
The following chapter reviews various western treatment options for Transverse Myelitis and future prospects for treatment. It will also show that research has not emphasized finding a "cure" but rather symptom relief, nor has it addressed the possibility of environmental causation..
Physicians in the Hippocratic-Galenic tradition were pledged to restore the balance or "health" of their patients constitutions but forbidden to use their skills to deal with death. Doctors had to accept natures power to dissolve the healing contract between patients and physicians, and allow them to die at natures command. But as technology grew, so did the curiosity and invention of physicians. Over one hundred years ago, Louis Pasteur stated, "Whenever I meditate on a disease, I never think of finding a remedy for it, but rather a means of preventing it." (Pasteur 1898). Doctors today are taught to consider themselves responsible for life from the moment of conception to the time of organ harvest. When a disease or condition escapes them, they not only feel responsible, but they are also determined to find a solution to the problema treatment, and if possible, a cure.
However, in the case of TM, there has been little progress toward a cure. And despite the fact that many years have elapsed since the initial cases, treating symptoms still involves a great deal of trial and error. In cases such as mine, as I am certain there are others, treatment has invariably been wrong. But before we look at the errors physicians may be making in the treatment of TM, we have to know what they are doing to treat it, to what extent such treatments are effective, and whether there are any side effects.
Western physicians often try the old and reliable before they try something new. Then again, propaganda campaigns launched by pharmaceutical companies often urge doctors to try new, improved and often under-tested drugs that may have undesired side effects. Synthetic drugs, versus being drawn from nature, can also have devastating effectsas evidenced by the used of thalidomide in the 1950s and 60s. Although drug testing has come a long way since then, the long-term effects of certain drugs, particularly of new drugs, are far from being known.
In addition to new drugs, we shall see that new techniques are being used and to some degree have been successful in treating the symptoms of TM. However, because such treatments are for symptoms, and are not a cure, and because the treatments may be somewhat debilitating themselves, the use and relative effectiveness of such treatments must sometimes be balanced with the patients desires for quality of life.
Treating the Symptoms
As with many disorders of the spinal cord, no effective cure currently exists for people with transverse myelitis. Treatments are designed to manage and alleviate symptoms and largely depend upon the severity of neurological involvement. Bed rest is recommended during the initial days and weeks of onset of the disorder. Therapy generally begins by treating the underlying problem, if known. Antiviral agents, antibiotics or immunosuppression drugs may be administered depending on the underlying disease or condition. To decrease inflammation, during the first few weeks of illness physicians may prescribe corticosteroid therapy regardless of the underlying condition. Although no clinical trials have investigated whether corticosteroids alter the course of transverse myelitis, these drugs often are prescribed to reduce immune system activity because of the suspected autoimmune mechanisms involved in the disorder. Corticosteroid medications that might be prescribed may include methylprednisone or dexamethasone.
Sexual dysfunction, particularly for males, is a common symptom of TM, and is often treated with sildenafil, a medication for erectile dysfunction. In sildenafil, nitric oxide activates the enzyme guanylate cyclase, which causes increased levels of guanosine monophosphate (cGMP) and subsequently smooth muscle relaxation in the corpus cavernosum and allowing inflow of blood. (PDR 2002)
Many TM patients are screened for osteoporosis, even if they are young, because the reduction or loss of weight-bearing, particularly on the lower extremities, may result in accelerated bone density decrease. A DEXA scan followed by treatment with calcium and Vitamin D and consideration of bisphosphonate treatment, diminishes the likelihood of fracture and further deterioration of bone density.
For bladder dysfunction, uro-dynamic testing is often performed and followed with continence improving medications such as tricyclic antidepressants (Elavil). Some patients also report significant improvement in terms of muscle strength and bladder function with the use of Fampridine (4-AP). This drug is a potassium-channel blocker that inhibits the repolarizing current in neurons; however, Fampridine can have serious side effects in some people (Kerr).
Pain or dysesthesias are the most debilitating long-term problems in approximately 40 % of TM patients (Kerr). Scientists have yet to fully grasp the intricate interplay of nerves and interconnections in the brain that produce the experience called pain. Neuropathic pain, inflicted by nerve damage, can be ferocious and extremely hard to control. Prolonged pain can cause changes in the CNS, shutting down circuits that might otherwise moderate pain and activate others that can prolong it (MacLeans 54). Therefore, it is sometimes difficult to control the pain experienced with TM without using strong pain medications that affect movement, emotions, personalities, and sleep cycles. Therefore, efforts need to be made on the part of the treating physician to make the patient aware of side effects and know the patients preferences before prescribing pain medications. Neuropathic pain in TM can be very difficult for patients to deal with on a personal level as well. They may have to choose between being a "zombie" or living with the pain. Currently, symptoms are often managed by treatment with gabapentin or carbamazepine (anticonvulsants with an unknown mechanism [PDR 2002]), nortriptyline (tricyclic antidepressant used to treat neurologic pain [PDR 2002]), or tramadol (analgesic with an unknown mechanism [PDR 2002]). Narcotics (opiates) are usually no more effective than these other medicines and can cause constipation and urinary retention and are not often used. Intrathecal opiates are occasionally given in an implantable pump offering significant relief with fewer of these side effects. Constipation is often a problem when using pain medications and laxatives are often prescribed. For dysesthesias, TENS units may be applied to a local area with significant relief of discomfort (Kerr).
Virtually all patients with TM experience spasticity, which affects and often limits the extent of recovery. Stiffness, tightness or painful spasms, often in the buttocks and legs, limit ambulation. A number of drug therapies may be employed to limit and improve spasticity. Baclofen (skeletal muscle relaxant inhibiting release of amino acids at synapses [PDR 2002]) is often the first line therapy and is effective in approximately 60% of individuals (Kerr). Unfortunately, fatigue and muscle weakness are common potential side effects. Tizanidine is a medication that presynaptically inhibits motor neurons in the spinal cord, and more specific for interneurons than is Baclofen and is less likely to cause muscle weakness, although fatigue is still a common side effect. Diazepam (anticonvulsant, skeletal muscle relaxant by way of presynaptic inhibition [PDR 2002]) is used in patients when neither Tizanidine nor Baclofen moderates spasticity. For severe spasticity, not effectively treatable with oral medicines, intrathecal Baclofen is a potentially effective alternative that can also be delivered through a subcutaneous lumbar pump. Side effects are somewhat less with intrathecal Baclofen, although there is risk of infection at the pump site (Kerr).
Some treating physicians suggest diet modification therapy as well. Some advocate a diet low in saturated fats; others suggest increasing the patient's intake of linoleic acid, a polyunsaturated fat, via supplements of sunflower seed, safflower, or evening primrose oils (DiBaise 29). Other proposed dietary "remedies" include megavitamin therapy, including increased intake of vitamins B12 or C; various liquid diets; and sucrose-, tobacco-, or gluten-free diets. To date, there have been no clinical studies to confirm benefits from dietary changes; in the absence of any evidence that diet therapy is effective, patients are generally advised to eat a balanced, wholesome diet.
Physical, Occupational and Vocational Therapies
Following initial therapy, the most critical part of the treatment for this disorder consists of keeping the patients body functioning while hoping for either complete or partial spontaneous recovery of the nervous system. This may sometimes require placing the patient on a respirator. Patients with acute symptoms, such as paralysis, are most often treated in a hospital or in a rehabilitation facility where a specialized medical team can prevent or treat problems that afflict paralyzed patients. Often, even before recovery begins, caregivers may be instructed to move patients limbs manually to help keep the muscles flexible and strong, and to reduce the likelihood of pressure sores developing in immobilized areas. Later, if patients begin to recover limb control, physical therapy begins to help improve muscle strength, coordination, and range of motion (Johns HopkinsOT/PT 2001).
Most rehabilitation programs attempt to address the emotional dimensions along with the physical problems resulting from permanent disability. Patients typically consult with a range of rehabilitation specialists, who may include physiatrists, physical therapists, occupational therapists, vocational therapists, and mental health care professionals.
Physiatrists (doctors) and physical therapists treat disabilities that result from motor and sensory impairments. Their aim is to help patients increase their strength and endurance, improve coordination, reduce spasticity and muscle wasting in paralyzed limbs, and regain greater control over bladder and bowel function through various exercises. Paralyzed patients are taught to use assistive devices such as wheelchairs, canes, or braces as effectively as possible. They also learn ways to avoid developing painful pressure sores on immobilized parts of the body, which may lead to increased pain or systemic infection. In addition, physiatrists and physical therapists are involved in pain management.
Commonly experienced permanent neurological deficits resulting from transverse myelitis include severe weakness, spasticity (painful muscle stiffness or contractions), or paralysis, incontinence, and chronic pain. Such deficits can substantially interfere with a persons ability to carry out everyday activities such as bathing, dressing, and household tasks. Occupational therapy is commonly recommended and used to help TM patients cope with these permanent disabilities. Occupational therapists help patients learn new ways of performing meaningful, self-directed, goal-oriented, everyday tasks such as bathing, dressing, preparing a meal, house cleaning, engaging in arts and crafts, or gardening. They teach people how to develop compensatory strategies, how to make changes in their homes to improve safety, how to change obstacles in their environment that interfere with normal activity, and how to use assistive devices (MacQueen 2001).
Vocational therapists acquaint people with their rights as defined under the Americans with Disabilities Act of 1990 and help people develop and promote work skills. They also identify potential employers, assist in job searches, and act as mediators between employees and employers to secure reasonable workplace accommodations.
Future Treatment Studies
Oligodendrocyte Proliferation. In cases of Multiple Sclerosis-evoked Transverse Myelitis, some studies focus on strategies to reverse the damage to myelin and oligodendrocytes (the cells that make and maintain myelin in the central nervous system [CNS]), both of which are destroyed during MS attacks. Recent research has shown that oligodendrocytes may proliferate and form new myelin after an attack and this gives hope to MS and TM patients and treating physicians. The trick is achieving the correct environment in which the oligodendrocytes may proliferate. There is a great deal of interest in agents that may stimulate this reaction. To learn more about the process, investigators are looking at how drugs used in MS trials affect remyelination. Studies of animal models indicate that monoclonal antibodies and two immunosuppressant drugs, cyclophosphamide and azathioprine, may accelerate remyelination, while steroids may inhibit it. (Chari, Vu)
Plasma Exchange Therapy. Another study (Mayo Clinic 1999) investigated plasma exchange (PE). Plasma exchange for a variety of illnesses, including MS, Devics Disease and Guillian-Barr, has been studied since 1980. This process involves the removal of blood from the body through an intravenous catheter, mechanical separation of the blood cells from the fluid plasma with a centrifuge, removal of the plasma, and replacement with an artificial plasma. The replacement solution is mixed with a patients own cells and returned through the same intravenous catheter. The theory for this treatment is that a component of the liquid portion in the blood is responsible for sustaining disease activity and replacement of the plasma with the replacement solution may dilute the activity of these potentially destructive factors where a plasma transfusion is given. The treatment is used on patients with severe acute attacks of inflammatory demyelinating disease (including MS and TM) when intravenous steroid therapy has failed. This was a randomized, double-blind study--the study was done with a control group and a treatment group, but neither group was aware of which group they were in or certain other details of the study. Patients were divided into groups by disease type and disease had separate control and treatment groups. The first group of patients received a true plasma exchange using continuous-flow centrifugation with serum albumin and crystalloid replacement every 2 days for a total of 7 exchanges. The control group received a plasma exchange with no centrifugation every 2 days for a total of 7 exchanges. Patients crossed to the alternate therapy if there was less than a moderate improvement by day 14. The treatment decision was determined by a blinded neurologic evaluation where the assessing party did not know what group the patient belonged to at the time of the evaluation.
Concurrent corticosteroids, other immunosuppressants, and high-dose barbiturates were not permitted in any of the patients during the treatment period. Side effects included anemia, minor sensory disorders and a temporary drop in blood pressure. About one-half of the patients required a carotid line (this is an intravenous fluid line through the carotid artery) to increase blood pressure. Although the control group was lost because of the cross-over technique used in the study, the researchers felt that because there was moderate or marked functional improvement in 44.1% of all treated patients, patients improved rapidly and improvement was sustained (Keegan 145-6), PE is a success treatment option for inflammatory demyelinating diseases. But, plasma exchange still has not been widely accepted as a treatment for such and treatment currently has limited availability (Weinshenker 39 ). Since September 1999, this treatment is almost exclusive to the Mayo Clinic at a cost of $1600 per exchange (a total treatment cost of $11,200) (Mayo Clinic 1999).
Similar therapies, such as high-dose intravenous immune globulin (IVIg) (Dalakas 721) and other therapeutic apheresis treatments (Khatri 236) have emerged as important therapies for various immunological neurologic diseases and may offer future hope for treatment of TM.
Nerve Conduction Research. There has also been some investigation on improving nerve conduction. Because the transmission of electrochemical messages is disrupted by the degeneration of the neurons, medications to improve the conduction of nerve impulses are being investigated. Demyelinated nerves show abnormalities of potassium activity so scientists are studying drugs that block the channels through which potassium moves, thereby restoring conduction of the nerve impulse. Such drugs have been particularly effective for those patients suffering form symptoms of TM secondary to MS (NMSF 1987).
In this chapter, a number of different treatments, most directed toward symptoms rather than an overall cure for TM, have been presented. There is a saying that nothing is 100%, and that is an understatement for the overall success for treatment of TM. I know that TM is a difficult disorder. There are so many variables, so many causes, so many different symptoms and reactions to available treatments. However, most of the underlying causes have the environment in common. Although diet therapy seems to be a step in the right direct, a general study of the available treatments fails to address this issue. Environmental causation does not appear to be on the agenda for future research on TM either. However, once consideration is given to the possibility of a gross factor causing not only TM, but the plethora of other autoimmune diseases that are on the rise, detoxification of the human environment and the human body may be the ticket to seeing a decline. Physicians and researchers may need to shift from the finding of palliatives for symptoms to finding a cure for the illness itself.
CHAPTER 5- AYURVEDA
When people with chronic illness have not found satisfactory answers from western medicine, they often seek alternative treatments. One such treatment option is based in the Ayurvedic philosophy of India. Since most people do not know much about this holistic lifestyle, as it is a much more than just medicine, this chapter will briefly review Ayurveda and its idea that illness is the result of an imbalance between us and our environment. This chapter will also touch upon the detoxification and rejuvenation methods of Chapter 6 and the treatment plan and daily regimen of Chapter 7.
Great things can happen when old meets new, when the experienced meets the fresh-minded novice, when east meets west. Idealistically, this is what can happen when western and eastern medicine meet. Ayurveda, although much more than a medicine, does not underestimate the role the environment plays in ones health, yet its practitioners do not fail to acknowledge the importance of technology either. Ayurveda, like modern medicine, also relies on a long history of practice and scientifically proven methods but uses this knowledge to eliminate toxic elements from the patients body. Whats more, when patients follow the lifestyle outlined for them by their practitioner, they often get well.
American physicians and many patients dont want to hear this, however. They want new machines and wonder drugs. Patients in particular want to eat junk food and remain healthy. It may require those wonderful minds that demonstrate the creativity of plasma exchange and potassium channel blockers to do just as Ayurvedic practitioners do and look outside their own medical philosophies for successful treatment of such illnesses as TM. They may have to be the ones to battle those who want to defeat the Complementary and Alternative Medicine (CAM) campaign, which according to our government necessitates investigation. If success in "legitimate" medicine can back the success of a natural approach, such as that found in Ayurveda, then there is hope for those who continue suffer without a modern cure. Modern medicine has been battling without success many illnesses where some CAMs have seen miraculous recoverywhether the cynics care to acknowledge it or not. Isnt it time for modern science to acknowledge this and look into the potential value of alternative medicine in treating conditions where western approaches have had little success?
This chapter outlines the philosophy of Ayurveda and the elements of daily maintenance to give a basic understanding of how it can lead to a healthier lifeone freer of migraines, acne, cancer, allergies, asthma, and TM among other health concerns. It also will show how Ayurveda, with few modifications, can fit into any belief system and lifestyle without much "pain." I myself lapse and regress into an "American" lifestyle, which is harmful to my condition, but I can easily catch myself and return to a life guided by the Ayurvedic philosophy and then quickly return to better health. Therefore, it is my feeling that Ayurveda should be considered as a possible technique of treating not only TM, but also any other illness where environment is a primary factor.
Ayurvedic medicine is the traditional, all-embracing system of medicine practiced in India and Sri Lanka. It is the "oldest complete medical system in the world" with its recorded origins going back about 3,500--4,000 years (Warrier 6). It is a comprehensive system of healthcare in which many elements work together prescribing a healthy way of living, and focusing on prevention of illness as well as healing the sick. Some of the elements of Ayurveda include diet, yoga, herbal medication, detoxification and rejuvenation, meditation and prayer. But Ayurveda is a philosophy as much as it is a way of life, so, besides health, it aims to achieve virtue, wealth, enjoyment and salvation. Further, there is an essential spiritual aspect to Ayurveda. In short, Ayurveda is a holistic way of living.
Although the concept behind Ayurveda should ordinarily be explained with an in-depth discussion of Indian philosophy, only specific ideas that are relevant will be touched upon in this essay.
The Science of Life. The word "Ayurveda" means the "science of life" and "life" is further defined as the union of the body and the senses with the mind and soul. Without this union, life cannot exist. This idea is based on the belief that everything within the universe, including ourselves, is composed of five elements. These elements, called panchamahabuta and often referred to as the "building blocks" of life (Tirtha 13), compose everything in the universe and are space, air, fire, water, and earth. It is important, however, to realize that these elements are not the physical elements with which we are familiar (Warrier 17). For example, space includes the property of smooth, soft, subtle, porous, and non-slimy, the properties of sound, and no distinguishable taste. Further, it produces the actions of softness, lightness, and porosity. In contrast the element of earth is characterized by the properties heavy, firm, immobile, dull, compact, thick, strong, rough, and having a sweet taste. Its actions include increased firmness, straight, hardness, emollient, nutritive, and purgative. Each of the other elements, air, fire, and water, likewise, has its distinct properties and actions that logically can be related to the physical elements with which we are familiar. The properties relating to each of these elements are then applied to the different aspects of Ayurvedic living (i.e., diet, yoga, prayer, herbs, etc.).
The Doshas. The elements make up the tri-doshas, Vata, Pitta and Kapha, which define the balance within ourselves and the world around us, promoting health on all levels. Each dosha has its own qualities, actions and responses, and, as we shall see, treatments of the doshas are equally different. The doshas are also the three pure healthy states of being, called prakriti. Most individuals do not have a pure prakriti, they are rather a blending of two doshas-- Vata-Pitta, Pitta-Kapha, Vata-Kapha, or occasionally three doshas--Vata-Pitta-Kapha, making seven types in all (Frawley 22 ). These can further be divided into mental/psychological or physiological doshas, which will be elaborated on later. Each of these doshas is composed of specific combinations of the five elements and reflects the qualities of those elements. For example, Vata is made up of the elements space and air. Air is characterized as being rough, light, dry, cold, soluble and largely astringent and slightly bitter in taste. Its actions are removing sliminess, producing lightness, dryness and emaciation. Similarly, treatments or food having Vata characteristics, along with the qualities of space as indicated above, also have dry, bitter or astringent taste, light, cold, subtle, unstable, rough, clear and transparent properties. Also in addition to actions of space, their actions include imparting motion to the body, conducting the impulses from respective sense organs, separating waste from digested food, and retaining and evacuating urine and semen. People with Vata constitutions are enthusiastic, have restless minds, weak memories, avoid confrontation, have active and sensitive natures and express themselves through sports and creative pursuits, and sometimes by overindulgence in pleasures. They are the most eager for sexual activity among the three prakritis (Warrier 49). They are often petite, quick individuals.
The doshas also each have five divisions or responsibilities with regard to the functioning of the body. Vata controls the nerve force and is also referred to as Vayu. It is mainly responsible for the physical and mental functions of the cerebral-spinal and sympathetic nerves throughout the body. (Tirtha 16). The five Vayus are Pran, residing in the head; Udan, residing in the chest; Vyan is found in the heart; Saman located near the digestive fire; and Apan, which can be found in the colon (Tirtha 16). Pitta relates to internal fire and is associated with the digestive and endocrine systems. The five Pittas are pachacka which exists in the small intestines; Ranjaka is located in the stomach liver and spleen; Sadhaka is found in the heart; Alochaka resides in the retina of the eyes; and Bhrajaka resides in the skin. (Tirtha 17). Kapha relates to stability and homeostasis. The five Kaphas are Avalambaka, which is found in the chest; Kledaka is found in the stomach, Bodhaka is found in the tongue, Tarpaka exists in the head nourishing the sense organs; and Shleshaka is located in the joints lubricating them. The three doshas (Vayu, Pitta, Kapha) exist throughout the entire body, in every cell, and yet are dominant in their original location (the colon, the small intestine and the stomach, respectively) (Tirtha 16).
If any of the doshas are out of balance, we experience discomfort, ill-health, and even disease, called vikriti. In this unhealthy state, doshas may be built up in excess or be lacking. For example, in a Pitta-Kapha dosha, the gain of excess weight is an increase in Kapha. This is a very common type of disorder because whatever dosha you are, you will have a tendency to become that dosha in excess, because that dosha is part of your being. In treating such disorders, logical balance is achieved by using treatments with opposite qualities or specifically reducing qualities. Disorders classified as a disturbance in the Vata balance may bring about conditions such as rheumatic and joint pain, arthritis, constipation, abnormal blood pressure, heart disease, and mental instability. For an imbalance of Vata, techniques could include (1) yoga, (2) diet, (3) herbs or (4) Pancha Karma (detoxification). The aim of the technique would usually be to reduced Vata, perhaps by increasing Kapha which has properties of earth and water, heaviness and moistness, and would counteract qualities of the lightness and dryness of the Vata disorder. Of course, this is a simplification of what would actually occur.
The Gunas. Parallel to the three doshas are the three Gunas: Sattva, Rajas, and Tamas (Tirtha 14). Just as the three doshas are essential elements of your being, the three Gunas are essential parts of your mind. Sattva represents purity and is the power of planning and organization; it represents equilibrium; it is the morning; it is fresh, clean and light. Raja is the manifestation of planning; it is motion and the heart of the day; it is the fire of wishes, desires and ambitions. Tama is the closing, when you begin thinking about retiring; it is the cleaning up period; it is resistance and heaviness. (Warrier 61-62). Because sattva is pure, it is not disturbed in anyway. Mental imbalances are caused by disturbances in tamas and rajas. Conscious movement to the correct balance among the three Gunas returns the mind to balance.
At this point, the complexity of the Indian philosophy of the evolution of matter can be seen. Life is seen as cyclic and involves 24 principal elements (prakriti, Maha or intellect, ahamkara or egoism , Manas or mind, five sensory organs, five motor organs, five rudimentary elements, five physical elements). This theory goes on to state that life is an evolutionary process that begins with the union of the physical part, prakriti, and the spiritual part, purusha. The remaining developed to give life to your body. Our life goes on continuously and when the physical part and the spiritual part cease to exist on the same plane and the other 23 elements no longer exists, our physical self ceases to exist. The 24 elements are the virtual life force of every living being, and when the energy in those elements runs out, we can no longer live (Warrier 40-41).
Living a balanced life, however, can assure that the life force is not wasted on draining illness and unfulfilling life. The Indian philosophy says that to live a fulfilled life is to achieve virtue, wealth, enjoyment and salvation. Sometimes this is expressed as the Three Desires and intelligent people are advised to pursue "health, wealth, and self-realization" and that life consists of charity, compassion, nonviolence, celibacy, devotion to Divinity and meditation or prayer (Tirtha). Again, to achieve this state you must have a healthy body and mind. Unfortunately, it is as easy for a state of well being to exist as a state of disease, therefore, it is important to maintain the balance of the biological units, the tri-doshas. As the science of life, Ayurveda attempts to set out good and bad practices by outlining the causes of a happy and an unhappy life and what is wholesome and unwholesome, provides guidelines for living better, and helps to balance are often hectic lives.
Charaka was a physician who propagated his knowledge into one of the three ancient Ayurveda texts--Charaka Samhita. This is text governing physiology, anatomy, etiology, pathogenesis, symptoms and signs of disease, methodology of diagnosis, treatment and prescription for patients, prevention, and longevity (Warrier 184). According to Charaka, life may be defined as one of four types either (1) useful or creative, (2) harmful or destructive, (3) happy, or (4) unhappy or miserable. Life is happy when we were not afflicted with physical or mental pain and are endowed with strength, virility, knowledge, excellent sense organs (eyes, nose, mouth, ears, and skin) and when we are prosperous and able to plan life as we wish. Well-being is the harmonious interaction of body and mind, and disease is caused by a deficient interaction between them (Warrier 39). The goals of a good life are Dharma (virtuous duty), Artha (wealth), Kama (enjoyment) and Moksha (salvation).
This leads us to the spiritual nature of Ayurveda and for a better understanding we must know something else about Vedic roots of Hindu philosophy, spirituality, and universal religion. According to the ancient Vedic scriptures of India, there is a goal to life. Because order and reason exist in life, we are not simply born to live and then to die without some meaning or purpose. Life is divine and its goal is to realize our inner divine nature. According to Ayurveda, the more a person realizes of their divine nature, the healthier they will be. The Ayurvedic doctor must inspire and help awaken the patient to their own inner divine nature, and positive thinking and love is the best medicine. When patients are taught that they have this divinity within themselves, they feel a connection to life and God (however each patient defines God, e.g., for atheists, it would be the great mystical power, which is synonymous to God). Patients then can feel that they have a handle on life, are in control of their reality and then have the ability to develop their own inner nature. After this, secondary therapies of herbs, diet, meditation and other treatment may be used.
Even modern medical doctors are finding a link between healthy and degree of spiritual faith. Spirituality changes the definition of health, giving it added dimension. Two types of health can be seendiagnosed health and true health. Often when a patient is diagnosed as healthy, they still may not feel healthy or full of life. This is due to psychosomatic conditions where troubled mind affects the health of the body. The deepest level of mental agitation is the longing for deeper spiritual connection.
Looking further into the spiritual philosophy, Ayurveda suggests true health is based on the healthy functioning of the four areas of life: physical/mental health, career or life purpose, spiritual relationships, and spirituality. As indicated before, first one needs to be physically and mentally able to work and play, and then he needs to work to support oneself to provide for a social life. Work, however, is defined as making a living doing something meaningful or purposeful. To do this type of work, someone needs to use innate or God-given talents and to work at something they love to do and it is this love that nurtures spirituality.
Purposeful career is an aspect of this definition of health. Especially in the United States, all too often we find people working at jobs that they dislike. Often people are forced into " practical " career by parents or societal beliefs because they lack the self-worth and confidence to resist and live their dreams. Working in meaningless and unfulfilling jobs can create mental and physical disorders. The most extreme example of illness caused by lack of purpose is cancer. Ayurveda considers cancer an emotionally-caused disease (Tirtha 57). By not having a purpose in life (i.e., suppressing life) people create life within their bodythat life is cancer. When seriously ill people discuss what they would love to do (instead of what they are told to do) life returns to their eyes. As they begin to follow up on these ideas, some remarkable recoveries are seen.
The third realm of health is spiritual relationships. When persons are healthy and purposefully working, they can truly enjoy their social life. We have become acutely aware of the emotional and physical abuses exist in many people's relationships. Co-dependency and enabling describe relationship diseases. From the spiritual standpoint, if one is dependent on anything, co-dependency exists. People look for something lasting or permanent; only God is eternal and everlasting. Spiritual development directs one to focus inwardly to discover ones eternal nature instead of the ever-changing realm of life. For relationships to be healthy, all people must continue to develop their individuality in their spiritual lives. Then they are able to share their spiritual fullness with their spouse and others. Too often individuals are attracted to one another because they see a quality that they think they do not have. In reality, each person has all the human qualities within themselves because inner eternal divinity, by definition, contains everything. Further, if one can see a quality in another, they must have it within themselves in order to recognize it. Thus, the third dimension of health involves healthy spiritual relationships.
Once people are sound in body and mind, work in a purposeful career, and enjoy fulfilling spiritual relationships, life develops into a state of grace. People then become eager to devote more time to spiritual development, the final dimension of health. Personal spiritual development is seen on many levels. The body becomes more relaxed and the mind more alert, and one becomes more personable and develops meaningful relationships. Yet, the most profound development takes place inwardly; divinity grows within. Gradually, one also begins to see the divinity in others and all of life. We must understand our own nature for our own happiness and well-being in life. Similarly, we must understand the nature of others, which may be different than our own for harmonious social interaction (Frawley 11 ).
This is the multi-dimensional definition of health according to Ayurveda. Life is composed of many interdependent elements. If one aspect of life becomes imbalanced, all the other aspects are affected. Rather than merely treating a symptom, Ayurveda looks to the root cause or underlying reasons of illness. The body may be sick because of mental or career stress. Rather than instruct the patient to merely take a drug or an herb to heal the physical condition, the practitioner of Ayurvedic medicine looks to restore balance within the patient (e.g., calming the mind or finding a more purposeful job). The deepest level is spiritual development and it affects all other parts as those parts affect it. Thus, all four areas of life must be cultivated: mind/body, career, spiritual relationships, and inner spiritual development (Tirtha 57).
Three Vital Essences. Vata, Pitta and Kapha have subtle counterparts in the level of vital energy, which in turn assists in meditative practices. These are Prana, Tejas and Ojas, which are called the "three vital essences." These essences are built up in two ways. First, on a gross level, they are derived from the nourishment we take into our bodies. On a subtler level, they are fed by our impressions. Prana, Tejas and Ojas are the master forms of Vata, Pitta and Kapha. They control ordinary mind-body functions and keep us healthy and free of disease.
Prana represents the primal life force and the subtle property of air. It allows us to move and respond to challenges in life. It is the master force behind all mind-body functions and responsible for coordination of breath, senses and mind. It is the life force of reproductive fluids. Finally, Prana governs the development of higher states of consciousness necessary for proper and elevating meditation.
Tejas is inner radiance. It is the subtle energy of fire through which we digest thought and impressions. Fed though visual perceptions, it allows us to perceive and judge correctly. Tejas gives courage and daring to reproductive fluids. It also governs the development of higher perceptual capacities, permitting meaningful meditation and allowing us to see what is true.
Ojas is primal vigor. It is the subtle energy of water as vital reserve energy, the essence of digested food, impressions and thought, fed through sensory organs. It gives reproductive fluid endurance. On an inner level, it maintains a sense of calm and supports and nourishes higher states of consciousness. It helps prolong meditative states.
While increases in the biological humors promote disease, increases in the vital essences promote positive health (as long as they are developed in conjunction with one another). These three forces give us vitality, clarity and endurance and are necessary to feel healthy, fearless and confident (Frawley 25-27 ).
Meditation and Healing. An essential part to achieving spiritual balance and developing inner spirituality is the use of meditation. When reading the ancient texts of Ayurveda, it is easy to see that it is truly a holistic science. In these writings, the body and the mind were seen as interdependent and an entire system of psychological healing was laid out (Tirtha 337). It is said that ill-health is a state of imbalance, or stress, within the various functions of the body and mind. Relaxation is the process that helps restore equilibrium so that the body can repair itself. Meditation is the art of consciously relaxing, accelerating the process. In other words, meditation settles the mind and relaxes the body, restoring the state of internal balance or " homeostasis, " which is the active state for self-repair and healing. (Harrison, 3).
An example of how meditation and psychological treatment in Ayurveda come together is in the development of self-worth. The Ayurvedic texts advise to 1) Test truth on the touchstone of your own heart; 2) Be aware that doubt can come even disguised as a friend, undermining your desires and efforts for health and self-realization; and 3) Realize that doubt is like a ghost trying to scare you from your sadhana (meditation) and spiritual life. To overcome doubts, a person learns what is true through a threefold process 1) what is read in the scriptures; 2) what is taught by the Guru or other teacher; and 3) personal experience. It is through the union of these three situations that experience is gained and true knowledge and the maturation of meditation are experienced. Through the experience of meditation and Ayurveda, doubt and low self-esteem become peaceful. Practice of meditation forces the mind to work, the work tires the mind causing thoughts to leave, the silent and healing mind is free to exist uninterrupted by negativity or restlessness (Tirtha 338).
The Gunas and Meditation. Ayurvedic psychology moves the mind through the Gunas from ignorance (Tamas) to vitality and self-expression (Rajas) to the apex of peace and enlightenment (Sattva). The three states of mental healing are (1) Breaking up Tamas/developing Rajasmoving from mental inertia to self motivated action; (2) Calming rajas/development Sattvamoving from self-motivation to selfless service; and (3) Perfecting Sattvamoving from selfless service to meditation.
From this example one can see that meditation is not an instant process. It takes time and practice. However, the time invested in meditation most definitely has its advantages. Studies have shown that meditation can reduce physical age, as compared to chronological age, by as much as 20 years (Chopra, 194). Other benefits of meditation are no mystery to even modern science. Many body processes depend on rhythms of tension and release. If we are chronically tight, the muscles work in a narrow, limited spectrum and often lose their rhythm altogether. In particular, our lymphatic system, digestion and breathing suffer. (Harrison, 9) In fulfilling spiritual development, meditation perpetuates health of mind and body, career and personal relationship. Spiritual development, the deepest root of all four areas of life, is the key to attaining those goals in life.
Several excellent examples of effective healing from meditation come from Quantum Healing, a book by the bi-philosophical (Allopathic/Ayruvedic) physician Deepak Chopra. Several cases of cancer have been miraculously cured through the use of Ayurvedic herbs, diet and transcendental meditation. Patients were asked to concentrate on their affected organ and visualize their body working to cure it. There is no way to be certain what caused the recovery of these patients, but the patients themselves attribute their survival to Dr. Chopra and his techniques (Chopra Ch.1).
Massage and Yoga
Massage and certain yogic practices play a very important role in Ayurvedic therapeutics (Verma 105). Through their use body organs are revitalized and aging is slowed. Ayurvedic massage and yogic practices may be either curative or preventive.
Massage. There are various types of massage used in Ayurveda, including pressure and pressing massage, foot pressing massage, oil massage (often used in Pancha Karma, or purification), head massage, and healing massage. Massage helps in maintaining the equilibrium of the humors and revitalizing the entire body. It opens all channels in the body, insures good circulation of energy and brings vitality and vigor. Massage can be done by family members and friends as well as professionals and still be highly effective (Verma 105).
Pressure massage can be done with the hand. The technique is to apply pressure to just about any part of the body with firm, but gentle, even pressure of the palm. Pressure should be appropriate for the part of the body (i.e., pressure to the face, neck, and groin area should be less than that to the calf, thigh, shoulders or back). Pressure massage may be modified by adding body weight, having a person of lesser weight walk or sit on a part of the body to apply firmer pressure. Similarly, foot pressure massage is a massage done by the feet applying partial body weights.
Oil massage is done by applying some oil or fat to the body and then applying smooth pressure by sliding fingers on it. Sesame, coconut oil or ghee (clarified butter) are among the best oils to use because of viscosity and penetrating and moisturizing properties. Medicated oils, such as mustard oil for skin infections, may also be used when appropriate. Oil massage is more specifically therapeutic and should be started at the solar plexus. This is the central distribution system for energy. When this part is properly massaged, the rest of the body relaxes automatically. When using oil massage, it is important to know the three principal energy channels of the spine. One is along the spinal cord and represents Sattva. On the left and right of the spine are Tamas and Rajas, respectively (Verma 115). Massage should address these areas equally and thoroughly to balance the energy.
Head massage (champi) is extremely important in Ayurveda. It promotes memory and longevity, cures headaches, removes Kapha from the head and is beneficial for colds, migraines and sinusitis. Oil should be applied in head massage and pressure should be gradually increased. Once hair and scalp are thoroughly oiled, all the hair, in small bunches should be gently pulled on to stimulate hair follicles, encourage hair growth and prevent baldness.
Healing massage is done without any oil and consists of very gentle stroking of the forehead or the ailing part of the body. This type of massage, while barely touching the subject, is consoling, soothing and reassuring and helpful in curing Pitta or psychiatric disorders.
Yoga. (See also Appendix D). Yoga, an art in self-healing and self-realization, is a complex science in itself requiring years of study and practice to reach ever-expanding goals. It is made of mental, physical and spiritual elements, all of which require concentration and thought for proper development. A brief summary of how Yoga and Ayurveda relate is outlined below.
Yoga has Eight Limbs. They include: Rules of Social Conduct, Rules of Personal Behavior, Physical Postures, Control of the Vital Force (breathing), Control of the Senses, Right Attention or Control of the Mind, Meditation, and Absorption. The first five of these make up the outer aspect of yoga, referring to ethics and physical actions of the practitioner. Ayurveda harmonizes the body and prana to enable us to proceed with the inner processes (the last three limbs). Ayurvedic healing, however, also involves the inner aspects of yoga like mantra and meditation. Ayurveda therefore shares the same scope as yoga with different purpose (Frawley 50 ).
Ayurvedic and yogic psychology were originally the same and have only recently begun to diverge (Frawley 5 ). Yoga is the spiritual aspect of Ayurveda, while Ayurveda is the healing and therapeutic branch of Yoga. Yoga as a medical therapy is traditionally part of Ayurveda, which deals with the treatment of both physical and mental disease. The Ayurvedic view of the mind is derived from Yoga philosophy and its understanding of the different levels of consciousness. Concentration and breathing (pranayama) practices of yoga may be used in curing psychic disorders and healing physical diseases (Verma 105). Ayurvedic treatment methods for the mind include yogic practices for spiritual growth, like mantra and meditation. (Frawley 5 )
The aim of yoga is for the individual to achieve immortality, freedom from samsarathe cycle of life and death, and becoming part of the eternal, indestructible Brahman, Purusa or Absolute. This spiritual development is not possible without healthy body and strong mind. The body is considered holy because it houses the soul, which is indestructible, unchangeable and is part of the Purusa (Verma 118). Yoga teaches harmonious development of the body and mind and their relationship to the cosmos, which is essential in order to realize our Inner Light and the power of the soul.
In Ayurveda, various yoga practices are used for maintaining or achieving equilibrium between the mind, body, soul and cosmos. Yoga exercises (yogabhyasa), yoga postures (yogasanas) and breathing practices (pranayama) energize and revitalize the internal as well as external organs of the body, bringing peace to the mind. They help in the unrestricted flow of the bodys energy and bring harmony with cosmic energy. For an Ayurvedic way of life, it is essential to comprehend yogic principles and learn some fundamental practices. However, if you are not prepared to do the yogic practices, you would have to force yourself to be successful and therefore do more harm then a good. In yoga, it is forbidden to use any force--all movements involve concentrated breathing and thought on the particular practice. The practices coordinate the body and the mind and assist in achieving self-awareness (Verma 119).
Yoga practice may be personalized for dosha type. Vata doshas suffer from a lack of flexibility, dryness and stiffness. Arthritis is common in this dosha type as well. This dosha benefits from regular oil massage, taking herbs for flexibility, tonic herbs for improving energy and laxatives (see next section). Vata has a tendency to rush things, therefore, key words for Vata are calm, slow, steady, grounding, strengthening and consistent (Frawley 223 ). Yoga positions for Vata include sitting poses, slow Salutation of the Sun, standing poses, inverted poses (except during menses), simple back bends, all forward bends, fetal positions, lying spinal twists and corpse pose. This last position should be done for a long time because Vata requires time for relaxation.
Pittas usually have internal heat and blood that requires detoxification. They benefit from cooling and detoxifying herbs. Nervines, substances that impact the nervous system, are also helpful for cooling Pittas overheated and emotional mind. Pittas have a full range of fiery actions and emotions. For this reason, key words for yoga poses are cooling, relaxing, surrendering, forgiving, gentle, and diffusive. Yoga positions for Pitta include most sitting postures (except Lion Pose), moon salutation, standing poses, forward bends with legs open, shoulder stand, fetal pose, bow pose, setting forward bends, twists, yoga mundra and corpse pose.
Kapha types suffer from stagnation and benefit from herbs that improve circulation, which counter complaints of heaviness, such as obesity, diabetes, asthma and heart disease. Spicy herbs are also recommended. Kapha key words for yoga practice include, stimulating, moving, warming, lightening, energizing, and releasing. Asanas for Kapha may include Lion pose of sitting poses with pranayama (breathing), Sun Salutation, standing extension poses, downward and upward dog, full inverted balancing poses like handstand and peacock feather pose, plow pose, all backbends, head and shoulder stands with variations, invigorating twists and short reclined positions (Frawley 223-225 ).
Those who practice yoga experience better health, attitudes and lives. Like other forms of exercise, Yoga reduces stress, excess weight and adds years to your life. But different from conventional exercise, after years of practice, yoga gives spontaneous enlightenment and a sense of self through thought and self-reflection.
It is important to understand that Ayurveda is a healing science and nourishment is considered a major therapeutic tool. Cooking for constitutions is equally a science. With regard to eating, Ayurveda prescribes that first you want to regularize absorption, assimilation and elimination. An Ayurvedic cook will want to make foods that are easily digested and the eater will want to take food well and easily. Next, any imbalances (vikriti) need to be corrected. Finally, foods should be chosen to suit physical constitution (prakriti). It is most important to attend to appetite, digestion and elimination, then you can work to balancing the finer parts of constitution. Ultimately, food needs to taste good and this is the chief Ayurvedic premise.
The Gunas. Just like human beings have an innate quality reflected in their Gunas, so do foods. When considering what to eat, the first step is to choose foods that are Sattvic, (fresh and pure), and avoid those that are Rajasic (fiery) and Tamasic (spoiled). Sattvic foods are fresh, light and help to clear the mind. They include foods that are free of additives, preservatives and pesticides. Once the cook and the eater have had some practice, more emphasis can be put on the finer points of Ayurvedic food dynamics.
Impacts. Ayurveda appreciates food from a number of perspectives. Food has varying impacts on the body. A foods taste, its rasa, is important whether it is sweet, sour, salty, bitter, astringent or pungent. Each of these tastes has a different effect on the body. Similarly, the food has a second effect when entering the stomach, its virya. Lastly, there is an enduring effect subsequent to absorption called its vipak. The dynamics of a food are reflected in whether it will relax, stimulate, warm, cool or sooth. A vast majority of foods available to us are Sattvic with sweet vipak, which are preferred foods from an Ayurvedic standpoint. The American diet, however, contains a majority of foods that are neither Sattvic nor easy to digest. Foods like hard cheeses, ice cream and tomato-based products are common and fall into the rajasic and Tamasic categories and can be compared with poisons to the body. However, Americans have acquired such a taste for these that it takes a great amount of effort to stay away from them.
Five Elements. If you are out on a camping trip, you have built a fire and that fire gets too big and too hot, you use either enough water or earth to bring it back to where it is under control or you put out altogether. You are applying the basic laws of the elements here; the same laws that operate within your body. If the fire inside of you gets too big, your system is out of balance, heat and pain result in the form of ulcers, inflammation or fever and sweet earthy foods and cooling liquids are needed to quench the fire. However, if a great amount of these foods and liquids are used, you may quench the digestive fire altogether and need to build it back up.
Ether or space plays a part in bitter taste and in the constitution Vata. Air is present in three tastes: pungent, bitter and astringent and also plays a strong role in the Vata constitutional type.
With the right amount of fire present in our bodies, in balance with all the other elements, we digest smoothly and well. Too little, things sit there in the gut. Too much, and foods can charge through too quickly or with inflammatory reaction. Fire plays a part in three tastes: sour salty and pungent. It is intimately connected with the constitutional type Pitta. Water is strongly present in the tastes sweet and salty. It manifests in the constitutional type Kapha and also in the prakriti Pitta. Earth element shows up in the tastes sweet, sour and astringent and is part of the Kapha type. Food in general has a lot of earth element in it. Taking in too much earth, we are likely to increase our mass and possibly douse the digestive fire.
Food and the Mind. Recall that the Mind has three properties (Gunas), Sattva, Raja and Tama. All three properties are contained in everyone. Sattva gives us curiosity and the urge to wake up; it is the plan. Raja wants us to re-organize or to work; it is the manifestation of the plan. Tama gives us the desire to rest; it is the completion and clean up. Depending on our state of mind, we may desire a food with a particular Guna. Consuming such a food will invariably affect the mind and the actions of the body. Therefore, much care and thought, and sometimes control, must be given to resist such desires as they can lead to a downward spiral to a Tama condition of the mind and build up of toxins in the body to create an imbalance in the doshas. This may be a particularly difficult task when a westerner tries to first convert to an Ayurvedic diet.
Preparation. With good reason, certain food preparations are preferred over others. Food essence rises through the channel to the brain, therefore it is important that foods are taken for their Sattvic essence, bringing the energy of Sattvas directly into the mind. When possible, food should be fresh and properly cooked, depending upon what that food item is and the constitution type you are cooking for. For example, warming food reduces Kapha and increases Vayu. This is preferred for a pure Kapha whose vikriti is Kapha or for a Vata constitution that requires Vata stimulation. Overcooking gives food a Rajaic quality and depletes life force and should be avoided. Too much oil douses digestive fire and could cause digestive problems. Raw food causes "roughness among persons on a spiritual path" with the exception of fruit, which is better fresh and uncooked. Microwaves also damage life-force and should be avoided. Microwaving in plastic or Styrofoam containers adds additional hazards as they may release toxins into the already nutritionally depleted food. Home-cooked meals are much better than restaurant meals because restaurants often overcook, over-spice, microwave and even serve food which is older than desired, giving restaurant meals generally a Tamasic quality. Leftovers are Tamasic and, with a few exceptions, should be avoided. Cured meats, such as lunchmeat should also be avoided (too many preservatives). Foods that are too hot, too cold or too light or too heavy can also play a part in upsetting the doshas and interfering with proper digestion. Highly spiced foods may increase digestive fire and aggravate or cause conditions such as heartburn, indigestion, or even ulcers so care needs to be taken when eating such foods, as sometimes they are necessary, but can also be harmful. For Vayu constitutions spice and salt should be kept to a minimum. Over or under salted foods equally cause digestive problems and may aggravate the blood. Pittas can moderately use these; however, it is wisest to keep spices to a minimum. Kapha is able to consume highly spiced foods, but should limit salt.
Quality. Sattvic foodsorganic, fresh, homegrown, fresh-picked and raw dairy foodsare most preferred. Rajaic foods should be eaten in moderation and Tamasicrotten, under or overcooked, burnt, unripe, overripe, stale or junk foodshould be avoided if possible. Other harmful foods that are considered Tamasic and should be avoided are canned, rancid, artificial, prepared with additives, preservatives, frozen foods, irradiated foods, meats and poultry containing steroids. Generally, animal meat products are not advised because once slaughtered, meat begins to decompose and quickly becomes Tamasic. By the time it reaches your table, it is undeniably so.
Quantity. The Ayurvedic belief is to fill your stomach 1/3 with food, 1/3 with liquid and leave the last 1/3 for God. Overweight people should drink before they eat, believing that liquid, preferably pure water, will fill them up and assist in weight loss and restoring balance to their body. Underweight persons should drink after eating, with the hope that they consume sufficient food to gain weight and restore their balance. Those of normal weight should drink with their meals to get the balancing 1/3 and 1/3 and maintain their balance. Previous meals should be digested completely before commencing on the next meal because mixing of meals can upset the doshas and personal balance and the digestive fires also need time to regenerate to be fully available for the next meal. In some cases, especially those where there are problems with the digestion or digestive fire, smaller more frequent meals may be advised. This can assist in better digestion, increased metabolism and gradual elimination of digestive problems altogether.
Combination. Certain combinations of foods, such as vegetables combined with fruit or milk, can cause digestive problems. Therefore, you need to be careful selecting food while still getting a daily balance. Eating smaller more frequent meals may assist in this. Other combinations which cause problems are eating dairy products with sour foods, cold food after eating ghee, eating equal amounts of honey and ghee or eating fish products with cheese (this creates unhealthy toxins). However, stews and curries are more easily digested than vegetables cooked and eaten separately.
Allergies. In Ayurvedic medicine, allergies are of little significance. When this science was developed some 5000 years ago, the world was a much different place. The environment was free of chemical and other man-made contaminants that have a significant damaging effect on the health of human beings. Ayurveda can strengthen immune systems and assist the alimentary system in functioning more effectively. Simply cleaning up the diet, eating pure and organic foods, and working with an Ayurvedic practitioner can do much to improve mild allergies.
Herbs in both the East and West have been the prime medicinal agents for traditional and holistic therapies. In the East, particularly in India and China, an extensive and intricate herbal science has been developed. Some people may feel that the ancient herbs of India may not be relevant today, however, the exploitation of the neem tree (Shiva 148-54), haldi (turmeric) by western pharmaceutical companies and recent studies on the roots of Withania somnifera (Bhattachary 2000) and ashwangandha show otherwise. In addition, most people are unaware that many pharmaceuticals have their origin from herbs that were once available to the common people. As a matter of fact, Hippocrates, the father of western medicine, listed 257 medicinal plants known to be helpful for restoring health. Today, all but 27 are recognized as pharmaceuticals. (Kamen 32)
In Ayurveda, herbs are an essential tool of maintaining health and correcting imbalances. They are used in cooking, as supplements and in oils for massage. Herbs are also used in the production of essential oils for aromatherapy. They also can be extracted as fresh juice, used as teas through hot and cold infusions, ground into powders and mixed with warm water, honey, milk, ghee or such other substances as aloe gel, to enhance their properties. Sometimes wine is mixed with raw, dried and boiled herbs as well. Seven different metal, i.e., gold, silver, brass, copper, lead , tin and magnetic iron ore, may also be mixed with herbs and consumed. Herbs are assessed in much the same way as foods. They possess elements of the various doshas and hold similar properties. They are used to increase or decrease the doshas to restore balance or supplement the individual dispositions of the doshas.
Herbs that deal with physical health issues have application in yoga practice as well. Some herbs can be used to increase flexibility, promote circulation and stimulate the movement of energy. These herbs help in proper performance of asanas (yoga positions), improving muscle and skeletal function and coordination. They are usually classified as anti-rheumatic or anti-arthritic agents (see also Appendix B) and include, guggul, shallaki, myrrh, nirgundi, turmeric, saffron, Siberian ginseng, angelica, kava kava, and dash mula (an Ayurvedic formula). Herbs are usually taken with honey and warm water or with spicy stimulants like ginger or cinnamon to increase their effectiveness. Complemented with medicated massage oil and sweating therapy or saunas, these herbs can be highly effective. (Frawley 189 )
Some herbs are used to increase physical energy and vitality. Ojas, and its higher form soma, are strengthened with these herbs (recall that Ojas is the essence of primal vigor and subtle counterpart to the doshas). These herbs build stamina, stability and endurance for yoga postures. These herbs include ashwangandha, amalaki, shatavari bala, vidari, ginseng, dioscorea, kapikacchu, lotus seeds, licorice, saw palmetto and fo ti. They are usually consumed with raw sugar, milk, ghee and other nutritives to boost their strengthening powers, and may also be taken with raw honey. A vegetarian nutritive is best and spices should be added to them as well to aid digestion of these heavy herbs.
The last type of herb which is beneficial to asanas are cooling herbs such as aloe gel, guduchi, gentian, barberry, gotu kola, brahmi, plantain, dandelion, comfrey leaf, nettles, yarrow and yellow dock. These herbs are detoxifying agents. They are bitter or astringent in taste and may contain large amounts of chlorophyll. These herbs may also be taken with ghee or honey, but also aloe gel. They are often combined with raw food, green juices and other detoxifying measures.
The key to inner healing is keeping the five pranas moving. For each of the five pranas (or Vayus) several types of herbs can help this process, some overlapping other pranas. For Prana, spicy diaphoretic herbs increase inhalation and open the head and sinuses. The mind and sense are also stimulated and appetite is improved. These include cinnamon, sage, calamus, mint, thyme, tulsi, eucalyptus, ephedra, cloves, pippali, and shilajit.
For Apana, mild laxative herbs increase elimination and clean the alimentary canals, thus aiding in absorption of Prana in the colon. They include tripala, haritak, psyllium, flax seed, castor oil, aloe gel, cascara sagrada, asafetida and hingashtak (Ayurvedic formula).
Samana requires spicy herbs that aid in digestion and absorption in the small intestines. They include such herbs as cardamom, fennel, ginger, cayenne, mustard, cumin, basil, black pepper, nutmeg, and trikatu (Ayurvedic formula).
Vyana herbs are spicy, bitter and promote circulation through the heart and musculoskeletal system. Cinnamon, nirgundi, arjuna, elecampane, guggul, saffron, turmeric, guduchi, Siberian ginseng, angelica and kava kava assist in Vyana.
Udana uses spicy astringent herbs to strengthen the voice, discourage cough, and increase vitality and power. Many herbs work to assist Udana including calamus, bayberry, elecampane, lobelia, tulsi, haritaki, peppermint, mullein, vasa, coltsfoot, cherry bark and licorice.
Other herbs are used to stimulate the mind, increase awareness and assist in meditation. Herbs that stimulate the mind, clear the head and improve sensory perception are calamus tulsi, basil, pippali, bayberry, ephedra, sage and elecampane and may be taken with honey and warm water. These are herbs that are mainly used in nasya therapy in Pancha Karma.
Herbs can increase awareness and intelligence and strengthen the mind. These herbs are particularly important in building nervous tissue and helpful in neurologic disease. These include shankha pushpin, brahmi, gotu kola, aswagandha, haritaki, shatavari, bala, kapikacchu, arjuna, lotus sees and shilajit. They are usually taken with warm milk, ghee, raw sugar, raw honey and other nutritive items to boost their strengthening powers.
Herbs for meditation and calming the mind are mild sedative and pain relieving agents. These herbs are effective at reducing anxiety and agitated nerves. Typical herbs include jatamamsi, valerian, nutmeg, passion flower, kava kava, skullcap, ladys slipper and zizyphus seeds.
Without herbs, many of the objectives of Ayurveda would be difficult to achieve. Herbs can be powerful prophylactics used to maintain health and allow individuals to achieve their main goals in life without the concern of ill health. They can also return ill health to one of stability. They may also be used to relax the mind, without concern for that "drugged" feeling, in order to achieve that highest goal in life, enlightenment.
Alternative Therapies and their Relation to Ayurveda
Color Therapy. Color and Gem therapy are closely related. If you have ever said that you like a certain color, or the way a certain piece of clothing looked on you, the color probably appealed to your dosha. Where herbs and food bring balance through the sense of taste, color achieves the same goal through the sense of sight. It is an Ayurvedic belief that colors are primarily absorbed through the eyes and secondarily through the skin. In turn, the body produces colors as well, reflected in the skin, eyes, mucus membranes, digestive track and excrement.
Mental fire (Tejas) is the area of ones existence most affected by bright colors. Tejas is increased by them, while it is diminished by dark colors. Colors that are too bright, like fluorescent colors, may burn out Tejas and cause mental distress.
Colors can provide emotional strength and stability and promote creativity, but if misused, they can initiate imbalance resulting in emotional disturbance or depression. Digestion, vitality and physical activity are also affected by colors. Primary colors in their most common shade are best for healing.
Colors should be applied according to constitution. All colors have shades that fall into Sattva, Raja, and Tamas categories. Those shades which are Sattva are light and bring joy, harmony and serenity to the wearer. White, gold violet and blue are the best Sattva colors. Bright, loud and neon colors are rajaic shades and are useful when energy is particularly low, although combinations of such colors, particularly opposites, can be irritating to the mind. Yellow, orange, red and purple are rajaic colors. Tamasic colors are dark, dull and muddy colors. They cause heaviness and thickness in the mind. Black, brown and gray are tamasic colors.
In Ayurveda, color therapy has a connection in spirituality and astrology. Vedic texts state that the 7 colors of the spectrum are associated with the "seven deities of the sun" (Tirtha). According to scriptures, colors of the spectrum are so important to health that positioning of the home and the materials used to build a home and their relation to the light of the sun were of the utmost importance (Tirtha).
There is extensive scientific evidence that colors affect mood. Ayurveda takes color therapy a step further and believes we can absorb color through the skin and take on their properties. They are assigned dosha-like qualities and may be utilized in the same way as herbs and foods to produce needed reduction or increase in doshas.
Gem Therapy. Gems should be worn touching the skin for proper absorption. Gems may also be crushed, mixed with herbs or other substance and consumed. Gems, metals and minerals may be burnt into ash and are said to have immune building properties. Even in India, however, few people manufacture these ashes because if improperly prepared then the effects can be life threatening (Tirtha 551-553). Gem solutions, called tinctures, are also prepared and consumed to impart certain affects. Hard stones, such as diamonds and sapphires, are soaked in strong alcohol solutions for up to a month. Softer stones are soaked in less strong solvents and for shorter periods. Gems may have properties of nervines (emerald), antacids (red coral), aphrodisiacs (diamonds), stimulants (cats eye, ruby), nutritives (diamond) or sedatives (pearl).
The color and feeling of the stone on the skin may be the most beneficial part of Gem Therapy. Most gemstones are made up of metal silicates, which for the most part are inert. Although minerals which are valuable to human beings may be found as a cation in the molecule, the crystalline structure formed by the molecules is fairly stable and, unless strong acids or bases are used to break them down (stomach acid may be strong enough to do this), reaping the benefits of these cations seems unlikely.
Some cures and medicines, however, just work because of faith. Believing in something that is said to heal, such as consuming rubies and garnets, may be all it takes to feel better.
Aromatherapy. Pure fragrances are used for healing and are used in the form of incense, flower essence and essential oils. Other methods of aromatherapy included scented soaps, candles and sachets. Aromas are most effective when they are pure. Used externally, as essences are to be applied to the skin, they should be diluted with a base oil as some essential oils and essences may cause skin irritation. Good base oils are sesame for Vayu dosha, coconut or sunflower for Pitta, and canola or mustard oils (also good for acne) for Kapha doshas. Essences should be mixed with base oils at a ratio of 25 ml (12 to 13 drops) to 1 fluid ounces of base oil.
Placement of the oil is also according to dosha. For Vayu, the oil should be placed on the third eye (on the forehead between the eyes). For Pitta, it should be placed on the chest over the heart, and for Kapha between the navel and the pubic bone. Proper placement of the oil will help to main balance within the dosha. These oils may also be used in steam or sweat therapy, which is part of the purification ritual prior to Pancha Karma (see Chapter 6).
Astrology. Astrology is a big part of traditional Ayurveda. However, in the West it does not seem to play as serious a role. In the United States, horoscopes, numerology and tarot cards are popular alternative culture forms of astrology, but using them does not rely on extensive knowledge. The moon and planets also play part in some astrological practices but most people do not allow astrology to play a serious part in their lives, let alone with their health. Ayurvedic astrology goes back to Vedic times and involved hundreds of Hindu gods and goddesses, along with phases of the moon and planets.
Change of LifestyleNew Routines
Perhaps the most difficult part of Ayurveda is establishing a daily routine. In Ayurveda, hygiene, lifestyle, and diet are crucial to good health. To attain good health, Ayurveda prescribes the specific daily routine and seasonal regimens. An examination of lifestyle and environment also causes us to look beyond ourselves for answers to health problems.
Daily Regimens. There is a saying that "cleanliness is next to godliness." The ancient Vedic texts put emphasis on hygiene and daily cleansing rituals. These may be difficult to commit to and a bit overwhelming at first, however, because Americans have "no time." But a little investment in ourselves every day makes our minds clearer and in the end can have a big payoff in how our day may go.
A given is that we must evacuate our system daily. Cleansing and oiling of the anus does not only promote hygiene but also keeps the area moist for easy passing.
Brushing and flossing our teeth twice a day, gargling as well as scraping of the tongue removes bacteria and contamination from the mouth. Brushing should be done with bitter, astringent or pungent roots or twigs made into brushes, or herbal tooth powders would be used as they are much better than commercial toothpastes, which contain saccharine, preservatives and other harmful chemicals. Scraping the tongue is also said to release repressed emotions. Gargling improves the voice, cleanses the palate and prevents dryness in the mouth and on the lips (Tirtha 331).
Eyes should be washed with cool to lukewarm water at least twice a day. This improves vision and helps to avoid eye disorders. It is also said to refresh the mind.
The head, ears and body should be oiled. This smoothes and firms the skin and prevents dryness. In the ears, oil improves hearing and prevents a stiff neck, jaw and back. Oiling of the head, along with massage and using appropriate oils for your dosha, prevents headaches, gray hair, hair loss and improves the senses and mood. This is also said to improve sleep.
Bathing or showering cleans your skin, removes sweat, toxins and dirt, purifies, rejuvenates and promotes life and removes fatigue. It is also said to be an aphrodisiac. Cleaning your feet and excretory orifices are said to improve intelligence, purity, longevity and to destroy that that is not favorable.
Wearing clean clothing is said to give you charm, fame and a long life span. It removes any question of impropriety and make it enjoyable to be around you.
Aromatherapy, as previously noted, is important to promote longevity, charm, nourishment and strength. It also improves manners and destroys all that is not proper.
Chewing of betel leaves, often mixed with fruits, improves clarity, and freshens the mouth. Chewing of fennel seeds also freshens the mouths and relieves gas.
Neatly trimmed hair, beard and nails is nutritive, promotes longevity, beatifies, and cleans.
The scriptures instruct one to carry an umbrella to protect from natural calamities and a walking stick for support, strength, longevity and protection from ones enemies.
Rest and sleep are essential for health and peace of mind. Before bed, meditation that evaluates ones owns conduct prepares for mindful sleep. Six to seven hours of sleep is generally sufficient except for Kapha, which may require less.
At 4:00 am, it is a good time for a walk and sadhana (meditation). Wake up time should be consistent and is recommended 1 to 2 hours prior to sunrise, and should be followed by yoga and meditation. Sunrise is for looking to the sky (but not directly at the sun), to improve ones vision and vitality. Sunlight is important to receive daily; it provides one with the few sources of vitamins D4 and D5.
Finding a livelihood that does not conflict with ones Dharma (God-given talents) is, as said before, essential for a healthy life. It is also important to be civic minded, care for the body and happiness will come to you.
Hands must be washed before every meal.
Facial washing with sandalwood paste mixed with milk is an astringent and tightens the pores and prevents wrinkles. This should be followed by facial oils such as brahmi. Nostrils should also be oiled and occasionally cleansed by pouring warm water and allowing it to flow out the opposite nostril. The process should be repeated cleansing the other nostril.
Sudhana should be practiced according to the guidance of ones teacher.
Exercise tones and balances all seven tissues and channels, improves circulation, muscle tone and strength, weight control and respiratory and digestive systems. It is also an essential part of daily routine. There are 3 levels of exercise consisting of passive (massage), active (walking, skiing) and energy balancing (yoga, tai chi). Everyone should practice passive and energy balancing exercise. And according to Ayurveda, walking is the best active exercise for all doshas.
Herbal supplements should also be made part of daily routine. Smoking of herbs without tobacco is useful in alleviation Kapha in the neck and for treatment of certain diseases and may be considered when establishing a daily routine.
Nasya or sniff should be used daily for Vayu, Kapha and Vayu/Kapha doshas.
Ethical Regimens. We now know that a healthy mind is as important as a healthy body. Ethics are an important part of Ayurveda not just because of the effects on the mind, but also in order to reach the spiritual enlightenment and achieve the goals of a good life. Ayurvedic practice includes the following ethical regimens: always speak the truth; do not lose your temper; avoid sensory pleasure addictions; do not harm anyone; when within your power, do not expose yourself to hardships; try to control your passions; endeavor to speak pleasant and sweet words; meditate every day for tranquility of mind; observe cleanliness in all things; be patient; observe self control; try to distribute knowledge, good advice and money to others; when possible devote yourself to service to God, spiritual personages or the elderly; be straightforward and kind; avoid irregularity in daily activities; consume food of sattvic quality; avoid overly spicy or sour foods, non-vegetarian foods and alcohol; behave according to the time and place where you are; act always in a courteous and polite manner; control your senses; make a habit of doing all that is good and avoiding all that is bad (Frawley 97 ). For the most part, common sense says that these actions are the way we should behave. There is no secret here. To live a good life, we have to be good.
Seasonal Regimen. Seasonal diet may require changing to alleviate aggravation of the doshas. According to Ayurveda there are six seasons: Cool/Dewey, Spring, Summer, Rainy, Autumn and Winter, although these seasons may vary form place to place. It is best to live in a location that is seasonally balanced to promote equal balance of the doshas.
In the Winter, a Vayu season, one should avoid Vayu-increasing foods and dress warmly. Foods should be hardy because increased digestive fire makes them more digestible. Marital relations are suggested at this time.
In the Dewy/Cold season, the house should be wind-proofed and warmly heated. Also, a Vayu season, Vayu-increasing foods and practices should be avoided. At this time, Pitta constitutions are well balanced, but Kapha has begun accumulating so measures need to be taken by Kapha constitutions to moderate Kapha.
In the Spring, Kapha accumulation leads to Kapha diseases. Evacuation methods, such as purging and eating lighter foods, are recommended. Exercise, aromatherapy, oil massage, smoking medicinal herbs, gargling and eye washing are suggested.
Summer is hot and dry. Vayu accumulates and Kapha is balanced due to the drying and dehydrating effects of the sun. Cooling foods including rice, milk, ghee and steamed vegetables are consumed. Mid-day naps are encouraged. Pearls should be worn on the skin to utilize their cooling effects. Sexual relations are not recommended in this time of the year.
In the Rainy season, digestive fire is weakened from the dryness of the summer and is further diminished by the rain. The condition of this season aggravates all doshas. Pitta begins to accumulate due to weakened digestion and increased acidity. During this period, diet and lifestyle should be adjusted from day to day, depending on the weather. Cold drinks, day naps, exercise and sexual relations should be avoided in the rainy season. Honey should be used in drinks and food. This is the season for Pancha Karma (see Chapter 5). Grain soups, medicated grape wine and fermented foods, although normally considered tamasic, are recommended for this season.
In the Autumn (Indian summer in the US), Pitta is aggravated from the two previous seasons, so Pitta reduction therapy is recommended. Ghee medicated with Pitta reducing herbs, water, bitter, astringent and sweet foods should be eaten. Sitting outside in the evening, drinking pearl water, or wearing pearls are recommended. Eating heavy foods and exposure to harsh conditions should be avoided.
During the transition period between the seasons (7 days prior to and 7 seven days after the beginning of a season), all doshas are advised to gradually fade out of the previous seasons diet and lifestyle and gradually move into the new seasons diet and lifestyle, thereby avoiding illness from transitions that are too quick (Tirtha 335).
In this chapter, the basic philosophy and daily routine of Ayurveda have outlined. The holistic philosophy of Ayurveda is obvious. Every aspect of your life should embrace what is good and positive. If you suffer illness, it is because of a break in some aspect of the purity of life. This should be common sense to just about anyone. The Ayurvedic lifestyle cannot hurt you. It is not unpleasant. It is not unhealthy by any standard. The most it could do is keep you healthy and leave you feeling good all of your days.
I have presented this case to my physicians and the general reaction is one of rolling the eyes and disregard. It is, however, ignorance of the facts that causes this reaction. No western physician should have any argument with most of aspects of Ayurveda. Certainly the use of herbal remedies puts physicians ill at ease. However, one must recall that these same herbs have been used for thousands of yearsthat is thousands of years of testing compared to an average 4 years of testing required by the FDA for most prescription drugs. And, almost no Ayurvedic herbal remedy has the side effect of "death," as is a regularly listed side effect on many modern drugs. In addition, modern pharmaceutical companies are beginning to reap the benefits of some of these ancient herbs.
Certain Ayurvedic therapies, such as gem and color therapies, may also find little place in modern medicine, but gems, being relatively inert, certainly cannot harm anyone and modern psychology has shown the benefits on emotional and mental health with regard to colors.
If the goal of modern medicine is really to help people and improve health, then physicians need to do away with some of their skepticim and buy into the idea that "it cant hurt." Then maybe they will see some results that they can truly buy into and genuinely recommend.
Having been involved in the medical malpractice field for a number of years, I realize the problems that such liberalism can present for physicians. That is why it is important that the governments CAM investigation be fully supported. This will help and undoubtedly open new doors and create new solutions for physicians, patients and the practice of modern medicine.
CHAPTER 6 REJUVENATION AND DETOXIFICATION IN AYURVEDA
Because detoxification and rejuvenation deal more specifically with illness than those points highlighted in the previous chapter, they are being dealt with separately in this chapter. Rejuvenation is an essential part of Ayurvedic living. It regenerates tissues, renews the mind and infuses the body with energy. Detoxification is the first and most important part of this process as it removes from the body the toxins that created illness and imbalance. This chapter shows that Ayurvedas emphasis on purifying the internal and external environments and its use of specific formulas and highly trained individuals makes it a logical and scientific process that deserves serious consideration by western physicians and scientists possibly as a complementary medicine to their own.
Ayurveda can be viewed in two parts. In the previous chapter, the maintenance aspect of Ayurveda was outlined. That is, the everyday activities, as they may change from season to season, that maintain our health. The second aspect, which includes rejuvenation and detoxification, is covered in this chapter. These last two processes make up the part of Ayurveda that is probably the most essential when we are ill.
Detoxification, called Pancha Karma, is the process of removing toxins from the body through various acts of purgation. When our body is laden with toxic substances, it makes sense that once these substances are removed we feel better and we are on our way to recovery. In the previous chapter, I stated that the Ayurvedic lifestyle could not hurt you, nor was it unpleasant. If there is an unpleasant part of Ayurveda, it may be the process of Pancha Karma. However, care is taken to balance discomfort with soothing massage and rest. It is, in my opinion, much more bearable than the discomfort of illness. In addition, to insure absolute safety, the procedures must be carried out by the highly trained practitioners of this specific area of Ayurveda. Still, danger in any of these procedures is negligible and effectiveness is unquestionable.
Rejuvenation, Rasayana, is the process by which our body recovers from illness and returns to a state of optimum health. This stage embraces what could be the critical element that is lacking in an American lifestyle regardless of the health care regimen that is followedtime. Lost in the shuffle of modern life, stress takes its toll on the entire person. No one has time to get sick and no one has time to heal. This is perhaps one reason chronic fatigue has risen to near epidemic proportions. Rasayana gives an individual not only time to heal, but also time to meditate, relax and get to know his mind and body. This should be a major consideration for any illness (again regardless of the medical regimen followed).
Rasayana is a treatment that consists of various types of rejuvenation. The therapy, which gives patients time to meditate and concentrate on self-improvement, strives to improve physical, mental and ethical qualities and conditions. The preliminary step to rejuvenation is detoxification through Pancha Karma.
Ayurveda contains perhaps one of the most complex and scientific purification processes in the world of alternative medicine. Pancha Karma (PK) consists of two preparatory practices, post-procedural massage, food and herb therapy and five purification measuresemesis, purgation, enemas, nasal medication and oleation and sudation (sweating).
PK is a radical cleansing treatment and one of the most important clinical procedures in Ayurveda. It is the best way to eliminate excess dosha from the body. Vamana, or induced emesis, eliminates Kapha by purging the "nutrient tissue-fluid pool," which contains water, electrolytes, plasma, muscle and fat. Virechana is herb-induced purgation that eliminates Pitta by causing an indirect effect on the total coloring material in the body, particularly the blood and bile. Basti is medicate enema, first performed with a concoction of herbs, water and minimal oil (Asthapana Basti) and then in an oil base (Anavasana Basti), that nullifies excess Vata. While the oils contact with the membranes of the colon, they remove fecal matter stuck to the walls, thereby increasing absorption and nourishment of the tissues. Sushrita, a great Ayurvedic physician, combined the two enemas into one step and added therapeutic bloodletting (Rakta-Moksha) as the fifth element in PK. The final PK therapy is Nasya, or nasal insertion of purifying herbs. These herbs clean the sinuses and improve the function of the brain and sense organs.
Despite the use of medications in PK, this purification uses the bodys natural processes to eliminate toxins in the body and remains safe.
PK has three objectives. Maintenance of health (when PK is used as part of seasonal regimen), treatment of disease, and preparation for rejuvenation or virilization therapies. Although the previously described techniques seem like typically performed medical procedures, PK is complex and requires extensive study and practice. Preparation for PK itself requires the use of oleation and sudation therapies. Oleation is the process of using oil, internally or externally, for health maintenance, healing and detoxification. In PK, oleation is used to lubricate the organs and channels of the body, thus making detoxification easier on the patient. Ghee (for Pitta and Kapha doshas) or sesame oil (for Vata) is taken internally for this process. Light diet or fasting are encouraged during the oleation process. The process involves gradually increasing the amount of oil ingested over a number of days to assure complete oleation. Signs that oleation is complete are oiliness of the skin, absence of white marks when the skin is scratched, oily appearance and softness of the stool, lightness of the body and distaste for oleating substances.
The second phase of preparation for PK, sudation or sweating, opens the pores so that excess doshas may flow out of the body easily. Sudation itself eliminates toxins and starts the process of detoxification even before PK begins. After oleation, sudation helps to remove excess oil from the body. Sudation can be done by application of heating pad or cloth, by medicated poultices, by application of steam, such as in a steam bath or by the patient soaking in a bath in which medicated herb decoctions have been added. Today, generally, a steam box is employed. This is followed by a light massage and a brief rest.
Following oleation and sudation, Vamana is administered. This is usually a combination of calamus, licorice and powdered seed of Randia dumentorum taken with honey. This promotes further sweating and nausea. The patient is then instructed to vomit freely without straining. First vomit will be white, sticky and slimy (Kapha), followed by bile (Pitta). Vomiting will usually stop at this point. Vomitus is measured to ascertain if the amount expelled was sufficient. After Vamana, the patient is encouraged to rest and smoke medicated herbs. When the patient becomes hungry, he should take a bath, and follow with a meal of basmati rice or Kicharee (a mild, savory mung bean and rice stew). The patient is instructed to return to a normal diet after 7 days.
Within 3 days, purgation (Virechana) may follow Vamana. Virechana may be performed without performing Vamana, if it is not needed. Oleation and sudation are once again performed. For purgation, a decoction of raisins, aragwadha and haritaki (12 grams each) and Katuka (6 grams) is used. Two ounces of the decoction are mixed with 2 oz of castor oil. Rhubarb root mixed with a mild spice like cardamom may be used in place of the decoction. The mixture should be administered mid-morning to cause spontaneous purgation. Patient will first pass liquid fecal matter and urine, then mucus (Kapha) followed by yellow bile (Pitta). Again, what has been expelled is measured for adequacy and the patient is encouraged to rest. Light food therapy should follow, beginning with vegetable soup and slowly increasing amounts of food until the seventh day. On the ninth day Basti therapy may begin.
Enemas clean and/or nourish the large intestines. Cleansing enemas use little oil and more detoxifying herbs and are indicated in Vayu channel obstruction. They are recommended for impaired sensory organs, hemiplegia, headaches, cardiac pain and facial paralysis. They are not recommended for those with stomach ailments, diarrhea or vomiting, or in older or debilitated patients. Oily enemas are more nutritive than cleansing enemas and are used for Vayu conditions caused by tissue loss. Anavasana basti can add heaviness and congestion and is counterindicated for patients with excess Kapha, particularly in the gastrointestinal track.
Cleansing enemas begin with honey, rock salt and water, followed by oil recommended for the dosha type. Finally a fine paste of herbs is added. Either enema should be performed four to six hours after the patients last meal. Enema should remain in the intestines for some time and then be permitted to exit with fecal matter and excess Pitta and Kapha. The patient should rest and be given warm water to drink. When hungry, he should be given nutritive grains, mild and other rich substance.
"The nasal passages are the gateway to the mind and the senses." (Frawley 2001, 120) The most common Naysa are liquid palliation therapies that decrease excess doshas. These are performed by light oleation and massage of the face in order to open it up for reduction in the doshas. Naysa liquid is placed in the nostril while the patient is lying down, neck extended so that nostrils face upward. Secretions will soon flow from the nose. After treatment, the head feels light and symptoms of disease are reduced. If done properly, Naysa improves sensory organ function and makes the patient feel fresh and awake. Mild facial massage should follow and patient should clear the throat of all residue by gargling with hot water. Inhalation therapy may occur at this time. Naysa using powders may use a similar procedure and yield similar results.
Because Pitta dosha has a special affinity with blood, bloodletting can be quite helpful. It is also helpful in treating diseases that are not amenable to the oily and hot, oily and dry or cold and dry therapies. Bloodletting may be done by making little incisions with sharp instruments or by venesection. It may also be done with leeches. Disinfecting is important with all forms of bloodletting, but particularly with leeching. In this case, the area is thoroughly cleaned, milk or a little scratch is applied to the skin and the leech is attached. After the leech detaches, the wound left by the leach is cleaned, medicated oil is applied and the wound is dressed with a clean bandage.
Bloodletting is not commonly performed in Ayurveda now. Sometimes, however, Pitta types are encouraged to donate blood to deal with the tendency to produce excess toxins. Other times, strong blood cleansing nervines, such as turmeric, are recommended as an alternative.
After Pancha Karma, Rasayana may begin. Rasayana increases body tissues and metabolic processes at a tissue level and improves endocrine function. It also helps to remove waste products or to remove excess tissues in the body. Digestive power is also increased by Rasayana. Rejuvenation therapy increases the functional capacity of the brain and it strengthens and increases immunity of the body. Finally, Rasayana helps to destroy disease and establish homeostasis of energy, which also prevents early aging. Although Rasayana performs all these functions, there are specific purposes for the therapy. It may be for a specific reason (Kamya), for longevity (Vayasthapana), for improving brain function (Medhya), for improving actions of tissues, the channel systems or the senses. It may also be used to counteract a particular disease (Naimithik). There is also daily Rasayana (Ajasrik) (Frawley 119 ).
There are two types of Rasayana therapy based on location and procedures. The first type is Kutipraveshika Rasayana, or non-moving rejuvenation; and the second is Vatatapika, ambulatory rejuvenation. Of the two types of rejuvenation therapy, the non-moving type is the most effective and gives maximum benefits (Frawley 117 [ 2001]). This therapy requires that the patient stay in one place and avoid physical movement whenever possible. Traditionally, a special three-sided hut is built, in which the Rasayana can take place; however, now often a cottage, retreat house or even a hotel room in a remote or rural area may be appropriate. Whatever the place, it should protect the person from the elements, moderate internal environment and contain all necessary medicines and requirements for daily life. According to Frawley the patient should enter the dwelling on an auspicious day, after Pancha Karma and mental preparation, and stay there for up to three months. During this period, he should meditate, use pranayama and perform other yoga practices while remaining motionless. During this time he should also only eat Rasayana food prescribed by his doctor. Herbs having spiritual effects are prescribed and may include Brahma Rasayana, Chyavana Prash, Brahmi, bhallataka and long pepper (see Appendix B).
Vatatapika Rasayana, also known as ambulatory Rasayana, can be administered while engaged in daily activities, although these activities should be reduced and replaced with mediation, pranayama, yoga and other relaxation techniques. Diet should eliminate oily, fatty, spicy and sour foods. Alcohol should also be avoided. The same herbal mixtures as used in non-ambulatory Rasayana may be used. This method of rejuvenation is suitable for all, although it is not as effective as non-moving Rasayana. However, even on this abbreviated level, it can produce measurable results. Emerging from a period of Rasayana, the patient will feel renewed, revitalized and full of energy. Some people report feeling younger and motivated to make positive changes in their life.
Rasayana is a much more in-depth process than indicated here however. Herbs, diets and meditation require consultation with trained Ayurvedic physicians.
The brief description of Ayurveda provided in these last two chapters is sufficient to see that it is a lifestyle with rich possibilities. The fact that it has been around for more than 3000 years should demonstrate its effectiveness. No one uses a product that doesnt work, nor do they opt for a different one if the one they are using does work. And although Ayurveda is based in natural remedies and relies on a balance with nature, it has a long and scientific history. Still, it is rarely considered by practitioners of western medicine as a plausible solution to even problems that have eluded them for years. Western physicians and scientists often either fail or refuse to accept that we are part of nature and that it is entirely possible that the solutions to our health problems can be found in nature as well. Human health, welfare, and enjoyment of life depend in fundamental ways on the systems of nature surrounding us and for our own health we cannot continue to deny this. And with this in mind, physicians and individuals should look at Ayurveda as a possible solution to previously unsolved health dilemmas.
CHAPTER 7 - AYURVEDIC TREATMENT OF TMMY STORY
This chapter has been included to give a personal aspect to the diagnosis and treatment of transverse myelitis by both western and Ayurvedic medicine. Such a comparison is necessary to show that when one medical philosophy is unable to provide an adequate solution, an alternative treatment can have positive results.
In this chapter, Ayurvedas effectiveness, in contrast to that of western medicine, will be discussed in my own case study. It should be noted that western medicine was not ineffective in treating my TM; as a matter of fact, medicine was hardly applied at all. But the most meaningful part of my treatment with Ayurveda was that it had an immediate effect without waiting to see what test was to be administered next. There was no pain, no poking or prodding. I did not have to lie still. My hair did not fall out. Nothing was invasive. And most importantly, Ayurveda was a cure that I could keep for life; and even if I strayed, I could return to a good state of health without a million tests that told doctors nothing.
I had not been sick. I had not been injured. That is why to this day there is no specific reason for me getting Transverse Myelitis. I just woke one morning numb and cold, and at that time not even aware such a condition existed.
My primary physician, Dr. Del, and my neurologist, Dr. Chak, worked together and before any possible diagnoses were discussed, they ran me through an extensive history and a battery of tests.
Recent history exposed a series of idiopathic occurrences. I had a history of migraine headaches that mysteriously turned into cluster headaches and lasted from January 1994 until the beginning of 1995. I had been on beta blockers, calcium channel blockers, Nortripthaline, Elavil, Anaprox, thyroid medication, anti-inflammatory medications and gastric medications and there had been some question about drug interaction, however, all but the thyroid meds and the Elavil had been stopped months before and the doctors quickly ruled out this etiology.
On June 22, 1995, I fell while doing exercise and injured my left ankle and foot. I thought that I was just clumsy, but there was substantial edema and Dr. Del suspected a possible venous blockage or a cyst in my calf. A follow-up on this suspicion yielded negative results. In a follow up visit on July 10, I had experienced vertigo and a near syncpatic episode. An EEG was done, the results of which were normal. I was given antivert (an antihistamine that relieves dizziness, vertigo and fainting by blocking vasodepressors and increasing bloodflow to vital organs). The doctor wanted to rule out a heart problem so on July 15, cardiac studies, including an ultrasound and an ECG were done. Again, the results were within normal limits.
The next day, however, I experienced my first episode of TM. My symptoms included parethesia from the waist down, tingling down my spine and neck, Lhermittes signs (flexing of the neck produces electric shock-like sensations that extend down the spine and shoot into the limbs, caused by trauma to the cervical portion of the spinal cord, multiple sclerosis, cervical cord tumor, cervical spondylosis, or even vitamin B12 deficiency), unexplained pain in my arms, vertigo and a slight headache. I was "cognitively intact." A CT of the brain and spine were performed and again the results were normal. The ER doctors had no clue. They recommended that I follow up with my neurologist (I had one for my migraines) or my regular doctor.
Over the next week, I saw my regular doctor and my neurologist, had an MRI of the cervical spine, which was normal except the loss of lordosis and some degeneration in my cervical spine supposedly caused by a neck injury when I was 12 years old. The extent of the degeneration was not significant enough to cause the extent of symptoms I was having, so this was disregarded. An EMG was also performed, the results of which were essentially normal. Interestingly, the neurologist who performed the EMG suggested TM due to clinical symptoms, but either no one read the report, or they just didnt tell me. A tibial somatosensory evoked potential (SSEP) was performed and a left side abnormality was shown, but it was attributed to difficulty locating the lumbar nerve. In August, an MRI of the thoracic spine was performed because of further arm involvement. I had increasing pain and dysaethesia, but the results, as usual, were normal.
An MRI of the brain, as with the cervical and thoracic spines, is used to visualize lesions. Multiple lesions could lead to a diagnosis of MS; a single lesion or area of inflammation (myelitis) on the spine could lead to a diagnosis of TM. They would also be able to see any tumors, if any. The results of my MRI did not show any of these things. Gadolinium, an inert contrast medium that only enters the brain where there is a breakdown in the blood-brain barrier, such as a lesion, was not used and therefore the test results may have been inaccurate. In 2001, however, I had a subsequent MRI of the brain, with gadolinium, and it did not reveal old or new lesions.
I should have been happy, I suppose, but I wanted to know what was wrong with me and I wanted proof. It may have been summer outside, but it looked dark as winter to me and I was freezing too. I felt so depressed, as if I was doomed. I even made out my will so that I could be secure in the feeling that at least my daughter was taken care of. This, I learned, is a typical reaction in TM.
By the end of August, 1995, I was still symptomatic with tingling in the arms, although some paraesthesia in low extremities resolved. I still had the sensation of being cold. Lhermittes sign was still prominent. Tingling, popping and cracking occurred in the neck when I moved my head or climbed the stairs. A nerve conduction study of upper extremities showed a normal reaction. Steroids were prescribed by the neurologist.
In September, I had another neurologic assessment. I was beginning to think that no one believed me because all the tests were coming back normal. I knew that it was real, and I didnt believe that a psychosomatic illness could bring on this much pain. I began trying to convince myself that I was not a hypochondriac. This, combined with the symptoms I was having was almost too much. I was beginning to get tired of being tested and poked and not believed, even by my family and friends.
On September 21, 1995, Dr. Del ran an ANA and an anti-DNA test specifically to rule out lupus, or possibly some other autoimmune disease. Although, my anti-DNA was elevated (222/ml, normal 99/ml), my ANA was normal and this result was used to rule out lupus and a number of other autoimmune disorders. The elevated anti-DNA was related to a familial tendency for this result. Two of my siblings and my mother have had similar readings, but all three also have some type of immune system disorder (gamma A deficiency, epidermal rash, and an idiopathic disorder possibly related to rheumatoid arthritis). For this reason, in my case an immune system disorder still has not been ruled out.
I developed tachycardia, a side effect steroids, so they were discontinued. This made me happy, because the drugs made me lose my hair. Clinically diagnosed with TM, the possibility of multiple sclerosis was raised. Visual Evoked Potential (VEP) was performed. This is a fairly certain test for MS when there is impending optic neuritis; however, the results again were negative. By this time, I had had enough of doctors, hospitals and tests to last a lifetime. In October, I refused a spinal tap because I felt it was invasive. I refused any further treatment, and I went back to my life. By the end of November, most of my symptoms had subsided, but I fell at school and broke my left ankle. I made two trips to the doctor and I did not return until I had further problems with my ankle in February of 1996. In March, I had another fall in which I broke my tibia and fibula of the right leg. Surgery was required for open reduction and internal fixation (a plate). In April of 1996, I had the first in a series of bladder infections and for some reason, my doctor took me off of Elavil, a medication often used to treat incontinence.
From January 96 until May of 98, I had intermittent urinary incontinence, urgency and bladder and kidney infections. These are common symptoms with TM, however, I had no other symptoms. They are also some of the lasting side effects of the disorder, but I had not experienced them during the exacerbation. In March of 1998, I had uro-dynamic testing done, which is an assessment for incontinence. The results were better than normal, and I was tired of being normal, but still having these symptoms. These symptoms were not normal for me.
In September of 1997, I experienced hearing difficulties. My hearing levels turned out to also be better than normal, and my temporary hearing loss was attributed to ear infection. A BAER test was not performed at this time. (This is another test for MS, which tests lesions of the cranial nerves.)
Over the next four years I experienced several bad falls and suffered some serious injuries, including neuropathy in my neck, right arm and wrist. All of the falls were unexplainable except for being weak in my legs or uncoordinated. In 1999, I suffered from fatigue, muscle weakness, anxiety and nervousness, but nothing was done. In April of 1999, having had a significant weight gain since the onset of my disorder, often feeling fatigued and just tired of being tired, I began a weight loss routine that consisted of working out twice a day, increasing my protein intake and decreasing my carbohydrates. By July, I had lost nearly 40 pounds, and I took a long awaited 16-day trip to Poland. I felt that this trip was a way for me to relax and fulfill a dream of seeing the homeland of my mothers side of the family.
In August 1999, following the trip to Poland and being subsequently laid off from my job, I experienced exacerbation No. 2. I tried to ignore it and did not go back to the doctor. I decided just to continued working out hard until it just went away. Going to Europe had broken my cycle somewhat. In Poland, the diet was heavier and richer than I had been eating at home, and I did not attempt to diet while I was there. When I returned home, I already felt sick. Then, when I lost my job, within three days my symptoms were as bad as they ever were. I limped and dragged my right foot. I had Lhermittes sign, urinary retention and then incontinence in cycles. My arms and legs were numb and I tingled at my waist. My upper arms, calves and neck ached with characteristic neurologic pain. Headaches tingled up from my spine. I wasnt going to let it get me; so I worked out and had protein shakes twice a day and a light, well-balanced meal at dinnertime. I drank 10 or more glasses of water and avoided pop, sugar and junk food. I sat in the hot tub and saunas until I could not breathe. I was probably on the right track, but I pursued this routine with such intensity that I was burned out by October. I still ate well, and exercised occasionally, but all that energy was gone. The good part was that by the time school started in September, all my symptoms were gone except that when I climbed stairs I felt a "gurgling" at the base of my skull which was a constant reminder that there was something still not right with me.
Unbeknownst to me, in January of 2000, I did one of the most important, spiritually enriching acts according to Ayurveda. The pursuit of a career and other activities that use your God-given talents (Dharma) and which you enjoy is one of the healthiest things you can do for your soul and your mind, and in turn your body becomes balanced too. I took an internship as a midwife, and began teaching elementary school children on my off days. I had always wanted to be a doctor, and being a lay midwife was, in a way, a partial fulfillment of that desire (while still in pursuit of my undergraduate degree). Education had also been a passion for me and I wanted to share that with the open minds of children. I was happy, and for a while, healthy.
By October, however, something had gone wrong in the midwife practice where I worked. I could not tell what it was, but I was worried. Soon after, the practice dismissed all of its students and I was devastated. I cannot remember a time when I had been so happy and now it was gone. I needed to be with those women, as much as they needed me to help them, but I couldnt even help myself. I fell into a deep depression. I couldnt even go back to school. But something told me not to take the antidepressants that the doctor recommended. Instead I exercised, tried to eat better, took vitamins and kept reading Midwifery literature. I had moved to a set of holistic beliefs through my exposure to midwifery, naturalistic reading materials (naturopathy) and practice, and I had not even discovered Ayurveda yet.
In January, I got a job as a legal assistant/secretary. It wasnt what I really wanted to do, but at least I was making some money. Eventually, I did get to enjoy it. At the end of February, however, my right hand began to tingle. I assumed that it was from an injury I sustained when my hand was accidentally snapped back. The NCS was normal, so I wore a wrist brace and the tingling eventually subsided. But then, the tingling began in my legs off and on, and I worried, but did nothing. I knew the doctors wouldnt help me.
In May 2001, TM symptoms returned in full force. Still, I did nothing but drink my teas, take my vitamins and hope it would all go away. In June, my daughter and I started Karate classes. My schedule also contained meditation and I began to believe that this was an important thing that was previously missing from my life. After my meditation class, I rose from the mat and felt relaxed and for the first time in months, my spine did not feel tight. I also explained my disorder to my Sensei (teacher); and the next Karate class, he handed me the book Quantum Healing by Deeprak Choprah. The book further opened my eyes to meditation and for the first time, I did not roll my eyes at holistic medicine. I was honored that my Sensei cared enough to share this wisdom with me. Dr. Choprah relayed the idea that the body knows how to cure itself and all it needed was a little push. Meditation was one of those little pushes. Meditation pushed me too. I did a great deal of research on neurological illness. I had fallen again and began having headaches, pressure behind my right eye, paraesthesia in my upper and lower limbs and numbness in my spine. Finally, in August 2001, I asked to be tested for MS, even though many of my symptoms had subsided. I wanted to known now, and I was prepared to take the answers.
My blood work was perfect except that my coronary risk was very low, and I dont think that should be considered a problem. A CT of the brain to rule of cephalagia and the brain auditory evoked response test (BAER test) was finally done. As expected, the results were normal, except the radiologist warned to check for a possible syrinx in the spinal cord (fistula) and recommended MRA to evaluate blood flow through circle of willis (an area of the brain) because of my history of chronic headaches. These tests were never performed, it was never even suggested and I began to wonder if my doctors were even reading the test results. An MRI of the brain with gadolinium contrast and one of the cervical spine was done to rule out MS and TM. The results were within normal limits. Thus far, MS was negative. And I was referred to my former neurologist, Dr. Chak, because my physician suspected an atypical seizure disorder.
On neurologic assessment, my symptoms consisted of intermittent tingling in the left arm and right wrist, accompanied with upper arm neurologic pain with cold exposure; tender and dull spots on the spine, intermittent paraesthesial girdle, intermittent urinary urgency and incontinence, increased muscle tone in lower limbs, affluent papillary defect in the right eye (not pertinent), abnormal upgoing plantar reflexes (due to injuries in both feet), complaints of anomia and dysarthria. The impression was that neurologic findings were suggestive of TM, up-going plantar reflexes (attributed to injuries), and common migraine relieved with Ayurvedic nose drops. Doctor Chak, who is originally from India, seemed amused at my use of the Ayurvedic practices, although he did not pursue it much further than asking where I got the medications and who was my Ayurvedic physician. His report simply stated that I was using "medication" for headaches and to boost my immune system. Like my primary physician, Dr. Chak also initially suspected possible seizures of an atypical nature, including "intermittent sensory symptoms of a transient nature" and "intermittent problems with language." Because during my examination, although I used the wrong words, I was aware that I used them incorrectly and was able to correct them, this complaint was disregarded. I also displayed high cognitive ability through my conversations with him. He refined is diagnosis to state that the overall suspicion for seizures is low given this evaluation.
He sent me for EEG studies, a visual evoked potential (VEP) and a tibial somatosensory evoked potential study (Tibial SSEP). A spinal tap again was suggested; however, I again declined this invasive procedure. If my condition had been severe and acute, I might have agreed, but my level of functioning was high and I was able to control my symptoms largely with the aid of Ayurveda.
Gradually, I was grasping the knowledge of this alternative care method. It seemed to me that I was always sickest in February and March, and July and August. This first period is when Kapha has built up and Kapha disease occurs. July and August are the months when all doshas are disturbed. I began to see that where doctors were offering tests, Ayurveda was giving some answers.
Ayurvedic Treatment of a Neurologic Disorder
In Ayurvedic medicine, Vayu is considered the vital nerve force that pervades the entire body and therefore the root of all nervous disorders. It is said that excessive cold, roughness, lightness, improper diet, sex, talk, lack of sleep, or release of toxins in the blood aggravates Vayu. Excessive physical exercise, travel, anxiety, fear and grief also aggravate Vayu and cause nervous system disease.
Ayurveda believes that neurologic disorders begin in the colon, where Vayu is housed and can move into the other areas of the body through channels that connect them all. Vayu increases cause distress along the alimentary canal, particularly in the proximity of the colon, with pain in the waist and back and difficulties in the low body parts. This results in symptoms such as twitching, pulsating and cutting pain throughout the entire body. There may be urinary or bowel obstruction, vertigo, vomiting, epilepsy, loss of vision, hearing or sensation, numbness redness and discoloration of the skin, indigestion, loss of appetite, poor complexion, severe muscle pain, heaviness, rigidity, insomnia, cramping, neck and back pain and stiffness and swelling in the joints. All of these symptoms can be see in SLE, MS and/or TM.
Once the other areas of the body are involved, symptoms may be mixed with symptoms of the other doshas, thus complicating diagnosis. For example, it is much easier to say that "a Vata Pitta is suffering from a disorder where Pitta covers prana," and immediately treat them with licorice root, followed by purification, massage and soothing herb, making them feel better immediately with no side effects and no recurrence, than it is to say that this "thin but athletic person with a good head on his shoulders suffers from a possible ulcer, with stomach pain, vomiting, weight loss, and mental distress," before testing shows an H. pylori infection with bleeding ulcers. This diagnosis requires several blood tests, fecal test, endoscopy, and stomach biopsy followed by at least four medications for up to 28 days. This is why Ayurveda assesses the symptoms, traces them back to their place of origin (the colon, small intestine or the stomach (V, K, P)), and treats them and thereby rebalances the system rather than trying to cure the disease. There is only balance and imbalance in Ayurveda, names are used to explain to those who have learned differently. Essentially, in Ayurveda, there are 20 different categories of symptoms, based on the five Vayus and each ones interaction with the other four. These categories give a point of reference for diagnosis and treatment of neurological disorders. (Tirtha 464)
When only Vayu is in excess, the disease can be treated with ghee and oil, internally and externally to sooth the nervous system. This is consistent with reparation of the myelin sheath through the increase in essential fatty acids. Treatment also includes Vayu reducing foods, (such as almonds, ghee, lassi, barley and sesame oil), oil massage, herb baths and herb wraps around affected areas (see herbs below). For urinary retention, a urethral douche is recommended along with diuretic herbs like gokshura and steamed vegetables. Pancha Karma regimens such as sudation, purgation, oil and non-oil enemas, bloodletting and nasya may be used as well. Herbs recommended include gugul, haritaki, brahmi, gokshura, ashwagandha, bibhitaki, bala, cedar, dashmul, trikatu.
A disease such as MS or a disorder like TM, result from an excess of Vayu and Pitta, but may be complicated by Kapha. The foremost suggestion for this type of illness is for nerve calming and strengthening and immune system building herbs. (Tirtha 475). Female herbs may include jatamanshi, shatavari, ashwagandha, yogaraj guggul, triphala, and brahmi. Male herbs (in males MS is more severe and occurs a little later in life) exclude jatamanshi and add vacha to the female herbs. Hot oil head drips and head oil baths which reduce excess Vayu in the head and calm and tone the nerves are also recommended. Hatha yoga is one of the most effective therapies for MS. Yoga can be a calm and relaxing way to increase flexibility, improve coordination, tone muscles and nerves and improve immunity. A stimulating body massage with sesame and mahadrayan oils has also been effective for those who suffer from MS, reporting a decrease in pain for hours following the therapy. Nasya is also recommended with herb oils from shad bindu. (Tirtha 476). Diet for ones dosha should be followed rigorously and other lifestyle changes could help as well.
My Personal Regimen
Until recently, Dalia Monassebian was my Ayurvedic practitioner. She assessed that my physical (prakriti) dosha was Pitta/Kapha and my mental dosha was Vayu. This makes me a VPK dosha, probably the rarest dosha type. My current state of health, or ill-health (vikriti), is the same. Dalia explained that when you are ill, you have built up within you more of your own dosha than is healthy and you become out of balance. So your state of ill health is you being too much of you (Monassebian 2001). To stay healthy, you must be your own watchdog and monitor your intake of that dosha, and I have to watch all three (no wonder I was sick).
My constitution is predominantly water (Kapha) and fire (Pitta). An excess of fire and water elements creates cold and heat, heavy and dampness in the body, specifically in the chest and lungs, sinuses, stomach and small intestines. An excess of fire causes heat-related issues like hot temper, overly critical and impatient behavior, skin rashes, skin eruptions, allergies, eye problems, ulcers, diarrhea, etc. An excess of water can create bronchitis, overweight and mental lethargy. The aim of Ayurveda is to create a balance between the elements of air, water and fire and earth. When Kapha/Pitta dosha types are balanced, they are flexible, cheerful, goal-oriented and leader (Monassebian 2001). Fire helps one be more goal-oriented, express leadership qualities and warmth, give physical strength. Balanced water gives loyalty, love, compassion and a solid personality. I believe these qualities are true of me when I am unstressed and Ayurveda has helped me be these things even though I have not fully managed to convert to an Ayurvedic lifestyle.
Below I outline the Ayurvedic treatment and changes I have made. This description relays my impressions and for the most part does not attempt to justify or discredit any Ayurvedic practices.
Detoxification. The first thing I should have done was receive Pancha Karma detoxification, followed by Rasayana rejuvenation, non-moving therapy for at least a month. But, because I am an American with a million things to do, initially I did not realize the importance of myself. I also needed to work for economic reasons and wanted to finish school. The closest PK facility was also in New York. For all these reasons, I opted for a mild self-detoxification based on Pancha Karma, guided by my practitioner.
Detoxification took place in early September 2001. It consisted of purgation by a mixture of herbal teas, raisins and cranberry juice over a series of 3 days. Preparation included use of sunflower oil for three days and use of the steam room each day for 40 minutes prior to purgation. I received oil massage during 2 of the three days and got a considerable amount of rest. Frankly, I felt sick for a few days following this procedure, but after I recovered my appetite and began eating purer (organic) food and drinking bottled water, I felt what can only be described as "lighter." This act of purgation removes Kapha, which creates heaviness. It also removes Pitta, which are the fires of the body. My stomach was not upset by foods, my head did not ache, my spine nor legs tingled any longer, and I was able to relax.
Rasayana. Throughout the month of October, I used self-guided ambulatory Rasayana. I concentrated on meditation and avoidance of stress. I kept to myself and was in a state of constant thought and contemplation. I tried not to think about my health, but instead about how I related with people and how I could resolve conflicts, particularly with my family. I also considered my own goals in life and how to fit those goals with my Dharma (gifts). The most important thing I did was tell people not to phone me for a month.
During this period, I was supposed to limit my movement. I temporarily left karate, but continued with yoga and took walks at lunchtime. This was probably a good thing because the movement prevented stiffness. I also took baths with brahmi oil to open my mind. By the end of October, I only had dysaesthesia in my thumb and index finger of my left hand, and I felt refreshed and younger. The stresses in my life and the disabilities caused by my illness made me feel old, but this period of withdrawal removed this shadow from my mind.
Diet. According to Ayurveda many physical health issues are due to poor digestion. I try to eat traditional home-cooked meals, but also try to avoid cooking the very heavy, oily, fried, sweet things I am used to because of my Polish and Italian heritage. I do chew fennel seeds to prevent stomach distress and foul breath. It is very effective for both and reminds me of Italian food.
Daily Herb Supplements. Mind Harmony Plus nose drops are a natural brain tonic with herbs that builds brain cells and tissues. The drops clear the head and relax the mind. Most people who are prone to headache/migraine are free of symptoms after taking the proper herbs internally and use nasya (nose dropsinhalation of medicated herbal oil). This part of Pancha Karma is a daily ritual and I am basically headache free.
Thyroid Harmony was prescribed for hypothyroidism because I was taking Armour, a brand name thyroid prescription drug that was derived from the thyroid of pigs. Since Ayurveda does not advocate the use of animal products and I felt funny about using such a drug anyway, I opted to use this remedy instead. I had also heard that natural forms of thyroid treatment have been said to "cure" thyroid dysfunction as well. Thyroid Harmony reduced the size of my thyroid gland and made swallowing easier, something no other thyroid drug was able to do in the past.
Edema Harmony is an herb mixture that is soaked overnight and then boiled in the morning, mixed with water and consumed. It prevents edema from occurring and I take it when I find I am having a problem with edema, particularly in the leg with the former fracture. Edema Rub is an herb-infused oil that is put on the skin and allowed to soak in. It is followed by a soaking bath of very warm water. Edema Rub also takes down edema within one hour.
Gall and Skin Harmony is perhaps my favorite herbal formula. I was plagued by digestion problems during my exacerbations, but when I combine my meal with Gall and Skin and a little warm water, I rarely have stomach distress. The wonderful side effect is having nicer skin.
Manas are brain tonic herbal tablets that improve mental clarity, concentration, memory and generally recommended for migraine patients. These herbal ingredients are known to nourish the nervous system and build healthy tissue.
I also use primrose and flaxseed oils, which are good sources of essential fatty acids (EFAs). I began taking these because I knew that they were often prescribed for MS by western physicians, and could possibly help my condition because most Americans suffer from EFA deficiencies.
Using diet to bring my doshas into balance, I was told to consume more bitter and astringent energies in the form of food, aromas and herbs. Nightshades, such as potatoes, tomatoes, eggplant, peppers and chilies, may cause allergic or other bad reactions for my Pitta element, so I do my best to avoid them. I also learned that it is very important to eat in a calm to celestial state of mind. Angry, driving, bad or sad moods feed negative energy and are difficult on digestion. Conversely, it is said that if a prayer is said of food, light incense is burned and some nice meditation music is played, the atmosphere is peaceful, healthy and easy on digestion. In other words, be relaxed, happy and dont rush through meals. Amazingly, this prevents indigestion, heartburn and overeating, even with foods that normally may encourage these conditions.
Cooking Herbs: Certain spices help make digestion less work for the body and improve nutrient absorption. I like cooking with or sprinkle on herbs such as coriander, mint, rose petals (syrup), saffron, turmeric, cardamom, raspberry leaf, cumin, and fennel, to aid in digestion and add nice flavor to food.
For my dosha, fruit should be eaten between meals as snacks. Apples should be eaten in the fall and apricots, mango, pears, pomegranate, prunes, quince and raisins are recommended throughout the year or when in season. I have consciously tried consuming more fresh fruit since my use of Ayurveda. I buy a few pieces of fruit every couple of days to insure their freshness. Canned fruits are not as good because they have a tamasic quality and I find that they give me indigestion. This rarely occurs with fresh fruits.
Vegetables recommended for my dosha include asparagus, bell pepper, broccoli, brussels sprouts, burdock root, cabbage, fresh corn, cauliflower, celery, green beans, dandelion, collards, lettuce, okra, parsley, peas, green peppers, squash (scaloppini, spaghetti, summer, yellow crooknecks, sprouts, watercress. Because of their fire element, onions, garlic and hot peppers should be avoided, especially in Pitta months. I have a problem with this because I have always cooked with them, but I either find mild onions and peppers and go light on the garlic or I find instead some other flavor, such as fennel, which has its own benefits.
As for grains, cooling barley is best for Pitta types. Basmati rice, cooked oat bran, wheat bran (in moderation) are for my Kapha side. One of the most difficult things for me to deal with was that bread should be yeastless unless toasted. I love soft fresh bakery bread (without preservatives), but I have learned to limit yeast bread to about once every 2 to 3 days. I also love oatmeal, but this can cause accumulation of Kapha, so I try not to eat it more than once a week. Among legumes, mung beans, which do not cause gas, are considered best for most doshas. Aduki, black, blackeyed peas, chana dal (yellow lentils), garbanzos, lima, navy, pinto, white or tur dal (lentils) are also recommended. Seeds and nuts, which provide necessary oils and proteins, are recommended in moderation and pumpkin and sunflower seeds are considered best for VPK dosha types.
Oils have many important uses in Ayurveda. Ghee (clarified butter) or sunflower are used in moderation in the summer. I prefer olive oil and my body is used to it, so I often cook in olive oil and flavor it with ghee. This also keeps down saturated fats, which remain in trace amounts in ghee.
Recommended dairy products for my dosha are ghee, as described above, and yogurt lassi (1 part organic yogurt: 3 parts water). Yogurt lassi can be a refreshing drink when mixed with preferred fruits and flavored with a little honey. This is one of my favorite drinks and makes me feel like Im drinking a milkshake for breakfast. In general, either raw honey or succanat/Florida crystals are used in limited quantities. Stevia, which I often use, is also okay, in moderation, but Ayurveda does not appear to address this substance directly.
Animal products are generally avoided except for strength when ill. In this case, it gives strength, but is disharmonious on finer levels, as meat is always tamasic by the time it reaches you. The best animal products for lowering air (Vata) are ghee and lassi. Other products used are poached or boiled egg white, white meat chicken or turkey. I also like to use ocean fish, (with the exception of swordfish and shark which are known to carry high levels of mercury). There is less chance of environmental contamination than with river or lake fish, and it adds protein to my diet.
Beverages are an important part of Ayurvedic living, as water in various forms hydrates and balances the body. Although I never had difficulty consuming 8 glasses of water a day, Ayurveda provided me with new perspective in how to creatively consume beverages. The juice of aloe vera, apple, pear, apricot, berry, carob, mixed vegetables, fig shake, other fruit juices mentioned above and boiled goat milk (I personally dont like this) are recommended for my dosha. Teas of alfalfa, barley, bansha, borage, burdock, catnip, chamomile, chicory, chrysanthemum, corn silk, dandelion, hibiscus, jasmine, lavender, elder, lemon balm, lemon grass, nettle, passion, raspberry, red clover, rose, saffron, sarsaparilla, mint, strawberry leaves, violet, wintergreen, and yarrow, not only impart water to the body, but also have medicinal and therapeutic properties (see Appendix B). I have now used many of these and have found that they have a particularly refreshing quality that soda and highly sugared drinks just cant match.
When herbal preparations are made, the average amount of herbs or herbal mixture used is between ¼ to 1 tsp, ½ hour before meals. Herbs may be mixed with clarified butter or with a drop of honey, but I prefer them in teas. Teas can be made with 1-2 tsp of herbs and boiled for at least one minute to release their properties into the water. Ayurveda also advises to cook herbs in heated clarified butter or oil and then add food to the mixturethis can be quite delicious.
Perhaps the most important medicine is knowing and following ones life purpose. As I said, I was never happier than when I was teaching and working as a midwife. I try to enjoy my current job so as not to drag myself down or cause undue duress or even fatigue. I do not think that I will be truly happy until I am a doctor and, I feel that is what I am meant to be. Therefore, I will pursue it to its end. That pursuit alone brings me personal harmony.
Other Therapies. I use sandalwood aromatherapy for peace of mind and improved concentration in meditation. It is also good at enhancing the memory for all doshas. I also use basil, recommended for spirituality, frankincense for anxiety and stress, cedar for grounding and warming. I use these various aromas in the form of oil, incense, soap, candles, sachets. I have even tried making my own mixtures, which is a therapeutic practice in itself.
Colors are used in your clothes, home and office. The most uplifting colors for me are white, lighter, healing pastel shades of pink and blue (e.g., sky blue, turquoise), which are said to be very good at balancing, and for me they are. For air, my Vata element, warmer colors like gold, orange, yellow and a bit of red are also suggested and are great for giving me energy. My sin is that I have a lot of clothing that are dark grays, browns and black which upset wind elements and drag me down mentally. I did not realize this until I took a good look at my wardrobe. I have gradually started adding bright and light colors clothing and discarding some of the darker items.
I have trouble believing in gem therapy because I have a strong chemistry background. However, I do believe in the psychological component that says we all prefer certain colors and therefore they make us feel good. All the stones recommended for my dosha are pleasing to me (I am easy to please however). White stones like pearl and moonstone set in gold are said to be best for Vayu, which is my mind dosha. Red coral, ruby or red garnet would be good for both Pitta and Kapha doshas. In rings, gems are said to be 3 carats and pendants or bracelets 5 to 7 carats, but that is a little expensive for me. I am happy, and it makes me feel good, just to have a beautiful stone on my hand or around my neck.
There is an astrological connection to gem therapy as well. A better way to use gemstones is by having a Jyotish (Vedic Astrology) reading, but some stones can be expensive and they are not absolutely necessary. So unless astrology is something you believe in, it is probably not a necessary part of your lifestyleit is not part of mine.
Yoga is an essential element of an Ayurvedic life. It provides energy-enhancing actions that promote healthy dosha balance. As an overweight individual, any yoga posture that bends at the middle is recommended, but my dosha must be taken into consideration. Sitting and prone positions are good when Pitta is in excess. Standing postures are best when Kapha is aggravated. Shoulder stands and back bends are also good, but not when my spine tingles. Deep breathing is essential and calming (pranayama). Specific postures for Thyroid are the bow, the shoulder stand and the fish (which promote blood flow in and out of the neck area and open the channels of the body). For migraines, the fish pose and pranayama are highly recommended. Because my family has a history of gall bladder disease, and I have had indication of it as well, the siddhasan and lotus poses are recommended (they open the body up to permit flow of energy and body fluids).
What impressed me with regard to yoga is that any condition can be improved with yoga through a specific routine of positions (see Appendix D), which routines can be rotated to attend to all conditions, and the variety of routines and positions prohibits boredom. I had to consider yoga for neuropathy, bladder control and obesity. One is constantly learning and improving in yoga and after a short time results can be seen and felt. I am much more flexible, particularly with regard to my spine and neck and I quickly recover from injuries I suffer.
I have always been big on summer exercise because I wasnt in school and it was a time I could work on weight reduction. But because Pitta is a fire element, I have learned, and it makes sense, that the heat of summer is not a time for strenuous exercise. Cold, rainy, damp weather is more tiring for heavy exercise like running, and because of my ankle and Achilles tendon, I am not supposed to run anyway. I prefer, and it is recommended, that I alternate jogging on the treadmill, lifting weights and swimming, in addition to daily yoga. According to Ayurveda, walking and swimming are the best for all doshas, and I enjoy these most.
Meditation can be done anywhere, any time; lying down, sitting, walking, or even while typing from copy. It can be with a mantra, with a thought, a feeling, a look at nature, thoughts about God, love, or virtually anything that doesn't cause strain or worry. It is a good way to practice giving up worry, fear, negativity, anxiety and lack of faith. As for mantras, "Hoom" and "Ram," which essentially mean nothing as words in themselves, are good for dispelling negative psychic impressions and give divine protection, respectively. I try to meditate at least 20 minutes per day, plus a little before I go to bed. Stress appears to be the biggest trigger of my illness. By replacing stress with meditation, my symptoms come on less and less. Meditation, the first part of Ayurveda, has been the most important to me personally.
As another helpful and enjoyable ritual, I regularly apply oils to various parts of my body and massage them myself, or I go to Mary Jo for a regular massage. Like meditation, these release stress and diminish the hypertonia in my neck, shoulders and arms. Brahmi oil, said to be excellent for the head, has a penetrating way about it and is the most helpful for relieving stress. Sesame or Sunflower oil are said to be good for the body, although I have only used sesame, which has a nice feeling to it. Mahanarayan oil is used for pains, arthritis, sports injuries etc., it is stimulating to the skin and releases tension from the muscles. I use this oil for my stiff neck and back and sometimes I put it in my bath.
There are a few things that I have just begun to do. One thing that I now do is that I scrape or brush my tongue, but I dont know if this in itself accomplishes anything. I dont choose to smoke or snuff herbs. I have never indulged in smoking and I dont think I ever will. Snuffing herbs seems bothersome when Naysa makes it much easier.
Music therapy has also become important to me. I am a musician and have always enjoyed music, but I have not really allowed it to consciously affect me. By using meditation music while driving, I think about the day and release all the stresses so I can go home and begin my evening in a positive mood. If I follow this music therapy with Yoga, I am already in a frame of mind to gain from the positions. Music therapy has helped me in another way also. I have played piano since I was seven years old, but since the recent onset of my illness, I shied away from playing because I felt clumsy. In January of 2002, however, I purchased a symphonic harp. Much thought went into this extravagant purchase, but I felt a need for it. For the first two weeks, I played two hours per day, and amazingly, most of the feeling returned to my left hand. The pressure I apply to the harp must be strong and steadythis is beneficial physical and musical therapy. To my surprise, I was able to play many of the musical pieces that I had not played since I was 17-years-old when finances required me to quit. I cannot express how returning to the harp has brought me joy and peace. What is even more rewarding is that through meditation, thought, and an acknowledgement of my Dharma, I was able to heal myself.
I have learned from my experience that one's intuition is, in the final analysis, the best doctor. My intuition led me an alternative direction to modern medicine and also taught me to take control of my health in a way that modern medicine was never able to do. Ayurveda is a science that aids us in taking responsibility for our own health. With Ayurveda, we personally must refine our dietary programs and daily regimen to take our constitutional mixture into account and this enriches us mentally with knowledge, as well as spiritually. If we fail to tend to our own needs, we are responsible for the loss of good health. Then, when we again focus on our needs, we are responsible for our return once again to good health. Ayurveda does not, however, necessarily replace any other form of medicine, but rather, it is based in universal principles which suggest that all forms of healing, prevention and rejuvenation, new and old, East and West, are useful and a part of Ayurveda, making it a truly holistic approach.
This chapter showed that when modern medicine was not effective, and was even, in some respects, detrimental to my health, I had somewhere else to turn. That avenue was Ayurveda. Although it was, I admit, no easy task, without it I doubt I would be as well off as I am today. For this reason, and because I have no doubt that there are others who have had similar experiences with disease and modern medicine, Ayurveda should be an acceptable, readily available, complementary philosophy to modern medicine.
CHAPTER 8 AYURVEDA AND OTHER COMPLEMENTARYAND ALTERNATIVE MEDICINES IN THE WEST
Ayurveda is not the only alternative medicine that can be beneficial to those who cannot be helped by modern medicine. This chapter on CAM provides some examples of what is included in CAM, insight into the current CAM evaluation in the US, and the position of proponents and adversaries to CAM integration. It also shows that there is some hope that allopathic and alternative medicines may soon have a peaceful partnership, through which we may see a decline in those many illnesses that are currently on the rise.
The previous chapters have covered the environmental ills, the illnesses they may be causing, and examples of what both modern and Ayurvedic medicine can do to alleviate the illnesses. Sometimes all it takes to see something is to open our eyes. Even in modern medicine there is no single approach to addressing any problem. And there is no reason that the entire healthcare field, including CAM, should not be examined when trying to solve a medical problem, treat a symptom or cure a disease. The question is, shouldnt all doors be open for all people? Of course, this runs into the issue of insurance and healthcare costs, not to mention regulation. But some health insurance companies are already paying for or considering covering CAM treatment because many times they are less expensive, effective and satisfying. The US government has also begun a campaign to examine CAM and the initiation of regulatory measures. But these issues are not as important as the fact that the entire world needs to open its eyes to other options, even if extensive research on CAM philosophies need to be done. We cannot close our minds, otherwise we could foreclose viable answers.
What is included in CAM?
The National Center for Complementary and Alternative Medicine defines CAM as "those treatments and health care practices not taught widely in medical schools, not generally used in hospitals and not usually reimbursed by medical insurance companies" (NCCAM 2002). This definition encompasses a huge range of healing philosophies, approaches and therapies and include anything from ancient Eastern traditions to recent holistic permutations.
Chiropractic. Chiropractic is undeniably the most often used and accepted CAM therapy. Chiropractors most often treat back, shoulder and neck pain. Chiropractic treatment involves manual manipulations, much like osteopathic adjustment, of the spine to adjust misaligned vertebra and restore the body to normal functioning. There is now substantial evidence that such manipulative therapy is effective for acute uncomplicated lower back pain (RAND 1989).
There is concern about the questionable and potentially harmful effects of aggressive chiropractic practice, however, chiropractic care has brought relief to millions of people for over a hundred years. And, although the scope of chiropractic practice is limited to neuro-musculo-skeletal problems (loosely defined as Type M conditions i.e. muscle spasms, strains, sprains, fatigue, imbalance of strength and flexibility, stretched or irritated nerve tissue, etc.), chiropractors have relieved conditions such as bronchitis, migraine headaches, kidney and bladder dysfunction, menstrual cramps, GI disturbances and sinus problems.
Acupuncture/Acupressure. Acupuncture and acupressure are parts of traditional Chinese medicine. They use fine needles inserted into, or pressure massage applied to, respectively, the skin at specific points to alleviate pain and reduce nausea. These therapies are gaining popularity and are accepted as viable medical therapies by many western physicians and insurance companies. A recent assessment of these therapies by the National Institutes of Health found that acupuncture in adult postoperative and chemotherapy nausea and vomiting and in postoperative dental pain. In other situations, such as addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma, these therapies may be useful as an adjunct treatment or acceptable alternatives to conventional medicine or as part of a comprehensive management program.
Massage Therapy. This type of therapy, which includes a variety of techniques including Swedish, deep tissue, sports and neuromuscular, manipulates soft body tissue to affect the musculoskeletal, circulatory-lymphatic and nervous systems and increase circulation, promote relaxation, and encourage healing and well-being. The massage therapy community rightly boasts that it is drug-free, non-traumatic, and pain-relieving without side-effects, and that it is arguably the earliest, the latest, and the safest health technology. This may indeed be true as massage now verges on not being a CAM any longer because of its extensive use in physical therapy, which now has a proven history of improving and accelerating recovery in debilitated patients.
Biofeedback. This is a relaxation therapy developed by an experimental psychologist. It uses electrical instruments to monitor bodily functions, such as blood pressure and heart rate, to train patients to become aware of and capable of altering normally involuntary responses. Biofeedback has effectively been used to treat chronic pain, tempromandibular joint disorder, irritable bowel syndrome, Raynaud's syndrome, epilepsy, attention deficit hyperactivity disorder, migraine headaches, depression, traumatic brain injury, sleep disorders, high blood pressure, panic or anxiety, and gastrointestinal problems. Meditation and biofeedback are interrelated and both of these therapies are gaining popularity in western culture and medicine.
Homeopathy and Naturopathy. Homeopathy "uses highly diluted solutions of natural plant, animal or mineral substances to cure ailments (chronic and acute) that the same substance, in larger quantities, could cause" (Sullivan, 56) in a sort of vaccination type approach. Naturopathy combines a number of alternative approaches, such as clinical nutrition, homeopathy, botanical medicine, lifestyle counseling and traditional Eastern medicine.
Both Homeopathy and Naturopathy have a large following particularly because of the popularity of Bach Flower Remedies, including Rescue Remedy. Dr. Edward Bach, once a prominent English physician and surgeon, because of personal dissatisfaction with the philosophies of orthodox medicine, left a successful practice to develop 38 single flower-based remedies (infusions) each directed at a particular characteristic or emotional state. Rescue Remedy is a combination of these flowers that attends to any state of stress. Physicians who choose homeopathy or naturopathy as their underlying philosophies usually feel as Bach did in his dissatisfaction with the way doctors were expected to concentrate on diseases and ignore the people who were experiencing them. This adds a very human element to the physicians bedside manner and appeals to patients, particularly those who were tossed around because western physicians could not come up with a diagnosis or treatment.
Herbal Preparations and Botanicals. Perhaps one of the biggest issues in the CAM debate is the use of herbs, nutritional supplements and other botanicals. The widespread use of botanicals has raised serious questions as to the quality, safety and efficacy of these products. (Mahady 3) Evaluating these drugs is further complicated by conflicting views on the use of modern versus complementary and alternative medicines. In developing countries, traditional systems of medicine, such as Ayurveda and Chinese medicine, have been the mainstay of healthcare for centuries. In some cases, it is the only medicine available. It is estimated that 65 to 80% of the population of developing nations rely on traditional medicines in which herbs are the mainstay of practice (Bannerman 1983). In Europe, herbal medicines have an important role in rational drug therapy and many herbal medicines have already been integrated into conventional medical practice (Mahady 3).
Western Medicines Concerns with CAM
A study published by the Journal of the American Medical Association (Eisenberg 1570) reported that visits to CAM practitioners in the US totaled 629 million in 1997, which exceeded visits to all primary care physicians by more than 243 million. The appeal of CAM is also prominent among the educated and in the upper income levels. This creates a great deal of fear in western medical professionals because it is seen as not only posing a health risk to their patients, but also as a threat to their livelihood. It also may make it necessary for some physicians to return to school and diversify their approach.
Because of their concern for health risks to their patients, physicians, particularly in the United States, also fear that such institutions as Ayurveda would object to scientific testing. On the other hand, alternative medicines proponents do not want their therapies tested in a manner more intense than modern scientists would test their own and with the intent to shoot the traditional therapy down. The truth of the matter is that many traditional medicines have gone through their own trials. Although alternative medicine is not typically measured using the traditional health-care model, many CAM organizations use strict credentialing standards. There are even a few organizations that have developed clinical guidelines, assisted by medical doctors, for the most widely used CAM services. For these reasons, CAM should not be viewed as fringe medicine. Its practitioners are often educated, committed and dedicated to developing an integrative approach to health care--one that both encompasses and respects allopathic medicine as well as CAM practices (Marber 88). In addition, philosophies like in Ayurveda have been around for thousands of years. They were developed with scientific processes of trial and error, and some of their remedies have already been indoctrinated into modern medicine as prescription pharmaceuticals. It is almost unheard of for someone, properly treated by an Ayurvedic physician, to suffer ill affects, let alone life threatening ones. Western medicine, unfortunately, does not have that same reputation.
According to the FDA, between 1993 and 1998, a total of 184 deaths resulted from "unproven" herbal remedies and supplements. However, this statistic is inconsequential when you compare it to the reported number of people who die in hospitals because of the side effects of properly prescribed pharmaceutical drugs (more than 100,000 each year), and you add that to the number of patients killed in hospitals because of "medical errors," another 100,000 or so (statistics of the Journal of the American Medical Association). With numbers like that, it is not surprising that people are seeking alternative forms of medicine (Goldberg 12).
But, not all natural and traditional remedies have been tested like Ayurveda. All pharmaceuticals in the US are regulated by the FDA and go through testing before they are put on the market. This process is supposed to keep ineffective, impure or dangerous drugs off the market. Even though such regulation has not prevented tragedies such as those seen with thalidomide, it is still fair, and much safer, to regulate everything we put into our bodies. If such tests could be administered fairly, few proponents of these remedies would have a problem with them.
There are still people out there, however, that say there is no alternative medicine, stating that Homeopathy, Ayurveda and even acupuncture are fictions and that their practitioners are nothing more than quacks (Lanford 1; Park 1, Phillips 1). It is their claim that there is only scientifically proven, evidence-based medicine supported by solid data (Fontanarosa 1618). Some are under the impression that CAM philosophies involve magical beliefs. They mistake prayer and meditation for mysticism and astrological nonsense. As far as the spiritual aspect of a CAM, any form of medicine that comes from another culture must be assessed from that cultures own spiritual standpoint. Ancient people, and therefore their medicine, relied on the wisdom of great men like Confucius and Buddha, but that does not make them any less effective. One must also realize that spiritualism and relaxation techniques, such as meditation and prayer, are alternative medical treatments advocated by modern medical practitioners already (Montegue 26).
The White House Commission on Complementary and Alternative Medicine Policy (WHCCAMP) was appointed at the end of President Clintons Administration. Its November 2001 draft report made legislative and administrative recommendations for maximizing the benefit to the public of complementary and alternative medicine. The report acknowledged CAM as a well-defined medical discipline rather than a marketing term used to promote unproven and disproved healthcare methods. This means that systems of traditional medicine, such as Ayurveda and Chinese Medicine, as well as certain procedures, like acunpunture, and certain philosophies, like homeopathy and naturapathy, with proven effectiveness, would and should fall under this term, despite the disclaimers of certain medical professions who disagree (Gorski 1). The report recommends that these two healthcare fields try to communicate, strengthening the bond between them as proponents of health, thereby encouraging communication, cooperation and collaboration among conventional and traditional practitioners and researchers. It also recommends that quality standards for research be set, both public and private sectors be involved in research, that training programs in various areas and informational material be developed, insurance companies be open to coverage of safe CAM therapies and CAM practitioners be open to teaching (WHCCAMP 2001). The theory is good, but the problem exists with both the expense of such programs and the opposition of conservative opponents.
These opponents are however missing something. Not only are they not realizing that traditional medical practice is in use by popular culture and modern practitioners in the US in the form of acupuncture, acupressure, reflexology, chiropractic care, massage and certain pharmaceuticals (that have been pirated away from the CAM philosophies), but they also are not realizing that many people have been saved from chronic and terminal illness, not just from the treatments, but faith in their practitioners. I am not the only one who has been disheartened by modern physicians talking at them instead of with them. Nor am I the first to realize that the tests and treatments can be worse than the illness itself. Within serious traditional medicine practices there are caring people who believe in what they are doing, and in return patients believe in them. For Ayurvedic practitioners, Ayurveda is part of their lifestyle; they are healthcare practitioners because their Dharma led them there. We only wish that this was the way of all medical practitioners.
Big Business and Proponents of CAM
Supporters of the CAM campaign are luckily not without hope. There are those in big business open to CAM therapies. When profits are shrinking, and HMO face fierce competition and high cost of pharmaceuticals, alternative care is a way to win new clients, separate themselves from the competition and still control costs. Many HMOs have already begun accepting alternative medicines and practitioners (Rauber 50). A plan in Illinois approves alternative care through a primary chiropractic care physician (CPC) (Robbins 38) to meet the demand of greater healthcare options. The concentration on wellness versus invasive interventions has kept costs low too. The west coast always seems to be on the cutting edge and more exotic forms of treatment are not only popping up, but they are finding popularity (Rauber 50). Nationally, consumers spend more then $27 billion annually on out of pocket expenses for alternative medicine and treatments (Robbins 38).
As for Ayurveda, as more people seek out CAMs as their personal healthcare choice, it will definitely gain popularity. Already, you can see Ayurvedic therapies at ritzy spas being practiced by celebrities and promoted by people like Dr. Chopra. To totally commit to Ayurvedic practice would probably divert us from our "Americaness" to force us to be open to new things and try a little bit of everything. Americans do not want to give up their hamburgers and junk food. Soda pop and coffee are probably the most popular drinks on the planet. Drinking 8 glasses of water a day is a drag with such interesting things to drink as "Strawberry Kiwi Splash". CAM may also appeal to people who feel that modern medicine is too stringent or unfriendly. As people get older and more informed about the environment, illnesses, health and the world around them, they find a change in lifestyle is in order, and CAM may just be a part of that change.
In this paper, we have seen that every day people eat food that has been treated with steroids, pesticides and radiation. Our bodies have been bombarded from the outside with synthetic chemicals. Hardly an ecosystem in the world has not been changed by new technologies. Those pushing for these new technologies have less concern for humankind than they do for profit.
We know that despite the wonderful advances in modern medicine, disease has changed along with those ecologies, and medical technology is not able to keep up. With every change in the external environment, more disorders and diseases come about, change and evade diagnosis and treatment.
Before civilization, before technology, human beings were more in balance with nature, at least to the extent they were not destroying themselves. It was a time of fear of the Gods, when frontiers still existed, when the night sky provided guidance. When meditation meant knowing yourself from the inside out. Life was slower and stress was lower. Can it be that good health is lost in the bustle of American life? Is it worth it to destroy our world and health for money? Likewise, should antibiotics be dispensed without running a test to see if you really need it, thus polluting our bodies with unnecessary poisons and creating monster bacteria in the process?
A return to nature would feel good too. Who is truly unhappy when they can relax, think good thoughts, drink clean water, eat good food, stretch, feel good and sleep well? Ayurveda, (and possibly other CAMs) can work in coordination with Western Medicine. Ayurveda can restore balance to an individual and then the western treatments may be able to work, or be avoided altogether. Ayurveda has some strange beliefs, I admit that. I would rather wear than swallow a diamond. But strange as it may be, it is good and wholesome and clean. In a time long ago, and far away, good health was a matter of keeping or restoring balance. Ayurveda remembers this time. It is still here today and can teach and enrich western medicine.
I have stressed myself while writing this paper. My neck is sore and my hands are numb. I cannot sleep. It is the time of year when excess Kapha has built up over two seasons and my body is heavy. My skin is thick and oily. I can tell my Pitta is aggravated as well because of heartburn with every meal. I have neglected myself in an effort to achieve a goal set by my Dharma. I havent eaten right, my meditation has lapsed and there has been no yoga for weeks. I do take my supplements daily and that is the reason, I believe, that I have not thrown myself into another exacerbation of TM. I can recognize this through my study of Ayurveda and writing this paper.
These weeks have been a necessary journey for me, testing my belief in this topic. I know that Ayurveda has saved me, not just from another exacerbation, but by giving me a new direction. My former path may have seen me pass from this earth before my goals were reached. I know I am in control of my life and my body now, and I am going where my gifts have directed me.
I have also been on an educational journey. I have always been stressed about what I was consuming when I ate, but from quite a different perspective. I always wondered about fat and salt, carbohydrates and fiber. Now I know that this earth, my home, has been abused and that we are all suffering as a result. The best I can do for this earth is make people aware. And even if I only informed one person, I have done something.
Om Shanti, Shanti, Shanti (peace)
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