Complementary and Alternative Medicine: Ayurvedic Medicine



so today I hope to take you on a quick tour of Ayurveda it's an ancient system of healing that's over 5,000 years old so I'm probably going to give it about 50 minutes so the ratio of five thousand to fifty is pretty pretty intense but we're going to try and cover a lot of ground in that area in that time and what I'm hoping to do today is really give a little bit of a theoretical overview of the discipline and then talk a little bit about how we might each be able to apply some of those principles to ourselves in terms of creating an optimal lifestyle that encourages our best performance in all realms and all realms of life and I really really is dedicated to bringing out the fullest potential at the body mind and spirit level so I'm just going to start out by defining the word Ayurveda Ayurveda comes from two Sanskrit roots IR meaning having to do with life for living and veda meaning wisdom or knowledge so systematized wisdom or knowledge is sometimes called science so sometimes it's translated as science of living sometimes it's wisdom of living sometimes knowledge of right living but in all of those definitions really speak to the idea of Ayurveda as a system for not just treating illness or disease but for actually creating optimal health in each of the individuals that uses that discipline now in the Ayurvedic worldview every single thing in the cosmos including we human beings are actually composed of five great elements and this is Buddha five great Buddha's or elements that's a Sanskrit word for it and these five great elements are space air Fire Water and Earth now when we talk about elements in this context we're not talking about the physical substance of fire or the physical substance of air we're actually talking more about the qualities that are embodied in these substances so for example you know fire would be the quality of heat or illumination water would be the quality of fluidity earth would be the quality of stability or solidity in Ayurvedic worldview these five great elements in all different permutations and combinations account for the entire universe as we know it now these five great elements when they come when they come together to form sentient life there they are trans mutated into a little bit more of a subtle form which are called doshas so those shows are bio energetic forces which are actually the result of the pairing of the great elements so space and air come together to form about the dosha fire and water come together to form pitta dosha and water and earth come together to form a photo show so I just want to say that this this diagram is something that we're going to have to come back to multiple times and refer back to this because even though it's a fairly simple diagram it actually contains a lot of profound information in terms of why I really recommends what it does in terms of treatments or in terms of its assessments and so it's really important to understand that these qualities of space air fire water and earth and understanding these qualities is really instrumental to understanding the whole Ayurvedic worldview so when we talk about the qualities of space and air in Ayurveda space and air have qualities of lightness of coldness of dryness of mobility so when these come together to form Vata dosha in all sentient life forms and all living beings whether they're animals or humans these these three great doshas are responsible for everything that we consider to be life respiration digestion breathing thinking feeling reacting movement all of these but each of these doshas about the pith and cuff up sort of govern or or ruled certain aspects of sentient life so space and air these qualities of space and air come together and form Vata dosha and Vata dosha is responsible for all movement in human beings are in all sentient life so when we talk about movement here we're talking not only a voluntary movement but also involuntary movement and I'm just going to talk about that a little bit in my next slide but just sort of hold this idea that vaartha is a force of movement the other next dish I want to talk about is Pizza dosha pitta dosha is almost all fire with just a little bit of water also combined in it the fire the the pizza dough show because it's mostly fire it has to do with the qualities of fire when we think about fire we think of something that sharp a penetrating hot illuminating and pizza in fact has a lot of these qualities in terms of its functions within the sentient life-forms so pitta dosha we consider the sort of fire of transformation in the human body and in all sentient life so whether that transformation is a very physiological concrete transformation like the digestive process is considered a form of transfer transformation or whether it's at a more mental level pitta dosha is the dosha of transformation the energy of transformation in the body the third dosha is kuppa Gosha and cup is formed by water and earth the great elements of water and earth coming together think about what water and earth when they combine in form sort of like mud right really thick heavy static and these are some of the qualities of kapha dosha cuff of those who is responsible for all of the binding energy in the body and in the mind and in all sentient life binding lubricating protecting these are all qualities of kapha dosha so just this is the quick overview of these three doshas and i'm going to talk in the next slide about a little bit more detail about each of these doshas so the very important concept to understand about doshas is that every dosha each of the three doshas has a very specific expression at every dimension of the human being so Vata dosha manifests as movement at the body level at the mind level and at more subtle energetic levels that you might want to call spiritual or consciousness or metaphysical whatever you want to call that realm it also is manifested at that level and then same thing with pizza Pizza has manifestations at the somatic level at the psychological level and then at more subtle levels that you might want to call spiritual COFA has again manifestation of body mind and spirit level and this is very important because this is not because in in the Ayurvedic worldview it's not that watt that controls the body put the controls the mind and cuff of control the spirit it's not like that it's each of these though shows is actually present at every single dimension of the human being and that in fact even down to the cellular level so even at the cellular level vodka has manifestation Pizza has manifestation and couply has manifestation so I want to say a little bit more about how these might manifest at each of these levels just to give you a little bit of a sense of something that might be very abstract as I'm speaking so Bob is the energy of movement so at the body level at the somatic level that would translate into all voluntary movements all involuntary movements like breathing well reading a sort of part voluntary part involuntary but let's say the beating of the heart peristalsis of the GI tract involuntary blinking of the eye all of that would be considered a manifestation of aught that the somatic level at the psychological level vada is also the force of movement of the mind now in fact we always say that what is the fastest entity of all we say it's the mind and Ayurveda because the mind can take you anywhere from here to the outer realm of the galaxy just like that you think about it and you're there and so the mind is supposed to be the swiftest most the quickest moving entity of all so the movement of the mind and natural tendency of the mind to jump from thought to thought from feeling to feeling from you know focus of attention from here to there that tendency of the mind to move is considered to be part about them and then at the most subtle level Vata is considered to manifest as prana prana is at the most subtle level the life force this is this is in Ayurveda the principle of just what do we consider the vital force that determines whether someone is dead or alive and that's prana so we say that thought that the most subtle level of manifest is prana now pitta dosha at the somatic level Pippa's is the energy of transformation heat assimilation digestion these are all aspects of pizza so at the somatic level pizza would be manifest for example as our body's capacity to generate heat so maintaining a constant body temperature of 98 points in 96 sorry 98.6 degrees that would be an example of pizza and the physiological functioning of pizza thermogenesis and then also the digestive enzymes the ability to heat up you know chemically the food that we take in and then break it down and digest it that's considered also a manifestation of pizza and then at the site is more a more subtle psychological level the the force of pizza manifests as the capacity of the mind to digest the perceptions and information that are taken in from the outside world and then you sort of digest and assimilate them into something that is a useful action or a useful game plan or a chi or an understanding of something so that ability to take in information but then really sort of digest it assimilate it into one's being as a manifestation of pizza and this is very important in fact when we say you know someone is very very smart we might say oh they're really bright or they're really sharp and these are actually qualities of Pitt the qualities of fire which Pitt that is mostly considered to be made up of and then at the most subtle level Pizza is manifest in diabetic view as pages pages is brilliance it's translated as brilliance so prana is life force it's whether we are alive or dead whether we have this movement of energetic force going through us but how vital how bright is that life force how brilliant is it you know is it very very weak or is it really strong and robust so Paige's is that sense of brilliance to the life force that permeates the being and so most subtle level pizzas manifest as pages then Cappadocia at the somatic level we talked about cuff of being the force of binding the force of lubrication so at the somatic level the ability of the body to actually create more body mass to create more cellular mass for example that would be a manifestation of COFA so a growing child you know who weighs 30 pounds last year and now weighs 40 pounds this year he gained an extra 10 pounds and that 10 pounds we say is a manifestation of cuff up working so in children Cappadocia is actually very very strong force in children but unfortunately even as we age cuff link and sometimes we have very interesting and important force to as we gain weight and as we perhaps slow down a little bit and become a little more static and a little more sort of deliberate in the way we operate these are all manifestations of kapha dosha again at this at the somatic level not only the amassing of body tissue but also the lubrication of the joints the lubrication of the alveoli the forming of mucus throughout the body this is all considered also a manifestation of kapha at the somatic level because remember cuff is water mostly an earth so the so think about those qualities of water and earth when you think about Kofa so water North binds but water and earth also lubricates and moistened and so that's one of the primary functions of Kufa at the mental level the psychological level Kappa the binding force of COFA is manifested in one way as memory so our ability to hold on to information to bind the information that we hear and be able to really recall it when we need it that's an expression of kava at the mental level and then also cover at an interpersonal level the ability to form interpersonal bonds to to bind ourselves to another person that ability to be caring and Pathak loving that's also considered to be a manifestation of cuff up so at the psychological level cuff manifests as these tendencies as well and then at the most level Oh justice is a manifestation of kapha that sort of metaphysical or spiritual level and oh just roughly translates into resilience or stamina if you want to call it that so it's the ability to sort of you know fight off and protect oneself in the face of whatever adversities might come up might beset us so that ability to just sort of have a certain kind of resilience and stamina and the foot in the face of stress that's a manifestation of Kuppa the most subtle level so prodigious and ojas or the most subtle level of manifestation of aught the pith and kapha but for the most of this talk we're going to be focusing more on Motty in mind although we can certainly also talk a little bit about the manifestations of these forces at the metaphysical level but a lot of the rest of this talk really has to do with how about the Pitta and kapha sort of manifest at the body-mind level and how we might be able to use this information in terms of guiding our own lifestyle choices so in Ayurveda every single human being is a has Vata Pitta and kapha within themselves but every single person has a very unique proportion about the pith and kapha so it's sort of like a bio energetic fingerprint no two people will have exactly the same proportions about the pith and kapha all three are necessary for life but every single person has a different proportion of these and this is very very important to understand in Ayurveda what this proportion is this proportion is called your Constitution and yours born with this Constitution essentially and the in the Ayurvedic worldview health or optimal living comes out of making lifestyle choices that keep you in balance with your basic Constitution about the pith and kapha because unfortunately the Sui doshas can be thrown off balance based on various lifestyle choices and I'll talk about that in just a minute but based on how you live your life you can either keep about the Pitta and kapha in the proportions that you were born with and that's considered to be your point of strength your sort of source of power maximum resilience in the face of stress and then when you are off balance in terms of about the pith in COFA then you're much more vulnerable to dealing with whatever whatever stress has come out you're much more vulnerable to developing some kind of distress or some kind of symptoms as a result of that and in Ayurveda this is sort of the explanation for why the same stressor might affect ten different people in ten different ways depending on how much in balance they are or not in terms of their constitution so if someone comes in coughing and sneezing into a room with ten people you know some people might walk away from that encounter with absolutely no ill effects whatsoever and they just keep going on their merry way and maybe other people will feel a little bit under the weather for a day or two but then kind of recuperate very quickly and move on and maybe somebody else will just come down with the flu for two weeks and be completely out flat for that period of time so irony that would say well that's because this differential response is because each of those individuals who encounter the exact same stressor in the form of this virus or whatever it was that was being spewed into the environment that these people had different internal capacity to sort of meet that stress and to overcome it based on how much in harmony they were with their basic Constitution so the goal in Ayurveda is to understand what your Constitution is and then to make wise lifestyle choices that keep you in balance with that Constitution so that you have maximal resilience in the face of stress and that stress can come in any form it can come in the form of you know viral or bacterial illness or it can come in the form of emotional stress or it can come in the form of financial stress or interpersonal stress whatever it is but you will have maximum resilience to meet that stress if you are living in balance with your Constitution so how does one determine Constitution in the Ayurvedic worldview so our view that says that first of all because going back to that definition of health health is when you are in optimal balance in terms of your Constitution so what is is well let's think back to when you were at your optimal functioning you know in your life at every level body mind and spirit level let's think about a time when you were at your best functioning and we will take that to be the point at which your you were most in balance in terms of your doshas and so let's think back to that point in time l and when I actually do these assessments with my patients I'll actually try to get them to even think of like a specific you know month of a specific year so in May 1985 when this person was 25 years old they really felt that they were up their optimal functioning so then I'll ask them a series of questions okay saying okay when you were 25 years old in May 1995 I want you to answer these questions for me and and depending on how that person answers the questions I will have a sense of how much vodka was in their Constitution how much Pizza is in their Constitution how much cuff is in their Constitution at that point of optimal health and so the questions that I'll ask will have to do with a variety of different mind-body parameters so Ayurveda really has an exhaustive list of questions and that are designed to get at different parameters mind body some of them are physical so for example I will look at body build and weight and think about well where were they when they were 25 what was their body build what was their body weight and then I compare it to where they are now so that will give me a sense of okay here's where they were at their optimal functioning and here's where they are now and then that gives me an idea of which dosha or set of doshas is most changed or most affected now if there's somebody that you know is in great health and is taking really great care of themselves there won't be much difference between how they would answer these questions from when they were at their optimal point of health to how they were how they would answer them now but for a lot of people there is a big difference in one dosha or another and so depending on which dosha is most affected that will determine the course of treatment in terms of helping them to bring back that particular dosha but this form of assessment is very important and critical not just for illness but also if someone is curious you know well how do I maintain my health how do I keep going you know so far you know thank goodness everything is going fine and I'm feeling pretty good but how do I maintain that and what can I do in terms of lifestyle that will keep me in balance so that I won't get thrown off balance and so Ayurvedic assessments have a very very important function and also maintaining wellness so some of the parameters as I mentioned are physical in terms of body building weight I will look at their tongue I will look at their skin look at their hair and nails because again in each of these parameters Vata Pitta and kapha will manifest in a certain way so for example and I'll talk about this more in my next slide but just to take one example in terms of body build a vodka person think about vodka being a combination of space and air about the person has a lot of lightness inherently built into their Constitution so a lot the people will generally tend to be very lean and very light in terms of their overall body build and shape they might be very very tall and skinny or very small and petite but in general they'll have a lean Ness and slimness to them and they will be one of those people that will really have a difficult time putting on weight you know their their problems and adolescents might have been that they had a hard time you know gaining weight with the rest of their classmates and even now they tend to lose weight if they're under stress or you know they're not taking care of themselves properly so that has to do with about the quality of air and space being such an inherent part of that person now the pipa person their body build will actually be a lot more what we would say fiery it would be a lot more sort of powerful and a lot more robust and a lot more having a tendency towards precision and sharpness and and sort of the quality of heat so that might manifest is a ruddy complexion or sharp features or a very very forceful way of walking or speaking in terms of their overall body habitus so this would be just one example and then couple of people would have a tendency to really be very very sturdy and well built maybe tending towards overweight weight very easily so it would take much for a cup of type to put on body weight but in general these are very large individuals not necessarily fat but just very large and very big-boned very very proportionately large in terms of both height and girth many times so this is just one example so then I might add some so as a child or as a you know at your point of optimal health you know what was your body build like and how is it now and how much has it changed if at all and that gives me one indication of which parameter in terms of out the path and kapha many have changed and so I go through a whole list of questions like this and I really gets very very precise about a lot of parameters I mean what I've listed here are just some of them you know eating an elimination patterns you know so we might ask well how many bowel movements a day do you have and sometimes people who look at me and say what does that have to do with treating my depression you know but in the Ayurvedic worldview it does because Vata Pitta and kapha govern all of you govern peristalsis they govern digestion they govern all kinds of things and so we need to understand who this person is in all of these different dimensions and then sleep patterns and so on and so forth so I'm going to just give you this slide for a minute which tries to put together some of the information some of the key information in terms of body mind parameters and how they might manifest in a given individual and again remember every single person has about the Pitta and kapha so no no one is going to be missing one of the doshas every single person has all three all three are critical for life but we say that usually there's a predominance of one dosha or sometimes two doshas in that person so when we speak here about constitutional types what we're talking about is about the predominance pitts the predominance or cuff of predominance we're not talking about the person being all about they're all pizza or all kapha but we say that in general you know one or two of these doshas may predominate in the person's mind body spirit being and so how would that look if that person had a lot of author a lot of pizza a lot of cover in their constitutional makeup so as I said wathah is a combination of air and space so going to translate in terms of physically you know into having a very lean bony build many times these are individuals that will have a very rapid way of speaking or moving or or going about doing things because again think about air and space you know think about wind wind is very erratic sometimes it goes whoosh like this and gusts and other times it's just very very still so that quality of like erratic Ness and unpredictability it's an aspect of aught though and so that really determines like a lot of the Vata physiological traits like being ravenous one minute and then being completely satiated five minutes later and having nothing in between and stamina levels also being very very erratic in that way now we had said that vada has a lot of air and space as a part of its constitution and that some of the qualities of Aaron's face inherently are coldness and mobility and lightness so lot of people are going to be very sensitive to any external wind and cold because they already have a lot of internal wind and cold and so for Bob the people since they already have so much of that in their internal makeup it doesn't take much from the outside in terms of those qualities to make them feel a little uncomfortable or off-balance so they're going to be the people that are going to be putting on sweaters and putting on you know a lot of layers when everybody else is feeling just fine in the room and they're like oh if they're air conditioning on and you know they're putting on sweaters and so on because they just have that inherent sensitivity to the wind and cold now at the mental level Vaught the predominant people when they are in balance that remember we have talked about the movement of the mind as being an aspect of author so that movement can manifest as a very quick creative flexible mind when it's in balance and so while the people can be great at dreaming up ideas and you know almost being able to almost sometimes like see into the future in terms of like knowing a trend and being able to have a very intuitive sense of which direction you know the spirit of the times is blowing in it's like a very very a very positive aspect of author when it's in balance and when it's not so much in balance if the Vata dosha is off balance in that individual if it's excessive or aggravated unfortunately that created a quick flexible mind can also then become very very anxious and unsettled and unable to focus so it becomes very erratic and that movement is kind of unpredictable unfocused movement rather than being channeled in a particular direction so all of these qualities in terms of out the Pitta and kapha they have positive aspects when they're in balance and they have negative aspects when they're off balance so no one of these is better or you know somehow more desirable than the other it's just about being able to tap into the positive qualities by staying in balance so about the individuals also in terms of mental activity because the mind is so flexible and movable sometimes about that people have a difficult time making decisions and sticking to them it's like they're always great are being able to say well that's a good choice but what about if we went this way and then that had some really good benefits too and then maybe we should go back to this way so there's a lot of nice elation with lata a lot of that movement and erratic Nastase over and then in terms of memory about the people are very good or learning they're very good very quick but sometimes they forget stuff really quickly too they learn things very quickly but then if you ask them a week later their retention rates might not be so great so that's one of the aspects of ratha and mentally so because these are some of the the qualities of vodka that air and space elements bring to the person we want to counterbalance air and space qualities as much as possible to keep that person in balance so for about though we want to for example encourage a lot of warmth in there in the food that they eat in the environment that they're in because there's so much inherent coldness involved that in terms of the air and space qualities having a lot of coolness attached to them so we want to counterbalance that by as much as possible keeping that the predominant people warm and so we encourage them to eat rich warm foods that are a little bit heating so a little bit of spice is good for Vata and and if they have a opportunity to pick you know where they're going to go on vacation about the person if they really want to feel rested and recuperated they need to go to a nice warm humid environment like Hawaii or the tropics you know for vodkas if they really want to feel settled trying to go on a windy hike you know up some steep mountain slope that's actually going to aggravate aboutthe that's actually going to create more air and space and coolness from external sources and so the internal Vata is less likely to feel calm down as a result and that doesn't mean that lots of people can't go on mountain hikes but it means that they need to understand that they're going to have to take extra steps done you know to try and maintain warmth and to maybe consider you know having a warm steam bath at the end of that hike or you know taking something with them that'll provide a lot of warmth on the journey and this is one of the ways to take this into account in terms of the lifestyle choices that you might make and then because Rafa is so erratic and so changeable in its nature the way to help off the people even though they'll resist this with all their might because their you know their Constitution is so not into this but what they really need a structure and regularity because structure and regularity is what helps to ground Vata it's the thing that gives that erratic movable sort of air air space energy some focus and some predictability and so it's very very important if what the people are going to function well that they sleep at the same time every day that they eat meals at the same time every day and that they have a really nice long sleep you know about the people we really encourage them eight hours of sleep isn't enough you know sleep nine sleep nine and a half sleep ten sometimes if you need it because vadas are really going to benefit from that extra rest because they're there's such a tendency to expend so much energy and movement during the day they really need that recuperative energy now I'm just going to move on quickly now to pit them so pit the people remember we said have a predominance fire a little bit of water but predominance of fire in the pit the Constitution so what that translates into at the somatic level is a sense of forcefulness and power at the physical level so they're very powerfully built usually have a lot of muscle mass have a very forceful way of expressing themselves they have very very strong appetites many times strong stamina but because there's so much internal heat in pizza first of all anything that in terms of external heat is very likely to throw them off balance so pit the people hate hot weather you know they're the kind of people that will you know just kind of strip down to whatever they can strip down at the slightest bit of warmth in terms of the day outside they heat their they sweat very very easily with just the least amount of heat they hate that sort of clammy hot sensation of being out in hot weather so it doesn't take much in terms of external heat to throw up it the person off and then similarly external heat like in terms of food that you eat will also throw if I put the person so pet the people might love spice but spicy food because it's supposed to have a lot of quality of fire in it will also make a pet the person really easily go off balance so when the pit the person is in balance at the mental level that sort of sharpness of mind that sharpness of fire will lead to a very quick very intelligent mind you know something that can a mind that can really just look at the situation and make an assessment and be right on target you know know exactly what's required in that situation and really be able to come up with a very appropriate plan for that scenario so er physicians for example are many times blessed with great pizza mines because they might not have all of the information available to them but they're very good looking at the information that they do have putting it together coming up with the right diagnosis and coming up with a plan of treatment that will really help save that person's life in that moment so these are very very good leaders very very good thinkers many CEOs of companies will have a lot of pithy qualities predominating and when they're in balance they're wonderful leaders and often have a very devoted following in terms of you know people in their company are people in their program really trusting their instincts and being able to follow their lead but when Penta is off-balance whether it's due to external heat internal heat or contact with you know other sort of heat what we would say elements of heat in terms of external stressors and that might even involve for example we would say alcohol a lot of sexual activity a lot of sensual activity those are all supposed to also be heating in Ayurveda so in access of all of those activities is supposed to throw the pit the person off balance much more easily than the other two constitutional types and so when I picked the person indulges and lifestyle choices that perdu that have too much heat that internal heat is aggravated and then that person gets thrown off balance in terms of PIPA and so what does that manifest as many times that will manifest as a kind of irritability and tendency towards anger very like a hair-trigger anger very competitive or very jealous kind of strivings and inability to really let go of something and just kind of hold on to it with with the kind of competitive spirit and and just sort of ruthlessly try to obtain your goal no matter what the costs are those are sometimes some manifestations of pit though when pit that goes off balance when it goes awry so those exact same leadership qualities that can be wonderful when they're in balance can also really work against the person you know when they're off balance and so the beloved leader might become a tyrant you know and the the leader that was able to make really good choices that really took the whole picture into account and really lead you know the company into the right direction they might make a very self-centered decision based on maybe rivalry with this other person and that not thinking about the company as a whole for example so those would be examples of the pizza mind when it's off balance not making a very good decision now the pit the person because they have so much internal fire in terms of what lifestyle recommendations we make for them those are recommendations that will help to counterbalance all of the internal heat by producing more coolness and and more of the more a little bit more of the heaviness also because pizza even though it's hot it also has some light qualities and so for pizzas what we recommend for example is whenever possible keeping their external environment cool but also in terms of their meals eating cool foods so salads for example are great for pizza sort of cool light food is good for pizza but but but salads with some likes a tofu thrown in or something for a little bit of weight in there but but for a pizza person they we also need to consider tastes because in Ayurveda I'll get to this in just a minute but in Ayurveda all of the different tastes also have an effect on what the pitman cuppa and sweet is supposed to be the best counterbalance to hot actually so we recommend cool and sweet foods and we recommend cool environments and we recommend a moderate amount of sleep not as much sleep as for Vata but as you'll hear not as little as for comfort so somewhere just in between for pizza so let's move on now to the cuff a predominant individual so the cup of predominate individual has a lot of water and earth inherent in their constitution so that's going to manifest as a very large hefty build and a sense of deliberateness in the way they move in the way they speak in the word the way that they will think and come to decisions and then because kava has a lot of dampness and a lot of coldness as a part of its inherent constitution the cuff a person is going to be most sensitive to foggy cold climates so actually like the kind of weather we had last week before it got all funny that would be the kind of weather that cuff of people would do the worst end because that external dampness and coldness will really aggravate that inner quality and cuff up and so when the cuff of person is in balance you know that that quality of water and earth creating that stability that sort of groundedness that will manifest is a very deliberate minded person someone who is very very slow to get angry who is very forgiving who's very remember Cappadocia was the energy of binding so very forgiving very loving very caring when they're in balance when they're off balance like because of aggravation of this Cappadocia then those same qualities take on more negative aspects so what might have been a study deliberateness in terms of the way that they would go about making a decision maybe that would turn into a kind of room native style you know where it's like clinging and holding on too much as binding too much to an old memory and not able to move forward from that memory and maybe becoming very very lethargic very slowed down almost frozen or paralyzed sometimes so those would be some aspects of cofell when it's off balance the cuff of individual when they're off balance so to counterbalance that you know tendency of coldness and dampness which is inherent in COFA we want to really see if we can introduce lifestyle choices that will that will create lightness spiciness and warmth in that person because these are all qualities that will counterbalance the dampness and coldness and heaviness of kava and so for cuff oh we say light and spicy meals warm light and spicy is really important so something like warm soup would be good for kava but but even the water element is already there and comfort so maybe not so much of a water element but you know a little bit a little bit of a watery soup would be good or having something like like some kind of like a spicy light cracker that would be a good but warmed if you can have it with a warm spicy cracker of it with some spices on it so that would be a really good cup of sort of snack to have and so we really have to I will get into the Ayurvedic nutrition in a later slide but we really need to think about the qualities of the food that we eat in terms of how they would affect about the Pythia and kapha in terms of making choices and then obviously I could the climate for cuff oh that would be the best would be a warm but dry climate remember with a lot that we said a warm but moist climate but for cuff a warm dry climate so a desert would be a perfect you know like living in Arizona or something would be great for a couple individual whereas for about the individual the warmth of the desert is good but the dryness would not be good because the dryness would aggravate some of the inherent qualities of dry that's our that our part about the Botha so but dry would be good for cuffin in terms of helping to counterbalance a lot of the inherent moisture so I packed a lot of information into one slide it's a little bit dense but this is a kind of reference point for thinking about in a very big picture way how does the Constitution affect the choices you make in terms of eating sleeping where you live the clothes you wear and so on yes those are actually different well the question was do the little graphics that I have with lots of pith and cuff I have any specific meaning no these are actually all mandalas within the Vedic system and so I just tried to pick they're not specifically connected to Vata Pitta and kapha but I tried to pick colors that are represented as the colors that are the best suited or the most representative of Vata Pitta and kapha so for example pit that has a lot of fiery colors in this mandala it has a lot of oranges and reds and so on Vata has this sort of some of the cooler colors in terms of the purples and the blues and so on and then the cuppa has a lot more of the sort of green grounded earth energy in it so those are the reasons that I did pick these but in fact in terms of meditative practices when we've been talking so far mostly about mind-body parameters remember I said that Vata Pitta and kapha also have more subtle through the metaphysical parameters and aspects as well and so these mandalas if you are going to try and prescribe a meditative practice for each of these three predominant types we might actually pick a symbol for that person to meditate on which would be the counterbalance actually you know to that person's predominant Constitution so rather than giving this particular mandala to apipa which might actually sort of aggravate some of the Pittock qualities I might actually pick something that had cooler colors in it or something that counterbalance the qualities of PIPA so I just wanted to bring some of this information together into a clinical example in terms of an example of how I might use in this information when I work with patients so since I'm a psychiatrist by training I have a lot of patients that come to me because they are experiencing some kind of psychological distress in their life and they're drawn to the Ayurvedic paradigm to try and understand what they're going through and interested in seeing how the lifestyle choices they make might be able to help them with their distress so I just wanted to give you this clinical example in terms of using depression for example as one way of understanding how those Sham balance might manifest so in these so I'm going to just give a little story a little vignette about a family with three sisters and the three sisters are varied they come from a very very close-knit family close-knit Midwestern family I actually grew up in Michigan so I knew a lot of close knit with Midwestern families and the three sisters are all getting together one winter for a holiday gathering and then the gathering goes on late into the night and so eventually it's time to say goodbye and one of the sisters takes off in her car and drives back home unfortunately it's a very very slippery icy road on the way home and as she's crossing a bridge she gets into an accident and runs her car over the bridge and tragically she dies so this is obviously a huge event in this family of close-knit sisters and the other two remaining sisters are just incredibly grief struck by this the passing away of their third sister so the two remaining sisters I'm going to call Alice and Bertha so Alice to begin with is a very creative person she actually works as a web designer and her lifestyle is the epitome of botha aggravation you know she has these deadlines to meet all the time where she stays up late and doesn't eat and hardly gets any sleep but she gets a lot of enjoyment out of the work that she does because it's a lot of spontaneous on-the-fly thinking a lot of creativity really calls for a lot of flexibility so Alice says this is the kind of work that she loves but she also has to work really hard to make sure she takes care of herself properly because that lifestyle that she's in has a tendency to aggravate vada so after her sister dies unfortunately this aspect is about that aggravating aspect of her life really takes off so what she does is she throws herself into her work to try and cope with this tragedy because she really just doesn't understand how to deal with this she just feels completely blown away and so she says well I'll do what I know what to do how to do and that's my work and and that I'll just bury myself in my work so she takes on more and more projects literally is driving herself you know to the bone with like no sleep at all she's losing weight she's losing she's already slimmed to begin with but she loses like 30 pounds in the course of six months and she doesn't have that much weight to lose so she becomes really really gaunt she can't sleep at night she's tossing and turning her mind won't turn off she's anxiously thinking ahead to the next day and to all of the problems that she might have to solve so she's losing sleep she's losing weight she's anxious all the time she can't sit still she's no she's really just grief-stricken about her sister but she just literally can't sit still you know whenever she sits down for one second she jumps up and goes to some other place and so on she gets on the phone and she talks a mile a minute she calls up you know her family all the time but she just rattles into the phone and as soon as the person you know tries to intervene and say a word they can't get a word in edgewise you know they might say well what do you think about getting to bed on time tonight or something and she'll just say she'll just move on to the next thing say but but I cannot do that because I have XY and Z you know things that a deadline would have to meet and bla bla bla bla and she'll just go on and on and on and so as much as she reaches out and tries to get help she actually can't take much in in her very very anxious agitated sort of you know Restless state that she's in and so sure enough you know after a few you know after her sister's death about three or four months after her sister's death she's just completely exhausted she just you know literally you know passes out at work one day and you know the sent home and she's told to take a leave of absence and she says okay very grudgingly but she goes home and she doesn't know what to do with herself you know she's just flitting around the apartment trying to keep herself you know occupied but nothing gets done and pretty soon she ends up you know in her doctor's office and her doctor says well I think you have depression and I think you have what we would call an agitated depression and she says oh I didn't realize because I'm very active and I think about a depressed person is someone that's very very slow and can't think or can't move but no in the Western you know diagnostic and statistics manual definition she meets criteria for major depression so that's Alice okay so let's just kind of keep her in mind on the backburner for a minute then her other sister Berthe also is very grief stricken by the death of their sister and the sister that died let's just call her Carrie so Carrie's deaf profoundly affects Bertha now before Carrie's death Bertha was one of these really home-loving gregarious warm welcoming people she has something like four children at home she loves the holidays because that's like her time to really shine she doesn't have a job outside of the home but she makes home making into a full-time job that's just brimming with welcome and love and joy for everyone and so for her you know she loves cooking she loves taking care of her kids she loves making her home physically a comforting place to be she puts a lot of thought and energy into having comfortable chairs and comfortable decor and so on and so forth and so for her you know when she learns about Kerry's death you know she and she's a she's a person that's also very hefty in her build so we can say that you know to begin with cause she's a sort of the embodiment of Kufa in many ways and so when she learns about Kerry's death she's also grief-stricken but because she is constitutionally who she is she has a tendency to react in a certain way in terms of how she deals with the stress and so because she has so much COFA within her Constitution what she tends to do under stress or under pressure is that she starts overeating so she starts like buying huge boxes of chocolates and keeping them at her nightstand and just eating eating eating she doesn't get out of bed the way she you know used to first thing in the morning and takes care of her home instead she's our over sleeps over eats when she does get out of bed she has a very hard time getting moving everything is sort of slowed down and much more effortful for her it feels to her like almost like even her thinking is slowing down like she feels almost paralyzed in her in her thought process she has a hard time sort of planning out her day and thinking about what to do next and her children are really really worried because this is so different from her usual loving warm gregarious self she still is in the home as she was before but now she's almost just kind of confined herself to one room you know and sits there watching TV with the curtains shut and eating chocolates and not doing much during the day at all and this is a Hugh change from her usual self so in the Western model Bertha also has major depression and it's a kind of interesting thing because we might say this is the melancholic subtype of depression we might say this is a subtype of depression but both of these individuals have depression both of them may be prescribed the same cognitive behavioral therapy they might be prescribed the same medications they might be prescribed or they might be you know taught some of the same techniques in terms of how to deal with their depression but in Ironmen that we would say you know these these two people are actually experiencing two very different phenomenon we would say that alice is actually experiencing what we would say is Vata excess or Vaught the aggravation because all of these qualities that she's manifesting in terms of anxiety insomnia lots of appetite that sort of compulsive moving and talking those are all manifestations of botha being too aggravated and too exacerbated in that person and we would concede that this is a very different phenomenological picture actually from the person who has the cuff of XS so birth that we would say is suffering from cuppa aggravation and so in the Ayurvedic worldview we would look at these two individuals look at their baseline and we would see that Alice had a lot of Vava in her baseline so it kind of makes sense that under stress her Vaught the aggravating activities are what gets her into trouble in terms of the way her reaction to her sister's death manifests and then similarly with Bertha she has a lot of cup find her inherent Constitution so she's going to tend towards more toughie a cup of response we might say in terms of how she deals with stress couple aggravating factors in terms of how she deals with her stress and and in our video we would then treat each person in a very very different way so in Ayurveda remember what we would do is look at which dosha is off balance compared to their baseline and then work at every level possible to bring which other dosha is out of balance back into balance so for Alice what we would do is recommend whole series of detoxification procedures that are called panchakarma to help bring Vata dosha down and so that might include for example Ayurvedic massage with certain medicinal oils intended to bring down bottom we might prescribe certain yoga asanas but again the yoga asanas in Ayurveda every single asana of in the yoga world has a specific effect on what the Pathan kapha so we would pick Vaught the lowering yoga asanas so not everyone should actually do all of the asanas which in terms of having the same effects so we wouldn't we would and pranayama which is the breathing exercises in yoga so we would give out the soothing of pranayama exercises about the soothing yoga asanas we would give meditative exercises for Vata that are intended to help ground that person so for example some of you have probably heard of it like an empty bowl meditation where the idea is to try and sort of empty your mind of all thoughts that is not a good technique for about the aggravated person because vodka has way too much space in air as part of their inherent constitution so for about the person it's much better to meditate on a particularly grounding or soothing word or soothing image for them that helps them to feel grounded and connected rather than dispersed and fragmented and out in space so I might ask them to imagine the face of someone whom they really love in a very unconditional way or think about a word which brings them a lot of comfort and grounding and ask them to meditate upon that as opposed to an empty bowl meditation so so again we really need to take who the person is into account and then again in terms of sensory experiences really making sure that they put themselves in environments where they have a lot of warmth about the person you know to counterbalance that wat the aggravation on social experiences so just to you know just to sort of pick like if a vodka person has a choice of going to a really loud stimulating rock concert you know versus having a long soak in a tub the night you know with maybe you know like I don't know with a close friend or something you know going to the hot tubs and having a good long soak for a while I would say do the hot soak you know for the person with about the aggravation where is it for the person for cuff Oh with cuff imbalance I might go ahead and say yeah go to a rock concert it might help stimulate you a little bit you know you have a little bit too much of that stagnation and stasis right now in your Constitution and then attention to nature is actually a big part of Ayurveda Ayurveda is exquisitely tuned in to how not only does the immediate environment of the person in terms of like weather and so on affect them but also what time of day is it what time at what season is it so in some of you have already heard about Chinese medicine here right in this talk so in the Chinese specification of the day I think the day is cut into like two hour chunks in which different organs are affected at different times well in the Ayurvedic paradigm every every part of the day is split into four hour intervals which are ratha or pizza or kapha dominant so for example pizza time is from 10:00 a.m. to 2:00 p.m. and also again from 10:00 p.m. to 2:00 a.m. and so that's the time when if you're going to be doing something that requires fit the energy that's the proper time to do it so digestion you know like eating meals eating your lunch which is supposed to be the biggest meal in Ayurveda that should be done between 10:00 a.m. to 2:00 p.m. because that's the pizza time of day if you try and eat a big meal at a different time when it's not pizza your digestive fires are not going to be as strong and so you're going to have more problems in terms of being able to digest your food and assimilate it properly and then similarly in the night time from 10 a.m. to 2 p.m. is when they say the highest quality sleep happens in terms of being able to process and assimilate you know all of the events of the day a lot of REM sleep happens you know in terms of phases in the night and if you don't have good quality REM sleep you don't actually end up feeling like you've had a restful sleep and so there's really something very interesting about this Ayurvedic worldview that if you sleep between those hours you know the quality of your sleep may be disturbed and I've often found that if I miss the the my bed time and if I stay up a little bit too late and I'm it's like midnight or something that is very hard again to go to sleep you kind of crossed over into that pit that time and pit those very fiery and awake and sharp and so sometimes I get my best work done at that time if I'm up late but it's also not such a great time then it's not so great to then sleep after that and not be having the best quality sleep that I could be having so anyway so I availa also really wants each person to think about their day and think about aligning their activities in such a way that Vata Pitta and kapha can sort of help them with their activities so you can either swim with the current or you can swim against the current and you can always swim against the current but you know why swim against it if you can swim with it and get more productive work done and so in working with the person with Vata dosha imbalance I might really get them to think about okay you know in terms of the Vaught that times in the day go ahead and do what you need to do in terms of activity because about the energy will kind of help you but then when it's the comfort time of day don't take a lotta you know I've sort of about the type activity to do at a cup of time so really try and match the time of day to what the quality of octopus a is for that time you can roughly divide the day like this and in an IRA that everything is determined by sunrise and sunset so this will also change according to the season in terms of when sunrise and sunset is but let's just say roughly that you know sunrise is at 6 a.m. and sunset is at 6 p.m. so if we if we divide up the day like that then we can say that roughly from 6 a.m. to 10:00 a.m. it's Coffee time this is pizza time this is about the time and then from 6 p.m. to let's say 10:00 p.m. to 2:00 a.m. so this is again pizza here and this is Vata and this is cuff up so just roughly speaking so 6 a of we say and I really that you should try and get up before the Sun before the sunrise because Vata is active from 2 a.m. to 6 a.m. so if you're able to wake up just before the sunrise you have the energy of the day kind of working with you to wake up but if you turn off that alarm you hit the snooze button and then it goes into like 7 or 8 it's much harder to wake up sometimes and that's because I really we say that we're in the cuff of time cuff buzz predominating then at that time and so cuff uh is a little bit slower you know it's a little bit more sleepy or a little bit more lethargic and so if you're not already awake this makes it much more of a challenge but if you are awake then that's the best time of day in the morning it's a slower time it's more deliberate time it's the best time of day to like be meditate to meditate to reflect upon the day to sort of calmly prepare you know for what you're going to be facing in the day I had so that would be it's so generally we say however that you should have a nice slow kind of calm start to be in harmony with COFA this time of day and then from tenth website and put the 2 p.m. here sorry then from 10 a.m. to 2 p.m. is pit that time so the meal your leer meal time to definitely fall here in the middle of that but in addition to meal time at the time is like when if you have to really do some kind of like serious thinking about something and really make you know an executive decision and really weigh all the pros and cons of something and come up with a plan for the day or a sort of an agenda this is good time from 10 a.m. to 2 p.m. is kind of like maximal productivity time from the standpoint of cognitive functioning and then from 2 p.m. to 6 p.m. is about that time again so then this is vodkas remember the energy of movement and so this would be a good time of day if you wanted to exercise if you wanted to do something that also involves some sort of creative brainstorming for example like pick the time in terms of cognitive decision-making is much more about being coming up with a plan and being able to like formulate you know a schema for something but while that is more like free-flowing brainstorming creative imagination kind of time so after lunch from 2:00 p.m. to 6:00 p.m. that sort of makes sense too after lunch a lot of us can't you know necessarily make the best decision sometimes because they're a little bit slower too as whereas we're digesting our food but in terms of just more freeform imagine it and imagination that's considered to be more about the time and then couple of time is again from 6 p.m. to 10 p.m. so then again this is considered to be a time of day where you sort of slow down again so you finish all the activity as much as possible by 6 p.m. and then you try to and you generally in Ayurveda we really try to also finish the meal the last meal of the day it's supposed to be finished by about 6 p.m. and then cup of time is considered to be here more of a time again for to spend with your family to sort of bring the people that you love close to you to be more sort of calm and reflective and loving with the people in your life and then you really want to go to bed before cuppa goes away because a cuppa energies from 6:00 p.m. to 10:00 p.m. so if you can optimally have your bedtime somewhere in there then you're kind of working with nature's rhythm in terms of allowing yourself to fall asleep naturally and calmly and peacefully and then pivot time here is sort of like the deep sleep with lots of dreaming and important assimilation of the day going on here and then from 2 a.m. to 6 a.m. lot that's starting to move again and so somewhere in here waking up so now I just wanted to talk a little bit about four modalities within Ayurveda and just some of the just very very quickly touch on some of the studies that are starting to be done to validate this particular system of medicine and so the four areas I'm going to be looking at our punch of karma which is the detoxification procedures in Ayurveda the herbal therapies in Ayurveda yoga from an Ayurvedic standpoint and then meditation from an Ayurvedic standpoint so first of all it's probably not going to be a surprise to most of us that most of the Ayurveda research being done worldwide is not happening in the United States it's happening in India which makes a lot of sense but also Britain Germany and Australia actually have a pretty large amount of data that's starting to get accumulated in the past three or four decades on our visa so unfortunately the u.s. is sort of behind the times but hopefully we'll catch up soon I actually visited a couple of years ago a large Ayurvedic Medical Center in India and I just wanted to show you a few slides from that this is at the National Institute of Mental Health and neuroscience it's called NIMH Hans and it's sort of India's version of the NIH so it's really like the National Center for mental health treatment and research and I was just really surprised to find that they have an entire building that's dedicated just to Ayurvedic and yoga therapies and so they provide conventional care for neuropsychiatric illness but they also have like this entire section that's also devoted to using Ayurvedic and yoga therapies for neuropsychiatric illness so in this in this para ayurvedic paradigm panchakarma is supposed to be a very very important way of resetting the body after it's been off-balance for a long time in terms of one particular dosha becoming too aggravated and so depending you know if someone has only had you know symptoms or has only been off balance for just a few weeks or something like that or even a month or two they will probably not require panchakarma but many people have long standing those Cham balance that's just been going on for years and years and so particularly when that's the case panchakarma is considered to be very very important in terms of removing the subtle and gross toxins that have built up as a result of the TOEIC imbalance and so panchakarma is a series of detoxification procedures and so one of them is is here Shiro Dhara which is a pouring of a stream of medicinal oils onto the center of the forehead and this is considered to be a very very subtle subtle treatment because within our Veda this this place between your two eyes just as in the yogic model is considered to be a point of great importance in terms of the convergence of different energetic points and so when someone is suffering particularly from botha imbalance this is considered to be a very important point in terms of soothing with medicinal oils and so there's an urn into which a particular formulation of medicinal oil is created that's specific to that person's Constitution and then it's poured in this gentle stream over the forehead for about 45 minutes to an hour and it might snow in sort of torturous but actually it feels incredibly soothing when you're going through it this is actually a young man with schizophrenia who is being treated with sheer adhara and then medicinal massage Abhyanga and Spadina Spadina a steam treatment so Abhyanga with medicinal oils and then followed by steam treatment is another very important aspect of panchakarma so the types of oils that are used or again those just specific for that individual and it's not always just oils that are used sometimes it's yogurt sometimes it's sand sometimes it's salt depending on what the qualities are that you're trying to balance in that person many many different types of substances can be used in this massage treatment and then this is usually followed up by a steam treatment here this person is immersed in a steam chamber but even if they don't have a steam chamber available they might be asked to just sit in a small room in which a small cauldron with water is allowed to just steam up the room and then they just stay in that room for you know 30 minutes or so until the oils or whatever have been applied to their body are well absorbed and then nausea is another important part of panchakarma and nausea is a nasal application of medicinal oils so this can be done either by just directly pouring some drops into the nose or by saturating a cotton ball in a particular medicinal oil and then putting it in the nasal cavity and then the ethmoid sinus is a little it's a that there's a cribriform plate right behind the nose here that actually is a very thin bony separation between the brain and the nose and so the medicinal oils very quickly actually enter the central nervous system through this route so and then oh in the night what I didn't also put here in addition to nausea we also have enemas and purgative treatments which are a big part of the Ayurvedic cleansing system so the idea behind that is that you use a variety of these different you use smooth and I use the massage you use the nasal application of oil you use the sheer adhara all of these things are said to sort of pull the toxins out of the tissues and some and concentrate them into the GI tract and then you use purgatives and Animas to sort of flush out those toxins that end up being concentrated there via these other routes and so these are very very important in terms of the final paths of elimination for these toxins but I chose not to show you photos of those so panchakarma studies are actually amazingly large in number we don't see a lot of them here in the US but there's actually literally just hundreds of these panchakarma studies that have been compiled over the last 40 or 50 years in India and there's a great book that I tell that I cited here called at the very bottom one the scientific basis for Ayurvedic therapies which the CRC press put out a couple of years ago and this particular editor has just done a fabulous job bringing together all the different studies that have been done within in the different disciplines and that are available in the English language and put them together into a nice chapter summary for various body systems and so I'd really encourage any of you that are really interested in looking at this in more detail to take a look at that book now so most of those studies have been done in India and but I just wanted to touch on a couple of other studies actually one other study in particular that was done here in the United States and that was the the second one from the bottom the control clinical trial of toxic occupational chemicals so out in Iowa which is a big agricultural state in the United States it turns out that agro chemicals seep into the groundwater and are very very commonly ingested by the population in those areas and so if you go around and actually measure serum levels of these toxic agro chemicals they're very very high in certain farm farm farming communities within Iowa and unfortunately these chemicals are such that they really are not very rapidly excreted out of the body they're kind of bound in fatty tissue for a long time so typically the rates of excretion might be something like less than a half a percent you know every few months and so you end up actually you know basically carrying these chemicals around with you for decades once you're exposed to them through food and through groundwater and so on and so there was a very interesting ayurvedic study that was done where they went to Iowa and looked at I think it was like 60 subjects and divided them into two groups and one group was one group was thirty subjects and they were just followed for two months they had their serum blood levels drawn at the beginning of the two-month period and then again at the end of the two-month period and then so one group just really had no intervention done just had their blood drawn at the beginning and at the end the second group actually had a series of punch of karma treatments done and these punch of karma treatments were specifically designed to try and draw out these toxins and it will make them from their body and so after two months they compared the serums of the group that had gotten the punch of karma with the control group and it was pretty amazing there was apparently a 2% reduction in the agrochemical levels in the group that had undergone the punch of karma and these control group in that same period of time had something like less than 1% you know change in their serum levels so there really is something to these ancient procedures we're not always able to explain how they might work from a Western standpoint but it's pretty hard to argue with some empirical findings like that in terms of efficacy the other study above that I wanted to just mention the open controlled trial with Parkinson's disease this is actually an important study in that it demonstrates that when you are trying to do an Ayurvedic treatment for some condition it's very important to look at the Ayurvedic treatments as a whole as a whole kind of system of treatment as opposed to trying to just extricate out one component of the treatment and use and use that alone so in this particular study it was a very small the end was very small so it's not by any means you know a definitive study it was also an open control trial which means that subjects knew what they were getting in terms of intervention but still I think it really points to an important concept which is that the whole package of treatments that you might give a person to bring down their dosha is more effective than just doing one alone by itself so in this study people with Parkinson's received either panchakarma plus and Ayurvedic herbal remedy for Parkinson's or they had only the only the herbal remedy for Parkinson's and then they were followed over a certain period of time and then symptoms were looked at you know at the end of the study period and the period the group that had gotten the panchakarma plus the ayurvedic herbal treatment had much more marked improvement in terms of Parkinson's symptoms and the folks that had gotten only the herbal remedy so this just really points to the importance of considering the system as a whole and not just trying to extricate out one element and Ayurvedic herbal treatments are just huge in Ayurveda I mean they're I mean it's just a huge topic when I went there this is an Ayurvedic school that I took some photographs and they the students in this particular class are required to learn that required to learn how to cultivate and prepare and and preserve 600 different herbs and then using those 600 different herbs combining them into literally thousands of different polly orb formulas and so they have this base of 600 and then they use that base of 600 to formulate a whole bunch of other polly org formulas but they literally have to grow that herb at their school so they have to understand all the factors that grow into the proper cultivation of the herb when to harvest it what part has the you know active you know medicinal ingredients what parts are toxic what parts aren't if there's something toxic how do you convert it into something that's usable and then how do you prepare it and then how do you mix it with other herbs safely and so on so it's just a huge endeavor and I was really quite impressed with their knowledge in I real as I said they're just literally thousands and thousands of combinations of herbs so I can't really even begin to get into the specifics there but since I'm a psychiatrist I'm interested in some of the herbs that have more psychotropic effects and so I listed for you some of the some of the main psychotropic effects on the right hand column there and and then the ones the herb names are written here in Latin but I've also given the sanskrit name on the picture of the herb and on the right hand side the latin name whenever there's a little asterisk next to it it means that it's actually been found to have that particular effect from a series of randomized control plus e bo control trials randomized double-blinded placebo-controlled trial but the ones that do not have the asterisk next to it indicates that this is a traditional use and indigenous use of that herb which has not yet undergone the kind of rigorous scientific testing that the others have so I just want to just give you a quick you know look at some of these I think the ones that a lot of my patients are actually the most interested in are the very bottom the cognitive and enhancement ones a lot of folks are very very interested in how to improve their memory and their cognitive functioning and this is actually an area probably some of the you know the most studies are coming out in the Western world bacopa monnieri which is called Grammy and withania somnifera which is called ashwagandha those are the two usher Gunda and Grammy are probably the two that are getting the most attention so those might be the ones to sort of keep your eye on and then I just listed here just for your reference you can look it up and in that scientific basis for Ayurvedic therapies if you'd like but I've just listed some of the other medical conditions that also have some very good evidence base behind them in terms of treatments from with Ayurvedic herbs so for example Parkinson's disease has pretty good data on mucin appeareance as a treatment so not all of them all of the studies that are listed here are placebo-controlled double-blind studies so these are pretty good quality studies but there's all lots and lots of like case reports and open trials – that are supporting some of the uses of these herbs some quick word about safety issues related to Ayurvedic herbs there's been a lot of negative press actually in the past year about a study that was done in Boston that came out showing that a lot of these think something like 20% of Ayurvedic medicines that were studied in a Boston area Indian grocery store ended up having heavy-metal poisons mixed in and so this is you know obviously concerned a lot of people and I just wanted to address that a little bit here because first of all as Ayurveda has become better known worldwide the demand for Ayurvedic herbs has just really really escalated and so unfortunately a lot of herbs are getting sent out from India which are not actually prepared according to traditional methods for detoxification and they're just sort of being mass-produced and being shipped abroad and I don't think this is a good thing because first of all remember we talked about Ayurveda very very tailored to the individual person to who that particular though constitution of that person is and when you start talking about you know one earn for all people for a particular condition you're getting very much into just like a conventional Western model which does not take into account who that person is you know what is which dosha is affected what are the factors that might be considered in terms of adjusting this herb or that room for that individual and so mass production of over-the-counter Ayurvedic herbs is just a bad idea and I think that that's unfortunately one of the things contributing to just sort of problems in terms of side-effects and poor use of these herbs but the other thing I wanted to say is that in Ayurveda many times actually things like mercury things like gold silver they actually are used in the production of these Ayurvedic herbs and our medicines and they can be very very powerful but they also have to undergo a very rigorous detoxification procedure in order for them to be considered useful so in Ayurveda everything is considered potentially a medicine under the Sun but everything is also considered potentially a poison and so the only difference between a poison and a medicine is how skillfully the preparation is done and whether it's applied properly so if you have the preparation done incorrectly or you apply it in the wrong context then what could be a potent medicine becomes a poison and vice versa and so it's very very important to understand that in an Ayurvedic in the traditional Ayurvedic training which actually took twelve years and you had to be an apprentice you know for years with the master practitioner before you could go out on your own and do the stuff you had to detox at learning detoxification was actually very very critical they have these these formulas called samskaras for how you detoxify something like lead for example or mercury to make it usable and when you bypass the detoxification methods and you just sort of throw in some lead into the herb into the medicine it's an it's not medicine you're you're not preparing it properly and you're not applying it properly and so a lot of the contaminants unfortunately what they found in the Boston study a lot of it was just contaminant frankly it wasn't even that people were deliberately putting in these heavy metals that they had they use contaminated water or contaminated soil that the plants were growing in and so on so it sort of leached into the product but other times people do just throw in you know trace amounts of these heavy metals because you know that's supposed to be part of the medicinal you know formula but they're not preparing them properly and then also as herbs are sort of being mass-produced there's a lot of the knowledge base is being lost in terms of the nuances between this herb family this particular species within this orb family and so on and so many times the wrong herbs are even put into these formulas and it's really becoming a big problem and also people are combining them in unorthodox ways that against the samskaras that sort of say this herb shouldn't be combined with this herb because of adverse effects and so on and so they're just sort of putting things together in this very unexamined way and it's really causing a lot of problems I do think that India is very aggressively addressing this by in 2002 they actually passed a law in terms of good manufacturing practices GMP that all of their herbs for export have to beat all the companies that produce Ayurvedic herbs for export have to meet GMP protocols but a lot of the small mom-and-pop operations sort of bypasses they send you know they send their cousin a bunch of these you know IRA via the curbs in a bottle to sell in their grocery store and so they don't end up you know coming under the same scrutiny or regulation that the large manufacturers do so when my patients are interested in Ayurvedic herbs I tell them to go to reliable large manufacturers that follow GMP so that we know that they're getting a good product and some of the ones that I recommend are Himalaya Healthcare and Banyan botanicals home organics isn't these are all good brands in terms of first of all cultivating their herbs organically so they're not using pesticides and fertilizers that are going to add contaminants into the product I'm just going to move on really quickly to Ayurvedic nutrition because in Ayurveda the idea is is that food is medicine that what you take in in the form of food is something that should fit your constitution that should be in harmony with your constitution so there's a very very elaborate list of food groups you know for Vata for pizza for kuffar to sort of to target botha pacification pit the pacification cover classification so if someone is feeling an imbalance or having an imbalance in one of the doshas i will go through the list of foods with them and pick the food groups that would be most suited to help bring them back into balance or to help maintain them in balance and then in addition to the specifics of which food is eaten there's also like the tastes the different tastes of the food and I really in our view there's actually six tastes rather than for the first floor we're all familiar with sweet sour salty and bitter but they have two additional tastes and I read that one is pungent so this is like sort of like spicy hot that's considered you know like ginger or cayenne would be a pungent so that's considered a separate taste in Ayurveda and then astringent is considered another taste and astringent is basically something that's very very drying and the best example I can think of for that is when sometimes you eat in a banana that's not ripe enough you know you bite it into a very unripe banana you know how it makes your whole mouth sort of pucker up and get very dry and your tongue sticks to the palate so that's considered an astringent taste so in Ayurveda these six tastes actually have a huge effect on the doshas and so in addition to which fruits or vegetables or dairy products or greens or whatever is eaten we also try to balance which tastes are taken in and so I've just listed here a little bit for ratha in general sweet sour and salty tastes are supposed to help balance swap them for pit the sweet bitter or astringent taste balancing and then for cuff a pungent bitter or stringent tastes our balancing so it's just it's a very complex formula to come up with a nutritional plan but this is kind of a very rough outline of that and then in yoga yoga and Ayurveda really our sister Sciences they kind of came out of the same Vedic tradition and we're used actually in harmony or in complement with one another originally unfortunately when these disciplines came traveled from India to America they soar traveled in separate times carried over by separate teachers who didn't necessarily keep that connection alive and so now we're sort of having to bring these two disciplines back together as they were originally intended to be used and so in yoga which includes asanas pranayama and meditation every one of those practices actually have supposed to have specific effects on bought the Pathan kava so for examples I'm sure so many of you are familiar with the Sun Salutation the Surya Namaskar and yoga so the Sun Salutation is actually you know a great you know a great series of asanas to do if someone is in very very good health and you know pretty much doesn't have a lot of though she can balance going on but if you do have some kind of Duchenne balance going on like for example if your pizza is very very aggravated Sun Salutation is actually supposed to aggravate pizza because you're rising in the morning facing the Sun and doing a lot of heating stimulating asanas and if pizza is already aggravated that's actually sort of the opposite effect that you want to create and so for pizza we I mean for pit the aggravation there's actually in pizza for fifth aggregation we we recommend mood and salutations as opposed to Sun Salutations and we can actually do a whole series of asanas that are designed to be done under the moonlight that are calming and cooling as opposed to Sun Salutations that are stimulating and done in the daytime and so I am a the really tailors which series of yoga asanas are done to meet the individuals you know though should balance and then there's just literally hundreds and hundreds of yoga studies unfortunately a lot of them are very poorly done in terms of you know scientific standards for having control groups being randomized having subjects blinded to which intervention they're getting and so on and so they're not necessarily always at the highest quality but I think the bulk of the studies generally indicate some real efficacy to yoga therapies as a whole for certain conditions and so I've listed here in the randomized control trials I've listed some of the ones that have to do more with mental health because again that's an area that I'm interested in and so there's a particular study that came out the second one that's listed here in the bullet the pranayama may be equivalent to tricyclics in treating depressed inpatient psychiatry patients that was a really interesting study where they looked at a series of yoga breathing exercises compared them to imipramine which is a conventional antidepressant medicine and also compared it to ECT electroconvulsive therapy which is also kind of which is also considered to be a very effective treatment for depression so they had three arms of the study and they follow the patients for about a month at the end of that period the folks that were in the imipramine group actually had pretty much equivalent results to the people that were in the pranayama or the yoga breathing group neither of those groups was quite as good as the ECT group in terms of improvement but a lot of people would probably pick breathing over overall ECT one critique of that study though was it was done for a very short period of time for weeks so you could argue that maybe the tricyclics medicine didn't really have a chance to kick in so maybe it looked as though it was equivalent to yoga breathing because it hadn't been done long enough and it's possible that if you did it for eight weeks or 12 weeks the imipramine group might have looked better than the pranayama group and so I basically want to replicate that study here at the Osher Center and see if we can do it for a longer period of time and see whether those findings actually would hold up I've also included in this next slide yoga therapies also for other medical conditions in addition to mental health conditions so I've listed some of the ones that again seem to have some better data and support of the yoga intervention for that condition but of the where in the comment box we have written that they have significant Co interventions that basically just indicates that when the yoga intervention was studied let's say for hypertension with asanas and pranayama being the intervention that was done there were all kinds of other changes that were also implemented at the same time so it's hard to know whether there was only due to the yoga or whether it was due to other factors that the person's hypertension improved and so these would be considered to be more sort of questionable studies in terms of what do they really show or what do they really prove about that yoga for those particular conditions but some of the other ones actually have a little bit more robust findings particularly the ones for carpal tunnel and osteoarthritis those are actually considered to be some fairly well-designed studies so that's it for my formal talk and I really want to thank you guys for staying extra a few minutes and if you have additional questions I'm happy to answer them you

31 comments

  1. 5 elements, 3 Doshas, each made of 2 elements…Fibonacci numbers, 5,3,2….not seeing any 8's or 13's yet

  2. Namaste. thank you. very informative. i am so grateful. i will watch it again perhaos more than once to drink in the concepts and then ask questions. i have one though, i wish to choose between Ayurveda and Chinese Medicine to study Doctorate. How would you suggest going about deciding?

  3. Will this cure what western medicine can't? If not than it doesn't matter. I will probably die with my eye disease.

  4. Sudhajiall is right. But please note your beloved Modi has brought the Yehudi (Jew) into India. They are an insecure people busy changing the history, culture, Ayurvedic literature, etc., by means of Wikipedia, etc. So stick to our ancient texts and not new translations. Also study what is circulating.

  5. great lecture and informative however as an MD it is surprising that she did not also mention the epistemic problems with Ayurvedic medicine. Appeal to ancient wisdom and anecdote mostly lead to false positive results – that is why we don't do blood letting anymore.

  6. Actually i have been reading books on ayurveda since a while and i am pretty interested in that, but what i loved much about this lecture is the way in which it is performed, not boring at all from the first word till the last one. Hence i deduce the performer's dominant dosha is vatta on addition to the nail specificity: thin, long and look fragile, but alaso a large part of kapha dosha as the hair and skin are oily, the violet dress and often putting hand and the cheeck when she becomes conscious of a point of the talk.

  7. what complete bullshit, its scary that so much people value this knowledge above actual science.

  8. Great Lecture.  We will show this to our Monthly Yoga Bharati, Los Angeles Chapter Alumni meeting in two parts, beginning August 2015.  Would like to thank Dr. Prathikanti, but do not have her email contact.

  9. To  Dr. Sudha Prathikanti my great thanks and I look forward to evaluate your extra research for health.
    I have applied Botanical Herbal Nutrients, Yoga, Tai Chi, Meditation to serve poor medical care villagers in remote areas since 1970 to 1979 during war and after war in Vietnam, which I found out great impacts to people with extended life to enjoy life. Recently, I have applied to serve Vietnamese Patients with Chronic Illness, (Cancer) since 1982 to present time in Los Angeles of California in which make happy for what I have done to serve the others. 
    My comments to encourage you since I do have many people who are always against me, even I do right.

  10. In my heartfelt respectful appreciation to Dr. Sudha Prathikanti and mindful viewers:
    Within my view points of Buddhist Practitioner, Independent Health Care and Caring for the others, I do understand the values of this valuable lecture.
    My Warm Best Regards to you all. 
    Duc Viet Nguyen
    Psychological Analyst. 
    Independent Research for Health.

  11. An  extremely clear and enlightening exposition of an ancient science! Thanks so much Dr. Prathikanti!

  12. I would love to know what my Constitution and that of my husband is.
    My problem is that of a well-known neurological disease and I want myself and husband to overcome any obstacles. 

  13. knowledge is human heritage not western . There is wisdom all over , we are one human nation but some exploit the others ruthlessly .British continue to exploit many native peoples.

  14. diagnostics is primitive.  but has merits in terms of therapeutics and life style modifications.
    – we know world is not flat . –  

  15. Ayurveda has been used successfully for 4,000 years or more. They do't need the scientific method to know it works. The have an enormous quantity of empirical evidence already

  16. I want to come back and watch/listen to more of this video. It is presented in a very understandable way for someone who is not trained in Ayurveda.

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  18. I love the idea of alternative medicine, a modern change to the traditional approach of curing illness.

  19. Quite the contrary. Modern medicine is a plague and causes far more problems then it claims to fix. Big pharma milks consumers and takes their money in exchange for their health. Ancient Indian medicines obliterate Western pharmacology in terms of effectiveness and healthiness.

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