The goal of Ayurveda is to maintain the health of a healthy person and heal the illness of a sick person. Part III of this book contains hundreds of suggestions to help you if you have fallen ill. But staying well is far easier than curing an illness, especially once an imbalance has progressed through the later stages of the disease process. That is why prevention is so strongly emphasized in Ayurvedic medicine. In this chapter we will consider some of the fundamental principles and approaches recommended by Ayurveda for remaining healthy.
The master key to remaining healthy is awareness. If you know your constitution, and you can remain alert to how your mind, body, and emotions respond to the changing conditions in your environment and the numerous facets of your daily life, such as the food you eat, you can make informed choices to maintain good health.
As we saw in chapter 3, the cause is the concealed effect and the effect is the revealed cause, as the seed contains the potential tree and the tree reveals the potency of the seed. To treat the cause is to treat the effect, to prevent it from coming to fruition. If a kapha person always has kapha problems in the spring season, such as hay fever, colds, congestion, sinus headaches, and weight gain, such a person should watch his diet and eliminate kapha-producing food like wheat, watermelon, cucumber, yogurt, cheese, candy, ice cream, and cold drinks. (Ice is not good for a kapha person; it will produce congestive disorders.)
The knowledge of the causes of disease, and the understanding that “like increases like” and “opposites balance,” give us all the information we need to maintain or restore our health, simply through conscious attention, moment-to-moment awareness of our behavior.
If I am living consciously, I may observe that after I ate yogurt two weeks ago, I felt congested and a cold developed. Then it cleared up and I was okay for a few days. When yogurt comes my way again, the memory will come up and my body will say, “Hey, last time you ate yogurt, you got sick!” If I bring lively awareness and listen to my body, it will tell me, “I don’t want yogurt.” To listen to the body’s wisdom, the body’s intelligence, is to be aware, and this is one of the most effective ways to prevent disease.
Developing an awareness of the potential causes of imbalance, and of one’s moment-to-moment state of well-being, is the necessary first step to maintaining health. The second step is taking action.
You can’t control the weather, but you can dress properly, so that cold winds, or rain, or summer’s heat will not aggravate the doshas. Changes in the weather are a potential cause of doshic imbalance. Windy, cold, dry weather will aggravate vata dosha; hot, sticky weather is sure to provoke pitta; cold, cloudy, wet weather will increase kapha dosha. Once we have knowledge and understanding, it is time to take action. Put on a hat, a scarf, a warm coat; stay out of direct sunlight. Modify the cause.
Potential causes of illness and imbalance are constantly arising, both within us and on the outside. The weather is changing, our surroundings are changing, our thoughts and feelings are changing, and stressful situations are coming and going. In response to these changes, we have to act skillfully. As the Bhagavad Gita says, “Skill in action is called yoga.”
I have to be smart enough to know my previous history and to learn from it. When I eat garbanzos, I get a stomachache, so this time I should not eat them. Or if there is nothing to eat except garbanzos, then I can add cumin powder, ghee, and a little mustard seed, and it will be suitable for me to eat. The garbanzos’ dry, light vatagenic effect will be modified by the moist, oily ghee and the warming spices.
A substantial part of the Ayurvedic pharmacy is the Ayurvedic art of cooking. Adding specific seasonings changes the property of food and can cause a “forbidden” food, one that might have provoked imbalance, to become acceptable. Some people, for example, are sensitive to potatoes. Potatoes give them gas and little aches and pains in the muscles and around the joints. But if they peel off the skin and sauté the potato with ghee and a little turmeric, mustard seed, cumin powder, and cilantro, it mitigates the vata-provoking property of the potato and the body can then handle it. One can take action to modify the cause; the body’s response will be different, and that particular causative factor will not have an adverse effect.
This principle applies equally well to psychological factors. You may know that watching violent movies upsets you and gives you nightmares. The violent imagery disturbs your doshic balance, provoking anxiety and fear. You have observed this happening to you; the next time you are confronted with the “opportunity” to subject yourself to a violent movie, you can just say no.
It keeps coming down to the same central issue: consciousness, awareness, finding out, “What is my role in this situation? What do I know? What can I do?”
The first step in staying healthy is developing awareness of the potential causes of disease so you can avoid them or deal with them intelligently. The second step is taking action to modify causes you can’t avoid or control (such as the weather). The next step is to restore balance once it begins to be lost. The main method for doing this is to apply the opposite quality or qualities.
If you’re cold, have some hot soup or take something warm to drink. If you’re agitated or upset (perhaps you watched that violent movie against your better judgment), sit down and do some meditation to calm your mind and emotions. If your pitta has been provoked and you’re feeling hot under the collar, take a swim or have some sweet cooling fruit.
This principle seems so simple and makes such good sense that it is easy to overlook it in practical daily life. But it is extremely powerful and effective. If you apply it, you will find that you can quickly and effortlessly restore balance to your mind and body.
Now we have to consider still another level of self-healing. What if you haven’t taken the opportunity to develop awareness, to modify the cause, or to apply opposite qualities to restore balance, and you have begun to get sick? What to do now?
The principle of opposites is almost universally valid and helpful at any stage of disease. But once disease has begun to develop, it will not be sufficient. At this stage it becomes necessary to use techniques for cleansing and purifying your body of excess doshas and accumulated toxins.
As we have seen, when the doshas are aggravated because of poor diet, unhealthy lifestyle, negative emotions, or other factors, they first affect agni (the body’s biological fire, which governs digestion and assimilation). When agni becomes weakened or disturbed, food is not properly digested. The undigested, unabsorbed food particles accumulate in the gastrointestinal tract and turn into the toxic, sticky substance called ama. In the third (“spread”) stage of the disease process, ama clogs the intestines, overflows through other bodily channels such as the blood vessels, and infiltrates the bodily tissues, causing disease.
Ama is thus the root cause of disease. The presence of ama in the system can be felt as fatigue, or a feeling of heaviness. It may induce constipation, indigestion, gas, and diarrhea, or it may generate bad breath, a bad taste in the mouth, stiffness in the body, or mental confusion. Ama can most easily be detected as a thick coating on the tongue.
According to Ayurveda, disease is actually a crisis of ama, in which the body seeks to eliminate the accumulated toxicity. Thus the key to prevention of disease—once ama has begun to build up—is to help the body eliminate the toxins.
To remove ama from the system, Ayurveda employs many internal cleansing programs. One of these, most widely known in the West, is a five-procedure program known as panchakarma (“five actions”). The panchakarma programs used at Ayurvedic treatment centers include prepurification methods to prepare the body to let go of the toxins, followed by the purification methods themselves.
The first preparatory step is internal oleation. The patient is asked to drink a specific, small quantity of ghee (clarified butter) every day for several days. The ghee creates a thin film in the body’s channels that lubricates them, allowing the ama lodged in the deep connective tissues to move freely, without sticking to the channels, to the gastrointestinal tract for elimination. Internal oleation is done for three to five days or even longer, depending on the individual circumstances.
This is followed by external oleation in the form of oil massage (snehana) and sweating (swedana). Oil is applied to the entire body with a particular kind of massage that helps the toxins move toward the gastrointestinal tract. The massage also softens both the superficial and deep tissues, helping to relieve stress and to nourish the nervous system. Then the individual is given a steam bath, which further loosens the toxins and increases their movement toward the gastrointestinal tract.
After three to seven days of these procedures, the doshas will have become well “ripened.” At this point the physician will determine that the patient is ready to eliminate the aggravated doshas and accumulated ama. One of the five karmas or actions is selected as the most expedient route to eliminate the excess doshas. These procedures may include:
• therapeutic vomiting (vamana) to remove toxins and excess kapha from the stomach;
• purgation or laxative therapy (virechana) to help remove ama and excess pitta from the small intestines, colon, kidneys, stomach, liver, and spleen;
• medicated enema therapy (basti) to help remove excess vata from the colon. Aggravated vata is one of the main etiological factors in the manifestation of diseases. If we can control vata through the use of bastis, we have gone a long way toward eliminating the cause of the vast majority of diseases.
• nasya or nasal administration of medication, in which dry herbal powders or oils such as ghee are inserted into the nose to help remove accumulated doshas in the head, sinus, and throat areas, and to clear up breathing.
• rakta moksha, purification of the blood, which is traditionally done in one of two ways. Bloodletting, in which a small amount of blood is extracted from a vein, is one method, though it is illegal in the United States and is therefore not available here. The second way is to cleanse the blood using blood-purifying herbs such as burdock.
Panchakarma is not the only method used by Ayurveda to remove ama from the body. Depending on the individual’s strength and the seriousness of the disease, one of two main approaches will be employed. If the person is weak and debilitated and the disease is strong, the preferred method is palliation and pacification (shamanam), which neutralizes ama through gentler methods of purification, including herbs. If the patient has more strength and energy and the illness is not so complicated or serious, then panchakarma is appropriate.
IMPORTANT NOTE: Panchakarma is a special, powerful procedure requiring guidance from a properly trained medical staff, not just someone with a modest amount of Ayurvedic training. It is performed individually for each person, with his or her specific constitution and medical condition in mind, and it requires close observation and supervision at every stage, including post-panchakarma support.
Should You Use Ghee?
The use of ghee for internal oleation is recommended for most people. However, individuals with high blood levels of cholesterol, triglycerides, and sugar should not use it. So before you begin your home treatment, see a doctor and have your blood tested for these factors.
If they are within the normal range, there is no problem. If they are high, then instead of ghee use flaxseed oil, which provides effective oleation and also contains fatty acids, which help to reduce cholesterol levels.
Take 2 tablespoons of the flaxseed oil three times a day for three days, fifteen minutes before eating.
Both for periodic prevention (to reverse any buildup of ama) and to deal with a specific health problem, panchakarma is a highly recommended art of cleansing and detoxification. If you are not near a center where panchakarma is available under the supervision of a trained Ayurvedic physician, you can do an effective purification program at home.
Begin your home detoxification program with internal oleation. For three days in a row, take about 2 ounces of warmed, liquefied ghee early in the morning. (See appendix 2 for instructions on making ghee.) For a vata person, take the ghee with a pinch of rock salt. For a pitta individual, take the 2 ounces of ghee plain. The kapha individual should add to the ghee just a pinch of trikatu (a mixture of equal amounts of ginger, black pepper, and pippali, or Indian long pepper).
The ghee provides internal oleation and lubrication, which is necessary so that the ama or toxins begin to come back from the deep tissue to the gastrointestinal tract for elimination.
After your three days of internal oleation, it is time for external oleation. For the next five to seven days, apply 7 to 8 ounces of warmed (not hot!) oil to your body from head to toe, rubbing it in well. The best oil for vata types is sesame, which is heavy and warming; pittas should use sunflower oil, which is less heating; kaphas do best with corn oil. You can do this oil massage for fifteen to twenty minutes.
After the oil is well rubbed in and absorbed, take a hot bath or shower. Then wash with some Ayurvedic herbal soap, such as neem. Let some of the oil remain on your skin.
The ancient Ayurvedic textbooks recommend rubbing some chickpea flour over the skin to absorb and help remove the oil. This works very well to remove the oil, but it is more suited to a culture in which individuals bathe outdoors. Today, if you use chickpea flour, be aware that oil, flour, and hot water combine into a formidable mass that can easily clog your plumbing. Flushing the drain with extra hot water immediately following your bath can help.
During your home purification, every night at least one hour after supper take ½ to 1 teaspoon of triphala. (For information on triphala, see appendix 2.) Add about half a cup of boiling water to the triphala powder, and let it steep ten minutes or until it has cooled down, then drink it. Along with its many healing and nourishing properties, triphala is a mild but effective laxative. It will provide the benefits of a more potent virechana or purgative treatment, but more gently and over a longer span of time. Triphala is safe and can be effectively used for months at a time.
To complete your home panchakarma treatment, on the last three days perform an Ayurvedic medicated enema, or basti, after your hot bath or shower. Use dashamoola tea for the enema. Boil 1 tablespoon of the herbal compound dashamoola in 1 pint of water for five minutes to make a tea. Cool it, strain it, and use the liquid as an enema. (See instructions for basti in appendix 3.) Retain the liquid as long as you comfortably can. And don’t worry if little or no liquid comes out. For certain individuals, particularly vata types, the colon may be so dry and dehydrated that the liquid may all be absorbed. This is not harmful in any way.
This snchana (oleation both internal and external with ghee and oil), swedana (sweating using a hot shower or hot bath), and virechana (purgation) using triphala, followed by basti using dashamoola tea, constitute an effective panchakarma that you can easily do on your own at home.
During this entire time it is important to get plenty of rest, and to observe a light diet. From day four to day eight, eat only kitchari (equal amounts of basmati rice and mung dal cooked with cumin, mustard seed, and coriander, with about 2 teaspoons of ghee added to it). Kitchari is a wholesome, nourishing, balanced food that is an excellent protein combination. It is easy to digest and good for all three doshas, and it is also cleansing.
Be your own healer. Do this simple home purification, preferably at the junction between seasons. Take responsibility for your own healing. You will start to experience a great change in your thinking and in your feelings, and you will really fall in love with your life!
The purpose of panchakarma is not just to get well but to purify the body and strengthen it so that future diseases will not occur, and you can enjoy a long life in good health. In this regard the panchakarma purification can be seen as a preliminary to rejuvenation. If you want to dye your shirt, don’t color it while it’s dirty. Wash it first, then dye it. The washing is the panchakarma detoxification program, and the dyeing is the rejuvenation and revitalization.
Ayurvedic rejuvenatives (rasayanas) bring renewal and longevity to the cells, and when the cells live longer, the person lives longer. Rasayanas give strength, vitality, and longevity, strengthen tone, increase energy, and build immunity. The body’s various agnis become more robust, so health becomes more robust.
For a vata individual, an excellent rejuvenative tonic is the herb ashwagandha. Take 1 teaspoon of ashwagandha in a cup of hot milk twice a day, morning and evening.
An excellent rejuvenative herb for pittas is shatavari. Take 1 teaspoon twice a day in a cup of warm milk. Kaphas can use punarnava, 1 teaspoon twice a day, but in a cup of warm water.
You can also use various herbal mixtures designed to tonify the system, such as the traditional recipe chyavanprash.
Three Cautions About Home Panchakarma
1. Panchakarma, even in this gentle home program, has a powerful effect and should be done only by individuals of sufficient strength. If you are anemic, or feel weak and debilitated, even this home procedure is not for you.
2. Do not do panchakarma in a clinic, or even this home purification, if you are pregnant.
3. One result of panchakarma, even in this mild home version, is that the deep connective tissue may start releasing unresolved past emotions, such as grief, sadness, fear, or anger along with the built-up ama and excess doshas. If this happens, make yourself some Tranquillity Tea (see recipe on this page), and meditate, using whatever method you have learned or the Empty Bowl meditation described in chapter 7. The releasing of emotions may happen weeks or even several months after you finish your home panchakarma.
To make your rejuvenation more effective, after completing your panchakarma purification program, set some time aside to build up your strength. Whether you take a weekend, a week, a month, or even more, use the time as a purposeful period of rest, relaxation, and rebuilding of body, mind, and spirit. Here are a few suggestions:
Quite a few more suggestions for rejuvenative herbs, foods, and tonics for all constitutional types are offered in Part III. See, for example, the recommendations under “Low Libido” and “Fatigue.”
Self-esteem is at the core of healing. Because of the connectedness of mind and body, our sense of self-esteem is our cells’ sense of self-esteem. This is because, according to Ayurveda, every cell is a center of intelligence and awareness. Every cell carries the sense of self for its own survival. It is the sense of self in the cell that maintains the size and shape of the cell. Self-esteem, self-confidence, and self-respect promote cellular intelligence, which is necessary for proper cell function and immunity.
Modern science is just now acknowledging the importance of the mind-body connection, but knowledge of it has been part of Ayurveda for five thousand years. Our sense of self, our attitudes and understandings, our feelings, are all psychobiological events. Self-esteem is one such event, one that is strengthening to our cells and to all aspects of our bodies. A lack of self-confidence and self-love is detrimental.
Cancer is an example of this lack. Cancer cells have lost their intelligence and grow separate from the body. They are irregular and robust and have an isolated, selfish sense of self which is in conflict with the life of normal, healthy cells. When cancer occurs, it’s as if a war is going on between the cancerous cells and the healthy cells. If the healthy cells are strong enough in self-esteem, they can conquer and kill the cancer cells. But if we do not have enough self-esteem and self-respect, then the cancer cells will win and will conquer the healthy cells.
Thus self-esteem is important for maintaining immunity. If you love yourself as you are, you will develop confidence, and that will heal disease. That is why cellular immunity, or natural resistance, depends upon self-esteem.