Ayurveda A New Way For Healthy Life in E

AYURVEDA:
A NEW WAY FOR HEALTHY LIFE IN EUROPE

AYURVEDA:
A NEW WAY FOR HEALTHY
LIFE IN EUROPE
EDITED BY
SAMO KREFT AND LENART ŠKOF
ZALOŽBA ANNALES
KOPER 2010
AYURVEDA: A NEW WAY FOR HEALTHY LIFE IN EUROPE
EDITED BY: SAMO KREFT AND LENART ŠKOF
Managing editor: Vida Rožac Darovec

Technical editors: Nina Turčin, Sara Štuva
Reviewers: dr. Tamara Ditrich, dr. Anton Mlinar
Translation: Martina Zajc
Layout design: Uroš Čuden, Medit d. o. o.
Publisher: Univerza na Primorskem, Znanstveno-raziskovalno središče Koper,
Založba Annales / University of Primorska, Science and Research Centre of Koper,
Publishing House Annales
For publisher: Darko Darovec
Printed by: Grafis trade d.o.o.
Copies printed: 500
Financial Support: Department of AYUSH of the Government of India
CIP - Kataložni zapis o publikaciji

Narodna in univerzitetna knjižnica, Ljubljana
615.8(540)(082)
INTERNATIONAL Scientific Conference on Ayurveda (2009 ; Portorož)

INAyurveda : a new way for healthy life in Europe : [proceedings
volume of the International Scientific Conference on Ayurveda,
Portorož, Slovenia, March 5-6, 2009] / edited by Samo Kreft and
Lenart Škof ; [translation Martina Zajc]. - Koper : Univerza na
Primorskem, Znanstveno-raziskovalno središče, Založba Annales, 2010
ISBN 978-961-6328-78-4
1. Gl. stv. nasl. 2. Kreft, Samo
251595776
A collection of papers from the international scientific conference
on Ayurveda
AYURVEDA:
A NEW WAY FOR HEALTHY LIFE IN EUROPE
Grand Hotel Portorož & Hotel Slovenija (Portorož, Slovenia)

March 5–6, 2009
Organized by:
University of Primorska, Faculty of Humanities Koper,

Departments of Anthropology and Philosophy (Slovenia)
Università del Litorale, Facoltà di studi umanistici Capodistria,
Dipartimenti di antropologia e filosofia (Slovenia)
University of Primorska, Science and Research Centre of Koper (Slovenia)

Università del Litorale, Centro di ricerche scientifiche di Capodistria (Slovenia)
University of Primorska, College of Health Care Izola (Slovenia)

Università del Litorale, Instituto universitario di sanità Isola (Slovenia)
University of Primorska, Turistica – Faculty of Tourism Studies (Slovenia)

Università del Litorale, Turistica – Facoltà di Studi per il turismo
di Portorose (Slovenia)
in cooperation with:
The Embassy of the Republic of India, Ljubljana
Department of AYUSH of the Government of India
Life Class Hotels and Spa, Portorož, Slovenia
The proceedings volume was financially supported by:
Department of AYUSH of the Government of India

Organization and Program Committee
Conference Chair
Dr. Lenart Škof, Associate Professor and Senior Research Associate,

Faculty of Humanities & Science and Research Centre of Koper,
University of Primorska, Slovenia
Honorary Organizing Committee
H. E. Dr. Villur Sundararajan Seshadri, Ambassador of India

to the Republic of Slovenia
Dr. Aleksandra Brezovec, Dean of Faculty of Tourism Studies Portorož,
Dr. Vesna Mikolič, Dean of Faculty of Humanities,
Dr. Darja Piciga, Ministry of Higher Education,
Science and Technology, Slovenia
Dr. Nadja Plazar, Dean of College of Health Care Izola,
International Program Committee
Dr. Nadja Furlan, Assistant Professor and Research Associate, Faculty of

Humanities & Science and Research Centre of Koper, University of Primorska,
Slovenia, Slovenia, Chair
Dr. Thakur Ramesh Singh Chouhan, Director, Ethicamatrix Clinical
Research, Hyderabad and Former Dean, DIAS, Dr. MGR University, India
Dr Tamara Ditrich, University of Sydney, Australia
Mr Nigel Hubbers, EUAA (European Ayurveda Association), UK
Dr. Gordana Ivanković, Assistant Professor, Vice Dean for Academic
Affairs, Faculty
of Tourism Studies Portorož, University of Primorska, Slovenia
Dr. Darja Barlič Magajna, Vice Dean for Academic Affairs, College of Health
Care Izola, University of Primorska, Slovenia
Dr. Metka Ravnik-Glavač, Faculty of Medicine,
University of Ljubljana, Slovenia
Dr. Regis A. de Silva, Associate Professor of Medicine Harvard Medical
School, Director Partners-Harvard Medical International, U.S.A.
Dr. Borut Štrukelj, Faculty for Pharmacy, University of Ljubljana, Slovenia
Dr. Nataša Tozon, Veterinary Faculty, University of Ljubljana, Slovenia
Mr. Thomas Vallomtharayil, Chief Executive Officer,
Medical Park Ruhr, Germany
TABLE OF CONTENTS
Introduction 13
OPENING SPEECHES
Rado BOHINC 21
Rector of the University of Primorska
Ms. S. JALAJA 23
Secretary, Department of AYUSH, Ministry of Health & Family Welfare,
Government of India
V. S. SESHADRI 27
Ambassador of the Republic of India to Slovenia
PART 1 AYURVEDA AND REGULATORY ASPECTS
Regis A. de SILVA 33
Role of Ayurveda and traditional indigenous medicine in global health care
Samo KREFT 49
Cultural (paradigmatic) and regulatory obstacles in integration of Ayurveda
into Western medicine
PART 2 AYURVEDA, SPIRITUALITY AND HUMANITIES
Christian KESSLER 63
Ayurveda between religion, spirituality und modern science
Tadeja JERE LAZANSKI 83
Systems thinking, Ayurveda and Yoga: convergence of the Western
science and the Eastern wisdom
Elmar STAPELFELDT 93
Spiritual development in classical Ayurveda: a practical teaching from the
Caraka-Samhita
Maja KOLAREVIĆ 103

Two worlds, two realities: psychiatry vs. Ayurveda
Andrej RUS 121

‘Consciousness-based medical treatment’ paradigm as the basis
of Ayurvedic therapy
Vasudevan NAMPOOTHIRI 133

Ayurveda – Indian wisdom for global health
PART 3 AYURVEDA, HEALTH AND MEDICAL SCIENCE
G. S. LAVEKAR 139
Healthy life through Ayurveda
Ajay G. NAMDEO, Kavita YADAV, Ajay SHARMA and

Kakasaheb R. MAHADIK 151
Biotechnological investigation of Withania somnifera: an important
medicinal plant
Gaurav DESAI 161

Ancient Ayurvedic apothecary and its application in Europe
Nadja PLAZAR and Tamara POKLAR VATOVEC 167

Options of Ayurveda in nursing and dietetics
Harsha GRAMMINGER 183
Ayurveda – more than just wellness. About the Ayurvedic treatment
of an 82 year-old woman with Cushing-syndrome
Biljana DUŠIĆ 197

The role of Ayurveda in early diagnostics of disease
Metka RAVNIK-GLAVAČ 201

Meditation induces gene expression changes
Notes on Contributors 209
Index of Names 213

INTRODUCTION
Nadja FURLAN, Anton MLINAR and Lenart ŠKOF
Health and disease are among the fundamental aspects of human experience.
The two concepts stretch into the very roots of human understanding of nature
and have a significant impact on the conceptualization of different cultures. Un-
derstanding health and disease has far-reaching implications for diagnosis and
therapy, for physicians’ attitudes towards disease, for the way people perceive
their illness or disease in general, for social understanding of health, for structures
dealing with health and disease, as well as for understanding human nature, con-
sciousness and spirituality, human position and well-being in one’s natural and
cultural/social environment, and ultimately also for one’s ethical reflection and
moral choices with associated political consequences (medical and broader social
policies, attitudes towards social groups and towards the environment - intercul-
tural and environmental or sustainable perspectives). Health and disease are not
only medical terms, they are life-related topics in art, humanities, social sciences,
and are also strongly present in politics and economics. Both health and disease
are anthropological and somewhat specific human subjects for it is through them
that medicine comes remarkably close to human destiny, to limitation.
If it can be said that modern medicine has had a significant effect on the per-
ception of health and disease, then the opposite must also hold true - due to their
dynamic nature, the changing concepts of health and disease have caused a si-
multaneous transformation of medicine and other fields where they appear as key
dynamic concepts. This is also indicated by the difficulty of arriving at a univer-
sally accepted definition of the terms. Health and disease are physical, social,
psychological and spiritual phenomena. Although there is a substantial difference
between the two, many correlations can also be found when comparing their de-
scriptive and normative concepts: any attempt to define them seems to contain
13
an underlying desire to not only understand them but also to know how to react
when faced with the actual experience. Such a definition of health makes it clear
that contemporary approaches to health require a highly interdisciplinary ex-
change of the humanities with social sciences, natural and medical sciences, and
a close cooperation of researchers and other agents (economists, social agents,
etc.) in the aforementioned fields.
The perception of health and disease and also the way in which medicine has
perceived its duties have been strongly influenced by the remarkable success of
the so-called scientific (Western, i.e. secularized) medicine. Complete seculari-
zation of medicine in Europe (and the West in general) has only been possible on
the basis of the forgotten holistic understanding of the human being as a continu-
ous form of physical-mental interactions contacting different environments and
constantly responding to them (Descartes and his full differentiation of physical
and mental substance in humans). European Positivism in its various forms has
only intensified this relationship into the belief in the ability of positive sciences
to answer all the questions of human beings and the world. It was in the second
half of the 20th century when modern sciences returned to a holistic perspec-
tive (from physics through biology to the humanities and various cross-culturally
shaped holistic models). It should be noted that on the basis of the mentioned tra-
dition, modern medicine (in its broadest sense) is still dominated by the norma-
tive concept of health, comprising technology-structured understanding of dis-
ease and its treatment (which is also largely technology-structured), evaluation of
activities (deontology) and expectations - that health is a ‘product’ - and that this
type of medicine is less susceptible to a holistic or integrated approach where per-
sonal relationship between the doctor and the patient is of primary importance,
as is a different understanding of the importance of one’s (un)healthy living envi-
ronment. There are many reasons for continuous in-depth studies of not only the
health-related aspects of the ‘quality of life’, but also of a holistic perspective of
the human being, defined in terms of health by the word therapy (gr. therapeúo),
‘waiting upon man’. Health is the highest level of one’s ability to lead a rich and
creative life (Hoyman) and thus one of the most important factors that contribute
to a healthy society and a healthy environment. Findings in neurology confirm
that human experience of health is indeed correlated with the mind state of the
entire personality and that the body does not forget anything (Jäncke).
In European Antiquity health was understood cosmologically (orderliness),
anthropologically (life orientation) and ethically (mission). In modern Europe
14
INTRODUCTION
much more striking than the formulated scale of values and the definition of the
term ‘doctor’ in its medical, psychological and spiritual sense is the secularisa-
tion of health, the loss of one of its essential dimensions – the ethical dimension
of life - and its transformation into a product. More amazing than the success of
medicine in the prevention of infectious diseases is the fact that social changes
have closely linked medicine and pharmacology to the pursuit of political and
economic goals and consequently often distracted them from their primary ob-
jective: to help people. In the early 20th century, the so-called anthropological
medicine (also known as psychosomatics) was one of the first attempts to slow
down the victorious march of science, albeit without much success. The para-
doxes of Western medicine were also highlighted by the Universal Declaration
of Human Rights (1948), declaring health as a human right. However, the defini-
tion of health by the World Health Organization from 1976 (“Health is not only
the absence of infirmity and disease but also a state of physical, mental and social
well-being”) again merely reflects the modern culture of health, i.e. health as a
product. Such a definition of health is at the same time one of the central clues
to the ‘health’ state of medicine, social sciences and many other fields of human
activity: it reflects the structuring of the modern world based on its difficulty in
accepting human limitations and finiteness and at the same time influences the
position of medicine and society on the ways of raising awareness regarding the
occurrence of disease, its progress and meaning and, finally, also leads to the loss
of sensitivity for others. In the context of modern paradigms in the field of health,
we should also mention biosemiotics - a term suggesting a broad range of human
experience of the interplay between the unconscious and the conscious memory,
for example fatigue, depression, proneness to disease, disabilities related to birth
defects and work-related stress and similar. Biosemiotics helps to identify the
thought patterns and behaviours that harm health and increase morbidity. It draws
attention to different forms of risk behaviour, to the need for applying strategies
of destigmatisation of certain diseases, mental illnesses in particular. It exposes
the one-sided idealised image of health and campaigned persecution of risk be-
haviour. It creates conditions for various modern scientific approaches to assist in
uncovering the secrets of correlativity - and not analogy – and confirms the fact
that one cannot deceive nature or one self. Needless to mention, at this very mo-
ment in contemporary Europe we are deeply aware of the importance of these in-
sights and approaches. It is clearly not only necessary but of essential importance
to approach health through a comprehensive treatment of the human position in
15
the natural (inter)cultural and wider social environment. Ayurveda in Europe is a

part of this important task.
We are living in a period when confidence in official medicine has found it-
self in a crisis. Although the achievements of modern medical science and tech-
nology are indisputable, they are accompanied by people’s growing discomfort.
Throughout centuries, Western medical tradition has witnessed radical transfor-
mations of the understanding and treatment of the human body and consequently
health and disease. Gradually, the secular-individualist paradigm prevailed, re-
placing the primordial, so-called irrational, medical systems and assumed pri-
macy of a religious formation of these concepts. Modern conventional medicine
is characterized by strong institutionalization, specialization and above all a sci-
ence-oriented nature of research. In conventional medicine the conception and
treatment of the body, of health and disease always involves often inconsistently
applied concepts such as norm, normal and pathological. The relationship be-
tween normal and pathological conditions is still based on the positivist para-
digm. Disease is characterized as a quantitative deviation from the normal state;
whereby the latter is determined by statistically calculable population average.
In reality, there are also (or above all) qualitative differences between the states
of health and disease that are not taken into account by the allopathic medicine.
The constructivist critique of the generally accepted medical standards for defin-
ing health and disease and their related causes also reveals the fact that medical
norms are strictly determined by historical, political, ideological and social con-
texts and therefore subject to emerging explanations and competing interpreta-
tions in the field of medicine. We can therefore find that there is no such thing as
an objectively defined disease. At the same time however, modern scientific med-
icine often asserts the right to command the criteria of normality and the norms of
“proper” life. The conception of medical categories of the body, health and dis-
ease also takes place via either implicitly or explicitly expressed moralistic dis-
course applied by medicine to go beyond the scope of its discipline and reach into
the field of ethics. Health in this context can be understood as an ideology and
an imperative of the modern world, but never before has it been so closely linked
to consumer culture as it is today. Any medical paradigm in the treatment of the
human body is not only distinguished for its specific strengths but also marked
for its limits. Nevertheless a common guiding principle for all medical systems
should provide people with the highest possible level of physical and mental
(spiritual) well-being, i.e. health. Western medicine thus focuses on treating the
16
INTRODUCTION
disease (considered as a variable) and not the individual in terms of personality in

its entirety - with specific needs, intentions and desires. These are among the fac-
tors that open the way to (mainly) ancient knowledge which the western thought
paradigm calls alternative medicine.
Ayurveda is a traditional Indian system offering a unique understanding of hu-
man life, health, disease and therapeutic methods of treatment. It is one of the old-
est known medical systems, which has, just like conventional medicine, changed,
shaped and evolved over time. It comprises knowledge that is not only confined
to the field of medicine, but deals with human life at its inextricably linked levels
of being, all of which influence the human body and its state of health. Ayurveda
connects the humanities, social and medical dimensions of human beings and
their self-knowledge. In its deepest sense it represents one of the fundamental
medical systems. Its eight main directions - paediatrics, obstetrics and gynaecol-
ogy, ophthalmology, geriatrics, otolaryngology, toxicology, general medicine and
surgery – form the bases for the organizational structure of modern medical sys-
tems. In certain respects Ayurveda is also the source for other modern medical
practices and approaches, including massage, diet and diet counselling and the
use of medicinal herbs. Many fields and practices of medicine are therefore fun-
damentally related to Ayurvedic philosophy and practice.
The present proceedings of the International Symposium on Ayurveda call
attention to all the mentioned elements of human relationship to oneself and to
one’s health. If Europe wishes to abandon its insistence on one-sided conceptions
of health and disease and if its view does not expand into a holistic understand-
ing of the human being, not only through Ayurveda, but also by attracting other
related non-European traditional and holistic medical systems, then its future is
uncertain. As S. Jalaja points out in the present proceedings, Ayurveda is pre-
cisely what can help many individuals for whom the so-called official medicine
does not have an answer or its answers and solutions are only associated with the
implementation of an increasing number of drugs with many side-effects on the
already weakened human balance. Many chronic diseases along with population
aging in Europe call for a reform of the European healthcare system. We believe
that the present contributions can help accomplish this task.
17
OPENING SPEECHES
Rado BOHINC
Rector of the University of Primorska
Dear Excellencies, representatives of Slovene and Indian governments, dear

representatives of the European Commission, dear Deans, participants and dis-
tinguished guests!
In 2008 the University of Primorska and the Embassy of India decided to es-
tablish cooperation and one of the main purposes of this initiative was to strength-
en the ties between Slovenian and Indian culture and science at all levels. I’m
very happy to say that the conference on Ayurveda is already the first concrete
outcome of this cooperation. It shows our dedication to the purpose of bringing
together European and Indian scholars from various disciplines (humanities and
medical science) in order to shed light on the interdisciplinary approach needed
in our times.
The University of Primorska is a young university open to new initiatives.
Recently (in 2008) a volume on Slovenian–Indian relations, edited by our prof.
Lenart Škof, has been published in Kolkata on the occasion of the Slovenian pres-
idency to the EU and supported by our Ministry of Foreign Affairs. The purpose
of the book was to put forth a fragment of the extensive history relations and ties
between Slovenia and India. Among other plans and activities related to India I
would also like to mention our plans to establish a new master on International
Relations with Indian studies included, a plan conducted in cooperation with the
University of Ljubljana. This will offer our students a new possibility of becom-
ing specialists in the field of Indian studies and will help them to shape the world
of politics, science and culture with their expertise.
The University of Primorska also fosters cooperation between its members –
our faculties and institutes. I’m therefore very glad to see four of our members
being the coorganizers of this conference! Many of our study programs already
address various life sciences (we have programs in humanities, since recently
21
also in sustainable development, we have health care and tourism studies, natural
heritage studies etc.) and it is only natural to try to provide new insights into chal-
lenges raised by many issues related to the understanding of health as an integra-
tive approach in today’s Europe.
The wider challenge of this conference is to answer the question how to pro-
mote Ayurveda in Europe and in Slovenia in particular. An international network
of scholars, practitioners and experts will present their research at this confer-
ence. I wish all of them a successful and fruitful scientific exchange!
22
S. JALAJA
Secretary, Department of AYUSH, Ministry of Health & Family Welfare,
Government of India
AYURVEDA LEADS THE WAY

1. Ayurveda, the science of life is on a path of resurgence today. It is estimat-
ed that 40% patients of the world over are affected by chronic diseases for
which biomedical science has no effective solutions. More and more people
are turning to traditional methods of treatments. Ayurveda has much to offer
to the world. This age-old system with its unique mind-body framework, can
provide preventive, curative as well as promotive health care and ensure bet-
ter quality life to millions of people across the world.
2. What are the unique strengths of this system? Unlike the biomedical system
which is a health-care system, Ayurveda is a way of life. It speaks about five
universal elements (air, space, earth, water and fire) acting upon the three
humors (Tridoshas) in the body, the mind itself with its three distinct quali-
ties acting in relation to these. The diseased state of the body is due to the
imbalance in the three humors-treatment is to bring back the balance into the
system. Mind, food, environment, exercise all have a role to play in human
wellbeing. The beauty of the system lies in its ability to interpret any disease
in terms of the Tridosha frame work and use the same corrective measures to
bring back the balance
3. The biomedical system dismisses Ayurveda as non-science and seeks its val-
idation through scientific methods acceptable to itself, forgetting that it too
recognises the importance of diet, exercise and the influence of mind-the
difference lies in the method of diagnosis and the herbal-mineral medicines
used. The validation of Ayurvedic treatments lie in the successful treatment
of disease conditions which have no answers in the biomedical system.
4. In India over 60% people are dependent on the Indian Systems for their med-
23
ical care. We have over 21,000 dispensaries in the rural areas dedicated to
these systems The mainstreaming of Traditional systems is one of the Im-
portant goals under the NRHM (National Rural Health Mission), a flagship
program of the government Facilities for traditional medical services are be-
ing co-located in 3,464 primary health centers. 919 community health cent-
ers and 203 district hospitals which offer Allopathic services, so as to pro-
vide choices to people. Efforts of the Government are also to provide these
services in all major allopathic hospitals in the country. High- end research
is being promoted to find out how these systems work on the human body,
help isolate active molecules, standardize raw materials and drugs, ensure
their safety, efficacy and quality, and Promote good manufacturing practices.
Efforts are on for reforming Ayush education to meet the emerging needs in
the sector. A National Mission on cultivation and propagation of medicinal
plants has been launched. Most important of all, these systems are being pro-
moted to enhance the value of preventive health.
5. The Department of AYUSH is actively promoting AYUSH interventions in
public health so as to make available the benefit of these systems to or-
dinary people across the country. National campaigns have been launched
on ‘Kshara Sutra’ for ano-rectal disorders, Ayurveda for Geriatric Care, Ho-
moeopathy for Mother and Child care and Quality Assurance of Ayurveda,
Siddha, Unani and Homoeopathy (ASU&H) drugs. New themes have been
identified for launch of new Campaigns including Control of Maternal Ane-
mia through Ayurveda, Unani for Skin Disorders and Yoga for Health. A
unique campaign is being launched to promote the cultivation and use of
Amla (Gooseberry) which takes care of ‘Tridosha’ in Ayurveda.
6. The Department is actively engaged with the World Health Organisation
which supports a number of our activities and under whose aegis the Depart-
ment has drawn up guidelines on basic training and safety in Panchkarma
with a view to standardise this practice in various centres offering this ther-
apy the world over. The guidelines are currently under consideration of the
WHO.
7. Another unique initiative of the Department of AYUSH is drawing up a da-
tabase on codified Medicinal Knowledge in Ayurveda, Siddha and Unani for
preventing misappropriation of this knowledge at International Patent Of-
fices (IPOs). Traditional Knowledge Digital Library (TKDL) enables con-
version of original formulations from classical texts into patent compatible
24
S. JALAJA
format into five international languages, namely, English, French, German,

Spanish and Japanese. Over 2 lakh Ayurveda, Siddha and Unani formula-
tions have so far been transcribed onto this database. The target users of the
TKDL database are primarily the Patent Examiner (s) in national and region-
al IPOs worldwide. India has signed as Access Agreement with European
Patent Offices (EPO) through which TKDL database would now be available
to all the 34 member States under the EPO for establishing prior art, in case
of patent applications based on Indian Systems of Medicine. This would ob-
viate the need for contesting wrong patents at IPOs, which is a time consum-
ing and expensive exercise.
8. Having stated above the strengths of the traditional systems, and the efforts
being made by the Indian government, now I may clarify why we want to
promote Ayurveda outside the country. Many countries in the world, in-
cluding USA, are now looking for an ideal system of universal health care.
Despite the progress made by mankind in every sphere of human activity,
chronic disorders of the body and diseases of the mind are on the rise. People
everywhere are looking for a personal health care. Toxic side-effects, com-
plicated treatment procedures and high costs are forcing ordinary people to
opt for simple, low-cost treatments. It may also be remembered that millions
of people are left out in the cold not covered by any system of care at all.
9. Government of India is now trying to propagate these systems, especially
Ayurveda abroad through various activities, including organization of major
events and exhibitions, exchange of scholars, funding for research, technical
support to universities, promoting Ayurveda education, bringing out publica-
tions etc. As a part of these efforts an Indo–US Centre for Research on In-
dian Systems of Medicine (CRISM) has been set up in the National Centre
for Natural Products Research (NCNPR), University of Mississippi, USA.
The Indian Systems of Medicine (ISM) and the industry today are faced
with the need for validation of both the systems and products on scientific
lines. There are increasing global concerns on the safety, efficacy and quality
of ISM products. The initiative of the Department of AYUSH in setting up
CRISM is intended to meet these concerns. The primary mission of CRISM
would be to facilitate scientific validation and dissemination of information
on Ayurveda, Siddha and Unani medicines through collaborative research
and advocacy. CRISM will also provide an institutional interface with US
FDA. It is expected that the establishment of this Centre would lead to world
25
class research and development on the potential of the traditional systems

and latest scientific advances therein for promotion and scientific acceptance
of Indian Systems of Medicine.
10. Ayurveda faces a number of challenges at present. Ayurveda is a nature-
based system and so is fully dependent on plants and mineral resources. Due
to population pressure, environmental pollution and other causes the avail-
ability and quality of these resources are badly threatened. The challenge is
to find alternate easy growable plants, substitutes, develop new agro-tech-
niques, propagation through tissue culture etc. Secondly, there is need to
protect classical Ayurveda in its purest form. In fact Ayurveda should be pro-
tected as a heritage by UNESCO and other international agencies. Devel-
opment of integrated medical systems wherein Ayurveda is used to support
treatments under biomedical system needs to be carefully looked into. Use
of AYUSH in public health is an emerging area. Ayurveda research needs to
be streamlined with clinical trials developed on the basis of Ayurveda proce-
dures. Ayurveda, Yoga, diet control need to be taken up together, instead of
separately, in the treatment of disease conditions. AYUSH education should
be revamped to be in tune with research and therapy. Finally, the most im-
portant of all, local health traditions need to be revitalized and AYUSH main-
streamed to pass on the full benefits of the system to the community, and,
indeed to the humanity as a whole.
11. Ayurveda congresses are being held in different parts of the globe, the con-
gress being organized in Portorož is the latest. The purpose is to assemble
scholars, Ayurveda practitioners, experts, teachers, researchers, organiza-
tions/associations working towards promotion of Ayurveda, to discuss dif-
ferent aspects of Ayurveda, promote its strengths, inspire research and fa-
cilitate net working. Govt. of India is providing both technical and financial
support for this endeavour. I hope the congress will be able to reach out to all
those in Slovenia and other countries who are in search of a holistic system
of healthcare and well being. I also hope that the Congress will bring about
a paradigm shift in the human understanding of health care and high quality
life.
On behalf of Government of India I wish the congress all success.
26
V. S. SESHADRI
Ambassador of India to Slovenia
Her Excellency Mrs. S. Jalaja, Secretary, Department of AYUSH, Hon’ble

Mrs. Sreemathi P.K. Teacher, Minister for Health & Social Welfare of Gov-
ernment of Kerala, Hon’ble Ombudsman Zdenka Čebašek Travnik, Mr. Janez
Remškar, DG of Healthcare of Slovenia, Mr. Rado Bohinc, Rector of University
of Primorska, Prof. Lenart Škof, Ms. Nadja Furlan, Distinguished delegates, la-
dies and gentlemen.
Let me, from the side of the Embassy of India in Ljubljana, extend a warm
welcome to all of you, to those who have come all the way from India, from oth-
er parts of Europe and elsewhere and, of course, from Slovenia itself. I would,
in particular, like to welcome the Secretary of the Department of AYUSH of the
Government of India, Smt. S. Jalaja and the Hon’ble Minister for Health and So-
cial Welfare from the Government of state of Kerala, Mrs. P.K. Sreemathi Teach-
er, from a state that is prominent in the Ayurveda map of India. I would also like
to welcome Mr. Janez Remškar, the Director General for Health Care of the Min-
istry of Health of the Government of Slovenia and thank him and his Ministry for
the encouragement they have given to this initiative of organizing this Confer-
ence. May I also welcome Mr. Rado Bohinc, the Rector of the University of Pri-
morska, which, as you can see from the words of the previous speaker, Prof. Škof
has been a key mover behind this Conference.
The motivations for this Conference were basically threefold. Firstly, as some
of you may know, there was a similar Conference held in September, 2007 in
Budapest at the initiative of our Embassy there in close collaboration with the
Ayurveda Foundation of Hungary. It was, therefore, felt that a follow up Confer-
ence in the same region in Europe could pick up the threads and promote further
interest in this area. I am, therefore, glad that we have amongst us some who at-
27
tended the Budapest Conference, including Dr. Istvan Riesz, the Chairman of the
Hugarian Ayurveda Foundation
The second reason for holding the Conference was the emerging interest that
has been perceived in Slovenia towards Ayurveda and wellness. This was evident,
for example, even in Lifeclass Hotels, where this Conference is being held, having
an Ayurvedic Centre. They were also keen to make it more authentic by recruit-
ing some Ayurvedic therapists from India. They eventually got them from the state
of Kerala and these were graduates from the Government Ayurveda College in
Thiruvananthapuram. I am, therefore, glad that we have amongst us the Principal
of the College and the Secretary of the Department of Health of the Government of
Kerala who were instrumental in facilitating these recruitments when the Embassy
contacted them. Of course, we are also fortunate that we have the Hon’ble Min-
ister of Kerala with us today and I am sure you are looking forward to the speech
that will follow and the special presentation on Kerala tomorrow.
The third reason for the initiative was the keen readiness and interest that Prof.
Lenart Škof and his colleagues showed when I had initially talked about this ini-
tiative with him almost an year ago. He said that he will be willing to collaborate
and provide all the academic back-up and support for such a Conference. Soon
we also had the support of the Dean of the College of Healthcare in Izola, the Fac-
ulty of Turism Studies and many other agencies of the University of Primorska
for which I owe special thanks to Mr. Rado Bohinc, Rector of the University and
to his colleagues. We are also fortunate to have Mr. Bohinc in our midst today.
The programme for the next one and a half days has already been explained to
us by Ms. Nadja Furlan and Prof. Škof and I am sure that you will agree it should
prove quite intensive and interesting. A key question, which I am sure will receive
attention, is how Ayurveda and Ayurvedic treatments will be regulated in Europe
so that Ayurvedic companies or other entities offering services or products either
from Europe itself or from countries like India, can conform to these regulatory
requirements. While Ayurvedic practitioners in Europe can throw some light on
this, I am also very grateful that the European Commission responded positively
to our request to send a representative from the EU Commission. I would there-
fore also welcome Mr. Per Thomas Thomassen from EU Commission who will
be speaking on the regulatory aspects in relation to marketing Ayurveda as a me-
dicinal product within EU, later today.
Lastly, I would like to thank all the agencies and sponsors who have made this
possible with their support and encouragement including the Department of AY-
28
V. S. SESHADRI
USH of the Government of India, the Slovenia Research Agency, M/s Lifeclass
Hotels and so many more. I would also, on behalf of the Embassy warmly wel-
come all the other Speakers, Panelists, researchers and Ayurvedic practitioners
who responded positively to the invitation.
Thank you.
29
PART 1
AYURVEDA AND REGULATORY ASPECTS
ROLE OF AYURVEDA AND TRADITIONAL INDIGENOUS
MEDICINE IN GLOBAL HEALTH CARE
Regis A. de SILVA
In the past 30 years traditional Indian, Chinese, Tibetan and other forms of
culturally-based medical systems have permeated the West and have become in-
creasingly accepted by the public. There has also simultaneously been recogni-
tion by Western medicine that illness and disease are not merely a physical phe-
nomenon, but have cultural, sociological and anthropological dimensions (Klein-
man A., Eisenberg, L., Good, B., 1987, 251-258). The development of Western
medicine had its original roots in indigenous medical systems, and the develop-
ment of the scientific method in the 17th century created a steady divergence from
the empirical practice of medicine from ancient Greece. In the last 400 years,
modern medicine has had a coeval existence with traditional or indigenous medi-
cine in many cultures, both in the West and in the developing world. Traditional
medical systems should be valued as a healing art, as they are the result of several
thousand years of empirical, observation, experience and learning. The present
situation is that medical care has evolved in many countries with patients par-
ticipating actively in both medical systems in order to improve their health. My
discussion will focus primarily on various forms of culturally-based medical sys-
tems such as Ayurveda, Chinese and Tibetan medicine, collectively referred to as
“Traditional Medicine” or “Indigenous Medicine”, and its current relationship to
Western medicine.
In the West and in developing countries, a number of heterodox approaches
are also used by lay practitioners who are not classically-trained in the traditional
indigenous medical systems listed above. In addition, there are a wide variety of
over-the-counter and patent preparations available for self-treatment. Terms such
as alternative, complementary, unconventional and unorthodox medicine have
33
been used to describe all of these multifarious approaches to healing. In an at-

tempt to systematize the heterogeneous approaches to medical and self-care ap-
proaches to health, the Australian Government’s Department of Health and Age-
ing has classified the various types of medical care into categories as shown in
Fig. 1 (modified from http://www.health.gov.au/medicareplus/). The first catego-
ry of treatments shown are basically self-care and over-the counter products, as
well as massage and aromatherapy. The second category consists of well-estab-
lished culturally-based systems including Ayurveda, Chinese and Tibetan medi-
cine. A third and somewhat controversial category, Homeopathy, was originated
in 1796 by Samuel Hahnemann, a German physician. The term Traditional, Com-
plementary and Alternative Medicine (TCAM) will be used inclusively here to
describe the systems of medicine that include traditional forms of medicine as
well as all the other forms of treatment that do not strictly fall under the rubric of
“Western medicine”. The term “Western doctor” refers to a physician trained in
Western medicine.
While TCAM is typically not taught in most European and American medi-
cal schools, many patients nonetheless seek such treatment, often in addition to
receiving Western medical care. In Europe, the use of homeopathy, herbalism,
naturopathy, acupuncture and spa treatments already have a longstanding history
and a firm place in the treatment of many acute and chronic medical conditions.
The use of Ayurveda, Chinese and other alternative and complementary medical
treatments is steadily on the rise in the West. It is striking that in both Europe and
the US, it is among Caucasians in higher social classes, and with higher incomes,
that this trend towards TCAM treatment is most evident. Eisenberg et al. at re-
ported in studying 1539 people in the United States in 1990 that 34 percent re-
ported using at least one unconventional therapy in the previous year (Eisenberg,
D. M., Kessler, R. C., Foster, C., 1993, 246-252). The majority used unconven-
tional therapy for chronic illnesses rather than for life-threatening, medical con-
ditions. They estimated that in 1990 Americans made an estimated 425 million
visits to providers of unconventional therapy, and exceeds the 388 million visits
to all U.S. primary care physicians. Expenditures associated with use of TCAM
amounted to approximately $13.7 billion, of which $10.3 billion was paid out of
pocket.
The main reasons for this trend towards TCAM may be (a) the rising cost of
medical care, (b) that hospitals are viewed as threatening and inhospitable, (c) the
invasive nature of Western medicine, (d) the decline in the number of primary
34
Regis A. de SILVA: ROLE OF AYURVEDA AND TRADITIONAL INDIGENOUS MEDICINE IN GLOBAL ...
care doctors, (e) the growing depersonalization of care in Western medicine, and
(f) TCAM being seen by some individuals as being safer and more in harmony
with their desires and views on illness and disease. Furthermore, the image of
Western medicine as a caring profession, especially in the US, has been eroded
in recent years as it has become more businesslike. There has also been a cultural
shift in that patients today – especially in the US - are more resistant to the rav-
ages of ageing, and less accepting and fatalistic about the inevitability of death,
and hence no longer accept the status quo when given a dismal diagnosis. Some
people seem to be unwilling to accept illness and death as being part of the natu-
ral progression of life and ageing. This growing cultural trend drives them in des-
peration, to seek alternatives to standard medical care in order to recover from
illness and to extend life.
USE OF PHARMACEUTICALS DERIVED FROM NATURAL

SOURCES – RESEARCH AND DEVELOPMENT
A large number of valuable modern pharmaceuticals are derived from nat-

ural herbs, e.g. digitalis, atropine, quinine, quinidine, reserpine, scopolamine,
ephedrine, hyoscyamine, yohimbine, tamoxifen and vincristine, to treat disor-
ders ranging from congestive heart failure, bradycardia and malaria to cancer. In
modern pharmacology, these agents have been isolated and studied to identify
their chemical structure, clinically tested to generate dose response curves and
to determine toxicity. Though many of these medications are also used in tradi-
tional Indian and Chinese medicine, the difference between traditional practition-
ers and Western doctors is that a standardized pharmacopeia has been developed
in the latter case with a Federal approval process with restrictions and guidelines
that are determined by regulatory agencies to safeguard the public. Most of these
drugs cannot be obtained without a physician’s prescription. Many herbally de-
rived medications used in TCAM vary in pharmacologic potency and effect and
may, in some cases, contain a combination of agents that may or may not act in a
co-permissive manner. The differences in manufacturing and compounding tech-
nology, quality control and distribution may create regulatory and policy prob-
lems in integrating the two systems.
The European Forum for Complementary and Alternative Medicine (EF-
CAM) has estimated that in the European Union, out of a total population of 500
35
million, at least 100 million people use TCAM. The cost of homeopathic and an-
throposophy medicinal products was about 930 million euro in 2007. Between
1995 and 2005, the market increased by 60%. These products now account for
approximately 7% of the total European non-prescription market or 1% of the to-
tal European pharmaceutical market. The recognition that the use of CAM is now
widespread, has led the National Institutes of Health in the US to form the Na-
tional Center for Complementary and Alternative Medicine (NCCAM). In 2007,
NCCAM estimated the cost of such treatments to be $33.9 billion annually in
2007, with 38% of all adults in the US admitting to using CAM. This number is
growing annually at an unknown rate.
Many members of the public perceive traditional practitioners as being more
kindly and their medications being less harmful, as they use “natural” medica-
tions, which are thought by some to be not only safer, but more efficacious. How-
ever, even traditional medical practitioners admit that for serious medical condi-
tions such as heart attacks, stroke, trauma and cancer, they themselves will seek
Western medical care where surgery and extremely powerful and toxic drugs are
utilized. The key question that remains is whether Ayurveda and other traditional
forms of medicine can be integrated successfully into a much more dominant
Western medical system.
CAN WE INTEGRATE TCAM INTO WESTERN MEDICINE?
From a public policy perspective, it does not matter whether or not one be-
lieves in the effectiveness of TCAM or, indeed, if there is a scientific basis for
such treatments. The fact is that use of TCAM is already widespread and growing
in the West. Since the public seeks out treatments such as Ayurveda, Chinese and
other forms of traditional medicine, governments have to be responsive not only
to their needs, but also should provide a regulatory framework for safety reasons.
To avoid misleading claims by any profession, rules and regulations, as well as
legal safeguards and disciplinary procedures need to be set in place to protect the
public. A second goal in policy making in integrating the two systems of medi-
cal care is to establish rules for best practices in order to achieve the best results
for the public.
Due to educational and clinical efforts undertaken by several agencies
and medical centers, an approach called integrative medicine has been used to
36
describe the meshing of Western medicine with TCAM. In India, the central gov-
ernment has already created a department to regulate Ayurveda, Yoga, unani and
homeopathic medicine, collectively called “AYUSH”. In the West, to achieve this
end, a number of organizations such as NCCAM in the US, and bodies in Europe
such as EFCAM, have advocated bringing together multiple stakeholders rang-
ing from Western medical doctors, TCAM practitioners, policy makers, public
interest groups and philanthropists. In 1997, the European Parliament called on
the EU Commission to take action in the area of TCAM, but no action has been
taken. The objective is to fashion a system that advocates policies that honor pa-
tients’ choices to integrate their care in a holistic manner. However, it is unlikely
that this area of medicine will receive much studied official attention soon, since
uniform standards for Western medical practice itself have not been fully estab-
lished in Europe, or even within the European Union. The EU’s current priority
is to achieve its primary goal of economic, monetary and political union, and this
goal has not yet been accomplished as of this writing.
BARRIERS TO INTEGRATION
There are several barriers in establishing a policy framework for integration

of TCAM with Western medicine and the following considerations are important:
– Lack of a common basis in TCAM in diagnosis and treatment
– Negative societal and professional bias
– Lack of validation of treatments and cures
– Regulatory issues
– Varying ethical and professional standards
– Incommensurability
It is difficult to create a uniform policy to integrate TCAM with the Western
medical system into a common policy framework since there are several forms of
medicine being practiced by TCAM practitioners. Such practitioners may engage
in non-haptic forms of treatment ranging from spiritual healing, prayer, and ener-
gy healing to hypnosis, biofeedback and relaxation. In other cases the practitioner
may use haptic treatments that include massage, acupuncture, chiropractic ma-
nipulation and various types of equipment that allegedly increase circulation to
various parts of the body. In yet other cases, the practitioner uses herbal and folk
remedies as well as medications that are available without a prescription. While
37
Ayurveda, Chinese and Tibetan medicine involves long periods of training, many
TCAM practitioners do not have a rigorous form of training with external aca-
demic review. Herbalism is often passed on generationally, and rather informal-
ly, from a practitioner to lay persons who are interested in learning about herbal
treatments and, who subsequently, become herbalists themselves. Since the prin-
ciples and practice of the many schools of TCAM are not uniform, there may
be wide variations in training and certification. The validation of treatments and
cures is anecdotal rather than via monitored trials as is common in Western medi-
cine. As Baer has pointed out, it can be difficult to evaluate partially profession-
alized and lay heterodox medical systems within TCAM and the holistic health
movement (Baer, H. A., 2001). Moreover, regulatory, ethical and professional
oversight does not really exist to the same extent as it does in Western medicine
(Kerridge, I. H., McPhee, J. R., 2004, 164-166). These factors have produced ex-
treme, and sometimes unfair, criticism by Western doctors and policy makers of
TCAM as being something ranging from quack medicine to outright fraud.
The greatest hurdle is probably incommensurability. As originally enunciated
by the philosopher and historian of science, Thomas Kuhn (Kuhn, T. S., 1962),
incommensurability is the principle that proponents of different scientific para-
digms cannot really appreciate or understand one another’s point of view because
they live in different worlds with different systems of thought. The systems that
govern TCAM and Western medicine are quite different in many respects. In
Western medicine, the framework for operation, ongoing academic development
and regulation is concentrated in three principal areas (a) Clinical Practice (b)
Medical Education and (c) Research. It is unlikely that at present there will be
synchrony between the markedly different schools within TCAM and the system
in Western medicine in these three key areas, and this will engender disagreement
and conflict in policy making.
A number of other difficulties prevent the wholesome integration of the two
systems. For example, the rules and regulations that govern Western medicine
are very stringent. Barriers to entry into practice are very high, and therefore jeal-
ously guarded because entry into medical school is highly competitive in the US
and in Western Europe. The bar for training and entry into practice for traditional
medical practitioners is not as stringent in most countries. Moreover, training pro-
grams in Western medicine of long duration have to be completed before practice
is permitted. State and Federal licensing laws are strict, and hospital credential-
ing and privileging procedures are extremely restrictive in what a practitioner can
38
and cannot do. Major deviations from practice are not easily tolerated, oversight
is provided by Quality Assurance panels and practitioners can be taken to task. It
is unclear if CAM practitioners are willing to undergo the same rigorous scrutiny
with the strict credentialing process that Western practitioners undergo or, indeed,
if they really wish to do so.
Continuing education and recertification is often a mandatory requirement for
re-licensure for many Western jurisdictions. This is also the case now, in many
developing countries where there is tightening of regulatory control of Western
medical doctors. Finally, malpractice risk is a much more serious problem for
Western doctors than for TCAM practitioners. Most countries also have a very
orderly complaint and disciplinary system for Western doctors that is well devel-
oped and strictly enforced. In many jurisdictions, a robust medico-legal system
is absent, or not well developed, for TCAM practitioners. Integration of both
systems will, very likely, force close scrutiny of TCAM and increase the risk of
legal action. All of these issues make it very difficult to integrate practice under
the same roof within hospitals. However, in the outpatient setting, integration has
already been successfully accomplished in many clinics. In the outpatient system,
this integration is much easier as the illnesses being treated are often not life-
threatening and thus, the risk of injury and harm is low.
POSSIBLE MODELS FOR INTEGRATION
I will discuss an idealized schema for integration, bearing in mind the dif-
ficult cultural, policy and legal issues involved. In Fig. 2, I have outlined three
basic categories of medicine, labeled as Traditional medicine, Coeval medicine
and Western medicine. In the first column are many conditions where the patho-
physiology is not understood, where treatments by Western medical doctors are
not particularly effective, where mortality risk is low, and where patients may re-
spond to relatively non-targeted treatments. Examples include arthritis, chronic
fatigue syndrome, and tension headache. On the other extreme are serious life-
threatening conditions such as myocardial ischemia and infarction, malignancies
and organ failure where advanced diagnostic technology and rapid therapeutic
interventions are required. There are however, also intermediate conditions such
as collagen vascular diseases, spinal disease, some allergic conditions where ana-
phylaxis is a concern and severe hypertension where both traditional and Western
39
medical approaches may work together to enhance recovery. I have labeled this
category Coeval medicine in recognition of the fact that treatments evolved con-
temporaneously over long periods of time in such diseases.
This provisional classification can also be utilized as a basis for discussion on
how to Integration between TCAM and Western medicine can occur at three lev-
els: (a) Clinical integration, (b) State and Federal policies for integration and, (c)
Integration of care in developing countries. In this schema, it is currently easier to
integrate at a clinical level rather than at the other levels as outlined. Many indi-
vidual practitioners from both areas of care have formed alliances and are willing
to work together for the benefit of their patients.
(a) Clinical Integration. At a clinical level, whether a patient presents to a
Western doctor or a TCAM practitioner, a diagnostic process is engaged,
wherein the practitioner has to decide on a provisional diagnosis (Fig. 3). Cer-
tain diagnostic tests are obtained and a diagnosis confirmed if possible. If
the diagnosis calls for Western medical treatments, e.g. suspected myocardial
ischemia requiring hospitalization and invasive testing, the patient is referred
to a specialist for further investigations and appropriate treatment such as car-
diac catheterization, angioplasty or surgery performed. However, if the patient
absolutely refuses such an encounter, the Western doctor may refer the patient
to a TCAM practitioner for exclusive treatment. For conditions where there is
no certain diagnosis, or if there are no appropriate Western medical treatment
modalities, the patient may continue to be treated primarily by a TCAM prac-
titioner. Referrals are thus made interactively between Western and TCAM
practitioners. In many cases, there may be dual treatment from both types
of practitioners and verification for drug interactions should be conducted to
avoid adverse side effects.
Because there are many conditions such as irritable bowel syndrome, rheuma-
toid arthritis, allergies, chronic fatigue syndrome etc. where there are really no
excellent treatments to be offered by Western doctors, TCAM may be offered as
a better, less harmful and more cost-effective alternative to alleviate these condi-
tions. There are conditions that are obviously better treated by Western medicine
and others that are better treated by TCAM as indicated in Fig 2. There are also a
variety of intermediate conditions where treatment can be shared by both systems
as indicated in the middle column.
40
(b) Integration at a State and Federal Level. Most countries and states have
separate Boards that regulate Western medicine and TCAM. Because of the
varying types of treatments in these two disciplines, the rules and regulations
and the legal process for adjudication of complaints are markedly different in
many countries. In both systems of treatment, there are charlatans who pur-
vey allegedly “novel” treatments and equipment that are designed to enhance
personal profit rather than benefit the health of the patient. In India, the gov-
ernment has taken on the serious task of creating policies to integrate the vari-
ous systems of medicine in their country by creating the Department of Ay-
urveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (“AYUSH”)
within the Department of Indian Systems of Medicines and Homoeopathy in
the Ministry of Health & Family Welfare in 1995. In Australia, the Ministry
of Health’s Department of Health and Ageing has taken steps to systematize
the field in order to integrate TCAM into a national framework of healthcare
(http://www.health.gov.au/medicareplus). Leadership in this area has been
shown by the Faculty of Medicine at the University of Tromso in Norway,
where the The National Research Center in Complementary and Alternative
Medicine (NAFKAM) has put out an excellent and exhaustive White Paper
providing an overview of the use and regulation of alternative medicine, effi-
cacy evaluations, concerns, legal and non-legal measures to protect the public,
and a registration and licensing scheme (http://www.regjeringen.no/nb/dep/
hod/dok/nouer/1998/nou-1998-21/24.html?id=141435). Other governments
need to systematize the rules and regulations that cover both Western and
traditional systems of medicine to provide appropriate care and to protect the
public interest. This can be done only with appropriate input from the profes-
sionals involved in the care and welfare of patients and with input from public
interest groups. It is a difficult process, as many treatments offered by both
Western and TCAM practitioners cannot be validated in many cases. How-
ever, despite the absence of definitive data, provisional regulations can be
crafted in order to integrate the two systems of care, and these regulations can
be modified and revised as necessary.
(c) Integration in Developing Countries. Perhaps the most interesting chal-

lenge in integrating Western medicine with traditional medicine lies in devel-
oping countries where there is lack of access to Western medical care for se-
rious illnesses that require interventions which as modern therapeutic agents,
41
fluid rehydration, and rapid transportation to a major medical center for ad-
vanced medical care.
In November 2008, Dr. Margaret Chan, the WHO Director- General addressed
the WHO Congress on Traditional Medicine in Beijing, China (http://www.who.
int/dg/speeches/2008/20081107/en/index.html). She pointed out the reality that
in developing countries in Africa, Asia and South America, care from traditional
practitioners is often the only treatment that is available, accessible and afford-
able. She commented that Ayurveda and Chinese medicine are deeply rooted in
the culture and are supported by folk wisdom and experience, and they command
the respect of the community. These methods treat many ailments, reduce pain
and alleviate suffering. She was not, however, advocating their exclusive use.
Rather, she spoke about upgrading traditional practices with skilled attention to
childbirth and infectious diseases in order to reduce mortality and morbidity. She
further addressed the need to integrate TCAM into Western medical practice,
particularly for chronic diseases for which Western medicine offers very little in
many cases.
To support Chan’s view, it can be seen in Table 1 that out of a total world
population of 6.78 billion, only a little over a billion people are served by West-
ern medicine. Thus, unlike in the West, traditional practitioners serve 85% of the
world’s population in poorer countries. If we take India as an example, for a total
population of 1.15 billion, there are only about 700,000 Western trained doctors
with a little less than a million traditional medical practitioners and Registered
Medical Practitioners (RMP). There are only 1.38 million trained nurses in all
of India. Thus, it would seem obvious that the vast majority of people in India
are getting their care from Ayurveda, Yoga, Naturopathy, Unani, Siddha and Ho-
meopathic (AYUSH) practitioners. Many “AYUSH” practitioners already work
within their hospitals and have adopted laboratory studies that are convention-
ally used by Western doctors and cross-referrals are done between practitioners
in cases that merit intervention in serious illness. Given the reality that advanced
Western medical care is lacking in developing countries due to lack of financing
and deficiencies in human capital, such integration should be an imperative with-
in the medical system in these countries.
One possible policy approach is to consider whether it is feasible to integrate
the two medical systems by bridging care for the under-served in a model where
new knowledge and technology are passed from Western practitioners to tradi-
42
tional medicine practitioners (or even to appropriately trained lay people). Thus,
it is possible for screening for cancer, heart disease, hypertension, HIV/AIDS,
dysentery, cholera etc. to be done after suitable training of traditional practition-
ers. If basic diagnostic procedures can be taught, it is possible for anti-malarial
drugs, antihypertensive agents, HIV-AIDS medications, fluid infusions etc. to be
provided to traditional practitioners in poor communities where ready access to
Western medical care is unavailable.
In fact, lay people are trained by the French non-governmental organization
(NGO) Inter-Aide in the Dharavi slum in Mumbai, which houses about 1 million
people, to gather sputum at collection stations for screening. These specimens are
then transferred to a mini- microbiology laboratory nearby for identification of
tuberculosis (TB). Anti-TB medications are provided at treatment stations staffed
by lay people where infected patients may pick up their medications (M. Giordan,
HA Gupte, Inter-Aide, personal communication). The whole process is monitored
by a local Western-trained medical doctor who supervises the system of collec-
tion stations, the laboratory and the medication stations. The specific details and
methods for integration need to be worked out for other conditions, but proper
education and training may accomplish this end without having to erect expen-
sive clinics staffed by nurses and Western-trained doctors. Safeguards need to be
in place as my colleagues in developing countries have expressed concerns that
local practitioners may misuse information to attain control over vulnerable pop-
ulations, and even sell the medications provided free of cost by the government
or non-governmental organizations. In communities where local practitioners are
not well-trained, the implicit appearance of approbation by an external authority
may do more harm than good.
On an educational level, the two systems of medicine in the West are essen-
tially completely separate. Since TCAM has a different regulatory structure in
the West from Western medicine, it is almost impossible to integrate the former
into the medical education system. However, in some developing countries such
as India this integration has existed in some form as there are schools of medicine
that teach traditional Indian medicine and there is extensive overlap with Western
medicine. In Malaysia, a relatively new medical school, the International Medi-
cal University, has introduced an innovative curriculum with graduates students
in Western medicine, but also offers training in Chinese and other forms of alter-
native medicine which have long existed in the community. Such a curriculum
takes into account the real world in Malaysia which is a polyglot nation with sev-
43
eral diverse ethnic groups with their own strong traditions of TCAM that have
existed for hundreds of years before Western medicine was introduced in the past
hundred years.
CONCLUSION
There is an increasing use of culturally based medical systems, such as Ay-

urveda, in the West. Since such use is accelerating and we need to accommodate
the wishes and needs of patients to help them heal. There are several cultural,
societal, regulatory and legal barriers in integrating TCAM with Western medi-
cine. Ayurvedic medicine is one form of medicine that is making inroads in both
Europe and the US. Traditional Chinese medicine also has a very strong presence
in both Asia and in the West. The incorporation of Ayurveda and Chinese medi-
cine into the medical system can be accomplished by dialogue, education and
advocacy. In developing nations, perhaps, the opposite approach may be taken,
to upgrade traditional medicine with modern drugs and newer health practices in
childbirth and infectious diseases. From a public policy perspective, we need to
fashion new approaches to integrate the two disparate systems of medicine to bet-
ter take care of the public.
REFERENCES
Kleinman, A., Eisenberg, L., Good, B. (1978): Culture, illness, and care: clinical
lessons from anthropologic and cross-cultural research. Ann Intern Med, 88,
251-258.
Australian Government Department of Health and Ageing, MedicarePlus Ac-
cessed at: http://www.health.gov.au/medicareplus/.
Eisenberg, D. M., Kessler, R. C., Foster, C. et al. (1993): Unconventional Medi-
cine in the United States -- Prevalence, Costs, and Patterns of Use. New Eng-
land Journal of Medicine, 328, 246-252.
The Use of Complementary and Alternative Medicine in the United States: Ac-
cessed at: http://nccam.nih.gov/news/camstats/2007/camsurvey_fs1.htm
44
Baer, H. A. (2001): Biomedicine and alternative healing systems in America: Is-

sues of class, race, ethnicity, and gender. University of Wisconsin Press, Mad-
ison.
Kerridge, I. H., McPhee, J. R. (2004): Ethical and legal issues at the interface
of complementary and conventional medicine. Med Journal of Australia,181,
164-166.
Kuhn, T. S. (1962): The Structure of Scientific Revolutions. University of Chi-
cago Press, Chicago.
Norwegian White Paper on Alternative medicine, accessed at: http://www.regjer-
ingen.no/nb/dep/hod/dok/nouer/1998/nou-1998-21/24.html?id=141435
Chan, M.: Address at the WHO Congress on Traditional Medicine Accessed at:
http://www.who.int/dg/speeches/2008/20081107/en/index.html
Acknowledgements: I wish to thank Drs. Elmar Staplefeldt, Christian Kessler

(Germany), Jarle Aarbakke, Vinjar Fønnebø, Geir Gotaas (Norway) an M. Marc
Giordan (France) and Lenart Škof (Slovenia) for their helpful input and sugges-
tions
Table 1. Distribution of the Total World Population of 6.78 billion
REGION POPULATION (billions)

Asia 4.05
Africa 0.973
Latin American/Caribbean 0.6
Europe 0.732
North America 0.337
45
TRADITIONAL, COMPLEMENTARY & ALTERNATIVE MEDICINE
HERBAL VITAMINS AND NUTRITIONAL AROMATHERAPY

MEDICINES MINERALS SUPPLEMENTS PRODUCTS
TRADITIONAL HOMEOPATHIC
MEDICINE MEDICINE
AYURVEDIC CHINESE OTHER TRADITIONAL

MEDICINE MEDICINE MEDICINE SYSTEMS
Figure 1. Classification of Traditional, Complementary and Alternative

Medicine (Adapted from the Australian Government Department
of Health and Ageing)
TRADITIONAL MEDICINE COEVAL MEDICINE WESTERN MEDICINE
Rheumatold arthritis Collagen diseases Coronary disease

Osteoarthritis Rheumatoid disease Arrhythmias
Chronic fatigue syndr. Osteoarthritis Cardic arrest
Irritable bowel Cronic fatigue syndr. Vascular disease
Migraine Spine diseases Stroke
Tension headache Allergies Major trauma
Asthma Hypertension Cancer
Stress/Tension Insomnia Genetic diseases
Psych disorders End-of.life care Infectious diseases
Psoriasis Transplantation
Insomnia
End-of-life care
Figure 2. Classification of Diagnostic Treatment Groups for TCAM

and Western medicine
46
CONVENTIONAL
Rx
TECHNOLOGY
BASED UNTREATABLE
DIAGNOSIS BY
CONVENTIONAL
Rx
SYMPTOM NO DIAGNOSIS AYURVEDIC

OR CAM
Rx
PATIENT
REFUSES
CONVENTIONAL
DIAGNOSTICS OR
Rx
Figure 3. Flow diagram for possible diagnostic and treatment options for a
presenting symptom
47
CULTURAL (PARADIGMATIC) AND REGULATORY
OBSTACLES IN INTEGRATION OF AYURVEDA INTO
WESTERN MEDICINE
Samo KREFT
Ayurvedic medicine, as well as other branches of traditional, alternative and

complementary medicine, is becoming more and more popular in Europe. De-
spite a huge public interest, the regulatory organs and profession react and adapt
to this new situation only slowly. In 2004 the European directive on medicinal
products was amended in regard to traditional herbal medicinal products. In No-
vember 2008 WHO adopted a so-called “Beijing Declaration on Traditional Med-
icine”. All this efforts are not sufficient to enable appropriate access to Ayurvedic
and other traditional medicines in Europe. In this article the sharp border between
the alternative medicine and official medicine will be questioned. Cultural differ-
ences with a possible influence on scientific paradigms will be presented as one
obstacle for integration of traditional Ayurvedic medicine and modern western
medicine. European regulatory and legal requirements that enable marketing of
some (e.g. homeopathic, traditional herbal), but not all (Ayurvedic, Anthropo-
sophical) medicinal products where the efficacy is not proven by the standards of
“Evidence based medicine” will be discussed.
CONTACTS OF AYURVEDA WITH EUROPEAN MEDICINE IN

HISTORY
During the history there were at least three major contacts between the Indian
and European medicine.
49
The first contact took place in Ancient times. It is not clear, whether it was a
direct contact or an indirect contact via Arab world. The two strongest evidences
for this interaction are: common Materia Medica and common basic principles.
In Materia Medica (the list of all medicines used) of Ayurveda and in Ancient Eu-
ropean medicine, there are many shared medicinal plants. The basic principle in
both medicines is humorism. An ancient Greek medicine is based on four body
liquids (Blood, Yellow bile, Black bile, Phlegm) and Ayurvedic medicine is based
on three Doshas (Vata, Pitta, Kapha). Both medicines are based of five elements:
Air, Ether, Fire, Water and Earth.
The second tight contact between the two traditions appeared during colonial
era. The British physicians that came to India brought with them the European
tradition. In contacts with local patients, local physicians and local pharmacists,
they were forced to adapt and to integrate the new experiences from India to their
European tradition.
The third time Ayurveda and Western medicine (at that time not only Euro-
pean but also American) contacted in the 20th century, when during New Age, the
interest in eastern traditions spread in the western world. This contact was not a
direct contact between the physicians from two traditions, but it was rather an
indirect contact when same patients were seeking help from the two traditions.
This is the reason that Ayurveda is considered as Complementary and Alternative
Method (CAM) in the west. Methods that were presented to the west at that time
were not always original Ayurvedic methods, but were sometimes adapted to the
New Age movement.
The table below lists the herbal substances that can be found in both European
and Indian tradition. The table is based on the compilation prepared by European
medical agency (EMEA, 2009). The sources of plants used in Ayurveda are:
– Ayurvedic Pharmacopoeia of India, first edit. 2001, Part 1 Vol. 1; Vol. 2, Vol.
3, Vol. 4
– Database on medicinal plants used in Ayurveda, Central council for research
in Ayurveda & Siddha. Vol. 1 2000, Vol. 2 2001
– Quality Standards of Indian medicinal plants, Indian Council of Medical Re-
search 2003. Vol. 1, Vol. 2, Vol. 3.
The sources of plants used in European tradition are: European pharmacopoe-
ia, Escop monographs, German commission E monographs and French Avis aux
fabricants (AFSSAPS).
50
Samo KREFT: CULTURAL (PARADIGMATIC) AND REGULATORY OBSTACLES IN INTEGRATION OF ...
Tabel of herbal substances that are common in Ayurvedic and European tradition
Acori calami rhizoma Juniperi pseudo-fructus

Allii cepae bulbus Juniperus communis summitates
Allii sativi bulbus Lini semen
Aloe Liquiritiae radix
Carvi fructus Myrrha (Commiphora molmol)
Caryophylli flos Phaseoli fructus (sine semine)
Centellae asiaticae herba Piperis nigri fructus
Cinnamomi cortex Plantaginis ovatae semen
Curcumae xanthorrhizae rhizoma Psyllii semen
Curcurmae longae rhizoma Quercus cortex
Foeniculi amari fructus Sennae folium
Foeniculi dulcis fructus Sennae fructus
Foenugraeci semen Valerianae radix
Hyperici herba Vitis viniferae folium
Juglandis folium Zingiberis rhizoma
DIFFERENT MEDICINES
There are many kinds of medicine: traditional, alternative, complementary,

integrative medicine on one side and conventional, western, official, evidence
based medicine on the other side. Different authors use different approaches to
discriminate first group from the second one, and there are different definitions
for individual terms. Science is often used as discriminator for the two main
branches. Some authors are very strict:
– “Evidence-based medicine, that’s the kind that’s been shown to work. Every-
thing else is alternative medicine - medicine that has not been shown to work”
(Colquhoun, 2008), but most authors do not necessarily require actual scien-
tific tests for methods to be part of conventional medicine, but just a possibil-
ity or consent to such tests is enough:
– “Alternative medicine has not been scientifically tested and its advocates
largely deny the need for such testing” (Angell & Kassirer, 1998).
– “Alternative medicine is a set of practices which cannot be tested, refuse to be
tested, or consistently fail tests” (Richard Dawkins, as cited in Wikipedia).
51
– “Modern medicine is based on the use of methods, which were scientifically

tested or at least were developed on the principles and biological facts that can
be scientifically tested” (Trontelj, 1998).
The other aproach to distinquish between conventional and alternative medi-
cine is self definition of western medicine:
– alternative medicine: any of various systems of healing or treating disease
(as chiropractic, homeopathy, or faith healing) not included in the traditional
medical curricula taught in the United States and Britain (Merriam-Webster
dictionary)
– alternative medicine are medical interventions not taught widely at U.S. medi-
cal schools or generally available at U.S. hospitals (Eisenberg et al., 1993; Ei-
senberg et al., 2001).
– CAM is a group of diverse medical and health care systems, practices, and
products that are not presently considered to be part of conventional medicine.
Conventional medicine is medicine as practiced by holders of M.D. (medical
doctor) or D.O. (doctor of osteopathy) degrees and by their allied health pro-
fessionals, such as physical therapists, psychologists, and registered nurses.
Some health care providers practice both CAM and conventional medicine.
(NIH, 2009).
These definitions also have shortcomings, since they neglect the medical fac-
ulties in other countries and the curriculum in all schools is not the same. Accord-
ing to the survey of 125 medical faculties in the U.S., the methods of alternative
medicine are taught at 64% (Wetzel et al., 1998). Among the European medical
faculties and other European faculties in the health sector this methods are taught
by 40% and 72% respectively (Berberis et al., 2001).
LEVEL OF EVIDENCE
What is the level of evidence required for a method to be accepted in conven-

tional western medicine and what kind of evidence is required in Ayurveda?
Double-blind, randomized, prospective, placebo control study is the golden
standard of evidence for conventional (evidence-based) medicine. But this level
of evidence is sometimes not possible to achieve and conventional medicine of-
ten accepts much lower evidences.
52
In some areas of western medicine, such studies could not be conducted or

they are complex and expensive. In such cases medicine is satisfied with the sub-
stantially lower level of evidence.
In surgery, for example, there are only few surgical procedures supported by
prospective, randomized, double-blind studies. Implementation of the placebo
operation is, of course ethically controversial, but it is not unacceptable (Hung,
2001). One of the first was made already in 1929 (Cobb, 1959). The lack of other
types of prospective randomized studies of surgical interventions (e.g., a compar-
ison of two types of interventions) is the result of high costs and lack of interested
founders. In the absence of a higher level of evidence, the evidence-based med-
icine accepts non-randomized or even retrospective studies (Transfeldt, 2007;
Mulpuri, 2007).
Double-blind, placebo-controlled randomized clinical studies, are also rear in
testing the effectiveness physiotherapy methods, non-pharmacological psychiat-
ric methods, dietetics and other. Nevertheless, there is no doubt that these meth-
ods are all a part of western conventional medicine.
Science and profession in each case determines what kind of evidence is re-
quired, taking into account the scientific criteria, possible consequences of the
wrong assumptions, technical and financial feasibility, and ethical principles (e.g.
it is not acceptable to compare the effectiveness of anti-cancer drugs with pla-
cebo). However, the question arises, who should determine the above-mentioned
criteria, and what role may the money have?
REGULATORY REQUIREMENTS
The European legislation (Directive 2001/83/), provides several possible ways

to demonstrate the effectiveness of medication: “In general, clinical trials are con-
ducted as controlled clinical trials and, if possible, randomized, every other pro-
cedure must be justified”. Exceptional cases are allowed: “applicant can show
that he is unable to provide comprehensive data on the efficacy and safety under
normal conditions of use, because: the indications for which the product in ques-
tion is intended are encountered so rarely that the applicant cannot reasonably be
expected to provide comprehensive evidence, or in the present state of scientific
knowledge, comprehensive information cannot be provided, or it would be contra-
ry to generally accepted principles of medical ethics to collect such information”
53
The additional exemption are traditional medicines: “The long tradition of the
medicinal product makes it possible to reduce the need for clinical trials, in so far
as the efficacy of the medicinal product is plausible on the basis of long-standing
use and experience.” For homeopathic medicines: “The proof of therapeutic effica-
cy shall not be required for homeopathic medicinal products” (Directive 2001/83/).
PROFESSIONAL REQUIREMENTS
Different levels of evidence accepted by conventional medicine are divided

into levels. One of such classifications was done by Oxford Centre for Evidence-
based Medicine Levels of Evidence in March 2009:
Level Therapy/Prevention, Aetiology/Harm

1a systematic review (with homogeneity) of randomized clinical trials
1b Individual randomized clinical trials with narrow Confidence Interval
all patients died before the Rx became available, but some now survive on it; or when
1c
some patients died before the Rx became available, but none now die on it.
2a systematic review (with homogeneity) of cohort studies
Individual cohort study (including low quality randomized clinical trials; e.g., <80%
2b
follow-up)
2c “Outcomes” Research; Ecological studies
3a systematic review (with homogeneity) of case-control studies
3b Individual Case-Control Study
4 Case-series (and poor quality cohort and case-control studies§§)
Expert opinion without explicit critical appraisal, or based on physiology, bench research
5
or “first principles”
A similar classification of scientific evidenc was prepared by WHO for re-

search of Traditional Medicine:
Level Type of evidence

Ia Evidence obtained from meta-analysis of randomized controlled trials
Ib Evidence obtained from at least one randomized controlled trial
Evidence obtained from at least one well-designed controlled study without
Iia
randomization
Iib Evidence obtained from at least one other type of well-designed quasi-experimental study
Evidence obtained from well-designed non-experimental descriptive studies, such as
III
comparative studies, correlation studies and case control studies
Evidence obtained from expert committee reports or opinions and/or clinical experience
IV
of respected authorities
54
There is no general rule, what level of evidence should be obtained for medi-
cal procedure (treatment) to be used as part of evidence based conventional medi-
cine. In every clinical case a procedure with best efficacy demonstrated at high-
est level of evidence should be used. In cases, that there are no better treatments
available, even a treatment with the level of evidence 5 can be used, but it is rec-
ommended to “alert the advisees to the flaws in the evidence on which it is based”
(CEBM; 2009). It is very possible, that such alert will diminish the effectiveness
of treatment via nocebo effect and it is not clear what the intention of such alert is.
On the other hand, there are very strict regulatory requirements for the level
of evidence obtained for a medicinal product to obtain marketing authorization
(see above). With very rare exceptions, only level 1 (or level I in WHO classifi-
cation) is accepted.
In general a very similar requirement is used for herbal medicinal product to
obtain full marketing authorization (so called well established use): “In general,
at least one controlled clinical study (clinical trial, post-marketing study, epide-
miological study) of good quality is required to substantiate efficacy.In the ab-
sence of a controlled clinical trial a case-by-case assessment taking into account
possible benefits, risks and types of disease may be acceptable, if clinical experi-
ence with the herbal medicinal product is well documented and supportive, con-
clusive (human) pharmacological data of good quality are available.” (EMEA;
2006).
The level of evidence that is available to substantiate the efficacy of CAM
methods is usually on the lower part of the scale (level II, III and IV). This is
logical consequence of the definition of CAM. Therapeutic methods for which
efficacy is demonstrated with randomized controlled clinical trials should in prin-
ciple by definition become a part of conventional medicine. 83 clinical trials of
Ayurvedic methods can be found in the Pubmed database (http://www.ncbi.nlm.
nih.gov/sites/entrez). This can be considered as relatively high number, but on
the other hand, compared to many different methods used in Ayurveda and many
diseases that can be treated with Ayurvedic methods, the number of clinical trials
is not so high.
In my view, there is a discrepancy between the levels of evidence required for
therapeutic procedure to be used in conventional medicine and evidence required
for marketing of medicinal product. To override this gap, European legislation
introduced a new category of “traditional herbal medicinal products” in 2004 (Di-
rective 2004/24/EC). For traditional herbal medicinal products it is sufficient that
55
its efficacy is “plausible”, but it should meet some other requirements: to have
indications exclusively appropriate for use without the supervision of a medical
practitioner; to be for oral, external and/or inhalation use; it has been in medici-
nal use throughout a period of at least 30 years, including at least 15 years within
the European Community. This provision covers only some but not all traditional
preparations. For instance many Ayurvedic products are not covered, since their
use in EU is not documented for 15 years, or they contain non-herbal constituents
(mineral, animal). Many Antroposophic medicinal products are also not covered,
since they are intended for parenteral administration (as injections). European
court of justice decided that individual European states are not allowed to prepare
separate legislation for these products (ECJ 2007). The legislation on medicinal
practice is on the other hand very different in individual European countries. Ay-
urvedic clinics can be established in some EU member states, and this is strictly
forbidden in others.
SAFETY ISSUES
It is often the case, that the use of products outside their intended way of use
and outside their original context is inappropriate or even dangerous. Lead, mercu-
ry, and arsenic intoxication have been associated with the use of Ayurvedic herbal
medicine product in Europe and USA. Fifteen case reports and six case series were
reviewed in 2002 (Ernst; 2002), and several were published after that (Kales et al.,
2007, Garnier and Poupon, 2006; Muzi et al., 2005; Roshe et al., 2005).
A research, where all stores in Boston were visited and all unique Ayurvedic
products produced in South Asia were purchased, showed that total of 14 (20%)
of 70 products contained heavy metals: lead (n = 13; median concentration, 40
μg/g; range, 5-37 000), mercury (n = 6; median concentration, 20 225 μg/g;
range, 28-104 000), and/or arsenic (n = 6; median concentration, 430 μg/g; range,
37-8130). If taken as recommended by the manufacturers, each of these 14 could
result in heavy metal intakes above published regulatory standards (Saper et al.,
2004). Maximal concentrations (3.7 % of lead, 10.4 % of mercury and 0.8 % of
arsenic) can not be considered as contamination, but as an intentional constitu-
ent. Similar heavy metal content was found in 193 Ayurvedic products sold on
internet. The metal content was higher among a subgroup of products classified
as rasa shastra (Saper et al., 2008).
56
It is not clear, why the traditional way of use of Ayurvedic products in the
scope of Ayurveda treatment in India does not result in heavy metal intoxications.
In Ayurvedic tradition metals are said to go through a process of conversion of
metals into their mixed oxides that may destroy their toxicity and induce their
medicinal properties, but the details of such conversion are not clear.
CONCLUSIONS
Ayurveda as well as other traditional medicines are becoming more and more
popular in the West. The legislation on medicinal products does not sufficiently
cover this new situation. Conventional western medicine with its own paradigm
is not prepared to include Ayurvedic methods. Many individual western physi-
cians are on the other hand open to Ayurveda and are willing to offer this addi-
tional service to the patients.
REFERENCES
Angell, M., Kassirer, J. P. (1998): Alternative medicine--the risks of untested and

unregulated remedies, N Engl J Med, 339, 839-41. http://kitsrus.com/pdf/ne-
jm_998.pdf.
Barberis, L., de Toni, E., Schiavone, M., Zicca, A., Ghio, R. (2001): Unconven-
tional medicine teaching at the Universities of the European Union. J Altern
Complement Med., 7, 337-343.
CEBM (2009): Centre for Evidence-based Medicine Levels of Evidence, Oxford.
http://www.cebm.net/index.aspx?o=1025.
Cobb, L. A., Thomas, G. I., Dillard, D. H., et al. (1959): An evaluation of internal
mammary artery ligation by a double-blind technic. N Engl J Med, 260, 1115.
Colquhoun, D. (2008): Quackery in Academia, http://sandwalk.blogspot.com
/2008/01/quackery-in-academia.html.
Directive 2001/83/EC of the European parliament and of the council of 6 Novem-
ber 2001 on the community code relating to medicinal products for human
use. Official Journal L – 311, 28/11/2004, 67-128.
Directive 2004/24/EC of the European Parliament and the Council of 31 March
2004 amending, as regards traditional herbal medicinal products, Directive
57
2001/83/EC on the Community code relating to medicinal products for human

use. Official Journal L – 136, 30/04/2004, 85-90.
ECJ (2007): Case C-84/06 Staat der Nederlanden v. Antroposana, Patiëntenv-
ereniging voor Antroposofische Gezondheidszorg and Others. http://eur-lex.
europa.eu/LexUriServ/LexUriServ.do?uri=CELEX:62006J0084:EN:HTML.
Eisenberg, D. M., Kessler, R. C., Foster, C., Norlock, F. E., Calkins, D. R., Del-
banco, T. L. (1993): Unconventional medicine in the United States. Preva-
lence, costs, and patterns of use. N Engl J Med, 328, 246-52.
Eisenberg, D. M., Kessler, R. C., Van Rompay, M. I., Kaptchuk, T. J., Wilkey, S.
A., Appel, S., Davis, R. B. (2001): Perceptions about complementary thera-
pies relative to conventional therapies among adults who use both: results
from a national survey. Ann Intern Med, 135, 344-51.
EMEA (2006): Guideline on the assessment of clinical safety and efficacy in
the preparation of community herbal monographs for well-established and of
community herbal monographs/entries to the community list for traditional
herbal medicinal products/substances/preparations. /HMPC/104613/05, ht-
tp://www.emea.europa.eu/pdfs/human/hmpc/10461305en.pdf.
EMEA (2009): Inventory of herbal substances for assessment – Alphabetical or-
der, London. Doc. Ref.: EMEA/HMPC/494079/2007; http://www.emea.eu-
ropa.eu/pdfs/human/hmpc/49407907en.pdf
Ernst, E. (2002): Heavy metals in traditional Indian remedies. Eur J Clin Pharma-
col, 57(12), 891-6.
Garnier, R., Poupon, J. (2006): Lead poisoning from traditional Indian medicines.
Presse Med, 35(7-8), 1177-80.
Hung, M. (2007): Placebo Surgery Gains Wider Acceptance. N Engl J Med, 344,
710-719.
Kales, S. N., Christophi, C. A., Saper, R. B. (2007): Hematopoietic toxicity from
lead-containing Ayurvedic medications. Med Sci Monit., 13(7), CR29 5-8.
Merriam-Webster online: http://www.m-w.com/dictionary/alternative+medicine,
accessed 11th June 2009.
Mulpuri, K., Perdios, A., Reilly, C. W. (2007): Evidence-based medicine analysis
of all pedicle screw constructs in adolescent idiopathic scoliosis. Spine, 32(19
Suppl), S109-114.
Muzi, G., Dell’Omo, M., Murgia, N., Curinam, A., Ciabatta, S., Abbritti, G.
(2005): Lead poisoning caused by Indian ethnic remedies in Italy. Med Lav,
96(2), 126-33.
58
NIH (2009): What is complementary and alternative medicine? http://nccam.nih.

gov/health/cancer/camcancer.htm
Roche, A., Florkowski, C., Walmsley, T. (2005): Lead poisoning due to ingestion
of Indian herbal remedies. N Z Med J, 118(1219), U1587.
Saper, R. B., Kales, S. N., Paquin, J., Burns, M. J., Eisenberg, D. M., Davis, R.
B., Phillips, R. S. (2004): Heavy metal content of Ayurvedic herbal medicine
products. JAMA, 292(23), 2868-73. http://jama.ama-assn.org/cgi/content/ab-
stract/292/23/2868.
Saper, R. B., Phillips, R. S., Sehgal, A., Khouri, N., Davis, R. B., Paquin, J.,
Thuppil, V., Kales, S. N. (2008): Lead, mercury, and arsenic in US- and Indi-
an-manufactured Ayurvedic medicines sold via the Internet. JAMA, 300(8),
915-23. http://jama.ama-assn.org/cgi/content/short/300/8/915.
Transfeldt, E. E., Mehbod, A. A. (2007): Evidence-based medicine analysis of
isthmic spondylolisthesis treatment including reduction versus fusion in situ
for high-grade slips. Spine, 32(19 Suppl), S126-129.
Trontelj, J. (1998): Stališče Državne komisije za medicinsko etiko o zdravilstvu.
ISIS, 4. http://www.mf.uni-lj.si/isis/isis98-04/html/zakomisijo23.html.
Wetzel, M. S., Eisenberg, D. M., Kaptchuk, T. J (1998): Courses involving com-
plementary and alternative medicine at US medical schools. JAMA, 280(9),
784-7.
WHO. General Guidelines for Methodologies on Research and Evaluation of
Traditional Medicine, http://apps.who.int/medicinedocs/en/d/Jwhozip42e/.
Wikipedia. Complementary and alternative medicine. http://en.wikipedia.org/
wiki/Complementary_and_alternative_medicine.
59
PART 2
AYURVEDA, SPIRITUALITY AND
HUMANITIES
AYURVEDA BETWEEN RELIGION, SPIRITUALITY UND
MODERN SCIENCE
Christian KESSLER
INTRODUCTION
Ayurveda is the largest traditional medical system in South Asia1 and it is

playing a growing part in European healthcare systems (cf. WHO, 2002). In
German speaking countries (Germany, Austria, Switzerland) Ayurveda is one of
the fastest growing CAM-methods.2,3 Still, key questions regarding the charac-
ter of Ayurveda (cf. Das, 1992), its underlying core-concepts for diagnosis and
therapy, its ultimate therapeutic aims and its demarcation to other South Asian
traditional medical systems4 and modern western medicine have not yet been
answered. In this context, questions of the importance of religion5 and spiritual-
1
Figure estimates suggest more than 300.000 registered Ayurveda-practitioners and more than
200 Ayurveda-colleges / universities in India alone.
2
Internet search engine Google locates more than seven million entries for the search term “Ay-
urveda” (In: www.google.de, June 2009).
3
Complementary- und alternative medicine (CAM) is growing rapidly in western countries. Ac-
cording to the last Allensbach study 75% of all Germans have had experiences with CAM-
methods, more than 10% of German MDs have a qualification in CAM-methods (cf. Marstedt
und Moebus, 2002).
4
E.g. Yoga, Siddha, Unani, Naturopathy.
5
“A religion is a solidary system of convictions and practices which relate to sacred, viz. seclud-
ed and forbidden things, convictions and practices that unite a moral community, called church,
and all those who belong to it. The second element that appears in religion is not less important
than the first one; as if one shows that the idea of religion cannot be separated from the idea of
church, one can sense that religion is in its essence a collective affair.” (In: Durkheim, 1912,
German translation by the author, June 2009).
63
ity6 within Ayurveda as a system7, have been posed over and over again in Ind-
ology, religious studies and medical discourses.
Two opposing positions can be observed:
– Supporters of a “scientific” Ayurveda state that it is an empirical medical sys-
tem in which religious and spiritual speculations are mere interpolations, alien
to the system.
– Their opponents state that religious and spiritual elements have always been
integral components of Ayurveda (cf. Engler, 2003).
In contrast to the growing request for Ayurveda in western countries and the
existence of far more than 1000 medical publications on Ayurvedic therapies in
European languages alone (cf. Pubmed Database, 2009), there is yet little sci-
entific evidence for the relevance of religion and spirituality in the classical Ay-
urvedic texts (cf. Das 1992, Engler, 2003, Wolz-Gottwald, 1993), and no data on
the influence of religious and spiritual elements on the diffusion and implementa-
tion of the modern Hybrid Ayurveda8.
To answer the latter question, a questionnaire was developed in order to learn
more about individual concepts, beliefs and expectations regarding the role of
religion and spirituality among patients and therapists in modern western Ay-
urvedic practices and other implementations.
6
The psychologist Rudolf Sponsel defines spirituality “as a more or less conscious engagement
with questions of meaning and values of existence, the world, people and especially with one´s
own existence and self-realization in life. In this way spirituality also comprises a special atti-
tude towards life (…) that relates to transcendental or immanent divine beings or towards prin-
ciples of a transcendental, non-personal last truth or higher reality.” (according to Sponsel 2006,
German translation by the author, June 2009).
7
“Systems thinking is any process of estimating or inferring how local policies, actions, or
changes influence the state of the neighboring universe. It is an approach to problem solving
that views problems as parts of an overall system, rather than reacting to present outcomes or
events and potentially contributing to further development of the undesired issue or problem.
[e.g. Ayurveda as] A system is a dynamic and complex whole, interacting as a structured func-
tional unit.” (In: www.wikipedia.de, June 2009).
8
“HybridAyurveda” is a term coined by the German social scientists Robert Frank and Gunnar
Stollberg. It describes the amalgamation of South Asian and western elements in modern west-
ern Ayurvedic approaches, creating a new local forms of Ayurveda (cf. Stollberg, 2001; Frank,
2004; Stollberg and Frank, 2004).
64
Christian Kessler: AYURVEDA BETWEEN RELIGION, SPIRITUALITY UND MODERN SCIENCE
HYPOTHESES
Individual social and cultural backgrounds influence expectations and atti-

tudes of Ayurveda patients and therapists towards Ayurveda in particular and
CAM-practices in general whenever questions of the roles of religion and spiritu-
ality within these methods arise:
(1) Ayurveda patients and therapists are religious and/or spiritual. Ayurveda is
not only perceived as a pure somatic system of medicine, but as a holistic,
integrative and philosophical healthcare approach which incorporates reli-
gious and spiritual demands.
(2) For Ayurveda patients and therapists, principles of Ayurveda and modern
science are not in conflict. Ayurveda is understood as a science. Concepts of
religion, spirituality and science can be put together.
(3) Elements from South Asian culture, religion and philosophy are important
factors in the modern Hybrid Ayurveda. They have an effect on the results
of Ayurvedic therapies and they influence the relationship between the Ay-
urvedic therapist and his patient.
(4) Women are more open to religious and spiritual matters in the case of Ay-
urvedic therapists and patients than men. Moreover, the usage of Ayurvedic
therapies is more common among women than men,
(5) Ayurveda is representative for CAM-therapies in general. Its adherers have
dealt with other CAM-practices and are open to other CAM-practices.
METHODS
Questionnaire background and framework9

There are different ways to perform a scientific survey:
– personal interviews or telephone interviews in various forms,
– questionnaires,
– a combination of interviews and questionnaires.
Religion, health and disease are topics that are often shrouded in taboo. An-
swer patterns in questionnaires are usually less prone to social acceptability the
more the participants´ anonymity is assured. A standardized questionnaire avoids
9
Cf. Philippsohn, 2001 and Kaiser, 2003 for more details on methods.
65
this source of errors with a relative certainty. It can be a disadvantage that because
of questionnaire-related comprehension problems, certain queries might not be
possible. Moreover, the investigator can not always react to inconsistencies with-
in certain answer patterns (cf. Gagnon, 1977). This has been tolerated here in fa-
vor of an assured anonymity.
Timeline, location and scale of data acquisition

To test the hypotheses, Ayurveda patients and therapists were interviewed be-
tween June 2006 and December 2006
• in greater Frankfurt a.M.10
• in Zurich, Vienna, Hanover, Bremen and Passau11
For this purpose two similar questionnaire versions with closed question items
were developed for patients and therapists.12 Overall 300 questionnaires were
distributed, 140 filled out questionnaire were returned, exactly 70 patient-ver-
sions and 70 therapist-versions. All returned questionnaires underwent a statisti-
cal analysis.
Inclusion criteria
– Participants were included as Ayurveda patients if they were al least 18 years
of age at the time of inclusion and had had a minimum of one experience with
Ayurvedic therapies as a patient.
– Participants were included as Ayurveda therapists if they were al least 18 years
of age, had undergone any kind of Ayurvedic training and were offering Ay-
urvedic therapies, or had planned to do so at the time of inclusion into the sur-
vey.
10
In cooperation with Dr. med. Kalyani Chopra 120 questionnaires were handed out to her pa-
tients in her Frankfurt Ayurveda practice. 53 questionnaires were returned. Moreover, 130 ques-
tionnaires were handed out to participating Ayurveda therapists and patients at the 7th Interna-
tional Symposium for Ayurveda at the European Academy for Ayurveda in Birstein, Germany,
in August 2006. The flyback was 45 questionnaires.
11
The rest of the questionnaires were handed out at seminars for Ayurveda therapists at the Euro-
pean Academy for Ayurveda in Birstein, Zurich, Switzerland and Vienna, Austria (24 question-
naires) and via private contacts of the author to Ayurveda therapists and patients in Hanover,
Bremen and Passau, Germany (18 questionnaires).
12
In order to give consideration to possible differences in answer patterns between therapists and
patients, questionnaires were adapted slightly by adding certain patient- and therapist-specific
question items respectively.
66
Exclusion criteria
The following individuals were excluded form this survey:
– Patients and therapists under the age of 18, based on the idea that this age
group in general has insufficient experience in choosing certain therapies and
therapists and, moreover, has insufficient experience in disputing individual
health and disease related matters per se.
– Patients with verified life threatening diseases, in order to avoid a systematic
bias / confounders due to a “last exit mentality” which can influence the over-
all compliance with respect to their choice of therapies and therapists.
RESULTS
Aim of this work was placing Ayurveda in the context of religion, spirituality
and modern science. Alongside an analysis of classical Ayurvedic texts, the focus
of this study was an evaluation of
– religious and spiritual backgrounds of Ayurveda patients and Ayurveda thera-
pists,
– the possible influences of religious and spiritual elements on the Ayurvedic
therapy itself and
– relationships between Ayurveda and modern science.
Analysis of classical Ayurvedic texts

Since the first systematic written records of Ayurvedic knowledge in the texts
of Caraka, Sushruta and Vagbhata more than 1000 years ago, Ayurveda has con-
tinuously changed concerning its range of knowledge, its teachings and its lo-
gistics in practical medical care. As to its basic assumptions though, it has es-
sentially remained constant.13 Thus Ayurveda is not only a medical system, but
at the same time a philosophy of life, which is not only based on proto-scientific
concepts, but also axiomatically on religious, spiritual and philosophical specula-
tions (cf. Kessler, 2007).
The reading of Ayurvedic classics shows that a narrower understanding of
Ayurveda as a scientific medical system cannot be maintained. Next to rational
13
Up to date the Ayurvedic classic texts of Caraka, Sushruta and Vagbhata are considered as the
ultimate authorities in the field of Ayurveda for a large majority of its supporters.
67
modes of therapy, religion, spirituality and philosophy play crucial roles from an
emic perspective. In the classical Ayurveda, clear connections between these enti-
ties are drawn. Contrary to other theses, the classical Ayurveda was not scientific
in a modern western sense. It clearly featured certain empirical characteristics
and developed theories for health and disease, which are coined materialistic.
But over all it does not fulfill the common modern definition criteria of science.14
Moreover, the classical Ayurveda did not explicitly discriminate between sci-
ence, religion and spirituality. Religious, spiritual and magic elements are not co-
ercively external interpolations or just to be evaluated as marginal or unauthen-
tic.15 They are too deeply rooted in the texts, too mingled up with empirical pas-
sages of text and too notably declared as essential constituents of Ayurveda per
se, that they could simply be rationalized away.
Overall, the question of whether and to what extent Ayurveda is science or re-
ligion or spirituality seems to be deceptive, because such concepts are not natural
entities. Religion, spirituality and science are, especially in this context, above all
modern western concepts and as such have a strong potential to export norma-
tive and ideological themes into primary non-western contexts. Moreover, these
categories are being used in a battle of wits, trying to define what the core and
essence of Ayurveda is.
In the future, the following aspects should be taken into deeper consideration
(cf. Engler, 2003):
– Concepts like “empirical”, “rational”, “spiritual”, etc, should be clearly and
feasibly defined; moreover the usage and discussion of terms, ideas and topics
should be more sober minded, translations should be more accurate and close
to the original texts, and commensurability kept high.
– While categorizing certain phenomena, dichotomous approaches (e.g. either
14 “
Main objective of science is the rational and comprehensible realization of interrelations, ac-
tions, causes and regularities of natural, historic und cultural realities. Next to an enlargement
of knowledge about the world, natural science and technology generate tools for planning and
modifying realities. One of the major characteristics of natural science is an objectivity based
on facts, ideally free of personal judgment, feelings and external inferences, which constitute a
methodic consensus, generalization and the verifiability of scientific assertations” (according
to Brockhaus, 1988, search term “science” [German: Wissenschaft], German translation by the
author).
15
Vedic Metaphors are to be found much more often in this respect, and are, moreover, connected
much more often with empirical text-passages than brahmanic concepts.
68
close or distant from a western or eastern understanding) should be transcend-

ed. Partial conclusions, for example in respect of certain empirical character-
istics of Ayurveda, cannot simply be used as exclusion criteria for genuine re-
ligious and spiritual items within traditional Indian systems of medicine.
– Future analyses should integrate social, economical and ideological themes
to maximize the basis of comparison. Pure positivistic perspectives on sci-
ence or Christian coined definitions of religion and spirituality, for example,
are not very helpful in comparative or historic works on Ayurveda. Terms like
“science”, “religion” and “spirituality” include several complex dimensions.
Future studies could profit from a stronger consideration of this complexity.
Questionnaire results
The meta-postulate of this work could be confirmed. Individual sociocultural
backgrounds, especially religious and spiritual, of Ayurveda therapists and Ay-
urveda patients influence attitudes and expectations towards Ayurveda and CAM
in general.
Statistical interrelations between individual religious and spiritual back-
grounds and individual decisions to offer or call upon Ayurvedic services are
clearly shown. It should be stressed that individual religious and spiritual back-
grounds should not be understood as Christian backgrounds, but as a more “su-
perordinate” religiosity and spirituality including non-Christian, non-western be-
liefs.16
Several studies have been published on the influence of individual religios-
ity and spirituality on health and disease. Within those, outcome parameters like
religious or spiritual experiences, practices, rituals and certain beliefs have been
disproportionately focused on Christian religions. Particulary among patients us-
ing CAM methods, questions that only relate to Christian axiomatics, are often
being denied. This effect has been considered within this work by trying to pose
question items within a more neutral framework.
The results of the questionnaire will be summarized in order of the respective
hypotheses. Results are being discussed on the following levels:
– The total study population,
– Ayurveda therapists and patients in comparison,
– Genders in comparison.
16
(e.g. certain Buddhist or Hindu concepts).
69
Sociodemographic basic data

A final appraisal of the questionnaire results is not possible without consider-
ing sociodemographic parameters like sex, age, education, etc.
Table 1 Basic sociodemographic parameters for therapists and patients
Sociodemographic Results
parameters Therapists Patients Total p-value
No of patients(%) 70 (50.0%) 70 (50.0%) 140 (100%)
Age 0.296
< 30 6 (11.6%) 2 (2.9%) 10 (7.2%)
30 - 50 42 (60.9%) 50 (71.4%) 92 (66.2%)
> 50 19 (27.5%) 18 (25.7%) 37 (26.6%)
Sex 0.693
Male 18 (25.7%) 16 (22.9%) 34 (24.3%)
Female 52 (74.3%) 54 (77.1%) 106 (75.7%)
Education 0.923
Secondary modern school 5 (7.1%) 5 (7.1%) 10 (7.1%)
Junior high school 16 (22.9%) 19 (27.1%) 35 (25.0%)
High school 13 (18.6%) 11 (15.7%) 24 (17.1%)
University/college 31 (44.3%) 28 (40.0%) 59 (42.1%)
Others 5 (7.1%) 7 (10.0%) 12 (8.6%)
Actual profession < 0.001
Medical doctor 24 (34.8%) 9 (12.9%) 33 (23.7%)
Alternative practitioner 5 (7.2%) 0 (0%) 5 (3.6%)
Ayurveda therapist 22 (31.9%) 11 (15.7%) 33 (23.7%)
Yoga instructor 3 (4.3%) 1 (1.4%) 4 (2.9%)
Psychologist 1 (1.4%) 0 (0%) 1 (0.7%)
Medical associated profession 3 (4.3%) 3 (4.3%) 6 (4.3%)
Others 11 (15.9%) 46 (65.7%) 57 (41.0%)
Income (€ per month) 0.233
< 1000 17 (25.0%) 7 (10.3%) 24 (17.6%)
1000 - 1500 11 (16.2%) 11 (16.2%) 22 (16.2%)
1500 - 2000 9 (13.2%) 12 (17.6%) 21 (15.4%)
2000 - 2500 7 (10.3%) 6 (8.8%) 13(9.6%)
> 2500 16 (23.5%) 17(25.0%) 33 (24.3%)
unknown 8 (11.8%) 15 (22.1%) 23 (16.9%)
Number of children 0.653
0 28 (40.0%) 34 (49.3%) 62 (44.6%)
1 11 (15.7%) 11 (15.9%) 22 (15.8%)
≥2 31 (44.3%) 24 (34.7%) 55 (39.6%)
70
Sociodemographic Results
parameters Therapists Patients Total p-value
Location 0.806
(number of inhabitants)
< 5000 10 (14.3%) 8 (11.6%) 18 (12.9%)
5000 - 50 000 18 (25.7%) 17 (24.6%) 35 (25.2%)
50 000 - 100 000 11 (15.7%) 8 (11.6%) 19 (13.7%)
> 100 000 29 (41.4%) 35 (50.7%) 64 (46.0%)
unknown 2 (2.9%) 1 (1.4%) 3 (2.2%)
– The typical Ayurveda therapist is female (74%), between 30 and 50 years of

age, with a 35% chance medical doctor and single. She comes from a family
background with one or more siblings, and is in 40% of the cases childless. A
majority of Ayurveda therapists has graduated from high school and / or has
graduated from college / university. 25% earn less than 1000 Euros per month,
another 25% earns more than 2500 Euros. A majority of therapists lives in ur-
ban areas, more than 40% in metropolitan cities.
– The typical Ayurveda patient is female (76%) and between 30 and 50 years of
age. She is married and in 30% of the cases working as a medical profession-
al. Almost 50% are childless, and has one or more siblings though. A major-
ity has graduated from high school, and 40% have an academic degree from
a university. She is with almost even proportions either catholic, protestant or
without a religious denomination. More than 33% of Ayurveda patients earn
more than 2000 Euro and live in urban areas with more than 100.000 inhabit-
ants.
– A statistically significant larger fraction of women in both groups is notice-
able. Both therapists and patients also share an above average education.
Among other factors, these results support the thesis posed before, that Ay-
urveda is being used by a predominantly well educated, civic, urban and fe-
male clientele (cf. Kaiser, 2001). Differences with respect to income between
groups support the thesis that hybrid forms of Ayurveda in the west are part of
a luxury medicine, their usage predominantly reserved for people with higher
incomes (cf. Kessler, 2007).
71
Hypothesis 1
“Ayurveda patients and therapists are religious and / or spiritual. Ayurveda is
not only perceived as a pure somatic system of medicine17, but as a holistic, inte-
grative and philosophical healthcare approach which incorporates religious and
spiritual demands.”
– More than 65% of the respondents belong to a religion and describe them-
selves as religious / spiritual. 81% describe the influence of religion and spir-
ituality on their daily life as important.
– Traditional Christian values and beliefs are confirmed (77% believe in God,
59% in angels, 51% in ghosts), but in contrast a majority also believes in pri-
marily non-Christian concepts (transgression of the soul 58%, rebirth 64%,
karma 66%).
– Patients adhere more to traditional Christian values and beliefs. A belief in a
Christian god can be observed among 83% of patients and 71% of therapists.
Therapists adhere more to traditional South Asian values and beliefs (E.g.
80% of therapists and 53% of patients believe in karma, 74% of therapists and
54% of patients believe in rebirth).
– Through factor-analyses18 three “groups of believers” could be isolated: (1) a
group, especially therapists, whose members simultaneously believe in kar-
ma, nirvāna, a universal soul, transgression of soul and rebirth, (2) a group, es-
pecially patients, in which a clear statistical relation between believing in the
devil, god and angels can be observed, and (3) a group, characterized through
coeval beliefs in a sense of life, god and the devil.
– A strong affinity to South Asian religions is also noticeable. Almost 67% are
enamored to Buddhism, and more than 40% to Hinduism. Overall no statisti-
cally significant differences between patients and therapists can be observed.
46% find Christian religions to be lacking mystical elements that can be better
17
The term “somatic” is primarily being used in medical contexts in order to delineate bodily or
organic from mental conditions.
18
“Factor analysis is a statistical method used to describe variability among observed variables
in terms of fewer unobserved variables called factors. The observed variables are modeled as
linear combinations of the factors, plus “error” terms. The information gained about the inter-
dependencies can be used later to reduce the set of variables in a dataset. Factor analysis origi-
nated in psychometrics, and is used in behavioral sciences, social sciences, marketing, product
management, operations research, and other applied sciences that deal with large quantities of
data.” (In: www.wikipedia.de, June 2009).
72
served by Buddhism or Hinduism. 43% think that South Asian religions can
respond better to prevailing problems than western religions.
– In depth analysis shows that significant differences can be seen when it
comes to details: 63% of therapists vs. 24% of patients have dealt with the
Bhagavadgītā, 54% vs. 33% with Buddhist commentary literature.
– 60% of all respondents believe that disease is conditioned through karma. Al-
most all (95%) are convinced that credence is an important prerequisite for heal-
ing. Still 76% think that divine power and karma (60%) are important healing
factors. Almost 67% have prayed (71% among therapists, 57% among patients).
73% consider Ayurveda to be a form of spirituality (76% of therapists, 570 of
patients), but only a small minority of 11% think of Ayurveda as a religion.
Hypothesis 2
“For Ayurveda patients and therapists, principles of Ayurveda and modern
science are not in conflict. Ayurveda is understood as a science. Concepts of reli-
gion, spirituality and science can be put together.”
Table 2 Characterisation of Ayurveda by therapists and patients
Results
Ayurveda = ? Total number
Therapists Patients Total p-value
of valid cases
Health doctrine 67 (100%) 69 (100%) 136 (100%) 136 1
Medical system 66 (97.1%) 57 (91.9%) 123 (94.6%) 130 0.196
Philosophical system 54 (87.1%) 37 (71.2%) 91 (79.8%) 114 0.035
Science 60 (92.3%) 53 (93.0%) 113 (92.6%) 122 0.887
Religious doctrine 16 (30.8%) 18 (36.0%) 34 (33.3%) 102 0.575
Religion 7 (14.0%) 4 (8.5%) 11 (11.3%) 97 0.394
Spirituality 47 (75.8%) 39 (69.6%) 86 (72.9%) 118 0.452
Esoterism 7 (13.7%) 5 (9.8%) 12 (11.8%) 102 0.539
Philosophy of life 39 (73.6%) 34 (66.7%) 73 (70.2%) 104 0.441
– 100% of all participants (valid cases) consider Ayurveda to be a health doc-

trine, 95% to be a medical system (therapists 97%, patients 92%; p = 0.196),
93% to be a science (therapists 92%, patients 93%; p = 0.887). 80% relate it
to a philosophical system, with a significant difference (p=0.035) between
therapists and patients: 87% of therapists relate Ayurveda to a philosophical
system. 73% of all respondents consider Ayurveda as spirituality.
73
– However, only 11% consider Ayurveda as a religion without a significant dif-

ference between groups (p=0.394).
– Almost 75% (78% of therapists, 68% of patients) are convinced that Ayurveda
therapists have pastoral functions.
– Even though a majority considers it to be a science, only 33% think that Ay-
urveda is scientific in a modern western sense. 59% think that Ayurveda is a
complement to modern medicine, just over 25% think that it should be used
without combination with other methods. Only about 33% state that Ayurveda
should be analyzed within scientific studies. However 75% think that medical
aspects of Ayurveda are more important than religious and / or spiritual as-
pects. Only a minority of 25% considers schooling in modern medicine to be
a negative influence on religious and spiritual characteristics of the therapist.
– Through factor-analyses, four statistically correlating groups could be isolat-
ed: (1) a group that at the same time considers Ayurveda to be spirituality, a
philosophical system and a way of life, (2) a group that accounts for it as a
religion, a religious doctrine and as esoteric, (3) a group that sees it as a medi-
cal system, a science and a philosophy of life and (4) a group that perceives
Ayurveda as a complement to modern medicine and as scientific in a modern
western sense.
Hypothesis 3
“Elements from South Asian culture, religion and philosophy are important
factors in the modern Hybrid Ayurveda. They have an effect on the results of
Ayurvedic therapies and they influence the relationship between the Ayurvedic
therapist and his patient.”
– More than 65% of the respondents believe that Ayurveda can also be expedi-
ently practiced in the West detached from South Asian culture, religion and
philosophy. However, at the same time 65% believe that Ayurveda experts
from South Asia should participate in the teaching of it (which actually took
place in 87% of the cases). Moreover, almost half of the participants are con-
vinced that Ayurvedic schooling should include at least one study visit to
South Asia.
– 71% have the opinion that Ayurveda therapists should educate their patients
in fundamental concepts of Ayurveda during the therapy. Almost half of the
interviewees think that basic knowledge about South Asian culture is im-
portant for patients. 61% agree with the statement that Ayurvedic therapists
74
should sympathize with South Asian culture, religion and philosophy. 66%
feel strongly attached to South Asian culture, religion and philosophy (80%
among therapists, 55% among patients)
– More than half of the interviewed (therapists 56%, patients 69%) think that
an Ayurvedic lifestyle-attitude is important. 57% actually practice such a life-
style (therapists 69%, patients 46%).
– A majority of the respondents is well acquainted with the concepts of reincar-
nation, karma, migration of soul, nirvana, attachment, atman, brahman, en-
lightenment and Buddhism. 30% of the interviewees even think that an exact
knowledge of the precise meaning of certain Ayurvedic Sanskrit terms is im-
portant. 61% of the therapists assert that they actually have such knowledge.
– 54% think that an Ayurveda apprenticeship for European Ayurveda therapists
should at least last 2 years (patients 60%, therapists 44%).
– Through factor-analyses, three statistically correlating groups could be isolat-
ed: (1) a group in which the concepts of dharma, vedanta, moksha and nirvana
can be correlated (2) a group that pulls together the concepts of reincarnation,
karma and Buddhism and (3) a group that correlates atman, brahman, attach-
ment and enlightenment
Hypothesis 4
“Women are more open to religious and spiritual matters in the case of Ay-
urvedic therapists and patients than men. Moreover, the usage of Ayurvedic ther-
apies is more common among women than men.”
– 76% of the participants are women; more than 65% of them are under 50 years
of age.
– Among women more than 65% avow themselves to a Christian doctrine,
among men only 43%.
– Half of the interviewed men have a monthly income of more than 2500 Euros,
among women only 17%.
– Gender differences can also be seen in the answer pattern for the question
whether Ayurveda is spirituality. 81% of women answered with “yes”, among
men only 46%.
– 91% of the women who consider Ayurveda to be a philosophy also relate it to
spirituality (p << 0.05). 74% of women think of Ayurveda as a dictum of life,
among men only 58%.
75
– 50% of men, as compared to 35% of women, deny that Ayurveda is scientific

in a modern western sense.
– 86% of the interviewed women think that Ayurveda therapists should be
trained by Ayurveda experts from South Asia, among men only 54%.
– 87% of women believe that Ayurveda therapists should also have pastoral
functions as compared to 65% among men.
– 64% of the women find that therapists should sympathize with South Asian
culture, religion and philosophy as compared to 50% in men
– 73% of the women agree with the statement that a modern western medical
education has negative effects on religious and spiritual characteristics of ther-
apists, among men only 59%.
– 79% of the women have dealt with rituals (men 66%), 72% with prayers (men
53%)
– 85% of the women believe in God, among men only 58% (p=0.04 < 0.05).
71% of the women believe in angels, among men only 45%.
– Almost 67% of the male respondents and 44% of the female respondents find
Christian religions lacking certain mystic perspectives which, for them, can be
found in South Asian religions.
– 33% of the men think that South Asian religions can give better answers to
current day to day problems than western religions, among women only 16%.
– When questioned whether South Asian religions play a role for one´s own
partner, 57% of men answered “yes”, among women only 22%.
Hypothesis 5
“Ayurveda is representative for CAM-therapies in general. Its adherers have
dealt with other CAM-practices and are open to other CAM-practices.”
– Ayurveda patients and therapists are also associated with to other CAM-meth-
ods. 78% of all interviewees have dealt with Acupuncture, more than 65%
with Homeopathy, 71% with Naturopathy, almost 50% with fasting cure.
– Only 39% of all respondents think that Ayurveda is more effective than other
CAM-methods.
– For 54% of the interviewed, the answers given in this questionnaire also apply
to other CAM-methods.
76
DISCUSSION
Individual forms of spirituality play a key role in the perception and defini-
tion of Ayurveda, whereas “classical religions”19 seem to play a less integral role
in the practice and perception of it. Adherers of Ayurveda have a tendency to be
especially attached to Buddhism. Christian and South Asian religious beliefs can
nevertheless be pulled together for a majority of the respondents. Spirituality,
much more than religion, seems to be central in individual concepts of salutogen-
esis and within the Ayurvedic therapy itself. The results are supportive of the as-
sumption that individual references to traditional Christian values have become
weaker due to a loss of confidence in established western religious institutions
(see Geisler, 2006). Through a debilitation of hitherto symbols of integration (see
Engler, 2003) a vacuum emerges that is being filled with individually composed
realities by Ayurveda patients and therapists, whose religious and spiritual desid-
erata yet keep on persisting.
While both therapists und patients are engaged with religious and spiritual
questions and are open for these issues, therapists seem to deal even more with
religious and spiritual matters than their patients. Beyond pure somatic healthcare
services, adherers of Ayurveda expect the therapist to also function in a spiritual
capacity. It is thus conjecturable that the Ayurveda therapist also frequently has
pastoral functions within an Ayurvedic therapy that is also characterized by re-
ligious and spiritual elements. Ultimately religious and / or spiritual individuals
seem to be more open minded about calling on Ayurveda.
It is interesting to see that elements from South Asian culture, religion and
philosophy seem to play an important part for Ayurveda patients and therapists.
Because of this, a high level of authenticity and authentic therapy is expected
from the therapist and his therapy. It is notable that not only therapists, but also
patients seem to be quite well versed in South Asian culture, religion and phi-
losophy. This suggests that the choice for Ayurveda might go hand in hand with a
basal affinity to the cultural area of South Asia.
Frustration with modern medicine is less important in the decision to use Ay-
urveda than other factors. For Ayurveda patients and therapists spirituality, re-
ligion and principles of modern science are not in conflict. For them, Ayurveda
contains aspects of spirituality, religion and modern science at the same time.
19
E.g. Protestant or Catholic Christian churches.
77
The use of CAM-Methods like Ayurveda does not exclude the simultaneous use
of modern medicine for the majority. The composition of characteristics of Ay-
urveda that is expected from a majority of the interviewed could be interpreted as
curiosity for inspiration and novel things, but at the same time as an expression
of uncertainty and discontent with prevailing structures. An “enchantment of the
world”, a concept often uttered in CAM-contexts, is supposed to help overcome
the separation of matter, mind and soul. Next to (scientific) knowledge, faith, or
better spirituality stands pari passu. Religion in a classical sense takes a back seat
in favor of spirituality.
Ayurveda is used – as is CAM in general - by a well educated middle class and
a female dominated clientele. It seems clear that women call more upon Ayurveda
than men among the interviewed and seem to be more open to religious and spir-
itual matters. Almost all characteristics and attitudes in these respects are more
distinct among women (see Kaiser, 2001).
Ayurveda patients and therapists seem to be more open about CAM, espe-
cially for non-western CAM methods, but the calling on these methods does not
exclude the simultaneous use of modern western medicine from the majoritar-
ian perspective of the respondents. From their viewpoints Ayurveda coevally is a
science, a medical system and spirituality and thus in accordance with the ideal
prerequisites for a holistic20 orientated medical system. Ayurveda can – as does
CAM in general – satisfy the wants of a growing number of therapists and pa-
tients for an individual therapy better than conventional therapeutic approaches
can (cf. Kessler, 2007). Moreover, it can compensate for deficits in the fields of
psychosocial healthcare logistics (see Andritzky, 1992). In this conception the
ideal Ayurveda therapist does more than simply treating bodily disorders.21 Ay-
urvedic concepts are strongly based on anthropologic assumptions which include
different levels of human existence into diagnostic and therapeutic healing ap-
proaches (see Rothschuh, 1972). As a result of this, therapist-patient relationships
of intimate and individual coining could emerge in the ideal setup.
20
CAM methods try to adopt holistic approaches to healing that stress an integration of all differ-
ent levels of existence, e.g. the emotional, mental, spiritual, and physical realms into individual
therapeutic approaches.
21
Interestingly the WHO-definition of health complies with the health definitions from the classi-
cal Ayurvedic texts CaS und SuS. The WHO defines health as being “a state of complete physi-
cal, mental, and social well-being and not merely the absence of disease or infirmity” (WHO,
1979).
78
Still, key questions to the character, essence, complexity and contextualiza-

tion of Ayurveda in its original and hybrid forms remain largely unanswered.
Among others, the following questions yet to be answered in subsequent studies
seem to be of high exigency:
– What is Ayurveda in general and can a clear definition of it be given?
– What is Ayurveda for its modern western supporters and are there any com-
mon denominators?
– What are the reasons to choose especially Ayurveda out of a range of different
CAM-methods?
– Is the choice for Ayurveda as a CAM-therapy specific or random?
– What exactly is “spirituality” for therapists and patients in the case of Ayurve-
da?
Overall, questions whether Ayurveda is science or religion or spirituality are

deceptive. Let´s keep in mind that these concepts are not natural entities. Re-
ligion, spirituality and science are modern western concepts and have a strong
potential to export normative and ideological items into primary non-western-
contexts.22
REFERENCES
Andritzky, W. (1992): Alternative Gesundheitskultur: medizinanthropologische

Perspektiven und Ergebnisse sozialwissenschaftlicher Studien. Jahrbuch für
transkulturelle Medizin und Psychotherapie. Berlin.
Brockhaus (ed.) (1988): Brockhaus Enzyklopädie. Neunzehnte völlig neu bear-
beitete Auflage. Weltatlas zur Enzyklopädie. F. A. Brockhaus, Mannheim.
Das, R. P. (1992): Indische Medizin und Spiritualität. JEAS, 2, 158-187.
Durkheim, E. (1997): Die elementaren Formen des religiösen Lebens. Suhrkamp,
Frankfurt.
Engler, S. (2003): “Science” vs. “Religion” in classical Ayurveda. Numen, Vol.
50. Koninklijke Brill NV, Leiden.
Frank, R. (2004): Globalisierung und Kontextualisierung heterodoxer Medizin.
Transcript-Verlag.
22
See Peterson 2000; Hardin 1998; Selion 1997; Goonatilake 1992; Engler 2003; Kessler 2008.
79
Geisler, S. (2006): Spiritualität in der Medizin. Arznei - Placebo - Droge? Univer-

sitas, 61. Jahrgang, 716, 132-143.
Google (2009): Key word “Ayurveda”. http://www.google.de, 10th June.
Goonatilake, S. (1992): “The Voyages of Discovery and the Loss and Rediscov-
ery of ‘Others‘ Knowledge.” Impact of Science on Society, 167, 241–264.
Kaiser, P. (2001): Arzt und Guru – Die Suche nach dem richtigen Therapeuten in
der Postmoderne. Diagonal-Verlag, Marburg.
Kessler, C. (2007): Wirksamkeit von Ayurveda bei chronischen Erkrankungen.
Systematische Analysen klinischer Ayurveda-Studien. KVC-Verlag, Essen.
Kessler, C. (2008): Ayurveda zwischen Religion, Spiritualität und Wissenschaft–
Fragebogenevaluation und Analyse klassischer Texte – Hausarbeit zur Erlan-
gung des Magistergrades (M. A.) der Philosophischen Fakultät der Georg-Au-
gust-Universität Göttingen.
Marstedt, G., Moebus, S. (2002): Inanspruchnahme alternativer Methoden in der
Medizin, Gesundheitsberichtserstattung des Bundes, Issue 9, RKI/Stat. Bun-
desamt, Berlin.
Murty, S. (ed.) (2001): Vāgbhaṭa´s Aṣṭāṅga-Hṛdaya Saṃhitā. Krishnadas Acad-
emy. Varanasi, India.
O‘Connor, J., McDermott, I. (1997): The Art of Systems Thinking: Essential
Skills for Creativity and Problem-Solving. Thorsons Publishing, San Fran-
cisco. http://en.wikipedia.org , 10th June.
Peterson, G. (2000): “Going Public: Science and Religion at Crossroads.” Zygon,
35(1), 13–24.
Philippsohn, S. (2001): Sexuelle Befriedigung und Sexualmythen bei Frauen:
Ergebnisse einer Fragebogenuntersuchung zu den Determinanten sexueller
Zufriedenheit. Dissertation zur Erlangung des Doktorgrades der Medizin in
der Medizinischen Hochschule Hannover.
Selin, H. (ed.) (1997): Encyclopaedia of the History of Science, Technology, and
Medicine in Non-Western Cultures. Kluwer, Dordrecht.
Sharma, P. V. (tr.) (1999): Suśruta Saṃhitā: Neu Delhi, Indien: Chaukhamba Ori-
entalia, 1999.
Sharma, R. K., Dash, B. (eds.) (1997): Caraka Saṃhitā: Chaukhamba Orientalia.
New Delhi, India.
Sponsel, R. (2008): Spiritualität: Eine psychologische Untersuchung. http://www.
sgipt.org/wisms/gb/spirit0.htm, last update 6th June 2008.
80
Stollberg, G. (2001): Asian Medical Concepts in Germany and the United King-
dom: Sociological Reflections on the shaping of Ayurveda in Western Europe.
Traditional South Asian Medicine, 6, 3-9.
Stollberg, G., Frank, R. (2002): “Ayurvedic patients in Germany”. In: Hsu, Elisa-
beth and E. Hoeg (eds.): Countervailing creativity: the globalisation of Asian
medicines; patient perspectives. Special Issue of Anthropology and Medicine,
9, 223-244.
US National Institutes of Health (2009): Pubmed Database. MESH-Term “Ay-
urved*”. http://www.ncbi.nlm.nih.gov/pubmed/, 19th June.
Wikipedia (2009): Search Term “Factor analysis”. In: http://en.wikipedia.org,
23th June.
Willich, S. et al. (2004): Schulmedizin und Komplementärmedizin: Verständnis
und Zusammenarbeit müssen vertieft werden. Deutsches Ärzteblatt 101, 19,
A-1314 / B-1087 / C-1051.
Wolz-Gottwald, E. (1993): Über die Möglichkeiten einer Wissenschaft vom Leb-
en – Grundlagen zur Phänomenologie des Ayurveda. JEAS 3, 305-318.
World Health Organization (2002): Traditional Medicine in Asia. WHO Regional
Publications, South-East-Asia Series, No. 39.
81
SYSTEMS THINKING, AYURVEDA AND YOGA:
CONVERGENCE OF THE WESTERN SCIENCE
AND THE EASTERN WISDOM
Tadeja JERE LAZANSKI
INTRODUCTION
One of the principal objects of theoretical research in the department of

knowledge is to find the point of view from which the subject appears in its great-
est simplicity (J. Willard Gibbs).
Turbulence in the world market is demanding on the entire service industry’s

flexibility and fast reaction time. It requires decisions, frequently reflecting op-
posite interests. Thus, an excellent methodological approach to these problems
is urgently needed. Since Ludwig von Bertalanffy published his manifesto of
general theory (Bertalanffy, L. V., 1952) and Norbert Wiener his on Cybernetics
(Wiener, N., 1948) as a methodology for complex phenomena research, theory
and cybernetics play an important role in different fields of scientific research. In
fact it they shifted a scientific paradigm. A shift of a paradigm can happen in two
categories (Gharajedaghi, J., 2006): a change in the nature of reality or a change
in the method of inquiry. The shift can also happen in both of them, which is a
case of contemporary world. This shift encounters western science of mind and
eastern wisdom or science of soul. In the paper we will present the methods of
system dynamics and system thinking as a tool for defining system, Ayurveda
and Yoga as main converging elements, which offer new means of knowing see-
ing and creating visions for wellness tourism. Systems thinking, which became
common management tools in 1990s (Senge, P., 2006) is supported by model-
ling. Since system dynamics models are essentially simple, one must find a com-
83
promise between simplicity, limited usefulness and complexity. We will present

a causal loop diagram (model), which is the basis of causal connections among
model variables. We will restore a connection between qualitative and quantita-
tive models (Rosenhead, 1989). Qualitative research provides a crucial perspec-
tive that helps scholars to understand phenomena in a different way from a posi-
tivist perspective alone (Riley, W. and Love L., 2000).
In this work, a critical analysis and evaluation of the methodologies will be at-
tempted and applied to a development model to wellness tourism offer.
COMPLEX SYSTEMS AND SYSTEM DYNAMICS
Complex systems are systems in process that constantly evolve and unfold
over time (W. Brian Arthur).
A system has common patterns, behaviours, and properties that can be under-
stood and used to develop greater insight into the behaviour of complex phenom-
ena and to move closer toward a unity of science. On the basis of the systems
point of view, a human being is a “complex web of interrelationships, energy or
wave patterns”, an essential a part of larger wave or a system, or energy pattern.
(Parikh, J., 1994) In general we can say that a system is a composition of inter-
related components, connected together in order to facilitate information, matter
and energy flows. The central concept system embodies the idea of a set of ele-
ments connected together, which form a whole rather than properties of its com-
ponents parts. (Checkland, 2000) In operations research and organizational de-
velopment, organizations are viewed as human systems comprised of interacting
components such as sub-systems, processes and organizational structures. Organ-
izational development theorist Peter Senge developed the notion of organizations
as systems and system thinking, where the least has been identified as an impor-
feedback
inputs outputs
Fig. 1: Feedback loop of the system
84
Tadeja JERE LAZANSKI: SYSTEMS THINKING, AYURVEDA AND YOGA: CONVERGENCE OF THE WESTERN ...
tant leadership competency where an individual thinks globally when acting lo-
cally. (Senge, P., 1994) Fig. 1 shows that all systems have a concept of feedback
loop, which connects inputs to the system (information) and the outputs (results,
products) on a way that outputs influences back to the inputs. This is an important
fact since this way happen regulation processes.
From systems perspective, the human being as a system is a part of the feed-
back process, which represents a profound shift in awareness. (Senge, P., 2006)
Complex systems always answer to their peaceful or turbulent environment
with behaviour that adapts a system to the environment. System dynamics is con-
cerned with the behaviour of a system over time. A critical step in examining a
system or issue is to identify its key patterns of behaviour - what we often refer to
as “time paths.” System dynamics provides the basic building blocks necessary to
construct models that teach us how and why complex real-world systems behave
the way they do over time. Wellness tourism as a system is a system concerning
wellness tourism offer (travel, resorts, hotels, programs, etc.) It is a type of inter-
organisational system with global and local properties. Even more - it is a com-
plex system with certain structural end behavioural properties. It can be described
by various components where different processes take place (economical, psy-
chological, sociological, physical, etc.) Thus we get a link between a system and
its dynamics. A system dynamics therefore can be introduced to combine both
‘hard’ quantitative dimensions and the ‘soft’ qualitative dimensions. Forrester
(1961) defined system dynamics as the investigation of the information-feedback
characteristics of systems and the use of models for the design of improved or-
ganizational form and guiding policy.
In addition, Wolstenholme (1990) defined it that a rigorous method for quali-
tative description, exploration and analysis of complex systems in terms of their
processes, information, organizational boundaries and strategies; which facilitates
quantitative simulation modelling and analysis for the design of system structure
and behaviour. According to Sterman (2000), system dynamics is a method to
enhance learning in complex systems. It is a method for developing management
flight simulators, often computer simulation models, to help us learn about dy-
namic complexity, understand the sources of policy resistance, and design more
effective policies.
85
SHIFT OF PARADIGM: FROM LINEAR THINKING TO

SYSTEMS THINKING
If we look far enough back in the depths of time, the disordered anthill of living
beings suddenly, for an informed observer, arranges itself in long files that make
their way by various paths towards greater consciousness (Teilhard de Chardin).
Linear or analytic thinking derives from one’s experience and brings short
sighted decision making. Mind of one’s experience is usually supported by one’s
five senses. The result is simplified cause-consequential explanation of events.
Observer or decision-maker, who thinks analytically, separates and presumes
phenomena, thoughts, ideas, actions. Linear thinking is common thinking since
it is taught in families and social surrounding. Normally it shakes observer’s
emotional system. We can compare linear thinking with the “tip of the iceberg”.
(Hutchens, 2001) With linear thinking one only see the peak of the iceberg but not
what is actually below the sea level. This question resolves systems thinking. If
we call everything what is above the sea level “an event” and everything what is
below the sea level “patterns and structures, then we understand and move from
linear to systems thinking. With a better ability to understand the links and pat-
terns between issues, one can seek to better understanding both the nature and the
consequences of relationships and change.
Systems thinking as a modern approach for problem solving was revived af-
ter WWII even though it had been an ancient philosophy. We can track systems
thinking back to antiquity. Differentiated from Western rationalist traditions of
philosophy, C. West Churchman often identified with the I Ching as a systems
approach sharing a frame of reference similar to pre-Socratic philosophy and
Heraclitus (Hammond, 2003). “The scientific knowledge of antiquity was sys-
tematised and organised by Aristotle, who created the scheme, was to be the basis
of the Western view of the universe for two thousands years” (Capra, F., 2000).
The first systems thinkers can be found in the oldest of human societies – the
ancient Phoenicians with their cuneiforms, the Egyptians with their pyramids,
Greek philosophers and Maya Indians are the earliest ancient societies of system
thinkers. The Mayan numerical system and long count units has been proven as
one of the most accurate systems for describing the present and future of the civi-
lization in which we have all evolved (Calleman, C. J., 2004).
Contemporary authors on systems thinking have the same vision of it but dif-
ferent observation. Systems thinking is a social approach using systems theories
86
to create desired outcomes, or change. It is a unique approach to problem solv-

ing, in that it views certain ‘problems’ as a part of the overall system so focus-
ing on these outcomes will only further develop the undesired element or prob-
lem (O’Connor, J., 1997). Systems thinking derives from one’s awareness of the
“big picture”, importance of long and short term solutions, systems are dynamic,
complex, interconnected and interdependent, qualitative and quantitative data are
equally important (Anderson, V., 1997). Systems thinking is a comprising four
characteristic dimensions: thinking in models, interrelated thinking, dynamic
thinking, and steering systems (Ossimitz, G., 2000).
We can see that there has been a shift in the assumptions regarding the method
of inquiry, the means of knowing from analytical (linear)thinking, which de-
scribes independent sets of variables, to holistic (systems) thinking, which de-
scribes interdependent sets of variables. The complementary nature of these two
dimensions is at the core of both understanding (Gharajedaghi, J., 2006).
SYSTEMS THINKING, AYURVEDA AND YOGA
Systems thinking is a discipline for seeing wholes. It is a framework for seeing

interrelationships rather than things, for seeing patterns of change rather than
static ‘snapshots’...Today systems thinking is needed more than ever because we
are becoming overwhelmed by complexity. Perhaps for the first time in history,
humankind has the capacity to create far more information than anyone can ab-
sorb, to foster far greater interdependency than anyone can manage, and to ac-
celerate change far faster than anyone’s ability to keep pace (Senge, P., 2006).
A person implementing effective systems thinking is operating on at least
seven “thinking tracks simultaneously”, namely dynamic thinking, closed-loop-
thinking, generic thinking, structural thinking, operational thinking, continuum
thinking and scientific thinking (Richmond, B., 1993). Systems thinking could
therefore be seen as interrelated thinking that entails the ability for grasping more
complex relations, interactions and situations which include, but go beyond,
simple cause-and-effect relationships (Ossimitz, G., 2000). In this way, systems
thinking also helps in building more accurate mental models of complex phenom-
ena. From written above, we can claim that systems thinking is a synonym for ho-
listic and sustainable thinking. Two of the ancient systems, which were once unit-
ed, are Ayurveda and Yoga. Nowadays they are more and more used in western
87
world as methods for maintaining health, harmony and homeostasis of those peo-
ple, who use their wisdom. They also mean a great expansion in world of well-
ness tourism. The world tourism trend is pointed to wellness, where Ayurvedic
centres play main role. If one discusses Ayurveda as a system, one describes the
three doshas, vata, pitta and kapha, which are interrelated and interdependent and
change constantly in stressful environment of mankind (the dynamics of the three
doshas). The disruption in the activities of one dosha affects the other, and if not
taken care properly, the body begins to degenerate and needs proper wellness
treatment. Balance (homeostasis) of three doshas produces a healthy body and
a healthy mind and eventually makes a well-balanced human being. If systems
thinking searches for solutions and does not look at the problems, Ayurvedic sys-
tems principle is the same: it searches for health maintenance rather than disease
treatment with system of diet and lifestyle (enhance the quality of life by dealing
with subtle trends that might lead to actual disease) and requires intentional and
sustained self discipline, perseverance and active personal role of an individual.
Ayurveda incorporates a whole system of dietary recommendations (Chopra, A.
S., 2003). Balance is emphasized; suppressing natural urges is seen to be un-
healthy, and doing so may almost certainly lead to illness (Wujastyk, D., 2003).
The same is valued for Yoga. The system of Yoga is interconnection between
Yoga exercise, breathing and meditation, which are the key to the system. To be
aware of every thought, to know from what source it springs and what its inten-
tion is - that is meditation. And to know the whole content of one thought reveals
the whole process of the mind (Krishnamurti, J., 1995). Yoga is a complex system
for achieving radiant physical health, superb mental clarity and therefore peace of
mind. In western world the term Yoga is typically associated with Hatha Yoga is
preparatory stage of physical purification that the body practices for higher medi-
tation and its asanas (postures) or as a form of exercise. These forms of exercises
are popular with creating wellness programs for tourism. As a physical discipline
Yoga teaches strength, flexibility, and balance of body. The word Yoga has many
meanings, and is derived from the Sanskrit root yuj, meaning “to control”, “to
yoke” or “to unite (Flood, G., 1996). We can say that Yoga is a system, which
unites, Ayurveda is a system, which balances and systems in general strive to be
in homeostasis in balance. Systems thinking, Ayurveda and Yoga are three ele-
ments, which are interdependent parts of a bigger wellness tourism system and
converge to each other.
88
QUALITATIVE MODEL FOR DEVELOPING WELLNESS

TOURISM IN A FRAME OF SYSTEM DYNAMICS
System dynamics models are essentially simple and can serve only as describ-
ers of the activity of basic mutual model values determination and the so-called
mental model, which is the basis of causal connections among model variables.
The model we developed in order to present the importance and interdependency
of wellness tourism vision with Ayurveda and Yoga offer is shown on causal loop
model, fig. 2.
Environment -
preservation
+
Ayurveda,
-
+ Yoga
+ Attractiveness Crowd
Infrastructure,
Culture, life quality +
+
Number
+ Of
Tourists
Investments +
to wellness
Tourism
Fig. 2 CLD (causal loop diagram) dependency of environment preservation,

Ayurveda and Yoga attractiveness and, number of tourists and wellness
infrastructure investments
The diagram can be described as follows: preserved environment (+) influ-

ences in the same direction onto tourism area attractiveness (+), which influences
upon number of tourists, (+), number of tourists influences growth of investments
into infrastructure and culture of life quality (+). On the other hand it can be said:
more tourists (+) causes environmental damage (-), which is a reason for fall-
ing of Ayurveda and Yoga attractiveness. At the same time, crowding (+) causes
detours, traffic standstills, drivers’ nervousness, accidents, anger and regrets for
making a decision and having vacation in this kind of area. (-) From these quali-
tative descriptions one can see what must be taken into concern. If we connect
89
set of elements (environment preservation, Ayurveda, Yoga, investments, crowd,

quality of life, etc) on a base of their descriptions with a pointed arrow to the
same direction and sign this with a symbol (+), opposite with a symbol (-), we get
an influential diagram respectively qualitative model of our simplified system,
shown on fig.2. From a model one can derive that there is one basic circle (-) of
causal loop, which means growth of number of tourists and borders of growth,
caused by infrastructure and environment damaging. In a vision of wellness tour-
ism strategic development one must predict development as a whole in order to
avoid limitations. If in the reinforcement circle, which consists from investments
to wellness resorts, environment preservation, only one element start to fall (-),
this means fall of all other elements. (number of tourists’ decreases)
System dynamics modelling is particularly useful in understanding the link-
ages between the qualitative and the quantitative aspects of tourism management.
It employs a set of techniques that allow both quantitative and a realistic repre-
sentation of variables that are typically perceived to be qualitative. In order to set
a quantitative model of systems dynamics (Forrester, J. W., 1961) a systems re-
searcher should take into concern all the attributes defined by the team of experts,
in our case experts in tourism, and combine them with numbers acquired from
actual statistical resources for each of the attribute.
CONCLUSION
Systems thinking offers a profound shift of researcher’s experience, when tak-

en as a substitute for general linear thinking. We presented systems dynamics
methods as legitimate. For an illustration of a methodology, we presented Ay-
urveda and Yoga as interdependent attributes among elements of a bigger com-
plex system, which we developed as causal loop diagram for vision of wellness
tourism.
CLD (causal loop diagram) seem to be practical and transparent methodol-
ogy for qualitative modeling. From all written above we can claim that: systems
thinking is a synonym for holistic thinking, which is a synonym for sustainable
thinking. Following systems principles we must request a feedback loop position
from sustainable thinking. This way we can claim that systems thinking is sus-
tainable thinking.
90
REFERENCES
Anderson, V., Johnson L. (1997): Systems Thinking Basics: From Concepts to

Causal Loops. Pegasus communication, Williston.
Bertalanffy, L. V. (1952): General System Theory. George Braziller, New York.
Banathy, B. (2000): Guided Evolution of Society: A Systems View (Contempo-
rary Systems Thinking). Springer, Vienna.
Burch, T. K. (1999): Computer Modeling of Theory: Explanation for the 21st
Century. University of Western Ontario, London, Ontario, Canada.
Calleman, C. J. (2004): The Mayan Calendar and the Transformation of Con-
sciousness. Bear and Company, Rochester Vermont.
Capra, F. (1997): The Web of Life A New Scientific Understanding of Living
Systems. Anchor, New York.
Capra, F. (2000): The Tao of Physics. An Exploration of Parallels between Mod-
ern Physics and Eastern Mysticism. Shambhala Publications, Boston.
Chopra, A. S. (2003): “Ayurveda”. In: Selin, H., Shapiro, H. (eds.): Medicine Across
Cultures. Kluwer Academic Publishers, United States of America, 75-83.
Flood, G. (1996): An Introduction to Hinduism. Cambridge University Press,
Cambridge.
Forrester, J. W. (1961): Industrial Dynamics. MIT Press, Boston.
Gharajedaghi, J. (2006): Systems Thinking: Managing Chaos and Complexity.
Butterworth and Heinemann-Elsevier, Burlington.
Forrester, J. W. (1961): Industrial Dynamics. MIT Press, Cambridge, MA.
Hammond, D. (2003): The Science of Synthesis. University of Colorado
Press, Colorado.
Jere Lazanski, T. (2008): Systems thinking and Complex Systems Modeling.
Academica Turistica I, 3-4, 79-83.
Krishnamurti, J. (1995): The Book of Life. Harper Collins, New York.
O’Connor, J., McDermott, I. (1997): The Art of Systems Thinking: Essential
Skills for Creativity and Problem-Solving. Thorsons Publishing, San Fran-
cisco.
Ossimitz, G. (2000): Entwicklung systemischen Denkens. Profil, München.
Parikh, J. (1994): Managing Your Self: Management by Detached Involvement.
Blackwell Publishing, Oxford.
Richmond, B. (1993): Systems thinking: critical thinking skills for the 1990s and
beyond. System Dynamics Review, 9(2), 113-133.
91
Riley W., Love, L. (2000): The state of qualitative tourism research. Annals of
Tourism Research, 27, 164-187.
Senge, P. (2006): The Fifth Discipline: The Art and Practice of the Learning Or-
ganization. Currency Doubleday, New York.
Wiener, N. (1948): Cybernetics. John Wiley & Sons, New York.
Wujastyk, D. (2003): The Roots of Ayurveda: Selections from Sanskrit Medical
Writings. Penguin Classics, London.
92
SPIRITUAL DEVELOPMENT IN CLASSICAL AYURVEDA:
A PRACTICAL TEACHING FROM THE CARAKA-SAMHITA
Elmar STAPELFELDT
INTRODUCTION
Ayurveda is known to be a holistic science, considering man as a unity of

physical, mental and spiritual dimensions. Especially Western Ayurvedic litera-
ture advertises psychological and spiritual aspects as essential parts of the healing
process and as desirable enrichments for current medical practice. This is in ac-
cordance with a survey recently conducted in Germany: A large majority of Ay-
urvedic therapists as well as patients in German speaking countries is acknowl-
edging the importance of spirituality within the framework of Ayurvedic practice
(Kessler, C., 2008). But what exactly are the psychological and spiritual concepts
and practical measures in Ayurveda?
A RELIABLE SOURCE – THE CARAKA-SAMHITA
It is an Ayurvedic tradition to allot highest authority to ancient scriptures, con-

trary to modern science, which generally focuses on the most recent publications.
Scholars of Ayurveda believe that the classical scriptures describe Ayurvedic lore
in its purest form, not tinted by personal motivations and shortcomings of sin-
gle authors, but representing time tested truths, which were generated by the be-
nevolent wisest of the wise (rshi) and which have to be reinterpreted according
to circumstances of given contexts. Especially the Caraka-Samhita (CS), being
93
the oldest available text of classical Ayurveda,23 is considered to be the ultimate

source of Ayurvedic knowledge. In order to follow classical methodology, it is
appropriate to search the CS for answers to the above raised question.
SELDOM REFERRED TO – CHAPTER 5 OF SHARIRA-STHANA
Surprisingly, the amount of passages dealing with psychology and spirituality

is very limited in classical Ayurvedic literature. In comparison to the descriptions
about the purification measures (panca-karma) or about nutrition, differentiated
instructions of how to conduct psychotherapy seem to be missing completely.
Usually, the texts state main principles in general form not displaying clinical
details (e.g. CS Sutra-sthana 1.58; 8.; 11.45–47; 28.34–40). Ethical conduct as
a main factor for psychological health according to Ayurveda is an exception
(e.g. CS Sutra-sthana 7.26ff.; 8.18ff). And the few interesting passages which
can found are usually not referred to in popular Western literature. In this respect
the fourth superordinate chapter of the CS (Sharira-sthana) should be looked
at more closely. It deals with embryology, obstetrics and childcare, but in some
subchapters also with the origin of life, the main components of life and the ulti-
mate goal of life are discussed.
The first subchapter of Sharira-sthana contains essential teachings from clas-

sical Indian philosophy schools especially Samkhya. It has attracted interest of
many Indologists since it contains a unique version of this important system of
thought. But according to my view, the lesser studied fifth subchapter depicts
much better the specific way how the CS suggests to conduct a holistic treatment
of the mind. It contains a concise practical approach for inner development. In
order for the reader to judge, if this teaching might serve as a basis for a modern
psychotherapy in accordance with classical Ayurvedic thought, this article will
give a summarising translation of the this chapter.
23
The Caraka-Samhita consists of serveral editorial layers. According to Indology scholars, the
main parts are definately about 2000 years old. But since the text is composed by different au-
thors probably using material from multiple oral traditions the original contents seems to be
even serveral centuries older.
94
Elmar STAPELFELDT: SPIRITUAL DEVELOPMENT IN CLASSICAL AYURVEDA: A PRACTICAL TEACHING ...
TITLE, CONTENTS AND SETTING
The title of the chapter reads “purusha-vicayam shariram”. Eminent Ayurve-

da scholars translate this cryptic title in following manner: “The Individual as an
Epitome of the Universe (as conducive to the understanding of the body)” (Dash,
Bh., Sharma, R. K., 1997) or “detailed knowledge about the person” (Sharma, P.
V., 1981).
Using the famous concept ‚microcosm equals macrocosm‘ as a guideline, the
chapter explains the ultimate realities of human existence. It amalgamates es-
sential teachings from different Indian philosophy schools in order to describe
a practical pathway how to make use of the understanding of these realities for
generating unconditioned happiness. Therefore my translation of the chapter‘s ti-
tle would be “In search of (the essence) of man (conducive to the understanding
of) the body”.
The whole chapter is composed as an instructive dialogue between Bhagavan
(Punarvasu) Atreya and his pupils. Atreya is a semi-mythical forefather (rshi) of
Ayurveda and the great teacher in the CS. He is questioned by his student Agnive-
sha, who later became the author of the first layer of the CS compiling the teach-
ings of his master Atreya. Let us adopt the role of Agnivesha, the unprejudiced
curious student, and follow the words of Atreya closely.
MAN AND THE UNIVERSE (CS SHARIRA-STHANA 5.3–5)
The first statement of the chapter is actually its summary. Atreya declares to
his students: purusho ‘yam loka-sammitam – “Man resembles the world” and
explains that all phenomena of the universe are present in the individual and all
those present in the individual are also contained in the universe.
With this enigmatic reference to the famous concept of ‚macrocosm equals
macrocosm‘ Agnivesha is not content or maybe even puzzled and humbly asks
his teacher for more details. So Atreya states that innumerable are the parts of the
universe and of man. For better understanding, these phenomena may be grouped
into six main components, which form the university at large as well as man as
an individual. The five elements and the soul principle are the basic substrata to
construct the universe and all beings entirely.
95
elements in the universe representations in man

Earth form
Water moisture
Fire heat
Air vital breath
Ether empty spaces
brahman (universal spirit) atman (individual spirit)
By drawing further analogies between entities of Hindu cosmology and my-

thology and their representations in man, Atreya describes the intimate relation-
ship between the cosmos and the individual.
phenomena in the universe representations in man

power of Brahman symbolised by Prajapati
power of the atman symbolised by the mind
(lord of all beings)
Indra (king of gods) ego
Rudra (God of thunder) anger
moon pleasure
Marut (Gods of the winds) enthusiasm
tamas (darkness) ignorance
jyoti (light) knowledge
beginning of creation impregnation
4 eons 4 stages of life
final destruction death
TRUE UNDERSTANDING – PHILOSOPHICAL EXPLANATIONS

(CS SHARIRA-STHANA 5.6–8)
Agnivesha again asks Atreya to be more precise. He wants to know the practi-
cal relevance of these general statements, probably having in mind the applica-
tion in day to day clinical practice.
In return Atreya evokes what he calls ‘true understanding’ (satya buddhi):
Seeing the entire universe in oneself and oneself in the universe leads to true un-
derstanding of the basic facts of life. All phenomena (the world and the individual
entities) change and go through following stages
– causation
– birth
96
– growth
– decay
– dissolution
As a consequence, attachment (pravrtti) to anything due to its impermanent

nature will lead to misery. But practicing detachment (nivrtti) brings about happi-
ness. Realising the similarity of universe and the self helps in developing detach-
ment, says Atreya. By this, the mechanism of cause and effect of actions (karma)
can be overcome, causing continuous bondage and cyclic change of happiness
and unhappiness.
ATTACHMENT AND ITS PATHOLOGICAL MECHANISMS (CS

SHARIRA-STHANA 5.9–10)
Agnivesha understands the importance of attachment and wants to know:

“What leads to attachment? Why is it so bad? And how can we understand de-
tachment? How to put it into practice?”
In accordance with Buddhist teachings Atreya describes the underlying causes
for attachment as
– ignorance (moha)
– longing (iccha)
– rejection (dvesha)
– and actions (karma) influenced by these
Like branches of large trees hinder a small plant to grow, attachment brings
about following factors in the mind hampering its positive development:
– egotism (ahamkara)
– non-uplifting mental, vocal and physical deeds (sanga)
– doubts
– pride and vanity
– feeling of belongingness towards family and friends
– lacking in the capability of differentiating between good and bad
– usage of wrong means (rituals etc.)
The mind gets carried away by these factors and the main mental and physical
aspects of Ayurvedic pathophysiology get disturbed.
97
disturbance aspect Sanskrit term

loss of correct thinking dhi
patience/ mental control dhrti
awareness/ memory smrti
provocation of mental doshas rajas, tamas
physical doshas vata, pitta, kapha
Like this, says Atreya, attachment forms the root cause of all miseries.
PERFECT MENTAL HEALTH (CS SHARIRA-STHANA 5.11)
Contrary to attachment is detachment, which leads to the highest fulfilment of

life in salvation, to inner peace, imperishable, to liberation in the universal spirit
(brahman). Atreya describes here the precondition for the ultimate realisation of
human potentials, for the perfect state of mind free from any disturbance or agi-
tation.
PRACTICE (CS SHARIRA-STHANA 5.12)
Without having to be reminded by Agnivesha, Atreya directly moves on to the

instructions about the practical implementation and explains several techniques
how to practice detachment. Here we encounter a multidimensional pathway for
mental development. In line with the holistic nature of Ayurveda, these practical
instructions are taking into account multiple aspects of human life. They appeal
to the individual to actively change his behaviour.
Realising the defects of worldly attractions, Atreya says, the persons desirous
for mental liberation, should do the following:
Atreya suggests to seek guidance in the beginning. But theoretical knowledge
doesn’t suffice, it has to be integrated in one’s life.
– seeking a teacher or a guide
– putting his teaching into practice
98
ETHICS (CS SHARIRA-STHANA 5.12)
According to Atreya right conduct is a presupposition of mental development.

– studying, understanding and patiently training in the ethical code of conduct
described in reliable scriptures
– seeking the company of the truthful and avoiding the non-truthful
– speaking the truth and useful statements for all creatures after prior examina-
tion and at proper time
– behaving with other creatures as if they were an inner part of oneself
– watchful behaviour towards opposite sex (in thought, word and act)
Belongings are a source for attachment in the eyes of Atreya; they should be
minimised.
– letting go of possessive attitude
– wearing simple, natural and serene clothes easy to maintain by oneself
– having simple food conducive to life and non-luxurious bedding
MEDITATION (CS SHARIRA-STHANA 5.12)
In the center of Atreya’s approach we find meditation practices. The different

techniques, views or ‘objects’ seem to derive from various traditions. Apparent-
ly contradictory approaches are juxtaposed in the list, e.g. the Vedanta-teaching
about the individual self (atman) merging into the universal self is closely fol-
lowed by the Buddhist view that no eternal principles exist (an-atman).
– training (nibandhana) the body for the purpose of meditation
– seeking secluded areas
– avoiding acts resulting in sleepiness and laziness
– non-attached attitude towards sense objects (no longing, no rejection)
– practicing constant awareness (smrti) of all postures and acts24
– keeping inner balance while facing honour, praise, criticism or insult by others
– keeping inner balance while experiencing pains and pleasures
– keeping inner balance while experiencing the stream of changing emotions in
oneself
24
This technique is known also from Buddhist meditation.
99
– discovering the dangers of the factors that grow in the mind due to attachment
(see above)
– practicing to realise the cosmos being embedded in us and us being embedded
in the cosmos
– seeing the danger of letting time pass in moments of due acts (esp. those lead-
ing to salvation)
– never tired to initiate spiritual practice (Yoga)
– loving clarity (of mind)
– directing ones thinking (dhi), patience/ mental control (dhrti) and awareness/
memory (smrti) on the pursuit of salvation25
– collecting the senses in the mind; the mind in the self (atman) and the self in
the self of selves26
– viewing the numerous body parts as composed of tissues
– understanding that everything that has a cause is leading to suffering, is not-
self (an-atman) and not eternal27
– realising that attachment (pravrtti) is bad
– and that detachment (nivrtti) is the source of true happiness
SIMILIES (CS SHARIRA-STHANA 5.13FF)
Atreya closes the chapter by beautiful similes about the purity, radiance and
stability of a perfected mind and by descriptions of the self (atman).
“Through the mentioned measures,” he says, “the mind gets purified like a
mirror and shines like the radiant sun not covered by clouds, dust, smoke or fog
(i.e. the senses). Restrained in the self the mind radiates, pure and stable, like a
flame is shining with bright light when protected by a lamp case.”
“This state of self cannot be described by any attributes, since it is free from
whatsoever link to the mind or senses.”
“He who knows the self spread in the whole cosmos and realises the cosmos
in himself, possesses true vision for the transcendental and the worldly. His inner
peace based on wisdom never ceases.”
25
These terms are typical for classical Ayurveda.
26
Similar descriptions can be found in Vedanta-philosophy.
27
This concept is central for Buddhist teachings.
100
INTERPRETATIONS
The path outlined by Atreya is hardly comparable with Western approaches of

psychotherapy. It rather represents a holistic training programme to improve and
perfect the mind. In such a state, the growth of pathological factors in the mind
is impossible. It is equal to perfect mental health, which can be regarded as the
ultimate goal of life. One may doubt that this approach is applicable to psychiat-
ric patients. But it should not be set aside, before its real potentials have not been
explored by further studies. The drastically growing numbers of so called psy-
chosomatic disorders and stress-related conditions would be an appropriate field
to begin with.
Atreya’s teaching seems to cater well to the demand of modern patients for ho-
listic and customised treatment. Merging concepts from different classical sourc-
es, the teaching offers many ways to practice. These different approaches don’t
seem to exclude one another but rather open up a set of options to chose from.
Even though the text suggests a life style of renunciation similar to a monk, the
main ideas should be considered applicable for common man in day to day life
as well. The fact that this approach is described in a medical text suggests that it
may even represent a careful selection of essential tools for the treatment of vari-
ous mental disturbances. Each statement should be thoroughly examined, since it
could serve as a basis for an effective psychotherapeutic technique for individual
indications.
Atreya’s approach actively involves the subject in the process of healing. By
personal practice and personal understanding of the nature of mental disturbanc-
es, the patient is not kept dependent on medical professionals. Emphasising ethi-
cal behaviour as the basis for inner balance and making use of different medita-
tion techniques the approach is truly holistic. It may even lead to health of the
society. But a real innovation for modern psychotherapy could be drawn from
the spiritual aspects of the approach. The impetus of faith and spiritual experi-
ences on the healing process should not be underestimated. Whatever has been
intensely motivating man over the ages should not be abandoned from medical
science. Especially the exploration of the inner self may liberate vast potentials.
And to achieve this goal, Atreya advised to gradually develop a positive state of
consciousness in which the difference between the individual and the outer world
ceases.
101
REFERENCES
CS Sharira-sthana 5.3–5.
CS Sharira-sthana 5.11.
CS Sharira-sthana 5.12.
CS Sharira-sthana 5.13ff
CS Sutra-sthana 1.58; 8.; 11.45–47; 28.34–40.
CS Sutra-sthana 7.26ff.; 8.18ff.
Dash, Bh., Sharma, R. K. (1997): Caraka Samhita. Chowkhamba Sanskrit Series,
Vol. 2, Varanasi, 414.
Kessler, Chr. (2008): Āyurveda zwischen Religion, Spiritualität und Wissen-
schaft – Fragebogenevaluation und Analyse klassischer Texte. Hausarbeit
zur Erlangung des Magistergrades (M.A.) der Philosophischen Fakultät der
Georg-August-Universität Göttingen.
Sharma, P. V. (1981): Caraka Samhita. Caukhamba Orientalia, Vol. 1 Varanasi,
439.
102
TWO WORLDS, TWO REALITIES: PSYCHIATRY VS.
AYURVEDA
Maja KOLAREVIĆ
The medical model of psychiatry28 in the European space today, holds a su-
perior posture and what is absolutely correct, or almost only proper. The roots of
this attitude dates back to 17th and 18th century, where the notches in epistemol-
ogy of knowledge happened which gave the seal of the entire later rationality, its
prominence, however, pulled up to the modern, “scientific” treatment of mental
illness. Through the deconstruction of European knowledge of mental illnesses
that used to posses the top position, I will show that the discourse of “madness”
created constructed, false myths about mental illness, which dispose people from
the real situation and understanding of it. It manipulates with people, arguing that
only they know what is the essence, correct aetiology and treatment of mental ill-
nesses. Discourse of “maddness” is organized in accordance with the interests of
the authorities, so it is controlled and selected. The authority has, with control-
led discourse, control over that part of the population (and of course all the rest),
which is the most sensitive and requires special attention, but they represent a
source of exploitation, while excessive medication, and people are persuaded to
believe that it is necessary and proper to use excessive medication, only releases
psychological distress that leads to the accumulation of profit and support for the
pharmaceutical industry. In line with this, as with infatuated “scientific” infalli-
bility and superiority, psychiatry is placed in a hegemonical attitude towards eve-
28
The medical model of psychiatry belongs to the field of biomedicine. Biomedicine is a complex
of medical practices and skills that are institutionalized in a society and represent official medi-
cine; for example in Europe, the official medicine is biomedicine, in India, the official medicine
is Ayurveda. See Ember, 2004, 95–109.
103
rything that could be designated for a different vision of the disease. By looking
differently at the disease we lean on the other half of our interest or consideration,
the Indian approach of treating mental illnesses. Ayurveda with a holistic view
of the individual and the orientation towards the effort of finding and resolving
the source of the disease, is completely opposite to psychiatry, which is focused
primarily on the removal and suppression of the symptoms, and not on deepen-
ing the search for causes. With the traditional Indian approach, I want to show the
fact that you can eliminate the disease in a natural way, what psychiatry, despite
research that speaks against it and in favor of alternative methods29, ignored or
was insufficiently aware of.
PSYCHIATRY AS A “SCIENCE”
Before the end of the 18th century there was nothing in Europe what could
be called psychiatry. Although individual doctors had themselves for adminis-
trators of “madness” and recorded the manuals of psychiatry it did not exist at
that time as a discipline, to which a group of psychiatrists with the same identity
were committed to. Relations, approaches and treatments have differed30 among
themselves, that is why a homogeneous corpus of medical knowledge was not
established.
At the end of the century a turnover occurred. The French Revolution (1789-
1799) opened a new political and ideological space; it contained the overthrow
of the old regime (Louis XVI) and located the new Republic based on the ideol-
ogy of Enlightenment – Liberté, Egalité, Fraternité – and completeness of man
(mind). It created new techniques of authoritiy that do not exclude prior disci-
29
The term alternative medicine means “optional”, “exclusive”, according to an official possibil-
ity. However, in the social reality in the case of the choice of the health systems situation is dif-
ferent, because users tend to choose alternative methods as parallel options (subject exchange
systems), that it why we are inclined to the use of the term “complementary medicine”, which
I will be using further on. See Židov, 1996, 15.
30
Medicine is historicaly characterized by rapid turnovers in aetiologies and treatments of mental
illnesses. From the Greek humoral theory to hostile spirits as the primary pathogens, from dis-
ease as a result of a incorrect distribution of the bodily fluits to the theory of autointoxication.
See Foucault, 1994, 1998; Merkel, 2003; Porter, 2002; Matevžič, 1971.
104
Maja KOLAREVIĆ: TWO WORLDS, TWO REALITIES: PSYCHIATRY VS. AYURVEDA
plinary techniques31, but according to Michel Foucault they are covered, inte-
grated, partly modified, and mostly exploited, to implement authority and are by
that actually strengthening it (See Foucault, 2007, 91). New authority exceeds
leaning on the human-body and leans on the man as a living creature; “in the
last instance to the human species”. It has renovated the administration’s moral,
introduced access to the people with scientific research32 and implemented so-
cial control and its accumulation. Thus, the state appears as an “upgrade in rela-
tion to a series of authoritative networks that invest the body, sexuality, family,
relationships, knowledge and technology and so on33. The new authority “cre-
ates a global mass (population), which is concerned with the common processes
(birth, death, reproduction, diseases, etc.) typical for life, something Foucault
calles “biopolitics”34 of the human species. It is these processes that constitute
the first objects of knowledge and control the first targets of this biopolitics. With
the first early demography they introduced statistical measurements of the above
31
In the 17th century, when the mind floods philosophical doctrines, mind became a guide for a
great closing, set up by the new form of authority. This is what Foucault calls the process, in
his History of madness, which took place in the 17th century throughout Europe and in which
they locked up a large part of the population. This is the time of a great hospices, custodial in-
stitutions, religious institutions and institutions of public policy, aid and punishment, author-
ity and charity care measures, where mainly closed the poor and deviating population groups:
the mentally ill, vangabonds, idlers, criminals, beggers, served soldiers and orphans, who were
endangering public peace and order. Foucault called it disciplinary authority, as it was focused
on the body of the individual and seeked to discipline it. As a result, at the forefront of concern
was not the soul, but the treatment entirely derived from the moral perception and moral treat-
ment of the body. Custosial institutions were linked to madness and this place was chosen for
its natural area.
32
They relied on the scientific discoveries in mathematics, physics and astronomy (the beginning
of the 18th century), where its possible to, measure and analyze verify practically all the claims.
Rational structure, where the claims are subjected to test the procedure of measuring, compar-
ing, analyzing and generalising, and become attributes of science.
33
This is evidently shown in his History of Madness and in The Birth of the Clinic, (which re-
late to psychiatry and medicine), where he talks about (political) authority (although the word
hardly used), which tries to control the body and behavior of individuals.
34
Under the concept of biopolitics, authority which has “started to deal with a life is understood;
authority includs man as a living being, a kind of nationalization of biological. This is under-
stood as “a way of the 18th century attempt to rationalize the problems that are in the form of
phenomena, typical for a community of living beings, who make up the population, and stand
up to authority’s practice: health, sanitation, fertility, longevity, race ...”. See Foucault, 2007,
88-109 and 132-138.
105
mentioned phenomena, and biopolitics obtained its knowledge, and defined the
field in which the authority will intervene.
With the revolution and, consequently, with the new authority medicine has
been converted. Source for the re-form of psychiatry as medicine, is a new ideol-
ogy. Ideology is a new empiricism, derived from Francis Bacon, John Locke and
the Abbé de Condillac (1714–1780), in which Pierre Jean Cabanis (1757–1808)
developed Candillac‘s empiricism into “medical observation”: “‘observation’,
not theory, is the logical center of medicine; the method of medicine is the “
analysis”; knowledge comes from direct experience; the primary causes need not
to be identified; the experience is a sufficient basis for facts; analyzed facts can
be useful for generalizing and analogies” (Foucault, M., 1994). As a result, the
Revolution wanted to establish a “free field” for investigation. This is the birth
of total institutions and the establishment of asylum35, which is set by the new
medical empiricism as the organized observing space, where medical practicants
are trained for direct observation of the disease. This closes the period of indis-
criminate closure; just the convicted and mentally ill are detained (only after the
judgments of doctors)36.
In this way, psychiatry became more particulary organized (it dismissed the
wide variety of observations and recipes of tradition and started working as “a
series of descriptive statements”. From the 19th century medical science has fo-
cused on the constant style and character of pronunciation (the same vocabulary,
the same metaphorical game). The concentration of this knowledge is a result of
the privileged group, which had “modified the forms of pronouncing medical dis-
course”. Psychiatry has become a knowledge-authority, that refers at the same
time to the body, population, organism and biological processes, and which will
have disciplinary and regulatory effects. Psychiatry has become a “political in-
tervention technique with typical authoritative effects (see Foucault, 2007, 100).
35
There were two theories on how to create and establish the asylum, of a French doctor Phillipp
Pinel, pioneer of moral therapy, who saved mentally ill from chains, but not confinement, and
William Tuke, founder of York Asylum (1792), who has with his non-violent and respectful
ways of treatment strongly impacted the development of psychiatry.
36
Before the asylum, there was Spital. Spital is a form of institutions that has existed in Europe in
any major site, not only in the cities. the name of medical institution or asylum was given in the
19th century (see Flaker, 1998, 61). At this point I want to warn that total institution’s already
existed in the Middle Ages, in the form of the monastery, court, leprosory and Spital; at that
time court and monastery had many features analogical to contemporary total institutions.
106
That what was already known was no longer discussed with others. In this way the
majority of knowledge became “subjected knowledge” under which Foucault un-
derstands “all knowledge that has been excluded, arguing that it is unconceptional,
not enough cultivated, naive, less hierarchical, knowledge which has not reached
the level of cognition or the required scientification (see Flaker, 1998, 87). Particu-
larly the “knowledge of people”: a (psychiatric) patient, nurses, doctors.
The newly established psychiatry was much more associated with normal-
ity than with health. It formed concepts and ordered its interventions in con-
junction with the standard operations of the organic structure and physiologi-
cal knowledge, which have been placed in the center of all medical reflections.
According to Foucault, “the reputation of science of life in the 19th century, it’s
role as a model / .. / is associated with the fact that these concepts are arranged
in space, where fundamental structure is responding to the conflicts of healthy/
morbid. When someone was talking about the life of groups and societies, life-
time of races, or even “psychological life” his first thoughts was not about the
internal structure of the organized being, but on the medical bipolarity of normal
and pathological37. If the science of man appeared as an extension of sciences of
life, it is because it is both medically as well as biologically based (see Foucault,
1994, 35–36).
Although the people in the 19th century rejected the ideas of medieval super-
stition, they have nevertheless created new myths and according to Foucault one
of the myths is the wisdom of doctors. He says that the cause of this wisdom in
the view, often called the “clinical gaze” and “observation gaze”. People in the
19th century believed that with a gaze a doctor perforated appearance and saw
through to the fundamental reality; he received the power to see the hidden truth.
37
Georges Canguilhem in his book The Normal and pathological exposes the fact that the doc-
tor is at least considering the notion of normal (healthy) and pathological (sick), because as he
says, the concept of pathological is less dependent on the judgment of doctors, but “more of the
judgment of patients and of the prevailing opinions of each cultural environment”. The virtual
judgments of value of different meanings, which are given today or were given to the concept
of disease, is common to all. “Sick is a general unworthiness concept that covers all possible
negative values. Being ill means to be harmful or undesirable or socially inferior, and so on”.
Pathological and normal are in essence the only possible norms of life, which can be restruc-
tured. Each culture defines for itself, what is normal and what is pathological, and establishes
the consensus of what is acceptable and what is deviate.
107
PACIENT AS AN OBJECT OF “EXPERIMENTATION”
With the transformation in the organization of medicine - the hospital and

asylum - and in medical knowledge – “clinical gaze” - a homogeneous corpus of
medical knowledge has been created or medical discourse was born, which does
not mean the absolute truth for psychiatry. Psychiatry still stands helpless in front
of the secrets of human psyche, and resorts to various alternatives.
A new ritual of examination – the “clinical gaze” - consequently leads to new
social relations; the patient becomes the doctor’s legitimate object of investiga-
tion and experimentation. While mental illness for centuries followed a dark,
mysterious and esoteric path the doctor is now seen as capable of penetrating into
the secrets of the psyche just by watching and as the one who diagnoses and talks
intelligently about treatment. Physician/psychiatrist was known as a wise man,
and not as the scientist, who deals with medical knowledge. The doctor became
a father and a judge, family and the law. In the eyes of the patient the doctor be-
came a miracle worker; he was recognized the power, which derives from almost
demonic secrets. In reality, however, the situation was significantly different, we
might say pretty much morbid.
In the first half of the 20th century psychiatry is caught in a dilemma. On one
hand, psychiatrists were able to “store” their patients in huge asylums in the hope
that they will recover spontaneously, on the other hand, they had psychoanalysis,
therapy appropriate to the needs of the rich, yearning for their inner-selves, but in-
appropriate for serious mental illness. Captured among unattractive choices, the
psychiatrists turned to alternatives. Some of them led to death and were discarded,
some became the basis for new visions of psychotherapy, while others led to the
foundation of the revolution in the treatment with drugs, which took place after the
2nd World War – introduction of antipsyhotic drugs led to massive dissmision of
mental patients from the asylums and returning them to the community38, known
as the process of disinstitutionalization, which quickly continued with psychiatric
hospitals. All of them had a taste of desperation; they were all radical and poten-
tially dangerous innovations. Among the alternatives, or paradigms (see Shorter,
38
Then it became possible to tranquillize the exited patient and remove psychoses with drugs, so
that the patient could theoretically live a fairly normal life in the community until the psychosis
ended. The problem, however, occurred when patients who were suddenly on the street, were
unable to organize their lives, to find shelter or a job.
108
1997; Merkel, 2003; Porter, 2001) (fever treatment and nevrosifilis, the begin-
nings of drugs, prolonged sleep, electroconvulsive therapy (electric shock), lobot-
omy, social and community psychiatry), there was no conflict. The doctor is free
to choose between alternatives; one day one, another day another. After the 60’s
of the 20th century, this form of pragmatic assuming and conjuctioning of the dif-
ferent views is not possible anymore. The Neurobiological paradigm was awoken
again; with medications that really work and with evidence that mental illness rep-
resents a biological phenomenon far from problematic relations or a schizophrenic
mother. A victory of biological, the view that mental illnesses live on a substrate of
disturbances in brain chemistry and its development means a return to the themes
that have resonated in the 19th century, during the time of the first biological psy-
chiatry. The genetic and brain development causes were in the centre. Parallel
with praising the biological, sharp criticism has begun to follow psychiatry, but
unfortunately until now they have not led to significant changes. An indispensable
part of psychiatric activity is still the use of psychopharmalogical drugs, and of
course some use of electroconvulsive therapy and insulin-comatozic therapy, since
they often reduce the duration of treatment. They also use psychotherapy that is a
slightly softer treatment which uses psychological methods through conversation,
and which is mostly very expensive. In clinical practice in the diagnosis of mental
and behavioral disorders in Europe the use of the tenth revision of International
Classification of Diseases MKB 10 currently prevails.
AYURVEDA AS A TRADITION
In contrast to psychiatry, India established well-based mechanisms against

psychological distress, which does not recognize the institutional trial, treatment,
and mostly consist of natural substances. Ayurveda is a tradition of folk practices,
where assistance to the individual, i.e. diligence is at the forefront, while in psychi-
atry we can talk about the tradition of technological progress as a form of authority
over people and in the forefront is mostly profit. Ayurveda is the oldest medical
system, which has it’s foundations in ancient India. With more than 5000 years of
use, it can certainly be among the most reliable systems of prevention and treat-
ment. It contains both philosophical and metaphysical theories, as well as theories
which are concerned with health and disease Ayurveda therefore has a greater im-
pact on the formation of cultural images of the bodies and persons as biomedicine.
109
In contrast to the stigmatization of the mentally ill in Europe, ancient texts

show kind understanding of “insanity” and relationships with the healers and in-
dicate a degree of acceptance of the mental illness that has not been registered
anywhere else in the world. Special “mental hospitals” or asylums are not men-
tioned anywhere although nowadays we can find them as a consequence of the
British colonial supremacy and its introduction of the European medical practic-
es (see Bhugra, 2006; Quaiser, 2001; Patterson, 1987; Mills, 2000, Mills, 2001;
Harrison, 2001; Ernst, 1987; Ernst, 2001). Nevertheless, they do not have the
same connotation as they do in Europe.
Ayurveda is a holistic system of treatment, which doesn‘t divide spirit and
body, as we know it in Europe, but it follows the principle that medicine should al-
ways focus on the person and not on the illness. It believes that the maintenance of
good health and the deliverance from illnesses is only possible if the doctor com-
pletely understands the person. The person in his wholeness is called the “asylum”
for illnesses and is the main subject of the medical science. According to Sudhir
Kakar, mind, soul and body are like a tripod; the world is sustained by their combi-
nation: they constitute the substratum for everything (Kakar, S., 1984). The philo-
sophical emphasis of the individual as a whole is reflected in a bright diagnostic
examination that is obligatory for every Ayurvedic doctor. The doctor tries to find
out how the patient understands the nature of his actions, passions, his blindness
because he lacks understanding, the degree of anger, sadness, dejection, pleasure
in richness etc. The patient’s behavior shows his mental state and his understand-
ing of himself that has to be improved within the family, social, geographical and
cultural context and the examination to which caste he belongs. Furthermore the
doctor has to be familiar with the region in which the patient was born, grew up
and got the illness. He asks the patient about the eating habits of the inhabitants,
their life style, physical vitality and character. He has to know the health condi-
tions in the region, special forms of the habitat, their affinity, and the types of ill-
nesses that often occur and what is generally accepted as being healthy. Before
he gives a diagnosis he prescribes a therapy or a prognosis in which he com-
pares and classifies the gathered information in a non-psychological scheme39.
39
The scheme was recorded on the basis of three types of landscapes (arid, marshy and ordinary),
three types of character (sattva, rajas, tamas), with their sixteen subtypes, three bases of physi
cal differentiation with twenty subtypes, and three periods (man-childhood, middle years, old
age) with a further division (Kakar, S., 1984, 227–229).
110
This method of approach is completely opposite to the European practice.

Ayurveda is a leading architect of India‘s view on the person and body. The
basis of the Ayurvedic treatment comes from the pancha-bhuta theory according
to which the human consist of five primary elements (ether, wind, fire, water and
earth) which he continually absorbs through food and from seven elements in the
body (blood, flesh, fat, bones, brain, skin, seeds) and from four elementary parts:
mind, body, senses, soul. Nutrition is a very important segment in Ayurveda as
the character, purity, good hearing, long life, talent, happiness, satisfaction, nutri-
tion, resistance and intellect are all dependent on food, says Kakar.
In the Hindi view individuum constitutes of two other bodies, beside the evi-
dent physical,of the “subtle body” and “causal body”. The causal body is a purely
metaphysical construct, the “pure self” of Hindu philosophy and as such, with
limited interest. Subtle body consists of the following elements: (1) buddhi - in-
telligence and the individual counterpart of the cosmic intelligence, (2) ahamkara
- the individuating principle which is responsible for the manifestation of indi-
viduality in the person and for limitation, separation and diversity in the cosmos,
(3) manas - roughly translated as mind and should include “heart”, (4) indriyah
– the five potential sensory organs (ear, skin, eye, tongue and nose) and the five
potential motor organs (speech, touch, walking, evacuation and reproduction),
(5) tanmatrah - forms of potential energy (namely sound, touch, color, taste and
smell) that later develop into the five basic elements of matter constituting the
gross physical body (Kakar, S., 1984, 238–242). The concept of subtle body of
the Indian constitutes solutions of mind-body problems. Ayurveda assumes that
any disorder, physical or mental, manifests in somatic and psychological spheres,
through an intermediate process of contamination of bodily juices.
The ancient doctors believed that health is a state of a dynamic balance of the
elements in the body. The balance of the three humors - wind, bile, phlegm is ex-
tremely important. The illness appears when one of these humors is excessively
excited and is higher than the other two. The goal is balance. Physical and men-
tal disturbances can disturb the humors and cause different illnesses with men-
tal or physical symptoms according to the type of disturbance. Besides the ill-
nesses which have a primary physical origin with predominantly physical symp-
toms, Ayurveda recognises three other types of illnesses: illnesses which have a
primary mental origin with predominantly mental symptoms like unmada, the
general term for all mental disturbances where the individual looses the con-
trol over his actions and does not have the ability to act according to the rules
111
of society. Unmada includes almost all psychic disturbances as well as what we

would nowadays describe as an impulse of neurosis and obsessions. The second
type are illnesses which have a primary mental origin with predominantly physi-
cal symptoms like epilepsy, psychoneurosis, diarrhea because of sadness or fear,
sleeplessness, fever because of depression and sexual desire. The third type are
the illnesses which have a primary physical origin with predominantly mental
symptoms, for example some illusionary states and poisoning with alcohol or
drugs (Kakar, S., 1984, 242-243).
Ayurveda does not have special psychotherapies for illnesses which have a
primary mental origin but nevertheless the Vaid (as the Ayurvedic physician is
called) usually chooses a therapeutic repertoire which consists of the following
treatments: (1) Purification – traditionally consist of laxatives, emetics, enema
and bleeding; it lasts for seven days and often many weeks and it begins and ends
with two precedent processes - oil massage and perspiration - and it is practiced if
there are disruptions connected to stress and a general physical and mental tired-
ness; (2) Pacification – the pacification treatment consists of the usage of exter-
nal ointments or of internal extracts from plants and metals; beside many differ-
ent mixtures which are used as tranquilizers and antidepressants there are also
special tranquilizing medicaments that calm the “strengthened nerves” in case of
epilepsy, hysterical convulsions and some forms of unmade and (3) Removal of
cause – one of the major causes for all forms of illnesses lies in the wrong use of
the body-mind-speech entity. However, nutrition and a guided therapy are very
important parts of the whole healing. In the treatment of mental disruptions the
doctor has an active role in the patient’s life and helps the patient to follow the
directions for the “right guidance” (in a sense that suits the society) by orienta-
tioning the directions, suggestions and persuasions in a way to stop him from
dealing with the harmful activity and start with the appropriate one (Kakar, S.,
1984, 250–251).
Today Ayurveda represents a serious challenge for Europe. The advantage
and consequently a higher efficiency of Ayurvedic healing of mental illnesses is,
compared to the psychiatry in Europe, that the whole healing process is complete-
ly adjusted to the individual. Individual is not expelled behind hospital walls and
is not forced to take synthetic medication. Although the majority still uncritically
accepts the psychiatric activities and their theories about mental illnesses, some
have turned their back on it. People have “broaden their horizons” with the help
of the media and the flow of information and realized the deficiency of psychiatry
112
and now seek help within the Ayurvedic medicine. Not only that ordinary people
think Ayurvedic treatment is important, psychiatrists and doctors are also among
them. Studies (Surya, Unnikrishanan, Thampi, Sathyavathi, in Sundarara, 1965
and Halliburton, 2004) also show that such treatments, in comparison to psychi-
atric practice, are highly successful at curing mental illnesses, even in a cases of
schizophrenia.
PSYCHIATRY IS NOT ABSOLUTE
In the history of science it has already been clearly shown that there is no one
rule, let it be so convincing and powerful, that it would not be infringed at one
moment. Errors are not merely random and do not arise from lack of knowledge,
but are absolutely necessary for progress. Paul Feyerabend clearly reminds us
about this fact, when he says that the events and developments made through his-
tory, just happened, “because some thinkers either decided not to be tied down to
the established “natural” methodological rules, or whereas such rules were un-
consciously violated” (see Feyerabend, 1999, 13).
The creation of the history of science is the sudden creation of some sciences
from nothingness, the very high speed of some advances, which were not ex-
pected. Canguilhem, who has tried to reconstruct the history of science, said that
this “is not real history, its slow epiphany; cannot pretend to uncover the narra-
tive of progressive truth /.../”. As a result, history of science cannot be based on
the integration and upgrade of what scientists might have believed or proved in
the past. In the history of science the truth can not be attributed as an established
fact. Furthermore, he said that the history of science is discontinuous, that is to
say, “if it could be analyzed only as a sort of “corrections”, as a new distribution,
which never finally and once and for all releases the final moment of truth, then
this is because it’s “error” still does not represent oblivion /.../” (Canguilhem,
1978, 70). Science is a way to reach the truth, and this does not mean that it is
not mistaken or that there are not other ways as well, as it does not mean that one
day it will reveal the truth, even though medicine and authority might perceive it
as being absolute.
Science, medicine and authority are closely intertwined, because science has
become the backbone of authority, which established in its name a dispositive
of psychiatry (and many others). Dispositive is Foucaults term which is for him
113
nothing but a “heterogeneous set of discursive strategies and some undiscursive

organization of visibility. Because, of course, there are no similarities and no
contacts between them mixing these two spheres is possible only through author-
ity. Authority is the “superior entity, which is in some way the scope of both”.
To understand the functioning of authority better, we have to imagine it as a spe-
cific diagram, as a diagram of forces or field forces, which regulate this field and
which is realized in individual dispositives (Foucault, 2004, 219). In this way, the
discourse of “madness” is controlled, selected and organized in accordance with
the interests of authorities, which extends even to our time. All social systems,
which were executed during the 19th and 20 century, have uncritically taken the
above mentioned authority mechanisms. However, from the 60s of the last cen-
tury, there have been critics40 who have undertaken the revision of “medical sci-
ence”. Criticism arose with the restart up of “subjected knowledge”, local knowl-
edge which was excluded in the name of discoveries in science. Foucault said that
it was “ the resistance of knowledge, not so much against the content, methods,
or the notion of science, but the resistance foremost against the centralizational
impact of authority, which is linked to the institution and operation of scientific
discourse in a society like ours” (see Foucault, 2007, 80). By doing so, it does
40
The argument that mental illness is not medical but social, political and legal in nature appeared
in the field of psychiatry, The society defines what is schizophrenia and depression, and not
nature. Mental illness is socially constructed so it does not exist, it is a myth. It opresses hu-
man subjectivity, and symbolizes the power that forces people to be subject to what is known
to the public as normal and prevents them to resist that authority. The arguments have been
reinforced by the simultaneous publications in early 60s, as an unusually influential series of
books on psychiatry. Michel Foucault with The history of madness, where he exposes the idea
of mental illness as a social and cultural invention of 18th century, Thomas Szász with The
myth of mental illness, which designates the whole idea of mental illness as scientific and so-
cially harmful and unworthy and Erving Goffman with Asylums, who named them as total in-
stitutions or closed systems, which infantilized the patients and restrict their lives. This work
affected the elite of universities and educated them against the “madhouse” and the entire psy-
chiatry. They created the idea, which spoke of psychiatry as a form of illegal social control,
and the power of psychiatrists, which may imprisone people. All off this had to be removed.
In the midle of the 70s first criticisms of science in general begun to emerge, which was fol-
lowed by a critique of medical science. According to the Slaven Letica, medicine is not sci-
ence, because the work of the doctor is not scientific work and medical practice is not scientific
practise. Sharper among them went so far as to put a doubt on the benefits of dominance in
general. Ivan Ilich in the meantime, put the argument that the official medical system started to
seriously endanger human health. Damage caused by medicine in his opinion feels larger than
its benefits.
114
not matter where the institutionalization discourse is going on, it is important that
the genealogy struggles against authoritative operating of discourse that applies
as scientific. Genealogy (which Foucault offers as a possible solution) would be
a kind of company that would stand “against the project of entering knowledge
in the authoritative hierarchy of science”. It would take off the yokes of historical
knowledge and free it, and by that qualify it for “the resistance and fight against
the forces of unitary, formal and scientific theoretical discourse”.
Whenever it is talked about different conceptualizations of mental illnesses,
psychiatry immediately convenes on science. Ayurveda opponents justify argu-
ments with the fact that psychiatry is based on scientifically verifiable facts, while
Ayurveda is not scientifically validated, although scientifically proven results ex-
ist, and are accumulating. In psychiatry rationality based on objective facts of
institutions plays a role, while the role in Ayurveda is irrational, which is not sup-
pose to be anything else than a placebo effect. However, in psychiatry or in bio-
medicine are they not used randomly, and being recognized? Although burning
opponents justify arguments - in their view – with rational and objective facts,
some of the doctors are waking up from “scientific nest”. The opinions of doc-
tors on the treatment of the complementary methods are not uniform, as they are,
according to Emil Žagar divided into two poles (Žagar, 2006, 10). On one hand,
the group, which is struggling to preserve its power in the belief that they are the
only orthodox bearers of medical science. According to Pierre Bourdieu the ob-
jective relations of power are often reproduced in symbolic power relations. In
the symbolic battle agents use symbolic capital, which was acquired in previous
battles, and can be legally protected. Certificates of symbolic ownership over it
are academic titles, which give a right to profit from recognition. Because the act
by which we grant title to whom, and which is a socially recognized qualification,
is one of the most typical manifestations of the monopoly of legitimate symbolic
violence, which belongs to a country. State guarantees for all of the certificates
and monopoly over legitimate symbolic violence (Bourdieu, 2003, 91–93). Com-
plementary methods or Ayurvedic doctors do not have this certificates, and con-
sequently they do not have validity. On the other hand, there is a group of doctors
who are aware of the fact that humanity needs to integrate medicine from of both
systems. It is believed that the knowledge of the spiritual aspects of human beings
and the meaning of life has to be returned to the doctors.
In the opinion of Feyerabend each person, who will turn to the greatness of
material, which is given by history, will recognize that there is only one princi-
115
ple, which corresponds to all circumstances. For him this principle (the principle,
which does not inhibit progress) reads Anything goes. Anything can go, but only
if the authority has an interest. However, it does not have it in complementary
methods yet. This does not suggest a replacement of some conventional rules,
but he wants to draw attention to the fact “that all methodologies /.../ have their
limits” (Feyerabend, 1999, 29–44). As biomedicine and complementary medi-
cine do. Both come to their limits, to the end from where they can no longer
continue. As Thomas Kuhn says there is no rational criteria that would allow a
unique choice of better or more advanced paradigms (Kuhn, T. S., 1996). The use
of diverse methods, Feyerabend believes, should be enforced by an unscientifical
instance, which has enough power to make a stand against powerful scientific in-
stitutions: the church, authority, political parties, public dissatisfaction, or money.
Pierre Bourdieu similarly says that only politics can reshape, what previously ex-
isted as a collection of numerous people who have been placed next to the each
other into a group, a class. And the class exist, “if there exist people who can say
that they are class simply because of speaking publicly, officially on its behalf
and because their actions are legitimized by people who recognize themselves as
members of that class” (Bourdieu, 2003, 94-96). We need inventions, develop-
ment and application of theories, that are not only opposed to other theories, but
even to experiments, facts.
CONCLUSION
Through the European and Indian deconstruction of knowledge about mental

illnesses, we intervened into two opposing worlds, the two opposing realities,
where interpretations, approaches and treatments of mental illnesses are com-
pletely contrary. One of these perspectives - the European approach – provides a
purely scientific, technological, (overly) medical treatment to mental illness, the
other perspective – the Indian approach – begins with a premise that individuals
are the carriers of symptoms and illnesses. The case of India clearly undermines
the European approach towards mental illnesses, mainly because it is grounded
in the claim that illnesses should be treated by natural means, particularly with a
deepened and holistic search for the causes. However, psychiatry did not take this
fact into consideration. Psychiatry is still trapped in the conventional discourse
of mental illnesses and constructs false myths about mental illnesses on the basis
116
and in the name of “scientific” observations, people are denied freedom without
being accused, forced to take medicine and it stands in a superior attitude to all
other medical systems, although they are equivalent and are struggling against ill-
nesses with the same success, in the case of Ayurveda with much more success.
Nevertheless, there is nothing leading towards its integration, or at least of those
parts which psychiatry is ignoring. If man would be orientated towards finding
new and unburdened ways of seeking truth, it would be much easier. But man
adopts his own product of truth as being the external truth, and starts to defend
it for his own security and stability of beliefs. “Scientist” or psychiatrists are no
exception in this, as academic education often means only academic defense, not
the width of the search. A lot of what has been the subject of criticism for more
than half a century ago still remains unchanged.
Psychiatry undoubtedly has an important and positive role in modern society,
but it also came to a degree, to the point where its effectiveness is halted, faced
with the limit and does not know how to continue. Like Ayurveda. None is com-
pletely successful in it’s methods, both of them have limits, to which their effec-
tiveness can reach. Both loose strength at some point. That is why we need the
union of both systems. We have to be aware, that “scientifically” validated meth-
ods as well as unscientifically validated one’s can be fallible, harmful or ineffec-
tive. Political, professional and general public should be encouraged to support
multidisciplinary approaches and by doing so enrich and integrate these skills.
If we see people as machines we can repair them with psychic interventions
when they are broken. If we see them as active agents we will treat them with
respect and with a deepened, heterogeneous approach to the individual’s crisis.
Health is a universal value and a human right and because of that we have to of-
fer the patient different medical services which match his needs and wishes. We
have to free ourselves from the negative points of view we have against every-
thing that can be defined as a different approach to illnesses. We have to treat the
patient as an individual who has an illness, as a personality and especially as a
person in need.
117
REFERENCES
Bourdieu, P. (2003): Sociologija kot politika. *cf, Ljubljana.

Canguilhem, G. (1987): Normalno in patološko. ŠKUC Filozofska fakulteta, Stu-
dia Humanitatis, Ljubljana.
Ember, C. R. (2004): Encyclopedia of Medical Anthropology: Health and Illness
in the World‘s Culture, Cultures – Volume 2. Springer, cop., New York.
Ernst, W. (1987): “The establishment of “Native Lunatic Asylums” in early nine-
teenth-century British India”. In: Studies on Indian Medical History. Gronin-
gen Oriental Studies, India.
Ernst, W. (2001): “Colonial Lunacy Policies and the Madras Lunatic Asylum in
the Early Nineteenh Century”. In: Health, Medicine and Empire. Perspectives
on Colonial India. Orient Longman, India.
Feyerabend, P. (1999): Proti metodi. Studia Humanitatis, Ljubljana.
Flaker, V. (1998): Odpiranje norosti. Vzpon in padec totalnih ustanov. Ljubljana,
*cf., Ljubljana.
Foucault, M. (1991): Vednost – oblast – subjekt. Krt, ljubljana.
Foucault, m. (1994): The birth of the clinic. An archaeology of medical percep-
tion. Vintage books, A Division of Random House, Inc., New York.
Foucault, M. (1998): Zgodovina norosti v času klasicizma. *cf, Ljubljana.
Foucault, M. (2004): Nadzorovanje in kaznovanje. Nastanek zapora. Krtina,
Ljubljana.
Foucault, M. (2007): Življenje in prakse svobode. Založba ZRC SAZU, Ljublja-
na.
Goffman, E. (1991): Asylums: essay on the social situation of mental patients and
other inmates. Penguin Books, London.
Halliburton, M. (2004): Finding a Fit: Psychiatric Pluralism in South India and
its Implications for WHO Studies of Mental Disorder. Queens College. http://
www.sagepublications.com, 9. 11. 2007.
Harrison, M. (2001): “Medicine and Orientalism: Perspectives on Europe‘s En-
counter with Indian Medical Systems”. In: Health, Medicine and Empire. Per-
spectives on Colonial India. Orient Longman, India.
Ilich, I. (1975): Medical Nemesis: Expropriation of Health. Pantheon Book, New
York.
Kakar, S. (1984): Shamans, mystics and doctors. A Psychological Inquiry into In-
dia and Its Healing Traditions. Mandala books, Great Britain.
118
Kuhn, T. S. (1996): The Structure of Scientific Revolutions. University of Chi-

cago Press, Chicago.
Leifer, R. (2000): “A critique of psychiatry and an invitation to dialogue”. In:
Ethical Human Science and Services, http://www.critpsynet.freeuk.com/cri-
tique.htm, 29. 07. 2008.
Letica, S. (1989): Intelektualec i kriza. August Cesarec, Zagreb.
Matevžič, V., Žvan, V. (1971): Psihiatrija in nevrologija. Tehniška založba Slov-
enije, Ljubljana
Merkel, L. (2003): The history of psychiatry. http://www.healthsystem.virginia.
edu/internet/psych-training/seminars/history-of-psychiatry-8-04.pdf.
Mills, J. H. (2000): Madness, Cannabis and Colonialism. The “Native-Only” Lu-
natic Asylums of British India, 1857 – 1900. Macmillan Press LTD, Great
Britain.
Mills, J. (2001): “Indians into Asylums: Community Use of the Colonial Medi-
cal Institution in British India, 1857-1880”. In: Health, Medicine and Empire.
Perspectives on Colonial India. Orient Longman, India.
Morgan, S. (2008): THE OTHER SIDE OF MENTAL HEALTH SCIENCE, ht-
tp://bipolarblast.wordpress.com/2008/07/10/the-other-side-of-mental-health-
science/, 29. 07. 2008.
Patterson, T. J. S. (1987): “Indian and European practitioners of medicine from
the sixteenth century”. In: Studies on Indian Medical History. Groningen Ori-
ental Studies, India.
Porter, R. (2002): Madness. A Brief History. Oxford University Press Inc., New
York.
Quaiser, N. (2001): “Politics, Culture and Colonialism: Unani‘s Debate with
Doctory”. In: Health, Medicine and Empire. Perspectives on Colonial India.
Orient Longman, India.
Shorter, E. (1997): A History of Psychiatry. From the Era of the Asylum to the
Age of Prozac. John Wiley & Sons, Inc., New York.
Surya, N. C., Unnikrishanan K. P., Thampi R. S., Sathyavathi K., and Sundarara
N. (1965): Transcultural Psychiatry, Ayurvedic treatments in mental illness – a
report, by Transaction of the All-India Institute of Mental Health. http://www.
sagepublications.com, 9. 11. 2007.
Szasz, T. (1961): The myth of mental illness: foundations of a theory of personal
conduct. Dell, New York.
119
Žagar, E. (2006): Možnosti in ovire vključevanja alternativnih metod zdravljen-

ja v sistem zdravstvenega varstva. Magistrsko delo. Univerza v Ljubljani,
Fakulteta za družbene vede, Ljubljana.
Židov, N. (1996): Alternativna medicina v Sloveniji. Etnološki vidik. Doktorska
naloga. Univerza v Ljubljani, Filozofska fakulteta, Ljubljana.
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‘CONSCIOUSNESS-BASED MEDICAL TREATMENT’
PARADIGM AS THE BASIS OF AYURVEDIC THERAPY
Andrej RUS
INTRODUCTION
Different surveys show that people consistently put good health at the very top
of their priorities. However, experience shows that at least in Slovenia - but also
most probably in other Western countries as well - often people consider health
care as something that is primarily concerned with treatment of the body. Peo-
ple therefore consider their health problems as something which is similar to the
problems they experience with their car: due to misuse, the car breaks down and
then it is brought for repairment. After it is repaired, it can be misused again until
it breaks once more, but there is no blame because the mechanican will repair it
again.
Such view reflects Western Cartesian-Newtonian materialistic paradigm,
where matter is of a primary importance, whereas mind is treated as second-
ary - as an epiphenomenon of a highly organized matter. Body is therefore usu-
ally treated as a mechanical device which can be repaired by a medical doctor,
while the mental patterns, which are the real cause of many diseases, are usually
not considered by medical treatment at all. The paramount importance is laid on
medications, surgery, and other treatments of the body, while the mental health
is usually put in completely another category, in the domain of psychology or
psycho-therapy.
In my career I have dealt with quite a number of people with health problems
and I must admit that very seldom a patient was advised by his doctor to use some
alternative treatments, or even any mental techniques for easing or curing the
disease. The predominant paradigm and methodology in the West regarding the
121
treatment of disease is obviously still a materialistic one. In the Western paradigm

of treating disease, the hierarchy of importance is very unambiguous: the primary
importance is given to treating the body, while treating the mind is in the best case
considered to be only a supplementary treatment.
This attitude is usually reflected in Western perception and practices of the an-
cient Vedic knowledge as well. For instance, in the West, Yoga Asanas have often
become just a pleasant physical exercise which is beneficial for the body, while
the spiritual component of Yoga Asanas is often minimized or in some cases even
neglected. Therefore, it comes as no surprise that in the West, Ayurveda is also
often considered to be a health care system which primarily deals with the body,
herbs, nutrition, massages, etc. In the West, Ayurveda is considered to primarily
deal with the matter, not with the spirit. If we look at the offer of Ayurvedic health
centres or spas that provide Ayurvedic treatments, we rather rarely find that they
would make available meditation techniques to be a part of their Ayurvedic treat-
ment. And in case they do offer meditation, it is not considered to be the primary
treatment. To be concrete, in Slovenia, there are several spas and health centres
which are offering Ayurvedic treatments, yet all of them deal with the body only.
MAHARISHI AYURVEDA
However, in Vedic tradition, which Ayurveda is a part of, consciousness is

considered to be primary and matter as secondary. Vedic tradition claims that all
the laws of nature are contained and emerge from the Veda, which is structured
in the transcendental field of transcendental consciousness. This field of pure,
transcendental consciousness has been equated with the Unified Field of modern
physics (Hagelin, 1987, 1989). Namely, modern physics also locates the source
of all energy and mater in the Unified Field, which is the unmanifested source
of everything there is. Such worldview of modern physics considers matter as an
expression of the Unified Field, which is the single, non-material, transcendental
and universal source of the whole Universe. It is the field of intelligence which
governs all activities in nature, including processes in the human body (Schneider
& Fields, 2006, 60). According to this paradigm, both mind and body have their
source in the transcendental field of consciousness which is the same as the Uni-
fied Field described by modern physics. Therefore, body was proposed to be an
expression of the Veda and Vedic literature (Nader, 2001). Mandukya Upanishad
122
Andrej RUS: ‘CONSCIOUSNESS-BASED MEDICAL TREATMENT’ PARADIGM AS THE BASIS OF AYURVEDIC ...
(Sarvananda, 1982, 10) states in the second verse: “Atman is Brahman”. That
implies that the transcendental source of individual mind is the same as the tran-
scendental source of all manifested Creation.
Maharishi Ayurveda, which represents a holistic system of traditional Ay-
urvedic practices, revived by His Holiness Maharishi Mahesh Yogi, therefore
maintains that a genuine Ayurvedic treatment should necessarily include, and
ideally even begin with mental techniques for balancing the mind, which conse-
quently beneficially influence the body. Maharishi Ayurveda believes that once
the boy is re-connected to the field of its own inner intelligence, it will natu-
rally heal itself. Such paradigm considers any health disorder as the final conse-
quence of the mind-body loosing the connection with the blueprint of the inner
intelligence, which upholds the normal functioning of physiology. Or to explain
this statement from the opposite angle: according to Maharishi Ayurveda, good
health is the result of unspoiled connection between body’s inner intelligence and
the physiology. Physiological imbalances are always preceded by mental imbal-
ances. Therefore, in the approach of Maharishi Ayurveda, a purely mental ancient
meditation technique known as Transcendental meditation is the most basic and
the most important approach for maintaining health and treating disease. The ef-
fectiveness of such approach, which Maharishi Ayurveda advocates, has been re-
peatedly verified by extensive clinical practice and by numerous peer-reviewed
scientific research studies, which confirm that the purely mental technique of
Transcendental meditation has enormous impact on improvement of physical
health.
DISCUSSION
If we probe deeper into the pathogenesis of disease, we find out that the mind
plays a crucial role in the origin of most health disorders. In medicine, there is
already a very abundant evidence for the existence of connection between mind
and physiology. Someone’s health is the sum total of all positive and negative im-
pulses that are emanating from his or her consciousness. It is known that positive
emotions will have a healthy influence on the body, while unregulated negative
emotions (for instance fear, doubt, anger, greed etc.) are damaging the body, be-
cause psycho-physiological connection will constantly transform these emotions
into harmful chemical toxins. Since unregulated negative emotions constantly
123
damage the body, one can not effectively treat the disease only on the physical
level, because in such case only symptoms are treated. This is the approach of
the conventional medicine, where surgery, drugs, massages and other physical
interventions are used to cure the disease. However, such treatments often do not
remove the primary cause of disease, but rather treat the symptoms only. Western
medicine recognizes the disease only after it has already become symptomatic,
which means that the disorder is detected only at the later stages of development.
Nevertheless, even Western medicine recognizes that a major proportion of
diseases are of a psychosomatic origin, which means that imbalances in the mind
are the real cause of illness. Therefore, without removing these negative mental
patterns, any treatment of disease will be incomplete and only partially effective.
However, the crucial question is how to remove those mental patterns, which are
the cause of so many diseases?
Obviously it is not possible to purify the mind on the level of thinking about
the problems only. Mere thinking is simply too superficial to have any signifi-
cant influence on the deeper structures of the mind and body. Moreover, thoughts
themselves are mere expressions of deeper levels of the mind. Common experi-
ence is that the mind is usually full of thoughts, memories, emotions, imagina-
tions desires, etc. Where do they come from? According to the Vedic tradition,
they arise from the unmainfested source, Atma, transcendental consciousness,
which is systematically experienced during meditation when the mind settles
down to the state of pure inner silence, where all that remains is a transcendental
consciousness itself.
Transcendental meditation is a simple, effortless, natural technique for bring-
ing awareness to the source of thoughts, emotions, feelings etc. that structure the
personality and shape the body. It is important to mention that transcending is a
natural phenomenon, not limited to Transcendental meditation only (Murphy &
Donovan, 1988). Transcendental meditation is just a systematic, easy and effi-
cient secular method for regularly experiencing the inner silence of the Self, the
transcendental consciousness. In Transcendental meditation, the mind systemati-
cally transcends the usual noise of thoughts, emotions etc. and experiences the
inner silence.
I would like to emphasize that in the practice of Transcendental meditation,
the experience of transcendental consciousness is not just a fancy philosophical
concept, but a real experience. Transcendence is not just a fascinating word, but
the least excited stated of consciousness which can be easily experienced during
124
Transcendental meditation. Transcendental meditation very effectively takes the

awareness beyond the realm of all mental patterns, where one transcends sick-
ness and experiences the state of balance within. The physiological description of
transcendental consciousness is “A Wakeful Hypo-metabolic Physiologic State”
(Wallace, 1970; Wallace et al., 1971). In simple terms it means that the physiol-
ogy is very deeply resting while the mind is alert.
Extensive scientific research has demonstrated that during the experience of
transcendental consciousness, the whole body starts to function in a very orderly
manner (Alexander et al., 1987). When awareness contacts the state of transcen-
dental consciousness, the connection between mind and body is maximally enli-
vened, while the physiological functioning is at its most optimal, natural state. By
learning to transcend, one is consciously opening the psycho-physiological con-
nection to the transcendental consciousness, to the Self, to the field of innermost
intelligence which is the blueprint for the whole physiology. Transcendental med-
itation thus enables the mind to spontaneously channel its own inner intelligence
and express it as health in the body. Regular transcending creates a physiology
which spontaneously and naturally maintains a state of health.
HEALTH BENEFITS OF THE TRANSCENDENTAL MEDITATION

PROGRAM
Does repeated transcending, repeated experience of transcendental conscious-

ness, actually create better health?
Clinical experience and numerous scientific studies demonstrate that such
‘Consciousness-based medical treatment’ approach has enormous positive im-
pact on health. Health benefits are numerous, ranging from increased energy lev-
els to significantly reducing even chronic diseases. The research findings are ex-
tensive, with over 600 studies about the effects of Transcendental meditation.
Several studies have found that Transcendental meditation significantly reduces
medical care utilization and hospitalization (Haratani et al., 1990a, b; Herron,
2005; Herron et al., 1996; Orme-Johnson, 1987; Orme-Johnson et al., 1997).
One of the most intriguing studies about the health benefits of Transcendental
meditation, inspected health insurance statistics of 2,000 practitioners of Tran-
scendental meditation from all over the United States. The data was provided by
one of the major health insurance companies in the U.S. The analysis compared
125
the data of the TM group with the health care utilization statistics of the control
group (Orme-Johnson, 1987). The study has found that during the period of five
years, those who practiced Transcendental meditation were 56% less often hos-
pitalized for surgery or illness. They also had 50% less doctors’ visits. Those
practitioners of TM who were over 40 years old, had this feature even more pro-
nounced: the reduction of disease was in this age group even more than 70%. It
was found that the Transcendental meditation group required much fewer medi-
cal treatments in all 16 categories of health disorders. For instance, there was
87% less heart disease disorders, 87% fewer medical treatments for nervous sys-
tem disorders, and even 55% reduction for cancer.
Another fascinating area of research concerns the benefits of Transcenden-
tal meditation in lowering high blood pressure. In the case of hypertension, in
more than 90% of the cases, it is not possible to determine a clear cause for the
increased blood pressure (Appel & Llinas, 2007, 4). Modern medicine does not
know to really cure or even reduce hypertension – or even find the cause. It has
only identified the risk factors. Therefore, most physicians use medications for
treating hypertension - not only because such treatment quite effectively reduces
the blood pressure and because such treatment is the easiest method for both the
doctor and the patient, but also because of the materialistic paradigm that is pre-
vailing in our society.
However, the conventional therapies which are based on medicaments, do not
deal with various causes of hypertension, but rather treat the symptoms. More-
over, such treatments often have side-effects. Conversely, Maharishi Ayurveda
recommends that the real cause of hypertension must be addressed. In come back
to the Vedic paradigm of locating and curing disease from the inner level of the
mind, even hypertension can be relieved. Several controlled studies and rand-
omized clinical trials have found that Transcendental meditation program is an
extremely effective method for reducing high blood pressure (Alexander et al.,
1996; Schneider et al., 1995; Walton et al., 2002; Walton et al., 2004). The effect
of Transcendental meditation in lowering the elevated blood pressure is similar
in size to the effect of conventional drug treatments, yet without adverse side
effects. Moreover, the Transcendental meditation treatment has proven to have
higher patient compliance, and the overall cost of treatment is much lower.
A meta-analysis conducted at the University of Kentucky Medical Center
(Anderson et al., 2008) attempted to evaluate the effects of Transcendental Medi-
tation on hypertension by analysing all the research studies done about TM and
126
hypertension that were published until December 2008. The meta-analysis as-
sessed randomized controlled trials where Transcendental meditation effect size
on hypertension was compared to control groups. For evaluating the quality of
the studies and the strength of statistical procedures (i.e. whether random effects
model was used or not), a 0-20 rating system was used. The meta-analysis has
found that compared to the control groups, Transcendental meditation treatment
produced statistically significant decrease of −4.7 mm Hg in systolic BP and −3.2
mm Hg in diastolic blood pressure.
Another meta-analysis (Rainforth et al., 2007) attempted to compare the ef-
fects of various stress-reduction and relaxation methods on lowering blood pres-
sure. Authors identified 107 studies that dealt with stress reduction and hyperten-
sion. It turned out that 17 trials were well-designed studies with appropriate sta-
tistical procedures (randomized controlled trial). Altogether, there were 23 treat-
ment comparisons, while these studies included 960 participants with hyperten-
sion. Meta-analysis has found that there were no statistically significant changes
on high blood pressure for biofeedback, relaxation-assisted biofeedback, progres-
sive muscle relaxation, stress management training and stress management train-
ing. However, the Transcendental Meditation program had statistically signifi-
cant effect on lowering systolic blood pressure for −5.0 mm Hg (P = 0.002), and
diastolic blood pressure for −2.8 mm Hg (P = 0.02).
Research show that hypertensive patients, who practice Transcendental medi-
tation significantly reduce the use of antihypertensive drugs, at an average of
23% (Schneider et al., 2005). Due to fascinating results of different studies, the
American National Institute of Health has already given more than 24 million
USD for research on effect of Transcendental meditation on hypertension (Of-
ficial TM Webpage, 2009). All this demonstrates that consciousness-based ap-
proach to health-care can very effectively remove the actual cause of disease.
Briefly I would also like to reflect upon my own experience as a long stand-
ing teacher of Transcendental meditation, and describe how course participants
experience and report positive effect of Transcendental meditation upon their
health. At the beginning of the Transcendental meditation course, questionnaires
are filled out by course participants, where they also answer about their possible
health problems. My experience shows that consistently course participants ex-
perience some improvements immediately after they learn Transcendental med-
itation. The positive effects then grow day by day and are usually more pro-
nounced in some areas. However, almost everyone notices that utilization of a
127
simple mental procedure (Transcendental meditation) positively affect the physi-

ological health.
For me, one of the most interesting category of course participants are those
with hypertension. This is due to a simple reason: hypertensive patients (in most
cases) regularly monitor their blood pressure and therefore objectively know the
level of their blood pressure. Therefore, it is very easy for them to objectively
follow whether the practice of Transcendental meditation has any effect on their
well being - particularly whether it lowers their high blood pressure. My experi-
ence shows that already after one or two days of learning Transcendental medi-
tation, almost everyone notices that immediately after the practice of Transcen-
dental meditation, high blood pressure significantly decreases. In a month or two,
this change is noticed to be persistent even during daily activity.
CONCLUSION
I would like to emphasise again the need for a paradigmatic shift in our ap-
proach of treating disease. Ayurveda is rooted in Vedic tradition, where con-
sciousness is of a paramount importance, and considered to precede the matter.
Therefore, the initial and the most important influence on health is coming from
the immaterial domain of consciousness, which means that mental techniques
should supplement not only Ayurvedic, but any medical treatment. Even though
Ayurveda possesses and utilizes very powerful approaches on the level of the
matter, various mental techniques deserve proper consideration and incorporation
into medical practices as well. Such approaches should definitely not be under-
mined, and deserve our uttermost attention.
A good (but surely not the only one) example of such approach is Maharishi
Ayurveda, which strongly promotes various modalities for creating good health.
Even though it abundantly utilizes different bodily treatments and herbal prepa-
rations, Maharishi Ayurveda strongly advocates the usage of purely mental ap-
proaches as well. Therefore, if we look at the list of various modalities of Maha-
rishi Ayurveda, we can find mental techniques (like for instance Transcendental
meditation) occupying all top positions of the list – without undermining the im-
portance of other modalities.
As it is often said, body can turn poison into nectar or it can turn nectar into
poison – depending on the state of the mind. In other words, it’s mind over mat-
128
ter. The mind is the place where most diseases start, and so does the health. The
central principle of Ayurveda is that the minds exert the major influence on the
physiology. Therefore, creating balance in the mind is the very first step to create
balance in the body. Since transcendental consciousness is the source of all men-
tal processes, transcending is therefore the most powerful and the most important
of all Ayurvedic therapies, embodying ‘Consciousness-based medical treatment’
paradigm as the basis of Ayurvedic therapy.
REFERENCES
Alexander, C. N. et al. (1987): Transcendental consciousness: a fourth state of

consciousness beyond sleep, dreaming, and waking. In: Gackenbach, J. (ed.):
Sleep and Dreams: A Sourcebook. Garland Publishing, New York, 282-315.
Alexander, C. N., et al. (1996): A trial of stress reduction for hypertension in older
African Americans (Part II): Sex and risk factor subgroup analysis. Hyperten-
sion, 28(1), 28-237.
Anderson, J. W., Liu, C., Kryscio, R. J. (2008): Blood pressure response to tran-
scendental meditation: A meta-analysis. American Journal of Hypertension,
21, 310-316.
Appel, L., Llinas, R. H. (2007): Hypertension And Stroke. Johns Hopkins Medi-
cine, Baltimore.
Hagelin, J. S. (1987): Is consciousness the unified field? A field theorist’s per-
spective. Modern Science and Vedic Science 1(1), 29-87.
Hagelin, J. S. (1989): Restructuring Physics from its foundation in light of Maha-
rishi Vedic Science. Modern Science and Vedic Science, 3(1), 3-72.
Haratani T. et al. (1990a): Effects of Transcendental Meditation (TM) on the
mental health of industrial workers. Japanese Journal of Industrial Health
32, 656.
Haratani T. et al. (1990b): Effects of Transcendental Meditation (TM) on the
health behavior of industrial workers. Japanese Journal of Public Health 37
(10 Suppl.), 729.
Herron R. E. (2005): Can the Transcendental Meditation program reduce medical
expenditures of older people? A longitudinal medical cost minimization study
in Canada. Journal of Social Behavior and Personality 17(1), 415-442.
129
Herron R. E. et al. (1996): The impact of the Transcendental Meditation pro-

gram on government payments to physicians in Quebec. American Journal of
Health Promotion 10, 208-216.
Murphy, M., Donovan, S. (1988): Physical and Psychological Effects of Medita-
tion: A Review of Contemporary Meditation Research With a Comprehensive
Bibliography, 1931-1988.
Nader, T. (2001): Human Physiology: Expression of Veda and the Vedic Litera-
ture. 4th ed. Maharishi Vedic University, Vlodrop, The Netherlands.
Official TM wepage (2009): National Institutes of Health. [Online] (Updated
2009).
Available at: http://www.tm.org/national-institutes-of-health
[Accessed 3 July 2009].
Orme-Johnson D. W. (1987): Medical care utilization and the Transcendental
Meditation program. Psychosomatic Medicine 49, 493-507.
Orme-Johnson D. W. et al. (1997): An innovative approach to reducing medical
care utilization and expenditures. The American Journal of Managed Care 3,
135-144.
Rainforth, M. V. et al. (2007): Stress Reduction Programs in Patients with Elevat-
ed Blood Pressure: A Systematic Review and Meta-analysis. Current Hyper-
tension Reports, 9, 520-528.
Sarvananda, S. (1982): Mandukya Upanishad. Madras, India: Sri Ramakrishna
Math.
Schneider, R. H., Fields, J. Z. (2006): Total Heart Health: How to Prevent and
Reverse Heart Disease with the Maharishi Vedic Approach to Health. Laguna
Beach, CA: Basic Health Publications.
Schneider, R. H. et al. (1995): A randomized controlled trial of stress reduction
for hypertension in older African Americans. Hypertension. 26, 820-827.
Schneider, R. H. et al. (2005): A randomized controlled trial of stress reduction in
African Americans treated for hypertension for over one year. American Jour-
nal of Hypertension, 18, 88-98.
Wallace, R. K. (1970): Physiological effects of Transcendental Meditation. Sci-
ence 167, 1751-1754.
Wallace, R. K. et al. (1971): A wakeful hypometabolic physiologic state. Ameri-
can Journal of Physiology 221, 795-799.
130
Walton, K., Schneider, R., Nidich, S. (2004): Review of controlled research on

the Transcendental Meditation Program and cardiovascular disease - Risk
Factors, Morbidity and Mortality. Cardiology in Review, 12(5), 262-266.
Walton, K. G. et al. (2002): Psychosocial stress and cardiovascular disease 2: Ef-
fectiveness of the Transcendental Meditation technique in treatment and pre-
vention. Behavioral Medicine, 28(3), 106-123.
131
AYURVEDA – INDIAN WISDOM FOR GLOBAL HEALTH
Vasudevan NAMPOOTHIRI
Life is a journey. For those who know the destination and the road map it is
a pleasure and source of enlightment. Ayurveda is that science and art of living
which guides you in the journey of life. It is the Indian wisdom for global health.
In fact the Indian sciences were always concerned about the wellbeing of not only
the mankind but also of the other living things and even non living things. The
bits of knowledge about the laws governing the universe in general got consoli-
dated as man started living in groups. In the light of this knowledge, he formu-
lated the laws governing the health and illness using his scattered experience of
healing he had gathered as the raw material. This gave rise to the science called
Ayurveda.
Ayurveda aims for a holistic man with sharp intellect which can pierce in to
the hidden truths of nature, and a heart concerned about the fellow beings, well
supported with a physical efficiency to perform duties properly.
Ayurveda considers man as an integral part of Mother Nature. Therefore the
laws of nature are very well applicable for him also. Ancient philosophy which
ponders the “secret of life and beyond” gives prime importance for health. It has
understood the need of longevity and effectiveness to attain the supreme goal. The
most ancient scriptures and the reference point of Indian life are Vedas. Ayurveda
is an offshoot of Vedas. The umbilical cord connection of Ayurveda with the Ve-
das explains its strong philosophical basement. Earlier Ayurveda was taught in
Gurukulas where the disciples stay serving their guru learning both theory and
practical of life in a very organic way.
Broadly Ayurveda is divided into two different school of thoughts, namely
Charaka and Dhanwantari schools. The former stresses the importance of medi-
cine where as the later gives importance for the surgical interventions. The prom-
133
inent surgeon of the Dhanwantari School, Susrutha is considered as the” father of

surgery”. Both the schools agree on the number of specialties as eight but differ in
priorities. They are Kayachikitsa, Bala chikitsa, Manasika chikitsa, Urdhwanga
chikitsa, Salya chikitsa, Visha chikitsa, Rasayana &Vajeekarana.
Over and above the difference of opinion in the modalities of treatment eve-
ryone agrees the basics. The two major theories that drive Ayurveda are the Pan-
chamahabhoota theory and the Tridosha theory. Tridosha theory is the derivative
of the former to explain the bodily situations. The Panchabootha theory postulate
the major constituents of the world are five in number and all the things, living
and non living are but the combination and recombination of these five basic
elements. The five elements are earth, water, fire, air, and space. Obviously hu-
man body is also formed by the five elements. This universality of constitution
is the basis of treatment. Any imbalance in the basic constitution of the body can
lead to disease and can be rectified by using appropriate material with the re-
quired Panchabootha combination. The Tridosha theory is the bodily version of
the Panchabootha theory where the Tridosha - vata, pitta, and kapha represent the
panchabhootas. The biological factors that constitute the body- Tridosha, when
remain in equilibrium is health and the derangement leads to disease. The balance
is maintained dynamically by intelligently adjusting to the changes happening
around. It has to be done on personal level and social level. Individual can take
care of the food he consume, judicious balance of rest and work, and the emotions
to ensure the Tridosha balance.
In addition, authorities should take care to provide a healthy enviournment.
Ayurveda clearly states the connection of bad governance and the deterioration
of health of masses. Good environmental awareness is essential for a healthy so-
ciety. Guard against epidemics, natural calamities like famine, flood, drought etc
are essentially man made. Ayurveda blames the responsibility on the governance
there by not leaving any area unnoticed which has any bearing on health – direct
or indirect. The duty of society to protect the environment by preventing pollu-
tion and by planting trees in large scale is the need of the hour. Being an integral
part of the nature any harm to nature will harm man’s very existence.
The prime effort of Ayurveda is to ensure health. The preventive aspects are
described in great detail. The daily regimen and seasonal regimen are mentioned
separately. Promotive medicine is another major area where Ayurveda has greater
say. The rejuvenative and aphrodisiac treatments cater this need. Finally, in the
curative domain, the etiology is analyzed and the imbalance it has created is eval-
134
Vasudevan NAMPOOTHIRI: AYURVEDA – INDIAN WISDOM FOR GLOBAL HEALTH
uated before deciding the mode of treatment. The cardinal reasons for all diseases
are the derailed intellect, weak will, and impaired memory together is termed as
Pranjaparadha. To conceive the right practice of health one need clear intellect.
To put them in to practice one need a strong will. To avoid the wrong doings of
the past, memory has to be intact. So Pranjaparadha remains the reason behind
all the reasons that cause diseases. Apart from this, environmental and genetical
reasons of disease are also recognized by Ayurveda.
In all diseases in spite of varying reasons, the basic reason is the imbalance of
Tridosha and the treatment principle is to bring back the normalcy. The disease
can manifest as somatic, psychiatric, or psycho somatic. The balance is achieved
by internal purification, external treatment modalities, administering medicine
internally and also using holistic methods addressing both body and mind. It
ranges from pancha karma, Rasayana, Yoga, meditation and so on.
Panchakarma is a unique treatment package which is meant to cleanse both
body and mind. They are emesis, purgation, enema, nasal medication, and blood-
letting.
Rasayana is the rejuvenative therapy which delays aging, provides immunity,
enhances memory and increases sensory perception.
Personal health is the sum total of good food, good regimen, good emotions
and good environment.
Ayurveda elaborate the science of diet stating the pros and cons of differ-
ent food items. The quantity and quality of food is instructed. Ayurveda warns
against the improper combination of food stuffs in detail and enlist the diseases
it can cause.
About exercise, sleep, and sex, Ayurveda gives clear guidelines. The timings
and frequency have to be adjusted according to the seasonal variations. Six sea-
sons have been identified in the Indian context and detailed seasonal regimens
are given along with the method of changing one regimen to another in a gradual
smooth manner. This helps to prevent seasonal disease and position the body
against the seasonal variations.
Ayurveda has some of the best answers for degenerative disorders, immune
disorders, life style disorders and psychic disorders. Life disorders like coronary
heart diseases, diabetes mellitus, hypertension, acid peptic diseases and cancer
can be better managed by Ayurveda. The psychic diseases and stress related con-
ditions can be managed by the cleansing methods, other external and internal
medications and counseling.
135
Ayurveda represents the thoughts of this great nation. Knowing Ayurveda in

its deepest sense is a pilgrimage through this nation’s heritage. Experiencing this
healing science for treatment purpose and positive health is an attraction for tour-
ists both domestic and foreign.
Ayurveda has the potentiality and the knowhow to enter new areas of healing
like the sports medicine, post-traumatic stress disorders, disaster management,
anti addiction program, and vetenary science. Commercially products like medi-
cated clothes and other improvisations are to be done. Another area of scope for
improvement for which Ayurveda is capable of is cosmetics.
Ayurveda which takes into account body, mind, intellect and soul in to account
in its pursuit of holistic health has a universal role to play. It’s all inclusive phi-
losophy makes it the healing science suited for the entire world. With the healthy
mind, intellect, and body given by Ayurveda, let us strive to ensure the recogni-
tion for this science which it surely deserves.
Kerala stands at the forefront of health status of people, in India, for the last
fifty years. It is almost neck to neck with Sweden, which is having the highest
level of health status in the world. Ayurveda plays a great role in improving and
maintaining the health status of people of Kerala. However, per capita health
expenditure of Kerala is very minimal compared to developed countries. This
means Ayurveda is the answer for cheap but effective health care delivery, espe-
cially in these times of global economic recession.
136
PART 3
AYURVEDA, HEALTH AND MEDICAL
SCIENCE
HEALTHY LIFE THROUGH AYURVEDA
G. S. LAVEKAR
The life is defined as constant and continuous union and amalgamation of

body, sense, motor organs, mind as well as soul, the life is the period from birth
to the death, this is the comprehensive definition of life. Ayurveda is the science
of life to lead a healthy life for achieving the main goals of life like:
– Dharma – to abide with the rules of nature having a natural way of life,
– Artha – to earn the material wealth with abiding dharma for livelihood,
– Kama – to full fill the different desires for enjoying the ideal life,
– Moksha – is salvation or detachment from worldly life for future journey.
Further the health is defined in different view of functional conglomeration
& balance.
Health is a dynamic integration and homoeostasis of doshas (biological-forc-
es), dhatus (tissue-systems), malas (metabolic wastes), mind, sensory system and
soul.
IMPORTANCE OF HEALTH CARE
All other issues are to be kept aside while looking after the health, for with-
out health all worldly things are of no value as health is pivotal in achieving the
goals of life.
139
SUBPILLARS OF LIFE
The diet, sleep & celibacy are considered the three pillars of life on which life
is sustained.
– Ahara – diet is the nourishing factor which sustain the life, whatever we con-
sume taking into body that is considers the Ahar which include Food, Water &
Air, all these should be pure, adequate & timely
– Swapna – Sleep
During sleep, the body repairs itself and revitalizes organs and muscles. In ad-
dition, sleep is important for proper functioning of the immune system and the
nervous system. Lack of sleep can result in increased feelings of stress, impaired
memory, shortened temper, lower motivation and slower reflexes.
– Sleep is a necessary activity for sound health. Ayurveda classifies sleep into 6
classes, sleep due to advent of night is the sustainer of all beings.
– Sleep should be taken at night as a rule, it should be taken in the day time al-
so by: old, children, women, lean, worked / traveled at night, those suffering
from asthma, hiccough, diarrhea, neuralgia, injury, indigestion etc.
– Day time sleep is advised to healthy one, half of the duration of his night
awaken time.
– With advancement of age the duration of sleep is reduced.
BRAHMACHARYA – CELIBACY
– Importance is given to celibacy in Ayurveda, in bachelor life it is to be strictly

observed.
– In married life monogamy, sexual relations with own wife are considered celi-
bacy.
– The married one should take regularly aphrodisiac preparations.
– Desired progeny is main goal in married life and sexual pleasure is secondary.
140
G. S. LAVEKAR: HEALTHY LIFE THROUGH AYURVEDA
If a man leads a life of celibacy even in his householder‘s life and has copula-
tion occasionally for the sake of progeny only, he can bring forth healthy, intel-
ligent, strong, beautiful, self-sacrificing children. The ascetics and saviours of
ancient India, when married, used to follow this excellent rule very carefully for
this purpose, and also used to teach by example and practice how to lead a life of
a brahmachari even as a householder.
APPROACH OF AYURVEDA TO MAINTAIN HEALTH
To maintain health and improve the quality of life it includes:

– Dincharya (daily regimen),
– Ritucharya (seasonal regimen),
– Sadvritta (behavioral and ethical considerations).
FOUR PRONGED TREATMENT PLAN IN AYURVEDA
– Nidana parivarjana (avoidance of causative and precipitating factors of dis-

eases),
– Samshodhana (bio-cleansing),
– Sanshamana (palliative measures),
– Pathya vyavastha (health promoting regimen).
DINCHARYA – DAILY REGIMEN
– Rising from bed three hours before sun – rise is called Brahma Muhurta. In
this period the atmospheric pollution is meager including noise due to this
body is exposed to sufficient oxygen present in air, all this resulted into calm-
ness of mind inclining to pious & creative thought. Brahma is considered a
god of creativity.
Waking up early is a productivity method of rising early and consistently so

as to be able to accomplish more during the day. This method has been recom-
mended since antiquity and is presently recommended by a number of personal
141
development gurus. Benjamin Franklin wrote a book entitled Early Rising: Natu-
ral, Social and Religious Duty.
– Examination of body – many times knowingly or unknowingly some body
part may remain in wrong position or an insect may have bite as not noticed in
sleep, hence after wake up in the morning one should examine his body.
– Should evacuate the bladder & bowels, should respond to the call immediately
as evacuation of excretory material gives a fresh & cleansing feeling, this fur-
ther stimulates the Agni - transforming energy & also the functional responses
of these organs.
– Cleansing teeth with an astringent, pungent, bitter or sweet plant sticks like
Khadira-Catechu, Karanja-Pongamia pinnata, Nimba-Azadericta indica,
Madhuka etc. this helps in removing coated / accumulated plegm over teeth
& gums. This practice renders the oral hygiene, pleasant, clean mouth which
helps in appreciating the real taste of food & also refreshes the mind.
– The Pongamia pinnata twig juice is having Antiseptic properties.
– Neem extracts have been very useful in destroying cavity-causing bacteria,
enhancing mouth immunity and preventing tartar and plaque buildup. They
have helped millions of people avoid cavities.
– The Catechu (Khadir) bark is tremendously beneficial in cases of toothache
and spongy gums it act as a binding agent.
– Ginger oil is an astringent for teeth, not allowing the growth of pathogens.
– The Acacia Arabica’s Natural ingredient strengthens the root of the teeth,
cleans and maintains the whiteness of the teeth.
– Next, clean the tongue with a long strip of soft wood, silver or gold. This
freshens the mouth, removes bad smell, intumescences if any & gives it a light
happy feel.
– There after gargle the mouth with Luke warm oil & hold it for some time. This
strengthens & prolongs the life of teeth, strengthens the chin & voice & gives
good shape to mouth.
– There after wash face & eyes with bit cold water or decoction of Amalaka -
Embelica officianalis or latex plants, this cleanses the face.
– There after apply the collyrium of Rasanjana – Aristata Barberis into eyes
once or twice in a week. It is beneficial to the eyes as it flushes tears removing
mucoid discharges.
142
– There after drop oil like Anu Taila into nostrils & after 1-2 minutes later gargle
with hot water. This nasal application of oil is beneficial in many ways like
preventing hair fall, cervical, facial diseases etc.
– There after one should enjoy the Dhumrapana i.e. medicinal smoking, which
helps in preventing diseases of Kapha & Vata affecting above Clavicle region.
– There after one should enjoy the chewing of tambula, prepared from betel leaf
added with camphor, clove, ginger, black & long pepper etc. This is to be prac-
ticed after getting up out of sleep, after food, bathing & vomiting. This helps
in removing the dirty excretions from the teeth, throat & tongue.
– After this one should rub whole body with oil – Abhyanga. Massage of the
body with oil imparts softness, cleans the skin, gives better sleep, delay the
signs of old age etc. The skin is constantly exposed to the atmosphere, reflects
the age of a person. The regular massage with suitable oil nourishes the skin,
maintains the proper reflexes & delays the wrinkle formation.
– Vyayama – exercise this should be in moderation suitable to own physique.
The Yoga Asanas are ideal form of body & mind balanced exercises.
– After exercise one should rub the body with ointments / powder etc. Udvar-
tana. This act removes the applied oil, excessive fat, harden - strengthen body
& brighten skin.
– Bathing should be practiced at least once every day, hot or cold water is to be
used as per the season, the hot water over head should not be used but advised
over other parts of the body, the regular hot water over head gives rise to early
baldness.
– Dressing – clean garments as per the code, country or one`s desires should
wear. Along with this scent, pleasant preparations, flowers, ornaments may be
put on the body, which improves the personality.
These daily regimens are likely to take three hours.
SHAVING & HAIR DRESSING
Service to oneself is not waste of time but it is productive of joyful tempera-

ment, gentleman image, aphrodisiac, etc.
– Worship of God etc. – one has to observe worship of God, of guests, learned,
elderly persons etc. this help in success in life by receiving good wishes &
provide mental peace.
143
RITUCHARYA – SEASONAL REGIMEN
Indian subcontinent undergoes six seasons, with the approximate duration of

each being two months, as Spring – March & April, summer – May & June,
Monsoons – July & August, early Autumn – September & October, late Autumn
– November & December & Winter – January & February. But according to the
modern climatic studies India has only three predominant seasons like Summer,
Rainy season & Winter.
– Summer season. Lasts from about March to June

The strong sun shine begins to liquefy the accumulated Kapha – mucous ma-
terial body try to eliminate this, the common cold, allergic episodes are common
in this period, digestion gets vitiated. Ayurveda advises emetics, nasal medica-
tions, etc. to eliminate accumulated Kapha. Weak wines like Drakshsava diluted
with water, honey, ginger water, etc. is to be used.
Day time is to passed in shady place & in the night in moon light whenever
possible, day sleep is prohibited. In further period the sun heat is extreme hot
hence pungent, salty, sour are not favoured. Only light exercise & morning sun
shine can be enjoyed. The food should be sweet, sour but easily digestible are
preferred. The liquid cold food, water scented with camphor, rose, vetivera is ad-
visable. Day time sleep can be taken.
– Rainy season. June to October

Rain starts, ground throws hot vapors, water became muddy, digestion be-
came weak due to vitiation of three doshas. To eliminate vitiated doshas Enema-
tas are advised. Strong wine, boiled water, water treated with ginger, pipper etc.
is advisable. Day time sleep, too much work is to be avoided.
– Winter season. November to March

Bitter-tasted herbs, purgatives to discharge the accumulated Pitta are to be
taken, in selected cases blood letting is also advised. Sweet, bitter, astringent tast-
ing but easily digestible food is to be preferred in the beginning part of winter. In
later period the cold increases hence oil massage is advised.
– Lean person may drink Sura a kind of wine.
– Fat person may take a mixture of water & honey to reduce their weight.
– Consumptive persons should drink a soup or decoction of flesh.
144
– Flesh eaters & people with weak digestion should drink wine.
– Those exhausted due to disease, medication, traveling, sexual enjoyment, fast-
ing, exposure to sunshine & physical exercise should drink milk.
Such liquid addition to food please the mind, satisfy hunger, soften solid foods
& effect digestion. After eating none should engage in too much talk, traveling,
exposure to sun, riding animals & in swimming.
– Ayurveda finally admonishes that, “Eat only beneficial things, that too in
moderation and at their proper time, as well as with due regard to your re-
quirements. Otherwise, disease will harass you in its manifold ways.”
BEST FOR HEALTH AMONG THE CONCERNED
– Red variety of rice

– Mudga – green gram class of pulses
– Rock salt best type of salt
– Rain water collected from high above ground
– Cow ghee is the best ghee
– Cow milk is the best
– Til oil
– Ginger
– Grapes
– Candy sugar
– Sugar cane best to increase urine
– Amalaki – Embelica officianalis is the best to preserve youth
– Haritaki – Terminalia chebula is best to remove metabolic waste
– Gargling oil is the best measure to strengthen teeth
– Giving every thing is the best thing to obtain happiness
145
NON-SUPPRESSIBLE URGES
These non-suppressible urges are to be attended promptly, the regular habit of

suppression leads to causation of diseases of the concerned systems C.S.S. 7/25
– Micturation
– Bowel evacuation
– Semen
– Flatus
– Vomiting
– Sneezing
– Hiccup
– Yawning
– Hunger
– Thirst
– Tears
– Sleep
– Dysopnia due to exertion
SUPPRESSIBLE URGES
– One who desirous of well being during his life time and after, should suppress
urges relating to rashness and evil deeds – mentally, orally & physically.
– A wise person should refrain from satisfying the urges relating to greed, grief,
fear, anger, vanity, shamelessness, jealousy, too much of attachment, malice,
extremely harsh words, back biting, lying & use of untimely words, violence,
adultery, theft & persecution. C.S.7/26-28
The virtuous one, who is free from all vices relating to mind, speech & physi-
cal actions, is indeed happy and alone enjoys the fruits of virtue (dharma), wealth
(artha) and desire (kama). C.S.7/30
PANCHAKARMA
– A bio-cleansing regime comprising of five procedures

– Strength
146
– Eliminates disease causing complexes from the body

– Facilitates better bioavailability of pharmacological therapies
– Helps to bring about homeostasis of body humors
– Checks the recurrence and progression of disease
FIVE FOLD BIO-CLEANSING MEASURES
Pre-Panchakarma procedures
– Snehana – oleation ext. & int.
– Swedana - sudation of different types
Main Panchakarma bio-cleansing procedures

1. Vamana (Therapeutic Emesis)
2. Virechana (Therapeutic purgation)
3. (a) Asthapana Vasti (Therapeutic Decoction Enema)
(b)Anuvasana Vasti (Therapeutic Oil Enema)
4. Nasya Karma (Nasal administration of medicaments)
5. Raktamoksha – blood letting with bio-apperatus and instrument
IMPORTANCE OF OIL MASSAGE
– Sparshenendriya i.e. skin is the extensive mega sensory organ covering exter-
nal & internal parts having extensive nervine net work. The skin is constantly
exposed to external atmosphere (mainly Vayu Mahabhoot) – manifested air &
skin is one of the important indicators of ageing.
– Vayu dominates in the tactile sensory organ and this sensory organ is located
in skin. The massage is exceedingly beneficial to the skin, so one should prac-
tice oil massage regularly. C.S.5/87
– One who practices oil massage regularly, the body even if subjected to inju-
ries or strenuous work, is not much injured; his physique is smooth, flabby,
smooth & charming.
By applying the oil massage regularly the signs of ageing will be delayed.
C.S.5/88
147
RASAYANA THERAPY – SPECIALISED HEALTH PROMOTIVE

AND REJUVENETIVE APPROACH OF AYURVEDA
– Prevents the effects of ageing.

– Improves intelligence, memory, complexion and sensory and motor functions.
– Rasayan drugs have immune enhancement, free radical scavenging, adap-
togenic or anti-stress and nutritive effects.
RASAYANA – REJUVENATING HERBS
– Ashwagandha Withania somnifera

– Guduchi Tinospora cardifolia
– Brahmi Baccopa moneri
– Shatavari Asparagus recemosa
– Amalaki Embelica officianalis
– Yashtimadhu Glycerhiza glabra
– Pippali Piper longum
– Hartaki Terminalia chebula
ACHAR RASAYANA / SADVRITTA – BEHAVIOR REGIMEN
– Keep the passion under control

– Always help to needy, old, women, guru etc. observe charity
– Never be egoistic
– Don’t allow energies to be wasted
– Sleep as long as body requires
– Believe in nature / God
– Always speak nice words
– Have a purposeful life
– Chant some holy words / mantra
– Have perseverance; never became impatient
148
THREE CARDINAL CAUSES OF DISEASE
– Atiyoga – Excessive uses of sensory / motor organs

– Ayoga – Not using own capacity at all either physical / mental
– Mithyayoga – Wrong uses of possessed natural / developed skills or potential
In nutshell if one follows the way of life described in Ayurveda that will lead
a healthy & long life.
149
BIOTECHNOLOGICAL INVESTIGATION ON WITHANIA
SOMNIFERA: AN IMPORTANT MEDICINAL PLANT
Ajay G. NAMDEO, Kavita YADAV, Ajay SHARMA

AND Kakasaheb R. MAHADIK
INTRODUCTION
Withania somnifera Dunal (‘ashwagandha’) is widely used in Ayurvedic med-

icine, the traditional medical system of India (Ali et al., 1997). Numerous phar-
macological investigations have established the pharmaceutical potential of this
plant. Leaf and stem extracts have shown nervine tonic (Sengupta, 1906; Bhagvan-
dash, 1991) and immunomodulator (Ziauddin et al., 1996) activities. The major
alkaloid, withanine, has adaptogenic, memory related conditions (Dhuley, 2000),
insomnia, anti-convulsant (Sengupta, 1906; Bhagvandash, 1991) and anticancer
(Davis and Kuttan, 2001) properties. Withanolide, a major steroidal lactone, is a
potent antileukemic (Christina et al., 2004), and a group of minor alkaloids, have
adaptogenic (Bhattacharya and Muruganandam, 2003) activity. Previous investi-
gations on W. somnifera concentrated mainly on micropropagation and plant tis-
sue culture (Singh et al. 2006; Saritha and Naidu, 2007), adventitious regenera-
tion and secondary metabolite production (Dhar et al., 2006). Various strategies
have been employed to improve the production of secondary plant compounds in
in-vitro systems (Bourgaud et al., 2001), including the use of genetically trans-
formed roots. The development of a system for the rapid and efficient production
of transformed roots and the establishment of stable and fast-growing transgenic
root clones capable of synthesizing target secondary products are prerequisites
for improving the productivity of transformed root cultures.
The soil borne gram-negative bacterium Agrobacterium rhizogenes infects
higher plants and produces roots that can be grown in axenic culture. This trans-
151
formed root culture phenotype is caused by the integration of one or both of two
transferred DNAs (TL and TR) from the bacterial root-inducing (Ri) plasmid into
the plant genome (Tepfer, 1984; Tepfer and Delbart, 1987). Transformed root cul-
tures have been established for several species of plants, among these are medici-
nal ones (Jung and Tepfer, 1987; Hamill and Lidgett, 1997) in which a number of
high-value pharmaceuticals, including several alkaloids, have been synthesized
(Sevon and Caldentey, 2002).
We describe here the genetic transformation of W. somnifera. The objectives
of this study were to establish an A. rhizogenes mediated transformation system
that would result in the rapid and high-frequency induction of transformed roots
and to produce stable and fast-growing root cultures as a means for studying the
relationship between growth and withanolides accumulation.
MATERIALS AND METHODS
Collection and Authentication of Drug Material

Plant material was collected from medicinal plant garden of Poona College of
Pharmacy, Pune. It was authenticated by Agharkar Research Institute, Pune (Au-
thentication No. 1946-2006).
Shoot initiation from Withania somnifera seeds

Surface sterilized seeds were used for germination of plantlet. Plantlet germi-
nation was observed after four weeks. The plantlet was subcultured twice. Differ-
ent concentrations of growth hormones were used for elongation of shoot. After
three subcultures of three weeks duration, the healthy leaves of elongated and
matured shoots were used as explant for the initiation of hairy roots (Sharada et
al., 2007).
Preparation of Agrobacterium rhizogenes cell line for genetic transforma-

tion
Wild type strain of A. rhizogenes ATCC 15834 used for transformation was
obtained from National Chemical Laboratory (NCL), Pune, India. This bacterial
culture was subcultured in YEB media. Bacterial suspension was prepared by
inoculating 10 ml of liquid YEB media, pH 7.0, with a loopful of bacteria fol-
lowed by culturing on a rotary shaker at 28 ºC at 180-200 rpm for 18 hrs in dark.
152
Ajay G. NAMDEO, Kavita YADAV, Ajay SHARMA and Kakasaheb R. MAHADIK: BIOTECHNOLOGICAL ...
Optical density of 18 hr old bacterial culture was adjusted to ±1. This bacterial
culture was centrifuged at 3000 rpm for 5 min at 40 ºC for pellet formation. The
supernatant media was discarded and bacterial pellet was re-suspended in 5 ml
MS media. This bacterial suspension was used for infecting leaf explants (Kumar
et al., 2005).
Establishment of genetically transformed hairy root cultures from W. som-

nifera
To study infectivity we wounded explants with a sterile scalpel. Excised leaf
explants were wounded either at the leaf midrib or petiole. Over each explants
10 μl bacterial suspension was poured. YMB media that had not been inoculated
with bacteria was used as the control.
Growth studies
The growth of 9 root clones transformed by Agrobacterium rhizogenes strain
ATCC 15834 in solid, semisolid and liquid media was studied for 4 week
RESULTS AND DISCUSSION
Shoot initiation from Withania somnifera seeds:

Different concentrations of auxins and cytokinins were used for initiation of
callus. The best callus initiation was found in MS medium contain IAA (1 IAA).
This callus was used for shoot initiation using different hormones.
Growth studies
Hairy roots were initiated from leaflet containing healthy leaves. Root cul-
tures were established from a single primary root formed at each wound site with
the help of A. rhizogenes. These roots grew rapidly and developed laterally within
4 weeks in BM for the development of clones. Twelve fast growing clones were
selected and used for subsequent experiments. The growth parameters of clones
in solid, semi-solid and liquid media were shown in Table 1-6.
Conclusion
Root cultured in liquid medium showed more rapid growth and higher branch-
ing than solid medium. Root culture in semisolid shows rapid growth and higher
153
branching than solid media but less than liquid media. W. somnifera hairy root
culture in solid and liquid medium exhibited vigorous growth and accumulation
of withanolides at higher levels than the control.
REFERENCES
Ali, M., Shuaib, M., Ansari, S. (1997): Withanolides from the stem bark of W.
somnifera. Phytochemistry, 44, 1163-1168.
Ambros, P. F., Matzke, A. J. M., Matzke, A. M. (1986): Localization of Agro-
bacterium rhizogenes T-DNA in plant chromosomes by in situ hybridization.
EMBO J 5, 2073–2077.
Aoki, T., Matsumoto, H., Asako, Y., Matsunaga, Y., Shimomura, K. (1997): Vari-
ation of alkaloid productivity among several clones of hairy roots and regener-
ated plants of Atropa belladonna transformed with Agrobacterium rhizogenes
15864. Plant Cell Rep, 16, 282-286.
Batra, J., Dutta, A., Singh, D., Kumar, S., Sen, J. (2004): Growth and terpenoid
alkaloid production in Catharanthus roseus hairy root clones in relation to
left- and right-termini-linked Ri T-DNA gene integration. Plant Cell Rep, 23,
148-154.
Bhagvandash, V. (1991): Materia medica of Ayurveda. Jain B. Publisher, 59.
Bhattacharya, S., Muruganandam, A. (2003): Adaptogenic activity of W. somni-
fera: an experimental study using a rat model of chronic stress pharmacology.
Biochemistry and Behavior, 75, 547-555.
Binns, A. N., Thomashow, M. F. (1988): Cell biology of Agrobacterium infection
and transformation of plants. Annu Rev Microbiol, 42, 575-606.
Bourgaud, F., Gravot, A., Milesi, S., Gontier, E. (2001): Production of plant sec-
ondary metabolites: a historical perspective. Plant Sci, 161, 839-851.
Bush, A. L., Pueppke, S. G. (1991): Cultivar strain specificity between Chry-
santhemum morifolium and Agrobacterium tumifaciens. Physiol Mol Plant
Pathol, 39, 309-323.
Cardarelli, M., Span, L., Mariotti, D., Mauro, M. L., Constantino, P. (1987): The
role of auxin in hairy root induction. Mol Gen Genet, 208, 457.
Christina, A., Joseph, D., Packialakshmi, M., Kothai, R., Robert, J., Chidambara-
nathan N. Ramasamy M. (2004): Anticarcinogenic activity of W. somnifera
154
Dunal against Dalton’s Ascitic Lymphoma. Journal of Ethnopharmacology,

93, 359-361.
Davis, L., Kuttan, G. (2001): Effect of W. somnifera on DMBA induced carcino-
genesis. Journal of Ethnopharmacology, 75, 165-168.
Dellaporta, S. L., Woods, J., Hicks, J. B. (1983): A plant DNA minipreparation:
version 2. Plant Mol Biol Rep, 1, 19-22.
Dhar, R., Verma, V., Suri, K., Sangwan, R., Satti, N., Kumar, A., Tuli, R., Qazi,
G. (2006): Phytochemical and genetic analysis in selected chemotypes of W.
somnifera. Phytochemistry, 67, 2269-2276.
Dhuley, J. (2000): Adaptogenic and cardioprotective action of W. somnifera in
rats and frogs. Journal of Ethnopharmacology, 70, 57-63.
Duncan, D. B. (1955): Multiple range and multiple F-test. Biometrics, 11, 1–42.
Ganzera, M., Choudhary, M. I., Khan, I. A. (2003): Quantitative HPLC analysis
of withanolides in W. somnifera. Fitoterapia, 74, 68-76.
Godwin, I., Todd, G., Lloyd, B., Newbury, H. J. (1991): The effects of acetosy-
ringone and pH on Agrobacterium mediated transformation vary according to
plant species. Plant Cell Rep, 9, 671-675.
Hamill, J. D., Lidgett, A. J. (1997): Hairy root cultures opportunities and key pro-
tocols for studies in metabolic engineering. In: Doran, P. M. (ed.): Hairy roots.
Gordon and Breach/Harwood Academic, London, 1-30.
Hobbs, S. L. A., Jackson, J. A., Mahon, J. D. (1989): Specificity of strain and
genotype in the susceptibility of pea to Agrobacterium tumifaciens. Plant Cell
Rep, 8, 55-58.
Hooykaas, P. J., Klapwjik, P. M., Nuit, M. P., Schilperoot, R. A., Hirsch, A.
(1977): Transfer of the A. tumifaciens Ti plasmid to avirulent Agrobacteria
and Rhizobium explanta. J Gen Microbiol, 98, 477-484.
Hu, Z. B., Alfermann, A. W. (1993): Diterpenoid production in hairy root cultures
of Salvia miltiorrhiza. Phytochemistry, 32, 699-703.
Jouanin, L., Guerche, D., Pamboukdjian, N., Tourneur, C., Casse-Delbart, F.,
Tourneur, J. (1987): Structure of T-DNA in plants regenerated from roots
transformed by Agrobacterium rhizogenes strain A4. Mol Gen Genet, 206,
387-392.
Jung, G., Tepfer, D. (1987): Use of genetic transformation by the Ri TDNA of
Agrobacterium rhizogenes to stimulate biomass and tropane alkaloid produc-
tion in Atropa belladonna and Calystegia sepium roots grown in vitro. Plant
Sci, 50, 145-152.
155
Jung, G., Tepfer, D. (1987): Use of genetic transformation by the Ri TDNA of

Agrobacterium rhizogenes to stimulate biomass and tropane alkaloid produc-
tion in Atropa belladonna and Calystegia sepium roots grown in vitro. Plant
Sci, 50, 145-152.
Mano, Y., Nabeshima, S., Matsui, C., Ohkawa, H. (1986): Production of tropane
alkaloids by hairy root cultures of Scopolia japonica. Agric Biol Chem, 50,
2715-2722.
Mano, Y., Ohkawa, H., Yamada, Y. (1989): Production of tropane alkaloids by
hairy root cultures of Duboisia leichhardtii by Agrobacterium rhizogenes.
Plant Sci, 59, 191-201.
Murashige, T., Skoog, F. (1962): A revised medium for rapid growth and bioassay
with tobacco tissue cultures. Physiol Plant, 15, 473-497.
Petit, A., David, C., Dahl, G. A., Ellis, J. G., Guyon, P. (1983): Further extension
of opine concept: plasmids in A. rhizogenes cooperate for opine degradation.
Molecular Gene Genetics, 190, 204-214.
Roja, G., Heble, M. R., Sipahimalani, A. T. (1991). Tissue cultures of W. som-
nifera: morphogenesis and withanolide synthesis. Phytotherapy Research, 5,
185-187.
Saritha, K, Naidu C. (2007): In vitro flowering of W. somnifera Dunal: an impor-
tant antitumor medicinal plant. Plant Science, 172, 847-851.
Sengupta, K. N. (1996): Ayurvedic system of medicine. Kevalram Chattergee
Publication, 424.
Sevn, N., Caldentey, K. M. (2002): Agrobacterium rhizogenes mediated transfor-
mation: root cultures as a source of alkaloids. Planta Med, 68, 859-868.
Shen, W. H., Petit, A., Guern, J., Temp, J. (1988): Hairy roots are more sensitive
to auxin than normal roots. Proc Natl Acad Sci USA, 85, 3417–3421.
Singh, A., Varshney, R., Sharma, M., Agarwal, S., Bansal, K. (2006): Regen-
eration of plants from alginate encapsulated shoot tips of W. somnifera (L.)
Dunal, a medicinally important plant species. Journal of Plant Physiology,
163, 220-223.
Sokal, R. R., Rohlf, F. J. (1987): Introduction to biostatistics. WH Freeman, New
York.
Tepfer, D. (1984): Genetic transformation of several species of higher plants by
Agrobacterium rhizogenes: phenotypic consequences and sexual transmission
of the transformed genotype and phenotype. Cell 37, 959-967
156
Tepfer, D., Delbart, F. (1987): Agrobacterium rhizogenes as a vector for trans-

forming higher plants. Microbiol Sci 4:1134-1141
Tepfer, D., Temp, J. (1981): Production d’agropine par des raciness transformes
sous l’action d’Agrobacterium rhizogenes souche A4. CR Acad Sci Paris Ser,
3 292, 153–156.
Ziauddin, M., Phansalkar, N., Patki, P., Diwanay, S., Patwardhan, B. (1996):
Studies on the immunomodulatory effects of Withania somnifera. Journal of
Ethnopharmacology, 50, 69-76.
Table 1: Fresh and dry weight determinat
Clone No. Fresh weight (gm) Dry weight (gm)

N 0.45 0.11
1 1.75 0.15
2 1.83 0.18
3 2.57 0.25
4 3.00 0.43
5 2.23 0.37
6 3.12 0.34
7 2.96 0.40
8 2.83 0.23
9 2.50 0.21
Table 2: Root tip elongation of hairy roots in solid media.
Clone No. Elongation rate (mm/day) Elongation after 28 days (cm)

N 0.9 2.52
1 4.5 12.60
2 4.2 11.60
3 5.0 14.00
4 5.6 15.60
5 4.7 13.16
6 5.9 16.52
7 4.9 13.72
8 5.1 14.28
9 4.6 12.88
157
Table 3: Fresh and dry weight determination of hairy roots in semisolid

medium:
S.No. Clone Fresh weight (gm) Dry weight (gm)

1. N 1.05 0.32
2. 1 2.96 0.96
3. 2 3.14 1.15
4. 3 2.16 1.10
5. 4 1.99 0.80
6. 5 3.11 1.12
7. 6 2.23 0.78
Table 4: Root tip elongation of hairy roots in semi-solid media.
S.No. Clone No. Elongation rate (mm/day) Elongation after 28 days (cm)
1. N 0.9 2.52
2. 1 4.6 12.8
3. 2 4.9 13.70
4. 3 5.1 14.20
5. 4 4.5 12.60
6. 5 5.0 14.00
7. 6 4.8 13.40
Table 5: Fresh and dry weight determination of hairy roots in liquid media.
S.No. Clone Fresh weight (gm) Dry weight (gm)

1. N 0.56 0.15
2. 1 3.43 1.33
3. 2 4.23 2.21
4. 3 3.00 1.19
5. 4 3.69 1.14
6. 5 4.70 2.22
7. 6 3.96 1.16
158
Table 6: Root tip elongation of hairy roots in liquid media.
S.No. Clone No. Elongation rate (mm/day) Elongation after 28 days (cm)
1. N 1.0 2.8
2. 1 5.0 14.0
3. 2 5.8 16.20
4. 3 6.0 16.80
5. 4 6.6 18.40
6. 5 5.7 15.90
7. 6 6.9 19.30
159
ANCIENT AYURVEDIC APOTHECARY AND ITS
APPLICATION IN EUROPE
Gaurav DESAI
INTRODUCTION
Man has been in pursuit of remedies for his ailments since eternity. Accord-
ing to Ayurveda, everything in the universe can be used as a remedy. But be-
fore it can be considered fit for therapeutic usage, it has to pass through certain
transformative procedures. Only after undergoing these procedures can a drug be
designated as a medicine. The process of transformation of a drug into medicine
is called ‘Samskara’. The branch of Ayurveda that deals with the processing of
drugs and formulating drug delivery systems is Bhaishajya Kalpana (Ayurvedic
Pharmaceutics).
Ayurvedic treatises describe five basic Kalpanas (Preparations) for adminis-
tration of any herbal drug.
They are:
1) Swarasa (Expressed juice)
2) Kalka (Paste)
3) Kwatha (Decoction)
4) Hima (Cold infusion)
5) Phanta (Hot infusion)
Each preparation has its own specific area of application based on the nature
of the patient and the disease. And as with almost everything, each comes with
its own disadvantages. For example, Swarasa has a shelf life of only 24 hours or
less, depending on the climatic conditions.
Further therapeutic preparations have then been developed from the basic
preparations. They are: 1) Solid preparations like Churna, Guti, vati, 2) Semi
161
solid preparations like Avaleha, Rasakriya, 3) Liquid preparations like Asavas,

Aristhas. These are aimed at countering some of the drawbacks of the basic for-
mulations.
Based on the media used in the preparations they, can be classified as 1) Aque-
ous Extract which includes Swarasa, Kwatha etc. 2) Protein Extract like Kshira-
paka 3) Lipid Extract including Sneha Kalpanas 4) Volatile Oil Extract i.e. Arka
5) Self Generated Alcoholic Extract including Asava, Arista.
Amongst these preparations and their subtypes, Asavas and Aristhas (Fer-
mented preparations) have gained greatest pharmaceutical and therapeutic value.
This is because of their inherent qualities that make them unique. Charaka Sam-
hita, the most ancient amongst the Ayurvedic treatises, describes four necessary
qualities that a drug has to possess, viz. Abundance, Applicability, Usability in
different modes, and richness in qualities. Sandhana Kalpanas possess all these
properties.
The origin of Sandhana Kalpanas can be traced as far back as the Vedic period,
with sufficient references available in Rigveda and Atharvaveda. The knowledge
developed with time and in the Samhita period, it was fairly well developed. In
14th century text, Sharangdhara Samhita one comes across a complete chapter
dedicated to the fermentative preparations.
DEFINITION
Expressed juice from vegetable material, filtered decoction, infusions etc.

When kept for a long time as liquids alone or mixed with vegetable drugs or di-
etetic substances are called Sandhana Kalpanas. The word Sandhana is derived
from the root word which means to keep up and to nourish. In its broader sense
it denotes, the acceleration of chemical and bio- chemical reactions in the drug.
The conditions playing an important role in proper Sandhana (Fermentation) are
place, time, quality and quantity of substance and potency of the substance. Asa-
va and Aristhas are types of Sandhana Kalpanas which contain self generated
alcohol.
Asava- Aristha Kalpanas signify a group of preparations in which the proc-

ess of Sandhana is applied. Sometimes these terms are used as synonyms of each
other. But strictly speaking, both are different. Asavas are products of fermenta-
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Gaurav DESAI: ANCIENT AYURVEDIC APOTHECARY AND ITS APPLICATION IN EUROPE
tion of expressed juices and Aristhas comprise of fermented decoctions. Due to

this basic difference, the Aristhas are comparatively superior in qualities.
METHOD OF PREPARATION OF ALCOHOLIC PREPARATION
The equipments required are Sandhana Paatra (Vats), Drugs, include main
drugs, liquid drugs, additives drugs. Other drugs are used in the preparation of the
vats, for coating the insides and fumigation.
The basic drugs are either converted to Swarasa (Expressed juice) or Kwatha
(Decoction). This is then kept in new, fumigated vats such that 3/4th of its capac-
ity is occupied. The other drugs including the sweetening agents and fermenta-
tive are added. The vats is then sealed and left undisturbed for a specific period of
time. On completion of the specified period, the vats are opened; the supernatant
liquid is filtered and used.
Quantities of various constituents have been specified and only if used in the
same proportion, optimum fermentation is obtained. According to the classical
treatise of Sharangdhara, 1 part of liquid drugs, 1/10th of the main drug, 1/3rd
sweetening agent and 1/20th part of additive constitute the general proportion of
constituents for Sandhana.
Most texts specify that the minimum period required for the process is 7 days.
It is shorter if the climate is warmer and longer if in a cold climate. The specified
maximum duration ranges from 1 month to 6 months. The average period ranges
from 15 to 30 days.
To identify proper the proper formation of Asava/ Aristhas, one has to observe
for appearance of a clear, froth less liquid. The aroma has to be sweet and slightly
alcoholic. The preparation has to de devoid of sour taste. Effervescence should
have died down completely. The additives settle down at the bottom of the vat.
All five sense organs are used to test the finished product for its proper transfor-
mation into Asava/ Aristha. Preparation possessing all these qualities is consid-
ered to be well formed Asava/ Aristha. The self generated alcohol content varies,
but generally ranges between 2 to 6 %. The pH range is 4-5. Other standardisation
tests have to be applied to ascertain quality.
During this process, proper sanitation is of utmost importance. The Vats have
to be clean and sterile. The place in at which the vats are stored also is of para-
mount importance. It has to be free from vermin and have suitable temperature.
163
As mentioned earlier, the proportion of constituent ingredients is also important.

Temperature plays a crucial role in the fermentation process. Too high temper-
ature leads to faster breakdown of constituents. Too low and the fermentation
doesn’t take place.
PROPERTIES OF ALCOHOLIC PREPARATIONS
Sandhana Kalpanas in general and specifically Asava and Aristha are diges-
tive stimulants and appetisers. They are sweet, slightly bitter, pungent and sour in
taste and astringent in nature. They promote voice, complexion and intuition. As
they contain sweet ingredients, they are palatable and generally better accepted
by patients, and benefit both emaciated as well as corpulent individuals. Similarly
they benefit people with excessive sleep and those who have difficulty in sleep-
ing. Clearing of the internal channels in the body is achieved by these formula-
tions. This is because of their un-unctuous and subtle nature. They are excellent
cardiac tonics
It is important to note that these qualities are exhibited by Sandhana Kalpanas
only if consumed in prescribed quantities. Like any substance, when consumed
in excess, they can prove to be toxic. Asava and Aristhas should be consumed in
moderation, along with wholesome food at the proper time. The quantity advised
in the classics is about 50 ml. They have to be diluted before use. If used likewise
they prove to be exhilarating, relishing and promotes good health.
ADVANTAGES OF ALCOHOLIC PREPARATIONS OVER OTHER

PREPARATIONS
Asava and Aristhas are considered to be superior to other types of prepara-

tions. This is attributed to the following reasons:
1) Due to the self generated alcohol, both alcohol soluble as well as water soluble
constituents become available for absorption.
2) They are easily digestible and absorbed.
3) The presence of alcohol leads to improved shelf life. In fact, the mature with
age and exhibit better efficacy.
4) As they are liquids, the administration is easy.
5) The most important advantage that Sandhana Kalpanas hold over other prepa-
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Gaurav DESAI: ANCIENT AYURVEDIC APOTHECARY AND ITS APPLICATION IN EUROPE
rations is that they are palatable. This is because of the addition of sweetening
agents like sugars and Jaggery.
6) They also exhibit nutritive properties, and are generally devoid of toxic effects
and hence are suitable for chronic patients.
Asava and Aristhas appear to be the most suitable drug delivery system for
Ayurvedic drugs in Europe. The European palate is very sensitive and cannot
tolerate strong tastes. Most Ayurvedic drugs are therefore not easily accepted by
European patients. To compound the problem, the adjuvants that are prescribed
along with the medicines are foreign to European tastes. The acceptability of Ay-
urvedic medication and thus Ayurveda can be increased many fold by popularis-
ing the use of Asava and Aristhas as the drug delivery system of choice by prac-
titioners of Ayurveda in Europe. This is because wine making and consumption
is already popular in the continent. The climatic conditions are also very suitable
for the consumption of medicated wines.
Sandhana Kalpanas appear to have been evolved to achieve total medicinal
value of drugs that are both water as well as alcohol soluble. The synergistic ef-
fect of the constituent drugs, the antagonistic effect of Honey, Sugars, and Jag-
gery against the strong nature of the ingredients, the palatability and long shelf
life are special features in Asava/ Aristhas that can be utilised in Ayurvedic treat-
ment in the West. These Kalpanas are rich in both medicinal and nutritional fac-
tors.
REFERENCES
Prasad, P. V. N. R. (2008): Bhaishajya Kalpana Vijnana, Chaukhamba Krishna-

dasa Academy, Varanasi, 1st edition, 284-318.
Ramchandra, R. (2001): Bhaishajya Kalpana Vijnanam, Chaukhamba Sanskrit
bhawan, Varanasi 2nd edition, 415-445.
Shastri, P. (ed.) (2000): Sharangdhara Samhita, Chaukhamba Orientalia, Vara-
nasi, 4th edition 2000, 233.
Shobha, H. (2000): Text book of Bhaisajya Kalpana, IBH Prakashana Bangalore
1st edition, 250-270.
165
OPTIONS OF AYURVEDA IN NURSING AND DIETETICS
Nadja PLAZAR and Tamara POKLAR VATOVEC
INTRODUCTION
The beginnings of the development of higher education in Slovenian Littoral

area go back to the sixties when the High School of Maritime Studies of Piran
was established, and to the seventies, when fundamentals for other higher educa-
tion institutions and colleges were set in Koper.
With the economic growth of Primorska region the need for its own Univer-
sity became even more evident, thus on 30th March 1993 a letter of intent envi-
sioning the establishment of the University Study Centre was signed by the may-
ors of the Littoral communities, the president of the Littoral Assembly, and the
representatives of the regional economy. On November 20, 1995 an additional
letter of intent was signed, assuring the conditions for the development of higher
education in the communities of Koper, Izola and Piran. On the basis of these ini-
tiatives the Littoral communities established and financed the University Study
Centre of Koper, whose aim was to facilitate the development of higher educa-
tion in the region.
In 1997 the project for the establishment of the College of Health Care Izola
started on the initiative of the Council of the University Study Centre of Koper.
It took almost four years to finish the project. During this period all the require-
ments for the functioning of the college were fulfilled, i.e. a strong support re-
ceived by professional and public institutions; adequate teaching and research
faculty secured, educational bases established, premises and equipment provided
and financial resources granted.
The Council for Higher Education of the Republic of Slovenia confirmed that
the requirements for the establishment and operation of an independent higher
167
education institution were met, thus the University Study Centre Council passed
the Act about the establishment of the College of Health Care Izola on its 22nd
March 2002 meeting. After the Council for Higher Education of the Republic of
Slovenia gave its consent to the introduction of the study programme Nursing
Care the provisional senate of the CHCI invited candidates to enrol in the first
year course.
In the academic year 2002/2003 the first generation of sixty students from
all over Slovenia was admitted. The study process was carried out in the rented
premises of the Secondary Nursing School in Izola. There were 17 contractual
lecturers employed at the College. It was the financial support of the Littoral
communities that secured the execution of the study programme as at the time the
college was still without licence.
The College of Health Care Izola is one of the seven founding members of
the University of Primorska, which was established in April 2003. We started our
second academic year (2003/2004) with the concession and our first permanent-
ly employed teaching faculty. When Slovenia entered the European Union we
aligned the study programme Nursing Care with Community rules on regulated
professions.
In 2004/2005 we started with the updated, undergraduate 3-year study pro-
gramme of Nursing Care, which offers the graduates – nurses and health care
workers – adequate knowledge and skills for an independent performing of their
profession without preliminary probation. The first part-time students enrolled
into the undergraduate study programme in Nursing in 2005/2006 and two years
later into the undergraduate study programme Nutrition Counselling - Dietet-
ics. In 2008/2009 full-time as well as part – time students enrolled for the first
time into the Master’s study programme Nursing Care. We have started with
the renewed Bologna undergraduate/first cycle study programme in Nursing in
2009/2010.
RESOLUTION ON THE NATIONAL PROGRAMME OF FOOD

AND NUTRITION POLICY 2005–2010 (RENPFNP)
In planning and implementing the nutrition policy in the Republic of Slovenia

(2005), the following principles shall be taken into account:
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Nadja PLAZAR and Tamara POKLAR VATOVEC: OPTIONS OF AYURVEDA IN NURSING AND DIETETICS
1. Respect of rights to healthy lifestyle, including healthy nutrition, and respect

of nutritional and cultural – specific nutrition regimes of the population in the
Republic of Slovenia.
2. Respect of ethnical principles – shared social, moral and environmental re-
sponsibility of all participants in a food chain: production, processing, distri-
bution and marketing of foods, and the responsibility of end food consumers.
3. Co-responsibility and proportional representation of all sectoral policies in the
implementation of nutrition policy and taking over of principles for formula-
tion and implementation of health-beneficial measures within joint and na-
tional agricultural policy and other policies for preservation and strengthening
of health.
4. Consideration of current scientific knowledge and professional development;
support to clinical and epidemiological research in the field of nutrition and
healthy lifestyle.
5. Special social concern for healthy nutrition and healthy lifestyle in the popula-
tion groups at risk.
6. Enforcement of the rights and consumer protection.
7. Active involvement of interested professional and laic public and of non-gov-
ernmental organizations.
8. Consideration of the financial possibilities of the state.
The importance of inter-sectoral cooperation and public services in planning
and implementing the nutrition policy from year 2005 to 2010 Formulation of ef-
ficient strategies in the implementation of nutrition policy requires coordinated
action of various ministerial sectors.
In the Republic of Slovenia, the central role in the creation and implementa-
tion of food policy strategies is played by the ministry responsible for health, the
ministry responsible for food and agriculture, the ministry responsible for edu-
cation, and the ministry responsible for higher education and science. In the im-
plementation of a few specific measures also participate some other ministries,
e. g. Ministry of labour, family and social affairs, as concerns nutrition regime in
elderly homes and student nutrition, and ministry responsible for the enviroment
via measures for environmental protection and the area of genetically modified
foods.
169
THREE PILLARS OF NUTRITION POLICY
WHO in its documents specifying the areas of food policy activities lays down
three basic pillars that are important for assuring safe and healthy nutrition:
1. Pillar of food safety – prevention of biological, chemical and physical contam-
ination of food or foodstuffs in all stages of food chain: production, processing
and marketing of foods, and in preparation/offer of food;
2. Pillar of well-balanced and protective nutrition – provision of optimal health
via healthy nutritional habits and healthy diet, particularly for the population
groups which are at risk from the health and socio – economic point of view,
and for groups with particular nutritional needs: children, child-bearing wom-
en, breast-feeding mothers, elderly and workers;
3. vPillar for assuring sustainable food supply – assurance of accession to hiqh-
quality and health-beneficial food which takes into account cultural – specific
ways of nourishment of the population and implements the development of
sustainable agricultural and environmental – protective policies.
HEALTHY NUTRITION
Healthy nutrition or healthy nourishment includes safe, energy- and nutrient-

balanced food, protective (functional) and biologically acceptable food in a spe-
cific cultural community which preserves and strengthens human health. In order
to achieve well-balanced nutrition, the norms or reference values for nutrients in-
take shall be used which are specific in relation to sex, age, physical activity and
other conditions. In recommendations are given the minimum amounts for indi-
vidual nutrient substances, which every person must take with food in order to
prevent the consequences of shortage, or maximum amounts to prevent chronic
diseases (Table 1).
RECOMMENDATIONS FOR NUTRIENT INTAKE
The recommended energy and nutrient composition of foods varies with re-
gard to the developmental period of each individual and his/her physical activity.
In Table 1 are given recommendations for energy shares, amounts and nutrient
170
density of individual nutrients for age group from 25 to 51 years. Some nutrient
values of foods may slightly vary from values in Table 1 with regard to the needs
of various age groups of the population; data for all age groups may be obtained
from the manual “Reference values for the intake of nutrients” (2004).
Table 1: Nutrition recommendations for the intake of nutrients or for nutrition

value of food for persons aged 25 to 51 years (Reference ..., 2004)
NUTRITION RECOMMENDATION
Energy intake must comply with energy use.
Share of total energy required from
Total fats < 30%1
Satured fatty acids < 10 %2
Trans fatty acids < 1%
Mono-unsaturated fatty acids > 10%
Omega-6 2.5%
Omega-3 0.5%
Carbohydrates > 50%
Mono and disaccharides (sugars) < 10%
Recommended daily intake
Proteins 0.8 g/kg body weight
Vegetables and fruit from 400 to 650 g/day
Folates in food > 400 μg/day
Dietary fibre 3 g/MJ - women
2.4 g/MJ - men
Sodium (as sodium salt) < 6 g/day3
Iodine4 200 μg (child-bearing women 230 μg/day,
breast-feeding mothers 260 μg/day)
1 workers performing heavy physical work may need higher percentage
2 more recent WHO recommendations state up to 7%
3 more recent WHO recommendations specify up to 5 g
4 these recommendations apply to countries Germany and Austria which have similar condition
in the field of iodine intake as in the Republic of Slovenia.
GUIDELINES FOR HEALTHY NUTRITION
For safe and healthy nutrition and in order to obtain the recommended nutrient
values and nutrition goals, a proper selection of foods is very important, as well
as the way of preparation of meals, and the rhtythm of nourishment.
171
Guidelines for healthy nutrition include:

– proper rhythm of nourishment: breakfast, lunch, dinner and two minor inter-
mediate meals, if possible (fruits and vegetables recommended);
– proper way of eating (slowly: 20-30 minutes for principal meals, 10 minutes
for intermediate meals);
– adequate distribution of daily energy intake with meals: breakfast 25%, morn-
ing snack 15%, lunch 30%, afternoon snack 10%, and dinner 20%;
– proper food composition to cover daily energy needs according to recommen-
dations for nutrient intake and consumption of more health-beneficial foods
(consumption of foods containing less total fats, saturated and trans fatty ac-
ids, and less sugar, a lot of dietary fibre, vitamins, minerals and substances
with antioxydant action), and
– healthy way of food preparation (physical and heat-treatment which preserves
the amount and quality of protective substances and does not use additional
fats, sugar and table salt, or uses them in the smallest possible manner, for in-
stance: cooking, simmering, food preparation in a convectional oven).
FOOD BASED DIETARY GUIDELINES (FBDG)
For the effective implementation of nutrition policy and the achievement of

nutrition guidelines and nutrition goals, nutrition instructions for healthy nutri-
tion shall be established on the basis of the state of unhealthy nutrition and the
consequences of unhealthy nutrition to health, based on nutrition patterns (FB-
DG-Food Based Dietary Guideliness). FBDG must be simple and comprehensi-
ble to the consumer and must inform him/her on how he/she should nourish him-
self/herself in order to preserve and improve his/her health. Because of specific
nutrition and health problems, food availability, cultural and other characteristics
of nutrition, and economic capacities, each state must formulate its proper dietary
guidelines (FBDG). In the Republic of Slovenia, the nutrition guidelines CINDI
WHO were adjusted to the circumstances in 2000. Nutrition guidelines for gen-
eral population, based on the recommended nutrition pattern and taking into ac-
count unhealthy nutrition in the Republic of Slovenia, are based on 12 steps to-
ward healthy nourishment.
Nutrition recommendations for population – 12 steps to healthy nourishment:
172
1. Enjoy your meal. Choose complete and varied food which should contain
more foodstuffs of vegetable than of animal origin.
2. Eat bread, pasta, rice and potatoes several times a day.
3. Consume a variety of vegetables and fruits several times a day (minimum
400 g daily). Select locally grown, fresh vegetables and fruit.
4. Be physically active in such an amount that your body weight is normal
(BMI 20-25).
5. Control the amounts of consumed fat (not more than 30 % of daily enrgy in-
take) and substitute most saturated fats (animal fats) by unsaturated vegeta-
ble oils.
6. Substitute high-fat meat and (fatty) meat products with legumes, fish, poul-
trymeat or leaner meat.
7. Consume daily the recommended amounts of reduced-fat milk and lesser
amount of fatty/reduced-fat and salty milk products (yogurt, curdled milk,
kefir, cheese).
8. Add moderate amounts of sugar and select foods with reduced sugar con-
tent. Limit the frequency of confectionery intake and consumption of sweet
drinks.
9. Eat less salty food. The daily salt intake shall not exceed 1 teaspoonful (6
g) of salt, including salt consumed with bread, ready-to-eat dishes and con-
served dishes.
10. If you drink alcohol, do not consume more than 2 units a day (1 unit is 10 g
of alcohol).
11. Prepare healthy and hygienic food. Suitable methods which influence the re-
duction of fat intake in food preparation are: cooking, simmering, baking, or
preparation in a microwave.
12. Most suitable for infants is exclusive breastfeeding up to six months of age
which shall be followed by an adequate supplementary diet in the first years
of life (Countrywide Integrated Noncommunicable Diseases Intervention -
CINDI, 2000).
The strategies and activities identified in the Resolution on National Nutrition

Policy Programme 2005-2010 are intended for the achievement of medium-term
objectives until year 2010 which are ambitious and attainable only if optimum
conditions (organizational, financial and human) are provided for the implemen-
tation of strategies and activities traced. The attainment of medium-term objec-
173
tives until year 2010 will significantly decrease health burden provoked by risk
factors and CNDs, and also with it the economic burden of the state.
Medium-term objectives of the Resolution on the National Nutrition Policy
Programme 2005-2010 are:
– to increase the intake of vegetables by minimum 30%;
– to increase the consumption of fruit by minimum 15%;
– to decrease the average share of ingested total fats by 20%;
– to decrease the average share of consumed saturated fats by 30%;
– to increase the consumption of dietary fibre by 20%;
– to increase calcium consumption with the aim of lowering by 25% the share of
population whose calcium intake is not sufficient (cf. nutrition recommenda-
tions);
– to increase the vitamin C intake by 15%;
– to decrease the amounts of daily consumption of alcohol by 35% in men, and
by 20% in women;
– to decrease the share of adult population which is overnurished and obese
(BMI>25 kg/m2) by 15%, and by 10% in children and adults;
– to achieve at least 60% exclusive breast-feeding to six months of child’s age,
and minimum 40% breast-feeding along with supplementary nutrition until
the child’s first year.
DIETARY RECOMMENDATIONS IN AYURVEDA
Ayurveda, the Science of Life, is a comprehensive system of natural health

care that originated in India more than 5000 years ago (Valiathan, 2006). It is still
widely used in India as a system of primary health care. Ayurveda has the knowl-
edge base and methodologies to provide health care throughout the course of life,
from the antenatal period to the geriatric stage. It provides simple, cost-effective
techniques that do not have the prevalence of toxic side-effects inherent in West-
ern allopathic medicine. There is a large body of research on Ayurveda that has
been conducted during the past 100 years. This research shows encouraging re-
sults in many areas of health care, especially the management of chronic disor-
ders associated with the aging process (Lazarou et al., 1998; Stewart et al., 2003).
According to Ayurveda, diet is one of the main pillars of health (Sharma et
al., 2007). Foods are categorized in several ways, one being according to taste.
174
Ayurveda describes six tastes: sweet, sour, salty, pingent, bitter and astringent
(Valiathan, 2003). Pungent foods are spicy hot and astringent foods have a drying
effect. Food affects the doshas in different ways (Table 2); therefore, one should
eat foods that are suitable to his/her psychophysiologic constitution or Prakriti to
mantain balance in the system. If the system is out of balance, foods can be used
in a therapeutic manner to restore balance to the doshas. For example, sweet, bit-
ter, and astringent foods reduce or pacify Pitta. Foods that are pungent, salty, and
sour increase Pitta. If a patient has vitiated Pitta that is causing a certain disorder,
it is recommended that he/she favor foods that decrease Pitta and avoid foods that
increase it.
Table 2: Some common examples of foods with the six tastes (Sharma et al.,
2007)
Tastes Foods
Sweet Sugar, milk, butter, rice, breads
Sour Yoghurt, lemon, cheese
Salty Salt
Pungent Spicy foods, peppers, ginger
Bitter Spinach, other green leafy vegetables
Astringent Beans, walnuts
Another factor to consider for dietary recommendations is the season. Differ-

ent doshas predominate during different seasons. The dosha predominance var-
ies depending on climatic conditions and geographic location, so it will not be
the same in every region of the world. The Indian subcontinent has six season:
spring, summer, rainy season, autumn, early winter, and late winter. Vata accunu-
lates during summer and is vitiated during the rainy season. Pitta accumulates
during the rainy season and is vitiated during autumn. Kapha acumulates during
late winter and is vitiated during spring (Table 3). The diet should be adjusted ac-
cordingly.
175
Table 3: How foods with the six tastes affect the doshas (Sharma et al., 2007)
Decrease Decrease Decrease

Sweet Sweet Pungent
Sour Bitter Bitter
Kapha
Salty Astringent Astringent
Pitta
Vata
Increase Increase Increase

Pungent Pungent Sweet
Bitter Sour Sour
Astringent Salty Salty
In general, Ayurveda recommends including lots of fruits and vegetables in

the daily diet. These foods contain phytochemicals (plant chemicals) that have
an abundance of health-promoting properties. Polyphenols and bioflavonoids are
phytochemicals that are powerful antioxidants. They have anticancerogenic ef-
fects, protect against heart disease, and increase immunity (Sharma et al., 2002).
ROLE OF HERBS AND SPICES IN HEALTH CARE
Common spices sauch as tumeric, coriander, cumin, ginger, garlic, and cin-
namon have significant therapeutic utility. Scientific studies have shown that tu-
meric has anticancer properties – it protects DNA and stimulates detoxifying en-
zymes (Piper, J. T. et al., 1998; Kawwamori et al., 1999; Limtrakul et al., 2001;
Aggarwal et al., 2003). Zumeric has anti-inflammatory properties (Chainani-Wu
et al., 2003) and is hepatoprotective (Deshpande et al., 1998). It is antibacterial,
antifungal, and promotes wound healing (Mahady et al., 2002). Tumeric protects
against heart disease: it decreases low-density lipoprotein (LDL) and trigliceride
levels (Babu et al., 1997), is antithrombotic (Olajide, 1999) and prevents lipid
peroxidation and aortic fatty streak formation (Quiles, 2002). Tumeric may pro-
tect against Alzheimer`s disease: it protects cells from beta-amyloid injury (Park
and Kim, 2002) and improves several aspects of Alzheimer`s disease in animal
models (Ringman et al., 2005). Common spices such as these are readily avail-
able, cost effective ways to prevent disease and in some cases provide treatment.
They can be used on a daily basis in preparing healthy meals.
Ayurveda`s materia medica is extensive, with more than 700 herbs described
in the ancient texts (Patwardhan et al., 2004). The herbs and herbal mixtures uti-
176
lized in Ayurveda are prepared by using the various parts of the plant (e.g., the
root, leaves, fruits, bark, seeds). Herbs are sometimes used singly but more of-
ten in combination to provide synergetic effects and mitigate toxic side-efects
(Mishra, 2004). Ayurveda does not recommend isolating the active ingredient
because toxic side effects can occur and the synergistic benefits are lost (Sharma,
1997).
Extensive research has been conducted on Ayurvedic herbs over the past 100
years (Mishra, 2004). One of them is Neem. It has beeen historically used for
treating a large number of disorders and few research had confirmed a broad
range of therapeutic properties (Subapriya and Nagini, 2005).
SWOT ANALYSIS FOR THE SUBJECT AYURVEDA
SWOT analysis is an extremely useful tool for understanding and decision-

making for all sorts of situations in business and organizations (Bell, 1988).
SWOT is an acronym for Strengths, Weaknesses, Opportunities and Threats (Ta-
ble 4).
Table 4: SWOT analysis for the subject Ayurveda
Strengths Opportunities
Quality of education Students and lecturer mobility
Innovative approach Science and research work
Global influences and local interest Cultural, attitudinal, behavioural influences and
Varied study course dialogue
Environmental effects Increased promotion of the study
Availability of modern technique for research Fast-paced lifestyle increases the demand for
wellness tourism and alternative cures
Weaknesses Threats
Absence of clear and well defined policies Uninterrupted implementation of the subject
Limited budget Fear of accepting novelties
Market demand Lack of professionalism and traditional work
Unknown obstacles faced Accreditations of the subject
Possible negative publicity
With SWOT analysis, we would like to show the importance of including

the subject Ayurveda in postgraduate fields of Nutrition Counselling – Dietetics
study programme, since we have noticed that in Slovenia Ayurveda is becoming
177
an important added value of Health tourism, nevertheless the Ayurveda course

contents have not yet been included in the curricula.
OPTIONS OF AYURVEDA IN NURSING AND DIETETICS
The secret of well being was discovered long ago at Slovenia’s thermal and
mineral springs. Archaeological excavations from the Roman period bear witness
to the rich history of thermal baths in Slovenia, written documents about our ther-
mal waters date back to 1147, and the healing qualities of our mineral water have
been appreciated throughout Europe for more than four centuries (Pahar, 2002).
First discovered by local people, the beneficial effects of the healing springs
gave rise to new methods of treatment, and in recent decades new health resorts
have developed at Slovenia’s springs.
At the intersection of roads leading from north to south and west to east, Slov-
enia has always been part of the culture of the Old Continent. In the period when
Central European health spas flourished, health centres developed in Slovenia
that today represent the foundations of our health resort tourism. At the same
time, due to the healing qualities of their natural elements, our health resorts
maintain a special status in Slovenia’s health care system as well as close ties
with the medical profession.
Fifteen Slovenian health spa and tourist centers take pride in their certi-
fied status as natural health resorts. The growing reputation of these health re-
sorts over the last few years has encouraged others to study Slovenia’s natural
assets more intensively and thus contribute to establishing new tourist bathing
centers.
The development and recognition of Slovenia’s health resorts was encouraged
by the wealth of natural assets in our country. The most important are thermal wa-
ters of various qualities and temperature (from 32°C to 73°C) and mineral waters
such as the world famous Radenska Three Hearts and Donat Mg followed by sea
water and brine, organic and inorganic peloids, and finally the Mediterranean,
Pannonian, and sub-alpine mountain micro-climates. The wealth of Slovenia lies
in its diversity (Šribar, 2003).
Vineyards reign on the hills of the sub-alpine world. Below the surface of the
Karst region are fascinating limestone caves. The alpine world is interlaced with
river canyons and adorned by waterfalls and glacier lakes. On one side, the Alps
178
descend into the green Pannonian plains and on the other toward the blue Adri-
atic Sea.
In this green oasis of Europe, there is an abundance of the most varied cultural
sites ranging from Roman remains to medieval castles, and ancient monasteries.
The folk tradition remains extremely vigorous, reflected in the preservation of
ancient crafts, customs, and typical regional cuisine.
At Slovenia’s health resorts, knowledge, experience, the natural surroundings,
and the character of the country are interwoven with the friendliness of the hosts.
In this harmonious mosaic of health and well being, everyone finds what they
truly desire and need.
Because the modern lifestyle has brought many previously unknown prob-
lems, Slovenian health resorts applying natural healing measures have developed
various new methods of treatment and new programs for the prevention of diseas-
es that take fully into consideration modern scientific research in various fields
of medicine.
Some years ago, our Western culture accepted the concept of the close link
between the body and the mind. Therefore, their health resorts offer not only bal-
neotherapy and physiotherapy services but also other kinds of modern therapies
based on education and learning.
Far from the city noise and the ever faster pace of modern life, we can discover
the secrets of unspoiled nature and devote time to ourselves in Slovenia’s health
resorts and thermal spa centers. There we can spend pleasant family holidays, do
something for ourselves, for our body and spirit, and improve our physical and
mental condition. This is made possible by well equipped health and recreation
centres where we can swim, jog, stroll, exercise on various equipment and play-
ing fields, play golf and tennis, bowl, ride horses, ski, enjoy mountain-biking, and
at the same time learn to live in a more healthy way.
And because an exercised and active body also enjoys exercising the spir-
it, these health resorts organize social, cultural, and folklore events and provide
plenty of opportunities for excursions.
Until now we haven`t participated in the field of Ayurveda and collaboration
opportunities for international mobility of teaching staff and students, practical
training placements, research projects and exchange of good practice were very
rare. Bio wellness programmes are very popular in Slovenia but the possibility of
the introduction of healthy organic meals as part of them is still uncertain. In her
179
dissertation (2009) Rama finds out that in fifteen Slovenian Natural Health Spas
only two offer Ayurveda treatment and counselling.
Health Tourism is closely linked with the health service and quality food
(Ćoralić, 2006). Spas, which have a medical indication for a particular disease,
must have a proper diet. Diet therapy is for a sick person, in spas means food re-
convalescents who are also users of the tourism offer (Repnik, 2003). Proper and
personalized diet in spas not only represents the basic food supply for guests with
special needs, but can also be included in a number of modern methods of treat-
ment and programmes for disease prevention, as well as Ayurveda.
REFERENCES
Aggarwal, B. B., Kumar, A., Bharti, A. C. (2003): Anticancer potential of curcu-

min: Preclinical and clinical studies. Anticancer Res, 23, 363-398.
Babu, P. S., Srinivasan, K. (1997): Hypolipidemic action of curcumin, the active
principle of tumeric (Curcuma longa) in streptozotocin induced diabetic rats.
Mol Cell Biochem, 166,169-175.
Bell, L. M. (1988): Managerial marketing: strategy and cases. New York, El-
savier.
Chainani-Wu, N. (2003): Safety and anti-inflammatory activity of curcumin: A
component of tumeric (Curcuma longa). J. Altern Compement Med, 9, 161-
168.
CINDI. Dietary Guide WHO Regional Office for Europe, EUR/00/5018028.2000.
Ćoralić, S. (2006): Načrtovanje jedilnikov in dietetsko svetovanje v zdraviliščih
in bolnišnici: diplomska naloga. Portorož: Univerza na Primorskem, Fakulteta
za turistične študije Turistica.
Deshpande, U. R., Gadre, S. G., Raste, A. S. et al. (1998): Protective effect of tu-
meric (Curcuma longa L.) extract on carbon tetrachloride-induced liver dam-
age in rats. Indian J Exp Biol, 36, 573-577.
Herman, I. (2002): Ponudba dietne prehrane v zdraviliškem turizmu: diplomska
naloga. Portorož: Univerza na Primorskem, Fakulteta za turistične študije Tu-
ristica.
Kawamori. T., Lubet. R., Steele, V. E. et al. (1999): Chemopreventive efect of
curcumin, a naturally occurring anti-inflammatory agent, during the promo-
tion/progression stages of colon cancer. Cancer Res, 59, 597-601.
180
Limtrakul, P., Anuchapreeda, S., Lipigorngoson, S., Dunn, F. W. (2001): Inhibi-

tion of carcinogen induced c-Ha-ras and c-fos protooncogenes expression by
dietary curcumin. BMC Cancer, 1, 1.
Lzarou, J., Pomeranz, B. H., Corey, P. N. (1998): Incidence of adverse drug reac-
tions in hospitalized patients. JAMA, 279, 1200-1205.
Mahady, G. B., Pemdland, S. L., Yun, G., Lu, Z. Z. (2002): Tumeric (Curcuma
longa) and curcumin inhibit the growth of Heliobacter pylori, a group I car-
cinogen. Anticancer Res, 22, 4179-4181.
Mishra, L. C. (ed.) (2004): Scientific Basis for Ayurvedic Therapies, New York:
CRC Press.
Olajide, O. A. (1999): Investigation of the effects of selected medicinal plants on
experimental trombosis. Phytother Res, 13, 231-232.
Pahar, K. (2002): Health Spas in Slovenia. Adria Airways inflight magazine. 50-
65.
Park, S-Y, Kim, D. S. H. L. Discovery of natural products from Curcuma longa
that protect cells from beta-amyloid insult: A drug discovery effort against
Alzheimer`s disease. J Nat Prod, 65, 1227-1231.
Patwardhan, B., Vaidya, A. D. B., Chorghade, M. (2004): Ayurveda and natural
pruducts drug discovery. Curr Sci, 86, 789-799.
Piper, J. T., Singhal, S. S., Salameh, M. S. et al. (1998): Mechanisms of anticarci-
nogenic properties of curcumin: The effect of curcumin on glutathione linked
detoxification enzymes in rat liver. Int J Biochem Cell Biol, 30, 445-456.
Plazar, N., Černe, D., Čemažar, M., Vouk Grbac, L., Bučar Miklavčič, M. (2006):
Vloga za pridobitev soglasja k študijskemu programu prve stopnje “Prehran-
sko svetovanje – dietetika”. Izola: Univerze na Primorskem, Visoka šola za
zdravstvo.
Plazar, N., Trobec, I., Barlič-Maganja D., Uršič Jakomin K. (2008): Vloga za pri-
dobitev soglasja k prenovljenemu bolonjskemu visokošolskemu študijskemu
programu prve stopnje “Zdravstvena nega”. Izola: Univerza na Primorskem,
Visoka šola za zdravstvo.
Plazar, N., Trobec, I., Čemažar, M., Černe, D., Barlič-Maganja, D., Žvanut, B.
(2008b): Vloga za pridobitev soglasja k študijskemu programu druge stopnje
“Zdravstvena nega”. Izola: Univerza na primorskem, Visoka šola za zdravstvo.
Quiles, J. L., Mesa, M. D., Ramirez-Tortosa, C. L. et al. (2002): Curcuma longa
Extract supplementation reduces oxidative stress and attenuates aortic fatty
streak development in rabbits. Arteriscler Thromb Vasc Biol, 22, 1225-1231.
181
Rama, S. (2009): Vključevanje ekoloških jedi v ponudbo biowellnessa: diplom-

ska naloga. Portorož: UP Fakulteta za turistične študije Turistica.
Ministrstvo za zdravje Republike Slovenije (2004): Reference values for the in-
take of nutrients. Ministrstvo za zdravje Republike Slovenije, Ljubljana, 214.
Repnik, S. (2003): Analiza prehrane v slovenskih naravnih zdraviliščih: diplom-
ska naloga. Portorož: Visoka šola za turizem Turistica.
Resolution on the national programme of food and nutrition policy 2005-2010.
Uradni list Republike Slovenije, 15, 39, 3681 – 3728.
Ringman, J. M., Frautschy, S. A., Cole, G. M. et al. (2005): A potential role of
curry spice curcumin in Alzheimer`s disease. Curr Alzheimer Res, 2, 131-136.
Sharma, H. M. (2002): Free radicals and natural antioxidants in health and dis-
ease. J Appl Nutr, 52, 26-44.
Sharma, H., Chandola, H. M., Singh, G., Basisht, G. (2007): Utilization of Ay-
urveda in Health Care: An Approach for prevention, health promotion, and
treatment of diseases. Part 1 - Ayurveda in Primary Health Care. The journal
of alternative and complementary medicine, 9, 1011-1019.
Sharma, H., Chandola, H. M., Singh, G., Basisht, G. (2007b): Utilization of Ay-
urveda in Health Care: An Approach for prevention, health promotion, and
treatment of diseases. Part 2 - Ayurveda in Primary Health Care. The journal
of alternative and complementary medicine, 10, 1135-1150.
Sharma, H. M. (1997): Phytochemical synergism: Beyond the active ingredient
model. Altern Ther Clin Pract, 4, 91-96.
Stewart, B. W., Kleihus, P. (eds.) (2003): World Cancer Report. IARC Press, In-
ternational Agency for Research on Cancer, Lyon, France.
Subapriya, R., Nagini, S. (2005): Medicinal properties of neem leaves: A review.
Curr Med Chem Anticancer Agents, 5, 149-156.
Šribar, R. (2003): Slovenska zdravilišča. Celje: Skupnost slovenskih naravnih
zdravilišč
Valiathan, M. S. (2006): Towards Ayurvedic Biology: A Decadal Vision Docu-
ment. Indian Academy of Sciences, Bangalore.
Valiathan, M. S. (2003): The Legacy of Caraka. Orient Longman, New Delhi,
India.
182
AYURVEDA – MORE THAN JUST WELLNESS: ABOUT THE
AYURVEDIC TREATMENT OF AN 82 YEAR-OLD WOMAN
WITH CUSHING-SYNDROME
Harsha GRAMMINGER
The following article tells the story of an 82 year-old patient, who had brain
surgery in October 2008, who had a life-long history of taking medications and
who has most recently been in and out of hospitals due to her various problems.
The reasons for her hospitalizations were first gastroenteritis, followed by peri-
carditis, cystitis, and oral Candida Albicans. Additionally she suffered from
KHK, hypertension, chronic gastritis, ama (toxicity), deep seated sorrow and
suppressed anger. According to her complaints as she mentioned them to the doc-
tors she was given steroids and antibiotics, which worsened her symptoms, put
her in a state of weakness and eventually deprived her of the will to live. The au-
thor took on this case on January 9th 2009.
CONDITION OF PATIENT IN JANUARY 2009
General diagnosis
Treated hypertension for the last 35 years. Facial paresis on left side in 1992.
Rezidivstruma diffusa et nodosa grade 1 in 2008 which was no change to an
earlier diagnosis 2 years ago. Knot strumaectomy in 1972. Radioiodinetherapy
in 1994 due to multifocal autonomie. Cholecystectomy in 1973. Coronary heart
disease for 30 years. Non-cardiac-caused dyspnea for many years. Chronic in-
somnia.
183
Symptoms
Moon-face, muscular atrophy-and weakness, edema on calves and ankles both
sides, strong dyspnea, dry cough, tachycardia, arrhythmea, glossitis.
Recent medical history

Hightened susceptibility to infections with 3 hospitalizations within the last 3
weeks; development of gastroenteritis (December 14-16 2008), pericarditis (De-
cember 17-23 2008), followed by cystitis and fungal infection in her mouth and
throat (January 9-12 2009). The patient complained about strong, burning pain in
her mouth and was no longer able to eat normally, which led to a weight loss of 4
kg within a week. She was suffering from dizzyness with diagnosed normotonia,
which led to her falling and developing hematoma despite the use of a walker.
She was found lying in her bathroom and was taken to a nearby hospital for
the third time within weeks.
Laboratory (January 9, 2009)

Low potassium levels of 2,5mmol/l, GPT 50 (35), Gamma-GT 53 (40), urea
raised up to 63 (10-50), low calcium levels, low protein levels
Medication found (January 9, 2009)

Dexamethason 4mg (1-0-0, since December 17, 2008): to treat inflammation
in pericarditis
Carvedilol 25mg (1-0-1): Betablocker, with additional effect of alphablocker
and vasodilator, patient has taken various betablockers for 35 years
HCT 12,5 (1-0-0): Thiacide-diuretic, also other diuretics for about 30 years
Omep 20mg (0-0-1): Omeprazol is a protone-pump-blocker, in exchange
with other antacids for about 50 years
Panthenol Lsg. (4xdaily)
Nystatin Pipette (4xdaily): for oral fungus
Kalinor Brause (1-1-1) for potassium substitution
Case-intake by Ayurvedic viewpoints

During her last stay at the hospital the patient also underwent an Ayurvedic ex-
amination on the 9th of January. The patient was weak and unable to prop herself
up in her bed. Her eyes were cloudy, the skin ashen-yellowish, and her tempera-
ture was slightly high (38°C).
184
Harsha GRAMMINGER: AYURVEDA – MORE THAN JUST WELLNESS: ABOUT THE AYURVEDIC TREATMENT ...
Prakruti: V1/P2/K3
Vikruti: V3.5/P3/K3
Vata pushing Pitta in Rasadhatu: pericarditis, cystitis, fever, low agnis (loss
of appetite, weight loss, hypocalcaemia, hypoproteinemia)
Oja Kshaya (loss of ojas): immune system weakened due to above factors
(=proneness to infections)
Vata pushing Pitta in Raktadhatu: liver metabolism disturbed, yellowish
skin, raised liver enzymes
Blocked Kapha: despite diuretics she still had strong edema on both legs
Amlapitta: acute and chronic gastritis Red tongue
The doshas have left their seat (Stanasamsrya) and have joined the dhatus,
and are now blocking or disturbing the srotas.
Stage of disease (January 9, 2009)

– Viakti, stage 5 (manifestation of disease): here with Cushingsyndrome
– Bheda, stage 6 (complication, differentiation, I.e. irreversible disturbances):
I.e. muscular atrophy, edema (reversible, but difficult to heal), gout tophia on
both hands (irreversible)
The six stages of disease
185
Condition of Vata-subdoshas:
– disturbed prana vayu: strong dyspnea, dizzyness, difficulty swallowing, diffi-
culty focusing, weakened short-term memory, difficulty hearing on right side,
irritability
– disturbed udana vayu: dry cough, difficulty swallowing, no desire to heal
– disturbed samana vayu: reflux esophagitis
– disturbed vyana vayu: dry skin, blocked metabolism · disturbed apana vayu:
diarrhea, opstipation, hemorrhoids, bloating, arhythmea
Condition of Pitta-subdoshas:
– disturbed pachaka pitta: due to suppresion of gastric acid with Omeprazol di-
gestion, absorption (deepan) and assimilation of food are disturbed
– disturbed ranjaka pitta: chronic digestive problems, cholecystitis, raised liver
enzymes, hyperurecemia
– disturbed sadhaka pitta: clouded consciousness, anger
– disturbed bhrajaka pitta: thin, spotty/blotchy skin, poorly healing lesion on her
right ankle
Condition of Kapha-subdoshas:
– disturbed kledaka kapha: protonepump- blocker is blocking hydrochloric acid
in stomach, which decreases production of protective mucous-layer, the natu-
ral balance of digestion is disturbed
– disturbed avalambaka kapha: first pericarditis, acute cough and dyspnea
– disturbed bodaka kapha: glossitis, candida albicans in mouth and throat
– disturbed tarpaka kapha: unsteady memory due to meningeoma extirpation
Condition of dhatus:
Weakened Mamsa and Asti dhatu (kshaya) due to intake of Dexametason.
Condition of srotas:
You can see in chart 1 just how strongly our nutrition, but also medications
influence our metabolism and disturb our srotas from an Ayurvedic perspective.
Chikitsa - Ayurvedic Treatment

Internal medication was kept almost completely at first, but Ayurvedic medi-
cation was given at the same time.
186
CONVENTIONAL MEDICINE (JANUARY 9, 2009)
Dexamethason 4mg (1-0-0, since December 17, 2008): to treat inflammation

in pericarditis
and vasodilator
HCT 12,5 (1-0-0): Thiacide-diuretic
Omep 20mg (0-0-1): Omeprazol is a protone-pump-blocker
Nystatin Pipette (4xdaily): for oral fungus
Novalgin drops (20-20-20): as needed
Ciprofloxacin TAD 100mg (1-0-1): antibiotic treatment for cystitis
Additional Ayurvedic medication (as of January 10, 2009)

Bai 47 (1-1-1) for continuous stomach pain and heart burn (antacid)
Bai 39 (1-1-1) regeneration of mucous membranes during and after fungal
infection
Bai 91 (1-1-1) cortisone replacement, to be able to reduce and replace Dex-
amethason Immediate stop of Omep 20 mg, reduction of Dexamethason to 2 mg
over 2 days
Progression: The patient did suffer stomach pain for 3 more days and was
still very weak.
On January 13 2009 the patient was moved to a nursing home near the Eu-
roved clinic. Because of her weakness it was not possible for her to stay at home
by herself. She was unable to turn in bed, but was able to walk a few meters in her
room with the aid of a walker. As of January 14 the patient was now solely cared
for by the author, both conventionallys well as Ayurvedically. All medicines were
adjusted to the “is-condition” of the patient.
CONVENTIONAL MEDICATION (AS OF JANUARY 14, 2009)

and vasodilator
187

Nystatin Pipette (4xdaily)
Novalgin drops (20-20-20), as needed (no longer needed)
Dexamethason discontinued

Bai 47 (1-1-1) for continuous stomach pain and heart burn (antacid)
Bai 39 (1-1-1) regeneration of mucous membranes after fungal infection and
under this medication (Kapha increase)
Bai 91 (2-2-2) cortisone replacement
Purnavadi Guggulu (2-2-2) for strong edema (tibial and ankle)
Srota Dushti
Srotas Dushti Hetu Laxanas
Prakara (Type
(affected channels) (Etiology) (Symptoms)
of disturbance)
lack of exercise, steroids, dyspnea, bronchial
Prana Vaha Srotas Sanga
Emotional stress, cold water stagnation, hypoxia
low appetite, loss of
wrong food combination,
taste, dyspepsia, nausea,
chron indigestion, disturbed
meteorism, stomach pain,
Anna Vaha Srotas Sanga agni, emotional eating, heavy
heart burn, diarrhea and
food, kapha increasing food,
opstipation, glossitis,
Medications and steroids
gingivitis
chronic indigestion, strong
perspiration, fear, emo
Ambu Vaha Srotas Sanga edema, dry skin
stress, sour food, cheese,
medications
heavy, oily, fatty food, low agni, low appetite, fever,
overeating, hard-to-digest edema, tinnitus previous
food, too many thoughts, hypertonia, fear, tachycardia
Rasa Vaha Srotas Sanga emo. stress, wrong food and arrhythmea, sigan of
combining, lack of trust, ama ama: body aches, heavy
(toxins), medications l. e. feeling, poor sense of smell
steroids and taste, low enthusiasm
188
sour, fatty, oily food, wrong

food combining, medications glossitis, hate, anger,
Rakta Vaha Srotas Sanga
/ steroids, suppressed anger, jealousy
hate
excessive
proteinconsumption, hard-to-
digestfood (dairy and meat), muscle pain, muscle
Mamsa Vaha Srotas Sanga wrong food combining, twitching in face, tiredness,
sleeping during the day, muscular atrophy
medications / steroids,
elevated liver enzymes
poor eating habits, sleeping
during the day, lack of
exercise, overeating,
overweight, previous lipoma,
Meda Vaha Srotas Sanga emotional stress and
hypertonia, dyspnea
unresolved emotions,
medications, all reasons as in
Mamsa Vaha Srotas
stiffness of joints, autonomy
of thyroid, years of
hormontherapy during gout tophia on all fingers,
Asthi Vaha Srotas Sanga
menopause - more than 20, poor dental health
vata emotins like loneliness,
insecurity in life
poor eating habits, trauma meningeoma, known facial
(brain surgery), hectic life nerve paresis, prev. tinnitus,
Majja Vaha Srotas Sanga style, emo. stress, unresolved insomnia, fear, dizzyness,
emotions, medications / stiffness of joints, lumbar
steroids syndrom known
poor eating habits, lack of
Ati Pravrutti exercise, emotional eating, diarrhea, constipation,
Purisha Vaha Srotas (excessive medications / steroids, emo. hemorrhoids, meteorism,
flow) stress, grief, fear, loneliness, negative thoughts, insomnia
insecurity
extreme wishes, sorrow, fear,
anger, obsessive thoughts,
feelings and emotions, anger,
irritability, hatred, jealousy, nagative thinking, wrong
Mano Vaha Srotas Sanga envy, pride, ambition, perception , no goals left in
presumptuousness of own life
self, stinginess, attachment to
matter, greedy, medications
/ steroids
189
Findings on January 14, 2009

No more stomach pain, reduced fungus, patient felt a little stronger and was able
to walk to the hallway with walker. Appetite was better. Blood pressure normal.
CHANGED MEDICATION AS OF JANUARY 17, 2009
Conventional medication (as of January 17, 2009)

and vasodilator
Nystatin Pipette (4xdaily)
Kalinor Brause (1-1-1)

Bai 15 (1-1-1) nerve tonic, with balancing effect
Bai 47 (1-1-1) antacid effect
Bai 39 (1-1-1) regeneration of mucous membranes, source of estrogen to bal-
ance hormones, general strengthening
Purnavadi Guggulu (2-2-2) for remaining ankle edema
Bai 24 (1-2-2) diuretic
Bai 50 (1-1-1) for support of liver function Findings on January 17, 2009
Blood pressure 120/80, pulse still elevated and weakened:
V 3,5 P 2, K 3, no specific desire to live, can wash herself without help, very
moody, still adenomatous, energy still blocked (sanga), stool rather dry. Patient
sleeps day and night. Oral candida no longer visible. 2 more days of antifungal
medication.
Conventional medication
and vasodilator
190

Additional Ayurvedic medication

Bai 15 (1-1-1) nerve tonic, with balancing effect
Bai 24 (1-2-2) diuretic
Bai 50 (1-1-1) for support of liver function
Other therapeutic measures

bi-weekly lymph drainage
Findings on January 20, 2009 For the first time Mrs. K. had been outside
taking a walk of 60 meters. She had a negative attitude, but accomplished the
task. Edema are barely visible anymore, only slightly on her ankles. Blood pres-
sure is steady, pulse still elevated but stronger. She now takes her meals in the
dining room with other people. Bowel movements are regular.
Laboratory (January 27, 2009)

Gamma GT still elevated, protein levels a little low, potassium normal, cal-
cium levels a little low.
and vasodilator
191

Bai 15 (1-1-1) nerve tonic, with balancing effect, improves concentration
Abana (1-1-1): heart tonic, to substitute beta-blockers later on
Mahalaxmivilas Ras (1-0-0) strengthens heart and lungs, helps to make
change happen
Findings on January 29, 2009

BP 110/70, trouble hearing on right side, pulse stronger and a little more mel-
low, she no longer sleeps so much and takes regular walks in the hallway

physical therapy with active exercises and continued lymph drainage
CHANGED MEDICATION AS OF FEBRUARY 2, 2009
and vasodilator
Kalinor Brause (half a tablet in the morning)

192

change happen
Findings on February 2, 2009

BP 110/70, pulse stronger and more regular Vikruti V3 P3 K3, better mood,
positive attitude, speaks English again and talks to others, climbs stairs with the
help of a therapist, is much more flexible, can easily turn in her bed, regular bow-
els. Preparation for discharge on February 8, she is excited and works with the
medical team to make this happen.

daily active physical therapy and 3x a week a full body massage
Changed medication as of February 6, 2009
Carvedilol 25mg (0-0-0): no more beta-blockers!!
HCT 12,5 (0,5-0-0): reduced
Kalinor Brause (0,5-0-0)

unchanged
Findings on February 6, 2009

BP 120/80, edema completely gone. The patient walks safely with her walker
and could probably even make a few steps without it. She takes life into her own
hands and organizes her home with the help of a care-taker who is supposed to
care for her 4 hours a day in her home. This is the patients plan as of February
9, 2009. After that, a reduction in hours of the care taker is planned. Addition-
ally, she will continue the physical therapy 5x a week to become more self-reliant
and secure. For the first few weeks she will receive her meals through a delivery
service.
193
LAST CHANGE OF MEDICATIONS ON FEBRUARY 8, 2009
HCT 12,5 (0-0-0): discontinued
Kalinor Brause (0,5-0-0)

Purnavadi Guggulu (2-2-2) only transitionally, until fluids are back in bal-
ance
change happen
194
Findings on February 8, 2009 BP 110/70, stable pulse, Vikruti V 2 P 3 K 3

has a poor sleep, as she was excited to go home, has had watery stools (excite-
ment). She is still a bit fearful, but believes she can manage her life in her own en-
vironment again. She can move well and is able to cook small meals for herself.
Conclusion
The condition of the patient improved dramatically, after the author not on-
ly substituted the corticosteroid with Boswellia Serrata (Bai 91) little by little,
but also the other medications that were prescribed to the patient over at least
35 years. Even the betablocker and the diuretic could be replaced by Ayurvedic
preparations.
Most of the symptoms turned out to be side effects of her many medica-
tions. The only remaining medication is currently still half a tablet of Kalinor
Brause, which she needs to substitute her loss of potassium. The changed pre-
scriptions not only lead to the survival of the patient, but granted her the ability to
move back into her home and take charge of her own life with the help of a care
taker. The biggest success in the eyes of the author is the fact that after so many
195
years of conventional therapies and the resulting reduction of agni (digestive fire)
and the almost complete loss of ojas (life force, immunity) the patient is - after a
short Ayurvedic treatment - on her way to being healthier and full of energy - than
she has experienced before. On February 11, 2009, the patient is boosting with
energy in her own home, goes outside every day and has already handled a bro-
ken pipe incident in her house.
196
THE ROLE OF AYURVEDA IN EARLY DIAGNOSTICS OF
DISEASE
Biljana DUŠIĆ
Although brought to life in ancient history of mankind, Ayurveda still has a

lot to give to modern man and a lot to teach modern medical science. Founded
on certain basic axioms of Life, as known to ancient sages and seers of India, it
lived and confirmed relevance, practical acuracy and usefulness of its principles
all through many centuries of history up to now. As time passed by, Ayurveda
kept on incorporating new knowledge of many generations of enlightened prac-
titioners of Ayurveda, as well as of medical systems which got into close contact
with Indian soil and, of course, with Ayurveda (namely, and mostly, Arabic unani
medicine) – but its basic principles, layed out by its fathers Caraka and Sushruta,
stayed unchanged, and are still taught as such at Universities of Ayurveda and by
traditional Ayurvedic teachers all through India.
As an introduction to its important role in early diagnostics of disease, I would
like to stress the fact that in dealing with three creative forces in nature and our
psycho-somatic reality – vata, pitta and kapha – we always deal with non-physi-
cal forces, representing universal principles of movement (vata), transformation
(pitta) and form-giving (kapha). They are representatives - in our human universe
– of basic trinity of manifested Universe. So when learning about Ayurveda’s
theoretical and also practical aspect, it is important to be aware that ‘sharira’ is
not anatomy, nor ‘kriya sharira’ is physiology as we know it in today’s modern
medical science. They are describing subtle forces of Universal life building and
operating through our mind and body, which wrap in different ‘garments’ on dif-
ferent levels of manifestation.
Let us take an example of vata fluid or force, which governs all movements in
our mind and body, as it is the principle of movement itself. Movements of our at-
197
tention, thoughts, mobilizing contents of memory into actual conscioussness and

back to memory storage, movements of electric impulses along nervous system,
peristaltic movements, movements of lungs, of vocal cords, eyes, movements of
substances across cell membrane, membrane of lung alveoli... they are all gov-
erned by it. Its parent is Universal prana, and through vata fluid our bodies and
minds are part of Universal prana. As vata is descending from the plane of mind,
where it is still of pranic, etheric nature, towards physical body, it partly gets
‘condensated’ into next element of air, which is present in sinuses of the head,
ventricles of the brain, bladder, digestive tract, bones... Those elements (ether &
air) are conditioning mind and body through their qualities or attributes – air, as
wind, is (without other influences) dry and cold (to mention just a few of its at-
tributes), ether is subtle and all pervading. When vata is pathologicaly increas-
ing, movements across cell, endothelial, mucous... membranes everywhere in the
body is increased, as well as all other movements within the body and mind. (Vata
is responsible, let us remember, just for movement – contents of life processes,
i.e. enzymatic part of cell processes, catabolic and anabolic functions... are gov-
erned by pitta or/and kapha creative forces – and those two are as well moved
along the body by vata.)
If movement is excessive, no mind or body process can proceed naturally and
develop its full potential. There is no time, because to fast a movement, for finish-
ing, for example, enzymatic action properly, or for substances (or thoughts) to be
properly formed and stored in their natural places. The mind is becoming lighter
and more diffuse, the body more dry and cold, tissues undernourished.
Now, in Ayurveda it is stated that vata, pitta and kapha, even though they are
all present in every tiny part of the body and mind, have their ‘homes’ in digestive
tube. It means that, when imbalanced, they tend to accumulate in certain parts of
digestive tract: vata in large intestine, pitta in small intestine and kapha in stom-
ach. So physician should pay close attention to the symptoms of digestive system,
as described by the patient, if the disease is to be catched in its early and prevent-
able or easily curable state. Another aspect of life which should be followed by
patient him/herself and by physician, is the mind and subtle changes in its atti-
tudes, moods, predominant feelings and patterns of sleep. Often, even before in-
crease of creative forces gives recognizable symptoms in the digestive system,
some subtle changes at the plane of mind can be detected. At this point it is good
to pause and note how Ayurveda presupposes certain inner composure, position
of silent observer within ourselves, which is enabling us to be aware of contents
198
Biljana DUŠIĆ: THE ROLE OF AYURVEDA IN EARLY DIAGNOSTICS OF DISEASE
of our minds all through the day, at the same time being involved in events at the
stage of life. Only in this way, we may follow state of creative forces within us
and act timely to prevent disease or be accurate in mentioning all symptoms to
our Ayurvedic doctor.
Disease develops in six stages, states Ayurveda. First stage of patophysiologi-
cal process is called sancaya and in this stage vata, pitta or kapha are accumulat-
ing in their ‘homes’, are thus becoming doshas (‘dosha’ literally means ‘ fault,
vice’), giving there first specific symptoms. Second stage is still happening in
digestive tube. Its sanskrit name is prakopa, which literally means ‘rage’. At this
stage doshas become vitiated, ‘enraged’, and are not just accumulated, but also
with expansive movement (and greater force) press to the walls of digestive tract.
Symptoms are similar as in the first stage, but more pronounced, and sometimes
some reflected symptoms may be present in the body outside digestive tract.
While the disease is still developing in the digestive system it is easily curable
– doshas are just expelled out of digestive system, using some prescribed prac-
tices. But if not caught and cured at this stage, disease proceeds to its next stage,
prasara, which means ‘overflowing’. Doshas are spreading through blood and
lymph outside digestive tract and get in touch with tissues and their waste mate-
rial, mixing with them. At this stage some other specific symptoms begin to oc-
cur outside digestive tract, while symptoms in digestive system may increase. But
sometimes, as with overflowing the pressure upon its walls diminishes, the symp-
toms within digestive system may transiently subside. After overflowing, doshas
relocate, sthana samsraya, and get fixated to specific sites in the body, rooting
themselves in tissues which are inherently weak, or are weakened by some ill-
ness. The symptoms are fixating too to this new ‘home’ of the dosha(s), vitality
of the patient is dicreasing, and disease is getting difficult to cure. This represents
the fourth stage in disease-developing process. It is only at the fifth stage of mani-
festation, vyakti, that specific symptom complex of the disease is manifested in
its entirety, and only at this stage modern western medicine can catch the disease
with its diagnostic instruments and give it a name. However, treatment at this
stage is becoming very difficult. The last, sixth stage is called bheda, and at this
stage the disease is developing and becomes chronic, with vitality of the patient
being quite low. Therefore the disease is very difficult to cure and even if it is
possible, the process takes a long time and a lot of effort. More often at this stage
palliation is the only thing that can be expected from the treatment.
199
This is just a brief and general outsketch of disease-developing process, given

in hope to offer an idea how with its simple, practically sound and theoretically
wide outlook of disease process, Ayurveda is offering us different, but deep in-
sight in understanding disease development. Not just useful in helping patients
and educating population, this outlook may be possible inspiration to look upon
many new diseases of today as possible phases of greater disease process(es),
which can easily be spotted, if only just for a moment, when we are open to use
some other, different point of view.
200
MEDITATION INDUCES GENE EXPRESSION CHANGES
Metka RAVNIK-GLAVAČ
INTRODUCTION
Meditation is a part of psychotherapeutic practice, which is also incorporated

in Ayurvedic holistic approach of healthcare and lifestyle. Meditation has become
an increasingly popular practice worldwide. It has been identified as a powerful
and effective tool in developing greater sense of emotional balance and well-
being
On the level of human being meditation was found to be benefical in reducing
anxiety, stress, pain and in improving learning ability, sleeping patterns, sensory-
motor performance. Several hundred studies have reported evidence of medita-
tion practices being connected to clinical, physiological and neuropsychological
changes. They include decreased oxygen consumption, decreased carbon dioxide
elimination, reduced blood pressure, reduced heart and respiration rate, promi-
nent low frequency heart rate oscillations and alterations in cortical and sub-
cortical brain regions (Wallace, 1971, Benson et al., 1975, Kesterson, Clinch,
1989, Beary, Benson, 1974, Peng et al., 2004). However, a systematic and com-
prehensive review of the majority of these studies led to the conclusion that the
field of research on meditation techniques and their therapeutic applications has
been clouded by confusion over what constitutes meditation and by relative weak
methodological designs and selection of controls.
It was agreed that several practices are meditation practices or involve a med-
itative component, including Mindfulness Meditation, Transcendental Medita-
tion, Zen Buddhist Meditation, Dhyana, Vipassana, Kundalini Yoga, Sudarshan
kriya Yoga, Pranayama, Qigong, Tai chi, Mantra, relaxation response (Ospina et
al., 2007).
201
Despite the wide recognition and adoption of meditation, it is still hard to

find an agreed definition. Some define meditation as a self-directed relaxing and
mind-calming exercise, others claim it to be an intensely concentrated mental
task. Meditation is more complex than mere relaxation and/or concentration,
which can be attained by several simpler methods (Jaseja, 2009). The criteria
of successful meditation practice are understood both in terms of properly prac-
ticing a specific technique and in terms of achieving the aim of the meditation,
such as stress reduction, calmness of mind or spiritual enlightenment (Ospina et
al., 2007). Successful meditation practice usually relies on the subjective evalua-
tion of the meditators, the results of practice judged by a subjective and objective
evaluation of the achievement of some health benefits.
MEDITATION AND NEUROPHYSIOLOGY
The majority of studies to date have focused on the effects of meditation on

brain functions and have shown that the combination of neuroimaging and neuro-
dynamics is a particularly promising methodological approach to revealing obvi-
ous neurophysiology changes induced by meditation (Lutz et al., 2008). Several
recent studies have reported the influence of meditation on neural function (Lutz
et al, 2008, Brefczynski-Lewis et al, 2004, Lutz et al., 2004, Chan et al., 2008,
Pagnoni, ekic, 2007, Baron et al., 2007, Hankey, 2006), Lutz et al. (2004) studied
a group of long-term Tibetan Buddhist practitioners who had undertaken mind-
fulness meditation for 10,000 to 50,000 hours over time periods ranging from 15
to 40 years. Compared to a group of novices, the practitioners self-induced high-
er-amplitude sustained electroencephalography (EEG) gamma-band oscillations
and long-distance phase synchrony, in particular over lateral fronto-parietal elec-
trodes, while meditating. Although the precise mechanisms are not clear, such
synchronizations of oscillatory neural discharges may play a crucial role in the
constitution of transient networks that integrate distributed neural processes into
highly ordered cognitive and affective functions (Engel et al., 2001) and are an
important constraint for synaptic plasticity (Bibbing et al, 2002). The combina-
tion of neuroimaging and neurodynamical information, in particular with first-
person reporting, may thus provide a particularly promising approach to the study
of the brain mechanisms underlying meditation (Lutz et al., 2008). However we
agree with Valera (2000) that the mind/awareness cannot be separated from the
202
Metka RAVNIK-GLAVAČ: MEDITATION INDUCES GENE EXPRESSION CHANGES
entire organism, the fact that the brain is intimately connected to all of the mus-
cle, the skeletal system, the guts, the immune system, the hormonal balances and
so on (Valera, 2000). There are not many studies on how meditation influences
peripheral biological processes important for health and illness, especially on the
molecular level using modern molecular approaches.
MEDITATION AND GENOME EXPRESSION
Great advances in the basic molecular knowledge after the sequencing of the
human genome together with development of high through-put molecular-genet-
ic techniques enabled that the expression profile of all human genes could be ana-
lyzed simultaneously. Since meditation is a subjective experience connected also
with changes in perception and awareness, detected consistent molecular changes
in meditation state would further interconnect and evaluate awareness/spirituality
with fundamental molecular changes in the whole body.
Whole genome expression profiling is a recent methodology widely used to
detect the presence of diseases or disorders in humans. In a comprehensive study
by Whitney et al. (2003), it was shown that the variation in gene expression pat-
terns observed in the blood of healthy individuals was strikingly less than the
variation observed among samples from individuals with different cancers or in
blood from patients with bacterial infections, supporting the feasibility of using
gene expression patterns in peripheral blood as a basis for detecting diseased
states in humans (Whitney et al., 2003). In order to find out if meditation prac-
tices influence molecular mechanisms, genome expression profiling was also re-
cently selected as a methodology for detecting transcriptional changes in blood
samples between meditation practitioners and age-matched control individuals
with no experiences in meditation practices.
Li et al. (2005) showed with a gene expression study that Qigong (a technique
that harmonises breathing, the body and the mind) practitioners may regulate im-
munity, metabolic rate and cell death. Gene expression profiling in practitioners
of Sudarshan Kriya (a breathing technique that involves breathing in three dif-
ferent rhythms) revealed better antioxidant status both in terms of enzyme activ-
ity and on the RNA level. This was accompanied by better stress regulation and
better immune status, due to the prolonged life span of lymphocytes by up-reg-
ulation of anti-apoptotic genes and prosurvival genes in meditation practitioners
203
(Sharma et al., 2008). Dusek et al. (2008) performed the first whole genome gene
expression profile of relaxation response practitioners. Similar genomic pattern
changes occurred in practitioners of various meditation techniques of relaxation
response and various periods of time of meditation. Of 2209 differently expressed
genes in a group of long-term daily meditation practitioners and 1561 differently
expressed genes in a group of individuals who had completed eight weeks of re-
laxation response training, 433 differently expressed genes were shared in both
groups compared to controls. In both, long-term and short-term practitioners of
daily relaxation response practices, which include Vipassana, mantra, mindful-
ness or transcendental meditation, breath focus, Kundalini Yoga and repetitive
prayer were detected significant transcriptional changes in cellular metabolism,
oxidative phosphorilation, generation of reactive oxygen species, and response to
oxidative stress Meditation practitioners had down-regulation of ubiquitin, pro-
teasome and stress response genes and mixed up- and down-regulation of genes
involved in apoptosis and immune function (Dusek et al., 2008). Although simi-
lar genomic pattern changes occurred overall, indicating a common relaxation
response state in practitioners regardless of the techniques used to elicit it, it was
not clear from these studies what subjective levels of meditation, were achieved
by different practices and practitioners. Larger groups of meditators are essential
for the generalization of original findings, although it may unfortunately result
in an averaging out of important details that might be specific to more advanced
stages of meditation
We performed our preliminary study (article in preparation) in a way to cor-
relate as far as possible the whole genome transcriptional changes induced by
a more defined meditation state. For this reason we include in this preliminary
study only one experienced long-term meditation practitioner who could experi-
ence an advanced stage of meditation. Thus, in order to exclude the possibility
of a differential genome expression profile due to a different personal genetic
background or due to personal subjective experiences of awareness, in this pre-
liminary study we analyzed the same long-term meditation practitioner during
advanced stages of meditation and during ordinary states of awareness.
His reports of clear experience of an advanced stage of meditation corre-
sponded well with other descriptions of this state in which the mind transcends
the subtlest level of mental activity and experiences a state of complete mental
quiescence, in which thoughts are absent and yet consciousness is maintained
(Bloomfield et al., 1975).
204
We observed from our preliminary study that the gene expression signature
of an advanced stage of meditation is characterized by significant and consist-
ent gene expression changes. Amazingly similar gene expression patterns of the
same meditatation practitioner during two separate advanced stages of medita-
tion, which he achieved with a combination of techniques of Kriya Yoga, Kun-
dalini Yoga and Pranayama, shows that this advanced stage of awareness might
be very specific and that the meditator in this study was very experienced in rec-
ognizing and describing his inner experience It has already been proposed that
collaboration with long-term practitioners is particularly relevant for extending
the strategy of research into meditation. Long-term meditation practitioners can
allegedly generate more stable and reproducible mental states than untrained in-
dividuals and are putatively better able to report accurately on the content and
process of their mind (Lutz et al., 2008).
With our preliminary results it has been shown for the first time that an ad-
vanced stage of meditation might have induced a consistent gene expression sig-
nature, in which 2266 probe sets have been significantly differently expressed;
92.6% of gene sets were significantly down-regulated and only 7.4% of gene
sets were significantly up-regulated (Ravnik-Glavač, article in preparation)(Fig
1). The down-regulated part of the signature is characterized by several major
biological and molecular processes, including co-translational protein targeting
to membrane, ubiquitin-dependent protein catabolic process and ubiquitin cycle,
small GTPase mediated signal transduction, anti-apoptosis, spliceosome assem-
bly, RNA binding, mRNA splicing, histone binding and double-stranded DNA
binding, transcription co-activator activity, protein transport, cell recognition,
membrane fusion, sphingolipid metabolic process, calcium-mediated signalling,
and response to stress. The up-regulated gene expression signature of advanced
stage of meditation was associated with oxygen transport and homeostasis, eryth-
rocyte development, maturation and structure, maintaining blood/cellular pH and
excreting metabolic acid, defence response to bacteria, antigen binding, neuro-
transmitter uptake and antioxidant activity.
The main conclusions from the gene expression studies performed until now
in connection with meditative states include the following recognitions (Li et al.,
2005, Sharma et al., 2008, Dusek et al., 2008, Ravnik-Glavač, article in prepara-
tion):
– Meditation practitioners may regulate biological processes at a genomic lev-
el
205
– Meditation practice may regulate expression of genes involved in immunity,

metabolic rate, and cell death
– Advanced meditation practice may exert transcriptional regulation of thou-
sands of genes and several tenths of biological pathways
– Meditation practice may engage and strenghten an individual´s internal re-
sources for optimizing health in both prevention of and recovery from illness
Additional studies with more advanced meditation practitioners are needed to
discover whether there is a common gene expression signature generated by an
advanced state of awareness. The more defined impact on health and well-being
of the detected complex gene expression changes induced by meditation is im-
portant to discover.
REFERENCES
Wallace, R. K., Benson, H., Wilson, A. F. (1971): A wakeful hypomethabolic

physiologic state. Am J Physiol, 221, 795-9.
Benson, H., Steinert, R. F., Greenwood, M. M., Klemchuk, H. M., Peterson, N.
H. (1975): Continuous measurement of O2 consumption and CO2 elimination
during a wakeful hypometabolic state. J Human Stress, 1, 37-44.
Kesterson, J., Clinch, N. F. (1989): Metabolic rate, respiratory exchange ratio,
and apneas during meditation. Am J Physiol, 256, R632-8.
Beary, J. F., Benson, H. (1974): A simple psychophysiologic technique which
elicits the hypometabolic changes of the relaxation response. Psychosom
Med, 36, 115-20.
Peng, C. K., Henry, I. C., Mietus, J. E., Hausdorff, J. M., Khalsa, G. et al. (2004):
Heart rate dynamics during three forms of meditation. Int J Cardiol, 95, 19-27.
Ospina, M. B., Bond, K., Karkhaneh, M., Tjosvold, L., Vandermeer, B. et al.
(2007): Meditation practices for health: state of the research. Evid Rep Tech-
nol Assess, 155, 1-263.
Jaseja, H. (2009): Definition of meditation: Seeking a consensus. Med Hypoth-
eses, 72, 483.
Lutz, A., Slagter, H. A., Dunne, J. D., Davidson, R. J. (2008): Attention regulation
and monitoring in meditation. Trends Cogn Sci, 12, 163-9.
206
Lutz, A., Brefczynski-Lewis, J., Johnstone, T., Davidson, R. J. (2008): Regula-

tion of the neural circuitry of emotion by compassion meditation: Effects of
Meditative Expertise. PlosOne, 26, e1897.
Brefczynski-Lewis, J. A., Lutz, A., Schaefer, H. S., Levinson, D. B., Davidson,
R. J. (2007): Neural correlates of attentional expertise in long-term meditation
practitioners. Proc Natl Acad Sci USA, 104, 11483-8.
Lutz, A., Greischar, L. L., Rawlings, N. B., Ricard, M., Davidson, R. J. (2004):
Long-term meditators self-induce high-amplitude gamma synchrony during
mental practice. Proc Natl Acad Sci USA, 101, 16369-73.
Chan, A. S, Han, Y. M., Cheung, M. C. (2008): Electroencephalographic (EEG)
measurements of mindfulness-based Triarchic body-pathway relaxation tech-
nique: a pilot study. Appl Psychophysiol Biofeedback, 33, 39-47.
Pagnoni, G., Cekic, M. (2007): Age effects on gray matter volume and attentional
performance in Zen meditation. Neurobiol Aging, 28, 1623-7.
Baron Short, E., Kose, S., Mu, Q., Borckardt, J., Newberg, A. et al. (2007): Re-
gional Brain Activation During Meditation Shows Time and Practice Effects:
An Exploratory FMRI Study{dagger}. Evid Based Complement Alternat Med
Epub ahead of print.
Hankey, A. (2006): Studies of advanced stages of meditation in the tibetan bud-
dhist and vedic traditions. I: a comparison of general changes. Evid Based
Complement Alternat Med, 3, 513-21.
Lutz, A., Greischar, L. L., Rawlings, N. B., Ricard, M., Davidson, R. J. (2004):
Long-term meditators self-induce high-amplitude gamma synchrony during
mental practice. Proc Natl Acad Sci, USA, 101, 16369-73.
Engel, A. K., Fries, P., Singer, W. (2001): Dynamic predictions: oscillations and
synchrony in top-down processing. Nat Rev Neurosci, 2, 704-16.
Bibbig, A., Traub, R. D., Whittington, M. A. (2002): Long-range synchronization
of gamma and beta oscillations and the plasticity of excitatory and inhibitory
synapses: a network model. J Neurophysiol, 88, 1634-54.
Valera, F. (2000): Steps to a Science of Inter-being: Unfolding the Dharma Im-
plicit in Modern Cognitive Science. In: Watson, G., Batchelor, S., Claxton, G.
(eds.) The Psychology of Awakening: Buddhism, Science and Our Day-to-
Day Lives. Rider, London.
Whitney, A. R., Diehn, M., Popper, S. J., Alizadeh, A. A., Boldrick, J. C. et al.
(2003): Individuality and variation in gene expression patterns in human
blood. Proc Natl Acad Sci USA, 100, 1896-901.
207
Li, Q. Z., Li, P., Garcia, G. E., Johnson, R. J., Feng, L. (2005): Genomic profiling
of neutrophil transcripts in Asian Qigong practitioners: a pilot study in gene
regulation by mind-body interaction. J Altern Complement Med, 11, 29-39.
Sharma, H., Datta, P., Singh, A., Sen, S., Bhardwaj, N. K. et al. (2008): Gene ex-
pression profiling in practitioners of Sudarshan Kriya. J Psychosom Res, 64,
213-8.
Dusek, J. A., Otu, H. H., Wohlhueter, A. L., Bhasin, M., Zerbini, L. F. et al.
(2008): Genomic counter-stress changes induced by the relaxation response.
PLoS One, 3, e2576.
Bloomfield, H. H., Cain, M. P., Jaffe, D. T. (1975): TM: Discovering Inner En-
ergy and Overcoming Stress. Delacorte, New York, 11-19, 160-164.
Figure 1. Analysis of differently expressed genes. Heatmap of 2266 significantly

differently regulated probe sets (p < 0.05, FDR <= 5%) between two states of
advanced stage of meditation (1T and 2T, respectively) and two ordinary states
of awareness (1N and 2N, respectively). Rows represent probe sets and columns
represent samples (controls: 1N, 2N; tests: 1T, 2T)
in green – down-regulated probe sets
in red – up-regulated probe sets
208
NOTES ON CONTRIBUTORS
Gaurav Desai
P.G Dept. of Rasashastra
K.L.E’S Shri B.M.Kankanwadi
Ayurveda Mahavidyalaya and
Research Centre
Shahapur Belgaum
Karnataka
India
drgauravdesai@gmail.com
Biljana Dušić
Ayurvedska posvetovalnica Aditi
Glogovica 21
1296 Šentvid pri Stični
Slovenija
biljana.dusic@aditi.si
Harsha Gramminger
dr.gramminger@euroved.com
Christian H. S. Kessler
Rigaerstr. 70
10247 Berlin
Germany
kessler.christian@gmail.com
209
Maja Kolarević
Faculty for Postgraduate Studies
University of Nova Gorica
Slovenia
ksiopeja@gmail.com
Samo Kreft
Faculty of Pharmacy
University of Ljubljana
Aškerčeva 7
1000 Ljubljana
Slovenia
samo.kreft@ffa.uni-lj.si
G. S. Lavekar
Central Council for Research in Ayurveda and Siddha 61-65, Institutional Area
Opp. D Block, Janakpuri New Delhi-110058 India
gslavekar@gmail.com
ccras_dir1@nic.in
Tadeja Jere Lazanski

University of Primorska
Faculty of Tourism Studies
Obala 29, 6320 Portorose
Slovenia
tadeja.lazanski@turistica.si
Ajay G. Namdeo, Kavita Yadav, Ajay Sharma, and Kakasaheb R. Mahadik

Department of Pharmacognosy & Department of Pharmaceutical Chemistry
Poona College of Pharmacy, Bharati Vidyapeeth University
Pune, Maharashtra - 411038
India
ajay_namdeo@rediffmail.com
210
NOTES ON CONTRIBUTORS
M. R.Vasudevan Nampoothiri
Ayurveda Medical Education
Trivandrum
Kerala
India
vnampoothiri@gmail.com
Nadja Plazar
College of Health Care Izola
Polje 42, 6310
Izola
Slovenia
nadja.plazar@vszi.upr.si
Tamara Poklar Vatovec

University of Primorska
College of Health Care Izola
Polje 42, 6310
Izola
Slovenia
tamara.poklar@guest.arnes.si
Metka Ravnik-Glavač
Faculty of Medicine
University of Ljubljana
Slovenia
metka.ravnik-glavac@mf.uni-lj.si
Andrej Rus
Velike Pece 27
SI-1296 Šentvid pri Stični
Slovenia
andrej.rus@atma.si
211
Regis A. De Silva
Harvard Medical School
Director, Global Programs
Partners-Harvard Medical International
31 Dartmouth Street
Boston, Massachusetts 02116, USA
regis_desilva@hms.harvard.edu
rdesilva@phmi.partners.org
Elmar Stapelfeldt
Europäische Akademie für Ayurveda
Fachbereich Ayurveda-Medizin
Forsthausstr. 6
D-63633 Birstein
elmar.stapelfeldt@Ayurveda-akademie.org
212
INDEX OF NAMES
A Checkland, P., 84
Agnivesha, 95, 96, 97, 98 Chopra, A. S., 88
Alexander, C. N., 125, 126 Chopra, K., 88
Anderson, J. W., 126 Christina, A., 151
Anderson, V., 87, 126 Churchman, W. C., 86
Angell, M., 51 Colquhoun, D., 51
Aristotle, 86 Condillac, A., 106
Atreya, B., 95, 96, 97, 98, 99, 100,
101 D
Dawkins, R., 51
B Deshpande, U. R., 176
Bacon, F., 106 Donovan, S., 124
Baer, H. A., 38
Bell, L. M., 177 E
Bertalanffy, L., 83 Eisenberg, D. M., 34, 52
Bhagvandash, V., 151
Bhattacharya, S., 151 F
Bohinc, R., 27, 28 Feyerabend, P., 113, 115
Bourdieu, P., 115, 116 Fields, J. Z., 122
Flood, G., 88, 91
C Forrester, J. W., 85, 90
Cabanis, J. P., 106 Foucault, M., 105, 107, 114
Calleman, C. J., 86 Franklin, B., 142
Canguilhem, G., 113 Furlan, N., 27, 28
Capra, F., 86
Caraka, 67, 93, 94, 197 G
Chan, M., 42 Gharajedaghi, J., 83, 87
213
H O
Hagelin, J. S., 122 O’Connor, J., 87
Hahnemann, S., 34 Orme-Johnson, D. W., 125, 126
Hammond, D., 86 Ossimitz, G., 87
Haratani, T., 125
Heraclitus, 86 P
Hung, M., 53 Parikh, J., 84
Hutchens, D., 86
R
J Richmond, B., 87
Jalaja, S., 27
S
K Saper, R. B., 56
Kakar, S., 110, 111 Sarvananda, S., 123
Kales, S. N., 56 Schneider R. H., 122, 126, 127
Kassirer, J. P., 51 Senge, P., 83, 84, 85, 87
Krishnamurti, J., 88 Sengupta, K. N., 151
Kuhn,T., 38, 116 Sharada, A.C., 152
Kuhn, T. S., 38, 116 Sharma, A., 174, 175, 176, 177
Sharma, H., 151, 174, 175, 176, 177
L Sharma, P. V., 151, 174, 175, 176, 177
Locke, J., 106 Sharma, R. K., 151, 174, 175, 176,
177
M Sterman, J. D., 85
Mahady, G. B., 176 Subapriya, R., 177
Mahesh, M., 123
Mishra, L. C., 177 Š
Mulpuri, K., 53 Škof, L., 21, 27
Murphy, M., 124
Muruganandam, A., 151 T
Transfeldt, E. E., 53, 59
N Trontelj, J., 52
Nader, T., 122
Nagini, S., 177 V
Valiathan, M. S., 174, 175
214
INDEX OF NAMES
W Wolstenholme, E. F., 85
Wallace R. K., 125 Wujastyk, D., 88
Walton, K., 126
Wetzel, M. S., 52 Ž
Wiener, N., 83 Žagar, E., 115
215

Ayurveda A New Way For Healthy Life in E

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Ayurveda A New Way For Healthy Life in E

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AYURVEDA:

A NEW WAY FOR HEALTHY LIFE IN EUROPE

Managing editor: Vida Rožac Darovec

Financial Support: Department of AYUSH of the Government of India

CIP - Kataložni zapis o publikaciji

INTERNATIONAL Scientific Conference on Ayurveda (2009 ; Portorož)

Grand Hotel Portorož & Hotel Slovenija (Portorož, Slovenia)

University of Primorska, Faculty of Humanities Koper,

University of Primorska, Science and Research Centre of Koper (Slovenia)

University of Primorska, College of Health Care Izola (Slovenia)

University of Primorska, Turistica – Faculty of Tourism Studies (Slovenia)

The Embassy of the Republic of India, Ljubljana

Department of AYUSH of the Government of India

Life Class Hotels and Spa, Portorož, Slovenia

The proceedings volume was financially supported by:

Department of AYUSH of the Government of India

Dr. Lenart Škof, Associate Professor and Senior Research Associate,

Honorary Organizing Committee

H. E. Dr. Villur Sundararajan Seshadri, Ambassador of India

International Program Committee

Dr. Nadja Furlan, Assistant Professor and Research Associate, Faculty of

PART 1 AYURVEDA AND REGULATORY ASPECTS

PART 2 AYURVEDA, SPIRITUALITY AND HUMANITIES

Maja KOLAREVIĆ 103

Andrej RUS 121

Vasudevan NAMPOOTHIRI 133

PART 3 AYURVEDA, HEALTH AND MEDICAL SCIENCE

Ajay G. NAMDEO, Kavita YADAV, Ajay SHARMA and

Gaurav DESAI 161

Nadja PLAZAR and Tamara POKLAR VATOVEC 167

Biljana DUŠIĆ 197

Metka RAVNIK-GLAVAČ 201

Notes on Contributors 209

Index of Names 213

Nadja FURLAN, Anton MLINAR and Lenart ŠKOF

the natural (inter)cultural and wider social environment. Ayurveda in Europe is a

disease (considered as a variable) and not the individual in terms of personality in

Dear Excellencies, representatives of Slovene and Indian governments, dear

AYURVEDA LEADS THE WAY

format into five international languages, namely, English, French, German,

class research and development on the potential of the traditional systems

On behalf of Government of India I wish the congress all success.

Her Excellency Mrs. S. Jalaja, Secretary, Department of AYUSH, Hon’ble

been used to describe all of these multifarious approaches to healing. In an at-

USE OF PHARMACEUTICALS DERIVED FROM NATURAL

A large number of valuable modern pharmaceuticals are derived from nat-

CAN WE INTEGRATE TCAM INTO WESTERN MEDICINE?

There are several barriers in establishing a policy framework for integration

POSSIBLE MODELS FOR INTEGRATION

(c) Integration in Developing Countries. Perhaps the most interesting chal-

There is an increasing use of culturally based medical systems, such as Ay-

Baer, H. A. (2001): Biomedicine and alternative healing systems in America: Is-

Acknowledgements: I wish to thank Drs. Elmar Staplefeldt, Christian Kessler

Table 1. Distribution of the Total World Population of 6.78 billion

REGION POPULATION (billions)

TRADITIONAL, COMPLEMENTARY & ALTERNATIVE MEDICINE

HERBAL VITAMINS AND NUTRITIONAL AROMATHERAPY

AYURVEDIC CHINESE OTHER TRADITIONAL

Figure 1. Classification of Traditional, Complementary and Alternative

TRADITIONAL MEDICINE COEVAL MEDICINE WESTERN MEDICINE

Rheumatold arthritis Collagen diseases Coronary disease

Figure 2. Classification of Diagnostic Treatment Groups for TCAM