Introduction to Ayurveda
Principles
For the Ayurvedic practitioner, it is necessary to understand the nature of the patient, the nature of the disease, and the nature of the remedy. Only then will a physician be able to provide the greatest care. The qualities of Nature are said to be either heavy or light, cold or hot, stable or mobile, sharp or dull, moist or dry, subtle or gross, dense or flowing, soft or hard, smooth or rough and cloudy or clear. A person, a disease or a remedy is understood to have a unique combination of these qualities. It is the goal of the Ayurvedic practitioner to understand as many of the qualities as they can about their patient and their patient's condition. A person may be heavy or light, move quickly or slowly, feel more warm or cool, have a sharp or dull mind, have moist or dry skin. These are examples of understanding the nature of a person.Similarly, a disease like arthritis may be defined as producing sharp or dull pain, migrating (mobile) or localized to one or more joints (stable), producing vasodilatation around the joint (warm), or vascular constriction (cool). By understanding the presentation of a disease through its qualities, the uniqueness of a disease is understood. Herbal remedies are also understood in terms of their qualities. Substances that are nourishing are described as being heavy, such as licorice. Substances that are depleting are light, such as red clover. Some herbs create warmth in the body, such as ginger, and others cool the body, such as goldenseal. The fundamental principle of treatment in Ayurveda is to treat the disease with the qualities opposite to its nature. Cold diseases are treated with warm remedies, heavy diseases are treated with light remedies, and so on.
Ayurveda describes the human being as being composed of five elements, three doshas (biological energies), seven dhatus (tissues), and numerous srotas (channels). The five elements are ether, air, fire, water, and earth. These five elements, which also make up all of Nature, are not meant to be taken literally. They are ideas described as elements. They are the ideas of space, motion, heat, flow, and solidity respectively. They have the qualities as noted above. The three doshas, the biological forces that govern the functions of the body, are composed of these elements.
Vata dosha is a biological force which governs all motion in the body. Composed of ether and air, it is light, dry, mobile, and cool. People with a predominance of this energy in their bodies tend to exhibit these characteristics. They tend to be thin, have dry skin, feel cold easily, and move and speak quickly. They also tend to have a greater amount of cold emotion, such as anxiety and fear. Vata dosha imbalance can affect any system of the body and cause an increase in those qualities. For instance, the respiratory system becomes dry as seen in dry asthma and non-productive coughs. The digestive system becomes dry and constipated, an abnormality of motion. Dryness may precipitate stone formation in the kidneys or gall bladder, and an increase in the motile quality of vata in the nervous system is understood to cause hyper-excitability. The cold nature of vata can become severely disturbed and cause Raynaud's syndrome. Wasting conditions are viewed as an increase in the light quality of vata. Therefore, anywhere in the body where there is an increase in the qualities of vata, there will be physiological disturbance.
Pitta dosha is a force which govern all digestion in the body. Composed primarily of fire, it is hot, light, exhibits flow, and is sharp. It contains a little water, and thus it is neither very moist or dry. People with a predominance of pitta in their bodies exhibit these qualities. They feel warm and are less affected by cold weather. They have a rosy complexion, are moderate and reasonably steady in their weight, have a mesomorphic body build, and can have a sharp and intense personality. This personality tends to be challenged by a greater amount of heated emotion such as anger, resentment, and jealousy. As pitta governs digestion, the digestive system tends to be strong. There is little trouble digesting food. Bowel movements occur frequently, 2-3X per day. Pitta dosha imbalance can affect any system in the body but is predisposed to affect systems that are said to contain a lot of fire. When pitta affects a system, usually greater heat builds at that location. The liver, small intestine, blood, skin, and eyes are systems in which pitta exerts a great influence. Hepatitis, hyperacidity, acne and conjunctivitis are examples of heated pitta conditions in these regions of the body. Pitta disturbance can affect any system. Infections anywhere in the body producing heat and fever are understood as pitta disturbances.
Kapha dosha is a biological force which governs growth in the body. Composed of water and earth, it is heavy, moist, stable, soft, and dull. People with a predominance of kapha in their bodies tend to carry more weight, have thicker, denser bones and skin, and have a more traditional endomorphic body build. They also tend to have moist supple skin and full, thick hair. This person's personality tends toward being relaxed and not easily disturbed. They talk and move slowly. They can be challenged by heavy feelings, such as lethargy and rigidity. When kapha increases in the body, there is a greater production of mucous which, like kapha, is heavy, thick, and moist. There may also be swelling and weight gain. While kapha can affect any system of the body, the stomach and lungs are the most susceptible. It is here that we see several common signs of kapha disturbance--nausea, limited appetite and mucous formation. Conditions such as obesity, some cancers, chronic bronchitis, lung congestion, and fluid retention syndromes have a kapha disturbance as a component of the pathophysiology.
While the doshas are seen as the causative agents of disease, dhatus, upadhatus, and srotas are understood to be the site of the disease. Dhatus are tissues, upadhatus are additional tissues, and srotas are channel systems. There are seven tissues; plasma, blood, muscle, fat, bone, marrow, and reproductive tissue. Unlike Western medicine, which understands each tissue to be separate, Ayurveda understands each to be dependent upon the tissues preceding it for its nourishment and health. Hence, a problem which develops in one tissue, if not corrected, will eventually have systemic consequences. Pathology in Ayurveda can be partially understood in terms of what dosha is affecting what dhatu. When vata enters a dhatu, that dhatu becomes lighter, drier, and hyper-mobile. When pitta enters, it becomes heated, and when kapha enters, it becomes heavier, moister, and more stable. In a muscle, vata disturbance causes wasting and atrophy, pitta disturbance causes infection and inflammation, and kapha disturbance causes excessive growth.
Srotas are channel systems similar to the organ systems of the human body. The major srotas are somewhat equivalent to the respiratory system, digestive system, reproductive system, cardiovascular system, urinary system, and water metabolism system. These are additional sites of disease where doshas may become aggravated.
During the metabolic processes of the body, Ayurveda recognizes that metabolic waste is produced and must be properly eliminated to maintain optimal health. Waste materials are called malas. Obstruction to their removal is another causative factor in disease.
According to Ayurveda, each person has a constitution that was determined at conception. This constitution is the inherent balance of these three doshas. The constitution determines a person's basic body type and personality. While other factors influence the formation of both the body and personality, the constitution provides the predisposition in much the same way as a person's genetics. It is a common misconception that Ayurveda groups people according to three types. In actuality, there are infinite combinations and permutations of these three basic energies in each person. Therefore, we see that each person is understood to be unique. The Ayurvedic practitioner's first objective is to understand the nature or constitution of the patient. This tells the practitioner who they are treating.
Next the practitioner attempts to understand the disease or the nature of the imbalance. Ayurvedic pathology is understood according to the doshic imbalance and the imbalance of qualities within the body. The practitioner assesses the state of the doshas, dhatus, upadhatus, srotas, and malas of the body. The overall strength of the body is an important factor in future treatment and is assessed as well. The term ojas is applied to the strength of the body, although more accurately it is that which gives the body the ability to endure stress. While pathology is important to understanding the nature of the disease, equally important is etiology. Etiology is understood according to how the patient's lifestyle, habits, and environment caused the doshas to become disturbed. A lifestyle which emphasizes a fast pace, changes of job or relationship, travel, fast foods, and dry, light foods, such as a vegetarian diet, is likely to cause an aggravation to vata dosha. A lifestyle which is intense, competitive, highly focused, and which emphasizes spicy hot foods is likely to aggravate pitta. Kapha is aggravated by a sedentary lifestyle and a diet of heavy, moist foods, such as milk, yogurt, and meat.
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