The Five Actions Of Ayurveda

It was a balmy weekend in August.

I was home at my apartment in Los Angeles, reading in bed, when my inbox pinged to inform me that the medical lab reports I had been anticipating had arrived. The report showed a cholesterol count that was off the charts, high blood pressure, inordinately high uric acid levels and indications of borderline diabetes.

I was sliding down a slippery slope and would have to take things into account or face the consequences. I realized I would have to get far away from my embedded routine and go somewhere with no moorings to my familiar habitat.

Having read up on numerous class action lawsuits initiated against major pharmaceutical companies for egregious violations of public safety and consumer trust, I had developed an aversion to Big Pharma, and wary of the side effects of hard prescription drugs - particularly liver damaging anti-inflammatory medication and cholesterol lowering Statins. They are invasive short-term remedies that extract a heavy price for the benefits they offer.

I had long been fascinated by indigenous and traditional systems of medicine, and after considerable research took what seemed like a leap of faith at the time and had myself admitted into an intense Ayurvedic regimen in the south Indian coastal state of Kerala.

Ayurveda means ‘Science of Life’ in Sanskrit. It was the holistic healing science of ancient India that had been practiced for at least five thousand years and down the ages had spread to the Far East, Arabia and Europe.

In late October of that year, after a long flight from Los Angeles and a two hour drive from Cochin airport, I arrived at Athreya Ayurvedic center, on the outskirts of Kottayam town at approximately 4 pm.

As I was driven into the grounds, the first thing to hit my eyes was an imposing statue of the Hindu deity Hanuman facing the entrance. Upon arriving, I was greeted by a smiling attendant and shown to a cottage facing a vast expanse of paddy fields that was to be my home for the next three weeks.

Soon after unpacking I was taken to meet Dr. Srijit, the head physician, for initial consultation. Without much ado he began to ask various probing questions while taking my pulse and peering into my mouth. This is the traditional method of Ayurvedic diagnosis that enables Vaidyas or Ayurvedic physicians to identify the patient’s core issues and design a tailored program for their specific needs based on Tridosha readings.

TRIDOSHAS

According to Ayurveda, every living organism is controlled and governed by three major life forces known as the Tridoshas. The Tridoshas are Vata, Pitta and Kapha - all physical and mental disorders occur when these three doshas lose their innate balance in the body.

Vata is attributed with qualities reflecting the elements of Space and Air. It governs movement in the body, activities of the nervous system and the process of elimination. Vata influences the other doshas.

Pitta contains the qualities of Fire and Water. It governs the body’s internal functions -digestion, metabolism and energy production. The primary function of Pitta is transformation.

Kapha connotes the Water and Earth elements. It governs structure and is the principle that holds cells together and forms the muscle, fat, bone and sinew as well as influencing the secretion and formation of body fluids.

When the levels of these doshas become either excessive or deficient, disorders begin to occur.

Broadly similar to other holistic systems of classical antiquity, Ayurveda classifies bodily substances in the context of the five classical elements (Sanskrit ‘Panchamahabhuta’):

• Earth (Prithvi)
• Water (Jala)
• Divine Fire (Tej)
• Air (Vayu)
• Ether (Akasha)

Divine Fire (Tej) is the primordial essence from which Pitta emerges and Pitta in turn manifests as Agni in the human body.

Agni plays a vital role in the creation and maintenance of the seven basic tissues or vital substances that constitute the human body called Dhatus, which in Sanskrit means ‘that which binds together’.

Ayurveda postulates that there are seven Dhatus in all. They are:

• life sap or Plasma (Rasa dhatu)
• blood (Rakta dhatu)
• muscles (Mamsa dhatu)
• fatty tissue (Meda dhatu)
• bones (Asthi dhatu)
• bone marrow and nervous tissue (Majja dhatu)
• semen (Shukra dhatu)

Daily food intake is converted into life sap or Rasa, which in turn transforms into blood or Rakta; Rakta transmutes into muscle or Mamsa; Mamsa is further transformed into fat or Meda; Meda is the precursor to bones or Asthi; Asthi forms bone marrow or Majja and Majja produces the ultimate dhatu i.e. semen or Shukra.

According to Ayurveda, it takes one hundred drops of Rakta (blood) to produce a single drop of Shukra (semen), thus making it the most vital and refined substance created by the body, indeed the ‘essence’ of life.

Ayurvedic treatments are designed to penetrate all seven dhatus for the deepest possible healing to take place.

The doctor described a fairly demanding and rigorous daily schedule which included the five integral Ayurvedic cleansing and detoxing modalities - known as Pancha Karma - combined with medication, a simple but nourishing vegan diet and a regular morning yoga regimen.

Tea, coffee, dairy products, meats, sweets, fried foods, tobacco, alcohol and refined carbohydrates were strictly off limits. He also advised me to be psychologically prepared for mental and physical changes and fluctuations that may occur due to the intensive therapy.

The Athreya Center had been tastefully designed in the traditional Kerala style, utilizing mainly wood and laterite, by Dr. Srijit’s father-in-law, Dr. Girish. The ancient healing science had been practiced and taught by his ancestors for 600 years, a tradition that continues to this day in a seamless progression. Handsome portraits of the family patriarchs going back five generations adorn the walls of the well-appointed reception area.

The retreat is nestled in a bucolic hamlet and surrounded by a network of canals flowing into the gorgeous Kerala Backwaters. Floating water hyacinths, vivid green paddy fields and gently swaying coconut palms, Ficus, Pipal, Banana, Papaya, Ashoka and Eleocarpus trees punctuate the Vedic symmetry of the resort. It includes a yoga room, a treatment center, ten residential cottages and a separate chamber for training in Kalaripayattu, the ancient martial art of Kerala, widely believed to be the source of later disciplines like Kung Fu and Karate.

Treatment started on the first day itself. Pancha Karma (the five actions) is a comprehensive system that facilitates the flushing of toxins from every cell, using the same organs of elimination that the body naturally employs such as sweat glands, blood vessels, the urinary tract and the intestines. It specifically addresses a toxin called Ama, one of the most damaging forces in our bodies.

Poor digestive fire, or weak digestive strength, leads to improper digestion of food. This results in gas, bloating, burning indigestion or constipation. In addition, a residue of this poorly digested food called Ama, accumulates in the digestive tract, overflowing into all bodily systems, clogging them and damaging tissues.

I was led into a building at the edge of the property and after stripping off all my clothes, made to lay supine on a raised wooden platform. Two male attendants wrapped my groin area with a langot which is a local variant of the jockstrap. They then began pouring a warm medicated solution over my body from head to foot. This process, known as Dhanya Amla Dhara, continued for over an hour.

The liquid is a blend of fermented puffed rice, lemon, tamarind, Amlaki and a few other herbs. Amlaki, commonly known as ‘Amla’ or Indian Gooseberry is one of the ingredients in the ubiquitous Triphala. The continuous and prolonged flow of the astringent solution penetrates to the deepest levels of body tissue, muscle and bone, facilitating the removal of lymphatic blockages and enhancing lymphatic circulation.

No exposition on Ayurveda is complete without talking about Triphala, which was given to me at the retreat three times a day. Tri-phala (Sanskrit ‘three fruits) is made from the dried and ground fruits of three trees that grow in India:

1) Amalaki or Emblica officinalis, is one of the most commonly used herbs in Ayurveda. It is a powerful antioxidant that contains 20 times more vitamin C than orange juice. It strengthens the immune system and cools the body, balancing the Pitta dosha.

2) Haritaki or Terminalia chebula is the strongest laxative of the three. The herb also has astringent and antispasmodic properties, balancing the Vata dosha.

3) Bibhitaki or Terminalia belerica helps remove excess mucous in the body, thus balancing the Kapha dosha. In addition, to being an excellent rejuvenative, astringent and laxative, Bibhitaki is very effective in curing lung conditions like bronchitis and asthma.

Dr. Sujit Basu of Ohio State University and his team of researchers recently found that administering chebulinic acid (the active molecule in Triphala) to cancer-afflicted mice showed significantly reduced growth in cancerous cells. The Ayurvedic medicine, as well as its main active constituent, the chebulinic acid, have been shown to block the action of a body chemical called vascular endothelial growth factor (VGEF) that plays a critical role in the formation of malignant tumors.

Evidently, Ayurvedic physicians and indigenous healers were aware of these properties thousands of years before the information became available to the West.

The medicated body wash was followed by a vigorous abdominal massage to loosen up stomach toxins. Recent medical findings have shown that the abdominal tract, especially the large intestine, contains as many neurons as the brain itself and therefore plays a vital role in one’s overall mental and physical wellbeing. Abdominal massage also helped to flush out the accumulation of Ama in the viscera and various organs.

DETOX

However, I went to bed that night feeling disoriented and slightly sick. I was not able to sleep very well and stayed up for most of the night tossing and turning in bed, coughing my lungs out. My neck, arms and belly were covered with a reddish rash.

The next day, in a panic, I called Dr. Srijit who allayed my fears by saying it was a natural reaction to the intense detoxification and internal cleansing that had been set in motion by the treatments.

Clearly my smoking habit for the past several years was now paying dividends!

Ayurvedic therapy did not suppress health symptoms but rather brought them out so they could be tackled more effectively. Understandably this was seldom an agreeable process from the perspective of the average city dweller, accustomed to allopathic quick-fix remedies.

The doctor had attendants bring me a glass of bitter green liquid extracted from the medicinal leaves of a bush growing right outside my cottage called Vasaka or Adulsa. I was instructed to take two teaspoonfuls every half hour combined with a heated herbal poultice or kizhi applied on my neck and chest region thrice a day. The coughing was rendered bearable by the treatment and eventually subsided after a few days.

The next day I was shown a rather disturbing instructional video of Dr. Srijit undergoing the process of Vamanan or the stomach wash; the first stage of Pancha Karma. Following a vigorous abdominal massage, I had to swallow several tumblers full of a muddy, slightly sweet liquid - Yeshtimadhu or Liquorice - that caused deep heaving, retching and vomiting - expelling all the muck that had attached itself to the stomach walls over time.

It was not a pleasant experience and at one point it literally felt like I was puking my guts out. Post Vamana, I felt strangely euphoric and was rewarded by a Shiatsu massage to the head by Gopu, my experienced therapist.

David Winston and Steven Malmes, in their comprehensive study of the subject titled, ‘Adaptogens: Herbs for Strength, Stamina and Stress Relief’, have expounded the virtues of Liquorice as an adaptogen which helps regulate the hypothalamic-pituitary-adrenal axis.

The active compound glycyrrhizic acid found in liquorice, is in common usage across Japan for the treatment and control of chronic viral hepatitis as well as regenerating damaged cells caused by liver injuries. Recent studies have also shown glycyrrhizic acid exhibiting a strong anti-viral effect.

KERALA

Natasha from Moscow and Luis, a retired film producer from San Sebastian, Spain were my only companions at the resort, it being the low season. On a day off, the three of us decided to explore the Kerala backwaters, the access to which was only twenty minutes away from the center.

Upon arriving at the jetty we were led to a traditional Kerala riverboat and soon began our cruise down one of the most beautiful and pristine bodies of water I had ever seen.

The Backwaters are a chain of brackish lagoons and lakes, created by the commingling of sea and freshwater, lying parallel to the Arabian Sea coast. The network includes five large lakes linked by a labyrinthine network of canals, almost 900 kilometers long, fed by 38 rivers criss-crossing half the length of Kerala state.

Crabs, frogs, mudskippers, terns, kingfishers, cormorants, otters and turtles are some of the creatures that thrive in the lush habitat generated by the unique eco-system, often compared to the Bayou of the Gulf Coast region in Louisiana.

On Day Four I was initiated into Virechana ie Ayurvedic purgation, wherein after the customary herbal bath, I was made to gulp down a cup of a thick muddy compound.

The compound was an intestinal purgative, made up of Castor oil and Trpihala, that made me pass stools about six times over the course of the day to empty out all the contents of my bowels and clean out the small intestines.

For the past couple of days I had been subsisting on a diet of rice gruel, boiled vegetables and bananas. During Vamana and Virechana, even the fruits and vegetables were dispensed with and I was given only steaming bowls of gruel accompanied by freshly squeezed juices of gooseberry, beetroot, watermelon, tomato, cucumber and carrot in various combinations by Amma, the amiable chef.

Surprisingly I did not crave more solid food and I grew to appreciate the minimal diet.

The next day my entire body was massaged vigorously with heated and medicated herbal oils by two attendants, while I lay on a raised wooden platform, a process known as Abhyanga. The massage oil is made up of Sesame oil, Camphor, Country Mallow and a compound named Dasha Moola or Ten Roots, extracted, as the name suggests from ten medicinal roots that are blended together in precise amounts.

Like all herbs used in Ayurveda, the Dasha Moolas are endowed with significant healing, regenerative and rejuvenating properties.

After Abhyanga, I sat in a wooden chamber large enough to accommodate one person, pumped full of herb infused steam. The process is called Swedana, the Indian version of the sauna.

After sweating out subcutaneous toxins for twenty minutes, I was let out of the box and once again made to lie down, this time on my side for Basti - the ancient precursor to what is commonly known as a ‘colonic irrigation’ in the American wellness community.

A long thin tube was inserted up my anus which acted as a conduit for a viscous solution released into my large intestine. Ten minutes later I got up and visited the restroom to empty out my bowels and left the place feeling lighter than I had in ages.

In Ayurvedic medicine, a Basti is a therapeutic treatment in which medicated, herbal decoctions are introduced into the rectum for the purpose of flushing toxins from the intestinal tract. The name has its source in antiquity, when healers used the ‘bastis’ (sterilized bladders) of animals to hold the medicated solutions.

Bastis are often referred to as enemas but go much further than merely emptying the large intestine. In Ayurveda, the colon is the principle site of Vata, the Dosha that governs movement and circulation. An excess of Vata manifests as many symptoms and diseases, including most digestive disorders, back aches, arthritis, gout, migraines, nervous disorders and Alzheimer’s among others. Basti therapy penetrates all the seven Dhatus and facilitates the elimination of excess Vata, helping restore total health.

However, the day wasn’t quite over yet.

My right big toe became swollen, inflamed and unbearably painful as is the case with chronic gout. I reported this to the doctor following which he recommended ‘leech therapy’. The leech, or Jalauki as it was called in Sanskrit, had been used since antiquity to remove toxic blood from affected areas in the body.

In this procedure a few selected leeches are placed on the affected area to suck out the contaminated blood. They grow fat and engorged from ingesting the thick red liquid and eventually fall off when they’ve had their fill.

The process was certainly efficacious as I can testify from personal experience. My toe regained its natural mobility in a few days, and after a few more sessions returned to normal once again. The leech’s saliva contains enzymes and compounds that act as an anti-coagulation agent. The most prominent of these anti-coagulation agents is hirudin.

Several other compounds have been identified in leech saliva with clot dissolving, anti-inflammatory, vasodilating, bacteriostatic and anaesthetic properties. Interestingly, the chief deity of Ayurveda, Dhanvantari, is depicted with four arms, one of which holds the Jalauki, alongside the Chakra (wheel), Shankha (conch shell), and Amrita or nectar of Life.

A paper published by Dr. Robert Mory and others ‘The Leech and the Physician: Biology, Etymology, and Medical Practice with Hirudinea medicinalis’ looks at how leeches are used to treat arthritis and other inflammatory processes, vascular (arterial and venous diseases), as well as heart and lung problems. It posits that diseases like hepatitis, stomach ulcers, and pancreatitis, and skin conditions like psoriasis, herpes, and eczema can be treated with leech therapy.

The daily abdominal massage, Abhyanga, Swedana and Basti sessions continued for the whole week. The colon was the most important organ of elimination and its treatment was therefore given the highest priority.

The days progressed slowly but steadily, punctuated by short sporadic showers rendering the vegetation a vivid green hue shot through with little explosions of red, yellow, white and purple flowers. Occasional thunder and lightning gave the experience an epic, almost mythical quality, like being healed by the Maharishis in some antediluvian Golden Age of the Vedas.

Later that evening as we sat down for dinner, the doctor and I spoke at length about the traditions and history of Kerala. The Maharajas of Travancore had made conscious efforts to preserve the ancient sciences thus ensuring that the traditional systems of learning would not wither away.

The Sushruta Samhita and Charaka Samhita, along with Vagbhatta’s Ashtanga Hridaya, were the three primary texts of Ayurveda, comprising an exhaustive practicum that dated back at least 3,000. They were named after Sushruta, Charaka and Vagbhatta, venerable physicians who had documented their work for the benefit of posterity.

I was amazed at the intricate details described in the one text I had access to the Sushruta Samhita, which contained complex procedures like cataract surgery, rhinoplasty, hernia surgery, haemorrhoids treatment, laparotomy, cauterization, amputation, fractures, dislocations and C-sections among others. It had exhaustive data pertaining to obstetrics, pediatrics, gynaecology, ophthalmology and the treatment of mental and nervous disorders, thyroid imbalance, dysentery, diabetes, angina, seizures, hypertension, kidney stones, to name just a few— essentially the entire gamut of contemporary medical prognosis and treatment.

The Sushruta Samhita is divided into 184 chapters—containing the descriptions of 1120 illnesses, 700 medicinal plants, 64 preparations from mineral sources and 57 preparations from animal sources.

The works of both Sushruta and Charaka were translated into Arabic during the 8th century into a tome called the Kitab-I-Susrud. The Arabic translation was received and further propagated in Renaissance Italy at the end of the medieval period by the Brancas of Sicily and Tagliacozzi of Bologna.

The works of both Sushruta and Charaka were translated into Arabic during the 8th century into a tome called the Kitab-I-Susrud. The Arabic translation was received and further propagated in Renaissance Italy at the end of the medieval period by the Brancas of Sicily and Tagliacozzi of Bologna.

The practices ultimately reached Britain inspiring physician Joseph Constantine Carpue’s voyage and twenty year sabbatical in India to study plastic surgery techniques. Carpue performed the first major surgery in the western world in 1815, dubbing it the ‘Indian method.’

RETURNING TO HEALTH

After my chest cold and cough had completely subsided, we commenced with Shirodhara.

It was a steady flow (Dhara) of cooling liquid streaming down on my forehead through a hole in an earthen pot, placed directly over the head. The liquid is a decoction of buttermilk processed with Amlaki and Cyperus rotundus. The leaves and root of the Cyperus plant have been recommended in Indian Ayurvedic texts for reducing fever and inflammation, digestive disorders, menstrual cramps and other maladies. In traditional Chinese medicine Cyperus was considered the primary Qi regulating herb.

Shirodhara has the effect of calming the mind and generating a feeling of peace and contentment. Indeed the warm, centered, glow stayed with me for a good few hours after the treatment.

I had also got into the habit of circumambulating the premises five to six times daily. One round of the periphery was a distance of approximately half a kilometer. It was a delight to walk amidst the lush vegetation, smell the flowers and listen to butterflies, squirrels and avian warblers rejoice at the first rays of the morning sun. Luis and Natasha had left the center and other guests had arrived; three couples from Germany, Switzerland and Mauritius.

At the end of two weeks a new round of treatments began called Nasyam or Nasya Karma (through the nose). Laying prostrate on the massage table, my neck, face and head were gently massaged, opening the channels, dislodging congestion and loosening up the tissues.

Next, I was made to inhale herbalized steam through a pipe to open the internal channels and liquefy the congestion of the nasal tissues. Lastly, two mililiters of Nasya oil was administered gently into my nose. The Nasya oil is pressed from Sida cordifolia, also known as Country Mallow, Fennel weed or ‘Bala’ in Sanskrit.

Country Mallow is used in the indigenous healing systems of Brazil and Africa for the treatment of asthmatic bronchitis, nasal congestion, stomatitis, asthma and nasal congestion. It also has psycho-stimulant properties due to the substantial ephedrine content, and affects the central nervous system as well as the heart.

Recent studies have shown that an aqueous extract of Sida cordifolia tested on rats had potent antioxidant and anti-inflammatory properties as well as the ability to stimulate liver regeneration.

According to the Sanskrit texts, Nasya therapy activates the Sringataka Marma which is a vital point situated on the surface of the brain where nerve cells and fibres (siras) converge that control the function of the sense organs - speech, vision, hearing, taste, and smell - the seat of cognition. From here it spreads into various Strotasas (vessels and nerves) and brings out vitiated Doshas from the brain. The absorption of Nasya medication takes place through the mucous membrane, the ophthalmic veins and directly into the cerebro-spinal fluid.

Nasya was also administered in the form of smoke - a burning stick of cotton cloth was tightly rolled up with camphor wood and turmeric, lit up at the tip, and its smoke funnelled through a cone shaped leaf directly into my nostrils.

I felt a tingling sensation running down the back of my head, all the way from my nostrils to the base of my neck. Almost immediately after, I felt a sense of clarity and sharpness, like all my senses were heightened and amplified. The state of heightened awareness stayed with me through the day.

In esoteric terms Prana or life energy enters the body through the intake of breath through the nose. Nasal administration of medication helps to correct the disorders of Prana affecting the higher cerebral, sensory and motor functions. The mechanism of Nasya can be summed up in a single statement made in the Ayurvedic texts - Nasahi Shirasodwaram which means the ‘nose is a pharmacological passage into the head’.

Apart from the evening Nasyam sessions, I was undergoing Njawara Kizhi therapy every morning. The treatment is named after Njawara, a unique strain of medicinal rice that grows only in Kerala and has been cultivated specifically for Ayurvedic therapy for eons. Its healing properties and various applications are well documented in the Charaka Samhita.

After boiling the rice in a decoction of Sida root and milk, it is bound in small cloth bags or boluses (Kizhis) and pressed all over the body, causing perspiration, opening the pores and absorbing the compound deep into the tissues.

The paste can also be massaged directly on the body. It has remarkable rejuvenating properties and is an effective cure for rheumatoid arthritis, neurological complaints, muscular degeneration, tuberculosis, anaemia, ulcerative disorders and skin diseases. The oil extracted from the bran of the rice has been used for neural diseases and eye disorders.

CONCLUSION

My three weeks were almost at an end and I was eager to verify the clinical effects of Pancha Karma for myself. The doctor referred me to a diagnostic lab in Kottayam town for the test. The report was emailed to me three hours after the blood sample was drawn from my vein.

At first glance I could not believe the numbers. My total cholesterol count had come down by a massive 80 points in just 20 days and was now safely in the normal zone. My triglyceride count was down from a staggering 800 to just 180.

Lastly, the abnormally high uric acid levels, the main cause of gout, were also in the safe zone. I let out a loud whoop and did an impromptu war dance around my room and patio, much to the amusement of the attendants passing by.

The long-term effects of the treatment became more apparent in the weeks and months that followed. I did not crave cigarettes, alcohol, meat or junk food anymore and the quality of my sleep was much better. I wasn’t nearly as prone to anger and irritability, and could focus on the many tasks at hand with gusto. My relationships with various family members and co-workers also improved significantly and I started what felt like a brand new chapter of my life.

To me there is no place on earth capable of inducing a major perceptual shift like India can. On the flipside, not everyone is equipped for dramatic changes in consciousness. Many come away from the experience feeling disassembled; like all the parts that make up the ‘Self’ have to be picked up and pieced back together into a new whole.

For me it was a journey worth embarking on and one that is never really over. I hope this personal account will prove to be helpful for others who wish to overhaul their lives and pull themselves out of embedded patterns but don’t know where to begin.