Āyurveda is a 5000-year-old all-encompassing system of medicine and philosophical guide to aligned living. It is both a system of curative medicine and preventative health through diet, lifestyle, rituals, ethical living, herbs and more. Ayurveda considers good health as far more than the absence of disease. To thrive with optimal health, we need to cast the net much wider.

How vibrant and alive do you really feel in the body, how calm and focused do you feel in the mind, how settled do you feel in your emotions and how nurtured do you feel from your social network and environments? All these elements contribute to our well-being.

Immunity is often only really considered during illness yett the immune system is constantly working in the background, maintaining health throughout life, bringing balance, homeostasis, healing wounds, and resisting invading pathogens. Immunity is the front-line defence of physical existence. 

In modern science, immunity refers to the system that protects the body from illness and infections that are caused by foreign invaders (pathogens), such as bacteria, viruses, fungi and toxins that cause disease in the body.

Bala, ojas and the three dimensions of strength
How the body responds to infectious conditions is deeply influenced by our underlying health or what is known as our bala (inner strength). Sage Vāgbhaṭa explains that bala sustains life, supports endurance, and determines resistance to disease, however the depletion leads to vulnerability (1). In Ayurveda, immunity is understood through three pillars of strength (bala):

• Hereditary (sahaja bala) — our innate immunity and strength we are born with
• Seasonal (kālaja bala) — immunity influenced seasons, stage of life, time
• Established (yuktikṛta bala) — acquired immunity developed through diet and lifestyle and self-care 

While we may not have total control over our encounters with infections or diseases, we have the power to navigate how our body responds. Through conscious choices in diet and lifestyle, we can build our immune resilience. This adaptive immune resilience is known as vyādhi-kṣhamatva’and it has two fundamental aims:  

• To maintain resistance to disease by building strength (bala)
• To enhance our capacity to adapt, recover and rebuild ojas after illness 

In other words, as mentioned in Charaka Saṃhitā scripture (2)Vyādhi-kṣamatva is both the art of preventing the onset of disease and of reducing disease severity once it has manifested. Immunity in Ayurveda is not merely about fighting disease, but about sustaining strong healthy body tissues from within that subsequently preserves vitality (ojas) (3) and supports long-term resilience (bala).

The purpose of immunity is to help us maintain balance in a world that is constantly changing. Today, immune challenges show up as infections, allergies, intolerances, autoimmune patterns, hormonal imbalance, and sensitivity to stress — all signs that the system is struggling to adapt.

Building strength (bala) and vitality (ojas) happens gradually over time and our task is to support our immunity through daily choices in diet, routine, rest, and how we relate to stress. When bala and ojas are strong, the immune system responds well, neither overreacting nor underperforming, but constantly adjusting to restore equilibrium.

From an Ayurvedic perspective immunity becomes compromised by a gradual wearing down of the body’s ability to adapt and self-regulate. The gradual loss of resilience reflects how well digestion (agni), doṣic balance and the body channels have been functioning over time. As these elements become strained, bala declines, and the formation of ojas is compromised. Some key factors that weaken immunity over time include:

• Improper diet, poor gut microbiome and ongoing digestive issues such as irregular or weak agni (visamāgni/mandagni) — disturbing how the body tissues get nourished.
• Nervous system dysregulation caused by excessive vāta, ongoing stress, negative mindset and emotions
• Lack of recovery time after an illness prevents the immunity from being fully recharged.
• Ongoing misalignment to daily and season rhythms including poor quality and lack of sleep, irregular eating patterns, lack of or excessive exertion.
• Excessive or prolonged cleansing or long-term stimulating / suppressive medications.

75–80% of immunity is formed in the gut, so it’s only as strong as agni (digestive fire). We are what we digest, and healthy ojas formation is the result of the healthy nourishment of the body tissues.

Through the Ayurvedic pathological lens immunity weakens when:

• Agni (digestive and metabolic fire) becomes impaired
• Āma (metabolic waste) accumulates
• Doṣas (vāta, pitta, kapha), the body’s functional intelligence becomes chronically aggravated
• Dhātus (tissues) are under-nourished, reducing ojas (the subtle essence of immunity and vitality)

Ayurveda aims to rebalance us at the root level. There are no short cuts to long-lasting wellness. The focus is to restore the doṣas to equilibrium, clear toxins from deep within and rebuild strength in every body tissue, rejuvenating the body at a cellular level.

The two-stage process of restoring mind-body-emotional balance.

1. Langhana – Lightening and cleansing therapies, including palliative measures and purification practices such as fasting, pañcakarma, to reduce excess, clear toxins and restore balance.
2. Rasāyana – Rejuvenation therapy focused on rebuilding strength in the tissues after cleansing. This includes supportive ahāra and vihara – wholesome diet, proper daily routines, good conduct and medicines when necessary.

Ayurvedic immune support through rasāyana

Rasāyana (rejuvenation therapy) focuses on protecting and rebuilding ojas. Through supportive diet, lifestyle adjustments, and targeted tonics, rasāyana helps restore strength, resilience, and long-term wellbeing, especially during periods of depletion or vulnerability.

In Ayurveda, herbs and home remedies are selected according to their energetic qualities — taste (rasa), potency (vīrya), action, and post-digestive effect (vipāka) — and the way they influence the doṣas, body tissues, channels, senses, and mind. This is the same principle applied to food, reinforcing the Ayurvedic view that food itself is medicine.

Immune-supportive herbs are traditionally used to build yuktikṛta bala, support digestion, clear metabolic waste, and nourish ojas. Classical formulations such as the Ayurvedic elixir Chyawanprāsha is valued for its holistic rejuvenating qualities.  Sitopalādi, Tālisādi are valued for their respiratory-supporting qualities. Single herbs such as tulsi (Ocimum sanctum), guduchi (Tinospora cordifolia), amalakī (Emblica officinalis), turmeric (Curcuma longa), garlic (Allium sativum), ginger (Zingiber officinale), shatavari (Asparagus racemosus), and ashwagandha (Withania somnifera) are commonly used to support resilience, digestion, vitality, and stress adaptation.

How herbs are taken is equally imperative. Traditional carriers (anupāna) such as milk, ghee, water and honey help guide the action and absorption of herbs to specific tissues. Rasāyana herbs are always personalised and used consciously, since herbal remedies work gently with a cumulative and nourishing approach to immune health as opposed to the quick fixes, we have become accustomed to. 

Actively cultivating yuktikṛta bala, begins with the first pillar of life in Ayurveda: satmya āhāra, a diet that is suitable for one’s constitution, digestive capacity, and current state of balance.

The body is shaped by what we are able to digest and assimilate making seasonal, local, whole foods the most supportive. Home-cooked, freshly prepared warm meals and slower cooking methods are becoming rare, yet they are the foundations for digestive and immune health. Our modern pace and reliance on processed foods weaken digestion (agni), contributing to rising food intolerances and gut imbalance. Stale, leftover, and heavily processed foods contain little vital energy (prāna) and do not support the formation of ojas.

Meals such as soups, stews, and gently spiced dishes provide grounding, easily absorbed nourishment for our immunity. A balanced immune-supporting diet may include wholesome grains and legumes, eggs or ethically sourced meats where appropriate, seasonal fruits and vegetables, nuts and seeds, and healthy fats such as ghee.

The connection between digestive health and immune resilience makes prebiotics and probiotics a vital part of the dietary mix. Traditional foods such as takra (spiced buttermilk) and fermented vegetables help support gut flora.

Eating consciously, in appropriate portions, and avoiding excess are just as important as food quality. Diets rich in vitamin C, zinc, healing spices, and warming teas gently kindle agni and support long-term resilience.

Building strength (bala)

Certain foods are traditionally known to build strength and resilience (rasāyana), including milk, ghee, green gram, figs, dates, and almonds. These are best supported with digestive spices and ingredients such as ginger, cumin, lemon, takra, and fresh seasonal fruits.

Movement, rest, and rhythm

Balanced exercise (vyayāma) is key to maintaining and build strength (bala), yet ensuring ojas is not depleted. Too little movement can lead to stagnation; excess can deplete strength. Regular conscious movement such as walking, yoga, strength training, massage, or breath-led practices support immunity, lymphatic flow, and the movement of prāna (life force energy). Just like the ebb and flow of life, it is equally important knowing when to rest and recover. 

Mind, breath, and emotional balance

Ayurvedic wellness is complete only when the mind, senses and emotions are cared for alongside the body. Chronic stress, mental overload, and emotional strain can erode bala. Practices such as conscious breathing, meditation, mudras, mantras, prayer, time in nature, and grounding routines help regulate the nervous system and restore balance. Traditional therapies like shiro-abhyanga (head massage) and shirodhāra (oil pouring on the 3^rd eye), along with medhya rasāyana, further support mental clarity and resilience when needed.

1. Vāgbhaṭa. Aṣṭāṅga Hṛdaya. Sūtrasthāna 11.1–2. Translated by Murthy KRS. Varanasi, India: Chowkhamba Krishnadas Academy; 2008.
2. Agniveśa, Charaka. Charaka Saṃhitā. Sūtrasthāna, Chapter 28, verse 7. In: Sharma RK, Dash B, trans. Charaka Saṃhitā (Text with English Translation). Vol 1. Varanasi, India: Chowkhamba Sanskrit Series Office; 2014.
3. Agniveśa, Charaka. Charaka Saṃhitā. Sūtrasthāna, Chapter 28, verse 7. In: Sharma RK, Dash B, trans. Charaka Saṃhitā (Text with English Translation). Vol 1. Varanasi, India: Chowkhamba Sanskrit Series Office; 2014.

Where low mood and melancholia has not reached the status of clinical depression, there are remedies derived from nature which offer natural approaches to lifting the spirits. In observing the cyclical patterns of nature, we can be afforded some comfort in the knowledge that as humans, we are a part of this cycle and feeling the need for rest and a turning inwards is a reflection of this rhythm.  At the very darkest, coldest, lifeless part of the year when many animals hibernate and are in a state of metabolic depression, studies have demonstrated neurobiological similarities to clinical depression, including changes in cortisol, neurotransmitters, metabolism and other biomarkers (3). Occurring at the same time, seeds and rootstocks are also at their most potent, conserving energy to use later for spring growth (4). 

Hibernating animals rest in the awareness that they will emerge with the next turn of the seasons. For many centuries humans have adapted to the cold, quiet darkness with a shared instinct to foster joy, connection and ritual such as the northern hemisphere midwinter festivals, Christmas, the Roman Saturnalia, Jewish Hannukah, Slavic Koliada, pagan Yule, Persian Yalda, or Asian Dongzhi, are all a call for celebration and community. Earlier in the season the Hindu festival Diwali symbolizes the victory of light over darkness and good over evil. Often the best way to beat the winter blues is in accepting the inherent cyclical nature of the world, and that  darkness has its role in the cycle as the precursor of light and life.

Being able to get out for a walk in nature, taking a moment to observe and be present with the plants, can be enormously enriching and mood enhancing, offering a subtle but profound healing opportunity. Nature can also be brought into the home— in Japan, small gardens are often found on doorsteps, balconies and small corners, bringing life to dense  urban landscapes. Tending a garden, even in pots, is a great source of serenity. The act of walking can also be significant as exercise is an efficient and rapid way to stimulate neurotransmitters including serotonin and dopamine which are responsible for uplifting mood  (5). 

In respecting the cycle of the seasons one is also in connection with the natural instinct to sleep and eat more. In Ayurveda winter is known as kapha time, time to build resources for the hungry gap in spring, when historically people would have worked hard to get the crops in and be left with limited food supplies. A gentle increase in body weight during winter is a normal physiological response to reduced activity, daylight and hormonal shifts, this often reverses itself in spring (6). Similarly, the need for extra sleep and change is impacted by lower light and colder temperatures (7).  

The following plants bring some of the comforting qualities of nature to support the body and mind during the winter period. Each is a powerful tool for lifting the spirits. The best approach is to get to know each herb as an individual first. Ideally, make a single preparation, perhaps a cup of strong tea or decoction, and build up towards a higher dose, the maximum from the range provided below. Taken in this form, at robust levels, benefits can be rapidly felt  and it is soon possible to work out which is most helpful. They can be experimented with to discover which ones resonate best with the body’s constitution. 

These herbs are not antidepressants in the conventional sense. Instead, in different ways they strengthen the constitution, offer a sense of calm and an ability to cope better, whilst also reducing inflammatory pressures on the brain.St John’s wort, widely thought of as a herbal antidepressant, is traditionally used as a tonic specific for the winter months to help bring in the light, offering a feeling of resilience (8). 

For more in depth information on these herbs, please see our herbal monographs. 

Brahmi (Bacopa monnieri)

A classic Ayurvedic brain tonic, and saponin-rich adaptogen, Brahmi appears to work in a number of ways to protect brain cells and improve cognitive functions, especially when these are challenged by long-term stresses, illnesses and ageing (9). It has been used to help recover from chronic fatigue and associated low energies. Brahmi is also calming and helps directly in anxiety and tension conditions, and in helping cope with stress (9,10).

The recommended dose is 2–6 grams of the dried leaf per day, either as  tea or, as popularly taken in India, several teaspoons of the fresh leaf juice (9). Dosages are meant as a guideline only, and it is recommended to consult a medical herbalist for safety considerations. 

Cinnamon (Cinnamomum verum)

This common spice offers an organoleptic treat, with good quality cinnamon stimulating the taste buds and warming the body. Cinnamon is particularly useful in facilitating recovery from illness or chronic fatigue, and especially for those who are particularly prone to feeling the cold (8) It helps restore a healthy appetite and reduce digestive problems such as sluggish digestion that can be associated with being run down. To increase the heating quality and stimulate more warmth, combine it with fresh ginger (Zingiber officinale) in a tea. Cinnamon can be combined with any of the other herbs on this list as a stimulating, warming remedy (9). 

Take a teaspoonful of freshly powdered cinnamon (Ceylon cinnamon has the most complex flavour profile), add 50 ml of boiling water, stir and steep for 5–10 minutes and sip. Feel the mix of spicy and sweet tones reverberating at the back of the mouth, with a slightly woody quality, followed by a warmth emanating from the chest chest. A slight bitterness can be experienced afterwards, with a profound sense of warmth moving throughout the entire body. 

The suggested dose of cinnamon powder is up to 8 grams per day (9).

Gotu kola (Centella asiatica)

This popular traditional Asia restorative tonic is revered in Asia for ‘opening the mind’, sometimes accompanying meditative practices as a tea. Taken in this way, gotu kola offers an initial bitter flavour, followed by an  aromatic sweetness. It has a particular effect in supporting cognitive function, including improving memory and concentration, especially when these are compromised by increased  stress (9,10).

The dose starts at 3 grams of dried leaf per day, titrating up to 30 grams, if the initial dosage has proved effective with no unwanted side effectsGotu kola is traditionally consumed as a tea (8–10). 

Rosemary (Salvia rosmarinus)

There is something inherently uplifting about the smell and taste of this common garden herb— it can be felt heading straight to the brain. Rosemary is an excellent tonic to raise spirits and boost recovery after illness or periods of low energy. Even inhaling the fresh leaf from a garden or window box will stimulate mental energy and the tea taken internally will expand on this effect. 

There is promising evidence that rosemary may reduce inflammatory pressures on the brain now implicated in many conditions associated with low mood and depression, including chronic fatigue syndrome, dementia as well as clinical depression. Further research indicates it can improve cognitive performance in the elderly adding to its reputation as a  brain tonic (11).

Taking rosemary as a tea can be overpowering, however very uplifting. The dose is up to 4 grams a day of the dried leaf (9).

St. John’s wort (Hypericum perforatum)

This is often described as the herbal antidepressant, however it has a much wider range of actions than its mood enhancing properties. The herb and flowers of St. John’s wort have been used in European traditions to relieve nervous tension and anxiety. Importantly, this calming effect is combined with underlying restorative benefits and the plant was also used as a convalescent treatment for melancholic conditions, depression and recovering from illness or trauma (8–10).

This makes St John’s wort ideal in situations where tension and exhaustion combine. Its most useful modern application is towards a programme of recovery from chronic fatigue conditions. It also has a long reputation as a support to those experiencing symptoms during the menopause (8,10).

Note that St John’s wort has been shown as an active inducer of drug metabolism, so it may reduce the activity and active life of many medicines. It is wise to avoid in conjunction with medications and consult a medical herbalist for further guidance (8–10).  it if there are any powerful treatments underway, where reducing the effect of a medicine may be critical.

St John’s wort can come in a variety of preparations, including powder, tincture and tea. It is recommended to combine the herb with others as a tea, for flavour considerations, however the easiest is to take it as a tincture. The traditional calming and tonic dose was the equivalent of 2 to 5 grams of the dried leaf and flowers per day (9). 

1. Heald A, Stedman M, Farman S, Ruzhdi N, Davies M, Taylor D. Seasonal Variation in Antidepressant Prescribing. The Primary Care Companion For CNS Disorders. 2021;23(2). https://doi.org/10.4088/pcc.20m02790 
2. Clery E, Morris S, Cooper C, Das-Munshi J, McManus S, Weich S. Mental health treatment and service use. Adult Psychiatric Morbidity Survey: Survey of Mental Health and Wellbeing, England. Published online 2025.
3. Tsiouris JA. Metabolic depression in hibernation and major depression: An explanatory theory and an animal model of depression. Medical Hypotheses. 2005;65(5):829-840. https://doi.org/10.1016/j.mehy.2005.05.044 
4. Klupczyńska EA, Pawłowski TA. Regulation of Seed Dormancy and Germination Mechanisms in a Changing Environment. International Journal of Molecular Sciences. 2021;22(3):1357. https://doi.org/10.3390/ijms22031357 
5. Ren J, Xiao H. Exercise for Mental Well-Being: Exploring Neurobiological Advances and Intervention Effects in Depression. ProQuest. 2023;13(7):1505. https://doi.org/10.3390/life13071505 
6. Fahey MC, Klesges RC, Kocak M, Talcott GW, Krukowski RA. Seasonal fluctuations in weight and self-weighing behavior among adults in a behavioral weight loss intervention. Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity. Published online May 15, 2019. https://doi.org/10.1007/s40519-019-00707-7 
7. Honma K, Honma S, Kohsaka M, Fukuda N. Seasonal variation in the human circadian rhythm: dissociation between sleep and temperature rhythm. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology. 1992;262(5):R885-R891. https://doi.org/10.1152/ajpregu.1992.262.5.r885 
8. Hedley C, Shaw N. Plant Medicine. (Waddell G, ed.). Aeon Books; 2023.
9. Bone K, Mills S. Principles and Practice of Phytotherapy: Modern Herbal Medicine. 2nd ed. Edinburgh Churchill Livingstone, Elsevier; 2013.
10. Mcintyre A. Complete Herbal Tutor : The Definitive Guide to the Principles and Practices of Herbal Medicine (Second Edition). Aeon Books Limited; 2019.
11. Rahbardar M, Hosseinzadeh H. Therapeutic effects of rosemary (Rosmarinus officinalis L.) and its active constituents on nervous system disorders. Therapeutic effects of rosemary (Rosmarinus officinalis L) and its active constituents on nervous system disorders. 2020;23(9). https://doi.org/10.22038/ijbms.2020.45269.10541 

“Creation is the expression of cosmic consciousness. It is a journey of energy into matter. The five great elements are uniquely expressed in both mankind and plants.” (1)

According to Vedic science, all matter is composed of five elements, known as the panchamahabhutas, which range from the finest to the grossest: space / ether, air, fire, water, and earth. This may seem simplistic, but it is a sophisticated way to classify all matter found on earth as they refer more to states of matter than elements as we may know them. Every individual is a microcosm of nature and, as such, contains all five elements. Let us explore each of them (2).  

Space / ether (akash)

Space / ether (akash) is ever humbly present as emptiness, allowing movement and communication as the other elements interact. Space is where life can take place, it is a place of potential, pure all-encompassing consciousness. In the human body we find it in the mouth, nose, digestive tract, uterus, lungs and abdomen. Its qualities are light, smooth, subtle and clear. Its actions are to give porosity or hollowness and lightness. It is associated with sound and the sense of hearing.

Air (vayu)

Air (vayu) is responsible for all movement. Where there is matter, there is motion, the constant motion of the planets, the change of the seasons and the spinning of electrons.  In the human body, this air principle is found in the nervous system, respiration, ingestion, elimination and feeding every cell with oxygen. Its qualities include being light, cold, rough, dry, subtle and clear. Its actions are to produce dryness, lightness, roughness, clarity, weakness and looseness (creating separation or division). It is also responsible for the sense of touch.

Fire (agni)

Fire (agni) is the radiant energy responsible for transformation. On a daily basis we see fire transforming water to steam and food from raw to cooked. In our bodies, fire is found in maintaining body temperature, transformation, digestion, absorption and assimilation of thoughts as well as food. Its qualities include being light, hot, sharp, subtle, dry and clear. Its actions are to heat, digest (transform) and give complexion and colour. It is associated with the sense of vision and the eye.

Water (jala)

Water (jala) binds everything together, the universal cohesive solvent. In the human body it makes up around 70% of our body mass and is found in plasma, intercellular fluid, urine, sweat and saliva. Approximately 70% of the earth is covered with water, a representation of the human body being a microcosm of the macrocosm. Water is oily, cold, soft, heavy, mobile and dense. Its actions are to moisten, lubricate, secrete, soften and give pleasantness. It is responsible for the sense of taste.

Earth (prithvi)

Earth (prithvi) gives stability, structure, strength and stamina. We see it in the form of bones, teeth and skin. We nourish ourselves with foods from the earth and the body returns to earthly matter. It is heavy, dense, stable and clear.  Its action is to help grow and accumulate mass, heaviness and stability.  It is responsible for the sense of smell and the nose.

Whether we’re talking about individual people, herbs, nutrition, lifestyle activities or even the weather, all things can be described in terms of these elements. We can assimilate herbs, minerals, food and fluids because these substances are made of the same elements found in our own underlying make-up. Using this idea, we can start to understand what herbs might support a particular person. For example, a person predominant in the fire element has a tendency to overheat, and should minimise use of heating herbs (e.g. black pepper and ginger), spicy foods and other sources of heat, such as excessive sunbathing and saunas. However, all of these will support a person predominant in air and ether, both cold by nature. 

“Just as the moon, sun and air support the body of this world by functions like releasing of strength, withdrawing of strength and initiating all actions respectively, similarly kapha, pitta and vata support this human body”. (3)

Ayurveda defines three dynamic pathophysiological entities as the basis for all body functions. Tridosha comprises two words: tri and dosha. Here, tri means a group of three basic elements (vata, pitta, and kapha) and dosha means ‘that which is capable of vitiation’. When vata, pitta, and kapha are vitiated (aggravated or imbalanced) they produce disease; when they are in equilibrium, they maintain balance and harmony in the body. 

Vata dosha 

That which carries smell (i.e. which has movement) (4).

Vata dosha is composed of ether and air, sharing qualities familiar to both elements: cold, light, rough, mobile, subtle and dry (5) The primary site of vata is the colon. It also resides in the bladder, thighs, ears, bones and the sense of touch. The root va means ‘to spread’ and it is responsible for all movements in the body; the flow of breath and blood, elimination of wastes, expression of speech, it moves the diaphragm, muscles and limbs, regulates the nervous system and stimulates the function of the intellect. It is like a current of electricity, responsible for regulating all electrical impulses in the body-mind. It is the messenger. In fact, without vata the other dosha are inert. At the cellular level, vata dosha may be associated with signaling pathways that regulate cell growth, differentiation, and cell death. Vata dosha also governs movements of cells, molecules, nutrients, and waste.

Pitta dosha 

That which heats, burns or warms up (4).  

Pitta dosha is made up of fire and water. This seemingly contradictory combination of fire and water is actually complementary. Pitta exists as water or oil in the body, thus pre-serving the tissues from the destructive aspect of fire. It is light, hot, sharp, oily, odorous and liquid (5) Its primary function is transformation being the force of metabolic activity associated with the endocrine function, hormone levels, digestion, body temperature, visual perception, hunger, thirst and skin quality. Mentally, it plays a role in understanding and in digesting sensory impressions. It resides in the eyes, blood, sweat glands, the small intestine, stomach and lymph. Its primary site is in the small intestine. Pitta dosha is responsible for processes bringing about change, such as digestion, metabolism, energy production, and maintenance of immunity. At the cellular level, it may be associated with the activity of enzymes, growth factors, hormones, and the reactions required for homeostasis and the maintenance of basal metabolism.

Kapha dosha 

That which embraces, adheres, or keeps together (4).

Kapha dosha is a combination of earth and water elements. As the water element is contained within the earthen structures of the tissues and skin, the dry earth is moistened by the reviving water element. It is slow, heavy, cool, dense, soft, greasy, unctuous, sticky, cloudy, liquid and sweet. Kapha holds the body together. It is cohesive, gives shape and form, aids growth and development, lubricates and protects, and facilitates the senses of smell and taste. It relates to phlegm in the body. It resides in the chest, throat, head, pancreas, stomach, lymph, fat, nose and tongue. Its primary site is the stomach.  It acts to form and maintain body mass, shape, and flexibility. At the cellular level, anabolic processes and the coordination of gene and protein function may be associated with kapha dosha.

According to Ayurveda, we are born with a unique and individual combination of the three doshas, known as our prakruti.  This is called our constitution (or mind–body type) and defines the ways our bodies and minds naturally function and respond. It is important to note that we all have all three doshas, it is just that we are born with ‘blueprints’ of a certain combination of them. Charaka, an ancient sage of Ayurveda, states that prakruti is determined by the doshic predominance of the following at conception (6): Sperm and ovum; seasons (as they have an effect on sperm and ovum); condition of the uterus; diet and lifestyle of expectant mother. For example, if your parents were both mainly pitta dosha but you were conceived during a period of change, stress and uncertainty, the chances are that both vata and pitta will be strongly represented in your constitution. 

Yet, how are doshas related to our DNA? One can think of prakruti as akin to genotype. The science of genetics is evolving rapidly but broadly our DNA doesn’t change (unless exposed to certain toxins or radiation). Similarly, our constitution (or prakruti) doesn’t change as both are set when we are conceived. There have been some studies looking for genomic variations between people who are vata, pitta and kapha dosha, which have found significant differences between people with different dominant doshas irrespective of their ancestry (7).

There is also growing research to support our understanding of how our doshic constitution impacts physiological factors, for example in how we sleep (8). The emerging field of Ayurgenomics integrates concepts such as prakriti, with modern genetics research. It correlates the combination of doshas with the expression of specific genes and physiological characteristics. It also helps to interpret Ayurveda as an ancient science of epigenetics that assesses the current state of the doshas and uses specific personalized diet and lifestyle recommendations to improve a patient’s health (9,10)

A vata constitution (more ether / space and air elements)

A vata constitution has a changing nature with fluctuation, irregular appetite, thirst and bowel movements, variable energy levels and irregular menstrual cycles. These individuals are more endowed with movement; active eyes, fast speech, quick bodily movements and are always on the go. The mind is also agile, creative, lively and enthusiastic. There is a desire for change and routines are often a struggle. Things are picked up quickly but more often forgotten in the long term. They have more dryness and roughness in the body; dry, rough skin, lips and hair, cracking joints. 

They’re more likely to be constipated and have wind. They are also colder; often have cold hands and feet and strongly dislike cold and wind, prefer warm environments, food and drinks. They will also be light; with a slender body and thin muscles finding it hard to put on weight.  Sleep is also light and sometimes elusive. Those with a vata constitution will be more likely to suffer from constipation, gas and insomnia when not in balance. The mind when out of balance tends towards anxiety, fearfulness and insecurity.

A pitta constitution (more fire and water elements)

These individuals tend to be hot / warm, sweat easily and have preference for cooling environments, food and drink, with strong thirst. They have both lightness and liquidity due to the combination of water and fire, with moderate builds and energy. There is moderation regarding their sleep, with a tendency to require six to eight hours to wake feeling rested. They have a strong digestive fire, well able to digest food, information and experiences.  If they go long without food, they’ll get irritable.  They have easy, regular, looser bowel movements, and can gain or lose weight as required. Physically, they have more red or yellowish tones regarding, skin, hair, lips and teeth. They also have a degree of oiliness, with relatively soft skin and soft, flexible joints. Hair is prone to early greying or balding, and skin irritation and burning. They have a mental intensity, being focused, driven, goal-oriented, competitive, intelligent and persevering. The eyes have a penetrating gaze and their speech is organised, sharp and clear.  Decision-making, organisation, discipline and routine come easily. They are more likely to have an odour, tend towards inflammation, hypertension and hypersensitivity when out of balance. Mentally, they may have a tendency to  being more angry, aggressive or argumentative.

A kapha constitution (more water and earth elements)

Such constitutions tend to be solid, heavy and firm, with naturally broad frames and large, well-padded joints. They gain weight easily and find it hard to shift. Their eyes are large and pleasant, lips, nose and teeth are also large. They have colder bodies, so tend not to like cold, wet weather. Sleep is heavy, eight hours is often needed, with some difficulty waking. They have thick, moist skin and abundant hair. They tend to be smooth with higher levels of oiliness in both skin and hair, with well lubricated joints. Speech and movements are slow and deliberate.  Their energy levels are steady, and they tend to have good stamina.  The slow quality is also seen in the digestion and bowel movements, with lower thirst and weaker appetite. There is a natural resilience in the face of stress, with an inner sense of stability and contentment.  Sometimes it takes a while to grasp new things but once they are remembered, they are there for life. When out of balance they tend to have excess mucus, congestion and water retention, along with lethargy and withdrawal.

Dual-dosha and tridoshic constitutions  

Ayurveda recognizes seven types of constitution, based on the different combinations of the doshas. The vata, pitta and kapha mono constitutions have been described above. It appears that people today predominantly have two main dosha. For example, a pitta–kapha or kapha-pitta constitution would have a combination of kapha’s heavy, firm oiliness and pitta’s fire and intensity, with both sharing oiliness in common. A vata pitta or pitta vata constitution manifests as a combination of vata’s airy, dry nature, along with pitta’s fire and intensity, with both doshas sharing lightness in common. With a vata kapha or kapha vata constitution, kapha gives strength and stability and helps balance vata’s light inherent instability. However, they share the quality of coldness in common, so are aided by warming herbs, diet and lifestyle suggestions. Finally, some people are blessed with a tridoshic constitution, or an equal balance of all three doshas. This is the strongest constitution as it’s the easiest to keep in balance and manage.  

Understanding one’s doshic constitution (and that of one’s clients) is a useful tool in getting to know oneself better. To be successful, we need the influence of vata to come up with ideas, creatively and enthusiastically; the influence of pitta provides the ambition, determination and drive to see these ideas through to completion; finally, the steady, sustaining influence of kapha keeps it all going on a day-to-day level.  Self-knowledge fosters self-acceptance, and by making subtle changes to diet, lifestyle, how we work and relate to others, the doshas can be brought back into a more balanced state with profound effects. In this way, doshas can be a ‘lens’ through which we look at the world. However, one must also heed the following:

“When you begin to solely identify with your body type, and worse yet, with your conditions, you lose sight of your marvellous gift of humanity. The Sanskrit word “dosha” from which the body types are derived actually means “fault.” In identifying or typecasting yourself solely as a pitta, or vata, or kapha person, or becoming fanatical about choices that support each type, you are limiting your true self and infinite joy to the mere mundane. You are more than bodily fluids, tissues, and diseased conditions. You are the ever generating, ever changing infinite consciousness. It is wise to remember that you are a whole entity with body, mind, and spirit, each with your own incredible karma” (11)

There are some useful online questionnaires which can help explore the doshas,  but it’s important to note these are in no way definitive and one may get different answers using different doshic questionnaires. It can get confusing as one may be ticking boxes covering both constitution (prakruti) and state of imbalance (vikruti). It is best to focus on answering the questions for when you felt most balanced — perhaps as a young adult — to find one’s constitution. Such approaches are best used as a spring board to a deeper exploration of doshic constitution with a qualified Ayurvedic Practitioner. There are also encouraging attempts to quantify the doshas in a reliable self-assessment questionnaire, so they can be readily applied in clinical studies to control for such differences in the same way sex, age, height and weight are routinely used (12). 

“A person having equilibrium of dosha, agni (fires), dhatu (tissues), mala (wastes) and kriya (processes/actions), and a person who is possessed by spiritual, sensual and mental happiness is called a healthy person.” (3)

The doshas are in dynamic equilibrium and the optimal function of each dosha and normal interactions between them are essential for good health. Accordingly, individuals with balanced doshas are less susceptible to disease than individuals with disturbed doshas. An abnormal dosha can be inhibited, excessive, or vitiated with the type and nature of disease primarily determined by which dosha is affected. This imbalanced state is known as vikruti. In fact, the definition of dosha is: “the actual intrinsic factors which become excited and imbalanced, either conferring a predisposition to or actually causing morbidities are called as the dosha.”(13). These are some of the signs and symptoms of an increase in each of the doshas, offering helpful indicators as to which dosha has become most out of balance and offering a pathway to restore health (14):

• Increased vata dosha: Black, red-brown discolouration of the body (hyperpigmentation), astringent taste in mouth, emaciation, desire for warm things, bloating, constipation, weakness, weakness, insomnia, excessive talking, giddiness, and loss of confidence.
• Increased pitta dosha: Yellow, green, red colour (seen in stool, urine, eyes, or skin for example, along with sour, bitter taste; hunger, thirst, burning sensations, insomnia, increase sweat and desire for cool things
• Increased kapha dosha: White discolouration (such as skin, stool), sweet and salty taste, weak digestion, excess salvia, feelings of coldness, flabbiness, breathlessness, cough, nausea, oedema, and excessive sleep. 

How do doshas get out of balance?

A key law in Ayurveda is the law of similarity and dissimilarity which states that ‘like increases like’.  So, if foods predominant in air and space such as astringent and bitter raw leafy vegetables are eaten, this will increase those two elements in the body, which correlates to an increase in vata. Conversely, if oily, sweet foods, predominant in earth and water are eaten, vata will decrease but kapha will increase. Eating excess chillies (high in fire element) will increase the fire element in our bodies, correlating to an increase in pitta; something immediately perceivable. Looking beyond nutrition, this law also explains why vata dosha (with cold, dry, mobile qualities) is aggravated in autumn, a cold breeze and excess travel / movement.

Pitta dosha (hot, liquid qualities) in summer, by excess intellectual work and saunas. Kapha dosha (cold, heavy, stable, damp qualities) in winter, with day time naps and not moving enough. It is important to be aware of our dosha as it is only when they are in their natural balanced state (our constitutional state, our prakruti) that we remain in health. It is most often our primary dosha(s) that will tend to go out of balance when our lives aren’t as measured as they should be. For example, the person with a kapha constitution eating lots of kapha-increasing foods and having kapha-increasing lifestyle factors, could end up with a kapha imbalance, with water retention, weight gain and mental lethargy.

According to the above law, kapha can be reduced by substances with opposing qualities such as warmth, dryness and lightness, so dryer grains such as barley instead of wheat, plenty of movement and some dry skin brushing. Vata dosha with warm, oily, nourishing foods, warm oil massage, plenty of rest and grounding activities. Pitta dosha with cool, slightly drying substances and calming lifestyle activities.

Ways to dysregulate vata	Ways to dysregulate pitta	Ways to dysregulate kapha
• Excess spicy, bitter, astringent food • Cold, raw, frozen food • Lack of food / fasting • Lack of routine or sleep • Cold, dry climate • Air conditioning • Excess worries, travel, movement • Use of stimulants and caffeine • High impact sports or adrenaline rush activities	• Excess spicy, salty, sour foods • Excess caffeine, alcohol • Frustration and anger • Overly heating forms of exercise • Exercise in midday heat • A hot climate • Work in hot environment / near fire • Regular use of steam baths and saunas • Competition	• Excess sweet, sour, salty taste • Heavy, sweet, greasy food  • Overeating  • Daytime sleep and sedentary lifestyle • Too little worries • A cool, damp climate • Bottling up feelings • Avoiding intellectual challenges • Use of sedatives
Bring vata into balance with warmth, nourishment, oil, grounding and routine	Bring pitta into balance with cooling, calming, moderation	Bring kapha into balance with lightness, dryness, warmth, and activity
• Warm, cooked, nourishing foods like soups, stews, whole grains, and healthy oils (ghee, sesame, olive oil) • Favour sweet, sour, and salty tastes • Maintain a regular daily schedule for meals, sleep, and activities • Practice calming yoga, meditation, and self-massage with warm oils • Enjoy warm oil massage • Wear warm clothes and avoid cold, windy environments	• Consume cooling foods like basmati rice, legumes, leafy greens, coconut water, and sweet fruits • Avoid spicy, fried, or overly salty foods • Favour cool environments, avoid excessive heat, and limit overexertion/ competition • Engage in gentle yoga, meditation, and cooling breathwork such as Sheetali pranayama • Enjoy coconut oil massage with cooling rose and sandalwood	• Favor light, warm, and dry foods such as steamed vegetables, barley, legumes, and spices like ginger and turmeric • Avoid heavy, oily, sweet, and cold foods • Engage in vigorous exercise and stimulating activities to energize the body and mind • Wake early, avoid daytime naps, and embrace social interaction and mental stimulation • Use dry brushing or massage techniques without oil to invigorate circulation

Applying the dosha to times of day, year, life and geography

The classical Ayurvedic texts are clear on the fact it is not just human beings who are subjected to categorisation by the dosha. As the whole universe is made up of the five elements, so all things are made up of the doshas and the concepts can be applied more broadly. This can offer useful insights for the herbal practitioner.

Times of day

Morning is kapha time — we are sleepy and can feel sluggish, and the earth is damp and covered in dew; midday is pitta time, as the fiery sun is at its peak and digestive fire is also at its strongest; afternoon is considered vata time, things are winding down and energy can lower. The second half of the day follows a similar pattern, with kapha domination 6 pm to 10 pm, pitta 10 pm to 2 am, and then vata 2am to 6am. So, consistently waking at 2.30 am, can indicate a vata imbalance is behind the sleeplessness.

Being too wired to go to bed until 1am, or else going to bed at 10pm but waking between  12 and 1.30am may indicate increased pitta is responsible. This insight also explains why Ayurveda suggests eating the largest meal between 10am and 2pm, as pitta dosha peaks at this time which governs the digestive fire.

Times of year

Spring is considered kapha time with its increase in water element leading to new growth and potential. Summer is considered pitta time with its heat. Autumn is considered vata time with its cold, dry windy weather and the leaves drying out on the trees. Many people notice a seasonal pattern to their symptoms flaring up and subsiding, which often make good sense with a doshic insight. For example, spring often sees an overflow of kapha dosha with spring colds and hayfever, late summer and early autumn are a common time for heat related skin issues to flare up such as psoriasis and rashes.

Life stages

Kapha dosha is responsible for the growth of children (who are soft, loving and cuddly) to physical maturity (0–16 years); pitta dosha is responsible for the maintenance of the body in its maturity (16–55 years) when we must be organised, focussing on careers and family life.  Elderhood is vata time, when we are full of wisdom and life’s experiences, as the space element increases in the mind. Individuals are especially vulnerable to dosha-related issues at this time, for example, there is a need for children to minimise mucus-forming foods (e.g. ice cream, orange juice and yoghurt) as they are at a kapha stage of life when excess kapha foods can cause coughs and colds. Conversely, in old age, when vata can aggravate, we need lots of warming food and warm oil massage to counter vata’s tendency to dryness and stiffness.

Geographical locations

A cool, dry, open, desert-like plain, breezy place or a mountain top can be considered places where vata dominates. A hot, steamy rainforest would be considered a pitta place. A damp, cool marshy place, rich in vegetation, would be considered a very kapha place. An air-conditioned building would also be viewed as a place that could potentially aggravate vata due to its cold, dry qualities. This insight may help explain why someone’s symptoms get aggravated or clear up completely when they change locations or working conditions. 

Understanding the doshas deeply enriches the practice of herbal medicine by providing a personalised, systemic diagnosis and treatment framework as follows:

Understanding doshic constitution (prakriti) and imbalance (vikruti)

As has been outlined, Ayurveda’s foundational concept of the three doshas defines an individual’s physiological and psychological makeup, and what health issues they are most prone to, as each dosha governs unique bodily functions and mental tendencies. Understanding a person’s dominant dosha(s) and imbalances supports precise diagnosis and personalised herbal interventions based on Ayurvedic pathophysiology. 

• A vata constitution is associated with erratic digestion and energy levels. Ginger and fennel are ideal digestives, along with a mild laxative if dryness has led to constipation.  Their naturally restless nature benefits from tonic, adaptogenic herbs such as ashwagandha and brahmi. Over the age of 55, vata starts to naturally increase so herbs to reduce stiffness in the body are helpful, such as boswellia. Herbs can be taken with warm water, milk, or almond milk and raw honey to enhance the effect (known as anupan in Ayurveda).
• A pitta constitution is prone to inflammation, irritability and excess acidity, so requires herbs to cool and calm, especially an overactive digestive fire (or agni). Amla is especially good for this with its sweet, cooling nature, along with aloe vera, shatavari, coriander, fennel, turmeric and liquorice. Herbs can be taken with warm water, milk or aloe vera juice.
• A kapha constitution is often associated with lethargy and congestion, requiring herbs to invigorate, supporting a slower digestion and metabolism. Ginger, black pepper and turmeric offer metabolic stimulation and reduce dampness. Trikatu (‘three spices’) is a wonderfully warming and pungent classic Ayurvedic blend ideal for this dosha. It dries mucous secretions and excess phlegm whilst also rejuvenating the lungs. Tulsi is also recommended if additional lung support and mucus reduction is required.

Understanding herbal energetics according to dosha

This approach empowers practitioners to harness each herb’s unique dosha-specific properties — nourishing and warming vata, cooling and calming pitta, stimulating and warming kapha — to restore doshic balance and optimising therapeutic success. 

Ashwagandha acts as an ‘adaptogen’ helping us adapt to stress and the fatigue and depletion that can often follow. Its warming, oily, and nourishing qualities especially counterbalance vata’s cold, dry, and mobile nature. For individuals with predominant or aggravated vata dosha, who may experience anxiety, nervousness, insomnia, or fatigue, ashwagandha supports calmness, stabilizes the nervous system and promotes vitality. With predominant or aggravated pitta dosha, its warming nature should be carefully moderated to avoid exacerbating heat-related symptoms. For increased kapha, Ashwagandha’s warming quality is of great benefit, but its oily quality may need dose adjustment to prevent heaviness or lethargy.

Shatavari is a renowned tonic for the female reproductive system, which also has a strong anti-inflammatory effect, particularly within the reproductive and the digestive systems. It is unusual in nourishing each of the body’s tissues. Its sweet taste and oily, heavy properties helps to soothe the dry, cold, and light qualities of vata. It acts as a gentle stabilizer that promotes calmness and vitality in restless vata constitutions or those with aggravated vata. With its naturally cooling and bitter-sweet taste, it pacifies the heat and inflammation associated with pitta. It balances hormonal fluctuations and soothes digestive discomfort such as acidity. However, it’s sweet taste and heavy, nourishing nature can increase kapha if taken excessively. It can be combined with warming herbs like ginger or cinnamon to balance its effects.

Gotu kola is a tridoshic herb (balancing each dosha) by grounding vata, tonifying pitta, and reducing kapha. It is the perfect herb to support a healthy mind, promote concentration, memory, and intelligence. It is calming and nourishing with aggravated vata, soothing the nervous system and relieving anxiety and restlessness often associated with vata imbalance. Gotu Kola’s sweet, bitter and astringent tastes all pacify pitta’s fiery nature, helping to reduce systemic heat and feeling hot ‘under the collar’. Additionally, its cooling action promotes skin health by calming irritated or inflamed skin conditions common with pitta imbalances. Its bitter, astringent tastes and light, dry qualities help reduce excess kapha by improving circulation and stimulating metabolism. It supports cleansing processes, enhances blood flow, and can aid in weight management. The herb also rejuvenates and uplifts energy with lethargy associated with aggravated kapha by rejuvenating the nervous system.

Tulsi is prized for its adaptogenic effects, bringing mental clarity whilst also calming any nervous tension. It steadies the adrenal hormonal stress response allowing you to cope better under pressure. It is seen to be mainly vata and kapha reducing with the potential to increase pitta when used in excess. In vata types, careful dosing is also required since tulsi can be a little drying or stimulating, potentially increasing vata if misused. In pitta-dominant individuals prone to inflammation, acidity, and irritability, tulsi’s heating effect may increase heat in their system too much. For kapha constitutions struggling with congestion or sluggishness, tulsi’s invigorating properties are ideal in aiding metabolism and digestion of mucus with its dry, light, heating properties.

Turmeric has potent anti-inflammatory properties and efficacy in treating digestive and immune conditions. It is seen as balancing for all three doshas due to its combination of qualities, acting on each of the body’s tissues recognised by Ayurveda. Vata constitution benefit from turmeric’s heating nature, but excessive use may aggravate due to its dry, light qualities unless balanced with oils for example. For pitta constitutions, with tendencies to internal heat and inflammation, turmeric’s bitter and astringent tastes aid digestion and reduces inflammation but it should be prescribed carefully due to its heating effects. In kapha constitution one can have less concerns as its pungent, bitter and astringent tastes, along with dry, light qualities and heating effect is the ideal combination to balance kapha,  stimulating metabolism and clearing mucus or stagnation, promoting vitality.

Triphala is such a widely used and useful formula as each of its ingredients specifically balances each of the doshas: Amla primarily pacifies pitta dosha due to its cooling action, along with sour, bitter astringent taste. It supports digestion, detoxification, and rejuvenation, combating excess heat and inflammation associated with pitta. Bibhitaki balances kapha dosha, due to its dry, light and heating qualities that help reduce mucus, promote detoxification, and support respiratory and metabolic functions related to kapha. Haritaki balances vata dosha with its heating nature and sweet post digestive effect. It aids in regulating the nervous system and digestive tract, supporting elimination, and calming the erratic qualities of vata. Because each fruit targets a different dosha, their combination provides a powerful synergistic effect that helps maintain digestive health, supports regular bowel movements, enhances immunity and promotes detoxification without disrupting doshic equilibrium. Its tridoshic nature makes it a cornerstone of Ayurvedic herbal therapy, explaining its widespread use and efficacy in Ayurveda.

Complementing lifestyle and diet suggestions 

Beyond the herbal prescription, understanding doshas can also guide some appropriate dietary and lifestyle recommendations (as outlined in the table above). In summary, a vata individual is advised to consume warm, moist, grounding foods and adopt calming routines. A pitta individual benefits from cool, non-spicy diets and stress-reduction practices to prevent overheating. For kapha types, more stimulating activities balances their natural heaviness and aids detoxification.

Daily and seasonal adjustments

The dynamic fluctuation of doshas with times of day, life, seasons and environment may inform both diagnosis and treatment. For example, during the cold and dry autumn season when vata is naturally higher, treatments aim to pacify vata‘s qualities (dryness, coolness, roughness). A herbal ashwagandha oil with its warming and stabilizing energetics would be ideal. Aloe vera is prized for its cooling, bitter, and moistening qualities, which help balance pitta dosha that tends to increase during summer months. Excess pitta, associated with heat and inflammation, can cause skin irritation, digestive disturbances, and inflammatory conditions and aloe vera’s cooling nature soothes these imbalances effectively.

Looking at how doshas predominate different times of the day, we’ve outlined how 6–10 am is a kapha time of day characterised by heaviness, stability, and moisture. Morning intake of kapha-pacifying herbs such as ginger, turmeric, or triphala can stimulate digestion and clear accumulated toxins. Pitta, governing digestion, peaks around midday when agni is strongest. So, this is a beneficial time to take herbs that stimulate digestion and that enhance assimilation like ginger, cumin or coriander. 

Understanding the doshic constitution and imbalances offers unique insight to guide herb selection by matching herbal energetics to individual doshic imbalances and constitutional needs. It supports holistic healing by addressing the root imbalances reflected in unique physical, mental, and emotional patterns. It helps anticipate and mitigate potential aggravations of dosha imbalances (e.g., overheating pitta with too much turmeric).

It also allows for the adjustment of formulations, doses, and complementary lifestyle or dietary recommendations to optimize effect and reduce side effects. Overall, it supports transforming herbal medicine from uniform protocols into personalised, integrative therapies that respect and work with the body’s intrinsic nature, alongside seasonal and even geographical considerations.

1. Pole S. Ayurvedic Medicine: The Principles of Traditional Practice. 2nd ed. Churchill Livingstone; 2013. Foreword.
2. Vāgbhaṭa. Astanga Samgraha, Sutra Sthana 17/4-8. (Classical Ayurvedic text; date unknown, traditionally ca. 7th century CE).
3. Suśruta. Sushruta Samhita, Sutra Sthana 21/8. (Classical Ayurvedic text; traditionally ca. 1000 BCE–500 CE).
4. Suśruta. Sushruta Samhita, Sutra Sthana 21/5. (Classical Ayurvedic text; traditionally ca. 1000 BCE–500 CE).
5. Vāgbhaṭa. Astanga Hridaya, Sutra Sthana 1/11. (Classical Ayurvedic text; traditionally ca. 6th century CE).
6. Caraka. Charaka Samhita, Vimana Sthana 8/95. (Classical Ayurvedic text; traditionally ca. 1000 BCE–200 CE).
7. Sharma H, Wallace RK. Ayurveda and epigenetics. Medicina. 2020;56(12):687. https://doi.org/10.3390/medicina56120687 
8. Telles S, Pathak S, Kumar A, Mishra P, Balkrishna A. Ayurvedic doshas as predictors of sleep quality. Med Sci Monit. 2015;21:1421-1427. https://doi.org/10.12659/msm.893302 
9. Wallace RK. Ayurgenomics and modern medicine. Medicina. 2020;56(12):661. https://doi.org/10.3390/medicina56120661 
10. Prasher B, Gibson G, Mukerji M. Genomic insights into ayurvedic and western approaches to personalized medicine. J Genet. 2016;95(1):209-228. https://doi.org/10.1007/s12041-015-0607-9 
11. Tiwari M. Women’s Power to Heal Through Inner Medicine. New York: Mother Om Media; 2007. p.47.
12. Edwards MT, Streiner DL. Development of a reliable dosha self-assessment questionnaire. Explore. 2022;18(5):573-578. https://doi.org/10.1016/j.explore.2021.09.003 
13. Dwarkanath C. Introduction to Kayachikitsa. 3rd ed. Varanasi: Chaukhambha Orientalia; 1996. p.20.
14. Vāgbhaṭa. Astanga Hridaya, Sutra Sthana 11/5-7. (Classical Ayurvedic text; traditionally ca. 6th century CE).

Guggulu (Commiphora mukul) as it is known in Ayurveda, or myrhh as it’s known in the West, is a highly popular ingredient in a number of important Ayurvedic remedies; in this introductory article we will take a closer look at its medicinal application as well as its recommended purification techniques (1).

Guggulu is the common name of this plant; the meaning of its name something akin to ‘having excellent benefit’. The categorisation of guggulu is a slightly complex affair as Ayurveda advises us that five colours abound. These very simply are: Mhashya (a blackish/brown colour and most suited to human patients, mahaneed, having a bluish colouration (indeterminate use (2)), kumud (having a pale or whitish colour), padma (brownish in colour and suited more to use on animals) and finally, kanak (yellowish in colour and most suited to human patients).

Typically, two varieties of guggulu are seen in the marketplace (3), these being: kana-guggulu, a greenish/yellow variety; and mhasha-guggulu, a blackish brown variety.   

Commiphora mukul is a smallish, thorny tree, usually 1.5–2 meters in height. It is found in South Asia, the Middle East and Africa, favouring an arid climate. In India, it is typically found in the Indian states of Gujarat, Rajasthan, Assam, Madhya Pradesh and Karnataka. The flowers of guggulu are reddish brownish, its leaves rounded, serrated and waxy looking. The fruits of this tree are reddish, pulpy and rounded.

Guggulu is an exudate or niryasa, being obtained via the method of tapping. Tapping involves stripping away or piercing the bark of the tree to facilitate the flow of its gum. Commiphora mukul has a number of ducts throughout its bark in which the oleo-gum-resin abounds. To effectively capture this exudate, large leaves or the shell of coconut is affixed around or just below the point of excision. Over a period, these receptacles slowly fill and are later collected.

Upon retrieval, the material has hardened and darkened. It is not uncommon for each catch to be contaminated with some amount of leaves, insects, bark etc. and so will need to undergo so level of cleaning, see shodhana process of guggulu.  The tree is usually harvested between May and June (4), with anywhere between 250–500 g of resin collected from each tree during any harvest season.  

Some of the more important chemical constituents of guggul (by quantity) include its gums and essential oils, sucrose, fructose, amino acids, flavonoids, α-camphorene, ellagic acid, sterols (such as guggulsterone, β-sitosterol, Z- and E-guggulsterone) and carbohydrates, as well as a variety of inorganic ions.

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1. Also guggula, guggal and gugar
2. In Ayurvedic and alchemical texts, the colour blue is usually associated with toxins and/or requiring purification/cleansing.
3. Most purified material is a slightly mixed colour, with an element of green, yellow and brown. Natural oxidation and older batches naturally darken. The traditional categorisation or colours is typical, in Ayurvedic text and sometime hard to qualify. 
4. In some cases – autumn? 

As previously mentioned, guggulu is an important medicinal compound in Ayurveda, but just how old is its use?

One of the earliest references to guggulu is found in the Atharvaveda (5). In Hymn 38 “With Guggulu, against disease“, we are told: “Disease obstructs him not, a curse attains him not, whom the agreeable odour of the healing guggulu attains. From him, diseases scatter away, like antelopes from a wild beast. If, O guggulu, thou art from the river, or if also from the ocean, the name of both have I taken, that this man may be uninjured”.

Later on, more detailed accounts of its action, uses and indications are discussed in Ayurvedic classical works such as Caraka Samhita, Susrutha Samhita and Astanga Hrdayam. All extol its healing prowess, along with its ability to reduce fat, cleanse the tissues and reduce pain, joint stiffness, inflammation and other maladies.

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5. Sometimes called the forth Veda and one most linked to the healing arts and Ayurveda, this text is tentatively dated at around 1000BCE. 

Modern Ayurvedic works define guggulu’s taste as being: bitter, pungent, sweet and astringent, with its pungency and heating qualities more prominent. The prabhava or special property of this resin is that it has beneficial effects for all Ayurvedic doshas. In those cases of diminished health, where all three doshas are involved, guggulu is often indicated as a staging post from which to strike out and combat disease.  

Guggulu has excellent anti-inflammatory and anti-arthritic properties as well as regulating thyroid function. It is a powerful antioxidant, with good cardioprotective and cytotoxic properties. It also has an antimicrobial action as well as being effective in reducing a good number of complicated and difficult to treat skin diseases.

Taken internally, guggulu has an antiseptic bitter/astringent effect; it stimulates appetite and digestion as well as promoting an overall calming effect in the mind and body.

Ayurveda commonly uses this resin to treat obesity, arthritis (osteo and rheumatoid), general paralysis, diabetes, sciatica, gout and haemorrhoids/constipation. It is also useful in combatting inflammation, cysts, coronary thrombosis, anaemia and urinary calculus.

Used externally in the form of a lotion/paste (known as lepa), it has proved useful in treating stubborn skin conditions. In the form of a tincture or herbal wine, it can be useful for sore throats, tonsillitis, gum infections and toothache. Finally, Inhalation of the resins fumes (a kind of incense if you will), is recommended for hay fever, nasal catarrh, bronchitis and laryngitis.

Within the Ayurvedic formulary of India, an entire section has been dedicated to guggulu based medicines. The resin of this tree might also be said to be something of an oddity within the materia medica of Ayurveda in as much as it has something of an alchemical nature to it.  

Akin to a number of popular alchemical ingredients found in Ayurvedic medicine, the resin is advised to undergo shodhana, prior to use. Shodhana simply means to ‘clean’ or ‘make ready’ for human consumption. This is usually done through the application of heat or being immersed/triturated with other ingredients. In the case of guggulu, ‘heating’ usually means boiling it in liquids such as milk, cow’s urine or other herbal decoctions.

Upon completion, the resin is referred to as suddha-guggulu; or pure guggulu. In effect this is highly refined and filtrated form of the resin. In some cases additional processing can reduce the resin to a powder form.

Another interesting property of guggulu resin is its appearance in a mixture of five ingredients (plus borax), the combination of which is used to ‘pull’ impurities from a selection of medicinal minerals. This alchemical extraction of ‘sattva’ or essence from such materials is lesser used process but none the less effective. 

Typically the minerals in question include: copper sulphate, iron sulphate, mica and types of water soluble bitumen. These are all then mixed with borax, a natural fluxing agent. Equal amounts of honey, gunja seed powder (Abrus precatorius), jaggery (coconut sugar), ghee and guggulu are then beaten together into a waxy pulp and mixed with the aforementioned minerals.

This mass is then subjected to very high temperatures (more than 1000 degrees) in an open crucible. The end result (a fine bhasma or alchemical ash) is then reduced to a fine powder and used medicinally.

The following outlines a few variations of guggulu shodhana. Therapeutically, there seems no clear favourite amongst these, each seemingly having merit. Ultimately, processing may just be based upon circumstance, i.e. availability of purification materials and amount of final purified gum that is typically obtained.

Method 1: Steaming

1. After collecting exudate, it is hand sifted to remove any obvious inclusions such as twigs, leaves, soil and insects that may have accrued during the collection process.
2. The remaining resin is placed into a course fabric, which is tied off into a rounded bolas or parcel. These are then secured about their neck with cord.
3. A quantity of triphala decoction is prepared at a ratio of 8 parts water to 1 part triphala. This then reduced to about 50% by volume and filtered.
4. The next procedure is to prepare an apparatus known as dola Yantra or swing device. Here, the cloth parcels with guggulu resin inside can be suspended just above the triphala decoction. This type of apparatus is used a lot in Ayurvedic alchemical preparations as well, allowing essences to be retained when steaming or soak without the risk of heat damage.
5. The decoction is now brought up to a point just below a rolling boil and the cloth parcel containing guggulu is ‘steamed’ for 2–3 hours.
6. The next step is to prepare a heavy wooden board. Its surface is cleaned and smeared lightly with ghee. The contents of the cloth parcel are emptied onto the board and sifted quickly by hand. Here any unwanted material is removed and resinous material is mixed and coated with ghee.
7. After sifting, guggulu is placed into a stone mortar and pounded until a tick and even mass is achieved. To reduce stickiness, the inside of the mortar is also lightly coated in ghee. The main thing to keep in mind here is that a warm environment greatly increased the efficiency of this method. If the work area or tools is cold, the resin will be much harder to work with.

Note: the steaming method by far produces the largest amount of end product. Subsequent methods produce fewer end products, but what is produced is highly concentrated.

Method 2: Boiling

This second procedure closely parallels the method given under ‘steaming’; only here the cloth parcel is actually immersed into triphala decoction. Having been cooked for about 1.5–2 hours, the cloth is squeezed just prior to removing. This allows any remaining resin to be liberated. Having separated the resin from the gum, the remaining mass is discarded.  

Note: composting on the garden is the best use for this material.

The retained portion of liquid holds the sattva or essence of guggulu. To fully recover this, the liquid needs to be reduced on a low heat until all water is removed and only the resin remains. Toward the end of this procedure, resin will starts to cling to the surface of the pan, indicating the water content is all but gone. The final resin collected from the pan is again mixed with ghee and beaten into a homogenous lump.

It is probably worth mentioning here that the liquid content (or decoction) used in these two steps can vary according to end use, or availability. In most cases triphala decoction will be the decoction of choice, however, cows’ urine, milk, or just hot water are also likely to be employed, and roughly do the same job.

Note: Guggulu resin is only partially water soluble, reducing to a milky white consistency in heated water. While an infusion of resin in cold water will discolour a little, it will require heat to help break it up and enable you to clean up after processing.

Method 3: Frying

Using this method, Guggulu resin may be lightly fried in ghee. Using a fairly high heat, the resin liquefied and fried. This pliable mass needs to be worked quickly with a wooden spoon. When the material fully liquefies, darkens or begins to stick to the pan, the heat is terminated.  At this point, semisolid, sticky cooked resin is removed and its excess oiliness removed. When cool, the mass hardens and can be powdered.

• Kanchanara guggulu — Reduction of glandular swellings and skin diseases
• Goksuradi guggulu — Reduction of osteoarthritis and worn joints
• Kaisora guggulu — Reduction of gout and raised uric acid levels
• Yogaraj guggulu — Strengthens muscular-skeletal system, reduces pain
• Simhanada guggulu — Reduction of swellings and joint pain (rheumatoid arthritis)
• Maha-togaraj guggulu — Reduction of urinary stones, respiratory and digestive dysfunctions

Note: Guggulu appears in a good number of Ayurvedic formulas and has an entire category assigned to it in The Ayurvedic Pharmacopeia of India. It has excellent longevity as a remedy, its resin is said to have a shelf life of around 20+ years (7).

Ayurveda advises that freshly harvested resin, has a potential to aggravate skin conditions, disturb menstruation (weaken fertility), make one nauseous, create headaches, vertigo and dryness. In some cases it can produce diarrhoea and/or derange liver function. For this reason, fresh resin (less than 12 months) is recommended to be given some level of purification. Indeed, patients experiencing any of the above conditions are contraindicated.

Note: Some texts indicate saffron and curd may be used as an antidote to adverse guggulu reactions.

In the author’s experience, mature batches of guggulu (more than two years) may no longer require shodhana; however, as this processing generally adds potency to the medicine, as well as insuring purity, it seems shodhana should be performed regardless of the age of the resin.

Agni The digestive fire with the function of regulating digestion, absorption and assimilation.

Ahara rasa The food essence created after agni transforms food into an absorbable form. It nourishes all the tissues.

Alochaka pitta The aspect of pitta residing in the eyes. It assimilates visual impressions.

Ama Undigested food, herbs or experiences that create disease-forming toxins.

Amashya The stomach

Apana vayu The aspect of vata responsible for moving downwards and elimination of stool, flatus, urine, menses and the foetus.

Arthava The menstrual channel, tissue and ova.

Ashtanga Hridaya Samhita The Eight-Limbed Heart Sutra written by Vagbhatta c600 CE. A collated work on the essence of Ayurveda.

Asthi dhatu Bone tissue giving support to the body.

Astringent A tannin-rich herb that dries discharges and reduces leakage.

Avalambaka kapha The aspect of kapha that resides in the heart and lungs, supports ojas and is connected with immunity.

Ayurveda The traditional medical system of India meaning the ‘science of life’.

Bhashma An alchemical tonic compound usually made from metal or gems.

Bhavaprakasha Written by Bhavamishra around 1596CE. The most important Ayurvedic materia medica treatise listing the energetics of herbs and foods.

Bhrajaka pitta The aspect of pitta that resides in the skin and gives awareness of touch, skin colour and lustre.

Bhuta agni The aspect of agni that resides in the liver and is responsible for transforming the elements of earth, water, fire, air and space.

Bodhaka kapha An aspect of kapha that resides in the tongue and mouth that facilitates taste and digestion.

Chakra An energy centre linking the physical and astral realms. Also related with the plexuses from where nerve fibres spread throughout the body.

Charaka The author is considered to have expounded the Charaka Samhita, the oldest extant Ayurvedic text written between 150BCE-100CE.

Dhanvantri The Lord of Ayurveda.

Dhatu One of the seven tissues that gives structure and support to the whole body.

Dhatu-agni (also written correctly as dhatvagni) The digestive fire that exists in the tissue membranes and is responsible for digesting the unstable portion of the dhatu into the stable portion. It also separates the waste products, secondary tissue and unstable portion of the next tissue from the stable portion.

Dosha One of the three humours called vata, pitta and kapha. When balanced they are responsible for good health, but when imbalanced they act as ‘faults’ and can cause illness.

Guna The three subtle qualities of nature; sattva, rajas and tamas. Also the twenty attributes that Ayurveda uses to describe the different qualities of matter.

Hridaya The heart

Jatar agni The digestive fire that lives in the stomach and duodenum. It transforms food to food essence (ahara rasa).

Kalaa The membrane which houses the dhatu agni of each tissue.

Kapha One of the three dosha with qualities of earth and water. It is heavy, wet and cold, lives in the stomach and is responsible for nourishing the mucus membranes, bones, joints, heart and memory. It lubricates the organs and joints and binds the whole body together. When healthy it creates love and compassion, when destabilised it creates phlegm, excess weight, lung problems, greed and attachment.

Kledaka kapha The form of kapha that resides in the stomach and nourishes the mucus membranes throughout the body. It is responsible for liquefying food and protecting the stomach wall from corrosive digestive acid.

Kshaya A deficient state of the dosha or dhatu.

Majja dhatu  Nervous tissue and bone marrow giving nourishment to the nervous system and unctuousness to the nerves.

Manda agni A slow and deficient digestive fire, characteristic of kapha disorders.

Mamsa dhatu Muscle tissue giving strength and binding the body together.

Manas prakriti The mental constitution regulated by sattwa, rajas and tamas.

Materia medica The materials of medicine. The study of the drugs or substances that are used to treat disease. Commonly used to refer to books that are collections of herbal materials.

Medas-dhatu (written correctly as medodhatu) Fat tissue protects the organs and other tissues and it lubricates the body.

Ojas The essence of all digestion that maintains the inherent immunity and strength of the body. The ultimate result of perfectly digesting kapha foods and experiences.

Pachaka pitta The aspect of pitta that resides in the small intestine, acting from the stomach to the ileo-caecal valve, and facilitates in the digestion of food.

Panch karma The five cleansing techniques of therapeutic emesis, purgation, enemas, nasal cleansing and blood-letting.

Panchmahabhuta The five great elements of space, air, fire, water and earth that make up the material universe. Created from a division of purusha and prakriti.

Pitta dosha The humour comprised of water and fire. It is hot, wet and light and its main site is the small intestines. It is responsible for the metabolic processes of the body. When healthy it adds zest, clarity and energy to life but when aggravated it creates burning, inflammation and anger.

Prabhava The unique action of a plant above and beyond its energetic qualities.

Prajnaparadha A crime against wisdom that is a formative factor in disease. Acting against your inner knowledge.

Prakopa The second stage of the disease process that irritates and aggravates organs in the body. The term dosha prakopa is commonly used to indicate an imbalance in the humours.

Prakriti The manifest aspect of reality that is expressed in matter, nature and creation. Also used to describe the individual constitution and inherent nature of every person.

Prana The subtle essence of the life force. It travels on the breath and is absorbed from the air, food and nature. It is responsible for vitality and cellular communication. It is the link between the body and the mind. The ultimate result of perfectly digesting vata foods and experiences.

Prana vayu One of the five aspects of vata that is responsible for inspiration and drawing things into the body. Its main seat is the brain and it operates between the navel and throat. It regulates mental functions and respiration.

Pranayama The yogic practice of breathing with awareness. The focus is on extending the length of breath and balancing the rhythm.

Purusha The subtle aspect of consciousness that is ever still and watchful. This is the witness to all of creation, detached yet ever conscious.

Rajas The quality of nature responsible for movement, passion and energy.

Rakta dhatu The blood tissue responsible for giving life and colour to the tissues.

Ranjaka pitta The aspect of pitta that lives in the liver and spleen and affects the quality of blood.

Rasa The taste of a substance. The six tastes of sweet, sour, salty, pungent, bitter and astringent are used in Ayurveda to classify the quality of foods and herbs. It also means the essence of something.

Rasa dhatu The plasma tissue nourishes the other tissues in the body and has a direct effect on the skin and the menstrual cycle.

Rasayana A substance that tonifies and nourishes the whole system. Literally something that extends the quality and quantity of life.

Rejuvenative  A substance that tonifies and nourishes the whole system.

Roga Disease

Sadhaka pitta The aspect of pitta that lives in the heart and is responsible for awareness and intelligence.

Samana vayu One of the aspects of vata responsible for regulating the flow of prana in the middle of the abdomen. This helps to support the digestive process.

Samprapti The pathology of a disease.

Sankhya The philosophical system that Ayurveda draws the cosmological understanding of matter and evolution from.

Sara Denotes tissues of a high quality.

Sattva The quality of nature reflected in compassion, light and intelligence.

Sedative A substance that tranquillises the function of the nervous system.

Shakti Meaning ‘energy’ and represents the dynamic feminine vitality throughout the universe. The natural and balancing opposite to Shiva.

Shiva Meaning the ‘auspicious one’, Shiva is one of the main Hindu deities and represents the energy of destruction and transformation.

Sleshaka kapha The aspect of kapha that lubricates and protects the joints.

Shukra dhatu The reproductive system relating to sexual function; sperm in men, ova in women.

Srotamsi The channels that carry nutrients, prana, tissues and wastes around the body. They interlink the body as a network of tubes. Srotamsi is plural ‘channels’ and srotas is singular ‘channel’.

Stanya Janana Galactagogue to encourage the flow of breast milk.

Sushruta Samhita A detailed surgical text written around c100-500 CE by the great Sushruta.

Swastha Health

Tamas The quality of nature that reflects dullness, inertia and darkness.

Tantra A spiritual path utilising all of the senses for deifying the body. Successfully practising this results in being carried across to the other side of existence, the shores of liberation.

Tarpaka kapha The aspect of kapha that lubricates and nourishes the brain. Responsible for memory retention.

Tejas The essence of the fire element. The result of the perfect digestion of all pitta natured foods that gives consciousness and clarity to the mind.

Tikshna The quality of sharpness that can penetrate deeply into the tissues.

Tikshna agni The nature of the digestive system when it is overactive. This can lead to rapid digestion, hunger, hypoglycaemia and over metabolism. The tendency of pitta aggravation is to have a tikshna agni.

Udana vayu The quality of vata that resides in the throat and upward movements, regulates speech and exhalation.

Vata The humour made from space and air elements. It is light, dry and cold and resides in the large intestine. It is responsible for all movement in the nervous system, muscles, heart and mind. When out of balance it creates bloating, erratic digestion, constipation and anxiety, when in balance it creates inspirational creativity and flexibility.

Vikruti The current state of someone’s health or the present state of imbalance, as opposed to the prakriti that is the life-long constitution.

Vipaka The post-digestive energetic effect of the tastes.

Virya The energetics of a herb: hot or cold.

Visham agni The nature of the digestive fire when it is erratic; sometimes digesting well and at other not digesting efficiently. Common in vata disorders.

Vitiate When the function or structure of a dosha, dhatu or mala is disturbed.

Vriddhi A condition of excess in the humours, tissues or wastes.

Vyana vaya The quality of vata that is responsible for spreading outwards. It regulates the circulation, nervous system and all joint movements.

Medicinal substances are classified according to groups that have different physiological actions. The Charaka Samhita lists 50 groups of ten herbs and the Bhavaprakasha Samhita has 24 such categories. These Ayurvedic pharmacological concepts offer deep insight into how herbs work to balance the doshas, dhatus, and malas. They tie together the concepts of taste (rasa), energetics (virya) and post-digestive effect (vipaka) as well as incorporating prabhava so that we can have a clear understanding of the primary action of the herb. The list below contains some of the most popular categories listed throughout the Ayurvedic literature.

Abhishyandi These substances block the channels and cause heaviness. The flow of rasa is hindered and stagnation occurs when too much of these substances are used. They are mainly unctuous and heavy in nature; e.g. yoghurt obstructs the flow in the channels.

Anuloma These herbs help vayu to move in its appropriate direction. They are often mild aperients and help with flatulence and constipation. They are usually aromatic and carminative herbs, commonly from the umbelifer Apiaceae family, such as fennel seed (Foeniculum vulgare) or ajmoda (Apium graveolens).

Arsoghna There are anti-haemorrhoidal remedies such as chitrak (Plumbago zeylanicum) or ginger (Zingiber officinale).

Artava janana Herbs promoting the menstrual flow such as myrrh (Commiphora myrrha).

Balya This means strengthening and these herbs are tonics. They are usually heavy and filled with the earth element, like bala (Sida cordifolia) or ashwagandha (Withania somniferum).

Bhedaniya These are purgative herbs that forcibly expel the solid and liquid parts of faeces. Kutki (Picorrhiza kurroa) has this effect at a high dose.

Brmhaniya These are nourishing herbs that are full of the water element; e.g. Shatavari (Asparagus racemosus).

Chaksushya These herbs improve eyesight; e.g. Amalaki (Phyllanthus officinalis).

Chhardi nigrahana These are anti-emetic herbs such as fresh ginger (Zingiber officinale recens), pomegranate juice (Punica granatum) or cardamom (Elettaria cardamomum).

Chedana These herbs actively draw out toxins by scratching them from the tissues; guggul (Commiphora mukul), shilajit (Asphaltum) and black pepper (Piper nigrum) all help to detoxify the deeper tissues.

Daha prasamana These herbs alleviate burning sensations in the body, such as sandalwood (Santalum album) or coriander (Coriandrum sativum).

Dipaniya These herbs enkindle the digestive fire. They indirectly digest ama. They are usually pungent, hot and dry; for example long pepper (Piper longum), black pepper (Piper nigrum) and chitraka (Plumbago zeylanicum).

Garbashaya These herbs have an affinity for the uterus, such as ashoka (Saraca indica) and roses (Rosa centifolia).

Grahi These herbs dry the moisture of the body and of the wastes; ginger (Zingiber officinale), cumin (Cuminum cyminum).

Hikka nigrahana These herbs are anti-hiccough such as Clove (Syzygium aromaticum).

Hridaya These herbs have a tonic effect on the heart; arjuna (Terminalia arjuna) and ashwagandha (Withania somnifera).

Jeevaniya These herbs are life-giving and rejuvenative herbs, such as amalaki (Phyllanthus officinalis).

Jwarahara These are anti-pyretic herbs for stopping fevers including Musta (Cyperus rotundus) and Kalmegh (Andrographis paniculata).

Kandughna These are anti-pruritic herbs such as peppermint (Mentha piperita), turmeric (Curcuma longa) and musta (Cyperus rotundus).

Kanthya These herbs are renowned for their affinity for the throat; for example licorice (Glycyrrhiza glabra), long pepper (Piper longum).

Kasahara These are anti-tussive herbs such as vasaka (Adhatoda vasaka) or long pepper (Piper longum).

Krumighna These herbs are specifically for removing parasites and worms; for example neem (Azadiracta indica) or kalmegh (Andrographis paniculata).

Kushtaghna These are herbs that treat skin diseases such as neem (Azadiracta indica) or manjishta (Rubia cordifolia).

Lekhaniya These herbs ‘scrape’ the waste residues out of the body by a drying action. They are usually bitter and pungent in flavour; for example guggul (Commiphora mukul), myrrh (Commiphora myrrha), vacha (Acorus calamus), turmeric (Curcuma longa), triphala, barley and honey.

Madakari These are substances that cause intoxication, such as alcohol.

Mutra sangrahaniya These herbs reduce the flow of urine, such as bhallataka (Semecarpus anarcadium)

Mutravirechana These herbs are diuretics that increase the flow of urine, such as gokshura (Tribulus terrestris) and coriander (Coriandrum sativum).

Nidrajnana These herbs promote sound sleep; e.g. tagarah (Valeriana wallichi), ashwagandha (Withania somnifera)

Pachana These herbs directly ‘digest’ ama.  They do not necessarily stimulate digestion as well; e.g. triphala.

Praja sthapana These herbs prevent miscarriage such as ashoka (Saraca indica).

Pramathi These herbs remove the accumulated doshas from the dhatus and cells; e.g. vacha (Acorus calamus) and black pepper (Piper nigrum).

Purisha sangrahaniya These are intestinal astringents that stop diarrhoea such as bilva (Aegle marmelos).

Rakta shodhana (rakta prasadana) These herbs specifically clean the blood and ‘alter’ its chemistry so that it does not cause inflammatory problems; for example manjishta (Rubia cordifolia).

Rechana These herbs are cathartics. They forcibly expel faeces as semi-solid diarrhoea; e.g. castor oil (Ricinis communis) or Rhubarb root (Rheum palmatum).

Rasayani These herbs rejuvenate the cells and extend life. They are anti-oxidants and also remove diseases; e.g. guduchi (Tinospora cordifolia), amalaki (Phyllanthus officinalis) and haritaki (Terminalia chebula).

Samjanasthapana These herbs are used to restore consciousness; e.g. vacha (Acorus calamus).

Sandhaniya These herbs heal broken bones and hasten the repair of broken bone tissue. Guggul (Commiphora mukul) is famous for this. Resins have a significant role here because resins in general are considered to relate to the blood part of plants just as the bark of trees is said to relate to bone tissue. The analogy is that just as resin heals the bark so it heals the bone. They also encourage circulation to flow to the wounded part of the body and hasten healing.

Shamana These are herbs that reduce the pathogenic level of a dosha to a more healthful level. The dosha is not expelled from the body, it is calmed. These are ‘palliative’ herbs; e.g. guduchi (Tinospora cordifolia).

Shirovirechan These are herbs that clear the orifices of the head, also known as errhines. Such herbs are vacha (Acorus calamus) or Cloves (Syzygium aromaticum).

Shodhana These herbs actually clear the excess doshas out of the body; e.g. triphala, castor oil (Ricinus communis) or manjishta (Rubia cordifolia).

Shonita sthapana These are haemostatic herbs such as manjishta (Rubia cordifolia).

Shramshana Herbs that are laxatives and clear faeces before complete digestion is complete; e.g. trivrut (Operculina turpethum).

Shula prasamana These are anti-colic herbs that prevent intestinal spasms; for example hingu (Ferula asafoetida) or cumin (Cuminum cyminum).

Shukrala Herbs that increase semen and/or give force to its ejaculation; e.g. amalaki (Phyllanthus officinalis), ashwagandha (Withania somnifera) and shatavari (Asparagus racemosus).

Shukra janana These are sperm increasing herbs; for example ashwagandha (Withania somnifera) and safed musali (Asparagus adcendens).

Shukra shodhana These herbs purify the sperm such as gokshura (Tribulus terrestris).

Snehopaga These are moistening herbs such as castor oil (Ricinis communis) or Tila/Sesame (Sesamum indicum).

Stambhana These are astringent herbs that are constipating, stop bleeding and are drying. They have the properties of vata and so increase it. Manjishta (Rubia cordifolia) is a renowned astringent that stops bleeding diseases.

Stanyavardhana These herbs can increase lactation; for example fennel (Foeniculum vulgare) and shatavari (Asparagus racemosus).

Stanya shodhana These herbs purify the breast milk, such as fennel (Foeniculum vulgare) and musta (Cyperus rotundus).

Sukshma These herbs are penetrating herbs that can travel through the minutest channels, such as salt, neem oil (Azadiracta indica) and gotu kola (Hydrocotyle asiatica).

Swasahara These herbs prevent breathing difficulties, such as somalata (Ephedra vulgaris) and vasaka (Adhatoda vasaka).

Swedopaga Herbs that induce sweating, such as vasaka (Adhatoda vasaka).

Triptighna These herbs are thirst quenching, such as amalaki (Phyllanthus officinalis).

Udara prasamana These are allergy treating herbs, such as pit shirish (Albizzia lebbek).

Vajikarana These are aphrodisiacs that increase sexual desire, strengthen the reproductive system and nourish shukra dhatu; for example, kapikacchu (Mucuna pruriens), ashwagandha (Withania somnifera).

Vamana These are emetic herbs. They work specifically on pitta and kapha that have accumulated in the stomach. They move upwards and outwards. High doses of licorice (Glycyrrhiza glabra) are emetic as is madanphala (Randia dumentorium).

Varnya These herbs benefit the complexion and skin lustre. Aloe vera (Aloe barbadensis), sandalwood (Santalum album) or rose water (Rosa centifolia).

Vedana sthapana These are analgesic herbs such as cloves (Syzygium aromaticum) or ashoka (Saraca indica).

Vikasi These herbs destroy the tone of the joints by loosening the ligaments; e.g. Betel nut (Areca catechu).

Virechana These herbs are purgatives that move downwards. They dissolve undigested foods and expel them; e.g. haritaki (Terminalia chebula).

Vishaghna These are anti-toxin herbs that destroy ‘poison’ in the system; e.g. neem (Azadiracta indica), kutki (Picrorrhiza kurroa) and sariva (Hemidismus indica).

Vyavayi These herbs spread everywhere in the body and are then digested; e.g. ganja (Cannabis sativum) and opium (Papaver somniferum).

Yogavahi These are catalyst herbs. When they are mixed with another herb they enhance its action; e.g. ginger (Zingiber officinale), Honey and Ghee.

• Treat the doṣa
• Treat the agni
• Treat the dhātu
• Treat the disease (Vyādhi)
• Detoxify the whole system and clear āma with pañcakarma 
• Pacify the disease and clear āma with samana
• Treat the gunas by increasing sattva and reducing rajas and tamas 
• Rejuvenate with tonics and aphrodisiacs 

Ayurveda uses herbs, foods and minerals according to their energetic qualities. Below is a simple introduction to the theory of the pharmacology of Ayurveda.

Taste: Rasa

Tastes have certain functions and effects:

• Temperature: Each specific taste effects the thermo-regulatory qualities within the body; hot (ushna) and cold (shita). They heat it up or cool it down. For example, Cinnamon is pungent and hot which raises temperature whilst Grapes are sweet and cooling which can help to cool a fever.
• Quality: The taste also defines whether a herb is light (laghu) or heavy (guru) to digest and wet (snighda) or dry (ruksha) on the mucus membranes. An example is Black Pepper that is pungent and also hot, light and dry; it is easy to digest and dries the mucus membranes.
• Tropism: The taste also implies an affinity for certain tissues and organs. A herb will influence the function of an organ, tissue or channel by tonifying or reducing, stimulating or pacifying, drying or moistening. For example hot and dry herbs clear wet mucus from the lungs, whilst cool and bitter herbs drain heat from the blood and liver.
• Doshic: The taste of each medicinal also influences the quantity and quality of each dosha. For example, sweet builds kapha, reduces vata and pitta and increases all the tissues
• Direction: The taste has an effect on the movement of vata dosha by influencing the direction the five vayu move in: For example, the pungent taste ascends and spreads vyana vayu outward causing sweating whilst bitter descends causing apana vayu to move downwards with a laxative effect.

Virya: The thermal action of herbs and foods

Hot (ushna): Heat warms, dries, invigorates and stimulates the tissues. Just as the sun on a hot day causes the blood to come to the surface of the body, so energetically hot herbs cause our metabolism to expand upwards and outwards causing the pores of the skin to open. Heat increases the metabolism, encourages circulation, causes sweating, light headedness and thirst. Hot substances are usually used to treat cold, contracted and hypo or sluggish conditions.

Beneficial to kapha and vata, it dries damp, phlegm and warms cold. As ‘like increases like’ pungent herbs encourage agni and digestion to function at optimum level. Herbs that are heating usually contain volatile oils or mustard glycosides that stimulate gastric secretions as well as assimilation of nutrients. Ushna substances have a particular affinity for the heart, head, liver and lungs and are commonly used when they are imbalanced but may damage them if used unjudiciously. Pungent, sour and salty herbs tend to be heating.

Cold (shita): Cold natured herbs cool, moisten and sedate the tissues and metabolism. Rather like the cold of a winter’s day causes you to shiver energetically cold herbs contract the muscles and narrow the channels of circulation. Cold substances are usually used to treat ‘hot’, inflamed and hyper conditions. Cold benefits pitta whilst aggravating kapha and vata; cold natured herbs soothe painful and inflammatory heat conditions.

Digestion is easily damaged by cold natured herbs and should be used cautiously when there is diarrhoea and sluggish digestion from cold. Cold herbs have an affinity for the stomach, the kidneys and the bladder and can weaken them if used excessively. Bitter, astringent and sweet herbs tend to be cooling.

Vipaka: Post-digestive effect

This is a unique energetic category peculiar to Ayurveda. Vipaka refers to the post-digestive effect of tastes; it is the effect a certain flavour has on the tissues having been digested or after cooking. It is the long-term effect of a food or herb. Vipaka results from the mixing of the digestive fire with the particular flavour:

Sweet and salty flavours: Digest into sweet: sweet is nourishing and moistening to the tissues and also has a mildly laxative effect. The cooling and anti-inflammatory nature of sweet make it beneficial to pitta and its wet and building properties will increase kapha.

Sour: Digests into sour: this will encourage digestion, benefit the liver, increase heat and moisture in the body whilst also calming the nervous system. Its long-tem effect is to aggravate pitta and calm vata.

Pungent, bitter, astringent: Digest into pungent: its nature is to increase dryness, constipation and gas. This can help kapha and aggravate vata.

To give an example of how the vipaka varies according to the specific energetics of each herb we will look at the peppers. Both black pepper (Piper nigrum) and long pepper (Piper longum) are pungent and heating. Whilst black pepper is pungent after digestion and therefore constipating, drying and damaging to the production of reproductive fluids, long pepper is sweet post digestively and therefore helps elimination, is moistening and is a beneficial rejuvenative tonic to kapha and as an aphrodisiac to the reproductive system.

Onions and ginger are other examples of herbs that are hot and irritating in the raw state but become less hot and sweeter and nourishing after cooking; both also have respected anti-inflammatory effects and promote the reproductive system.

Guna: The qualities of the herbs

The specific ‘quality’ of a herb indicates its potential therapeutic activity.

There are twenty qualities listed in Sushruta but these five listed below are the main ones used in Ayurvedic herbal energetics:

Light (laghu)

Plants, foods and minerals that are light have a quality that moves upwards, are easily digested and also remove sluggishness and kapha. Aromatic and warming herbs often have a light quality. The bitter and astringent flavoured herbs are usually light in nature. Leaves, seeds and fruits are mainly light.  The aromatic Cardamom (Elettaria cardamomum) seeds are light.

Heavy (guru)

Substances that are heavy sink downwards, are difficult to digest, increase kapha and nourish the whole system. They benefit vata by opposing its light, dry qualities. Heavy natured herbs are often sweet, salty or sour. Roots, resins, nuts and barks are often heavy. Ashwagandha (Withania somnifera) is heavy.

Unctuous (snigdha)

These medicinals are soft, demulcent and oily. They are strengthening, increase virility, fertility and kapha. They are usually sweet, heavy and contain a high content of volatile oils, mucilage or essential fatty acids. Sesame (Sesamum indicum) seeds and oil are unctuous.

Dry (ruksha)

Any plant with a dry quality is naturally astringent, absorbs moisture and therefore reduces kapha and increases vata. They are usually high in tannins and may also be heating as well (as heat dries fluids). Most plants have tannins in but certain barks and fruits are especially astringent. Haritaki (Terminalia chebula) is dry.

Penetrating or Sharp (tikshna)

Herbs with a penetrating or sharp quality are usually pungent, acrid and aromatic. They spread deeply into the tissues, open the channels and by their intense nature increase pitta and calm kapha and vata. Vacha (Acorus calamus) has penetrating properties.

Prabhava: The unique action of a plant

Ayurveda includes the descriptive category of prabhava or specific action. This term implies the individual action of a substance regardless of its taste, energy or post-digestive effect. It includes these concepts but is not dependent upon them. It is the specific action of a plant above and beyond its energetic classification.

For example, tulsi (Ocimum sanctum) is classified as heating but it therapeutically helps to clear heat and reduce fever through diaphoresis. This means that whatever the causes of the fever, tulsi is indicated and this is its prabhava.

Sesame seeds (Sesamum indica) and Madanphala (Randia dumentorium) are both sweet, astringent and bitter in flavour but Sesame is a tonic whilst Madanphala is an emetic and reduces any excess of the doshas. Whilst they have similar flavours, their actions are different. Each has their own unique and individual prabhava.

Pole, S. (2013) Ayurvedic medicine: The principles of traditional practice. London: Singing Dragon.

The use of Kajal (sometimes referred to as Kohl) is very old; it was and is still considered both a cosmetic as well as a health regime. Kajal is seen not only to improve one’s looks, but also to help protect the eye from harsh, gruelling environments. The use of Kohl is also believed to stave off infections via air born contaminates as well as, parasites and general industrial pollution.

Kajal comes in a number of guises; these being either a mixture of herbal and animal products or a mixture of herbs and powdered minerals. The former is obtained by collecting the soot from lamps burning clarified butter, known as ghee.

Here a burning cotton wick draws up the oil and deposits the resulting soot onto an upturned brass bowl, placed just above the flame. The end result is rich black soot which can be harvested using one’s finger, brushing the accumulated material to the edge of the dish. In some cases the soot can be combined with a little ghee to make a paste to apply as a kind of mascara or to delicately apply the soot about the eye with a brush.  

Another popular form of Kajal uses galena (lead sulphide). Here pieces of the raw mineral are ground into a soft fine powder and applied as collyrium.  As this material is toxic in its native form, some prefer to use a purified form before applying in the form a collyrium.

Purification of galena usually involves the mineral being ground and mixed with lemon juice until a creamy paste is achieved. This is then allowed to dry under the sun before repeating the process, seven times in total. In some cases an additional heating of the mineral (in a closed crucible) may also be undertaken. Heating is continued for about one hour at about 400°c. The end result is a highly processed bluish-black lead sulphide.

X-Ray diffraction analysis of more ancient sources of Kajal reveal it to be a mixture of four different types of lead compound, these being: galena (lead sulphide), white cerussite (lead carbonate), phosgenite (lead chlorocarbonate) and laurionite (lead chloride hydroxide). Typically these materials would be mixed in a medium (like oil) for application and applied like paint directly onto the skin under and around the eyes.

A closer examination of Kohl suggests it stimulates the immune system via its lead ions which are known to react with human skin; this then causes an overproduction of nitrogen monoxide (nitric oxide), a molecule known to be an important biological messenger in mammals. It therefore might be said that Kajal functions as an immune system stimulant.

By applying this toxic substance to the eyes, some more ancient cultures apparently discovered that there were health benefits in mildly provoking their immune systems and thus warding off attacks from flies, contaminated water, sunlight, dry air and bacteria, not to mention sand and grit. 

Even the application of the aforementioned lamp soot stimulates eye tearing, which then produces a flow of natural saline, washing and brightening the eye.

Note: Some samples of Egyptian Kohl, taken from burial tombs, shows traces of malachite, turquoise and lapis lazuli included in the mixture, all bound together with goose fat. The addition of these minerals may well have enhanced the overall cleansing effect i.e.: the copper in malachite having natural antibacterial properties etc.   

Please note: It is not recommended that anybody uses lead for medicine, we are simply describing traditional techniques.

The word ‘Rasa’ is associated with rejuvenation and ‘anjana’ is a common term used to describe different types of collyrium.

Rasa-anjanum is popular traditional eye remedy. The main herbal ingredient used is Berberis aristata. Ayurveda refers to this plant as Daruharidra, meaning ‘woody turmeric’, and while it has a large number of uses, it is particularly useful in eye disorders, particularly inflammatory conditions such as conjunctivitis.

Berberis root yields a hard yellowish wood with an aromatic small, not dissimilar to turmeric. When the bark is dried and broken into small pieces, about the size of a barley grain, a decoction can be prepared by boiling it in water. Due to the hardness of the root, the decoction process is usually done over a low flame for a prolonged period.

After boiling, the root and small particles are filtered out and the remaining decoction is mixed with an equal quantity of goat’s milk. The next process involves reducing the water content until a thick paste of milk solids and decoction resins remain.

The finished paste is then sold wrapped in a lotus leaf or sun dried in pill form. Either paste or pill can be mixed with water and used in eye drops or an eye wash. The highly astringent nature of this herb can be a mild irritant in larger doses, and so is contraindicated in pregnancy or during lactation.

Simply put, ghee is the oil obtained from cooking butter. This is best obtained by heating butter over a low flame for long periods. Gentle cooking allows the heavier milk solids to sink and the residual water content to evaporate.

The end result is golden coloured oil which retains a semi-solid structure at room temperature. Ghee has excellent stability when re-heated at higher temperature and is well noted for its longevity, if stored in a cool environment in a sterile container.

Ghee is highly prized in Ayurvedic medicine, noted for its ability to both preserve and stabilize herbal infusions. Medicated ghee’s known as Grtha form an important mainstay in the Ayurvedic pharmacopeia. The synergistic interchange between oil and herb doubly enhancing potency, while improving bodily assimilation and penetrating power.

One popular use of liquid ghee is in eye baths. This treatment method is known as akshi-tarpana, meaning ‘eye satiation’. The technique literally sees both eyes immersed in a warm medicated variety of ghee. The ghee of choice for akshi-tarpana is known Triphala ghee. I will firstly explain the treatment procedure then outline the method to prepare this medicated ghee.

Before beginning akshi-tarpana, the subject is firstly required to have the area about the eyes (and head in general) gently fomented (steamed).  This practice is seen as the best way to open all the heads channels of elimination. Ayurvedic thought pays close attention to elimination channels in the body, making sure that once turbid material has been separated from the tissue, it has somewhere to exit the body without becoming lodged in another place.

Fermenting is achieved by lightly tamping a cotton bolus filled with warm herbal pastes about the face, forehead, upper neck and ears. This process is repeated until the patient shows signs of sweating.

Next, a well macerated ring of gram flour mixed with water is rolled into short lengths and pressed about the periphery of the eye sockets. From here the compacted paste is smoothed down – forming a sticky oil-tight seal against the skin. This barrier will act as a container for the liquid ghee.

The inside and outside of this retaining ring are paid special attention – making sure its contact with the skin is consistent all the way around the eyes. Once the ghee is poured into them there is not much one can do about seepage and so better to spend a bit more time in their affixation to avoid annoying drips during the treatment.    

When the retaining wall is complete and its integrity seems satisfactory, both rings are filled slowly with warm ghee. This is heated to just above body temperature. Filling is firstly undertaken by dripping small amounts of oil onto the skin furthest from the eye. This is to test the subject’s reaction to warm ghee.

The temperature of the oil should not be ‘HOT’ for obvious reasons but it should also be noted that ghee cools very quickly once poured. Treatment is therefore relatively swift; something close to 7 minutes is optimal by Ayurvedic reckoning. As ghee cools, it loses transparency, giving the subject the initial feeling of looking out through golden coloured lenses which slowly dull and become foggy.

During the initial part of akshi-tarpana, toxins are thought to be expelled both through the normal channels of circulation as well as those drawn directly outward from the eyes into the ghee. While all parts of the eye have been observed to benefit from ghee baths, it seems the actual lens benefits the most from the immersion, regaining some of its youthful elasticity ‘during the brief soaking period’.

At the close of akshi-tarpana, excess oil is removed by cotton pads, along with the removal of the gram flower wall. The subjects face is then washed in warm water to remove any residual oil.  The final, and some say the most important procedure, is known as Nasya or nasal lubrication. Here, another type of medicated oil is dripped into each nostril and allowed to penetrate deeply.

This then stimulates the sinuses and produces large amounts of mucus. The oil also stimulates sneezing, and expectoration which again helps the purgation of toxins. Nasya is not pleasant, but is an essential part of akshi-tarpana and sometimes missed. I cannot stress enough how important this part of the treatment is, so be wary if it’s missing from the program.  

After akshi-tarpana, the subject is advised to avoid any intense or localized light source for about 4 hours, for example: bright sunlight, car headlights, television, mobile phones etc. As a consequence of this, the procedure is often preferred in the evening, whereby patients may retire to a bedroom and subdued light, almost immediately after a treatment.

Usually akshi-tarpana treatments are performed weekly for a period of about eight weeks. Over time improvements become clearer. It is unlikely that one or two treatments will have a long lasting effect.  

For those not acquainted with ghee making I have given the method here also.

To prepare about 1.5 liters of ghee you’ll need about 2kg of organic, unsalted butter. It’s worth spending a little more on a trusted brand, as the final quantity varies widely upon producer quality.

1. Butter is melted in a pan. The heat source should be as low as possible. Making ghee is an art and the slower you prepare the better the ghee.
2. Cook butter, as it melts and liquefies, foam will form on the surface. This is a kind of emulsion and is best removed with a flattish spoon.
3. This collected emulsion paste can be discarded.
4. After about 2 hours the ghee will become still and quiet, you will be able to see to the bottom of the pan. If you have made a good job of removing contaminants, the floor of the pan should be quite clear of debris.
5. Ghee may now be ready to remove from the heat; however a quick test is first needed.
6. Make a small wick from a piece of cotton and dip it into the heated oil. Remove this wick and ignite it. If a cracking noise is heard, the heating process should be continued as water is present still.
7. If wick burns without noise, stop the heating and allow the ghee to cool.
8. While ghee is cooking Triphala decoction can also be prepared. This requires the following ratio: 1 cup of triphala powder to 8 cups of water. Mix triphala and water and bring to the boil.
9. When the decoction has been reduced by roughly 1 third, or just under half the amount, heating is stopped and the decoction allowed to cool.
10. Carefully filter the decoction through a cloth. If you allow the powder to settle, it will not clog the filter cloth.
11. Filtered decoction can now be added to previously prepared ghee.
12. In addition, an equal quantity of milk is added to the mixture, as is 1 tablespoon of fresh triphala powder.
13. The mixture is again heated and very slowly cooked. As the process continues, a second residue accumulates on the surface and is similarly scraped off. The heavier milk solids and triphala powder will sink to the bottom and become a dark sticky paste.  
14. Nearing the end of the process, clear ghee oil will be seen between a surface foam, and lower depth paste.
15. Again, a cotton wick dipped in the ghee is used to determine the water content of the ghee.

Before decanting the finished ghee into a sterilised jar (a Kilner variety is best), it is advisable to pour the ghee through another cloth, just to make sure there is no debris (milk solids) present in the final ghee.

Allow ghee to stand at room temperature for 24 hours before use. Do not refrigerate as this will dampen its penetrating power. Ghee has a unique property to improve digestion and penetrate the tissues. If you refrigerated ghee, this property will be reduced.

Ghee contains high levels of significant vitamins such as A, E and D as well as monounsaturated fats (Omega 3). Ghee also contains a number of important short-chain fatty acids such as Butyric acid, as well as important medium-chain fatty acids. These stimulate liver function without contributing to excess adipose tissue.

This simple technique does not require any heating and is relatively simple to implement. The down side of this method is that to experience lasting benefit, the process will need to be repeated for about one month, minimum. It is well worth the effort, and compared with other methods, relatively simple.

Firstly wash a glass and add water, about half a cup will be sufficient. Next place 1 teaspoon of triphala powder into the water and stir carefully until it is thoroughly mixed. Cover the glass and allow the contents to settle. This technique is known as ‘cold infusion’ and will require the water and powder to stand for a good number of hours. Ideally this is done in the morning and allowed to stand until the evening.

Returning to the glass, it can be seen that the triphala powder has settled, and that the water now has a brownish hue. No not disturb the liquid.

Taking two cotton pads, gently dip them into the water. Allow them to retain some liquid and lying on your back place both pads over the eyes and gently press down, allowing some liquid to flow directly into the eyes.

The liquid will sting, so close the eyes until you can open them again and continue to ‘bath’ the eyes much as is possible. This process should be repeated for about 10 minutes, upon which the pads can be discarded and the faced washed with cool water. The remainder of the triphala water can be drunk, but do not drink the powder at the bottom of the glass. The glass is then washed out and the process repeated for the following day.

These techniques end the introduction to Ayurvedic eye care, a fascinating part of this ancient medical doctrine.

In 2017, research explaining the underlying mechanisms of how plants and animals adapt to circadian rhythms was awarded the Nobel Prize in Physiology.  

After nearly 200 years of exploration by scientists, the impacts of circadian rhythms, created by the Earth’s 24-hour rotation, were recognized by the world’s top scientific institution.

Sadly though, modern medical recommendations for how to live in balance with circadian cycles of light and dark and seasonal change are still a topic of debate and confusion.

Enter Ayurveda. For thousands of years, this ancient mind-body healing system has integrated circadian medicine into protocols and treatment plans.

The foundational strategies in Ayurveda that relate to circadian medicine are called rasayanas. Rasayanas are lifestyle protocols that promise rejuvenation, longevity, and higher states of consciousness.

Ayurvedic textbooks describe four major categories of rasayanas:

1. Vihara rasayana – having to do with lifestyle or aligning your biological clocks with nature’s circadian rhythms through balanced daily and seasonal routines.
2. Ahara rasayana – having to do with food
3. Acharya rasayana – having to do with behaviour
4. Aushadha rasayana – having to do with herbs

Ayurveda makes the case that rasayanas support health, longevity, and spirituality by maintaining a connection to nature, or circadian rhythms. These four main rasayanas could live under a larger umbrella called circadian rasayanas. These ancient practice suggests that living seasonally offers an opportunity to align yourself with nature.

For example, in Ayurveda, winter, or vata season, is cold and dry, and naturally balanced by heavier and fattier foods. Spring, or kapha season, is heavy and damp and naturally balanced by a harvest of bitter, astringent, and dry foods. Summer, or pitta season, is balanced naturally by a harvest of cooling fruits and vegetables. 

Vihara rasayana describes lifestyle rules for healthy daily, nightly, and seasonal rituals or routines, also called dinacharya in Sanskrit and Ayurveda.

To understand vihara rasayana, it helps to understand the circadian science behind how different frequencies of light during different times of day affect our bodies and minds.

At sunrise, the sun’s rays prepare your body for the day. The sun’s infrared, red, orange, and yellow light have long wavelengths and are able to penetrate the Earth’s atmosphere and your body, while the sun’s faster-frequency blue light is scattered and less direct.

The light at sunrise and sunset are mostly free of damaging ultraviolet rays. In fact, morning infrared rays, which penetrate deeply into the skin, help you endure the damaging UV light of the day. Research has also shown that infrared light from sunset can help heal your skin after a full day of UV exposure.

Exposure to scattered blue light, as well as its contrast to yellow, orange, and red light, at sunrise prompts your biological clocks to stop producing melatonin, which helps us sleep, and start producing cortisol for coping with daily life stressors.

Research suggests that the overwhelming amount of near infrared and red light that accompanies the sunrise stimulates the mitochondria in each of our cells to amp up production of cellular energy, sharpening your eyesight and providing the fuel your body needs for the day’s activities. This may have been more relevant to our distant ancestors, who needed to get up and hunt and gather for survival.

Research also shows that the contrast between the fast blue and slower yellow, orange, and red light at sunrise keeps the biological clocks of mammals in rhythm with nature’s daily and seasonal light and dark cycles, helping us and other animals wake with the sun and spring into action. In fact, researchers believe that before mammals had color vision, it was the contrast alone that triggered a biological response to sunrise.

The physiological changes that take place at sunrise are the drivers of an Ayurvedic morning routine.

The sunrise turns on biological clocks that spark hunger for breakfast. This sunrise circadian boost explains why gyms are packed in the early morning hours, which is the kapha time of day and naturally supports building muscle strength. Starting the day with the sun is a zeitgeber, or external stimulus, that synchronizes your biological clocks to nature’s rhythms. From here, if you listen closely to your body’s signals, Ayurvedic daily and seasonal routines are as natural for us as they are for migrating birds and whales.

Synchronizing our biological clocks to the light of sunrise is the most important aspect of vihara rasayana.

Of course, to get these benefits, you have to be up to witness the sun rise. Ayurveda prescribes numerous sunrise rituals and routines, or dinacharya, including waking up with the sun and doing yogic Sun Salutations and pranayama (or breathing exercises) and meditations. These practices encourage us to bath in morning red and infrared light.

See also Ayurvedic daily routine (Dinacharya)

Ahara rasayanas are dietary plans prescribed according to the season. They can be further modified based on a person’s unique constitution, or Ayurvedic dosha.

In Ayurveda, the qualities of prescribed foods provide a natural antidote to the extremes of each coming season. For example, a high-fat fall harvest of nuts and seeds prepares the body for the cold and dryness of winter. A harvest of cooling fruits and vegetables, as well as astringent and bitter roots, in the wet, rainy, and muddy season of spring prepares the body for hot summers.

According to the Caraka Samhita, one of the Ayurveda’s main texts, eating seasonal foods will keep you healthy:

“A person who has the knowledge of appropriate food articles and activities applicable to specific seasons and the discipline and inclination to practice them (in accordance with those seasons) stays healthy. Whereas a person without knowledge (or with limited knowledge) of wholesome regimen for different seasons or without the discipline or temperament of following these seasonal practices is likely to suffer from various diseases.”

Even the potency of vegetables changes throughout the day. In one study on vegetables from the cabbage family, immune-boosting phytochemicals were released at greater rates during midday, then severely declined in the evening. This was found even after the vegetables were picked.

Emerging science suggests that it is not only seasonal qualities that help maintain health and balance, but also the synergistic relationship between a plant and its microbiology, which also changes with the seasons.

Studies on one of the last remaining hunter-gatherer tribes, the Hadza, show that their gut microbes change with each season. In winter and early spring, their guts host a greater number of actinobacteria, which effectively break down fat and fiber – naturally harvested in colder months. In summer, their gut microbiomes shift to predominately bacteroidetes, which better break down a diet of carbohydrates – abundant at summer’s end.

In a 2021 study, researchers determined that the circadian rhythms of soil have a broad influence on the health of plants and those who consume them. The soil microbes attached to the organic and whole foods we consume carry circadian-synched microbes that support our health.

See also Should you eat for your Ayurvedic body type (vata, pitta, kapha) or the season?

Acharya rasayanas are the behavioral and ethical codes of Ayurveda. Two of these rasayanas relate specifically to circadian rhythms:

1. Be balanced in sleep and wakefulness. This suggests that the routine of going to bed early and waking up early are fundamental practices that, beyond being vihara rasayanas that help us connect with nature, are also lifestyle prescriptions that regulate behavior. The more aligned a lifestyle is with nature’s rhythms, the more natural it is for behavior to be of a sattvic altruistic nature.

2. Knowing the measure of time and place with propriety. This acharya rasayana suggests that the ability to adjust your routine according to the seasons can mitigate the type of stressors we now call social jet lag, nightshift work, and travel jetlag. Studies suggest that circadian stress not only affects health but behavior and aggression as well.

See also What are Rasayanas? Ayurvedic’s sacred longevity therapies

Medicinal herbs, much like foods, are intimately tied to nature’s circadian rhythms. Herbs are harvested seasonally, while their associated soil microbes also change from season to season.

Every plant and its related soil microbiome carry unique biochemical and microbial blueprints that combine to support the medicinal intelligence of that plant. For example, in the case of ginseng, which is known as a brain and nerve tonic, the plant gleans some of its unique brain-function benefits from the synergistic root bacterium rhizolutin.

Preserving the biochemistry and microbiology of a plant when processing and formulating herbs ensures the delivery of the most benefits.

There are many stand-alone herbs and herbal combinations that are considered rasayanas. The following individual herbs and substances actually help to reset biological clocks and help you live in sync with nature’s circadian rhythms.

Melatonin

Melatonin does the lion’s share of the work when it comes to keeping  the body in line with circadian rhythms. Consuming more melatonin-rich foods and herbs, such as tart cherries, walnuts, corn, rice, asparagus, and tomatoes, will help you keep melatonin levels in balance – a challenge in the modern world because of light pollution.

In general, diets rich in vegetables, fruits and grain products contain considerable levels of dietary melatonin. Vitamins and minerals from these foods contribute to the synthesis of melatonin and the regulation of circadian rhythms.

See also Eat foods with melatonin & improve your health

Ashwagandha (Withania somnifera)

Ashwagandha is a rasayana that has been extensively studied. It is an adaptogen, supporting the body’s ability to adapt or cope with stress. Stress disrupts circadian cycles by raising cortisol levels and inhibiting melatonin production when the sun sets. Research shows that ashwagandha supports healthy cortisol levels and circadian alignment.

Science also shows that ashwagandha can boost energy, muscular strength, stamina, and endurance in the mornings, while supporting deep sleep in the evenings.

Ashwagandha also supports nervous system repair by boosting brain derived neurotrophic factor, a protein responsible for building new brain cells.

When we take away stressors and cellular damage, the body more naturally aligns with the light and dark cycles of nature, helping us wake up and sleep in alignment with the sun and circadian rhythms.

Turmeric (Curcuma longa)

According to recent research, one of the major constituents of turmeric, curcumin, may alter the timing of circadian rhythms in cancer cells.

Curcumin also has certain polyphenols that activate sirtuin 1, a protein that  regulates circadian rhythms in both normal and cancer cells.

Bacopa (Bacopa monieri)

Bacopa may alter the genes responsible for regulating circadian rhythms. Research suggests that Bacopa can mediate cell survival and cell death in neural cells by altering nerve growth factor receptors that govern the body’s biological clocks.

Researchers have also found that bacopa supports cognitive function and mood. In a 28-day study of 100 adults, study subjects either received a placebo or 150 mg of bacopa twice a day.

The study concluded that taking bacopa resulted in a 14 percent improvement in emotional wellbeing, a 12 percent improvement in general health, and a 16 percent reduction in pain, compared to a 6 percent improvement, 4 percent improvement, and 3 percent reduction, respectively, in the placebo group.

In another study, researchers investigated the connection between the body’s circadian clocks and damaging oxidative stress. Bacopa, an antioxidant, helped to restore healthy circadian rhythms. After altering the circadian rhythms of fruit flies with hydrogen peroxide (oxidation), researchers administered bacopa and saw a significant restoration of the circadian rhythms. Researchers identified the abundance of antioxidants in bacopa as the mechanism for the restoration of normal circadian rhythms post oxidative stress.

In nature, the roots of turmeric, ashwagandha, and bacopa are all harvested in the fall and best taken during the winter months, when there is less sunlight and it is harder to maintain a good mood. Research shows that during the winter months, levels of brain derived neurotrophic factor (BDNF) and serotonin naturally decline, but increase again in the spring and summer.

The three herbal circadian rasayanas described above offer natural support for better mood and cognitive function by boosting winter serotonin and BDNF levels.

Rasayanas are Ayurvedic tools for rejuvenation and longevity. They are strategies that help the body support optimal health, longevity and higher states of consciousness. Underlying lifestyle, behavioral, dietary, and herbal rasayanas is a key Ayurvedic principle that is often overlooked: the importance of aligning with circadian rhythms.

When we align ourselves with the light and dark cycles of nature, maintaining a healthy lifestyle in accord with these rasayanas becomes natural and spontaneous, rather than a struggle or chore.

Each person’s journey to becoming a herbal practitioner is highly personal and may be influenced in various ways:

• Family or community
• Successful treatment of a condition by a practitioner or someone in the community
• Reading
• Botanical gardens or places in nature
• An enthusiastic teacher at primary or secondary school
• Workshops
• Introductory training leading to more in-depth studies
• Apprenticing to a practitioner

These are some of the things that may kindle an interest in pursuing this vocation.

Anyone who starts to explore the rich ecosystem of herbal healing  will at some point decide whether they are a lay enthusiast or wish to take their learning to a deeper level to become a professional/vocational herbalist.

Many people start with a foundation or introductory course to see if this path is indeed for them and there are some excellent ones such as:

• Heartwood foundation course 
• The Scottish School of Herbal Medicine Apprenticeship
• The Rhizome Clinic Courses
• Grass Roots Remedies Wild Things
• Betonica Home Herbalist
• Anne McIntyre offers courses in the Ayurvedic approach
• The Ayurveda Academy
• Plant Medicine School – At home with Herbs (this can lead to a herbal apprenticeship)
• School of Intuitive Herbalism
• Kitchen Medicine Introductory Course

This list of foundation trainings is not exhaustive, there are others of excellent quality and it really depends on what kind of course, teaching methodology and teachers appeal to you. There are also quite a few herbalists running short introductory taster courses in domestic herbalism, gathering or growing herbs.

You can find a list of herbal practitioner schools and courses on our Study herbalism page.

In order to become a herbalist one needs to decide on one’s pathway, although this may evolve and change of time and as one studies.

When choosing where to train, it is important for a person to identify the best fit for them.

Some people like a more reductive biomedical or scientific approach and some prefer a more experiential and relational approach.  It is important to explore the approaches taken by the various training establishments before making a choice.

One also needs to decide on the style of practice and the energetic system they wish to learn-TCM, Ayurveda, Western traditions, ethnic energetics from one’s own cultural background, Biomedical, Psycho-emotional, Relational for example. Some trainings are multifaceted, combining several approaches. There is no single way to practise herbalism so it is important to find what feels right for you.

There are also the practicalities of time available and finding a course structure that fits into your life commitments.

Then there is whether you prefer more online or in person learning, although most of the courses combine a mixture of the two as an adaptation to the times we live in.

Finally, there is the element of  cost.

 Thankfully, these days there is a breadth of training available and many of the schools are now working together to ensure inclusivity, diversity and mutual support between schools to open up student centred learning which helps the student become the kind of herbalist they wish to be and excel at it. It is exciting to see many of the schools collaborating to build a student centred approach with the possibilities of exchanges and decentralisation of learning but with the mentorship and guidance of the chosen ‘home’ school there to support and evaluate progress.

The purpose of undertaking a training is to gain the core competencies needed to be a herbalist of quality and of practitioner capacities.

The core competencies needed to become a proficient herbalist include most, if not all, of the following:

1. Safety (herbal safety, red flags, drug herb interactions , posology or dosage facts)
2. Professionalism-legal and ethical practice. Understanding the scope and limit of practice
3. A knowledge of materia medica, the herbs used in one’s tradition, and sources of sustainable supply of herbs
4. The capacity to study and integrate evidence from different knowledge sources  including traditional, creative, and scientific. Both literary sources and direct experience
5. The capacity to assess and diagnose
6. A knowledge of medicine making, pharmacy, pharmacognosy and dispensing.
7. Nurturing diversity and inclusivity and developing a culturally appropriate paradigm, including an understanding of the history and politics of plant medicine ( removing erasure, colonialism, commodification and appropriation)
8. Patient-centred care-integrative and holistic. Acknowledging the importance of physical, emotional, mental and spiritual aspects of wellness. The capacity to offer advice on diet, lifestyle and other factors contributing to health and wellness in an achievable manner taking account of financial, cultural and other factors.
9. Reflective practice
10. Practice-based learning
11. Sustainability-ecological, social and economic
12. Communication skills

For a person training to be a herbalist there are 2 main options as regards the evaluation of competencies gained.

Most people attend their school/college of choice and work through the programme gaining competencies until they reach their final assessments and graduate.

Other people may have gained competencies in another country or in several locations and therefore their experiential learning needs to be evaluated to ensure they have gained the required competencies.

In the latter case some of the schools offer a bridging training whereby any gaps in studies and competencies are filled rather than having to undertake a complete programme. Alternatively, several of the professional associations offer a grandparenting process to enable those who have not undertaken an accredited course to identify any gaps and give advice on how to fill these to achieve the required level of competencies needed. These processes are often honed to make them more user friendly in many instances.

Along the journey to becoming a herbalist there may be many influences and detours, explorations and experimentations. And when one gets the piece of paper the learning and development does not stop- it is more of a starting point again since there is so much to learn and explore. This is the evolution of the practitioner. It truly is a lifelong journey. Continuing professional development and reflective practice are a valuable and necessary part of the practitioner’s work.

It is also important to check if one can get insurance as a herbalist with the course they choose to embark on. Check if schools are accredited with a verified regulating body and call the school, and insurance companies to be sure. This applies if you plan to take on patients as a practitioner.

Once a person has become a practitioner the next step is to decide how they are going to use their skills and this may change over time. It may also be influenced by how they came to decide to be a herbalist in the first place.

Some people choose to have a consulting practice working in a clinic one to one with patients as their entire work.

Others may decide to use their skills in developing products and supplying these OTC either in a shop setting or over the internet.

Some may decide they wish to work with the plants-growing harvesting and processing.

Some go into research whether historical, lab based, ethnobotanical and traditional herbal practice or one of the other fascinating areas of this discipline.

Some go into a more artistic way of working- story telling and writing, drawing, painting, dyeing, fabricating, performance art.

Then there are those who wish to use their knowledge to share information and skills with those who wish to use herbs for the health of themselves, their family and community.  They may run workshops and short course about plant identification, wild crafting, growing herbs, simple medicine making or other skills. They help people learn how to safely harvest and prepare their own domestic remedies from the plants growing around them and also from kitchen materials and ingredients like ginger, cabbage, cinnamon, salt and many more.

Practitioners may work with in their local communities with special interest groups, schools, community gardens, active retirement groups and many other groups to educate and teach safe community herbalism.

By broadening the concept of what a herbalist is from purely a consulting practitioner we see how those who have trained can use their expertise and knowledge to further promote and educate people about the value of our medicine so that we can work towards once again having a herbalist in every community and communities where herbal medicine is seen as a first choice in health care and a vibrant and valuable part of keeping ourselves well and treating disease. All this helps to shift the societal culture forwards to a place where this potentially most sustainable form of medicine is once again central in our culture. This is the way it is for over 60% of the world’s population.

The breath is revered across cultures as a grounding force which ultimately connects us with life, and that marks the beginning and end of life.  We can go for days without water, weeks without food but only minutes without air.

 In Chinese medicine it is where circulating qi is generated, in Ayurveda it is where prana is received. Both of these terms essentially describe our life force. In TCM the lungs are the source of our vitality, and they extract qi from the atmosphere (“heavens”). You can read more about the TCM perspective on respiratory health here, and more about the Ayurvedic perspective on respiratory health here.  

“Heaven’s Qi flows freely to the Lungs”

“The Lungs are the root of Qi” (10 p69)

Every single system in our body relies on oxygen, the breath and therefore our lungs. Effective breathing can have remarkable effects for mental wellbeing, and there are even studies being conducted for using breathwork to deal with PTSD.

It can also help us sleep better, improve immunity and digestion. It is key for regulating our nervous systems, which are vital for mental health and clarity. A healthy respiratory system is key for processing oxygen in our body, as well as removing carbon dioxide and our lungs are the main organ responsible for this. 

“When the breath is unsteady, all is unsteady; when the breath is still; all is still. Control the breath carefully. Inhalation gives strength and a controlled body; retention gives steadiness of mind and longevity; exhalation purifies body and spirit.” – Goraksasathakam

Optimising our breath and respiratory system is critically important for restoring the body and minds harmony. Ayurveda offers practices such as pranayama, and TCM offers Qigong as a way to work with the breath. Breathwork is increasingly popular across Western cultures now too.

The lungs are known as the main organs of the act of breathing. They control the entry of air, without which the body would quickly die. Thus, their function is of great importance to overall health and quality of life.

The two lungs sit in the upper third of the thorax. The left lung has two lobes and is slightly larger than the right, which has three lobes. When breathing, the movement between the lungs and the chest wall is facilitated by the pleura.

The lungs contain bronchi (airways) which branch into smaller airways, alveoli, blood vessels, lymph vessels, connective tissue, and nerves. The bronchi not only transport the air, but they also warm and humidify it, while removing particulates. The alveoli are the site of gaseous exchange with the blood.

The natural defences of the lungs include both the innate and the adaptive immune systems. In the upper airway, airborne particles are captured by either the nasal hairs or the mucosa. These particles are either expelled through sneezing, blowing one’s nose, or the mucus is swallowed into the digestive tract.

The particles captured in the lower airways by the mucus there are expelled by the mucociliary escalator, where the small hairs of the respiratory tract beat together to bring mucus up the tract to be coughed or swallowed. The airways also contain a number of anti-microbial chemicals and immune cells to help deal with pathogens.

The lungs have their own closed circulation with the heart, and thus any issue with their health will immediately impact upon the circulatory system. The lungs are also an organ of elimination, as they excrete gaseous acidic waste on the exhalation. Other organs that share eliminatory function are the bowels, kidneys, and skin. If there is a lack of functionality in the lungs, these other systems will experience strain.

Some problems with respiratory health include asthma, COPD, cystic fibrosis, tuberculosis, bronchitis, pneumonia, emphysema and lung cancer. Also pollution effects the lungs, so some extra nourishment can be very helpful for people living in cities.

It is clear that good nutrition is essential for overall health, and the lungs are no exception. The development of the lungs starts in the third week after conception, and continues until the age of 22. While in development, the foetus must receive sufficient nutrition and oxygen in order to properly develop the lungs.

Otherwise, structural changes occur in the airways that present limited recovery potential (1). In children, the Mediterranean diet with little processed food has been associated with a reduced risk of developing asthma, while the Western diet has been linked to an increased risk (2).

There are a variety of nutrients that support the function of the lungs. Foods such as fruit and vegetables that are high in vitamin C and beta-carotene have been shown to support lung function, as well as fish which is high in omega-3 fatty acids. Additionally, vitamin C, beta-carotene and vitamin E have been shown to reduce phlegm production in the respiratory tract, the over-production of which is involved in a number of respiratory pathologies (3).

Flavonoids, which are found in fruits, vegetables, dark chocolate, wine, nuts, seeds, and most herbs, have been shown to reduce symptoms of asthma. Magnesium may improve the condition of the smooth muscle in the bronchioles, promoting relaxation instead of over-constriction. Vitamin D may also be useful, as a deficiency may lead to a reduced ability to fight off infection (3).

There are environmental factors that contribute to the health of the lungs that must be considered. Air contamination is a concern, especially to those who may have weakened immune systems, children or the elderly. This contamination may come in several forms, such as fungi/mould, dust, smoke, chemical fumes or toxic particles.

Exposure to these contaminants may depend on one’s occupation, lifestyle and/or living situation. These may be linked to the increased urbanisation of the world, and climate change. For instance, ozone is one example of environmental detriments to lung health. Ground level ozone is created when engine gasses and sunlight interact.

This is a phenomenon in urbanised areas and is linked to hospital admissions (4).  The impact of the increasing prevalence of dust storms in the wake of climate change is also being linked to declining respiratory heath (5).

Examples of disease caused by occupational exposure to toxic particulates are silicosis and asbestosis. Silicosis is caused by silicon-containing compounds that people who work in quarrying, mining, stone masonry, glass working, and pottery are commonly exposed to. Silicosis can lead to the development of tuberculosis which leads to further complications. Asbestosis is caused by inhaling the fibres of asbestos, and is found in asbestos miners as well as construction workers who were involved in building works with the material. Asbestos gradually destroys lung tissue (6).

Exercise is supportive of lung health. Exercise is broadly defined, as it can be sport or gardening or cleaning. The general recommendation is to take 30 minutes of exercise.

Exercise strengthens the muscles. If their function is made more efficient, the require less oxygen and produce less carbon dioxide, which reduces the load on the circulatory and respiratory system transporting and excreting these two gasses. Exercise also strengthens the heart, which is in close relationship to the lungs and so benefits pulmonary circulation (9).

Smoking has extremely detrimental effects to lung health. Apart from depositing dangerous tar residues it increases mucus production in the airways, and inhibits the tiny hairs, or cilia, that are key to the function of the mucociliary escalator (7).

This all makes the lungs much more prone to developing breathing difficulties, chronic disease and infection. Smoking is also the cause of most lung cancers and cases of COPD (which encompasses both chronic bronchitis and emphysema) (8).

There are a variety of herbs that can support the lungs, depending on the presenting issue. As most herbs have multiple actions, the following classifications are made for the sake of simplicity, and this is certainly not an exhaustive list. Always consult a medical professional and herbalist if you are experiencing challenges with your lung health.

Tonics

These support the overall function of the lungs.

• Elecampane (Inula helenium) has a spasmolytic on the bronchioles and has a long tradition of use in asthma, bronchitis, whooping cough, tuberculosis and pleurisy. 
• Horsetail (Equisetum arvense)

Expectorant herbs aid the body in excreting excess mucus that may be building up in the respiratory tract. They are divided into warming, relaxing and stimulating.

Warming expectorants

These are used when the lungs are congested and suffering from cold and damp:

• Ginger (Zingiber officinalis): The classic remedy
• Cinnamon (Cinnamonum spp): Most often combined with ginger
• Fennel (Foeniculum vulgare)
• Aniseed (Pimpinella anisum)

Relaxing or antispasmodic expectorants

Useful where the lungs are tight, wheezing and any cough is dry:

• Thyme (Thymus vulgaris): Particularly effective at relieving spasmodic coughing though may also help where there are excess levels of mucus
• Coltsfoot (Tussilago farfara): Generally avoided due to pyrrolizidine content
• Ma huang (Ephedra sinica): Not available in the USA and restricted in the UK to practitioners
• Hyssop (Hyssopus officinalis)

Stimulating expectorants

Typically emetics are used in low doses for helping to move stubborn congestion in the base of the lungs:

• Lobelia (Lobelia inflata): In the UK restricted to practitioners, with additional relaxing properties to provide a rounded effect on the lungs
• Squills (Scilla spp): A strong emetic mostly used in a syrup
• White horehound (Marrubium vulgare)
• Liquorice (Glycyrrhiza spp): Combining a gentle stimulating with demulcent action for a range of lung and cough conditions – a true lung amphoteric!

Demulcents

These herbs help to soothe the respiratory tract in conditions that feel dry and scratchy.

• Marshmallow (Althea officinalis): For irritated and dry conditions of the airways with unproductive and tickly coughs. Marshmallow can help provide long-term relief in lung infections by allowing time for the inflamed and infected mucosa to heal.
• Mullein (Verbascum thapsus): Mullein is a wonderfully soothing remedy for the lungs, used to good effect in irritating, hacking coughs with bronchial congestion (flowers have additional stimulating properties)
• Iceland moss (Cetraria islandica)

Antitussives

Remedies that can suppress a cough – usually because they contain cyanide-producing constituents.

• Wild cherry (Prunus serotina)

Anticatarral

These herbs help reduce the amount of mucus being produced from the airways.

• Horseradish (Amoracia rusticana)
• Elderflower (Sambucus nigra)
• Ribwort plantain (Plantago lanceolata)

Immunomodulatory and anti-allergic

These herbs moderate immune function to an appropriate level, if the respiratory tract is being affected by pathogens or hypersensitivity.

• Elderberry (Sambucus nigra): Have a specific action in preventing an enzymes produced by the flu virus from attaching to the cilia in the mucosal membranes of the lungs so can be helpful for viral respiratory infections
• Echinacea (Echinacea angustifolia or purpurea): A useful preventative if you are prone to upper respiratory problems like frequent colds, sore throats, sinuses, middle ear pain, or viral infections like flu
• Baical Skullcap (Scutellaria baicalensis): Commonly used for asthmatic conditions (especially when associated with secondary bronchitis), hypersensitivity conditions like hayfever and allergic rhinitis. It has a reputation in China of being effective also in acute viral infections of the airways. 
• Nettle (Urtica dioica): Particularly for allergies that target the respiratory system.
• Reishi (Ganoderma lucidum): Together with Cordyceps sinensis, G. lucidum has the most extensive range of indications and combines well with it in treatment of lung and liver conditions, as well as to provide all-round adaptogenic support.
• Cordyceps
• Black seed (Nigella Sativa): Has been shown to be useful for asthma, allergic rhinitis and other respiratory conditions as it has anti-inflammatory and bronchodilatory effects

Other commonly used herbs:

• Andrographis: For reducing symptoms in viral respiratory infections including the common cold, flu and sore throat
• Ashwagandha
• Astragalus
• Bibhitaki has astringing and strengthening action on the mucus membranes throughout the body, especially in the lungs
• Catnip
• Haritaki
• Horseradish is also effective against conditions that are characterised by the presence of an obstruction, commonly within the respiratory system. The pungency of horseradish will help to eliminate obstructions and expel them from the body by coughing up
• Trikatu (Zingiber officinale, Piper longum and Piper nigrum): It is a heating combination that dries mucous secretions and excess phlegm whilst also rejuvenating the lungs.
• Tusli (Ocimum tenuiflorum): When used as a hot tea, tulsi clears kapha and mucus from the lungs and upper respiratory tract. It is of value in respiratory infections and fever where it reduces temperature by encouraging sweating whilst its penetrating nature clears dampness and toxins.
•  Vasaka

Most of these herbs can be made into a tea or decoction, except for those restricted to practitioners. They can be used acutely, however the immunomodulatory herbs are often used prophylactically as well. Aromatic herbs may also be used as part of a steam inhalation to bring their antimicrobial benefits into the airways directly, while adding moisture.

There are many types of breath practices that can help with building control over the breath as well as calming the system, which allows for more efficient breathing. There are physiotherapists who specialise in breathing. There are also other practices such as Butyeko, Wim Hoff, pranayama, and Inspirational breathing. Two of our favorite breathwork practitioners are Georgie Lawlor and James from Breathe With James.

1. Arigliani M, Spinelli AM, Liguoro I, Cogo P. Nutrition and Lung Growth. Nutrients. 2018;10(7):919. Published 2018 Jul 18. doi:10.3390/nu10070919
2. Berthon BS, Wood LG. Nutrition and respiratory health–feature review. Nutrients. 2015;7(3):1618-1643. Published 2015 Mar 5. doi:10.3390/nu70316184.
3. Kelly Y, Sacker A, Marmot M. Nutrition and respiratory health in adults: findings from the Health Survey for Scotland. European Respiratory Journal. 2003;21(4):664-671. doi:10.1183/09031936.03.000557026.
4. Hoffmann D. Medical Herbalism. Rochester: Inner Traditions; 2003.
5. Schweitzer MD, Calzadilla AS, Salamo O, et al. Lung health in era of climate change and dust storms. Environ Res. 2018;163:36-42. doi:10.1016/j.envres.2018.02.001
6. Wilson K, Waugh A. Ross And Wilson Anatomy And Physiology In Health And Illness. New York: Churchill Livingstone; 2010
7. Walker B, Colledge N, Penman I, Ralston S. Davidson’s Principles And Practice Of Medicine. London: Elsevier Saunders; 2014.
8. Health Effects of Cigarette Smoking. Centers for Disease Control and Prevention. Published 2021. Accessed December 30, 2021.
9. Your lungs and exercise. Breathe (Sheff). 2016;12(1):97-100. doi:10.1183/20734735.ELF121

Āyurvedic treatments (cikitsā) are traditionally organized as eight branches (or lotus petals) of medicine, namely:

1. Kāyacikitsā (internal medicine for the body)
2. Śalyatantra (surgery)
3. Śālākyatantra (ear, nose, throat and cephalic diseases)
4. Bālā/Kaumārabhṛtya (children’s’ ailments/paediatrics, obstetrics, gynaecology)
5. Agadatantra/Viṣagaravairodhatantra (toxicology)
6. Graha/Bhūtavidyā (psychiatry/demonology)
7. Rasāyana (rejuvenation)
8. Vājīkaraṇa (aphrodisiacs)

In Āyurvedic understanding it is generally maintained that a satisfying sex life is important for health; hence an entire branch of treatment (vājīkaraṇa = ‘stallion capabilities/actions’) is concerned with this topic and the use of aphrodisiac plants, animals and minerals to enhance sexual experiences and semen production.

This recommendation is primarily based on the general notion in Āyurveda that no natural urge should be suppressed, including those related to urine, faeces, semen, flatus, vomiting, sneezing, eructation, yawning, hunger, thirst, tears, sleep and breathing after exertion. Suppression of these urges is said to lead to health disorders. However, even if accustomed to it, a wise person avoids excessive sexual intercourse.

Sood et al. (2005) detail around 800 plants that can have an aphrodisiac effect; and that publication only details plants native to India. Multi-plant aphrodisiac formulas are also produced in Africa, South America and other parts of Asia, particularly in China.

The author has explored some of these formulas, which mostly use plants that are different to those used in India, and which are often not native to South Asia; however, non-South-Asian formulas are beyond the scope of this article. Numerous aphrodisiac formulas are also provided in dozens of Āyurvedic and alchemical texts that were composed later than those of Caraka and Suśruta, but this inquiry is restricted to the formulas found in the foundational texts of Āyurveda and in modern use.

Caraka (II.II) describes, in a chapter of four sections, around thirty-five aphrodisiac formulas, which contain numerous plants and animal products. These concoctions are variously heated and cooked in ghee and other substances. It may perhaps be surprising to learn how many plants can have an aphrodisiac effect, to varying degrees.

The first formula (II.II.1.24–32) is as follows (all plant ingredients are listed in English in Section 8 below).

śara (roots), ikṣu (roots), kāṇḍekṣu, ikṣuvālikā, śatāvarī, payasyā, vidārī, kaṇṭakāri[kā], jīvantī, jīvaka, medā, virā, ṛṣabhakā, balā, ṛddhi, gokṣuraka, rāsnā, kappikacchū, punaranavā. 120 gms of each of these drugs, mixed with 2.56 kg of new, black gram should be cooked in 10.24 litres of water till a quarter of it remains.

Then a paste of madhuka, drākṣā, phalgu, pippalī, kappikacchū, madhūka, and śatāvarī should be added to it, along with the juice of vidārī, āmalaka and ikṣu, added separately, along with 2.56 kg of ghee and 10.24 litres of milk. This should be cooked until only ghee remains. This should be filtered well and added to with 640 gms powdered sugar, 640 gms of vaṃśalocana, 160 gms of pippalī, 40gms of marica, 20 gms of tvak, 20 gms of elā, and 20 gms of nāgakeśara. 320 gms of honey should be added. Then boluses of 40 gms each should be made from the concoction.

Caraka’s second formula (vv. 33–37) is for an aphrodisiac ghee: 2.56 kg of both newly harvested grains of black gram and seeds of kappicacchū should be boiled together with 160 gms each of jīvaka, ṛṣabhaka, virā, medā, ṛddhi, śatāvarī, madhuka and aśvagandha. Then, 640 gms of ghee, 6.4 litres of cow-milk, and 640 mls of both the juice of vidārī and ikṣu should be added and cooked.

In the second section of Caraka’s chapter on aphrodisiacs, more formulas are described, which contain similar ingredients to those described above. Besides ṣaṣṭika rice, honey, ghee and cow-milk, the first formula provided contains kapikacchū, balā, mugdgaparṇī, jīvantī, jīvaka, ṛddhi, ṛṣabhaka, kākolī, gokṣura, madhuka, śatāvarī, vidārī, drakṣā, kharjūra and vaṃṣalocana as well as various animal products.

The formulas that follow are similar in form, comprising nearly all the same plants noted above. In one of them, the milk of a cow fed on black gram leaves, or sugarcane, or arjuna leaves is said to be aphrodisiac. Another recommends śapharī (fish) rohita (fish) and goat’s meat soup. One formula comprises only śatāvarī, milk, honey, sugar and pippalī (long pepper).

The plants used in the other formulas in this chapter that have not already been mentioned are śṛṅgāṭaka, mṛdvikā, and māṣa.

Suśruta, in his chapter on aphrodisiacs, first details the causes of impotence—such as old age, a congenital condition, forced intercourse, excessive sexual activity, and voluntary continence—and then provides formulas similar in style and content to those of Caraka.

Some of the plants that Suśruta includes in his formulas are also in Caraka’s formulas, while some are not. Like Caraka, Suśruta includes vidārī, āmalaka, gokṣura and ātmaguptā (= kappicaccū)in his formulas. However, Suśruta also includes the sprouts, bark, roots and fruit of the aśvattha (peepal) tree, the seeds of kokilakṣa, and powdered uchchatā.

Most traditional cultures effective medicinal plants are very often used in combination with other plants. In many traditional remedial formulas not only is the full spectrum of the chemical ingredients of the medicinal plant consumed but additionally the full spectrum of ingredients of other plants. Plant combinations often have a synergetic effect more potent than that derived from a single plant.

The same principle applies to Āyurvedic aphrodisiac formulas. As indicated above, nearly all of the aphrodisiac formulas given by the classical Āyurvedic authorities are multi-plant formulas. Individual plants taken even in large amounts may be much less effective than multiple-plant formulas that may utilize up to around fifty different kinds of plants in small amounts.

The aphrodisiac effect of plants depends on two main factors, one being a general increase in blood flow (also to the genitals), the other being an effect on libido. Some plants only effect blood flow, some only libido, and some do both. Viagra and Cialis, which are both popular, pharmaceutical, aphrodisiac drugs, use sidenfil, which only increases blood flow and has no effect on libido.

Sidenfil can be very dangerous for the heart. Sometimes, because it is so extremely effective, sidenfil is added to aphrodisiac formulas, such as Libidus and other Indian formulas, without it being declared in the list of ingredients. Unfortunately adulterated products are quite common in the supplements world. 

All of the plants recommended by Caraka and Suśruta are listed below. Even though featuring in their formulas, some of them are common foods or spices that currently have no psychoactive profile or known aphrodisiac effect.

It could be that some of the plants may have properties yet to be discovered, or perhaps they may act synergistically with the other ingredients. Several of the plants have multiple synonyms and are of uncertain botanical classification; so there may possibly be mistakes in the botanical classifications identified below.

Plants with a known (perhaps slight) or greater aphrodisiac effect are marked with an asterisk.

• āmalaka: āṃvlā, Emblica officinalis/Phyllanthus emblica
• *aśvagandha: Withania somnifera
• *aśvattha:peepal tree
• *balā: bījband/khareṭī, country mallow, Sida cordifolia
• drākṣā: grapes, Vitis vinifera
• elā: cardamom, Elettaria cardamomom
• *gokṣuraka: gokhrū/gokṣurā/gokṣura, Tribulus terrestris
• ikṣu (roots): sugar cane
• ikṣuvālika: wild sugar cane/Kans grass, Saccharum spontaneum
• *jīvaka: orchid, Crepidium acuminatum/Malaxis acuminata
• *jīvantī: orchid, Desmotrichum fimbriatum
• *kākolī: Roscoea purpurea
• kāṇḍekṣu: wild sugar cane/Kans grass, Saccharum spontaneum
• *kaṇṭakāri[kā]: yellow-fruit nightshade
• Solanum virginianum/surattense/xanthocarpum
• *kappikacchū: ātmagupta/kauṃc/kevāṃc, cowhage, Mucuna pruriens
• *kokilakṣa: tāl makhānā, fox nut/prickly waterlily, Astercantha longifolia
• kharjūra: dates
• kṣīṛikā: milk, rice and ghee
• *madhuka: mādhūkā/madhukā/madhūka, Mahuā tree, Madhuka longifolia
• marica: black pepper, Piper nigrum
• māṣa: urad, black gram, Phaseolus mungo
• *māṣaparṇī: Teramnus labialis
• medā: mahāmedā, Polygonatum cirrhifolium/verticillatum
• mṛdvikā: grapes, Vitis vinifera
• mugdgaparṇī: Phaseolus trilobos
• *nāgakeśara: Assam ironwood tree, Mesua ferrea
• payasyā: Holostemma rheedianum
• *phalgu: redwood fig tree, Ficus hispida
• pippalī: long pepper, Piper longum
• *punaranavā: Boerhavia diffusa
• *rāsnā: Pluchea lanceolata
• *ṛddhi: Lantanthera edgeworthii or Habenaria intermedia [this plant has sixty-six synonyms in Sanskrit]
• *ṛṣabhaka: Dienia/Malaxis/Microstylis muscifera
• śāli: a kind of rice
• śara (roots): a reed/Baruwa grass, Saccharum sara/bengalense
• *śatāvarī: Asparagus racemosus
• śrāvaṇī: Sphaeranthus indicus
• *śṛṅgāṭaka: Trapa natans/bispinosa
• tvak: cinnamon, Cinnamonum zeylanicum
• *uchchatā: nāgaramustā, Cyperus scariosus
• vaṃśalocana: pith of bamboo, tugākṣiri, Bambusa arundinacea
• *vidārī: kudzu, Hedysarum tuberosum/Pueraria tuberosa
• *virā: [probably] kākolī, Roscoea purpurea [this plant has fifteen synonyms in Sanskrit]

If you enter any pharmacy in India you will see in most of them, displayed on shelves and in cupboards, numerous packets and bottles of so-called ‘Āyurvedic’ aphrodisiac formulas, some comprising four or five ingredients, others containing up to around fifty ingredients.

These formulas mostly comprise of plant extracts but some include various metals, minerals and shells, which began to feature more significantly in Āyurvedic treatments about 1,000 years ago, as an overlap began between the Āyurvedic branch of rasāyana, which is the science of longevity, and vājīkaraṇa. In rasāyana, shells, minerals and metals are commonly used. There are many dozens of these formulas on the market, which come and go over the years, due to their popularity (or otherwise), and depending on the vagaries of the business world.

Over the course of twelve years, between 2006 and 2018, I purchased around forty different, Āyurvedic, aphrodisiac formulas, in the form of either capsules, powders or pills. Some formulas contained substances, such as opium, which are illegal (another case of adulteration mentioned earlier).

There are formulas for both men and women, though more formulas for men are available than for women. In classical Āyurveda, the formulas provided are generally for men, even though many plants would affect women also. I recorded the ingredients of thirty-two products made and distributed throughout India. Bioassays and anecdotal reports revealed that some were not very effective, others were found to be too strong (inducing excessive palpitations and sometimes a significant hangover), and some were highly effective, leaving little or no hangover.

Many factors influence the perceived potency of the products, including not only the usual range of effects of particular plants, but also the constitution of the consumer at the time, the ‘setting’ in which the product is consumed (‘romantic’ or otherwise), the age of the organic ingredients, which degrade in potency over time, and the specific dosage included in a particular formula.

Perusing the ingredients of the thirty-two formulas under consideration, it is evident that all of the plants recommended by Caraka’s and Suśruta are included in modern aphrodisiac formulas. The most frequently mentioned, effective, aphrodisiac plants that are recommended by Caraka and Suśruta, and which are also included in modern formulas are as follows.

• aśvagandha: Withania somnifera
• balā: bījband/khareṭī, country mallow, Sida cordifolia
• gokṣuraka: gokhrū/gokṣurā/gokṣura, Tribulus terrestris
• jīvaka: orchid, Crepidium acuminatum/Malaxis acuminata
• jīvantī: orchid, Desmotrichum fimbriatum
• kākolī: Roscoea purpurea
• kappikacchū: ātmagupta/kauṃc/kevāṃc, cowhage, Mucuna pruriens
• kokilakṣa: tāl makhānā, fox nut/prickly waterlily, Astercantha longifolia
• madhuka: mādhūkā/madhukā/madhūka, Mahuā tree, Madhuka longifolia
• māṣaparṇī: Teramnus labialis
• medā: mahāmedā, Polygonatum cirrhifolium/verticillatum
• nāgakeśara: Assam ironwood tree or cobra safron, Mesua ferrea
• śatāvarī: Asparagus racemosus
• śrāvaṇī: Sphaeranthus indicus
• śṛṅgāṭaka: Trapa natans/bispinosa
• uchchatā: nāgaramustā, Cyperus scariosus
• vidārī: kudzu, Hedysarum tuberosum/Pueraria tuberosa
• virā: [probably] kākolī, Roscoea purpurea [this plant has fifteen synonyms in Sanskrit]

Many modern formulas also include aphrodisiac plants not mentioned by Caraka and Suśruta. Some of the many dozens of plants included in modern aphrodisiac only appear once; others are more frequently included. The most common of these are:

• akarkarā/ākārakarabha (Spanish chamomile, Anacyclus pyrethrum)
• babūl goṇd (thorny acacia tree, Acacia arabica/nilotica/Vachellia nilotica)
• giloy, guḍūcī (Tinospora cordifolia)
• harītaki, black myrobalan tree, Terminalia chebula)
• jāyphal/jatiphal/jāvitrī (nutmeg, Myristica fragrans)
• kuclā/kucilā/kupīlu (strychnine tree, Strychnos nuxvomica) 
• lāl mūslī/semal/śālmali/kapok (silk cotton tree, Salmalia/Bombax malibaricum/ceiba)
• safed (white) mūslī (Chlorophytum arundinaceum/borivilianum)
• sālam/sālab miśri (Orchis mascula/latifolia)
• samūdraśoś/samūdra patra/vidhārāv/vṛddhadārū (Hawaiian baby woodrose/elephant creeper, Argyreia speciosa)

Also very commonly included in modern aphrodisiac formulas are various minerals and metals, in particular śilājīt (Asphaltum panjabicum), a kind of tar that exudes from high altitude rocks. Other additives include various shells, metals and bhasms (powders):

• gold, mercury, sulphur in a ratio of 1:8:24 (makardhvaj)
• calcinated iron ash (lauh bhasm)
• calcinated mica ash (abhrak bhasm)
• calcinated silver ash (raupya bhasm)
• calcinated gold powder (svarṇ bhasm)
• calcinated tin powder (vaṅg/baṅg bhasm)
• calcinated copper and iron sulphide (suvarṇāmakśak bhasm)
• calcinated pearl infused in rosewater (mukta piṣṭī)
• tin, lead, zinc: processed in aloe vera juice and turmeric (trivaṅg bhasm)
• gold foil (svarṇ varaq)
• mercury (pārad/pārā)
• yellow sulphur/brimstone (gandhak)

Makardhvaj is used as a traditional medicine in the treatment of sexual dysfunction in the rural population of South Asia and is the most commonly used bhasm in modern Āyurvedic formulas. Now we know that mercury is poisonous, however he medicinal effectiveness of minute particles of gold, one of the main ingredients of makardhvaj,has been explored. Outside the South Asian context, several metals and minerals (phosphorus, zinc, calcium, silicon, sodium, potassium, sulphur, magnesium, manganese, selenium and vanadium) are included as aphrodisiac potentiators in some publications.

From the dozens of ingredients used in modern, Āyurvedic, aphrodisiac formulas, listed below are the ‘top twelve’ plants that most are most commonly included.

1. akarkarā/ākārakarabha, Spanish chamomile: Anacyclus pyrethrum
2. aśvagandha: Ashwagandha: Withania somnifera
3. balā/bījband/khareṭī, country mallow: Sida cordifolia
4. giloy/guḍūcī: gilo:  Tinospora cordifolia
5. jāyphal/jatiphal/jāvitrī, nutmeg: Myristica fragrans
6. kappikacchū/ātmagupta/kauṃc/kevāṃc, cowhage: Mucuna pruriens
7. kokilakṣa: tāl makhānā, fox nut/prickly waterlily: Astercantha longifolia
8. safed (white) mūslī: mushali: Chlorophytum arundinaceum/borivilianum
9. sālam/sālab miśri: calamiciri: Orchis mascula/latifolia       
10. samūdraśoś/samūdra patra/vidhārāv/vṛddhadārū, Hawaiian baby woodrose/elephant creeper: Argyreia speciosa
11. śatāvarī: shatavari: Asparagus racemosus
12. vidārī: kudzu: vidari:  Hedysarum tuberosum/Pueraria tuberosa

From the preceding discussion, it can be seen that there is considerable overlap between the plants recommended by Caraka and Suśruta for aphrodisiac effect, and those most popular in modern formulas. However, it is also evident that most modern formulas use some plants that are not mentioned by the classical Āyurvedic authorities, possibly because they were not aware of those plants, or possibly because those plants were introduced to South Asia after the time of Caraka and Suśruta, around 2,000 years ago.

Some of the plants used in Āyurveda as aphrodisiacs are not recorded in modern aphrodisiac compendia; more research will undoubtedly reveal currently unknown aphrodisiac properties of several plants native to South Asia. As mentioned previously, a combination of plants can be far more effective than the use of an individual plant, even when taken in large amounts. There is still a great deal to learn about the effective chemistry of numerous substances on the human organism.

Plant identifications

Caraka, vol. 4:287–317; Monier-Williams; Pandanus Database of Indian Plants; Sensarma; Sudarshan; Wisdom Library.

References

• Canada Vigilance Program (2013). ‘Archived – Health Canada warns consumers not to use Libidus or any unauthorized products promoted for erectile dysfunction’. Ottawa: Health Canada/Government of Canada (25^th April). https://healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2008/13282a-eng.php
• Caraka (trans. and ed. Priyavrat Sharma) (1994–1996). Caraka-Samhitā (Agniveśa’s treatise refined and annotated by Caraka and redacted by Dṛḍhabala, text with English translation) (Jaikrishnadas Ayurveda Series 36), vols. 1–4. Varanasi/Delhi: Chaukambha Orientalia.
• Clark, Matthew (2021). Botanical Ecstasies: Psychoactive Plant Formulas in India and Beyond. London: Psychedelic Press.
• Dalal, P. K., Adarsh Tripathi, and S. K. Gupta (2013). ‘Vajikarana: Treatment of sexual disfunctions based on Indian concepts’. Indian Journal of Psychiatry, vol. 55 (Suppl. 2), January,  pp. S273–S276.
• Lee, William H., and Lynne Lee (1994). The Encylopedia of Concentrated Aphrodisiacs. New York: Instant Improvement, Inc.
• Monier-Williams, Monier (1994) [1899]. Sanskrit-English Dictionary. New Delhi: Munshiram Manoharlal Publishers Pvt. Ltd.
• Pandanus Database of Indian Plants (2021). http://iu.ff.cuni.cz/pandanus/database/. Prague: Seminar of Indian Studies, Institute of South and Central Asia, Faculty of Arts, Charles University.
• Panyala, Nagender Reddy, Eladia M. Peña Méndez, and Josef Havel (2009). ‘Gold and nano-gold in medicine: Overview, toxicology and perspectives. Journal of Applied Biomedicine, vol. 7(2), May, pp. 75–91.
• Plotkin, Mark J. (1993). Tales of a Shaman’s Apprentice: An Ethnobotanist Searches for New Medicines in the Amazonian Rain Forest. Harmondsworth, Middlesex, UK: Penguin Books.
• Plotkin, Mark J., Brian Hettler, and Wade Davis (2017). ‘Viva Schultes – A Retrospective’. In Ghillean Prance et al. (eds.), Ethnopharmacologic Search for Psychoactive Drugs (50^th Anniversary Symposium, June 6–8 2017), vol. 2, pp. 95–119. London/Santa Fe: Synergetic Press Ltd.
• Rätsch, Christian, and Claudia Müller Ebeling (trans. Aida Sepic Williams) (2013) [2003]. The Encyclopedia of Aphrodisiacs: Psychoactive Substances for Use in Sexual Practices. Rochester, Vermont/Toronto: Park Street Press.
• Roy, Sagor Chandra, Md. Mamum Sikder, Arjyabrata Saker, Md. Afaz Uddin, Neshat Masud, Md. Rakib Hasan, Nilay Saha, and N. S. K. Choudhuri (2017). ‘Preclinical Anemia Panel Studies of “Makardhvaja” after Chronic Administration to Male Sprague-Dawley Rats’. Biology and Medicine (Aligarh), vol. 9, issue 2, pp. 1–4.
• Sensarma, P. (1992). ‘Plant Names – Sanskrit and Latin’. Ancient Science of Life, vol. XII, nos. 1 & 2 (July–October), pp. 201–220.
• Sood, S. K., Sarila Rana, and T. N. Lakhanpal (2005). Ethnic Aphrodisiac Plants. Jodhpur: Scientific Publishers (India).
• Sudarshan, S. R. (2005). Encyclopaedia of Indian Medicine, vol. 4: Materia Medica – Herbal Drugs. Mumbai: Ramdas Bhatkal/Popular Prakashan Pvt. Ltd.
• Suśruta (trans. and ed. Kaviraj Kunja Lal Bhishagratna) (1911). The Sushruta Samhita (with a full and comprehensive introduction, additional texts, different readings, notes, comparative views, index, glossary and plates), vols. 1–3. Calcutta: Kaviraj Kunja Lal Bhishagratna.
• Vāgbhaṭa (trans. Kanjiv Lochan) (2017). Aṣṭāṅga Hṛdayam of Vāgbhaṭa: Sutra Sthana (The Mohandas Indological Series 12). New Delhi: Chaukhambha Publications.
• Wisdom Library (2021). https://www.wisdomlib.org
• Wujasyk, Dagmar (2017). ‘Acts of Improvement: On the Use of Tonics and Elixirs in Sanskrit Medical and Alchemical Literature’. History of Science in South Asia (Special Issue: Transmutations: Rejuvenation, Longevity, and Immortality in South Asia and Inner Asia), eds. Dagmar Wujastyk, Suzanne Newcombe, and Christèle Barois, pp. 1–36. Wujastyk, Dominik (1998). The Roots of Āyurveda: Selections from Sanskrit Medical  Writings. New Delhi/London/New York: Penguin Books.

“There is nothing in the world which does not have therapeutic utility when applied in appropriate conditions and situations.” – Charaka Samhita Sutrasthana

The creation of Ayurvedic formulas is based on some fundamental herbal pharmacological principles that are all grouped together in what is known as the dravyaguna shastra – the treatise on the qualities of medicinal substances.

Over 6,000 species have been described in Ayurveda, though perhaps around 600 are in common use today. At its heart is a very simple idea that opposites balance each other (samanya-vishesha). And that the opposite is also true that ‘like increases like’.

Essentially it promotes the idea that substances with like qualities increase each other proportionally:

• Cinnamon and ginger = double spicy, very heating
• Neem and andrographis = double bitter, very cooling
• Those with opposing qualities balance each other: Cooling diets, lifestyles or herbs such as aloe vera remove hot inflammation, whilst heavy herbs like Ashwagandha balance lightness.

Below is a list of the different criteria that are used in Ayurveda to differentiate the potency of each herb that need to be considered when combining herbs:

• Taste (rasa): Sweet, sour, salty, pungent, bitter, astringent (Find more about tastes in our article The Six Tastes of Ayurveda)
• Effect on the metabolic thermal body (virya): Hot, cold and neutral; this category clarifies whether herbs warm you up or cool you down, if they stimulate or reduce the digestive fire, whether they are expansive or contractile by nature, whether they increase circulation or reduce it.

The quantity of impact is graded into degrees:

Degree of heat	Heating flavours
hot in the third degree (hottest)	Pungent (katu)
hot in the second degree	Sour (amla)
hot in the first degree	Salty (lavana)
Degree of cold	Cooling flavours
cold in the third degree (coldest)	Bitter (tikta)
cold in the second degree	Sweet (madhura)
cold in the first degree	Astringent (kashaya)

• Post-digestive effect (vipaka): How the taste of a natural substance changes after digestion and cooking, hence how it influences the doshas and physiology in the long-term. This rather unique interpretation primarily refers to the long-term effects on the fluids of the body and their impact on the bowels and fertility. Drying bitter and pungent herbs, like neem for example, are considered to reduce fertility if used long-term as they ‘dry’ the reproductive fluids.
• Effect on the digestion, fluid system and tissues in the body (guna): The herbs have qualities of light, heavy, unctuous, drying, penetrating and soft; e.g. Mint is light, shatavari is heavy, aloe vera is unctuous, cinnamon is drying.
• The unique properties of the plant (prabhava): This describes what the plant’s unique activities are above and beyond their energetics. For example, tulsi (Ocimum tenuiflorum) is classified as heating but it therapeutically helps to clear heat and reduce fever through diaphoresis. This means that whatever the causes of the fever Tulsi is indicated, along with other appropriate herbs, and this is its prabhava; jwarahara– the fever destroyer.
• Tropism (satmya): The affinity a plant has for a certain organ, tissue or channel (ashaya/dhatu/srotas); e.g. Garlic for the lungs, turmeric for the liver, brahmi for the brain.
• Constitutional (dosha): The effect of the herb on the constitution; i.e. whether it increases, decreases or balances the doshas.

These energetic descriptions of the herbs are all based on the different qualities of nature. To use an artistic metaphor, the theory of energetic pharmacology is the canvas; this is the basis. The herbs are the paints that the artist uses to paint a picture full of texture, depth, colour and clarity.

How the colours of the paints are blended depends on the artist’s interpretation of the scene in front of them, just as the energetic qualities of the herbs are merely guides along the path to finding the perfect formula for the patient. They are not absolutes. This is the stroke of the brush that gives the picture its unique quality. The interpretations of herbal energetics are flexible and depend on who is taking how much, of what and when.

As beauty is in the eye of the beholder, so herbal energetics are in the senses of the experiencer. The skill of the herbalist lies in uniting the theoretical framework of energetic pharmacology (dravyaguna), with the reality of the balanced or imbalanced physiological state of the patient (dosha prakriti and dosha vikriti). 

“Drugs act by virtue of their own nature and qualities at the proper time, in a given place, in appropriate conditions and situations; the effect produced is considered to be their action (karma); the factor responsible for the effect is their energy (virya); where they act is the place (adhisthan); when they act is the time (kala), how they act is the mode of action (upaya); what they accomplish is the achievement (phalam).” – Charaka Samhita Sutrasthana

Having arrived at an accurate Ayurvedic diagnosis the next step is to define the treatment plan. Treatment focuses on clearing out excess doshas, ama and malas and strengthening deficient dhatus, agni, prana, tejas and ojas. Ayurveda uses six main techniques to treat disease and create health:

• Reducing (langhana) where there is an excess. Purification (shodhana) or palliation (shamana) are prescribed for reducing any excess pathologies.
• Tonifying (brimhana) where there is deficiency. Sweet and nourishing tonics (rasayana) are given for building strength.
• Drying (rukshana) therapy is used to alleviate any excess fluids in the system. Herbs that are diuretic or remove mucus dry the system.
• Oleating (snehana) treatments moisturise dryness and give unctuousness to the tissues by using oily and demulcent substances.
• Sweating (svedana) therapy reduces coldness, heaviness, stiffness, ama and trapped heat in the body by using steam and diaphoretic herbs.
• Astringing (stambhana) therapy is used to slow the excessive flow of bodily fluids with tannin rich herbs.

When making a formula based on these techniques, you always focus on:

• Disease specific treatment (vyadhi pratyanika):– focus on mitigating the disease
• Dosa specific (dosa pratyanika):– focus on regulating predominant doshic pattern
• Dhatu specific (dhatu pratyanika):– focus on predominant tissue imbalance
• Digestionspecific (agni):– focus on digestive energy
• Clearing toxins (ama):– focus on cleansing with bitter and pungent herbs

And you may include solutions for:

• Removing obstacles: low digestive fire (mandaagni), blocked channels (srotorodha), undigested wastes/toxins (ama), inflammation (raktapitta, shotha), palliation (shamana), deep cleansing (shodhana)
• Increase mental clarity (sattvavajaya), nourishing the intellect (medhya varga)
• Increase circulation (rakta pravritti)
• Rejuvenate inherited strength (ojas), inner metabolic fire (tejas), life-force (prana), general tonic rejuvenation (rasayana)

Carrier herbs (anupana)

This is the idea that certain substances either act as catalysts or messengers to the main active herb and help carry them to certain parts of the body. The carriers are either mixed with or taken alongside the medicine. Known as an anupana they are the medium that carries the herbs to their intended destination and enhances or moderates their effect. Water (hot or cold), milk, ghee, oil, herb juices, sugar, salt and honey are all used as vehicles.

• Water when hot encourages digestive agni, clears toxic ama and reduces vata and kapha;
• Water when cold reduces pitta;
• Milk counteracts pitta and also encourages the nourishing effect of Ashwagandha (Withania somnifera) or Shatavari (Asparagus racemosus);
• Ghee carries the herbs deep into the tissues, nourishes the nervous and reproductive systems and it also has a catalytic (yogavahi) effect on the herbs that helps to potentise them;
• Aloe vera (Aloe barbadensis) carries herbs to all the tissues with a special affinity for the plasma, blood and reproductive tissues;
• Honey clears kapha due to its warming astringency and is often used with herbs that treat the lungs and congested mucus conditions. It stimulates the appetite and prevents excessive excretions. It acts as a catalytic yogavahi substance that enhances the activity of the herbs taken with it

The herbs ride on these carriers like the scent on the wind. Using an anupana can enhance the potency of a preparation as well as facilitating its journey to the intended destination.

Famous Ayurvedic formula such as Triphala, Trikatu and Kaishor guggul incorporate these principles. Kaishor Guggul is a classic preparation including Triphala, Trikatu and a range of other herbs for reducing pain and inflammation, with a focus on arthritis, gout and skin problems.

Preparing Kaishor Guggul

Dose: 2 pills 2-3x/day with warm water

Each 250mg pill contains:

Common name	Latin name	Dose
Haritaki	Terminnalia chebula	7.75mg
Bibhitaki	Terminalia bellirica	23.26mg
Amalaki	Phyllanthus officinalis	7.75mg
Guduchi	Tinospora cardifolia	11.63mg
Shunthi	Zinigber officinale	5.81mg
Marich	Piper nigrum	5.81mg
Pippali	Piper longum	5.81mg
Vidanga	Embelia ribes	5.81mg
Jaypala	Croton tiglium	0.73mg
Trivrut	Operculina turpenthum	0.73mg
Guggulu	Commiphora mukul (purified)	186.05mg

Triturated with the decoction of: Haritaki (Terminalia chebula), Bibhitaki (Terminalia bellirica), Amalaki (Phylanthus officinalis), Guduchi (Tinospora cordifolia)

• Guduchi has a powerful pitta reducing action that penetrates deeply into the tissues.
• Guggulu scrapes the pitta and vata toxins from the plasma, blood and muscle tissues.
• Triphala, vidanga and trivrut combine to clear inflammatory toxins and ama.
• Trikatu digests the toxins in the tissues and enkindles the tissue agni.

‘Kaishor’ indicates ‘youth’, hence it is used to prevent ageing and keep youth intact.

For the best results the Sarangadhara Samhita recommends that when using guggulu preparations one should avoid sour foods, penetrating foods, indigestion, excessive exercise, hot sun, alcohol and anger.

By learning the basic language of herbs, getting to know the herbs and, overtime, developing your intuition you can take these principles and mould them with your expertise using base formulae as building blocks and adjusting as appropriate for each individual case.

Also read “The Ayurvedic approach to digestive health and nutrition“.

Medicinal substances are classified according to groups that have different physiological actions. The Charaka Samhita lists 50 groups of ten herbs and the Bhavaprakasha Samhita has 24 such categories. These Ayurvedic pharmacological concepts offer deep insight into how herbs work to balance the doshas, dhatus, and malas. They tie together the concepts of taste (rasa), energetics (virya) and post-digestive effect (vipaka) as well as incorporating prabhava so that we can have a clear understanding of the primary action of the herb. The list below contains some of the most popular categories listed throughout the Ayurvedic literature.

• Abhishyandi: These substances block the channels and cause heaviness. The flow of rasa is hindered and stagnation occurs when too much of these substances are used. They are mainly unctuous and heavy in nature; eg. yoghurt obstructs the flow in the channels.
• Anuloma: These herbs help vayu to move in its appropriate direction. They are often mild aperients and help with flatulence and constipation. They are usually aromatic and carminative herbs, commonly from the Umbelliferacea family, such as Fennel seed (Foeniculum vulgare) or Ajmoda (Apium graveolens).
• Arsoghna: There are anti-haemorrhoidal remedies such as Chitrak (Plumbago zeylanicum) or Ginger (Zingiber officinale).
• Artava janana: Herbs promoting the menstrual flow such as Myrrh (Commiphora myrrha).
• Balya: This means strengthening and these herbs are tonics. They are usually heavy and filled with the earth element, like Bala (Sida cordifolia) or Ashwagandha (Withania somniferum).
• Bhedaniya: These are purgative herbs that forcibly expel the solid and liquid parts of faeces. Kutki (Picorrhiza kurroa) has this effect at a high dose.
• Brmhaniya: These are nourishing herbs that are full of the water element; e.g. Shatavari (Asparagus racemosus).
• Chaksushya: These herbs improve eyesight; e.g. Amalaki (Phyllanthus officinalis).
• Chhardi nigrahana: These are anti-emetic herbs such as fresh Ginger (Zingiber officinale recens), Pomegranate juice (Punica granatum) or Cardamom (Elettaria cardamomum).
• Chedana: These herbs actively draw out toxins by scratching them from the tissues; Guggul (Commiphora mukul), Shilajit (Asphaltum) and Black Pepper (Piper nigrum) all help to detoxify the deeper tissues.
• Daha prasamana: These herbs alleviate burning sensations in the body, such as Sandalwood (Santalum album) or Coriander (Coriandrum sativum).
• Dipaniya: These herbs enkindle the digestive fire. They indirectly digest ama. They are usually pungent, hot and dry; for example Long Pepper (Piper longum), Black Pepper (Piper nigrum) and Chitraka (Plumbago zeylanicum).
• Garbashaya: These herbs have an affinity for the uterus, such as Ashoka (Saraca indica) and Roses (Rosa centifolia).
• Grahi: These herbs dry the moisture of the body and of the wastes; Ginger (Zingiber officinale), Cumin (Cuminum cyminum).
• Hikka nigrahana: These herbs are anti-hiccough such as Clove (Syzygium aromaticum).
• Hridaya: These herbs have a tonic effect on the heart; Arjuna (Terminalia arjuna) and Ashwagandha (Withania somnifera).
• Jeevaniya: These herbs are life-giving and rejuvenative herbs such as Amalaki (Phyllanthus officinalis).
• Jwarahara: These are anti-pyretic herbs for stopping fevers including Musta (Cyperus rotundus) and Kalmegh (Andrographis paniculata).
• Kandughna: These are anti-pruritic herbs such as Peppermint (Mentha piperita), Turmeric (Curcuma longa) and Musta (Cyperus rotundus).
• Kanthya: These herbs are renowned for their affinity for the throat; for example Licorice (Glycyrrhiza glabra), Long Pepper (Piper longum).
• Kasahara: These are anti-tussive herbs such as Vasaka (Adhatoda vasaka) or Long Pepper (Piper longum).
• Krumighna: These herbs are specifically for removing parasites and worms; for example Neem (Azadiracta indica) or Kalmegh (Andrographis paniculata).
• Kushtaghna: These are herbs that treat skin diseases such as Neem (Azadiracta indica) or Manjishta (Rubia cordifolia).
• Lekhaniya: These herbs ‘scrape’ the waste residues out of the body by a drying action. They are usually bitter and pungent in flavour; for example Guggul (Commiphora mukul), Myrrh (Commiphora myrrha), Vacha (Acorus calamus), Turmeric (Curcuma longa), Triphala, Barley and Honey.
• Madakari: These are substances that cause intoxication, such as alcohol.
• Mutra sangrahaniya: These herbs reduce the flow of urine such as Bhallataka (Semecarpus anarcadium)
• Mutravirechana: These herbs are diuretics that increase the flow of urine, such as Gokshura (Tribulus terrestris) and Coriander (Coriandrum sativum).
• Nidrajnana: These herbs promote sound sleep; eg Tagarah (Valeriana wallichi), Ashwagandha (Withania somnifera)
• Pachana: These herbs directly ‘digest’ ama.  They do not necessarily stimulate digestion as well; e.g. Triphala.
• Praja sthapana: These herbs prevent miscarriage such as Ashoka (Saraca indica).
• Pramathi: These herbs remove the accumulated doshas from the dhatusand cells; e.g. Vacha (Acorus calamus) and Black Pepper (Piper nigrum).
• Purisha sangrahaniya: These are intestinal astringents that stop diarrhoea such as Bilva (Aegle marmelos).
• Rakta shodhana (rakta prasadana): These herbs specifically clean the blood and ‘alter’ its chemistry so that it does not cause inflammatory problems; for example Manjishta (Rubia cordifolia).
• Rechana: These herbs are cathartics. They forcibly expel faeces as semi-solid diarrhoea; e.g. Castor oil (Ricinis communis) or Rhubarb root (Rheum palmatum).
• Rasayani: These herbs rejuvenate the cells and extend life. They are anti-oxidants and also remove diseases; e.g. Guduchi (Tinospora cordifolia), Amalaki (Phyllanthus officinalis) and Haritaki (Terminalia chebula).
• Samjanasthapana: These herbs are used to restore consciousness; eg Vacha (Acorus calamus).
• Sandhaniya: These herbs heal broken bones and hasten the repair of broken bone tissue. Guggul (Commiphora mukul) is famous for this. Resins have a significant role here because resins in general are considered to relate to the blood part of plants just as the bark of trees is said to relate to bone tissue. The analogy is that just as resin heals the bark so it heals the bone. They also encourage circulation to flow to the wounded part of the body and hasten healing.
• Shamana: These are herbs that reduce the pathogenic level of a dosha to a more healthful level. The dosha is not expelled from the body, it is calmed. These are ‘palliative’ herbs; e.g. Guduchi (Tinospora cordifolia).
• Shirovirechan: These are herbs that clear the orifices of the head, also known as errhines. Such herbs are Vacha (Acorus calamus) or Cloves (Syzygium aromaticum).
• Shodhana: These herbs actually clear the excess doshas out of the body; e.g. Triphala, Castor oil (Ricinus communis) or Manjishta (Rubia cordifolia).
• Shonita sthapana: These are haemostatic herbs such as Manjishta (Rubia cordifolia).
• Shramshana: Herbs that are laxatives and clear faeces before complete digestion is complete; e.g. Trivrut (Operculina turpethum).
• Shula prasamana: These are anti-colic herbs that prevent intestinal spasms; for example Hingu (Ferula asafoetida) or Cumin (Cuminum cyminum).
• Shukrala: Herbs that increase semen and/or give force to its ejaculation; e.g. Amalaki (Phyllanthus officinalis), Aswagandha (Withania somnifera) and Shatavari (Asparagus racemosus).
• Shukra janana: These are sperm increasing herbs; for example Ashwagandha (Withania somnifera) and Safed Musali (Asparagus adcendens).
• Shukra shodhana: These herbs purify the sperm such as Gokshura (Tribulus terrestris).
• Snehopaga: These are moistening herbs such as Castor oil (Ricinis communis) or Tila/Sesame (Sesamum indicum).
• Stambhana: These are astringent herbs that are constipating, stop bleeding and are drying. They have the properties of vata and so increase it. Manjishta (Rubia cordifolia) is a renowned astringent that stops bleeding diseases.
• Stanya janana: These herbs can increase lactation; for example Fennel (Foeniculum vulgare) and Shatavari (Asparagus racemosus).
• Stanya shodhana: These herbs purify the breast milk such as Fennel (Foeniculum vulgare) and Musta (Cyperus rotundus).
• Sukshma: These herbs are penetrating herbs that can travel through the minutest channels, such as Salt, Neem oil (Azadiracta indica) and Gotu Kola (Hydrocotyle asiatica).
• Swasahara: These herbs prevent breathing difficulties such as Somalata (Ephedra vulgaris) and Vasaka (Adhatoda vasaka).
• Swedopaga: Herbs that induce sweating such as Vasaka (Adhatoda vasaka).
• Triptighna: These herbs are thirst quenching such as Amalaki (Phyllanthus officinalis).
• Udara prasamana: These are allergy treating herbs such as Pit shirish (Albizzia lebbek).
• Vajikarana: These are aphrodisiacs that increase sexual desire, strengthen the reproductive system and nourish shukra dhatu; for exampleKapikacchu (Mucuna pruriens), Ashwagandha (Withania somnifera).
• Vamana: These are emetic herbs. They work specifically on pitta and kapha that have accumulated in the stomach. They move upwards and outwards. High doses of Licorice (Glycyrrhiza glabra) are emetic as is Madanphala (Randia dumentorium).
• Varnya: These herbs benefit the complexion and skin lustre. Aloe vera (Aloe barbadensis), Sandalwood (Santalum album) or Rose water (Rosa centifolia).
• Vedana sthapana: These are analgesic herbs such as Cloves (Syzygium aromaticum) or Ashoka (Saraca indica).
• Vikasi: These herbs destroy the tone of the joints by loosening the ligaments; e.g. Betel nut (Areca catechu).
• Virechana: These herbs are purgatives that move downwards. They dissolve undigested foods and expel them; e.g. Haritaki (Terminalia chebula).
• Vishaghna: These are anti-toxin herbs that destroy ‘poison’ in the system; e.g. Neem (Azadiracta indica), Kutki (Picrorrhiza kurroa) and Sariva (Hemidismus indica).
• Vyavayi: These herbs spread everywhere in the body and are then digested; e.g. Ganja (Cannabis sativum) and Opium (Papaver somniferum).
• Yogavahi: These are catalyst herbs. When they are mixed with another herb they enhance its action; e.g. Ginger (Zingiber officinale), Honey and Ghee.

You can find all Ayurveda articles on our Insights page

• Ayurvedic Pharmacopoeia of India, Government of India, 2001, India
• Bartram, T, Encyclopedia of herbal medicine, Grace Publishers, 1995, UK
• Bensky, D and Gamble, A, Chinese herbal medicine: Materia medica, Eastland Press, 1989, USA
• Bensky, D and Gamble, A, Chinese herbal medicine: Formulas & Strategies  Eastland Press, 1993, USA
• Bhishagratna, K, Susruta Samhita, Chowkhamba Press, 1996, India
• Bone, K, Clinical applications of Ayurvedic and Chinese herbs, Phytotherapy Press, 1996, Australia
• Bone, K, A Clinical guide to blending liquid herbs, Churchill Livingstone, 2003, UK
• Bone, K and Mills S, The principles and practice of phytotherapy, 2^nd edition Churchill Livingstone, 2013, UK
• British Herbal Medicine Association, British Herbal Compendium, BHMA, Vols 1 and 2, 1992, 2006, UK
• British Herbal Medicine Association, British Herbal Pharmacopoeia. BHMA, 1983, UK
• Che, Chun-Tao & Wang, Zhi & Chow, Moses & Lam, Christopher. (2013). Herb-Herb Combination for Therapeutic Enhancement and Advancement: Theory, Practice and Future Perspectives. Molecules (Basel, Switzerland). 18. 5125-41. 10.3390/molecules18055125.
• Chen J and Chen T, Chinese medical herbology and pharmacology, Art of medicine press 2004, USA
• Dash, B, Fundamentals of Ayurvedic medicine, Konark Publishers, 1978, India
• Dash, B, Materia medica of Ayurveda, Jain Publishers, 1991, India
• Dash, B and Sharma, R, Charaka Samhita, Chowkhamba Press, 1996, India
• Dwarkanath, C,  Introduction to Kayachikitsa, Chaukhambha press, 1996, India
• Ganora, L, Herbal Constituents, Foundations of Phytochemistry, 2019, USA
• Gogte, V, Ayurvedic pharmacology and therapeutic uses of medicinal plants, Bhavan’s Book University, 2000, India
• Govind das Vicharita, Bhaishajya Ratnavali, Motilal Banarsidas, 1997, India
• Hoffman, D, Medical herbalism, The science and practice of herbal medicine, Healing Arts Press, 2003, USA
• Kaptchuk, T, The web that has no weaver: understanding Chinese medicine, Congdon and Weed, 1983, USA
• Lad, V,  Textbook of Ayurveda: Fundamental Principles, The Ayurvedic Press, 2002, India
• Lad, V,  Textbook of Ayurveda: General Principles of Management and Treatment, 2012, The Ayurvedic Press, 2002, India
• Maclean, W and Lyttleton, J, Clinical handbook of internal medicine, Volume 1& 2, University of Western Sydney, 2002, Australia
• Meulenbeld, G, The Madhava Nidana and its chief commentary: chapters 1-10, Leiden and Brill, 1974, Holland
• Meulenbeld, G, Reflectons on the basic concepts of Indian pharmacology, in studies on Indian medical history edited by G Meulenbeld and D Wujastyk, Forsten, 1987, Holland
• Meulenbeld, G,  A history of Sanskrit medical literature,  Egbert Forsten. 2001, Holland
• Mills, S, The essential book of herbal medicine, Penguin Arkana, 1991, UK
• Murthy, P, Sarangadhara Samhita, Chowkhamba Press, 2001, India
• Murthy, S, Vagbhata’s  Astanga Hridayam, Krishnadas Academy, 1991-1995, India
• Murthy, S, Madhava Nidana (Roga viniscaya) of Madhavakara, Chaukambha Orientalia, 1995, India
• Murthy, S, Sarangadhara Samhita, Chaukhamba Orientalia, 1995, India
• Murthy, S, Bhavaprakasha of Bhavamisra, Krishnadas Academy, 2001, India
• Nadkarni, A, Indian materia medica, Popular Prakashan, 1954, India
• Namjoshi, A et al, The Ayurvedic formulary of India,  Government of India Press, 1978, , India
• Paranjpe, P, Indian medicinal plants: forgotten healers, Chaukhamba Sanskrit Pratishthan, 2001, India
• Paranjpe, P, Ayurvedic medicine, the living tradition, a guide to Ayurvedic generic formulations Chaukhamba Sanskrit Pratishthan, 2003, India
• Rang, H, Dale, M, and Ritter, J, Pharmacology, Churchill Livingstone, 1999, UK
• Reddy, R, Bhaisajya kalpana vijnanam, Chaukhambha Sanskrit Bhavan, 2001, India
• Sexena, N, Yogaratnakara, Chaukhambha Orientalia, 1995, , India
• Sharma, P, Cakradatta: a treatise on the principles and practices of Ayurvedic medicine,  Chaukhamba Publishers, 1998, , India
• Svoboda, R, Prakruti: Your Ayurvedic constitution, Geocom, 1988, USA
• Svoboda, R, Ayurveda: life, health and longevity, Penguin/ Arkana, 1992, India
• Svoboda, R and Lade, A, Tao and Dharma, Lotus Press, 1995, USA
• Tierra, M, Planetary herbology, Lotus Press, 1992, USA
• Tillotson, A, The one earth herbal sourcebook, Twin Streams, 2001, USA
• Tirtha, S, The Ayurveda encyclopedia, Ayurvedic Centre Holistic Press, 1998, USA
• Trease and Evans, Pharmacognosy 16^th edition, Harcourt 2009, UK
• Tobyn, G, Culpepper’s medicine: a practice of holistic medicine, Element, 1997, UK
• Williamson, E, Major herbs of Ayurveda, Churchill Livingstone, 2002 (Williamson 1), UK
• Zhou, Xian & Seto, Sai Wang & Chang, Dennis & Kiat, Hosen & Razmovski-Naumovski, Valentina & Chan, Kelvin & Bensoussan, Alan. (2016). Synergistic Effects of Chinese Herbal Medicine: A Comprehensive Review of Methodology and Current Research. Frontiers in Pharmacology. 7. 201. 10.3389/fphar.2016.00201.

Preparation

A simple first step is to eliminate sugars, additives, refined carbohydrates, gluten, meat, dairy, processed foods, caffeine and alcohol which tend to create ama. You are likely to feel cravings for these foods during the first few days and caffeine withdrawal headaches can be severe. 

Eat simple, whole foods (fruits, vegetables, whole grains, legumes, herbs and spices, nuts and seeds) to set the stage for the actual cleanse, though for some a shift to just eating these foods may be a suitable cleanse in itself.

Active cleansing

This stage involves a ‘mono-fast’ of eating one type of simple, easily digestible food such as green juices, mung dhal soup or kitchari (basmati rice with mung) with plenty of fluids. This allows the digestive system to rest while providing nourishment. Two foods which often feature are basmati rice and mung beans. Rice is considered the king of grains in Ayurveda, being sweet to taste, aromatic, cooling and light, healing the digestive tract and clearing stagnation.

Mung beansaresweet and astringent, cooling, light, and dry in quality. They are an excellent detoxifying food for all the doshas, cleansing the tissues, strengthening the eyes, tonify the heart, draining dampness and clearing toxic heat from the body. Research supports that they are one of the healthiest sources of plant protein there is: Mung beans have biological activities including antioxidant, antimicrobial, anti-inflammatory, antidiabetic, antihypertensive, lipid metabolism accommodation, antihypertensive and antitumor effects (Chung et al, 2011).

Using the Ayurvedic doshas (mind body types) can be a helpful way to find a suitable cleansing regimen.

Airy and coldvata specific cleansing regime must support strength and energy levels, so a short cleanse of up to 3 days with simple nourishing foods is best. Warm food is vital, so no raw, cold foods or juices favouring simple, warm and lightly spiced foods such as kitchari, dahl, soups and vegetables, along with aromatic herbs such as fennel, cumin, coriander and turmeric. Hydrate with warm herbal teas that support digestion such as fennel, cardamom and ginger.

Fiery and warm Pitta types benefit from cooling cleanses that help reduce excess heat and can tolerate cooler and raw foods. Favour green juices, fresh fruit and vegetables whilst hydrating with cooling juices and herbal teas that include herbs such as aloe vera, mint, dandelion and licorice. 

Watery and earthed Kapha types benefit from regular, prolonged cleansing being most susceptible to congestion with slower digestion and metabolism. They have a naturally lower body temperature and need some heat to encourage detoxification. Foods should be simple, vegetable based, warm and spiced with ginger, black pepper, ginger, fennel and turmeric limiting any cooking oils. 

Whatever foods are chosen, its vital to use fresh, organic and nutritious food full of prana (life-force) so the amount of toxicity the body is having to deal with is reduced. Prepare all your food for the day first thing in the morning and avoid leftovers from the previous day. Allow at least three hours between meals, aiming or three- four small meals per day though two meals may be enough for kapha types. Eat enough to feel satisfied but do not overeat.

Try not to eat anything after 7 p.m. and drink at least 8–12 cups of room temperature, warm, or hot fluids each day to ensure adequate hydration and to flush toxins as they are released. Most fluids should be taken between meals to avoid diminishing the digestive fire. As toxins are released it is normal to experiencetiredness, headaches, rashes, belly noises, loose stool/constipation, odorous sweat/urine and stool, muscle ache and a foggy head. It’s key to rest and stay hydrated if you experience these.

This process can also stir up unresolved emotions, which need to be witnessed, honoured and released. Having support of family or friends, as well as from a health practitioner, can be key for this.

Ayurveda’s most famous ‘three fruit’ formula triphala has sweet, sour, pungent, bitter, and astringent tastes, pacifies all doshas, rejuvenates all tissues and cleanses all channels, especially those of elimination. Constipation is common during a cleanse, making this formula especially relevant.

Amla has one of the highest vitamin C contents in the plant kingdom and helps regulate the liver. Haritaki means ‘remover of disease’ and helps promote the bowel and tone intestinal muscles. Bibhitaki helps maintain healthy mucus membranes. Its balanced spectrum of the five tastes can also reduce food cravings and over eating.  Take one teaspoon at night with warm water to detoxify the bowel.

Another useful formula is Trikatu (‘three hots’) with ginger, black pepper and long pepper providing a pungent taste and strongly heating effect, along with light, drying qualities. It pacifies vata and kapha but aggravates pitta so is not suitable with hyperacidity, ulcers, with signs of aggravated pitta (heat) or in pregnancy.

It acts on plasma, blood, muscle, fat, channels of digestion, respiration and the colon, being used in Ayurveda to support weight loss, metabolism, digest fats and ama (and LDL cholesterol). Take ½ teaspoon after breakfast and dinner, traditionally taken with honey.  

Aloe Vera juice is bitter and sweet in taste with a cooling effect, reducing all three doshas with heavy, unctuous, slimy nature. It is nourishing, balancing and clears inflammatory heat from the body, whilst supporting gentle detoxification of the liver.  It is one of Ayurveda’s most potent cleansing and rejuvenating elixirs. Take 1-2 tablespoons every morning on an empty stomach.

Massage is a key part of Ayurvedic cleansing. You can give yourself a daily self-massage during the cleanse.

Massage yourself from head to foot every day with 50ml of warm organic oil such as sesame oil. Leave the oil on your body for 15 minutes, then wash off in a hot bath or shower.

By helping congested lymph return to the heart, massage also enables residual toxins to be excreted via the liver and kidneys or surface of your skin and will have an improved cleansing effect both internally and externally.

Generally, its vital to rest and to keep activities as quiet and mindful as possible to ensure your energy is devoted to cleansing.

Surround yourself with things that you find uplifting and nourishing, and minimise screens, stress and exposure to busy environments. Slow, gentle exercise (ideally in nature) supports cleansing but more than that can be counterproductive. Walking, tai chi, qigong, or gentle yoga are ideal. Sleep is the body’s best time to detox so be sure to get plenty of it throughout the cleanse.

Reintroduction

After the active cleansing phase, your body is still processing toxins and the digestive system has got used to a very easy to digest diet. It’s key to take time to go back to your normal diet as digestion needs time to gain strength. Keep the diet light and nourishing, or more toxins can form, gradually reintroducing diverse whole foods over a period equalling the time you spent actively cleansing.  Avoid heavy foods (meat, fish, eggs, sugar, bananas, bread, cakes, biscuits). This can be the most challenging phase as eating a monodiet is often easier than starting to reintroduce only certain foods.

Even after this phase, it may take more time before you feel the benefits of a cleanse. This is normal because the body is often still working to eliminate the toxins released. For women who menstruate, the first menstrual cycle following a cleanse can deliver a meaningful sense of completion to the cleanse.

Rejuvenation

This is the time to offer deep nourishment to the tissues as the body is a little vulnerable after cleansing. Apoptogenic, tonifying herbs like ashwagandha and shatavariare very helpful, alongside the Ayurvedic herbal jam Chywanaprash.

Made in a base of Ayurvedic superfruit amalaki, it is full of antioxidants, and it is said to have been created by an ancient sage to promote energy, vitality, youthfulness and longevity. It contains many of the major Ayurvedic rejuvenative herbs (including ashwagandha, shatavari, guduchi, punarnava, pippali) bringing replenishment to the immune system, metabolism, respiratory, nervous and musculoskeletal systems. 

Focus on foods with high antioxidant capacities, which kindle the digestive fire, build ojas (the essential vitality of the body), and support immunity, such as ghee (clarified butter), dates, almonds, figs, organic raw milk, mung beans, sweet whole grains, and nutritive vegetables like greens and asparagus. Spices that kindle the digestive fire include turmeric, ginger, fennel, saffron, cumin, and cardamom.

Ayurveda says the best time of year to undergo a cleanse is at the change of the seasons around the spring and autumn equinoxes as we are more vulnerable at these transitions. For example, during the winter months there may be a build-up of accumulated damp and mucus, and during the summer months heat and dryness can accumulate. 

Our bodies are having to adapt at these times as seasonal changes in temperature affect our body’s metabolic rate. Women should not actively cleanse during menstruation. If her period comes unexpectedly, she can continue simple food but should suspend all other practices such as self-massage and use of herbs until menstruation is complete.

Mung bean soup

Mung bean soup is simple, nourishing, delicious and easy to make perfect meal for a monodiet while you are cleansing.

Makes 2-3 bowls so double up as needed

Ingredients

• 1 litre water
• 1 tsp turmeric powder
• 1 pinch asafoetida or Hing (from Indian stores, health shops or large supermarkets
• 1-2 tsps. of fresh root ginger
• 3/4 tsp each of cumin seeds, ground coriander, garam masala, ground fennel
• Lemon juice
• 1 tbsp Ghee (clarified butter) or coconut oil
• Salt or herb salt and pepper
• Fresh coriander or other green herbs to garnish

How to make mug bean soup

Wash the mung beans thoroughly and soak overnight or for at least four hours. Add them to a pan with the water with the water and turmeric and simmer gently until soft (around 30-40 minutes), adding more water if needed.

Once cooked, heat the ghee or coconut oil in a small frying pan and fry the cumin seeds, hing (asafoetida) and ginger until aromatic. Add the remaining spices and heat for 20 seconds or so and then stir them into the soup.   Add salt to taste. Serve warm with a squeeze of lemon juice, and some fresh coriander.

For variety, you can add green leafy vegetables (chard, kale, spinach), grated courgettes, carrots or pumpkin.  You can also gentle fry some onions and garlic to add a little sweetness.  You can blend the soup for better consistency and flavour.

Kicharee

Kicharee is known as ‘the food of the gods’ and is an all-round healing and digestion-kindling meal, balancing for all doshas.

Ingredients

• 1 tbsp ghee (clarified butter) or coconut oil
• 2 bay leaves
• ½ tea spoon each of cumin seeds, fennel seeds, mustard seeds, coriander powder, turmeric, fresh grated ginger root
• 1 pinch salt or herb salt
• 2 pinches asafoetida
• 1 cup basmati rice
• 1 cup split mung dal (yellow, green soaked overnight)
• 4-6 cups water
• 60g diced organic carrots/celery/ seasonal vegetables
• Fresh lemon juice and chopped coriander/ herbs to serve

How to make kicharee

Wash rice and dhal separately in at least 2 changes of water. Sauté mustard seeds in ghee till they pop, then add other spices, starting with the seeds and the powders. Add mung dhal and rice and sauté for 2 minutes. Add boiling water, bring to boil and simmer for 30 minutes.

Prepare vegetables that suit your constitution by cutting into small pieces. Add vegetables, salt and extra water if required and simmer for another 20 minutes or until fully cooked.

Aim to have minimal water remaining. Vata dosha types can add a little extra ghee and hemp seed oil to counter vata’s dry tendencies Pitta dosha can add extra coriander which is cooling and calming. Kapha types can add extra fresh ginger and green leafy vegetables to add more spicy, bitter flavours.

A simple cleansing tea

Throughout a cleanse, the following tea can be drunk during the day. It supports agni and helps digest and eliminate toxins. Ensure you drink regularly throughout the day but avoid drinking excessively. Listen to your body and drink according to its needs.

Ingredients

• 1 litre water
• 1 tsp. cumin seeds
• 1 tsp. coriander seeds
• 1 tsp. fennel seeds
• 1 tsp. fresh root ginger juice
• 3 cardamom (discard the pods and grind the seeds)

How to make a cleansing tea

Mix everything and gently heat in a pan. Remove from the heat just before it boils and leave to steep for a further 10 minutes. Filter and drink or keep warm in a flask to consume throughout the day.

• Chung, I.M., Yeo, M.A., Kim, S.J. and Moon, H.I., 2011. Protective effects of organic solvent fractions from the seeds of Vigna radiata L. wilczek against antioxidant mechanisms. Human & experimental toxicology, 30(8), pp.904-909.
• Kaur, M. and Chandola, H., 2012. Role of Virechana Karma in cure and prevention of recurrence of Vicharchika (Eczema). Ayu, 33(4), p.505.
• Monteiro, C.A., Moubarac, J.C., Levy, R.B., Canella, D.S., da Costa Louzada, M.L. and Cannon, G., 2018. Household availability of ultra-processed foods and obesity in nineteen European countries. Public health nutrition, 21(1), pp.18-26. 2017
• The Paleovedic Diet: A Complete Program to Burn Fat, Increase Energy, and Reverse Disease Hardcover – 21 Jan. 2016 by Akil Palanisamy
• Peterson, C.T., Lucas, J., John-Williams, L.S., Thompson, J.W., Moseley, M.A., Patel, S., Peterson, S.N., Porter, V., Schadt, E.E., Mills, P.J. and Tanzi, R.E., 2016. Identification of altered metabolomic profiles following a Panchakarma-based Ayurvedic intervention in healthy subjects: The Self-Directed Biological Transformation Initiative (SBTI). Scientific reports, 6(1), pp.1-14.
• Patterson, R.E. and Sears, D.D., 2017. Metabolic effects of intermittent fasting. Annual review of nutrition, 37.
• Schwartz, J, Air pollution and children’s health, 2004, Paediatrics, Vol.113 (4 Suppl.), pp.1037-1043

As cleansing is carried out continuously, mainly by the liver and kidneys, some feel emphasis on the need for additional detoxification or cleansing is misguided. Misinformation in the media has also given these a bad name, such as the ‘quick fix detox’ each January. Much of the resulting ‘detox backlash’ has quite rightly focused on the need for a consistently balanced approach to health. However, any increase in toxins- be they from normal metabolism within the body or from external sources- increases the workload for organs which were never designed for today’s toxic overload. 

Our ancestors did not eat ultra-processed diets lacking in diversity, which now make up half the average family’s trolley in the UK (Monteiro et al, 2017). Nor were they exposed to chemicals, pharmaceutical and recreational drugs, atmospheric and industrial pollutants and pesticides which pose novel challenges for our detoxification system.  Numerous studies support the adverse effect these endogenous toxins are having, both on planetary and human health (Schwartz, 2004).

It seems common sense to ensure we help our bodies to cleanse, enhancing our natural ability to metabolise waste effectively. ‘Fasting’ and eating a simplified diet are highly regarded in both Ayurveda and its sister science Yoga, as well as most traditional wisdom systems and religions.

The Ayurvedic view is that eating and digesting food requires significant energy and when you have a break, your body diverts this energy for ‘housekeeping’. It makes sense from an evolutionary perspective in that we have endured feast or famine for much of our history, with an unpredictable supply of food. We have adapted to survive for periods with less food- as opposed to today when most are overfed but undernourished. Whichever way you look at it – from a traditional Ayurvedic or modern biomedical view – there’s no doubt that wastes in our bodies and the stresses of modern life are not good for us.

From an Ayurvedic perspective, not feeling our best offers an invitation from our bodies to correct early imbalances before they progress. Even if we feel full of health, a periodic cleansing is one of the most valuable gifts we can offer ourselves and our clients. In today’s world when so many of us are overly busy, overly toxic and consistently weighed down by stress, a cleanse can be a profound experience. The following signs often indicate that such a cleansing could be beneficial:

• Any digestive issues
• Reduced focus and brain fog
• A lack of energy and fatigue
• Stress and anxiety
• Sleep issues

Ayurveda recognises 3 steps for a practitioner to follow in managing any kind of ill-health:

1. Removal of the causes (primarily a diet and lifestyle approach),
2. Pacify the condition with tailored diet, natural remedies and therapies that are opposite in nature to the aggravated dosha/ qualities of the disease. Or actively purging the body of the disease-causing agents. Both these involve some form of cleansing.
3. Rejuvenation of body and mind

Along with many wisdom traditions, Ayurveda recognises that faulty digestion contributes to any illness. Digestion is likened to a fire (known as agni).  For a fire to burn wood effectively and create heat, the flame needs to be burning brightly.  If it is not and it is just a glowing ember or a small flicker, you could put the best logs on it, but they will just get a little charred with no breakdown nor heat.  This concept of agni can be broken down into 3 main types: 

• The main digestive fire: The digestive processes we have in our digestive tract which break down food to a simple form and allow it to be absorbed
• The elemental fire: The processes in the liver and circulation which transform and sort through the broken-down food into useable nutrients and excretable waste 
• The tissue fire: The transformational processes which use these nutrients to synthesise tissues and provide energy for those tissues

If agni is weak, we suffer with bloating, wind, heartburn, nausea, diarrhoea, constipation, feelings of heaviness, lethargy, lack of energy and a sense of blockage in the body.  This can develop to a whole host of diseases due to the formation of undigested matter or ama. 

With optimum agni, we feel light, energetic and strong, our tissues are nourished, and we have good resilience and immunity.  Ayurveda sees balanced agni as key in achieving optimal health.

A practitioner must rekindle the digestive fire to its optimum capacity so that both food and herbs can be digested and assimilated. To do this we must first cleanse the gastro-intestinal tract of undigested toxins via the process of amapachana. Then restore the digestive fire, a process known as agni deepana. Hence, any Ayurvedic cleansing supports this aim by resting and purifying the digestive system.

It is obvious that the body tissues cannot be nourished and developed when food is not properly digested by your digestive fire (Charaka SamhitaChikitsa Sthana 15/5) 

It is now well known that the role of digesting food is just the tip of the iceberg for the gut, with it being the interface between the outside and our bodies. Its total surface area is two hundred times greater than that of the skin and has major impacts on our health. 

As the gut plays such a central role, anything that stimulates gut signals can have a major impact throughout the body – without being absorbed. The gut hosts most of the immune system, is our largest hormone organ, an extension of the nervous system and is a key recycler of metabolites via the bile, bowel, and microbiome- all of which add weight to Ayurveda’s view that most issues begin with a weak digestive fire. 

When food is undigested because digestion is low, it becomes imbalanced and collects in the stomach. It is known as toxic ama. (Ashtanga’s Heart of Medicine)

Ayurveda’s term ama means ‘unripe, uncooked, immature and undigested’ and offers a broad concept of waste, being any un-metabolised substance not assimilated by your mind or body. Initial signs of ama are food cravings, mood swings, weakness, fatigue, fogginess, anxiety, bad breath, a coated tongue, body odour and sluggishness.

It has damp, sticky, heavy qualities and if left to stagnate, becomes poisonous and can lead to IBS and other digestive issues, rheumatic joint or muscle pain, high cholesterol, autoimmune conditions, weight gain, low energy as well as many other issues.  

Most of us have some degree of ama even if we feel healthy due to the increase in both internal and external toxins today. Beyond increasingly processed diets and environmental pollutants, we are exposed to stress, extreme emotions, negative images and distressing world events through the media on a regular basis. Eating food incompatible with your digestive capability and constitution, incompatible food combinations (such as milk with meat or fish) and withholding urges (e.g., bowel movements, flatus, urine) can also cause agni to diminish allowing ama to form. 

If ama is purely caused by poor digestive power, it may just remain in the digestive tract causing various acute and then chronic digestive issues. Increasing the digestive fire allows this to be digested, the passed out of the body. However, if ama crosses the GI tract membranes and is absorbed into general circulation it can impact deeper metabolic processes (elemental-fires or tissue-fires). 

These blockages cause further reduction in metabolic fires in a vicious cycle leading to many serious, chronic diseases. These depend on where it gets lodged (often at an inherently weak tissue) and with which doshas it combines. If ama remains in the body for a long time, it can lodge deep in the tissues and cells initiating autoimmune reactions (such as in rheumatoid arthritis or multiple sclerosis) and cancer. 

Purging the body was traditionally done through a programme of panchakarma (‘five actions of purgation’). This protocol returns a person to their natural state, free from ama, with balanced doshas, a peaceful mind, good organ function and waste elimination.

It works by drawing deep-rooted toxins and aggravated doshas from tissues and returning them to the gut for elimination through: Vamana (emesis); Virechana (Purgative therapy), Basti (medicated enema), Nasya (nasal therapy) and Rakta mokshana (bloodletting). Before these powerful cleansing therapies can be administered, the patient must be prepared on a strict diet, with ama-digesting herbs, drinking and massaging the body with oily substances and using steam and saunas).

For example, Virechana is used to cleanse the blood, stomach, intestines, liver, spleen and kidneys. It is commonly used in skin disorders, especially eczema where it has been shown to give an 81% cure rate and negligible recurrence (Kaur et al, 2012).  It is useful for any disease caused by high pitta dosha (excess heat and inflammation) and is traditionally recommended each autumn to prevent this build-up. Studies have also looked at panchakarma-style cleansing programmes, showing that taking herbs, a vegetarian diet, using meditation, yoga, and massage reduced markers indicating risk of diabetes and cardiovascular disease and altered gut bacteria (Peterson et al, 2016).

All Ayurvedic cleanses aim to eliminate ama from the system, but one key difference between panchakarma and other types is that it reverses the flow of nutrition. Normally, nutrition flows from the digestive tract into the blood and then tissues. During panchakarma, the digestive fire is intentionally reduced, by intake of medicated ghee.

This reverses the direction so ama moves from the tissues, into the blood and then gut for elimination. While this may occur in other Ayurvedic cleanses on a superficial level, panchakarma intensifies the process to deeply cleanse tissues and channels. It is perhaps the most powerful tool in Ayurveda’s medicine chest, treating serious, chronic and acute issues, as well as maintaining health. However, it is complex and lengthy, taking 3-6 weeks to complete and must be administered by an experienced practitioner. Such strong practices are not appropriate for many people the elderly, and those who are pregnant, breastfeeding, weak or with heart disease.

For those lacking the time, funds, suitability and access to panchakarma, a simpler method is to follow a fasting regime. Fasting is often viewed as a deprivation, but Ayurvedic fasting does not necessarily mean going without food. It can involve eating a cleaner, lighter diet and offers a good alternative to panchakarma. As we’ve seen, a practitioner must first rekindle the digestive fire to its optimum capacity as well as cleanse the gut of undigested toxins.

A cleanse or fast achieves both by minimising potential toxins entering the body so that it can rest and repair, then building agni so that tissues are nourished and ama digested. This experience can still be challenging as toxins are released into the circulation to be eliminated. However, if an Ayurvedic cleanse is undertaken correctly, benefits include:

• A sense of calm and groundedness in the nervous system
• Improved energy and enthusiasm
• A healthy body weight
• Balanced sleep cycles
• Regular elimination of wastes
• The tissues are prepared for rejuvenation

The term Ayurveda is used today as a generic term for traditional Indian medicine. Through combining organoleptic (sense based) empirical medicine with religious ritual perspectives, Ayurveda really is a complete medical system.

It deals with health in all its aspects, including

• Physical health
• Mental balance
• Spiritual well-being
• Social welfare
• Environmental considerations
• Dietary and lifestyle habits
• Daily living trends
• Seasonal variations in lifestyle
• Treating and managing specific diseases

Ayurveda teaches respect for nature, appreciation of life and the means to empower the individual. It is holistic medicine at its best.

1500 BCE (Before the Common Era): Vedic religion Rg, Yajur, Sama & Atharva Vedas: 125 herbal medicines mentioned in Atharva Veda.

c600 BCE: Rise of heterodox traditions of Jainism, Buddhism. Also growth of what is now called Hinduism. Ayurveda as a codified system of medicine is also thought to have appeared at this time.

150 BCE-100CE: Charaka Samhita: The earliest complete Ayurvedic treatise. Herbs are here classified by action and morphology. Again reformatted by Drdhabala circa 400CE.

c100-500 CE: Sushruta Samhita: Detailed surgical text.  Bhela Samhita.

500CE: Dhanvantri Niganthu: An early compilation of herbs into certain functional groups based on the property of the herbs.

c600 CE: Ashtanga Hridaya Samhita by Vagbhatta:A collated work on the essence of Ayurveda.

c650-950 CE:  Madhava Nidana (aka Rogavinishchaya): The first text committed solely to pathology.

C875 CE: Siddhayoga by Vrinda: Early alchemical text.

900-1400 CE: Goraksha Samhita: Early hatha yoga text where many Ayurvedic concepts are fused with tantric yogic practice.

1075 CE: Chikitsasangraha/ Chakradatta by Chakrapani: Professional Ayurvedic handbook of the medieval era.

1100 CE: Dravyagunasangraha. The first Nigantu written by Chakrapani.

c1300 CE: Anandakada: An early alchemical treatise.

1374 CE: Madanphal Nigantu: A further compilation of herbs and minerals.

1300-1400 CE: Sharngadhara Samhita: collected work on Ayurvedic formulas and preparations. First record of pulse taking as a diagnostic method. A pivotal work linking early Ayurvedic thought with new Tantric alchemical techniques.

1449/50 CE: Lakshmanotsva: A text describing pulse taking.

1474-1538 CE: Jvaratimirabhaskara of Camunda. The first mention of ashtasthanapariksha, the eight methods of diagnosis (pulse, tongue, urine, eyes, face, faeces, voice and skin).

1596 CE: Bhavaprakash Nighantu by Bhavamishra: The most important Ayurvedic materia medica treatise.

c1600 CE: Ayurvedasutra. A text mixing Ayurvedic, yogic and tantric thought.

C1600 CE: Rasaratnsamuccaya. A pivotal alchemical text compiling much earlier thought and theory.

1676 CE: Yogaratnakara. A pivotal work reflecting the assimilative trait of Unani and European influences on Ayurveda.

1760 CE: Rajvallabh Nighantu: Progressive materia medica.

1815 CE: Sangrah Nigantu.

1893 Bhashajya Ratnavali: Govindadasa’s work listing numerous medical preparations and introducing different European diseases.

c1900 CE: Nadiprakashan: Shankara Sen.

1924 CE: Nighantu Ratnakar.

This chapter gives a broad overview of ancient Indian culture and Ayurvedic history. It discusses some of the original concepts that developed out of this ancient culture that have had such a profound influence on Ayurveda. Modern Indian culture appears to be a unified tradition and many sources claim that it has always been so, but as you search deeper you find layers of different cultural influences woven together.

For example, it appears today that Ayurveda and Yoga have always been a part of the same system but historical and textual evidence does not back this up. They may now be inextricably linked and even work very well together but, as we shall see, this link has not always been in place. I think that it is an error to claim that they have always been a part of the same system.

Some authors and promoters of Ayurveda today claim that Ayurveda has always been a part of mainstream Indian culture. This also is not the case. Actually the one continual thread in Indian culture is the trait of absorption, cohesiveness and collection of ideas within mainstream Indian culture. This integrative tendency of absorbing diverse cultural elements is a recurrent theme throughout Indian history. And so it is with Ayurveda which is the result of assimilating different cultural strands and medical insights.

Culturally speaking, in India there was a competitive atmosphere between an orthodox religious tradition and a heterodox religious tradition. As everything in India had a relationship with religion Ayurveda has developed within this cultural friction. Early in Ayurveda’s evolution there was tension between the superiority of ritual practices verses the scientific use of herbs.

Which was the most effective medicine, ritual or science, the past tradition or new experience? The Ayurveda practised today is a result of this development in a paradoxically conservative yet progressive culture. These cultural tensions are clearly expressed in the texts as well as experienced in the clinic. Modern Ayurveda is also the result of scientific research into and experience of nature. The defining context is that Ayurveda is a medical tradition steeped in religious tradition as well as natural medicine and it is based on both tradition and experience.

Any history of Ayurvedic development requires discussing two different perspectives; a linear religo-historical approach and a circular organic expansion.

• The first perceives Ayurveda as a timeless system of medicine where its knowledge is perfect and divinely inspired.
• The second view is that Ayurvedic medical knowledge has developed out of ritualistic healing into an empirical medicine system that is grounded in clinical experience.

The introductory verses of Ayurvedic texts reflect the perspective that Ayurveda is an eternal revelation. They all start with a mythological account of the gods passing Ayurvedic knowledge down to humans. This divine stamp is a well-known Indian method of authenticating a text and making it orthodox (2). It is a way of bringing formerly untraditional and perhaps unaccepted ideas within mainstream culture. Much of the secondary and modern Ayurvedic literature also implies a consistent tradition that is divinely inspired and eternal (3).

But, as you unweave the web of influences that have affected Ayurveda the evidence clearly reveals an expanding tradition that accumulates knowledge over time and through experience. This latter organic perspective holds that Ayurveda is a science of unfolding truth and as a path of discovery it has not and will not remain static (4). These developments are not necessarily mutually exclusive, but it is useful to understand where different Ayurvedic traits have come from.

The concept of a timeless tradition has great appeal, for the insights of Ayurveda are incredible and they do appear to be divinely inspired. How else have we learnt about the properties of so many herbs and minerals? How was it discovered, for example, that Brahmi  (Bacopa monieri) is so effective at improving the intellect and Guggulu (Commiphora mukul) so useful at reducing tumours? How did the pioneers of Ayurveda learn to diagnose illness with only the five senses at their disposal?

Having said this, the idea of human knowledge growing through experience, logic and insight has great value. Human development is  firmly grounded in endeavour. For Indian minds this duality causes no conflict as Ayurveda can be two things at the same time: both divinely inspired and open to human adaptation. This is a powerful medium for expression of the truth as it is both reductionist and holistic.

Taking the first paradigm, whilst there is nothing inherently wrong with the claim of eternal divine origins there are some potential problems with this perspective. It could potentially stifle new ideas within Ayurveda as, in order to gain validity, there is a tendency for clinical experience to be referenced back to a divine eternal source. Humble that this approach is, new ideas are not easily propagated. There is an element of this attitude displayed by the core theoretical ground of Ayurveda remaining very similar over the last two thousand years.

The relative lack of modern innovative Ayurvedic literature generating improved methods of treatment, in comparison to Chinese and Western herbal medicine, is perhaps partially a result of this. It may be that the inherent theories of Ayurveda are already complete, but effective clinical insights are always of benefit as new diseases and cultural habits arise. The insistence on divine origins has stagnated this process of valuing both clinical experience and theory.

It is not therefore surprising that as Ayurveda has recently (last 400 years) been under continual threat from certain Moghul, British and currently allopathic forces it developed a complex that has, in some quarters, meant that it felt the need to fall back on its ancient roots in order to validate and justify its presence. This has protected but also weakened Ayurveda. Her strength is really in her present clinical excellence and the Ayurvedic community should be harnessing powerful social forces and speaking with confidence about its ability to help our society.

Albeit, this is made more difficult when Ayurveda is presently only recognised an adjunctive medical system where Ayurvedic doctors can only hold the position of a third medical officer at Primary Health Centres in India and complementary medicine the world over  holds a similarly lowly position in the medical hierarchy.

As a literature base of over 2,000 years, hundreds of thousands of expert physicians, millions of healed patients and numerous positive clinical trials attest to Ayurvedic treatment works and practitioners and professional registers should promote this, researchers should professionally publish clinical data and governments should enthusiastically support it. The past is where we have come from but the present is where we live. Ayurveda and Ayurvedic physicians deserve greater recognition than they receive today.

Another, and potentially more serious problem of relying on a doctrine that holds its origins as divinely and infallibly inspired is that it can and has resulted in right wing fundamental political doctrines utilising them to their own end. This is clearly the case in India today with the current rise in popularity of right wing fundamental Hindu groups and shows how the struggle for political supremacy can infect religion (and vica versa).

If this insistence of the divine origins of Ayurveda ignores modern Indological historical knowledge then this attitude, wittingly or unwittingly, may reinforce this political doctrine.

By this, I refer to certain quarters of the academic community promoting this ideology as though Vedic knowledge has remained eternally and statically predominant in all aspects of Indian culture for all time. The point is that whilst religion, medicine and politics are interrelated, caution must remain ever present when it comes to understanding the potential repercussions of ones ideology. In this case, pandering to extreme political causes that actually oppose the central tenets of Ayurveda: caring for all humanity.

Now moving to the second paradigm. In contrast to the belief in a divine past, the scientific dependence on empirical evidence can also be taken too far to the extreme with similar detriment. This has occurred within the modern medical paradigm of ‘evidence-based medicine’ requiring ethically dubious double-blind clinical trials and animal experiments with a heavy dependence on single active ingredients, synthesised medicines, separate chemical pathways and a reductionist methodology that has lost the holistic view.

Holding onto the primacy of either of these two paradigms means that the complete picture is missed. As we shall see, Ayurveda can offer a balance to these extremes as it contains both paradigms within it.

I think this inner debate between tradition and progression is mirrored in our everyday lives and specifically experienced when using natural medicine. It is a part of the question of how to respect your tradition whilst still integrating your personal experience. Internally it is a case of communication between heart and head where intuition and intellect are both valid. As we shall see, intuition and intellect are both essential for medicine to be, as Ayurveda is, truly holistic.

To see the world from which Ayurveda developed cast your mind back 4000 years. Ayurveda is not yet established. Imagine a people living close to the cycles of nature. It is an agrarian society dependant on the abundance of the harvest and the bounty of water for its survival.

It is also a world in which the people are subjected to the full force of the power of nature; the torrents of rain and the fierce heat of the sun as well as the reassurance of Spring returning and the joy of reaping a mature harvest. It is a society thriving along the banks of the river Indus. Subservience to the power that controls these natural extremes is at the centre of everyday life.

It is a religious world full of rituals. Regular fire sacrifices are carried out to supplicate the deities upon whose favour the world depends. Ritual performance is as central to maintaining health as eating enough food. Both are needed to live and flourish.

To treat disease, herbs and potions are used alongside the incantations of the priests. In fact the priests are both doctors and religious specialists. Disease in these warm and humid climes spreads fast. Fear of illness and of the death of loved ones is an everyday reality.

According to this belief system disease could be imposed from the spiritual world, from an accident or from the natural world. Here is the world in which the eternal tradition and the empirical experience of everyday life meet and intermingle.

It was out of such a cultural context that Ayurveda developed. Here was a fast changing society that was exploring its ideals of religion, royalty, leadership, law, medicine and family. Philosophical insight expanded as agrarian culture flourished. This is now known as the Vedic period (c15000-500BCE) (5).

With hindsight we can see that an orthodox religious tradition (astika darsana) and a heterodox religious tradition (nastika darsana) developed out of this milieu. In Indological terms ‘orthodox’ means adhering to the Vedas and ‘heterodox’ means not following the Vedas (like the Buddhists).

The Vedas, including the Rg, Sama, Yajur and Atharva Vedas are the receptacles of traditional wisdom whose oral tradition goes back at least 4000 years. They codify ritual hymns, sacrificial rules, poetic metres and medical incantations. As we will see, Indian medicine faced many challenges to become a part of the orthodox culture.

It is very difficult to place the exact origins of Ayurveda. Our first meeting with Ayurveda proper in a fully coherent and documented format is in the texts of Charaka, Sushruta and Bhela (150BCE-500CE). These texts were clearly codified long after Ayurveda was fully established and was thriving as an oral tradition.

An earlier text is known to have been compiled by Agnivesha, the Agnivesha Samhita, but it no longer exists although the Charaka Samhita is said to be a revised edition of this work. There are of course medical facts found in earlier texts but they are not classical Ayurveda with dosha, dhatu and mala at the heart of their teaching.

Prior to this codification of Ayurveda as a complete medical system it seems as though two patterns emerged as Indian medicine developed. One represented the worship of and subordination to the supernatural forces whilst the other pattern was the development of ideas based purely on empirical experience. Two concurrent and interlinked medical traditions appeared from within the Vedic literature:

• Firstly there was the orthodox Vedic tradition full of elaborate religious rituals dedicated to the powerful nature divinities; Surya, the Sun god, Agni, the Lord of Fire, Indra, the Lord of Heaven and Thunderstorms. This was the ritual tradition where the gods were appeased through prayer, chanting, amulets and ritual offerings. These were also the healing tools used to treat disease.
• Secondly there was the heterodox tradition that was outside this ritual fold and was based on the direct experience of medical physicians where herbs, minerals and surgery were the healing tools.

These patterns were like two rivers running through the same Vedic land that later converged to form Ayurveda.

An example of these two patterns and how they were connected can be found in an ancient Vedic prayer. It includes both the ritual and the experiential approach where the priest-doctor is praying to the plant and the disease:

“He through whom you plants creep limb by limb, joint by joint, you banish disease from him like a huge man coming between fighters. Fly away disease along with the blue jay; disappear with the howl of the wind, with the rain storm” (6)

Here the invocator is both priest and doctor. Both the prayer and plant seem to play the same healing role.

Imagine the priest-doctor standing by the side of a patient racked with fever. The room is full of the heady smell of incense. The priest-doctor is chanting and praying. The smells and sounds waft towards the delirious patient. The priest-doctor’s incantation is directed at the healing of the bedridden patient. He is also preparing a medicinal brew of special herbs that are empirically known to cure fever.

Whilst feeding the infusion to the patient he is also praying to the gods that the herbs cure the patient. This is ritual medicine; prayer, invocation, sound, smell and intention. It is intermingled with the empirical human based medicine as well as specific disease-based herbal knowledge.

But this harmony was short lived and the role of the priest as doctor changed. At some time after the Atharva Vedic period (c1000BCE), medical practice fell out with religious ritual practice. The medical experience and perhaps clinical results of the physician started to supersede the authority of the priest and thus the priest became superfluous to the healing rite as it then was. The so called priest-doctor occupation divided into two roles to become individual priest and doctor.

The dependance on the priest for maintaining the cosmic and social well-being guaranteed their position at the top of the social ladder. The doctor’s ideas and methods were pushed away from the centre to the outside.

There was an evident paradigm shift from religious supernatural medicine being the modus operandi to a scientific observation based practice being the primary medical model. There were social, and cultural reasons for this as well as empirical.

It must be remembered that Indian society was strictly class based, dependent on a caste system with a clear division of labour and with rank determined by birth. It was a society governed by a system of ritual purity that was loosely governed by physical contact with people, wastes, food and water.

Any transgression of the rules caused pollution and led to a state of ritual impurity, and this was a terrible place to be in as it meant that you could not experience Vedic healing rites and authority. As the higher priestly caste sought to enforce their identity as the holders of ritual power and this ritual purity became a more rigid definition of caste hierarchy it started to cause problems for the medical profession.

Because of the requirements of their job, physicians touched people from any caste, performed surgery and came into contact with bodily fluids. The higher castes started to consider them to be extremely polluted. Physicians were finally excluded from the soma sacrifice (an essential religious rite) and not recognised in the social hierarchy (7).

The Manu Smrti, a text codifying Hindu custom, was positively aggressive in its exclusion of the physician from the sacrifices and asserted that food accepted from a physician was like “pus and blood” (8). Physicians were definitely out of favour and out of the orthodox fold. They were still doctors but, at this point, not included within the central social hierarchy.

Around this time (1000-600 BCE) Vedic religion moved into a further period of transformation as the authority of the priests was called into question. The growth in the influence of the wandering ascetic (parivrajaka) tradition, the Upanisadic awareness of the possibility of liberation from the perpetual cycles of birth and rebirth, and a growing disillusionment with the excessively elaborate Vedic ritual sacrifices led to branches of knowledge splintering from Vedic practice.

These movements resulted in the growth of Jainism, Buddhism and Hinduism. These were dynamic and progressive traditions not content to rest on the conventions of the past. They sought explanations about life and the universe through direct experience, and especially through knowledge of nature and the self. This had a profound influence on the developments within Ayurveda by establishing its growth in the bed of empiricism and its acceptance by the orthodox. It is at about this time that Ayurveda as a complete medical system became codified.

Much of the evidence at this time points to the fact that the empirical based medical science of Ayurveda and the Indian ascetical tradition both grew up outside the orthodox religious hierarchy.

Beyond the confines of ritual and convention, physicians explored the energetics of the natural world; the taste (rasa), energy (virya) andthe specific action (prabhava) of plants and minerals. Meanwhile the ascetics explored the inner realms of consciousness; the layers of the mind (buddhi, manas, citta), energy centres (cakra) and supernatural powers (siddhi).

These two traditions met in the heterodox realm as they were united by their separation from the mainstream culture. It seems evident that early ascetics used plant medicine and possibly were amongst some of the pioneers of Ayurveda (9). Later however, these new developments were absorbed into mainstream culture as Ayurvedic physicians and ascetic yogis became accepted by the orthodox traditions (10).

Despite being heavily influenced by Buddhism, Ayurveda’s primary reference point for the last 2500 years has been Hinduism (11). They have evolved within the same cultural framework. To summarise Hinduism’s worldview, orthodox Hindu culture perceives reality as an existence in which the nature of the Self (atman) is obscured by a veil of ignorance (avidya). Individuals are destined to play out the effects of their karma in a perpetual cycle of rebirths.

Karma, the causal relationship that effects every action, has a reaction; the results of previous actions determine our present condition and, in effect, ‘trap’ the Self in this physical world. This is seen as pure suffering. But, “from torment by three-fold misery (endogenous, exogenous and supernatural) arises the inquiry into the means of terminating it” (12). Hence developed the purpose of finding a way out of this misery.

In order to fulfill this purpose of life, to be liberated from ensnarement, the orthodox Hindu must pursue the four ends of life; these are wealth (artha), sensual fulfillment (kama), religious observances (dharma), and liberation (moksa). To ensure that these ends can be achieved Ayurveda embraces the health (arogya) of the body as its main aim.

What is now known as Ayurveda is the blending of a tradition that has contained elements of purely ritual medicine as well as empirical practice. Ayurveda becomes Ayurveda ‘proper’ through its association with the respected philosophical systems of Nyaya-Vaisesika, Samkhya-Yoga and to a lesser extent with Vedanta-Mimamsa.

The Nyaya-Vaisesika philosophy is concerned with perspectives of logic and analysis, Samkhya is an ontological system that deals with the metaphysical nature of being, Yoga with the soteriological methods to attain liberation, Mimamsa with the knowledge of Vedic rituals and Vedanta deals with the esoteric nature of reality and its expression as an experience of both unity and duality or what is known as ‘non-dual’.

Ayurveda has the classical philosophies of Indian culture at the root of its principles. These philosophies infuse Ayurveda with a solid theoretical structure that shape its practical framework; the ideas behind the development of matter (prakriti), the formation of the five elements (panchmahabhuta), how consciousness (purusha) pervades reality and the various methods of gaining knowledge (pramana), so essential to diagnosis, are all found in the Indian philosophical tradition (sat darshana).

In fact Ayurveda is an embodiment of these philosophies; it makes the theory real. Its codification in Sanskrit in the Charaka and Sushrita Samhitas confirms its absorption by conventional tradition.

The philosophical view of  Ayurveda is infused with this culture of attempting to understand reality. Poignant throughout later and more classical Indian philosophy is the theory of duality propounded through the Upanishads and Vedanta philosophy.

What we perceive as reality is really just an illusion or maya. We experience reality as separate from ourselves and it is our ego nature that causes this duality. This representation of duality is seen in the mythology of shiva  and shakti, the two poles of masculine and feminine energy that together hold all the opposites of life together.

Our self identity fragments this unconditional unity of Brahman into segmented parts. Hence we feel separate from the whole and as a result lead a life in self-perpetuating ignorance that results in us accruing numerous karmic bonds that tie us to endless lives of rebirth in the wheel of life, known as samsara. Taking steps to alter this world view and ‘unify’ our individual consciousness with the universal consciousness is the goal of all Indian philosophical systems. They offer the path to enlightenment and the means to get there.

This experience of undivisible unity is meditated on as ‘tat tvam asi’ meaning ‘that art thou’. It cannot be described as it is ‘neti, neti’ or ‘not this, not that’.

The Isha Upanishad says

‘It moves, It moves not,
It is far and It is near.
It is within all this,
And it is outside all of this’.

The result is a tension between the individual experience and the ritual experience, between individual consciousness and social hierarchy. The journey through Indian philosophical literature mirrors our own journey through our perception of our experiences; a deep search for truth, peace of mind and undivided bliss.

This tension that occurred in a broad sense within Indian culture also occurred in the development of Ayurveda as a whole. This is shown in the earliest extant sources of Ayurvedic theory and practice, the Charaka Samhita, Sushruta Samhita and Ashtanga Hridaya Samhita. Their content clearly displays the continual efforts to assimilate empirical experience within the divinely revealed Vedic tradition. This creates theoretical tension as well as confusion over some Ayurvedic principles.

For example, the Charaka Samhita starts with revered salutations to the divine propounders of Ayurveda, Lord Brahma, the Asvins and Lord Indra. The tradition says that when Brahma awoke to create the universe he also generated the wisdom that is Ayurveda.

He passed this onto Lord Draksha-Prajapati (the protector) who then taught it to the Ashvin twins (the physicians to the Gods) who taught it to Lord Indra (the Lord of the universe). When human suffering had become so unbearable Lord Indra met with the great Himalayan sages and through his student Bharadvaja passed this knowledge onto these enlightened beings.

Hence the great student Agnivesha came to study Ayurveda, under Atreya, and eventually compile this wisdom in the now lost Agnivesha Samhita that is said to be contained in the Charaka Samhita.This marks Ayurveda’s claim to divine origins and its connection to an eternal tradition for, as we know, all Indian traditions that have sought recognition by the orthodox have invoked the authority of the Vedic deities as an expression of their allegiance.

But as you compare it with the other texts clear inconsistencies in this premise arise.Divergent theoretical opinions appear, thus disqualifying this attempt at seeking an eternal and divine foundation. For example, Charaka and Sushruta (13) differ in their opinions of the post-digestive effect of the flavours (see chapter three on Ayurvedic pharmacology). Sushruta only lists sweet and pungent as the flavours that remain after the process of digestion whereas Charaka also includes sour.

There were also differences in the understanding of human physiology; were there three or four humours (dosha)? Is blood actually a dosha or not? (14) Another example is the discussion over the energetic nature (virya) of herbs; are there two primary energetic classifications of herbs or eight? Is it just hot and cold or hot-cold, unctuous-dry, heavy-.light and soft-sharp? The texts seem to differ (15).

This is the difficulty in determining the meaning of the texts: on one hand they are divinely inspired knowledge and on the other they are evolving human debates that are seeking to unravel the nature of nature and develop a medical system that is accurate and effective. What emerges later is a collective opinion drawn together by commentators and practitioners.

The development of Ayurveda continued alongside the growth of the mystical tantric and yogic traditions, each fulfilling their different roles. Whilst Ayurveda concentrated on the ‘health’ of the body, yoga was mindful of the state of ‘consciousness’ and tantra with the deification and immortality of the body. Yoga is a tradition of mental and spiritual refinement; the art of joining your individual-self (atman) with the universal-self (Brahman). It rejects the first three goals of Hinduism (wealth, sensual pleasure and religious duties) in preference of seeking the ultimate goal of life, spiritual emancipation (moksa).

As with many Indian traditions, philosophical differences were often overcome by a broadening of perspective on either side. Hathayoga, growing out of the tantric yogic tradition, seems to have adopted many Ayurvedic principles, notably the ‘purification’ of the body. The hathayoga pradipika is full of references to the dosha and techniques to remove phlegm, bile or the winds (16).

With hathayoga becoming filled with Ayurvedic practices and Ayurveda adopting yogic attitudes the two traditions connected. The body became a priority in order to attain the goals of liberation and health. Yoga, after centuries of interest in the mind and self, became fascinated with the body. Hathayoga adopted an Ayurvedic language, as well as similar practices, to facilitate this new focus on the body.

There is a very close similarity, in activity and intention, between the cleansing practices of the yogic shatkarma and the purification of Ayurvedic panch karma.  This movement from yogic spiritual practice to physical purification of the body has been significantly termed ‘corporealisation’ (17). The body, as it became the terrain of spiritual experience, became the focus of spiritual interest.

Ayurveda also adopted insights from this yogic realm. It began to incorporate the tantric practice of using various mineral substances (notably mercury, gold and silver) and re-emphasised its objectives from merely maintaining a long and healthy life to that of virilisation (vajikarana) and rejuvenation (rasayana), which is, potentially, immortality. These concepts essentially oppose the mortification of the body and seek a long life filled with rejuvenative potential. Thanks to these yogic influences the body is no longer considered to be mortal! Today Ayurveda and Yoga are practically synonymous in the pursuit of good health and a calm mind.

Here we can see that Ayurveda continued to display the wonderful Indian trait of absorbing everything around it, even if that meant broadening and modifying its own perspectives.

Modern day Ayurveda, as practised in India today, is based on a resurgence that occurred around the 17^th century. The causes are varied. One may be the increased competition that Ayurveda faced by the coming of the Moghuls and the rise in use of Unani medicine. Another may be the new energy Ayurveda felt from the synthesis that occurred between Ayurveda and yogic-tantric thought.

Two fundamental new techniques that arose from this synthesis were the introduction of pulse diagnosis and the use of new mineral remedies. They are both central to the practice of contemporary Ayurveda. Pulse taking seems to have arisen from the Shaiva yogic tradition that thrived in South India under the guidance of the Tamil Siddhas. It later arose in North India with such works as the Sharangadhara Samhita, Nadivijnana  and Nadichakra adding to this theoretical base (18). 

The Unani hakim’s were also useful teachers in the art of pulse taking. The mineral remedies (mercury, gold, silver ashes) are very potent and revolutionised the Ayurvedic pharmacopoeia. These additional techniques greatly enhanced the efficacy of Ayurveda and this gave impetus to its resurgence.

The 19^th and 20^th centuries saw a further revival with the building of new Ayurvedic colleges (approximately 100 in 1983), the creation of the Central Council for Ayurveda in 1970 to overseeing standards and practice and the establishment of Ayurvedic pharmaceutical companies. Its patronage by the Indian government now gives it some form of nationally recognised status but this really needs to be more proactive and supportive.

The 21^st century really is a time of challenges and opportunities for Ayurveda. As Ayurveda spreads throughout the world it is facing many challenges to the traditional way in which it has been practised. There are legislative, environmental, educational, clinical and culturally based challenges that are stirring the winds of the Ayurvedic community.

It really is a time to act or be acted upon, meaning that the Ayurvedic community must unite and speak up to express its needs or will face legislation on which it has had no influence.

The reason the global Ayurvedic community is facing many challenges is due to;

• Political patronage: The fact that Ayurveda is considered a second rate medical system by the Indian authorities with a poor professional standing given to Ayurvedic doctors. This results in a weak image projected from its native country to the rest of the world and does not send a supportive message to other national governments looking to India for guidance.
• Cultural: The fact that Ayurveda contains cultural traditions that differ to the rest of the world potentially causing conflict when they mix with other cultures with different agendas. The complexities of defining how Ayurveda should be taught and practised outside India reflect this..
• Scientific: The competition between western science and the traditional medical paradigm practised by Ayurveda. The lack of evidence based research and clinical trials is hindering its acceptance by mainstream medical institutions and practitioners. Whilst there are many respectable research institutes in India many of the clinical trials that are carried out are not available in easily accessible journals and some do not meet rigorous research standards.
• Conservation: A lack of environmental awareness amongst Ayurvedic practitioners about the pressures that harvesting herbal medicines from the wild is placing on herbal supplies.
• Legislative: Increased popularity of herbal medicine throughout the world resulting in fears about safety issues which is leading to further herbal legislation regulating the prescription and sale of herbal remedies.

Some examples of this are:

• The legislative threats to the use of certain medicinals such as Vidanga (Embelia ribes) being banned for use in the UK. The illegality of using many bhasmas (oxidised metallic and mineral preparations) that are often considered to be the mainstay of internal treatments is another challenge.
• The environmental pressures on many species used in Ayurvedic remedies is serious. For example, Chandan (Santalum album) and Kushta (Saussurea lappa) face increased demand on the domestic and international markets whilst natural populations dwindle.
• There are also pressures on the educational front as different countries define in law how Complementary and Alternative Medicine (CAM) as a whole can be practised.

How Ayurveda meets these challenges will steer its fate in the future.

The central works of Ayurveda, The Great Triad (brihad trayi), includes Charaka Samhita, Sushruta Samhita and Ashtanga Hridaya Samhita, The Lesser Triad (laghu trayi) includes the Madhava Nidana, Sharangadhara Samhita and the Bhavaprakasha Nighantu (or Yoga Ratnakar according to some authorities).

The growth of the Ayurvedic materia medica is clearly displayed in these texts. The increase of ‘alchemical’ medicine and developments in chemistry are included from the 12^th century onwards with the introduction of Rasa Shastra, or alchemical literature, in such texts as Anandakanda, Rasaratnasamuccaya and Ayurvedaprakasha. From here onwards metals, gems and mercurial medicines are included in the Ayurvedic pharmacopoeia.        

One of the difficulties facing Ayurvedic pharmacology today is the botanical identities of many of the Sanskrit named plants. Many are lost to history. The translation of their Sanskrit name gives a tantalising indication of their potential. For example, jivaka, ‘the life giver’, still remains unidentified. The precise identification of many Ayurvedic plants has been a source of continual frustration, debate and botanical challenge.

Having said this many do remain in the herbalist’s realm. Although the Vedas mention around 260 plants (19) the first insights to the Ayurvedic pharmacopoeia are found in the Charaka Samhita. Here we find the beginning of a pharmacopoeial trend of collating substances (dravyas) into specific classes; herbs, cereals, liquids, fruits, metals, gems, vegetables, meats, cow products, flowers, salts, oils, alcohols, sugarcanes, sources of water and urine.

In the Charaka Samhita herbs are classified into fifty groups (varga) of ten according to their primary actions (20). For example, herbs that are jeevaniya or life-giving include the well known liquorice or madhuka (Glycyrrhiza glabra) and the group that is brmhaniya or strength promoting includes ashwagandha (Withania somnifera).

Sushruta has also classified herbs according to groups with specific actions (21). But instead of being titled with a specific action they are named after the most representative herb. For example, the pippalyadi varga (meaning ‘the pippali etc group’) describes the group of herbs that have a similar action to pippali or long pepper (Piper longum). This is a digestive, warming, carminative group of herbs that also includes black pepper, cardamom, asafoetida and calamus. Interestingly, there are also groups of herbs classed together because of their cleansing (shodhana) effects: emetics, purgatives and vata pacifying herbs.

The Ashtanga Hridaya Samhita also looks at groups of foods and herbs. For example it mentions five types of liquids; water, milks, oils, sugarcanes and alcoholic drinks. The Ashtanga Hridaya Samhita follows the herbal classification of Sushruta by grouping the substances according specific actions.

Sanskrit plant names are sometimes used to generically cover various botanical species. Whilst the Latin nomenculture that I have used in this book to define the equivalent for the Sanskrit name is based on the works of numerous scholars, common clinical practice and accepted norms it cannot represent hard and fast scientific certainty. The discovery of the Ayurvedic pharmacopoeia is a work in progress that shall continue for many years to come.

Later texts consolidated this trend of classifying groups of herbs based on their action. Again the group title is usually named after the herb that is renowned for that group’s primary action. The Dhanvantri nighantu (c500CE) lists the first group as guduchyadi varga’ or the ‘Tinospora cordifolia etcetera group’. All the herbs in the group have the dual action of removing the aggravated dosha from the body as well as rejuvenating the system, just as guduchi removes pitta as well as rejuvenating the blood and reproductive fluids.

The Bhavaprakasha is the most commonly used materia medica today.  Written by Bhavamishra around the 16^th century it is a compilation of many earlier texts. The Bhavaprakasha lays out the rules and guidelines for collecting herbal materials and understanding the language of the pharmacopoeia.  For example, “when there is no mention of the part of the plant to be used, the root is to be used”.

There are some wonderful descriptions of how to identify herbs, how to collect the fresh plants and what the ideal growing conditions are. Specific pointers to quality are mentioned; “ Haritaki (Terminalia chebula) which has a small seed inside, more fruit and which sinks in water is considered the best form for all purposes”.  It includes a very useful section on what to replace an unobtainable herb with; “In the absence of tagara (Valeriana wallichi) kushta (Saussurea lappa) should be used by the wise physician”.

The text is also full of invaluable insights into the nature of the tastes, gunas and pharmacological properties of the herbs. There are twenty four groups of herbs and minerals listed in  the Bhavaprakasha and it is actually very systematic as only the herbs that should be in each group are actually listed (not always the case in other pharmacopoeias!). For example, only flowers are found in the flower group (puspa varga)andonly aromatics are in the Camphor group (karpooryadi varga). It is a must for any serious student of Ayurveda.

And so we can clearly see that Ayurveda has grown out of a dynamic tradition that has survived and thrived in the face of much intervention, influence and change. As a medical tradition existing in Indian culture it has faced a complex task: that of fitting into the orthodox fold whilst also remaining true to its holistic aspirations and prioritising its ultimate goal of the health of the patient.

These requirements were not always compatible but Ayurveda has managed to grow organically into the respected position that it holds today. Ayurveda is now experiencing a worldwide revival and it faces many challenges as it blends with the legal, social and climatic conditions of different cultures. Ayurveda’s main challenge is whether it can thrive as a global medical system.

1. I have relied heavily on Jan Meulenbeld’s works for categorising dates. Notably ‘A History of Indian Medical Literature’ 1999-2002. Whilst the dates that I have given are the commonly decreed historical dates of authorship Indian Indologists often place these dates of the early Ayurvedic texts significantly earlier (c4000-1000BCE). This is a contentious issue and reflects some of the different perspectives on history, origins and tradition that exists between certain European and Indian medical historians.
2. D Wujastyk. The History of Ayurveda in The Science of Medicine OUP 2003
3. For example, see Dr Frawley and Dr Svoboda’s insightful books on Ayurveda.
4. Jan Meulenbeld first introduced this idea in ‘Reflections on the basic concepts of Indian pharmacology’ from Studies on Indian Medical History 1987. His contribution to the study of Ayurveda is unsurpassed and his massive ‘A History of Indian Medical Literature’ is testimony to this. I am indebted to his work.
5. SW Jamieson & M Witzel, Vedic Hinduism 1992.
6. Rg Veda 10.97 Translated by Wendy Doniger O’Flaherty.
7. Taittiriya Samhita 6.4.9.1-2.
8. Manu Smriti 3.108, 152; 4.212, 220.
9. There is some evidence for this; c.f. Brahmajalasuttanta of the Dighanikaya 1.1.27 and 1.12 confirms that the sramanas (wandering mendicants) used various medical techniques to earn a livelihood. A Greek writer, Strabo (c. 64 BCE-21 CE), in his Geography, refers to Megasthenes’ comments that these sramanas were known as physicians. See K. Zysk’s works on Indian medicine.
10. The Sanskritisation of early hatha yoga texts, ie. Gorakshshataka (circa 1300CE), is a good example of this.
11. See K Zysk’s study on ‘Asceticism and healing in ancient India: medicine in the Buddhist monastery’.
12. Samkhya Karika 1.1 Edited by S Radhkrishnan and C Moore.
13. Charka Sushruta Sutrasthana 26.57-58 Sushruta Samhita Sutrasthana 50.10-12
14. See Jan Meulenbeld, The Characteristics of a dosha. Journal of the European Ayurvedic society 2 (1992) for a thorough discussion of the definition of a dosha. Also refer to Charaka and Sushruta for a more detailed debate on this matter
15. Charaka Samhita 26.64-65 and Ashtanga Hridaya Samhita 9. 12-13 from Jan Meulenbeld Studies on Indian Medical History 1987
16. The hathayogapradipika is a seminal work on hatha yoga that represents the contemporary approach to spiritual liberation using physical, breath and meditative techniques.
17. ‘When fat or mucus is excessive then the six cleansing procedures (shatkarma) should be practised before pranayama. Others in whom the dosha are balanced, should not do them.’ Hathahogapradipika 2.21.
18. ‘Nauli is the foremost of the hathayoga practices. It kindles the digestive fire, removing indigestion, sluggish digestion, and all disorders of the dosha and brings about happiness’ Hathayogapradipika 2.34.
19. ‘Perform exhalation and inhalation rapidly like the bellows (of a blacksmith). This is called kapalabhati and it destroys all mucus disorders.’ Hathayogapradipika 2.35
20. ‘Surybheda is excellent for purifying the cranium and destroying imbalances of the wind dosha and eliminates worms.’ Hathayogapradipika 2.50
21. Translated by Swami Mooktibodhananda Saraswati and Swami Satyananda Saraswati
22. Sir Dr J Mallinson “The Khecarividya of Adinatha: A Critical edition and Annotated Translation.” Unpublished Oxford University Doctorate 2002.
23. Jan Meulenbeld, A History of Indian Medical Literature, Dr. Upadhyaya, Nadi Vijnana.
24. V.Gogte  Ayurvedic Pharmacology.
25. Charaka Samhita Sutrasthana 4.
26. Sushrita Samhita Sutrasthana 38 & 39.

Immunity is the organism’s natural response to protect us from infections and help maintain homeostasis. It maintains the ecological relationship between the mind-body-spirit and the world in which we live and interact.

Our immunity is a holistic system interconnected with the psychological-neurological- endocrine systems, it is multi-dimensional and requires nourishment from diverse sources. Healthy communication between these different sources is the key to healthy immunity.

Our immune system is facing a unique historical challenge as we encounter increased environmental, industrial, social, pharmaceutical, dietary and spiritual stressors. This microcosmic challenge is a reflection of the larger environmental challenge that our macrocosmic world is also facing.

The pressures of global population increase, industrial expansion and the destabilisation of many natural ecosystems are clearly stressing the earth’s natural immunity. We now know that these challenges also have a negative impact on our immune systems. How we care for ourselves and advise our patients can have a direct impact on the Earth’s immunity.

Let’s now look at some of the information that can help us understand how we can weave our way through this quagmire of health challenges.

In order to protect us from foreign invaders the immune system must be able to differentiate from ‘self’ or ‘non-self’ or what is ‘us’ and what is ‘not us’. In order to fulfil this objective the immune system galvinises the cooperation of numerous cells, organs and chemicals to work coherently to protect us against disease. There are two categories of immunity; a natural, innate, non-specific immunity and an acquired, adaptive, specific immunity.

Non-specific immunity

Non-specific immunity is a natural, genetic type of immunity present at birth; for example, cows appear to have immunity to small pox, but it can be fatal in humans. Our innate immunity includes the skin, certain chemicals in the blood and special immune system cells that attack foreign substances in the body. It is responsible for 99.9% of all immune activity and is our first line of defence.

• Non-specific immunity is partly regulated by macrophages that literally hoover up foreign bodies in a process known as phagocytosis. Andrographis, guduchi, ashwagandha and garlic all increase the action of phagocytosis.
• Natural Killer (NK) cells are a part of this non-specific system that act independently of other chemical messages and act as the first line of defence against many diseases. They are formed in the bone marrow and then travel to lymphoid tissue (tonsils, lymph nodes and spleen). From here they either attack cells infected with viruses or DNA damage (e.g. tumour cells). They also work as part of the acquired immune system (see below) and release cytokines that modulate T and B lymphocytes. Liquorice and garlic assist NK cell activity.
• Specific chemicals are used by this aspect of immunity to keep the body healthy: Interferons, interleukins, Tumour Necrotic Factor. Ashwagandha, turmeric and green tea have all been shown to positively affect these immune system workers.

Specific immunity

Specific immunity was a later development in our evolution and generates  lymphocyte activity at a cellular level against invading foreign substances known as antigens. It is an induced response that is slower than our innate immune response.

It has to be learned by the body and it also creates a memory. For example, the adaptive immune system creates a secondary response to a pathogenic infection by a disease to which the body can become immune after recovery (e.g. chickenpox) or via vaccination, or from receiving antibodies via your mother’s breast milk.

• T-lymphocytes are released by this specific immunity and they have ‘killer’ ‘helper’ and ‘suppressor’ activity. Kutki, andrographis, garlic and liquorice modulate T-cells.
• B-lymphocytes are produced by the bone marrow in adults and live in the spleen and digestive tract. They are transformed into plasma cells which create immunoglobulin anti-bodies on meeting a foreign invader and create memories of these invaders to recognise them when they next appear. Ashwagandha and liquorice modulate B-lymphocyte activity. Punarnava, guduchi, karela, turmeric, garlic and liquorice all help to modulate antibody response.

In recent medical history it is the specific immunity which has received most emphasis, even though it is responsible for only 0.1% of immune activity,. The excitement and therapeutic potential generated by the discovery of vaccinations and anti-biotics has led the way in medical research and investment.

Tragically this one-dimensional ‘magic-bullet’ mentality has left the potential of our innate and non-specific immunity largely untapped as a resource for healing. As we shall see, Ayurveda offers enormous potential in nourishing non-specific immunity simply because, like us, it is multi-dimensional (Spelman et al 2006, Ferlazzo et al 2004, Clayton 2004, Bone 2003 &1996, Pole 2006).

• Regular or persistent bacterial, fungal, viral or parasitic infections
• Slow healing wounds
• Auto immune diseases
• Allergies
• Inflammatory disorders
• Chronic fatigue
• Depression
• Chronic degenerative conditions, where impaired immune system response is present in such diseases as cancer, candidiasis, ME, AIDS, TB

• Thymus
• Spleen
• Lymph system
• Bone marrow
• White blood cells
• Antibodies
• Hormones
• Neurons

The endocrine and nervous systems are in continual feedback with the immune system and their state of balance regulate the immune response. So, the balance of our hormones and the functioning of our neurons are implicated in how our immune system responds to visiting foreign substances.

The brain and immune system have a continual dialogue so that immune mediated chemicals inform the brain what to do and visa versa. It is clear how we can under perform when faced with an intolerable level of negative stress. As we know, emotional, hormonal and immune states all affect our digestion, sleep and mood. Certain studies have shown how different emotional states affect the immune system:

• Loneliness reduces NK cell activity. Lonely students have reduced NK cell activity and higher Epstein Barr virus levels (Kiecolt-Glaser et al 1984 & 1987).
• Excessive stress reduces immunity (as well as increasing the risk of strokes, increases atherosclerosis, high blood pressure, reducing neuronal regeneration and ageing). Caretakers of dementia patients suffer from reduced immunity. People under extreme academic stress show reduced levels of lymphocyte and interleukein production and higher cortisol levels (Kiecolt-Glaser et al 1984, Schultz R et al 1999, Stein 1985).
• Bereavement causes reduced immunity with reduced lymphocyte activity in men and post-bereavement depression can cause increased cancer and death. (Schleifer et al 1983 &1989, Kiecolt-Glaser et al 1986 & 2002).
• Marital conflict also affects immunity raising Blood Pressure, cortisol and NK cell activity (Miller et all 1999, Kiecolt-Glaser et al 1987).

Whilst many pharmaceutical drugs are often life-saving their chronic use is having a debilitating effect on the health of many people. The cocktail of drugs that patients arrive with in the clinic is often astounding. We are in the middle of a human experiment that encourages end-stage emergency medicine instead of a more integrated approach that engenders health and nourishes the whole system.

It is now clear that the poly-pharmacy approach of current allopathic practice is both not working in either the preventative or curative sense. Iatrogenic disease is now considered to be the third largest cause of death in the USA. As Ayurveda would recommend, health is all about time (kala) and space (desha) and who is using how much of what, and when. Practitioners of holistic medicne are helping to inspire change in the current medical paradigm and serve patients, society and environment in the most complete and healing manner (Lazarou 1998, Starfield 2000, Holford 2006, Clayton 2004 & 2007).

Some immunosuppressive medication

Corticosteroids, such as prednisolone, dexamethasone

Often used to treat inflammatory digestive, skin or arthritic conditions.These work by blocking the action of inflammatory prostaglandins. They can depress the immune system, reduce T and B-lymphocytes, increase susceptibility to infection, osteoporosis, reduced efficacy of insulin, cause peptic ulcers, increase in blood pressure, fluid retention, acne, moon face, atrophy of body’s ability to produce corticosteroid hormones. They are cold, damp and aggravate kapha, and reduce ojas.

Immunesuppressants and antimetabolites, such as cyclosporine and methotrexate

Cyclosporine is used as an immunosuppressive drug after organ transplants or to treat certain auto-immune diseases. It can lead to increased susceptibility to infection, tremors, facial swelling, nausea and kidney damage. Methotrexate helps to block the metabolism of cells and is used to treat cancer, arthritis, psoriasis and cancer.

The most frequent reactions include mouth sores, stomach upset, low white blood counts, headaches, itching, skin rash, dizziness, and hair loss. Methotrexate can also cause severe toxicity of the liver and bone marrow. They are hot, toxic and aggravate agni, rasa, rakta, majja and shukra dhatu.

Anticancer drugs: Chemotherapy and radiotherapy

As they are cytotoxic these drugs literally prevent cell formation and hence may halt the growth of tumours. This action also opposes the natural regenerative force of life, new cell formation and can lead to a range of side-effects including nausea, hair loss, red and white blood cell depletion, platelet reduction and bone marrow depletion. They are hot, toxic, depleting to agni, and every dhatu.

Antihistamines

Antihistamines are used to suppress allergic symptoms.They act on H1 receptor sites by preventing histamine from attaching to these sites and theoretically preventing the body from responding to allergens. They are used to relieve mild to moderate symptoms and can cause drowsiness. An example is diphenhydramine. The different varieties have different energetics but are essentially stagnating to prana.

Antibiotics

These are the mainstay of treatment in acute bacterial infections, including tetracyclines, macrolides (erythromycin), penicillins (amoxicillin or ampicillin). Antibiotics may be routinely dispensed without specific bacterial strain analysis. Common side effects are disturbed intestinal flora leading to outbreaks of Candida albicans, other yeast infections and diarrhoea. Rarer reactions are severe allergic reactions. Antibiotics are mainly cooling depleting agni, causing kapha and ama to accumulate.

Antivirals

Antiretroviral drugs used for treating AIDS can cause hepatic injuries, renal and genitourinary diseases, allergies, fever, anaemia, nausea, diarrhoea, vomiting, skin problems, photosensitivity, elevation of cholesterol and triglyceride levels leading to coronary artery diseases. These appear to be heating and toxic. (British National Formulary 2006)

Ayurveda has a beautiful understanding of our immunity which it considers within a completely holistic context, including both a qualitative and quantitative understanding of immunity. The Ayurvedic view of immunity is based on the concept of inherited reserve and acquired reserve. It is literally known as ‘vyadhi-kshmatva’ or ‘self-avoidance of disease’.

”The immunity (vyadhi-kshamatva) is a strength within all of us that resists the causes of diseases and their aggressive tendencies.” – Chakrapannidatta

The Ayurvedic concept of immunity involves the health of the ojas, the heart(hridaya), the eyes (chakshushya), digestive strength (agnibala) and tissues (dhatu).

Ojas

The quality of your inherited (sahaj) and acquired (yukti) organ reserve is generically known as ojas. Ojas holds a special place in Ayurveda as it nourishes and orders the functioning of the body. Just as ghee is the most refined essence of milk so ojas is considered to be the most superfine essence of all inherited organ reserve, digested nutrition and experiences.

“It is ojas which keeps all living beings refreshed. There can be no life without ojas…. It constitutes the essence of all the tissue elements.” – Charaka Samhita 1.30.9

If it is depleted, disease can set in:

“When ojas is low the person is fearful, weak, worried, has deranged senses, poor complexion, weak mind, is rough and thin’. – Charaka Samhita (CS) 1.17.73

When maintained at an appropriate level its beneficial qualities are seen in the lustre of the eyes, strength of the body, suppleness of the limbs, resistance to disease, efficient digestion, potent fertility, vital energy and lucidity of the mind. It is the seat of prana and agni helping to sustain their potential in the body. It is considered to sustain life (CS 1.30.10) and to provide strength (bala) (Ashtanga Hridaya 1.11.41). Bala is closely related to ojas. In fact, Sushruta views ojas and bala as being identical and uses the terms synonymously (Sushruta Samhita.1.15.20). Bala also possesses the quality of resisting diseases (CS 6.3.141), because it is able to inhibit their root cause, the doshas (CS 6.3.167).

Ojas has sweet (madhura), heavy (guru), cool (sheeta) and unctuous (snigdha) properties. Based on the principle of samanya-vishesha (CS 1.1.44 and 1.62) it is built by substances or experiences with similar attributes, such as ghee, milk, nuts, love, contentment, calm. It is also nurtured by non-violence, preservation of reproductive fluids, knowledge, self-control, understanding of the truth and sexual abstinence (CS 1.30.15).

Conversely it is reduced by dry (ruksha), astringent (kashaya), light (laghu) and hot (ushna) qualities. Hence, ojas can be depleted by excessive: alcohol, fasting, consumption of un-unctuous food, eating food only tasting of one flavour, exposure to the wind and sun, over work, under nourishment, orgasm, exercise, depression, fever, infections, sadness, irritability, anger, anxiety and stress.

The heart (hridaya)

Ayurveda understands that the ‘seat’ of ojas is in the heart (CS 1.30.6) and that emotional balance and nourishment is an integral part of an efficiently functioning immunity. It is said that eight drops of ojas (para ojas) resides in the heart and that this is the regulator of all the ojas in the body. It can never increase and must be maintained for preserving health. The type of ojas flowing around the body is known as apara ojas. It is said to be half a handful (anjali). This type of ojas can increase and decrease.

From the heart the channels of prana, manas and rasa all extend revealing it as the source of breath, mental balance and nutrition. The heart, as well as being a governing organ of blood circulation, is also the seat of consciousness (CS 1.30.4). This emphasises the importance that Ayurveda places on using treatments that nourish both the physical and emotional heart for maintaining a health of the immune system. As we all know, oppressive stress negatively affects the immune system (Khansari et al 1990).

It is one of Ayurveda’s gifts to humanity that it reminds us to care for the emotional nourishment in our patients. To help generate a healing experience of self-worth and love is priceless prasad.

Eyes (chakshushya)

The eyes absorb external experiences and feed directly into the heart. Using positive visualisations and herbs that nourish the eyes plays a part in supporting ojas and the immune system.

Digestion (agni)

A healthy digestion helps to feed the tissues (sapta dhatu), which feed the heart and nourishes immunity. If digestion is impaired then it cannot metabolise the appropriate nutrients required for nourishment of the tissues and hence results in the depletion of ojas. If the digestive fire becomes impaired in any way then toxic accumulations known as ama can clog the channels and obscure the clarity of  nutritional absorption and emotional assimilation.

‘It is obvious that that the body tissues cannot be nourished and developed when food is not properly digested by agni’ – Charaka Samhita6.15.5

The importance of good diet on immunity cannot be over emphasised. Nutritive food protects health and prevents disease. It has been shown that 30% of all cancers are diet related and that 70% of these cancers are connected with typical diets that are high in animal fat, low in fruit, vegetables and fibre (WHO).

Since 1950 there has been a global reduction of calorific intake by 38% in the consumption of complex carbohydrates and an increase of 36% for meat and 46% for vegetable oil. In the same period in the UK there has been a fall in fresh vegetable consumption by 24% and in the EU and US there has been a 35% increase in sugar and refined starch consumption. Our shift in nutritional habits is evidently having a negative impact on society’s health.

An increase in nutrition received from meat is a good example. Well-cooked meat, especially barbequed meat contains aromatic amines, including 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (2, 3) PhIP which is associated with bowel, breast and prostate cancer in human cell line studies.

The more meat that is eaten is directly correlated with an increased incidence of death from cancer, as seen by statistics showing New Zealand as having the highest meat consumption and the highest levels of colon cancer. There has been a 36% calorific increase from meat consumption since 1950. Vegetarian diets are known to extend life and reduce degenerative diseases. (Clayton 2004 & 2007)

Other qualitative and quantitative nutritional factors are altering society’s health. Obesity has clear links with some forms of cancer (Cerhan 1997). Low selenium levels are specifically implicated in prostate cancer (Li et al 2004). Conversely, the increased use of protective oils containing Omega-3 and Omega 6 fatty acids is related with a reduced rate of cancers.

Lycopene, carotenoids and onion flavonoids have proven to be protective against prostate cancer. Studies have shown that increasing essential nutrients can give essential protection against degenerative diseases such as Alzheimer’s, arthritis, coronary heart disease, macular degeneration, depression and cancer  (Giovannuci et al 1995, Lewin et al 2006, Taylor 2004, Drewnowski 1997 & 2003).

Interestingly, but not surprisingly, organically grown food has been shown to have higher levels of nutrients and anti-oxidants than non-organic products. Studies comparing the nutritional value of organically grown and conventionally grown fruits, vegetables, and grains conclude there are significantly more nutrients in organic crops. These include: 27% more vitamin C, 21.1% more iron, 29.3% more magnesium, and 13.6% more phosphorus, 70% higher omega-3 content and certain vegetables have been shown to have 100% higher levels of flavonoids.

In addition, organic products have 15.1% less nitrates than their conventional counterparts. It is also noted that the government recommended five daily servings of vegetables (lettuce, spinach, carrots, potatoes and cabbage) provided the recommended daily intake of vitamin C for men and women when they are organically grown but their conventional counterparts did not. Eating organic affects the amount of flavonoids, quercetin, and anti-oxidants that are protecting and nourishing you. You are also avoiding exposure to excessive levels of immune damaging pesticides and organophosphates (Worthington 2001, Heaton 2001, Grender-Pedersen et al 2003, Zheng et al 2001).

All this shows that the quantity and quality of food as well as the quantity and quality of agni affect immunity.

Tissues (dhatu)

The health of the tissues leads to the final nourishment and support of the immune response. With good digestion of food the tissues are maintained in a healthy state, and if of exceptional quality, they can actually help to replenish any depletion of ojas caused by ageing and the ravages of time. This is clearly seen when a patient with manda agni leading to dhatu kashaya commonly suffers from degenerative disease. Looking after agni will look after the dhatu.

Channels (srotamsi)

Any excessive, deficient, stagnation or overflow in the channel system throughout the body-mind impairs the nutritive and detoxifying function of the srotamsi. Whether there is constriction from vata tension (cold or dry), inflammation from pitta intensity (hot or oily) or congestion from kapha or ama mucus (wet or sticky) any imbalance in the flow of the channels (srotorodha) leads to imbalances in the movement of the dosha, dysregulation of the dhatu and this results in impaired immunity.

Channel stagnating nervous, inflammatory and mucus proliferation all seem to be encouraged by modern diets and life-styles. Pharmaceutical drugs, amagenic diets, emotional indigestion and environmental pollutants are some of the current contributors to obstructing the healthy flow in the srotamsi.

The functional principles (dosha)

• Vata immune problems will manifest in people where there is a poor response to a disease and general depletion. This often involves lingering illness, chronic degeneration, wasting and weakness. This requires immune stimulants and immune tonics. Tulsi and ashwagandha are good examples.
• Pitta immune problems will manifest with inappropriate and extended inflammation. This will require reducing the inflammatory cascade and reordering the immune response. Andrographis and guduchi and good examples.
• Kapha immune problems will manifest with abnormal growths and mucus secretions. This will require clearing treatments that reduce congestion and remove stagnation. Pippali and ginger are good examples.

To summarise, good immunity in an Ayurvedic context comes from:

• Avoiding the causes of poor immunity (nidana parivarjana)
• Balance of the dosha (tridosha hara chikitsa)
• Balanced digestion (sama agni)
• Reduced toxins (ama pachana)
• Keeping the channels of circulation open (srotas mukho vishodhana)
• A strong heart and balanced emotions (hridaya manas bala chikitsa)
• Nourishing the tissues (dhatu poshana)
• Avoidance of negative habits and behavioural patterns that can reduce your inherent reserve (asatmeya indriya samartha hara).

When considering a treatment plan, I also like to think of the condition of the different ‘bodies’ we have (as propounded in the yogic texts); the food (annamaya kosha), breath (pranamaya kosha), mental (manomaya kosha), knowledge (vijanomaya kosha) and bliss (anandomaya kosha) bodies all need attention. The teachings of Ayurveda offer the wisdom to treat in a multi-dimensional manner.

Achieving abundant ojas means having access to:

• Pure air
• Pure water
• Pure food
• Emotional stability: Love, peace of  mind, balanced relationships.
• A regular lifestyle (dinacharya): Ayurveda lays much emphasis on prevention so as to prevent the degenerative cascade that can occur. This is an orderly routine that balances personal hygiene, nourishment, exercise, relaxation, creativity, wealth and love.
• Protection: Your daily activities should be 100% healing with active avoidance of immune depressing chemicals and foods to keep your immune system intact.
• Detoxification: Daily, seasonal and whenever required: Deep purification if there is strength (shodhana and panch karma), gentle purification in more depleted states (shamana), daily regulation of the elimination of toxins (amapacana).
• Tonify: Daily, seasonally and as much as possible.
• Herbs and foods: Sweet in taste, sweet in post-digestive effect, cooling, heavy and unctuous all go to build ojas.

Special Ayurvedic treatment categories to nourish ojas and overall immunity

All of these dravya can taken with milk and or ghee to guide them to the deeper tissues (Bhavaprakasha, Charaka Samhita, Ashtanga Hridaya Samhita).

• Balya: Strengthening treatments giving power to the digestive fire (agni) and tissues (dhatus). Sweet nourishing tonics such as bala, vidari kandha, gokshura, guduchi,  kapikacchu, ashwagandha, shatavari.
• Brimhana: Building treatments including snehana and oleation techniques to nourish the tissues using unctuous and oily substances such as figs, milk, honey, ghee, vidari kandha, gokshura, chywanaprash, hemp seeds, linseeds, almonds and walnuts (and their omega rich oils).
• Jeevaniya: Life-enhancing herbs and treatments that include anti-oxidants and life-enhancing herbs; amalaki, tulsi, turmeric, guduchi, green tea, ashwagandha, chywanaprash.
• Agnivardhaka: herbs and foods including all the six tastes that strengthen digestion to assist absorption of nutrients including chitrak, ginger, pippali, cinnamon, cumin, fennel.
• Medhya: Nourishes the heart and brain to feed ojas with intellect promoting herbs such as gotu kola, amalaki, licorice, vacha, brahmi, shankapushpi, kapikacchu, guduchi.
• Chakshusya: Nourish the eyes to feed your heart using lotus root, chrysanthemum flowers, bluberries, triphala and amalaki.
• Hridaya: these herbs directly nourish the heart to feed ojas including arjuna, roses, amalaki, punarnava, cinnamon and chywanaprash.
• Rasayana: These rejuvenative treatments nourish rasadhatu which is the first tissue responsible for creating a feeling of pleasure in life. In turn it nourishes the heart which feeds the production and protection of ojas. Such herbs as guduchi, amalaki, haritaki, bibhitaki, shatavari, ashwagandha, chywanaprash, vidari kandha and licorice are beneficial here.
• Vrishya: Aphrodisiacs to rejuvenate the reproductive tissue including kapikacchu, ashwagandha, gokshura and shatavari.
• Shukrala: Fertility enhancing treatments directly feed shukradhatu which nourishes the heart and ojas: shatavari, vidari kanda, ashwagandha, safed musali

An amazing feature of these herbs is their ability to help the body adapt to stress, hence many of them are known as adaptogens. There excellence manifests from their non-specific nature. They perform multiple actions on diverse organ and tissue systems.

Adaptogen’s qualities

• Sweet, heavy, wet, nourishing, building, tonifying
• Improve overall well-being, increase energy, optimise organ function, reduce stress response, increase inner strength, improve glucose levels, optimise protein synthesis, reduce cortisol levels, improve cholesterol ratios.
• As biological response modifiers (BRMs) they restore the body’s innate immune function and help the body adapt to different stressors. This gives them preventative, protective as well as curative activity against immune compromisation. By replenishing ojas, rasayana adaptogens replenish the wellspring of health and vitality.
• Initiate anti-oxidant enzymes to protect cellular DNA from damage and reverse the ageing and carcinogenic process.
• As systemic protection from drugs, adaptogens increase the tolerability of steroids, anti-biotics, chemotherapy and radiation treatments by protecting the immune system, bone marrow, blood counts and vital organs. They specifically prevent opportunistic infections and protect the vital organs and vital prana. Adaptogens actually potentiate steroids whilereducing both short and long-term side effects.
• Ideally an adaptogen will possess the ability to protect ojas, replenish deficiencies in the dhatu, increase prana, enkindle tejas as well as reduce oxidation, repair DNA damage, inhibit cellular proliferation, induce differentiation, induce apoptosis, inhibit angiogenesis, inhibit metastasis, enhance immunity (NK activity, antibody response, interferon levels, leucocyte function), reduce inflammation, regulate metabolism, balance the endocrine system, and check blood glucose levels. Ashwagandha is a good example of a herb that does many of these things.
  (Rege et al 1999, Panossian et al 1999 and 2003, Yance 1999, Clayton 2004 & 2007, Sharma 1997, Dhuley et al 1997, Koul 1993).

• Exercise: Moderate exercise (up to an hour per day) is known to improve immunity (WHO, Nieman 1997).
• Yoga: The benefits of regular yoga practice are invaluable to a healthy immune system (Grossman et al 2004).
• Breathing: Regular exercises to bring prana into the system and regulate the flow of vitality around the entire system (Jayasinghe 2004).
• Meditation: Meditation has been shown to improve cellular immunity in geriatric patients. Relaxation and assertiveness training improves helper T-cells in HIV infected men. Melanoma patients who learnt stress management had improved NK cell function and greater survival rates. (Antoni et al 2002, Davidson et al 2003, Fawzy et al 1990, Wenger 1961, Kasamatsu 1964, Cohen 2004, Carlson et al 2004, Arias 2006).
• Expressing your emotions (verbally or through writing) improves immune function, results in less sick leave, improved liver function, reduced asthma, reduced arthritic pain. Spiegal’s ground-breaking work has shown how support groups have specifically helped to double the survival rates of women with metastatic breast cancer (Pennebaker et al 1988, Pietrikiet al 2004, Smyth et al 1999, Stanton et al 2002, Spiegal 1989 and 1993).
• Hopefulness improves the outcome of severe trauma (Irving et al 1997).
• Optimism improves the chance of preventing heart disease and recovery from heart surgery (Kubzansky et al 2001).
• Emotional support leads to improved recovery from illness and surgery (Berkman 1984).
• Regular massage: Along with helping you relax, feel energized and clearing stagnant lymph and toxins massage is good for immunity. Massage improves NK cell activity in HIV infected and cancer patients (as well as improving mood,  reducing depression, and reducing anger). Massage increases weight gain in premature babies. Massage decreases cortisol and increases serotonin levels. Massage reduces pain and anxiety in cancer patients (Ironson 1996, Hernandez-Reif 2004, Corbin 2005).
• Surround yourself in a pleasant environment: Pleasant music and visual stimulation are good for you! They may help to reduce the release of high levels of cortisol stress hormones. Lavender oil has been shown to improve mood in the workplace as well as reduce aggressive behavior in patients (Knaska 1992, McKinney 1997).
• Seasonal detoxification is a wonderful way to keep your tissues bathed in healthy rasa.
• Getting the correct amount of sleep is essential to good immunity (Lange et al 2003).
• Making peace with everyone around you.
• Having fun. There is a great Hindi adage that goes ‘Sau rogon ka dwai, hason! Yeh hain mera bhai’, ‘There is medicine for 100 diseases, but laughter is my healing brother!’

As we have seen, the foundations of a healthy immune system are based on a whole food diet.

An important factor in immunity is the avoidance of poor quality foods that have been refined, heavily processed, denatured, are stale or rancid; examples are margarines with hydrogenated oils, low quality oils, refined sugars or processed and preserved foods.

Eat a diet rich in vitamin A, B, C, E, germanium, iodine, selenium, manganese, zinc, chlorophyll and including flavonoids, carotenes, anti-oxidants, omega-3/GLA oils, pre-biotic fructo-oligosaccharides (inulin).

In order to ensure that agni is primed to transform the food that is eaten it can be helpful to supplement the digestive enzymes by using hingvashtaka, trikatu or avipattikar churna.

Essential for any type of compromised immunity condition is a diet that removes toxins and regenerates any deficiencies. This is a dedicated effort to health and healing that can also be delicious.

• Follow a primarily vegetarian diet that is constitutionally appropriate. All food should be organic
• Wholegrains, millet and roasted buckwheat are alkaline and can benefit the acidity associated with ageing along with brown and basmati rice, barley, quinoa and amaranth
• Pulses: mung beans, aduki beans, chickpeas, fermented soy products
• Super foods: Sprouted beans (chickpeas, mung, fenugreek, sunflower, pumpkin), 5 soaked and peeled almonds/ day, micro-algae, seaweeds
• Vegetables: Carrots, asparagus, artichokes, mushrooms (shitake, oyster, maitake), ginger, cooked garlic, cooked onion, leeks, beetroots, celery, Brassica family; high in a range of cell protecting and immune boosting flavonoids
• Inulin: Jerusalem artichokes, leeks, onions, garlic, chicory root
• Beta-carotenes: Yellow and orange vegetables; carrots, squash, pumpkin, paprika, chlorophyll rich micro-algae. Rich in cellular protecting anti-oxidants
• Cruciferous vegetables: The Brassica family, including cabbage, broccoli, brussel sprouts are high in indoles and isothiocyanates that are anti-cancer agents
• Chlorophyll foods: Dark, dreen leafy vegetables, micro-algae-spirulina
• Sulphur: Allium family;  garlic, onions, chives
• Oils: Omega-3 oils –hemp seed oil, linseed oil, micro-algae
• Fruit: Primarily berries with skins. Citrus peels
• Dairy: Some ghee
• Avoid sugar and excess sweet foods, salt, low quality oils/fats

Recipe: Immune nourishing soup

Ingredients

• Guduchi (Tinospora cordifolia) 20g
• Ashwagandha (Withania somnifera) 20 g
• Amalaki (Emblica officinalis) 20g

How to make an immune-boosting soup

1. Simmer in 1.5 litres water for 1/2 hour.
2. Strain and remove guduchi, ashwagandha and amalaki.
3. Add 1/2 cup organic pearl barley and 1/2 cup soaked and sprouted mung beans.
4. Add root vegetables, such as beetroots and carrots.
5. Add fried leeks, onions, garlic, 10 shiitake mushrooms.
6. Add seasonal greens, such as kale, spinach, nettles, asparagus.
7. Add ginger, rosemary, thyme, turmeric.
8. Add 1-2 sticks kombu / wakame.
9. Simmer for 45 mins.
10. Adjust quantities and water as desired.
11. Add any particular favourite vegetables or herbs.

You can eat this delicious broth in convalescence, or one to two times a week for general immune tonification. It benefits the immune system, digestion, allergies, fatigue and inflammatory conditions. 

Ayurveda offers us many so many effective insights into how to successfully help our patients. I thought I would discuss some of the things that I do in my clinic to try and achieve this. Depending on my patient’s personal requirements and their energetic pattern I prescribe a treatment that targets multiple aspects of someone’s health; body, mind, spirit, emotions, fitness and happiness. I will blend specific aspects of the above recommendations to help touch the heart of my patient and, in some way, to try and help them ignite their own inner healing. As health depends on many qualities so does the treatment to restore it.

This treatment may often include various dinacharya recommendations that will help the patient when they are living their daily life.  I find that when internal remedies are given they often seem to ‘dredge’ unprocessed emotions from the tissues and bring them to the surface of consciousness.

Some psychological work is beneficial to help digest these newly released old experiences. Writing a personal journal to facilitate free expression of undigested emotions can help. It may also include working with a psychotherapist or encouraging specific mediation practices. I will also use some body work techniques that may involve self-massage, more formal abhyanga, yoga, or referral for acupuncture or cranio-sacral work. Incorporating different healing modalities can help people truly heal.

The art I love most about my actual practice is the art of blending a unique formula for a patient. For me it epitomises what Ayurveda is all about; we are all unique and therefore need unique treatments. Blending a formula is a creative blend of ones practical, methodological and intuitive skills that are woven together to touch the essence of the patient’s heart. It is the subtle gift from the practitioner to their patient.

Agni is often boosted with hingvashtaka, trikatu or avipattikar churna. Inulin rich foods and pre-biotics are especially helpful when the intestinal flora has been disturbed by anti-biotics, NSAIDs and poor diet. As appropriate, fresh tea made with ushna quality spices, triphala and psyllium are a great help here.

Dhatus are nourished with a good diet (see above) and specific recommendations for the affected dhatu(s). I have started to recommend a food-state multi-vitamin and mineral supplement wherever dhatu depletion is apparent. I wonder whether these work like some bhasmas? Evidence showing the poor nutritive levels in commonly available foods, as well as the poor nutritional status of the population is overwhelming. I find hemp seed oil and ghee especially valuable for lubricating and building the dhatu. I frequently use aloe vera juice, ginger tea or honey as a vehicle for transporting other herbs to the dhatu.

Srotas are kept clear and regular by using a range of treatments including some of the guggul preparations which I find invaluable for channel integrity. Kanchanar guggul is especially effective for clearing growths and accumulations, triphala guggul for general clearing of the srotas, kaishore guggul wherever there is any inflammation.  Our friend triphala is also invaluable here. For some obstructions castor oil (internally and externally) is invaluable. These all help to clear any ama.

Ojas is nourished using chywanaprash and a specific formula often including such wonderful rejuvenating herbs as ashwagandha, shatavari, amalaki, gokshura, vidari kandha, kapikacchu, turmeric, ginger, cinnamon. I also use some of the medicinal mushrooms (reishi, coriolus or maitake) for certain cases of extreme deficiency.

Inflammation, so common in immune irregularities, is cooled using turmeric, sariva, manjistha, neem, andrographis, aloe vera juice, gotu kola, guduchi and bhringaraj.

Manas and hridaya are a central part of most treatments. Whenever anyone is in pain and suffering their ‘heart’ needs nourishment. I will often use variations of rose, arjuna, brahmi, gotu kola, liquorice, shankapushpi and vacha at about a 10-25% of the mixture.

Using plants as healing medicines helps people tap into the innate healing potential in Nature. I often like to give some herbal tea so that the actual colours, shapes and patterns of the plants can be seen, smelt and felt. A simple mix of liquorice, gotu kola and cinnamon can work wonders for immunity, ojas and consciousness alike.

• A healthy appetite and a balanced desire for food without cravings
• Appreciation of the flavour of food and feeling satisfied after eating
• Good digestion without any signs of discomfort, belching, flatulence or borborygmus
• Clear voice
• Relief from any pain or discomfort
• Proper functioning of the senses; hearing, feeling, seeing, tasting and smelling
• Clear complexion
• Appropriate length and quality of sleep
• Regular elimination of stool, urine and sweat
• Constant energy with good stamina & ability to exercise
• Enthusiasm for life
• Youthfulness and reduced ageing
• Balanced emotions; neither too happy with success nor too sad in times of difficulty
• Regularly compassionate, peaceful, loving, generous and calm 

“While resting in the spirit, the mind, pure and stable, shines as a lamp shines with a bright flame from within the lantern.” – Charaka Samhita 5.5.15

• Antoni et al, Stress Management and Immune System Reconstitution in Symptomatic HIV-Infected Gay Men Over Time: Effects on Transitional Naive T Cells (CD4⁺CD45RA⁺CD29⁺), Am J Psychiatry 159:143-145, January 2002.
• Albert J. Arias, Karen Steinberg, Alok Banga, Robert L. Trestman, Systematic Review of the Efficacy of Meditation Techniques as Treatments for Medical Illness, The Journal of Alternative and Complementary Medicine. 2006, 12(8): 817-832.
• Berkman L, Assessing the Physical Health Effects of Social Networks and Social Support, Annual Review of Public Health, May 1984, Vol. 5, Pages 413-432.
• Bone K, Clinical applications of Ayurvedic and Chinese herbs, Phytotherapy Press, 1996, Australia.
• Bone K, A Clinical guide to blending liquid herbs, Churchill Livingstone, 2003, UK.
• British National Formulary, British Medical Association, 2006.
• Carlson, LE, et al, Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress and levels of cortisol, dehydroepiandrosterone sulfate (DHEAS) and melatonin in breast and prostate cancer outpatients. Psychoneuroendocrinology 2004;29:448-74.
• Cerhan JR, Torer JC, Lynch CF, et al. Association of smoking, body mass, and physical activity with risk of prostate cancer in the Iowa 65+ Rural Health Study (United States). Cancer Causes and Control 1997; 8(2):229–238.
• Clayton, P, A Pharmaco-Nutritional Approach to Cancer, lecture notes, 2007.
• Clayton, P, Health defence, Accelerated learning systems, 2004.
• Cohen L, et al. Psychological adjustment and sleep quality in a randomized trial of the effects of a tibetan yoga intervention in patients with lymphoma. Cancer 2004;100(10):2253-60.
• Corbin, L, Safety and Efficacy of Massage Therapy for Patients With Cancer, Cancer control July 2005, Vol 12, No 3.
• Dash, B and Sharma, R, Charaka Samhita, Chowkhamba Press, 1996, India.
• Davidson R et al, Alterations in Brain and Immune Function Produced by Mindfulness Meditation, Psychosomatic Medicine 65:564-570 (2003).
• Dhuley JN, ‘Effects of some Indian herbs (Ashwagandha, Shatavari, Guduchi) on macrophage functions.’ Journal of Ethnopharmacology, 1997.
• Drewnowski, A. Fat and Sugar: An Economic Analysis J. Nutr. 133:838S-840S, March 2003.
• Drewnowski, A. & Popkin, B. M. (1997) Dietary fats and the nutrition transition: new trends in the global diet. Nutr. Rev. 55:31-43.
• F. I. Fawzy, M. E. Kemeny, N. W. Fawzy, R. Elashoff, D. Morton, N. Cousins and J. L. Fahey, A structured psychiatric intervention for cancer patients. II. Changes over time in immunological measures, Archives of General Psychiatry, Vol.47, No.8, August 1990.
• Ferlazzo G, Munz C. NK cell compartments and their activation by dendritic cells.
• J Immunol. 2004 Feb 1;172(3):1333-9.
• Ferlazzo G, Thomas D, Lin SL, Goodman K, Morandi B, Muller WA, Moretta A, Munz C. The abundant NK cells in human secondary lymphoid tissues require activation to express killer cell Ig-like receptors and become cytolytic. J Immunol. 2004 Feb 1;172(3):1455-62.
• Giovanucci E., et al ‘95. “Intake of carotenoids and retinal in relation to risk of prostate cancer.” Journal of National Cancer Institute; 87:1767–76. 
• Grinder-Pedersen, Salka E. Rasmussen, Susanne Bügel, Lars V. Jrgensen, Lars O. Dragsted, Vagn Gundersen, and Brittmarie Sandström, Effect of Diets Based on Foods from Conventional versus Organic Production on Intake and Excretion of Flavonoids and Markers of Antioxidative Defense in Humans, J. Agric. Food Chem., 51 (19), 5671 -5676, 2003.
• Grossmana P, Niemannb L, Schmidtc S, Walachc H, Mindfulness-based stress reduction and health benefits, A meta-analysis, Journal of Psychosomatic Research 57 (2004) 35–43.
• Hernandez-Reif M, Ironson G, Field T, Hurley J, Katz G, Diego M, Weiss S, Fletcher MA, Schanberg S, Kuhn C, Burman I, Breast cancer patients have improved immune and neuroendocrine functions following massage therapy, J Psychosom Res. 2004 Jul;57(1):45-52.
• Heaton , Organic Farming, Food Quality and Human Health: A review of the evidence, The Soil Association, United Kingdom, 2001.
• Holford P, Burne J, Food is better medicine than drugs, Piatkus publications, 2006.
• Ironson G, Field T, Scafidi F, Hashimoto M, Kumar M, Kumar A, Price A, Goncalves A, Burman I, Tetenman C, Patarca R, Fletcher MA, Massage therapy is associated with enhancement of the immune system’s cytotoxic capacity, Int J Neurosci. 1996 Feb;84(1-4):205-17.
• Irving L.M.; Telfer L.; Blake D.D, Hope, Coping, and Social Support in Combat-Related Posttraumatic Stress Disorder, Journal of Traumatic Stress, Volume 10, Number 3, July 1997 , pp. 465-479(15).
• Jayasinghe, Satyajit R., Yoga in cardiac health (A Review). European Journal of Cardiovascular Prevention & Rehabilitation. 11(5):369-375, October 2004.
• Kasamatsu, A., and T. Hirai, An EEG Study on the Zen Meditation (Zazen), Folia Psychiatrica et Neurologia Japonica 20, no. 4 (1966): 315-336.
• Kiecolt-Glaser, J., Malarkey, W., Chee, M., Newton, T., Cacioppo, J., Mao, H.-Y., & Glaser, R. (1993), Negative behavior during marital conflict is associated with immunological down-regulation. Psychosom Med. 55, 395–409.
• JK Kiecolt-Glaser, D Ricker, J George, G Messick, CE Speicher, W Garner and R Glaser, Urinary cortisol levels, cellular immunocompetency, and loneliness in psychiatric inpatients, Psychosomatic Medicine, Vol 46, Issue 1 15-23, 1984.
• JK Kiecolt-Glaser, JR Dura, CE Speicher, OJ Trask, and R Glaser, Spousal caregivers of dementia victims: longitudinal changes in immunity and health, Psychosom Med, July/August 1991; 53: 345 – 362.
• JK Kiecolt-Glaser, W Garner, C Speicher, GM Penn, J Holliday and R Glaser, Psychosocial modifiers of immunocompetence in medical students, Psychosomatic Medicine, Vol 46, Issue 1 7-14, 1984.
• JK Kiecolt-Glaser, Glaser R, Psychological influences on immunity, Psychosomatics.1986; 27: 621-624.
• JK Kiecolt-Glaser, LD Fisher, P Ogrocki, JC Stout, CE Speicher and R Glaser, Marital quality, marital disruption, and immune function, Psychosomatic Medicine, Vol 49, Issue 1 13-34, 1987.
• Janice K. Kiecolt-Glaser , Lynanne McGuire , Theodore F. Robles , Ronald Glaser, Emotions, Morbidity, and Mortality: New Perspectives from Psychoneuroimmunology, Annual Review of Psychology, 2002.
• Khansari, DN; Murgo AJ, Faith RE (1990). “Effects of stress on the immune system”. Immunology Today 11: 170–175.
• Knasko S, Ambient odor’s effect on creativity, mood, and perceived health, Chemical Senses 17: 27-35, 1992.
• Lange, T; Perras B, Fehm HL, Born J (2003). “Sleep Enhances the Human Antibody response to Hepatitis A Vaccination”. Psychosomatic Medicine 65: 831–835.
• Laura D. Kubzansky, PhD, David Sparrow, DSc, Pantel Vokonas, MD and Ichiro Kawachi, MD, Is the Glass Half Empty or Half Full? A Prospective Study of Optimism and Coronary Heart Disease in the Normative Aging Study, Psychosomatic Medicine 63:910-916 (2001).
• Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA . 1998 Apr 15;279(15):1200-5.
• Lewin MH, Bailey N, Bandaletova T, Bowman R, Cross AJ, Pollock J, Shuker DE, Bingham SA. Red meat enhances the colonic formation of the DNA adduct O6-carboxymethyl guanine: implications for colorectal cancer risk. Cancer Res. 2006 Feb 1;66(3):1859-65.
• Li, H, et al. A prospective study of plasma selenium levels and prostate cancer risk. Journal of the National Cancer Institute, Vol. 96, May 5, 2004, pp. 696-703.
• McKinney CH, Antoni MH, Kumar M, Tims FC, McCabe PM, Effects of guided imagery and music (GIM) therapy on mood and cortisol in healthy adults, Health Psychol. 1997 Jul;16(4):390-400.
• Miller, G., Dopp, J., Myers, H., Felten, S., & Fahey, J. (1999). Psychosocial predictors of natural killer cell mobilization during marital conflict. Health Psychol. 18, 262–271.
• Murthy, S, Bhavaprakasha of Bhavamisra, Krishnadas Academy, 2001, India.
• Nieman DC, Exercise immunology: practical applications, Int J Sports Med. 1997 Mar;18 Suppl 1:S91-100.
• Panossian A (2003)  Adaptogens: a historical overview and perspective.  Natural  Pharmacy 7(4), 19-20.
• Panossian A, Wikman G, Wagner H (1999) Plant adaptogens III. Earlier and  more recent aspects and concepts on their mode of action. Phytomedicine 6, 287-300. 
• Petrie KJ, Fontanilla I, Thomas M, Boot R, Pennebaker J, Effect of Written Emotional Expression on Immune Function in Patients With Human Immunodeficiency Virus Infection: A Randomized Trial, Psychosomatic Medicine 66:272–275 (2004).
• Pennebaker JW, Kiecolt-Glaser JK, Glaser R. Disclosure of traumas and immune function: health implications for psychotherapy. J Consult Clin Psychol 1988;56:239–45.
• Pennebaker JW. Writing about emotional experiences as a therapeutic process. Psychol Sci 1997;8:162–6.
• Pole, S, Ayurvedic medicine, the principles of traditional practice, Elsevier, 2006.
• Raub JA, Psychophysiologic Effects of Hatha Yoga on Musculoskeletal and Cardiopulmonary Function: A Literature Review The Journal of Alternative and Complementary Medicine. 2002, 8(6): 797-812.
• Rege NN, Thatte UM, Dahanukar SA (1999) Adaptogenic Properties of Six Rasayana Herbs Used in Ayurvedic Medicine. Phytotherapy Research13, 275-291.
• Schleifer SJ, Keller SE, Camerino M et al. (1983), Suppression of lymphocyte stimulation following bereavement. JAMA 250(3):374-377.
• Schleifer SJ, Keller SE, Bond RN et al. (1989), Major depressive disorder and immunity. Role of age, sex, severity, and hospitalization. Arch Gen Psychiatry 46(1):81-87.
• Richard Schulz and Scott R. Beach, Caregiving as a Risk Factor for Mortality: The Caregiver Health Effects Study, JAMA, Dec 1999; 282: 2215 – 2219.
• Sharma, P, Cakradatta: a treatise on the principles and practices of Ayurvedic medicine,  Chaukhamba Publishers, 1998, India.
• Sharma KA, ‘Immunopotentiating compounds: (Guduchi) Tinospora cordifolia.’ Journal of Ethnopharmacology,1997.
• Simon D, The scientific basis of mind body medicine, lecture, 2005.
• Smyth JM, Stone AA, Hurewitz A, Kaell A. Effects of writing about stressful experiences on symptom reduction in patients with asthma ornrheumatoid arthritis: a randomized trial. JAMA 1999;281:1304–9.
• Spelman K, Burns J, Nichols D, Winters N, Ottersberg S, Tenborg M, Modulation of cytokine expression by traditional medicines: a review of herbal immunomodulators, Altern Med Rev. 2006 Jun;11(2):128-50.
• Spiegel, D., Bloom, J.R., & Gottheil, E. Effects of Psychosocial Treatment on Survival of Patients with Metastatic Breast Cancer, Lancet, 2(1989): 888-891. 
• Spiegel, D. Social Support: How Friends, Family, and Groups Can Help. in Mind Body Medicine, Golrman, D. & Gurin, J. Consumer Report Books, 1993.
• Spiegel D, Classen C, Group Therapy for Cancer Patients: a Research-based Handbook of Psychosocial Care. New York: Basic Books, 1999.
• Stanton AL, Danoff-Burg S, Sworowski LA, Collins CA, Branstetter AD, Rodriguez-Hanley A, Kirk SB, Austenfeld JL. Randomized, controlled trial of written emotional expression and benefit finding in breast cancer patients. J Clin Oncol 2002;20:4160–8.
• Starfield, B, Is US Health Really the Best in the World?, JAMA, Volume 284, No. 4, July, 2000.
• Stein et al, Stress and immunomodulation: the role of depression and neuroendocrine function, J Immunol.1985; 135: 827-833.
• Taylor, PR, et al. Science peels the onion of selenium effects on prostate carcinogenesis. Journal of the National Cancer Institute, Vol. 96, May 5, 2004, pp. 645-47 (editorial).
• Tillotson, A, The one earth herbal sourcebook, Twin Streams, 2001, USA.
• Wenger, M.A.,and B.K. Bagchi, Studies of Autonomic Functions in Practitioners of Yoga in India, Behavior Science 6 (1961): 312-323.
• WHO, Cancer: diet and physical activity’s impact http://www.who.int/dietphysicalactivity/publications/facts/cancer/en/
• Worthington V, Nutritional Quality of Organic Versus Conventional Fruits, Vegetables, and Grains, The Journal of Alternative and Complementary Medicine, Vol. 7, No. 2, 2001 (pp. 161-173).
• Yance D, Herbal medicine, healing and cancer, Keats publishing, 1999.
• Zheng T, Zahm SH, Cantor KP, Weisenburger DD, Zhang Y, Blair A. (2001) Agricultural exposure to carbamate pesticides and risk of non-Hodgkin lymphoma. J Occup Environ Med. 43(7):641-9.

Our fat, or ‘lipid layer’ protects us, comforts us as well as helps to carry fat-soluble nutrition into our body and brain. According to Ayurveda our fat tissue is made from a combination of the Water and Earth elements that bring protection to our organs, bones and tissues.

However, if we have too much or too little or poor quality fat tissue then health can become imbalanced. Too little fat tissue then we can be too thin with cracking joints, joint weakness, tired and brittle hair, bones, nails and teeth.

Too much and there can be obesity, excess fat tissue around the breasts, abdomen and buttocks, sexual debility, asthma, poor mobility, fear, hypertension and diabetes. If the fat is of poor quality and the doshas (Ayurvedic constitutions) invade it then there can be multiple symptoms from hard and small lumps, excessive sweating, kidney infections, diabetes, fibroids and other growths dependant on the causative factors.

Ayurveda can help people to balance their fat tissue and regulate the lipid layer. If the digestive fire (metabolism) in the lipid tissue (medas-dhatu-agni) is low then fatty tissue accumulates in the body, especially around the abdomen. This is often due to excessive intake of sweet, poorly digested, low quality fatty foods that block the vata dosha (the bodily humour responsible for all movement in the body). This causes vata to accumulate in the stomach which – because vata’s predominant element is air – fans the digestive fire leading to a hyperactive digestive system. 

Any food ingested thereafter “cooks” too quickly causing excessive hunger and the patient to continually over-eat.  This causes a vicious circle of increased hunger but reduced metabolism. Eventually all three doshas become imbalanced and improper nourishment of the tissues leads to a chronic depletion of the body’s natural immunity and an increase in weight. It is worth noting that obesity is described in the Charaka Samhita as one of the “eight despicable diseases” as it is so hard to treat because the enduring willpower of the client is essential for any management plan to be effective.

Modern science has determined that one of the main causes of weight imbalance and hence imbalanced medodhatu, is insulin resistance. The term “insulin resistance” means that your body is more resistant to the action of insulin than normal. Insulin is the hormone that keeps your blood sugar within “normal” limits.

It helps to open the keyhole for the glucose to lock onto so that it can be metabolised in the liver and muscle ready to be used as energy. ‘Insulin resistance’ makes you less sensitive to insulin and less able to absorb glucose and this results in higher blood sugar levels.  It is a complex process involving, amongst other things, thyroid function, oestrogen levels, leptin resistance and glycosylation.

When there is excess sugar in the blood stream it gets deposited as stored energy, otherwise known as fat. The body’s genetic wisdom is ‘to make hay whilst the sun shines’ and it stores that potential energy for a time when it really needs it. If this cycle of high blood sugar being converted to fat stores continues, it leads to weight increase, obesity and the associated health implications of high blood sugar levels including weakened immunity, repetitive infections, inflammation and blood clots.

The high blood glucose levels cause the red blood cells to become coated in excess sugar that damages the protein leading to something known as ‘glycosylated heamoglobin’. This causes the formation of Advanced Glycation End products- known as AGE- damaged molecules that literally cause ageing.

Glycosylation is a natural process where sugar molecules bind with another molecule through a process known as cross-linking, and impair its function. It’s more common in diabetics and people with insulin resistance but happens to us all as we age.

When crystalline proteins in the eye are ‘glycosylated’ it leads to cataracts; when collagen and elastin are ‘glycosylated’, and sugar molecules attach to these extra cellular matrix proteins, it can disrupt the integrity of the connective tissue which can harden and become less flexible; in the arteries this causes arteriosclerosis, or hardening of the arteries and in the skin it causes wrinkles. Even insulin can become glycosylated, leading to more deep-set insulin resistance. 

Looking at treatments from a purely plant chemistry perspective, flavonoids are the remedy par excellence for addressing glycosylation. It is why foods, such as colourful berries (think blueberries, amla and acerola), with the highest levels of sweetness in foods, often have high levels of protective flavonoids, as nature has an in-built protective mechanism to help offset any of the potential damage of exposure to excess natural sugars. Other vibrant and colourful spices, such as Turmeric, are also excellent and reducing glycosylated cross-linking and just half a teaspoon a day (1-2g) is protective.

When continually exposed to sugars, the high insulin levels trying to manage the high blood sugar levels also leads to excessive tissue growth, particularly due to something called Insulin-like Growth Factor-1 (IGF-1), which is implicated in some forms of cancer. IGF-1 also leads to a high release of free radicals that cause more tissue oxidation, which disrupts the integrity of the dhatus. In fact, it is this high insulin level causing oxidation of LDL cholesterol that is now associated as one of the causes of the high levels of heart disease that we have in many industrialised countries.

Conversely, high levels of free radicals have also been implicated in causing insulin resistance. This eventually leads to pancreatic burn-out. After years of over-activity, the insulin producing pancreas eventually tires of all the extra insulin it has had to produce to ‘force’ the glucose into the cells and it ‘packs up’ and diabetes develops. Insulin resistance is also associated with depression, cognitive decline and some forms of cancer (notably, breast and colon).

It is thought that 35% of the population have some form of insulin resistance, otherwise known as dysglycaemia. More than 50% of women with Poly Cystic Ovarian Syndrome (PCOS) have insulin resistance. Evidence points to an inherited abnormal form of insulin that is inefficient at regulating blood sugar levels. There also appears to be a problem with the insulin receptor not allowing insulin to facilitate the entrance of glucose into the cell. Mixed with poor eating habits, low exercise and plenty of stress you have a dangerous cocktail.

Fortunately nature and Ayurveda have an answer. Mixed with a kapha-reducing diet, high quality Omega-3 oils and sensible amounts of short and medium-chain-fatty-acid-easy-to-digest oils (such as flax, hemp, coconut oil and ghee), regular exercise, reduced stress and a by using certain plants that have been shown to assist with glucose and lipid metabolism, you can help to regulate your body to find your perfect balance of medodhatu.

Cinnamon (Cinnamonum verum var zeylanicum)

Cinnamon regulates blood sugar, increases digestion, reduces weight and helps normalise intestinal flora by reducing pathogenic Candida. A study in 2003, gave three groups of diabetics 1, 3 or 6 grams of cinnamon per day. All responded to the cinnamon within weeks, with blood sugar levels 20 per cent lower on average than those of a control group.

Some of the volunteers taking cinnamon even achieved normal blood sugar levels. Reports suggest that improvements can be seen after just 20 days. Cinnamon on its own will not remove insulin resistance but as part of a healthy diet and exercise programme it can be of great benefit due to its ability to strengthen agni (digestive fire) and regulate kapha with its warming, light and astringent qualities.

Fenugreek seed (Trigonella foenum-graecum)

The pungent, bitter and astringent seed of fenugreek has been used in Ayurveda to improve digestion and help reduce weight for centuries. Its spicy and bitter flavour have been shown to increase digestion, reduce lipid levels and removes fats. It has a positive effect on the digestive fire in medas-dhatu helping the agni to metabolise food into useful nutrition. It also increases the efficiency of the water circulating channel (ambuvahasrotas) and the urinary channel (mutravahasrotas) helping to regulate fluid retention and proper moisture levels in the tissues.

Ginger (Zingiber officinale)

Considered to be the universal healer in Ayurveda, and known as vishvabheshaja, ginger has been used in food and medicine for thousands of years. It is a wonderful warming spice that is superior at assisting digestion and circulation. It specifically helps with the assimilation of nutrients, quickens circulation and warms the body. By increasing the digestive agni in all the tissues it helps to assimilate the other herbs in any formula whilst also strengthening digestion and thermogenically increasing metabolism.

Green tea (Camellia sinensis)

Though not a traditional Ayurvedic plant the Camellia plant is indigenous to India. As India is now a large producer of green tea it would also be a great addition to the Indian diet as a replacement for all that deliciously sweet masala-chai.Green tea is a potent antioxidant whose slightly stimulating nature brings a lift to your energy.

Green tea is made by lightly steaming the fresh leaves to inhibit enzymes that breakdown the important polyphenol compounds, known collectively as catechins. The water soluble properties of green tea have been shown to help reduce cholesterol, regulate weight, increase metabolism, correct gene function, reduce bacterial and viral overload as well as help absorb oxidative molecules that damage cells and encourage aging. It helps to regulate the body’s detoxification mechanisms in the liver. It is slightly bitter and astringent helping to remove lipid accumulations and stimulate the agni in medas-dhatu.

Guggul (Commiphora mukul)

Guggul is a pungent and acrid oleo-gum-resin that has a very special property appropriate for regulating medas-dhatu, and more specifically as a medhogna, a herb that reduces fatty accumulations. It increases the digestive fire in the lipid tissue and through its ‘scraping’ (lekhaniya) properties clears toxic ama that coats cells, tissues and organs to reduce insulin resistance, imbalanced cholesterol levels and weight accumulation.

Its effect on metabolism has been verified by its ability to help with the conversion of T4 to the more active T3 and increasing iodine uptake in the thyroid, enhancing its homeostatic regulatory function. It is usually used after being ‘purified’ in a decoction of triphala (amla, bibhitaki, haritaki) and then used as a powder at doses from 50-500mg 2-3x/day. It is combined with other remarkable regulating plants such as kanchanara (Bauhinia variagata) that has potent effects on lymphatic congestion, glandular swellings and growths and with trikatu and triphala.

These combinations incorporating guggul are so important to treatments that a large range of ‘guggul’ containing products have been developed in the Ayurvedic pharmacy including kancanara guggil, kaishore guggul, punarnava guggul, triphala guggul, yogaraj guggul and gokshuradi guggul, to name just a few.

Bitter melon (Momordica chiranta)

A common food in Asia, this member of the cucumber family helps to regulate blood sugar, reduce insulin resistance and reduce fats. It is extremely bitter but has a pungent effect after digestion (and therefore a metabolic enhancing action that does not aggravate vata) and is very useful for helping to regulate weight. Bitter melon has a specific action, known as bhedaniya, which means to remove accumulations, and in Karavella’s case, specifically from the digestive, fat and water systems.

Seaweed (Ascophyllum nodosum)

Also known as Arctic wrack and Ascophyllum nodosum, this sea vegetable is renowned for its diverse range of essential macro and micro-nutrients that provide the nutritional foundation to health. Not a traditional plant used in Ayurveda, but a crucial part of every island-faring nation’s diet, seaweeds are in fact the most nutritious form of vegetation on the entire planet.

They are full of nutrients that help facilitate the absorption of vital proteins and other nutrients. This includes 14 times more calcium, 200 times more iron, 8 times more magnesium and 100 times more iodine than any land vegetable. They are also filled with detoxifying polysaccharides that can help to bind with toxic heavy metals. There is a substantial body of research showing how seaweeds can improve the thyroid function, heart health, cancer and high blood pressure.

The improved thyroid function can benefit metabolism and help reduce excess weight, fat and blood sugar control. Use at least 1g per day with food, and it makes an excellent salt replacement.

In Ayurveda, understanding your own personal health concerns is centred around recognising your ‘dosha’, or constitution. In some ways, your ‘dosha’ is a little like your ‘health star sign’. Understanding your dosha will help you to understand how your body works and, therefore, how you can help it. There are three core Ayurvedic ‘dosha’, Vata, Pitta and Kapha.

Put simply, everyone will have a little bit of all three, but there is often one that is more dominant than the other. Vata types are highly creative and a little like a whirlwind of ideas, Kapha types are your steady, strong grounded individuals’ that often hold everything together. Your Pitta types are fiery, passionate, competitive and determined. Already you can probably recognise which one you might be.

But, how does this relate back to the menstrual cycle? Interestingly, in Ayurveda, the menstrual cycle has its very own Vata, Kapha and Pitta stage. How can this help? If you can recognise which phase affects you most, there are differing strategies in terms of how you can support yourself.

Here is how the Ayurvedic menstrual cycle works:

• The Vata phase lasts from approximately day 1-5 (from the first day of bleeding)
• The Kapha phase lasts From the end of bleeding until ovulation (approx. days 4-14)
• The Pitta phase lasts from ovulation until your period starts (days 14-18)

And, here is how each phase is characterised with tips on what you can do to help:

Vata types

Vata is the force that regulates all downward movements in the body, pushing the menstruum down and out of the body. Vata, therefore predominates during the period itself. If your Vata is out of balance, it will manifest as digestive upset, constipation, pain on intercourse, fatigue, anxiety and/or insomnia indicating the need for some Vata balancing practices.

How do we balance Vata? This is a time to keep warm, rested and safe. Manage your diary so that you have some calm space during this time to recharge and keep life on your terms. This is an opportunity for an extended me-time. Calming, nourishing herbs that will strengthen and support your adrenal glands are key here. For example, liquorice and ashwagandha. Steer clear of anxiety inducing stimulants and create space for mindfulness and meditation.

Kapha types

Kapha types naturally nourish and strengthen others. They are your mother-earth. So, the Kapha stage of the cycle is all about building the endometrium (the mucous membrane that lines the inside of the uterus). Oestrogen is the hormone that builds and increases at this time. It is the phase of restoring strength to the body and preparing for conception.

If your Kapha is out of balance it will manifest as imbalances such as fluid retention, breast distension, weight gain, discharge, fatigue, back ache and general ‘heaviness’ may appear at this time. Kapha types also store not just energy, but memory and emotion. If you notice you feel teary and a little low, it could be an indicator of imbalanced Kapha.

How do we balance Kapha? This is a time so often filled with energy and vitality when you can rebuild your nutritive strength, take tonifying herbs and spread your wings. Building herbs that support oestrogen balance are key here. Oestrogen dominant conditions are characteristic of a Kapha imbalance. Shatavari is your primary herbal remedy alongside cleansing, decongesting herbs such as aloe vera.

Pitta types

Pitta types are naturally hot and fiery. Fire is transformative and this is stage where the body prepares itself for new life; the endometrium for implantation of the fertilized egg and the breasts for milk production. Essentially, Pitta fires our body in readiness for conception. It is the hormone progesterone that peaks during this phase.

Severe PMS is a classic sign of imbalanced pitta, due to hot pitta accumulating in the blood and liver. As the blood channels and menstruation are connected, there can be extra heat in the system, leading to skin irritations, headaches, diarrhoea, feelings of irritation and emotional overload. This is when Pitta types can really manifest as fire!

How do we balance Pitta? This is an important time to help the liver metabolise the high hormone levels; increase the amount of colourful vegetables, do your exercise and let your spirit soar. Use heat-clearing and liver-regulating solutions such as turmeric and classic greens like spirulina.

The Ayurvedic cannon details very specific treatments for bone and joint diseases. The earliest texts of Charaka Samhita (150BCE-100CE) and Sushruta Samhita (50-500CE) detail various symptoms associated with joint pain as part of other diseases involving fever (jwara) and neurological vata disorders (vatavyadhi).

Vaghabata in his Ashtanga Hridaya Samhita (600CE) mentions a disease named vatashonita meaning ‘vata in the blood’ which is associated with intense joint pain and has symptoms similar to gout. Madhava Nidana (c650-950) in his classic on pathology is the first to mention amavata as a disease in its own right. Amavata literally means ‘toxic vata’ and is commonly associated with Rheumatoid Arthritis.

Ama is a term used to describe all unmetabolised wastes that have cold, heavy, wet and sticky qualities infamous for obstructing the channels and causing degeneration of health. Vata relates to the functional principle in the body associated with all movement and is associated with the qualities of cold, dry, lightness and irregularity. Vata is also associated with the experience of pain so commonly felt in bone and joint diseases.

• Low digestive fire leading to creating of toxins (mandagni, ama)
• Vata aggravating diet and lifestyle (vatakara ahara vihara)
• Malnutrition including nutrient deficiency and wasting of the tissues (dhatu kshaya)
• Incompatible foods; milk and fruit, milk and fish, meat and dairy
• Inappropriate diet: stale foods, cold foods, constitutionally inappropriate foods, processed foods, fermented foods.
• Excessive exercise (Ati vyayama)
• Deficient exercise (Kashaya vyayama)
• Injury
• Hormonal disorders
• Hereditary causes (sahaja vikritis)

The basic pathogenesis of bone related diseases is due to the intimate connection between vata and the bones. There is an inherent link between the main site of vata in the colon and the bones. The colon is responsible for the uptake of many types of minerals that nourish the bones. This is the link to their natural qualitative relationship as both vata dosha and the bones are high in the air element.

This means that a healthy vata directly nourishes the bones. The other association is that from the colon excess ‘wind’ and ‘toxic gases’ can be expelled, whilst important minerals are absorbed, ensuring that an excessive accumulation of vata does not occur.

If the digestive fire is low then vata will be aggravated in the colon. This will lead to a dual problem. Firstly, there will be reduced assimilation of these precious mineral nutrients intended to nourish the bones, hence leading to a deficiency. Secondly there will be an increased accumulation of toxic wastes (ama) leading to an excess. These toxins will be carried by vata to the connective tissue, joints and bones where the ensuing congestion will lead to the multiferous forms of ‘arthritic’ diseases.

These ama toxins have a watery, sticky and mucoid like nature and hence have an affinity for similar kapha-like tissues in the body; hence the attraction to the protective linings of the connective tissue and synovial fluid covering the joints. Vata is the mover and ama is the obscurer. The joints then become involved which can result in pain and deformity.

Whilst the main dosha involved with bone and joint disorders is usually vata the other doshas may also be involved. Some general signs and symptoms of bone and joint diseases are:

• Vata: Thin body and bones, fragile, bones breaking easily, rough and dry skin, cavities, rough, severe pain, migrating pain, loose joints
• Pitta: Inflammation, red hot joints, sharp pain, fever, infective disorders
• Kapha: Excess and large bones/teeth/hair, stiffness, itching, pitting oedema over joint, less pain, thickening skin, osteo-tumours, heaviness, hirsutism

It is said that when one dosha is involved the disease is curable, if two dosha are involved the disease can be managed and if all three dosha are involved then it is incurable.

Ayurveda has a time tested ability to differentiate the causative factors, the pathogenesis and the diversification of the different forms of every disease. This allows for remarkably precise and accurate treatments that are individualised to suit every patient, which is why we recommend seeing a herbalist rather than simply buying an over-the-counter product.

Rheumatoid arthritis is a chronic condition involving loss of mobility and enduring pain of the joints with some swelling of the synovial joints. It has similarities to many arthritic diseases with specific clinical features associated with Rheumatoid Arthritis (RA).

Arthritis is the generic name for a number of diseases involving inflammation of the tissue surrounding one or any number of joints with pain, redness, warmth, pain and restricted motion. Such conditions may include rheumatoid, osteo, psoriatic, gout, ankylosing spondylitis and tuberculosis.

RA is a chronic inflammatory disease which typically affects the synovial membrane involving the peripheral joints of the joints of the fingers, wrists, feet and ankles and later the hips, knees and shoulders. The symptoms manifest between exacerbation and remission and are three times more likely to occur in women than in men. RA is diagnosed by a blood test indicating the presence of rheumatoid factor. It is also diagnosed by X-rays revealing rheumatoid erosions around the joints. The exact causative factors of RA are not known by are thought to involve some form of autoimmune condition or some infective pathogen. It affects 1-3% of the population and peaks between 30-50 years of age.

Arthritic diseases are usually treated with pharmaceutical medication that may have associated side-effects; Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), steroidal anti-inflammatories (corticosteroids), immunosuppressive drugs (methotrexate, cyclosporine) and remittive drugs (penacillamine). Whilst these drugs may offer symptomatic relief they have been associated with hepatotoxicity, kidney damage and immunodeficiency.

Whilst there are obvious similarities, amavata cannot be directly linked with arthritis as it has a distinct pathology and treatment strategy with different objectives to those sought by allopathic mediciation. It involves the diagnosis of the three dosha and the treatment of them along with the tissues, channels and digestive fire. The objective is to treat the root causative factor as well as the symptoms.

Weak digestive fire, sedentary lifestyle, heavy oily food, no exercise or exercising directly after eating heavy food can all make people more susceptible to the onset of arthritis.

People of a vata/kapha constitution become susceptible to this condition due to the extreme opposites of qualities. This constitutional combination can be like two people living in one body, always contradicting oneself…I should, shouldn’t etc.

The seasonal change that takes place moving from the heat of summer to the coolness of Autumn can aggravate chronic conditions that may have remained dormant during the summer months where heat and dryness kept them under control.

Arthritis is a condition that often manifests in the autumn season as it is aggravated primarily by an excess of vata that builds up in this season.

Toxins are produced from the causative activities associated with vata and are carried quickly to seats of kapha (joints) and fill the channels with a waxy toxic material (ama) which has similar qualities to kapha. Joints are a primary site of kapha. This produces weakness of body, heaviness of heart, affects the joints (comprising of synovial fluid) of waist, neck and shoulder, stiffness and is itself a cause of many diseases.

Low grade fever, reduced appetite, increased thirst, lethargy, alternate feelings of heaviness and hollowness (kapha/vata). Symptoms can be reversed at this early stage by correcting digestion and with simple Ayurvedic treatments such as steaming and oil massage.

• Stiffness
• Pain
• Inflammation
• Excess saliva
• Coated tongue
• Lack of enthusiasm
• Thirst
• Bloating
• Insomnia
• Fainting and constipation. At this stage stronger treatment such as cleansing the system and herbs are required.

Ayurvedic treatment methods for arthritis:

• Support digestion
• Remove toxic ama
• Rejuvenate the whole system and repar damage

The first line of treatment should be ‘lightening’ therapy involving strengthening the digestion whilst initiating cleansing treatments. Enkindle digestion with spices such as ginger, asafoetida and trikatu. Once digestion is working well and toxins (ama) have been removed through appropriate diet and herbs you move to a rejuvenation treatment to restore vitality (ojas).

Diet should be light and warming with lots of digestive spices. Including some high quality essential fatty acids and oils is important. It is worth avoiding foods with the same sticky-clogging-inflammatory nature of amavata; dairy, gluten, flour, sugar, greasy foods and rich meats such as pork.

Some people benefit from avoid members of the Solanaceae family (potatoes, aubergines, peppers) as well as other potential irritants such as peanuts, soya and corn.

Recommended herbs are guggul, ginger, celery seed, castor oil, haritaki, boswellia, gotu kola, turmeric, ashwagandha and sariva. Triphala powder at night to clear ama from the colon is also beneficial. Warming and invigorating oils, such as mahanaryan oil and castor oil packs, help to remove congestion and gentle exercise and yoga are recommended but avoid strenuous exercise such as jogging or weights.

According to Ayurveda, skin has seven layers, corresponding to the seven dhatus. Similarly, in modern physiology, skin has been found to have seven layers, stratum corneum, on the surface, stratum lucidum, stratum granulosum, stratum spinosum, stratum basale, the basement membrane and the dermis.

At the same time, the epidermis of the skin, as whole, is seen as an secondary (upadhatu) of plasma tissue (rasa dhatu), and the dermis as part of muscle tissue (mamsa dhatu). Skin belongs to bahya marga, the external pathway of disease, and as such is very vulnerable to toxins carried by plasma rasa) and blood (rakta dhatus) during the spreading (prasara) stage of disease, accounting for the relatively common nature of skin inflammations. 

Let us turn our attention first to atopic dermatitis (AD). Also called eczema, this condition is due to a hypersensitivity reaction in bahya marga, leading to long-term skin inflammation which creates itchy and scaly skin. Long-term irritation and scratching may cause the skin to thicken and develop a leathery texture. If the ear canal is affected there may be discharge from the ears (for pictures of atopic dermatitis, for atopic dermatitis on ankles, for atopic dermatitis on arms, for atopic dermatitis in infancy).

Atopic dermatitis is most common in infants, often clearing by the age of three, while in adults it becomes a yapya condition that persists or recurs throughout the lifetime. In infants, lesions of AD begin on the cheeks, elbows and knees, while in adults the lesions are more commonly found on the knees and elbows alone.

Typically, AD occurs on the flexor surfaces (the parts of the skin that touch when a joint bends). It arises most often where there is a family history of atopic conditions such as hay fever, asthma and eczema. Because skin belongs to bahya marga, AD is typically the first condition in the atopic picture, later followed by asthma or allergic rhinitis as the atopic process moves from the prasara stage to localize in prana vaha srotas (1).

A combination of genetic factors (adi bala pravrutta), doshic skin type (dosha bala pravrutta), exposure to environmental allergens (parya varana) and immunological reactivity (pittaja), come together to create the tendency to AD. (1) Vata skin is more prone to AD because of dryness and pitta skin because of its greater irritant response. Manasaja or psychogenic causes also play a part, as stress can trigger an outbreak of AD in both children and adults. Annaja or dietary causes are extremely important in AD, and so are agantu causes or infective agents.

In one study, 56% of children with AD were found to have food allergies that could trigger the condition. (3) Major food allergens associated with AD are eggs, cow’s milk, wheat, soy and peanuts (1, 3). Most patients with AD are colonized with Staphylococcusaureus instead of healthy, normal skin flora (1). Hence secondary (anubandha) Staphylococcus aureus overgrowths or infections are typical and can create AD relapses (1, 4).  Although AD is not in itself infectious, lesions infected with Staph. aureus can be passed on to others.

Dermatitis treatment

Because AD is a multi-factorial condition, it can only be addressed effectively in a holistic manner, taking into account emollients for doshic skin type, removal of environmental toxins, pacification of pitta and cleansing of pitta ama with a herbal blends such as guduchi and neem or Neem and Sarsaparilla, dietary modifications to address annaja causes and ointments to address infective agents. Neem or coconut oil will act as excellent pitta emollients and can be mixed with neem powder as an anti-infective agent. For psychogenic causes, counselling, stress management, yoga and meditation will be beneficial.

Case studies: Patient A

A thirteen year old pitta prakruti girl presented in great distress with AD that affected her arms and face. As a teenager, she found an assault on her appearance to be unbearable. Fortunately for the practitioner, her exasperation rendered her a highly compliant patient. She agreed to use Neem and Sesame oil and to take triphala and an herbal formula containing guduchi, turmeric, neem and manjista with aloe vera as an carrier (anupan). She was even willing, in her desperation, to follow a one month exclusion diet, eliminating eggs, cow dairy products, wheat, soy and peanuts from her diet completely.

We explained to her that exclusion diets are only effective if followed meticulously. “This is an experiment. You don’t have to eat this way for the rest of your life.” Within two weeks of the exclusion diet, her skin had cleared completely. She then began challenging the allergens, one allergen per week. The challenge process used was to eat a significant amount of the suspected item, wait two days and then eat it again.

During this process, she learnt that dairy products were the trigger food for her unwanted symptoms. She thus became a staunch devotee of the casein-free diet.  She continued her herbal regimen for three more months to ensure that pitta was pacified and pitta toxins removed, after which she remained symptom free by following her prescribed diet.

Case studies: Patient B

A forty two year old pitta woman presented with eczema localized to the fourth finger of her left hand. The symbolism of this location was not lost on us and we explored emotional causes in detail. She had a history of relationships with unavailable men and had remained unmarried as result. Currently, she was in her first promising relationship, with a man who wished to marry her and adopt a family. It is worth noting that her AD remained intractable when treated with a similar herbal regimen to the one which proved highly effective for patient A. 

In her case, emotional toxins were of more significance than physical ones. Accordingly, we started her on brahmi tea to help move the emotional toxins.  On her third follow up she had an epiphany, realizing that she feared intimacy and had created the eczema, “To make sure I can’t wear a wedding ring.”  Following this realization, her eczema rapidly cleared. I last met her in the grocery store. She was proudly wearing a wedding ring and carrying her adopted son in her arms.

Turning now to psoriasis; this is a condition opposite in many ways to AD. Psoriasis is a non-contagious, genetically based condition that typically appears as inflamed, oedematous skin lesions. The lesions are red and are covered with distinctive silvery white scales.

It is a lifelong illness for which there is no known cure, although it can be quite effectively managed Ayurvedically. Severe cases often move into asthi dhatu, presenting with pitted nails and painful joints. Unlike AD, psoriasis typically manifests on extensor surfaces, is not associated with atopy and does not result in frequent staphylococcal skin infections. 

It also begins in an older age group, with typical onset between the ages of ten and forty rather than in infancy. Although psoriasis is one of the most common skin conditions, affecting over 7 million Americans, its aetiology has long been poorly understood. It is now widely accepted as an auto-immune disorder sharing the same disease pathways as rheumatoid arthritis and inflammatory bowel disease (6, 7, 8).

In psoriasis, the journey of the keratinocytes from stratum basale to stratum corneum is shortened from 311 to 36 hours (5). The epidermal layer of the skin becomes thicker and cells are distributed abnormally (5).

Psoriasis treatment

As an auto-immune condition, psoriasis requires a rather different treatment protocol than AD. It is not sufficient to clear pitta toxins and return pitta to its seat. In addition, anti-inflammatory herbs are needed, while pancha karma is necessary to reverse the disease pathways involved in auto-immunity.

Case studies: Patient C

A forty five year old pitta woman presented with psoriasis on her scalp and extensor surfaces.  She was vata provoked and under great stress as she was conflicted in her marriage and currently involved in an extra-marital affair. She was given a medicated ghee containing ashwagandha, neem and manjista to apply topically, and an herbal formula which also included ashwagandha and manjista, but not neem, on account of her vata provocation.  It is important to note the value of ashwagandha in dry, scaly skin conditions such as psoriasis, and also the role vata provocation may play in flaring up the condition. She took Brahmi tea to help her depression and stress and a formulation of guduchi and guggulu as an anti-inflammatory helpful in many auto-immune conditions. With this herbal regimen and a pitta-soothing diet, her psoriasis began to improve gradually. 

She then did seven days of pancha karma treatments using Refresh Pitta Massage Oil with a few drops of added cold pressed neem oil for therapeutic massage (abhyanga), amalaki for its mild laxative effect (virechan) and decoctions of Dashamoola and Guduchi for basti. After this process, the psoriasis went into complete remission for the first time since its onset at the age of fifteen. She continued to maintain this level of improvement except for a small patch on her scalp, which would flare up whenever she stepped out of integrity with herself in terms of relationships. It was as if this remaining patch on her head acted as a kind of visible moral compass, calling her back to the journey of truth and compassion for self and others. 

Both AD and psoriasis are quite prevalent inflammatory skin conditions which are very responsive to the holistic approach of Ayurveda. By combining topical and systemic herbs, appropriate diet and lifestyle, pancha karma therapies and emotional awareness, these conditions can be effectively cured or brought into remission.

1. Donald Y.M. Leung, Mark Boguniewicz, et al, New insights into atopic dermatitis J. Clin. Invest. 113(5): 651-657 (2004).
2. Gupta, Gupta (1998) Depression and suicidal ideation in dermatology patients with acne, alopecia areata, atopic dermatitis and psoriasis. British Journal of Dermatology 139 (5).
3. Sampson HA, McCaskill CC. Food hypersensitivity and atopic dermatitis: evaluation of 113 patients J Pediatr. 1985 Nov;107(5):669-75.
4. James J. Leyden¹¹Department of Dermatology, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, U.S.A., Richard R. Marples¹¹Department of Dermatology, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, U.S.A. and Albert M. KligmanStaphylococcus aureus in the lesions of atopic dermatitisBritish Journal of Dermatology Volume 90 Issue 5 Page 525-525, May 1974.
5. Gerald D Weinstein, Jerry L McCullough and Priscilla A Ross Cell Kinetic Basis for Pathophysiology of Psoriasis Journal of Investigative Dermatology (1985) 85, 579–583; doi:10.1111/1523-1747.ep12283594.
6. Davidson, A, Diamond, B: Autoimmune diseases. N Engl J Med 2001 345: 340–350.
7. Frank O Nestle and Michel Gilliet, Defining Upstream Elements of Psoriasis Pathogenesis: An Emerging Role For Interferon Journal of Investigative Dermatology (2005) 125, xiv–xv; doi:10.1111/j.0022-202X.2005.23923.x.
8. Joshi R. Immunopathogenesis of psoriasis. Indian J Dermatol Venereol Leprol [serial online] 2004 [cited 2008 Jun 15];70:10-2.

Symptoms of pravahika include frequent elimination, often of small quantities of faeces, mucus in stools and tenesmus. The small quantity is accounted for by the fact that mucus is extremely irritating and can trigger an urgent call to stool simply to pass some mucus or a small amount of mucus-filled stool.

As described in the classical texts, pravahika is characterized by bahusam (frequency), alpalapam (small quantity), sashulam (with pain), sapravahikam (straining i.e. a very intense urge again caused by the irritant effect of mucus), saraktam (blood in stool), sapicham (jelly-like mucus), upveshayte (urgency of defaecation) (2).

Vataj pravahika is characterized by frequent defaecation accompanied by pain, a typical symptom of Crohn Disease. Pittaja pravahika is accompanied by burning sensation, kaphaj pravahika by mucus in stools, common in amoebic dysentery and raktaj pravahika with blood in the stools, as in the case of ulcerative colitis (2).

Crohn disease is a typical form of vataj pravahika, since its main symptoms are dysentery and pain. In addition, the course of the illness is unpredictable (3), a typical vata quality.

The disease affects the small intestine, particularly the terminal ileum, as well as the ascending colon (3). Thus as it progresses it can lead to malabsorption as well as to small bowel obstruction and abscess formation. Secondary conditions resulting from fat malabsorption include steatorrhoea (fatty diarrhoea), fat-soluble vitamin deficiency, gallstones, kidney stones, clotting disorders and osteoporosis (4).

The causes include a genetic khavaigunya in the digestive tract along with dietary and lifestyle factors, notably a high fat diet and smoking. In our clinical experience, a combination of a high-fat junk-food diet of pizza, burgers and fries, accompanied by smoking, is often a prelude to Crohn Disease in susceptible subjects (5). Crohn Disease typically begins in young people between the ages of fifteen and thirty. (4) It occurs with increased frequency in Ashkenazi Jews (6).

Ulcerative colitis (UC) is a type of raktaj pravahika, characterized by rectal bleeding, mucus discharge from the rectum and frequent stools. Tenesmus may also occur. Unlike Crohn disease, it is confined to the large intestine, beginning in the rectum and spreading into the rest of the colon. UC is three times more common than Crohn disease (7).

It frequently begins in young people aged 15-25 although onset can occur at any age (8). Like Crohn disease, it is more common in Ashkenazi Jews. An autoimmune condition, UC may be associated with autoimmune disorders outside the digestive tract. Up to 6.2% of patients with UC have such manifestations, which include autoimmune eye disease (uveitis), ankylosing spondylitis, inflammatory back pain and sclerosing cholangitis (9).

Primary sclerosing cholangitis is a severe autoimmune liver disease leading to jaundice and liver failure and is found mainly in patients with IBD (10). Genetics (11), diet and stress (12) play a role in the development of UC. A pittagenic diet high in sulphur, as found in heavy consumption of red meat and alcohol, is associated with increased likelihood of relapse (13).

Micropscopic colitis includes both collagenous colitis and lymphocytic colitis (14). This milder form of colitis presents as atisar or diarrhoea and lacks the typical features of pravahika. Indeed, microscopic colitis is often misdiagnosed as diarrhoea dominant irritable bowel syndrome, although it is actually a mild form of IBD. The colloidal colitis form of microscopic colitis is twenty times more common in women than in men (15).

Microscopic colitis occurs more commonly over 40, peaking in the sixth and seventh decades of life, and should be considered in the differential diagnosis of atisar (diarrhoeal disease) in older women (16). Most if not all patients with microscopic colitis have lived for decades with undiagnosed coeliac disease (17). These patients respond extremely well to a gluten free diet, usually getting complete remission of symptoms when this diet is used in tandem with Ayurvedic herbs.

Treatment of pravahika is carefully described in both Sushrut and Vagbhat. Diet is of course of great importance since the condition arises due to use of unsuitable diet. During an acute episode, diet begins with rice gruel seasoned with cumin (18).

Ghee

When solid food can be taken, the first food is rice with curds or yoghurt (19). After this, soups, kitcheri and boiled rice with rock salt and ghee can be given. Once the condition is in remission, patients with Crohn disease (vataj pravahika) can take a vata soothing diet while carefully avoiding trans fats and deep-fried foods.

They should also be counseled to quit smoking. Patients with UC should adopt a vegetarian or semi-vegetarian pitta-soothing diet, avoiding alcoholic beverages. They should be instructed in relaxation and meditation techniques to manage their stress. Patients with microscopic colitis should adopt a gluten free diet regimen tailored to their constitution.

Herbs to improve pravahika

Herbs can be used both rectally and orally. Sushrut mentions the use of picchila vasti with liquorice powder, unpastueurized boiled milk, Salmali stems (silk cotton tree), kusha grass and ghee (20). Today, licorice ghee vasti can be used as a simplified version and in our clinical experience has proved highly effective in ulcerative proctitis and UC, due to the ropan or wound-healing properties of licorice (21). Vasti with a decoction of dashamoola will relieve pain in the case of painful tenesmus (20).

Takram or buttermilk is the ideal vehicle for oral herbs during episodes of pravahika (22). When rectal bleeding is present, arjun, both haemostatic and ropan (wound healing) can be used in takram (23). Other astringents herbs favoured for dysentery include bilva ( 24) and kutaja (25).

Ajwain, black pepper and ginger are used to stimulate normal agni (25). Triphala in small amounts (pinch size) is also effective in dysentery because of its astringency (22). As well as these herbs and remedies for use during the acute phase, guggulu is extremely valuable for maintenance and relapse prevention. Guggulu blocks pro-inflammatory gene expression, thus addressing IBD at the profound level of epigenetics (26).

Because Guduchi (Kaishore) is anti-inflammatory and anti-spasmodic (27), the best guggulu formulation for IBD is kaishore guggulu. Therefore, in the absence of contra-indications, Kaishore guggulu should be continued long term in patients with IBD. Due to the autoimmune aetiology of IBD, shodhan therapies such as pancha karma should be effective to maintain remission and prevent relapse (28).

Diet

As we have seen, IBD is a disease of Western lifestyles, linked to consumption of high-fat, high meat diets, junk foods and stress (29). The Ayurvedic texts have considered mainly tropical diseases under the heading of pravahika. Yet Crohn disease, UC and microscopic colitis fit well into the descriptions of vataj pravahika, rakta pravahika and atisar, respectively. Furthermore, the traditional treatments for these conditions offered in the texts remain highly effective today, accompanied by lifestyle modifications. Due to the persistent and relapsing nature of IBD, maintenance therapies are also necessary in the long term.

1. Bishagratna KL tr, Sushrut Samhita, Chowkhamba Sanskrit Series, Varanasi, 1981 ut XL 82-83
2. Srikantha Murthy KR tr. Madhava Nidhanam, Chaukhambha Orientalia ,Varanasi Ch 3 v 21-22.
3. Farmer RG, Hawk WA, Turnbull RB Jr. Clinical patterns in Crohn’s disease: a statistical study of 615 cases. Gastroenterology. Apr 1975;68(4 Pt 1):627-35.
4. Kornbluth A, Sachar DB, Salomon P. Crohn’s disease. In: Feldman M, Scharschmidt BF, Sleisenger MH, eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, and Management. Vol 2. 6th. Philadelphia, Pa: WB Saunders Co; 1998:1708-34.
5. Kornbluth A, Sachar DB, Salomon P. Crohn’s disease. In: Feldman M, Scharschmidt BF, Sleisenger MH, eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, and Management. Vol 2. 6th. Philadelphia, Pa: WB Saunders Co; 1998:1708-34.
6. Duerr RH. Update on the genetics of inflammatory bowel disease. J Clin Gastroenterol. Nov-Dec 2003;37(5):358-67.
7. Garland CF, Lilienfeld AM, Mendeloff AI, Markowitz JA, Terrell KB, Garland FC. Incidence rates of ulcerative colitis and Crohn’s disease in fifteen areas of the United States. Gastroenterology. Dec 1981;81(6):1115-24
8. Jang ES, Lee DH, Kim J, Yang HJ, Lee SH, Park YS. Age as a clinical predictor of relapse after induction therapy in ulcerative colitis. Hepatogastroenterology. Sep-Oct 2009;56(94-95):1304-9.
9. Bernstein CN, Blanchard JF, Rawsthorne P, Yu N. The prevalence of extraintestinal diseases in inflammatory bowel disease: a population-based study. Am J Gastroenterol. Apr 2001;96(4):1116-22.
10. Cox KL, Cox KM. Oral vancomycin: treatment of primary sclerosing cholangitis in children with inflammatory bowel disease. J Pediatr Gastroenterol Nutr. Nov 1998;27(5):580-3.
11. Xavier RJ, Podolsky DK. Unravelling the pathogenesis of inflammatory bowel disease. Nature. Jul 26 2007;448(7152):427-34.
12. Levenstein S, Prantera C, Varvo V, Scribano ML, Andreoli A, Luzi C, et al. Stress and exacerbation in ulcerative colitis: a prospective study of patients enrolled in remission. Am J Gastroenterol. May 2000;95(5):1213-20
13. S L Jowett, C J Seal, M S PearceInfluence of dietary factors on the clinical course of ulcerative colitis: a prospective cohort study Gut 2004;53:1479-1484
14. Baert F, Wouters K, D’Haens G, Hoang P, Naegels S, D’Heygere F, et al. Lymphocytic colitis: a distinct clinical entity? A clinicopathological confrontation of lymphocytic and collagenous colitis. Gut. Sep 1999;45(3):375-81
15. Margret Agnarsdottir, Olafur Gunnlaugsson, Kjartan B. Orvar,Collagenous and Lymphocytic Colitis in Iceland Digestive Diseases and Sciences Volume 47, Number 5, 1122-1128
16. Fernandez-Banares F, Salas A, Forne M, Esteve M, Espinos J, Viver JM. Incidence of collagenous and lymphocytic colitis: a 5-year population-based study. Am J Gastroenterol. Feb 1999;94(2):418-23
17. Matteoni CA, Goldblum JR, Wang NCeliac disease is highly prevalent in lymphocytic colitis.J Clin Gastroenterol. 2001 Mar;32(3):225-7.
18. Bishagratna op cit ut XL 90
19. ibid 87
20. Bishagratna op cit ut XL 84-86
21. Tuhin Kanti Biswas,Biswapati Mukherjee Plant Medicines of Indian Origin for Wound Healing Activity: A Review The Journal of Lower Extremity Wounds 2003 2, 1, 25—39
22. Ashtanga Hridayam chi IX 25-28
23. Rethinam Sundaresan Devi, Shoba Narayan, Ganapathy Vani, Gastroprotective effect of Terminalia arjuna bark on diclofenac sodium induced gastric ulcer Chemico-Biological InteractionsVolume 167, Issue 1, 5 April 2007, Pages 71-83
24. Ashtanga Hridayam chi IX v 23- 25
25. Bishagratna op cit ut XL 92
26. Cheon JH, Kim JS, Kim JM, Kim N, Jung HC, Song IS (2006) Plant sterol guggulsterone inhibits nuclear factor-kappaB signaling in intestinal epithelial cells by blocking IkappaB kinase and ameliorates acute murine colitis. Inflamm Bowel Dis 12:1152–1161.
27. Avnish K. Upadhyay, Kaushal Kumar, Arvind KumarTinospora cordifolia (Willd.) Hook. f. and Thoms. (Guduchi) – validation of the Ayurvedic pharmacology through experimental and clinical studies Int J Ayurveda Res. 2010 Apr-Jun; 1(2): 112–121.
28. Ram Harsh SinghExploring Quantum Logic in Ayurveda with special reference to Srotovijnana of AyurvedaAyu-Vol.30,No.4(October-December)2009, pp.360-368
29. Yang, S.-K., Loftus, E. V. and Sandborn, W. J. (2001), Epidemiology of inflammatory bowel disease in Asia. Inflammatory Bowel Diseases, 7: 260–270. https://pubmed.ncbi.nlm.nih.gov/11515854/

Nutritive food protects health and prevents disease. It is as simple as that. It is estimated that at least 30% of all cancers are diet related and it is also known that 70% of these cancers are connected with typical diets that are high in animal fat, low in fruit, vegetables and fibre (1). Prostate, breast and colon cancer are frequently connected with diet. Why is this? Perhaps it is to do with dietary changes?

Since 1950 there has been a global reduction of calorific intake in the consumption of complex carbohydrates by 38% and an increase of 12% for meat and 46% for vegetable oils. In the same period in the UK there has been a fall in fresh vegetable consumption by 24% and in the EU and US there has been a 35% increase in sugar and refined starch consumption.

In the USA 35% of all fruit and vegetables consumed are consumed as ‘french fries’! Our shift in nutritional habits over the last 60 years has evidently had a negative impact on society’s health as the same time period has seen cancer rates double and also sharp increases in heart disease, alzheimers, diabetes and other chronic degenerative diseases. Despite there being a surplus of food quantity there has been a decline in food quality to the extent that Type-B malnutrition is now prevalent in the industrialised world with up to 60% of hospital admissions displaying nutritional deficiencies (2,3,4).

An increase in nutrition received from meat is a good example of how more can be less. Well-cooked meat, especially barbequed meat contains aromatic amines, including 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (2, 3), more accessibly known as PhIP, which is associated with bowel, breast and prostate cancer in human cell line studies. The increase in meat consumption is directly correlated with an increased incidence of death from cancer, as seen by statistics showing New Zealand as having the highest meat consumption and the highest levels of colon cancer. Conversely, vegetarian diets are known to extend life and reduce degenerative diseases (see below) (6).

Other qualitative and quantitative nutritional factors are altering society’s health. Obesity has clear links with some forms of cancer as well as heart disease, diabetes, infertility and bone disorders (5). Low selenium levels are specifically implicated in prostate cancer (6). In contrast to this, the increased use of protective oils containing Omega 3 and Omega 6 fatty acids is linked to a reduced rate of cancers.

Certain plant nutrients, known as ‘phytochemicals’, such as lycopene (the red pigment in tomatoes), carotenoids (the orange in carrots) and flavonoids (found in onion) have proven to be protective against prostate cancer. Studies have shown that increasing essential nutrients can give essential protection against degenerative diseases such as Alzheimer’s, arthritis, coronary heart disease, macular degeneration, depression and cancer. Changing one’s diet to a health promoting diet has been shown to reactivate certain genes known as Tumour Suppressor Genes, especially p53, that can keep tumours in check and force their cells to die (7, 8, 9,10,11).

Interestingly, but not surprisingly, organically grown food has been shown to have higher levels of nutrients and anti-oxidants than non-organic products. Studies comparing the nutritional value of organically grown and conventionally grown fruits, vegetables, and grains conclude there are significantly more nutrients in organic crops. These include: 27% more vitamin C, 21.1% more iron, 29.3% more magnesium, and 13.6% more phosphorus, 70% higher omega 3 content and certain vegetables have been shown to have 100% higher levels of cell protective flavonoids.

In addition, organic products have 15.1% less toxic nitrates than their conventional counterparts. Interestingly, the government recommended five daily servings of vegetables (lettuce, spinach, carrots, potatoes and cabbage) provided the recommended daily intake of vitamin C for men and women when they are organically grown but their non-organic counterparts did not. Eating organic affects the amount of flavonoids, quercetin, and anti-oxidants that are protecting and nourishing you. You are also avoiding exposure to excessive levels of immune damaging pesticides and organophosphates (12, 13, 14, 15).

“It is obvious that the body tissues cannot be nourished and developed when food is not properly digested by the digestive fire.” – Charaka Samhita

Ayurvedic Nutrition is a deep science. It is not a one-diet-fits-all approach. And that is the beauty of Ayurveda, the traditional medical system of India. It recommends what is right for you. It also reminds us that what is right for us one day may not be right for us the next. It teaches a deep awareness and connection with our digestive system. If you practice Ayurveda, you begin to fall in love with your belly…’if music be the food of love, play on!’ The negative impact that a poor diet can have on our health, as we have seen above, shows that there has never been such a need for some salient nutritional advice. Ayurveda can help add to this nutritional advice.

Ayurveda has a theory that anything can sometimes be a food, sometimes be a medicine or sometimes be a poison depending on ‘who’ is eating, ‘what’ is eaten, and ‘how much’ is eaten. For example, fresh ginger root is delicious in cooking as a food to flavour and help digestion. It is a stimulating medicine that can help clear a cold and induce a sweat when taken as a strong hot tea. However, if too much is taken it can make you sick causing acidity and vomiting, hence acting as a poison in the wrong circumstances.  This refers to Ayurveda’s focus on the ‘quality’ of what we eat as well as the ‘quantitative’ nature of the food. So, there is no strict ‘Ayurvedic diet’ per se, only sage recommendations to help you find the tastiest and healthiest diet for your personal optimum health.

Eating is considered to be the most important activity that can affect health. Whilst eating is an essential habit, and for some an addiction, it can be empowering to transform your eating habits to only include healthy foods that are rejuvenating and life-giving. This is a healthy habit. Whilst herbal remedies, massage, exercise and spiritual practice can balance and repair health it is a ‘good’ diet that gives us an every day opportunity to take control of our health. We are stuck with our genes, family and climate but we can change our diet; when it comes to what we put in our bodies, we are in charge.

Generally speaking, Ayurveda considers that the most beneficial foods are rice, wheat, barley, mung beans, asparagus, grapes, pomegranates, ginger, ghee, milk and honey. These are all tonics to the tissues and digestion. It also generally recommends that it is best to avoid habitual use of heavy meats, cheeses, yoghurt, refined salt, processed foods, refined sugar, coffee, tomatoes, bananas, citrus fruits and black lentils. These can create stagnation and undigested toxins, the scourge of all of our health problems.

Of course, many people have now become ‘intolerant’ to wheat and dairy. In my experience this is a result of a combination of a weak digestive fire with ‘unnatural’ foods.

For example, I call bread ‘unnatural’ as modern baking techniques require that it is leavened with synthetic yeast in a couple of hours. For a proper healthful fermentation bread should leaven over an 8 hour period using a natural sour-dough fermentation; this neutralises phytic acid which helps make the nutrients in the bran more bio-available and does not block calcium and iron absorption; it creates gut-healthful lactobacillus bacteria (as opposed to Candida albicans-promoting synthetic yeast) which assist with assimilation and the health of the digestive tract and also increasing the B vitamin content of bread. Add a powerful digestive system and you get optimum absorption of the best quality food.

Commercially yeasted bread causes bloating, gas and aggravates the nutritional state of the tissues and the micro-flora in the digestive tract. No wonder so many people are intolerant to it. Ayurveda says that yeast is a negative ingredient that aggravates every constitution.

This sort of understanding pervades Ayurveda. After all it is literally translated as ‘the Science if Life’. It has detailed practical theory covering all aspects of living a positive and health generating life-style. It literally gives you the clear information to live healthily and fulfill your potential. I have seen its innate wisdom empower and transform hundreds of people’s lives.

I clearly remember one 48 year old woman with ulcerative colitis who had been on various courses of steroids that helped whilst she remained on the medication but all the symptoms flared when she came off the drugs. Minimal dietary advice had been given by her primary carer. She ate a typical British diet including coffee, cereals, milk, sandwiches, frequent meat, low vegetables  and occasional alcohol.

Through simply applying some of the principles mentioned in this article to strengthen her digestive fire, adjust her diet to a more wholegrain (rice, quinoa, barley), high vegetable, low sugar diet along with some herbs to clear intestinal inflammation (triphala, neem, turmeric) she has remained almost symptom free and has not needed steroids for over 3 years. It was by allowing her digestive energy to flourish that her health was able to heal.

Now let’s look at how we can all look after our digestive altar. Remember that digesting your food properly depends on:

• A strong digestive fire called agni in Ayurveda
• Eating appropriate foods in the correct quantity and of the correct quality
• Healthy food combining based on Ayurvedic principles

The Indian Vedic culture revered agni or fire, which gave them light, warmth and cooked their food. Agnideva is the Fire god who acts as a messenger between the mortal world and the heavens. In Vedic rituals humans offer oblations (the act of offering something such as worship or thanks to a deity) to the sacred fire. The fire takes a portion for himself and then vaporises the rest for the benefit of the gods. The gods imbibe this nutritious fragrance and in return give life-giving waters and favourable environmental conditions from which crops flourish and humans can feed themselves. This benevolent cycle continues as long as both parties are happy.

It is a metaphor of our own digestive system. We eat and ‘offer’ food into the fire of our bellies. Agni digests this food and the control centres in the brain are nourished by these fragrant nutritional ‘vapours’. This nourishment feeds the nervous impulses, which release enzymes and hormones. This stimulates systemic metabolic activity so that the whole body-mind complex functions efficiently.  Hence eating is seen as a sacred act that should be given its full attention away from stress, disturbance and distractions.

Agni is seen as the metaphor for all metabolic functions in the body. It includes the digestive function, sense perception, cellular metabolism and mental assimilation. The agni’s ability to transform also gives it a pivotal role in absorbing life’s experiences as it works through the heart and mind to help process emotional and cognitive experiences. It is said to carry the inherent cosmic intelligence into our tissues.

Agni is involved in many functions:

• Absorption
• Assimilation
• Metabolism
• Digestion
• Perception
• Taste
• Touch
• Hearing
• Vitality
• Clarity
• Alertness
• Regular appetite
• Immunity
• A sparkle in the eyes
• Lustre to the whole body

The qualities of digestive agni are:

• Hot
• Light
• Sharp-penetrating
• Pungent
• Luminous-clear

When it is balanced it causes emotions that are beneficial to health: courage, happiness, cheerfulness, lucidity, optimism, enthusiasm and intelligence. It also provides energy, vitality and a system able to maintain homeostasis.

When it is out of balance it causes emotions that are destructive to health: fear, anger, confusion, idiocy, depression. This also leads to low energy, congestion and an accumulation of wastes. Modern research also shows that gut health is closely linked to energy levels, mental clarity and wellbeing.

There are four types of digestive fire that generally categorise people’s digestive tendencies. Which one are you?

Ayurveda recommends specific foods for each type of digestive fire.

1. Irregular digestion

This is an irregular appetite and digestive system with signs of variable hunger, bloating, indigestion, intestinal cramps, constipation, dry stools, gurgling and gas. It is common in nervous people (known as vata types in Ayurveda).

Using spices that have a carminative, warming and relaxing action can be useful. Ayurveda has a formula called Asafoetida Plus (made from asafoetida, fennel, cumin, nigella seed, ginger, black pepper) taken 30 minutes before meals can help balance this erratic type of digestive system.

2. Intense digestion

Intense hunger but with poor digestion is a sign of a hyperactive digestion. There may also be symptoms of thirst, parched mouth, dry throat, loose stool and a burning sensation in intestines are common concurrent symptoms. It is more common in ‘fiery’ people known as pitta types in Ayurveda.

Using herbs that can dilute the acidity in the stomach can help.  Amla and Peppermint formula mixes certain bitter and cooling herbs to help balance this intensity of pitta in the digestive system.

3. Weak digestion

Weak hunger is a sign of low metabolism and sluggishness. These types of people also commonly have slow digestion, heaviness after eating a meal, sluggish bowels, bulky stool, feeling cold, sweet cravings and they crave stimulants. It is more common in kapha types of people in Ayurveda.

Stimulating spices such as in the formula Trikatu (Ginger, black pepper and long pepper) before a meal it can help alleviate this tendency and works a bit like proteolytic enzymes.

4. Balanced digestion

Balanced hunger and digestion; food is digested within 4 hours with no excess craving or lack of interest in food. These people can just use Ayurveda’s premium digestive regulator Triphala to help maintain a healthy digestive system.

If you really know your digestive system and how it reacts to the different challenges of your diet and the day then you can understand how to live right for your own needs. It is the best way to perfect health.

In fact, the simplest and best suggestion of any diet is just to follow your hunger. Only eat when you are hungry. This way your digestive fire will express its own innate wisdom and let you know when it is time to eat, when it is time to drink and when it is time to rest. It really is that simple. Learning to really understand true hunger gives you an insight into the deeper workings of your self, your attachments to food, how you are nurtured by what you eat and how you care for yourself by what you eat. A beautiful way to love yourself is by giving yourself the food you really need. We all love a bit of chocolate cake and so you should enjoy it. It tastes great and chocolate is a wonderful mood enhancing food. Just make sure that the remaining 99% of the time you are giving yourself what you truly need.

Ayurvedic food combinations

It is not just the food you eat that affects digestion but how you put them together that affects your health. When it comes to food, not everything is equal. Foods have different tastes, heating or cooling qualities, moistening or drying qualities and building or cleansing effects. According to Ayurveda, if foods with different energetic qualities are combined then they can cause incompatibilities which can upset digestion leading to indigestion, gas, diarrhoea, constipation and ama. This ultimately leads to food intolerances and other health imbalances such as sinus congestion, lowered immunity and skin problems.

Ayurveda has these lovely balancing tricks. Its not a puritanical system dictating what is ‘good’ and what is ‘bad’. It is an experiential system based on creating what is right for you. If we can agree that foods have effects: e.g. beans are good for your heart via their plant sterol cholesterol lowering function but beans are also hard to digest, then we can agree that foods can have opposing effects. These can be balanced with careful food combining and Ayurveda recommends cumin, coriander and asafoetida to help with the digestive disrupting side effects of beans.

Incompatible foods can cause problems because they digest at different speeds and can cause fermentation or excessive mucus.

Overview of foot compatibilities

Food type	Compatible with	Exceptions
Fruit	Other food. It should be eaten at least 2 hours away from other foods	Dates together with milk are ok.
Milk	Bananas, bread, yoghurt, fish, meat, melons, cherries, sour foods
Yoghurt	Fruit, milk, meat, solanacea family, eggs, fish
Eggs	Milk, fruit, yoghurt, cheese, fish, meat
Grains	Fruit
Beans	Fruit, cheese, eggs, yoghurt, milk, fish, meat
Lemons	Milk, yoghurt, tomatoes, cucumbers
Honey	Ghee (by weight) 1tsp honey = 3tsp ghee Honey should not be heated	Adding honey to a warm drink is ok.
Radishes	Bananas, raisins, milk
Melons	Any other food
Raw food	Cooked food
Fresh food	Leftovers

Incompatible foods and antidotes for balance

Food	Antidotes	Effect
Dairy	Black pepper	Reduces mucus
Coffee	Cardamom	Reduces nervous system aggravating effect of caffeine
Potatoes	Ginger or black pepper	Makes them easier to digest and less heavy
Potatoes	Ghee, olive oil	Makes less dry and reduces gas
Cucumber	Black pepper	Makes less cold and easier to digest

• Start each meal with chutney of ginger, lime and a pinch of rock salt (or just chew a piece of fresh ginger)
• Eat warm food that is freshly cooked (Ayurveda promotes the use of warm food as this is easier to digest)
• Avoid processed, cold-refrigerated and stale foods
• Chew properly to ensure that digestive enzymes get to work in the mouth
• Sip warm water with each meal but do not drink lots of fluids within an hour after finishing your food as this can weaken the digestive fire
• Avoid iced water
• Eat in peace
• Do not eat when stressed, angry or depressed
• Eat with awareness; be aware of how your digestive fire is every day and eat appropriately for your constitution.
• Stop eating when you are half full of food and a quarter full of liquid, leaving a quarter of your digestive capacity free for life-giving prana to circulate and help digestion
• Eat your food with respect for nature and the gift of nutritious food she has bestowed upon you. Give thanks to the creator of your meal
• Eat sitting down. Do not eat standing up. (16)
• Have a short walk after each meal, however do not take excessive exercise, sleep or have seat for an hour after eating
• Do not eat a heavy meal at night and leave at least two hours from eating before going to bed

Although Indian culture is often associated with vegetarianism, Ayurveda is not wholly vegetarian. Ayurveda is a science in pursuit of health. It is not a moralistic system, although morality does creep into its practices. If someone’s health can benefit from the properties of eating some animal meat, then this is recommended. For example, this might happen if someone is extremely weak after an illness. Ayurveda would understand that there is some karma, or effect, from using animal products, but argues that the health of the individual is paramount. That being said it does recommend a primarily vegetarian diet that is easy to digest. In accordance with Ayurvedic principles it would also encourage an awareness of one’s actions and there is little doubt that the massive impact of the meat industry on the environment, economy and health of society would influence the opinion of the original propounders of Ayurveda.

Environmentally vegetarianism is more sustainable. One quarter of the earth’s surface is now pastureland to support livestock! ¾ of all grains and beans grown in the US are destined for animal feed (17).

Economically vegetarianism costs the world less. As demand grows, intensification practices rush to support the market. This means that many animals are kept in conditions that increase the risk of disease, requiring persistent treatment with anti-biotics. Of all food poisoning incidents in the UK 95% are due to animal products.

Vegetarians have been shown to have longer and healthier lives than meat eaters as well as less cancer, obesity and heart disease. Interestingly, New Zealand has the highest per capita levels of meat consumption and the highest levels of bowel cancer in the world. Globally calorific intake from meat has increased by 36% since 1950 and vegetable consumption has dropped by 24% in the same time period in the UK. The shift in our nutritional habits is clearly having a negative impact on society’s health as the WHO state that 30% of all cancers are diet related and that 70% of all cancers are connected with typical diets that are high in animal fat, low in fruit, vegetables and fibre (18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31 32, 33, 34).

Whatever your dietary predilection Ayurveda would recommend eating with awareness.

The following are tried and tested delicious recipes.

Kicharee

Serves 2-3

Ingredients and preparation

• 1/3 cup or 100 gms split mung dal, 2/3 cup 200gms or basmati rice (or other grain) simmered in 3-4 cups of water (a ratio of 1:3 or 1:4).
• Add 1/4 tsp organic turmeric, ginger, roasted cumin and coriander.
• Add seasonal vegetables: spinach, peas, carrots or seaweeds and simmer on low heat in the lentil-rice mix for 30-40 minutes for an all round healing, healthy and agni enkindling meal.
• It’s best not to stir this once all the ingredients are in as it can go ‘mushy’. Mix it once, put a lid on, turn the heat down and enjoy the fragrant aromas filling your house. Leave it to sit for 10 minutes at the end.
• Add a teaspoon of ghee or hempseed oil at the end.
• Salt and pepper to taste.

 Other kicharee tips

• Whilst fasting on kicharee it can be useful to sip hot drinks; try spicy teas of black pepper, cinnamon and cardamom to burn ama, clear toxins and relax your contracting stomach.
• For a ‘medicinal’ meal add powders of shatavari, bala, ashwagandha, pippali, amla, almonds, walnuts; approx 1 tsp/person.
• Try adding fresh rose, marigold, borage petals.
• Try adding rose petal jam or rose water.

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Rice pudding elixir

Ingredients

• 100g rice pudding rice (You can also try with black or red rice)
• 1 litre of cow’s, almond or rice milk (option of more)
• 3 tbs almond powder
• 7 strands of saffron
• 5 cardamom pods
• Rose Jam
• Ghee or honey, optional

How to make rice pudding elixir

1. Place the rice in a heavy pan and add the milk. Bring to boil and simmer for 1 hour.
2. Add the almond powder. Add more milk as desired. (coconut milk is an interesting change)
3. Soak the strands of saffron in a tablespoon of milk for 10 minutes to extract its golden pigment and then add to rice pudding. Add cardamom and rose jam.  Serve and add ghee or honey as desired.
4. You can also add grated carrots or beetroots to this recipe for a colourful and nourishing variation.
5. This is a very nourishing food for reducing vata and pitta, strengthening the tissues and building reproductive tissues.

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Hot milk recipe

Serves 1

Ingredients

• 1 cup of cow’s, almond or rice milk
• 2 tsp organic almond powder
• 2 cardamom pods
• 5 strands saffron   
• Pinch of nutmeg

How to make a delicious hot milk

1. Put all the ingredients into a pan and heat until boiling.
2. Allow to cool and add 1 tsp honey (optional). Take with 1-2gs or caps of organic ashwagandha at night to help nourish the nervous system, reproductive system and it helps you sleep.

I hope that some of this wisdom that Ayurveda offers you for dietary balance helps you towards healthier and more delicious eating.

1. WHO, World Cancer Report 2003.
2. Gallagher-Allred CR, Voss AC, Finn SC, McCamish MA.  Malnutrition and clinical outcomes: the case for medical nutrition therapy. J Am Diet Assoc 1996 Apr;96(4):361-6, 369.
3. Bistrian BR, Blackburn GL, Vitale J, Cochran D, Naylor J. .Prevalence of malnutrition in general medical patients. JAMA 1976 Apr 12;235(15):1567-70.
4. Naber TH, et al. Prevalence of malnutrition in nonsurgical hospitalized patients and its association with disease complications. Am J Clin Nutr 1997 Nov;66(5):1232-9.
5. Cerhan JR, Torer JC, Lynch CF, et al. Association of smoking, body mass, and physical activity with risk of prostate cancer in the Iowa 65+ Rural Health Study (United States). Cancer Causes and Control 1997; 8(2):229–238.
6. Cui Z, Liu D, Liu C, Liu G. Serum selenium levels and prostate cancer risk. Medicine (Baltimore). 2017;96(5):e5944. doi:10.1097/md.0000000000005944
7. Giovanucci E., et al ‘95. “Intake of carotenoids and retinal in relation to risk of prostate cancer.” Journal of National Cancer Institute; 87:1767–76. 
8. Lewin M, Bailey N, Bandaletova T, Bowman R, Cross AJ, Pollock J, Shuker D, Li, H, et al. A prospective study of plasma selenium levels and prostate cancer risk. Journal of the National Cancer Institute, vol. 96, May 5, 2004, pp. 696-703.
9. Taylor, PR, et al. Science peels the onion of selenium effects on prostate carcinogenesis. Journal of the National Cancer Institute, Vol. 96, May 5, 2004, pp. 645-47 (editorial).
10. Drewnowski, A. Fat and Sugar: An Economic Analysis J. Nutr. 133:838S-840S, March 2003.
11. Drewnowski, A. & Popkin, B. M. (1997) Dietary fats and the nutrition transition: new trends in the global diet. Nutr. Rev. 55:31-43
12. Worthington V, Nutritional Quality of Organic Versus Conventional Fruits, Vegetables, and Grains, The Journal of Alternative and Complementary Medicine, Vol. 7, No. 2, 2001 (pp. 161-173).
13. Heaton , Organic Farming, Food Quality and Human Health: A review of the evidence, The Soil Association, United Kingdom, 2001.
14. Grinder-Pedersen, Salka E. Rasmussen, Susanne Bügel, Lars V. Jrgensen, Lars O. Dragsted, Vagn Gundersen, and Brittmarie Sandström, Effect of Diets Based on Foods from Conventional versus Organic Production on Intake and Excretion of Flavonoids and Markers of Antioxidative Defense in Humans, J. Agric. Food Chem., 51 (19), 5671 -5676, 2003.
15. Zheng T, Zahm SH, Cantor KP, Weisenburger DD, Zhang Y, Blair A. (2001) Agricultural exposure to carbamate pesticides and risk of non-Hodgkin lymphoma.J Occup Environ Med. 43(7):641-9. 
16. Pole, S, Ayurvedic medicine, the principles of traditional practice, Elsevier, 2006.
17. Vesterby, Marlow and Krupa, Kenneth S. 2001 Major Uses of Land in the United States, 1997 Statistical Bulletin No. (SB973) September 2001 LEAD digital library: Livestock’s long shadow – Environmental issues and options.
18. Bingham SA. Red meat enhances the colonic formation of the DNA adduct O6-carboxymethyl guanine: implications for colorectal cancer risk. Cancer Res. 2006 Feb 1;66(3):1859-65.
19. Burr, M & Butland, B. (1988) Heart disease in British vegetarians. Am Jnl Clinical Nutrition v.48 p.830-2.
20. Claude-Chang, J et al. (1992) Mortality pattern of German vegetarians after 11 years of follow-up. Epidemiology v.3 (5) p.395-401.
21. Cummings, J & Bingham, S. (1998) Diet and the Prevention of Cancer BMJ v.317 p.1636-1640.
22. Doll, R. (1990) Symposium on diet and cancer. Proc of the Nutrition Society v.49 p.119-31.
23. Dwyer, J T. (1988) Health aspects of vegetarian diets. Am Jnl Clinical Nutrition v.48 p.712-38.
24. Gale, Catharine R; Ian J Deary, Ingrid Schoon, G David Batty, G David Batty (2006-12-15). “IQ in childhood and vegetarianism in adulthood: 1970 British cohort study”. British Medical Journal 333 (7581).
25. Galeone C, Pelucchi C, Levi F, et al. Onion and garlic use and human cancer. Am J Clin Nutr 2006;84: 1027-32.
26. Margetts, B M et al. (1986) Vegetarian diet in mild hypertension: a randomised controlled trial. BMJ v.293 p.1468-71.
27. Marsh, A G et al. (1988) Vegetarian lifestyle and bone mineral density. Am Jnl Clinical Nutrition v.48 (3) p.837-41.
28. Sellmeyer, D E et al. (2001) A high ratio of dietary animal to vegetable protein increases the rate of bone loss and the risk of fracture in postmenopausal women. Am J Clin Nutr 2001; 73:118-22.
29. Spencer, Colin: The Heretic’s Feast. A History of Vegetarianism, London: Fourth Estate 1993.
30. Thorogood, M et al. (1994) Risk from death from cancer and ischaemic heart disease in meat and non meat-eaters. BMJ v.308 p.1667-1671.
31. Thorogood, M et al. (1987) Plasma lipids and lipoprotein cholesterol in people with different diets in Britain.
    BMJ v.295 p.351-3.
32. Walters, K and Portmess, L, Religious Vegetarianism From Hesiod to the Dalai Lama, Albany 2001.
33. Willett, W C et al. (1990) Relation of meat, fat and fibre intake to the risk of colon cancer in a prospective study among women. New England Jnl of Medicine v.323 p.1664-72.
34. World Health Organisation (1990). Diet, nutrition and the prevention of chronic diseases. WHO, Geneva.

However, Summer doesn’t last forever. Autumn is a beautiful season seeing an extravaganza of golden colour but also a keen increase in cooler winds. The characteristic windy, cold and dry weather in Autumn naturally aggravates the vata dosha, which is unsurprisingly governed by the element air. The qualities of vata are cold, light, rough, mobile, subtle, clear, dry and astringent.

After the heat of the summer and with the change of the season these qualities can increase, thereby aggravating vata. Vata regulates the nervous system, moisture in the body, how relaxed we feel and how well we digest food. So, keeping our vata in check during this seasonal change is key to feeling fit and healthy.

Interestingly, vata is responsible for all communication and movement in the body; the flow of breath and blood, elimination of wastes, expression of speech for example. It can be described as a current of electricity responsible for regulation of all electrical impulses in the body and mind. Optimal balance of the vata in all of us is crucial. In fact without vata the other dosha are inert. Especially during those times of the year where it is at risk from becoming out of balance, such as in Autumn. As it is said in the ancient writings Sharangadhara Samhita without vata, “pitta is lame, kapha is lame”. So, how can we keep our inner vata in balance? Here are a few top tips:

• Rise early when the world is still calm
• Daily 5-10 minute morning self-massage with a warming and relaxing oil like sesame oil. This offsets seasonal tendencies to dryness, joint cracking, stiff muscle pain and poor circulation.
• Diet to consist of warm, sweet, mildly spicy, sour and salty foods. Here are just a few that suit vata: Soups, casseroles, warming spices such as ginger, turmeric, fennel, root vegetables, ghee, hemp seed oil and kicharee.

Autumn is also a common month to perform a seasonal cleanse to prepare for the winter ahead and to clear the excess heat accumulated during the winter months. Kapha types are particularly prone to accumulation, and a seasonal cleanse can be especially beneficial for them. A successful fast leaves you feeling lighter, refreshed and energised.

The first and most important point to consider when undertaking a cleanse is to pick one that suits your personal constitution. There are many types of fasts; water fasts, fruit juice fasts, rice fasts, soup fasts, kicharee fasts. Here are some top tips for each of the three dosha:

• Kapha types store energy and a tendency to be too static. They can tolerate longer fasts and benefit the most from them. Their fasts can be more light soup/broth based or just hot water and spicy teas.
• Pitta types are good at managing energy but accumulate excess heat and inflammation. They benefit from a fast of one to three days and can manage on fruit or vegetable juices as their high levels of digestive fire at the best at breaking down raw fruit and veg.
• Vata types have difficulty holding on to energy and have a tendency to be ungrounded. Fasting must be undertaken with caution and should only fast for a short time of between one and three days. Their fast should always contain some nourishment and could be a mono fast of brown rice, mung soup or kicharee.

Here are some top tips to keep in mind for anyone undertaking a seasonal fast:

• Drink lots of warm water and replace caffeinated drinks for spicy teas that help to burn toxins
• You’re not eating your regular diet, so your body will need time to adjust. Rest and take plenty of sleep.
• There is a saying ‘Any fool can fast but it takes a wise one to break it’. It is very important to break a fast slowly, one day fast requires one day of re-introduction to normal diet.

Another very useful way to build the strength of your digestive fire that is in some way a light fast is to follow an incremental diet. Its very useful to help people with IBS, Crohn’s, Ulcerative colitis, acidity, recovery from fever, for removing toxinc ‘ama’. It is based in a traditional Ayurvedic practice known as ‘samsarjana karma’ that gradually cleanses and buolds digestive strength.

• Use basmati rice or quinoa and follow each stage for a day or two depending on your digestive strength.
• Drink lots of ginger tea during this time.

Phase 1: Rice water (manda)

• 14 parts of water to 1 part of rice simmered for 30-40 minutes: Strain the grains out.
• Add a pinch of salt and cumin powder to taste.
• This is a milky-coloured liquid, and is the easiest of all the foods to digest, usually given just once at the outset of the practice.
• Then follow the below having each one for a day or two.

Phase 2: Rice water with rice part 1 (peya)

• 8 parts of water to 1 part of rice simmered for 30 minutes: Leave the grains of rice in.
• Add a pinch of salt, cumin and ginger powder to taste.

Phase 3: Rice water with rice part 2 (yavagu)

• 6 parts of water to 1 part of rice simmered for 30 minutes: Leave the grains of rice in.
• Add a pinch of salt, cumin and ginger powder to taste.

Phase 4: Rice water with rice part 3 (vilepi)

• 4 parts of water to 1 part of rice simmered for 30 minutes: Leave the grains of rice in.
• Add a pinch of salt, cumin, coriander, ginger powder to taste. Also add1/2 tsp ghee.

If your digestion is feeling strong add some steamed vegetables such as carrots or spinach.

Phase 5: Rice water with rice part 4 (odana)

• 2 parts of water to 1 part of rice simmered for 20 minutes.
• Add a pinch of salt, cumin, coriander, ginger powder to taste.
• Also add1/2 tsp ghee.

Eat this with some yellow split mung lentils: Simmer 1 part lentils in 14 parts of water for 40 minutes with some spices and ghee in.

Then start to eat kicharee. Try eating kicharee regularly. It is easy to digest and very nourishing.

• 1/3 cup split mung beans, 2/3 basmati rice (or other grain) simmered in 3-4 cups of water (a ratio of 1:3 or 1:4).
• Add 1/4 tsp each of organic turmeric, ginger, roasted cumin and coriander.
• Add seasonal vegetables: spinach, peas, or seaweeds, shitake mushrooms for an all round healing, healthy and digestion enkindling meal.
• The best practice is to cook it on a very low heat in a covered saucepan and it is best not to stir it after all the ingredients are added or it will go mushy.
• Add a teaspoon of ghee or hemp seed oil at the end with some salt to taste.