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Can you briefly describe to me the concept of treatment according to Ayurveda?

Ayurveda primarily describes treatments to be of two types namely samana or pacificatory treatment and sodhana or purificatory treatment. The former type looks at gently pacifying the aggravated doshas (and disease) by the intake of relevant medicines and mild external treatments including oil application. Here the increased doshas are either subsided or naturally expelled through the excretory channels.

In sodhana treatment, the aggravated or vitiated doshas are deliberately brought into the alimentary canal and then forcibly expelled by either emesis (vomiting), purgation or enema based on the nature of the dosha that is aggravated. The preferred method of treatment according to the Ayurveda texts is “sodhana”, for the complete expulsion of the accumulated toxins would mean that the root cause is being treated and would ensure that the problem does not recur provided the patient takes sufficient care.

Both these treatments are very elaborate and need to be done with utmost care – this is especially true of the purificatory treatments. It is partly due to the intensity of the purificatory treatments that the pacificatory treatment is greatly preferred today where the risks are far less and the restrictions are more relaxed as compared to the purificatory treatments.

Can the effect of these treatments be measured by modern scientific methods?

It is not easy to explain the effects of these treatments in scientific parlance. This is mainly because the indigenous thought process and the western scientific thought process look at the same individual from two entirely different standpoints. As yet, the two systems stand on two opposite sides of a river and are yet to find a common meeting point wherein the foundational principles, categories, classifications etc. of both systems are given due and equal respect. However there have been efforts by some scientists to study the effect of some of these treatments on the human body.

One such study looked at “improvement in cardiovascular risk factors through panchakarma purification procedures” and was done by Hari M.Sharma, Sanford I.Nidich, David Sands, De and D.Edwards Smith with the support of the Maharishi Ayurved Foundation of America and the Department of Pathology Academic Enrichment Fund, The Ohio State University, Columbus, Ohio, USA. They studied the effect of snehapana (internal oleation), virechana (purgation), abhyanga (medicated herbal whole body oil application), sirodhara (flow of medicated oil on the forehead), swedana (medicated fomentation), nasya (nasal administration of herbs) and basti (medicated enema) done in sequence over a period for 31 patients. The biochemical and physiological tests were done at periodic intervals and it was found that after 2.9 months after this course of treatment, the vasoactive intestinal peptide (VIP), a coronary vasodilator, rose a significant 80%. Total cholesterol fell acutely in all the patients. The lipid peroxide (a measure of free radical damage), pulse and diastolic blood pressure were also reduced after the treatment. State anxiety measures improved significantly. Thus the study concluded that these treatments are useful in decreasing the effect of cardiovascular risk factors.

Another study done by Rainer Waldschutz at the Albert-Ludwigs University of Freiburg, Germany studied the effect of purification treatment on Physiological and Psychological Health. Here 93 patients were given a two week course which included snehapana (intake of medicated ghee), swedana (fomentation), virechana (purgation) and basti (medicated enema) over a period of two weeks. Physiological evaluation was done before and immediately after the course of treatment was over; psychological evaluation was done before, immediately after, and 6-8 weeks after treatment. Results show reductions in total cholesterol and urea. At the psychological level, there were significant changes including reduction in bodily complaints (psychosomatic), irritability, bodily strain (often feeling stressed), psychological inhibition, and openness, as well as greater emotional stability.

The above two studies are only cited as examples of limited work done in establishing  scientifically the benefit of different Ayurveda treatment processes. This is only the beginning and there still remains a lot of work to be done in this area.

How long will the treatment normally take to show full effect?

This is entirely dependent on the individual patient – the nature of the problem, the chronicity of the problem, the nature of the associated problems, the intensity with which the patient follows all the advice of the physician during and after the treatment for the requisite period, and also the astrological time cycle which is affecting the patient.

Generally it is seen that most patients respond positively within 3 months after completion of the treatment. The extent of cure is dependent on all the above mentioned factors. It takes 3 months or 3 lunar cycles to see the benefit primarily because the body needs time to get accustomed to the intensive cleansing that it has undergone and to get back into its normal rhythm. In one research study, it was found that after 2.9 months after this course of treatment, the vasoactive intestinal peptide (VIP), a coronary vasodilator, rose a significant 80%. This study was restricted to the study of just this factor. Since the treatment is aimed at total rejuvenation of the entire body, mind and soul, it would be interesting to study the effect of the treatment on a whole range of factors covering all the systems of the body. Thus it is extremely important to continue the internal medicines, external oil application (where advised), and diet and lifestyle restrictions as advised by the physician for the suggested duration to get the maximum benefit.

In some patients, the benefit may not be seen even after three months either due to greater damage having occurred or due to improper diet and movement and not following the physician’s advice. Please do remember that it is your health that it is most important and hence please adher to the instructions given, and wherever and whenever not possible, please take the permission of your physician before violating any instructions.

Why is the course of treatment of such a long duration – can’t the duration be cut down considerably? This will also make it more accessible to more number of people.

Let us explain this by an example – if your house has not been cleaned for several years (or even months), it will be fully covered with dust and grime; the paint may have begun peeling off the walls; there will be cobwebs all over the place; there are chances of clogging in the plumbing lines especially if the water used has a high salt content; in all probability, your house would have become a home to several insects. If, on one day, you suddenly decide to take on the task of repairing and cleaning your house, most probably you will find that you need several days to get the entire place cleaned and dressed up; most certainly one or two sessions of cleaning will have absolutely no effect and can even be disastrous for as we always find out, any repair work will invariably result in hitherto unknown problems being uncovered and hence unless the work is undertaken and completed in one stretch, half-hearted efforts can have the opposite effect.

If the above picture is clear, we can apply the same to the human body. A course of treatment is looking at uncovering and cleaning the toxins accumulated over an extended period of neglect, and hence one or two or even eight to ten sessions may not have the desired results. Hence it is very important to approach the task systematically – thus, first the body has to be prepared for the cleansing process, then the actual cleansing has to be done based on need, and then time needs to be given for the effect of the cleansing to be felt – this is a very important phase. Any neglect shown during this period can undo the entire effect of the treatment.

Hence it is very important that one listens and faithfully follows the advice given by one’s physician regarding the course of treatment and the restrictions to be observed during this period.

I have heard of treatments like dhara and panchakarma – why am I not able to get those in a duration of time like 7 or 14 days or 1 day?

The concept of the panchakarmas and intensive oil therapies in Ayurveda is based on the bio-rhythms or natural time cycles that each of us go through. Simply put, the treatments are normally done in multiples of 7 days and the optimum duration is 35 days – again this is based on the physician’s understanding of the need of each patient.

All these treatments work at a very deep level within the human body and psyche and thus, to experience the actual benefit of these treatments, it is important that one go through it for the prescribed period. Even as a major surgery in the western medicine hospital demands a preparatory stage initially and is followed by a recuperative phase post-surgery, similarly these intensive treatments also have three phases namely a preparatory phase, the main treatment phase and the post-treatment or recuperative phase. Unless these are strictly adhered to, one cannot be assured of any real benefit and in fact, one cannot be sure whether there may be any side effects too.

Hence to reiterate, the time cycles are clearly prescribed along with the mode of giving the treatment and the dietary and lifestyle restrictions to be followed during and after the treatment, and it is best to follow this as it is without any compromise to ensure that one gets the maximum benefit.

Why are you not doing hard massage?

Almost all the different Ayurveda oil therapies are primarily revolving around the specially prescribed medicated oil rather than the “actual act of massage”. The focus is on rubbing the oil in gently and allowing the oil and the herbs in the oil to do the work rather than the actual act of massage. Please do remember that normally a “hard massage” gives pleasure at the sensual level which is mostly temporary. While the effect that the “Ayurveda treatment” is looking to give you is more deep and long lasting. Having said this, there are occasions where our physicians advise the therapists to give deeper treatments based on the necessity of the situation.

There is a type of treatment in Ayurveda which looks at manipulating the marmas or vital points on the body. There are 108 vital points on the body which are virtual power centers controlling a whole range of functions and activities depending on their location and importance. Treatments where the emphasis is on the manipulation of the marma points can involve hard massage over shorter time periods – but here the treatment is done by a knowledgeable physician rather than a therapist for this treatment can be extremely dangerous if not done by an experienced person.

Why are you not putting more Therapists to work on me for a single session of treatment rather than just 1 Therapist?

The number of therapists for a treatment session is decided by the physicians. Normally, for a course of abhyanga or simple oil application, one therapist works on the patient. Please do remember that in the session of abhyanga, the emphasis is on the application of oil rather than the act of massage. In abhyanga, it is the oil (and the herbs in the oil) that is actually working rather than the massage and hence it is not really necessary to have more than one person working on you.

In a treatment like pizhichil, 3-5 therapists will work on you simultaneously. Each therapist will select one part of your body and will focus on squeezing the warm medicated oil specifically onto the selected part. Here again, the emphasis is on the act of squeezing rather than the act of massage.

In sirodhara, 2 therapists will work simultaneously. One will be engaged in the act of moving the pot of oil slowly and evenly over the forehead allowing the oil to drip down while the other will collect the oil and pour it back into the pot. If the sirodhara is done alone, sometimes a third therapist is engaged in application of oil all over the body of the patient. Many a time, sirodhara is done in conjunction with pizhichil and on some such occasions, there can even be upto 7 therapists working together on the patient in a single session.

Thus, as may be seen, different treatments have different requirements. Please do remember that your physician is conscious of your individual requirement and will make the necessary arrangements accordingly. Where necessary, he/she may even depute two therapists for the simple abhyanga.

Can I not be given two treatments every day and thus reduce the prescribed time period by half? In this way, I will also be able to get over my boredom to some extent. Further will I not get additional benefit by going through two treatment sessions every day?

This question is akin to asking whether intake of excess nutritional food (more than one can consume) at every meal time will contribute more to one’s health – in all probability, the effect will be just the opposite. Or eating food before the previous meal has been digested. Even as your vehicle cannot accelerate beyond a certain point, your body too cannot work overtime beyond a certain limit.

Hence there is no use trying to rush the treatment by taking additional sessions every day. You need to give your body time to absorb the therapeutic effects of the treatment – two sessions a day will not necessarily give this benefit except in certain conditions. As mentioned earlier, the entire effort of the treatment is to keep pace with your natural body cycle and to bring your body back to its natural state of harmony.

Why are you telling me that my immunity power decreases during the course of the treatment?

Like any major surgical procedure, the Ayurveda treatments too are very intensive and need to be done very carefully to ensure that the patient is not subject to any side effects during/after the treatment. The Ayurveda texts say – The patient should be taken care of with all efforts just like a young (just laid) egg or a vessel filled with oil (to its brim) protecting him/her from all hazards and risks.

During any service procedure, the machine is temporarily not working during the cleaning process, and even after the cleaning, it is normally advised to take it easy and let the machine slowly build up its capacity. Even the computer systems and servers are “temporarily down” during the process of housekeeping. Similarly too, during the treatment, the different systems of the body are functioning at their minimal level to prevent complete shut-off and to enable greater and more effective cleansing. If at this time, the body is lightly abused or the mind briefly traumatised, this would directly and immediately affect the treatment, and can create complications – hence it is important to ensure that one gets total physical and mental rest during the treatment and for a certain duration after the treatment. After the treatment is over, one should slowly build up one’s strength and functioning capacity through a very strict diet and lifestyle, and thus return to full functioning over a period of three months or as advised by the physician.