Prof. Dr. Shivenarain Gupta (IND)

• Where does Ayurveda stand today, in Europe and worldwide?
• What can we learn from the past?
• And what does holistic health look like in the future?

In the face of the long tradition of Ayurveda appear 30 years as a short section. But has the Ayurveda in this time made a big step towards Europe, not least due to the symposium and the pioneering spirit of Kerstin and Mark Rosenberg, who founded the European Academy of Ayurveda in 1993.

The project "Ayurveda in Germany" has started with much vigor and important milestones have been reached, thanks to the tireless energy of all the participants. In this session, dear companions, supporters and friends of the Academy chat about anecdotes from 30 years and dare to look ahead to the next 3 decades.

 

Learn and discuss with famous Vaidyas of traditional Ayurveda!

In the tradition of Ayurveda, personal instruction within a trusting teacher-student relationship is highly valued to impart deep knowledge and enhance the personal development of the aspiring physician or therapist.

Following this ancient Gurukula tradition, we have invited outstanding teachers to meet with our students and alumni to share their knowledge analogous to this ancient approach. The professors and medical practitioners will share their special perspective and experience on a topic and delve into the therapeutic intricacies and philosophical dimension of Ayurveda.

The Gurukul is free of charge and exclusive for alumni and students of the European Academy of Ayurveda.

- Exclusive and free of charge for all graduates and current participants of the medicine trainings at the European Academy for Ayurveda and the Heilpraktikerschule Lucerne -

You are an essential part of the REAA family. With this in mind, we would very much like to strengthen our bond and are hosting this meeting. After you complete your training with us, you will be actively involved in the field. We believe that you have some exciting success stories to tell. We would be happy to in our big academic family at share.

The alumni reunion is also a unique opportunity, Questions from your daily Ayurveda practice to clarify with a real capacity. In this session, Prof. Dr. S.N. Gupta will address special patient cases that you bring to the Alumni Meeting. Active participation is strongly encouraged! Get fresh inspiration for your work with Ayurveda and Gain confidence in diagnosis and treatment.

And of course, the alumni meeting is the ideal platform to to meet colleagues from the study time again and to make new contacts. Look forward to meeting, exchanging and taking another step on your path with Ayurveda - of course in a relaxed, friendly and cheerful atmosphere.

There are several diseases equally or more dangerous than cancers but not seeking much attention. Chronic kidney disease is one of them. Chronic kidney disease (CKD) is emerged as one of the most prominent causes of death (Csaba P. Kovesdy- Epidemiology of chronic kidney disease: an update 2022-Kidney Int Suppl (2011). 2022 Apr; 12(1): 7–11. Published online 2022 Mar 18- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9073222/ ).

Its worldwide ranking among diseases causing death was 27th in 1990 which was raised to 18th in 2010 and at 12th in 2017. With this 41% growth it is estimated that in 2040 it will be at 5th rank. Besides this frightening fact the management of this problem is only renal replacement therapy which is highly expensive and much beyond the reach of a common men. Even in developed countries the management of chronic kidney disease in not convenient. Ayurveda can offer a big support to the patients of this problem in following manner:
- Reduction in the frequency of dialysis
- Postponement of need of RRT
- Normal survival without RRT

Management includes stress free behavior, wholesome and nourishing food according to Ayurvedic rules of dietetics, rasāyana acting specifically on mūtravaha srotas . The results show significant improvement in life quality and biochemical parameters in the patients of CKD in long term treatments even better than conventional treatments in non-dialysis patients. In dialysis dependent patients also either dialysis could be stopped without a deterioration in condition or frequency of dialysis is reduced significantly.

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Science is systematic study of the nature and behavior of the material and physical universe, based on observation, experiment, and measurement, and the formulation of laws to explain these facts in general terms. Science is outcome of human quest about facts related to the existence and to discover the means to make life comfortable and happy. It evolves in every epoch according to needs, socio-cultural influences, academic atmosphere, economic and political culture etc.

As often commonly believed science is not a modern word and did not begin couple of centuries back. In fact, it started with the origin of life itself particularly the human beings. Because of amazing developments of science and technology we do not think about human intelligence which discovered agriculture, textile, means of transportation, weapons, cooking technique, housing and so on. These all discovered before the era of modern science. Surprisingly several of these ancient methods are still in practice. Besides the means to make life comfortable, ancient thinkers throughout the globe also took interest in explaining the happening in their immediate and distant surroundings including their own interiors. These thinkers are named as philosophers and their thoughts as philosophy. These thoughts were extraction of huge experience of the truth which was not observed merely by ordinary perceptive faculties but also with extraordinary perceptive tools. Therefore, it was not easy to express those observations with limited capacity of languages. As it was need of that time the scientific theories and techniques were described in poetic form that gave an impression of being ‘philosophical’ rather than scientific. This all resulted into a general distinction between ancient knowledge system as philosophy and modern system as science. A truth which could not be explained with ordinary logics and could not ordinarily be demonstrated was philosophy and opposite to this a fact which could be explained with ordinary logics and could be demonstrated in ordinary circumstances was science. Ayurveda is an ancient science which has mystic attributes of philosophy and explainable reproducibility of science.

Mystic descriptions of cyclic manifestation and unmanifestation of universe is an important theory in Ayurveda. If one thinks upon it deeply may find that the fact of interchangeability of matter and energy which was established by Albert Einstein in modern era, was hidden in this theory. There are several such concepts which are credited to modern science are hidden in the concepts of Ayurveda. The theory of blood circulation is credited to William Harvey (1628). However, brief poetic aphorisms from Ayurvedic texts explain it logically mentioning it as rasa-circulation. Caraka Saṃhitā gives brief account of genetics and genetic diseases using terms as bīja, bījabhāga, bījabhāgāvayava and bījadoṣa. Behind the three words of prāṇa, agni and apāna in description of pathogenesis of jalodara(ascites), the concept of disturbed cellular transportation and cellular metabolism is hidden. In same verse the terms sveda and aṃbu explain the disturbance of fluid and electrolytes in the disease. The concept of dhātupariṇāma beautifully indicates possibility of modern stem cell therapy. The concept of three roga mārga is very close to concept of three germ layers in embryology. Surprisingly the organs which are developed from these layers are very similar to the organs related to the roga mārgas. There are several concepts and descriptions which if explored deeply, one may find the scientific concepts hidden inside the poetic and aphorismic beauty of ancient Ayurvedic texts. These concepts if understood rightly helpful in diagnosis, prognosis and treatment of diseases.

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In last years until end of 2019, attention was paid more to non-communicable diseases, especially in relation to their management of Ayurveda. Communicable diseases were not an important issue. It was believed that Ayurveda is useful in non-communicable diseases but not in communicable diseases. Now suddenly paradigm is shifted to communicable diseases and immunity. People are concerned about immunity because Present pandemic has put the question mark on antimicrobial approach for which we have been proud of. Ayurvedic approach is not microbe oriented, for the prevention and treatment of infectious diseases. This is person oriented. In Ayurveda immunity is not limited to infections and neoplasia but a defense against all diseases. To understand the defense system, we may take example of defense system of a castle, which includes strong wall, watch guards at entry points and patrolling soldiers inside. Similar to that we have defense system in our body in which outer most barrier is our skin and mucous membrane, inner to that macrophages and complements etc. and the innermost level of antibodies and cellular defense.

In Ayurveda the equivalent word for immunity is vyadhiksamatva which is an outcome of strong bala which again is based on normal status of body components most particularly kapha, rasa and ojas. Science is emphasizing much on microbe related immunity which is now questioned. While in Ayurveda it is generalized and based on strengthening the barriers at every level. Moreover, Ayurveda considers immunity at different levels viz. universal level, social or familial level and personal level. To attain immunity there is no instant method. The measures consist of pro-nature behavior, planned progeny, wholesome daily routines (including food according to rules), seasonal regimen, periodic cleansing and rasayana.

Nutritional, pathogenic and therapeutic significance of amlarasa with particular emphasis on amlapitta as a clinical manifestation of it

Rasa (gustatory perception, or gustation) which is generally known as taste is the sensory perception of substances on the tongue and is one of the five senses. Modern science generally considers four basic tastes that are perceived by the taste buds such as sweetness, sourness, saltiness and bitterness. However, Ayurveda considers two more i.e. pungency and astringency. In fact, rasa is not mere a taste, but it is a total perception in buccal cavity when a substance is put into the mouth. Ayurveda considers six rasas viz. madhura (sweetness), amla (sourness), lavaṇa (saltiness) kaṭu (pungent) tikta (bitterness) and kaṣāya (astringent).

Amla (sourness) has dominance of prithivī and agni protoelements for its manifestation. This detects acidity. This shows a presence of some acidic components in a substance coming in the contact with tongue. This taste promotes salivary secretion in the mouth and produces a peculiar type of numb feeling on the teeth. Proper consumption of items with amla rasa supports in promoting agni and appetite, regulating vāta, pleases mind and satisfying the senses. However, an improper and excessive consumption may lead to inflammations, provocation of pitta, vitiation of rakta, looseness in the body, interference in wound healing.

As a clinical manifestation this is one of the clinical features of pitta provocation in the form of sour eructation. Amlapitta is a disease entity in which sour-bitter eructation is a presenting feature. This is mentioned first in carakasamhitā as a clinical consequence of āmaviṣa, produced due to indigestion and its association with pitta. However, later in mādhavanidāna this is described as a result of transformation of pitta due to pitta-provoking factors, in to vidagdha pitta (amla -pitta) which is sour in taste. Later bhāvaprakāśa had elaborated this further. It describes two clinical forms: adhoga and ūrdhvaga on the basis of primary descriptions of mādhavanidāna and madhukoṣa commentary on it. It also describes treatments in detail. In this way grossly the occurrence of amla -pitta would be in two forms. The treatment is to be planned according to that.

 

 

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Pañcakarma - psychic status of patients during various phases of pañcakarma
Prof. Dr S.N. Gupta
Pañcakarma is a group of therapies meant for radical expulsion of harmful accumulations from the body those are not eliminated through routine excretory procedures. In this way, these therapies bring the body's environment to normal. Being delicate procedures they require special care and attentiveness at every level. They do not clean the body's atmosphere only but also influence at mental level as mind has to operate through body. The body is in highly turbulent state during all phases of pañcakarma. This is like cleaning a glass bottle by shaking vigorously after pouring a cleansing liquid in to it. Because of turbulence in body's milieu, mind is also in a shaky state. Therefore, patient needs a good support not only physically but mentally at every level. Then it may result into wonderful outcomes. Therefore, Ayurveda advices to take care of a patient like a tender egg, bowl brimful of oil or like a cowherd carrying a stick manages the cows (Ca.si.12/5)
Patients usually have some misunderstandings and confusions about pañcakarma procedures. They often compare them with some spa type of treatments. Therefore, when they encounter real pañcakarma, this is difficult for them to accept it easily and immediately. Moreover, they are not familiar with such situations. Patients have a common belief that Ayurvedic treatment consists of only pañcakarma, though it is not necessary to perform these procedures in every condition. In several conditions pañcakarma, especially the oleation is contraindicated. When the image about pañcakarma created by them is shattered they develop confusion, uncertainty and anxiety.

When it comes to internal oleation therapy, they develop anxiety because of their early information though unrealistic, about harms of the fatty substances especially ghee. Body's milieu is turbulent during the pūrvakarma. Doṣas are agitated and set to come out. It also influences the mental status of the patient which may give rise to certain emotional outbursts. When we think about mental reaction during pañcakarma (in which gut is the major operating organ), we have to keep in mind also the theory of gut-mind relation. These emotional reactions are observed when patient is alone in the room are while getting abhyaṅga etc.

Anxieties are observed during pradhānakarma also. Emotional outbursts have been observed sometimes during vamana. During virecana, frequency of stools may cause anxiety even though there is no dehydration. Forceful expulsion of colonic contents and straining during nirūha may sometimes cause vasovagal attack resulting into momentary fainting. This may also generate anxiety related to basti. During paścātkarma patient is weakened bodily which also influence his mental status. He has to observe absolute rest. He gets enough time to contemplate. This free contemplation is beneficial for the patient to see the mental problems clearly. However, if a proper support is not provided, he may be dragged in to anxiety and negative thinking.

Ojas - myths and facts with practical understanding about management of its disorders
Prof. Dr S.N. Gupta
As usually happens in samskrita language, the word Ojas has several meanings which results into its interpretations in different ways in different disciplines. Often these are mixed up with Ayurvedic concepts and put it into the category of some mystic entity. In Ayurveda it is clearly a material form which may be a substance or a cellular structure. This is again not a single substance. It is a term used for several entities possessing similar properties and functions.

In Ayurvedic field ojas, rasa, kapha and balam are sometimes used as synonyms as they are similar in functions and are supportive as well as responsible to each other. (Su.Su. 15/23-26,A.Hṛ.Su.11/8,Ca.Su.17/117,Ca.Ni.4/7, Dalhaṇa on Su.Su.15/19)

Ojas is described as a substance or structure with reddish pale color and guru, snigdha, picchila, śīta, madhura, mṛdu, ślakṣṇa, sthira, sāndra and prasanna properties. (Ca. Ci.24/31) This is responsible for immunity, vitality of the dhātus, body strength, mental strength, confidence, fearlessness, potence, tolerance, pleasure and brilliance.

There are two forms of ojas- param and aparam. (Cakrapāṇī commentary on ca.su.30/6-7)
Param ojas is most precious and inherited in the child from the mother, while apram is a final product of dhātupariṇāma. The amount of former is about half an Anjali while of the later is about eigth drops. Loss of former is fatal in consequences while of latter causes proneness for serious illnesses both physical as well as mental.

If we interpret the available classical descriptions about ojas, we may find that it may be substance essential for the cell membrane, substance essential for the health of heart, immune cells and the substances, and cells or substance promoting cell-reproduction and repair. Glycerophospholipids and coenzymes Q10 are also worth attention seeking substances in this context.

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Head, Post Graduate Department of Kāyacikitsā
J. S. Ayurveda college & P.D. Patel Ayurveda Hospital, Nadiad, India
Head, Academic advisory board,
European Academy of Ayurveda, Germany

Cikitsā followed by a proper rogaparīkṣā which again based on a proper rogīparīkṣā is a recommended approach in Ayurveda. (ca.su.20/20; ca.su.10/21). Ayurveda duly emphasizes the consideration of deśa and kāla in every segment of clinical practice. Ayurveda is śāśvata and sārvabhauma (having all time and everywhere applicability) science. To experience these attributes one has to understand and apply the principles of Ayurveda in relation to deśa and kāla. Surprisingly in Ayurveda deśa denotes both patient as well as his land (his immediate and remote surroundings) and both are interrelated. This concept is described in detail in Ayurveda (Ca.vi.8/92-93) Success of cikitsā lies in knowledge about all the aspects of patient and his surroundings. Human-behavior is always influenced by his beliefs and that again are influenced by sociocultural environments. This is applicable also for patients, especially regarding their (mis)beliefs, understanding, approach towards their disease, its treatment, and their surroundings. If a clinician is not aware about the contribution of these factors in the disease process, he may be misled and cannot successfully treat a patient. In this presentation an attempt is made to analyse these factors which is not based on scientific research, but on a 25 years' observation on patients and health care providers and the information gathered from the students.

There are some false beliefs due to cultural influences always prevalent in every society and they affect the patient's mind set. For example, in India Dhāt syndrome is a quite prevalent problem which is basically related to some sex-taboos.

In Europe certain clinical conditions are observed which are believed by a patient without any evidence. Teeth-amalagam, intestinal fungus, liver problems and food intolerances are some presenting issues which do not often show any evidence but confuse a clinician in making a proper diagnosis. It does not mean that a patient may not suffer with such problems. A clinician has to ascertain after proper examination. There are some misconceptions about Ayurveda itself. A common belief that Ayurvedic treatments are unexceptionally safe or Ayurveda can cure any disease.
There are also certain common observed dispositions which may be named as Atlas syndrome, Space syndrome and world-managership syndrome. These dispositions of individuals towards surrounding, contribute in some of their psychic or psychosomatic issues. It is vital for a clinician to know all these facts before proceeding for a diagnosis as well as treatment of a patient.
jñānabuddhi pradīpena yo nāviśati tattavavit āturasyāntarātmānam sa na rogānścikitsati (Ca. Vi. IV.12)
(Even a knowledgeable physician if does not enter into the inner-soul of the patient by virtue of the light of his knowledge he will not be able to treat the disease)