1. Therapeutic Principles of Ayurveda
N.SRIKANTH
ASSISTANT DIRECTOR
CENTRAL COUNCIL FOR RESEARCH IN AYURVEDIC SCIENCES
Department of AYUSH
Ministry of Health & Family Welfare
Government of India

2. Background
Ayurveda, the science of life is one of the ancient and comprehensive systems of health care.
Quest for good health and long life is probably as old as human existence.
According to Indian philosophy, health is prerequisite to pursue materialistic, social and spiritual upliftment of human being.

3. Strength of Ayurveda
The strength of Ayurveda lies in its three fold holistic approach of
prevention of disease
promotion of health
cure of disease
This is achieved through care of
body
mind
soul
where physical, mental and spiritual aspects of health are considered.

4. Background

5. Principles of Ayurveda therapeutics
Comprehensive definition of health
Acceptance by the community
Emphasis on promotion of Health and Prevention of Diseases
Importance of diet and lifestyle
Holistic Concept of Health
Individualized Approach
Universal Approach
Stress on Public health and Eugenics
Use of natural products

6. Comprehensive definition of health & Disease
Ayurveda defines health as a state of equilibrium of
dosha (regulatory and functional entities of the body)
dhatu (structural entities)
mala (excretory entities)
agni (digestive and metabolic factors)
and healthy state of sensory and motor organs and mind with their harmonious relationship with the soul

7. Comprehensive definition of health & Disease
The diseased state is defined in Ayurveda as a loss of equilibrium of essential body constituents.
The objective of disease management is to bring back the equilibrium, principally through lifestyle management rather than through curative therapies.

8. Acceptance by the community
About 80-90% of population in India is reported to use Ayurveda and other traditional systems of medicine to meet their health care needs.
Safety of this system is attributed to time-tested use substantiated by scientific evidences.
Besides, synergy of ingredients in conjunction with individual need based treatment plan forms the basis of efficacy and safety of Ayurvedic formulations.

9. Use of Traditional Medicine
CHINA
40%
CHILE
71%
COLUMBIA
INDIA
80-90 %
AUSTRALIA
48%
BELGIUM
70%
CANADA
FRANCE
49%
USA
42% UK
NORTH IRELAND
90%
WHO traditional medicine strategy Document WHO/EDM/TRM/2002.

10. Study on Role of AYUSH and Local Health Traditions Under National Rural Health Mission(NRHM)*
18 states across India
Implications of the NRHM strategy of mainstreaming AYUSH’ in terms
Coverage
Quality of services
Demand of services
Validation of Local Health Traditions (LHTs)
Outcome
80-90% house holds aware about utility of AYUSH/LHTs
Co-located services are Well utilized in some states
Utility ; 1. Chronic illness 2. acute illness 3. Health promotion
70% Allopathic doctors viewed AUYSH is not rudimentary
*Status and Role of AYUSH and Local Health Traditions Under National Rural Health Mission- Report of a Study;National Health Systems Resource Centre, Ministry of Health & Family Welfare Government of India New Delhi; 2010

11. Emphasis on promotion of Health and Prevention of Diseases
Ayurveda lays great emphasis on preservation and promotion of health and preventing the occurrence of diseases.
The treatment modalities of Ayurveda are based on the inherent ability of the living body to rejuvenate, regenerate and restore the natural equilibrium. While treating the patient, Ayurvedic treatment helps to enhance the natural healing process in the body.

12. Importance of diet and lifestyle
The ultimate aim of this medical science is preservation of health and it can be attained in two ways, i.e observation of lifestyle recommendations to prevent the diseases and eradication of already afflicted diseases.
The prerequisites to attain the prevention include wholesome diet, conservation of environment, congenial social and cultural atmosphere. Diet is an essential factor for the maintenance of health.

13. Importance of diet and lifestyle
Ayurveda emphasizes on diversified aspects of dietetics and nutrition viz. quality, quantity, processing methods, rationale of combination of food articles, emotional aspects, nature of the consumer, geographical and environmental conditions etc.
Advocacy of proper diet and life style, which is congenial to the individual maintains normal body functions thus prevents the diseases.

14. Holistic Concept of Health
Ayurveda considers a living being as a combination of body, mind and soul.
All health management approaches are intended to maintain the harmony and homeostasis of these entities.
Ayurveda employs holistic and personalized approach to health.
The holistic, integrative and systems approach of Ayurveda involving body, mind, and soul is a pivotal attribute.
Taking the human being as a whole, the Ayurvedic preventive and therapeutic approaches aim at homoeostasis of this integrated milieu.

15. Individualized Approach
Ayurveda considers that each individual has distinct psycho-somatic constitution(prakriti) and health status.
Diverse approaches of clinical examination and diagnosis viz.
prakriti
Agni
srotas
shatkriyakala etc.
form determinants of individual specific precise tailor-made treatment plan.

16. Individualized Approach
The systems approach embodied with Ayurveda concepts such as
disease process, diagnosis
principles of drug action
processes, dosage forms
diet, therapeutics
personalized approach towards lifestyle advocacy, disease management
are highly appreciated since antiquity which are now the evolving concepts of pharmaco-epidemiology, pharmaco-genomics of modern medical science

17. Universal Approach
According to Ayurveda, the individual (microcosm) is a miniature replica of the universe (macrocosm).
Every aspect of the universe is represented in the individual.
Any change in the environment affects human being.
Therefore, emphasis is laid on social and environmental factors which are interlinked with health.

18. Stress on Public health and Eugenics
The activities of the individual through his thought, word and deed have their good or bad effects on the environment.
Ayurveda emphasizes upon healthy body, sound mind, benevolent speech and spiritual practices to create a healthy and happy environment.
The pivotal role of eugenics mentioned in Ayurveda is to produce strong, healthy and ideal progeny.

19. Use of natural products
Ayurvedic products are derived mainly from plants and other natural resources.
Supportive leads are emerging from revalidation of Ayurvedic drugs.
Identification of active principles of some plants has led to discovery of many allopathic drugs.
Some pharmacologically proven constituents of the Ayurvedic plants like Aloe vera, Curcuma longa, Withania somnifera, Bacopa monnieri etc. are used globally.

20. Reverence And Strength
Considering health of an individual as dynamic integration of environment, body, mind and spirit, Ayurveda lays great emphasis on preservation and promotion of health and preventing the occurrence of disease
Besides, it advocates employing holistic approach to understand all aspects of human life including diagnosis and management of diseases.
Ayurveda attributes primary importance to preventive medicine and the maintenance of positive health.

21. Reverence And Strength
The major preventive approaches for maintaining and improving the quality of life include individualized specific
daily regimen (Dinacharya)
seasonal regimen (Ritucharya)
behavioral and ethical considerations (Sadvritta).
Healthy lifestyle is emphasized as the determinant of longevity of life, which by and large depends on the Prakriti (bio-identity i.e. body-mind constitution) of an individual.

22. Therapeutic Streams
Proper understanding of Prakriti leads the physician in making right diagnosis, prognosis and treatment plan and in guiding patients as well as disease-free individuals what dos and don’ts they need to follow for restoration and maintenance of health.
The therapeutic streams advocated in Ayurveda comprise
-Daivavyapasraya chikitsa (Spiritual measures)
-Yuktivyapasraya chikitsa (Pharmacological therapies)
-Satvavajaya (Non-pharmacological Psychotherapies)
The treatment plan is worked out on the basis of underlying morbidity keeping in mind the strength of the disease and the tolerability of the patient.

23. IDEAL DRUG/THERAPY
An ideal drug or therapy should cure the disease alone, but not to create any adverse/toxic effects and must restore the homeostatis of somatic/psychic environment of human body
Safety of a drug also depends upon its dosage.
Dose of a drug plays a pivotal role in clinical practice as Ayurveda says
“Poison in proper dose acts a wonder drug while an effective drug in higher dose acts as Poison ”.

24. Four-pronged treatment plan
Avoidance of causative and precipitating factors of disease (Nidan parivarjan )
Bio-purification (samshodhan)
Use of palliative remedies (samshamana)
Health-promoting regimen (pathya Vyavastha)
is the hall mark of Ayurvedic therapeutics recommended for physicians to prescribe.
Specific diet and lifestyle guidelines are always prescribed along with the drugs and therapies so as to facilitate restoration of bio-humoral balance and health status.

25. Essentials of therapeutics

26. Three pillars

27. Preventive Approaches

28. Three principles of Therapeutics

29. Concept of Pathya – Advocacy on Lifestyle and Diet in Health and Disease29
“Pathyae sathi gadartasya kimoushada savenam----
----Pathye aasathi gadartasya kimoushada savenam”
- Pathyapathyavinichaya

32. Anupana Anupana is usually
water
honey
ghee
jaggery,
milk
butter milk
and herbal decoction
which is given along with main drug to help in absorption and drug delivery to the target organ in the body.

33. Pharmaceutics
Bheshaja kala exemplifies the administration of medicines with regard to specific time and frequency in the management of disease.
It decides the extent and rate of its digestion, absorption, biotransformation and excretion.

34. Selection of Therapies
The type of therapy to be administered to the patient is planned out on the basis of stage of disease and state of patient which are ascertained by using manifold methods of examination.
The due importance is given for a thorough clinical examination and proper understanding of the disease before planning for a treatment.
Different principles like shatkriyakala, nidana panchaka are employed for this purpose

35. Specialized Therapeutic Procedures
Ayurveda advocates preventive and curative therapies along with specialized techniques of
panchakarma (purification)
rasayana (rejuvenation)
Various scientific studies and clinical experiences have validated the efficacy and acceptability of these procedures.

36. Unique Approach
Panchakarma is essentially applicable in a wide range of preventive, curative and promotive conditions.
These therapies are advocated even in a healthy person to combat seasonal imbalance of dosha.
Ayurveda quotes that the disorders treated with this mode of therapy do not recur while those treated with palliative methods do have ample chances of recurrence.

37. Panchakarma
Panchakarma literally means "five types of bio- cleansing therapies".
These five therapies of eliminating toxins from the body are
vamana (therapeutic induction of vomiting)
virechana (therapeutic induction of purgation)
shirovirechana/nasya (nasal instillations)
niruha basti (therapeutic enema predominantly with medicated decoctions)
anuvasana basti (therapeutic enema with medicated oils)

38. Therapeutic Indications
Vamana for diseases of Kapha
Virechana for diseases of pitta
Basti for diseases of vata.

39. Principles of panchakarma
Classically panchakarma therapy is prescribed and practiced through following schedule viz.
(1) purva karma (preparatory procedures)
These measures are preceded by
snehana (internal or external administration of medicated oils or fats)
swedana (induction of sweating)
(2) pradhana karma (main procedures)
(3) pashchat karma (post procedure measures)
followed by samsarjana karma (restorative regimen after panchakarma).

40. Some Allied panchakarma procedures
Abhyanga
Sarvanga Dhara or Pizhichil
Shirodhara
Nadi Sweda
Patra Pinda Sweda
Kati Basti 
Uttara Basti
Shashtika Shali Pinda sweda

41. Safety of Panchakarma
When employed skillfully and appropriately, Panchakarma procedures are safe and effective for the prevention and management of a number of health problems.
The scientific evidence on clinical safety and efficacy of Panchakarma was re-validated through a number of clinical studies by adopting the classical Ayurvedic notations and contemporary clinical, bio-chemical and pathological parameters.
These parameters have shown substantial evidences towards regresssion of many chronic disease.

42. Rasayana
We are aware of known and new diseases of body and mind fast spreading and threatening comfort, peace and welfare of life on earth
Attributable to modern scientific technological advances disturbing universal laws of nature

43. Current day Needs

44. Current day Needs
These factors can be successfully tackled with the unique strength of Ayurveda ie.Rasayana.
Rasayana Tantra provides number of herbs having diversified actions on human body

45. Concept of Rasayana Health promotion and Disease management

46. The Holistic Rasayana Effect

47. Benefits of Rasayana Approach
Optimum strength of body
and senses.
   Utterance that always gets
Fulfilled/Confidence
   The reverence of people
  Body-glow
Longevity
    Heightened memory and
intelligence
  Freedom from disease
    Youth
Excellence of luster
   Excellence of Complexion
and voice
all these can be obtained by the use of Rasayanas

48. Approach A. As Per Scope of Use 1. Kamya Rasayana (Health Promoting)
a. Prana Kamya for Vitality and Longevity
b. Medha Kamya for Mental Competence
c. Sri Kamya for Lusture and Complexion
2.Naimittika Rasayana (Disease specific)
B. As Per Method of Use
1.Vatatapika (Outdoor Regimen)
2.Kutipravesika (Intensive Indoor Regimen)
C. As Per Contents
1.Ausadhi Rasayana (Drug Rasayana)
2.Ajasrika Rasayana (Dietary Rasayana)
3.Acara Rasayana (Lifestyle Rasayana)

49. Indication of specific Rasayana
Decades
Years
Losses (Sarangdhara)
First
0-10
Balya (Boyishness)
Second
11-20
Vriddhi (Growth)
Third
21-30
Chhabi (Beauty)
Fourth
31-40
Medha (Intellect)
Fifth
41-50
Twaca (Skin)
Sixth
51-60
Drsti (Vision)
Seven
61-70
Sukra (Sexual Ability)
Eighth
71-80
Vikram (Strength)
Ninth
81-90
Buddhi (Wisdom)
Tenth
91-100
Karmendriya (Locomotor Activity)

51. The concept of Prakriti/ Mizaz: Bio identity/ Psycho somatic constitution
The individuals of each prakriti are prone to certain specific disorders.
Every individual has differing proportions of each dosha which accounts for differences in preferences, aversions, behavioral patterns and emotional predilections.
The proportions of the three doshas present in any individual will determine his or her essential constitutions or prakriti.

52. Vata/ Vazhi Prakriti Pitta/ Azhal Prakriti Kapha/ Iyyam Prakriti
Tall and lean
Medium build
Good physique, stout
Fickle mind
Intelligent and impatient
Steady, matured mind
Very talkative
Intelligent
Rather silent
Dry body, little sweating
Excessive sweating
Oily body / hair
Less hair
Early baldness
Hairy
Irregular appetite/ thirst
Excessive appetite
and thirst
Normal appetite and thirst
Constipative tendency
Quick motion
Normal steady evacuations
Skin of earthy colour
Pinkish skin
Fond of travelling
Brave and ambitious
Fond of hot oily dishes
Dislike hot and oily foods
Not so fond of hot and oily dishes
Irregular sleep
Average sleep
Deep sleep
Dreams of storms in the sky etc.
Dreams of fires and flames
Dreams of earth and water

53. Health seekers code

54. A Way Forward Evidence base of Ayurveda can offer for global health
Credible Therapeutic Modalities
Panchakarma a bio-cleansing regimen
Ksharsutra a Minimal invasive para -surgical measure for management of fistula-in-ano and piles
Rasayana. specialized health promotive & rejuvenative approach for geriatric health care

55. A Way Forward Evidence base of Ayurveda can offer for global health
These modalities
Stand alone
As add on therapies
are proven to have an edge over conventional medical approach in dealing with Chronic and refractory disease conditions sharing huge Global burden
Cancer, Rheumatoid arthritis and Allied conditions;
Conditions with an allergic component in their etiology (e.g. bronchial asthma, skin allergies, eczema, psoriasis etc.);

56. A Way Forward Evidence base of Ayurveda can offer for global health
Liver disorders; Obesity, Hyper lipidaemia and Atherosclerosis; Diabetes mellitus;
Ischemic Heart Disease; Squeal of Cerebro-vascular disorders like Hemiplegia and Paraplegia;
Epilepsy; Mental disorders including psychosis, anxiety neurosis, stress disorders

57. Thank You