Chikitsa: Disease Management
By Michael Dick, Ayurvedic Practitioner Ayurvedic Practitioner
There are four main classifications of management of disease in Ayurveda: shodan, or cleansing; shaman or palliation; rasayana, or rejuvenation; and satvajaya, or mental hygiene. Along with medicine, proper diet, exercise and lifestyle is advised. This is very important, If we are taking a medicine to remove the root cause and at the same time we are eating food which may increase the cause of disease, then we will not get well and will get less relief. In Sanskrit the daily routine is called the Dinacharya. Ayurveda recommends that in order to be optimally healthy we should tune our bodies to the nature’s master cycle, which in turn regulates the various other rhythms. Everyday two cycles of change pass through us, each bringing a Vata, Pitta, or Kapha predominance. The approximate times of these cycles are as follows: First cycle: 6 A.M. to 10 A.M. - Kapha 10 A.M. to 2 P.M. - Pitta 2 P.M. to 6 P.M. - Vata Second cycle: 6 P.M. to 10 P.M. - Kapha 10 P.M. to 2 A.M. - Pitta 2 A.M to 6 A.M. - Vata Considering the above cycles the ideal schedule should be like this : MORNING: Time to wake up: A healthy person should get up two hours before sunrise. During this hour the Vata element is dominant. Waking up two hours before dawn you utilize the Vata qualities in the nature. Vata is light, subtle and clear and this helps in tuning the body to the delicate messages the nature sends. This is the time when there is the most sattva in the air. It is the most fresh and pure time of the day. Some exceptions to this rule of rising early are the very young, the old, parents with small children, and people with fevers or diarrhea. Elimination: Drinking a glass or two of warm water helps in the elimination. As soon as possible empty your colon and bladder. If you wait until later in the morning or during the day you are slowly poisoning yourself and creating an opportunity for chronic conditions to arise. Cleaning of Senses: Wash the eyes with water. Preferably use rose water and Triphala to purify the sight. Brush the teeth and scrape the tongue with a tongue cleaner to purify your mouth and sense of taste. Ayurveda considers the coating of the tongue as an indicator of 'Ama' or toxins in the colon. Gargle with warm water or herbal tea to purify your voice and strengthen your teeth. Finally do Jal neti and put a little medicated oil in your nose (nasya) to purify the sinuses and your sense of smell. The traditional Dinacharya also recommends that you inhale the smoke of medicinal herbs every morning to purify the mind, head, face, neck and lungs. Massage: Abhyanga is the name for oil massage with sesame oil. This is typically a self-massage. It is one of the main ways that Ayurveda keeps us strong and prevents us from aging. This massage need not be long and cumbersome. Massaging the scalp, forehead, temples, hand and feet for about 5 minutes is sufficient. Exercise: Vyayama is the name for physical exercise. This is usually some Yoga postures and breathing exercises (Pranayam) but it can be anything including a walk, a swim, sun salutes or whatever. This early morning exercise removes stagnation in the body mind, strengthens the digestive fire, reduces fat and gives you an overall feeling of lightness and Joy as it fills your body with good Prana. It is not to be strenuous. In fact, exercising at one fourth to one half of your capacity is recommended. Bath: After exercise useful to bath and remove any excess oil and dirt. Both showers and bathtubs are recommended in the classics. Usually warm water baths are suggested. Put on clean clothing after the bath. Meditation: For a few minutes to an hour sit down and see who you really are, put your attention towards Awareness. This is the most important aspect of Dinacharya. Simply be quiet, sit in Peace. NOON: Lunch: It should be taken early between 12 and 1 P.M. this coincides with the peak Pitta period, Pitta is responsible for the digestion. Ayurveda recommends that the lunch should be the largest meal of the day. After the meal it is good to take a little walk, a couple hundred steps only, to help the food digest. Siesta: Anything more than a short nap should be avoided because sleeping in the day is prohibited in Ayurveda. Study / Work: Do what you do from now until supper. SUNDOWN: Sundown is a special time of balance between day and night. In this balance it is easier for your mind to stop long enough so that you can see your Self. This is the time for evening prayers and meditations in many cultures around the world. DINNER: It should be taken around 7 P.M. It should be lighter than the lunch. The dinner should be at least three hours before bedtime as gives the body ample time to digest the food. Sleeping just after the dinner with a heavy stomach is not conducive to a sound sleep. Walk to aid digestion for about 10–15 minutes. Ease: From dinner to bedtime just take it easy. Spend time with family, read, and relax. BEDTIME: Go to sleep around 10 P.M. so that you can get 6 to 7 hours of sleep before 4:30 am. A good practice is to massage the soles of your feet with a calming oil before going to bed. This will calm your system and promote well-being. And remember to take your Triphala before sleep. One should try to keep the routine as close to the recommended Dinacharya as possible. The body might resist the change for a first few days but if you do manage to persist then you will be rewarded with a much healthier and satisfying life. Samprapti: Pathogenesis Samprapti is the progress of pathology, from the earliest stages of imbalance to the full expression of a particular disease. The study of samprapti includes types of samprapti, stages of samprapti, sanchaya, (accumulation of aggravating factors), prakopa (provocation of imbalance), prasara (spread of aggravating factors), sthana samsraya (deposition and localization of pathology), vyakti (manifestation of disease), bheda (differentiation, full expression of disease symptomlogy), dosha gati (direction, movement and characteristics of pre-pathology) and vyadhi marga (pathways of disease).