Gurukula Blog

Thyroid Disorders

2013-02-01T21:18:42Z

by Alakananda Devi (Alakananda Ma), M.B., B.S. (Lond.)

An overview of thyroid diseases
The thyroid is an endocrine gland situated in the neck at the level of the cricoid cartilage at the base of the larynx and extending from the level of the fifth cervical vertebra down to the first thoracic. It is butterfly shaped with 2 elongated lateral lobes with superior and inferior poles connected by a median isthmus. The gland contains two hormones, L-thyroxine (tetraiodothyronine, T4) and L-triiodothyronine (T3). Affecting between one and two percent of the population worldwide, thyroid disease is among the most common endocrine disorders. Thyroid disorders and thyroid cancer disproportionately affect women.

]]> Thyroid disorders may at first appear quite simple as they consist either of excess production of T3 and T4 (hyperthyroidism/thyrotoxicosis) or insufficient production (hypothyroidism). Hyperthyroidism is a vata or vata-pitta disorder with symptoms that include fine tremor, weight loss, loose stools, insomnia, anxiety, heat sensitivity and a sensation of being "tired from the neck down." The main diseases that relate to hyperthyroidism are toxic nodular goitre and Grave's disease. Goitre, exophthalmos or bulging eyes and pretibial myxedema (a diffuse, non-pitting oedema and thickening of the skin on the anterior aspect of the lower legs) are characteristic of Grave's disease. Hypothyroidism is a disorder of vata, kapha and medas. Symptoms of hypothyroisism include weight gain, sluggishness, constipation, cold sensitivity and impaired short term memory. Hypothyroid disorders include Hashimoto's thyroiditis, silent thyroiditis and post partum thyroiditis. Hashimoto's is a painless, diffuse enlargement of the thyroid gland which typically occurs in a young or middle-aged woman. In silent (painless) thyroiditis there is an initial thyrotoxic phase, which later swings into hypothyroidism and, finally, a return to euthyroidism. Post-partum throiditis is silent thyroiditis occurring in the first six moths after delivery. This condition affects from 3-8% of all deliveries and disproportionately affects women with insulin dependent diabetes (1, 2). Goitre, or enlarged thyroid, is described in Charak as galagraha, a kapha condition (3).

Auto-immunity and the thyroid
The reason thyroid disorders are not so simple as they at first appear is that all the conditions mentioned above are basically auto-immune. Thus ultimately there is one thyroid disease--auto-immune thyroid disease (AITD)--manifesting in a variety of overlapping syndromes. The same patient can be thyrotoxic at some points in the course of their illness and hypothyroid at other points. AITD is an example of organ-specific auto-immune disease and relates to khavaigunya in the thyroid gland that is genetically based. Hashimoto's thyroiditis and hypothyroidism may occur together with other auto-immune endocrine disorders--Addison's disease, diabetes mellitus, hypogonadism, hypopara-thyroidism, and pernicious anemia. This is described as polyglandular failure syndrome. There is also an increased incidence of auto-immune connective tissue disorders including Sjogren's syndrome, (4) fibromyalgia and rheumatoid arthritis. (5) Grave's disease is associated with increased incidence of other auto-immune conditions including pernicious anemia, vitiligo, alopecia, angioedema, myasthenia gravis and idiopathic thrombocytopenic purpura and, to a lesser extent, systemic lupus erythematosus.

Dignostics and referral
Darshanam or inspection is used to evaluate the thyroid gland by noticing if there is an enlargement in the neck that moves on swallowing. The thyroid gland can then be gently palpated (sparshanam). A palpable mass that moves on swallowing is goitre. Note whether the goitre is soft and diffuse or nodular and irregular. A mass that does not move on swallowing is probably an enlarged cervical lymph node. Examination of the carotid pulse will indicate the presence of vata, pitta or kapha in the thyroid. Basal temperature is crucial in the assessment of thyroid function. If the basal temperature is consistently below 97.8F, there is a hypothyroid condition irrespective of normal blood tests. Basal temperature is determined first thing in the morning before the patient has moved and generated heat. The blood test most frequently done is TSH (thyroid stimulating hormone) a pituitary hormone that is in inverse ratio to thyroid function. Thus an elevated TSH indicates hypothyroidism and a low TSH indicates thyrotoxicosis. Although the standard reference range is 0.4 -5.0 uIU/mL, many endocrinologists accept that subclinical hypothyroidism may occur with numbers in the upper limit of the normal range. Life-threatening complications of thyroid disease include thyroid storms, atrial fibrillation and myxedema (thyroid failure). For this reason, it is wisest for the Ayurvedic practitioner to work alongside an endocrinologist. In particular, nodular goitre must be referred to exclude thyroid cancer.

Thyroid disease in Ayurvedic practice
The thyroid conditions most effectively managed by the Ayurvedic practitioner are subclinical Grave's disease and subclinical hypothyroidism. In addition, all patients with AITD should have the benefit of pancha karma and Ayurvedic diet and herbs to help improve their auto-immune status and preclude further complications such as fibromyalgia. As with all auto-immune conditions, it is essential to eliminate dietary allergens that may be increasing reactivity, gluten and dairy being the most critical. Soy is a goitrogenic food and should be eliminated in patients with goitre.

Subclinical Grave's Disease
A twenty seven year old mother of three with vata prakruti had a previous history of Grave's disease treated with methamezole. When she was pregnant with her second child, she was treated with PTU (Propylthiouracil) as this is safer during pregnancy. During this pregnancy her Grave's disease went into remission at five months. She continued in remission through the course of her third pregnancy, but when she was three months post partum she started getting an 'electrical feeling' which she knew was symptomatic of thyrotoxicosis. Her heart rate remained normal. Tests showed subclinical hyperthyroidism. Note that she shows a perfect example of overlapping syndromes. Given that she had goitre but no exophthalmos or pretibial myxedema, did she really have a recurrence of Grave's disease or had she developed post partum thyroiditis? In any case, her endocrinologist suggested that since her lab tests were subclinical, she "should try a natural approach," so she presented for Ayurvedic treatment.

As always, Ayurvedic management addresses the underlying doshic imbalance (vata and pitta) with dosha pratyanika (combats the dosha) herbs, diet and lifestyle measures. An ideal vyadhi pratyanika (combats the disease) for thyrotoxicosis is Shankhapushpi, which has been found in clinical trials to be more effective than neomercazole, an antithyroid drug (7). There is also some evidence that Tulsi may be of value in hyperthyroidism (8). Kaishore Guggulu is always recommended in auto-immune conditions, as is Amlaki. She was recommended a pitta soothing diet and yoga routine and was asked to take warm milk with Cardamom at bedtime. To pacify vata she did regular self abhyanga with Sesame oil.

It is important to note that Ashwagandha is a thyroid stimulant and is not recommended in hyperthyroid conditions. There have been two documented case reports of thyrotoxicosis following administration of Ashwagandha, one in the author's own practice (publication pending) and one published in the Netherlands (9).

Subclinical Hypothyroidism
Subclinical hypothyroidism is a condition where the patient is symptomatic for hypothyroidism in terms of cold sensitivity, weight gain, constipation, fatigue, headache, muscle aches, hair loss, dry skin, low libido and menstrual irregularities, yet their thyroid tests are within the normal range. Typically, TSH is at the high end of the reference range. They may have a visible goitre. They are suffering from a subclinical form of AITD. These patients often respond well to Ayurvedic management of their condition. Basal temperature can be used as an objective measure of the success of treatment.

A typical thyroid formula includes Punarnava as dosha pratyanika for kapha and good remedy for goitre, Guduchi as an immunomodulator for auto-immunity, Guggulu to improve thyroid hormone production (10) and Chitrak to kindle agni. Trim Support, which contains shilajit, traditionally used to enhance metabolic rate, as well as Punarnava, Chitrak and Guggulu, is a good supplement for subclinical hypothyroidism with weight gain. There is an intimate connection between thyroid and liver function. "The liver has an important role in thyroid hormone metabolism and the level of thyroid hormones is also important to normal hepatic function and bilirubin metabolism... thyroid diseases are frequently associated with liver injuries or biochemical test abnormalities...Liver diseases are also frequently associated with thyroid test abnormalities or dysfunctions." (11) Hence Liver Support is valuable in subclinical thyroiditis, particularly in terms of maximising conversion of T4 to the more highly active T3. (12). Asanas important for hypothyroid disease include sarvangasana and matsyasana. The mantra hrim can be used to strengthen the thyroid gland through opening the throat chakra. Although iodine is an essential nutrient for the production of thyroid hormones, practitioners should hesitate before recommending iodine supplementation or ipodine containing herbs such as bladderwrack or Irish moss. There is a body of evidence suggesting that excess iodine consumption is implicated in Hashimoto's thyroiditis (13) and that iodine restriction can be of benefit (14).

Although all patients with AITD can benefit from complementary Ayurvedic therapies, subclinical conditions can be most effectively managed by the Ayurvedic practitioner with good relief of troublesome symptoms.

Amino N, Tada H, Hidaka Y. Postpartum autoimmune thyroid syndrome: a model of aggravation of autoimmune disease. Thyroid 9: 705-713, 1999.
Weetman AP. Postpartum thyroiditis and insulin-dependent diabetes mellitus: an important association. J Clin Endocrinol Metab 1994;79:7-9.
Charak samhita, sutrasthana, ch xviii vs 22.
Loviselli A, Mathieu A, Pala R, Mariotti S, et al,Development of thyroid disease in patients with primary and secondary Sjogren's syndrome. J Endocrinol Invest 11:653, 1988
Becker KL, Ferguson RH, McConahey WM. The connective-tissue diseases and symptoms associated with Hashimoto's thyroiditis. N Engl J Med 268:277, 1963.
Doerge DR, Sheehan DM Goitrogenic and estrogenic activity of soy isoflavones. Environ Health Perspect. 2002 Jun;110 Suppl 3:349-53
Gupta R. C. et al, Probable modes of action of Shankhapushpi in the management of thyrotoxicosis, Ancient Sci Life, 1,46, 1981.
Sunanda Panda and Anand Karocimumsanctum leaf extract in the regulation of thyroid function in the male mouse Pharmacological Research Volume 38, Issue 2, August 1998, Pages 107-110
van der Hooft CS, Hoekstra A, Winter A, de Smet PA, Stricker BH Thyrotoxicosis following the use of Ashwagandha Ned Tijdschr Geneeskd. 2005 Nov 19;149(47):2637-8
Sunanda Panda, Anand Kar Guggulu (Commiphora mukul) potentially ameliorates hypothyroidism in female mice Phytotherapy Research Volume 19, Issue 1 , Pages 78 - 80 30 Mar 2005
Huang MJ, Liaw YF. Clinical associations between thyroid and liver diseases J Gastroenterol Hepatol. 1995 May-Jun;10(3):344-50.
TJ Visser, E Kaptein, OT Terpstra and EP Krenning Deiodination of thyroid hormone by human liver Journal of Clinical Endocrinology & Metabolism, Vol 67, 17-24,
Noel R. Rose, Raphael Bonita and C. Lynne Burek Iodine: an environmental trigger of thyroiditis Autoimmunity Reviews Volume 1, Issues 1-2, February 2002, Pages 97-103
Yoon SJ, Choi SR, The effect of iodine restriction on thyroid function in patients with hypothyroidism due to Hashimoto's thyroiditis. Yonsei Med J. 2003 Apr 30;44(2):227-

All products mentioned in this article are available from www.banyanbotanicals.com.

Alakananda Devi (Alakananda Ma) is director of Alandi Ayurvedic Clinic in Boulder, Colorado, and principal teacher of Alandi School of Ayurveda, a traditional ayurvedic school and apprenticeship program. She can be reached at 303-786-7437 or by email at: info@alandiashram.org.

Skin Inflammation

2012-12-07T05:20:42Z

by Alakananda Devi (Alakananda Ma), M.B., B.S. (Lond.)

Skin inflammations are quite common conditions, with atopic dermatitis or eczema affecting 10-20% of all children and 1-3% of adults (1) and psoriasis affecting between 2 and 2.6% of the US population. The prevalence of atopic dermatitis has doubled or tripled in industrialized countries during the past three decades. The visible and often disfiguring nature of skin inflammations leads to far greater levels of distress and depression than would be experienced with a more severe but less disfiguring condition. (2) Because a number of patients are suspicious of cortisone creams prescribed for them by their family practitioner or dermatologist, they may frequently present for Ayurvedic care as an alternative.

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. (For a diagram of the seven layers of the skin, click here.) At the same time, the epidermis of the skin, as whole, is seen as an upadhatu of rasa dhatu, and the dermis as part of mamsa dhatu. Skin belongs to bahya marga, the external pathway of disease, and as such is very vulnerable to toxins carried by rasa and rakta dhatus during the 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, see below links.

For a picture of atopic dermatitis on ankles, click here.
For a picture of atopic dermatitis on arms, click here.
For a picture of atopic dermatitis in infancy, click here.
For a picture of atopic dermatitis on palm, click here.

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. (However, in the author's experience, facial eczema is not uncommon in Caucasian women during the dry, windy, cold of the Colorado winter.) 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 Staphylococcus aureus 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.

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 formula such as Blood Cleanse,dietary modifications to address annaja causes and ointments to address infective agents Soothing Skin Balm will act as an excellent pitta emollient as well as anti-infective agent. For psychogenic causes, counselling, stress management, yoga and meditation will be beneficial.

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 Soothing Skin Balm and to take Triphala and an herbal formula containing Guduchi, Turmeric, Neem and Manjista. 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.

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. (For pictures of psoriasis see here. See here plaque psoriasis photo. for psoriaisis photo. Click here for guttate psoriasis photo.

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)

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.

Patient D: 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 Kaishore Guggulu as an anti-inflammatory formulation 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 Neem Oil mixed with Pitta Massage Oil for abhyanga, Amlaki for 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.

Donald Y.M. Leung, Mark Boguniewicz, et al, New insights into atopic dermatitis J. Clin. Invest. 113(5): 651-657 (2004).
Gupta, Gupta (1998) Depression and suicidal ideation in dermatology patients with acne, alopecia areata, atopic dermatitis and psoriasis. British Journal of Dermatology 139 (5)
Sampson HA, McCaskill CC. Food hypersensitivity and atopic dermatitis: evaluation of 113 patients J Pediatr. 1985 Nov;107(5):669-75
James J. Leyden1 , Richard R. Marples1 and Albert M. KligmanStaphylococcus aureus in the lesions of atopic dermatitis British Journal of Dermatology Volume 90 Issue 5 Page 525-525, May 1974
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
Davidson, A, Diamond, B: Autoimmune diseases. N Engl J Med 2001 345: 340-350,
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
Joshi R. Immunopathogenesis of psoriasis. Indian J Dermatol Venereol Leprol [serial online] 2004 [cited 2008 Jun 15];70:10-2

All products mentioned in this article are available from www.banyanbotanicals.com.

Sinus Infections

2012-11-12T07:07:33Z

by Alakananda Devi (Alakananda Ma), M.B., B.S. (Lond.)

Aetiology
In the Ayurvedic approach to sinusitis, exposure to an infective agent such as pathogenic bacteria is just one factor in the development of the illness. Of far greater significance is the build up of excess doshas in the body, due to incorrect diet and lifestyle. Once excess doshas have built up and become prevalent due to repeated errors in daily regimen, they are readily carried by vata upwards to the head, where they lodge in any weak spot, creating acute illness. Unfortunately, due to today's polluted environment, the integrity of the mucus membranes of the nasal sinuses is under constant attack. Thus weakened, the sinuses are particularly vulnerable to invasion by provoked doshas. It is the unwholesome situation created by a combination of weakened sinuses, accumulation of doshas and build-up of ama or toxins in the body that provides a fertile ground for the multiplication of pathogens.

Sinusitis, as an inflammatory condition, always involves some component of pitta, the fiery humour. However, provocation of either vata or kapha within the sinuses can give rise to pitta irritation of the mucous membranes. Sinus infections thus can be regarded as either vata, pitta or kapha in nature, each type having specific causative factors and symptoms.

]]> Causes of vata-type Sinus Infection
According to the Charak Samhita, factors which tend to provoke vata in the sinuses and head include suppression of natural urges, sleeping by day, staying awake at night, loud or excessive talking, excessive sexual intercourse, fasting, and consumption of too much salad and other raw foods. Charak notes that emotional factors play a significant role in the development of vata type sinusitis, particularly too much weeping; suppression of tears; grief, fear and anxiety. Head injury causing fracture of the sinus passages can predispose to vata type sinusitis, while Charak specifically mentions environmental causes, namely exposure to smoke or dust. Nowadays, environmental factors play an even greater role in creating a predisposition to sinus infections. All particulate air pollution, including soot, industrial pollution, dust from synthetic carpets and forced-air indoor heating, as well as air-conditioning, play a major role in provoking the vata dosha in the head and sinuses.

Causes of pitta-type Sinus Infections
The factors listed by Charak as giving rise to pitta-predominant sinus infections include excessive intake of spicy foods, salt, sour fruits, vinegar and alcohol, excess exposure to the sun, and overly warm indoor environments. Anger is the main emotional factor underlying any episode of pitta sinusitis. In modern times, environmental pollution plays a key role in creating a predisposition to pitta type sinusitis, for the pitta in the sinuses is greatly provoked by inhalation of fumes and toxins. In the outdoor environment, car exhaust, herbicides, pesticides, and factory fumes are significant provoking factors. Unfortunately, most indoor environments today offer even more opportunity to irritate pitta in the sinuses. Formaldehyde, paint fumes, carpet glues, epoxy resins, asbestos, drain cleaner, household cleaners, detergents, and chlorine bleaches are just some of the toxins to which we and our children are consistently exposed, and which ongoingly irritate the sinus passages. Furthermore, pitta type sinus infections are an occupational hazard for many, including house painters, carpet fitters and artists who work in oil. Another significant cause of both vata and pitta sinusitis is cocaine snorting.

Causes of kapha-Type Sinus Infections
kapha-type sinus infections are a classic disease of the "couch potato" type. Sedentary habits, excess sleep, and a diet high in oily, sweet and heavy foods, are the main provoking factors mentioned by Charak. Denial and "stuffing" of emotional pain can manifest as stuffy sinuses, while molds, damp, fog and smog also serve to provoke kapha in the sinus passages.

Symptoms of vata-type Sinus Infections
In vata-type sinus infections, the sinuses are dry, painful and sensitive. Nasal discharge is scanty and may be brownish in color. Pain is extreme, particularly in the temporal region, the forehead and between the eyebrows, while the patient may complain of pain in the ears and dizziness. At times the pain may be so severe that the affected person feels as if the head is breaking apart and the eyes are falling out. A patient in this condition is extremely restless, nervous, and hypersensitive, pacing back and forth or writhing on the bed. The neck and shoulder muscles are stiff and sore, while the condition may be accompanied or preceded by generalized vata symptoms such as constipation. Application of hot rocks or warm castor oil packs provide a measure of relief.

Symptoms of pitta-type Sinus Infections
pitta-type sinusitis is accompanied by fever--in some cases, such as acute frontal sinusitis, by very high fever with delirium. The sinuses throb and the facial bones are tender to the touch. Nasal discharge is yellow, orange or green, and may be streaked with blood. The head burns, and the eyes burn and there is a throbbing headache, while thirst and sweat accompany the fever. The patient is irritable, angry, critical and demanding. Application of cold packs provides a measure of relief from the burning head pain.

Symptoms of kapha-type Sinus Infections
In the case of kapha-type sinusitis, the sinuses and nose are so stuffy that the patient breathes through the mouth. Nasal discharge is copious, thick, white and sticky. There is dull pain in the head, numbness and a feeling of heaviness. The head feels cold, while the patient also complains of drowsiness, lack of appetite and general lassitude.

Diagnosis of Sinusitis
In the presence of the above-mentioned symptoms, it is fairly easy to diagnose vata, pitta, or kapha type sinusitis, while a sinus infection involving a combination of two doshas will show a mixture of symptoms. What is of key importance in the diagnosis of any sinus infection is to determine which of the three doshas is the root of the condition. Is the patient's kapha-type sinusitis, for instance, part of a generalized kapha provocation, or has the kapha disorder in the head arisen as a result of overall vata provocation? It is extremely important to answer the question in order to employ the correct treatment strategy.

In the case of vata-type sinusitis, this typically results from generalized vata disturbance, although other, more complex situations are possible, since either pitta or kapha may be blocking the vata in the sinuses. With pitta-type sinusitis, the condition may result from pitta provocation, or from generalized vata provocation which has pushed pitta into the head, or from an overall kapha condition, displacing and blocking pitta in the head. And while kapha sinusitis can and frequently does manifest as a symptom of kapha provocation, there are also very many vata provoked individuals who experience kapha-type sinusitis, as a result of vata pushing kapha to the head. Correct diagnosis of this situation is essential, for typically, kapha sinusitis would be treated by bitter, pungent and astringent herbs and foods--the very tastes that provoke vata. If generalized vata disturbance is the underlying cause of the kapha sinusitis, treatment aimed solely at pacifying kapha will serve only to worsen the condition.

Thus, the particular type of sinus infection may be diagnosed from the symptoms and from examination of the temporal pulse, but the overall doshic balance must also be assessed carefully, by taking a detailed history and performing a thorough examination of the tongue, face, nails, and above all, the radial pulse--nadi vignan, or pulse diagnosis. Assessment of the vikruti pulse, showing the current state of balance or imbalance of the doshas, will clearly reveal, for example, general vata provocation accompanying kapha type sinus infection. Careful history taking and use of the questions, "When were you completely well?" and "What was the first symptom you experienced?" will perhaps show a history of constipation, restlessness, fear and insomnia--all vata symptoms preceding the onset of kapha sinusitis.

Treatment
The treatment protocol for any sinus infection involves the following:

Management of fever
Use of neti or nasal cleansing
Use of Nasya or nasal medication
Herbs
Diet
Cleansing or purificatory measures
Lifestyle adjustments to prevent further episodes

Management of fever
Acute sinusitis, like any acute condition, should be treated according to the classic guidelines for fever. If this is not done, either the sinusitis will become chronic or other, more severe conditions will arise. Of the utmost importance in the management of fever is fasting. The patient should abstain from solid food for the duration of the fever, until the temperature returns to normal and keen appetite arises. The vata person can fast on warm tea made from fresh ginger or from ajwan (Sanskrit, ajamoda, Lat. apium graveolens), which calms vata and relieves stuffy sinuses. The pitta person can fast on cool or lukewarm teas made from coriander, sandalwood, rose or fresh ginger, all of which are anti-infective and anti-febrile. The kapha person can fast on tea of dry ginger.

Once keen appetite returns, the first meal should consist of a soup or gruel such as rice gruel, barley gruel, squash soup or mung bean gruel, cooked with digestive spices such as ginger, black pepper, cumin, coriander, fennel, turmeric, cinnamon, cardamom, and bay. This preparation helps restore digestive fire. That evening, bitter and pungent herbs such as Mahasudarshan, a combination of about forty different herbs, and Trikatu, a combination of three pungents, dry ginger, black pepper and piper longum should be taken. These bitter and pungent herbs help to restore digestive fire and remove toxins. Next day, well-cooked and easily digestible foods should be taken, such as kitcheri, a preparation made from basmati rice and mung dal, and the specific herbal regimen for the sinus infection should be instituted.

Jala Neti - Salt Water Nasal Cleansing
The use of jala neti or salt water nasal cleansing is essential in both the treatment and prevention of sinus infection. This involves washing the nasal passages with salt water which is poured into the nostril and exits out the other nostril or through the mouth. The water used for the purpose should be pure, free of chlorine, while the salt should be either pure sea salt, or better still, rock salt from Utah. Classically, a brass vessel with a long spout is used, although an indoor plant watering can with a spout makes an excellent substitute. This procedure cleans the passages, enabling the sinuses to drain freely, an essential aspect of treatment.

Like any other part of the body, the nose, after being washed with lukewarm water of the same salinity as tears, must be carefully dried. This is effected by vigorous breathing exercises and forward bending yoga poses which allow any excess water to drain from the sinuses.

The other form of neti is sutra neti, using a string stiffened and lubricated with beeswax, which is passed in through the nose and out through the mouth. Sutra neti, which helps to maintain the passages in a free condition, so that the sinuses can drain, is of great use both in the prevention of sinusitis and in the treatment of chronic, allergic or non-infective sinusitis. However, SUTRA NETI SHOULD NEVER BE USED IN ACUTE SINUS INFECTIONS, since it has the potential to spread the infection further.

Nasya - Nasal medication
Since sinusitis is a localized infection, localized treatment in the form of nasal drops is particularly helpful. One patient, who came to see me complaining of a severe sinus infection, had recently been treated by an antibiotic so strong that, once she took it, her hair fell out. Even so, due to the poor blood supply of the sinuses, which ensures that only small doses of antibiotic reach the sinuses, her infection was just temporarily relieved. After being treated with Nasya, she recovered in a few days. Her only regret was that she did not learn about the value of Ayurvedic treatment until after her hair fell out.

Nasyas may be of two kinds, water-decoction or oil-based. An excellent decoction Nasya for sinusitis is ginger-rose-jaggery, consisting of a decoction of equal parts fresh ginger, rose petals and jaggery, a product made from boiled-down sugar can juice and readily available in Indian grocery stores. This preparation is tridoshically balanced, the coolness of the rose balancing the heat of the ginger. It is tremendously effective in clearing the head.

Oil Nasyas may be prepared using a sesame oil base and may include anti-infective oils such as eucalyptus, rose and tulasi (sacred basil--ocimum sanctum). For both vata and kapha type sinusitis, vacha oil Nasya (acorus calamus) is extremely helpful, as it is decongestant and reduces both vata and kapha. For pitta type sinusitis, the best Nasya is ghee medicated with Brahmi (herpestis monniera). All Nasyas should be administered in fish pose, with the head tilted backwards. According to Ayurvedic teachings, the correct does is five drops per nostril, one drop for each of the Five Elements.

Oral use of botanicals
In oral, that is, systemic, use of botanicals for sinusitis, it is of the utmost importance, as described above, to consider not only the type of sinus infection that is present, but also the overall doshic balance in terms of both vikruti, or current imbalance, or prakruti, or constitution. Those herbs should be selected and combined which will treat both the sinus infection and the general vikruti, while not ignoring prakruti--for example, very hot herbs are generally avoided in pitta prakruti, even if vata or kapha are the main provocations.

Marich (Black Pepper, piper nigrum)
Marich is pungent in taste, heating in energy, pungent in post-digestive effect. It pacifies vata and kapha, but provokes pitta. Its name, marich, is one of the names of the sun, for it is believed to absorb and concentrate solar energy. Its active principle is piperin. It has decongestant action and can be used in both vata and kapha type sinus infections, one pinch orally mixed in honey, two or three times daily.

Tvak (Cinnamon, cinnamomum zeylonicum)
Cinnamon is pungent, sweet and astringent in taste, heating in energy and sweet in post-digestive effect. It pacifies vata and kapha and may provoke pitta. Diaphoretic, expectorant, decongestant and analgesic in action, it is helpful in the treatment of vata and kapha type sinusitis. It should be taken only in pinch-sized amounts and is best combined with other herbs.

Vacha (acorus calamus)
Pungent and bitter in taste, heating in energy, pungent in post-digestive effect, vacha calms vata and kapha, but may provoke pitta. In sinusitis, it may be administered systemically, in a balanced yoga or formula with other herbs, topically, as a paste applied externally to the sinuses, or nasally, either as a snuff or in the form of vacha oil Nasya. By all these routes of administration, it will clear and heal the sinuses.

Chitrak (plumbago rosea)
Pungent in taste, heating in energy, pungent in post-digestive effect, chitrak is generally tridoshic, although if used in excess it will provoke pitta. Chitrak is generally useful in all fevers and respiratory tract infections, and should form part of a balanced yoga (formula) for the treatment of sinus infections.

Tulasi (ocimum sanctum)
One of the most sacred and revered plants in India, tulasi is bitter in taste, heating in energy, pungent in post-digestive effect. It pacifies vata and kapha, but provokes pitta. In effect, it is antibacterial, antiviral, antiseptic, antipyretic and diaphoretic. It is the herb of choice for all vata and kapha type fevers and respiratory tract infections, including acute sinusitis, but should not be used in pitta sinusitis. Above all, it is the perfect herb for the situation of vata pushing kapha to the head, with kapha-type sinusitis, for it both removes the kapha from the nasal passages and balances vata in its seat, the colon. Tulasi is best taken as a tea or infusion, with honey.

Rose
Rose is bitter, pungent, astringent and sweet in taste, cooling in energy, and sweet in post-digestive effect. In pitta-type sinusitis, it serves to lower fever, reduce pitta and soothe the inflamed sinuses. Rose can also be used to balance a formula to make the overall effect more suitable for pitta.

Sitopaladi Churna
This is a formula consisting of rock candy, bamboo manna, pippali (piper longum), cardamom and cinnamon. It may be taken in does of 1-4 gm, 2-4 times daily, and is a balanced formula, extremely valuable in all types of sinusitis, although it is most effective as an anti-kapha remedy.

Abrak Bhashma
Abrak is a preparation made from mica ash, and is a valuable anti-infective agent, useful in all types of sinus infections. It should be used in very small quantities, combined with other herbs to form a balanced yoga.

Diet
Selection of the proper diet is important in the prevention of and treatment of sinus conditions. In vata-type sinusitis, a diet of warm, moist, oily, soupy food should be taken, and raw, dry and bitter foods avoided. In pitta sinus infections, it is necessary to reduce the intake of spicy, sour and salty foods. For kapha-type sinusitis, a light, dry, warming diet is needed, strictly avoiding all dairy products except ghee and goat milk.

Lifestyle adjustments
Lifestyle adjustments both facilitate the treatment of sinus infections and prevent them recurring or becoming chronic. Habits which tend to provoke vata in the sinuses, such as smoking or snorting cocaine should be stopped. Attention must be paid to indoor air quality, reducing as far as possible the uses of chemicals in the home and office. In certain cases, there may need to be an adjustment in the person's occupation. For example, one patient of mine has switched from painting in oils to watercolor. Underlying emotional factors should also be addressed, particularly when the patient has a history of recurrent sinus infections. Positive habits such as a proper exercise program should be encouraged while a pranayama practice is extremely valuable in maintaining the balance of vital airs (prana) in the head.

Cleansings
Cleansing practices other than jala neti and Nasya cannot be used during the acute stage of a sinus infection, but can be applied either after the condition is resolved, or after it has persisted for more than three weeks. The value of cleansing practices is to reduce the excess doshas and to restore the doshas to their seats, thus preventing recurrence, chronicity or the onset of other, more serious conditions. In the case of vata sinusitis, or of vata pushing the other doshas into the head, the most important cleansing is snehan svedan--that is, oiling the whole body with sesame oil and then sweating. Basti or Ayurvedic enema should also be employed to calm the upward movement of vata. Oil enema can be done, using a few ounces of warm sesame oil, to calm the vata in the colon. This can be followed by a decoction enema, using two tablespoons of dashmoola (a combination of ten roots including castor root) to one and a half pints of pure water, simmering this without reducing, for twenty minutes.

Pitta-type sinusitis is an indication that pitta should be reduced by virechan (purgation). The most simple and gradual method of purgation is to take an infusion of one-half teaspoon of amlaki (emblica officinalis) daily at bedtime. Amlaki can be prepared as either a cold infusion or hot infusion; however, it may be easier to digest when drunk as a warm tea than as a cold infusion.

For kapha-type sinusitis, vaman, or emesis, is a key therapy. The excess kledak kapha which accumulates in the stomach--the main seat of kapha-- is what overflows into tarpak kapha, the kapha of the head, leading to stuffy sinuses. Hence, to get to the root of the problem, it is essential to pacify the kapha in the stomach, and to remove excess doshas from the seat of kapha. The Ayurvedic method of vaman typically involves ingestion of about a quart of liquorice tea, after which the uvula is immediately stimulated until vomiting occurs. The yogic method is slightly different, salt water (normal saline) beings used instead of liquorice tea. Saline is used to cleanse the stomach, in exact proportion of one and a half teaspoons of salt per quart of pure water. Concentrated salt solution, despite its emetic effect, is not used for this practice, since it would have a dehydrating effect. Vaman is also effective in clearing the sinuses in situations where vata is pushing kapha to the head. However, in this circumstance, emesis should be employed only with great caution, since this practice has a potential to promote vata.

Conclusion
Like all conditions of the head, sinus infections are less easy to diagnose and treat then might appear at first glance. This is because of the tendency of vata to move upwards, carrying other doshas to the head. Thus, the provocation occurring within the head and sinuses is by no means always the same as that affecting the rest of the body. Chronic or recurrent sinus infections may result from a failure to treat the underlying doshic imbalance. In particular, great caution is needed when using extremely bitter anti-infective herbs, such as goldenseal (hydrastis canadensis). If pitta and kapha are the main doshic imbalances, these herbs will be very effective, but if an underlying vata imbalance is giving rise to a pitta or kapha type of sinus infection, excess use of bitter herbs will greatly exacerbate the condition.

Similarly, the use of antibiotics for pitta-type sinusitis is very much a double-edged sword, since most antibiotics are pitta provoking. By aggravating the underlying cause, antibiotics, although effective in the short run, may tend to create recurrent pitta-type conditions.

Peer-reviewed article first published in the Protocol Journal of Botanical Medicine.

Silent Bladder Infections

2012-11-12T06:55:29Z

by Alakananda Devi (Alakananda Ma), M.B., B.S. (Lond.)

Silent bladder infections, also known as asymptomatic bacteruria, may result in generalized ill health or may lead to acute cystitis or to pyelonephritis, a potentially life-threatening kidney infection. Hence it is important to appreciate the groups affected by silent bladder infection, as well as how to make an Ayurvedic diagnosis of this condition and give appropriate chikitsa.

]]> Bladder infection, also known as cystitis, is typically diagnosed when there is a complaint of frequency of urination, dysuria (burning pain on urination) nocturia and discomfort suprapubically, in the bladder area. Urine may be cloudy or foul smelling. If there is fever, rigors, nausea and headache, the infection may already have spread to the kidney. However, many cases of cystitis and even some cases of pyelonephritis have silent or imperceptible symptoms. In this case, accurate Ayurvedic diagnosis can prevent some of the potentially dangerous outcomes of this lingering condition. A variety of faecal organisms can cause cystitis if spread to the bladder, since mutravahsrotas, the urinary tract, is vulnerable to these organisms. E. coli, staph, klebsiella, enterobacter, enterococcus and pseudomonas are commonly implicated in cystitis and asymptomatic bacteruria. Candida albicans can also grow in the urinary tract, leading to silent bladder infection and predisposing to bacteruria or symptomatic cystitis.

Baby girls are prone to bladder infections, so much so that it is quite typical for a girl to experience as many as two bladder infections under the age of five. Many of these infections may be silent, or may go undiagnosed because the baby cannot describe her symptoms. Pregnant women have a relatively high incidence of asymptomatic bacteruria. If untreated, this will lead to symptomatic cystitis in approximately 30 percent of patients and to pyelonephritis in as many as 50 percent. (1) Silent bladder infection is also associated with an intrauterine growth retardation and low-birth-weight infants.

Low oestrogen is connected with both silent and symptomatic bladder infections. This is thought to be caused both because the urethra is thinner when oestrogen is low and because the vagina becomes more susceptible to colonization by faecal bacteria, which may then spread to the urethra and bladder. Low oestrogen occurs in nursing mothers, as well as in menopausal and post menopausal women. As many as 25 percent of bladder infections in post-menopausal women are silent. Diabetics are another group which has a high incidence of silent bladder infections. Women on immunosuppressive therapy, such as those with MS, are especially vulnerable to silent bladder infections. Although women are in general more prone to bladder infection than men, older men with BPH are also a susceptible group.

The following case histories indicate the importance of effectively diagnosing and addressing silent bladder infections.

A thirty two year old pregnant woman, prakruti V3P2 K1, had had few health complaints other than pregnancy acne. However, her bladder pulse was persistently weak with pitta, and red margin of her tongue indicated pitta in rasa dhatu. Although she was treated throughout her pregnancy with herbs such as Vidari to support the placenta, she ultimately delivered a low-birth -weight infant by caesarean section. She was then hospitalized for septicaemia resulting from fragments of retained placenta and almost lost her life. This is a cautionary tale showing the importance of being proactive when the bladder pulse has a pitta spike, an indicator of possible infection. Perhaps if her silent bladder infection was treated early on in her pregnancy, the subsequent difficulties could have been avoided.

A forty year old pitta woman with MS took immunosuppressant therapy whenever she had an episode of neurological symptoms. During the heat of summer, she developed a bladder infection and was given antibiotics. Summer is a typical time for developing silent bladder infection both because it is pitta season and because it is difficult to stay sufficiently hydrated in hot weather. Following a round of antibiotics she took a formula which included Punarnava, Turmeric, Gokshura and a small amount of Neem. The anupan for this formula was Cumin, Coriander Fennel tea, since these spices also soothe the urinary tract. A month later, she had no symptoms of bladder infection but still had red margins of the tongue, indicating pitta in rasa dhatu, as well as coating of the tongue and a pitta spike in the bladder pulse. She continued CCF tea for bladder calming. Unfortunately, although her continuing bladder infection was easy to track by Ayurvedic pulse reading, her Western physicians remained unaware of it. We continued to track persistent silent bladder infection for an entire year, through the pitta spike in the bladder pulse. During this time she took several rounds of the formula mentioned above. However, because of her major medical condition, she would have benefited from some further antibiotic treatment as a complement to her Ayurvedic formula. The following July, during a heat wave, she developed loss of function of both legs such that she could scarcely walk. This episode was treated as a MS relapse and she was given cortisone. However, cortisone, as an immunosuppressant, only served to further exacerbate her bladder infection. In fact, what she experienced was not a genuine relapse but a typical episode of pseudo symptoms resulting from bladder infection. Pseudo symptoms arise when excess ushna quality leads to pitta provocation in myelin that has been previously affected by MS. Hot weather and fevers, particularly urinary infections, are typical sources of excess ushna. When bladder infection is the precipitating factor, pseudo symptoms typically occur in the lumbar area, due to tiryaga (horizontal) movement of pitta from the bladder to the lumbar spine. Following this experience she became more proactive about using herbs such as Gokshura and Punarnava whenever she had a pitta spike in the bladder. She could also use Kidney Formula, which contains bladder-soothing and pitta pacifying herbs such as Gokshura, Punarnava and Guduchi.

A sixty six year old diabetic kapha woman was doing well on her Ayurvedic regimen, noting an excellent, steady drop in her blood sugar readings. From blood sugars as high as 200 mg/dl, she was stabilizing at a near optimal range of under 130 mg/dl. Suddenly, during a May heat wave, her blood glucose went back up to its old levels. We noted that her bladder pulse, which had been normal at every previous visit, was now weak with vata pushing pitta. Thus we suspected a silent bladder infection in this post-menopausal diabetic woman. Bladder infection could account for the elevated blood sugar because of the added physiological stress of dealing with the infection. She was given a formula which included Gokshura, Myrrh, and Hibiscus, all of which act to cleanse and soothe mutravahasrotas. Sure enough, after she took this formula for ten days, her blood sugar returned to optimal levels and her diabetes continued to improve incrementally.

A fifty seven year old woman, prakruti V3P1K2, complained of urgency of urination, thirst, pain in the renal angles, brain fog and fatigue. She had a long history of systemic candidiasis. Thirst is a symptom of depleted rasa dhatu, and there is a great functional integration between rasavahasrotas, ambuvahasrotas, (the water carrying channels) and mutravahasrotas, since all are involved in fluid balance. Her bladder pulse was weak with vata pushing pitta. She was given kidney formula, which improved her symptom of urgency. Unfortunately she then fell away from Ayurveda and was seeing other practitioners who attributed her renal pain to her adrenals, rather than to chronic renal infection secondary to candida in her bladder and bacteruria. She returned over two years later, still with renal pain, urgency, thirst and vata pushing pitta in the bladder. This history illustrates how long a yeast-related silent bladder infection can persist unless addressed long term with appropriate herbs. She is now taking kidney formula and Purnarnava Guggulu and should see an improvement if she can overcome her vata tendency to jump practitioners.

In giving Ayurvedic chikitsa for bladder infections, agni is, as always, the first consideration. By following proper food combining and meal timing and avoiding allergens, a healthy bowel flora can be sustained. Bowel dysbiosis, or presence of undesirable microflora in the gut, provides the opportunity for the urethra to be invaded by pathogenic organisms from the colon. Yeast overgrowth should be addressed by cutting out sugar, sweets and vinegar. Next, it is important to ensure proper hydration through drinking sufficient water. The indicator of hydration is urine colour. Although the early morning urine is normally yellow because urine concentrates during the night, daytime urine should be essentially colourless in a properly hydrated condition. Clients often need encouragement to drink sufficiently, particularly in the summer. Aloe Vera juice can be added to the water to pacify pitta and soothe the bladder. In addition to drinking plain water, bladder soothing teas can also be used. Hibiscus tea is beneficial for both the bladder and the menstrual cycle, while Cumin-Coriander-Fennel tea is beneficial for bladder, digestion and hormonal balance. Turmeric is also useful as a home remedy for bacterial infections and can be taken half a teaspoon twice a day in honey. Proper bladder emptying is essential for bladder health and can be supported by asanas such as cat/cow, pelvic rocks, gentle twists, fish pose (matsyasana), butterfly (baddha konasa) and shoulder stand (sarvangasana ). Ashvini mudra and mula bandha help prevent dribbling and stress incontinence due to bladder infection. Moon Salutations (chandra namaskar) help calm pitta and prevent inflammation. Herbs that have affinity for mutravahasrotas include Gokshura, which soothes the urinary tract and improves urine flow, Punarnava, which also soothes the urinary, tract, supports urine flow and helps protect the kidneys, and Manjista, which also reduces pitta and kapha in the bladder. Blood purifying and pitta soothing herbs such as Anantamula and Guduchi will also help eliminate bacteruria. For candidiasis-related bladder infections, Musta has a specific anti-Candida activity. Indications of candida overgrowth in the bladder include persistently cloudy urine and a history of vaginal yeast infections, excess sugar consumption or multiple courses of antibiotics. As the case studies quoted above illustrate, it may be necessary to continue herbs for mutravahasrotas for many months, using either an individualized formula or Kidney Formula. Silent bladder infections may have no perceptible symptoms and yet can lead to kidney infections or to exacerbations of chronic health conditions. A kidney/bladder formula should be continued as long as there is a pitta spike in the bladder.

Kass EH. Pregnancy, pyelonephritis and prematurity. Clin Obstet Gynecol 1970;13:239-54
Harris RE, Thomas VL, Shelokov A. Asymptomatic bacteriuria in pregnancy: antibody-coated bacteria, renal function, and intrauterine growth retardation. Am J Obstet Gynecol 1976;126:20-5.

Tridoshic 'Yam' Kitcheri

2012-09-30T14:38:16Z

Ingredients:
1cup split hulled mung beans
1 cup basmati rice
3 tbsp ghee
1 and half inches minced fresh ginger
2 tbsp shredded coconut
1 tsp turmeric

1 handful cilantro leaves
8 green cardamom pods
8 whole cloves
11 black peppercorns
3 inch piece cinnamon stick
3 bay leaves Salt to taste
1 large yam, cubed (actually a golden sweet potato)

Preparation:

Rinse mung beans well with cold water and soak for a few hours
Rinse rice well and soak while beans are cooking
Put ginger, coconut, turmeric, cilantro and some water in a blender or food processor and blend. Use enough water to blend well.
In a large pot, melt ghee over medium heat and sauté cardamom pods (split open first), cloves, peppercorns, cinnamon stick and bay leaves for a few minutes. Then add the blended spices and sauté for a few more minutes until lightly cooked
Next add beans and yams; cook for a couple more minutes. Add enough water to cover the beans with at least 3 inches of water and bring to a boil. Turn heat down to simmer. Cook for about 45 minutes or until the beans are completely broken down. Then add the rice and cook until the rice is broken apart. Add more water as needed Salt to taste and enjoy!

The White Powder: Ayurvedic Strategies for Sugar Addiction

2012-09-11T00:43:34Z

by Alakananda Devi (Alakananda Ma), M.B., B.S. (Lond.)

Addiction to sugar is a significant cause of overweight, obesity, diabetes, dental caries, candidiasis and adrenal deficiency. In addition, by lowering immunity, white sugar may contribute to the incidence of cancer and acute and chronic infections. Although white sugar as an addiction of choice affects all ages from infancy on, individuals born in the 1950s are particularly susceptible, due to the prevalence of sweetened infant formula at that period. All types of agni may be involved in sugar cravings, but the nature, consequences and management of sugar addiction differs depending upon the agni type.

English: A bowl of white granulated sugar. The background has been erased. (Photo credit: Wikipedia)

Visham Agni and Sugar
The individual with visham agni has cravings for sweet, salty, sour, spicy and oily foods. They are just as likely to indulge in tortilla chips and salsa, potato chips, French fries and ketchup, salted peanuts or crackers as in sugar. To complicate matters, manufacturers frequently include sugar in savory items such as crackers, chips or peanut butter. Often, such individuals may realize that sweet baked goods such as cookies upset their digestion. Instead, they will use M&Ms or chocolate peanuts, seeking the combination of sweet, fat and crunch.

The impact of white sugar on such an individual can be devastating to the adrenals. Vata-provoked clients with visham agni are prone to under-eating and random meal plans. Breakfast could be a few Twinkies or a Power Bar in the car on the way to work. Feeling hungry while at work, they may snack on chips, crackers, doughnuts or whatever is in the office or the vending machine. After a salad for lunch, they are hungry again by mid afternoon and begin consuming chocolate and other munchies. By dinner time, they have no appetite left, having wasted their available agni on junk foods. Each time sugar is eaten, it stimulates an adrenal-type energy rush, gradually leading to adrenal exhaustion, especially if combined with caffeine. As the adrenals become increasingly exhausted, the urge to eat sugar grows stronger, in response to the need to "get some energy". As much as sugar may be a cause of overweight in other agni types, it can contribute to chronic underweight in the person with visham agni. Yet despite being underweight, the junk-food junkie may have more toxic hard fat in the system than the pitta with a chubby little belly.

A young woman with this agni condition worked at a residential elder care facility. When at home, she followed a strict diet of brown rice, steamed vegetables and carrot juice. At work, she indulged in big portions of lasagna and stacks of Oreo cookies. After explaining to her that there was in fact nothing wrong with lasagna for her constitution, we encouraged her to stash healthy treats at the elder care facility, so that Oreo Cookies would not tempt her. This strategy works well for both visham agni and tikshnagni. Creating a stash of suitable treats made with whole sugars or other natural sweeteners gives an outlet for the desire stimulated by the presence of poor quality sweets.

A good remedy to balance sweet cravings for vata can be prepared using Ashwagandha. Roast an ounce of Ashwagandha in ghee and add a tablespoon of date sugar. Store in a screw top glass jar in the refrigerator. This can be eaten in the morning about twenty minutes before breakfast, in the mid afternoon-- if sweet cravings arise-- and at bed time with a cup of hot milk. To help reduce the stress levels that exacerbate sweet cravings, tulsi tea can be used as a general beverage or Tranquil Mind formula can be taken three times daily. For adrenal exhaustion, Stress Ease can also be taken.

Tikshnagni and Sugar
The individual with tikshnagni craves sweet, bitter and astringent foods. A sugary cup of black tea satisfies the desire for a mixture of sweet with astringent, a cup of sweet latte or a rich dark chocolate meets the need for a mixture of sweet and bitter. Unfortunately, caffeine and white sugar provoke pitta, intensifying tikshnagni. Thus, the more the pitta individual indulges in white sugar, coffee, tea and supermarket chocolate, the worse their tikshnagni becomes and the more strongly they crave sweets. Next, they begin to crave yeasted breads and sweet baked goods in an attempt to diminish their raging inner fire. Yeast, being sour, further provokes pitta, worsening tikshnagni. People with tikshnagni need extra protein, a slower burning fuel. Thus the empty calories of muffins, cookies, cupcakes and brownies only serve to make them hungrier. Soon they are twenty to thirty pounds overweight while being essentially malnourished.

A fifty year old real estate agent with a pitta prakruti presented with a lifelong history of tikshnagni and compulsive overeating. She came from an alcoholic family and had been an active alcoholic herself for ten years, a typical finding with tikshnagni and sugar addiction. She had a set of very strict diet guidelines that inevitably fell apart each evening. Until that point each day she perceived herself as a person who ate healthily and avoided dairy and processed flours. She took fruit for breakfast and typically ate a business lunch with her clients. Feeling remorseful about the size of her stressful lunch, she took only fish and salad for dinner. Like most stressed out individuals with tikshnagni, she began craving chocolate around four in the afternoon, but held back, determined to be 'good.' By the end of her austere dinner she was ready to spend the rest of the evening consuming chocolate, ice cream and cookies. She was about forty pounds overweight.

Her troubles each day began with her fruit breakfast. Although this may be a good strategy for a healthy pitta with a tranquil life, fruit was not advisable for breakfast given her tikshnagni and the competitive nature of her job, with its stressful lunches. Instead of starting the day with the sweet taste, she could begin with bitter. A half teaspoon of Mahasudarshan in a teaspoon of honey works well for most people to diminish cravings for breads and sweets. This can be followed, twenty minutes later, by a breakfast containing protein. It is better to avoid a sweet breakfast altogether in this situation and to start the day with a small but complete meal such as a bowl of kitcheri and a whole wheat chapatti.

To regulate tikshnagni she could prepare Shatavari Kalpa. Roast an ounce of Shatavari with ghee and add a tablespoon of sucanat or turbinado sugar. This can be taken mid-morning and mid-afternoon to prevent hypoglycemia and to regulate tikshnagni. For stress and addictive tendencies she should drink Brahmi tea three times daily. She could also take Stress Ease three times daily.

Mandagni and sugar
For the kapha individual with mandagni, sugar addiction is truly a life or death situation. Waking sluggish and dull, kapha seeks energy from a donut or sugary cereal with cold milk. Although this gives a short burst of adrenal energy, these foods, to which a majority of individuals with mandagni are allergic, serve only to make him more sluggish and sleepy. Worse still, in kapha individuals, the insulin response is easily over stimulated. Whereas vata will burn all the sugar they consume in a frenetic rush of adrenal energy, kapha's body will immediately respond by storing sugar as fat. Gradually, the pancreas becomes more and more oversensitive, leading to a peri-diabetic condition of obesity, low energy and constant cravings for sweets and refined flours. White sugar and refined flour do not contain enough chromium for their own metabolism and thus deplete the body of chromium, essential to metabolism and to the functioning of the pancreas. Continued over-consumption of such refined foods will tip the kapha individual from peri-diabetes to diabetes proper, complete with retinopathy, neuropathy, arterial disease and diabetic ulcers. This is truly a high price to pay for a bowl of cereal and a Snickers Bar a day.

A forty year old financial planner had reached a level of mandagni so severe that not only wheat, dairy and sugar but even brown rice made him nauseated, tired, heavy and dull. He was sixty pounds overweight and lived on an energy roller-coaster, consuming caffeinated soda and sugar to get a burst of energy and then breads and cereal to calm him down. The breads made him tired and lethargic, so then he needed sugar and caffeine, which wired him, after which he needed more bread. In a few short years, if he did not change his ways, he would be diabetic.

He could be helped by taking a teaspoon of Shardunika after each meal or Sweet Ease formula three times daily. This would help balance his insulin secretion and reduce his craving for sweets. As with tikshnagni, a morning dose of Mahasudarshan would help with his craving for breads. Ten minutes before each meal he could take a half teaspoon of organic turmeric powder to aid in balancing the blood sugar load from that meal. To help reduce weight and kindle agni, he could use Trikatu. For stress he could take Bacopa tea three times daily or Mental Clarity formula, which would help with the sluggishness and lethargy that drove him to drink Pepsi-Cola.

In accordance with the basic principles of Ayurveda, although white sugar is a poison for all three doshas, its use must be handled very differently depending upon agni type. It is essential, as we have seen, to provide dietary counseling and to offer appropriate stress-reduction strategies, as sugar consumption is a manifestation of mental stress and a cause of physiological stress. Because of the importance of stress in the overall picture, it may often be wise to begin the treatment program with the appropriate stress-reducing herbs and to hold the other suggestions for a later appointment.

All products mentioned in this article are available from www.banyanbotanicals.com.

Kapha Toxins: Candidiasis

2012-09-06T03:37:33Z

by Alakananda Devi (Alakananda Ma), M.B., B.S. (Lond.)
Candida, Liquid-based Pap (Photo credit: euthman)

In this article, we will consider candidiasis as a condition of kapha ama, reviewing the epidemiology, diagnosis and Ayurvedic management of this common condition.

Candida is a unicellular yeast whose cells reproduce by budding. A normal flora which can under certain circumstances become an invasive pathogen, it can flourish in most environments. Candida species frequently colonize the oropharynx, skin, mucous membranes, pranavahasrotas (lower respiratory tree), annavahasrotas (gastrointestinal tract) and mutravahasrotas (genitourinary tract). Candida can be found on foods, countertops, air-conditioning vents, and floors (6).

A discussion of candidiasis leads us to larger look at considerations of the ways in which epidemiology has changed from classical times until now. Many factors pertinent to the development of Candida overgrowths are relevant to modern industrial society and were not in effect in ancient times. These factors include a diet high in refined sugar and refined flour products, antibiotic therapy, environmental stresses that weaken immunity including EMFs (1), ELF radiation (2), chemical toxins and increased background radiation; sedentary lifestyles (3), epidemic obesity (4), development of immunodeficiency diseases such as HIV, and medical use of immunosuppressant therapies including inhaled corticosteroids. All these factors play a part in the frequency with which candidal conditions are seen in a typical Ayurvedic practice setting. Patients with endocrine disorders including diabetes, hypothyroidism and adrenal insufficiency are at increased risk for Candida overgrowth (6).

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The most common Candida condition is vulvovaginitis, known as a vaginal yeast infection. Three quarters of all women experience at least one vaginal yeast infection during their lifetime, with at least half of these individuals having recurrent infections (5). Oral thrush is another form of localized Candida infection found particularly after oral antibiotic use and in those with dentures and asthmatics using inhaled corticosteroids (5). Intertrigo, or skin fold infection, occurring especially in warm weather, as well a diaper rash, are commonly occurring localized skin yeast infections.

In terms of Ayurvedic pathology, the association of candidiasis with curdy white discharge, thick white plaques, and lethargy as well as the relationship to kaphic predisposing factors such as obesity, diabetes mellitus, hypothyroidism, sedentary lifestyle and consumption of sugar and starchy foods mark it out as a condition of kapha ama. Candidiasis also has a relationship to gluten sensitivity and celiac disease. Gluten is a kapha allergen, being heavy, sticky, and dense in nature. We will quote here a crucial abstract from The Lancet, a highly respected medical journal, regarding the relationship between Candida hyphal wall protein and gliadin.

Coeliac disease is a T-cell-mediated autoimmune disease of the small intestine that is induced by ingestion of gluten proteins from wheat, barley, or rye. We postulate that Candida albicans is a trigger in the onset of coeliac disease. The virulence factor of C albicans-hyphal wall protein 1 (HWP1)-contains amino acid sequences that are identical or highly homologous to known coeliac disease-related alpha-gliadin and gamma-gliadin T-cell epitopes. HWP1 is a transglutaminase substrate, and is used by C albicans to adhere to the intestinal epithelium. Furthermore, tissue transglutaminase and endomysium components could become covalently linked to the yeast. Subsequently, C albicans might function as an adjuvant that stimulates antibody formation against HWP1 and gluten, and formation of autoreactive antibodies against tissue transglutaminase and endomysium (7).

By the same token, antigliadin antibodies have been found in chronic Candida infections (8), suggesting that not only should candidiasis be considered in celiac disease but also gluten should be strictly avoided in Candida infections.

Non-local Candida infections typically begin with symptoms of mandagni and or vishamagni including slow appetite, heaviness, lethargy, slow digestion, gas and bloating, proceeding on to nausea, congestion and distention. These symptoms reflect the sanchaya and prakopa stages of samprapti. As the disease process proceeds to the prasara stage there may be sinus congestion, plugged ears, tinnitus, brain fog and water retention. Typcially, the disease process will proceed no further but may continue at this level for years on end, resulting in a sate of fatigue, lethargy and general discomfort very far from health. However, in immunocompromized patients including those on chemotherapy, corticosteroids or immunosuppressant drugs and those with HIV, candidiasis can progress to the vyakti stage with serious conditions such as candida tracheobronchitis or candida pyelonephritis and even to the bheda stage, with fever, sepsis, multi-organ failure and potential fatality (5). The latter stages of candidiasis constitute medical emergencies whereas the sanchay to prasar stage of candidiasis is often best dealt with Ayurvedically.

Some case histories are given to illustrate typical patterns seen in candidiasis:
An eighteen year old male of kapha prakruti complained of low appetite, lethargy and brain fog. He was not hungry in the morning and typically skipped breakfast. He also rarely ate lunch, although sometimes he would have a cold sandwich. Between six and nine at night he took a main meal consisting of meat, potatoes, bread and vegetables. He snacked on granola and milk later in the evening. This patient displayed a typical pattern of self-perpetuating mandagni, since his late main meal, followed by snacking, made it unlikely that he would be hungry in the morning. His tongue had a thick, greasy yellow-white coating; his nails were longitudinally ridged (typically seen in candidiasis), his vata and kapha were increased and there was a kapha spike in his rasa dhatu pulse. Many of these findings are typical of chronic gastro-intestinal candidiasis.

A thirty year old woman of vata kapha constitution had been constipated all her life. She had been placed on antibiotics many times during her childhood and suffered from recurrent vaginal yeast infections, chronic vaginal irritation, depression, brain fog and sweet cravings. Her tongue had a thick white coating, and the area below her nails was red and puffy (another typical finding in candidiasis).

A thirty three year old woman of vata-pitta prakruti had gas and chronic abdominal pain. She was allergic to wheat, dairy, nuts and eggs. She had constant post-nasal drip, low energy, fatigue and lethargy. She also had a history of severe vaginal yeast infections and currently suffered from vulvodynia, a painful condition of the vulva that may follow a long history of vaginal yeast infections (9). From age thirteen to twenty two she had used a nasal corticosteroid spray. She had ridged nails and a shaved area in the back of her tongue. She was tridoshically provoked.

A fifty nine year old professor suffered from recurrent episodes of otitis externa (infection of the external ear canal) marked by oozing, crusting and itching. These symptoms are typical of candidal otitis externa. She also bitterly complained of loudly passing gas during class, an occurrence that disturbed her professorial gravitas. She was depressed and lethargic with low motivation.

Ayurvedic treatment for Candida follows the usual pattern of ahara, vihara and aushadhya or diet, lifestyle and herbs. Diet is a key factor in successful management of candidiasis. A strict kapha-pacifying diet is needed to eliminate the Candida kapha toxins and rehabilitate agni. Sugar and refined flour products must be eliminated and the sweet taste should generally be controlled in the diet. As discussed above, a gluten-free regimen is highly beneficial for Candida infections. Experience has shown that many people with candidiasis feel best when they eliminate grains from their diet for the duration of their candidal illness. Substitutes such as quinoa, amaranth and buckwheat, which are not grains but seeds, may be used to make most recipes. For example, quinoa may be substituted for rice in kitcheri or pilau or for bulgar wheat in tabboleh. Quinoa and buckwheat pastas are available too. Another food that is very kapha provoking is cow's milk, so milk and cheese are best eliminated from the diet until the Candida overgrowth is cleared up. However, cultured milk products such as dahi and kefir have been found highly beneficial in candidiasis (10). In sensitive subjects, these products can be prepared using goat milk or even coconut milk instead of cow's milk.

For rehabilitation of agni it is important to use digestive spices in preparing the food. Many spices typically utilized in the Ayurvedic diet are also anti-candida, including turmeric, ginger, cumin, cardamom and cinnamon. Therefore, recipes and teas that employ these spices are valuable in the anti-candida regimen.

In terms of lifestyle, it is important to examine ways in which overall immunity is being lowered. Habits such as alcohol abuse, which lowers immunity while introducing more yeast into the system, need to be addressed. Overall exposure to environmental toxins can also be examined and advice given about reducing use of cell phones, microwaves and other forms of debilitating EMFs. An exercise program should be gradually introduced to enhance immunity. As well as brisk walking, surya namaskar is a great practice to strengthen ojas. Important herbs for Candida infections include neem, turmeric, Vidanga, Triphala, and above all Musta. Trikatu and hing help build healthy agni and are also antifungal.

For localized vaginal yeast infections a douche of 1 T licorice, 2 tsp. turmeric and 1t Triphala steeped in boiling water is very effective. The douche is used twice weekly during active infections and once a month as a maintenance. For localized skin infections such as intertrigo, and otitis externa, neem oil can be applied. For oral thrush, turmeric mouthwash is extremely effective.

Internally, a formula can be made that combines anti-candida herbs such as those mentioned above together with the indicated dosha pratyanika herb for the individual. Alternatively or additionally, Paracleanse can be given. Because Candida is an overgrowth rather than an infection, the organisms may be present in massive amounts and hence there may be significant die-off reactions when herbal treatment is given. Symptoms of die-off reactions may include fatigue, body aches, flu like symptoms, ringing in the ears and similar indications of toxins in rasa dhatu. Sat isabgol is helpful for such reactions as it has an ability to pull toxins out of the digestive tract. Typically, anti-candida treatments should be continued for three months, after which pancha karma and rejuvenation can be done. At this point the diet will typically become less exacting and the patient's life will gradually return to normal. All that has been internalised in terms of Ayurvedic diet and lifestyle during the months of treatment will serve to prevent relapses into future outbreaks by eliminating the causes of the condition.

Raloff - Science news (Washington), 1998 - cat.inist.fr Emf's Biological Influences: Electromagnetic Fields Exert Effects on and through Hormones. J Raloff Science News(Washington) 153:22, 29-31, Science Service, 1998
Vesna Rajkovic, Milica Matavulj and Olle Johansson The effect of extremely low-frequency electromagnetic fields on skin and thyroid amine- and peptide-containing cells in rats: An immunohistochemical and morphometrical study Environmental Research Volume 99, Issue 3, November 2005, Pages 369-377
Christof Handshin and Bruce M. Spiegelman The role of exercise and PGC1 in inflammation and chronic disease Nature 454, 463-469 (24 July 2008) | doi:10.1038/nature07206;
DC Nieman, DA Henson, SL Nehlsen-Cannarella Influence of Obesity on Immune Function Journal of the American Dietetic Association, Volume 99, Issue 3, Pages 294-299
Emily A Carpenter Rose, MD, Candidiasis, emedicine.com Dec 6 2007
Jose A Vazquez, MD, Candidiasis, emedicine.com 14 July 2008
Nieuwenhuizen WF, Pieters RH, Knippels LM, et. al. Is Candida albicans a trigger in the onset of coeliac disease? Lancet. 2003 Jun 21;361(9375):2152-4
Yolanda Hidalgo Garcia, M.D., Santiago Gómez Díez, M.D.,et al, Antigliadin Antibodies Associated with Chronic Mucocutaneous Candidiasis Pediatric Dermatology Volume 19 Issue 5, Pages 415 - 418
Ramirez De Knott HM, McCormick TS, Do SO, Goodman W, Cutaneous hypersensitivity to Candida albicans in idiopathic vulvodynia. Contact Dermatitis. 2005 Oct;53(4):214-8
Arthur C. Ouwehand, Seppo J. Salminen The Health Effects of Cultured Milk Products with Viable and Non-viable Bacteria International Dairy Journal Volume 8, Issue 9, September 1998, Pages 749-758

All products mentioned in this article are available from www.banyanbotanicals.com.

Green Peas and Cancer

2012-05-22T17:14:51Z

Peas in pods. (Photo credit: Wikipedia)

I always eat my peas with honey;

I've done it all my life.

They do taste kind of funny

but It keeps them on my knife.

My father used to enjoy reading me this rhyme from the Penguin Book of Comical and Curious Verse. He also loved to grow peas in the garden of our Victorian house. We would shell them and eat them lightly steamed with butter and mint.

As a teenager I used to volunteer for Help the Aged by visiting a ninety year old widow, Mrs Scopes. She loved to tell me 'Old Wive's Tales'. One oft-repeated saying was "Peas give you cancer, my father said.' As it turns out, this adage could not be further from the truth. In fact a a unique constituent of green peas, coumestrol, is being investigated for its benefits in preventing cancer. A Mexico City study pointed to the potential of green peas in preventing stomach cancer (1). And the Prostate Cancer Sweden Study points to green peas as helpful in preventing prostate cancer (2). The antioxidant components of green peas may also be helpful in breast cancer (3) as well as in preventing heart disease.

According to Ayurveda, green peas are pitta soothing and laxative, beneficial for purisha vaha srotas or the colon. Enjoy green peas with rice, in kitcheri,in a sabji or vegetable curry with cauliflower and potato or in matar paneer. Or serve them like my father did, lightly steamed with butter and mint

1. Hernandez-Ramirez R, Galvan-Portillo M, Ward M et al. Dietary intake of polyphenols, nitrate and nitrite and gastric cancer risk in Mexico City. Int J Cancer. 2009 September 15; 125(6): 1424-1430. 2009.
2. Maria Hedelin, Åsa Klint, Ellen T. Chang, Rino Bellocco, Jan-Erik Johansson, Swen-Olof Andersson, Satu-Maarit Heinonen, Herman Adlercreutz, Hans-Olov Adami and Henrik Grönberg, et al. Dietary Phytoestrogen, Serum Enterolactone and Risk of Prostate Cancer: The Cancer Prostate Sweden Study (Sweden) Cancer Causes and Control

Volume 17, Number 2 (2006), 169-180, DOI: 10.1007/s10552-005-0342-2
3. Pamela J. Magee* and Ian R. Rowland Phyto-oestrogens, their mechanism of action: current evidence for a role in breast and prostate cancer British Journal of Nutrition (2004), 91, 513-531

Alakananda Ma's 2012 Graduation Speech

2012-05-20T16:35:45Z

Honoured guests, faculty, staff, graduates and students, each of you in your own way a part of our Alandi family-- today's graduation is a tender and triumphant moment.

It is a tender moment, as you, the candidates, graduate from student to practitioner, or from practitioner to doctor. Like the fledgling finches on the porch, you now leave the cozy nest of Alandi to find your wings, to sing and soar. Some of you are moving on to new levels of responsibility as graduates in our community, some to bring the light of Alandi into the wider world.

It is a tender moment, as the founding students of our gurukula graduate and move on, stretching precious cords of love and friendship across distance and time. In myriad ways, all of us will miss our daily contact with these graduates, who helped lay the foundation stones of the gurukula. For four years we have chanted, meditated, eaten, studied, walked and served in clinic together. Now these bonds of love will be put to the test as our family matures to embrace the world.

It is also a triumphant moment for students, faculty and the gurukula. We did it! Heather has succeeded in graduating as a practitioner while raising her family and relocating from Evergreen to Boulder. Paula has crossed the finishing line after four years of patient part-time study. Annalise had upheld her commitment to Pancha karma and body therapies despite all obstacles. Bhavna has Skped into classes faithfully even as her young family moved from Texas to California. Ceci has surmounted myriad hurdles with great dedication to her studies. And Lauren, Kourtney and Heidi have stood the course through four years of demanding full time study, determined to be the best-trained practitioners of Ayurveda ever to be home-grown in America. Their thirst for learning and quest for excellence led us to create our advanced programme and bring the study of Ayurveda in America to new heights.

Each of us--students, faculty, staff and ashramites-- have sacrificed much, enduring financial challenges, long work hours, and lack of privacy (in the case of Sadananda), to make this moment possible. With minimal resources, we have achieved great things. We have created a vibrant learning community, continually pushing the frontiers of pedagogy and practice--an environment where teachers and students alike grow continually. We have honoured the ancient roots of Ayurveda in the Gurukula system, creating an Ayurvedic family with deep spiritual roots. Let us relish our accomplishment!

Dear graduates, as you step out as practitioners, pancha karma therapists and Ayurvedic doctors, you represent and embody not only Ayurveda, but also the lineage and teachings of Alandi, which has nurtured you for these past four years. Leaving our walls but not our family, carry with you our core teachings of love, simplicity and oneness.

In your time here, you have experienced radical simplicity in Alandi's capacity to do much with a little. As a visitor from Poland said recently, "What I love about this place is that in a small space you do great things." You have learnt to value authenticity over appearances and true richness over wealth. As you move on to your own practice, remember the basic lesson you have learnt here: do what you are here to do with what you have right now, without waiting for it to be bigger, better or more perfect. Or as Jesus, Peace upon Him, said, "Since you have been faithful in small things, I will give you charge over much."

If you want your dream to be
Build it slow and surely
Small beginnings greater ends
Heart felt work grows purely
If you want to live life free
Take your time go slowly
Do few things but do them well
Simple joys are holy
Day by day, stone by stone
Build your secrets slowly.

As members of Alandi's family, you have experienced on a daily basis the teachings of oneness and tolerance--sahishnuta. Ekam sat vipra bahuda vidanti. Truth is one, the wise call that by many names. Many rivers, one ocean, as Raghudas taught us.

Creation, like a prism
Fragments the pure white light of Truth.
People in different lands
Catching sight of different colors
Have taught that 'It is green'
Or 'It is gold!'
Today, from the seeds of light
Scattered over the Earth
We reap a rainbow harvest.

As healers, carry this understanding forth in your practice and your life, meeting each person where they are, honouring their beliefs, culture and life path while guiding them on the path to wellbeing through Ayurveda. This begins, every day, with meeting yourself where you are right now, including and accepting all the parts and aspects of yourself.

Above all, carry into the world the love you have received and shared here at Alandi. Love is the essential qualification of an Ayurvedic practitioner.

Maitri karunyam aarteshu

Shakye priti upekshanam

Prakruti shtheshu bhuteshu

Vaidyavritti chaturvidha

Friendliness and compassion towards the sick, joy in their recovery and equanimity towards those whose life is coming to an end; this is the fourfold attitude of the physician.

And love, compassion and friendliness are the most important core values you have received in your time at Alandi, which exists as a beacon of love for all beings. Let love permeate not just your Ayurveda practice, but the tiniest aspects of daily life. Love is the need of the hour, the urgent call of the Divine Mother. In all her manifestations, the divine feminine calls us to leave behind enmity, callousness and indifference and embrace the way of love and compassion. In the words of a great contemporary dakini, Yoko Ono, "Remember love!"

Remember love, remember love, Love is what it takes to know love.
Remember love, remember love, Love is what it takes sow love.
Remember love, remember love, Love is what it takes to grow love.
Remember love, remember love, Love is what it takes reap the fruits of love.
Remember love, remember love, Love is what it takes to be love.

Remember love, remember love.

(Sadananda's version of Yoko Ono's song)

Fibromyalgia

2012-04-30T02:52:10Z

by Alakananda Devi (Alakananda Ma), M.B., B.S. (Lond.)

Tulsi's your special servant; his heart's your abode
Yet, God, he seems to have a surfeit of suffering.
This limb pain's like a wild creeper, so seize
It's spreading roots in monkey play and yank them out!
Whether from my own sins, or just the triple-torment of this world,
Or someone else's curse, this arm pain's passed expression or endurance.
I've tried every tonic, spells, talismans,
Propitiated a whole herd of gods--all in vain.
Tulsidas, Hanuman Bahuk(1)

As vividly portrayed by Tusidas, one of North India's greatest poets and a fibromyalgia sufferer in his later life, the causation of fibromyalgia syndrome (FMS) is unknown and there is likewise no known cure. FMS is widely understood as a yapya condition--one that cannot be cured and yet is not fatal. FMS sufferers may make up a disproportionate amount of the Ayurvedic practitioner's caseload because the lack of effective biomedical treatment, combined with the severity of the suffering involved, often drives patients with FMS to seek out alterative care.

]]> Fibromyalgia is one of a large group of soft tissue pain conditions. Unlike arthritic conditions such as rheumatoid arthritis and osteoarthritis, FMS does not involve the joints. However, it is also different from other forms of soft tissue pain known as myofascial pain syndrome, which largely involves a single muscle or muscle group. The specific diagnostic criteria of FMS include widespread pain for at least three months, affecting both sides of the body, both above and below the waist, as well as the presence of at least 11 of 18 specific tender points, also known as trigger points. These trigger points correlate to amsa marma-- (related to fatigue) kukundara marma--(kidney, bladder, colon) Sira matrika and apalapa marma as well as the medial side of the knee joint, lateral side of the elbow joint and the left and right sides of the occiput.

Tender points are tested by applying enough pressure with the thumb to cause the tester's thumbnail to become white.

FMS is quite a common medical condition, affecting 2% to nearly 12% in the general population. It is increasingly prevalent with age, particularly affecting in women over fifty (7.4% to 10%). Adult women are 4-7 times more likely to be affected than adult men. (2) Children of both genders may be affected with FMS but typically grow out of it. There is no definitive blood test for FMS and a number of serious illnesses including Hepatitis C, Lyme disease and hypothyroidism may mimic the symptom picture of fibromyalgia, so it is important for the Ayurvedic practitioner to be assured that the client has received a biomedical workup. Fibromyalgia may occur as a primary condition or may also be concomitant with one of the auto-immune connective tissue diseases, in which case it is known as secondary fibromyalgia. Nearly 30% of patients with rheumatoid arthritis, 40% of systemic lupus erythematosus patients, and 50% of Sjögren's syndrome patients have concomitant FMS (2).

The issue of whether FMS is a genuine pathology or a psychiatric illness has been hotly debated within the medical profession. At this point, more than 80% of physicians appreciate that FMS is a pathology in its own right and that concomitant depression is a result of chronic pain and physical limitation (2). From an Ayurvedic standpoint FMS falls into the category of mamsagati vata conditions. Vata invades with tiryaga gati (sideways movement) into the muscle tissue, typically pushing pitta and ama into the soft tissues. Hence from our perspective it is hardly surprising to note that FMS is often accompanied by a host of other vatagenic conditions such as vata type of insomnia (waking in the early morning hours), cognitive and short term memory issues, anxiety, headaches, dizziness, fatigue, morning stiffness, numbness and tingling of the extremities, irritable bowel syndrome, temporo-mandibular joint syndrome, cold intolerance and restless legs syndrome (2). Vata-pitta syndromes accompanying FMS include urethral syndrome, also known as irritable bladder syndrome. The onset of FMS is often traced to a severe vata shock such as a car accident with whiplash injury, a fall, surgery or childbirth. Pitta triggers include febrile conditions resulting from a bacterial or viral infection. FMS is related to a low pain threshold and to low levels of serotonin.

A twenty six year old construction worker of pitta prakruti had a history of multiple vata traumas including two car accidents as well as several work-related injuries and falls. He complained of generalized soft tissue pain, with all his muscles feeling constantly sore for the last six months. He also experienced confusion, poor motivation, depression, chronic fatigue, constipation and weakness. His attitude was generally negative, with a perception of his life as an ongoing catastrophe. This symptom is typical both of low serotonin and vata invading manovahasrotas (the channels of the mind) and is frequently found as part of the symptom picture of FMS. Both his vata and pitta were currently provoked. As a home remedy for his generalized pain he took sunthi kalka:

1 tsp organic ginger powder
1tsp white sesame seeds
1tsp jaggery

Grind together and add 4 parts milk as an anupan.
This is used as a fibromyalgia remedy with the addition of 1tsp Ashawagandha. Because of his pitta provocation we also added half a teaspoon of Guduchi.

Although Yogaraj Guggulu is often used in FMS with accompanying vata syndrome, in this case we used Kaishore Guggulu because of the intense pitta provocation. Because of the pitta ama involved with his FMS, it was also beneficial for him to take an infusion of Amlaki daily. To support his serotonin levels and address anxiety and depression he took Brahmi tea three times daily. He could also have used Tranquil Mind, which addresses stress, anxiety, fatigueand muscle aches. Gentle restorative yoga was helpful for his generalized pain and morning stiffness. Weekly abhyanga treatments with Mahanarayana Oil also provided significant relief.

A sixty year old woman of pitta prakruti had a history of auto-immune hypothyroid disease and severe fibromyalgia. She was generally cheerful and outgoing, taking a positive attitude despite her constant experience of chronic pain. She represents the 60% of fibromyalgia patients who are not actively depressed.(2) She took Chyavanprash daily for its rejuvenative capacity in helping her overcome FMS-related fatigue. Regular asana practice and meditation helped her chronic pain and concomitant stress levels. She obtained the most relief from frequent abhyanga with Mahanarayana Oil and shirodhara with Shirodhara Oil. She noted that shirodhara was essential for relief of the central nervous system stress related to chronic pain. The greatest relief of all came from sarvangadhara or pizichil with Vata Massage Oil.

A thirty six year old vata-pitta housewife complained of fibromyalgia, chronic headaches, hyperacidity and diarrhoea-dominant irritable bowel syndrome (a vata-pitta condition) accompanied by fatigue and depression. Like the first patient cited, she was prone to extremely negative thinking. Despite being happily married and leading quite a privileged lifestyle she habitually engaged in catastrophic ideation. She did a full panchakarma treatment including seven days abhyanga with Vata Massage Oil for the general abhyanga and Mahanarayana Oil on the painful areas; sudation in steam medicated with Dashamoola and shirodhara with Brahmi Oil. Brahmi Oil was used for the oil bastis and Dashamoola, Guduchi and Brahmi for the decoction bastis. Following this course of purvakarma and panchakarma therapies her fibromyalgia pain started improving and her digestion normalized. Her negative moods at first worsened and then suddenly dissipated. As long as she continued taking Brahmi tea and Brahmi ghee and doing regular self-abhyanga and bastis she felt peaceful and happy and began doing creative projects such as baking and dressmaking. Once she went off her Ayurvedic regime her condition gradually deteriorated and attempts at other natural therapies only worsened her FMS pain, perhaps because these therapies were not addressing the underlying doshic imbalance. Her history serves to remind us that one round of panchakarma is not a panacea. In a yapya condition, Ayurvedic chikitsa must be continued ongoingly, with regular panchakarma treatments at least annually (in fall for a vata condition) and preferably twice a year.

By addressing the underlying vata and pitta imbalances and offering shodhan therapies to remove ama from the mamsa dhatu, Ayurveda can offer significant relief to patients with FMS. In particular, FMS sufferers can derive ongoing relief from oleation therapies such as abhyanga and sarvangadhara. Herbs that address majjavahasrotas and manovahasrotas, such as Brahmi and Tranquil Mind, help alleviate the underlying serotonin imbalance, while rejuvenatives such as Chyavanprash are helpful for the fatigue component of FMS.

Philip Lutgendorf, Hanuman's tale OUP, 2007 p 98
Jon Russell, MD, PhD Fibromyalgia Syndrome: Presentation, Diagnosis, and Differential Diagnosis Primary Psychiatry. 2006;13(9):40-45

All products mentioned in this article are available from www.banyanbotanicals.com.

Prostate Cancer

2012-04-30T02:24:16Z

by Alakananda Devi (Alakananda Ma), M.B., B.S. (Lond.)

Prostate cancer, Ayurvedically, is a tumor of the prostate gland involving provocation of all three doshas. Because the prostate gland forms part of the male reproductive system, shukra dhatu, prostate cancer reflects the physical, emotional, and spiritual relationship which the affected man has had with his reproductive capacity. And because the shukra dhatu is the seventh and last dhatu, receiving the essence of food refined through the previous six dhatus, any disorder at this level also reflects the overall relationship with the entire body. Negative lifestyle habits and diet, which seem at the time to have caused no harm, may eventually manifest in the form of tridoshic disturbance of the prostate gland.

]]> Causes of Prostate Cancer
Prostate cancer arises from a combination of doshic disturbances in the shukra dhatu and accumulation of ama, or toxins, in the vicinity of the prostate gland. Once one dosha is provoked in the shukra dhatu, and this provocation goes unchecked, the other two doshas will gradually accumulate there also, leading to tridoshic provocation.

There are many factors which lead to vata provocation in the shukra dhatu. These include excess discharge of semen, emitting semen during the daytime, and habitually emitting semen outside the context of a safe, nurturing relationship. Hasty or surreptitious sexual activity, without time to relax afterwards, will also provoke vata. Holding back the natural urge to ejaculate, once at the point of ejaculation, is very vata provoking and also causes congestion of the prostate gland. Excess bicycle riding, or other forms of "bumpy" activity involving sitting astride a saddle, will also lead to vata provocation in the shukra dhatu. Exposure to electromagnetic fields, microwave or radiation is another significant cause of vata in shukra, particularly if one habitually sleeps near a live electrical outlet. Habits that are generally vata-provoking to the entire system, such as working night shifts, drinking coffee, and over-consumption of raw or dry foods, may eventually cause vata provocation in the shukra dhatu.

Pitta may be provoked in the shukra dhatu due to exposure to infective agents such as gonorrhea or syphillis. Consumption of spirits, spicy food, salt, or sour fruits, may also provoke pitta in shukra. If anger or frustration is associated with the reproductive act, pitta will quickly become provoked in the reproductive system. Stagnation of one's creative energies, excess sleep, lack of exercise, a sedentary lifestyle, and a high fat diet, may cause kapha to accumulate in the shukra dhatu, leading to benign prostatic hypertrophy or, if the other doshas become involved, to prostate cancer.

Because of its anatomical position, the prostate gland is vulnerable to the accumulation of ama in both the urinary bladder and the colon. Benign prostatic hypertrophy may cause partial or complete urinary retention, leading to ama and infection in the urinary bladder. This in turn causes ama to accumulate in the prostate gland, where a malignancy may eventually develop. Above all, toxins accumulated in the colon and rectum are readily transferred to the prostate gland, where these toxins may give rise to carcinoma. Thus constipation, indigestion, improper food combining (such as mixing milk with meat, fish, beans or grains), eating immediately before sleeping, snacking, and any factors that create toxins in the colon are directly implicated in the causation of prostate cancer.

Environmental toxins ingested in food and accumulated in the colon may expose the prostate gland to carcinogenic chemicals such as pesticides and solvents. The shukra dhatu is also particularly vulnerable to the effects of radiation exposure. Radiation is a tridoshically provoking factor which may, at this time in history, be playing a significant part in the etiology of prostate cancer. Unfortunately, the burden of proof rests on residents in the locality of a nuclear installation environment, whose cancers may be related to nuclear emissions.

Detection of Prostate Cancer
Prostate cancer can be detected both by pulse diagnosis (to check for tridoshic provocation), and by digital examination of the prostate gland, via the anus. Ideally, men over the age of forty-five should regularly examine their own prostate, to check for any enlargement or irregularity. In practice, however, many older men have been trained to regard inserting a finger in the anus as something dirty, disgusting or perverted. I have met a number of patients who had only the vaguest idea of where the prostate is situated. Health education is very much needed to encourage men to play an active part in the prevention and detection of prostatic disorders.

Prevention of Prostate Cancer
Prevention essentially lies in the removal of causative factors. This requires that sexual activity take place in a calm, safe, relaxed environment, and is not associated with guilt, fear, anger, or frustration. Ayurvedically, the general rule is that seminal emission can take place roughly once a month, although this amount may be considerably increased in the case of a young, healthy man, and reduced in one who is old, sick, or weak. Sexual activity should take place within a safe, loving relationship, and should not be divorced from the other aspects of relationship. Sexual addiction, using orgasm as a means of escape, rather than as a means of giving life or expressing love, provokes vata in the shukra dhatu, leading to prostate cancer or other reproductive disorders.

Proper diet, exercise, and lifestyle, and the maintenance of colon health (through meal timing and food combining), is essential for older men. Many of the same factors that may create prostate disorders, such as sedentary lifestyle and excess fat consumption, also contribute to other disorders such as heart disease and arterial disease. Thus it is not uncommon to find a man affected by a combination of these ailments, all having the same causative factors.

In addition to these lifestyle measures, the prostate gland requires daily care and attention. Just as the teeth need to be cleaned daily to prevent cavities, the prostate gland must also be properly maintained. Daily castor oil massage of the prostate, using cold-pressed castor oil, takes only a few minutes each day. The prostate may be massaged either anally or at the perineum, to maintain a healthy prostate and to prevent hypertrophy or cancer. In addition, daily perineal exercise should be performed, to squeeze and pump the prostate.The best way to do this is to practice ashvini mudra. This consists of rapid contractions of the anal sphincter while holding the breath on the inhale and applying jalandhara bandha, or chin lock. Ashvini mudra not only enhances circulation and lymphatic drainage of the prostate gland, but also raises the sexual and creative energies which, if blocked at the level of the prostate gland, may give rise to cancer. According to Gheranda Samhita, verses 82 and 83, ashvini mudra awakes the kundalini shakti, gives strength and vigor, and prevents premature death.

Prostate Cancer and the Chakra System
The prostate gland is associated with muladhara chakra (the root chakra), apana vayu, the downward moving air responsible for ejaculation, urination, and defecation, and prtvi mahabhuta, the Earth Element. The root chakra is the seat of the sperm survival urge, and governs procreation, among other functions. There is also a connection between the prostate gland and svadhisthan chakra, the second chakra, seat of the water element, ap mahabhuta. All non-procreative aspects of sexual intercourse, both erotic and affective aspects as well as addictive and destructive ones, are related to svadhisthan chakra. Imbalances or blockages or energy associated with either the first or second chakra can lead to disorders of the prostate gland, and, eventually to prostate cancer. Hence, in both the prevention and treatment of prostate cancer, it is extremely important to address the overall relationship with sexuality, procreation, and the entire spectrum of generative and creative energy. An infantile, juvenile, or unintegrated approach to sexuality is harmful to health and can lead to prostate cancer, both by setting up a negative energy pattern related to the reproductive system, and by causing unhealthy behaviors which directly damage the prostate gland.

Blocked creativity is similarly harmful to health and can give rise to cancer. A life devoid of meaningful creative expression is a physically, mentally, and spiritually destructive situation. Whenever the energy of creation is absent, the energy of destruction, tamas - darkness, dullness, and ignorance, will take over. This destructive energy will readily find expression within the shukra dhatu, the tissue associated with procreation, generation, and creation.

Treatment
A sixty-two year old single man diagnosed with prostate cancer adamantly refused surgery. Instead, he chose to heal his cancer with organic foods, Ayurvedic herbs, yoga, meditation, and ballroom dancing. Now, at sixty-seven, he is fit, healthy, and still dancing. His approach was a truly holistic one. First, he assumed complete autonomy, refusing surgery against the advice of both his allopathic and his Ayurvedic physicians. Then, he pursued physical healing through diet and herbs, emotional health through the new, nurturing relationships he formed with fellow dancers, and the spiritual health through yoga, meditation and clear spiritual commitment. Most importantly, he also dedicated himself to ballroom dancing as form of creative expression.

However, by no means is every man with prostate cancer able, ready, or willing to work on all these levels. All too often, cancer of the prostate may be the effect of a life dominated by sheer physical and economic survival. To such men, emotional or spiritual transformation may be perceived as something alien or threatening. It is important that the Ayurvedic physician not impose upon the man with prostate cancer the physician's model of the way healing ought to be approached. With genuine compassion and understanding, the physician must allow the patient to determine which areas of his life he is willing to change, and which he prefers to avoid. If he is willing to change his diet and take herbs, but unwilling to practice emotional awareness or meditation, this is his choice, and one that he has every right to make. Change on many levels includes embarking on the work of forgiving grudges, reviewing one's life, and opening spiritual consciousness.

Diet
It is difficult to recommend a specific diet for prostate cancer. This is a tridoshic provocation, and therefore the diet should be a balanced one, avoiding extremes which might further provoke one of the doshas. Secondly, there frequently are concurrent systemic conditions such as hypertension, heart disease, or atheroma, in which case the diet may have to be tailored in accordance with these conditions. However, to prevent further accumulation of ama in the colon, a strict Ayurvedic regimen for the maintenance of agni, the digestive fire, must be followed. This involves leaving at least three hours between meals or snacks, not sleeping within two hours of eating, not drinking water within two hours of eating, not combining incompatible foods, and avoiding old, cold, and stale foods and drinks, including ice water and ice cream.

Botanicals
The following categories of herbs are combined in the treatment of prostate cancer:

Specific herbs for the urogenital system
Herbs having Lekhaniya and Bedhaniya tendencies, for breaking, down tumors
Alteratives
Tridoshically-balancing herbs

Herbs with an affinity for the urogenital system not only help to strengthen the shukra dhatu, they also act as an anupan for that dosha, carrying the other herbs in the formula to the site where they are needed. Most important amongst these is gokshura (Tribulus terrestris). In cancer treatment, the herb has the great merit of being tridoshically balancing. It has sweet and bitter taste, cooling energy, and sweet post-digestive effects. In action, gokshura is diuretic, rejuvenative, nervine, and soothing to the urinary tract. Famed for its effect in increasing semen, it is frequently mentioned in the erotic text, Ananga Ranga Sutra./

Punarnava (Boerhaavia diffusa) is another important herb which rejuvenates the urinary tract and is essentially tridoshic, although when used to excess, it may stimulate pitta. It is also useful in the treatment of cancer because it reduces swellings and its alkaloid, beta punarnavine, has a specific anti-cancer effect. However, punarnava should not be used in cases of dehydration or emaciation.

In the lekhaniya (scraping) category, the two most important herbs used in prostate cancer are kutki and shilajit. Kutki (Picrorrhiza kurroa) is bitter in taste, cooling in energy, and pungent in post-digestive effect. It is purgative and breaks down fecal matter, thus helping to remove ama from the colon, and tends to break down tumors due to its scraping effect. Shilajit (Bitumen) is pungent, astringent, and bitter, heating in energy, and pungent in post-digestive effect. It reduces vata and kapha but may increase pitta. Its main action is on the urogenital system, and it has a specific effect in reducing both benign and malignant swelling of the prostate. The compound Chandra Prabha, containing both kutki and shilajit, is extremely useful in the treatment of prostatic cancer.

Of the alterative herbs, jasmine (Jasminium grandiflorum) has affinity for lymph nodes and bone, and is particularly useful in the event of metastasis to the lymph nodes, and bone metastasis. Manjisthta (Rubia cordifolia) is an excellent blood purifier useful for all benign or malignant tumors.

Tridoshically balancing herbs include saffron (Crocus sativa), and Four Fragrances, a combination of cardamom, cinnamon, bay, and Nagkeshar (Mesua ferrea Linn.). These should be used in small quantities, and will catalyze the action of the other herbs in the formula. Because it is important to maintain a clean, healthy colon, to prevent further exposure of the prostate gland to colonic ama, Triphala tea should be taken before bed, one half teaspoon steeped for ten minutes in one cup boiling water. (Triphala is an Ayurvedic combination of Emblica officinalis or amla, Terminialia belerica, or bibhitaki, and Terminalia chehula, or haritaki.)

In addition to taking a balanced combination of the above herbs orally, twice-weekly basti, or enema, should be performed, using a decoction of Dashmoola ("ten roots"), a formula which includes Castor root, Gokshura, and Kantakari (Solanum xanthocarpum).

Yoga Therapy
Prostate massage using castor oil should be performed daily, as should ashvini mudra. Asanas that apply perineal pressure are very important, for example, kukutasan gomukhdsan, and padpedandsan. Salabhasan (locust pose) is also extremely useful, as are the inverted poses, sirsasan and sarvangasan. The marma point for the prostate is Trik marma (subcutaneous pressure point) at the tip of the coccyx. This should be massaged daily.

Conclusion
There are a number of extremely valuable Ayurvedic herbs which may be used in the treatment of both benign and malignant swelling of the prostate. However, the importance of simple measures should not be overlooked. Prostatic massage, ashvini mudra, Yoga therapy, the maintenance of good agni and a clean, healthy colon, are essential in both the prevention and treatment of cancer of the prostate.

Recommended Reading
Schachter-Shalomi, Z., and Miller, R. From Age-Ing to Sage-ing: A Profound New Vision of Growing Older. Warner Books, NY. 1995). Published in the Protocol Journal of Botanical Medicine, Vol. 2, No. 3, pp184-186

Peer-reviewed article first published in the Protocol Journal of Botanical Medicine.

Kumari: Aloe Vera

2012-03-27T16:59:39Z

Aloe vera (Photo credit: Wikipedia)

by Nellie Shapiro

instructor Alakananda Ma

Alandi Ayurveda Gurukula

ALOE VERA

Common Name: Aloe Vera

English Names: Barbados Aloe, Curacao Aloe, Indian Aloe, Jafarabad Aloe

Sanskrit Names :Kumari, Kanya, Ghrita-kumari, Vipulasrava, Sthuladala, Dirgha Patra, Mandala.

Hindi Names: Ghee-kunwar, Ghee-kuvar, Gvar patha

Family: Liliaceae

Habitat: Aloe Vera grows wild predominantly in India, Central/South America , Africa, Arabia, also cultivated in Europe.

Part used : Whole plant

Aloe Vera is a coarse-looking perennial plant with a short stem.

Widely prized in the ancient world as "plant of immortality". Ancient Egyptians buried it with pharaohs in tombs. Cleopatra and Queen of Nile used it for bathing. Many ancient physicians, such as Galen, Pliny, Dioscorides as well as Surushta and Charaka, praised its values. It was brought to the USA from Africa in the sixteenth century. In many countries it has become a common household remedy for the variety of uses.

Ayurvedic Herbal Energetics

Rasa Tikta,Madhura

Virya Shita

Vipaka Madhura

Gunas Guru, Picchila, Snigdha

(1,2)

Karmas of Aloe Vera

Vranaropana (wound healing activity), Rasayana(rejuvenative for the skin, intestines, female reproductive system),Artavajanana (promotes menses),Dipana (enkindles the digestive fire),Visphota (removes pustules), Bhedaniya Purgative - powder), Raktapitta (alleviates bleeding),Amapacana (clearing ama),Visahara (destroys poison), Llihayakrdvrddhihara (reduces inflammations of spleen and liver), Granthi(clears tumor).(1)

Aloe Vera works on all dhatus and following srotas: digestive, circulatory, female reproductive, excretory.

VPK =

(1,2)

Aloe vera contains B12, vitamin A and E, iron, potassium, calcium, protein, folic acid, chromium, magnesium, zinc, vitamin C, essential fatty acids and amino acids.

In human clinical studies, the juice of the Aloe plant aids digestive irritations like colitis, IBS and soothes stomach ulcers because the plant extract encourages the release of gastric juice enzyme needed to aid digestion called pepsin.

Aloe Vera gel is an excellent tonic for the liver and spleen, for the female reproductive and blood system. Chromium--the mineral that researchers found in the Aloe plant--is known to benefit patients suffering from circulatory problems, as well as cardiac disease. It was found that high concentrations of the Aloe gel stimulated the production of white blood cells in the body.

For 5 years, studies of five thousand patients with atheromatous heart disease were done, adding the 'Husk of Isabgol' and 'aloe vera' to the diet. A noticeable reduction in total serum cholesterol, serum triglycerides, fasting and post-prandial blood sugar level in diabetic patients, total lipids and also increase in HDL were noted. Also, "the clinical profile of these patients showed reduction in the frequency of anginal attacks and gradually, the drugs, like verapamil, nifedipine, beta-blockers and nitrates, were tapered. The patients, most benefitted, were diabetics (without adding any antidiabetic drug)." The exact mechanism of the action is not known, but probably it is working because of high fiber contest. No side effect was noted and all the five thousand patients are surviving till date.(3 )

Chinese scientists researched antioxidant properties and cell protective effects of a polysaccharide from Aloe vera. The result suggested that it "could be a preventive and therapeutic significance to some free radical associated health problems such as coronary heart ailments, Parkinson's and Alzheimer's diseases. Furthermore, the finding shed as well fresh light helpful for a better understanding of the health-benefiting potential of the edible plant consumed by the Chinese people for a couple of centuries."(4)

It supports the immune system and healthy breathing. Pacifies all agnis, reduces and rejuvenate Pitta. 2t of it can be taken 3 times a day, with a pinch of turmeric as a general tonic (2). Externally, the gel has been used in many ways: cosmetics, wound-healing, psoriases (5). "Freeze-dried Aloe vera extract is a natural effective ingredient for improving skin hydration, possibly through a humectant mechanism. Consequently, it may be used in moisturizing cosmetic formulations and also as a complement in the treatment of dry skin."(6,). Separate studies revealed that adding aloe vera gel in the sunscreen increases efficiency of the formulation more then four times. (6)

Aloe latex is officially approved as a laxative in the US, Germany, England. It is recommended for such conditions as hemorrhoids, fissures, after rectal and anal surgeries. Externally, latex is used as a soothing agent in treating burns and mild cuts in a gel form (7).

Aloe Vera gel showed significant results in treating diabetes mellitus, asthma, and peptic ulcers

In animal studies, aloe gel showed wound healing, anti-inflammatory, gastro protective, spermicidal, antiviral, as well as cholesterol lowering and immune-stimulating qualities (8, 9 ).

Wound healing. A recent study showed aloe is more effective than conventional treatments for burns, frostbite, and intra-arterial damage.

Antiviral and spermicidal effect was shown in an in vitro study. The authors concluded that it might be useful as a contraceptive, especially in preventing the transmission

of HIV.

Gastro protective properties. When aloe gel was given to rats before ulcer inducing stress, the number of ulcers decreased by 80%. After developing ulcers, the animals given aloe vera gel recovered 3 times faster compare to the control animals (9).

Immune stimulation. When given orally to animals, it was shown to lower cholesterol.

Animal studies found antitumor and anticancer activity in alcoholic extract of aloe.

Recent human clinical studies of external use of aloe vera gel for wound healing and psoriasis showed that aloe accelerated healing by 72 hours (patients after dermabrasion).

The wounds of patients with frostbites and burns healed faster and had less tissue loss and fewer complications compare with conventional methods (10).

The internal use of the gel has been studied for treating asthma; diabetes mellitus and peptic ulcers showed and reported positive results ( 8 ).

In addition to gel and powder form, tincture and fermented gel are being used.

The famous classic Ayurvedic medicine, Kumaryasava, uses fermented aloe gel to make a tonic herbal wine, such a wine which is normally flavored using jaagery or honey and varied spices. It is used as a remedy for the treatment of anemia in patients; in the treatment of the digestive system, various female reproductive and liver disorders.

"...This recipe increases strength, color, digestive capacity, weight and taste, acts as a aphrodisiac, relieves pain of indigestion, eight kinds of udara (abdominal inlargment ), severe kshaya (consumption), twenty kinds of prameha (diabetes ), udavarta ( reverse peristalsis ), apasmara ( epilepsy ), sukra dosas ( disorders of the semen ), ashmari ( urinary calculus ), krmi ( parasites ) and raktapitta ( purpura ) without doubt (18-27)." (11).

Aloe can be combined with shatavari as a nutritive tonic, with gentian as a bitter tonic, with manjista as an emmenagogue (12).

Contraindications: pregnancy (powder), powder in vata constipation.

Aloe Vera is contraindicated in cases of known allergy to plants in the Liliaceae family.

Conclusion

Aloe vera is well known and used worldwide as a medicinal plant.

The external use of aloe vera for minor wounds, burns (including radiation burns), and frostbites has been established through extensive use and clinical and pharmacological studies. The internal use of Aloe vera for peptic ulcer, diabetes type 2, asthma, HIV and many other potential uses needs additional studies. Since ancient time, aloe has provided humankind with numerous valuable medicinal products. Human studies continue to confirm its therapeutic use.

References.

1. Dr.Pole, Sebastian. Ayurvedic Medicine. Livingstone: Elsevier, 2006.

2.. Frawley, David, and Dr. Lad ,Vasant. The Yoga of Herbs. Twin Lakes: Lotus Press , 2008

3. Agarwal , OP. "Prevention of atheromatous heart disease". Angiology 1985 Aug;36(8):-: 485-492.

4. Wu JH, Xu C, Shan CY, Tan RX, "Antioxidant properties and PC12 cell protective effects of APS-1, a polysaccharide from Aloe vera var. chinensis". Life Sci. 2006 Jan : 622-630.

5.. Bruneton,J. 1995. Pharmacognosy, Phytochemistry, Medical Plants. .Paris Lavoisier Publishing.

6. Dal'Belo SE, Gaspar LR, Maia Campos PM., "Moisturizing effect of cosmetic formulations containing Aloe vera extract in different concentrations assessed by skin bioengineering techniques.". Skin Res Technol. 2006 Nov;: 241-246.

7. Bradley,P.R.,1992.British Herbal Compendium.Vol.1.Dorset:British Herbal Medicine Association

8. Davis,R.H.et.al.1994.Mannose-6-Phosphate:Anti-inflammatory and wound healing activity of a growth substance in Aloe vera.J.Appl.Hort.,2(1):10-14

9. Danhof,I. 1991.Potential Benefits from Orally ingested Internal Aloe vera Gel. Irving, Texas: International Aloe Science Council 10th Annual Aloe Scientific Seminar

11. Bhavaprakasa of Bhavamisra. Chwkhamba Krishnadas Academy

12. "HerbMed". Alternative Medicine Foundation, Inc. 03.29.10 .

Lavender: An Ayurvedic View

2012-03-27T16:45:13Z

Lavandula angustifolia, Lamiaceae, Common Lavender, True Lavender, English Lavender, inflorescence; Karlsruhe, Deutschland. The fresh flowers are used in homeopathy as remedy: Lavandula (Lav-o.) Deutsch: Lavandula angustifolia, Lamiaceae, Echter Lavendel, Infloreszenz; Karlsruhe, Deutschland. Die frischen Blüten werden in der Homöopathie als Arzneimittel verwendet: Lavandula (Lav-o.) (Photo credit: Wikipedia)

By Shaw Lathrop

Dec. 2, 2010

Herbology Class, Alandi Ashram, Boulder, CO

Instructor, Jane Bunin, PhD

INTRODUCTION

Since a young age I have been intoxicated by the fragrant smell and delightful color of lavender. When choosing a plant to write a research report on my mind swiftly settled on this lovely variety.

True lavender (Lavandula angustifolia) is one member of a genus of 39 species of flowering plants of the mint family (Labiatae) that are considered "lavenders". The Lavandula genus includes annuals, woody perennials and small shrubs.

RESEARCH

Upon beginning to research lavender I at once discovered that a widespread use and love of this plant has provided the world with a wealth of information with which to draw from. Lavender is one of the oldest medicinal herbs, having over 2500 years of recorded use. In my research I attempted to draw on a diverse background of sources including scientific journals, field guides, gardening and horticulture books, and ethnobotanical sources. My work is by no means exhaustive, but rather attempts to provide a well-rounded resource for those interested in the potential medicinal properties of this delightful herb.

PLANT NOMENCLATURE

The name "lavender" is often said to come from the Latin word "lavare" meaning "to wash" because the Romans were known to use it in their baths. (Oxford English Dictionary (second ed.). 1989)

However, Sally Festing in The Story of Lavender (Festing, S. (1985) The Story of Lavender, Hyperion Books pg. 137) suggests that the English name "lavender" most likely came from the Latin word "livendula" which means "bluish" and is the root of the word "livid".

Kingdom:Plantae

Division:Magnoliophyta

Class:Magnoliopsida

Order:Lamiales

Family:Lamiaceae

Genus: Lavendula

Species: Angustifolia

Synonyms: Lavandula officinalis, Lavandula vera

Common Names:

Alhucema, Common Lavender, English Lavender, French Lavender, Garden Lavender, Lavanda, Lavande, Lavandula, Lavender Essential Oil, Ostokhoddous, Spanish Lavender, Spike Lavender, True Lavender.

APPEARANCE

Lavender (Lavendula Angustifolia) Deutsch: Lavendel (Lavendula Angustifolia) (Photo credit: Wikipedia)

Flower and Fruit: The flowers are in false whorls of 6 to 10 blossoms forming interrupted terminal spikes. The pedicles are 10 to 15 cm long downy stems. The bracts are 5 mm long, ovate to broadly triangular, often brown and brown-violet or violet-tinged. The tubular calyx has 5 uneven tips, it is amethyst-colored, tomentose and after flowering it is closed by a lidlike appendage of its upper tip. The corolla is longer with a cylindrically fused base, the lips are flat, and the upper lip is larger with 2 lobes. The lower lip is 3-lobed with even tips. The stamens are enclosed in the tube. The ovary consists of 4 carpels and has a nectary below it. The fruit is a glossy brown nutlet.

Leaves, Stem and Root: English Lavender is a 60 cm high sub-shrub and is heavily branched with leafy, erect, rod-like, gray-green, young branches. The leaves are sessile, oblong-lanceolate, entire-margined, involute, gray, later green with glandular spots beneath.(Bailey, L.H. (1949) Manual of Cultivated Plants Most Commonly Grown in the Continental United States and Canada. MacMillan Publishing Company pg. 1116)

HABITAT

Lavender is reported by most sources to be native to southern Europe and the Mediterranean region, tropical areas of Africa, southern India, and the area around modern day Iraq. Today lavender is grown in herb gardens throughout the world and is commercially grown in Europe, Australia, Russia, and America. It can even be grown right here in Boulder, Colorado.

Easy to grow, Lavender likes warm weather, a sunny location and moderate water. In cold climates it may not survive the winter. Lavenders flourish best in dry, well-drained, sandy or gravelly soils in full sun. All types need little or no fertilizer and good air circulation; in areas of high humidity, root rot due to fungus infection can be a problem.

(McCaleb, Roberts S. The encyclopedia of popular herbs 2000 Prima publishing pages 281-287)

PHENOLOGY

Depending on the growing region, Lavender growers can enjoy different varieties of the plant from early spring to mid summer. Each variety has a distinct flowering period.

Non-English Lavenders such as Spanish, Yellow, Sweet, French, Allardii, Goodwin Creek Gray, and Woolly Lavender start blooming early to mid spring. Spanish and Yellow Lavenders finish up after four or five weeks, with the others blooming for a bit longer.

The English Lavenders which include English, Munstead, Hidcote, Hidcote Pink, Jean Davis, Sarah, and Vera flower in mid to late spring. These second-round bloomers are finished by late spring or early summer.

The English Lavender Hybrids, sometimes referred to as Lavandins; come in third in the bloom cycle, starting just as the English Lavenders are finishing, and continuing to mid summer.
(http://www.mountainvalleygrowers.com/lavendercareandtips.htm No author cited. 1997)

COLLECTING/PREPARATIONS

Flower stalks are harvested in full bloom and during the hottest part of the day. The parts of the plant that are collected and used for medical application include the essential oil extracted from the fresh flowers and/or the inflorescences, the fresh flowers and the dried flowers.

The essential oil, which is the most commonly used medicinal form of lavender, is distilled from the flower stalks and flowers. The best quality oil is distilled from the flowers (without the stalks) which are distilled immediately, with no drying or fermentation since fresh lavender yields more esters.

In herbal medicine, the fresh or dried flowers are used in infusions, tinctures, or macerated oils. An infusion is prepared by adding 5 to 10 ml of lavender per cup of hot water (150 ml), drawing for 10 minutes, and straining. For external use as bam additive, 100 g of lavender is scalded or boiled with 2 liters of water and added to the bath.

The fresh or dried flowers are also used in cooking and impart a delicious, distinctive flavor to cookies, sauces, and other dishes. Combinations with other sedative and/or carminative herbs are generally considered to be beneficial.

An absolute and concrete of lavender are also produced by solvent extraction for use in perfumery but should is not recommended for aromatheraputic use. (Joerg Gruenwald, PhD (eds) (2000) Physician's Desk Reference for herbal medicines. Medical Economics Company pg. 277)

MEDICINAL USES

Historical Uses

Lavender has a long history of use, and is cited as having a wide range of applications. I will begin by discussing historical uses of lavender and then go on to look at modern day applications.

The lavender plant may have first been domesticated in Arabia well before the time of Jesus and was used there as an expectorant and antispasmodic. From Arabia, it was then carried by the Greeks and Romans, who used it to cure or ward off a host of illnesses. Eventually it reached France, Spain, Italy and England where it became well established as a remedy for stomach complaints and nervousness and as a cosmetic water to benefit the skin. It was used from very early times as a strewing herb for its deodorizing and disinfecting properties. (Festing, S. (1985) The Story of Lavender, Hyperion Books pg. 137)

Dioscorides, the famous first century Greek physician, recommended lavender for "grief's of the thorax" and also noted that it relieved headaches, indigestion and sore throats when used internally and was good for treating wounds or burns and for skin conditions when used externally (Dioscorides (c. 65 A.D.) De Materia Medica. Ibidis Press).

It was often cited by Hildegard of Bingen, the famous 12th century mystic. It was one of her favorite herbs and she recommended it for migraine headaches, a use which has persisted into modern times, as well as for "maintaining a pure character". (Hildegard,B. (reprint 1997) Causae et Curae. Pattloch pg. 307) Later, it was one of the major ingredients of the so-called Thieves Vinegar used in the Middle Ages during the Plague and was also considered an aphrodisiac. (Festing)

By the 19th Century, doctors used lavender essential oil to treat headaches, memory loss, fainting, depression, and infertility in women. (Festing)

Maude Grieve, the famous 20th Century herbalist, offered an extensive treatise on various species of lavender in her Herbal and this has been the source of much of the historical information on this plant that is now widely quoted in many books and articles . Regarding the therapeutic actions and uses of lavender, she mentions its carminative and nervine properties and its use in depression, fatigue, snake bites, headache, loss of memory and an extensive array of other aliments. (Grieve, M. (1971) A Modern Herbal, Vol. II. Dover Edition pg. 521)

Modern Uses

In modern days, the most commonly used preparation of lavender is the essential oil. The majority of scientific journal reports I found are dealing with the use of the oil. Lavender essential oil is described as one of the most versatile essential oils and a wide range of therapeutic uses is reported. It is described as having outstanding cooling, soothing, and calming properties which make it useful in conditions involving inflammation, spasm, pain and restlessness. Lavender has been described as having remarkable balancing effects on the central nervous system and as being an outstanding choice for people who are suffering from stress, tension, insomnia, nervous exhaustion and related depression. It is described as calming and soothing to the nervous system and the body-mind and its reputed tonic properties are believed to help overcome exhaustion and apathy.

Moss M, Cook J, et al, "Aromas of Rosemary and Lavender Essential Oils Differentially Affect Cognition and Mood in Healthy Adults", International Journal of Neuroscience, Vol. 113, Issue 1, Jan. 2003, pp. 15-38: Results suggest that olfactory presentation of lavender essential oil decreased performance on cognitive tasks while rosemary oil produced mixed results (performance on some measures was enhanced compared to controls while on other measures it was degraded); the rosemary group was found to have greater alertness than the control or lavender groups, while both the lavender and rosemary groups reported better mood than controls. The authors conclude that the olfactory properties of essential oils can produce objective effects on cognitive performance and subjective effects on mood.

Buchbauer G, Jirovetz L, et al, "Aromatherapy: evidence for the sedative effects of the essential oil of lavender after inhalation", Naturforsch C. 1991, Nov-Dec; 46 (11-12): pp 1067 - 72. Inhalation of lavender essential oil was found to reduce caffeine-induced hyperactivity in mice to near-normal motility. The reduction showed a correlation with serum linalool levels and the authors conclude that the study provides support for the aromatherapeutic use of herbal pillows to facilitate falling asleep and to reduce stress.

Saeki Y, "The effect of foot-bath with or without essential oil of lavender on the autonomic nervous system: a randomized trial", Complimentary Therapies in Medicine, 2000, Vol. 8, Issue 1, pp. 2-7. Subjects sat with their feet soaking in hot water, with or without lavender essential oil, for ten minutes during which electrocardiogram, finger-tip blood flow and respiration were recorded; autonomic function was evaluated using spectral analysis of heart rate variability. The foot baths caused no changes in heart rate or respiratory rate but produced a significant increase in blood flow. On spectral analysis, the parasympathetic activity increased significantly during both types of foot-bath. In the lavender foot-bath, there were delayed changes to the balance of autonomic activity in the direction associated with relaxation.

Soden K, Vincent K, et al, "A randomized controlled trial of aromatherapy massage in a hospice setting", Palliative Medicine, 2004, Vol. 18, No. 2, 87-92. Forty-two patients were randomly assigned to receive massage with or without lavender essential oil added to the inert massage base. Outcome measures include a Visual Analog Scale of pain intensity, a sleep scale, an anxiety and depression scale, and symptom checklist. No significant long-term effects were found for lavender essential oil in terms of improving pain control, anxiety or quality of life. Sleep scores improved in both groups and depression scores improved in the massage-only groups. The authors conclude that lavender essential oil did not increase the beneficial effects of massage.

Bardeau F., "Utillisation d'HE aromatiques pour purifier et desodoriser l'air (Use of essential aromatic oils to purify and deodorize the air", Le Chirurgien-dentiste de France, 1976, Sept 29; 46 (319): 53 Vaporized essential oils and their capacity to destroy bacteria such as Proteus, Staph. Aureus, Strep. Pyrogenes and others were examined. Oils which were found to be the most effective in destroying air borne bacteria included clove, lavender, lemon, marjoram, mint, niaouli, pine, rosemary, and thyme.

Piccaglia R, Deans S G, et al, "Biological activity of essential oils from lavender, sage, winter savory, and thyme of Italian origin", 1993 Programme Abstracts 24th International Symposium on Essential Oils. The oils were tested for antimicrobial activity against 25 species including food poisoning types and human disease pathogens. All oils showed good activity against the majority of the bacteria. Lavender was most effective against Clostridium sporogenes.

Imberger I, Rupp J, et al, "Effect of Essential Oils on Human Attentional Processes" 1993 Programme Abstracts 24th International Symposium on Essential Oils, The authors investigated the effects of inhaled jasmine and lavender on human attentional processes. The excitatory effects of jasmine and sedative effects of lavender were clearly indicated in the results of vigilance tests. No effects were demonstrated regarding alertness as measured by reaction time.

Dale A, Cornwall S, "The role of lavender oil in relieving perineal discomfort following childbirth: a blind randomized clinical trial", Journal of Advanced Nursing, 1994, 19:89-96. 635 women participated in a clinical trial to assess the possible benefits of adding lavender oil to daily bath water for the first 10 days following childbirth. Subjects were assigned to one of 3 groups: one in which 6 drops of lavender essential oil was added, one with the addition of an inert aromatic substance, and one with synthetic lavender oil. Analysis of daily discomfort scores showed no significant differences between the groups. The authors concluded that lavender essential oil was not effective in this application.

Ghelardini C, et al, "Local anaesthetic activity of the essential oil of Lavandula angustifolia" Planta Med. 1999 Dec;65 (8):700-3.This work we studied the local anaesthetic activity of essential oil obtained from lavender. The authors compared its activity to the essential oils obtained from two citrus fruits, Citrus reticulata Blanco and Citrus limon (L.) Burm. f., which have no medical uses. Anaesthetic activity was evaluated in vivo in the rabbit conjunctival reflex test, and in vitro in a rat phrenic nerve-hemidiaphragm preparation. The essential oil of lavender but not the oils of Citrus reticulata and Citrus limon were able to drastically reduce, in a dose-dependent manner, the electrically evoked contractions of rat phrenic-hemidiaphragm. In the rabbit conjunctival reflex test treatment with a solution of essential oil of lavender administered in the conjunctival sac) allow a dose-dependent increase in the number of stimuli necessary to provoke the reflex, thus confirming in vivo the local anaesthetic activity observed in vitro.

Winston D. "The use of herbs for treating chronic back pain: a materia medica." J Am Herbalists Guild. 2005;6 (1):20-24. In this outline of recommendations of using herbal remedies in conjunction with other treatments the author recommends using lavender as a nervine and sedative to reduce stress and decrease muscle tension.

Approved by Commission E:

• Loss of appetite

• Nervousness and insomnia

• Circulatory disorders

• Dyspeptic complaints

Internally, English Lavender is used for mood disturbances such as restlessness or insomnia, functional abdominal complaints (nervous stomach irritations, Roehmheld syndrome, meteorism, nervous intestinal discomfort). Externally, English Lavender is used in balneotherapy for treatment of functional circulatory disorders.

When taken internally, lavender is a mild sedative that helps with restlessness and insomnia, reduces stomach acid and gas, and alleviates other intestinal difficulties. Bitter tasting but with a rich and sweet aroma, lavender is often used in colognes and perfumes and in many calming teas. Lavender is also used in aromatherapy as a holistic relaxant and is said to have carminative, antiflatulence and anticolic properties. Its sedative nature, on inhalation, has been shown both in animals and man. Lavender has spasmolytic activity, as does linalool, one of lavender's major components. The mode of action of lavender oil resembles that of geranium and peppermint oils.

PRIMARY CONSTITUENTS

Lavender flowers contain: 1-3% essential oil, containing mainly monoterpenes (Lavandulae aetheroleum, DAB 100, the most important component of which is linaloyl acetate (30-55%), also linalool (20-35%), b-ocimene, cineole, and camphor, and also the sesquiterpene caryophyllene oxide; tannins (5-10%), derivatives of rosmarinic acid; courmarin; flavonoids; phytosterols.

Lavender makes a complex essential oil with over 100 constituents including linalyl acetate, linalool, lavandulol, lavandulyl acetate, terpineol, cineol, limonene, ocimene, pinene, caryophyllene, linalyl butyrate, geranyl acetate, camphor, coumarin, etc. The essential oils of lavender with a high ester content and relatively low cineol and camphor are preferred. (Joerg Gruenwald, PhD (eds) (2000) Physician's Desk Reference for herbal medicines. Medical Economics Company pg. 277)

CONTRA-INDICATIONS

Lavender must be used in the appropriate dose to achieve best results. 4 drops or less per application produces a relaxing, balancing effect. When more than 4 drops are given in a two hour period, lavender may loose its balancing and calming effect and can become too stimulating, leading to restlessness and anxiety. (http://www.newyorkbuyersclub.org/resources/recommended-reading-files/13-DEPRESSION-ANXIETY-SLEEP.pdf No Author cited)

Lavender essential oil is generally considered non-toxic, non-irritant, and non-sensitizing in normal doses. However, at least one author has reported that it can cause dermatitis (J.A. Duke, 1985, cited in Aromatherapy for Health Professionals by Shirley and Len Price, 2nd Edition, (1999)).

An article in the Feb 2007 issue of the New England Journal of Medicine· (Derek V., et al, "Prepubertal Gynecomastia Linked to Lavender and Tea Tree Oils" New England Journal of medicine 356;5 February 1, 2007 http://www.nejm.org/doi/pdf/10.1056/NEJMoa064725) reported one researcher's concern that products containing lavender and/or tea tree essential oils may have been responsible for abnormal breast development in three pre-pubertal boys. Each of these boys had used a product, such as a soap or hair product, containing one or both of these essential oils and the author hypothesized that since these oils have a weak hormonal effect in vitro, they could have caused the abnormal growth in the boys. This article received a lot of press and has raised concerns for some about the use of these oils, despite the fact that the study was poorly designed and not well controlled. The Aromatherapy Trade Council (Great Britain) has published a critique of the study and dismisses the conclusions of the original article as unfounded. (Robert Tisserand (2007) http://www.a-tc.org.uk/pages/index.cfm?FuseAction=ShowPage&sec=6&page=189)

Many of the theraputic uses listed were approved by commission E.

Readers will quickly notice that the Commission E monographs do not include any references to the literature used by the Commission members in assessing the safety and efficacy of the herbal drugs under review. This is unlike the format for the monographs published in 1990 and subsequently by ESCOP. Commission E and ESCOP monographs are similar insofar as they are therapeutic monographs and do not detail standards for quality as are found in a pharmacopeial monograph.

According to Prof. Schilcher every monograph has a Begrundung , an unpublished justification with most of the relevant references. This material is stored at the BfArM in Berlin and only in conflicts or cases of disputes to the Medical Act can an attorney or a scientific organization view these references. The references were originally included in data reviewed by members of the Commission in determining monograph evaluations (Schilcher, 1998a).

McCaleb, Roberts S. The encyclopedia of popular herbs 2000 Prima publishing pages 281-287

http://www.mountainvalleygrowers.com/lavendercareandtips.htm

Festing, S., The Story of Lavender, Hyperion Books, 1985

Lavender by Elen Spector Platt and Lavender: Practical Inspirations by Tess Evelegh)

(Dioscorides, De Materia Medica, and c. 65 A.D.).

A Modern Herbal, Vol. II by Mrs. M. Grieve, Dover Edition, 1971

Withania somnifera- Ashwagandha

2012-03-26T16:38:14Z

by Shaw Lathrop

Instructor Alakananda Ma

Alandi Ayurveda Gurukula

This herb -Withania somnifera was photographed at Pune. Common name- Ashwagandha. (Photo credit: Wikipedia)

Common Names

Ashwagandha, winter cherry, "Indian Ginseng", also known as Physalis somnifera

Regional Names

Sanskrit- Turangi-gandha; Hindi- Punir, Asgandh; Bengali- Ashvaganda; Marathi- Askandha tilli; Gujarati- Ghodakun, Ghoda, Asoda, Asan; Telugu- Pulivendram, Panneru-gadda, Panneru; Tamil- Amukkura, Amkulang, Amukkuram-kilangu, Amulang-kalung, Aswagandhi; Kannada- Viremaddlinagadde, Pannaeru, Aswagandhi, Kiremallinagida, Punjabi- Asgand, Isgand

Other names

Achuvagandi, Ajagandha Alkekengi,Amikkira-gadday, Amukkira-kilzhangu, Amukran-kizhangu, Asagandha, Asundha, Bladder Cherry, Chinese Lantern Plant, Fatarfoda, Hirimaddina-gadday, Hirre- gadday, Pevette, Physalis, Sogade-beru, Withania, Kanaje, Samm Al Ferakh.

Etymology

The Sanskrit name, Ashwagandha, comes from the unusual smell of its root, which is similar to that of a sweaty horse. Ashua= horse Gundha=smell.

The species name somnifera means "sleep-bearing" in Latin, indicating it was considered a sedative.

Kingdom: Plantae
Subkingdom: Tracheobionta
Division: Magnoliophyta
Class: Magnoliopsida
Subclass: Asteridae
Order: Solanales
Family: Solanaceae
Genus: Withania
Species: Wilthamnia Somnifera

Ecologic Status

Ashwagandha is native to the dry regions of south central Asia, and thrives in a Mediterranean-type climate such as Southern California. It grows prolifically in India, Nepal, Pakistan, Sri Lanka and Bangladesh. It is commercially cultivated in Madhya Pradesh (a state in India).

Here is a list of where it is found natively-

AFRICA
Macaronesia: Cape Verde; Spain - Canary Islands
Northern Africa: Algeria; Egypt; Libya; Morocco; Tunisia
Northeast Tropical Africa: Chad; Eritrea; Ethiopia; Somalia; Sudan
East Tropical Africa: Kenya; Tanzania; Uganda
West Tropical Africa: Liberia; Mali; Nigeria
South Tropical Africa: Angola; Malawi; Mozambique; Zambia; Zimbabwe
Southern Africa: Botswana; Lesotho; Namibia; South Africa - Cape Province, Free State, KwaZulu-Natal, Transvaal; Swaziland
Western Indian Ocean: Mauritius

ASIA-TEMPERATE
Arabian Peninsula: Arabia
Western Asia: Afghanistan; Iran; Iraq; Israel; Jordan; Lebanon; Syria; Turkey

ASIA-TROPICAL
Indian Subcontinent: India; Pakistan; Sri Lanka

EUROPE
Southeastern Europe: Greece; Italy - Sardinia, Sicily
Southwestern Europe: Spain

Plant Parts Used

Dried roots are used in Ayurveda in various formulations. Powdered roots are also used for its nutritive properties.

Ethnobotany

Ashwagandha root has been used in India for at least between 3,000-5,000 years, to enhance libido and sexual vitality, improve fertility and overall reproductive health, and to reduce stress. In ancient times it was drunk in buffalo milk.

Robin Lane Fox, an English scholar, mentioned Ashwagandha in his biography about Alexander The Great. According to the biography in the time of Alexander, wine prepared from Ashwagandha was in wide use. He and his army use to prepare this wine to gain energy and get rid of various ailments.

According to Anne Van Arsdall, a scolar of Medieval herbal remedies, Ashwagandha was called apollinaris and also glofwyrt in The Old English Herbarium, and had a legend that Apollo found it first and gave it to the healer Aesculapius.

Ayurvedic Herbal Energetics

Rasa: Madhura tikta, kashaya
Guna: Laghu, Snigdha

Vipaka: madhura
Virya: ushna
Karma: medhya, nidrajanana, stanyajanana, vedanasthapana, balya, vajikarana, rasayana, Vatakaphahara

Preparation

Ashwagandha was traditionally available as powder that was made after crushing roots of the plant thoroughly and then sieving it through a very fine cloth. Various other preparations were being made using this powder that is mentioned below. In today's global market Ashwagandha is available in powder, capsules, syrups and tablet forms. It is readily available.

Ayurvedic classical preparations

Ashwagandharista -a decoction preparation that is being prepared with Ashwagandha as a main ingredient.

Ashwagandhaghrta - an Ashwagandha preparation in which it is processed in the ghee.

Ashwagandha churna- a powdered preparation of Ashwagandha root.

Ashwagandhavaleha -a classical preparation in which Ashwagandha along with other herbs are processed to make it in a paste texture that can be licked.

Saubhagyasunthipaka - a preparation in which Ashwagandha and sunthi (dried ginger) are taken in major proportion with other herbs taken in smaller amounts.

Sukumaraghrta - an Ashwagandha preparation made in ghee. It is generally prepared for children.

Maharasnadi yoga - a Ashwagandha preparation that is widely used as pain killer by ayurvedic practitioners.

Dosage

Dosage of various forms of Ashwagandha is given below considering a person of normal weight and height. These can vary from person to person.

Churna (powder) - 3 to 6 grams

Arisht (decoction) - 15 to 20 ml

Ghrit (ghee) -3 to 5 ml

Capsules -(350 to 400 mg) - 1 or 2

Syrups -5 to 10 ml

Avleha (paste) - 3 to 6 grams

Indications

ADD/ADHD, Anorexia, anti-oxidant, asthma, bronchitis, cancer, consumption, cough, leucoderma, edema, asthenia, anemia, exhaustion, aging, immune dysfunction, impotence, infertility, insomnia, repeated miscarriage, paralysis, memory loss, multiple sclerosis, neurological diseases rheumatism, arthritis, lumbago.

Contraindications

Caution should be used with clients on anticonvulsants, and barbiturates. Ashwagandha is traditionally avoided in lymphatic congestion, during colds and flu, or symptoms of ama.

Ayurvedic Uses

-It is used in formulations for its excellent anti inflammatory & pain relieving properties.

-Application of soft paste or poultice made of leaves or roots or both of Ashwagandha is indicated in cases of goiter & glandular inflammations.

-Oil prepared with infusion from roots of Ashwagandha is recommended in 'Daurbalya' (general weakness) to rejuvenate muscles & to strengthen joints and associated tissues and in Vata related disorders.

-It is a rasayana herb & is used for rejuvenation and revitalization of musculo-skeletal system.

-It is used in circulatory disorders for its hypotensive, brady-cardiac & depressant properties. It helps to control cardiac inflammation.

-It helps in congestion & helps in breathing difficulty. Widely used in Ayurvedic formulations for asthma, chronic cough, allergic cough.

-Ashwagandha has excellent diuretic properties. In females it is used in formulations for uterine inflammation, leucorrhea and menstrual disorders.

-Ashwagandha is widely used in Ayurvedic formulations as a tonic for stimulating male genital system and in conditions such as loss of libido, erectile dysfunction, oligospermia & impotence.

-It has sedative & mild hypnotic properties.

-Root and bitter leaves are used as a hypnotic in alcoholism and emphysematous dyspnea.

-Root is used in doses of about 30 grains in consumption, emaciation of children, senile debility, rheumatism, in all cases of general debility, nervous exhaustion, brain-fag, low of memory, loss of muscular energy and spermator rhoea. It infuses fresh energy and vigor in a system worn out owing to any constitutional disease like syphilis, rheumatic fever etc., or from over-work and thus prevents premature decay.

-Leaves are used as an anthelmintic and as an application to carbuncles.

-Fruits or seeds are used as diuretic, and to coagulate milk.
-Root is used as an application in obstinate ulcers and rheumatic swellings.

-Ashwagandha is an ingredient in chyavanaprash. Chyavanaprash is used as a treatment for kasa (cough), svasa (dyspnea), kshaya (consumption), svarabheda (voice problems) and hrdroga (heart problems). It is also used in a special type of rasayana therapy called kutipraveshika, employed after pancha karma, whereby the patient is housed in a specially constructed hut and consumes nothing except Chyavanaprash, rice, ghee for a specified period of time.

Ashwagandha is frequently a constituent of Ayurvedic formulas, including shilajit.

Specific Ayurvedic Remedies

-A decoction of Ashwagandha root is useful as nutrient and health restorative to pregnant and elderly people. You can also take its powder with milk as an alternative.

-Ashwagandha Ghrita promotes the nutrition and strength of children. For improving the nutrition of weak children, give for two weeks.
-For curing the sterility of women, Ayurveda practitioners often prescribe a boiled down decoction of Ashwagandha, milk and ghee. Take this for a few days, soon after the menstrual period.

-For involuntary loss of semen, and loss of strength, a powder consisting of Ashwagandha, sugar, ghee, honey and long pepper is often given daily, with a milk and rice diet.

-Ashwagandha root taken with milk or clarified butter acts as an aphrodisiac and restorative to old men. Ashwagandha - Vidari Combination is a herbal remedy for this condition.

-The powder of Ashwagandha and rock candy, in ghee is often prescribed for lumbago, pains in the loins or small of the back.
-Fresh green root of Ashwagandha reduced to paste with cow's urine or with water heated applied to the parts affected is useful for glandular swellings.
-Narayana Taila, an Ayurvedic herbal remedy containing Ashwagandha, is useful for consumption, emaciation of children and rheumatism and as an enema in dysentery and anal fistulae.

-A ghrita prepared with a decoction and paste of Ashwagandha root is used internally and an oil prepared with a decoction of the root and a number of aromatic substances in the form of a paste is used externally for rheumatism.

-For skin diseases apply Ashwagandha powder well mixed with oil to the skin.

-Also for skin diseases make a paste of 1 tsp Ashwagandha, 1/2 tsp Manjistha, and 1/2 tsp Turmeric. Apply to Scaly eczema, psoriasis, and dermatitis.

-For improving eyesight take a mixture of Ashwagandha powder, licorice powder and juice of amla.

-Apply drops into the nose in deafness, and as an ointment over the body in hemiplegia, tetanus, rheumatism, and lumbago.
-Use a decoction of the roots of Ashwagandha, and licorice, with cow's milk to promote lactation.

-For vitiligo mix 1 tsp Ashwagandha and ½ tsp Red Sandalwood. Take internally + externally.

-For Tuberculosis make a Yakshma, 1 tsp Ashwagandha boiled with goats milk, 1/16 tsp pippali

Take 1 cup goat's milk, add 1 cup water, put 1 tsp Ashwagandha + 1/16 tsp pippali, boil milk back to one cup. Give 1 cup morning + evening

Medical research

-Adaptogen:

Researchers found that rats treated with an extract of Ashwagandha showed better stress tolerance in cold water swimming tests, a classic experimental model of adaptogenic activity (Archana and Namasivayam 1999).

-Anti-inflammatory:

An extract of the aerial parts of Ashwagndha had excellent anti-inflammatory effects in rats subjected to having cotton-pellets surgically implanted under their skin (al-Hindawi et al 1992). An extract composed 80% of Ashwagandha displayed significant anti-inflammatory activity on rats that were exposed to a substance called carrageenan which is used to induce paw swelling (al-Hindawi 1989).

-Antioxidant:

A root extract of Ashwagandha prevented the rise of experimentally induced free radical build-up in rabbits and mice (Dhuley 1998a). In tests conducted on rats' brains with an extract taken from Ashwagandha root, it was found that there was significant increase in three natural anti - oxidants. The natural antioxidants found were glutathione peroxidase, catalase and superoxide dismutase. This ratio was constant in various repeated tests conducted. (Bhattacharya et al 1997).

-Cancer:

The administration of Ashwagandha rasayana (an Ayurvedic formulation containing Ashwagandha) significantly reduced the lung tumor nodule formation by 55.6% in experimental animals (Menon et al. 1997). An alcoholic extract of the dried roots showed significant antitumor and radio-sensitizing effects in experimental tumors in Chinese hamster cells, without any noticeable systemic toxicity (Devi 1996). Ashwagandha displayed significant antitumor and radio-sensitizing effects, inhibiting tumor growth and increasing survival in Swiss mice inoculated with Ehrlich ascites carcinoma, a specific type of cancer (Devi et al 1995; Sharad et al 1996). The administration of an extract of Ashwagandha was found to significantly reduce induced leucopenia in lab animals, indicating its usefulness in cancer therapy (Davis and Kuttan 1998).

-Central Nervous system:

Isolated constituents of Ashwagandha increased neuron receptor capacity, partly explaining the cognition-enhancing and memory-improving effects traditionally attributed to Ashwagandha (Schliebs et al 1997). A commercial root extract of Ashwagandha used repeatedly over nine days lessened the development of tolerance to the pain-killing effect of morphine and suppressed morphine-withdrawal jumps (Kulkarni and Ninan 1997).

-Diabetes:

The hypoglycemic, diuretic and hypocholesterolemic effects of roots of Ashwagandha were assessed in six patients with mild Non-Insulin-Dependent Diabetes Mellitus and six patients with mild hypercholesterolemia. The treatment consisted of the powder of roots over a 30 day period. At the end of the study, researchers noted a decrease in blood glucose comparable to that of an oral hypoglycemic drug, and a significant increase in urine sodium and urine volume, coupled with a decrease in serum cholesterol, triglycerides, LDL (low density lipoproteins) and VLDL (very low density lipoproteins) cholesterol, with no adverse effects noted (Andallu and Radhika 2000).

-Immunity:

Myelosuppressed mice (those with decreased production of red blood cells) treated with an extract of Ashwagandha showed a significant increase in hemoglobin concentration, red blood cell count, white blood cell count, platelet count and body weight as compared to control groups. (Ziauddin et al 1996). Mice infected intravenously with Aspergillus fumigatus (a fungus which causes strong allergic reactions) and treated for 7 consecutive days with an oral preparation of an extract of Ashwagandha displayed increased white blood cell activity and prolonged survival time (Dhuley 1998). The antifungal activity of Ashwagandha has been confirmed elsewhere, attributed to a component it contains known as withanolides (Choudhary et al 1995).

-Musculo-skeletal:

A formulation containing roots of Ashwagandha, the stem of Boswellia serrata (Indian frankincense), rhizomes of Curcuma longa (Turmeric ) and a zinc complex (Articulin-F), was evaluated in a randomized, double-blind, placebo controlled, cross-over study in clients with osteoarthritis. The results produced a significant drop in severity of pain and disability, although radiological assessment did not show any significant changes. Side effects were minimal and did not necessitate the withdrawal of treatment. (Kulkarni et al 1991)

Classical References

Bhavaprakasa, Karsyadhikara, 40-9

Bhavaprakasa, Karsyadhikara, 40

Bhavaprakasa Nighantu, Guducyadi vara, 190

Bhavaprakasa, Rasayanadhikara, 73-13

Bhavaprakasa, Snayukarogadhikara 57-8

Bhavaprakasa, Yonirogadhikara 70-26

Cakradatta

Cakradatta, Rasayanadhikara, 16

Cakradatta, Vatavyadhi cikitsa, 22-90

Cakradatta Vatavyadhi cikitsa, 22/141-145

Cakradatta, Yonivyapata cikitsa 26

Caraka Samhita, cikitsa 17-117

Caraka Samhita, cikitsa 27

Caraka Samhita, Siddhi 10-3

Caraka Samhita, Sutra 3-7, 8, Vimana 8-144 etc. Cikitsa 2-1, 34 etc. Siddhi, 3-37 etc.

Kaiyadeva Nighantu, Osadha varga, 1045-1047

Raja Nihantu, Satahvadi varga, 112

Raja Martanda

References

Acharya Deepak Dr., Sancheti Garima Dr., Pawar Sanjay Dr., Shrivastava Anshu Dr. 2006-11-24. Traditional medicines of Gonds and Bharias - 28 - Herbal medicine for Paralysis http://www.disabled-world.com/artman/publish/paralysis.shtml

Abraham, A., I. Kirson, E. Glotter and D. Lavie.1968. A chemotaxonomic study of Withania somnifera (L) Dunal . Phytochemistry, 7: 957-62.

Al-Hindawi, M.K., I.H. Al-Deen, M.H. Nabi, and M.H. Ismail. 1989. Anti-inflammatory activity of some Iraqi plants using intact rats. J Ethnopharmacol. Sep; 26(2):163-8

Andallu B, Radhika B. 2000. Hypoglycemic, diuretic and hypocholesterolemic effect of winter cherry (Withania somnifera, Dunal) root. Indian J Exp Biol. Jun;38(6):607-9

Aphale A.A., A.D. Chhibba, N.R. Kumbhakarna, M. Mateenuddin and S.H. Dahat. 1998. Subacute toxicity study of the combination of ginseng (Panax ginseng) and Ashwagandha (Withania somnifera) in rats: a safety assessment. Indian J Physiol Pharmacol Apr; 42(2):299-302

Archana, R. and A. Namasivayam. 1999. Antistressor effect of Withania somnifera. J Ethnopharmacol. Jan; 64(1):91-3

Atal, C.K. and Schwarting, A.E., 1961. Ashwagandha - An ancient Indian drug. Economic Botany, 15: 256-263.

Bhattacharya, S.K., K.S. Satyan and S. Ghosal. 1997. Antioxidant activity of glycowithanolides from Withania somnifera. Indian J Exp Biol. Mar; 35(3):236-9

Choudhary, M.I., Dur-e-Shahwar, Z. Parveen, A. Jabbar , I. Ali, Atta-ur-Rahman. 1995. Antifungal steroidal lactones from Withania coagulance. Phytochemistry Nov; 40(4):1243-6

Dash, Bhagwan. 1991. Materia Medica of Ayurveda. New Delhi: B. Jain Publishers.

Davis, L. and G. Kuttan. 1999. Effect of Withania somnifera on cytokine production in normal and cyclophosphamide treated mice. Immunopharmacol Immunotoxicol Nov; 21(4):695-703

Davis L. and G. Kuttan. 1998. Suppressive effect of cyclophosphamide-induced toxicity by Withania somnifera extract in mice. J Ethnopharmacol. Oct; 62(3):209-14
Devi, P.U. 1996. Withania somnifera Dunal (Ashwagandha): potential plant source of a promising drug for cancer chemotherapy and radiosensitization. Indian J Exp Biol. Oct; 34(10):927-32

Devi, P.U., A.C. Sharada, and F.E. Solomon. 1995. In vivo growth inhibitory and radiosensitizing effects of withaferin A on mouse Ehrlich ascites carcinoma. Cancer Lett. Aug 16; 95(1-2):189-93

Dhuley, J.N. 1998. Effect of Ashwagandha on lipid peroxidation in stress-induced animals. J Ethnopharmacol. Mar; 60(2):173-8

Dhuley, J.N. 1998b. Therapeutic efficacy of Ashwagandha against experimental aspergillosis in mice. Immunopharmacol Immunotoxicol. Feb; 20(1):191-8

Ayurvedic Pharmacopiea of India. E-book

http://www.ccras.nic.in/PharmacopoeialWork/20081103_AyurvedicPharmacopoeia.htm

Frawley, David and Vasant Lad. 1986. The Yoga Of Herbs: An Ayurvedic Guide to Herbal Medicine. Santa Fe: Lotus Press.

Kulkarni, S.K. and I. Ninan. 1997. Inhibition of morphine tolerance and dependence by Withania somnifera in mice. J Ethnopharmacol. Aug; 57(3):213-7

Kulkarni, R.R., P.S. Patki, V.P. Jog, S.G. Gandage and B. Patwardhan. 1991. Treatment of osteoarthritis with a herbomineral formulation: a double-blind, placebo-controlled, cross-over study. J Ethnopharmacol. May-Jun; 33(1-2):91-5

Kuttan, G. 1996. Use of Withania somnifera Dunal as an adjuvant during radiation therapy. Indian J Exp Biol. Sep; 34(9):854-6

Lane Fox, Robin. 1974. Alexander the Great New York: E P Dutton

Mehta, A.K., P. Binkley, S.S. Gandhi, and M.K. Ticku. 1991. Pharmacological effects of Withania somnifera root extract on GABAA receptor complex. Indian J Med Res. Aug; 94:312-5

Menon L.G., R. Kuttan, and G. Kuttan. 1997. Effect of rasayanas in the inhibition of lung metastasis induced by B16F-10 melanoma cells. J Exp Clin Cancer Res. Dec; 16(4):365-8

Nadkarni, Dr. K.M. 1954. The Indian Materia Medica, with Ayurvedic, Unani and Home Remedies. Revised and enlarged by A.K. Nadkarni. 1954. Reprint. Bombay: Bombay Popular

Prakashan PVP.

Schliebs, R., A. Liebmann , S.K. Bhattacharya, A. Kumar, S. Ghosal, and V. Bigl. 1997. Systemic administration of defined extracts from Withania somnifera (Indian Ginseng) and

Shilajitu differentially affects cholinergic but not glutamatergic and GABAergic markers in rat brain. Neurochem Int. Feb; 30(2):181-90

Sharad, A.C., F.E. Solomon, P.U. Devi, N. Udupa, and K.K. Srinivasan. 1996. Antitumor and radiosensitizing effects of withaferin A on mouse Ehrlich ascites carcinoma in vivo. Acta Oncol. 35(1):95-100

United States Department of Agriculture Agricultural Research Service
Germplasm Resources Information Network (GRIN) 30-Aug-1999

http://www.ars-grin.gov/cgi-bin/npgs/html/taxon.pl?102407

Van Arsdall, Anne. 2002. Medieval Herbal Remedies: The Old English Herbarium and Anglo-Saxon Medicine. Routledge.

Shilajit: Conqueror of the Mountains and Destroyer of Weakness

2012-03-24T22:40:24Z

A Monograph

by:

Annalise Ozols

dragonflyhlr@gmail.com

Herbology: Alandi Ayurveda Gurukula

Instructor: Alakananda Ma

April 30, 2010

Introduction

A highly mineralized exudate that oozes from the rocks of mountainous regions in Asia in the heat of summer, shilajit is a curious resin that resembles asphalt and smells distinctly like cow urine. Loosely translated from Sanskrit as "conqueror of the mountains and destroyer of weakness", shilajit's lofty prabhav is that it will cure any cureable disease when combined with other appropriate medications. (Caraka Samhita)

A note on my research process

The naturally occurring and medicinal shilajit is sometimes referred to as asphaltum but is not to be confused with the asphaltum that is derived as a residue from the refining of petroleum or the natural tar-like substance that washes ashore from oil seepages beneath the Gulf of Mexico. It is also often called "bitumen" which refers to a fossilized, tar-like, black and oily substance which is a natural by-product of decomposed organic materials and ranges from viscous to hard and brittle. There are documented accounts of coastal aboriginal people using asphaltum and bitumen for the purpose of sealant, adhesive and paint and as early as the Neanderthals using it to assemble tools. It is now known that true shilajit has a certain set of characteristic constituents which account for its evidence based use as a timeless rasayana[1] widely used in Ayurveda. That being said, an internet search for shilajit may also very well land one in a world of advertisements for "Indian Viagra" and "the fountain of youth". For the purposes of this article I will be referring to the humic substance comprised mainly of minerals known as Himalayan shilajit.

A fair amount of research has been done on shilajit in Eastern Universities. Unfortunately, I found that the majority of studies testing medicinal hypotheses of shilajit was done using animal subjects.

Botany and ethnobotany

Latin Name: Asphaltum, Asphaltum punjabianum

Common Names: mineral pitch, vegetable asphalt, bitumen , Jew's pitch,; Silajatu, mumiyo.; Other synonyms according to Bhavprakash are: adrija, saila niryasa, gaireya, asmaja, girija ans sailadhatuja; Other names appearing in formulation are: jatu, jatuna and adrija (The Ayurvedic Formulary of India Part I & II, 2003)

Plant Nomenclature: It appears that as it is not a single plant, there is no further taxonomic classification for shilajit. It is simply listed as a "drug of mineral origin" in the Ayurvedic Formulary. Research at Banaras Hindu University in India reveals via chemical analysis that shilajit is the result of the humification of resin and latex bearing plants. (Agrawal, 2003) including Euphorbia royleana and Trifolium repens.

Constituents: Resins, Benzoic acid, hippuric acid, fulvic acid; minerals: silica, iron, antimony, calcium, copper, lithium, magnesium, manganese, molybdenum, phosphorus, sodium, strontium, zinc (Pole, 2006)

The primary active ingredients in shilajit are fulvic acids, di-benzo alpha pyrones, humins, humic acids and trace minerals. Chemical analysis has shown that about 80% of the humus[2] components are present in shilajit.

While there are other similar substances containing fulvic and humic acids, shilajit is differentiated in that it contains oxygenated di-benzo alpha pyrones. Shilajit collected from different areas does in fact exhibit differing chemical characteristics and bioactivities, however, the core composition includes low molecular weight chemical markers, aucuparins, di-benzo alpha pyrones and triterpenic acids. (Ghosal, 1990)

Ecologic Status: Shilajit is formed and found primarily in Asia in the Himalayan ranges in India, Nepal, Pakistan, China, Tibet, and part of Central Asia and Scandinavia It has been found all over the mountains of Europe as well. Millions of years ago, before the Himalayan mountains were formed, a fertile valley and lush foliage existed in their place. As the movement of the continents caused the valley to become the tallest mountain range in the world, the vegetation became trapped and preserved between the rock formations. Still today, the range continues to grow 1 cm. per year (U.S. Geological Survey) Due to extreme weather conditions and temperature variation, rock formations shift and in doing so expose precious shilajit. Because of its ancient nature, the vegetation was never exposed to any type of fertilizer, pesticide, herbicide, or pollution. (Hartman)

Some say that shilajit's origin is not absolutely known. According to others, it was discovered by Himalayan villagers who observed large white monkeys migrating to the mountains in the warm summer months. The monkeys were seen chewing a semi-soft substance that flowed from between layers of rock. The villagers attributed the monkeys' great strength, longevity and wisdom to the substance. So, they began to consume it themselves and reported a broad spectrum of improvements in health. (Hartman)

While there are several areas from which the raw material is collected, it is thought that the highest levels of therapeutic ingredients come from the "sacred" mountains, specific areas in the Himalayas in Nepal at 10,000-12,000 feet above sea level. (Hartman)

It is not readily mentioned what the current supply situation for shilajit is like. It does come from an immense source-the Himalayan mountain range, but may be difficult to collect due to the foreboding nature of the source.

Part used: Purified Exudate. It is literally the oozing from the crevices of the rocks on exposure to the heating sun rays of summertime. The exudate that is shilajit appears to be the result of several factors: composted residue of certain resin or latex containing plants, the local environment, the temperature, humidity and the geological makeup of the rocks that it comes from. These varying factors account for different varieties and the difference in energetics and chemical constituents. According to Bhavprakash, there are four varieties: Sauvarna-gold Silajit (red color), Rajata-silver (white color), Tamra-copper (blue color), Ayasa-iron (blackish/brown color) and referred to as Lauha in other sources. Of these, the black variety appears to be the best for medicinal use, especially in cases where rasayana is indicated, although all types are applicable in all conditions. (CH chi, ch1, v 55-61)

Preparation: Shilajit is eaten by rats and monkeys in its natural state but it needs to be purified in order to be suitable for human consumption. Proper processing of raw shilajit is very important as it contains free radicals and possibly mycotoxins and fungal toxins. Processing removes free radicals, polymeric quinone radicals, toxins, mycotoxins, and other inactive ingredients. (Hartman)

The Ashtanga Hrdayam states that to prepare shilajit, it should first be washed in plain water and then dried. Then, it should be soaked in a decoction of other medicines (suitable to the disease to be treated) and then stored in an iron vessel. The ratio is 1:8 (shilajit:decoction) and boiled down to 1/8. Then it is filtered and dried. This process is repeated seven times. (AH Ut 39, 134-135 ) It is commonly boiled in a decoction of triphala.

According to the Sarngadhara Samhita, crude shilajit is powdered and then macerated in hot water (or a decoction of Triphala) for several hours. The maceration is then filtered and the liquid collected in an earthen plate and exposed to the sun until a scum

begins to form on the surface. This scum is then skimmed off and dried in the sun until it forms a hard mass. At this point it is considered to be pure and can be processed further or "impregnated". Purified shilajit may be macerated in a decoction of different dravyas chosen specifically for their medicinal actions in a particular disease. Caraka reads that the shilajit should be soaked in this decoction and dried in the sun each day for 7 days, then combined with lauha bhasma (purified iron) and consumed with cow's milk. (Caldecott, 2006)

Ethnobotany: According to lore shilajit is "amrta" or nectar from God given to mankind in order to "live long and happy life". It is one of the most important medicines used for centuries and still today in Ayurvedic medicine. There is evidence of shilajit in the Indus civilization. (Agrawal, 2003) Traditionally it is known as rasayana and used as a power increasing tonic, age defying and aphrodisiac. In Chinese medicine it was used as a kidney/adrenal tonic.

"Mumiyo" is a similar substance (if not the same) collected by the native peoples of the northern regions of Russia and Afghanistan (Tillotson, 2001) and used by the people of the former Soviet union. The name is often used interchangeably with shilajit and bears similar health claims.

Ayurvedic Herbal Energetics

As mentioned before, there are different varieties of shilajit based on the factors involved which comprise its makeup. The following information is for the black/brown form coming from iron and most commonly used in a healing context: (Pole, 2006)

Rasa: Katu (pungent), Tikta (bitter), Lavana (salty), Ksaya (astringent)

Virya: ushna (heating)

Vipaka: katu (pungent)

Guna: ruksha (dry), guru (heavy)

Shilajit's Dravya karma or ayurvedic plant action is chedana which is the class of drugs that actively draws out toxins by scratching them from the tissues.

Karmas: rasayana (rejuvenative) for kapha & mutra, vajikarana (enhances sexual potency), medhya (enhances intellect), mutrakrcchraghna (alleviates painful urination), apasmaromadaghna (alleviates disorders of the nervous system), medohara (reduces fat tissue), sandhaniya helas broken bones, chedhana (scratches accumulated toxins from tissues and channels), tridosaghna (alleviates all three doshas)

Dhatus: All dhatus

Srotansi: mutra (urinary), majja (nervous), sukra/artava (reproductive)

Shilajit is usually thought of as having ushna virya, but according to Caraka it is either moderate (neither too cold nor too hot) or shita (cooling) virya. (chi, ch 1, v48-50, 55-61) Caraka also states that it is slightly amla (sour) and ksaya in rasa. The varieties are as such, according to Carak:

From gold: madhura (sweet) and slightly ksaya, shita, katu; V/P

From silver: katu, shita, madhura; K/P

From copper: tikta and katu, ushna, katu; K

From iron: tikta, lavana, shita, katu; tridosha

Shilajit used as medicine

The aforementioned fulvic acid constituent of shilajit acts as a carrier for di-benzo alpha pyrones, trace minerals and other nutrients into the deep tissues. They are small lattice shaped molecules absorbed by plants that need the trace minerals and other nutrients for their growth. When we eat the plants (or the animals that ate the plants) we ingest fulvic acids. However, currently, our depleted soil is lacking the beneficial microbes and plant material to produce fulvic acids and humus. Fulvic acid removes deep-seated toxins from the body and trace minerals are needed as cofactors for enzymes, play important roles in turning food into energy, maintain the electrical balance in bodily fluids, carry oxygen in the body, are part of blood and bone, allow nerves to transmit messages and more. (Hartman) (Harsahay Meena, 2010)

Di-benzo alpha pyrones are able to pass the blood brain barrier (BBB) and act as a powerful antioxidant protecting the brain and nerve tissue from free radical damage. It also inhibits the enzyme acetylcholinesterase, thereby increasing acetylcholine. Low levels of acetylcholine are associated with alzheimers, poor memory and concentration. (Hartman)

Panacea: A cure-all which boosts the curative effect of other herbs. It acts as a catalyst by promoting the action of other tonic agents. (Lad, 2001)

To name a few, claims are made that shilajit is helpful in: asthma and allergic conditions, gout, rheumatoid arthritis, joint disorders, antioxidant, anemia, asthma, cystitis, diabetes, dysuria, edema, epilepsy, gall stones, hemorrhoids, insanity, jaundice, kidney, obesity, sexual debility, skin diseases, menstrual disorders, and parasites.

Shilajit and specific conditions and systems

The following tends to be the agreed upon list for which there is more substantial evidence.

Urinary: Shilajit's action on mutra vahasrotas helps to clear stagnated vata and kapha and redirects the flow of apana vayu through the pelvic area. By this token, it can help clear stagnation of kapha and vata in prostatitis. (Pole, 2006). It is useful in treating painful urination, cystitis, stones, incontinence and glycosuria. It also acts as a diuretic by increasing urination, promoting kidney and bladder activity, reduces and removes toxins and decreases water retention of all tissues. (Tirtha, 1998-2007)

Diabetes: "For these (diseases), treatments which reduce medas (fat), anila (vata) and slesman (kapha) are desireable (required)". (AH Su 14, 21-24) Shilajit's affinity for both the fat tissue and the water channel make it useful in treating diabetes. It enhances peripheral glucose uptake so is used in hyperglycemia and regulating blood sugar levels. It also scrapes fat making it helpful in metabolic syndrome (excess weight, high cholesterol, low thyroid and diabetes). (Pole, 2006) According to Susruta Samhita (15,32-40) obesity can be cured by taking enemas of drugs with liquefying properties which contain minerals like Silajatu, cow's urine, the three myrobalans, honey, barley etc.

A study done with 61 diabetic subjects who were administered 1000mg of shilajit, twice daily for 30 days demonstrated antioxidant activity. As an adaptogen, it resulted in the reduction of lipids per oxidation and may be of benefit as a supplement in the prevention of diabetes complications. (Nidhi Saxena, 2003) Rat studies have also demonstrated that shilajit produces a significant reduction in blood glucose levels as well as improving lipid profile. (N. A. Trivedi, 2004)

Reproductive: Strengthens the entire reproductive system and is tonic (aphrodisiac) for the sex organs. It treats deficiency and weakness due to high vata in the female reproductive system with symptoms of weakness, infertility, dysmenorrhea and PMS, as well. (Pole, 2006) Its spermatogenic effects are evidenced in a study of male oligospermic patients. (Biswas TK, 2010) In rat studies testing shilajit as a fertility agent, it was estimated that it had both a spermiogenic and ovogenic effect in mature rats. (Jeong-Sook Park, 2006)

Mental health: Nootropic[3] and anxiolytic activity. Investigated for its effect on memory, learning and anxiety and reported that shilajit enhanced the acquisition of learning and memory in aged rats while exhibiting a marked reduction in anxiety levels. (AK Jaiswal, 1992) It may also be used in treating epilepsy.

Bones: Promotes the movement of minerals, especially calcium, phosphorous, and magnesium into muscle tissue and bone. Shilajit is naturally high in iron and other minerals making it useful in osteoporosis, osteoarthritis and spondylosis. It is building to both rakta and asthi dhatus and therefore used to heal broken bones. (Pole, 2006)

Lekhaniya: By virtue of its scraping quality shilajit may remove benign tumors(lipoma, osteoma, uterine fibroid, goiter) and detoxify breast tissue (sthanya shodan).

Immunomodulator [4]: Shilajit has been found to be effective in treating allergies and boosting immunity. Di-benzo-alpha-pyrones and triterpenic acid (humic and fulvic acids) affect the endocrine, autonomic, and central nervous systems, "bringing about an immunomodulating result by increasing the activity of macrophages". (Ghosal S. , 1990) Another study on rats showed that white cell activity rose in accordance with dosage and time after exposure. (Ghosal S. e.)

Tissue Recovery: Shilajit has been used in wound healing, specifically peptic ulcer, and other inflammation and shown to help in muscle recovery after exercise. Shilajit increased the carbohydrate/protein ratio and decreased gastric ulcer index, indicating an increased mucus barrier. (Goel RK, 1990) Fulvic acid and 4/-methoxy 6-carbomethoxy bi phenyl, active constituents in shilajit are found to have ulcer protective effect. (Ghosal S, 1988)

Longevity: The fountain of youth; some say that the name itself suggests that one can stave off the aging process much as the rock does. Shilajit exhibits antioxidative properties (Acharya, 1988) and is said to cure diseases of aging. It is an important rejuvenative and tonic, especially for vata and kapha. (Lad, 2001)

Administration: Shilajit is most often given as pills (vati) or powder.

· A paste may be dissolved in boiled, hot water or milk and taken 2X daily.

· 2-3 pills 3X daily or 500 mg-5g/day (Pole, 2006)

· Caraka Samhita recommends a minimum dose of 12g/day for two months to attain maximum benefit.

Special classical formulations Shilajit may also be used in the following important formulations:

· Chandraprabha which acts as tonic, aphrodisiac and rejuvenator is said to cure all diseases; especially all twenty kinds of prameha (diabetes), dysuria, urine retention, renal calculi, constipation, anaha (enlargement of the abdomen), colic, tumors and cancers of the penis, hernia, katishula (pain in the waist), dyspnea and cough, psoriasis, scrotum enlargement, anemia, jaundice, chlorosis, skin diseases, piles, itching, splenomegaly, anal fistula, disease of teeth, eye disease, menstrual pain, semen disorders, mandagni, anorexia and other diseases of vata, pitta and kapha. (Sarngadhara Samhita)

· Silajatuvataka (Shilajit pills) made with decoction of indrayava, triphala, neem, patola, mustha, and sunthi, plus sugar, vamsalochana, pippali, amalaki, karkatashringi, kantakari, trigandha (tvak, ela and patra), are powdered together and mixed with honey and made into 10 gram doses are again referred to as panacea according to the Carak Samhita. (Chi, ch XVI, v )

· Arogya vardhini

· Chyavanprash: a rejuvenative medicated jelly (avaleha) prepared with sugar or honey

Other Formulations and combinations: (Pole, 2006)

· Gokshura & guggulu for stones & prostatitis

· Punarnava & guggulu for edema & fluid retention

· Gurmar, karavella, neem, turmeric, black pepper, for hyperglycemia

· Ashwagandha & gokshura for male reproductive problems

· Shatavari & licorice for female reproductive problems

· Amalaki, ginger, & shatavari for anemia

Contraindications: shilajit should not be used in instances of high uric acid levels or with heavy and vidahi (hot-natured) foods. (Carak Samhita)

Conclusion

Although on the internet today one will find numerous wild claims that shilajit will cure nearly anything that ails you, recent research has proven that there is, in fact, some scientific basis for its fame as a wonder drug. This strange and mystical resin has been used by humans for thousands of years in a medicinal context with positive result and those who support the "evidence based medicine" approach of Ayurveda can appreciate that there is a growing body of work pertaining to the exploration of why the ancient texts say it works. Shilajit is truly another gift of nature and should be respected and applied as such.

Refernces:

(n.d.). Retrieved March 2010, from Merriam-Webster Online: http://www.merriam-webster.com/dictionary/asphaltum

(n.d.). Retrieved March 2010, from HolisticOnline.com: http://www.holisticonline.com/herbal-med/_Herbs/h189.htm

Acharya, S. B. (1988). Pharmacological Actions of Shilajit. Indian Journal of Experimental Biology , 26 (10), 775-777.

Agrawal, L. T. (2003). Shilajit, The Traditional Panacea: Its properties. Diabetes Care (26), 2469-2470.

AK Jaiswal, S. B. (1992). Effects of Shilajit on memory, anxiety and brain monoamines in rats. Indian journal of Pharmacology , 12-1.

Austin, U. o. (n.d.). Retrieved March 2010, from Texas Beyond History: the Virtual Museum of Texas' Cultural Heritage: http://www.texasbeyondhistory.net/coast/nature/images/asphaltum.html

Bhavprakasa. Bhavprakasa. Varanasi: Chaukhamba Orientalia.

Biswas TK, P. S. (2010). Clinical evaluation of spermatogenic activity of processed Shilajit in oligospermia. Andrologia , 48-56.

Caldecott, T. (2006). Ayurveda: The Divine Science of Life. Elsevier Ltd.

Carak Samhita.

Ghosal S, S. S. (1988). Antiulcerogenic activity of fulvic acids and 4-metoxy-6-carbomethyl biphenyl isolated from shilajit. Phytother Res. , 187-191.

Ghosal, S. (1990). Chemistry of Shilajit, an Immunomodulatory Ayurvedic rasayan. Pure and Applied Chemistry , 62 (7), 1285-1288.

Ghosal, S. (1990). Chemistry of Shilajit, an Immunomodulatory Ayurvedic Rasayan. Pure and Applied Chemistry , 1285-1288.

Ghosal, S. e. Shilajit-Induced Morphometric and Functional Changes in Mouse Peritoneal Macrophages. Varanasi: Banaras Hindu University.

Goel RK, B. R. (1990). Antiulcerogenic and antiinflammatory studies with shilajit. Journal of Ethnopharmacology , 95-103.

Harsahay Meena, H. P. (2010). Shilajit: A panacea for high-altitude problems. International Journal of Ayurveda Research , 37-40.

Hartman, D. M. (n.d.). Shilajit: Sacred Soma of the Alchemists. Retrieved 2010, from Drhartman.com: http://www.drhartman.com/shilajit_info.htm

Jeong-Sook Park, G.-Y. K. (2006). The spermatogenic and ovogenic effects of chronically administered Shilajit to rats. Journal of Ethnopharmacolog , 349-353.

Lad, D. D. (2001). The Yoga of Herbs. Twin Lakes: Lotus Press.

Merriam-Webster. (n.d.). Retrieved April 2010, from Merriam Webster's online dictionary: http://www.merriam-webster.com/dictionary/humus

Mishra, L. C. (2003). Scientific Basis for Ayurvedic Therapies.

N. A. Trivedi, B. M. (2004). Effect of shilajit on blood glucose and lipid profile in alloxaninduced. Indian Journal of Pharmacology , 373-376.

Nidhi Saxena, P. U. (2003). Modulation of Oxidative and Antioxidative Status in Diabetes by Asphaltum Panjabinum. Diabetes Care , 26 (8), 2469-2470.

Pole, S. (2006). Ayurvedic Medicine: The Principles of Traditional Practice. China: Elsevier Limited.

Sarngadhara Samhita.

Shibnath Ghosala, J. L. (1991). The core structure of shilajit humus. Soil Biology and Biochemistry , 23 (7), 673-680.

The Ayurvedic Formulary of India Part I & II. (2003). Civil Lines, Delhi: The Controller of Publications.

Tierra, M. (1988). Planetary Herbology: an integration of Western herbs into the traditional Chinese and Ayurvedic systems. Twin Lakes: Lotus Press.

Tillotson, A. (2001). The One Earth herbal Sourcebook. New York: Kensington Publishers.

Tirtha, S. S. (1998-2007). The Ayurveda Encyclopedia: Natural Secrets to Healing, Prevention & Longevity. Bayville, NY: Ayurveda Holistic Center Press.

Vagbhata. (Reprint 2007). Astanga Hrdayam (Vol. 3). (P. K. Murthy, Trans.) Varanasi: Krishnadas Academy.

Vagbhata. (Reprint 2007). Astanga Hrdayam (Vol. 2). (P. K. Murthy, Trans.) Varanasi: Krishnadas Academy.

Vagbhata. (Reprint 2007). Astanga Hrdayam (Vol. 1). (P. K. Murthy, Trans.) Varanasi: Krishnadas Academy.

Whitehead, D., & Tinsley, J. (2006). The biochemistry of Humus Formation. Journal of the Science of Food and Agriculture , 14 (12), 849 - 857.

Yadava, P. K. (2005). Medicinal Plants of Susruta Samhita (Vol. Vol. 1). France: Vaidya Atreya Smith B.Sc.

[1] A Sanskrit word referring to a rejuvenative tonic. Much more than a bulk promoter, a rasayana increases the quality of the body, rebuilds the body/mind, prevents decay, postpones aging and may even help to reverse the aging process. (Lad, 2001)

[2] According to soil science, humus is defined as any organic matter that has been broken down to the point of stability, and theoretically, if conditions do not change, remains stable, unchanged for centuries, if not millennia. It is completely amorphous and no longer has any cellular structural characteristic of plants, animals or micro-organisms. It forms the organic portion of soil. (Merriam-Webster)(Whitehead & Tinsley, 2006)

[3] A substance that enhances cognition and memory and facilitates learning. (Merriam-Webster Online)

[4] A substance that affects the functioning of the immune system. (Merriam-Webster Online)

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Dosage

Dosage of various forms of Ashwagandha is given below considering a person of normal weight and height. These can vary from person to person.

Classical References

Bhavaprakasa, Karsyadhikara, 40-9

Bhavaprakasa, Karsyadhikara, 40

Bhavaprakasa Nighantu, Guducyadi vara, 190

Bhavaprakasa, Rasayanadhikara, 73-13

Bhavaprakasa, Snayukarogadhikara 57-8

Bhavaprakasa, Yonirogadhikara 70-26

Cakradatta

Cakradatta, Rasayanadhikara, 16

Cakradatta, Vatavyadhi cikitsa, 22-90

Cakradatta Vatavyadhi cikitsa, 22/141-145

Cakradatta, Yonivyapata cikitsa 26

Caraka Samhita, cikitsa 17-117

Caraka Samhita, cikitsa 27

Caraka Samhita, Siddhi 10-3

Caraka Samhita, Sutra 3-7, 8, Vimana 8-144 etc. Cikitsa 2-1, 34 etc. Siddhi, 3-37 etc.

Kaiyadeva Nighantu, Osadha varga, 1045-1047

Raja Nihantu, Satahvadi varga, 112

Raja Martanda

References

Acharya Deepak Dr., Sancheti Garima Dr., Pawar Sanjay Dr., Shrivastava Anshu Dr. 2006-11-24. Traditional medicines of Gonds and Bharias - 28 - Herbal medicine for Paralysis http://www.disabled-world.com/artman/publish/paralysis.shtml

Shilajit: Conqueror of the Mountains and Destroyer of Weakness

by Alakananda Devi (Alakananda Ma), M.B., B.S. (Lond.)
Candida, Liquid-based Pap (Photo credit: euthman)