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Here at Alandi Ayurveda Clinic, we ask our patients to bring in their medications and supplements so we can see what they are taking. Many of our patients have digestive concerns and we see that a number of them are taking various over-the-counter digestive enzyme supplements. But do these supplements really work and are they the best way to support digestion?

First, not all enzyme supplements are created equal. Rarely, an individual may suffer from Exocrine Pancreatic Insufficiency (EPI), a condition in which the pancreas is unable to make the enzymes needed to digest food. Autoimmune chronic pancreatitis and cystic fibrosis are two conditions that may cause EPI, a condition that affects roughly 8 per 100,000 men and 2 per 100,000 women. Patients diagnosed with this condition are in danger of severe, chronic malnutrition. These patients are treated with special prescription pancreatic enzymes that are 'enteric coated'--that is, they have a special coating that prevents them being digested in the stomach and allows them to work where they are needed, in the duodenum. On the other hand, OTC 'enzyme supplements' are not enteric coated and relatively little of what is taken will actually be active in the duodenum.

According to the teachings of Ayurveda, agni--your digestive fire is at the root of health. As the seminal Ayurvedic text, Charak Samhita says in discussing malabsorption issues:

Longevity, complexion, strength, health, enthusiasm, muscle-mass, lustre, immunity, energy...all these depend on agni. One dies if this fire is extinguished, lives long free from disorders if it is functioning properly, gets ill if it is deranged, hence agni is at the root cause of all. (CS, chi xv, 3-4).

So rather than trying to prop up a weak digestive fire by consuming digestive enzymes, it is more effective and helpful to turn that weak agni into strong agni. This is a process that has several steps: remove the cause, improve your diet, use herbs and home remedies to strengthen agni.

Remove the causes of your digestive disturbance by following these simple Agni Rules.

  • Eat food at room temperature or slightly above
  • Allow three hours between meals to allow digestion to be complete before adding new food to the system
  • Don't drink and eat at the same time. Drink half hour before or two hours after eating.
  • Use proper food combining.
  • Relax after eating to allow for proper digestion.
  • Don't eat and then sleep--wait two hours.
  • Don't eat and then exercise--wait two hours.
  • Don't eat and then meditate--Leave one hour.
  • Follow the diet appropriate to your constitution and the season.

Improve your diet by focusing on warm, soupy and well-cooked foods such as soups, stews, kitcheri and dal. Using spices such as ginger, turmeric, cumin, coriander, fennel, cardamom, fenugreek, cinnamon and clove in your food will enhance digestion. Studies show that these spices help improve our body's natural secretion of pancreatic enzymes. Rosemary, sage and oregano are beneficial too.

Use home remedies and herbs to convert a weak digestive fire into a strong one.

CCF Tea: At Alandi we encourage our students and patients to drink CCF tea. Mix one-third teaspoon each of cumin, coriander and fennel 'seeds' in a cup of water, boil until the seeds sink and strain. Drink after meals to aid digestion or to relieve colic. This tea is also a great way to help get adequate iron and calcium in your diet. You can also use this tea to bring down a fever.

Agni Kindler: Grate fresh ginger and fresh turmeric, add a squeeze of lime and some salt. Eat half a teaspoon a few minutes before meals to improve digestion. If you can't get fresh turmeric root, you can make the remedy with ginger, lime and salt.

Chewing Spice (like in an Indian restaurant but minus the sugar and colouring): chew ½ tsp. roasted fennel and cumin seeds after each meal.

If you continue to have issues such as gas and bloating despite using these remedies, your agni issues may be more complex, or there may be underlying causes such as parasites or food intolerances. An Aurvedic Practitioner will help unravel the underlying cause and provide individually tailored remedies to improve your digestion.

Empathy and Compliance

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          Reflections on the Clinic Experience

Lord of Ayurveda,Dhanvantari

Lord of Ayurveda,Dhanvantari (Photo credit: Wikipedia)

            Amid the vast swirl of new information I've been working and playing with during these first eight weeks studying Ayurvedic medicine at Alandi, the clinic experience has been the most profoundly affecting. 

Observing and interacting with patients on a regular basis provides grounding and human context for the timeless theory and Sanskrit vocabulary, which might otherwise tend towards academic abstraction. I have gleaned many useful facts and practical principles so far, but here I will focus on the broader issues that are making an impression on me.

One fundamental point I've observed (and experienced) in these sessions is that the presenting health concern is often a secondary or even tertiary issue. Many people are simply craving to be truly seen and heard.

It seems that a person's innate capacity for self-healing is activated by the attentive presence of the practitioner, through the exchange of deep listening and empathetic response. This process allows the more subtle causes of dis-ease to emerge and become self-evident to the patient. 

In being that clear mirror, the practitioner creates an opportunity for the patient to notice patterns and connections that were previously invisible to them. On its own, such awareness can stimulate positive shifts within a person.

IBM CIO Report: Key Findings

The other major issue I had not previously considered is that of compliance

In an imaginary, ideal world, healing is a clean process where expert diagnosis leads to a prescription for herbs and adjustments to diet and lifestyle. Then, we simply wait for the patient to return with reports of steady improvement.  

This obviously skips over the most crucial step -- that is, the patient actually doing what is asked. 

Ayurveda requires a certain level of dedication and willingness to do whatever it takes in order to be effective. By this measurement, not everyone is qualified for Ayurvedic treatment. 

Clearly, some individuals are more comfortable with their disease than with the procedures for treating it, and would therefore prefer to remain ill rather than venture outside their comfort zone.

This is mostly an unconscious choice. Deeply ingrained patterns of behavior are powerful forces. Just because a person is seeking healing on the surface doesn't necessarily mean they are able to comply with the changes prescribed. 

With this in mind, it has been valuable to observe Ma as she gently "coaxes" compliance from patients. Some people need more stern instructions, while others do well with some flexibility. Some folks are eager to do everything all at once, while others can only introduce one thing at a time. 

Knowing a person's mental and physical constitution is helpful, but coaxing is more art than science, and involves a good deal of intuitive feeling into the situation to know what is realistic, and what is asking too much.

Smoking Intuition

Smoking Intuition (Photo credit: Callt_o)

Finally, I will note how humbling it is to sit in clinic. It is a regular reminder that everyone is fighting unseen battles and should therefore be treated with the gentlest of care. 

It is a very powerful experience to have someone bare their deepest traumas, share their oldest secrets and express their greatest hopes and fears with the hope that you can help them. It is a responsibility not to be taken lightly, and serves as inspiration for me to learn as much as possible as fast as possible so as to actually be able to help. 

There is also a dampening effect as I realize that we can't possibly help everyone to the extent that we would like, that each person must take responsibility for their own healing, and all we can do is offer the best guidance we can and pray the rest will unfold in the most benevolent manner possible. 

This is heartbreaking, but then again, a heart must break in order to be open, and as we've seen, an open heart is truly the most potent medicine available to us.



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Thyroid Disorders

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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.

Skin Inflammation

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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.

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Sinus Infections

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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.

Silent Bladder Infections

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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.

The White Powder: Ayurvedic Strategies for Sugar Addiction

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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.

Kapha Toxins: Candidiasis

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

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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Late Spring - April & May (Colorado, USA)

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Cherry Blossom 21st April and the cherry bloss...

Cherry Blossom 21st April and the cherry blossom is flourishing. (Photo credit: Wikipedia)

By Kourtney Nelson

Zodiac Signs: Taurus & Gemini

Dosha Accumulation: Kapha & Pitta primarily, some Vata

Dosha Provocation: kapha during wet, cloudy weather, pitta with hot clear days, vata with large or frequent weather changes and windy days

Gunas Involved: cold-sita, hot-usna, snigdha-oily, heavy-guru, mobile-cala, clear-visada, picchila-cloudy, dry-ruksha, light-laghu

Conditions
April - Average sunrise - 6:30am, average sunset - 7:45pm; Temperature range 62-34, average 53.
May - Average sunrise - 5:45am, average sunset - 8:00pm; Temperature range 71-44, average 61

Weather - Wide range of weather patterns, and large temperature changes. Can be very warm and sunny, or cold. April and May are often some of the wettest months in the year, with snow storms or thunderstorms. May experience windy periods as well.

Recommendations

Diet

Kapha - during late spring Kapha has accumulated is liquefied by the increasing heat, which can disturb the digestive system. Kapha can become provoked during precipitation, snowy days and cloudy rainy days

To minimize Kapha:
Favor:

  • warming, drying, and activating foods
  • Pungent, bitter, and astringent tastes
  • Honey and hot herbal teas
  • Vegetarian, low-fat diet
  • Limit oils - Sesame oil and flax seed oil can be used minimally
  • Vegetables, grains, and beans, cooked and well-spiced
  • One salad per day
  • Whole grain crackers and toasted breads of millet, quinoa, and corn
  • Pungent spices: cinnamon, ginger, black pepper, mustard, cloves, celery seed, dill, radish,
  • Spiced, cooked fruits
  • Cranberry, pomegranate, carrot, grapefruit, and spinach juices can be used in moderation
  • Herbal teas 
 Reduce or Avoid:

  • Cold, wet, bland foods
  • Excessive use of oils, sours, salty
  • Too many dairy products (especially yogurt)
  • White sugar and too many sweets
  • Wheat, oatmeal, unless toasted
  • Too many cooling fruits such as banana, dates, mangos, apples and apple juice, especially in winter 

Pitta - During late spring Pitta begins to increase in the body. Pitta can increase or be provoked on warm clear days

To minimize Pitta:
Favor:
  • Astringent, bitter, and sweet tastes
  • Moderate use of oils: Olive oil, coconut oil, and ghee
  • Spices: cumin, coriander, fennel, anise, and cardamom.
  • Organic milk, cottage cheese,
  • Basmati rice, barley, millet, quinoa,
  • Cucumber, lettuce, winter squash, yams, tofu, avocado
  • Sweet fruits (e.g. figs, grapes and raisins, dates, blueberries, red raspberries, Babcock peaches, apples, pears, mango, and coconut.)
  • Bitter and astringent herbal teas and nonalcoholic beers and wines
  • Whole grains 
 Reduce or avoid:
  • Excessive sour, oily, salty, and fried foods
  • Red meat, shellfish fish
  • Alcohol, caffeine, and soda pop
  • Excessively hot spices, such as cloves, mustard, onion, garlic, chilies, radish, and cayenne.
  • Frequent use of acidic fruits, juices, and vegetables: tomatoes, beets, eggplant, corn, carrots, hot leafy greens, papayas, pineapple, citrus (except limes), and vinegar.
  • Cashews, peanuts

Vata - During late spring Vata can be aggravated by the highly changeable conditions and dry windy days

To minimize Vata:
Favor:

  • Cooked, warm, soupy, moderate to heavy foods, soothing and satisfying
  • Plenty of healthy oils (monounsaturates, sesame oil, ghee, butter, nut butters, and EFAs) - avoid hydrogenated oils, other saturated and polyunsaturated oils
  • Natural sweet, sour, and salty tastes and flavorful sauces
  • Carminative spices such as basil, oregano, ginger, cardamom, cinnamon, cumin, pippali, coriander, and dill.
  • Protein-rich diet of animal products: ghee, warm milk, yogurt, cooked cheese, buttermilk, kefir, eggs, etc, as well as the grains like quinoa, corn, and basmati rice, and easily digested nuts and sesame seeds
  • Best fruits and juices: tomato, pomegranate, carrot, fresh-squeezed orange and grapefruit, apricot, peach, strawberry, raspberry, and vegetable juices
  • Lots of fresh veggies (cooked are easier to digest for Vata): pumpkin, carrots, beets, green leafy veggies, avocado, broccoli, baked potato, winter squash, tomatoes, etc. 
 Reduce or Avoid: 

  • Caffeine, white sugar, and soda
  • Excessive use of beans and heavy grains (prepare them with ghee and spices)
  • Dry foods taken alone, large amounts of raw vegetables
  • Taking foods and drinks colder than room temperature  Red meat

Lifestyle

Late spring is a time of changing weather and release of accumulated kapha in the body, so digestion can be especially delicate, it can be especially important to follow agni rules at this time

Agni Recommendations:

  • Follow agni rules
  • Proper food combining
  • Drink ginger tea in the morning (fresh for vata and pitta, dry for kapha)
  • Take Agni kindler before meals
  • Drink CCF tea after meals

For Kapha:

  1. Movement: vigorous exercise daily (ex. jogging, aerobics etc), strength training, engage in new activities and mental challenges
  2. Do not skip meals, and do not fast. The Kapha digestive agni tends to be low, as does appetite, and not eating on time slows down the metabolism even more. Start your day with a light breakfast. Eat a sustaining meal at lunch, and a lighter meal for dinner.
  3. Vigorous oil massage with warming oil
  4. Protect yourself from the damp and cold. Drink lots of warm water, infused with warming spices such as turmeric, dried ginger and black pepper. At-home steam therapy can help open clogged channels.
  5. Go to bed early and wake up really early in the morning, 90 minutes before sunrise, do not indulge in daytime snoozes.

For Pitta:

  1. Stay cool--both physically and emotionally. Avoid going out in the heat of the day, especially on an empty stomach or after you have eaten tangy or spicy foods. Avoid exercising when it's hot. Walk away from situations that make you see red.
  2. Do not skip meals, do not fast and do not wait to eat until you are ravenously hungry. You want to keep the fire burning at a moderate temperature, you don't want to put the fire out or to stoke it too high.
  3. Daily oil massage with moderate to cooling oil
  4. Water-based activities are ideal exercise for Pitta-dominant people. Try swimming or aqua-aerobics to stay fit but cool. Strolling after sunset, especially along a waterfront, is also a soothing way to fit some leisurely activity into your day.
  5. Go to bed early, rise 60 minutes. Make sure to turn off the computer or TV by 10pm and turn the lights out. A cup of warm milk, with some cardamom, can be helpful before bedtime.
  6. Balance work and play. Set aside some time for R&R everyday, and do not get so absorbed in a project that you are unable to detach from it.

For Vata:

  1. Establish a daily routine. Go to bed and rise at same time (30 min before sunrise). Regulate meal times, eat even if not hungry to establish routine. Don't skip meals.
  2. Foods and drinks that nourish
  3. Daily oil massage with warming oil such as sesame
  4. Light to moderate daily activity (don't over do and exhaust self) - slow classical vinyasa, swimming, dancing, bike riding
  5. Keep warm, stay out of wind.

Flatirons with Spring flowers

Flatirons with Spring flowers (Photo credit: Wikipedia)


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Last month, we looked at easily curable conditions of prana vaha srotas as well as those curable with difficulty.  This month, we will look at chronic (yapya) conditions of prana vaha srotas and also mention briefly how to be aware of potentially fatal conditions.

 

One extremely common yapya respiratory condition is chronic rhinitis, affecting as many as 40% of the US population. One of the world's most common chronic disorders, rhinitis affects the entire spectrum of life from infancy to old age (1). Sushrut discusses thirty-one diseases of the nose, including Apinasa (rhinitis) and pratishaya (nasal catarrh)(2). Apinasa is classified as a disease of vata and kapha (2). Pratishaya with dryness, hoarsenss, temporal headache and nasal obstruction arises from Vata (3), with thirst, yellowish nasal discharge and a feeling of hot smoky breath, pitta is involved (4) and with thick white or yellowish catarrh, swollen eyes, heaviness and itchy throat and palate, kapha is implicated.

 From a modern standpoint, classification of rhinitis is less based on clinical presentation and more on etiology. Rhinitis is either allergic or non-allergic. Allergic rhinitis results from IgE reactivity to both outdoor, seasonal allergens such as pollens and indoor allergens including moulds, house dust and animal dander. It is often associated with another chronic condition of prana vaha srotas, asthma. (See http://www.alandiashram.org/school/school_html/reviews/bronchial_asthma.html for a previous Vine discussion of asthma). While allergic rhinitis is common in infants, children and young adults (5), non-allergic rhinitis becomes increasingly prevalent in older adults and is more common in women (1). Although there are many etiologies of non-allergic rhinitis, some of the most common include chronic sinusitis, allergic fungal sinusitis, eosinophilic nasal polyps (6) and deviated nasal septum. For an in depth treatment of chronic sinusitis and allergic fungal sinusitis see archived Vine article http://www.alandiashram.org/school/school_html/reviews/chronic_sinusitis.html. Irritants such as dust, smoking and household cleaning agents can cause or contribute to rhinitis, as expressed by both Madhava and current medicine (7, 8). Hormonal causes of non-allergic rhinitis include pregnancy, menstruation, puberty and hormone replacement therapy as well as hypothroidism (8).

As we review the various ways of classifying rhinitis, we can see that the Western medicine classifications are more useful in terms of Western treatments. For example, allergic rhinitis would respond to anti-histamines whereas other kinds will not. By the same token, Sushrut's symptom based classification is more useful for Ayurvedic treatment since it points to the dosha involved and hence to the appropriate therapies.

 

Patients with chronic rhinitis frequently present for Ayurvedic treatment as an alternative to steroidal and non-steroidal nasal sprays and systemic antihistamines. Indeed, the persistent nature of this condition has led doctors, as well as patients, to look 'outside the box' for adjuvant therapies. As an example, a friend of mine recently visited National Jewish Hospital in Denver, one of the premier respiratory hospitals, only to be told to increase his use of the nasal rinse cup from once to twice a day! A number of studies have been done, demonstrating the effect of jala neti or saline irrigation using a nasal rinse cup.  As one abstract puts it, "The use of nasal irrigation for the treatment of nose and sinus complaints has its foundations in yogic and homeopathic traditions. It is often prescribed as an adjunct to other treatments such as intranasal steroids or antibiotics. ...This review summarises the evidence for the effect of saline irrigations in the management of the symptoms of chronic rhinosinusitis. There is evidence that they relieve symptoms, help as an adjunct to treatment and are well tolerated by the majority of patients. While there is no evidence that saline is a replacement for standard therapies, the addition of topical nasal saline is likely to improve symptom control in patients with persistent sino-nasal disease....There are no significant side-effects reported in trials."     ( 9)

An earlier study also indicated that "Endonasal irrigations with salt solutions are effective in the treatment of chronic sinusitis," (10) and an Australian study investigating nasal irrigation showed that neti, also known as nasal douche, was more effective than nasal sprays or nebulizers and effectively reached the maxillary sinuses and frontal recesses. The sphenoidal and frontal sinuses are not easily reached by irrigation methods. (11).

While local use of oils and herbs in the form of nasya have not been investigated to the same extent, some recent studies published by Gujerat Ayurved University indicate that nasya therapies are effective in both allergic and atropic rhinitis. Local (nasal) administration of herb via nasya was effective in giving immediate relief of signs and symptoms of allergic rhinitis and can best be paired with longer acting systemic herbs such as turmeric. (12). Nasya is also effective in atropic (non-allergic ) rhinitis (13).

Similarly, in terms of asthma, there has been a search for adjuvant therapies for this chronic condition. Steam inhalation, using natural mineral saline is one valuable adjuvant. The Ayurvedic use of steam and herbal smokes for administering medicines directly to the lungs is the precursor of today's asthma inhalers (14). Yoga therapy is also valuable in managing asthma. "Forty six young asthmatics with a history of childhood asthma were admitted for yoga training. Effects of training on resting pulmonary functions, exercise capacity, and exercise-induced bronchial lability index were measured. Yoga training resulted in a significant increase in pulmonary function and exercise capacity. A follow-up study spanning two years showed a good response with reduced symptom score and drug requirements in these subjects. It is concluded that yoga training is beneficial for young asthmatics." (15).

Herbal therapies of course are also effective for asthma, including Boswellia (16) and kapi kacchu (17). Ayurvedic and yogic therapies including neti, nasya, steam inhalation herbal smokes, yoga therapy and oral herbs can be of tremendous use in enhancing quality of life for patients with chronic prana vaha srotas conditions and reducing the amount of medications they need to use.

With regard to fatal conditions of prana vaha srotas, lung cancer remains the leading cause of cancer-related death both in the United States and throughout the world (18). Ayurvedic practitioners as well as primary care physicians should be highly suspicious in the case of any person with a history of smoking who presents with cough, breathlessness or wheezing or simply fatigue and malaise. A pneumonia or bronchitis may be more than it seems as lung cancer may frequently present as pneumonia or bronchitis. Swift referral for chest X ray is vital to avoid overlooking cancer. Patients with a history of coal mining or working in or living near an asbestos plant should also be treated with great caution in the event of a history of cough as they too are susceptible to lung cancer. And of course, one should not forget spouses of chain smokers, who may have been exposed to a lifetime of carcinogenic second and third-hand smoke. Tridoshic disturbance of overall vikruti, of the lung pulse or of the rasa dahtu pulse can lead the Ayurvedic practitioner suspect lung cancer, although these same pulse findings may also hold good in chronic obstructive pulmonary disease (COPD).  

To give some examples, some years ago a fifty-year-old woman presented with a non-specific complaint of "feeling unwell". She had never smoked cigarettes, although she was a marijuana smoker. However, her husband was a former chain-smoker. A few weeks later, she presented with cough and breathlessness and tridoshic disturbance in her lung pulse. Suspecting pneumonia, we referred her to her primary care practitioner, who diagnosed bronchitis and sent her home with antibiotics.  Days later she was admitted to hospital with for pneumonia and within three months she had died of advanced pulmonary adenocarcinoma.  This story serves to remind us of how nebulous the initial presentation of lung cancer may be.

A seventy five year old former smoker complained of chest pain during winter and was diagnosed with pneumonia and put on antibiotics. Bronchoscopy revealed Stage IV adenocarcinoma of the lungs and she presented for Ayurvedic adjuvant therapy alongside her chemotherapy. She went into remission for some time but recently, again in winter, developed cough and breathlessness and was found to have a pleural effusion, which may be malignant in origin. This case history too illustrates how difficult it is to diagnose lung cancer until a late stage of the condition and how closely its symptoms can mimic typical winter ailments.

Ayurvedic practitioners can facilitate considerable improvements in quality of life for patients suffering from chronic conditions of prana vaha srotas. When working with respiratory conditions, it is important to take note of lung cancer risk factors and to be aware that this condition can present as a typical winter chest infection.

 

 

1. John W. Georgitis  Prevalence and differential diagnosis of chronic rhinitis Current Allergy and Asthma Reports Volume 1, Number 3 / May, 2001

2. Su. Uttarasthan, XXII

3 ibid XXIV 6

4 ibid v 7-8

5 Quoc A Nguyen, MD Allergic Rhinits  http://emedicine.medscape.com/article/834281-overview

6. Maria Staevska and James N. Baraniuk Persistent nonallergic rhinosinusitis Current Allergy and Asthma Reports Volume 5, Number 3 / May, 2005

7. Madhava Nidhanam Ch 58 v 13-14

8. Vijay R Ramakrishnan, MD, Nonallergic Rhinitis http://emedicine.medscape.com/article/874171-overview

9. Richard Harvey, Saiful Alam Hannan, Lydia Badia, Glenis Scadding, Nasal saline irrigations for the symptoms of chronic rhinosinusitis  Otolaryngol Head Neck Surg. 2007 Oct;137(4):532-4.

10. G. Bachmann, Gerhard Hommel and Olaf Michel Effect of irrigation of the nose with isotonic salt solution on adult patients with chronic paranasal sinus disease European Archives of Oto-Rhino-Laryngology Volume 257, Number 10 / December, 2000

11. Peter-John Wormald, Tim Cain, Lyndell Oates et al, A Comparative Study of Three Methods of Nasal Irrigation The Laryngoscope Volume 114 Issue 12, Pages 2224 - 2227

12. Neha j Modha ,V.D. Shukla, MS Baghel Clinical study of Anurjata Janita Pratishaya (allergic rhinitis) and comparative assessment of nasya karma Ayur-vol 30 No 1 2009 47-54

13. BV DHARMENDRASINH, K SINGH, KN PANSARA, et al A clinical study of Vyoshadivati and Pathadi Taila Nasya on Apinasa-Atrophic Rhinitis Ayu vol 30 No 4 2009 475-47

14. Mark Sanders Inhalation therapy: an historical review Primary Care Respiratory Journal (2007) 16(2): 71-81

15. S. C. Jain; L. Rai; A. Valecha; U. K. Jha; S. O. D. Bhatnagar; K. Ram Effect of Yoga Training on Exercise Tolerance in Adolescents with Childhood Asthma   Journal of Asthma, Volume Issue 6 December 1991 , pages 437 - 442

16. Gupta I, Gupta V, Parihar A, Gupta S, Lüdtke R, Safayhi H, Ammon HP.Effects of Boswellia serrata gum resin in patients with bronchial asthma: results of a double-blind, placebo-controlled, 6-week clinical study  Eur J Med Res. 1998 Nov 17;3(11):511-4

17. Mallaiah, GK | Thirupathi, K | Ganapaty, S | Rao, PT | Mohan, GK Phytochemical and AntimicrobialStudies on the Seeds of Mucuna Monosperma DC Current Trends in Biotechnology and Pharmacy. Vol. 2, no. 3, pp. 442-446. Jul 2008.

18. Syed Huq, http://emedicine.medscape.com/article/279960-overview

 

 

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