Ganzheit in Gesundheit und Bildung . Society for Holistic Health and Education

Europäische Akademie für Ayurveda European Academy of Ayurveda

16th International



Ayurveda Symposium2014 Prime Sponsor

Grußworte . Greetings

Mark und Kerstin Rosenberg, Initiatoren und Geschäftsführer der Gesellschaft für ganzheitliche Gesundheit und Bildung gGmbH

Herzlich willkommen! Liebe Symposiums-Teilnehmer, mit unserem diesjährigen 16. Symposium gehen wir einen neuen Schritt und unterstützen das von einem internationalen Forscherteam organisierte 1. Internationale Research Seminar für Ayurveda (IRSA). Damit entsteht eine Plattform, die AyurvedaExperten auf wissenschaftlicher Ebene zusammenbringt. Ziel ist es, neue Studienergebnisse vorzustellen sowie Empfehlungen für die zukünftige Richtung der Ayurveda-Forschung zu formulieren. Gleichzeitig führen wir unser bewährtes Symposiumskonzept fort, indem wir praxis- und therapiebezogene Vorträge und Workshops von namhaften Experten anbieten. Es gibt wohl kaum eine andere Gelegenheit, an der man sich so vielfältig über erfolgreiche ayurvedische Therapiestrategien orientieren kann wie hier in Birstein. Auch zum 16. Internationalen Ayurveda Symposium erwarten wir wieder hochkarätige Sprecher aus Indien, Europa und Amerika. Über 40 Live-Vorträge, Workshops und Expertenrunden können die Arbeit mit Ayurveda praktisch bereichern und mit fundiertem Fachwissen untermauern. "Krankheitsursache & Pathogenese ayurvedisch neu betrachtet" ist eines unser bedeutsamen Schwerpunkt-Themen. Die genaue Diagnose unter Berücksichtigung der gesamten Symptomatik, die ein Patient aufweist, ist eine besondere Stärke des Ayurveda. Sie ermöglicht, dass Störungen bereits früh erkannt werden können und damit bessere Heilungs-Chancen eröffnet werden. Trotz Wohlstand und vielen Sicherheiten nehmen in Europa psychische Probleme und Schmerzen drastisch zu. Hier kann der Ayurveda durch seine systemische Betrachtungsweise wertvolle Hilfe leisten. Das Forum Mental Health mit Dr. Antonio Morandi (IT), Ram Manohar (IND), Parvathidevi Kirathamoorthy (IND) u.a. wird ein besonderes Highlight des Symposiums sein. Auch wenn die Männer oft erst sehr spät Therapie in Anspruch nehmen, sollten wir uns gerade deshalb intensiv um diese Zielgruppe kümmern. Spannende Präsentationen sollen Ihnen hierfür gedankliche Anregungen geben.

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Der Ayurveda wird in seiner Bedeutung international immer mehr sichtbar. Weltweit wachsen die Bemühungen, ihn in die jeweiligen Gesundheitssysteme zu integrieren. Hierfür wollen wir mit unserem erweiterten Symposium einen Beitrag leisten und zum Motor für zukünftige Entwicklungen werden. Wir freuen uns, dass wir sechs viel versprechenden Nachwuchsforschern aus Indien die Möglichkeit eröffnen konnten, sich auf einem internationalen Symposium zu präsentieren. Damit möchten wir einen ermutigenden Impuls für die Entwicklung des Forschungssektors in der Heimat des Ayurveda setzen. Wir danken den herausragenden Ayurveda-Ärzten und Professoren aus Indien, Europa und anderen Ländern der Welt, die unserer Einladung gefolgt sind und so unsere Veranstaltung wieder mit ihrem wertvollen und tiefgehenden Erkenntnissen bereichern. Außerdem danken wir unseren Ausstellern und Sponsoren, die nicht nur das Symposium, sondern auch den Ayurveda mit ihren Produkten und Ideen unterstützen und voranbringen. Ebenso herzlich begrüßen wir Sie als Gäste, die dieses Wochenende zur fachlichen Weiter­bildung und zum Gedankenaustausch nutzen. Als Kompetenzzentrum für Ayurveda in Europa bieten wir Ihnen dafür den Raum und wünschen Ihnen viel Freude und interessante Begegnungen mit den anderen Teilnehmern und unseren Ayurveda-Experten. Ab 2015 werden wir in vergrößerten Räumlichkeiten noch mehr Möglichkeiten umsetzen. So können wir dann kontinuierlich medizinisch fundierte Ayurveda-Kuren in ruhiger und entspannter Atmosphäre anbieten und gleichzeitig dynamische und inspirierende Seminare durchführen, ohne dass sich beide Bereiche stören. Darauf freuen wir uns alle. So hoffen wir, dass wir Sie und viele andere Gäste, die sich vertieft mit Ayurveda beschäftigen wollen, auch in den nächsten Jahren wieder hier in Birstein begrüßen können.

Kerstin & Mark Rosenberg mit Team

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

A very warm welcome to you! Dear symposium's participant, With this year's 16th Symposium we take another step forward and support the 1st International Research Seminar on Ayurveda (IRSA) which was organized by an international team of Ayurveda researchers. A new platform will develop, bringing together Ayurveda experts on a scientific level. The aim is to present new study outcomes as well as drafting advice for the future direction of research on Ayurveda. At the same time we continue our established Symposium concept in presenting practical and therapy-related lectures and workshops from renowned experts. You will hardly find another opportunity apart from Birstein to be informed in such a wide range of diversity about successful Ayurvedic Therapy strategies. For this 16th International Ayurveda Symposium we expect again top-class speakers from India, Europe and America. More than 40 live lectures, workshops and expert panels will enrich your practical work with Ayurveda and profoundly substantiate your expertise. "Etiology and pathogenesis seen from an Ayurvedic perspective" is one of the main topics. A precise diagnosis in due consideration of the complete symptomatology of a patient, is one of the special strengths of Ayurveda. As dysfunctions can be detected at an earlier stage, better chances of healing are rendered possible. Despite wealth and many securities psychic problems and pain are dramatically encreasing in Europe. Here Ayurveda can provide valuable assistance through its systemic perspective. Our Forum on Mental Health with Dr. Antonio Morandi (IT), Ram Manohar (IND), Parvathidevi Kirathamoorthy (IND) and others will therefore be a special highlight of the Symposium. Even though men quite often come to therapy at a rather late state, this is exactly why we should take special care of this target group. Fascinating presentations will give you some clarity of thought in that matter.

Ayurveda is becoming more visible at an international level. All over the world, endeavours are made to integrate Ayurveda in the specific health care systems. The Symposium aims to contribute to this process and to become a driving force for future developments. We are happy that we are able to offer six promising young researchers from India the opportunity to present themselves at an international symposium. Thus we hope to send an encouraging impulse for the further development of research to the motherland of Ayurveda. We thank our out-standing Ayurveda doctors and professors from India, Europe and other countries of the world for following our invitation and for enriching our event again with their valuable and deep knowledge. In addition we thank our sponsors and exhibitors who do not only support the Symposium but also Ayurveda itself with their products and ideas. Equally warm we welcome you as our guests who will use this weekend for professional further education and exchange of ideas. Being a competence center for Ayurveda in Europe we offer the space for this exchange. We wish you lots of joy and interesting encounters with other participants and our Ayurveda experts. In 2015 we will realize more ideas in bigger premises. Thus it will be possible to offer continuously medicine-based Ayurveda treatments in a peaceful and relaxed atmosphere, while at the same time executing dynamic and inspiring seminars without any interference of the two fields. We are all eagerly looking forward to that. We hope to see you and many other guests, who wish to dive deeper into Ayurveda, again in the next years here in Birstein.

Kerstin & Mark Rosenberg and team

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

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Inhalt · Content

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2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

Inhalt . Content

16th International Ayurveda Symposium 2014

Abstracts Deutsch Abstracts German Abstracts Englisch Abstracts English Sponsoren · Aussteller Sponsors · Exhibitors Referenten Speakers

6 16 37 38

1st International Research Seminar on Ayurveda (IRSA)

Abstracts IRSA Abstracts IRSA Partner Partners

42 52

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

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Abstracts · Deutsch

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2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

Abstracts . Deutsch Abstracts · Deutsch

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Oliver Becker HP: Mentale Pathogenese und Tonisierung: therapeutische Möglichkeiten von Medhya-Rasayana

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Dr. med. Hedwig Gupta: Ayurvedische Differenzialdiagnose und -therapie bei Schmerzen im Bewegungsapparat

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Sascha Kriese BA Hons (Ayu): Der Zweck von Krankheit – ein ganzheitliches Verständnis von Pathogenese

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Marco Lebbing MD: Adjuvante ayurvedische Behandlung chronischer vs. akuter Schmerzen in der Neurologie

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L. Mahadevan MD (Ayu): Eine klinische Studie zur Bewertung der Wirksamkeit von Vasti Chikitsa in Verbindung von Bandscheibenvorfall-Management unter Berücksichtigung der Radikulopathie

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Prof. Dr. Martin Mittwede PhD: Die Krankheitsspirale durchbrechen – verhaltenstherapeutische Perspektiven des Ayurveda

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Dr. med. Kalyani Nagersheth: Schmerztherapie mit pflanzlichen Mitteln

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Dr. Karin Pirc MD PhD: Die multifaktorielle Behandlung von Panikattacken

13 Dr. med. Rotraud Scheiderbauer: Krankheitsursache und Pathogenese moderner Krankheiten ayurvedisch neu betrachtet 14

Elmar Stapelfeldt HP: Reizmagen und Reizdarm aus der Sicht der Ayurveda-Medizin

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Ralph Steuernagel HP: Ayurvedische Anti-Aging Medizin für Männer

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Dr. Dr. med. Bernhard Uehleke PhD: Wissen und Verwendung von ayurvedischen Heilpflanzen in der Klostermedizin

Zusammenfassung der Vorträge in Deutsch Mit den folgenden Texten möchten wir eine Übersicht der vielschichtigen Erfahrungswerte jener praktizierenden Ayurveda-Ärzte und -Therapeuten vermitteln, die am Ayurveda-Symposium 2014 mitwirken. Wir bedanken uns bei all unseren Gästen, Referenten und Mitwir­kenden, die diesen Kongress an der Europäischen Akademie für Ayurveda zu einem einzigartigen Ereignis mit vielfältigem Er­fahrungs­austausch möglich machen. Die Artikel sind teilweise nur kurze Zusammenfassungen oder Auszüge aus den Präsen­tationen und geben einen Eindruck über das reiche Wissen und die Informa­tions­fülle der eigentlichen Vorträge und Workshops wieder.

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

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Abstracts . Deutsch Mentale Pathogenese und Tonisierung: therapeutische Möglichkeiten von Medhya-Rasayana Oliver Becker HP Die starke Zunahme psychischer Problematiken ist ein typisches Merkmal der heutigen Zeit. Immer mehr Menschen sind auf der Suche nach Werkzeugen zur mentalen Tonisierung und Stressreduktion. Die Ayurveda-Medizin bietet hier simple und effektive Unterstützungsmöglichkeiten. Der Workshop skizziert die ayurvedische Sichtweise der mentalen Ätiopathogenese sowie Grundlagen und praktische Bedeutung der rasayana- und medhya-Konzepte als therapeutische Interventionsmöglichkeiten.

Die effektivsten pflanzlichen medhya-Substanzen sind Shankhapushpi (Convolvulus pluricaulis), Mandukaparni (Hyrocotyl asiatica) und Brahmi (Bacopa monniera). Auch Ashvagandha (Withania somnifera) und Tulasi (Ocimum sanctum) beeinflussen das mentale Milieu durch ihre adaptogene (die Anpassung des Organismus an Stress verbessernde) Wirkung positiv. Darüber hinaus besitzen auch einige Nahrungsmittel (z.B. Kuhmilch und Ghee) eine medhya-Wirkung. Weitere einfache und wirkungsvolle Maßnahmen zur mentalen Tonisierung sind eine vegetarische konstitutionsgemäße Ernährung, eine moralisch hochstehende Lebensweise (sog. acara-rasayana) sowie die regelmäßige Praxis von Yoga-Techniken (pranayama, Konzentration und Meditation) oder anderen Entspannungsmethoden.

Gemäß der Caraka-samhita erhält eine vernünftige Verwendung des Geistes sowie der geistigen Fähigkeiten die mentale Gesundheit, während eine unvernünftige (ausbleibende, falsche oder exzessive) Verwendung mentale Störung erzeugt. Rasayana-Maßnahmen, die primär der Verlangsamung des Alterungsprozesses dienen, verbessern auch die Arbeitsweise des Geistes. Medhya-Substanzen ermöglichen eine spezifische mentale Tonisierung. Dem Phänomen der Alterung kommt hier eine besondere Signifikanz zu. So beschreibt der ayurvedische Gelehrte Sharngadhara (13. Jhd.) die schrittweise Beeinträchtigung der kognitiven Fähigkeiten des Geistes als Teil des natürlichen Alterungsprozesses. In einem Schema sequenzieller Alterung ordnet er die jeweils betroffenen Komponenten bestimmten Lebensdekaden des Menschen zu und empfiehlt gleichzeitig spezifische Substanzen (dravya) zur frühzeitigen Gegensteuerung. Gemäß diesem Konzept beginnt der allmähliche geistige Abbau bereits mit Beginn des vierten Lebensjahrzehnts. Moderne Studien bestätigen dies. Rasayana-Maßnahmen bezwecken die Optimierung des kontinuierlichen Transformations- und Regenerationsprozesses der essentiellen strukturellen Körperkomponenten (dhatu-parinama). Über die Verbesserung der Körperebene entfalten sie rückwirkend auch eine Verbesserung des mentalen Milieus, worin sich der psychosomatische Ansatz des Ayurveda widerspiegelt. Einige der rasayanas besitzen gleichzeitig eine medhya-Wirkung. Der Fachterminus „medhya“ entstammt der ayurvedischen Substanzlehre (dravyaguna-vijnana). Er beinhaltet die pharmakologische Wirkung einer Substanz auf die intellektuelle Komponente (medha) des Geistes. Medhya-Substanzen verbessern kognitive Funktionen wie Auffassungsgabe, Verständnis, Analyse, Problemlösen sowie Speicherung und Wiederabrufung von Informationen. Medhya-Substanzen setzen auf körperlicher Ebene an. Sie stärken das zentrale Nervensystem als Sitz des Geistes, beeinflussen den Geist also indirekt. Denn nur in einem gesunden Körper wohnt und operiert ein gesunder Geist.

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2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

Ayurvedische Differenzialdiagnose und -therapie bei Schmerzen im Bewegungsapparat

Der Zweck von Krankheit – ein ganzheitliches Verständnis von Pathogenese

Dr. med. Hedwig Gupta

Sascha Kriese BA Hons (Ayu)

Schmerzen sind eine zentrale Grunderfahrung der Menschen. Diese werden im Ayurveda sehr differenziert untersucht, diagnostiziert und behandelt.

Samkhya und Yoga, zwei grundlegende Philosophien, auf denen der Ayurveda basiert, postulieren, dass die Schöpfung beginnt, wenn sich bewusster, passiver Purusha mit unbewusster, dynamischer Prakrti vereinigt, um Selbsterfahrung zu erlangen und sich in Richtung Erlösung weiterzuentwickeln. Evolution wird hier als ein bewusster und zielorientierter Prozess gesehen, der laut Caraka initiiert und erhalten wird von Paramatman, dem Schöpfer und Bewahrer des Universums. Leben wird daher im Ayurveda nicht als zufälliges Ereignis oder versehentlicher Unfall der Natur betrachtet. Caraka geht sogar soweit, den Glauben an Zufall als eine der größten Sünden zu bezeichnen (Caraka Samhita 1.11.14-15).

Nicht ein Schmerz ist wie der andere. Wenn zwei Menschen aus moderner Sicht zum Beispiel eine Gonarthrose, eine Arthrose des Kniegelenkes, haben, kann dies aus Ayurvedischer Sicht nicht nur von unterschiedlichen Faktoren verursacht sein, sondern es können völlig verschiedene Krankheitsentitäten vorliegen. Sie bedürfen dementsprechend einer unterschiedlichen Therapie. Woran aber kann man differenzialdiagnostisch ableiten, welcher dosha in welchem Gewebe auf welche Art verändert ist? Wie wirkt sich das aus bei unterschiedlichen Konstitutionen und Möglichkeiten des Zustandes von agni? In was für einem Stadium liegt die Erkrankung vor? Wie werden Schmerzerkrankungen grundsätzlich therapeutisch angegangen und welche differenzialtherapeutischen Aspekte sind zu bedenken? In diesem Vortrag werden diese Fragen durchleuchtet und – unterbaut von klassischen Zitaten – werden Beispiele für die Differenzialdiagnose und Differenzialtherapie vom Phänomen des muskuloskelettalen Schmerzes im Ayurveda gegeben. Wir besprechen mögliche Krankheitsbilder und Wege der Verursachung sowie die genauen Anzeichen des Schmerzes, die uns differenzialdiagnostisch voranbringen. Der Vortrag stellt für im Ayurveda schon Fortgeschrittene eine geeignete Vertiefung der Ayurvedischen Zusammenhänge dar.

Wenn das Leben also einen Zweck hat und frei von Zufällen ist, dann müssen Gesundheit und Krankheit ebenfalls einen bestimmten Sinn haben. Das erklärte Ziel des Ayurveda ist die Erhaltung von Gesundheit als Mittel und Weg zur Erreichung der vier Hauptziele im Leben: dharma, artha, kama und moksha (Ashtanga Hrdaya 1.1.2). Gesundheit gilt nicht einfach nur als wünschenswerter Zustand, sondern als notwendige Voraussetzung für das Erleben von wahrer Erfüllung und letztendlicher Erlösung. Worin besteht dann der Zweck von Krankheit im Leben? Laut ayurvedischer Ätiologie führt ein Ungleichgewicht ausgelöst durch asatmyendriyartha samyoga und prajnaparadha zu Krankheit (Charaka Samhita 1.1.54). Dies verweist auf das, was im Ayurveda als Hauptursache von Krankheit angesehen wird: Individuelle Entscheidungen und darauffolgende Handlungen, die schädlich und nicht im Einklang mit der wahren Natur (dharma) eines Individuums sind. Mit anderen Worten: Krankheit ist das Ergebnis eines nicht authentischen Ausdrucks des eigenen Selbst. Da menschliches Verhalten bestimmt wird von tiefliegenden Glaubenssätzen darüber, was ein Mensch als ‘richtig’ oder ‘falsch‘ betrachtet, führt jede inkorrekte Annahme über das eigene Ich zu einem nicht authentischem Selbstausdruck und folglich zu einer nicht authentischen Erfahrung des eigenen Ich. Wenn dies von einer Person nicht erkannt und verändert wird, etabliert sich eine sogenannte psycho-emotionale Dynamik im Unterbewusstsein, die die selbe Erfahrung stetig neu hervorruft. Um mit der Dynamik konstruktiv umgehen zu können, muss die Person sich dieser zuerst klar bewusst werden. Und genau hierin liegt der eigentliche Sinn und Zweck von Krankheit: jede psycho-emotionale Dynamik manifestiert sich mit der Zeit als spezifische Krankheit, welche einer Person die Möglichkeit bietet, diese Dynamik bewusst wahrzunehmen. Krankheit dient also als Einladung dazu, diejenigen Ausdrucksweisen des eigenen Ich zu erkennen und zu verändern, die nicht authentisch sind und auf falschen Annahmen aus der Vergangenheit beruhen. In diesem Vortrag werden die oben genannten Konzepte genauer erklärt und deren klinische Relevanz und praktische Anwendung an den Beispielen Krebs und Diabetes mellitus verdeutlicht.

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

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Abstracts . Deutsch Adjuvante ayurvedische Behandlung chronischer vs. akuter Schmerzen in der Neurologie

Eine klinische Studie zur Bewertung der Wirksamkeit von Vasti Chikitsa in Verbindung von BandscheibenvorfallManagement unter Berücksichtigung der Radikulopathie

Marco Lebbing MD

L. Mahadevan MD (Ayu)

Schmerz wird im Ayurveda ebenso wie neurologische Erkrankungen durch eine Störung von Vata verursacht. Während akute Schmerzen meist klar zugeordnet und behandelt werden können, sind chronische Schmerzen oft multifaktoriell bedingt und bedürfen eines komplexeren Behandlungskonzepts. Im Gegensatz zu traumatisch bedingten Schmerzen ist eine klare Ätiopathogenese nicht immer zu erzielen, was eine zufriedenstellende Behandlung zusätzlich erschwert. Dabei gehen gerade neurologisch bedingte Schmerzen oftmals mit diffusen und teilweise schwer beeinflussbaren Beschwerden einher.

Bandscheibenvorfall ist eine der häufigsten Erkrankungen, die durch einen Ayurveda-Arzt in der klinischen Praxis beobachtet wird. Die Krankheit zeigt sich durch einen Vata-Anstieg bedingt durch einen Lebensstil, der akute Rückenschmerzen mit Taubheitsgefühl, Missempfindungen und Schmerzen in den Beinen verursacht. Die Patienten nehmen oft Analgetika für ein paar Tage und erhalten symptomatische Linderung , aber Schmerzen treten nach dem Absetzen der Medikamente wieder auf. Die meisten dieser Menschen besuchen Ayurveda Vaidyas hier in meinem Dorf für eine vollständige Heilung.

Der Vortrag gibt einen Überblick über die verschiedenen Arten von Schmerz und die Schmerzentstehung. Anhand von primär neurologischen Schmerzerkrankungen erfolgt dann eine Beurteilung nach ayurvedischen Gesichtspunkten und mögliche Therapieansätze werden erläutert.

Die Ayurveda-Beurteilung stützt sich auf Prinzipien wie dosha, dushya, guna vikalpa, srotodushti prakara usw. Diagnose wird durch Prüfung und Untersuchungen wie SLR , Trendelenburg Test, Blasenkontrolle, Fußkontrolle, plantare Reflexe und MRT der Lendenwirbelsäule , sowie Screening der sagittalen Ansicht bestätigt. Therapiestrategie (cikitsa) ist vor allem die Redultion von Vata und Kapha (vatakapha-hara, ushna und vatanulomana und wird in verschiedenen Stufen durchgeführt. In der ersten Phase können gandharva hastadi kashaya, vaishvanara curna, abhayarishta usw. eingesetzt werden. Die zweite Phase umfasst die Anwendung von nagaradi lepa. Die dritte Phase umfasst die Anwendung von taila wie kottamchukkadi taila, chinchadi taila usw., wonach ruksha sveda folgt. In der vierten Phase wird vasti cikitsa wie pippalyadi taila für anuvasana und eranda muladi niruha für sthula dehi eingesetzt, während für krusha dehi dhanvantara taila anuvasana angewandt und madhutailika vasti genutzt wird. Vasti cikitsa kann vom Yoga- oder Karma-vasti-Typ in Abhängigkeit von dem Durchmesser des Wirbelkanals sein. Auf Vasti cikitsa folgen shamana-aushadhas. Kati vasti ist das letzte Instrument in der Behandlungsphase Tägliche Bewegung während einer Dauer von 20 Minuten wird empfohlen, bei Lumbalflexion zu vermeiden. Die Gesamtdauer der Behandlung beträgt 12 Wochen, in den ersten zwei Wochen stationäre Patientenbehandlung, gefolgt von shamana-aushadha. Die Wiederherstellung der Gesundheit liegt bei 99%. Der Referent präsentiert MRT Dokumentationen der Resorption des Bandscheibenvorfalls nach vasti cikitsa während des Referats.

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2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

Die Krankheitsspirale durchbrechen – verhaltenstherapeutische Perspektiven des Ayurveda

In diesem Sinne lohnt es sich, den Ayurveda im verhaltenstherapeutischen Sinne zu beleuchten; dabei spielen Erklärungsmodelle zur Funktionsweise der Psyche, aber auch klassische Empfehlungen zur Lebensführung eine Rolle, weil sie die therapeutische Vision der alten Ayurveda-Ärzte beleuchten und Auswege aus der Krankheitsspirale aufzeigen.

Prof. Dr. Martin Mittwede PhD

In dem Vortrag werden wir versuchen, die ayurvedischen Strategien zur Verhaltensänderung zu begreifen, um sie dann für unsere eigene Arbeit mit Patienten praktisch nutzbar zu machen.

Der Ayurveda nähert sich der Entstehung von Krankheiten auf verschiedene Weise und entwickelt Systematiken, um die Prozesse zu beschreiben und eindeutig diagnostisch zu erfassen. Als ein komplexes Medizinsystem betrachtet er die ursächlichen Faktoren in einem Zusammenhang und entwickelt daraus angepasste Strategien für die Behandlung. Klassisch bekannt ist das Konzept der zeitlichen Dynamik (kriyakala), in der sich eine Krankheit entwickelt: 1) Samcaya = Stadium der Akkumulation 2) Prakopa = Stadium der Provokation und des weiteren Anstiegs 3) Prasara = Stadium der Ausbreitung und der Einwanderung in andere Bereiche 4)  Sthana-Samshraya = Stadium der Lokalisierung bzw. des Festsetzens in den Geweben 5) Vyakti = Stadium der Manifestation (volle klinische Symptomatik vorhanden) 6)  Bheda = Stadium der Entstehung von Komplikationen und Chronizität Für die Veränderung der Dosha-Dynamik kennt der Ayurveda eine Vielzahl an Ursachen, wobei das selbst verantwortete Handeln eine bedeutende Rolle spielt. Das Ungleichgewicht der Doshas ist also häufig nicht die primäre Ursache der Störung, auch wenn es in der Literatur oft so dargestellt wird. Tatsache ist jedoch, dass ursächliche Belastungsfaktoren in der Regel zu einer Veränderung der Dosha-Situation führen und daher dementsprechend klassifizierbar sind. Ein entscheidendes Problem ist nun, dass gestörte Doshas auch auf die Psyche zurückwirken und zu einer Störung des Unterscheidungsvermögens (buddhi) und der Erkenntnisfähigkeit (prajna) führen. Gleichzeitig wirken Gewohnheitsmuster mit hinein, die dazu führen, dass selbst nach einer Balancierung der Doshas alte, eingeübte Verhaltensweisen wieder auftauchen und den Therapieerfolg zunichte machen können. Dieses Phänomen wird u.a. mit dem Begriff Anhaftung (klesha) beschrieben. Damit sind wir bei einem grundsätzlichen Problem der Prävention und der Gesundheitsbildung angekommen: Menschen verhalten sich nicht so, wie es für die Verwirklichung und Erhaltung der Gesundheit wünschenswert wäre. Viele Programme und Maßnahmen des öffentlichen Gesundheitswesens sind erfolglos, weil es nicht zu einer nachhaltigen Veränderung des Verhaltens kommt. Viele Menschen benötigen letztlich therapeutische Unterstützung, um sich auf den richtigen Weg zu begeben. Und dafür bedarf es sinnvoller Strategien.

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

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Abstracts . Deutsch Schmerztherapie mit pflanzlichen Mitteln

Die multifaktorielle Behandlung von Panikattacken

Dr. med. Kalyani Nagersheth

Dr. Karin Pirc MD PhD

Im Vortrag wird ein Schmerzkonzept vorgestellt und dann über zwei ausgewählte Pflanzen gesprochen, die im Ayurveda bei Schmerzen Verwendung finden.

Burn-out, Depressionen, Ängste, Schlafstörungen und Panikattacken zeigen in den letzten Jahrzehnten eine ständig steigende Tendenz. Statt Beruhigungsmitteln setzt der Ayurveda auf Ursachenanalyse. Wie ist die Lebenssituation des Betroffenen, sein Schlaf- und Wachrhythmus, seine Arbeitsbelastung ebenso wie die familiäre Situation und seine Ernährungsgewohnheiten über welchen Zeitraum und wodurch haben sich die Störungen eingestellt? Eine solche detaillierte Erhebung der Ursachen ist immer individuell auf die einzigartige Lebenssituation des Patienten zugeschnitten und schließt auch eine differenzierte Pulsdiagnose mit ein.

Boswellia serrata (shallaki, indischer Weihrauch) gehört zu den ayurvedischen Pflanzen-Substanzen, die in der letzten Zeit sehr intensiv erforscht worden sind. Es liegen viel versprechende Erkenntnisse über seine Wirkungen vor. Weihrauch setzt an der selben Stelle wie Cortison an und findet daher Verwendung bei überwiegend entzündlich bedingten Schmerzen. Syzygium aromaticum (lavanga, Gewürznelke) ist ein Klassiker im ayurvedischen Gewürzregal. Bei Schmerzen findet insbesondere auch das Nelkenöl Verwendung, welches in der Zahnmedizin häufig eingesetzt wird. Aber auch in Europa sind die Nelken seit dem Mittelalter in der Heilkunde bekannt. Sie können vielfältiger verwendet werden, als heute meist bekannt ist. Nelken wirken auf die Schmerzrezeptoren und werden besonders bei Schmerzen im Kopfbereich und bei Zahnschmerzen eingesetzt.

Darauf aufbauend erarbeitet der Ayurveda-Arzt gemeinsam mit dem Patienten einen in seinen Alltag umsetzbaren Maßnahmenkatalog, der die gestörten Doshas wieder ins Gleichgewicht zurückführt, sodass das verloren gegangene Wohlbefinden sich wieder einstellen und auch auf Dauer erhalten bleiben kann. Je ausgeprägter das Beschwerdebild bereits ist, desto mehr Faktoren müssen ausgeglichen werden. Als Basis gilt eine Lebensweise, die im modernen, hektischen Leben oft verloren gegangen ist: - ausreichend Schlaf angepasst an den biologischen Rhythmus, - leicht verdauliche, lebendige Nahrung, regelmäßig und zur richtigen Tageszeit genossen, wobei die individuelle Verdauungskraft und Stoffwechselleistung berücksichtigt werden, - im Alltag einfach durchzuführende Entgiftungsmaßnahmen, - sportliche Bewegung und/oder Yoga-Übungen, ebenfalls fein abgestimmt auf die individuelle Befindlichkeit und Leistungssituation - und vor allem in diesen Situationen extrem bewährt Meditation, speziell die Transzendentale Meditation ebenso wie Phytotherapie, die das Nervensystem stärkt und beruhigt. Selbst in schweren Fällen hilft eine Pancakarma-Kur, die klassisch überlieferte und seit Jahrtausenden bewährte Umstimmungs- und Ausleitungstherapie des Ayurveda. Diese wird unter ärztlicher Aufsicht individuell auf den Einzelnen abgestimmt. Sie löst mit vielen verschiedenen Formen von Ölmassagen - die von zwei Therapeuten mit synchronen Bewegungen durchgeführt werden - und Ölgüssen systematisch Umweltgifte und körpereigene Abbauprodukte aus den Zellen. Diese werden anschließend durch Abführen und sanfte Einläufe systematisch wieder ausgeschieden. Diese Entlastung des Körpers, die eine tiefe Regeneration einleitet, wird begleitet von gesundheitsfördernder, schmackhafter Ernährung und einem Tagesablauf, der alle Aspekte der Regeneration weiter vertieft.

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2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

Krankheitsursache und Pathogenese moderner Krankheiten ayurvedisch neu betrachtet Dr. med. Rotraud Scheiderbauer In unsere ayurvedische Praxis in Europa kommen Patienten häufig mit Beschwerden, die entweder bereits schulmedizinisch klassifiziert wurden oder in kein allopathisches Krankheitsbild passen. Die “moderne“ Medizin unseres Jahrhunderts beschreibt Krankheiten, die in den ayurvedischen Schriften nicht angeführt sind und für die es in den alten Texten keine Entsprechungen gibt. Das weite Feld der Autoimmunerkrankungen sei hier als Beispiel genannt. Sucht man in der ayurvedischen Pathophysiologie, findet man für AutoAntikörper kein Pendant. Wie geht man also als Ayurveda Mediziner mit “modernen“ Krankheiten wie z.B. multipler Sklerose, Lupus erythematodes oder Hashimoto Thyreoiditis um? Bei Sushruta finden wir folgende Empfehlung: nasti rogo vina doshair yasmat tasmad vicaksanah anuktam api doshanam lingair vyadhim upacaret Da es keine Krankheit ohne (Beteiligung von) doshas gibt, möge also der Verständige auch nicht genannte Krankheiten nach den Symptomen der doshas behandeln Sushruta-Samhita, Su 35.19

tasmad vikaraprakrtir adhisthanantarani ca samutthanavisheshamsh ca buddhva karma samacaret Also möge man die Behandlung beginnen, nachdem man die Natur der Krankheit, die Veränderung der Lokalisation und den spezifischen Beginn erkannt hat. Caraka-Samhita, Su. 20-22 Wie kann nun eine Therapie aussehen, die zum Benefit des Patienten Ayurveda und Schulmedizin vereint? Anhand einer Fallstudie wird auf diese Frage detailliert im Vortrag eingegangen: Eine 55-jährige Patientin wurde mir vor 11 Jahren zur internistischen Abklärung rezidivierender Entzündungen im Genitalbereich überwiesen. Die Bartholinischen Drüsen waren in unregelmäßigen, immer kürzer werdenden Abständen schmerzhaft geschwollen und eitrig, sodass eine chirurgische Intervention unumgänglich war. Begleitend litt sie an Gastritis und nächtlichem Schwitzen am Kopf. An pathologischen Laborwerten fiel neben akuter Entzündungsparameter ein deutlich erhöhtes TSH auf, das so gar nicht zu der äußerst agilen Patientin passte. Sie litt weder unter Müdigkeit, Energieverlust noch Antriebslosigkeit. Der Verdacht auf eine Immunthyreoiditis Hashimoto bestätigte sich in weiteren Untersuchungen und eine Substitutionstherapie mit SchilddrüsenHormonen wurde eingeleitet. Die Beschwerden besserten sich teilweise. Die als „vegetative“ Symptome bezeichneten NebenErscheinungen blieben allerdings unverändert. Jetzt, in meiner ayurvedischen Praxis, wurde die allopathische Therapie durch Ausgleich der aggravierten doshas ergänzt.

In der ayurvedischen Pathogenese (samprapti) werden über 30 mögliche Krankheitsursachen, u.a. abhyantara und bahya (innere und äußere Ursachen), sama dosha und nirama dosha (dosha mit und ohne ama) genannt, die zu einer Veränderung der doshas führen können. Sechs verschiedene Stadien abnormer dosha Aktivität bieten Gelegenheit zu therapeutischer Intervention. Schulmedizinisch gesehen ist die Ursache “moderner“ Erkrankungen häufig unbekannt. Desto wichtiger scheint – gleichwie zum Ausgleich – eine genaue Klassifizierung und Nomenklatur zu sein. Im Ayurveda gibt es auch hierzu Hilfe von den Klassikern: vikaranam akushalo na jihriyat kadacana na hi sarvavikaranam namato sti dhruva sthitih Wer den Namen einer Krankheit nicht kennt, der möge sich niemals schämen, denn es sind nicht alle Krankheiten vom Namen her festgelegt. sa eva kupito doshah samutthanavisheshatah sthanantaragatash caiva janayaty amayan bahun Der erregte dosha aufgrund der Besonderheit seiner Lokalisation und bei Wechsel der (Körper-)Region erzeugt viele Krankheiten.

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

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Abstracts . Deutsch Reizmagen und Reizdarm aus der Sicht der Ayurveda-Medizin

Ayurvedische Anti-Aging Medizin für Männer

Elmar Stapelfeldt HP

Ralph Steuernagel HP

"Das Verständnis und die Therapiemöglichkeiten von funktionellen Erkrankungen des Magen-Darm-Trakts können durch traditionelle Medizinsysteme wie dem Ayurveda bereichert werden."

Anti-Aging ist das Zusammenspiel mehrerer Disziplinen mit dem Ziel länger, gesünder, schöner, biologisch jünger und glücklicher zu leben.

Dieser von der Schulmedizin hinsichtlich seiner Ursachen und Entstehungsmechanismen schwer zu greifende Beschwerdekomplex lässt sich mithilfe der dynamischen Konzepte der Ayurveda gut fassen. Traditionell liegt der Fokus des Ayurveda in vielerlei Hinsicht auf dem Magendarmtrakt und er hat an großen Populationen umfangreiches Erfahrungswissen bei der Behandlung funktioneller Verdauungsbeschwerden gesammelt. Dank seines ganzheitlichen Ansatzes bietet Ayurveda gerade bei den psychisch beeinflussten Erscheinungsformen vielfältige therapeutische Möglichkeiten.

Das Leben verlängern heißt, es nicht zu verkürzen. Die AntiAging-Medizin beinhaltet Maßnahmen zur Verhinderung vorzeitigen Alterns. Ihre Quelle liegt im alten Indien und wurde vorwiegend in der Lehre von RASAYANA CIKITSA, einer der acht Glieder klassischer Ayurvedamedizin, verarbeitet.

Übereinstimmend mit den sog. ROM-Klassifikationskriterien, die funktionelle Magendarm-Beschwerden auf zwei Hauptbeschwerdebilder (funktionelle Dyspepsie und Reizdarmsyndrom) reduzieren, finden sich im Ayurveda zwei wesentliche Kriterien für die Diagnose: 1. das "Verdauungsfeuer" (agni) für den oberen und 2. die Darmsensibilität (koshtha) für den unteren Verdauungstrakt. Die jeweiligen Untereinteilungen dieser beiden Kriterien ermöglichen eine praxisnahe Typisierung. Zur differenzierten Zuordnung individueller Symptome wird die dosha-Theorie herangezogen. Nach der individualisierten Diagnose unter Berücksichtigung der Patientenkonstitution steht am Anfang der ayurvedischen Therapie die Ursachenvermeidung. Da im Ayurveda-System Ernährung, Verhalten und Denkweisen die wichtigsten ursächlichen Felder darstellen, kommen die umfangreiche Diätetik und Ordnungstherapie des Ayurveda zum Tragen. Mithilfe der ayurvedischen Phytotherapie lassen sich nebenwirkungsarm Impulse auf individuelle Beschwerden setzen. Im Vordergrund stehen hier die Korrektur der Verdauungsfunktionen (agni) und die Regulierung der Darmmotilität (koshtha). Die psychische Komponente wird mittels harmonisierender Ölanwendungen, Phytotherapeutika und übender Verfahren wie Yoga und Meditation behandelt. Sollten genannte Therapiemethoden nicht den gewünschten Erfolg zeitigen, so werden traditionelle Ausleitungsverfahren zur Verbesserung von Digestion und Stoffwechsel, zur Darmsanierung und zur Beseitigung pathogenetischer Schadstoffe durchgeführt.

Läuft die biologische Uhr der chronologischen voraus, lässt sich diese durch sieben Methoden wieder zurückdrehen in den richtigen Takt der Natur: • Ernährungsplanung (Ahara) • Bewegungstraining (Vyayama) • Lebensstiländerung (Vihara) • Supplementierung (Aushadha) • Hormonelle Balance • Mentale Balance (Sattvavajaya) • Ästhetisches Anti-Aging (Saundarya) Für ayurvedisches Anti-Aging gibt es keine Altersbegrenzung – unser Organismus altert, weil er lebt. Frauen und Männer können gleichermaßen von den ganzheitlichen Ansätzen des RASAYANA profitieren. In diesem Fachvortrag werden u.a. folgende Themen behandelt: • Ursachen der Alterung aus ayurvedischer Sicht • Ganzheitliche Maßnahmen zur biologischen Verjüngung von Organen und Funktionen • Andropause: Ayurvedische Begleitung der hormonellen Umstellung bei Männern • Problemlösungen bei sexuellen Funktionsstörungen • Prävention von männlicher Demenz und Depression im Rentenalter • Verwirklichung männlicher Lebensziele in unterschiedlichen Lebensphasen • Die Rolle von Attraktivität in jedem Lebensalter

In diesem Workshop vermittelt Elmar Stapelfeldt seine umfangreiche Praxis-Erfahrung mit diesem weit verbreitetem Krankheitsbild, das mit Ayurveda gut behandelt werden kann. DiagnoseÜbungen, praktische Tipps und Fallanalysen machen die Inhalte für die Teilnehmer leicht umsetzbar.

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2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

Wissen und Verwendung von ayurvedischen Heilpflanzen in der Klostermedizin Dr. Dr. med. Bernhard Uehleke PhD Es gibt eine deutliche Überlappung bei den verwendeten Heilpflanzen im Ayurveda und in der Traditionellen Europäischen Medizin bzw. Klostermedizin. Bereits in der frühen Phase (8.-10. Jh.) der Klostermedizin war bereits Ingwer eine der meist erwähnten Pflanzen überhaupt (bes. 'Lorscher Arzneibuch'), fast ebenso wichtig war Pfeffer (schwarzer, weißer und langer Pfeffer), daneben Kardamom, Gewürznelke und Zimt.

Die Zuordnung von Qualitäten ist bei diesen Gewürzen ebenso wie in den asiatischen traditionellen Medizinsystemen übereinstimmend heiß und trocken. Sie werden bei feucht-kalten Zuständen angewandt – dennoch unterscheiden sich die spezifischen Indikationsangaben nicht unerheblich. In der 2. Phase: 11.-12. Jh. (erste arabische Rezeption) kamen hinzu: Muskatnuss und Galgant (beide auch direkt aus China) und die Zittwer-Wurzel (Curcuma zedoaria). Alle diese Gewürze und Arzneipflanzen gehörten zu den äußerst beliebten Heilmitteln, nicht zuletzt auch bei Hildegard von Bingen. Ein genauerer Vergleich der Indikationsangaben in Abhängigkeit von Zeit und Raum könnte Hinweise zu vergessenen Indikationen bringen.

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

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Abstracts · English

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2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

Abstracts . English Abstracts · English

Page 18

Anand Chaudhary MD (Ayu) PhD: Pathogenesis in Ayurveda

18  Matthijs Cornelissen MD: How to develop rigorous subjectivity as a new research methodology for psychology and mental health 19

Prof. Anand Dhruva MD: Developing modern perspectives on the concept of ama

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Prof. Antonella delle Fave MD: The management of mental health – challenges and solutions

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Prof. Antonella delle Fave MD: Towards sustainable healthcare: the benefits of an integrated approach

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Prof. S. N. Gupta MD (Ayu): Etiopathogenesis of diabetes mellitus and its treatment

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Prof. S. N. Gupta MD (Ayu): Psychological aspects of pain: role of the mind in causation as well as in management of pain

23  Parvathidevi Kirathamoorthy MD (Ayu) MSc: Treatment strategies of unbalanced states of mind due to pitta ( paittikonmada) 24  Nikolaos Kostopoulos MD and Asvin Barot MD (Ayu): Acute and chronic pain managed with agnikarma and the use of a novel herbal cream 24

Rajesh Kotecha MD (Ayu): Clues on pain management from an Ayurvedic perspective

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Sascha Kriese BA Hons (Ayu): The purpose of disease – understanding pathogenesis holistically

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Sascha Kriese BA Hons (Ayu): The sacred masculine

28  Marco Lebbing MD: Adjuvant Ayurvedic treatment of chronic and acute pain in neurology 28  L. Mahadevan MD (Ayu): A clinical study to assess the efficacy of vasti chikitsa in the management of intervertebral disc prolapse associated with radiculopathy 29

Ram Manohar MD (Ayu): The role of dhatu in etiology and pathogenesis of diseases

29  Ram Manohar MD (Ayu): Reproductive medicine in Ayurveda – the concept of vrishya (fertility) and vajikarana (potency) 30

Prof. Martin Mittwede PhD: Breaking the disease spiral – behavioral perspectives of Ayurveda

31  Antonio Morandi MD: Neuropathic pain after lombotomy for renal cancer resolved with Ayurvedic treatments – a case report 31

Ashtavaidyan Narayanan Nambi MD (Ayu): Management of prostate disorders and BPH

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Ashtavaidyan Narayanan Nambi MD (Ayu): Neurological descriptions in classical texts

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Prof. Tanuja Nesari MD (Ayu) PhD: Medicinal plants for improving dhatvagni and qualities of dhatuin Ayurveda

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Sukumar Sardeshmukh MD (Ayu): Importance of shukra dhatu in Ayurveda

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Madan Thangavelu PhD: The agni-ama-srota triad in disease aetiology and pathogenesis

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Carmen Tosto: External basti in pain management

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Ramesh Varier MD (Ayu): Ayurvedic treatment of male infertility

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Ramesh Varier MD (Ayu): Polycystic ovarian syndrome and its management through Ayurveda

Composition of all lectures in English By the following texts we would like to give you an overview on the manifold experiences of the Ayurvedic doctors and therapists participating in this year‘s symposium. We would like to thank all our guests, lecturers and contributors who enable this Ayurveic Congress at the European Academy of Ayurveda to become a unique and qualitative event with lots of exchange of experiences. The articles are often only short abstracts of the lectures and reflect the deep knowledge and informational richness the lectures and workshops have.

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

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Abstracts . English Pathogenesis in Ayurveda

How to develop rigorous subjectivity as a new research methodology for psychology and mental health

Anand Chaudhary MD (Ayu) PhD

Matthijs Cornelissen MD

The holistic approach of Ayurveda intends to make human life healthier. The classical and contemporary literature of Ayurveda has conceptualized the doctrine of origin of diseases and its remedies as per its fundamental philosophy /principles based on core concepts like Tridosha, Pancamahabhuta, Saptadhatu, DoshaDushya-Sammurcchana, Kha-Vaigunya, Avarana and SampraptiVighattana.

In recent years, a number of health-related disciplines and practices from India have found widespread acceptance in the emerging global civilization. But the acceptance is still largely at the margins. Ayurveda tends to be bracketed as a "complementary and alternative" form of medicine of which the "usefulness and safety" is still to be established, and hathayoga and mindfulness are accepted only as neatly packaged but severely simplified and decontextualized auxiliary techniques. The sophisticated underlying knowledge systems and the well-developed ontologies and epistemologies on which they are based are ignored.

Ayurveda believe that if basics of body such as Dosha, Agni, Dhatu, Mala and various physiological factors and procedures are in balanced state and performing with equilibrium, person will maintain a disease free status. Any disturbances in symmetry of these factors will lead to pathogenesis of disease. Ayurveda describes how the etiological factors bring about changes in the structural and functional units of the body, i.e. Vata, Pitta and Kapha, further, how these structural changes derange the functions of organs and finally how the deranged functions of one organ lead to derangement of other organs i.e. complications. The concept of pathogenesis of diseases in Ayurveda discussed various stages of commencement of diseases as under a) Samcaya – Accumulation of Doshas because of action of etiological factors. b) Prakopa – Further enhancement in imbalance status of Doshas c) Prasara – Propagation of Doshas at different sites d) Sthanasamshraya – Collection of Doshas in specific sites e) Vyakti – Expression of disease f) Bheda – Differentiation of diseases Ayurveda defines different varieties of diseases in accordance of their causative causes, such as diseases of body and mind, diseases due to internal and external causes (Nijja and Agantuja), diseases as per number of Doshas involved and their different sets of cross combination termed as Ekadoshaja (any one Dosha), Dvandvaja (any two Doshas) and Sannipatika (all three Doshas are involved), Hereditary diseases (Adibala Pravritta or Sahaja), congenital diseases (Janmabala Pravritta or Garbhaj), diseases due to environmental factor (Kalabala Pravritta or Kalaja), diseases arising due to bad luck or misfortune (Daivabala Pravritta or Prabhavaj) and many more.

In this presentation I will focus on mindfulness where a shift from its limited present usage to its full potential could have a far-reaching impact on our collective and individual lives. Mindfulness is increasing accepted as an auxiliary technique in Cognitive Behavioral Therapy (CBT), because even its present crippled, decontextualized usage simply works. But a good understanding of the underlying philosophy, the psychological theories, and the practical know-how on which this technique is based, could lead to much more. It could not only lead to more effective usage in counseling, therapy and the maintenance of mental health, but it could also open up the possibility for the systematic development of what Maslow called the further reaches of human potential. It could do this by the development of consciousness-based research methods, which could (finally) offer psychology the possibility of studying (and influencing) with perfect rigor and mental rectitude the subtle, yet powerful, innermost movements of the mind. The issues involved are, however, many and the whole territory is rather complex. What I'll try to do here is to give a short outline of the underlying philosophical assumptions, indicate a few basic techniques, hint at the possibilities their usage might open up to, and hope that this will lead to discussion and further studies.

Understanding of pathogenesis of all these kind of diseases as per principles of Ayurvedic doctrines is necessary to decide root cause of disease so that instead of symptomatic treatment total cure may be provided to patient. The classical and contemporary thoughts of pathogenesis in Ayurveda will be discussed in detail during discourse of symposium.

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Developing modern perspectives on the concept of ama

The management of mental health – challenges and solutions

Prof. Anand Dhruva MD

Prof. Antonella delle Fave MD

Given trends in globalization, it is becoming increasingly important to have productive dialogue among different thought systems. Biomedicine and Ayurveda are two major systems that interact in the modern framework. As such, encouraging discussion of core concepts that may be shared between the two systems is of importance.

The impressive advancements in pharmacology and medical technology, improvements in diet, hygiene practices, immunization campaigns, and the inclusion of health in the Human Development Index increased policymakers’ attention to health-related issues. Although this positive trend led to a substantial reduction of infectious and acute diseases, and to a relevant increase of life expectancy, this success was counterbalanced by the worldwide increase of chronic and degenerative diseases, mental disorders and substance abuse, partially derived from massive urbanization and consequent lifestyle changes.

According to Ayurveda, ama represents partially digested metabolic toxins that are retained in the body and linked to the formation of disease. The concept of ama is central to the practice of Ayurveda. The diagnosis and treatment of ama represents the first step in a treatment approach. In this session we will review the textual description of ama; consider Ayurvedic clinical perspectives on ama; discuss possible modern correlates of ama; and conclude with a panel discussion on developing modern perspectives on the traditional concept of ama. Learning objectives include: • to consider the importance of dialogue between modern and traditional medicine • to understand the traditional textual description of ama • to recognize key clinical features of ama and • to consider possible modern correlates of ama

The negative impact of inappropriate dietary regimes, excessive workload, sedentary style and lack of social connections on physical and mental health are increasingly evident. In order to cope with these challenges, specific effort is required to identify personal and social resources that can promote health and prevent disease onset or progression, over and above medical interventions whose relevance is anyway limited. The recent development of health psychology and positive psychology shed light on the psychological and social resources that can be mobilized and built to promote individuals’ well-being. However a more systematic approach is required, based on cooperation across disciplines, including traditional medical systems, such as Ayurveda, that structurally encompass the environmental and psychological components of health in their view of human functioning.

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

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Abstracts . English Towards sustainable healthcare: the benefits of an integrated approach

Etiopathogenesis of diabetes mellitus and its treatment

Prof. Antonella delle Fave MD

Prof. S. N. Gupta MD (Ayu)

Western scientists have developed different theories and models of human health and functioning, often proceeding autonomously and without seeking for connections with other perspectives. This trend led either to over-generalizations (typically exemplified by the bio-psycho-social model) or to knowledge fragmentation across sub-disciplines.

Diabetes mellitus (DM) is one of the diseases which have longest recorded history of its prevalence in human society. Nearly all ancient scriptures including the oldest ones ‘the vedas’ have descriptions of this disease. Ancient Ayurvedic scriptures e.g. Caraka samhita and Sushruta samhita have described this disease as madhumeha, kshaudrameha or ojomeha, a subtype of prameha. Etiology, pathogenesis, symptomatology, complications and its treatment are described in detail, these have their relevance even today in managing this disease.

The binary view contrasting universalism and relativism, quality and quantity, holistic and reductionist frameworks cannot take researchers and practitioners very far in their attempts to provide an exhaustive description of life and health. The complexity of human behaviour can hardly be captured through simplified paradigms, and the current state of the art in Western science does not allow for a unified perspective yet. Moreover, the attempt to achieve a stable and ultimate description of human functioning does not fit the growing challenge of resource limitations in welfare societies, calling for healthcare programs that can be sustainable in the long run. The dynamic and flexible nature of living systems and groups, highlighted by a variety of disciplines ranging from psychology to economics, is more consistent with the person-centred and agentic approach characterizing traditional medical systems, that should be more systematically integrated in health policy.

Diabetes is very big challenge for medical science. Though invention of insulin and several hypoglycemic drugs have given good assurance to the sufferers, its complications are still considered among life threatening conditions. This is the fourth main cause of death in developed countries. This is an alarming fact that in the year 2000 150 million people world wide have diabetes and this is estimated to be doubled by 2010. In Europe itself there are 30 million diabetics. Classification Ayurveda classifies DM into two types which are well comparable with two main types of DM in modern medical science: • Krisha Pramehi – these are the lean patents, in which the vata principle is hyperactive due to diminution in dhatus (dhatu kshaya). This type is very well comparable with Type 1 DM in modern conventional medical classification. • Sthula Pramehi – these are comparatively overweight patients having excess of medas and mamsa dhatus in abnormal form, which block the action path of vata principle (avarana of vata). This type is very well comparable with Type 2 DM in modern classification. Etiopathogenesis in Ayurveda Krisha Pramehi / Type 1 DM Causative factors: • Bija dosha – genetic factors • Excessive work / work or exercise beyond capacity • Mal nourishment • Diseases causing defects in dhatus Pathogenesis: In this category there is damage to dhatus or the body tissues resulting into hyperactivity of vata principle; that again causes further damage to the body tissues. In this way a vicious cycle is formed which results into more and more damage to the body tissues. In other words we can say that the beta cells of pancreas are damaged due to above mentioned causes which modern science explains in terms of autoimmune beta cell destruction. This results into lack of insulin resulting into metabolic defects and ultimately damage to the body tissues, the dhatus.

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2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

Sthula Pramehi / Type 2 DM Causative factors: • Bija dosha – genetic factors • Lack of physical activities and exercise • Day time sleep • Excessive consumption of nutrition

Psychological aspects of pain: role of the mind in causation as well as in management of pain

Pathogenesis: These causative factors produce abnormal increase in medas and mamsa dhatus. These abnormal dhatus block the action path of vata principle. This is comparable with inhibition of insulin action, insulin resistance and relatively less production of insulin and thus DM.

‘Pain’ is originated from the Latin "Poene," which means to punish. When we are in pain, we feel like a punishment. Pain is the most common and attention-seeking symptom, which interrupts all other activities. Pain is described in various forms with various words in Ayurveda, however vata is the principle in every type of pain which conveys the pain impulse through sanjnavaha srotas to manah – the mind which is the receiver for all senses including pain and recognises it in its form, location and severity. Mind is not only receiver of the impulses but also generator of the impulses. Ayurveda and other associated sciences in India have recognised the importance of mind in causation, experiencing and managing a pain as it can generate the pain but also can generate pleasure.

Treatment strategy based on etiopathogenesis Krisha Pramehi / Type 1 DM Since insulin producing cells are non working in this category, Ayurvedic treatment can not compensate the metabolic functions of insulin but Ayurveda can help a lot in cases of chronic complications of DM. For this type of DM our strategy shall be 1.  improvement of quality of dhatus and ojas nourishing and anti-vata measures 2. controlling and regulating vata principle 3. supportive Ayurvedic treatment together with modern medicine (insulin) 4. prevention and treatment of the complications Sthula Pramehi / Type 2 DM Ayurveda can help significantly to this type of Diabetics. For this type of DM our strategy shall be 1.  Removal of the factors blocking action vata principle (insulin inhibiting factors) through shodhana (pañcakarma) procedures. The factors those interfere with the functions of Beta cells as well as insulin are eliminated. This results into better functioning of beta cells and insulin. 2. Weight control: This helps in reduction of abnormal medas and mamsa dhatus and reduces the requirement of insulin. 3. Prevention and treatment of the complications. The patients of DM are successfully treated with these measures at Ayurveda clinics in India and in Europe.

Prof. S. N. Gupta MD (Ayu)

Role of psychic factors in causation of pain, experiencing a pain and in managing a pain Causation Pain is grossly of two origins: physical and psychogenic. A physical pain may be due to stimulation of pain receptors by substances produced by damaged tissues (nociceptive pain), or it may be due to a nerve injury (neuropathic pain). A psychogenic pain is due to mental factors without any physical cause, in which mind creates and imagines a pain. Headaches, muscle pains, backache and abdominal pains are some of the most common types of psychosomatic pain. Whether it is a psychic origin or it is a physical origin, but in any case, it is not all either in the mind or in the body. It is all in the mind-brain-body. Experiencing pain Pain is a complex process which is a resultant experience influenced by several factors beginning from the generation of pain impulse till it reaches to the brain-cortex and perceived by mind. The pain experience depends on a complex interplay of mind, central and peripheral nervous systems those process pain signals in their own way. The pain signals before reaching to brain have to pass through a ‘gate’ system in spinal cord which is believed to be situated in substantia gelatinosa of the dorsal horn. These are events and conditions that may open the pain gates and cause more suffering include: • sensory factors such as injury, inactivity, long-term narcotic use, poor body mechanics • cognitive factors such as focusing and worrying on the pain, distractions, negative thoughts, catastrophic thinking’ and hypervigilance to threat • emotional factors such as depression, anger, anxiety, stress and frustration

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

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Abstracts . English Opposite to this influences that can close the pain gates and reduce suffering include: • sensory factors, such as encouraging activities, short-term use of analgesics, relaxation training and meditation • cognitive factors such as outside interests, thoughts helping in coping with the pain, and distraction from pain • emotional factors, such as positive attitude Besides these factors, enkephalins and endorphins present in substantia gelatinosa are likely to act here. Once a pain signal reaches the brain, a number of things can happen. Certain parts of the brain stem (which connects the brain to the spinal cord) can inhibit or muffle incoming pain signals by the producing endorphins that occur naturally in the human body. The brain can also send signals down the spinal cord to open and close the Gates

Patients have to be guided to develop insight into the nature of self-defeating and self-denigrating patterns of thinking and to test the reality of these patterns of thinking and develop ways of challenging them. With this one can understand the effects of thoughts upon feelings and feelings upon thoughts. Education about causes and consequences of pain and positive information as well as predictability reduces pain. Meditation serves a purpose to focus the mind away from the pain. Most importantly meditation shuts down the stress response which intensifies the pain. For meditation lie down in quiet and comfortable dark room with closed eyes. Take slow, deep breaths, focus on only inhalation (through nose) and exhalation (through mouth). Autosuggestions of painful area being filled with a cooling mist (hypnoanaesthesia), shifting attention to non-painful part and altering sensation in that part, imagination of strong painkiller injection at painful site (mental analgesia) during meditation are beneficial.

A fast pain message reaches the cortex quickly and prompts immediate action to reduce the pain or threat of injury. In contrast, chronic pain tends to move along a "slow" pathway (C-fiber). Slow pain tends to be perceived as dull, aching, burning, and cramping. Initially, the slow pain messages travel along the same pathways as the fast pain signals through the spinal cord. Once they reach the brain, however, the slow pain messages take a pathway to the hypothalamus and limbic system. The hypothalamus is responsible for the release of certain stress hormones, while the limbic system is responsible for emotions. This is the reason of association of stress, depression, and anxiety with chronic pain. The cortex also controls pain messages by attaching meaning to the personal and social context in which the pain is experienced. Periaqueductal grey matter and raphe nuclei in brain stem produce analgesia, and also inhibit pain inputs at dorsal horn.
 Personality may also influence the pain intensity. Vatala may feel more pain while pittala and shleshmala less. People respond differently to pain-inducing stimuli and to attempts at pain management. Influencing factors besides personality are gender, age and culture. Chronic pain patients are often disabled and complain of associated problems. They may become interpersonally isolated and develop unsatisfactory family responsibilities. They often suffer with depression, phobias, poor concentration and poor memory. Treatment Treatment plans are based on above mentioned factors. To remain active and to believe in the ability to control pain are useful. Often the consequences of pain behaviour are detrimental for the patient and add to suffering. Avoidance behaviour is the most common form of reinforcement of pain and disability. These patterns are replaced within cognitive behavior therapy by encouraging patients to behave time-contingently and to plan for achievable goals. The sedentary patients may develop symptoms of physical disuse. Increasing general fitness is thought to reduce fatigue and reduce the number of fatigue-related somatic symptoms that can be judged to be pain related. Personal achievement in fitness and function are common goals for patients. 22

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

Treatment strategies of unbalanced states of mind due to pitta (paittikonmada) Parvathidevi Kirathamoorthy MD (Ayu) MSc Unmada is one of the major psychiatric disorders elaborately dealt in Ayurvedic psychiatry (manasarogavijnana). This is considered as the disordered state of mind in which an individual loses the power of regulating his conduct and behavior in accordance to norms of the society. According to Ashtanga Hridaya, a classic text of Ayurveda, unmada is the unbalanced state of mind produced by morbid doshas (vata, pitta and kapha along with manasa dosha namely rajas and tamas). Mainly it is classified into two groups: doshonmada and bhutonmada. The cause for doshonmada is the vitiation of the doshas whereas that of bhutonmada is a pure psychological insult. Doshonmada is again classified into vatika, paittika, kaphaja and sannipatika. Among various doshonmada the psychic unbalance caused by vata (vatonmada) is the one which is more common these days whereas psychic unbalance caused by pitta (paittikonmada) stands for the one which is very difficult to manage. We can correlate the symptoms of paittikonmada to mania with an irritable mood, the main symptoms being increased anger, irritability, destructive tendency, increased psychomotoric activity, increased thirst and sweat, insomnia, increased appetite and the like.

The general treatment for pittadosha includes snehapana, svedana, virecana and shamana measures. Different types of shamana are food with sweet, bitter and astringent taste, residing in a cool atmosphere, enjoying pleasant music and the company of good friends. This treatment methodology is administered in the treatment of paittikonmada as well. The common treatment strategy followed in GARIM (Government Ayurveda Research Institute for Mental diseases, Kottakkal, India) for paittikonmada include mriduvirecana followed by talapothichil, snehapana, svedana, virecana, yogavasti and nasya respectively Sirolepa with shita virya drugs are advised in treatment of pittadosha. Traditional physicians from Kerala practice lepa on head in mental disorders. In paittikonmada lepa with dhatriphala curna, guluchi curna etc. are drugs of choice. Siropichu with specific oils will help in subsiding the morbid symptoms in paittikonmada. It is observed that the extreme energy and not wanting sleep or other relaxing states that are very common symptoms exhibited in paittikonmada as well as in mania are the target of shodhana therapy. Through various procedures like snehapana, and virecana exhaustion is brought about. Further the specific drugs and drug formulae indicated in this condition as shamana cikitsa, directly breaks open the aetiopathogenesis and brings forth significant clinical changes in the patient.

As far as Ayurvedic psychiatry is considered, the most challenging element is the management of paittikonmada. The patient being in a very aggressive and agitated state, special care must be taken while giving medicines and also while undergoing treatment procedures. But among all the other types of unmada, paittikonmada gets striking results as the change the symptoms will be conspicuous. Principles of treatment of mental disorders basically do not vary from that of kayacikitsa, because both are caused by vitiated doshas. The basic treatment modality specific to doshonmada is purification (shodhana) and pacification (shaman). On observing the treatment methodologies prescribed in Ayurvedic treatises we can understand that the ancient scholars have given prime importance to shodhana than to shamana measures. Methodologies: Treatment measures of paittikonmada can be categorized into two depending upon the involvement of pittadosha: 1. General treatment for pittadosha 2. General treatment for unmada

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

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Abstracts . English Acute and chronic pain managed with agnikarma and the use of a novel herbal cream

Clues on pain management from an Ayurvedic perspective

Nikolaos Kostopoulos MD and Asvin Barot MD (Ayu)

Rajesh Kotecha MD (Ayu)

Osteoarthritic pain is a challenging and debilitating condition that undermines the ability of a patient to move, work, rest and enjoy everyday activities that make life worth living.

Although other contemporary medicines have found cures for many troubling health problems including some infectious diseases that cause sickness and premature death on a grand scale, they have been less successful in combating many chronic and life style illnesses. Likewise drugs of contemporary medicine offer potent treatment for several common ailments, but they also carry the high risk of adverse reactions, which in some cases are powerful and become distressing. Amid all these deficits of treatment it becomes mandatory that one should search for medicaments, which can overcome all these vagaries. In this direction a search in the field of Ayurveda for medicines, which can fulfill the requirements, is the need of the hour.

The side effects of anti-inflammatory therapy (NSAIDS) include gastrointestinal bleeding, for the non-selective ones and possible cardiovascular toxicity for selective COX-2 inhibitors. Agnikarma is a procedure described in Ayurveda that is not widely used because of its main side effect which is the burn and the possible formation of scar. Having done research in Miami University (deep 2nd degree burns), Benares Hindu University and Civil Hospital in Ahmedabad (treatment of post burn hypertrophic scars) with a novel herbal cream, we developed a tool to treat and prevent in a fast and pain free way the main side effect and obstacle in the use of Agnikarma. In the presentation we will show our data from both fields of our research. First the basic and clinical data from the use of the herbal cream for burns and hypertrophic scars, and then our data from the use of Agnikarma for the management of pain.

In Ayurvedic texts pain and inflammation have been discussed under various headings. They have always been a problem of unease to all clinicians and patients. It is the self-protective reaction of the tissues towards infection, irritants or foreign substances. Though it is a part of host defense mechanism when it becomes critical it turns to be a hopeless condition which causes tissue damage and also do harm to the body. Hence, taming is always essential. These two symptoms are always associated with various diseases and musculo-skeletal system is the most affected one in the form of arthritis. To combat these symptoms, Non-Steroidal AntiInflammatory Drugs (NSAID), immunesuppressants and certain steroids are the routine drugs being used by modern physicians. These drugs of modern medicine are effective but have an increased risk of causing adverse reactions like gastric erosion etc. Hence, clues are being taken from rich Ayurvedic treasure house to find out safe analgesic and anti-inflammatory drugs. This has given a momentum to search remedies from natural sources, which may tame the threat of inflammation efficiently. In addition to these, there is a term called functional pain and it applies to pains and aches in clinical conditions like Irritable Bowel Syndrome, Fibromyalgia etc. that hamper quality of life of individuals. There are evidences that some Ayurveda plant based medicines and therapies are very effective for such types of functional pains. In current exercise it has been attempted to put forward the basic concepts of pain in Ayurveda and present clues and evidences on analgesic and anti-inflammatory activities of certain Ayurveda drugs.

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2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

The purpose of disease – understanding pathogenesis holistically

The sacred masculine

Sascha Kriese BA Hons (Ayu)

Sascha Kriese BA Hons (Ayu)

Samkhya and Yoga, two principal philosophies underpinning Ayurveda, postulate that creation starts when the conscious, passive purusha becomes associated with the unconscious, dynamic prakrti in order to gain self-experience and evolve towards the ultimate aim of liberation. Evolution is thus considered as a conscious and goal-oriented process that, according to Caraka, is initiated and upheld by paramatman, the creator and sustainer of the universe. Hence, life is not viewed in Ayurveda as meaningless happenstance or a series of accidents of nature. In fact, Caraka goes as far as condemning faith in the theory of chance as “the worst of the sinful” (Caraka Samhita 1.11.14-15).

All humans are born with a unique potential to express themselves fully and to achieve any goal they desire. Although vast and multifaceted, this potential is only latent when we enter our bodies, which means that each aspect of it needs some form of activation before we can make use of it in our lives. If certain parts of our potential do not get empowered and transformed into dynamic creative energy, we are unable to authentically and fully express those parts of ourselves.

If life itself has specific meaning and no aspects of it are coincidental, then health and disease must be purposeful too. Ayurveda’s stated core aim is the maintenance of health as a pathway towards achieving four primary goals in life: dharma, artha, kama and moksha (Ashtanga Hrdaya 1.1.2). Health is not simply a desirable state but considered an essential prerequisite for the experience of true fulfilment and ultimate liberation. What then is the purpose of illhealth or disease in life? According to Ayurvedic aetiology, any imbalance that is caused by asatmyendriyartha samyoga or prajnaparadha will eventually lead to disease (Caraka Samhita 1.1.54). Stating these as primary reasons for pathology clearly indicates what Ayurveda considers to be the root causes of disease: decisions and consequent actions that are unsuitable to and not aligned with an individual’s true nature or dharma. In other words: ill-health is the result of inauthentic self-expression. Since human behaviour is informed and instigated by underlying belief systems of what an individual considers ‘right’ or ‘wrong’, every incorrect assumption about the nature of the self leads to inauthentic expression and consequently to inauthentic experience of the self. If this is not realised and corrected by an individual, a so-called psycho-emotional dynamic gets established in the subconscious that keeps re-creating the same experience over and over again. In order to be able to constructively deal with the dynamic, an individual needs to become consciously aware of it. And herein lies the actual purpose of disease: over time, every psycho-emotional dynamic manifests as a specific illness that represents an opportunity for the individual to become conscious of it. Disease therefore serves as an invitation to recognise and change expressions of the self that are inauthentic and based on incorrect assumptions from the past. In this talk the above concepts will be explained in more detail and their clinical relevance and practical application clarified with example conditions such as cancer and diabetes mellitus.

Every man and woman embodies a gender-specific combination of both feminine and masculine energies. Even though men are the physical manifestation of the masculine principle, they are also endowed with aspects of the feminine. The same holds true for women: while representing femininity incarnate, each female has access to inner masculine parts as well. What then makes a man a man and a woman a woman? Are we already men and women from the moment of genetic sex allocation after conception? The simple truth is: we are born as boys and girls; not men and women. Neither physical maturity, sexual activity nor the age of consent are sufficient to make us a man or a woman. For this we require a deep transformative process of experiential empowerment. Unless we are consciously initiated into our sacred core energies through rituals facilitated with wisdom and love, we fail to experience the truth of who we really are: embodiments of the sacred feminine and masculine. This keynote lecture offers insights into the causes of symptoms that many male patients present with today: low self-esteem, feelings of inferiority among other men, an inability to gain weight and sexual problems like premature ejaculation. While there may be associated physiological reasons, such conditions often develop due to a man’s lack of access to the sacred masculine. Understanding the subconscious psycho-emotional dynamics as well as recognising their physical manifestations in these men is essential for effective treatment and support.

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

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Authentic solutions in Ayurve

Somatheeram Ayurveda Group, Chowara P.O South of Kovalam Triv [email protected], [email protected]

eda and Yoga Somatheeram has been in the forefront of dispensing authentic solutions for the needy from all around the world.Its lovely locations, traditional knowledge and first - rate services and performances make it a unique provider of general well-being through Yoga and Ayurveda.Located in Kerala on the South - West coast of India it has been offering exellent facilities to discering customers for more than 20 years.Explore and discover an ancient world of well-being with all modern conveniences.Welcome to Somatheeram, the land of the spirit !

vandrum, Kerala, India, 695 501 +91 471 2268101, +91 9447755077 n www.soma.in, www.somatheeram.in

Abstracts . English Adjuvant Ayurvedic treatment of chronic and acute pain in neurology

A clinical study to assess the efficacy of vasti chikitsa in the management of intervertebral disc prolapse associated with radiculopathy

Marco Lebbing MD

L. Mahadevan MD (Ayu)

In Ayurveda pain as well as neurological disorders are due to a disturbance of vata. Acute pain can often be related to a certain dysfunction and thus be treated whereas chronic pain often is multifactorial and needs a more complex treatment pattern. In contrast to traumatic pain the etiopathogenesis of chronic pain is not always clearly understood which hampers a satisfactory treatment. Especially neurologic pain disorders often go along with diffuse complaints hard to be influenced. The lecture wants to give an overview about different kinds and origins of pain. On the basis of neurological pain disorders an ayurvedic evaluation will be carried out and suitable therapeutic options will be explained.

Intervertebral disc prolapse is one of the common conditions seen by an Ayurvedic physcian in clinical practice. The disease is due to vata increase in lifestyle which causes acute back pain associated with numbness, paraesthesia and pain in the leg. Patients often take analgesics for few days and get symptomatic relief but pain reccurs after stopping the medication. Most of these people visit Ayurvedic vaidyas here in my village for complete cure. Ayurvedic assesment is based on principles like dosha, dushya, guna vikalpa, srotodushti prakara etc. Diagnosis is confirmed by examination and investigations like SLR, Trendelenburg test, bladder control, foot control, plantar reflexes and MRI of lumbar spine, screening the saggital view. Strategy of therapy (cikitsa) is mainly reduktion of Vata and Kapha (vatakapha-hara, ushna and vatanulomana) and is performed in different stages, in first phase gandharva hastadi kashaya, vaishvanara curna, abhayarishta etc are employed. Second phase involves the application of nagaradi lepa. Third phase involves application of taila’s like kottamchukkadi taila, chinchadi taila etc., followed by ruksha sveda. In fourth phase vasti cikitsa like pippalyadi taila for anuvasana and eranda muladi niruha for sthula dehi is employed whereas for krusha dehi dhanvantara taila anuvasana and madhutailika vasti is utilised. Vasti cikitsa may be of yoga or karma vasti type depending on the spinal canal diameter. Vasti cikitsa is followed by shamana-aushadhas. Kati vasti is the last modality in the treatment phase. Daily exercise for a duration of 20 minutes is advised wherein lumbar flexion is avoided. Overall total duration of treatment will be of 12 weeks in which first two weeks treatment is advocated as an in patient treatment followed by shamana-aushadha. Recovery will be 99%. Author will present the MRI documentation of resorption of prolapsed disc after vasti cikitsa during the presentation.

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2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

The role of dhatu in etiology and pathogenesis of diseases

Reproductive medicine in Ayurveda – the concept of vrishya (fertility) and vajikarana (potency)

Ram Manohar MD (Ayu)

Ram Manohar MD (Ayu)

Nidana (Etiology), dosha and dhatu constitute the trinity that plays a critical role in the pathogenesis of diseases. Out of these three components, the doshas are considered to be the most important in initiation of the disease process. Etiological factors cannot cause diseases as long as the doshas do not get deranged. For this reason a single exposure to an etiological factor does not always result in a disease. In some individuals even repeated exposure to etiological factors do not cause diseases while in other individuals even a single exposure may lead to imbalance and disease. Indeed the critical factor that makes the difference are the doshas. Therefore, the doshas are considered to be the primary causative factors of disease.

Vajikarana is one of the eight branches of Ayurveda. In fact it is the last of the eight classical specialties of clinical medicine in Ayurveda. It comes last because reproduction is something that assumes relevance only when the basic health of the individual has been established. The first two branches of general medicine (kayacikitsa) and pediatrics (balacikitsa) help to protect the body in adulthood and childhood. This is followed by psychiatry (grahacikitsa) and the branch dealing with the diseases above the neck (shalakya). These two disciplines take care of the mind and its physical structures. Then comes surgery shalya) and toxicology (visha) which takes care of the threats from the outside world in form of injuries and bites. This is followed by the branch of rejuvenative medicine (rasayana), which seeks to protect the body and mind throughout life to achieve healthy ageing. Finally comes Vajikarana, which aims to ensure survival of the species through reproduction.

But what happens in reality? Little do we realise that doshas do go out of balance more often than we think. Under the influence of the etiological factors, the doshas are constantly swaying back and forth across the boundary of normalcy and abnormality. In the course of the day, in the course of the night, during digestion, during the seasons, the doshas shift from their state of normalcy and become almost deranged. When the dosas reach the brink of the upper limit, beyond which it can cause illness, it retreats and returns back to its state of normalcy. Therefore it has to be understood that it is not the imbalance of the v that cause disease, but rather the inability of the doshas to return back to normalcy, when it reaches the critical point of imbalance beyond which the process of pathogenesis is initiated. The critical factor that enables the doshas to return back to normalcy from the boundaries of abnormality is the innate strength of the dhatus. According to Caraka, a viewpoint seconded by Vagbhatta, the strength of the dhatus itself can pacify and bring the doshas back to balance (balam hyalam doshaharam). In similar vein it has been mentioned in another context that diseases tend to be chronic when the weakness of the dhatus has not been resolved (dehadhatvabalatvac ca jvaro jirno ‘nuvartate). This paper discusses the etiology and pathogenesis from the viewpoint of the dhatus instead of the doshas and seeks to highlight the definition of health as proposed in Caraka Samhita as dhatusamya or balance of the dhatus rather than the doshas and disease as dhatuvaisamya or imbalance of the dhatus rather than the doshas. An attempt will also be made to reconcile this viewpoint with that of disease as doshavaisamya or imbalance of the doshas.

Vajikarana is often misunderstood as sexual medicine dealing with aphrodisiacs. While this is one aspect of this discpline, the major focus of this clinical specialty is fertility, reproductive health and prevention of diseases that are transmitted through heredity and factors that operate at the time of conception. The concept becomes clear when we understand the meaning and implications of two terms that are used as synonyms of reproductive medicine in Ayurveda. These terms are Vrishya and Vajikarana. The word Vrishya denotes fertility. It is derived from a Sanskrit root that means to irrigate or rain. It denotes sowing, irrigation and thus fertility. For this reason the bull, which is known as vrisha in Sanskrit, became the symbol of fertility. We can see the bull in front of the temples of Lord Shiva, denoting fertility, whereas the Shivalinga itself symbolises creation and reproduction. On the other hand, Vajikarana means to make one potent like a horse. This means arousal and sexual vigour. Vajikarana follows Vrishya. Traditionally sexual potency had meaning only in the backdrop of fertility. However, in due course of time, this branch of medicine became a tool to protect and preserve the body from the deleterious effects of excessive indulgence and also to enhance sexual pleasure. There is a need to strike a balance between these two aspects of reproductive medicine in Ayurveda to reap the full benefits. There is especially a need to understand the various interventions described in Ayurvedic texts to enhance fertility in such a manner that not only does one beget children, but there is also an enhancement of the quality of the reproductive tissue resulting in progeny that is not susceptible to hereditary and genetic diseases.

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

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Abstracts . English A very important point to bear in mind is the fact that Vajikarana becomes effective only when it is preceded by Rasayana treatment. In fact, both these branches go hand in hand in enhancing the immunity of the body. Every year, Ayurveda advises that the individual should cleanse the body and then undergo a course of Rasayana and Vajikarana, which improves the immunity of the body by creating an abundance of Ojas. Ojas impacts not only the health of the body but also that of the mind. This paper seeks to explore the scope of reproductive medicine in Ayurveda as a systematic approach to enhance fertility, improve the quality of progeny, boost sexual potency, modulate immunity and also promote psychological health.

Breaking the disease spiral – behavioral perspectives of Ayurveda Prof. Martin Mittwede PhD Ayurveda approaches the development of diseases in different ways and develops classifications to describe the processes and to capture clear diagnostic. As a complex system of medicine he considers the causative factors in a context and develops appropriate strategies for treatment. Classically known is the concept of temporal dynamics (kriyakala) in which a disease unfolds: 1) Samcaya = stage of accumulation 2) Prakopa = stage of provocation and further increase 3) Prasara = stage of propagation and immigration in other areas 4) Sthana-Samshraya = stage of localization or of setting in the tissues 5) Vyakti = stage of manifestation (full clinical symptoms present) 6) Bheda = stage of development of complications and chronicity For the change in the dynamics of doshas Ayurveda knows a multitude of causes, the self-responsible action plays an important role. The imbalance of doshas is therefore often not the primary cause of the disease, even though it is often presented in the literature. But the fact is that causal exposure factors usually lead to a change of dosha situation and are therefore classifiable. A crucial problem is now that disturbed doshas also affect the psyche and lead to a disturbance of discrimination (buddhi) and insight (prajna). At the same time habitual patterns act into it. Old practiced behaviours may appear again and destroy the therapy success even after balancing the doshas. This phenomenon is, inter alia, with the term adhesion (klesha) described. Thus we have arrived at a fundamental problem of prevention and health education: people do not behave as would be desirable for achieving and maintaining good health. Many programs and public health measures are unsuccessful, because they do not lead to a sustained change in behaviour. Many people ultimately need therapeutic support in order to embark on the right path. And this requires effective strategies. In this sense, it is worthwhile to examine the Ayurveda in the context of behavioural therapy. Explanations on the functioning of the psyche, but also classic recommendations of Ayurveda for lifestyle are essential, because they illuminate the therapeutic vision of the ancient Ayurvedic physicians and show ways out of the disease spiral. In the session, we will try to understand the behaviour change strategies of Ayurveda, to then make practical use for our own work with patients.

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2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

Neuropathic pain after lombotomy for renal cancer resolved with Ayurvedic treatments: a case report

Management of prostate disorders and BPH

Antonio Morandi MD

Ashtavaidyan Narayanan Nambi MD (Ayu)

Neuropathic pain is a complex, chronic condition deriving from damage or alteration of nerve fibers. Conventional medicine is often ineffective and only a minority of patients may achieve partial relief. Here we report one case in which the therapeutic approach with Ayurveda shows promising results for this pathology.

Prostate is a gland seen in male a major participant in the reproductive system. Hence in later half of the reproductive era of a man disturbance of prostate could be a very common presentation similar to uterus or ovary in females. A male aged above fifty and less active in sexual life are more prone for Benign Prostate Hypertrophy (BPH) and not uncommon to have Prostate Carcinoma. Whereas below fifty aged people with active sexual life often experiences Prostatitis (an inflammatory condition). As elderly population is growing all over the world especially in Euro zone, it is interesting to note that a geriatrician is largely been addressing this problem.

One patient, male, 58 years old, carpenter, diabetic, developed severe neuropathic pain after lesion of ileo-inguinal nerve during lombotomy for renal cancer. The pain was continuous and disabling, rating 8-9 (NRS-11 scale), associated with insomnia and depression. The patient was unable to perform his work and also the overall quality of his life was very poor. The patient tried to manage the pain with NSAIDs (nonsteroidal anti-inflammatory drugs), Morphine, Pregabalin, antidepressants (Duloxetine, Sertraline) and Benzodiazepines for 6 months treatment without significant results. Only a limited and short time results (2-3 hours pain reduction) were obtained with Acupuncture. The patient was then evaluated according to Ayurveda from a certified ayurvedic doctor, and for a period of 4 months both conventional drugs as well as acupuncture were suspended and the following ayurvedic therapy has been given: 1. Oral administration of Ashvagandha 500mg t.d., Shilajit 500mg o.d., Triphala 1500mg o.d. 2. Two sessions a week of Sarvanga Abhyanga using Dhanvantara Taila alternated with Kati Basti using Kottamchukkadi Taila on lombotomy site, both treatments were associated with 15’ of ShiroPichu using Dhanvantara Taila. The treatments where carried out by expert certified ayurvedic therapists. 3. Personalized life style as well as nutritional advices. The results were quickly evident. After the first week of treatment the neuropathic pain was significantly reduced, and after 4 months its intensity was decreased to 2-3 from the initial 8-9 according to the NRS-11 scale. Some rare peaks of increased pain were still present but for very short time. The sleep of the patient improved and he was able to resume his work. On this regard it is worth noting that the patient’s occupation is carpenter, an heavy activity which can be carried out only if in good health conditions. The treatments continued for one year with continuous improvement of patient’s clinical situation as well as his quality of life. This case provides important evidence of the therapeutical possibilities of the multidimensional approach of Ayurveda to chronic disabling conditions, such as neuropathic pain, which are difficult to resolve with conventional means.

If we look into the disease of prostate, the whole issue can be classified into four: 1. Obstructive symptoms 2. Storage symptoms 3. Complications 4. Psycho-social issues It is very vital to look from ayurvedic perspective these manifestations based on abnormal behaviors of Apana. Various disease pathologies in Ayurveda like Gulma, Prameha, Mutrakruchra also taken in due consideration for understanding the various expressions of Apana. Psycho-social issues also need special attention like using diapers in elderly people when they participate in social gatherings. Prostate malignancy need to be independently understood or evaluated as it mostly begins with asymptomatic phase. Many Ayurvedic interventions are highly effective in the management of prostate diseases. Ayurvedic management observes the situation in totality not only to balance apana but also to prevent the progression of manifestation like malignancy. Initial stage largely may be influenced by medicinal usage to correct the apana which is ruksha in nature by using ayurvedic products containing Castor Oil. But later stages need complete protection and preservation of whole apana zone. Vasti, avagaha sveda are some of the major ayurvedic therapies, they deeply influence the management. Use of shilajit, guggulu also has some direct influence. In the presentation the concept of understanding the prostate with illustrations and examples is delivered. A detailed discussion will be given about the samprapti of all prostate diseases and a special highlight will be given to Benign Prostate Hypertrophy as it is the most common clinical problem. This presentation also includes experiences of mostly time-tested formulations successfully utilized in the management of prostate. Recent research work observations and some bird’s eye view on other alternative treatments are also deliberated. An active discussion also will be made at the end with sharing our own experiences and insights by correcting the life style and dietary habits.

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

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Abstracts . English Neurological descriptions in classical texts

Medicinal plants for improving dhatvagni and qualities of dhatuin Ayurveda

Ashtavaidyan Narayanan Nambi MD (Ayu)

Prof. Tanuja Nesari MD (Ayu) PhD

It is believed that the ayurvedic knowledge system looks into very subtle details of body functioning majorly named as system of tridosha. But when we analyze the subtle details of the descriptions of tridosha in classics, we are able to derive all so called anatomical systems described by western bio-medicine, but they are expressed in a different way. For example, the neurological concepts are widely diffused and principally been identified in the part of vata in general. From embryogenesis till the establishment of neural system all the functional attributes are related in some or the other way with vata.

Ayurveda is a science of healthy & happy life, which is divided in eight specialized branches. First and of prime importance branch is Kayachikitsa (Internal Medicine). Kaya means Agni & Chikitsa is management. Thus treatment of any disease condition aims at restoring the normal status of Agni.

Ayurvedic classics describe five sub-types of vata with its habitat and behavior patterns. The nature and extent of the required movements for actions and reactions are maintained by any biological (bio-physical, bio-chemical and electromagnetic) entity, but all these are seen in the vata much more before than the instigation of gametogenesis and continue till the death. If we analyze these and try to understand it profoundly, we may be surprised to see that most neurological expressions are included in the frame. For example in Caraka Samhita, while explaining the disease named ardita (cerebrovascular accident / stroke including facial palsy) the text is able to demonstrate all possible neurological deficits in all twelve pairs of cranial nerves both in sensory and motor. This example itself shows ayurvedic acharyas deepest insights in neurology beyond the frame of single system. Caraka explains later the management of possible treatment measures for correction which again include neuro-regenerative therapies. This presentation extensively illustrates all available anatomical entities described in ayurvedic classics especially in the field of neurology. It also comprises elaboration of sites, behaviors and expressions all five vata from neurological perspective. Later with help of various clinical cases this presentation demonstrates neuro-pathological aspects from ayurvedic classics with its management. A detailed discussion will be done at the end with all possible expansions about its implications in ayurvedic therapies.

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The human body consists of 3 doshas – vata,pitta and kapha; 7 dhatus i.e. Rasa, Rakta, Mamsa, Medas, Asthi, Majja, Shukra; and three malas i.e. Purish, Mutra and Sweda. Agni is separate entity which governs the synthesis & metabolism of these elements. Thus Agni is defined as unit of bioconversion in the body. Importance of Agni is described in every classical Ayurveda text (e.g. Charak samhita, Chi. 15)). In Bhagwad-Geeta, Lord Krishna states that I am the ‘’Vaishwanar’’ i.e who stay in body in the form of Agni in all living creatures. This underlines the importance of Agni. When we talk of Agni, it is assumed as Jaatharagni i.e. which resides in GI system & responsible for digestion & assimilation of food with its transformation in bodily suitable substances. The part which nourishes five basic element (panchbhoota) is known as Panchbhoutikagni. Similarly, parts of Jaatharagni, intended for metabolism of each of specific seven Dhatu is termed as Dhtavagni. (Ref. AshtangHrudaya. Sutrasthana. Ch11. 34/35). Hence functional aspects of total 13 types of Agni are to be considered in health & disease management. Due to wrong diet and lifestyle, Jaatharagni gets vitiated, which leads to commencement of disease process. Also similarly agni vitiation can also occur at dhatvagni level, leading to manifestation of dhatu-specific diseases. For e.g. Rasa vitiation leads to diseases like Jwara (fever), Pandu (anaemia), where along with Jathar-agni, ras-agni is also vitiated. Similarly low medoagni manifests in to Obesity & Prameha (Dibedes Mellites etc.). Dhatu

Some dhatu specific diseases (e.g.)

Rasa

Jwara (Fever), Shootha (inflammatory disorder )

Rakt

Kushtha (Skin) diseases, Visarpa

Mamsa

Granthi (Fibroid, Tumors) etc.

Meda

Sthaulya (Obesity) Granthi

Asthi

Adhyasthi, Adhidanta, Asthikshaya (Osteoporosis)

Majja

Bhrama (Vertigo), Unmad, Apasmar

Shukra

Vandhyatva, Shaandhya (female & male infertility), Arajaskata (Pathological amanorrhoea)

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

Excess or increase in intensity of dhatvagni (teekshagni) leads to depletion of specific dhatu. Whereas decrease (low) or vitiation of dhatvagni (Mandagni) leads to excessive production of dhatu of substandard quality.

Importance of shukra dhatu in Ayurveda

It is necessary to balance & treat that specific dhatvagni while curing dhatu specific diseases.

Sukumar Sardeshmukh MD (Ayu)

Panchakarrmas i.e .Bio-purificatory procedures are very useful in improving state of all agnis. However in medicinal treatment also, some dhatu specific herbs / medicines are described in Ayurveda. Some herbs improve dhatvagni & some herbs nourish this dhatu with the help of specific dhatvagni.

Dhatu

Useful for dhatvagni Useful to nourish dhatu

Rasa

Guduchi, Haritaki, Pippali, Vasa

Shatavari, Amalki

Rakt

Manjishtha, Nimba, Kutki

Sariva, Madoor

Mamsa

Marich, Pippali, Musta, Triphala

Vidari, Ashwagandha, Shatavari, Bala, Yashti

Meda

Guduchi, Triphala, Shunthi, Shilajita, Vidanga

Vasa, Ghruta (Ghee), Navneet (Butter)

Asthi

Guduchi, Musta

Asthishrunkhala, Kukktanda-twakbhasma, shrunga bhasma

Majja

Guduchi, Musta, Shankhapushpi, Vacha

Majja, Brahmi, Ghruta

Shukra

Shilajit, Karpoor, Lavanga, Kapikacchu, Jatiphala

Dugdha, Ghruta, Ashwagandha, Shatavari, Kapikacchu

In addition to this, any substance, which is ushna veerya (hot in potency) generally stimulates for Agni. Paper highlights the details about therapeutic administration of the dhatu specific herbs in specific disorders.

Caraka has clearly stated in his Samhita (Ca ina 6.9) that shukra (Semen) is the final transformation of food taken and one should always conserve this tissue. The loss of this tissue is responsible for many disorders and can even cause death in extreme cases. Human body is composed of 7 dhatu (tissues) and shukra is the last one. Its main function is the reproduction of healthy progeny. It is the only tissue in the body that is normally expelled out for this function but excessive sexual desire and indulgence in sexual activity creates unnecessary loss of this pure form of tissue. Body has to get involved again to regenerate this pure tissue from diet which takes approximately 30 days. Since the other functions of this tissue are maintaining confidence level, love and affection towards our mate, body strength and energy level, excessive loss of this dhatu causes imbalance of physical and mental status of body leading to unhealthy and unhappy life. On the contrary proper formation or conservation of shukra dhatu increases the ojas level and contributes to keep body healthy and happy. Ayurveda has described three pillars of life viz., ahara (diet), nidra (sleep) and brahmacarya (celibacy). Celibacy is practiced to get the benefits of conservation of shukra dhatu that is to achieve healthy and happy long life. It does not indicate to avoid sex totally but follow the rules and regulations described in Ayurveda. “The pure or natural form of Shukra Dhatu is white like Rock crystal, sometimes like oil or honey, liquid and unctuous in consistency and sweetish.” (Sa saa 2.11) “The vitiated Shukra Dhatu is not thick, less in quantity, frothy, not white color, foul smell, very sticky, contain other tissues like blood and creates considerable energy loss when expelled.” (Ca sa 19.4) Current problems faced today like oligospermia, infertility, erectile dysfunction, nocturnal emissions etc. are due to the modern culture and lifestyle like altered diet and sleep patterns, excessive mental stress etc. Ayurveda has its own diagnostic methodology and has described treatments like shaman (pacification) and shodhana (purification). This is accompanied by diet and behavioural management to overcome these problems. Hence, it is very important to understand shukra dhatu and its function throughout body. Only Ayurveda has described the importance of shukra dhatu, and this will be elaborated.

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

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Abstracts . English The agni-ama-srota triad in disease aetiology and pathogenesis Madan Thangavelu PhD Life forms are complex adaptive systems. Life's scales of organisation, structures, functions, integrity and resilience are maintained by networks of well-ordered and logical sub-systems and processes / hyperprocesses. Multiple formalisms, mostly similar and sometimes competing, have been developed over the millennia to understand and describe this complexity. Ayurveda offers one such formalism. Ayurveda’s process-based and scale-free rationale can contain inanimate dynamic processes necessary for pre-Life and the origin of Life, subsequent ‘complexification’ of life forms and also to comprehend and describe health and disease. At the heart of this system is a qualitative, top-down, holistic approach where there are no separate parts but relationships, where entities are viewed as fluid and constantly changing and transforming - where "nothing is, but everything is becoming"! A powerful central metaphor in this scheme is the agni-ama-srota triad where Agni transforms, Ama is the partially or incorrectly transformed and Srotas are the conduits that transport or convey both materials and information, both material and immaterial. The predominant contemporary discourses and descriptions of agni-ama-srota are based mostly on a clinically-biased functional perspective but form an important first step to appreciate this triad. However, a rigorous semantic - lexical and logical - analysis of agni - the transformer offers broader, richer and more sophisticated implications than currently appreciated. Agni, the 'absolute transformer', implies layers and textures of meaning with a deep logic and rich grammar. For instance, forms of agni different from bhutagni of clinical parlance preceded life. Agni implies ama. Agni is prior to dosha and dhatu. Agni complexifies as system complexify, agni enables signalling in complex systems, agni evolves to help systems evolve. This implies radical inseparability of agni from ama and srota also forces the emergence of higher and ultra-levels of complexities - with novelty at each level. Such novelty is seen most certainly in the manifest and perhaps even exists in the unmanifest Agni-ama-srota, when viewed as such an inextricably intertwined triad offers the most parsimonious description of the driver of complex system generation. The inextricably interlinked triad enables the evolution of complex systems having independent but interdependent processes where agni transforms and vayu moves. This description also offers an invaluable metaphor not only for understanding the grammar of life and how life emerges and evolves and complexifies but also the earliest errors in the organisation of cellular logic as the basis for disease aetiology and pathogenesis. The triad is also an error generation and an error correction unit that is the basis of agni dipana and ama pacana rationale of Ayurveda.

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In earlier presentations I have alluded to ama in the context of intracellular mucin accumulation (1). The ‘triad’ forms a powerful tool and offers novel ways to dissect aetiology and pathogenesis in innumerable previously unapproachable problems related to complex human diseases. By drawing on selected examples from contemporary research evidence I will extend this theme by highlight the agni-ama-srota triad in the context of: • endothelial cell physiology and dysfunction with reference to stroke, • synaptic architecture and neuroplasticity and dynamics in neurological disorders, • neurodegeneration and anxiety, • errors in autonomic responses in hypertension and other human diseases, • inappropriate interactions between gastrointestinal and skin microflora and the human immune system in inflammation and disease like autism and multiple sclerosis, and • errors in the regulation of mammary epithelial cell fate in development and breast cancer (PMID:25056120). Ama if viewed as a faulty outcome of a process can readily account for disease causing DNA and RNA mutations, misfolded proteins, misorganised cellular and subcellular components - all of which are now recognized as the predominant aetiological mechanisms in innumerable human, animal and plant diseases. In this context I will present briefly the recent observation of - aberrant methylation of tRNAs and neuro-developmental disorders (PMID: 25063673). Paving the way for understanding the complex origins of age related conditions like myelodysplastic syndrome with origins in inaccessible locations, namely the bone marrow haematopoetic stem-cell compartment might be greatly aided by the rational and logic of such a ‘triad’ – exploited in the rasayana treatments of Ayurveda. Such an “agni-ama-srota” triad when extended into the unperceivable and the unmanifest can also be exploited to explain the vyadi (disease) from adhi (anxiety) aspects at the interfaces of Ayurveda and Yoga. Errors in such triads might also be extendable to accommodate Yoga's panca kosha theories about human health and wellness.

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

External basti in pain management

Carmen Tosto Kati basti is a peculiar ayurvedic procedure that belongs to the category of the various external basti and specifically is a procedure of Bahya sneha that brings together in itself both effects of snehana and svedana or "Snehayukta sveda". Kati basti is used when one needs to act primarily through ushna and snigdha qualities. The treatment kati basti involves, in its most superficial and external expression, the lower back region actually called kati (according to Sadanga Sarira, Kati is the region of Antaradhi or Madhyasarira, or the area that we call sacro-lumbar) while the word basti, in this case, has the meaning of "to hold, to retain". When the basti is held in Kati pradesha, it is called Kati Basti. Susruta defines the size of the area called Kati to the extent of 18 anguli.

In this procedure the taila is used as snigdha, and it is also Agni samyoga since the oil is heated and kept constantly hot. So the treatment should also be considered for its snigdha sveda nature. In the classical texts several svedana therapies are mentioned, and observing the characteristics of Kati Basti it can be considered belonging to Drava Sveda therapies. During the process of holding the taila still it can be considered as a variety of Avagaha Sveda, while, during the procedure of the changing of the oil, in other words if a leak is present, it can be related to a variety of Parisheka. It is a relatively simple procedure in its implementation, but it requires an “a priori“ proper prescription as it is necessary to carefully consider the altered gunas of the underlying condition as well as the imbalance of the dosa involved. As is the case for any Ayurvedic treatment, there are strict rules to be observed as well as specific indications and contraindications. Special attention has to be given to the patient as well as customized information regarding the type of taila to be used, the constant temperature to be maintained and the duration of the treatment is given.

It is important to consider that the region traditionally considered for the application of Kati basti corresponds exactly at the origin of the metameric distribution of pain for typical alterations of the lumbar spine. One of the most typical painful manifestation of this region is defined by the term Gridhrasi, which can be related to what modern medicine calls sciatic pain, and is considered to be Shula Pradhana Vata vyadhi.

In this specific region of the back it is easy to observe disorders referring to the musculoskeletal apparatus that are called with different names in modern medicine, actually they mostly refer to an imbalance of Vata dosa in one of its main site. Unfortunately, nowadays the activities of man are totally contrary to the regimes of Svasthavrtta and often even opposite to it. Thus, one of the main causes of disease is just poor management of one's lifestyle.

The Ayurvedic reading of "pain" phenomenon can have so many different shades that can be grasped only through direct and careful observation of the manifested gunas. The pain may in fact derive from the alteration of various structures involved, and for each one the manifestation of pain will be specific. Therefore a correct diagnosis will be of paramount importance in order to prescribe the most adequate treatment as well as the right product (in this case the most suitable medicated taila). The treatment should therefore have the gunas opposite to the reported imbalance and should be synergic with the internal therapy.

The task of the ayurvedic therapist is to perform the treatment in the best possible way, taking into account the real postural difficulties of the patient and, when necessary, adapting to different situations.

The local action of basti on the pain depends on the ability to counteract the gunas expressed by the pain itself. From the point of view of western medicine one can conceive an action at the level of the nociceptive sensory system beyond the more complex systemic effects and on the tissues. The basti can in fact be used in typical neuropathic pain conditions whether resulting from compression or from lesion of the nerve trunks. The basic principle is to report the organism in its state of natural balance which is a process that can take a certain period of time. The peculiarity of the treatment kati basti is that it gives an almost immediate effect and real relief to the patient.

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

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Abstracts . English Ayurvedic treatment of male infertility

Polycystic ovarian syndrome and its management through Ayurveda

Ramesh Varier MD (Ayu)

Ramesh Varier MD (Ayu)

Vajikarana, being one of the eight branches of Ayurveda, includes the treatment of male infertility; it is considered one of the most commonly practised disciplines of Ayurveda. Vajikarana is considered as a solution to problems relating to male sexuality and fertility and is interpreted to have all sorts of actions and is administered through the use of randomly selected vajikarana combinations.

Polycystic Ovarian Syndrome (PCOS) is one of the most common endocrine disorders in the females with an incidence of about 6% in the general population world over. The condition is known to be genetically inherited, it is characterised by anovulation or hypo-ovulation, hyper-androgenism and hyper-gonadism and is associated with a high risk of insulin resistance, diabetes, dyslipidaemia and obesity. The problem presents as menstrual irregularities, an ovulation, infertility, hirsuitism and acne, endometrial hyperplasia and predisposition to cancer. Conventional medical approaches comprise of weight reduction, treatment of insulin resistance with drugs like metformin, treatment of acne and hirsuitism with androgen antagonists and with clomiphene citrate and or FSH to induce ovulation and achieve conception, for failing IVF is adviced.

While a few cases do respond to such arbitrary treatment, the overall success rate is not all that great largely due to the lack of proper diagnosis and differentiation of the aetiology involved. Ayurvedic classic literature has clearly differentiated different types of semen related problems and prescribed different approaches conceptually though not very elaborately. Modern knowledge has further increased the level of understanding of the underlying issues and backed by investigations that are now available it helps to arrive at a more rational prognostic conclusion. A major part of the population suffering from male infertility suffers from idiopathic causes of male infertility and so treatment is often arbitrary. This large section is highly responsive to properly carried out Ayurvedic intervention. Several other gropus of patients with clearly identifiable cause also respond positively. There are however several conditions like genetic abnormalities and irreversible causes of infertility which do not respond to medical treatment - Ayurvedic or conventional and some even to surgical intervention. In some cases modern assisted reproduction techniques hold great promise. So the first crucial step in treatment of male infertility is to understand the underlying aetiology and pathology and proceed through the appropriate pathway. This presentation focusses on the different causes and an Ayurvedic approach to differentiation and treatment of the treatable causes of male infertility.

Ayurveda has an established role in the management of several gynaecological disorders. Several Ayurvedic products and therapeutic approaches are described and practised. While different manifestations of PCOS are described as separate entities there is no single disease entity in Ayurvedic literature that matches PCOS. The modern understanding of the patho-physiology of PCOS provides a comprehensive approach to devising concepts and protocols for the management of PCOS and associated complications including infertility. Ayurveda recommends purification (shodhana) to be followed by pacification (shamana cikitsa). Snehana is the initial step in the treatment of most chronic diseases. This is particularly relevant in PCOS, as the disease is chronic and is mediated by the central neuro-endocrine axis. Snehapana with ghritas like Kalyanaka and Maha-Kalyanaka ghrita which are indicated for “Aretasi & Alpa Rajasi” (amenorrhoea & hypo-menorrhoea) are seen to provide significant improvement to the hormonal milieu normalising menstruation and ovulation. Vamana and vasti aid the process in several cases. Shamana cikitsa with different herbal and mineral compounds like Sukumara Kashaya, ghrita, Saptasara Kashaya, Ashokarishta, Dhanvantara Taila, Kulathadi kashaya, Rajapravartini Vati and many more are described and used for menstrual disorders. While many patients respond to the administration of these formulations, there are also several non-responders. This is largely because of in-adequate sub-classification of the cases and lack of clear understanding of the specificity of each of these formulations or protocols for different sub-classes. Treatment is far more effective if patients are categorised into sub-classes and specific shamana protocols developed and fine-tuned for different sub-classes of patients by observing the associated conditions by taking into account modern bio-chemical markers for hypo-thyroidism, hyper-insulinaemia, hyper-estrogenism, hyper-androgenism and hyper-prolactinaemia. Further individualisation could again be based on Ayurvedic principles. These approaches are detailed in the presentation. This approach has been observed to provide a much larger percentage of success in the management of infertility due to PCOS.

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2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

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Referenten . Speakers Referenten

Speakers

Asvin Barot MD (Ayu), erfolgreiche 20-jährige Praxistätigkeit in London. Entwickelte einen nahe am Originaltext ausgerichteten und psychologisch orientierten Zugang zum Ayurveda. Internationale Vortragstätigkeit. Intern. Forschungsprojekte.

Asvin Barot MD (Ayu) from Nadiad successful 20-year practice in London. Developed a psychologically oriented approach to Ayurveda closely in keeping with original texts. International lectures. International research projects.

Oliver Becker Heilpraktiker, Diplom-Pädagoge und Ayurveda-Mediziner mit eigener Praxis. Dozent, medizin. Kurleiter sowie Modulleiter im MSc Studiengang Ayurveda-Medizin an der REAA. Experte für Ayurveda, vedischen Wissenschaften und Sanskrit.

Oliver Becker Master in Paedagogics, practitioner of Natural Medicine, Ayurveda-Medical-Practitioner in his own clinic of naturopathy. Lecturer and interpreter within the Master‘s Training at the REAA. Profound experience in Ayurveda, vedic sciences and sanskrit.

Dr. med. Jorge Luis Berra, Facharzt für Pädiatrie, Direktor der Fundatión de Salud Ayurveda Prema und des PG Course in Ayurveda Medicine, Faculty of Medicine, Buenos Aires University (Argentina)

Jorge Luis Berra MD, pediatrician, director PG Courses on Ayurvedic Medicine, Faculty of Medicine, Buenos Aires University, director PG Course on Ayurvedic Phytotherapy, Great Rosario University Institute (ARG). Director Fundacion de Salud Ayurveda Prema.

Dr. med. Ashish Bhalla Allgemeinmediziner, medizinischer Ayurveda-Spezialist, ÖAK Diplom Kurortmedizin. Er leitet eine Ayurveda-Praxis, praktiziert als Kurarzt und unterrichtet Ayurveda-Medizin in Deutschland, Italien und Österreich.

Ashish Bhalla MD, general practitioner, medical Ayurveda specialist, spa physician (Austrian medical diploma), teaching ayurvedic medicine in Germany, Italy and Austria. Medical director for post-gradual studies in ayurvedic medicine für doctors in Vienna.

Dr. Anand Chaudhary MD (Ayu) PhD, Associate Professor im Department of Rasa Shastra der Banaras Hindu University, Varanasi. Über 90 wissenschaftliche Veröffentlichungen. Mitglied im Zentralrat für Forschung, Industrie und Lehre, Department of AYUSH.

Anand Chaudhary MD (Ayu) PhD, associate professor of the Department of Rasashastra at the Banaras Hindu University, Varanasi. Over 90 scientific publications. Member of the Governing Council for Research, industry and education, Department of AYUSH.

Dr. med. Matthjis Cornelissen Niederländ. Arzt und Buchautor, lebt seit 1976 in Indien, unterrichtet Integrale Psychologie am Sri Aurobindo Int'l Centre of Education in Pondicherry, Direktor des Indian Psychology Institute. Projekte zu Psychologie aus Sicht indischer Traditionen.

Matthjis Cornelissen MD, physician and author from the Netherlands, resident of India since 1976, teaches integral psychology at Sri Aurobindo Int'l Centre of Education in Pondicherry, director of the Indian Psychology Institute. Projects on psychology from an Indian traditional perspective.

Parvathidevi Kirathamoorthy MD (Ayu) MSc, Stu-dium der Ayurveda-Medizin & Psychologie, Superintendent des Gvt. Ayurveda Forschungsinstitut für mentale Erkrankungen in Kottakkal. Weltweit führend in der Erforschung ayurv. Behandlung psycho-mentaler Störungen.

Parvathidevi Kirathamoorthy MD (Ayu) MSc, studied ayurvedic medicine and psychology, superintendent of the Govt. Ayurveda Research Institute for Mental Diseases in Kottakkal. Global leader in the research of the ayurvedic treatment of psycho-mental disorders.

Prof. Dr. med. Anand Dhruva Medizinischer Onkologe, Hämatologe und Internist. Forschung über Komplementärmedizin in der Krebstherapie. Associate Professor of Medicine an der School of Medicine der University of California, San Francisco (UCSF).

Prof. Anand Dhruva MD Medical oncologist, hematologist and internist. Researcher specializing in complementary therapies for cancer symptom management. Associate Professor of Medicine at the School of Medicine, University of California, San Francisco (UCSF).

Prof. Dr. Torkel Falkenberg PhD, ist Associate Professor am Karolinska Institutet, Schweden. Er beschäftigt sich mit Forschung im Bereich integrativer Gesundheitspflege un d war beteiligt an der Erstellung der WHO Direktive zur Traditionellen Medizin (2002).

Prof. Torkel Falkenberg PhD, associate professor at the Karolinska Institutet, Sweden. Dedicated to research in the field of integrative health care and was involved in the creation of the WHO directive for traditional medicine (2002).

Prof. Dr. med. Antonella delle Fave Ärztin mit Spezialisierung auf klinische Psychologie, Professorin für Psychologie an der med. Universität in Mailand, Italien. Präsidentin des European Network of Positive Psychology (ENPP) & der Int'l Positive Psychology Association (IPPA).

Prof. Antonella delle Fave MD, physician with specialization in clinical psychology and professor for psychology at the Medical University of Milan, Italy. President of the European Network of Positive Psychology (ENPP), president of the Int'l Positive Psychology Association (IPPA).

Prof. Dr. med. Olga Golubnitschaja hat Musik, Journalismus, Biotechnologie & Medizin studiert. Pionierin in der personalisierten Medizin, Expertin in der Molekulardiagnostik, Autorin für integrative Medizin. EPMA-Generalsekretärin. Lehrstuhl an der Universität Bonn.

Prof. Olga Golubnitschaja MD, has studied music, journalism, biotechnology and medicine. Pioneer in the area of personalized medicine, an expert in molecular diagnostics, author for integrative medicine. Secretary General of EPMA. Professor at the University of Bonn.

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2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

Referenten

Speakers

Dr. med. Hedwig Gupta Fachärztin für Orthopädie & Rheumatologie, arbeitet seit 1995 mit Ayurveda und dem therapeutischen Yoga in eigener Praxis. Vorstandsmitglied Dägam. Ayurvedastudium an der BHU, Indien.

Hedwig Gupta MD Specialist for orthopaedics and rheumatology, has been working with Ayurveda and therapeutic yoga in her own practice since 1995. Studies in Ayurveda at BHU, India.

Prof. S. N. Gupta MD (Ayu), Chefarzt am Ayurveda Hospital und Professor am Ayurveda-College in Nadiad, Gujarat (Indien). Seit über 15 Jahren Dozent und Vor­ sitzender des akademischen Beirates der Europäischen Akademie für Ayurveda (REAA).

Prof. S. N. Gupta MD (Ayu) Head of department and professor at the ayurvedic hospital and college in Nadiad, Gujarat. For more than 15 years now lecturer and chairman of the academic advisory board of the European Academy of Ayurveda.

Dr. med. Nikolaos Kostopoulos ist bekannter Spezialist für Ayurveda und Ganzheitsmedizin. Praktiziert in Athen. Schwerpunkt seiner Arbeit als Arzt und in eigener Forschung ist die Behandlung psychosomatischer Beschwerden und Stressmanagement.

Nikolaos Kostopoulous MD, well-known specialist for Ayurveda and holistic medicine. Practicing in Athens. Emphasis (of his work as physician and in his research) is the treatment of psychosomatic disorders and stress management.

Rajesh Kotecha MD (Ayu), ist Präsident der renommierten Gujarat Ayurved University, Jamnagar. Er leitet außerdem seine eigene Ayurveda-Klinik in Jaipur. Umfangreiche, langjährige Lehrtätigkeit auch international, vor allem in Süd- & Nordamerika.

Rajesh Kotecha MD (Ayu), is the president of the recognized Gujarat Ayurved University, Jamnagar. He also directs his own Ayurveda clinic in Jaipur. Also extensive, long-standing international teaching career, particularly in South and North America.

Sascha Kriese BA Hons (Ayu), Ayurveda-Studium an der Thames Valley University London, erlernte das Pulslesen in Indien (Mentor Dr. Pankaj Naram), eigene Ayurveda-Praxis in Brighton, Co-Präsident der Ayurvedic Practitioners Association (APA).

Sascha Kriese BA Hons (Ayu), 3-years-study on Ayurveda at the Thames Valley University, London. Learned the art of pulse-diagnosis in India with his mentor Dr. Pankaj Naram, runs his own practice in Brighton. VP of the Ayurvedic Practitioners Assoc. (APA).

Dr. med. Ludwig Kronpaß Chefarzt der Klinik für Frauenheilkunde und Geburtsmedizin in Rotthalmünster Leiter der AyurSan-Klinik. Medizin. Direktor und Studienleiter der Ärzte-Fortbildungen an der REAA. Stellvertretender Vorsitzender VEAT e.V.

Ludwig Kronpaß MD, Chief physician in the clinic for gynecology and obstetrics in Rotthalmünster. Director of the AyurSan clinic, medical director and director of studies for post-graduate education for doctors at the REAA. Vice President of the VEAT e.V.

Prof. Dr. Abhimanyu Kumar MD (Ayu) MSc PhD, Direktor des Central Council for Research in Ayurveda des Ind. Bundesgesundheitsministeriums, Direktor des All India Institute of Ayurveda. Davor Leiter der Abt. Kinderheilkunde am National Institute of Ayurveda (NIA), Jaipur.

Prof. Abhimanyu Kumar MD (Ayu) MSc PhD, director of the Central Council for Research in Ayurveda of he Indian Ministry of Health. Director of the All India Institute of Ayurveda. Was director of the dept. of pediatrics at the National Institute for Ayurveda in Jaipur.

Marco Lebbing MD, Facharzt für Allgemeinmedizin, studierte Ayurveda-Medizin in Deutschland und Indien und beschäftigt sich mit klassischen europäischen Naturheilverfahren. Vorstandsmitglied der Deutschen Ärztegesellschaft für Ayurveda-Medizin DÄGAM.

Marco Lebbing MD, Ayurveda Medical Practitioner with comprehensive training in Germany and India. Studied traditional European medicine. Board member of the German Doctors Association for Ayurvedic Medicine (DÄGAM).

L. Mahadevan MD (Ayu) Leitender Arzt am Sri Sarada Ayurvedic Hospital, weitreichende Unterrichtserfahrung in der Ärzte-Ausbildung. Intensive Tätigkeit als Sprecher auf nationalen wie indischen Kongressen sowie als Autor wissenschaftlicher Publikationen.

L. Mahadevan MD (Ayu), senior physician at Sri Sarada Ayurvedic Hospital, extensive experience in the training of physicians. Intensive work as speaker at national as well as Indian congresses as well as author of scientific publications.

Ram Manohar MD (Ayu), Ayurveda-Arzt und -Pharmakologe, Forschungsdirektor bei Arya Vaidya Pharmacy in Coimbatore. Mitarbeit in Ayurveda-Forschungsprojekten in Europa und den USA, Mitglied des Internat. Council for Indian Systems of Medicine.

Ram Manohar MD (Ayu) and pharmacist, director of research at AVTAR (Arya Vaidya Pharmacy) in Coimbatore. Collaboration in Ayurvedic research projects in Europe and the US, member of the International Council for Indian Systems of Medicine.

Prof. Dr. Martin Mittwede PhD Indologe und Religionswissenschaftler, lehrt an der Universität Frankfurt/ Main. Habilitierte zum Thema Ayurveda. Leiter des Master-Studiengang MSc Ayurveda-Medizin und Dozent an der Europäischen Akademie für Ayurveda.

Prof. Martin Mittwede PhD Scholar of religion and indology, teaches at Frankfurt/Main. Postdoctoral thesis on Ayurveda. Director of studies for the Master Program in Ayurveda Medicine at faculty member of the European Academy for Ayurveda.

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

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Referenten . Speakers Referenten

Speakers

Dr. med. Antonio Morandi Neurologe und Vaidya (Ayurveda Academy, Pune (Indien) / Joytinat International College of Ayurveda). Direktor Ayurvedic Point, Mailand, und Präsident der Wissenschaftlichen Gesellschaft für Ayurveda Medizin Italien (SSIMA).

Antonio Morandi MD Neurologist and Vaidya (Ayurveda Academy, Pune / Joytinat International College of Ayurveda). Director of Ayurvedic Point, Milan and president of the scientific society for Ayurvedic medicine (SSIMA).

Vanitha Muralikumar MD (KC), Präsidentin des Central Council of Indian Medicine der indischen Regierung. Rektorin und Direktorin für klinische Forschung am Sri Sairam Ayurveda Medical College and Research Centre in Chennai.

Vanitha Muralikumar MD (KC), President of the Central Council of Indian Medicine, Government of India. Principal cum Director Clinical Research at the Sri Sairam Ayurveda Medical College and Research Centre in Chennai.

Vijayendra Murthy MS, B.Nat, MPH praktiziert, forscht und lehrt seit mehr als 20 Jahren Naturheilkunde mit Schwerpunkt Ayurveda u.a. in Neuseeland, Australien und Großbritannien.

Vijayendra Murthy MS, B.Nat, MPH More than 20 years of experience in Ayurveda practice, research and teaching, e.g. in New Zealand, Australia and Great Britain. Runs his own clinic for natural medicine in London.

Dr. med. Kalyani Nagersheth wirkte als Ärztin der Ayurveda-Abteilung an der Habichtswald-Klinik, Kassel. Langjährige Erfahrung als Ayurveda-Dozentin. Eigene Praxis in Frankfurt. Eines ihrer Spezialgebiete ist die westliche und ayurvedische Phythotherapie.

Kalyani Nagersheth MD, practice as managing doctor of the Ayurveda department at the Habichts-Wald-Klinik, Kassel (Germany). Longtime experience as lecturer on Ayurveda (inter-)nationally. One of her areas of expertise is Western and Ayurvedic.

Ashtavaidyan Narayanan Nambi MD (Ayu), Leiter der Abteilung Forschung und Lehre am Institute of Ayurveda S.N.A. Oushadhasla (P) Ltd., Thrissur, Kerala. Er ist Extraordinarius am Vishnu Ayurveda College sowie ein angesehener Dozent in Indien und Italien (AP)

Narayanan Nambi MD (Ayu), Director of the Department of Research and Teaching at the Institute of Ayurveda S.N.A. Oushadhasla (P) Ltd., Thrissur, Kerala. Associate Professor at the Vishnu Ayurveda College and well-respected Ashtavaidya and lecturer in India.

Prof. Tanuja Nesari MD (Ayu) PhD, Ayurveda-Ärztin, Professorin, Leiterin der Abtlg. für medizinische Pflanzen und Pharmakologie am Ch. Brahm Prakash Ayurved Charak Sanstan in Dehli. Erfahrene Didaktin und Forscherin im Bereich ayurv. Pflanzenheilkunde & Diätetik.

Prof. Tanuja Nesari MD (Ayu) PhD, additional director (academics) and head of department of Dravyaguna (Dept. of medical plants & pharmacology) at Ch. Brahm Prakash Ayurved Charak Sanstan, Dehli. Extensive research in herbal medicine & clinical herbal pharmacology.

Dr. med. Karin Pirc PhD, leitende Ärztin und Gründerin der Privatklinik Bad Ems. Spezialistin für Pulsdiagnose und Panchakarma. Buchautorin und Preisträgerin des Global Hakim Ajmal Khan Award als „Bester Ayurveda-Arzt 2006“.

Karin Pirc MD PhD, leading physician and founder of the Maharishi Private Clinic Bad Ems. Specialist for puls diagnosis and pancha karma. Author and laureate of the Global Hakim Ajmal Khan Award as “Best Ayurvedic Physician 2006”.

Dr. Hans H. Rhyner MD (AM) PhD, Naturarzt, Autor, seit 30 Jahren Ayurveda-Kur-, Lehr- und Praxistätigkeit vorrangig in der Schweiz, Österreich und Indien. Seit 2012 auch im Parkschlösschen, Traben Trabach aktiv. Hersteller von Ayurveda-Bio-Produkten.

Hans H. Rhyner MD (AM) PhD, naturopath, author. working for more than 30 years now internationally in the fields of treatments, teaching and practice esp. in Switzerland, Austria and India. Producer of AyurvedaOrganic-Products.

Prof. Dr. med. Paolo Roberti di Sarsina Experte für komplementäre und alternative Medizin im Rat für Gesundheit im Italien. Gesundheitsministerium. Er leitet und koordiniert das permanente Kommitte für Konsens und Koordination in CAM, Italien.

Prof. Paolo Roberti di Sarsina MD Expert for complementary and alternative medicine at the Italian Board of Health. Ministry of Health. He directs and coordinates the permanent committee for consensus and coordination in CAM, Italy.

Kerstin Rosenberg Geschäftsführende Gesellschafterin sowie Fachbereichs- und Ausbildungsleiterin der Europäischen Akademie für Ayurveda, bekannte Spezialistin, Dozentin und Autorin für Ayurveda-Ernährung, Therapie und Psychologie.

Kerstin Rosenberg Internationally renowned specialist, lecturer and author on ayurvedic dietetics, therapy and psychology. Head of department of Education of the European Academy of Ayurveda.

Mark Rosenberg Direktor REAA und Geschäftsführender Gesellschafter der Rosenberg Ayurveda Unternehmen, 1. Vorsitzender des Verbands Europäischer Ayurveda-Mediziner & Therapeuten, auch als Vastu-Berater (altindische Architekturwissenschaft) aktiv.

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Mark Rosenberg Managing Director of the European Academy of Ayurveda and the Rosenberg Group of Institutes, President of the European Professional Association for Ayurvedic Practitioners and Therapists. Vastu-Shastra Expert.

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

Referenten

Speakers

Dr. med. Rotraud Scheiderbauer Seit 20 Jahren Fachärztin für Innere Medizin, davon 16 Jahre in eigener Praxis. PGDip in Ayurveda Medizin, arbeitete 1 Jahr als Ärztin an der Ayurveda-Abt. der Habichtswaldklinik, Kassel. Eigene Ayurveda-Praxis in Salzburg.

Rotraud Scheiderbauer MD, specialist in internal medicine, 16 years in her own practice. PGDip in ayurvedic medicine, physician for one year in the department for Ayurveda at the Habichts-Wald-Klinik, Kassel. Own Ayurveda practice in Salzburg.

Sukumar Sardeshmukh MD (Ayu) Enkel des ehrwürdigen Parampoojya P. K. Sardeshmukh (Bharatiya Darshan Trust, Pune) und Leiter der Atharva Nature Healthcare. Praktiziert Ayurveda in der dritten Generation. In Projekten zur Krebsforschung involviert.

Sukumar Sardeshmukh MD (Ayu), grandchild of the honourable Parampoojya, P. K. Sardeshmukh (Bharatiya Darshan Trust, Pune) and director of Atharva Nature Health Care. 3rd generation of practice in Ayurveda. Involved in cancer research projects.

Elmar Stapelfeldt Heilpraktiker, Magister der Indologie, Buchautor. Wissenschaftlicher Mitarbeiter am Immanuel Krankenhaus, Berlin. Langjähriger Dozent an der REAA, darunter 5 Jahre als Leiter des Fachbereichs Ayurveda-Medizin.

Elmar Stapelfeldt HP Practitioner of natural medicine, Master of Indology, author. Scientific associate at the Immanuel Hospital in Berlin. Experienced lecturer at the European Academy of Ayurveda and 5 years as director of the faculty of Ayurvedic medicine.

Ralph Steuernagel Heilpraktiker, widmet sich seit 18 Jahren der interdisziplinären Zusammenarbeit von westlicher und östlicher Medizin. Leitet eine eigene Ayurveda-Praxis und Akademie in Bad Homburg. Redaktionsleiter des Ayurveda-Journals.

Ralph Steuernagel HP Practitioner of Natural Medicine, dedicated for 18 years now to the interdisciplinary collaboration of Western and Eastern medicine. Running his own ayurvedic practice & academy in Germany. Editor of the Ayurveda Journal.

Dr. Madan Thangavelu PhD, Forschungstätigkeit an der Universität Cambridge in der Krebs-Genomik. Entwickelte neue Ansätze zur Analyse von Gen-Dynamik und -Variation. Mitglied des Research Advisory Board der AVP Research Foundation.

Madan Thangavelu PhD, researcher at Cambridge University in the field of cancer – genomics. He developed new approaches to the analysis of gen dynamics and variation. Member of the Research Advisory Board of the AVP Research Foundation.

Carmen Tosto Yogalehrerin und Ayurveda-Therapeutin, Vize-Direktorin Ayurvedic Point, Mailand (Italien), hält einen Honorary Degree of Ayurveda Acharya vom Ayurvedic Institute Ashtavaidya Thaikat Moss, Thrissur.

Carmen Tosto Yoga teacher and Ayurveda therapist, deputy director Ayurvedic Point, Milan, Italy. Holds an Honorary Ayurveda Acharya Degree from the Ayurvedic Institute Ashtavaidya Thaikat Moss, Thrissur.

Dr. Dr. med. Bernhard Uehleke PhD Mediziner und Physiker; forscht, lehrt und arbeitet in der Phytopharmakologie & -therapie. Spezialist für Kneipp-Therapie und Geschichte der Komplementärmedizin.

Bernhard Uehleke MD PhD in medicine and physics. Teaches and works primarily in phytoparmacology and phytotherapy. Specialist for the history of complementary medicine and hydrotherapy. Pubished more the 50 research papers in the field of CAM.

Ramesh Varier MD (Ayu), über 25 Jahre klinische Erfahrung als Ayurveda-Arzt. Beteiligt an der Entwicklung von Medikamenten und Behandlungskonzepten gegen chronische Erkrankungen. Managing Director der AVNGroup.

Ramesh Varier MD (Ayu), more than 25 years of experience as an Ayurvedic doctor. He developed several proprietary formulations for specific ailments from traditional Ayurvedic preparations. Managing Director of the AVN group.

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

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Abstracts IRSA

Young Research Parameswarappa Shivappa Byadgi MD PhD Dept. of Vikriti Vigyan, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi Sriranjini Jaideep Institute of Transdisciplinary Health Sciences and Technology, Jarakabande kaval, Post Attur, Via Yelahanka, Bangalore Aparna Wilson Panikkasseril Department of Roganidana, Government Ayurveda College, Kannur Sunil Rapolu Department of Kriya Sharir, Faculty of Ayurveda, Banaras Hindu University, Varanasi, Uttar Pradesh Dinesh Karayil Subrahmanian Assistant Professor, Kottakkal Ayurveda College Basavaraj Tubaki MD PhD Department of Kayachikitsa, KLEU BMK Ayurveda Mahavidyalaya, Belgaum, Karnataka

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2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

Abstracts IRSA Abstracts IRSA

Call for papers The scientific committee of IRSA called on researchers from India, Europe and other countries to present their works in the field of Ayurveda medicine on the 1st International Research Seminar on Ayurveda. Interested scientists and students were requested to send an abstract of their presentation in English to be scrutinized in a multistage blinded peer review process. The following research works got selected out of a total of 151 abstracts:

Selected for oral presentation Page 44  Parameswarappa Shivappa Byadgi MD PhD: Kapha and kapha-pittaja type of body constitution and MTHFR 677CC are strong risks for Type2 diabetes mellitus 45

Sriranjini Jaideep: Effect of Ayurveda on recovery in pakshaghata (stroke) – a clinical and electrophysiological assessment

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Aparna Wilson Panikkasseril: An observational study to explore the dhatugata-avastha in breast carcinoma

47  Sunil Rapolu: Certain autonomic responses in healthy individuals may have some association with constitutional types defined in Ayurveda 48  Dinesh Karayil Subrahmanian: Correlation of a gut therapy protocol (ama chikitsa) in changes of ama and behavioral symptoms of autistic babies 49

Basavaraj Tubaki MD PhD: Development and psychometric analysis of Ayurveda assessment scale for anxiety (AAA)

Selected for honorable mention Page 50

H.T. Eswaran: Formation and validation of questionnaire to assess jatharagni

51  Dr. Naveen Chandran Venkallil: An observational study to explore the Ayurvedic etiopathogenesis of skin diseases prevalent in endosulfan affected areas

2014 © Europäische Akademie für Ayurveda, herausgegeben zum Anlass des 16. Internationalen Ayurveda-Symposiums, 12. – 14. September 2014

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Abstracts IRSA Kapha and kapha-pittaja type of body constitution and MTHFR 677CC are strong risks for Type2 diabetes mellitus Parameswarappa Shivappa Byadgi MD PhD Archana Gupta, MD Department of Vikriti Vigyan, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi Email: [email protected] Akhtar Ali, PhD Center for Genetic Disorders, Faculty of Science, Banaras Hindu University, Varanasi Email: [email protected] Priyadarshini Tewari, MD, PhD Department of Vikriti Vigyan, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi Email: [email protected] Neeraj Kumar Agrawal, MD Department of Endocrinology and Metabolism, Institute of Medical Sciences, Banaras Hindu University, Varanasi Email: drkavns@ gmail.com Rashmi Patel, MSc Center for Genetic Disorders, Faculty of Science, Banaras Hindu University, Varanasi Email: [email protected] Parameswarappa Shivappa Byadgi, MD, PhD Department of Vikriti Vigyan, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi Email: [email protected] Name and postal address of presenting author Presenting author: Parameswarappa Shivappa Byadgi, MD, PhD Assistant Professor Address: Department of Vikriti Vigyan, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005, Uttar Pradesh, India Cell phone : +91 9450711759 Email: [email protected]/[email protected] Background and Purpose Type 2 diabetes mellitus (T2DM) is a complex, multifactorial disorder that results from interaction between genetic predisposition and environmental factors. Ayurveda’s Prakriti concept also has a genetic and environmental element and alludes to links and susceptibilities of individuals to diseases. In the context of diabetes, Prameha/ Madhumeha (Diabetes Mellitus) Kapha Prakriti individuals are said to be particularly susceptible (Caraka Samhita Vimanasthana 6/15). Genetic markers, if any, for Prakriti and risk factors for T2DM will help stratify individuals susceptible to diabetes and can provide a way for effective intervention – from early recommendation of preventive life style changes to early detection of the disease and thus help reduce the burden of the disease in the society.

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5,10-Methylenetetrahydrofolate reductase (MTHFR), an enzyme involved in the folate-homocysteine metabolic pathway is now known to be associated with complex diseases like cancers, cardiovascular and neurodegenerative diseases. In this preliminary study we address whether two well-studied polymorphisms at positions 677 and 1298 of the MTHFR gene are associated with Prakriti and /or Type 2 diabetes. Design / methodology / approach After informed consent, Ayurvedic constitution, MTHFR C677T and A1298C genotypes were determined and disease assessment was done for 54 patients with T2DM and 56 normal controls. The polymorphisms were detected by PCR-RFLP. The study was approved by the institutional ethical committee and work was funded by Banaras Hindu University from UGC Grant for young Faculty. Findings The frequencies of the CC, CT and TT genotypes in patients were 50, 3 and 1 whereas in controls 43, 13 and 0 respectively. The number of individuals in the Kapha/Kapha-Pittaja Prakriti in patients and control groups were 44 and 12 respectively. Kapha/ Kapha-Pittaja Prakriti were found to be associated with T2DM (x2 = 39.67, p< 0.001) and found to be strong risk factors [odds ratio (OR) =16.133, 95%CI=6.32-41.20] for T2DM. MTHFR C677T was associated (x2 = 7.743, p-value=0.02) with T2DM where the major CC genotype was found to be a risk for T2DM (OR=3.78, 95% CI = 1.14- 12.45). A1298C was not associated with T2DM (x2 =2.264, p-value=0.322). No correlation was observed between Prakriti and C677T/A1298C variants. A noticeable higher number of CT (heterozygotes) was seen in the control group (13 out of 56) in comparison to the T2DM group (3 out of 54). Interpretation & Conclusions A significant correlation was observed between Prakriti (Kapha/ Kapha-Pittaja) and T2DM (p