A BRIEF REVIEW OF AYURVEDIC CONCEPTS

with examples of essential Ayurvedic herbs and useful formulas

by Subhuti Dharmananda, Ph.D., Institute for Traditional Medicine, Portland, OR

Ayurvedic medicine is one of the major traditional medicine systems of the world, second only to Chinese medicine in terms of the extent to which it is used today. It has influenced Chinese medicine by virtue of the transfer of several herbs native to India to China for incorporation into the Chinese system. Much of that transfer was accomplished over a thousand years ago. Chinese medicine and India's medicine have been combined into Tibetan medicine to help produce yet another major traditional medical system. India's tradition has also combined with that of the Greeks to help form the modern Unani medicine as practiced in Pakistan and surrounding areas.

There is no licensing for the practice of Ayurvedic medicine in the United States (or most other countries outside those where it has been a central part of the healing tradition for centuries). It is provided by health professionals who have studied the subject independently (a few medical doctors, naturopathic physicians, acupuncturists, etc.), or interested persons may obtain herbs and formulas on their own by self-selection of remedies sold in stores or via the internet.

Ayurvedic medicine is of some interest to these practitioners and the general public for several reasons, aside from its long history of use, such as:

• Ayurvedic suppliers are becoming a strong force in the nutriceutical industry, providing concentrated extracts or isolated components from major Ayurvedic herbs. These are coming to the attention of the public at large as well as many practitioners.
• While all traditional medical systems emphasize the importance of diet in health and use of certain foods as medicines, the Ayurvedic system is especially known for this and offers some practical advice.
• The modern emphasis on scientific evaluation of traditional remedies means that there is increasing desire to use "proven" substances, regardless of which medical system they have been derived from. Thus, those who have studied Chinese medicine or Western herbs will still find any well-studied Ayurvedic herbs of value to know, understand, and possibly use.
• In trying to grasp the meaning and application of traditional and modern medicine concepts, it is helpful to see the differences between medical approaches around the world so that one does not become confined to a single cultural model.

In this document, there are a few pages devoted to depicting the basic Ayurvedic system, with focus on the dominant tridosha framework. This is followed by an exposition of 12 of the key Ayurvedic herbs, with examples of one formula each that have them as their primary ingredients. These formulas are available for use in convenient tablet form. Many other Ayurvedic formulas, both traditional and modern, also rely on these key herbs, so that the explanations provided here should be helpful in understanding other formulations that may be encountered.

AYURVEDA: WHAT IT MEANS

The name Ayurveda was given to the ancient healing tradition of India. It is often translated as the "science of life," from ayus (life) and veda (knowledge), but this is actually a poor representation of the term. "Science" refers to a particular method of study for gaining knowledge that developed long after Ayurveda was already well-established. Reading Ayurvedic texts, one sees a religious document rather than a scientific one. Another translation is this: "Love of the Divine is the basis of health and longevity." In fact, this is a better reflection of what is seen in the defining texts of Ayurveda.

The basics of Ayurvedic medicine are set down in ancient texts, of which the Charaka Samhita is the principal resource. Samhita refers to a collection of rules that is part of the larger collection of sacred texts known as the Vedas. Charaka (also spelled Caraka) is the legendary author, who lived about 2,000 years ago. It is likely a compilation of the work from several authors over an extended period, attributed to one who had a great name. As described by Dr. P. Kutumbiah, author of Ancient Indian Medicine (1969): "The Charaka Samhita stands as the finest document of the creative period (600 B.C.-200 A.D.) of ancient Indian medicine, in regard to the extent of its contents and to the state of its preservation....Charaka is the most rewarding author among the writers of classic medicine…."

The ancient Charaka Samhita reminds us that the first cause of all illness is the loss of faith in the Divine. In other words, Ayurveda is an instruction based on divine inspiration (and teaching of fundamental rules) aimed at enhancing and prolonging life and returning to full faith. The introductory chapter of the Charaka Samhita depicts the response of wise men (Rsis: enlightened masters, sages) to a new human condition: disease. The text opens thus (after a mention of names of those Rsis involved):

When diseases appeared as impediments to penances, fasts, study, celibacy, vows, and the life of people, the great Rsis of righteous deeds, keeping compassion for all beings before them, assembled together on the auspicious side of Himavat [a mountain of the Himalayas]….These Rsis, seated there at their ease, took part in this beneficial conversation, saying: 'Freedom from disease is the ultimate source of religion, benefit, pleasure, and salvation. Diseases are depredators thereof, as also of a happy life. This, therefore, is a great enemy of men that has appeared. What shall be the means of overcoming them?' Having said this, they undertook deep meditation. Then, with the eye of meditation they beheld Sakra [Indra; Lord of the Devas] to be their refuge: 'The Lord of the Celestials will duly declare the means of overcoming diseases.'…[Upon being transported to the Lord of the Celestials, their representative, Bharadvaja, pleaded]: 'Diseases have sprung into existence, striking fear into every creature. Therefore, O Chief of the Celestials, tell me duly what the means of defeating them are!' The Illustrious One of a Hundred Sacrifices declared all of Ayurveda unto that great Rsi in a few words, knowing his intelligence to be great….Having learnt it in its entirety, Bharadvaja acquired through it unlimited life, and blessed with happiness, declared it to the Rsis exactly as he had acquired it….Good and evil; happiness and unhappiness, is life [ayus]. That knowledge [Vedas] with which are declared its nature and measure, what is beneficial and what is injurious, is called Ayurveda.

The Rsis, thus enlightened by the teaching Bharadvaja gave them, also became immortal and, with their compassion for all creatures, they relayed this message of Ayurveda to all, which is largely explained in the Charaka Samhita, as well as in a few other ancient texts that are less famous. A summary of the teaching is then provided in this introduction to Charaka Samhita:

Mind, soul, body-this trinity called a 'person'-rests in union like three sticks standing with one another's support. Upon that trinity, everything rests….Body and mind are regarded as the subjects in which health and disease reside; parity of correlation [harmony and balance] being the cause of health. The soul is immutable and eternal. Wind, bile, and phlegm [the three doshas] have been said to be the causes of all bodily diseases. Passion and darkness have been indicated to be the causes of mental diseases. The bodily disease is cured by medicines founded upon acts performed in respect of the deities [ceremonies and rites of propitiation] and upon reason [analysis of their properties and effects]. Mental disease is cured by knowledge of the soul, knowledge of the scriptures, exercise of patience, and retreat of the mind from all worldly objects.

To clarify, it was understood at the founding of Ayurveda that asceticism-the practice of restraining worldly desires and unnecessary actions-was the method of spiritual growth; disease was an obstacle to these practices, as well as an obstacle to life itself. In the Hindu pantheon, Indra is the king of gods, and it was he who conveyed the basis of Ayurveda. The message was a basic philosophy conveyed in a few words and concepts, and then expanded greatly only to convey therapies for specific circumstances and diseases. While the soul is immutable and free of outside influence, the body and mind are subject to disease. The body may become imbalanced, and restored to balance by medicines; the mind may become imbalanced and be restored by religious practices. Ayurveda includes therapies for both mind and body, though in the modern world, people turn to it primarily for its influence on the body; those remedies for the body may also be used to affect the brain, as part of the body.

Although those involved in natural healing in the West mention the trinity of body, mind, and spirit (soul), religion is often not part of the recommendation. Meditation, separated from its religious significance, might take its place, relied upon for its calming effects. However, prescribing herbs, administering massage, and other medical therapeutics become the dominant method of alleviating disease conditions. The largest part of the Charaka Samhita describes herbs for treating various conditions; even though it is presented in the context of the religion, the listing of herbs and their uses (often in complex formulas) is today taken out of that context. The herb formulas described in the Charaka Samhita are said to be given by Indra to the Rsis and then recorded in this text. This suggests that they were not based on human analysis of herbs and their effects. Still, the text allows for one's "reason" to be employed in the practice of medicine, so one can adjust the formulas according to an understanding of the basic principles. This is what has been done in making modern Ayurvedic formulas.

SOURCES OF TRADITIONAL MEDICINE INFORMATION

The Ayurvedic medical system relies heavily on a pair of texts that are revered as statements of all the fundamental principles within the tradition. The two dominant texts are the Charaka Samhita (already described) and the Susruta Samhita, both estimated to have been written around 100 A.D. These are huge volumes (an English translation of the two Indian texts runs 2,700 pages). The Susruta, though it contains a diversity of information, is mostly known as a text on surgery. The Charaka, by contrast, is relied upon as the primary source for information about basic Ayurvedic theory and about herbal medicine. Therefore, it is the quoted source book for virtually any discussion of Indian herbs.

A 5-volume translation of the Charaka Samhita, revised for publication in 1996, is available from India (a 6-volume set is also produced). Quotes from the Charaka are to be found in virtually every Ayurvedic book and article, but few practitioners outside of India go back to the original work to study the principles. There is a third Indian text that is usually grouped with Charaka and Susruta, called Vagbhata Samhita; however, this one is relatively infrequently referenced, because, according to Kutumbiah, "the object of the author was to gather up into a harmonious whole the more or less conflicting medical systems current in his time, especially those contained in the compendia of Charaka and Susruta." As such, this text is often seen as a source for academic checking of the two more famous texts, rather than having much influence as an independent work.

Kutumbiah sums up the situation regarding traditional medical texts in India this way: "The creative period of ancient Indian medicine ends with the samhitas of Charaka and Susruta. Charaka accomplished the final synthesis of Indian medicine, and Susruta that of surgery. Their works have thereafter held undisputed sway in Indian medicine up to the present time. The Indian medical writers after Charaka and Susruta were only their imitators and abstractors. No real original work was accomplished after them."

The Charaka presents steps to take in one's daily life to promote health; it also describes causes of disease (such as environmental, dietary, and emotional factors), has many chapters devoted to specific diseases with some details of disease progression, and offers a variety therapeutic measures. The Charaka mainly presents herbs, oil massages, and enemas. The heavy reliance on therapeutic massage with specific oils according to the disorder being treated and on enemas (usually made with an oil base) is unique to the Ayurvedic system.

Ayurvedic medicine has had a limited tradition of Materia Medica works (listing of herbs and their properties). In 1908, Dr. K. M. Nadkarni published a two-volume Indian Materia Medica, a guide to Ayurveda that is still considered the standard text. It combines information from ancient traditional practices, current Ayurvedic practices, and reports from Europeans (such as analysis of active constituents, pharmacology, and European uses of the same herbs). This Indian text has several limitations: it makes no reference to previous works on Indian herbs, does not outline any history of the development of the drugs, and does not indicate when an herb was introduced into practice. It provides occasional references to Charaka, but doesn't otherwise quote earlier authors on Ayurvedic medicine, except for those working right around the time of its publication, mainly R.N. Chopra.

TRIDOSHA: THE UNDERPINNING OF AYURVEDIC THEORY

In Ayurvedic medicine, although the total system is quite complex, there is a dominance of one theoretical framework: the tridosha (three dosha) system: kapha, pitta, vata (the latter is also called vayu). These three serve both as entities and as influences in describing the body and its functions. To study Ayurveda is to become intimately aware of the three doshas, how to analyze their presence and activities, and how to adjust their influence.

The physical make-up of the body in which the three doshas are present is described primarily in terms of two patterns:

• the set of physical structures that comprise the form of the body
• the stages of transformation of substances in the body-following the path of ingested food as it is converted into the essential substances; the process yields useful materials as well as wastes that must be disposed of.

The reliance on a triad of influences on health and disease sometimes forces Ayurvedic medicine into a relatively simplistic system. The fact is that three entities and influences are too few to easily depict the complexity of human life. There are several other groups of influences that are utilized to further describe the nature of the world and the human body (such as the triad of the gunas: sattva, rajas, and tamas), but the limitation of tridosha is overcome, to a large extent, by the fact that the foods and herbs used in gaining health have great diversity. Their unique properties force the practitioner to look beyond the basic three-entity pattern to the larger range of influences of the therapeutic substances. In other words, the complexity and uniqueness of the remedies induces one to go beyond the three doshas.

Several books on Ayurvedic medicine that have been presented to the Western reader expend most of their pages on classifying individuals and their symptoms into the three groupings by doshas, often in a way that is counterproductive. For example, people (or their body forms) might be classified into three "types" based on the doshas. Then, the author(s) may present foods, herbs, and physical therapies that are classified primarily by their effects on the three doshas. In fact, this is wrong thinking that has invaded the less well-trained members of the profession. All three doshas (as well as all three gunas, and all other groups of properties) are present and active in each human, and even when one is dominant, it does not rule all outcomes; similarly, each are present, to a certain extent, in all the remedies. The unfortunate oversimplification has damaged the potential of this intricate medical system to provide help to people in need. As stated by P. Kutumbiah in his book Ancient Indian Medicine: "The doctrine of the tridosha plays an important role in ancient Indian medicine. It is the basis of its diagnosis, pathology, and therapeutics. A correct appreciation of it is, therefore, essential for a proper understanding of Indian medicine....In the later medical works, it underwent great elaboration owing to the influence of the cosmological speculations and consequently suffered much violence to make it fall in line with them." The enforced alignment with so-called "cosmological speculations" (including astrological considerations, and what is today called bioenergetics) had a stifling effect because everything was forced to fit three archetypes, even when reason and experience indicated otherwise.

TRANSLATING TRIDOSHA

The proper translation and understanding of the key element of the Ayurvedic tradition, the tridosha, remains at the heart of making Ayurveda accessible to those who did not grow up with and assiduously study this field. As to understanding the tridosha system, in the introduction to the Indian Materia Medica, this is offered:

The doshas-vayu, pitta, and kapha-constitute the tripod on which Ayurveda stands. To understand their theory perfectly and correctly is by itself a long and arduous study. The subject being a very complicated one, it cannot be explained within a few pages. Also, it has been defined by different experts in different ways, but the basic principles to which they all point to are the same.

Dr. Nadkarni suggests that the tridosha system actually represents two forms of doshas:

1. An invisible or essential form, which mainly guides the physiological processes pertaining to them naturally.

2. A crude or visible form, the products (as secretions or excretions) of those processes induced by these essential forms.

The relation between the two forms is very close, so that the derangement of the essential form of one principle gives rise at once to increased or morbid secretions and excretions of that principle.

In other words, the Ayurvedic system describes an influence-one or more of vayu, pitta, and kapha-and there are the material results of those influences, which might be referred to as humors, secretions, and excretions, but which have been given the same names.

These two forms-influence and manifestation-are easily confused, and it is seen in the Ayurvedic medical literature that the flow of thought back and forth between these two aspects leads one to easily forget which is the focus of concern. Further, each of these three influences is not solely pathological, despite the frequent reference to their role in pathology. They are pathological when there is an excess or deficiency or some other type of deviation from normal (most often an agitation); otherwise, they are essential to life. In fact, in the traditional Ayurvedic system, when vayu, kapha, and pitta are in their normal measure they are described as supporters of the body; but they are considered doshas (literally: faults) if they are producing imbalance. So it is that one can become disoriented by considering a fundamental entity, defined by a single word such as vayu, as being both essential and pathological, a causative factor and a result, a symbol, an influence, and a manifestation.

Pitta, kapha, and vata (vayu) have been translated as bile, phlegm, and wind, respectively, based on translations that arose out of the ancient Greek system. These terms are poor representatives of the underlying meaning, however. One can understand the terminology conundrum by reading the description of vayu in the Charaka Samhita. On the one hand, vayu is described this way:

When moving in the world in an excited state, without doubt, vayu achieves the following functions: It breaks the summit of mountains. It uproots trees. It agitates seas. It swells the waters of lakes causing them to rise upwards. It causes the currents of rivers to run in opposite directions. It makes the earth tremble. It urges the clouds. It causes frost, thunder, dust, sand, fish, frogs, snakes, ashes, blood, stones, and lightning to fall down on the earth. It causes excess of virtues, absence of virtues, and contrariety of virtues in respect of the six seasons. It causes failure of crops. It produces disease and plagues. It destroys many objects.

A large part of this description sounds like wind as we all know it, at least as it occurs in hurricanes and tornadoes (it is only so destructive in the "excited state"). A portion sounds like infectious agents (pests, pathogenic fungi, viruses, etc.) that cause crop failures, diseases, and plagues.

When describing vayu as an aspect of the human body, it takes on a different form. Here is the Charaka Samhita presentation of its favorable side, that is, when not "excited" (the parenthetical statements being clarifications included by the translators):

The wind upholds the constituents of the body (such as blood, flesh, marrow, fat, etc.) and their courses through the body. It exists in the five-fold form of prana, udana, samana, vyana and apana. It is the urging cause of movements of diverse kinds. It restrains the mind (from all undesirable objects) and concentrates it (on objects that are desirable). It causes all the (ten) senses (of knowledge and action) to perform their functions. It bears all the objects of the senses (after contact with the senses) to the mind. It holds together all the elements of the body. It assists the cohesion of the particles of the body. It causes speech. It is the prime cause of touch and sound, and the root of scent and touch. It is the origin of joy and cheerfulness. It excites the heat of fire. It dries up all faults. It throws out all impurities. It pierces through all the ducts of the body, gross and fine. It gives form to the embryo in the womb. It furnishes evidence of the existence of life. The wind, when unexcited, achieves all these functions.

The idea that wind encompasses all the functions of the central nervous system or that its main function is to provide for any movements within or of the body, as many modern writers suggest in their depictions, doesn't seem to fit all that well with the above description. The Charaka Samhita continues:

When excited within the body, vayu pains the body with diverse afflictions. It destroys and injures strength, complexion, happiness, and duration of life. It agitates the mind. It injures all the senses. It kills the embryo and causes miscarriage. It maims the embryo (by suspending the development of particular parts). It holds the fetus longer than usual. It causes fear, grief, stupefaction, cheerlessness, and delusions. It destroys life.

Here, the agitation of mind, injury to senses, and the development of various mental states and delusions that result from agitated wind all seem consistent with a role of the central nervous system. Then, additionally, pathological vayu has adverse effects on pregnancy.

The translation term for vayu as wind is probably as good as one can manage to capture this diverse traditional concept in one word. Likewise, the term feng in traditional Chinese medicine, translated as wind, is equally problematic; it also has some connections with the central nervous system (wind diseases often involve involuntary muscular conditions and abnormal sensory conditions, which are related to central nervous system activity), perhaps more so than in the Indian system. Vayu, unlike pitta and kapha, has its own chapter in the Charaka Samhita; in fact, it has two full chapters. It is the condition that requires the most explanation, and did so even in ancient times.

The description of pitta as bile has some similar problems. According to the Greek tradition, there were three humors in the body: blood, phlegm, and bile (the latter could be subdivided into two forms: yellow and black). The term bile was simply carried over to explain the term that arose in the Indian system. In both those traditional systems, it was associated with burning sensation and feverish condition, though that is nearly the full extent of the connection. Reference to pitta in terms of heat or "fire" is probably more appropriate, but in the Ayurvedic thinking, pitta is also liquid (oily), like bile, so it differs from the "dry" connotation of something that is burning. In the Ayurvedic system, there is a manifestation of pitta, called agni, which is often translated as digestive fire, and we understand that to be the highly active aspect of transforming food into its useful components, as a cooking fire transforms raw food into edible cooked food. But, the digestive juices, including actual bile, are fluid in nature.

The term phlegm fits kapha sufficiently to be usable, though it remains far from ideal. In the Ayurvedic system, the qualities of cold, damp, and thickness go together in this concept. We might think of the common cold, with its chills and excess production of mucus (phlegm). But, other thickened fluids of the body (including normal ones that are lubricant and protective) are also associated with kapha. So long as one understands that the translation terms are applicable to broad traditional concepts rather than limited modern definitions, one should be able to make use of them in communicating general ideas about the use of Ayurvedic medicine.

To sum up tridosha in a few words, one of the leading Western authorities on Ayurveda, Robert Svoboda, in his book Ayurveda: Life, Health and Longevity, has said this:

The three doshas enable the spiritual and mental planes of existence to express themselves through the physical body. Vata is in charge of all motion in the body and mind. Everything that moves, from a molecule to a thought, moves because of vata, and every motion of any kind influences every other motion....Pitta is in charge of all transformation in the organism. Digestion of food by the gut, of light by the eyes, and of sensory data by the brain are examples of pitta's activities. Kapha is the stabilizing influence in the living being. It lubricates, maintains and contains, and its various activities, like those of vata and pitta, are interrelated.

THE DOSHAS IN THE BODY

In a person who is physically healthy, the three doshas are present in appropriate proportions, their quality is pure, and their activities are calm and orderly. That person has strong, stable energy, good digestion, flexible joints, clear thinking, calm demeanor, glowing complexion, and is able to sleep well. In a person who is unhealthy, at least one, but almost always two or all three of the doshas are relatively deficient or excessive, their quality has become impure, and their activities disorderly. These latter two aspects, impurity and disruption, are commonly called "vitiation" (the doshas are "vitiated"), meaning corrupted. A term for imbalance of the doshas is tundoskopa: anger of the doshas, capturing the idea that the doshas have an active role in the disease process, not just a passive one of being deficient or excessive in amount.

Following are some of the expected manifestations of deficiency, excess, and aggravation (vitiation) of the individual doshas:

Kapha

Kapha deficiency: sensation of dryness or internal burning, feeling of emptiness in the stomach and other cavities of the body, looseness of the joints, thirst, weakness, and insomnia.
Kapha excess: whiteness of complexion, heaviness of limbs, nausea and fullness of the stomach, feeling of coldness, drowsiness, excessive sleep, and looseness of the joints.
Kapha vitiation: aversion to food, inertness of limbs, vomiting, and impaired digestion.

Pitta

Pitta deficiency: dullness of complexion and reduced body heat.
Pitta excess: burning sensation of the body, desire for coolness, yellowish coloration (of skin, eyes, feces, urine), insufficient sleep, fainting fits, weakness of sense organs.
Pitta vitiation: heat (fever or hot sensation).

Vata

Vata deficiency: languor, uneasiness, loss of consciousness.
Vata excess: roughness of the voice, thinness of the body, dark complexion, desire for heat, throbbing sensation, hard stool, insomnia, and weakness.
Vata vitiation: swelling or distention of the abdomen, rumbling sound of the intestines.

Each of the doshas has a location in the body where it generates the corresponding humors and from which it initiates its actions. These sites are also where vitiation of the doshas and humors is most likely to occur. Kapha has its seat in the stomach, pitta in the small intestine, and vata in the large intestine. That is, the three doshas have their initial and dominant influence in the gastro-intestinal system.

The principal site of action for each of these influences explains the importance attributed to food consumption by Ayurvedic doctors. Food enters the gastro-intestinal system and portions of it encounter, one by one, the seats of the three doshas. Interacting with the doshas, the food is transformed and transported and made into the substance of the body and activates the movement of the body. Persons who are sluggish and those who are agitated may each suffer from a disorder in the transformation of food into usable energy and substance; an important aspect of this is the production of unhealthy byproducts, known as ama.

Dietary adjustments, along with the use of herbs, are the most important aspects of healing regimens, at least for long-term therapy. Dietary factors are not the only ones that affect the body, so herbs, massage, and other techniques are also important. Yet, one should not forget the underlying basis of Ayurveda, which is not physical medicine, but spiritual medicine: it is the unsettled spirit and the mind not open to full consciousness that remains at the root of these problems.

CONCEPTS OF DISEASE PROGRESSION

While some diseases are of short duration and mainly affect one part of the body, others progress to affect additional parts of the body and can eventually engulf the entire organism. As described by Rob Svoboda: "Weakness of the digestive fire is the root cause of all diseases, vata is the chief cause of the development of all diseases, and ama is the principal nourisher of disease." The primary stages of disease are depicted as accumulation, aggravation, and overflow.

Accumulation: As a result of exposure to various disease-causing factors, one or more of the doshas accumulates in its seat: kapha in the stomach, pitta in the small intestine, and vata in the colon. Each produces its own characteristic symptoms, for example: kapha creates lethargy, heaviness of the limbs, pallor, bloating, and loss of appetite with weakened digestion; pitta produces burning sensations, increased body heat, a bitter taste in the mouth, yellowness of the skin, acidity of the stomach, and increased anger; vata causes weakness and dryness of the body, desire for warmth and hot articles, stiffness and fullness of the abdomen, flatulence and/or constipation, disturbed sleep, and increased fear. The disease is relatively easy to resolve when the imbalance is primarily one of accumulation.

Aggravation: In this stage, for which the Sanskrit term literally means rage, the doshas continue to increase and put pressure on their reservoirs, intensifying the symptoms they have produced. It is still fairly easy to remove the doshas (as faults) even at this stage, but while treating them, their reservoir organs, which have been stressed by the ire of the corresponding doshas, need also to be strengthened. The doshas do not always accumulate before they become enraged; if the causes are strong enough, aggravation of doshas at their normal levels may occur directly.

Overflow: If aggravation is permitted to proceed unchecked, the doshas escape their original seats, wandering about the body like vagabonds, searching for a place to camp. All the symptoms that already existed from aggravation now worsen. At this point, kapha may produce vomiting, pitta may produce burning diarrhea, and vata may produce colicky pain in the colon and painful defecation, with the liberation of copious quantities of gas. Overflow of pitta or kapha can occur without previous accumulation or aggravation in their reservoir organs if either or both of those doshas are displaced by the force of a strongly aggravated vata. This "wind" may be directly disturbed by exposure to strong imbalancing causes, such as excessive desire, sleeplessness, excessive talking and activity (especially on an empty stomach), sudden vomiting or diarrhea (particularly if self-induced), intense joy or sadness, and the restraint of any of the natural reflex urges.

The fourth stage (purvarupa) is the initial manifestation of symptoms that result from accumulation of the doshas at susceptible sites. The fifth stage (rupa) is when the disease has become readily apparent: the sites of secondary accumulation of the doshas have been substantially disturbed; there are local structural changes. The sixth stage is when the disease erupts from the body. At that point, symptoms might include obvious inflammation, enlarged glands, abscesses, skin eruptions, fever, diarrhea, leukorrhea, etc. That is, there are indications that the body is filled, and material is either stuck (as in a swelling), erupting, or draining out. At the same time, complications of the disease, manifesting now at additional sites, will occur.

The therapies at each of the stages as the disease progresses must become more specific, more potent, and more frequently applied. It is best to catch the disorder early, when dietary adjustments and a few days of using simple herb formulas may be sufficient; perhaps massage will be applied once or twice, and some cleansing procedures might be followed.

INDIAN CONCEPTS OF HERB PROPERTIES

For the herbalist, perhaps the important thing to know about the herbs and the doshas (or the physical manifestations of the doshas) is that vata is cold and dry in nature, kapha is cold and moist in nature, and pitta is hot and moist in nature. By analyzing the symptoms and constitution of the patient, one determines the prevalence of each of the physical manifestations of the doshas (and the degree of influence exerted by the non-material aspects of each of the doshas), and selects herbs or prepared herbal formulas to harmonize the influences and correct the physical imbalances, based on the characteristics of the herbal materials.

One of the dominant descriptions of herb properties is based on the taste of the herbs. The taste groups are listed in the table below with a description of their associated effects:

In order to influence the doshas, one usually combines certain tastes together within a formula, as follows:

Thus, for example, if a patient has agitation of vata, and insufficiency of the kapha and pitta, involving a weak digestive function and stiffness of the joints (but this would not be joint swelling), the herbalist would combine (or select a formula containing) sweet, sour, and salty agents, with a small amount of pungent taste. Taste is only one of the qualities that Ayurvedic herbalists rely upon (other qualities include cooling or heating, heavy or light). However, aside from the individual properties and traditional indications of herbs, this aspect is probably the most important.

There are differing opinions about the action of the herbs on the doshas. For many herbs, the doshic effects are not formally recorded and can only be implied by an interpretation of the tastes and the obvious effects of the herbs. Also, there is some diversity in translating to English the two basic actions of herbs on the doshas: haram (interpreted as reducing, calming, removing, etc.) and karam (interpreted as supporting, supplementing, increasing, etc.). For the presentation here, haram refers to calming agitated vata, releasing excessive kapha, and mollifying intense fire; karam refers to promoting movement of vata, enriching the essential kapha, and invigorating a weak fire.

In addition, it may be stated that an herb balances two doshas, or all three doshas. Balancing refers to coordination of their functions so as to produce a healthier condition, or reducing one and increasing another to attain the desired levels. For many herbs, the action on the doshas is not mentioned in their description.

The properties of herbs and effects of the doshas are taken into account in designing Ayurvedic herb formulas. The person who wishes to use such formulas need not know the details of herbal properties of each ingredient once a formula has been properly designed for a specific treatment area. However, by knowing these features, one can have greater understanding of the formulas and control over the entire therapeutic regimen.

Information about the Ayurvedic herbs presented in this booklet are derived primarily from three sources: Nadkarni's century-old Indian Materia Medica, and two recent books: Medicinal Plants by Shankar Gopal Joshi (2000) and Major Herbs of Ayurveda edited by Elizabeth Williamson (2002).

HERBS FROM INDIA TABLETS

The Herbs from India line of tablets was introduced by ITM in 1996. ITM imports the prepared formulas, in powder form, from Universal Medicaments, a manufacturer in Nagpur, India, certified for its 'Good Manufacturing Practices' and adherence to World Health Organization standards. The powders (dried extracts) are made into tablets in the U.S. Universal Medicaments sells the same or similar formulations in India, packed in capsules. The tablets permit a higher dosage (500 mg caplets are used) than the capsules (400 mg per capsule is the amount provided in India) to reflect the higher average body weight of Americans compared to the people of India.

The current Herbs from India line is comprised of 9 proprietary formulas developed by specialists at Universal Medicaments and prepared as dried extracts (5:1 concentration ratio), plus 2 traditional formulas: Triphala (modified by adding a small amount of ginger) and Hingwastaka, prepared as crude powders (in accordance with their traditional method of preparation), and one formulation (Cordifolan) designed by the current author (prepared as an extract). The Herbs from India labels feature the neem leaf, representing one of the most widely used of the Indian herbs. The modern formulas have been given new names, usually derived from the botanical or Indian name of one or two of the key herbs in the combination. For example, Karnim is named after karela and neem (also spelled nim); Saracant is named after its key ingredient Saraca indica (often referred to as Ashoka or Asoka). The traditional formulas retain their original names, though the spelling can vary depending on the transliteration used.

NAMES OF THE HERBS

The naming of foreign herbs is always a problem, but it is particularly difficult in the case of India, which has several dozen language groups. As an example, Terminalia chebula, one of the most commonly used ingredients in Ayurvedic formulas, has the following names, amongst many others: pathya (Sanskrit), harara (Hindi), kadookai (Tamil) and chebulic myrobalans (English).

Ayurvedic specialist Robert Svoboda has proposed that the Sanskrit names be adopted for use in the West, since Sanskrit is the formal classical language of India. However, few books written for Western readers present this terminology. Universal Medicaments relies on the Indian common names that are prevalent in Bombay (Nagpur is nearby), one of India's largest cities and a center for publication of Ayurvedic literature. ITM has adopted a common naming system as follows:

1. If a well-established common name already exists, this will be retained as the common name: examples are garlic, cumin, and ginger. Generally, this will apply only if the plant part used is the same as in general use. In two cases, the Ayurvedic name has become well known in the West and is adopted as the common name: ashwaganda and neem.
2. If a common name does not already exist, the genus name will be used: e.g., pluchea, picrorrhiza, embelica. In most cases, the genus name is used.
3. If an herb comes from a genus for which several species are commonly used (but are not considered the same herb), then either the Indian name (typically, the Hindi name) or the species name will be used. In the case of two myrobalans fruits from Terminalia species, the species names chebula and belerica have been selected. These correspond with the longer common names chebulic myrobalans and beleric myrobalans.

For the presentation of herbs in the following section, the subject of each monograph has been arranged alphabetically according to the name adopted by ITM. To aid in identification, the commonly accepted botanical name for the herb is also provided. In the list of formula ingredients, both the Indian name and the common name are given.