Health Care and Disease Management - Introduction

 2.1 Introduction 

In Ayurveda, health is defined as the state where physical body, senses, and psyche are in original or natural state with respect to body and function. Although the genetic makeup of an individual determines the basic body constitution with respect to dosas (biomaterials) and psychological factors, total health is determined by physical and psychological environment. It is currently believed that the expression of genes largely depends on environ- mental factors. Consistent with this belief, Ayurveda emphasizes the role of environmental factors, daily routine, seasonal changes, lifestyle, diet, regular exercise, and body tonics (rasayana) in maintaining health. It also emphasizes that all needs of the body and senses must be in balance in order to avoid illness and maintain good health — a scientifically valid concept. 

The founding fathers of Ayurveda believed that the world is made up of five elements called Panch-mahabhuta. Their criterion was that an element must not be “divisible into” a new material. They determined that earth, water, fire, air, and space are indivisible and therefore designated them as the five basic elements (Panchmahabhuta). The human body in Ayurveda was also believed to be made up of these five elements. In order to understand the whole body physiology, Ayurveda postulates three main factors called tridosa, which are also called biomaterials, biofactors, or bioenergies. These tridosas or biomaterials are vata, pitta, and kapha. The primary dominant elements in vata, pitta, and kapha are air, fire, and earth, respectively. According to the tridosa theory the total human body consists of an intensive interplay of a solid material substrate referred to as kapha, chemical activity (biofire) referred as pitta, and an energy pool of motion and movement referred to as vata. These three dosas coexist in a predetermined proportion and function in a complementary manner to overall function of the total organism in spite of their opposite properties and functions. The existence of the dosas can be understood at both the macromolecular and micromolecular levels. A balance in the activity of these dosas is necessary for health. 

The human body according to Ayurveda is made up of somatic dosas (vata, pitta, and kapha) and psychic components (dosas), body tissues (dhatus), and waste products (malas). The three psychological components are satogun, rajogun, and tamogun. A close interdependence among the somatic and psychological components exists; if one component is out of balance, the others are also out of balance. The imbalance or vitiation of vata, pitta, or kapha is considered the major factor in the causation of a disease.

Ayurveda has a concept of agni (fire) for all digestive and metabolic activities. Use of the word “fire” can be rationalized based on the fact that fire generates carbon dioxide as a result of burning carbon-based materials, and metabolism of carbon-based nutrients in the body also generates carbon dioxide. Digestion and absorption processes are called digestive fire (pakwagni) and the enzymic action causing transformation of nutrients into various tissue materials is called tissue fire (dhatwagni). Food must not only be digested and absorbed from the intestine and circulate in the blood plasma, but also must be absorbed by the tissue cells in order to be assimilated by the body. There are seven primary supportive tissues (dhatus) in the body: (1) plasma, (2) blood, (3) muscular tissue, (4) osseous tissue, (5) adipose tissue, (6) marrow and myeloid tissue, and (7) reproductive tissue. All tissues are made up of cells with different structures and functions connected with other cells through minute channels or pores (suksma srotas) to receive and distribute nutrients and excrete metabolic waste products. This description of cellular communication in Ayurveda is consistent with the modern understanding of intercellular uptake and release of substrates and metabolites. All tissues have a material called activator, essence, or hormone (ojas) which has specific properties and functions that are perceived to produce a healthy essence. The properties and balance of excretory products (stool and urine) and breakdown products of tissues (nitrogenous products) are also important factors in determining health and disease.

Soure: Lakshmi chandra Mishra, scientific Basis for Ayurvedic Therapies; 2004 by CRC Press LLC

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