Exploring insights towards definition and laws of health in Ayurveda: Global health perspective

Abstract

The current healthcare system is focused on disease management. Our current approach to treatment begins only after the diagnosis, and then attempts to treat the symptoms and prevent the progression. Despite increased global healthcare spending, there has been an increasing incidence, and severity of diseases pointing to impaired health of the populace. This progressive deterioration in general health has created an unsustainable increase in healthcare costs that has hampered the economy. Much of the rising costs in healthcare are secondary to treating the progression of preventable diseases and focus on creating new treatments. There has been an ongoing discussion of incorporating a "defense" or prevention as part of our health system. However, there are few established guidelines beyond tactical use of vaccination in known infectious diseases and screening for chronic diseases and cancers. Ayurveda has the core competency and strategy for prevention of disease. Sushruta has propounded the laws of health, which are unknown to the current healthcare system. This article describes these laws and strategic combination of Ayurveda (defense) and modern medicine (offense) to create a complete healthcare system. This system is called Symbiohealth and is potentially more effective, less expensive, less toxic and creates a healthier society.

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identify the factors contribute to disease process and recommend
removing them, such as diet and exercise in heart disease.
Patient: So, your defense strategy is only against diseases where
the cause is known? That does not seem like a proactive defense
strategy, but more like a reactive tactic. In order to have a good
defense strategy you have to ask different set of questions, such
as why the majority of population does not have a specific disease
most of the time? What is health and how it can be protected,
enhanced, and rejuvenated?
Doctor: That makes sense!
Patient: Doctor, are there any laws of health?
Doctor: I don’t know. I have not read anywhere.
Patient: After all, when Newton discovered the laws of
gravity – they have always existed and exhibited a particular
pattern. There must be undescribed laws of health, don’t you
think?
Doctor: Hmmm… And so the dialogue continues.
I started to ask the question, what is health?
Modern medicine healthcare providers understand
health as the “absence of disease”. The World Health
Organization (WHO) uses a more holistic view of health;
“state of complete physical, mental and social well‑being
Introduction
Having practiced modern medicine for many years in the field of
rheumatology, I have the views and opinions on healthcare similar
to those of any experienced physician in my field of practice. But
when I had a heart attack a few years back, I found myself in the
position of the patient. Since then, an internal dialogue has been
going on between the patient and the doctor within me.
A question that my “patient self ” asks my “physician self ” is, as
a modern medicine physician what can you do at the fundamental
level to help your patients?
Doctor: We can ask four questions leading to the diagnosis,
etiology, pathology, pathophysiology and treatment of the disease
afflicting the patient.
Patient: In other words, you find the disease and try to remove it?
This seems like an offense strategy. What do you do to prevent
disease, or what is your defense strategy?
Doctor: In the case of known infectious diseases, we create
vaccines and in certain diseases where the cause is not known, we
Address for correspondence: Dr. Gopal Basisht,
1300, Edgewater Dr. Orlando, FL 32604, USA.
E‑mail: gopalbasisht@gmail.com
Invited Article
Exploring insights towards denition and laws of health in
Ayurveda: Global health perspective
Gopal Basisht
Senior Consultant Rheumatology, Orlando Health, Orlando, Florida, USA
Abstract
The current healthcare system is focused on disease management. Our current approach
to treatment begins only after the diagnosis, and then attempts to treat the symptoms and
prevent the progression. Despite increased global healthcare spending, there has been an
increasing incidence, and severity of diseases pointing to impaired health of the populace. This
progressive deterioration in general health has created an unsustainable increase in healthcare
costs that has hampered the economy. Much of the rising costs in healthcare are secondary to
treating the progression of preventable diseases and focus on creating new treatments. There
has been an ongoing discussion of incorporating a “defense” or prevention as part of our
health system. However, there are few established guidelines beyond tactical use of vaccination
in known infectious diseases and screening for chronic diseases and cancers. Ayurveda has
the core competency and strategy for prevention of disease. Sushruta has propounded the
laws of health, which are unknown to the current healthcare system. This article describes
these laws and strategic combination of Ayurveda (defense) and modern medicine (offense)
to create a complete healthcare system. This system is called Symbiohealth and is potentially
more effective, less expensive, less toxic and creates a healthier society.
Key words: Allopathy, Ayurveda, disease, health, healthcare, prevention, Symbiohealth
Access this article online
Website: www.ayujournal.org
DOI: 10.4103/0974-8520.158975
Quick Response Code:
AYU | Oct‑Dec 2014 | Vol 35 | Issue 4 351
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Basisht: Are there Laws of Health?
352 AYU | Oct‑Dec 2014 | Vol 35 | Issue 4
and not merely absence of disease or infirmity.”[1] After a
“global conversation” and a 2 days meeting in Netherlands in
2009, a group of healthcare academicians, practitioners, and
administrators proposed a new definition of health as “ability
to adapt and self manage in the face of social, physical,
and emotional challenges.” It was also observed that WHO
definition has “unintentionally contributed to medicalisation
of society, as more and more human characteristics are
recruited as risk factors for disease and it minimizes the role
of the human capacity to cope autonomously with life’s ever
changing physical, emotional, and social challenges and to
function with fulfilment and a feeling of well being with a
chronic disease and disability.”[2,3] The definition of health
should be specific, clear and should guide the healthcare
provider how to achieve it. Between the period of 1200 BC ‑
600 BC, Sushruta, a great surgeon and teacher of Ayurveda[4]
defined health as “a state of equilibrium of Tridosha
(fundamental physiological governing principles of the
body), Agni (metabolic and digestive processes) and Dhatu
(principles that uphold the formation of body tissues). Waste
products are excreted well. The sense organs, mind and the
soul are in a state of bliss.”
A careful look at the Ayurvedic definition reveals that this
definition not only defines health but also includes a path to
achieve it.
I call these five laws of health, and have enumerated them
below:
First law
Connection to the source (consciousness), Indriya or sensory
faculties (vision, hearing, smell, taste and touch) and psyche
should be working well in coordination with body and the
person is in a state of bliss. This is achieved by meditation,
Pranayama (disciplined breathing) and Yoga exercise.
Meditation
According to National Institute of Health meditation may
reduce activity in the sympathetic nervous system (fight‑or‑flight
response) and increase activity in the parasympathetic nervous
system (heart rate, breathing and digestion), resulting in a
variety of medical benefits.[5]
Pranayama
Breath regulates systems of the body and slow deep breathing
cleans out the system and prolongs life.[6] The practice of
Pranayama has been shown to reduce the frequency of asthma
attacks,[7] increase vital capacity of lungs, reduce cholesterol,
lower blood pressure, slow down heart rate and regulate adrenal
cortical functions.[8] All of this increases immune system
function.
Yogic Asanas or exercise
The amount of exercise needed by an individual depends upon
the psycho‑physiological constitution or Prakriti of a person and
season of the year. Many scientific studies support the health
benefits of regular moderate exercise or Yoga.[9]
Second law
Equilibrium of the three Doshas is the second requirement of
health. The Doshas are fundamental physiological governing
principles of the body and are described in further detail later.
The equilibrium is achieved by daily and seasonal purification
of excessive Dosha.
Third law
Equilibrium of Agni (responsible for digestion, metabolism
and transformation) is third requirement of health. Most of
the disease states are from decreased Agni (Mandagni). Agni is
stimulated by:
Discipline in eating guided by state of physiology and disorders
in system or Prakriti (body type). By eating warm, light and
fresh food when hungry. Stimulation of Agni by herbs like
ginger and Panchkola. Ayurveda describes diet and nutrition
covering the taste, quality of food, time of the day and season
and state of body physiology.
Digestive stimulants help in digestion of food and Ama (partially
digested food and toxins).
Fourth law
All seven Dhatus or principles that uphold the formation of
body tissues with their subtypes (Upadhatus) need to be in
balanced state. Dhatu potentiation and quality improvement is
done by Rasayana (rejuvenation) treatments, which are:
• Conscious eating (Ahar Vidhi Visheshayatana)
• Behavioral (Achar Rasayana)
• Anti aging and immune enhancing preparations (Oushadh
Rasayana)
• Purfication therapies (Panchkarma).
Fifth law
Waste products of digestion and metabolism at various levels
be well excreted.
• Avoid suppression of natural urges
• Evacuate and clean body cavities regularly.
The above five methods not only help in their specific
category but also reinforce all others. For example, Meditation,
Pranayama and Yoga, helps in balancing the Doshas, Agni,
Dhatus and excretion of waste products.
Establishing a state of equilibrium in the body, as described
by the laws of health, and in the universe is a key element in
achieving perfect health.
As a matter of fact, Ayurveda begins the study of health
with consciousness and takes the knowledge‑seeker through
the aforementioned Laws of Health, while also describing
a comprehensive lifestyle to follow these laws. Ayurveda,
therefore, provides an excellent defense strategy. On the other
hand, modern medicine starts from conception of fetus and
addresses symptoms of disease. It has a comprehensive method
of identifying and treating a disease, but not preventing it.
During this period, I also started to identify various phenomena
in life where there is duality, for example duality in thinking
is reflected in right or left‑brain persona. Left brain thinking
is linear with narrow focus of attention, articulate, good
in arguments, attention to detail, narrow cause and effect
relationship, quick results in the fast pace life of today.
On the other hand, right brain thinkers possess broad and
sustained attention, are alert and connected, are emotional,
use metaphors (and artistic expressions), and are generally not
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Basisht: Are there Laws of Health?
AYU | Oct‑Dec 2014 | Vol 35 | Issue 4 353
argumentative.[10] Most of us have become left brain thinkers
since the time of Isaac Newton. Duality is also observed in
vision (central and peripheral vision), physics (Newtonian vs.
Quantum) and personal relationship (man and woman).
Duality is also present in medicine. I view this duality as the
offense (treatment) and defense (or preventative) approaches to
health. The current system of medicine takes a predominantly
offensive approach to healthcare.
Over the last 50 years, there has been an increasing incidence,
frequency and severity of chronic diseases pointing to impaired
health of the populace.[11] This progressive deterioration in
general health has created unsustainable increase in healthcare
costs that has hampered the economy. There has also been
impaired health of the planet with environmental degradation.
In the recent years, there have been efforts to improve the
environment or the health of the planet. It has faced opposition
because of prohibitive cost, myopic thinking and the inability
to comprehend the problem. Human beings are a microcosm
of the planet[12] and exhibit holographic phenomenon.[13]
Improvement in our health is crucial to the improvement of the
planet’s health [Figure 1].
According to Ayurveda, the evolution starts with consciousness
creating five elements; space, air, fire, water, and earth. These
five elements in different combinations create the three Doshas.
These Doshas are fundamental physiological governing principle
of the body. Each person is born with unique combination of
these three Doshas called Garbhaj Prakriti, which remains fixed
for life. This is compared to modern science where each person
is born with unique set of genetic polymorphisms. The effect of
environment, food, and lifestyle alteration and stress can lead
to disequilibrium of Dosha (Jataj Prakriti). When there is too
much alteration of Dosha, pathology or Vikruti occur causing
diseases, if not checked. Parallels to this concept are being
studied in basic science laboratories Epigenetic alterations can
turn on or off certain genes, in response to the environment,
diet, and lifestyle‑with consequences of aging and diseases.[14] If
good genes are suppressed and bad genes are activated, disease
occurs. However if good genes are activated and bad genes are
suppressed, health occurs [Figure 2]. This process has been
described in cancer[15] and various other autoimmune diseases[16]
and aging.[17]
It seems both systems (Ayurveda and modern medicine) address
the same issue, but at two different levels of physiology‑while
Ayurveda describes a disease at the phenotypic level, modern
medicine explains it at the genetic level. Ayurvedic scholars,
thousands of years ago, lacked current technology and
microscopy to identify genes. They bypassed that handicap by
using phenotype to provide personalized care to all patients.
Let us see some of the phenomenon where this overlapping of
thinking between Ayurveda and modern science is seen:
• Ayurveda heralded the concept of personalized medicine
in its identification of unique body type or Prakriti of a
person. Prakriti is phenotype of unique genetic sequence.
On identification of Prakriti and its alteration (Vikriti)
physician knows what disease a person is predisposed
to and is able to diagnose the disease in early stages
before the disease manifestations begin and can provide
Ayurvedic treatments, diet, exercise and other lifestyle
measures
Today modern medicine is just beginning to explore how to
administer treatments and drugs that are highly tailored to
an individual’s genetic and chemical makeup and lifestyle
There is research supporting the role of Dosha or Prakriti
in relation to disease. Recent studies have shown that
different teams of Ayurvedic practitioners can consistently
identify a combination of Dosha in a person. In addition,
surveys created by an Ayurvedic team could predict
patient’s illnesses by identifying imbalances in Doshas[18]
• Ayurveda described the concept of genetics thousands of
years ago. The great Ayuvedic practitioner Charaka referred
in 1000 BC to “Bijabhagavayava” as the combination of the
Bija (what we know today as the male sperm and female
ovum), Bhaga (what we today call the mitochondria) and
Avayava is the DNA.[19] He wrote of the imbalances that
result when the parents have Dosha imbalances and pass
along diseases to their children
• Ayurveda identified the interconnectedness between the
mind and the body and their reciprocal effect on health
when the two are not in balance
A key factor of Ayurveda is the idea that the mind and
the body are not separate; what happens to one influences
Figure 2: Pathway to health and diseaseFigure 1: Microcosm / Macrocosm holographic phenomenon
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Basisht: Are there Laws of Health?
354 AYU | Oct‑Dec 2014 | Vol 35 | Issue 4
the other. There can be no mental health without physical
health and vice versa, and one’s entire life and lifestyle
must be in harmony before one can truly be called healthy
Recent medical studies are finally connecting the impact
of psychological states such as anxiety and depression on
physical diseases. There is also comprehensive evidence that
personality traits – such as resiliency or optimism – can
have profound impacts on longevity and immunity[20]
• Charaka,[21] in context of Krimi (parasites), discussed
about the concept of macro and micro‑organisms
divided into two categories viz. pathogenic and
nonpathogenic.[22,23] These two categories of parasites
seems to simulate with “friendly” and “unfriendly”
bacteria. Evidence is emerging that bacterial flora is
linked to increased incidence of chronic and autoimmune
disease.[24] Furthermore, overuse of antibiotics can alter
the gut flora, causing irregularities in gut function,
including diarrhea and constipation
• The emerging field of epigenetic, or the study of why
certain genes “turn on” or “turn off,” is beginning to look
at what Ayurveda described thousands of years ago. In
other words, genes do not necessarily dictate our destinies.
Lifestyle changes including diet and removing stressors
can help patients fight back against genetic disorders.
Epigenetics can control the expression of genes. It is like a
charioteer controls the horses of a chariot or like software
of a computer
It is thought that lifestyle, psychological states, and one’s
physical environment alter or maintain gene expression
levels and patterns
An unhealthy lifestyle “turns on” the bad genes through
an epigenetic process, which in turn stimulates the
excessive formation of pro‑inflammatory cytokines or other
disease‑producing proteins. We have medicines that block
the effect of these cytokines, but we don’t know how to
stop their formation. And medicines often have toxic effects
But if we can figure out what factors can “turn on” the
good genes and “turn off” the bad genes, then we can
prevent disease. Recent studies suggest a link between
Ayurvedic Tridosha principles and phenotypes[25]
• Ayurveda can also better inform us about what causes
diseases, even before patients become symptomatic
In Ayurveda, there are six stages of disease:
Sanchaya (accumulation), Prakopa (aggravation),
Prasara (dissemination), Sthana Samshraya (localization),
Vyakti (disruption), and Bheda (manifestation). There
are no symptoms or vague complaints during the first
four stages. If a patient comes to a doctor during the first
four stages, the patient is often labelled a hypochondriac,
as modern medicine frequently does not have screening
techniques to identify early stages of disease.
Dual Healthcare Strategy
A common question asked is “Are you talking about alternative
or complementary medicine?” The answer is no. Currently
modern medicine, or offensive strategy, providers are looking
for treatments that are less toxic and/or more effective for
conditions where there is no current treatment available. This
article seeks to provide an answer to their search. The proposal
is a healthcare system where offense and defense strategy are
used based upon the need of the individual. A person without
disease does not need any treatment but should prepare
himself to protect his body from disease. However, if disease
occurs, an offense strategy will be utilized to treat the disease
symptoms and eradicate the cause of the disease. In addition,
an ongoing defense strategy will lessen the morbidity and
mortality secondary to the disease. While there is dialogue
about a defensive approach within the modern medicine
community, there are very few guidelines and research available
to both doctors and patients. However, in Ayurveda there is
comprehensive defense strategy.
Sushruta described the traits of health between the period of
1200 BC ‑ 600 BC[4] and Ayurveda provides ways to achieve that.
These laws should be debated and tested with the same rigor
applied to modern science. A physician should be able to identify
any disequilibrium in the patient’s physiology, guide the patient
to re‑establish equilibrium and simultaneously identify and treat
disease. This combination of defense and offense strategy can
provide the best and most cost‑effective outcome. This system
is called Symbiohealth [Figure 3]. As discussed earlier modern
medicine physician tries to answers four questions leading to
diagnosis, etiology, pathology and pathophysiology and treatment to
help patients with disease. Symbiohealth practicing physicians tries
to answer the four questions for treatment of disease and five more
questions for prevention of disease.
Acknowledgements
The author gratefully acknowledges the following for help in editing
and critiquing the article: Dr. Kartik Pattabhraman, Prof. S.K. Khandel,
Dr. Yogesh Deole, Dr. Sampath Parthasarthy, Dr. Bethany Powers,
Prof. R.H. Singh and Dr. Hari Sharma.
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Figure 3: Symbiohealth
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AYU | Oct‑Dec 2014 | Vol 35 | Issue 4 355
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How to cite this article: Basisht G. Exploring insights towards denition and
laws of health in Ayurveda: Global health perspective. Ayu 2014;35:351-5.
Source of Support: Nil, Conict of Interest: None declared.
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