Similar to other traditions of nature-based medicine, Ayurveda teaches that vital energy, referred to as prana, is the basis of all life and healing.
As prana circulates throughout the human body, it is governed by the five elements: earth, air, fire, water, and ether. These terms represent subtle qualities of prana energy and how it expresses itself in the body. Health is a state of balance and harmony among the five elements, and illness occurs when there is imbalance or lack of harmony among them.
The five elements combine with one another into pairs called doshas. There are three doshas: vata (ether and air), pitta (fire and water), and kapha (earth and water).
Certain doshas predominate in each person from conception to determine their personal energetic constitution – called their prakriti – that stays with the person for life. Each person’s prakriti has an identifiable pattern in which one or more doshas are dominant. Thus, there are seven prakritis possible: vata, pitta, or kapha; the combinations of vata-pitta, pitta-kapha, or vata-kapha; and the most complex, vata-pitta-kapha.
Illness or imbalance is referred to as the person’s vikriti. The vikriti is described in terms of how the doshas are out of balance in comparison to the prakriti.
Ayurveda gives the highest priority to prevention, health promotion, and enhancement. When illness is present, however, it offers a complete system for treatment. The overall goal is always to foster balance and harmony among the doshas, and to purify and harmonize the entire mind/body system.
Disease entities or pathogens (germs, viruses) are not the main focus of treatment. Rather it is the person’s level of balance and harmony between the doshas and elements and the consequent level of the body’s resistance to illness that is of concern.
The health practices of Ayurveda are selected according to the person’s prakriti and what energetic imbalances may be present. Foods, herbs, exercises, and other treatments are all chosen on the basis of their ability to regulate certain doshas.
Food and diet: The regulation of diet as a form of therapy is a central ideal; an individual’s mental and spiritual development as well as temperament can be influenced by the quality and quantity of food consumed. An important principle in Ayurveda is that “there is nothing in the world that is not a medicine or food.”
Foods and herbs are described in terms of their energetic qualities rather than the chemical properties of Western scientific understanding.
Food should be eaten according to one’s prakriti (constitution). Certain foods should not be combined, and certain foods should be eaten at different times of day.
Spices are used to aid digestion or counteract the energetic qualities of different foods.
Chronobiology: Ayurveda holds that each 24-hour cycle is divided into four-hour segments that are governed by the doshas. From 10-2 (both a.m. and p.m.) is a pitta period, from 2-6 is a vata period, and from 6-10 is a kapha period. These time periods are believed to correspond with nature, and they dictate optimal times for certain activities or bodily functions such as exercise, work, rest, digestion, fasting, or healing. Practitioners guide patients to plan their activities to be in harmony with these natural principles of timing. For example, the mid-day pitta period is the time of strongest digestive function and should be the time of the largest meal; food should not be consumed during the night pitta period as this is a time of restoration and healing of vital organs.
Diagnosis: In an Ayurvedic theory, “diagnosis” means determining one’s prakriti and what imbalances are present (vakriti), not by labeling specific diseases with Western terms. Ayurvedic theory calls for diagnosis using a variety of sources of information. A practitioner usually conducts an extensive individual interview for taking a health history, which may include written questionnaires. This information is followed by pulse diagnosis (palpating the wrist to determine subtle qualities of the pulse). Practitioners may also evaluate the appearance of the tongue, face, lips, nails, and eyes for diagnostic information. Some use laboratory tests of blood, urine, and stools to assist with diagnosis.
Treatment: Treatment theory focuses on a comprehensive treatment plan (rasayana) that may combine dietary changes, herbs, meditation, breathing exercises (pranayama), Ayurvedic massage (abhyanga), yoga postures (asanas), detoxification and rejuvenation programs (panchakarma), and lifestyle changes. Thus, the bulk of the responsibility for treatment rests with the patient through integrating the recommendations into their daily lifestyle.
Most practitioners do not perform actual treatments or healing in the office, although some massage therapists will perform Ayurvedic massage.
Typically, the first consultation is the longest, lasting from 45-90 minutes. Follow-up consultations may be spaced several weeks or even months apart to monitor progress. These will usually be brief office visits involving diagnostic review and a fine-tuning of the treatment regimen.
Research support: Ayurveda is predominantly a “person-specific” approach. This means that two individuals with the same symptoms might be treated very differently in terms of herbal remedies, lifestyle changes, yoga postures, diet, or other factors. Such individualization makes it difficult to design Western-style clinical trials of Ayurveda treatment regimes. Nonetheless, several specific herbal formulations have been studied in Western-style clinical trials. Recent research in Ayurvedic genomics is examining if there is a link between a person’s genetic composition and their response to Ayurvedic treatments.