Time (kala) or change (parinama) is the principal causative factor for ageing and degenerative diseases. Parinama, or change, is the sequential event of the ageing process which goes through the stages such as infancy (Balya), adolescence (Tarunya), youth (Youvana), middle age (Proudha) and old age (Vardhakya). While it is impossible to stop the process of change (parinama) or the advent of time (kala), it is possible to identify the impact they have on the body and find ways to slow it down.

(Kalasya parinamena Jara Mrityu nimmitaja

Rogas swabhavika drusta swabhavo nispratikriya) -- (Charaka Samhita 1/115)

Time (kala) or change (parinama) is the principal causative factor for ageing and degenerative diseases. Parinama, or change, is the sequential event of the ageing process which goes through the stages such as infancy (Balya), adolescence (Tarunya), youth (Youvana), middle age (Proudha) and old age (Vardhakya).

Sage Sharngadhara notes that with each passing decade, the body loses -- one by one – felicities such as growth, luster and complexion, intelligence, skin health, strength of sight, virility, valour and sensory perceptions. While it is impossible to stop the process of change (parinama) or the advent of time (kala), it is possible to identify the impact they have on the body and find ways to slow it down.

Ayurveda, which has a holistic approach to life, has thought through this and hence we have Rasayana Tantra, one of the eight branches of Ashtanga Ayurveda, dealing exclusively with rejuvenation. Acharyas like Charaka and Vagbhata named the very first chapters of their books Deerghamjivitiyam (long life) and Ayushkamiyam (desire of life) respectively, in which the measures to be adopted to gain a longer and healthier life were enumerated. This proves that Ayurveda has long back incorporated viable and vibrant concepts of rejuvenation in its scheme of things.

Rasayana (rejuvenation) and Vajeekarana (revitalisation) are meant to re-energise tissues that were worn out or are in the process of wearing out due to factors like disease and ageing. There are exhaustive procedures that enhance the immune system, arrest ageing, give luster to skin, provide youthful energy, nourish blood and body tissues (saptadhatus), and eliminate senility and other diseases. They also enhance health and Ojas (vital force).

The procedures include administration of drugs with specific qualities such as immune-modulation, antioxidant action (which prevents bio-oxidation thereby checking age-related disorders, autoimmune disorders, degenerative disorders), and adaptogenic effects.

The Principle

A guiding principle of Ayurveda is that the mind exerts the deepest influence on the body. A state of balanced awareness in an individual leads to maintaining right attitudes, there-by right actions and finally culminating in a higher state of health. Disease is seen as a result of climatic variations, bacterial attack, nutritional deviance, and stress as well as other emotional imbalance. Optimal health is achieved by cultivating mental, physical and dietary habits that are conducive to physical and spiritual well-being.

Primary concepts of health

Panchamahabhutas, tridoshas and sapta dhatus are the foundational constructs of Ayurveda. In addition, the concept of mala, agni and srotas add value and strengthen them. As per Ayurveda, every living thing is made from the combination of panchamabhutas, i.e, the five basic eternal substances or elements: solid (prithvi), liquid (jala), energy as heat and light (tejus or agni), dynamic energy state of matter (vayu) and the time space entity (akasa). Similarly, the universe and everything contained within it is made of the panchamahabhutas and the universal consciousness.

The human body is composed of three fundamental constructs called doshas (three in number), dhatus (seven), and malas (three). The tridoshas (vata, pitta, Kapha) are composed of the panchamahabhutas but one or the other is predominant in each one. Thus, the vata dosha has akasha and vayu dominating, pitta has agni dominating; and kapha has jala and prithvi dominating. The sapta dhatus are the seven basic tissue elements that make up the structure of the human body and include chyle, lymph, plasma (rasa), haemoglobin in blood (rakta), muscle tissue (mamsa), fat or adipose tissue (medas), bone tissue including cartilage (asthi), bone marrow (majja), and semen, sperm or ovum (sukra). The malas are the waste products of the body. The principal malas include urine, stool and sweat. The other waste products are fatty secretions of the intestines or skin, ear-wax, mucous, saliva, beard and body hair, nails, tears etc.

Agni is the primordial digestive fire in the body, tantamount to enzymes, that is responsible for the conversion of food into doshas, dhatus, and malas. Agni thus has a two-fold role: help in the digestion (breaking down catabolic metabolism) and assimilation (synthesis, regeneration and growth-anabolic metabolism) in the body. There are 13 main groups of agnis. One among them, jatharagni (in the GI Tract) enables the primary digestive process and breaks down the food. Thereafter the food is broken down into five mahabhutas by the five bhutagnis (mainly in the liver) so that the essential constituents of the ingested food are ready for absorption and assimilation. Thereafter, the seven dhatvagnis assimilate and ensure renewal/ growth of the seven dhatus which constitute the human body.

Srotamsi or srotas represent the channels in the body through which the doshas, dhatus and malas circulate. The 13 srotas include the big channels such as the GI tract as well as micro channels such as the capillaries. For proper functioning of the body, the agni has to function in equilibrium (samagni under the influence of the three doshas in equilibrium), and function without weakening (mandagni under the influence of kapha) or not function excessively (tikshagni under the influence of pitha) or not function unstably, i.e; agni which oscillates (vishagni under the influence of vata). Further, the srotas has to remain unobstructed and circulation must proceed in an uninterrupted way, failing which the process of metabolism is affected and ama or toxins are produced. Usually an organ or tissue that is intrinsically weak or which is similar in mahabhautic composition has a greater tendency to accept the ama or toxin, leading to manifestation of disease in the organ or tissue.

Ageing

The human body sustains vitality through a continuous process of disintegration and integration of each and every tissue in the body, co-ordinated and enabled by the doshas. The various kinds of tissues (dhathus) are replenished in the course of metabolism. The nutritional part is assimilated and the residue is left for elimination through various channels. However, any disorder such as faulty diet and lack of exercise can upset the system of metabolism. If the metabolic waste is not properly eliminated, it accumulates in a putrefied form, as toxins, in the various tissues and organs and channels. This upsets the balance of the doshas, resulting in disease.

The word doshas has a two-fold meaning – that which instigates proper function in proper conditions of life, and that which pollutes the tissues and disturbs the various functions of the various subsystems of the body. With a proper lifestyle (physical, mental and spiritual), the doshas ensure health. When the lifestyle changes and becomes vitiated, the functioning of doshas changes, and the balance is lost, resulting in diseases. The symptoms of health denote ease, pleasantness –mental and physical. In disease, as the term itself denotes, the ease is lost and the symptoms indicate unpleasantness and pain. Health is the natural state of the mind-body system, and diseases its unnatural state. Thus, according to Ayurveda, rejuvenation essentially means that the doshas remain in equilibrium, so that the body replenishes itself. When the metabolic process is hampered, the replenishment slows down, speeding up the process of ageing.

Preservation of good health is made possible by the observance of the regimen of swasthavritta as represented by dinacharya (daily routine) and ritucharya (seasonal routine). Further, in the latter half of one’s life, the practice of injunctions-- laid down by sage Charaka in the chapter on Janapadodhwamsaniya (in the Vimanastana), as well as the adoption of measures, described by him under rasayana and vajeekarana therapies, shall promote vitality, virility and sustenance of good health. In Ayurveda, treatment is not just about curing a disease; it also aims at promotion and preservation of health and strength. This is undertaken by:-

1)     Removing the causative factors of the disease.

2)     Restoring the doshic (dosha-dhatu-mala) equilibrium.

The achievement of these two-fold aims depends upon effective fulfilment of the role of the four essential limbs of therapy or chatuspada; the Physician, medicinal drugs as well as food substances, the attendant and the patient.

Role of purification therapy

Treatment in Ayurveda essentially means to regain the vital strength; the accumulated waste has to be eliminated to make the tissues (dhathus) pure. If the accumulation of toxins is moderate, it can be transformed by medicine and easily eliminated in the natural course of the system, by milder palliative treatments known as samana chikitsa (pacification therapy). Samana chikitsa ignites the vital fire, the agni, responsible for digestion and metabolism. A man with good and natural digestive functions and a correct lifestyle seldom gets sick; and if on account of omissions and commissions gets disease, it can be easily corrected and cured with simple medication – yukthivyapasraya, the rational application of drugs. If accumulation of toxins is excessive, the lifestyle corrections and medication may not suffice and has to be cleared by evacuative-cleansing treatment, ie, sodhanachikitsa or purification therapy. Panchakarma is the most known process of purification therapy.

Ayurveda has, thus, laid a full roadmap for the rejuvenation of the body and mind through an elaborate process, which includes various treatments such as samana, sodhana, dietary control and a strict adherence to a proper daily and seasonal routine.

 (The author Dr B Rajeev is an honorary consultant, Amrita Institute of Medical Sciences, Kochi.)