In general, meditation leads to slower breathing. A similar effect is achieved by prayer. That’s why, according to the American concept of mind-body medicine, prayer is a part of meditation. This may cause some furrowed brows—prayer as part of medical therapy? People pray for a variety of reasons, usually not to treat hypertension or headaches. But nevertheless it has a positive effect on our health. Of course, people with no religious background are unlikely to start praying solely for therapeutic reasons. But if you are already doing it, you can be happy about the fact that it also has a medicinal effect.
One of the researchers who published particularly impressive findings on the matter is the Italian physiologist and internist Luciano Bernardi at the University of Padua. He and his team have conducted research into the positive effects of slow breathing. In a couple of studies, they were able to prove that breathing according to ancient yoga techniques—wherein only six breaths are taken a minute—leads to positive effects in patients suffering from cardiac insufficiency. These people often breathe very fast in their desire to get more air, but this causes their breaths to be shallow. Many times, the shallow flow of air is not enough to achieve the necessary interchange of gases in the pulmonary alveoli, i.e., the coupling of oxygen to the red blood cells. As a consequence, they breathe even faster because they feel a shortness of breath.
Bernardi and his colleagues demonstrated that oxygen content in the blood increases as soon as patients are instructed to breathe calmly and slowly. Inspired by this observation they began to take an interest in other techniques of prayer and meditation, including those that work with mantras, the slow and repeated sequences of words. Many meditation techniques that employ mantras have been developed in Asia; in the Catholic Christian tradition there is the rosary prayer, which consists of periodic repetitions of word sequences, so-called decades. In the rosary, each prayer cycle is said over the course of one breath that lasts for about ten seconds—this comes out to six breaths a minute, which aligns with the six breaths of yoga. Bernardi and his team studied the rhythms of the pulse rate and the breath as well as the delicate coordination by the autonomic nervous system in three situations: having participants recite the Ave Maria in Latin, having participants recite the ancient Tibetan mantra “om mani padme hum,” and having participants speak normally.
Interestingly, reciting both the Ave Maria and the Tibetan mantra led to a breathing sequence of six breaths a minute as well as an astonishing synchronization and thus an improvement of heart, lung, and breathing rhythms. Even blood pressure and heart rate were lowered, and the cerebral blood flow improved. When speaking normally, however, the study participants took in more than twice as many breaths—fourteen times a minute.47
The repetition of religious prayers and mantras seem to have profoundly beneficial effects on our body. But it’s not just praying that is healthy—regular visits to church have a positive effect on our health, too, according to the findings of the largest study as of yet on the matter, published in 2016 in JAMA Internal Medicine. In the Nurses’ Health Study, the health and disease development of roughly 75,000 nurses was documented continuously over a period of sixteen years. During that time there were 13,500 deaths. After risk factors like smoking, high cholesterol levels, or insufficient exercise were excluded statistically, it became apparent that women who visited mass at least once a week had a death rate that was 33 percent lower than the average. This was especially significant in heart diseases, where the death rate was 38 percent lower, but also in cancer diseases (27 percent less). The researchers were unable to explain what exactly had caused this phenomenon. But it wasn’t just the solidarity within the congregation, the social factor. Maybe it was a trust in God that manifested itself in greater serenity.48
Unsurprisingly, people—religious or not—usually begin to pray when they are going through hardship, when they have grave sorrows. Intuitively, this relieves the stress they are under in that situation. Trust in God and church attendance probably also help against depression. Areas of the brain that are connected to positive moods show greater resonance in these instances. Though doctors certainly won’t prescribe a visit to church, for people who are already religious or practice spirituality it can constitute a further health-promoting reinforcement.
CHAPTER EIGHT
Global Medicines
Ayurveda, Acupuncture, and the Healing Power of Plants
It was the year 2006 and I found myself, still in Essen at the time, in a period of upheaval. I had just finished a study on yoga with impressive results, and from the growing success that mind-body medicine had in my patients it was foreseeable that meditation, which I was practicing with increasing enthusiasm, was the supreme discipline among the different relaxation methods and mental techniques. This shifted my focus increasingly eastward.
Up until that point, I had never been to India, and maybe that is why I realized quite late, but all the more intensely, that this country was an important birthplace of naturopathic medicine. After all, I had already developed a strong interest in Ayurveda—particularly within the scope of comparative traditional medicine that spanned the cultural areas of Europe, China, Tibet, and India. In doing so, some remarkable analogies had become apparent. Ayurveda, I noted, is among those healing methods that focus on the individual and is based on constitutional types. Beyond that, traditional Indian medicine emphasizes prevention, lifestyle, and self-efficacy. It has developed techniques that aren’t merely targeted at symptoms, but at an internal power balance. If necessary, eliminating methods like bloodletting and leeches are employed. Ayurveda possesses a range of healing methods and aims for the activation of self-healing powers. Just as in European naturopathy, chronic diseases and functional disruptions are the focus. What’s particularly great about Ayurveda is that it’s an undogmatic healing system and can be easily combined with Western naturopathy or even scientifically oriented conventional medicine.
AYURVEDA: HOW TO LEAD A HEALTHY LIFE
I decided to meet with Syal Kumar, a doctor trained in Western as well as traditional Indian medicine. Kumar came from a family dynasty of Ayurvedic physicians in Kerala, one of the birthplaces of Ayurveda. It was especially important to him that Ayurveda was understood and used as a healing method, not as an exotic wellness program. We began a discussion on what could be achieved with Ayurveda in Germany, especially in combination with Western medicine. Finally, my plans were made: I would bring him to the hospital in Essen. We thought about how we could integrate the Ayurvedic approach to therapy and garner a valuable collection of scientific data at the same time. As a first step, we bought an Indian treatment couch made of wood for oil treatments, an important part of this healing method.
In 2006, many Germans had already heard of Ayurveda, but patients had mainly images of palm-lined beaches and Shirodhara in their heads when we suggested an Ayurvedic treatment to them. In fact, Ayurveda is a complete system of diagnosis and therapies. In my opinion, it is the traditional healing method with the greatest body of practical knowledge and the most extensive collection of treatment details in the world. Records of European Medieval healing methods have—with a few exceptions, such as the works of Hildegard von Bingen—not survived. Traditional Chinese Medicine was largely revived in the twentieth century through state-controlled measures and programmatic politics initiated by Mao Zedong, since the huge country could not be supplied with Western medicine comprehensively, and because there was a desire to market parts of the healing system, especially acupuncture, successfully in the West.1
Ayurveda, on the other hand, has been practiced continuously for more than two thousand years. Accordingly, this healing tradition is an equal to modern medicine, recognized by the Indian government and bordering South Asian nations. Every year, hundreds of millions of people in South Asia are treated primarily with Ayurveda—while conventional medicine is only used in emergency cases.
By now, Ayurveda is recognized as a medicinal scien
ce by the WHO as well. In India itself, there are more than 400,000 registered Ayurvedic doctors and more than 250 tertiary institutions that offer an extensive training in Ayurveda, which lasts five to eight years. Ayurvedic physicians work at more than 2,500 hospitals and 15,000 outpatient clinics. This shows that in its country of origin, Ayurveda is anything but a wellness treatment.
At the center of Ayurveda stands the teachings of a healthy life—ayus meaning “life,” and veda meaning “the knowledge.” Their roots are anchored in the Vedas, the holy Indian texts that incorporate physical, psychological, and spiritual aspects of healing. In India, Ayurveda is also a reverence to the gods. After all, according to tradition, the creator god Brahma personally gifted this knowledge to humans.
Symptoms can be treated in numerous ways in Ayurveda, depending on the patient’s type. That the combination of body type, physical appearance, and behavior says something about the predisposition for certain diseases is also recognized in German naturopathy. In Ayurveda these factors are taken into consideration to choose the right therapies for each individual. You have probably already heard about the doshas: the combination of body type, skin, and hair, as well as the characteristics of numerous other physical traits that make up the three basic types in Indian medicine—vata, pitta, and kapha. But forget about the dosha tests you may have seen in magazines, cookbooks, or on the internet. All people are mixed types, and what constitution and individuality is present exactly can only be determined with professional experience.
In Sanskrit, the language in which the Ayurvedic texts (some that date back two thousand years) are written, the word “constitution” is called prakrti (“nature”). Constitution is inherent and doesn’t change, unlike the symptoms that it produces as a result of stimuli and stresses. These symptoms are called vikrti (“disturbances”), and it’s these disturbances that are being treated. Similar to the concepts of Chinese medicine, the doshas also express opposite poles of characteristics: vata symbolizes wind and movement, the airy. This can either be interpreted as ease or as being under too much stress (“being rattled”). Pitta symbolizes temperature, energy, and metabolism. Change, in other words, that is caused by fire. Kapha means “construction” and “mass” and is found in water and earth.
AYURVEDA THINKS IN CHARACTERISTICS
I would like to demonstrate here how complex the structure of Ayurveda is. The content, form, and direction of movement of a disruption are always analyzed and treated in conjunction with one another. The doshas exemplify principles that illustrate the three major areas of reaction patterns in a simplified manner. With their help, we as doctors keep track of the complexity of events in the body and the psyche. But the dosha theory can by no means explain all medical details. It would be too simplistic to divide all people and all diseases into only three groups. “The doshas are like primary colors,” explains Elmar Stapelfeldt, an Indologist and expert on Ayurveda who counsels many patients at the Immanuel Hospital in Berlin: “By using different mixing ratios, millions of colors are described and explained as patient histories.”
To describe the doshas more precisely, they are each allocated seven characteristics, the gunas. An arthrosis in the shoulder joint, for example, is attributed to an excess of gunas (dryness) and thus ascribed to the vata area. In Western medicine we diagnose a loss of synovial fluid and a painful constriction of the joint cavity coupled with a roughening of the cartilage layer—also a kind of dryness.
Western medicine is guided by a molecular biological model of the body—and analyzes enzymes, hormones, neurotransmitters, genes, or pathogens. That’s why it has developed into a highly specialized science that tries, on the micro level, to change, supplement, or disable some of these biological substances according to the lock-and-key model. Ayurveda, on the other hand, thinks in characteristics. “Movement,” the main characteristic of vata, fosters a milieu that generates stress symptoms, tension, indigestion, and concentration disorders. In the long run, “sour” (pitta) leads to inflammations whereas “sweet” (kapha) carries obesity and the danger of diabetes with it.
An essential instrument for influencing an imbalance of the doshas, and thus the symptoms of diseases, is nutrition. The power of digesting food is seen as the center of the body. This includes all substances and functions that dissemble the food, transform, and excrete it. Imagine a stove at the center of your body that needs a lot of energy to process a meal. That’s why we become tired after eating. The more indigestible things we eat—the heavier, more compact, and colder a meal is—the more energy we use, and this energy is then lacking in other areas of the body.
The Ayurvedic Treatment of Arthrosis
Understanding the Sickness
According to the teachings of Ayurveda, every human being contains a balance of three doshas, or constitutional types: vata, pitta, kapha. If one of the doshas is excessively dominant, symptoms of a disease develop. The aim of Ayurvedic treatment is to reinstate a balance of the constitutional types.
Sickening Factors
Poor diet, physical stress, trauma, worries, anxieties, stress, suppression of bodily needs
Symptoms
Pain, inflammations, degradation of cartilage, and restriction of movement are typical symptoms of vata.
Diagnosis
By observing the tongue, eyes, physique, urine, feces, heart rate, palpating, auscultation, as well as using modern diagnostics: laboratory and imaging methods
Therapy
Reducing the vata through excretion (e.g., purging, sweat baths), manual therapies (e.g., massages), treatment with medications (e.g., nose oil, medicinal herbs), diet, behavioral modifications (e.g., daily-, sleep-, and eating rhythms)
Internal heat is central in Indian medicine. Internal heat is fueled by warming soups, ginger tea, and spices. In Ayurveda, spices are an everyday component of a healthy life. They are meant to stimulate the agni, the “digestive fire.” Modern nutritional science focuses on the ingredients of food and places little importance on how meals are consumed and processed within the body. But in Ayurveda the physician diagnoses the condition of the agni as a key factor. It can be weak, slow, and sluggish (mandagni), a sign of the kapha dosha; this leads to burping or bloating. An irregular agni (vishamagni) changes often, fitting the “animated” vata type. In pitta people, the agni is often “too sharp, penetrating” (tikshnagni). People of this type are often hungry, suffer from acid reflux, and don’t put on weight, no matter how much they eat.
Supporting the agni is the first and most important step of Ayurvedic nutritional therapy. This first step is easy to implement and maintain and is quite effective. In the second step, the individual dosha is taken into account for specific recommendations—such as eating less wheat, avoiding certain kinds of vegetables or spices or, on the contrary, using larger quantities of them.
Finally, there is the mala, which we would translate as “by-products and wastes.” Generally, mala denotes all substances that do not belong in the body, i.e., environmental toxins, unhealthy foods, tobacco, alcohol, and particularly metabolites that have not been broken down. In Ayurveda these substances are called “sticky”—they aren’t easy to get rid of. When you try to excrete them, you harm tissue that occurs naturally in the body—as though you were trying to squeeze juice from unripe fruit. It is necessary to stimulate the metabolism first in order to transfer the mala into a state in which it can be excreted. This is achieved by fasting or through eating light, warm meals. According to Ayurveda, animal proteins contained in meat and cheese (especially mold cheese) as well as cold foods are generally hard to digest.
Just as Ayurvedic medicine focuses not on individual substances but on complex relationships between characteristics, it also doesn’t take an interest in individual cells or organs, but in entire tissues. They permeate the whole body and symptoms manifest themselves in them. An important term in this is the rasa, the nutritive fluid. It contains the nutrients tha
t are distributed to all tissues via the blood. Rasa is a force that also includes mental and immunologic bodily defenses. Healing oils that are often massaged into the skin are involved in its regeneration. Fatty acids also ensure that the plant-based components are able to penetrate the connective tissue better.
It’s not always easy for patients to think in processes and characteristics in this manner, especially since it can contradict our general idea about what is “healthy.” There are no healthy or unhealthy foodstuffs in Ayurveda, only suitable or unsuitable ones. An orange, rich in vitamin C, may be healthy according to Western thinking, but is wrong for a pitta type. The same goes for pickled vegetables, i.e., vegetables that have been preserved by malolactic fermentation or immersion in vinegar and that are considered a health food in the West because of their lactobacilli content.
Patients quickly notice how pleasant changing their dietary habits is. Then they are delighted to find that they not only feel better with having a warm lunch, which they had hitherto denied themselves, but that they also tend to lose weight—because the “digestive fire” is unburdened by it. Many value Ayurvedic dietary therapy also because it’s easy to integrate into their daily routine.
Even the initial experiences with food showed that Ayurveda has an immense potential. We recommended Ayurvedic treatment to patients who didn’t achieve sufficient successes despite our extensive range of naturopathic therapies—often with surprisingly positive results.
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