AYURVEDIC CASE STUDIES
Veterinary Ayurveda: Cat Case Study
Healing the Damage from Alcoholism: Case Study
Extreme Vata: Case Study
Kapha Clients: A Case Study
Veterinary Ayurveda: Cat Case Study
by Dr. Alakananda Devi
In this paper, we present case histories of a family of five geriatric cats, four litter mates, the fifth a male foundling. We will discuss the cats’ symptoms, Ayurvedic diagnosis, treatment protocols and responses with a view to demonstrating the immense potential benefits that Ayurvedic approaches have for the welfare of companion animals.
The cats in question all receive a mono-diet of Avoderm, a high quality dry cat food. They also receive an afternoon snack of organic baby food, as well as some fresh vegetables. All these elderly cats, with their long history of mono-diet, are in the vyakti and bheda stages of the kriya kala process. Neither the cats, the pet-guardian nor the veterinarian were receptive to the suggestion of changing or varying the cats’ diet in any way. At this stage, since the cats have advanced kidney disease, their vet prefers dry cat food as lower in protein and hence easier on the kidneys. Ayurvedic treatment has thus proceeded ahead as best could be in the face of a continued mono-diet of a high carbohydrate food rich in corn, a major allergen and pitta≠-provoking substance. The causative factor of many of the cats’ severe health challenges--a carbohydrate rich mono-diet of rough, dry food--continued unabated.
It is worth noting here that a cat’s natural life expectancy is about twenty-five years. The emergence of a geriatric condition in sixteen-year-old cats, although very familiar to all of us, would be rendered unnecessary were the cats fed in an optimal way throughout the duration of their lives. Cats would likely become geriatric sometime in their twenties.
Diagnosis of the cats took place by the usual method of darshanam, sparshanam and prashanam. Darshanam includes examination of fur health, weight, muscle bulk, eyes and tongue. (Cats yawn freely frequently, thus providing good access to examine their tongues). Sparshanam included examination of the pulse just above the cat’s front paw. The method of pulse diagnosis used was that outlined in Secrets of the Pulse by Dr. Vasant Lad. Prashanam took place by questioning the owner and by attuning psychically to the cats.
Helpful
Case Presentation A sixteen-year-old male cat, Helpful was brought to me for help with his diabetes. The task requested of me was to focus on reducing his insulin usage, leaving the vet to manage his overall condition.
Pulse diagnosis: Prakruti: V1P3K3 Vikruti: V2P4K4, Udana and samana vaya, ranjak pitta and sleshak kapha showed impaired function. There was excess raw ojas, indicating a blood lipid imbalance. The liver and colon pulses were weak with pitta, the bladder weak with vata and pitta, and the kidneys weak with vata.
Helpful had a long history of giardiasis. In 1999 he suffered a seizure as a result of metronidazole administered for the giardiasis. He had osteoarthritis and was unable to jump. He also had renal disease and chronic cystitis. His fur was dry, lusterless and ragged.
Chikitsa (treatment):
Helpful was given triphala guggulu, one 0-capsule daily and the following formula:
shardunika 3: haridra 4: neem 1: bibhitaki2: shankapushpi 4: punarnava 5: vidanga 1, one 0-capsule thrice daily.
Because I felt that it would be impossible to control his blood sugar as long as he had active giardiasis, I also gave him a krumigna formula with vidanga and pomegranate skin. The same formula was given to all five cats to prevent Helpful being reinfected by his companions.
Outcome: Within a month, Helpful was able to jump and climb again. His ragged fur molted away and he developed a luxuriunt, shining coat. His temper improved and his insulin usage gradually decreased from 2 units twice daily to 0.5 units twice daily.
Sadly, Helpful developed an incurable cancer, resulting in his being euthanized. Despite the added physiological stress, his blood sugar remained excellent to the end. We supplied his guardian with Ganges water and holy ash, which were administered to ease his transition and promote a good rebirth, according to the ancient traditions of sannatan dharma.
Grey
Grey is the male foundling, aged about 12-13 years. He had scar tissue on his vocal cords and could barely mew. His guardianís main concern was his aggression with the other cats.
Pulse diagnosis: Prakruti: V3P3K1 †and Vikruti: V4P3.5K1. He also had pitta in the thyroid gland, an early-warning signal of throxoscicosis, which frequently affects cats. I immediately requested that he be taken off thyroid supplementation, which he was receiving.
Chikitsa (treatment):
Herbs: yesti madhu 2, shatavari 5, ashwaghandha 5, dashamoola 5, shankapushpi 4, sarasvati 2, one 0-capsule thrice daily, brahmi one 0-capsule 2x daily.
Within a couple of weeks on this program, Grey became less aggressive, although the difficulty of unrelated male cats cohabiting can never be completely helped by herbal remedies. He gained muscle weight and his fur thickened. As a result of the krumigna formula given to all the cats, Grey and all his companions became giardia free for the first time in ten years. After six months of treatment, Grey suddenly began mewing loudly and sweetly. This was especially noticeable to his guardian, who is hearing-impaired. Previously, Grey ís mews were not audible to her; now they are loud and clear.
Butterscotch
Another geriatric cat, Butterscotch had glomerulonephritis with renal enlargement. His prakruti was V3P3K1 †and vikruti: V4P4K1. He was also diagnosed with hyperthyroidism, although the pulse revealed vata in the thyroid indicating irregular thyroid activity.
Chikitsa:
Because of this finding, we advised that the Tapezol be discontinued and he be given the following herbal protocal: kaishore guggulu one 0-capsule daily. (a 0-capsule is between 1/16 and 1/8 tsp, an ideal dose for a cat). He was also given: punarnava guggulu 5, bala 5, gokshura 5, yesti madhu 2, one 0-capsule thrice daily.
Butterscotch had been needing twice daily fluids for dehydration for the previous six weeks. After three days on his formula, he no longer needed fluids. From a semi-moribund state, he gained muscle weight, resumed walking, and became less stressed. He became responsive to his guardian and the other cats, and began acting normally, no longer manifesting as an invalid or terminally ill cat. His fur became thicker and stronger.
Liquorice
A littermate of Butterscotch, Liquorice was complaining of arthritis, cystitis, and giardiasis. Like Butterscotch, he had vata in the thyroid pulse. His prakruti was V2P3K1 †and vikruti: V2.5P3K1.
Chikitsa:
Herbal protocol: He was given:kaishore guggulu 2, guduchi 5, shankapushpi 2, mutral 2, one 0-capsule thrice daily.
As a result, his arthritis gradually improved. After six months on the herbs, he regained his ability to jump up and down. His cystitis symptoms also abated. Two months later, he had major dental work. As a result of a broken tooth, he then developed toxaemia and was given Baytril injections. He became pitta-provoked from the antibiotics and was given a new formula: kaishore guggulu 2, punarnava 3, gulvel sattva 1, yesti madhu 2, shankhabhasma 1, one 0-capsule thrice daily
This formula helped to control his pitta through he still tended to develop diarrhea if he went off the herbs.
Muffin
A geriatric female cat, Muffin was complaining of ulcerative colitis with chronic diarrhea, cystitis and low weight. Her prakruti was V3P2K1 †and vikruti: V4P3K1. She had vata in the thyroid pulse.
Chikitsa:
Herbal protocol:, arjun 4, kaishore guggulu 2, bala 5, shanka bhasma 1, gulvel sattva 2, yesti madhu 1, one 0-capsule thrice daily. Also: bhumyamlaki one 0-capsule once daily.
For the previous month, Muffin had needed nightly supplemental fluids. After two weeks on the formula, she no longer needed fluids. Her diarrhea continued for about three weeks more after which she began to have formed stools. She gained weight and her fur became thicker and softer. She later developed an eye infection which was effectively treated with one 0- capsule of turmeric twice daily.
Pet Guardian Comments
The catsí guardian remarked that her animals had been treated with allopathy, homeopathy, Chinese herbs, reiki, Feldenkreis, chiropractic and jin shin. In the face of all these multiple therapies, Ayurveda was the vital missing link in providing an enhanced quality of life for the cats and their guardian. In particular, Ayurvedic herbs ended a ten-year battle with giardiasis and provided a welcome relief from cystitis. The cats were able to drop their homeopathics and cranberry extract at a significant financial savings. The successful discontinuation of Butterscotchís Tapezol was also an important financial savings.
Discussion:
The cats’ guardian remarked that her animals had been treated with allopathy, homeopathy, Chinese herbs, reiki, Feldenkreis, chiropractic and jin shin. In the face of all these multiple therapies, Ayurveda was the vital missing link in providing an enhanced quality of life for the cats and their guardian. In particular, Ayurvedic herbs ended a ten-year battle with giardiasis and provided a welcome relief from cystitis. The guardian was able to drop the cats’ homeopathics and cranberry extracts at a significant financial savings.
Benefits of Veterinary Ayurveda
Veterinary Ayurveda provides a benefit for the animal, the pet guardian and for Ayurveda. For the animal, Ayurveda provides greater longevity and well being, a preventative approach and a deep respect for the innate self-healing power of animals. For the pet-guardian, Ayurveda provides a healthier, happier companion animal and a safer home environment, free from the hazards of cross-species communicable diseases such as giardiasis. Ayurvedic approaches are also less expensive than either allopathy or supplements, a benefit for the pet guardian’s finances.
For Ayurveda, the small-animal veterinary angle offers a significant research benefit, since cats and dogs are shorter lived than humans and so provide opportunity to observe the lifelong benefits of Ayurveda within a shorter time frame. Cats and dogs respond swiftly to herbs and diet adjustments, well-portraying the value of Ayurveda. Developing veterinary Ayurveda also affords an additional avenue for the mainstreaming of Ayurveda within the healthcare delivery system.
The Future of Veterinary Ayurveda
Since animal healthcare is the scope of practice of veterinarians, the future of this dimension of Ayurvedic healing depends upon encouraging vets to study and practice Ayurveda, just as they have enthusiastically embraced homeopathy, naturopathy and Chinese medicine. Vets should receive a full practitioner training with emphasis on pulse diagnosis, in-depth understanding of samprapti and a thorough knowledge of herbal formulation. Only if Ayurvedic vets are thoroughly trained will the full benefits and potential of veterinary Ayurveda become apparent.
Alakananda Devi, M.B., B.S., is a British trained physician who travelled to India in 1980 where she met her teacher, Dr. Vasant Lad. She was among the first Western physicians to take up Ayurveda. She is principal of Alandi School of Ayurveda, a traditional gurukula, in Colorado and is known for her insightful articles on Ayurveda. Contact information:
Tel: 303-786-7037 Email: alandi_ashram@yahoo.com
The author would like to thank pet guardian Kathleen Geary and the friendly staff of Colorado Canines and Felines.
Reprinted: Light on Ayurveda Journal, Vol. II, Issue 4, p. 18-19
Caring for Your Cat's Agni
As a carnivorous hunter, your cat's digestive system is very different from yours. Although the following rules may sound harsh from a human's perspective, they are essential for your cat's health.
1. Leave 12-24 hours between feedings
2. Do not expose your cat to the smell of cat food between feeding times.
3. All food MUST be room temperature to lukewarm, NEVER refrigerator-cold.
4. Feed your cat when he/she is most hungry. For many pitta cats, your bedtime is their dinner time.
5.Keep kitty's food bowl and utensils very clean.
6. Don't feed old or stale food.
7. Don't give kitty milk! Cats easily develop a severe addictive allergy to cow's milk.
8. Rotate protein sources. Cats readily develop food allergies and do not tolerate a mono-diet.
9. Avoid dry cat foods.
10. Your cat needs a calm, safe place to eat, where they have no fear of being chased or stepped on
Hazards of Dry Cat Food: An Ayurvedic Analysis
• It provokes vata because it is dry and rough (ruksha khara)
• It provokes pitta due to content of toxic chemicals such as ethoxyquin (used to harden rubber) and BTA. These lead to aggressive behavior and fighting. Even high-quality dry cat food such as Avoderm contains corn, a pitta-provoking allergen. Feeding of a mono-diet also causes food allergies and other pitta reactions, leading to diarrhea and ulcerative colitis.
• It provokes kapha because it is high in carbohydrates, an unnatural food for cats. Due to its unnatural dryness, dry cat food disturbs uddakavaha srotas (the water carrying channels) leading to diabetes, dehydration and thirst.
• Because the mouth of uddakavaha srotas in the renal glomeruli is the root of mutravahasrotas (urine carrying channels), cats fed on a diet of commercial dry cat food readily develop urinary stones, cystitis, or even glomerulorephritis (kidney disease).
• Commercial dry cat foods are extremely tamasic, often containing such items as rendered cats and dogs, cancerous parts of cows, meat from diseased animals (all so-called meat by-products) as well as sweepings from granary floors. Such foods can lead to prion-caused diseases such as mad-cow disease, as well as impeding the cat’s spiritual progress. (Companion animals live with humans in order to progress spiritually from human association.)
• Commercial wet cat foods also contain dangerous meat by-products. Use a good quality wet food such as Avoderm, Innora, Wellness or Wysong.
Healing the Damage Caused by Alcoholism: A Case Study
by Jacob Griscom, C.A.S.
Howie came for a consultation in January2003. Howie is a 52-year-old male working as an estate grounds-keeper. He came to me concerned about the damage he had caused to his liver during his years of alcohol abuse. He had high liver readings, as well as high cholesterol, and he has a history of cirrhosis in his family.
He has really turned his life around. He quit smoking, has been sober for two years, and is on a spiritual path with a regular yoga, pranayama, and mantra practice. He’s the type of client I feel honored to work with because of his enthusiasm and commitment to healing.
Howie had seen a western MD with an alternative approach. He was taking a lot of different herbs and supplements—over thirty—that his doctor had prescribed to try to reduce the high levels of liver enzymes and cholesterol. From an Ayurvedic perspective, some of these herbs and supplements could be classified as brimhana, or tonifying, others, langhana, reducing. Altogether, I’ve found that it takes a strong agni to digest and effectively utilize so many supplements.
Howie’s diet was fairly wholesome. However, there were some items very dear to him that he knew were not contributing to his well-being; those delightful caffeine-rich substances, coffee and chocolate often visited his palate!
In addition to the high liver readings, Howie was experiencing a subtle discomfort in the liver area of the abdomen. He had some bloating after eating, and occasional constipation, as well as burning arthritic pain in his joints that would flare up from time to time. Due to the stress being unable to reduce his liver readings, he was experiencing a full range of emotions from worry, anxiety and depression to anger and irritability. He noted that the irritability was foremost in his daily life.
A full history revealed a Pitta-Vata prakruti with a dominance of Pitta and secondary Vata in his vikruti. He is tall and thin with good muscle development but prominent bones, angular features, deep-set eyes, rosy complexion, and dry rough skin with wrinkles. Heat and dryness dominated his symptoms and systemic patterns. His tongue was long and pointed, red in color, with a midline crackvand a thick yellow coating in the small intestine and colon regions. His superficial and deep pulses on his right wriwt were strong, bounding, and wiry.
Howie had fairly strong ojas and significant ama, so langhana (purification) was called for. However, it was winter, so I decided to wait until the seasons began to change to really emphasize purification. The warmth of Spring naturally facilitates the removal of ama.
He was started on a Pitta-Vata pacifying diet with a preliminary emphasis on reducing coffee and chocolate. For this difficult assignment I used a formula that Caraka has given us:
On the first day one should give up a quarter of the unwholesome practice...and correspondingly adopt a quarter of wholesome practice ...on the second day give up half....on the fourth day, .... (1)
Each day he replaced some coffee with the coffee substitute, and did not experience any withdrawal symptoms. I also had him put all of his supplements and herbs on hold until the ama cleared, and I recommended a specific herbal formula for his digestion and another formula for his mind.
Digestive Formula (ratio):
2 Cumin(Cuminum cyminum)
1 Bhringaraj (Eclipta alba)
1 Triphala (Emblica officinalis, Terminalia belerica, Terminalia chebula)
3 caps 3x/day at meals with one half cup aloe juice
Cumin is a wonderful digestive herb, being tridoshic and very effective for digesting pitta-type ama. Bhringaraj and triphala are also very good in their abilities to clear ama and simultaneously act as rejuvenatives. Aloe juice is a terrific anupana to use for liver conditions because it is a liver tonic, tonifies the agni, and at the same time clears pitta.
Mind Formula (ratio):
3 Gotu Kola (Centella asiatica)
2 Skullcap (Scutellaria spp.)
2 Jatamamsi (Nardostachys jatamansi)
2 Shanka Pushpi (Evoluvus alsinodes)
1 Ashwagandha (Withania somnifera)
3 caps 2x/day morning and night with warm water.
Gotu kola is an alterative and a nervine tonic for pitta. At the same time is calms vata, and reduces ama. Skullcap has similar properties, but is bitterer and can aggravate vata. Ashwagandha is a nervine tonic specific for vata. Shanka pushpi is warm and jatamamsi is cool. Both are tridoshic tonic nervines and sedatives. This formula addressed his combination of emotional concerns, and supported the cleansing of the liver and blood.
As we continued working together, I introduced Howie to the Ayurvedic guidelines for healthy eating, helping him transform his eating into a form of sadhana. Howie’s symptoms improved over the first few weeks, as the weather warmed, he began a month-long khichadi mono-diet to clear the remaining ama and rejuvenate the liver. Khichadi mono-diets are ideal for those that do not have the financial resources to go through a full Pancha Karma. In fact, there are few that would not benefit from at least a short khichadi fast at the onset of spring. Howie’s khichadi included a good deal of turmeric and greens to aid in clearing the liver. I supported Howie through the normal initial fluctuations in energy that come with a khichadi fast.
I usually teach patients a form of pranayama using a double inhalation double exhalation, as well as focusing on drawing in prana from the sun and using affirmations that support the mind to let go of its addiction to getting life “from bread alone.” Howie did a marvelous job and was fully compliant.
After the first week, Howie was feeling wonderfully light and his symptoms were entirely relieved. By the third week, Howie went to have his liver readings and cholesterol levels checked again. His doctor was amazed with the results. Not only was it quite rare to see these high readings drop so much, but he had never seen them drop so quickly! Howie was thrilled.
I instructed Howie to take a month to return to the Pitta-Vata diet, starting with the most easily digestible foods. The following are some good guidelines to follow for a post-fast samsarjana krama:
• Spend the same length of time returning to a normal diet as the length of the fast.
• The first foods after the fast should have the same ingredients, but in different forms. For example, instead of khichadi the meal may be rice, steamed vegetables with ghee, and spiced mung dal.
• The portions should be small.
• Digestive herbs should be continued, increasing the dosage if there is any gas.
I continue seeing Howie occasionally and he continues to look and feel increasingly better. At the last visit I introduced color therapy to him. As he continues to integrate the healing principles of Ayurveda into his lifestyle and his knowledge of self-healing deepens, I am deeply inspired and grateful for the opportunity to share the science of Ayurveda. I am reminded of the intentions of our ancient rishis when they sat together in the Himalayan Mountains and sent Bharadvaja to ask of Lord Indra the principles of Ayurveda; the rishis were seeking to relieve the pain of suffering humanity, and to support our health on the path of Self-realization. May their light continue to guide us always as we practice with these goals in our hearts and minds.
Jacob Griscom, CAS is a Clinical Ayurvedic Specialist with an Ayurvedic practice at the Peaceful Living Holistic Healthcare Center in Nevada City, CA. He is also a teacher and intern supervisor at California College of Ayurveda, and serves as secretary of the California Association of Ayurvedic Medicine. Tel: (530) 478-0729. Web site: www.peacefullivinghhc.com
Email: jacob@peacefullivinghhc.com
References:
(1) Dash, B. and Sharma, R.K. Caraka Samhita. Volume I, Chpt.VII (Navegandharaniya), v.37. Varanasi, India.
Extreme Vata: A Case Study
by Debbie Mathis, MA, D.Ay.
Bob, a 52 year-old male with a history of anxiety, was under a psychiatrist’s care for bipolar disorder. He came to our practice because he needed a physical and because he had heard we had a “different approach to things.”
He was first evaluated, as are all of our new patients, via lab work and physical exam. Lab work included CBC, a comprehensive metabolic panel, urinalysis, lipid panel, GGT, serum iron, Thyroxine (T4) sedimentation rate, and prostate-specific antigen. He had a slight elevation of polymorphonuclear cells, urine pH of 8.0 (normal is 5.0-7.5) and an elevated cholesterol of 208 (normal is 100-199). His HDL was 37 mg/dL (normal is 40-49) while his LDL was 146 (normal is 0-99). White blood cell count was at the upper reaches of normal at 9,900. All other lab results were within normal limits.
Objective findings on his physical exam included height of 6’5’’, weight of 194, blood pressure of 134/80, pulse of 85. He had male pattern baldness and light brown hair, hazel eyes, deeply tanned dry skin and roughened hands and feet. Tongue exam showed extensive white/yellow exudate with heavier patches paralleling the lateral anterior borders (the area corresponding to the lungs). Bob’s tongue moved constantly on extension. Pulse exam suggested Vata 3, Pitta 1, Kapha 0, with both Prana and Udana Vata disruption.
Medical history revealed several rehabilitation hospitalizations for alcoholism and 2 for manic episodes (one of which was violent), and an electrocution while hanging cable from trees in 1975 with subsequent abnormal electrocardiograms. His recent EKG was normal.
Medical history also included mild hearing loss and tinnitus, respiratory allergies, (stuffiness and shortness of breath around mold and fungus). His medications: 150 mg daily of amitriptyline (antidepressant) and a nasal decongestant prn.
Unmarried, Bob had worked for some years as a “tree climber” hanging cable for film companies, and as a construction worker on high rise buildings. His current occupations included operating heavy equipment for his water management company, and running his 61-acre farm. In his spare time he did woodworking and built airboats, running them on a river near his farm, and occasionally on the ocean.
Bob’s habits included smoking for thirty years, regular use of marijuana, and heavy caffeine consumption (at least 60 ounces of coffee per day). He had achieved sobriety 8 years before his first visit to us. His diet was irregular. He often didn’t feel like eating and might not take any food for “a few days.” Other than coffee and caffeinated colas, he favored cold water (60-100 oz. per day), craved chocolate, eating several candy bars in the evening, and loved hot pickled habanero peppers and hot red pepper sauce. He normally did not eat during the day and had his only meal in the evening. Bob said he had to fight to stay near 200 lbs. He had 5 dry bowel movements per week with difficulty and occasionally abdominal cramping. Constipation was exacerbated by travel.
Except for his hazel eyes and male pattern baldness, Bob presented as classic Vata, very tall, quite thin for his height, cold extremities, extremely dry, rough skin, variable appetite, difficulty in maintaining weight, and constipation. Constantly talking, having difficulty staying on track, Bob told us that although he had graduated from college, he was labeled “stupid” in elementary and high school. (Though he was never diagnosed with ADD/ADHD, it would be in keeping with disruption of Prana Vata.)
While Bob had overcome his addiction to alcohol, he still had addiction to smoking and marijuana. Smoking directly disrupts Prana Vata, while Marijuana is additionally ungrounding. In general, addictions are quite Vata unbalancing.
Bob was also addicted to height and speed. He had been nicknamed “Squirrel” by coworkers because of his agility and affinity for tree climbing, and he had a self-avowed love of racing his jet engine airboats. Added Vata derangement came from the unbalancing effect of the high decibel levels he experienced several days a week from his operation of heavy equipment (he could not wear ear protection, he said, because he could not hear people or other equipment at the work site).
One of Bob’s more pressing problems was the imbalance created by his medication and his attempts to remedy that with caffeine. Bob told us that his psychiatrist had prescribed the amitriptyline to help control his bipolar disorder, and while he claimed his bipolar disorder was more manageable with the antidepressants, it had “a pretty big kick.” In order to counter its sedative effect, he needed plenty of coffee to get going and stay alert during the day. He took the amitriptyline around 4 PM, in order to get to sleep by 10 PM. If he forgot to take it, he could not sleep. If he didn’t sleep, he couldn’t operate his equipment safely.
Our assessment of Bob was that he had obvious signs of Vata derangement, due in part to his genetic predisposition (mother and maternal grandmother were bipolar, maternal grandfather was alcoholic and committed suicide and father was alcoholic) and exacerbated by his addictions, life-style and diet choices. We also suspected a childhood history of sexual abuse, based on other bipolar patients we have seen. Bob confirmed this on a subsequent visit.
We did not want to reduce his medication, nor did Bob, because of the possible exacerbation of his bipolar disorder. While the medication “masked” his bipolar symptoms and did not address the underlying imbalances, it was keeping him functional. Instead, we first approached some of the habits and life-style issues which were contributing to his Vata disruption. David Frawley has suggested that bipolar disorder is an example of extreme Vata imbalance (lecture, Southwest Yoga Conference in Austin, Texas, November 2000), and for Bob, this certainly seemed to be the case.
• We gave Bob 250 mg. of Trikatu before meals to help stimulate appetite, improve digestion and reduce ama. We set up a weekly schedule of mealtimes. For the 4-5 days he was on his farm, we encouraged him to eat his evening meal in the middle of the day, thereby taking advantage of stronger agni, and reducing the deleterious effects of his less than optimal food choices. On the days he ran his heavy equipment, he had to follow the job site schedule and would often have to work during the lunchtime of some of the other operators in order not to be in the way of their machinery. We suggested he try to eat his lunch around 10:30 or 11:00 am, a time which had previously been his customary coffee break.
• To further reduce ama, we had him begin the simple practice of drinking hot water rather than cold (he was accepting of the suggestion: an uncle had followed the practice and had lived well past ninety)
We suggested a gradual withdrawal from caffeine and carbonated beverages. We told Bob that if his nervous system weren’t so jagged on caffeine, eventually, he wouldn’t need as much amitriptyline to calm it down, but it was best to proceed slowly. Hot water would be able to replace some of the coffee “habit.” Improved appetite and increased food intake would give him more energy so coffee wouldn’t be needed. We also told him that one likely benefit of reducing or eliminating caffeine would be a decrease in his LDL cholesterol. (Caffeine is implicated in elevated cholesterol.)
• We recommended 3,000-4,000 mgs. of Triphala BID to improve bowel function, reduce his abdominal discomfort and help gently detoxify the body.
• To protect prana, we also recommended that if possible, he do his heaviest farm work in the morning, rather than in the afternoon vata time slot (2-6 PM).
• We had Bob agree to choose morning whenever possible as the least disruptive time to run his airboats, and to wear protective ear muffs whenever the engines were on. (We also strongly encouraged him to wear protective ear muffs when he ran his woodworking tools.)
• Bob had already reduced his daily cigarette consumption by 1/2 when he first came to see us, but other than discussing with him the disruption of Prana etc., we did not recommended at this time that he quit smoking. In our experience, patients must have some balancing tools in place to be successful at smoking cessation.
• Farm work and heavy equipment work stir up tremendous amounts of dust and particulate matter. In addition, Bob’s woodworking hobby created large amounts of sawdust, and his smoking was drying to the nasal mucosa. We instructed him in the use a Neti pot twice a day to clean foreign matter from his nasal passages and reduce his stuffiness.
• We also gave Bob some instruction in a simple meditation technique as well as several Yoga asanas (Knee to Chest, Backward Bend, Cobra and Corpse) for supporting the colon and the central nervous system and suggested he practice them for a few minutes every day, preferably first thing in the morning. We taught him Bhramari, good for quelling anxiety quickly, recommending it as needed and before bed. And we advised him to share his treatment plan with his psychiatrist.
At a two-week follow-up, Bob was using the Neti Pot at least once a day. He was beginning to institute a large meal at noon on the days he was just at the farm (he felt that the old farmers had this right, anyway), but was still skipping food on the days he ran his equipment. His bowel movements had improved in consistency and he was having one per day. He seemed to be moving mucous in the upper respiratory tract. While his tongue still had exudate, it was less extensive than before and more uniform in thickness. He enjoyed practicing the meditation technique, but had only done it a few times.
• We advised him to continue practicing the meditation technique on a regular basis, as it would be helpful to him if and when emotional releases began to occur.
• We encouraged him to eat lunch on his heavy equipment days and had him increase the Trikatu to 500 mg. before the midday meal.
• We gave him some additional diet counseling and guidelines to help pacify Vata.
At six weeks, Bob reported a significant reduction of caffeine. From a high of 60 ounces per day he was down to 12 ounces first thing in the morning, though he reported some slowing of bowel function. He also reported that he had forgotten to take his medication one day during the previous week, but had been able to fall asleep that night without it. His was encouraged by this. A modest increase in weight was also observed (from 194 lbs to 196 lbs). He also reported that he was smoking less because he wasn’t drinking as much coffee.
• We reduced his Trikatu back to 250 mg. before his main meal .
• We added a small amount of haritaki to his Triphala regime to help overcome the loss of caffeine’s laxative effect.
• We had Bob do three days of internal oleation (about 2 oz. ghee first thing in the morning) for several days, followed by 3 consecutive days of abhyanga (including ear basti) and swedana treatments at our clinic, during which time he did his best to follow a mono diet of basmati rice and split yellow mung beans, and to reduce his activities as much as possible. He was also instructed in daily abhyanga with sesame oil. He did this at home for the next three days and concurrently was given dashmoola and sesame oil to self-administer basti. Following his three days of self-massage and basti, we told Bob he could slowly reintroduce steamed vegetables and other foods.
At one week after panchakarma, Bob reported minimal anxiety, more stable energy, no tinnitus and 1-2 soft to medium bowel movements per day. His skin was more supple and he seemed calmer. He had returned to a variety of foods, and his mealtimes were more regular. He was not taking any caffeine, cold or carbonated drinks. He had improved appetite and a weight increase to 198 lbs.
• We added Ashwagandha (1,000 mg BID) for its strengthening, adapotogenic and nervine qualities; Vacha, Brahmi (Hydrocotyle asiatica) and Jatamansi (in equal parts, for a total of 1,000 mg BID) for their ability to restore balance to the CNS and the Vata mind (Alakananda Devi on Prana Vayu in “Ayurvedic Specific Condition Review: ADD,” Protocol Journal of Botanical Medicine, II:1, 1996; Acharya Prakash, Lecture “Mental Disorders” Rishikesh, 2000).
• We also suggested some weekly shirodhara and abhyanga at our clinic, but cautioned Bob not to do any heavy equipment operation (or airboat or power tools) for several hours afterwards.
Bob had a follow-up with his psychiatrist after his limited panchakarma, and together they instituted a plan for gradual reduction of his amitriptyline. The intention was to get him to as low a maintenance dose as possible.
At 12 weeks post consult, Bob had made marked improvement. He was down to 75 mg. of amitriptyline QD, near his psychiatrist’s target of 50 mg. QD. Weight had increased to 199 lbs. Total cholesterol had dropped to 191. Bob seemed relatively settled and wanted to give the nicotine patch a try. He was even doing abhyanga before running his airboat and oiling his ears on the days he operated his heavy machinery. Recommendations at this time included:
• Nasya with sesame oil after his morning and evening Neti pot.
• Trikatu only as needed
• Reducing the Ashwagandha, as well as the Vacha, Brahmi and Jatamansi combination to 500 mg. BID for a few weeks, and then 500 mg. BID PRN.
• Lung Formula (Banyan, 500 mg BID), an herbal combination for boosting immunity, strengthening the lungs, and countering the effects of smoking on Prana. From a functional standpoint, we felt Bob’s elevated polymorphonuclear cells along with his borderline high WBC were a result of his 30-year smoking history. Taking this combination of Licorice root, Rock Sugar, Pippali, Pushkarmula, Triphala, Kantakari, Banslochan, Tulsi, Talisa, Mica, Cardomom and Cinnamon, would support Bob during and after his use of the nicotine patch.
• Continue jala neti, Bhramari, abyhanga, and Yogasanas.
• Seasonal oleation, swedana and basti.
Bob was by no means free of his Vata imbalances, but he had done a lot to reduce them. He was less anxious, he was sleeping, eating and eliminating well, and he was stable with half the amount of antidepressant he’d been on before. He had insight into his constitutional tendencies along with important strategies for restoring balance, tools we hoped he would use if he decided to take on his more difficult issues of addiction and abuse.
Abbreviations used: QD: once daily; BID: twice daily; PRN: as needed
Debbie Mathis is an Ayurvedic Practitioner and a Certified Meditation Instructor. She is also the administrator and program director for NOVA NAMASTE, the educational arm of Integrative Medicine of Northern Virginia, the first medical practice in Loudoun combining Allopathy and Mind Body Medicine.
In addition to her Ayurvedic consultations, Debbie teaches meditation, assists her husband, Dr. David Mathis, with his Mind Body Medicine classes, and promotes Ayurveda in the community. For patients and the healthcare professionals who treat them, she is currently developing a series of workshops on Ayurvedic and Yoga Therapy approaches to specific chronic conditions.
Tel: 703-777-4203 Web site: ayurvedicmd.com
Email: debbie@ayurvedicmd.com
Reprinted from LOAJ, Vol. I, Issue 1, Fall 2002.
Kapha Clients: A Case Study
by Linda Reynolds, Ph.D., D.Ay.
Kapha – water/earth, the energy of structure and lubrication. Water is chemical energy (the universal solvent) and associated with taste. Water in the body is plasma, cytoplasm, serum, saliva, nasal secretion, cerebral spinal fluid, urine and sweat. It is responsible for the emotions of love and compassion, for thirst, edema, and obesity.
Earth is mechanical or physical energy. In the body it is the cartilage, nails, teeth, hair, skin, solidified consciousness. It promotes anabolism (the process of building up the body), cell repair and growth. Attributes of high Kapha are: lymphatic congestion, lung congestion, mucus secretions, colds, allergic manifestations, sneezing, attachment, possessiveness, and greed.
• Kapha people are blessed with a strong, healthy, well- developed body
• Strong muscles and large heavy bones
• Kaphas tend to gain weight and have difficulty taking it off, To complicate matters, kaphas generally have a slow digestion and metabolism
• A kapha person may even do a water fast and gain weight
• They can comfortably skip a meal or work without food
• Slow metabolic rate
Kaphas who maintain health and balance generally enjoy a long span of life, longer than the other two-doshic types, who tend to “burn out” more quickly. However, if kapha dosha is allowed to become aggravated, the person is likely to become obese, which is one of the main causes of diabetes, hypertension, and heart attack.
Kaphas have quite a sweet tooth and love candy, cookies, and chocolate. They are generally attracted to sweet, salty, and oily foods, but these contribute to water retention and weight gain. Their bodies need lighter fare and do better with the bitter, astringent, and pungent tastes.
• Daytime sleep increases kapha and is not good for them
• Kaphas shun exercise. Vigorous exercise is good for them, but they prefer to sit.
• They have excellent long term memories
• Although a kapha individual is forgiving if you insult them or hurt their feelings, they will forgive you, but they will never forget.
• They hold on to money, and are good at saving
Kapha dosha is aggravated by kapha- producing food, such as watermelon, sweet fruits, candy cookies, yogurt, and other dairy products. Cold and frozen food, chilled water, sitting and doing nothing all increases kapha. Sedentary work, especially when combined with steady munching at the desk, produces too much kapha in the body.
Case Study
John Doe is a 56 year old Kapha predominant male. When he first visited my office last November (Vata Season) he was experiencing extreme fatigue, muscle aches and pains, muscular cramps, restless leg syndrome, depression, excessive nasal discharge with congestion, bleeding gums, lymphatic swelling, loss of memory, often bloating after meals and excess gas. These symptoms are indicative of a secondary Vata constitution. He is cold most of the time but he does fluctuate between hot and cold (stagnant heat). He also has a history of long-term chemical exposure.
He was diagnosed with hypothyroidism in 2000 and was put on Levoxyl. He has past history of German measles and has traveled extensively throughout the world warranting immunizations at times. He is also on Wellbutrin and Serzonf for anxiety and depression and Clonazepam for restless leg syndrome. Blood chemistry indicated low mineral density (minerals are earth elements and are responsible for many catalytic functions in the body, you can not address brain function unless you improve one’s ability to access these elements from their food), low cholesterol (typical in blood type A’s and in people who have chronic health problems, this is also related to liver congestion) and poor hematology which relates to low AGNI.
He would like to get off all these medications. I told him legally I cannot do this but if we work together with his primary care physician we can attempt the process.
Like most Kapha patients, his dialog was mostly resistant, especially when we talked about eliminating all carbohydrates as in bread, pasta, and deserts. He loves his oatmeal cookies and bread. He drinks 2-3 cans of diet coke a day so I gave him the research on Aspartame and its potential negative effects on brain chemistry. I told him to switch from olive oil, which is the main lipid he uses, to ghee and a 4:1 ratio oil of sunflower to flax and to use this minimally for now. Olive oil is a wonderful fat, good for cooking too, but it does nothing for the function of essential fatty acids, which produce the prostaglandins that regulate brain function and so many other metabolic processes.
We kept the protocol simple for the first month. I suggested the anti AMA diet in spite of the vata season: no food after 6:00 PM, eat his main meal and or main caloric intake between 10:00 AM and 2:00 PM, no beans except mung as in Kichadee. He was instructed how to make an Indian Spice paste (see insert) to add to his foods.
We chose a German Isopathic Nasal remedy to minimize bacterial growth in sinuses and to promote lymphatic drainage. For his bleeding gums he was to do a sesame oil swish for 2 minutes after brushing his teeth and to gargle with a folic acid/chlorophyll mouthwash afterwards. Sesame oil works as an antiinflammatory, nourishes the bone and extracts toxicity from the mouth.
For his circulation, GI function and connective tissue problems, I chose Hawthorne Solid extract (I find this better then its Ayurvedic counterpart Arjuna). It is also sweet and easy to take, remembering that compliance is key. At the end of the appointment he moaned and groaned, and said he will try…….. my response was that “to try” usually means “not to do”. I told him he has a wonderful constitution and should have a long prosperous life, or he could be resistant. I asked him what he thought of resistant people and he said “they are sick and unhappy people”— a major acknowledgment for him. With the high kapha or high AMA people you see, the more you eliminate from their diet, and change the momentum of their “stuckness”, the faster they will improve. By the next appointment three weeks later he had lost 25 lbs. and was feeling better at many levels. His sinuses were much better but he still had some congestion. His energy level was impressively better.
He was convinced that the regimen was appropriate and his compliance was excellent, which is what we all hope for with our Kapha people. He said he tried to stop his medication for restless legs but the symptoms came back. Hawthorne will eventually help, but recommended that he use the classic remedy for the Vata restless leg syndrome: Mahanarayan Oil applied to the legs, covered with saran wrap to protect clothing . Use as often as is needed.
We now started to integrate a more Kapha pacifying diet that was not as restrictive as the anti-AMA diet. The 4:1 oil was to be used only when eating a protein meal. We decided to put him on Bhumy Amalaki (a great liver purgative: 1 teaspoon in a cup of boiling water, let stand for 15 minutes, then consume before bedtime.
As for his meals, he complained about not wanting to cook for every meal. As with most of us, he likes the idea of having something quick to eat, and of course these quick meals are usually the worst for us. So we came up with a lipoprotein drink using the 4:1 oil, which I find to be very health promoting at many levels. This 4:1 concept allows cells to subdivide more quickly (which is their main function). With cell division we allow the dynamism of Vata (nuclear and electrical), Pitta (transformative) and Kapha (physical and chemical energy) to work their magic.
He was placed on ionic minerals to improve his mineral density. This is a manipulative protocol, but with compliance, it works quicker then anything else I have ever used. People usually get a surge of energy after drinking this also.
There are clearly vata and pitta issues here as there will be when ama and kapha are blocking their function, but as long as we continue to work on stimulation and circulation, we will see improvement. On his next appointment, we will more specifically deal with the depression/anxiety issue, which is not as intense as it was in the beginning. To help with this, I did suggest a Spagyric remedy called Cerebretik by Soluna. Spagyric remedies are Alchemic preparations very similar to Indian Bhasmas. Indian Bhasmas are not allowed in this country but these remedies are.
Reprinted from LOAJ, Volume I, Issue 1, Fall 2002
Dr. Reynolds holds her PhD in Nutritional Science, is a graduate of NEIAM, has completed a clinical internship in Ayurveda in India under Vaidya P.D. Yawatkar, M.D. and is working on her doctorate in Ayurvedic Sciences. She maintains an integrated Ayurvedic practice, Whole Health Consultants in Maynard, MA and in Barnstable, MA. She can be reached at: .978-897-0042 Email: dr1linda@netzero.com
