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Metaphysical fitness and Ayurvedic medicine - Medical Anthropology
Townsend Letter for Doctors and Patients, April, 2003 by Tim Batchelder Continued from page 2. Ayurveda thus acknowledges the physical uniqueness of each individual (Majumdar 1971) which allows more people to pursue health and be healthy in a number of ways. There are "windy" people, "phlegmy" people, and "bilious" people who are affected by different jobs, diets, climates and routines. Caraka notes that the eight types of sara (constitutional essence) that characterize different kinds of people come in different degrees of strength noting that in people who are twaksara (having the constitutional essence of skin), the skin is smooth, soft, clear with fine, sparse, deep rooted and delicate hairs and lustrous. This essence indicates happiness, good fortune, power, enjoyment, intelligence, learning, health, cheerfulness and longevity. (Caraka-Samhita, Vimanasth anam) People with essence of mamsa (fat) have temples, forehead, nape, eyes, cheek, jaws, neck, shoulders, abdomen, axillae, chest, hands, feet, and joints equipped with firm, heavy, and good-looking muscles. This essence indicates forbearance, re straint, lack of greed, wealth, learning, happiness, simplicity, health, strength and longevity. Zimmermann (1987:160) notes that the notion of plumpness (pushti) conjures up images of obesity from the vantage point of a culture that is preoccupied with slimness even though it denotes something else entirely in Ayurvedic fitness, aesthetics, and health. Plumpness is good, however, only when it is manifest as firmness rather than as flabbiness, a distinction that has very little to do with exercise but is related to the balance or imbalance of phlegm. Zimmermann explains that plumpness is strongly related to purity of the mind in much the same way as meat eating and violence are related, or rain and order. Those with asthisara (essence of bone) have prominent heels, ankles, knees, elbows, collar bones, chin, head, joints and also bones, nails and teeth. Such persons are enthusiastic, active, enduring, having a strong and firm body, as well as longevity. Those with sukrasara (semen as essence) are charming and have eyes that appear to be filled with milk, seem exhilarated, have teeth that are rounded, firm, even and compact, have a pleasant complexion and voice, and have prominent buttocks. They are "liked by women for enjoyment," are strong and endowed with happiness, supremacy, health, wealth, honor and progeny. The theoretical ideal of perfect health is the sum of all eight sara types and people can refine themselves and work toward an ideal of hyperfitness by influencing the ebb and flow of the various constituents. Thus the Ayurvedic physician attempts to see why a person is "sicker then he or she should be" under the circumstances appropriate to the biosocial configuration of his heap. This ambiguous ambivalence about the variability of the health trajectory in Ayurveda is shown in the Ayurvedic texts which describe an underlying dissatisfaction with a purely remedial, restorative, effect of drugs and therapies. Majumdar notes that Ayurveda is concerned primarily with prolonging life and health and preventing disease and senility and only secondarily with curing disease (1971:213). This has been understood in popular accounts used by the Holistic Health Movement as well (Ranade 1996: 571). The focus on radical self-improvement in Ayurvedic medicine explains why incredible curative powers are attributed to various therapies, a tendency which has made Western health professionals skeptical about Ayurveda overall. For example, enemas made from oils, broths and other liquids are used to treat headaches, diarrhea, glaucoma, cataracts, and fevers but are also claimed to make thin men fat, fat men thin, remove wrinkles and grey hair, and reverse impotence (Jolly 1977:33). Similarly, the canonical texts are very stubborn about the quality of various substances (insisting that ghi is the best animal fat while sesame oil is the best vegetable fat) (Jolly 1977:33) and minutely specific about daily regimens where diseases of deranged sense organs are attributed to seemingly trivial things like riding in a defective vehicle, sitting on a hard seat that is knee-high, sleeping without a pillow, going outside without first touching gems, or laughing too loudly (Caraka-Samhita, Sutrasthana). Again none of this detail would have been necessary according to Alter if some grander purpose than simply treating medical emergencies wasn't behind Ayurveda, which he believes is the possibility of achieving immortality and freedom through medical means. Zimmermana notes that Ayurveda is concerned primarily with physiology and only somewhat ambivalently with pathogenesis as a discrete science and medicine in the sense of science as we understand it today is not really relevant to Hindu medicine (1987: 177). Conclusion As Leslie (1976, 1980, 1983, 1992), Brass (1972), Obeyesekere (1g76a, b, 1982, 1992), Kakar (1982), Trawick (1983, 1gg1), Cohen (1995), Nandy 1995a, b), and others (Majumdar 1971: 266-68) have discussed, many are debating whether Ayurveda is and should remain a science unto itself or should be combined with Western medicine in a syncretic approach. However Alter's analysis shows that Ayurvedic medicine uses a paradigm very different from that of Western medicine and uniquely powerful in its own right -- focusing on radical self-improvement through enhanced metaphysical fitness rather than simply removal of disease in order to achieve a state of questionably good health. It is only through careful studies such as this that we can hope to preserve the original intent and effectiveness of traditional medicines in the face of Western techno-medical imperialism. Appendix Personal Hygiene and Daily Routine Two dimensions of Ayurveda svasthavrtta (personal hygiene) and dinacharya (daily routine) described in Ayurvedic texts focus on detailed prescriptions for such everyday activities as sleep, evacuation of the bowels, taking care of oral, ocular, and aural hygiene, hair care, sartoriology, and especially diet (Kutumbiah 1962:130-43; Majumdar 1971:243). We are told in great detail how to manage almost every aspect of our lives including when to smoke various substances to increase the strength of hairs, skull, sense organs and voice, what ointments to use daily to make eyesight keen and color vision perfect, the kind of oil to use in one's ears to improve hearing, which twig to use to brush teeth to make them bright and strong, the best metal tongue scraper, ideal water temperature for bathing for various parts of the body, the best use of mirrors, umbrellas, and walking sticks, the ideal wood to use to make a bed, cloth for making a shirt, and flowers to decorate a room. The detail is amazing and in many ways superior to Western medical manuals in its thoroughness (Larson 1993). According to Ayurvedic medicine one is supposed to awake at 3:30 or 4:00 a.m. and think carefully about whether the food eaten the previous evening has sufficiently digested to enable one to defecate without "forcing the bowels." Likewise, careful attention to hair and nails is necessary and cutting one's hair, trimming one's beard, and having a manicure is considered "nutritive, aphrodisiac, and life-promoting." Properly fitting footwear "benefits eye-sight, promotes strength, and inhibits the libido." And when walking it is important to keep one's eyes fixed on a paint 6 ft. ahead of you on the ground. Of course, most people (except the elite who can afford gold tongue scrapers) could not follow such rigorous regimens and so Ayurveda became the prerogative of kings and a prerequisite for kingship (Zimmermann 1980:104). This obsessive concern with hygiene and regimentation in Ayurveda results because it is assumed once again that people are inherently unhealthy. Personal hygiene and the daily routine are not forms of preventive medicine but rather radical means of self improvement. Water, Bathing, and the Reduction of Morbid Heat for Sleep The daily regimen prescriptions are not particularly "holistic" or "natural" in Ayurvedic medicine. For example a common dinacharyj prescription requires that water be cooled overnight in a copper vessel and drunk at dawn (ushah-pana). Likewise, well water is considered superior since it is warm in cold weather and cold in warm weather. However both of these are constructions of humans, rather than natural outlets of water flow from the earth.
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