Ayurveda in America

Francis C. Assisi

Indian Current

Published on May 1, 2007

Despite the stunning advances in modern medicine, the world is becoming increasingly aware of the limitations of mainstream health care. Americans too are realizing that Western medicine has some answers, but not all the answers.

It is in this scenario that ayurveda—along with yoga and meditation—has entered the American consciousness.

Ayurveda’s holistic premise—that mind, body, and spirit are intimately connected—is revolutionizing the way Americans understand their health. Ayurveda teaches that separating mind and spirit from the body creates physical imbalance, which is the first stage in the disease process. It naturally follows that re-integration is the first step toward healing. Based on the principle that disease is the natural end result of living out of harmony with our environment, ayurveda views symptoms of disease as the body’s normal way of communicating disharmony. With this understanding of disease, ayurveda’s approach to healing becomes obvious: to reestablish harmony between self and environment and create an optimal environment for health.

Meanwhile, the emerging integrative medicine movement—which calls for restoration of the focus of medicine on health and healing, and emphasizing the centrality of the doctor-patient relationship—is also reflecting the basic tenets of ayurveda. No wonder that the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (NIH) summarizes the present status of ayurveda in America quite well, identifying it as one among "Whole Medical Systems" that ought to play an important role in the present complementary and alternative medicine (CAM) scenario.

THE EARLY YEARS

Interest in ayurveda emerged as Americans started to question the tenets of their own health care system. Today, nearly three decades after it was first transplanted in American soil by Indian pioneers such as Dr. Vasant Lad, and Maharishi Mahesh Yogi, ayurveda is still struggling to establish roots as well as legitimacy.

The dissemination of ayurveda in America continues as a result of the confluence of several trends: Indian and American doctors and health scientists approaching the tradition on a more scientific basis; Western doctors and researchers recognizing that ayurveda offers much that they do not know; ayurvedic doctors (vaidyas) from India setting up consultations; and patients seeking non-Western healing modalities.

Most importantly, the signing of the Health Freedom Act (SB 577) in California is seen as a landmark event towards the legitimization of ayurveda and other forms of CAM in America. The bill, which became effective January 2003, allows trained practitioners of alternative and complementary health care to legally provide and advertise their services. It provides that a person is not in violation of certain provisions of the Medical Practice Act (that prohibit the practice of medicine by anyone who is not a licensed physician) as long as that person does not engage in certain specified medical acts. Similar laws have also been passed in Rhode Island and Minnesota.

Today, many American medical colleges offer introductory ayurvedic education in the form of seminars and workshops. Many renowned medical hospitals, including the Mayo Clinic, offer ayurvedic therapies. Hundreds of thousands of yoga practitioners are partial towards the ayurvedic lifestyle. There is an increasing demand for ayurvedic products and massage procedures. All these are signs of ayurveda gaining acceptance in the United States, and hence revitalizing the health scene.

But getting ayurveda licensed is the need of the day, says Dr. David Frawley (Vamadeva Shastri), author of Ayurvedic Healing and co-author, with Dr. Vasant Lad, of the first book on ayurveda published in America, The Yoga of Herbs(1986). Frawley agrees that the main obstacles confronting ayurveda in America are lack of proper recognition and limited acceptance by the public. Meanwhile, medical researchers suggest a great potential for integration of ayurvedic therapies into the healthcare system in the United States.

A MODERN MEDICAL PERSPECTIVE

In fact this is what the foremost cancer researcher in America, Dr. Bharat B. Aggarwal of the University of Texas M.D. Anderson Cancer Center in Houston, recommends. In his article "From Ancient Medicine to Modern Medicine: Ayurvedic Concepts of Health and Their Role in Inflammation and Cancer," published in February 2007, Aggarwal wrote, "Recent statistics indicate that the overall cancer incidence in the United States, in spite of billions of dollars spent on research each year, has not changed significantly in the last half-century … Ayurveda can be used in combination with modern medicine to provide better treatment of cancer." Aggarwal himself has led the way by his pioneering studies on a whole range of ayurvedic herbs, especially turmeric.

The most recent outcome of this is the ongoing nationwide clinical trial where patients are being given curcumin (from turmeric) supplements for 30 days to help reduce the levels of pre-cancerous biomarkers. "Though it has been used for centuries in traditional medicine, we’re very early in the clinical development of curcumin as a chemopreventive agent," acknowledges Dr. Frank Meyskens of UC Irvine.

Because of increasing interest and evidence of its efficacy, it is in America that we may be witnessing the first tentative attempts to integrate ayurveda into the mainstream establishment.

That’s exactly what Dr. Michael J. Balick and Sarah Khan of the New York Botanical Garden showed when they examined clinical studies relating to 166 medicinal plants from a standard ayurvedic repertoire. Their results, published in the 2001 issue of the Journal of Alternative and Complementary Medicinecontradict the generally held notion that herbal remedies used in ayurveda have not been evaluated in human or in vivo trials. The problem, as they pointed out, is one of accessibility, because the findings are not published in Western journals or they are not available in English. According to Balick and Khan, the clinical studies already available do suggest that at least 100 of the 166 plants studied are appropriate for larger and better-controlled clinical trials. As if to prove this point, our recent survey of Medline and Pubmed databases reveal that over the past decade a large number of clinical studies on ayurvedic plants are being published, not only from U.S. and Indian laboratories, but also from research centers in China, Japan, and Europe. Surprisingly, it is China that is most aggressively pursuing research into ayurvedic plants.

AMERICANIZATION OF AYURVEDA?

Sita Reddy, who wrote her Ph.D. dissertation at the University of Pennsylvania on the reinvention of "Ayurvedic Medicine in New Age America," makes an important observation: "Ayurveda’s spread in the United States relies primarily on its appeal beyond exclusively South Asian constituencies. Its uniqueness, in other words, lies in the fact that it is reproduced for non-Asian American audiences and clients rather than for immigrant South Asians."

She adds: "… transplanted ayurveda is marketed not simply as effective medicine but as cultural commodity, as a uniquely Indian ethnomedicine for primarily Western audiences." Furthermore she notes that as ayurveda gains legitimacy, the practice itself is being transformed into an American composite.

But how can we transplant ayurveda to this culture without doing violence either to the integrity of the teachings or to the cultural bias of our students and patients? This question was raised in a 2003 conference paper entitled "Cultural Issues in Bringing Ayurveda to the West" by British-born physician Alakananda Devi (nee Olivia Hudis). Alakananda Devi earned her medical degree from St. Bartholemew’s Hospital Medical College in London and is presently director of Alandi Ayurvedic Clinic and its gurukula in Boulder, Colo. In other words, will ayurveda remain always an exotic hothouse plant, unable to naturalize itself in the soil of this land? Or will its commodification happen with the creation of a palatable, user-friendly pseudo-ayurveda? Specifically, she asks: If we make a preparation from a combination of both traditional ayurvedic and Western herbs, departing from classic formulations in favor of our own creativity, is this ayurvedic? On what authority do we validate the preparation? And what is our understanding of authority and authenticity in ayurveda, if we depart from the texts?

"In offering ayurveda to the West, there is no need to bring about conversion to either Hinduism or Buddhism. However, we must always walk in the spirit ofsanatana dharma, honoring its essential teachings of truth and ahimsa, of reverence for the indwelling mystery within all things animate and inanimate, and of striving for loka sangraha, the welfare of the Whole," says Alakananda Devi. That’s why she warns: If fame and gain are the motives, we will in the end so distort and prostitute ayurveda that there will be nothing vibrant or vital left. But, on the other hand, if fear of change is the motive of our efforts at Sanskritization, we will alienate the public from the great benefits of ayurveda.

FORWARD MOMENTUM

Four developments may account for the current popularity of ayurveda in America: 1) the formation of a core base for ayurvedic instruction and practice through the untiring efforts of pioneers such as Dr. Vasant Lad and his students such as Dr. David Frawley; 2) The arrival of Euro-American practitioners who received their ayurvedic medical training in India: Dr. Robert Svoboda and Dr. Scot Gerson (M.D from U.S. and Ph.D. in ayurveda from the University of Pune); 3) the re-packaging of Ayurveda as "Maharishi Ayurveda" to the Euro-American followers of Transcendental Meditation (TM), and the subsequent popularity of its original promoter, Dr. Deepak Chopra; 4) the teaching efforts of independent ayurvedic physicians who came directly from India, such as Drs. Subash Ranade, Vivek Shanbhag, Virender Sodhi, Sunil Joshi, Jay Apte, Sekhar Annambhotla, and Aparna Bapat.

Two other factors are: the founding of educational institutions that offer training in ayurveda, and the creation of organizations such as the National Ayurvedic Medical Association (NAMA), California Association of Ayurvedic Medicine (CAAM), National Institute of Ayurvedic Medicine (NIAM), Association of Ayurvedic Professionals of North America (AAPNA), and the American Academy of Ayurvedic Medicine (AAAM). Under the circumstance, it would help if all these disparate organizations came together under a common umbrella to advance the cause of ayurveda in America.

"This is a time of great forward momentum for ayurvedic education," affirms Cynthia Copple, dean of Mount Madonna Institute College of Ayurveda in California, and one of the earliest practitioners of ayurveda in America. "More schools are being founded and the number of ayurveda students is increasing. There is good reason to believe that during the next 10 years NAMA will continue to work alongside state ayurvedic associations to enable state licensure and to promote national exams; there will be thousands of America-trained ayurvedic practitioners; and the public will be reaping the benefits …"

FUTURE OF AYURVEDA

Today there are at least 15 institutions that teach ayurveda in America—from certificate level to the masters degree level. The latest entrant into the scene is Seattle-based AYU Ayurvedic Academy which has teamed up with Kerala Ayurveda Pharmacy in India to set up a string of franchised institutions all over the country.

Ayurvedic institutions claim that a well-trained ayurvedic practitioner may choose to enter into private practice in compliance with the laws of the state where he resides, join other health care practitioners at a wellness center, teach public education classes on ayurvedic principles, supervise a pancha karma center, teach at an ayurvedic college, and conduct workshops, seminars and retreats—everything short of a licensed independent medical practice. In this respect, one might say that ayurveda’s current status in the United States is analogous to traditional Chinese medicine and acupuncture during the 1970s.

The Ayurvedic Institute’s Dr. Lad is hopeful that in time ayurveda will become recognized, and ayurvedic physicians will be able to enter into full professional practice. And Dr. Robert Svoboda, the first American to earn an ayurveda degree in India, and the author of two bestsellers in the field, is convinced that ayurveda is as valid here in America as it was 5,000 years ago in India. Dr. Jay Apte, an ayurvedic practitioner and teacher in California, goes even further. "It will be one of the main healing modalities in U.S. in 21st century," Apte predicts.

Cynthia Copple too is optimistic: "We are near the tipping point for the process of licensing of ayurveda to begin." She adds: "To attain state licensure, I believe we need to find one area in which ayurvedic treatment can be scientifically proven to work, put our focus, our money, and our intention behind it, and, like Chinese medicine and its emphasis on scientific studies of acupuncture and pain, enlist Western scientists, doctors, and state politicians in the cause of the licensure of ayurveda." She hopes that licensure will benefit all B.A.M.S degreed practitioners (from India), American-trained practitioners, and that it will "continue the great cultural exchange between India and America."

American-born Swami Sada Shiva Tirtha is author of the Ayurveda Encyclopedia (1998) and founder of Ayurveda Holistic Center in New York. He has been lobbying for ayurveda in Washington, D.C., and is clearly optimistic: "It won’t be long before ayurveda becomes established as the rock-solid core of medicine." He adds: "With the advent of colleges and universities conducting research, we can only hope they properly give credit to India and not take the credit for themselves. Someday the Nobel Prize in medicine will go to someone who works with ayurveda."

Already, Dr. Bharat Aggarwal’s prolific efforts are along those lines. He has become the first mainstream medical researcher to recommend that ayurveda be used in combination with modern medicine to provide better treatment for cancer. Referring to Aggarwal as "Spice Healer," the February 2007 issue of theScientific American reported that Aggarwal’s chapter in a new textbook is entitled "Curcumin: The Indian Solid Gold." From the humble haldi (or turmeric, from which curcumin is derived), Aggarwal is now exploring the biochemical basis of a whole range of perennial favorites in ayurveda’s repertoire of cancer fighters—including tulsi and all of the commonly used Indian spices—with astonishing results.

Nobel prize or not, with disease mongering on the rise, and with the hazards of modern medicine well documented, it is worth speculating that perhaps America is where ayurveda’s 21st century avatar will emerge triumphant. In this context too it is worth noting that Native American medicine shares ayurveda’s philosophy of healing, based on the reestablishment of harmony between self and environment.

May everyone be happy;

May everyone be healthy;

May everyone be holy;

May there never be disharmony of any kind anywhere.

This is the ultimate message of ayurveda.

Francis C. Assisi (indiaspora@gmail.com) has had a lifelong interest in India’s indigenous medical systems and closely follows current research on ayurveda.

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Ayurveda Basics

According to ayurveda, each person has a constitution created at conception that determines basic physiology and personality. This constitution is the inherent balance of three doshas, or subtle biological principles that govern the functions of the body, known as vata (motion), pitta (metabolism), and kapha(cohesiveness).

There are infinite combinations and permutations of these three basic energies, and each person’s constitution is a unique expression. Constitution determines what a person is naturally attracted to and what is experienced as repulsive, what is in harmony with his or her nature, and what will cause imbalance and susceptibility to illness.

Because no two people are alike and no two presentations of a disease are alike, ayurveda does not approach the cure of a disease as much as it addresses enhancing the health of the person.

It must be remembered that ayurveda is the healing side of yoga, and yoga is one of the spiritual traditions from which ayurveda emerged. Through yoga one prepares the body and mind for self-realization or union with the Divine. Through ayurveda one supports the spiritual journey by maintaining body and mind in a state of balance and well-being.

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Ayurveda and Yoga

The paths of yoga and ayurveda are so closely intertwined that it is hard to imagine traveling down one without knowledge of the other. And more than in India, it is in America that these two paths are converging.

That’s why Julie Deife declares in the January-February 2006 issue of the Yoga Journal: "An obvious foothold for Ayurveda would seem to be within the yoga community since both have roots in the Vedic sciences."

And Diane Finlayson who obtained a master’s degree from Johns Hopkins University in 2005 with her thesis "Ayurveda in America," writes: "Alternative medical therapies have become a mainstay for many people in America. Practices that were once considered marginal, have now become practices that mainstream medical institutions are investigating for efficacy in healing, and coming up with some very positive results. Ayurveda, the traditional healing practice of India, is the latest alternative therapy to assert itself in the United States as a result of its association with hatha yoga and America’s growing enthusiasm for yoga."