Psychosomatics 43:345-346, August 2002
© 2002 The Academy of Psychosomatic Medicine
An Elementary Textbook of Ayurveda: A Six Thousand Year Old Healing Tradition
By Frank John Ninivaggi, M.D., Madison, CT, International Universities Press, 286 pages $28.75, ISBN 1–887841–33–4
Andrew L. Stoll, M.D.
A huge proportion of our patients are either openly or surreptitiously using complementary and/or alternative medicine treatments. Now, Yale psychiatrist Dr. Frank J. Ninivaggi has written a concise yet surprisingly comprehensive book for the Western audience on Ayurvedic medicine. Ayurveda is the traditional healing system from India that dates back many thousands of years. It has not received as much attention as other forms of complementary and alternative medicine treatments, such as herbal remedies and traditional Chinese medicine. Ayurvedic medicine is a complex and an unambiguously Eastern system of healing. Many of its diagnostic and treatment principles were later incorporated into traditional Chinese medicine. An Elementary Textbook of Ayurveda is intended for a professional and an educated lay audience. In the text, Dr. Ninivaggi discusses the relationship of Ayurveda to Western (Allopathic) medicine. He clearly respects both systems and is a strong proponent of the integration of Ayurvedic practices and Western medicine.
Dr. Ninivaggi has an engaging writing style and provides clear definitions of sometimes confusing terms and concepts. The book has an excellent glossary and ample references. In the first two chapters, Dr. Ninivaggi describes the history and philosophical underpinnings of Ayurveda. Later chapters are devoted to the Ayurvedic view of the anatomy and physiology of health and diseases, as well as the principles of Ayurvedic therapy, including nutritional interventions, lifestyle changes, and more specific techniques of yoga and herbal remedies.
The chapters introducing the history, philosophy, and treatment principles of Ayurvedic medicine were fascinating. A reader familiar with traditional Chinese medicine and acupuncture will recognize some of the key concepts of Ayurveda. For example, Prana is identical to the traditional Chinese medicine concept of chi (or qi), which is the "life force" that flows through the body's energy channels (meridians). Dr. Ninivaggi describes Ayurveda's method of diagnosis, which he divides into four steps. The first step is pratyaksha, defined as "a multisensory understanding of each individual patient," where the five senses of vision, hearing, touch, smell, and taste are used in conjunction with a thorough history to arrive at the second step, anumana. Anumana is defined as "inference," or hypothesis generating. The third and fourth steps are sabda (or aptopadesha) and upamana, which are the traditional knowledge base handed down through oral teaching and texts and the use of "analogy" with known cases to make a diagnosis, respectively.
As in Western medicine, a specific diagnosis directs the clinician to a specific treatment. However, Ayurveda's principles of pathophysiology are quite distinct from those in Western medicine. In addition, diagnoses and treatments are much more highly individualized than in Western medicine.
As in traditional Chinese medicine, Ayurveda uses an empirical approach honed over thousands of years to diagnose and treat illness. Western medicine also advances with empirical discovery, although innovation based on the scientific method and reductionism is the underlying philosophy in the West. Also unlike Western medicine, Ayurveda admirably stresses preventive medicine, with self-inquiry, self-realization, and self-actualization as "central themes." The principles of treatment are based on the notions of samanya, defined roughly as "like increases like," and vishesha, where "opposites balance and so cure each other." These treatment methods are carried out with specific manipulations of diet, lifestyle, or the introduction of yoga practice and specific herbal therapy.
All in all, An Elementary Textbook of Ayurveda is a great resource. However, the lack of an index made it difficult to find items in the text quickly. More information on specific herbal treatments would have also been useful. Another challenge, not adequately described in the book, is specifically how to integrate Ayurvedic practices into a conventional (Western medicine) psychiatry practice. One other aspect not fully addressed in the book is how or even whether Ayurvedic medicine evolves or makes advances. Is there "research" and new additions to the knowledge base, or is Ayurveda stagnant or dogmatic? Despite its philosophical and tangible differences with Western medicine, the efficacy and effectiveness of Ayurvedic treatments could be tested with standard controlled clinical studies. It is hoped that this book will inspire some readers to design and carry out scientific studies to confirm or refute the utility of Ayurvedic treatments. This would be a first step toward a genuine integration of the world's best medical traditions.
I highly recommend this book as a way to simply and quickly access the complex world of Ayurvedic medicine. One basic and commonsense principle of Ayurvedic medicine is familiar: Live in moderation, without deprivation or excess. This is excellent advice for all of us.
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Academy of Psychosomatic Medicine.
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