Understanding Yogic Concepts of Health and Disease

Introduction

Yoga is a spiritual science for the integrated and holistic development of our physical, mental and moral-spiritual aspects of being. The philosophy of Yoga is practical and applicable in our day-to-day living. Yoga has been documented to normalise physiological function and recent advances in the field of research have shown that it has sound scientific basis.

Yoga understands health and well being as a dynamic continuum of human nature and not a mere ‘state’ to be attained and maintained. The lowest point on the continuum with the lowest speed of vibration is that of death whereas the highest point with the highest vibration is that of immortality. In between these two extremes lie the states of normal health and disease. For many, their state of health is defined as that ‘state’ in which they are able to function without hindrance whereas in reality, health is part of our evolutionary process towards Divinity.  The lowest point on the dynamic health continuum with lowest speed of vibration may be equated with lowest forms of life and mineral matter while the highest point with highest speed of vibration may be equated with Divinity.

The process of human evolution passes through numerous forms on the journey from the lowest to the highest. This journey is very well brought out in a verse from the Shivapuranam of Dravidian culture that describes the evolutionary journey from the non-moving state of rocks, grass, small plants and trees to the moving state of worms, various animals, birds and snakes up to the human state and finally ending at the divine state of sages and celestial beings (pullaagip poodaay puzhuvaay maramaagip pal virugamagip paravaiyaayp paambaagik kallaay manidharaayp peyaayk kananggalaay val asuraragi munivaraayth thevaraayc cellaa nindra iththaavara sanggamaththul ellap pirappum pirandhu ilaiththen emberumaan -Sivapuranam verse 30).

This evolutionary journey was beautifully described by the Sufi Saint Rumi some hundreds of years ago. Rumi declared in ecstasy, “I died as a mineral to become a plant, I died as a plant to become an animal, I died as an animal to become a man, I died as a man to become an angel, I died as an angel to become a god. When was I ever the less by dying”?

Yogi Swatmarama in the Hathayoga Pradipika, one of the classical Yoga texts gives us the assurance, “One who tirelessly practises Yoga attains success irrespective of whether they are young, old decrepit, diseased or weak.” He gives us the guarantee that Yoga improves health of all alike and wards off disease, provided we properly abide by the rules and regulations. (yuvaa vrddho ativriddho vaa vyaadhito durbalo pi vaa abhyaasaat siddhimaapnoti sarvayogeshvatandritah  –Hathayoga Pradipika I:64)

 Yogic View of WHO Definition of Health

The World Health Organization (WHO) defines health as a state of complete physical, mental, and social well-being and not merely absence of disease or infirmity. WHO has also in recent times suggested a fourth dimension of spiritual health but has fallen short of defining it without confusing it with religion. From a yogic perspective it is heartening that the WHO definition gives importance to ‘well-being’ that is a vital aspect of ‘being’ healthy as well as ‘feeling’ healthy. There is no use in a doctor telling patients that all their investigations are ‘normal’ when the patients themselves are not feeling ‘well.’

This qualitative aspect of health is something that Yoga and Indian systems of medicine have considered important for thousands of years. The definition of asana given in the Yoga Sutra as sthira sukham implies this state of steady well being at all levels of existence (sthira sukham asanam- Yoga Darshan II:46). Patanjali also tells us that through the practice of asana we can attain a state that is beyond dualities leading to a calm and serene state of well being (tato dvandva anabhighata- Yoga Darshan II: 48).

Yoga aims at enabling the individual to attain and maintain a dynamic sukha sthanam that may be defined as a dynamic sense of physical, mental and spiritual well being. The Bhagavad Gita defines Yoga as samatvam meaning thereby that Yoga is equanimity at all levels. (yogasthah kurukarmani sangam tyaktva dhananjaya siddiyasidhyoh samobutva samatvam yoga uchyate –Bhagavad Gita II: 48) This may be also understood as a perfect state of health wherein physical homeostasis and mental equanimity occur in a balanced and healthy harmony.

One of the main lacunae of the WHO definition lies in the use of the term ‘state’ that implies health is something to be achieved ‘once and for all’ with no need for care about it thereafter! It is definitely not so. We need to keep working on our health with great vigour and dynamic enthusiasm for the entire span of our life. If health is to be understood as a ‘state’, then it must be understood as a dynamic state that varies from day-to-day and often from minute-to-minute! It is often actually more challenging to maintain this dynamic state of health than to even attain it in the first place. Ask any World No.1 sports champion and they will testify to this inherent truth that applies to sports as well as to life itself.

 Yogic Concepts of Health

Yoga is first and foremost a moksha shastra meant to facilitate the individual to attain the final freedom, liberation or emancipation. One of the important by-products of the Yogic way of living is attainment of health and well being. This is brought about by right-use-ness of the body, emotions and mind with awareness and consciousness. This must be understood to be as healthy a dynamic state that may be attained inspite of the individual’s sabija karma that manifests as their genetic predispositions and the environment into which they are born. Yoga also helps maintain and sustain this dynamic state of health after it has been attained though disciplined self effort.

Structural aspects of the human being: Yoga considers that we are not just the physical body but are of a multifold universal nature. Concepts of pancha kosha (fivefold aspects of our existence) and trisharira (threefold aspect of our bodily nature) help us understand our multi-dimensional real nature where health and result from a dynamic interaction at all levels of existence. At the level of the gross body, Yoga and Ayurveda consider that the human body is made up of seven substances. These sapta dhatus are rasa (chyle), rakta (blood), maamsa (flesh), medas (adipose), asthi (bone), majjaa (marrow) and sukra (semen). Both these ancient health sciences understand importance of tridosha (three humors) whose balance is vital for good health. Health is further also understood as harmony of prana vayus (major energies of physiological function), upa prana vayus (minor energies of physiological function) and stability of nadis (subtle energy channels) with proper function of all chakras (major energy centres that may be correlated to the psycho-neuro-immuno-endocrine axis).

Tridoshas and health: The tridosha theory of health and disease that developed during the late Vedic period (circa 1500-800 BC) is common to virtually all Indian systems of medicine. Tridosha concept has correlation with pancha mahabhutas (elements of the manifest universe) as well as triguna (inherent qualities of nature).  Health is understood to be the balanced harmony of the three humours in accordance with individual predisposition while disease results from an imbalanced disharmony.

Qualities of physical health according to Yoga: The yogic view of health is exemplified in Shvetaasvatara Upanishad where it is said that the first signs of entering Yoga are lightness of body, health, thirstlessness of mind, clearness of complexion, a beautiful voice, an agreeable odour and scantiness of excretions (laghutvam arogyam alolupatvam varnaprasadam svara sausthavam ca ganghas subho mootra pureesam Yoga pravrittim prathamam vadanti -Shvetaasvatara Upanishad:  II-13).

The Hathayoga Pradipika echoes these qualities when Yogi Svatmarama says, “Slimness of body, lustre on face, clarity of voice, brightness of eyes, freedom from disease, control over seminal ejaculation, stimulation of gastric heat and purification of subtle energy channels are marks of success in Hathayoga.” (vapuh krsatvam vadane prasannataa naadasputatvam nayane sunirmale arogataa bindujayogni diipanam naadiivishuddhir hatha siddhi lakshanam  –Hathayoga Pradipika II-78).

In the Patanjala Yoga Darshan we find an excellent description of the attributes of bodily perfection (kaya sampat). It is said in Vibhuti Pada that perfection of body includes beauty, gracefulness, strength, and adamantine hardness (rupa lavanya bala vajra samhanana kaya sampat-Yoga Darshan III: 47). The effulgence that is characteristic of good health is also mentioned when it is said that deep concentration on samana (energy of digestion) leads to radiant effulgence (samana jayat jvalanam -Yoga Darshan III:41).

Qualities of mental health according to Yoga: Yoga not only considers physical health but also more importantly mental health. Qualities of a mentally healthy person (stitha prajna) are enumerated in the Bhagavad Gita as follows:

• Beyond passion, fear and anger (veeta raga bhaya krodhah –BG II.56)
• Devoid of possessiveness and egoism (nirmamo nirahamkarah -BG -II.7)
• Firm in understanding and unbewildered (sthira buddhir asammudhah –BG – V.20)
• Engaged in doing good to all creatures (sarva bhutahiteratah– BG V.25)
• Friendly and compassionate to all ( maitrah karuna eva ca– BG XII.13)
• Pure hearted and skilful without expectation (anapekshah sucir daksah –BG XII.16)

The central theme of Yoga is the golden mean, finding the middle path, a constant search for moderation and a harmonious homoeostatic balance. Yoga is the “unitive impulse” of life, which always seeks to unite diverse streams into a single powerful force.  Proper practice produces an inner balance of mind that remains stable and serene even in the midst of chaos.  This ancient science shows its adherents a clear path to the “eye of the storm” and ensures a stability that endures within, even as the cyclone rages externally.

Maharishi Patanjali tells us that we can gain unexcelled happiness, mental comfort, joy and satisfaction by practicing contentment (santoshat anuttamah sukha labhah– Yoga Darshan II: 42). This link is quite apparent once we think about it, but not too many associate the need for contentment in their greed for anything and everything in this material world.

Qualities of spiritual health according to Yoga: The Bhagavad Gita also delineates qualities of a spiritually healthy person in verses 1, 2 and 3 of chapter XVI. These include: fearlessness (abhayam), purity of inner being (sattva samshuddhih), steadfastness in the path of knowledge (jnanayoga vyavasthitih), charity (danam), self control (dama), spirit of sacrifice (yajna), self analysis (svadhyaya), disciplined life (tapa), uprightness (arjavam), non violence (ahimsa), truthfulness (satyam), freedom from anger (akrodhah), spirit of renunciation (tyagah), tranquility (shanti), aversion to defamation (apaishunam), compassion to all living creatures (daya bhutesv), non covetedness (aloluptvam), gentleness (maardavam), modesty (hrir acaapalam), vigour (tejah), forgiveness (kshama), fortitude (dhritih), cleanliness of body and mind (saucam), freedom from malice (adroho), and absence of pride (naa timaanita).

Relationship between food and health: Yoga emphasizes the importance of not only eating the right type of food but also the right amount and with the right attitude. Importance of not eating alone, as well as preparation and serving of food with love are brought out in the Yogic scheme of right living. Guna (inherent nature) of food is taken into consideration to attain and maintain good health. Modern dietary science of diet can learn a lot from this ancient concept of classification of food according to inherent nature as it is a totally neglected aspect of modern diet. We are what we eat!

The great Tamil poet-saint Tiruvalluvar offers sane advice on right eating when he says, “He who eats after the previous meal has been digested, needs not any medicine.” (marunthuena vaendaavaam yaakkaikku arundiyathu atrathu poatri unnin-Tirukkural 942). He also says that life in the body becomes a pleasure if we eat food to digestive measure (attraal alavuarinthu unga aghduudambu pettraan nedithu uikkum aaru-Tirukkural 943). He also invokes the Yogic concept of Mitahara by advising that “eating medium quantity of agreeable foods produces health and wellbeing” (maarupaaduillaatha undi marutthuunnin oorupaadu illai uyirkku
–Tirukkural 943).

Yogic methods to attain and maintain health: The science of Yoga has numerous practical techniques as well as advice for proper life style in order to attain and maintain health and well being. Bahiranga practices such as yama, niyama, asana and pranayama help produce physical health while antaranga practices of dharana and dhyana work on producing mental health along with pratyahara. A detailed description of these techniques and their benefits on health is beyond the preview of this lesson and will be discussed in detail in other lessons. It will suffice to say here that Yoga works towards restoration of normalcy in all systems of the human body with special emphasis on the psycho-neuro-immuno-endocrine axis.

In addition to its preventive and restorative capabilities, Yoga also aims at promoting positive health that will help us to tide over health challenges that occur during our lifetime. Just as we save money in a bank to tide over financial crises, so also we can build up our positive health balance to help us manage unforeseen health challenges with faster recovery and recuperation. This concept of positive health is one of Yoga’s unique contributions to modern healthcare as Yoga has both a preventive as well as promotive role in the healthcare of our masses. It is also inexpensive and can be used in tandem with other systems of medicine in an integrated manner to benefit patients.

In the Gheranda Samhita, a classical treatise on Hathayoga, the human body is likened to an unbaked clay pot that is incapable of holding the contents and disolves when faced with the challenge of water. It is only through intense heat generated by practice of Yoga that the human body gets baked, making it fit to hold the Divine Spirit. (aama kumbha ivaambhastho jeeryamanah sada gatah yoganalena samdahya ghata shuddhim –Gheranda Samhita I:8)

Tirumoolar has given numerous references to therapeutic benefits of Yoga for attaining and maintaining health in his monumental Tirumandiram. He emphasizes Swara Yoga concepts when he says, “If breath flow dominates in left nostril on Mondays, Wednesdays and Fridays no bodily harm can occur” (velliven thingal vilangum budanmoondrun thalli idatthe tayangume yaamaagil olliya kaayatthuk koona milaiyendru –Tirumandiram 791). He has further described the human body as the temple of the divine and stresses on the proper preservation of the body with reverence and care. (udambinai munnam izhukken drirunden udambinuk kulle yuruporul kanden udambule uttaman koilkon daan endru udambinai yaanirun thombugin drene –Tirumandiram 725). He has emphasized purification of internal organs to attain an imperishable body with perfect health (chuzhattrik kodukkave chuttik kazhiyunj chuzhattri malatthaik kamalatthaip poorithu uzhattrik kodukkum ubayam arivaarkku azhattrith thavirththudal anjana mame –Tirumandiram 726).

According to Swami Kuvalayananda, founder of Kaivalyadhama positive health does not mean mere freedom from disease but is a jubilant and energetic way of living and feeling that is the peak state of well being at all levels—physical, mental, emotional, social and spiritual. He says that one of the aims of Yoga is to encourage positive hygiene and health through development of inner natural powers of body and mind. In doing so, Yoga gives special attention to various eliminative processes and reconditions inherent powers of adaptation and adjustment of body and mind. Thus, the development of positive powers of adaptation and adjustment, inherent to the internal environment of man, helps him enjoy positive health and not just mere freedom from disease. He emphasizes that Yoga produces nadi shuddhi (purification of all channels of communication) and mala shuddhi (eradication of factors that disturb balanced working of body and mind).

According to Swami Kuvalayananda, Yoga helps cultivation of positive health through three integral steps:

1. Cultivation of correct psychological attitudes (maitri, karuna, mudita and upekshanam towards those who are suka, duhkha, punya and apunya),
2. Reconditioning of neuro-muscular and neuro-glandular system—in fact, the whole body—enabling it to withstand stress and strain better,
3. Laying great emphasis on appropriate diet conducive to such a peak state of health, and encouraging the natural processes of elimination through various processes of nadi shuddhi or mala shuddhi.

To live a healthy life it is important to do healthy things and follow a healthy lifestyle. The modern world is facing a pandemic of lifestyle disorders that require changes to be made consciously by individuals themselves. Yoga places great importance on a proper and healthy lifestyle whose main components are:

1. Achar –Yoga stresses the importance of healthy activities such as exercise and recommends asana, pranayama and kriyas on a regular basis. Cardio-respiratory health is one of the main by-products of such healthy activities.
2. Vichar –Right thoughts and right attitude towards life is vital for well being. A balanced state of mind is obtained by following the moral restraints and ethical observances (yama-niyama). As Mahatma Gandhi said, “there is enough in this world for everyone’s need but not enough for any one person’s greed.”
3. Ahar – Yoga emphasises need for a healthy, nourishing diet that has an adequate intake of fresh water along with a well balanced intake of fresh food, green salads, sprouts, unrefined cereals and fresh fruits. It is important to be aware of the need for a sattvic diet, prepared and served with love and affection.
4. Vihar – Proper recreational activities to relax body and mind are essential for good health. This includes proper relaxation, maintaining quietude of action-speech-thoughts and group activities wherein one loses the sense of individuality. Karma Yoga is an excellent method for losing the sense of individuality and gaining a sense of universality.

According to Yogacharini Meenakshi Devi Bhavanani, Director ICYER at Ananda Ashram in Pondicherry, Yoga has a step-by-step method for producing and maintaining perfect health at all levels of existence. She explains that social behaviour is first optimized through an understanding and control of the lower animal nature (pancha yama) and development and enhancement of the higher humane nature (pancha niyama). The body is then strengthened, disciplined, purified, sensitized, lightened, energized and made obedient to the higher will through asana. Universal pranic energy that flows through body-mind-emotions-spirit continuum is intensified and controlled through pranayama using breath control as a method to attain controlled expansion of the vital cosmic energy. The externally oriented senses are explored, refined, sharpened and made acute, until finally the individual can detach themselves from sensory impressions at will through pratyahara. The restless mind is then purified, cleansed, focused and strengthened through concentration (dharana).  If these six steps are thoroughly understood and practiced then the seventh, dhyana or meditation (a state of union of the mind with the object of contemplation) is possible. Intense meditation produces samadhi, or the enstatic feeling of Union, Oneness with the Universe.  This is the perfect state of integration or harmonious health.

Yogic Concepts of Disease

Vyadhi (disease) is considered one of the nine obstacles (antaraya) to integrative oneness of Yoga (samadhi) according to Maharishi Patanjali (Yoga Darshan I: 30). Patanjali also enumerates manifest symptoms such as duhkha (mental or physical pain), daurmanasya (sadness or dejection), angamejayatva (anxious tremor) and shvasa prashvasah (respiratory irregularities) as concomitant expressions of mental disturbances (Yoga Darshan I: 31).

These antaraya are one of the major causes of disintegration (vyadhi) according to the late Dr. M. L. Gharote, an eminent Yoga expert of Kaivalyadhama. He has described samadhi as the ideal state of health which is disturbed by the chitta vikshepa (disturbances in mind) due to the kleshas and antarayas. He has further also stated that mind is responsible for bondage and liberation as well as happiness and unhappiness. According to him the purpose of Yoga is to lessen the impact of these factors (klesha tanukaranam) and promote the state of integration (samadhi bhavanam).

Maharishi Patanjali gives us a clue to control the mental agitation by advising us to concentrate on slow and deep flow of respiration to still the mind (prachchhardana vidharanabhyam va pranasya – Yoga Darshan I: 34). He also advises concentration on a painless inner state of luminosity to produce stability and tranquillity (vishokava jyotishmati –Yoga Darshan I.36).

Patanjali has also explained the primary causation of stress based disorders through concept of pancha klesha (psychological afflictions). These are avidya (ignorance of the ultimate reality leading to bodily identification), asmita (a false sense of identification), raga-dvesha (addiction and aversion), abhinivesha (clinging on to life for fear of death), (avidya asmita raga dwesha abhinivesha kleshah -Yoga Darshan II: 3). Avidya as the root cause enables other kleshas to manifest in different forms from time to time. They may be dormant, attenuated, manifest or overpowering in their causation of pain and suffering. (avidya kshetram uttaresham prasupta tanu vicchinna udaranam –Yoga Darshan II:4).

As a proponent of preventive medicine, he advises us to prevent that which can be prevented so as to avoid future pain and suffering (heyam duhkham anagatam –Yoga Darshan II: 16). This helps us to understand that disease is not something to be feared but is an indicator of where we have been erroneous in our lifestyle, thinking pattern or diet. When this is done with awareness and conscious self analysis is made, it can become an impetus for healthy change putting us back on the right track to a happier and healthier life. Suffering or duhkha can be a dynamic springboard in our evolution if we have the right attitude towards it and don’t wallow in self pity. Yoga helps train our whole process of thinking thus creating right attitudes for evolutionary growth, every moment of our life.

The Yogic concept of health and disease enables us to understand that the cause of physical disorders stems from the seed in the mind and beyond. Adhi (the disturbed mind) is the cause and vyadhi (the physical disease) only the manifest effect in the Yogic scheme of things. By paying careful attention to personal history, one can nearly always trace origins of psychosomatic disease back to patterns of mental and emotional pressures.

From the Yogic viewpoint of disease it can be seen that psychosomatic, stress related disorders appear to progress through four distinct phases. These can be understood as follows:

1. Psychic Phase: This phase is marked by mild but persistent psychological and behavioural symptoms of stress like irritability, disturbed sleep and other minor symptoms. This phase can be correlated with vijnanamaya and manomaya koshas. Yoga as a therapy is very effective in this phase.
2. Psychosomatic Phase: If the stress continues there is an increase in symptoms, along with the appearance of generalized physiological symptoms such as occasional hypertension and tremors. This phase can be correlated with manomaya and pranamaya koshas. Yoga as a therapy is very effective in this phase
3. Somatic Phase: This phase is marked by disturbed function of organs, particularly the target, or involved organ. At this stage one begins to identify the diseased state. This phase can be correlated with pranamaya and annamaya koshas. Yoga as a therapy is less effective in this phase and may need to be used in conjunction with other methods of treatment.
4. Organic Phase: This phase is marked by full manifestation of the diseased state, with pathological changes such as an ulcerated stomach or chronic hypertension, becoming manifest in their totality with their resultant complications. This phase can be correlated with the annamaya kosha as the disease has become fixed in the physical body. Yoga as a therapy has a palliative and quality of life improving effect in this phase. It does also produce positive emotional and psychological effects even in terminal and end of life situations.

Often, however, the early stages of the disease process are overlooked and the final stage is seen as an entity unto itself, having little relationship to one’s living habits and patterns. This is because modern medicine only looks at the physical aspects and neglects effects of pancha kosha and trisharira on health and disease.

One of the major Indian concepts of disease causation is the imbalances of tridosha. This is found in numerous classical texts of Yoga and Ayurveda like Shiva Swarodaya, Sushruta Samhita, Charaka Samhita and Tirumandiram. According to the Dravidian poet-saint Tiruvalluvar, disease results from tridosha imbalance (miginum kuraiyinum noiseyyum noolor valimudhalaa enniya moondru –Tirukkural 941). Vata is the energy of the body that moves like the wind and causes flow in the body. It may be related to the nervous system as well as joints that enable us to move. Pitta is related to bilious secretion and is the cause of heat in the body. It is the energy of catabolism that is essential for digestion.  Kapha is the glue that holds everything together and is the energy of anabolism helping generative and regenerative processes.  According to Mark Halpern, Founder-Director, California College of Ayurveda, USA the tridosha fluctuate constantly. As they move out of balance, they affect particular areas of our bodies in characteristic ways. When vata is out of balance—typically in excess—we are prone to diseases of the large intestines, like constipation and gas, along with diseases of nervous system, immune system, and joints. When pitta is in excess, we are prone to diseases of the small intestines, like diarrhoea, along with diseases of the liver, spleen, thyroid, blood, skin, and eyes. When kapha is in excess, we are prone to diseases of the stomach and lungs, most notably mucous conditions, along with diseases of water metabolism, such as swelling.

Tirumandiram of Tirumoolar, the 3000 versed Tamil treatise by the Dravidian saint has prescribed the practice of Yoga at different times of day to relieve disorders arising from tridosha imbalances. According to him, practice of Yoga at dusk relieves kapha, practice at noon relieves vata and practice in morning relieves pitta disorders. (anjanam pondruda laiyaru mandiyile vanjaga vatha marumaddi yaanatthir senjiru kaalaiyir seithidir pittarum nanjara sonnom naraithirai naasame –Tirumandiram 727).

According to Shivaswarodaya, a classical text on Swara Yoga, disease develops when swara (smooth and regular air flow) in the nostrils do not adhere to their fixed timings and days. Normally swara flows in the nostrils in a certain pattern according to phases of the lunar cycle. It is also said that in case a disease develops due to erroneous functioning of swara, then a correction of that malfunctioning can cure that disease. The use of different techniques is also advocated for changing swara to relive various disorders.

Yoga Vashista a great text of Yoga describes causation and manifestation of disease in an admirable manner. It describes both psychosomatic as well as non-psychosomatic ailments. It attributes all psychic disturbances and physical ailments to the fivefold elements (pancha mahabhuta) in a manner similar to other systems of Indian medicine. Samanya adhija vyadhi are described as those arising from day-to-day causes while sara adhija vyadhi is the essential disease of being caught in the birth –rebirth cycle that can be understood in modern terms as congenital diseases. The former can be corrected by day-to-day remedial measures such as medicines and surgery whereas the sara adhija vyadhi doesn’t cease until knowledge of the self (atma jnana) is attained. The Guru Stotra from the Vishvasaaraatantra also takes a similar line in saying that the ultimate ‘wisdom of the self’ gained through the Guru destroys karmic bondages from many births (anekajanma samprapta karma bandha vidhahine atmajnana pradanena tasmai srigurave namah-Guru Stotra, verse 9). It is interesting to note that traditional Indian thought views the very occurrence of birth on this planet as a disease and a source of suffering! Tiruvalluvar reiterates this when he says, “It is knowledge of the ultimate truth that removes the folly of birth” (pirappu ennum pedaimai neenga chirappu ennum chem porul kaanbadhu arivu  –Tirukkural 358)

Yoga understands that physical ailments that are not of a psychosomatic nature can be easily managed with surgery, medication, prayers, douches and lifestyle modifications as required. Various Yoga techniques may also be used to help correct the physical ailments and restore health with regeneration, recuperation and rehabilitation as necessary. Accident prevention is an important benefit of a Yoga life, for better alertness, reflexes and physical condition enables one to prevent accidents as well as avoid getting traumatized both physically and mentally by such occurrences.

Yoga Vashista gives an elaborate description of the mechanism by which psychosomatic disorders occur. Mental confusion leads to agitation of prana (life force) and haphazard flow along nadis resulting in depletion of energy and / or clogging up of these channels of vital energy. This leads to disturbance in the physical body with disturbances of metabolism, excessive appetite and improper functioning of the entire digestive system. Natural movement of food through the digestive tract is arrested giving rise to numerous physical ailments. We need to remember that this text is many thousands of years old whereas the concept of psychosomatic disorders in modern medicine has only been realized and accepted in recent times. Our ancients had great inner vision and it is up to us to realize their dreams and understand the great message they have left for humanity.

Yogamaharishi Dr Swami Gitananda Giri, founder of Ananda Ashram at Pondicherry has written extensively about the relationship between health and disease. He says, “Yoga views the vast proliferation of psychosomatic diseases as a natural outcome of stress and strain created by desire fostered by modern propaganda and abuse of the body condoned on all sides even by religion, science and philosophy. Add to this the synthetic “junk food” diet of modern society and you have the possibility of endless disorders developing…even the extinction of man by his own ignorance and misdeeds”.

He explains the root cause of disease as follows. “Yoga, a wholistic, unified concept of oneness, is advaitam or non-dual in nature. It suggests happiness, harmony and ease. Dis-ease is created when duality or dvaitam arises in the human mind. This false concept of duality has produced all conflicts of human mind and the vast list of human disorders. Duality (dis-ease) is the primary cause of man’s downfall. Yoga helps return man to his pristine, whole nature. All diseases, maladies, tensions, are manifestations of divisions of what should be man’s complete nature, the atman or ‘Self’. This ‘Self’ is “ease.” A loss of “ease” creates “dis-ease.” Duality is the first insanity, the first disease, the unreasonable thought that “I am different from the whole…. I am unique. I am me.” The ego is a manifestation of disease. Only a distorted ego could feel alone, suffer from “the lonely disease”, in a Universe, a Cosmos totally filled with the ‘Self’. It is interesting that the one of the oldest words for man is “insan.” Man is “insane”. A return to sanity, “going sane,” is the subject of real Yoga sadhana and Yoga abhyasa. Yoga chikitsa is one of the methods to help insane man back onto the path of sanity. A healthy man or woman may be known by the term-Yogi”. A very strongly worded yet very true statement indeed from the Lion of Pondicherry!

Tiruvalluvar has emphasized the link between overeating and disease by saying, “the one who eats on an empty stomach gets health while with the greedy glutton abides ill-health” (izhivu arindhu unbaankan inbampol nirkum kazhiper iraiyaankan noi- Tirukkural 946). He also warns us that those who eat beyond the level of hunger will suffer from untold hardships (theeyalavu andrith theriyaan perithu unnin noialavu indrip padum –Tirukkural 947). He advises all doctors to look for the disease, then look for its root cause and finally search the remedy for the underlying cause (noinaadi noimudhal naadi athuthanikkum vaai naadi vaippach cheyal  –Tirukkural 948).

Yogic Methods of Diagnosis and Health Evaluation

Yoga has its own system of diagnosis and health evaluation that has been described by Yogamaharishi Dr Swami Gitananda Giri as a method of self-analysis (svadhyaya) enabling patients to understand themselves better. They may be then stimulated to make a sincere and dedicated attempt to regain their lost health, happiness and wholeness through unitive methods. The twelve major methods described by Swamiji include:

1. Triguna: This is most important as a person of a tamasic (dull and lazy) nature needs to be treated differently than rajasic (overactive) and sattvwic (calm and composed) types. Western medicine treats everyone “democratically the same” and turns simple toxicity into permanent sickness. The trigunic nature must first be evaluated to bring about self-healing in a patient. The more sensitive and evolved the person, the more sensitive must be the treatment.
2. Tridosha: Without evaluating patients according to their dosha, modern medicine dries up the kapha, increases chemical poisoning and produces pressure conditions that are all chronic disorders, while the original dosha imbalances may be easily rectified and balanced.
3. Trivasana: The psychological background to one’s personal nature represents personal propensities that bind us to the wheel of birth and rebirth. Lokha vasana (position in life), jnana vasana (level of education and knowledge) and deha vasana (hang-ups and attachments to the body). These may be considered to be the most ingrained of all human conditions.
4. Prana: One must determine which of the prana vayu is active or recessive, and which upa prana vayu is shut down, inactive, or recessive. Improper functioning of the various prana vayu leads to various conditions depending on the vayu involved. For example, if it is the samana vayu, then digestion is affected whereas the excretory function is affected in apana vayu malfunction. Loss of prana is death whereas disease is the manifestation of its malfunction.
5. Abhyasa: A disciplined patient can be trusted to carry out directions, while those who are undisciplined will be difficult patients, disobeying injunctions about life, transgressing body laws, and therefore, will remain disturbed, negative and ill. A disciplined person is seldom ill and is usually suffering only from ignorance or avidya. When truth is revealed they will immediately follow the truth. Most real Gurus will refuse to accept students unless they are disciplined.
6. Jiva Karma: A healthy lifestyle is one where there is proper adherence to yama-niyama, the system of morality and ethics, as expounded by Maharishi Patanjali. Disobedience or lack of discretion in following these moral and ethical precepts are the cause of much sickness, pain, suffering and violence. A moral and ethical life is necessary for attaining and maintaining good health.
7. Chetana: The quality of thought of the individual matters! Are they idealistic, positive, and outgoing? Or lacking ideals, reserved and negative? Thought is the cause of all body action and this is the rationale behind adhi-vyadhi, the Yogic concept of psycho-somatics. The Christ Yogi said, “As above, so below”: As we think so also we become. Now there are dangerous vyadhi-adhi, somato—psychic conditions where condition of the body in turn produces mental disturbances.
8. Vacha: Much can be diagnosed from the way a person speaks, how they pronounce and enunciate language and how they deliver the “power of sound in speech”. Refined speech should be met with refined results. Crude and rough speech elicits crude and rough response.
9. Ahara: As food plays an important part in health or sickness, dietary habits must be examined. It is universally understood that a meat-eating diet is destructive, while a vegetarian diet is more conducive to good health, emotional equilibrium and unitive evolution. Junk foods especially must be curtailed.
10. Viparita Buddhi. There is no possibility of good health for a person who deliberately misuses tobacco, alcohol and illicit drugs. Other habits like over eating or under eating, over exercise and under exercise as well as sexual abuses must also be considered.
11. Jiva Vritti: Considerations such as periodicity of nasal cycle; number of breaths per minute, whether deep or shallow, whether sectional or complete; heart beat and blood pressure; regularity of passing urine and emptying of bowels are classified in this category.
12. Sankalpa: Aspirations of the individual which may only involve a desire to be well must also be examined. What are the beliefs of the patient? Are they negative or positive? High or low? Are they idealistic enough to accept help, suggestions, and spiritual advice, or are they the type who rejects positive help. One who accepts is a ready listener and follows up with direct actions.

Application of yogic concepts in promotion of positive health, prevention of disease and management of diseased conditions 

1. Become aware of your body, emotions and mind: Without awareness there cannot be health or healing. Awareness of body implies conscious body work that needs to be synchronized with breath to qualify as a psychosomatic technique of health and healing. Psychosomatic disorders that are the bane of the modern world cannot be tackled without awareness.
2. Improve your dietary habits: Most disorders are directly or indirectly linked to improper dietary patterns that need to be addressed in order to find a permanent solution to health challenges. One of the most important lifestyle changes that needs be implemented in management of any lifestyle disorder is diet.
3. Relax your whole body: Relaxation is most often all that most patients need in order to improve their physical condition. Stress is the major culprit and may be the causative, aggravating, or precipitating factor in so many psychosomatic disorders. Doctors are often found telling their patients to relax, but never tell them how to do it! The relaxation part of every Yoga session is most important for it is during it that benefit of practices done in the session seep into each and every cell producing rest, rejuvenation, reinvigoration and reintegration.
4. Slow down your breath making it quiet and deep:  Rapid, uncontrolled, irregular breathing is a sign of ill health whereas slow, deep and regular controlled breathing is a sign of health. Breath is the link between body and mind and is the agent of physical, physiological and mental unification. When breath is slowed down, metabolic processes are also slowed and anabolic activities begin the process of healing and rebuilding. If breath is calm, mind is calm and life is long!
5. Calm down your mind and focus it inwardly: The mind is as disturbed as a drunken monkey bitten by a scorpion say our scriptures. To bring that wayward agitated mind under control, and take it on a journey into our inner being is fundamental in finding a way out of the ‘disease maze’ in which we are entangled like a fly in the spider’s web. Breath work and sensory control are the base on which mind training can occur; hence much importance is given to pranayama and pratyahara. It is only after this that concentration practices leading to meditation can have any use. Just sitting and thinking about something is not meditation!
6. Improve the flow of healing ‘Pranic Life Energy’: Improve the flow of healing ‘Pranic Life Energy’ to all parts of the body, especially to those diseased parts, thus relaxing, regenerating and reinvigorating yourself. Prana is life and without it there cannot be healing. The different prana and upa prana vayu that are energies driving different physiological functions of the body need to be understood and applied as per needs of the patient. In patients of digestive disorders, focus must be on the samana vayu whereas in pelvic conditions it needs to be on apana vayu. The fifth chapter of the Hathayoga Pradipika has a detailed analysis of various malfunctions of the vayu and their correction.
7. Fortify yourself against omnipresent stressors: Decrease your stress level by fortifying yourself against the various omnipresent stressors in your life. When face to face with the innumerable thorns in a forest, one may either choose to spend all their time picking them up one by one while other thorns continue falling or choose to wear a pair of shoes and walk through the forest. The difference is in attitude. Choosing the right attitude can change everything and bring about a resolution of the problem by healing the core. Stress is more about how you react to the stressor than about the stressor itself!
8. Increase your self reliance and self confidence: Life is full of challenges that are there only to make us stronger and better. The challenges should be understood as opportunities for change and faced with confidence. We must understand we have the inner power to overcome each and every challenge that is thrown at us by life. The Divine is not a sadist to give us challenges that are beyond our capacity!
9. Facilitate natural emanation of wastes: Facilitate natural emanation of waste from the body by practicing shuddi kriyas like dhauti, basti and neti. Accumulation and stagnation of waste materials either in inner or outer environment always causes problems. Yogic cleaning practices help wash out impurities (mala shodhana) thus helping the process of regeneration and facilitating healing.
10. Take responsibility for your own health: Remember that ultimately it is “YOU” who are responsible for your own health and well being and must take the initiative to develop positive health to tide you over challenging times of ill health. Yoga fixes responsibility for our health squarely upon our own shoulders. If we do healthy things we are healthy and if we do unhealthy things we become sick. No use complaining that we are not well when we have been the cause of our problem. As Swamiji Gitananda Giri would say, “You don’t have problems-you are the problem!”
11. Health and happiness are your birthright: Health and happiness are your birthright, claim them and develop them to your maximum potential. This message of Swamiji is a firm reminder that the goal of human existence is not health and happiness but is moksha (liberation). Most people today are so busy trying to find health and happiness that they forget why they are here in the first place. Yoga helps us regain our birthrights and attain the goal of human life.

When we remember to inculcate these principles of Yoga in our practice and help our patients to understand them thus assimilating them in their own lives, we are practicing Yoga. If not it is merely Yogopathy, the symptomatic management of conditions using techniques of Yoga!

The art and science of Yoga has infinite possibilities for providing answers to most health problems troubling modern humankind. However we often misunderstand this science and want it to be a miracle pill. A pill that we take only once, and want all the problems to vanish into thin air! Yoga is a wholistic science and must be learnt and practiced with a holistic view. The dedicated practice of Yoga as a way of life is no doubt a panacea for problems related to psychosomatic, stress related disorders helping us to regain our birthright of health and happiness.

 About the Author:

Yogacharya Dr. Ananda Balayogi Bhavanani is Director of the Centre for Yoga Therapy Education and Research (CYTER), and Professor of Yoga Therapy at the Sri Balaji Vidyapeeth University, Pondicherry (www.sbvu.ac.in). He is also Chairman of the International Centre for Yoga Education and Research at Ananda Ashram, Pondicherry, India (www.icyer.com) and Yoganjali Natyalayam, the premier institute of Yoga and Carnatic Music and Bharatanatyam in Pondicherry (www.rishiculture.in). He is son and successor of the internationally acclaimed Yoga team of Yogamaharishi Dr. Swami Gitananda Giri Guru Maharaj and Yogacharini Kalaimamani Ammaji, Smt Meenakshi Devi Bhavanani.

He is a Gold Medallist in Medical Studies (MBBS) with postgraduate diplomas in both Family Health (PGDFH) as well as Yoga (PGDY) and the Advanced Diploma in Yoga under his illustrious parents in 1991-93. A Fellow of the Indian Academy of Yoga, he has authored 19 DVDs and 23 books on Yoga as well as published more than two hundred papers, compilations and abstracts on Yoga and Yoga research in National and International Journals. His literary works have more than 1500 Citations, with an h-Index of 19 and an i10-Index of 33.  In addition, he is a Classical Indian Vocalist, Percussionist, Music Composer and Choreographer of Indian Classical Dance.

In recent years he has travelled abroad 18 times and conducted invited talks, public events, workshops and retreats and been major presenter at Yoga conferences in the UK, USA, Italy, South Africa, Germany, Switzerland, Canada, Australia and New Zealand.

He is an Honorary Advisor to International Association of Yoga Therapists (www.iayt.org), Australasian Association of Yoga Therapists (www.yogatherapy.org.au),  World Yoga Foundation (www.worldyogafoundation.in) and Gitananda Yoga Associations worldwide  (www.rishiculture.in). A recognized PhD guide for Yoga Therapy he was recognized as an IAYT Certified Yoga Therapist (C-IAYT) by the International Association of Yoga Therapists, USA in September 2016. It is notable that he is the first Indian to receive this honour.

He is currently member of numerous expert committees of the Ministry of AYUSH including its National Board for Promotion of Yoga and Naturopathy, Scientific Advisory Committee & Standing Finance Committees of CCRYN, Expert Committees for Celebration of International Yoga Day and the Yoga & Diabetes program. He is Consultant Resource Person for the WHO Collaborative Centre in Traditional Medicine (Yoga) at MDNIY, New Delhi. He is also EC member and Director Publications Committee of the Indian Yoga Association (www.yogaiya.in) and Board of Directors of the Council for Yoga Accreditation International (www.cyai.org).