Proceedings of the National Workshop on

INTRODUCING YOGA IN MEDICAL CURRICULUM

19 and 20 March 2009 Organized by
Advanced Centre for Yoga Therapy, Education & Research, (ACYTER)

& Department of Physiology, JIPMER, Puducherry in collaboration with Morarji Desai National Institute of Yoga (MDNIY), New Delhi
(An autonomous organisation under Department of AYUSH, Ministry of Health and Family
Welfare, Government of India)

Editor and Organizing Secretary: Dr. MADANMOHAN

Director-Professor & Head, Department of Physiology & Programme Director, ACYTER Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER),
(An Institute of National Importance under the Ministry of Health & Family Welfare, GOI)

Puducherry 605006, India

CONTENTS
From the desk of the Organizing Secretary Report on the workshop Workshop faculty List of participants Academic programme Rationale of introducing yoga for medical professionals Need for introducing yoga in the medical curriculum Yoga and modern medicine: possible meeting points Need and feasibility of introducing yoga in medical curriculum Modality of introducing yoga in medical curriculum Strategies for integrating yoga in the medical curriculum Yoga curriculum in MBBS course Yoga for medical students Therapeutic potential of yoga Yoga therapy module for respiratory disorders Reversal of heart disease the yogic way: facts, programme and research Meditation: an overview Meditation for medicos Health benefits of yoga Diabetes mellitus and its yogic management 2 3 13 14 18 20 23 26 37 40 44 47 49 51 56 59 63 65 67 73

FROM THE DESK OF THE ORGANIZING SECRETARY

At the outset, I wish to express my heartfelt thanks to the Secretary AYUSH, Ministry of Health and Family Welfare, Govt. of India, New Delhi for giving me the opportunity and honour to organize this national workshop on Introducing Yoga in Medical Curriculum. It was the dynamism and youthful enthusiasm of Dr. Ishwar V Basavaraddi, Director, Morarji Desai National Institute of Yoga (MDNIY), New Delhi, that motivated me to take up the challenge at a very short notice. He and the staff of MDNIY have offered unconditional support for the success of this workshop. This workshop is the culmination of my long cherished desire to introduce the science of yoga to medical students. I am grateful for the encouragement, guidance and support of Professor KSVK Subba Rao, Director, JIPMER. He inaugurated the workshop and set the tone for its success. I thank Professor Ashok Kumar Das, Medical Superintendent, JIPMER, whose active participation in the workshop inspired the delegates. Professor S Badrinath, Project Coordinator and Professor KS Reddy, Dean have been a source of support for organizing this workshop. I am grateful to the distinguished faculty of the workshop who readily responded to my invitation at a very short notice. I thank my colleagues and friends from the Department of Physiology, ACYTER and other departments of JIPMER who were of great help in organizing this workshop. Professor GK Pal made extra efforts to manage the scientific programme. Special thanks are due to Yogacharya Dr Ananda Balayogi Bhavanani, Programme Coordinator, ACYTER for compiling the proceedings. Thanks are due to Dr. Zeena Sanjay for her help in proof reading. It is a matter of great satisfaction that the workshop was conducted in a fitting manner and to the satisfaction of delegates as well as the faculty. Lectures were of high quality and demonstrations were educative and useful. I am very happy to bring out the proceedings and hope that its contents will be useful to the readers and motivate them to conduct similar workshops that will ultimately lead to the integration of the science of yoga with modern medicine.

Dr. Madanmohan drmadanmohan123@rediffmail.com & drmadanmohan123@gmail.com

REPORT ON THE WORKSHOP

ACYTER and the Department of Physiology, JIPMER organized a two day National Workshop on Introducing Yoga in Medical Curriculum on 19 and 20 March 2009 at JIPMER. The workshop was organized in collaboration with Morarji Desai National Institute of Yoga (MDNIY), New Delhi, an autonomous organization under the Department of AYUSH, Ministry of Health and Family Welfare, Govt of India. The workshop was inaugurated by Dr KSVK Subba Rao, Director JIPMER. Dr Ishwar V Basavaraddi, Director, MDNIY, New Delhi and Dr AK Das, Medical Superintendent, JIPMER were guests of honour. Dr S Badrinath, Project Coordinator, Dr KS Reddy, Dean and many faculty and staff members from various departments of JIPMER participated in the inaugural function. The workshop deliberated on the need, feasibility and modality of introducing yoga science in the medical curriculum for medical students in particular and medical professionals in general. 25 resource persons from JIPMER, MDNIY, DIPAS, sVYASA, KYM, Karuna Trust, Iyengar Yoga Institute, Mumbai Yoga Institute, Kaivalyadhama and ICYER as well as 105 participants from all over the country and 100 first year medical students of JIPMER participated in the workshop that covered the theory, practicals, therapeutic aspects of yoga and evaluation methods for such a course. The following are the recommendations of the workshop: 1. The workshop appreciated the Department of AYUSH and Morarji Desai National Institute of Yoga, New Delhi for making efforts to integrate yoga science in the medical curriculum and create awareness of yoga amongst the medical students in particular and medical professionals in general. 2. It was recommended to introduce yoga science to medical students and medical professionals through a Foundation Course in Yoga Science. 3. It was recommended that 14 hours of yoga theory be included as lectures for 1st, 2nd and 3rd professionals and 32 hours practicals be included in the 2nd professional. 4. It was also recommended that an optional foundation course be conducted after class hours for interested professionals through the yoga units of the institutions. This can utilize the 48 3

hour foundation course syllabus that has been prepared by MDNIY in consultation with eminent yoga and medical experts. The workshop started with inaugural function at 9.30 am. This was followed by invited talks, which dealt with the importance of yoga in medicine, and the need to introduce it into the medical curriculum. The afternoon session of the first day and forenoon session of the second day had two parallel workshops each where the participants could attend the workshop of their interest. In the afternoon session of the second day, moderators of the four workshops presented the summary and recommendations of their respective workshops.

WORKSHOP I ON THEORY CURRICULUM : The workshop on evolving the theory curriculum for the introduction of yoga in medical education was held in the afternoon of 19 March and was chaired by Dr Mythily Bhaskaran, Head of the Dept of Physiology, Saveetha Medical College, Chennai. Dr TM Roy, Head of the Dept of Physiology, Manakula Vinayagar Medical College, Pondicherry was co-chairperson and Dr GK Pal, Prof of physiology, JIPMER was moderator. Members of the faculty included Dr G Himashree of DIPAS, Delhi, Dr Aparna Agrawal, Professor of Medicine, JIPMER, Dr KV Naveen of sVYASA, Bangalore and Dr Ananda Balayogi Bhavanani, Programme Coordinator ACYTER, JIPMER. Dr Mythily Bhaskaran introduced the topic and stated the aims and objectives of the workshop. She shared her experience in introducing yoga to medical students in Stanley Medical College, Chennai and hoped that the workshop would evolve a consensus on a uniform syllabus that could be recommended to MCI for inclusion in the MBBS curriculum. Dr Himashree in her talk explained how a healthy lifestyle creates a balance between the two limbs of the autonomic nervous system and that manipulation of the autonomic nervous system by yoga is the safest non-pharmacological therapeutic intervention. She stressed that almost all disorders are psychosomatic in nature and there is great potential for including yoga as a therapeutic tool. Discussion points that came up following her talk were that teaching yoga to medical students is different from teaching it to the general population. It was stressed that yoga

teachers must have basic knowledge of anatomy and physiology and use evidence based teaching methods for medical students. Dr TM Roy explained that students need to be convinced about the potential of yoga. He narrated the experience of giving yoga training to the repeaters of the 1st MBBS and that 24 out of the 27 repeaters passed the exam in the second attempt. He stressed the need for having a meditation hall and qualified instructors for imparting yoga training to medical students. He recommended that the morning time be utilized for the training. Dr Ananda Balayogi Bhavanani discussed the proposed syllabus for introducing yoga to medical professionals that has been devised by MDNIY in consultation with eminent medical and yoga experts. The chairperson then called for a general discussion and a detailed and fruitful discussion resulted with inputs from participants and faculty and heartfelt feedback from first year medical students of JIPMER. It was felt that having all theory lectures and practical classes in 1 or 2 months wasnt feasible due to the tight schedule of the MBBS curriculum. It was recommended that there could be a total of 10 hours of theory lectures and 4 hours of lecture demonstration of yoga in the MBBS curriculum. In addition, there may be 32 hours of practicals which can be phased as 12 mandatory in 2nd MBBS and 20 optional in 2nd & 3rd MBBS course. The 20 optional practical classes will be conducted after the college hours. 5 hours of theory lectures during the first year will be with Physiology as Unit I under the heading of Basic physiology of yoga. This would include: Introduction to yoga and relevance in modern social life. Misconceptions about yoga and the true nature of yoga. Schools of yoga. Basic scientific principles of yoga and yogic practices. Effect of yogic practices on different systems of human body. Yogic practices for promotion of positive health. Yogic concept of health and disease, yoga as therapy, its strengths and limitations. Yogic management of disease. 5

It was suggested that 4 hours of lecture-demonstrations of yoga as a preventive health science could be introduced with preventive and social (community) medicine during the second year as Unit II under the heading of Yoga: a preventive health science. It was also suggested that 5 hours of theory lectures on yoga be included along with medicine in third year as Unit III under the heading of Yoga therapy modules for the management of various disorders. This could have the following topics: Yoga therapy for the management of digestive and metabolic disorders. Yoga therapy for the management of cardio-vascular disorders. Yoga therapy for the management of respiratory disorders. Yoga therapy for the management of musculoskeletal disorders. Yoga therapy for endocrine, neurological and psychiatric disorders. Pathophysiology of stress, stress-induced disorders and their yogic management. It was recommended that the details of yoga theory such as philosophy and practice of Patanjal yoga, hath yoga, shat chakra, pran, nadi etc may be incorporated into the practicals and these concepts may be taught to the students by the yoga instructor. The MDNIY syllabus for the Foundation course in yoga for medical professionals was approved without change as it is an optional course that may be undertaken by both medical students and the medical professionals outside their office hours.

WORKSHOP II ON YOGA THERAPY MODULES: The workshop on various yoga therapy modules was held in the afternoon of 19 March and was chaired by Dr AK Das, Medical Superintendent of JIPMER. Dr. Arpan Bhatt, Programme Director ACYER, Gujarat Ayurved University, Jamnagar was the moderator. Members of the faculty included Dr. N Chandrasekaran, Director Chikitsa, Krishnamacharya Yoga Mandiram, Chennai, Dr.DR Vaze of Kaivalyadhama, Lonavla, Dr. Shantaram Shetty of The Yoga Institute, Mumbai, Dr Rajvi Mehta of Ramamani Iyengar Memorial Yoga Institute, Pune and Dr Ishwar Acharya, Programme Officer (Yoga Therapy), MDNIY, New Delhi.

Dr AK Das gave an enlightening presentation on diabetes and explained the lifestyle disorder that begins and ends with obesity and lipids. He explained that exercise has a beneficial effect on any stage of type 2 diabetes. He suggested various yoga practices that may help in the management of diabetes and mentioned that good metabolic control, better control of concomitant hypertension, better I/G ratios and better insulin sensitivity were the effects of yoga practice. During the discussion that followed, it was suggested that evidence based research must determine the usage of the modules and that whenever diabetes is taught in the medical curriculum, the benefits of yoga must be taught and not just a few asans pertaining to diabetes. All medical practitioners must be sensitized to the principles of yoga and encouraged to know more about this ancient science. Dr N Chandrasekaran gave a presentation on the aspects of yoga for back pain. He suggested that yogic therapy is highly focused and yet complete. He explained that all the tools in yoga are like clay and need to be moulded by the teacher or therapist to suit the individual student or patients need. He detailed various practices that can benefit the persons suffering from back pain and explained how to modify them to suit the individual needs. Dr DR Vaze discussed various problems of digestive system and also gave many suggestions on the Dos and Donts of yoga therapy. He detailed the importance of the teacher, time, place, clothing, mat etc and also advised that yoga therapy should not be used in acute infective conditions, malignant growths and within 6 weeks after a major surgery. He also discussed various yoga techniques for relieving constipation. Dr Shantaram Shetty extolled the need to achieve a transformation in lifestyle for healthier living. He explained the importance of achar (right action), vichar (right thoughts), ahar (right food) and vihar (right recreation) in improving health. It was suggested that medical students be introduced to the secondary preventive aspects of yoga. The quality and quantity of yoga may then be gradually increased. Proper training and lifestyle modifications can go a long way in making everyone healthier. Dr Rajvi Mehta talked about the aspects of yoga for respiratory disorders and stressed that tall claims must not be made. She also made it clear that over simplification was also not acceptable. She equated yam-niyam with preventive and social aspects of medicine and asan-pranayam with anatomy and physiology and the inner aspects of yoga to the super specialty training in medicine. 7

She emphasized that the quality of the asan was of paramount importance and that specific sequences were important in therapy. The sequence must give the patient confidence, symptomatic relief as well as work on adjacent areas without straining the already weakened part. Later the affected area can be worked on. She emphasized that the efficacy of any therapy programme will depend on selection of the right yogic techniques, practice to perfection, right sequence and finally compliance of the patient. She then gave a detailed description of various asans with and without props that can be beneficial to patients suffering from asthma and other respiratory conditions. Dr Ishwar Acharya of MDNIY detailed various yoga practices that can be beneficial to patients suffering from obesity. He suggested that when scientific evidence is weak or absent, experience based practices may be adopted and also reference given to the claims and practices as given in traditional texts of yoga. In the discussion that followed it was suggested to compile a common programme of therapy as different texts and different traditions use different practices and names for the practices. It was pointed out that the therapy needs to be modified according to the individual patient and a clear understanding of the etio-pathogenesis was important. It was emphasized that the primary aspect of yoga therapy was to produce a sense of well being, the secondary aspect was of a disease specific nature while the third was of a relaxative nature. On the evening of the first day, there was a memorable cultural programme by Yoganjali Natyalayam, Pondicherrys premier institute of Bharatanatyam, yoga and Carnatic music under the dynamic direction of Kalaimamani Meenakshi Devi Bhavanani. The young students and faculty of Yoganjali Natyalayam presented the beauty of the Indian classical performing arts with skill and grace. A spectacular yogasan group demonstration by young boys was one of the highlights with music by Dr Ananda Balayogi Bhavanani, Smt Devasena Bhavanani and their team. This enjoyable and relaxing cultural programme was highly appreciated by the delegates and the distinguished audience which included foreign dignitaries.

WORKSHOP III ON YOGA PRACTICES FOR MEDICAL STUDENTS: The third workshop on yoga practices for medical students was held in the forenoon session on the 20th. The workshop was chaired by Dr IV Basavaraddi, Director, MDNIY, New Delhi and moderated by 8

Smt. Meena Ramanathan, Coordinator of Yoga Courses at the Pondicherry University Community college. The faculty for the workshop included Yogacharini Meenakshi Devi

Bhavanani, Director ICYER, Puducherry, Dr Manoj Naik of the Ramamani Iyengar Memorial Yoga Institute, Pune, Dr P Vishvanath of the Karuna Trust, Bangalore, Dr GS Gaur, Professor Physiology JIPMER and Shri R Murugesan, Physical instructor JIPMER. Dr GS Gaur strongly supported the formulated schedule of yogic practices as given in the proposed syllabus compiled by MDNIY. He felt that there is no need to make any changes in the proposed syllabus as the JIPMER students have already undergone training in those practices and they were found beneficial to them. He also commented that the basics need to be taught to them during the 1st and 2nd semester and advanced practices during the 6th and 7th semester. Yogacharini Meenakshi Devi Bhavanani gave an excellent presentation in which she emphasized the 3 Rs (regularity, repetition and rhythm) for the benefit of the medical students. She commented that while a yogi learns from inside with meditative awareness, modern doctors learn from the outside. Once integration is brought between these two, the knowledge becomes more complete and holistic. The faculty and teacher trainees from ICYER gave an excellent demonstration of various jathis and kriyas which loosen the body parts, improve circulation, enhance awareness and cleanse our energy body (pranamaya kosh). They energise our whole body and improve the sense of well being. Meenakshi Devi emphasized that emotions and movements of the body are closely related, and physical movements associated with sound let out the negativities from within, stimulating the cells and energizing the whole body. She concluded by saying that these yogic techniques when practiced along with asans, pranayam and dhyan will most certainly produce a sense of well being, stabilizing us physically, mentally and emotionally. Dr. Manoj Naik gave an emphatic, convincing and inspiring presentation with a lecture-cumdemonstration extolling asans as an advanced applied physiology. He explained that the alignment of various body parts in an asan is nothing but bio-engineering in detail and showed how standing properly with the weight distributed equally on both the legs

(tadasan) can bring about samatvam, meaning equanimity or equipoise in an individual. He demonstrated various postures like trikonasan, parshavakonasan, ardhamatsyendrasan and bhadrasan, emphasizing on the stretched and contracted muscles and explaining the agonist and antagonist group of muscles and their working during the holding phase of an asan. The 9

concept of isometric and isotonic contraction while performing an asan was demonstrated very well. All the students in the audience joined in and started mentioning names of muscles

contracted and stretched while he performed the postures. The presentation was highly educative and entertaining. Dr P Vishvanath appreciated JIPMER for being the role model in integrating yoga science in the medical curriculum. He pointed out that there were too many cultural asans in the syllabus and suggested that they have to be cut down to just three or four postures in each type. He also said that surya namaskar with 12 steps might be a little difficult and taxing for the students in the beginning. Shri R Murugesan said that it was important to move in tune with nature and not against it. He suggested that the practices should be taught from the supine, then prone, then sitting and finally standing positions just as the child learns to crawl, sit and then stand. The practices done in this way will be less taxing. He made a special mention about yogic diet and proper dress code for the yoga practice. He demonstrated some asans that may benefit the medical students and help them improve their overall performance. During the general discussion, suggestions were made to add more general text for the practices and web pages from where interested students may gather information and knowledge about yoga. It was also suggested that the existing glossary needed to be altered a bit. A general consensus was established on the following points: The scheduled practices must be taught by well trained yoga instructors having the capacity to motivate and inspire students to continue their practice even after the classes are over. The practices must give them complete relief and relaxation from their regular stressful routine. It should not tax them further in addition to their already existing heavy work load. The practices schedule must help them in their transition from the secure school life to the strenuous college life and attain a sense of well being as many were away from their home environment. It was agreed that once the medical students start doing the practices, they are sure to experience the benefits of becoming physically healthier, mentally stronger and emotionally more secure. Once they are convinced that yoga practices are beneficial and can be safely 10

practiced by all, they are sure to recommend these practices to their patients. Once doctors develop a good rapport with the yoga therapist, the patients can greatly benefit and can be treated better with minimum risk. In conclusion, it was agreed upon unanimously that the introduction of the yoga practices for medical students will certainly make them more perceptive and discriminative and help them understand and empathize with their patients better.

WORKSHOP IV ON EVALUATION METHODS: The fourth workshop on evaluation methods was held in the forenoon of 20 March. The workshop was chaired by Dr Santosh Kumar, Head of the Department of Medical Education, JIPMER and moderated by Dr Pravati Pal, Associate Professor of Physiology, JIPMER. The faculty for the workshop included Dr. Aparna Agrawal, Professor of Medicine, JIPMER, Dr. Vivek Sharma, Assistant Professor of Physiology, JIPMER. Dr Madanmohan, Dr DR Vaze, Dr Himashree, Dr GK Pal and Dr KV Naveen were co-opted on the expert panel and participated actively in the discussion. Yoga helps in prevention of lifestyle diseases but there is a thin line of difference between the preventive and curative aspects of yoga. There was heated discussion on the efficacy of yoga as therapy as the first year medical students considered the evidence as biased or insufficient. They felt that the physiologic effects of yoga have been studied extensively as compared to the therapeutic clinical trials that are few and far between. In addition, the problem of inherent dangers of ending up referring patients to quacks in yoga who dont have necessary expertise or knowledge was discussed to a great extent. It was suggested that all medical colleges should have a yoga unit with qualified and experienced staff to manage the patients referred by other departments. It was also suggested that the yoga training should be choice and credit based. It was decided that the scheme of introducing yoga in medical curriculum should have 14 hours of theory and 32 hours of practice sessions. The theory sessions will be divided as 5 hours in physiology, 4 hours in preventive and social medicine and 5 hours in medicine. Out of the 32 hours of practicals, 12 hours be made compulsory to be completed during the 2nd MBBS. It was decided that the remaining 20 practical hours be optional. After a lengthy discussion it was decided that the must attend-need not pass policy be followed with regard to the practice sessions and that a certificate be given to the successful candidates at the end of the training. It 11

was also proposed to give ONE mark in internal assessment to the students who complete the mandatory hours of practicals. It was suggested that a systematic survey be done to see the response to the idea all over the country before introducing yoga in the curriculum per se. It was also suggested that all medical colleges and hospitals recruit yoga therapists and instructors to give yoga training to medical students and also facilitate proper and standard yoga therapy for all. It was also suggested that yoga be introduced at higher secondary level to augment the awareness of yoga amongst the students. The valedictory function was conducted on the afternoon of the second day during which reports on the four workshops was presented by moderators of the respective workshops. Feedback from the faculty and participants was obtained and certificates were distributed to the faculty and participants. The function ended with a vote of thanks by the organizing secretary.

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WORKSHOP FACULTY
1. Dr Arpan Bhatt Programme Director ACYER, Gujarat Ayurved University Jamnagar, Gujarat 2. Dr Aparna Agrawal Professor, Dept of Medicine, JIPMER 3. Dr Ananda Balayogi Bhavanani Programme Coordinator, ACYTER, JIPMER 4. Dr IV Basavaraddi Director, MDNIY, New Delhi 5. Dr N Chandrasekaran Director Chikitsa KYM, Chennai 6. Dr AK Das Medical Superintendent, JIPMER 7. Dr. GS Gaur Professor of Physiology, JIPMER 8. Lt. Col. Dr G Himashree Head Dept.of Physiology, ACMS, New Delhi. OSD, DIPAS, DRDO, Timarpur, Delhi 110054 9. Dr Manoj Naik Ramamani Iyengar Memorial Yoga Institute, Pune 10. Dr Mythili Bhaskaran Professor of Physiology, Saveetha Medical College, Chennai 11. Dr Madanmohan Director-Professor & Head, Dept of Physiology & Programme Director, ACYTER, JIPMER 12. Shri R Murugesan Physical Instructor, JIPMER 13. Yogacharini Smt. Meenakshi Devi Bhavanani Director, ICYER, Pondicherry 14. Smt Meena Ramanathan Co-ordinator, Yoga Courses, Pondicherry University Community College, Puducherry 15. Dr Rajvi Mehta Research Associate, Light on Yoga Research Trust, Iyengar Yogashraya, Mumbai 16. Dr KV Naveen sVYASA, Bangalore 17 Dr GK Pal Professor, Dept of Physiology, JIPMER 18. Dr Pravati Pal Associate Professor, Dept of Physiology, JIPMER 19. Dr TM Roy Head, Dept of Physiology Manakula Vinayagar Medical College, Puduchery 20. Dr Shanthram Shetty The Yoga Institute, Santa Cruz, Mumbai 21. Dr Santhosh Kumar Head Dept.of Medical Education and Urology, JIPMER 22. Lt. Col. Dr DR Vaze Kaivalyadhama, Lonavla, Maharashtra 23. Dr P Viswanath Treasurer, Karuna Trust, BR Hills, Mysore 25. Dr. Nirmala Nithyananda Dhyanapeetam, BIDADI, Bangalore

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LIST OF PARTICIPANTS
1.

2.

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4. 5.

6.

7.

8.

9.

10.

11.

12.

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14.

15. 16. 17.

18.

Achalananda Nithyananda Dhyanapeetam, BIDADI, off Mysore Road, Bangalore Ambarish V Asst. Professor, MSRMC, Bangalore. Anil MB Asst. Professor, Dept. of Pathology, SMCV, Ariyur, Puducherry. Annamalai. C CHRI, Padur, Kelambakkam. Anupama V Betigeri S/R Dept. of Physiology, JIPMER Arun J Vinayaka Mission Medical College, Karaikal Arun Kumar T Naturopathy & Yoga Physician, PSGIMSR, Coimbatore Asmita Patil Asst. Professor, Dept. of Physiology, LHMC, New Delhi Balaji R UG Student, MGMCRI, Puducherry. Barbara Bova Himalayan Institute Hospital Trust, Dehradun Basanta Manjari Naik S/R Dept. of Physiology, JIPMER Baskaran N Principal Govt. Higher Secondary School,Indra Nagar Betsy Mathai Medical Officer, Dept. of Pediatrics, JIPMER Srikumari Srisailapathy CR Research Scientist, Genetics Department, PGIBMS, Chennai Chandrasekaran K Sport Officer, Pondicherry University Amudharaj D J/R Dept. of Physiology, JIPMER Daisy Martin Nursing Section, JIPMER Dayanidy G Yoga Instructor, Pondicherry University Community College

19.

20.

21.

22.

23.

24.

25.

26.

27.

28.

29.

30. 31. 32. 33.

34.

35.

Desh Deepak Asst. Professor, Physiology, VCSGGISMR, Srinagar, Pauri Garhwal, Uttarakhand Ester Gonzalez Pondicherry University Palaniswamy H Prof. & Head, Dept. of Physiology, AVMC, Puducherry Harish BN Professor, Dept. of Microbiology, JIPMER Hemadri Rao Asst. Professor, D S Vishwavidyalaya, Haridwar Ishwar Acharya Programme Officer (Therapy), MDNIY, New Delhi. Jayasettiaseelon E SRF, ACYTER, JIPMER John Rajpathy Vinayaka Mission, Karaikal Joydeep Majumdar Assistant Research Officer (Scientific), MDNIY, New Delhi Ramesh Babu K Asst. Professor, Dept. of Ophthalmology, JIPMER Venkatachalapathy K Technical officer, Yoga Studies, Annamalai University Kalairani Nursing Section, JIPMER Karthik S J/R Dept. of Physiology, JIPMER Kaur Sohinder Professor, Dept. of Anatomy, JIPMER Komala Devi Associate Professor, Bengaluru. Lakshmi Jatiya Professor of Physiology, AV Medical College, Puducherry. Ma Gayathri Nithyananda Dhyanapeetam, BIDADI, off Mysore Road. 14

36.

37.

38.

39.

40.

41.

42.

43. 44. 45.

46.

47.

48.

49.

50.

51. 52. 53.

54.

Madhanika Madhavan Professor & Head Dept.of Physiology, Sri. Balaji Medical College, Chennai Maity NK Professor & Head, Dept. of Pharmacology RG Veterinary College, Puducherry Mallika Kothandraman MRO, JIPMER Manikandan ES Dept. of Physiology, PSGIMSR, Coimbatore Mohamed Abdullah Z Aarupadai Veedu medical College Puducherry Monica Malhotra Salem Muralikrishnan K Asst. Professor, Stanley Medical College, Chennai. Nand Kishore MDNIY, New Delhi Navasakthi S Health Instructor, JIPMER Niranjan Biswal Professor of Pediatrics, JIPMER Nivedita J MBBS Student, AV Medical College, Puducherry. Nivedita Nanda Asst. Professor, Dept of Physiology, PIMS, Puducherry. Paramita Bhattacharyya Asst. Professor, Dept. of Physiology, PIMS, Puducherry. Pashanth BV RIMS, Adilabad Pednekar JR Associate Professor, Dept. of Physiology, Medical College, Goa Prabhnjan Tiwari Research Scholar, D S Vishwavidyalaya, Haridwar Pragya Nair, Gujarat Raina TR Asst. Professor Transfusion Medicine, Govt. Medical college, Jammu Rajajeyakumar M J/R Dept. of Physiology, JIPMER

55.

56.

57.

58.

59.

60.

61.

62.

63.

64. 65.

66.

67.

68.

69.

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71.

Ramakrishnan M Jr. Occupational Therapist, Dept. of Psychiatry, JIPMER. Ramesh Babu K Asst. Professor, Dept. of Ophthalmology, JIPMER Rathnavel Kumaran M Stanley Medical College, Chennai Ravindra PN PhD Scholar, NIMHANS, Bangalore Ruluma Ramu Dodawad Devangeree Medical College, Karanataka Nalini S Coimbatore medical College, Coimbatore Ashok R Nair Professor of Physiology, PS Medical College, Karamsad , Gujarat Sakthignanavel D Reader, Dept. of Physical Education, Pondicherry University Satish Ramarao Gaikwad Research Officer (Scientific), MDNIY, New Delhi Sebanti Dev J/R Dept. of Physiology, JIPMER Senthil Kumar S J/R Dept. of Physiology, JIPMER Shankarappa V J/R Physiology, Sri Devraj Urs Medical College , Kolar, Karnataka Shenoy Jnaneswar Asst. Professor, Dept. of Physiology, Mangalore. Shivakumar T Ragiv Gandhi Institute of medical Sciences, Adilabad Bharathi Balakumar Senior Technical Supervisor, Dept. of Physiology , JIPMER Sri Nithya Yogeshwarananda, Nithyananda Dhyanapeetam, Bangalore Sri Sailapathy BS PGIBMS, Chennai 15

72.

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80. 81.

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Sridhar VR Professor of Psychiatory, SVMCH, Ariyur, Puducherry. Srinivasan V KYM Chennai Srividya G Lecturer in Psychology, RMMCH, Annamalai University Subas Chauhan Rajiv Gandhi Institute of medical Sciences, Adilabad Subathra S J/R, Dept. of Physiology, Coimbatore Medical College. Subhasis Das Asst. Professor, Dept. of Physiology, PIMS, Puducherry. Sugathan M Director, SADAY Special School, Puducherry Suman Latha Asst. Professor, Dept. of Anaesthisiology, JIPMER Suneel Saxena Professor, Dept. of ENT,JIPMER Susanta Kumar Padhi S R, Dept. of Psychiatry, JIPMER Suseela V Technical officer, Centre for yoga studies, Annamalai University. Swaroop Kumar Sahu Asst. Professor, Dept. of PSM, JIPMER Thenmozhi D J/R, Dept. of Physiology, JIPMER Umamaheswari K Asst. Professor of Physiology, Aarupadai Veedu Medical College, Puducherry. Varun Malhothra Associate Professor of Physiology, Salem, TN Vasantha Nursing Section, JIPMER Vasudev Anand Rao Director Professor & Head, Dept. of Ophthalmology, JIPMER

89.

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95. 96.

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104.

105.

Velkumari S Asst. Professor of Physiology, PK Medical College, Puducherry Vishrutha KV PG, Dept. of Physiology, PIMS, Puducherry. Vithalkumar M Betigeri Asst. Professor, Dept. of CTVS, JIPMER Vithiyalakshmi L Yoga instructor, Puducherry University Community College, Yogacharini Devasena Bhavanani Senior Faculty, ICYER, Puducherry Yogacharini Dr Nalini Devi Senior Faculty, ICYER, Puducherry Yogacharini Shobana Faculty, ICYER, Puducherry Yogacharya Srikant Faculty, ICYER, Puducherry Yogacharini Janani Teacher trainee, ICYER, Puducherry Yogacharini Maya Clair Teacher trainee, ICYER, Puducherry Yogacharini Shalini Teacher trainee, ICYER, Puducherry Yogacharini Vaishnavi Teacher trainee, ICYER, Puducherry Yogacharya Kaarthik Teacher trainee, ICYER, Puducherry Yogacharya Bernd Plaschek Teacher trainee, ICYER, Puducherry Yogacharini Inga Teacher trainee, ICYER, Puducherry Yogacharya Bernd Plaschek Teacher trainee, ICYER, Puducherry Yogacharini Helen Teacher trainee, ICYER, Puducherry 16

MBBS STUDENT PARTICIPANTS FROM JIPMER

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. Aarthi RR Adithya Gautam Aishwariya Ajay Krishnan Amirtha Anahitha Kate Anandhi D Ankit Gautam Ankita Dey Anoop Kumar Tiwari Anupriya Aswin Chandran Aswin K Awalpreet Singh Bablesh Meena Baby Swetha Balaji Biju Sarungbam Chanchal Kumar Singh Cromwell Biak Dasuklang Disiar Deepa Satheesan Deepak Kumar Bahmania Deepak M J Dharanipriya Dhayaguruvasan Dinesh Elvis Senthil Eswary Ezao L Ezung Gautham Surya Teja Gayathri Gido Pertin Hariharan Jigish Arvind Jithin C Johnson Maibam Kamlesh Katre Kavitha M Krishin K 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. 54. 55. 56. 57. 58. 59. 60. 61. 62. 63. 64. 65. 66. 67. 68. 69. 70. 71. 72. 73. 74. 75. 76. 77. 78. 79. Laster D Sangma Manoj Marie Gilbert Meera Mohamed Ibrahim Asif Mohamed Iqbal Mohamed Tausif Ullah Mying Nandan PG Naveen E Neelam Neha Rawat Neikhriele Khro Nikhil Rajan Nimesh Misra Nirmal Jyothi Nishant Ranjan Nishanthini Nithin Prakasan Nair Nithya Pallavisamariya Parul Thakur Pradosh Kumar Sarangi Preethi Prince Kumar Priyadharsan Purvesh Raj Sisodia Pyntgen Khar Bamon Raghvendra Bharti Ramya Ranjith Rashmi Remruata TR Saisree Pradhan Sam Charles D Shabana Shabana Sulaiman Shalini Sarkar Sharmila 80. 81. 82. 83. 84. 85. 86. 87. 88. 89. 90. 91. 92. 93. 94. 95. 96. 97. 98. 99. 100. Shatrishna Shekhar Anand Shri Biswajyothi Shri Varthan Simi Misra Sinduja Soham Bhattacharjee Subhash Chandra Meena Subhashini P Sunny Kumar Supriya Suresh Kumar Meena Sushmita Sana Chowdhury Tamal Priya Barman Tenzin Vignesh Vijai Krishnan Vijitha Vikashe Swu Vikram Singh Vishnu Nair

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ACADEMIC PROGRAMME 19 March 2009 9.30 10.30 am: INAUGURAL FUNCTION followed by high tea 11.00 am: INVITED TALKS 1. Dr. IV BASAVARADDI: Introducing yoga to medical professionals 2. Dr. MADANMOHAN: Introducing yoga to medical students: The JIPMER experience 3. Dr. SHANTARAM SHETTY: Yoga in medical practice 4. Dr. SANTOSH KUMAR: Yoga in medical education 5. Dr. NIRMALA: Nithya yoga meditation 1.00 pm: Lunch 2.00 pm: TWO PARALLEL WORKSHOPS WORKSHOP I: THEORY CURRICULUM 1. 2. 3. 4. 5. 6. 7. Dr. MYTHILY BASKARAN: Chairperson Dr TM ROY: Co Chairperson Dr. GK PAL: Moderator Dr. G HIMASHREE Dr. APARNA AGRAWAL Dr. KV NAVEEN Dr. ANANDA BALAYOGI BHAVANANI

WORKSHOP II: YOGA THERAPY MODULES 1. 2. 3. 4. 5. 6. 7. 8. Dr. AK DAS: Chairperson. Role of yoga in diabetes mellitus Dr. ARPAN BHATT: Moderator. Yoga as a therapy Dr. N CHANDRASEKARAN: Yoga for back pain Dr. DR VAZE: Yoga for digestive and metabolic disorders Dr. SHANTARAM SHETTY: Yoga for cardiovascular diseases Dr RAJVI MEHTA: Yoga for respiratory disorders Dr. ISHWAR ACHARYA: Yoga for obesity Dr. MADANMOHAN: panel discussion

6.30 pm: Cultural programme: A fusion of Yoga and Bharatanatyam by Yoganjali Natyalayam, Puducherry under direction of Kalaimamani Meenakshi Devi Bhavanani

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20 March 2009 9.30 am: TWO PARALLEL WORKSHOPS WORKSHOP III: YOGA PRACTICE FOR MEDICAL STUDENTS 1. 2. 3. 4. 5. 6. 7. Dr. IV BASAVARADDI: Chairperson Smt. MEENA RAMANATHAN: Moderator Smt. MEENAKSHI DEVI BHAVANANI Dr. MANOJ NAIK Dr. P VISHWANATH Dr. GS GAUR Shri R MURUGESAN

WORKSHOP IV: EVALUATION METHODS 1. Dr. SANTOSH KUMAR: Chairperson 2. Dr. PRAVATI PAL: Moderator 3. Dr. APARNA AGRAWAL 4. Dr. VIVEK SHARMA 5. Dr. MADANMOHAN 6. Dr GK PAL 7. Dr. G HIMASHREE 8. Dr. KV NAVEEN 9. Dr. DR VAZE 10.Dr. AB BHAVANANI 1 pm: LUNCH 2 pm: REPORTS FROM THE WORKSHOPS & RECOMMENDATIONS 4 pm: VALEDICTORY FUNCTION

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RATIONALE OF INTRODUCING YOGA FOR MEDICAL PROFESSIONALS Dr Ishwar V Basavaraddi PhD1

INTRODUCTION: Yoga is the spiritual and cultural heritage of India. It has been practised as a way of healthy living from ancient times and we find numerous references to Yoga in our ancient literature. Up to recent times Yoga was limited only to the privileged hermitage of Saints and Sages but now in the course of its modern development, it has crossed all boundaries of age, gender, caste, creed, religion and nationality and is growing worldwide. Although the system of Yoga is primarily of spiritual orientation aiming for self emancipation (moksha), it has also evolved to become one of the best, authentic and most efficient healthcare systems for prevention and management of diseases plaguing the present age. Today, many countries have adopted Yoga as a part of their daily life and the spiritual science of Yoga has become a household word all over the world. PRESENT TREND: The practitioners of modern medicine have realized the need for lifestyle modification for effective management of many chronic diseases. The concept of prevention of disease and promotion of positive health has gained importance in healthcare management systems. Moreover, the holistic approach of treatment has emerged and gained momentum as modern medicine has realized the interrelation between body and mind in causation and management of psychosomatic disorders. Concepts such as mind-body medicine and psycho-neuro-immunology have become popular worldwide. Yoga has the capacity to complement modern medicine especially in management of lifestyle disorders and chronic psychosomatic diseases. As a result, Yoga is fast becoming a complementary part of mainstream medical care. SCIENTIFIC STUDIES: Over the past few decades, numerous scientific studies have been carried out to determine the efficacy of Yoga in managing various ailments. It is to be noted that modern medical scientists were the first to promote scientific research in the field of Yoga. They have now also started to realize the therapeutic benefits of Yoga in a much broader sense with a holistic approach. After
Director, Morarji Desai National Institute of Yoga (MDNIY), 68, Ashok Road, New Delhi-110 001 . E Mail: mdniy@yahoo.co.in Website: www.yogamdniy.com

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the first waves of Western interest in Yogic practices, there has come an understanding of the importance of Yoga in emotional and physical well-being. The 1970s saw the development of a remarkable bond between body mind spirit approach embodied in Yoga and the physical approach to health of modern medicine. With scientific evidence becoming available, medicine is now in the process of confirming it by standards it has developed for recognition of any health system. It is very encouraging that many eminent medical institutions of India like AIIMS, JIPMER, NIMHANS, DIPAS etc. are involved in Yoga research and premier medical institutes like AIIMS have opened Integral Health Clinics while Advanced Centers for Yoga are functioning in NIMHANS, DIPAS , Gujarat Ayurved University and JIPMER.

INTERACTION BETWEEN THE TWO SYSTEMS: It is notable that many modern medicine experts have started recommending to their patients adoption of a Yogic lifestyle for management of chronic diseases. This healthy positive trend is to be promoted and facilitated at all levels of interaction between the two systems and is on a path of ascent. Yogic techniques can undoubtedly act as an adjuvant to drug therapy and can be used to reduce side effects of modern medicines. They can also help in promotion of positive health and rehabilitation along with other modern therapies such as physiotherapy. Interestingly another positive spin off resulting from this closer association between Yoga and modern medicine is that yoga is getting a firm scientific footing thanks to the active involvement of modern medicine scientists in understanding the mechanisms and efficacy of yoga.

NEED FOR AN INTRODUCTORY / APPRECIATION COURSE IN YOGA SCIENCE FOR MEDICAL PROFESSIONALS: With the growing popularity of yoga, especially of yoga therapy around the world, the need has been felt to integrate yoga in the modern medical system with emphasis on filling up gaps in treatment for modern-day health challenges. With this background in mind, it has been proposed to introduce yoga to medical students / professionals in a step-by-step manner. MDNIY has made an effort to prepare a basic syllabus with the basics of yoga keeping in view educational background and necessity of the target group. Of course, this present introductory / 21

appreciation course will not be able to cover all details of yoga or therapeutic aspects of yoga, as the subject of yoga is very vast. The basic aim however is to introduce the system of yoga to medical students / professionals in an amiable manner for their understanding, own practice and application in patient care. I wish all yogic traditions of India should unite together with our modern medical counterparts in a concentrated effort to bridge the gap between yoga and modern medicine and let our beloved India take the lead in this unique programme for the benefit of the world.

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NEED FOR INTRODUCING YOGA IN THE MEDICAL CURRICULUM Dr. Madanmohan

MD, PGDY, FIAY Medical students face stress due to overloaded curriculum and frequent examinations. The most effective technique for prevention as well as management of this stress is the holistic science of yoga. Regular practice of yoga will improve ones personality, ability and overall performance, enabling one to achieve the Vedic goal of purushaarth chatushtaya (four-fold achievement) of i) dharm i.e. performing ones duty selflessly ii) arth i.e. material prosperity iii) kaam i.e. worldly enjoyments and iv) moksh i.e. ultimate liberation. A physician practicing yoga will be more efficient and have a calm mind. Hence he will be a better physician and a boon to the society. Western medicine (allopathy) is concerned with our physical body and is primarily disease oriented. However, from the holistic point of view, our health and disease have physical, mental-emotional as well as moral-spiritual dimensions. Ancient Indian rishis recognized this fact and yoga as well as ayurved have taken into account all the three aspects of our being, i.e. the physical body, the mind and the non-material soul (Satvam-aatmaa-shariram cha trayamet tridandavat. Charak Samhita, Sutrasthanam, 1:46). Mind, body and soul are intricately interrelated, one influencing and enhancing the other. Development of one without a parallel development of the other two results in imbalanced personality and psychosomatic disorders. Spirituality and religious belief determine the decisions about our behavior and lifestyle, which in turn influence our health and wellness. Spirituality has a great impact on our health and healing. Prayer and meditation (dhyaan) relax our brain and mind and this is associated with desirable changes in the secretion of neurotransmitters, hormones and antibodies. The result is psychosomatic relaxation, activation of bodys natural defences, stimulation of growth and repair and a feeling of well being. WHO defines health as A state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity. Holistic definition of health should include spiritual health as well. Here, it is relevant to mention that the father of surgery, Acharya Sushrut (~600 BC) has defined health as Balanced elements and humors, normal digestion and elimination and happy mind, senses and the soul (Samadoshah samagnishch
Director-Professor and Head, Department of Physiology and Programme Director, ACYTER, JIPMER, Puducherry. Email: drmadanmohan123@gmail.com, drmadanmohan123@rediffmail.com

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samadhaatumalakriyah, prasannaatmendriyamanah swasth ityabhidheeyate. Sushrut Samhita, Sutrasthanam, 15:41). Yoga is the best means to achieve such holistic health. Meditation is good for physical, mental as well as spiritual health. Yogeshwar Krishn says that during meditation, the yogi enjoys oneness with Brahman and great joy (Yunjannevam sadaatmaanam yogi vigatakalmashah, sukhen brahmasamsparsham atyantam

sukhamashnute. Bhagavadgita, 6:28). Mediation is an effective way to promote health and happiness and prevent disease. Disciplined practice of meditation purifies, enriches, strengthens and transforms our body-mind-soul complex resulting in holistic health. Joint prayer (satsang) where physician also participates is more effective. Those who attend satsang are more likely to follow healthy lifestyle, exhibit desirable social behavior and live longer and healthier life. Elderly people are more happy and healthy if they are spiritually committed and active. It is fashionable to talk of separating science / secular from the religious. This western concept of conflict between science and religion started in Europe where great scientists like Galileo and Darwin had to face opposition from the Church and thousands suffered persecution in inquisitions and witch-hunts. In contrast, science and spirituality were in perfect harmony in Vedic India. The sacred Vedic literature is the foundation of Indian science and culture including mathematics, astronomy, architecture, dance, music, yoga and ayurved. The great Indian physician Charak (~100 AD) says that ayurved is a meritorious and holy science because it teaches what is beneficial in this life as well as hereafter (Tasyaashuh punyatamo vedo vedavidaam matah, vakshyate yanmanushyaanaam lokayorubhayo hitam. Charak Samhita, Sutrasthanam, 1:43). It needs to be emphasized that science and spirituality complement each other and both enrich our lives. Being holistic, ashtang yoga is for our total development as it modulates different aspects of our lifestyle. That is why Sri Aurbindo said that All life is yoga. Despite the phenomenal advances in modern medicine, millions suffer from stress-induced, chronic degenerative and lifestyle disorders which are beyond the scope of modern medicine. Escalating diagnostic and curative costs render modern high-tech medicare beyond the reach of majority of our citizens. Besides being expensive, drugs have many undesirable side effects. Health for all by 2000 AD has remained a pipe dream. Unless we adopt a holistic attitude and encourage other forms of health management, we will not be able to achieve health for all even by 3000 AD. It needs to be emphasized that yoga is effective in prevention as well as management of a number of chronic diseases. The therapeutic effect of yoga may 24

be due to improvement in physiological function, autonomic modulation and management of stress. Yoga has the potential to augment the existing medicare and reduce drug dosage, treatment cost and pressure on our under-staffed, fund-starved and over-burdened hospitals. Yoga as well as modern medicine have strengths as well as limitations. While yoga has virtually no role in medical and surgical emergencies, it is very effective in restoring and maintaining holistic health. It is effective in a number of psychosomatic disorders like insomnia, migraine, backache, hypertension, bronchial asthma, diabetes mellitus, irritable bowel, impotence and non-specific pelvic disorders. Both yoga and modern medicine have sound scientific basis and universal outlook. They are complementary to each other and natural allies. Hence, they are bound to come together. Their combination will give us a holistic health science which will be an effective paradigm for preventive, promotive as well as curative needs of our masses and a boon to the society. To achieve this beautiful goal of blending the boundaries, we need open minded medical professionals and enlightened political will backed by a nonbureaucratic and responsive administration. Keeping in view the above facts, I strongly believe that yoga should be introduced in the medical curriculum.

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YOGA & MODERN MEDICINE: POSSIBLE MEETING POINTS Yogacharya Dr. Ananda Balayogi Bhavanani
MBBS, ADY, DPC, DSM, PGDFH, PGDY, FIAY Introduction: We are today faced with numerous debilitating chronic illnesses related to aging, environment, and hedonistic lifestyle, such as cancer, diabetes, osteoporosis, and cardiovascular diseases as well as many incurable diseases such as AIDS. Modern medical advancements provide the rationale for the integration of various traditional healing techniques including yoga to promote healing, health, and longevity. It is imperative that advances in medicine include the wholistic approach of yoga to face the current challenges in health care. The antiquity of yoga must be united with the innovations of modern medicine to improve quality of life throughout the world. At first glance, modern medicine and yoga may seem to be totally incompatible and in some ways even antagonistic to each other. Practitioners of either system are often found at loggerheads with one another in typical modern one-upmanship. However it is my humble endeavour as a student of both these life giving, life changing and life saving sciences, to find the similarities that exist between them and build a bridge between these two great sciences of todays world. It would of course be much easier to build a bridge between yoga and ayurveda as both share many similarities of concepts such as the trigunas, tridoshas, chakras and nadis. They also understand that a healthy balance between body, mind and soul leads to total health. Diet and behaviour are given importance in both systems and the ultimate goal of both is the attainment of moksha. Though modern medicine may not share all of these concepts with yoga, it is to be seen that there are a great many meeting points for the construction of a healthy bridge between them. Both modern medicine and yoga understand the need for total health and even the Word Health Organization has recently added a new dimension to the modern understanding of health by including spiritual health in its definition of the state of health. Spiritual health is an important element of yoga and now that even the WHO has come around to understanding this point of view, there is hope for a true unification of these two systems. Modern medicine has the ultimate aim and goal of producing a state of optimum physical and

Programme Co-ordinator, ACYTER, JIPMER, Puducherry. www.icyer.com. Email: ananda@icyer.com

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mental health thus leading to the optimum well being of the individual. Yoga also aims at the attainment of mental and physical well being though the methodology does differ. While modern medicine has a lot to offer humankind in its treatment and management of acute illness, accidents and communicable diseases, yoga has a lot to offer in terms of preventive, promotive and rehabilitative methods in addition to many management methods to tackle modern illnesses. While modern science looks outward for the cause of all ills, the yogi searches the depth of his own self. This two way search can lead us to many answers for the troubles that plague modern man. The Shiva Samhita lists the characters of a fully qualified disciple (shishya) as follows. Endowed with great energy and enthusiasm, intelligent, heroic, learned in the scriptures, free from delusion Doesnt a modern medical scientist require the same qualities? Anatomy and physiology: The study of anatomy and physiology is a great meeting point for modern medicine and yoga. Yoga therapists and practitioners can benefit from the intricate and detailed break-down study of modern medicine where the body is broken down into many systems, then into many organs, many tissues and finally into billions of cells. On the other hand the yogic wholistic view of the pancha kosha (the five sheathed existence) can help modern doctors realise that we are not just, one-body organisms but have four more bodies that are equally if not more important. We are a manifestation of the divine and have, not only the physical body but also an energy body, a mental body, a body of wisdom and a body of eternal bliss. An understanding of the psychic anatomy and physiology of nadis, chakras and bindus when coupled with the practical understanding of the details of the physical body can inspire real knowledge of the self in all health care personnel. Maharishi Mahesh Yogi has tried to correlate 37 areas of human physiology with 37 areas of intelligence or consciousness as available in Vedic literature. Some of the examples are the correlation between Nyaya and the thalamus as well as Samkhya and the types of neuronal activity. In his excellent book, The Shambala Guide to Yoga, Dr. Georg Feuerstein says, Long before physicists discovered that matter is energy vibrating at a certain rate, the yogis of India had treated this body-mind as a playful manifestation of the ultimate power (shakti), the dynamic aspect of Reality. They realized that to discover the true self, one has to harness attention because the energy of the body-mind follows attention. A crude example of this process is the measurable increase of blood flow to our fingers and toes that occurs when we concentrate on them. Yogis are very careful about where they place their attention, for the 27

mind creates patterns of energy, causing habits of thought and behavior that can be detrimental to the pursuit of genuine happiness. Professor Dr SV Rao, an eminent medical doctor and yoga scientist says, Yoga is a science because it is verifiable. Yoga as a science of living is also an art. Yoga, therefore, may be defined as the science and art of optimum living. Yoga has the capacity to move, either side by side with medical science or independently. This is because yoga has a sound system of etiology, diagnosis and pathogenesis of disease. Thus we have a complete system by itself in yoga. Prevention of disease: Modern medicine has come to realise the importance of prevention only in recent times but the role of preventive medicine is still very limited. The yogic lifestyle that includes the yama and niyama can help prevent a great many of the modern diseases like Hepatitis B and AIDS. Cleanliness that is taught through shoucha can help prevent and limit spread of contagious and infectious diseases. Mental peace and right attitudes of yoga such as pratipaksha bhavanam (taking the opposite view), samatvam (equanimity of mind) and vairagya (dispassionate detachment) can help prevent many psychosomatic ailments running wild in the modern world. If these yogic values as well as practices such as asana, pranayama, kriya and dhyana are inculcated in the modern human race, we can prevent virtually all diseases that abound today. Communicable diseases as well as degenerative disorders of the body can be well prevented in a true manifestation of the adage, A stitch in time saves nine. However the will to do so is also of paramount importance as there is no money or fame in prevention and we dont know what we have prevented because we have prevented it from happening! To quote the eminent neurosurgeon Padma Bhushan Dr B Ramamurthi, The revival of the science of yoga bodes well for mankind. All technological advances in the third millennium will not lead to happiness of mankind as man has a severe aggressive tendency and is likely to destroy himself because of this aggression. The only way out of this mess is through the science of yoga, which transcends all religions and cults. It is a science of the mind and the body and needs to be practised by all human beings to ensure their own future. Promotive health: Yoga is an excellent tool of promotive health that can enrich modern medicine. The practice of yoga leads to the efficient functioning of the body with homeostasis through improved functioning of the psycho-immuno-neuro-endocrine system. A balanced equilibrium between sympathetic and parasympathetic wings of autonomic nervous system leads to a dynamic state of health. According to Dr B Ramamurthy, Yoga re-

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orients functional hierarchy of the entire nervous system. He has noted that yoga not only benefits the nervous system but also cardiovascular, respiratory, digestive, endocrine and immune systems in addition to bringing about biochemical changes in yoga practitioners. He has also said that the science of yoga has been Indias greatest contribution to mankind. Management of diseases and disorders: Yoga doesnt negate use of drugs and other methods of modern medicine. Maharishi Patanjali in his avatar as Charaka didnt shy away from the need to use medicinal herbs as well as surgical methods when necessary to benefit the patient. Ayurveda is definitely more in tune with yogic views of healing in this regard. Modern antibiotic treatment of infectious diseases and modern emergency medical and trauma management techniques are life-savers in times of dire need. No yoga therapist in his or her right mind should try to treat an acute myocardial infarction or an unconscious accident victim by yoga alone. A symbiotic relationship between techniques of modern medicine and yoga can help the patient more than a dogmatic refusal to see the other side. Yoga has a lot to offer in psychosomatic stress related disorders such as diabetes, asthma, irritable bowel syndrome, epilepsy, hypertension, back pain as well as other functional disorders. Yoga can help reduce and in some cases eliminate drug dosage and dependence in patients suffering from diabetes mellitus, hypertension, epilepsy, anxiety, bronchial asthma, constipation, dyspepsia, insomnia, arthritis, sinusitis and dermatological disorders. To quote Dr Steven F Brena, Yoga is probably the most effective way to deal with various psychosomatic disabilities along the same, time-honoured lines of treatment that contemporary medicine has just rediscovered and tested. Asanas are probably the best tool to disrupt any learned patterns of wrong muscular efforts. Pranayama and pratyahara are extremely efficient techniques to divert the individual's attention from the objects of the outer environment, to increase every person's energy potentials and 'interiorize' them and to achieve control of one's inner functioning. Moreover, in restoring human unity, the yoga discipline is always increasing awareness and understanding of ourselves, adjusting our emotions, expanding our intellect, and enabling us not only to function better in any given situation, but to perform as spiritual beings with universal values." Yoga therapists must work in tandem with medical doctors when they are treating patients who have been on allopathic treatment. There are many instances where patients stop medical treatment thinking that it is no more necessary as they have started yoga. This leads to many catastrophes that could be easily avoided by tandem consultations with a medical specialist.

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Similarly many modern doctors tend to tell patients to take up yoga or relaxation and forget to mention to the therapist what they actually want the patients to do. Most allopathic medications need to be tapered off in a progressive manner rather than being stopped suddenly. We often find this mistake in regard to corticosteroids as well as cardiac medications where sudden stoppage can be harmful. We must remember Platos words, The treatment of the part shouldnt be attempted without a treatment of the entirety, meaning that treatment of body without treating mind and soul is a useless waste of time. Rehabilitation: Yoga as a physical therapy has a lot to offer patients of physical and mental handicaps. Many of the practices of physiotherapy and other physical therapies have a lot in common with yoga. Mentally challenged individuals can benefit by an improvement in their IQ as well as by learning to relate better with themselves and others. As their physiological functions improve with yoga, a combination of yoga and physical therapies can benefit such patients as well as those with learning disabilities. Musculoskeletal problems can be treated by a combination to improve function as well as range of movement, strength and endurance abilities. Balance and dexterity can also be improved by such combination therapy. The use of yoga can help those recovering from accidents and physical traumas to get back on their feet faster and with better functional ability. An example of this was Dr Swami Gitananda Giri who managed to get back on his feet and function normally after a debilitating stay in a full body cast for more than six months. Swamiji used to say, Modern medicine kept me alive, but yoga gave me back my life. Yoga also has a lot to offer those suffering from drug and substance abuse in assisting them to get back to a normal life. Yoga helps develop their self-control and will power and also gives them a new philosophy of living. This is vital as otherwise they will lapse into their old negative habits. Healthy diet: This is a place that modern medicine and yoga can help give a patient as well as normal person proper wholistic values of a good diet. Modern research shows us benefits of break-down study of foods on the basis of their physical and chemical properties. This is important for knowing how much of each constituent of food is required and the proper quantity. Yoga can help a person learn the right attitude towards food as well as understand concepts based on trigunas and tridoshas for better health. Yoga teaches us that the cause of most disease is through under (ajjeranatvam), over (atijeeranatvam) or wrong

(kujeeranatvam) digestion. Yoga also teaches us about the approach to food, types of food as well as importance of timings and moderation in diet. A combination of modern aspects of

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diet with a dose of yogic thought can help us not only eat the right things but also eat them in the right way, at the right time thus ensuing our good health and longevity. Relaxation: Most medical doctors understand that relaxation is important in order to get better. However, though doctors tell patients to relax, they dont tell them how to do so. Maybe they dont know the answer themselves in the first place. Hatha yoga and jnana yoga relaxation practices help relax body, emotions and mind. Relaxation is a key element of any yoga therapy regimen and must not be forgotten at any cost. Shavasana has been reported to benefit hypertensive patients while practices such as savitri pranayama, chandra nadi pranayama, kaya kriya, yoga nidra, anuloma viloma prakriyas and marmanasthanam kriyas are also available to attain a state of complete relaxation. It is important to remember that relaxation on its own is less effective than relaxation following activity. Coping Skills: Yoga has a lot to offer those unable to cope with death and dying as well as those suffering from incurable diseases. Yoga philosophy sees death as an inevitable aspect of life that cannot be wished away. Swami Gitananda Giri used to say that the whole of life is but a preparation for the moment of death, so that we can leave our body in the best possible manner. Those who are taking care of the dying as well as those taking care of patients of incurable diseases and major disabilities are under extreme stress and yoga practice as well as its philosophy helps them gain inner strength necessary to do their duty. Yoga can help break the vicious spiral of pain-drug dosage-pain and by doing so help reduce drug dosage in patients suffering from chronic pain. It has been reported that yoga helps improve the quality of life in patients suffering from cancer and also helps them cope better with the side effects of treatment. It relaxes them and helps them sleep better. As someone rightly said, Yoga may not be able to always cure but it can surely help one to endure. Expenditure: Modern medicine is often criticized for its exorbitant costs. Yoga offers an inexpensive method of health care that can be added to medical armoury when required. Yoga only requires the patients own effort and really doesnt need any paraphernalia. Of course the modern yoga industry would rather have us believe that we need tons of yoga equipment, but they are awfully off the mark. Reduction in drug dosage and avoidance of unnecessary surgeries in many cases can also help reduce spiralling cost of medicare. Aging: Aging is inevitable and yoga can help us age gracefully. Modern medicine tries to retard aging and help people look better by costly surgical methods that are only an external covering over underlying aging process. Healthy diet, regular exercise, avoidance of negative 31

habits and cultivation of the positive habits and a healthy lifestyle can help us to age with dignity. Yoga can also help our silver citizens retain their mental ability and prevent degenerative disorders such as Parkinsons, Alzheimers and other dementias. Physical accidents and falls can be minimised and many an artificial hip, knee or shoulder replacement surgery avoided. Swami Gitananda Giri, Yogashri Krishnamacharya, Sri Kannaiah Yogi, Yogeshwarji, Yogendraji, Sri Pattabi Jois and Padma Bhushan BKS Iyengar are but a few of the yogis who have shown us that its is possible to grow old without losing any of the physical or mental faculties of youth. Psychotherapy: In the field of psychotherapy and psychoanalysis we can find a lot of ancient yogic concepts being reiterated time and again. Many modern psychotherapeutic concepts such as identification, projection, and transference are similar to concepts in yoga psychology. Yoga psychology integrates diverse principles within a single body. CG Jung had a great interest in yoga and the eastern thought and said, Chakras represent a real effort to give a symbolic theory of the psyche. His Centre of Personality concept based on dream analysis is very similar to the yogic concept of a central psychic or spiritual personality. He also correlated chakras to archetypes that abound in collective unconscious. Yoga helps psychotherapists in training self-awareness, and in self-regulation of body, diet, breath, emotions, habit patterns, values, will, unconscious pressures and drives. It also helps in relating to archetypal processes and to a transient being. It offers an integrated method rather than one that is found in isolation in many different therapies. The theory of kleshas is an excellent model for psychotherapy while emotional therapies of yoga include swadyaya, pranayama, pratyahara, dharana, dhyana and bhajans. Development of proper psychological attitudes is inculcated via concepts of vairagya, chitta prasadanam as well as Patanjalis advise on adopting attitudes of maitri, karuna, mudita and upekshanam respectively towards the happy, the suffering, the good and the evil minded persons. Yoga also has a lot to offer in terms of spiritual therapies such as swadyaya, satsanga, bhajans and yogic counselling. It is also interesting to note that both yoga and psychoanalysis share common ground in understanding that symptoms of disease are often willed by patients. While all psychoanalysists must undergo psychoanalysis themselves, it is taught in yoga that one must first undergo a deep sadhana, before attempting to guide others on the path. However, while psychoanalysis searches the unconscious, yoga attempts to understand and explore the superconscious.

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Lifestyle changes: Yoga helps patients take their health in their own hands. They learn to make an effort and change their lifestyle for the better so that their health can improve. Lifestyle modification is the buzzword in modern medical circles and yoga can play a vital role in this regard. Yogic diet, asanas, pranayamas, mudras, kriyas and relaxation are an important aspect of lifestyle modification. Dr Dean Ornish, an eminent American medical doctor who has shown that yogic lifestyle can reverse heart disease says, Yoga is a system of perfect tools for achieving union as well as healing. Womens health: Women are the chosen ones blessed with the responsibility of the future of our human race. Healthy mothers give birth to healthy babies and a healthy start has a great future ahead. Yoga has a lot to contribute in combination with modern medicine to health status of women. Puberty and menopause become easier transitions with yoga and many eminent yoginis have said that they were not even aware of a single menopausal symptom as they went through this normally difficult period. Similarly our young girls can vouch for the fact that their pubertal changes and menarche have been relatively smoother than their counterparts who dont practice yoga. Once conception occurs, yoga helps the young mother to prepare herself physically and mentally for the upcoming childbirth. Yoga helps open the joints of the pelvis and hip as well as strengthen abdominal muscles aiding childbirth. Simple pranayama and relaxation techniques help the new mother relax and enjoy the new experience of her life. Postpartum introduction of simple practices along with breathing, relaxation and a lot of crawling helps her come back to normal earlier and this can be used in all maternity hospitals along with allopathic management. Yoga practices can also help reduce drug dosage in medical problems often complicating pregnancy such as diabetes, asthma and hypertension. Research: Positive benefits of yoga research are of vital significance. An understanding of how various practices work in different conditions and in normal situations is of great value for both yoga and for the world of medicine. Yoga therapists can benefit through scientific understanding of yogic techniques bringing about a rational approach to yoga therapy rather than a haphazard application of individual knowledge. Institutions such as AIIMS, BHU,

NIMHANS, DIPAS, JIPMER, sVYASA, Kaivalyadhama, Bihar School of Yoga and ICYER have done significant work in bringing forth the scientific methods of yoga vidya. Universities such as BHU, Sagar, Himachal, Mangalore, Venkateshwara, Gujarat Ayurvedic, Annamalai and Andhra University have created Centres for Yoga Education and Research and are doing great service. Scientists such as Dr BK Anand, Dr KK Datey, Dr KN Udupa, 33

Dr B Ramamurthy, Dr W Selvamurthy, Dr T Desiraju, Dr Nagendra, Dr Nagaratna, Dr Shirley Telles, Dr MV Bhole, Dr Rajapurkar, Dr Mittimohan, Dr Lajpat Rai and Dr Madanmohan have contributed extensively towards the scientific understanding of yoga vidya and yoga vidhi. The Central Government has created the Central Council for Research in Yoga and Naturopathy (CCRYN) that is the governing body for research in yoga and naturopathy under the Ministry of Health. Under the Department of AYUSH, Morarji Desai National Institute of Yoga (MDNIY) has created advanced centres for Yoga in JIPMER, NIMHANS, AIIMS, Gujarat Ayurved University and DIPAS to promote yoga in these premier medical institutions of our country. Various private institutions are running in our country and doing their best to propagate yoga-vidya. Yoga therapy is being used both in conjunction with modern medicine or alternative systems of medicine as well as on its own in various centres. Various conditions such as diabetes, hypertension, arthritis, mental depression, bronchial asthma etc have been found to be relieved by yoga therapy and centres such as sVYASA, Kaivalyadhama, National institute of Naturopathy, Manipal Institute and the Morarji Desai National institute are doing a great deal of work in this field. A lot of yoga research is being done nowadays but it is important to remember Swami Gitananda Giris words, We must research yoga and not the lack of yoga. Many studies are badly constructed and many-a-time we find that yoga practices performed by patients have no real relation to yoga at all. The higher aspects of yoga are still not in the researchable realm of modern science. Dr VSSM Rao writes that, The tradition of yoga is so perfect that we have to seek ways of expounding it in modern scientific terminology instead of simply evaluating it in terms of current concepts of science, which is expanding so rapidly that a time may come when man would like to live by his intuition rather than by scientific planning, bristling with conflicts and balancing a number of variables not completely understood. In conclusion: Many medical doctors have tried to bridge the gap between modern medicine and Yoga and in my humble opinion the best work till date has been that of Dr Steven F Brena who in his work, Yoga and Medicine puts into perspective similarities between yoga and medicine and discusses their relationship with different aspects of human phenomena. He says, Besides more or less close similarities, is there a realistic ground upon which both contemporary science and yoga philosophy are going to meet and possibly to cooperate? The actual field of convergence between them lies in the recognition that physical laws of matter are binding only to a certain point; beyond them, man can find inner freedom, using his will 34

power and proper techniques to select his habits and to gain control of his visceral and emotional functioning, according to the principles of learning. Psychology tells us that our biological functions are bound to the rhythmicity of earthly phenomena, but it also has demonstrated that our performances can be controlled by instrumental training, which is not influenced by circadian rhythms. It looks as though scientific investigations from one side are showing man bound to the earth, like any other living creature, while from another side they seem to prove that the human potentials are greater than the forces binding us which is exactly what the Vedas have been teaching for thousands of years. The concept of dysponesis is much more than a new theory in medicine. It is almost a new philosophy, bringing into perspective the value of energy-spending in problems of health and disease. Because of our habitual lack of control over our visceral systems, we are often too prodigal in spending our energy capital. In any given situation we are not only prone to overshoot, but also to learn the overshooting as a model of habitual interrelation with our environment. We are always tense and aggressive in whatever task we perform, always in competition with somebody or with ourselves, wasting our energies in confused actions and maladjusted reactions. We often do not cope with some given situation following a rational and intelligent evaluation, but with emotional outbursts, burning a lot of fuel. The experiences gained from the various rehabilitation centres around the world, dealing with a variety of disabilities, confirm that our potentialities are greater than we assume, provided that we adequately train our energy-spending and effort-making. Yoga has been teaching for centuries that the secret of fulfilment in life and spiritual evolution lies in the ability to concentrate vital energy instead of dissipating it. The Royal Way of Yoga takes man as he is, with all his handicaps, and brings him above the boundaries of material forces to cosmic consciousness, teaching him how to expand his energy capital and how to use it wisely. Along the way, while he is seeking spiritual realization, man can also discover the key to health, joy and inner freedom. In this field of thinking and teaching, the age-old yoga discipline and the more advanced investigations in health sciences have actually met and do agree. It is apt to conclude with a favourite statement of my Guru, Pujya Swamiji Gitananda Giri Guru Maharaj, who said, Health and happiness are your birthright. Do not forsake your golden culture for the plastic playthings of the western world. Learn and live yoga, for then you will know true health and happiness.

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Recommended reading:
1. 2. 3. 4. 5. 6. 7. 8.

Ajaya Swami. Psychotherapy east and west. Himalayan institute, Pennsylvania, USA 1983. Anand BK. Yoga and medical sciences. Souvenir: Seminar on Yoga, science and man. Central council for research in Indian Medicine and Homeopathy. New Delhi. 1976. Anantharaman TR. Yoga as Science. Souvenir: Seminar on Yoga, science and man. Central council for research in Indian Medicine and Homeopathy. New Delhi. 1976. Anantharaman TR. Yoga Vidya and Yoga Vidhi. The Yoga Review 1983: III: 3, 119-137. Bhavanani Ananda Balayogi. A primer of Yoga theory. 3rd ed. Dhivyananda Creations. Puducherry-13. (2008) Bhavanani AB. Yoga for health and healing. Dhivyananda Creations. Puducherry-13. (2008) Brena Steven F. Yoga and medicine. Penguin Books Inc. USA. 1972. Carlson LE et al. Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress, and immune parameters in breast and prostate cancer outpatients. Psychosom Med. 2003 Jul-Aug; 65(4): 571-81. Chidbhavananda Swami. The Bhagavad Gita. Ramakrishna Tapovanam, Trichy, 1984. Feuerstein Georg. The Shambala Guide to Yoga. Shambala Publications Inc, Boston, Massachusetts, USA.1996. Gitananda Giri Swami. Frankly Speaking. Satya Press, Pondicherry, 1997. Gitananda Giri Swami. Yoga the art and science of awareness. Souvenir 1996; 4th International Yoga Festival, Govt of Pondicherry. Gitananda Giri Swami. Yoga: Step-by-Step, Satya Press, Pondicherry, 1976. Gitananda Giri Swami and Meenakshi Devi Bhavanani (Ed). Bridging the gap between Yoga and science. Souvenir of the international conference on biomedical, literary and practical research in Yoga. ICYER, Pondicherry, India. 1991. Go VL and Champaneria MC. The new world of medicine: prospecting for health. Nippon Naika Gakkai Zasshi. 2002 Sep 20; 91 Suppl: 159-63. Healthy mind, healthy body. Sri Ramakrishna Math, Chennai, India.1997. Mahesh Yogi Maharishi. Natural law for doctors. Maharishi institute of management. New Delhi.1996. Nagarathna R and Nagendra HR. Integrated approach of Yoga therapy for positive health. Swami Vivekananda Yoga Prakashana, Bangalore, India. 2001. Ramamurthi. Uphill all the way. Guardian press, Chennai. 2000. Taimni IK. The Science of Yoga. The Theosophical Publishing House, Adyar, Chennai.1961. Yoga the Science of Holistic Living. Vivekananda Kendra Patrika. Vol. 17- 2. Aug 1988. Yogi Ram. Health and longevity through Yoga. Yoga Thara 1997; July/Aug, pp 7-9.

9. 10. 11. 12. 13. 14.

15. 16. 17. 18. 19. 20. 21. 22.

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NEED AND FEASIBILITY OF INTRODUCING YOGA IN MEDICAL CURRICULUM Lt. Col. Dr. DR Vaze AMC (Retd)
Summary: Inspite of considerable technological advances in recent times, modern medicine hasnt neither succeeded in controlling disease nor been able to offer health to people. WHO has admitted the inability of modern medicine to achieve health for all even by 2005 AD. It has therefore sought help of other therapies including yoga. Common consensus in world community is that yoga can be an effective complement to modern medicine and can help in psychosomatic disorders. Once we adopt a balanced outlook towards intuitive and rational knowledge, we will be able to unite aspects of yoga and the Hippocratic tradition. Paradoxical situation - lack of health in spite of technological advancement: The principal aim of medical education is to train students in intricacies of structure and function of human body to suitably treat diseases arising from human responses to environmental changes, dietetic deficiency or excess, drug abuse and sedentary living of modern man. Inspite of developing technologies and great advances in medicine, we are witnessing a profound crisis in health care. The reasons are (i) inaccessibility of service, (ii) lack of sympathy and care, (iii) malpractice and (iv) striking disproportion between cost and effectiveness of modern medicine. Despite staggering increase in costs of health care and continuing claims of scientific and technological advances, health of the general population hasnt improved in any significant manner. In the holistic view of illness - physical illness is only one of several manifestations of basic imbalances in the individual. manifestations may take the form of psychological and social pathologies. Treating individuals as machines: The engineering approach to health believes that cure of illness requires outside interventions through surgery, radiation and drugs. Current medical therapy is based on this principle of medical intervention relying on outside forces of cure and alleviation without taking into account the inherent healing potential of the individual. Failure of the ambitious plan of WHO to achieve health for all by 2005 AD: WHO had the ambitious plan to achieve health for all, initially by 2000 AD and later on extended to 2005 AD. WHO initially relied on allopathy alone but has now realized that we are far from Other

Faculty, Kaivalyadhama, Lonavla, Maharashtra

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the target and has tried to promote health through other conventional and non-conventional therapies including yoga. Absence of reference to intuitive knowledge: Intuition and subjective knowledge are used by every good physician in their practice but is not acknowledged in professional literature nor taught in medical schools. Health is a multidimensional phenomenon involving physical, psychological and social aspects. The common representation of health and illness as

opposite ends of one-dimensional continuum is quite misleading. Physical disease may be balanced by a positive, mental attitude and social support, so that the overall state is one of well being. On the other hand emotional problems or social isolation can make a person feel sick inspite of physical fitness. Inclusion of yoga in medical education can fulfil definition of health: WHO defines health as a state of physical, mental, emotional, social and spiritual well being. Yoga can complement medicine in achieving health at all levels through the systematic process of ashtanga yoga and the observation of yama-niyama. Change in approach of understanding mental health needed: Wilber's and Grof's model of consciousness indicates that ultimate understanding of human consciousness goes beyond words and concepts. This raises the question whether it is possible to make scientific

statements about nature of consciousness. Genuine mental health would involve a balanced interplay of both modes of experience, a way of life in which one's identification with ego is playful and tentative rather than absolute and mandatory, while concern with material possession is pragmatic rather than obsessive, Such a way of living would be characterized by a positive attitude towards life, emphasis on the present moment and deep awareness of spiritual dimensions of existence. The idea that the human organism has an inherent tendency to heal itself and to evolve is as central to psychotherapy as to any other form of therapy. Understanding body functioning at subtle level: With advancement in electronic technology, body functioning at subtle level is understood to be the circulation of micro electric currents in tissues producing and maintaining health through metabolic activities that may be measured by ECG, EEG, GSR etc. Bach expressed in medical terms what Einstein had conceived that matter is energy modified by pernicious energies so that we fall prey to disease when our central nervous system becomes too weak to maintain its control. It has been found that magnetic fields can act therapeutically by facilitating communication between aberrant cells and adjacent normal cells thereby bringing about a return to normalcy. 38

Given the premise that disease is caused by a cell or group of cells going off tune, then the action of a cell is to receive correct healthy signals and rebroadcast them so that specific normal wave length can be reproduced with regaining of normal function. Understanding body structure & function yogic way: It is fascinating to know that yogis and rishis through their supraconscious awareness were able to realise body working at three levels - gross, subtle and causal. At the subtle level there is a continuous flow of energy from one cell to other which is of electric nature and said to be prana. Chakras that are energy stations work on specific sound vibrations known as bijaswaras that in turn stimulate other systems of body known as pancha pranas. The concept of pancha kosha gives an understanding of utilisation of energy in different forms such as heat, electrical and chemical. Inclusion of raw food in diet: To penetrate the mysteries of raw energy biochemists and nutritionists will need to acknowledge that healing powers implicit in raw food are greater than the sum of their parts as measured in terms of nutrients and calories. Rishis also used to depend on raw food. Feasibility: Once we adopt a more balanced attitude towards rational and intuitive knowledge, it will be easier to incorporate some aspects characteristic of both yoga and the Hippocratic tradition with integration of psychological and social measures into our health care system. Any change in approach to health care will be effective only if it is based on concepts and ideas rooted in our own culture evolving according to dynamics of our society. Lifestyle has become complicated today and requires a holistic approach rather than the dependence on any one system alone. The yogic approach towards tackling social and psychological aspects of health at individual and community levels must be encouraged world over.

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MODALITY OF INTRODUCING YOGA IN MEDICAL CURRICULUM Lt. Col. Dr. DR Vaze AMC (Retd)
Summary: Yoga is an experiential science and its practices should be learnt by medical students from 1st year. To experience the changes in one self, student will have to learn internal adjustment of body, mind and intellect. At intellectual level adjustments are done by observing yama-niyama, pratyahara, chittaprasadana, pratipakshabhavana, at body level through asana-pranayama and at mind level through dharna, dhyana and Samadhi. When imparting yogic techniques, changes are need according to the patients physical condition. It is important that patients are taught to experience inner changes. Modality: Yoga is a self experiential science and therefore its inclusion into medical education will require learning various yogic practices at physical level under guidance of experienced yoga instructors from 1st year itself. There has been consensus of opinion not only in India but in other parts of the world to include yoga in school and college education. Students who have been exposed to yoga during school or general college education will be benefited as they will be able to correlate their experiences as they progress in anatomy and physiology. Yoga's experiential knowledge is to be achieved by internal adjustment at body, mind, intellect level and external adjustment which are discussed below. Intellectual adjustment: 1. Yamas: Observing certain codes of behaviour in relation to society such as non violence (ahimsa), truthfulness (satya), none stealing (asteya), sexual control (brahmacharya) and non covetedness (aparigraha). Intellectual acceptance that you are a part of society and observation of yamas helps the individual to quieten the mind. 2. Niyamas: Shoucha (personal and environmental cleanliness), santosha (contentment), tapa (austerity), swadhyaya (self analysis), and ishwarpranidhana (surrender to the divine). Tapa, swadhyaya and ishwarpranidhana are grouped together and known as "kriya yoga". Tapa is not just physical austerity but is intellectual discrimination to prefer shreyas or actions giving long lasting benefits than preyas which give pleasurable feelings only. Swadhyaya is experience by the individual about structure and functions of different organs of body by inner awareness. Ishwarpranidhan is the realisation that all activities of body take place because of higher forces therefore reducing ego.
Faculty, Kaivalyadhama, Lonavla, Maharashtra

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3. Asanas: Regular performance of asanas gives a balanced activity to all groups of muscles with complete relaxation of mind utilizing minimum energy. Some asanas such as sirsasan, sarvangasan and viparitkarni help to compensate adverse effects of the upright human posture. Asanas can bring about improvement in cardiovascular, respiratory, digestive and excretory funtion. They can also give gentle massage to internal organs as in case of bhujangasan, dhanurasan, yogmudra, paschimottanasana, ardhamatsyendrasan and mayurasan. Relaxative asanas such as shavasan and makarasan reduce both physical and mental tension. Meditative asanas keep the head, neck and trunk straight to ensure proper flow of neural impulses without any hindrance. Twisting asanas divert blood to deeper organs improving the blood flow and immunity. Thus the cultural asanas improve energy production by internal organs. 4. Pranayama: It is the control of energy supply to all parts of body by attending to the even entry of pranic energy from external universe in form of food, water, heat (sun) and air. This is effectively described by Maharishi Patanjali (Yogadarshan 2:1-3). Pranayama increases clarity of thinking enabling progress in meditation. Pranayama reduces energy utilization by all organs and avoids production of oxygen free radicals thus acting as antioxidant therapy. 5. Pratyahara: The withdrawal from sensuous pleasures is brought about by intellectual understanding that involvement in sensuous pleasures doesn't give lasting happiness. 6. Pratipakshabhavana: By thinking about adverse effects of negative acts such as violence etc, we get the conviction to lead a good life with principles. 7. Chittaprasadana: Patanjali has advised friendship with individuals who are happy,

sympathy for those who are unhappy. He advises us to appreciate noble persons and avoid the evil. This approach enables us to maintain equipoise and mental quietude. 8. Pranav sadhana: Chanting of AUM has been praised by many rishis in Upanishads. AUM comprises of three and half syllables representing all three states, three forms and three levels of awareness. AUM chanting is found to be effective in making body tissues sensitive to gross and subtle energy changes during yogic practices. External adjustment: Health of the individual also depends on external factors such as good food, clean water, clean air, clean atmosphere, well lighted and ventilated accommodation

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and space for exercise activities. Loving, amicable and secure behaviour with members of family and society in general is also very important for maintaining good health. Diet: In yoga, diet is considered in a very comprehensive manner. Food should satisfy hunger but not produce laziness. Traditional texts have also given emphasis on state of mind of the person preparing, serving and consuming the food. Food is to be partaken in a quiet place with pleasant surrounding and when there is right nostril dominance. One should express gratitude to God for availability of food. Traditional texts also mention effect of seasonal changes on digestion and suggest suitable measures to avoid adverse effects. Texts mention the importance of food in proper development of personality through its effect on mind, body and speech. Bhagavad Gita classifies food according to the effect it produces on mind as satvik, rajasik and tamasic. It advises that yogis should prefer satvik food that is fresh, juicy, soft, sweet, stable and pleasing to senses. Food should promote health, strength, intelligence and longevity. Environment (vihar): Environment has important role to play in health. Normally the body can make necessary changes in the internal milieu to combat external changes. However, if the external environmental changes are of an extreme nature or occur suddenly or frequently, then behaviour adaptations are necessary in terms of changes in place of working living, type of clothing or type , timing and temperature of food, so that the effect of environment is nullified and health maintained. Use of technical advances to modify our places of living, work, transport, storage of food etc have increased our comforts but have weakened the natural compensatory mechanisms of our body. Behaviour (achar): Development of ones personality depends on tender loving care from parents, family, teachers and society in general. The individual groomed in a lovable atmosphere develops a helpful attitude towards others and a sense of compassion towards the less privileged. On the other hand those who are not so fortunate, tend to grow in a discontented manner. They usually carry feelings of anger, hatred and jealousy and suffer various psychosomatic disorders. If we follow principles advocated by Maharishi Patanjali, we can form the correct outlook even if we have gone through bad experiences. Then we can have amicable relationship with society and lead a healthy, happy and contented life. Yoga therapy to be introduced with clinical subjects: Yoga therapy is best suited for psychosomatic stress disorders. Treatment should be designed for every patient by modifying yogic practices as best suited for their physical condition. Observation of dos and don'ts is 42

important .We must realize the limitations of yoga as a therapy. Yoga practices should not be advised to patients suffering from acute conditions even if they are of psychosomatic nature. Yoga has no role in the treatment of new growths either benign or malignant. Though certain asanas are effective in treatment of certain ailments, yogic practices were not meant to treat disease but to help healthy persons achieve and maintain positive health. Yogic practices are therefore preventive in nature and also help the persons evolution at psychological level. Medications should not be stopped abruptly and the dose of medicines should be adjusted after observing effects of yogic practices and under medical advice. The practices should always be taught by well trained and experienced yoga teachers. The effect of yogic practices can be ascertained by performing biochemical, physiological and clinical tests. However, the patient's subjective observation of the beneficial effects is more assuring. All yogic practices need not be done everyday in case of paucity of time and one or two from various groups of asanas like sitting, standing, prone and supine may be selected on different days so that the individual gets benefit from different asanas. Yogic practices are not only to be performed for treating ailments but should be continued throughout the life for sustained effects and for promotion of positive health.

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STRATEGIES FOR INTEGRATING YOGA INTO ALLOPATHIC MEDICAL CURRICULUM Dr P Viswanath

Since the targeted group is medical professionals who may or may not have physical education culture / habits, the following strategies are suggested: Practical modules: 1. Yogasana, pranayama and meditation are practice oriented more than theory oriented. Therefore practical aspects need to be given more time. 2. It is suggested that a limited number of simple postures which can be learnt within a short period of 7 days in 45 - 60 minute session per day be introduced. 3. The main stress should be on maintaining a few postures for a longer duration than trying to practice many postures within a short time. Theory modules: Stress should be on re-orienting the target group towards other dimensions of human body and life, thus creating an awareness of other alternative modes of treatment for holistic health. Research angles: General topics can be different types of health problems and the impact of yoga (asana, pranayama, meditation) on them. Topics like impact of yoga on different parts of the brain, heart rate, GSR that can be measured, objectified and demonstrated with accuracy with some new age devices e.g. CT scan, MRI, QEEG, PET. Yogasana practicals: Standing postures: ardhakati chakrasana, ardha chakrasana, padahastasana, parvatasana, vrikshasana, trikonasana, parivrta trikonasana , pavanamuktasana Sitting postures: vajrasana, shashankasana,ushtrasana, vakrasana, ardha -matsyendrasana, sukha / sidha / padmasana , tolasana , supta vajrasana Supine postures: matsyasana , halasana , sarvangasana Prone postures: makarasana, bhujangasana, shalabhasana, chakrasana General postures: suryanamaskar, shavasana, yoga nidra Pranayama practicals: nadi shuddhi, loma-anuloma, surya and chandra bhedi, kapalabhati, bhastrika, sheetali, bhramari etc.
Treasurer, Karuna Trust, Bangalore

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Meditation practicals: guided meditation, omkaara, crystal and vipasana meditation Yoga theory: 1. Goal of life

2. Three types of constraints: birth and accidents (aadi daivika), diseases, germs and virus (aadi bhowtika) and by lifestyle (aadhyatmika) 3. Exercises & all round development 4. Isometric, isotonic & hypotonic exercises, their strengths and weaknesses. 5. Yoga: a way of life 6. Yogasana: types, benefits and for all-round development 7. The contradictions in yoga 8. What yoga is? 9. What yoga is not? 10. Schools of yoga: their strength and weaknesses 11. Yoga in daily life 12. Ashtanga yoga 13. Yoga & ayurveda 14. Yoga therapy Pranayama theory: 1. Breathing & pranayama, Benefits of pranayama 2. Inter-relationship between lung, heart & mind. 3. Breathing and oxidation/low BMR/HRV/GSR 4. Pranayama, metabolic switches & endocrine system 5. Mudras, the + ve body language 6. Vedic schools & pranayama 7. Lifestyle diseases, anxiety, stress 8. Progression from physical diseases, stress to depression. Meditation theory: 1. Pranayama to prathyahara and dharana 2. From dharana to dhyana 3. What is dhyaana? 4. From dhyaana to samadhi 5. What is samadhi / brahasthithi? 45

6. Signs of a person who reaches samadhi 7. Benefits of samadhi 8. Braamyaha sthithi and human goal 9. Ancient Indias unique contribution to the world in health 10. Dharma, artha, kaama, moksha, life vision statement for holistic development

Prayers sahana vavatu sahanow bhunaktu sahaveeryam karavava hai tejasvina vadhitamatsu, maavidvishavahai hiranmayena paatrena satyasya pihitam mukham tattvam pushan apavrunu satya dharmaya drishtaye praanasedam vashesarvam tridiveyat pratishthitam mateva putran rakshasva shreescha pragnascha vidhehi neti sarve bhavantu sukhinah sarve santu niramaya sarve bhadrani pashyantu ma kashchit duhkha bhagbhavet aum shanti, shanti shantih

Literal Meaning May he protect us both May he nourish us both May we both work together with great energy May our learning be enlightening and fruitful May we never hate each other Like a lid to a vessel O sun! Your golden orb covers the entrance to truth Kindly open thy entrance To lead me to truth & dharma Whatever exists in the three worlds, Is all under the control of prana O prana! Protect us as mother protects her children Give us wealth, wisdom and liberation May all be happy May all be free of diseases May all see auspicious things May grief comes to none Let there be peace, peace, peace

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YOGA CURRICULUM IN MBBS COURSE Dr TM Roy

There are four major paths of yoga: jnanayoga, karmayoga, bhaktiyoga and rajayoga. It may be said that rajayoga is easier to follow and practice. The goal of all paths of yoga is the same, only techniques differ. Introduction of yoga in medical curriculum and its practice will not only improve the mental capacity for understanding medicine but also give a spiritual flavour to life, a feeling of abundance and inner bliss. Spiritualism is not performance of rituals but an elevated state of mind. There can not be a dark spot in a bright light. All ignorance vanishes as truth manifests. Today, in this modern civilization, teaching has become institutionalized. We are totally removed from the concept of yoga which in ancient times used to be part of life culture. The students are totally ignorant of it and dont value it. Moral values are degrading. All are running after material gain and running the rat race. Everybody wants happiness in life and everybody tries to find happiness in material gain. Our mind is so programmed that we believe in matter and dont believe in abstract things. Both consciousness and mind are abstract and we cannot deal with them directly. Even the concept of God is abstract as no one knows whether God exists or not. If we take a fresh look, the world may appear different. The material world is a limited world and we judge it as an object of our senses. We judge it in terms of reasoning, arguments and experimental findings. Yogis say that the world beyond reasoning is more vast and unlimited and that there is endless joy in it. If we look at the world from this angle, our attitude towards life will change and our moral values will improve. We will be able to do more service to humanity and uplift society from poverty. Practice of yoga shows us the true path and gives us freedom in life. Western countries have started accepting the potential of yoga in curing diseases. Yoga has become increasingly popular in the west for fitness training. Greater and greater attention is being drawn towards yogic management of various ailments. Researchers are also attracted to its great possibilities. The trend today is to apply yoga as a complimentary or supplementary therapy in various diseases.

Head, Department of Physiology, Manakula Vinayagar Medical College, Puducherry

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Syllabus and curriculum for medicos: Theoretical rajayoga classes. Eight classes for eight steps of - yama, niyama, asana, pranayama, pratyahara , dharana, dhyana and samadhi. The book recommended is Rajayoga by Swami Vivekananda Practice of yoga- morning session consisting of 45 min everyday between 6 to 6.45 am. Prior to practice some warm up exercise is desirable. Yama and niyama are two important steps to be followed in the beginning. This is required to make our body and mind ready to perform yogic techniques. This brings about a sacredness of body and mind. It can be achieved by cultivating good things in our daily life processes like restriction in food, truthfulness, non-violence, service mindedness, loving nature, nonreceiving of gifts, attitude of surrender to God and always thinking good for others etc. This will build up moral excellence and in turn help elevate our state of well being. Practice of asanas is required to keep various joints fit and is necessary for maintaining good health. This also creates ability to sit still for a long time without discomfort. Pranayama is a type of breathing technique to control prana. This helps elevate our mind to a finer state of vibration enabling conduction of prana to all parts of the body. According to Swami Vivekananda if one attains success up to the stage of pranayama, one start feel a difference in his life. The following pranayamas are suggested for practicing in the morning session: kapalabhati pranayama, anulom vilom pranayama, sudarshana kriya and ujjayi pranayama. Pratyahara is returning back to centre. Mind is attracted to the objects of senses through our sense organs and is always flowing outward. Reversing the flow of mind and bringing it back to the centre by applying willpower is pratyahara. Dharana, dhyana & samadhi are three succeeding stages of meditation. They are the higher steps for controlling the mind by cultivating concentration power. Concentration means ability to control the mind and focussing it to flow uninterruptedly. Sustained concentration leads to final meditation.

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YOGA FOR MEDICAL STUDENTS Dr Manoj Naik

Yoga is an art, science and philosophy. It is a science of health, happiness and longevity. All other health sciences give their views on health, happiness and longevity but not the way and means to achieve it. Yoga is a science which shows the way. In medical science we have many specialties and super specialties focusing on narrow or specific studies. Similarly, BKS Iyengar the legendary yogi has super specialized in two limbs of yoga: asana and pranayama. These limbs are important because they show the way to health. Comprehensive and holistic health can be developed by regular practice of asanas. If introduced in medical curriculum they will give good health to medicos. Other limbs of yoga seem abstract or remote. Asanas and pranayamas can be shown, demonstrated, experienced and studied by medical students. Asanas are postures. Their innumerable health benefits accrue from precise placement of various anatomic parts. Knowledge of anatomy, especially surface anatomy is extremely helpful for asana practice. Iyengar Yoga gives emphasis to correct placement of various parts and alignment of external body. This alignment results in balance, transformation and evolution of inner subtle body (mind, intelligence, ego, awareness). External body is used as a tool to access and shape the mind. In this sense, asanas are a somatopsychic science. Asanas give many benefits. They give physical health, organic health, as well as mental, emotional, intellectual and spiritual health. However, the higher aspects cannot be felt by a beginner. Hence, introduction has to be with the basics. Standing postures help develop a strong healthy musculoskeletal body. All muscles, bones and ligaments are made strong, stable and flexible. These postures are difficult for beginner. Hence, supports are used for ease, timing and correct action. Further, higher grades of asanas do not come by negating the body but from evolving from the base given by standing postures. After exercising the muscles and skeletal body, asanas exercise the organic body. This is a unique term coined by Guruji. Various exercise forms exercise only the limbs and muscles. Asanas also exercise abdominal organs like liver, spleen, intestines and kidneys. They also exercise heart and lungs. All asanas have this action but this action is especially prominent with twisting asanas. Negative intra abdominal pressure coupled with rotation of the spine causes extension, twisting and massage of these
Consultant physician, Ramamani Iyengar Memorial Yoga Institute, Pune

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organs and keeps them healthy. Various props and supports are used to achieve this action. For these higher effects correct alignment is of paramount importance. These can be understood when anatomy of abdomen and thorax is introduced. After exercising various systems and organic body, neurological exercise is done. After a few months when students are well versed with standing, sitting, twisting and supine postures, inversions can gradually be introduced. Here again for neurological, intellectual and mental exercise, the body is used as a tool. These include inversions, shirshasana, sarvangasana, and back bends. These can be introduced when neurology is taught. Inversions are actually advanced use of various neurological facilities. Anatomy teaches us parts of human being on a dead body. Asanas teach us the function of anatomy in a live body. Thus physiology of the anatomy is learned and experienced. So many of the known physiological facts are used in asanas brilliantly. It is surprising how the yogis could use these even before physiology was known.

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THERAPEUTIC POTENTIAL OF YOGA Yogacharya Dr. Ananda Balayogi Bhavanani

In modern times when the terms yoga and yoga therapy have become synonymous, this paper is an attempt to put into perspective what yoga therapy can offer us as an integrative system of wholistic well being. According to Dr Swami Gitananda Giri, the founder of Ananda Ashram at ICYER, Pondicherry and one of the foremost authorities on yoga in the past century, Yoga chikitsa is virtually as old as yoga itself, Indeed, return of mind that feels separated from the universe in which it exists represents the first yoga therapy. It may be termed mans first attempt at unitive understanding of mind-emotions-physical distress and is the oldest wholistic concept and therapy. Principles of yoga therapy: Become aware of your body, emotions and mind Improve your dietary habits Relax your whole body from toes to head Slow down your breath by making it quiet and deep Calm down your mind and focus it inwardly Visualize the flow of healing pranic life energy to all parts of your body, especially to those diseased parts, thus relaxing, regenerating and reinvigorating yourself Decrease your stress level by fortifying yourself against omnipresent stressors and improving your resistance to stress. Increase your self reliance and self confidence Facilitate the natural emanation of waste from your body by the practice of yoga shuddhi kriyas such as dhauti, basti and neti. Remember that ultimately it is you who are responsible for your health and well being and must take initiatives to develop positive health to tide over challenging times of ill health. Health and happiness are your birthright, claim them and develop them to your maximum potential. Potentialities: Extensive research done all over the world has shown promise with regard to various disorders and diseases that seem to be amiable to yoga therapy. These include the
Programme Co-ordinator, ACYTER, JIPMER, Puducherry. www.icyer.com Email: ananda@icyer.com

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psychosomatic and stress disorders such as bronchial asthma, diabetes mellitus, hypertension, irritable bowel syndrome, gastro intestinal ulcer diseases, atherosclerosis, seizure disorder (epilepsy) and headache. It also includes physical disorders such as heart disease, lung disease, and mental retardation. Psychiatric disorders such as anxiety disorders, obsessivecompulsive disorder, depression and substance abuse can also be managed along with other therapies. Musculoskeletal disorders such as lumbago, spondylosis, sciatica and carpel tunnel syndrome can be tackled effectively with yoga practices that offer a lot of hope in metabolic disorders such as thyroid and other endocrine disorders, obesity and the modern metabolic syndrome. Modalities of yoga therapy: 1. Physical therapies: Asanas, kriyas, mudras and bandhas gently stretch and strengthen muscles, improve mobility, flexibility, respiration, circulation, digestion and elimination, and promote a general sense of health and well being. 2. Emotional therapies: Swadhyaya, pranayama, pratyahara, dharana, dhyana and bhajana can calm and centre the mind, helping to relieve stress and mental fatigue and bring about emotional balance. 3. Development of proper psychological attitudes: By encouraging us to step back and look objectively at our habitual patterns of behaviour and thoughts, jnanayoga can help us to cope better with situations that put our bodies and minds under strain. Development of the following qualities are also emphasized in order to become mentally balanced humane beings: vairagya (detached, dispassionate attitude), chitta prasadan (acceptance of the divine will), maitri (friendliness towards the happy), karuna (compassion for the suffering), mudita (cheerfulness towards the virtuous) and upekshanam (indifference and avoidance of the evil) etc. 4. Mental therapies: Relaxation and visualization practices, trataka, pranayama, pratyahara, dharana as well as dhyana. Relaxation is a central element in yoga therapy as relaxation is the bodys way of recharging itself and helping to ease physical, emotional and mental tensions. 5. Spiritual therapies: Swadhyaya, satsanga, bhajana sessions and yogic counselling are important aspects of yogic therapy that are often neglected in favour of the physical therapies alone.

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6. Preventive therapies: Yoga has numerous preventive benefits especially when it is started early in childhood. It helps in the prevention of accidents by increasing awareness as well as agility. Improved immunity helps in preventing infectious and contagious diseases. The added benefit of starting early is that the person knows the technique so that he can do it if needed at a later stage in life. Yoga also offers rehabilitative therapies for most musculoskeletal conditions as well as in recovery for debilitating illnesses. The practice of yoga also goes a long way towards prevention of disability and improving quality of life in numerous chronic conditions. 7. Pain relief: Yoga is a useful addition to pain relief therapies as it increases pain tolerance and provides an improved quality of life. It can be safely said that yoga helps us endure the conditions that it may not be able to cure. Integrated approach to yoga therapy: In yoga therapy it is vital that we take into consideration all of the following aspects that are part of an integrated approach to the problem. These include a healthy, life nourishing diet, a healthy and natural environment, a wholistic lifestyle, adequate bodywork through asanas, mudras and kriyas, invigorating breath work through the use of pranayama and the production of a healthy thought process through the higher practices of jnana and raja yoga. The application of yoga therapy can be correlated with the pancha koshas and various yoga practices may be used as therapeutic interventions at different levels in this respect. Annamaya kosha (anatomical level): jattis (simple units of movements), mudras (gestures for energy generation and conservation), kriyas (structured movements), asanas (steady comfortable postures) and dietary modifications. Pranamaya kosha (physiological level): shat karmas (cleansing actions), various pranayamas, development of breath awareness, working on breath-movement coordination and the energizing and balancing of the pranic energy. Manomaya kosha (psychological level): trataka (concentrated gaze), dharana

(concentration), dhyana (meditation), japa and ajapa-japa practices are useful. Various aspects of concentration such as the mandala dharana and other yoga drishti techniques are available for this purpose.

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Vijnanamaya kosha (intellectual level): swadhyaya (self analysis), satsanga (lectures and spiritually uplifting exchange) along with the wonderful jnana yoga and raja yoga relaxation and concentration practices of yoga.

Anandamaya kosha (universal level): learning to implement the principles of karma yoga (yoga as skilled action performed without expectation) and following the principle of action in relaxation help us to bring about joy in all our activities. A realization that we live in a blissful universe and that all life is joy is to be brought about in this intervention through use of bhakti yoga, karma yoga and other aspects like bhajana, yogic counselling and satsanga.

Need for coordination: The need of the modern age is to have an integrated approach towards therapy and to utilize yoga therapy in coordination and collaboration with other systems of medicine such as allopathy, ayurveda, siddha and naturopathy. Physiotherapy and chiropractic practices may be used with the yoga if needed. Advice on diet and lifestyle is very important irrespective of the mode of therapy that is employed for a particular patient. A word of caution: A word of caution is also required. Though yoga and yoga therapy are very useful in bringing about a state of total health, it is not a miracle cure for all problems. It needs a lot of discrimination on the part of both the therapist as well as the patient. It may not be useful in emergency conditions and there is a strong need to consult a qualified medical doctor where in doubt. Each patient is different and so the therapy has to be moulded to suit the individual needs rather than relying on a specific therapy plan for patients suffering the same medical condition. A very true problem is that there is a different approach of the different schools of yoga to the same condition. It is better to follow any one system that one is conversant with, rather then trying to mix systems in a yogic cocktail. One must also be vigilant as there is a strong presence of numerous quacks pretending to be yoga therapists and this leads to a bad name for yoga therapy as well as yoga in general. Conclusion: Yoga helps us regain the ease we have lost through dis-ease (as implied by sthira sukham asanam). It also produces mental equanimity (samatvam yoga uchyate) where the opposites cease to affect (tato dwandwa anabhigata). This enables us to move from a state of illness and disease to one of health and well being and ultimately from lower animal nature to the higher human nature and finally the highest divine nature that is our birthright.

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Recommended reading: Yoga: step by step by Dr Swami Gitananda Giri, Ananda Ashram,

Puducherry.www.icyer.com The science of yoga by IK Taimni, The Theosophical Publishing House, Chennai Asana, Pranayama, Mudra, Bandha by Swami Satyananada Saraswathi, Bihar School of Yoga, Munger Yoga its basis and applications by Dr HR Nagendra, sVYASA, Bangalore Yoga for health by Dr HR Nagendra and Dr H Nagarathna, sVYASA, Bangalore Yoga for health and healing by Dr Ananda Balayogi Bhavanani, Dhivyananda Creations, Puducherry-13 A primer of yoga theory by Dr Ananda Balayogi Bhavanani, Dhivyananda Creations, Puducherry-13 www.icyer.com www.iayt.org

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YOGA THERAPY MODULE FOR RESPIRATORY DISORDERS Dr Rajvi H Mehta, PhD

The goal of all therapies, including yoga therapy, is to give freedom from pain and provide ease from the diseased condition. Patanjali states Avidya kshetram uttaresham prasupta tanu vicchinna udaranam(Yoga Darshan 2:4). This means that lack of knowledge is the source of all pains. These pains can be dormant, interrupted, attenuated or fully active. Disease, a source of pain, also occurs in these 4 stages. Udaranam when the patient expresses acute symptoms of a chronic disease (e.g. during an asthmatic attack), vicchinna the disease is in the chronic stage (an individual prone to asthma), interrupted (generally in the initial stages which a patient tends to ignore) and finally prasupta (the disease is inherited but not yet expressed). Yoga works on all four stages of the disease. Principle of yoga therapy: Specific asanas performed in a specific sequence for a specific period of time aid in alleviating symptoms and often the disease itself. This principle is similar to medical therapy where specific drugs are administered in a specific dosage and combination for a specific period of time. In case any of these specificities is incorrect, the therapy will be ineffective. Similarly, the quality of asana is of utmost importance for yoga therapy to be effective. We

may have a prescription of asanas for a specific problem, duration for which one has to stay in each asana as well as sequence in which they have to be performed, but if quality of the asanas is not perfect then the entire yoga therapy will be ineffective. Efficacy of yoga therapy: The efficacy of yoga therapy depends on: Selection of the right asanas. Determining the right sequence of performing the same. Staying and maintaining the asanas. Performance of asanas to a level of perfection. Compliance of the patient.

Selection and sequencing of asana for yoga therapy: Of hundreds of asanas known, it is important to select the right asanas and perform then in right sequence. Research done by many practitioners shows that asanas selected should be such that: It is possible for the patient to perform them despite his/her limitations.

Editor, Yoga Rahasya and Research Associate, Light on Yoga Research Trust, email: mehtat@vsnl.com

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They build confidence in the patient They provide symptomatic relief to the patient They gradually tune and tone the affected part and strengthen it One generally does not perform asanas that directly act on affected part but start with those that work on adjacent parts and then gradually perform those which act on the affected area.

Attaining perfection in the asanas: Ancient texts refer to a few asanas with a minimal description on how to do them and often explaining the effects of performing a particular asana. We refer to the detailed description of performing various asanas in the Light on Yoga. This book has been translated in 19 languages since its publication in 1966 and is in its 53rd impression in India. However, it is not often possible for even a normal individual, least of all a diseased or disabled person to perform these asanas to that extent of perfection. Taking this into consideration, Yogacharya BKS Iyengar has shown how external supports like wall, chair, blankets, belts, blocks, pillows etc can be used to perform an asana to a reasonable level of perfection and retain the position for prolonged periods of time despite physical or health limitations. Yoga therapy for chronic respiratory disorders: The two most common respiratory disorders for which individuals seek yoga therapy are asthma and chronic cold / upper respiratory tract disorders. Yoga therapy has a two-fold aim in both these conditions. Its first objective is to provide symptomatic relief to the patients and then to decrease the frequency and intensity of attacks. The types of asanas and the sequence in which they are performed differ to fulfill both these aims. Asanas recommended to attain relief from an asthmatic attack: An asthmatic finds it very difficult to exhale. All the asanas described here facilitate exhalation by compression of the thoracic cavity. The reader is referred to the Light on Yoga by BKS Iyengar and Yoga in Action by Geeta S. Iyengar for detailed techniques on how to perform these asanas. Baddhokonasana with the spine/back supported and head slightly raised/inclined. Ardha uttanasana with arms and chest in line with hips and abdomen rested on stool. Prasaritta padottanasana with abdomen rested on a stool. Janu sirsasana with the chest rested on a bolster Paschimottanasana with the chest rested on a bolster

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Supta virasana with the spine/back supported on a bolster and the head slightly raised and the back of the head placed over a folded blanket.

Asanas recommended for decreasing frequency and intensity of asthma attacks: Inverted asanas help in reducing frequency and intensity of future asthmatic attacks. It is advisable that all these asanas be done with props with support to back and head. Rope sirsasana Viparita dandasana on a bench or chair Setu bandha sarvangasana on a bench Sarvangasana with a chair Viparita karani with the legs supported and rested on the wall.

Asanas recommended for URT problems such as common cold and sinusitis: The sequence of asanas is so designed to initially provide the practitioner relief from congestion and then those asanas which open out the chest are performed. These asanas include: Ardha halasana with legs rested on a stool. Niralamba sarvangasana with the feet rested on the wall. Viparita karani with the back of the legs supported by the wall. Setu bandha sarvangasana with support Viparita dandasana with support as described earlier. Finally, supta virasana with the back supported

Yogic therapy for such chronic disorders is currently being used effectively in several countries indicating that this form of therapy is replicable. Despite all the standardizations with reference to the selection of asanas, the sequence in which to perform them and the duration for which one has to stay in these asanas, the compliance of the patients and the ultimate success of the therapy on individual patients will depend upon the experience and the insight of the teachers.

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REVERSAL OF HEART DISEASE THE YOGIC WAY: FACTS, PROGRAMME & RESEARCH Dr. Shantharam Shetty MBBS, MCPS, FCGP2 Smt. Hansaji Jayadeva Yogendra3
Coronary heart disease (CHD) has assumed epidemic proportions in India. The disease is more prevalent in urban populations and there is a clear gradient in its prevalence from rural to semi urban populations. The disease occurs at a younger age in Indian subjects compared to the subjects of Western developed nations. The global burden of diseases (GBD) study reported the estimated mortality from CHD in India to be 1.6 million in the year 2000. Extrapolation of these numbers estimates the burden of CHD in India to be more than 32 million patients. Epidemiological studies show a sizable burden of CHD in adult rural (3-5%) and urban (7-10%) populations. Thus there could be 30 million patients with CHD in India of whom 14 million are in urban and 16 million in rural areas. There is a strong positive correlation between CHD and primordial risk factors of urbanization, stress, excessive fat intake, faulty diet, tobacco consumption and sedentary lifestyle. Major coronary risk factors include high blood pressure, high cholesterol levels and low HDL cholesterol. Insulin resistance and diabetes are also escalating in India and

correlate strongly with the increase in coronary disease. There is an urgent need to develop CHD risk factor surveillance and prevention effort in India. The ancient scriptures say, Prasanna atman indriya manah swastha ityabhi dheeyate i.e. where the mind, the soul and the senses are tranquil, health is guaranteed. Science too is inching towards components of subjective attitudes, like compassion, empathy, integrity, faith, relaxedness as some of the powerful modes of healing. Medical science today has started realizing the importance of a correct lifestyle towards management of most of the chronic diseases. This certainly has generated interest in the minds of most people towards yoga as a pioneer in the field of lifestyle management. By following yoga based lifestyle, the risk factors can be modified. The overall change in value system and favourable effect of techniques on the limbic system (emotion centre) can reduce the impact of stress. Serotonin is the chemical responsible for tranquillity and its levels are higher in those practicing yoga. It is well known that endorphin
2

Consultant, 2 Director, The Yoga Institute, Mumbai

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levels are increased by recreational and relaxation activities leading to a sense of well being.Researchers at the Universities of Milan and Paris found that people who follow relaxation techniques and breathing exercises at their work place showed an improvement in their heart rate variability (beat to beat fluctuation of the heart rhythm governed by the autonomic nervous system).Erratic functioning of satiety and appetite centres in the hypothalamus is a leading cause of obesity. Yoga can help regulate these centres. The isometric effect of yogic techniques helps build up muscle and lean body mass. The yoga way of eating definitely plays an important role in all risk factors. By regular yoga practice, insulin resistance gets reduced, peripheral resistance of blood vessels decreases and cortisol and catecholamine levels are normalised. All these factors help in management of hypertension, diabetes and dislipidemia. Likewise, other risk factors like smoking, alcoholism, sedentary lifestyle and faulty food habits are modified by yoga based better living.As one practises yoga for longer duration, homeostasis gets established. Yoga philosophy and yoga techniques lead to favourable changes in the psycho-neuroimmunological system. These changes can enhance natural healing. The progress of the disease process can be arrested and in course of time it can be reversed. At the Caring Heart Project of the International Board of Yoga, conducted at The Yoga Institute, Santa Cruz, Mumbai, India, objective of the project was to achieve reversal of coronary artery blockages through improvement of personality and modification of lifestyle. People with ischemic heart disease (30 to 70 y) were invited to participate through the media. The exclusion criteria were IHD patients who had undergone intervention, severe triple vessel disease, myocardial infarction less than 8 weeks on anti-coagulant drugs, ejection fraction less than 30 and severe co-morbid conditions. The Caring Heart Project was implemented after detailed case study evaluation of each participant. Complete medical investigation was done including coronary stress myocardial perfusion studies and coronary angiography in coordination with hospitals. Detailed biochemical tests like lipid profile were also done. Guidance was provided by cardiologists, psychiatrists, yoga experts, nutritionists and yoga lifestyle was imparted in following four sections: 1. Achar (right action): In 1990, Morris reported that executives who engaged in moderately intense exercise had three times lower coronary artery disease after 10 years than their sedentary colleagues. Dr. Stephen Blair and colleagues published in JAMA that even 60

moderate exercise like walking for 30 minutes can lower mortality rate by as much as 40%. Participants in the Caring Heart Project were instructed to reschedule their routines, as regard to time management and priorities. Accordingly, time for exercise, food, sleep, recreation and working hours were sorted out. Yogic asanas, pranayams and kriyas were incorporated on a regular basis. Apart from that, regular walks were emphasised. 2. Vichar (right thoughts): Studies at the University College of London have revealed that people prone to anger are 2.5 times more liable to get MI and sudden death due to MI in comparison to calmer counterparts. Studies have also shown that hopelessness and depression in people lead to 4 to 5 times more chances of heart disease. Behavioural modifications bring about significant positive results. We are what we think about ourselves and we shall be what we decide to be. 30 years of Mayo Clinic studies showed that people with positive attitude live 19% longer than pessimists. Yoga essentially prescribes a balanced state of mind with certain restraints and observances (yamas and niyamas). There is enough in this world for everyones need but not for any ones greed. The right attitudes promote ideas of duty, faith, objectivity and a balanced state of mind. 3. Ahar (right food): Keeping all the nutritional principles intact, only sattvic food was recommended. Accordingly sprouts, dairy products, unrefined cereals, fresh fruits and vegetables were recommended. Carbohydrates with a low glycaemic index and high fibre content were preferred. At the Yoga Institute, sattvic meals are served during programmes. 4. Vihar (right recreation): The experiences of relaxation, silence (mauna) humility and recreational activities were promoted. Group activities and family based programmes were arranged. Karma yoga, altruistic work, humorous interactions and identifying positive qualities of others were given as home work.

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RESEARCH ON CAD & YOGA BASED LIFESTYLE AT THE YOGA INSTITUTE Comparison of overall effect of intervention between yoga and control groups Parameters
Improved MPI status Angiography status as per no. of patients Angiography as per lesions CGI (psychological) CGI - nutritional 43.7 70.4

Yoga Group
Status Quo 46.5 0 Deteriorated 9.8 29.6 Improved 31.0 28.0

Control Group
Status Quo 33.3 12.0 Deteriorated 35.7 60.0

68.6 90.2 93.0

14.4 9.8 5.6

17 1.4

39.8 35.7 35.7

22.6 54.8 35.7

37.6 9.5 28.6

The above table reveals that intervention of yoga has a significant impact in study group as compared to control group as following parameters showed considerable change: 1. 90.2% of the cases had improvement/status quo in study group as compared to 64.3% among control group in relation to MPI status. 2. 70.4% of the cases had improvement/status quo in study group as compared to 40.0% among control group in relation to angiography findings as per myocardial jeopardy due to artery disease. 3. 83.0% of the cases had improvement/status quo in study group as compared to 62.4% among control group as per number of coronary lesions. 4. 90.2% of the cases had improvement in study group as compared to 35.7% among control group in relation to CGI (psychological) score. 5. 93.0% of the cases had improvement in study group as compared to 35.7% among control group in relation to nutritional status. MPI: Myocardial perfusion imaging. CGI: Clinical global impression

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MEDITATION: AN OVERVIEW Prof MR Kotwal

MBBS, MD, MNAMS, FIMSA, FACG (USA), MRCP (LONDON), FRCP (EDIN) Yoga and meditation achieve the most important change in our life, to change the way we breathe daily. In India, generations of yogis and scholars have contemplated in timeless fashion to realize that there is an inner meaning of life and a purpose beyond human suffering. They were convinced that there is a way to escape the tragic problems of life by diverting the mind towards something more interesting and everlasting. They were moved by the suffering they saw around them and wanted human beings to be free from sufferings and ignorance. The great yogis and scholars gave rational interpretations of their experiences and brought them within everyones reach by creating a practical and scientific method of healthy living. Hence, the science of yoga emerged to counter the multifold problems and human sufferings. In ancient time, medicine was dominated by magical and religious beliefs which were an integral part of ancient cultures and civilizations. Although primitive man may be extinct, his progeny- the so called traditional healers are found everywhere. They live close to the people and their treatment is based on a combination of religion, magic and empiricism. The greatest Greek physician Hippocrates, who is often called the Father of Medicine studied climate, water, air, clothing, food habits and the effect they had in producing disease. The Greeks believed that matter was made up of four elements (earth, air, fire, water) and this was true of human body also. They also believed that the equilibrium amongst these elements maintains normal health. Medicine has moved from organism to organ, from organ to cell and from cell to molecular level. Contemporary medicine is no longer solely an art and science for the diagnosis and treatment of disease but is also a science of disease prevention and promotion of health. The world today is increasingly fascinated by yoga that draws its conceptual framework from the philosophic and spiritual texts of ancient India. The utility of yogic exercises needs to be assessed not only at basic level of health and fitness but also in specific systemic disorders. Through regular practice of yogic exercises (asana, pranayama & meditation) autonomic stability can be established. Lifestyle modifications through meditation & yoga as a way of
Medical Adviser to the Chief Minister of Sikkim, International Adviser GERD Center Beijing & Visiting Prof Capital University of Medical Sciences, Beijing

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life can be a primary public health approach to reduce prevalence of many stress related / lifestyle disorders. Meditation, health, intelligence: Meditation is a Vedic exercise that produces mental and physical well being with the attainment of super consciousness. Yoga is a traditional science which helps to effectively coordinate body and mind. It produces tranquillity of mind and calmness in the conscious state. It is perhaps the easiest and safest method to promote mental health. Yoga emphasizes concentration of mind (meditation) along with physical exercise to coordinate body and mind as a preventive, curative and promotive measure for maintaining sound health. Ayurveda emphasizes a balanced diet along with exercise for health and cure of various diseases. Recently, meditation has been shown to reduce anxiety and tension, incidence of various diseases and improve intelligence and performance. Methods of meditation: There are many methods of meditation. Maharishi Patanjali describes eight steps to achieve the goal of super consciousness. This can not be achieved in a short time as one must first improve ones social and personal behaviour and then regularly perform yogic exercises and breath control along with various mental exercises. Buddha (500 BC) described Vipasana (vipashyana) method of meditation in which a person sits in a comfortable posture with eyes closed and directs his attention to the tip of his nose concentrating on the breathing continuously. By this simple procedure one learns to practice meditation on any noble objective, thus attaining peace and happiness.

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MEDITATION FOR MEDICOS Dr P Viswanath

India Today, a premier English magazine in its lead story (4 August 2003) screams: Unhealthy teens, indulgent lifestyles now cause a slew of serious ailments. The lead story is about a WHO sponsored survey in Delhi and other metros which found that:

1 out of 6 adolescents in the metros is overweight 2 out of 5 Delhi Youth have high cholesterol Diabetes is common among Delhi youth 1 out 3 teens has bad eye sight 1 out 5 has stress related emotional disorders 40% Youth suffer from anxiety disorders Nearly 32% of urban teens are alcoholic 25% of them smoke Teenage pregnancies on the rise even in mofussil towns In some Mumbai & Solapur hospitals, 30% of abortions seekers are below 15 years In Thiruvananthapuram, 24% of STD victims were in the 16-20 age group As may as 40% of the new AIDS cases are in the 15-29 age group Teen suicide rates have trebled in the past 25 years and 40% suffer from anxiety. 80% of obese teens grow into obese adults & are twice as likely to suffer heart attacks Adolescents suffer from cavities, bleeding gums, bad breath and in 40% of them the milk teeth do not fall out naturally.

The reasons: The following are reasons cited for the sorry state of affairs:

The craze for junk food (soft, carbohydrate-rich, fibreless food) Eating junk food and snacking between meals Lack of physical exercises with too much TV Break down of joint family structure and emergence of nuclear families with empty rooms!

Situation is grave indeed! We are so near to destruction of the present and the future. The present children who are falling sick are only going to beget a nation of unhealthy people in the future. Needless to tell, Indian metros are only reflecting what has already happened on a large scale in the western countries during the last three decades!
Treasurer, Karuna Trust, Bangalore

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The contrast: The 4 August 2003, issue of Time Magazine published from USA, ran a cover story on meditation. It showed photos of men, women and children practicing meditation. According to the article more than 10 million Americans now practice meditation of some sort or other. And these people are not New Age eccentrics, neurotics or mystery mongers, but mainstream Americans belonging to different walks of life. What ails the gen next, the world over? The materialistic model of education adopted the world over is heavily career oriented with stress on covering the syllabus and passing examinations. One of the major drawbacks of educational system is that it is treated merely as transmission of knowledge and no attempt is made to give proper training to the mind or other aspects of the human personality. The education that our youth are receiving now in schools and colleges is only making our children a race of dyspeptics. This model gives too

much importance to one side of the personality without comprehending its inner spirit and source of strength. The paradigm shift in west: In its cover story on meditation, the Time magazine gives details of the way western nations are combating disease. There are specially marked meditation rooms in airports, alongside prayer chapels and internet kiosks. But current interest is as much medical as it is cultural. Meditation is being recommended by more and more physicians as a way to prevent, slow or at least control pain of chronic diseases like heart conditions, AIDS, cancer and infertility. It is also being used to restore balance in the face of such psychiatric disturbances as depression, hyperactivity and attention deficit disorder. In a confluence of eastern mysticism and western science, doctors are embracing meditation not because they think it is hip or cool but because scientific studies are beginning to show that it works, particularly for stress-related conditions. And compared with surgery, sitting on a cushion is really cheap! Thus, yoga and meditation are fast emerging as the time tested, most effective, easily affordable, most accessible, holistic, promotive, preventive and curative care for health, wealth and happiness ever invented by the human brain!

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HEALTH BENEFITS OF YOGA Lt Col G Himashree

MBBS, MD (Physiology), DNBE (Physiology), MD (Alt Med) Yoga is a comprehensive system whose aim is the achievement of physical, psychological, and spiritual health and well-being and incorporates a wide variety of postures / exercise, breathing, and meditation techniques (Goyeche, 1979). Yoga has also been used as a therapeutic intervention (Khalsa, 2004; Sharma & Singh, 1989) as it is believed that different techniques can produce unique psycho-physiological effects and that this specificity can be used to target specific disorders. Basic research on yoga has suggested that it is effective in influencing psycho-physiological, neuroendocrine, and autonomic parameters and therefore, has mostly been used to treat disorders that have a strong psychosomatic component (Arpita, 1990; Funderburk, 1977; Goyeche, 1979; Khalsa, 2004; Murphy & Donovan, 1999; Sharma & Singh, 1989). Research on the efficacy of yoga has been reported on its component techniques independently, as well as on its practice as a comprehensive multicomponent discipline (Funderburk, 1977; Goyeche, 1979; Khalsa, 2004; Patel, 1993; Raub, 2002; Sharma & Singh, 1989). Respiration is a unique physiologic function which is automatic, but can be modified to great extent by volition. It has an ability to modulate several visceral functions. The relationship is not one way and there are several physiological states like pain, emotion, and cardiovascular challenges that modify respiration in a patterned manner. For this reason, respiration has emerged is an important subject matter for psychosomatic studies both as dependent parameter and also a modifier of psycho-physiological states (Ayesha, 1996). Our body is a self-regulating system. There are threats to its equilibrium as its environment changes and as the organism grows. These threats can be responded to adaptively by appropriate responses or destructively by inappropriate responses. The key to self-renewal lies in the level of awareness of threats and the strategies available for dealing with them. Yoga is a highly effective strategy for stress management. Stress is often defined as the response of the human organism to any change or demand. Be it internal or external, the stress response automatically initiates. The stress response is
Head of the Department of Physiology, ACMS, New Delhi. Officer on Special Duty DIPAS, DRDO, Lucknow Road, Timarpur, Delhi - 110054

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coordinated by the autonomic (or automatic) nervous system. The sympathetic nervous system controls the stress response while the parasympathetic nervous system controls the opposite, i.e. the relaxation response. The endocrine system also releases hormones in response to stressors. Yoga practices include body postures and movements (stretching), breathing practices, imagery, meditation, and progressive relaxation techniques. Each practice has specific purposes and all combine to help develop a focused awareness of what is happening to the practitioner physically, mentally, emotionally and energetically. Developing an awareness of bodily sensations and feelings, emotional states of being, and mental attitudes and beliefs is the first step to reducing stress and using yoga therapeutically in healing. By regular yoga practice, awareness develops and we can extend more and more control over what happens to us physiologically and psychologically. Physiological benefits of yoga:
1.

Stable autonomic nervous system equilibrium

15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30.

Grip strength increases Eye-hand coordination improves Dexterity skills improve Reaction time improves Posture improves Strength and resilience increase Endurance increases Energy level increases Weight normalizes Sleep improves Immunity increases Pain decreases Steadiness improves Depth perception improves Balance improves Integrated functioning of body parts improves

2. 3. 4. 5.

Pulse rate decreases Respiratory rate decreases Blood pressure decreases. Galvanic skin response (GSR) increases

6.

EEG: alpha waves increase. Theta and delta waves also increase during various stages of meditation

7. 8. 9. 10. 11. 12. 13.

EMG activity decreases Cardiac efficiency increases Respiratory efficiency increases Gastrointestinal function normalizes Endocrine function normalizes Excretory functions improve Musculoskeletal flexibility and range of joint movements increase

31. 32.

Haemoglobin and hematocrit increase Lymphocyte count increase

14.

Breath-holding time increases

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Psychological benefits of yoga:

1.

Somatic and kinesthetic awareness increases

5. 6. 7. 8. 9. 10. 11.

Anxiety and depression decrease Hostility decreases Attention and concentration improve Learning and memory improve Symbol coding improves Depth perception improves Flicker fusion frequency improves

2.

Mood and subjective well-being improve

3.

Self-acceptance and self -actualization increase

4.

Social adjustment improves

Biochemical benefits of yoga:

1. 2.

Glucose decreases Total cholesterol , LDL and VLDL cholesterol and triglycerides decrease

5. 6. 7. 8.

Catecholamines decrease ATPase increases Thyroxin increases Total serum proteins increase

3. 4.

HDL cholesterol increases Cholinesterase increases

Benefits of yoga versus exercise Yoga Parasympathetic nervous system dominates Sub-cortical regions of brain dominate Slow dynamic and static movements Normalization of muscle tone Low risk of injuring muscles and ligaments Low calorie consumption Effort is minimized, relaxed Energizing (natural & controlled breathing) Balanced activity of opposing muscle groups Non-competitive, process-oriented Awareness is internal (focus is on breath and the infinite) Limitless possibilities for growth in selfawareness Exercise Sympathetic nervous system dominates Cortical regions of brain dominate Rapid forceful movements Increased muscle tension Higher risk of injury Moderate to high calorie consumption Effort is maximized Fatiguing (breathing is taxed) Imbalanced activity of opposing groups Competitive, goal-oriented Awareness is external (focus is on reaching the finish line, etc.) Boredom factor

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There are numerous studies that have substantiated the above findings but there is some distance to be covered on the road of research before we can cement these findings conclusively and with high objectivity. It can be safely concluded that manipulation of breathing which is an important part of yoga is one of the best available non-pharmacological interventions to modulate the autonomic nervous system and thereby increase ones efficiency to combat stress and ameliorate a number of psychosomatic disorders. References 1. Goyeche, J. R. (1979). Yoga as therapy in psychosomatic medicine. Psychotherapy and Psychosomatics, 31,373381. 2. Khalsa, S. B. S. (2004). Yoga as a therapeutic intervention: A bibliometric analysis of published research studies. Indian Journal of Physiology and Pharmacology, 48, 269285. 3. Sharma, I., & Singh, P. (1989). Treatment of neurotic illnesses by yogic techniques. Indian Journal of Medical Sciences, 43, 7679. 4. Arpita (Harrigan, J.). (1990). Physiological and psychological effects of Hatha Yoga: A review of the literature. The Journal of the International Association of Yoga Therapists, 1, 128. 5. Funderburk, J. (1977). Science Studies Yoga: A review of physiological data.Glenview, IL: Himalayan International Inst. 6. Murphy,M.,& Donovan, S. (1999). The physical and psychological effects of meditation: A review of contemporary research with a comprehensive bibliography 19311996 (2nd ed.). Sausalito, CA: The Institute of Noetic Sciences. 7. Patel, C. (1993). Yoga-based therapy. In P. M. Lehrer & R. L. Woolfolk (Eds.), Principles and practice of stress management (2nd ed., pp. 89137). New York: Guilford Press. 8. Raub, J. A. (2002). Psychophysiologic effects of Hatha Yoga on musculoskeletal and cardiopulmonary function: A literature review. Journal of Alternative and Complementary Medicine, 8, 797812. 9. Ayesha AK, Sachdeva U, Guleria. S, Deepak KK. (1996) Study of pulmonary and autonomic functions of asthma patients after yoga training. Indian J.Physiol Pharmacol. 40:4,318-324. 10. Chohan IS, Nayar HS, Thomas P, Geetha NS. (1984) Influence of yoga on blood coagulation. Thromb Haemost Apr 30;51(2):196-7 11. Madanmohan, Thombre DP, Balakumar B, Nambinarayanan TK, Thakur S, Krishnamurthy N, Chandrabose A. (1992) Effect of yoga training on reaction time,

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respiratory endurance and muscle strength. Indian J Physiol Pharmacol Oct; 36(4):229-33. 12. Berger BG, Owen DR. (1992) Mood alteration with yoga and swimming: aerobic exercise may not be necessary. Percept Mot Skills Dec;75(3 Pt 2):1331-43 13. Telles S, Hanumanthaiah BH, Nagarathna R, Nagendra HR. (1994) Plasticity of motor control systems demonstrated by yoga training. Indian J Physiol Pharmacol Apr;38(2):143-4. 14. Raju PS, Madhavi S, Prasad KV, Reddy MV, Reddy ME, Sahay BK, Murthy KJ. (1994) Comparison of effects of yoga & physical exercise in athletes. Indian J Med Res. Aug;100:81-6. 15. Raghuraj P, Nagarathna R, Nagendra HR, Telles S. (1997) Pranayama increases grip strength without lateralized effects. Indian J Physiol Pharmacol. Apr;41(2):129-33. 16. Telles S, Nagarathna R, Nagendra HR. (1996)Physiological measures of right nostril breathing. J Altern Complement Med. Winter; 2(4):479-84. 17. Schmidt T, Wijga A, Von Zur Muhlen A, Brabant G, Wagner TO. (1997) Changes in cardiovascular risk factors and hormones during a comprehensive residential three month kriya yoga training and vegetarian nutrition. Acta Physiol Scand Suppl 640:158-62. 18. Raju PS, Prasad KV, Venkata RY, Murthy KJ, Reddy MV. (1997) Influence of intensive yoga training on physiological changes in 6 adult women: a case report. Altern Complement Med. Fall;3(3):291-5. 19. Garfinkel MS, Singhal A, Katz WA, et al. (1997) Yoga-based intervention for carpal tunnel syndrome: a randomized trial. JAMA 1998 Nov 11;280(18):1601-3. Vani PR, Nagarathna R, Nagendra HR, Telles S. Progressive increase in critical flicker fusion frequency following yoga training. Indian J Physiol Pharmacol. Jan;41(1):71-4. 20. Malathi A, Damodaran A, Shah N, Patil N, Maratha S. (2000) Effect of yogic practices on subjective well being. Indian J Physiol Pharmacol. Apr;44(2):202-6. 21. Raghuraj P, Ramakrishnan AG, Nagendra HR, Telles S. (1998) Effect of two selected yogic breathing techniques of heart rate variability. Indian J Physiol Pharmacol. Oct ;42(4):467-72. 22. Birkel DA, Edgren L. (2000) Hatha yoga: improved vital capacity of college students. Altern Ther Health Med. Nov; 6(6):55-63. 23. Ray US, Mukhopadhyaya S, Purkayastha SS, Asnani V, Tomer OS, Prashad R, Thakur L, Selvamurthy W. (2001) Effect of yogic exercises on physical and mental health of young fellowship course trainees. Indian J Physiol Pharmacol. 45(1):37-53. 24. Konar D, Latha R, Bhuvaneswaran JS. (2000) Cardiovascular responses to headdown-body-up postural exercise (Sarvangasana). Indian J Physiol Pharmacol 44 (4) : 392-400. 25. Arambula P, Peper E, Kawakami M, Gibney KH. (2001) The physiological correlates of Kundalini Yoga meditation: a study of a yoga master. Appl Psychophysiol Biofeedback. 26 (2) : 147-53. 26. Yadav RK, Das S. (2001) Effect of yogic practice on pulmonary functions in young females. Indian J Physiol Pharmacol. 45 (4) : 493-6. 71

27. Manjunath NK, Telles S. (2001) Improved performance in the Tower of London test following yoga. Indian J Physiol Pharmacol. 45 (3) : 351-4. 28. Tran MD, Holly RG, Lashbrook J, Amsterdam EA. (2001) Effects of Hatha Yoga Practice on Health-Related Aspects of Physical Fitness. Prev Cardiol 4 (4) : 165-170. 29. Satyajit R. Jayasinghe. (2004) Yoga in cardiac health (A Review). European Journal of Cardiovascular Prevention and Rehabilitation. 11: 369375 30. Bernardi L, Sleight P, Bandinell;I G, Cancetti S, Fattorini L, Lagi A,Wdowczyc-Szulc J. (2001) Effect of rosary prayer and yoga mantras on autonomic cardiovascular rhythms: A comparative study. BMJ 2001; 323:14461449. 31. Roth B, Stanley TW. (2002) Mindfulness-based stress reduction and healthcare utilisation in the inner city: preliminary findings. Alter Therapies Health Med 2002; 8:6066.
32. Spicuzza L, Gabutti A, Porta A, Montana N, Bernardi L. (2000) Yoga practice

decreases chemoreflex response to hypoxia and hypercapnia. Lancet 2000; 356: 14951496.

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DIABETES MELLITUS AND ITS YOGIC MANAGEMENT Dr. Arpan Bhatt4MD

It is interesting that even as mankind started exploring the abyss of science and came to know of many unknown secrets about life and its existence, we have become victims of many hitherto unknown and uncommon diseases like AIDS and now Swine Flu. Many new dreadful diseases have sprung up almost from nowhere and all the inventions and medical possessions seem to be futile. Then, a question arises as to how and why such disorders are generated and why science does not have a ready answer? A definite answer to this corollary is the unhealthy diet and lifestyle of a person, at times known but helpless to revert back to normal and at times unknowingly indulging in it. Today, medical science has recognized the importance of lifestyle and postural disorders. One such lifestyle generated disorder is diabetes mellitus. According to the World Health Organization (report of 2000) at least 171 million people (i.e.2-8% of the population) worldwide suffer from diabetes. Its incidence is increasing rapidly and it is estimated that by the year 2030, this number will almost double. Diabetes mellitus occurs throughout the world, but is more common (especially type 2) in the developed countries. The greatest increase in its prevalence is expected to occur in Asia and Africa, where most patients will probably be found by 2030 if no proper care is taken. India is going to be the World Diabetic Capital by the year 2030 AD. It is therefore important to be very attentive about this silent killer which creeps in stealthily and at times results in sweet death. The word diabetes mellitus literally means sweet urine. This condition of metabolic derangement arises due to improper functioning of the pancreas where there is partial or total lack in the production of insulin which metabolizes the sugar in the body. A reference to the sweet taste of the urine has been noticed by the ancient Greeks, Chinese, Egyptians, Indians, and Persians. According to the ancient science of life Ayurveda, the disorders enlisted among having an increased output of urine are termed as prameha. There are 20 types of prameha categorized under varying dominance of vata, pitta and kapha doshas, and if not taken proper care, they all culminate in madhumeha, the symptoms of which are almost similar to diabetes mellitus. It has been said that: Aasyaasukham swapnasukham dadhini graamyaudakaanuparasaah payaamsi;

Navaannapaanam gudavaikrutam cha prameha hetu kaphakruchcha sarvam (Charaka Samhita)

Reader & Head, Department of Swasthavrutta Yoga Nisargopachara, Shri Gulabkunverba Ayurved Mahavidyalaya and Project Director ACYER, Gujarat Ayurved University

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Which means that a person who exceedingly indulges in eating rich (high calorie) diet and sleep, consumes more curd, meat juices/soups of the animals, milk and milk products, consumes new food and drinks, food articles having jaggery and all such factors which increase kapha are the causative factors of prameha. Another reference suggests the importance of legitimate induction of sexual activity for the householder saying: Avyavaayanmeha medovruddhi shithilataa tanoh (Bha. Pu. Ch. 5 /280) This means that not only the dietetic relevance, but also the indulgence of the lifestyle factor was well known to our ancient visionaries. It would be worthwhile to cast a glance on the classifications of madhumeha as per the ancient classics of health and the modern texts and see how almost identical they are: 1. Acharya Charaka : i) Avaranajanya (Cha. Su. 17) due to a specific humoral condition ii) Dhatukshayajanya (Cha. Ni. 4) - due to tissue degeneration iii) Sthula Rugna (Cha. Chi. 6/15) - obese patient iv) Krusha Rugna - lean and thin patient 2. Acharya Sushruta: i) Apathyanimittaja (Su. Chi. 11/21) - caused due to unhomologus diet & lifestyle ii) Sahaja congenital or genetic 3. Acharya Bhela : i) Prakruta - natural ii) Swakruta acquired Keeping within the limits of the present purview, in a nutshell, it may be opined that the causative factors according to the eastern classics are the kapha increasing factors and a sedentary lifestyle, which is accepted almost universally today. The resultant pathophysiology is well understood where the body is unable to utilize the sugar due to lack of insulin and thus, a higher concentration of glucose is found in the urine and blood. In yogic terms, the tamas may be held responsible leading to avidya and the resultant generation of faulty ahara, vihara, achara and vichara disturbing the pancha koshic functioning and the activities of the physical aspects of manipura, swadhishthana and muladhara chakras and related nadis emerging from them.Therefore, while focusing upon the yogic management of such a disorder, the first focus should be made on the diet pattern which should be nutritive yet having less carbohydrate and calories in case of an obese person and the nutritive and nourishing for a skinny person. Likewise, the lifestyle 74

modifications also may be induced depending upon the work and working schedules of a person. Besides these, the following yogic practices converging on decreasing kapha and generating a physical activity or relaxation may be incorporated looking into the need for an individual, making a proper sequence and modifying them after a careful observation time and again. a. Sukshma and sthula vyayama: subtle and gross exercises effective on the digestive tract. b. Shuddhi kriyas: danda dhauti, vaso dhauti, varisara dhauti / shamkha prakshalana, jala dhauti, mulashodhana, jala basti, shushka basti, sutra neti, bhalabhati (vatakrama), bhalabhati (vyutkrama) c. Asanas: padmasana, bhadrasana, simhasana, shavasana, matsyasana, bhujangasana, mayurasana, sarvangasana, halasana, shalabhasana, dhanurasana, pashchimottanasana, ardhamatsyendrasana, shashankasana, yoga mudra, gomukhasana, vatayanasana, supta vajrasana, tadasana d. Pranayama: nadishodhana, ujjayi, bhramari, bhastrika, shitali kumbhaka e. Mudra: mahamudra, khechari, kaki mudra, bhujangi mudra, f. Bandha: uddiyana bandha g. Dhyana and shithilikarana: yoga nidra and ajapa japa Thus, if a legitimate use of yogic practices is done, it frees from various ailments including diabetes.

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