Health of the humans, the society, and the planet *International Journal of Ayurveda Research *
The pandemic COVID-19 has changed the global perspective and placed the health of humans and society on priority. The health-care systems across the world faced challenges and got engaged in finding solutions. However, individual responsibilities to take care of health by following advisories issued by government authorities were expected to prevent spread and illness. This provokes the thoughts on pivotal role of a person at a microlevel to help and reduce the global burden of diseases and preservation of health. It leads to a healthy society at macrolevel or development of universal health-care management. At this time, it becomes essential to review the concept of health in medical sciences and design a strategic action plan for its preservation at large scale. Ayurveda provides a deep insight into personalized approach toward health termed as “ *Swastha*.” It is needed to understand and elaborate this approach in today’s times to provide affordable, easily accessible, and convenient health care. This article describes the concept of health, clinical assessment, and its application to preserve and protect the health of humans, society, and ultimately the planet. INTRODUCTION The global pandemic of SARS COVID-19 has been a greatest challenge to humanity. It unmasked the limitations of human interventions in global health-care systems. It showed that the current health-care system is focused on disease management alone and is insufficient to manage overall global health. The pandemic provoked the need to change the health-care perspectives to the population’s self-reliance on health.[1] Society needs to rethink about synergistic vision in health care in the post-COVID-19 era.[2] The sustainable development goals include actions to end poverty, protect the planet, and ensure the health of all people with peace and prosperity.[3] These goals, indeed, ponder thoughts about interactions of the health of humans, society, and the planet. Observing the pandemic with a broader view beyond the health-care system shows emerging challenges. Humanity today faces three challenges needing urgent attention: 1. Rising incidences of chronic and autoimmune diseases, while newer diseases are emerging. This increases the global burden of diseases 2. Increasing polarity/discord in the thinking of people in the society and increasing violence. This hampers the global scenario of peace and harmony 3. Environmental degradation is evidenced by global warming, pollution, melting of glaciers, and polar ice caps. Is there a relationship between these three phenomena? and is there a common causative factor? Is there a standard, workable solution to these challenges? The possible answers to these questions are presented in this paper, which should be debated and then implemented. THE HUMAN BEING AS A MICROCOSM OF THE UNIVERSE Vedic scholars in India for thousands of years have known a *Mantra*- *YathaPindeTathaBrahmande*, meaning that the state of a human body corresponds to, or mirrors, the state of the universe. As is the cosmic life, so is the individual life.[4] In other words, a human being is a microcosm of the universe or the planet.[5] Leonardo Da Vinci compared human organs and tissues with nature. His Vitruvius Man reflects this same concept of a man as a microcosm and the world as a macrocosm.[6] More recently, Prof. David Wiebers MD, in his book “Theory of Reality” has described the holographic phenomenon about the human mind and the universe.[ 7] The common causative factor for the challenges mentioned above is the deteriorating health of humans, society, and the planet. Considering the above viewpoint, it can be argued that if the health of human beings improves, the other two challenges should also get sorted. After all, humans are responsible for it and should be capable of reversing it. To improve the health of the people, it is important to understand what health is clear. The definition of health should be such that it states the components of health so that the health-care provider should be able to guide people on what steps they can take to preserve, protect, rejuvenate, and promote health. APPROACH TOWARD DEFINITIONS OF HEALTH In the last 70 years, many definitions of health have been presented because the current WHO definition is not considered satisfactory from many points of view. One of the reasons is the word “complete,” which makes almost everyone unhealthy. WHO definition Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.[8] Conference of International Health definition A 2-day conference was held in the Netherlands in 2009 to redefine health, in which distinguished scholars from all over the world in the field of health were invited. Various parameters were taken into consideration like, “health promotion and disease prevention, research and research funding, scientific advice on health issues, health insurance, and social security coverage, health policy, and politics, international regulatory and policy-making organizations, and last but not the least, the public and patients.” The conclusion was that it was not possible to define health, but it is not a “state,” but is an “ability to adapt and self-manage in the face of social, physical, and emotional challenges.”[9] Traditional Chinese Medicine definition Traditional Chinese medicine (TCM) is based on a concept of balanced *qi* (pronounced *chee*), or vital energy that is believed to flow throughout the body.[10] *Qi* is proposed to regulate a person’s spiritual, emotional, mental, and physical balance and to be influenced by the opposing forces of *yin* (negative energy) and *yang* (positive energy). The disease is proposed to result from the flow of *qi* being disrupted and *yin* and *yang* becoming imbalanced. Among the components of TCM are herbal and nutritional therapy, restorative physical exercises, meditation, acupuncture, and remedial massage. Unani definition of health Unani system of medicine was originated in Greece. It states that all elements (~*Arkan*), humors (~*Akhlat*), organs (~*Aaza*), spirit (~*Arwah*), and faculties (~*Quwa*) shall function normally to maintain health. Their imbalance leads to diseases. The first two definitions (i.e., the WHO and the Conference of International Health definitions) describe health, but are very broad and do not guide the health-care provider on specific actions to take to achieve healthy status. TCM narrows down to achieve an equilibrium of positive and negative energies, but still falls short of being specific. The concepts and practices in the Unani system are almost similar to Ayurveda. Considering too many parameters to define the more significant issue of human health is bound to fail. However, if an attempt is made to define an individual’s health (microcosm), then success is possible. Defining and understanding a forest is more challenging than knowing the properties of good quality seeds of a tree, because the quality and health of trees in the forest depend on the seeds and nurturing. In turn, forests determine the health of the planet. THE DEFINITION OF HEALTH IN AYURVEDA Health is known by the terms like “*Swasthya*” or “*Aarogya*.” The first term states about a personalized state of well-being, whereas the latter depicts the absence of diseases. *Swastha* means a healthy individual. Derivation and meaning of these terms explain the approach toward health. The innate nature to sustain life or one’s stand to protect life is explained by the term “*Swastha*.”[11] It explains the self-abiding or self-dependent state.[12] A healthy person is established in self. The inner self is characterized by the quality of bliss. Self represents totality and wholeness, and contact with the inner self is achieved by the technique of meditation.[13] This can be viewed as a connection with the source. Health is defined as a state of equilibrium of components at a given time. It makes the definition of health dynamic and relative, subjected to a specific time. Ayurvedic definition of health The definition of health was formulated by Sushruta over 2000 years ago and has been used widely by Ayurvedic practitioners since. This definition is more specific and guides the health-care provider to specific actions to attain health and prevent, identify, and treat disease. Definition in Sanskrit is “*Samadoshasamaagnischasamadhatumalakriyah*. *Prasannatmendriyamanahswasthaitiabhidhiyate.”*[14] The definition has five components that need to be in a state of equilibrium to attain and sustain health, and disequilibrium is a precursor to disease. Each component can be identified clinically by an Ayurvedic physician and is described as follows: - Three *Dosha* (interaction between epigenetics and genes): *Vata*, *Pitta*, and *Kapha* are the fundamental physiological governing regulators of the body explained later in this article - *Agni* (~metabolic and digestive processes by various enzymes and interaction with microsomes) - *Dhatu* (~principles that uphold the formation of body tissues) - *Mala* or bodily wastes produced that are either reutilized or excreted well, and - The sense organs, mind, and the soul. Assessment of health Five components of Ayurveda definition can be described and assessed based on their functions as follows: 1. Equilibrium of the three *Dosha*: *Doshas*, as the fundamental physiological governing regulators of the body, influence epigenetics to regulate genes, which in turn create proteins to influence the tissues and functions of the body. *Doshas* are formed, per extant Ayurveda texts such as Charaka–Samhita and Sushruta–Samhita, by the combinations of five fundamental elements (~*Panchamahabhuta*), which in turn originate from consciousness. Each person is born with a unique combination of these three *Doshas*, called *Prakriti* (~personality, trait, or body type), which remains fixed for life, just as modern science knows that each person is born with a unique DNA sequence. Environmental influence and diet can, however, cause disequilibrium of these *Dosha*, and if it continues unchecked, causes *vikriti* or imbalance, which is a precursor to disease. The Ayurvedic physician identifies unique attributes of a person’s body, in health and disease, by the phenotypic map and provides personalized care to every patient in a community. This tradition has continued for thousands of years without genomic testing. Early interventions to balance *Doshic* imbalances prevent disease before its manifestation. The equilibrium of *Dosha* is achieved by daily and seasonal purification of excessive *Dosha* and by regulation following other four components of health. 2. Equilibrium of *Agni*: *Agni*, or fire, (corresponds to digestive and metabolic processes caused or triggered by enzymes, hormones, cytokines, and microsome) is the second requirement of health. There are thirteen categories of *Agni* in Ayurveda. The first is *Agni* in the gastrointestinal tract, which is the strongest and is composed of digestive enzymes and bacterial flora of the gut. The second category is of five-elemental *Agni* corresponding to the five elements (space, air, fire, water, and earth). Finally, the third category is of seven-tissue *Agni*. Most of the disease states are due to depleted *Agni* (*Mandagni*). *Agni* is stimulated by following a disciplined dietary regimen designed to suit an individual’s *Prakriti* (body type) and by eating warm, light, and fresh food when hungry. Stimulation of *Agni* by various agents helps in achieving equilibrium. 3. Equilibrium of seven *Dhatu*: These are fundamental principles that support tissues (but are often used interchangeably with tissues) that need to be in a balanced state. There are various therapeutic processes and detoxification techniques, including massages, emetics, and the use of purgatives and laxatives, followed by proper nourishment and care, prescribed in the Ayurveda treatises that help restore equilibrium among *Dhatu* 4. Bodily wastes should be well excreted in a timely fashion, and suppression of natural urges to evacuate bowels, urine, or flatulence should be avoided 5. Connection to the source (consciousness), *Indriya* (sensory faculties, i.e., vision, hearing, smell, taste, and touch), and psyche should be healthy and in harmony with the body. It can be assessed by the overall productivity and quality of life. This is achieved by following a disciplined lifestyle constituting meditation, *Pranayama* (disciplined breathing), and *Yoga*. *Yogic* exercise is considered better (in comparison to conventional aerobic and anaerobic exercises), because it can be titrated to a person’s unique body type and state of his health. Excess or lack of exercise is detrimental to health. On close observation, it becomes clear that the five components of health, when followed properly, reinforce each other. These could be called Laws of Health. Clinical assessment of components of health Determinants of health and clinical interpretation are depicted in Table 1. [image: T1]*Table 1: * Determinants of health and clinical interpretation Levels of understanding health The healthy state or equilibrium state is continuously interacting with the macrocosmic source or connection. Therefore, it is influenced by various interactions with the surrounding individuals, their behavior, and interpersonal relationships. Likewise, the factors at a family level, social level, and universal level can affect an individual’s health. This holographic phenomenon can be viewed from a broader perspective to protect global health or the health of the population at large [Figure 1]. [image: F1]*Figure 1: * Different aspects of health Exogenous factors affecting health Apart from personal health, various external or exogenous factors influence the equilibrium, especially at a psychological plane. The Holmes–Rahe Stress Rating Scale[15] includes stressors such as financial status, living conditions, family life, violation of laws, work conditions, holidays, and education apart from personal health. The professional stress rating scale[ 16] includes interaction with surrounding people to assess stress levels. These assessment scales suggest that the exogenous factors can heavily influence the individual’s mental equilibrium. Improved well-being and quality of life is the outcome of health. The Quality of Life Scale[17] includes the assessment of various parameters in domains of physical state, mental/emotional state, stress evaluation, life enjoyment, and relative feelings to quality of life. This scale directs toward a comprehensive approach toward assessing the quality of life that fundamentally depends on an individual’s health. Laws of health The five laws of health are formulated based on close observation of dynamic health mechanisms.[18] They denote various components required for the preservation of equilibrium state at personal, family, social, and universal levels. Table 2 depicts their importance. [image: T2]*Table 2: * Application of laws of health Therefore, to preserve the health or equilibrium of humans (microcosm) and planet (macrocosm), the following three processes shall be in a continuum and balanced state [Figure 2]. [image: F2]*Figure 2: * Three processes to preserve equilibrium WHAT CAUSES DISEASE? There are the following endogenous and exogenous factors that are considered to be responsible for diseases,[19] per Ayurveda: - Mistake of the intellect (~*Pragyaparadha*) - Misuse or abuse of the five senses and motor organs (~ *Asatmendriyartha*) - Season, time, place, etc.(~*Kala*). These are three fundamental causes of disease. It explains the fundamental process of the formation of disease. When any incompatible change or stimuli comes in contact with the body cells, they respond to those stimuli. The cell has a durable memory and can respond/adopt or modify the stimuli based on that memory. The good stimuli for maintaining equilibrium states are accepted, whereas the bad stimuli are rejected. Thus, the ability of cells to discriminate/accept/modify/adapt the stimuli decides response time. This mechanism is essential for preserving equilibrium in the *milieuinterior*. If the cellular memory cannot recognize or respond, it leads to disequilibrium and initiates the disease process. The disease manifests and progresses in due time through six stages of pathogenesis (*Shatkriyakala* ).[20] Thus, all three causes are essential for causing diseases. On the other hand, preserving good cell memory and response, protecting it from incompatible stimuli, and corrective measures at the appropriate time are essential for health. Bacteria, viruses, trauma, diet, etc., are considered foreign stimuli that attempt to hamper equilibrium. SYMBIOHEALTH In the current scenario, none of the health-care systems seems to be complete and efficient to manage global health-care needs. It needs current times to develop a better health-care system with a comprehensive approach. Symbiohealth is the development of a symbiotic relationship between Allopathy and Ayurveda. It is fundamental in creating a health-care system that is (a) more effective than either system used alone, (b) less expensive, (c) less toxic, and (d) more likely to create a healthier society. The fundamental basis of allopathy is “offense thinking,” corresponding to Newton’s physics, which makes it an excellent disease management system; on the other hand, Ayurveda is based on “defense thinking” and corresponds to quantum physics and is an excellent system for prevention of disease and protection and rejuvenation of health. Judicious use of the two systems in a group practice will provide better care to the masses. Symbiohealth approach guides management principles for the human ecosystem at microcosmic and macrocosmic levels. It includes yogic practices, meditation, dietary guidelines, lifestyle modification, detoxification therapies, and rejuvenation therapies to preserve and protect health. These help manage the disease and prevent its progression too.[21] CONCLUSION Any definition of health should be not only inclusive but also actionable. Moreover, any effective roadmap implementation to attain health needs to have offense (treatment) and defense (prevention) strategies. A combination of modern medicine’s offense (treatment of disease) and Ayurveda’s defense (restoration of health and disease management) would provide for such an actionable roadmap. For implementing such a roadmap, health-care providers should be trained to assess the following key factors as below: 1. Equilibrium of three *Dosha*, *Agni*, *Dhatu*, and *Mala* 2. Blissful state of mind, *Indriya*, and soul These are helpful in cost-effective health-care management and prevention of diseases. It can reduce the global burden of health-care costs significantly by promoting the preservation of health 3. Diagnosis of disease at the earliest stage 4. Knowing the etiopathogenesis and blocking its progression 5. Treatment focused on simultaneous management of exogenous factors (including disease-causing microorganisms) and building up a strong defense mechanism to combat with them. Effective implementation of these strategies would help attain individuals and communities’ physical, mental, and social well-being while decreasing the incidence of diseases. Such a system would undoubtedly be more sustainable, less expensive, more effective, and less toxic, leading to healthier people, the society, and the planet. If the microcosmic unit is healthy and preserves equilibrium, then the macrocosmic health and equilibrium is preserved for eras to come. KR IRS 10123 -- You received this message because you are subscribed to the Google Groups "Thatha_Patty" group. To unsubscribe from this group and stop receiving emails from it, send an email to [email protected]. To view this discussion on the web visit https://groups.google.com/d/msgid/thatha_patty/CAL5XZoq5hw4H-%3Di5XbRw8arOgBWwF%2BFtotVdu5mi32jb6mSsPQ%40mail.gmail.com.
