Health Beliefs and Practices East and West Ancient and Modern Public and Private Mental and Physical Rita Flattley, M.Ed., RYT Pima Community College Health Beliefs and Practices • How have we developed our ideas and practices about health – from public sanitation to our personal mental and physical well-being? • In this era of high tech medical imaging and pharmaceutical development, is there any need to look back at ancient concepts of health? • Are there complementary ideas and practices from other eras and cultures that we could integrate to our benefit? Why Expand our Views of Health? “The core teachings of Buddhism are systematically directed toward developing keen and caring insight into the relational or interdependent nature of all things.” (Hershock, 2006) We can’t poison the environment without poisoning ourselves. Many cancers, respiratory diseases, etc. are caused or exacerbated by environmental toxins. Currently more health issues are caused by poor lifestyle choices than infectious diseases. Obesity, diabetes, and heart disease are good examples. Mental and physical health are in a constant interplay. Many severely depressed people feel physical pain. Some physical issues like thyroid imbalance mimic mental illness. The physical side effects from psychiatric medications often cause “noncompliance.” Byodo-In Temple, Oahu Health Beliefs and Practices: Research There are health conditions for which Western medicine has no cure, leaving people crippled by pain or dazed by medication. Techniques such as meditation and yoga have lead to a better life for people with chronic fatigue syndrome, lupus, phantom limb pain, and psychological issues like anxiety and depression. The mission of the National Center for Complimentary and Alternative Medicine (of the National Institutes of Health) is to: Explore complementary and alternative healing practices in the context of rigorous science. Train complementary and alternative medicine researchers. Disseminate authoritative information to the public and professionals. http://nccam.nih.gov/ Health Beliefs and Practices: Research University of Arizona Center for Integrative Medicine Leads the transformation of healthcare by creating, educating and actively supporting a community that embodies the philosophy and practice of healing-oriented medicine, addressing mind, body and spirit. Health in 2500 BCE • Indus Valley or Harappan civilization: “Covered brick drainage , both inside private homes and on public streets, was more technologically sophisticated and more sanitary” . (Wolpert, 2009) than anything until Roman times. Seals found at Indus sites show figures in yoga meditation postures such as padmasana (Lotus position) and badha konasana (bound angle pose.) • Egyptian civilization: • Egyptians were “masters of human anatomy and healing mostly due to the extensive mummification ceremonies.” (Brier, 1981) They performed surgeries and used medicinal herbs and other substances. The Golden Age of Greece: 460 - 377 B.C. The Time Period of Hippocrates, “father of medicine”, the Hippocratic oath, and the 4 "humors" or fluids (blood, phlegm, black bile and yellow bile) which was the basis for using leeches until the 1800s. Health Beliefs and Practices: Egyptian Texts 1500 – 1000 BCE A great deal of our knowledge of ancient Egyptian medicine comes from the Edwin Smith Papyrus, the Ebers Papyrus and the Kahun Papyrus. The Edwin Smith Papyrus and the Ebers Papyrus date from the seventeenth and sixteenth centuries BCE. These manuscripts are believed to be derived from earlier sources. They contain recipes and spells for the treatment of a great variety of diseases or symptoms. They discuss the diagnosis of diseases and provide information of an anatomy. They detail the ancient Egyptian concept of medicine, anatomy, and physiology. Some Egyptian treatments: Honey and milk for throat irritations Aloe vera for burns, ulcers, and skin diseases Juniper to soothe stomache cramps and digestive problems Poppy seeds as an anaesthetic and for insomnia and headaches Mint for digestion and as a breath freshener Cure for Burns: Create a mixture of milk of a woman who has borne a male child, gum, and, ram's hair. While administering this mixture say:” Thy son Horus is burnt in the desert. Is there any water there? There is no water. I have water in my mouth and a Nile between my thighs. I have come to extinguish the fire.” Cultural Exchange Between Harappans and Indo-Aryans? • Harappan seals have been found in Mesopotamia. There are some words in the Rg Veda that appear to be Munda, a central Asian language, and Dravidian, related to languages spoken today in southern India as well as in Pakistan and Iran (Sharma, 2005.) Therefore it appears that these early peoples communicated and learned from each other. Does the so-called “proto-Shiva seal” indicate early evidence of yogic or tantric practices? Did the conquering Aryans learn about local plants for herbal medicines from the people who had resided in the region for centuries? Scholarly debates on the rise and fall of Harappa and Mohenjo-Daro are ongoing. Health Beliefs and Practices: Indo-Aryan Vedic Texts 1500 – 1000 BCE • Atharva Veda: Last of the four Vedas, includes some material from the Rg Veda and many prayers and treatments for medical conditions, as well as describing some psychiatric condition as shown below. Prayers are often included, unfortunately the specific plants they reference in many passages are no longer known. For example, they used a “dark plant” for leprosy. • VI, 111. Charm against mania.1. Release for me, O Agni, this person here, who, bound and well-secured, loudly jabbers! Then shall he have due regard for thy share (of the offering), when he shall be free from madness! 2. Agni shall quiet down thy mind, if it has been disturbed! Cunningly do I prepare a remedy, that thou shalt be freed from madness. 3. (Whose mind) has been maddened by the sin of the gods, or been robbed of sense by the Rakshas, (for him) do I cunningly prepare a remedy, that he shall be free from madness. 4. May the Apsaras restore thee, may Indra, may Bhaga restore thee; may all the gods restore thee, that thou mayest be freed from madness! – Translation by Maurice Bloomfield, “Sacred Books of the East” 1897 Health Beliefs and Practices: Atharva Veda meets eHow VI, 57. Urine (gâlâsha) as a cure for scrofulous sores.1. This, verily, is a remedy, this is the remedy of Rudra, with which one may charm away the arrow that has one shaft and a hundred points! 2. With gâlâsha (urine) do ye wash (the tumour), with gâlâsha do ye sprinkle it! The gâlâsha is a potent remedy: do thou (Rudra) with it show mercy to us, that we may live! 3. Both well-being and comfort shall be ours, and nothing whatever shall injure us! To the ground the disease (shall fall): may every remedy be ours, may all remedies be ours! From eHow http://www.ehow.com/how_2075188_use-urine-cure-fungus.html Curing fungus requires a combination of treatment. Fungus thrives in stagnant, damp areas, so cleaning up the area where the fungus thrives will begin the eradication process. Washing the area with urine is an effective disinfecting agent Bathe an area, such as the feet, in urine. The urine bath allows a concentrated sterilizing effect. This is especially useful for athlete's foot fungus. The bathing of the infected area should be done in a tub or on a towel to avoid staining the treatment area. Collecting urine should be done fresh daily. Use of the patient's own urine for urine therapy is recommended. Health Practices and Beliefs: Ayurveda and the Caraka Samhita Health Practices and Beliefs: Ayurveda and the Caraka Samhita • The text starts with Sūtra sthāna which deals with fundamentals and basic principles of Ayurveda practice. • Unique scientific contributions credited to the Caraka Samhita include a rational approach to the causation and cure of disease and introduction of objective methods of clinical examination. • Much of the treatise of Caraka Samhita is in the form of a symposium wherein various topics are discussed by groups of ayurvedic scholars and dealt with internal and external medicine • The samhita focuses on healing the body, mind, and soul of a patient in a minimally invasive manner. • Emphasized careful diagnosis of disease and stages of disease • Timing and manner of collection of medicinal herbs is important. Health Practices and Beliefs: Ayurveda and the Caraka Samhita • The enormous medical text Caraka Samhita*, which reports on this tradition, divides the entire practice of medicine into four factors: (1) the physician; (2) the substances (drugs and diet); (3) the nurse; and (4) the patient. • The four essential qualifications of the physician are: (1a) a clear grasp of the science learnt; (1b) a wide range of experience; (1c) general skillfulness; and (1d) cleanliness. • The four key factors concerning drugs and diet are: (2a) abundance of supply; (2b) applicability; (2c) their many imaginable uses or multifacetedness, which is now called the "broad-spectrum" nature; and (2d) richness. • The four qualifications of the nurse are: (3a) a knowledge of attending techniques; (3b) skill; (3c) caring involvement with the patient; and (3d) cleanliness. • The most interesting quartet of desiderata is that concerning the rational patient, who must have: (4a) a good memory (so as not to forget her own case-history!); (4b) obedience to the doctor's instructions; (4c) courage; and (4d) the verbal ability to describe the symptoms. (Chakrabarti, 1997) Health Practices and Beliefs: Ayurveda and the Tri-Dosha Theory • Maintaining health is a matter of keeping the body and mind in balance through appropriate diet, herbs, exercise, and meditation for the season and your dosha. • The three doshas are: – Vata – air and ether – mobility, prana, people who are alert and imaginative. In excess, anxious and “spacy.” – Pitta – fire – digestion, vitality, thinking, people who love learning and are highly principled. In excess, obsessive thought patterns and irritability. – Kapha – earth and water – lubrication, connective tissues and fat, people who are laid back and loving. In excess, laziness, weight gain, headaches, lethargy. Health Practices and Beliefs: The Yoga Sutras of Patanjali (100 AD?) • I.2 “Yoga is the restraint of fluctuations of the mind” and the sutras discuss mental states and selfdiscipline primarily. • II.46-48 “Asana is steadiness and ease. From the relaxation of effort and endless unity, there is no assault by the pairs of opposites.” • II.29 “The 8 limbs of yoga are yama (self-control) niyama (observances) asana (posture or seat) pranayama (control of breath and energy) pratyahara (withdrawal from the senses) dharana (concentration) dhyana (meditation) and samadhi (unified state of awareness.)” Yoga Today: Lineages, Group Practice, and Yoga Therapy Krishnamacharya trained a number of influential yoga teachers and lived to 101. Yoga should always integrate the body, breath, and mind. Some yoga classes include mantra, mudra, & meditation. Yoga should be adapted to the needs and level of practioners. Yoga is beneficial for emotional and physical health. The Americanization of Yoga? The physical elements of Yoga have been emphasized in the U.S. and credited with everything from improving your looks to increasing sexual stamina. “This conflation of yoga with the Kama Sutra — India’s most famous exports to the West prior to information technology — would have startled not only its Brahman practitioners in the Himalayas or along the Ganges but also the sages of Walden and Concord who first embraced Indian ideas of nondualism, the indivisibility of mind and matter, and the essential oneness of the universe.” (Mishra, “Posing as Fitness,” Health Practices: Yoga Research • Dr. Richard Miller and Integrative Restoration: “iRest is an evidence based ancient transformative practice of deep relaxation and meditative inquiry that releases negative emotions and thought patterns, calms the nervous system, and develops an inner sanctuary of well-being and equanimity that underlies all circumstance you may encounter in your life. Research has shown iRest effectively reduces PTSD, depression, anxiety, insomnia, chronic pain, and chemical dependency, as well as increases well-being.” • Amy Weintraub and Yoga for Depression: NIH data states that 17 million people in the US suffer from depression. Yoga, including asana, breathing practices, and meditation, has been shown to be “nearly as effective as antidepressant medication and electroconvulsive therapy in treatment-resistant depression.” Amy leads workshops and conducts teacher trainings around the country. “Dr. Jon Kabat-Zinn's major research pursuits lie in the emerging field of mind / body medicine, with the focus on the clinical, social, and human performance effects of mindfulness meditation training in various populations. These include people with chronic pain, stress related disorders, and / or a wide range of chronic diseases with a particular focus on breast cancer…” ”You can’t stop the waves, but you can learn to surf.” Health Practices and Beliefs: Emotions and Health • In the Natya Shastra, a treatise on dance and drama from about 300 BCE, Bharata described 8 major emotions: disgust, pleasure, pain, laughter, anger, fear, valor, and wonder. • Paul Ekman, Ph.D. studied 6: disgust, happiness, surprise, sadness, anger, and fear and used photos to test their universality across cultures. • Bharata noted 33 transient emotions which include some of psychiatric interest, such as depression, anxiety, and insanity. • In the 9th century Abhina Gupta included peace or tranquility as a 9th major emotion. Health Practices: Psychological Research Tibetan Buddhism and research psychology: a match made in Nirvana? “With an eye toward understanding the inner workings of the mind and using that knowledge to reduce human suffering, psychologists and Buddhist monks may have more in common than they realize, and possibly even compatible methodology.” Richard Davidson, PhD, a psychology professor at the University of Wisconsin-Madison Dealing with emotions: Buddhist monks have long been admired for their emotional control, and Paul Ekman thinks exploration of this skill may help psychologists better understand ways people can deal with unpleasant emotions. Tibetan Buddhist monks practice intensive mental awareness through mindfulness meditation--where emotions and other mental events are recognized, but not reacted to. This training may give them the ability to weather emotional experiences--such as fear--to an extent unheard of in Westerners. In the course of his research, Ekman and Robert Levenson, PhD, may have found a man who cannot be startled. They exposed one Tibetan Buddhist monk to a sudden sound as loud as a firecracker and monitored the participant's blood pressure, muscle movements, heart rate and skin temperature for signs of startle. The Buddhist monk, possibly due to hours of practice regulating his emotions through meditation, registered little sign of disturbance. "We found things we had never seen before," says Ekman. Paul Ekman, PhD, a psychology professor at the University of California, San Francisco School of Medicine So Back to the Question… • There is a substantial body of research evidence that health practices developed since ancient times in other lands such as India and China can be a valuable complement to Western medicine. • The Physician’s Desk Reference now publishes a book on herbal supplements. Tell your doctor if you are prescribed medication, as herbals and pharmaceuticals can interact or counteract. • If you choose to pursue physical practices such as yoga or tai chi select a class at your fitness level and appropriate to your abilities. • Meditation can be non-sectarian or can be part of a religious practice. At its core it is simply focused attention and is not mysterious or scary. Thanks to the East-West Center, the Freeman Foundation, and Pima Community College Professional Development References • Chakrabarti, Arindam (1997) “Rationality in Indian Philosophy.” Companion to World Philosophy, Deutsch and Bontekoe, Ed. Blackwell, Oxford. • Chapple, Christopher and Yogi Anand Viraj (1990) The Yoga Sutras of Patanjali. Indian Books Centre, Delhi, India. • Hershock, Peter D. (2006) Buddhism in the public sphere: Reorienting global interdependence. Routledge, New York. • Mishra, Pankaj (2010) Posing as Fitness. New York Times book review. July 15, 2010. • Paranjpe, Anand V. (1998) Self and Identity in Modern Psychology and Indian Thought. Plenum Press, New York. • Wolpert, Stanley (2009) A New History of India, 8th ed. Oxford University Press. References: Web Sites • http://www.mnsu.edu/emuseum/prehistory/egypt/dail ylife/medicine.html • http://nccam.nih.gov/ • http://www.sacred-texts.com/hin/sbe42/ • http://ayurveda.ygoy.com/2009/07/31/charakasamhita/ • http://www.umassmed.edu/behavmed/faculty/kabatzinn.cfm • http://www.yogafordepression.com/ • http://www.irest.us/ • http://www.jisha.in/art2/9rss1jc94ha903hcxx01u.pdf • http://www.bluelotusayurveda.com/doshas.html