बुधवार, 23 नवंबर 2011

A Perspective of the Ayurvedic Application to HIV


A Perspective of the Ayurvedic Application to HIV 

Abstract

   The role of traditional, complimentary and alternative health care is rapidly changing in the world climate. A greater emphasis on complimentary and alternative health care, and its practitioners, is developing in the wake of economic downturns. Healthcare and Health Insurance prioritized as a moneymaking industry rather than the greater seva, act of service, to heal and promote longevity is unsustainable. Although the care received in hospitals and by Doctors is beneficial for the most part; when the bottom line speaks louder than the individual that lies ill, great tides of change can and must occur. Communities have taken into their own hands the motto, “I am my primary care physician.” By integrating alternative health care practitioners as a tool in educated themselves in preventative and natural care, individuals empower themselves to take their health into their own hands, thus creating a truly holistic approach to health which is the very core of Ayurvedai.
   The goal of this paper is not to prove viability of one herb, approach or method as a viable healing agent of HIV. Rather, the goal of this paper, like Ayurveda, is to show the extensive tools available to the HIV individual and in fact all individuals managing chronic disease. The important term here is managing. The goal of this paper is to show that with the use of an Ayurvedic framework; or roadmap, one can use allopathic technology in addition to the abundant tools available, thus taking back the power of healing from the healthcare industry and its beneficiaries and placing it back into the hands of each and every one of us.
Introduction to Ayurveda
“Forgetting our true nature as spirit is the primordial cause of disease.” – Dr. Marc Halpern
   Ayurveda is the ancient science of life and the world’s oldest holistic medical system.  It is said to be as old as humanity itself, but scholars place the age between five and 10,000 years.[1]   The term Ayurveda is derived from the two sanskrit root words “Ayus” meaning life and “veda,” meaning knowledge, “The science of life.”  Ayurveda takes its origins from the spiritual texts of India known as the Vedas. The Vedas are the oldest known written text with subjects as vast as grammar, phonetics, astrology, ritual, etymology and prosody (metric verse). [2] There are four Vedas, The Rig Veda, Atharva Veda, Yajur Veda and Sama Veda. Ayurveda is a gathering of knowledge from all four texts.
Vedic knowledge was perceived by merging ones consciousness with the subject of inquiry. Tajjayat Prajnalokah, “By the mastery of [one pointed focus and meditation] comes the light of knowledge.” [3] From this practice true wisdom was received as gifts from the Devas (Gods). Dr. David Frawley writes in his book Ayurveda – Natures Medicine, “[Ayurveda] is not merely a kind of antiquated folk medicine as it is sometimes considered to be.”  [4] Many discoveries in modern sciences and technology can often be linked with parallel wisdom in the Vedas.  “Today, quantum physicists have become the torchbearers in the realm of the ‘tinier than tiny.’ Ten million to one hundred million times smaller than the sub- atom lies the level of the quanta, the new frontier of min-body research. The source of this quantum level is a field of pure energy, which serves as the underlying intelligence and glue of the entire universe. 65 years ago, quantum physicists labeled this the Unified Field. Nearly six millennia ago, Ayuvedic sages called it the Cosmic Life Force or Field of Pure Consciousness. While modern science is only beginning to understand implications of this discovery, Ayurveda has been steeped in quantum theory for a millennia.” [5]
   Unlike our modern age where our focused intent is outward, ancient Rishis chose to place their eye on the internal universe and in doing so they discovered this Unified Field as modern scientist call it; “[Is a,] field of consciousness, which connects every thought, wave pattern and particle of our being.” [6] It is here where we discover infinite potentiality as well as the understanding that what is in the microcosm is in the macrocosm and what is in the macrocosm is in the microcosm. Our ability to heal can be attained by simply watching the rhythms of the universe … or better yet, our own backyard.
   The philosophies, principles and techniques in Ayurveda, the Vedas, Tantra, Yoga; these are all part of an ancient wisdom known as Sanatana Dharma (now known as Hinduism) roughly translated as the eternal truth.  As the same sun is called by different names in different countries at different times, these truths are universal and cannot be defined by time nor are written by, or for; the benefit of one man, one nation or one race. These truths have been written and passed chest –chest for the benefit of humanity.
   “… great rishis sat together on the slopes of the Himalayan Mountain. They discussed the occurrence of great diseases that had arisen and how to deal with them … They decided that they should ask the Gods how to stay well and avoid disease as well as how to heal those who are sick … (The rishi ) Bharadvaja was selected … as he was best suited for the mission. Bowing before Indra, he explained the reason he needed an audience before such a great God. Bharadvaja was successful and Indra taught him the knowledge of Ayurveda…” [7]
   Bharadvaja went on to teach many great rishis and sages the science of Ayurveda. One of the great sages was Atreya, who passed on the knowledge to Agnivesa. Agnivesa later wrote the Agnivesa Tantra, which became the Caraka Samhita after Caraka revised it. [8] The Caraka Samhita is one of the primary Ayurvedic text that many practitioners gather their information from. In it myth and history are woven revealing the secrets of Ayurveda.
   “Forgetting our true nature as spirit is the primordial cause of disease.” Writes Dr. Halpern. When we forget our true nature as spirit we become dominated by the ego. We are wrapped up and consumed in vrittis, the dramas of everyday life. Yogas citta-vritti-nirodah, Yoga is the cessation of the mind or settling of the mind into silence. [9] When we connect our physiology with the dramas of everyday life, time seems to increase and our reality becomes further attached to maya, illusion. By connecting to our ego; my car, my house, my job, my safety, my money, my family, my society, my government; and defining these transient things as I, simply, we forget. We forget our true and timeless nature is here in this infinitesimal moment of the now. It is here where the deepest secrets unravel and one can capture a glimpse into the internal pharmacy where anything is possible.
Ayurveda uses the language of nature to describe the rhythms and cycles of the macrocosm and shows the similarities within the microcosm. It relates and shows how the five elements of earth, water, fire, air and ether are intrinsically connected in this beautiful lila or cosmic play, in the outer world, and how they are part of the body - and the internal world. It uses the language of 10 sets of opposite characteristics: hot/cold, moist/ dry, heavy/ light, gross/ subtle, dull/ sharp, soft/ hard, smooth/ rough, cloudy/clear… to further describe and relate the harmony and the imbalance in the individual.  These principles are used to describe the body, the disease and ultimately the path of healing. For example, if one were to present constipation (cold/ dry) Ayurveda recommends opposite therapy, so in said example one would employ warm, moist and nourishing qualities as an anecdote.
    The three causes of disease in Ayurveda outlined in the Caraka Samhita, are: 1) The unwholesome conjunction of the senses with the objects of their affection (“Having forgotten its true nature as spirit, mankind understands itself to exist only as its senses, its body and its mind … the meaning of life becomes the simple pursuit of pleasure.” 2)Intellectual blasphemy, the failure of the intellect or crimes against wisdom (“When we listen deeply inside ourselves, we find that we know how to act in ways that would bring us toward health … Yet, we often do not follow what we know to be true.”) 3)Transformation or decay due to time and motion. (There are two kinds of time: Linear time, which is static. Then there is biological time, which changes in response to motion. The faster our pace of life, biological time increases, gross motions such as air and automobile travel exacerbate this. More important than gross motions is the motion of the mind. The faster the rate of our thoughts time seems to increase and so does our biology. When the mind slows down such as in meditation or yogasana the biology also slows down.) [10]
   When we look at the three causes of disease we can see how the nidana or cause of HIV falls into the first two categories and the treatment and rate of action on the body falls into this third cause. Hope lies in reconnecting the individual to the eternal. We are more than our senses perceive. The path of healing lies in the ability to turn on the innate intelligence that resides within.  Understanding that how we move through life and that how we perceive to move through life are two very different things and can be altered.
The History of HIV
“Due to funding constraints AVERT is unfortunately not able to fund any new projects, or accept project proposals until at least April 2012. Please do not send in any applications for funding until that date.” [11]
   1981 was the year AIDS was first reported in the U.S. Scientists scrambled through much confusion in the first few years surrounding the illness, attempting to pin down transmission of the virus and treatment of those infected. Advancements in the 1990s with new classifications of drugs have greatly changed the landscape of treatments. [12]
   The genetic research places the origins of HIV in West-central Africa. The Mayo Clinic states, “Scientists believe a virus similar to HIV first occurred in some populations of chimps and monkeys in Africa, where they’re hunted for food. Contact with an infected monkey’s blood during butchering or cooking may have allowed the virus to cross into humans and become HIV”[13]
Before 1970s
1    HIV (the virus that causes AIDS) probably transfers to humans in Africa between 1884 and 1924.
2    HIV probably enters Haiti around 1966.
1970s
1    HIV probably enters the United States around 1970.
2    African doctors see a rise in opportunistic infections and wasting.
3    Western scientists and doctors remain ignorant of the growing epidemic.
1981
1    AIDS is detected in California and New York.
2    The first cases are among gay men, then injecting drug users.
1982
1    AIDS is reported among haemophiliacs and Haitians in the USA.
2    AIDS is reported in several European countries.
3    The name “AIDS” – Acquired Immune Deficiency Syndrome – is created.
4    Community organisations in the UK and USA promote safer sex among gay men.
1983
1    AIDS is reported among non-drug using women and children.
2    Experts become more confident that the cause of AIDS is infectious.
3    Three thousand AIDS cases have been reported in the USA; one thousand have died.
1984
1    Scientists identify HIV (initially called HTLV-III or LAV) as the cause of AIDS.
2    Western scientists become aware that AIDS is widespread in parts of Africa
3    The world's first needle exchange program is set up in Amsterdam, the Netherlands.
1985
1    An HIV test is licensed for screening blood supplies.
2    AIDS is found in China, and has therefore been seen in all regions of the world.
1986
1    More than 38,000 cases of AIDS have been reported from 85 countries.
2    Uganda begins promoting sexual behaviour change in response to AIDS.
1987
1    AZT is the first drug approved for treating AIDS.
2    The UK and other countries act to raise awareness of AIDS.
1988
1    The American government conducts a national AIDS education campaign.
2    Health ministers meet to discuss AIDS and establish a World Aids Day
1990
1    Around 8 million people are living with HIV worldwide, according to estimates made later.
1991
1    Thailand launches Asia’s most extensive HIV prevention program.
1993
1    AZT is shown to be of no benefit to those in the early stages of HIV infection.
1994
1    AZT is shown to reduce the risk of Mother to child transmission.
2    Infant HIV infections begin to fall in developed countries, due to use of AZT.
1995
1    The Joint United Nations Programme on AIDS (UNAIDS) is established.
1996
1     Combination antiretroviral therapy shown to be highly effective against HIV.
1    In developed countries, many people begin taking the new treatment.
2    Annual global spending on AIDS in low- and middle-income countries is $300 million.
1997
1    AIDS deaths begin to decline in developed countries, due to the new drugs.
2    Brazil is the first developing country to begin providing free combination treatment.
3    In other developing countries, only a tiny minority can access treatment for HIV.
4    Around 22 million people are living with HIV worldwide, according to estimates made later.
2000
1    President Thabo Mbeki of South Africa voices support for Aids dissidents
2001
1    At a UN Special Session, world leaders set long-term targets on HIV/AIDS.
2002
1    The Global Fund established to boost the response to AIDS, TB and malaria.
2    Botswana begins Africa’s first national AIDS treatment programme.
2003
1    AIDS drugs become more affordable for developing countries.
2    The “3 by 5” campaign is launched to widen access to AIDS treatments.
3    The first HIV vaccine candidate to undergo a major trial is found to be ineffective.
2004
1    America launches a major initiative called PEPFAR to combat AIDS worldwide.
2    After much hesitancy, South Africa begins to provide free antiretroviral treatment.
2006
1      Circumcision is shown to reduce HIV infection among heterosexual men.
1    28% of people in developing countries who need treatment for HIV are receiving it.
2    Annual global spending on AIDS in low- and middle-income countries is $8.9 billion.
3    It is estimated that $14.9 billion would be needed for a truly effective response.
2007
1    Around 33 million people are living with HIV, according to revised estimates.
2    Another major HIV vaccine trial is halted after preliminary results show no benefit.
2008
1    A controversial Swiss study claims people adhering to ARVs have a "negligibly small" risk of transmitting HIV through unprotected sex.
2    PEPFAR is reauthorized, committing $48 billion for the next five years.
3    Michel Sidibé is named as new head of UNAIDS as Peter Piot steps down.
2009
1    President Obama announces the removal of the travel ban that prevents HIV-positive people from entering the US.
2    4 million people in developing and transitional countries are receiving treatment for HIV; 9.5 million are still in immediate need of treatment.
2010
1    The United States, South Korea, China and Namibia lift their travel bans for people living with HIV.
2    The CAPRISA 004 microbicide trial is hailed a success after results show the gel reduced the risk of HIV infection by 40%.
3    Results from the iPrEx trial show a reduction in HIV acquisition among men who have sex with men taking PREP [14]
What is HIV?
Western Interpretation
Definition
   HIV (Human immunodeficiency virus): A disease of the human immune system that attacks white blood cells reducing the body’s ability to fight off illness. This condition progressively reduces the effectiveness of the immune system. Left untreated individuals become susceptible to opportunistic infections or tumors that usually are handled by a strong immune system. At this stage HIV has manifested into AIDS (Acquired immunodeficiency syndrome). [15]
Etiology
   HIV is transmitted with direct contact with a mucous membrane or bloodstream with a body fluid containing the virus such as infected blood, semen, vaginal secretions, preseminal fluid and breast milk. Infection cannot take place via hugging, kissing, dancing or shaking hands. HIV is temperamental and cannot live long outside of the body. It cannot be transmitted by air, insect bite or water. [16]
Signs and Symptoms
    Initially there is brief flu like systems presented two to four weeks after infection that dissipate and generally go away. Symptoms are fever, headache, sore throat, swollen glands and rash. Years later as the condition progresses some may develop mild infections or chronic conditions such as swollen lymph nodes (often a first sign) diarrhea, weight loss, fever, cough and shortness of breath. If the condition progresses and the HIV infection is not treated the disease typically progresses to AIDS. At this stage the symptoms include: soaking night sweats, shaking chills or fever, cough and shortness of breath, persistent white spots and unusual lesions on the tongue or in the mouth, headache, persistent fatigue, blurred and distorted vision, weight loss, skin rashes. [17]
Complications
   Complications can be as individual as the person infected with HIV. From the Avert website here is a partial list of some of the most common: “Bacterial diseases such as tuberculosis, bacterial pneumonia and septicaemia (blood poisoning) Protozoal diseases such as toxoplasmosis, microsporidiosis, cryptosporidiosis, isopsoriasis and leishmaniasis.  Fungal diseases such as PCP, candidiasis, cryptococcosis and penicilliosis. Viral diseases such as those caused by cytomegalovirus, herpes simplex and herpes zoster virus.  HIV-associated malignancies such as Kaposi's sarcoma, lymphoma and squamous cell carcinoma.”
   Complications also arise in the treatment of HIV with the side effects from the antiretroviral therapies. Some common side effects are: Hepatoxicity (liver damage), Hyperglycemia (elevated blood sugar), lipodystrophy (fat redistribution) and skin rash. [8]
Test and Diagnosis
   The ELISA (enzyme-linked immunoabsorbant) is the most common test for routine diagnosis of HIV among adults. There is however a window period after HIV infection from weeks up to 6 months where the antibodies are not produced after infection.  During this time an antibody test can give a false negative. To avoid a false negative it is recommended that a second test be done three months after possible exposure. [19]
Blood Tests and Treatments
   An HIV positive result will result with the patient being referred to an Infectious Disease Specialist (I.D. Dr.). This specialist will work with the patient and come up with a selection of drugs to treat the virus. In some cases with the advancement in research only 1 pill, once day that is a cocktail of multiple drugs is used, such as Atripla. It is imperative that the patient takes the medication as directed to curb side effects as well as drug resistance.  The Mayo Clinic lists on their website the classifications of drugs for the treatment of HIV:
        “Non-nucleoside reverse transcriptase inhibitors (NNRTIs). NNRTIs disable a protein needed by HIV to make copies of itself. Examples include efavirenz (Sustiva), etravirine (Intelence) and nevirapine (Viramune).
        Nucleoside reverse transcriptase inhibitors (NRTIs). NRTIs are faulty versions of building blocks that HIV needs to make copies of itself. Examples include Abacavir (Ziagen), and the combination drugs emtricitabine and tenofovir (Truvada), and lamivudine and zidovudine (Combivir).
        Protease inhibitors (PIs). PIs disable protease, another protein that HIV needs to make copies of itself. Examples include atazanavir (Reyataz), darunavir (Prezista), fosamprenavir (Lexiva) and ritonavir (Norvir).
        Entry or fusion inhibitors. These drugs block HIV's entry into CD4 cells. Examples include enfuvirtide (Fuzeon) and maraviroc (Selzentry).
        Integrase inhibitors. Raltegravir (Isentress) works by disabling integrase, protein that HIV uses to insert its genetic material into CD4 cells.” [20]
    Some of the blood tests that the I.D. Dr. will use to determine which medication to use as well as its effectiveness and the management of possible side effects are: CBC (Complete Blood Count), this will tell the I.D. Dr. the kinds and numbers red and white blood cells along with platelets; Liver Function panel to assess the function of the liver and avoid toxicity; CD4 (T- Cell) count tells the I.D. Dr. how the immune system is functioning – with the standard range being between 290-2077 and Viral Load. This Test measures how many counts of HIV are in the blood. Today, with increasingly newer technology, an undetectable viral load is becoming more common. [21]
Ayurvedic Interpretation
“Remember that no disease can harm you if agni is balance, ojas is strong and you are living a sattvic lifestyle.” – Dr. Marc Halpern
   No, disease can harm you if agni is balance and ojas is strong. These words written in an email by Dr. Halpern inspired the approach of this paper. How does one address Ayurveda’s message to HIV? - Hope.
   Underlying the message of Ayurveda is a deeper wisdom of spiritual connection that can get lost in the interpretation of Ayurveda. As western-minded individuals it is easy to struggle with the tendency to take Ayurveda out of its context and westernize its procedures and treatments, thus losing the very heart that differentiates Ayurveda from allopathic medicine.  By simply treating the symptoms and not uprooting the entire tree of dis-harmony we lose the opportunity Ayurveda presents to create a deeper change within. It is the deeper meanings beyond what we see with our eyes that Ayurveda has so eloquently conveyed. Yogi Baba Prem wrote, “…one must learn to look at eastern teachings through eastern eyes. The literalist tradition, common in the west and relevant in the east, does not afford much opportunity to unlock the vast secrets held within the eastern traditions and the more familiar system of yoga.” [22] We must understand this in order to facilitate a deeper awareness within ourselves when we venture into these ancient traditions for healing. When we blend the modern treatments of western allopathic medicine with the wisdom from the east we truly discover a holistic approach to healing. “Whether animal, herb or pharmaceutical everything is medicine when given to the right person, at the right time, for the right reason. Whether animal, herb or pharmaceutical everything is poison when given to the wrong person, at the wrong time, for the wrong reason.” [23] It is by accessing these internal secrets that each one of us is gifted with; will we have the capability to surpass great odds and learn great lessons.
   When we step into an Ayurvedic mind, we realize that Ayurveda includes all forms of medicine as treatment and the need to battle or pit one group against another just isn’t there. Shanti, Peace. In the fullness of a harmonious and global, community mind - adversity does not have a place to function. What we discover is that this subtle wisdom is the very philosophy that is capable of powerful treatment in chronic disease. When the mind, body and spirit create a harmonious community within, adversity melts and naturally the route of healing and the ability to access the internal pharmacy becomes alive. And, even in the face of chronic conditions such as HIV, one can find Shanti.
*    *    *
    According to Ayurveda, HIV can be correlated to Ksaya  or  OjaKsaya, the loss and consumption of vital energy. “Ksaya,” is most commonly associated with tuberculosis, it is characterized as an end stage respiratory condition with all three doshas vitiated. Any disease that is not properly treated can result in this condition and is considered, rajayaksmadi, “king of diseases.” [24] In The Ayurvedic Encyclopedia, Swami Sadashiva Tirtha writes,” In an ancient Ayurvedic text, Madhava Nidan, written around 700 A.D., the author, Madhavakara foretells a disease that will come to India. From its description, we know it as HIV/ AIDS. Its cure was said to be shilajit.” [26]
Nidana (Cause)
   HIV is a tridoshic viral infection affecting the strength and ability of the immune system to function.  It causes a deficiency in life-sap, ojas.  When ojas is strong the HIV virus cannot develop. Ojas is lost or diminished by excess sex, improper food, improper routine, worry and insomnia.  The HIV virus uses the body’s immune cells to replicate itself.  Much like a ghost, this virus does not have a body of its own and uses its host’s cells and body to function and survive. Dr. Marc Halpern, director of the California College of Ayurveda wrote on Ksaya “A lifestyle that reduces ojas leads to individual susceptibility to the condition. A lifestyle that results in a loss of shukra (vital fluid) is considered to increase the risk of developing the condition. In addition, a person is weakened by the suppression of natural urges and the intake of foods and drinks that are disharmonious.” [26]
Purva Rupa (Premonitory Symptoms)
   According to the Ashtanga Hrydayam, the following is a list of premonitory symptoms that often precede the onset of the disease. [27]
•    Nasal catarrh
•    Increased salivation
•    Sweet taste in the mouth
•    Weak agni
•    Increased desire for sex and wine
•    Swelling of the feet and face
•    Dreams of being defeated by animals
•    Visions of dirt in foods
•    Denial of emaciation
Rupa (Symptoms)
   Vata and Pitta are primary factors, however Kapha may present symptoms of congestion and lung disorders as the virus manifests. Fever, chills, headaches, tiredness, enlarged lymph nodes and general flu like symptoms in the first stages of infection. Symptoms of vata vitiation include: Fatigue, nerve disorders, cough, pain, change in voice and emaciation. Pitta symptoms include:  fever, low energy-burnout, yellow, green or red foul smelling sputum. Symptoms due to kapha vitiation are loss of appetite, congestion, oral candida, vomiting and dyspnea. [28]
Samprapti (Pathogenesis)
   The symptoms that develop from HIV have one major factor in common – movement. The symptoms seem to manifest throughout the various dhatus and strotas (tissues and channels) throughout the entire body, affecting all dhatus. Because HIV affects the white blood cells, the actual infection is located in the rasa dhatu of the rasavaha strota. Dr. Marc Halpern of the California College of Ayurveda states, “It is a constituent of rasa. (lymph)”   According to the Madhava Nidanam, Vata then becomes the primary vitiated dosha in the pathogenesis. Vata vitiation then leads to pushing pitta and kapha. From this we can see the condition is sannipattika (tridoshic) with vata at the root, overflowing into the rasa dhatu and the rasavaha strota and relocating to various sites through out the body creating the classic symptoms of early HIV infection as well as later stages. [29]
StageEvidenceDoshaSubdoshaDhatuIncr/DecrSrotaHerb CategoriesHerb Examples
rmdHIV Infection/ low ojas/ reduced immuntiyVvyanaRasadecrRasa-vaha StrotaRasayanaChywanprash
AshwagandhaShatvari
Shillajit
rmdEma-ciationVapana
Medas
Mam-sa
 
decrMedo-vaha StrotaFat tonics
Muscle tonics
Shatavari, licorice
Amalaki ashwagandha
rmdanxietyVpranan/adecrMano-vaha StrotaNervine sedadtive
Nervine tonic
Jatamamsi/ shankha pushpi
Brahmi
ashwagandha
rmdFatigueVvyanaraktadecrRakta-vaha StrotaBlood tonicsAmalaki/ turmeric
rmdHIV Infection / Fever
 
Pn/araktadecrRakt-vaha StrotaAnti-microbialsTurmeric/ neem/ goldenseal
rmdFatiguePn/araktadecrRakta-vaha StrotaBlood TonicsAmalaki/ Turmeric
rmdHIV Infection
Swollen lymph nodes
Kn/arasaincrRasa-vaha StrotaChannel clearing
Anti-Microbial
Turmeric/ Garlic
rmdLoss of appetiteKkledakarasaincrAnna-vaha StrotadipanaTrikatu/ Ginger
rmdOral candidaKBodhakarasaincrAnna-vaha StrotaAnti-Microbials
Anthelmintic
Musta, Pau d’arco
Asofatida
vidanga
rmdDepressionKtarpakan/aincrMano-vaha StrotaNervine stimulantBrahmi/ Calamus
Chikitsa (Treatment)
   Ayurveda gives the patient the framework to lead a harmonious life and build ojas.This is key in preventing the infection form further manifesting as well as managing the possible side affects associated with the pharmaceuticals employed to treat HIV.  Along with numerous others, all HIV allopathic medications list possible digestive imbalances and anxiety/ depression, as common side affects that may subside as treatment continues. Little is known as to whether the psychological disturbances are caused by the disease, the medication, the outlook of the patient or a combination.  These side affects in treating HIV from an Ayurvedic perspective will be taken into account below.
   Because Vata vitiation is of concern, a treatment for general vata imbalance is employed. Nourishing foods that are vata pacifying are consumed being aware that vatain HIV individuals can very quickly push pitta and kapha out of balance. (As HIV is tridoshic in nature. See samprapti above.) The diet will often need to be adjusted to compensate. It is interesting to note specifically the use of goat meat in soups as well as fried in ghee in Caraka Samhita.  Many recipes included goat milk along with all the recipes employ ghee, cows milk, sugar and honey for their nourishing nature on vata andrasa dhatu (lymph). [30] Because HIV affects the nourishment of the tissues, regulatingsamana vayu ( the ability to absorb nutrients) is considered a primary focus when it comes to nutrition as well as daily routines. The annamaya kosha (food sheath or physical body) is nourished by the right foods at the right time, thus creating ojas, immunity. The daily routines are vital in treatment of HIV, keeping patterns and routine grounds samana vayu. Daily routines consist of regular bowel movements, self-abhyangai(daily oil massage), yoga, pranayama, and the routines around meals such as prayer and the routines around sleep. Tongue scraping and neti, nasal irrigation, help remove toxins and dead cellular debris from the tongue and sinus cavity. Abhyanga increases lymphatic flow from the heat it generates and can promote the detoxification of pharmaceuticals as well as the removal of the virus from the body.
   Considering what sort of mental impressions are being digested is a factor in healing and creating strength in the mind, nerves and musculoskeletal system. On the lectureAyurvedic Psychology, Dr. David Frawley, comments how “…we let people into our minds that we wouldn’t let into our houses.” [31] Allowing the junk impressions into the mind is akin to eating junk food. Ojas is depleted and the body, mind and spirit must digest these junk impressions. Therefore it is paramount for the psychology and treatment ofmajjavaha strota and manovaha strota or the mind and nervous systems, to begin to build and nourish the environment from which one lives and functions.
   Auditing ones life and evaluating how nourishing each situation is within the home, career and self is extremely beneficial. How nourishing is the quality of the mind and heart? Systematically moving through each segment of the day one can audit and discover how nourishing and ojas building is each segment of the day is.  Break these segments into drying, heating, cooling, astringent etc. and one can begin to see the picture and quality of the course of the day. What aspects can be nourished?  Meditation can significantly effect the quality of these segments as the more one meditates and reconnects to Self, the more the various circumstance seem less important or less attachment is placed on them.  Color therapies play an important role in this segment. Gold is the most healing and nourishing, an abundance of this color in the form of flowers can uplift and tonify any environment.
   The use of herbal Anti-microbial herbs to treat the infection and rasayana (longevity/ojas building therapies), to increase immunity is the corner stone of the treatment for HIV. Nervine sedatives and tonics help treat anxiety while fat and muscle tonics help in weight loss. Blood tonics are used for fatigue and oil massage and nasya with herbs like ashwagandha and brahmi. The gold ash formula, Survana Vasant Malti  is revered as being excellent for all immune disorders. [32]
   Essential oils are the rasa of the trees and plant kingdom. They prove very effective in healing and rebuilding the rasa of the human organism. Vata pacifying essential oils are highly effective in treating vata imbalance as they can be applied via Abhyanga. They are applied through the pathways of the skin, nasal passages, lungs and gastro-intestinal tract. Once absorbed, essential oils quickly penetrate into the rasa and rakta(lymphatic and blood systems). As the oils circulate through the circulatory system, tissues and organs may choose any portion of the essential oil it wishes to use in the metabolic process, receiving the stimulating, sedating or beneficial property of the oil.[33] Essential oils are diluted in base oils that are constitutionally appropriate. A general accepted ratio of essential oil to base oil is about 25ml (12-13) drops: 1oz base oil. See the table below for doshic appropriate base oils. [34] Essential oils can be applied to the main marma point that balances each dosha: Vata, third eye; Pitta, Heart chakra;Kapha, between the navel and pubic bone.
Vata……………………...Sesame
Pitta…………Coconut/Sunflower
Kapha …………Canola/ Mustard
   Essential oils can be used as misting bottles with either healing oils or anti-microbial/ anti-viral/ anti-bacterial oils which are great for the rooms, bedding and the space in which the HIV patient resides. The general rule is one drop per 2 oz of water. [35] Shirodhara is effective in calming the mind, relaxing the nerves and immune system, providing individuals with a profound state of rest. Deep-seated stressors can be released via this treatment. [36]
   Mantra is sacred sound. On an esoteric level it is the sound or vibration pattern behind the universe itself. [37] Connecting to this sound vibration puts one in harmony with the universe and unlimited potentiality. It connects the individual with the sound vibrations available to awaken the internal pharmacy of healing. On a practical level it has gained wide recognition for its use in affirmations of healing. “According to the researchers, … repeating a mantram may help HIV-positive individuals examine stressful situations in a more nonjudgmental and accepting way…” [38]
   Gemstones can also be used as they speak to the body via outside the realm of the five senses. Stones are grounding representing the earth element however; gemstones like all of nature are composed of all of the five elements.  When wearing the gemstone the qualities of the gemstone interact with the qualities of the person. Gem infusions are made by soaking the gem in a glass of water in the moon or sunlight. [39] Time moves slower as mass increases; so time moves faster in the atmosphere above earth than it does on earth. This can be noted that by large structures such as mountains and even the great pyramids in Egypt, its hypothesized time moves at an infinitesimally slower rate. [40] Pondering this opens the attitude that there is more to life than what can be understood by the five senses.
Ayurvedic Treatments for HIV
Pancha Karmai
   Pancha Karma is the process of removing ama and excess doshas from the body and mind and then rebuilding the internal strength and ojas, immunity. The state of ojas is important to determine whether or not the individual is ready for pancha karma.  Birmhana Chikitsa , tonification therapy may need to be performed prior to beginning a pancha karma routine. During the first stage, Purva Karma, a palliative doshic appropriate diet is indicated. During this time the built up toxins in the body from medications as well as viral debris can be thought of as moving towards the organs of elimination. Abhyanga  is performed as well as color, mantra, and pranayama. The duration for this initial phase is determined by doshic imbalance. As HIV is primarly vata, then tridhoshic, balancing vata and taking care not to cause vata imbalance is key to the success of the treatment.
   Pancha Karma literally means the five actions. Vamana (Therapeutic vomiting), Virechana (Purgation), Bastii (Enema), Nasya ( Nasal Purgation), Rakta Mokshana (Bloodletting). Therapies like anuvasana basti, tonifying enema, are employed to heal and calm vata at its root site. These therapies performed by a skilled Pancha Karma specialist help to alleviate excess doshas and bring balance to the HIV individual as well as prepare the body to receive the tonification therapies of the third step, Praschat Karma.  These therapies are the tonifying and rasayana portion of the treatment and is the key in building immunity, ojas, as well as strengthen agni, the fire of digestion. The fire of agni is key in the overall health of the HIV individual. If the fire of agni burns to low, ama is left behind; if the fire of agni burns to hot, it smokes and burns and metabolizes the individual. When in balance agni burns clean and clear with no residues left. This is the goal of Pancha Karma.[41]
Amalaki
   The amalaki fruit is also known as Dhatri, the nurse, as it is like a nurse or mother in its healing properties.  It has a sweet, sour, astringent, pungent and bitter rasa, a cool virya, and sweet vipaka. It is part of the revered preparations, Chyawanprash and Triphala.  It is one of the best herbs for pitta and considered a rasayana for pitta type vitiation. The amla fruit contains the equivalent of nine oranges of vitamin C, as well as studies confirmed the bioavailability of the vitamin C in amla is better than that from synthetic ascorbic acid. It has anti-microbial properties and was shown to have inhibitory effects on HIV. [42] Increased cholesterol is a common side effect in many HIV medications. Studies have shown it to reduce cholesterol. Amalaki shows anti-oxidant properties against oxidative stressors. [43] It is considered the best among rasayana as well as it clears all three doshas from the body. When vitality is low amla with ashwagandha, ghee and honey is restorative and invigorating. [44], [45], [46]
Ashwagandha *
   Ashwagandha has a sweet, astringent and bitter rasa, warm virya and sweet vipaka. Its qualities are light and oily. is used in general debility and is the best rejuvenation herb for muscle, marrow and semen and for Vata constitution. [47] It is adaptagenic and increases the bodies ability to handle stressors. It is used in weakness, consumption and debility.  [48] It is a nervine sedative and nervine tonic and is known to treat anxiety, arthritis, insomnia and stress as well as an antioxidant. [49] Because Vata vitiation is paramount in the treatment of HIV Ashwagandha becomes an herbal ally in treating the stressors on the nervous system from the virus and/or the medications. Ashwagandha has been shown to increase body weight and total protein content.  It has been shown to have anti-cancerous activity and has shown to be effective against hepatotoxicity, chemical driven liver damage. [50]  (*See Appendix I For related research)
Shilajit
   A unique ayurvedic panacea or cure all.  Its rasa is pungent, bitter, and salty. It’s Virya is warm and its vipaka  is pungent. It is not actually an herb but a mineral pitch.  “It is an exudate that oozes out from ceratain rocks in the Himalayas, as they become warm.” [51] “Shilajit is renowned as a rejuvinative tonic with specific action on the urinary, reproductive, and endocrine systems. According to Caraka, almost all diseases can be controlled or cured with the use of this substance.” [52] In a comparative study of shilajit and 2 other herbs and AZT in 2006, shilajit performed 80%-90% effective against an enzyme found in HIV necessary for its multiplication. AZT was 70% effective. [53]
Turmeric*
   “When a virus replicates the ‘long terminal repeat’(LTR) sequence is activated. Without this activation there can be no replication of a virus like HIV. Published laboratory tests, completed by researchers at Harvard Medical School in 1993, indicated three inhibitors of HIV LTR. Curcumin is one of them…”  [54] Curcumin is what gives turmeric its yellow color. Turmeric works on all the tissues of the body. It has a bitter rasa warm virya and pungent vipaka. It is an anti-microbial, good for indigestion, poor circulation, cough, skin disorders, diabetes, arthritis, anemia, wounds and bruises. It helps to improve intestinal flora and is good antibacterial for those chronically weak or ill. It purifies the blood and warms and stimulates the formation of new blood tissue. It helps in digestion of protein as well as promotes proper metabolism in the body, correcting both excess and deficiencies. On an energetic level it gives the Shakti of the Divine Mother and is effective in cleansing the chakras (nadi-shodhana)  purification of the channels of the subtle body. [55] It seems to be slightly controversial as to whether or not Turmeric is Vata/ Pitta aggravating or tridoshic. As a satvic herb Tumeric has the ability to clear the intensity, anger and heat in the blood from excess Pitta. According to Prashanti de Jager, Turmeric is tridoshic because of its herbal actions and high carbohydrate percentage (70%) – the sweet taste. [56] (*See Appendix I For related research)
Triphala*
   Triphala, perhaps the most famous combination of herbs in the Ayurveda, Triphala is made of the three herbs amalaki, bibhitaki and haritaki. Considered a panacea for digestive disorders and is useful in almost every condition of the intestines. Triphala tones the intestinal muscles, creates regularity and dispels gas.  “Triphala’s actions extend beyond the digestive system. Each herb in Triphala is itself a rasayana for one dosha… Hence, this formulation builds internal strength and ojas.”  [57] Unlike over-the-counter laxative and laxatives in general Triphala is not dependency forming; in fact it is a remedy for this sort of dependency. Triphala becomes and ally in the treatment of digestive imbalance occurring form the virus as well as the pharmaceuticals employed to treat HIV. The individual’s ability to digest and absorb foods properly increases when the doshas are brought into balance and removed when in excess from their sites of origin. (*See Appendix I For related research)
Chyawanprash*
   This famed rasayana is considered the supreme rasayana of Ayurveda. It is a tasty dietary supplement that strengthens the organs under the ribs. It is very effective in the convalescence of the weak. It is made from amalaki (see below) and is the premier builder of ojas. It is heavy, sweet, sour and pungent in taste. Its vipaka is sweet.  It is said to dispel drowsiness, fatigue and preserve the harmony of all three doshas. It inhibits aging, rejuvenates depleted bodies, increases all dhatus and builds ojas. Chyawanprash becomes a strong ally in the treatment of individuals with HIV in maintain tissue strength and tone and helps bring balance into Vata dosha. Note that some are heating and others are more tridoshic as well as it is heavy. Those who have ama should undergo purifaction by Pancha Karma for its most beneficial effects.
    Legend has it that the sage Chayavan was an old man. He was destined to marry a very young woman from his village. Fearing that he could not satisfy this young woman and produce healthy progeny, he sought the counsel of the Gods. In meditation, he was instructed in the preparation of the now famous confection. Upon eating it, he became young and virile again. Hence, chywanprash is used by those who wish to remain young for many years.  [58] (*See Appendix I For related research)
Gemstomes
   Gemstones can be worn as jewelry such as a ring or pendant. The effect is greatest when the setting is designed for allowing contact to the skin. Gold is warming and tonifying as well as tridoshic and is best for Vata. Silver is cooling and purifying and is best for Pitta. Infusions can be made by soaking the gem in water in the sunlight for Vata and Kapha, and the moonlight for Pitta. Emerald/ Jade builds ojas is a nervine sedative and is good for degenerative diseases such as HIV. Pearl/ Moonstone, increases ojas is a tonic and is calming. It reduces hyperacidity  and ails the liver and kidney. Yellow Sapphire/ Yellow Topaz/ Citrine, increases ojas as well as discrimination, tejas. Reduces fear, nervousness and anxiety and is good in wasting conditions and regulates the hormonal system. [59]
Aromatherapy
   Aromatherapy speaks to the subtle channels as well as the mind. The mind has the ability to choose to attach to healing or sorrow, in this regard Aromatics become useful in the overall well being and healing of the individual. Rose increases love, compassion, has a prabhava of reducing anger and increasing immunity. It is a anti-microbial and cools the eyes (what the body digests via the eyes.) In this manner it is used as rose water. Rose increases ojas. Sandalwood is calming to the mind, is a nervine sedative and tonic and is useful in nourishing the heart. It increases ojas and has a prabhava for reducing anxiety and fear. Lotus is tonifying on the immune system and helps build ojas. Saffron increases faith which is the antidote for Vata. It is a rasayana, builds ojas, and is considered useful in cancer and HIV. [60]
Mantra
   Utilizing the Sanskrit language mantra is a powerful tool for healing. The Sanskrit alphabet is based on the cosmic sounds of creation and as such resonates deep within our beings. On a subtle level each letter resonates in the petals of different chakras, wheels of energy. When we use healing mantras they resonate on our physical, psychological and spiritual selves. However mantra does not need to be specifically in Sanskrit, although powerful; affirmations in ones own language can and should be considered equally as healing. In an article that Yogi Baba Prem, wrote,
“Within the Atharva Veda, one can find teachings of modern day visualization and affirmation tools; with such quotes as, ‘My mind stands against disease.’ Or from the Yajur Veda (Sukla version).


Preserve my life.


Assist/Preserve my prana (life-force).


Assist/preserve my vyana (circulating life-force).
Assist/preserve my sight.


Assist/preserve my ears [hearing].


Assist/preserve my speech, let it abound.


Be active in my mind.


Keep my soul.

[Keep] my light pure. 


Yajur Veda XIV.17


This is a powerful affirmation for health and wellness.” [61]
   Maha Mritunjaya Mantra is found in the Rig Veda. It is dedicated to Shiva and is considered the Death- Conquering mantra. Along with the Gayatri Mantra it is hailed as the heart of the Vedas. It is used for contemplation and meditation and is considered a nourishing mantra.  Swami Satyananda Saraswati of the Devi Mandir (www.shreemaa.org) says that by reciting this mantra 108 times one receives the blessings of Lord Shiva.
OM. Tryambakam yajamahe
Sugandhim pushtivardhanam
Urvarukamiva bandhanan
Mrityor mukshiya mamritat
We worship the Father of the three worlds, of excellent fame, grantor of increase. As a cucumber is released from bondage to the stem, so may we be freed from death to dewll in immortality.  (www.shreemaa.org)
   The practice of mantra should be approached with care in the HIV positive individual as to fully integrate the healing benefits and to not cause undue stress and imbalance. Intense emotions, tiredness or fatigue are signs of pressing too hard into the practice of mantra.  Creating routine and allowing the practice to unfold is the key to the success of mantra japa. So-Hum mantra is a wonderful mantra to begin with, as it is the natural mantra of the breath. With each inhalation and each exhalation the breath naturally repeats this powerful mantra. In the text supplement to the California College of Ayurveda, Dr. Marc Halpern guides the so-hum meditation in this fashion: “Allow your mind to become completely present. Bring your awareness within and follow the flow of your breath as it moves in and out of your body. (Pause) Do not control your breath, just be the witness as it moves in and out. (Pause) And now, with each inhalation I want you to listen within the breath for the sounds soooooo as you inhale and huuuuuuuum as you exhale. Let your breath and your mantra be your point of focus. If, at any time, your mind begins to wander, gently bring it back to your breath and your mantra.”  This is the secret in this meditation, find the mantra naturally within the breath rather than verbally repeating “So-Hum.”  Another mantra practice is reciting the Sanskrit name of the herbs that are being consumed. The names themselves are mantras and often times are broken into stories and legends that give keys into how they are used and employed as well as the energetics behind them. The act of story in this fashion speaks to the more subtle nature of the individual and works on the subconscious to heal from within.
Meditation
   In 2008 UCLA did a study on mindfulness meditation and its effect on the CD4 count of the individual. “This study provides the first indication that mindfulness meditation stress-management training can have a direct impact on slowing HIV disease progression," said lead study author David Creswell, a research scientist at the Cousins Center for Psychoneuroimmunology at UCLA. [62] The benefits of meditation on the immune system and stress are numerous. When given the opportunity to quiet the mind and let go of the attachments of the day - the mind, body and spirit are afforded an opportunity to heal. Meditation however is a challenging prospect for many and “to get there” is often a struggle. One must first understand that meditation cannot be taught. Meditation must be experienced. Only the technique to experience meditation can be taught. Some of the techniques noted above in the mantra section are useful as well as the use of breathing techniques such as alternate nostril breathing and observing the movement of the breath. Trataka, gazing at the flame of a lit candle or ghee lamp is another technique employed to help with meditation. One observes the candle without blinking and allows the initial tears to come and pass. Upon closing the eyes, the flame will still be able to be seen. Keep the gaze at this point until it is no longer there.  In Oshos translation of the Vigyam Bhairav Tantra, he writes, “Shiva proposes one hundred and twelve methods (for meditation). These are all the methods possible. … these one hundred and twelve methods are for the whole of humanity – for all the ages that have passed and for all the ages that have yet to come. In no time has there ever been a single man, and there will never be one, who can not say ‘ These one hundred twelve methods are all useless for me.’”  [63]
   When one is guided with a few techniques the inner light turns on and the remaining journey is lead from within. In the Yoga Sutras, sutra 1:4-6 refers to the waves and motions of the mind.  In any given 24 hour period the mind is attached and wrapped up within five states: right knowledge, wrong knowledge, memory, sleep and the stories that we imagine due to something we see, hear, smell etc [64] When one quiets the mind beyond these five states equilibrium is created; a certain detachment is cultivated and a deep awareness and connection with spirit is rekindled. In the practice of meditation one has the opportunity to connect with Self, consciousness or God. Experiencing this aspect of the divine instills faith, the most healing emotion to vata dosha and HIV.
Hatha Yoga
   Hatha Yoga, here referred as the general asana, posture, practice that all the styles in the west branch from. Since yogasana can increase the effectiveness of the immune system it has the potential to limit the damage the HIV virus can create. “The practice of yoga appears to improve the immune function in part by lowering levels of the stress hormone cortisol and yoga asana may boost immunity by improving the circulation of lymph, a fluid rich in disease-fighting white blood cells like lymphocytes.” When in states of secondary disease or fatigue long restorative postures such as child’s pose and savasana during a practice is very therapeutic. Grounding poses such as those were both feet are firmly on the ground help ground vata, in addition to hip compression and forward folds. Side lateral extensions and twists move the lymph and reduce pitta dosha. Back bends clear kapha and should be approached with care as they invigorate the nervous system. To stimulate the thymus, Pandit Rajmani Tigunait, PhD. Recommends two pranayama, breath techniques: Ujjayi and Bhramari. He also suggests meditating on the hollow of the throat.
   When one steps onto a yoga mat it is a different moment each and every time, those living with HIV need to pay particular attention to their bodies and ask “How am I feeling in this posture today?” Those that are feeling good are encouraged to do a normal, energetic yoganasana practiced balanced with plenty of restorative work. Iyengar methodology for HIV insists that one not strain during any pose or practice as well as supported inversions and restorative postures are prescribed.  [65]

Conclusion
   In the article, “Conversations With My Virus,” Shana Cozad writes a heroic journey of acceptance of her virus and how she transforms and spiritualizes her journey. “This disease is simply remarkable at bringing out the raw and emotional and scariest aspects of Life, or Death, and often at the same time. Our culture doesn't prepare us how to deal with death very well, and as far as I am concerned, our culture has haphazard way of preparing us for life anyway.” [66]
    Ayurveda guides one on the journey toward equanimity and harmony. The two goals of Ayurveda are: to keep the body in a state of health and free from disease, and, To show us how to use health as a basis of, or as a part of, the path to enlightenment. [67] As noted earlier Sanskrit, the language of the Vedas, has the uncanny ability, like modern URL’s, to guide us further and deeper into stories and secrets. Ayus = life. Veda = knowledge. Ayurveda - the knowledge of life. But when one meditates on this further, the question arises; what sort of knowledge? And what and how is life defined?  The knowledge gifted to us by Ayurveda asks us to look deep within and find the Sadguru, the teacher within; to spiritualize our circumstances and to learn from them. When, as Shana Cozad demonstrates so heroically, we transform ill fortuned circumstances and diseases like HIV into spiritual teachers, we can then see the knowledge Ayurveda may be hoping to impart.
Hatha Yoga Prayer
I offer this practice to the Sadguru, the Teacher within all things,
The Teacher that is the Prana (life) from which my body emerged,
The Teacher that sustains and nourishes me with each breath,
The Teacher whose lessons are in every life experience – even pain and death.
May this practice open me to the wisdom of the Sadguru,
That my mind may know peace,
That my heart may know compassion
And my life may offer peace and compassion to all beings.
Om Shanti, Om Peace
- Darren Main[68]

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