REVIEW JGWAI 200ff(2) 1: 12-18 The Use of Vyayama or Physical Exercise, Prescribed in Ayurveda Ven. Dhammissara, M (BA., MA., MPhil., Royal Pandit) Senior Lecturer in Sanskrit, Language Unit, Department of Basic Principles, GWAI, University of Kelaniya. Sri Lanka. Abstract: Ayurveda also gives an importance to the physical exercise for the maintenance of good health. According to Ayurveda the consequences resulting from physical exercise are not only lightness of the body capacity for work, collectedness, power of enduring hardship; but also it removes of all imperfections and augmentation of the digestive fire. Therefore, vyayama has both the values: preventive and curative. (A Paper presented for the International Seminar on Science & Medicine in Sports at the Grassroots Level, Department of Physical Education, Visva-bharati Santiniketan, lndia(17-18 Jan. 2004) Introduction Vyayama or Physical Exercise is essential for a person to maintain his normal health. It also helps to carry out daily tasks with energy and attentiveness, without undue tiredness, and with ample vigor. Vyayama (Vi + A + Yam + Ghat))* is the term, especially used in Ayurveda for the physical activities, which can be identified with the 'physical exercise' in the present time. Ayurveda, the medical system of India, has also prescribed vyayama in connection with both measures: preventive and curative. The use of vyayama is, therefore, has been discussed in this paper from the point of view of Ayurveda only. Sources for the discussion made here, are main ly the Vrddhatrayl, namely the Carakasamhita (CS)2, the Susrutasamhita (SS)3 and the As\angahrdayasariihita (AH)9 and from among the Sri Lankan medical texts, the Sararthasahgrahaya (Sara)7, written in Sanskrit in the 3 r d Century A.C.; the Bhesajjamanjusa (BM)6 written in Pali, the Yogamavaya(Yoga)5ar)6 the Prayogaratnavaliya (Prayof, written in Sinhala in the 13 m century A.C.. Therefore, these four are the oldest treatises on medicine so far found in Sri Lanka. The phrase 'Sri Lankan Medica l Tex ts ' is used here to distinguish them from the Indian Ayurvedic texts only. Otherwise, Sri Lankan medical system is nothing but Ayurveda though it has some distinctive features. The history of vyayama can be traced from a remote past, even from the primitive societies. We have, at least, more than three thousand years old wri t ten evidence for the use of vyayama and as the Carakasamhita and the Susrutasamhita took their present form exactly before the 2 n d century A.C., we have nearly two thousand years history of medical perspective of vyayama. Nevertheless, there is no scope to discuss the long history of vyayama in this paper. The definition of vyayama has been given in the Carakasamhita, thus: "sarira cesta ya cesta sthairyatha balavardhinl, dehavyayamasankhyata matraya tarn samacaret." (cs.1.7.31) (That exertion of body which is productive of good consequences to the body itself, which conduces to concent ra t ion of mind and increases strength is called physical exercise. One should have recourse to it in due measure). This verse is the aphorism of vyayama given in the Carakasamhita, and according to this definition, vyayama promotes the perfect health which includes both the body and mind. Importance of vyayama In the aphorism "mithyaharaviharabhyam"2 ahara comes first and vyayama comes under Vihara to emphasize the importance of physical 12 JGWAI 2004f>(2) l: 12-18 REVIEW exercise. Ayurveda as the science of life, which is based on the principles of nature, focuses on the balance of the physiological functions to maintain perfect health. The dosas {vata, pitta and kapha) represents the variations, improper interaction of sense and sense objects; unwholesome acts performed by body and mind are all responsible for the disturbance of dosas. Ahara (diet) and vihara (physical exerc ise) p lay a c ruc ia l role towards maintaining the body in a state of perfect health. Moreover, the person indulges in the physical exerc ises should consider the seasons (ftus) also - CS.1. 6.32 or it should not be continued in the same way throughout the year as the natural changes overpower the health. Physical exercise done in the proper time, considering the season improves not only strength and complexion but also happiness and span of life - CS. 1.6.3.2 Ayurveda, therefore, advises the avoidance of vyayama in two seasons: grf$ma (summer) - CS.1.6.29 2; AH.1.3.279 and varsa (monsoon) - CS.1.6.292; AH.1.3.27*. Ayurveda advises the physician to examine the 'vyayamasakti'or capacity for physical exercise while examining a patient. It should be ascertained from the capacity for action. "vyayamasaktisceti; vyayamasaktirapi karmasaktyapanksya."- CS.3.8.1212 The judgment on three kinds of strength viz. superior, middling and inferior, is done in the same way -AH.1.1.12ff 9. vyayama as a Therapy vyayama, in Ayurveda, is used even as a theraphy; in both aspects, preventive and curative. The foundation of Ayurvedic treatment lies on vayu, pitta and kapha. These are the three 'Bio-regulating principles' present inside the body and are known as tridosa, which controls the various physiological functions of the body; "sarvesameva roganamnidanamkupita malah "-AH.1.1.12ff9;SS.1.21z (for all the d iseases, the causes are the aggravated dosas). In all the living things, animals or plants, the three Bio-regulating pr inc ip les , vayu, pitta and kapha , are responsible for all physiological functions taking place in a cell or a body. Vayu, Pitta and Kapha are found in each and every cell which regulates and conducts the process in the body. These Bio-regulating principles or dosas, when got disturbed, manifest some abnormal symptoms due to their malfunctioning within the body. According to the classical texts of Ayurveda eighty diseases or symptomatic disorders are caused by an unbalanced state of vata (asftirvatavikarah) - CS.1.20.10 2. Whi le diseases caused by pitta are of forty types (catvarimsatpittavikarah. - CS.1.20.102), disorders caused mainly by kapha as mentioned in the classical texts are twenty in number (vimsatih&esmavikarah - CS.1.20.102). Vyayama is also one of the treatments which have been prescribed in Ayurveda for the twenty types of diseases and disorders caused by phlegm (slesma) - CS.1.20.192; AH.1.3.199; Sara. 1.1157. Again, the Carakasamhita, in the section of Vimana, has recommended the physical exercise as a treatment for phlegm. There, it prescribes running (dhavana), jumping (larighana), leaping (plavana) walking about (parisarana), night- keeping (jagarana), pugilistic combat (boxing- niyuddha) and athletic exercise etc. for the disturbed phlegm - CS.2.6.182; AH. 1.3.10s. The way vyayama works against the phlegm can be understood in the following description too given by Caraka: "evamasayamanupravisyorogatarh kevalam vaikarikam slesmamula murdhvamutksipati, tatravajite slesmanyapi sarfrantargatai) slesmavikarah prasantimapadyante, yatha bhinne kedarasetau saliyava$a$tikadinyanab- hisyandyamananyambhasa rasosama padyante tadvaditi"-CS.1.20.192. (As paddy, barley and other crops are dried up when water collected in the field escapes upon through the ridges enclosing it being broken; even 13 REVIEW JGWAI 2004^(2) I: 12-18 so d iseases caused by the ph legm are destroyed upon the root of the phlegm being thus destroyed.) As already mentioned above, the reasons for the advice given in Ayurveda for indulgence in physical exercise during four seasons namely Sarat (autumn) Sisira (winter) Hemanta (early winter) Vasanta (spring) are clear. According to the law of nature, water becomes cold, clear and heavy and the Sun's rays are mild during Hemanta. The water and vegetables part taken of in Hemanta season g ive r ise to an accumulation of kapha in the body on account of their heaviness and cold nature - BM. 1.546. This accumulated kapha finds expression in spring season and so brings about kapha type of disease - SS. 1.6.113. Therefore, in this aspect vyayama acts as a preventive measure. Moreover, the Astahgahrdayasamhita has prescribed the "anekarupavyayama-exerdses of different kinds" - AH. 1.3.119, as a therapy for the diseases of kapha. Even the Bhesajjamanju -sa has mentioned the vyayama as a therapy for the same diseases - BM. 1.1086 vyayama is one of the treatments ment ioned for the suppression of vomiting - BM.4.14s; AH. 1.4.18*. According to another explanation given in the Asfaahgahrdayasamhita, the therapy is of two kinds; i.e. brahana (stoutening) and lahghana ( th inn ing , s l imming ) santarpana and apatarpana are also used as their synonyms respectively. Brrhhana nourishes the body while lahghana makes the body light - AH. 1.14.1,2*. Lahghana is of two kinds: sodhana and samana. Vagbhata includes the vyayama among the seven kinds of s'amana - AH. 1.14.6,7 9. According to Caraka too the vyayama is listed under lahghana. "catusprakara samkiddhih. pipasa marutatapau, pacananyupavasaSca vyayamasceti larlghanam." -CS.1.22.182 It also shows the importance of the vyayama as a therapy in both measures: preventive and curative. Besides, sveda or Sudation without the agency of fire is suitable for diseases of vata inactivated by medas and kapha. Vyayama is also one of the methods used in this connection - BM. 1.77 6; AH.1.17.28 9 . Further, both tradit ions, Ayurveda and Sri Lankan, have prescribed the vyayama for diseases arising from the decrease of sveda (sweat) - BM.1.79 6; AH.1.11.33*. Caraka prescr ibes var ious exercises. "vyayamayogair vividhaih pragadhaih" -CS.3.6.502 What does vyayama do? One may ask the quest ion:" If the vyayama causes the increase in both the vata and pitta while decreasing the Slesma, then, how vya yama makes the balance of cfo$as or Bio- regulating principles?" In fact, what vyayama does is the increasing of the digestive fire (pa cakagni). When the digestive fire is in its good conditions, all types of foods become easily digested. Then, there is no doubt in the increase of vata or pitta. On the other hand, according to Sus'ruta, pitta is also identical with the elemental fire. He says; "pitta is the same as fire, since such symptoms, as a burning sensation, digestion and all other characteristics of fire can never exhibit themselves in the human body without the intervention of pitta, pitta, therefore, is called internal fire" - CS.6.6.492. And vyayama contributes for the digestion of food - BM. 6.33 6 . Even Vagbhata has ment ioned about the excess of physical exercises too - AH.1.1.159 as causes for the aggravation of pitta, The ativyayama or excess of physical exercise causes d iseases based on both , vata - AH.3.1.15 9 and pitta, whereas the proper physical exercise causes good health. Further the excess correlation of vyayama may cause 14 JGWAI 200^(2) I: 12-18 REVIEW "Sramah klamah ksayastcsna raktapitta pratamakah, ativyayamatahkaso jvarasardisca jay ate."- CS.1.7.332; BM.20.16;Sara.10.f; Yoga.p. 10f;Prayo.p.14f And it causes the kasya or loss of flesh - SS. 1.15.39 3. According to the Ayurvedic texts, the karsya or thinness is better than sthaulya (fattiness). " atyantagarhitavetau sada sthulakfoeau narau, i res to madhyasarlrastu k&h sthulattu pujitab"- SS. 1.15.3& Even Vagbhata says that the emaciation (/cars ya) is better than corpulence (sthaulya) because there is no treatment for the obese, for, neither brmhana nor lahghana is capable of vanquish excess of fat, digestive activity and vata. "karsyameva varamsthaulyat na histhulasya bhesajam, brmhanamlanghanam valamatimedognivatajit." - AH. 1.14.31s; Sara. 1.139-1417 Limitations The person who is thin (ktfa) should not practise the vyayama -SS. 1.15.393. If he does, it is called injudicious correlation of vyayama (mithyayoga) and it causes diseases. Further, the Bhesajjamahjusa and the Astahgahfda- yasamhita mentions that "persons suffering from diseases of vata and pitta; children, the aged and those having indigestion should avoid vyayama. According to the Yogarnavaya, patients who are suffering from upadamia (venereal diseases) too should avoid vyayama - Yoga\p.171s. "vatapittamayi balo vuddho samo ca tarhcaje, ativayamato kaso jaro caddhi ca jayatl, raktapittam padamako khayo tan ha ca vaddhati."-BM.3.106 Therefore, even though the vyayama is essential for the good health, there should be certain limitations. Because the person, who indulges in physical exercises, laughter, talking, walking, sexual congress and night-keeping excessively, though these are necessary, over - indulgence in them one soon meets with destruction like an elephant that assails a lion - CS.1.7.352. Even accord ing to SusrutasamhitS, physical exercise etc. though recommended should not be inordinately indulged in - SS.4.24.163. The limitation of physical exercise depends upon the tiredness. Therefore, Caraka says; "praTc sramad vyayamavarjf syat "-CS.1.8.182. Vyayama should be stopped before one becomes tired. Otherwise, according to the Astahgahrdayasarhhita, vyayama should be done by a person using only a half of his strength. "Persons who are strong and who indulge in fatty foods, in cold seasons and spring seasons, should do vyayama consuming half of their strength only while others and in other seasons should do it mildly"- AH.1.2.11,12 9 . The Bhesajjamahjusa differs to some extent in this regard, from the Astahgahfdayasamhita;. "sltakale vasante ca so sebbo addhasattiya ahhakale yathasatti acare mandameva va"- BM.3.9* It is to be done saving half of strength in cold season and in spring. In the other seasons one should follow it according to one's strength. Not only ativyayama or excess of correlation of physical exercise, but also rest correlations: absence of correlation and injudicious correlation of ativyayama are causes of diseases -CS.11.39- 412. Absence correlation of vyayama is also included among the causes for twenty types of disease based on kapha; such as: 15 REVIEW JGWAI 20C#(2) I: 12-18 1. trpti - Sense of fullness in the stomach without having eaten anything. 2. tandra - Drowsiness 3. nidradhikya - Excessive sleep 4. staimitya - Rigidity 5. gurugatrata - Heaviness of the body 6. alasya - Lassitude. Letharginess of the body 7. mukhamadhurya - Presence of a sweet taste in the mouth 8. mukhasrava - Excessive salivation from the mouth 9. slesmodgfrana -Mucousexpectoration 10. balasaka - Loss of strength 11. apaktih - Inability to digest the food taken 12. hrdayopalepa - Sensation of the heart 13. kathopalepa -Secret ionof excessive mucous in the throat 14. dhamanipraticaya - Heaviness of the veins and nerves 15. galaganda- Enlargement of the glands of the neck 16. atisthaulya - Excessive obesity 17. sJtagnita - Suppression of the digestive power; Loss of appetite 18. udarda - Urticaria, a kind of Erysipelas 19. svetavabhasata - Pallor of the skin 20. svetamotra-netra varcastva - Whiteness of urine, eye and complexion -CS.1.20.172 According to SuSruta, the absence of vyayama causes fatt iness of the body (sthaulya) - SS. 1.15.383. The Bhesajjamafljusa considers the absence of vyayama as a cause for many diseases - BM. 1.54,55%. Therefore, not only should the ativyayama be avoided but also injurious exercises or physical exercises which are injudicious be refrained. The physical practices which are injurious to the body, should be avoided. But it is not easy to stop them all at once, if it has been practiced for a long time. It is still possible to abstain from such injurious pract ices if we do it gradually. Caraka, therefore, prescribes both 'gradual abstaining' and 'gradual practicing'. Caraka says; "An intell igent man should abstain gradually from all habitual practices that are injurious and adopt gradually practices that are beneficial." What is meant by 'Gradually' or 'krama' also has been explained thus: "praksepacaye tabhyam padamslko bhavet, ekantaram tata&cordhvam dvyantaramtatha."'- CS.1.7.372 Progressive procedure or the 'krama' of abstaining from the injurious practices and getting accustomed to the healthy practices is called 'padams'ika'; that is one - fourth, half and three fourth. Caraka's this theory which is called 'padamiika' has been exp la ined by Cakrapanidatta, the well versed commentator to the Carakasamhita, in his commentary with an example; thus: "apatyayavakadayo'bhyastastetyqyafrraktasa lya dayahpathya anabhyastaste sevyah; tatra prathama dineyavakapadatrayam rakta&alfna mekah padahdvitiye divase dvau pathyasya pa dau dvavapathyasya, evam trtiye, evam - dviffyapadabhyaso dvyantaro bhavati; caturthe trayah padah pathyasya eko'pathyasya evam pahcame sasfrte ca, 16 JGWAI 2004*(2) 1: 12-18 REVIEW evam trtiyapada-bhyasastryantaro bhavati; saptadina prabrti tu catuspada pathyabhyasah -CS.p.512.n (Yavaka (barley) etc. which is unwholesome should be abandoned though they have been practised; red-rice (raktaSali) etc. which are who lesome shou ld be pract ised though unaccustomed. For the first day three fourth of the unwholesome and one fourth of the wholesome is to be practised. For the second day half of the unwholesome and the rest half to be filled with wholesome. The same for the third day. For the fourth day one fourth of unwholesome and three fourth of wholesome. The same for the fifth and sixth days. From the seventh day the wholesome only is to be practised. In this way one should get rid of faults gradually, and good habits be acquired gradually. Suiruta also prescribes the same method. " anucitamapyaseveta kramas'o na caikantatahpSdahinaf- SS.4.24.172. A bad habit should be gradually discontinued and a good one even when beneficial to health should similarly be gradually inculcated by a quarter only and at once. In this way are faults to be got rid of by the good, never to return and healthful habits are acquired without ever losing them again. "kramenSpacitS dosSh kramenopacitS gunSh, santoyantyapunarbhSvam prakampyS bhavantica"CS.1.7.382 VySySm is not mere external physical exercise. Taber's cyclopedic medical Dictionary has defined the term physical activity and exercise as follows "A general term for any sort of muscular effort but especially the kinds intended to train condition or increase flexibility of the muscular and skeletal systems of the body" 1 0 Nevertheless, according to the discussion made above, it is clear that the vyayama or physical exercise mentioned in Ayurveda is not mere external physical exercise which supports the muscular and skeletal systems of the body. vyayama works for the perfect health or 'physical fitness' which provides "the ability to carry out daily tasks with vigor and alertness, without undue fatigue and with ample energy to enjoy leisure-time pursuits and meet unforeseen emergencies"'. The definition on 'exercise and physical conditioning' done in the Encyclopedia Britannica: "the training of the body to improve its function and enhance its fitness." is the aim of vyayama in Ayurveda. Both these traditions, i.e. Indian and Sri Lankan, have shown the result of vyayama in a similar way. The Carakasamhita: "Laghavam karmasamarthyam sthyairyam duhkhasahisnuta, dosaksayo gnivrddhiSca vyayamadupajayate. CS. 1.7.322 The consequences resulting from physical exercise are lightness of body, capacity for work, collectedness, power of enduring hardship, removal of all imperfections and augmentation of the digestive fire. The A$tha~hgahrdayasamhita "LSghavam karmasSmarthyam dfpto'gnirmedasa ksayah vibhaktaghanagStratvam vySya~ma~dupaj8yate"-AH. 1.2.709 (Lightness of the body, ability to do hard work, keen digestion, depletion of excess fat and stable and distinct physique accrue from vyayama). The Bhesajjamarljusa: Aggino dfpanammedakkhayo kammasamatthata Laghavam ghanadehattam vyayama upajayate - BM.3.8* 17 REVIEW JGWAI 20«T(2) 1: 12-18 (Keen digestion, depletion of excess fat, ability to do hard work, lightness of the body and stable physique from physical exercise). Conclusion We, therefore, conclude here that Ayurveda also has given an importance to the physical exerc ise or vyayama conce rn ing the ma in tenance of good hea l th . The consequences resulting from physical exercise are not only lightness of body, capacity for work, co l lec tedness, power of endur ing hardship; but also it removes of all imperfections and augmentations of the digestive fire, which is very much needed for the balance of three humors which otherwise causes i l lness. Nevertheless, the intelligent person should never indulge in physical exercise as, according to Ayurveda, it results in fatigue, faintness, loss of vigor, thirst asthma, consumption, fever and attacks of cold. Further, the time, when the physical exercise to be done, should also be highly considered. The use of the physical exercise, according to Ayurveda, can be included in both preventive and curative methods. "aharacaracestasu sukharthi pretya cehaca, paramprayatnamatisthed- buddhiman hitasevane."- CS.1.7.602 (One endowed with intelligence and desirous of happiness both here and hereafter, should, bent upon achieving what is beneficial, bestow great care upon everything connected with food, deportment and physical practices). Reference: 1. Encyclopaedia Britannica, 2. Jadav Jl, TA. Ed. Carakasamhita. 1967; Chaukhambha . Sanskrit Sanstan, Varanasi. 3. Jadav Jl, TA. Ed. Su£rutasamhitaA968; Chaukhambha Sanskrit Sanstan, Varanasi 4. Jnanavimala, K. Ed. Prayogaratnavaliya. 1943; Gunasena and Company, Colombo 5. Jnanavimala, K. Ed. Yogarnavaya. 1963; Gunasena and Company, Colombo 6. Kulatilaka, K.D., Ed. Bhesajjamanjusa. 1962; Modern Books Company, Colombo 7. Kumarasingha, A. Ed. Sararthasa- ngrahaya. 1987; Department of National Museum, Colombo. 8. Radhakantadeva. Ed. Sbdakalpadrma. 1813, Calcuta 9. Sastri, HS. Ed. Asthahgahrdayasamhita 1997; Chaukhamba Surabharati Prakashan, Varanasi, 10. Thomas, C.L. Ed. Taber's Cyclopaedic Medical Dictionary: 1993: 1505, Philadelphia. Diabetic Clinic A special Medical Clinic conducted by Dr. Chandrasiri Waliwita Lecturer in Clinical Pathology Depatment of Cikitsa at Gampaha Wickramarachchi Ayurveda Hospital on Every Monday 18