The Gerson Institute of Ayurvedic Medicine

Scott Gerson, M.D., Ph.D. (Ayurveda) Medical Director, Jupiter Medical Center Dept. of Integrative Medicine Division of Education and Research






Lake Mary Clinic, Gerson Ayurvedic Spa, and Panchakarma Facility: at 635 Primera Blvd. Lake Mary, Florida 32746

Jupiter Medical Center at The Calcagnini Center for Mindfulness
1210 S. Old Dixie Highway, Jupiter, Florida 33458, Suite M-117.2




 Telephone: (561) 263-MIND (6463); option 2 (407) 549-2800

The Ayurvedic Approach to Rejuvenation: Rasayana Chikitsa

Rasayana chikitsa (rejuvenation) is one of the eight original branches Āyurveda. The Sanskrit word rasa has various meanings: "taste“, “essence", "flavor”, “juice”, or “emotion", but is not limited to any of these. In the context of Āyurveda, rasa is denotes the preservation, transformation, and replenishment of energy. The word ayana also has various meanings; here it connotes “to increase” or “to circulate”. Thus, we can understand a rasayana substance as one which will increase and promote the circulation of the vital essence or juices of life.

Rasa nourishes our body, strengthens natural immunity and helps maintain the body and mind in equilibrium. Rasayana shastra describes herbal, herbo-mineral preparations and behaviors that promote a youthful state of physical and mental health and sustains clarity and happiness. Rasayana herbs, like all natural substances, when used properly, are safe for daily use and are effective over time. They are given to small children as tonics, and are also taken by the middle-aged and elderly to protect against disease and promote longevity.

Need for Rejuvenation: The Best Antidote to Stress

Nowadays it is almost impossible to go through a day without hearing a reference made to the stress of “modern life”. I place this term within quotation marks because, while it’s almost universally agreed that life is more stressful than ever before, it’s also true that the stress-quotient of any era seems to always appear extra-ordinary to the generation living through it. In 1892, Dr. William Osler was already observing the effect of “high-pressure life” on human health (Principles and Practice of Medicine, D. Appleton Publishers, New York, 1892). Today many regard that time as one of the ‘golden ages’ of recent history. Time, like distance, creates charm. It is tempting then to agree with those who maintain that the stress of “modern life” here in the twenty-first century is no greater than that which existed in ancient times during periods of war, famine, plagues, and many other hardships. Yet in those times and even up until the start of the last century, coronary artery disease, diabetes, hypertension, autoimmune disease, and depression were relatively rare. Why is that and do different forms of stress have different effects?

Mental stress is elusive; it does not boldly announce its presence in the room. Rather it usually hides silently in the shadowy corners of the mind. The shapes and disguises it assumes are infinite and chameleonic. It never appears the same in any two individuals. Situations which might be terrifying or unbearable to some are to others barely noticed. Stress can be not only mental in origin but physical in nature as well.

For example, the modern Western diet has become a source of physical stress as many people are consuming fast food items laden with chemicals and additives which place a daily burden on the physiology. The timing of meals has also become irregular and unnatural due to scheduling demands of modern life.

More and more people are becoming addicted to caffeine, alcohol, sugar, tobacco, excessive sex, too little sleep and too many prescription drugs. Due to availability of cars, public transportation, elevators, television, comfortable sofas, cellphones and computers we have become a society converted to the faith of sedentarism. This all leads to deficient dhatu bala (tissue vitality), ojakshaya (diminished ojas), mandagni (low metabolic energy) and vitiation of the tridosha leading to premature aging, fatigue, debility, degenerative diseases, emotional instability, inability to adopt to stress, recurrent illness and depression/anxiety syndromes. Teleologic

Teleologic Purpose of the Stress Response

Teleologic means that something expresses itself in Nature in order to either simply survive or achieve a more evolved state. In other words, a teleologic argument would say that humans are designed to achieve cosmic consciousness and any features we evolve are for serving that goal. As we all know, not all stress is unhealthy. All primates have developed the capacity to respond to stressful situations by releasing hormones such as adrenalin and glucocorticoids, which instantaneously increase the animal's heart rate and available muscular energy. The stress response is incredibly ancient evolutionarily. Biological functions which evolve are dependent upon mutations which occur and are selected to survive because of the advantage they confer. The stress response goes back even further than primates. Vertebrates including fish, birds and reptiles also secrete similar stress hormones to ours, but as far as we know they play no significant role in disease as it does in people and higher life forms.

Let’s try to explain why. First we need to remember that whether the stress is physical or psychosocial in nature, the hypothalmo-pituitary-adrenal (HPA) axis is activated.

So in the case of a physical real and present danger—i.e. you hear an intruder in your home in the middle of the night— stress hormones are magnificently designed to help you survive an unexpected threat. Energy surges in your skeletal muscles, your heart rate and blood pressure increase and you basically deactivate every physiological function that's not essential at that moment to survival, such as digestion, immune response, growth and reproduction. Your senses are heightened, you think more clearly, and certain aspects of learning, decision-making and memory are enhanced. All of that is spectacularly adapted if you're dealing with an acute, physical, short-term physical stress.

Now consider the health consequences when you're turning on the same stress response for months or years due to purely non-physical chronic psychosocial reasons. These non-life-threatening stressors, such as worrying about personal finances, enduring an unhealthy relationship with a spouse or employer, or living in a constantly loud, cold or otherwise irritating environment also trigger the release of adrenalin, corticosterones and other stress hormones. These chemicals which evolved for use in short-term situations can, with chronic long-term exposure, have devastating consequences to your health. If the stress response operates chronically due to purely psychological reasons, this means that you will be interfering with the normal function of your digestive, immune, reproductive, and almost every other system/tissue and you increase your risk of heart disease, ulcers, auto-immune conditions, osteoporosis, adult onset diabetes, high blood pressure and certain cancers.

In children, chronically elevated serum levels of glucocorticoids due to psychosocial stress can suppress the secretion of normal growth hormones. Not only is normal growth is markedly impaired, but this also affects intellectual development and immune status.

Āyurvedic Rasayanas

Rasayana therapy promotes the assimilation and delivery of nutrients needed by the body tissues for optimum structure and function. Rasayana Chikitsa boosts the ojas (vital force) and immune system helping a healthy person maintain good health or to re-establish impaired physical or mental health.

Charaka Samhita, one the earliest texts of Āyurveda, gave extensive information on the subject of rasayanas and rejuvenation. In his volume on Medical Treatment of Disease (Chikitsa Sthana) he begins with an exhaustive chapter devoted to Rasayana therapy detailing the physiological, pharmacological, therapeutic and clinical aspects of Rasayana therapy. The knowledge appears to have been so much developed that Rasayana Therapy has to be designated as one of the eight major branches of Āyurveda. Charaka categorized Rasayana Therapy in two ways:

(i) According to method of administration

• Kuti Praveshika (indoor use)

• Vatatapika (outdoor use)

Kuti Praveshika Rasayana (kuti, grass hut; praveshika, auspious to enter) is administered in cottage or hut constructed at an auspicious site facing east or north, high-roofed, well-ventilated, protected from noise and other disturbances and where the required appliances can easily be procured. The cottage should be three walled (trigarbha kuti). In a favorable muhurta (time period), when the day and constellation is propitious, a person desirous of undergoing rejuvenation therapy, firm in his purpose, full of faith, and single-minded, having cast off all sins of the heart, and having performed the circumambulation of the gods, the cows and the brahmanas, should enter into the cottage. That individual should then be cleansed by the administration of elimination therapy. After administration of elimination therapy, normally the patient becomes a little weak. Therefore, proper diet (Sansarjana karma) should be given to patient by this he will regain his strength. Thereafter, when he is happy and has regained his strength, the rejuvenation therapy should be administered. (CS. Chi. I,16-23)

Vatatapika Rasayana (vatatapika, occurring in wind and sunshine), unlike the kutipraveshika process, does not involve isolating the person in a secluded hut away from all contacts and distractions. Rather, this form of rasayana chikitsa is performed in a common facility for groups of individuals. Diet, physical therapies, medicines, prescribed behaviors, and other aspect of treatment are otherwise the similar. Among other contacts, one can be exposed for specified durations to wind and sunshine, hence the name.

(ii) According to type of Medicines (Bheshaja)

• Swasthasyaurjaskara Medicines. Promote vigor and strength in healthy persons

• Kinchit Artasya Rognut Medicines. Destroy diseases in the ailing (CS. Chi.I/4)

Medicines belonging to first category are considered to be useful for a healthy person. There are certain natural conditions like old age, which affect even a healthy individual. The medicine belonging to this category helps to maintain excellent physical structures and mind. Those medicines which invigorate a healthy person in this manner are mostly rasayanas. The Sharangadhara Samhita advises that in each decade of age, every person should take specific rasayana for warding off disease.

Medicines in the second category (arta, afflicted, ailing) are usually specific to a tissue, organ, or system.

We must also note the writings of Maharishi Sushruta considered the Father of modern surgery, whose writings on rasayana chikitsa diverged somewhat from Charaka in that he gave less weight to its psychological aspects and did not emphasize the differences between Vatatpika and Kutipraveshika procedures. However, he did certainly acknowledge the use of ahara (diet) to support the rasayana process. Sushruta had a very interesting view of what he did consider to be two categories of rasayana therapies:

ʃ Kamya Rasayana: for healthy individuals. These are promoters of general health, metabolism and immunity. Kamya is derived from the root word kam meaning desire or wish. Sushruta’s use of the term kamya as a category of rasayana denotes therapies that can be used to achieve a desire for a specific object or personal advantage. It is further divided into:

ʃ Prana Kamya-- for promotion of longevity  ʃ Medhya Kamya-- for promotion of intellect   ʃ Shri Kamya--for   promotion of bodily luster

ʃ Naimittika Rasayana: for diseased individuals The meaning of naimittika is “produced by a particular cause”.

It should be kept in mind that, though both Charaka and Sushruta, as well as later commentators, allude to their use in treating disease, Rasayanas have a decidedly more preventive intention than a curative one. This said, specific rasayanas can be used in the treatment of disease especially those of an autoimmune or systemically degenerative nature. It is also sometimes administered after the treatment of disease to prevent recurrence of that disease or to nourish the tissues that have been damaged by the disease. It can also be done in absence of a disease to prevent the occurrence of diseases.

Rasayanas are nontoxic in normal doses and are amphoteric. The conventional meaning of this term is that a given substance can act as both acid and base. When using the term with reference to rasayanas, we mean that they won't over-tonify nor over-pacify the mind or body. By contrast, tonics are used to build up or stimulate the body towards normal health but can be over-tonifying. Rasayanas will also help normalize physiology, but do it through both gentle nutritive and eliminative functions that tend to simultaneously support several or more tissues or organs, so are quite different. Amphoteric herbs seem to have a built in buffer that will help the body achieve homeostatic balance, building or eliminating as required to achieve physiological equilibrium.

Rasayana Dravyas (Rasayana Substances)

The classical Rasayana formulas contain(ed) a large number of ingredients, including plant materials, metals, minerals, and gemstones. Many of these ingredients must undergo a specific process (samskara) in order to purify it, make it able to combine, remove harmful effects, and increase bioavailability. Because of ignorance of our traditional Āyurvedic alchemical procedures, negative publicity and increasing expense, the use of the classical rasayana formulas has declined considerably. Most of the preparations available now, which use the same names, have an incomplete array of the herbal ingredients and either only traces or none of the mineral and animal products. This renders them not only less effective but potentially harmful. The non-availability of all ingredients, governmental restrictions on most metal-containing medicines, and the necessary changes in our wild life protection policies have made the use of musk, amber, metals, gemstones and parts of wild-life animals, nearly impossible and in some cases unethical.

The current Rasayana formulas, many of which are ancient classical preparations, are those based on such ingredients as Amalaki (Emblica officinalis) Bibhitaki (Terminalia belerica), Haritaki (Terminalia chebula), Shilajit (a mineral exudate high in fulvic acid), Long pepper, Black pepper, Ginger, Guggulu, Guduchi, Ashwagandha, Shatavari and other primarily plant-based ingredients.

Here is list of the more common herbs and select non-organic materials used for rasayana therapy and their actions. This list is by no means comprehensive.

• Bala (Sida-cordifolia), Nagbala, Kashmari (Gmelina arborea), ghee, dugda and Ashwagandha (Withania somnifera) - act as dietary adjuvants and are good for increasing the strength of tissues and organs (Balya).

• Pippali (Piper longum) - acts as a respiratory rasayana

• Lasuna (Garlic -Allium sativum) – acts as a meda dhatu rasayana

• Haritaki (Terminalia chebula) and Triphala - act as digestive rasayanas; promote waste product elimination from all tissues/organs, particularly digestive tract.

• Brahmi (Bacopa monnieri), Vacha (Acorus calamus), Shankhapushpi (Evolvulus alsinoides), Mandukaparni (Centella asiatica) - medhya rasayanas help to increase intellect and memory.

• Guggulu (Commiphora mukul), Vidanga (Embelia ribes) - supports elimination of waste products (āma).

• Amalaki (Emblica officinalis), Yashtimadhu (Glycerrhiza glabra) and Guduchi (Tinospora cordifolia) - vayasthapaka rasayanas- decrease the catabolic process and thus postpones aging. (adaptogenic tonics).

• Bhallataka (Semicarpus anacardium) - an immune promoting substance used primarily as naimittika rasayana in conditions including rheumatoid arthritis and some stages and types of arbuda (cancer).

• Punarnava (Boerrhavia diffusa) - promotes the functions of the kidney and improves the regenerating capacity of the nephrons (functional unit of the kidneys).

• Shatavari (Asparagus racemosus) - a female rejuvenative and cytoprotective sukra dhatu rasayana. It is useful for infertility, decreased libido, menopause, and leucorrhea. Shatavari also is a galactogogue (promotes lactation in lactating mothers).

• Pravala (Red Coral-Corralium rubrum), kukkutandatwak bhasma (calcinated hen's egg) and Vanshalochana (bamboo manna) – asthi and mamsa dhatu rasayanas which provide calcium essential for bone and muscle development.

• Kapikachhu (Mucuna pruriens) and Ashwagandha (Withania somnifera) - promote normal function of nervous tissues, restore senile sexual dysfunctions and cure impotency.

• Svarna (Gold) and Hiraka (diamond) - increase the ojas (the vital essence)

• Vardhaman pippali rasayana is the rasayana-chikitsa is advocated for pranvaha shrotas (respiratory system).

• Chyawanprash is an ancient and most popular antioxidant rejuvenating tonic of Āyurveda.

With regard to chywanprash, Maharishi Chyavana first prepared this medicine to restore youth to his old and fragile body. Today we know that Chywanprash enhances body metabolism (agni) and immunity and is still considered to be one of the most health promoting rasayanas of Āyurveda when the formula is executed completely as detailed in the Charaka Samhita.

The benefits of Rasayana Chikitsa (rejuvenation therapy) are truly comprehensive, improving the overall health anyone undergoing this treatment. Apart from promoting good health, increasing concentration and memory, giving the skin a radiant glow and alleviating stress from the mind, its most important effect is creating a greater resistance to diseases. So regardless if today we are indeed living in the most stressful of times or not, rasayana therapy is a extremely useful strategy for remaining healthy.

Rasayana effect is not a specific pharmacological action but is a complex phenomenon operating through a comprehensive holistic mechanism involving the fundamental factors of rasa-samvahan (circulation of nutrient juices), and saptadhatu, agni and srotasmi optimization. In modern terms, some of the possible mechanisms by which we can interpret the actions of rasayanas include: antioxidant action, immunomodulatory action, hemopoetic effect, adaptogenic action, DNA repair action, anabolic action, nutritive function, neuroprotective action.

Rasayana chikitsa used properly will ultimately lead to the achievement of the ultimate effect as stated by Charaka:

दीर्घमायुः स्मृतिं मेधामारोग्यं तरुणं वयः | प्रभावर्णस्वरौदार्यं देहेन्द्रियबलं परम् ||७||

वाक्सिद्धिं प्रणतिं कान्तिं लभते ना रसायनात् | लाभोपायो हि शस्तानां रसादीनां रसायनम् ||८||

dIrghamāyuḥ smṛutim medhāmārogyam taruņam vayaḥ|   prabhāvarnasvaraudāryam dehendriyabalam param ||7||                                                                                                                                      vāksiddhim praņatim kāntim labhate nā rasāyanāt|    lābhopāyo hi shastānām rasādInām rasāyanam ||8||

Long life, heightened memory and intellect, freedom from disease, youthfulness, excellence of complexion, luster, and of voice; optimum strength of the physical body and the senses; fulfillment of whatever is spoken; reverence of all people—all this does one obtain by the proper use of rasayanas. These rasayanas are so called because they replenish the vital fluids of the body. (Charka Samhita, Chikitsasthanam I/7-8)