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  1. 1. THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE Volume 7, Number 5, 2001, pp. 567–574 Mary Ann Liebert, Inc. PERSPECTIVES Ayurvedic Physiology and Etiology: Ayurvedo Amritanaam. The Doshas and Their Functioning in Terms of Contemporary Biology and Physical Chemistry ALEX HANKEY, Ph.D. ABSTRACT The three doshas of Ayurveda and their five respective subdoshas are related to the modern scientific framework of systems theory, phase transitions, and irreversible thermodynamics. These empirically well-established concepts of Ayurveda then appear to be far more general biologic concepts than the neuroendocrinology of their functioning might imply. They express universal concepts applicable across living organisms—control structures governing living systems. The hypothesis that the 15 subdoshas can themselves be considered as 5 triplets implies that on the level of the whole organism, these secondary structures of control appeared at specific stages in the evolution of life, yielding new insights into their development and evolution. The description of varying states of health and disease given in Ayurvedic etiology is related to the format of phase transitions in irreversible thermodynamics. INTRODUCTION A yurveda is well known as the Vedic system of health care of India, practiced effectively for thousands of years by millions of people (Sharma, 1981–1996; Bhishagratna 1991 and 1996; Murthy, 1984, 1986, 1991 and 1992, 1998 and 2000; Sharma and Clark, 1998). Yet the terms and concepts it uses to describe types and functioning of the human body, to classify levels of health, and to describe the onset of disease have not yet been related to modern scientific biology and medicine. Despite its success, Ayurveda appears unscientific to the scientist, and for that reason has attracted crit- icism (The Lord Walton, 2000; U.K. Department of Health, 2001; Hansard, 2001). The purpose of this paper is to outline possible ways in which certain concepts in Ayurveda can be related to those in modern biologic sciences. In this way, the substance of Ayurvedic theory may become better understood. Furthermore, there is the resultant potential for related research into the nature of life and living systems. Linguistically, Ayurveda is the union of the two words “Ayus,” meaning lifespan of anything in creation from the smallest subatomic particle to the whole universe, and “Veda,” meaning knowledge in the pure sense of the Maharishi Foundation, London, United Kingdom. 567
  2. 2. 568 term. Ayurveda thus literally means the science of the lifespan of all things in creation, including how such lifespans may be related to each other. One verse from the primary text on Ayurveda, the Caraka Samhita (Sharma, 1981–1996), states “Ayurvedo Amritanaam,” that the purpose of Ayurveda is to gain immortality—the longest lifespan of all. The image of life as a river—an endless stream of processes that produce continuous change, yet enable the overall form to remain the same—is consistent with the viewpoint of Ayurveda. Every day we breathe, eat and drink, and process large quantities of various kinds of matter, yet we may remain relatively unchanged. By understanding how the different processes involved maintain the bodily system, we may gain insights into its various modes of functioning. The river image is parallel to modern understandings of life based on systems theory (e.g., Weinberg, 1975) and nonequilibrium thermodynamics (Eigen and Schuster, 1979; Prigogine, 1980), and points to such areas of modern science as possible sources of parallels to Ayurveda. Most Western biomedical explanatory models of the body are framed in terms of biochemistry, rather than physics. In contrast, most traditional medical systems such as Ayurveda begin with “energy” for their theory of biologic processes, so that in essence they begin with physics, and move on to explaining biochemical and biologic levels on that basis. This may explain the misunderstanding, and, often, dismissal of such models found in modern Western medicine. It may also be in part because of lack of appreciation of the true scientific nature (and basis) of these explanatory models or paradigms. It is to be noted that the relative lack of physics in modern medical explanatory models does not imply the absence of laws of physics in bodily processes. This paper attempts to begin a process of elucidating the fundamental Ayurvedic explanations of physiologic functioning in terms of contemporary physics, physical chemistry, and a systems approach to biology. From these perspectives, Ayurveda’s concepts make sense, and provide a theoretical basis for linking biologic processes and outcomes across species. Our paper may also provide a starting point HANKEY for bridging the conceptual divide between Western and non-Western traditions—a divide that has recently seen the dismissal of Ayurveda and Traditional Chinese Medicine by the House of Lords Committee on Complementary and Alternative Medicine (The Lord Walton, 2000; U.K. Department of Health, 2001; Hansard, 2001), because of a failure to appreciate the theoretical underpinnings of these systems. THE DOSHAS AND THEIR SUBDOSHAS Ayurveda states that the human body is governed by three doshas that play the role of regulatory factors governing the internal processes by which it functions and is maintained (Sharma, 1981–1996; Bhishagratna, 1991 and 1996; Murthy, 1984, 1986, 1991 and 1992, 1998 and 2000; Sharma and Clark, 1998). The three doshas also govern more external processes through which they interact with the outside world. They are given the names vata, pitta, and kapha. Each dosha is supplemented by five subdoshas regulating specific processes in different parts of the body (see Tables 1 and 2). Systems theory identifies three fundamental processes requiring regulation present in any system: input/output (transport), turnover, and storage (Weinberg, 1975). This is as true for any subsystem as it is for the overall system, and indicates that regulatory control factors should be present in triplets: one each for transport, turnover, and storage. Systems theory thus requires the existence of triplets of regulatory control factors for any living system: for the whole system and for each of its major subsystems, such as the epiderm, the digestive system, the central nervous system, and the circulatory system, of which the major organs are the heart and lungs. TABLE 1. PHYSIOLOGIC FUNCTIONS A SSIGNED TO THE THREE DOSHAS Vata Pitta Kapha Communication Digestion Connecting structures Transport Transformation Cohesion Movement Metabolism Lubrication
  3. 3. 569 AYURVEDIC PHYSIOLOGY AND ETIOLOGY TABLE 2. SOME MAJOR PHYSIOLO GIC FUNCTIONS Vata subdoshas Prana Vital “breath” Mind Senses Pitta subdoshas Pachaka Stomach Digestion Kapha subdoshas Kledaka Stomach Mucous Samana Intestines Peristalsis Nutrient absorption Apana Colon/kidney Water balance Nutrient absorption Vyana All over/skin Horripilation Shivering Ranjaka Liver Bile/blood Alochaka Eyes Retina, etc. Sadhaka Heart Subtle quality Bhrajaka Skin pigmentation Avalambaka Lungs Trachea Bhodaka Mouth, pharynx Saliva Taste Tarpaka Cerebrospinal fluid Shleshaka Everywhere “Joints” 5 Connective tissue & sinovial fluid TABLE 3. ASSIGNMENT Vata Pitta Kapha FIFTEEN SUBDOSHAS Udhana Upward “breath” Speech/facial glow Eructation/coughing, etc. From this perspective, and also using the suggestion that the digestive tract of living organisms evolved in two distinct phases, first the mouth and stomach, and then the lower digestive tract, it is possible to make the tentative identifications of the three doshas and their five respective subdoshas given in Table 3. In this simple way, all the doshas and subdoshas can be related to the concepts of systems theory and control theory based on the elementary correspondence: doshas constitute the regulatory factors for a whole living system, while subdoshas are the corresponding factors for its principal subsystems. Whole system OF THE OF DOSHAS AND The structure of Table 3 thus suggests that the concept of doshas is fundamental to biology and lends strength to the Ayurvedic perspective that all life and living systems may be considered in terms of them. DOSHAS FOR A SINGLE CELL It is pertinent to look at the case of the single cell, for this gives an indication of which sectors of cellular metabolism are governed by the different doshas. Vata, governing input/output, would clearly be responsible for active SUBDOSHAS TO Digestive tract Ia Digestive tract IIa Central nervous system Apanab Pachakab Bhodakab Samanab Ranjakab Kledakab Prana Alochaka Tarpaka PHYSIO LOGIC SYSTEMS Lungs and heart Udhana Sadhaka Avalambaka Epidermal Vyana Bhrajaka Shleshaka a Here Digestive tracts I and II do not refer to regions of the human digestive tract, but to its developmental stages in multicellular organisms in biologic history. First, just a “mouth” and a ‘stomach” with taste, digestion, absorption, and water regulation functions as indicated in I and then in, e.g., primitive worms, a true gut with peristaltic motion, different regions for acid and enzyme production, absorption and elimination, additional functions are represented here under II. b Because certain doshas are involved in more than one subsystem, e.g., prana in taste in the mouth and also in swallowing, this correspondence is not exclusive. Table 3 is only meant to suggest which dosha function dominates each subsystem at its earliest stage of development. For example, samana and kledaka are necessary after the development of a gut but not for organisms possessing only a mouth, which only require the functions of apana and bhodaka. Similarly, the liver plays a vital role in blood purification as well as promoting digestion. The latter function is emphasised here for ranjaka. Because the liver’s enzymes take more time to act in the moving chyme, pachaka is taken as representative of the functioning of digestive tract I.
  4. 4. 570 transport across the cell membranes, and, in particular, for homeostasis, including such things as the sodium/potassium balance, the scavenging of particular ions and molecules, the entry of food and other molecules into the cell and the elimination of waste materials, inasmuch as regulated active transport is required for the processes concerned. Governing motion, it would also be responsible for mitosis (and meiosis). Pitta, being responsible for metabolism, must govern the Krebs cycle because this is the principal way food molecules are used to create energy-rich adenosine triphosphate (ATP) and other high-energy molecules used for the synthesis of molecules needed in cell growth. Taken together with transformation, this suggests that all the processes involved in ribosome-mediated enzyme synthesis are also the domain of pitta. Energy production and its regulation are of central importance. Life continuously produces entropy as its strategy of bypassing the second law of thermodynamics. It creates and maintains order (or negative entropy), only as a byproduct of its greater, overall entropy production. This is a first indication that the detailed thermodynamics of the availability of energy and other important resources must be of critical importance in optimizing the functioning of any organism, and in coping with unusual or unwanted demands made by the environment. The thermodynamics of such nonideal processes should therefore be an appropriate way to chart the organism’s coping strategies, as outlined in the next section. Kapha, being responsible for storage, becomes identified in the simplest single cells with the cell membrane and the cell wall, basic reserves for such a cell to call on in hard times, and the only sizeable structures in a prokaryotic cell. On a molecular level, kapha thus becomes identified with lipids and polysaccharides, the molecular basis for membranes and cell walls, respectively. In the human body vata and kapha are, dynamically speaking, found to be in opposition to each other. Correspondingly, in the single cell, transport and storage functions both manifest in the cell membrane and cell wall, but in completely different ways, so that they would HANKEY naturally compete for ATP available in that location. The opposition would appear to be long-standing. The above identifications of the three doshas are of interest because their functions correspond simply and obviously to those of the doshas identified by Ayurveda in the human body. For example, the main subdosha of vata is apana, which governs colon (and aspects of kidney) function. The colon is well known to be responsible for nutrient uptake, water absorption, and as the organ that ends in the rectum and anus, the elimination of waste matter. The kidney regulates water balance. All these functions correspond to those of the cell membrane in single cells enumerated above. Prana, the best-known vata subdosha, governs movement of the mind. It is ultimately responsible for gross mechanical motion of the body. The transmission of nerve impulses in the central nervous system (CNS) (primarily the domain of vata) relies completely on cellular input/output processes: first, those governing sodium/ potassium balance in nerve axons, and second, neurotransmitter release and reabsorption at synapses. Passing to eukaryotic single cells, the correspondence continues. The motion of single cells undergoing chemotaxis is governed by sensors on the membrane connecting to mechanisms regulating cell shape, also attached to the membrane. Hence it is not surprising to find vata identified in the human body as the dosha responsible for motion of many different kinds— samana for intestinal peristalsis, udhana for eructation, etc., vyana for horripilation (goose bumps) and shivering. Similarly, for pitta, its identification as being responsible for energy production and regulation in single cells has many expressions in the doshas on the level of the body. Pachaka, the chief pitta subdosha, is responsible for the production of digestive juices in the stomach, while ranjaka governs bile production and other aspects of liver metabolism (such as the stomach, a pitta organ). Alochaka governs the eyes, which are an extension of the CNS. Photosensitivity here is parallel to photoenergetic processes in single cells, clearly a pitta responsibility. Sadhaka is more subtle and assigned to the heart. Bhrajaka governs transformations in
  5. 5. 571 AYURVEDIC PHYSIOLOGY AND ETIOLOGY the skin, e.g., pigmentation regulating light entering the body. Kapha in the human body is said to coordinate structure, including cohesion and lubrication. Cohesion results from reactions and interactions at the cell wall, the original domain of kapha. Mucous production is governed in the stomach by kledaka; in the lungs by avalambaka; saliva by bhodaka; spinal fluid by tarpaka; sinovial fluid by shleshaka, which is concerned with joints, connections and cohesion of all kinds. All these can be traced to the functions of kapha in single cells: The function of kapha in single cells is storage, using, e.g., polysaccharides and lipids; similarly, mucus is polysaccharide, while other lubrication may use lipids. These correspondences suggest a continuity of function of vata, pitta, and kapha throughout the history of life on earth; their simplicity demands a correspondingly simple explanation. It would appear that the strategies, which maintain processes of control in single cells and other living organisms, possess an underlying continuity throughout their biologic development, starting from the microscopic level of regulation of biochemical processes in single cells, and proceeding to the macroscopic level of control processes regulating whole organisms and their subsystems. This means that during evolution, certain factors are of a primary and unchanging nature whereas others are secondary and can be more subject to alteration. Thus, on a microscopic biochemical level, the sequences of amino acids in enzymes and the corresponding base sequences in the nucleic acids may vary. In contrast, the choice of molecules for the subunits of proteins and nucleic acids, once made, do not: genes may change with the passing of generations, but the genetic code is an invariant of evolution. In a similar way, on the macroscopic level of a whole organism, the fundamental strategies of control by which behavior is regulated need to remain invariant. This seems to be true not only in terms of the systems theory reasoning given at the outset, but also to extend to the level of molecular structures each dosha uses to exert control throughout biological history. Active transport in cell membranes is the domain of vata, material turnover related to en- ergy production of pitta, polysaccharides and lipids of kapha. Their corresponding functions in different subsystems at different stages of biologic development continue to make use of these basic domains in the processes they regulate. It is proposed, therefore, that throughout history, the processes of biologic development have maintained similar strategies of control to those used in the original cells, adding to and building on them as appropriate, but without fundamental alteration. This suggests the following understanding of doshas. Throughout the historical development of living organisms, there have existed three strategic domains of functional control, which have retained their functional modalities and that Ayurveda identifies as the three doshas, vata, pitta, and kapha. This suggests that the three doshas may be considered as fundamental to life as proteins, nucleic acids, and the genetic code. It could even be argued that they are more fundamental, for the systems theory argument identifying them would remain valid for other conceivable biologic systems evolving on other planets where enzymes, genes, and the genetic code were constituted in a chemically different way. AYURVEDIC ETIOLOGY The doshas and subdoshas would be of secondary interest to any system of medicine were it not for the fact that they provide an etiologic system of fundamental importance. Doshabased etiology provides as significant a description of the health of an organism as of its pathology. For the human organism, Ayurveda identifies a state of perfect health: when all three doshas (and other aspects of the system) are functioning in balance, sama-dosha (Sharma, 1981–1996; Sharma and Clark, 1998). Each dosha can go out of balance by measurable degrees, meaning that the proportion of its energy is not correct with respect to the other doshas (see Table 4). A continuing imbalance of a dosha, resulting from some failure of regulation of metabolic processes, is said to produce an accumulation of the resulting problem or impurity (the literal translation of the word dosha).
  6. 6. 572 HANKEY TABLE 4. STAGES OF BALANCE AND IMBALANCE OF THE DOSHAS AND SUBDOSHAS Perfect balance—All of the doshas are functioning correctly in correct proportion to each other and in their right locations. Imbalance—Some aspect of the above is not satisfied. Stage I: Accumulation—A disproportion of a particular dosha or subdosha increases or accumulates. Stage II: Aggravation or Vitiation—The dosha or subdosha becomes overstimulated and may go into a wrong channel. The dosha or subdosha begins to act in an inappriate way. Stage III: Spreading or Migration—The dosha or subdosha moves beyond the location of its normal function. Stage IV: Condensation or Localization—The dosha or subdosha localizes in an inappropriate region. Stave V Manifestation—Pathologic symptoms manifest in the new location, e.g. a boil, arthritis or angina. Stave VI: Bursting (possibly)—An acute crisis occurs as with an aneurysm, an embolism or an infarction. Only stages V and VI have recognizable symptoms on a gross level. Stages I–IV do not and must be detected by direct measurement of doshas themselves. As imbalance accumulates to a higher degree, the dosha changes to a condition described as vitiated or aggravated, in which it is overstimulated and may go into inappropriate channels and even push another dosha or subdosha out of balance. In the next degree of imbalance, the boundaries of the normal region of its operation become violated, the dosha’s condition is described as spreading, resulting in its migration, and eventual condensation or localization in another, inappropriate, location on a permanent basis. It is only after these stages of imbalance have developed that the final two, pathologic, stages occur: manifestation and, possibly, bursting as in a boil or embolism. According to Ayurveda, no pathologic condition, even that resulting from an acute infection, can develop without such a sequence of identifiable stages taking place. So, Ayurveda can identify four stages of departure from “perfect balance,” charting “loss of health,” before any actually pathologic condition manifests. Ayurveda thus offers the possibility of “nipping any condition in the bud” before it develops into a problem. Ayurveda can also identify a pathologic condition in terms of corresponding displacements of the various doshas and subdoshas, because specific conditions have corresponding specific dosha/subdosha signatures. But to what do the concepts of perfect balance, imbalance, etc., correspond? Although specific instances might be recognizable biochemically, these concepts do not have any precise correlate in conventional biomedical terminology. The various terms used by Ayurveda to describe departure from perfect bal- ance or perfect physiologic functioning seem parallel to a description of a journey across a phase diagram. In one phase, a particular condition holds that seems more or less stable, but that makes a drastic change of type at the edge of that phase. In the next phase a different general condition holds, which may, if a phase transition is taking place, become more accentuated as that region is transited. This may indeed be a pertinent parallel and more than a mere analogy. Consider regulatory control in complex systems such as those involved in the biochemical pathways in living cells (Eigen and Schuster, 1979). In the last section, we saw that the thermodynamics of entropy producing (and thus nonequilibrium) systems should be central to quantitative treatments of cell functioning. In this context, it is well-understood from the work of Ilya Prigogine (1980) on nonequilibrium chemical processes of the kind found in cells and more complex living systems, that they exhibit complex behaviors that can be represented in terms of phase diagrams for the corresponding chemical potentials and other free energies. The major necessary condition identified by Prigogine (1980) for such behavior to take place is that there should be cyclic processes involved, for example through the self-catalysis of particular chemical reactions. Now, it is well known from control theory, that feedback is a necessary condition for regulation; and in a system of chemical reactions, any feedback loop will yield a cycle (Eigen and Schuster, 1979). Biochemical processes of regulation in a living cell therefore cannot but satisfy Prigogine’s condition. This implies that regulation ascribed
  7. 7. 573 AYURVEDIC PHYSIOLOGY AND ETIOLOGY to the three doshas should be describable in terms of thermodynamic phase diagrams precisely parallel to Ayurvedic descriptions of how the doshas “go out of balance.” Indeed, useful research could be conducted on, for example, the thermodynamics that this implies or on details of specific pathologies and how they relate to other modalities of complementary and alternative medicine. The hypothesis that stages of dosha imbalance can be described by phase diagrams is consistent with another, general, observation about doshas from Ayurvedic practitioners. They are not simply mechanical concepts, as might be implied from the definition in terms of systems and control theories. Rather, they come to be perceived more as subtle values of energy, which may be activated in different regions of the body to a greater or lesser degree at different times and under different circumstances, almost as if they had field-like qualities. It seems intuitively satisfying to consider that patterns of activation of such empirically detected “fields” may be described in terms of phase diagrams resulting from their various mutual interactions. AGGRAVATION OF DOSHAS BY FOOD MOLECULES Another analysis of dosha function can be made by considering the kinds of food molecule, which tend to aggravate or pacify each dosha (see Table 5). Failure to consume enough water, or an excess of dry food, aggravates vata. An excess of chili or other hot food, or heat, aggravates pitta. An excess of sweet or fatty foods aggravates kapha. These confirm the connections of vata to homeostasis and water balance; pitta to regula- TABLE 5. AGGRAVATION OF tion of heat and metabolism; and kapha to polysaccharides and lipids. On the single cell level, pacification of vata is caused by foods that provide source molecules for energy, enzyme, and macromolecule synthesis, implying that less gross motion will then be required to search for new food; aggravation of pitta is caused by molecular types increasing the rate of digestion, e.g., acid/sour; aggravation of kapha is caused by molecules making the organism overweight (sugars, fats). These observations are possible further confirmation of one of the fundamental suggestions of this paper, that vata, pitta, and kapha present concepts applicable to single cells as well as to human beings, and that tracing the continuity of their development will show how they are valid for all living organisms. CONCLUSIONS The ideas offered in this paper have seminal possibilities. Ayurveda’s doshas can be identified as regulatory control factors for fundamental physiologic processes in living systems that maintain their identity throughout biologic history: vata and its subdhoshas regulating input/output processes and motion; pitta and its subdoshas regulating throughput, turnover, and hence energy; and kapha and its subdoshas regulating storage, structure, and lubrication. Thermodynamic phase diagrams for nonequilibrium processes in the cyclic sets of chemical reactions governing the appropriate regulatory systems provide a starting point for elucidating Ayurveda’s dosha-based etiology. These suggestions offer the basis for many kinds of investigation into the nature, inheritance, and systematic development of func- DOSHAS BY FOODS OF VARIOUS TASTES Taste Dosha Sweet Sour Salty Bitter Pungent Astringent Vata Pitta Kapha Pacifies Pacifies Aggravates Pacifies Aggravates Aggravates Pacifies Aggravates Aggravates Aggravates Pacifies Pacifies Aggravates Aggravates Pacifies Aggravates Pacifies Pacifies
  8. 8. 574 HANKEY tional control in biologic systems, from the simplest organisms to the most complex ones. For medicine, the idea that states of health can legitimately be described in terms of phase diagrams could prove to be particularly rich and yield new insights into the classification of pathologies recognized by conventional Western medicine, as well as other modalities of complementary medicine. These suggestions also offer fresh approaches to therapy for any given condition. Comparative and integrative paradigmatic analysis, such as that offered in this paper, is a necessary step in moving toward a genuinely integrated approach to health care. It is necessary in order for us to move beyond the superficial situation where technologies with documented effects, but seemingly implausible explanatory models, are only applied by believers. In the new, more developed, paradigm, theory as well as technology is understood and enriches our understanding of the processes of life in the context of explaining specific bodily processes. Taken together, the documented technologies and their theory then become universally available as means of influencing such physiologic processes in the direction of improving human health. ACKNOWLEDGMENTS I would like to express my gratitude to His Holiness Maharishi Mahesh Yogi who has revived the ancient Vedic sciences, deeply studying their relationship to the sciences of the West, encouraging his students to further this exploration. This paper draws on his scholarship. I would also like to thank Dr. Gerry Bodeker, Professor Shinde, and Dr. Donn Brennan for very helpful advice and comments on this paper, and Dame Miriam Rothschild and Professor Lynne Margulis for conversations and encouragement during earlier stages of its development. I am particularly grateful to Professor John Fagan of Maharishi University of Management for his hospitality and encour- agement and to his associates, Dr. Phil Tomlinson and Dr. Charlotte Beck for their helpful insights. Finally, I am most grateful to Dr. Geoffrey Clements, Dr. Steven Cross, and Geoff Gay for their encouragement and support. REFERENCES Bhishagratna KK, Sushruta Samhita. 4th ed., 2 vols. Chowkhamba Sanskrit Series Office, Varanasi, India: Chaukhambha Orientalia, 1991 and 1996. Eigen M, Schuster P. The Hypercycle. Heidelberg: Springer-Verlag, 1979. Hansard. House of Lords Report, March 29, 2001. London: Hansard, 2001:468–520. Murthy KRS. Sharngadhara Samhita: A Treatise on Ayurveda. Varanasi, India: Chaukhambha Orientalia, 1984. Murthy KRS. Madhava Nidanam (Roga Viniscaya) of Madhavakara: A Treatise on Ayurveda Varanasi, India: Chaukhambha Orientalia, 1986. Murthy KRS. Vagbhata. Ashtanga Hridayam. 2 vols. Varanasi, India: Krishnadas Academy, 1991 and 1992. Murthy KRS. Bhava Prakash Samhita Vols. I & II. Varanasi, India: Chaukhambha Orientalia, 1998 and 2000. Prigogine I. From Being to Becoming. San Francisco, CA: WH Freeman & Co., 1980. Sharma H, Clark C. Contemporary Ayurveda. Philadelphia: Churchill Livingstone, 1998. Sharma PV. Caraka Samhita. 4 vols., 4th ed. Chowkhamba Sanskrit Series Office, Varanasi, India: Chaukhambha Orientalia, 1981–1996. The Lord Walton. Complementary and Alternative Medicine, HL Paper 123, November 21, 2000. London: Her Majesty’s Stationery Office, 2000. U.K. Department of Health. Government Response to the House of Lords Select Committee on Science and Technology’s Report on Complementary and Alternative Medicine. CM 5124, March 2001, London, 2001. Weinberg GM. An Introduction to General Systems Thinking. New York: Wiley, 1975. Address reprint requests to: Alex Hankey, Ph.D. Maharishi Foundation 6 Palace Green London W8 4QA United Kingdom E-mail: alexhank@dircon.co.uk