Close

Yātrā For svāsthya: A Perspective From Āyurveda

Yatra

I Introduction

Jīvana-yātrā: journey in fulfilment of life’s pursuits 

For millennia, Indic tradition has invested human life with definite meaning, using a pattern of symbolism that would be commonly understood both by the elites and the masses.  Human life span is normatively re-ordered in four overlapping stages of twenty-five years duration each with age specific duties, norms, roles, and values.

The stages are conceptualized as following one another in a continuous process of cognitive and spiritual growth and fulfilment. They are traditionally identified as (1) the young student (up to age twenty-five; Brahmacārin), (2) adult householder (from 25-50 years; Gṛhastha), (3) aging hermit (from 50-75 years; Vānaprastha), and (4) elderly wanderer (age 75 upwards; Sannyāsin).

The main task of the first two stages is development of outward-directed skills for fulfilling the first three goals of life—dharma (righteous behaviour), artha (material security and prosperity), and kāma (carnal & emotional satisfaction) by learning a trade to earn a living, getting married, and raising a family. The final two stages are characterized by the quest for 'inner' spiritual growth and subsequent self-realization (identified as mokṣa or kaivalya in the six traditional schools of philosophy = darśana).

The stages of life are predicated upon the theory, that humans are capable of increasing degrees or levels of knowledge, as they mature and grow old. The process of aging brings about increased awareness and comprehension of new psycho-spiritual dimensions and emergent symbolic life, which was inhibited previously by the preoccupation with the external world. Undertaking pilgrimage (tītha-yātrā) is therefore one of the suggested activities in the latter half of jīvana-yātrā in the tradition of Āyurveda, the art and science of living a long and healthy life.

II Tīrthayātrā

Tīrthayātrā constitutes a major socio-cultural concept in the Indic thought world as an act of dharma that also assures health and wellbeing of one’s body, mind, and self; as well as one’s family and departed ancestors. Tīrthayātrā is formed from two words—tīrtha is derived from the Sanskrit verb tṛ meaning to “cross” or to “surpass.” So, the derived meaning of tirtha is a place from where one can surpass or overcome one’s wrong deeds (tarati pāpādikam yasmāt) or a place from where one can ascend to a higher stage of life (tarati yasmāt sthānāt. Yātrā is a feminine noun from the Sanskrit root “” (to go) meaning something like “vehicle,” i.e. that which keeps you going, proceeding. Yātrā also means journeying through one’s life as in Jīvana-yātrā.

Tīrtha

As “aquatic gateway,” tirtha, literally and figuratively, is also a transition zone for many situations and is therefore pan-Indic in scope, both temporally and spatially, because the source of water is central to life, everywhere and anytime. Indic tradition has always offered a way to “crossover” whatever the situation, be it overcoming a personal problem, passing over to a new stage of life (aśrama), crossing from one life to rebirth, traversing the realms (loka) for reaching heaven (svarga), or ultimately transcending the cycle of saṁsāra itself.

The existential focus on the source of water as the pivot of sustenance (dharma), prosperity (artha and kāma), and self-realization (mokṣa) is the very pivot of Indic tradition (Young 1980: 61-68). The centrality of water, rivers, and bathing in Indic culture was already present in the ancient Indus Valley Civilization, in which bathing was of central ritual importance.

Field, location (kṣetra) is another major concept of the Indic tradition that is associated with ritual and veneration. The status of tīrtha is confirmed on many hilltops, headwaters, and confluences of rivers, the pools, ponds and groves of the forests. In this locative form of religiousness, the place itself is the primary locus of devotion, and its traditions of ritual and pilgrimage tend to be older than the particular myths or deities which attach to it. Pilgrimage to these tīrthas is one of the oldest and still one of the most prominent features of Indic religious life.

The gveda refers to the notion of tīrtha as (1) a route or a place where one can receive power (gveda 1:169.6; 1:173. 11); (2) a place where people can take a dip in sacred waters as a rite of purification (gveda VIII:47.11; 1:46.8) and (3) a sacred site where God is immanent through possessing the power of manifestation (gveda 10:31.3) (see Ṛgvedasamhitā 1997).

Topographically, holy tīrthas may be classified into three groups: (i) Jala-tīrtha (water-sites), associated mostly with a sacred bath on an auspicious occasion, (ii) Sthāna-tīrtha (temple/shrines related to a place), related to a particular deity or sect and mostly visited by pilgrims that are attached or belong to that particular deity or sect, and (iii) kṣetra, areas usually shaped by the form of cosmic maṇḍala, the travelling to which brings special merit (Singh & Rana 2019: 145).[i]

The connection of tīrthas with health of the body, mind, and self at both individual and extended family levels is hinted at in most dharmaśātra texts. Departed ancestors, too, are not ignored and instructions on how to perform special rituals for immersing the ash or the bones of deceased persons into sacred rivers are provided. Important Hindu rituals such as piṇḍa-dāna (feeding the ancestors), tarpaṇa (offering water to them), and srāddha (regular worship of them) are enjoined during the visit to a tīrtha for one’s sake and for family’s peace of mind.

More than one-third of the Tristhalisetu of Bhaṭṭa Nārāyaṇa (1915), for instance, is devoted to such rituals preferably at Gayā, in the state of Bihar, a major pitṛ-tīrtha where the ancestors are ritually remembered and honored. The śrāddha ritual has special merit when performed in this place. Hundreds of thousands of pilgrims therefore gather there every year during the pitṛ-pakṣa, the time of year especially set aside for this practice, in order to perform the śrāddha and related rituals.

Pilgrimage is also positively valued as a way for sick and infirm people to die with dignity; especially in Kāśī (Vārāṇasī), one of the oldest and best-known Hindu tīrthas, By the twelfth century it had become the premier pilgrimage place in India. Lying on an unusual north-turning bend of the Gaṅgā River, the entire riverfront of Kāśī is lined with ghāṭs, stone steps that lead pilgrims from the city's lanes to the edge of the river to bathe. Kāśī therefore has pride of place in Lakṣmīdhara's book.

Prayāgarāja is even more ancient than Kāśī. It is located at the confluence of the two sacred rivers—the Gaṅgā and the Yamunā—along with an invisible third river, the Sarasvatī. It is also the site of the Kumbha Melā, the largest religious gathering in the world, as well as a pilgrimage fair that occurs there once every twelve years. For those lacking the time or opportunity for such a long pilgrimage, local and regional tīrthas such as Muktidhāma at Nashik serve as substitute places for the performance of such rituals (Tilak 1996).

Yātrā

Yātrā may be undertaken as part of a formal closure of a vrata (vow), which a Hindu may make to mark a special occasion--the birth of a baby or as part of a rite of passage such as a baby’s first haircut. It may also be the result of prayers answered, or consequent to a vow a person had made, if his or her prayer were to come true, such as the wellbeing of a family member, or overcoming poverty or destitution or a challenging situation such as long illness (Eck 1981). Another reason for visiting a tīrtha is the Hindu belief that a yātrā has rejuvenating potential to purify the inner state of the human being, and hence there is spiritual merit in travel, a theme asserted by the Vedic texts.

This reasoning is also related to the themes of penance and atonement. Viṣṇu Dharmaśāstra asserts that the type of sin that may be expiated through yātrā is referred to as anupātakas (minor sins), in contrast to mahāpātakas (major sins) that require other penances. An alternate reason for a tīrthayātrā, for some Hindus, is to respect wishes or in memory of a beloved person after his or her death. This may include dispersing their cremation ashes in a tīrthakṣetra located in a forest, mountain, river or sea to honor the wishes of the dead. The journey to a tīrtha, assert some Hindu texts, helps one overcome the sorrow of the loss (Shravan Kumar 2019).

Balarāma’s Sarasvatī River pilgrimage from the Mahābhārata’s Tīrtha-yātrā-parva provides an archetype for modern Hindu yātrā. The fruits offered by his visit to each of the tīrthas shows that they concern the satisfaction of individual’s this-worldly desires as well as spiritual purification and liberation. These themes confirm the status of a tīrthayātrā as prototype for the modern pilgrimage, with all of the diversity of goals and meanings that such journeys involve (Haigh 2011).

During pilgrimage yātris assume a "temporarily ascetic" lifestyle; visiting Sabari Mallai in Kerala in South India, for example, yātris become "renouncers" for a period ranging from forty-five to sixty days, adding the energy of their asceticism to the power of the sacred place. Similar practices are followed by the kānvariās, who carry Gaṅgājala from Haridwāra in North India back to their local Śiva shrines in time to offer it on the annual festival of Śivarātrī, observing strict asceticism on their journey.

In Vālmīki's Rāmāyaṇa many of the places visited by Rāma and his entourage subsequently became important places of pilgrimage for Hindus, such as Ayodhyā, the city of Rāma's birth; Citrakūṭa, where he paused with Sītā on his journey; and Rāmeśvaram, in the far south, where he worshiped Śiva before crossing to Rāvaṇa's island of Laṅkā. The purāṇas, composed roughly between the fourth and the eleventh centuries CE, have preserved a large number of names of pilgrimage places extolling the benefits to be obtained by pilgrimage to them (māhātmya). These include prominent pilgrimage places to the present day: rivers like the Gaṅgā, the Godāvarī, and the Narmadā; as well as places such as Badrinātha and Puṣkara.

The famous ‘four dhāmas’ are pilgrimage places at the four corners of kite-shaped India of today--Badrinātha in the central Himalayas of North India, sacred to Viṣṇu, Jagannātha at Puri to the East in Orissa is, like Badrināth, sacred to Viṣṇu. Rāmeśvaram in the South, sacred to Śiva, is where Rāma worshiped Śiva before crossing to Rāvaṇa's fortress city of Laṅkā. Finally, Kṛṣṇa's temple-city of Dvārakā is in the West. The great philosopher Śaṅkarācārya (c. eighth–ninth centuries) made a circumambulatory pilgrimage of India and established these four shrines.

III Āyurveda: assuring health across jīvana-yātrā

Being an auxiliary limb (upaveda) appended to the Atharvaveda, Caraka advises the physician to abide by the Atharvaveda, which teaches therapy for the benefit of longevity (Carakasaṁhitā, Sūtrasthāna 30: 21). Āyurveda is the science (veda) leading to the fulfilment of dharma and other goals in life supported by a healthy and long life till ripe old age (Carakasaṁhitā Cikitsāsthāna 1: 57).

In fact, chapter eleven of Sūtrasthāna of the Carakasaṁhitā provides in summary form daily and seasonally adjusted regimen (including Svasthavṛtta and Sadvṛtta; see below) for accomplishing the goals during one’s jīvanyātrā which are presented as three pursuits of life--Prāṇaiṣaṇā (good physical health and wellbeing), Dhanaiṣaṇā (material prosperity and emotional satisfaction within one’s family and community) in the first half of life followed by pursuit of Paralokaiṣaṇā (quest for attaining the world of one’s chosen deity in afterlife) in the second half of life preferably at the tīrtha/s of one’s choice or kaivalya, spiritual liberation as defined in the Sāṁkhya-Yoga darśana). Performing śrāddha (ritual for assuring continued welfare of departed ancestors) accompanied by dāna (giving in charity) during the tīrthayātrā at this time also secures the overall welfare of one’s departed ancestors (Carakasaṁhitā, Sūtrasthāna adhyāya 11).

The relationship between the body and self, however, can only be implied or deduced logically; it cannot be empirically demonstrated because the self only acts as witness of the bodily proceedings. Self is implicated or can intervene only indirectly in medical treatment insofar as it is embodied (i.e.as jīva) through the intermediary of the mind (Carakasaṁhitā, Śārīrasthāna. 1: 59). Like the lamp, the self only serves the function of illumination without getting involved in whatever is (or can be done) in the presence of light. While the self is without a beginning and end, the body is ephemeral and dissolves into the five cardinal elements upon death.

The day-to-day healthy functioning of life and its welfare (both at individual and collective level) as well as pathological changes culminating in death are explained in Āyurveda in terms of the balance obtaining among the three body humors; phlegm (kapha, a derivative of water), bile (pitta, a derivative of fire), and wind (vāta, a derivative of wind). The three humors are in continuous flux possessing definite rhythms reflected in (1) the earth's rotation, which creates the circadian rhythm of day and night (dinacaryā), (2) the cycle of six seasons (ṛtucaryā), and (3) the field of gravitation and the tidal rhythms of the water mass in the oceans and the body fluids (including blood). These rhythms structure the bio-rhythm in the human beings.

Though they betray contrary properties, the humors (like the poison carried by the scorpion) are not fatal to each other; nor do they neutralize one another (sahajasātmya). When they are functioning normally in the body, the humors defy empirical observation or description. They can, however, be observed, described, and analyzed in terms of the functions they perform and with reference to the circulating blood in the body which is deemed to be their direct and visible manifestation of prāṇa (Carakasaṁhitā Sūtrasthāna 24: 4).

Svasthavṛtta and Sadvṛtta

Good health prevails when the humors are maintained in a state of dynamic equilibrium within tolerable limits. Because daily, monthly, and seasonal (sixty days) variations and uncongenial interaction between the senses and the sense objects, constantly threaten the equilibrium of the humors, specific dietetic and moral regimen, composed of Svasthavṛtta and Sadvṛtta, is prescribed to maintain health.

Svasthavṛtta refers to a specific lifestyle that is prescribed to promote health and successfully forestall or prevent the genesis of diseases so that the jīvanyātrā can proceed unhindered. Caraka defines it as the process whereby the person stands in his/her own natural healthy state of being by the dint of self-effort and care (Carakasaṁhitā sūtrasthāna 5: 13). Cakrapāṇi's gloss renders it as that which makes one free from disease by maintaining the state of equilibrium of the seven body tissues (dhātus).

Caraka discusses personal hygiene extensively in chapters five, six, and seven of Sūtrasthāna. The daily intake of food (āhāra) should be measured and in moderation. In preparing the daily meal, the basic properties of primary foodstuffs must be considered; the six savours (rasas: sweet, sour, salty, bitter, astringent, and pungent) that together maintain the balance of the humors (Carakasaṁhitā Vimānasthāna, chapter one). Rational control over the content, quantity, and timing of diet, therefore, is integral to health. In fact, moderation in eating (mitāhāra) is a dominant normative principle of the Āyurveda’s approach to food, dietetics, and personal health.

Recommended everyday health-promoting practices (dinacaryā) include proper sleep, cleaning of teeth and tongue, inhaling medicated herbs, oil massage, physical exercises, worship of a chosen deity (Carakasaṁhitā Sūtrasthāna 5: 13-102). These daily actions must be adjusted to the exigencies of each of the six seasons (ṛtucaryā). The changing season affects the balance of the humors, which must be re-established by changing the diet. Other health-promoting activities include measures taken to prevent premature old age and to assure and cultivate a happy conjugal life (Rasāyana and Vājīkaraṇa).

Sadvṛtta

Āyurveda posits an optimum relation between a healthy, happy life (sukhāyu); and a morally ‘good’ life (hitāyu). A healthy, long life is a ‘good’ for which one should actively strive during each of the four stages of life (āśramas) (Carakasaṁhitā sūtrasthāna 30: 24).). Long and healthy life is correlated with virtuous life and is deemed to be a moral obligation incumbent upon every individual (Manusmṛti 1946: 4:156-57).

Health, longevity, and wealth cannot be obtained, admonishes Caraka, by those who do not subscribe to these rules of personal and moral hygiene (Carakasaṁhitā Sūtrasthāna  8: 17). He then goes on to list dozens of rules of moral behaviour (most of them are worthy of universal application)-do not speak untruth, do not sin, be compassionate toward all, and so on (Carakasaṁhitā Sūtrasthāna 8: 18-33). Self-care through vigilant effort, thus, is a very important plank of personal and moral hygiene.

Āyurveda shares a common normative concern with dharmaśāstras, where medicine prescribes the right conduct for the body, while philosophy prescribes the right conduct in the social and ritual life. The family and community, accordingly, are introduced as the additional loci of the jīva in health promoting process. While ‘curing’ in modern medicine is restricted to removing the symptoms of an ailment, and restoring a client to health, healing in Āyurveda has additional scope: helping the ailing jīva to attain wholeness or harmony with the community on the one hand and with one's mind, body, emotions, and the self on the other.

Metaphysics and theory of health (svāsthya cikitsā) in Āyurveda

The metaphysical foundation of Āyurveda may be found in the Sāṁkhya-Yoga darśana as set out in the Carakasaṁhitā, which includes an adhyāya (chapter) on Patañjali’s Yoga system with eight auxiliaries (aṣṭāṅgas) indicating that vaidyas (physicians) of that time recruited yoga-sādhanā as part of healing (Carakasaṁhitā Śārīrasthāna 1: 137-155; Wujastyk 2012: 33–35).

Inversely, Patañjali’s commentarial definition and discussion of disease (vyādhi) is similar to one given by Caraka. The notion that disease results from an imbalance in the bodily constituents is also mentioned in the Patañjali’s Yogasūtra (1:30; see Bhāṣya on Yogasūtra 1:30; Maas 2008: 153). The Haṭhapradīpikā recommends the ṣaṭkarma practices--cleansing the stomach with cloth (vastradhauti), emesis (gajakaraṇī), a water enema (jalabasti), cleansing the sinuses with thread (sūtraneti), gazing at a fixed point (trāṭaka), churning the abdomen (nauli), and rapid breathing (kapālabhāti) for those who are not healthy. Therefore, they are more like therapeutic interventions that are dispensed with as soon as the practitioner regains health (Maas 2008: 153).

Preservation and promotion of health as per Āyurveda is prāṇic; in that health is assured if prāṇa flows freely through the proper channels (Carakasaṁhitā Cikitsāsthāna 28: 4). Usually translated as vital breath or basic life force, the term prāṇa is derived from the Sanskrit root an meaning to ‘breathe.’ In this sense it is analogous to qi (China) or élan vital (Bergson) suggesting that the functions and processes of life are due to a vital principle, which is distinct from physico-chemical forces.

To the Vedic imagination, prāṇa is connected with both the external and internal life and cosmic processes. In its external aspects, prāṇa is explicitly or implicitly related to such processes as eating, growing, and breathing. When internalized, prāṇa is consciousness, self, vitality, and energy. The sense of binding (bandhutā) that is implicit in the concept of prāṇa operates on different domains--physical, mental, metaphysical, and social. It establishes equation between two or more domains through a process of homologization of multiple breaths and the sense organs.

Prāṇa thus acts as the prototype of all motor forces in piṇḍa (the microcosm) and brahmāṇḍa (macrocosm). An important purpose of Vedic yajña involves re-unification of the human being and cosmos; and the wholeness achieved through this process recreates the original state, which is equated with svāsthya (optimal health).

Three components of restoring health

Āyurvedic healing is traditionally presented as three interpenetrating components for practical and didactic purposes (see Cakrapāṇi's gloss on Carakasaṁhitā Vimānasthāna 8: 87).

(1) Rational component (Yukti vyapāśraya cikitsā) deals principally with internal medicine and surgery (Carakasaṁhitā Sūtrasthāna 1: 54). Success in therapy depends on rational application of dosage and time (Carakasaṁhitā Sūtrasthāna 1: 16). The healing process involves first determining the cause/s of imbalance of humors (diagnosis), and then recommending means of promoting balance of the three humors and five cardinal elements (treatment).

The humors and elements combine with each other in various proportions to produce a specific body type, psychological temperament, and attitude in each person. They also produce the abundance or otherwise of flora, fauna, and minerals which must be used in the sustenance and the healing of the body. The smooth and harmonious flow of life is possible only if the body adjusts properly with the world outside which is made of the same five elements and time.

By mixing various food items judiciously and creatively, the physician can assure a positive, therapeutic outcome. The goal of therapy based on rational application of medicine is two-fold: ‘empowering,’ that is, boosting the healthy individual's resistance to forestall illness that may lie in the future (ūrjaskaram) and curative, i.e. treating the jīva whose illness has reached full manifestation (roganut) (Carakasaṁhitā Cikitsāsthāna 1:1.4).

(2) The psychological component (sattvāvajaya cikitsā) accords a central role to the mind in the healing process. Its purpose is to encourage the patient to restrain the mind and senses from coveting material objects (Carakasaṁhitā Sūtrasthāna 7: 50). Cultivating rhythmic breathing (prāṇāyāma), and meditation (dhyāna) leads to mental peace and prepares the individual for the spiritual quest. Satvāvajaya cikitsā invites the ill individual to discard harmful (ahitakara) thought patterns and adopt healthy (hitakara) thought patterns after careful consideration.

In other words, the mind should be restrained from craving for unwholesome objects and engaged, instead, in (1) seeking the wholesome ones (ahitānām anupasevanam and hitānām upasevanam); (2) trivarga anvekṣaṇam. While treating the state of the mind in the ill person, the course of conduct relating to the three eṣaṇās (tivarga) i.e. three pursuits of life should be attended because they are responsible for a stable mind and happiness. This can be attained by proper jñāna (knowledge or cognition); and (3) tadvidyasevā--one should consult only those who are well versed in the nature and treatment of Sattvāvajaya cikitsā (Bagali et al 2016).

Sattvāvajaya is an approach which prevents the impairment of intellect, patience and memory and brings them back to normal state. Sattvāvajaya embodies such qualities as loving, accepting, appreciating, compassion, patience, and tolerance. Sattvāvajaya thus is an approach which prevents the impairment of intellect, patience and memory and brings them back to normal state. It is a therapeutic technique described specifically for the management of mental states by withdrawing it from undesired objects. Sattvāvjaya cikitsā helps in determining the healing decisions by regulating the thought process and ideas and by challenging the presumptions (Bagali et al 2016).

(3) The metaphysical and ontological component (Daiva vyapāśraya cikitsā) treats disorders that are beyond the purview of Yukti vyapāśraya or Sattvāvajaya. The word daiva refers to acts committed in previous births and vyapāśraya means that which provides a basis or support (āśraya). Daiva vyapāśraya therefore connotes a treatment that is informed and conditioned by acts committed by the jīva in its previous births.

Chakrapāṇi in his commentary explains that Daiva vyapāśraya cikitsā cannot be ascertained through a general logic (yukti) because it acts on the basis of prabhāva (unknown/ inexplicable mode of action). Another feature of Daiva vyapāśraya cikitsā is inclusion of prāyaścitta (act of atonement). As Āyurveda accepts the doctrine of prior and/or repeated birth (pūrvajanma + punarjanma), it is rational to device methods which can effectively deal with daiva ordained maladies (daivakṛta) (Jyothi et al 2018).

References regarding this mode of healing, however, are limited in extant āyurvedic classics except perhaps the Kaśyapa Samhitā (still unpublished) which opens up a wider perspective on Daiva vyapāśraya cikitsā by shedding additional light on the involvement of karma and karmaphala in the role of ādāna (symptom), nidāna (cause  and  pathology), and prāyaścitta (atonement). This implies that diseases which are considered to be asādhya (incurable) could be given a try using this treatment.

Harita Saṁhitā, a text from 1600-1700 CE, advises that Daiva vyapāśraya cikitsā should be followed when all the other medical approaches fail to produce results (Jyothi et al 2018). In light of the above, āyurvedic healing cannot be labelled merely as ‘rational’ or ‘magical.’ It is holistic, insofar as medicine is projected as a counterpart of ethics and spirituality, and the care of the body (cure and healing) are predicated on a moral, social, and spiritual duties as prescribed by dharma.

From physical health (ārogya) to wholistic health (svāsthya)

The threefold cikitsā in Āyurveda is predicated on the presupposition that physical and mental health (ārogya) are two mutually interdependent phases leading to holistic health (svāsthya). Caraka refers to the “nonrecurrence of diseases” (rogānām apunarbhāvah) (Carakasaṁhitā Sūtrasthāna 9:19). While this is a negative manner of expression and presentation, it is in line with the claims and ideas of the authors of darśanas who discuss quest for final liberation from all cyclical recurrences--from rebirth and repeated existence (samsāra, punarjanma, punarbhāva).

Most Darśanas (including Āyurveda) use the term ārogya when the context is health of the physical body. While this term, too, implies an ‘absence of disease’, it does so in a different manner- the state of ‘being again free of disease,’ where a broader, wider ranging, previous state of svāsthya is presupposed.

Though modern medicine, too, seeks to terminate a state of suffering and confusion; it is not explicitly concerned with a ‘previous’ state of wholeness and health. It seeks to ‘cure’ the patient with a focus on the needs and demands of the physical body and to relieve it of any discomfort, aches and pains as mediated through symptoms. It does not look for some hidden contributors or agents (such as karma) responsible for the formation of these effects. Here, curing by itself implies restoration of good health i.e., the absence of symptoms and the elimination of whatever is causing the body to not function properly, even if that means removing a part of the body. Such an approach implies compensation and removal.

For example, if a person is experiencing muscle cramps, the treatment is relaxants; if pain persists, then painkillers are prescribed. If cancer is detected, curing seeks to remove cancerous cells. Curing amounts to giving a physical reprieve from discomfort by using medications or surgery. While this method, implicit in modern medicine, certainly makes it easier for us to live physically, it does not address the origin of the problem, only the effects. As a result, the perpetrators may still lurk in the body and may continue to gain strength, thus weakening the body’s ability to sustain good health.

Healing in Āyurveda, on the other hand, begins with the recognition that self is a member of one’s family and society; healing aims to identify, transform, and remove any obstacles preventing the self, mind, and the body from working together in a unified manner with one’s family and society. The objective is to re-establish ‘wholeness’ so that one can experience svāsthya, which involves creating a harmonious internal space so one can explore the hidden contributors behind illness at a deeper level.

Going on tīrthayātrā (gamana) to a person that has recently recovered from an illness as part of Daiva vyapāśraya for this reason. Tīrthayātrā symbolically brings about formal closure to the episode of illness by emotionally rehabilitating the convalescent. The vaidya may additionally prescribe one or more of the following practices that are part of the Daiva vyapāśraya cikitsā--chanting the sacred formulae (mantra), fasting (upavāsa), wearing of consecrated beads or precious stones (maṇī), performance of prescribed sacrifices (homa, havana), and observances of vows (vrata) Carakasaṁhitā Sūtrasthāna 57:11).

From the discussion above, it can be argued that svāsthya implicates the metaphysical and societal dimension of the ailing jīva and his/her family in addition to the concern with physical health (ārogya). Disease is not merely an objective biological state explainable and verifiable by objective criteria, it is also relative to metaphysical and socio-cultural norms and values.

The Śārīrasthāna section of the Carakasaṁhitā, accordingly reiterates rationale for adding a metaphysical and sociological dimension to the purely conceptual and intuitive entity- the self (puruşa) and its embodiment (jīva). This corresponds to the “natural state of the self” (ātmanah svāsthyam) that the Upaniṣads allude to, which is also known as “resting of the self m its own true nature” (svarūpe ^vasthitir ātmanah, i. e. establishment of the self m its identity), i.e. the state of final release (kaivalya). The Kaṭha Upaniṣad characterized it as the truly good (śreyas). Śankarācārya, too, mentions the “natural state” (svasthatā) as also the goal of “yogic” quest for liberation (kaivalya, mokṣa [ii] (Halbfass 1991:252).

Svāsthya, and its promotion and maintenance in Āyurveda, thus come across as a blend of rational, moral, and metaphysical/ontological values. While sins can be a cause of malaise, health is a sign of virtue. The jīva therefore must realize and owe moral lapses and errors of judgment that contributed to ill health, perform necessary restorative rites, and take vows of repentance and reform.

Going on a pilgrimage and donating to worthy recipients may constitute a major component of such vows toward healing. The giver of food, for instance, attains health, longevity, and eternal happiness. The gift of medicine to the sick assures freedom from diseases for the giver. Skandapurāṇa advises the pilgrim to give away in gift a replica of the eye made in gold with a studded jewel. The eyesight of the giver then would always remain clear in this and in future births (cited in Acharya 1993: 174, n.1).

Svāsthya, however, is more comprehensive than physical health (ārogya). It must be attained by fulfilling prescribed age-specific goals, and by cultivating values during the two halves of life as noted in the introduction above (Carakasaṁhitā Śārīrasthāna 1: 20-23). The idea is, when there is rightness, moderation, and the golden mean in both physical living, and mental and societal thinking, the individual becomes fit for the spiritual quest of kaivalya.

The question of ethics (and morality) is ingrained within the cosmos and philosophy of Āyurveda. “Good, evil, happy and unhappy is life. That (knowledge) in which are declared its nature, and measure, and what is beneficial to it and what is injurious, is called the science of life.” (Carakasaṁhitā Sūtrasthāna 1:40). “The union of body, senses, mind and self is called life, which is known variously as dhāṛ, jīvita, nityaga, and anubandha” (Carakasaṁhitā Sūtrasthāna 1:41).[iii]

IV Metaphorizing Yātrā

Metaphors are used to figuratively describe complex thoughts and emotions in order to make them more vivid and easy to understand. Since metaphors are so effective at clarifying abstract ideas, the human brain practically thinks in them to grasp reality, prompting some researchers to suggest we use metaphors every twenty-five words.

A metaphor describes something in a way that is figuratively true, though not literally true. By stating one thing is another thing, metaphors compare abstract ideas with concrete pictures, breathing life into words and helping readers grasp broad concepts and ideas.  For instance, to discuss the anxiety and angst that a visit to a hospital would evoke, comedian Groucho Marx famously said, “A hospital bed is a parked taxi with the meter running.”

Metaphor is implicit in the imagery of life’s journey from birth to death in the fulfilment of dharma and mokṣa/kaivalya as jīvanyātrā. The ‘tīrthayātrā’ and its geographical manifestation may then be understood metaphorically as evoking a new vision of landscape that for the yātrī overlays sacred and symbolic meaning upon a physical and material base. If touring (pravāsa) is an outer journey in geographical space, then yātrā becomes an inner journey to the self. If touring is something largely oriented to pleasure seeking (and/or the satisfaction of curiosity) then yātrā becomes something that combines spiritual and worldly aspirations in places where the immanent and the transcendent blend (cf. Singh & Rana 2019: 142).

Extending the metaphor of yātrā as a journey from illness back to overall health (svāsthya via ārogya) it may be argued that the three-fold cikitsā enables the convalescing jīvanyātri to return to his/her foundational spiritual self in a healthy mind and body (the state of svāsthya). This state is akin to the state of kaivalya attained by the yogin that has attained nirvikalpa samādhi. If we realize that health is foundational and not something ‘new’ to be ‘attained’; then we will live in alignment with our spiritual nature.

Ārogyayātrā

The foregoing discussion helps understand the rationale behind Dr Achanta Lakshmipathi’s (1880-1962) extension of the metaphor of yātrā to launch ārogyayātrā. Lakshmipathi graduated from Madras Medical College in 1909 and practiced modern medicine for many years. But in 1938, inspired by Mahatma Gandhi's thoughts on ‘rural uplift’, Lakshmipathi switched to Āyurveda and initiated ‘Ārogya yātrā’, a national ‘health pilgrimage’ to improve the people's health by popularizing two catchy slogans: ‘svasthasya svāsthyarakṣaṇam’ (preservation of health of the healthy), and ‘āturasya vikārapraśamanam’ (cure of disease for the ill).

“Medicines are only a small part of cure,” he would tell participants, emphasizing the need for beneficial diet and lifestyle, including exercise. Accompanied by one hundred physicians, he travelled on foot to villages, teaching simple principles of Āyurveda, offering guidance on diet, lifestyle, behavior, and exercise, and promoting cultivation of herbal gardens.

Having learned the importance of yoga āsanas, and such āyurvedic practices as taking bath after massaging the entire body with oil (abhyaṅga) to maintain health, villagers willingly took a pledge to follow healthy recipes, consumption of milk and buttermilk, instead of tea and coffee, and good lifestyle habits and hygiene to maintain health. Local physicians and volunteers were trained, and health centers opened where required. Villagers were encouraged to start an herbal garden in their villages (Domala & Domala 2012).

In 1939, on Gandhi's invitation, Lakshmipathi joined Sevagram in Wardha, Maharashtra, as a consulting physician where he expanded the scope of Ārogyayātrā to raise awareness of ‘Pancaśuddhi praṇālikā’, a system of introducing the five principles of cleanliness in five areas of life: body (deha), location and milieu (deśa)), food (āhāra), mind (manas), and self (ātman).

He appealed to the vaidyas to assume the responsibility of appraising the people of four inimical vices viz. ignorance (ajñāna), lack of cleanliness (aśauca), idleness (aśraddhā), and immorality (avinithi) that threaten health, and four measures to strengthen the mind: self-restraint (ātma nigraha), self-confidence (ātma viśvāsa), self-effacement (ātma tyāga), and self-help (svayam kṛti). He introduced the practice of using films, toy shows, and ārogya gītas (health promoting songs) to popularize the theme of health promotion (Domala & Domala 2012).

Svāsthyayātrā

It seems likely that Lakshmipathi conceptualized Ārogyayātrā with the metaphor of yātrā by predicating it on the causality orientation (yukti), which is comparable to the categories, rules, and methodology of modern medicine and discursive mathematico-logical reason with which he was more familiar.[iv]

His metaphorization should be extended to the other two components of cikitsā (Sattvājaya and Daiva vyapāśraya), which are participatory in orientation, in order to present a more comprehensive form and goal of Svāsthyayātrā. The participatory orientation may be understood in terms of active involvement (physical and mental) of the ailing jīva, and its family and community in the recovery process.

Such holistic and configurational grasping of reality is facilitated by the concept of synergy. Madhulika Banerjee (2008:206) points out, in this context that such synergy obtaining in āyurvedic cikitsā is distinct from the activity attributed to a single principle or molecule (the formula in allopathy).[v]

Caraka clearly warns that the whole cannot be understood by only studying a part of the whole. The action of a drug, for instance, is a function of various factors that include substance (dravya), quality (guṇa), substratum (adhikaraṇa), time (kāla), application (yukti), intent (abhipreta) etc. (see Payyappallimana 2002).  Healing then can reach to a level deeper than the physical cells—it can reach the ‘Unified Field’ of matter and consciousness. To put it differently, cikitsā can extend, depending on context etc., from ārogya to svāsthya. This may explain why the ideal of a jīvanayātrā, informed as it is by the principles and practice of Āyurveda, has remained popular in the Indic tradition.

In light of the foregoing it may be posited that metaphorically, yātrā is a journey of restoration of what was mistakenly believed to have been lost in disease/illness—the sense of what self is, what is its very essence, what is one’s connection with the rest of the world, and how to regain the sense of self fulfillment. In that sense yātrā operates and connects in a liminal (i.e. transitional) space between the material world and a transcendental reality.

Yātrā to a tīrtha is prescribed, it may be argued, for the sake of journeying from ārogya to svāsthya within to remove the veil of illusion (māyā) that separates the material world from spiritual reality. This is why a yātrā undertaken to the visible without knowing of (and re-connecting to) the self within is incomplete. Yātrā leads to yātrī’s consciousness, which may be construed at two levels—material and metaphysical (Singh and Haigh 2015).

The metaphor of yātrā then will reveal the common bond between the āyurvedic ideal of svāsthya and the yogic goal of kaivalya. While the yogis may not necessarily presuppose a ‘previous’ state of health and perfection (i.e. a past state in a temporal sense), they nevertheless appeal to the idea of a ‘return’ in a nontemporal sense, a rediscovery and retrieval of an identity; and inherent, underlying perfection that has always been there, and that has to be freed from obscuration, confusion, and disturbance.

Āyurvedic ideas of healing as re-emergence of freedom from illness, as a regaining of a “natural,” “inherent” state of health, balance, and harmony, would be compatible with this understanding. It was such a conception of health that offers itself as a bridge between the therapeutic and adhyātmic paradigms that dominate the notion of self-understanding in yoga and Āyurveda.

Tīrthayātrā then may be understood as a component of a time-honored regimen to reconnect with one’s self. Metaphorically, tīrtha acts as a vortex of subtle energy. Just as some spots in the human body are sensitive conduits for energy that goes unnoticed by other parts, some places on the planet are sensitive conduits of awakened consciousness.

Various Sthala mahātmyas (texts narrating the history and glory of tīrthakṣetras) suggest that down through the ages, spiritual seekers made a concerted effort to find sacred places; and to connect themselves with the local illuminating energy. As they did, the awakened consciousness inherent in those sites transformed their individual consciousness; this expanded consciousness in turn further awakened the subtle energy of the site itself rendering them jāgṛta = alive.

Such reciprocating manifestation of energy is the beginning point of a kṣetra. As the yātrī (recovering jīva) opens him/herself to the illuminating energy that infuses these sites, it allows a renewed vision of spiritual awareness to reawaken in it, which in turn further intensifies the illuminating energy in the space within (see Willoughby n.d.).

Research of Dr Sathish Kumar

Dr. J. Sathish Kumar of Chennai undertook interesting research (entitled ‘Discovery of India as the Ved Bhumi Bharath through the Scientific Perspective of Physiology) on his dynamic between an awakening yātrī and the alive (i.e. jāgṛta) kṣetra  with a view to connect it to Daiva vyapāśraya cikitsā.[vi]

It is a follow up study based on the research carried out by Professor Tony Nader under the guidance of Maharishi Mahesh Yogi on Human Physiology as an (iconic) expression of the Vedic Cannon in which Kumar proposed a startling correlation between the human brain, and the land mass and the geomorphic form and shape of India to explain why ancient temples dedicated to different Hindu gods/goddesses are to be found in specific geographical locations of India. For instance, Subramaṇya's traditional abode is in the region of Tamil Nadu and the great Sun Temple is in  Konark, Odisha.

Maharishi was an early proponent of holistic functioning of a universe speculating that the Veda constitutes prototype for the human body and its physiological functioning. The physical shape of India compares favorably with the spiraling shape of Ṛgveda giving India its peculiar physiological structure.

Nader therefore proposed that reading particular sections from the Veda and from the allied Vedic literature energizes and enlivens the corresponding parts in the human body and its physiological functions (Nader 2001). If this is true, then undertaking pilgrimages to ancient shrines of different Hindu/Vedic deities, situated in cosmically strategic spots could also possibly accomplish the same, since Ṛgveda is held to be the basis of human physiology and it is that which gives a geomorphic structure to India too. The impulses and vibrations of the Ṛgvedic hymns iconically represent the holistic functioning of human physiology (particularly the nervous system).

Kumar tried to correlate the ancient temples in the land of India with neurological centers in the brain. His conclusion is that the outline map of the ancient undivided India resembles the shape of the human brain in the sagittal view (Kumar 2003). The landmass and landscape of India act as mediator between the visible and the invisible worlds, an area of 'lived myth'.

Maurice Leenhahardt, an anthropologist and missionary in Melanesia, elaborated the notion of 'participation' as the central feature of the 'mythical sensibility' of the New Caledonians (see Tambiah 1990: 106). This sense of 'participation' in a mythic landscape or a sacred geography as a reality-orientation seems to figure in Caraka's inclusion of pilgrimage as a component of Daiva vyapāśraya.

Indeed,  yātrīs bring sands from Rāmeśvaram, the Southern tip of India and immerse them in the Gangā at Prayāgarāj or Vārāṇasī. They return with the sacred Gangā water to sprinkle it on the Śivalinga at Rāmeśvaram. Diana Eck refers to this ritual as 'a sacramental natural ontology' (1981: 336).

Dr Sathish Kumar’s research may answer (1) why the sacred pilgrimage centers with temples in India are situated at the nodal points of the cosmic forces and; (2) how they correspond with the knowledge processing and accumulating centers in the human nervous system.  Obviously, further research is warranted in order to convincingly demonstrate the presence of such rationale behind Caraka's inclusion of yātrā as part of therapy.

Concluding comments

The purpose of this presentation was to understand the contemporary institution of yātrā in light of the common Indic cosmological tenet held in the system of Āyurveda (shared with Yoga and other darśanas) that the physical world (piṇḍa) and its metaphysical counterpart (brahmāṇḍa) function as two parallel (though interconnected) dimensions of existence.

The yātrā helps open a dialogue between an outer realm of the body and mind and an inner realm of self-replicating a two-way journey: (1) from the body to mind, and (2) from mind to self. By their ongoing, mutually active involvement they proceed to an even deeper understanding –from self (ātman) to Brahman (see Singh & Rana 2019: 143). At the completion of their journey, the yātrī returns home, following the reverse steps, so that he/she proceeds from ‘awakened’ Self to a balanced mind, and subsequently, from the balanced mind to a healthy body in svāsthya.

This process[vii] is comparable to the maṇḍala pattern where the point of return is synonymous with the point of departure; one’s yātrā starts from and returns to the point of departure in svāsthya.

Bibliography

1. Acharya, Kala. 1993. Purāṇic concept of Dāna. Delhi: Nag Publishers.

2. Bagali, S. S, Baragi, R. A. Deshmukh 2016. “Concept of Satwavajaya Chikitsa (Psychotherapy).” Journal of Ayurveda and Integrated Medical Sciences 2016;1(1):56-63; accessed on 11 Sept 2019.

3. Banerjee, Madhulika. 2008. “Ayurveda in Modern India: Standardization and Pharmaceuticalization.” In Modern and Global Ayurveda: Pluralism and Paradigms edited by Dagmar Wujastyk and Frederick M. Smith.

4. The Carakasamhitā by Agniveśa. 1941. Revised by Caraka and Dṛdhabala with commentary by Chakrapāṇdatta. Edited by Vaidya Jādavaji Trikamji Āchārya. Bombay: Nirnaya Sagar Press.

5. Domala, S.N. and Snehalatha SN Domala. 2012. “Bhishagratna Achanta Lakshmipathi: Pioneer of Ayurveda in Public Health. Journal of Ayurveda & Integral Medicine 2012 July-Sept 3 (3): 158-161.

6. Eck, Diana. 1981. "India's Tīrthas: 'Crossings' in Sacred Geography," History of Religions 20 (4): 323–344.

7. Gadamer, Hans-Georg. 1996. The Enigma of Health: The Art of Healing in a Scientific Age. Translated by Jason Gaiger & Nicholas Walker. Stanford: Stanford University Press.

8. Haigh, Martin J. “Interpreting the Sarasvatī Tīrthayātrā of Srī Balarāma.” https://www.researchgate.net/publication/303564817_Interpreting_the_Sarasvati_Tirthayatra_of_Shri_Balarama accessed on 25 Aug, 2019.

9. Halbfass, Wilhelm. 1991. Tradition and Reflection: Explorations in the Indian thought. Albany, N.Y. State University of New York Press.

10. Jyothi, Divya, Hitesh A Vyas, Dr. K. Shyamasundaran. 2018. “Excerpts of Daivavyapashraya Chikitsa in unpublished manuscript Kashyapa  Samhita -A  New  ” Journal of Ayurveda & Integrative Medical Sciences 2018; 6.129-134. http://dx.doi.org/10.21760/jaims.3.6.18 [accessed 24 August 2019]

11. Kane, P. V. History of Dharmaśastra (in five volumes), Pune. Bhandarkar Oriental Institute. 1930–1962.

12. Kumar, Sathish J. 2003. Discovery of India as the Ved Bhumi Bharath through the Scientific Perspective of Physiology.(personal communication; August 2003).

13. Maas, Philipp 2008. “The Concepts of the Human Body and Disease in Classical Yoga and Āyurveda.” Wiener Zeitschrift für die Kunde Südasiens, 51: 125-162.

14. Manu Smŗti [With the Commentary Mānavārtha Muktāvali of Kullūka]. 1946. 10th ed. Edited by Narayana Ram Acharya, Kavyatirtha. Bombay: Nirnaya Sagar Press.

15. Nader, Tony. 2001. Human Physiology: Expression of Veda and the Vedic Literature. Fairfield, Iowa: Maharashi Vedic University Press.

16. Payyappallimana, Unnikrishan, 2002. “Validation of Ayurveda: Limitation of the Current Cross-cultural Medical Approaches.” In Ayurveda at the crossroads of care and cure edited by Ana Salema, 206-217, Lisboa & Pune: Centro & Historia de Alem-Mar.

17. Ṛgvedasamhitā. 1997 [6th Ed]. Edited by S.D. Satavalekar. Pardi. (Dist. Balsad, Gujarat): Svadhyay Mandal.

18. Shravan Kumar. 2019. Tirtha and “Crossing Over.” Organiser 13 Aug 2018. (Accessed 30 Aug, 2019).

19. Singh, Rana P.B. and Martin Haigh. 2015. “Hindu Pilgrimages: The Contemporary Scene.” 2 vols. In The Changing World Religion Map: Sacred Places, Identities, Practices, and Politics edited by Stanley Brunn. New York: Springer.

20. Singh, Rana P.B. and Pravin S. Rana. 2019. “Faith and Place: Hindu Sacred Landscapes of India.” In The Routledge Handbook of Place edited by Timothy Edensor, Uma Kothari and Ares Kalandides. London: Routledge.

21. Tambiah, Stanley J. 1990. Magic, science, religion, and the scope of rationality. Cambridge: Cambridge University Press.

22. Tilak, Shrinivas. 1996. “Under the Canopy of Tīrtha: Sharing the Sacred Space the Hindu Way.” Ecumenism 123, Sept 1996.

23. Tristhali setu of Bhaṭṭa Nārāyaṇa. 1915. Pune: Ānandāśrama.

24. Willoughby Deborah. n.d. “On pilgrimage: An Interview with Pandit Rajmani Tigunait…” https://yogainternational.com https://yogainternational.com/article/view/on-pilgrimage; accessed on Aug 29, 2019.

25. Wujastyk Dagmar and Frederick M. Smith, eds. 2008. Modern and Global Ayurveda: Pluralism and Paradigms. Albany, N.Y.: State University of New York Press.

26. Wujastyk, Dominik. 2012. The Path to Liberation through Yogic Mindfulness in Early Ayurveda.” In Yoga in Practice, edited by David Gordon White. Princeton: Princeton University Press.

27. Young, Katherine K. “Tirtha and the metaphor of crossing over.” Studies in Religion vol 9, issue 1, March 1980: 61-68).

End Notes

[i] The first exhaustive and annotated list of about 2200 Hindu sacred sites, shrines and places was presented by P.V. Kane (1974)

[ii] See introduction to Māņdukyabhāṣya--rogārtasya-iva roganivrttau svasthatā, tathā duhkhātmakasyor ātmano dvaitaprapancopaśame svasthatā (Halbfass 1991: 252).

[iii] Hans-George Gadamer, who has explored ethical humanist issues raised by technological successes of modern clinical practices, has argued that modern medicine, on its own, cannot guarantee us a feeling of well-being, of being together in harmony with one’s fellow beings (see Gadamer 1996).

[iv] Lakshmipathi perhaps closely followed Caraka’s dictum that leaving everything else aside, jīvas must first build a healthy body because in its absence everything else is lost (Carakasaṁhitā Nidānasthāna 6: 7).

[v] Banerjee adds that in Āyurveda single-herb prescriptions are comparatively uncommon. The synergy between herbs in a given formula is deemed to reduce potential toxic side effects. Both the drug and a detailed method of management of a condition through diet and lifestyle plans are implicated. Design and formulation (yoga) takes into account a range of specific conditions and stages of the jīva’s disease and health (Banerjee 2008:  206).

[vi] Dr. J. Satish Kumar, is a practitioner of Transcendental Meditation and this account is based on correspondence I had with him in August 2003.

[vii] The Yoga darśana describes it as return of the self to abide in its own nature (tadā draṣṭuh svarūpe’vasthānam (Yogasūtra 1:2).

(The paper was presented at the Yatra Conference jointly organized by Indic Academy and Bharat Adhyayan Kendra, BHU, at BHU, Varanasi during 15th-17th November, 2019.)

We welcome your comments at feedback@indictoday.com