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wellness

Ayurveda is the principal health system in India, but other forms— such as Unani, Siddha and Tibetan medicine are also practiced. This chapter considers all these, along with many specific therapies from each. A variety of therapeutic massages is covered, as well as heat and steam therapies, and more obscure treatments for eye or skin health. All are geared towards detoxification, both internal and external, with the ultimate aim being good health, longevity and spiritual enrichment.

abhyangam

Traditional Ayurvedic Massage

The Charaka Samhita, one of the foremost Ayurvedic texts, advises that every person should have an Ayurvedic massage or abhyangam on a daily basis, preferably in the morning. “It is nourishing, pacifies the doshas, relieves fatigue, provides stamina, pleasure and perfect sleep, enhances the complexion and the luster of the skin, promotes longevity and nourishes all parts of the body,” it says. A therapeutic massage, not a relaxation tool, abhyangam ’s primary aim is to encourage the movement of toxins from the deeper tissues into the gastrointestinal tract where they can be efficiently eliminated. It is also given to stimulate circulation of the blood and lymph.

Abhyangam is traditionally performed with lashings of medicated herbal oil chosen according to one’s dosha, and is meant to be performed by one, two, four, or more therapists simultaneously. It employs long strokes, mainly with full palm involved, and all the pressure movements are in the direction of blood circulation, from the trunk to the extremities and up to down. The reverse hand movements are passive (without pressure).

The classic texts outline five different positions that the client should adopt during abhyangam, with the first two postures being repeated at the end, thus making a total of seven. These are: 1) Seated with both legs extended. 2) Lying on the back. 3) Lying on the left side. 4) Lying on the stomach. 5) Lying on the right side. 6) Seated with both legs extended (a repeat of 1). 7) Lying on the back (a repeat of 2).

Dr Renja Raphel, the Keralan-trained Ayurvedic doctor at the spa at Rajvilas in Rajasthan, prepares an oil mix with medicated herbs for a client.

Therapists generally spend an equal amount of time on each posture, but if there are particular areas that need more attention, they will take precedence.

If you have abhyangam at one of the Oberoi Spas, the therapist soon gets a feel for your body, and concentrates on repeated strain injured areas (RSIs) to increase benefits. The idea is that the physical therapy has a direct connection to the mental and the spiritual: by the end, you should be physically and mentally relaxed — yet alert and rejuvenated also. Benefits of good abhyanga massage include increased circulation, improvement in muscle tone, calming of the nerves, increased mental alertness, soft, smooth skin and, of course, the elimination of impurities and toxins from the body.

The Ayurvedic center called Ayurmana at Kumarakom Lake Resort in Kerala was believed to have been bestowed with the grace of the both Kodungalloor goddesses and Narasimhamoorthy — so is as close to a sacred structure (barring a temple) as you are likely to get. Therapy rooms including this prayer room glow with polished wood and the sanctity that comes with total peace and seclusion.

Ayurveda tends to advocate the use of brass vessels for oils, although clay containers are also used. As metal was considered extremely pure as well as hard-wearing, it is a sensible choice.

Abhyanga massage is traditionally performed by two, four or more therapists simultaneously and follows strict guidelines from Ayurvedic texts. Massage is first mentioned in the 6,000-year-old Atharva Upaveda, although was almost certainly practiced before this. Later, in the two major Ayurvedic treatises, the Charaka Samhita and the Sushruta Samhita, believed to have been written at the turn of the first millennium BC in Sanskrit verse, it is discussed in depth with exhaustive listings of positions of the body and measurements of oils, pastes and powders. In the Charaka Samhita, discussion of massage as a purification means to alter the chemical processes in cells is detailed and comprehensive. This comes in the chapter on panchakarma (see pages 46–49), whereby methods for the evacuation of toxins and the restoration of prana or cosmic energy to the body via lymphatic drainage are outlined. The Sushruta Samhita, on the other hand, is a treatise on surgery; it is here that methods of acupressure on the Meridian points, magnetism on the chakras and the positive spiritual and mental effects of massage are covered.

chavitti thirumal

Pressure Point Massage with Feet

Ayurvedic texts indicate that exercise, be it cardiovascular, involving stretching and breathing, or therapy, must be practiced on a daily basis for total wellbeing. Exercise is necessary to raise the metabolism, increase oxygenation, improve the function of the heart and circulatory system, and expel toxins.

For martial art and dance pupils, exercise and body conditioning are particularly important. In the past, pupils were taught (often individually) by gurus in what is known as the guru -shishya tradition; their education didn’t just include the one particular activity, but involved a thorough grounding in the classical texts, as well as such disciplines as yoga and pranayama. Nowadays, this tradition continues, but there are both residential and non-residential dance, drama and martial arts’ schools as well.

Kalari payattu gurrukal (master or teacher) Tomy Joseph stresses the importance of conditioning the body to stay in shape. “Gurrukal need to master both preventative and curative techniques too,” he notes. He says that chavitti thirumal, a very particular massage technique done with bare feet with the masseuse hanging from ropes tied to the ceiling, are mandatory for a gurrukal. Teachers routinely massage their pupils in this way to prepare the body for the stresses of the martial art, to maintain suppleness and to treat pain and swelling caused by combat.

The treatment is also given to those with neuro-muscular and skeletal disorders as well as to help clients reach beyond their psychophysical limitations. Based on a precise knowledge of the body’s energetic channels (nadis) and vital spots (marmas), the therapist suspends his weight from ropes overhead and applies pressure with long strokes of the soles of his feet, after the client’s body has been prepared with specially medicated oil. There is usually some manipulation of the joints and limbs also.

What distinguishes chavitti thirumal from other massage treatments is the application. The foot of the masseur is able to give a deeper, more thorough pressure and is able to cover the whole length of the body from the tips of the fingers to the tips of the toes, with long continuous graceful strokes. Therapists need to undergo many years of training: learning the chavitti art requires a certain type of calling and certainly a deep dedication to the wellbeing of clients and their physical, emotional, mental and spiritual upkeep.

After placing a foot in some medicated oil, the chavitti therapist balances his or her weight via ropes hanging from the ceiling, and presses deep into marma points along the client’s back and legs.

hot stone abhyangam

This deeply penetrating, all-over body blast is an example of how Ayurveda may be integrated with other healing traditions from elsewhere in the world. Developed by therapists at the world-famous Soukya International Holistic Health Center near Bangalore, it employs the healing medicated herbal oils and massage movements of Ayurveda with the warmth and nurturing qualities of hot stones developed by both Native American Indians and Tibetans (separately of course!). It is one and a half hours of pure bliss.

Small stones placed between the toes are delightfully indulgent, while larger ones are used for the massage itself. Feelings of warmth and security emanate from them; all the while the medicated oil does its detoxifying work.

There is both a therapeutic element and a feel-good factor to this treatment, so you can relax cocooned in the warmth emanating from the hot stones knowing that what is taking place is good for you. The long, firm strokes of the masseuse encourage the elimination of toxins from the deeper tissues and also stimulate peripheral circulation of both blood and lymph. This, along with the heat from the stones, enables the medicated oils to be absorbed to do their work. Naturally, as with all Ayurvedic treatments, oils are chosen according to the client’s constitution and/or ailment.

One therapist is in charge of heating and re-heating the stones, while the other alternates between oil massage, stone massage with oil, and placing stones at key points on the body. As the treatment progresses, a rhythm is established. One part of the body is being massaged, while a strategically placed stone sends heat deep into another part of the body; as the stone cools, it is replaced or taken away and another stone is placed elsewhere. After the back, legs and arms have been seen to, the client turns over, and is then invited to lie down on eight stones that run up either side of the spine. The heat is then twofold: coming up through the back, and down from stones on the front.

Stones are often basalt, a black volcanic rock with a high iron content, that absorbs and retains heat well. Such stones are believed to improve energy flows in the body.

With soothing music, firm massage strokes and the wonderfully nurturing warmth from the smooth stones, this is an experience to savor. The mind wanders and returns, the body sighs in acceptance, the spirit is soothed. Unfortunately, it seems all too soon when the treatment comes to an end. Nonetheless, the benefits linger and if this therapy is prescribed as a daily treat during a long-term stay, the effects are magnified considerably.

marma massage Pressure Point Massage

Indian pressure points are known as marmas and are similar to Chinese acupressure points. Translating from the Sanskrit as “secret” or “hidden”, they are found at junctures of the body where two or more tissues, muscles, veins, ligaments, bones or joints meet.

In Traditional Chinese Medicine (TCM), there are thousands of such points, but only 107 exist in the Ayurvedic system. Consisting of major points that correspond to the seven chakras and minor points that radiate out along the torso and limbs, they are measured by finger units (anguli) to detect their correct locations. There are 22 points on the lower extremities, 22 on the arms, 12 on the chest and stomach, 14 on the back and 37 on the head and neck. The mind is considered the 108th marma point. In the Sushruta Samhita each point has a Sanskrit name.

Ayurveda states that every marma point is placed at a junction of different channels of prana movements in the body. Prana, similar to chi in TCM, is considered the subtle vital energy that pervades every part of the body, nurturing the cell systems. If marma points become blocked or ruptured, prana flow is interrupted and organs may become diseased. If they are clear, prana is free to travel the meridians or nidas unchecked — and the body is healthy.

The idea of massaging the marma points began in Kerala at around 1500 BC when masters of kalari payattu first used the marma points as points for injury. It was only a matter of time before Ayurvedic physicians realized that these points could also be used for healing — and began to experiment with massaging the points to trigger a healing flow of energy. Today, marma massage is practiced at clinics and spas for a number of different reasons, be it therapeutic, relaxing or revitalizing.

Marma massage generally combines soft, flowing movements (abhyangam) with pressure point therapy. For the latter, the therapist uses one or more fingers depending on the size of the marma point, and either presses directly or in circular motions on that particular point. It is believed that clockwise movements stimulate and energize a marma point, while counterclockwise motions break up blocked energy and toxins held within a point. The practice is quite similar to Chinese acupressure or Japanese shiatsu, the origins of which lie in Ayurvedic practice. Benefits of regular marma massage are a general balancing — emotional, spiritual and physical — resulting in clarity, calmness and confidence.

Showing both chakra points and meridians, this educational drawing (left below) shows how prana or the vital force needs to flow around the body. Specific points (left and below) are pressed to release blocked prana.

champi Indian Head Massage

In spite of its name, Indian head massage involves work not only on the head but on the upper back, shoulders, neck, scalp and face too. In much the same way that Traditional Chinese Medicine dictates that certain points on the feet are directly aligned to internal organs, Ayurvedic texts relate certain parts of the head to other body parts and/or symptoms or diseases. Therefore, a champi or head massage does not only affect the immediate areas massaged: it can be a healing, rejuvenating and thoroughly stimulating experience as well.

The moment a baby is born, the fontanel on the top of its head is covered immediately with cloth soaked in oil with a bala root decoction to strengthen the head, sight and intelligence. Mothers massage their babies’ heads to facilitate strong skull and brain development, and later, give their daughters head massages to stimulate the scalp and infuse conditioning oils into the hair. Men are used to receiving a sharp rubdown at the barber’s shop and another place you are likely to receive an Indian head massage is in a salon or spa.

The massage normally takes 30 to 60 minutes and is given seated in a chair. It may be dry or oils may be used to both condition hair and calm the nervous system, as hair roots are connected to nerve fibers. Techniques vary, but the therapist usually start by gently kneading upper back, shoulder and neck muscles, then works up to the head. Here, the scalp is squeezed, rubbed and tapped and hair may be combed or pulled. The therapist locates the marma points along the head and spends time tugging and pressing earlobes, before moving on to the face. Facial massage is usually a mixture of acupressure and gentle manipulation, ending with soft stroking.

People who suffer from vertigo, headaches, migraines, insomnia, tinnitus and depression are all reported to find champi helpful. As the therapist works on the three higher chakras, the vissuddha (the base of the throat), ajna (the forehead) and sahasrara (the crown), mental and emotional stress is immediately released. In addition, the localized massage improves the supply of glucose and blood to the brain, improves the circulation of cerebrospinal fluid, dissipates accumulated toxins and opens pranic channels. Results include improved memory, clarity of mind, better eyesight and concentration, and clearing of the sinuses.

The therapist at the Ayurvedic Penthouse at Mandarin Oriental in Bangkok, first prepares for a 60-minute Indian head massage session by creating an atmosphere of calm with candlelight and aromatic oil burners. Then, she starts the therapy with pressure point massage to stimulate the vital energy points in the skull, thereby increasing the flow of subtle energies in the body. The result is a client comforted, nurtured and relaxed.

udwarthanam Dry Massage with Herbal Powder

A stimulating massage that uses dry powders not oil, udwarthanam is vigorous, energizing and not for the faint hearted. Dry herbal powders, chosen according to one’s dosha, are rubbed into the skin in the opposite direction to hair growth with strong repeated movements. The friction of the powder during the massage creates body heat that increases circulation, breaks down cellulite, firms muscle tone and reduces fat by improving the metabolism of the muscles. It is recommended for those who want to lose weight, as it reduces cholesterol levels and adipose tissue and promotes better digestion and. It also removes toxins and exfoliates the skin, leaving skin tingling, soothed and soft.

Most Ayurvedic massages tend to use long, flowing strokes that go away from the heart and from bottom to top, but udwarthanam employs short, sharp superficial rubs that go in the opposite direction, away from the heart towards the extremities and from the top of the body downwards. This is the opposite of the dosha flow. According to Ayurvedic physician, Dr Ajitha of Soukya, the powder helps to open up the micro-channels in the body, so reduces fat accumulation, tautens up muscles, reduces bad body odor and exfoliates dead surface skin cells. In a clinical setting, udwarthanam is usually prescribed for 10 to 14 days for those with ama twan or slowness of flow in the channels, and as a means to reduce fat. However, the massage type is increasingly finding its way into spas and retreats, where its invigorating style is gaining popularity.

At the spa at Udaivilas, a beautiful resort on the shore of Lake Pichola in Udaipur, one of three Ayurvedic powders or choornam are used: the popular triphala choornam or three fruit powder, a powder composed from Terminalia chebula or Terminalia bellaruca, or kola kula thadhi choornam, made from a variety of pulses and herbs. The massage is quite rough and the powder enters the superficial bloodstream, but also enters nasally as it flies about in the air. This cleanses the internal system too. Afterwards, the client is encouraged to spend 10 minutes in the steam room and further massage any residual powder into the skin. As sweating occurs, toxins are released through the skin’s pores, and the skin is left feeling soft, extremely smooth and rejuvenated.

Another place that offers udwarthanam is Soukya International Holistic Health Center. Here it is prescribed for guests who are obese and the powders are prepared on site. They differ from patient to patient, but may contain vacha (Acorus calamus) to alleviate swelling, the Ayurvedic all-round wonder fruit amalaki or Indian Gooseberry (Emblica officinalis), green gram powder and/or basil. All the herbs are washed, cut into small pieces, dried and pulverized on site to make either a fine or coarse powder, which is then strewn on to the body and massaged in by two therapists simultaneously.

Some of the powders used at Udaivilas; they contain what doctors call madagna properties that reduce fat and help clear blockages.

Two therapists at Soukya massage a client with powder made on site. Udwarthanam is also useful as a depilatory because the short, sharp rubs tend to pluck hairs from the roots.

sirodhara Oiling the Third Eye

Surprisingly, sirodhara is the most widespread Ayurvedic therapy offered at spas outside India. Why this is the case is unclear, as it is not prescribed for many ailments in a clinical environment. It invariably comes top of the Ayurvedic menu, and even spas without an Ayurvedic department offer bastardized versions. Many people have tried it, and even if they haven’t, they will almost certainly have heard of it.

Coming from siro (“head”) and dhara (“pouring of herbal liquids on specific body parts”), sirodhara denotes the continuous pouring of herbal oils, milk, buttermilk or ghee over the head and scalp. The patient lies on his or her back on a wooden treatment table, cocooned in warm towels, while a therapist trains a steady rhythmic stream of warm liquid from a perforated vessel made of clay, wood or metal on to the forehead. The table is made from one of seven therapeutic woods and is designed to catch the oil for recycling on the same client.

Oil stroking the “third eye” has a balancing effect on the deepest recesses of the brain and is profoundly relaxing. In Ayurveda, it is seen as a stimulating procedure for the nervous system and is prescribed for bringing down aggravated vata conditions such as insomnia, headache, insecurity, fear and nervous strain. Irritable pitta predominant people with overactive minds can experience a cooling, calming benefit from a session or two and kaphas often fall asleep. Used in conjunction with other therapies, sirodhara has been practiced for thousands of years to treat many and varied conditions such as ear, nose and throat disturbances, glandular problems, psychiatric disorders, hypertension, skin diseases, facial paralysis and more. During a session, the nervous system unwinds, busy brains become clear, and tired bodies are refreshed.

In a clinical environment, the choice of liquid and duration of treatment varies according to the individual. Vata patients are generally prescribed medicated herbal oil, pitta types receive herbal milk, ghee or coconut oil, and buttermilk is often recommended for kapha patients. Ancient texts denote 53 minutes for vatas, 43 minutes for pitas and 31 minutes for kaphas! It is suggested the best time to receive sirodhara is early in the morning for a period of 21 consecutive days, depending on the client. A variation of sirodhara is deha-dhara, where two to four therapists pour a continuous flow of oil over the entire body.

Beautifully carved beds are usually made from one piece of wood, often neem, and are designed so that oil flows through a drainage channel and is captured in a wooden bowl for re-use.

The Charaka Samhita specifies seven types of wood for an Ayurvedic bed or patti with the emphasis being on the wood having no joins. Because of the quality of the wood, beds are often works of art in themselves; often inlaid with copper or tin inserts, the more elaborate ones have evocative carvings as well.

At Quan spa in the JW Marriott Mumbai, oil at a sirodhara session is forced to flow back over the forehead down to the bed with the fastening of a piece of cloth just below the “third eye”.

The palatial surrounds of Neemrana Fort Palace’s courts and halls are highly conducive to healing. Here, a therapist trains the flow of oil on to the forehead of a client.

vasthi The Medicated Enema

To most Westerners the subject of enemas is one to be avoided, at best; subjected to, at worst. This probably stems from an innate squeamishness, but, be that as it may, the insertion into the anus, urinary organs and genitals of various kinds of enemas such as water, medicated and nonmedicated oils and milks, and herbal decoctions is an integral part of Ayurvedic practice. This is because Ayurveda states that the status of the alimentary canal and other internal organs is of vital importance to one’s overall health.

Vasthi (basti) is the word for a medicated enema, and in Ayurveda vasthi involves the introduction of herbal and medicinal concoctions in a liquid medium into and also on to the body. Sites where vasthi may be administered therefore also include external areas such as the eyes, lower back, head and the chest region. It is believed that these medicinal vasthi remove wastes and toxins from the body (either internally or externally), balance the functions of the doshas, provide nourishment and raise the body’s mmunity.

Vasthi is most effective in the treatment of vata disorders, although many enemas over a prescribed period of time are usually required. There are different types of vasthi given for many vastly differing ailments, including constipation, chronic fever, cold, sexual disorders, kidney stones, heart pain, backache, sciatica and other pains in the joints. Many other vata disorders such as arthritis, rheumatism, gout, muscle spasms and headaches may also be treated with the varying vasthi.

After a doughnut-style mix of gram flour and water is placed on the lower back and deemed watertight, warmed medicated oil is poured into the “container”. It is left to seep into the client’s sacrolumbar region or “foment” as Ayurvedic physicians call it.

The nurturing Ayurvedic Penthouse at the Oriental Spa in Bangkok offers a number of vasthi treatments including hrid or uro vasthi, an effective therapy for complaints of the heart and respiratory organs. Warm medicated oil, chosen according to the client’s complaint and doshic imbalance, foments on the chest area for 40 minutes or so.

A Keralan therapist at the atmospheric Ayurmana facility at Kumarakom Lake Resort pours warm medicated oil on to the skull of a client. Prior to this therapy, which is thought to relieve stress and regulate brain function, it is recommended the head be shaved.

Vasthi is one of the five main procedures of the famous (or infamous) panchakarma therapy (see page 46), but it may also be used in localized areas for neck complaints (greva vasthi), knee joint conditions (janu vasthi) and heart disease or asthma and respiratory diseases (hrid or uro vasthi). In Indian spas, a couple of vasthi therapies are offered for one-off “try-outs”:

Siro Vasthi

Usually offered for conditions such as facial paralysis, depression, insomnia, dryness of nostrils, mouth and throat illnesses and severe headaches, siro vasthi is on some Indian spa menus as a relaxing, stress-relieving and hair-conditioning therapy. Siro vasthi (siro means “head”) involves the application of lukewarm herbal oils poured into a cap fitted on the head for any time between 15 to 60 minutes. The oils are left to stagnate on the scalp for the time required; according to one’s dosha, current imbalances and/or medical conditions, medicated herbs will have been added to the oil. An antioxidant medicated oil called dhan wantharam that contains 28 herbs and an earthy fragrance is often used as it has rich pain-relieving properties.

Kathi Vasthi

A vasthi treatment that concentrates on the sacro-lumbar region of the back (kathi), this is a curative treatment useful for lower back problems. It is also used for complaints that affect the abdomen, such as irritable bowel syndrome, endometriosis, menstrual and urinary tract disorders. It involves the pouring of warm medicated oil into an enclosed area of the lower back, created with a reservoir of dough (see right).