By Bhaswati Bhattacharya
A 43-year old Indian female patient came to me in early December with pain in her right knee and a headache, requesting a ‘dava’ (medicine) for the ailments. Ayurveda does not treat symptoms; it treats patients, and so I asked her several questions. She was clearly concealing information about herself for unknown reasons. When in the day did her headaches occur more? Where on the head did it hurt? How long did it last? What was the pattern of pain in the knee? She recalled no injury, was not an athlete, and finally allowed me to see her two knees, of which the right knee was clearly larger and reddish.
When asked about her bowel movements, she replied they were ‘normal.’ Since I had never accompanied her to the toilet, I asked her what normal meant for her. She said they were fine. She was dismissive about her daily stools. I persisted. I asked if they were sticky, formed, or in pieces. She hesitated. Then she quietly admitted that sometimes they were not formed… but sometimes they were small and “fine.”
Based on the unclean bowel movements in the middle of December when the fire is the most robust in a healthy gut, I surmised that her gut had toxins that were not being digested properly, and was traveling into her blood, affecting her knee chronically with toxins, combined with a probable weakness in her knee joint. Known as leaky gut, the undigested food leaked from the gut into the blood and put a load on the organs that continually filter the blood, such as the liver and kidney, and spleen.
For most, successful treatment requires several phases, the first of which for her was to clear out her gut so that the blood could have a chance to be cleaned. My mental notes were to clean her gut for 5-10 days, then add a lepa (herbal poultice) for her knee to gain some pain relief while cleansing her liver for 2 weeks, then add a topical oil to her pre-bath and pre-sleep regimen to relieve the knee pain and rebuild strength.
Triphala, 1 tsp at night in warm, post-fully-boiled water was my first suggestion. I asked her to also eat 10-15 munakka (fig-like raisin-like fruits) each day, and report to me whether her bowel movements had changed after 3 days. I guided her that there are 4-5 levels of herbal formulations, each with different ways and effects for cleaning the bowels depending on the issue. Based on her response to Triphala I would advise her for a stronger gut cleansing herb, or alter the prescription so that she could have a full evacuation of the toxins in her bowels for 10 days.
She then demanded relief for the headache, and I counseled her that the headache would be relieved when the bowel movements were clear. The toxins in the blood were likely causing the non-radiating pains in her forehead, which were not triggered by light or heat. I also asked her to stop cooking with refined oils such as canola or safflower, as refined oil processing introduces toxins to the gut through the sand and nickel residues that remain in refined oils.
She left and I learned from her niece that she had an MRI done for her head for which she had willingly paid a large fee. The scan showed no abnormalities, and she was perplexed. I also was perplexed that she was so willing to pay so much for a scan that was not a treatment or a solution to her pains but was not willing to pay me anything for the wisdom of understanding her issues, which took decades of time, my time in observing her, and the process of consultation that included a specific prescription.
When she returned a few weeks later, she wanted to show me a bag full of several scans and tests to prove her bowels were fine medically. I simply asked, what was the process, form, and outcome of your bowel movements? She tried to force her way into the office, and I asked her to return another time.
I also toil with the reality that medical doctors charge huge payments for a non-healing 5-minute visit, but seasoned and competent integrative and ayurvedic clinicians do not charge up-front for their visits, which often include a lot of lifestyle counseling. If patients are willing to spend on tests and pills which often give side effects and no cure, why are they not willing to spend for the prescriptions and education that ayurvedic clinical experts provide?