body, sleeplessness, sticky stools and saliva, swelling in the body, aches
and pains, etc.”^44 Daniel C. Tabor reports the explanation of a vaidyaor
Åyurvedic physician who asserts that chronic disorders (e.g., backache)
result from ̄amain the body. Acute illnesses (e.g., cholera) have other im-
mediate causes, but proximally, “the predisposition of the body to these
infections was held to be caused by ̄amaalso.”^45
Nirama ̄ (without ama ̄ ) is the state of normality and hence of health. It
is indicated by signs including lightness of limb, and proper appetite and
elimination. Åyurvedic treatment employs measures to return the body to
the normal nir ̄amastate before the administration of medicines appropri-
ate for particular disorders. A major therapeutic strategy in Åyurveda is
samana ́ or alleviation therapy: elimination of ama ̄ by rekindling the diges-
tive fire or agni(in modern terms: digestive enzymes and processes, along
with metabolism). Alleviation therapy includes fasting or light diet, exer-
cise, the drinking of warm water, and adminstration of digestive herbs,
singly or in compounds—for instance, dried ginger (Zingiber officia-
nale).^46 These procedures reactivate the reciprocally related functions of
the gastric fire and elimination, and the ‘drying up’ of excess doÓsas.
While normality has many applications as a diagnostic criterion in
Åyurvedic and Western medicine, Nietzsche provides another perspective
on medical normality. Nietzsche rejects the idea of ‘normal health’ in gen-
eral terms. He valued sickness and other morbid states for showing us
“under a magnifying glass states that are normal but not easily visible
when normal.”^47 But as for a standard of ‘normal health’ Nietzsche says
the concept should be abandoned, for what constitutes health for the
body(let alone the soul) “depends on your goal, your horizon, your ener-
gies, your impulses, your errors, and above all on the ideals and phan-
tasms of your soul.”^48 With the forsaking of the idea of a normal health,
he says, we may reflect on the health and illness of the soul. The sick soul
is really necessary, Nietzsche holds, to provoke the growth of our knowl-
edge, self-knowledge, and virtue. Difficulties and suffering can demand
our self-reflection and the exercise of our power. An ambiguity thus
emerges in the suggestion that while medical science—contemporary or
Åyurvedic—relies on a concept of normality as a criterion of health, our
‘abnormality’ can be a generative factor for healing.
Freedom from Pain
Freedom from pain is a foremost determinant of health, and relieving
pain is among the primary goals of medicine. Pain is generally the most
prominent and immediate indicator of the presence of illness and injury.meanings of health in ̄ayurveda 61