a determinant of health: awareness is both a determinant of health and a
resource for protecting and improving one’s health.
In psychological terms, physical pain and mental suffering can be re-
sults of a person’s subjection to injurious forces outside his or her con-
trol—another’s abusive behavior, for example—or they can arise from
tensions in a person’s own psyche. As Nietzsche says, however, psycho-
logical suffering can have the productive quality of provoking a person’s
development.
The motive to avoid pain (physical and/or psychological) can lead to
reliance on alcohol or drugs, prescribed or non-prescribed. Physical de-
bilitation is a possible consequence of substance abuse, and other kinds
of damage can result from abusing drugs. Spiritually, substance abuse can
cloud a person’s motivation and clarity of understanding. Morally, it can
interfere with the making and fulfilling of commitments. Alleviation of
suffering without reflection on its meaning neglects its positive value to
provide information about physical health problems. Additionally, it can
involve overlooking the potential of psychological suffering to incite the
development of personhood and maturity.
Wholeness and Integration
Åyurveda’s medical holism is founded on a cosmology wherein the per-
son is a microcosm of the macrocosmic world, a position that has reli-
gious as well as medical implications:
An individual is an epitome of the universe, as all the material and spiri-
tual phenomena of the universe are present in the individual, and all those
present in the individual are also contained in the universe.... As soon as
he realizes his identity with the entire universe, he is in possession of true
knowledge which stands him in good stead in getting salvation.
CS 4:5.3, 7Åyurveda considers the universe (and all matter in it, including human
beings) to be compounded of the basic substances earth, water, fire, air,
and ak ̄ a ́ ̄sa (‘ether’ or space), and Brahmanor supreme consciousness [CS
4:5.3–5]. On this metaphysical basis, Åyurvedic therapeutics aim to re-
store the doÓsas’equilibrium in consideration of influences such as season,
climate, and local foodstuffs and medicinal substances. Classical
Åyurvedic pharmacology recommends medicinal substances conditioned
by the environment, and holds that the rasaor essence of foods and med-
icines (gained from the rasaof the soil in which they grew) pervades the
rasaor essence that is the basis of the human’s seven dhatus ̄ or tissues.^52
meanings of health in ̄ayurveda 63