Digestion Protocols. General Points and Definitions

Transcription

1 Digestion Protocols General Points and Definitions 1) Definition of "digestion" and its significance from the Ayurvedic perspective: Digestion is the process of breakdown of food into its component nutrients and subsequent synthesis of these components into bodily tissues (dhatus). When balanced, digestion results in liberation of energy, which drives physiological processes, and the production and renewal of healthy bodily tissues. Balanced digestion=sama Agni. It results from balanced functioning of the mind-body system (including balanced doshas, agnis, and dhatus). Imbalanced digestion results in sub-optimal energy production and impairment of production of healthy tissues. It is at the root of many or most chronic disorders. Imbalanced digestion results in formation of toxic digestive impurities (collectively called "ama"); ama is key to the pathogenesis of most chronic diseases. 2) There are 3 types of imbalanced digestion, associated with Vata, Pitta, and Kapha imbalance. Vata digestive imbalance = Vishama Agni Can manifest as: irregular digestion and hunger, constipation, hard/dry stools, gas, bloating, postprandial discomfort (variable), fatigue (especially postprandial). See Vata Digestion Protocol Copyright 2009, Maharishi Ayur-Veda Association of America 8.1

2 Pitta digestive imbalance = Tikshna Agni Can manifest as: epigastric burning ("heartburn"), gastroesphogeal reflux, very strong hunger, intolerance of spicy foods, tendency toward diarrhea or irritable bowel. See Pitta Digestion Protocol. Kapha digestive imbalance = Manda Agni Can manifest as: sluggish/slow digestion and post-prandial heaviness (on a regular basis), post-prandial fatigue, small food capacity, overweight and difficulty losing weight despite small food intake. See Kapha Digestion Protocol. 3) Signs and symptoms of imbalanced digestion may be subtle and easily overlooked. Maintain a high index of suspicion of digestive imbalance in any client with a chronic disorder, even if digestive symptoms are subtle. Assessment of digestive imbalance: Pulse diagnosis Digestion Assessment questionnaire Ama questionnaire Diet history: see Initial Client Questionnaire Management of digestive imbalance: "herbal preparations are 30%, diet is 100%": if diet is not optimized, herbs won't work. Copyright 2009, Maharishi Ayur-Veda Association of America 8.2

3 Note on Ama: If Ama* is a significant feature, include Ama-reducing measures (Ama-pachana), such as: Sip hot water frequently throughout the day. (Note: not recommended for Pitta digestion; use Pitta Spice Water instead see below.) Vata, Pitta, or Kapha Spice Waters. May be substituted for or alternated with hot water. Lemon-honey water in the morning Use of digestive spices, or Vata, Pitta, or Kapha Churna (spice mix) Ginger-lemon pickle before meals Light dosha diet Once a week liquid diet (especially for Kapha Prakriti) * For symptoms of Ama, see the Ama Questionnaire for patients Copyright 2009, Maharishi Ayur-Veda Association of America 8.3

4 Some Traditional Ayurvedic Compounds for Digestive Imbalance 1. Hingvastak Churna (Powder) Formula for Vata Digestive Imbalance (Vishama Agni) Ingredients: Cumin seed (Cuminum cyminum), Ajamoda seed (Apium graveolens), Black Cumin seed (Nigella sativa), Ginger root (Zingiber officinale), Black Pepper fruit (Piper nigrum), Pippali fruit (Piper longum), Mineral Salt, Asafoetida (Ferula asafoetida), Fenugreek (Triognella foenum-graecum) 2. Avipattikar Churna (Powder) Formula for Pitta Digestive Imbalance (Tiksna Agni) has a mild laxative effect Ingredients: Cane Sugar, Nishoth herb (Operculina turpethum), Clove bud (Syzgium aromaticum), Cardamom seed (Elettaria cardamomum), Musta root (Cyperus rotundus), Vidanga fruit (Embelia ribes), Cinnamon bark (Cinnamomum tamala), Salt, Ginger root (Zingiber officinale), Black pepper (Piper nigrum), Pippali fruit (Piper longum), Amalaki fruit (Emblica officinalis), Bibhitaki fruit (Terminalia belerica), Haritaki fruit (Terminalia chebula). 3. Dadimastak Churna (Powder) Formula for Pitta Digestive Imbalance (Tiksna Agni), when accompanied by loose stools Dry Pomegranate seeds, Cinnamon, Cardamom, Coriander, Ginger, Black Pepper, Pippali (fruit), Bamboo, Pippali (root), Sugarcane, Cinnamon Oil 4. Trikatu Formula for Kapha Digestive Imbalance (Manda Agni) Ginger root (Zingiber officinale), Black pepper (Piper nigrum), Pippali fruit (Piper longum) 5. Triphala Formula for re-establishing proper downward flow of Vata (carminative, Vata anulomana), detoxification, relief of constipation Amalaki fruit (Emblica officinalis), Bibhitaki fruit (Terminalia belerica), Haritaki fruit (Terminalia chebula). Copyright 2009, Maharishi Ayur-Veda Association of America 8.4

5 Vata Digestion Protocol Irregular digestion, gas, bloating, constipation, postprandial discomfort Part 1: Diet and Regimen Diet guidelines: Start with Light Vata Diet (see Vata Diet section: Vata Comprehensive Purification Diet ). If Ama is significant, apply Ama reducing measures, as described in Digestion Protocols General Points. As digestion improves, advance to regular Vata Diet as tolerated. See Vata Diet section: Eat Your Way to Balance-Vata. If there is a concern about Pitta aggravation (e.g., Pitta digestive symptoms, such as acid-reflux, co-exist with Vata symptoms), you may add Pitta Diet Restrictions (see Pitta Diet section). Favor: well-cooked, mildly spiced, warm, fresh and freshly prepared foods. Avoid: heavy foods such as cheese, frozen food, raw vegetables, red meat, seafood, fried food, yogurt, canned food, oily food, leftover food, packaged or processed foods, aged or fermented foods, nut butters, cold foods and drinks, carbonated beverages. Special foods for Vata digestion (see accompanying recipes/hand-outs): Hot water: bring 2 cups of water to a boil and place hot water in a thermos. Take a few sips about every 1/2 hour throughout the day up until sundown. Ghee (clarified butter): it enhances agni, oleates (lubricates), and is a rasayana (rejuvenator, enhancer of immunity). Use with caution if history of hyperlipidemia. (Ghee may be purchased already prepared, or may be freshly prepared from butter: see recipe.) Other oils (cooking oils, or add to food): olive oil, sunflower oil, safflower oil (organic, if available): oleation is important for individuals with Vata imbalance. However, oil intake should be moderate if digestion is weak. As digestion is strengthened, oil intake may be increased. Lassi (blended yogurt drink): nutritious and easily digested, lassi also enhances digestion and aids elimination. Unlike yogurt itself, which is heavy and difficult to digest, lassi is well-tolerated by those with Vata digestion (especially if dilute). There are two types of lassi: sweet and "digestive" (salty). See recipe. Copyright 2009, Maharishi Ayur-Veda Association of America 8.5

6 Mung Dal: made from hulled, split mung beans, mung dal is the most digestible of all legumes. When combined with rice or other grains, it is a good protein source that can be easily digested and assimilated by those with Vata digestion. See recipe. Cooked fruit: easier to digest than raw fruit, it is particularly useful in prevention and treatment of constipation. Stew raisins, dates, figs, apples, pears, peaches, other sweet fruits. Take with breakfast, as afternoon snack, and/or at bedtime. Kanji (rice broth or gruel): especially useful in the beginning stages of treating Vata digestive imbalance, it is easily digested and helps stimulate digestion. See recipe. Other fiber sources (use fiber sources that are not too heavy): soaked or blended seeds (sunflower, pumpkin, sesame, flax), soaked nuts (almonds, walnuts, pecans), green leafy vegetables (avoid raw vegetables if digestion is weak), whole grains. Regimen guidelines: Follow balanced daily routine especially: regular mealtimes main meal at lunch, if possible avoiding over-eating / eating before the previous meal is digested early, regular bedtime (by 10:00-11:00 p.m.), early arising time regular physical exercise, as tolerated regular practice of meditation (Transcendental Meditation) Copyright 2009, Maharishi Ayur-Veda Association of America 8.6

7 Vata Digestion Protocol Part 2: Use of Spices Spices for Vata digestive imbalance = irregular digestion (Vishama Agni) include: ginger, cumin, black pepper, hing (asafoetida), basil, mustard seeds, clove, mint, ajwain (Indian celery seed), nutmeg, paprika, bay leaves, fenugreek, turmeric, salt. How these spices act on the body: Ginger: ginger is a warming spice, predominantly pungent in taste, and Pitta promoting. It is useful in aiding digestion, enhancing appetite, and pacifying Vata in the stomach. It is called Vishwabhisaj ("universal medicine") because of its effect on enhancing digestion. Fresh grated ginger root is preferred for Vata digestive imbalance (the dried powder is preferred for Kapha digestion). Black Pepper: an important healing spice, it has cleansing and antioxidant properties, and is a "bioavailability enhancer" -- it helps transport the benefits of other herbs to the different parts of the body. It helps enhance digestion and circulation and stimulates appetite. Cumin: enhances digestion, is mildly Pitta promoting, and is a detoxifier (helps eliminate ama). Hing (asafoetida): a warming spice, pungent in taste, is somewhat more Pitta promoting than the above spices. It is a good stimulator of appetite and digestion. Basil is used both in its fresh and dried forms. Sweet basil is the type most commonly used in cooking. It is balancing for both Vata and Kapha, and also for Pitta when used in lesser quantities. It is a warming herb, and contributes sweet, bitter and pungent tastes. Mustard seeds (generally the black or brown variety): they are warming and pungent in taste. They are balancing for Vata and Kapha, but increase Pitta dosha somewhat more than the above spices. Mustard seeds are a good digestive and especially good for alleviating gas, bloating, or cramps caused by Vata. Cloves: they are more pungent and hot (Pitta increasing, Vata and Kapha balancing), and can be used in small amounts to enhance circulation, digestion and metabolism and help counter stomach disorders such as gas, bloating, and nausea. Copyright 2009, Maharishi Ayur-Veda Association of America 8.7

8 Fennel: moves Vata downward in the digestive tract (Vata anuloma); carminative (prevents formation of and expels gas), Mint: Spearmint and Peppermint are the most common varieties. Mint is a cooling herb, with a sweet taste and a pungent after-taste. Most varieties are Vata and Kapha pacifying, as well as slightly Pitta pacifying. Mint is good for digestion as well as for respiratory system health. It is found in many Maharishi Ayur-Veda herbal teas. Mint is also extensively used to make digestive lassi and chutneys. How to use these spices: Include a selection of these spices in the daily diet, either in food preparation or added to food after preparation. These spices are common in natural foods cuisine and ethnic cuisine, including Indian, Asian, and Mediterranean cooking. Numerous such cookbooks are available: e.g., Heaven's Banquet, by Miriam Hospadar (Dutton/Plume publishers). Use Vata Spice Mix in meal preparation or added to food after cooking. Prepare your own Personal Smart Spice Recipe (see accompanying instructions in Spices section). Vata Balancing Spice Water Instructions: In 1 quart of water, add the indicated amounts of the following spices: cumin 1 teaspoon, coriander 1 teaspoon, fennel ½ teaspoon, ginger ½ teaspoon. In the case of fennel and coriander, use the whole seed form if available. If not available in whole seed form, use the dry powdered spice. In the case of ginger, use fresh grated ginger root if possible, otherwise use dry ginger powder. Bring the spiced water to a boil, then remove from the flame and allow to steep for 10 minutes. Strain and place the liquid in a thermos. Take frequent sips throughout the day ideally, at least a couple of sips every 30 minutes. You may discontinue sipping the spice water in the evening. Copyright 2009, Maharishi Ayur-Veda Association of America 8.8

9 Vata Digestion Protocol Irregular digestion, gas, bloating, constipation, postprandial discomfort Part 3: Herbal Preparations Traditional herbal compound for Vata Digestive Imbalance: Hingvastak Churna, ½ to 1 teaspoon mixed with a little warm water, followed by a little warm water. Take after meals if main indication is to strengthen agni and reduce ama; take before meals if mostly for carminative effect (to reduce gas and constipation). Individual herbs for Vata digestive imbalance, by category: 1. Digestion stimulating herbs (Agni Deepana): hing (asafoetida), black pepper, long pepper (pippali), cinnamon, cumin, cloves, ginger, mustard seeds, cayenne, garlic. 2. Carminative herbs (Vata anuloma): these herbs move Vata downward in the digestive tract, expelling gas, preventing its formation, and relieving cramps: a. Heating carminatives: hing (asafoetida), basil, Indian celery seeds (ajawan), cardamom, cinnamon, cloves, ginger. b. Cooling carminatives: coriander, cumin, dill, fennel, mint. 3. Laxative herbs (Virechana): a. Stimulant laxative herbs: castor oil, senna, aloe vera, haritaki (terminalia chebula), triphala ("3 fruits": haritaki, amalaki, bibhitaki). b. Moistening/bulking laxative herbs: psyllium seed, flax seed, prunes 1. MAPI herbal compounds for irregular digestion (Vishama Agni): Preparation/Indications Ingredients Actions Directions Herbal Di-Gest (MA 593) First-line preparation for Vata digestive imbalance. Crystal Sugar, Hing (Asafoetida), Black Cumin Seeds, Sweet Pomegranate, Cumin Seeds, Natural Salt, Catkins, Ginger, Cardamom, Black Salt, Black Pepper, Cinnamon, Lemon Digestive stimulant and carminative. Balances Vata, promotes normal downward movement of Vata in the GI tract, dispels gas and prevents its formation, helps relieve intestinal cramps/spasm. Take 1-2 tablets, 2-3 times daily before or after meals. Copyright 2009, Maharishi Ayur-Veda Association of America 8.9

10 MA 685 (herbal powder) Use this preparation if stronger effect is desired. Zingiber officinale, Foeniculum vulgarae, Cassia angustifolia, Terminalia chebula, rock salt, Cuminum cyminum Digestive stimulant, carminative, mildly laxative. Similar in action to Digest-VK 1 (above), though somewhat stronger. Take 1/2 to one teaspoon after meals. May mix the powder with warm water; follow with warm or room temperature water. Take 1-2 tablets 2-3 times a day after meals. May be combined with MA593 for stronger effect: follow directions above for each preparation. MA 154 Switch to this compound if a stronger preparation with more potent laxative effect is needed. May be combined with MA593 (see directions above). Indian sweet fennel, Ginger, Indian Senna, Indian Gallnut, Salt, Cyprea Moneta Similar to the above preparations, but somewhat hotter and stronger in Vata pacifying properties, carminative, and laxative properties. (Not recommended if Pitta is aggravated, e.g., in hyperacidity, GERD, other Pitta disorders.) 2. Additional formula for constipation: Digest-Tone May be used in addition to the above preparations or alone. "Triphala-Plus": Haritaki, Amalaki, Bibhitaki, Cabbage rose. Mild to moderate laxative properties and bowel tonic. It is also a general Rasayana (promoter of strength and immunity). Take 2 tablets at bedtime. May increase to 3-4 tablets as needed. Copyright 2009, Maharishi Ayur-Veda Association of America 8.10

11 3. As digestion improves, add a Rasayana: e.g., Maharishi Amrit Kalash Nectar and/or Ambrosia. Maharishi Amrit Kalash-Nectar (MAK-4) Available as herbal paste or tablet. May add to above regimen as digestion improves. Indian Gooseberry, Indian Gallnut, Cardamom, Cinnamon, Long Pepper (catkins), Thyme-leaved Gratiola (Bacopa monnieri), Cyperus, Nutgrass, White Sandalwood, Aloeweed, Butterfly Pea, Ceylon Ironwood, Licorice, Tumeric. Paste only: Ghee ( Clarified Butter), Whole Cane Sugar, Honey. Traditional health promotion and antiaging formula. Potent anti-oxidant. Take 1 teaspoon paste or 1 tablet around 8 a.m. and 5 p.m. with warm water on empty stomach. Maharishi Amrit Kalash-Ambrosia (MAK-5) Available as herbal tablet. May add to MAK-Nectar to enhance effect. Ashwagandha, Licorice, Finger-leaf Morning Glory, Asparagus Adscendens, Elephant Vine, Amla, Indian Tinospora, Shatavari, Simple-leaf Chaste Tree, Dwarf Morning Glory, Curculigo, Karira, Indian Gum Arabic Tree As above. Take 1 tablet around 8 a.m. and 5 p.m. with warm water on empty stomach. May be taken with MAK- Nectar. Copyright 2009, Maharishi Ayur-Veda Association of America 8.11

12 Pitta Digestion Protocol Part 1: Diet and Regimen Pitta Digestive Imbalance (Tiksna Agni) may manifest as epigastric burning ("heartburn"), gastroesophageal reflux (GERD), very strong hunger, intolerance of spicy foods, tendency toward diarrhea or irritable bowel. Diet guidelines: Start with Light Pitta Diet (see Pitta Diet section: Pitta Comprehensive Purification Diet ). If Ama is significant, apply Ama reducing measures, as described in Digestion Protocols General Points. As digestion improves, advance to regular Pitta Diet as tolerated. See Pitta Diet section: Eat Your Way to Balance-Pitta. Favor: well-cooked, mildly spiced, warm, fresh and freshly prepared foods. Avoid: Spicy Foods Sour foods, acidic foods, fermented foods: including sour citrus, vinegar, yeast, ketchup, pickles, commercial salad dressing, coffee, tea (black and green) soy sauce, kefir, yogurt (exception: sweet lassi is OK; see recipe). Alcoholic beverages Aged foods, including aged cheese Fried foods Frozen foods, raw vegetables, canned food, oily food leftover food, packaged or processed foods, nut butters cold foods and drinks, carbonated beverages Red meat Favor: well-cooked, mildly spiced, warm, fresh and freshly prepared foods. Breakfast: cooked or stewed fruit (not raw fruit), milky grains or porridge, flat breads (toasted tortilla or chapatti), date-shake, soaked almonds or walnuts (small quantity), ghee (if no lipid problem), rose petal preserve. If hyperacidity is experienced, between meals: sip warm milk with 1-2 teaspoons of rose petal preserve or 2 teaspoons rose water per cup. (For symptoms occurring at night, keep this mixture in a thermos at bedside and sip during the night). Copyright 2009, Maharishi Ayur-Veda Association of America 8.12

13 Afternoon snack: Do not leave the stomach empty for prolonged periods. Try soaked almonds, toast or flat bread with ghee or olive oil or rose petal preserve, warm milk, or fresh vegetable juice (selected from the favor section of the Pitta Pacifying Diet). Sip Kanji between meals or at any time (see Kanji recipe: Kanji is Pittapacifying). Behavioral Guidelines for Pitta digestive imbalance: sharp digestion (Tikshna Agni) Regular mealtimes Main meal at lunch if possible Avoiding over-eating / eating before the previous meal is fully digested / eating too quickly / frequent traveling Early, regular bedtime (by 10:00 11:00 PM), early arising time Regular physical exercise Stress management (Transcendental Meditation technique) Eat in a settled atmosphere with pleasant conversation. Avoid in-depth discussions, doing business and emotional issues during the meal Rest for 5 minutes after meals Eat sitting down with attention on the food. Avoid eating while standing, walking, driving, reading, talking on the phone, in front of a computer or television, etc. Eat mainly at home cooked meals and limit restaurant / take out meal Special foods for Pita digestive imbalance: sharp digestion (Tikshna Agni) (see accompanying recipe/hand-outs) Ghee (clarified butter): it has a particular effect in pacifying Pitta, at the same time balancing Agni (digestion). It s a Rasayana (rejuvenator, enhancer of immunity). Use with caution if history of hyper-lipiedemia. (Ghee may be purchased already prepared, or may be freshly prepared from organic butter: see recipe). Juicy sweet fruits: These are particularly good, especially melons. Coconut is especially Pitta-pacifying. Other sweet fruits are also good, including apple, pear, sweet peaches (not sour/unripe) raisins, figs & dates. Cooked fruit: Easier to digest than raw fruit. Stew raisins, dates, figs, apples, pears, apricots, and other sweet fruit. Take with breakfast, as an afternoon snack and/or bedtime. Lassi (Blended yogurt drink): take sweet lassi only (not spicy or salty lassi). Unlike yogurt itself, which is heavy and difficult to digest, lassi is easily digested (see recipe). Copyright 2009, Maharishi Ayur-Veda Association of America 8.13

14 Rose Petal Preserve (jam): the fragrance and taste of rose is especially Pittapacifying (available form Maharishi Ayurveda Products international). May be used to make sweet lassi (above). Mung Dal: made from hulled, split mung beans, mung dal is the most digestive of all legumes (see recipe). Kanji (rice broth or gruel): it is Pitta-pacifying, nourishing and easily digested. When sipped between meals, it helps prevent hyperacidity (see recipe). Raw sugar: it is the favored sweetener for Pitta (in moderation), because of its cooling property (as opposed to honey or molasses). Aloe Vera juice: it is cooling and mildly laxative. May take ¼ to ½ cup after lunch and supper. Copyright 2009, Maharishi Ayur-Veda Association of America 8.14

15 Pitta Digestion Protocol Part 2: Use of Spices Spices for Pitta digestive imbalance (Tikshna Agni) include: coriander, fennel, cardamom, turmeric, parsley, cilantro, saffron, sweet basil, rosemary, mint. How these spices act on the body: Coriander is a tridoshic spice highly appreciated in Ayurveda. It is a cooling spice and contributes sweet and astringent tastes. Ayurvedic texts suggest that it is good for digestion, whets the appetite, helps combat allergies and also helps purify the blood. Fennel enhances Agni without aggravating Pitta. It promotes normal peristaltic movement through the digestive system. Turmeric is one of the most prized spices and is ubiquitous in Ayurvedic cooking. It contains the flavanoid curcumin, which has anti-inflammatory, anti-oxidant and immunomodulating properties. It is a cooling spice and is thus balancing for Pitta. It is predominantly bitter and astringent in taste. In Ayurveda it is considered a blood purifier that helps detoxify the liver, boost immunity, balance blood glucose and lipids, modulate allergies, and enhance the complexion. Cinnamon stimulates digestion. In small quantities, it is soothing to the stomach without aggravating Pitta. Cilantro consists of the fresh leaves of the coriander plant. Its actions are similar to coriander (above). Saffron is considered tridoshic: balancing for all 3 doshas. It helps promote assimilation of nutrients and formation of bodily tissues (dhatus), as well as to eliminate toxins from the tissues. Basil is used both in its fresh and dried forms. Sweet basil is the type most commonly used in cooking; it is balancing for Vata and Kapha and for Pitta when used in lesser quantities. It is a mildy warming herb. Mint: Spearmint and Peppermint are the most common varieties. Mint is a cooling herb, with a sweet taste and a pungent after-taste. Most varieties are Vata and Kapha pacifying, as well as slightly Pitta pacifying. Mint is good for digestion as well as for respiratory system health. It is found in many Maharishi Ayur-Veda herbal teas. Mint is also extensively used to make digestive lassi and chutneys. Copyright 2009, Maharishi Ayur-Veda Association of America 8.15

16 How to use these spices: Include a selection of these spices in the daily diet, either in food preparation or added to food after preparation. These spices are common in natural foods cuisine and ethnic cuisine, including Indian, Asian, and Mediterranean cooking. Numerous such cookbooks are available: e.g., Heaven's Banquet, by Miriam Hospadar (Dutton/Plume publishers). Use Pitta Spice Mix in meal preparation or added to food after cooking. Prepare your own Personal Smart Spice Recipe (see accompanying instructions in Spices section). Pitta Balancing Spice Water Instructions: In 1 quart of water, add the indicated amounts of the following spices: cumin ½ teaspoon, coriander 1 teaspoon, fennel 1 teaspoon, turmeric ½ teaspoon. In the case of cumin, fennel and coriander, use the whole seed form if available. If not available in whole seed form, use the dry powdered spice. Bring the spiced water to a boil, then remove from the flame and allow to steep for 10 minutes, then strain. Allow the spiced water to cool until it is warm but not hot, then place the liquid in a thermos. Take frequent sips throughout the day ideally, at least a couple of sips every 30 minutes. You may discontinue sipping the spice water in the evening. Copyright 2009, Maharishi Ayur-Veda Association of America 8.16

17 Pitta Digestion Protocol Part 3: Herbal Preparations Tiksna Agni may manifest as epigastric burning ("heartburn"), gastroesophageal reflux (GERD), very strong hunger, intolerance of spicy foods, tendency toward diarrhea or irritable bowel. Traditional herbal compounds: Avipattikar Churna: preferred compound for Pitta digestive imbalance if bowel movements are normal to hard. It is ama-pachana and has a mild laxative effect. Dose: ½ to 1 teaspoon mixed with a little warm water, followed by a little warm water. Take before meals if main indication is to balance Tiksna Agni and/or reduce ama; take after meals if main indication is antacid effect. Dadimastak Churna: preferred compound for Pitta digestive imbalance if bowel movements are loose or diarrhea. It has a binding effect. Dose: ½ to 1 teaspoon mixed with a little warm water, followed by a little warm water, before or after meals. Individual herbs for Pitta digestive imbalance (Tiksna Agni): Fennel, often combined with cumin and coriander ("3 cooling spices") Turmeric: bitter and astringent tastes pacify Pitta, reduce inflammation Licorice: demulcent (moistening), cooling herb Aloe vera: cooling and laxative (both actions reduce Pitta) Shatavari (Indian asparagus root): demulcent and cooling Amalaki (Indian gooseberry): cooling rasayana for Pitta Turpeth root: bitter/astringent, mild laxative properties (compounded with other herbs) Pearl oyster shell, red coral, conch shell (turbinella rapa): natural antacids containing sodium carbonate 1. MAPI Herbal compounds for sharp digestion (Tikshna Agni): Preparation/Indications Actions Ingredients Directions Aci-Balance or (MA 320) First-line preparation for Pitta digestive imbalance. Balances and pacifies Pitta, and promotes normal downward movement of Vata in the gastrointestinal tract. Cooling, antiinflammatory, demulcent; helps relieve intestinal cramps/spasm. Crystal Sugar, Indian Gooseberry, Licorice, Turpeth, Salt, Ammonia Crystal, Alumin, Sodium Carbonate, Clove, Ginger, Black Pepper, Catkins, Indian Galllnut, Bedda Nut, Nut Grass, Butterfly Take 1-2 tablets, 2-3 times daily after meals (up to 6 tablets daily). Copyright 2009, Maharishi Ayur-Veda Association of America 8.17

18 Pea, Cardamom, Chinese Cinnamon MA 323, herbal paste Add to MA 320 (above) for stronger effect. Cooling, antiinflammatory, demulcent. Also helps balance Vata in the nervous system (calming). Augments the effect of MA 320 above. Best for those with strong agni. Avoid if overweight or in high ama conditions. Indian Gooseberry, White Gourd Melon, Ghee, Sugar, Chinese Cinnamon, Cardamom, Cinnamon, Cobra's Saffron, Bamboo, Syzgium Asomaticum, Nutmeg, Saffron. Take 1-2 teaspoons at bedtime, followed by warm milk or water. 2. As digestion improves, add a Rasayana (herbal preparation for general health promotion and rejuvenation): Maharishi Amrit Kalash-Nectar (MAK-4) Available as herbal paste or tablet. May add to above regimen as digestion improves. Maharishi Amrit Kalash-Ambrosia (MAK-5) Available as herbal tablet. May add to MAK-Nectar to enhance effect. Traditional health promotion and antiaging formula. Potent anti-oxidant. As above. Take 1 teaspoon paste or 1 tablet around 8 a.m. and 5 p.m. with warm water on empty stomach. Take 1 tablet around 8 a.m. and 5 p.m. with warm water on empty stomach. May be taken with MAK- Nectar. Copyright 2009, Maharishi Ayur-Veda Association of America 8.18

19 Kapha Digestion Protocol Part 1: Diet and Regimen Kapha digestive imbalance will generally manifest as: sluggish/slow digestion and post-prandial heaviness (on a regular basis), post-prandial fatigue, small food capacity, overweight and difficulty losing weight despite small food intake. Note: If Ama is a significant feature, digestion will often appear to be Kapha-type (Manda Agni), even if the underlying dosha imbalance is Vata or (less often) Pitta. Copyright 2009, Maharishi Ayur-Veda Association of America 8.19

20 Dietary guidelines for Kapha digestive imbalance: dull digestion (Manda Agni): Recommend Kapha Pacifying Diet. Alternatively, if Ama is a significant feature, start instead with the Vata, Pitta, or Kapha Comprehensive Purification Diet, depending upon the underlying dosha imbalance (these diets are located in the respective dosha diet sections). Also apply Ama reducing measures, as described in Digestion Protocols General Points. If there is a concern about Pitta aggravation (e.g., Pitta digestive symptoms, such as acid-reflux, co-exist with Kapha symptoms), you may add Pitta Diet Restrictions (see Pitta Diet section). Avoid: large quantity of food; heavy foods such as cheese, frozen food, raw vegetables, red meat, seafood, yogurt, canned food, leftover food, packaged or processed foods, aged or fermented foods, nut butters, cold foods and drinks, carbonated beverages. Avoid greasy, fried or oily foods and refined carbohydrates. Avoid cold drinks and frozen desserts (such as ice cream, frozen yogurt, etc.) Avoid sugar, sweets, salty, rich and creamy foods. Favor: lighter foods; well-cooked, moderately spiced, warm, fresh and freshly prepared foods. Eat home-cooked, organic food as much as possible. Avoid eating frequently in restaurants Favor hot or warm beverages and food. Favor dry, light, non-oily and crunchy foods. Favor pungent (hot, spicy), bitter and astringent tastes. Substitute legumes for cheese, meats and non-vegetarian foods in your daily diet. Favor light whole grains such as barley, millet, quinoa, couscous, and Amaranth for rice, wheat and any refined grains and flours. Behavioral guidelines for Kapha digestive imbalance: dull digestion (Manda Agni): Eat the main meal at lunchtime. Eat a lighter, vegetarian evening meal without cheese, yogurt or other curdled products. Avoiding over-eating. Eat smaller portions. Copyright 2009, Maharishi Ayur-Veda Association of America 8.20

21 Eat according to true hunger. Avoid eating before the previous meal is digested. Regular mealtimes Get up by 6:00 a.m. and avoid daytime sleep. Regular physical exercise (moderately vigorous) Stress management (Transcendental Meditation technique) Sit and relax for 5-10 minutes after meals Avoid eating while standing, walking, driving Weekly liquid diet: consider once-a-week liquid diet to strengthen digestion (Agni) and remove impurities (Ama). May include hot water, herbal teas, fruit juices (room temperature), low-fat or diluted milk (boiled, taken warm or at room temperature), lassi, kanji, and barley water. Special foods for Kapha digestive imbalance: dull digestion (Manda Agni) (see accompanying recipes/hand-outs): Digestive (spicy) lassi (blended yogurt drink): it enhances digestion and aids elimination. Unlike yogurt itself, which is heavy and difficult to digest, digestive lassi is well-tolerated by those with Kapha digestion (especially if dilute, e.g., 1:4 to 1:6 dilution). See recipe. Mung Dal: made from hulled, split mung beans, mung dal is the most digestible of all legumes. When combined with barley, millet, quinoa or other grains, it is a good protein source that can be easily digested and assimilated by those with Kapha digestion. See recipe. Cooked fruit: easier to digest than raw fruit, it is particularly useful in prevention and treatment of Manda Agni. Stew raisins, apples and/or pears. Take with breakfast, as afternoon snack, and/or at bedtime. For breakfast, cooked fruit stimulates agni and helps prepare the digestive tract for lunch. Especially important to have if not hungry in the morning-- a sign of Manda Agni. Copyright 2009, Maharishi Ayur-Veda Association of America 8.21

22 Barley water (barley broth or gruel): especially useful in the beginning stages of treating Kapha digestive imbalance, e.g., during an initial detoxification program for Ama condition. It is easily digested and helps stimulate digestion. It is also diuretic and promotes weight loss. See recipe. Ginger pickle (grated fresh ginger, lemon juice, and salt).. Lemon-honey water (taken in the morning on an empty stomach): lemon juice and honey mixed in lukewarm water. Hot water: freshly boiled water, placed in a thermos in the morning and sipped frequently throughout the day (to cleanse the body tissues and prevent the accumulation of wastes and toxins). Copyright 2009, Maharishi Ayur-Veda Association of America 8.22

23 Kapha Digestion Protocol Part 2: Use of Spices Spices for Kapha digestive imbalance, dull digestion (Manda Agni) include: ginger, black pepper, coriander, turmeric, cinnamon, clove, Indian celery seed (ajawan), mustard seed, mint, paprika, basil, fenugreek. These spices are natural medicinals that have the property of kindling the digestive fire (Agni deepana) and at the same time digesting and removing Ama (Ama pachana). How these spices act on the body: Ginger: dried ground ginger is a warming spice, predominantly pungent in taste, and Pitta promoting. It is useful in aiding digestion, enhancing appetite, and pacifying Vata and Kapha in the stomach. It is called Vishwabhisaj ("universal medicine") because of its effect on enhancing digestion. Black Pepper: an important healing spice, it has cleansing and antioxidant properties, and is a "bioavailability enhancer" -- it helps transport the benefits of other herbs to the different parts of the body. It helps enhance digestion and circulation and stimulates appetite. Turmeric is one of the most prized spices and is ubiquitous in Ayurvedic cooking. It is balancing for both Pitta and Kapha and helps remove Ama. It is predominantly bitter and astringent in taste. In Ayurveda it is considered a blood purifier that helps detoxify the liver, boost immunity, balance blood lipids, modulate allergies, and enhance the complexion. Cinnamon stimulates digestion. In small to moderate quantities, it enhances agni and removes Ama without aggravating Pitta. Mustard seeds (generally the black or brown variety): they are warming and pungent in taste. They are balancing for Vata and Kapha, but increase Pitta dosha somewhat more than the above spices. Mustard seeds are a good digestive and especially good for alleviating manda agni and Ama. Copyright 2009, Maharishi Ayur-Veda Association of America 8.23

24 Cloves: they are more pungent and hot (Pitta increasing, Vata and Kapha balancing), and can be used in small amounts to help counter digestive disorders including manda agni. Mint: Spearmint and Peppermint are the most common varieties. Most varieties are Vata and Kapha pacifying, as well as slightly Pitta pacifying. Mint is good for digestion as well as for respiratory system health. It is found in many Maharishi Ayur-Veda herbal teas. Mint is also extensively used to make digestive lassi and chutneys. Sweet paprika lends aroma and flavor without the "hot" fieriness of cayenne or hot paprika. Paprika is a warming spice, and predominantly contributes pungent taste. It pacifies kapha and vata and increases pitta. Paprika and cayenne have antioxidant properties and are used to enhance circulation. Basil is used both in its fresh and dried forms. Sweet basil is the type most commonly used in cooking. It is balancing for both Vata and Kapha, and also for Pitta when used in lesser quantities. It is a warming herb, and contributes sweet, bitter and pungent tastes. Indian celery seed (ajawan): used in small quantities in cooking, it is a potent digestive enhancer, pacifies both Vata and Kapha, and helps remove Ama. Fenugreek seed: it is bitter and pungent and has a particularly potent Kaphapacifying effect. Acts as a digestive stimulant, as well as on other systems (respiratory, endocrine, urinary). How to use these spices: Include a selection of these spices in the daily diet, either in food preparation or added to food after preparation. These spices are common in natural foods cuisine and ethnic cuisine, including Indian, Asian, and Mediterranean cooking. Numerous such cookbooks are available: e.g., Heaven's Banquet, by Miriam Hospadar (Dutton/Plume publishers). Use Kapha Spice Mix in meal preparation or added to food after cooking. Prepare your own Personal Smart Spice Recipe (see accompanying instructions in Spices section). Copyright 2009, Maharishi Ayur-Veda Association of America 8.24

25 Kapha Balancing Spice Water Instructions: In 1 quart of water, add the indicated amounts of the following spices: cumin 1 teaspoon, coriander 1 teaspoon, fennel ½ teaspoon, ginger 1 teaspoon. In the case of cumin, fennel and coriander, use the whole seed form if available. If not available in whole seed form, use the dry powdered spice. In the case of ginger, use fresh grated ginger root if possible, otherwise use dry ginger powder. Bring the spiced water to a boil, then remove from the flame and allow to steep for 10 minutes. Strain and place the liquid in a thermos. Take frequent sips throughout the day ideally, at least a couple of sips every 30 minutes. You may discontinue sipping the spice water in the evening. Copyright 2009, Maharishi Ayur-Veda Association of America 8.25

26 Kapha Digestion Protocol Part 3: Herbal Preparations Symptoms of Kapha digestive generally include: sluggish/slow digestion and postprandial heaviness and fatigue (on a regular basis), small food capacity, overweight, and difficulty losing weight despite small food intake. If Ama* is a significant feature, include Ama-reducing measures (Ama-pachana): Sip hot water frequently throughout the day Digestive decoction (see recipe below): not recommended if Pitta is predominant. May be substituted for or alternated with hot water. Lemon-honey water in the morning Use of digestive spices, Kapha spice mix Ginger-lemon pickle before meals Light dosha diet Once a week liquid diet (especially for Kapha Prakriti) * For symptoms of Ama, see the Ama Questionnaire for patients. Traditional herbal compound for Kapha Digestive Imbalance: Trikatu (the 3 Pungents ): take ½ to 1 teaspoon mixed with a little warm water or honey, followed by a little warm water, after meals. For more intensive effect, Hingvastak Churna ½ to 1 teaspoon may be added before meals (see Vata Digestive Imbalance). Individual herbs for Kapha digestive imbalance (Manda Agni): all heating digestive stimulant (Agni deepana) herbs, including: Ginger: the dried powder is best for Kapha digestion (the fresh grated root is better for Vata) Pippali (long pepper, piper longum): pungent and heating, it is also a rasayana. Black pepper: with ginger and pippali, above, these 3 pungent spices mixed together constitute "Trikatu" ("3 pungents"), a potent digestive stimulant which also digests Ama (Ama pachana). Others, including ajawan (Indian celery seed), hing (asafoetida), cayenne pepper, cloves, etc. (See Use of Spices, Chart 3 for Kapha Digestive Imbalance.) Copyright 2009, Maharishi Ayur-Veda Association of America 8.26

27 1. MAPI Herbal compounds for dull digestion (Manda Agni): Preparation/Indications Actions Ingredients Directions MA 154 MA 685 (herbal powder) Add this preparation if stronger effect is desired. Heating property stimulates agni and digests ama. Promotes normal downward movement of Vata. (Not recommended if Pitta is aggravated, e.g., in hyperacidity, GERD, other Pitta disorders.) Similar in action to Digest-VK 3 (MA 154), though somewhat milder. When used together, these preparations act synergistically. Indian sweet fennel, Ginger, Indian Senna, Indian Gallnut, Salt, Cyprea Moneta Zingiber officinale, Foeniculum vulgarae, Cassia angustifolia, Terminalia chebula, rock salt, Cuminum cyminum Take 1-2 tablets 2-3 times a day after meals. Take one-half to one teaspoon before meals. May mix the powder with warm water; follow with warm or room temperature water. Digest-Tone Promotes downward flow of Vata, elimination of ama. "Triphala-Plus": Haritaki, Amalaki, Bibhitaki, Cabbage rose. Take 2 tablets at bedtime. If constipated, may increase to 3-4 tablets. Copyright 2009, Maharishi Ayur-Veda Association of America 8.27

28 2. As digestion improves, add a Rasayana (herbal preparation for general health promotion and rejuvenation): Maharishi Amrit Kalash-Nectar (MAK-4) Available as herbal paste or tablet. May add to above regimen as digestion improves. Indian Gooseberry, Indian Gallnut, Cardamom, Cinnamon, Long Pepper (catkins), Thyme-leaved Gratiola (Bacopa monnieri), Cyperus, Nutgrass, White Sandalwood, Aloeweed, Butterfly Pea, Ceylon Ironwood, Licorice, Tumeric. Paste only: Ghee ( Clarified Butter), Whole Cane Sugar, Honey. Traditional health promotion and antiaging formula. Potent anti-oxidant. Take 1 teaspoon paste or 1 tablet around 8 a.m. and 5 p.m. with warm water on empty stomach. Maharishi Amrit Kalash-Ambrosia (MAK-5) Available as herbal tablet. May add to MAK-Nectar to enhance effect. Ashwagandha, Licorice, Finger-leaf Morning Glory, Asparagus Adscendens, Elephant Vine, Amla, Indian Tinospora, Shatavari, Simple-leaf Chaste Tree, Dwarf Morning Glory, Curculigo, Karira, Indian Gum Arabic Tree As above. Take 1 tablet around 8 a.m. and 5 p.m. with warm water on empty stomach. May be taken with MAK- Nectar. Copyright 2009, Maharishi Ayur-Veda Association of America 8.28

29 Digestive Imbalance: Summary of Main Points of Management If Digestion is weak and/or Ama is significant, begin with: o Light Dosha Diet (Comprehensive Purification Diets, located in the respective Dosha diet sections). o Continue until digestion and/or Ama condition improves (e.g., 3 to 8 weeks), then switch to Regular Diet (either General Diet or Regular Dosha diet, located in the respective Dosha diet sections). Use digestive spices or commercially prepared Vata, Pitta, or Kapha Churnas at meals. Also may use Digestive Spice Waters. (See Spice and Spice Water handouts in the Dosha diet sections.) Apply Ama-reducing measures as described in Digestion Protocols General Points, Page 8.3. These include hot water routine, ginger pickle before meals, lemon-honey water in morning, periodic liquid diet, etc. Follow General Principles Regarding Diet, located in General Diet section, pp Enhancing Digestion and Removing Ama (Agni Deepana and Ama Pachana) Additional Points Follow diet plan and other points, as above Add supplemental diet and regimen points contained in Vata, Pitta, and Kapha Digestion Protocols (Part 1: Diet and Regimen) Use digestive herbal compounds, per dosha digestive imbalance (described in Vata, Pitta, and Kapha Digestion Protocols, Part 3: Herbal Protocols): Generic compounds: o Vata: Hingvastak Churna o Pitta: Avipattikar Churna (if bowel movements are normal to hard) or Dadimastak Churna (if bowel movements are loose) o Kapha: Trikatu Churna (+ Hingvastak Churna for more intensive effect) MAPI formulas: o Vata: Herbal Digest/MA 593 or MA 685 (stronger; only in powder form) or MA 154 (strongest, most laxative) + Digest-Tone at bedtime. o Pitta: Aci-Balance/MA MA 323 at bedtime o Kapha: MA 154 (may supplement with MA 685) + Digest-Tone at bedtime Detoxification: the above measures stimulate digestion (Agni-deepana) are digestive of Ama (Ama-pachana). Direct detoxification of Ama may also be recommended for certain clients after initial phase of Ama-pachana has resulted in improvement of Copyright 2009, Maharishi Ayur-Veda Association of America 8.29

30 Ama condition (generally after 4 to 8 weeks). See Home Herbal Cleansing Program in Treatment Forms section. More intensive detoxification with Panchakarma modalities may also be recommended for certain clients: to be covered in future Modules. Follow-up phase: as digestion improves and Ama condition ameliorates: o Reduce digestive herbs and Ama-pachana measures and introduce Rasayana preparations (e.g., Maharishi Amrit Kalash) or herbs for other specific imbalances, as appropriate. o Once digestion is normalized, digestive herbs may be discontinued; however, if digestive imbalance persists, continue at least one digestive preparation along with other imbalance-specific herbs. o May also continue hot water routine and/or Dosha Spice Waters, as above, as well as additional procedures for elimination of Ama (e.g., ginger pickle, lemon-honey water, periodic liquid diet) as indicated. Copyright 2009, Maharishi Ayur-Veda Association of America 8.30

31 SUMMARY OF HERBAL COMPOUNDS CITED IN THE DIGESTION PROTOCOLS Preparation Herbal Di-Gest/ MA 593 MA 685 MA 154 Aci-Balance/ MA 320 Digest-Tone MA 323 Action Principal (mildest) preparation for Vata digestive imbalance Somewhat stronger (hotter) preparation for both Vata and Kapha digestive imbalance. An herbal powder: consider whether client will be compliant. Third level strength (hottest) for Vata and Kapha digestive imbalance. Principal preparation for Kapha digestive disturbance. Particularly useful for gas and constipation (laxative effect). Principal preparation for Pitta digestive disturbance, including Ama-pachana in Pitta-predominance. Basic preparation for detoxification and promotion of normal elimination, for all doshas (esp. Vata and Kapha). Preparation for Pitta digestive disturbance; supplements the effect of MA 320, taken at bedtime. Copyright 2009, Maharishi Ayur-Veda Association of America 8.31

32 Brief Diagnosis and Treatment of Digestive Imbalances Vata, Pitta, Kapha Flow Chart Level One, Block 1 P I T T A K A P H A V A T A Heartburn or any burning sensations* Sour/acidic stomach or reflux* Ravenous hunger Can eat anything Tendency for loose stools Total Pitta Evaluation Heavy feeling after eating (on a regular basis)* Food just sits there in stomach Sleepy after eating Can easily skip a meal Regular, well-formed daily bowel movements Total Kapha Evaluation Variable Digestive Symptoms* Gas and bloating Belching Variable hunger Constipation tendency Total Vata Evaluation 1. Drink 6-8 cups of room temperature spring water during each day. 2. Drink ¼ cup aloe vera juice after lunch and dinner 3. Favor watery vegetables and sweet juicy fruits like zucchini, summer squash, melons, pears, apples, coconut, red/black grapes 4. Avoid hot spices, alcohol, caffeine, vinegar, citrus, acidic foods, deep fried foods, fast foods, salty foods 5. Digest-P 1 (MA 320), Digest-P 2 (MA 323) 1. Sip boiled, hot spring water throughout the day, a few sips at a time. 2. Eat a slice of fresh ginger root dashed with a pinch of salt and a squeeze of lemon before lunch and dinner. 3. Favor green leafy vegetables, cruciferous vegetables(broccoli, cauliflower), legumes, nuts, seeds, barley and warm, well-spiced food in general. 4. Avoid cold foods and drinks, sugar and white flour, creamy rich food, cheese, red meat, bread, other starchy foods. 5. Digest-VK 3 (MA 154), Digest-VK 2 (MA 685) 1. Sip boiled, hot water about every ½ hr throughout the day 2. Chew on ¼ tsp. of baked fennel seeds after meals. 3. Favor warm, cooked foods 4. Avoid cold foods and drinks, carbonation, caffeine, dry and crunchy foods, salads, raw veg s 5. Digest-VK 1 (Herbal Di-Gest, MA 593), Digest-VK 3 (MA 154) * Defining symptom Copyright 2009, Maharishi Ayur-Veda Association of America 8.32

33 Maharishi Ayurveda Training Program Clinical Workshop, Module 1 Sequence of approach to the client: 1. Initial pulse reading 2. Review intake forms: a. Initial Client Questionnaire b. Digestion Assessment c. Ama Questionnaire (General Health Survey). d. Note key areas such as chief complaints; past medical history; medications; diet history, digestion status, elimination status, sleep status, daily routine, mental-emotional status, and environment. 3. Prakriti evaluation: observation/palpation/questioning. (Use Brief Prakriti Assessment form.) 4. Digestion (use Digestion questionnaire): Assess digestive type: Sama, Vishama, Tiksna, Manda 5. Ama evaluation (by pulse, tongue, and Ama questionnaire): 0, 1+, 2+, or Identify causative factors that need to be corrected, such as: a. Dietary factors: suitable/unsuitable items b. Behavior and Routine: suitable/unsuitable factors c. Other factors: e.g., environmental 7. Repeat pulse assessment Write-up of client: 1. Prakriti: your working assessment from Brief Praktiti Assessment form 2. Vikriti (imbalance): identify the following (from your 3-fold evaluation + pulse assessment): a. predominant Dosha(s) at the basis of the imbalance b. state of Agni (digestion): Sama, Vishama, Tikshna, Manda c. state of elimination (bowel function): regular/irregular, frequent, normally formed, hard, loose Copyright, Maharishi Ayurveda Association of America, 2012 Copyright 2009, Maharishi Ayur-Veda Association of America 8.33

34 d. quality of sleep: sound/adequate, interrupted, delayed, early awakening e. presence and degree of Ama: 0, 1+, 2+, 3+ f. other pertinent factors, if present 3. Causative factors identified (to be corrected) a. Diet b. Behavior and Routine c. Other (e.g., environment) Therapeutic Plan: Consider: 1. Dietary recommendations: consider General Diet, Regular Dosha diet, Light Dosha diet (Comprehensive Purification Diets), specific foods to include or avoid 2. Procedures to eliminate Ama? (Hot water routine, spice waters, ginger-lemon pickle, lemon-honey water, periodic liquid diet, home cleanse, etc.) 3. Behavioral recommendations: a. Daily routine; lifestyle b. Behaviors to include or avoid c. Causative factors to be removed 4. Herbal preparations: see Digestion Protocols for each Dosha (summarized in Digestive Imbalance: Summary of Main Points of Management ) 5. Multimodality recommendations: a. Transcendental Meditation technique, stress-reduction b. Exercise/degree of strenuousness: Yoga asanas, brisk walking, etc. c. Physiological purification (Panchakarma) d. Maharishi Vedic Vibration Technology e. Aroma therapy f. Gandharva Veda music therapy g. Environmental approach: Sthapatya Veda (Vastu vidya) h. Cosmic cycles: Maharishi Jyotish and Yagya Copyright, Maharishi Ayurveda Association of America, 2012 Copyright 2009, Maharishi Ayur-Veda Association of America 8.34