Ayurvedic Diagnosis and Therapy - SAI Swiss … · IN COLLABORATION WITH Ayurvedic Diagnosis and...

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Ayurvedic Diagnosis and Therapy

Dr. Harsha GrammingerLugano, 4th-6th September 2015

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Content Page / s

Qualities of the 5 elements 2-3

Roga Pariksha – Ayurveda-Diagnostics 4

Dasavidhya Pariksha – Charaka´s 10 point diagnostic 5

Tongue diagnosis (Jihva) 6-9

Finger Nail diagnosis 10

Face diagnosis 11

Lip diagnosis 12

Eye diagnosis 13-15

The 5 elements of the hand 16

The Three Basic Gatis of Nadi 17

Examples of Gati and their conditions 18

Where the different organ pulses are situated 19

Urine examination 20

Ayurvedic healing – 8 points program 21

Location of Vata, Pitta and Kapha 22

Appearing dysfunctions of the different doshas and their treatment (Shamana)

Vata imbalance 23

Pitta imbalance 24

Kapha imbalance 25

Mixed constitutions

Vata-Pitta-/Pitta-Vata imbalances 26

Pitta-Kapha-/Kapha-Pitta imbalances 27

Vata-Kapha-/Kapha-Vata imbalances 28

Vata-Pitta-Kapha imbalances 29

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The qualities of the 5 elements are as follows:1. Ether:

Light, smooth, soft, in – active, clear, small, neither cold nor hot, no movement, no taste

Sense organ: Ear, Sense: To hear

Body: In all hollows of the body

Food: e.g. popcorn

2. Air:

Light, rough, clear, tiny, cold, active, centrifugally, movement

Sense: Sense of touch

Organ: Skin

Body: Physical activity, pulsation, inhalation, exhalation

Food: e.g. smoke, gaseous substances

3. Fire:

Light, rough, sharp, clear, tiny, atomic, dry, hot, shining brightly, active

Organ: Eyes

Sense: To see

Movement: Upwards

Taste: Hot, slightly sour, and salty

Body: Heat and gloss

Food: e.g. Pepper, Onion, Garlic, Ginger

4. Water:

Heavy, liquid, soft, not active, mucous, tense, big molecules, flowing, cold, wet, moist

Sense organ: Tongue

Sense: To taste

Movement: Downwards

Taste: Mainly sweet, slightly astringent, salty, sour

Body: All body fluids

Food: e.g. Zucchini, fresh fruits

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5. Earth

Heavy, rough, hard, slow, inactive, constant, clear, tense, big, bumped, not hot and not

cold

Sense organ: Nose

Sense: To smell

Body: Nose and all solid substances as nails, bones, hair, sinews, teeth, muscles, skind,

medulla

Food: e.g. Rice, wheat, minerals, carrots, beans, asparagus

It is said, that all matter is combined of these elements, but always in different composition.

So what is t he difference between matter and creature regarding the composition?Following the teaching of the "Panchamahabut", which means the 5 elements, creatures andmatter is simply distinguished by their souls.

1.1 Panchamahabut

+ Soul

Ether

Air

Vata

Fire

Water

Pitta

Earth

Kapha

Responsible for movement and nerve impulses

For Enzymes and metabolism

For body structure and stability

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ROGA PARIKSHAAyurveda Diagnostic

Diagnosis starts with

1. Darshana – Observation of the patientBrilliance of eyes, proportions, sick or healthy look

2. Sparshana – clinical examinationPalpation – condition of skin and tissues, does it feel cold, rough, smooth, auscultation of heart,lungs, intestine, percussion of heart, lung, liver, spleen

3. Preshna – anamnesis, interrogation of the patient

Main troubles History of actual disease prehistory Family anamnesis Social anamnesis

4. Pulse diagnosis

For a further in – depth anamnesis of Prakruti – the physically inheritatedconstitution and Vikruti – the actual condition of either health or illness or ratherorgan pulse diagnosis

5. Tongue diagnosis6. Fingernail diagnosis7. Eye diagnosis8. Lip diagnosis9. Face diagnosis10. Examination of urine11. Examination of stool

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Dasavidhya ParikshaCharaka's 10 point diagnosis

In pursuance of Charaka vigorousness of the patient as well as of the illness maybe determined by the 10 point diagnosis

1. Determination of the Prakruti - constitutionWith the aid of pulse diagnosis, survey, examination and anamnesis feasible.Tells a lot about the nature of the patient and determines essentially nutrition andlifestyle of the patient.

2. Determination of the Vikruti - conditionQuickest way of determination with the aid of pulse diagnosis. Informs about theactual status of illness and which dosha is out of balance for the moment. Thevikruti defines substantially the therapy approach.

3. Evaluation of tissue's vitality - SaraAll 7 tissues should be evaluated, e.g. Astidhatu and the condition of thefingernails.

4. Evaluation of the body composition - SamhanaThrough this one can easily make a statement regarding the strength of thepatient. How compact is e.g. the bone structure, are shoulder and hips symmetric,is the body muscular ... etc.

5. Determination of body measurements - PramanaThe question is here, if the body is well – proportioned or overemphasized at aview spots

6. Evaluation of adaptability - Satmya regarding food, medicaments, climate etc.

Is the patient's nourishmend rather one – sided or does he involve all flavors inhis food. Does he use restorative dishes such as Ghee or milk, in cold seasons, isthe person capable to adapt in summer by eating more salad, fruit etc.? If so, theperson is presumed to be strong.

7. Evaluation of the psychological constitution - SattwaIs the patient in contact with his soul, with his upper self? How is the mind definedas to Sattwa, Rajas and Tamas? Is Sattwa prevailing the person is presumed tobe strong.

8. Evaluation of digestion power - Ahara saktiIt is estimated, how much the patient can eat respectively how much he candigest. Is the patient able to evaluate himself correctly, is he able to notice, whatis good for his body and what not?

9. Evaluation of motility - Vayama saktiThis is about the efficiency and physical capability of the patient, is he able toperform or easily exhausted?

10. Evaluation of age - VayaEvaluation of the life age and if the condition of the patient is suitable to his age

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Tongue diagnosis (Jihva)

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Marks and conditions (tongue diagnosis)

A certain discoloration and / or sensibility of a special part of the tongue show the imbalanceof the particular organ, which is related to this part of the tongue (see picture). A whitelytongue shows a Kapha imbalance, a red or a yellow – green tongue show Pitta – disturbanceand a black to brown discoloration finally shows Vata imbalance. A dried – up tongue is asymptom for the decrease of the (plasma), meanwhile a pale tongue shows decrease of theRakta-Dhatus (red blood cells).

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Dorsal pain, lower sectionof spine (bent centre line),mental: Money problems,

financial worries

Dorsal pain, middle ectionof spine (bent centre line),

mental: guilt feeling

Dorsal pain, uppersection of spine (bentcentre line, mental:Feeling of missingemotional support

Chronical Vataimbalance in the colon

(fissures)

Deep fears or sorrows(trembling)

Feelings, which gotstuck in the area oft he

spine

Over sensitive intestinaltract

Kidney dysfunction Weak heart

Weak lungs(slots)

Bronchitis(foam)

Pneumonia(brown discoloration)

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Lacking reabsorption ofnutrients

(Dental impressions)

Toxins in the colon(white)

Toxins in thegastrointestinal tract

(White, red surrounding)

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Finger nail diagnosis

Marks and conditions (finger nail diagnosis)

The colour of the fingernail may hint at a special misbalance. A pale fingernail is a hint foranaemia. A yellow nail is a hint, a blue one for weak lungs or a weak heart. If the fingernail“moon” at the nail basis shows a blue coloration this indicates a liver weakness. Generalweakness is shown by a red “moon”.

VATA(brittle)

PITTA(smoothe,

pinkt,tender)

KAPHA(thick,

strong, oily)

NervosityVATA-

dysbaöamce(bitten nail)

MalabsorptionVATA-

imbalance(transverse ribs)

Bad nutritionalcondition,

disturbed AGNI(layers in the nail

surface)

Chronic infectionoft he lung, Kapha

imbalance(thickening at theend of the nail)

Lack of Calciumor zinc (white

spots)

Chroniccoughing,

Kaphaimbalance

(parrot's beak)

Weak heart andlung (drum

stick)

Chronic fever orchronic disease

(distinctivelongitudinal rib)

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Face diagnosis

Liverline (repressed

anger)

Sorrow

Spleenline

Kidneys

Agni(digestion)

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Lip diagnosis

Marks and conditions (finger nail diagnosis)

Vata-lips are thin and dry. Pitta – Lips are red and Kapha – lips are bulging and oily. Dry lipswith fissure show dehydration and a Vata imbalance. Pale lips are an indication for anemia.Brown spots show chronic digestion problems and may show the presence of worms in theintestine. Herpes or abscesses on the lips show a Pitta – imbalance. Trembling lips indicatefear or solicitousness.

Thyroid gland

HeartSpleen Liver

Lung Lung

Kidney KidneyStomach

Intestinal tract

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Eye diagnosis

Colour, size and form of the iris are examined. Peculiarities give information aboutdysfunctions, such as degenerations, acute problems or dietary mistakes.

Vata – eyes are small and nervous,with drooping eye – lids and drysparely eyelashes. The white part inthe eye is dull, the iris itself dark,grey – brown or black.

Pitta – eyes are middle – sized,lightning, the view is sharp. There isa high photosensitivity. Theeyelashes are spare and oily,meanwhile the iris is red or yellow.

Kapha – eyes are big, beautiful andmoist, with long and strong, oilyeyelashes. The white part in the eyeseems to be extra – white, the irisitself rather pale, blue or black.

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ConjunctivitisPitta – imbalance

(see glossary)

AlcalcinosisToo much sodium or sugar in the

systemDegeneration of jointsSclerosis of vessels

(White ring around iris)

Arthritis(small iris)

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Each finger is dedicated to an element

Thumb = Element ether, especially connected with the brain Trigger finger = Element air, is ruling the lungs Middle finger = Element fire, related to the intestines Ring finger = Element water, connected to kidneys Small finger = Element earth, related to the heart

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The Three Basic Gatis of Nadi

Vata Pulse Pitta Pulse Kapha PulseCharacteristics Fast, feeble, cold,

light, thin, disappearson pressure

Prominent, strong,high amplitude, hot,forceful, lifts up thepalpating fingers

Deep, slow, broad,wavy, thick, cool orwarm, regular

Location Best felt under theindex finger

Best felt under themiddle finger

Best felt under thering finger

Gati Moves like a cobra Moves like a frog Moves like aswimming swan

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Location of diverse organ pulses

1 2 3 3 2 1 PulseColon Gall

bladderPericardium Bleb Stomach Small intestine 1. level

Lungs Liver Circulation Kidneys Spleen Heart 7. level

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Examination of urine

Examination of „midstream urine“ in the morning. Consider colour:

black – brown colouring shows Vata imbalance dark yellow shows Pitta imbalance dull and pallid urine indicates a Kapha imbalance

With a dropping glass you may but a drop of sesame oil in the urine sample:

if the drop diffuses immediately, it is just a light imbalance if the drop sinks to the mid – level of the vessel, the imbalance is middle – severe if the drop sinks down to the bottom of the vessel, it might be a difficult to heal

disease if the drop diffuses in a wavelike movement it is a Vata - imbalance if the drop diffuses in diverse colours it is a PITTA - imbalance Pearly drops at the surface indicate a KAPHA imbalance

Smell:

Rotten means, that there is AMA in the body Acid smell indicates a PITTA - increase Sweet smell indicates a KAPHA – increase or diabetes

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Ayurvedic healing – the 8 point program

1) Determination of the basic constitution - Pakruti

2) Determination of disease history (actual condition) - Vikruti

3) Determination of causes for disease(s), e.g. wrong nutrition, unhealthy lifestyle,

emotional models, quality of social contacts and – life, genetic pre – disposition,

etc.

4) First and most important step: Eliminate the cause for the disease

5) Inform about the adequate lifestyle- and nutrition guidelines, corresponding to

Pakruti, Vikruti, season, climate, age etc.

6) Take care for an adequate detoxification program, either soft through herbal

preparations (Shamana) or through elimination (Shodana), like e.g. in the 5 –

piece cleaning cure Panchakarma

7) Take care for a personal and adequate rejuvenation therapy (Rasayana), which

strengthens the body, immune system, the specific organs and tissues

8) Take care for an adequate compensation therapy, which means: a therapy to

balance the provoked Dosha and the resultant disease through „opposite quality

balance".

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Location of Vata, Pitta and Kapha

NourishingPrana

KaphaWater and

Earth

PittaFire andWater

VataAir andEther

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Imbalances of the diverse Doshas and treatment (Shamana)

Basic cleaning schemes for VATA, PITTA and KAPHA for the family doctor

In general:

1. Regulate Agni (digestion fire)2. Clean colon3. Use Rasayana (rejuvenation appliances)4. Nutrition following basic constitution5. Lifestyle (Sports, Meditation, Yoga, etc.) following basic constitution

Vata – imbalances:

Digestion problems, no hunger, „stone in the stomach“, constipation, dry stool, pain,which is difficult to localise, pain which is caused by cramps, nightly cramps in thecalf, physical restlessness, lack of concentration, disturbed sleep, nightly awaken,superficial sleep, pain in the joints, arthritis, anxiety, fear, confusion, stuttering,incoherent reports …

1. Agni hat to be increased:e.g. with substances such as Plumbago Zeylanica (Chitrak), e.g. in Bai 01 – nottoo heating, but still Agni stimulating

2. Cleaning intestine, especially colon:e.g. with Plantago Ovata, like in Bai 07 or with the support of the 3 fruitpreparation Terminalia Chebula, Terminalia Belerica and Phyllanthus Emblicalike in Bai 35 (main location of Vata ist he colon, therefore it is very important, toclean this thoroughly)

3. Rasayana:For a Vata – imbalance you ideally take Withania Somnifera, either as Arista asBai 32 or in form of an extract like in Bai 80. For patients who are stronglycachectic, one should use Cyavanprash, Bai 203, as well (Amla fruitpaste).

4. Nutrition:Anti – Vata diet: Sweet and seasoned fruits, easy – to – digest vegetables, oats,rice, wheat, white meat and all spices (except Chilli). It is good to follow aregular plan of warm meals and drinks in a cosy atmosphere.

5. Lifestyle:Ruminant dance, classical music and silence reduce Vata, soft massage withwarm Vata oil (e.g. Bai 84), increase well – being.

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Pitta – imbalance:

Heartburn, reflux oesophagitis, burning pain, inflammatory diseases, ulcerea,diarrhoea, hot flashes, hypertension, hot temper, choleric tendencies,censoriousness, jealousy, sleeping problems, extreme sweating, extreme thirst, skindiseases, varicose veins, piles ...

1. Regulate Agni, often needs just be reduced and Ama needs to be diverted:Liver cleaning herbs such as Picrorrhiza Kurroa, Eclipta Alba and PhyllanthusEmblica, e.g. like in Bai 50

2. Clean intestine, especially small intestine:Very good in this context is Plantago Ovata, like in Bai 07 (main location ofPitta is the small intestine, therefore purgatives are very important)

3. Rasayana:Pitta – people have a lot of energy, but a tendency to accumulate toxins.Therefore it is recommended to take precautionary Phyllanthus Emblica as anextract, like in Bai 33 or as fruit paste in Bai 203. Very helpful as a constantcleaning preparation is Bai 50 (liver preparation). It has a cooling impact on liverand mind.

4. Nutrition:Anti – Pitta diet: Meals not too sour nor too hot. Red meat, alcohol and coffeeshould be – as far as possible – avoided. Salads and fresh vegetables are verygood for Pitta – people.

5. Lifestyle:Outdoor – sport, active meditation and yoga helps to reduce Pitta. Deepmassages such as Shiatsu or the South – Indian Ayurveda massage with Pittaoil (Bai 86) help Pitta doshas to relax. Well ventilated, large rooms, hold theright atmosphere.

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Kapha imbalances:

Tendency to develop oedema, Water retention, mucus, adipositas, bronchitis, sinusitis,concretions, diabetes, slow metabolism, fatigue, dullness, depression, late rising, chronicaltiredness, affinity to stinginess and greed, possesive ...

1. Agni has to be increased:e.g. with substances, which are strongly heating or drying, to dissolve slime, such as the„3 pepers) Zingiber Officinalis, Piper longum and black pepper (Bai 17)

2. Bowel cleanse and execute slime:Suceeds mainly with the 3 fruit extract Terminalia Chebula, Terminalia BelericaandPhyllanthus Emblica ( Bai 35). Main location of Kapha is the stomach.

3. Rasayana:A stimulating and slime dissolving permanent therapy is possible with Bai 17 or withBai 35, ideal for Kapha constitutions.

4. Food:Dry, warm, spicy anti – Kapha – food is ideal. Oil should be used rarely. Dairy productsto be avoided.

5. Lifestyle:Diversified activities, as much sport and physical exercise as possible, active meditationand Yoga. Deep massages with Boerhaavia Diffusa oil (Bai 87), are stimulating andflushing.

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Mixed constitutions

Vata-Pitta-/ Pitta-Vata-imbalances:

Indigestion, constipation as well as diarrhoe, heartburn, inflammations, wandering aches,megrim, sleeping disorders, restlessness, extrem eruptions mixed with anxiety states, itchingeczemas, many diverse symptoms, tendency to extremes, extreme challenges, extremesports, high tension, „runs on adrenalin“ ..., followed by tendency for depression.

1. Regulate Agni:

In most of the cases Agni is either too low or too high. Here one should use balancingsubstances with Aloe Vera and Plumbago Zeylanica (Bai 55) – they have a balancingeffect on VP and PV and clean in the same spleen and liver. Furthermore they actcompensatory on the hormonal system.

2. Bowel cleans, colon as well as small intestine.

Main location of Vata ist he colon, of Pitta the small intestine. For this Plantago Ovata,is a good cure, such as e.g. Bai 07.

3. Rasayana:

To balance VP and PV the 10 roots are advised as Rasayana, like e.g. in the ArishtaBai 59. The effect is both on the nerve system and the 7 tissues cleaning andreconstructing. Additionally one may give the Amla fruit paste (Bai 203). With adominating PV you may use instead as Rasayana Asparagus Racemosus, (e.g. Bai39), depending on the desired overall effect.

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Pitta-Kapha-/Kapha-Pitta-imbalances:

Intoxication, unhealthy lifestyle, tendency to overweight, skin diseases, smellingsweat, „toxins are stored and deducted“, because Kapha tends to hang on things ...principally very unhealthy.

1. Balance Agni:In case of PK Agni might be increased, due to the Kapha there might be a lot of Amaand intoxication and water retention as well. Therefore it is advisable to take the Arishtawith Boerhaavia Diffusa – Bai 63. It is very detoxifying, liver cleaning and flushing.In case of KP an increase of Agni could be desired. Here a preparation on basis ofginger, long Pepper and black Pepper, e.g. Bai 17, is advisable to start the cleansingprocess.

2. Bowel cleanse:Affected are stomach and small intestine, which means that, besides the balancing ofAgni the small intestine has to be cleaned as well. A very soft way to do so is with Bai07 or with castor oil as well, depending on the desired effect.

3. Rasayana:PK or KP owns generally a good energy and health. There should be only a bitcaution regarding nutrition. Preventive is e.g. the Arishta with Boerhaavia Diffusa, Bai63, which is especially in Germany used sustaining and on a long term basis.

4. Food:Warm, spicy dishes and drinks, restrained use of oils and ice – cold drinks.

5. Lifestyle:Regular, dynamic, powerful training, dynamic meditation, challenges in work, deepmassages with Bai 87 bring relaxation and detoxification. Regular visits of a Sauna areadvisable as well.

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Vata-Kapha- / Kapha-Vata-dybalances:

Freezes very easily, bad digestion, tendency to constipation, anxious, tends to lethargy, nightlywake up but excessive sleep as well, wandering aches and oedemas. Concretions,indiscipline, disorientation, schizophrenic disorders and depressions, main characteristic: „gaspedal and break” at the same time.

1. Agni has to be increased due to a large deficiency:Best preparation is Plumbago Zeylanica (Bai 01).Should be taken regularly.

2. Bowel cleanse:Weak points are stomach and colon. To contain the slime the receipt of the 3 fruitextract, such as Bai 35, is advised (Terminalia Chebula, Terminalia Belerica andPhyllanthus Emblica).

3. Rasayana:Due to the lacking element fire Bai 01 should be taken, as conditioning preparation,if desired, one should take Whitania Somnifera (such as in Bai 80 or Bai 203).

4. Food:Warm, regular, seasoned dishes and warm drinkgs should be the keystones. IfKapha is inflated, ginger water may be a good regulative, in case of Vata increaseonly in modest quantities.

5. Lifestyle:Regular Hatha-Yoga, regular warm dishes and the keeping of one's own disciplinesare very important to get back in balance. Daily routines should be as structured aspossible.

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Vata-Pitta-Kapha imbalance:

Digestion problems, no hunger feeling, feeling of having a stone in the stomach, constipation,dry stool, aches, which are hard to localise, aches which are caused by cramps, nightlycramps in the calf, physical restlessness, poor concentration, restless sleep, nightly wake up,superficial sleep, aches in the joints, arthritis, fear, confusion, stammering, incoherentnarrations ...Heart burn, reflux oesophagitis, burning aches, inflammations, ulcerea, diarrhoea, hotflashes, hypertension, hot temper, choleric, censoriousness, jealousy, sleeping problems,extreme sweating, extreme thirst, skin diseases, liver diseases, varicose veins, piles ...Oedema, water retention, slime, adipositas, bronchitis, sinusitis, concretions, diabetes, slowmetabolism, fatigue, dullness, depression, late rising, chronical tiredness, affinity to stinginessand greed, possessive ...

1. Normally Agni is in balance, if not for a certain period, the herbal mixture withPlumbago Zeylanica is advised, as in Bai 01.

2. Bowel cleansing:Short term cleansing with the „3 fruits“, such as in Bai 35, should be sufficient.

3. Rasayana:For rejuvenation of cells the Amla fruit paste Bai 203 is advisable, eventually incombination with 1 tablet of Bai 17 (Tikatu) before breakfast.

4. Food:Balanced with spices and dishes containing all elements will support equilibrium.

5. Lifestyle:A meditative perfectly executed lifestyle seems to be inborn here.

Ayurvedic Diagnosis and Therapy - SAI Swiss … · IN COLLABORATION WITH Ayurvedic Diagnosis and...

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