DR. K. N. RAO MEMORIAL ORATION
Year : 2010 | Volume
: 54 | Issue : 2 | Page : 65--70
Health and spirituality: An attempt to understand the scope
Former Professor and HoD, Community Medicine, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India
Sri Somanatha Kshetram, Hyderabad, Andhra Pradesh
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Swarajyalakshmi B. Health and spirituality: An attempt to understand the scope.Indian J Public Health 2010;54:65-70
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Swarajyalakshmi B. Health and spirituality: An attempt to understand the scope. Indian J Public Health [serial online] 2010 [cited 2020 Sep 25 ];54:65-70
Available from: http://www.ijph.in/text.asp?2010/54/2/65/73272
Health and spirituality are generally looked upon as different from each other and also as not connected to one another. When we examine the deeper aspects of both more closely, we find that they are interdependent and almost merge with each other. Both the words have been subjected to various interpretations from ancient times till now.
Homeostasis : The human body is actually a social order of about a hundred trillion cells organized into different functional structures, some of which are called organs. Each functional unit provides its share in the maintenance of optimum conditions in the extra-cellular fluid which is called the internal environment. The term homeostasis is used to mean maintenance of static or constant conditions in the internal environment. 
The individual functions of the different organs and cells are integrated into a functional whole, the human body. Life depends on this total function.
Somanatha Maharshi calls this integration as "Samatva Yoga," i.e., yoga of equanimity. The throat does not refuse to give passage to the food masticated in the mouth. The pylorus does not refuse to accept the food passed on to it by the esophagus. The various organs of the body observe wonderful cooperation and equanimity. "It is we humans who possess these organs and do not observe equanimity and fight each other resulting in chaos and destruction the world over" he says.
Health may also be therefore defined as a perfect coordination of the functions of all of the organs of the body while dysfunction of any one or more of them can be called disease.
This continuous and timely coordination of the functions of the body is facilitated wonderfully by the vast network of feedback controls which achieve the necessary balances in a continuous manner without break. Without these balances we would not be able to live.
The immune system:  One of the ways of measurement of health is the immunity level. It is the capability of the body to resist the organism or toxic substances that tend to damage the tissues or organs. Innate or natural immunity results from the general processes of the body. These processes include phagocytosis of bacteria by the white blood cells and macrophages, destruction of the swallowed organisms by the acid secretions of the stomach, and resistance of the skin and certain chemical substances circulated in the blood. Natural killer cells (NK) of the lymphocytes can also kill the organisms.
Acquired immunity is developed by the body when exposed to individual organisms, toxins. It is powerful and specific. It may be active, when it is developed in the body, or passive when introduced artificially.
Acquired immunity may be cellular or humoral. Cellular immunity is conferred by T-lymphocytes and humoral immunity by antibodies developed by B-lymphocytes.
The major groups of T-cells are (1) helper T-cells, (2) cytotoxic T-cells, and (3) suppressor T-cells. The helper T-cells help by activating the other T-cells. The cytotoxic T-cells kill the bacteria by direct attack. The suppressor T-cells suppress the other types whenever there is overaction. An individual whose immune system is good enjoys a high level of health.
Psychoneuroimmunology (PNI): PNI is a recent addition in our armamentarium of scientific study of the links between the mind, brain, and immunity. It is relevant to an understanding of the mutual influence of spirituality and health. It is an emerging branch of medicine connecting psychiatry, neurology, immunology, endocrinology, and internal medicine. Research on these links started in the late 80ss of the 20th century. Research on caregivers of Alzheimer's disease and controls showed disturbance in innate immunity (NK cells) and acquired immunity (T-cells and B-cells).  Mind-body interventions like meditation and relaxation techniques were shown to reduce stress and enhance the immune system and overall well-being of individuals. 
Development of concepts of health
Different concepts have come up regarding health since times immemorial. In ancient times, health was believed to be a blessing of the gods and disease a consequence of the wrath of gods. Efforts through offerings and rituals were made to appease the gods for the restoration of health. These practices and beliefs persist even now all over the world and the traditional healers found in the tribal and rural areas practice folk medicine. Even the urban elite believe in them. In many instances, these practitioners are closer to the people than the modern medical practitioners of allopathy whose services are definitely more expensive.
With the industrial revolution of the 18th century, the living standards had greatly improved in the West. Discoveries of microbes as the cause of disease led to the bacteriological era. The Preventive Medicine Era and the rise of Public Health followed in the early 20th century. Preventive and Social Medicine and Community Medicine came up later. Multifactorial causation of disease and application of levels of prevention came up.
The advent of World Health Organization in 1948 was another landmark and the oft repeated definition of health in the preamble of its constitution that "health is a state of complete physical, mental and social well being and not merely absence of disease or infirmity." Later this statement was amplified (1978) to include "The ability to lead a socially useful and economically productive life."
The slogan Health for All by 2000 (1977) and its proposed achievement through primary health care (1978) were brought about by WHO.
Health is recognized as an integral part of development. This is reflected in the Millennium Development Goals  brought about in year 2000. Three of the eight goals are health related and all the other goals have important effects on health. A total 8 of the 18 targets required to achieve these goals and 18 of the 48 indicators of the progress are health related. India is a signatory of these goals and the Government is committed to take active steps in that direction.
The WHO's definition is seen by many as being more on idealistic, rather than a realistic proposition. It is felt that health is not a "state" but a dynamic process of adjustment of the organism to its environment. When there is an alteration in the adjustment (to the worse), the result is disease.
In recent times, the spiritual dimension has been added to the concept of health. It cannot be described in materialistic terms but is something that the individual looks up to in times of need as a support in the hope of deriving relief.
The concept of well-being:  Like the word "health," the term "well-being" also has no satisfactory definition. It is said to have an "objective" and a "subjective" component. The objective component is the "standard of living" and the subjective component is the "quality of life." These terms again are multidimensional, difficult to define and measure.
Sixty years after the WHO definition has enunciated, it is agreed all over the world that the principles enshrined in the definition and attempts made subsequently have remained unfulfilled. The numbers of premature deaths and the burden of disease of the community are on the increase in both developing and developed countries.
It is mentioned that "We might finally conclude that any attempt to define health is futile and that a definition cannot capture its complexity. We might need to accept that all we can do is to frame the concept of health through the services that society can afford, and moderate our hopes and expectations with the limited resources available, and commonsense." 
Spirituality can be considered as a way of life to be followed on a more or less continuous/daily basis consisting of a disciplined life of moderation in every aspect with an unswerving belief in that supreme power within not necessarily with a form and not necessarily accompanied by ritualistic worship. Spirituality can be taken as the search for or the development of inner peace or the foundation of happiness. It does not mean the belief in or communication with spirits but rather the essence of equanimity as the way of life taught by all religions.
It may or may not include belief in supernatural beings. Many techniques developed in the context such as meditation, prayer, etc. are immensely valuable in themselves as skills for managing aspects of inner life.
Some aspects of spirituality
Some of the aspects of the practice of spirituality may be broadly considered as follows:
Efficacy of prayer as a means to alleviate human suffering due to disease or stress is recognized even now as in ancient times. Generally, it is a part of all religions.
Anne Mc Caffry of Harvard Medical School Boston and colleagues  conducted a national survey in 1998 on 2055 people aged 18 or older and investigated the prevalence patterns of the use of prayer for health concerns. They found that 35% of the respondents prayed for health concerns. Out of them 75% prayed for wellness and 22% prayed for specific medical conditions. A total of 69% of these persons found prayer very helpful. The authors suggested that physicians should consider exploring their patients' spiritual practice to enhance their understanding of their patients' response to illness and health.
Efficacy of meditation
Meditation is focusing the mind on a word or small set of words (a mantra) inwardly which produces calmness by reducing thoughts.
It is a practice which has been there since times immemorial practically all over the world familiar to most religions. It was devised by Sage Patanjali of Vedic times in our country as a part of a discipline with eight limbs known as Ashtaanga Yoga.
There are several varieties of meditation devised by preceptors or gurus. Transcendental meditation (TM) devised by Maharshi Mahesh Yogi and Vipassana of the Buddhists are some of them which are claimed to be beneficial by the practitioners.
Principle of meditation
The mind which is a source of thoughts will cause strain on the bodily organs after sometime which is given the name stress. When an attempt is made on a continuous basis to divert the mind away from thoughts by focus on a word inwardly, the thoughts gradually weaken and the mind is in a relaxed state. Meditation is described as a state of alertful rest.
Several studies have been made to study the efficacy of meditation but definite conclusions could not be drawn in many instances due to methodological difficulties for comparison. However, the subjective sense of well-being after a period of the practice seems to be definite and is experienced by almost all the practitioners.
Shirley Telles and others at SVYASA (Swami Vivekananda Yoga Anusandhana Samsthana), Bangalore,  made a study in 2004 on 20 male volunteers (average age 31.9 ± 7 years). It was done to find out the effect on oxygen consumption related to meditation on the syllable "AUM." Each subject was assessed in two types of sessions, namely, meditation (MD) and random thinking (RD), of 20 min each. Recordings were made during pre- and post-5 min in each meditation session. There was a significant reduction of 13% in oxygen consumption during meditation sessions showing that there was physiological rest during meditation.
Thus meditation is gaining popularity as a healing technique complementary to conventional therapy even with medical practitioners.
Efficacy of breathing techniques
As in the case of practice of meditation, several ways of breath control have been devised by ancient sages and preceptors of the present age. Sage Patanjali has given it the name Pranayama. Breath regulation leads to quietening of the mind resulting in mental peace. Breathing is a semivoluntary activity of the muscles of the chest wall. This rhythmic action is disturbed in stressful conditions and other ailments. By conscious regulation, the stress can be reduced and will have a positive effect in the control of the ailments with conventional medical treatment. In normal individuals too, it is expected to control the mind leading to improved health and longevity.
Vinod Kochu Pillai  and others (2004) at All India Institute of Medical Sciences, New Delhi, studied the effect of breathing process, namely, Sudarshana Kriya (SK) and Pranayama (P) in a group of cancer patients in remission and normal controls. Parameters studied were NK cells, lymphocyte subsets, antioxidant enzymes and glutathione, and electroencephalogram (EEG). Sudarshan Kriya is a rhythmic breathing technique devised by Sri Ravi Shankar. It has gained popularity in recent times. At the end of 5 months of regular practice, a fourfold decrease in blood lactate levels, and a significant increase in NK cells, lymphocyte subsets, antioxidant enzymes were found in the study group as compared to controls. The researchers concluded that the practice of breathing techniques reduce the stress, improve antioxidant enzymes and immunity levels, and may possibly help in reducing the incidence of many chronic diseases, including cancer.
Yoga as a spiritual discipline
Sage Patanjali propounded Yoga  as an eight-limbed spiritual discipline to help the human to evolve into the level of the Divine. It is a Sanskrit word meaning union. Union refers to the union of the body, the mind, and the Cosmos. It involves, along with postures, breathing practices and meditation, a code of behavior of dispassionate action, selfless service, truth, inner and external cleanliness, and spiritual study. In short it is a physical, mental, and behavioral discipline leading to the deliverance of the attachments to life and to ultimate liberation or union with the Supreme, Divine, or God, by whatever name that Power is called.
As in the case of meditation, several Yogic practices by different names are devised by the preceptors.
However, in the present day life where control of disease has become technology intensive and expensive for the majority, the practice of Yoga as a complementary therapy, which is also of late subject to scientific proof, is slowly gaining acceptance not only in the East but also in the Western countries. But most of these practices are limited to postures and breathing techniques to the exclusion of the other aspects of Yoga.
The practice of Manoyoga or the application of nature's basic power
Somanatha Maharshi, a self-realized Master and renowned Yogi, after 11 years of meditation (penance) in the deep forests of Srisailam in Andhra Pradesh (AP) since the age of 11 years, developed and is propagating a unique Yoga practice which he named as Manoyoga or Application of Nature's Basic Power (ANBP). He came back into society to help people to achieve peace of mind and good health in their hectic lives. Manoyoga means union of the mind with Nature's Basic Power. The practice consists of three stages. They are as follows: a stage of breathing out and pause followed by breathing in and out slowly. The next stage is visualizing the internal organs mentally. The third stage is total relaxation. The first stage is done in the sitting posture and the next two in the lying down posture. Details of the practice are given in the guide book. 
Case studies to show how Manoyoga has complemented modern medicine
Marked improvement was observed in the Manoyoga practitioners suffering from various diseases. Some of the case studies are presented here. With limited resources and practical difficulties, they were carried out as pilot studies only.
Efficacy of Manoyoga Sadhana (MYS) among diabetics
A residential camp for diabetics was organized at the Kshetram Headquarters in Hyderabad. Sixty-two patients, selected after preliminary screening by specialists from Nizam's Institute of Medical Sciences (NIMS), a post graduate institute and deemed university, were given training in Manoyoga by trained Kshetram instructors. Blood sugar estimations, fasting and postprandial, were made on day 1, 8, and 15 with the help of an authorized laboratory. Diet and drug regimens were followed according to instructions of NIMS specialists who visited on the same days. The blood sugar levels and consequent medication levels were significantly reduced in 40 (65%) patients. The remaining 22 (35%) did not show improvement and the reasons attributable were age factor and inadequacy of the practice. All of them reported an improved sense of well-being.
Efficacy of Manoyoga Sadhana in improving health and academic performance among students of a residential school at Simhachalam, AP 
Under a scheme called "Golden Future for Children" students aged 10 years and above are being taught Manoyoga Sadhana (MYS) since the year 2000 with permission from the Government of AP. A few lakhs of students have been covered so far under this scheme. The study conducted in one of such schools in 2000-2001, namely, AP Residential School for Boys (backward classes), is briefly reported here.
A total of 511 male students in the age group of 12-16 years were given MYS training for 6 months by the trainers of the Visakhapatnam branch. A team of medical experts conducted the initial and final health check-up. The trainers visited the school once a week and the students had their daily practice under supervision of their residential teachers in their hostel. The results in terms of health parameters and academic performance like number of passes in the examination, weight increase, and reduction in disease prevalence showed statistically significant improvements. The students also reported improved sleep, appetite, and friendly behavior toward each other. The improvement could be attributed to MYS as there was no other extraneous factor.
Efficacy of MYS among people living with HIV/AIDS 
During 2005-2006, with the cooperation of APSACS (AP State AIDS Control Society), Hyderabad, a total of 220 people living with HIV/AIDS (PLHAs) from across 11 centers in 9 districts of Andhra Pradesh consisting of 143 study groups and 77 control groups were taken up for a study of the efficacy of Manoyoga practice for a period of 6 months. The training was imparted by the MYS trainers of the respective centers under the guidance of Somanatha Maharshi. The selection of the PLHAs was made on a random basis with the help of the NGO, providing services to them. Complete medical evaluation was done at the beginning and at the end of the training period. The evaluation included Hb%, ALC%, and weight. CD 4 counts could be done in 22 of the study group. All of them were ambulatory, non-ART group. The subjective or qualitative parameters like appetite, etc., were also recorded apart from the medical check-up record.
There were several constraints in the conduction of this study like assembling the PLHAs for the training, the sample frame, etc. But the confidence of the PLHAs in the practice produced fairly satisfactory and significant results which were statistically analyzed and brought out as a report. The report was appreciated by APSACS.
The findings showed that in the study group there was an overall health improvement in weight gain (73.94%), Hb% (53.33%), and CD 4 counts (77.27%). Along with it, subjective or qualitative parameters like appetite, sleep, confidence, and hope to live longer had also shown marked improvement compared to the situation prior to their joining the project.
Somanatha Maharshi's philosophy
The main theme of Somantaha Maharshi's philosophy is "Creation is a great science which is an embodiment of the Divine.  Man is God. The divinity of man lies hidden in him and can be manifested by him through his Sadhana and Sadaacharana (practice of Manoyoga and following the principles of good conduct). This hidden power is venerated with names and forms only by the human mind."
Children are very dear to Somanatha Maharshi.  He calls them white papers (blank) without any typed matter on them. He feels that it is possible to mould them from the tender age of 10 years through sadhana and sadaacharana. A youth wing is functioning effectively under Somanatha Kshetram for this purpose.
Somanatha Maharshi believes that superstitions  are just blind beliefs which are set up by humans for convenience and should not be followed blindly which is leading mankind to lethargy.
In this article an attempt has been made to piece together some of the already known facts about bodily functional aspects from human physiology, microbiology, immunology, psychology, neurology, and endocrinology, while community medicine aspects regarding the community were brought in to develop the concept of health. Practices of the disciplines of spirituality like prayer, meditation, and the eight limbs of Yoga as applied to individuals and studied scientifically to find out the health benefits have been described. A few research studies on the practice of Manoyoga have been briefly given.
Health and spirituality can be harmoniously blended to achieve happiness in the present day world of strife and turmoil.
The point stressed here is that spirituality can be practiced as a way of life from childhood onward, or alternately, introduced at any stage or age in life with benefit. Then the spiritual dimension which was added on to the definition of health, originally spelt out by the WHO, would be successfully incorporated and make the sense of "well-being" a total phenomenon. When it is practiced universally by everyone, irrespective of the religion one follows, the entire world will become an abode of peace. Vishwashanti or universal peace will be established, a goal toward which Somanatha Maharshi and other great personalities of the world are striving. Let us all join hands in this noble endeavor.
I express my reverential gratitude to Poojya Somanatha Maharshi for kindly granting the permission to utilize the work being done at Sri Somanatha Kshetram and for guidance in the preparation of this paper. My thanks are also due to the members of Sri Somanatha Kshetram for their unstinted cooperation, technical, secretarial, and otherwise.
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