Picture of Health: Transform your self-care and health care through Ayurvedic and Integrative Medicine


Written by Charles R Elder, MD, MPH, FACP, & Leslie D Elder, MD

Sanford Nidich, EdD1,2

Perm J 2019;23:19.179 [Full Citation]

E-pub: 11/01/2019

book review for fall 2019Picture of Health is a practical and user-friendly guide for patients and clinicians to promote health and wellness through a complementary and integrative approach. It aims for coordinated care between conventional and ayurvedic systems that is patient-centered and treats the whole person. Using diet, herbs, meditation and other behavioral modalities, alongside conventional medicine, Picture of Health offers a natural and effective option for prevention and treatment of chronic illness.

Ayurvedic health care has been continuously practiced in India and other parts of the world, and “is likely the oldest practiced tradition of health care, dating back to 500 BCE” (the oral tradition is much older). Part I of the book takes the reader though the basics of this system of health care, emphasizing the importance of prevention through daily routine, diet, exercise, and stress-reduction techniques.

Health, from the platform of ayurveda, is a state of balance and disease a state of imbalance, based on 3 fundamental “psychometabolic principles”: “doshas.” The 3 doshas are “vata,” “pitta,” and “kapha.”

The dosha vata governs all the movement—mind, body, and spirit: Movement of thoughts through the mind, food through the digestive tract, blood through the blood stream. Pitta governs digestion, metabolism, and transformation. Kapha governs structure, the physical structure of the body.1

The balance/imbalanced state of each dosha can be detected through the ancient technique of pulse diagnosis of 3 fingers (index, middle, and ring) placed on the pulse of the patient to determine the degree to which the qualities, functioning, and structure of different aspects of the physiology are in a state of balance. A self-report questionnaire is also used to determine mental and physical conditions and health behaviors.

There are 10 constitutional types based on the 3 doshas. A central feature of the book is the presentation of dietary menus based on constitutional type. The book has recipes to help in adjusting and adhering to one’s prescribed diet.

The discussion of daily routine and healthy eating habits can benefit everyone, irrespective of constitutional type. According to ayurveda, good health and digestion go hand-in-hand. Because good digestion is so critical, we are advised to eat our main meal during lunch, in the middle of the day around noon, when the digestive fire (agni) is greatest. The Elders cite research linking the secretion of digestive fluids, and other biochemical processes, to the time of day and suggest that these studies reinforce the ancient ayurvedic principle of eating the main meal during the midday to aid proper digestion.

For good health and wellness, many simple recommendations are included such as eating a lighter dinner at night, avoiding cold drinks, eating fresh and cooked food in a settled environment, sleeping by 10:00 pm, rising by 6:00 am, and exercising between 6:00 am and 10:00 am. The Elders, with extensive experience as both practitioners and researchers, recommend the daily practice of Transcendental Meditation (TM) in one’s daily routine morning and evening. Research studies on the benefits of TM for chronic conditions, such as high blood pressure and cardiovascular disease, are described. They also discuss how neurophysiologic functioning during TM practice is different compared with other relaxation and meditation programs.

The important discussion of the use of herbs in prevention such as turmeric for its anti-inflammatory properties, brahmi for optimizing mental functioning and reducing emotional stress, and ashwagandha for improving overall well-being takes place in Part II. Ashwagandha is a particularly good herb for balancing vata.

Part III provides many case histories and testimonials from patients who have gained benefit from using the ayurvedic system of medicine. These case studies include benefits for pain and hormonal changes, and recommendations for diabetes.

Picture of Health achieves its goal of providing an easy-to-read guide for health and wellness based on ayurveda and integrative medicine. I highly recommend its adoption in medical schools and continuing medical education programs for physicians.

Disclosure Statement

The author(s) have no conflicts of interest to disclose.


Kathleen Louden, ELS, of Louden Health Communications performed a primary copy edit.

How to Cite this Article

Nidich S. Picture of health: Transform your self-care and health care through ayurvedic and integrative medicine written by Charles R Elder, MD, MPH, FACP, & Leslie D Elder, MD. Perm J 2019;23:19.179. DOI: https://doi.org/10.7812/TPP/19.179

Author Affiliations

1 Center for Social and Emotional Health, Maharishi University of Management, Fairfield, IA

2 Institute for Natural Medicine and Prevention, Maharishi University of Management Research Institute, Fairfield, IA

Corresponding Author

Sanford Nidich, EdD (snidich@mum.edu)

1. Elder CR, Elder LD. Picture of health: Transform your self-care and health care through ayurvedic and integrative medicine. Portland, OR: The Permanente Press; 2019.

Keywords: alternative modalities to enhance allopathic care, ayurvedic medicine, daily routine, doshas, holistic medicine, integrative medicine in traditional health systems, mind-body techniques


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