Healthy Sound in a Healthy Body

Ayurvedic physicians Dr Poornima Krishnamurthy and Dr N.V. Krishnamurthy of Mysore have been treating musicians, including many leading vocalists, earning the monicker of “musician’s physician.” Soft-spoken, generous, and kind-hearted, they share their invaluable knowledge and deep insight about everything from Ayurveda, Yoga, Veda to Sangeetha.

By C.K. Shridhar

It is dawn at the Prajna Kuteera Ayurveda Centre campus in Kergalli just outside the city of Mysore. It is small but well-laid out, on one acre of land, and a couple of in-patients are taking brisk walks. Lights are on at the meeting hall.

By 6 am, all the staff, and the patients gather in, and wait for Dr N.V. Krishnamurthy (Dr NVK).

He and his wife Dr Poornima Krishnamurthy are the founder directors of the Centre, both Gold Medallists from the University of Mysore. Dr NVK is from a family of Ayurvedic physicians treating the royalty of Mysore for over two centuries.

Before Dr NVK reaches the hall, a couple of hours of his day have already passed. He typically gets up at 3.30 a.m, before Brahma Muhurtam, to begin his personal sadhana, which includes japa of 500 Gayatris.

When he comes to the hall, an elderly gentleman greets him. “Thanks to you, I can walk again,” he says, gratefully, hailing him as a healer who is one in a million. “You did it yourself, actually,” says Dr NVK smiling.

In the hall, he leads hospital staff, men and woman, in their morning sadhana, a 45-minute round of pranayama and chanting. It begins with the Prathasmarana Stotram, considered part of Shankaracharya’s works. Then comes a series of Pranayaamas, breathing excercises, like Shitali, Sadanta, and Brahmari, culminating in Vibhageeya Pranayama – in Vibhageeya Pranayama, the three components of Om, the aa, ou, and mm sounds are chanted separately, followed by the full Om. And finally, everyone chants the magical Sanskrit verses of the Upadeshasara, 30 verses composed by Sri Ramana Maharshi.

He then requests one of the staff members to sing, and she does so, in a sweet, engaging voice.

“All their voices have improved so much. So much clarity and strength,” says Dr NVK.

Their morning routine is not necessarily one that was developed exclusively for the voice – it is considered a whole body, lifestyle practice. But it is for the voice that the Prajna Kuteera Centre has been receiving some of its most distinguished seekers of good health, including many leading Carnatic vocalists, prompting the seer of the JSS Matha to comment, specifically pointing to Dr Poornima, that she is the “musician’s physician.”

Over a cup of coffee that Dr Poornima makes, (coffee and tea of course is not part of Dr NVK’s diet), we chatted about Ayurveda, the voice, stress, seasonal changes, and general health.

C.K. Shridhar (CKS): What brought you to the study and treatment of the voice?

Dr Poornima: We both come from a lineage of Vedic culture. We have been practising chants for all our lives. As young toddlers we were introduced into Om chanting and all the sahasranamas and shlokas. Then a guru came into our lives, Sri Nagaraj of Mysore, a senior sadhaka, to whom I owe most of my learning of Vedanta. And later, it was Dr Krishnamurthy, my husband, who took me further into spiritual and Vedic culture after our marriage. Sri Nagaraj taught us how to pronounce words, the rhythm, the tempo, the pauses, the tone of the recitation of a mantra or a shloka. It involved a lot of voice modulation. For instance – (She chants the Mahamrityunjaya mantra (tryambakam yajamahe) with power, articulation, and melodic tone, casting a spell in the room).

CKS: In traditional Vedic chanting in most chanting paramparas, there are no pauses in between mantras, unless mandated by sutras governing certain vowel sandhis. Some schools do have pauses, though, like how you are chanting.

Dr Poornima: Yes, in the pause there is also Pranayama. There is inhalation, exhalation. Our chanting was highly influenced by the Chinmaya Mission chants. We have been ardent students at Swami Vivekananda Yoga Anusandhana Samasthana (SVYASA), Bangalore. There again we had to chant with a lot of voice modulation. Along with that, we did our music lessons in Mysore. Dr NVK did his lessons in violin. His father was also a violinist. I picked up vocal Carnatic music. Our teachers were task masters. Vidushi Gowri Kuppuswami and Vidushi Koviladi R Kalaare my teachers They would concentrate on all aspects of music. From small children to adults there was no change in the way they taught.

Later, in our medical practice, we would come across people who would approach us randomly for their voice issues. Then the musicians started approaching. Many would have bad cases of Chronic Obstructive Pulmonary Disease (COPD).One senior Vidwan, well into his 80s, was still performing, but had COPD. We would treat him, using techniques similar to what you experienced in the morning session here.

Then we get many lady vocalists. Obviously we cannot mention names, but one vocalist had an issue with sudden strained voice in the middle of a concert.  After examination and history, including Nadi pariksha by Dr NVK, I realised she had severe GERD, and because of acid reflux, there was a lot of erosion inside. ENT physicians, who she went to earlier, could not diagnose the erosion. They would go only upto the throat. She was treated here for two weeks and she is performing well with absolutely no issues. Also, because of their stressful lifestyles and erratic eating habits, concert vocalists suffer voice issues frequently. Acidity is caused basically by stress. All this brought us into contact with artistes who came seeking help for voice culture.

CKS: Dr NVK, so your inputs with NadiShastra clearly play a role. Do tell us about your own early introduction into Ayurveda.

Dr NVK: I chose to do Ayurveda because of my strong family tradition of Ayurveda. I am the ninth generation in a lineage that was the chief physician of the royal family of Mysore. With that background from childhood I knew a lot of things. When we were small, we would see our father and grandfather doing Nadi pariksha. That inspired us to join Ayurveda. I studied in Government College, Mysore. Then I did my course in modern medicine in Bangalore Medical College and then went on to my MD post-graduation in Kayachikitsa.Then we met our guru Nagaraj. He was a tapasvi in every sense.  For 12 years he visited us. Classes would happen from 10 to 11 pm in the night on the Upanishads, various prakarana granthas, Sahasranamas with commentary for Poornima and her mother, and so on.  So this prepared us a lot in our quest for the Self. There were a lot of principles of Ayurveda too that we adopted and practised.

 In my understanding, it is not as if anyone can give medicine and cure a patient. There is a krama for diagnosing and giving medicines to patients, thereby healing the patient.

In Charaka Samhita, there is something called Hastha Shuddhi (purity of the hand). Hasthashudhi is not just about washing our hands. Only when the mind is pure, the medicine given will have an impact. All herbs are governed by an adhidevatha. When we pray to these devathas and then administer the medicine, the effect is different from buying something from the shop and taking it. This we have really experienced here.

Dr Poornima: There is a traditional krama to source an Ayurvedic herb. We go near the plant, pray and chant a mantra which is specific to the adhidevata of that plant. We seek permission and say, ‘I am taking your root, your leaf, your flower, your fruit or your stalk. Please come out with all your potency as I will be using you to cure /help humanity.’ Even to process it, there are specific days, muhurthas, and the right nakshatra. Only when we do all this in a systematic way, will it have the right effect on the ailing. Patent medicines are different.

Dr NVK: We have a critical responsibility. If we are on the right path, we can cure any disease. There is a krama as to how a physician has to be.  A Vaidya has to be swastha in the first place. Swa – Astha means to dwell in The SELF. We  get up early in the morning and do our japas. Then we will be able to feel the Nadi correctly. (Ayurveda is based on a system of Nadipariksha, a reading of the pulse which tells the physician  precisely about the vitiation of the Doshas viz. Vata, pitta, Kapha and how to treat it).

We have to pay attention to our own Ahara Krama (food). Ayurveda advocates  us to follow a regime of two meals a day (Dwe anna kalou pratah sandhya).  I have been following that for many years. After I finish examining the nadi of patients in the morning, I come home and have a meal at 11 am. In the evening I finish my pooja, and Gayatri japam, and then have a light meal. This feels great. Your health is good and so is your mind.

CKS: Voice users are also subject to external stresses – pollution, seasonal changes and the like. How do they defend themselves?

Dr NVK: There is something called Vyadikshamata, or body resistance. Each and every organ will have its own weaknesses. Even if the whole body’s immune system is good, if one organ is weak, then the others are also prone for attack.  Firstly Ayurveda talks about Swasthasya Swasthya rakshanam, which means protect the health of the healthy.  Ayurveda is both a preventive and curative science.  This ancient Vedic tradition, cognized by the great Indian seers, offers a wealth of knowledge for a healthy and meaningful life. Ayurveda is a 5000 year old healing tradition which teaches us how our lives can be enriched, enhanced and extended without interference from disease and ageing. It propounds that good health is not simply the absence of disease, but a state of harmonious and dynamic balance on all levels, even encompassing the environment.

  It deals with Sadvritta (good conduct), Dinacharya (Daily regimen), Ruthucharya (Seasonal Regimen) and Ratricharya,  as lifestyle practices. If  on follows this discipline from morning to night, they could build immunity and build resistance against hazards of pollution, seasonal changes and can manage physical strain.  Wake up at  Brahmakalam,   do yoga,  follow a proper ahara krama and   practice Sadvritta  can be the key to good health.

Dr Poornima: All our procedures are unique, aimed at whole body recovery. They have all undergone research and scrutiny. Take the Abhyangas, oil massage for example. Each stroke depends on the origin  and insertion of a  muscle on a particular bone.   It is done in a very synchronised way. We have our own standard operating procedures.

On Stress…… Man may have made a lot of progress in the last four centuries of growth, but there is the challenge of stress and pollution. Even kids are stressed today. If pollution is shaking our material front, the buzz word called stress if shaking our existence.

Musicians, like everyone, have their own stresses and pressures. They feel they have to keep accepting concerts, or somebody else will take their place. They compromise on everything. For women there is another big conflict. Whether to take care of family or pursue passion for music. They end up playing multiple roles.

CKS: Many singers and other voice-users have this challenge of acidity and GERD (Gastro-Esophageal Reflux Disease). How to tackle this?

Dr Poornima: Everyone today has erratic eating habits. There is work, and for musicians, concerts. There is travel. They need to keep talking all the time too.  It strains their voice unnecessarily. They are constantly accosted by people with greetings and questions. I travel to speak all over the world, so I have experienced this too. Organisers and their assistants do not necessarily respect an artiste’s quiet time before a performance.

Stress creates GERD. GERD from the Ayurveda perspective is more to do with the mind. It is sometimes due to  irrational eating. When a person is stressed, unnecessarily stomach acids  ooze out, eventually damaging the stomach flora.   Regurgitation of these acids will erode the throat area, eventually leading to voice issues.

Wrong practice times for singing practice like in the evening, excessive travel,  emotions, all create  voice irritation. From IHD to skin disease, to CVA or migraine, spasms, infertility, lack of libido, lack of concentration, you name it, they are all related to the mind. So  spend a lot of time with my patients, give them a good listening. History taking is very detailed. I make them aware where they are erring in their lifestyle, diet, workday, and the like.

I also give them a panchakarma therapy, staring with deepan pachana to address their agni or the digestive fire, then Snehapana which consists of medicated ghee… There is another ghee Kalyanagunam which is also useful for vocalists. Depending on the ailment, we  infuse the ghee with certain herbs. This is given internally followed. Abhyangam for five days. There are different types of Abhyangam. On the last day, they are subjected to Virechana, which is a purgative therapy. For some people we give emesis therapy, which helps to eliminate kapha (from the respiratory and gastrointestinal tract). The body then becomes so clean from within that even a little quantity of medicine given, soon after, works wonders. The body becomes receptive to change.

We do this Panchakarma therapy on ourselves too every year. We take a 10 day break exclusively for this regimen.

Vibhageeya Praanayama for development of voice

Dr NVK: Vibhageeya Praanaayama helps a lot in developing a good voice, besides aiding general health of the organs of the body. When you say Aaaa, the lower part of the body vibrates. This part is monitored by Brahma.  It helps in healing problems in the lower part of the body. When you chant Ooo, the middle part of the body vibrates. And it cures and corrects chest diseases. Once Vishnu is satisfied with his Bhijakshara, he will bless us. Similarly during chanting of mmmm… (makara), only the part above the neck vibrates. Maheshwara  is pleased. When we join aa, oo and mm, in Omkara, the whole body vibrates. So much can be achieved with just this practice!

Using Yashtimadhu (GlycyrhizaGlabra) and Ghee for voice

Dr NVK: Take pieces of Yashtimadu root, crush it and soak it in water overnight. Boil this the next morning. After cooling, drink half a cup and gargle with the other half with a little salt. Another wonderful Kantya, a substance which helps the voice, is ghee. We should use it with our food.

The power of Rasayanas

Dr Poornima: There are many powerful herbs in Ayurveda. For example, there is a herb called Madhuyashti. In Sanskrit it is called Athimadhura. This clarifies the voice. So we ask patients to gargle  its decoction.

But there are everyday items at hand which we ignore. Most people don’t take ghee and milk. Ghee and Milk in Ayurveda are Rasayanas. Rasa in Ayurveda is to nourish. Ayana is a channel. That which nourishes every channel of the body is a Rasaayana.  They are nutritive and rejuvenative especially for all the dahtus and especially for the voice. The benefits of Rasaayana are captured in a shloka from the first chapter of the Charaka Samhita chikitsa sthana:

Deerghamayuhu smrti medha arogyam tarunamvayaha l

Prabha varna swaroudaryam dehendriyabalam paramll

Vaaksiddhim pranatimkantim labhate varasayanatll

Longevity, memory, intellect, health, youthfulness, radiance, complexion, and voice, strength of body and sense organs, and power of speech, lustre, all are enhanced by Rasayanas!

Ghee, milk, honey are all rasayanas. We are influenced by Western nutrition culture. The science of talks about milk, butter from milk, and cheese from milk. They don’t know that when butter goes through an agni-samskara it becomes ghee. For our joints, eyes, for brain development, for voice and for every organ, ghee is necessary.. It soothes, lubricates, strengthens the organs and help dislodge the toxins.   Therefore medicated ghee is used in Ayurvedeeya Panchakarma chikitsa. ihid

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