Atharva 06
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This document announces an international Ayurvedic conference to be held from December 1-3, 2006 in Gadag, Karnataka, India. It is being organized by D.G.M. Ayurvedic Medical College to celebrate its silver jubilee. The President of India, Vice President of India, and Governor of Karnataka have sent messages of support for the conference and best wishes to the organizers. The conference aims to bring together experts in Ayurveda to further research and understanding of Ayurvedic medicine.
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![Reception Committee
Dr. R. K. Gachinmath Dr. G. S. Hiremath
Dr. B. S. Patil Dr. B. M" Mulkipatil
Shri M. K. ]oshi Smt. M. B. Halli
Shri A. V. Lakkundi Shri S. B. Gadad
Smt. T. S. Kotabagi Dr. Kushal Kori
Miss. Madhavi Bhat Mr. Kiran Mourya
Miss P. Khatwate
Registration Committee
Dr. G. S. ]uktihiremath Shri N. B. Rayanagoudar
Dr. V. M. Malagoudar Miss Shantawa
Shri V. M. Mundinamani Dr. L. M. Biradar
Dr. Veena Kori Miss Deepa Ashtaputri
Shri B. L. Karamudi Mr. K. K. Gurupadaswami
Smt. L. S. Bhaiantri
Shri L. V. Bevinkatti
Stage Committee
Dr. S. A. Patil Shri S. T. Kerur
Dr. B. G. Swami Shri S. G. Patil
Dr. S. B. Govindappanavar Smt. R. H. Bandi
Dr. S. G. Vijapur Dr. Sharanu Angadi
Dr. R. V. Shettar Dr. Ravi Nandi
Shri. S. K. Belavadi Mr. Viiay Mulimani
Smt. M. N. Kotabagi Miss T. S. Saiini
Smt. V. T. Medagoppa Mr. Yogesh Kulkarni
Catering Committee
Dr. C. S. Kudarikannaur Shd B. B. Masanagi
Dr. S. D. Yarageri Shri D. H. Nabinavar
Dr.M. V. Aiholli Smt. K. H. Agasimani
Dr. S. B. Sankdal Dr. Kattimani
Shri T. B. Hanchinal Dr. Shailej
Smt. Y. S. Bidikar Dr. foshi
Smt. A. C. Patil Dr. Shivakumar
Shri B. N. Bumannavar Mr. Lingarai Shivareddy
Miss Aishwarya V. I.
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PRESENT SCENARIO IN THE EDUCATION
.:. As stated earlier, there are a large number of educational institutions. However intensive
training in Ayurveda, both theoretical and practical is being provided only in a f-ew institu-
tions.
t Number of qualified teachers in most of the institutions are minimal and do not even fulfill
the requirement of minimum standards.
* Many teachers though working on part time basis are shown as full timers. In some of the
institutions. they are only on rolls but physically present only when there are visitors from
C.C.I.M or UniversitY.
* Many others come only for one or two hours as per teaching schedule. They never utilize
library and do not participate in the departmental enlistment.
* Extra curricular activities in most of the institutions are negligible.
* In some of the institutions, even classes are not regularly conducted. Bogus attendance is
shown in attendance registers.
PRBSENT SCENARIO IN THB EDUCATION
* Many students are also not serious in teaching and training. Their objective is to obtain degree
by hook or crook.
* The attraction of degree of Ayurveda is to practice modern medicine
* After Supreme Court judgment and restrictions by many State Governments and also objection
made by Medical Council of India, Indian Medical Association, etc. practice of modern
medicine by Ayurvedic Graduates is becoming very difficult
* Hospitals attached to Ayurvedic Colleges, in most of the cases, is also without patient or have
only a few patients
* Dissection halls are without cadavers so there is no arrangement for teaching and practice of
Anatomy
* There are many such lacunae and I need not explain all those before you. Many teachers and
students present in the conference must be aware about many of these difficulties. We must
make proper efforts to strengthen Ayurvedic education
SUGGESTIONS FOR IMPROVEMENT IN AYI]RVEDIC EDUCATION
* The minimum standards should be maintained by all Ayurvedic Colleges without exceptions
* Teachers not only be regular but work hard for obtaining latest technical and scientific knowl-
edge of the subject concerned
* They also be in touch with scientists and counterparts in medical colleges to acquire up-to-
date knowledge
* Deep knowledge of Sanskrit and working knowledge of computers are absolutely necessary
, for every teacher of Ayurveda
* The teaching should be based on applied aspect so that it should be convincing to students
* In addition to Ayurvedic teaching, latest diagnostic methods should be taught to students and
equipments must be made available in the libraries](https://image.slidesharecdn.com/atharva-06-121203104137-phpapp01/85/Atharva-06-43-320.jpg)
![PRACTICAL AYURVEDIC NADIPARI KSHANA
Dr. Vaibhav Lunkad
Pune
MBBS, DVD, D.Yoga Ayurveda, , Director, Sangam Health Research Centre.
AYURVEDA (Complete science comprising all dimensions of vision)
Principles of "Panchamahabhuta" (5 elements :- Water, Air, Fire, Space.
Earth)
Nothing is beyond these five principles. So the science remains never-changing in
o correlation
with nature.
o Tridosha Theory - Vatta, Pitta, Kapha'
o Saptadhatu - Rasa, Rakta, Mansa, Meda, Asthi, Majja, Shukra'
Ayurvedic nadipariksha is based on practical principles of ayurveda, keen observation
of body
language, feel, vibrations, facereading, receptivity, and the real dedication and
devotion to cure a person'
Some say it is impractical, subjective, divine, humbug because grapes are
always sour to the wolf
since they are lying high on the tree. Only those with clinical acumen,
practical down-to-earth attitude
can learn it. Others are just like the wolf of sour grape story'
Guru shishya parampara(tradition) has kept this art alive. Is it a $cience or art? I
prefer to call
it an art because it is not just bookish, it requires the heart more than the head. The patience and
preserverance of seeing thousands and lakhs of pulses is just very important'
Lots of people are known to practice Ayurvedic Nadipariksha since ages but many have not
made
it practical and easy to learn. Hence Ayurvedacharya, students and post graduates feel it is subjective,
just love to see how wonder-
difficult, incomprehensible. I too felt the same before learning. But now I
It is
fully I can diagnose so difficult and unclear disorders in a patient without even asking him.
challenging and only for people who like challenges'
It is wrong to compare allopathic parameters when we compare pathies. Instead of seeing from
for e.g.
their eyes it is important we create at the outset such parameters that allopaths can understand
a pulse is seen only in parameters such as force, volume, tension, rate. But in Ayurveda
we have
different parameters such as feel, point of touch, meaning of those points, strength of
pulse, rate,
volume etc..
Instead of comparing we need to be clear in our terminology :
The mind influences the pulse such a lot that no allopath can believe that mere mind itself
can turn
-
the strongest pulse into a weakest pulse.
or low blood pressure. I have seen depression patients at least 68-70 titl now showing
such feeble slow
pulse.
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This Rasayana Therapy can be planned in two ways- as charka Samhita
1. Minor Rasayana program - suitable for day to day life
(vata atapika Rasayana)
to certain period of
2. Major Rasayana program - is serious program in a confined environment
time. (kutipraveshika Rasayana).
of the individual seeking
These Rasayana therapies can be planned as per the need and requirement
lor the treatment.
Rasayana for the specific illness, Rasayana for the convalescents, Rasayana
for kids and
women, Rasayana in seasonal regimens, Rasayana for every day based
on the constitution
(Prakriti), General Rasayana for the whole family, Rasayana to combat ageing process in
the bod]-,
Rasayana specific to tonify the systems/ tissue, Rasayana to combat
mental stress and induce
relaxation, I{asayana for sexual health and progeny
ilI. Achara RasaYana :
and pain
India philosophy identifies 'untrue knowledge as the basic cause for all type of sickness
and emphasized the realization of truthful knowledge as the solution for all
pain and penury in life'
conduct (prajnaaparadhai'
Ayurveda reiterates suffer in life arises out of errors in judgment and imprudent
Few code and conduct for an individual in the society are laid down in Ayurveda
in the form of Achara
Rasayana. The person who is willing for a sound mental and physical health
is desired to follorv these
codes and conducts referring to his day to day life.
iile
To give up falsity and adopr virruous conduct (Sadvritta) is the way for healthy and happi'
and the society of
devoid of sufferies. Further more it is good of the individual, his surroundings "rhich
he is a part - a wholesome living promotes a wholesome environment'
package
Under the light of holisti| definition of Ayurveda , the Achara Rasyana is a comprehensive
platform of an
for health promotion. Convicingly the Achara Rasayana operates on the psychosomatic
integritl"
individual paving path to a stress free life and environment apparently building the system
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![a notion that grahas or some super natural powers seize the person butit is not so. It is clear tr] C.mrflr,l0me $
words that neither the gods not the goblins causes any disease in the person. In fact the peru,rn umf;clllll
or his misdeeds are the cause of all his disease. Vagbhata explains further as these disor'jers '&ris s$'id"islli
name due to similarity of a person in appearance, action, language etc, with that of any creax--.1-l-.- :N'lrrHtJ*
divine people, demon etc.
The management of psychiatric disorders in Ayurveda is done through three broad
therapy namely -
o Daivavyapasraya chikitsa (Devine therapy)
o Yuktivyapasrayachikitsa(Biological therapy)
o Sattavavajyachikitsa(Psycotherapy)
Yukti vyapasraya chikitsa includes purificatory methods which not only purify the body but alt'"
the mind its doshas. Then the palliative measures include different methods as application of tale.
colyrium, Shirodhara with importance to fumigatory methods.
In devine therapy includes the use of mantra, japa, other activities and wearing of
precious stones etc.
In Biological therapy - The patient is subject to bio-purificatory therapy by Panchakarma in order
to cleanse the channels of the body followed by Samshamana therapy or palliative treatment with the help
of Oushadhi (drugs) anna (dietetics) and vihara (lifestyle).
The Ayurvedic Psychotherapy - Popularly known as sattvavajaya is practiced encorporating the
principles of assurance therapy (asvasana), replacement of emotions and psycho cathartic therapy. The
entire Ayurvedic management is more health oriented than disease oriented.
Thus Ayurveda has excellent outlook towards the psychiatry and can turn out to be the best if
handlecl properly since in a country like India we come across psychiatric pluralism - a judicial appro-
priation of different clinicians have accepted that neither aetiology nor treatment should focus narrowly
on the scientific ideas of the day instead, the approach should be broader, encompassing whatever
psychological, social and biological factors seen most important is the individual case. As Ayurveda
covers all the factors it can prove best in handling psychiatric disorders.
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Care in the plane of conSciousness
Garbhadaana
Garbhadana is a common ritual described by Dharma Shastra and Ayurveda: each of them contrib-
uting the ritual part leading to psychological tranquility & body purification and treatment methds
ieading to physical equilibrium
Samskara" means making something refining or purifying: Garbhiidhiina-Samskiira. a child-beger-
ting religious ceremony is the observation of the reformatory method or fervent prayer for a ri'onh-full
child in order to fulfill the parental obligation to continue the human race, to endow future genera[ions u-ith
good health, noble quality and high intelligence by improving the innate quality of human kind voluntarill'
To get a male child an auspicious day among the even days of Rutu K-ala should be selected: and
wishing for a female child the auspicious day among odd days of the Rutu Kala should be selected.
Putneshti
o In Putresti Yajna oblation will be given with Charu
r Reciting hundred times the hymn 'Somah Pavana ' and Savitri mantras. The inhalation should
be given with 'Apodevirupasrija' mantras.
o Repeating the name of Vamadevi in low tone.
The hymns described for recitation before inter-course are;
"(O Garbha) you are like sun you are my longevity; you are my prestige. You are god of protection
(Dhata) and the god of protection (Vidhata) should protect you. You are Brahman."
"Lords Brahma, Brhaspati, Vishnu, Soma, Surya, Ashwini Kumara and Mitra Varuna having divine
powers bless me with valiant.son."
It appears impractical in present era to practise above methods. the same will power to get
a high qualitative child can be practiced by the most accepted and agreeable forms like yoga.
pranayama etc...
When this Sanyama is maintained in the up most exhilarating moments of life causes Dosha
Samyatha, (Vata, Pitta, Kapha Samyatha), Guna Samyatha (Satwa, Rajas, Tamas) leading to ideal ps1'cho-
somatic lay out of future embryo.
The will power to have a qualitative issue and the rituals observed just before the intercourse.
prepares the mind not to be illusioned in sexual pleasure, but to be concentrated to invoke a high spirited
soul to enter in the womb of particular woman.
This Sthira Chithatha of parents may be inherited to the child thus designing the psychological
nature of Garbha.
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![UPADRAVA VIGYAN : Science, Theory & Application
Dr. B. C. Jana M.D., Ph.D.
Reader Dept. of R.V.V.V. J.B.Roy S.A.M.College Kolkatta.
Dr. Debasis Khan M. D. (Ayu)
Principal & HOD Kayachikitsa Dhanvantari Ayurveda College, Siddapur (N.K')
CONCEPT OF L]PADRAVA : (Disease related Complication ) the term Upadrava is compound
word consisting of " IJpa" & " Dru" (Upa means near, Dru means to go ). So, Upadrava means nearer
to a disease. It may be defined as a separate clinical condition develops in patients in the late stage of
a disease. It may be mild or Severe ( Mridu / Daruna ), may af fect one system or more than one system.
It requires immediate therapeutic intervention. It is a guide line feature to the physician for prediction of
Prognosis ( Progress of the disease) and for selection of line of treatment. When dosa or dosas has become
l
further vitiated owing to abnormal diet, behaviour etc. a second disease is added with the primary or
Swarantra Roga known as Upadrava. It is very much linked up with Dushy Adhisthan and Srota of the
concerned disease. A disease associated with Upadravas draws early and special attention to the physi-
cian. Why not all patients developed Upadrava not clearly mentioned in the literatures but Prakriti,
Ojavikriti, Hetu. Vyadhiakshama, Sharir and Kala directly or indirectly involved in the development of
Upadrava. So, the important facts to be mentioned regarding Upadrav4'
i. The Doshas responsible for the Vyadhi and its Upadrava i;e Both are same.
ii. The Hetu / Etiology both are same
iii. The main disease is independent ( Anubandhya ) where as Upadrava is dependent
(Anubandha).
iv. Usually Upadrava subsides with the treatment given for the main disease many time i;e
treatment of the two is not contradictory-
v. Though Upadrava is causes by some dosha but it has own Dosa, Dushya Samurchana and
Samprapti. Charaka has divided Upadrava into two categories. i;e Sthula & Anu ( Major &
Minor ). A minor Upadrava is one with a mild pathology and mild Symptoms. Such, Upadrava
get cured by the treatment given for the main disease. If severe Pandu ( Anaemia ) is devel-
oped in Raktapradar, it may produce its own complication Sotha and Moorcha. Hence Pandu
should be treated first by blood transfusion and haematinics.
CONCEPT OF VYAPAT : Vyapat refers to treatment related complications. Vagbhata emphasizes
that truly "suddha Chikitsa" is that which cures the disease without creating new disorder. Nowadays
number of iatrogenic illnesses are gradually increasing.
' Vuyupat is closely associated with faults in Chikitsa Chatuspada or four limbs of therapy. They are
as follow:-
a). Physician : Lack of Proper Education resulting in Un-Skill physicians having lack of confi-
dence in Ayurveda with up to date scientific knowledge and extensive practical training.
118](https://image.slidesharecdn.com/atharva-06-121203104137-phpapp01/85/Atharva-06-150-320.jpg)
![HOLISTIC APPROACH TOWARDS HEALTHY AGEING
o Dr. Managalagowri V. Rao.
M.D.Ayu.'LecturerinSwasthaVfitta,DepartmentofBasicPrinciples'I.M.S..B-H.L
Introduction :
Every man,s scare, a multi factorial and inevitable biological phenomenon
is ageing. The propor-
Even from the ancient time
tion of elderly people is constantly increasing along with age related diseases.
we have reference of yayati who feared foi ageing & exchanged the youthfulness
of his son Puru' ln
ancient science of Ayurveda measures to postpone ageing the rejuvenation
in the forrn of food' medicine
where sages lived
& behaviors have been explained. If we refer back to ancient literature lot of contexts
for hundrecls of years without any ailments can be traced'
The reasons for their long & healthy life can be taken as-
Healthy life style, Healthy food. Mental peace
Even though it is impossible to adopt all the things certain changes in life style
like practice ot
as well as to over corne
rejuvenating diet, medicine Yoga will certainly help to prevent many diseases
many problems related to ageing.
phenomenon
Ageing-Ageing is a terminology representing multi factorial, inevitable biological
characterized with many changes in the body'
The person may suffer from common disease like Hypertension Arthritis. Hearing &
I'ision
peripheral vascular disea-se-
impairment, coronary artery disease, chronic lung diseases. Diabetes mellitus,
sleep disorder'
cancer, parkinson's disease cerebro-vascular disease, prostate disorders, osteoporosis
Depression & mood disorders' Dementia etc.
Factors for Ageing :
tripoth-
Environment factor & genetic factor are two main factors responsible for Ageing. Different
esis have been put forward regarding the causes for ageing. Free radical theory
is one of the acceptable
theories.
Free radical & tissue injury mechanism :
Free radicals are molecules or fractions of molecule having unpaired electron
in their oi]ter nnosi
enz mes ca"sins
orbit. The free radicals cause the destruction of cell membrane, modify or inactivate
attack t-he
protein injury, interfere with carbohydrate metabolism leading to improper release of energl'-
blood fat leading to atherosclerosis and decrease HDL cholesterol which are protective against hean and
i
t
arterial diseases.
Oxy radicals dis -differentiation hypothesis of ageing
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Oxy radicals react with genetic apparatus of cells leading to production of different and ineCl'-ient
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![m. Excess surge of Stecobilinogen in stool and Urobilinogen in urine
IV. Choleretic activity
V. Prevents the reuptake of remaining Albumin
o On Experimental studY
a Less cellular damage on Histopathological study followed by ccl4 & PCM challenge
a Less bio-chemical derangement followed by ccl4 & PCM challenge
o Membrane stabilizing activitY
o Anti-oxidant effect
Experimental studY - 1
o ,To study the Hepatoprotective activity of Phalatrikadi in Albino Rats'
o Hepatitis induced by CClo (carbon tetra chloride)
o Biochemical parameters show raised level in Se. bilirubin, AST, ALT & ALP
necrosis
a Histopathological changes are hepatocyte damage with ballooning degeneration and
with inflammation of biliary canaliculi
Adminisrration of Phalatrikadi for 10 days prior to CClo challenge showed significant
hepatoprotactive activity as evidenced by mild elevations in AST, ALT & ALP with relatively
less degenerative changes on HP study
Experimental studY - 2
o .Effect of Amrita on hydraulic permeability of cell membrane' l
i
1
Administration of Amrita decreases the hydraulic permeability during inflammatory process l
and checks the damage caused by Se. bilirubin
o Thus Amrita has membrane stabilizing and hepatoprotective property.
JV=LpxDP
Lp = Hydtuulic conductivity
DP = pressure difference
o Hyraulic permeability of membranes in presence of Trial drugs
Lecithin + Cholesterol = 0.49
Lec. + Chol.+ Daruharidra= 0.45
Lec. + Chol.+ Katuka = 0.30
Lec. + Chol.+ BhumYamalak=O.29
Lec. + Chol.+ Kalmegha = 0.28
Lec. + Chol.+ Amrita = 0.27
Experimental studY-3
I To study the anti-oxidant properties of Triphala; on PCM induced Hepatic damage
I Triphala have been reported to have anti-inflammatory, immunomodulator and anti-oxidant
properties.
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Atharva 06
- 1. ,. 11
- 2. On The Eve of Silver Jubilee Year Celebration of D.G.M. Ayurvedic Medical College, Hospital & P, G. StudiesResearch Centre, GADAG ATHARVA 2006 . INTERNATIONAL AYURVEDIC CONFERENCE & AYUR EXPO 1'*, 2no, 3'd DECEMBER 2006 Organised bY : D.G.M. AYURVEDIC MEDICAL COLLEGE GADAG . 582 103 Karnataka (lndia) Venue : NANDEESHWARA VEDIKE College Premices, Dr. S.V. Savadi Road, Shivananda Nagar, GADAG
- 3. Atharva - 2006 tnternational Ayurvedic Conference & Ayur Expo 1o,2*, 3d December 2006 Organised by : D.G.M. AYurvedic Medical College Cadag- 582 103, Karnataka (lndia) Venue : Nandeeshwara Vedike D.G.M. Ayurvedic Medical College Premices Dr. S.V. Savadi Road, Shivananda Nagar, Cadag. Published ln December 2006 Copies : 2000 o nll nights are Reserved Chief Editor : ' Dr. G. B. Patil Publication : Publication Division D G Melamalgi Ayurvedic Medical College, Gadag Mudran : , Twarit Mudran Offset Prints Kagadgeri Oni, Cadag @:237566, 235509 dH nYd w ffi
- 4. s;;: Lord Dhonvontori - God of AYurvedo
- 5. Press Secretary to the President President's Secretariat Rashtrapati Bhavan NEW DELHI - 110 OO4 ffi rsr{4cqn MESSAGE The President of India, Dr. A.P.J. Abdul Kalam, is happy to know that the D.G.M. Ayurvedic Medical College, Hospital and P.G. Research Centre, Gadag is organising the International Ayurvedic Con-ference during December 1 to 3, 2006 and bringing out a Souvenir'Rajatamrita' on this occasion. The President extends his warm greetings and felicitations to the organisers and the participants and wishes the Conference and the Souvenir all success. gtf A*.r..-.o,"- PRESS SECRETARY TO THE PRESIDENT
- 6. K. L. KOCHAR Joint Secretary and Press Adviser to Vice-President of India Vice-President's Secretariat ffi wHqd NEW DELHI - 110 011 MESSAGE Hon'ble Vice-President of India is glad to know that D.G.M. Ayurvedic Medical College, Hospital and P.G. Research Centre, Gadag is organising an Intemational Ayurvedic Conference during December 1 to 3 , 2006 on the occasion of its Silver Jubilee Vice-President of India extends his good wishes to the organisers and wishes the Silver Jubilee Celebrations and the Conference all success. :tG-" (K. L. Kochar) New Delhi, 4thNovember,2ffi6 *W 71.lp 6d ffi 14fiF ffi
- 7. FeJd dJs3dro od ieiaaooS> =F KARNATAKA GOVERNOR S SECRETARIAT K V. JAGANNATHA Fersonal Assistant to Governor llelephone :22254102 Raja Bhavan, BANAGALORE MESSAGE His Excellency the Governor of Karnataka is glad to know that D.G.M. Ayurvedic Medical College, Hospital and P. G. Research Centre, Gadag has completed 25 years of its purposeful existence and is celebrating the Silver Jubilee duringDecember2006. It is an occasion for joy and celebration. At the same time, it affords and an opportunity to look back the way the organisation traversed and plan for the future based on its experience. Twentlive years of service itself is indicative of its being accepted by the people and the place it has carved for itself in the hearts and minds of the people. This is also an occassion to remember with gratitude the founder philosopher Jagadguru Nandeeshwar Mahaswamiji and all others who have rendered dedicated and selfless service to the organisation to reach it to the place where it is today. The Governor hopes that in times to come the organisation will grow further in strength and stature. The Governor felicitates the management, the faculty and staff of the college, hospital and Research Centre and wishes every success to the Silver Jubilee Celebrations. Nov. l-5,2006 (K. V.fagannatha) Personal Assistant To Governor *H &d w ffi
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- 11. c. &edeo{, dttdobdd) bre $dcr{S - 574216 dflea ddd, doar$d o : d$eo: (08256) 277121 ioded dd:nd bre esrld:$> baadod e)oDddCFd do{o$ ud9d8o*$dq E. 8. dreen*fl soJldred aoeJease, er{d, d;dl dodoedoa EeoQ-,rd -eee ddrrld sad.n8d dedod:af1 d-OJ$e-J$d dad d')droedrddq sdod0d:d cl?^tdd .99dr dogoedaa$od:. no{o$ dJrl,grrdR dJ"bAdJd ae.:-d6rod: ddfbddl e?pdoa$q, d$odcdro dod dr Ho{o3u wdj.oe{d {rrlg FaQ& 8egrz19:i:dooorleSod> ubt'r:d-ed. dnd drdoedrdd ds $tf *od$rd iodd&nah "e{dr" aoz: d.deo dori8odoodq {rds3dOdrdc$ EtSd*dpeararond. iodoJl ddd> nod oao aarlo soJudredd d:odc oa$-elodoa$ dJ€Ad e;oJ$dred octo"iodd o$)d .SHDbils dodoedoa o?^radd+ do?ioQAd dsod ado$i'l9doo*rlood eJ e eod d€o o a ri d osBE eJd d Fd il" R 4 d t^laa rl d o d> ubd:d-e d. * ado$O- sdger* {o$-d;dodJdt i$oaad:dod bre dlozsroa$ aa*Ao ddieSod;aorQF$d-ed. E'q&ad *k/ b. :30-10-2006 (8. aedeoed{dc$d$) ffi w rcre
- 12. d dd:{pa:* zrodo3o e n bdo3-o e R aol do6d dtuloar dO rlaaogodgdd) $aa*drd:, doz^o{d drld, ildrl elededdd @:238464 $d ioded d dd$pg c-ril do. dqroaa d.r d6"o$d$ddr, aededrd {aa.drd>, rldil "edd add sooCdaod 6"tt 8. E. ddu3ee; {q?S dooaddd>, calt o$). ,3e. ddd ioaaddOrl dc{ d:orlo. u. baadod "ldrddCFd do{od: G. d. ao. soJ>dred drd*6eod: dcoaooare.:o$, u{,d, saoddoed_d aado do8oefoa deo{ rldrl. €r clo-od do{.t€ dzsd dcd.roedrd{.ade adozrd o, s dtdlc"de aooodrtsodo a$rb{dQ d e€ dodo edd"6)d). &rldlcb baadod e{rrl$d$ erd*6 ddoddosO_z,:aildod saddd:. "addQ dro${de e,odr gea* -t1o e'd4 aged. ndd ddodO- oezs dO aardortaad so3::dred dndr*eo$ dcoa.)oa*e.:o$ * aoe.:r dddoddO-aoQ:,d FDCd, tJ€d 0e8, doend$ ded dDGd do ae.:;dn eldoed, ud>d#:. a. md4 rbcbtrdjd"r 6he5os*R addr gdLndr*gdd1e9&r&dl, uoeie*d ?.3gdrddo$ qjo?))ilaofDqb$. iDdd*d ?.Jdd dead, ddd;{Bq baailod{,rlg, dtoa,s doa€ dd er{,219, dpad sq:dd baadod er{rtd ddfud ubeaardd fler, a3e dd:duod er$gja e:?po$odood breoJr:d iobod:dd 04ood dorlrddrd, ioee;ood:d rrd. B. zg. ror3eod erdoeuo8, dro$d4d Se.:, drgadod aarpa*ddd dduod, z$o co$ t dJd ,)6ader e,rdrl, uoe.:dd dsd$d a3oersilgod ds aoaf {uer, aaerdO_erd}danh a3€Bd. z"od) dddraddO-a3€d: a^rod dood:Qd:el$ ao${dd del;son dzgd dtdJoe*ddd.A "l6"6d4-, erd.qoohn eceJon>.L$dd: ioddd dorl8. dr drard:o$, db{, ddodoaldq eodo.:geo$ eco$)dred ddl"e$dddl iooSoea&d> , dOdrsdo$ dddO_ g3oa39d SodUosand. ds uqlod{pdr BaJodoC*, ooq.d od%ddoqdaoJroR,rlFadgdea*doud.3:r,J%cbddJ$qJioded. 'ode iodqJrdO-e.odr i"dea do$8 doddd:d doorldip en-dseodraaddl. * doz.g8 dd.rddogd ae.l_ ?3[3)d[.3trl€ qadddrrlddl z.drtood:, srd> xboddaan dJod zrdOd. .eddO eeodoo*furo$ cJoi)dred drd*6eo$ dodd Ada3dr, gdL adc$ dodgd e3eerditdQ derrdc€*c$_ z"odr u$r{pear drdea ioasd dodndeJod; drd aadts>dd. €e i.deo SozBE oQeo$O_ nodoeudrlood:, cneoe3oJroft $e_?ie_, "3Qq d.n rl r db r d.d eo d ozid .eoorl e3od: aa dn*. .?eSJ4o cro. do. dqroouc d"3 dddc0Jrl$ddJ bJe "leded.jd 4)aa* _,,d:, rldrl 6d tLaY-/ ffi
- 13. Shri Siddeshwar Mahaswamiii Gyana yogashram, Bijapur MESSAGE DearSriDr. G. B. Patil Pranams How glad I am to know from your letter that the College institution is celebrating, meaningfully, its Silver Jubilee existence. During the last two and a half decades the college has imparted the age-old knowledge of Ayurved a to thousands of students and trained them in the art of diagnosis and treatment of diseases; moreover it has instilled in those young medicos the benevolent desire to go to the corrunon people and serve them with loving kindness; in this way the medical institution has served the Nation. The past and. the present Holy pontiffs of Shri Shivanand Math whose blessings have gone into the formation and development of the college, and all the persons whose services and sacrifices have, meticulously, nourished the center to its present growth, need to beremembered withthe sense of appreciation. Yours is a good decision to bring about a cominemorative volume, 'Atharva' to Honour the memory of the SILIVER-EVENT. I hope it contains very valuable articles on Ayurved. Good Wishes €'E'Xb-t'r'"' ln Nov.2006 (Swami Siddheshwar) ffi ffi
- 14. M. V. RAIASEKHARAN Minister of State For Planning Govemment of India Planning Commission ffiqaqqt Yojana Bhawan Sansad Marg, NEW DELHI - 110 OOl Tel : 01L-2309 6561,23096562 MESSAGE I am very much delighted to learn that the D.G.M. Ayurvedic Medical College Hospital & P.G. Research Centre, Gadag is celebrating its Silver Jubilee. It is heartening to also know that on the eve of the Silver Jubilee and an International Ayurvedic Conference will be organized from 1 to 3 December 2006.I am sure this International Ayurvedic Con-ference, which is an important initiative, will to a great extent promote one of the most valuable ancient heritage and tradition of our land - our knowledge of Ayurveda. The Ayurvedic system of treatment is gaining more and more momenturrr across the globe and its imperative to take advantage of the vast potentialfor promotingthis science, bothinternationally and domestically. I have no doub,t that the Souvenir brought out on this occasion will contain useful information and articles contributed by eminent scholars and researchers in this field and will benefit all of us particularly aspiring students of this profession besides spreading this knowledge among the international community. I take this opportunity to convey my heartiest congratulations and best wishes on this occasion. I wish the Conference all success. aryl'n,/;*'-.' (M.V. Raiasekharan) & ffi
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- 18. Vaidya S. K. Mishra Ayurvedic Consultant President All India Ayuweda Vidyapeeth Ex. Advisor (ISM), Govt. of India A-60 4, Tower APartments, Swasthya Vihar, Delhi-110092 @ : 22522335,22502766 MESSAGE IamextremetyhappytonotethatDGMAyurvedicMedicalCollege, Hospital & P. G. Research Center, Gadag. Is organising "International Ayurvedic Conference,, on 1-3rd December 2006 and Publishing the souvenir 'RAIATAMRITA' on the eve of its Silver Jubilee' Ihadopportunitytovisitthiscollege.Graduate&P.G.educationis is one of the best college of imparted in this college at appropriate level and this Ayurveda in Kamataka State. ways & I am sure the lnternational Ayurvedic ConJerence will contribute means for future prospect of Ayurveda not only in India but entire world' The souvenir being published on this occasion will be full of informations also useful articles onAyurvedic education, Research, Drug standardization and for generalPublic. I wish success of these celebrations' Yours SincerelY (S. K. Mishra) 4# Erre€
- 19. His Holiness Shri Jagadguru Abhinava Shivananda Mahaswamiji ## '.lagq taaY-- .ffi
- 20. DONERS Danappa Gurusiddappa Giriiamma Danappa Melmalgi Melmalgi *S a.n ffid ffi <!ffiiF *re *#
- 21. OUR BETOVED CHAIRMAN SHRI S. B. SAUNSHI', CHAIRMAN *g fl-F ffid ffi 1ffi1't* ffi
- 22. OUR BELOVED PRINCIPAT DR. G. B. PATIL es M 6d ffi 'i6n'F
- 23. Lingaring Tunes Silver Jubilee celebration is a Land mark in the history of D.G.M. Ayurvedic Medical College. The year was celebrated ceremoniously throughout by origanising useful academic, social and cultural prograrrunes to make the event more memorable. Here we are with this Atharva 06, an Internatinal Ayurvedic conference and Ayaur Expo with theme of "EVIDENTAL TOOL FOR ETERNAL CURE" There are the days of evidence based medicine and also we say "ysft i{Bq q{, g*qFrglqftgf'l The time tested, proven this Ayurvedic science of life is always evidential tool for eternal cure for the mankind. Many stallworts of this Ayurvedic field around the nation have responded to our call and sharing their vast experiences in the deliberations of the conference. This souvenir contains preserveble articals written by eminent writers of Ayuravedic fratinity. With his blessings, Jagadguru abhinava shivananda Mahaswamiji, president of institute always encouraged us to reachthe gool. We extend our special thanks to his excellency shri T. N. chaturuediji Governor of Karnataka for inagurating the colourful event. We are greatful to Shri H. K. Patil, Leader of opposition legislative counsil. Who helped for governer's visit to our institute. Our heartiestthanks to Shri D. R. Patil MLA, Gadag,, Honoaray president of organising comrnittefor his encouragement and help to make succes. It is our previledge to thank Dr. P.S. Prabhakaran, Vice Chanscellar of RGUHS, Bangalore Dr. B. N. Prakash Director, Ayush Bangalore who are the great personalities behind our positive Success Our beloved chairman Shri S. B. Saunshi B.E. president of organising committee and all other members gave their valuable guidance to make this function a grand SrrCCESS. We have offered this colourful occassion through Atharva 2006 to share*and shower your thoughts, exchange your valuable ideas and uplift the knowledge of Ayauveda. All employes of our insititute, Students, deserve appreciation for their dedicated, involved service to make this mega eventa grand success. Dr.G.B.Patil Chief Editor M dH tr ffi
- 24. FROM THE EDITOR'S DESK Its my immence pleasure to put forth before you this souvenir "Atharva-2006" with the theme "Evedential tool for eternal Cure" on the eve of Silver jubilee celebration of our esteemed institution. In Spite of many difficulties in organising an International Ayurvedic conference in a remote city like Gadag, the inspiration and blessings of His Holiness, Shri f a gad guru Abhinava Shivananda Mahaswamij i and the team work of our college and kind people of Gadag made it possible. In Present senario the whole world is looking towords Ayurveda with open mind and bright vision. The main motto of releasing this souvenir is to know about the present research works carried out across the globe. We have documented the articles of the renouned Ayurvedic stallwords and scholors. There is no doubt this souvenir makes the path to learn the vastknowledge about the science of healthby various eminentpersonalities. 4. I owe my humble gratitude to His excellency Honorable Fresident, Vice president of India, FIis excellenry Governor, Honorable chief minister and Deputy Chief minister of Karnataka, Holy ponti{fs and Ministers, official dignitaries for there well wishes. I would to thank shri S. B. Saunshi chairman of our institute and our beloved Like principal Dr. G. B. Patil for completing this difficult task successfuly. My speacial gratitudes to Dr. M. C. Patil, Dr. C. S Hiremath and all the staff members for communicating dignitaries and encouraging to participate across,the globe. My sincere thanks to authors for contributing their valuable reserach out come in the form of articles. I am personally great full to pharmaceuticals companies, donors, sponsors for stalls and advertisements by supportingwhole heartdly to make this event grand success. I should be very thankful to co-editors Prof. C. S. Bhat, Dr. K. S .R. Prasad, Dr. S. N. Belavadi, Dr. Sankadal,Dr.M. D. Samudri, Dr. SobagiruDr. Kendadmath,Dr. AdarshDr. S. B. Naveen B. Sajjan, Dr. Kumar C., Dr. Salma, Mr. Siddalingaswami and Miss Divya for their kind co-operation. I extend my gratitude to all the members of souvenir committe. I would like to thank all media persons for encapturing the proceeding of glistenary occasion. I express my gratitude to Shri K. K. Makali who has given scenic beauty to this souvenir, artistic glimpse to entire conference. I am pleased to thank Shri Ashok Khatawate, Shri Parashuram Khatawate, propriter of Twarita Mudrana Offset Printers for their kind co-operation in printing the souvenir in time. Last but not least my special acknowledgments to all the dedicated percons who helped directly or indirectly to bringthissouvenir. Dr.U.V.Purad Editor xw &d tr re
- 25. From the desk of organising secretary I have promised to keep miles to go before I sleep (William Words Worth) Its my proud privilege to be organizing secretary of an International Ayurvedic conference and Ayur Expo ATHARVA 2006 held on the eve of silver jubilee year celebration of our institution Shri D.G.M. Ayurvedic Med ical College, Gadag. Ayurveda, right from the ancient period, is the essence of India's indigenous and traditional heritage and eternally vibrant innovations for modifications in to allied systems. In the era of ANTIBIOTIC and LPG world atlatge, is looking at Ayurveda not because that it has rich treatment for sufferings but for its vast, experienced, enriched principles.In the new millennium, to face the challenges of globalization the age old concept of Ayurveda requires modification and specification, grving scientific validation to classical formulations in terms of safety and efficacy without deviating from the fundamentals. In pursuance of above these points, ATFIARVA 2006 is organised to reinforce the purity and potency of Ayurveda which provides a platform and abridge academicians, industrial persons for exchange and updating the current scientific informations wth plenary sessions along with stalls where different dimensional things are exhibittd.To refresh, culturalfestival is organised inthe evening. The how of work constitutes techniques, it is know how, getting superior results, art of utilizing the s€une resources, materials, man power, money, time and effort. More skillfully is technique. What turns ordinary into extraordinary is the extrawe putinto it. I take this opportunity to express my sincere gratitude to all the resource persons/ delegates, faculty members of our sister concern institutes, colleagues, chairmen and members of different comrnittee, non teaching and hospital staff, PG and UG students, advertisers, stallholders, press personnel and allthosewhohavehelpedmeinshouldering the responsibility. By above and all it is the blessings of His Holiness |agadguru Sri Abhinava Shivananda Mahaswamiji, which encouraged me to carry out this responsibility sincerely. "Manaswi karyartihi na ganayati dukha na cha sukham" To succeed you must be easy to start and hard to stop. May Lord Dhanwantari enshower with the success in your future endeavor. With tender regards, Dr. M. C. Patil Organising Secretary ATHARVA 2006. w w "qi
- 26. Chief Editorial Board Members Dr. G. B. Patil Dr. U. V. Purad Prof. C. S. Bhat Dr. K. Shivaram Prasad Chief Editor Editor Co - Editor Co - Editor Dr. S. N. Belavadi Dr. S. B. Sankadal Dr. M. D. Samudri Co - Editor Co - Editor Co - Editor Souvenir Committee Stage und Decorution Committee tE U ffi w
- 27. Reception Committee Re gistr utio n C ommitte e I i Scientijlc Committee Ayur-Expo Committee # w w
- 28. Catering Committee Cultural Committee Ac c omudation C ommitte e Volunteers Committee iY ,M tr re
- 29. OKGANISING COMMITTDE OF ATTIAKVA '06' Chief Patron Shri jagadguru Abhinava Shivananda Mahaswamiji Patron Dr. V. S. Acharya Minister for Medical Education Govt. of Karnataka Vaidya Shriram Sharma President, CCIM, New Delhi. Dr P. S. Prabhakaran Vice - Chancellor, RGUHS, Bangalore. Dr B. N. Prakash Director, ISM & H, Bangalore. Shri. S. B. Saunshi Chairman, JSWS's, Gadag. Organising Chairman Dr. G. B. Patil, Principal, DGMAMC, Gadag. Vice-Chairperson Dr. R. K. Gachinmath i: Dr. S. A. Patil Organising Secretary Dr. M. C. Patil Joint Secretaries Dr. K.Shiva Rama Prasad Dr. K. S. Sankh Dr. R. V. Shettar Dr. Santosh N. Belavadi Chief Co-ordinators Dr. V. Varadacharyulu Dr. Purushottamacharyulu Dr. G. V. Mulagund
- 30. Reception Committee Dr. R. K. Gachinmath Dr. G. S. Hiremath Dr. B. S. Patil Dr. B. M" Mulkipatil Shri M. K. ]oshi Smt. M. B. Halli Shri A. V. Lakkundi Shri S. B. Gadad Smt. T. S. Kotabagi Dr. Kushal Kori Miss. Madhavi Bhat Mr. Kiran Mourya Miss P. Khatwate Registration Committee Dr. G. S. ]uktihiremath Shri N. B. Rayanagoudar Dr. V. M. Malagoudar Miss Shantawa Shri V. M. Mundinamani Dr. L. M. Biradar Dr. Veena Kori Miss Deepa Ashtaputri Shri B. L. Karamudi Mr. K. K. Gurupadaswami Smt. L. S. Bhaiantri Shri L. V. Bevinkatti Stage Committee Dr. S. A. Patil Shri S. T. Kerur Dr. B. G. Swami Shri S. G. Patil Dr. S. B. Govindappanavar Smt. R. H. Bandi Dr. S. G. Vijapur Dr. Sharanu Angadi Dr. R. V. Shettar Dr. Ravi Nandi Shri. S. K. Belavadi Mr. Viiay Mulimani Smt. M. N. Kotabagi Miss T. S. Saiini Smt. V. T. Medagoppa Mr. Yogesh Kulkarni Catering Committee Dr. C. S. Kudarikannaur Shd B. B. Masanagi Dr. S. D. Yarageri Shri D. H. Nabinavar Dr.M. V. Aiholli Smt. K. H. Agasimani Dr. S. B. Sankdal Dr. Kattimani Shri T. B. Hanchinal Dr. Shailej Smt. Y. S. Bidikar Dr. foshi Smt. A. C. Patil Dr. Shivakumar Shri B. N. Bumannavar Mr. Lingarai Shivareddy Miss Aishwarya V. I. rH ,fd w
- 31. Accomodation Committee Dr" V. M. Sajian Shri Prabhu Dr. S. H. Radder Dr. Sulochana" B. Dr. N. S. Hadli . Dr" V. G. Hiremath Shri B. M. Sarvi Dr. Umesh K. Shri B. S. Tippangoudar Dr. Payappagoudar Smt. R. J. Choudi Dr. Neeraj Shri A. B. Hatti Dr- Budi Shri F. L. Bhajantri Miss Vidya Chandu Smt. R. D. Talawar Mr. Shivanand K. Shri M. H. Dambal Miss Ashwini T. S. Cultural Committee Dr. R. R. Joshi Shri N. T. Tuppad Dr.J. S. Viraktamath Shri S. B. Navalekar Dr. S. B. Nidagundi Dr. |agadish H. Smt. S. C. Sarangamath Miss Shivaleela Smt. S. Cl Koppal Miss Subhalakshmi Smt. K. I. Girimalla Miss Shilpa AYUR EXPO COMMITTEE Dr. C. S. Hiremath Smt. M. S. Koppal Dr. P. C. Chappanmath Dr. Krishna Jigalur Dr. Kuber S. Sankh Dr. Patil G. Dr. Y. A. Phaniband Dr. Nataraj Shri H. K. Dasar Dr. Prasankumar Smt. S. H. Eekbote Dr. Uday Ganesh Shri S. S. Shyavi Dr. Kamalakshi Shri M. S. Patil Miss Shweta Volunteers Committee Dr. S. S. Awanni Shri R. Y. Navalgund Dr. K. S. Paraddi Dr. Sarvi Dr. S. V. Sankanur Mr. Dharmendra P. Dr. G. N. Danappagoudar Miss Nandini K. Shri Y. H. Harijan Mr. Adarsha B. Shri G. B. Nagthan Mr. Rajesh D. Shri N. B. Bommannavar *H u aY# ,ffi tffixt* ffiffi
- 32. Souvenir Commitee Dr. U. V. Purad Prof. C. S. Bhat Dr. K.S.R. Prasad Dr. S. N. Belavadi Dr. Shankargouda Dr. M. Q. Samudri Shri S. C. Biradar Shri S. K. Kallanagoudar Shri S. B. Sureban Shri S. T. Kulkarni Smt. P. B. Bidari Dr. Sobagin M. Dr. Kendadmath Dr. Adarsh E. K. Dr. Naveen Sajjan Dr. Salma Shirin Dr. Kumar ChoudaPPalavar Mr. K. M. SiddhalingaswamY Miss Divya N. Scientific Committee Dr. M. C. Patil Dr. Anita Dr. R. V. Shettar Dr. Suvarna Dr. I. G. Mitti Dr. jayshree Dr. Ashok M. G. Dr. Sanjeev Dr. Madhushri Dr. Ashwini Dr. Savita Bhat Dr. Shibaprasad Editorial Board Chief Editor Dr. G. B. Patil Editor Dr. U. V. Purad Co-Editors Prof. C. S. Bhat Dr. K. Shiva Rama Prasad Dr. S. N. Belavadi Dr. S. B. Sankadal Dr. M. D. Samudri Members Dr. Mallikarjun Sobagin Dr. Kendadamath Dr. Adarsh E. K. Dr. Naveen Sajian Dr. Salma Shirin Dr. Kumar Choudappalavat Mr. K. M. SiddhalingaswamY Miss Divya N. * {H oid w
- 33. Organising Committee of Silver fubilee Celebration Chief Patron : His Holines Shri Jagadguru Abhinava Shivanand Mahaswamiji Shivanand Math, Gadag Honorary President ' Shri D.R. Fatil M.L.A. Gadag Honorary Adviser Comittee Members Shri Shashidhar K. Kuradagi, President Zillapanchayat, Gadag Shri G. M. Dhananjay, I.A.S. Dist. Commissioner, Gadag I Shri K. V. Shridhar, I.P.S. Superintendent of Police, Gadag t Shri Avatar Singh, I.F.S. Deputy Conservator of Forest, Gadag I Shri H. V. Bellikatti, Commissioner of Gadag-Betageri Mulcipalty Shri C. S. Muttinapendimatll Ex. M.L.A. Gadag Shri Shrishilappa Bidarur, Ex.M.L.A. Ron Shri S. B. Sankannavar, President Merchants Co-operative Bank, Gadag Shri B. B. Bannad, President Chamber of Commerce, Gadag Shri K. Sudhakar, President Hotel Owners Association, Gadag Shri K. B. Talageri, President Kannada Sahithya Parishath, Gadag Shd S. V. Sankanq, Vice President of Kamataka Rajya Viinarn Padshath Bangalore Shri S. S. Mushannanavar, President Gadag District Principals Forum Shri Ananth Karkal, President Shri N. RamRao, President Shamiyana Suppliers Association, Gadag Dr. B. N. Patil, President,I.M.A. Gadag Dr. S. R. Hiremath, President, N.I.M.A. Gadag Shri S. R. Mandre" Consulting Engineer, Gadag Shri N. A. Gularaddy, Chief Commandent of Homegaurds, Gadag Shri H. S. Patil, President Rotary Club, Gadag-Betageri Shri Shushilendra joshi, Abhinaya Ranga, Gadag Shri Siddu B. Yapalparvi, Samarasa Balaga "S 1L!9 6d 6W 1ffitr' ffi
- 34. President Shree S. B. Saunshi, Chairman, j.S.V.V.S. Gadag Vice-President Shree S. S. Patil, Ranebennur Shree M. S. MulkiPatil, BhairidevarakoPPa Secretary Dr. G. B. Patil, Principal Treasurer Dr. C. S. Kudarikannur Members Dr. R. K. Gachinamath Dr. S. A. Patil Dr. U. V. Purad Dr. S. D. Yarageri Shree M. K. Joshi Shree B. L. Karamudi Shree S. T. Kerur Shree L. V. Bevinakatti u ilH ^q,--4 trNE.., &wkz ew *16$" ruB
- 35. INDEX Part I THEME TALK Status and Strategies for Development of Ayurveda In 21st Century r Vaidya S. K. Mishra Part ll PLENARY Immunity Promoting Bffects of Rasayana and Vajikarana Drugs o Prof. Gurdip Singh 3. Ayurveda verses today's life threatening diseases o Dr. Krishna U. K. l5 4. Keraleeya chikitsa Kramam o Dr. M. R. Vasudevan Namboothiri t7 Role of ayurvedic herbs for preserving and restoration of mental health o Dr. K. Nishteswar Practical Ayurvedic Nadipari kshana o Dr. Vaibhav Lunkad A 7. Management of Growing Mangement of Growing Children - Ayurvedic Perspective r Dr. V. L. N. Shastry 8. An observational Sfudy on dose - Safety Relation of certain Ayurvedic Metallo-Mineral & Herbo - Mineral & Herbo - Mineral Formulations r Dr. Shastry J. L. N. 30 9- Bvidence base for Tiaditional Medicine through Practice Based Research o Dr. P. Ram Manohar 10. Current Trends and Recent Advances in Vasti o Dr. L. Mahadevan ll. Maternal and Child health care India new approaches o Prof. Manjari Dwivedi - u 12. Natural Product Chemistry: For better efficacy of plant products. o Dr. Hrishikesh Damle 50 13. A comparative preliminary study of anti-bacterial effect of an Ayurved preparation of Sarva visadee oil o B. M. Nageeb 52 l!t. Rejuvenate and Promotive aspect of Ayurveda o Dr. Srinivas H. Acharya 54 *B a-9 aY# ffi
- 36. Part lll KEY NOTES 15. Pathophysiology of hypertension in Ayurveda o Dr. G. Shrinivasa Acharya 61 16. Preventive and curative In pedlatrics o Dr. Shailaja U. Rao 66 t7. Scenatio of Rasa Shastra : Past Heritage and Glory, Present Status and Challenges and Future scope and message r Dr. T. N. Nagaraja M.D. 68 18. Modalities of Rasoushadhies in Clinical Practice o Dr. Ramesh Harwalkar 72 19. Anlyti'cal approach to the Rawdrugs and Prepared Medicine of Rasashastra o Dr. P. H. C. Murthy 76 Graha Chikitsa (Ayurvedic Psychiatry) A Branch of Ashtanga Ayurveda o Dr. Prashanath. A.S.M.D. 77 21. Scientific Method of Screening The Endogenous Toxins Expelled During The Panchakarma Therapy o Dr. Shashidhar H. Doddamani 80 Significance of Rasaushadhi's in Atyaika chikitsa r Dr. B. Gurubasavaraja 85 .,., In Rasayana and Vqieekarana Perspective - Practice-scope and Research o By Dr. Madhava Diggavi 87 24. Critical Evaluaition of Ojovaha Srotas and Managment of its vikara by Panchakarma Therapy o Dr. Parameshwarappa S. Byadgi 90 Part lV Articles 25. Panchakarma And Cosmetology Holistic Approach o Dr. G. Purushothamacharulu 97 26. Importance of Pathya In urinary Disorders Special Reference To Madhumeha o Dr. Anand V. Joshi, Dr. Vijaya A. Joshi 104 27. Metabolic liver disorders and there management - an Ayurvedic view r Dr. Prasanna N. Rao 107 Necessity and Problems In formulating New Technical words for Ayurveda o Dr. Prasad B. S. 110 29. Pre-concept ional care in Ayurveda r Dr. V. N. K. Usha tt4 *S w nY# ffi
- 37. 30. Upadrava Vigyan : Science, Theory & Application r Dr. B. C. Jana, Dr. Debasis Khan 118 31. Encrypted Ayurveda to Decrypted Evidence o Dr. K. Shiva Rama Prasad t)) 3L Non-Invasive Procedures in Arshas / Haemorrhoids o Dr. P. Hemantha Kumar 127 33. A study of Clinical Efficacy of Janu Thrpana In sandhi vata (Osteo Arthritis) of knee o Dr. R.N. Pradhan 130 }{. Quality Assurance in Ayurvedic pharmacy o Dr. Sathyanarayana B. f33 35. Concept of Swasthavritta o Dr. Ashok Kumar Panda 136 x. Role of yogabasthi in the management of Gradhrasi o Dr. Muralidhar P. Pujar o Dr. Santosh Bhatted o Dr. Ashvinikumar M. f40 37. Holistic Approach towards Healthy ageing o Dr. Managalagowri V. Rao 143 3t. Ahara the dynamic principle in prevention of Diseases o Dr. P. Nagaraju MS L46 39. Pelvic Region Marmas'in Clinical Practice r Prof. Dr. N. G. Mulimani 148 .r,0. Folklore Medicine - The Treasure house of Ayurveda o Dr. T. S. Bairy, Dr. Ravikarishna S. 150 1r. Postmenopausal Osteoporosis is an age related Physiological Change not a disease and Ayurvedic Perspectives o Dr. Basavaraj S.. Hadapad 152 12. Mental Health And yoga r Dr. Manjunatha N. S. 155 43. Vivid Analysis on Abhyantara Snehapana e Dr. Santosh N. Belavadi 158 4. Conception Sandhana karma o Dr. M. D. Samudri 165 {5. Evidence Based Ayurvedic Treatment for Migraine r Vaidya Balendu Prakash 172 #. Should use of condom be spoken openly in the prevention of of AIDS. o Dr. Padmanabha Kulkarni 175 u 6c w F,+'
- 38. 17. Cure Cataract and incurable eye diseases by Ayurvedic Isotine Eye Drop o Dr. M. S. Basu 176 48. Virechana in Svastha o Dr. Shivakumar S. Harti, Dr. Sajitha K. 178 49. Preventive Measures in Hypertension (Raktatimardam Pratishedopaya) o Dr. Ashok Patil, Dr. R. G. V. Ramana, Dr. Sajitha K., S. D. M. C. A, Hassan 180 50. Uttara Basti in male Infertility Dr A. S. PATIL 174 51. Surgery in Ayurveda ' . Dr. Ramasunder Rao 186 52. "Clinical and Experimental Validation of Ayurvedic drugs on Infective Hepatitis" o Prof. N. P. Rai, Dr. Vijay Kumar Srivastava 193 53. Atyayika chikitsa in Ayurvedic o Dr. V. V. S. Rama Sastry 197 T B d6 tr
- 39. Part I THEME TALK
- 40. STATUS AND STRATEGIES FOR DEVELOPMENT OF AYURVEDA IN 21ST CENTURY o Vaidya S. K. Mishra, President, All India Ayurveda Vidyapeeth Ex.-Advisor (Ayurveda), Government of India, Neu'Delhi. INSTITUTIONS RESPONSIBLE F'OR DEVELOPMENT OF AYURVEDA AT CENTRAL LEVEI- : ..'. Dept. of AYUSH, Ministry of Health & Family Welfare, Govt. of India * Central Council of Indian Medicine in respect of education * Central Council for Research in Ayurvedic and Siddha for Research in various aspects * National Institute of Ayurveda, Jaipur for Model Education and Health Care * National Medicinal Plants Board for development of Medicinal Plants * Pharmacopoeial Laboratory for Indian Medicine at Ghaziabad + Dept. of Health/Ayurveda of State Government .." Directorate of Ayurveda/Indian systems of medicine * State Boards/Council of Ayurveda fr:r registration and regulation of practice * State Drug Controller of Ayurveda * Approved State Drug Testing Laboratories INFRASTRUCTURE OF AYURVEDA : * Colleges conducting Graduate Course 233 * Institutions conducting P.G. Courses 58 * AyurvedaUniversities 2 * Registered Practitioners of Ayurveda 4,35,000 * Licensed Pharmacies of Ayurveda 9,500 + Universities with affiliated Ayurvedic Colleges 46 * Number of Ayurvedic Dispensaries 20,000 * Number of Ayurvedic Hospitals 2,200 CENTRAL ACTS REGULATING EDUCATION AND DRUG CONTROL + Indian Medicine Central Council Act .i. Chapter IV-A of Drugs and Cosmetics Act and Rules * Drugs and Magic Remedies Act 'l1-)Zttt ,/ r'E_o &wk1 8,ebTJ'# a -//,r rry)/n$ t(xw W 1-
- 41. Ofi'RSES OF STT'DY FOR AYURVEDA * Ayurvedacharya - B.A.M.S SVz Yrs. * Ayurveda Vachaspati - M.D. (Ay.) 3 Yrs. * Ayurveda Dhanvantari - M.S. (Ay.) 2 Yrs. .... Ph. D. (Ayurveda) 2 Yrs. (Minimum) RAV COURSES * Member of Rashtriya Ayurveda Vidyapeeth - MRAV 2 Yrs. * Advanced Training under Chikitsak Guru 1 Year PARA MBDICAL AND OTHER COURSES * B. Pharma (Ayurveda) 4 Yrs. * D. Pharma (Ayurveda) 2 Yrs. * M. Pharma (Ayurveda) 2 Yrs. * PanchakarmaTechnichian 2 Yrs. * PanchakarmaAssistant I Year * Ayurvedic Nursing Course 2 Yrs. QUALITY CONTROL OF AYURVEDIC DRUGS A. ORGAMSATIONS * Ayurvedic Pharmacopoeia Committee * Ayurveda Siddha Unani Drugs Technical Advisory Board t * Ayurveda Siddha Unani Consultative Committee * Pharmacopoeial Laboratory for Indian Medicine * Drugs Standardization units under CCRAS B. PHARMACOPOBIA AND FORMULARIES * 5 Voulmes of Ayurvedic Pharmacopoeia of India already published - 425 Drugs * 2 Volumes of Ayurvedic Formulary of India already published - 636 Drugs * Good Manufacturing Practices (GMP) for Ayurvedic Drugs already enforced ORIGIN OF AYURVEDIC DRUGS * Drugs of Vegetable Origin 2000 * Drugs of Mineral/I4etallic Origin 125 * Drugs of Animal Origin 50 * Drugs of Sea Origin 15 MEDICINAL PLANTS BOARD * National Medicinal Plants Board under Dept. of AYUSH functioning at New Delhi * 15 State Govts already established State Medicinal Plants in their States. 4
- 42. MBDICINAL PLANTS BOARD (FUNCTIONS) * Enlistment of RARE and ENDANGERED species of individual plants used ,{1'un'edicl Siddha/Unani Systems .:. Development of growing techniques for these medicinal plants on priority basis * Providing financial assistance to farmers for growing these plants * Creating and developing infrastructure for the purpose of value addition, storage and packing of drugs conforming to international standards * Scientific technological and economic research on medicinal plants SCENARIO OUTSIDE INDIA Regular GRADUATE & POST GRADUATE Courses conducted, Sri Lanka, Bangladesh. Myanmar (similar to Ayurveda), Thailand (similar to Ayurveda), + Short Term Courses being conducted at: . Australia, Italy,Britain,Holland,Germany,Brazil {. Ayurveda formally recognized in: . Hungary, Mauritius, South Africa, Ayurvedic Panchakarma in Russia TURN OVER OF AYURVEDIC DRUGS * Domestic Market Rs. 5000 Crores + Export Worth ,: Rs. 1000 Crores * These are in addition to medicines prepared by individual physician and colleges for their patients GROUPING OF PHARMACIES * Producing more than Rs. 1000 Crores 10 * Producing more than Rs. 5 Crores 100 * Producing more than Rs. 1 Crore 1000 ol Producing less than Rs. 1 Crore 7400 MEDICINAL TOURSIM THROUGH AYURVEDA * Health Care according to Ayurveda is an important factor in Kerala * Karnataka is also progressing on this line * Ayurvedic Panchakarma Centre has been established in most of the FIVE STAR Hotels like Hotel Ashok in Delhi * One day Health Care by massage and fomentation is also becoming a point of attraction After going through these facts and figures in respect of development of Ayurveda during last 50 years or so, one may feel satisfaction with these achievements. Howeve4 there is much more to be done in every aspect of Ayurveda in this competitive and scientific era .
- 43. l l PRESENT SCENARIO IN THE EDUCATION .:. As stated earlier, there are a large number of educational institutions. However intensive training in Ayurveda, both theoretical and practical is being provided only in a f-ew institu- tions. t Number of qualified teachers in most of the institutions are minimal and do not even fulfill the requirement of minimum standards. * Many teachers though working on part time basis are shown as full timers. In some of the institutions. they are only on rolls but physically present only when there are visitors from C.C.I.M or UniversitY. * Many others come only for one or two hours as per teaching schedule. They never utilize library and do not participate in the departmental enlistment. * Extra curricular activities in most of the institutions are negligible. * In some of the institutions, even classes are not regularly conducted. Bogus attendance is shown in attendance registers. PRBSENT SCENARIO IN THB EDUCATION * Many students are also not serious in teaching and training. Their objective is to obtain degree by hook or crook. * The attraction of degree of Ayurveda is to practice modern medicine * After Supreme Court judgment and restrictions by many State Governments and also objection made by Medical Council of India, Indian Medical Association, etc. practice of modern medicine by Ayurvedic Graduates is becoming very difficult * Hospitals attached to Ayurvedic Colleges, in most of the cases, is also without patient or have only a few patients * Dissection halls are without cadavers so there is no arrangement for teaching and practice of Anatomy * There are many such lacunae and I need not explain all those before you. Many teachers and students present in the conference must be aware about many of these difficulties. We must make proper efforts to strengthen Ayurvedic education SUGGESTIONS FOR IMPROVEMENT IN AYI]RVEDIC EDUCATION * The minimum standards should be maintained by all Ayurvedic Colleges without exceptions * Teachers not only be regular but work hard for obtaining latest technical and scientific knowl- edge of the subject concerned * They also be in touch with scientists and counterparts in medical colleges to acquire up-to- date knowledge * Deep knowledge of Sanskrit and working knowledge of computers are absolutely necessary , for every teacher of Ayurveda * The teaching should be based on applied aspect so that it should be convincing to students * In addition to Ayurvedic teaching, latest diagnostic methods should be taught to students and equipments must be made available in the libraries
- 44. SUGGESTIONS FOR IMPROVEMENT IN AYURVEDIC EDUCATION + Bedside clinical training for clinical subjects is necessary so that students can gain practical knowledge * Knowledge of Ayurvedic medicine should be paramount. f{ow a medicine acts and u'hat are the main ingredients of that medicine should be taught to the students t In addition to attendance in class rooms, attendance in library and reading room should also be observed Teachers training program must be made compulsory for further promotion etc. Consortium of subject teachers on regional basis is organized to learn from each other's expenence + Teachers and students must understand that they are for Ayurveda and devote their for upliftment of Ayurveda and also health and medicare through Ayurveda RESBARCH IN AYURVEDA * Coordination among institutions engaged in research is absolutely essential * Research should be basically to fill up the gap of knowledge essentially needed for Ayurvedic teachers and practitioners. ltr Ayurvedic treatment even now is most effective in diseases, which occur due to functional disorders in the body. These are basically due to Mithya Ahara and Vihara. Diabetes, Hyper- tension, Gastro intestinal disorders, etc. are in this group. Ayurvedic physicians are in search of Ayurveclic medicine, which will reduce Blood Glucose, level or increase of blood pressure on time bound basis. These are available but need to be proved scientifically. Research organizations must work on such projects on a priority basis. * Big Pharmaceutical concerns of Ayurveda should also invent some medicines of such imme- diate utility instead of maintaining their R & D only for namesake. RESEARCH IN AYURVEDA * The ready made answer to students and physicians about action of Ayurvedic drugs - horv and why is the need of time + Golden triangle for Research in Ayurveda involving CSIR and ICMR with CCRAS is a welcome step. However, objective should be very clear and results must be on a time bound basis * Results of Research so far conducted be published subject wise. DRUGS AND MEDICINAL PLANTS * Availability of genuine and effective Ayurvedic drugs must be ensured. Drug control or,sani- zations should work effectively. * The Propaganda of reaction of drugs of mineral and metallic origin be rebutted on scientific lines. Nano technology is well known now worldwide. The Ayurvedic Pharmacy is mother of Nano technology. This aspect must be forcefully spread. * Medicinal plants, which are not available in required quantity, be cultivated on lar-se scale. The farmers should be encouraged by paying them more than what they can get by farming of cereals.
- 45. * Banning or licensing of use of drugs of Animal origin like Musk, Coral. Horn of deer, etc" should be lifted for Ayurvedic drug purposes. Likewise availability of Opium, Cannabis, etc" for Ayurvedic drug industry be liberalized. * Export of Ayurvedic drugs be encouraged. aa"a Preparation of patent and proprietary Ayurvedic drugs by using total extract of drugs of vegetable origin be encouraged. * Many other aspects may also be important but only some pressing issues have been raised due to paucity of time + I hope that these suggestions will be taken up seriously for future growth of Ayurveda I
- 46. Part II PLENARY "S tl-tt aY# " /1E.0 ffi l&rtn)F4 M
- 47. IMMUNITY PROMOTING EFFECTS OF RASAYANA AND VAJIKARANA DRUGS Prof. Gurdip Singh Director PG Studies SDM College of Ayurveda, Hassan & Formerly Dean Gujarat Ayurveda University Jamnagar Ayurveda does not merely believe in adding the number of years to life but it advocate to add life to the each year. This may be one of the reasons that the first aim of Ayurveda is to preserve and promote the healthy of healthy persons. To fulfill this aim Ayurveda maintains two separate branches viz. Rasayana and Vajikarana since the time immemorial. Rasayana mainly deals with promotion of physical and mental health and Vajikarana is for promotion of sexual health. The properly and timely use of Rasayana drugs promote youthfulness, provides longevity, memon'. intelligence, complexion, body glow and best physical strength as well as of senses (Charaka Chikitsa uI). All these actions of Rasayana indicate towards the fact that by undergoing the Rasayana therapv one can live a long span of youth life, full of vigor and free from diseases as well as adverse effects of aging. But such a span of life is possible only when one has a strong resistance and general immunitl' against the diseases. Therefore,. it can be postulated that Rasayana drugs may have immunity improving effect. Now a day prevention of the diseases is achieved by immunization specifically against the each F , disease. But the number of the diseases is so much that practically it is not possible to immunize a person against all the diseases. On the other hand the concept of Rasayana seems to increase the general immunity so that one can live a long span of youthful life free from the diseases. It may provide an umbrella against the diseases and aging by promoting the physical and mental health. All these points generate an idea that Ayurveda believes in promoting the general immunity of a person so that he can fight out any type of disease at its very onset. The concept of Vyadhi Kshamatva is clearly available in Charaka Samhita, wherein it is mentioned that the persons who are neither obese nor thin, who are having well functioning muscular, blood and bone tissues; who are brought up on wholesome and nourishing diet, and who are psychologically strong do not suffer from the diseases frequently and if suffer then they can tolerate it well because of having good immunity (Vyadhi Kshamatva). On the other hand the persons who are either obese or thin, who are not having well functioning muscular, blood and bone tissues, who are brought up on unwholesome and un-nourishing diet, and who are psychologically weak are unable to tolerate the diseases as well suffer from the diseases frequently. It is due to diminished state of immunity (Vyadhi Kshamatva) in such persons (Charaka Samhita Sutra 28:7). Chakrapani has further classified Vyadhi Kshamatva into two type viz. Vyadhi Bala Virodhani (passive) and Vyadhi Utpada Pratbandhaka (active). In addition the concepts of three types of Bala viz" 1'l
- 48. l Sahaja (natural), Kala (seasonal) and Yukti (acquired) and Pratyanika Bala (tissue resistance) are also there. It is obvious from the foregoing that of general immunity (Vyadhi Kshamatva) is present a concept in Ayurveda since the period of Charaka Samhita. For this purpose Rasayana drugs were particularly used. Other measures used for increasing the Vyadhi Kshamatva were Vajikarana, seasonal administration of Shodhana and practicing the rules of Dina-Charya, Sad-Vritta and Achara Rasayana. To prove the hypothesis that Rasayana drugs may have immunity promotion effects, Singh, Gurdip (1982) canied out an experimental study and showed that Vacha (Acorus columus), Shatavari (Asparagus racemosus) and Mandukaparni (Hydrocotyle asiatica) significantly increase the serum humoral antibodies in rabbits. Out of these three drugs the effect of Mandukapami (Hydrocotyle asiatica) was considered better. Encouraged from the results of the above mentioned experimental study, further studies were undertaken on human beings to evaluate the immunity promotion effects of certain Rasayana drugs viz. Mandukaparni (Hydrocotyle asiatica), Ashvagandha (Withania somnifera), Guduchi , (Tinospora cordifolia), Amalaki (Embelica officinalis), Shatavari (Asparagus racemosus), Varahikanda (Diascorea bulbifera) and milk and Vajikaran drug- Kapikacchu (Mucuna pruriens). Patients and Methods: The body maintains its immunity through immunoglobulins, which are classified into five groups viz. IgA, IgG, IgM, IgE and IgD. Out of these IgE is related mainly with allergic response and at the time of conducting this study the function of IgD was not known, Therefore IgA, IgG and Igm were selected as parameters for this study. The main functions of these immunoglo- bulins are as follow:IgA: Protects mucous membranes,IgG: Provides general immunity,IgM: It is a first class immunoglobulin with 10 sites to destroy ten antigens at a time. Measurement of Immunoglobulin: Immunoglobulins-IgA, IgG and Igm were measured by using Tripartigen plates of Behringweke (Pfizer) before and after the treatment.The duration of treatment in all the groups was one month. The other details are mentioned along with findings of each group of the treatment. Immunity Promoting Effects of Mandukaparni (Hydrocotyle asiatica) : Twelve aged patients who were frequently suffering from seasonal diseases such as common-cold, phyringitis etc were included in this group. These patients were administered Mandukaparni powder in the dose of 3 gm three times a day with water for one month.The results of this study showed that Mandukaparni caused significant increase in the serum IgA and IgM levels of the patients of this group. Immunity Promoting Effects of Ashvagandha (Withania somnifera) : Twenty two patients of allergic rhinitis and phyringitis were studied in this series. They were randomly divided into two groups. The patients of first group were administered powder of Ashvagandha in the dose of 6 gm twice a day with ghee for one month. The patients of control group were kept on placebo for one month.The results of this study showed that Ashvagandha highly significantly (P<0.001) increased rhe serum IgA, IgM and IgG in comparison to control group. It was also observed that the recurrence of these diseases was prevented by the treatment ranging from six months to one year. , Immunity Promoting Effects of Guduchi (Tinospora cordifolia) : A group of aged persons was administered powder of Guduchi in the dose of 4 gm twice a day for one month. The results of this study showed that Guduchi significantly (P<0.05) increased the serum IgA. 12
- 49. Immunty Promoting Effects of Amalaki (Emtrelica officinalis): The immunity promotion effect of Amalaki was evaluated in both aged persons and young volunteers. The volunteers of both the groups were administered powder of Guduchi in the dose of 4 gm twice a day with water for one month-The results of these two studies showed that Amalaki significantly increases the serum IgA in aged persons and it significantly increased serum IgM in healthy young volunteers. Immunity Promoting Effects of Shatavari (Asparagus racemosus) : The powder of Shatavari was administered to a group of healthy volunteers in the dose of 4 gm twice a day with water for one month.It has been shown in this study that Shatavari significantly increases (P<0.05) the serum IgA and IgM levels. Immunity Promoting Effects of Varahikanda (Diascorea bulbifera) : 11 aged persons were treated with the powder of Varahikanda administered in the dose of 4 gm twice a day for one month.It has been reported that Varahikanda significantly increases serum IgA and IgM levels. Immunty Promoting Effects of Atibala (Abutilon indicum) : Atibala (Abutilon indicum) is a Rasayana drug commonly used for Vata disorders. Its powder was administered in the dose of 6gm trvice a day with ghee and hot milk to a group of aged persons. The duration of treatment was one month.The results of this study showed Atibala does not cause significant increase in any of the immunoglobulin. On the other hand it caused slight 4nd insignificant decrease in the serum IgG level Immunty Promoting Effects of Milk : According to Ayurveda milk is Ajasrika Rasayana i.e. it is to be taken daily in the diet to get continuous Rasayana effect. Therefore the immunity promotion effect of milk was also studied. For this purpose the aged persons were given 400m1 of milk twice a day for one month.The results of this study showed that rnilk significantly increases serum IgA, AgG and I-eM of the aged persons of this series. Immunty Promoting Efiects of Kapikacchu (Mucuna pruriens) : Kapikacchu is a well knorvn Vajikarana drug. Its effect on the immunoglobulin was also studied. For this purpose a group of 11 aged persons was treated with powder of seeds of Kapikacchu administered in the dose of 4 gm twice a da1' with water for one month.It has been found that Kapikacchu significantly (P<0.05) increased the serum IgM level. Discussion : The body maintains its immunity through immunoglobulin, which are classified into five groups viz.IgA, IgG, IgM, IgE and IgD. Out of these IgE is related mainly with allergic response and at the time of conducting this study the function of IgD was not known, therefore IgA, IgG and Igm were selected as parameters for this study. The main function of these immunoglobulins was as follorv: IgA: Protects Mucous Membranes,IgG: General Immunity,IgM: First class immunoglobulin with i0 sites Immunoglobulin A: IgA is the primary immunoglobulin of all mucosal surfaces and exocrine secretions. It is secreted in colostrum, saliva, tears, mucous membrane and other external secretions. It forms the first line of humoral defense against infections of Respiratory and GI Tracts. It forms a protective coating over mucous membranes and thus behaves as an antiseptic coat. IgA group of antibod- ies also contain some types of antibacterial antibodies which gives immunity against diphtheria and tetanus (exotoxin producing agents). It has been observed that the patients in deficient of IgA subject to frequent pulmonary infections. Patients of Ataxia telangiectasia are also reported deficient in IgA IgA does not pass through placental barrier and is not usually detectable at birth and human infant is capable to synthesize it at 2 to 3 weeks of age. 13
- 50. Immunoglobulin G: IgG class of immunoglobulin contains most of the antibacterial and antiviral protective antibodies which determine immunity against infection. It provides general immunity, but it is a secondary or recall immune response. Its ability to diffuse into body tissues facilitate combination and efficient elimination of antigenserum IgG crosses the placenta and at birth baby possesses high amount of IgG. But infant produces it at about seven weeks of age. Immunoglobulin M: IgM is having ten combining sites to destroy ten antigens at a time as well as it activates compliment fixation system. IgM is the major part of the early/primary response, especially in response to non-protein bacterial antigens. It readily fixes compliment, allowing for the efficient lysis of antigen.As mentioned earlier Ashvagandha significantly increases IgA, IgM and IgG. Mandukaparni significantly increases IgG and IgM. Varahikanda, Milk and Shatavari significantly increase Serum IgA onA Igiut. Amalaki and Guduchi significantly increase the serum IgA. The implication of these findings on each of the immunoglobulin is being discussed here under separate heading. Effect of Rasayana Drugs on fmmunoglobulin A Ashvagandha, Shatavari, Guduchi, Amalaki and Milk caused significant increase in the serum IgA levels of the patients. As mentioned earlier IgA is secreted in colostrums, saliva, tears, respiratory tract and intestinal mucosa. It forms a protective coating over mucous membrane and thus behaves as an antiseptic coat. Hence these drugs may be very useful in prevention of diseases of Respiratory and GI Tract. They may also be used as Naimittika Rasayana for the disorders of these systems. Effect of Rasayana Drugs on Immunoglobulin M Ashvagandha, Shatavari, Mandukaparni, Varahikanda, milk and Kapikacchu caused significant increase in serum IgM levels of the patients of this series. IgM is having ten combining sites to destroy ten antigens at a time as well as it activates compliment fixation system. Therefore these drugs may be very useful as general immunity promotion drugs against the infections. If is further noticed that most of Rasayana drugs caused increase in this immunoglobulin, which indicates the beneficial effect of these drugs in improving the general immunity. Effect of Rasayana Drugs on Immunoglobulin G Ashvagandha and Mandukaparni increased the serum IgG. As this immunoglobulin crosses the placenta, therefore these drugs may provide passive immunity to the child during the infancy period if administered to the mother during pregnancy. However, before such use, it is desirable to evaluate the safety profile of these drugs on the fetus. On the other hand the drugs like Atibala, Guduchi and Kapikacchu caused slight and insignificant decrease in the serum IgG level, so such drugs may be avoided during pregnancy. But these drugs may be useful in treating the auto-immune diseases due to the immuno- suppressive action of these drugs. Conclusion On the basis of the results of this study it can be concluded that most of the Rasayana and Vajikarana particularly. studied in this series has general immunity promotion effects. On the basis the results of these studies it is recommended that further studies may be undertaken to evaluate their utility in improving the general immunity against infectious diseases as well as against immunity deficiency disorders including AIDS. 14 "S g ffi
- 51. AYURVEDA VERSES TODAY'S LIFE THREATENING DISEASES o Dr. Krishna U. K. B.S.A.M., M.D.(Ay), Ph.D.(Japan) , Director, Nippon Ayurveda School. Japan Introduction : Ayurveda, the age old science of human living, aims at promoting health and managing ailments. A normal life span with a natural death is considered to be the result of incorporating Ayurveda in daily Iife. The interest in adopting the principles of Ayurveda is growing world wide. Modern world with all its astonishing progress in science and technology is facing serious problems in the field of medicine. Escalating health care costs and deteriorating quality of life is seen hand in hand with economical and industrial growth. Heart diseases, Cancer, Cerebrovascular accidents are the main killers, which make.nearly 70Vo of the causes of death in adult population in a modern society like Japan. These ailments, once set in, have no satisfactory treatments, hence is the stress laid on preventing them. Of course, there are several high-tech treatments offered to manage these diseases, all of which are financially expensive and reduce the Quality of Life (Q.O.L.) of the sufferers to a miserable level. What is a life threatening disease Food and Drug Administration (FDA) of the U.S. Department of Health and Human Services has defined the term life-threatening disease as (1) diseases or conditions where the likelihood of death is high unless the course of the disease is intemrpted and (2) diseases or conditions with potentially fatal out- comes. The seriousness of a disease is a matter of judgment, but generally is based on such factors as survival, day-to-day functioning, and the likelihood that the disease, if left untreated, will progress from a less severe condition to a more serious one. For example, acquired immunodeficiency syndrome (AIDS), all other stages of human immunodeficiency virus (HIV) infection, Alzheimer's disease, angina pectoris, heart failure, cancer, and many other diseases are clearly serious in their full manifestations. Furthermore, many chronic illnesses that are generally well managed by available therapy can have serious outcomes. For example, inflammatory bowel disease, asthma, rheumatoid arthritis, diabetes mel- litus, systemic lupus erythematosus, depression, psychoses, and many other diseases can be serious in some or all of their phases or for certain populations. In short, life threatening diseases are chronic, usually incurable diseases, which have the effect of considerably limiting a person's life expectancy. These include, but are not limited to cancer, diabetes, neurological conditions, coronary heart diseases and HIV/Aids. What Ayurveda says about life-threatening diseases In the above definition it is clear that life-threatening disease is either a disease where death is almost sure, like cancer or a disease which will lead to death if not managed properly. like diabetes. According to Ayurveda the former is an incurable disease and the latter is a disease which gets converted into an incurable one due to improper or inefficient management. 15
- 52. Ayurveda too, may not be able to cure these diseases and it is wrong to conceive that whatever is incurable in modern medicine is cured in Complimentary Alternative Medicines (CAM). Diseases are classified mainly as curable and incurable according to the tenets of Ayurveda. A disease, where VATA, PITTA, KAPHA. all the three life energies are involved; if the ailment has spread to all the three paths of disease; besides disease being chronic and the patient being weak, is considered to be incurable. Thus, today's life threatening diseases many a times are incurable as per the views of Ayurveda also. Ayurveda versus life threatening diseases As it is evident, today's life threatening diseases can only be prevented but can not be successfully managed once they set in. The teachings of Ayurveda, if followed religiously, help anyone to improve rhe status of health. That means the immunity is enhanced and a life of good quality is enjoyed. The important life style guidelines based on the principles of Ayurveda are: 1. Regular in going to bed and rising in the morning. 2. Not suppressing the natural urges 3. Physical exercise performed with a pleasant disposition 4. Intake of food in moderate quantity 5. Food that is fresh and seasonal, devoid of harmful chemicals 6. Habitual consumption of rejuvenating herbs 7. Inclusion of wholesome food items in the daily menu 8. Positive emotions, breathing exercises and relaxation Not only are these helpful to prevent the serious diseases, but also dependable to manage the incurable diseases. Though few there are instances in which patients have cured incurable diseases by themselves, with the help of radical changes in their life style and thinking I 16 ffi n@fr6 'ffi
- 53. KERALEEYA CHIKITSA KRAMAM Dr. M. R. VASUDEVAN NAMPOOTHIRI, Principal, Govt. Ayuneda College Thiruvananthapuram, Dean, Faculty of Ayurveda, Kerala Univenitl. The traditional physicians of Kerala developed some treatment procedures without deviating from the basic principles of Ayurveda. These are mainly sweda karmas and Sneha karmas applied in different ways and forms. Probably these were developed considering the factors like climate, nature of landscape, body constitution and strength of people, regional availability of medicines etc In general Chikitsa is classified as Santharpana and Apatharpana. This is a broad classification. In Santharpana, we can incorporate Brumhana (Nourishing), Snehana (Oleating) and stambhana. Langhana (Lightening), Rookshana (Drying) and Swedana (Sudation) can be enumerated under the head- ing Apartarpana. Each one of the treatments termed under Shadupakrama has predominance of Gunas in the following order. Unakrama Guna Brumhana Guru Snehana Snigdha Stambhana ,.Seetha Langhana Laghu Rookshana Rooksha r Swedana - Ushna Subsequently, analyzing the general mahabhoota predominance in the two basic treatments, it is vividly observed that Santarpana is prithwi and Jala predominant where as Apatharpana is Agni, Vayu and Akasha Bhoota predominant. On the other hand, it is worthwhile to make a gradation in the case of Apatharpana based on the strength of doshas. (ie) Langhana in Alpadosha Langhana pachana in Madhya dosha Doshavasechana in Prabhoota dosha The two basic levels of Langhana are Samana and Sodhana. Sodhana implies Panchakarma *'hich includes Vamana, Virechana, Asthapana, Anuvasana and Nasya. Among these, even though Anuvasana appears as a brumhana therapy, it removes pakwashaya gatha pureesha and vata. Hence it is included among Panchakarma. While dealing with Karma, one point should be kept in mind. (i.e) the poorvakarma and Paschat Karma differs based on the major karma or Pradhana Karma intended. For example when Panchakarma is taken as pradhana karma, Snehana and Swedana are the poorva karmas and Peyadikrama is the paschat karma. Similarly while considering Keraleeya Chikitsa which are mainly modified forms of sneha and 17 *B 17l' 6d w w-
- 54. Sweda kriyas, we can take Pachana, Rookshana and Deepana as Poorva karmas. Actually poorva karmas improve the bioavailability of pradhana karma. The pathya krama told in the context of Snehana can be I the paschat karma. The important ones :rmong Keraleeya Kriya Krama include the following. Udwarthana Thalam Thalapothichil Abhyanga Pizhichil Kateevasthi Urovasthi Sirodhara (Takra, Ksheera, Taila dhara) Pinda Sweda (Shashtika, Pathrapotala, Jambeera) Going into details of each: Udwarthana : It is the application of paste of medicine over body, which is rubbed in pratiloma direction after drying. It is very much useful in Medobahulya, Diabetic neuropathy etc. Drugs used for Udwarthana differ based on the condition. Commonly used medicines are Kolakulathadi choorna, Vara choorna. Jeevanthiadi choorna, Aragwadhadi gana etc. Thalam : It is one among the 4 types of moordha taila prayoga. It is done as a protective measure for the Uthamanga. before applying sweda karmas. The medicines used for Thalam differ according to the clinical condition. Thala Pothichil : This can be otherwise termed as Sirolepa; here suitable medicinal paste is applied over the head and retained for about 45 minutes and removed. While doing this, Thalam is kept with suitable oil. It is useful in memory loss, psychiatric illness, developmental disorders in children etc. Abhyanga : It is oil message done as a routine procedure in Dinacharya and also as a treatment procedure for diseases. It is preventive, curative and rejuvenative in action at the same time. Various tailas can be used according to the constitution of the patient, clinical condition, climate etc. Pizhichil : This karma is otherwise termed as Kayaseka and it is one of the most popular Keraleeya Chikitsa. It is a procedure which induces snehana and swedana simultaneously. It is highly effective in pitha and raktha associated condition like Vatasonitha and kevala vata vyadhees. Kateevasthi : It is a modified way of retaining warm medicated oil over the lumbosacral spine. The oil is retained within a boundary of l/zinches height built with black gram paste. This procedure is found to be effective in disc degeneration, prolapse and spondylosis. Urovasthi : It is performed in a similar manner as Kateevasthi, the location is over the rnediastinum. Advised in conditions like vatika Hritsoola. Sirodhara : This term is commonly applied for any type of pouring of medicated liquid over the head as a single stream. It can be performed with medicated buttermilk (Thakradhara). This is a well known procedure in the management of psoriasis & insomnia. Sirodhara with medicated milk is done tbr diseases of the eyes and thaila dhara is performed for various vatavyadhees. psychological distur- bances elc. *W 18 eYd 6W tffiw Etw
- 55. : Pinda Sweda: It is a soothing and patient friendly form of sudation and massage together. The various types include Shashtika pinda sweda, Pathra potali sweda and Jambeera pinda sweda. The various aspects of Shashtika pinda sweda is dealt in detail here. Shashtika:It is a variety of rice which ripen within 60 days. The types include Sita tWhite) and Asita goura (Blackish white), red etc... Shashtika Pinda Sweda is a unique contribution of Kerala among Sweda Karmas. It performs massage and fomentation along with nourishment. Also it has a rejuvenative effect. Preparation of the Pudding:600g Bala root is boiled I n 8 litres of water and reduced to 3 litres. Shashtika rice (500g) is boiled in lVz litres Bala Kwatha and lt/z litres milk. till it becomes a soft semisolid pudding. 1/z litres of milk is boiled along with equal quantity of kashaya which is used for dipping the shashtika bolus covered by cloth while doing the process. Restrictions during the procedure: Tha patient should take light food, should avoid riding. walking, over talking, day sleep, suppression of natural urges, physical and mental exertion etc. Usage of luke warm water is advised for bathing and drinking. Benefits + Provides massage and fomentation together + Increasescirculation. + Causes mechanical stimulation on muscles. + Stimulates cutaneous nerve endings. + Raises local temperature. + Increases secretion'and absorption of tissue fluids. + Increases the elimination of waste products. + Improves the nutrition. I i Finally as a remark about Shashtika pinda sweda, I would like to state that the substances recom- mended for daily internal usage can also be applied externally in a judicious manner. This unrvinds the i secret behind using food as medicine. Keraleeya Chikitsa is now gaining global attention due to it. efficacy and simplicity. By incorporating these marvelous therapies in alternative systems of medicine into the present health strategy, WHO's concept of health can be easily achieved. I 19 u &# €tr .f-5ri.'
- 56. ROLE OF AYURVEDIC HERBS FOR PRESERVING AND RESTORATION OF MENTAL HEALTH Dr. K. NISHTESWAR, u.o., Rn.n." DAFE, Professor & Head, Dept. of Dravyaguna, Rasa Shastra & BK. Govt. Ayurvedic College, Mjayawada. A sound mindin a sound body has been recognised as a social ideal for many centuries. Mental health is not mere absence of mental illness. A mentally healthy person has three main characteristics. (1) He feels comfortable about himself, that is, he fells reasonably secure and adequate. He neither underestimates nor overestimates his own ability. He accepts his shortcomings. He has self-respect. (2) The mentally healthy person feels right toward others. This means that he is able to be interested in others and to love them. He has friendships that are satisfying and lasting. He is able to feel a part of a group without being submerged by it. He is able to like and trust others. He takes responsibility for the neighbours and his fellow-men. (3) The mentally healthy person is able to meet the demands of life. He does something about the problems as they arise. He is able to think for himself and to take his own decisions. He sets reasonable goals for himself. He shoulders his daily responsibilities. He is not bowled over by his own emotions of fear, anger, love or guilt. According to Ayurveda, the human being is made up of four constituent parts l) Body (Sharira), 2. Senses (Indriyas), 3. Mind (Manas), 4. Soul (Atma). In general human being is made up of the gross physical body and subtle mind. Sushtura identified the manifestation of mind during 5'h month of intrauterine life and Buddhi during 6'h month. Dalhana commenting on the seat of Manas further quotes that mind in association with Chetana (consciousness) resides in Hridaya. Compare positive, negative and neutral conditions of electricity. Both these, attraction and repul- sion may again be included in one word, desire (Trishna). Attraction (Raaga) is a desire to possess a thing which an individual likes, repulsion (Dwesha) is a desire to get rid of a thing, which the individual does not like. So both together may be classed as desire. Mind may therefore be considered as an active substance binding an individual to his desires. It is therefore said that desirelessness should be the objective for obtaining freedom from bondage. Modern psychology and physiology have not reached the necessary level in the study of the preliminary sciences, in order to understand the full meaning of desire and desirelessness. Physical Life largely Depends on Psychic Life : Ayurveda lays down the hypothesis that physical life depends largely on the psychic life. The development of all the limbs of the body merely follow the mind. Charaka says: "Sarvaangaanaam Hi Asya Hridayam Moolam" - Sareera 6-30. Hridayam here means the mind. The importance of the mind when compared to the limbs is beautifully illustrated in the following lines from Mahaa Baratha - Santhi Parva: Yaabhyaam Aalingita Kaantaa ' Thbhyaam Aalingyete Sutaa. The same limbs which embrace the beloved wife embrace the beloved son. In one, there is the emotion of sex and in the other there is the emotion of affection. The limbs are moved and led by the mind in either case for a different purpose. The leader is the mind - the limbs only follow. .H 20 '!,-9 oYc €w t<F
- 57. Desire is a Disease : This is the first verse in the most popular text book of Ayurveda called Ashtaanga Hridaya. It says that of all diseases, the diseases which are called 'Raagaddi diseases' are most formidable. These 'Raagadi diseases' permeate the whole body of every living organism and they are always there diffused throughout the whole system. These diseases cause intense excitement, unconsciousness and restlessness. just like fever or other serious diseases. l The 'Raagaadi diseases' are sub-divided into many sub-divisions, chief among them are those due to Raaga - Kama (Lust), Lobha (Greed), Moha (Infatuation), Krodha (Anger), Mada (Anogance) and Maatsarya (Jealousy). The first three are derived from excess of Raaga. The last three are derived from rhe excess of Dwesha. These six are called passions in English. These are described in Ayurveda as six enemies of man. The symptoms of these diseases are intense excitement, unconsciousness and restless- ness like the symptoms of fever and many other diseases. An ordinary physician may treat the disease of the body such as fever by various medicines and diets, but these "Raagadi diseases" which pertain to the rnind can be treated only by specialists (Apporva Vaidyas - Extraordinary physicians). Vagbhata appeals to God as the expert physicians whose grace is the only solace for people afflicted with mentai diseases. Self Control : Desire subside by self-control but not by satisfying them. Just as the flames of fire are not subdued, but only increased by pouring more ghee into it, so also desires cannot be satisfied by becoming a pra)' to them. Therefore Ayurveda says : Never control the Vegaas (physical urgings of nature) such as urine, stools etc. But, always conrol the emotional urgings of nature 'Raagaadeenam", such as Lust, Anger, Greed. Infatuation, Arrogance and Jealously. t Aatma - Soul : ! According to Ayurveda, self, soul or Aatma is Nirguna-qualityless. It is pure eternal reality behind all visible manifestations. Manas, according to Ayurveda, is the internal organ of sense - Antakarana. which is linked to the Aatma on the one hand and the external organs of sense on the other and u'hich brings about consciousness. It is only when Rajas (emotion) and Thamas (ignorance) predominate in the mind that Aatma is lilked to the Manas, and gets entangled in its own web and suffers from the effects of its own actions. (Charaka, Sareera 4-51) The word Chetus, Chitta, Hridaya, Mahat and Ardha are also sometimes used synonymously with the word Manas. Panchakoshas - Five Sheaths : According to Vedaanta, the Jeevaatma is described as enveloped in five sheaths. One has to rip open and penetrate into the innermost core in order to attain self-realisation. These five sheaths are recognised by the qualities given below: There appears to be a tug of war between the lower mind (Manas) which is dragged by Raaga (attraction) and Dwesha (Repulsion) into wrong ways and the higher mind (Buddhi) which is pulled up 21
- 58. by Sama (self control) and Dama (tolerance) etc. If Buddhi succeeds, there is elevation and if the senses (Indriyas) succeed, there is defeat of Buddhi. The Vaasanas are the inherited tendencies which help or mislead the Buddhi. If the tendencies are Raajasa, the mind is prompted to lustful and vigorous action and if Taamasa to bewilderment and ignorance. If the tendencies are more towards Saatwika - enlightenment, he is saved from downfall. This is the road to Moksha. This method of attaining self-realisation throughout the acquisition of true knowledge is called Jnaana Yoga. Prakriti + Purusha I I Consciousness I I Self-consciousness I I I I I I More Satwa More Thamas Mind and Indiryas i.e., 5 Tantras Animate objects 5 Mahabhootas, i.e., Inanimate objects Rajas being the supplier of energy is in both sides. It is more latent in inanimate and more potent is animate objects. Psycho-Analysis in Ayurveda: The mental states are divided into: 1. Suddha - Pure Satwa - enlightening knowledge 2. Raajasa - Exciting due to Rosha - Excitement 3. Thaamasa - Depressing due to Moha - Ignorance The Suddha state is the state of harmony caused by the predominance of Satwa. (Charaka Saareera). The mental and physical states are interdependent; one cannot change without a change in the other. The man and the mind are so interrelated to each other, that all the distinctions are to be considered artificial. When hot ghee is put into a cold metal cup, the cup gets heated and when cold ghee is put into a hot cup, the cup gets heated. Similarly, if a man is ill, the mind is also affected and if mind is ill, the body is also affected. This is called Anyonya Aasrayanta, i.e., the interdependence of the one on the other and it represents as inseparable condition. So, there can be no water-tight compartments. Basing on this it can be concluded that most of the diseases are psycho-somatic in nature. Further, Saatwa, Rajas and Thamas - the three Gunaas do not exist independently of each other. But they are always together and exist simultaneously in the body exerting their influence on each other like some internal secretions such as those of Thyroid, Testis, Pitutary and Adrenalin, which although they are contradictory to each other, they yet remain together in the circulation of the body fluids and exert and important influence upon the other members of the series. Three chief methods of treatment are recognised in Ayurveda: *S 22 ffid 'LE &*k ffi
- 59. 1. Thtra Daiva Vyapaasrayam : Psychic Treatment - it is treatment by by methods such as Mantra. 2, Yukti Vyapaasrayam : Treatment by Rational Methods. Yukti Vyapaasrayam treatment is a treatment which depends upon reasoning out the causes of diseases and on planning suitable ways and means for its cure. It deals with the appropriate administration of food. medicines and habits etc. 3. Satwaava Jayah Punah : Satwaavajaya treatment consists of controlling the states of the mind (Chitta Vrini) and their modifications. (Charaka Sootra XI-63) This involves the derachment of mind from unstuitable influences, when the mind is in contacr with the senses. The mind should be trained by constant practice (Abhyaasa) to develop dispassion or detachment (Vairragya) from all evil habits and thoughts. The influence of Rajas and Tamas should be controlled and the influence of Satwa should be gradually developed. Varieties of Faith Cure : The following varieties of treatment are recommended for diseases caused by Daiva (unknown or non-physical causes). Mantra, Aushadi, Mani, MangalaBali, Upahaara, Homa, Niyama, Praayaschitta, Upavaasa, Swastyayana, Pranipaata, Yaatraagamana : In Ayurveda the diseases namely unmada, Apasmara, and Atatwabhinavaesa are enumerated under Manasika rogas (Mental illness). A few recipes to relieve insomnia are also recorded in various ayurvedic yogasangraha books. The following drugs are recommended in the management of Apasmara, Unmada and Anidra. 1. Brahmi + Madhu (Honey) 2. Lasuna + Taila (Oil) 3. Satavari + Ksheera (Milk) 4. Kushta + Madhu (Honey) 5. Vacha + Madhu (Honey) 6. Sankhapushpi 7. Jatamansi 8. Jyotismati 9. Tulasi 10. Sirisha 11. Kushmanda 12. Pippalimoola 13. Matulunga Patra 14. Mandukaparni 15. Yashtimadhu 16. Guduchi 23
- 60. PRACTICAL AYURVEDIC NADIPARI KSHANA Dr. Vaibhav Lunkad Pune MBBS, DVD, D.Yoga Ayurveda, , Director, Sangam Health Research Centre. AYURVEDA (Complete science comprising all dimensions of vision) Principles of "Panchamahabhuta" (5 elements :- Water, Air, Fire, Space. Earth) Nothing is beyond these five principles. So the science remains never-changing in o correlation with nature. o Tridosha Theory - Vatta, Pitta, Kapha' o Saptadhatu - Rasa, Rakta, Mansa, Meda, Asthi, Majja, Shukra' Ayurvedic nadipariksha is based on practical principles of ayurveda, keen observation of body language, feel, vibrations, facereading, receptivity, and the real dedication and devotion to cure a person' Some say it is impractical, subjective, divine, humbug because grapes are always sour to the wolf since they are lying high on the tree. Only those with clinical acumen, practical down-to-earth attitude can learn it. Others are just like the wolf of sour grape story' Guru shishya parampara(tradition) has kept this art alive. Is it a $cience or art? I prefer to call it an art because it is not just bookish, it requires the heart more than the head. The patience and preserverance of seeing thousands and lakhs of pulses is just very important' Lots of people are known to practice Ayurvedic Nadipariksha since ages but many have not made it practical and easy to learn. Hence Ayurvedacharya, students and post graduates feel it is subjective, just love to see how wonder- difficult, incomprehensible. I too felt the same before learning. But now I It is fully I can diagnose so difficult and unclear disorders in a patient without even asking him. challenging and only for people who like challenges' It is wrong to compare allopathic parameters when we compare pathies. Instead of seeing from for e.g. their eyes it is important we create at the outset such parameters that allopaths can understand a pulse is seen only in parameters such as force, volume, tension, rate. But in Ayurveda we have different parameters such as feel, point of touch, meaning of those points, strength of pulse, rate, volume etc.. Instead of comparing we need to be clear in our terminology : The mind influences the pulse such a lot that no allopath can believe that mere mind itself can turn - the strongest pulse into a weakest pulse. or low blood pressure. I have seen depression patients at least 68-70 titl now showing such feeble slow pulse. *S 24 ']-g ^X# "/1t;r &,w)G1 ew ffit'* t-
- 61. II{ADI PARIKSHA (3 TYPES) 1. Nadipariksha of the patient directly. 2. "Doot-nadi" - Diagnosis from messenger's pulse. 3. "Swara-nadi" -Diagnosis from voice of the person. Observation and correlations Ilaterials & Methods Patient : One who has emptied his bladder and bowels satisfactorily early morning. One whose mind is at peace, receptive. Unfit Patient : Tired, wicked, trickster, mental patient, sleepy, hungry, thirsty. Time : Early morning hours especially 5-7 AM, but can be extended till 9 AM. Lot of expertise is required with experience for seeing pulse of the patient anytime at the day- or night" Better avoid seeing pulse of patient as follows : 1. After food,2. After sex,3. After bath,4. During a fast,5. During hunger/thirst,6. Durin-e sleep, 7. During emotional or mental disturbance, 8. After massage, 9. Drunk, 10. During or immediately after Pranayam. , Fingers - kept * removed againg and again while seeing pulse for the following : (i) Pressure knowledge (ii) Difference in pulse lgat (iii) Mode of feeling "Nadi Bal" - slight pressure to be applied to understand If doubtful wait and recheck, if required change position of patients head/body. Gender : Female's pulse better felt on left part of body A male's pulse felt better on right half of body. Terms used in Nadipariksha : 1. Frequent 2.Infrequent 3.Regular pulse 4.Irregular pulse 5.Intermittent 6.Full or Large T.Small S.Thready 9.Hard 10.Soft il.Quick l2.Slow 13. Light 14. Heavy 15. Dry 16.Moist (Thick, heavy) 17.Thin (Thready)18.Hot19.Cool 20.According to spot.21.Rate22.Energy 23.Volume 24.Force What all is seen in nadi ? (D Nadi Bal - "Balvat", "Prabala", "Sabala", "Nirbala", "Durbala terms to express nadibal. Three fingers are kept on pulse & pressed just enough to stop pulse beating. If slightest pressure required - Weak, great pressure - Strong (ID Rhythm - Sarna, Sarala, Niram, Vishma (i) Sudden increase or decrease in rate (ii)Missing / ectopic beat 25
- 62. (iii) Regularly irregular (iv)Irregularly irregular (III) Volume : Sthula, Sukshma, Apoorna, Krisha If pulse fill completely with Rach heart systole - Full Pulse If weak and smooth - Thin or threadY (IV)Elasticity (V)Condition of the blood vessel Dr, V. G. Lunkad,s Techniques of Pulse diagnosis (Nadipariksha) Vl = Respiratory syst, V2 = Back (Spinal Parts), V3 = Genitourinary, Skin, outermost & tips System V4 = Gastrointestinal and parts near umbilicus, V5 = Circulatory and Cardiac Vl = Dietary system and BMR, V2 - Blood & Circulatory system, V3 = Muscular system : system V4 = Fat, V5 = Bone, V6 = Bone marrow and Nervous system, V7 Reproductive ffi V QUALITIES OF VATA PITTA & KAPHA VATA : DrY, Light, Microfined, moving PITTA : Slightly unctous, sharp, hot, having foul odour, moving and fluid KAPHA : Cold, unctous, heavy, stable. slow, soft' physiological functioning These qualities of vATA, PITTA and KApHA helps to cany out different of the body. If these doshas are unbalanced either of the qualities gets disturbed & carries it's impact on the disease Process' When these are in pathological state VATA Causes'Pain PITTA Causes inflamation and KAPHA Causes congestion PRAKRITI The constitutional arrangement or basic configuration of tridosha, is termed as Prakriti' It is clecided at the time of conception & remains unchanged throughout the life span. This configuration dominates every activity within the human life & is the biological marker of the healthy state of human of three body. Seven various types of the constitutions are observed by permutation & combination doshas. These are as follows : l) In accordance of the dominace of a single particular dosha. (As all the three doshas take part in the formation of human life) Viz. Vata, Pitta, Kapha' 2) Vatapitta, PittakaPha, Kapha-Vata 3) Vata, Pina, Kaph all together NADI VIGNANA - SUB DOSHAS OF TRIDOSHAS : Main locations of the subdividions of Vata, Pitta, Kapha in the body 26
- 63. VATA PITTA KAPHA Prana Alochaka Tarpaka - Brain Udana Bodhaka - Tongue Sadhaka Avalambaka - Lung Rajaka Kledaka - Stomach Samana Pachaka Apana (Vyana) (Bhrajaka) (Shleshaka) (These sub types are situated within the whole body) The more puritan and clear intellect the physician is the more authentic is the Nadi Pariksha. Duta - Nadi : Messenger Nadi resembles the pulse related to him if the patient is female then the left hand and if the patient is male then the right hand of the messenger should be examined. As per the principal "Yat Pinde Tat Brahmande" i.e. the unit is microcosm of the Macrocosm or a full replica. Hence the interaction of the rwo Atma -one of the patient and the other of the Duta creates a philosophical and physiological replica of the condition of the patient. In the Manas or Duta (messenger) which may be examined by the Nadi Pariksha. Ayurveda adopts the version for yoga and Tantra i.e. Manas is the master of Indriyas and Vayu is of the Manas. Nadi Pariksha estimates Prana and Doshas of which Vatta is the most vital by estimating the Vata and Prana of Duta, one could get an idea and draw some logical conclusion regarding health and disease of the patient. The brain of Duta may act as computer information to be decoded during Nadi Pariksha. Pulse in Pathological States : In Ayurvedic and literature the nature of pulse in pathological state was given pertaining to almost all the system. For eg. in the G I T disorders.. if the person is suffering from hyper acidity his pulse will be tortous, tremulous, broad unctous and slow. Agni definitely has impact on Nadi movement and thus its relevance in the G I T disease. The sympathetic and parasympathetic system of the human body regulate the homeostasis which is outcome of normal physiological status of Agni.The seat of Agni is Amasaya and Grahani 27
- 64. MANAGEMENT OF GROWING CHILDREN-AYURVEDIC PERSPECTIVE Dr. V. L. N. ShastrY Paediatrics by the name of Ayurveda laid down a great emphasis on the branch of .Kaumarabhrityam'. The ancient Paediatrician Kashyapa preferred to keep it as number one among the .Ashtaangas'. The vision of Ayurveda in understanding the significance of childhood is marvelous and the care and caution that it advocates to bring up a child is excellent. The measures of support during are fantastic. The principles and the phase of child,s growth and develop*eni described in Ayurveda practices in relation io gro*ing children as described in Ayurveda signify the moulding techniques of which pulports the way of life tili instituting healthy personality, a prime component of holistic health death. .Child physiology' is denoted by three classical terms of Sanskrit. Their etymology The status of denotes (i) who sleeps a lot (sISU) - more a neote till infancy; (ii) who has less stfength / immunity and sustains with less exertion (BAALA) - more upto the age of toddler and pre-schooling (5 years) and (iii) more upto pre-pubescent age (around 12 who holds deficient of reproductive potentialt (KUUAARA) - age of 16 years is said to be the years); also the term defines 'who plays more'. All put together, the maximum limit to call the child 'Kumaara'' of TANTRAM seen It is interesting to note the term 'Kaumarabhrityam' in contrast with the suffix in the branches 'Salya & Saalaakya'. Bhrityam means service. It includes nursing care on one hand and in view of the settlement of child's the support and management on the other. It is absolutely essential description of her expected ideal quali- physiology and psycnJlogy.The concept of DHAATRI with vivid care right from the birth of the child stands ties & characteristic features in order to extend special nursing a 'Kumaaraa gaara' (abode of the child) unique even today. similarly, it is advised to construct specially play area, toys, musics' other amusement nanating the special requirements and facilities in it like indoor systems etc. Today,s crdches with specially trained maids and nurses are nothing but the improvised establishments of the said ancient concepts' the child' That is the reason why deep Breast milk (stanyam) is said to be the best of all milks to to be checked immediately' children importance is given foi the vitiated breast milk (stanya - dushti) are more prone for infections due to their less immunity. To encounter such varied infectious diseases' Also deep stress was given to induct much is described in Ayurveda on the name of GRAHA ROGAS' Sunskriti"' more immunity in chiliren on the name of "Kshamatva & Viruddhaabhi (Anna - Praasana) appropriately' Kashyapa and Susrutha took maximum care in advising weaning rasa (meat soups contain more The fruit juices, easily digestable gruels, nutrients enriched Maamsa - foods and feeds are also essential amino acidsi are-stressed a lot during infancy itself. Supplementary described a lot. On compiling the above said aspects, the over all management of growing children (especially upto as follows' the age of 5 years and necessarily upto 16 years) can be categorized u 28 6.d 'i..}t r- ---rI- w
- 65. : Laalana (Concerned with psychic support) Paalana (General support), Poshana (Nutrition & nur- turing) r POSHANA : Salient features of practical implementation. (a) Mother's breast milk is the best of all varieties of milks and is a must upto the age of six months. Alternatives are the milks of cow, buffalo and goat. (b) Weaning is must at sixth month. Fruit juices are also very important. In the absence of breast milk, fruit juices may be started right from 3'd month onwards. The semi liquid diet for weaning should be sweet, light, nutrient and congruent. Addition of Maamsa-rasa (meat soup) is Kasyapa"s preference. (c) All varieties of food and tastes are advised to the child gradually after the first annual birth duy. (d) By way of supplemental feeds several Lehyas are advised. It means something by way of licking / chanting but not to drink. Several ghritas (Samvardhana, Panchagavya, Kalyana etc- ) are indicated to promote mental faculties as well as general vigour and appetite. In Kaashyapa Samhita, one special Chapter (Lehanaadhyaaya) is spared for this. Also "Vatakas & Parpata" made of Simbi - dhaanya (some other eatables equivalent to snacks, as supplementary food) are advocated for older children. (e) Kashyapa's another indication for children's health & immunity is Lasuna (garlic). It can be consumed in some form or other in judicious doses. (f) Yavagu & Yusha (gruels as soups) are indicated as good digestants. (g) lcohol generated in food preparations is described healthy to children. (Vaaruni - generated out of fermented cooked rice / Jaagala) * PAALANA : General support includes periodical verification of attainment of mile - stones appropriately. Personal hygience and environmental hygiene are to be ensured to prevent infectious diseases. Protection from physical impacts and menace is needed. * LAALANA : It refers to psychic rapport by emotional support with the child for ideal personality development and to prevent the stress disorders and behavioural problems. Neither neglect nor over protection is encouraged to rule out the possibilities of emotional upsets. Some instances or advises in Ayurveda to ensure healthy mental development are as follows: (a) Child should not be frightened. (b) Special Nursery for the purpose of playing (Kumaaraagaara) with Toys (Kreedaanaka) and other amusement equipment is advised to be constructed for the sake of children. (c) The age of Akshara - Lekhana Samskaara is said to be five years. Schooling under 5 years of age results into taxation to the mind of the child. (d) Aseervachanam (benediction / blessing) to the child is a positive dictum for his positive outlook. I 29
- 66. AN OBSERVATIONAL STUDY ON DOSE - SAFETY RELATION OF CERTAIN AYURVEDIC METALLO-MINERAL & HERBO- MINERAL FORMULATIONS o Dr. Sastry J. L. N., Medical Advisor Ayurveda, Dabur-Dhanwantry Hospital, Chandigarh Dr. Lakshman Prasad V Lecturer, Kayachikitsa, Shri Dhanwantry Ayurvedic College, Chandig;rh TNTRODUCTION: Ayurveda under gone a revolutionary change during the medieval period. Introduction of Rasa Sastra opened new frontiers for ayurvedic pharmacology and pharmaco-therapeutics. We come across references of Naga bhasma and l-oha bhasma in the vedic literature (2000 BC). But seldom metallic I mineral / herbo-mineral recipes are advocated in the Brihat trayee texts (Charaka, Sushruta & Vagbhata). Though Charak (500 BC) mentioned certain metals and minerals under Bhoumya varga, their utility in therapeutics is restricted to Loha, Makshika, and Gandhaka etc. Sushrut's (2 AD) Trapvadi varga and Vagbhat,s (5-7 AD) description about metals / minerals in therapeutics are the early indications towards their utility of these substances in treatment of diseases. Sarngdhara Samhita (I3-I4 AD) for the first time, incorporated several dhatu sodhana and marana processes. Later, all the Yoga Granthas included metal, mineral and herbo-mineral formulations as integral part of therapy. But the recent trend indicates that majority of tlie BAMS, MDA4S (Ayurveda) & Ph D holders are resorting to either to herbal or herbo-mineral formulations in their practice. The author belongs to a traditional family of ayurveda which utilizes rasa-oushadhis as a major part of treatment. Today, still the Sanskrit prescriptions I records of his grand father are available on at ieast 400-500 patients where metallic or herbo-metallic formulations were prescribed. No one reported any toxic effects. More over, the author himself consumed several grams of arsenic as a child when Seetamsuras and Hingula were prescribed by his grand father for viral fevers & rhinitis' Now, also observing his father (a qualified MBBS doctor), who is practicing ayurveda since 1977 using mostly the rasa oushadhis containing mercury and arsenic. The author happens to discuss with several other vaidyas like Vd. Madhan Gulathi from Chandigarh and Dr. Vastyayan from Ludhiana on toxicity of metallo- mineral and herbo-mineral formulations. He also had discussions with modern physicians like Dr. Sripatibhat of Udupi, (Late) Proff. Dr. Sripathirao of Hyderabad who use mineral and herbo-mineral formulations in their practice. REVIEW OF LITERATURE : Use of Metals in modern pharmacologr : The heavy metal salts, in very small quantities, are lethal to several Gram-positive and Gram- negative organisms and this effect is referred to as the oligodynamic action. 1. Arsenic: As is in fact a metalloid. Organic arsenicals, used in the chemotherapy of trypano- somiasis, amoebiasis and trichomoniasis; they are no more used in the treatment of syphilis. The pentava- lent compounds, which are anionic in character in body fluids, probably penetrate the host cells less *W 30 1lF oid €w ffiu*=
- 67. readily than the trivalent compounds and have higher therapeutic index. Urinary excretion usually smrts within 2-8 hours after oral administration and continues for 8-10 days. Cumulative poisoning can occur on repeated ingestion of small amounts. Small amounts also appear in sweat and in saliva. Externally arsenic trioxide has been applied as a paste with cocaine or morphine, to the cavities of caries teeth to destroy the nerves before filling the teeth. Leakage of this agent may, however, cause necrosis of gum or bone. Organo-arsenicals like carbarsone and glycobiarsol are now rarely used anti-amoebic. 2. Lead : Lead compounds have hardly any therapeutic use. Lead subacetate is some-times employed as a constituent of lotions of soothing astringent applications. 3. Mercury: The organic mercurials are used as antiseptics, preservatives, spermicides and di- uretics. Introduction of organic mercurial compounds as diuretics came from the clinical observation of an unexpected adverse reaction. 4. Copper : Copper sulphate is used to induce vomiting. Mostly copper is avoided in therapeu- tics owing to the toxicity of its salts. Copper as metal is non-toxic. 5. Iron : Iron is extensively used in the deficiency conditions i.e., in anemia. Hydrated ferrous sulfate I.P., ferrous sulfate, ferrous gluconate, ferrous fumerate, iron & ammonium citrate I.P. etc are some of the important iron salts. 6. Tin: Tin is not reported in modern therapeutics. But it is abundantly used ayurvedic therapeutics" 7. Zinc: Zinc is extensively used as mineral and especially for diabetes subjects. It perman- ganate is astringent and caustic. It is used for mouth wash and urethral inigation. Zinc undecylenate is also used locally in 207o conc. 8. Gold : Water solubl,e gold preparations like sodium aurothiomalate, aurothiosulfate and au- rothioglucose shown beneficial effect on RA. Sodium aurothiomalate (Myocrisin) is usually employed @ 10-25 mg i.m. weekly for prolonged periods or 50 mg i.m. weekly for 20 injections. The mechanism of action of gold salts is not known. The drug, however, gets deposited in synovial macrophages. especially in actively inflamed joints. They produce marginal but definite clinical improvement accom- panied by lower titers in the Rose Waler test (Satoshkar & Bhandarkar, Pharmacology & Pharmacothera- peutics, Popular Prakashan, Bombay 1985 p. 829). 9. Silver : Silver nitrate I.P. appears as colourless or while crystals is extremely soluble in rvater. Silver nitrate has antiseptic, astringent and caustic properties. i7o solution as eye drops is used for conjunctivitis and ophthalmia neonatorum. A lVo solution is also used in the treatment of burns. Silver nitrate stick is used to remove warts and other small skin growths and for cauterization of wounds and trachoma follicles. It is used for inigation of bladder and urethra at 1 : 10,000 conc. Colloidal silver compounds are ill defined mixtures of metallic silver, silver oxide and various silver proteinates. A silver present in these preparations is largely in the non-ionized form, these compounds do not precipitate tissue proteins. 10. Aluminum: Aluminum chlorhydrate acts by local astringent action and blocks the sweat ducts at the skin surface (anidrotic effect). Aluminum hydroxide gel is available as a white, colloidal viscous suspension or as dried gel in the form of powder or tablets. It reacts with gastric acid to form aluminum chloride. Each ml of 4Vo gets suspension nueutralized I.2 to 2.5 m.eq. of acid. Aluminum phosphate gel is sometimes preferred to aluminum hydroxide get as it does not interfere with phosphate absorption. 31
- 68. I i i The History of Gold Therapy for Thberculosis : [Benedek, Thomas G.; Journal of the History of Medicine and Allied Sciences - Volume 59, Number l, January 2004, pp. 50-89 Oxford University Pressl This is a historical study of the popularization of a medical therapy contrary to pertinent experi- mental findings. Presumably this circumstance reflects the desperation about tuberculosis: highly prevailent, highly fatal, and lacking any etiologically directed therapy. Gold compounds were introduced, based initially on the reputation of Robert Koch, who had found gold cyanide effective against M. tuberculosis in cultures, but not in experimentally infected animals. Treatment of pulmonary tuberculosis with these compounds was popularized, particularly by Danish physicians, in the mid-1920s, despite consistently negative experimental results, based on Paul Ehrlich's theories of antimicrobial drug effects. Difficulties in the design of interpretable clinical studies were soon recognized but also generally ignored, thus permitting data to be interpreted as favorable to anti-tuberculous gold therapy. Eventually toxicity was considered to outweigh the alleged therapeutic benefit of all gold compounds. This resulted in their discard shortly before the introduction of streptomycin therapy. ICMR study on scientific evidence of ayurvedic bhasmas: At the Jamia Hamdard, New Delhi, a study was'undertaken to investigate the neuro-psychopharmacological properties of metallic prepara- tions used in the Indian systems of medicine and to study the rationale of their therapeutic action so as to establish their LDro/ minimum therapeutic dose and therapeutic index. Calcinated preparations of gold and silver used in Ayurveda (saran bhasma, raspy bhasma) and Omani Tibbi (Kushta Tila Kalan, Kusha Nugra), thin silver leaves used in India on sweets and betel and on tonic pills (chandi worf), and oral gold preparation (Auranofin) used in modern medicine were subjected to a battery of >30 screening tests for general neuro-psychopharmacological effects, cognitive functions, anti-depressant, anxiolytic, neuroleptic and serenic activities as also for the effects on endurance andfatigue. Both gold and silver preparations showed moderate to marked analgesic effects which appear to be mediated through opioidergic mecha- nisms. Other interesting effects included reduction of haloperidol-induced catalepsy in rats (in both gold and silver preparations), nootropic effects in rats and mice against both active and passive avoidance models, anxiolytic effects observed by Vogel's conflict test and elevated plus maze studies (in gold preparations) and anti-aggressive action (in silver preparations). Some pro-convulsant effects were ob- served with silver preparations which, needs further evaluation (www.icmr.nic.in/annual/bms.htm - 30k). MATERIALS & METHODS : Commonly prescribed 10 metallo-mineral and herbo-mineral ayurvedic formulations are selected as materials in the present study. Patients coming for the consultation of Dr. Sastry (during 1999-2006) and those attending the OPD of DDH, Chandigarh have formed the subjects of the present study. The dose related side-effects / safety of about ten formulations are reviewed in patients 1 subjects who have consumed these 10 medicines for at least I to 12 months. "Sastry's Evaluation Sheet for Heavy Metal Toxicity" (vide: annexure I) is used in this study to understand clinical toxicity of various dosage forms of the above mentioned formulations in patients consuming these medicines orally for I-12 months period. The evaluation was made on 5 symptoms or conditions (in acute and chronic toxicity categories). The scores were classified as mild, moderate & severe groups. An attempt is made to review the subject's clinical condition before and after administration of these formulations. About 10 formulations are picked for the present observational study. A format is *S 32 L9 6c w *tffi,.*
- 69. made to analyze / in each formulation group. The format is to assess the assess at least 100 subjects patient whether any of the heavy metal toxicity related symptoms area available on the subject or nol On the other hand, their LFT & RFT are also obtained where ever possible. A soft-ware is developed by the technical assistance of We-excel, Chandigarh towards proPer documentation of ayurvedic practices. Review of data through this software reveals the patient informa- tion along with the follow-up visits etc. Observations & Results : It is observed that the formulations were given to individuals between the age of 12 to 76 yeam of age belonging to both sex. All these subjects are assessed as per their ailments and the details are tabulated below (Vide: table no. I to 10. This observational study includes about 1904 patients (n=1904) who received l0 different formu- lations as mentioned above, either as stand alone or as combination therapy for specified disease condi- tions. The minimum period of oral consumption was I month while the maximum was 12 months. 'Daily Dosage (Minimum & Maximum) Patterns : Sl.No. Name of medicine Dosage Forms No. of times Min. & Max. Daily Dose 1. Arogyavardhiniras 250 mg to 450 mg b.i.d. to t.i.d. 500 mg to 1350 mg 2. Chandraprabha vati 250 mg to 450 mg b.i.d. to t.i.d 500 mg to 1350 mg Brihat Vata Chintamani 100 mg to 120 mg b.i.d. to t.i.d 200 mg to 360 mg 4. Brihat Vangeshwara Ras - 100 mg to 120 mg b.i.d. to t.i.d 200 mg to 360 mg 5. Vata Kulantak Ras 100 mg to 120 mg b.i.d. to t.i.d 200 mg to 360 mg 6. Svarna Suta Sekhar Ras 100 mg to 120 mg b.i.d. to t.i.d 200 mg to 360 mg 7, Gorochanadi Vati 100 mg to 120 mg b.i.d. to t.i.d 200 mg to 360 mg 8. Seetamshu Ras 100 mg to 120 mg b.i.d. to t.i.d 200 mg to 360 mg 9, Sirah Shuladi Vajra Ras 100 mg to 120 mg b.i.d. to t.i.d 200 mg to 360 mg I 10. Vasanta Kusumakar Ras 100 mg to 120 mg b.i.d. to t.i.d 200 mg to 360 mg I Informulation 10, dosage of metallic ingredients was less than the recommended and fatal doses. The minimum and maximum dose of Svarna (gold) and Rajata (silver) was 16 mg and 28.8 mg each per day. The minimum and maximum dose of Vanga (tin), Naga (lead) and Loha (iron) was 24 mg and 43.2 mg per day. The minimum and maximum dose of Abhraka (mica) was 32 mg and 57 .6 mg per day (table no.22). The Evaluation sheet was used to assess the toxicity levels after the consumption of the medicines. Except getting positive scores for nausea/ vomiting, gastric irritation, dianhea and head ache in about 68 subjects (out of 1904 subjects), no major adverse reaction or side effect are observed. Totally, about 3.57Vo (who were under Arogyavardhini ras, Chandraprabha vati, Seetamsuras and Gorochanadi vati groups) were found with 1 positive score as per Sastry's Score Sheet. It is also observed that the therapeutic doses recommended / allowed in Ayurvedic texts for indi- vidual bhasmas vis a vis the doses of the metallic ingredients within a given formulation are not the same. In fact the later are found to be less in quantity compared to individual bhasma dosage forms. Similarly, the recommended doses in the Ayurvedic literature are far below compared to the toxic / fatal doses 33
- 70. mentioned in modern toxicology texts. Only in one formulation (Seetamsuras) the dosage of Manahshila and Talaka are excess / high compared to overall recommended / allowed individual doses. Therefore, a careful clinical examination is done for evaluation of these subjects but did not reveal any serious adverse effect. RFT & LFT values : Among these subjects (n = 1904) there werc 207 subjects for whom the renal functional tests & liver function test reports were available at the baseline and during the course of treatment / end of study. These results were obtained from the laboratory records for random assessment. RFT values.. There are about 20? subjects available with their RFT values before, during and after the course of treatment. There are 139 male and 68 female patients. The mean S. Creatinine in male patients (randomly picked from non-renal cause group) of this study was I.43 mg/dl (+ 0.02 mg/dl) at the baseline and was l.4I mg/dl(+ 0.031 mg/dl) at the end of therapy. This was 0.97 mgldl (t 0.23 mg/ dl) and 1.01 mg/dl (+ 0.21 mg/dl) in female patients (randomly picked from non-renal cause group) at the baseline and at the end of therapy respectively. This is statistically not significant (p = > 0.05) on application of ANOVA. The mean S. Urea in these 207 patients was 39.44 mg/dl (+ 2.12 mg/dl) at the baseline and it was about 40.21 mg/dl (2.09 mg/dl) at the end of therapy. This is found to be statistically not significant (p - > 0.05) on application of ANOVA. S. Creatinine in the renal cause group (n=23) receiving Chandraprabhavati was about 7.67 mg/dl at the baseline and was found to be 1.65 mg/dl at the end of the study. This is found to be statistically not significant (p = > 0.05) on application of ANOVA. LFT values: There are about 207 subjects available with their LFT values before. during and after the course of treatment. There are 139 male and 68 female patients. It was also observed that the mean SGPT (ALT) & SGOT (AST) were 34.25 IU/L and 41.23 IIJII- at the baseline respectively for males. These readings were 36.26IU/L and 40.98lUfi- for SGPT (ALI) & SGOT (AST) respectively in case of females. There was no significant change ((p = > 0.05) in their mean readings from baseline to therapeutic end point. It was also noticed that there is no significant change (p = > 0.05) in the S. Bilirubin (total) of these patients (non-jaundice group). The final results are suggestive that majority of patients (who received the above formulations for 1-12 months) have shown no serious toxicity symptoms as evaluated against the symptoms mentioned in toxicology texts against the heavy metals. Neither, their clinical status nor the blood chemistry is suggestive of hepatic or renal damage. DISCUSSION : The results are suggestive of dose related safety of the 10 formulations assessed in the cuffent study. Both clinical and biochemical data supports the same view. However further protocol based observational studies evaluating the blood, urine and stool samples for atomic absorption may provide further information. The safety issues were certainly addressed in the ancient Rasa Sastraworks. All the rasa aushadhis wcire mentioned with one or other doshas (viz., parada sapta kanchuka doshas, trividha doshas etc) and Sodhana (purification) and Marana (calcinations) are required to make them safe. The fact that both Ncga (lead) and Vanga (tin) are indicated for prameha (if properly calcinated) and at the same time are also cautioned for causing prameha (nephrotoxicity if improperly made). Restricted salt diet, while *W 34 ## t!_g ffi <rffFF
- 71. administerin gKajjali is another proof of scientific approach in the ancient times. These references are indicating complete knowledge of ancient saints and seers about these heavy metals. The ayurvedic mineral or herbo-mineral drugs should be studied for ligand chemistry and chelate chemistry. Ayurvedic bhasmas to be studied for hydrophobic and lyophobic colloidal states / structures. Therefore, their journey is safe in side the body" Since atomic absorption spectroscopy can not detect the ligand / chelate chain attached to the ayurvedic bhasmas alternative methods of analysis to be developed. Till such time clinical safety to be emphasized than atomic absorption. The authors intend to further continue with the study of blood samples for atomic absorption to detect the blood levels of heavy metals and also to find out the effect of heavy metals present in herbal formulations / single herbs as well. CONCLUSION : Post JAMA article on 15'h December 2004, authors felt the necessity of safety data on metallo- mineral and herbo-mineral formulations used in ayurveda. Hence, this bservational study (as part I study). Conventionally, modern toxicology and pharmacology consider all the heavy metals as highly toxic. Interestingly, metals like arsenic, antimony and copper are considered non-toxic in modem toxi- cology while, their salts are highly toxic. This provides a lead for the ayurvedic scholars to work further on the hypothesis that the rasas (minerals) or dhatus (metals) mentioned in ayurvedic texts in the rax' state may be toxic, but not in the purified / calcinated forms. One important finding is that rasas for which no marana process is mentioned are found to be relatively safe [e.g. Kasisa (FeSOo) and Chapala (antimony)l compared to others. Similarly, bhasmas of several minerals and heavy metals can be safery prescribed in the specified therapeutic dosage form / formulation. This study could not provide any substantial evidence for serious adverse reactions or toxiciry symptoms with the above ten formulations, when studied in large patient population (n = 1904). Only 3.57Vo of patients (n=68) shown symptoms like nausea, vomiting & head ache which is clinically not significant. These findings favour the traditional approach of vaidyas towards the dose related safery of ayurvedic metallo-mineral and herbo-mineral formulations. This study also disproves recent apprehen- sions that ayurvedic herbo-mineral formulations exert cumulative toxicity. The results indicate that there is no significant change in evaluation scores at baseline, during and after completion of therapy (p = > 0.0s). Review of RtrT & LFt values in 207 patients did not reveal any toxicity. Some of the patients who received Seetamsurar were subjected to critical evaluation for both RFT & LFT values along with the clinical evaluation. But none of these patients showed symptoms of arsenic toxicity. This study lays in-roads to provide safety data on ayurvedic formulations. The authors emphasize the role of observational studies as basis for EVIDENCE BASED AYURVEDA. Finally, it is to be concluded that - IT IS THE 'CLINICAL SAFETY', BUT NOT THE I-LBORATORY TOXICITY t WHICH COUNTS IN THE END" r ACKNOWLEDGEMENTS : I i ; I 35
- 72. EVIDENCE BASE FOR TRADITIONAL MEDICINE THROUGH PRACTICE BASED RESEARCH . Dr. P. Ram Manohar MD (Ay),Director of Research, Arya Vaidya Pharmacy, Coimbatore Introduction There is an urgent need to initiate systematic practice based research (PBR) in the field of tradi- tional medicine (TM). In the case of conventional medicine, researched knowledge gets translated into practice as a rule whereas in the context of traditional medicine, there is a tradition of clinical practice that has a continuity of several thousand years already existent. This tradition of clinical practice is a heterogeneous mixture of partly verified and partly innovative clinical experimentation. The challenge is to generate reliable knowledge through research on ongoing clinical practice in traditional medicine. In other words, there is a need to promote PBR in TM. Evidence based medicine or EBM as it is called, has become the corner stone of clinical practice in conventional medicine. EBM insists that clinical practice should be based on research generated evidence. In this model, the flow of knowledge is from the research laboratory to the clinic. However, it is being increasingly realized that the clinical scenario cannot be completely controlled by EBM. New knowledge is discovered in the context of clinical practice that has not been previ- ously discovered by research. In other words, EBM has to be supple- mented with inputs from PBR even in the case of conventional medicine. TM has a rich resource base of clinical expertise but not an equally rigorous body of researched knowledge to back up the clinical practice that has been in vogue for thousands of years.Continuity of use cannot by itself be the criteria to establish safety and efficacy of TM. The expressions of clinical practice in TM are so rich and diverse that it would be a Herculean task to conduct prospective clinical studies to build up an evidence base to substantiate them. Without preliminary clinical documentation, it would be impossible to even identify the most potential areas in the TM practices for more rigorous clinical research. Scattered and isolated attempts at PBR by a few clinical centers or hospitals in TM will not be able to meet the challenge of creating a comprehensive evidence base that can address safety and efficacy concerns in the wake of globalization of TM. Therefore, there is a need to create a network of PBR based clinics in TM. Centres of excellence in TM practice should be identified and networked to implement a uniform protocol based clinical documentation program with a view to generate epidemiological data and evidence of safety and efficacy. The logistics of a PBR based research model that could be effectively implemented in the context of traditional medicine are discussed below based on actual attempts made to execute the program in traditional Ayurvedic hospitalst . 36
- 73. The RUDRA Program I The RUDRA program is currently implemented at Arya Vaidya Chikitsalayam, Coimbatore and steps have been taken to replicate the program at National Institute of Ayurveda under Dept. of AYUSH' Ministry of Health and Family Welfare The PBR program for TM is called RUDRA, which is an acronym for Random Unintemrpted Documentation for Retrospective Analysis. RUDRA is based on the concept of randomly (all clinical encounters included) and uninterruptedly (goes hand in hand with clinical practice) documenting all encounters between patients and physicians in the field of TM in a systematic manner with a view to generate epidemiological data and evidence of safety and efficacy of TM practices. Metaphorically. RUDRA is the fiery form of Lord Shiva with his third eye opened. In the context of the PBR program in TM, it represents the introduction of the third dimension of the researcher's gaze on continuing clinical practice, over and above that of the patient and physician. The third eye represents the objectivity that burns biased, opinion- ated views and projects facts. The central theme of RUDRA therefore, is the investigation of ongoing clinical practice in TM by a team of well-trained researchers. The basic operation plan of the RIIDRA program is to diverl patients to a research documentation cell before they enter the consultation chamber of a physician. Through effec- tive planning and management of the patient registration pro- cess, the clinical documentation is done by utilizing the time that a patient has to wait before being called for consultation. It thus becomes a value additlon to the typical clinical en- counter in TM practices by making productive use of the extra time which patients have to spend to consult a practitio- ner. RUDRA has twelve components that address quality, security, flexibility and reach of the program. A judicious blend of clinical research, information technology, personnel management applications as well as intellectual property rights laws contribute to make up the backbone of the RUDRA program. The i vruious components are listed and reviewed below. 1. Documentation Protocol,2. Qualified Personnel, 3. Training Program,4.Infrastructure,5. Equip- ment, 6. Software Solutions, 7. Quality Assurance, 8. Certification, 9. Data Security, 10. Networking, 11. Publication and 17.Up gradation. 37 *W 1l-19 g 6lEF '$tr "?6n'1" W-
- 74. 1. Documentation Protocol : A modulated documentation protocol is designed to cover the complete cycle of a clinical encounter including booking, registration, documentation, investigations, with consultation, medicine dispensation and therapy scheduling in the case of Out Patient Department admission, progress monit-ring, diet section and discharge being the additional modules in the In Patient Department. Generating a one time unique registration ID for every patient is the key data management categories, logic. The data entry forms are customized according to gender, patient population, disease first visit andfollow up visits and there are specific forms for the different documentation modules done periodically" mentioned. These forms are coded and assigned version numbers that indicate revisions The documentation forms are designed to gather epidemiological, safety and efficacy data in a comprehensive way. A unique feature of the documentation protocol is the ICD (lnternational Claisification of Diseases) - ACD (Ayurvedic Classification of Diseases) Interface, which will greatly facilitate presentation of efficacy data in a scientific language for global acceptance. Manual documen- when the program tation is envisaged only in the phase of training and is replaced by software modules becomes fully functional. 2. eualified Personnel : For the sake of objectivity, RUDRA program requires recruitment of Ideally, qualified personnel to form a team of researchers who will engage in the clinical documentation' and Data Managers a combination of TM physicians, Allopathic physicians, Social Scientists, Statisticians can create a good blend of the diverse skills required for successful implementation of the program. Alternatively, TM physicians could take up the diverse roles after proper training and certification" 3. Training Programs : Specific skills are required to participate in the RUDRA documentation program. Hence a variety of training mod- ules have been developed to ensure that the recruited personnel will be able to effi- ciently execute the documentation protocol. Training includes Ethics in Research, Clini- cal Skills, Diagnostic Procedures, Technical Terminology, Good Clinical Practice Guide- lines, Computer Literacy and Data Manage- ment. Computer Based Training modules facilitates self learning. 4. Infrastructure : Minimal infrastructure requirements are to be met by creating a documentation cell and data archive cell. Provision should also be made for an in house clinical laboratory. 5. Equipment: The major equipments required are computers and networking solutions, which could optionally be wireless. Computers would be a combination of high configuration servers, low and high configuration pCs, data back up devices and the like. The specific requirements would vary from hospital to hospital. 6. Software Solutions: Software modules have been designed to minimize manual work and data entry time, while at the same time enhancing capabilities for data analysis and report generation. The modules have inbuilt features that will generate alerts to prevent wrong entries and ensure that all the data fields are completed. The software also has inbuilt training modules, which have to be completed successfully to generate a certificate and system assigned user id and password, without which the data entry modules cannot be accessed. This ensures that only skilled and authorized personnel can operate 38 *H r,-9 ## '/.8-9 4s3.< wp I
- 75. the software. The software also has administrative capabilities to tack bookings, generate prescriptions, track medicine dispensation, schedule therapies etc. The software solution works on the general principle of converting data into information, information into knowledge and to convert knowledge into informed decisions. 7. Quality Assurance: Quality assurance in ensured through a process of external auditing. Qualitl' of the personnel, data, equipment and medications is checked periodically by auditors appointed for the purpose. A full time Quality Control Manager at the documentation site will be responsible for day to day enforcement of quality parameters and will report to the auditors when external audit is conducted. Quality of the RUDRA program is thus achieved by the two pronged strategy of appointing neuual researchers for clinical documentation and then scrutinizing the process through external audit. 8. Certification: Based on the external audit, institutions, equipment, physicians, researchers. laboratory and pharmacy will be certified for quality from time to time. It is hoped that this certification program will play a crucial role in authenticating evidence oriented clinical practice in TM. 9, Data Security: The designed software operates in a highly secure environment and will allow only authorized personnel to access the data. However, higher levels of security in the light of IPR laws and patent system have also been envisaged. Every institutional participant will have the choice of depositing the clinical data generated through the documentation program in a national registry preferably regulated and controlled by Government authorities. This registry could be made available to patent offices to prevent misappropria- tion of knowledge. 10. Networking: It is imperative that an efficient network of the centers of excellence in traditional medicine be associated to form a practice based research network (PBRN) in TM. In the initial stages it may be feasible to implement the RUDRA program only in selected major hospitals and clinical centers of TM in the country. In the long run, it could be extended to cover a wider extent of the clinical resource 39
- 76. i base in TM. Networking will facilitate queries on safety and efficacy issues of specific TM interventions across the networked centers. It will also help to easily identify areas of strength in TM in clinical centers across the length and breadth of the country. For example, if there is a public debate on the safety issue of a particular medicine, a network querry can be raised to find out whether any clinical center in the PBR Network has reported similar concerns. Through the ICD-ACD Interface discussed earlier, ICD nomenclature could be used to search for areas of strength in TM clinical practice across the networked centers. However, each center will have the freedom to withhold data on grounds of security and/or concerns of misappropriation. 11. Publications: The software is designed to generate annual/periodical state of the art reports on epidemiological aspects of TM practice with carefully analyzed data on safety and efficacy issues. By organizing the documented data into a national registry regulated patent filing systems could be enforced. 12. Up gradation: The documentaiion protocol will be revised and updated from time to time based on advancements in the field of medical sciences, information technology and the like. Documentation protocols may be suitably altered, hardware may be updated and new software versions created. Epidemiology Safety and Efficacy Data The central theme of the RLIDRA program is to generate epide- miology, safety and eff,rcacy data from ongoing clinical practice of TM. Epidemiological data deals with distribution of patient popula- tion, diseases, disease categories and the like. Safety data will throw light on adverse events, serious adverse events and adverse drug reactions associated with Ayurvedic interventions.The principles of pharmaco vigilance will be applied to monitor safety of Ayurvedic medicines and treatments. Research personnel will be rigorously trained to document safety data in a meticulous manner. Efficacy data will be generated by documentation of symptomatology, clinical examination and lab investigations. Treatment outcomes will be evaluated by comparing baseline mid point and end point observations. All claims of efficacy will be evaluated against the natural course of a disease to determine the exact role of the TM intervention - symptom management, arresting disease, preserving function, disease modifying effect, remission or resolution. RUDRA Program Implementation Schedule The RUDRA Program is launched in a phased out manner. The first step is a questionnaire feedback from the target site. This is followed by on the spot evaluation to determine the exact require- ments at a clinical center of TM. The 'one size fits all' approach does not hold good for the RIIDRA program and a customized solution will have to be developed for each center. The'study site evaluation is done to determine the infrastructural, personnel and equipment requirements based on the number of departments, practicing physicians and the volume of patients in a *W 40 e-9 ## : tr
- 77. : particular center. A site set up and management progiam is designed to ensure that the infrastructure. equipment and personnel are utilized in an optimal way. This is achieved by dynamic projections of requirements based on real time monitoring of patient volumes, practicing physicians, research personnel and computer networks. Calculations are done on the basis of certain general principles like there should be a 1:1 ratio of practicing physicians and researchpersonnel during actual implementation of the docu- mentation program. An additional researcher should be available as standby and to work on shifts n'hen the documentation schedules are prolonged. Research personnel requirement is projected on the basis of average time required to complete documentation of a single patient, which is ten minutes for the first visit and twenty minutes for the follow up visit in the Out Patient Department (OPD). Requirements are calculated for the In Patient Department (IPD) on the basis of the average number of admissions and discharges in a day as well as the time required for documentation, which are forty-five minutes for baseline and endpoint assessment and about ten to twenty minutes for midpoint assessment. In the OPD. each researcher and each practicing physician requires a networked computer as well as the lab, pharmacl' and registration counter. In the IPD, the researcher's cell will need adequate number of computers as u'ell as the nursing station, pharmacy, dietetics section and the therapists room. The growth of the clinical center may demand either better management of existing facilities or more infrastructure and personnel. The site management module has the ability to anticipate and identify such requirements and recommend appropri ate sol utions. Following the onsite evaluation and the establishment of required infrastructure, equipments and recruitment of personnel, the documentation program is implemented in four steps. The first step is the manual documentation module including training of the recruited personnel. The second step is mock data entry to create acquaintance with the software modules. The third step is alpha testing of the soft$'are and the fourth step is the testing of the beta version of the software. After successful completion of these steps the final version of the software is launched. Prior to launch, all trained personnel will have to obtain computer-generated certificates, user ids and passwords to access the software. In big hospitals, the final launch may also be phased out and implemented department by department. Prior Use and Continuity of Use TM practices embodied in systems of medicine like Ayurveda and Siddha have both codified knowledge documented in manuscripts and an uninterrupted tradition of practice. The codified texts bear testimony to the prior use of medicines and interventions and to a limited extent provide information on safety and efficacy of TM. TM practices have been continuously evolving and therefore the codified texts do not completely capture the entire gamut of practices that are actually in vogue. For this very reason, there is a need to generate documented evidence on continuity of use in the context of TM clinical practices. The TKDL project provides organized access to documented evidence on prior use in TM. The RUDRA program will generate documented evidence on and access to continuity of use of TM practices. It is akin to erecting the second pillar to reinforce the validity of TM practices. Upon the pillars of codified prior use and documented continuity of use, scientific validation of TM can be firmly and fruitfully established. This is the philosophical backdrop in which the RUDRA program is positioned with the long term vision of generating rigorous evidence to defend, protect, and utilize the rich inher- itance of TM practices for the common good of humanity. I T 41
- 78. CURRENT TRENDS AND RECENT ADVANCES IN VASTI . Dr. L. Mahadevan, BAMS, MD, Director, Dr' Y' Mahadeva lyer's Sri Sarada District-629851,Tamilnadu' Ayurvedic Hospital,Derisanamcope, Kanyakumari o Vasti is one of the most important pancakarma procedure practiced by physicians all over the India. Vasti is mainly useful for all metabolic diseases and most of the metabolic diseases are cured by vasti. That is why it is called ardha cikitsa' o This is the only treatment which is used in eight branChes of Ayurveda' marma because of the reason that an injury a Gudam has been mentioned as a Sadyapranahara shock' in ano-rectal valve can produce faecal incontinence or vasovagal laflghana' sthambhana' svedana' There are shad upakramAs in Ayurveda namely brimhana, snehana, rukshana' o These six therapies are based on shad gunas' They are o Profmhana Bemhada denotes guru guna o Lafrghana denotes laghu guna o Stambhana denotes Sita guna o Svedana denotes ushna guna o Snehana denotes snigdha guna o Rukshana denotes ruksha guna when we use these shad $unas by kasaya etc it is called samana cikitsa when we use the shad gunas for sodhana cikitsa it is called Pancakarma' possible by vasti' Vasti is used in infectious' Immunomodulation and immuno suppression are and endocrinb disorders' immunological, degenerative, inflammatory, infertility, metabolic o Itistheonlytherapythatisusedfrompaediatricstogeriatrics. The authors have developed special vasti netra for infantile use. o practice has been standardized up O The dosage and application of anuvasana vasti in paediatric tothreeyears30mlofoil,6to8years45ml'gto13years60mlofoil' a AsthApana vasti up to the age of 10 years can be up to 250 ml' ganam and anuvasana ganam" a Madanaphalam has been mentioned in dsthapana of Madanaphala as PhalamAtra a A separate chapter has been told in Caraka Samhita, the glory siddhi. maintain the pH of the vasti o We have to add madanaphala in every vasti yoga. Madana material and vyApaths are also prevented by madana' 42 *S tr ffid
- 79. Vasti is commonly done in o Neurological deficit o Rheumatoid syndrome and other Arthropathies o Low backache of varied etiology o Peripheral Vascular Disorders o Chronic rhinitis o Headaches o Ulcerative Colitis e I.B.S. o Infertility (Men & Women) in our practice. Sneha vasti can be given maximum up to 400 ml. Vasti given by enema bag and vasti given by vasti Rutaka are different, because of the pressure gradient difference. The pAkam of the tailam in vasti has got significance because only in acidic media bacterial destruction takes place. a Honey and lavadam acts as glucose and electrolytes which prevent dehydration. o Sterilization is very important to prevent bacterial contamination in vasti. o Making vasti dravya will take at least 20 minutes. a Always do proctoscopy before vasti procedure. a No karma like lifting the leg, etc are needed after nir0ha vasti. a PicchA vasti is hig-{V useful in ulcerative colitis. o RajAydpana vasti is useful in infertility. o We are able to reduce the dosage of anti epileptic drugs after rAjayApana o Ankylosing spondilitis is very well treated with karma vasti. a According to Ayurveda administration of catheter in the urethra is only upto 6 afrgulAs that is 12 cm. Male urethra is 17 to 2l cm,so the uttara vasti in Ayurveda is intra penile, not intra bladder. The uttaravasti for women is intra vaginal. For intra cervical and intra uterine it has to be done in theatre in aseptic precaution with help of a gynaecologist. a Cervical dilatation is also needed. It is usually done in tubal block. o In summer anuvAsana vasti can be given in the evening time. a Reabsorption of lumbar inter vertebral disc material after giving eranda m0lAdi nir0ham. Serotonin secretion, mood changes, reduction in adrenaline level after vast were assessed by the author. a Changes in electrolytes were observed by the author which will be elaborated in the seminar session. a Comparison of Barium studies of mddhutailikam given with bladder and enema can rvere done. o The ultrasonography after 24 hours of uttaravasti, urine assessment after uttaravasti, follicular maturation study after uttaravasti, immunoglobulin and plasma proteins after yApana vasti were done. That will be elaborated by the author in the seminar session. T 43
- 80. MATERNAL AND CHILD HEALTH CARE INDIA _ NEW APPROACHES c Prof. Manjari Dwivedi, Faculty of AYurveda,BHU,Varanasi In 2000. leaders of all 191 member nations of the United Nations committed themselves to achieve eight specified goals - the Millennium Development Goals - by 2015(1). Two of these, goals 4 and 5, relate to improving maternal and child survival - a commitment to reduce matemal mortality by 75 per cent and child mortality by 66 per cent from the levels seen in 2000. In India, an estimated 136000 mothers2 and 2.5 million childrens die every year, most often due to causes that are preventable or easily treatable if immediate help is available. In order to keep its commitment, India should reduce its maternal mortality MMR from 540 to 135, and its under-five child mortality to 32. l Why new approaches are needed I Although improving maternal health is one of the Millennium Development Goals, actual progress in reduction of maternal mortality remains limited. Handly few countries have seen any noticeable reductions over the last 20 years.Unacceptably high maternal mortality rates prevail, despite 15 years of the global Safe Motherhood and RCH {nitiative Unfortunately, maternal death is not a vaccine preventable disease and there is no one-shot remedy for reducing matemal mortality.Ayurveda is a time tested reliable system of medicine The antenatal care provides should take this opportunity to make the women and her family aware and confident about integrated approach during during pregnancy and childbirth. Few important definitions are as follows. Maternal Mortality Ratio:The maternal mortality ratio is the number of women who die from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, per 100,000 live births. The 10'h revision of the International six Classification of Diseases makes provision for including late maternal deaths occurring between weeks and one year after childbirth perinatal Mortality Rate:The PNMR refers to the number of perinatal deaths per 1,000 total births. It is usually reported on an annual basis. It is a major marker to assess the quality of health care delivery. Major causes of Maternal Death:The major causes of maternal death are bacterial infection. roxemia, obstetrical hemorrhage ,ectopic pregnancy ,puerperial sepsis ,and complications of abortion. perinatal mortality:WHO's definition "Deaths occurring during late pregnancy (at22 completed weeks gestation and over), during - childbirth and up to seven completed days of life" is not universally accepred. The perinatal mortality is the sum of the fetal mortality and the neonatal mortality. s 44 w- ofr b6k-< f$w 1ff'r''
- 81. Fetal mortality :Fetal mortality refers to stillbinh - or felal death. It encompasses any death of a fetus after 20 weeks of gestation or 500 gm. In some definitions of the PNM early fetal mortality (week 20-27 gestation) is not included, and the PNM may only include late fetal death and neonatal death. Feml death can also be divided into death prior to lobour, antenatal (antepartum) deathduring labour. intranatal (intrapartum) death. Fetal mortality can be decreased by good prenatal care. Neonatal mortality Early neonatal mortality refers to a death of a life-born baby within the first seven days of life. while late neonatal mortality covers the time after 7 days until before 29 days. The sum of these t*'o represents the neonatal mortality. Some definitions of the PNM include only the early neonatal mortality. Neonatal mortality is affected by the quality of in-hospital care for the neonate. Neonatal mortaiity and postneonatal mortality (covering the remaining 11 months of the first year of life) are reflected in the Infant Mortality Rate. What is NRHM ? :The National Rural Health Mission (2005-12) was launched in April 2005 by GOI. It seeks to provide effective healthcare to rural population throughout the country with special focus on 18 states, which have weak public health indicators and/or weak infrastructure. These States are Arunachal Pradesh, Assam, Bihar Chhattisgarh, Himachal Pradesh, Jharkhand, Jammu and Kashmir. Manipur, Mizoram, Meghalaya, Madhya Pradesh, Nagaland, Orissa, Rajasthan, Sikkim, Tripura, Uttaranchal and Uttar Pradesh. GOI would provide funding for key components in these 18 high focus States( I ). NRHM Goals and strategies The goals of the NRHM jncludes: a) Reduction in Infant Mortality Rate (IMR) and Maternal Mortality Ratio (MMR); b) Universal access to integrated comprehensive public health services; c) Child health, Water. Sanitation and Hygiene; d) Prevention and control of communicable and non-communicable diseases, including locally endemic diseases; e) Population stabilization, gender and demographic balance; 0 Revitalize local health traditions and main-stream Ayurvedic, Yoga, Unani, Siddha and Homeopathy Systems of Health (AYUSH); g) Promotion of healthy life styles(1). Maternal Anaemia :Oral iron supplementation may improve matemal anemia, but thereis no clear effect of iron supplementation on maternal and perinatal or neonatal outcomes. However, the evidence for impact of iron supplementation (in normal pregnant women )on health outcomes is inconclusive, primarily due to a paucity of adequately designed and robust trials ofiron supplementation in developing countries rather than a demonstrated lack of effect(2,3) Folate is critical for DNA synthesis, and folate deficiency is associated with dysfunction in rapidly dividing cells. Observational studies have suggested that lower maternal serum folate levels are associated with LBW and prematurity.(4,5) In an RPCT in Indonesia in which women were supplemented with vitamin A. iron. or both, I Suharno et al( 14) found that women given both supplements had maximal Hb increases and one third I 45
- 82. of this response was attributable to vitamin A supplementation, suggesting that vitamin A may help reduce rates of maternal anemia and subsequent adverse birth outcomes. Ayurveda advocates Use of Dhatri Lauh, Punarnava Mandoor and many more preperation which showed their positive result in improving maternal anemia ( not of the severe anemia. where only blood transfusion may be the only choice). The tolerance of the medicine is better. Dhatriphala showed highly beneficial effect during pregnancy protein supplements : Many protein supplements as advised during masanumasik paricharya of pregnant women.(in the form of milk and other protein as dietetic substance and few herbs) of Ayurveda if followed it will not only be effective but also prove easy available and cost effective door step supplement. various forms of protein from Qualified doctor must be consulted during pregnancy before taking grocery market. Benefits of unbalanced protein supplementation in pregnancy were largely refuted re- cently in a meta-analysis of available evidence (6) Such interventions have been tried historically in a uariely of malnourished and at-risk populations including poor communities in developed countries.(7) In 3 studies among Asian women in the United Kingdom and Chile, where the usual maternal energy intake was isocalorically replaced with 107o to IIVo protein(S,9) there was no effect on pregnancy outcornes' although there was a irend toward reduced birth weight. Even higher levels of protein supplementation (>25Vo of energy) in relatively well nourished populations failed to show any benefit on pregnancy as a viable outcomes and birth weight (10,11). Thus,protein supplementation alone is no longer viewed intervention during pregnancy. (12) UTIs and Reproductive Tract Infections :Ascending bacterial infections of the genitourinary tract preterm canbe a significant underlying factor in many late fetal deaths(14) as well as spontaneous onset of labor(l5).-There is considerableevidence, however, that bacteriuria and,occult UTIs are widespread in developing countries. (16) However, the logistics, technicalrequirements, and frequency of screening necessary for diagnosis of asymptomatic bacteriuria in developing-country settings are formidable barriers to wide-scale imple- mentation of this intervention. Thus, pending additional evidence as to the feasibility and cost-effective- ness of this strategy, and require additional operational and cost-effectiveness research (17) Ayurvedic advocacy of routine use of Gokshuru during pregnancy is evidence as to the feasibility and cost- effectiveness care during pregnancy. Bacterial Vaginosis :Some studies have found high rates of bacterial vaginosis in developing countries (17),- butdata are lacking on the attributable risk of bacterial vaginosisfor LBW. preterm labor is PPROM (18)' The , Antibiotics for PPROM? :The most common antecedent ofin such cases ranges from 32Vo Io culture positivity rate of amniotic fluid for microbial organisms 35Vo.(19) The mechanisms underlyingPPROM may include local subclinical infection and inflammation leading to weakening of the amniotic membranes(2O) So there is strong need for planed conception and utility of preconception counseling with obste- trician going through checkuP. ' preterm Labour :No clear overall benefit for routine antibiotic therapy forpreterm labour with intact membranes has been demonstrated intrials in urban settings in developed or developing countries' Thus, this intervention cannot be recommended routinely. Evidenceindicates that antibiotic administration in preterm labor shouldbe considered only when there are clear indications of associatedinfection, or" as u 46 ,4d I w
- 83. indicated in the next section, in the presence of other risk factors.(l7) Ayurvedic regimen ( Aahaar Vihaar) during pregnancy is safe and effective measures. Thus, tetanus immunization of pregnant women in combination with promotion of hand-washing and clean delivery, including clean umbilical cord care, was protective against neonatal tetanus and re- sulted in reduced neonatal mortality and morbidity Maternal Vaginal and Newborn Skin Antisepsis : Maternal intrapartum and postpartum infec. tions are a major cause of maternal morbidity and mortality in developing countries. A large proportion of early-onset neonatal infections in developing countries may also be related to vertically transmitted infectionsfrom the maternal genital tract(2I,22,) Thus, there is interestin evaluating low-cost strategies for preventing and reducing infectious complications of maternal infections, particularly for settings in which antenatal care may be suboptimal and use of Uttar basti and medicated oil Pitchu in vagina of pregnant women during last month of pregnancy helps in attaining the normalcy and work as Newbom Skin Antisepsis Hypoglycemia Prevention and Management : Hypoglycemia after birth is a major cause of morbidity, particularly among intrauterine growth-restricted and pretenn infants. The risk of hypoglycemia is significantly greater among preterminfants because of their reduced energy and glycogen reserves and inability to mobilize alternative metabolic fuels(23). Hypoglycemia is also relatively common among LBW infants and macrosomic infants of diabetic mothers (24) Prevention and management of neonatal hypoglycemia have been the subjects of a major review by Williams (25) Advise of Ayurvedic text of putting small amount of honey on the tongue of neonate justifies it's use. Maternal Vaginal and Newtrorn Skin Antisepsis :There is linle evidence as to whether the current practice of umbilical cord clamping soon after birth, to prevent polycythemia on the one hand or anemia on the other, is based on solid scientific criteria. Some studies have demonstrated that delayed cord clamping (after the cord stops pulsating) may increase neonatal blood volume by approximately one third(28,29). Neonatal Vitamin A Supplementation :The significant public health benefits of vitamin A supplementation on child mortality in developing countries are well established. There is much interest in the potential benefit of neonatal vitamin A supplementation on neonatal and infant outcomes, given the widespread subclinical vitamin A deficiency that exists among pregnant women and lactating mothers in many developing-country settings, the demonstrated positive impact of antenatal vitamin A supplementa- tion on maternal mortality. Topical Emollient Therapy (Newborn Thermal Care Practices ) In India, topical therapy of preterm infants with corn oil every 4 hours resulted in a significant reduction (P < .001) in need for an external source of heat to maintain normal body temperature(26) Another study in Nepal found that traditional oil massage with mustard oil, swaddling with a plastic swaddler, or KMC was equally effective in preventing hypothermia during the first 24 hours after birth(27). The skin barrier of preterm infants is compromised for a variety of reasons including developmental immaturity-(30)and lack of vemix, which is produced near term during gestation and serves as a naturally protective cutaneous biofilm(31)In addition,the skin barrier of preterm infants is easily injured (32) Particularly in developing-country situations, the skin barrier of even term infants may be compro- mised as a result of intrauterine malnutrition(33) Thus, the skin may serve as an important portal of entry for serious bacterial infections(34) However, evidence from laboratory studies in animals and clinical 47 *S 1-.C ffid 6tr "q-Ss'
- 84. trials in humans suggests that it may be possible to enhance skin-barrier function through application of topical emollients or oils, thereby improving health outcomes' Oil massage of neonates is a nearly universal practice in south Asia. The typical timing (from the (throughout first days of life), frequency (typically 1-3 times daily), pattern (total body), and duration infancy and early childhood) of use suggest that the practice is an important event in daily child care, that significant time and resources are devoted to it, and that exposure of the infant's skin to the oil is significant. The most commonly used oil for infant massage is mustard oil, which, as noted above, is potentially toxic(35) and, when tainted with seeds of the weed Argemone mexicanal may cause the neurologic syndrome coined "epidemic dropsy."(36,37) Emollient therapy is a promising intervention, particularly for LBW infants in developing countries, lipids Choice of emollient is important. Emollients containing a physiologic balance of epidermal (3:1:1:1 molar ratio of cholesterollceramide/palmitate/linoleate) are optimal for barrier repair, There has been much interest in recent years in the cost-effectiveness of community-based strate- gies for perinatal care. Such data, however, are almost exclusively available from developed countries and include the institution of community-based nurse-midwifery services, culturally adapted perinatal care. Thus we should understand that human reproduction is not just a natural biological phenomenon for which no special efforts are required to have children rather it is an organized effort to have off springs with better qualities, much more higher than their parents. The concept of progeny in ancient times was to achieve qualitative growth of society and not just quantitative spurt in population' Diet and mode of life of mother throughout pregnancy influence the fetus. The diet of mother or emotions experienced by her are supposed to be shared by the fetus. While describing the benefits of dietetic regimen for the pregnant lady having normal development of fetus. Charaka says that with observance of dietetic regimen women remains healthy and deliverse a child endowed with good health, energy/strength, voice, compactness and shall be much superior to other family members. All the Ayurvedic texts have also advised to avoid certain dietetics and mode of life by pregnant woman as they can harm the fetus. Management of Puerperium ini€Mrtl (.rF First day to seven daY .l,l*'ilrWS**|M lmrudiatd Nfttirrocrry .ud*d4dli,dld*ll$ In general all clasics have advised massage,oral use of "|{rss/Wsq4q -,ry&id@Eh4&!4li@ ,,,@dewilaxb@ fats with drugs and decoction for three to seven days after delivery.Diet should be medicated with drugs From seven to l2th day medicated meat soup is ad- vised. CONTRAINDICATION Asthapan Basti( Decoction enemata),Nasya( Nasal insuflation.Venesection,Purgatives and Continuum ofCare sudation. It is the time when basic concepts of ayurveda and Ayurvedic cost effectivemanagement in relation ro maternal and child health ( Garbhini and navjaat shishu paricharya)be promoted and propagated Globally and in India specially. Only an integrated approach to safe motherhood and newborn health will be effective in achieving the MDG Goals in relation to MCH. 48 "S H-o ffi
- 85. . .. ar'lil fi>l rir;*l*rn;iJ nrort;rlity PO,'ERTY AND &[ATE& Al MORTALITY S$*ffggx-"4'r"6 T 49 *S aiE ffi nYd v<6F M W
- 86. l NATURAL PRODUCT CHEMISTRY: FOR BETTER EFFICACY OF PLANT PRODUCTS. o Dr. Hrishikesh Damle, BAMS, MD. MD&CEO ATRIMED Pharmaceuticals Pvt Ltd.Bangalore-1 Knowledge is a perception about a concept nearest to the truth. Knowledge can be gained by repeated observation or iogical deduction. The repeated observation within comparable environment is the best known method of generating knowledge. Logical deduction is a very poor method of acquiring knowledge. nevertheless it is sometimes necessary. Science is built on unbiased repetitive observations. That knowledge which is nor having proof of being acquired using scientific tool is difficult to be called as scientific. The reason for scientific knowledge being the ruler of the world without any army backing it is due to its inherent strengths like definability reproducibility, measurability, precision and hence objective mass application. Scientific knowledge also has an inherent nature of falcifiability which is condemned by many as a shortcoming. It is mindless to think that a tool to correct oneself as a disadvantage! Probably this one character of science has improved it so much leaving all other type of knowledge lurking in the dark. Chemistry is one such branch which tries to define why one substance is different from others and how they behave in proximity at micro structural levels. Chemistry can tell why and how Neem is different from Mango. Is it absolutely true? Yes, it is absolutely true in today's world with the advent of biotechnology, genetics and modern chemistry. Not having knowledge of chemistry would definitely disable one from creating standards in manufacturing, precision in diagnosis and measuring the outcome of treatment. However knowledge of chemistry does not discount one from reading and understanding ancient knowledge systems provided they are understood in context and aptly interpreted. How is Neem dissimilar to Mango? Wise would be to ask, 'Are they similar'? They are similar. in fact all plants are made up of similar chemicals. These chemicals help the plant to survive on this universe. The survival depends on longevity and reproducibility of the plant. Those chemicals which help them to live and reproduce are called'Primary metabolites'. Think of carbohydrates, proteins etc' They are constantly produced in the bodies of all plants. They are similar and hence Neem and Mango almost share same type of primary metabolites. In fact the genes coding the metabolic pathways of producing primary metabolites are almost the same in most of the plants. Literally Neem and Mango are indistin- guishable in their chemical world barring few compounds called secondary metabolites. What is a sec- ondary metabolite? Imagine manufacturing of Ghee. First we get fresh milk. The fresh milk is converted to boiled milk. When a little bit of buttermilk is added to this we get curds. Curds when churned gets converted to iutterrnilk and butter. The butter when heated gives us ghee. So there are series of steps involved in getting ghee from cow's milk. Similar steps give plants (in humans as well) carbohydrates, proteins or fats. There are genes in the plant which code for the same. Alas! The genes in Neem and Mango are ;rlmosr the same but for very few changes in those which code their flower and fruits. During multipli- 50
- 87. cslion these genes can get mutated and hence the pathway as well will change. The metabolite arising rxom rhis changed pathway is different and is called as secondary metabolite. The secondary metabolites ;3n I ) Strengthen the life of the plant and hence can improve the chances of its survival 2) Mai' be inert and rvill be carried with the next generation of plants 3) May be lethal to the piant and hence kill the plant s,pecies without continuing. Mango and Neem have many secondary metabolites which are different from each other. Since animals and humans have similar primary metabolites what is not there in us is the secondary metabolite present in the plants. It is observed that these secondary metabolites may or ma)' not carry a biological activity. Most of secondary metabolites are believed to be having no significant biological activity! So to understand the difference of Neem from Mango all we need is to understand ferv secondary metabolites present in them. Hence lets stop talking about millions of chemicals in a plant but concentrate on those very few secondary metabolites. Did you know that most of these secondan' rnetabolites can be classified into few types. If we understand the basic structure and character of these groups we can get grasp on them at a glance. They can be classified as 1)Shikimates 2)Polyketides 3)Mevlonates 4)Alkoloids and others. I sincerely request all Ayurvedic graduates to learn and understand these chemicals. The reason is l) It's a well-known fact that secondary metabolites are biologically active compounds 2) It's a u'ell known fact that all your Classical and Patented medicines are to be standardized for presence of these 's materials 3) Their absence will lead to therapeutic inefficacy 5) Most of them are known since 1970 still not included in ayurvedic cumiculum. 6)Your results will be consistent in patients Summary: The rubber from rubber plant, orange oil in orange, caffeine in coffee and nimbidin in neem are all secondary metabolites" There would be no value for these plants without secondary metabolites. The anti fungal activity of Cassia alata, the mast cell stabilization property of Tylophora asthrnatica in bron- chial asthma or anti inflammatory activity of Guggulu will disappear the moment you remove seconda4' metabolites from them. Natural product chemistry is the way one should understand a DRAVYA. Please I get rid of the myth that there are thousands of biologically active chemicals in a plant. The biologicalll' I r active substances in a plant are secondary metabolites. Most of the secondary metabolites have insignifi- F I cant biological activity. Hence there are very few significant secondary metabolites in a plant, which one t should know. Knowledge of secondary metabolites will provide us precise knowledge of utility of a plant. how does the plant work. how to standardizelhe medicine, how to fix the dosage and last but not the . least consistent precise therapeutic outcome. (further details and discussions contact drdamle@gmail.com. -080-41123727) I 51
- 88. A COMPARATIVE PRELIMINARY STUDY OF ANTI-BACTERIAL EFFECT OF AN AYURVED PREPARATION OF SARVA VISADEE OIL r n c rmarasil'.? ;,Y;Jlf;:i"; Introduction Plant based medicaments have been man's prime therapeutic weapons to rescue him from disease. Plants are of relevance to pharmacology. Pharmacological properties of medicinal plants may be used in developing modern therapeutic agents. Sarvavisadee oil is a common Ayurvedic formula used in traditional system of medicine in Sri Lanka which contain about thirty five plant based ingredients' Most of these ingredients were already proved as anti bacterial agents. .This oil is being used as internal and external medication on infectious conditions such as Tonsillitis Pharyngitis and other common throat conditions.2,3. Most of these conditions may develop due to bacterial infections .The main objective of this study was to evaluate the anti bacterial effect of this preparation.. Material and method Well diffusion method and paper disc method was carried out to detect the antibacterial effectr. The market samples of different manufactures below two years of the manufacturing date were selected to this study.. 0.1 ml of these oil were used on this study .Petri dishes and pippets were sterilized by using hot air oven at 160.0C for three hours. Nutrient broth , Nutrient Agar and Metal cylinders ( 0.5 cm diameter, and 1.0 cm depth) were sterilized by autoclaving at 120.0 C for 20 minutes. 0.7 gram of Nutrient broth was dissolved in 50.m1 of distilled water and transferred in to five metal cap test tubes and sterilized. These tubes were inoculated separately using sterile inoculating needle with identified pure test cultures of Pseudomonas aerogenosa, Escherichia coli, Staphylococcus aureas , Salmonella typhi, and klebsiella. 2.8 gram of Nutrient agar was dissolved in 100 ml of distilled water and sterilized under aseptic condition. This sterilized agar was transferred in to already sterilize five Petri dishes at 40.0 C and allowed to solidify at horizontal plane. These plates were sealed and kept in incubator at 37.o C for 24 hours in order to exclude any contaminations and to reduce the moisture content of the plates. 0.05 firl. of the above test cultures were added to these agar plates by using sterilized glass pipette and spread evenly by using sterilized glass spreader. With gentle pressure already sterilized metal cylinders were placed (03 cylinders per plate) over these seeded agar plates. These cylinders were filled with 0.1 ml of sterile distilled water , 0.1 rnl of Sarvavisadee oil, and 0.1 rnl Chloram penicol solution of 25 mg /rnl. Results and discussion Pseudomonas aerogenosa 1.0 cm Escherichia coli, No clear zone Staphylococcus aureas 0.5 cm klebsiella. 0.5 cm Salmonella typhi, 0.5 cm *S 52 u q 'ffi ffitl"=
- 89. coli Clear inhibition zone of bacterial lawns were noted in every plates except Esclzerichia clear inhibition Salntonella typhi, klebsiella and Staphylococcus aureus plates were showed 0.5 cm ei)fle seudomonas aeruginosa plates showed 1.0 cm clear zone This preliminary study rnay justify scientifically to some extend the use of this oil preparadon in, tnfective conditions such as Tonsillitis. Bronchitis and other infective conditions of upper respiraton' ffact.. Conclution Salmonellct of any strains of is pathogenic. Same time other strain of Pseudomoncts aeruginosa, pathogenic' Eschericlia coli, Staphylococcus antreus and klebsiella also may opportunistically Sarvavisade oil shows antibacterial activity on all of these organisms. Sri Lankan traditional ph1'- onl1" sicians have been using this compound preparation on the basis of their own clinical experience The results of this preliminary study justify scientifically the use of Sarvavisadee oii in infective con- ditions such as Tonsillitis, Bronchitis and other infective conditions of upper respiratory tract. The exact mechanism of this effect and more detail study in this regard is still to be established. Reference l. Chalabian F, Norouzi Arasi H, Moosavi S. A study of growth inhibitory effect of essential oils of seven species from different families on some kinds of microbes' journal of medicinal plants 1969 2. Ayurvedic pharmacopia volume -l,Department of Ayurveda. colombo .1_ Ayurvedic pharmacopia (Unani) volume -1 Department of Ayurveda. Colombo I I I 53 w 9W aY# /1UO /go"rkz r9a-cr;T'tll,'V roKy <if.+Y" ' ta.' i E W,
- 90. l REJUVENATE AND PROMOTIVE ASPECT OF AYURVEDA o Dr Srinivas H. Acharya M.D(Ayu)., ph D, Program Officer, International Center for Ayurvedic Studies, Reader & HOD, Department of Panchakarma, GA Mahavidyalaya, Gujarat Ayurved University, JAMNAGAR One of the few highlighting specialties in Ayurveda system of medicine is about the approach to individual health. Health planning apan from the holistic approach, is very lucrative, precise and convinc- ing for the modern world today Comprehensive health approach is very much evident in the definition of healthy person in Ayurveda which reiterates the 'well being'of bodily elements, senses and mind and spirit. These invari- ably appreciate the individual person as not only a healthy biological mass but also health as applied to emotion, behavior, thinking pattern (pleasant mind) and interaction with the external world, attitude, compassion towards other beings i.e., socio-spiritual well being of that individual (pleasant soul). The next important contribution of Ayurveda regarding this issue is the considering health of an individual as unstable 'phenomenon'. Health is constantly influenced and being bombarded every second of an individual's life span. Biophysicists of today apparently consider the biological system as an 'open system' constantly reacting with the external environment. Thus health is the integrity of the systems in maintaining the internal milieu of the living individual balancing against the impact of inevitable interaction with internal and external environment. In other words, integrity of Tridosha (Vata-Pitta-Kapha) in balancing the harmony of the body shall determine 'health'. In Ayurveda the state of Tridosha in the body is considered to be highly influential and reactive in nature. The following chart shows the rhythmic variations of Tridosha being influenced by many physi- ological and environmental factors; Kapha Vata Pitta morning time time evening mid day night windy day hot sunrays winter & spring rainy season autumn & summer first phase digestion end phase digestion mid phase digestion day nap night awake night awake low physic activity exhaustion exhaustion lethargy high mental activity worry & rage Kapha foods Vata foods Pitta increasing foods Mind influence the body - body follows the mind Vata - Rajas,Kapha- Tamas,Pitta- Sattva & Rajas ,H ,u 54 R* : ffi
- 91. Thus for a harmonious living, balancing the state of Tridosha through promoting integritr is the key. Thus to maintain the health one has to follow promotional plans laid down in Ayurveda taking into consideration of individual biological rhythmic pattern as 'Prakriti'. Promoting integrity through -. Timely bio purification and practice of allied Panchakarma thera- pies.. Special cadre of herbs and regimens L Panchakarma Practices : Biological purification (Shodhana) is again pivotal concept of Ayurveda therapy and a contribution io medical world. Extraction of unhealthy biological elements apparently in the form of disturbed Tridosha through different approved means and would pave way for the internal harmonious iunction of biological systems. Gradual accumulation of morbid substances accrued through faulty practices and environmental influences can lead to pathological forms either by long term or immediate. These need either culmination or removal from the body before they weaken the biological system. Ayurvedic scrip- [ures pay more weightage to removal of such morbid elements from the body first than just attempting to culminate thern. Culminate or appeasing measures (Shamana) are also familiar among Panchakarma practices. Manv such procedures are said strengthen the weakened systems and reduce their vulnerability to dangers. Thus by both the means Panchakarma in Ayurveda is an important tool for health promotions. Following are the few subtitles showing certain areas where Panchakarma can be encouraged for nealth promol"ion. Annual health curriculum: - a health card can be prepared for the individual persons after detailed checkup by the physician. Ayurveda recommends seasonal regimens (Ritu Charya) looking into the Doshic variations due to change in the environment. The biological purification as well appeasing pro- cedures of Panchakarrna are planned in the periodical program. Monitoring health periodically through checkups eventually after every procedure and follo"r, up would be a wise promotional program for the sociery. Every day Panchakarma: - few of the procedures considered under Panchakarma are recommended as part daily regimens (Dina Charya) in Ayurveda. Every day practice of Ayurveda massage (Abhyanga) is said to improve the health status of different tissues in the body imparts good eye sight and combats ageing process of the body. If nothing could be practiced then at least one should oil the head, ear and soles of the foot (shira-shravana-pada) in the minimum for maintenance of health and longevity. Unctuousness (Sneha) in the body tissue is viewed in Ayurvedic literatures as vital for the normal functioning of the body. Thus consumprion of Sneha like 'ghee' is an essential portion of diet and administration of Sneha in the process of Abh-v-anga has a Further effect. Oil massage to the head (Shirobhyanga or shirasneha) is a daily practice of Panchakarma is u'ell appreciated in Indian society even to the date today. Protection of the important 'Marma' through proper oleation makes an individual sturdier in his physical and mental performance. It is highlighted in Ayurveda that ageing process can not gain its impetus very easily on rhe organs of the head if a person is having the practice of doing nasal oiling (Sneha Nasya) every day. Slorvin_e the degenerative process of the brain cell could be very important issue in the public health. Programs can be made for constitutional basis. 55
- 92. regular oil massage ,Pitta types (Parakriti) - Utsaadana with herbal powdersl Vata types (prakriti) - paste ,Kapha types (Prakriti) Udvartana with or without oil - These are only examples highlighting field of Panchakarma for promotional purposes Fanchakarma and cosmetics:- good complexion to the skin' Practice of regular Ayurveda massage (Abhyanga) said to impart imparts shapely appearance of the body (subhakta Ghana Gaatra). Vacha Chandana Haridra etc' said to improve Utsaadana or Lepa with aromatic medicinal herbs like the health & complexion, in addition they alleviate bad odor. good facial complexion' dark colored long Pratice of nasal errhine (Pratimarsha Nasya) can impart hairs. crack on the foot' which is also a Regular practice of massage to the foot can alleviate and avoid cosmetic problem. impaft to the cosmetic Like wise there are lot more scope for Panchakarma practices which can aspects. baby - panchakarma for convalescents: - chronic illness, post delivery for women, for new born sneha Pichu, Sneha Basti, Nasya etc. are useful when used with discretion for health here Abhyanga, Panchakarma to relieve physical and mental stress:- can help a lot for the needy Head very important area where again simple Panchakarma procedures for physical stress and exhaustion persons. Abhyanga the Ayurveda massage again a well know remedy {shrama Hara). In addition clinically it is seen that Abhyanga can also provide a lot mental relaxation roo, it provides good sleep (Susvapna). Shirodhara is another therapy tp impart serene and calm mind' IL The world of RasaYana : science the obscure and phantom terminologies like 'anti In the yester years of modern medical .male virilizors, did exist. probably Ayurveda is the only ancient scripture which provided ageing, & rational basis of such thoughts in leu among the public. Chapters of Rasayana and Vaajikarana are the standing proofs for today. Maintaining ."^uul health and extension of youthful period could be a slogan of health promotion in the modern social life' brews of flavunoids and The fascinating world of herbs gave the modern scientist many magic orher phytochemicals which opened new vista of research in pharmacology. Happened to be the introduc- etc are supposedly the tion of new terminologies likl adaptogenics, immunomodulators, and antistress the majority of these plants outcome of research in the field of certain herbal remedies' Noteworthy, falling under Rasayana herbs mentioned in the Ayurveda books. The whole concept of Rasayana therapy is oriented to enhance quality of health in an individual (oorjaskara) which one of the two prime motto of Ayurveda treatments. These herbs seemingly posses special affinity in augmenting the 'integrity of Tridosha Balance' in the body. Thus providing a favourable media to promote a holistic concept of Ayurveda in balancing herbs (Divya Aushadha) which can body-mind-spirit. Many of such herbs are proclaimed as celestial purify and ellvate the soul to higher order of consciousness. Apparently the philosophy behind the ancient the Yoga and Tantra ut"t dealing with the process of mercury - Parada, speaks of the same connecting "roy philosonliY together. 56
- 93. puts itl This Rasayana Therapy can be planned in two ways- as charka Samhita 1. Minor Rasayana program - suitable for day to day life (vata atapika Rasayana) to certain period of 2. Major Rasayana program - is serious program in a confined environment time. (kutipraveshika Rasayana). of the individual seeking These Rasayana therapies can be planned as per the need and requirement lor the treatment. Rasayana for the specific illness, Rasayana for the convalescents, Rasayana for kids and women, Rasayana in seasonal regimens, Rasayana for every day based on the constitution (Prakriti), General Rasayana for the whole family, Rasayana to combat ageing process in the bod]-, Rasayana specific to tonify the systems/ tissue, Rasayana to combat mental stress and induce relaxation, I{asayana for sexual health and progeny ilI. Achara RasaYana : and pain India philosophy identifies 'untrue knowledge as the basic cause for all type of sickness and emphasized the realization of truthful knowledge as the solution for all pain and penury in life' conduct (prajnaaparadhai' Ayurveda reiterates suffer in life arises out of errors in judgment and imprudent Few code and conduct for an individual in the society are laid down in Ayurveda in the form of Achara Rasayana. The person who is willing for a sound mental and physical health is desired to follorv these codes and conducts referring to his day to day life. iile To give up falsity and adopr virruous conduct (Sadvritta) is the way for healthy and happi' and the society of devoid of sufferies. Further more it is good of the individual, his surroundings "rhich he is a part - a wholesome living promotes a wholesome environment' package Under the light of holisti| definition of Ayurveda , the Achara Rasyana is a comprehensive platform of an for health promotion. Convicingly the Achara Rasayana operates on the psychosomatic integritl" individual paving path to a stress free life and environment apparently building the system I 57
- 94. Part lll KEY NOTES Hu I : ffi
- 95. PATHOPHYSIOLOGY OF HYPERTENSION IN AYURVEDA . Dr. G. Shrinivasa Acharya M.D (Ayu), H.O.D, Postgraduate Department of kayacikitsa SDM College of Ayurveda, Udupi The illness, essential hypertension is so common that there can't be any day in a clinic with out the attendance of a hypertensive. Corroborating the same a recent survey in India said approximately 14 percent of people suffer from hypertension and majority of them had essential hypertension. Explanation of hypertension in the language of Ayurveda is a moot point till today. A number of renowned Ayurvedic physicians and academicians have made an attempt to explain this condition and its effective treatment in Ayurveda. Attempts were made to explain the hypertension according to the morbidity of dosa. The affliction of different dhatu is argued in the pathogenesis of hypertension. Few names of the diseases are suggested representing the essential hypertension. Easiest way of translating hypertension into Sanskrit is also tried. The different names suggested to embody the hypertension in Ayurveda include raktagata vata, raktavrita vata, pittavrita vata, Pranavrita udana, raktavega vriddhi, rasa bhara, rakta samvardhana and vyana bala. This tendency of naming the illness unravels the confusion in the understanding of hypertension in Ayurveda For the clinical purposes hypertension is divided into to three categories according to its severity. Besides, according to prognosis it is known as labile, benign and malignant hypertension. A woman is said to suffer from hypertension when the blood pressure is > 160/95 mm of Hg at any age. In men below the age of 45, the blood pressure > 130/90 mm of Hg is considered as hypertension. Similarly in men above the age of 45, the blood pressure exceeding 140/95 mm of Hg is diagnosed as hypertension- When the blood pressure is lesser than the above mentioned level of hypertension, the person is considered a-c normotensive. In any person if the diastolic pressure always exceeds the level of 105 mm of Hg, then it is called as sustained hypertension. Repeated recording of blood pressure over a period of time in a person, when ranges between 90 or 95 and 105 mm of Hg; then is known as borderline hypertension. Blood pressure fluctuating between the hypertension and normotension range in any person is suggestive of labile hypertension. When the blood pressure exceeds 2001140 mm of Hg it is called as malignant hypertension. Significant increase in blood pressure from the earlier hypertension level is indicarive of accelerated hypertension. Exploration of the Ayurvedic literature in this regard reveals the following facts. The disease hypertension is an abnormality of rakta dhatu and is popularly known as sonita dusti. Sonita dusti includes horde of illness ranging from obstinate skin disorders to abnormality of blood coagulation. It also includes clinical manifestation that is akin to hypertension.The illness sonita mada simulates the symptoms of malignant hypertension. Details of the above facts are explored in the following lines. Etiology of sonita dusti and hypertension : Among the different etiological factors of sonita dusti enlisted, some of them are specific in predisposing the hypertension. Consumption of alcohol, excessive 61 *H oYd @ w
- 96. l l intake of dietary salt, good nutrition with sedentary habit, mental stress, physical strain all are said to l cause sonita dusti, and the same causative factors can trigger the hypertension. Alcohol intake:Excessive intake of alcoholic beverage is incriminated to cause sonita dusti. Alco- hol has direct effect on the excitability as well as contractibility of the heart muscle. And thus the intoxicating doses of alcohol raises cardiac rate, cardiac out put and hence increasing the systolic as well as pulse pressures (Caraka, sutra,24, 5-7). Salt intake:Sonita dusti may be the outcome of excessive consumption of dietary salt. In modern parlance the excessive intake of sodium causes raise in the level of sodium salts in the blood for apparent reasons. Further, the sodium salt has an ability to hold water in the blood and consequently increases its volume. It is understood that the volume of the blood is directly proportional to the blood pressure. For the same reason it is contended that excessive intake of the salt increases the blood pressure. Further more it is established fact that moderate restriction of dietary salt is beneficial in patients suffering from hypertension. (Caraka, sutra, 24, 5). Sedentary habits:Excessive intake snigdha and samtarpana foods in combination with inactivity and day sleep is said to cause morbidity of rakta dhatu. Extensive investigations have proved that nutritious food habit with sedentary behavior leads abnormal increase in the lipids in the blood and that in turn predisposes to atherosclerosis. Atherosclerosis increases the peripheral resistance and thus contrib- utes to the increased risk of hypertension(Caraka, sutra, 24, 8-9). Mental stress:Anger is enlisted as one among the causes of sonita dusti. Internal as well as external stresses tend to cause hypertension. Anger is an expression of such an emotional status and likely to precipitate hypertension. When the person is calm, heart beat is regular, Pulse is even, blood pressure is relatively low, visceral organs are well supplied with blood. Contrary to this with stress - vessels of the visceral organs constrict. Blood flows in larger quantities to the muscles or trunk and limbs. It is part of flight or fight pattern of response to stress. The heart beats faster and works harder. As the heart speeds up the pulse quickens and the blood pressure mounts. When the crisis passes, the body resumes normal functioning. Due to chronic emotional stress the hypertension becomes chronic and persistent(Caraka, sutra, 24, 9). Physical strain:Injudicious practice of physical exercise may predispose to the morbidity of sonita dhatu. Physical exercise has both beneficial as well as deleterious effects. The isotonic exercises like jogging and swimming that does not cause any physical strain helps in lowering the body weight and hence beneficial in patients suffering from hypertension. In contrast to this the isometric exercise like weight lifting increases the blood pressure. The word srama refers to such exercises that cause strain to the body and heart there by precipitating sonita dusti and hypertension(Caraka, sutra, 24, 10).. From the above citations it is clear that certain etiological factors of sonita dusti may also predis- pose to the illness hypertension. Clinical presentation of sonita dusti and hypertension:The affliction of rakta dhatu may cause plethora of illness belonging to different srotases. Abnormal coloration in the body is a manifestation of sonita dusti and is seen in disease like pandu and kamala. Tendency of abnormal bleeding is indicative of affliction of rakta dhatu and the same is reflected in rakta pitta and rakta pradara. The different types of skin lesions that are collectively known as kusta roga; is characteristic of sonita dusti. Further more, there is another list of symptoms of sonita dusti like head ache, tiredness, insomnia, dizziness, vomiting, altered states of consciousness, delirium, seizures, visual disturbances and different neurological deficits 62 ffi
- 97. etc, that does not fall on any of the above said category, and more interestingly these symptoms are akin to the clinical manifestations of hypertension. Headache:Headache is caused due to the sonita dusti. The illness is said to be asymptomatic in most of the hypertensives, except in cases of malignant hypertension as well as hypertensive encephal- opathy where a number of typical symptoms manifest. As no symptoms that signals the illness hyperten- sion, as the patient does not suffer from any sort of discomfort; the condition is likely to be ignored. Further more, about 40Vo of the patients suffering from the hypertension more particularly the mali-enant type develop headache. And is said to be present on awakening, and in some patienrs this is characrer- istically occipital in nature. In others there is no specificity of the site of headache. Quite parallel to this, sirasula is regarded as a symptom of sonita dusti(Caraka, sutra, 24, I3)., and the citation from caraka samhita further conoborates the same(Caraka, sutra, 17, ll). Tiredness:Undue exhaustion is another symptom of hypertension as quoted in Harrison's texrbook of medicine. The exact pathophysiology of this symptom is not clear. Caraka is also of the opinion thar general debility is a symptom of sonita dusti. Ati daurbalya and klama are the two words mentioned in Caraka samhita referring to tiredness (Caraka, sutra, 24, l4). Insomnia: Disturbance of sleep is not uncommon in hypertension. Some patients of hypertension seek medical help for the same complaint. And the sphygmomanometer examination reveals the hyper- tension. Caraka has clearly stated that disturbance sleep is a symptom of sonita dusti. Dizziness:Bhrama meaning dizziness is a symptom of sonita dusti. Occasional dizzy spell is seen in some patients suffering from hypertension. This may be transient or persistent. Some times it may be mild and the patient is likely to ignore the symptom. And in some the dizziness is likely to affect the routine functioning of the patient there by making patient to seek medical help. Vomiting: I5Vo of the patients suffering from malignant hypertension are likely to present wirh vomiting along with other symptoms. This is also true in case of sonita dusti as stated in Caraka Samhia The vomitus may contain the foods, gastric acidic content, or bile. Accordingly the patient feels the msre in the mouth, and also according to the vomitus the associated symptom may vary (Caraka, sutra. 24. 14). Altered states of consciousness:This is seen in patients suffering from malignant type of hyper- tension associated with hypertensive encephalopathy. It is understood that in malignant hypertension the cerebral edema is a sequel. Arteriolar fibrinoid necrosis as well as spasm of the vessels are said to precipitate cerebral edema. This cerebral edema presents with altered state of consciousness. A study shows that about 5O to 90To of the patients suffering from malignant hypertension develop this altered state of consciousness. This may range from the simple confused state to stupor and coma. The same is attributed to sonita dusti in Ayurvedic literature (Caraka, sutra. 24, 15). Seizures:About 50 to 90Vo of patients of malignant hypertension suffer from convulsions and is usually generalized one. Kampa is the word mentioned in Ayurveda to explain this involuntary movemenr in sonita dusti (Caraka, sutra, 24, I5). Visual disturbances including transient blindness:Hypertension is characterized,by retinoparhy with or with out papilledema associated with necrosis of small arteries and arterioles. This in turn results in visual disturbances as well as transient blindness. This manifestation is said to be found in about 40aza of patients suffering from hypertension. Abnormality of the visual perception is also a feature of sonita dusti as cited in the following lines of caraka Samhita (caraka, sutra, 17, 13). 63 "B a,_9 6d 6W tffi'n= i
- 98. Focal neurological signs:In about 5Vo of the patients the cerebral edema as well as necrosis results in focal neurological signs it may be in the form of monoplegia or the other kinds of neurological deficits, The following reference from caraka samhita unravels the same opinion (Caraka, sutta, 24, I7, Il'14). Abnormality of the urinary system:Oliguria, proteinuria, hematuria and decline in the renal function are the manifestation of the malignant hypertension. Hematuria is described in Ayurveda as manifestation of sonita dusti (Caraka, sutra, 24, l2). From the foregoing descriptions it is clear that some of the nidana of sonita dusti can predispose to hypertension. Many of the clinical manifestation of the sonita dusti can be explained by the patho- physiology of hypertension. At this juncture it is wise to make a statement that the hypertension of modern medicine is described as a manifestation of rakta dusti. There are substantial evidences to accept that a category of symptoms of sonita dusti pertaining to the psychological abnormality as well as altered states of consciousness are similar to the clinical manifestation of malignant hypertension. When we go through the Ayurvedic literature it is clear that in many of the occasions the leading . symptom of the illness is considered for its naming. Atisara jvara sula gulma are some of the examples" where in pratyatma linga is taken as name of the disease. An attempt may be made to name the hyper- tension based on the leading symptom, but most of the patients of hypertension are asymptomatic. In patients who are symptomatic, it is the alteration in the behavior or delirium, which is the commonest amongst the symptoms; most probably during the phase of hypertensive encephalopathy. It's worth noting here that, the unwanted anger, irritability, restlessness and delirium are the hallmark of the symptomatic hypertensives and the same is described as mada in Ayurveda. Thus giving importance to this commonest manifestation, so also; as per the leading manifestation of the illness if it is named, hypertension should be named as mada roga. It implies that the sonitaja mada or raudhiraja mada is the name of hypertension. Deliriurr/ mada in hypertensive encephalopathy:One of the commonest presentations of malig- nant hypertension is the state of delirium or confused state. In this state many of the mental faculties are said to be deranged. Ability of perception may be affected in the state of confusion. Patients attention cannot be drawn easily by simple stimulations like addressing his name rather one may require to give physical stimulation to arouse the patient. When the patient is aroused, unlike a man awakening from sleep, the patient fails to understand the surroundings with all the earlier precision" He may fail to understand the orientation of time and'space. And even to keep him alert continuously, stimulation is needed and the patient may misidentify his relatives; this is popularly known as clouding of sensorium (Caraka, sutra,24,30-32). Patient may show tremulousness in speech, speech may be irrelevant, irrita- bility and restlessness may be apparcnt. Patient may show unusual hyperactivity for a trivial stimulation and all these are characteristic feature of delirium suggestive of dominance of morbid vata. Patient with delirium may exhibit unwanted anger and agitation as well as aggression. Even just speaking to the patient to ask his health may irritate him and is likely to respond with scolding words. Such a presentation of delirium is indicative of Pitta dominance. Patient's consciousness is clouded. He can not be aroused by simple verbal stimulation. Once awakened, he cannot maintain the alertness. He seems to be thinking and concentrating, rather he is blank and thinking nothing. May not speak much, speech is restricted to yes or know and is suggestive of kapha 'predominance. This is also known as hypo kinetic delirium or quiet delirium Due to the increased activity of the autonomic nervous system the conjunctiva are injected, the pulse is rapid, temperature may be raised there is much sweating and the urine is scanty and raised *S 64 t!-19 oYc rrW €d[$.-
- 99. specific gravity. Inability to sleep, vivid hallucinations. extreme agitation and tremulousness is another presentation of delirious state. Patient will have a tendency to convulse Unlike the mada due to intoxication or poisoning, the patient of sonita mada may not give the hisrory of alcohol intake or poisoning as mentioned in the following lines (Caraka. sutra. 24.34)- Spon- taneous onset for no apparent reason, variable course and spontaneous remission is characteristic of raudhiraja mada. If left untreated leads to murcha and sanyasa as in hypertension leading to stupor and coma. In a nutshell, several etiological factors of rakta dusti are also the etiological factors of hypenen- sion. A category of symptoms of sonita dusti pertaining to psychological change and altered state of consciousness is similar to the symptoms of malignant hypertension. Based on the criteria of naming the disease by their leading symptoms the raudhiraja mada is related to the symptomatic phase of malignant hypertension. Asymptomatic hypertension can very well be considered as avyakta stage of the illness or may be simply referred to sonita dusti. I 65 t t r ' t
- 100. l PREVENTIVE AND CURATIVE IN PEDIATRICS . Dr. Shailaja U. Rao, Prof & Head, Kaumarabritya, S.D.M.C.A, Hassan Kaumarabhritya is one among eight branches of Ayurveda which deals with care and cure of pediatric age group. In the childhood as they have many limitations in them, chances of different diseases and infection are common. Aaparipakwadhatutva, Asampurnabalatwa, Ajata vyanjanatva, Sukumaratva, Aklesha sahatva being the qualities of bala makes them to suffer from different diseases. when we consider the management it is of two fold. They are Preventive and Curative management. Here preven- tion is having great important as the Khavaigunya which takes places during balyavasta may stay deep rooted and it may leads the patient to suffer for long duration. Prevention of diseases in childhood, We gave a lot of importance for prevention so the Swasta vritta. Sadvritta, Dinacharya etc are given so much importance. When we consider balyavastha it is from the first day of life the preventive care starts. The Pranapratyagamana, Jata karma, Shishu Rakshakarma etc. procedures are with the same inten- sion. It is advised to do the Suvamaprashana along with the Jatakarma with prime intention of improve- ment of bala the Vyadikshamatva. Lehana. Prashana, Rasayana prayogas are with the intension of improving the immunity of child only. Not only that keeping up of the Satva of child is also given prime imporrance as we know that "Thiralpa Satvasya" being cause for many Psycho, Psycho somatic disorders .For that, suggestions like not to hurt the childs feeling, prevent from Psychological injury, usage of toys erc are advised by our Acharyas. Some of the common problems and their management Admana or Colic pain is a very common problem during breast feeding age or Ksheerada period. Proper training to mother to feed the baby and also burping will reduce the problem. But with this if it is not relieved usage of Omasatwa, Carminatives, Kuberkshabeeja majja internally will be helpful, Lepa of Haritaki or Vacha over umbilicus is also helpful in this aspect, some time proper stimulation for defecation solves the problem. Digestive problems like Indigestion Regurgitation Vomiting; Loose stools etc are commonly occur- ring during infancy and childhood. It is necessary to keep the system healthy and Agni in proper condition. So regular usage of Oma satva .Kalamega kashaya. Hingwastaka choorna. Bhaskara lavana choorna, etc will prevent such problems. Madhiphala Rasayana also helps a lot in this problem. In case of loose stool or Atisara first we have to diagnose it properly, some simple remedies like Decoction of Dadima phala twak, Decoction of Bilva pallava are also useful .As a diei during that time arrow root powder ganji is very helpful. Upper and lower respiratory infection Adenoids, Tonsillitis etc are also common problems what we come across. Taleesadi choorna, Dashamoola katuthraya kashaya, Indukantha kashya, Kantakari leha, .,.lgt 66 flE ovc .^&ffi< "ffi-
- 101. Kooshmanda leha, Vyoshadi vati etc are very helpful in such condition .In case of tonsillitis gargling with Khadira Sara jala or Tankana jala or Triphala kashaya or Kaseesa bhasmayuktha jala are very useful. For acute and chronic tonsillitis the use of peeta saireyaka moola for long duration is very much helpful. In condition like Chicken pox, Measles, Mumps etc.Shadanga paneeya without shunti can be given.sudharshana Ghana vati, Kamaduga rasa, Guduchyadi kashaya, Panchatiktha kashaya, Nabi vati which contain vatsanabha reduces the fever quickly are useful in managing such cases. Another most common problem is worm infestation. Use of Kampillaka choorna for Krimi apakarshana is found to be very useful in children. It should be given with guda, Ashta choorna. Vidangarista, Krimi kuthara rasa, Manibhadra rasayana are also found to be effective in doing Prakmti vigatana in case of Krimi. Developmental disorders Usually the developmental problems after visiting all the doctors they will come to Ayurvedic doctors at last. Nowadays this trend is changing; they are coming in earlier also. As usually these developmental problems are Vata pradana vyadhi, Vata shamaka chikitsa like Basthi, Abhyanga, Shastika shali Pinda sweda. Shirodhara, Nasya etc are very much useful. Depending on the condition we have to select the therapy .It requires long duration to treat such condition through that we can improve the general condition, Motor function etc but not completely cure the disease. So to build up healthy nation it is our duty to keep up the health of tomorrow's citizens. It is very' much important to improve the Vyadhikshamatva in children. We have to take care of their proper nutrition as it is one among the. factor which plays an important role in growth and development. T 67
- 102. l SCENARIO OF RASA SHASTRA : PAST HERITAGE AND GLORY PRESENT STATUS AND CHALLENGES AND FUTURE SCOPE AND MESSAGE Dr. T. N. Nagaraja M.D. (AY)' Ph.D. Professor and head Department of post graduate studies in Rasa Shastra J.S.S.Ayurveda Medical College, Mysore INTRODUCTION Lord Dhanvantari has bestowed the essence of nector- AYURVEDA Ayurvedo Amritanaam. (cha su 25) viz Ayurveda renders health in turn enables the individual to achieve the fourfold purusharthas dharma, artha, kama and moksha. Further Lord Shiva the deity of Rasa Shastra blesses the human beings through Siddha rasa in their endeavors of fourfold purusharthas. This address gives a brief account of past heritage and glory, present status and challenges and future scope and message of Rasa Shastra. THE PAST HERITAGE AND GLORY : Rasa Siddha Nagarjuna, the Father of Rasa Shastra rendered health and wealth by achieving success over alchemY' SIDDHE RASE KARISHYAMI NIRDARIDRYA AGADAM JAGAT He contributed the field of Rasa Shastra by transformation of lower metals in to gold and silver. Based on the principles of loha vedha he also contributed in deha vedha. The development of Rasa Shastra is based on the principles laid down by Acharyas of Sarnhitha kala. In this direction Acharya charaka has contributed considerably. cha vi 8/37 and The conclusions that are established after examination by the investigators by various methods reasoning are siddhanthas. Basically Jala, Agni. Desha, Kala etc ten types of different samskaras have been described. They help in bringing about the desired changes in the dravya. iha vim lt2l2 Based on the above principles the Ashta Parada Samskaras, Shodhana, Marana, Satwapatana ' Parada Bhandha, Jarana, Moorchana etc of Rasa, Rasadi dravyas and different Rasa yogas have been developed. 68
- 103. : I I I ALPAMATROPAYOGITVAADARURAPRASANGATIIAHA KSHIPRAMA.RO GYA DAAYITWAADAUSHADHEBHYO ADHIKORASAHA R.S.S. t Rasoushadhas are popular as they act in smaller dose, so no question of bad taste of medicines. give quick relief, effective in incurable diseases, have long long shelf life. The treatment by Rasoushadhas is considered as Daivi Chikitsa A Divine Treatment and the Rasa Vaidyas as Utthama Vaidyas. I The main secret of success of Rasa chikitsa has been the practice of Dharma i.e chanting of various rnantras, practice of japa, tapa, homa and other religious and spiritual practices, a strict code of conduct and high morality. The medicines used to be prepared by the physician himself. Due consider- I ation has been given to Vaasthu. The medieval period is considered as the golden era of Rasa Shastra. Basically Rasoushadhas are good Rasayanas, Gold is considred as the best R asayana and Vishahara dravya. t I The popular Rasoushadhas are Rasa Sindoora, Makaradhwaja, Swarana Vanga, Rasa Parpati. I Panchamrita Parpati, Hemagarbha Pottali, Vasanthamalati Rasa, Vasanthakusumakara Rasa. t i Bruhatvatachinthamani Rasa, Pravalpanchamrita. Gandhaka Rasayana, Arogyavardhini Vati. t Chandraprabha Vati, Yongendra Rasa, Chaturmukha Rasa etc besides the preparations of Loha Kalpas and I Guggulu Yogas. I By virtue of different anupanas they act in wide range of diseases. Tamra was considered as the most toxic material as it gives rise to Ashta Doshas. i NAVISHAM VISHAMITHYAHUHU TAMRAM THU VISHAMUCHYATHE The changes of recent past of a century especially the post independence period has left its impact on the present status of Rasa Stiastra. Incorporation and development of Pottali yogas, Pisti preparations, literary work like Rasa Tarangini, Rasayogasagara, Rasa Jala Nidhi, Rasamritam, Sidha Yoga Sangraha etc, publishing of six volumes of Ayurvedic Pharmacopoeia and the two volumes of Ayurvedic Formulary Of India, establish- ment of CCRAS-AYUSH, Governing body-CCIM by Central Ministry of Health, University based insti- tutional education both Under graduation and Post graduation, research centers, analytical laboratories are some of the mile stones of the recent past. THE PRESENT STATUS AND CHALLENGES The present scenario of Rasa Shastra is quite different. The advent of Modern medicine. science. technology , research, electronic media etc are some of the contributing factors. The major changes are 1. Values and principles based to enquiry Rational and scientific philosophical and spiritual outlook 2. The Devopasana and spiritual gains to Vishayopasana and material gains 3. Jnana, Bhakti and Vairagya to Nidra, Ahara and maithuna 4. Gurukula toUniversity based institutional education 5. Physician's hand made classical Preparations by samskaras and conventional methods Phar- macy based manufacturing by employing modern Equipments and Parameters and Prepara- tion of Proprietary medicines 69 u 1t-9 6d M w
- 104. 6. Loha vedha and Deha vedha of to Mere treatment. '7. Shudha Ayurveda Chikitsa to Integrated medicine. The teaching from Gurukula system has changed to college education. The selection criteria have been changed. Many government and private under graduate and post graduate institutes have mush- roomed, Maharashtra and Karnataka have taken the lead in these directions. Modern subjects are included in the curriculum. From Sanskrit the medium instruction has been changed to the regional languages later to English. Conduct of seminars and conferences at different level are being arranged frequently' The medicines which were being prepared by physician's ones own hand are being manufactured by pharmacies by adopting modern technology, equipments, parameters, analysis etc. The companies prefer to manufacture the proprietary medicine than classical preparations. The government has restricted the manufacturing and marketing spurious and substandard drugs by implementing laws related drugs and cosmetics and GMP is being imposed. The quality control, standardization and consumer protection is the order of the day. The modern medicine is the treatment of first choice. Panchakarma chikitsa and herbal preparations in Ayurveda are popular. People desire to subject to Nadi pareeksha. get effective and affordable ayurvedic treatment as there are no side effects. There is a search for good ayurvedic physicians and treatment at global level. Swamijis of reputation have raised this ayurveda along with yoga to an inter- national level. The priorities and orientations of the present day teachers and taught are different than past. The Sanskrit base and the depth of the knowledge is not as strong as before. The field of Rasa Shastra is restricted to mere medical treatment. Practice of Loha Vedha and Deha Vedha is outdated. Heavy metals and other minerals like arsenic etc containing preparations are considered to be toxic. The quality. efficacy, safety and integrity of Rasoushadhas are being challenged. The law prevents and restricts the sale of certain raw materials including those of animal origin. The preparation and practice of Rasa Yogas and Rasa chikitsa is minimum especially in the south parts of India. The National policy on Indian Systems of medicines and Homeopathy 2002, emphasize importance of ASU drugs, standards of safety, efficacy and quality of ASU drugs. Rasa Shastra as the existing parameters and techniques are insufficient. Today it is difficult to start manufacturing of preparations of metals and minerals as there are too many restrictions, many prepa- rations are getting outdated and no new companies are coming forward for this reason. The general knowledge and the awareness of the common man is very little as far as Ayurveda. Rasa Shastra and their preparations are concerned. People are finding that Ayurvedic treatment is also becoming unaffordable and there is a confusion as the drugs are heard toxic. At times people hardly differentiate between Ayurveda and Homeopathy. FUTURE SCOPE AND MESSAGE : If the present trend continues the future may be dark or a stand still considering the implementation, prevention and restrictions as already mentioned. At the same time it may not be as disappointing as it appears. On the other hand there are positive aspects. Finance may not be the constraint, more and more people including from abroad are showing interest to take up studies as well as the benefit of the ffeatment. Candidates from well educated and affluent families are coming forward to take up Ayurvedic education u 70 ou6 -"&M6 nw t<n'b= re
- 105. Application of modern technology and science for standardization, analysis, evaluation and clini- cal monitoring without compromising with the basic values, philosophy and principles of Rasa Shastra, good number Post graduate institutions, research centers. analytical laboratories and implementation of GMP,awareness programme for common man through different media, screening of safe, popular, effec- tive and affordable preparations, undertaking the study of drugs containing arsenic, heavy metals etc. substituting safer raw materials, clinical monitoring including dietic regimen can take Rasa Shastra to a height where again Rasa chikitsa is preferred to other treatment and Rasa Shastra can render services to the suffering mankind. The involvement of government and other organizations like NGO'S, NRI'S etc to promote the preparations and practice of Rasa Yogas and Rasa chikitsa certainly boost the cause. 71
- 106. MODALITIES OF RASOUSHADHIES IN CLINICAL PRACTICE o Dr. Ramesh Haarwalkar MD(Ay) Principal Karnataka Ayurveda Medical College, Hospital, Mangalore. ,RASA CHIKITSA'is considered as DAME CHIKISTSA in Ayurveda : keeping in the mind its multiple facets of Rejuvenation of micro cells of the body and curative impact in a positive way while treating the disease of chronic and acute condition. So it is said as 'RASA RASAYANA CHIKITSA' Rasa Chikitsa has a special identity, as it has holistic impact on the micro cells of the body by improving their quality to resist the causative factors of the pathic condition of the concerned system of the body. Rasayana Aushadhies in the true sense is considered the Daivee Chikitsa as they rejuvenate the system and by that helps the body to heal it self" In other words Rasa Chikitsa builds and promotes the naturally maintained endogenic defensive factor by activating the various bio- potentials with in a Protective frame. Regarding the quality of the drug and safety measures, precautions have been taken in Rasa Chikitsa with clear instructions. Qualitative drugs are supposed to be collected, keeping in mind its related factors of environment, seasonal effects, geological factors and occult relation with the time factor, star and the day etc. Once these measures are strictly maintained for the collection of qualitative, potential drugs, systematic processings has been advised and modified the drugs in different dimensions, then comes the dosage, vehicle and dietic restrictions. Adopting these parameters, Rasa Chikitsa is considered as Daivee Chikitsa compared with other types of Chikitsa mentioned in Ayurveda. ..RASA-MERCURY IS THE NUCLEUS OF RASA CHIKITSA. ThE TESEATCh WOTK Of Rasoushadhes taken for centuries together with individual efforts of the Siddhas. The heavy metal has been studied and experimented in both the fields 1. Dathuvada 2. Dehavada. "Pakse jayanyaha patati sa aavishathi purushaha" In the above said reference Mercury has been compared to the bird with two wings by which it can fly successively , means by conquering two fields of Rasa sastra ((Dathuvdta /Dehavada). One can have quantum jump in the Rasa Chikitsa successively. Ground reality regarding the importance of Rasoushadhi nirmana is that one should have a deep knowledge in both the fields of Rasa Shastra ( "yatha dehe tatha lohe, karthavyaha soothakaha sada") This reference gives the hint regarding inter relation of micro cells of the body and their quality based on the contents of bio molecules of various elements and minerals to strengthen the defensive mechanism of endogenic system. Rasachikitsa has been classified in two sections. RASACHIKITSA * Vyadhi pratyaneeka * Immunomodulator * Laxanika x Bio activator 72
- 107. * Dhatu balya x Vitaliser * Mala shodhaka + Pramoter * Dhatvagni Deepaka * Anti oxidant * Dosha Pratyaneeka * Stabiliser of microcellular Quality Multiple facces of Rasoushadhi and Rasa Chikitsa has been highlighted in Ayurveda analyzing ttre rnode of active of the Rasoushadhi o Avyabhicharathavyadhigathakatvam r Iti ghana shareera bhogan matvan anithayan satata yataniyam o Amaree karothi mrithaha... These above said concepts are nothing but the coniinuation of 'CHARAKAS'- DEERGHANJEEVITA concept stated in Chikitsa Sthana. Aging process and the state of disease are basically related with the 'DEGENERATION' of celis and tissues in various conditions. 'SHEERYATE ITI SHAREERAM' is applicable in both of these conditions. The pharmacopoeia of ancient wisdom developed based on the concept of IMPROVING THE BASIC QUALITY OF THE MICRO-CELLSITISSUES FOR LONGER TIME AND PRAMOTE THEM BY PREVENTING MEASURES SO THA| THE STATE OF EQUILIBRIUM OF MIND-BODY-SOUL (Jeavan) COULD MAINTAIN In new millennium the eminents of the medical field are thinking in the same direction. , Dr. Nir Bazila and Cynthia Kenya of California University USA and San Francisco Biologist who was one of the first, to liberate " ANTI AGING MEDICINE In research field of genes, the trial of Anti -16 genes in worm research and importance of HD2 cholesterol which could extend our 'LIFE SPAN' -supports the above statements. Drug that mimic results of certain gene that increases 'worms' life span by 'SIXFOLD' are currently being tested in mice. Actually AGING AND DEGENERATION IN PATHIC-CONDITION are two faces of the same coin. Important changes takes place in both of these conditions are: Fatal net loss of cells in heart brain and muscle tissues WBC that don't divide regularly accumulate a variety of unwanted molecules that can't broken down and eliminated. Too many fat cells create life shortening metabolic problems. Unneeded proteins and sugars sur- rounding the cells of the vessels walls eventually bond to each other in a process called 'CROSS LINKING' Ground breaking research of America Academy 2004 revealed on entirely different explanation for O.A. THE CARTILAGE DAMAGE OF O.A HAS LITTLE TO DO WITH WEAR AND TEAR. LOTS TO DO WITH 'AGING CARTILAGE' CELLS BECAUSE OF THE FACT OXIDATION " In case of free radicals contribution the only solution is ANTI OXIDANTS.Anti oxidants which naturalize them could be part of the solution: Ultimate way is Harnesting the body's own power. Above said points of new millennium meets the same concept of ANCIENT WISDOM SHEERYATE(degeneration) and RESTRAIN- is the treatment that is RASA RASAYAN CHIKITSA This 73 .,.tu, R*N " ,t 1lt-A ltzva&:{ tsw {4FY$-
- 108. leads to ultimate conclusion - SUSTAIN -MIND-BODY-SOUL RELATION thar is ToMAINTAIN-IM- PROVE THE QUALITY OF CELLS/TISSUES SUSTAIN-MIND-BODY _SOUL RELATION The mode of actions of Rasoushadhies basically depends on above said facts as most of the are anti oxidating along with curative ingredients which have major role in SAMPRAPTI contents VIGHTANA OF VYADHI AND LAKSHANAS IN LAKSHANIKA CHIKITSA. Rasaoushadies or Bhasmas actually contain hundreds of micro molecules based on chemical com- position. i.e, Abhraka Bhasma (Sahasraputi) is potentiated thousand times with more than sixty herbs rvhich contains many anti oxidants .It works on a different principle than the chemical deficiency rnodel. ln the terms of Ayurveda it is basically a Rasayana dravya and acts as Dhatu balya, Srotoshodhaka and Dhatvagni deepaka. It improves the immune system promotes tissue protection, acts as immune modu- iator and adaptogen activity, and strengthen the vital organs etc. Planning of the prescription in general practice following drugs to be used as mediators to prepare sammishrana Group - I Godanti bhasma Rasa rnanikya Amrita satva Abhraka bhasma Kajjali Swarna vanga Ashwagandha Churna Swarna bhasma Rasa Sindhoor Rajata bhasma Sw. makshika bhasma Shilajathu Following are the important medicine which comes under the group of Rasayana and Chikitsa Group I r Gandhaka Rasayana o A. Vardhana a MSR a Rasamanikya + Swarna Vanga - Kusta/Skin Disorder a Manibhadra Lehya a Shuddha Gairika churna a Galath Kustharirasa Group II- a Hridayarnavarasa a Prabhakara Vati - Flridroga o Nagarjunabhra a A Gandha churna ghrita sharan + dugdha 74
- 109. Group III o MNJ with Amritarista a Dashamoolarista a Pushkaramoolasava - Jwara o Sootashekhararasa with Madhu Ardraka swarana + Dugdha a Nabhi Vati o Jayamangala rasa Group trV r Rasa Parpati /Tamra Parpati . Swarna Parpati /Kshara parpati - Grahani /Pandu & Ksaya Group V . Chandrapabha Vati. . Panchatiktaghrita guggulu . Amrita guggulu/Flexy caps - Vata Vyadhi . I-ashuna Ksheera paka . Rasna eranda paka bala punarnava In above said prescription the components of rasaoushadhies are planned in such away that every prescription related to the specific group of ailments contains one curative component with a specific rejuvenative (Rasayana) compohent which mainly contains few of the important antioxidants. This plan- ning helps to prevent the degeneration and promote the rejuvenative by improving the quality of the cells of the concernad faculty. I I I 75 a ,44 ry.s&^ - W €trSr" lffiW$ilW
- 110. l ANALYTICAL APPROACH TO THE RAWDRUGS AND PRE- PARED MEDICINE OF RASASHASTRA Dr. P. H" C. MurthY M. D (Rasashastra) Incharge Professor & Head P.G"Dept. of Rasashastra Dr.N.R.S.Govl Ayurvedic College VIJAYAWADA With the increased awareness followed by adaptation of the Ayurvedic Medicines. In general' the Standardization of these products has become inevitable. In order to standardize these products, apart from the physical identification of the Raw drugs and Finished products envisaged in Classics, in general and the texts of Rasashastra in particular, the Modern Analytical procedures are of great help. However, the qualitative Therapeutic values are to be confirmed by Clinical trials. The Modern techniques of chemical analysis including X-Ray diffraction (XRD), Thermo gravimetric Analysis (TGA) and HPLC etc. have become indispensable in the process. Some old age rcchniques like Spot test brought into practice in the name of NPST , provide more accuracy in confirm- ing, especially the Metallic presence in the given compounds' A sincere effort has been made in the following lights to present need for Analytical approach and utility of various technicalities with a stress on certain examples of Namburi Phased Spot Test. I B 76 q FX& w
- 111. = GRAHA CHLK|TSA (AYURVEDIC PSYCHIATRY) A BRANCH OF ASHTANGA AYURVEDA o Dr. Prashanath. I.S.NI.D. t-{i u Asst. Professor, Dept. of P.G. Studies in Kayachikitsa, Ayurveda Mahavidyalala Huri. Introduction : Ayurveda is one of the most ancient systems of medicine in the world. Its antiquity goes into reda-i - the oldest recorded wisdom on the world. The unique ancient science has arrived vividly down the ages and is flourishing in the present times in newer dimensions attracting the attention of world at large. Ayurvedic psychiatry is one among "Astanga Ayurveda" called Bnoorewnw. One of the synonyms given for this part of Ayurveda is "Graha Chikitsa". This branch is misconcepted at the utmost level. Among the people there is widespread notion that Bhootavidya deals with the supernatural evil spirit demonology' etc., whereas the fact is that the Ayurvedic psychiatry is terms of conceptual and literary understanding it consist of 2 components namely, r Ayurvedic Manas Roga Vijnana or Ayurveda Psychiatry o Bhootavidya, which deals with psychiatric problems, like Bhootonmada, grahavesa etc. Ayurvediya Manasa Rog:i Vijnana : It deals with clinical conditions where the disease and its treatment is based on fundamental principle of Ayurveda like theories of panchamahobhuta, tridosha, triguna etc, as in case of unmada. apasmara, chittodvega atatwabhinivesha etc. Bhootavidya : Deals with Psychiatric problems like Bhootonmada, grahavesa etc, where the disease and its treat- ment is not based on classical principles of Ayurveda, but is based on paranormal factors like the doctrine of karma, graha, bhoota etc. It seems those different kinds of bhootonmadas and grahas described in ancient text are nothing but diff'erent forms of affective disorders. There are many causes prevailing for misconception of 'Ayurvedic psychiatry'. The Indian history written by the Dutch, Portuguese and later by the British, tried to impress others that, Indians believed in demonology, supernatural powers, evil spirits, etc. It may be so that, the theories on the scientific approaches are presented, congenial to the social beliefs. As can be seen from the history of modern psychiatry that during the middle ages the causes of mental illness were formulated in theological terms of sin and evil with the consequences that many mentally ill patients were prosecuted as witches. In actual practice it was not possible for a doctor to house a psychiatric patients for treatment nor even he dared to go to the patients due to many a reasons. The propagation of philosophy by the people such as Swami Vivekananda during the 18' centun' was one among the reasons for the negligence of this branch, which attracted the foreigners to$'ards philosophy but not towards Ayurvedic psychiatry. 77 22 g ffi {+d*-a ffi- .f'x,* I i I
- 112. i Authors of 19'h century and teachers of psychiatry emphasized the multiplicity of causesl many practitioners did not give much significance to the findings of genetics and pathology and adopted a pessimistic approach to treatment. The degree of distress and disability varied much in manifestation of enormous human problems in the modern era. Life is full of competition in the present day, to heighten one's own self esteem; every individual means a lot of expectations from one's own self and the world around. The person undergoes frustration, depression, and stress when such expectations are not fulfilled leading to many of psychiatric disorders. As Ayurveda has rich heritage, people have started paying attention towards Ayurveda mind. mental temperaments, mental disease are specially considered. Concepts of Ayurvedic psychiatry in another way, are utilized in such a way which is rather unscientific in principle. The companies are competing with their products like intellect promoters and memory builders. Most of these products are combination of Medhya and Sanjnaasthapana drugs like Brahmi, Shankapushpi, Jyotismati etc, which are believed to act as brain tonics and adaptogenics. Even though such is the general condition of people and prevailing in nation, Ayurvedic institutions in Jamanagar, BHU, Kerala and Karnataka have started separate Post-Graduate course in Manasa Roga (psychiatry) the subject has got considerable attention, as there are more than 50 research works in relation with psychiatric problems at Kottakkal , Kerala an Ayurvedic mental Hospital is functioning , and at NIMHANS Banglore an Ayurvedic OPD For Psychiatry is functioning . In India from time immemorial the concept of mental illness and the trearment of mentally ill appears to have existed. The modern concept of psychotherapy as is understood in west, perhaps had its beginning in India. In Our ancient literature as Bhagavad Geeta, Mahabharatha etc, many instances of psychotherapy, are described, which if only properly utilized and co-coordinated with modern psycho- therapeutics could serve as the most efficacious for mental disorders. For instance, in Bhagavad Geeta, the preaching of Lord Krishna to Arjuna at the time of Mahabharatha battle is a fine illustration of psychotherapy, which raised Arjuna from the dumps of extreme helplessness and inaction, to the elevations of courage and activity. While all the teachings of vashishta were actually aimed at upliftment of "psyche" and combating with the conflicts of the rnind. During the period of Vaisheshika darshana analysis of reasoning in medical psychiatry thinking came up, according to which mind is substance, which is atomic in constitution. Ayurveda looks at the mind as integral part of life and health, being a health science with holistic approach. Ayurevda regards mind as one of the tripods of the very existence of a person. Mind is enumerated as one among dravyas and dravya is defined as the substratum of action and qualities and is the co-existent cause. Mind is regarded as panchabhouthic and this view is the basis for treatment. Atomicity and oneness are the qualities of mind, while satva, rajas and tamas are its attributes, Indriya abhigraha is its karma. Due to the deviation from the normal state of dhi, dhriti, smriti, causes mental illness leading to the unlawfull acts, misconducts, unsatisfied desires, destruction of one's ownself. The predisposing cause is- avara quality of satva i.e. mind. Traditional way of diagnosing disease according to Ayurveda depencls upon specific symptoms of Vata, Pitta and Kapha respectively. But in case of Bhootanmada - a persohality disorder described in Ayurveda the diagnosis is done by considering the language, gait, style of the patient. Though there is oS lrs 78 ffid w
- 113. a notion that grahas or some super natural powers seize the person butit is not so. It is clear tr] C.mrflr,l0me $ words that neither the gods not the goblins causes any disease in the person. In fact the peru,rn umf;clllll or his misdeeds are the cause of all his disease. Vagbhata explains further as these disor'jers '&ris s$'id"islli name due to similarity of a person in appearance, action, language etc, with that of any creax--.1-l-.- :N'lrrHtJ* divine people, demon etc. The management of psychiatric disorders in Ayurveda is done through three broad therapy namely - o Daivavyapasraya chikitsa (Devine therapy) o Yuktivyapasrayachikitsa(Biological therapy) o Sattavavajyachikitsa(Psycotherapy) Yukti vyapasraya chikitsa includes purificatory methods which not only purify the body but alt'" the mind its doshas. Then the palliative measures include different methods as application of tale. colyrium, Shirodhara with importance to fumigatory methods. In devine therapy includes the use of mantra, japa, other activities and wearing of precious stones etc. In Biological therapy - The patient is subject to bio-purificatory therapy by Panchakarma in order to cleanse the channels of the body followed by Samshamana therapy or palliative treatment with the help of Oushadhi (drugs) anna (dietetics) and vihara (lifestyle). The Ayurvedic Psychotherapy - Popularly known as sattvavajaya is practiced encorporating the principles of assurance therapy (asvasana), replacement of emotions and psycho cathartic therapy. The entire Ayurvedic management is more health oriented than disease oriented. Thus Ayurveda has excellent outlook towards the psychiatry and can turn out to be the best if handlecl properly since in a country like India we come across psychiatric pluralism - a judicial appro- priation of different clinicians have accepted that neither aetiology nor treatment should focus narrowly on the scientific ideas of the day instead, the approach should be broader, encompassing whatever psychological, social and biological factors seen most important is the individual case. As Ayurveda covers all the factors it can prove best in handling psychiatric disorders. I v9
- 114. SCIENTIFIC METHOD OF SCREENING THE ENDOGENOUS TOX- INS EXPELLED DURING THE PANCHAKARMA THERAPY o Dr. Shashidhar H. Doddamani M. D (Avu) RESEARCH OFFICER, REGIONAL RESEARCH INSTITUTE FOR AYURVEDA (CCRAS) JAMMU. The panchakarma is the major elimination or purifactory procedure which is the unique contribu- tion of Ayurveda. No such measures are existing in other medical science. Shodhan therapy has wide range of application to maintain the normal health, cure and in the management of various diseases belongs to any kind of origin range from Metabolic Degenerative, Autoimmune, Allergic and even in endo foxnic conditions. It is believed that most of harmful toxins expelled during this processas person is free from the disease and increased biochemical values are brought to normals. But what happens in the body during and after the process, what is exact cause for complete cure or no relaps of ailment is still obscure, Expellation of toxins from the body is still vague and toxins are beyond the imagination. It is very difficult to know and pin point the mode of action of shodhana as it has dual actions. It can be inferred that Shodhana is achieved by many ways by increasing the immunity acting as major antioxidant for the free radical, producing the cytokines to arrest the disease progress or part of clefensive mechanism by which the body combats the toxin effect of cifculating endotoxins. In this paper an effort is being made to screening the toxins expelled out during the Shodhan Therapy with help of modern experimental & clinical studies. ENDOGENOUS TOXINS ACCUMULATION : Number of unwanted and harmful substances get entry into the body, daily activities such as tooth brushing and defecation, introduce endotoxins in to the circulation i.e. transient endotoxenia and inactive by the defensive mechanism. Some of physiological substances normally produced in the body, Hormones etc, which are re- quired to eliminate regularly to prevent accumulation in the body prolonged accumulation of the sub- stances, formed as endogenous toxin or Bio accumulation and needs detoxification. Free radical and other reactive oxygen species in the human body are derived either from normal, essential metabolic process or from external sources. IN TERMS OF FREE RADICAL : Any chemical species capable of independent existence that contains one or more unpaired elec- trons, most of the free radical are unstable and highly reactive. ' Reactive oxygen species are produced continuously in the body as the consequence of normal metabolic processes. Some reaction that lead to free radical formation. If free radicals are not inactivated, their chemical reactivity can damage all types of cellular macromolecules including proteins carbohydrates lipid and nucleic acids. *S 80 H--o '&fu 1ffitt'=
- 115. . For e.g. destructive effect on proteins result into decreased enzyme activity leading to cell injury. o Target on lipid oxidation led to LDL damage causes Atherosclerosis. Metabolic disease. o Effects on DNA are involved in caner. effect on carbohydrates, reduced viscosity (synorial fluid degenerative disease and so on. Some important reactive oxygen species in living organisms Free Radicals Hydroxyl radical oH' Super oxide radial 02' Nitric oxide radical NO' I-ipid Peroxyl radical LOO' Non radicals Hydrogen peroxide HrO, Singlet oxygen to, Hypochlorous acid HOCI Ozone o. Some sources of free radicals Internally generated sources Mitochondria Phagocytes Xanthine oxidase Reactions involving iron and other transition metals Arachidonate pathways Exercise Inflammation Ischaemia / reperfusion F I External sources ii r Cigarette smoke i Environment pollutants i 'i Radiation i' !" I Ultraviolet light Certain drugs, pesticides, anaesthetics and industrial solvents Ozone I I Nutrition plays a key role in maintaining the body's enzymatic defences against Free radical several i I essential minerals including selenicim, opper, magnese and zinc are involved in the structure or caralytic F i activity of these enzymes. It is the supply of these minerals is inadequate enzymatic defence ma1' impaired. 81 rS a:9 nY# "ahk: rys trSr" M
- 116. A second line of defence is small molecular weight compounds which acts as antioxidants that is react with oxidising chemicals reducing their capacity for damaging effect. Fat soluble antioxidant play an important role in cellular defence against oxidative damage. Other small molecular weight antioxidant are found in the diet and herbs the best known being Vit E & Vit. j C. INFLAMMATORY DISEASES : Inflammation a defensive response to local tissue injury or infection, serving to prevent the spread of injury and activate the immune system, which are regulated by cytokines, prolonged or excessive inflammation can damage health tissue. "The potential role of inflammation within fat in generating the metabolic syndrome. Focusing on cytokines secreted by Adipose tissue that modulate the immune system in favour of chronic systemic inflammation. Chronic inflammation is common feature of the Metabolic syndrome. Both adipocytes and mac- rophages within fat secrete numerous hormones cytokines that may contribute to the characteristics path physiological changes seen in the metabolic syndrome. ENDOTOXIN : Endotoxin stimulates many physiologic responses including disturbances in lipid metabolism. It is hypothesized that this lipemia may be part of defensive mechanism by which the body combats the toxins effect. Number of studies examining the effect of serum on endotoxin were directed at understanding the mechanism by which serum reduced the toxicity of endotoxins. It is suggested that endotoxins might interact with B a a lipoproteins with a resultant modifica- tions of endotoxins physical and chemical properties and demonstrated that the incubation of endotoxins with serum both vitro & invivo reduced its buoyant density and subsequent toxicity. It has been proposed that after incubation with serum, Endotoxin is first disaggregated and the binds to HDL to form a stable lipoprotein Endotoxin complex. A recent study has suggested that VLDL, B-VLDL, LDL as well as HDL can bind the endotoxin. Interestingly most studies that have previously examined the ability of VLDL to interact with endotoxin concluded that these TG-rich lipoproteins had minimise endotoxin binding capacity as com- pared to LDL or HDL in contrast other results demonstrate. that incubation of the triglyceride rich VLDL or chylomicrons with endotoxins can effectively protect mice against endotoxin induced death. The fact that human VLDL is frequently contaminated with endotoxin probable endogenous origin raises the possibility that increased triglyceride rich lipoproteins play a role in the host's defence against endotoxenia & infection. AYURVEDIC C0NCEPT : DOSHAS MovE FROM THE KosTHA Vyayamat : : l. Exercise leads to increased oxygen consumption. It causes increase in the production of oxygen initiated free radicals. 2. Ushnat Tikshnat : Such quality substances take part in the production of Free radical as external sources of free radicals. *S 82 nYd ^/e'o6*.< "ffi"
- 117. = 3. Ahithacharanadapi : Reactive oxygen species are produced continuously in the human bodi' as a consequence of normal metabolic process and some reaction leads to free radicals. STIAKA TO KOSTTIA : Deepana-Fachana : Methodically consumption of Deepana-pachana drugs like trikatu, panchakola etc are enhance rhe internal fire and acts on digestive system and prepare for the further therapy. To check the liver condition as it is actively involved in the fat metabolism. Most of the Drugs of Deepana and Pachana are havin_s the antioxidant properties. Snehan : Before the Oleation, the fat (oil or Ghee) is subjected to Murchana process as fat contains poll' unsaturated fatty acid which may produce the Free-Radicals. The drugs used in the Murchana process are having the proven antioxidant properties so that medicated fat can be used without any hesitation. Vruddyat, vishyandanat, pakat, srotomukha vishodanat and vayuvacchanigrahanat which are musr before the shodhana therapy and attained by Purvakarmas. Internal oleation plays vital role on the liquefying the fat soluble toxins from the various parl. of the body. Abyanthara snehapana is must to facilitate the Vruddyat, and vishyandanat so that bodill, toxins (Vitiated doshas) are going to be increased in their size the drugs which are teekshna in nature are able to get into cell membrane by medicinally induced inflamation. As cell membrane is made up of predominantly by lipids so this is essential prior to shodhana. Vruddi is seen at two levels microlevel and macro level. In micro level as the cell membrane is made up of predominantly by the lipds so snehana is must to supplement the lipids so Vruddi is seen bv samana bhava. As the fat is given in gradual increasing dose facilitates the conditioned response of bile secretion which brings the conjugation in the liver and collected in the gall bladder So detoxification of drugs and noxious substances will occur i.e. these toxins to be eliminated during the vamana ard F. virechana karmas. I Further Ushna ,Teekshna qualities medicines are able to enter into the cell. When the tissues are i damaged due to any caused like physiological injury or diseases. The enzyme contained in them is going to enter the blood stream so the given drugs injure the tissues. So that metabolites and enzymes are going to enter into blood stream. "Pakat, Srotomukha Vishodanat" is achieved by Swedana karma i.e. sudation therapy. So many chemical changes are going on during this swedana karma. This method can able to cause the displacement of exudates. Often swedana Karma will help in two ways such as one in micro level i.e. in the cellular level from which easily the metabolites and enzymes are liberated in to blood stream due to dehydration in the body. In the macro level the other channels are get open and helps in bringing these substances into kosta. As mentioned earlier the lipeomia may be the part of defensive mechanism by which the bodi' combats the toxin effect in panchakarma wide use of oleation to increasing the defensive mechanism. During the oleation therapy temporvarily increased VLDL, T.G., LDL as well as HDL, is must to inreract with the endotoxins or endogeneous toxins which are in protein form. Shaman Snehan in purvarupa of Jwara and Snehepana in Vadakasa got rationality because endot- oxins are disaggregated and bind to VLDL then it is inactivated this in acure condition of the disease. 83 ,B v ilx g
- 118. snehan in Arohana Krama and heavy dose of fat In chronic condition of the disease various consumption has got relevance as endotoxins are more in chronic stage and it most to bring to the Kosta as the fat metabolism done by the liver so Triglyceride rich VLDL or chylomicrons. can bind to the endogenous toxin reach the liver. Then the major elimination therapy like Vaman & Virechan expelled them out. l The reason beyond the using the Snehapan for 3-7 day is to increase the volume of VLDL & I triglyceride & chylomicrons everything has got rationality. I Coming to major and the paper i.e. how to screen the Endogeneous toxins and what are the scientific methods can be centralized in this manner. 1. Entry of foreign substances into the body undergoes many changes by the body defence system & broken, then turn into endogeneous protein form. 2. In case of inflammatory diseases also number of endogeneous toxins are produced and depos- ited in the body. in both the condition, immune profiles given us clue B-Cell/T-Cell Status. Before and after the panchakarma therpay lymphocyte Proliferation TNF 6 and Immune Profiles may reveals the effect of shodhan on the body. As mentioned earlier endotoximia stimulates the disturbances in the lipid metabolism. A recent study has suggested that Triglyceride rich VLDL, LDL. Chylomicrone as well as HDL can bind the endotoxins, lastly the fact that human VLDL is frequently contaminated with endotoxins of probable Endogenous origin raises the possibility that increased triglyceride rich lipoproteins play a role in the host defence against endogenous toxin and infection. This gives us in what way we have to screening the Endotoxins in the body. CONCLUSION . . Before panchakarma therapy, After the senhana, Shodhana and after the Samsarjana therapy measurement of Lipid Profile and VLDL Contamination give the solid information about the toxins expelled during the panchakarma The increase in VLDL is now known to be mediated by Cytokines in particular tumor necrosis factor. The increase in VLDL could be an attempt by the body to bind and neutralized the toxin effect of any circulatory toxin. If VLDL as part of the defensive mechanism then the Neutralization of Endotoxins by circulating TG-rich lipoproteins. Major and important reactive oxygen species in the body like Hyroxyle radical (OH) Superoxide radical (O2), Nitric acid radical (No), Lipid peroxyle radical (LOO). estimation of the above free radicals before and after the panchakarma (Shodhan) gives as another form of toxins expelled out from the body. I 84
- 119. SIGNIFICANCE OF RASAUSHADHI'S IN AATYAIKA CHIKITSA Dr. B. Gurubasavaraja CMO, JSS Ayurveda Medical College and HospimJ.I'I.r-sore 1. Aatyaika chikitsa is one of the Grey areas of Ayurveda. 2. The single obstracle in the path of Ayurveda's desired progress. 3. Ayurvedic acute medical care which posses the potentiality to meet emergency challenges in situations - Drug to cross over the blood - Brain - Barrier is the need off the hour. 4. Rasaushadhi's have a definite role in Aatyaika Chikitsa. 5. Smaller the particles greater the absorption and faster the action - is the fundamental principle of Pharmacology. These consist such as sukshuikarna, Amrithikarna, Bhavana which enhances the bioavailability of Drug in emergency conditions. 6. Suchikabharana rasa prayoga denotes the historical evidance of emergency drug delivery system. 7. Indications of Rasaushdhi are in asadhyaroga, and in acute condition (Rasendra sara sangraha). IL AATAYAIKA AOUSHADHI DRAVYA KARMUKATA 1. Aoushadhi prayoga should help in Laxanika Chikitsa. 2. Aoushadhi should have the properties of life saving effect. Such as Chandrakala rasa, Swarna Sindoora rasa, Chaturbhuja rasa, Swasakasa Chintamani, Yogendra rasa, Hema garba pottali, Siddha makara dwaja rasa, Kanaka sindoor, Agasti shootaraja, Chandraprabha, Chandrakala, Laxminarayana, Laxmi vilas guti, Ekanga veera rasa, Vasantha kusumakar, Pratap Lankeswara, Sidda Makar Dwaj aSomarajiya 3. Aoushadhi which give bala immediately and effect being continued Ex. Kasturi bairava rasa,Vasanta kusumakara rasa,suvarna soota shekara rasa 4. Aoushadhi which found interfering in Oupasargika avasra KarpurarasaAshtamurthyrasa, Rasamanikya, TamraBhasma, Karpura Bhasma III. AN EMERGENCY KIT DESIGNED AND USED IN JSS AYURVEDA HOSPITAL CON- TAIN FOLLOWING DRUGS _ I.E. RASAUSHADHI'S Hema Garba Pottali, Suvarna sootha shekara rasa, Brihat vata chintamani rasa, Maha Laxmi Vilasa rasa, Rasa sindoor, Sameera pannaga, Hridyarnava rasa, Mahaavaatavidhvamsa rasa ry. AATYAIKA CHIKITSA IS PRACTICES IN MANY INSTITUTES. EX. IN HRIDROGA- GRAHNI CHIKITSA BY DT. C.P. SUKLA and MARNA CHIKITS,d - (IN TRIVANDRI.JM) V. SCOPE AND LIMITI{TIONS DEPENDS UPON IN tsSTABILISING THE STANDARDISED RASAUSHADHI'S.WIDE RANGE OF UTILITY _ MINIMUM DOSE _ POTENTIALITY _ FASTER ABSORPTION WITH BETTER BIO AVAILABILITY 85 g,q oic i b tr
- 120. CONCLUSIONS . The word Aathyyikaa being seen as a passing remark in Brihatrayees' Contributions of Rasatantrakaaras are not a matter of only academic but also of Research o interesr. parameters for the practical applicability should be and made fixed evaluated' Research work in the field of the Marma Chikitsa, would definitely make o Aatyachika Chikitsaa a more practicatr approach for both the Aathyachika Vyaadhi Chikitsaa and Aatyachika Avasthaa Chikitsa. The Agadatantra is being taught as a theory topic. Therefore more work in the o field of Vishachikitsaa will definitely bring in a new Dimensional approach for the Aatyachika Chikitsaa. Thank you. I t *S 86 W,-u : ffi
- 121. PERSPECTIVE -PRACTICE-SCOPE AND RESEARCH IN RASAYANA AND VAJEEKARANA o By Dr. Madhava Diggavi MD (Ayu), Lecturer in Kayachikitsa, TGAMC. Bellary, Ayurveda is one among secular biomedical sciences. It is based on biophysical, biochemical. physiological and biopharmacodynamic principles. As an applied science with professional art its outlook is primarily utilitarian. The percipient man is an epitome of the perceived environment. Even though the man is really a part of the environment, though paradoxically enough, he seeks to examine and analyze his environment as though he is an entity different and apart from it. "Man is both a spectator and an actor in the drama of existence" Niels Bhor et al. The primordial entity moola prakruthi, the cosmic egg is a composite of TRIGUNAs: from which the penta cosmic elements called panchamahabhootas are evolved. The panchamahabhootas inherit the qualities of Trigunas in different permutations and combinations to constitute various animate and inanimate of universe. And based on cause and effect theory the creation continued.Ayurveda in its therapeutic form is applied and is in broad perspective. It incorporates various approaches in its applied health manage- ment. Psychobiospiritual values are synchronized and aim not only at disease free body but also at holistic complete health and in turn eternal peace. The health and disease are dependents of positive and negative interactions between cosmos envi- ronment and human lifestyle. The percipient and the perceived will interact with respect to Indriyarrtha- Kala-Buddhi; based on the relativity of ayoga, atiyoga and mithyayoga of the wide above. Asatmendriyartha-Parinama & Prajnaparadha will basically initiate pathophysiology saga. It is also true that as the percipient and the perceived environment is the outcome of similar cosmic egg (Moola prakruthi); the human biophysical impairments can be checked by the appropriate utilization of environ- mental outlook based on the law of Samanya and Vishesha. PERSPECTIVE OF RASAYANA Nutritional perspective : ( Balakaram) The administration of which yields/produces/supplements/circulates/enhances optimum tissue nutri- tion is called Rasayana. A precious Rasa i.e. a medicament or medicinal complex on consumption which produces energy, strength, psychophysical power and optimum immunity and tissue strength is called Rasayana. The Neutraceutics is that branch of medicine which has the capacity of providing the vide I above merits. The nutritional value of food and drugs which have the nutritional supplementation and i hence enhance the tissue life quality/longevity are best adopted in Rasayana Chikitsa in nutritional i perspective" Nutritional research of madhura etc Rasas, food supplements, Rasa predominant Phyto substances. Rasa Aushadhi (Trace elements and aqua marine products) are incorporated and their respecrive nutri- tional Calories are to be updated in Rasayanacology. 87
- 122. Nootropic perspective : ( Medhakaram) Rasayana therapy incorporates Medhya Rasayana as its specific branch. Various psychotropic Rasayanas are enlisted which have their clinical effect at neurotransmitter and psychotropic synaptic level to modulate mind and neuropsychiatric imbalances. E.g. Medhya-Haritaki, Jyotishmati, Brahmi, Shankhapushpi, Yashtimadhu. Mandukaparni, Kushta, Tagara. Curative perspective : (Rogapaharanam) Rasayana is also classically indicated in the management of so many of Age and organ specific disorders. Rasayana is choice of treatment in Geriatrics. Acharya Sushrutha has categorized it as Naimittika Rasayana which is intended to cure the pathogenic state along with promotive and prophylac- tic effects. Dhatu, Srotas, organ and disease specific Rasayanas are explained in Sushrutha, Vagbhata and Vangasena samhita.For the current trends in medical practice, every system specific Naimittika Rasayana have much importance. Premature ageing due to stress and age related degenerative disorders are also treated with Rasayana. E.g. 1) Gambhari phala & Bhringaraja-Keshya, beejaka-Tvachya,guggulu-Svarya Jeevanti-Chakshushya and Shilaj it-Medoroga/Sthoulya Immunological perspective : (Vayasthapanam, Balakaram) Prevention, cure and prophylaxis of the diseases are also practical in Rasayana therapy. Genetic material disorders and those diseases which are not responding to general line of treatment are again treated with Rasayana. Ageing is a natural time related phenomena. The proper adaptation of Rasayana chikitsa helps in prevention of premature ageing and delays ageing or postpones ageing by its adaptogenic and immuno enhancement properties. Psychobehavioural perspective : Rasayana chikitsa is incomplete without adopting Achara Rasayana. Of course, one who has ad- mitted acharyas Rasayana is most suitable person to undergo Rasayana Chikitsa. Observing Achara Rasayana itself bring many bimolecular level Rasayana effects. The complete positive and promotive health care is achieved through Achara Rasayana augmented with Kamya Rasayana or any other suitable Rasayana. Even in Kutipraveshika Rasayana the recipient is advised to follow Achara Rasayana. Perspective of Vajeekarana : Androsemenological perspective : The superspeciality practice of Ayurveda which deals with diagnosis and management of defective spermatogenesis is accordance with Vajeekarana. Alpa retas treated with shukra Apyayana chikitsa, Dushta retas with shukra prasadana, Ksheena retas with shukra upachaya and Vishushka retas with shukra jarana Vajeekarana chikitsa.This perspective of Vajeekarana is missing in common notion and during the emperors, the Vajeekarana was promoted as only sex medicine unfortunately. ' Sexological perspective : sexual potenification of the person practicing sex with his legal partner or the persons with sexual dysfunctions at the same zue treated with Vajeekarana chikitsa" Enhancement of sexual vim, vigor, desire, libido, penile erectile capacity, sexual sustence power, modulation of ejacu- lation, repeated sexual performance etc are the benefits of Vajeekarana Therapy .But to be cautiously prescribed for the needy. *W 88 'tLsp ffid : ffi .tr$$y*
- 123. Nutritional perspective : Vajeekarana phytopharmacopia, animal sources and minerallo metallaceutics have been found to possess abundant energy and nutritional potent. To name a few-Milk and milk products, wheat. urad. ghee, sugar etc. Nutritional value of Vajeekarana yoga's can be researched to confirm the same. Antistress, adaptogenic, anabolic and Immunological perspective : . Classically Vajeekarana yoga is said to be best on the recipient with Tushti.Pushti. Jeevana. Brumhana, Balya, Yasha and Manoharshana properties.It is intended to note the antistress, antiageine. adaptogenic, psychotropic, life promoting, anabolic and immuno enhancing effects which can also be contextually prescribed in Vatavyadhi, Balakshaya ,Iara and other clinical conditions. Practice, scope and research in Rasayana and Vajeekarana : Rasayana and Vajeekarana are the integral part of Kaya Chikitsa and are superspeciality royal clinical sectors of Ashtangayurveda. Every married couple before copulation and fertilization must un- dergo Shodhana and Rasayana Vajeekarana in the current scenario. The applied clinical part of rasayana and Vajeekarana is to prevent genetic carrier diseases, unborn errors of metabolism and idiopathic mu- tations if any. Central and state govt can probe into the preventive national health programmes on parallel to vaccinization and RCH, MCH programmes by the applied usage of rasayana and Vajeekarana yoga's. Rasayana yoga is utmost help in parailel management of Anti tubercular and anti cancer regimes. They augment the clinical host cell immuno chemical responses and even reduce the untoward effects of anti cancer and antitubercular_drugs. The cosmetic effect of Rasayana and Vajeekarana therapies cannot be neglected at any cost. The total packageof Shodhana Rasayana and Vajeekarana can be a new era in cosmetology and asthetics. To maintain and boost the compliance of sports persons again the role of Shodhana and Rasayana Chikitsa cannot be forgotten. At the global perspective hence it seems that the superspeciality practice of Shodhana and Rasayana Vajeekarana packages can be very promising. All the above said applications are clinically seen with positive results hence the documentation. update pharmacological research and global publication can be taken up in Rasayana and Vajeekarani. The nanotechnology, biotechnology, molecular biology, nuclear medicine, electronic instrumenta- tion and technology, cell biology, genetic engineering, cloning and tissue culture studies etc are ne$' applied science fields helpful in updating the ancient proven results of Rasayana and Vajeekarana. T I I 89 & a.E o1d ffi -y'e,D;trrt
- 124. CRITICAL EVALUAITON OF OJOVAHA SROTAS AND MANAGMENET OF ITS VIKARA BY PANCHAKARMA THERAPY o Dr. Parameswarappa S. BYadgi r M S. B anaraffi'H:"'?"'i:Iff:;;i'J"'fi' J"?3! Introduction : Ojas is considered as one of the vital essence responsible for the sustainance of life 'Its presence and absence decides the quality of life.For example:if para ojas depleted, then person dies immediately on the contrary reduction or displacement or vitiation of apara ojas manifest various kinds of disorders or kills the individual slowly by suppressing immunity. Some people say it is the upadhatu. Sikradhatu mala, Sarvadhatu Sara, Jivasonita etc..It may be understood depending upon its involvement in expressing positive or negative symptoms. Role of ojas directly mentioned in certain disorders like ojonirodhaja Jwara, pandu, murcha, hataujasa jwara, rajayaksma, udanavrta prana, prameha etc, this signifies its impoftance in the genesis of disease. Ojovaha Srotas (Su. Su 15/27 (Dalhana) t Dhatugrahana refers dhatuvaha srotas.It is also called Ojovaha Srotas as stated by Cakraltani' Root : Su. SuI 5/27 ( CakraP ani ) The seat of Ojovaha srotas is hridaya along with blood vessels attached to it. (Ca. Su 30/B) (As. Hr. Su 11/37-38 (Hemadri) Ojas is the essence of shukra. Some peopl e say ojas is the shukradhatu malarupi and its function is the production of garbha. Mala rupa ojas enters garbha hridaya, which is eight drops in quantity. which is capable of union with artava, slightly reddish with yellowish tinge and foetus develops by this is called jiva shonita ojas- (As. Hr. Su 1l/37-38) During process of paka two things are observed i.e. Mala and Sara. Mala is lhe malarupi ojas & sara is the garbha. , (Su. Su 17173-74 (Gangadhara) If astabindu quantity ojas (para ojas) decreases then person will die. On the contrary if ardhanjali (apara ojas) ojas decreases or vitiated manifest 3 kinds of abnormali- ties i.e. ojokshaya, ojo vyapat and ojovisramsa.But person may die due to ardhanjali ojakshaya. 90
- 125. Ojovaha Sroto dusti Hetu : II etu-etiological factors (Su. Su 15/23) Ojrzs undergoes decrease due to injury, tissue depletion(dhatukshaya), anger. grief. rvorry. exerrion. hunger etc. resulting into the flowing out from the dhatus and getting associated with tejas and instigated by vata, which gives various discomfort to the body. Astanga Sangrahakara also mentioned same etiological factors. (As. Sa. Su 19/32-33) Ojovaha Srotodusti Ojas undergone changes if unfavourable etiology found. (Su. Su 15/24) Oiodusti i.e. abnormalities in ojas is of 3 kinds i) Oja visramsa ii) Oja vyapat and Ojakshala. Ojo visramsa : (Su. Su l5/24 (Dalhana) Visramsa means displacement from its normal place. (Su. Su 15/24) Clinical features due to oja visramsa are as follows- Looseness of the joints, Weakness of the body, Displacement of the doshas from their respective eats. Impairment in activities or sluggish behaviour. Ojo vyapat (Su" Su I5/24 (Dalhana) Vyapat means ojas gets vitiated by dusta dosha and dushya. (Su. Su 15/24) General symptomatology due to ojo vyapat are as follows- Stiffness and heaviness in body, Swelling due to vata. Discolouration or loss of complexion, Exhaustion, Stupor, Excess sleep Ojokshaya : (Su. Su 15/24 (Dalhana) Clinical Features of Ojokshaya Decrease in its quantity. (Su. Su I5/24) Fainting, Wasting of muscles, Unconsciousness, Delirium,Death (Ca. Su 17/73; A. Sa. Su 19/32-33) Fear complex develops or full, Of fear, General weakness, Worr, Discomfbrt in sense or-sans. Loss of complexion, Unstable mind, Roughness, Emaciation. Ojo Vriddhi Lakshana : (As. Sa' Su 19/34) Increased ojas is responsible for unique growth, nourishment and promores strength. 91
- 126. I)iseases Ojovaha srotas Roie of Ojas in the Genesis of Various Disorders (Su. Utt 39/41) Others also call Abhinyasa jwarahataujasa jwara. Due to loss decrease of ojas' this condition is srated to difficult to cure- Ojo Nirodhaja Jwara (Su. Un 39143-46) pitta and vata' Ajonirodhaja iwara manifest due to depletion of ojos by aggravated unconsciousness, clinical features : Stiffness all over the body,coldness, Desire to sleep always. Horripilations, De- Disturbed sleep (sleep for a while followed by awakening oftenly),Stupor'Delirium, bility, Mild increase of temperature' Discomfort. Time Period for Pacification or Kill Symptoms greatly aggravated on seventh day, tenth clay and l2th day or symptonxs may subside on seventh diy, tenth day and 12th clay. R.ajyakshama (Ca. Ci. 8/4t-42) resulting into production Due to disturbance of doshas proper digestion is going to be hampered important in case of Rajyakshama' of excess mala and less ojas. That's why protection of pureesha is very (Su. Utt 4I/4) In case of shosha roga there will be severe dryness or extreme depletion of tissues' Murcha : (Su. Un 46/5) Unconsciousness, loss of strength is the purvarupa observed in mpurcha. Udanavrta prana : (Ca.Ci. 281208) Jwara (Ca. Ci 3/345) Jwara is the king of all diseases. It causes death to all creatures on earth and which is seriously afflicting individual. Prameha (Ca. Su 30/6-7 (CakraPani) even slight In case of prameha, apara or ardhanjali ojas is involved and not the para oias because reduction of paraojasleaditodeath. Inmadhumeha, inspiteof reduction of oiasi.e.aparapersonstill survives. Ojiprameha has been described as sub classification of vataia prameha. Pandu Roga (Ca. Ci I6/5'6) Due to excessive exacerbation of three doshas especially pitta afflicts dhatus as a result development of panclu complexion, strength, unctuousness and ojas get exceedingly reduced leading to foga. *S 92 ffi # ^&*6
- 127. ::. Some people say that bala having three kinds of abnormalities. (Su. Su 15/25) Bala abnormalities are of 3 kinds namely bala vyapat, bala visrantsa and balaklnva. (Su. Su 15/26) Symptoms observed due to bala visratnsa are as follows- Looseness of joints,Debility,Displacement of three doshas,Fatigue,Impaired body functions : (Su. Su 15/26-27) Symptoms due to bala vyapat are as follows- Heaviness and stiffness in body, Exhaustion, Discoloration, Stupor, Excessive sleep, Swelling due to vata (Su. Su 15/27) Symptoms due to bala kshaya are as follows- Fainting,Depletion of muscles, Unconsciousness, Delirium,Improper perception of knowledge. Death Ojo vaha srotodusti chikitsa Prognosis of Oja and Bala Abnormalities (Su. Su 15/28) Oja visramsa and vyapal are curable by adopting treatments, which are not opposite. Ojctkshaya is incurable entity because it produces due to improper understanding. Normal Kapha and ojas are considered as one due to by this principles Ojovaha Sroto dusti can be successfully treated by Vamana Karma. (Ca.Su. 30113-14) The following factors helps to protect ojas and heart are as follows - o Avoid factors which leads to disturbance in mental faculties r Diets and drugs conducive to heart ojas and channels of circulation. e Tranquility and wisdom should be followed meticulously for this purpose. CONCLUSION : Ojas is the essence of saptadhatu. It is of two kinds para ojas and apara ojas. Para ojas present in a person who is having sarva sara, pravara satwasara and sama prakrti individual and never suffers from diseases. I I : 93
- 128. Fart lV ARTICLES *& 6c _&oqn,]F<a ws etr$sn'
- 129. i PANCHAKARMA AND COSMETOLOGY HOLISTIC APPROACH o Dr. G. Purushothamacharulu. PROF & HOD, Dept of Panchakarma. D.G.M.A.M.C. Gadag INTRODUCTION i Most of the cosmetic procedures are intended to enhance the beauty or healthfulness of the com- I plexion of the skin, hair, hands etc. The substances, measures applied for beautifying, preserving, or altering the appearance or for cleansing, coloring conditioning or protecting the skin, hair, nails, lips, eyes. teeth etc. are all termed as cosmetics. The beauty, and attraction of the individual is depends upon the age, health, race, society, parents, social status, dress, gestures, behavior, speech, psychological make up etc. of the individual. The beauty, attraction of the body mainly depends upon the general health of the individual, u'hich is basing on the normal functioning of other organs and factors of the body. In other words the beauty' of the skin. hair, nails, other organs and factors of the body influence colour complexion etc. The samsodhana mode of therapy i.e. Panchakarma which maintains the health and equilibrium of doshas and dushyas will also help in maintaining, improving, preserving and restoring the beauty of the individual. Factors Responsible for affecting the Beauty A brief review of the main factors which are responsible for affecting beauty and the role of Panchakarma therapy are presented here : 1. Doshas and Dushyas Vata, Pitta, Sleshma, Rakta Factors responsible for structural effects of face, head, lips, mouth, teeth, nose, eyes, ears etc. such as congenital deformities, deformities due to injuries leaving permanent effect. The Panchakarmas may not help in these conditions, only cosmetic surgery, ' Dentistry, lasser treatment etc. may help. 2. Astounindita Purushas 1) Too tall,2) Too short, 3) too hairy 4) Hairless 5) Too black 6) Excessively white in colour 7) Too obese 8) Emaciated. The first six are not significant for treatment .The treatment for obese and emaciated persons is as For obesity Vasthi Karma with drugs possessing Teekshna, Rooksha and Ushna properties is given. Udvartana (unction) with Rooksha substances. For Emaciation - Vasthi with drugs possessing Snigdha and Madhura properties be given. Regular Oil Massage - Udvartana with Snigdha substances & other. Panchakarmas should done in appropriate time. General ill health: Any ill health may affect the features of beauty temporarily. After restoration of health by appropriate Sodhana, Samama and other therapies the beauty also may get restored automati- cally. 97 v" rS oi6 w
- 130. Manovikaras: Psychological disorders not only unmada (insanity) Apasmara (Epilepsy)' but also etc. are also reflect the other disorders such as Kama (Passion), anger, greed, attachment, envy, excitement on face, eyes, lips etc. and impairs beauty' All the panchakarmas are to be adopted according to necessity and suitability to alleviate particu- larly unmada. Aparmara and other manovikaras' Non-Adoption or In-appropriate Adoption of Swasthavrutta, Sadvrutta. which include dinacharya, rutucharya, ahara, nidra, brahmcharya etc-' of Adoption of swasthavrutta appropriately, including regular Abhyanga, Nasya,seasonal adoption Panchakarmas, restores the beauty. Madhyama Sara, Avarasara The Sarvasara features have already been described. The appearance Avarasara in order' of these features moderately or loss of these features is termed as Madhyamasara and promote beauty' In such circumstances the rasayana treatment preceeded by Sodhana therapy may help to Old Age Senile changes occur in old age. It is already stated that any person will have utmost such as beauty at his adolescent age. The beautiful features will be gradually lost as age advances, wrinkles of skin, whiteness of hair, loss of teeth, looseness of body etc. Disorders of the Organs Pertaining to the Beauty The disorders of the organs such as skin, face, hair, and lips etc, which affect beauty, are as follows- Hair Loss Alopecia or darunaka can broadly be divided as follows- p atchy hair thinning or alopecia accompanied by scalp skin disorders. (a) Sebonhoeic dermatitis (arumshika) (b) Contact dermatitis (pama) (c) Tinea capitis (alasaka) Folliculitis Bacterial (arumshika)Decalvans (arumshika)Lupus erythematosus (raktamandala) Liqhen planus (darunaka) Luus vulgaris Male pattern baldness-Restricted to top of the scalp, frontal recession. Female paftern baldness-Normal frontal hairline present. Decreased hair density -It occur in hypothyroidism, iron deficiencies. patchy baldness (alopecia areata)-One or several well defined areas of loss of hair. Alopecia areata of the beard-do-Skin diseases affecting the scalp- are (a) Eczema, (b)PsoriasisScarring alopecia-Lichen planusSeborrhoeic eczema. Head lice. EXCESSIVE HAIR GROWTH Hirrsutism Hyperstrichosis. Diseases of the Lips Allergic eczema of the liPs- It can occur on the lips due to lipstick, lip salves, toothpaste, or mouthwashes. Angular cheilits- cheilitis means inflammation of the lips, and in angular cheilitis only the corners of the lips are involved it can occur in individuals with dentures, and is usually due to candida infection from under the top denture. Recurrent herpes simplex-It usually affects the lips if the primary infection was in the mouth,. It precedes by a prodromal sensation of itching, burning or tingling Small grouped vescicles appear, burst, crust.,and then heal in 7 to 10 days without scarring. u 98 A9 -e W 16r*
- 131. Lichen planus-Chronic single ulcer on lower lip, non-infiltrated. Hereditary hemorrgic telangectasia-Red multiple tiny macules, papules. F*zema of tlre lips. Apthous ulcers-foul smell improper suppuration. (Sannipataja osta roga) Lip granuloma-Similar to raktaja osta roga Dental and Gum Disorders :Bleeding gums (seetada)-Raktamokshana, nasya, gandusha are to be adopted. Gingivitis, periodontitis (dantapupputaka) Raktamokshana, nasya. Pyorrhoea (dantavestaka)Suppurative gingivitis (Upakusha)-vamana, virechana, nasga- raktamokshana. Carries- (Krimidanta) Raktamokshana, swedana, avapeedaka nasya, gandusha. Looseness of teeth (danta chala-Nasya, gandusha. Haltosis-(pootivaktrata)Sneha, sweda, vamana. virechana. nas).a- avapeedaka dhooma pana. Face : dcne -- Acne is a disease of sebaceous follicle. Everyone gets some acne. In girls it may appear several years before menstruation commences, some times as early as Eight years of age. In both sexes the peak incidence is 13 to 16 years. although it may continue into the 20s, 30s and occasionally later. Acne occurs on face, chest, and back depending on the distribution of the sebacious follicles in that individual. Genetic factors are important in determining the severity, duration and clinical patterns. The exact pattern of the rash depends on the allergen responsible. ERYSIPELAS (Visarpa):It is an acute rapidly spreading rash caused by the entry inro skin of a group of a beta jaemolitic streptococcus. The rash itself is bright red, well demarcated, and may or may not contain large blisters in the center. TINEA (RINGWORM) Of THE FACE : Acute eczema-acute erythematos small pin head pap- ules or plaques all over the face. Acute sun burn (atapa dugdha; raika) Acne vulgaris (mukha dooshika) Acne excariee-any where on the face particularly for females, isolated papules and nodule, Rosacea-occur on cheeks, fore head, nose, chin, Characteized by pappues on erythematusbase withtelangectasia. Perioral dermatitis, small papules around mouth or eyes Seborrhoeic dermatitis-scaling around the sides of the nose, eyelashes, eyebrows, around the ear. Scalp, with scaly plaques.Malasma Melanoderma(neelika) Chloasma SKIN : Pityriasis versiolor(Sidhma) pale round macules appear on the face Melanoderma (eka kushta) -Uneven Zeraderma pigmentosa (charma kushta) Psoriasis (kitibha kushta) Rhagades (vipadika) Ring worm (alasaka) Dishydrosis (charma dala) Pama (acute eczema) Weeping eczema (vicharchika) Vitiligo (switra) BEARD : Stycosis barbbae-Small papules with normal hair. Pseudosycosis barbae-small papules with tight curly or in growing hair. Tinea barbae-confluent logee swelling. NAILS : Nail fold telangactasia Psoriasis (kitibha)-pitting of nails. Whitelow (chippa) NOSE : Rhinophyma- enlargement of the skin of the nose due to hyperplasia of the sebaceous glands Role Of Pancha Karma Therapy in preserving and promoting beauty 99 tr
- 132. Panchakarma Therapy is also termed as sodhana or purificatory therapy. waste The therapy, which causes elimination of, accumulated doshas i.e. morbid or disease causing rnaterial either through the upper orfices or through the lower orfices or through both is termed as Samsodhana Therapy (Sarangadhara l-4)' panchakarma therapy is the contribution of our ancient Acharyas of Ayurvedic System of Medicine. in No other system of medicine in the world is having similar therapeutic measures like Panchakarma systematic, practicable and effective manner. This therapy is highly effective in preserving, maintaining and promoting excellent health and longevity. The effects of appropriate adoption of Panchakarma are: Elimination of morbid disease causing doshas from the body. Alleviation of diseases; preservation and promotion of excellent colour, complexion, strength, stamina; preservation of youthfulness, preven- tion of senile changes for long period; Panchakarma accomplishes clarity of mid, intelligence. healthy, happy long life. panchakarma therapy is indicated in many diseases as well as to preserve, maintain and to promote health. Even for healthy individual seasonal adoption of Panchakarma is prescribed. Adoption of panchakarma before Rasayama therapy is a must for favourable results. Basing on the above panchakarma therapy is expected to be highly effective in preserving, restoring, promoting excellent health, youthfulness and longevity. In other words it accomplishes excellent dhatusamyata so that the person will be endowed with Sarvadhatusara purusha features, which are described earlier as features of ideally beautilul person. (Sneha Hence a brief review of important aspects of Panchakarma along with its poorva karmas i.e.. - Swedas) with special reference to their role on preserving, restoring ahd promoting beauty is presented here. SNBHANA (Oleation):Adoption of snehana (internal and external) in general alleviate Vata causes smoothness, helps in the production of new dhatus, promotes strength, complexion, preserves youthful- to ness, prevents senile changes.Ghee in particular promotes beauty; alleviate Pitta and Vata, conducive Rasadhatu, Sukradhatu, and ozas. It has cooling and softening effect on the body i.e. skin, face, lips, eyes etc. It promotes clarity of complexion and voice. Gingly oil is particularly conducive to skin' eyes, causes softness, slimness, lightness, smoothness, oiliness of the body and skin; promotes strongness of the body, alleviate Kapha, Medas and Vata, disorders of beauty. Many snehas processed with suitable drugs are prescribed for pana, nasya, abhyanga, murdhitaila, gandusha, vasthi etc. in diseases which effect beauty. Some salient features are as follows: Abhyanga (Oil massage): Massage of oil is to be adopted as a daily routine to preserve health and beauty. It accomplishes smooth, soft and strong body; promotes lustre and clarity of the skin' subdues ageing process, promotes longevity' Massage with varieties of medicated oils are prescribed for various skin diseases of face and for other parrs of the body and for improving lustre and beauty. (Ch.sut. 5/85-90; AH. Sut. 2/7). Oiling on Head: Oil is to be applied on head everyday. It prevents baldness, greying of hair, hair fall. The hair become black, long and deep rooted by regular application of oil on head. It improves brightness of the skin on the face. (Ch. Sut. 5/81-83; Su. Chi. 24125- ). Oil massage on the soles of feet alleviates roughness, dryness, prevents cracking of feet, and promotes tenderness. (Chi Sut. 5). Gargling 100 "S a-g oYd I w
- 133. of oil promotes strength of jaws, depth of voice, and flabbiness of face. It prevents dryness of *roat. cracked lips, toothache, Dantaharsha (teeth set on edge of sour intake), carious of teeth. His tooth will be deep rooted, and he can chew even hardest eatables till old age. (Chi. Sut. 5; Su. Ch. 24 Ak. Sut. 2). For prevention and cure of dental and oral disorders promotion of dental and oral health manv oils are prescribed such as Irimedaditaila for gandusha.. Swedana (Sweating) : The Adhistana (site) of Sweda is skin. The sites of origin of swedavaha srotases (Channels carrying sweatl are medas and hair follicles. Sweda eliminates accumulared r*,aste products from skin. Hence, it causes clarity of skin; Swedana alleviate Vata and Kapha disorden pertaining to beauty. Swedana is usually being adopted before Panchakarma. Swedana karma promores softness, colour, and complexion of skin. It alleviates hoarseness of voice. (Su. Chi. 32/21-22. 17 Ch.Sut. 14/16-19)" But Swedana is contra indicated in Leprosy and skin diseases associated with loss of sensarion. redness, inflammation, oozing etc. Erysepalas, obesity, pitta disorders. Vamana : Vamana preceded by sneha swedas eliminates immature, improperly formed Kapha and Pitta doshas through mouth, which includes endogenoustoxic substances accumulated in the body and gives scope for the manifestation and sustenance of disorders affecting beauty. Hence it can be used in disorders, which effect beauty and associated with immature Kapha, Pitta or Utklesha of the doshas Vamana is particularly useful in the disorders of face, head, scalp and upper part of the body'. being the seats of kapha. It is pertinent here that actually the important organs of special attraction of appearance is situated in the head and face itself. Vamana is also indicated in Kusta, visarpa (erysepalas) and Halitosis (Putivaktrata. urdhwa_euda.1- Virechana : Virechana {s the tlest treatment for pitta and or rakta predominant diseases of beauty. Hence it is very much important for the disorders of skin, and hair. In fact the beautr' mainly depends upon the skin itself. Vierchana eliminates doshas, restores strength and complexion. It prevents ageing process i.e. loss of colour, complexion, looseness and wrinkles of skin, whitening of hair etc. are prevented. It promores, purifies and strengthens all the dhatus. Hence accomplishes the features of sarva dhatu sara. Vasthi : Vasthi is the main treatment for vata disorders. However due to the Administration of various drugs through vasthi its action also is varied i.e. it causes sodhana- samana: plumpness, leanness; It promotes dazzling colour, complexion intelligence, wise, strength. stur- diness, youthfulness, health, happiness and longevity. In fact vata prakopa causes much harm to beauty similar to ageing process Appropriate adoption of vasthi karma alleviate both vata prokopa and ageing process and restores youthfulness. Anuvasana vasthi promotes colour, complexion, strength and stamina. The deteriorated or degenerated cells of tlre skin and other parts of the body will get regenerated with freshly formed more healthy rissues u,hich reflect in excellent and beautiful appearance Rakth Mokshana :Bloodletting is also an important measure to promote colour of the skin, clarity of complexion, strength, happiness, and longevity. It protects health, beauty and prevents many diseases. Healthy persons also under go rakta mokshana every year in sharadruthu to mein- tain trlood in pure state, there by maintain health and beauty. Its results are very quick, but complications also may occur unless adopted cautiously. It promotes the normal functioning of tbe trlood, prevents disorders which occur due to its vitiation .The role of rakta in maintaining health i I 101 , /t*-t ffi 4u*1 tffi,F
- 134. and beauty is already discussed in detail. Rakta mokshana alleviates all the skin diseases such as macules, papules; pigmented disorders like melanoma, cholesma, nyachha, tumours,oedema etc. It is specially indicated in diseases like leprosy, vitiligo, psoriasis, dermatitis, eczema' eryseplous' gout etc. REGIMEN OF PANCHA KARMA THERAPIES IN GENERAL IN THE DISORDERS OF BEAUTY : Almost all the disorders of beauty pertain to skin, hair and nails. According to Ayurveda most of these disorders fall under the purview of KUSTA and kshudra rogas. The term Kusta has been used a synonym for all the skin diseases in Ayurvedic texts. But lay people will feel fearful if we diagnose a case of skin as Kusta. However the etymological meaning of Kusta is Kutsitam Karoteeti Vapuhu Kustam i.e. the disease which causes Kurupatva i.e. ugliness is called as Kusta. It is almost opponent to beauty.The therapeutic measures described for Kusta itself are to be adopted in general in all skin diseases and Kshudra rogas Hence a brief description of role of Panchakarma in Kusta is presented here. Panchakarmas in Kusta Chikitsa:In the stage of poorvarupa itself urdhwa and adhah sodhana i.e. Vamana, Vireehana etc. are to be adopted. When thp disease settled in Twak i.e. skin, sodhana and Alepana are to be adopted. When the disease settled in Rakta, Mamsa or Medas, Samsodhana Rakta mokshana, along with other measures be adopted. In the beginning Snehapana be adopted followed by Vamana, Mrechana, Raktamokshana etc. Snehapana can be adopted as a Samana treatment also' In long standing cases of Kusta or skin diseases Vamana be given every fifteen days, Virechana be given once in a month, Raktamokshana once in 6 months and Nasya be adopted every third day. Vamana - In skin diseases of predominance of Sleshm4 skin diseases of upper part of the body i.e. head, face, neck, chest etc. and particularly when doshas are in utklesa state.The Vamana./Virechana yogas prescribed in Kalpastana may also be used according to suitably of cases. Ideal Virechana drugs - Trivrut, Dantimoola' and Triphala. Asthapana Vasthi - Darvyadi Vasthi prescribed in Kusta Chikitsa of Charaka be given when required according to condition of the patient. Anuvasana Vasthi - In Vata predominant cases after adopting Virechana and Niruha Vasthi, Anuvasana Vasthi be given according to necessity of the cases. Madanaphaladi Anuvasana Vasthi may be used (C.S.Kusta chi). Nasya - Nasya is very effective for skin diseases, which occur on head, face and neck. Hence it can be regarded as most important mode of Panchakarma in preserving, promoting and restoring beautv of the face Raktamokshana - In skin diseases characterizedby strong (stira) and hard patches prasthara and nadiswedas be adopted at the beginning followed by. Rakshamokshana by gharshana (Scrapping) with Kurchaka Sastra. Then Pottalee sweda be adopted with meats of wetland and aquatic birds and animals followed by scraping (Lekhana) with Teekshana Sastra.If doshas are mild Pracchana be adopted. If doshas are 102 dd tu86 ry,€ 14$F I
- 135. excessive and in Vata predominance cases Raktamokshana be done with shringa. In Pina predominant cases jaloukavacharana be adopted. If doshas are deep seated, Siravyadhana be done. Visarpa Chikitsa Vamana :All the erythematous skin diseases and skin disorders associated with sphota, redness, tenderness burning (daha), pain, hot etc. are similar to visarpa and acharyas prescribed visarpa chikitsa itself in many skin conditions. Hence the treatment of visarpa is presented here.In Virarpa when the doshas are in immature state and settled in upper part of the body i.e. skin disorders of head. face. neck and chest, Langhana are adopted first followed by Vamanamay also be adopted in Kapha predominanl Pitta predominant and Kapha Pitta predominant cases of Visarpa with yogas prescribed in Kalpastana or Madanaphaladi yoga or Patoladi yoga, which are specially prescribed for Visarpa. Virechana :In cases settled at middle part of the body, and Pitta predominant cases, Vrechana and Raktamokshana be adopted. Trivrutadi yoga, Trayamanadi yoga, Trivrutadi Churna, Amalaki rasa may be used according to necessities for Virechana (Cha. Chi 21). Raktamokshana :Vitiation of Rakta causes impairment of skin, muscle tissues, and ligament. Rakta is the main seat for Visarpa. Without the involvement of Rakta and Pitta no Visarpa type of skin disease occurs. Raktamokshana is important Sodhana measure for both Rakta and Pitta. Hence in all Virarpa type of skin diseases Raktamokshana be adopted at the beginning itself.In Vata vitiated dosha-s shringa, Pitta vitiated doshas, Jalouka, Kapha vitiated doshas Alabu be used. Snehapana :Snehapana be given only in Vata predominant Visarpa and mild Pitta associated Virarpa cases. Except Ghrita used for Mrechana, Snehapana is contra indicated in general in Visarpa In Granthi Visarpa, Swedana be adopted with Utkarika and Vesavara processed with hot, Vatahara drugs. In no. Other Kusta or Visarpa Swedana is prescribed. Swedana is contra indicated in general. Dhoomapana, Nasya also be adopted in Granthi Visarpa. In Visphota also the same treatment prescribed in Kusta and Pitta Virarpa be adopted with speciat reference to Vamana and Virechana. In Granthi visarpa also Snehapana, Vamana, Virechana are prescribed in immature stage. In the varied disorders of organs of beauty described above, the panchakarma therapies relevant to the particular dosha, dushya etc. are to be adopted according to the suit ability of the cases. The adoption of panchakarmas to suit the individuals will preserve and promote youthfulness and beauty for a long period along with health and longevity. 103 I L
- 136. IMPORTANCE OF PATHYA IN URINARY DISORDERS SPECIAL REFERENCE TO MADHUMEHA . Dr. Anand V" Joshi Mdyapeeth Deemed University' Pune M.D. (Ay.), Ph.D.(Ay.) Principal/Dean' Bharati o Dr. Vijaya A. Joshi' M.D- (Ay. Rader in Roga nidan College of Ayurved'Dhankawadi' INTRODUCTION Ayurvedahasdealtverydeeplytheaspectofdieticsinviewofthelndiansocialandclimatic taken in appropriate and moderate proportions conditions. pathya is defined as that which isleneficial, which keeps and taken at the proper time of the day. Here the work beneficial has special meaning of food thepersonhealthy,maintainsnormalbodyfunctionsandpreventsdiseases sthana 27'h chapter that pathya is sustainer of all living beings. Charak has told its scope in sootra clarity, good voice, longevity, intellect are all food sustains the life of all living beingslComplexion, but considered dietics as not only a science of nutrition conditioned by pathyakara ahara itself. Ayurveda holy "Yajna karma" in realitY" AIMS AND OBJECTS of pathya in urinary and disorders special The object of present study is to update the concept refernce to PathYa in Madhumeha" BRIEF CLASSICAL DESCRIPTION OF MADHUMEHA pathological changes are noticed in urine with presence Madhumeha is a disease in which certain system with comparison with Diabetes Mellitus of sugar. since this disease is connected with the urinary as one out of the four varieties of vataja in modern medical parlance. charak considers Madhumeha if nor treated and auended to at the out set, will ultimately ;;;;;susruta sltes that any prameha, is clearly stated that there is an increase in the sweetness or develop in to Madhumeha. In vagthata, it quallities of urine, being the colour sweet substances in the body, which is expressed through the physical and taste resembles honeY. Pathogenesis of Madhumeha is of two varieties' l.ThedepletionofthedhatuleadingtothevitiationofVata. doshas leading to the vitiation of the z. obstruction to the normal circulation of vata by other former. Specific Laxana?s of Madhumeha ? One among the four vataja Prameha *S 104 a!-9 n -9[ : ffi
- 137. = ? Madhumeha rogi passes urine which is astringent and sweet in taste, yellowish or whitish in colour. ? The urine contains similar properties of Honey. ? Bahumootrata and Avila mootrata are cordinal symptoms of Madhumeha. ? Susruta stated that a patient who is suffering from pidakas, hridgraha and other complications in addition to the other characteristics of urine should be considered as Madhumeha patient- ? It is stated that once the Madhumeha has menifested, it is very difficult to cure IMPORTANCE OF PATHYA It is said in vaidyajeevana that without proper diet medicines are of no use means without prcper diet, the disease will not get cured in spite of the use of appropriate medicine. Ayurveda enumerates pathyapathya in most of the diseases. Especially few diseases the pathya is said to be the major part of the treatment rather than the prescribed medicines itself. It has been substan- tiated in all the Ayurvedic literatures that mithyahara vihara constitute the most important sannikrista nidana for various urinary disorders and it is also said that the Madhumeha can be prevented at the same time controlled with suitable diets. PATHYA IN URINARY DISORDERS Though pathya has been described in most of the diseases, an attempt is made to quote ferv important urinary disorders and their apathya pathya under the heading where in the pathya constirures part and partial of actual treatment. The disease like Madhumeha required the administration of suitable pathya. Though specific treat{nent has been described in all urinary disorders but still the pathya constitutes major part of the treatment of the same diseases. The urinary disorders and their pathyas are furnished in tabulated form. PATHYA IN MADHUMEHA The vyadhipratyaneeka chikitsa of Madhumeha is categorised in to I) Pathya II) Vyayama ilD Shamana PATHYA : Pathya plays an important role in controlling the Madhumeha. As stated earlier, w'ithout proper pathya, this disease will not get cured inspite of the use of appropriate medicine. It is stated in Vagbhata that Madhumeha rogi's are emaciated due to vata prakopa and depletion of dhatu, so one should administer the Bramhana ahara and oushadha and it should not be medaskar and mootrala. Mudga Yoosha Prayoga :- In this preparation 4 to 8 tolas of mudga is taken and boiled rvith 64 tolas of water by reducing it to half part or r/a quantity by boiling and filtered through the cloth, rhe drava bhag is used as yoosha. Froperties & actions :- Mudga is kashaya, laghu sheeta veerya, pachana, grahee in its property. It relieves trishna and acts as a dhatu powstika. 105 U "S 3,-,a. ,ffi *4FY'- ffi
- 138. varga. Simi- Kulatha yoosha, godhooma, shalyanna, yavanna are to be administered amoung anna larly patolla, Karavellak, tikta shaka's are advisable. Mamsa rasa is best bramhana dravya. It is to be used as best pathya in Madhumeha. Sneha Prayoga In Madhumeha, vata prakopa is predominant. So taila is the best for vata dosha. If the anubandha is kapha then kaphanashaka kashaya siddha taila, if the anubandha is pitta then pittanashak kashaya siddha grita is to be administered' SHAMANA :- Madhumeha is santarpana janya roga, the patient should not be subjected to appropriate medicine Apatarpana kriya. (Shodhana chikitsa). Bramhana/Shamana chikitsa Madhumeha, and suitable pathya ahara and vihara (vyayama) is beneficial. pathya is very beneficial in the treatment of urinary disorders particularly inlege of Ayurvedic 106 {g ffid w
- 139. METABOLIC LIVER DISORDERS AND THERE MANAGEMENT - AN AYURVEDIC VIEW Dr. Prasanna N. Rao Prof & Principal, S.D.M.C.A. Hassan. Metabolic diseases of liver are a big entity to deal with it and having its own importance for different clinical presentations and treatment modalities. Problems with metabolic processes in the liver can be either congenital or acquired. Some of these disorders, such as Wilson's disease and haemochromatosis can present as hepatitis or cirrhosis and must be distinguished from other causes of these forms of liver disease. Because of different kinds of vital metabolic events takes place in the liver. activity of this organ is very much important for life. There are different liver diseases comes under the metabolic category. Some of them are- wilson's disease, Haemochromatosis, Alpha 1 - antitrypsin deficiency, Crigler-Najjar syndrome, fatty liver (both steatosis and steatohepatitis), Galactosaemia, Amyloidosis etc. Conditions like Biliary Lithiasis should be also considered under metabolic diseases as defective cholesterol mechanism plays key role in this context. Clinical presentation of all these disease differs from one from another. In Wilson's disease. as it is a rare inherited condition, mostly affecting a young person, which is characteri zed by an inability to excrete copper into bile, resulting in the toxic accumulation of copper in the liver and nervous system. Organ dysfunction in patients with wilson's disease results from inadequate biliary excretion of copper and subsequent copper deposition, most notably in the liver and central nervous system. Haemochromatosis is an iron overload syndrome causing iron deposits and consequent damage to various organs, including the liver (cirrhosis), heart (heart failure), pancreas (diabetes), and pituitary gland (decreased sex drive and impotence). The disease may be due to an inherited increase in gut absorption of iron or to multiple blood transfusions, since iron is normally found in circulating red blood cells. Joint pain is the most common complaint of people with haemochromatosis associated with fatigue, lack of energy, abdominal pain, and loss of sex drive, arthritis and liver disease including an enlarged liver, cirrhosis, cancer, and liver failure. Alpha-l antitrypsin deficiency is a lack of a liver protein that blocks the destructive effects of certain enzymes. The protein alpha-l - antitrypsin is a substance made in the liver. It plays an important role preventing the breakdown of enzymes in various organs of the body. The condition may lead to emphysema and liver disease. Alpha , - antitrypsin inactivates other enzymes, causing damage to organs if left unchecked. The lung is the most severely affected organ in patients with this disease. but approxi- mately 10Vo of adult patients will also develop cirrhosis. It is the most common genetic cause of liver disease in children. Fatty liver disease can range from fatty liver alone (steatosis) to fatty liver associated rvith inflam- mation (steatohepatitis). This condition can occur with the use of alcohol (alcohol-related fatry liver) or in the absence of alcohol (nonalcoholic fatty liver disease INAFLDI). Fatty liver associated with the use 107 ow w&,*-- t@t"
- 140. also can be of alcohol may occur with as little as 10 oz of alcohol ingested per week. Identical lesions caused by other diseases or toxins. metabolism' Two Crigler-Najjar syndrome (CNS) is a rare autosomal recessive disorder of bilirubin distinct forms have been described, as follows: type I and type 2' (high levels) and kernict- Type 1 CNS, is associated with neonatal unconjugated hyperbilirubinemia serum bilirubin level and responds erus. Type 2 CNS (also called Arias syndrome), presents with a lower to pfrenoUartital treatment. Persistent jaundice is present at or soon after birth in type 1 CNS' Jaundice may not manifest until later in infancy or childhood in type 2 cNS. Galactosemia is Galactosemia is a disorder caused by an inborn error of galactose metabolism. of galactose in the blood an autosomal recessive disorder that is characterized by elevated concentrations resulting from the absence or dysfunction of any of the three enzymes responsible for the transformation of galactose to glucose, i.e., D-galactose-1-phosphotransferase, a-D-galactose-1-phosphate uridyltrans- ferase or UDP-glucose-4-epimerase. Amyloidosis is not a single disease but it is a conditions linked by a common features. In this termed amyloid, condition there is extracellular tissue deposits of protein materials which are generically in one or many organs are more Regarding biliary Lithiasis, as among all the types of gall stones Cholesterol stones_ common and that,s why cholesterol metabolism and biliary lithiasis is highly inter-related. Pignnent stones and mixed variety of both cholesterol and pigment stone also contribute to biliary lithiasis' Cholelithiasis is common in Western populations and represents a consequence of altered choles- terol homeostasis. Changed food habits and westernization of life style contributes major cause brehind the rise in the inciden"" of biliary lithiasis in recent days. Gallstones forms because of a precipitation of cholesterol due to imbalance in bile acids and cholesterol ratio. Apart frorfi these metabolic factors, stasis of bile, reflux of pancreatic enzymes and infections are causative factors for gall stones.The clinical features of this condition vary from asymptomatic gall stones to calculous cholecystitis and obstructive jaundice. Biliary lithiasis in the intrahepatic radicles remains unchecked and diagnosed incidentally or while investigating for other associated biliary pathologies' Management of metabolic liver disorders : In modem medicine there are different methods of management of all these disorders. The effec- in tively of modern drugs is a questioned today as there is not a single proven drug which is effective are utilized the management of liver disorders like jaundice. For the same reason Ayurvedic medicines widely now a days and results are good compare to modern drugs. Hepato- protective drugs is a boom today as some proven hepato toxic drugs are now used with from ayurvedic drugs (AKT) to minimizetoxic effects Andrographolide, the active constituent isolated the plant Andrographis paniculata. (kalmegh), showed a significant protective activity against paracetamol-induced toxicitY' Boerhavia diffusa (Punarnava) : An alcoholic extract of whole plant Boerhavia diffusa (Punarhava) given orally exhibited hepatoprotective activity against experimentally induced carbon tetrachloride hepatotoxicity in rats and mice. The extract also produced an increase in normal bile flow in rats suggesting a strong choleretic (Bhringaraj)' activity. In the ,u*" *unner drugs like, Phyllanthus Amaris (Bhuiamala), Eclipta alba r& 108 !-E tr ovd
- 141. Swertia Chirata(Chirayata), Terminalia belerica(Baheda), Tinospora cordifolia(Guduchi), Picrorhiza kuroa (Katuki) are used to treat liver disorders. Rakta Mokshana : In the management of Hemochromatosis blood letting is adviced in modern practice. The idea behind it is to rid the body of excess iron. The process is called phlebotomy, which means removing blood the same way it is drawn from donors at blood banks. Depending on how severe the iron overload is, a pint of blood will be taken once or twice a week for several months to a year, and occasionallv longer. According to ayurvedic principles Raktamokshana is helpful for the elimination of toxic materials. The same principle we can implement in the metabolic liver disorders where we can eliminate excess products by means of Shodhana methods like Raktamokshana. Gall bladder flush vis-i-vis Virechana : During a gallbladder flush, 1-2 cups of olive oil are consumed to simulate the gallbladder into releasing bile. This increased demand on the gallbladder to release bile works to push the stones out. In virechana Sneha is administered before purgative therapy. Though the purpose of Snehapana is quiet different than mare emptying of gall bladder, the same may be used to treat patients with liver and gall bladder diseases. Medicinal treatment for Biliary Lithiasis : Rohitakarishta was tried in the patients of Pittashmari and results observed were enthusiastic. The contents of this prepration are-_ Rohitaka, Arjuna, Parpataka, Somalata, Tila, Haritaki, Kalmegha. Ghrit Kumari, Panchakola, Anjubar, Trijatak, Triphala, Dhataki, Pashanbheda. Other than this many drugs are used to treat pittashmari like- Gokshura (Tribulus terrestris), Punarnava (Boerhaavia diffusa ) etc. Apamarga is a drug which acts as a cholagogue, responsible for more secretions of bile and also acts on gallstones.Apamarga Kshara , Narikela lavana and Arka lavana are given in the cases of biliary colic and shows good results. Rasaoushadhies and Hepatic disorders : Tamra bhasma is used in many compounds which are used in liver diseases. But some metabolic disorders like Wilson's disease where there is accumulation of copper in hepatic tissue. In the same manner there is accumulation of iron in the body in diseases like Hemochromatosis. In such disorders.use of tamra bhasma and loha bhasma in questionable matter. Use of genuine drugs having no active metabo- lite in them is a proper answer for this. 109 "B r I #* 1:E! '6tr ffiitw
- 142. NECESSITY & PROBLEMS IN FORMULATING NEW TECHNI' CAL WORDS FOR AYURVEDA o Dr. Prasad B. S. Principal, B' M. Kankanawadi Ayurvedic Medical college' Belgam' TNTRODUCTION : terms are very essential Every branch of science has its own technical terminologies. Appropriate to describe or to understand a particular object, a disease or a clinical condition etc. An ideal term should what we want to say' eg' be self explanatory. The term itself should represent or carry the meaning Madhumeha, amavata, dosa" dhatu etc' points for consideration: When we think about technical terms of ayurveda the following are the Problems by avoiding classical terms : Always it is better to stick on classical terms as far as possible. For example, if a clinical picture and to use churnas, of a patient ieveals shareera klinnata, it directs us to avoid gritha type of preparations preparations. This type of approach on the contrary if rukshata is there then one can go for gritha or taila is possible only when we use classical terms' until one urives Similarly simple diagnosis of oligospermia will not serve the purpose. Unless and to retodusti drug selection is not possible. Let us see the following seminogram reports : Principal KLES BMK AYurveda MahavidYalaYa Shahapur, Belgaum, Karnataka Volume 1.5ml Liquefaction time 40 minutes Viscosity Increased PH 7.6 Spe*m count 5 millionslml 110
- 143. Sperm motility : Active 40Vo Sluggish 40Vo Non motile 20Vo lmpression Oligozoospermia In general we prescribe sukrajanaka dravyas in case of oligozoospermia. A list of sukrajanaka drugs are given in ayurveda. Then the problem comes with selection of drugs. In the above case if one considers viscosity then it will be diagnosed as atipicchila where we have to administer lohabhasma and triphala churna. On the contrary, if satavari and kokilaksha are administered as sukrajanakas they further increase viscosity and thus hampers sperrn motility. The above case is also oligozoospermia but with increased pH which may be called as ruksha retodusti. In such conditions aswagandha, kapikacchu, samudraphena etc. should not be given. Sat*'ari. kokilaksha, vidari etc. are to be administered. The case is also oligozoospermia, but refers to granthibhuta retas where sati or palashakshara siddha gritha are to be administered. So, aniving to ayurveda diagnosis is must for better clinical practice. And in order to arrive ayurvedic diagnosis one must use classical terms. Further Eleboration : As ayurveda is in very precise form further elaboration is required. For example, Vata is divided into 5 types. Each type of vata again performs a group of functions. As modern science is describing verl' elaborately each function, eagh type of vata or pitta or kapha may be subdivided in respect to their functions. For example pranavata may be subdivided and elaborated in respect to its following functions: - Swasakriya - Cough reflex - Cardiac control - Belching reflex - Spitting reflex - Deglutition reflex etc. Similarly apanavata concerned to erection, ejaculation, maturation, defecation, parturition etc. are all may be well elaborated with the help of modern knowledge and then given suitable terms, so that more scientific and precise application of drugs may be possible. Same is the case with ama also. Ama includes many things eg. A toxin, an abnormal protein, an undigested food material, an improperly digested food material, an abnormal metabolite, an immune complex etc. Hence, equating ama as undigested food material will minimize greatly the understanding. It would be better if we give separate names to each type of ama, with which one can better understand and can better employ drugs. Say for example, immunomodulator in case of immune complexes- meta- bolic enhancers in case of defective metabolism etc. Necessity for New Technical Terms : Ayurveda has described anatomy, physiology, pathology and all the medical subjects sufficient enough to understand and to practice it , still but very precise. Due to paucity of time there is a lot of ambiguity which exists in understanding ayurveda. In order to plan treatment, it is essential to establish dosa, dushya sammurchana. When we want to plan the treatment of hypoftryper thyroidism which dhatu we have to consider as dushya- Because we g 111 f.E g ffi ^,ef <rf,ftY$ M
- 144. hardly find description of glandular tissue in ayurveda. But the thyroid gland must have been included under one or the other dhatus. So, finding a suitable word for thyroid itself is not sufficient. We have to label it under a dhatu. then only it will have clinical value. Ayurveda enlisted only seven dhatus and their upadhatus. Whereas modern science has identified innumerable number of tissues. Probably keeping in view the clinical application, ayurveda might have grouped several tissues under one dhatu. That is to say, either a group of tissues having same embryo- logical origin or where we can adopt a common line of fieatment under one head. So, for better under- standing and proper application, it would be better to sub classify a dhatu with the help of modern science but within the preview of dhatu concept. Presently what is happening ? In recent past a trend has started to translate the modern words into Sanskrit and to mimic ayurveda. But how for it is justifiable? Will it serve the purpose? In actual sense this type of tendency is causing lot of confusion in students. It is also breaking the interlink between subjects. The following are some of the examples. Problems with true translation : In the context of rakta dhatu ranjana means colouring. So all the pigments such as haemoglobin. bilurubin, beliverdinn, melanin etc. are all come under rakthadhatu. This is the reason why we have pandu, kamala, switra etc. under rakthapradoshaja vyadhies. So, labeling raktha as blood minimizes the scope, learning and understanding ayurveda. Sphatikabha the colour of suddhasukra which has been translated as crystal clear. But in reality crystal clear is seen with the semen samples of azoospermia which are totally pathological. Anguli is equated with inch i.e. 2.5 centimeters which is totally misleading. Rarely and only gigantic personalities we may get2.5 centimeters that too thumb width. In actual sence, anguli is a relative type of measurement, which stands ever. The ideal values given were ideal thousands of years back" presently and stands ideal even after thousands of years. That is the specialty and purpose of relative measurements. If this is the case how for it is justifiable to give a fixed value to anguli. Same is the case with vasti, the vatasthana, which has been equated with urinary bladder, throwing the students in total confusion in establishing the relation between urinary bladder and vata functions. In actual sense vasti includes thdwhole urinary system including the kidneys. So simple translation of names is not sufficient but it should be established with functional relation. Amashaya has been translated as stomach while pakwashaya as large intestine. This type of label- ing is misleading in applying the classical knowledge. Infact, the whole gastro intestinal system is divided into amashaya - the part of GI system where the digestion is ongoing process and pakwashaya - the part of GI system from where the absorption starts. Problems with coined terms : Coined terms are minimizing the scope of learning of students. For example. Pragandasthi (humurus), Brahmavarijala (CSF), Brahmavarikuhara (foramen ovale), Chakrika (platelet) etc. If a student want to know further details or doubt where he has to refer? These words are neither found in ayurveda classics nor in modern books. If such is the case one can easily imagine the applicability of such terminologies in clinical practice. Nothing but mere wastage of time and energy of students. & 112 v, trry6
- 145. In the same fashion the students are being taught grahani as duodenum; the same students u'hen comes to clinics and examine a patient of grahani he will be in mere confusion to establish relation between duodenum and grahani vyadhi. What to be done : terms Guidelines for formulation & implementation : * As far as possible stick on to classical terms * Find suitable new technical words keeping in view the application in respect to ayun'eda {. Avoid in appropriate translations and to find coined terms for what ever the new modern u ord comes * Orientation courses to teachers of ayurveda to bring uniform usage of technical terms .i. Encourage students to use more ayurved technical terms At this juncture I would like to congratulate and appreciate the Commission for Scientific & Technical Terminology under Ministry of Human Resource Department especially Dr. Bhimsen Behra and his team for their efforts in bringing out glossary of technical terms of ayurveda in almost all Indian languages. Further, I would like to request them to conduct orientationtourses to teachers of ayun'e,n.l so that. these technical terms may be brought into use in uniform way. At the same time I call upon the teachers of ayurveda for more and uniform implementation of appropriate technical terms in teaching a-. well as in clinical practice and to insist the students to use ayurvedic terms as for as possible. It would be better if CCIM makes it mandatory for teachers of ayurveda to undergo such orientation programmes. Conclusion : Usage of actual and appropriate terms are very essential to understand and to develop alun'eda further. Take the help of allied sciences and latest technologies to understand ayurveda but not to translate and mimic ayurveda. I 113 *S 1!_g w oYd 9-Sr'
- 146. PRE.CONCEPT IONAL CARE IN AYURVEDA . Dr. V. N. K. [lsha Professor & Head Department of prasuti tantra & stree Roga S. D. M College of Ayurveda UDUPI Pre conceptional care can be defined as the care or advice given to a couple planning a pregnancy, well before the time of actual conception. The aim of contemporary antenatal care is early diagnosis of pregnancy, early detection of compli- cations, treating of toxaemias, care leading to safe delivery to get a healthy mother with so-called healthy child. Modern obstetrics forwarded the pre-conceptional concept as an extension of antenatal care to provide optimal health to mother and baby by extending the care to couple prior to conception and to the pregnant mother up to 12 - 14 weeks of pregnancy i.e. the period right from before fertilization to organo-genesis. Organo-genesis is the extensive basic systematic development, which occurs in the period of first sixty days after conception. The objectives of this cate are . Identification of certain high risk factors like cardiac diseases, previous molar pregnancy, muscular dystrophy, colour blindness, elderly primi-gravida . . Stabilization of pre-existing chronic diseases like - HTN, diabetes. epilepsy, overweight etc. . Treatment and immunization to certain disorders like rubella etc. o To discontinue potential teratogenic medication . To record or to improve base level health status of would be mother. . To prevent repetition of reproductive diseases. Pre-conceptional care includes medical screening, genetic counselling, basal health check up of would be mother and is essential for couples that are determined as being at risk (the high risk group) and couples that are willing to get a high-quality child (the aspiring group). Even though the pre-conceptional care is described as new concept by modern obstetricians, the antiquity of this concept dates back to the time of Before Christ. Ayurveda, an abode of basic concepts and treatment aspects was having more deep and intricate view of pre-conceptional care to elevate the multi-dimensional quality of child. Importance of healthy child with excellence ,t Acquiring eminent child is reputation as it liberates from the bonds of ancestors. - A person with many virtuous children has multi-facial, versatile, multi-dimensional, multi acti- vated, multi vision personality. This person is regarded as auspicious, praise-worthy. blessed, and poten- tial as a big tree having many branches. The concept of elevating the reproductive function from mere biological process to socio-spiritual benefits by adding psychic and spiritual elements is the contribution of Ayurveda as it described 114
- 147. Charaka Samhita (1000 B C), a known first book on medicine has spared one chapter ' Jati Sutreeya' which explains about the upliftment of human race by getting 'Shreyasi Praja' a baby meant for social and self (spiritual) welfare. Sushruta 1000 BC, Kashyapa 600 BC and both the Vagbhata-s have univocally extended same views with slight differences in the procedures. It seems in ancient India, the very purpose of marriage and rituals of cohabitation were pointing towards the 'worth full child', worthy enough to elevate himself to higher places and to impart positive impact on society. The pre-conceptional care in Ayurveda probably can be employed for r Couples that are determined as being at risk (the high risk group) and . Couples those are willing to get a high-quality child (the aspiring group). The pre-conceptional care is divided in to: - . Care in physical plane . Care in psychological plane . Care in the plane of conscious ness Care in physical plane It maintains the state of equilibrium in Doshas, Dhatus (physical entities) hence necessary in promoting the physical traits like Prakriti, Sara, Samhanana, Pramana etc. Care in psychological plar-re It maintains the static equilibrium of Mano-Gunas and pacifies the Satva (psyche) thus promoting the psychological qualities like intelligence (Dhi, Dhriti, Smriti) etc. Care in the plane of conscious ness The soul being the salient feature of Ayurvedic embryology a series of sacrifices and oblations have been advised and advocated to invote the soul of higher origin. Care in physical plane The man oleated with Ghrita should under go purificatory methods like Vamana, Virechana. Vasti and after observing celibacy for one month nourished by Shali Rice with ghritha and milk in the afternoon should approach woman who was oleated with oil having observed chastity for one month taken food prepared mainly with oil and Masha. The eligible wife and husband fulfilling the purificatory methods should undertake Brahmacharla (physical, verbal and psychological sexual abstinence) for a month from the first day of the menstrual cycle of the wife. Ahara ' The husband on the particular day of intercourse in rutukala of wife should anoinr his hdi with ghee and should have meals containing of ghee, rice, milk and butter.Madhr.ra Ahera promotes the production of Shukra.Pumsavana Yoga includes Phalaghrita, Maha Kallan-r Ghrita etc. which promore pregnancy. 115 tu tr
- 148. l " The wife should anoint her body with oil should consume the food consisting of oil and black gram. Pittala Dravyas promote the production of Artava. . Born child acquires similar characters of that type of diet, behavior and conduct followed by couple at the time of inter-course. ' The woman desirous of having a child resembling specific person or of specific region should use specific diet, mode, behaviour and garments identical to the person of that region. Care in psychological plane . Woman should be particular about articles what she inspects, feels and perceives after conclu- sion of her menstrual periods. r She should enter the place of god with pious feeling, should offer oblation with rice and ghee to fire God. . She should worship God, Vishnu, Skandha, Sun, Moon and Brahmanas. . She gives birth to a child with such a physique and psychology to whom she observe and think about. hence she should always see God, Cow, Bramhana, Priest, and Teachers . She should remain of generous mind. The additions during intercourse described are o High spirits of mind o Psychological intimacy with life partner o Spontaneous intense sexual urge o An appropriate auspicious period of night (Muhurta) o Cordial atmosphere surrounded by friends o Relatives and husband with tender, courteous words and behavior. o Provocative and decorative environment with fragrant flowers, comfortable bed, Favourable external environment and sound interpersonal relations described in Ayurveda prove well in dealing with sexual dysfunctions. Kama, the sex motivation is essential for the fruition of self's desire that can shake the hedonic structure of sensual elements of the dynamic mind stuff leaving a sustained impression on it in a latent form. She should practice similar behaviour as she wishes to be the nature of her child in terms of truth, faith, honesty, humanity, charity, mercy, compassion and politeness etc. Satwa of fetus It depends upon o Satwa of parents o Nature of food taken by parents before Inter-course ' . Nature of food &behavior observed by pregnant woman o The previous deeds of foetus o The species the foetus has acquired in previous binh g 116 'tt-g 6d I tr M6
- 149. : Care in the plane of conSciousness Garbhadaana Garbhadana is a common ritual described by Dharma Shastra and Ayurveda: each of them contrib- uting the ritual part leading to psychological tranquility & body purification and treatment methds ieading to physical equilibrium Samskara" means making something refining or purifying: Garbhiidhiina-Samskiira. a child-beger- ting religious ceremony is the observation of the reformatory method or fervent prayer for a ri'onh-full child in order to fulfill the parental obligation to continue the human race, to endow future genera[ions u-ith good health, noble quality and high intelligence by improving the innate quality of human kind voluntarill' To get a male child an auspicious day among the even days of Rutu K-ala should be selected: and wishing for a female child the auspicious day among odd days of the Rutu Kala should be selected. Putneshti o In Putresti Yajna oblation will be given with Charu r Reciting hundred times the hymn 'Somah Pavana ' and Savitri mantras. The inhalation should be given with 'Apodevirupasrija' mantras. o Repeating the name of Vamadevi in low tone. The hymns described for recitation before inter-course are; "(O Garbha) you are like sun you are my longevity; you are my prestige. You are god of protection (Dhata) and the god of protection (Vidhata) should protect you. You are Brahman." "Lords Brahma, Brhaspati, Vishnu, Soma, Surya, Ashwini Kumara and Mitra Varuna having divine powers bless me with valiant.son." It appears impractical in present era to practise above methods. the same will power to get a high qualitative child can be practiced by the most accepted and agreeable forms like yoga. pranayama etc... When this Sanyama is maintained in the up most exhilarating moments of life causes Dosha Samyatha, (Vata, Pitta, Kapha Samyatha), Guna Samyatha (Satwa, Rajas, Tamas) leading to ideal ps1'cho- somatic lay out of future embryo. The will power to have a qualitative issue and the rituals observed just before the intercourse. prepares the mind not to be illusioned in sexual pleasure, but to be concentrated to invoke a high spirited soul to enter in the womb of particular woman. This Sthira Chithatha of parents may be inherited to the child thus designing the psychological nature of Garbha. T 117 u 6d 6W +4[i]$'
- 150. UPADRAVA VIGYAN : Science, Theory & Application Dr. B. C. Jana M.D., Ph.D. Reader Dept. of R.V.V.V. J.B.Roy S.A.M.College Kolkatta. Dr. Debasis Khan M. D. (Ayu) Principal & HOD Kayachikitsa Dhanvantari Ayurveda College, Siddapur (N.K') CONCEPT OF L]PADRAVA : (Disease related Complication ) the term Upadrava is compound word consisting of " IJpa" & " Dru" (Upa means near, Dru means to go ). So, Upadrava means nearer to a disease. It may be defined as a separate clinical condition develops in patients in the late stage of a disease. It may be mild or Severe ( Mridu / Daruna ), may af fect one system or more than one system. It requires immediate therapeutic intervention. It is a guide line feature to the physician for prediction of Prognosis ( Progress of the disease) and for selection of line of treatment. When dosa or dosas has become l further vitiated owing to abnormal diet, behaviour etc. a second disease is added with the primary or Swarantra Roga known as Upadrava. It is very much linked up with Dushy Adhisthan and Srota of the concerned disease. A disease associated with Upadravas draws early and special attention to the physi- cian. Why not all patients developed Upadrava not clearly mentioned in the literatures but Prakriti, Ojavikriti, Hetu. Vyadhiakshama, Sharir and Kala directly or indirectly involved in the development of Upadrava. So, the important facts to be mentioned regarding Upadrav4' i. The Doshas responsible for the Vyadhi and its Upadrava i;e Both are same. ii. The Hetu / Etiology both are same iii. The main disease is independent ( Anubandhya ) where as Upadrava is dependent (Anubandha). iv. Usually Upadrava subsides with the treatment given for the main disease many time i;e treatment of the two is not contradictory- v. Though Upadrava is causes by some dosha but it has own Dosa, Dushya Samurchana and Samprapti. Charaka has divided Upadrava into two categories. i;e Sthula & Anu ( Major & Minor ). A minor Upadrava is one with a mild pathology and mild Symptoms. Such, Upadrava get cured by the treatment given for the main disease. If severe Pandu ( Anaemia ) is devel- oped in Raktapradar, it may produce its own complication Sotha and Moorcha. Hence Pandu should be treated first by blood transfusion and haematinics. CONCEPT OF VYAPAT : Vyapat refers to treatment related complications. Vagbhata emphasizes that truly "suddha Chikitsa" is that which cures the disease without creating new disorder. Nowadays number of iatrogenic illnesses are gradually increasing. ' Vuyupat is closely associated with faults in Chikitsa Chatuspada or four limbs of therapy. They are as follow:- a). Physician : Lack of Proper Education resulting in Un-Skill physicians having lack of confi- dence in Ayurveda with up to date scientific knowledge and extensive practical training. 118
- 151. b) Drugs : Adulteration of the drug and decreased potency of the herbs due to polluted environment. c) Nursing Personal : Unskilled nursing Personal due to faculty training system. d) Patients : Lack of faith and patience in the patients due to lack of recognition of Ayurv'eda in Society. Lower potency of drugs leading to slow action of the drug. Sometime Vyapat ma)' occur during the course of Samsodhana or Shamsamana therapy. For development of treatment related complication the following are also most important like failure to take proper history, lack of careful examination, wrong diagnosis, delay in diagnosis, Relying on investigations even when the clinical picture contradict to it, Error in treatment, Using inappropriate drug, Telephone advice. Failure of advice and Communication. CONCEPT OF NIDANARTHAKAR ROGA : The term Nidana refers to three different mean- ings in Ayurveda namely: i. Diagnosis ii. Etiology iii. Printed Document But Nidanarthakar Roga means when a disease acts as Nidana or Etiology of some other diseases. The former disease is called the Nidanarthakar Roga. Primary diseases usually subside after the development of second one" As for example Yakridalyudar ( Hepatomegaly ) leads to Jalodara (Ascites). Hence Yakridalyudara is the Nidanartha Kar Roga of Jalodara. The principle of treatment of this Roga is Dosa Pratayanika. CONCBPT OF VYADHISANKAR: It is also known as Roga Sankara or Vyadhi Samudaya. When the first disease i;e Nidanarthakara Roga and second one Ekarthakara Roga exists in the patient at a same time known as Vyadhisankara. It is very much similar with Symptom Complex and Syndrome as described in Western Medical Science. Kasa Roga is developed from Pratishaya. When both are persist then it is known as Vyadhisankara. But these are contradictory to treatment. CONCEPT OF UDARKA: It refers to Sequence of a disease. " Uttarakalina Fala" After effect of a disease appearing in the bbdy e;g Kasa ( cough ) & Daurbalya ( Weakness ) may persist even after Jwara ( Fever ) is subside. CONCEPT ON ARISTA LAKSHAN (Sensorial Prognosis) : It is indeed, interesting to note thar Ayurveda has studied prognostic features at different levels and it appears that the Ancient Acharyas u.ere in a position to predict the life or death of the patient. Says Charaka - the physician desirous of ascertaining the period of life left to the patient should, by means direct observations, inference and authoritative instruction. There are detailed descriptions about the Symptoms and signs which point the gravity of the situation and it could be said whether the patient would survive or die and after how many days would the patient die. So, Arista Lakshana may be defined as certain Symptoms produced in patient or healthy individual. Suggest definite deathof the individual such dangerous Symptoms are called Aristas. They posses some kind of miraculous divine or Supernatural characteristics. Susruta says if sudden drastic and abnormal changes occur in the physical and mental constitution of a patient without appropriate reasons, such changes may be considered as Arista Lakshana. APPLICATION OF THEORY IN CLINICAL SCIENCE : Having limited scope, availability and resources in our institution we had to depend on our sister organisation for detailed study on the features of Upadrava and other related condition like Vyapat. Vyadhisankar and Arista Lakshana etc of G.I.Tract and hepatobiliary disease, we had approach to Dr. B.C Roy Memorial Hospital for children Kolkatta. 119 *S w c'6 6W dd8Fb i M
- 152. REASONS BEHIND THE SELECTION OF CHILDREN PATIENTS : 1)Theyshifttoseverityveryquicklyduetolackofdefencemechanismorimmatureimmunity. etc' balance quickly' 3) Without timely medical intervention 2) Susceptible to develop fluid and electrolyte MATERIALS AND METHODS : 25 children patients between the age group of 0 -9 years who presenting with acute diarrhoeal I. for admitted to the Dr' B'C'Roy Memorial Hospital symptoms und ,ron diarrhoeal f"utir" *"." Kolkata for clinical co- relation' "hild."n' II.LiteraturesofAyurvedaandtheiravailableCommentariesalongwithLiteraturesofWestern Medicine for gastroenterologY' relation and analysis of 25 patients separately' III. Specially prepared Proforma for clinical co - as group- i (Upadrava), Group- ii (Vyapat)' Group - iii IV. To point out advance stages of disease (Nidanarthakar Roga), dro.,p- iv (Vyadhi sankar) and Group-v (Arista Vyabhaharic) OBSERVATIONS &CLINICAL CO'RELATION : outof25patientsofAcuteDiarrhoealSymptomsandNonDiarrhoealfeaturesbetweentheage groupof0-1year(40.00vo)andhighestnumberofpatientwerefemale(64.00vo).itwasfoundthatBody Most of the cases showed chronological involve- weight was in between 4.r-6 kg. in the most suffereis. mentofSrotasi;ePurishvaha->Mootravaha->Annavaha->Udakavaha&->Pranavaha'Attheend upadrava, 3 Vyapat, 2 Nidanarthakar Roga' 3 Vyadhi of study it was found that 13 patients presented with Sankar and 4 Arista Lakshana. All are showing in table below' TABLESHOWINGTHEADVANCESTAGEOFDISEASES: WESTERN DIAGNOSIS AYURVEDIC GROUP ADVANCE STAGES OF HOSPITAL DIAGNOSIS TYPE OF DISEASE * Haemolytic Uraemic Syndrome(2) * Mootra Kashaya (13 ) UPADRAVAS * Septicaemia e- Selerema (3) * Pittaj Atisara * Severe Dehydration (5) * Apadhatu Ksaya x Convulsion (l) I AkshePa * Bronchopneumonia (1) * Vat Kapholan ,. Post Diarrhoeal Distension (1) * Sannipat Jwara * Dandalasak. (l) x Dandalasak II (3 ) VYAPAT t< Signs of Ext. PYramidal Lesion * Post. Dianhoeal Distension (l) * Adhman x Purishaj Anaha t( Toxic Distension (1) * Peritoneal tuberculosis (1) * Sankraman m (2) NIDHANARTH (Ascitic Type) Sosa KAR ROGA x Round worm Obstruction (1) * Baddhodar. *S 120 a-9 e a--- ffi
- 153. = TV (3) VYADHI SANKARA * Post Necrotic Cirrhosis Plihodar & With Splenomegaly and ascites Jalodar * Liver Cirhosis with portal Jalodar & Hypertension (1) Sotha * Mid Gut Bleeding (1) Ubhayaja Raktapiua V (4) ARTSTA LAKSHANA * Ac. Hepatic failure * Shiromarma With cerebral oedema (l) Bhighat * Ac. Renal failure (l) x Vasti Marmabhighat * Ac. Gastroenteritis * Shiromarma with Meningitis & PEM (1) Bhighat. * Ac. Renal failure (1) * Vastimarma Bhighat CONCLUSION & FUTUR"E MESSAGE: Upadrava Vigyana needs further explanation and exploration. As because patients come to the Ayurvedic professionals in advance stage of the disease in many a time with multi system dysfunction. Madhabkara (700AD), the author of clinical treatise " Madhabnidana" first enlighted the concept of Upadrava Vigyana and others advance stage of the disease. It still remain a mysterious subject in the clinical science. There are 87 diseases described in Madhayanidana but description of Upadravas only mentioned in 17 diseases. The terminology like Upadravas Vyapat, Nidanarthakara Roga, Vyadhi Sankara and Arista Lakshana are nothing but advance stages of the disease. Critically ill and Chronically debilitated patients are liable to develop those conditions. It is a type of double trauma i;e one for the disease and another for the complications just like fracture of a bone. According to Western Medicine those condition may be correlated with complication i;e disease of the one system may affect some other system adversely with same phenomenon. These a-re ahvavs Tridosha in origin and very much linked up with Dushya, Adhisthan and Srotas. Role of Prakriti. Oja Kshaya, A suddha Chikitsa and incomplete knowledge are partly responsible for development of Upadrava and allied condition. However a larger clinical co-relation is needed in different system in a wider perspective field. I I l 121 *B t-9 t
- 154. ENCRYPTED AYURVEDA TO DECRYPTED EVIDENCE o Dr. K. Shiva Rama Prasad, M.D (Ayu), C.O'P'(German)' M'A" Ph'D' (Jyotish) Department of Kayachikitsa (PG), PGARC, DGM AMC' Gadag shadow with under the blue sky looking at the horizon sun Me. My self and my professional words not understood for many optimism thinks it as rising if notlatalistic to setting. Ayurveda in other whether it is mounting its ioot, deep in to all over globe or declining the values loosing its charisma and countries and people too appealing nature to Jo*-on man. Globalisation and liberalisation made the close to be. As like China, the Indian political policy are neither encouraging the Ayurveda market to expand nor to the Ayurvedic fraternity to establish them selves as eligible physicians. It is the jinx of Ayurveda, even though in many such problems crunched' limping to establish its existence through Ayurvedic colleges. Pharmacies, Seminars and NGO organisations, etc' Many times what exactly happening is not justifiable by common man whom ambitiously looking at the so-called safe' is Whether the conventional economic and our.ountry medicine, Ayurveda. A big question for the day - Ayurvedic schools are capable of conveying the protective ideology of vedic era? out of the vast is taught to the student, information,s and technologies, how much is available right now, and how much and what is the amount oi kno*ledge is retained by him? How much student is given assurances of medicaments and courage of practicing Ayurveda. This all goes rhythm of implicity explanations of teachers and also bureaucrats, beatinga round the bush. Encrypted Ayurveda for ages has to be decrypted for the need of present generation is the chore of Ayurvedic fratemity- Ascent to present Any one does not enlighten the Ayurveda; they are many people's collective intellectual informa- as clinical tion banks of knowledge, streamed from ages. Much of the times the knowledge is transferred are made in black and practical knowledle to the student. Later in due course when this information's and white available, the shortage of palm leaves compelled them to abridge the information' India, a country of well to do, made many people to invade and filch the Indian treasure. From Mahabharata and of Muslim rulers Bhagavatam, we observe the references of Mlescha invasions till to the Ghajani, Ghori impeOeA the glory of Indian wealth. Later many European communities on the name of trade encroached the science noi only the land but also the intellectual piracy. At this juncture the Indian scientists made be encrypted and abridged in want of protection. As the generations passed, the decryption is not to possible for the present. One such effort is necessary from the Ayurvedic fraternity with the help and supervision of government. ,Nomenclature magnanimitY Medicines are identified by the name, but the difference of the traditional to the proprietary is ernbedded information of medicament pharmacological functional utility. Jittered Ayurvedic physician couldn't understand inherent sagacity of nomenclature. Here I wish to bring in to notice some observa- tions. for the sake of acquaintance. rW 122 'It-F aE# 6tr tr$b' r-
- 155. Gangadhhara Churna is used in Atisara, etc of diarrhoeal conditions, where water loss per rectum is visualisecl. By colloquial meaning Gangadgara is Lord Shiva and the medicine is told b1 him- but the embeddecl information is "Ganga = water", "Dhara - holding", the full meaning as follor'rs is rhe Udakadhara kala or the water retaining muclts layer at large intestines for which Ayurveda defines roots as Talu and Kloma. The water retention and absorption is chiefly from the large intestine mucosa- The medicine works at this site for retaining or absorbing the water to balance the internal environment and there by restoring to normalcY. Another example is "Mrutyunjaya Rasa", even its meaning in general is lord shiva, who conquereC the death, generally is used in fever. The embedded meaning to understand is the cellular death. u'hich is by the encroachment of the invaded organisms assassinating target cells of the internal bodl are protected with the wrap of guard. Thus the cells fighting against are becoming "Mrutunjaya". and lirei longer time. This could be applicable even for the diseases in which the cell fester or decomposition is occurring. Thus probably it could be understood as antibiotic for the present treads' This sort of thinking is possible with the proper knowledge of Sanskrit because much of the Indian Ayurvedic medical assets are in Sanskrit. Here one point to clarify is an Ayurvedic student is required with not just Sanskrit but a medical Sanskrit. Medical Sanskrit Is it possible to differentiate a language in to segmental or sectional? Yes, certainly. The Sanskrii. as like the other got a very long history behind. Initially learned language is only Sanskrit in India. Aee' back "Veda" - "Apourusheya" are scripted in Sanskrit today referred as "Vedic Sanskrit". Later. the "Kavya Sanskrit", i.e. poetic Sanskrit is developed. To day the Sanskrit is getting extinct and no measLlres are at the compensative because of global language, English. The Ayurveda, an ancient medical branch and Yoga - a traditional ph ilosophical division has much relation of ecstasy with Sanskrit. At this point in time, it is necessary to discriminate the medical Sanskrit and taught to the initial stage of Ayun'eda learning along with the Vedic philosophy related to life existence and survival, i.e. physics and chemistrl in terms of "Padartha Vijnana", in detail. Vedic Physics and Chemistry Fundamentally, present Ayurveda student comes from 10+2 level of Meacale's educational meth- ods. At this level student learns the language of regional, national and global along with Physics. Chem- istry and Mathematics. The three-phase pattern of B.A.M.S education at the length of one and half y'ear with one year of house surgeon functioning is good as per the educationalists, as fundamental pre clinical. Para clinical and clinical groups of studies. Ayurveda has to decide whether it wants to follow the traditional Samhita oriented studv or a subject oriented study, which suits the present day needs. Unnecessary Astanga San-eraha. Charalii' Samhita are omitted and in their place utility subjects are added. Thus the curriculum has to take a specified diversion either Samhita oriented or subject oriented, if not this makes confusion to student to stand at cross roads. Reforms at Graduation (BAMS) At the pre clinical area. the student is burdened with many subjects of non-relevancy and unnec- essary. Few of the observations at your perusal are - 123 * "'c{ 6c €w <trSsf-' M
- 156. The oriental language and the authorised scientific language Sanskrit is not taught for the needs of rhe student as medical Sanskrit. Medical Sanskrit and Itihasa in Sanskrit as Samskrita-Itihasa can be taught with part A & B of each 50 marks. where the student gets the knowledge of history and also of Sanskrit simultaneously. Other wise the student is not able to understand the Ayurveda because with conflictive, confusing, non-communicative language and unnecessary Sanskrit implications along unworthy English translations. Shareera Rachana is fundamental subject of knowing the human anatomy may not require any reforms but the unnecessary Sanskrit terminologies are to be alternated with the day-to-day usage termi- nologies of upcoming link subject surgery and unnecessary conflict has to be taken out' Shareera Kriya is the basis of entire philosophy of the Ayurveda. A clear practical approaches of Ayurveda kriya principles are to be highlighted than to have a translations of contemporary medical branches, on the other hand they could be studied to enrich the practicality of Ayurvedic principles. From the fundamentals of Ayurveda, there is no more requirement of Astanga Sangraha, but the principles for the initial level students are separated and taught as the fundamentals of Ayurveda. Study of ,nuny Samhita makes one to develop confusion at graduation level, thus the clear ideologies of the Ayurveda authors are introduced and conflicts are entrusted to the PG level study. The padartha Vijnana, it on one of the fabulous subject perhaps the least interest is shown by the student, just because of one reason - not able to follow it and not told this subject in the patterns their previous study. The principles are taught with relevance to the physics and chemistry as Vedic Physic, vedic chemistry and vedic Biology to utilise them in Nidana Practice, Rasashastra and Dravyaguna respectively. The syllabus has to be framed in this concern' Dravyaguna is a fantasised branch of Ayurveda, in which many hprbs - (no herb is useless) are identified by their morphology and utilised with pharmacological knowledge. Out of many (around 300) herbs many are either extinct or banned by the Government. Various'authors by virtue of their understand- ing make the groups. The limited listing is not sufficient to served the needs of ailed humanity. The new herb introduction in to Ayurveda glossary is the need of the hour along with study of pinpoint level. At present the phyto-chemistry and paramagnetic values are brought forward in herbal medicine. Thus this information is taught to the student along with the practical principles. ,,Agada tantra & Vyavahara Ayurveda' is one more branch with much background of Excellency but no significance at present. Toxins are the best medicines in small doses, community medicine and toxic interferences with judicial proceedings are taught here. But government doesn't allow Ayurvedic many physician to the post-mortems. The encrypted technology of the Agada Tantra has to bring out and chronic incurable diseases such as Cancer, etc, could be treated well under the silhouette of gada' Swastavrutta & Yoga are to maintain the health in normal. The various areas of Samhita told are principles mounted here and utilised. The Yoga branch also contributed philosophy to Ayurveda. These of happy healthy living are to be taken in to the mass stating that the Ayurveda is not just a medicine for disease it is an approach of living means. ' The clinical subjects Kayachikitsa, Shalya Tantra, Shalakya Tantra, Prasooti Tantra' Stree Roga, Koumarabhrtya Tantra, etc. are already well furnished with the subject strategies' But as the clinical practice is concern almost all institutions are facing a big problem. It is necessary to find out how the inrerest and inclination of the patients drags towards Ayurveda. 124 "U oYd trffi ffit*
- 157. PG curriculum restructuring It is glad that the multi faculty management systems are introduced even at Ayurveda. But the rolls back to UG studies are not up that level. 2005 recommendations of the CCIM made enormous mod.:f- cations expanding the branches. Every time it is a big fight between the faculties at the clinical leven- Tne paramedical group of the Dravyaguna and Rasashastra fellows intrude to the clinical and "Arshas" goes to Shalya tantra and "Pradara" to that of stree roga. A clinical medicine or General practice refe;re,; ''Kayachikitsa" is at the stake after the introduction of Manasa roga and also Panchakarma. More branc.:es like Rasayana and Vajikarana also anticipated soon. At this moment of development it is absurd to frg;: against one each other. The limitations of the individual branches are well told but why the Kayachilcr-". i.e. universal clinical (general) medicine is interrupted and punished not known. CCIM recently revised the syllabus. Many recommendations are made to flourish the A1'unei:: glory. Simultaneously many new problems also a rise. For example, Third paper of Kayachikitsa FG formerly having Manasa roga, Rasayana and Vajikarana replaced with Charaka Samhita Uttarartha- Th: contents of the third paper are covered in Nidana and Samanya Chikitsa. 4'h paper formerly Panchakarm:- and as the Panchakarma made another super speciality recommendatory committee felt that there Ls n.- much Panchakarma required any more to Kayachikitsa and condensed to half and further added Rasal'an"r and Vajikarana there. This becomes clumsy and student feels a lot. Simultaneously the purpose ot in- troducing these subjects doesn't justify. A recent controversy came in to lime light. A Kayachikitsa teacher recommended "Pradara as a topic of dissertation to the scholar. It has been refused that as a topic of Prasooti. But the topic is :n Charaka Uttararadha, which is studied and examined in Kayachikitsa curriculum. Such complications ani controversies are many in curriculum. Rajiv Gandhi University of Health Sciences, Bangalore is the first university to implement rh,r latest recommendations of CCIM. RGUHS provide a checklist for the teacher as well as to the schoXar- Many institutions at full length do not properly encourage the ideology, because of not having ar1 significance at examinations. Neither the scholar nor the teachers any interest about these life-mourXding protocols. Marks or merits as followed by the western universities are introduced for the evenrs of rle three years work under taken by the scholar and awarded for the doctorate. Probably exam less r.leir points oriented PG curriculum may solve the problem, of course even at the researches. Revelation starting but not conclusion A long time observational knowledge of ancient Indian scientists contribution expaldal *r-. Ayurveda, treasures of Indians with eight branches of healing nature. Presently losing its glaze under' Ia;k of student teacher communication and insufficient no-confidence promoting curriculum. Here I put forth few of the suggestions for revelation starting but not conclusion, which are ar d'le interest of developing and interfering the scientific attitudes of the forth coming prospective Alun'eda. Thinking Ayurveda as back door entry to become doctor to practice medicine is to be prevented and rna.Je the Ayurvedic physician to practice precisely Ayurveda. Ayurveda made easy taking out conflicrive. confusing, non-communicative language orientation and unnecessary Sanskrit implicationt don* rn,;r1', unworthy English translations. The oriental language and the authorized scientific language Sanskrit is broughr back ro rhe Ayurvedic students as medical Sanskrit. 125 I ffi
- 158. Ayurvedic students should be taught with Vedic Physics, Vedic Chemistry and Vedic Biology but not unnecessary History. Last but not least the curriculum has to take a specified diversion either Samhita oriented or subject oriented, if not this makes confusion to student to stand at cross roads. At this juncture a full-length understanding of Ayurveda is necessary to shine and propagate with true scientific values. If not tomorrow's India praise, honour and recognize the foreign studied Ayurveda specialist as Herbalist. r After so much of me, my-self, my professional shadow interactions even though no specific con- I i l crete critical faculty rationalistic attitudes are brought out, one thing is certain, if we do not rouse at this l jiffy, the world will move front, leaving us behind. T rS 126 w, os6 6W 1ffi1't'=
- 159. : NON.INVASIVE PROCEDURES IN ARSHAS / HAEMORRHOIDS o Dr. P. Hemantha Kumar lI. S. '?t:i',":;"'J;gl,?":;::*Xff Jtri;L'j,lfi Jilff *T qmAyurveda has immense potential to help in the solution of many challenging and unresolved problems of Medical science. Since time immemorial, Ayurveda has been showing the ideal way of living. which promises a disease-free, happy and long life. The Shalya Tantra a prime branch is rich in many aspects of modern surgical concepts. Ayun,edic classics have described various treatment modalities like Medical, Surgical, and Para surgical in Arshas. Now a day parasurgical procedures like Kshara karma (Caustic Cautery), Kshara Sutra (Caustic Thread). Agnikarma (Thermal Cautery) and Raktamokshana (Blood letting) are more popular than other treatmenr modalities of Arshas. These procedures are simple, very safe, effective, ambulatory, and minimal or no complications, unhazardous, negligible recurrence rate and easily acceptability by the patients. There is minimal interference in patient's routine work. It is also effectively administered to age patients and those unfit for work. Acharya Sushruta, the father of Indian Surgery described about this disease in detail in his Sushruta Samhita. The prime etiopathogenic factor of Arshas is Mandagni i.e., hypo function of digestive en- zymes, which in turn leads to Constipation, prolonged contact of accumulated mala or excretory material to Guda vali causes development of Arshas. CLASSTFICATION OF ARSHAS I I 1. Vataja Arshas: Dry, hard, painful, different shapes, centrally irregular surface, different colours I I of fleshy masses associated with constipation, pain radiating to perineal region during defaecation.It ma1' be comparison with the sentinel piles or external piles, hypertrophied papillae, anal warts or condyloma i accuminata and painful conditions. 2. Pittaia Arshas: Small, bluish, moist, fleshy mass of different shapes enlarges during straining with passage of blood mixed stools and burning sensation during defaecation, causing faintness, thirst, shock etc .It may be comparison with thrombosed haemorrhoids. t 3. Kaphaja Arshas : Broad-based, smooth, fixed, oval, fleshy masses and does not suppumre, severe pruritis and passing of mucous containing stool. It may be comparison with Fibrosed piles & F External piles. r 4. Raktaja Arshas : Fleshy masses which bleeds excessively during defaecation, usually associ- p ated with blood loss symptoms. It may be comparision with bleeding piles. 5. Sahaja Arshas : Genetically determined, ugly appearance, fleshy masses, with immuno-com- promised symptoms. It may be considered as Familial adenomatous polyps. 6. Tridoshaja Arshas : Mixed features of all the above doshas, clinically resembles anr, malig- nant growths in anorectal region. 127 73 q tr ffi
- 160. ANUSHASTRAS KARMA / PARASURGICAL PROCEDURES 1. KSIIARA KARMA (Caustic therapy): Kshara karma is more effective than the other modalities of treatment, because they can administer both internally and externally. Kshara karma is useful as the substitutes of surgical instruments, because they can be used safely on the patients who are afraid of surgery. PRATISARANEEYA KSIIARA : Indications of Pratisaraneeya Kshara in Arshas - Soft, spread out, deep rooted and elevated type of Arshas. According to doshic involvement mild Kshara should be used in Pittaja and Raktaja Arshas and stronger Kshara in Kaphaja and Vataja Arshas. Mode of Action of Pratisaraneeya kshara in Arshas Pratisaraneeya kshara acts on haemorrhoids in two ways (l) It cauterizes the pile mass directly because of its ksharana guna (corrosive nature). (2) It coagulates protein in haemorrhoidal plexus. The coagulation of protein leads to disintegration of haemoglobin into haem and globin. Synergy of these actions result in decreasing the size of the pile mass. Further, necrosis of the tissue in the haemorrhoidal vein will occur. This necrosed tissue slough out as blackish brown discharge for 3 to 7 days. The haem present in the slough gives the discharge its colour. The tissue becomes'fibrosed and scar formation seen. The haemorrhoidal vein obliterates permanently and there is no recurrence of haemorrhoids. 2. KSHARA SUTRA (Caustic thread) : The Kshara sutra is a Para surgical measure capable to perform excision slowly by virtue of its mechanical pressure and chemical action. Acharya Sushruta advised in Nadivrana and Bhagandara. Chakrapani (11'h century) in his treatise chakradutta has given reference of Kshara sutra preparation by smearing repeatedly the latex of Snuhi and Haridra powder in the treatment of Arshas- The Standard Apamarga Kshara Sutra is prepared by repeated coatings of Snuhi Ksheera, Apamarga Kshara and Haridra churna. The order of coatings is divided as follows: Mechanism of Action: -Kshara sutra by its action i.e. Chemical Cauterization and Mechanical strangulation of the blood vessel causes local gangrene of the pile mass tissue and ultimately resulting in falling out of the mass within 5-7 days. The healing of the resulting wound takes 10-15 days. 3. AGNI KARMA (Thermal Cautery) Agni karma is an important Para surgical measure and is still used extensively in the surgical practice in modified form by way of electric heat cautery and freezing. It is regarded as superior to other surgical and Para surgical procedures because of non-recuffence of the disease. When it is properly employed, it can destroy the tissue in the lesions which are incurable by other measures. Indications : Agnikarma is indicated in rough, fixed, broad and hard type of pile masses. It is also advised in Vataja & Kaphaja Arshas and those which are prolapsed and dosapurna (thrombosed or infected piles) type of arshas. w 128 R# ffi
- 161. Mechanism of Action - ,/ Agnikarma considered as superior most, due to its no recurrence inherent qualitv and cure the disease from the root. / Excision and scraping action. ,/ It is having effect of Nirjiwanukaran (Sterilization), the pathogens will destroy and chances of infection are rare. / Haemostatic action- The bleeding will stop due to vasoconstriction. So wound u'ill heal quickly. ,/ Involvement of Agni Mahabhuta is seen in application ofAgnikarma. ,/ Agnikarma subsides Vata and Kapha dosha and aggravates Pitta dosha. ,/ Chedana of Sthayi dhatus like Twak, Mamsa & Medas. ./ Agnikarma both Dosha (vata,kapha) and Dooshya (twak, mamsa. medas) Pratya)'anika chikitsa for the complete cure of the Arshas. 4. RAKTAMOKSHANA (Blood letting) : Sushruta advised blood letting in protruding type of Pile masses. But Vagbhata advised local blood letting in such type of Arshas where vitiated blood is retained and the Arshas is inflamed and hard. Charaka also advised local blood letting with the help of leeches, knife, needle etc. to let out the vitiated blood" Mechanism of Action - o Anticoagulant effect - Hirudine present in the leech saliva acts as an anticoagulant in addition to its clot dissolving and anti-platelet functions. o Local Anaesthetic effect - The leech saliva contains mild anaesthetic agent to relieving the pain in inflamed condition. PATHYA (Do's) 1. Anna varga: Godhuma, Yava, Rakthashali, Sastika, Kulattha, Priyangu. 2. Shaka varga: Surana, Nimba, Patola, Vartaka. Punarnava, Shigru, Balamuli. 3. Ksheera varga: Aja ksheera, Chaga ksheera, takra. 4. Phala varga: Amalaki, Kapittha. 5. Ahara upavarga: Palandu, Nagara, Maricha. 6. Mamsa: Mruga mamsa. APATHYA (Don'ts) Ahara : Viruddha ahara, Vistambika ahara, Guru ahara, Anupa mamsa, Dusta udaka etc. etiolo-si- cal factors. Vihara : Vegaavarodha (Suppression of natural urges), Ati Streesanga (Excessive sexual act) I 129 w ffi a..g w .f-SF
- 162. A STUDY OF CLINICAL EFFICACY OF JANU TARPANA IN SANDHI VATA (osrEo ARTHRlrls) OF KNEE o Dr. R.N. Pradhan u.e(puu-Adm), M.D (Avu) Kerala, P.G.C.R (Mumbai) INTRODUCTION Now nonsteroidal, anti-inflammatory drugs (NSAIDS) are widely prescribed for the management of osteoarthritis(O.A). Various short and long term adverse events limit their usages. Very few safe remedies available for the management of osteoarthritis. According to Ayurveda "SANDHIVATA" is caused, when prakupita (excited vata), kames its place in sandhi, and causes signs and symptoms of Sotha (in flammation fo sandhis), Sandhis feel like vatapurna Druti, (Air filed bag) on touch There is pain during Akunchana (Adduction /(Flexion) and prasarana (Abduciton / extension ) of the bodu parts. Sandhivata may be related to Osteo Arthritis, which is a degenerative disease of weight bearing joints. When management of joint disorders in Ayurvedic medicines , this is recommended that to manage vitiated Vata Dosha(the main causative factors )of sandhi yyadhi (oint disorders), the patients to under go, (i). Snehaana (Olearion), (ii) Svedana (Thermo therapy), (iii) Mridir virechana (mield laxative) (Iv) Niruha vasti (Decoction enema), (v) Nashya (Enihine therapy) and (vi) Vatanulomana treatment. (ii) Rakta (blood) dhatu, when vitiated along with Vata Dosha. then procedure of Rakta mokshnana (Removal of vitiated blood from body) is indicated with Jalauka (leech ) or siravyadha (vein puncture) iii. Ama Dosha along with vitiated Vata Dosha leads to joint disorders, then Langhana (Fasting) , administration of Tikta-katu and Agni Sandipana drugs is recommended . iv. Treatment like kashaya vasti, Aruvasana Vasti, Katitarpana is also indicated in Sandhivata (O.A.) AIM OF STUDY The present study was planned to evaluate the clinical efficacy and safety a "JANU TARPANA" on patients suffering from OA of the knee. STUDY DESIGN This study was a prospective climical trial and was conducted at department of panchakarma , Govt. Ayuvedic Hospital, Bhubaneswar , Orissa . The study protocol , case record forms and informed consent forms of the patient is duly maintained. MATERIALS AND METHODS Inclusion Criteria One hundred ambulatory patients of either sex, who attended the out patient clinic of the Depart- ment of panchakama Govt. Ayrvedic Hospital, *S 130 ,ffi #^M6
- 163. =:-- Bhubaneswar, Orissa, with clinical and radiological evidence of O.A of the knee (tibiofemoral joint ) were included in the study. All the patients had clinical symptoms of OA over a period of 3 years , prior to the study and were suffering from moderate to severe knee pain ( with or rvithout morning stiffness of & 30 minutes duration). The patients those, who were attending for treatment had radiolo-eical evidence of O.A with findings like osteophytes, marginal limping, narrowing of joint space. sharpened articular margin or sclerosis (damaged, thickened, eburrated subch ondral bone) EXCLUSION CRITERIA Patient suffering form Hypertension, renal, hepatic or cardiac failure, those who are taking corti- costeroids treatment , patients with biochemical and clinical evidence of Rhematoid Arthritis (RA) or Gout and patients, those, who were unwilling to attend for specific treatment were excluded from the study . STUDY PROCEDURE All the 100 patients were divided in 2 groups of 50 in each group, such as Group as Group A and Group B. The Group A patient was treated of medicated oil 80 ml some as "JANU VASTI" and 80 ml of oii atravasti respectively to the two group of patients . Group A and Group B patient was treated "JANU TARPANA" and "MATRA VASTI" respec- tively. A detailed medical history of all the patients was recorded and symptomatic evaluarion was done using the scoring system (sign and symptom score). Group -B patient were identical as compared to the demographic parameters and sign and symptom scores, which is included number of involved joints . level of joint activity (eg. difficulty in climbing steps), joint mal function, degree of pain and secondan, muscle wasting . A complete systemic and joint examination and blood investigations (ESR, ASOTire. CRP, Uric Acid) and liver functions test were done . Radiological examination of the affected joint rvas carried out for osteophytes , sub chondral sclerosis, trabecular hypertrophy , thickening , fracrure cratering , cartilage proliferation calcified cartilage layer fibrosis, crystal deposition and viscosity of synovial fluid. Group "A" patient was administered ,, JANU TARPANA" and Group -B patients administered "MATRA VASTI " for 14 days in each month, continuously as per treatment scheduled for a period of 90 days " FOLLOW UP AND ASSESSMENT Group A and Group B patients were followed up for 3 months . A clinical examination rvas done after the completion of each month . A complete biochemical and radio graphic evaluation was done ar the end of 3 months. PRIMARY AND SECONDARY END POINTS The predefined primary efficacy endpoint was a decreased in the disease progression as evident by the reduction in the sign and symptom scores at the end of 3 months. The secondary safety end points were incidence of adverse events and patient compliance tb the vasties. Adverse effects t All adverse effects either reported or observed by the patients, were recorded with information about severity date, of on set , duration and the theraputic measures as advised at the time of continuation of treatment. 131 u a-E e d6 ^ew,kz tYp
- 164. l RESULTS j l All the enrolled 100 patients completed the study duration and there were no drop outs. j There was highly significant (HS) reduction in the mean number of involved knee joints, (i) Joint swelling (ii) pain (iii) joint malfunction (iv) secondary muscle weakness (v) and difficulty in climbing l steps, (vi) in rhe "JANU TARPANA " group after 30 days on wards till the end of the study in j comparable to Group -B patient . In Group -B patients, those, who have under gone "MATRA VASTI" has not shown marked imProvement . No clinically significant changes was marked in the Biochemical ,Haematological and Radio- graphic parameters . There were no climically significant adverse reaction was reported by the patient at the time of treatment. Over all marked improvement is Excellent in Group A patients and Fair in Group-B patients . The excellent beneficial actidns due to ingredients in Valiya Narayan Taila 20ml + Murivena 20ml + Valiya prasaranyadi Taila 20ml + karpooradiTil might be due to synergism to anti imflammatory analgesic dnd depress cutaneous sensory pain receptors, acts directly to diminish or oblit- erate pain increases mobility of the affected joints. CONCLUSION The comparative clinical trial was conducted to evaluate the efficacy and safety of 'KATI TARPANA" in sandhi vata of knee. The study observed an Excellent reduction in the mean scores of pain intensity at the involved area, pain intensity at the adacent area , swelling and tenderness at the involved area and overall function improvement of the local /joint mobility of Group A patient and Fair improvement in Group -B patients. There were no climically significant side effects and overall compliance to the treatment, was Excellent . The Excellent beneficial effects " KATI TARPANA" were due to anti imflammtory analgesic and potent local healing ProPerties. This can be concluded that "JANU TARPANA" is effective, safe and without any adverse effects and has Excellent tolerability profile in the treatment of "SANDHMTA" of knee joint. I T 132
- 165. QUALITY ASSURANCE IN AYURVEDIC PHARMACY o Dr. Sathyanarayana B. Principal, Muniyal Institute of Ayurveda Medical Sciences, 'L{-TP.{I Success in Ayurvedic treatment greatly depends on the quality of the medicines used. A ph-vsician becomes helpless if he is provided with the substandard medicines. In the present day scenario, physician does not have a direct control over the preparation of the medicine. Ayurvedic pharmaceutical indust4" is having a substantial part playing in the commercial market. The fact that around 10000 Ayun'edic medicine manufacturing units are present in India, indicates the potentiality of the of the Ayurvedic pharmaceutical companies. But, unfortunately, majority of them are below the minimum standards. not at all following any quality control procedures and not having the commitment to quality. GMP guidelines are even though good, are not being strictly implemented. Statutory bodies have miserably failed in strictly implementing the quality norrns in these manufacturing units. Qualrty should become a habit not a compulsion. Quality conscious companies will go for the certifications like ISO 9001:2000 which effectively helps in implementing QMS (Quality Mana-eement System). Professional approach for quality management as seen in other industries and sectors is lacking in Ayurvedic people. This can be overcome by the commitment for quality assurance. t i PLAN : Establish the objectives and processes necessary to deliver results in accordance with the specifi- cations. DO Implement the processes. CHECK Monitor and evaluate the processes and results against objectives and Specifications and report rhe outcome. ACT Apply actions to the outcome for necessary improvement. This means reviewing all steps (Plan. Do, Check, Act) and modifying the process to improve it before its next implementation. PDCA was made popular by Dr. W. Edwards Deming, who is considered by many to be the father of modern quality control; however it was always referred to by him as the "shewhart cycle." Later in Deming's career, he modified PDCA to "Plan, Do, Study, Act" (PDSA) so as to bener describe his recommendations. In Six Sigma programs, this cycle is called "Define, Measure, Anall'ze, Improve, Control" (DMAIC). 133 u w, ffi# ffi
- 166. pDCA should be repeatedly implemented, as quickly as possible, in upward spirals that converge is basedon the understanding that on the ultimate goal, each cycle closer than the previous. This approach our knowledge and skills are always limited, but improving as we go' over time and with better knowledge and skills, PDCA will help define the ideal goal, as well as help get us there' for its For example, when we wish to introduce a new formulation(classical or proprietory)' successful introduction we can follow this PDCA principle. First, we have to plan i'e, decide which reference is to be followed, plan the required infrastructure for manufacture and quality control, man power, Space, machinary, ,u* *ut"riuls, time frame, expertise etc. According to the selected reference batch size, have an idea form SOp and manufacture control sheet, quality control proforma, decide the about th possible problems that may come across and possible solutions. After such planing do the Then check each and every preparation i.e. implement the whole process as planned with all precautions. pro""r, carefully till the packing and dispatch. If any intervention, preventive action' correction' lead to the successful corrective actions are needed act accordingly. This PDCA principle will certainly i.e. find out how production and market of the product. Then one has to follow continual improvement output, turn around nu. you improve the process in subsequent batches. It may be in terms of quality, time, economy etc. Quality control or services In manufacturing, quality control is involved in developing systems to ensure products are designed and produced to meet or exceed customer requirements. Total qualitY control Total Quality control is the most necessary inspection control of all in cases where, despite sales decrease' statistical quality control techniques or quality improvements implemented, did not include The major problem which leads to a decrease in sales was that the specifications the most important factor, "What the customer wanted"' overall business The major characteristics, ignored during the search to improve manufacture and performance were:- o Reliability o MaintainabilitY o Safety As the most important factor had been ignored, a few refinements had to be introduced: 1. Marketing had to carry out their work properly and define the customer's specifications' 134 *S ffi ffi
- 167. 2. Specifications had to be defined to conform to these requirements. 3. Conformance to specifications i.e. drawings, standards and other relevant documents. u,ere introduced during manufacturing, planning and control. 4. Management had to confirm all operators are equal to the work imposed on them and holidal s. ce1ebrationsanddisputesdidnotaffectanyofthequality1eve1s. 5. Inspections and tests were carried out, and all materials, bought in or otherwise. conformed to the specifications, and the measuring equipment was accurate, this is the responsibilitl' of the QA/QC department. 6. Any complaints received from the customers were satisfactorily dealt with in a timely fashion. 7. Feedback from the userlcustomer is used to review designs. If the original specification does not reflect the correct quality requirements, quality cannot be inspected or manufactured into the product. The above forms the basis from which the philosophy of Quality Assurance has evolved, and the achievement of quality or the "fitness-for-purpose" is "Quality Awareness" throughout the companl'. T 135 sdf 7.-g aY# ,ffi tf+t*
- 168. CONCEPT OF SWATHVRITTA . Dr. Ashok Kumar Fanda, M.D" (AYu) Research Officer Incharge, Regional Research Institute (Ayurveda), Gangtok' Sikkim^ Nature is one symphony and plays dance in perfect abundant in the body. When our rhythms are in perfect harmony with the rhythms of the cosmos then we feel energetic, vital, joyful, creative, com- fortable within us and tuneck in. Good health is the harmonious interaction with all elements and forces within us and those within nature. INTERACTIVE PRINCIPLE : COSMOS NATURE BODY MIND SOMA MATER KAPHA TAMA SOORYA FIRE PITTA SATVA ANILA AIR VATA RAJAS NORMAL FUNCTIONS: . KAPHA -Cooling effect, unctuous. PITTA - Balance metabolic and enzymatic. V ATA- Bio-Motive force E,XAGGARATED FUNCTION: . KAPHA - block the channels PITTA - irritant VATA - dryness & break the channels' avarana NATURAL RYTHMS (l) Diurnal rhythms - the spinning of the earth on its own axis in a 24 hr cycle known as .Circadian rhythms'. Synchronizing our daily routine with the natural daily rhythm enhances health i.e Dinacharya. (2) RYTHMS OF SEASON : , The earth revolves around the sun causing seasonal rhythms that run throughout the year. Mainly three seasons we feel Winter (kapha), Summer (pitta), Autumn (vata). *W 136 oid ffi 1<l'
- 169. (3) I-UNAR RYTHMS : The earth. sun and moon move in relationship to each other in relation to planets. The human menstrual cycle is a lunar cycle. We also observed that diseases like Unmada, Sleepada affected by lunar rhythms. Changes to electrolytes and osmosis are effected by kapha aggravation during the full moon. b1" pitta during the mid-cycle (half moon) and by vata in dark moon. (4) TIDAI- RYTHMS: - ' Gravitational force effects of the sun and moon on the earth cause the rhythms of the ocean tides .The body fluids are similar to the ocean. High tide is vata; low tide is kapha and in between is pitta. We always trying to tune our body with the movement of the cosmos and if rhythms u'ere fail to adjust by our body, then it is called as diseases. Our science codified certain laws for promotion of health. preservation of health, restoring the health when it is impaired and to minimize suffering and distress. A successful prevention can fulfilled the goals and it depends on the knowledge of cause (nidana), dy'namics of kriyakala, origin and site of the diseases, mode of transmission, identification of risk factors and risk groups and available prophylactic and treatment measures. Primary and Secondary prevention are the ne" concepts in preventive medicine for speciai attention and continuous evaluation of chronic diseases. (A) VIKARA ANUTPATTIKARA (PREYENTION): - (1) Primary prevention (2) Secondary prevention (B) VIKARA PRASANANA (INTERVENTION): . (l) Sodhana (2) Samana (1) PRIMARY PREVENTION : Many people coming to us for the prevention of malaria. measles, chicken pox etc. Primary prevention can be defined as the measures taken prior to the onset of diseases, which will remove the possibility of future diseases. It signifies the intervention in the pre pathogenic phase ( Sachaya, Prokapa, Prasara and Sthanasamsraya stage ) of diseases or health problem ( Low birth weight ). The measures designed to achieve are promote general health and qualit5' of life by Kamya Rasayana and specific protective methods by Naimitika rasayaya. The concept of Priman, prevention is now being applied to the prevention of chronic diseases such as Coronary heart diseases. hypertension, diabetic and cancer based on elimination or modification of risk factors. Primarl' prevention is a holistic approach. Ayurvedic medicine can be widely implemented for Primary prevention due to is safety and cost effective. Now Primary prevention has identified with health education and the concept of individual and community responsibility for health( Satbrutta).the following points can be considered for discussion of primary prevention. (2) SECONDARY PREVENTION : People consult us to prevent second heart attack. stroke and prevent congenital anomalies of forth coming child. Secondary prevention can be defined as 'the action which halts the progress of a disease at its incipient stage ( Purba rupa & rupa ) and prevent complication ( upadrava ). The specific interventions are early diagnosis and adequate treatment. Secondary'prevention is largely the domain of Ayurvedic practice, but it is still a matter of research interesr- In case of Hemiplegia (Pakyaghata), Secondary prevention is an important tool in the control of disease process and further attack. 137 "B ffid 6tr {4S}5'
- 170. GENERAL : Do not unnecessarily provoke nor suppress the 13 urges, which are natural bodily functions and necessary for proper health and functioning of the mind, emotions and body, as this may lead to serious health problems and various diseases. (B) VIKARA PRASAMANA (INTERVENTION) : As you know "vikara dhatu vaisamya" when tridoshas, sapta dhatu and trimala along with ojas undergo changes due to (i) asatmendriyarthasamyoga (ii) prajyaparadha (iii) Parinama Sometimes creates the irreversible changes in the dhatu. Patients got complications, where we it need the intervention. Intervention can defined as any attempt to disturb or interrupt the usual sequence in the development of disease (Kriya kala). This may be the provision of treatment (chikitsa), education, nutritional change (pathya) and avoid the etiological factors. Now a day five modes of intervention have been designed- these are (1) Health promotion (2) Specific protection (3) Early diagnosis and treatment (4) Disability limitation (5) Rehabilitation. Heahh promotion: - It is the process of enable people to increase the awareness to control the disease and improve the health. Among the efforts, health education is the most cost-effective and large number of diseases can prevent without medicine. Health education is the information regarding disease, Dinacharya. Ratricharya, Rutucharya and Sadbruta. Other aspects are,.(I) environmental modificationby safe water, improve housing and sanitation. (11) Nutnfional change comprises food distribution and nutritional improvement in poor people. It also the program to change unwholesome diet (apathya) to wholesome diet (pathya).(iii) Change of life style is the method to changing views, behavior and habits of the individuals. (1) Specific protection;- To avoid the disease, one should immunized against the available dis- eases, protection against occupational diseases and protection against accident. (2) Ear$ diagnosis and treatment can possible if the detection of dosa, compensatory mechanism and functional change are reversible. This is of particular importance of chronic diseases. (3) Disability limitation: - When a patient reports in bheda stage (late pathogenesis phase) then the mode of intervention is disability limitation. In Ayurveda, maximum patients are being reported to our hospital after modern medication and almost all are in advance stage. So the objectives of this intervention is to prevent of disease process from impairment to handicap. Disease- impairment- disability- handicap Sroke (Pakhyaghata)- disease. Loss of function of one side- impairment. Cannot walk- Disability. Unemployed- handicap. Rehabilitation is defined as the combined and co-ordinate use of medical, social, education, and vocational and spiritual measures for training and re- training the height possible level of functional *S 138 't!-g nE# Wr W
- 171. ability. Ayurveda can contribute to restore the function by the purification therapy (Panchakarma) and Rasayana. The following areas of concern are in rehabilitation. (a) Medical rehabilitation- restoration of function (b) Vocational rehabilitation- restriction of the capacity to earn a livelihood. (c) Social rehabilitation- restoration of family and social relationship. (d) Psychological rehabilitation - rpstoration of personal dignity and confidence. DISCUSSION : Now a days maximum people are interfering unnecessary matters (atatva), which is no ways related with them, this type of physical and psychological interference imbalance the internal environment of us. It triggered the reflexes and vibrates the regulation of nervous, endocrine and immune system. We always emphasized prevention is better than cure. Ayurveda give us routine that balanced over doshas with the change of cosmos. Give little thought to your daily routine, amazing the events and activities of your life for your optimum well being. Ask your self whether your commitments. habits and preferences are benefiting or disturbing your doshic balance. Modern living style can pressure you that you have little choice over many aspect of your life. don't despair. The accumulated benefits arising from the small change you made will make a noticeable difference to you. I 139
- 172. ROLE OF YOGABASTHI IN THE MANAGEMENT OF GRADHRASI o Dr. Muralidhar P. Pujar, o Dr. Santosh Bhatted, o Dr. Ashvinikumar M. Gradhrasi is the most common problem observed in our day today practice. The reason behind this is the altered life style. It is common for all group of people like the officials, sales men. Athletes, formers etc. Improper sitting posture, continuous and over exertion, Jerky moments while journey, jerks during the sports etc are the most common causes for the complaint. Its prevalence is 40Vo in the population and increasing 5 Vo every year. Gradhrasi is the common cause for the disability in the patients under the age of 45 years. 50Vo of the adult patients are admitting to the hospitals with the complaiqts of Gradhrasi. Anal route is the most common route of drug administration in the management of various vatavyadhis. Hence Bastichkitsa has been selected here. Eranda is said to be as best Vatahara and Gradhrasihara drug, hence the Erandamoola Kashaya has selected for the Nirooha basti and Sahacharadi taila is indicated in vatavyadhis which are characterized by the difficulty in movement. Hence the Sahacharadi tails has selected for the Anuvasana basti. The Course of basti karma is selected hare is Yoga basti with 5 anuvasana basti and 3 nirooha basti. Objectives of the study : with Sahacharadi taila) in the management of Gradhrasi. ' Drug Review Eranda is having Madhura rasa, Snigdha Teekshna and Sookshma guna. Ushna veerya and Madhura Vipaka. Amylase, Ricin Recinine are the chemicals present. On dosha it acts as Kaphavatahara and it is indicated in Gradhrasi, Katishula, Hritshula, Amavata, Kushtha, Ardita etc. Ingredients of Sahacharadi taila are Sahachara, Devadaru, Nagara (Shunthi) and Tilataila. Sahachara is having Tiktha and Madhura rasa, Ushna veerya and Katuvipaka, and Kaphavatashamaka. Devadaru is having Tiktha rasa, Snigdha guna Ushna veerya, Katuvipaka and Kaphavatashamaka. Shunthi I is having Katu rasa, Laghu and Snigdha guna Ushna veerya and Madhura Vipaka and Kaphavata shamaka. The drugs which are selected here all are having the Snigdha guna Ushna veerya and Katu Vipaka, hence they acts on both Vata dosha and Kapha dosha. The dosha involved in Gradhrasi are Vata and Kapka and Basthi karma is the vatadosha pratyaneeka Chikitsa. Preparation of Erandamooladi basthi : , Erandamoola Kashaya 300 ml Sahacharadi taila 100 ml Pootoyavnyadi kalka 15 grams 140
- 173. F{oney 80 rnl Sanidhava lavana 5 grams Total 500 ml Dose of Anuvasana basti 80 ml Procedure done as exPlained in the texts. Course : Yoga basti; Anuvasana Anuvasana 10 patients who fulfill the following criteria were selected for the study from IPD of SDI'I Ayurveda Hospital Hassan. Diagnostic Criteria : like Stambha Ruk, Toda over the Kati Prushtha Uru Janu Jangha pada in order Inclusion criteria : Exclusion criteria : $elf gradation was given to all the symptoms for assessment' Observations: patients of both the sex were selected for the study. Patients of age group ben{een class people and 20 to 60 years were selected. Maximum patients were of businessmen. The middle patients from urban area were more in the clinical trial' and after the Results: The self gradation was given to the symptoms and were assessed before shows the result after treatment. Statistical anuiysis was done by students't' test. The following table completion of a course of Yogabasti treatment' 141 b" I
- 174. Mean Scymptoms SD SE t p Remarks Mean BT Mean AT Ruk 3.9 1.9 0.516 0.163 8.589 <0.001 FlS Toda 2.3 0.9 0.966 0.305 4.583 <0.05 SS Pain on standing 3.2 2.4 0.632 0.200 6.00 <0.001 HS Walking distance 3.r 2.0 0.3216 0.100 1r.00 <0.001 HS SLR test 2.9 1.8 0.568 0.180 6.r28 <0.001 HS Conclusion: yogabasti with Erandamoola Kashaya and Sahacharadi taila provided significant results in reliving the Ruk with 58.3Vo, Sthambha with 65.3Vo, SLR test 44Vo, standing capacity 59Vo and walking distance 61Vo and shows highly significant results. * Asst Prof & HOD, Dept of PG studies in Panchakarma, SDM College of Ayurveda. Hassan ** Lecturer, Dept of PG studies in Panchakarma, SDM College of Ayurveda, Hassan r l xxx lsg1s1s1, Dept of PG studies in Panchakarma, SDM College of Ayurveda, Hassan 142
- 175. HOLISTIC APPROACH TOWARDS HEALTHY AGEING o Dr. Managalagowri V. Rao. M.D.Ayu.'LecturerinSwasthaVfitta,DepartmentofBasicPrinciples'I.M.S..B-H.L Introduction : Every man,s scare, a multi factorial and inevitable biological phenomenon is ageing. The propor- Even from the ancient time tion of elderly people is constantly increasing along with age related diseases. we have reference of yayati who feared foi ageing & exchanged the youthfulness of his son Puru' ln ancient science of Ayurveda measures to postpone ageing the rejuvenation in the forrn of food' medicine where sages lived & behaviors have been explained. If we refer back to ancient literature lot of contexts for hundrecls of years without any ailments can be traced' The reasons for their long & healthy life can be taken as- Healthy life style, Healthy food. Mental peace Even though it is impossible to adopt all the things certain changes in life style like practice ot as well as to over corne rejuvenating diet, medicine Yoga will certainly help to prevent many diseases many problems related to ageing. phenomenon Ageing-Ageing is a terminology representing multi factorial, inevitable biological characterized with many changes in the body' The person may suffer from common disease like Hypertension Arthritis. Hearing & I'ision peripheral vascular disea-se- impairment, coronary artery disease, chronic lung diseases. Diabetes mellitus, sleep disorder' cancer, parkinson's disease cerebro-vascular disease, prostate disorders, osteoporosis Depression & mood disorders' Dementia etc. Factors for Ageing : tripoth- Environment factor & genetic factor are two main factors responsible for Ageing. Different esis have been put forward regarding the causes for ageing. Free radical theory is one of the acceptable theories. Free radical & tissue injury mechanism : Free radicals are molecules or fractions of molecule having unpaired electron in their oi]ter nnosi enz mes ca"sins orbit. The free radicals cause the destruction of cell membrane, modify or inactivate attack t-he protein injury, interfere with carbohydrate metabolism leading to improper release of energl'- blood fat leading to atherosclerosis and decrease HDL cholesterol which are protective against hean and i t arterial diseases. Oxy radicals dis -differentiation hypothesis of ageing I : i t Oxy radicals react with genetic apparatus of cells leading to production of different and ineCl'-ient cells. t 143 --E E# ' l'-J +#+( #tr I
- 176. Ageing is a biological phenomenon associated with imbalance between oxidative stress, pro oxi- dants production & antioxidant protection system. According to Ayurveda : Parinama can be taken as the factor for Ageing Especially is factor for ageing. 'Jara' or ageing is a natural process which may be timely or untimely (Su.Su. ) . Now-a-days early onset of ageing is common with the symptoms like wrinkling, graying etc. Improper food, unhealthy life style and mental tensions are important in the onset of early ageing along with the environment pollution which is an unavoidable factor in this scientific era. These enhance the release of free radicals and fasten the process of ageing. Causes for Apacaya in old age : 1. Old age is predominant with vata which is appreciated in each and every structural & func- tional unit of the body. Vata is responsible for depletion of tissues that is. 2. Due to vata the patient will have visamagni and jatharagni mandya which leads to impairment of digestion & assimilation of food which leads to depletion of dhatu & intern vata vrddhi. 3. This will lead to depletion of ojus which leads to reduced immunity. Characters of depletion Rasa- Rough skin, wrinkling, hair, graying (graying & hairs) Rakta- Rough skin, appearance of patches on the skin, diminishing of beauty, loss of elasticity of wall Mamsa Flabby muscles, hollow cheeks, mild joint pain, dryness, general weakness Medas Numbness in different parts of the body, emaciation, feeling of emptiness in joints, decreased lusture. Asthi Loss of movements , brittle hard nails , cracking of nails. decreased lusture of teeth, gum, lose teeth, increased graying & falling of hair , rheumatic complaints. Majja Brittle bones, dementia, emptiness of bones, giddiness. l Shukra Lack of libido, emaciated buttock, sunken eyes I Aim Our aim is to make elderly healthier & happier by assisting in over coming there psychological, physical & physiological problems by a healthy life style, none other than Rasayana and Yoga. As many of our senior citizens suffer from multiple disor- ders which may need lot of medications, many a times they are not able to with stand the impact of strong medication. Rasayana : Rejuvenation is the ideal therapy which can counter act the above effects. It may be used in the form of food, medicine or behavior. Rasa means essence of food and ayana means circulation. It enhances the nourishment of all tissues and cells. Rejuvenating diet : Milk, Ghee, Rice, Wheat, Green gram, Black gram, Bengal gram, Sugarcane, Honey 144
- 177. Fruits- Grapes, Dates, Almonds, Banana, Papaya, Pine apple, Mango, Gooseberry. Pumpkin Tubers - Onion, Garlic. Amarphophallus, campanulatus. Non vegetarian- Chicken, Eggs Rejuvenating Medicines : Amalaki, Mandukaparni, Yastimadhu, Satavari, Vidari, Atmagupta, Bala, Khadira. tdanga- Silajatu. Lasuna. Bhringaraja, Kasmarya, Citraka, Varahi, Vaca, Bhallataka, Pippali, Punamava. Hariraki. Vibhitaki, Guduci, Sankhapuspi, Aswagandha, Nagabala, Kupilu, Jivaka, Rsabhaka, Meda, Mahameda. Kakoli, Ksirakakoli, Mudgaparni, Masaparni, Jivanti, Madhuka, Aindri, Atibala. Rejuvenating behavior (Acara Rasayana) : Speaking truth, not expressing anger, forbidding intake of alcohol, sexual indulgence, nonviolence. peaceful, speaking sweetly, indulging in meditation, penance giving alms, respecting elder, cow. brahmin- preacher etc who acts by compassion, does not wake in night, takes ghee and milk daily who knows about place, time etc. properly, who is devoid of ego, acts according to rules will be imparted with qualities of Rejuvenation. Mode of action Some drugs like Ashwangandha and Shilajatu nullify the effects of stress . Drug like Gambhari improve nitrogen balance and promote tissues building. Guggulu clears the channels and enhances the nutrition to all tissues and cells. Amalaki and Bala contain anti oxidants which help in the scavengin_e of free radicals released. Achara Rasayana act as psycho immuno modulator, reduce stress and thus prevent the release of free radicals. Schedule of Yoga for elderly-Padahastasana, Ardha kati cakrasana, Ardha candrasana. Vajrasana- Paschimottasana, Sukhasana, Bhujangasana, Makarasana, Salabhasana, Padottasana, pavanamuktasana- Navasana, Savasana,Pranayama, Nadisodhana, Sitali, Dhyana (Omkar).The asanas can be modified or even change according to persons conditions of health & according to disease. Conclusion : accompanied with diseases. efficiently. I 145
- 178. AHARA THE DYNAMIC PRINCIPLE IN PREVENTION OF DISEASES o Dr. P. Nagaraju MS (Ay) Principal Shri S.B.S. Ayurvedic Medical College, Mundargi' Karanataka INTRODUCTION The Indian System of medicine Ayurveda is the best available health care system. Ayurveda delineates three supports of life Ahara, nidra and brahmacharya, for maintenance of perfect health. Human species is unique in its dietary practices.The drastic changes in food habits due to modernization have led to occurence of incurable diseases. To get excellency of tissues one should have proper nourishment and following the dietic regimen improves the immunological status. The tridoshas of the body get vitiated due to improper diet and regimen, so ahara plays major role in the prevention and cure of diseases.The nutritional imbalance triggers the irreversible degenerative changes in Sapta dhatus.At this juncture a mention of few references from Ayurveda are made so that the nutrition of the dhatus as well as a prevention of diseases is achieved. Here are several ways to boost the immune factor through diet. The citrus fruits should not be taken along with milk. i.e. Milk shakes and fruit salads should be avoided. Banana should not be taken along with milk and Butter milk. Once cooked food should not be reheated. So better to avoid hotel food and Refrigerators. Curd should not be taken during nights.Because Curd causes srotorodha and curd inturn enhances the srotorodha which is naturally seen during nights. Preparations of flour should not be eaten and if taken should be in limited quantity. Chapati, idli, vada etc, should be consumed in proper amount. Rice should be washed properly before cooking, and manda bhaga should be filtered. This rice is good for health. if manda is not removed and if not cleaned properlythen that rice is heavy for digestion Water boiled and reduced to l/4'h is called as ushnodaka. Boiled water is indicated both in health and diseased condition as it reduces kapha,meda and vayu ,removes toxins, stimulates digestive power and causes vastishodana that is the whole urinary tract is cleansed by the ushnodaka . Our acharyas have clearly mentioned that this ushnodaka should not be of previous night . Ghee is the best drug of choice to stimulate the agni that is digestive power.That is in other words the stimulated agni can digest the most heavy foods. The blood vessels are cleansed by the butter milk and enhances the cellularlevel circulation.Butter milk is contraindicated in summer season.Ama takra reduces kapha of digestive system,but amatakra increases kapha of respiratory system.Pakwa takra reduces kapha of respiratory system.Ama takra does not contain any ingredients supakwa takra is added with ingredients like, garlic, ginger etc. Atheroscle- rosis, thrombosis are prevented. *H 146 't!-E ffid w
- 179. Unripened brinjal should be taken. Ripened kushmanda should be taken, as unripened kushmanda is toxic in nature. Unripened banana is constipative and vitiates kapha. Ripened banana is nutritive. Point of interest lies in the fact that one who follow pathya need not take any medicine,one u'ho does not follow pathya need not take any medicine. One should avoid ahita ahara to prevent the attack of diseases as hita ahara alone enhances body resistance,growth and development. : Vagbhata has told that the person who performs exercise regularly and who consumes snigdha ahara and who has stimulated digestive power can consume viruddha ahara and that person is not effected by the illeffects of the viruddha ahara. Eat the proper quantity of food at proper time in right amount. If you want to stay healthl'. 1'or.r need to choose foods thatwill brings balance to your body type. CONCLUSION There fore to conclude with when compared to present day knowledge, Ayurvedic concepts plal an important role to approach to the problem of body resistance.This article is an humble anempt to highlight the dietic procedures of Ayurveda. I 147 ffi M< "ffi
- 180. PELVIC REGION MARMAS IN CLINICAL PRACTICE o Prof. Dr. N. G. Mulimani, H.O.D. Shareera Rachana, N.K .Jabshetty Ayurvedic Medical College & P.G Centre, BIDAR INTRODUCTION : The concept of marma has been one of the most important subject of Ayurveda. In ancient days the knowledge of anatomy was mainly supplied by the concept of marma. Acharya Sushruta was first scholar provided a detail knowledge of marma in his shareera Stana under the Pratika marma Nirdesha Shareera. The knowledge of marma was consider as half the knowledge of surgery in ancient days and surgeons were advised to be more careful about the extent of vulnerability of marma while performing a surgery over these areas leading to complications. As such there is no classification of marmas particularly concemed to pelvic region in our ancient samhitas. By seeing above importance of pelvic region in the regional study of anatomy, marmas of this region is need Table Showing the Marmas of Pelvic Region : Name of Numbers Structural Regional Parinamanusara Pramana marma classification classification Classification l Guda I Mamsa Udaragata Sadhya Pranahara 4 anguli I Dhamani Basti 1 Snayu Udaragata Sadhya Pranahara 4 anguli Virapa 2 Snayu Adha Shakhagata Vaikalyakara I anguli Katikatavuna 2 Asthi Prustagata Kalantara Y2 anguli Kukundara 2 Sandhi Prustagata Vaikalyakara t/. anguli Nitamba 2 Asthi Marma Prustagata Kalantara Pranahara % anguli DISCUSSION : The marma situated in pelvic region are Guda, Basthi, Vitapa, Kateeka Taruna, Kukundara, Nitamba. Apart from these Astasrotogata marma are also located in this region. In reference to surgical management of ashmari and advised to be cautious about these marmas. They are Mutravaha, Sukravaha, Mushka Srota, Mutraprzrseka, Seevani, Yoni (vaginal cavity), Guda, Basti. Guda marma : It is mamsa marma situated at the perineal region. it is the terminal end of elementary tract and considered as sadhyapranahara four anguli pramana. This is also included under dasha pranayantana. The anal canal alongwith anal sphincter within the vicinity of the panitala pramana is identified as marma. The sudden stretch reflex leading to shock. During the intervention of basthi netra, per rectal examination the physicians must take more care of this marma because sudden stretch, kshara sutra, reflex leads bad irreversible shock and cause death. 148
- 181. Basti : It is snayu marma four anguli pramana, sadhya pranahara marma and also includad in dasha pranayatanaThe bladder and its appendages are confirmed as Basthi marma. A rrauma on full bladder rupture of the bladder that may cause vasation of the urine and leads sepsis and even dearh- Vitapa is snayu marma one anguli pramana, vaikalyakara in nature situated between vankshana and vrishana. Trauma may cause shandata or alpa sukrata. Based on anatomical location and symptomatologl" the superior inguinal ring in the anterior abdominal wall through which spermatic card passes may resulr in failure of ejaculation of semen produce sterility or alpa sukrata. Anterior pelvic injury of pelvic bone may cause rupture of the bladder alongwith Uro-genital structures like seminal vesicles, ejaculatory ducts. or membranous part of the urethra resulting into sexual dysfunction or sterility. Most of the pelvic injury over the pelvic region the bladder alongwith its membranous part of the urethra is injured or ruptured causing the extra vasation of the urine either intraperitonial or extra peri- toneal depending upon the site of injury. Intra peritoneal rupture is more serious and life threatening which needs immediate surgical intervention otherwise it may lead to death. Kateeka Taruna : It is asthi marma situated on the back o the pelvic region on both sides lower spine. Trauma produces hemorrhage leads to anemia & distortion of the pelvis shape and lead to life threatening. The fracture dislocation or sub luxation of sacro-iliac joint, avulsion of intra pelvic internal iliac vessels and nerves resulting intra pelvic hemorrhage and distortion of normal contour of pelvis and ultimately lead to death due to sepsis and shock. Kukundara is situated at posterior pelvic bones on both sides of lower spine, produces loss of motor and sensory functions of lower extremities, injury to posterior pelvis at lumbo-sacral region manl' cause anterior dislocation or displacement of spine causing spandhylolisthe and may produce prolapse of disc resulting into radiating pain and loss of motor functions of the lower extremities. Nitamba marma is asthi marma situated on lateral wall of the pelvis in the iliac bones and an injury may produces atrophy of lower limbs, weakness and may lead to death in course of time. Injurl to lateral wall of pelvis involving the iliac bone may cause disruption of pelvic nerves and vessels leadin_e to disability to stand or walk results to disused atrophy of muscles of the lower limbs and inability to bear *'eighr Asta srotogata marma refened in Ashmari Chikitsa through perineal approach may cause injuries to perineum and perineal muscles levator ani. The perineal lacration during child birth by unanenM spontaneous delivery resulting zigzag tear of the posterior wall of the vagina and perineal bodl-- A forceful blow on the perineum give rise to injuries to all srotogata marmas. CONCLUSIONS : The functional and traumatological importance of pelvis in weight bearing locomotion. €rcfdriJr-. and reproductive functions the marmas of the pelvic regions are important in clinical practice ot surgeq- and medicine. The fracture of pelvis usually occurs across a weak part of the pelvis and may cause injul' ro pelrrc soft tissues, blood vessels and even some time organs. The weak areas of he pelvis are the pubic ramia anteriorly, Ala of the ileum and acetahu-i,'r:n laterally, sacrum or sacro-iliac joint posteriorly. Injuries to the posterior pelvis are more impomam Soml the locomotion point of view and are more disabling due to associated injuries to pelvic rren,es- rassels resulting into hemorrhage and shock. I I I 149 €, ffi -&<:- 1*C=Tr!{ .Hv +ff.,+F= t + m
- 182. H" FOLKLORE MEDICINE . THE TREASURE HOUSE OF AYURVEDA o Dr. T. S. Bairy o Dr. Ravikarishna S. Conventional wisdom suggests that those who have good sleep, a healthy appetite and regular bowel habit be truly blessed. Any medical practice with this aim and achievement can be well appreciated. In recent times globalization of Ayurveda is acquiring a new dimension that was never achieved earlier. There is a lot of curiosity in the west about original Ayurvedic practice.W.H.O refer to revolve traditional medicine policy in 3 aspects viz regularization, safety and efficacy. Folklore system of medi- cine- rich, age old, time tested, experienced, worthy informations, available in the originality in the native places. This heritage knowledge, we can get stronger, and prove that Ayurveda has those strength. which the world perceives it to possess. All the traditional healers believed that it is possible to use Ayurvedic medicines only on the basis of Ayurvedic understanding and not on the basis of conventional medical understanding of the diseases. The institutional knowledge when boosted with this time tested practical folklore knowledge will surely generate the confidence in Ayurvedic practice. Collection, systematic documentation, and proper adaptation of traditional health informations can 1 enhance the Ayurvedic health. i We see lot of variations in the flora and fauna at every i2 yojanas. Hence collection of regional resources enables the success in the treatement. How to plan the folklore research ? Our Acharyas advise conversation with authentic, experienced persons to enrich the exiting knowl- edge. To carry out the fieldwork following preliminary methods can be adopted to initiate the folklore research work. Collection of details of Folklore practitioners and folk informers with the help of different NGO's, schools, SHGs. Approaching them, after gaining their confidence. Collection of the information with an assurance that the knowledge is used for the betterment of the humanity. Give keen interest to each and every point of their explanations and assess with their own words. Give respect to their knowledge without showing your depth in their subject.Don't force them to implement your opinion and experiences. Encourage to continue this traditional knowledge by the family. Documentation : The gathered informations can be systematically arranged according to the diseases, drugs, formu- lations etc in their words. The herbs used by them have to be identified and herbarium sheets can be preserved with details. 150
- 183. li.! Supportive programmes : * Felicitation to the able folklore informers often and interacting with them ro share their knowledge supports the research work. * Fulfillment of the needs and demands of folklore doctors with respect ro their sen'ice. like sapling of seeds of plants used by them, photos and other information of the plants. * Public awareness programmes on traditional health knowledge in various schools and othei associations to become familiar with public. Folklore research is in emergency : * It is a time tested, age old, experienced treasure of Ayurveda has to be preserved. * We observed the lack of interest and enthusiasm in young generation for the continuation of this traditional knowledge hence,we have to gather and preserve maximum informations. * Folklore informers are well versed in the local or regional wealth like herbs names, availabil- ity, habit, description, cultivation, propagation etc details of the surrounding Flora. * Ayurvedic research approach may boost to develop the different observational parameters in the field of drug research. + Inclusion of traditionally used herbs after a systematic research will surely increase rhe Ayuvedic Pharmacopoeia. + Proper clinical research of the formulations will provide new and simple effective therapies for various ailments. * The collection and systematic documentation iself bypass maximum steps in the Ayurvedic research- "Knowledge is power" lel the knowledge come from all the sides with this proverb every Ayunedic physician should side their ego and learn to accept the time tested, experiences of genuine folklore informers. * Director, * * Junior Research Fellow Folklore Medicine Research Center, S.D.M.College of Ayurveda, Kuthpady, Udupi.574ll1. 151
- 184. POSTMENOPAUSAL OSTEOPOROSIS IS AN AGE RELATED PHYS|OLOGICAL CHANGE NOT A DISEASE AND AYURVEDTC PERSPECTIVES o Dr. Basavaraj S. HadaPad Kasturba Medical College. Manipal A renowned American medicine Professor Isenberg with thirty five years of practical experience in her field raises two important questions and surprisingly answers both her questions herself. The first of it being "'When does a healthy individual become a patient?" and she answers" After consulting a physician". Second question being "When does a patient become healthy individual" She answers "It is very rare". Doctors with hi-tech modern diagnostic aids predict the unpredictable complications of age related asymptomatic postmenopausal osteoporosis (PMO) and treat with hormone replacement therapy and calcium to make healthy woman as a patient who will never become a healthy individual again' According to the textual description of osteoporosis is the most common metabolic bone disease which is defined as reduction of bone mass (or density) or the presence of a fragility fracture. The reduction in bone tissue is accompanied by deterioration in the architectural of skeleton, leading to markedly increased risk of fracture. In 1994 a World Health organization study group recommended a clinical definition of osteoporosis based on bone mineral density (BMD) measurements expressed in standard deviation (SD) units called T- scores which is calculated by taking the difference between a patient's measured BMD and the mean BMD of healthy young adults matched for gender and ethnic group and expressing the difference relative to the young adult population SD. There is some space for a doubt to consider this clinical definition of osteoporosis for postmeno- pausal woman because decrease in bone density is a universal feature of ageing then how feasible is it to compare bone density of postmenopausal women with bone density of healthy young adults? How ever now days, irrespective of age related changes in the bone remodeling process a patient with T- score less than - 2.5 at spine, hip or forearm is diagnosed with postmenopausal osteoporosis. The screening (bone density) could seriously damage your health (8MJ.1997; 314:533) brings to my mind saying of Mark Twain which goes "For a man with a hammer in the hand, and wanting to use it badly, everything in the world looks a nail needing hammering. Epidemiological studies in the United States of America have estimated that more than one million Americans experience a significant fragility fracture each year at a cost of over $ 14 billion and In the United Kingdom osteoporotic fractures occur in 150,000 individuals annually at a cost of over f750 million. High incidence of PMO could be because of "disease mongering" by the pharmaceutical industries' disease mongering can include turning ordinary ailments into medical problems, seeing mild symptoms as serious, treating personal problems as medical, seeing risks as diseases, and framing prevalence estimates to maximise potential market (BMJ.324; 2002: 886-890). 152
- 185. But over the past few decades it is taught at medical schools that hormonal and calcium deficiencies are the main causes. Because of this preaching, hormone replacement therapy (HRT) has been used increasingly to prevent and cure PMO and other chronic diseases by the medical graduates at global level. But based on pathophysiology of PMO there are no scientific convincing clinical evidences to use HRT and calcium. This view is supported by recent conclusion of many clinical trials of HRT that is "do not use estrogen / progesterone to prevent chronic diseases" including PMO, risks are higher than benefits: those being ovarian cancer, breast cancer, stroke, pulmonary embolism, coronary heart disease etc (Ref. BMJ 2002; 325:61, JAMA 2002:288:321-33,366-8 etc). Present day management of PMO brings to m)' mind a saying of Nin Anais: "We do not see things as they are; we see them as we are" Looking at clinical features of PMO, most individuals diagnosed on the basis of bone densitomeul' are asymptomatic; many patients with quite advanced osteoporosis remain asymptomatic until a frac- ture occurs, because low bone density alone does not cause any symptoms, osteoporotic fractures, lifting a heavy weight precipitates pain in the vertebral fracture. The clinical presentation of vertebral fracture is highly variable, in some cases the onset is sudden with acute back pain, where as in others the presentation is insidious with gradual loss of height and chronic back pain, the pain of osteoporotic fracture often radiates anteriorly with nerve root distribution and may be made worse by back movement. Asymptomatic postmenopausal women are treated with HRT without knowing through rvhat mechanism hormones act (JAMA 2003; 289: 2673-2684) for prevention and cure of chronic diseases including osteoporosis and osteoporotic fractures based on very poor evidence of benefits (Lancet 2002: 359l-26). Use of HRT has increased among postmenopausal women in western countries. As estimated 20 million women world wide were using it in the late 1990's (Lancet 2002:360:-942-944) As per my present compiled knowledge - Ayurvedic texts do not explain anything regarding asymptomatic diseases and thelr management. Acharya's have explained kriyakala (different stages of disease manifestation) with chikitsa (treatment) to check progress of the samprapti (pathogenesis) but not for asymptomatic disease or healthy person. Ayurvedic diagnosis of PMO is also not possible until and unless there occurs a fracture so question of management looks very vague when detection itself is difficult but based on the osteoporotic changes detected by DEXA it can be diagnosed as Asthisoushirya. Arunadatta and Hemadri commenting on symptoms caused by aggravated vata dosha (AHSu.12l 50'h shloka) opine that Asthisoushirya means Asthi (Bone) and Sarandratwam (with pores). Comparison of PMO with Asthigata vata does not hold u'ell because latter is characterized by "Bhedho asthiparvanam, sandhishoolam, marnsabala kshal'am. aswapnah santataruk cha" (Cha Chi 28/?). Asthi Soushirya in case of PMO is because of swabhavika (age related changes etc) so curative approach by any system of health delivery may not be acceptable and successful (Sr"'abhar"o Nispratikriaya - natural changes can not be treated) but surely the rate of resorption can be slou'ed dor.r'n by l.Diet and lifestyle regulations according to Dinacharya (daily regimen) and Rutuchar-va (seasonal regimen) 2.Asthi pradoshaja chikitsa that is Basti in Grishma rutu. All women community irrespective of race and nation attain menopause and have deficiency of hormones but incidence of PMO is high in western countries than Asian countries, could be because of cold, preserved and microwave cooked food, smoking, alcohol, contraceptives, refined oils (oilauoted by cam. January 2002 from Am J Clin Nutr,74: 6,783-790,2001 (Dec) etc. Moderate traditional Asian diet must be having preventive effect 153 *S u e ffi w
- 186. Asthi pradoshaja chikitsa "Bastaya Ksheera Sarpishi tiktakopahitani cha" (Cha Su 28/ ) means basti with milk and ghee processed with bitter drugs and shamananga snehapana with Panchatikta Guggulaghrta, Mahatiktaghata, Patoladighrta, Panchatiktaghrta, Tiktaka ghrta etc given in every Grishma rutu can be tried to slow down bone resorption as a preventive measure. To sum up: Estrogen deficiency is not the only responsible culprit in postmenopausal osteoporosis as it is age related disease. For diagnosis of Asthisuoshirya bone densitometry test is must. Curative approach for an age related disease by any system of medicine looks sarcastic but the rate of resorption U" slowed down by diet and lifestyle according to Dinacharya and Rutucharya and by Basti in every "un Grishma Rutu as explained in Asthi pradoshaja Chikitsa' That is a good book which is oPened, with expectation, and closed with delight and profit - Amos Bronson Alcott, American reformer & PhilosoPher. I l I l rS 154 'tL.9 ,44 fxtr," ,#--,lX< tiy€ t(lY'T rc
- 187. MENTAL HEALTH AND YOGA o Dr. Manjunatha N. S. IIID (Ayu) Lecturer dept. of Swasthavritta, JSS Ayurveda Medical College. Mysore. Introduction : A sound mind in a sound body has been recognized as a social ideal for many centuries. Mental health is thus the balanced development of the individual's personality and emotional attitude which enable him to live harmoniously with his fellow-men. Mental health is not exclusively a matter of relation between persons; it is also a matter of relation of the individual towards the community he lives in. towards the society of which the community is a part, and towards the social institutions which for a large part guide his life, determine his way of living, working, leisure, and the way he earns and spends his money, the way he sees happiness, stability and security. Problem statement : Mental illness In the world People affected in million Neurotic, stress-related & somatoform 500 Mood disorder such as chronic & manic depression 200 Mental retardation 83 Epilepsy 30 Dementia 22 Schizophrenia I6 Characteristics of a mentally healthy person : Charaka told in the context of satva sara laxana - Smrithimanta, Bhaktimanta, Kritagna, Pragna, Shuchi, Mahotsahi, Daksha. Dheera Samaravikranta, Yodha, tyakta vishada, Suvyavasthita gati, Gambheera buddhi chesta- Warning signs of poor mental health : He/she Always worrying,unable to concentrate because of unrecognized reasons,continually unhappy with- out justified cause, lose his/her temper easily and often, troubled by regular insomnia, have rvide fluc- tuations in hislher moods from depression to elation, back to depression, which incapacitate. Conrinually dislike to be with people. Upset if the routine of his/her life disturbed. Consistently get on nerves by hiV her children. "browned off' and constantly bitter. Afraid without real cause. Always right and the other person always wrong. Have numerous aches and pains for which no doctor can find a physical cause. Causes of mental ill health : 1. Organic conditions: such as cerebral arteriosclerosis, neoplasms. metabolic. neurological, endocrine diseases and chronic diseases such as tuberculosis, leprosy, epilepsl'etc. 2. Hereditary: child of two schizophrenic parents. 3. Social pathological causes: combination of genetic and environmental factors such as worries, anxieties, emotional stress, tension, frustration, unhappy, marriages, broken homes. poverty, 155 rH ffid 6W <4ftr* ffiw --
- 188. industrialization, urbanization, changing family structure, population, mobility, economic in- security, cruelty, rejection, neglect and the like. Charaka explain in short regarding causative factors for mental disorders. They are classified into three. kaya, vacha and manasa - physical actions-including adultery, theft and persecution, by speech- speaking harsh words, back biting, lying and use of untimely words and by manas-arishad varga ( kama, kroda, lobha, moha, mada & matsarya), bhaya, shoka, dukha, nairlajya, eershya, and atiraga. Pathology : Due to above causative factors which leads to mental stress. It is one of the important factors, which affects the autonomic and endocrine functions. The sympathetic nervous system is usually stimulated in mental stressful conditions which resultant rises in blood pressure and heart rate. The stressful impulses mediating through the hypothalamic-pituitary axis could bring about hyperactivity of the sympathetic nervous system. The end result is increasing mental ill health and psychosomatic diseases. Prevention and control of mental ill health through yoga : 'Prevention is better than cure'; this proverbial saying is kept only as an accepted proverb in modern Medicare delivery system. Promotion of positive health is being by many who do not want to be the victims of modern ailments. Yoga is playing a vital role in this aspect in the new millenium. This includes astanga yoga (eight limbs of yoga), shat kriya (cleansing technique) and satvika ahara. The eight limbs of yoga : The eight processes, steps of yoga are the evolutionary processes of refining man at all levels of his/her consciousness. 1. Yama: It is the control of the body, speech and mind. The Yama are five in number. They are: a) Ahimsa (b) Satya (c) Celibacy (d) Asteya (e) Aparigraha 2. Niyama: The obedience of proper conduct. It is too five number. They are: a) Saucha (b) Santosh (c) Tapas (d) Svadhyaya (e) Iswara Pranidhana 3. Asana : It helps in concentration of the chitta and the control of the mind. Yoga has prescribed several postures like padmasana, vajrasana, etc. these are very much helpful in control of the mind as well as the vital elements in the body. They remove our physical sufferings, due to cold and heat. They also keep our body free from disease and make it strong. By these, one can control the external as well as the internal organs in the body. 4. Pranayama : It means control of breath. By this, the aspirant controls the inhaling and exhaling of breath, which helps in the concentration of the mind. In it, there are three main steps in Pranayama. A) Inhaling: to take as much air as possible. B) Retaining of the breath: after the maximum air is taken, to retain it for half the time taken in inhaling. C) Exhaling: to gradually exhale this air in almost the same time as taken for inhaling. 5. Prathyahara : The introversion of the various sense organs by retaining them from the objects is what we call Prathyahara. By doing this, the mind of the aspirant is not disturbed by a worldly object, even while he/she lives in the world. It requires very strong determination and repression of the senses. 6. Dharana : It is the concentration of the mind on one object which can be external like the idol of some God, etc. as well as internal, as the part in between eye brows, the lotus of the heart. This is the beginning stage of Samadhi. g" 156 6,tF ffi
- 189. 7. Dhyana: This requires total medication on the object of concentration. One has clear knou'ledge of the object by this process. In the beginning, the aspirant knows only the forms of the objecr and gradually realizes the whole of it. 8. Samadhi: This is the last and most imporlant stage of yoga. The above seven sta_ses are onlv preparatory steps to reach this stage. When the process of concentration and this object become one. negating the difference between the subject and object, this oneness is known as Samadhi. Here. there is no distinction between subject and object. The first five are known as external ones. The remaining three are internal means, which affect the psych or mind. These processes increase moral, physical and mental purity as each one gradually reaches perfection. The first five steps of yoga constitute the psycho-somatic approach. Shat kriya (cleansing technique) : Yoga kriya s refers to special yoga techniques meant to clean the inner organs, developed by the yogis- Among several kriyas available in the yogic lore 6 major kriya called shat kriya are quite comprehensive- They are : Trataka, Neti, Kapalabhati, Dhouti, Nauli & Basti By using these yoga processes making one's mind silent and steady. Especially Dharana, Dhyana and Samadhi reduce mental stress by giving maximum rest to the nervous system. The mental calmness produced by meditation reduces the impulses going through the over stimulated sympathetic nervous sysrem in mental stressful conditions. Acceleration in heart rate, rise in blood pressure, tensioning of muscles and resultant increase in basal metabolic rate are noted in mental stress. Lowering of metabolic rate and reduction in oxvgen consumption leads to marked mental relaxation and hence improvement in the cardiac function. Yoga J Hypothalamus J Autonomic nervous system J J Sympathetic Parasympathetic Equitibrium of mind Conclusion : Every human being is having an innate urge to experience peace, bliss and satisfaction. These could only be realizing when four aspects of human personality are balanced and evolved in an integral manner. The present world is highly advanced in providing material comforts, but it miserably failed to bring an inner peace and harmony. It also failed to give an insight to handle the stressful situations. ro promore hormonial inter-personal relationships and to cope up with varied situations of life. In this conrexr. voga our ancient Indian tradition and an art of healthy living has a lot to offer. Yoga has got the porentiality to bring prosperity and happiness to all mankind. Yoga brings about suitable changes in rhe behavioral pattern and attitude of efforts thereby helps to improve the inter-personal relationship at home and also in the society. Therefore, yoga has become more relevant and essential part of modern day' living. I 157 *H rrYC #tr M
- 190. VIVID ANALYSIS ON ABHYANTARA SNEHAPAN . Dr. Santosh N. Belavadi rra.o r,qvul Lecturer Department P.G studies in Panchakarma D.G.M Ayurveda Medical College, GADAG INTRODUCTION : In Ayurvedic classics all acharyas have explained different types of chikitsa principles in which swedana are the shodhan chikitsa has got its own identity. Dalhana commented that snehana and prayoga used poorvakarmas prior to Vamanadi Panchakarmas. Snehana is of Abhyantara and Bahya Shamanasneha, interms of Arohanasneha or Shodhanangasneha and also Sadhyasneha,Vicharanasneha, Brumhanasneha etc.Tanupastita doshas that is shakasrtita doshas brought back to koshta by snehana and swedana then the leena doshas should be eliminated by panchashodhanas according to matra and kala' UTPATTI : Sneha shabdha is formed by sniha dhatu with lut pratyaya it means tailadidwara mardana or abhyanga. NIRUKTI : Snehahanam sneha vishyandhana mardhavam kleda karakam' (cha.su.22l10) Snehana is one which does sneha,vishhyandhana,mriduta and does kledana.Chakrapani comented on vishayandana as vilayanam further he comented'Tilayanat vileenascha dravatwadeva kostham" ie draveekruta (Cha.Su.22l10 Chakrapani). Sneha Yoni or Ashaya : Mainly two types: o .(Dwi yoni dwiprakaraka"(Dalhana Su. Chi 3l/3, and Ka.su. 22) o "Dwi yoni sthavara jangama"(Cha.Su.13/9 and BP) l) Sthavara : Sthavara means the sneha obtained from Vanaspathi. Tila,Amra, Amalaki indicated in Vanaspatya' ,Bibhitaki, Bilwa, Eranda,Atasi, Shigru ,Maduka, Mulaka, Karanja are (Ka.St.22l4). to Z)Jangama : The Sneha which is obtained from Prani i.e. Gritha, Vasa and Majja.According Charaka Matsya, Mriga, Pakshi Dadiksheera, Ghrita,Mamsa, Vasa and Majja should be considerd (Cha.Su.13/11) Four vikalpas of Sneha : 1) Grita. 2) Taila . 3) Vasa' 4) Majja. (Ka.Sam.su 2214 and also Dalhana). , In Jangama Ghrita is sreshta (Because Samskarasyanuvarthanam A.H.Su 16) and in Sthavara Tilataila is sreshta(Su.Chi.3l. BP,And Sha.U.l)Here for the word"sarva" Chakrapani commented "sarvashavashabdena Dadhiksheeradaya Grihante"' 158
- 191. Chaturvidha Snehaguna and its uses : Grita : Pittanilaharam, Rasashukrojasam, Mridukaram, Swaraverna Prasadanam (Cha.Su.13/ 14).Dhee. Smriti, Medhya Shashya (A.H.Su.16/8) Indicated in : Vatapittavikara, Chakshuvikara, Kshataksheena, Vridda Baala, Abala Stree. Balaverna Swararthi, Unmada, Apasmara,(Cha.Su.13) "Gritam tullyagunam dosham samskrit jayetkapham" (Ka.Su.2216) Taila : Ushna, Teekshna, Madura rasa, Madhura vipaka, Brimhana, Preenana, Vyvayee. Sukshma. Vishadam, Guru, Vrishya, Twakprasada Meda, Mardhava, Mamsastirya, Bala,Vernakaram. (Su.Su.45). Indicated in : Pravridda SleshamaMedhaska, Chala SthoolaGalodara, Vatavyadi, Vataprakriti, Balartha, Dridata, Stiragatrata, Twaksnigdhata, Krurakoshti,Krimikoshti, Nadivrana, Ardita (Ch.Sul3/44- 45.A.H.Su.16/9)In atyayeeka avasta if Sneha is required for Shodanartha in Hemantha and Shishira rutu Taila is used (A.H.Su.16/15). Vasa: Guru, Ushna, Madurarasa, Vataghna, Jagala Lagu sheeta Kashaya, Raktapittahara. Kaphanashaka (Su.Su.45ll 3 1 ) Indicated in: Vatatapasevi, Ati ruksha, Karshita, Bharadwa, SanchaRaktasukrakshyaye, Kapamedakshayee. Asti Sandhi Sira Snayu Marma kostha Teevra ruja, Srota Sanga, teeksnagni, Visha and Bhagna, Yonikarna Shira Shoola, Vyayami, (Cha.Su.l3 / 4j -49) Majja: Bala sukra rasasleshma Medomajja Vivardhanam. (Ch.Su.13/17) Indicated in: Deeptagni, Kleshasaha, Bhasmaka, Vata peedita Krurakosta. (Ch.Su.13/50). Chatur Sneha Yogya Rogi : Grantinadi Krimi, Sleshma medha maruta rogi (Ga.Ni.1/26) Gritapana for - 3days,'Tail- 4days, Vasa- 5days, Majja-6 days, after Tdays Sneha become Satmeebhuta (Sha.U. 1/3Gudarthadeepika.) Sneha Prayoga Marga:Pana, Nasya, Gandusha, Mastishakya, Karnapoorana, Aksheetarpana and Basti (anuvasana.niruha.u.ttara)(charaka, Sushruta and vagbhata-Snehadikara) ROLE OF RUTU, KALA AND ANUPANA : Doshanusara Snehapanakala according to different rutu Shodhana Snehapanakala: The food taken previous night should be digested then shodhana snehapana is followed (Ch.Su. 13/61) Chakrapani commented on Samshodhanarthasthu doshotkleshanamkaroti and said "jarnante pratareva kriyate". After digestion of taken food and before annabhilasha for dosha shodhanartha uttama pramana snehapana should be followed (A.H.S 16119). In pratakala means pratapa suvanna samuha samana Peeta Rakta varna Surya uda1,a. Depending upon the Vyadhi, dosha and after examination of aturas (heena, madhyama and uttama bala) tailadi pana should be followed. (Su. Chi. 3l/14) Charaka said " sleshamadika divasheete pibbechamalabhaskara"(Cha- Su. 13) For amlabhaskar Chakrapani commented prabala rashmin dinasya bage. Kashay'apa explained "sleshamadhike divoushna nirmala surya" (K.SI.ZZ/I7). Vipereeta kala snehapana hani : Murcha, pippasa, unmada, kamala, aruchi, anaha, shoola (cha. Su.l3/20-21) 159 *B 11_g aY# 6tr
- 192. -;tF1- Sneha snupana: "Anupanam karotiyurja trupti drudangatam. Anupaschat niyatam panam anupanam,' (Sha.Utt.1/8 deepika) In case of Ghrita pana -Ushnaja, Tailapana - Yush Vasa & Majjapana Manda (Cha.Su. 1 3/22, K.S.,Vangasena,B'P.,C.D.,G.N.)' - Ushna jala is considered as sresta anupana after snehapana according to Gadanigraha & l I Kashyapa.Anupana helps for the pachana of bheshaja and destroys its bad effects (Cha.Sul3 22 l Chakrapani). Proper anupana in abhyantara snehapana : l Vataja- Lavana Bahukapha- Trikatu + Yavakshra should be mixed to the sneha (Sha.Utt. 1/11 Deepika) Snehapana poorva, nantara, bhojana Vyavastha (pathya): Snehapana poorva the food that is drava, ushna and pramanayukta is pathya Snehapana nantara abhishyandi, sankeerna and atisnigdha bhojana is apathya (Cha.Su"13/60,V'S., K.Su.22, A.Su.16) Snehapananantara pathya: Ushnodaka, bhramachari, kshapashayaya, mala, mutra, vayu, udgara, vega na avarodha, Vyayama. Ucchabhashana, Krodha, Shoka, Sheetala vayusevana, Atapa sevana varjayat Shayanashana, vata rahita these should be followed other wise leads to bhayankara roga for kshapashya. Arunadatta commented .,diwa sayana and ratri jagarana nishedha".Ushna jalapana should be followed Jitendriya brahmacharyapalana, nivata shayana sthana, Vyayama,Vata mutradi, vega nadharana. diwa swapana (Ka. 5u.22137, Sha. Utt. l/33 deepika) Snehapana Matra, Koshta, and its Avadi Vichara: Matra:Charaka explained Trividha Sneha Matra. "samshodhanathsthy Doshotklesha karoti" (Chakrapani) o Pradhana (Uttama): The Sneha which get digested in one ahoratri i.e Ashtaprahara -24 hrs. o Madhyama: The Sneha which gets digested in Ardhadine-Chatuprahara-l2 hrs o Hrushwa (Avara): The Sneha wich get digested in Dwi prahara-6 hrs. o So depending upon Snehapachananusara 3 typeg of matra have been explained in the classics. Madyama matra Sneha and its Yogya rogi : In Aruksha, Sphota, Pidika, Kandu, Pama, Ardita,Prameha, Kusta, Vatashonita, Natibubukshita, Mridu koshta, Madhyma bala, Madyama Matra sneha is indicated. Benefits : There is no upadrava that's why it is called " Mandavibhramsha"means wont reduce the bala and it is indicated for shodanartha(Ch.Su.13/35-37.) Sneha Hriswa Matra Yogya Roga and Rogi : Vridda, Balaka, Sukumara, Sukhostita, Riktakosta, Medagni purush, Jwaa, Atisara, Kasa peedita- Alpa Matra is indicated. Benefits : Does Snehana, Brumhana, Vrushya, Balya, it is upadravarahita and the benefits of Sneha will be seen for longer time (Ch.Su.13/38-40) 160
- 193. {l4J. Pradhanamatra Snehana Yogya Rogi and Roga : In Adhikamatra Snehabhyasi, Kshutpipasa saha. Uttama jataragni, Uttama Shariraka bala. Gulma peedita, Sarpa visha, Visarpa, Unmada, Gadhaverchas-Uttama matra is indicated. Dosha : Utkrushta,Madya Alpadi bhedena.Bala : Heena madhyati.Kala : Sheetoshna, Versha, lakshana trividhaAgni: Sama, Vishama, Manda, Teekshana.Vaya:Bala, Madhyama, Vridda.(Sha.Utt.U4 Deepika).Pradhana matra: Kshut pipasa, Uftamabala, Gulma, Visha peedita, Vsarpa, Unmada here uttama matra is indicated.Sarvamarga Kostha sandhi Marma shaka ashrita vyadhi(C.Su.I3129-30).Kushta, Visha, Unmada, Apasmara.(B.P)In deeptagni person the sneha matra is-Phala, Madyama-Trikarsha; Jaganya-Dvikarsha. (Sh.Utt. 1/7). Vangasena: matra should be based on Dosha. Kala, Agni, Vyadhi. Bala. satmya,or depending on this the buddhiman vaidya should decide heena madyama. uttama matra .Sharangadara also opines the Bhavamishras version (Sha.Utt.l). Commentator on Bhavamishra said ivladl'ama -Madyamagni, Jaganye-Heenagni Vagbhata explained-Hrisiyasi-lyam4 Hrisr.,'a-2yam4 Madyama-4yam4 Uttama-8yama. 1 yama=3 hours The sneha digested in this avadi are difrerent matra .In mruidu kosta 3 days and in krura kosta Saptadina Snehapana or up to attaining Sarnl'ak Sni,eda Laxana Sneha should be followed (A S.Su.25l Z?)After this the sneha becomes Satmeebhoota means "Namalanamudiranam"(Arunadatta)Uttama matra -1, day,Madyama -3 day and Avara -7 day'.'angasena explained: r Jaganye-3 karsha increase li karsha up to 1 r/z phala o Madhyama-+ increase I karha up to 3 phala o Uttama- + increase l/z phala up to 6 phala (Vangasena), Charaka explained Sneha Praharsha kala maximumTdays minimum3days and Mridukoshta 3 days, Krura -7 days C.Su. 13/65. Shodhana Snehapana KaIa : The food taken in the previous night must be before administering Snehapana. Hriswa -Dinarde Madyama-DinamadS'e Mahati- Ahoratra (Ka.Su.22l19) llrswa .;. The Sneha ri'hich digest after chatura buggateanni i.e. prahara does agnideepti is shreasta for alpa dosha. * The sneha. rvhich digest after ardadivasa, does vrushya and bruhana * Shresta for madyadosha atura. .:. The sneha, which digests "chaturbhagavasestrita" three prahara and is it, is shresta adhikadosha atura and * The sneha which digest "parinathohani" i.e end of the day which wont produce Glani,Murcha,Mada i.e shresta. * The sneha, which digest in "ahoratra"i.e, eight prahara, indicated in Kushta, Vsha. Unmada, Graha and Apasmara (Su.Chi.31 125 -29). 161
- 194. +:.:$.; Dalhana Commented on Satmeebhvati as "snehakaryamutkleshnamadinam karoti" Arunadatta and others as "Namalanamudiram"(S u.Chi 3 I /36.Dalhana). Hrusiyasi matra is a trial dose, which is administered on the first day of sneha pana. Chakrapani mentioned Uttam Matra should be for shaman not for shodhan.Even after administration of sneha pana after Tdays if sheha lakhana are not noticed Then give one-day vishram kala then once again start thesnehapana. (Arunadatta). (A.H.Su.16/30)' The Uttam Matra of Sneha is administered in morning hours when previous day food has been digested and individuval shows less hunger.Aarohana means administration of sneha in increasing order. Koshta pareeksha : Mridukosta : Guda, Ikshurasa, Dadhi, Ksheera, Payasa, Krushara, Kashmarya, Triphalarasa, Draksharasa,Peelurasa, Ushnajala, or Naveenamadhyapana- Mrudukosti-Virechana. Doshabahullya : In Grahani pittapradhanata, kapha and Vayualpa So Vrechana. : l Krurakoshta The above mentioned dravyas when taken by Krurakosti there is no virechana. B ecause "Grahanyavayuulbananila"(Ch. Su. 13 / 66 -69). Kasyapa also opines the same (Ka.Su.22l39). Sushruta : In bahupitta mrudu kosta is seen ald by Gudasevana Virechana is Noticed. In bahuvatasleshma krura kosta - Navirecha (Durvirech) In Samadosha Madyama-SadaranaMridu-Mrudutara-Madyama tara Krurakosta.(Sha.Utt.l/ Deepika.) Mityacharat Upadrava tat Langana vidana : Durinng Snehapana kala by mitya achara and vihara Jwardi upadrava.In this condition langhana is followed then depending upon the Rogi and Roga balabala Virechana is given(Vangasena I Sneha).Sushruta explained by mityahara leads to visthambha for pachanartha Vamana with Ushnajala is followed.Su.Chi.3 1/3 1. Ati Snigda Upadrava; Ati matra sevana ofSneha leads to Gudadaha, Aruchi, Chardi, Murcha, Trushna, Pravahika, Sushkatangata, Bhrama, S wasa, Kasa utpatti(A'S.Su.25). Sneha Vyapat tat Pratikra : Samanya Chikitsopakrama: In all types of Snehajannya Upadrava)Vamana, (Ullekhana) Sweda and Kala prateeksha by seing the bala of individual a well as Vyadhi, Virechana is followed then Takrarishta, Ruksha anna and Peya sevana deferent maatra and Triphala sevana these are Snehavypatti Bheshajam. (Ch.Su.13/7l)Kashyapa is also explained the same chikitsa explained by Charaka and added "Tasmin Samshodanum pathyam" (Ka.St.22l50)Vaghabata added Pippali , Kshoudra, Gomuytra Guggula, Haritaki, for Sneha upadrava chikitsa (A.H.Su.16/33 & A.S.Su.25l55)Chakradatta, Bhavamishra and Vangasena advised to take Ushnajalapana (C.D,B.P/Vangasena/Sneha) Saddyosneha:Snehapana is followed for 3,5,and 7 days if the person is not ready to take Sneha for 3,5 or 7 days if we want immediate Saddyosneha and in emergency condition."saddya snehamiti *S 162 M ffi oYd 14F'*
- 195. tadahareva" (Su.Chi.31/3 Dalhana.Dalhana commented the one, which does Snehana immediately or in one day. Deepika commenting or Sharangadara commented "Saddya iti tasminneva divase twaraya Snehanam karoti" "saddyo grahanam stutiparmityanne trahena Snehatitarthaha". Saddya means the one, which does immediate Snehana i.e, in one day and Saddyo, means the one, which does Snehana in 3 days (Sha.Uttal Deepika.) Saddya Sneharta Yogas It must be Saindavayukta, Abhishyandi, Sukshma, Ushna, Vyavayee, gunayukta because it does immediate Snehana. Here for Vyavayee Chakrapani explained "Akiladehavyaptipuruatapakagami" (Ch.Su. 13/98 Chakrapani) Different Saddyasneha Preparations are as follows Charaka Sadya Sneha Yogas : 1. Bhojanapurva with Chatusneha mix tila and Prabuta sneha prepare phanita. 2. Along with Madira ,Sunti mix tila taila. 3. Along with Madiramanda taila, Vasa, Majja sevana. 4. In darushnaksheera add Chatusneha then mix Sharkara. 5. Grita Taila Vasa Majja and Shali each prasruta with this prepared Peya is Panchaprasrutika peya. 6. Milk +Rice+Masha-Prepare peya (Ch.Su.13/85-90) Panchaparnita Peya with Sushruta : (Su.Chi.3i 138-45) Vagbhata : (A.H.Su.16/19.& A.S.Su.25/67-72). Bhavaprakasha, Vangasena, Chakradatta Snehadikara also opines the same Yogas. Discussion : * There are different types of Snehas are mentioned depending upon the Roga and Rogi Chatusneha should be selected accordingly. + The Snehana acts based on their Gunas like drava, sukshma, sara etc. * Among Chatusneha in Atyaeeka avasta if Sneha is required for Shodanarta in Hemant & Shishirarutu taila is used and Even in some emergency condition Saddyosneha is followed. + Different routes are mentioned for Snehaprayogartha like Pana, Nassya, Abhyanga" Gandusha- Karnapurana, Akshitarpana, and Basti.Here Basti route is considered as best route because the absorption will be more effective when given through this route.To get desired effect & avoid vyapats the Snehana should be followed according to Vatadi dosha, Proper kala. like Sheetakala,Ushnakala,and Dina, Ratri. According to rutu only amoung Chatusneha only one Sneha should be Selected because for example in Sharad rutu Griya should be selected because "Sharadi bahupittatvena pittavriddam Gritameva" * Anupana plays very important role deferent anupanas have mentioned for different Snehas like For Gritapana-Ushnajala, Taila pana-Yusha, Vasa & Majja-Manda. In all conditions Ushnajala is shresta.Anupana helps for the Pachana of the Bheshaja & minimise its bad effects About Matra, Koshta & its Avadhi : Different Acharyas have given their opinion about Matra like Pradana, Madyama, & Hriswamatra. Some Acharyas used Uttama, Madyama, & Avara Vagbhata 163 *& E:g aEao ffi ffi+r.- @
- 196. mentioned like Hrisiyasi, Hriswa & Madyama, Uttama.Vangasena mentioned Jaganye, Madyama & Uttama. Kashyapa mentioned Hriswa. Madyama & Mahati.And total days of Snehapana should be decided according to Koshta like Mridu-3 days, Madyama---4,5,6 and Krura-7 days.Minimum 3 days and maximum 7days. 9 days in Tantrantare.Dalhana deepika Mrudutama, Mrudtara Mrudukoshta(l- 2.3days),Madyama(4,5,6 days),Krura koshta(7,8,9 days) All Acharyas mentioned specific matra should be used in specificdiseases.Dalhana said Uttama matra is Sarvamarganusarana.Chakrapani commented for Shodanarta Madyama matra should be followed.Some other opines Uttama matra for Shodanarta some comrnented Minimum 3days & maximum 7 days.Some opines up to attaining Samyaksnigda laxanas' Arunadutta commented after 7 days of Snehapana Samyak laxanas are not obtained then give one day Vishramakala then once again start the Snehapana with uttamamatra.Snehapana should be selected according to dosha, kala, vyadhi, bala,vaya, agni, satmya,or Buddiman Vaidya should decide the dose accordingly. Conclusion : o Snehanakarma is one the major Poorvakarma prior to Panchakarma and itself acts as Pradhanakarma. o Snehapana matra should be decided according to an individuals Koshta and its Avadhi is t decided and also Dosha, Desha, Kala, Bala, Vyadhi, Agni, Satmya etc. o In Chatusneha Grita and Tailas are more frequently using Sehas in daily practices. s In emergency condition and those who are not having enough time to follow the Shodannga Snehana then in Sneha situations.So Saddyosneha is practiced. I *S 164 nE# " ttllL &w)f4 ew "lffxt.- ffi
- 197. SANDI-IANA KARMA o Dr. M. D. Samudri, Lecturer, Dept of Shalya Tantra , D.G.M.A.M.C. Gadag Introduction : It is a special branch of shalya Tantra which is unique contribution of sushruta. Now the plastic surgery is the advanced branch based on the principles told by Acharya sushruta. Often boundary lines of this branch of surgery are vague plastic surgery encroaches upon almost every other surgical domain and just now far it would extended into each allied field is a matter for individual surgeons to determine. depending upon his knowledge, imagination and skills.Acharya sushruta follower of Dhanvantari parampara at every step of any procedure be it minor operation like abscess drainage, or a complicated one he has specified special care for cosmetic reasons. This care starts from giving an incision and ends the care and treatment of scars. Considering all the ancients treatises Sushruta samhita stands first to mentiEn about sandhana karma. In sutrasthana l6th chapter elaborately explained about otoplastly and rhinoplasty. And we get scattered references about incision (appropriate) prevention of scar etc other a> facts of cosmetology and Aesthetic surgery. Sandhana karma means which gives pleasure to eyes or u,hich look good. Perfect union followed by shodhana and ropana The word plastic is derived from Greek word plastikos giving meaning of "Moulded" or "reshap ing". Plastic surgery is defined hs repair or reconstruction of lost, injured or deformed parts of the bodl' bye transfer of tissue. Historical Aspects : Vedic Period:In Rigveda Daksha cut the head and trunk of Rishi Chavana. Then Ashwini Kumaras perform the 1st plastic operation Sandhanakarma and gave life to him. At the time of war when enemies cut the leg of Bipasha, wife of king Khela Ashwini Kumars transplant the leg by a leg made rvith iron (Rg. 1-ll-6095). The part of body lost by Rishi Atri rejoined by Ashwini kumars giving evidence of micro surgery. Samhita period : Methods of transplautation, Sandhanakarma, 1st found in Sushruta samhita. also told about cosmetic value.Astanga hridaya and Astanga sangraha also told about the concept.From l'769 AD to 1799 AD 4 mysore wars werer fought between Hyder Ali and Tippu Sultan and British. Brirish leamt two very important Indian techniques, Missile (Rocketry) and plastic surgery.A Maratha cart-driYer Keshwajee, who had served the British and Indian soldiers of British army had been caught by lippu Sultan. His nose and right arms were cut off as a punishment. After some days, when dealing u'ith and Indian merchant, the English commanding officer noticed that he had a peculiar nose merchanrs nose had been cut off as punishment for adultery and scar on his fore head. On enquiry he had substitute nose made by a Maratha vaidya commanding officer sent for the vaidya asked him to reconstruct the nose of Keshwajee and others. The operation was performed near pune in presence of two English doctor. Thomas cruso and James Findlay'An illustrated account of this operation, carried out bye a unnamed vaidya appeared in 165 *& a,E ow -&wlk: .ffi
- 198. at London at the Madras Gazette, Subsequently the article was reproduced in the Gentlemans magazine october 1?94.Since then plastic surgery gained popularity and may surgeons started performing surgery' So he is known Giliese an ENT surgeon has done extensive work on reconstruction of nose and ear etc. as Father of Modern plastic surgery. Pre - Operative procedures : Sushruta has advised the surgeon should collect and keep required things before surgery' yanrra and sashtra, Kshara Basic principles of plastic and reconstructive surgery. Prevention of bad scar A bad scar may be avoided by a good incision. An adequate incision given neatly with a sharp scalpel possibilities of keloid along the langer lines or natural creases will not only produce minimum scar but formation will also minimized. Sushruta advocates a neat and adequate incision on along the direction of hair growth on the body given at proper site Tfeatment of Bad Scar: Su.Su.15/20 The prevention and treatment of bad scar are among most important problems that conflict the plastic surgeon. Scar is the future wound. He has described 60 up-karmas for treatment of wound nearly i0 pro."dures are for treatment of a bad scar. A bad scar may be avoided by a good incision- An adequate incision given neatly with a sharp scalpel along the longest lines or natural cases will not only pfoduce growth minimum scar but possibilities of keloid foundation adequate incision along the direction of hair I on the body given ut p.op", site. Sushruta has preferred medicinal.preparations over surgical procedures l for treating bad scars. It seems that he was capable of treating bad scars by using only medicines. He has l categorized bad scar as follows. l a) Depressed scar (avasadita): Scars are those which are depressed below the level of surrounding l 1 tissue, If necessary the subcutaneous tissue are restored bye flap or skiri with subcutaneous fat' Sushruta l area' A has preferred utsadaniadravya eg; Apamarga and ashwagandha, locally for restoring depressed nutritious diet in the form of animal fat and protein is said to be restorative for such scars. b) Hypertrophied and Keloid scars : It is one in which there is excessive fibrous tissue formation within the original limits of the wound. This excessive tissue is extended beyond the original limits in mamsakanda (Keloid). Now a days radium therapy is used. Injection of cortisone is some times effective. Otherwise excision or scraping of the entire keloid and replacement by a skin graft will help the condition.Medicinal preparation for hypertrophic scar consist of Avasadaniyadravyas like tuthaya, kshara karma and agni karma are also indicated. c) Diryamana vrana(Extensive unstable scar) : Extensive unstable scars result from spread loss of surface and epithelium which is replaced by scar tissue instead of being replaced by true skin' These This scars have tendency to break down and ulcerate recurrently. sushruta has advocated scraping. permits the scar to thicken and acquire stability. d) Extensive soft scar (Mriduvrina) : Soft scar is traded by daruna karma. Many drugs like mula, haritaki, bibhitake, along resins are used for the purpose' e) Bald scars : Hair loss in a scar resulting from destruction of hair follicles may be an embar- rassment especially on eye brows and the scalp. The condition may be improved by using Romasanjanana preparations eg. rasaut + a preperation of daruharidra with goats milk and carbon over the area" Now a day such bald spots in the scalp are improved bye implanting small islands of hair bearing area and permitting the hair to grow long. 166 I
- 199. f)Discolored scar.' A black scar is treated by pandu karma for this rohini variety of haritaki taken is kept in goat's rnilk for seven days then grinded and applied over the black area. For a pale scar Krishna karma is done to darken it. Bhallathaka taila with animal toe carbon is dusted over the area. Techniques of Wound closure: (Su.Su.15/26) Ensure complete homeostasis before closure. Allorv time for scar maturation before revision is undertaken. Technique of ear piercing:The ear should be punctured in an auspicious day, time,moment and' sukla paksha after mangalavacharana and swatikavacharana. Baby should be place in the lap of the mother (foster mother). The mind of baby should be.diverted by giving toys. Then the surgeon pulls out the ear bye his left and slowly pierces straight by his right hand at the (above mentioned site). Mid ear to be used for piercing. If the ear lobe is thick then "ara" is used. If the baby is male its right ear should be pierced. if the female baby then left ear should be pierced. A cotton pichu and varti is to be introduced into the slit. Fate of improper piercing: If improper piercing is done there will be bleeding, increased secre- tions and pain occur at the time of pricing. Complications due to improper Technique: (Su.Su.16/25) when a quack pierces the Kalika Marmarika and lohitika, the following complications occur (1) If piercing done in Kalika then jwara, daha,shopha and pain occur. (2) If Marmarika is pierced then vedana, jwara and granthi takes place (3) If Lohitaka is punchered then Manyastamba, apatanaka shirograha and karma shoola occur. Management of compilation : (Su.Su.16/6) If the above complications occur then thick su'ab should be taken out immediately. A paste made up of Madhuka,erandamoola,manjistha and taila mixed with madhu and gritha should be applied repeatedly till the proper healing takes place. After proper healing the ear lobe is again punctured as described above. 15 Techniques of,ear to be repair (Su.su.telt2) Acharya sushruta has told 15 types of different repair in different ear injuries. Among these first 10 can be done successfully and last 5 are unsuccessful i i techniques. (1) In case of absence of both the ear lobule, the surgeon should puncture at the central portion of the pinna (Karnapithatt madhye) and dilate. This should be performed for cosmetic purpose. (2) (Su.Su.16/14)If case the outer flap of the split ear lobule is bigger it should be approximated to the inner flap and vice versa. (3) (Su.Su.16/15)If there is only one flap split ear lobule and if it is thick, wide and fixed, then it should be divided trimmed and joined with upper proportion. The plastic surgeons named it as Y-V-Repair. (4) (Su.Su 16/6)In case both ear lobules are absent, then the surgeon should take a living flap of skin from the cheek (Gandapradesha). This is called a full thickness skin flap. Then the living skin flap should connect and reconstruct ear lobule. Correct method of structuring: (su.Su 25t20) the edge of the wound should be raised, both the flaps should be brought into approximation, then structuring should be done by a fine renead. 167 *S Eg nY# 'ffi t<[$F- M
- 200. *; " '.-?.i I Contra indication of suturing : (Su.Su 16/19) At the time of Bandhana if the vitiated blood comes out from the ear lobule or excessive bleeding takes place from the ear lobule, then the surgeon should not suture. Ignoring the above mentioned conditions if the surgeon suture the ear lobe then following complications takes place. (1) (Paripota) If blood is Vitiated by vatadosha then paripota occur. Here there will be. loss of skin ear lobule, Inflammation of ear lobule and pain in the ear lobule (2) (Pitta dushta rakta) If the blood is vitiated by pitta then follow symptoms Daha Paka, raga and vedana (3) Khapha dushta rakta: Sthabdata and Kandu If the surgeons suture the wound which bleeds more the following complication occur Discoloration and Odema. Post operative management of sutured ear lobule.Su.Su.19/23 Su.U.60/ 3 Su.Ch.1/190 and Va. Su.2/35 During and after surgery proper asepsis and antiseptic measures should be followed.The ear lobule should be irrigated with fresh tila taila continuously for three days. Dressing should be done in every 3'd day, when the wound is properly healed without any complications and attains its normal color then proper measure should be taken to elongate the slit by means of piercing, otherwise complication like shotha, daha,paka ragata and shoola occur again and lobe may split into two parts. Elongation of ear lobule: Su.Su.16/21 Acharya sushruta has advocated some tailas and kalkas for elongation of ear lobules. Abhavanga: Majja and vasa of anupa and samudra animals, milk,gretha tila tail and sarshapa are taken and cooked arka,alarka,bala,atibala,anantamoola,apamarga,ashwagandha,vidarikanda and also pre- pare sarshapa tila by above ingredients and apply over for 15 days. Treatment of palishosha according to Vag bhata : Nasya, alepana,swedana have to be done, after this kalka prepared by tila,changeri, yasti, ashwagandha is to be applied. Rhino plasty: Su.Su.16/16: The skilled surgeon should reconstruct the ear lobule by taking a pair of skin from the check(Ganda) region with a slip attached to the donor site. (Su.Su.t6119:53) A leaf equal to the dimension of the excised nose is taken. It is used to measure the dimensions of the nose over the.cheek. The skin flap from cheek is taken, remaining attached to donor site with a thin slip. The stump of nose is then stitched quickly with the help of a needle. After this two small hollow stems of Kamala are fitted at the nostrils. position and shape of both nostrils is checked and the columellar processes joined and stitched.After this a powder of patanga. yashti anjana is to be sprinkled over the operated area. Then the operated part should be covered with cotton pad or quare and irrigated with sarshapa taila frequently. Post operative: After digestion of food pt issued to take the gritha and virechana karma is done. When the flap is well attached to the nose then cosmetic measure should be done. If the nose is short then try to massage it and if it is extra large then it is reduced by encising. The injured lip or Khandoshta is also reconstructed according to the same procedure as mentioned in nasasandana, here the kamalanala are not kept.According to the Vagbhata repairing a left lip the margins of the lip are trimmed and sutured properly. Then the necessary measures are taken to assure good healing. Now days zigzag scar is made 168
- 201. by extending the incision during the reconstructing of lip, in complete lip is repaired by similar procedure. Sushruta had taken flap from neck, Now-days cosmetic reasons, in termediate thickness -eraft is used to cover the under-surfac e of flap and domain area.In sushruta's method of ear and nose repair graft consist of full thickness of skin- Regarding this, two factors are important. First the nose and ear are cartilaginous and so partial thickness and intermediate thickness grafts are thin for the purpose. These gralls u'ill .onstruct during healing effecting will fail to survive because they will need immediate nourishment i,,hich they will not get in a cartilage due to its low vascularity. Probably sushruta faced these problems too and that is why he made the provision that graft remains attached to donor site for nourishment until it <ievelops its own organ in body with success. Repair of cleft lip : According to Vagbhata for repair a cleft lip, the margins of the cleft lip are trimmed and structured properly.Then necessary measures are to assure good healing (Fig III) Now- a - days a zigza-e scan method is applying veins incision during the reconstruction unaltered cleft palqte. It will avoid the shortening of hare lip is repaired by similar procedure. But unilateral or bilateral complete harelip extending to alveolar process needs more skill and fine procedure. Flaps taken from adjustment check area has colour match proper texture left hair follorved. It avoids prolonged immobilization of arm and head as occurs in Italian graft. If large supply of skin is available.The main disadvantage of sushruta's method is scarring of donor area which some original defect. Sushruta did not make any provision for the resulting donor scar. The advantages of cheek grafts may be acquired by using a fare had graft in which the resulting scars. How ever, the problem of resulting scar remains as from the arm avoids such disgigurement bul flap does not have proper color and texture to match recipient area. More ever prolonged immobilization of head, ann is very uncomfortable for the point. Now a days skin from post articular chance is preferred for minor defect and for intermediate defects tube pedicle grafts are taken from neck.For traurn&tic amputation of the nose vagbhata has indicated to suture it back in position as soon as possible.For sucl'r amputation a six hour period is considered golden - if the lost part is obtained it should be sutured back in position within six hours of amputation to get better result. Reconstruction of ear : The development of ear pinna by the fixing of 6 tubercles around the extend auditory canal in tire fourth month of intrauterine life. Malfunctions of external ear such as microtia,anolia,uneque ears are common. Sushruta has described these and its corrective procedures to repair them. According to sushruta although the incision should be adequate it should not be unnecessarily' [ong. For the exposed parts of the body which are cosmetically important landmarks like face, lips. e1-ebrou s. cheeks abdomen and axilla. He has advocated incision to avoid mamsakanda formation and other com- I I plications. If needle bites are too close to the margins it will fear the margins adding to deformiry. Secondly, chances of union will be remote if needle passes through nocrotic margins instead of adjoining healthy tissue. It is important to avoid any additional disfigurement by living ugly stick rnarks- Proper approximation of both wound margins is important to assure good union and to avoid a scar. Sushruta also advocates meticulous wound apposition. 169 u ff ffi
- 202. eg a Ostha sandhana Sushruta's method Vagbhata's method Nasoplasty : The ayurvedic importance of a nose is great because of its position on the face. Diseases and injuries disfigurement of nose are very common. since time of sushruta. the skill of surgeons was "uuring evaluated by their ability to perform nasoplasty, ear reconstructing and hair lip reconstruction. Now-a days corrective procedures for a disfigured nose compromises shortening of the nose, correction of deflected, twisted nose, reconstruction (sub total) of absence nose. correction of the cleft lip of the nose wide nostrils and deformities of columella. The nasal repair described by sushruta appears to graft be sub total nasoplasty as he has correcred it with full thickness skin graft only. Bone and cartilage to give a proper shape and support to newly constructed nose is not indicated. Susruta's method of reconstruction of nose : According to so, far the reconstruction of nose, eye recipient area in nose is mapped with a tree/ The leaf. Now a day's metal foil or poi-film is used for the purpose. The donor area is accordingly sized. margins of the recipient area are trimmed to assure proper union. Now a flap is taken from the cheek' It should remain connected with donor area with one of its margins. Two hollow tubes are inserted in the proper bandag- nasal cavities to support the newly constructed nose and to assure proper breathing. Then ing is done. Wherthe flap at the donor area is served. Any remaining deformity is connected. When flap is taken at recipient area the pedicle is served.Subtotal loss of nose, Flap of adjustment is taken and sutured at the recipient area, Flap is still in correction and cheek at one of its margins by pedicle. Ear lobule is absent. Flap of adjustment cheek is taken and sutured at the recipient area. Flap is itill correction and cheek at one of its margins by a pedicle.When healing is complete pedicle is served and the remaining deformity is repaired. Concept of micro surgery : 1) (su.su 2l3I)It an ear lopped off then the ear should be kept in proper position and sutured and should tighrly bandaged. Then rail is to be applied.(su.ch 2132,33) If the Krukatika is cut and if the air comes oui through cut wind pipe then the part should be brought together properly sutured and bandaged. So that no intervening space will remains. The part should be irrigated within buffer prepared from goats (su,ch Z milk. It is asked to iut" food in laying position, So that head should move. Micro surgery 34,35):If a hand or leg is cut then the part should cauterized with the application of hot and bandaged by Koshabandha and proper measures should be taken healing. *W 170 M f,-9 tr
- 203. Pathya pathya : Socio cultural Behaviors: Achara Rasayana These includes of life help to accelerate the psychological stress adoption and sound healin_e and also to maintain the harmony and interlay of social life. Pathya i , Cereals, pulseslike shali,kulatta,yava,godhuma,asana,shyonyaka,mudga,mamsa of deer, gritha of cow and amalaki. Follow bramhachrya, ushnodaka snana, sleep in night only. Apathya : valliphala,lavana.wine goat's and sheep's meat,fish, Eastern wind, western wind. Conclusion : British along with other thing they have taken the plastic surgery technique.If the surgeon is able to prefer the repair of left lip he is eligible to treat Raja. Sushruta concept of surgery is still survey as {t the foundation for the modern plastic surgery. L Karnasandhana procedure Nasasandhana I I 171 *S I 6d 6W <ffifrts
- 204. EVIDENCE BASED AYURVEDIC TREATMENT FOR MIGRAINE o Vaidya Balendu Prakash Co-investigators: Vd. S. Raghavendra Babu. Vd. S.S. Hiremath, Vd. Sunil Kumar. Vd. Hema, Vd. Savitha, Vd. Shaila Bangalore - 560 030 Introduction : Migraine is a vascular disorder with an unknown etio-patho-physiology. However results from the protocol based Ayurvedic clinical practices indicate that common migraine is an outcome of physiological changes in gastrointestinal tract due to irregular and undisciplined life style and dietary habits of individu- als. Observational research of clinical practice on 104 patients of chronic migraine ranging from < I to 50 years duration, and frequency of attacks ranging from continuous to occasional showed that Ayurvedic treatment along with dietary and lifestyle modifications was effective in relieving headache. To further evaluate the findings of this observational research, systematic multicentric clinical practice documentation was undertaken in patients who volunteered to receive Ayurvedic treatment after being diagnosed of common migraine. This report is an interim evaluation of efficacy and safety of ayurvedic treatment for common migraine. Method "An Integrated Approach in the treatment of Migraine" was organized at Indian Institute of Science, Bangalore on 15'h May 2005 The seminar was well attended by general public. scientist, students and physicians of Ayurveda and modern medicines. Padamshree Vaidya Balendu Prakash pre- sented his earlier experiences in the treatment of migraine patients in the seminar and such results were discussed and appreciated by all and was well reported in the press. Simultaneously Ayurvedic clinic were set up in the state of Karnataka at Bangalore, Tumkur and Bellary in a phased manner under professionally trained Ayurvedic physicians who were provided treat- ment protocol with case record forms to document his/trer clinical practice following WHO, GCP guide- lines. Following media report large number of patients suffering with headache approached these clinics; these patients underwent scrutiny following IHS diagnostic criteria for migraine. Such patients were called for pre-recruitment counseling where they were explained about medicines, diet, investigations, cost and duration of treatment. The willing patients were called for the third time for registration and their detail medical history was recorded on numbered Case record form at each clinic by the concerned Ayurvedic physicians. Each patient signed his/ her CRF and a postcard carrying his name, age, sex, time, date of enrollment and CRF number. These postcards were posted within 24 hours to the central office of VCP Cancer Research Foundation. Dehradun. Only those patients were enrolled at the following centers 172
- 205. Duration of Ayurvedic Treatment Of the 267 patients only 101 (37.8Vo) patients could complete the desired 90 days of ueatment. These patients were evaluated for efficacy and safety" Results : Out of 267 patientl 101 patients completed at least 90 days of treatment. The efficacy of Ayun'edic treatment was evaluated by assessing the severity of pain; frequency of migraine attacks and IIIDAS scores (Migraine disability assessment scale). There was a significant reduction in frequency of migraine attacks, pain intensity and l!trDAS scores. Patients reported a significant reduction in frequency of attacks from day 0 to day 90.The ma-ri- mum cases having continuous or weekly frequency of pains reduced to occassional or monthly pain on completion of 90 days of treatment. The severity of pain was captured on 1O-point visual analogue scale. Where the point '0' signihes no pain. 1-3 mild pain, 4-6 moderate pain, 7-8 severe pain and 9-10 worst possible pain. At day 0 rhe mean pain scores for 101 patients who completed at least 90 days of treatment had a mean score of 9.01. At day 90 there was 74.47Vo reduction in mean pain scores. The impact of migraine headaches on ability to function in work, home and social situations u'a-s evaluated using MIDAS Scale. It was followed to monitor a patient's response to disease progression. The score may range from a minimum of 0 to a maximum of 180 or 270 where lesser score signifies bener response. On day 0 the mean MIDAS score was 60.45 that reduced to 19.21on day 90 resulting a 60.lcr reduction in the mean score. Hence the impact of migraine headaches on ability to function in rvork. horne and social situation was significant reduced. The number of patients reporting associated symptoms reduced significantly after treatmenr. The data on 101 patients who completed 90 days of therapy reported that number of patients complaining of nausea was reduced from 96 to 14 by the end of treatment, similarly vomiting was reduced in 68 parienrs out of 83, and photophobia and phonophobia were reduced in 74 out of 87 patients. Other symptoms like fatigue, Blurred vision sweating and abdominal pain were also significa-nd1 reduced after therapy. Overall response Out of 101 patients 34Vo of patients showed total disappearance of headache and associaled slmp' toms and the prescribing physician graded the response as good. The response was graded as far in lrcE of patients as these patients reported mild episode of headache without need of any medicadon- The response was graded as poor in 19Vo of cases that reported low intensity of pain w'irh less dependence on medicines. There was no change reported in 10Vo of patients and no patienrs reponed worst response. Similar evaluation of response was done on entire population of 267 patients based on the available data till cut off date reported that out of 267 patients I5Vo of patients showed total disappearance of headache and associated symptoms and the prescribing physician graded the response as good. The response was graded as fair in 33Vo of patients. The response was graded as poor in 20% of cases. Five percent of patients did not respond to the ayurvedic treatment and hence the response rvas graded as worst in such cases. 173 e,E #64 ffi
- 206. l Discussion : Migraine is one of the most common disorders, which fall under the domain of neurology. How- ever. the results obtained from the protocol based clinical practice at Chandigarh, Tumkur, Bellary and Bangalore indicate that it could be correlated with one of the symptoms of Amla Pitta - a well described disease in traditional Ayurvedic text. The observation indicates that the etio-pathogenesis of migraine is related to irregular dietary habits and undisciplined life style of an individual. It first deracinates the acid-alkali balance in the body causing morphological and structural changes in the gastro-intestinal tract. These effects the digestive cycle. There are many factors which directly effect the process of digestion in human body such as long gap between meals, intermittent eating, rich calorie food, lack of sleep, traveling. weather variations, lack of exercise and certain acid enhancing dietary allergens. Over the years nearly five hundred patients have been treated at various Ayurvedic clinics with significant success by using Ayurvedic formulation along with dietary advice and lifestyle modifications. The entire Ayurvedic treatment protocol is aimed to restore acid-alkali imbalance in the gastro-intestinal tract, thus normalizing the digestive cycle of the individual. The above observations become more evident with the long-term relief in the frequency, intensity and associated symptoms in migraine patients after receiving the above approach. These findings suggest re-looking into the etio-pathogenisis of migraine. A comprehensive research should be carried to establish the seen result by combining scientific tools of modern medicine, modern science with Ayurvedic knowledge. I I I 174
- 207. :- SHOULD USE OF CONDOM BE SPOKEN OPENLY IN THE PREVENTION OF AIDS. o Dr. Padmanabha Kulkarni BAMS. CGO. At: Satti Tq: Atha;i "How many of you have seen condoms?" a lady student of Pharmacy College asked hundre*Cs or her colleagues who were present to watch an inter college level debate competition last 1'ear. u har followed was a long lasting pin drop silence. She repeated the question and the response was rhe sanre as before. "This is the problem we have to tackle with. If we do not speak about such things rr'ho else will do." Lady student asked many speakers like a lady student had to literally force the audience ro respond to their suggestion during the debate on "should use of condom be spoken openlf in r-1re prevention of AIDS". Another lady student from Hyderabad College, quoting the figures published by the WHO poined out that every day nearly 6300 women were infected by HIV throughout the world. In man;- 'esrern countries condom vending machines have been installed in public places. In our country people are shr to go to a Pharmacist and ask for one what is so bad in it? She asked "I do not know how a condorn looks like." I could not dare to ask any one, least of all, my parents. The so called sex education lesson. in text books were vague. It as only in college that I got to know about in from friends circle". u'as hou a girl student narrated her forced plight of ignorance. President of this debate competition said that earlier the importance of promoting the condorm rr s*; restricted to farnily planning but today it was emerged as an important tool in the prevention of Dreadi-ul Disease like AIDS. Chief guest of this debate competition said Hypocrisy was the Angle most stumbling blocks in the society's campaign for practice of safe sex and prevention of dreaded AIDS " Parents raise a heave and cry when we emphasize on sex education in schools, but have no qualms in taking their children to lo* grade (vulgar) films filled with double entendre and vulgarity. Till they enter into college. our ),ounssrers are over protected and shielded from reality. I 175 v o'# frfri- ffi 4trS'*
- 208. CURE CATARACT AND INCURABLE EYE DISEASES BY AYURVEDIC ISOTINE EYE DROP (Eye speciarisu,"'""1"31;,Y;"L"-3:; Eye's are God's most precious gift to mankind. Take care of eyes, so that they can take care of you. The challenge before eye specialists all over the world is to preserve eye sight which becomes weak on account of cataract, different diseases of Retina etc. It is unfortunate that the population of blind people is increasing despite cataract surgery, Recently,Dandona and Cowarkers (2000) reported in American journal of Ophthalmic that about 22Vo patients lose eye sight even after Cataract operations laser, Fhaco, IOL etc. India tops the list of the blind people (about 1.2 crore) in the world. At any one time in U.K alone, there are over five million handicapped blind awaiting surgeries. For the first time in the world, a ray of hope for tackling the problem of vision has come from research of Dr. M.S.Basu who has invented ISOTINE EYE DROP (IED) from Ayurvedic herbs and Bhasmas, (Table l) which cures cataract, different diseases of Retina & weak vision without any operation ' CLINICAL TRIALS : Clinical trials on IED have been carried out by Ayurvedic, Allopathic, Homeopathic & Veterinary specialists who gave very good results with regard to improvement in vision in various eye diseases and no side effect (Table 2). RECOGNITION BY GOVBRNMENT : Govt. of U.P. (INDIA) issued Drug license manufactur- ing and sale of IED (Regd. No A-1571/88Govt. of India patented IED (No. 178877/DEL/94) ; Small Scale Industries Department ; Govt. of U.P issued registration in 1991; Patented by WTO FR No. 14711 1996; has been obtained for IED. RESULTS : During the past twenty five year by using IED, thousands of patients suffering from any type of senile, zuvinile, traumatic & congenital immature cataract, cure by eid . BCONOMIC ASPECT : Patients of weak vision lead a miserable life & become a burden on family. Full course of IED in just 30 US $ solves the problem. CHRONIC HEADACHE : A large number of patients suffering from chronic headache for a number of years have been relieved of their pain by using IED' RESULTS IN 5 MINUTES : IED start giving results with regard to improvement in vision in just 5 minutes . Many times patients did not believe it but expressed "Really Magic" "Wonderful Results" etc. after using it. EYE CAMPS AND MEDIA COVBRAGE : During the past about 25 years, many eye camps in different parts of India like U.P. , Punjab, Haryana, Chandigarh, Kerala,New Delhi, Gujrat, Maharastra, Rajasthan etc, have been organised. One eye camp was also organised at Kathmandu (Nepal) which was sponsored by Govt of U.P.(India). Media has given wide coverage of the above activities. Please see *H 176 w ry6 w
- 209. glimpse of news (Table -6) . The electronic media in India has also been giving ven, good coverage ar different channels. AWARDS : Sight First Excellence and Effort Award by Lions International U.S.A.. Excellent Vision Research Award by NIMA U.P. State India & 35 other awards and 2 gold medals have been uon for this Ayurvedic research. COMPLICATBD CASES : In complicated cases of cataract & different diseases of Retina. Glau- coma, Emblyopia, early stage of Squint, Optic Atrophy, Proptosis, loss of vision on account of computer viewing very closely, heavy doses of antibiotic / steroids, snake bite, Solar Retinitis, electric/sas ueldine viewing, heavy doses of liquor, gas poisoning, crackers, poisonous colour etc. , Dr. Basu has treated such patients successfully using eye drop and Ayurvedic oral medicines at his CENTRB FOR CATARdCT cuRE WITH OUT OPERATION, BAREILLY, U.p. INDTA. l IN VIEW OF ABOVE CONSIDERATIONS, ISOTINE EyE DROP (AYURVEDTC) Is l 1 DRUG OF CHOICE FOR CAMPAIGN AGAINST BLINDNESS & LIKE POLIO DROPS,IT CA i BE USED ALL OVER THE WORLD. T 177 E i ffi
- 210. r.ii :f.d VIRECHANA IN SVASTHA o Dr. Shivakumar S. Harti o Dr. Sajitha K. Need for Virechana in Svastha : Charaka defines mala as substances, which cause impairment in the normal physiology of body tissues and thereby obstructing physiological activities. As the mala such as picchalika' singhaanaka adhere to the bahirmukha chidra. in the same way the mala of dhaatus and upadhaatus adhere to antarmukha sroras, which gradually give rise to many disorders. Along with these. even dhaatupaaka janya mala, aparipakva and saama dhaatus are considered as mala. The quantitative and qualitative increase or decrease of doshas, which disturb the normal physiological activities, are also considered as mala. For elimination of these minute malas, which gradually increase and may participate in the different stages of vyaadhi kriyaa kaala, shodhana is advised in svastha. Dalhana says the vruddi of doshas is of 2 types - caya and prakopa, characterized by samhati (compactness) and vilayati (liquefaction) respectively. It is in the latter part the shodhana is prescribed. In fact, the aggravated doshas after sometime invade the dhaatus leading to Dosha-dushya-sammurchana. This further leads to accumulation of mala which must be eliminated regularly from the body, otherwise they cause disorders. According to svabhaavoparama vaada, the deranged and morbid doshas or dhatus are irreversible to their normal state. Hence these excretions should be eliminated to facilitate normal functioning of dhatus. Virechana in svastha can be given in two conditions - (Ca.Su. 6144, A.H.Su. 4/35) o Sharad ritu a As a purva karma for rasaaYana. Virechana in sharad ritu Due to the intense sunrays in the sharad ritu, the pitta which sanchita in varsha ritu gets prakupita in this ritu. Hence virechana should be undertaken' (A. Hr. 6/12) Kashyapa opines, the dosha prakopa, which has taken place in a particular ritu, should be eliminated in that ritu itself. As such prakopa is svaabhaavika, elimination of such malas will be easy. Virechana has to be done in the second maasa of the ritu because doshas get completely prakupita in this maasa. The reason being, doshas are eliminated only when they are fully aggravated and liquefied" The logic is that malaas have a tendency to pass out. The measures are only to help them move out naturally rather than driving them out forcefully. Kashyapa mentions - in hemanta, griishma and varshaa, the cold, heat and rains are pronounced respectively *nit" ln between are the 3 moderate seasons -vasanta, pravrut and sharad. It is in moderate 178 I
- 211. : seasons that the shodhana are applied to Svastha in order to avoid complications due to external envi- ronmental factors. Benefits of Virechana in Svastha I Prasanna Varna, Kanti, Teja U Sthira upachita mamsa I Kayagni abhivardhana I Aharasya kale jaranam I Nidra labho yathakala I Sukha swapna prabhodanam ! Srusta vinmutra vata I Suprasannendriyatvam a Dhrudendriya I Jarakruchrena labhate Conclusion : Pitta dosha is required for all process of digestion and metabolism at various levels in the b'od1. normalcy of pitta dosha is essential for the maintenance of svasthya. Seasonal evacuation of vitiated pina dosha in sharad ritu helps in maintaining this homeostasis. Virechana has multidimensional benefits. Periodic evacuation of mala helps in prevention of diseases and promotion of health. *PG scholar **H.O.D. Dept of PG studies in Swasthavritta, S. D. M. C. A. & H. Has.san. I I 179 g v, I trffi
- 212. PREVENTIVE MEASURES IN HYPERTENSION (RAKTATIMARDAM PRATISHEDOPAYA) o Dr. Ashok Patil r Dr. R. G. V. Ramana o Dr. Sajitha K. o S. D. M. C. A, Hassan INTRODUCTION : It is one of the most common problem encountered in clinical practice. Many a time people are unaware about the condition until they fall victims to its complications. It has become worldwide problem affecting 29Vo of adult population. All the Present anti Hypertension drugs reduces the BP without correcting the cause. Thus the drug treatment of Hypertension is still in 'empiric' stage. Hypertension appears to be most important risk factor for the development of CAD UNDERSTANIDING IN AYURVEDA Specific disease description not found in classics. Recent authors have made Literary translation of BP and of the Hypertension As we are getting the reference of Sushruta that the physician should not get dishearten by not knowing the name of the disease, instead he should research and try to collect the information with regards to its signs and symptoms and cause of the condition and relate them to the tridoshas. and then the physician should chart out the management of doshas. Thus this is the guideline principle can help us to evolve etioparhogenesis and its management. A critical and careful study of the classics conforms that Hypertension is merely a collective concept for a number of conditions It can be considered as a stage of disease in early phase of kriya kala. As we are not so specific to recognize the early phase of kriya kala, clinical diagnosis may be missed. Its samprapti can be understood as follows - vitiation of vyanavata by shoka, arivyayama etc - impaired function of vyana- Hridaya spandanaadikyata & Rakta chankramanaadikyata - Raktatimardam. NEED FOR TTIE PREVENTION & CONTROL As Sushruta told. in chayavasta itself, early steps should be taken to arrest further development of doshas. Then they may not be able to proceeds in to subsequent evolutive changes. If left untreated, they may gain in strength and can intensify in course of development. Recent Survey is shou,ing that 25Vo of adults are having diastolic > 90 mm of Hg, Prevalence is 5g.g & 69.9 I 1000 in Males & Females in urban and 35.5 &. 35.9 /1000 Male & Females in rural population respectively. It is the only chronic disease showing largest decline in mortality rate during last 2 decades. If left untreated or uncontrolled may lead to dangerous complications. AETIOLOGICAL FACTORS OF SHONITA DUSTI WHICH PREDISPOSE TO HYPERTENTION Madyatisevana, Ati lavana sevana. Sedentary habits, Mental stress & Physical strain *S 180 t-9 aE# Wr
- 213. RISK MCTORS : Non modifiable - Age & Genetic facror. o children of both normotensive parents are having 3vo chance of developin_e Hy'peilens. ;: : o children of both hypertensive parents are having 45vo chance of developing Hrpen:n:::r: Modifiable obesity, salt intake' Saturated fat, Alcohol, Physical activity & Environmental stress PREVENTION OF HYPERTENSION Primordial prevention Survey to be conducted at schools to screen for family history and to identify children with hieher average BP levels to that age. Discouraging children from adopting harmful life styles is essential. Educating about correct food habits. School curricula should include Health education programme and Nutrition programme for rhe benefit of children' Healthy life style aimed at preventing ivDa chronic diseases is to be taught to them_ PRIMARY PREVENTION Population straregy Awareness about cause and prevention of disease to be undertaken through media about follo$.ine aspects. 1'Nutrition, weight reduction, Exercise promotion, Behaviour changes Health education Self bare NUTRITION Salt intake must be reduced (not more than 5gm/day). Potassium supplementation (3500mg) shou)d be given as it is antagonizes the biological effect or sooium and thereby reduces the Bp. For rvhich uhe daily usage of saindava lavana is recommended as it contains sodium along with potassium and man,, more essential minerals' Some studies also showing that calcium ,uppl"n'"ntutt ;;1 reduction in BP. ""il.-;; FATS : In the diet, fat should not to exceed 207o of total caloric intake and supplementation u.irh ornega - 3 polyunsaturated fatty acids will in turn reduces high BP. The usage of safflower. sunflo*,er. sesarrlr oil' groundnut etc should be promoted. In our science we found a lot of references regarding the rJa:;,i usage of Atasi, Tila taila. The usage should be promoted in day to day life. WEIGHT REDUCTION v one should maintain BMI between 18.5-24.9kg/m2.Diet ll should be rich in fruits & r.egeabtres & low fat dairy products and reduce content of saturated I & total fat intake. Regular aerobic phi.sical acu,,.ir,- should be done and one should undergo udvaftana, Upavasa. Karshana & shodhana processes period;- cally. 181 22 _d, lqttr6- / 1-9 ^e*rx4 ffiF *16*
- 214. EXERCISE PROMOTION One should adopt regular Isotonic exercises such as jogging & swimming and also regular aerobic physical activity such as brisk walking atleast 30min /day and 5 days a week. BEHAVIOURAL CHANGES Yoga measures for Prevention Practice of Shavasana and other relaxation postures are found very effective in reducing Blood pressure and Meditation is having prime role among yogic measures. These Relaxation techniques reduce ihe activity of sympathoadrenal system and this helps in reduction of catecholamine turnover and gradu- ally reduces Blood Pressure. YOGAS WHICH ARE EFFECTIVE IN HPT Shavasana, Nadi Shodhana, Chandra bhedhana Pranayama in Sukhasana, UjjayiPranayama MEDITATION IN HPT After intensive meditation for 10 days, there is marked increase in neurohumours and their enzymes such as acetylcholine, catecholamine, cholinesterases and monoamine oxidases, with a fall of plasma cortisol. Combination of relaxing postures, breathing exercises and meditation has given better results in Hypertensives Based on these findings it can be postulated that the regular practice of integrated yoga can promote tranquility of mind and increase resistance to stress. 5. IIEALTH EDUCATION a Preventive advice on all risk factors and related health behavior. a Advice for regular health checkup of all male more than 4O & Females after menopause. a Advice regarding balanced diet for maintainance of optimal weight or lVo less than optimal weight should be given. 6. SELF CARE o An important community based health program is patient participation. o Patient is taught self care that is to record his own BP and keep a log book. o Proper advice regarding following Dinacharya, Ritucharya, Sadvritta, Bhojana vidhi, Aachara rasayana is to be given. One should undergo Ritu anusara shodhana. PANCHAKARMA Panchakarma has been scientifically investigated in relation to cholesterol levels and studies have shown that Panchakarma helps to significantly reduce cholesterol. VIP (vasoactive intestinal peptide), a neuropeptide that dilates the coronary arteries, rose by 807o three months after panchakarma. HDL cholesterol, the "good" cholesterol rose757o after three months in those subjects who had original values that were low. Apparently, the ghee. ses€rme oil and other aspects of Panchakarma had loosened the lipid peroxides from cell membranes and set them free. circulating in the blood. In the weeks after Panchakarma, the body eliminated these circulating lipid peroxide molecules- and the rate at which new ones were being pro- duced also apparently declined. 182
- 215. ABHYANGA Technique involving specific stroke over different body and the motion of massaee u'ill create heat & friction, which enhances the circulation and cleanses affected tissue of chemical impurities that could be causing symptom of Hypertension. The oils & herbs used here cleanse & nourish the tissues. Oil is the only media by which more deeply penetration to affected tissues is possible. SHIRODHARA J This procedure helps in Stress reduction by reducing the activity of sympatho adrenal s1'stem. Ir also brings behavioral modification in the person. By reducing catcholamine content. gaining more stres competence, the person becomes resistant to various types of environmental stress MATRABASTI As we considered Hypertension as'Vyanavayu prakopa, Matrabasti should have definite role in appeasing exited vata. And it has no restriction as in other remaining treatment procedures. HIGH RISK STRATARGY Detection of high-risk subjects should be encouraged by optimal usage of clinical methods. Since Hypertension tends to cluster in families, the family history and tracking of BP from childhood ma1' b< used to identify individual at risk. Marriage councelling should be done to avoid marriages among person with known familiar traits. CONCLUSION 1. All the measures aimed at controlling vata are to be undertaken. 2. Effective prevention should aim towards primordial and primary aspects. 3. Nidana parivarjana, good hygienic ways of living and diet helps in preventing Hypertension. 4. The best way to avoid Hypertension is to follow habits of our forefathers. I 183 "W u,-9 R# ^ ,t 1u_0 &ru.}Fz ffi-P
- 216. UTTARA BASTI IN MALE INFERTILITY o Dr A. S. PATIL M.D. (AyuI HOD of Kaya Chikitsa S J G Ayur Med College, Koppal "Infertility is one of the burning problem of the current era. Ayurveda has an unique treatment to offer in this regard. "Uttara Basti" - The administration of medicine through urethral route - is one of the best therapies that can be relied upon. It is observed that many childless couple are benffied hy this treatment modality". The management of male infertility by Panchakarma is indicated depending upon the affliction of shukravaha srothas .The therapies including snehana, swedana, basti are incorporated in the disorders of vrishana, medra ,shukra & basthi etc. i Among the Panchakarmas uttarabasti is ultimate therapy in the management of male infertility. In charaka samhita uttarabasti is explained in two ways. In female, administration of medicine into the garbhashaya, in male. administration of medicine through the mootrmarga. In male infertility the causative factors which interfere with normal production, storage & ejacu- lation of shukra at proper time, and erection of penis needs to be treated by uttarabasti. THB INDICATIONS FOR UTTARA BASTI IN MALE : Mutrasada, Mutrajathara, Mutrakruchra, Sankshaya, Mutrothsanga, Mutrashtila, Vatabasti, Ushnavata, Vatakundalika, Granthi, Bastikundala, Shukradosha, Shukrothseka, Dhwaj abhanga. (klaibya) PRB OPERATIVE MEASURE : Collection of sterile equipments & Medicines. Rubber catheter. 50 ml syringe, Gloves, Artery forceps, Sponge holding forceps, Steel tray, Kidney tray, Medicated ghee.(Luke warm), Triphala kwatha. Preparation of Patient : The patient should be subjected to general and systemic examination . o The laboratory and radiological investigations whenever necessary . a Arohana snehapana a Swedana for three days. o Virechana. o Samsarjana karma for seven days. o Preparation of part o Abhyanga from kati to pada with ksheera bala taila. *S 184 ffi ouc -$ffi {dFF} M
- 217. o Parisheka sweda . o Patienl placed in supine position . o Prakshalana of genital organs by Triphala kwatha . o Lubricate the urethra by Ghrita . OPERATM PROCEDURE : ., ln the penis firmly lift with hand and introduced the sterile, lubricated rubber catheter through urethra to bladder . o Evacuate the bladder . o The syringe containing the sterile Luke warm medicated ghee is connected to outer end of tube. o Slowly and steadily the medicine is injected with controlled pressure. o The tube is blocked by artery forceps and syringe is disconnected. o Slowly the catheter is removed. o Gentle circular massage is done over hypogastric region. o Patient is made to lie on supine position for thirty minutes. POST OPERATIVE CARE : Advice to retain the urine for two hours. Laghu , madhura and drava Ahara should be consumed. Abstain from sexual act. Avoid physical and mental strain. COURSE OF UTTARA BASTI Advisable to give consecutively three days. DOSAGB : Two tola (25m1) BASTHI KARMUKATHA. Without involvement of vata dosha , there can be no klaibyatha and Shukra dusti. Basti treatment is the best for Vata dusti. Uttara basti acts as a Shukrashaya and Mutrashaya shodhaka and also improves tonicitl' of the bladder. In Uttara basti the veerya enters the whole system and imparts its beneficial effects over the functional integrity of entire reproductive system. I 185 "lb R# a,_9 ii ffi @
- 218. SI.JRGERY IN AYURVEDA . Dr. Ramasunder Rao. Rtd. Principal, Susruta Eye Hospital, Dornakal Road, Vijayawada Historical aspects : 1. Susrutha the father of Surgery and the son of sage Viswamithra of Ramayana belongs to Tretayuga i.e nearly about 10000 years back 2. By that time itself there are evidences of surgeries for piles, Fistula. Urinary calculus. intes- tinal obstruction, nasal re-construction, entropion, intestinal perforation etc. 3. Even before Tretayuga i.e..in Kritayuga wherein the Devasura Sangrama took place the Asrvanis have performed commendable surgeries like re-construction of testis with goat's restis, transplantation of eyeballs, replacement of broken leg bones with iron leg, re-organisation of dislodged teeth and treatment of war wounds in the Devasura Sangrama. Even if we take all the above mentioned Tretayuga's surgeries as just legendary and Myth we can atleast conceive up to this extent that the Indians did have ideas of possibilities of such surgical adventures. Relavence of Ayurvedic Surgery Today : Modern surgery has reached unusual and unimaginable heights to-day. We can never compare to-day's adventures like micro surgery, laparoscopic surgery, Foetal surgery, Endoscopic operations, trans- plantations of almost every organ of the body, implantations made up of artificial material, gynaecological and obstetric surgical and para surgical techniques like if gift Sunogate births and gamate transplantation, open heart surgery, heart transplantation, brain surgery etc. And, within a short future modern medical science is likely to invent remote control surgeries, Robot mediated surgeries, satellite surgeries etc., also. When the situation is so sophisticated to-day, one may ask "how far is it relavent to think of the Ayurvedic surgery of a primitive age of about 5 thousand to 8 thousand years back. Inspite of all these controversies Ayurvedic surgery also has got its own role even to-day. First of all one has to study Ayun edic surgery to assess the evolution and history of a series of events which have enabled the present society to march forward on the footsteps of its ancestors with utmost reverence and gratitude. Second point is to introspect the lapses which the modern surgery is facing today despite its so called tremendous progress. To-day the time has come to question ourselves about which one is more scientific and rational as far as its fundamentals and basic structure are concerned - whether Ayurvedic surgery ? or Modern surgery. 186
- 219. Ayurvedic Principles And Their Scientificity 1. Except traumatic Surgery, almostall the remaining conditions of surgery related to derelo'pme:- tal, congenital, inflammatory, infective, neoplastic and degenerative conditions will definitelv ha'*'e s:r:,. or other deep rooted systemic imbalance of long duration. Tumors, coronary thrombosis. r'alvunar e-:n-:- malities, appendicitis, peptic ulcer, abscess, cancer etc. would definitely have a deep roored crtr-'. :: which a modern surgeon generally will not focus his attention. Hardly we find a general surgecn "a; ' probes into the probable systemic imbalance of long duration for the above conditions. He is t:=: bothered about the excision of the new growth or the affected organ. That is not the case with Ayurveda. At the outset it thinks about its eteology in terms of vitialrcr of Doshas - the bio-chemical factors of the body, next it thinks of Poorva Karma, Pancha Karres." Medical treatment etc.. and lastly the surgery. Post-operative care : Ayurveda is very strict about the end result of its treatment no matter whether it is medical ..: surgical. The universal law with Ayurveda is that the patient while leaving the hospital must presenr n- following features of perfect health. Good appetite and digestion, free and timely passage of flatus, faeces, urine and other physiological urges, feeling of lightness of body, pleasant state of all the sense organs and mind, comfortable sleep and comfortable waking, normal and charmful strength colour and complexion, long life and balance ol hormones and enzymes in the body. Unless and until the Doctor can achieve this condition in his patienr his treatment is supposed to be ineffective. In case of operations, the postoperative scar should be so perfect that there should not be anl elevation, depression, adhesion, obstruction to the channels, discolouration. growth of un-wanted hair loss of normal hair, recurrence, pain, burning sense and disfigurement. To achieve this perfection Ayun'eda advocates 60 steps of management under the caption of Shasti Upakramas, out of which forty are posr operative. Such a meticulous care is not taken by a modern surgeon. Not only that, wherever Ayurveda finds systemic pathology more in a so called surgical condition it discourages surgery. For example, piles, though a surgical condition Ayurveda proposes surgery as a last resort. L Rectal prolapse 2. Impotance 3. Swelling of Anus 4. Obsturction to urine and bowel movemenr 5. Flatulence 6. Pain 7. Bleeding 8. Recurrence 9. Continuous oozing 10. Death So, better not to prefer surgery in piles. I prescribe simple and gunshot remedies for piles". - Charak Care of the Scar : Problem may be apparently very simple. But the care an Ayurvedic surgeon is supposed to tal: is a little meticulous. A few such post operative treatmenrs are L Utsadana : when the ulcer or its scar is hollowed. . 2. Avasadana : When the scar or ulcer is hypertrophied. 3. Nirvapana : when the operated area is having pain and burrring scrrsc. 187 g.6 tr .*F
- 220. T4- 4. Roma sanjanana : when the normal hair is lost at the site of operation. 5. Roma shaatana : when the hair is grown un-naturally' 6'KrishnaKarma:Whenthescariswhiteorredincolour. 7. Pandu Karma : When the scar is black' probably a modem surgeon will not even think of such a post operative care' several researches have proved that simple pre operative enemas will encourage wound healing and uncomplicated post karma' operative result better than the surgery done without pre-operative vasti be done only after performing Ayurveda has gone to such an extent that it advocates an operation to poorva karmas like: Deepana Pachana' Apatarpana, (Jpanaha, Sneha Karnta, Sweda Karma, Vimlapana, Parisheka' Shodhana etc today,s modem surgeons can think about the scientific of overhauling the field before surgery, If they would have achieved better and fastpr results than what they are getting today' SUSRUTA'S OPERATIONS WHICH CAN BE DONE EVEN TODAY Fracture management Today the orthopedic surgery is progressing so tremendously that; joint replacement' ozone and routine. inspite of such nucleosis intra medullary nailing, bone grafts etc., have become very simple unusual progress the basic principtes of management of fractures are same in ayurveda also' Ayurveda same lines of modem ortho- advocates reduction , immobilization and rehabilitation for fractures on the has shown different pedic surgery, the difference being the progress in the technicality. Ayurveda also immobilization techniques like "Kusha bandhanam" "Kapata ShaYanam" ,.Keelava bandhanam" etc. in some what crude manner. This was only because of the non avail- implants etc', in those ability of the materials like plaster of paris, splints, anaesthesia, bone prosthesis. healing with primiiive days. Still Ayurveda has got some specialty in showing quicker results in fracture its simple medications like "Gristi Ksheeram" - cow's milk of first delivery "Godhuma & Sali annam - wheat & ticel in diet "Brahma charyam" - Abstinance from sex " Asthisamharaka" "Muruvenna etc., able to show Even today there are traditional bone setters in Andhra Pradesh and Kerala who are good results through their Ayurvedic approach OPERATIONS THAT CAN BE DONE BY AN AYURVEDIC SURGBON to-dav Historically there are claims and evidences that the ancient Ayurvedic surgeons like "Sushrutha. jeevaka and Aswini devatas did highly sophisticated surgeries like. 1. Perineal method of removal of vesical calculus' 2. Nasal displacement of lens in mature catatact' 188
- 221. 3. Rhinoplasty in nasal deformities and injuries l 4. Fracture reduction including plating and nailing 5. Repair of intestinal perforation with organic suturing material (Red ants) 6. Tarsorrhaphy (repair of eye lid) in entropion. 7. Ceasarean section as an abdominal delivery B. Craniotomy in dead foetus. 9. Cosmetic or atraumatic sutures with special needle and thread called "Nigudha pasha"' 10. Extraction of impacted foreign bodies from bones and muscles by hooking, fixing them u'ith some gum like material as laksha or with magnet. 11. Para surgical treatment for intussusception and valvulus by giving mercurial enema (Parada basti) and keeping the patient upside down till the intestinal loops are straightened. 12. Tonsillectomy and draining of peritonsillar abscess, 13. kshara sutra prayoga in Hemorrhoids and fistula in ano. 14. Fistulectomy and Fistulotomy and hemorrhoidectomy in Fistula and piles. The list which I have narrated thus contains such operations which can be practised as such even today. But unfortunately because of an unusually long communication gap even an Ayurvedic surgeon also cannot dare to practice these techniques. We could just preserve the theory of our science to some extent but we have totally lost its practice. But still there are persons doing certain operations according to the same age old technology iuhich is not altered till today, even in modern world. Cosmetic Suturing : What ever the operation a surgeon does, if the patient is young and wants that surgical scar should not be seen, then in all such cases we can apply "Nigudha pasha technique" Technique: Pass the needle through the subcutaneous layer just under the wound flaps & rvithout rocking the thread. Apply continuous suture by apposing the cut edges. Leave off the loops of thread at both the ends. Thread can be removed on 7th day just by.pulling it out. This leaves no scar and there will be no disfigurement of the skin at all. This technique is developed by vagbhata in 5th Centurl' A.D- This technique was not invented during sushruthas time-5000 B.C. let us know and admire our past glory You will wonder if you go back to our past history. Listen to a few such examples of the grearness of Ayurvedic surgery. An Ayurvedic knife : Ayurvedic surgeons were having a separate branch for the manufacturing of surgical instrurnents. Vagbhata says Attractive in appearance with fine blade that can slice the hair into two and iour lon-eirudinal sections and Are made up of "Teekhsna loha" (Magnet) The instruments are highly polished Fine and looking like "Neelakamala" in glow i.e. highly polished 189 *B C-g nYa" ^ /aL4 ffi -AwR.1
- 222. e,€" Parts of the knife : 1. Vrinta = Holding part of the knife 2. Phala = Cutting parl 3. Moola = Rare end 4. Agra = TiP 5. Dhara = Cutting edge 6. Prista = Non cutting edge Dhara : 1. poorna Dhara = One side cutting edge2. Dwidhara = Double blade 3. Ardha Dhara = Half cutring edge 4. Adyardha Dhara = one and a half cutting edge 5. Khara Dhara = saw like edge Agra : 1. Rijvagra = Straight Tip 2. Suchyagra - Sharp Tip 3. Unnatagra = Upward bent Tip 4. Avanatagra = Downward bent Tip 5. Kuntitagra = Blunt Tip Size of the cutting edge = Dhara pramana: LMaasuree = As thin as a masoor dal = For Bhedana 2. Ardha maasuree = Half of the above = For Lekhana 3.Kaisiki = To slice a hair of scalp longitudinally above = For excision of microscopic new = For Vyadhana and Visravana 4.Ardha Kaisiki = Half of the growths 5. Roma vahi = Slicing the skin hair = For micro surgery Surgery was being done with utmost care. A few examples are: ,) 1. What to do in a RiskY OPeration The surgeon has to obtain the permission of the patient's guardian or king before he wants to undertake any risky operation like : Intestinal Perforation, Perineal Method of Lithotrity etc., He has to explain like this. Sir! if the case is not operated the death is immanent and if operated there is a chance of survival. If you are kind enough to permit me i shall operate upon. Susruta advises the king or the Govemment to hang the unqualified Vaidyas. He says If the Vaidya knows only the practice but out of arrogance does not study the science institutionally, he must be hanged to death or the society must boycott him' Similarly a vaidya who knows only theory but does not have practical knowledge he boasts too much about himself but on entering the operation theatre or on seeing a serious case, becomes nervous, gets anxiety tremors and runs away from the site leaving off the patient, like a coward soldier. Therefore susruta says that one must be wellversed both in theory and practice FRANKNESS OF SUSRUTA : Susruta was very practical and bold, and hence whatever he said it was quite authentic. An should example for this is " While doing an operation if the patient goes into surgical shock, the surgeon not think of his personal false prestige. He further states that he should stop the operation and undertake resuscitative measures ' Wh"n you hold the foreign body or vesical calculus in between your fingers, if you notice that his eyes are wide open and rolled up, goes into unconsciousness, and the head is drooped down like that of a dead person, then he should discontinue the operation. If the Patient is allright. he should continue the surgery. a 190 -K,---4 I')8fu -4wRl ry"d€ Fgxn
- 223. Fakshma kopa - Bntropion Operation Shastra Karma 1. Expose the trasal plate of the upper eye lid. Make 5 diamond shaped markin_es ot -1mm nengn in each limb of the diamond. 2.Unite the upper and lower angle and suture it .3.Fix the loops oi ::: sutures on the eye brow. "Kapata shayana" for fracture Femur and Tibia l 1. Wooden cot or Bench. 2. Fixation of planks of wood just one inch away from the site of the streched lorver lirno. 3. Fix 5 nails on both the sides of the table just to fix the fractured lower limb. Note : Though it looks a little crude, it is more safer than the 'p.o.p' cast or splint rvith nailing and plating. offcourse in Ayurveda also the nailing and plating were described. Perineal method of lithotrity : Ashmari shastra chikitsa : 1. Patient in lithotomy position 2. The surgeon passes his index and middle fingers of left hand in to the anus. 3. Feels the stone in the bladder in between his fingers and thumb, fixes it to the perineunr 4. Gives small niche on the impression of the stone which cuts the skin , muscles and anterior wall of the bladder. 5. The stone is expressed through the incision. The wound is sutured and a special oil u.hich guaranties instant healing, is applied 6. The blood collected in the bladder during operation is washed out by uttara Vasti karma- INSTANT CURE OF LIPOMA : 1. Cover the lipoma with a chapati like masha pistam,placed in a cloth bag. cover this bag u ii:r 2 or 3 layers of wet cloth or green leaves like shigru=pafas, Nimba pallavas etc. 2. Burn a round iron rod which is of the size and shape of a chapati lathi 3. Hold the ends of the iron rod with a cloth. Now role this lathi over the lipoma nhich is covered by Masha pistam. In this the lipoma is vigorously subjected to heat appli;ai,:n without any danger of burns. In 2 or 3 sittings the lipoma of moderate size will be subsidoj. Abscess opening : Ayureveda alone has developed a technique to hasten the suppuration process of an abscess. io ;s to minimize the horrible suffereing of the patient. There are several groups of drugs called pacht-,a- darana, peedana, Bhedana etc. In case the abscess is not opened on its own accord, the procedlrre ro opex: and drain it is, l.Touch the fluctuation point of the abscess with a match stick dipped in aqua regia tHlSGl=FIcl, so as to make a thin transparant burnt point on the skin of the abscess. Through this point pass a btrunr probe and stir all around to break the pus pockets. Ayurveda has designed a technique of ernulsiry-ing fhe pus in the abscess by a manual process called vimlapana. Though the surgical condirion seerns ro -he very simple Ayurveda, keeping in view, the torture suffered by patient, has devised several technrque . rc' cure at the earliest. 191 e ft- ti -t#< €s<-,,^- li lH'f' 1:><iP fr
- 224. "ni=r:{q:i. COR.RECTION OF INTESTINAL OBSTRUCTION If the obstruction is due to intussusception= telescoping of the intestine or valvulus =Twisting of the intestine, Ayurveda has shown an easy and foolproof technique. In this 1. Give a simple enema with 200m1 of mercury. Plug the anus with a ball of cotton. 2. Make the patient to lower the head and raise his feet as in sirsha asana. Keep him like that for 2 or 3. the Jammed or twisted intestinal loops will be straightened due to the pressure of mercury. This is called parada Vasti, Udara poorana, udaka poorana ( in case where only water is used for enema) or hydrostatic enema. CATARACT OPERATION 1. Give a small nick on the sclera with a pin pointed knife in between medial 1/3rd and lateral 2l3rds of the temporal sclera. 2. Take out the knife and pass a blunt probe through this hole and separate the temporal scleral attachment of the suspensory ligament of lens' 3. Now slowly and carefully push the lens towards the nose. So that lens neither falls down in to the Vitreous nor totally gets detached from its relation with the suspensory ligament. By this the lens will not become a foreign body and hence does not cause any irritation, obstruction or Glaucoma. The only thing that happens is, the pupil gets cleared of the opaque lens. Note These are only a few examples to show the rationale and scientificity of Avurvedic surgery. The techicalities might be improved today but the techniques shown above are in no way impracticable or unscientific. every indian medical practitioner irrespective of the system he practices must study Ayurvedic surgery and must try to remodel and simplify them with ulmost reverence and respect on his i ancient Indian system of Medicine. One must be very proud to claim himself as a child of this greatest science which has shown such miracles in the days where the man in other parts of the world did not at least have any culture or civilization. At this time man in the west was roaming in the jungle line any other beast' q 192 u I tr ^Y#
- 225. ..CLINICAL AND EXPERIMENTAL VALIDATION OF AYURVEDIC DRUGS ON INFECTIVE HEPATITIS'' o Prof. N. P. Rai. Professor and Head Department of Ka1'achilar*i e Dr. Vijay Kumar Srivastava" Senior Resident Faculty of Ayurveda, IMS, BHU, 'aran;r;i 6lnfective Hepatitis Myth and Reality" "Are We Sitting al Volcano, Time to Wakeup" "Liver is the Hub of the Wheel; of the life, and creates havoc in the patients of the Infective Hepatitis" Introduction : In Ayurveda 'Kamala' has been mentioned as full disease entity whereas in modern medicine it is just a symptom i.e. jaundice. Charaka, Susruta, Vagbhata have vividly described Kamala roga and orer clinical basis Kamala and Hepatitis seem to be one and the same. Kamala (aundice) is the main present- ing symptom of almost all liver.disorders. Hepatitis due to Virus has become 5th rank in mortalitl'. -ratr Hepatitis has been labeled alphabetically from Hepatitis 'A' to Hepatitis 'G' but Hepatitis 'B' and Hepatitis 'C'are more dangerous than others, They are termed as 'carriers of cancer'. Among toml population 5Vo are HBV carriers and ZVo are HCV carriers in our country; approximately 25Vo of HB- positive persons get liver disease in their life time. HBV is a major country health problem and is on top of agenda for public health administrations. Ayurveda have ample amount of drugs to cure the Karnala roga, the drugs have proven their efficacy on experimental studies too and a few trial drugs of the department are included in PUB Med India, index for medicine. Aim & Objectives - To Establish Ayurvedic Hepatoprotective drugs as a safe and ffictive nleasures r The criteria for safe are r The drugs are natural and herbal o They are time tested r On laboratory investigations they are found non toxic and without obvious side efr-ects t The criteria for effectiveness are o On Patients I. Clinical improvement II. Liver profile becomes normal 193
- 226. m. Excess surge of Stecobilinogen in stool and Urobilinogen in urine IV. Choleretic activity V. Prevents the reuptake of remaining Albumin o On Experimental studY a Less cellular damage on Histopathological study followed by ccl4 & PCM challenge a Less bio-chemical derangement followed by ccl4 & PCM challenge o Membrane stabilizing activitY o Anti-oxidant effect Experimental studY - 1 o ,To study the Hepatoprotective activity of Phalatrikadi in Albino Rats' o Hepatitis induced by CClo (carbon tetra chloride) o Biochemical parameters show raised level in Se. bilirubin, AST, ALT & ALP necrosis a Histopathological changes are hepatocyte damage with ballooning degeneration and with inflammation of biliary canaliculi Adminisrration of Phalatrikadi for 10 days prior to CClo challenge showed significant hepatoprotactive activity as evidenced by mild elevations in AST, ALT & ALP with relatively less degenerative changes on HP study Experimental studY - 2 o .Effect of Amrita on hydraulic permeability of cell membrane' l i 1 Administration of Amrita decreases the hydraulic permeability during inflammatory process l and checks the damage caused by Se. bilirubin o Thus Amrita has membrane stabilizing and hepatoprotective property. JV=LpxDP Lp = Hydtuulic conductivity DP = pressure difference o Hyraulic permeability of membranes in presence of Trial drugs Lecithin + Cholesterol = 0.49 Lec. + Chol.+ Daruharidra= 0.45 Lec. + Chol.+ Katuka = 0.30 Lec. + Chol.+ BhumYamalak=O.29 Lec. + Chol.+ Kalmegha = 0.28 Lec. + Chol.+ Amrita = 0.27 Experimental studY-3 I To study the anti-oxidant properties of Triphala; on PCM induced Hepatic damage I Triphala have been reported to have anti-inflammatory, immunomodulator and anti-oxidant properties. u 194 oYd -#*camd ry€ .rfi[].]
- 227. r Triphala prevented PCM induced Lipid peroxidation esrimated by fall in raised levels of MDA and depletion of SOD levels in Hepatocytes I Triphala pretreatment in PCM injury of Hepatocytes stabilizes the raised serum levels of AST. ALT and ALp I Histopathological observation showed preservation of lobular architecture, less regenerative activity and maintaining strucrural integrity Thial Drugs with their Botanical names : t Amalaki - Emblica-fficinalis r' Haritaki - Tbrminalia-chebula t Vbhitaki - Tbrminalia-bellerica I Amrita - Tinospora-cordifulia I Vasa - Adathoda-vasica I Katuka - Picroruhiza-kurroa I Bhunimba- Swertia-chirata T Nimba Azadiracta-indica I Daruharidra- Berberis-aristata I Bhumyamalaki- Phyllanthus-niruri t Kumari - Aloe-vera All of the above mentioned' drugs have the following properties t Pittahara t Pitta Rechaka t yakrit Uttejaka t Dipana t Pachana t Rechana t Sothahara t Jvarahara Validated mode of action of above mentioned drugs r Capacity of Hepatocellular regenration r Cholegogue and choleretic activity r Hampering the Entero-Hepatic Circulation r Excess flow of Stercobilinogen and Urobilinogen with stool and urine r Membrane stabilizing effect r Anti viral and anti oxidant effect t Enzymatic and metabolic correction 195
- 228. Discussion 1) The study is continued since 1993, under Prof. N.P. Rai in the Department of Kayachikitsa, IMS, BHU, Varanasi. 2) Data of clinical improvement in >950 patients (drop out was 50 patients) of Infective Hepatitis received AYurvedic treatment 3) Biochemical parameters like Serum Bilirubin and Liver enzymes (AST, ALf, ALP) are re- duced significantly 4) Experimental study confirms the Membrane stabilizing action of drugs over Hepatocytes 5) Experimental study over Liver enzymes and Histopathology confirms the Hepatoprotective action of drugs on Albino Rats Liver followed by CCl4 challenge 6) Enhancement of Stercobilinogen in Stool and Urobilinogen in Urine after administration of drugs 7) About 3Voof HBV +ve patients became -ve and a few became weaker +ve after completing the trial treatment Conclusion r Hepatitis 'B' as stated by W.H.O. is not as dangerous as AIDS r We have found that the Ayurvedic drugs are safe and effective in the management of Hepatitis clinically as well as experimentally r The residual symptoms i.e. the Abdominal and Psycho-somatic problems persisting up to 6 months, in the form of symptoms only, while bio chemically the liver became healthyl for the betterment drugs has been prescribed at least for 3 months continuously; to prevent the recurrence especially in decoction form. r The drugs are included in PUB-med, index for medicine. u 196 'tL.g aY# ffi I ! I F@
- 229. ATYAYIKA CHIKITSA IN AYURVEDA o Dr. V. V. S. Rama Sastry, M.D. (Ay), Formerly: Prof. & Head (Vc.), Post Graduate Dept. of Kaya Chikitsa- Govt. Ayurvedic College, Hyderabad. Ayurveda is a holy science dealing with the life style of the individuals as a whole, besides giving treatments to all the diseases. Diseases in general can be managed/treated with conservative line of treatments based on the principles of Ayurveda. We come across some Atyayika vyadhis in Ayurveda with their timely management. According to Ayurveda Atyayika vyadhi means, a disease which is de- structive in nature. A literal meaning for Atyayika is 'T.{asah". With this, it is clear that Atyayika vyadhis need to be attended successfully with Asu Chikitsa. Hence Atyayika chikitsa in Ayurveda can be taken as Atyayika vyadhi & Asu chikitsa. Therefore it is clear that Asu Chikitsa will have more appropriate utility in the management of Atyayika Chikitsa. Many interesting references in our classics are seen, both in the contexts of Atyayika vyadhis and Asu Chikitsa. Asu Chikitsa has become more essential in the present day living conditions. Atyayika Chikitsa for some of the diseases in Ayurveda is really interesting. These references show about, the supremacy of our Acharyas for their critical findings. In this context, SABDA PRAMANA plays a prominent role in practicing Ayulyeda, which is more supportive for a physician. We find many references of diseases in Ayurveda which are Atyayika in nature and references of Asu Chikitsa for those diseases. They are to be followed / practiced religiously with confidence over rhe science. Atyayika vyadhis and their management with Asu Chikitsa for some of the diseases viz. JWARA ATISARA, SHOOLA etc. is given with more information in detailed paper. I 197 #, tr
- 230. ATHARVA - 2006 INTERNATIONAL AYURVEDIC CONFERENCE & AyurExpo PROGRAMME PROCEEDINGS 01-12-2006, FRIDAY REGISTRATION and BREAK FAST Theme talk by Dr. S.K. Mishra followed by - INAUGURATION 1:00 - 2:00 PM : Lunch 2:00 4:00 PM - PLENARY SESSION - - | VENUE: ATREYA AUDITORIUM Chair person: esource persons Dr. Nataraj B.S. 2:00- 2:25 PM -Dr. M.S. Baghel, Jamnagar Co-chair persons: on Global status and opportunities in Dr Hullur.M.A. Ayurveda Session Guests: 2:25 - 2:50 PM - Dr. Vaibhav Lunkad, Pune Dr. K.B. Nagur on Nadi pareeksha Dr. Jagadeesh Kunjal 2:50 3:15 PM - Dr. V.V.S. Ramashastry, - Dr. K.C. Ballal Hyderabad on Atyayika chikitsa in Ayurveda Dr. Suresh Ambarkar 3:15 - 3:40 PM - Dr. J.L.N. Shastry, Dr. Giridhar Khaje Chandigarh on Safety relation of Ayurvedic Conveners: metalo-mineral & herbo'inineral formulations Dr.R.K. Gachchinmath 3:40 - 4:00 PM - Dr. B.S Nataraj, Bangalore, Prof. C.S. Bhat Chairperson remarks 4:00 - 6:00 PM: PLENARY SESSION - ll VENUE: ATREYA AUDITORIUM Chair personl Resource persons Speech by - Dr. Prasanna Rao 4:00 - 4:25 PM - Dr. Ramasundar Rao, Co-chair persons: Vijayawada on Surgery in Ayurveda and Dr. B.V. Prasanna relevant in today's practice Dr. P.G. Subbanagowdar 4:25 - 4:50 PM - Dr. Manjari Dwivedi, Session Guests: Dr. S.B. Hiremath Banaras on Women and child health in Dr. R.G. Sajjan shetty Ayurveda Dr. M.A. Kundagol 4:50 - 5:15 PM - Dr. Shankar Rao, Jaipur on Dr. Vishwambar Ayurveda & Modern drug development Dr. K.S.Malini 5:15 - 5:40 FM - Dr. N. P. Rai, Banaras on Conveners: Management of Hepato-biliary disorders Dr. S.A. Patil 5:40 - 6:00 PM - Dr. Prasanna Rao, Hassan, Dr.Yarageri Chairperson remarks by 6:30 PM Onwards: Cultural Fest B:30 PM: Dinner V,ieit u,s @ www;dgmamcgadag:org
- 231. A2.12.2O06. SATURDAY 9:00 - 11:00 AM: PLENARY SESSION - til VENUE: ATREYA AUDITORIUM Chair person: -Hesource personsS.H. Acharya, Spiech by - Dr. Satpute A.D 9:00 9:25 AM - Dr. - Jamnagar Co-chair persons: on Rejuvination and promotive practice in Dr. K. Ramachandra Ayurveda. Dr. Satish shringeri g:2s - 9:50 AM -Dr. Gurudeep Singh, Session Guests: Hassan on lmmunology and related disorders Dr. S.R. Hiremath 9:50 -10:15 AM - Dr. Shailesh Nadkarni, Dr. A.M. wali Mumbai on Rasaushadhies - A critical Dr. B.B. Hunagund approach Dr. B.S. Patil 10:15 -10:40 AM - Dr. Nageeb B M, Sritanka Dr. Ajit Kumar on A Comparative preliminary study of Convener: Antibacterial effect of an Ayurveda preparation Dr. G.S. Hiremath of Sarva vishadee oil 10:40-11:00 AM - Dr. A.D Satpute, Mysore Chairperson remarks 11AM - 1:00 PM - PLENARY SESSION - tV VENUE: ATREYA AUDITORIUM Chair person: Resource persons Speech by - Dr. Anjaneya Murthy 11:00 -11:.25 AM - Dr. P. Rammanohar, Co-chair persons: Coimbatore on Basic principles of Ayurveda Dr. Gururaja M.B. 11:25 - 11:50 AM - Dr. V.L.N.Shastry, Chennai Dr. G.M. Kanti on Management of growing children - Session Guests: Ayurvedic approach Dr. Smt. V.M. Hiremath 11 :50 -12:-15 PM - Dr.Vasudevan Dr. Chikkahanumaih Nampoothiri, Thiruvanantapuram on Dr. R.N. Gennur Keraleeya Panchakarma Dr. Uma Soudi 12:'15 - 12:40 PM - Dr. L. Mahadevan, Dr. S.G. Hiremath Kanyakumari on Current trends & recent Convener: advances in vasti. Dr. G.S. Juktihiremath 12:40 - 1:00 PM - Dr. Anjaneya Murthy, Mysore, Chairperson remarks :00 - 2:00 PM - LUNCH 1 ORAL PAPER PRESENTATION SESSIONS IN CHARG@ Over all supervision : Dr. M.C. Patil, Orqanisino secret ATREYA AUDITORIUM NAGARJUNA AUDITORIUM BHAVAMISHRA AUDITORIUM Dr. Kuber S. Sankh Dr. K.Shiva Rama Prasad Dr. Santosh N. Belawadi Dr. Jagadeesh G.Mitti Dr. R.V. Sheflar Dr.B.Dilip Kumar Dr. Y. A. Phaniband Dr.G.N.Danappagoudar Dr. Shashikant Nidagundi Dr. B.M.Mulki Patil Dr. Shankaragouda B.S. Dr. M.D.Samudri Dr. Madhushri Dr. Sibaprasad Dr. Ashok M.G. Dr. Prasanna Kumar Dr. Ashwini Vastrad Dr. Sharanu Dr. Savitha Bhat Dr. Adarsh Dr. Jayashree S. Oi. Vtlay G Hiremath Dr. Shalini Sharma Dr. Anitha Dr.Prasn Joshi Dr.Veena Jigalur Dr. Suvarna Sergeants at arm: Ms. Manjula, Ms. Sajani, Ms. Brinda, Ms. Rajeshwari Halvi, Mr. yogesh, Mr. Lakshman shivatli, Mr.shashikant Hiremath, Ms. Vishalakshi, Ms. Vidyavathi ttr.'lt,Si. i'W. .$m.e.m,C$,adeg"6}g Athiatrfel0.S.:1fi:f,,,:$y;:i$o eience..i&
- 232. 2:00 - 4:00 PM: ORAL PAPER PRESENTATION SESSION - I A VENUE: ATREYA AUDITORIUM Chair person: :00 - 2:20 PM Keynote Dr. A.V. Joshi 2.2O - 3:45 PM Paper presentation Co-chair persons: 213-Dr.M.N. Hiremath -AAMC Davangere Dr. T. Srinivas 016-Dr. Basavaraj S. Hadapad. K.M.C Manipal Dr. S.K. Hiremath 149-Dr. Usharani K M, TGAMC, Bellary Key note address: 024-Dr. N. Prasad, S.V.M.A.C, llkal Dr. G.S. Shrinivas AcharYa 027-Dr. Sriram C. Mishra, B.M.T.A.C. Gaiendragad Session Guests: 035-Dr. Santosh N. Belavadi, D.G.M.A.M.C. Gadag Dr. B.S. Tamagonda 044-Dr. M.A. Hullur, A.M.V. Hubli Dr. Chandrakant Hiremath 047-Dr. Mahantesh P.M., A.M.V. Hubli Dr. SubramanYa PadhYana 048-Dr. Vaishali Patil, A.M.V. Hubli Dr. K.S. Kuchanur Dr. Bhusnurmath Rajashekhar 125-Dr. Ashok M.G, DGM.AMC Gadag Conveners: 018-Dr. Pankaj R. Doshi, A.M.V. Hubli Dr. V.M. Sajjan 019-Dr. M.P. Sahoo, RA Podar Att/C Mumbai. Sn V.M Mundinamani 3:45 - 4:00 PM - Chairperson's remarks 2:00 - 4:00 PM - ORAL PAPER PRESENTATION SESSION - IB VENUE: NAGARJUNA AUDITORIUM Chair person: 2:OA - 2.20 note address Dr. S.K.Bannigol 2.20 - 3:45 PM- Paper presentation Co-chair persons: 085-Dr.Krishna R.Hebbar, M.l.A.M. Sciences Manipal Dr. Vijaybabu V 009-Dr. K. Flavindra Bhat.V.P.M.A.M.C. KOTTAKAL Dr. VinaY lt4ohan 010-Dr.M. Srikant V.P.M.A.M.C. KOTTAKAL Key note address: 042- Dn Vijay J Dandavathimath, G.A. M.C. Trivandrum Dr. Shylaia U. 147-Dr.Naveen Kodlady, TGMAMC Bellary Session Guests: 098-Dr.Prashanth G.S, A.A.M.C. Davanagere Dr. P.V. Savanur 1 12-Dr.Manu.R.A.A.M.C.. Davanagere. Dr. Prabha Sharma 123-Dr.Shwetal Shivhare, AAMC Davangere Dr. Manik Kulkarni 13S-Dr.Om Prakash Lenka, GAM Orissa Dr. Shekhar ReddY Dr. B.S.R.L.N. Shastri 081-Dr.Shri Krishna Jigalur, DGMAMC, Gadag Conveners: 082-Dr.Kamalaxi M. Angadi, DGMAMC,Gadag Dr. C.S. Kudarikannur 078-Dr.V.S. Hiremath, BVVS AMC Bagalkot VENUE: BHAVAMISHRA AUDITORIUM Chair person: 2:00 - 2:20 PM Keynote address Dr. Dingari Laxmanachari 2:20 - 3:45 PM Paper presentation Co-chair person: 015-Dr. Arun kumar Biradar, S.D.M.A.C. Hassan Dr. Muralikrishna 022-Dr. Veerayya H iremath, S. D. M.A. M.C. Hassan Dr. R.S. Ganiger 028-Dr. Roopa 1., S.D.M.A.M.C. Hassan Key note address: 029-Dr. Pushpavati, S.D.M.A.M.C. Hassan Dr. B.A. Venkatesh 030-Dr. Satish Hadimani, S.D.M.A.M.C. Hassan Session Guest: 108-Dr. R. Annapurna, N.K.J.A.M.C. Bidar Dr. G.l/. Devagirimath 111-Dr. Suja K. Shreedhar, G.A.M.C. Bangalore Dr. C.l. Kajagar. 122-Dr. Smita Mohan P.V., A AMC Moodbidri Dr. l.H. Kinnal 064-Dr. Krishnakumar K.M., AMV Hubli Dr. Manoj Katti 134-Dr. N^H. Kullkarni, S.V.P.n.A.M.C Badarni Dr. A.B. Kulkarni 110-Dr. Veena. G.D., A'AMC. Davanagere Conveners: 208-Dr.Guheshwer B Patil,SSAMC, Haveri Dr" C.S. Hiremath 3:45 - 4:00 PM - Chairperson's remarks m$ Dr. S.V. Sankanur . Af;:;$onf eioll#$:i&i:Ayu:rrEx'pu
- 233. 4:00 - 6:00 PM - ORAL PAPER PRESENTATTON SESSTON - il A VENUE: ATREYA AUDITORIUM r person: {.vv - a.zv rtut ess Dr. S.G.Mangalagi 4:20 - 5:45 PM Paper presentation Co-chair persons: 113-Dr. Manoj L. Sonaje, A.A.M.C. Mudbidri Dr. Govindarajalu 124-Dr. Deshraj Singh, lMS, BHU Key note address: 049-Dr. Deepti Kokane, A M V, Hubli Dr. Madhav Diggavi 101-Dr. Sarvesh. Dubey, IMS BHU Varanasi Session Guests: 065-Dr. Anita G. Kadagad, AMV Hubli Dr. Prashanth Jadar 025-Dr. Chandramoulishwaranr D.G.M.A.M.C Dr. N.G. Mulimani 073-Dr. Vijay G. Hiremath, D.c.M.A.M.C. Dr. S.G. Kulkarni 152-Dr. Poornima B, BMK AC Belgaum Dr. Sham Flao 196-Dr. Sudharani S.J.,NKJ AMC Bidar Dr. Seetaram Prasad 138-Dr. Nayana Ram M,NKJ AMC Bidar Convener 132-Dr. K.Shiva Rama Prasad, DGM AMC Gadag Dr. S.B. Govindappanavar 206-Dr. Pradeep L. Grampurohit, RG AMC Ron Dr. N. S. Hadli 5:45 - 6:00 PM Chairperson's remarks_ 4:00-6:00 PM - ORAL PAPER PRESENTATTON SESSTON - il B ) VENUE: NAGARJUNA AUDITORIUM ) Chair person: 4:00 - 4:20 PM Keynote address Dr. Ksheerasagar 4:20 - 5:45 PM Paper presentation Co-chair personl 005-Dr. Rashmi R. Sharma, P.G.T.R.A. JAMNAGAR, Dr. R.P. Hosamath 031 -Dr. Flemya, S.D.M.A.M.C. Hassan Dr. Lakshmeesh Upadhyaya 032-Dr. Pradeep S. Shinde, S.D.M.A.M.C.Hassan Key note address: 033-Dr. Tanuja M.P , S.D.M.A.M.C. Hassan Dr. Mrityunjay Panda 034-Dr. Pallavi Hegde , S.D.M.A.M.C. Hassan Session Guest: 055-Dr. C.S. Koushik, N.l,A. Jaipur Dr. P.G. Savanur 061-Dr. Deepak S. Nayak, A.M.V. Hubli Dr. Debasis Khan 068-Dr. Praveen R.,G.A.M.C. Tripunithara Dr. M.S. Karpurmath 069-Dr. Shafeer M.S, G.A.M.C. Tripunithara Dr. B.S. Koparde 095-Dr. Swapna Kumari, A.A.M.C. Davanagere Conveners: 102-Dr. S.M. Kudari, B.V.V.S.A.M.C. Bagatkot Dr. R.R. Joshi 185-Dr. Manohar J.,NlA. Jaipur Dr. Vijapur 5:4$ - 6:00 PM Chairperson's remarks 4:00-6:00 PM - ORAL PAPER PRESENTATTON SESSTON - il C VENUE : BHAVAMISHRA AUDITORIUM person: note address Dr. Ramesh Haiwalkar 4:20 - 5:45 PM Paper presentation Co-chair persons: 004-Dr. Avinash M. Pastore, A.L.N.R.A.M.C. Koppa Dr. Shashidhar Hombal 007-Dr. Janardhan V. Hebbar, A.L.N.R.A.M.C. Koppa Dr. Shirurmath 071-Dr.Shaila 8., DGMAMC Gadag Key note address: 211 -Dr.Jayanti C.,A.A.M.C, Davangere Dr. T.N. Nagaraj 026-Dr. Pramod C. Baragi, l.P.G.T.R.A. JAMNAGAF. Session Guests: 188-Dr.ERR. Lenin, JSS AMC Mysore Dr. Sujata Patil 037-Dr.D.V. Anand, R. Ay. Medical Malladihalli. Dr. Basamma Lingareddy 109-Dr.B.S. Hiremath, AMC lnchai Dr. Veena Datwadkar 093-Dr.Pradeep Agnihotri, D.G.M.A.M.C. Gadag , Dr. Alka Kulkarni 118-Dr.Anita H, D.G.M.A.M.C. Gadag Dr. Sunitha.V.Sajjan 072-Dr.Suvarna Nidagundi, D.G.M.A.M.C. Gadag Convener: 164-Dr.Manjunath S. Gavimath,BMK AC Belgaum Dr. S.H. Radder 5:45 - 6:00 PM -Chairperson's remarks
- 234. 03-12-2006. SUNDAY B:00-9:00 AM - Breakfast 9:00-11:00 AM - PLENARY SESSTON - V VENUE: ATREYA AUDITORIUM Chair persons: Resource person Speech by - Dr. Gopinath B.G 01-9:00-9:25 AM - Dr. U.K. Krishna, Japan, Co-chair persons: Ayurveda verses today's life threatening Dr. Mohantha T.K" diseases Dr. Suresh Negalaguli O2-9:25 -9:50 AM - Dr. Jayashree K.S, Session Guests: Bangalore, Unraveling the hidden treasures of Dr. Mohan Alva Dravyaguna Dr. Hanume Gowda 03-9:50-10:15AM - Dr. Hrishikesh Damle, Dr. Chandrappa K.G. Bangalore, Understanding plant chemistry for Dr. Raju Shet getting qr-rick results in Ayurveda Dr. M.S. Doddamani 04-10:15-10:40 AM - Dr. K. Nishteshwar. Convener: Vijayawada, Role Of Ayurvedic Herbs ln Dr. B.G. Swarni Preservation & Restoration Of Mental health 05-10:40-11:00AM -Dr. Gopinath B.G, Ba , Chair remarks 11:00Am -1:00 PM - ORAL PAPER PRESENTAT|ON sESStoN - ril A VENUE: ATREYA AUDIT0RIUM Chair person: 11:00 - 11:25 AM - Key note address ' Dr. U.N. Prasad. 11;25 - 12:45 PM - Paper presentation Co-chair persons: 056-Dr. Pooja sabharwal, N.l.A. Jaipur Dr. Satyanarayan Bhat 059-Dr. Kiran M. Khot, A.M.V. Hubli Dr. S.B. Kotur 062-Dr. Neeranjan .Y., A.M.V.Hubli Key note address: 063-Dr. Anjai Kannan .C.R., A.M.V.Hubti Dr. P.S. Byadagi. 218-Dr. Ajantha, GAMC, Mysore Session Guests: 066-Dr. Gurubasavaraj Yalagachin,S.D.M. Hassan Dr. S.R. Jahagirdhar 067-Dr. Chandrashekhar K.M, S.D.M. Hassan Dr. P. Nagaraj 074-Dr. Priya Kumari, A.A.M.C.Davanagere Dr. C.T. Basavarajappa 079-Dr. A.K.Tripati, B.H.U. Varanasi Dr. S. Gangadharan 080-Dr. V.Sunitha, S.D.M. Hassan Dr. K.A. Patil 089-Dr. M.K.Seeni, N.l.A. Jaipur Convener: 091-Dr. l.B. Kottur shetti, R.G.E.s.A.M.c. Ron Dr. B.S. Patil 12:45 -1:00 PM - Chairperson, remarks PUBLICATION DIVISION BOOK SERIES DGM Ayurvedic Medical college post Graduate studies and Research centre - Gadag AMRUTA BINDU SERIES _ 1 Dr. V.V. Subrahmanya Sastry,s ESSENTIALS OF BASIC AYURVEDA CONCEPTS Please turn off your mobiles or in to Silent mode when sessions are going on vrlr$it,,ns:,ii@rr4 idgffi .fffi $afi aEEru Sfi;arrr,a.06j lnt:.,.4y;.0on@hdal *it*Vdffi ffi
- 235. 11:00 -1:00 PM -ORAL PAPER PRESENTATION SESSION - lll B VENUE: NAGARJUNA AUDITORIUM Chair person: 11:00 -11:20 AM - Key note address Dr. S.S. Hiremath 11:20 - 12:45 PM -Paper presentation Co-chair persons: 038-Dr. Krishna Kumar K., A.M.V. Hubli Dr. B.B^ Joshi 039-Dr. Dhiraj V. Zope, A.M.V. Hubli Dr. u.N.K. Usha 040-Dr. Sandeep Nair, G.A"M.C. Trivandrum Key note address: 041-Dr. Sripathi Adiga, G.A.M.C. Trivandrum Dr. A.S. Prashant 045-Dr. Ravindra Kumar Arahunasi, A.M.V. Hubli Session Guests: 046-Dr. Avadhut Suresh, A.M.V. Hubli Dr. D. Bhattacharya 043-Dr. Madhushree H S, DGMAMC, Gadag Dr. Narayan 07 S-Dr. Harsha Murthy, A.A.M.C. Davanagere Dr. AdiA. M. 076-Dr. Naveen Kumar B.V, A.A.M.C.Davanagere Dr. R.A. Kolkar 094-Dr. J.S. Tripati, B.H.U. varanasi Dr. Raghavendra M.P 2'1 O-Dr. Bharati D.A, A.A.M.C.Davanagere Convener: 100-Dr. Rajni Chandre, l.M.S. , B.H.U. Dr. P.C. Chappanmath 12:45 - 1:00 PM - Chairperson's remarks 11:00 -1:00 PM - ORAL PAPER PRESENTATION SESSION - lll C VENUE: BHAVAMISHRA AUDITORIUM Chair person: 11:00 -11:20 AM- Keynote address Dr. B.S.Shridhar 11:.2O - 12:45 PM -Paper presentation Co-chair persons: 07V-Dr. Ashu;ini Vastrad, D.G.M.A.M.C. Gadag Dr. Krishnamurthy 163-Dr. Jaya Malagoudar, D.G.M.A.M.C. Gadag Key note address: 159-Dr. Archana A,. Joshi, B.M.K.A.M.C. Belgaum Dr. S.Fl. Doddamani 173-Dr. Surekha L. Khot,B.M.K.A.M.C. Belgaum Session Guests: 161-Dr. Ambika A. shitole, B.M.K.A.M.C. Belgaum Dr. Veeresh Angadi 148-Dr. Ajith Narayan K.S,T.G.A.M.C. Bellary Dr. K.D. Murshillin 143-Dr. Ramacharya Gudi, T.G.A.M.C. Beliary Dr. Makali 150-Dr. Mallamma 8., T.G.A.M.C. Bellary Dr. Hemanth Patil 145-Dr. Srimukund S. Alur, T.G.A.M.C. Bellary Dr. Amrut Haridar 165-Dr. Krishna Nayak, BNM AMC Bijapur Convener: 189-Dr. N.M. Harsha, JSS AMC Mysore Dr. Aiholli M.V. 195-Dr. Rajendra Prasad ML, JSS AMC Mysore Dr. Paraddi K.S. 12:45 - 1:00 PM -Chairperson's remarks 1:00 - 2:00 PM - LUNCH i!€i T- I ---1 "",J I I RTplock I Herb Garden .EE E# :V:i$it::$$..: @0Em A![i:Atr$A{0$l. ffiir,fiV:i:,Sffifef,'on6.E:i: i:i y.UltEX$s
- 236. 2:00 - 4:00 PM - ORAL PAPER PRESENTATION SESSTON - tV A VENUE: ATREYA AUDITORIUM Chair person: 2:00 - 2:2O PM -Keynote address Dr. Sarashetti R.S 011-Dr. Sandeep V. B.,V.P.M.A.M.C. Kottakat, Co-chair persons: 012-Dr. Mahesh P. S., V.P.M.A.M.C. Kottakat Dr. N.S.Shettar 0 1 3-Dr. Narayana Bavalatti, L P. G.T. R.A. Jam nagar. Key note address: 070-Dr. Shobha Bhat, V.P.S.V. Kottakkal Dr. Himasagar Chandramurthy 103-Dr. Subhash Sahu, S.V.M.A.M.C. ttkal Session Guests: 114-Dr. Vijayalakshmi P.B.,A.A.M.C. Mudbidri. Dr. K.L. Shirahatti 115-Dr. Shehna S.R.,A.A.M.C. Mudbidri. Dr. B.S. Savadi 1'16-Dr. G.H.Subhashree.,A.A.M.C. Mudbidri. Dr. Vinaya Kulkarni 117-Dr. Sumanth Shenoy H, A.A.M.C. Mudbidri. Dr. T.B. Tripathi 121-Dr. Prakash L. Hegde, SDMAMC Hassan Dr. Ujwal Deshpande 133-Dr. Veena Kori, DGMAMC Gadag Convener: 130-Dr. Shivaleela Kudari, DGMAI/C Gadag Dr. V.M. Malagoudar 3:45 - 4:00PM - Chairperson's remarks 2:00 - 4:00 PM - ORAL PAPER PRESENTATION SESSTON - tV B VENUE: NAGARJUNA AUDITORIUM Chair person: 2:00 -2:25PM - Keynote address Dr. B. Srinivas Prasad 096-Dr. S.K.Das Adhikari, S.V.M.A.M.C. llkal Co-chair persons: 097-Dr. Usha Veeresh, A.A.M.C. Davanagere Dr. Hemant Kumar 087-Dr. Shivaleela S. Kalyani, DGM AMC Gadag Key note address: 126-Dr. Siba Prasad, DGl,4 AMC Gadag Dr. Tanmaya Goswami 207-Dr. Satish S. Annigeri, SSAMC. Haveri Session Guests: 217-Dr. D S Kendadmath, DGMAMC,Gadag Dr. J.l.Hiremath ',l99-Dr. Katarki V.M,.,DGM AMC Gadag Dr. J.C. Huddar 131-Dr. Vijay Kumar K.C, AAMC Davanagere Dr. Subhash Bagade 092-Dr. Santosh Yadehalli Dr. G.R. Hublikar 1 67 -Dr. C.Haritha Lakshmi, B. R. K. R.G.AMC Hyd. Dr. Karamudi 168- Dr. S.Ramalingeshwar Rao, B.F.K.R.G.AMC Hyd. Convener: '1 69-Dr. Sundararaja. Perumal, B.R.K.R.G.AMC Hyd. Dr. U.V. Purad. 3:45 - 4:00PM - Chairperson's remarks 2:00 -4:00PM - ORAL PAPER PRESENTATION SESSTON - tV C VENUE: BHAVAMISHRA AUDITORIUM Chair person: 2:00 -2:25PM - Keynote address Dr. Shailesh Nadakarni 190-Dr. Shreevidya M., JSS AMC, Mysore Co-chair persons: 192-Dr. Fajiv G.B. JSS AMC Mysore Dr. Muralidhar Pujar 197-Dr. Premakumari M.S, GAMC Bangalore Keynote address: 205-Dr. Sreela R. JSS.AMC. Mysore Dr. Gurubasavaraj 120-Dr. Jayashree S., DGM AMC Gadag Session Guests: 144-Dr C M Joshi TGAMC, Beilary Dr. Hiremani Patil 141-Dr. Pallavi Shetty K., TGAMC Bellary Dr. Ashok Talbal 142-Dr. K.V. Guruprasad, TGMAMC Bellary Dr. Ashok Kukanor 155-Dr. Vaishali H.P., BMK AC Betgaum Dr. M.B.Sajjan 156-Dr. Harshitha M., BMK AC Belgaum Dr. Shivanand Swami 203-Dr. Mohan Kumar B. N, JSSAMC Mysore Convener; 157-Dr. Prasanna Mathad, BMKAC Belgaum Dr. S.S. Avvanni 3:45 - 4:00PM - Chairperson's remarks Vi$,it,iu$,r@,,;w.ffi xdg.rnaffi Cg6dag;idt$ t
- 237. 4:00 .- 5:00PM Panel Discussion 5:00 PM - Onwards Valedictory ceremony Followed by - Cultural Fest & Eye-catching events Organisers of ATHARVA 2006 International Ayurvedic Conference & AyurExpo Thankful to one and all lnvites & Delegates Chairman Dr. G. B. Patil, Principal,DGMAMC, Gadag (9448275050) Vice-Chairpersons: Dr. R. K. Gachchinmath (9448967262) Dr. S. A. Patil (9448232029) Organising Secretary: Dr. M. C. Patil(9448591188) Joint-Secretaries: Dr. K. Shiva Rama Prasad (9448746450) Dr. K. S. Sankh (9448223636) Dr. R. V. Shettar (9845613116) Dr. Santosh N. Belavadi (9886916367) Reception Committ€e: Accommodation & Transport: Dr. G. S. Hiremath (9448136792) Dr. V. M" Sajjan (9242127455) Dr. B. S. Patil (08372-234977) Dr. S. H. Radder (9448338100) Registration Committee; Dr. N. S. Hadli (9a48922340) Dr. G. S. Juktihiremath (9448337862) Expo Committee: Dr. V. M. Malagoudar (9448591295) Dr. C. S. Hiremath (9449243088) Shri. V. M. Mundinamani(08372-234022) Dr. P. C. Chappanmath (9448303001) Stage & Decoration Committee: Volunteer Committee: Dr. B. G. Swami (9448186208) Dr. S. S. Avvanni (9448646403) Dr. S. B. Govindappanavar (9448629677) Dr. K. S. Paraddi (9448338120) Dr. S. G. Vijapur (9343515049) Dr. S. V. Sankanur (08372-239417) Cattering Committee: Action Force Dr. C. S. Kudarikannur (94a8759735) Dr. G. N. Danappagoudar (9448079112) Dr. S. D. Yarageri (9448337855) Dr. Jagadeesh G. Mitti (9886801315) Dr. M. V. Aiholli (9342243257) Souvenir & PuPlicity Dr. S. B. Nidagundi (9986077528) Dr. U. V. Purad (9448185885) Dr. B. M. Mulkipatil (9886342489) Shri. C. S. Bhat (08372-234911) Dr. Y. A. Phaniband (9844326382) Cultural Committee: Dr. Shankaragouda. B.S.(9448235994) Dr. R. R. Joshi (9448540584) Dr. M' D. Samudri (9986070856) Dr.Smt.J.S.Viraktamath (08372-239377) Dr. Veena Kori (9449394127) ffi ffi ffi 3€ 3€ ffi H ffi ffi ffi ffi ffi 3r ffi H ffi ffi ffi 8r ffi 3r ffi ffi H ffi ffi ffi 3€ ffi ffi ffi H ffi ffi H ffi ffi St ffi ffi ffi ffi ffi ffi ffi ii'
- 238. INSTITUTION PROFILE Shri Jagadguru Shivananda Mahaswamiji was a great saint of Advaita Philosophy. His later perceptor Jagadguru Nandeeshwara Mahaswamiji established Jagadguru Shivananda Vidyavardhaka Samsthe in the Year 1 978 to serve the educational development of this area. Swamili's divine inspiration motivated Shri Danappa Gurusiddappa Melmalagi, Smt. Girijamma. D. Melmalagi the couple of Benakanahalli Village of Kundgol taluk to donate all their property to establish Ayurvedic Medical College at Gadag in the year 1979. Presently the institution celebrates its Silver Jubilee year and stands as one of the pioneer reputed Ayurvedic institution in the state. The institution ever remembers the valuable contribution of Jagadguru Nandeeshwara Mahaswamiji who inspired Danappali to be a donor and Late Dr. S. V. Savadi, the principal who struggled honestly to resolve all difficulties of the college at its budding stage. : Ctossing quartel century with progress is a challenge for any institution, but we lead the institution with pride by the divine force of present Swamiji, President Jagadguru Abhinava Shivananda Mahaswamiji and visionary guidance of our chairman Shri S. B. Saunshi. The institution is situated in 1 0 acres of land at very posh layout at Gadag city. lt has attractive building worth 8 crores. The entire campus is well maintained with rose gardens. At present inslitution has B.A.M.S. degree course with intake of 60 students per year where in 375 students are studying at present. lnstitution is running post graduation courses in 4 specialities viz. Kayachikitsa, Panchakarma, Rasashastra and Dravyaguna Vignana. 75 Scholars are engaged in research studies in P.G. studies. 1 1 0 teaching and non teaching staff are rendering their service for the progress of the institution. 1 4 wdl established depaftments, Labotatodes with all modern medical equipment. Herbal garden with more than 400 rare species of medicinal plants, Libraty with valuable books, Ladies hostel, beautiful lawns and rose gardens in the campus have created very good academic environment in the instituti0n. I 50 bedded. well equipped, with all modern diagnostic facility hospital is functioning in college premises to fulfill the need of public health care system with students studies. Throughout the state, college hospital is well known for its successful treatment for the disease Parshwavayu, (Paralysis), Piles and other chronic aliments. Panchakarma theatre is well equippied with all facilities, more than 50 to 60 procedures are done every day. Hospital has well equippied operation theatre where all surgeries are canied out. Department of panchakarma has organised conference and workshop on Basti, Mastishkya. Department of Rasashastra has organised seminar chyavana on Rasayana. Apart from this many guest lectures, symposia are organised regurally as a part and parcel of P. G. Cariculum by different depailments. College has N. S. S. Unit. lt conducts special camps Regularly. As wdl as free health checkup camps are also organised. Ambulance service is made available tound the clock for the needy patients. Sri D. G. Melmalgi Ayurvedic Medical College and Hospital, with a shoil span of time excellently catering the health services in all the branches of Ayurveda and gaining popularity not only in lndia but also in abroad. This lnstitution is focusing its effort 0n research works to meet the challenges of the present day. Vision and Mission o To ptopagate and promote the basic principles and concepts of Ayurveda to the world in an impressive & understanding way. a To introduce modern scientific techniques in all possible fields of our branches. a To encourage young generation to study and practice Ayurveda. o To conduct seminars, wotkshops and practicle demonstrations for the benifit of practioners, students and researchers of Ayurveda. o To cteate environmental awareness, cultural heritage, social concern in the students, by conducting cullural programmes and social awareness camps. o To conduct Personality development pr0grammes, to establish positive approach in leaming and teaching. a To stan P.G. & PhD courses in all specialities and upgrade the institution t0 its heighest level. -rI' rl_tNr I ltlltrt :l:::: -zd [!#l*'b- II II II I I. II TT TI I r IIIII II llI f, I tl I jG rt