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KAMALA

Etimology of the word: - The word kamala literally means the loss of desires of doing any work, eating, etc. It can be called as severe anorexia or malaise.

  • Acharya charak and Harita considered the disease as a type of second stage of Pandu roga.
  • Acharya vaghbhat considered it as a separate disease.
  • Although the pandu roga is the important etiological factor of the disease the pathogenesis can also take place independently.

Types:

  1. Bahupittakamala - similar to haemolytic jaundice
  2. Rudhapathakamala - similar to obstructive jaundice

Bahupitta kamala

Samprapti ( Causes and pathogenesis)

The patient of panduroga who takes pitta aggravating things & lifestyle then it leads to more pitta prakopa. It leads to burning and It leads to excess secretion from the liver. This secretion spreads all over the body and thereby producing yellowish discoloration on nails eyes skin urine and stools. Thereby leading to Bahupitta karma.

Rudhapata Kamala

Causes and pathogensis:

Due to intake of dry, cold, heavy, sweet food items, holding the urges like urine and stools etc. leads to vitiation of vata and kapha. So these vata prakopa makes the kapha dry and thereby leading to the obstruction in pittavahini .The other reasons for this obstruction are gall stone, any tumor in the surrounding area & worms. Due to these obstruction though the formation of pitta is normal. It will not be able to reach the intestines and the colour of stools becomes whitish. Again the obstruction in pittavahini causes the improper movement of pitta producing the symptoms of indigestion, loss of appetite, burning sensation, thirst, debility of body.

Complications

Itching, fever, breathing difficulty

Treatment:

Line of treatment of Bahupitta kamala:

Panchakarma

  • Snehan: For snehan Katuka ghee, guduchi ghee, tiktak ghee, etc.
  • Mrudu virechan (Mild purgation) For virecham: Sweet, bitter taste and cool potency medicines should be used eg. Amalaki, Indian gooseberry, draksha, Nishottari, kutki.

For shaman chikitsa:

  • pittaghna chikitsa: To remove the vitiation in the liver try giving some internal medicines like Arogyavardhini,, sutasekhar,, kumari Asav No. 1, etc

Line of treatment of Rudhapathkamala:

  1. Since there is kapha prakopa in Rudhapath kamala, snehan is contra indicated.
  2. strong purgatives like preparations of trivrit,, danti,, kutki, Jaypal
  3. For shaman chikitsa:- Kaphaghna chikitsa
    But when obstruction is removed and when pitta comes in intestine it gives yellowish colour to stools then to do pacify the pitta, pittashamok treatment to be done.
  4. If obstruction is because of warms or tumour then it has to be removed by surgical treatment if required.


SHWASA (BRONCHIAL ASTHMA)

  • The disease in which vata (prana vayu) is directed in upward movements resulting in the sound like bhasrika is called as shwasa.
  • Acharya charak has stated that there are many fatal diseases but in comparison the fatality of hikka (hiccoughs) and shwasa is much more than the person suffering from any other disease. hikka and shwasa are present at the time of death.
  • It means that all the diseases in which there is increasing in breathing movements (dyspnoea) are collected under the heading shwasa.
  • Also when hikka and shwasa are produced due to there own causes, they can be treated but if it is a complication of other disease, they may prove fatal.

Etiological factors

Dust, smoke, fumes, pollen grains, industrial gases, air pollution, cold places, drinking cold water, Ecess exercises, excess sexual intercourse, movements, increased in indigested food particulars in the body. Malnutrition and trauma to the vital parts of body (Marmopaghat), atiyoga of panchakarma, weakness.

Food items:-

Milk and milk products ,meat, fermented food items ,excess intake of food items which increases the kapha dosha.

  • Also shwasa is push as a complication to many disease like diarhoea, fever, vomiting, cold tuberculosis, epistaxis, anaemia, coughkasa heart diseases etc.
  • Out of these etiological factors some are responsible for doshaprakoa and some weakness of the pranvaha srotas (respiratory system)
  • Combination of doshaprakopa and weakness of pranavaha srotas leads to the formation of shwasa disease

Pathogenesis

Due to improper diet and lifestyle it leads to the vitiation of Respiratory tract. Also because of that improper diet and lifestyle, kapha and ama (indigested food particulars) increases in Amashaya (stomach).

This vitiated kapha moves upwards and reaches the respiratory system thereby producing obstruction in the respiratotry tract.Therefore the normal movements of prana are hampered and it moves upward producing the disease shwasa

Types
  1. Maha shwasa
  2. Urdhwa shwasa
  3. Chinnashwasa
  4. Tamak shwasa
  5. Kshudra shwasa

Purvaroopa (prodormal symptoms):

Distention of abdomen, backache, pain in the chest, difficulty in breathing, Anorexia, gas trouble, etc.

Out of some symptoms indicated Amashya dusti, agnimandhya and upward movement of pranvayu

Roopa (symptoms):

All prodormal symptoms are more manifested Increased in the breathing movements

Specific symptoms:-
  1. Mahashwasa heavy breathing, with obstruction ,biots breathing, sounds like aggressive bull common sense and intelligence is lost. Rolling or unsteady eyes, abnormal eyes and face speech is choked, retention of urine and faeces, anxious ,depression.
    Mahashwasa is fatal these symptoms resembles to biots respiration which is produced as a complication in some serious like renal disorders and uraemic coma.
  2. Urdhwa shwasa:- The patient has prolonged expiration but cannot take deep inspiration
    • It is also fatal and also produced as a complication in pulmonary congestion consolidation, pneumonia, pneumonitis lung disease.
    • The opening of respiratory tract are covered and kapha. It shows symptoms like upward gaze, rolling eyeballs, fainting, restlessness patient also have dryness of mouth and throat.
  3. Kshina shwasa:- Respires intermittently or do not respire at all for some time . The breathing movements are irregular. Initially the breathing movements are more It goes on deserving and stop momentarily.
    There is cutting pain in head and chest, associated with sweating, fainting, flatulence and burning sensation in the pelvis There is downward gaze and rolling eyes, redness in eye, loss of complexion, suffering from kshina shwasa dies instantly . This condition is identified as chyne stroke breathing.
  4. Kshudra shwasa:- In this, vata is aggravated by exertion and heavy meals. It produces kshudra shwasa which subsides itself on taking rest. No treatment is required.
  5. Tamak shwasa:- Due to the improper diet and lifestyle, the obstruction in the respiratory tract is produced by kapha .It produces obstructing sound. This condition is labeled as tamak shwasa . In which if acute attack is produced may prove fatal.
    The name tamak shwasa is suggested for 2 reasons. Tam means darkness.
    1. In this darkness before the eyes or fainting is observed.
    2. The attack is observed especially during night times.
    The hereditary factor is prominently observed which is responsible for weakness in course of disease.

Symptoms:-

It starts from rhinitis, cough like disease and then produces obstructing sounds occurs in cold season, monsoon season, period of kapha dominance at night.

After the asthma attack, if sputum is expelled then some relief is attained

  • In lying posture asthmatic attack gets aggravated
  • Patient feels comfortable in sitting position, after intake of hot food or in warm climate as the disease is kaphavata dominant
  • paraxysmos ,dyspnoea is observed

Prognosis of tamak shwasa / Bronchial Asthma :
If can be maintained or can be cured if newly arised..

Types

Two types depending on dosha involvement

  1. vata bhuyista - dry cough, sticky sputum
  2. Kaphabhuyista -sputum is more, cough is less thin sputum
2 stages in tamak shwasa
  1. Vegavastha (acute stage) All the symptoms are observed in the acute stage depending on dosha strength time, and weakness of the respiratory track
  2. Avegavastha (dormant stage) It is absolutely normal and no symptoms are observed

Complication :

hoarseness of voice, cough heart disease

Prognocies:

  • Kshudra shwasa -easily treated
  • Tamak shwasa –(kastasadhya or yapya) can be maintained or if new arisen is treated.
  • Mahashwasa-Not curable
  • Urdhwa shwasa
  • Kshinna shwasa

Treatment of tamak shwasa

In acute stage of shwasa (Asthma hiccups)-first massage on chest and upper back should be done with sesame oil and saindhaw Afterwards steam should be given . Due to this the blocked kapha mucus in the respiratory tract gets liquify and the vata moves in the normal downward direction In shwasa, purgation should be given with vata kapha reducing drugs, due to this the upward movement of prana is corrected

The medicines, diet and drink selected for swasa hiccups should be reducing kapha and vata ,vatanulomaka, hot and opposite properties should be reducing kapha and vata.

Chikitsa like brihan(nourishing) ,shaman(supressing) are described for shwas Some mistakes in brihan chikitsa and shaman chikitsa may lead to complication but can be managed easily.

But the complication produced as a result of karshan chitisa(shodhan) ie vaman is dangerous and difficult to treat that’s why prime attention should be payed while doing karshan chikitsa.

Treatment of tamak shwara (Asthma) varies in vegavastha and Avegavastha:

In vegavastha

dosha shamak and vatanulomaka is important . In kaphabhuyista shodhan is indicated

If kapha is not utklista the internal oleation with til oil or narayan oil External oleation on the chest and upper back with sesame oil and saindhav

Swedan whole body on chest and upper back Diet should be kaphotkleshak diet(diet which increases kapha), meat soup, curd ,fermented items.

Vaman must be mild
Dhoompan
Virechan

It vatabhuyista then unfit for vaman or due to any other reason vaman is not possible then mrudu virechan(mild purgation) can be given or even after vaman chikitsa mrudu virechan can be given.

For these mild purgatives like castor oil, gandharva Haritaki can be used.

In tamak shwasa pran vayu moves in upward direction so by viredran the pran vayu start to move in normal downward direction.

Also virechan is also one o f the good chikitsa for kapha.

Basti -Matra basti with narayan oil sahachar oil can be given Dhoomapan is also indicated

Avegavastha

In this, the srotosuddhihar and preventive treatment is advised. Diet is advised to the patient

  1. The things should be avoid are like heavy , ,cold fermented food items and promote the patient to have hot ,uncotus , amd liquid ,diet sensitivity or allergy to particular food should be asked.
  2. Panchakarma Vaman advised in kapha parakopk kala ie. Vasant shitu
  3. Rasayan chikitsa like vardhaman pippali Rasayan, Chyavanprash
  4. Drugs acting on Amashaya as the origin site of this disease in Amashaya
  5. parpati kalp like Rasa parpati
  6. Pranayam chikitsa

Diet advice

During acute stage, light, warm and liquid diet is beneficial Avoid eating at night Avoid all types of fermented food items like curd , fish ,idli, dosa, Use warm water for drinking and for bath.



PRAMEHA

Defination:-
The disease in which there is frequent and excess amount of urination is a called as prameha

Prameha is a kapha disorder. Even though all the 3 doshas are involved there is dominance of kapha dosha in prameha.

Etiological factors:-

Idle sitting or sitting in a comfortable posture for a long duration,sleeping during day time sedentary work Excesive intake of yoghurt ,milk products excessive intake of liquid ,cool, unctuous sweet and fatty , meat soup, jaggery any sweets along with kapha promoting food items, depression are the causes of prameha. Also prameha may be hereditary also

Pathogenisis:-

Due to the indulgence in the etiological factors,it leads to 3 dosha vitiation Due to the vititation of kapha, it leads to incresase in the kledak kapha leading to agnimandhya(decreased digestive power). Due to dhatu agnimandhya the dhatus don’t get proper nourishment and it leads to excess formation of kleda. Along with kledak kapha there is vititation of vata and pitta dosha also. Due to pitta vitiation digestion not proper and dhatus don’t get proper nourishment Also there is vitiation of saman vayu and Apan vayu Due to pitta vitiation digestion not proper and dhatus dont get proper nourishment .Due to the dhatu agnimandhya there is quantative increase in the malnourished dhatus, producing laxity in the tissues. Also the vitiation of meda, rakta, shukra, lasika ,vasa,majja, rasa oja ,mansa takes place The meda is having the similar properties of kapha and so the meda abnormality is more .It leads to the increase in the kleda . So to excrete this kleda, excess urination is there and vitiation of medovaha and mutravaha system is there and producing prameha (diabetes)

Poorvaroopa ( Prodormal symptoms)

  1. Increased mala formation (coatings) at teeth ,palate and tongue
  2. Burning sensation of hands and legs
  3. Sticky feeling in the body
  4. Thirst
  5. Sweet taste sensation in the mouth

Roopa /Symptoms

Prabhut and avil mutrata i.e. urination is more in amount and it is turbid Depending on the dosha dushya combination, different types of colours, odours and nature are produced and are refered as different types of prameha.

Different types of kaphaja prameha :

  1. Udakmeha- similar to Diabetes Insipidus-excessive urination,cool, odourless, colourless,little slimy and little turbid
  2. Ikshumeha -similar to Elementary glycosuria- urine is like sugarcane juice and is very sweet
  3. Sandrameha -similar to phosphaturia- urine become thick when kept overnight
  4. Sandraprasadmeha/ Surameha:- In this condition urine resembles sura i.e. clear top and thick bottom with solid precipitate .This resembles acetoneuria.
  5. Shuklameha / pistameha:- In this condition the urine is thick like a solution of corn flour and horrripulation during micturation This condition can be correlated phosphaturia or albuminuria.
  6. Shukrameha: Urine is like semen or mixed with semen .It can be correlated spermaterrhoea
  7. Sikatameha:-In this, patient passes urine containing particles resembling the sand. This condition resembles lithuria.
  8. Sheetameha -In this urine is sweet, more and cold and frequent
  9. Shannirmeha- In this urine passes slowly with little force but frequently . This condition may be produced because of some obstruction pathology in the system.
  10. Lalameha –In this urine is slimy. This condition resembles albuminuria.

PITTAAJA PRAMEHA

  1. Ksharmeha- generally urine is acidic But when it stagnats in bladder for a long time, then it becomes alkaline It may be caused due to the obstruction resembles in the wine flow This condition is alkaline uria.
  2. Neelmeha- In this the urine become blue This is seen when there is presence of the coloured substance called indicans. This condition resembles indicanuria.
  3. Kalameha -In this colour of urine becomes black like black ink .This condition resembles melanuria.
  4. Haridrameha- Urine is like colour of manjista kwath, slight red in colour and having foul smelling .This condition resembles haemoglobinouria.
  5. Manjistameha- Urine is like colour of manjista decoction, This condition resembles haemoglobinouria.
  6. Raktameha -In this urine is having foul smell, hot, salty in taste and red colour This condition resembles Haematuria.

VATATA PRAMEHA

  1. Vasameha-The patient passes urine mixed with fatty material only This condition resembles lipuria.
  2. Majjameha-The patient passes urine mixed with vasa. This condition is found in gonorrhea, pylitis or pylonephritis
  3. Madhumeha/ Kshaudrameha-Patient passes urine of sweet and astringent taste frequently .This condition can be corelated Diabetes Mellitus or glycouria.
  4. Hastimeha-urination is more, mixed with lasika

Complications of

  • In kaphja prameha :- Anorexia vomiting, excess sleeepig rhinitis
  • In Pittaja prameha- pain near the bladder testis, fever, burning sensation unconsciouness diarrhoera
  • In vataja prameha of tremos , cardic pain and arrest

Prognocies of diseases

  • Kaphaja prameha curable (sadhya)
  • pittaja prameh difficult to treat (kastasadhya)
  • vataja prameha incurable (Asadhya)
  • The prameha which hereditary is also incurable

Treatment

The prameha patient may be either

  1. sthoola & strong or thin and weak The 1st type of point are having kapha-pitta dominance
  2. The shodhan panahakarma procedures can be done in only strong patients and it should be followed by santarpan upachar ( nourshing treatment)
  3. While in weak points shodhan is contra indicated and only santarpan upadhar( nourshing treatment) should be done.
  4. In sthoola and strong patients,
    • Vaman or virechan According to the dosa dominance. If both are required then first vaman and then virechan should be administered
    • Then in shaman chikitsa ushna, dry , lekhaniya, apatarpan drugs are used bitter and astringent taste herbs are used Eg. curcuma, neem, bittergourd, musta, daruharidra Arjun , Khadir, lodhra, guduchi, jambul, etc. Medicines like chandraprabha ,shilajit, Arogyavardhini vati, vasant kusumakar, Jambwasav, Asandi kashay

Pathapathya

Pathya Aahar: puran dhanya i.e. old grains preferably barley, wheat, moong , kulitha, old rice, bitterground, ridge gourd, pumpkin vegetable like Jangal mansa

Vihar

  1. Ruksha udwartan (powder massage)
  2. Exercises
  3. Sleep less

Apathya
Aahar; New grains, curd, oil, ghee, sugar, sour food items, sweet items, meat,

Vihar: sedentary lifestyles Day sleep, smoking



Grahani

The disease in which there is malfunctioning of grahani (duodenum)is called as grahani.

Normal functions of grahani are digestion of food and then separation into essence part and the waste products

All these functions are hampered due to the malfunctioning of grahani

Modern science view:

  • Symptoms of Intestinal tuberculosis are similar to pittaja grahani
  • Symptoms of chronic colitis are smilar to kaphaja grahani
  • Also diarhoea due to pancreatic diseases can be also included in kaphaja grahani
  • Symptoms of sprue are similar to sannipatik grahani in Ayurveda

Etiological factors

  • Indigestion, improper combination of food
  • Holding the natural urges
  • Improper panchakarma
  • Taking more food, cold food
  • After diarhoea if patient doesn’t follow proper diet
  • All these factors leads to agnimandhya (loss of hunger) and leading to vitiation of grahani organ (duodenum)

Pathogenesis

When patient having loss of hunger but still indulge in the above mentioned types of food it leads to improper digestion .This brings vidagdhatha of food when it starts for a long time it leads to vititation of grahani organ so the functioning of grahani is hampered like digestion and separation food into essence (saar) and waste products (kitta)

Poorvaroopam (prodormal symptoms):-

  • Thirst
  • lazyness
  • lack of energy
  • heaviness in the body
  • takes long time for digestion
  • vomiting
  • lack of apetite
  • giddiness
  • peristalsic sounds

Symptoms :-

  • Sometimes loose stools and sometimes hard stools
  • When food is eliminated without the digestion , stools are loose, bad odour and with pain
  • When food is eliminated after the digestion of food, hard stools is observed
  • Frequent stools means 2 to 4 times in a day, for some days hard stools and for some days loose stools are observed
  • As the duodenum becomes weak, mostly the loose stools are observed
  • In some chronic cases indigested particles are observed in the stools.
  • Also symptoms like loss of apetite, giddiness,darkness in front of the eyes, vomiting ,bleeding, excessive salivation are observed.
  • Fatigue with loss of weight
  • Tenderness and pain in the umbilical region is observed

Types of grahani:-

  1. Vataja grahani
  2. Pittaja grahani
  3. Kaphaja grahani
  4. Sannipatik grahani

Vataja grahani:-

  • Dryness in the body, thirst
  • Darkness in front of the eyes, noise in the ear.
  • Pain in the neck back ,thighs and hips
  • Patient feels discomfort during digestion of food due to the gas trouble or pain
  • Desire for the intake of 6 taste food items
  • Pain while defaecation
  • Stools are sometimes loose and sometimes hard

Pittaja grahani

  • Loose stools ,yellowish and bluish
  • Sour taste,
  • bleeding
  • Anorexia,
  • thirst ,
  • fever

Kaphaja grahani:-

  • Nausea,vomiting, loss of apetite
  • feeling of sweet taste in the mouth,
  • digestion of food takes with difficulty
  • cough rhinitis
  • heaviness in the abdomen, belching and bad odour
  • stools are sticky
  • weakness loss of libido

Sannipatik grahani:- symptoms related to all the 3 doshas depending on the dosha dominance are seen.

Complications
  • Hepatomegaly or spleenomegaly, itching, constipation worm infestation ascites
  • Also anaemia ,fever, diarhoea ,Haemorhoids may be present

Treatment:-

General treatment:-
  1. Deepan
  2. Pachan is the important like the treatment
    • The treatment should be depending on the stage Aam and Niram stage
    • If there is Aamavastha then mild laxatives can be used eg. Haritaki, Amlaki, triphala gandharva haritaki etc. Once the digestion is improved, then deepan, pachan and grahi medicines which give strength to the duodenum should be used
    • dried ginger, kapardik bhasma, panchamrut parpati and buttermilk are beneficial
    • In grahni if exeessive loose stools are there, then for sthamban Ahifen, bhanga, jayfala, camphor preparations can be used.

Specific treatment

  1. vataja grahani
    • Ama Pachan
    • Ghritapam like Dashamooladi ghee
    • Niruha Basti
    • Mild Purgation
    • If dryness is observed then basti
    • Drugs like – lashunadi vati sanjivani vati Takrarista etc.


  2. Pittaja grahani:-
    • ghritapan like tiktak ghee
    • vaman or virechan
    • Drugs like Bhoonimbadi choorna,shoonthyadi choorna, chandanadi kwath ,parpati kalpa like loha parpati, kutaja parpati

  3. Kaphaja grahani:-
    • Vaman
    • Asavarista preparations like Bhallatakasav, kutajarista, Madhukasav
    • Parpati kalpa like panahamriti parpati, tamra parpati
  4. Sannipatik grahani:- Depending on the dosha imbalance treatment has to be done.

    Pathyapathya:-
    • Diet should be light and which is apetiser and digestive
    • Drinking buttermilk is very beneficial
    • Honey ,goat milk, cheese,moong beans , Navara rice , cow’s curd is very beneficial
  • Avoid heavy, hard and sticky food items.


Sandhigatavata (osteo arthritis):-

The disease in which there is pain and swelling in the joints is called sandhigatavata.

Etiological factors :-
The causes which leads to aggravation of vata like

  • intake of dry ,cold ,bitter, spicy and astringent taste food items
  • taking less food
  • excessive intercourse
  • less sleep
  • improper panchakarma
  • heavy work ,stress ,trauma etc.
  • vata dosha prakopa naturally occur in rainy season and after the digestion of food

Pathogenisis

There are 2 types of pathogensis

  1. srotorodhajanya (due to obstruction)
  2. dhatukshayajanya ( due to less nourishment)
  1. Srotorodhajanya samprapti:- Due to etiological factors it leads to kaphaprokopa (due to ama and intake of more cold items or cold atmosphere) it leads to obstruction in the channel (srotas). Due to this vata moves in opposite direction and producing the joint pain and swelling producing sandhigatavata
  2. Dhatukshayajanja samprapti:- Due to etiological factors it leads to vataprakopa (vata aggravation) .It leads to dryness and roughness in the srotas and produces weakness of the particular part, causing pain and swelling of joint.

Purvaroopa:-

The symptoms of sandhigatavata are slightly visible.

Symptoms

Sandhishoola , Sandhishotha

  • Pain while doing movements
  • Crepitation sounds from the joints
  • Difficulty in doing movements
  • Sometimes loss of movements is also seen

In srotorodhajanga sandhigatavata :- There is tenderness in the joints, redness and warm ,sometimes fever is also present.

Treatment

General line of treatment:-

A) Dhatukshayajanya sandhigatavata:

  1. In External and internal oleation with Narayan oil and bala oil
  2. Fomentation
  3. Lepa (paste) of herbal medicines like lepa gutika, hirva lepa etc,
  4. Anulomak- use of mild laxatives like castor oil and gandharva haritaki
  5. Raktamokshan - blood letting
  6. Dahan karma or Agnikarma
  7. Internal medicines like Yogaraj guggulu, mahayogaraj guggulu, ashwagandharista, shatavari etc.

B) Srotorodhajanya sandhigatavata:-



Yogic Practices in Hypertension

(Dr.Ajay Kumar, Dr. Tina Singhal, Dr, B n Upadhyay)

Hypertension accounts for 6% of adult deaths worldwide and is found in all human populations, except for a minority of individuals living in isolated societies. In developed countries, the prevalence of hypertension rises with age and affects 25-30% of the entire adult population, reaching up to 60-70% of individuals beyond the seventh decade. Elevations of systemic blood pressure play an important role in the pathogenesis of stroke, heart disease, and end-stage renal disease. Evidence increasingly suggests that control of hypertension can prevent stroke, retard the development and progression of renal failure reduce left ventricular hypertension can prevent stroke, retard the development and progression of renal failure, reduce left ventricular hypertrophy, and possibly modify the consequences of coronary artery disease. Hypertension is a sustained level of BP above which treatment is more beneficial than harmful.

As per yogic view the mind is the most important component in the etiology of hypertension. The causes of hypertension may be 1. Mental causes 2. Physical causes

a.Lifestyle
b.Hereditary
c.Ageing

Through experiences and deeper understanding of the whole human organism, we see that the mind plays an important role in the function of body and can cause diseases such as hypertension . Recent researches point to the significance of mental tension and personality factors. The body is directly influenced by the mind. If a positive attitude as well as strength and health of mind are maintained, then the body is well nourished and flourishes. If there are mental problems, stress and tension, the balance is disturbed and illnesses such as hypertension appears as sign that something is not functioning properly.

Mind is the basis because it controls our personalities, emotions, life- styles and habits. Aspects of lifestyles such as smoking, high fat diet, heredity and ageing all come under the influence of mind as it is more stuble and powerful aspect of our body. There is no doubt that personality plays an important role in the development of certain types of diseases. Any situation can produce stress even if it is designed to being relaxation, like playing golf or going swimming. It all depends on our personal view of the situation.

Todays lifestyle is not based on scientific principles and this is reflected in the increased amount of sports, television watching, cinema and newspaper. Today lifestyle is not in harmony with the world around us and therefore destiny we rip causes suffering. Diet and sleep are not scheduled to harmonies with the light and dark cycles of the day, season, temperature, climate and so on. The average modern diet and sleep patterns are unhealthy in quality and quantity. Too much sleep leaves us still feeling tired and un able to get out of bed in the morning while too much food makes us feel heavy and full. All these predisposes to ill health and high blood pressure over a period of time.

Yoga aims to remove hypertension and its potential lethal effects through a system of asanas, pranayam and meditation along with a complete reappraisal of lifestyle. In this way we remove mental disease that often leads to physical disease. Yoga helps us to cure from hypertension by offering the following practices

  1. Relaxation techniques
  2. Asanas & Pranayamas
  3. Yognidra
  4. Meditation

Relaxation Technique

These practices help us to cultivate a positive attitude towards life and ourselves. By removing mental problems we remove the causative factors that have lead to hypertension. The following points can help in the process of relaxtion.

  1. When something disturbs your mind, don’t get involved in it.
  2. Accept yourself and your feeling. Don’t compare yourself with other person. Remember that each person has his own talent and outstanding features.
  3. look within for happiness.
  4. Anger, greed, jealousy and other negative mental factors are to aqvoided.

Asanas-

Asanas means a steady and comfortable posture. These are physical postures both static and dynamic which are designed to relax and strengthen the body and mind. Asanas when practiced correctly in conjunction with mental concentration and breathe awareness will allow us to achieve a state of integration or homeostasis.

On the other hand the wrong kind of exercise such as muscle building can cause or aggravate hypertension. These asanas are to be practiced in morning and before dinner at night for5 -10 minutes. Asanas stretches the muscle like a good massages and Pranayam performed in the morning and before sleep transforms day and night and improve the quality of both, our activity and our rest.

The following practices should be thoroughly understood before going to be performed

  1. Shavasana
  2. Vajrasana
  3. Padmasana
  4. Pawan muktasana

  1. Shavasana:
    Shavasana literally means ‘Corpse Pose’ or Dead Man’s Pose. It is a posture of complete relaxation. While this asana is frequently assumed at the end of a yoga practice session, we can also use it to rest between yoga poses. We should try shavasana for ourselves to see how it can help us to calm our mind and reduce tension and anxiety. The Sanskrit word shava means corpse hence this is the Corpse. The Shavasana is also known as the mritaasana.
    Steps and Instructions

    1. Lie flat on your back with your legs together but not touching, and your arms close to the body with the plams facing up.
    2. Keep your eyes gently closed with the facial muscles relaxed and breathe deeply and slowly through the nostrils.
    3. Starting at the top of the head and working your way down to the feet, bring your attention to each part of your body, consciously relaxing it before proceeding on to the next.
    4. Remain in the shavasana for between 3 and 5 minutes or longer. If you become sleepy while in the shavasana begin to breath a bit faster and deeper.

  2. Vajraasana
    The Sanskrit word vajra means thunderbolt or diamond.

    Steps and Instructions

    1. The vajraasana is a seated posture. Begin by sitting back on your heels and pacing your knees, legs and feet together.
    2. Keeping the back straight place the palms of your hands down on top of your thighs.
    3. Breathe gently through your nostrils and sit in this position for at least three minutes.

  3. Padmasana:
    Lotus Pose is an intermediate to advanced seated pose can also help to open our hips and improve our seated posture. We can use this pose for breathing exercise or meditation.

    Steps and Instructions
    1. Sit on the floor with the legs stretched out straight in front.
    2. Bend the right knee and grasp the right foot with both hands and place it on top of the left thing bringing the heel as close to the navel as possible .
    3. Bend the left knee and grasp the left foot with both hands and plae it on top of the right thing bringing the heel as close to the navel as possible.
    4. Both knees should be on the ground and the soles of the feet are pointed upward . The spine is held straight but not rigid.
    5. The position of the legs may e switched after period of time if the posture becomes uncomfortable.
  4. Pavana muktasana:
    The Sanskrit word pavana means air or wind and mukta means freedom or release, therefore this is the “wind relieving posture” so named because it assists in releasing trapped digestive gas form the stomach and intestines.

    Steps and Instructions
    1. Inhale and bend the right knee and pull it close to the torso with both hands while interlocking the fingers just below the knee. Keep the left leg flat the floor.
    2. Hold the inhaled breath for a few seconds them exhale slowly through the nostrils and lift the back, shoulders and head of the floor and touch the knee with the forehead.
    3. Hold the exhaled breath for a few seconds then slowly inhale and return the back, shoulders and head to the floor. Remain holding the knee.
    4. Hold the inhaled breath for a few seconds then exhale while bringing the right leg to the floor.
    5. Lie flat on the back in the shava-asana for a few seconds then repeat beginning with the left leg.
  5. Pavana muktasana:

    The Sanskrit word pavana means air or wind and mukta means freedom or release, therefore this is the “wind relieving posture” so named because it assists in releasing trapped digestive gas form the stomach and intestines.

    Steps and Instructions
    1. Inhale and bend the right knee and pull it close to the torso with both hands while interlocking the fingers just below the knee. Keep the left leg flat the floor.
    2. Hold the inhaled breath for a few seconds them exhale slowly through the nostrils and lift the back, shoulders and head of the floor and touch the knee with the forehead.
    3. Hold the exhaled breath for a few seconds then slowly inhale and return the back, shoulders and head to the floor. Remain holding the knee.
    4. Hold the inhaled breath for a few seconds then exhale while bringing the right leg to the floor.
    5. Lie flat on the back in the shava-asana for a few seconds then repeat beginning with the left leg.

Pranayama : Yogic Breathing Techniques

Pranayama means ‘control (or extension) of the breath’. Practitioners of yoga believe that it is essential to learn to control the breath in order to still the mind. Consequently, detailed practices have been developed to enhance the flow of breath, or vital life force. These practices include various ways of inhaling, retaining, and expelling the breath.

Pranayama is sometimes described as the science of breath or extension of the breath. Pranayama is a highly evolved system of practices that can enable men to gain control over the breath. Pranayama is considered an invaluable practice because of the vital role that prana (‘air’, ‘breath’, or vital life-force energy’) is believed to play in a man’s physical, mental, and spiritual wellbeing. According to the tradition of yoga, parna is more than just air. It is the vital life energy that animates the being of not only every man, but also the entire world. When trying to calm an anxious friend, we intuitively suggest: “Take a deep breath.” Yogis have studied the power of the breath for millennia. They have discovered that by controlling the breath, we can control the mind.

One of the most common techniques taught in pranayama is three part yogic breathing. This technique brings one’s awareness to the breath in such a way that the duration of each inhalation and exhalation is lengthened. One does this by mindfully inhaling air in three steps: first, into the belly; next, into the mid-chest; and finally, all the way up to the shoulders and collarbones. Once the inhalation is complete, the breath is exhaled in three parts: first, from the top of the chest; second, from the top of the chest; second, from the mid-chest; and finally, from the abdomen. This cycle of breathing is repeated a number of times to provide increased oxygenation to the body, as well as to relax and restore.

Yoga Nidra: Deep Relaxation

Yoga nidra, which literally means ‘yoga sleep’. Yoga nidra is more commonly known as “Deep Relaxation,” or when performed at the end of the yoga session, “Final Relaxation.” This deeply calming experience can help us to integrate the benefits achieved during our yoga session, as well as let go of any areas where we may still be holding tension-whether that tension be physical, mental, emotional, or even spiritual. Nearly every yoga class concludes with a period of deep relaxation. Many yoga teachers believe that this is the most important part of a yoga practice. It provides the opportunity not only to integrate the benefits of our yoga session, but also to tune into ourselves- a priceless benefit for the typical man suffering from the pressures of time constraints and societal demands.

There are many powerful ways of preparing for Deep Relaxation. We should try concluding our yoga practice session with this progressive relaxation exercise. While deep relaxation is frequently performed at the end of the yoga session, we can perform yoga nidra any time we are in need of relaxation, independent of practicing other yoga poses. Assuming yoga nidra when we come home from work can be deeply restorative.

Meditation:
Meditation now forms an integral part of many well- recognized medical programs. Meditation helps us to enter the alpha state of brain wave activity, which is associated with relaxation and the reduction of stress. This, in turn, can help reduce blood pressure, heart rate and speed of breathing as well as promote healing.

The words “meditation’ and ‘medicine’ are both derived from the same Latin root word. Western medical research is only now validating what practitioners of yoga have known for thousands of years: Meditation can be good medicine a powerful tool for healing body, mind, and sprit.

Steps and Instruction

  • Find a quiet, clean, safe space for yourself. Make yourself comfortable.
  • Assume comfortable position, sitting on a chair, or in any cross-legged position of your choosing on the floor, spine erect but not rigid, hands softly resting on your knees or in your lap.
  • Close your eyes.
  • Shrung your shoulders up towards your ears, then down towards your feet to realease any tension you may be feeling.
  • Now bring you awareness to the point just below your nostrils.
  • Focus on your breath. If possible, breathe in and out through your nose helps to filter, purify, and moisten the breath before it is distributed throughout the body.
  • On each inhalation, focus your awareness on the cool intake of air into your nostrils.
  • On each exhalation. Feel the warm, moist outflow of breath form your nostrils.

Continue breathing in this manner for several minutes. Let the focus of your awareness be the breath. If you attention becomes distracted by other thoughts, just gently dismiss them and bring your awareness back to your body. Feel the energy flowing to your fingers and toes. With your eyes still closed, gently stretch your fingers and toes. Rub your hands together and cup the palms lightly over eyes. Feel the warmth of your hands cupped over your eyes. Keep your hands cupped over your eyes for a moment while you adjust to the light, and then slowly release your hands. Take a moment to notice any changes in how you feel or how you perceive your surroundings.

This basic meditation can help to make us feel more relaxed and centered. It can give us renewed energy and help us to think more clearly. It can be used to start our day, as a stress-buster during a busy day of work, or as a way of clearing mental debris at the end of a workday. The greatest benefits of meditation will come with regular practice. Through meditation, the mind can become more created and clear. This provides an ideal opportunity for us to access your deepest, inherent wisdom.

We should try meditating early in the morning if we can, after we’ve gotten up and done our morning ritual and before starting the workday. As we progress, we might also add a 15-minue period of meditation at he end of the workday to clea our mind of the clutter of thoughts and feeling that have accumulated during the morning and afternoon, and so restore ourselves as we prepare for our evening activities.

References-

  • Maran illustrated Yoga, 2005, Thomson Course Technology PTR, 25 Thomson Place Boston, MA.
  • Yoga for Men, Thomas Claire 2004, The career Press , Frankin Lakes, NJ.
  • Effect of Yoga on Hypertension, 2006, Dr Swami Shankardevanand, Yoga publication Trust, Bihar, India.
  • Hypertension Principles and practice, Edouard J. Battegay et al, Taylor & Francis Group, Broken Sound Parkway, NW.
  • Hypertension Management, 2005, GYH Lip, Panthers Publishers Private Limited Bangalore, India.
  • Clinician’s Manual on Treatment of hypertension, 2004, FH Messerli, Panthers Publishers Private Limited , Bangalore, India.
  • Harrison’s Pinciple of Internal Medicine, 16th Edn. 2003, Fauci AS, Kasper DL, Braunwald E, Hauser SL,Longo DL, Jameson JL, The McGraw-Hill Companies, U.S.
  • Davidson’s Principal & Practices of Medicine, 19th edition, 2002, Christopher H, Edwin R C, Nicholas A B, Nicki R C, Churchil livingstone Publication, U.K.



Gridhrasy (Sciatica) and Ayurvedic Treatment

Prof: Dr K Muraleedharan Pillai MD (Principle Vishnu Ayurveda College Shoranur)

The term Sciatica is applied in a somewhat imprecise manner to the conditions in which pain is experienced along the course and in the distribution of the Sciatica nerve- that is to say, is the buttock, back of the thigh outside and back of the leg and outer border of the foot. It is important at the onset to notice the limitations of this distribution, and in particular to notice that the sciatica nerve does not supply and structure on the front of the thigh and so pain in the regions or in the groin is not included in sciatica. The Sciatica nerve is originated from the scaral plexus. It is the largest nerve in the body. Its terminal branches consist of two distinctive nerves, antagonist of each other, the common peroneal (ext popletia) and tibial (int. popletial) nerves. The former nerve arises from the posterior and the latter from the auterior portion of the scaral plexus.

Cases of Sciatica, defined thus, are common, and many of them have a prolonged course and other well described features. Until recent years they were all confidently attributed to interstitial neuritis (sciatica neutitis) but it is now recognized that while a number of them are probably due to this cause, many are the result of irritation of one of the roots of the great sciatic nerve by the extruded nucleus of a ruptured intervertebral disc, and others are cases of referred pain in the sciatic distribution. The differential diagnosis between these different varieties of sciatica is frequently, and in fact in many cases it cannot as yet be made with confidence. Sciatica is the syndrome, which herniation of the nucleus pulposes of a lumbar intervertebral disc most commonly give a history of injury at, or shortly before the onset of symptoms. The injury is commonly of the variety known as a strain of the back due to sudden bending, the lifting of heavy weights or sudden movements of the back, as when striving to avoid a fall. Males are more commonly affected. In females child birth, especially with instrumental delivery, is an additional cause.

The outstanding feature of Sciatica is pain. It begins in the small of the back either at the time of the back either at the time of an injury or after an interval of some hours, days or weeks. It may remain limited to the back, but in most cases it extends, after a variable interval, on the back and down to the leg and possibly in the foot, so that clinical condition becomes one of ‘Sciatica’. The exact distribution of the pain in the leg depends on the spinal root which is affected. The pain is severe and lancinating, aggravated by stooping, by coughing and sneezing and by turning bed, and relieved by lying still. Flexion of the extended lag at the hip is always painful. Lesegues sign and the patient adopts an attitude of partial flexion of the affected limb at the knee hip, which avoids tension on the sciatic nerve and its root.

The condition is said to be Gridrasy, where first hip, then waist, back, thigh, knee and calf are gradually affected with stiffness, excruciating pain, and pricking sensations, associated with frequent twitching due to vata. If the disease due to vata and kapha there will be additional symptoms of tandra, Gourava (heaviness of the body) and arochaka (anorexia). The patient affected with gridhrasy disease walks abnormally, more or less like eagle walk, to avoid tension of the sciatic nerve and hence the name Gridhrasy. The patient is unable to lift the leg. In Ashtanga hridaya it is said thatwhen the nadi (nerve)which is going towards the parshny (foot) is affected by vata, the flexion and lifting of the leg will be very diffucilt. When the patient suffers excruciating pain along with the above said symptoms, the condition is said to be ‘Kalwi’.

According to Bhavaprakasa, there will be stambhana (numbness) and different kinds of pain in the lumbar region, uttock, thigh, pattelar and calf region. There is also Spandana (viberation) of the nerve is the above parts of the body.

There are two varieties of Gridhrasy Vataja and Vatakaphaja. In Vataja Gridhrasy there will be thoda, Vakrata of the body and Spandana over the knee joint and hip joint. There will be extreme Sthabdatha. In Vatakaphaja Gridhrasy, Jataragnimandia (indigestion), Tandra (fatigue), Arochaka (anorexia) and mukha praseka (excessive salivation) will be seen. Guruthwa of the body (heaviness of the body) also will be present in hareetha Samhita. Also (Thritheeya Sthana-Chapter 24) nidana and Lakshana (aetiology and symptoms) are described following with its treatment. Hareetha describes Gridhrasy as Vataraktaja Vyadhya.

In Susrutha Samhita Vatavyadhi nidana, Gridhrasy is mentioned as a disease in which two great nerve trunk emanating from the lower extremity of the thigh and reaching down to the bottom of the in steps and toes become stiffed or pressed with the deranged Vayu and thus deprive the lower extremities of their power of locomotion.

Gridhrasy is included in ‘Nanatmaja Rogas’ by Charaka. He says that there are two types of diseases-Samanya and Nanatmaja rogas. Nanatmaja roga, as vata is the root cause of the disease. There are eighty Vataja Nanatmaja rogas, of which Gridhrasy is the ninth one.

Nidhana of the Gridhrasy is not specifically mentioned in any of the ancient texts. So it can be presumed that the general Vata kopa may be the cause of the Gridhrasy also.

The vayu get vitiated by excessive travelling by car or scooter or driving continuously for hours, lifting of heavy weights continuously or by an inordinate indulgence in things which are possessed by the specific virture of eraging or aggravating that vital principle- Vata. On the other hand an over indulgence in such articles of food as are usna virya in their potency or in a surfeit, largely composed of sharp acid or alkaline substances or man exposture to heat, tends to vitiate the blood of the organism which on account of such contamination, tends speedily obstruction of the passage of Vayu. The vayu thus impeded in its course, becomes more and more agitated. Stanasamsraya takes place on the nadi which goes to the Parshny (foot). This particular nadi is Gridhrasy by the various acharyas of Ayurveda.

Regarding the treatment no detailed description of the Gridhrasy is seen in any of the ancient texts. Susrutha prescribes general vataroga treatment for Gridhrasy. He also mention about Rakta moksha by Sisavedha-Venesection, of the vein situated between kandara (Tendo Calcenius) and gulpha (Malleolus).

Neither Vagbata nor charaka has mentioned any specific treatment for Gridhrasy. As a vataroga, general Vataroga treatment can be done in this disease also.

If Vata is the only dosha which gets vitiated without any kind of occlusion (Avarana), it should be treated at first with oral administration of unctuous preparation such as ghee, fat, marrow, and oil. The person when over strained by the oleation( snehakrama) therapy should be comforted by rest for a while and should again be oleated with milk and meat juice of domestic, wetland and aquatic animals, mixed with unctuous articles or with milk pudding. When he is well oleated he should be subjected to sudation (Swedana) treatment as required. Naleeswada, Samkara Swedana Karma-in which unctuous articles are used can be done according to the suitability and condition of the patient. With the aid of oleation and sudation (Snehana and Swedana) treatment, even a distorted and stiffened limb can be slowly brought back to normalcy, just as it is possible to bend according to one’s desire, even a dried piece of stick by such measures. Stiffness, prickling pain, aches horripilation and similar other conditions can be quickly cured and the softness of the art restored by means of Sweda. Sneha and sweda will remove all the abnormalities of the body due to vata kopa. The sneha karma replenishes the diminished body elements, increases the vitality and strengthens the Jataragny (Digestion). The sneha and sweda Krishna should be administered repeatedly, in order that disorder of vata may not recur in the Viscera, Softened by Snehakarma.

If due to excessive morbidity the doshas do not subside with the above producers, the patient should then take shodhana oushadha (purgatives) mixed with snehads so that the accumulated doshas can be eliminated. For this purpose, the patient may take the medicated ghee prepared with thilwaka, or he may take castor oil with milk. These are beneficial and will expel the vitiated doshas. By excessive use of unctuous articles, saltish and usna and amla dravyas (Acid) in diet to excretory matter gets accumulated and occluding alimentary passage, obstruct vata and the normal peristaltic movement has to be stimulated to expel it. Bhavamisra the great master of Ayurveda in his book says that Gridhrasy patients should be treated with Vaman and virechana (Vathavyadhiadhikara 133-135). After vamana and virechana, to over come Amavastha drugs which would produce agny deepthy may be given. After attaining Agnideepthy Snehavasthy may be used. Hareetha another acharya prescribe Swedakarma and raktamoksha. Rasna panchakakwadha and Abhyanga with Vataghnatailas also be advised. The powder of Santhavary, bala, pippally with Evandathaila can be taken internally. Sarghadhara prescribes Ajamodadichoorna. Agnykarma also be advised. In yoga ratnakara it is said that maha panchamoola kwadha added with Thrivrit choorna is an effective remedy for Gridhrasy.



Ayurvedic Management of Premenstrual Dysphoric Disorder (PMDD)

Dr. Hemanta Panigrahi(C.R.I.A. New Delhi), Dr. Mahadeo Prasad (C.R.I.A. New Delhi), Dr.M.M.Padhi, Dr.G.S.Lavekar (C.C.R.A.S.New Delhi)

A lot of reproductive age women suffer from physical, emotional and behavioural premenstrual symptoms. It is essential for physicians and researchers to be knowledgeable about recogonizing, diagonising and managing premenstrual disorders, because they have a significant impact on women’s quality of life and productivity. Untreated premenstrual disorders can lead to higher direct costs associated with increased medical visits and laboratory tests, and higher indirect costs to employers through lower work productivity. This paper focuses on the most severe form of premenstrual disorder, premenstrual dysphoric disorder. Premenstrual syndrome (PMS) has been estimated to occur in as many as 20% to 46% of women. Depending on the diagnostic criteria for PMDD (they may have “subsyndromal”, and others, for a variety of reasons, do not seek treatment regardless of the severity of symptoms and their impact on social behavior.

Etiology
It is limited to ovulatory menstrual cycles and therefore does not occur premenarchally, post menopausal disorders are characterized by numerous mood,somatic, & behavioural symptoms that occur during the luteal phase of most menstrual cycles and subsides soon after onset of menstrual cycles and subsides soon after onset of menses. Various authors consensus that it is a distinct clinical entity with characteristic symptoms of irritability, anger, internal tension, dysphoria , and mood lability. Physical symptoms most commonly reported by women with premenstrual dysphoric disorder include breast tenderness, pain and swelling, appetite changes (predominantly food carvings), abdominal bloating, fatigue and lethargy, sleep disturbances (hypersomnia or insomnia), headache, general aches and pains, joint pain, and muscle stiffness.

Various hypothesis are postulated regarding its etiology. There is evidence that hormonal and neuroendocrine factors are responsible for this. The most commonly hypothesized etiopathogenesis of this disorderis serotonin dysregulation. Serotonin is responsible in expression of irritability and anger, but also has been found to play a role in depressive symptoms and food carvings. Ovarian hormones appear to produce their effects via their actions on the serotonergic and gamma aminobutyric acid (GABA) systems. Disturbances in cortical GABA neuronal function and modulation by neuro active steroids have been implicated as potentially important contributors to the premenstrual of PMDD. GABA levels are decreased in women with premenstrual dysphoric disorder during the late luteal phase compared with normal women. Behavioural and social factors associated with this disorder have not have been well depicted but can include smoking, alcohol consumption, caffeine intake, dietary patterns and use of an oral contraceptive.

In Ayurveda this disease is called as Rajavikriti. The main causative factor for this disorder are vata dosha. The association of Vayu in causation of most of the gynaecological disorders has been stressed by almost all the authors of Ayurvedic classics. Vayu plays an important role in producing this disease.

DIAGNOSIS CRITERIA
At least four of the symptoms should be present.

  1. Depressed mood or dysphoria.
  2. Anxiety or tension.
  3. Affective lability
  4. Decreased interest in usual activities.
  5. Concentration diffuclties
  6. Marked lack of energy.
  7. Marked change in appetite, over eating of food carvings.

Management

  • swarnabanga 500 mg b.d after food
  • Asokarishta 20 ml b.d after food
  • Kukutandatwak bhasma 500 mg bid after food.
  • Ashwagandha churna 5 mg bid after food with warm milk.

Supportive measures:

  1. A dietary increase in calcium content and a reduction in salt, sugar and caffeine intake.
  2. Aerobic exercise for 20-30 minutes 3 times per week.
  3. Stress management techniques.

Discussion
Ashokarishta: The chief ingredient is Saraca Asoka (Roxb) de wild. It regulates and restores normal menstrual flow. Improves blood supply to pelvic organs and improves ovarian function. It contains phytoestrogen which helps to regulate hormonal imbalance. It has anti oxidant, anti proliferative and angiogenetic effects.

Withania somnifera has titka, kashaya and madhura vipaka and ushna veerya, laghu and snigdhanguna, rasayana, vrishya, valya, vishaghna and nidra janana prabhava. This improves quality of life, reduces the stress, improves mental functions and also improves physical strength in women.

Withania Somnifera is rich source of phytoestrogen which inhibits the bone resorption. It also decreases the urinary excretion of pyridinoline, doexypyridinoline and also inhibits the osteoclast like cells in the presence of 1,25-(OH)2 VitD3. Withania somifera has powerful adaptogenic & anti stress potential. Kukkutandatwak bhasma and Godanti bhasma are rich source of elemental organic calcium carbonate which has higher bioavailability. The abrupt decrease in estrogen in women promotes reabsorption of bone, and it has been reported that depression or depressive state directly increased inflammation induced cytokines including interleukin-6. It has been pointed out that stress induced easy infectious may produce chronic infection. Withania somnifera and Kukkutandatwak bhasma take care of these effects. Ashwagandha exerts anxiolytic effect, exhibits sleep enhancing properties, anti stress adaptogenic and mood stabilizer, neuro protective action and calms the nervous system.

Plant adaptogens are defined as “smooth pro-stressors”, which reduce reactivity of the host defense systems and decrease the damaging effects of various stress disorders due to increased basal level of chemo mediators involved in stress response. This adaptogenic effect helps the women in premenstrual stage to adapt to the changes in the neuro transmitter levels, which is responsible for the resultant premenstrual anxiety and depression. Ovarian senescence is accompanied by physical changes, and life stress and poor health exacerbate these symptoms. Phytoestrogens found in these formulations are currently heralded as the potential therapy for estrogen dependant disease. The incidence of cardiovascular disease among post menopausal women has been active. Modification of LDL-C is a pre requisite for the uptake of LDL-C by macrophages in the arterial wall (an initial step in the formulation of atheroma), and incorporating anti oxidants into LDL-C particles, may be possible strategy for preventing lipoprotein oxidation. Phytoestrogens found in the Ashwagandha and in Ashoka rishta stimulate the clearance of cholesterol, probably by up-regulating LDL receptors and thereby increasing LDL-C receptor activity, kukkutan-datvakbhama is a rich source of natural organic calcium, resulting in healthy bone formation and improvement in body mass density, which helps improve quality of life in young women.

Conclusion
The increased risk for women with premenstrual dysphoric disorder to experience a reproductive related psychiatric disorder, coupled with the high degree PMDD commordibity with other psychiatric disorders like major depressive order and post partum depression, highlights the importance of careful screening and diagnosis of women who complain of bothersome or debilitating premenstrual symptoms. Management should be planned to the individual patient’s needs and preferences, and appointment should be scheduled to determine whether prescribed therapies are producing improvements in the patients behaviourial and physical symptoms. The fundamentals of Avurveda involve multiple dimension of health care, suitable for Indians. Ayurvedic drugs are grooming exponentially. The above facts prompted us to further validate the beneficial role of Ayurvedic formulations in premenstrual Dysphoric disorder in collaborative manner.

Reference:

  1. Atri deva,Susruta Samhita, Uttar Tantra Chaukhumbha Publication, Varanisi.
  2. Charaka 1962 Charak Samhita, commented by Girijadas Chawkhumbha Vidyabhavan Varanasi.
  3. P .V Sharma D.G Vigyana 1983 Chawkhum Publication.
  4. Sastri, Ambika Dutta 1969 Bhaisajya Ratna vali commented by R.D Sastri 2nd Edition Chowkhamba Sanskrit office Varanasi.

Acknowledgment
Thanks are due to Prof. G.S. Lavekar, Director, CCRAS, Janak Puri, New Delhi, Dr.K.K Jaysing Principal, G.A.M Puri, Prof. H.K. Khuswaha of NIA Jaipur, Prof.S.S Sharma of Jaipur for their co-operation and guidance.



HERBS SAVE YOUR LIVER

Liver is a reddish- brown wedge-shaped organ in the upper right-hand part of the abdomen. It weighs about three pounds (1.361 kgs) Liver functions are as given below

  • Storing energy in the form of sugar (glucose)
  • Storing vitamins, iron, and other minerals
  • Making proteins, including blood clotting factors, to keep the body healthy and help is grow
  • Processing worn out red blood cells
  • Making bile which is needed for food digestion
  • Metabolizing or breaking down many medications and alcohol
  • Killing germs that enter the body through the intestine

The liver is the body's quiet workhorse. And its our duty to protect the liver from untoward effects. it has a remarkable power to regenerate itself. Certain conditions that develop, such as fatty liver and steatohepatitis, may be signs of liver injury that can lead to permanent liver damage.

Acute Liver Failure: When a large portion of the liver becomes damaged and cannot function effectively, this is called acute liver failure. This serious condition can be the result of hepatitis, cirrhosis, alcohol/ drug abuse or certain medications.

Alcoholic liver disease: As many as ten percent of all American men and three percent of all American women may have health problems related to alcohol abuse. In India States like Kerala has the same problem. Alcohol affects many of your body’s organ, but one of the most commonly affected is liver. Alcohol abuse can lead to three main types of liver problems: fatty liver (steatosis), hepatitis, and cirrhosis.

Fatty liver: Fatty liver involves the accumulation of fat within the liver cells. It’s most common in people who are overweight or who have diabetes. These excess fat cells can cause your liver to become inflamed, and in some cases, to cirrhosis and liver cancer.

Hepatitis: Hepatitis is an inflammation of the liver. Alcoholic hepatitis can include severe liver dysfunction with complications.

There are several forms of hepatitis, which is an inflammation of the liver caused by one of the several viruses, toxic agents or autoimmune disorders. If the condition lasts more than six months, it is called chronic hepatitis.

Hepatitis A: Hepatitis A is usually spread through dirty food and water.
Symptoms typically appear 2-6 weeks after start of infection. They are as follows.

  1. Fatigue
  2. Fever
  3. Abdominal pain
  4. Nausea
  5. Diarrhoea
  6. Appetite loss
  7. Depression
  8. Jaundice, a yellowing of the skin or whites of the eyes.
  9. Sharp pains in the right upper quadrant of the abdomen
  10. Weight loss

There is no specific treatment for hepatitis A. Sufferers are advised to rest, avoid fatty foods and alcohol, eat a well-balanced diet, and stay hydrated. Hepatitis A can be prevented by good hygiene and sanitation.

Hepatitis B: it is a disease of the liver caused by a virus (the Hepatitis B virus) infection. It causes destruction of the liver tissue. The thing that makes hepatitis –B dangerous is the fact that it can lead to liver cancer in a significant number of patients, later in life. Following are the major routes of transmission of Hepatitis-B

  1. Contact with infected blood and body fluids, like from blood transfusions or to medical personnel during operations and patients care.
  2. Contaminated I.V. needles
  3. Sex with infected person or multiple partners
  4. From infected mother to new born

There may not be any manifest signs and symptoms in a majority of sufferers. Some patients develop symptoms of tiredness, bodyache, loss of appetite and mild fever. They may develop yellow discoloration of skin and eyes (jaundice), dark urine and complain of pale feces.

Hepatitis C: Hepatitis C is a blood –borne infections disease that is caused by Hepatitis C virus (HCV), infecting the liver. The infection can cause liver inflammation (hepatitis) that is often asymptomatic which can result later in cirrhosis and liver cancer.

There is no vaccine against hepatitis C. The symptoms of infection can be medically managed, and a proportion of patients can be cleared of the virus by a long course of anti-viral medicines. Although early medical interventions is helpful, people with HCV infection often experience mild symptoms, and consequently do not seek treatment.

Cirrhosis: This term refers to a group of chronic liver diseases in which normal liver cells becomes damaged and are replaced by scar tissue. Cirrhosis involves a widespread presence of nodules in the liver that leave scar tissue this decreases the amount of normal liver tissue available, so your liver works less efficiently. As scar tissue increases, your liver loses its ability to function. Cirrhosis can lead to end-stage liver disease.

Herbal therapy has been an important part of health and wellness for hundreds of years.

Given below is a list of herbs which act as a liver medicine and tonic, which have been studied under various clinical trials.

Bhumyamalki- Phyllanthus amarus
Bhumyamalaki is a bitter herb that help protect the liver. Traditionally used to care for liver related indigestion, hepatitis, and jaundice in children, it is also useful for viral infections. Phyllanthus primarily contains lignans called phyllanthine and hypophyllanthine, alkaloids, and bioflavonoids.

While it remains unknown as to which of these ingredients has an antiviral effect, research shows that this herb acts primarily on the liver. This action in the liver confirms its historical use as a remedy for jaundice. Phyllanthus, the enzyme needed for the hepatitis B virus to reproduce. In one study, fifty-nine percent of those infected with chronic viral hepatitis B lost one of the major blood markers of HBV infection (e.g. hepatitis B surface antigen) after using Phyllanthus for thirty days.

Katuki – Picrorhiza kurroa
The katuki plants is native to the Himalayas and is now part of Ayurvedic medicine as a treatment for primarily gastrointestinal problems, such as indigestion and constipation. Usually the root or rhizome of the plant is used medicinally.

In Ayurveda Picrorhiza kurroa is also a reputed remedy for the treatment of liver diseases. The chemical composition of the Picorhiza has been studied and active constituents were found to be iridoid glycosides known as picrosides and kutkosides. Modern clinical studies have confirmed the efficacy and safety of Picrorhiza kurroa for the treatment of liver diseases.

Most of the research studies carried out have shown that Picrorhiza kurrrao extract (standardized to kutkin content) has potential hepatoprotective activity as compared to placebo. In a randomized, double- blind placebo controlled trial in patients diagnosed to have acute viral hepatitis, Picrorhiza kurrooa root powder 375 mg three times a day was given for 2 weeks or a matching placebo was given. Difference in values of bilirubin, SGOT and SGPT was significant between placebo and Pk groups.

Picroliv, the active principle of katuki, exhibits anti HBsAg like activity in acute and chronic liver disease, and inhibits HBV antigens (HBeAg and HBsAg)

Picrorhiza is not readily water-soluble and is therefore not usually taken as a tea. While it is ethanol soluble, the bitter taste makes tinctures unpalatable, so it is therefore usually administered as a standardized (4% kutkin) encapsulated powder extract.

Neem-Azadirachta indica
Neem is used widely in Ayurveda, has been reported to have anti-inflammatory, immunomodulatory and adaptogenic properties. In a research study carried out, fresh juice of tender leaves of Neem inhibited paracetamol induced lipid peroxidation and prevented depletion of sulfhydryl groups in liver cells. There was an increase in serum marker enzymes of hepatic damage after paracetamol administration. Neem pre-treatment stabilized the serum levels of these enzymes. Histopathological observations of liver tissues corroborated these findings.

Guduchi- Tinospora cordifolia
Guduchi promotes regeneration of the liver and protects it from disease. It is one of the best herbs for the long- term health of the liver. Its tonic properties benefit the entire body, especially the immune system. It is beneficial for people of all constitutional types, making it one of the safest herbs to use. This herb is used to strengthen the body’s resistance to infection and its ability to cope with jaundice, digestive upsets, and nervous system problems. The liquid extract is also referred to as Indian quinine, which is considered especially important for fevers related to colds.

Outstanding results in people suffering from jaundice have been obtained using Guduchi. In 1993, American scientist Rege and his group used the herb in malignant obstructive jaundice: half of the group received conventional treatment- drugs and drainage- the other half were treated with drainage plus Guduchi. After conclusion of treatment,50% of the drug –treated group developed this problem. After surgery, only 40% of the drug- treated group survived, whereas an amazing 92.4% of those treated with the herb lived.

Clinical studies in twenty patients of infective hepatitis showed that Guduchi plays an important role in relieving the symptoms as well as normalization of altered liver functions. The majority of cases i.e. 15 cases (75 %) were cured and 5 cases (25%) improved after treatment with Tinospora cordifolia.

Punarnava- Boerhavia diffusa
It is found growing wild all over Indian and other Asian countries, to an altitude of 2000 m, in sandy soil and on waste ground.

An alcoholic extract of whole plant of Boerhavia diffusa fiven 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 activity.

Roots contain the rotenoids boeravinone A B, C and F and punarnavoside has also recently been isolated.

Hepatoprotective activity: An aqueous extract of the root conferred marked protection of the serum parameters GOT, GPT, ACP and ALP; however, no protection of GLDH and bilirubin was observed. The aqueous extract was more potent than the powdered drug. The chloroform and methanolic extract of roots also exhibited hepatoprotective activity and oral administration of an ethanolic extract of the whole plant of Punarnava showed activity against carbon tetrachloride –induced hepatotoxcity in rats and mice. A strong choleretic action was observed which resulted in an increase in bile flow and no signs of toxicity were observed up to an oral dose of 2 g/kg body weight in mice. Three rotenoids, one steroid and one flavone isolated from the plant lowered the content of enzyme GOT

Alcoholic subjects when treated with punarnava showed absence of any hepatic fatty changes and significant fall in ALT, triglycerides, cholesterol and lipids. It also exerts anti- inflammatory action by blocking adrenergens, suggesting alternations in the cell surface biology involving protein meditation. It lowers serum cholesterol, raises serum protein and relieves oedema and ascitis.

Kalmegh- Andrographis paniculata
For centuries kalmegh has been an important herb in the Asian healing systems of Ayurveda, Unani and Traditional Chinese Medecine. Traditionally this herb has been used to potentiate immune system response to inflammation and infections, and as an anti- inflammatory, antipyretic (lowers fevers) and a hepaqtoprotective (liver protector)

Kalmegh has been used as a house hold remedy specifically for jaundice and fevers, especially the intermittent type. It is a component of over 50% of the multi- ingredient herbal formulations available in India for the treatment of liver ailments and many books on Indian material medical equate the therapeutic applications of the plant with those of chiretta, Swertia chirata.

The major constituents in Andrographis are diterpene lactones known as andrographolides. These bitter constituents are believed to have immune-stimulating, anti- inflammatory, fertility- decreasing, liver- protective, and bile secretion stimulating actions.

Infective hepatitis is an acute inflammatory condition of the liver. It is often followed by liver cirrhosis and may progress to a coma and death. In India, where ancient physicians used kalmegh to treat similar liver ailments, a study was conducted to evaluate the effect of kalmegh in infective hepatitis. There was marked improvement in the majority of patients tested, when given a decoction or infusion of kalmegh. Appetite improved on the fifth day of treatment, jaundice (yellow color of conjunctive of the eye and skin) gradually diminished and completely disappeared within 24 days, and fever subsided after 7 days on average. Other indications of effectiveness of kalmegh included improvement in liver function tests. The researchers concluded that kalmegh was a useful remedy for treatment of infective hepatitis.

The andrographolides present in kalmegh are potent stimulators of gallbladder function. In animal experiments, those that received andrographolides for seven consecutive days showed an increase in bile flow, bile salts, and bile acids. These increases are beneficial and result in enhanced gallbladder function. Use of kalmegh might, therefore, decrease the probability of gallstone formation and might also aid fat digestion. The andrographolides also prevented decreases in the amount of bile that are caused by acetaminophen toxicity.

Bhringaraja – Eclipta alba

Bhringaraja has similar properties to the well-known western liver herb, dandelion (Taraxacum officinale).This Ayurvedic herb not only provides support for liver-related problems, including skin disorders, but also is suggested to improve poor digestion of fatty food and to help with anemia and lymphatic congestion.

An alcoholic extract of freshly collected Eclipta alba exhibited dose-dependent significant hepatoprotective activity against carbon tetrachloride-induced liver injury in rats and mice. It indicated its protective role on parameters such as hexobarbitone-induce sleep, zoxazolamine-induce paralysis, bromosulphalen (BSP) clearance,serum levels of transaminases, bilirubin and protein, Eclipta alba has a new triterpene saponon, named eclalbatin.



ACACIA CATECHU A UNIQUE REMEDY

Dr.MAMTA, Dr.O.P. SINGH, Dr. A.Trigunayat (IMS, Banaras Hindu University)

Dr.S.P.SINGH (Yoga therapist) Siliguri)

Acacia catechu is commonly called as khair babul in Hindi and katha in Urdu. Katha is frequently used with beetle leaf for chewing. It is indigenous to India, Burma, Srilanka and East Africa. Acacia catechu is small sized tree from 15-20 feet high with thick bark. Its bark is the main source of catechu which is prepared by concentrating a strong aqueous decoction of the reddish inner wood and pouring it into square clay moulds to dry. Acacia is very important herbal tree for skin disorders and bleeding tendencies.

Habitat
It is found in drier regions of India particularly Punjab, Madhya Pradesh, Uttar Pradesh, Bihar, Andhra Pradesh, Orissa and Rajasthan.

Synonyms
In Sanskrit Acacia is also known as Khadir, Balapatra, Dantadhavan, Gayatri, Raktasara, Kantaki, Natakidrum, Bahushalya, Yagyik,(Ref. Shaligrama nighantu bhushane, Vatadi varga).
In English it is called as Indian peninsula cutch, or Red Cutch.

Parts used: Bark, heart wood, flowers, pods, fruits.

Flowering - it flowers during rainy season and fruiting is during winter season.

Use of khadir in Ayurvedic literature.

Khadir is used in Skin disorders, Itching problems, disease of teeth, disease of mouth and throat, Cough, Obesity, Worms, Diabetes, Fever, Vitiligo, Swelling, Wound, Bleeding disorders, Anemia, Eruptive boils, Filaria and is used as Rasayana (longevity enhancer). (shaligraam nighantu).

In Chinese medicine it is used for poorly healing ulcers, weeping skin disease, oral ulcers, with bleeding and traumatic injuries.

Traditional uses of Khadir

  1. In healing wounds and with other herbs used in leprosy because of strong astringent action.
  2. To suppress coughing up of blood

Chemical composition

The concentrated extract of the decoction contains: (D.S.Seigler 2002)

  1. Tannis -2-20%
  2. Catechins-25-33%
  3. Phlobotannins including Catechutannic acid 20-50%
  4. Flavonoids including Queretin
  5. Gums, Resins and Pigments

Action:

Tannins:
Acts topically to astringent mucosal surfaces and following oral ingestion and consequent hydrolysis alter the fluidity of the bowel contents (so used in anti diarrhea remedies) they are also attributed dwith anti hemorrhagic, anti inflammatory and antacid properties.

Catechins:
Have significant antioxidant and antimicrobial effects. It is considered to be the best antioxidant. (G.H.Naik et al, 2002)

Flavonoids:
Have property to increase secretion of insulin and inhibit cycloxygenase and lipoxgenase so has anti-inflammatory effect. (Noreen et al., Planta Medica 64, 1998; United States)

Properties:

Antioxidant:
The extract of Acacia catechu is proved to be antioxidant in action by studying the inhabitation of radiation induced lipid per oxidation in rats liver microsomes. (GH Nail.et.al. Bhabha atomic research centre Trombay. 2002)

Antidiarrhoeal:
The study was done on castor oil induced diarrhea in albino rats. The Acacia catcheu extract significantly decreased the number of stools passed and is as effective as the standard drug diphenoxylate. The anti diarrhoeal property appears to be due to its tannin contents which have astringent property.( D Ray et. Al. 2006)

Hepatoprotective:
In chloroform administered group of albino rats, the extract of Acacia catechu was found to be hepatoprotective, which was analyzed by doing serum AST and ALT levels which was markedly reduced. This property is could be due to presence of bioflavonoid which has hepatoprotective and antioxidant property. (D.Ray et.al. 2006)

Hypoglycemic :
The study was done in alloxan induced diabetic albino rats in which rats were given the extract of Acacia catechu and compared with standard drug glibenclemide (oral hypoglycemic drug). The result was hypoglycemic effect of Acacia catechu but less then that the effect was due to presence of flavonoids, which act as insulin secretagoges, epicatchin a flavoniod compound id reported to promote regeneration of beta cells of Islet of langerhans.(D.Ray et.Al 2006)

Antipyretic:
The study was done on yeast induced pyretic rats. The extract of Acacia catechu was found to have antipyretic effect may be due to flavonoids as they are predominant inhibitors of cycloxgenase and lipoxygenase. (D.Ray al. 2006)

The extract of Acacia catechu

Precaution:
Khadir must be used cautiously with antimotility drugs and in constipation. References:

  1. Shaligraam Nighantu, Vataadi varga.
  2. Ray D, Kh Saratchandra, Thokchom IS (2006) Department of pharmacology, Agartala.
  3. United states document (2006) on Isolation of a dual cox-2 and 5-lipoxgenase inhibitor from acacia.
  4. G.H Naik et. Al. (2002), Radiation Chemistry and Chemical Dynamics Division, Bhabha Atomic Research Center,Trombay, Mumbai, Indaia
  5. D.S.Seigler (2002) Department of Plant Biology, University of Illinois USA.


SCIENTIFIC BASIS OF ALZHEIMER’S DISEASE AND AYURVEDIC PERSPECTIVE

Dr.Santosh Jalukar BAMS

21st September is recognized as “World Alzheimer’s day”. In case of Alzheimer’s disease, there are sufferings hidden in the disease process. We are completing 103 years to discover the Alzheimer’s disease but still there are lots of gray areas in the field in terms of understanding the cause, diagnosing it and getting proper treatment to find the solution

What is Alzheimer’s disease?

Alzheimer’s disease is a type of mental disorder which affects the process of memory related functions of the brain. As on date, it is considered as an incurable disease. The progress of Alzheimer’s disease is very slow but affects permanently which wipes out the process of thinking, judgmental skills and finally an affected person becomes incompetent to carry on day – to-day activities for his own survival. Most of the cases are over the age of 60 but the pathology of this disease starts 10-15 years before the symptoms are noticed. At the beginning, the symptoms are taken very casually where there the seriousness is hardly known to anybody. Gradually the disease spreads in other parts of the brain which interferes with all the physiological functions of the brain.

Medically, it is recognized as gradual degeneration of the brain tissue. The disease is named based on the observations done by German psychiatrist and neuropathologist Alois Alzheimer in1906. He was the first to correlate the symptoms of memory loss and the structural changes in the brain of a lady after she died. He found that the brain of the lady had tangles and a plaque made from protein fragments and the entire structure was drastically changed. It is now over 103 years after the disease is known to the medical fraternity but there is still no remedy to cure it.

What is the cause?
The short answer to this question is “Not known”. There are some imaginary theories based on epidemiological data as follows:

  1. Depressed individuals are more prone to Alzheimer’s disease
  2. Statins (the drugs given for cholesterol lowering ) increase the incidence Alzheimer’s disease. Recent research from Prof. Yeon- Kyun Shin, Iowa State University has recently published a report on his exhaustive work on this subject.
  3. It is likely that the causes include genetic, environmental, and lifestyle factors. A gene located on chromosome 19 is associated with late onset Alzheimer’s disease.
  4. Other risk factors for Alzheimer’s disease include high blood pressure (hypertension), coronary artery disease, diabetes, and possibly elevated blood cholesterol.
  5. Some studies have found that women have more risk for Alzheimer’s disease than men.
  6. Few studies have proven that Alzheimer’s disease is more prevalent in cases of previous head injuries.
  7. It is also studied that Estrogen therapy after menopause triggers Alzheimer’s disease.

But these causes are completely hypothetical. There is no concrete data available to understand the real cause. Hence it is extremely difficult to adopt any precautionary measures to prevent or treat Alzheimer’s disease.

Since medical fraternity has hardly anything to offer for Alzheimer’s disease, caregiver plays a major role in management of such cases. Common suggestion are given to the sufferers like regular exercise, good diet, peace of mind, hygienic surroundings, pleasant atmosphere with cheerful communications etc. Practically all these recommendations are good for any individual for overall health and wellbeing. There is nothing specific attributed to Alzheimer’s disease.

What is the treatment of Alzheimer’s disease?
The shortest answer to this question is “No treatment”. According to modern medicine, when the cause is not clearly understood, how can there be a solution? Most of the disease are of infectious origin, the causative organism is detected and hence it becomes easy to find a recipe to overcome the infection. In the disease of systemic origin, the pathophysiology is understood properly and the treatment becomes easy. In Alzheimer’s, the picture is different. The disease mechanism is unknown and hence “No treatment’. There is one drug, Donepezil which is used to treat symptoms of Alzheimer disease in individuals with mild to moderate illness. The drug may cause small improvements in demands for a short period of time, but donepezil helps prevent the breakdown of acetylcholine in the brain, thus temporarily increasing its concentration. In doing so, it improves the thinking process by facilitating nerve impulse transmission within the brain. Diarrhea, nausea, and vomiting occur more often with the 10mg dose than the 5-mg dosage. Other side effects are abnormal dreams, depression, drowsiness, fainting, loss of appetite, weight loss, frequent urination, arthritis, easy bruising, difficulty in sleeping, dizziness, nausea, muscle cramps, headache, or other pains. Donepezil is not safe as it also has interaction with many other medicines which later its effects. Since there is no other option left, Donepezil is prescribed for Alzheimer’s. The medical field should have open doors to welcome newer ideas and safe drugs to treat this dreadful condition.

What other alternative?
Considering the patho-physiology of the disease, it is rqtional to think whether Ayurveda can offer something in Alzheimer’s? it is true that the disease was not mentioned in Ayurveda by this name. But there many recipes mentioned to treat various kinds of mental, phychological and emotional disorders. While studying the subject, many hidden things came out which are of immense importance in managing Alzheimer’s disease. Few important references are given below to scientific thinkers.

  • Nasal medication has immediate access to the brain as it bypasses the blood brain barrier. Hence the nasal route would be the best route to treat Alzheimer’s disease. Ayurveda has mentioned very clearly that nose is the gateway to brain and diseases attributed to Central Nervous System can be successfully treated only with nasal medication. American Association of Pharmaceutical Scientists (AAPS) has published a research paper on this concept and the conclusion is “In summary, the advantage of intranasal delivery are considerable .It is both rapid and non-invasive. It bypasses the BBB and targets the CNS , reducing systemic exposure and thus systemic side effects. Even for drugs that can cross the BBB . It can reduce systemic side effects by reducing the need for the drug to enter the systemic circulation. It does not require any modification of the therapeutic agent being delivered and should work for a wild range of drugs. Intranasal delivery may facilitate the treatment and prevention of many different neurologic and psychiatric disorders ”. S Talegaonkar , PR Mishra ; Indian J Pharmacol June 2004 Vol 36 Isseu 3; 140-145 .
  • Hanuman brain is made of approximately 70% fat and 30% protean. Therefore it has a natural affinity towards lipids for its normal functioning. Considering references from Ayurvedic texts ,cow ghee is the best available lipid and has 3 different action on the nervous system. Acquisition, storage and recall are three basic functions of the brain and cow ghee possess the properties to enhance these three fold brain functions. It is as to simple to understand that water is not easily soluble in oil but another oil or ghee can easily be absorbed. Therefore water-soluble or water based drugs do not penetrate the brain easily. This concept also goes very scientifically with the research on new drug in Europe for Huntington’s disease. Huntington’s disease (“HD”) is a genetic neurodegenerative disease characterized by movement disorder, dementia and psychiatric disturbance. Early symptoms might affect cognitive ability or mobility and include depression, mood swings, forgetfulness, clumsiness, involuntary twitching and lack of coordination. Later, concentration and short term memory diminish, and involuntary movements of the head, trunk and limbs increase. Eventually, the person is unable to care for himself or herself. Death follows from complications including choking, infection or heart failure..the drug developed for treating this is basically an Omega 3 based fatty acid, given orally and has proved quite effective. The drug is in the process of launching world-wide in a short span of time. Ayurveda has given emphasis on Cow Ghee which is also a fat, easily available and has been a household item of Indian kitchen.
  • A brain wave ‘p300’ is linked to memory and learning. The faster the rate of transmission, the brain functions more efficiently. Researchers took 26 volunteers hooked them with electrodes and checked their p300 rate. Immediately after taking the test, they were given DHA (derivative of Omega- 3). Two hours later, their brain waves were measured, and this time the p300 rate was significantly faster in the group. This supports importance of lipids in the neurotransmission as well. What Ayurveda has recommended also goes very much hand in hand with this research. Therefore in Indian tradition, it is customary to put few drops of oil (the purpose is to introduce a fatty substance) during massage given since infancy period. (Myanaga, K, K.Yonemura, and K, Yazawa. International Conference on Highly Unsaturated Fatty Acids in Nutrition and Disease Prevention.1996 Bacelona, Spain.)
  • The nasal route is studied for the administration of systemically active drugs because of delivery is convenient, reliable and rapid. A drug developed was administered through Nasal route and the florescent imaging showed that the absorption is 100= 30% just within 1.5 minutes (Ref: Maria Dahlin and Erik Bjork: Department of Pharmacy, Division of Pharaceutics, Uppsala University, Biomedical Centre, SE-751 23 Uppsala, Sweden)
  • Another research from VA Medical center, San Francisco, USA which is published in the journal “ Future Neurology” in 2008 says that “The nose may help the brain; intranasal drug delivering for treating neurological diseases.

There are end number of research papers published which give us a guideline to treat neurological disease and which could be a breakthrough in treating Azheimer’s disease. Not only Ayurveda but even modern research also supports the concept of treating the brain diseases through nasal route. Importance of Lipid in neurological disease is also established by modern medicine which is evident in Ayurvedic classics. Indian traditional way of life supports the theory of using unctuous substances for lubricating the sensory paths to acess the central nervous system. In spite of that why do we still pursue the issue of Alzheimer’s disease?

When should one Star Nasal treatment?
The symptoms of Alzheimer’s disease star appearing after 10 to 15 years later after the actual pathology stars in the brain. Therefore it is extremely at the age of 50.

There are many herbs proven to have phenomenal improvement in the brain at the cellular level. The well known are Brahmi (Bacopa monnieri), Ashwagandha (Withania somnifera), Shankhapushpi (Evolvulus alsinoides), Vacha (Acorus calamus),Saffron (Crocus sativus), Tulasi (Ocimum sanctum) etc. Oral medicines find difficulty in reaching the brain as there is a physiological mechanism called Blood Brain Barrier which prohibits the absorption. Therefore it is practical to lose these herbs in the form of nasal medication and also should be processed by special method called “Sneha – Paka – Widhi” described in Ayurveda. This will bypass the Blood Brain Barrier and allow the active herbal constituents to reach the central nervous system and arrest the progress of Alzheimer’s eventually. Besides this, the nasal medication also helps to improve vision, arrest hair fall, prevent graying of hair, improve hearing and many other disease attributed to ENT and supra-clavicular disorders. Like synthetic drugs have side effects, Ayurvedic drugs have side benefits and contribute to positive health achievements

As on date, there is no technique available to available to detect or forecast the Alzheimer’s disease in advance. Therefore it is safe to start such nasal medication at the age of 50 and keep fingers crossed and think positive for gaining health in older age. Ayurveda recommends that this nasal treatment should be done daily, 4 to 6 drops in both the nostrils, preferably in the morning or evening. It is good to take a sip of warm water after introducing the drops if there is a feeling of the contents coming in the throat. Since the base is ghee, the bottle should be made warm to liquefy the contents in case it is not properly flowing. The name of the product formulated for treating Alzheimer’s is “CLEVERIN Nasal Drops” manufactured by a Mumbai based company.

Considering the research in modern era and viewing the verses in Ayurveda it becomes evident that Ancient science has enormous hidden potential.It is rather a golden treasury for human being but need to be explored and understood properly. Many times it seems that Ayurveda has given short verse with big meaning which is equivalent to one doctorate in that field. It is just like a question asked and the answer given in Ayurveda, modern research helps to find the various steps involved in getting the answer.


MEDICINE TO PREVENT THE EFFECTS OF AGE

Dr. Jose Geoerge

Name: Tinsopora Cordifolia
Sanskrit: Amrta, Guduci
Family: Menispermaceae
English: Tinospora
Hindi: Guduca, Giloy

Properties and uses

The stem, leaves, roots, watery extract and starch are all used as medicine. The whole plant is regarded as a tonic. It is pungent, bitter, sweet after digestion, rejuvenator, astringent, hot in potency, strengthening, kindles digestive fire, mitigates vata, pitta, kapha, digests undigested food substance, cures thrist, burning sensation, fever, jaundice, skin diseases, diabetes, leprosy, gout, worms, urinary diseases, dyspnoea, cough, piles, cardiac desorders, anemia and vomiting.

The fresh juice of the steam is given with milk as a tonic. An infusion of the steam is given twice/thrice a day in fever, blood impurities and malaria. Dose1-3 ounces. The juice of the plant mixed with long pepper powder and honey is given in gonorrhea, cough, spleen enlargement, anorexia and chronic fever, cold infusion of the stem is given with honey in bilious fever.

Decoction of amrtha, parpata (Hediotis Corymbosa ) mustaka (Cyperus rotundus) Chirata (Ophelia chirata) and ginger is useful in fever caused by vata and pitta. A decoction of amrata, neem and amalaka (gooseberry) mixed with honey is useful in intermittent fever.

The facula prepared from the stems known as amrta satva is very effective in intermittent fevers, chronic diarrhea, dysentery, gonorrhea leucorrhoea, jaundice, rheumatism and urinary troubles.

Amrta, ginger and dhanyaka (Coriandrum sativum Linn ) 30 grms each made into a decoction alleviates gout, leprosy and amavata. Amrta is the best remedy for gout. A decoction of amrta, triphala (three myrobalans) neem, patola mixed with honey and sugar is used in vomiting and acid gastritis. Cold infusion of amrta with honey is very effective in vomiting. In fever accompanied with vomiting cold decoction of amrta with honey is given.

Paste of amrta leaves with buttermilk is given in jaundice, cooled decoction of amrta with honey in the morning is also useful. Juice of amrta mixed with honey is given is diabetes.

Powder of amrta amalaka (Emblica officinali ) and goksura (Tribulas terrestris) equal parts mixed with honey and ghee (unequal parts) is to be taken to become potent and to be youthful.

The following confection is recommended in chronic fever enlarged spleen, cough and loss of appetite:- Take chebulic and emblic myrobalans, ginger, long pepper one part each, watery extract of amrata four parts, water sixteen parts and boil till reduced to one fourth and prepare confection with eight parts of suger. When a proper consistence divide the mass into boluses of about sixty grams each. One of these is taken every morning.

In eruptive skin diseases the following oil preparation is useful to apply:- Take fresh amrta 3.840 kgs water 30.720 kgs boil till reduced to one fourth and strain.

Then add prepared seasamum oil 1.920 kgs and amrta pasted with water 480 grms to the strain decoction, and boil till the water is evaporated. This is known as amrtayadi taila (Chakra data)

Another one known as vata guduchyadi taila is thus prepared: take guduchi 6kgs water 30.720 kgs and boil together till reduced to one fourth. Take the fresh juice of vasaka (Justicia Adhatoda) and of datura leaves each 1.920 kgs, prepare mustard oil 1.920kgrms aromatic in the form of paste 480 grms. Boil together till the water is evaporated. This oil is useful in eruptive skin diseases with troublesome itching and diseases of nervous origin.

Terminalia ChebulaRetz.
Family: Combret
English: Chebulic myrobalan
Sanskrit: Haritaki, Abhaya
Hindi: Harad Malayalam:- Kaduka

Properties and uses
Haritaki is very astringent causes dryness, hot in potency, stimulates digestive fire, good for intelligence, rejuvenates and stoutens the body, good for eyes, easily digestive, initiates the downward movement of faeces, urine, flatus etc. it is a powerful alternative and tonic. It has also known as pranada or life giver, sudha or nector. Bhishakpriya or physicans favourite and so on. Seven kinds of haritaki are described in Bhavaprakasa as vijaya, rohini, putana, amrta, abhaya, jivanti and cetaki, the distinctions being described upon the shape, colour, marks on the outer covering of the fruits and the regions where that grows. Only two varieties are recognized at present. A good haritaki fit for use should be heavy, smooth, dense, fresh, rounded in shape and should be sink into water when put. Fruits with small seeds and abdundant cortex are preferred and the seeds are not used as medicine.

Haritaki cures dyspnoea,cough, asthma, diabetes, haemorrhoids, leprosy and other skin diseases, dropsy, enlargement of abdomen, worms, hoarseness, disease of the duodenum, abdominal tumor, flatulence, hiccup itching, heart disease, jaundice, colic, enlarged spleen and liver, renal caslculus, dysuria, retention of urine, piles etc.

Haritaki consumed with food stimulates intelligence and strength of sense organs, mitigates kapha and vata, eliminates urine, faeces and other wastes. (Bhava praakasa)

As a tonic for promoting strength, preventing the effects of age and prolong life haritaki is used as follows:-
One haritaki mixed with salt is taken every morning in the rainy season, with suger, in antumn, with ginger in the first half of winter, with long pepper in the second half, with honey in spring and with guda (jaggery) in summer.

Haritaki used after meals removes the bad effects of food and disorders caused by vata and kapha, used with sugar cures diseases of pitta used with ghee it cures diseases of vata and used with guda it cures all diseases (chakradatta)

The fruit’s pericarp (flesh) boiled in cow’s milk and then dried and the powder mixed with 15ml Castrol oil is given daily in the morning is useful for hydrosel.

The fruits kept in cow’s urine over night and in the morning it is pasted and given orally is useful in piles, ascitis and obesity.

Hataki fried in ghee and mixed with jaggery and long pepper is given in piles as carminative.

Hartaki and ginger powder mixed with jaggery is given in hot water to alleviate asthma and hiccough, paste of haritaki, ginger and pepper is useful in hiccough and asthma.

In hyper acidity haritaki powder, black raisins and sugar are given. The powder of haritaki with jaggery is given in gout.

Haritaki powder taken with honey is useful in diabetes.

Haritaki powder is mixed with honey is given with wine in the morning provides fragrance in the body and also useful in obesity.

Haritaki and neem or neem with amalaka are given to overcome leprosy.

Haritaki heated and powdered and mixed with tila oil is applied in chronic leprosy and wounds.

Paste of haritaki fried in castor oil then mixed with long pepper and rock salt is a good remedy for scrotal enlargement and inguinal hernia.

Take three or five haritaki fruits with jaggery and then take guduci decoction in gout.

Take three myrobalans (triphala) chireta, and guduci and prepare a decoction. It is given 1-2 ounces is useful in dysepia, feverishness and hemicranias.

The decoction of haritaki or triphala is given in hepatits. The decoction of haritaki with honey reduced the excessive body fats and so useful in obesity.

Haritaki, musta (Cyprus rotundus) ginger, and jaggery is an effective panacea for diarrhea, dysentery and flatulence.

Buttermilk and haritaki or triphala is useful in obesity and diabetes.

Powder of mango seeds and haritaki in equal parts are pounded with milk and applied in severe dandruff.

By taking haritaki and grapes followed by intake of milk one is freed from fever.

The decoction of triphala is useful in malaria; haritaki given with honey is also useful.

The triphala powder is very effective as a tooth powder (Chebulic myrobalan, Emblic myrobalan, Beleric myrobalan in equal panty is known as triphala)

Indian Gooseberry (Emblica officinalis Geartn),

Syn:- Phyllanthus Emblica linn. Sanskrit :- Dhatri, Amalaka Hindi:- Amla

Properties and use

Dhatri is similar to haritaki in properties and especially useful in bleeding diseases, diabetes, greyness of hair, best aphrodisiac and rejuvenator, mitigates vata by sour taste, pitta by sweet taste and cold potency, kapha by astringent taste and dryness.

The juice of dhatri with honey is given in fever, burning sensation, dyspepsia and other complaints of digestive system. The juice is given in hemorrhage, scurvy, constipation and urinary problems. Juice is used as an eye drop in eye troubles.

Powder of the fruits is effective in hyperacidity, peptic ulcer, gastric troubles, blood impurities, hemorrhage and dysentery. It is useful in cough, asthma, cardiac complaints, leucorrhoea and epitaxis. Dhatri is very effective to prevent the decay of cells and thus helpful to retain youthfulness.

A tablespoon of fresh juice of dhatri mixed with equal quantity of honey taken every day early in the morning is a good medicine to prevent tuberculosis of the lungs, asthma, cancer, stress, tension, weakness of memory, influenza, cold, premature old age, loss and greyness of hair.

A table spoon of amalaka juice mixed with a cup of fresh bittergourd juice taken once daily for a couple of months is useful in diabetes. A teaspoon of the juice mixed with popy seeds, milk and sugar 1-2 teaspoons given once or twice a day is a good medicine to cure dysentery diarrhea, colitis, amoebiasis and piles.

A tablespoon of the juice mixed with a cupful of coconut milk is given daily twice for a week expels tape- worms and hook-worms.

A table spoon of amalaka juice mixed with equal quantity of banana leaf or flower juice and honey two teaspoon full taken with a glass of black cow’s boiled milk daily once for a couple of months regularly is an excellent medicine for excessive bleeding during menstruation, sterility scanty urination due to kidney disorders.

Powder of dry fruits 1 teaspoon mixed with jaggery 2 teaspoon is given twice daily for a month to cure rheumatism, gout, constipation, piles, rectal fissure, anaemia, jaundice, lose of hair and premature greyness

Powder of amalaka 1 teaspoon given with a glass of buttermilk once daily is a medicine for burning on the rectum, soles and palms; given with a teaspoon of jamun seeds daily once is a medicine to control sugar in the urine of diabetic.

The juice of the fruits with honey and long pepper is given in hiccup and painful respiration.

Amala hair oil is good for premature greyness, hairfall, lengthens hair and cures insomnia. The recipe is as follows:-
Fresh amla juice 1-part Til oil 2-parts Heat oil and add amala juice little by little, when the oils is sufficiently hot continue to heat the mixture until only oil remains. Then cool the oil and strain it through a muslin cloth.Now it can be used.

FOOD SUPPLEMENTS FOR HEALTHY LIFE
Prevention is better than cure. Even cure through food is better than taking medicines. Food supplements give complete control over common complaints like diabetes, obesity, arthritis, cholesterol management etc. This way of treatment through food supplements which are produced from original and pure natural herbs, fruits and seeds have become available due to the modern automatic machines which extract the medicinal contents of herbs. This eliminates the unwanted details from natural herbs and become pure as they are refined in the process.

The use of such pure herbal extracts thus becomes more effective. But it has to be taken after proper diagnosis and under medical supervision. Capsules of these life supporting pure extracts are available.

Two widely approved and extensively recommended traditional dietary supplements are Turmeric and Amla. These are used in managing diabetes. Circuminoids, the active ingredients of Turmeric and Emblicanins the active ingredients of Amla, are isolated and standardized, given in the dosage form for increased efficacy, assured safety and enhanced user compliance in various products.

Turmeric is an important herb in most treatment regiments in Indian material medica for diabetes. It lowers blood sugar, increases glucose metabolism and potentiates insulin activity more than three fold. Circumin, the active ingredient in Turmeric would repair the diabetic impaired healing.

Amla, possessing Vitamin C like compounds is considered invaluable in diabetes. Amla regulates blood sugar and prevents lipid peroxidation in cell membranes.

Diabetes Mellitus is a medical disorder characterized varying or persistent hyperglycemia (elevated blood sugar levels), especially after eating. All types of diabetes mellitus share similar symptoms and complications at advanced stages. Hyper glycemia itself can lead to dehydration and ketoacidosis. Longer term complications include cardiovascular disease, chronic renal failure, retinal damage leading to gangrene with risk of amputation of toes, feet and even legs.

Gymnema has been used in India for the treatment of diabetes for over 2000 years. The leaves were also used for stomach ailments, constipation, water retention and liver disease. Gymnema Sylvestre, also known a Gurmar and Meshashringi, whose Hindi name literally means ‘sugar destroyer’, has been used in Ayurveda for several centuries to regulate the metabolic pathways of carbohydrates and sugars. Gymnema leaves raise insulin levels by regeneration of the beta cells in the pancreas that secrete insulin. Other research has shown that gymnema also improves uptake of glucose into cells by increasing the activity of the glucose utilizing enzymes, and prevents adrenaline from stimulating the liver to produce glucose, thereby reducing blood sugar levels. The leaves are also noted for lowering serum cholesterol and triglycerides. It also abolishes the tastes of sugar, which effectively suppresses and neutralizes the carving for sweets. The leaf extracts contain gymnemic acid which inhibits hyperglycema and also acts as a cardiovascular stimulant.

There are reports that Gymnema leaf extracts reduce hyperglycema in diabetic, rats, rabbits and humans and these glucose lowering effect may be mediated by increase in insulin secretion by direct action on the pancreatic-cells. These actions have been confirmed in a variety of cell lines and rat islets in the absence of another stimulus.

Obesity Management The World Health Organisation (WHO) has raised alarm on obesity, as by the year 2010 more than 60% of the Indian population will be suffering from one or other non communicable chronic degenerative disease conditions like Diabetes, Arthrits, Coronary Heart Diseases etc. Over weight and obesity will be causative mechanism behind this impending calamity.

The hydroxyl citric acid (HCA) derived from the fruit rind of Malabar tamarind (Garcinia cambogia), Guggulipid extract (Commiphora mukul) and Green tea extract (Camellia sinenis) in a rational blend. It is 100% natural and safe in the scene having no activity at the central nervous system nor rebound phenomenon as evidenced with commercial propagations. The intake of these can inhibit the conversion of excess calories in the diet in the form of simple carbohydratesand simple sugars into fat (HCA). It also inhibits citrate cleavage enzyme (ATP citrate lyase) to inhibit cholesterol synthesis leaving to fat deposition and induces thermogenesis - berning of stored fat or heat rather has energy (Guggulipid) It also Inhibits the enzyme alpha amylase to reduce the conversion of carbohydrates into glucose (Green Tea).

Green tea capsules

Oxidative damage due to free radical attack is the root cause of more than 70 chronic degenerative conditions like Coronary Heart Diseases (CHD), Diabetes, Arthritis, stroke etc.

Green Tea Extract is very potent antioxidant that protects against oxidative damage induced by the free radicals. Green Tea polyphenols are potent natural antioxidants that are many times stronger than vitamins – in terms of antioxidant property.

Green Tea extract increase antioxidant enzymes (SOD, GPX, CAT) by 100%. Recharge the antioxidant Vitamins A, E, K. Protect antioxidant Vitamins from free radical attack. Act as a sacrificial target for free radical attack. And improves intestinal flora. It interferes with carbohydrate conversion into glucose.

Recommend Green Tea capsules to an active, passive, or ex-smoker. Also those exposed to polluted air and water (tab water) and those taking medicaments can use this.

Cholesterol Management

Amla ( Emblica officinails) is said to be the first tree in the world.

Amla fruits offers five of the six basic tastes. It possess the mysterious taste of sweet after bitter taste.

Amla is the active ingredient of many an Ayurvedic formulations like Chyavanaprash as a rejuvenator, biological response modifier and immunity enhancer. Amla is the richest source of natural Vitamin C complex and is the most potent antioxidant ever. It is heavily recommended in Diabetes.

Standardized, reconstituted extract of Amla fruit offers the unique properties of Amla in dosage form. One capsule is equivalent to 15 to 20 gms of raw amlas in terms of active ingredients.

It is true that all animals can synthesize Vitamin C in their body whereas human beings cannot. It is believed that this is the reason why human beings die of heart attack and animals do not. The Vitamins C complex not only provide properties seven times better than any other form of Vitamin C but go beyond to protect the antioxidant vitamin E oxidized by free redicals.

It can increase the inherent antioxidant enzymes of the body like SOD, CAT,GPX by many fold for an unmatched defence. It Elevates HDL-C the good cholesterols and lowers LDL-C, the ugly cholesterols. Where as it lowers VLDL-C and TG, the bad cholesterols and protects liver and kidney. It can increase the sexual performance in men suffering from erectional problems also. (For more details and advice on herbal extracts and food supplements contact email: Healthinherbs@gmail.com cell:9809817546)


Leucoderma and its Ayurvedic Management

Prof. Dr. K Muraleedharn Pillai (MD)
(Principal, Vishnu Ayurveda College, Shoranur)

Ayurvedic Science has dealt with the body and soul as one entity. So unless and until the mind is healthy, the person is not said to be totally healthy.

According to Ayurvedic science the diagnosis and the treatment of a disease should be understood on the Tridosha theory, that is the concept of three doshas, namely Vata. Pitta and Kapha. This three principle factors are said to be present in any living being in a particular proportion. These are said to govern the body both in the state of health and disease.

The proportion in which these doshas are present varies from the state of co-existence of the three doshas in a perfect state of equilibrium in one particular individual and is referred to as ‘Prakruthi’. Any change in the equilibrium state of a dosha of the individual is referred to as ‘Vikruthi’. The change in the above said principle, that is Prakruthi to Vikruthi is due to “Madhyahara Viharas”. This principle is applicable for the causation of all diseases in general.

Can a person be called as healthy if all the three doshas in him are in a perfect state of equilibrium? The answer is ‘no’. This is because the Ayurvedic Science has dealt with the body and soul as one entity. So unless and until the mind is healthy, the person is not said to be totally healthy. The balanced state of three doshas, 13 agnis,7 dhatus, proper evacuatory functions, together with the happy state of Atma (soul ), Indriyas (sensory and motor) and mind, is referred to as perfect state of health.

As explained earlier, we attach more importance in identifying the disease in relation to dosha that is involve. The diagnosis, prognosis, treatment etc is done based on tridosha theory. Thus we do not attach more importance for naming of a disease, there has been a reference of a fourth dosha especially by Sushruth in the form of of raksha .

The prerequisite skins are the healthy Sukla and Shonika . This throws light on the congenital disorders of skin .Ayurvedacharya refers to a particular variety of pitta by name “Bhrajaka Pitta” which aids to impart pigment to the skin. Even according to the Allopathic medicine, the colour in the skin ie: melanin pigmentation is formed by memetabolism of a substance called thyrocinase. The number and distributors of melanin producing cells vary from individual to individual. Frequently there is a congenital absence of these cells in various regions, resulting in patchy pigmentation.

The word Kusta is normally misunderstood as Leprosy. But it is not so. The word Kushta has a very broad terminology and it includes all the skin diseases, along with leprosy.

Skin disease-General aetiology

a) Intake of hot and cold stud indiscriminately.
b) Excessive consumption of fish, sour fruits, horsegram, blackgram, linseed along with milk and buttermilk.
c) Excessive use of salt.
d) Consumption of heavy foods during indigestion which may result in Agnivikara which in turn may cause skin diseases.

The symptoms that are exhibited by the skin when there is a vitiation of twak , rasa, and rakta dhatu by a corresponding dosha are as follows :

  1. Discolouration of the skin ,dryness of the skin ,numbness ,lack of sensation , horripilation ,excessive sweating ,and kandu(itching) . When the mamsa dhatu (muscular sweating) is vitiated by the correspondind dosha ,the skin exhibits symptoms like Bahulyam-nature of the infection will be more or intensive manifestation, toda spota- when the madhu dhata gets affected, the patient will lose the ability to function using the affected. This is said to be ‘his is said to be ‘Yapya’. When asthi and majji gets affected there will be susceptibility for fracture owing to fragility of nerves.
  2. Bed Sore is also said to be incurable.
  3. Lastly when Shukla or Artava gets affected the resultant disease is Kushta and is transmitted to the next generation.

With this background of generic study of Aetiology, diagnosis, prognosis etc, of the skin disease ,let us attempt to know what Ayurveda says about “Switra” (Leucoderma).The aetiological factors causing Switra are similar to that of causing Kushta in general. Switra is classified under two heads namely Kilasa nad Aruna .Switra when caused by vitiation of Rakta dhatu by Vata dosha is termed Kilasa ,when it is formed by vitiation of Mamsa dhatu by Pitta dosha ,it is termed by Aruna .It is non-suppruative in nature .In Kilasa the skin will be dry and red in colour .In Aruna the skin will be copper colour and the distribution of colour will be a shade lighter in the centre than in the periphery .A third variety of Switra which is caused by vititation of Metodhatu .By Kapha dosha ,the discolouration will be more whitish ,the skin appears slightly thicker with itching sensation .

According to Charakacharya ,all these three varieties of Switra are curable but the first one ie: vataja Switra is very easily ,curable . Pittaja Switra is difficult to cure .Kaphaja Switra is Yaapya as because it effects the medodhatu (adipose tissue).The Switra caused by vitiation of tridosha is said to be Kasta Sadya .A whitish discoloration of the skin which is the resultant of a burnt wound is Said to be incurable.

The Switra is curable when:

  1. The hairs of the affected area has not turned white (as in Albenism)
  2. The patches are not too many and not wide spread.
  3. The patches are distinctly distributed
  4. The onset is new
  5. It is not because of Dagta- Vrana (burnt wound) Switra, other than these, are not advisable to be taken up for treatment.

Charaka has also emphasized that the whitish discolouration appearing over the genital area, palmar and planter surfaces and lips are incurable, even with their onset is new.

Treatment of Switra:
A Switra patient should be given Virechana Chikitsa, Rakta Miksha (Blood letting) also can be done.

Akashayam of Dhatri (Embilica Officinalis) and Khadira (Acaia Catechu) along with two or three pinches of Avalguja Choorna (powder of seeds of Psorlia Corylifolia). Khadira can be individually used for lepana etc, which is said to be very useful in treating Switra.

A paste preapared out of Avalguja Beeja Choorna and Haritaki in ratio 1:4 along with Gomootram (Cow’s urine) used as an external application in Switra is proved to be very useful in bringing back the normal colour of skin.

Ankola (Alongium Salvifolium), Langali (Glorosa), Kusta (Saussurea Lappa), Tulasi moola (Roots and seeds of Occimum sanctum), Bhringaraja (Eclipta alba), Eranda (Risinus communis), Arka (Calotropis proce4ra) and Sarshapa (Mustard) along with Kanjeekam is said to be useful in treating Switra.

The preparations like Panchatikta gulgulu ghrita. Tiktaka- ghrita, Khadiraristam, Panchatiktarista, Amrtia bhallatakalehya, Madhusnahee Rasayana, all these internally and the medecines like Dinesavilwadi thailam, Doorvadi thailam, Mareechadi thailam, Gandhaka thailam, and Avalguja beejadi lepachoornam used externally in a judicious combination judging the constitution of the complaint have proved to be very useful in treating this condition. When we go through the above said formulate of different drugs which are commonly used in treating both these condition, we see that some of the drugs are commonly exployed in treating skin (both acute and chronic) ailments. Nimba (Azadiracta Indica), Manjista (Rubia Cardifolia), Khadira (Acacia Catechu), Madhusnahee (Smylaxchina), Guduchi (Tinispora cordfolia), Katuki (Picrorhiza Kussora), Haridra (Cuscuma longa), BHallataki (Semicarpus anacardium), Avalguja beeja, Dinesha Valli (Alkanna Tinctoria) and minerals like Talakum (Arsenic trisulphide), Tamara Bhasma (Copper powder Kaseesa Bhasma.

The mineral origin is said to be very useful in the management of Switra. The importance of the use of Avalguja beeja Choorna (powder of the seeds psolaria) in treating Switra has been elaboratery dealt in Ayurvedic texts. Giving its therapeutic value. It is referred to as Krishneekarana (Bringing back the normal colours).To get best therapeutic effect, good quality of Avalguja beejas should be taken, cleaned and soaked in fresh Gomotram and kept overnight. Subsequently it should be removed and dried in sun.

On the second day it should be once again be soaked in fresh cow’s urine and kept overnight. The process should be repeated for seven days and on the eighth day purified, processed seeds should be powdered and should be stored in clean corked containers. This can be used internally in a dose of 200-400 mgs, along with Amalaki Swarasa (Emblica officinalis) or Khadira Kashaya (decoction of Acacia catechy bark). Its external application along with either Gomootra or Dineshavilwadi thailam stimulates the Bharajaka pitta (Melanocytes) and effects the proper formation of the pigmens-krishnee karana.



DISCOVER ALOE VERA

This was the information Mahatma Gandhi gave his biographer on asking what were his secret forces which sustained him during his long fasts.

Arab traders were probably responsible for Aloe Vera’s spread into Persia, India and the Far East. The name “Aloe” was derived from the Arabic word “Alloeh” meaning ‘shining bitter substance’ because of the bitter liquid found in the leaves. ‘Vera’ was later added to it in order to distinguish from the most popular used species of Aloe- Aloe Barbadensis Miller, from the rest. Vera means ‘true’ in Latin.

Scientific Name : Aloe Vera/ Barbadensis
English Name : Aloe Vera
Malayalam name : Kattar Vazha
Nepali Name : Gheukumari
Sanskrit Name : Kumari, Grhakanya
Taste (Rasa) : Bitter, Sweet
Quality (Guna) : Heavy, oily, viscous
Potency (Virya) : Cold
Vipika : Bitter
Alleviates :Pitta, Kapha

Description: Aloe Vera is a member of the Lily family and distantly related to onions, garlic and asparagus. It is a coarse- looking perennial plant of 1-2 feet high with a short stem. The leaves are long, erect, succulent & broad at the base and pointed at the tips, with spines along the edges. These leaves are fleshy & contain a clear sticky juice (aloe vera gel). Aloe Vara grows well in hot and dry conditions and wilts only if it receives excessive amounts of water of if exposed to freezing temperatures. Once in a year (later winter) a bunch of short tubular yellowish flowers appear.

The gel from the inner core of the leaf is rich glucomannans and other polysaccharides.

Distribution: Mostly found in tropical and subtropical plains.

Parts Used: Leaf gel and sap. now we see people selling Aloe Juice by the sides of the road and pack etc saying it reduces weight and is good for diabetes condition etc.

Aloe vera has been widely marketed as having a number of benefits when taken internally. For example. Aloe has been marketed as a remedy for coughs, wounds, ulcers, gastritis, diabetes, obesity, cancer, headaches, arthritis, immune-system deficiencies, and meny other condition. However, these uses are unproven. The only substantiated internal use is as a laxative. Preliminary studies suggest that aloe juice may help lower blood sugar levels in people with type2 (adult onset) diabetes.

Aloe vera gel products may also be used internally. Aloe vera juice can be used as a natural remedy in the treatment of stomach ulcer and mouth ulcers because of its anti-inflammatory effect. It appears to have a soothing effect on the ulcer, and interferes with the release of hydrochloric acid by the stomach. Oral aloe gel supplement may lower blood glucose levels in people who suffer diabetes. The anti inflammatory effects of aloe gel may be of benefit in arthritis for the control of joint inflamm action. The stimulating effects of aloe on the uterus may also help to induce suppressed menstruation.

Side effects, precautions, interaction for aloe vera
Internal use of Aloe vera latex may turn the urine red, and may also cause abdominal pain or cramps when products containing anthraquinones are consumed. Occasionally, some people develop a mild allergic reaction marked by itching or a rash, when used as topical treatment, Due to improper processing, Aloe vera juice sometimes contains small quantities of the laxative compound in aloe latex. Because of the imbalance. Aloe latex may cause severe intestinal cramps or diarrhea.

Pregnant women should not take aloe latex because it may cause uterine contractions and trigger miscarriage. Aloe latex is not recommended for people with gastrointestinal obstruction, appendicitis, or stomach pain. It may worsen ulcers, hemorrhoids, diverticulosis, colitis, or irritable bowel syndrome. Children and the elderly should not consume an aloe vera latex laxative internally. Chronic internal use of products containing aloe vera latex may increase the likelihood of potassium loss when used concomitantly with diuretic or corticosteroids.

Internal use of aloe vera is not recommended for people taking digoxin, diuretics, topical or oral steroids, medication for arrhythmia (irregular heart beats) and drugs which cause potassium to be lost form the body .

Though it has been used internally its well accepted as a external application for its wonderous actions since ages

History
Aloe Vera was originally a native to Egypt where ancient herbalists passed on the many used of the Aloe vera plant, especially the ability to promote and restore healthy skin.

The first recorded evidence of its healing properties was discovered in an ancient Egyptian papyrus dated 3500 BC – by George Ebers in 1862. The Egyptians referred to it as “the plants of immortality”. Drawings of this plant have even been found inscribed in the tombs of pharaohs. Cleopatra is reputed to have relied on it to help preserve her legendary beauty. Se used the fresh Aloe Vera gel to keep her skin soft and young.

Aristotle persuaded his student Alexander the Great to seize the island of Socorra for the Aloe Vera to treat the wounded Soldiers.

In the early Christian era references to the Aloe Vera plant could be found in all advanced medical texts. The North Americans people believed in the plants powerful rejuvenating properties and called it “Fountain of Youth”

In 1953 the U.S. Atomic Energy Commission conducted experiments on Beta radiation as was in nuclear bombing. After months of testing it was conducted that Aloe Vera enhances both the degenerative and reparative phases of the lesions

After this “The Federal Drug Administration (F.D.A.) of U.S.A.” admitted that Aloe Vera does actually regenerate the skin tissue.

Here are some of the many names of Aloe Vera passed down through the ages which further testify to its numerous health benefits.

So therefore aloe Vera has a lot of action both externally & internally, out of which we are dealing with the external (topical) actions of it.

Photochemical properties Aloe Vera contains over 200 active compounds and 75 nutrients, which include 12 vitamins, 20 minerals, and 18 amino acids. Aloe Vera is a complex plant that contains many biologically active substances. Davis, Parker, Samson et al (1991b) reported that one tablespoon of Aloe Vera contains over 75 different chemicals that have biological activity. Therefore it has proved difficult to isolate a single active ingredient, and it has been suggested that there is as synergistic relationship between the constituents (Leung, cited in Bradshaw, 1966, p.25). These active ingredients are known to help reduce swelling, relieve pain, eliminate itching, increase blood flow to an injured area & speed up the healing process

Aloin, is the main active principle obtained from the gel in leaf. This is Responsible for the plant’s healing properties. Other constituents include barbaloin, chrysophanol glycoside and the aglycone, aloe-emodin.

Medicinal value: (both internal & external)
The Aloe Vera plant has been known for its skin softening, soothing and healing capabilities since the dawn of civilization, but only recently have scientists attempted to verify the many claims that have been made about it. “It is this gel that is thought to have moisturizing effects and therapeutic properties.” (Rund, 1996, p.19). When applied topically, the gel is used to treat cuts, scars, abrasions, burns, ulcers, dandruff, acne, skin cancer, chicken pox, eczema, stings, insects’ bites, itches, rashes, infection, stretch marks, varicose veins, and frostbite by its soothing properties. On internal intake it treats – colic, constipation, coughs, dys- menorrhea, dysentery with bloody stools, fat and sugar metabolism, spleen enlargement, etc. this gel is best effective when used fresh rather than stabilized” gels found in the stores. It promotes and accelerates wound healing. At the same time the antiseptic effects decrease the risk of infection.

A suprising info:
Aloe Vera was successful in America only when scientists found out that many survivors of Hiroshima and Nagasaki healed their skin with the inner gel of aloe and drunk the juice specifically prepared. The number of skin cancers within the Japanese was lower than the probable forecast after such a nuclear attack…

The beneficial effects and the healing ability o0f the clear aloe gel have been proven in extensive research carried out on the aloe since the 1930s in the US as well as in the Russian Republic. These studies have pointed out that the clear aloe gel has a very effective ability to heal all types of external wounds, different kinds of ulcers, and all sorts of burns in the body, this action is made possible as the gel makes a protective coat on the surface of the affected area and this results in the sudden speeding up of the rate of the body. The presence of the compound known as aloectin B, which stimulates the immune system in the body is the agent partially responsible for this action.

Here is a brief abstract of the study done by – Davis, Kabbani and Maro:

In 1887, Davis Kabbani and Maro conducted an experiment to determine the effect of A.vera on wounds in mice and rats. The animals were subcutaneously injected with either A.vera or decolourized A.vera (ie.with anthraquinnone removed). The control groups had no injections.

They discovered that decolourized A-vera was more effective in stimulating wound healing and reducing inflammation, than A.vera. Because of this result, the authors recommended A.vera for the treatment of wounds, presumably in humans. However it cannot be assumed that human skin would respond to A.vera in a similar way to that of mice and rats.

The study was limited to 712 days. This not only threatens the external validity of the study because some wounds take longer than 12 days to heal, but it leaves the question of whether A.vera would continue to stimulate healing over a longer period.

The authors concluded by suggesting that A.vera could be considered as a substitute for steroids in wound healing as it, unlike steroids, does not initiate connective tissue breakdown.

Recently the effectiveness of the Aloe Vera plant and its ingredients has been proven in treating various skin lesions and skin burns- more specifically first degree burns, including sunburns, and certain minor second-degree burns. One study of 27 people with moderately severe burns showed that the subjects using Aloe Vera healed in an average of 12 days, while the control group who covered the affected areas with a regular gauze dressing took an average 18 days to heal.

A study on the anti-inflammatory properties of Aloe Vera showed that small amounts of the processed gel applied topically resulted in a 47% inhibition of an inflammation induced by moderate quantities of irritant. A later study by the same researchers showed the effectiveness in the proportion of wound healing.

Due to aloe vera’s extensive range of actions on skin, a number of further studies have been carried out on properties of the Aloe Vera plant and their mechanism when healing wounds in general. One such study is effectiveness of the Aloe Vera gel in the treatment of skin cancer. It is showed a 33% reduction in the –number of tumors, reducing the incidence of tumors and causing tumor regression after treatment effectively.

Many studies have been done & many more are under process. Aloe Vera has a lot of credit on the skin especially as a topical application. One such affectivity is seen in stretch marks too.

Stretch marks or striae are a form of scaring on the skin with a silvery white hue. They are caused by tearing of the dermis but not disappear completely. Stretch marks are generally associated with pregnancy and obesity. When a person gains weight suddenly, the skin expands to accommodate the increase in body weight. Skin is elastic (dermis) and can be stretched to a certain limit. Once the limit is crossed the innermost layer of the skin tears as it can stretch no more. As the underlying layer tears and the ones above (epidermis) are intact, the skin appears to be streaked. As soon as the skin tears, pink or purple lines appear as the capillaries bursts. After some time these lines look slivery white. Some times it may be associated with symptoms of itching & burning sensation (especially in pregnancy) due to inflammation.

Stretch marks occur in the dermis, which is the middle layer of the skin and is elastic and hence allows the skin to retain its shape. Women and men can have stretch marks on their thighs, abdomen, hips, breasts and upper arms.

Stretch marks are a normal part of puberty for most girls and guys. Many women get them during pregnancy. Once stretch marks appear they are permanent and diffucilt to get rid of.

Common causes of stretch Marks

  • Pregnancy
  • Obesity
  • Rapid weight loss
  • Body building
  • Hormonal disorders
  • Insufficiency of nutrients in the body
  • Sudden change in physical or environmental conditions
  • Certain medications
  • Use of steroids

Most common & prominent sort of stretch marks are those which appear during pregnancy & they are called as – Stirae gravidarum medically. “Striae” in general means thin, narrow grooves or channels, which are parallel or close together. About 90% of pregnant women can develop stretch marks or striae either during or after pregnancy.

The best treatment for stretch marks is preventive care it is impossible to remove the stretch marks completely. However, they may become less conspicuous with appropriate treatment over period of time. As stretch marks are permanent they cannot be removed. Products that claim that their use can either prevent or remove stretch marks are misleading.

The Aloe gel can be squeezed directly from the fresh leaf and applied to affected areas. Its skin repair qualities on burns, and sub burns is truly remarkable-healing occurs quickly and without scarring. It is an excellent additive for cosmetic preparations as it can moisturize and rejuvenate the skin by stimulating synthesis of elastin and collagen.

Although the skin is fairly elastic, when it’s overstretched, the normal production of collagen (the major protein that makes up the connective tissue in your skin) is disrupted. The glucocorticoid hormones affect the epidermis by preventing the fibroblasts form forming collagen and elastin fibers. Which are necessary to keep the rapidly growing skin taut. This creates lack of supportive material resulting is scars called Stretch Marks must be to restore normal quantities of collagen and elastin fibers.

Aloe Vera 99 percent water, and yet, it contains a storehouse of nutrients – more than 200 active elements. In its most direct effects, aloe vera increases fibroblast production in skin tissue. The fibroblasts stimulate new collagen; this collagen production supports the dermis to keep skin intact, thus accelerating wound healing. Though there is no direct reference to aloe vera’s action on stretch marks, but the ages of practical experience & the following studies support its action on stretch marks.

In Studies conducted by Dr. Ivan E. Danhof, M.D., Ph.D., president of North Texas Research Laboratories and a retired Professor of Physiology from the University of Texas, - interior gel from Aloe Vera was found to increase production of human fibroblast cells six to eight times faster than normal cell reproduction.

Fibroblast cells are found in the dermis of the skin and are responsible for fabricating collagen, the skin’s support protein. Dr. Danhof, found that not only did aloe improve fibroblast cell integrity; the gel also quickened the making of collagen.

Aloe’s penetrating ability was proven in another study conducted by Dr. Danhof, where the gel was found to penetrate the skin almost four times faster than water. This was an interesting fact, since Aloe gel is 99.5 percent water. Yet the 0.5% of ingredients penetrated taking the moisture of Aloe far into the underlying layers of the skin which plain water can not do. This penetrative action & enhanced collagen synthesis refers to healing process of the injured skin.

Therefore, the biologically active components synergic ally work together to restructure the underlying Collagen matrix of the skin and increase stimulation of collagen synthesis. Hence, trying to reunite the dermal tear. This process may take a very long duration. On due course we can notice the smoothing & the lightening of the stretch marks

This was for the reduction of the stretch marks already present. To prevent the occurrence of stretch marks as such, the following guidelines will play an important role.

  1. Monitor weight gain or in case of a pregnant eat a healthy, diverse and balanced diet that keeps your weight gain within the recommended range.
  2. Drink sufficient quantity of water or other nutritious fluids daily to hydrate your skin and maintain elasticity.
  3. Use a natural moisturizer like Olive oil, Vitamin E oil, Aloe Vera gel, Almond oil etc, which brings elasticity to the skin. Aloe Vera gel is contraindicated in pegnant.
  4. A moisturizing oil massage before your bat is ideal. As. This reduces skin damage, and induces the skin to be pliable and stretch rather than get broken
  5. Eat plenty of fresh fruits, vegetables, healthy oil and low fat foods which mainly contain Vitamin C, E, A & zinc that are particularly great contributors to the quality of the skin.
  6. Avoid hormone based medicines like steroids as they may cause stretch marks.

Caution: Aloe Vera application stimulates uterine contractions and should be strictly avoided during pregnancy. Although, it could be used after the delivery. For the best results, apply the fresh gel from the origin period of stretch marks. Fresh exuded gel application externally is safer and inexpensive treatment of minor skin ailments, there is doubt regarding the effectiveness of some aloe Vera creams and ointments.

Much of the aloe gel in the market has been reconstituted from a powder or occurs as a “stabilized ex tract.” There is concern regarding the activity of some of these commercial products. In addition, some products that claim to contain aloe actually have so little aloe actually have so little aloe that they have no therapeutic value at all.


SPICE TALK

Dr. Raakhee Mehra BAMS, MD, PhD*

Influenza (flu) is an acute, contagious respiratory infection characterized by sudden onset, fever from 101 to 103 F t (38.3 C to 39.4 C), chills, headache, myalgia and sometimes prostration or exhaustion out of proportion to the fever, sneezing, hoarseness or sore throat and hard paroxysmal cough. Moderate to severe Coryzn are common and less frequently, gastro- intestinal symptoms including anorexia, nausea, vomiting and diarrhea are present.

The causative agent is a virus of which several genera A, B, C and subtypes, such as H0N1 (A0 human), H1N1 (A1), H2N2 (A2), H3N2 (AHK, A3), Hsw N1 (swine), He N (2 equine and Nav N (8 avain) have been identified. The influenza virus has shown great genetic variation. This ability provides the basis for development of epidemics in populations that have previously been exposed to influenza caused by another subtypes.

Usually more prevalent in winter and spring, young adults in robust health, appear to be particularly susceptible. The disease in contagious and is spread by disease is contagious and is spread by discharges form the mouth and nose of infected persons. It may occur sporadically, epidemically or pandemically. Our ancient medical science i.e. Ayurveda has already described the Janpadodvasnsa or medical disaster is the result of adulterated of polluted food, air, water so awareness for maintaining individual, social or community hygiene is very essential. In the terminology of Ayurveda Hawan or fumigation with Guggulu (Commiphora with mukul), Jatamanisi (Nordostachys jatamansi DC), Vacha (Acorus calamus), nem (Azadirachta), Sarso (Mustard) etc keeps the environment free from pathogens. It is need to redevelop our ancient medical rules and regulation to prevent as well as to cure such type of genetic mutated various diseases in its own norm.

The incidence is the highest in ages 5-9 years. The very young and the very old, pregnant and to the persons who have low immunity due to his/ her chronic illness. Even during an epidemic, the number of people infected who remain asymptomatic is high as compared to those who are symptomatic.

Bleeding, low vitals increasing fever, convulsion, and confusion, further lead crises and speedy lysis. As this disease spreads very fast, sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose. Infected people may be able to infect others beginning 1 day before symptoms develop and up to 7 or more days after becoming sick.

Ayurveda indicates to adopt some measure for its prevention as well as cure.

  • Avoiding close contact with people who show influenza – like symptoms (trying to maintain a distance of about 1 metre if possible)
  • Avoid touching your mouth and nose every now and then; clean hands thoroughly with decction of Neem (Azadirachta indica on a regular basis (especially if touching the mouth and nose, or surfaces that are potentially contaminated);
  • Hand Hygiene is one of the most important activity and it helps arrest the infection. Hence high traffic zones like schools, /dayoffices, malls, muntiplexes … should provide good hand hygiene facilities and help arrest the infection.
  • Avoid closer contact with people who might be ill;
  • Reduce the time spent in crowded settings if possible;
  • Improve airflow in living space by opening windows and the practice of Pranayam on regular basis;
  • Practice good health habits including adequate sleep, eating nutritious food, and keeping bowel free. Use of Trifla-combination of Haritaki (Terminalia chebula Retz), Amalaki (Emblica officinalis Gaertn ). And Bibbitaki (Terminalia bellrica Roxb) is very beneficial . Rats exposed to noise stress for fifteen days and given Triphala showed increase neutrophil function and lowered cortisone release.( Srikumar R, S Prathasrathy NJ, Manikaordan S, Narayanan GS, Sheeladevi R. Effect of Triphala on Oxidative stress and on cell-mediated immune response against noise stress in rats. Mol Cell Biochem. 2006;283:67-74). Antimicrobial alcoholic and aqueous extracts of emblica showed positive results in vitro activity against certain dermatophytes 55 and against certain common human pathogens (Ahmad I, Mehmood Z, Mohammad F. screening of some Indian medicinal plants for their antimicrobial properties. Jethnoparmocol 1998;62:183-193)
  • Do not exert and take rest
  • Cover your mouth and nose with a three layered mask made up with Handkerchief, Scarf, etc with putting up two drops of Euceliptus oil or clove oil when coughing or sneezing. It may prevent those around you from getting sick.
  • Smear mucus membrane or inner lining of each nostril with finger dipped with mustered oil. This will provide a oily mechanical barrier for any external pathogens.
  • Dispose of used tissue, mask or cloth in the waste basket. Then, clean your hands, and do so every time you cough or sneeze.
  • Avoid touching your eyes, nose or mouth germs often spread when a person touches something that is Contaminated and then touches his or her eyes, nose or mouth.
  • Symptomatic, Agastya Haritaki for congestion, Vasa (Adhatoda vasica Nees) for cough, force fluids of Shadangpaniya, nutrition (Amsalaki etc), bed rest, antipyretics Tikta Ras (Bitter) like Kirattiktadi, Tribhuvan Kiriti, Neem, Karela, analgesics like Guggulu preparation, antiviral like Giloy (Tinospora cordifolia), tulsi (ocimum sanctum Linn) Haridira (curcuma longa Linn), appetizer and digestive Ginger etc are beneficial. Fresh gooseberries juice with honey twice a day helps in taking out the phlegm and controls cold. Licking gooseberry powder with honey regularly twice or thrice a day cures chronic dry cough.

These are few examples of existence of wisdom of great vision of Ayurveda towards today’s infectious epidemic flu etc in more than 5000 years back even.


Pomegranate juice for life

Dr. Preetha Sreekumar MD
Pankajakasthuri Ayurveda Medical College
Thiruvananthapuram

Pomegranate is one of the best antioxidant drugs having high dietary and medicinal value. It is extensively described in the classical texts of Ayurveda. The fruit rind is highly esteemed in the treatment of diarrhea and dysentery. The seeds represent about 52% of the weight of the whole fruit. The ancient Sanskrit synonym “Beejapoorka” indicates the abundance of seeds in the fruit. Literally the word meaning of “Dadima” is that the fruits break open when they ripe.

The generic term”Punica” was the Roman name for Carthage from where the best “Pomegranates derives from Latin pomum(“apple”) and granatus(“seeded”). The fruit was featured in Egyptian mythology and art, praised in the Old Testament of the Bible and Babylonian Talmud and it was carried in the desert caravans for the sake of its thirst quenching juice.

“Grenade” was the French name for the Pomegranate while “Grenadine” was the name of a kind of fruit syrup originally made from the Pomegranate, being used as a cordinal in cocktails. Before tomato arrived in the Middle East grenadine was widely used in many Iranian foods and is still found in traditional recepies.

The Pomegranate is the symbol and heraldic device of the city of Granada in Andalusia, Spain. It is the official logo in many cities in Turkey and a symbol of fertility in Armenia.

Pomegranate juice is highly beneficial in the treatment of dyspepsia. Extracts of the barks, leaves, immature fruit and fruit rind have been given as astringents to halt diarrhea, dysentery and haemorrhages due to the presence of tannins.

The bark of the stem and root contains several alkaloids including isopellitierine which is active against tape worms.

The leaves, seeds, root and bark of the plant have exhibited hypotensive , antispasmodic and anthelmintic properties in bioassay. Recent drug researchers prove the juice of Pomegranate highly efficacious in reducing heart disease risk factors, including LDL oxidation, macrophage oxidative status and foam cell formation , all of which can lead to atherosclerosis and cardiovascular disease.

Abundance of tannins (Punicalagins) are identified as the primary components responsible for the reduction of oxidative stress. The drug exhibits a reduction in the systolic BP by inhibiting serum angiotensin- converting enzyme.

Invitro studies reveal the Pomegranate seed oil effective against the proliferation of breast cancer cells since it contains polyphenols which inhibit estrogen synthesis.

DISTRIBUTION
The Pomegranate tree is native from Iran to the Himalayas in North India and has been cultivated since ancient times throughout the Mediterranean region of Asia, Africa and Europe .The most important growing regions are Egypt, China Afghanistan, Pakistan, Bangladesh, Iran, Iraq, India, Burma and Saudi Arabia.

In India the plant is found growing wild in the valley and the outer hills of Western Himalayas between 900 and 1800 metres and cultivated in many parts of the country.

THE PLANT
Punica granatum Linn. is a small tree or more than often a large handsome shrub growing to 2 to 2.5 meters in height with several nearly uniformly erect trunks arising from the ground level, covered with smooth grey or grayish brown thin bark , branches terete, with the branch lets often terminating as spines.

The plant often flowers from April to May and fruits ripen from July to September.

Leaves: Opposite, sub-opposite or fascicled oblong or obovate to oblong lanceolate, entire, base often narrowed to a very short somewhat reddish petiole, 2.5 7 centimetres long, glabrous shining above bright green beneath, minutely pellucid punctuate.

Flowers: Large, 3.8 to 5 centimeters long and much across, scarlet red borne in terminating short shoots, sometimes 2 to4 together, sessile with a thick fleshy at first spherical finally flask shaped hypanthium produced considerably beyond the ovary and bearing above a thickened disc; the flowering calyx about 2.5 centimeters long and 1.5 centimeters broad as its mouth sepal lobes 5-7 short, valvate’ persistent in the fruit. Petal lobes 5-7 inserted beteen the sepals 1.2-2.5 centimeters long, thin, obovate or lanceolate bright red imbricate in bud and the edges wrinkled. Stamens numerous, inserted on the calyx below the petals at various levels; anthers versatile. Ovary adnate wholly or for the most part to the hypanthium, inferior with several locules; style long bent ending in a capitatestigma. Ovules are numerous.

Fruits: Globose or ellipitic, many celled and seeded berry 5-8 centimeters in diameter with a thick hard coriaceous reddish brown rind or epicarp and crowned by the persistent calyx lobes.

Seeds: Angular with red pink or rarely white fleshy testa, cotyledons convolute.

CHEMICAL CONSTITUENTS
Tannin occurs in all parts of the tree.

Root bark: 4 alkaloids, pseudopellitierence, pellitierence, isopellitierence and metthlpellitierence

Stem bark: 4 alkaloids, pseudopellitierence, pellitierence, isopellitierence, methylpellitierence; 3 basic components and betulic acid.

Leaves: Friedelin , betulic acid ,ursolic acid etc. leaves of young plant contain an unstable alkaloid.

Flowers: Contain the pigment pelargonidine 3,5 diglucoide. The buds contain ascorib acid as major components besides the minor components oxalic acid, maslinic acid and unidentified compound.

Fruit: Analysis of the edible portion of Pomegranate shows the presence of proteins, fat, phosphorous, iron, sodium, potassium, copper, sulphur, chloride, carotene, thiamine, riboflavin, nicotinic acid and vitamin C. Fruit is a good source of sugars and vitamin C. Glucose and fructose are the principal sugers.95 percentage of the total acid is contributed by vitamin C and the minor component is contributed by malic acid. The amino acids asparagines, tryptophan , methionine , alanine, arginine, aminobutyric acid , cystein, glycerin, lleucine, lysine , phenyl alanine, praline, tyrosine and valine . Valine and methinonine are present in very high concentrations. Fresh rind of the fruit contains resin, mannitol, inulin, tannin, gallic acid, calcium oxalate and pectin. Fruit rind also contain isoquercetin and ursolic acid.

Seeds: yield estrone, a drying oil which contains punic acid possessing antibacterial properties. Seeds oil contains plamitic acid, stearic acid , oleic acid , linoleic acid and behenic acid.

Bark and root are used in the treatment of tape worm. Alkaloids are the active principles of which isopellitierence are the most potent taenicide.

PARTS USED
Roots, Bark, Flowers, Fruits and Seeds.

STEM BARK
Macrosopical features
The bark from a stem about 5cms in diameter is comparatively thin, being only 3 or 4 mm in thickness. It is greyish brown and mottled with grey and blue green patches of lichens. A few small rounded brownish, slightly protruding lenticels about 2 mm in length make the surface not entirely smooth. The outer skin is found to exfoliate in thin flakes leaving smooth shallow depressions. On peeling of the outer corky layer, a dark green smooth tissue is exposed. The inner surface of the bark is quite smooth and pale yellow in colour. The bark imparts a yellowish brown colour to water in which it has been kept for sometime and this coloured water turns greenish brown when treated with ferric chloride solution.

DRIED FRUIT RIND
Macroscopical features
Drug occurs in 0.1-0.5 cm thick, more or less concave, salver-shaped pieces, some pieces showing residual carpel walls and some having persistent toothed calyx tube along with withered stamens styles and a few seeds; coriaceous, tough and nearly smooth , brown brownish yellow internally; bearing impressions left by seeds; fracture , short; odour not distint; taste astringent.

Microscopial features
Epicarp is single layered and covered with thick cuticle; mesocarp consists of wide zone of oval to polygonal thin walled parenchymatous cells; a few fibrovascular bundles, tanniniferous vessels, secretory cannals , oil globules , single and a number of groups of round or oval to elongated stone cells, simple and compound starch grains having two or three components with concentric striations and central hilum and rosette crystals of calcium oxalate present in mesocrap.

Powder
Yellowish –brown; shows single or groups of stone cells; oval to polygonal, parenchymatous cells in surface view; vessels with scalariform thickening, tanninferous vessels and a few rosette crystals of calcium oxalate and rounded to oval starch grains, measuring 3-5 microns in diameter.

IDENTITY PURITY AND STRENGTH
Foreign matter – Not more than 2 percent
Total ash-Not more than 4 percent
Acid – insoluble ash-Not more than 0.4 percent
Alcohol soluble extractive- Not less than 9 percent
Water- soluble extractive –Not less than 20 percent

PROPERTIES AND USES
The root and stem back of the plant are astringent, cooling and anthelmintic are and good for type worm and strengthening the gums. A concentrated decoction of the fresh root bark in water with little cloves effectively expels taenia or tape worm. Bark of the roots is also used in several medicinal preparations as a cure for worms.

Decoction of the back of the tree and rind of the fruit are valuable in chronic diarrhoea and advanced stages of dysentery. Chakradaatta recommends a compound powder ‘ Dadimashtaka choorna’ for chronic bowel complaints.

Pomegranate fruits is highly esteemed as a food and medicine during the convalescence after diarrhea. Compound decoction made of the rind of the fruit, rind of mangosteen fruits, kurchi bark is an efficacious remedy for dysentery, in does of one ounce three times daily.

The Fruits are sweet, sour astringent, cooling, tonic, aphrodisiac, laxative and diuretic, laxative and diuretic. They are useful in anaemia hyperdipsia, spleenopathy , bronchits and otalgia.

The rind of the fruit with a belleric myrobalan is slowly chewed in the mouth is cases of chronic bronchitis. Powder of the dried rind along with chalk and myrrha form an excellent astringent dentifrice. Ghee prepared with the juice of the fruits is internally administered to check bleeding piles. Juice of the grains fruits in combination with cloves, ginger and galls are given in piles along with honey. An infusion of the fruits rind along with sugar can be taken internally in gonorrhoea. 15-30 ml acid saccharine juice of the fresh fruit is much esteemed in dyspepsia and as a cooling pleasant beverage in fevers and morbid thirst.

Pomegranate juice is enriched with polyphenols which are hydrolysable tannins called”Punicalagins” Punicalagins are absorbed into the human body and have dietary value as antioxidants and possess free radical scavenging properties.

Dried fruit rind is an ingredient of Hinguvachiadi choornam, Kapithashtashtaka choornam, Mustakarishtam, vani sura, Kalyanaka ghritha, Marichadi gulika , Neelikadya thaila etc.

Powder of the dried fruit rind alone may be administered at a close of 3-6 grams. Paste of the rind of the fruit along with a little suger taken internally arrests bleeding from the mouth.

Pomegranate aril juice is also a good source of vitamin C, vitamin B5, Potassium and antioxidant polyphenols.

Flowers are sweet, sour astringent, cooling, tonic and aphrodisiac. Juice of the flowers with the juice of Cynodon dactylon equal parts is given to stop bleeding from the nose.

Flower buds powdered andgiven in doses of 4-5 grains are useful in bronchitis . Unripe flowers are dried and pounded to make a snuff which is considered to be the best astringent in nasal haemorrhage, while internally it is very effective during infantile diarrhea and dysentery.
A decoction of the flowers is gargled to relieve oral and throat inflammation.

Seeds are astringent, stomachie , diuretic and cardio tonic and are good for vomiting, ophtalmodynia, scabies, hepatopathy, sleenopathy etc.

Leaf juice is styptic and astringent. Green leaves are made into a paste and applied on the eyes during conjunctivitis.

In some countries, such as Iran, the juice is very popular beverage. In Saudi Arabia, the juice sacs may be frozen intact or the extracted juice may be concentrated and frozen, for future use. Pomegranate juice is widely made into into grenadine or used in mixed drinks.

In Asiatic countries it may be made into thick syrup for use as a sauce. It is also converted into wine.

The juice has long been a popular drink in Middle Eastern and Indian cuisine. In Andhra Pradesh it is used for the preparation of curd rice.

In Turkey, Pomegranate sauce is used as a salad dressing, to marinate meat, or simply to drink straight. Seeds are also used in salads and sometimes as garish for desserts.

Pomegranate is used to make a high quality wine, in Azerbaijan and in Greece it is an ingredient in many recepies.

In India and Pakistan wild Pomegranate seeds are sometimes used as a spice known as Anardana.

The juice of wild Pomegranate yields citric acid and sodium citrate for pharmaceutical purpose.
All parts of the tree have been utilized as sources of tannin for curing leather.
Fruits rind and flowers yield dyes for textile industry.
Ink can be made by steeping the leaves of Pomegranate in vinegar.
An insecticide is derived from the bark in Japan.
The wood of the plant is very hard and is used for making walking sticks and wood crafts.

CULTIVATION PRACTICES
Climate
The species is primarily mild-temperature to subtropical. It is naturally adapted to regions with cool winters and hot summers. The plant favors a semi-arid climate and is extremely drought tolerant.

Soil
The Pomegranate thrives on calcareous, alkaline soil; on deep acidic loam and a wide range of soils in between these extremes. In Northern India, it is spontaneous on rock strewn gravel.

Propagation
The plant may be propagated from seeds as well as from stem cuttings. Seeds germinate readily even when merely thrown into the surface of loose soil and the seedlings spring up with vigor. The cuttings are set in beds with 1 or 2 buds above the soil for 1 year and are then ready for transplantation to the field. Treatment of the cuttings with 50 ppm.indole butyric acid greatly enhances root development.

Rooted cuttings or seedlings are set out in pre-fertilized pits 2 feet deep and wide and are spaced12-18 feet apart, depending on the fertility of the soil. Initially the plants are cut back to 24-30 inches in height and after they branch out the lower braches are pruned to provide a clear main stem. For the first three years the branches are shortened annually to encourage the maximum number of new shoots on all sides since fruits are borne only at the tips of new growth. After the third year only suckers and the dead branches are removed. The plant may begin to bear fruits in1-3 years after planting out.

Harvesting
The fruits ripen 6-7 months after flowering and are ready for harvest if it makes a metallic sound when tapped. They must be picked before over maturity when it tends to crack open if it is rained upon or under certain condition of atmospheric humidity, dehydration etc.

Protection
Since the fruits are liable to the attack of birds, bats, and squirrels, they may be covered with paper or plastic bags.


AYURVEDIC PREVENTIVE ASPECTS

Prof. Dr. K. Muraleedharan Pillai MD (Retd. Principal Ayurveda College), Thrissur
drkmpillai@ yahoo.co.in

The means and methods of living a healthy life are called ‘Swastha vritha’. While explaining health Susruta says that health does not mean only the absence of disease but it means that mind and spirit should also be happy. Complete psychosomatic equilibrium is the key to health.

For achieving sound and perfect health both Psyche and Physique should be in their normal form and also in a condition of equilibrium. For maintaining physical health Ayurveda has laid stress on proper living during day (Dinacharya) night (Ratricharya) and season (Ritucharya). For perfect mental health Sadachara is to be practiced. Social hygiene occupies an important position in our life. The cultivation of civic sense is necessary for the development of the village, city and there by the whole country.

Dinacharya comprises of the dos and don’t during the day time i.e. starting from the time of getting up from bed to the time of going to bed. It is advised to get up early in the morning before sunrise, in ‘Brahma Muhutra’. This practice is rewarding as it avoids dreams which generally appear in the morning when a man is in a condition of half awaking and half sleep (Tandra) and it provides a time when mind is clear and body loss is repaired.

A drink of water taken at the time of getting up causes a free passage of motion and urine. It is very necessary to inculate the habit of easing in the morning. A tendency to suppress the natural urges (Vega Vidharana) is the root cause of many serious diseases.

Cleaning the teeth, tongue and mouth every morning should be ensured. Teeth may be cleaned by Babul stick or any good powder. Which is antiseptic and astringent. So that the accumulation of dirt, tartar etc on the teeth could be removed.

If there is some disease of the teeth or gums, an oil massage on the teeth and gums is necessary. Accumulation of mala (impurities) on the tongue should be scraped by a tongue cleaner. Its edges should neither be very sharp nor blunt. Before and after cleaning, the cleaner should be properly washed.After cleaning the teeth and tongue gargling with salt water should be done.

It is necessary to massage the whole body with suitable oil. For massaging Tail taila (Gingelly oil), Sarsapa thaila (Mustard oil) or coconut can be used. But generally Sarsapa thaila is the best. Medicated oil also may be used. Oil massage ensures (1) softness and unctousness of skin there by eliminating chances of infection (2) Free movement of points and muscles is increased (3) Increases circulation of blood (4) Speedy removal of metabolic waste products through skin and (5) Maintaince of perfect health. It also serves as an exercise.

Regular exercise is essential for perfect health. It brings up stamina and resistance against diseases, clears the channels (Srothas) of the body and efficiency of lungs. However on should careful in selection and extent of exercise when he is suffering from a disease like cough, Tuberculosis, heart disease etc.

Generally one should take bath with warm water. Head should be washed with water having the temperature of the body. Bath increases digestive capacity, clears the pores of the skin and the skin becomes clear.

Diet should be regulated taking in to account the Desa, Kala and Habit. Diet should be planned to include all six rasa (Taste) i.e. sweet, saltish, acid, bitter, acrid and astringent. Diet should be balanced and the quantity should be according to one’s digestive capacity.

Fresh Ginger with a small amount of salt should be taken, ten to fifteen minutes before food. The diet, specially hard substances should be properly chewed. Wherever possible intake of curd should be follow food. The food should be tasty, fresh and good in appearance. It should never be avoided at least fifteen minutes before food. The quantity of water after food should be taken in limited quantity. Heavy food should not be taken at night as it may disturb good sleep. The proper time for night meal is two to three hours before going to bed. After supper, it is better to go for a short walk. Heavy work or exercise, and bathing must be avoided after intake of food .After meals heavy mental or physical work should be avoided. Some rest is advisable for digestion of food.

Sleep is most important for maintenance of health and longevity for the human beings. Sleep over comes wear and tear of the body due to physical work and mental stress and tissue loss. One should sleep with head to the east or north. The bed room should be absolutely clean, well ventilated and away from noise and disturbance. The bed must be neat, clean and free from bugs. One should avoid sleep when the brain is excited, e.g: after reading thinking or alcohol drinking. The mind must be absolutely free from worldly affaires and worries while going to the bed. This may be achieved by praying to God at the time of going to bed. Sleeping late at night is not good. A minimum seven hours sleep is required in twenty four hours to repair the wear and tear of the body . Sleep during the day time increases Kapha and produces Kapha rogas. However if one keeps awake at night, he can take some sleep in the day time. Day sleep is not contra indicated in summer. But in winter the day time sleep increases Kapha, thereby causing respiratory and digestive troubles.

It is advised to massage the head soles and plams with oil, before going to bed.
For all creatures sexual act is a natural urge. Sexual act is also essential for the procreation of species. Even animals of lower form practice certain amount of restrictions, but human beings are prone to over indulgence or abuse of the sexual act. Some regulation an this activity is essential.

Over sexual act is harmful for the body, and cause some debilitating disease like tuberculosis. Sexual act should be performed at during night time, preferably first quarter of the night, so that after performance of sexual act one can take rest for the whole night .For sexual act Lithotomy position is said to be the best. Ladies suffering from any venereal disease should be avoided. So that the disease may not be contacted. After sexual act at least one glass of milk should be taken to promote health and energy. During the course of disease or in convalescence, sexual act should not be performed, otherwise debility will increase and resistance will be lowered.

There are thirteen natural urges. These urges (Vegas) should never be suppressed, because suppression of natural urges leads to many diseases. These urges are, (1)desire to pass urine (2) stool (3) semen (4) adhovayu (wind) (5) vomiting (6)sneezing (7) eructation (8)yawning (9) hunger (10)thirst (11) tears (12) respiration and (13) sleep. Some serious disease and vata rogas are produced by suppression of these natural urges.

The most important point to be kept in mind is that as soon as a case infectious disease is seen, the same should be reported to the proper authorities, So that they can take proper steps to check the spread of the disease and we may take such steps so as to help the authorities in their efforts

Not only the behaviour of a person is responsible for causation of disease but seasonal changes also bring about disease. The seasons are classified mainely by the movement of the sun i.e. Daksinayana and Uttarayana and according to cold, heat and rains. But the main classification is that there are six seasons viz:-Sisira ,Vasanta, Grisma, Varsa, Sarat and Hemanta and Sisira are cold seasons.Grisma is hot season. Varsa is the season of rains. Sarat and Vasantha are moderately hot and nights are cold and pleasant.

There are three variations of Doshas. Viz: Sanchaya, Prakopa and Prasama. Sanchaya is the accumulation of doshas, prakopa is spread or excitement and Prasana is normals. Those three variations of dosha take place in the body of the seasonal variations over which there is no human control. But it is possible to keep the variations of doshas to the minimum by changing the mode of living. The seasonal variations of Dosha have been shown in the table below:-

Season
Sanchaya
Prakopa
Prasara
Hemanta
-
-
Pitha
Sisiva
Kapha
-
-
Vasanta
-
Kapha
-
Grisma
Vata
-
Kapha
Varsa
Pitha
Vata
-
Sarada
-
Pitha
Vata

Hemanta is the only season when not a single dosha is accumulated or spread. While in other season the dosha are in a state of derangement. Hence it can be inferred that Hemanta is the season most suited for building up of the body and increase resistence to disease.

In Greesma due to the scorching heat the son, the body becomes weak, perspiration is excessive leading to fluid loss, impaired digestion and skin diseases also take place. Due to humidity in weather, the digestion is impaired in Varsar ritu.

Sarat is very pleasant season, but due to sudden climatic changes, incidence of many diseases is high eg. Visamajwara, vigoochika etc.

The principles of Swastavritha mentioned in Ayurveda like Dinacharya, Ritucharya, are for preventing the diseases as well as for promoting the general health. Proper following of these principles leads to the perfect bodily and mental health, to live longer without any disease.


AJAMODA A WONDER HERB

Dr. N. Sujatha, Dr.G.D.Gupta, Dr. Ajay Dhanik, Dr. N.P.Rai
(Dept. of Kayachikitsa, I.M.S, Banarus Hindu University)

Ajamoda (Apium graveolens), in Ayurveda is also known as Garden Celery, a herb of Umbelliferar family. It is mentioned by in all authentic texts as deepaniya, pachaniya and soolahara drug.

General Information
Botanical Name: Apium graveolens
Sanskrit Synonyms: Agnika, Ajamodakam, Deepyaka, Kharasva, Yavanika
Plant Family: Umbelliferae
Common names: Garden Celery, Sellerie, Wild Celery
Officinal part Used: seeds, whole fresh green plants

Properties Rasa: Katu, tikta Guna: laghu, usna, ruksa, tikshna Virya:Ushna Vipaka: Katu Karma: vata kapha hara

Constituents of Ajamoda (Celery seed)
Alpha – linolenic – acid , betaeudesmol, coumarins, flavonoids isoimperatorin, isoquercitrin, limonene, linoleic acid, p-cymene, terpinene-4-01, 3-N-butylphthalide, Umbelliferone Vitamin A, Vitiman C, Vitiman B, volatile oils , including apiol.

  • Phamacologic actions
  • Deepan i..e. appetizer (an agent that excites the appetite.)
  • Panchan and Vatanuloman i.e. carminative digestive, aromatic, anthelmintic Shoolshara i.e. antispasmodic (an agent for easing griping pains , colic and expelling gas from the intestines)
  • Rajahpravartak i.e. emmenagogue (an agent that promotes menstrual flow).
  • Vedana hara & shoollahara i.e. analgesic, anti-rheumatic (eases symptom of rheumatism) and anti spasmodic relieve intestinal and uterine cramps.
  • Alkaliser and anti bacterial and antiseptic( an agent for inhibiting the growth of microorganism on living tissue or destroying pathogenic or putrefactive bacteria)
  • Mutra rechan i.e diuretic (an agent that increases the volume and flow of urine which cleanses the urinary system)
  • Vata samaka i.e. nervine (an agent that has a calming or soothing effect on the nerves, any agent that acts on the nerves to their natural state.)

Some Important Therapeutic Uses of Ajamoda Celery Seed is used for:

  • Gastrointestinal Conditions
  • Flatulence (gas/wind)
  • Indigestion
  • Lack of appetite
It pacifies vitiated Samana Vayu and corrects Apana vayu which is encouraged to freely flows downwards (Tierra 1988) in the channels.

Respiratory and Cardio vascular conditions:

  • Pratisyana ( common cold, influenza chronic pulmonary catarrh)
  • Kasa and Swasa i.e. allergic respiratory conditions like Tropical Pulmonary Esnophilia, Bronchial asthma etc.
  • Antihpertensive Excess accumulation of Kapha causes congestion and breathlessness in the chest. Ajamoda by its properties acts an expectorant , helps in thinning the secretions, relieves congestion and their expulsion by dilating larger airways.(Frawleyand Lad 1994)

Inflammatory Conditions
Reduces inflammatory in the following conditions

  • All painful inflammation arthralgias.
  • Rheumatism and rheumatoid arthritis and gout like conditions

Genitourinary Conditions:

  • Urinary antiseptic
  • Inflammation and/or infections of the urinary tract (Celery Seed’s diuretic action combined with its antibacterial compounds make it a useful herb for treating urinary tract infections)
  • Strengthens the muscles in the uterus

Reproductive Conditions:

  • Aphrodisiac (restores sexual potency impaired by illness)
  • Checks dysmenorrheal, promotes the onset of menstruation, increases menstrual flow

Other Conditions:Clears up skin problems checks overweight

Dosage: and Form of Administration: Churna and tea decoction
Whole celery seeds: 5-10g freshly crushed dry seeds .Prepare a decoction by adding water in the ratio 1:8 and reduces it to half drink twice a day as lukewarm Add a pinch of saindava lavana for G.I and Respiratory conditions and then administer.

Precautions: Ajamoda should be used by:
Pregnant women as it may cause muscle contractions in the uterus and uterine bleeding
People with an active acute kidney inflammation or problems, but may be taken in modest amounts for chronic kidney problems.

Drug Interactions

  • Ajamoda contains properties that may thin the blood so should not be used if taking Aspirin and Warfarin
  • Ajamoda has diuretic effects and diuretics can deplete your body of potassium. With therapeutic doses.


AYURVEDA TREATMENT FOR EPISTAXIS

Dr.Triveni KTC

Nasal bleeding is known by the medical term-Epistaxis . An obvious symptom of nosebleed is blood coming down the nostril, most often it is one sided. Epistaxis is one of the most common ENT emergencies. Although most patients can be treated within an accident and emergency setting, some are complex and may require special intervention .Epistaxis can affect any age group, but it is elderly population who often require more intensive treatment and subsequent admission.

The nose is highly vascular organ of the body (i.e. rich in blood vessels) and is situated in a vulnerable position on the face. As a result, any trauma to the face can cause bleeding from the nose. Nose bleeds can also occur spontaneously when the nasal membranes dry out, crust, and crack, this is common in dry climate or during the winter months when the air is dry or in hot and dry areas. Air moving through the nose can dry and irritate the membranes lining the inside of the nose due to low humidity, forming crusts. These crusts bleed when irritated by rubbing, picking, or blowing the nose.

Nasal bleeding can occur from the anterior or posterior portion of the nasal septum. Most of them are from the anteroinferior septum (Kiesselbach’s area), where a plexus of vessels are present. On the other hand posterior nasal bleedings are less common but more serious, which tend to occur in patients with preexisting atheroscelerotic vessels or bleeding disorders who have undergone nasal or sinus surgery. Severe epistaxis could oftenly be caused by coagulopathy from liver diseases.

Causes: A nose bleed normally begins from the nasal mucosa overlying a dilated blood vessel is injured

  • Most common cause of a nosebleed is drying of the nasal membranes. The incidence is higher during the winter because when upper respiratory infections are more frequent, and the temperature and humidity fluctuate more dramatically.
  • Trauma or injury to the nose by nasal picking or insertion of foreign bodies, nose blowing etc.
  • Malignant tumors of the nose or sinuses.
  • Thinning of the mucus membrane by long term usage of nasal sprays of steroids.
  • Use of “blood thinning medications “ that prevent normal blood clotting (Coumadin, warfarin, aspirin, or any anti-inflammatory medication)
  • Recurrent nasal bleeding may be a symptom of an underlying disorder such as high blood pressure.
  • Rhinitis or sinusitis and cold may cause bleeding too.
  • Alcoholics
  • Those who inherit bleeding problems such as haemophilia

Symptoms

  • Bleeding from one or both nostrils. Bleeding may range from a trickle to a strong flow
  • Bleeding down the back of the throat with spitting blood frequently
  • Swallowed blood irritates the stomach, frequently causing vomiting.
  • Sensation of smell of blood in the back of the nose and throat.
  • Most nose bleeds do not result in sufficient blood loss to cause significant problems. However, a very prolonged and vigorous nose bleed may result in anemia.
  • If there has been a significant quantity of nose bleed recently, you may notice dark or tarry bowel movements; this indicates that you have swallowed a significant amount of blood.

Diagnosis

  1. Anterior bleeding sites are usually apparent on direct examination with a nasal speculum and a bright light. If no site is apparent and bleeding in severe or recurrent, fiber optic endoscopy may be necessary.
  2. A thorough medical history for previous bleeding, high blood pressure, liver disease, use of anticoagulants, nasal trauma, family history of bleeding etc should be taken.
  3. Analysis of blood coagulation parameters.
  4. Measurement of the blood pressure and X-rays of the skull and sinuses may be necessary.

Treated:Most nosebleeds stop spontaneously within 5 minutes with or without pressure to the forehead, nose, or upper lip. The treatment includes the following:

First Aid: Clam the patient (if necessary a physician could be consulted and medication could be used) .The patient should sit with the upper part of the body tilted forward and the mouth open so that they can spit out the blood instead of swallowing. Check to see if there is an object inside the victim’s nose and remove it if necessary.

Local procedure:

  1. Pinch all the soft parts of the nose together between the thumb and index finger. Hold the nose for at least 5 minutes. Repeat as necessary until the nose has stopped bleeding.
  2. Apply ice (crushed in plastic bag or washcloth) to nose and cheeks.
  3. For dryness of the nose ointments or coconut oil can be applied.
  4. Nasal packs are used when bleeding fails to stop.
  5. Cauterization (the application of a heated instrument or caustic chemical to tissue to stop bleeding) may be required if bleeding persists or recurs.

If the bleeding is from the anterior part of the nose and is quite profuse usually be controlled by pinching the nasal alae together for10 minutes. If this maneuver fails, a cotton plug impregnated with a vasoconstrictor (e.g., phenylephrine).

The bleeding point may then be cauterized with electrocautery or silver nitrate on an applicator stick. Cauterizing 4 quadrants immediately adjacent to the bleeding vessels is most effective. Care must be taken to avoid burning the mucous membrane too deeply. Alternatively, a nasal tampon of expandable foam may be inserted. Coating the tampon with a tropical ointment, such as bacitracin or mupriocin posterior bleeding may be difficult to control. Commercial nasal ballons are quick and convenient; a gauze posterior pack is effective but more difficult to position. Both are very uncomfortable; IV sedation and analgesia may be needed, and hospitalization is required.

In patients with liver disease, blood may be swallowed in large amounts and should be eliminated promptly with enemas and cathartics to prevent hepatic encephalopathy. The G I tract should be sterilized with antibiotics to prevent the breakdown of blood and the absorption of ammonia.

Do’s and Don’ts

  • Avoid heavy blowing of the nose or putting anything into it. If one feels likes sneezing, keep the mouth opened so that the air will escape out the mouth and not through the nose.
  • Avoid straining during bowel
  • Try to keep the head higher than the level of the heart.
  • Do not stain or bend down to lift anything heavy.
  • Do not smoke or drink alcohol.
  • Stay on a soft, light and cool diet and avoid hot foods and liquids for at least 24 hours.
  • If the nasal bleeding is due to increased blood pressure, then it should be got under good control.
  • Those prone to nosebleeds should avoid aspirin products because they slow down clotting
  • Apply a small amount of petroleum jelly, butter or coconut oil, inside the nostril to protect it from drying.
  • If bleeding is stopped by direct pressure, it is important not to blow the nose vigorously or pick at any clots, because this may restart the bleeding.

When to consult the doctor:

  • When the nose is gushing with blood or if there are repeated episodes of vomiting from swallowed blood
  • If applying direct pressure to the nose for 30 minutes does not control the bleeding.
  • If there are more than three or four nosebleeds a day.
  • Nosebleeds are caused by elevated blood pressure or a bleeding problem such as hemophilia or leukemia
  • When the victim is on blood thinners such as heparin or coumadin.
  • When the patient has body temperature of greater than102F, especially when his nose was packed or cauterized earlier.

Ayurvedic Medical Science describes a similar condition called-Raktapitta. Raktapitta (bleeding through the upward) and
*Adhoga Raktapitta (bleeding in downward direction) Bleeding is said to express in 9 orifices in men and 10 orifices in women.

Nose/Nostrils
+
Eyes (2)
+
Ears (2)
+
Mouth (1)
+
Uretha (1)
+
Anus (1)
And an additional orifice in women –Vagina making it 10 in total for her.

The blood discharged is considered to be the vitiated pitta itself, which is expelled out due to the excessive production of it .It is advised not to stop the bleeding or this vitiated pitta or blood immediately after it starts, because the bleeding will stop spontaneously within few minutes as soon as the stock of vitiated pitta is expelled out .but, acharyas also caution that if the bleeding is profouse and is not stopping then manures to stop it should be done. Few Ayurvedic Medicines for this condition are:

  • Chandrakala
  • Vasavleham
  • Dadimavleham
  • Vasaghrit
  • Vasapatra svarsasa nasya (instillation of drops into nose)etc
    Acharyas also have explained the drug of choice in raktapitta as –Vasa

Praising Vasa the “Harita” states: why should any one suffering from hemorrhage, wasting, and cough be doubtful about survival, in the presence of Vasa.?”-
Ref: Harita samhita 3, 10/24

Sanskrit Name: Vasaka or Vasa Botancial Name: Adhatoda vasica , Justicia adhatoda Plant Family: Acanthaceae

Vernnacular names: Sanskrit –Vasa; Hindi- Arusha- Adulasa ;English-Malbar nut ; Unani –Arusa; Tamil –Adathodai; Bangali - Bakash

Part used: leaves, root, flowers, stem bark

Adhatoda vasica is a small evergreen subherbacious bush, minutely pubescent and broadly lanceolate . It grows to about 3m high, with leaves about 10-16 cm long and 5cm wide, and white or purple flowers and 4-seeded fruits. Native to India, it is commonly cultivated in the tropics.

The leaves are sometimes used as an insecticide and this small evergreen shrub has been used in traditional Indian medicine for more than 2000 years .Its qualities are as follows:

Rasa (taste): Bitter, astringent
Virya (action): cold
Vipaka(post-digestive effect) :Pungent
Guna(quality): Light , dry
The leaves and roots contain alkaloids, vasicinone , vasicinolone and vasicol, which may have a bronchodilatory effect of the bronchii.

Action of Adhatoda vasica:

  • The juice from the leaves and the decoction of the leaves and roots are helpful in asthama , bronchits , and chronic coughs and breathlessness.
  • Commonly used for bleeding due to idiopathic thrombocytopenic purpura, local bleeding due to peptic ulcer, piles, menorrhagia.
  • Relief in pyorrhea and for bleeding gums (applied locally)
  • Antitussive (an agent that relieves coughing)
  • Bronchodilator (an agent to dilate the bronchials)
  • Expectoranat (an agent that promotes the discharge of mucous and secretions from the respiratory passages)

Ayurveda Treatment for Epistaxis

  • Febrifuge (an agent that reduces or eliminates fevers)
  • Mucolytic (an agent that thins and breaks down mucus)
  • Oxytocic (stimulates contraction of the uterine muscule, facilitating or speeding up childbirth)
  • Lowers blood pressure.

*Although the precise mechanism of action of the Adhatoda vasica alkaloids remains to be elucidated, the active alkaloid vasicine and its autooxidation product vasicinone are potentially useful phytochemicals showing bronchodilator and antihistaminic effects. The leaf extracts has been used for the treatment of bronchitis and asthama for many centuries. It relieves cough and breathlessness. Adhatodavasica is also accredited with antimicrobial properties with proven in vitro action against Mycobacterium tuberculosis and reduction of gingival inflammation. Its local use gives relief in pyorrhea and in bleeding gums. Uterine stimulant activity and moderate hypotensive activity of the alkaloids were also repoted.Vasicine hydrocholoride possess significant thrombopoetic action in animals and potential use in the management of hemorrhagic disorders-ref: Atal,C.K.et al. (1982) Thrombopoetic (platelet-increasing) activity of vasicine hydrochloride. Ind. J. Exp. Biol.20:704-709
*Report of another study says –It astringes the mucus membranes and is effective for bleeding from ulcers, metrorrhagia, epistaxis and the gingivitis.

SAFETY & CONTRA INDICATIONS
Adhatoda vasica leaf extract, is considered safe and the oil has low toxicity. The oil is shown to have low toxicity in mice and guinea pigs. The alcoholic extract has insecticidal and pesticidal activity. Teratogenic studies were safe. However, the abortificent activity prevents its use during pregnancy, particularly, in high doses of extracts.

  • It is exceptionally powerful and should be only be used under the guidance of the herbalist.
  • Only use short term for up to 6 weeks maximum.
  • Excess use can cause hypotension.
Lack of clinical & research studies keep our herbal heritage in darkness. If there could be more research findings in this regards and many other such herbs we could make a better and healthy society.


Baldness and Its Ayurveda Management

Hair loss or baldness is usually caused because of genetics (inherited tendency), disease, medications, stress, injury or damage to the hair. Generalized hair loss is termed Alopecia whereas small, circular bald patches are termed as Alopecia Areata. The two conditions have been clubbed here together because of similarity of symptoms, and the Ayurvedic principles of treatment both are here. It is noteworthy to mention here that treatment is usually effective for premature hair loss, and where the cause is amenable to treatment.

In Ayurveda:
Baldness is termed as “Khalitya” in Ayurveda. Alopecia areata is termed as “Indralupta”. Ayurvedic herbal treatment is aimed at treating known causes, immunorestoration, treating the local scalp condition and reducing stress.

Ayurveda Treatments:

  1. Local Treatment:Medicated oils are used for local application. Some of the commonly used oils are: Vranashodhan oil, Bhrungraj(Eclipta alba) oil, Amalaki(Emblica officinalis) oil, Brahmi (Bacopa monnieri)oil, Jaswand (Hibiscus rosa-sinensis) oil, Vatajatadi oil and Bhallatak (Semicarpus anacardium)oil. Some Ayurvedic physicans use leech therapy at the bald sports before using the above mentioned local medications. Some advice a course of enemas of medicated milk (called as “Tikta-Ksheera Basti”) in conditions of extensive hair loss.
  2. Immunomodulators:Some medicines which are used orally are:Arogya Vardhini, Gandhak Rasayan, (a combination of Gokshur (Tribulus terrestris Amalaki (Emblica officinails) and Guduchi (Tinospora cordifolia).

    Ayurveda believes hair to orginate from the “Asthi” or bone tissue, and therefore , to treat hair loss, medicines to strengthned bone are given orally on the long-term basis. Some medicines used for this purpose are: Pancha Tikta Ghruta, Praval Panchamruta, Laxa and Asthishrunkhla (Cissus quadrangularis). Milk and black gram are advised for consumption in large quantities.

    Medicines like Brahmi (Bacopa monnieri), Jatamansi (Nardostachys jatamansi), Shankhapushpi (Convolvulus pluricaulis) and Vacha (Acorus calamus) are given orally to reduce stress.
  3. Detoxification (Panchakarma) Treatment:It is believed that regular application of medicated oils in the nose (a procedure called “Pratimarsha Nasya”) has an important role to play in preventing premature baldness and graying of hair.
    Dr.Gaurang Joshi
    Atharva Multisppeciality Ayurveda Hospital Rajkot.
    Cell No: 919825163953


SANJEEVANI: THE HERB OF IMMORTALITY

(Dr.C.I. Jolly, Scientific Advisor, Kerla Ayurveda Ltd., Alwaye & Amala Cancer Hospital & Ayurvedic Research Centre, Trichur)

Sanjeevani grows on the hills of tropical areas, particularly the Arawali mountain terrains from east to west in India.

21 st century has been the glorious period of medicinal herbs. Utilization of the traditional system of medicine for promotive, preventive and curative health sciences has taken seriously by the western world today.The World health organization, in one of their resolutions has emphasized the needs of these medicinal herbs by the underdeveloped and developing countries.

Even though some of these traditionally used herbs are only folklore but many of them are originally composed in languages like Sanskrit, Chinese etc. Here in this following text a traditionally used plant sanjeevani is narrated in a lucid manner. It is a great honor and pride for Indians that sanjeevani was discovered long ago by our ancestors. Sanjeevani is a true reflection of hoe the traditional medicine and flora are closely associated.

SANJEEVANI SELAGINELLA BRYOPTERIS FAMILY: SELAGINELLACEAE

Selaginella bropteris (L) Baker, popularly known as Sanjeevani, is a lythophytic plant with lot of medicinal properties. The popular name “Sanjeevani” which translates as “one that infuses life” derives from the medicinal properties. Sanjeevani grows on the hills of tropical areas, particularly the Arawali mountain terrains from east to west in India. The dry plants have traditionally been used as an effective remedy for several human health complications for centuries in India, particularly in the tribal areas.

Traditionally plants have been used:

  1. relief from heat stroke and the burning sensation during urination,
  2. restorating menstrual irregularities to normal and applied topically to pregnant women, aids easy delivery; and
  3. for treating jaundice , however whether such treatment have any factual basis is unknown(1)

HISTORY
In Hindu mythology, Sanjeevani is a magical herb which has the power to cure any disease. It is believed that medicines prepared from this herb can even revive a dead person. This herb is mentioned in the Ramayana when, during the battle with Ravana, Lakshmana was wounded and was nearly killed by Ravana’s son Indrajit. Hanuman was called upon to fetch this herb from the mount Dronagiri in the Himalayas. Upon reaching mount Sumeru , Hanuman was unable to identify the herb and decided to lift the entire mountain and brought it with 10% aqueous extract enhanced cell growth by about 41% in Sf9 cells and 78% in mammalian cells. Pre-treatment of cells with the Selaginella extract (SE) (1-2*5%) protected against oxidative stress (H2O2)- induced cell death. The killing potential of ultra violet (UV) was also significantly reduced when the cells were pre –treatment with SE for 1 hour. Thermal radiation suppressed cell growth by about 50%. Pre-treatment of cells withes for 1h afforded complete protection against heat-induced growth suppression. SE may possess anti-stress and antioxidant activities that could be responsible for the observed effects. (4, 5)

Look at our traditional knowledge. “We need to speak in one voice, learn from different issues across the world and various solutions to our problems, then the traditional system, the Ayurveda will succeed”. If we can employ different scientist s, why not make use of international expertise with area of medicine, So that this traditional knowledge will reach scientifically to the masses.

Western medicinal system says that the Ayurvedic medicines are baseless. Let me place it in this way that our people are getting trained to deal with such situations and, that one day we will succeed.” If we can employ different scientists, why not make use of international expertise with area of medician, so that this traditional expertise with area of medicine, So that this traditional knowledge will reach scientifically to the masses.

Western medicinal system says that the Ayurvedic medicines are baseless. Let me place it in this way that our people are getting trained to deal with such situations and, that one day we will succeed. The fact remains that this is not the first and in all probability, not the last case either, the system survived the storm thousands of years.

The ground infrastructure is improving, but we need to constantly upgrade our standards along with technology and services to our community .There are arm- twisting tactics the western system in employing against the traditional system of medicine will over come all dangers and suspicions. They just want to harass, but Ayurvedis system wont be deterred and will come with flying colours.

REFERENCE

  1. Sah N K et al., 2005, Indian herb ‘sanjeevani’ (Selaginella bryopteris) can promote growth and protect against heat shock and apoptotic activities of ultra violet and oxidative stress.Journal of Bioscience, 30,499-505.
  2. Silva G L, Chai H, Gupta M P, Farnsworth N R, Cordell G A, Pezzuto J M , Beecher C W and Kinghorm A D 1995 Cytotoxic biflavonoids from Selaginella willdenowii; Phytochemistry 40129-134
  3. Ma S C, But P P,Ooi V E ,He Y H , Lee S H, Lee S F and Lin R C 2001 Antiviral amentoflavone from Selaginella sinensis; Biol, Pharm. Bull.24311-312
  4. Sun C M, Syu W J, Huang Y T,Then C C and Ou J C 1997 Selective cytotoxicity of ginkgetin from Selaginella moellendorffii; J. Nat. Prod.60382-384
  5. Zentella R, Mascorro-Gallardo J O,Van Dijck P, Folch-Mallol J, Bonini B, Van Vaeck C, Gaxilola R, Covarrubias A A, Nieto-Sotelo J, Thevelein J N and Iturraiga G 1999 A Selaginella lepidophylla trehalose complemenet broth and stress- tolerance defects in a yeast tps1 mutant ; Plant Physiol.1191473-1482


HOW TO CONTROL YOUR WEIGHT

Obesity can result from increased energy intake, decreased energy expenditure, or a combination of both.

Dr. Ajay Kumar M.D
Dr.Tina Singhal M.D
Prof. Dr. B.N Upadhyay M.D

Obesity is one of the most common disorders in medical practice and among the most frustrating and difficult situation to manage. Obesity is a state of excess adipose tissue mass. Obesity is a state of excess adipose tissue mass. Obesity is a state of excess adipose tissue mass. Obesity should not be defined by body weight alone, as muscular individuals may be overweight by arbitrary standards without having increased adiposity. The most widely used method to gauge obesity is the body mass index (BMI), which is equal to weight/ height2 in kg/ m2 is considered an appropriate weight for most individuals.

Overweight is deuned as a BMI between 25 30kg/ m2, and obesity is deuned as a BMI e” 30kg/m2.

In Ayurveda, obesity is described as a most undesirable trait with special reference to treatment. In Charka Samhita, obesity is described as sthoulya under the title ‘Asthoninditiya Purusha’. The main causative factor in pathogenesis of obesity is tikshnaagni. Due to excessive accumulation of Medo dhatu, all Srotas obstruct resulting in vitiation of vata dosha. Then aggravated Vata increases the Jatharagni. Tikshana Jatharagni causes excessive consumption of food and excess production of Medo and Mamsa dhatu resulting in excess weight gain & obesity.

Obesity can result from increased energy intake, decreased energy expenditure, or a combination of both. Excess accumulation of body fat is the consequence of the enviroment.


Ayurveda and Insomnia

Dr.K.C.Thriveni, BAMS

As an irish proverb says: “A good laugh and sleep are the best cures in the doctor’s book.” A restless mind is never a happy place. They will hardly ever adorn a smile on their faces and become rather grim and glum personalities. Lack of sleep causes mental fatigue which does not let them concentrate on what they are doing. Mental fatigue gives way to physical tiredness too and they practically become unwilling persons.

Sleep is a natural periodic state of rest for the mind and body, in which the eyes usually close and consciousness is completely or partially lost, so that there is a decrease in bodily movement and responsiveness to external stimuli. During sleep the brain in humans and other mammals undergoes a characteristic cycle of brain wave activity that includes intervals of dreaming.

Almost everyone has occasional sleepless nights. Most individuals just experience a night or two of poor sleep, but sometimes the sleep disturbance can last for a week, months, or even years. Insomniacs typically complain of being unable to close their eyes or “rest their mind” for more than a few minutes at a time. Insomnia can occur in people of all ages. Insomnia is most common among women and older adults.

An estimated 30% -50% of the general populations are affected by insomnia, and 10% have chronic insomnia.

Stages of sleep
Usually sleepers pass through five stages: 1,2,3,4 and REN (rapid eye movement sleep. These stages progress cyclically from 1 through REM then begin again with stage 1. A complete sleep cycle takes an average of 90 to110 minutes. The first sleep cycles each night have relatively short REM sleeps and long periods of deep sleep but later in the night, REM periods lengthen and deep sleep time decreases.

Stage 1 is light sleep where you drift in and out of sleep and can be awakened easily. In this stage, many people experience sudden muscle contractions preceded by a sensation of falling.

Stage 2 eye movement stops and brain waves become slower with only an occasional burst of rapid brain waves.

Stage 3 when a person enters stage 3, extremely slow brain waves called delta waves are interspersed with smaller, faster waves.

In stage 4 the brain produces delta waves almost exclusively. Stages 3 and 4 are referred to as deep sleep, and it is very difficult to wake someone from them. In deep sleep, there is no eye movement or muscle activity.

In the REM period, breathing becomes more rapid, irregular and shallow, eyes jerk rapidly and limb muscles and temporarily paralyzed. Brain waves during this stage increases to levels experienced when a person is awake. Also, heart rate increases, blood pressure rises, males develop erections and the body loses some of the ability to regulate its temperature. This is the time when most dreams occur, and, if awoken during REM sleep, a person can remember the dreams. Most people experience three to five intervals of REM sleep each night.

Causes: About half of all insomnia cases are caused by psychological or emotional problems such as *Stress *Anxiety * Depression *Pain *Aging and changes in sleep patterns (insomnia occurs more frequently in those over age 60) *Caffeine * Irregular Schedule of sleep such as sleeping during day time and working during nights.

*Prescription drugs, including some antidepressant, high blood pressure and corticosteroid medications, can interfere with sleep. Many over the counter (OTC) medication including some pain medication combination, decongestants and weight loss products, contain caffeine and other stimulants.

Doctors generally recommend using sleeping pills for no more than four weeks, or until you notice benefits from self-help measures. If you need sleep medications for longer, take them no more than two to four times a week, so they don’t become habit-forming. Sleeping pills often become less effective over time.

Short-term insomnia can be linked to events and factors that are often temporary , such as adjustment sleep disorder, jet lag, working the night shift, medications, overuse of caffeine and alcohol, environmental noise, extreme temperatures, or a change in a person’s surrounding environment.

Apart from that, lack of a good night’s sleep can create psychological problems. Another factor which can cause insomnia is decreased melatonin. The levels of melatonin decreases as the person grows older. This is a hormone that helps control sleep. By the time a person reaches the age of 60, the body produces very little melatonin.

Complications:

  • Increased risks for depression
  • Impaired concentration, slowed reaction time and poorer work performance
  • Impatience & irritable
  • Higher incidence of accidents
  • Insomnia can lead to severe fatigue, anxiety, depression and lack of concentration.
  • Chronic insomnia more likely can develop psychiatric problems such as depression and anxiety disorders.
  • Long term sleep deprivation may increase the severity of chronic diseases, such as high blood pressure and diabetes.
  • Insufficient sleep can also lead to serious or even fatal accidents. According to the National Highway Traffic Safety Administration, more than 100,000 crashes each year are due to drivers falling asleep at the wheel.

Treatment
Commonly Doctors recommend sleeping pills to promote relaxation or sleep but, avoid prescribing it for the long term because they may cause side effects. In addition, sleeping pills can become less effective after a while.

In Ayurveda Chakara explains that happiness, sadness, nourishment, emaciation, strength, strength-less ness, libido or infertility, consciousness or insanity, all depends on sleep itself.

Therefore sleep is a very important component for existence.

  • Frequent oil massage (full body) using medicated oils such as Mahabhringaraj taila etc followed by warm water bath may relax the mental state.
  • Medication such as ashwagandha ksherapaka, brahmi ghruta etc help to combat the stress.
  • Avoid sleep during day time as it makes it harder to fall asleep at night
  • Avoid or limit your use of caffeine (coffee, tea, sodas, chocolate), decongestants, alcohol and tobacco, instead drink milk.
  • Avoid drinking alcohol and smoking as these are also stimulants
  • In chronic insomnia patients’ panchakama treatment such as- virechana followed by application of oil on head are found very effective.

Daily application of oil on to head relieves headache, balding or graying of hair, makes the roots strong thick and dark. Oiling head strengthens the nerves in the head, sharpens the sense organs, improves the scalp & enhances good sleep.

Shiro abhyanga
Soothing or relaxing Massage of the head, neck & shoulder for 15 minutes using warm herbal oils is called shiro abhyanga.

Massage is very helpful for the whole body as it relieves stress and improves blood circulation. Body massage is a great way to heal the body. There are different types of massages and the most preferred one is the oil massage.

Oil massage is the best way of relaxation for the whole body. There are different types of oils used for massaging the body. Each oil has its own properties to heal, relax, and strengthen the body and immune system.

Massage techniques have been practiced for thousands of years in many cultures. There are references to massage in ancient record of Chinese, Japanese, Arabic, Egyptian, Indian, Greek and Roman nations.

People were also using abhayanga as a way to improve well-being, help with relaxation, relieve stress relief, and enhance sleep and quality-of-life.

Practitioners may use their hands, forearms, elbows, or feet with oils, to improve the smoothness of Massage strokes. Touch is central to Massage. It allows therapists to locate painful or tense areas, to determine how much pressure to apply, and to establish a therapeutic relationship with clients.

In a proactive role, Massage treatments are performed on a regular basis to help the body and mind maintain an optimal level of relaxation and stress-relief. Massage therapy also reduces the chances of migraine attacks and tension headaches significantly by relaxing muscle spasms and trigger points. Massage also switches the nervous system from the sympathetic (fight or flight) mode to the parasympathetic (rest and digest). This change enables the recipient to sleep uninterrupted and wake up refreshed and rested. Massage is performed to ease the pressure brought on during a migraine or tension related headache. By focusing on the neck, shoulders, and head, massage can decrease the pain and discomfort brought on by migraine or stress.

A recent study showed that massage therapy recipients exhibited fewer migraines and better sleep quality during the weeks they received massage, and three weeks following, than did participants that did not receive massage therapy. Another study found that in adults with migraine headaches massage therapy decreased the occurrence of headaches, sleep disturbances and distress symptoms. It also increased serotonin levels, believed to play an important role in the regulation of mood, sleep and appetite.

Shirovasti
This is the most important of all external use of Snehana (oil application). Certain lukewarm Ayurvedic/herbal oils are poured into a cap fit on the head of 15 to 60 minutes per day accordingly to the patient’s conditions for a period of 7 days.

Shirovasti is considered more of a palliative (Shamana) treatment of Ayurveda than an eliminative (Shodhana) one. As usual the treatment is preceded by oleation and sudation.

A leather sleeve about six to eight inches high is placed on the shaven head of the patient and a band (Vasti) tied around the forehead to secure it in place. The inside bottom edge of this sleeve is lined tight with kneaded dough to prevent leakage.

Medicated oil is then poured into the sleeve and allowed to remain for a while. The oils commonly used are Ksheerabala or Dhanwantaram. The length of time for the oil to be kept on the head is determined by the severity of the illness. Usually it is up to fifty minutes for diseases caused by severe Vata disorders.

Shirovasti is found very effective in diseases like facial paralysis, insomnia and disorders of the cranial nerves.

It is believed that the warm oil when retained in this manner actually clears the blockage of blood vessels (if any) & also relaxes the muscles.

Shiro dhara
Dhara is a method of poring warm herbal oil/ herbal decoctions / medicated milk/ buttermilk in a thin and slow continuous stream onto the forehead for about 45 to 50 minutes. This procedure often induces a mental state similar to a trance, which creates profound relaxation of the mind and body. It deeply relaxes and revitalizes the central nervous system. Shirodhara gives the best results when taken after an Abhyangam. Dhara is good for all ailments. Selection of the liquid used is done on base of the status of the Dosha, Body constitution (prakruti) & the disease condition with necessary alterations in the procedure.

Shirodhara has been used to treat a variety of conditions including eye disease, sinusitis, allergic rhinitis, graying of hair, neurological disorders, memory loss, insomnia, hearing impairment, tinnitus, vertigo, and certain types of skin diseases like psoriasis. It is also used non-medicinally for its relaxing properties.

Recent research studies have shown that Shiro dhara results in Vaso Dilation (dilation of blood vessels) in the brain enabling increased supply of oxygen to the blood cells.

Researchers have conducted two human clinical trials on the psychoneuroimmunologic effects of shiro dhara. In the first study of group of healthy females were randomly assigned to receive a shiro dhara treatment (with plain sesame oil) or remain in a supine position (control group), while being monitored for numerous physiologic, biochemical, immunologic and psychometric parameters. The second study hd a similar design, with the addition of third group that received shiro dhara with a medicated sesame oil containing essential oil of lavender. Both shiro dhara treatments resulted in decreased anxiety and promoted ASC (altered state of consciousness). After the plain sesame oil treatment there was a significant decrease in plasma noradrenaline and urinary serotonin excretion vs. the control group. Significant Anxiolytic effect within the shiro dhara group also observed.

Takra dhara
Takra means buttermilk and Dhara means pouring. This therapy clams the individual down by using medicated buttermilk, which is poured onto the forehead to relieve insomnia, depression and other stress related problems.

Paada abhyanga (Foot massage) Massage therapy is a known method to reduce stress and tension, but can it really help you sleep better? The research shows that Massage therapy can help you sleep.

All of us have an autonomic nervous system comprised of two parts: the parasympathetic is activated and you will feel the urge to fight of flight. So if stress and tension are the reasons why you are not sleeping very well, you might be relieved to know that one of the benefits of Massage therapy is improved sleep patterns. Some people even fall asleep while having a professional Massage.

In one of the study aimed to investigate the effect of foot Massage on sleep, vital signs and fatigue in the elderly who live in their Home. Tried foot massage therapy on 20 elderly who live in the Seoul- Kyunggi province area.

Change of sleep and sleep satisfaction, vital signs (pulse, respiration, systolic and diastolic blood pressure) and general fatigue between pre and post foot massage were analyzed using Paired t- test at 0.05 of significance level. There were very significant differences in the sleep and fatigue between pre and post foot massage.

Authentic Thai Foot Massage originated in Thailand about 2000 years ago & is a Massage of the lower legs, feet and hands. It is practiced as a routine & a common procedure there.

The therapy involves the gentle manipulation and Massage of hands, legs and feet. This is believed to open energy lines, stimulating reflex points on the feet which correspond to the internal organs of the body.

A truly relaxing experience as the toes, feet, ankle & lower legs are manipulated, stretched & loosened.

Thai Foot Massage benefits:

  • Improve circulation
  • Improve flexibility
  • Improve sleep patterns
  • Reduce stiffness in joints
  • Reduce stress
  • Stimulate the mind


Ayurveda, Yoga and Nature (Herbs Minerals) Heritage for survival of human beings

Ayurved is a science of ages and also of life. This has its roots in B.C. it was the only system, which had wide spectrum of prophylactic and preventive medicines, knowledge of cure of sickness and its treatment and maintenance for over all health care. Yoga is a science, which balances the body and nature and develops human personality. Yoga and Ayurved has worked with nature for survival since the ages. Deep knowledge of herbal remedies, agriculture, eco-balancing, identification of herbal, traditional knowledge specifically in tribes of mother and child care also for animal, human diseases and nature. Since origin of human race Ayurved, has detailed the knowledge in Ayurved and Yoga disappeared before the independence. But this knowledge has long life. None of the science is as old as this in our country. Urbanization, modernization, deforestation and destruction of nature is again switching human beings to adopt this valuable knowledge toe protect health and to prevent yourself. Now many plants people nature are extinct. We have to think over for survival of Yoga and Ayurved for the human life longevity.

Dr. Rajesh Shukla
Sagar (M.P)


Ayurvedic Approach to say Good Bye to Allergy

Dr.Archana Rai

Shree Dhanwantry Ayurvedic College, Chandigarh

Life is ever-changing. Today’s busy life standards has not created only a harmful lifestyle but also a polluted environment. Due to all these major changes with a negative and imbalanced impact, a lots of problems including health hazards such as Allergies etc had attacked the people.

Allergy=allos(other) + generon(to produce)

Allergies are typically a form of hypersensitivity reactions against allergens.It is an acquired abnormal responses to a substance.

In this process, sensitization or an initial exposure to allergen is required, subsequent contact with allergen results in broad range of inflammatory response known as hypersensitivity or allergy.

ALLERGEN CONTACT = PRIMARY DOSE = SHOCKING DOSE = ALLERGY

In Ayurveda it is termed as Anurjata. Anurja=an+urja dhatu.

According to Amarkosha urja deals with vitality and immunity. Therefore absence of urja bhav is anurja i.e. loss of immunity and vitality with weakness. Immunity may be compared with Vyadikshmatva , which is described in classics of Ayurveda. This also includes Oja, bala and Prakrit Sleshma etc.

Allergen
Allergen are the substance that causes manifestations of allergy. Some common allergens are-

  • Inhalants = dust, pollen fungi, smoke perfume, odor
  • Foods = egg, milk, chocolate, strawberries, wheat etc.
  • Drugs = Aspirin, antibiotics etc.
  • Infectious agent = Bacteria, fungi, virus, parasites.
  • Contactants = chemicals, plants, animals etc.
  • Physical agents = heat, cold, light, pressure, radiation etc.
These allergens and their response differ from person to person. In Ayurveda some bhavas are termed, which can be compared with allergens and allergy are – Apathya / Ahita /Asatmya Anupsaya /Adhyasana / Psychological Factors etc.

Samprapti Ghatak of Allergy:
Dosha=Vata & Kapha Sannipata

Dushya= rasa & Rakta dhatu

Srota= Rasavaha srotasa – skin allergy

Pranavaha srotasa –allergic asthma

Annavaha srotasa – food allergy etc

Adhisthana = Sarva sharer

Agni = Agnimandya

General Cause:
Ama vs Free Radicals
Prime causative factor of allergy is a byproduct of improperly digested food,a toxic substance known as AMA. This ama is produced in digestive system and then absorbed in circulatory system. After entering in circulatory system, ama can block and clog the channels of circulation (called srotas) Being circulated in whole body it produces symptoms according to samprati.

Ama = ‘Aa’ means near to or toward + ‘Ma’ means poison.

Hence the word Ama denotes a substance or group of substance near to poison or which acts like poison. This is raw, indigested, immature, oxidized combusted food particles. This abberated metabolite (ama) is hazardous and injurious to the tissues of the body.

Ama of Ayurveda may be compared with Free radicals of western side. With unpaired unstable molecules Free radicles are lacking appropriate electron to be stable. They always lookout to swap electron from the other molecules as DNA, Protein, Fat etc.

In this endeavor of gaining stability, they kill cells, destroy enzymes and produce toxic agents that damages cellular function. Free radicles are most threating factor for health. That is exactly what ama does in body and it is also very difficult to remove or correct this enemy.

Psychological distress factors, Mental and emotional stress are other common contributing factors in a hypersensitive allergic response.

Factors Producing Ama and Free Radicals
  • Cooked food, animal products, metabolic waste products contained in animal tissues and organs.
  • Refined food as white sugar, white flour, hydrogenated oil etc.
  • Preservatives, coloring agent, food additives, cold storage vegetables etc.
  • Aireated drinks, Alcohol etc.
  • Pollution – air, water, pesticide residue.
  • Polyster, plastics.
  • Electronmagnetic radiation- television,computer etc.
  • Breathing smoke, lack or overdue of exercise etc.

Therefore by just avoiding above told factors one can get rid of the fear of ama and free radicles production that are the contributing factors in allergy and other disorders.

Allergy Symptoms as per Body Constitution:
Depending on the body type, the underlying cause and symptoms of allergic hypersensitivities varies.

Vatabody Type
The vata body type is susceptible to various hypersensitivity reactions. The vata imbalance causes excessive dryness in the body. When this dryness finds its way to the respiratory system and sinuses, the protective mucous lining dry up. This natural protection acts as a filter, temperature buffer, and first line of allergic immunity. When this layer of mucous dries up, the airborne allergens of dust, pollen and pollution act as irritants in the sinuses, evoking an immediate hypersensitivity response. The body’s natural response to these irritants is to lay down mucous as a means of protection. The dryness alone will also trigger the body to produce mucous, making allergic symptoms a common vata condition. In this instance, allergic symptoms can be chronic and constant due to a deep mucosal dryness rather than a particular allergen. For the vata body type, precautions during the beginning and end of vata season (fall and spring) must be made to prevent against vata-based allergic symptoms. The vata body type is also particularly sensitive to lifestyle and daily routine. Most important with regard to allergens and distractions, that aggravate the vata aspects of digestion, producing ama and hypersensitivity reactions.

Pitta Body Type
The Pitta type is identified with excess of heat and burning sensation in the body. The heat is produced as a result of a physiological hypermetabolic state needed to burn off the excess ama in the blood. This heat, as does all heat, will rise in the body. When this heat rises up onto the sinuses, the effect is one of dryness along with the accumulation of impurities (ama) in the blood. The result of the dryness aggravates vata as we mentioned previously, and the axcess blood ama aggravates pitta. The sinuses respond by acting as organs of excretion rather than secretion.

The treatment for pitta-based allergic response os twofold. The blood must be purified with pitta-pacifying herbs and thr dryness must be dealt with, as in the case of vata.

Kapha Body Typa
The Kapha body type is classically the most susceptible to allergies, and Kapha imbalance is often the causative factor in most allergic conditions. It is the nature of kapha to-produce and hold more water, congestion, and ama, however, and the treatment of kapha in all allergies is a common mistake.

Congestion, Sputum Production, Fatigue, Malaise, Heaviness and Dullness in Body are some common symptoms.

In this regard, the treatment is straightforward with the focus on pacifying kapha with bitter, astringent, and pungent herbs and spices.

Allergy treatments can become more complicated when multuiple causes are present. Imbalances in vata and kapha, for example, can easily create chronic allergic symptoms. Treatment for each are opposite in nature, and care must be given to balance both kapha and vata at the same time.

Management
Ama Treatment: To treat the produced Ama and prevents its further production is the first line of treatment. Ama can be neutralized by following guidelines-

  • Sip plain hot water every half-hour for one month.
  • Drink eight to ten glasses of warm lemon water each day.
  • Avoid dairy and wheat and favour fruits and vegetables.
  • Avoid having heavy food in dinner.
  • Have a mild and relaxing walk after meal.

Different Types of Allergy and their Treatment:
Manifestation of Allergic reactions depend upon the site of its production. As Ayurveda states that the place where Khavaigunya is present vyadhi and its symptoms appear. In the same manner allergic hypersensitivity reactions also depends upon khavaigunya. So many different forms of allergy is possible. Such as-

Skin Allergy -Skin is the first and foremost layer for defence. Therefore it is most susceptible for allergen attack. Commonly seen in four forms-
  1. Contact dermatitis with inflamed skin and rashes etc.
  2. Prickly heat in warm weather due to trapped sweat.
  3. Bites and sting.
  4. Urticaria also known as Udarda and Shitapitta.

Treatment
  • Herbs – Neem, giloy, manjistha, Haridra, Sariva, Chandana, Lodhra, Aamalka etc.
  • Pharmaceutical Preparations- Sarivasava, Manjisthadya kwatha, Lodhrasava, Trifaladya churna etc.
  • Diet- Dring plenty of water/ Intake of tikta substances regularly/ Avoid extra amount of protein and fat/ Avoid heavy and difficult to digest food.
  • Life Style- Clean body regularly/ Wash skin with herbal gentle soap/ Use cotton garments/ Exercise regularly / Avoid excess sunrays/ avoid chemical contacts/ Avoid polluted water air surroundings etc.
  • Yoga – Try Sarvangasana/ Pranayama/ Jalaneti/ Kapalbhati.
  • Preparation – Try following prapations
    • Take Trikatu + Basil leaves +Cloves + Camphor + Coriander = make powder of all. Have three times in a day with luke warm water.
    • Make herbal tea with Mulethi, Cardamom, Camphor, Clove, Chandana.
    • Inhale medicated vapour made by mixing Basil leaves with Eucalyptus oil in water.


    Food Allergy –It is a term applied to a group of disorders characterized by abnormal or exaggerated immunological response to specific proteins present in food resulting in a variety of symptoms. It is most common in children, It is very difficult to diagnose and treat as well. Food items implicated in allergy are- Cow’s milk, eggs, Shell fish, Soyabean, Chocolates etc.

    Ayurveda states that prakriti of a person, climate variation, place, doshas condition, agni, bal etc are key factors for allergy or any kind of disorder to appear.

    Symptoms –GIT disorder, lip swelling, urticaria, angioedema, eczema, allergic tension fatigue syndrome etc.

    Treatment
    1. Avoid that food
    2. Follow the ritucharya and dincharya as told by ayurveda i.e. lifestyle.
    3. Have the foods in accordance with one’s prakriti or body type.
    4. Avoid curd at night.
    5. Start use of rasayanas such as – Ashwagandha, basil, shatavari, Brahmi, amalaki etc.
    6. Use of Panchakarma if needed.

    Allergic Rhinitis –It is the most common type of allergy seen in children as well as adults.

    Cause – Pollution, Temperature fluctuation, Chemicals and tixins, Seasonal variations, Canned frozen processed food, Dust, Pollengrains, unusual odour etc.

    Symptoms – Running nose, Headache, Mailaise, Sneezing, Redness in eyes, Fever etc.
    Treatment
    1. Use immunity enhancer rasayanas as told above.
    2. Herbs – Turmeric, Basil, Shirisha, Vasa, Guduchi etc.
    3. Try mixture of Haritki + Kutuki to eliminate tixins present in body.
    4. Nasya of Shadbindu tail – two times a day.
    5. Medical Yoga – Chitraka Haritki, Vasawaleha, Haridra khanda, Sitopaladi churna, Vyoshadi vati, Marichadi vati, Abhraka prep. etc.
    6. Home Remedy – 3 parts of Turmeric +6 parts Fennel + 6 parts Coriander + 1 part Black pepper + 1 part Ginger = Fry it in ghee. Have it two times a day.
    7. Yoga - Practice Asanas, Pranayam, Kapalbhati etc daily.

    Some other forms of allergy are allergic Asthma, allergic Conjuctivities, IVDye allergy etc.

    Treatment According to Doshawastha-
    Vata Dosha: vata dosha can be treated with Dashamoola kwatha, Panchmoda, til taila, triphala, shunthi, Garlic pills etc.

    Pitta Treatment: Triphala powder, Neem churna, jirak churna, Haridra khand etc. can treat pitta type of allergy.

    Kapha Dosha: Trikatu churna, Sitopladi churna, Mulethi (licorice) churna, etc. are useful for pacifying Kapha.

    Line of Treatment for all types of Allergy:
    1. Ama reduction and removal by Srotosodhan and Improve Digestion is the primary management of allergy.
    2. Use of Rasayanas as immunity enhancer and rejuvenation.
    3. To follow properly the life style and ahar vihar as told by classics of Ayurveda.
    4. Use fresh and seasonal fruits-vegetables.
    5. Try to use natural vegetables and fruits since natural coloring agents i.e. phytochemicals are known to be excellent antioxidants and act as scavenger to free radicles. Vit. C, Vit. E, selenium, B Carotene, Lycopene, Zeaxanthein are antioxidants present in fruits and vegetables.
    6. Exercise daily.
    7. Practice Yogic Asanas, Pranayam etc.
    8. Daily Morning walk in fresh air.
    9. Avoid unusual stress and strain, be always happy and enjoy the precious life.
    10. Practice meditation.


HOW TO CONTROL YOUR WEIGHT

Dr.Ajay Kumar M.D.
Dr.Tina Singhal M.D.
Prof.Dr.B N UpadhyayM.D.

Obesity Can result from increased energy intake, decreased energy expenditure, or a combination of both.

Obesity is one of the most common disorders in medical practice and among the most frustrating and difficult situation to manage.Obesity is a state of excess adipose tissue mass.Obesity should not be defined by body weight alone, as muscular individuals may be overweight by arbitrary standards without having increased adiposity.The most widely used method to gauge obesity is the body mass index(BMI), which is equal to weight/height2 in kgs/m2.A BMI between 19-25 kg/m2 is considered an appropriate weight for most individuals.

Overweight is defined as a BMI between 25 and 30kgs/m2, and obesity is defined as a BMI e” 30kg/m2.

In Ayurveda, obesity is described as a most undesirable trait with special reference to treatment.In Charaka Samhita, obesity is described as athoulya under the title ‘Asthoninditiya Purusha’. The main causative factor in pathogenesis of obesity is tikshnaagni.Due to excessive accumulation of Medo dhatu, all Srotas obstruct resulting in vitiation of Vata dosha.Then aggravated Vata increases the Jatharagni.Tikshna Jatharagni causes excessive consumption of food and excess production of Medo and Mamsa dhatu resulting in excess weight gain & obesity.

Obesity can result from increased energy intake, decreased energy expenditure, or a combination of both.Excess accumulation of body fat is the consequence of environmental and genetic factors, social factors and economic conditions.Some of the features of overweight or obesity include:
*Clothings feel tight andneedings a larger size.
*The scale showing that you’ve gained weight.
*Extra fat deposition around the waist.
*A higher than normal body mass index and waist circumference.
*Excess adipose tissue resulting in BMI greater >30.

Grading of obesity:
In practical settings, obesity is typically evaluated in obsolute terms by measuring BMi(body mass index), but also in terms of its distributionthrough waist circumference or waist-hip circumference ratio measurements.BMI is a simple and widely used method for estimating body fat.BMI was developed by the Belgian statistician and anthropometrist Adolphe Quetelet.It is calculated by dividing the subject’s weight by the square of his or her height, typically expressed either in metric or US “customary” units:

The current definitions commonly in use establish the following values, agreed in 1997 and published in 2000:
*BMI less than 18.5 is underweight
*BMI of 18.5-24.9 is normal weight
*BMI of 25.0-29.9 is overweight
*BMI of 30.0-39.9 os obese
*BMI of 40.0 or higher is severely (or morbidly) obese

A BMI of 35.0 or higher in the presence of atleast one other significant comorbidity is also classified by some bodies as morbid obesity.

Overweight and Obesity associated Risks:
Overweight or obesity raises the risks in adults for many diseases and conditions.Overweight and obesity also increases the health risks for childrens and teens.Overweight and Obesity related health problems are following-
*Heart Disease*Hypertension
*Type 2 Diabetes
*Abnormal blood Fats
*Cancer *Osteorthristis
*Sleep Apnea
*Reproductive Problems
*Gallstones

Guidelines to control your weight:
Obesity is a chronic medical condition that requires ongoing treatment and life-style modifications.Treatment is important and early control over obesity becomes necessary because of associated health risks.The urgency and selection of treatment modalities should be based on the BMI and a risk assessment.

Successful treatment for weight loss include setting goals and making lifestyle changes such as eating fewer calories and being more physically active.Drug therapy and weight loss surgery are also options for some people if lifestyle changes don’t work.Following are the line of management-

  1. Lifestyle Changes:
    For long term weight control, it’s important for you to make lifestyle changes:
    *Keep Attention on energy intake (calories from food/drinks) and energy consumed(physical activity)
    *Always follow healthy eating plans & adopt more healthful lifestyle habits over time, these changes will become part of your everyday life.

  2. Calories
    One should try to take low calories by cutting the food intake.Cutting back on calories(energy intake) will help you lose weight.To lose 1to 2 pounds a week, adults should cut back their intake by 500 to 1000 calories/day.

    *In general, 1000 to 1200 calories a day will help most women lose weight safely.While in men, 1200 to 1600 calories a day will help lose weight safely.Very low-calorie diets of less than 800 calories a day shouldn’t be used unless your doctor is monitoring you.For overweight children or teens, it’s important to slow the rate of weight gain.

  3. Healthy Eating Plan
    A healthy eating plan gives your body the nutrients it needs every day.It should have enough calories for good health, but not so many that you gain weight.A healthy eating plan also will lower your risk for heart disease and other conditions.Cutting down on fats and added sugars also can help you eat fewer calories and lose weight.

    Healthful foods include:
    *Fat-free milk and milk products such as yogurt, cheese and milk.
    *Lean meat, fish and poultry.
    *Whole grain foods such as whole bread, oatmeal, brown rice cooked, beans and peas.Other grain foods like pasta, cereal, bagels, bread and crackers.
    *Fruits, vegetables which can be canned fresh, frozen or dried.
    *Coconut, and palm oils found in many processed foods.

  4. Portion size
    A portion is the amount of food that you choose to eat for a meal or snack.It’s different from a serving, which is measured amount of food and is noted on the nutririon label on food packages.Cutting back on portion size is a good way to help you eat fewer calories and balance your energy intake.

  5. Food Weight
    Various studies have shown that we all tend to eat a constant”weight” of food.Weight by weight, our food intake is fairly constant.Knowing this, you can lose weight if you eat foods that are lower in calories and fat for a given measure of food. For example, replacing a full-fat food product that weighs 200gm with one that’s the same weight but lower in fat helps you cut back on calories.Another helpful practice is to eat foods that contain a lot of water like vegetables, fruits, and soups.

  6. Physical Activity
    More physically active and eating low calories will help us to lose weight and keep the weight off over time.Physical activity also will benefit us in other ways.It can be:
    *Lower the risk of heart disease, diabetes and cancer.
    *Strengthen our lungs and help them to work better.
    *Strengthen our muscles and keep our joints in good condition. Helps us to relax and cope better with stress.
    *Allow us to fall asleep more quickly and sleep more soundly.
    To maintain weight loss, we should do physical activity daily for at least 60 to 90 minutes of moderate intensity.

  7. Behavioral Changes
    Changing your behaviors or habits towards food and physical activity is important for losing weight.The first step is to understand the things that lead us to overeat or have an inactive lifestyle.The next step is to change these habits.

  8. Over-the-Counter Products
    Over-the-counter (OTC) products often claim that a person taking them will lose weight.The FDA doesn’t regulate these products because they’re considered dietary supplements, not medicines.However, many of these products have serious side effects and aren,t generally recommended.

Say Goodbye To Constipation

Constipation is a very common problem these days.Our lives of hectic schedules, late night awakenings and junky food habits have turned this problem into epidemic proportion.A person normally has to pass stools once every twenty-four hours, or else he is considered to be suffering from constipation.

The main factor involved in the etiology of constipation is imbalance of vata spacifically the apana vata.The other causes associated with this are inadequate food intake, low fibre diet, intake of less fluids,excessive intake of beverages like coffee and alcohol, inactivity or weakness leading to decreased bowel movements, cultivation of wrong toilet habits, improves use of laxatives e.g senna, castor oil and certain other herbs.Use of medications like opioids or diuratics which lead constipation, some conditions like malignancy even leads to this problem.

Although treating a case of constipation seems to be a tedious job as the diagnosis of the exact cause is very difficult.The treatment depends on the cause, severity and duration of the constipation, but in most cases dietary and lifestyle changes, relieve the symptoms to a much greater extent.

Simple measures like regularizing food and sleeping habits,not suppressing urge for defecation, simple exercises like jogging outdoors, simple stretching, swimming, yoga are best ways to get rid of this problem forever.

Prevention of constipation is easier when a person develops regular habits since childhood.Practicing daily regimen of waking early, following dinacharya-vyayama(suitable exercises), abhayanga(application of oils & proper body massage), dhyana(meditation), eating the food with respect to ones appetite or agni, ones health condition and season regularizes the digestive and bowel habits.

Panchakarma as per season helps a lot.One should consult an ayurvedic physician before undergoing any panchakarma procedure.Since vata prakriti people are more prone to constipation & basti is the main treatment of vata, it can be considered as the important panchakarma for constipation.

Including more fruits in the daily diet helps a lot.Fruits like grapes, apple, oranges, lemon, chicko and vegetables which have ample amount of roughage show dramatic results in case hard stools.

Avoid eating lot of fried foods, spicy and frozen food and food with preservatives.

There are around 500 herbs given in Ayurveda which prove to be very efficient in this condition, but consulting a physician is very important and especially, diagnosing the exact cause.


AYURVEDA AND INSOMIA

Dr. K.C. Thriveni,BAMS

As an irish provobe says:”A good laugh and sleep are best cures in the doctor’ book.”A restless mind is never a happy place.They will hardly ever adorn a smile on their faces and become rather grim and glum personalities.Lack of sleep causes mental fatigue which does not let them concerntrate on what they practically become unwilling persons.

Sleep is a natural periodic state of rest for the mind and body’in which the eyes usually close and consciousness is completely or partially lost,so that there is a decrease in bodily movement and responsiveness to external stimuli.During sleep the brain in humans and other mammals undergoes a characteristic cycle of brainwave activity that includes intervals of dreaming.

Almost everyone has occasional sleepless nights.Most individuals just experience a night or two of poor sleep,but sometimes the sleep disturbance can last for weeks,months, oreven yerars.Insomniacs typically complain pf being unable to close their eyes or”rest their mind” for morethan a few minutes at a time.Insomnia can occur in people of all ages.Insomnia is most common among women and older adults.

An estimated 30%-50% of the general populations are affected by insomnia,and 10% hane chronic insomnia.

Stages of Sleep:
Usually sleepers pass through five stages:1,2,3,4 and REM (rapid eye movement)sleep.These stages progess cyclically from 1 through REM then begin again with stage1.A complete sleep cycle takes an average of 90 to 110 minutes.The first sleep cycles each night have relatively short REm sleeps and long periods of deep sleep but later in the night,REM periods lengthen and deep sleep time decreases.

Stage 1- is light sleep where you dift in and out of sleep and can be awakened easily.In this stage the eyes moves slowely and muscle activity slows.During this stage, many people experience sudden muscle contractions preceded by a sensation of falling.

Stage 2 -eye movement stops and brain waves become slower with only an occasional burst of rapid brain waves.

Stage 3 –When a person enters stage 3, extremely slow brain waves called delta waves are smaller, faster waves.

In Stage 4, the brain produces delta waves almost exclusively.Stages 3 and 4 are referred to as Deep sleep, and it is very difficult to wake someone from them.In deep sleep,there is no eye movement pr muscle activity.

In the REM period ,breathing becomes more rapid.irregular and shallow,eyes jerk rapidly and limb muscles are temporarily paralyzed.Brain waves during this stage increase to levels expience when a person is awake.Also,heart rate increases,blood pressure rises,males develop erections and body loses some of the aility to regulate its temperature.This is the time when most dreams occur, and if awoken during REm sleep, a person can remember the dreams.Most people experience three to five intervals of REM sleep eachnight.

Causes: About half of all insomnia cases are caused by psychological or emotional problems such as Stress,Anxiety,Depression,Pain,Again and changes in sleep patterns(insomnia occurs more frequently in those over age 60),Caffeine,Irregular Schedule of sleep such as sleeping during day time & working during nights.

Prescription drugs include some antidepressant,high blood pressure and corticosteroid mrdications, can interfere with sleep.Many over-the-counter(OTC)medications, including some pain medication combinations,decongestants and weight-loss products,contain caffeine and other stimulants. Doctors generally recommend using sleepjng pills for no more than four weeks, or until you notice benefits from self-help measures.If you need sleep medications for longer,take them no more than two to four tomes a week,so they don’t become habit-forming.Sleeping pills often become less effective over times.

Short term insomnia can be linked to events and factors that are often temporary, such as adjustment sleep disorder,jet lag,working the night shift or long shifts medications, overuse of caffeine and alcohol,environmental noise, extreme temperatures or a change in a person’s surrounding environmemt.

Apart from that, lack of a good night’s sleep can create psychological problems.Another factor which can cause insomnia is decrease as the person grows older.This is a hormone that helps control sleep.By the time a person reaches the age of 60, the body produces very little melatonin.

Complications:
*Increased risks for depression.
*Impaired concentration,slowed reaction time andpoorer work performance
*Impatience $ irritable
*Higher incidence of accidents
*Insomnia can lead to severe fatigue, anxiety, depression and lack of concentration.
*Chronic insomnia more likely can develop psychiatric problems such as depression and anxiety disorders.
*Long-term sleep deprivation may increase the severity of the chronic diseases, such as high blood pressure and diabetes.
*Insufficient sleep can also lead to serious or even fatal accidents.Accordingly to the National Highway Traffic Safety Administration, more than 100,000 crashes each year are due to drivers falling asleep at the wheel.

Treatment
Commonly doctors recommend sleeping pills to promote relaxation or sleep but,avoid prescribing it for the long term because they may cause side effects.In addition,sleeping pills can become less effective after a while.

In Ayurveda Charakha explains that happiness, sadness,nourishment, emaciation, strength, strength-lessness, libido or infertility, concioussness or insanity, all depends on sleep itself.

Therefore sleep is a very important component for existence.
*Frequent oil massage(full body)using medicated oils as Mahabhringaraj taila etc followedby warm water bath may relax the mental state.
*Medication such as ashwagandha ksherapaka, brahmi ghruta etc help to combat the stress.
*Avoid sleep during day time as it makes harder to fall asleep at night.
*Avoid or limit your use of caffeine(coffee, tea, sodas chocolate),decongestants, alcohol and tobacco, instead drink milk.
*Avoid drinking alcohol and smoking as these are also stimulants.
*In chronic insomnia patients panchakarma treatment such as-virechana followed by application of oil on head are found very effective.

Daily application of oil on head relieves headache, balding or graying of hair, makes the roots strong thick & dark,Oiling head strengthens the nerves in head, sharpens the sense organs, improves the scalp & enchaces good sleep.

Shiro abhyanga:
Soothing or relaxing Massage of the head, neck & shoulder for 15 minutes using warm herbal oils is called shiro abhyanga. Massage is very helpful for the whole body as it relieves stress and improves blood circulation.Body massage is a great way to heal the body.There are different tyoes of massages and the most preferred one is oil massage.

Oil massage is the best way of relaxation for the whole body.There are different types of oils used for massaging the body.each oil has its own properties to heal, relax. And strengthen the body and immune system.

Massage techniques have been practiced for thousands of years in many cultures.There are references to massage in ancient records of Chinese, Japanese,Arabic Egyptian,Indian,Greek and Roman nations.

People were also using abhyanga as a way to iprove well-being, help with relaxation, relieve stress relief, and enhance sleep and quality-of-life.

Practitioners may use their hands, forearms, elbows, or feet with oils to improve the smoothness of massage strokes. Touch is central to Massage. It allows therapists to locate painful or tense areas, to determine how much pressure to apply, and to establish a therapeutic relationship with clients.

In a proactive role, Massage treatments are performed on regular basis to help the body and mind maintain an optimal leval of relaxation and stress-relief.Massage therapy also reduces the chancesof migraine attacks and tension headaches significantly by relaxing muscle spasms and trigger points.Massage also switches the nervous system from the sympathetic (fight or flight) mode to the parasympathetic (rest and digest).This change enables the recipient to sleep uninterrupted and wake uo refreshed and rested.Massage is performed to ease the pressure brought on during a migraine or tension related headache.By focusing on the neck,shoulders, and head, massage can decrease the pain and discomfort brought on by migraine or stress.

A recent study showed that massage therapy recipients exhibited fewer migraines and better sleep quality during the weeks they received massage, and the three weeks following, that did participants that did not receive massage therapy.Another study found that in adults with migraine headaches massage theraphy decreased the occurrences of headaches, sleep disturbances and distress symptoms. It also increased serotonin levels, believed to play an important role in the regulation of mood, sleep and appetite.

Shirovasti:
This is the most important of all external use of Snehana(oil application).Certain lukewarm Ayurvedic/herbal oils are poured into a cap fit on the head for 15 to 60 minutes per day according to the patient’s conditions for a period of 7 days.

Shirovasti is considered more of a palliative (Shamana)treatment of of ayurveda than an eliminative (Shodhana) one.As usual the treatment is preceded by oleation and sudation.

A leather sleeve about six to eight inches high is placed on shaven head of the patient and band (Vasti) tied around the forehead to secure it in place.The inside bottom edge of this sleeve is lined tight with kneaded dough to prevent leakage.Mediacated oil is then poured into the sleeve and allowed to remain for a while.The oils commonly used are Ksheerabala or Dhanwantaram.The length of the time for the oil to be kept on the head is determined by the severity of the illness.Usually it is upto fifty minutes for diseases caused by severs Vata disorders.

Shirovasti is found very effective in diseases like facial paralysis,insomnia and disorders of the cranial nerves.

It is believed that the warm oil when retained in this manner actually clears the blockage of blood vessels (if any) & also relaxes the muscles.

Shiro dhara:
Dhara is a method of pouring warm herbal oil/herbal decoctions/medicated milk/ buttermilk in a thin & slow continuous stream into the forehead for about 45 to 50 minutes.This procedure pften induces a mental state similar to a trance, which creates profound relaxation of the mind and body.It deeply relaxes and revitalizes the central nervous system.Shirodhara gives the best results when taken after an Abhyangam.Dhara is good for all ailments.Selection of the liquid used is done on the base of the status of the Dosha,Body constitution(prakruti) & the disease condition wirh necessary alterations in the procedure.

Shirodhara has been used to treat variety of conditions including eye diseases, sinusitis,allergic rhinitis,graying of hair, neurological disorders, memory loss, insomnia, hearing impairment, tinnitus , vertigo, and certain types of skin diseses like psoeiasis.It is also used non-medicinally for its relaxing properties.

Recent research studies have shown that Shiro dhara results in Vaso Dilation(dilation of blood vessels) in the brain enabling increased supply of oxygen to the blood cells.

Researchers have conducted two human clinical trials on the psycgoneuroimmunologic effects of shiro dhara.In the first study a group of healthy females were randomly assigned to receive a shiro dhara treatment (with plain sesame oil) or remain in a supine position(control group), while being monitored for numerous physiologic, biochemical,parameters.The second study had a similar design, with the addition of the third group that received shiro dhara with a medicated sesame oil containing essential oil of lavender.Both shiro dhara treatments resulted in decreased anxiety and promoted ASC(altered state of consciousness).After the plain sesame oil treatment there was a significant decrease in plasma noradrenaline and urinary serotonin excretion vs. the control group.Significant Anxiolytic effect within the shiro dhara group was also obsereved.

Takra dhara:
Takra means buttermilk and Dhara milk means pouring.This therapy calms the individual down by using medicated buttermilk, which is poured onto the forehead to relieve insomnia, depression and stress related problems.

Paada abhyanga (foot massage):
Massage theraphy is known method to reduce stress and tension, but can it really help you sleep better?The research shows that Massage theraphy can help you sleep.

All of us have autonomic nervous system comprised of two parts:the parasympathetic and sympathetic.The parasympathetic balances the sympathetic.When you have a massage, the parasympathetic is activated and thus allows your body to relax.When you are stressed, the sympathetic is activated and you will feel the urge to fight or flight.So if stress and tension are the reasons why you are not sleeping very well, you might be relieved to know that benefits of Massage theraphy is improved sleep patterns.Some people even fall asleep whle having a professional Massage.

In one of the study aimed to investigate the effect of foot Massage on sleep, vital signs and fatigue in the elderly who live in their Home.Tried foot massage theraphy on 20 elderly who live in the Seoul-Kyunggi province area.

Change of sleep and sleep satisfaction, vital signs(pulse, respiration, systolic and diasystolic blood pressure) and general fatigue between pre and post foot massage were analyzed using Paired t-test at 0.05 of the significance level.There were very significant difference in the sleep and fatigue between pre and post foot Massage.

Authentic Thai Foot Massage originated in the Thailand about 2000 years ago & is a Massage of the lower legs,feet and hands.It is practiced as a routine & a common procedure there.

The theraphy involves gentle the manipulation and Massage of the hands, legs and feet.This is believed to open energy lines stimulating reflex points on the feet which correspond to the internal organs of the body.

A truly relaxing experience as the toes, feet ankles & lower legs are manipulated, stretched & loosened.

Thai Foot Massage benefiys:
Improve circulation
Improve flexibility
Improve sleep patterns
Reduce stiffness in joints
Reduces stress
Stimulate the mind.


Use of “PINAK” in the treatment of Scorpion Stings

Use of “PINAK” in the treatment of Scorpion Stings
Dr. R.G.RAUT
Medical officer, PHc Dimbhe,Pune District

Dr.HANAMANTRAO CHAVAN
District Health Officer,Pune District

Dr. P.S. PAWAR
Medical Superintendent,
Sassoon General Hospital, Pune

Dr. S.P. GAIKWAD
Head of the Department of Ayurveda,
Sassoon General Hospital, Pune

Pinak is an ayurvedic antivenin used for snake bite cases. Feedback from patients of scorpion stings stimulated us for this study. Now we have concluded that a single table of Pinak is able to cure scorpion stings cases completely. More tables may be required in few selected cases of scorpion stings.

Scorpion stings are a major public health problem in many under developed tropical countries. Every year more than 1,25,000 cases of scorpion stings are reported in India and a few unlucky ones loose their life due to it. Most of these cases occurs in the rural areas.

Out of 1500 scorpion species, 50 are dangerous to humans. The lethal scorpion found in the Asia continent belong to Megobuthus.

The scorpion’s venom is composed of varying concentrations of neurotoxin, cardiotoxin, nephrotoxin, hemolytic toxin, hyaluronidases, phosphodiesterases, phospholipases, histamine, serotonin, tryptophan and cytokine reieasers. Scorpion stings cause a wide range of contributions, from severe local skin reactions to neurologic, respiratory and cardiovascular collapse. Most deaths occur during the first 24 hours after the scorpion sting and are due to respiratory or caddiovascular failure. Further more, patients in rural areas tend to fare worse than patients in urban areas because of the delay in getting medical helo due to a longer travel time to medical centres.

Treatment generally consists of moving the patients’ airway and vital signs, follwed by administration of antivenin and institution of symptomatic and local treatment.

It may be noted that scorpion toxins do not induce abtibodies that cross-react against toxins of other scorpion species. Thus, no universal antivenin is available. Instead, 22 different types of scorpion antivenins exist. It does not prevent or protect the victim from cardiovascular manifestitaions.
Moreover, it is not free from cardiovascular manifestations; also it is not free from anaphylaxis. It takes 45 minutes to reach peak tissue concentrations. In animals no beneficial effects of antivenin are observed if, it is injected more than 15 minutes after envenomation.

A majority of the victims go to ‘vaidu’ for treatment. Very few patients of scorpion stings come to State hospitals, because of lack of availability of treatment for scorpion bite in the State hospitals.Antivenom although available in the market, is very costly. It is beyond the reach of the rural folk. The treatment given by the doctors in the hospitals consists of a local xylocaine injection.

Pinak tablet has been in use in the area i.e. Satara, Solapur, Pune districts in India for quite some time. People store these tablets in their household and administer themselves as and when required i.e.any bite. There have been encouraging reports from people regarding Pinak use for scorpion stings. And, there have been no untoward incidents so far.If the Pinak tablet is made available to all in the area and then across the country, a large menace troubling the people can be effectively tackled there by reducing the morbidity and preventing mortality.

Oral toxicity of Pinak tablets were studied by the Indian Institute of Toxicology, Pune (a NAbL accredited laboratory) which concluded that LD50 in rats was found to be greater than 2000mg/kg body weight.

The Pinak tablet is purely of herbal origin. It is polyvalent.The contents are:

  • Erythrina Indica
  • Mangifera Indica
  • Eugenia Jambolana
  • Jasminum Sombac

The heavy metal content of the Pinak preparation is well below the permissible levels i.e.0-6 ppm.
All the patients were given single Pinak tablet sublingually and observed for a minimum of 30 minutes.
Hence, the present study was taken the effect of yhe Pinak used in scorpion sting cases.

Case Definition:
Any person irrespective of age, coming with a history of scorpion sting or symptoms suggestive of scorpion stings were considered for study.

Material and Methods:
The study was conducted from 01.02.2008 to 25.03.2009 in a little over one year. Cases were more during May, June, July and August months. However, a clear cut seasonal association was not observed. Also there was no diurnal variation observed.

All the patients were treated in dimbhe PHC of Pune District. 25 Patients were referred by MPW/ANM while rest of the patients i.e. 35 patients came to PHC on their own and seen by the Medical Officer In charge of PHC. A detailed history was taken so as to confirm the scorpion stings and type of scorpion species involved. All the patients were given single Pinak tablet sublingually and observed for a minimum of 30 minutes. After stabilization of their clinical condition and relief of pain, the patients were allowed to go home. A home visit was paid to these patients, the next day by the ANM/MPW of the PHC area to enqyire about the condition of the patient.

After giving Pinak tablets sublingually, they were assessed for relief of pain and the effects on their CNS status by a visual analogue scale.

Results of the study:
A total of 30 patients of scorpion sting were included in the present study. Table I shows the age wise distribution of these patients.

Table I. Age wise distribution of scorpion sting cases

Age (in years)
Male
Female
Total
Less than 5
0(0.0)
0(0.0)
0(0.0)
5-9
0(0.0)
1(3.3)
1(3.3)
10-19
3(10.0)
2(6.7)
5(16.7)
20-29
5(16.7)
3(10.0)
8(26.7)
30-39
4(13.3)
3(10.0)
7(23.3)
40-49
3(10.0)
1(3.3)
4(13.3)
50-59
2(6.7)
0(0.0)
2(6.7)
60~
0(0.0)
3(10.0)
3(10.0)
All
17(56.7)
13(43.3)
30(100.0)

Note: Figures in bracket indicate percentages in under five age group. Except that, there were patients from all other age groups. A large proportion of patients were in 20-29 years (26.7%) and 30-39 years (23.3%). There were fewer cases from extreme age groups. The 20-40 years is an active age group involved in field work and is naturally exposed to scorpion stings more.

Table II. Site of scorpion bite

Body part involved
Number
Percentage
Lower Limbs
16
53.34
Upper Limbs
13
43.33
Abdomen
0
0.0
Head and Neck
0
0.0
Back
1
3.33
All
30
100.00

Lower limbs were the most commonly involved (53.34%) followed by upper limbs (43.33%)since these are the peripheral parts involved in field work,they were exposed to Scorpion stings.

Table III. Swelling at the site of scorpion bites

Swelling
Number
Percentage
Present
16
53.33
Absent
14
46.67
Total
30
100.00

A little over half of the patients (53.33%) had swelling at the site of the bite. Most of the patients i.e 25 (83.33%) had a burning sensation at the site of bite, while 2(6.67%) had tingling sensation. Also, in 26 (86.67%) redness was observed around the site of sting. One patient had oedema around the site of sting.

On examination, it was observed that all the patients were conscious, afebrile and palpitation out of the 30 patients. 20(66.67%) out of the 30, complained of sweating.

Table IV. Pulse rate of patients

Pulse rate per minute
Number
Percentage
Up to 69
0
0.0
70-79
3
10.00
80-89
15
50.00
90-99
8
26.67
100-110
4
13.33
All
30
100.00

In 4 patients (13.33%) tachycardia was observed while in 8 patients (26.67%), an increased pulse rate of 90-99 per minute was observed. Usually in scorpion stings, an increased pulse rate is observed.

Table v.Diastolic blood pressure of patients

Blood pressure (in mm Hg)
Number
Percentage
Up to 60
0
0.0
60-69
5
16.67
70-79
15
50.00
80-89
10
33.33
90-99
0
0.0
100~
0
0.0
All
30
100.00

Table VI. Respiratory Rate of patients

Respiratory rate per minute
Number
Percentage
14-15
9
30.00
16-17
18
60.00
18-19
3
10.00
All
30
100.00

In 9 (30%) patients the respiratory rate was 14 or 15 per minute.

Table VII.Time gap from scorpion bite to administration of Pinak tablets

Time Gap
Number
Percentage
Up to 30 min
9
30.00
31-60 min
10
33.33
61- 90 min
3
10.00
91-120 min
3
10.00
151-180 min
1
3.33
181 min~
1
3.33
 
30
3.33

Table VIII. Blood pressure (Hypertension) in patients

Systolic BP(in mm Hg)
Number
Percentage
Less than 90
0
00.00
91-120
23
76.67
121~-140
7
23.33
141~
0
00.00
All
30
100.00

None of the patients had hypotension or hypertension. Majority i.e.(76.67%) had a systolic blood pressure between 91 to 120 mm Hg.

Table Ix. Evaluation of CNS effects

CNS Effects
Upto 20%
21-40
41-60
61-80
81-100
Depressed to Euphoric
0 (0.0)
4 (13.3)
14 (46.67)
11 (36.67)
1 (3.33)
Passive to Active
0 (0.0)
0 (0.0)
7 (23.33)
13 (43.33)
10 (33.33)
Tired to alert
0(0.0)
4 (13.3)
9 (30.00)
11 (36.67)
6 (20.00)
Relaxed to tense
6 (20.00)
7 (23.33)
5 (16.67)
11 (36.67)
1 (3.33)
Anxious to confident
0 (0.0)
3 (10.00)
6 (20.00)
11 (36.67)
10 (33.33)

Note: Figures in parentheses indicate percentages.

When the effects of Pinak in CNS were evaluated, it was observed that, 4 (13.3%) were depressed as opposed to 12 (40%) patients with euphoric state. While in the remaining 14 (46.67%), it was neither depressed nor euphoric.

Majority of the patients i.e. 23 (77%) were active with none in passive state.

Majority i.e.17 (56.67%) were alert. However 4 patients (13.3%) felt tiredness.

Almost equal number of patients were found to be relaxed 13 (43.33%) as compared to tense patients 12(40%).

While 3 patients (10%) were found to be anxious, 21 (70%) felt that they were confident.

The patients were evaluated on a visual analogue scale of 1 to 10 for assessment of pain before and after administration of Pinak tablets.

Table X: Mean visual analogue score of pain

Before Pinak
After Pinak
Mean Reduction in Score
7.47
1.9
5.57

Paired P<0.001 Highly Significant t-test=19.17

Table XI: Change in visual analogue score level of pain after Pinak

 
Visual Analogue Score Level
Pinak administration
0-3
4 to 6
7 & above
Before Pinak
Nil
6(20.0)
24 &above
After Pinak administration
27(90.0)
2(6.67)
1(3.33)

Z test for score 7+ =9-58 P<0.001 Highly significant

Majority of the patients came with severe pain i.e., 24 (80%) had pain score of more than 7 while 20 (20%) were in 4-6 pain score. After Pinak administration an overwhelming proportion i.e., 27 (90%) were in 0-3 scale while only one individual had a pain score of more than 7 and above. In the absence of any active international treatment, the pain due to scorpion sting takes many hours to come down. It may be noted that the assessment in reduction of pain was done after 30 minutes. Hence, this reduction of pain can be attributed to the effect of Pinak administration (Table XI).

From table x, we can compare the mean visual analogue score of pain assessment before and after Pinak Administration. The main pain score which was 7.47 before Pinak reduced to just 1.9 after Pinak administration, which was highly significant statistically also.

Clinically, we noted swelling and redness followed the same fate as pain.

Summary and Conclusion:

A total of 30 cases of scorpion stings were considered in the present study. They were all administered Pinak tablets orally. Only one patient needed lignocaine injection locally. No serious untoward reactions were noted to Pinak administration. None of the patients experienced the serious effects of scorpion evvenomation. The severity of pain came down rapidly after Pinak administration. In fact in 5 patients there was no pain at all after Pinak intake. It is worthwhile noting that 80% of the patients had a severe pain i.e a pain visual analogue score of 7 and above before Pinak administration; and which came down to just 3.3% after Pinak intake. 90% of the patients had little or no pain at all. Thus the present study demonstrates the effectiveness of Pinak in scorpion stings cases.

The high cost of the present antivenom, non-availability of antivenom in most of the rural areas, the non-specific antivenom that is available today; all these factors compared with the easy availability, storage and administration of Pinak, relatively it’s low cost and high effectiveness of Pinak make it a good alternative choice for consideration in the treatment of scorpion stings cases.


Use Of Herbo Mineral Formulation In ayurveda:

BOON OR BANE

Dr Anand Chaudhary

Converting toxic materials like minerals, metals and heavy metals in to medicinal forms to eradicate many diseases which cannot be properly treated with the help of other drugs, is an art in Ayurveda.

Since last two decades,Ayurveda, the complete system of medicine and a way of living in positive renovation of human health in all stages of life, is creating its own space on global canvas of wellbeing, effectively.The basic rationale and explanation for this is its doctrine of pharmaceutics, diagnostics, therapeutics and over all attention on mental health through spirituality and learning processes to cope up stress and build up individual psychosoma to the grade of enlightenment. The material- medica of Ayurvedic system of medicine comprised of resources of three different origin viz herbal, mineral-metal and animal. More than six hundred herbs are addressed in writings of Ayurveda from 2000 BC to 2000AD.These herbs have been attended by scholars to explore their pharmacological and therapeutic area.Pharmacognosy and pharmaceutics of these herbs are taken care of by concerned personnel to provide best exclusive dosage forms of Ayurvedic medicaments of herbal origin.

A big boom was felt in Ayurvedic pharmaceutics in 15th century AD and onwards when material-medica of mineral and metal origins started taking over on exclusive herbal phenomenon of Ayurvedic formulations. Substantial incorporation of these medicines of mineral-metallic origins as single drug or in combination of herbs which may be termed as Herbo mineral formulations are visible from the classics of Ayurveda since 11 century AD with palpable prominence from 14 century AD to 18 century AD. Fascinating inventions were made during that period for proper assimilation and absorption of these drugs which eventually showed extensive variety of pharmacological and therapeutic results on specific disorders with better palatability, greater shelf life period and less dose pattern.

The essence of substances of animals origin are also viable in Ayurvedic formulations as application of milk, ghee, urine and other materials are added in specific medicaments for purpose of potentiating or purifying of different substances.

In present global scenario very optimistic attitude is prevailing for Ayurvedic system of medicine not only to cure and prevent ailments but for adding unconstrained quality in life. This created fear and jealousy among managers of giant allopathic manufacturing concerns because any progress in Ayurvedic system of medicine would affect directly their income. And their combined efforts are very much targeting Ayurveda by means of TV shows radio talks and up to my surprise with some so called designated research papers. Although the Gove of India challenged the methodology of these papers it remains unanswered, And in the end of the game when these medicines were banned by some European Government, we had done some research into it. But the findings were presented in media in misleading form. In fact we invite Indian stakeholders of Ayurveda to collaborate with us in this regard.

Ayurvedic Pharmaceutics
All substances of any origin are first treated with many pharmaceutical processes for their conversion from raw material to remedies for treatment diseases and strengthening normal physiology to enhance immune culture of body.

The herbal dosage forms are prepared by applying techniques to prepare particularized formula which have been depicted in table 1

Table No.1

Sr no
Dosage Forms
Formulation
Indication
01
Swarasa (self expressed juises)
Tulsi swarasa
Mild respiratory disorders
02
Kalka (mass/paste)
Nimba Kalka
Wound healing
03
Kwath (decoction)
Rasna saptak kwath
Anti inflammatory and analgesic effects
04
Churna (fine powder)
Hinguastak churna
Digestive disorders(appetizer)
05
Vati (Pills)
Rasona Vati
Anti arthritis remedy
06
Avaleha (confectionaries)
Chavyan prash
Immuno modulator
07
Ghee & Thaila (medicated oleogenous product)
Brahami ghrita
Memory enhancer and stress releaser
08
Asav & Arishta (fermented products)
Dashmularishta
Gynecological disorders

These all exclusive herbal dosage forms are privileged with their unique method of preparation which is described very systematically in Sharangdhar samhita of 13 century AD.

The ranges of dosage forms of herbo mineral formulations are also full of illustrations which are summarized in table no 2

Table no.2

Sr no
Dosage Forms
Formulation
Indication
01
Bhasma (Incinerated/calcined form)
a.Metallic
b.Minerallic
c.Non metals
Swarna Bhasma
Makshila Bhasma
Shankha Bhasma
Rejuvenator
Haematinic
Osteoporosis
02
Kajjali (a triturated product of Parad and Gandhak)
In combination of many other ingredients
As per indication of formulations
03
Parpati (a specially designed product of Parada and Gandhak)
Panchamrita parpati
Digestive disorders
04
Kupi Pakwa rasa (a Spacially designed product of Parada and gandhak)
Rasa Sindoor
Potency enhancer of many formulations when mixed with them and alone esed as anti geriatric agent
05
Pottali (a specially designed product of Parada and Gandhak)
Abhra garbha pottali
A wide range of respiratorty disorders

The processes responsible for transformation of these industrially toxic materials of mineral and metallic origin to medicinal form for eliminating various kinds of acute and chronic diseases are as follows:

*Shodhan of Raw material (purification and potentiation)

*Maran of Shodita Material(incineration/calcinations)

*Jaran of Shodita material (intermediary process of polling)

*Sanskar of Parad (spacially designed process for purification and potentiating of mercury)

*Miscellaneous other procedures

*Completion test of Bhasma

Shodhan of Raw materials

These first two pharmaceutical processes namely Shodhan and Maran are basically credited fpr all good qualities of all minerals and metals used in practice of Ayurveda in general and in Rasa Shastra in particular. It is very interesting to know that Swarana (Gold), Rajat (Silver), Tamra (Copper), Loha (Iron), nag (Lead), vanga (Tin), Yashad (Zinc), Abharak (Mica), Makshika (Chalcopyrite), gairika (Hematite) kasisa (Green vitriol), Hartal (Orpiment), Hingula (cinnabar), Cowry (Sheepi), shankh (Conch shell) and many more are used in practice of Ayurveda as single ingredients or as multi component compounds with other drugs oh gerbil origin and even with other drugs of mineral or animal origin.

We are overwhelmed when we informed the world that these processes which were invented back in 08 to 10 century AD to purify and potentiate these metals and minerals and facilitate their use as medicine. These processes are very individualized in nature, for each and every substance there is unique process which consist of a specially designed instrument and very selective herbal media or any other liquid media is indicated there. No random interchange with any vision is permissible here. It was established by researchers of Ayurveda that if media of reaction or processes are not as per indications of classics, then there may be chances of very harmful effects on administration. Even in classics of rasa Shastra it has been clearly mentioned that untoward effects are possible if Shodhan process was not followed with high degree of alertness.

The selection of process and media for Shodhan of individual substances are absolutely in accordance of their physicochemical properties. Such as for hard substances like Mica, Chalcopyrite, Copper and Iron the process of Nirvap (Heating and quenching in liquid media of different nature and pH0 have been advocated with certain number of repetition of process to ensure complete purification and to achieve a requisite physical form necessary for next step of Maran. Where as for substances like Hartal and Shankh only swooning in Dola yantra (a designer instrument) with some specific herbal juices are indicated for certain period in one set and there also repetition of process is indicated for desired characters.

It may be perceived with soundness that one has to follow compulsorily the indicated process in literature in totality to avoid any untoward effects of these substances of mineral and metallic origin.

Maran of Shodita Material

In fact the process of maran is developed of Maran is developed for application of desired quantum of heat to shodhita material for their conversion in form of Bhasma. The scientific explanation of Bhasma is that it is a unique chemical constituent of individual material used in practice of Ayurveda which is obtained by treating them with very precise liquid herbal juice in process of Bhawana (impregnation) and ther after discs are formed which are exposed for heating under controlled temperature range for a definite duration. Here also repetition of process is specified in classics to achieve an accurate colour and particle size which facilitate therapeutic effect of the particular bhasma. If any one is compromising on color of bhasma means patients have to develop unwanted effects because that particular powder is not the desired bhasma of the substances but that is a different chemical entity may be not advocated for therapeutic purposes.

Certain colors of bhasma are accepted for therapeutic purpose viz; Swarana bhasma-chamapak color means an yellowish tint, Loha Bhasma-pakwajambuphal chayam means deep brownish color shade, Naga Bhasma-kapota varnameans a grayish appearance tone, Vanga Bhasma-shweta varna white color streak etc. This distinctiveness in color of bhasma of different minerals and metals ensures formation of that meticulous chemical constituent which would act as drug after administration.

This heart business in Ayurveda is controlled by certain measures collectively termed as ‘Puta’ means the knowledge of application of specific quantum of heat needed for individual substances in which heat is produced by fuels like wood, coal and cow dung in pits of different dimensions. There are variety of Puta viz maha Puta, Gaja Puta, Lavaka Puta which guarantee a temperature range of 800 degree C to 1000 degree C for shorter duration and shorter shelf cooling period suitable for incineration of Loha, Tamra, Abharak etc or a range of 400 degree C with longer duration and longer shelf cooling period suitable for incineration of Hartal etc which provides better opportunities for preparation of drugs. How ever, the current situation is in favour of replacement of all old methods by furnaces which are eco friendly and capable to provide desired amount of heat with all specifications needed for the formation of a compound.

Jaran of Shodhita Material

This is the process which is applied for those metals which posses low melting point like Naga, Vanga and Yashad who do not bear heat of higher range. These are powdered by a specia process called Jaran which is very nearer to the process of polling in which melted metals are rubbed with green alkaline wood under temperature till it solidified. Thus finely obtained poeders are further processed in puta to have perfect bhasma of these materials. This is again a very vital example of vision of saga of Ayurveda which ensures toxicity free preparation of bhasma of high therapeutic efficacy.

Sanskar of Parada

Parada (Mercury) is always centre of attraction in both cultures of east and west but with different reasons. East is crazy with unparallel alchemical and therapeutic properties )metallic transformation) i.e conversion of lower value metals to metals of higher value viz Gold and metabolic transformation i.e strengthening of body tissue for healthy longevity of life) of Parada where as west is afraid of all hazardous effects of Mercury. The classics of Ayurveda have prominently elucidated eight specialized procedures termed as Parada Sanskar which ultimately turns Mercury free from its toxicity and further specially designed procedures in which temperature range of 100 to 150 C for preparation of Parpati. 200 to 600 C temperature with intermittent heating for specific duration ranges from 24 hrs to 72 hrs for preparation of Kupi pakwa rasa and sulphur bath at the temperature range of 400 degree C. For products of Pottali dosage forms are given for standard production of medicines which free from toxicity. In all these formulations other substances have been used with basic material of Kajjali. All these pharmaceutical processes are serving only one object in service of human civilization that they are converting toxic materials like minerals, metals and heavy metals in to medicinal forms to eradicate many diseases which cannot be properly treated with the help of other drugs, is an art in Ayurveda.


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