Ayurveda Treatments for Public Health Dr. U. Indulal B. A. M. S The Arya Vaidya Pharmacy Coimbatore, India Health Transition • Dramatic changes and transitions in the world's health needs are expected in next two decades as a result of epidemiological transition. • At present, lifestyle and behaviour are linked to 20-25% of the global burden of disease. This proportion is rapidly increasing in poorer countries. • Non-communicable diseases such as depression and heart disease are fast replacing the traditional enemies such as infectious diseases and malnutrition, as the leading causes of disability and premature death. • By the year 2020, noncommunicable diseases are expected to account for seven out of every ten deaths in the developing regions, compared with less than half today. NCD in Brazil • In Brazil, CNCDs account for 60% of all deaths and about 40% of the disease burden. In 2010, the Ministry of Health estimated a high prevalence of CNCD risk factors among adults (3), including low consumption of vegetables (81.8%), being overweight (48.1%), smoking (15.1%), binge drinking (18.0%), and sedentary lifestyle (14.2%). Moura EC, Pacheco-Santos LM, Peters LR, Serruya SJ, Guimarães R. Research on chronic noncommunicable diseases in Brazil: meeting the challenges of epidemiologic transition. Rev Panam Salud Publica. 2012;31(3):240–5. Causes for health and ill health Internal External Food “हे तुर्द्विधा, अन्तरङ्गो बहहरङ्गश्चेतत I अन्तरङ्गो र्दविधा, दोषा दष्ू याश्चेतत I बहहरङ्गो र्दविधा - विहार: आहारश्च I विहारो र्दिेधा तियतकालोऽतियतकालश्च I तियतकालो र्दिेधा दै िन्न्दि: आत्िश्च I” Hemadri. Ayurvedarasayana Comm. Ashtangahridaya. Sutra. 1. 6 /2. 1 Activities Daily Of definite period Seasonal Of indefinite period Indian Health Sector • Health sector trends suggest that no single system of health care has the capacity to solve all of society’s health needs. India can be a world leader in the era of integrative medicine because it has strong foundations in Western biomedical sciences and an immensely rich and mature indigenous medical heritage of its own. (Eleventh Five Year Plan, India) स्वस्थ निववचिम ् - Definition of Health १ २ समदोष: शमान्निश्च समधातुमलक्रिय: I प्रसन्िात्मेन्न्ियमिा: स्िस्थ इत्यभिधीयते II Susrutasamhita. Sutrasthana. 15.41 the doshas are in a state of balance, the agni is working properly, the dhatus are actively engaged in the nutritive process the malas are eliminated naturally from the body, the atma, indriya and manas are in a pleasant state विकारोधाति ु ैषम्यं साम्यं प्रकृततरुच्यते I सुखसंज्ञकमारोनयं विकारोद:ु खमेि च II Charakasamhita.Sutrasthana.9.4 Disease = imbalance; sorrow Health = Balance; Pleasure आरोग्यलिङ्गानि – HEALTH INDICATORS अन्िाभिलाषो िुक्तस्य पररपाक: सुखेि च II सष्ृ टविण्मूत्रिातत्िं शर्रस्य च ला्िम सप्र ु सन्िेन्न्ियत्िं च सख ु स्िप्िप्रबोधिम II बलिर्ा्यष ु ां लाि: सौमिस्यं समान्निता I विर्दयादारोनयभलन्गाति विपर्ते विपय्यम II 6-8. Bhojyojopakramaneeya adhyaaya. Khilasthaanam. Kaashyapasamhita Proper appetite Proper digestion Proper elimination of wind Proper elimination urine Proper elimination of feces Lightness of the body Clarity of senses Proper sleep Proper waking Proper strength Proper complexion Healthy longevity Pleasant state of mind Balanced state of agni Purpose of Ayurveda इह खल्िायुिेदप्रयोजिं व्याध्युपसष्ृ टािां व्याधध - पररमोक्ष: स्िस्थस्य रक्षर्ं च Susrutasamhita. Sutrasthana.1.14 अन्स्मस्तन्त्रे आय:ु पालिं प्रकृतम तर्दर्दविविधम, स्िस्थित्त ृ मातुरित्त ृ ं च Arunadatta. Sarvangasundara Comm. Ashtangahridaya.2.1 स्िस्थित्त ृ ं : Preserving the health of a healthy person आतरु ित्त ृ ं : Curing the disease of a diseased person Swasthavritta/ Preventive Care • Counseling for self-awareness • Healthy routines – daily and seasonal • Diet – suitable for the individual with relation to the time and place • Healthy mental and spiritual practices • Guideline for periodic cleansing, rejuvenation etc Two attributes of the Body “शर्रगर् ु ा: पुिर्द्विविधा: संग्रहे र् - मलित ू ा: प्रसादित ू ाश्च “ Charakasamhita. Sareerasthaana.6.17 • Pure Attribute • Impure Attribute How to keep the body pure? • By maintaining the digestive strength • By enabling liquefaction and flowing back of lodged toxins • By eliminating the toxins Treatments • Samana • Sodhana Sodhana Treatments: Problems Ref: Keraleeya Chikitsa Paddhati • It demands the physicians to go beyond the ordinary awareness of medical herbs and be well acquainted with the subtle nuances of fundamental principles along with their clinical implications. (C. S. Sutra. 15.5) • This higher standard expected is declining. (C. D. 71.34) • Indiscriminate practice of Panchakarma cause many complications known as panchakarmabhava roga (Sa. S. 1. 7. 194) Healing techniques • Anta parimaarjana (Internal) • Bahi parimaarjana (External) Cleansing treatments in Preventive Medicine • The person enjoying a positive health due to a good Ayurveda doctor is forbidden from undergoing any sodhana/elimination therapy (Nbh. R. V. S. 1 – 1) • Elimination therapies prescribed under a specific season are not a general rule. It should be administered only to those who digress from the regime laid down in Ayurveda (ibid) Use of these treatments in health care • • • • • • • Simple and non-invasive Easy to make them available Less complications Easy acceptance Needs less resources Wide range of therapeutic use Suitable for mild to moderate levels of dosha vitiation • Balances Vata, the major dosha • Has rejuvenation effect too Kerala Special Treatments • Bahi parimaarjana. • Based on the concepts of Snehana and Swedana. • Should not be named as Kerala “panchakarma” • Performed for curative, preparatory and rejuvenation purposes. Kerala Special Treatments: Texts • Dhaarakalpam by Sri. Bharatitirthaprasada • Sirassekaadi Vidhi by Puthiyedathu Raman Menon Sirodhaara • With medicated oil/buttermilk • Performed on a specially designed wooden plank. Sirodhara with thaila • • • • • Imparts vitality to the dhatus Bestows virility Stabilizes agni, complexion and ojas Enhances sensory acuity Deters the process of senility and confers longevity • Prevents bones from becoming brittle • Reduces the vitiation of dhatus Sirodhara with Takra • • • • • • • • Prevents premature graying Sharpens sensory acuity Reverses the agitation of doshas Reduces headache Reduces depletion of ojas Reduces pain (palms and feet) Reduces problems with urine Gives relief to slackening of joints, diseases of the heart, aversion to food and decreased appetite • Effective in diseases afflicting head, eyes and ears Improperly performed Sirodhara • • • • • • • • • Burning sensation Skin lesion General Pain and Joint pain Fatigue or loss of consciousness Malaise Weakness to sound Vomiting Hemorrhage Fever Sirovasti Sirovasti: Duration • Till nostrils and mouth gets moistened • Till the discomfort of the disorder subsides • Till a stipulated period (more for Vata, medium duration for pitta and less for kapha) “Pizhichil” Pizhichil • • • • • Temperature of the oil Height, thickness and speed of the oil flow Duration of the treatment Positions of the patient Time of treatment Thalam and its importance • Process of applying medicines over the center of the head. • Purpose • Procedure Kizhi • Ila Kizhi or Leaf Bundle • Podi Kizhi or Powder Bundle • Navara kizhi or Rice Bundle Navara Kizhi: Precautions • • • • Type of cloth Ventilation Continuity of application Cleaning after kizhi Sirolepa • Application of medicinal paste on head • Paste is made either by boiling the drugs or by triturating the dry medicinal powder in buttermilk. • Commonly used drug: Amalaki/Gooseberry Effects of Sirolepa • • • • Cures tiredness, nodular enlargements Imparts strength to sight Induces sound sleep Other effects similar to that of Takradhara Food during these treatments िोज्योऽन्िं मात्रयापास्यि श्ि: वपबि पीतिािवप I ििोष्र्मन्न्िष्यन्न्दिाततन्स्िनधमसङ्करम II Dharakalpam Should be liquid, hot, not causing abhishyanda, not increasing kapha, not excessively unctuous and not a combination of wholesome and unwholesome food Regimen during these treatments उष्णोदकोपचारी स्याद् ब्रह्मचारी क्षपाशय: I िवेगरोधीव्यायामक्रोधशोकहिमातपाि ् II प्रवातयाियािाध्वभाष्यात्यासिसंस्स्थती: I िीचात्यच् ु चॊपधािाि: स्वप्िधम ू रजांलस च II Ashtangahridayam. Sutrasthaanam.16. 26 • Use only hot water • Observe celibacy and proper sleeping habits • Avoid control of urges, exercises, anger, worrying, cold weather, sun, breeze, travelling, excessive walking, excessive talking, very low or high pillows, study, prolonged sitting, exposure to smoke and dust Recommendation • Address the fundamental causes of health and illness, and provide incentives for healthy ways of living rather than reimbursing only drugs and surgery.