Ayurveda Treatments for Public Health

Dr. U. Indulal B. A. M. SThe 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

Dosha

Internal

Dushya

External

Food Activities

Of definite period

Of indefinite period

Daily

Seasonal

“हेतुर्द्वि��धा, अन्तरङ्गो बहिहरङ्गशे्चहित I अन्तरङ्गो हि�धा, दोषा दूष्याशे्चहित I बहिहरङ्गो हि�धा - हि�हार: आहारश्च I हि�हारो �ेधा हि�यतकालोऽहि�यतकालश्च I हि�यतकालो �ेधा दै�न्दिन्द�: आत!�श्च I”Hemadri. Ayurvedarasayana Comm. Ashtangahridaya. Sutra. 1. 6 /2. 1

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 नि�व�च�म् - Definition of Health

समदोष: शमाग्नि&�श्च समधातुमलहि'य: Iप्रसन्नात्मेन्दिन्+यम�ा: स्�स्थ इत्यभि0धीयते II Susrutasamhita. Sutrasthana. 15.41

हि�कारोधातु�ैषम्यं साम्यं प्रकृहितरुच्यते Iसुखसंज्ञकमारो&यं हि�कारोदु:खम�े च IICharakasamhita.Sutrasthana.9.4

the doshas are in a state of balance, the agni is working properly, the dhatus are actively engaged in the nutritive processthe malas are eliminated naturally from the body, the atma, indriya and manas are in a pleasant state

Disease = imbalance; sorrow Health = Balance; Pleasure

१

२

अन्नाभि0लाषो 0ुक्तस्य परिरपाक: सुखे� च II सृष्टहि�ण्मूत्र�ातत्�ं शरीरस्य च लाघ�म् सुप्रसन्नेन्दिन्+यत्�ं च सुखस्�प्नप्रबोध�म् II बल�र्णाा!युषां ला0: सौम�स्यं समाग्नि&�ता Iहि�द्यादारो&यलिलन्गाहि� हि�परीते हि�पय!यम् II

6-8. Bhojyojopakramaneeya adhyaaya. Khilasthaanam. Kaashyapasamhita

Proper appetiteProper digestionProper elimination of windProper elimination urineProper elimination of fecesLightness of the bodyClarity of senses

Proper sleepProper waking

Proper strengthProper complexion

Healthy longevityPleasant state of mindBalanced state of agni

आरोग्यलि�ङ्गानि� – HEALTH INDICATORS

इह खल्�ायु�Mदप्रयोज�ं व्याध्युपसृष्टा�ां व्याधिध - परिरमोक्ष: स्�स्थस्य रक्षर्णां च Susrutasamhita. Sutrasthana.1.14

स्�स्थ�ृतं्त : Preserving the health of a healthy personआतुर�ृतं्त : Curing the disease of a diseased person

Purpose of Ayurveda

अस्मिस्मस्तन्ते्र आय:ुपाल�ं प्रकृतम् तद्दह्ि�हि�धम्, स्�स्थ�ृत्तमातुर�ृत्तं चArunadatta. Sarvangasundara Comm. Ashtangahridaya.2.1

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

“शरीरगुर्णाा: पु�र्द्वि��हि�धा: संग्रहेर्णा - मल0ूता: प्रसाद0ूताश्च “ 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: ProblemsRef: 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

• Dhaarakalpamby 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

0ोज्योऽनं्न मात्रयापास्य�् श्व: हिपब�् पीत�ा�हिप I+�ोष्र्णामस्मिन्0ष्यन्दिन्द�ाहितस्निस्�&धमसङ्करम् 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 treatmentsउष्णोदकोपचारी स्याद ्ब्रह्मचारी क्षपाशय: I�वेगरोधीव्यायामक्रोधशोकनि%मातपा�् IIप्रवातया�या�ाध्वभाष्यात्यास�संस्थिस्थती: I�ीचात्युच्चॊपधा�ा%: स्वप्नधूमरजांलिस 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.