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.

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:

• 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

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

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..

Two types depending on dosha involvement

1. vata bhuyista - dry cough, sticky sputum
2. Kaphabhuyista -sputum is more, cough is less thin sputum

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.

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

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

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

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.

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

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.

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

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 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.

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

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.

Vajraasana
The Sanskrit word vajra means thunderbolt or diamond.

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.

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.

• 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.

• 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.

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.

• 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.

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.

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.

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.

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.

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.

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.

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.

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:-

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

• 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.)

• Gastrointestinal Conditions
• Flatulence (gas/wind)
• Indigestion
• Lack of appetite

• 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)

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

• 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.

• 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

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.

• 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

• 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.

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.

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.

• 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 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.

• 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.

• 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)

• 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.

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.

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.

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.

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

Ayurveda and Insomnia

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.

• 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.

• 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.

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

Ayurvedic Approach to say Good Bye to Allergy

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.

• 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.

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

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.

• 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.

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.

• 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.

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.