PANCHAKARMA-THE FIVE FOLD TREATMENT PROCEDURES OF AYURVEDA

PANCHAKARMA-THE FIVE FOLD TREATMENT PROCEDURES OF AYURVEDA

Definition of Ayurveda: The term Ayurveda consists of two words, Ayu and Veda.Ayu means life and Veda means knowledge and the whole term Ayurveda translates into “Knowledge of life”.

The knowledge of what is good, and what is bad for our health is provided by Ayurveda. It gives equal importance to both preventive as well as curative aspects. Thus Ayurveda provides solutions to a person who wishes to maintain his health (Swasthya) as well as another who wishes to rid himself of diseases (Roga). In Ayurveda, Panchakarma is one of the important methods used to bring back health as well as prevent diseases. This article tries to throw some light on these very important procedures used in the treatment in Ayurveda.

First cleansing followed by healing with medicines: Ayurveda has a dual approach towards treatment of all diseases. The first one is Shodhana and the second one is Shamana.

Shodhana is defined as the treatment process by which the aggravated doshas are thrown out or expelled from the body. Shodhana or cleansing of the body is done using the fivefold procedure which is referred to as Panchakarma. Panchakarma is a radical treatment and if done properly leads to complete eradication of the disease causing doshas.

In clinical practice of Ayurveda, Shodhana or Panchakarma is resorted to when the aggravation of doshas is very severe and also when the disease is not responding to routine Shamana treatment. The chances of the disease recurring lessens with the adoption of shodhana procedures. To give an example: In the treatment of Jaundice due to hepatitis, Ayurveda adopts the procedure of Virechana or therapeutic purgation(Inducing loose motions to the patient).This leads to throwing out of the excess bile secretions and reduction in the bile presence in the blood. Later the physician will prescribe medicines which rectify liver malfunction such as patolakturohinyadi or Bhunimbhadi kadha.

Shamana is defined as the treatment process by which the aggravated doshas are brought back to normal, inside the body itself. E.g. - by using decoction of different herbs, selected based on their specific actions.

Shodhana is also referred to as Panchakarma literally meaning the five procedures. Below is the list of Panchakarma procedures and also a brief description of each one of them:

1. Vamana

2. Virechana

3. Anuvasana Vasthi

4. Nirooha Vasthi

5. Nasya.

Vamana: It is the process of inducing therapeutic vomiting in the patient by using emetic herbal medicines. It is an elaborate procedure involving preparation, administration and post emesis management. It takes a maximum of thirteen days and a minimum of nine days for the whole Vamana process to be completed, the duration being decided by the condition of the disease and the assessment of the treating doctor. The process of emesis is conducted on a single day but the process is preceded by preparation of the patient using snehapana(Intake of medicated ghee)and followed by 3-4 days of dietary and lifestyle discipline.

 Vamana is the main treatment procedure for treating Kapha Dosha related disorders.

•      All kapha diseases

•      Upper respiratory and lower respiratory tract infections

•      Sinusitis, bronchitis

•      Asthma

•      Diabetes

Virechana: It is the process of inducing therapeutic purgation or loose motions in the patient by using purgative herbal or herbomineral medicines. It is also an elaborate procedure, which takes up around 15 days and a minimum of eleven to be completed. The process of purgation is conducted on a single day but the process is preceded by preparation of the patient using snehapana (Intake of medicated ghee) and followed by 3-4 days of dietary and lifestyle discipline.Virechana is the main treatment for Pitha dosha related diseases such as:

•      All Pitha related diseases

•      Skin diseases with rash, oozing, redness or inflammation

•      Phemphigus or Bullous eruptions

•      Pimples

•      Asthma

•      Migraine headache

•      Hyperacidity

•      Gastritis

•      Jaundice

•      Anemia

Anuvasana Vasthi & Nirooha Vasthi: Vasthi, also known as medicated enema is the process of administering medicines through the anal route. The number of vasthis or enemas to be given is determined by the treating Physician based on the disease and its severity. Vasthi is the main treatment procedure for diseases caused by imbalance of Vatha dosha such as:

·         Paralysis

·         Alzheimer’s disease

·         Parkinson’s disease

·         Osteoarthritis

·         Lumbar Spondylitis

·         Cervical Spondylitis

·         Sciatica

·         Brachial Neuralgia

·         Poliomyelitis

Anuvasana Basthi is administered using medicated oils such as Dhanvantharam, Ksheerabala etc., Nirooha Basthi is administered using a combination of herbal decoction and medicated oils. Among the Panchakarma procedures of Ayurveda, Vasthi has got a special place since it has the ability to control Vatha doshas, which is considered to be the controller of all the other Doshas, Dhathus and Malas.

Nasya: It is the process of administering medicines through the nasal route and used mainly to treat the head & shoulder related problems such as:

•      Sinusitis

•      Chronic headache

•      Epilepsy

•      Cervical spondylitis

•      Eye and ear diseases

•      Facial paralysis

Ideally the relevant panchakarma procedure should precede Shamana treatment and if done accordingly, the chances of recurrence of the disease are minimal unless the patient continues to indulge in the causative factors of the disease.

Panchakarma packs a real punch in the treatment of diseases in Ayurveda. Once punched the disease has to come to its heels. Our ancestors have blessed us with a science which is so beautiful and elaborate that we should be grateful to them forever. Panchakarma forms a major part of Ayurveda treatment and has been practiced by Ayurveda Physicians since centuries giving excellent results and relief to patients suffering from very chronic diseases.

Author’s profile:

Dr.K.Jayakrishna B.A.M.S,P.G.Dip.in Yoga,

Ayurvedic Physician,

Agasthya Ayurvedic Clinic,

Anandbagh Crossroads,Safilguda, Hyderabad

Ph:9849195413

OSTEOARTHRITIS AND AYURVEDA-FURTHER DETAILS

Osteoarthritis (OA) is one the most common painful ailment seen above the age 45 and is characterized by mild to severe pain in the joints. Osteoarthritis is also known as degenerative arthritis or degenerative joint disease.

Usually the pain is restricted to a single joint and is most commonly seen in the knee and Hip joints. It is one of the most common causes for decreased mobility and joint pain in the elderly population.

OA is described as Sandhigatha Vatha or Sandhivatha and is one of the eighty Vata related disorders.

Cause:

ü  Abnormal wearing of the cartilage that covers the bone ends and acts as a cushion inside joints

ü  Destruction or decrease of synovial fluid that lubricates the joints

ü  In Ayurveda, the specific cause for OA is aggravated vatha dosha

ü  Aggravated vatha dosha tends to dry up the synovial secretions and also destroys the cartilage since Vata dosha has got the tendency to dry(Rooksha guna in sanskrit). Cartilage is composed of 65 to 80 percent water

What are the changes that happen?

The contact areas of the bones are coated with a slip membrane, a 3-4 cm thick cartilaginous tissue. This is called articular cartilage and helps smoothen the bone ends.

• This extremely smooth cartilage reduces friction within the joint and cushions hard impacts, e.g. when running.
• Wear and tear of the cartilage,inflammatroy changes inside the joint leads to OA

Prevalence:
Osteoarthritis (OA) is the leading cause of disability in elderly people.

• OA most often strikes the knee, particularly the inner aspect of the tibiofemoral joint
• Women in the menopausal age are more likely to suffer from this condition
• Prevalence is particularly high among overweight individuals and the elderly(Women more than men,Urban populace more than the rural)

Symptoms:

Pain and reduced mobility of the affected joint

• Pain aggravates or shows up more during walking, climbing steps or running
• The pain can vary based on the stage of the problem,from mild to severe
• Inability to use Indian toilets, pain on getting up
• Creaking or clicking sounds inside the joints
• Loss of flexibility in the affected joint/s, pain on moving the joint
• Swelling in the joint

Who is more prone to suffer from this problem?

ü  Sports persons with injuries to the joints

ü  People involved in military training involving lot of jogging or running

ü  People who are overweight or obese

ü  Persons suffering from osteoporosis

ü  Women above age 40 and men above age 45

ü  Prevalence is higher among women because they are more prone to osteoporosis due to hormonal imbalance

Diagnosis:

ü  An experienced physician will be able to detect the changes inside the joint by doing a thorough examination of the affected joint

ü  X-rays of the joint will show reduction in the joint space due to wearing out of the cartilage and other typical changes of OA

ü  MRI and CT scans

Prevention:

ü  Earlier detection and treatment is the most important aspect which determines whether the individual gets good relief.

ü  OA which is in the initial stages is treatable with Ayurveda and once the wear and tear becomes extreme, surgical intervention may become necessary.

ü  Once cartilage damage has begun, it is going to progress at increasing speed

ü  Resting of the affected joint is a very important part of prevention from further aggravation

ü  Exercise to strengthen the group of muscles supporting the affected  joint

ü  Avoid consuming green chillies and red chillies excessively

ü  Consume 1/4^th to ½ tsp of Cow ghee in your diet

ü  Avoid legumes such as beans, Red beans, Indian pea or chickpea, green peas on a daily basis. According to Ayurveda, these food articles  have the tendency to aggravate Vatha dosha

Prevention in Ayurveda:

ü  Abhyanga or applying medicated oil such as Narayana taila or Ksheerabala taila should be started by people who are prone to OA or are in the age when OA incidence rises

ü  Intake of medicated tila taila which is rich in Vitamin D such as Ksheerabala 101 Avarthi or Gandha taila is advisable

Treatment in Ayurveda:

OA is one the commonest problem seen in an Ayurveda OPD and is addressed successfully when the patient comes for treatment in the initial stage of the problem. To do so there is an increased need for awareness creation regarding the problem among the public.

Medicines:

ü  In Ayurveda, we use different guggulu based preparations in the pill form to treat OA.e.g:Yogaraja guggulu,Trayodashanga guggulu

ü  Apart from that medicated Cow Ghee and til oil based preparations are used to improve lubrication in the joints. e.g:Ksheerabala and Dhanvatharam Avarthi

ü  The fat based medications used in Ayurveda are rich in Vitamin D and this helps enhance the absorption of calcium from the gut.

ü  This process helps strengthen the bones and joints by slowing down the demineralization process which is the basic cause of the problem.

Panchakarma:

ü  Use of medicated oils and liniments externally over the affected joint

ü  Local steam or hot fomentation

ü  Ayurveda advocates the use of medicated oil in the form of Ahyanga, Vasthi, pathra pinda sweda, Janu vasthi, localized dhara etc over the joints. The complete explanation of these procedures is beyond the scope of this article.

ü  A good doctor usually will try to help by recommending medicines first and will advise panchakarma if he does not see the expected benefits from the medicines alone

Caution/red signals:

ü  Avoid using OTC painkillers without consulting a doctor

ü  Avoid going to quacks who promise miraculous results because there are none

ü  Avoid using products promoted through the visual media, especially television and before deciding on doing so take the opinion of your family doctor

ü  There are incidents being reported of people being approached with the promise of miraculous results even on the road and being cheated of thousands of rupees

ü  If the joint pain is associated with symptoms such as fever, you may need to go in for more detailed tests such as ESR; Differential count etc.This will be determined by your physician.

Final word:

Remember, successful treatment and recovery depends on the right doctor as well as a good patient. You will be on the path to recovery if you choose the right doctor and the right system of medicine.

COW MILK AS EXPLAINED IN AYURVEDA

COW MILK AND ITS IMPORTANCE AS EXPLAINED IN AYURVEDA

Ayurveda has described eight types of milk obtained from different animal sources and the pride of place has been given to Cow milk of desk breeds of India (Ksheera varge agryam). Cow milk has been described as nutritive and good for the vital organs such as the Eyes, Brain and the Heart. It possesses sweet taste (Madhura rasa) and is cooling (Sheetha veerya) in nature. Cow Milk promotes immunity and acts as rasayana and ojovardhaka.

All of us know Milk is a good source of protein and fat and minerals such as calcium. But there are facts about Cow milk which we are not aware or we have not given a thought about. Let me explain some of them in the following paragraphs:

Easy to digest: In the absence of mother’s milk, Cow milk has been suggested as a natural alternative. Children who have a weak digestion very commonly suffer from frequent vomiting and loose motions. Recurrent diarrheal episodes in these children lead to malnourishment and stunted growth. For such Children, Milk form Indigenous breeds of Cow will be a better alternative since it is easy to digest and more nutritive. Milk from genetically modified cows will aggravate the problem by hampering the immunity of the Child as well as affecting the digestive system. That is why in the absence of Mother’s milk, the next best alternative is always Cow’s milk.

 Milk from Indigenous breeds and better quality:

Indigenous breeds of Cow have better disease resistance and this result in reduced usage of potent chemical drugs for disease control. Their milk has better immune booster effect described in Ayurveda as Rasayana property. Rasayana is the ability of a dietary article or medicinal herb or medicinal product to nourish the body in a uniform manner. Chyavanaprasha Avaleha is a common example of a rasayana medicine. The person who consumes Cow milk from Indigenous breeds of Cow will have better disease resistance and less of digestive problems such as irritable bowel syndrome (IBS). Cow Milk is a tonic to the skin, eyes, blood and has good nutritive properties. It has the additional advantage of being easy to digest when compared to other milk sources such as buffalo milk etc.

Milk and immunity: If your child is regularly suffering from recurrent infections such as tonsillitis,bronchitis,sinusitis it is time you shifted from your present source of milk to one which is obtained from Indigenous breeds of Indian Cow. Milk from Indian breeds of Cow has immune booster effect.

Cow milk and improved intelligence and memory:

Poor performance of their kids in Studies is the most common complaint of parents. Cow milk has the effect of improving medha or intellect and also is a good memory booster. Properly nourished kids perform better in their academics than poorly nourished children. To have a good intelligence and memory, it is essential that the brain gets adequate and proper nutrition. Cow milk is ideally suited as a brain tonic because according to Ayurveda it has the ability to pacify Vata dosha. Vata dosha is the one which is responsible for the proper functioning of Nervous system.

Parents are always in search of good brain tonics to be purchased from the Pharmacy but we forget that our ancients have advised Cow milk and Cow ghee as the best brain tonic. This is a medicine which is available at our doorstep and the most important thing about it is that it does not have any side effects.

Cow milk and its effect on the mind:

Our ancestors went beyond the calorie value of milk and found that milk has a calming influence on the mind. They have said that Cow milk improves the Sattva Guna in us and leads to enhancement of positive characteristics of a person. Milk from indigenous breeds of our Country has good medicinal value and it is advised to be used in preparation of Ayurveda medicines.

Cow milk and bone strength:
For pure vegetarians, Cow milk is a good source of Vitamin D and Vitamin D plays a huge role in the absorption of Calcium from the gut. Good absorption of calcium will lead to good bone strength. So Cow milk is very important for women who are nearing menopause because menopause increases the susceptibility to Osteoporosis.

Milk and its effect on the Tridoshas of Ayurveda:

Among the doshas, Milk has the capacity to alleviate aggravated Vata and Pitta dosha. We have to understand that these properties have been explained in the context of Desi or indigenous breed of Cow. There is a need to institute comparative studies on the quality and health giving properties of the milk obtained from indigenous and hybrid (genetically modified) cows. Cow milk is one of the most important ingredients in several Ayurvedic preparations such as Mahanarayana Taila, Ksheerabala Taila, Panchagavya Ghritha, Amrtaprasha ghrtha etc.

Cow Milk and its effect on Ojus as per Ayurveda:
Ayurveda explains Ojus as Saptha dhathu saara and in layman’s language it can be said that milk is tonic of all tonics. If used according to classical guidelines, milk nourishes all the tissues in our body.

If you are suffering from milk allergy- is there an alternative:If you are allergic to Milk in any way, the best way out is to consume it in the form of buttermilk. The milk is converted into curd and later churned to obtain nectar like buttermilk. Buttermilk can be taken by people who are suffering from lactose intolerance and it actually improves the absorptive strength of the intestines. Ayurveda has extolled the virtues of buttermilk in several instances and modern research also confirms that buttermilk is a rich source of probiotics. Probiotics are nonpathogenic microbes. They are present as normal flora in the alimentary canal and they contribute to the digestive and metabolic process by their enzymatic activities. An imbalance in the probiotics flora will lead to susceptibility of the individual to frequent loose motions and digestive upset. In my clinical practice, I advise patients suffering from gastritis, irritable bowel syndrome, colitis and piles to consume lot of buttermilk prepared out of Cow milk.

How to drink and how much quantity?
Milk should be ideally boiled before consumption. Since Cow milk from Indigenous breeds of Cow has a natural sweet taste, there is no need for additional sugar. Since Cow milk itself is a complete formula, ideally it should be consumed without any additives.

Quantity of milk to be consumed:Quantity of milk to be consumed depends on the age and the digestive capacity of the individual. It is always good to have a complete diet with adequate sources of protein, carbohydrate, fats and minerals. Milk can be a good source of proteins, fats and minerals. One to two cups of milk per day should be ideal.

Cow milk and the elderly: Fifty and above is the age when our bones start showing signs of degeneration and Milk is an ideal supplement at this age. Elderly are more prone to fractures and arthritis due to weakness of bone tissue and Cow milk is an ideal bone tonic.

Cow milk and Women:Women during their pregnancy and lactation should consume adequate quantities of milk. They are prone to Osteoporosis during  and after the menopause and should ideally have a cup or two of Cow milk during this period since Cow milk is a rich source of calcium and other minerals.

How not to consume milk-Combinations to be avoided: Do not consume milk along with sour tasting fruits such as Pineapple, berries etc.Avoid consuming fish and sea food alongwith milk. For people who are having elevated cholesterol levels and suffering from heart problems, buttermilk is better than milk. Buttermilk has the property of making obese people lean and so overweight people should ideally consume less of milk and more of buttermilk.

Ayurveda and Cervical spondylitis

CERVICAL SPONDYLITIS-A nagging pain in the neck

Spondylitis is a disorder characterized by inflammatory changes in the spine. Spondylitic changes can affect all parts of the spine and based on the site of affection there are three variants, viz.:

ü  Cervical spondylitis-charecterized by spondylitic changes in the cervical spine(C1 to C7)

ü  Ankylosing spondylitis- characterized by spondylitic changes in the Thoracic spine(T1 to T12)

ü  Lumbar spondyltits- characterized by spondylitic changes in the Lumbar spine(L1 to L5)

Spondylitis does not have a simple explanation and reams of research papers have been published on the subject. The reasons for its occurrence are multiple and in this article we try to give a simple idea about cervical spondylitis.

Before we move on to understanding cervical Spondylitis (CS), there is a need to understand the vertebral column.

Vertebral column:

The vertebral column also known as the backbone consists of 7 cervical vertebrae, 12 Thoracic vertebrae, 5 Lumbar vertebrae, 5 sacral vertebrae and 4 coccygeal vertebrae. It extends from the cranium to the coccyx and the bones forming this column are separated from each other by soft structures known as intervertebral discs. The backbone and its components are held together by an intricate arrangement of cartilages, ligaments, muscles and tendons. You can compare it with a multi structured building supported by different structures.

The vertebral column encases the spinal cord and prevents damage to the very sensitive spinal cord just like the skull bones prevent injury to the brain.

Importance of a healthy backbone:

In an organization if there is somebody very important, he/she is referred to as the backbone of that organization. If that person quits, the organization will find it very difficult to replace him/her. This is an example to demonstrate the importance of the backbone for the health of a humanbeing.If it is affected by any problem, the repercussions are very painful severe.

Cervical spondylitis-What happens?

Degenerative changes in the intervertebral disc leads to cervical spondylitis.Thinning and weakening of the intervertebral discs leads to reduction in the intervertebral space. Osteophyte formation takes place leading to impingement of the nerves that leave the spine for other parts of the body.

Signs and symptoms of CS:

ü  Pain and discomfort in the neck

ü  Radiating pain in the arms

ü  Scapular pain

ü  Shoulder pain

ü  Giddiness in severe cases due to pressure over the vertebral arteries

ü  Weakness and pin pricking sensation in either or both of the arms

Who is more prone to suffer from CS:

ü  Software professionals are more prone to CS

ü  Constant forward bending position

ü  Repeated movements of the upper arm

ü  Puts pressure on the neck and shoulders

ü  We can include DTP operators or anybody who has high usage of computer or laptops

ü  Women above 40 and women who have experienced premature menopause

Diagnosis:

ü  A detailed examination by the physician will reveal the restricted and painful movements of the cervical spine

ü  X-rays will help in the diagnosis by visualizing the degenerative changes in the cervical spine

Simple tips for prevention of CS in Ayurveda:

ü  Apply oil over the scalp and massage

ü  Use Til oil(Sesame oil) or coconut oil

ü  Medicated oils such as Bhringaraja taila, Triphaladi taila can be used

ü  Also instill a few drops of bilwa taila in the ear once in a fortnight

ü  Apply oil over the body and especially the spine

ü  Gently massage the part after applying the oil

ü  Use medicated oils such as Mahanarayana taila or ksheerabala taila

Treatment/Management:

q  Combination of Ayurveda and Yoga works well

q  Kashayams and pills prepared out of rasna,eranda and guggulu are commonly used. These are Vata shamaka in nature

q  Oil massage(Abhyanga) and leaf poultice massage (Elakizhi or pathra panda sweda) give good relief in acute pain conditions

q  Greeva vasthi-a procedure of using medicated oil for fomentation over the neck helps strengthen the bones

Medicines for CS in Ayurveda:

CS is considered as a Vata Vyadhi and all the medicines aim at establishing/restoring balance of Vata dosha. Some of the commonly used medicines are:

ü  Guggulu thikthaka ghritha

ü  Maharasnadi kashaya

ü  Yogaraja guggulu

ü  Gandha taila

ü  Ksheerabala taila 101 avarthi and dhanvantaram tailam 101 avarthi

ü  Simhanada guggulu

The right combination of medicines will be  prescribed by the vaidya based on the prakruti of the patient and the severity of problem.

Panchakarma treatment for CS:

Since CS is considered as a Vata Vyadhi, all the panchakarma procedures aim at establishing/restoring balance of Vata dosha

ü  Abhyanga and swedana –this is the basic treatment adopted to improve the blood circulation and to bring in flexibility of the spine.

ü  Nasya karma-Instillation of medicated nasal drops helps strengthen the cervical spine and bring back normalcy of Vata dosha

ü  Vasthi karma-is one of the most important treatment procedures to restore balance of vata dosha. Vasthi is the administration of different medicated oils and medicated decoctions through the rectal route.The number and type of medicated enema to be given is decided by the physician.

Diet:

ü  Avoid vata aggravating food articles such as chana,green peas, beans, green chillies,excess of spicy pickles

ü  Take adequate quantity of dairy products such as buttermilk, milk and ghee in your diet

ü  If you are suffering from constipation, take ½ to 1 tsp of medicated castor oil at bedtime along with warm water

Avoid:

ü  Avoid extreme backward bending postures or movements while doing exercise or yoga

ü  Continuously sitting in front of the computer without a break. Take small breaks in between and do simple exercises of the neck

ü  Big and hard pillows

ü  Asking your barber to relieve the pain by neck manipulating movements, this may be an invitation to disaster sometimes

ü  Uneven mattresses

ü  Watching TV for long durations

ü  Sitting in awkward positions

Final word:

If you are confused about the entire medical jargon written above, let me give you some very important advice which you should not miss for prevention of CS and if you are already suffering from it, to prevent from its aggravation:

ü  Have a proper sleep waking cycle-the simplest rule but very difficult to follow-early to bed and early to rise keeps your bones healthy

ü  Apply medicated oil to your scalp thrice in a week and have medicated oil bath once in a week

ü  Do simple neck exercises regularly

ü  Try to reduce the time you spend in front of your desktop or laptop