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Ayurveda Treatments for Public Health Dr. U. Indulal B. A. M. S The Arya Vaidya Pharmacy Coimbatore, India

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Health Transition Dramatic changes and transitions in the world's health needs are expected in next two decades as a result of epidemiological transition. At present, lifestyle and behaviour are linked to 20-25% of the global burden of disease. This proportion is rapidly increasing in poorer countries. Non-communicable diseases such as depression and heart disease are fast replacing the traditional enemies such as infectious diseases and malnutrition, as the leading causes of disability and premature death. By the year 2020, noncommunicable diseases are expected to account for seven out of every ten deaths in the developing regions, compared with less than half today.

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NCD in Brazil In Brazil, CNCDs account for 60% of all deaths and about 40% of the disease burden. In 2010, the Ministry of Health estimated a high prevalence of CNCD risk factors among adults (3), including low consumption of vegetables (81.8%), being overweight (48.1%), smoking (15.1%), binge drinking (18.0%), and sedentary lifestyle (14.2%). Moura EC, Pacheco-Santos LM, Peters LR, Serruya SJ, Guimares R. Research on chronic noncommunicable diseases in Brazil: meeting the challenges of epidemiologic transition. Rev Panam Salud Publica. 2012;31(3):2405.

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Causes for health and ill health Dosha Internal Dushya External FoodActivities Of definite period Of indefinite period Daily Seasonal , I , I - : I I : I Hemadri. Ayurvedarasayana Comm. Ashtangahridaya. Sutra. 1. 6 /2. 1

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Indian Health Sector Health sector trends suggest that no single system of health care has the capacity to solve all of societys health needs. India can be a world leader in the era of integrative medicine because it has strong foundations in Western biomedical sciences and an immensely rich and mature indigenous medical heritage of its own. (Eleventh Five Year Plan, India)

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- Definition of Health : : I : II Susrutasamhita. Sutrasthana. 15.41 I : II Charakasamhita.Sutrasthana.9.4 the doshas are in a state of balance, the agni is working properly, the dhatus are actively engaged in the nutritive process the malas are eliminated naturally from the body, the atma, indriya and manas are in a pleasant state Disease = imbalance; sorrow Health = Balance; Pleasure

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: II II : I II 6-8. Bhojyojopakramaneeya adhyaaya. Khilasthaanam. Kaashyapasamhita Proper appetite Proper digestion Proper elimination of wind Proper elimination urine Proper elimination of feces Lightness of the body Clarity of senses Proper sleep Proper waking Proper strength Proper complexion Healthy longevity Pleasant state of mind Balanced state of agni HEALTH INDICATORS

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- : Susrutasamhita. Sutrasthana.1.14 : Preserving the health of a healthy person : Curing the disease of a diseased person Purpose of Ayurveda : , Arunadatta. Sarvangasundara Comm. Ashtangahridaya.2.1

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Swasthavritta/ Preventive Care Counseling for self-awareness Healthy routines daily and seasonal Diet suitable for the individual with relation to the time and place Healthy mental and spiritual practices Guideline for periodic cleansing, rejuvenation etc

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Two attributes of the Body : : - : Charakasamhita. Sareerasthaana.6.17 Pure Attribute Impure Attribute

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How to keep the body pure? By maintaining the digestive strength By enabling liquefaction and flowing back of lodged toxins By eliminating the toxins

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Treatments Samana Sodhana

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Sodhana Treatments: Problems Ref: Keraleeya Chikitsa Paddhati It demands the physicians to go beyond the ordinary awareness of medical herbs and be well acquainted with the subtle nuances of fundamental principles along with their clinical implications. (C. S. Sutra. 15.5) This higher standard expected is declining. (C. D. 71.34) Indiscriminate practice of Panchakarma cause many complications known as panchakarmabhava roga (Sa. S. 1. 7. 194)

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Healing techniques Anta parimaarjana (Internal) Bahi parimaarjana (External)

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Cleansing treatments in Preventive Medicine The person enjoying a positive health due to a good Ayurveda doctor is forbidden from undergoing any sodhana/elimination therapy (Nbh. R. V. S. 1 1) Elimination therapies prescribed under a specific season are not a general rule. It should be administered only to those who digress from the regime laid down in Ayurveda (ibid)

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Use of these treatments in health care Simple and non-invasive Easy to make them available Less complications Easy acceptance Needs less resources Wide range of therapeutic use Suitable for mild to moderate levels of dosha vitiation Balances Vata, the major dosha Has rejuvenation effect too

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Kerala Special Treatments Bahi parimaarjana. Based on the concepts of Snehana and Swedana. Should not be named as Kerala panchakarma Performed for curative, preparatory and rejuvenation purposes.

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Kerala Special Treatments: Texts Dhaarakalpam by Sri. Bharatitirthaprasada Sirassekaadi Vidhi by Puthiyedathu Raman Menon

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Sirodhaara With medicated oil/buttermilk Performed on a specially designed wooden plank.

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Sirodhara with thaila Imparts vitality to the dhatus Bestows virility Stabilizes agni, complexion and ojas Enhances sensory acuity Deters the process of senility and confers longevity Prevents bones from becoming brittle Reduces the vitiation of dhatus

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Sirodhara with Takra Prevents premature graying Sharpens sensory acuity Reverses the agitation of doshas Reduces headache Reduces depletion of ojas Reduces pain (palms and feet) Reduces problems with urine Gives relief to slackening of joints, diseases of the heart, aversion to food and decreased appetite Effective in diseases afflicting head, eyes and ears

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Improperly performed Sirodhara Burning sensation Skin lesion General Pain and Joint pain Fatigue or loss of consciousness Malaise Weakness to sound Vomiting Hemorrhage Fever

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Sirovasti

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Sirovasti: Duration Till nostrils and mouth gets moistened Till the discomfort of the disorder subsides Till a stipulated period (more for Vata, medium duration for pitta and less for kapha)

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Pizhichil

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Pizhichil Temperature of the oil Height, thickness and speed of the oil flow Duration of the treatment Positions of the patient Time of treatment

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Thalam and its importance Process of applying medicines over the center of the head. Purpose Procedure

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Kizhi Ila Kizhi or Leaf Bundle Podi Kizhi or Powder Bundle Navara kizhi or Rice Bundle

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Navara Kizhi: Precautions Type of cloth Ventilation Continuity of application Cleaning after kizhi

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Sirolepa Application of medicinal paste on head Paste is made either by boiling the drugs or by triturating the dry medicinal powder in buttermilk. Commonly used drug: Amalaki/Gooseberry

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Effects of Sirolepa Cures tiredness, nodular enlargements Imparts strength to sight Induces sound sleep Other effects similar to that of Takradhara

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Food during these treatments : I II Dharakalpam Should be liquid, hot, not causing abhishyanda, not increasing kapha, not excessively unctuous and not a combination of wholesome and unwholesome food

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Regimen during these treatments : I II : I : II Ashtangahridayam. Sutrasthaanam.16. 26 Use only hot water Observe celibacy and proper sleeping habits Avoid control of urges, exercises, anger, worrying, cold weather, sun, breeze, travelling, excessive walking, excessive talking, very low or high pillows, study, prolonged sitting, exposure to smoke and dust

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Recommendation Address the fundamental causes of health and illness, and provide incentives for healthy ways of living rather than reimbursing only drugs and surgery.