Sinusitis (Dushtapradisyaya) and its Ayurveda management

SINUSITIS/ RHINO SINUSITIS

Inflammation of Para nasal sinuses is called Sinusitis (Rhino sinusitis). It can also be defined as inflammation of mucus membrane that lines the Para nasal sinuses. Usually sinuses are filled with air, but when it is infected with bacteria, viruses, etc, it is blocked with mucus or germs and it will ultimately lead to Sinusitis. It may causes symptoms like cold. headache, dizziness,etc.

What is Sinus:

The Sinuses or Para nasal sinuses are air filled spaces in the skull. They are located behind the forehead, nasal bones, cheeks, and eyes.

There are four pairs of Para nasal sinuses are there:

Urinary Calculi/ Kidney Stone (Mutra asmari) and its Ayurveda Treatment

Urinary Calculi/ Kidney stone

Calculi or stone is a solid/ crystal sedimentation formed in the urinary system. It is also called as Urolithiasis. It is mainly formed from the dietary minerals and waste materials found in the urine. It is usually comprised as a compound called Calcium oxalate or Phosphate. These are result of an accumulation of dissolved minerals on the inner surface of urinary system like Kidneys etc. It may have different sizes. Some of them have the size of a pin head and may be pass unnoticed through urine without causing any symptoms. Some of them have enough size to obstruct urinary passage and can cause symptoms like pain,etc. These can be grouped and classified according to the location and chemical composition.

SHASHTIKA SHAALI PINDA SWEDA OR NAVARAKIZHI

Shashtika shaali pinda sweda also known as Navarakkizhi is a Kerala specialty of treatment in which the whole body or any specific part is made to perspire by the application of heated medicinal rice (Navara) puddings externally in the form of boluses tied up in a cotton cloth in a specific manner for specific period of time.These procedures are very commonly used in Keraliya Panchakarma.

'Navara' means special rice which is harvested in 60 days. 'Kizhi' means bolus bag.

Bashpa Sweda or Steam Bath in Ayurveda Treatment

BASHPA SWEDA or STEAM BATH

This is kind of sudation by which medicated steam is applied to the patients body for a certain periods of time to get perspiration.It removes stiffness,heaviness and coldness from the body.(ref:A.H).

For this purpose Bashpa Sweda Yantra (A steam bath chamber) is required.Medicinal herbs decoctions is kept boiling in the Bashpa Sweda Yantra from where the steam is generated and applied all over the body or any specific part through a tube or pipe.The patient is advised to lie down inside the steam chamber after massage with warm oil (20-22C). A thick cotton sheet may be used to cover the body to get proper perspiration.

WRIST PAIN AND NUMBNESS/ CARPAL TUNNEL SYNDROME AND ITS AYURVEDA TREATMENT

CARPAL TUNNEL SYNDROME AND ITS AYURVEDA MANAGEMENT

Carpal tunnel syndrome or median neuropathy at the wrist, is a medical condition in which the median nerve is compressed at the wrist leading to paresthesia numbness, pain and muscle weakness in the hand. It is caused by an inflammation or collapse of carpal tunnel that allows nerves to pass through the wrist. It is a common complaint of office workers, drivers and is usually associated with repetitive activities such as typing, etc. Because the nerves of the tunnel run through the neck and arms before reaching the wrist. Tension in the neck and shoulders can also aggravate the condition. Some predisposing factors like diabetics, pregnancy, hypothyroidism, and heavy manual work or work with vibrating tools may also cause the symptoms.

KERALIYA AYURVEDA PANCHAKARMA

KERALIYA PANCHAKARMA

Panchakarma procedures are utilized for the purpose of preservation, maintenance and conservation of health and the promotion of longevity.

While checking the history of Ayurveda we can see that,with the spread of Buddhism to the southern parts of India,Ayurvedic treatment got popularized as it was practiced in the monasteries.After the decline of the Buddhism,many of these monasteries where converted to the temples and the practice of Ayurvedic treatment through these temples still continues in Kerala. Panchakarma procedures where not confined to the higher societies only.Rather lower classes of the society also contributed to the promotion,progress,and development of these specialized techniques.Due to these fact modified technique of Panchakarma treatments developed in Kerala unlike north part of the India.

Based on Ayurvedic principles and own experiences, the Ayurvedic scholars in south India have modified certain techniques or procedures according to dosha, Prakriti(body constitution),Kala (season),drug availability etc.and found them quite effective.Later on thees procedures got popularized as Keraliya Specialties of Panchakarma which are extensively practiced in India and abroad as main procedures. With the modernization and globalization of Ayurveda,more and more peoples are showing interest in these treatment procedures due to their effectiveness in addition to the conventional Panchakarma practices.

Some of the main procedures are:

• Shashika Shali Pinda Sweda
• Pizhichil
• Shirodhara
• Shirovasthi
• Shirolepana

These procedures are specialized varieties of snehana and swedana which have more nourishing effects than bio-cleansing or depleting effect.

Sankara Sveda in Ayurveda treatment

SANKARA SWEDA in AYURVEDA TREATMENT

Samkara means mixing of dravyas like Tila,masha,etc together should be rubbed into pinda (ball like) made Luke warm and kept over the painful part of the body.This is a ideal procedure for application of heat to a selected part of the body.Depending on the drug used it can be  ruksha or snigdha.

Fomentation by means of hot bolus of prescribed drugs with or without being wrapped in a cloth.

CLASSIFICATION OF SVEDA KARMA/FOMENTATION THERAPY IN AYURVEDA

Svedana karma- classification

1.Niragni Sveda (without fire) and 2. Saagni sveda(with fire)

(ref: susurutha and vaagbhata)

Niragni sveda:                                   Saagni Sveda

1. Vyayama (Exercise)                   1.Tapa Sveda -done with hand
2. Ushna sadana                            Kaansya,Kapaala,Kanduka,Vaaluka and
3. Guru pravarana                         vastra (cloth)
4. Kshudha                                  2.Upanaha Sveda-bandhan,pradeha,potali
5. Bahupan                                  3.Ushma sveda-done with kapaala,Pashana
6. Bhaya                                      Loha ball,Sankar,Kumbhi,Prasthala,bhru etc
7. Krodha                                  4.Drava sveda-Done with parisheka,and
8. Upanaha                                   avagaha.
9. Ahava
10. Aatapa

Abhyanga or Oil Massage Therapy in Ayurveda

ABHYANGA or Oil MASSAGE THERAPY

Abhynga is type of oleation therapy used in Ayurveda.Abhyanga can be defined as the procedure of application of Sneha Dravya/medicine over the body with mild pressure.The word abhyanga is derived from terms "abhi" and "anga". Thus it is a treatment comprised of Taila/ ghritha/ vasa etc, are rubbed over the body in directions comfortable to the patient.It improves strength and alleviate Vata.It is a type of bahya Sneha. It can be performed as therapeutic procedure as well as preventive procedure.Abhyanga can be done as part of the steps of panchakarma therapy, especially in the first stage: Purva Karma (pre-treatment), or as its own therapy. It is often followed by swedana therapy, a warm bath, yoga or laying out in the sun. Many times abhyanga is performed by two or more massage therapists working in sync but it can also be done by oneself. Oils used can vary depending on the season and the individuals constitution (dosha) It is mainly used an Vata aggravated diseases because oil has the effect reducing vata.In Ayurveda it also mentioned as a daily regimen.In Kerala it is largely used as therapeutic as well rejuvenation and also as seasonal therapy.

SNEHA PAANAM and its Procedures

 SNEHAPANA IN AYURVEDA TREATMENTS

Internal administration of Sneha or fat materials in the body is called Sneha panam/ Abhyantara Sneha.It is again classified into two Achapana Sneha and Vicharana Sneha.This type of snehana mainly used prior to the shodhana therapy as preparatory procedure and also to prepare the body and other morbid doshas to purification therapy. By doing so our body will be softened etc.
Before doing all these procedures one should understand patients condition like age,disease condition,season, digestive capacity etc. And also have some pre and post operative procedures before and after this Snehana therapy.

Pre-Sneha measures/poorva karma/preparatory measures:

One day before the actual administration of snehapana(internally),the concerned individual should be given food in the moderate quantity. The food should be liquid, hot and anabhishyandi(free from stickyness,etc),that does not cause avarodha/obstruction to the channel of circulation(srothas).

The food should be Drava(liquid), ushna (hot), pramana (proper quantity),not snigdha(excess),Asamkirna (Avirudha veerya) and one should not consume food quickly or slowly.Food should be taken calmly (without talking,should not laugh while taking food,and one should take the food, which is favorable and conductive to his body constitution(saatmyahara).

Materials Required:

Before initiating the snehapana always check the all emergency and routine things.because in an emergency situation some times it may not poosible to get the required drugs,etc.Further all anupana dravya like ushna jala/hot water,yusha etc.should be kept ready.

since snehapana in certain individual may cause some complaints,especially such drugs which control these effects should be kept ready.(if required).

some of the complaints are:

Agnimandya (indigetion)-Hinguvachadi vati,chitrakadi vati.

Arochaka (anorexia) -Ashtachurna,etc

Sula (pain)- Shanka basma,etc

Bhrama (giddiness)-Pravala pishti,etc

Murcha -Kamadugdha ras,etc.

and medicines required for vamana and virechana.

• Medicated Ghee or oil according to the requirement.
• Measuring glass.
• Hot water drinking.(boiled with Shundi+ Dhanyaka).

Medicines commonly used:

• indukantham ghritham
• Gulgulu thikthakam ghritham.
• Mahatikthakam ghritham.
• Sukumara ghritham.
• Ksheera bala tailam.
• Dhanwantaram tailam,etc.

Man Power:

• Ayurvedic Physician: 1
• Attendant/ Nurse: 1

Dosage of Snehapana:

Four types of Snehapana dosage schedules  are indicated-

1. Pravara Matra-Sneha digest in 24 hrs.
2. Madhyama Matra- Sneha digest in 12 hours.
3. Avara Matra - digest in 6hrs.
4. Hrasiyasi Matra with arohana krama-digest in minutes

These to be fixed,keeping in view the various factors like state of agni, clinical condition, Prakruti of patient,etc.and aim of snehapana.
Minimum dosage for snehapana is approximately 50ml,this can be increased gradually by 25 or 30ml every day for 3,5,and 7 days desired by the physician.

Procedure of Snehapana:

Agnibala (digestive power) may be assessed in the patient prior to Snehapana,so as to assess the dose of sneha dravya(unctous substances).For the patients with unknown doshas,agni,etc one may start with Hrasiyasi Matra (which digest in 2 yamas).

The patient who is intended to under go snehapana is to take sneha in the early morning (within 15mts of sunrise) in the prescribed dose based on his Agnibala,nature of the diseases,condition of the body,etc.The usual dosage is between 50 to 75mlof ghritha and 30 to 50ml for Taila on the first day.The dose for the next day should be fixed after assessing the time taken for digetion. Hot water boiled with piece of sundi (dry ginger) + Dhanyaka (dry coriander seeds)is given in small doses toenhance the digetion.

Snehapana (internal administration of unctuous substances) may be continued till Samyak snigdha lakshana (symptoms of disired effects) are observed and usually it is obtained within 3 to 7 days.

Step-wise procedure:

1. instructed to offer prayer to the god (according to one's faith).
2. Patient should be assured about the safety of treatment and confidence and courage levels should be raised.
3. selected Sneha should be heated to Luke warm water.
4. In Vata vyadhi- ghee mixed with little saindhava (rock salt), in Pitta diseases- pure ghritha should be used, in kapha diseases-powders of pippali,shundi,and maricha should be mixed before giving orally.
5. medicine should be given in early hours of morning at the time of sunrise in an empty stomach.(after patient completes daily routines like brushing,evacuation etc.
6. Patient asked to sit comfortably on a knee high chair.
7. The patient asked to drink the sneha.If the patient has some aversion to consume,he should be asked to close his eyes and nostrils and to drink (to avoid smell and appearance).
8. Hot liquids should be given as anupana.If required hot water should be taken repeatedly up to six hours of snehapana,especially when large dose is taken.

Usual practice of increasing order of snehapana dosage:

First day :          50ml.

Second Day :    100ml

Third day:         150ml

Fourth Day :      200ml

Up to 7th day :  350ml.

When to terminate the course of Snehapana:

The standered procedure of snehapana and pathya should be continued with gradual increase of Sneha (as described) for a maximum period of 7 days. During the treatment, every day the patient's condition should be assessed to "note the effect of snehapana".
This procedure of snehapana should be stopped on the day the patient/person develops the Samyak Jirna Lakshana.
The time of feeling of hunger and appearance of the Sneha (Fat) in the stools, are the correct indicators samyak snigdha hence further Sneha pana should be terminated.
If any adverse effects of Atisnigdha or Asnigdha occurs suitable treatment should be given.

Observation of Jeerna Lakshana:

After the intake of Sneha on first day as well as in the rest of days of treatment, the patient/person is likely to experience certain symptoms,which indicate the jeerna or ajeerna of consumed sneha.Hence observation is essential for continuing further treatment,because in certain instances, it may not be proper to continue.

Symptoms indicative of progression of digestion (Sneha Pachyamana Lakshana)Ref A.S.Su:

• Shirorug (head ache).
• Bhrama (giddiness).
• Nishti (Excess-salivation).
• Murcha (Fainting)
• Sada (Tiredness)
• Klama (feeling of tiredness even during rest).
• Trsna (Thirsty feeling)
• Daha (burning sensations) and
• Arati (Restlessness).

Symptoms indicative of complete digestion (Samyak jirna Lakshanas):

• Disappearance of all symptoms stated under pachyamana.
• Laghuta (Feeling of lightness in the body).
• Vatanulomana (Proper passage of the flatus).
• Kshut (appearance of proper hunger).
• Trshna (Proper thirst).
• Udgara shudhi (Clear erection with out any taste, odor,etc.).

After Snehapana:

After snehapana is considered as completed,after matching with symptoms of proper Snehana the individual should be subjected to abhyanga and swedana from the very next day as per the planned Panchakarma treatment by the concerned physician.

Paschat Karma(pathyapathya)/post operative regimen during Snehapana:

During Snehapana treatment one should use hot water, observe bhramhacharya (celibacy), should not sleep during day time or suppress urge like urine (mutra),etc.

He should avoid physical exercise, loud talking,anger,anxiety,cold,wind,sun,etc.These measures should be continued some more time even after the completion of snehapana. If one indulges in wrong regimen during the course of snehapana, is likely to suffer from serious upadravas (complications).

Take rice gruel after feeling hungry (when consumed sneha is digested).

Indications of Snehapana:

• Swedya, Samshodya (Persons eligible for sudation and bio cleansing procedures).
• Ruksha Sarira (Roughness in the body).
• Nithyamadya (Alcoholic).
• Krisha (emaciated).
• Timira (Premature cataract).
•  Vata roga (Neuromuscular disorders).
• Kasa (cough)
• Swasa (dyspnoea)
• Hikka (Hiccough).
• Swarabheda (Hoarseness of noise), etc.

Contra indications of Snehapana:

• Sthoola (Obese).
• Kaphaja Vikaras (Kapha disorders)
• Atisara (Diarrhoea)
• Raktapitta (Bleeding disorders).

Complications and managements:

• Indigestion.
• Vomiting.
• Nausea.
• Anorexia.
• Headache.
• Constipation.etc.

In such conditions Snehapana should be discontinued and fasting ,Deepana (Stomachic), Pachana (Digestive),drugs may be given based on the patients condition.

Benefits and Observations:

Oleation pacifies Vata,lubricates and softens the doshas.It improve digestion,regularizes bowels,improves the strength and complexion and prevents premature aging,etc.

Other experiances with disease descriptions:

If readers have any additional experiences in Snehapana related to particular diseases can also add their opinions here,which will help other to cure the conditions and get a chance to practice.Other doctors ,students,vaidyas can also add their experience here which will  act as additional benefits to Ayurveda and Of course to patients and to other physicians.

1. Sneha pana with Gulgulu tikthaka ghritha,found great effective in reducing high cholesterol.

Thank you,

By: Dr.Rimin Razak

Ref:Charaka Samhita,Ashtanga hridaya,etc.

Indications and contra indications for Sneha therapy

Sneha yogya Purusha or General indications for Sneha Therapy: 

Sneha chikitsa in generally is recommended for the following:

• For those who are given to be swedana or shodhana therapies like Vamana,Virechana etc.
• For those who are Rukshana (roughness in the skin).
• Vatavyadhi (vata aggravated) patients.
• For,those who indulge in physical exercises(more).
• Who drinks more and indulge in excess sex,etc.
• Persons of mental stress (Chintaka).
• Aged persons.etc

Sneha Ayogya Purusha or Contra Indications:

 Sneha chikitsa is generally contra indicated in the following:

• Who are fit for the rukshana type of treatment(opposite to sneha therapy),except for the purpose of samshodhana therapy.
• To those in whom Kapha and Medas are aggravated.
• To those who are having mandagni (weak digetion).
• Trishna piditha, murchita, Gharbhini stree(pregnant lady).
• Who are annedweshi (aversion for the food).
• Suffering from Chardi (vomiting).
• suffering from digestive disorders.
• gara visha piditha (poisoned),weak,emaciated.
• Sneha dveshi (who dislikes sneha), etc.

to such persons to such conditions ,sneha should not be given,if administered it may causes sever diseases.

By: Dr.Rimin Razak
Ref:Charaka samhitha,kayachikitsa.

SNEHANA OR OLEATION THERAPY IN AYURVEDA

It is a type of Poorva karma(pre operative) procedures in Panchakarma.Snehana stands for lubrication of  the body systems by the administration of fatty substances internally or externally.Internal administration of Sneha/oil is called Snehapanam.It is an important preparatory procedure for Panchakarma.
Mainly four types of Snehana dravyas.medicines are used for this purpose.they are Ghritha (Ghee), Taila (Oil),Vasa (Fat) and Majja (bone marrow). Out of these Ghritha is considered as the best.

Snehana types:

• Abhyanthara Snehana (Internal oleation)
• Bahya Snehana (External oleation)

Abhyanthara Sneha/Snehapanam (internal oleation):

it is again classified in to Achapana and Vicharana Snehapana.
Achapana Snehapana is the oral intake of medicated or non medicated Sneha (ghee/oil) without mixing with food or other medicinal preparations and used for the purpose of softening and lubricating the body tissues prior to the Sodhana therapy or Panchakarma.
Vicharana Snehapana is the intake of oil along with other food items or with some Ayurveda medicines as a divided quantity.
Internally it can also be given as through rectal route like Vasthi,through nasal route like Nasya karma.

Bahya Sneha (External oleation):

Externally sneha dravya are used in the following forms of treatments like:

• Gargles (oily) oil pulling,etc
• Head massage (Siro Abyangam)
• Oil massage (Abhyangam)
• Lepa (external application, etc..

Classification of Snehana:

From combination point of view:

1. Yamala Sneha: combination of any two varieties of fat substances.eg: Sarpi (Ghee) + Taila (oil).
2. Trivrit Sneha: combination of any three varieties of fatty substances. eg: sarpi+ Taila+ Vasa.
3. Maha Sneha: combination of all the three.Eg: Sarp+Taila+Vasa+Majja.

From therapeutic point of view:

depending on the therapeutic effect it can be divided into three:

1. Brhimhana Sneha: Sneha given with little amount of food or drink for nourishment purpose. Eg: Sarpi (10ml)+ milk (100ml).
2. Shamana sneha: given with processed drugs in moderate dosage for the purpose for treating small to moderate deranged doshic conditions.In these various medicated ghrithas or tailas are given in various diseases.Eg: Pancha thikthaka gritha in warm water.,ksheerabala.
3. Shodhana Sneha: Medicated sneha when given orally in the full therapeutic dose to cause vamana,etc. Eg:use of eranda taila,Sneha given under poorva karma for shodhana procedure is also known as Shodhana sneha.

On mode of administration:

1. Achapeya: Administering orally the pure sneha without adding anything in large dose.
2. Sadya sneha:is a rapid actilng sneha generally given with addition of Lavana.it causes Snehana within 3 days.
3. Pancha prasrutiki peya:100gm each of ghee,taila,vasa,majja and rice are combined together and cooked into peya(rice soup) form and given orally.it cause snehana in 2 to 3 days.

On the basis of paka:

1. Mridu Paka:In this Sneha prepared with minimum frying and subjected to Mridu paka. It is specially used in Nasya procedures.
2. Madhyama paka: Moderate frying used for internal and external purpose.
3. Kharapaka:sneha is obtained by subjecting to maximum frying.used only for external application.

On the basis of Maatra(dose):

1. Hrasiyasi matra (digest in minutes): oral administration of sneha for seven days almost,starting from the smallest amount,gradually increasing day by day.it is a test dose.
2. Hrasva matra: (digest in 6 hours): given in small amounts only.
3. Madhyama matra (digest in 12 hours): medium dose given orally for therapeutic benefits.
4. Uttama matra: (digest in 24 hours): big dose.

Attributes(qualities) of Sneha dravya/medicine:

The effect of the fatty substances on the body is mainly based on some qualities.they are

1. Snigdha guna: greasy or oil like character.which helps to decrease VATA DOSHA and increase the quality of kapha.thereby promotes softness of the body,colour,complexion,etc.
2. Guru guna: indicates heavy character.act a VATA HARA,pushti kara(nourishing) and as an anabolic agent.
3. Sita Guna:give cooling effects to the body,pacify thirsty feeling,burning sensation etc.helps to constrict and contract the body organs thereby imparts firmness and stability of the body.
4. Mridu guna:give softness to body channels/srothas.
5. Drava guna: liquid nature.spread quickly and bring moistening effect.
6. Pichila guna: cause slimness to the body.thereby helps in the integrity,firmness of the body parts etc.cause kapha dosha increase.
7. Sara guna:
8. Manda guna:cause sluggishness of activity of sneha dravya.
9. Sukshma guna: this penetrating character of sneha is responsible for quick action.

Seasonal prescription of Sneha dravya:

1. Sharat hritu (Autumn): since PITTA DOSHA is aggravated in this season ghee should be given as it is good pitta samana.
2. Grishma hritu (Summer): VASA  and MAJJA are suitable.because of excessive depletion due to heat takes place.
3. VARSHA, SARAT, and HEMANTHA: VASA and MAJJA are suitable.
4. Pravrit hritu: TILA TAILA is suitable.because in these season VATA dosha is dominent so tila taila is vatahara in nature

(indications and contra indications of snehana)


by: Dr.Rimin Razak.
Ref:Panchakarma texts.

KERALIYA PANCHAKARMA- TREATMENTS IN AYURVEDA

PANCHAKARMA CHIKITSA/TREATMENTS IN AYURVEDA

Ayurveda treatments comprises of two major parts,Samshodhana Chikitsa (Bio cleansing therapy) and Samshamana Chikitsa (Pacifying Therapy).Samshamana Chikitsa consist of conservative treatment like Langhana,Pachana, drug administration etc.Samshodhana Chikitsa  envisages Pancha karma treatment which is basically a Bio-cleansing regimen indented to eliminate the toxic element from the body and thereby enhances the immunity of the body.Samshodhana Chikitsa is considered superior to Samshamana Chikitsa as the chances for recurrences of the diseases so treated are remote.

Panchakarma increases the acceptability of body to various therapeutic regimens like Rasayana (Rejuvenation) and Vajikarana (Aphrodisiac). Thus Panchakarma therapy is believed to impart radical elimination of diseases causing factors and maintain the equilibrium of  Doshas.

Types :

Five fold measures comprehended as Panchakarma are:

1. Vamana (Therapeutic Emesis)
2. Virechana (Therapeutic Purgation)
3. Anuvasana (Medicated Oil enema)
4. Asthapana (Medicated Decoction Enema)
5. Nasya (Nasal Insufflations) [ref: C.S Kalpa sthana,S.S Chiktsa, A.H. Sutra sthana].

Vagbhata in Ashtanga Hridaya has enumerated five types of Samshodhana are:

1. Niruha
2. Vamana
3. Virechana
4. Nasya
5. Rakthamokshana

Prior to these five Pradhana Karma (main procedure), Poorva Karma (pre operative),and Paschat(post operative) Karma has to be done.some of the Poorva Karma are:

• Pachana and Deepana (correct digestion and Ama condition by using digestive or and appetizer medicines)
• Snehana (oleation) and
• Swedana (Sudation).

After the main procedures, Paschat karma a special diet and life regimen is advocated as post operative measures.Pancha karma therapy plays a definite role in the management of disease especially of neuromuscular, rheumatological and gastro intestinal origin.In addition to this Panchakarma procedures are utilized for the purpose of preservation,maintenance and conservation of health and the promotion of longevity.
Based on Ayurvedic principles and own experiences,the Ayurveda Scholars in South India have modified certain procedures according to Dosha,Prakriti, Kala/season and found them effective.Later these got popularized as Keraliya Panchakarma.some of theses practices are:

• Shashtika shali pinda sweda
• Pizhichil
• Shirovasthi
• Shirodhara
• Shirolepana,etc which will explain later.

These procedures are specialized varieties of Snehana and Swedana which have more nutritive/nourishing effects than bio cleansing or depleting effects.
Before administering of Panchakarma procedures,one must carefully select,assess and prepare the patient explaining all the procedures to be followed.The doses of drugs,vegas/urges and frequency of procedures may vary according to the condition of the patient and severity of the diseases.While undergoing the procedures,it is duty of the physician to asses the patient's strengths,Constitution,age,diseases stage and other relevant factors.(ref A.H.Su)
The Samshodhana Chikitsa of Ayurveda,which include Panchakarma treatment,basically indent to eliminate the toxic elements from the body and thereby enhanced the immunity of the body.The toxic products of the body metabolism can be broadly divided into water soluble,fat soluble and volatile substances.the volatile substances like carbon dioxide can easily be removed from the body through the lung.While there are number of mechanisms available to get rid of the water soluble toxic materials through Kidney,Sweat and other body secretions, removal of fat soluble toxic material is very difficult and only liver can play a small role.Hence it is likely that there would be accumulation of fat soluble toxic products in the body.Liberal use of oil and ghee in various Panchakarma procedures makes it possible to eliminate these toxic products.In modern day medicines ,we can see that molecules moves from higher concentration to lower when separated by a diffusion membrane.The skin and the mucous membrane provide an excellent opportunity for this maneuver.While skin of an average adult provides a surface area of less than 2 sqr mm,the gastro intestinal tract is many meters long with highly permeable mucous membrane.The mucous membrane of the gut has many folds and projections in the form of villi and micro villi,which helps to increase the total exchange area.Various Panchakarma procedures like Vamana,Virechana,and Anuvasana use oil liberally,thereby removing toxic fat soluble waste materials.Prior to the Pradhana Karma,Poorva karma ie,Bahya Snehana (External Oleation) and Sarvanga Swedana(Whole body Sudation) are given to the patient.These procedures further helps in removing toxic materials from the body.Swedana procedures using hot steam increases the local skin blood flow there by enhancing the exchange process.It is known that the fat soluble toxic substances are stored in the body fat.Fat in the body is largely located below the skin and inside abdomen around the mesentry of the gut.During various procedures exposure of skin and gut mucous membrane to a quantity of oil seems to be logical and ideal procedures.repetition of these procedures over several days will largely remove the toxic wastes by concentration gradient.The Ayurvedic medicines added to the oil might give additional benefits.
One of the important features of these procedures is the safety and easiness  by which these can be administered without any major side effects(if done properly). In Ayurveda practice of Panchakarma, Dosha (humoral factors), Prakriti (body constitution), Kala (season), drug availability etc are always prime concern.

Scope of Panchakarma:

 The important aims and objectives are:

1. Curative approach
2. Preventive approach
3. Promotive approach
4. Preparatory approach
5. Vishahara/toxicology etc

By:Dr.Rimin Razak

Ref: practical hand book of panchakarma.

Treatments In Ayurveda

TREATMENTS IN AYURVEDA

Ayurveda is not only a science only to treat patients but also it is a wast science that taught people to meaning of nature,life etc.so it is considered as the science of life or science of nature.In Ayurveda treatment is mainly divided into shodhana and Samana chikitsa.

Treatment concepts:

The Ayurveda medicines are for the prevention and therapeutic purposes.its main aim is preservation of health for Swastha/healthy peoples and treat to cure the diseased people using method that suitable to nature.basically Ayurveda and its treatments depend upon some principles or theories like Panchamahabhootha theory, tri-dosha theory etc. it is probably the only branch of medicine that lays more stress on preventive rather than curative medicines.According to Ayurveda another main concept about treatment is the removal of causative factors and stoppage of manifestation of disease is considered as treatment.
 there are many approaches to diseases in Ayurveda as there are lots of disease exist.even though Ayurveda mainly categorized treatments into

• Preventive Medicine
• Curative medicine(Samana therapy and sodhana therapy)
• Rasayana and vajeekarana therapy(rejuvenation therapy).

Preventive:

Here give more importance to the physical,mental and spiritual well being of an individual.their are certain life style modifications and food habits that help to person to maintain the health.these modifications are laid down according to the season and condition of the individual as all the human being are different according to tri dosha concept and prakriti of that particular person.As the season is one of the factor that changes the human body normalcy, so in Ayurveda by bringing about some modifications like periodic cleansing(shodhana) of the body through panchakarma,and some other methods like yoga and other seasonal therapies,can cure any diseases and also can prevent from disease.these will help the body to detoxify and prevent any illness.

Curative Therapy:

it mainly focuses about treat existing problems and give long lasting relieve without any complications and negative effect.here we consider the above mentioned Shodhana and Samana chikitsa.

Samana Chikitsa/Treatment:(Curative)
This method is considered when the derangement of dosha,and disease is mild to moderate.it includes various drugs that are administered to patients to bring down the deranged doshas.these is the choice of the patient where panchakarma is not advised,or persons who cannot follow strict rules of diet and lifestyle that need to be followed for few days during and after Shodhana chikitsa/panchakarma treatment.When the samana is done recurrence of chances are more.this type of disease are advised for the patients that re weak,child,old,psychologically unwell.

Shodhana Chikitsa/Treatments:(Purification)
When the doshas are in highly provoked stage and the patient is physically and mentally fit it shall be done.It means removal of excess doshas in the body that causes diseases by means of Panchakarma.(Pancha means five,karma means therapies)they are

1. Vamana (Artificially induced vomiting to cure diseases excess kapha)
2. Virechana (purgation to cure pitta aggravated diseases)
3. Vasthi (medicated enema used predominantly to treat diseases caused  by vaata)
4. Nasyam (medicines administered through nasal roots for diseases above shoulder)
5. Raktha detoxification of the blood (blood letting done either with the help of leches or with other methods)

While doing these type of therapy it is mandatory to do POORVA KARMA(pre operative) and PASCHAT KARMA(post operative)while doing these need to be undertaken with lots of care.If it is done correctly it will give fast relieve from the symptoms but would provide hazardous if done incorrectly.and before and after Panchakarma patient has to follow strict diet and lifestyle advised by the physician for few days before and after the therapy.

Rejuvenation treatments:

It is a type of diseases mainly indicates for the mind health and body health.this type of treatments used for the conditions like after diseases,after purification therapy,because after all these the Satwaguna or strength of the body and mind of the patient reduced.so this treatment help to regain the power.it also advice for weak patients etc.it also include Rasayana (rejuvenation) and vajeekarana(fertility treatment) etc..

Other treatment types:

• Santarpana and Apatarpana Chikitsa.
• Rasayana-Vajikarana type
• Daiva vyapasraya,Yuktivyapasraya,Satvavajaya,etc

By: Dr.Rimin Razak

Plantar Fascitis and its Ayurveda Management

PLANTAR FASCIITIS AND ITS AYURVEDA MANAGEMENT

Plantar Fasciitis is a painful inflammatory process of the plantar fascia ,the connective tissue on the sole of the foot. The plantar fascia is a thick fibrous band of connective tissue originating on the bottom surface of the calcaneus (heel bone) and extending along the sole of the foot towards the toes. It supports the arch of the foot.  The most common causes of the heel pain is the inflammation of this area. Main causes are overuse of the plantar fascia or arch tendon of the foot.by the over strain of the plantar fascia, it gets weak ,swollen and inflamed. Sometimes small tears may also be occur and this will causes the severe pain. The pain is mainly seen in the anterior part of the calcaneous. Commonly seen in middle aged peoples however pain also occur in younger people whose are on their feet a lot. It can also be termed as "policeman's heel".

Causes of Plantar Fasciitis: 

It is mainly caused by over straining of the Plantar Fascia. The straining may occur in different ways and its finally lead to inflammation, pain, swelling etc.

• Flat foot.
• calcaneal spur.
• Over straining like long walk, running etc. especially on hard surface.
• Bare foot walk.
• Feet roll inward too much while walking.
• Over weight.
• Improper shoes,
• High heeled foot wears.
• Weak calf muscles etc.

Panchamahabhootha concepts in Ayurveda

PANCHA-MAHABHOOTHA THEORY OR CONCEPT OF PANCHA-MAHABHOOTHA IN AYURVEDA

In Ayurveda it is said that component and functioning of the nature is similar to human body components and its functions.Ayurveda is based on the principle that the human body is made up of five basic element such as “Panchamahabhootha”, namely, Prithvi (earth),Aap (water), Theja (fire), Vayu (air) and Akasha (space). According to Ayurveda not the human body itself,but the whole creatures in the world(living or non-living) are brought into existence with composition of Panchamahabhootha or these five elements such as prithvi,aap etc.all these materials are composed of panchamahabhootha not in a same proportion.These Panchamahabhoothas are the establishment materiel of all the existing material in the universe.not the materials itself tridoshas also made up of these panchamahabhootha.
The ancient Ayurveda text, charaka says that ,"man is the epitome of the universe.within the man.there is as much diversity as in the world out side.similarly the out side world is as diverse as human beings themselves."

Origin of Panchamahabhootha??

these five elements originates from the concept of Pancha(five) tanmatra according to Ayurveda. these five tanmatra unite to form pancha mahabhootha.each element is a combination of all the five tanmatra,but shows predominance of any one Tanmatra because the combination of these five tanmatra in panchamahabhootha are different.These Pancha Tanmatra are

• Sabda(Sound)-Aakasha mahabhootha
• Sparsha(Touch)- Vayu mahabhootha
• Roopa (Vision)- Tejo mahabhootha
• Rasa (Taste)- Aap mahabhootha
• Gandha(Smell)-Prithvi mahabhootha

these are related to each sense organs.the equivalents shown in brackets may not the correct and full implication of these terms.Eg: ordinary water does not contain jala mahabhootha alone.it is composed of all the five.these five elements are  to be understood in material sense as well as a subtle sense.
in Ayurveda/veda it is clearly mentioned the origin of the universe and so panchamahabhootha also. According to these the universe originates first from AVYAKTHA(may be god or some power as from Veda)gradually it brought in to existence to MAHAN(soul),then AHANKARA (ego)and step by step PANCHATANMATRA, and then PANCHAMAHABHOOTHA.the group of all these creations is known as life.All living are came into their existence in this order but the ration of these things differs creature to creature.

Panchamahabhootha concept in treatment:

According to Ayurveda all doshas,medicines,instruments,human body,food items,are made up of panchamahabhootha.so they are all the substitute for each other.the proportion of mahabhootha fluctuate in these things.so maintaining the normalcy in human body with materials like food,medicine etc are the treatment principle.

Materials and there Qualities like shape,taste etc may vary.but the the overall panchamhabhootha quality will not vary for a substance in any circumstances.this also helps in treatments.

 The panchamahabhootha theory may sound simplistic,but actually it is a very sophisticated method for classifying thing and understanding them.it helps to classifying the things,season,diseases,etc.fro example the human life cycle is divided into childhood,where physical growth takes place (water and earth predominant-kappa),adulthood where activity and change occur(fore-pitta dosha),and old age where body begins to weak (space and air_vata dosha)the year is divided into four seasons Winter (cold and rainy Water and earth predominant),Spring(new growth occurs(water and fir),Summer(hot and dry-for and air),Autumn when it is windy and cool(air and space.)
understood and Applied correctly,about panchamahabhootha concept help as a powerful analytical tool provide for internal (mind) and external assessment.

Characteristics of Panchamahabhootha:

1.Prithvi Mahabhootha (Earth):

represent the solid state of matter in the planet and living things.it related to all solid and hard structures that show shape.The human body consist of bones ,teeth,ceells,etc as the manifestation of the earth.it is  regareded as a stable substances.it is responsible for giving structure,shape and strength to the body.

it is eternal,tanmatra of prithvi is Gandha(smell).the small particles of the earth are scattered to environment and give the sense of smell.

sensory organ: Nose.

Features: heavy,dull,dense,hard etc

Examples: fried foods,chees,etc

intake:increase heaviness,stability,obesity,and solidity in the body.

2.Akaasha Mahabhootha (Ether/Space):

Qualities:soft,light,subtle and abundant.

Action:provides room,looseness,etc.

Facilitates:Sound and nonresistence

substances:anything that is light,profuse and ethereal.

Example:hollow and light foods.

Intake:increase softness and lightness in the body.

tanmatra of the element:Sabda(sound).

 the sense organ predominant of aakasha bhootha is EAR.

it is described as space,in which everything happens.All matter exist in space.it is the distance that separates matter.it is everything and touches every thing.it is receptivity and non-resistance to what-is true.talking about the human body,space is considered as the vessel that receive all impressions.in the heart it is believed that space accepts love.

3.Vayu Mahabhootha(Air):

Qualities:Weightless,mobile,cool,dry,porous etc.

Action:motion or movement,evaporation and dryness.

Facilitates:touch and vibration.

Substances:dry and airy,or that creates gas.

Example:toast,cookies,etc

Intake:increase cool,dryness,movement and circulation.

Tanmatra of Vayu bhootha: Sparsha(Touch)

the sensory organ related to Vayu is Skin.

 Air element keeps the body in constant motion.

it is mobile and dynamic.within the human body it is represent as oxygen.existent without form,air is the per-requisites to fire to burn.talking about the human body air is indirectly required to produce energy

4.Tejo Mahabhootha (fire):

it has the power to change state of any substances.in human body fire is present in the form of energy that binds together ,converts food etc.it creates impulses of nervous reaction,brain functions and hormonal functions.

 Qualities:hot,sharp,dry,subtle,weightless and rough.

Action:radiation of heat and light.

Facilitates: form,colour,and temperature.

Substance:anything combustible and spicy.

Example:chillies,pepper etc.

Tanmatra of Tejo bhootha: Rupa(Vision).

Sense organ: Eye.

5.Aap (water):

Qualities:oily,moist,cool,soft,and sticky.

Attribute:cohesion,lubrication.

Facilitates:fluidity and taste.

Substance:anything liquid,fluid or watery.

Example:drinks,water 

Tanmatra of Aap bhootha: Rasa (Taste).

Sense organ:tongue.

water shows important Quality of binding.this element is a constructive force.

about 70% of the body combined of water,it is important to function all the processes.in human body also included in blood,lymph.cells etc.has functions like temperature regulation.

By Dr.Rimin Razak

Ref:Ayurveda medical books,etc.

KAPHA DOSHA ACCORDING TO TRI-DOSHA CONCEPTS IN AYURVEDA

KAPHA DOSHA ACCORDING TO TRI-DOSHA CONCEPTS IN AYURVEDA

Kapha dosha is a combination of aap(water) and Prithvi (earth) according to Ayurveda panchamahabhootha concepts.it provides stability,strength and Resistance to diseases.it is the basis for the structural integrity of human body.it has the meaning in Ayurveda like to embrace or to keep together.

Physical Properties:

Colour- whitish and transparent.

Taste- madhura when it is well formed and lavana not well formed.

Touch-soft,Snigdhata or unctuousness etc.

Consistency- sthira and sandra.

other-guru manda etc

Location:

it is present in chest, throat, head, sinuses,joints,cytoplasm,rasa dhathu,mamsa dhathu,medo,majja and sukra dhathu, heart,amasaya,jihwa etc.

Special seat:

Uras/ chest.

amasaya/stomach according to susurtha.

Normal Functions:

Physiological-

confess softness to the body.

binds or keeps together various structures of the body including joins and jiva paramanus. confers stability ,firmness and steadiness through weight and bulk. confess strength to perform weight and resistance to increase and decrease.confers sexual stamina and productivity including growth.promotes healing process and tissue building.

Psychological:

memory,intelligence,interest(utsaha),etc

Types of Kapha dhathu:

they are subdivided into 5-

1. Avalambaka kapha
2. Kledaka kapha
3. Tarpaka kapha
4. Bodhaka kapha
5. Sleshaka kapha

1-Avalambaka Kapha:

Location- chest,
functions-supports Trika by its inherent power supports hrdaya.by its power of anna rasa supports other kapha sthanas/locations by virtue of the ambu rasa.

2-Kledaka kapha:

Location-Amasayaa/ stomach
Functions- Disintegration and liquefaction of food in amasaya.Benefits the remaining kapha sthanas. cooling property countering the heat of pitta dosha,protecting amasaya.

3-Bodhaka kapha:

Location -jihwa(tongue) and kanda (throat)
Functions- taste perception.

4-Tarpaka kapha:

Location-head
Functions-nourishes and smooth ens the sense organs situated in brain.

5-Sleshaka kapha:

Location-in joints
Functions-keep joints firm and lubricated.

Abnormal Functions of Kapha Dosha:

Abnormal functions arise due to derangement of normal functions of kapha by use of mityahara/improper food habits and other activities.
some of they are Whiteness,coldness,itching,heaviness,stiffness,oiliness,hardness,numbness,feeling of being sweetness, laziness etc.

Pathopysiology of Kaphaja Diseases:

in all the kaphaja type of diseases enumerated or implied,the inherent natural qualities and actions of kapha are  quite obviously manifested fully or partially.Unctuousness, coolness,whiteness,heaviness,sweetness,steadiness,etc are the inherent qualities of kapha.the natural actions of kapha moving from one part of the body to the other are whiteness,upadeha(act of being covered with bodily excreta),stickiness etc.
Numbness is described as the both action of kapha and vata..

General principles of treatments for kaphaja diseases:

it should be treated with drugs having pungent,bitter,astringent,sharp,hot and unctuous qualities and by such Ayurveda treatments like fomentation,ememsis,elimination of doshas from the head,nasya,exercise ,etc.which should all contain materials like having anti-kapha properties.this is of course to be done with due regard to the dosage and seasons.of all the therapies stated above ,emetic therapy is treatment par excellence for the cure of diseases due to kapha because immediately after entering the stomach,it strike at every root causes of the vitiation of kapha and when it is overcome in the stomach ,even the entire vitiated kapha dwelling in other parts of the body is automatically alleviated.this can be likened to the withering away of paddy,barley etc. for want of barriers of the cornfield (full of water)being broken.{ref-C.S}

Kapha prakriti people:

according to Ayurveda some the living being are categorized under kapha prakriti people as like vata prakriti and pitta prakriti with some particular characteristics.

kapha predominant people are calm and steady,but once they get angry it will be difficult to calm down.these peoples are considered as relaxed ,slow [laced affectionate and living,forgiving,compassionate,reliable,and faithful and they strive to maintain harmony and peace in their surroundings.they may have soft hair and skin.their voice may be low and soft.the have poor appetite.due to low agni.they have slow learning quality and once they learned something will not forget easily.and will have out standing long term memory.

they have well developed body parts.chests are expanded and broad.the veins tendons of these people are not oblivious.have fair and bright complexion with soft lustrous and oily skin.hair is thick,soft,eyes are dense black or blue in colour.neck is solid type.nose is large and rounded,attractive.they crave for pungent,bitter and astringent foods.

 

by Dr.Rimin Razak
ref:some of Ayurveda ref

HEEL PAIN OR CALCANEAL SPUR AND ITS AYURVEDA TREATMENTS IN KERALA

CALCANEAL SPUR/ HEEL PAIN (VATAKANTAKA) AND ITS AYURVEDA TREATMENTS in KERALA

The most common form of heel pain is mainly due to calcaneal spur. it is one of the most troublesome common health complaint usually affects badly peoples routine work, and once it is manifested very difficult

for the body to heal. a large percentage of people suffer from this disease.this is most often seen in the patients over the age of 35 years. Many surveys tell that women are the common sufferer. it may be due to the use of high heeled foot wear and over weight.
Calcaneum is the name for the heel bone, and spur means tiny projections.pain caused by this thickness at the heel is called as heel spur. actually the pain is not caused by the deranged bone but the inflamed soft tissue causes the pain. Calcaneal spur is as small osteophyte projections located on the calcaneum.it is not an acute disease that manifest suddenly. it occurs due to gradual changes on that region.
Calcaneal spur is mainly seen in two region inferior calcaneal spur and posterior one.Inferior one is located on the inferior aspect of the calcaneum and is typically a response to Plantar Fascitis over a period but may also be associated with Ankylosing spondylitis.An inferior spur consist of a calcification of the calcaneum,which lies superior to the plantar fascia at the insertion of  plantar fascia.it something like an hook shaped one.

Eight main causes of Heel Pain

EIGHT CAUSES OF HEEL PAIN

There are many form of foot pain experienced in my clinical practice, from these heel can be one of the most troubling one. usually pain in the heel is a common symptoms found in clinical practice especially for the patients who had age over 40yrs more on females.

pain in the heel can be classified into 3 according to the location of the pain.1.pain within the heel,2.pain behind the heel, 3-pain beneath the heel.

cause of these three types of pain are different.while a patient coming with a pain over heel,then should understand the exact location and cause, then only a physician can manage the disease.

CERVICAL SPONDYLOSIS AND ITS AYURVEDA MANAGEMENT

CERVICAL SPONDYLOSIS

Spondylosis is a term meaning to degenerative Osteo Arthritis of the

joints between the centre of the spinal vertebrae and or neural foramina
resulting pain paraesthesia etc. If it is occurs on cervical vertebrae it is called Cervical spondylosis. So this is a diseases of elderly (more than 40 years) where there is degeneration of the apophyseal joints and inter-vertebral disc joints with osteophyte formation and associated with or without neurological signs.

PATHOLOGY:

With the progressing of age in the spine disc gradually breakdown and degeneration occurs. As the age advances disc begins to loses its water content, elasticity begins to weakens and age related wear and tear affecting the cervical vertebrae, cause settling and collapse of the disc space and loss of the disc space height.

As the facet joint experiences increased pressure they also begins to degenerate and develops arthritis. Resulting in bone rubbing. for this mechanism body develops some preventing measures as a result growing new bones in facet joins to help support, further result as spur. It may narrow space between the vertebrae (stenosis). Due to age and some other factors brings down the calcification leading to extra bone formation known as osteophytes.
Due to trauma, pressure etc some factors like intra vertebral disc herniation may also result to cause this disease.

INTRA VERTEBRAL DISC HERNIATION:

The disc are made up of two concentric layers, The inner gel like annulus pulposes and outer annulus fibroses. As a result of advancing age and other precipitating causes the nucleus loses fluid volume and resulting the entire disc structure become more susceptible to trauma compression (dehydration of the disc). The disc is then highly vulnerable to tears and wears. As a results inner annulus pulposes protrudes thereby fibrosis layer produce bulges in the disc (herniated disc) cause compression to the spinal cord and nerve root. When space narrows compression of nerve root emerging from spinal nerve may result radiculopathy (sensory and motor disturbances), direct pressure on the spinal cord may result myelopathy, weakness,  gait disturbances, loss of bowel and bladder control. May experience phenomena of numbness or burning sensation on hand and legs.

CAUSES and  AGGRAVATING FACTORS:

• Trauma
• Incorrect posture while sleeping and working.
• Excess intake of sour and spicy food- cause to early degeneration.
• Genetically
• Smoking- tends to increase the disease and other symptoms.
• Occupational- reduced physical activity, sedentary habit, stress,
• Repetitive strain injury (RSI)- caused due to lifestyle without ergonomic care (while working in front of  computer), travelling, etc.
• Age. 
• Cold food, direct exposure of wind, heavy meal at night time, heavy exercise, use of improper pillow, lack of sleep at night and sleeping during day time, etc may aggravate the condition.