Ayurveda, science of life as it literally means, is the Indian System of Medical treatment. Like many other the knowledge systems of lndia it has got wider scope . than what it is dealt with .Ayurveda deals with everything related to life. Life is conceived as a conglomeration of body, mind, five senses and atma‘. Diseases aiTect both body and mind which are inseparable. The function of the body during health and disease is explained by the doctrine of tridésha. Body is maintained by these three basic functional units. As recognized by all the philosophical schools of India, the material basis of the substances is the five bhutas. The composition of doshas is also pancabhat‘ithic which denotes its structural nature. Disease is due to the vitiation of the doshas. They may exhibit an excess of functions or the opposite which is reflected as various signs and symptoms.
To treat the disease the cause is to be analysed. Basic causes are asamyagyoga of kala artha and karma i.e. erratic seasons, non-congenial uses of five senses and non—congenial activities“.
There are well defined seasons (kala) for each geographical area. These show definite manifestations in the environment in the stipulated time (samayakyoga). Body can adjust to these changes accordingly. Any variations beyond certain limits (asamyakyoga) can cause changes in the body affecting its normal functioning. Lesser manifestations of a season is hinayega. If a season shows higher levels of its presence it is atiyoga. In some occasions a season may appear in undue periods of a year. This is called mithyayoga. So there are three forms of asamygyoga.
Perception with the five cognitive senses (indriyas) also has certain limits both in upper and lower levels. Over use of a sense is atiyoga i.e. viewing computers for a very long period. Less use is (hinayoga) also morbid factor. Example for perverted use of a sense (mithy'ayoga) is viewing through microscope very long period of time. These are the asamykyoga of artha.
Activities (karma) with body mind and also of speech are also important in the context of causative factors of diseases. These also should be of moderate. Anything in excess (exerting too much) with body mind and speaking without enough break are the atiyoga of karma. Similarly lesser activity (hinayoga) may also cause illnesses.
The identification of the disease is done mainly by analyzing the causative factors (nidana‘ and symptomotology. Ayurveda recognizes two types of symptoms. Prodromal symptoms (purvarupa are manifested earlier, followed by the well defined signs and symptoms (lakshana). These are mos important in diagnosis. Aggravating and relieving factors are another tool (upasaya and anupa’saya From all of these the genesis of the disease (samprapti) can be inferreds.
Arresting the disease process is, of prime importance in the management of the illness.
This is achieved by avoiding the causative factors. Simultaneously, administering the food activities and medicine opposite in qualities of the causative factors is also to be done. This is the basic principle of treatment. To be opposite to the causative factors of the disease, total correction may be needed in the life Style. This is achieved through modified ahara (food) and vihara (activities). This in total is called pathya. Pathya literally means that which is not deviated from the path of health‘. The likes and dislikes of the patient is also to be considered while formulating pathya and apathya. Nowadays We often hear about life style disorders. For Ayurveda, each and every disease is life style disorder. The Western system of Medicine more concentrated on a single causative factor failed to address several health problems and recently found that the cause especially in non infectious diseases, is in the way one lives. Hence the term life style disorder. But in fact, it can be seen that even in infectious diseases, life style is the main culprit. So the role of pathya is to be emphasized much in this context. Pathya enables the medicine to deliver a positive effect in the body.
Specialization has been prevalent since the very early periods of Ayurveda". Kayacikitsa is the treatment of diseases affecting the whole body. Balacikitsa is childcare. Manasaroga cikitsa is the treatment modalities for mental afflictions. Urdhvangacikitsa consists of the methods for the cure of diseases of structures above neck i.e. throat mouth tooth nose eyes and head. Salyacikitsa is the surgical school in Ayurveda. The diseases pertaining to this branch are piles, anal fistula, calculus of urinary system etc. Traumatic conditions affecting bones and other structures also come under the purview of Salayacikitsa. Agadatnatra or Vishachikitsa is Ayurvcdic toxicology. Poisoning can be from both animate and vegetable origin. It needs specific remedies and emergency management. Rasayana is rejuvenation therapy. It delays ageing process or minimizes its effects. Vajikarana is intended as a cure to infertility. These are the eight clinical branches of Ayurveda. It is interesting to note how all these branches adapt the same treatment principles to suit to the different clinical conditions concerned.
Treatment is actually a team work under the leadership of the bhishak (physician). Others in the team are paricaraka (attendant) and rogi (patient)’. With Dravya (drug) added to this team it is called padacatushtaya. Physician is the leader who compensates if any other pada missing or lacks in quality. The qualities required for each of the pada, is mentioned in the classical texts in detail. It is noteworthy that Ayurveda recognizes the patient with a significant role in the execution of the total treatment. Even in decision making, implementing the treatment protocols, assessing the therapeutic effect, the patient does have a role.
Several forms of medication (kalpa or kalpana) are used in Ayurveda. Fresh extracts (svarasa), powder (cums), pills (gutika), chewable (léhya), dccoction (kashaya or kwadha), infusion (phanta) medicated ghee and oil (ghrta and taila), and alcoholic preparations (arishta and asava) are the main examples. These are chosen in accordance to the disease, site of illness etc. Somekalpas enable preservation and easiness in handling and administration.
Treatment is administrated internally and externally. Oil bath (abhyanga), poulticcs (upanaha and lepa) massage (samvahana), sudation (swédana) are/some of the external modalities.
Elimination (sodhana) is special therapeutic procedure. The vitiated morbid factors are eliminated through natural orifices by administrating specific medicines. These need strict supervision and monitoring. Emesis (vamana), purgation (virécana), oily enema (snéhavasti), non oily enema (niri‘iha), nasal instillation (nasya) is the modalities of elimination. These are also known by the term pancakarma. This is a specialized area of Ayurveda. The eligibility (arhata) of the patient should be strictly assessed before administering pancakarma. Strict regimen is also important while undergoing pancakarma. Otherwise there are chances of complications. Cure to the core and prevention of recurrence validates the efficacy of sodhana than any other modality.
The counterpart of sédhana is called éamana. In this modality medicines are given orally.
Treatment is classified severally. Sodhana and samana are mentioned earlier. In a three fold classification, yuktivyapasraya daivavyapasraya and satvavajaya are included9. The first one is the logical rational approach where the response of the body can be well understood or explained Daivavyapasraya makes use the cultural environment of the patient and the society in the management of the disease. In satvavajaya mode patient is instilled with more will—power and self—control so that he turns away from the life style that harms the body. This is relevant both in physical and psychological illnesses.
Individualization of the treatment is made possible by observing and interpreting the constitutional features, habits, likes and dislikes and other personal traits of the patient under consideration. These can be well incorporated into treatment.
The responsibility of the physician is not limited to the cure of the illness but he has to give advises on the prevention of recurrence of the disease”. The pathway of the vitiated doshas inside the body, causing genesis of the disease demarked even when the doshas are pacified. Hence the recurrence is possibility for each and every disease. To avoid the recurrence modified life style and medicines in lower doses may be necessary.
Ayurveda has got its own limitations also. Severe infections will not respond well to Ayurvedic medicines. Emergency management is lacking. The tradition of surgery is lost irrecoverably. Terminal diseases are also a problem. But in these situations also, there is certain scope for Ayuveda. Recurrence of infections may be prevented; there is possibility of medical management in surgical cases. Scope of post surgical care may be explored. Palliative can be given to terminal cases with Ayurvedic medicines.
Holistic principles of Ayurveda give an individualistic approach in treatment. This system is a part of our culture. The adverse effects are very less with Ayurvedic medicines. The chance 01 recurrence is also remote with Ayurvedic treatment. There is a health oriented Vision in Ayurveda.
