A CASE STUDY ON PRIMARY OPEN ANGLE GLAUCOMA

PERSONAL DATA
w NAME: MR. R. VENKATRAMANI
w SEX:MALE
w AGE:63
w OCCUPATION: RETIRED BANK OFFICIAL
PRADHANA VEDHANA
w REDNESS,
w WATERING OF EYES,
w PAIN (OCCASIONALLY, BUT INTENSE)
w GRITTINESS IN EYES(PAMSHU POORNABHAM),
w LACK OF PROPER VISION SINCE 3 YEARS
ANUBHANDHA VEDANA
w FREQUENT ALLERGIC EPISODES
w OCCASIONAL PAIN IN LEGS
w DISTURBED SLEEP
w ANXIETY
w BRONCHIAL ASTHMATIC
PERSONAL HISTORY
w FOOD HABBITS- VEGETARIAN, FOND OF MADHURA, KATU RASA, FRIED ITEMS
w NON ALCHOHOLIC, NO SMOKING HISTORY
w SLEEP- DISTURBED
w STATUS- MARRIED, DEPENDENT
w NO RELAVANT FAMILY HISTORY WAS OBSERVED
HISTORY OF PAST ILLNESS
n 11 YEARS- SUFFERED FROM HEAD INJURY
n 30 YRS- HAD A MAJOR ACCIDENT AND MALLEOLUS WAS REMOVED FROM THE RIGHT LIMB.
n 44YRS- VIPER BITE( ANTI VENOM WAS GIVEN)
n 48YRS- B/L HYDROCELE OPERATION WAS PERFORMED
n SUFFERING FROM BRONCHIAL ASTHMA SINCE 10 YRS
n ALLERGIC TO PENCILLIN
n ALLERGIC TO SMOKE, DUST AND SOME FOOD ITEMS.
n RECENTLY BEFORE 2 YEARS HAD A DOGBITE AND PROPHYLACTIC MEASURES WERE TAKEN
OPTHALMIC HISTORY
DEGENERATIVE PROGRESSIVE MYOPIA
IN 1984 LEFT EYE CATARACT WAS DONE- A FAILURE, AND RESULTING IN COMPLETE LOSS OF VISION DUE TO IATROGENIC REASONS.
IN 1990 CATARACT OPERATION CARRIED OUT IN RIGHT EYE

n IN 1998- SYMPTOMS OF GLAUCOMA WERE PRESENTED AND WAS DIAGNOSED AS POAG, AND OPERATION WAS ATTEMPTED WITHOUT SUCCESS, RESULTANT VISION BEING 2/60
n IN 2005 ANTI GLAUCOMA OPERATION (TRABECULOTOMY ) WAS DONE SUCCESSFULLY, RESULTANT VISION -1/60
n UNDER CONTINUOUS TREATMENT OF PILOCARPINE DROPS TO MAINTAIN IOP
n IOP BEFORE AND AFTER OPERATION ARE 29 AND 19 mm OF Hg RESPECTIVELY.
AKSHI PAREEKSHA
n VARTHMA- STHANIKA, PRAKRUTHA
LACRIMAL GLANDS AND DUCT ARE NORMAL AND PATENT
n SUKLA MANDALA- A CYST ( WHITE ) IN COLOUR WAS SEEN OVER THE SCLERA OF RIGHT EYE, THE EXACT NATURE OF THE CYST WAS UNKNOWN, THE OPTHAMOLOGIST HAVE OPINED THAT , THIS CYST IS A COMPENSATORY MECHANISM FOR HIGHER IOP.
n KRSHNA MANDALA- BILATERALLY BOTH EYES ARE APHAKIC( ABSENCE OF LENS)
n THARA MANDALAM- DIMINISHED PUPILARY REFLEX TO LIGHT, BLACK IN COLOUR
n DRSTI MANDALA- IN LEFT EYE NO VISUAL ACTIVITY, IN RIGHT EYE VERY MINIMAL VISUAL ACTIVITY
n PAIN, REDNESS, SWELLING OF RIGHT EYE WAS SEEN.
n IOP PRIOR TO 2005 WAS 29 AFTER THAT THE LAST IOP VALUE DURING FEB 2008 WAS 19
n FINGER COUNTING ONLY UPTO 1 FEET B4 TREATMENT.
SAMANYA PAREEKSHA
n JIHVA- DRY
n R.R- 20/MIN
n H.R- 80/MIN
n B.P- 138/88 mm hg
n MALA- NORMAL BOWEL MOVEMENTS,
(2/ DAY) NORMAL CONSISTENCY.
P.R- 78/MIN
WEIGHT- 66 KGS
MOOTRA- D/N -5-6/2
SATWA- PRAVARA.

APPROACH IN AYURVEDA
n THOUGH MOST OF THE SYMPTOMS BORE CLOSE SIMILARTITY WITH KAPHAJA ADHIMANTHA, BUT VATA DOSHA INVOLEVEMENT IS ALSO UNDERSTOOD THROUGH RUJA, CHRONICITY AND OTHER FEATURES. PITHA INVOLVEMENT IS CRUCIAL IN ANY AKSHI VIKARA, AND SAME HOLDS HERE TOO.
n SYMPTOMS ALSO RESEMBLE THOSE OF SA SHOPHA AKSHI PAKA, TIMIRA TOO.
n HENCE RATHER THAN TRYING TO FIND EXACT AYURVEDIC NAME OF THE CASE IT IS BETTER TO ANALYSE THE DOSHA AWASTHA AND UNDERSTAND THE DISEASE.
n DOSHA INVOLVED- KAPHA PRADHANATHAMA, VATHA SECONDARY, AND PITHA ALSO.
n SROTHA- RAKTHA AND RASA
n SROTHO DUSHTI- SANGA AND VIMARGA GAMANA , ATHI PRAVRUTHI.
n ROGA MARGA- MADHYAMA
n SADHAY SADHYAM- YAPYAM
n ROGA AWASTHA- BHEDA
NIDANA PANCHAKAM
n NIDANAM- VIPERBITE, ABHISYANDHI AHARA,
n POORVAROOPA- RAGA DAHADI IN MILDER FORM, PAIN IN FREQUENTLY IN HEAD
n ROOPA- RAGA, SHOTHA, DAHA, RUJA, SRAVA, LOSS OF VISION.
n UPASAYA, ANUPASAYA-MORNING SYMPTOMS ARE MORE, AND AS TIME GOES ON SLIGHTLY BETTER.
n SAMPRAPTHI- NIDANA CAUSES KAPHA DUSHTI, BECAUSE OF SANGA I.E MARGA AVARODHA OCCURRED AND ULTIMATELY PITHA AND RAKTHA BECOMES DUSHITHA RESULTING IN THE ILLNESS.
CHIKITSA
n ON JUNE 2008 WHEN HE WAS FIRST ATTENDED,
HE WAS GIVEN
DHANWANTHARA AND MAHATHIKTHA KASHAYAM IN B.D DOSE IN EMPTY STOMACH( 5ML EACH WITH 30 ML HOT WATER)
LATER DHANWANTHARAM WAS DISCONTINUED,
AMRTHA PRASHA GHRTHAM 5G B.D WITH KSHEERA A/ FOOD
w RUMORID TABLETS- NAGARJUNA PREPARATION CONTAINING, GUGGULU, SHALLAKI, ERANDA, PARADHA, GANDHAKA WAS GIVEN IN 2 B.D DOSE AFTER FOOD
w MANASAMITRAM WAS ALSO ADMINISTERED TO REDUCE ANXIETY AND TO INDUCE GOOD SLEEP. 1 H/S.
w PATIENT WAS INSTRUCTED NOT TO DRINK HUGE AMOUNT OF WATER MORE THAN 1 LTR AT A TIME, AS IT WOULD INCREASE THE IOP!!
AUSHADA NIRNAYA

w MAHA TIKTHAKAM- PREDOMINANTLY KAPHA PITHA SHAMAKA, BRINGS PITHA TO SWASTHANA.
w AMRTHA PRASHA GHRTHAM- ACTION MAINLY IN GAMBHEERA VYADHIS, A VATHA PITHA SHAMAKA, VERY EFFECTIVE FOR ANY CHRONIC CASES.
w RUMORID- NAGARJUNA PATENT- GUGGULU, SHALLAKI, ERANDA, PARADHA, GANDHAKA- SYMPTOMATICALLY TO REDUCE INFLAMATORY SIGNS AND PAIN
w MANASAMITRAM- REDUCES ANXIETY AND INDUCES GOOD SLEEP
TARPANA KARMA
w IT WAS DECIDED TO PROCEED WITH THARPANAM FOR THIS CASE, AS THERE WAS SOME IMPROVEMENT WITH MEDICATION.
w 1ST COURSE OF THARPANAM WAS CARRIED OUT FOR 7 DAYS BETWEEN 20-9-08 TO 27-9-08
w MAHA THRIPHALA GHRTHAM WAS USED
w THE MESSAGE IS THOUGH THE ACTUAL KALA NIRNAYA IS TOLD IN TEXT, ONE HAS TO ASSESS THEM TO FIND OUT EXACTLY WHAT AMOUNT OF TIME IS NEEDED FOR A PARTICULAR PATIENT.
w AFTER THARPANA THE GHRTHAM IS COLLECTED AND WAS ADMINISTERED INTERNALLY AT NIGHT WITH USHNODAKAM.
w A PART OF GHRTHAM WAS USED FOR PADABHYANGAM BEFORE SLEEP
w THEN AFTER A BRIEF PERIOD , SECOND COURSE OF THARPANAM WAS RESUMED FROM 25- 10-08 TO 31-10-08.
w THARPANAM WAS FOLLOWED BY A BRIEF SWEDANAM WITH PICHU AND USHNODAKAM.
PROGRESS
n BEFORE THARPANA
w FINGER COUNTING 1 FEET
w IOP 19 mm of hg
w CYST IN SCLERA
w REDNESS, EPIPHORA,
w BURNING SENSATION
w VISION 1/60
AFTER THARPANA
AFTER 1ST COURSE OF THARPANAM
w FINGER COUNTING UP TO 3 FEET
w REDUCTION IN REDNESS ETC
w THE CYST SPONATEOUSLY
DISAPPEARED, AFTER 10
DAYS FROM THARPANAM.
AFTER 2ND COURSE OF THARPANAM
w IOP 6 mm of hg (remember diurnal
variations are very high in POAG)
w FINGER COUNTING UP TO 5 FEET
w VISION 5/60
w NO REDNESS, BURNING
w SENSATION ETC,
w REDUCTION IN SWELLING OF EYE

INFERENCE
v THUS THROUGH THIS CASE IT COULD BE UNDERSTOOD THAT IN A CASE OF POAG OUR AYURVEDIC THERAPEUTIC MEASURES COULD GIVE BETTER RESULT AND COULD HELP IN PARTIAL RESTORATION OF VISION, IMPORTANTLY IT CAN INFLUENCE THE IOP .
DISCLAIMER
THE MOTIVE OF THIS PRESENTATION IS NOT TO BOAST OFF WITH THE SUCCESS , BUT TO SHARE THE JOY AND TO MAKE OUR FRIENDS TO BELIEVE THAT THEY COULD TAKE AND HANDLE SUCH A CASE IN FUTURE. THIS FORMULA MAY NOT BE WORKING IN ALL CASES, OR EVEN SOME BETTER MEASURES AND MEDICINES COULD HAVE PRODUCED BETTER RESULTS, WE ARE PRESENTING HERE HOW WE UNDERSTOOD AND HOW WE REAPED THE FRUIT.

AYURVEDA AND ITS SIGNIFICANCE

What is ayurveda?

Ayurveda is the oldest system of organized living rather than just a system of medicine. “ ayusho vedaha” , the etymology of ayurveda means “ knowledge of life”. The system is enriched with wise inputs from the great and noble souls who contributed immensely for the ayurveda, and human race as a whole. Its principles and wisdom are time tested and eternal, the gift of ancestral wisdom has been passed on from generations to generations with updated knowledge and is handed over to the present generation.

Origin of ayurveda
Ayurveda is said to be an upaveda ( a subordinary ) of atharva veda. References of various diseases and treatments are mentioned in the oldest book of the world rig veda too. Jwara is menmtioned as takma,and rituals using various herbs are mentioned in the hymns of rigveda itself. Ayurveda is said to be anadhi and anantha and nithya meaning having no origin and no end and its eternal. So there is no exact starting point to ayurveda. Ayurveda deals about understanding nature’s wisdom , hence its older than human beings too. Mythologically speaking, the first acharya of ayurveda was lord brahma, the creator, among the trinity of Indian gods, its by his penance he was illuminated with knowledge of ayurveda. He preached it to lord daksha prajapathi, who passed on the wisdom to the twin physicians of the heaven the two ashwinis, who are known as deva bhisak i.e the physician for the gods , from them it was passed on to lord indra . Later when human race was suffering from various diseases which stood as obstacles to attain the ultimate aim of life, the liberation. The ancient rishis or the sages gathered around the Himalayan region and prayed the god to put an end to the sufferings. Owing to the request of rishis, lord indra taught to the rishis the divine science of life and hence ayurveda came to earth and since then it has been taught to various disciples in guru sishya parampara.

Ayurveda has eight angas in it. Each having its own importance.” Kaya bala graham urdhwanga shalya damstra jara vrushai hi”the eight angas are
1.kaya chikitsa- general medicine
2. bala chikitsa or kumara thanthram or koumara brhthyam- paediatrics
3. graha chikitsa or bhutha vidhya- dealing with paranormal phenomenons, psychiatry.
4. urdhwanga chikitsa or shalkya- dealing with diseases of head and neck.
5.shalya tantra- surgery
6. damstra or agada tantra or visa chikitsa- dealing with animal and plant poisons
7.jara or rasayana tantra- rejuvenation therapy and geriatrics
8. vrusha or vajee karana – aphrodisiac and sexual disorders.
Apart from this, there were other allied branches of ayurveda like vriksha ayurveda which deals with plants , and mriga ayurveda which deals with animals like horse, elephant, cow etc. in mahabharatha nakulan is said to be an expert of haya ayurveda.

Ayurveda has been taught in guru sishya parampara since its inception. Hence it was passed on from generations to generations, without documentation.though there were separate sampradhyas for various angas, but now only two sampradhyas exist , the atreya sampradhaya ,basically deals with kaya chikitsa or general medicine based on charaka and vaghbhatta’s works and dhanwanthari sampradhya who basically deal with surgery based on sushrutha samhitha. Even now in some parts of kerala there are vaidya traditions who are following other branches like visha chikitsa, bala chikitsa, graham chikitsa and akshi chikitsa. Brhat thrayees and lagu thrayees are the important works on ayurveda, brhat thrayee includes charaka samhitha , sushrutha samhitha and ashtanga sangraha(hrdaya). Laghu thrayees include sarangadhara samhitha, bhava praksha, and madhava nidana. There are other important books like bhaisajya rathnavali, yoga rathnakara, basavarajeeyam , sahasra yogam, etc. bhela samhitha, haritha samhitha and kashyapa samhitha are available incompletely. Sushrutha and charaka can be considered as the pioneers of surgery and medicine respectively in the Indian system of medicine. After the invasion of Buddhist ideas were surgery was considered as a type of himsa or torture lead to the advancement of the dormant field of rasa shashthram. Plenty of works were done exclusively on rasa shastram in the time span of 2-14 AD. Nagarjuna acharya is an important contributer for enhancing rasa shastra. Rasarathna samuchaya, rasa tharangini, rasendra sara samgraha or some important works in rasa shastram. Nigantus are the works which deal with various usages , proceesing , preservation , cultivation , and classification of medicinal plants. They contain extensive description including the morphological and pharmaceutical features of plant. Important works includes dhanwanthari nigandu, raja nigantu , shodala nigantu and kaiyadeva nigantu.

Philosophy of ayurveda:
Ayurveda believes in god and considers ultimate aim of life as getting liberation. The principles of ayurveda are deep rooted with various Indian philosophical systems like sankhya, nyaya, yoga, vaiseshika and meemasa darshanas.
Ayurveda strongly believes on pancha mahabhutha theory. Every thing in this materialistic universe is composed of five elements of nature
1.prthvi- compared to earth component
2.ap- compared to water or the liquid component
3.agni- compared to fire component
4.vayu- compared to wind element
5.akasha- compared to space component..
The evolution of universe has been understood by the ancient seers. The chaturvimsathi tatwas or the 24 components show the evolution of universe. Purusha is considered to be the spectator of everything and resides in the body, which is formed of pancha mahabhutas. Chetana or the athma resides inside the body and remains as a spectator of life and remains inside the body as long as the shareeram holds it. Prakrthi and purusha relationship could be understood with this pangu- andha nyaya. Purusha is compared to pangu i.e a lame person who knows were to go and what to do but is unable to carry out the activity since he is lame , he requires a vehicle to do his functions, to carry out his missions, that vehicle which carries the purusha is prakruthi which is compared to blind person who has the ability to move but doesn’t know were to go. Hence purusha and parakrthi together like a blind man carrying lame man in his shoulders only could reach the destination of life.
Satva , rajas , and tamas are called as the trigunas or the maha gunas or ahamkara. Everything in this world is composed of the trigunas. Satva is a state of potential untapped energy state representing balance and spiritual steadiness. Rajas is the state of hyperactivity , a state of kinetic energy , a unsteady and restless behaviour. Tamas a state of exhaustion and dark manifestations. Satva is considered to be uthama and indicates a balanced and poignant state of mind and highly spiritual attitude. Rajas and tamas are considered to be mano doshas , whose imbalance causes disturbance in the mind. The food items also have various combination of the trigunas in them. Hence rajasika and tamasika food have to be avoided to avoid stress, and keep mental health intact. Food items which are hot and spicy like chilly etc are high in rajasika content, nonvegetarian foods, icecreams and junk food items are tamasika in nature . hence these should be avoided.

The concept of three doshas are very important and forms the basis of the ayurvedic treatment. The three doshas are very similair to the humor concept that was put forth by Hippocrates . it could be said that the sushrutha’s four doshas concept was the humor concept of Hippocrates.
Three doshas are
Vatha- component which is possessing the qualities of dryness, movement, lightness, coldness etc and carries out functions like respiration, conduction, locomotion, transportation of various other components of the body.
Pitha – component which is possessing the qualities of hotness, penetrating and sara etc, forms the agneya part of body , carries out functions like digestion, metabolism, vision, and other such functions.
Kapha- component which protects and covers the body , characterized by stability , coldness, heaviness etc and carries out functions like protection, giving nourishment and providing strength etc.
“Vayuhu pitham kaphamscheti trayo doshaha samasathaha…
Thae vikrutha avikrutha deham gnanthi thae varthayanthi cha”
These three doshas are also known by the name tri dhatus – as they support the growth of the body. They are also known as tri sthunas- three pillars of life. The balance between these three doshas is the state of health and any imbalance creates disturbances and causes diseases. These three doshas are not anatomical entities, which can be visualized but physiological components which are having particular characteristic features (gunas) and functions (karmas). These three doshas are nothing but the divinity manifested in the human being, vatha is brahma tatvam pitha is lord maheshwara and sleshma is lord janardhana. Lord shiva is pitha amsham hence he is having soma (moon ) in his head , lord Vishnu is kapha amsam hence he is sleeping in ksheera sagaram (milky ocean). These three doshas are prevalent in various periods of time,
“ vayo aho rathri bhukthanam thae antha Madhya adhigaha kramath”
,eans vatha is predominant in the anthima avastha or the end stage of age,(old age) last part of day and night, last part of digestion. Similairly pitha in middle part and kapha in earlier stages respectively. In body the upper part from head to chest especially chest is the main sthana of kapha, the region between chest and umbilicus forms the main sthana for pitha and below umbilical region is the main sthana for vatha doshas respectively.similairly during various seasons also one or the other dosha dominates and the diseases of that particular doshas dominate during those periods. The trigunas satwa , rajas and tamas and the three doshas of the shareera are closely interrelated. When rajas is getting disturbed it disturbs vatha and pitha and vice versa. Similairly when kapha is disturbed it disturbs tamas and vice versa. Pure kapha form is satvika in nature.

There are seven dhatus in human body namely.
Rasa- the liquid component which is formed as essence of digestion and nourishes
Raktha- shonitha or blood which is essential for living and nourishing
Mamsa- the muscular component which forms the mass and protects the internal organs
Meda- the component of fat, which acts as buffer , and acts as lubricant
Asthi – the skeletal system which gives the basic framework for our body
Majja – that which is filled inside the cavities of bone, compared to marrow
Sukra- the reproductive counterpart which helps in procuring offspring.

Ojus is said to be the sara or the essence of all these seven functional components. It provides strength, stamina and valour to the person. Of these seven dhatus,
Rasa, meda, mamsa, majja, sukra- are kaphamsa
Raktha- pitham
Asthi- vatha. The relationship between the dhatus and doshas is known as ashraya ashrayee sambandha.

MANAGEMENT OF LUMBAR SPONDYLOSIS IN AYURVEDA

• LUMBAR SPONDYLOSIS
  DEFINITION- IT’S A DEGENERATIVE JOINT DISEASE AFFECTING LUMBAR VERTEBRAE AND INTERVERTEBRAL DISCS, CAUSING PAIN, STIFFNESS , SOMETIMES WITH SCIATIC RADIATION DUE TO NERVE ROOT PRESSURE BY ASSOCIATED PROTRUDING DISCS OR OSTEOPHYTES- DORLAND’S DICTIONARY



• CLINICAL FEATURES OF LUMBAR SPONDYLOSIS
  1. LOW BACK ACHE
  2. PAIN RADIATING TO BACK OF THIGH, BUTTOCKS.
  MAY BE SUPER IMPOSED WITH SCIATICA BECAUSE OF ROOT COMPRESSION.
  3. NUMBNESS OF LIMBS.
  4. LOSS OF TOUCH SENSATION.
  5. CONSTIPATION
  6. SOMETIMES HEADACHE
  7. MUSCLE WEAKNESS, TINGLING
  8. MORNING STIFFNESS MAY BE PRESENT
  9. PAIN INCREASES BY CHANGING POSTURES AND MOVEMENTS LIKE BENDING ETC
  
  INVESTIGATIONS & DIAGNOSTIC MEASURES
  1. RADIOLOGICAL- X-RAY
  2. MRI, CT IMAGING
  3. DISCOGRAPHY
  AYURVEDIC CONCEPT
  l KATI OR LUMBAR REGION IS VATA SITE ACC TO AYURVEDA’
  l AT THE SAME TIME JOINTS ARE SITE OF SLESHAKA SLESHMA(KAPHA).
  l BECAUSE OF NIDANAS( CAUSES) VATHA AGGRAVATION OCURS IN KAPHA STHANAM AND BECAUSE OF THE INCREASE IN RUKSHA GUNA(QUALITY OF DRYNESS) , THE DEHYDRATION OF THE DISC BEGINS, INITIATING THE SCLEROSIS AND WHEN UNINTERVENED THE CONDITION PROGRESSES TO OTHER LEVELS, SUCH AS BULGING, HERNIATION, PROLAPSE AND OSTEOPHYTE FORMATION ETC.
  TREATMENT PRINCIPLE
  l THE AIM OF THE TREATMENT IS TO REDUCE THE DRYNESS AND BRING BACK THE SNEHA GUNA, ELASTICITY AND TO REHYDRATE THE DISC , REMOVING THE OSTEOPHYTES, OR THE MALA ROOPA KAPHA.
  l IN SIMPLE TERMS , VATA HARAM AND KAPHA HARAM IN INITIAL STAGES AND BRMHANAM IN LATER STAGES TO NOURISH THE DISC.
  l ITS IMPORTANT TO MAINTAIN AGNI, IN THE PROCESS OF VATA HARAM , KAPHAM SHOULD NOT BE VITIATED. PROPER VATHA ANULOMANAM HAS TO BE ENSURED FOR EFFECTIVE RESULT.
  MANAGEMENT
  l AUSHADAM- MEDICINAL MANAGEMENT
  l STHANIKA CHIKITSA- LOCAL MEASURES
  1.ABHYANGAM-MASSAGE
  2.KATI VASTHI- SNEHANAM
  3. PATRA POTALI- SWEDANAM
  l PANCHA KARMA PROCEDURES
  1.SNEHA VASTI
  2.KASHAYA VASTHI
  l DIET AND YOGA ASANAS, PHYSICAL THERAPY, LIFE STYLE MODIFICATIONS.
  AUSHADHAM- MEDICINES
  l MAHAYOGA RAJA GUGGULU
  l LAKSHADI GUGGULU
  l ABHA GUGGULU
  l YOGA RAJA GUGGULU
  l TRAYODASANGA GUGGULU
  l MAHA RASNADHI KASHAYAM
  l RASNA SAPTHAKAM KASHAYAM
  l RASNA ERANDADI KASHAYAM
  l RASNADI KASHAYAM
  l DHANWANTHARAM KASHAYAM
  l ASHTA VARGAM KASHAYAM
  l VIDARYADI KASHAYAM
  l BALA ARISHTAM
  l ASHWA GANDHARISHTAM
  l VATA GAJANKUSA RASA
  l VAYU GULIKA
  l LASHUNA KSHEERA
  l PRAVALA PISHTI
  l KSHEERABALA 101
  l DHANWANTHARAM 101
  l GANDHA THAILAM
  POPULAR PATENT PRODUCTS
  l RUMALAYA- HIMALAYA
  l SHALLAKI- HIMALAYA
  l LUMBATON- AVN
  l DAZZLE- VASU
  l ARTAB-VASU
  l RHEUMAT 90-NAGARJUNA
  l ARTHOJITH- AVP
  l RHUE- BAN
  l R.PAIRYN- BAN
  l ARHIT FORTE- CAPRO
  l R.COMPOUND- ALARSIN
  l LOBAK- PENTA CARE
  l ARTIBAN FORTE- SANTHIGIRI
  l AUROYOG- ARYA AUSHADI
  l HERBOGESIC- ARYA AUSHADI
  l AYURFINE- BAL VEDICS
  l ORTHONERVIN- PANKAJA KASTHURI
  STHANIKA CHIKITSA
  l ABHYANGA
  USUALLY CARRIED OUT AFTER KATI VASTI PROCEDURE, CAN ALSO BE DONE SEPARATELY TOO.
  SPECIAL TYPE OF SPINAL MASSAGE HAS TO BE DONE WITH SPECIAL EMPHASIS ON THE LOWER BACK.
  ZIG ZAG STROKES, PARALLEL STROKES AND OTHER SPECIAL SPINAL STROKES WITH PROPER PRESSURE( TOO MUCH OF PRESSURE IS HARMFUL!) FOR A PERIOD OF 25 TO 30 MINUTES
  OILS USED
  SAHACHARADI THAILAM
  KARPASA ASTHYADI
  BALA THAILAM
  DHANWANTHARAM
  NARAYANA
  MAHA MASHA THAILAM
  KOTTANCHUKKADI
  KSHEERA BALA
  KARPURADI
  GANDHA THAILAM
  KATI VASTHI
  l REQUIREMENTS
  MASHA PISHTA ( BLACK GRAM FLOUR)
  MEDICATED THAILA
  COTTON
  VESSELS, AND
  OIL HEATING
  ACCESSORIES
  DHARA TABLE.
  
  PROCEDURE
  l PATIENT IS MADE TO LIE IN PRONE POSITION.
  l PISHTA OF MASHA IS MADE IN TO PASTE AND BUILT LIKE A WALL AROUND LUMBO SACRAL AREA.
  l OIL IS HEATED AND POURED SLOWLY INSIDE THE BOUNDARY WITH THE HELP OF COTTON.
  l WHEN OIL BECOMES COOL IT IS REPLACED WITH WARM OIL.
  l CONTINUED FOR A PERIOD OF TIME. APPROX- 30 TO 50 MINS, FOR 7 DAYS OR 14 DAYS.
  l AFTER THE DURATION , THE OIL IS DRAINED AND FLOUR IS REMOVED
  l ABHYANGAM OF THE BACK IS GIVEN USING SAME OIL.
  l ALWAYS SNEHANA MUST BE FOLLOWED WITH SWEDANA PROCEDURE
  
  PATRA POTALI OR ELA KIZHI
  l A TYPE OF PINDA SWEDAM. WHICH COMES UNDER USHMA SWEDA.
  l MATERIALS REQUIRED
  LEAVES OF VATA HARA LIKE ERANDA ,ARKA , CHINCHA,NIRGUNDI, SHIGRU, KARANJA DHATURA VATHAGNI SINDUVARA -500 gm
  CHOORNA OF SATAHVA AND METHIKA-25gm EACH
  SAINDHAVA-15gm
  LEMON -4 NOS
  NIMBA OR SAINDHAVA THAILA OR ERANDA THAILA (REQD QTY)
  CLOTH
  TWINE TOWEL. VESSEL, FRYING PAN, SPOON, STOVE
  l RASNADI CHOORNAM
  l MEDICATED OIL
  PATARA KIZHI PROCEDURE
  l ALL THE LEAVES ARE CUT IN TO SMALL PIECES, AND SLICES OF LEMON, CHURNAS, SAINDHAVA ARE ADDED AND FRIED IN THE CASTOR OR NEEM OR COCONUT OIL , TILL IT BECOMES ROASTED RED.
  l THEN THEY ARE MADE IN TO POTALI(USUALLY 4 IN NO)
  l AFTER ABHYANGA, THE POTALI IS APPLIED OVER THE BODY BY DIPPING IT IN TO THE HEATED OIL.
  l CIRCULAR MOVEMENTS ARE DONE.
  l PROCEDURE DONE FOR A PERIOD OF 25-45 MINS
  VASTI PRAYOGAM
  l SNEHA VASTI
  MATRA VASTI- MINIMUM DOSE OF SNEHA VASTI ( APP 60-75 ML)
  ANUVASANA VASTI.(APP 150 ML)
  SNEHA VASTI(250-300 ML)
  KSHEERA VASTI CAN BE ADVOCATED.
  KARMA VASTI, KALA VASTI, YOGA VASTI- 30, 15 , 8 DAYS OF VASTI ALTERNATELY KASHAYA AND SNEHA VASTHI. KALA VASTI IS IN PRACTICE.
  OIL USED FOR SNEHA VASTI
  TILA TAILAM
  GUGGULU TIKTAKA GHRTHAM
  MAHANARAYANA TAILAM
  MAHAMASHADI TAILAM
  SUDDHA BALATAILAM
  KSHEERABALA
  SATAHVADI TAILAM
  SUKUMARA GHRTAM
  LAKSHADI TAILAM
  SAHACHARADI TAILAM
  DHANWANTHARAM
  GANDHARVA HASTADI
  
  KASHAYA VASTI
  l DHANWANTHARAM
  l GANDHARVA HASTADI
  l SAHACHARADI
  l ERANDA MOOLA
  l ASTHAPANA GANA
  l DASAMOOLA
  l SATAHVADI



• ASANAS, EXERCISES, LIFE STYLE MODIFICATIONS
  l Pavanamuktha Asana, Bhujanga Asana, Shalabha Asana, Uttanpada Asana, Shava Asana and Rechka Purak Pranayama
  l Travelling in bumpy roads should be avoided, proper and full back support should be avoided, straining, lifting heavy weights, pressure jobs should be avoided. Proper posture has to be maintained.
  l Physical therapy measures can be adopted suitably.

PURUSHAM PURUSHAM VEEKSHYA AND PERSONALISED MEDICINE!!

Pranams to all, this time we shall try to discuss about some thing which is mentioned in ayurveda centuries back and has been recently understood by contemporary people as thier own discovery. ayurveda deals with the diseases not just the disease, i.e we believe in bringing the entire environment of the body in harmony and normalcy, health is not just absence of disease, its the complete psychological, social well being says w.h.o.in its definition of health. but ayurveda has understood this concept several centuries back, it has understood all thge parameters of health, sama dhoshaha, samagni , sama malaha- these are physical parameters, then comes prassnathma indriya manaha- these psychological and psycho social parameters are understood by our ancient seers. coming to the treatment concept, ayurveda doesnt believe in irrational treatment, i.e one cant just blindly administer any medicine, a aushada may not cure the same condition in all the people. a disease just cant be cured by the same medicine to all. it may work or may not work. ayurveda considers each and every individual as different and hence the medicine should be close to his own self. even in diagnosing we consider various things like prakrithi, kala, bala, ahara shakthi, vikrti, vyayama shakthi , satwa, etc. every individual need not respond to the same medicine. hence we have several preparations having similair properties and action but with subtle variations that has to bve appropriately selected according to the individual and his condition. unlike ayurveda , the contemporary system of medicine had the practice of administering drugs which are target specific or condition specific. these are nothing but poisons in low doses, they have antipyretics to relieve fever, anti spasmodics, anti inflamatory, ant helminthic etc. but the net result is the suppression of expression of the disease. the root cause and disease causing tendency remains un disturbed. but now a recent system of practice, a branch of medicine has evolved with advance ments in genetics, the branch called as personalized medicine, it believes that 400mg of paracetamol given at same time and for same temperature of 100 degree f, to two individuals say x and y, will not elicit the same response. the bio availability, action duration, solubility, cause etc all are independent , they are purely objective, and more over the genetic make up of individual and the environment also plzys an imporatant role. this is what our ancient seers have observed several centuries before. acharya charaka has wonderfully described as purusham purusham veekshya, every individual is different. now the modern system is looking in this field and tremendous scope is there in future for this field for sure, ayurveda and its concepts have once again proved its eternity.

PANCHA MAHA BHOOTHA 2

To continue our exploration, first we need to understand what is aakasha?
and how to understand aakasha? aakasha is said to exhibit shabda guna. shabda gunakam aakasham. but our range of hearing i.e what human ears can percieve is in the range of 20- 20000 decibels, so there is sound which may exixst above 20000 or below 20, the difficuilty is we cant percieve. absence of perception doesnt mean that the thing is not exixting. sound exists , but cant be percieved, thats it. one more sole property in defining aakasha is "aprathighathatvam" , the term aphrathighathatvam means not hindering, .i.e allowing to go through without any obstruction, e.g from water flowing in pipe, to electrons jumping in orbit, and so on. we have to understand that everywhere aakasha exists, even in the midst of solid substances aakasha exists. it is a medium through which displacement occurs. in human body how to understand aakasha? acharya charaka in vimana sthana 5th chapter srotho vimanam has described wonderfully about the srothas , in that he has said the entire body is made up of srothas, so what is srothas? sravanath srothamsi- in which something flows, he has given synonym of srothas as kha, kha means aakasha mahabhuta. and he has wonderfully explained that all diseases are due to the abnormalities in srothas, and he has given 4 types of dusthi of srothas. permeability in cell membrane to blood circulation everything falls in this category.
as i said earlier about evolution of mahabhuta from aakasha to prthvi, the disease manifestation or vyadhi awasthas also form similair pattern. every roga starts with kha vaigunyam or vitiation of aakasha, as times goes on it invades and involves subsequent mahabhutas and when prthvi the last mahabhutha is affected the disease or vyadhi is said to attain gambheera awastha, remember prthvi is manifested kapha, and remember the quotation " prakruthasthu sleshma balam " kapha in its natural state is bala or strength , bala is closely related to ojas, hence the final stage of a disease is oja kshayam. ayurveda is not merely a set of old stories, it tells about some great facts and uses logic. knowledge of pancha maha bhutas are very essential for all of us for good clinical practice.

pancha maha bhootha

ayurveda as it is known is science of life, it is more a life style rather than an alternate system of medicine, ayurveda the term is literally derived from the root "ayusho vedaha" i.e knowledge of life, hence ayurveda deals with the whole of life , it works on a person as a hole and not as fragments, it doesnt suppress your symptoms it works on a very different platform, ayurveda is more scientific that most traditional systems of medicines.

one of the most fundamental concepts of ayurveda is the pancha maha bhootha theory,

first what are these 5 mahabhoothas, they are

1. aakasha - compared to space, ether

2.vayu -compared to wind , air

3. agni -compared to fire, energy

4. jala or ap_ compared to water, liquidity

5. prthvi - compared to solid or earth

i feel that there is no exact or proper transalation to for these sanskrit terms exactly, let them be understood as they are. interstingly in sanskrit we call it as prapancham, which can be taken as universe. the name prapancham derives its name from the fact that it is formed of 5 maha bhootas. these mahabhootas doesnt exist as they are, but in mixed and sublime forms.

ANYONYANU PRAVESHA:

this theory tells about evolution of universe and mainly about the 5 maha bhootas. it says that maha bhootas are formed in succesive order from akasha to prthvi i.e aakasha ---vayu---agni---jala---prthvi.

one can cleanly relate that this order shows one striking feature, from emptiness or unstability of aakasha the travel ends in the most stable and solid prthvi. intersting do you see? also the states of matter solid, liquid and gas is also related. coming to human body now our human body is also made up of pancha maha bhoothas, a living person is said to be composed of 5mahabhootas and chetana or athma, and hence said to be shad dhatvatmaka purusha.

so how does these 5 maha bhootas in human body? yes it is in the form of 3 doshas...

vatha- aakasha+ vayu

pittha-teja+jala

kapha-jala+prthvi

its wonderful that u can find the same order from unstable to stability in 3 doshas too.

MAHABHOOTAS EVERY WHERE IN YOUR BODY:

again how to understand the presence of mahabhootas in your body? the answer to this is , to understand some thing which cant be percieved or understood directly as it is, one need to understan the guna- qualities and karma- action or effects, it goes like this

digestion, anabolism ,catabolism, glucose break down etc in all these processes there is transformation of something in to other which is the key , hence energy is involved and heat or ushna is felt or used up hence agni maha bhootha is there. think about solid organs composed of prthvi and jala mainly. thin about blood, lymph anything thats liquid composed of jala, think about respiration, neve conductio, motor and sensory activities, vayu is there. aakasha . how to understand this? all the other four combine in various proportions and undergoes various things within aakasha, any cavity, any space is aakasha. we will see more about clinical applications in next blog.