HAND BOOK OF DOMESTIC MEDICINE AND COMMON AYURVEDIC REMEDIES

Āyurveda, the Indian system of medicine from the literary point of view, is composed of two words viz. Āyu and Veda. Āyu means life and Veda denotes to the science.

Āyu is defined as a combination of Śarīra (body), Indriya (senses), Satva (mind) and Ātma (spirit). Body without senses, mind and spirit is dead and it is not Āyu. Therefore while defining the Svastha it has been mentioned that one having equilibrium of Doṣa and Agni (digestive and metabolic enzymes) with proper functioning of Dhātu (tissues) and Mala (metabolic bye products and excretions), and possesses happiness of Ātmā (spirit), Indriya (senses) and Mana (mind) is a Svastha or healthy. Thus Āyurveda deals with diseased person and not solely with his disease. It is a complete science of life and not merely a treatise on some of the medicines or treatment of the diseases.

Āyurveda has mainly three aims viz. first to preserve the health, second to promote the health of the healthy persons and third to cure the disease of the patient. It fulfils these aims through 8 branches viz. Kāyacikitsā (medicine), Śalya Tantra (surgery), Śālakya Tantra (otorhinolaryngology and ophthalmology), Kaumāra bhṛtya (paediatric and obstetric), Rasāyana, Vājīkaraṇa, Agada Tantra (toxicology) and Bhūta Vidya. Out of these generally Rasāyana and Vājīkaraṇa including Svasthavṛtta deal with the preservation and promotion of the health of the healthy persons and the remaining branches deal with the diseased person.

From the Indian philosophical point of view all the matters of the universe are made up of 5 elements, collectively known as Pañca Mahābhūta (five basic elements). These are Ākāśa, Vāyu, Tejas, Jala and Pṛthvī. Each of these can be perceived by its distinctive quality viz. Ākāśa by Sabda (sound), Vāyu by Sparśa (touch), Agni by Rūpa (colour), Jala by Rasa (taste) and Pṛthvī by Gandha (odour).

Ātma when joins with Pañca Mahābhūta then the matter assumes life and the body is termed as Puruṣa. In Āyurveda the term Puruṣa is specifically used for human beings. Thus Pañca Mahābhūta are the basic elements required for the formation of all the bodily tissues and sensory and motor organs including mind.

The concept of Doṣa has been evolved by the great sages of Āyurveda to differentiate with livings and non-livings. Though Śarīra (human body) is made up of Pañca Mahābhūta, it attains life only when Ātma (spirit), Indriya (senses) and Mana join to it. Doṣa are the biological units of the living body which are responsible for its all functions. Doṣa are three viz. Vāta, Pitta and Kapha, and each of which is also made up of Mahābhūta. Vāyu and Ākāṣa Mahābhūta form Vāta, Agni Mahābhūta forms Pitta, and Pṛthvī and Jala Mahābhūta form Kapha Doṣa.

The word Doṣa is derived from the verb ‘Duṣa’ which means to vitiate. In the normal state of equilibrium they support the body and when vitiated produce the disease. Doṣa play important role in the pathogenesis, diagnosis and treatment of the diseases.

The word ‘Vāta’ is derived from the verb ‘Vā’ which means Gati (motion). This Doṣa is responsible for all the movements in the body. It is of 5 types viz, Prāṇa Vāyu, Udāna Vāyu, Samāna Vāyu, Vyāna Vāyu and Apāna Vāyu.

The seat of function of Prāṇa Vāyu is head, chest, throat, tongue, mouth and nose. It controls the functions of salivation, eructation, sneezing, respiration, deglutition etc. The seat of function of Udāna Vāyu is umbilicus, chest and throat. Its main function is phonation. It also provides enthusiasm, vitality, complexion etc. to the human beings.

Functions of Samāna Vāyu are closely related to Agni (digestive-juices). It regulates the secretion of the gastric juice, retains the food in the stomach or intestine for the required time, thus helps in its absorption. Vyāna Vāyu which is situated all over the body is responsible for pulsation of heart and blood circulation. It also controls the movement of eyes, limbs etc.

The seat of function of Apāna Vāyu are testes, bladder, umbilical region, thigh, groin etc. It controls the functions of elimination of the semen, urine, faeces etc. The movements related with the delivery of foetus are also governed by it.

The word Pitta is derived from the root ‘Tapa’ which means heat (Santāpa). This Doṣa is responsible for digestion and metabolism of the body. It is of 5 types viz. Pācaka Pitta, Rañjaka Pitta, Bhrājaka Pitta, Ālocaka Pitta and Sādhaka Pitta.

Pācaka Pitta is located in the Grahaṇī (stomach and intestine). Its main function is digestion and it also augments the other Pitta situated in the body. Seats of function of Rañjaka Pitta are liver and spleen. Its main function is to convert Rasa into Rakta (blood), Bhrājaka Pitta is found in the skin and it provides pigment to the skin, hair etc.

Ālocaka Pitta is situated in the eye, and vision and discrimination of colours are its functions. Sādhaka Pitta is located in the Hṛdaya and it is responsible for intelligence and ego. It is due to this Pitta that all the functions of the mind and body are co-ordinated.

Kapha is also called Śleṣma. One of its main functions is to provide nutrition to the bodily tissues. Kapha is also of five types viz. Kledaka Kapha, Avalambaka Kapha, Tarpaka Kapha, Bodhaka Kapha and Śleṣaka Kapha.

Kledaka Kapha is situated in the stomach. It is slimy (Picchila) in quality, sweet in taste and has the action of moistening the food ingested. It also protects the digestive organs from being hurt by the digestive juices.

Avalambaka Kapha is located in the chest where it provides the nutrition to the heart. Bodhaka Kapha is found in the tongue and it is responsible for perceiving the taste. Seat of function of Śleṣaka Kapha is joints where it lubricates the joints so that they may function properly. Tarpaka Kapha is situated in the head and gives nutrition to the mental faculties.

In addition to Vāta, Pitta and Kapha which are the bodily Doṣa, there are two Mānasa Doṣa viz. Rajas (passion) and Tamas (darkness). Mānasa Doṣa may be held responsible for mental diseases.

In the disease process first Doṣa are vitiated which inturn vitiate Dhātu and Mala. As Dhātu and Mala get vitiated by Doṣa, therefore they are also named as Dūṣya. In the normal condition, Doṣa, Dhātu and Mala support the body, but when vitiated produce the disease.

The word ‘Dhātu’ is derived from the verb ‘Dha’ which means to hold. The matters which hold the body are termed as Dhātu. In general, it is a term signifying bodily fluids and tissues. Dhātu are of seven types viz. Rasa (nourishing fluid of plasma), Rakta (blood), Māṁsa (muscular tissue), Meda (fatty tissue), Asthi (bone and connective tissues), Majjā (bone marrow) and Śukra (vital substance).

There are three types of pathological changes in these Dhātu viz. Kṣaya (decrease), Vṛddhi (increase) and Pradoṣa (vitiation). The Kṣaya of the one and Vṛddhi of other may be simultaneous in the same disease and in the same patient. In this condition, the Dhātu increases at one place at the cost of other.

Upadhātu are actually not nourishing the body but they are the bye products of Dhātu, necessary for supporting the body. They are Stanya (breast milk), Ārtava (menstrual blood), Kaṇḍarā (tendons), Śirā (vessels), Vasā (fat), Tvak (skin), Snāyu etc. They are also vitiated by Doṣa.

Mala are different excretions viz. faeces, urine, Mala Kapha, Mala Pitta, excretions from organs, Sveda (sweat), Nakha (nails), hair, the oily discharge from skin etc. The Mala are also get vitiated and included in Dūṣya.

The word ‘Srotas’ is derived from ‘Sru’ which means oozing. The oozing of nourishing fluid and the return of waste matters take place through these Srotas. In fact, the whole body is composed of Srotas, but for the convenience of diagnosis and treatment, they have been classified in 13 groups. They are Prāṇa-Vaha (channels through which oxygen and carbon dioxide exchange takes place), Udaka-Vaha (water-balance), Anna-Vaha (food passage), Rasa-Vaha, Rakta-Vaha, Māṁsa-Vaha, Meda-Vaha, Asthi-Vaha, Majjā-Vaha, Śukra-Vaha, Mūtra-Vaha (urinary channels), Purīṣa-Vaha (channel for faeces) and Sveda-Vaha (channels for sweat).

The pathological conditions in these Srotas are Atipravṛtti (excessive flow), Sangraha (accumulation), Vimārga-Gamana (extravasation), and Sirā-Granthi (thrombosis). Any one, two, three or even four types of pathological conditions may occur in the disease.

Agni is a very important factor because Āyurveda believes that majority, if not all the diseases are caused by vitiation of Agni. It is responsible for all the digestion and metabolism of the body. It is of 13 types viz. Jaṭharāgni (digestive juices), seven Dhātvāgni i.e. Agni of Rasa, Rakta, Māṁsa, Meda, Asthi, Majjā and Śukra, and 5 Bhūtāgni i.e. Agni of Ākāṣa, Vāyu, Tejas, Jala and Pṛthvī. Out of these, Jaṭharāgni is very important and all the other Agni are dependant upon it.

The vitiation of these Agni are of three types viz. Viṣamāgni, Tīkṣnāgni and Mandāgni. These three abnormalities of Agni are responsible for producing the various types of diseases but Mandāgni is the common cause of most of the diseases.

Āma has been defined as (i) undigested or semi-digested food (ii) Mala-Sañcaya (the accumulation of excretions) and (iii) first vitiation of Doṣa. Generally, it is produced by diminished power of digestive juices (Mandāgni), but it may also form at other levels of the Agni i.e. Bhūtāgni and Dhātvagni.

In short, Āma may be produced at any level of digestion and metabolism. It is also a frequent cause of the diseases. Great stress has been laid in Āyurveda on correction of the digestion. The word Kāya-Cikitsā means treatment of vitiated Agni as Kāya means Jaṭharāgni and Cikitsā means treatment.

The condition which causes uneasiness to Śarīra (body) or Mana (mind) is defined as Vyādhi or disease. It is produced by the three factors viz. (i) Asātmyendriyārtha Saṁyoga, (ii) Prajñāparādha and (iii) Pariṇāma.

The excessive (Atiyoga) or faulty (Mithyāyoga) or no use (Ayoga) of the sense organs is called Asātmyendriyārtha Saṁyoga. Constantly seeing of bright objects like sun, reading in the dark and not seeing at all are the examples of Atiyoga, Mithyāyoga and Ayoga respectively.

If the right thing is not done at the right time then it is called Prajñāparādha. It is the root cause of Asātmyendriyārtha Saṁyoga.

The seasons play important role in the health and its abnormality may disturb the equilibrium of Doṣa. Excessive cold, heat or rain in their respective seasons is Atiyoga; less cold during winter or less hot during summer is Ayoga; and hot during winter and cold during summer is Mithyāyoga of Kāla (season).

The causes of the disease may further be divided into two groups viz. Bāhya (extrinsic) and Ābhyantara (intrinsic). Errors of diet, season, unnatural use of sensory and motor organs etc. are the Bāhya causes. Vitiation of Doṣa, Dūṣya, Srotas, Agni etc. are the Ābhyantara causes.

All the diseases are classified into 3 major groups viz. Nija Roga, Āgantuja Roga and Mānasa Roga. The diseases caused by the vitiation of Vāta, Pitta and Kapha are called Nija Roga; the diseases due to the trauma, bite etc. are Āgantuja Roga; and mental diseases are Mānasa Roga.

The diseases are also classified in 3 groups viz. Ādhyātmika, Ādhibhautika and Ādhidaivika.

Ādhyātmika diseases are further subdivided into Ādibalapravṛtta (hereditary), Janmabalapravṛtta (congenital) and Doṣa Bala Pravṛtta (due to vitiation of Doṣa).

Ādi-Bala-Pravṛtta or hereditary diseases are of two types viz. maternal or Mātṛja and paternal or Pitṛja.

Janma-Bala-Pravṛtta (congenital) diseases are also of two types viz. Rasa-Kṛta which are due to the vitiated Rasa, Rakta etc. of the mother and Dauhṛdapacāraja which are due to the irregularities in diet during pregnancy.

Doṣa-Bala-Pravṛtta diseases are produced due to the vitiation of the three Doṣa-Vāta, Pitta and Kapha.

These type of diseases are also called Saṅghāta-Bala-Pravṛtta diseases. They are produced by extrinsic factors e.g. injury, bites etc.

These diseases are produced by natural forces beyond the control of the man. They are of three types viz. Kāla-Bala-Pravṛtta, Daivabala-Pravṛtta and Svabhāva-Bala-Pravṛtta.

Kāla-Bala-Pravṛtta diseases are produced by seasonal changes which may be due to the vitiated (Vyāpanna) seasons or normal changes (Avyāpanna) of the seasons.

Daiva-Bala-Pravṛtta diseases are produced by contamination (Saṁsarga) or accidental causes e.g. lightning, fall etc.

Svabhāva-Bala-Pravṛtta diseases are produced by natural physiological processes e.g. old age, sleep, hunger, thirst etc.

During the disease process the abnormalities of Doṣa pass through six stages viz. (i) Sañcaya (stage of accumulation), (ii) Prakopa (stage of provocation), (iii) Prasara (stage of spread), (iv) Sthāna Saṁsraya (localization), (v) Vyakti (diseases manifestation), and (vi) Bheda (chronicity or permanent pathological changes or incurability). These 6 stages are called Ṣaṭ-Kriyā-Kāla or time for the treatment. It has been emphasized in Āyurveda to diagnose and treat the disease at an early stage, so that its complications may be prevented. As the proverb says prevention is better than cure, Doṣas treated timely may prevent the disease.

Whatever is planned for prevention or elimination of the disease may be known as Cikitsā. It is of three types, viz. Daiva-Vyapāśraya, Yukti-Vyapāśraya and Sattvāvajaya.

Daiva Vyapāśraya Cikitsā consists of wearing the Auṣadha and practice of Mantra, Maṅgala etc. It is not in common use now a days. Sattvāvajava Cikitsā is specially useful for the mental diseases and it consists of Manonigraha i.e. control of mind.

Yukti-Vyapāśrya Cikitsā is being widely used for the prevention and elimination of diseases by the Āyurvedic physicians since time immemorial. This type of treatment consists of planning (Yojanā) of dietetic regimen (Pathya) and medication.

The main object of Yukti-Vyapāśraya Cikitsā is Yukti or Yojanā which means planning. In this type of treatment the physician plans the Āhara, Vihāra, Auṣadha, Matrā, Kāla etc. by taking into consideration, Deśa, Kāla, and causes, symptoms, signs, stage, complications, curability etc. of the disease. Taking all these points in view, a physician whatever plans (by Yukti) for prevention or elimination of a disease is known as Yukti-Vyapāśraya Cikitsā.

Taking the different Yukti into consideration, the physician plans two types of treatment depending upon the condition of the patient. These are Śodhana and Śamana.

The treatment planned for the elimination of increased and morbid Doṣa from the body is known as Śodhana therapy. It is also termed as Pañca Karma (five fold therapy). It consists of Vamana, Virecana, Anuvāsana Basti, Āsthāpana Basti and Śirovirecana (Nasya).

Before undertaking the above five purificatory processes some treatment is to be given, which is called Pūrva-Karma meaning ‘pre-treatment steps.’ It consists of Snehana and Svedana. In the after-treatment steps the patient is taken to normal diet gradually and this is called Saṁsarjana Krama.

The treatment in which the Kupita Doṣa is pacified without eliminating it from the body is defined as Śamana Cikitsā. It is classified in two groups viz. Apatarpaṇa and Santarpaṇa. Apararpaṇa Cikitsā consists of three measures viz. Laṅghana, Rūkṣaṇa and Svedana; and Santarpaṇa Cikitsā is divided in Bṛṁhaṇa, Snehana and Stambhana.

This type of treatment is prescribed in the disorders caused by the increased Kapha or Āma. It consists of Pipāsā, Ātapa Sevana, Māruta Sevana, Pācana, Upavāsa and Vyāyāma. Vamana, Virecana, Āsthāpana Basti and Śirovirecana are also included in it. Thus it is clear that from Āyurvedic point of view, only fasting is not Laṅghana. Any of the above mentioned measures may be prescribed for Laṅghana, taking into consideration the strength of the patient.

It is indicated in the disease caused by Āma, Ūrustambha etc. In this type of treatment Rūkṣaṇa, Laghu, Tīkṣṇa drugs are used.

The treatment which causes sweating is known as Svedana. It is indicated in the disorders of Vāta and Kapha.

The treatment which increases the Dhātu is Bṛṁhaṇa Cikitsā. It is indicated in weakness and diseases causing debility.

This type of treatment is particularly useful for disorders of Vāta. It consists of administration of oily preparations.

This type of treatment is indicated in the diseases of Pitta, Agnidagdha, Atisāra, Vamana etc. The drugs having Śīta, Manda, Mṛdu, Ślakṣṇa, Rūkṣa, Sūkṣma, Drava, Sthira and Laghu properties are used for this treatment.

The above mentioned treatment is done through Auṣadha (medicine), Āhāra (diet) and Vihāra (treatment with other means excluding medicines and diet e.g. exercise, rest, etc.).

In fact, Āyurveda puts a great stress on the diet and diet habit which are called ‘Pathya’. It has been mentioned in Āyurveda that if a person suffering from any disease follows strictly the regulation of diet (Pathya), he may not require medicine, but if he does not follow the regulation of diet, medicine may be fruitless. Taking account of these, it is necessary to follow ‘Pathya’ in health as well as in disease.

Selection of items of food and diet in general is to be made according to Rasa (taste), Guṇa (properties), Vīrya (energy), Vipāka (ultimate results), Prabhāva (active principles of action), compatibility and incompatibility (Viruddha). Other important factors of diet are method of intake of the food, the time of taking the food and Sātmya (homologous) etc. Stress is also laid on purity of Vāyu (atmosphere), avoiding pollution of water, Deśa (habitat) and Kāla (season) for prevention of epidemics (Janapadodhvaṁsa).