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Saturday, December 24, 2011

21. Agni and Aam

By: Jonathan H Edwards, Fullbright Scholar in Nepal, from USA


          The concept of jathara agni, or digestive fire, is central to Ayurveda.  The idea is that our digestive capacity transforms food into energy just as fire turns wood into heat and light.  Healthy agni is synonymous with a hearty appetite, radiant skin, enthusiasm and an abundance of energy.  Like other fire, agni needs proper fuel and tending to burn optimally.  Without fuel--food-- the flame of agni will grow small and disappear.  On the other hand, an excess of heavy, hard-to-burn foods will smother the fire, generating unwanted byproducts--picture a fire fed with wet cardboard sending off a plume of thick black smoke.  The physiological equivalent of such smoke and soot is known as aam, and it lies at the root of many types of ill health.  Over time Aam can accumulate and cause a sense of heaviness, fatigue, sticky and smelly feces, foul breath, diminished appetite and a host of other symptoms.  Aam clogs the system and undermines our bodily intelligence.
            When this happens it can change the nature of our cravings, from natural balance-maintaining urges to perverse once that perpetuate imbalance.  For example, a healthy person with slightly high kapha but no aam may crave hot, spicy food and bitter greens, both of which will help to reduce kapha and restore balance.  However if the same person has an aam condition, his natural bodily intelligence may become distorted.  He may crave ice cream and sweets, even though he doesn’t have the agni to digest them thoroughly.   
            Agni and aam are two sides of the same coin: without strong agni, aam develops; without aam, agni is free to burn hot and clean.  However, agni is vulnerable not only to aam but also to the three doshas.

Types of Agni
            There are four classifications of agni, although most people will experience some combination.
            The idea type of agni is sama agni, balanced digestion.  Those with sama agni can digest almost anything and experience no gas, bloating, or discomfort after eating.  They get hungry at regular intervals but not so intensely that they cannot function if they skip a meal.  Sama agni is closely associated with a balanced state of the doshas and is both a cause and an effect of good health.
            Each of the other types of agni is connected with an imbalance of each of the three doshas:
            Vishama agni is agni affected by Vata, the airy humour.   Vata affects agni like a wind does a fire, sometimes causing it  to flare up and other times nearly extinguishing the flame.  Vishama means “irregular,” and those with vishama agni may get intensely hungry or may forget to eat for a day or more at a time.  Their digestive capacity is often limited so they may eat more than they can properly digest.  They usually have sensitive digestion, and can feel off if they don’t eat the right thing at the right time.  In general, those with vishama agni should take care to eat a Vata-pacifying diet and to eat regular, small-to-moderate size meals without snacking in between.  Establishing regular dietary habits and controlling Vata are key to bringing vishama agni back to balance.
            Tikshna agni is associated with high Pitta, the force of fire.  Tikshna means sharp, and those with tikshna agni tend to get extremely hungry and burn through their food quickly, as a hot fire that requires frequent feeding.  They are prone to hyperacidity and burning pain during digestion or elimination and are intolerant of missing a meal.  Tiskhna agni can handle heavy, relatively hard-to-digest foods like dairy products and meat and indeed need sweet and heavy foods to cool their fire.  A generally Pitta-pacifying diet is appropriate for them.
            Manda agni is Kapha-type digestion.  Kapha affects agni like damp weather does a fire.  This kind of agni is sluggish, so those with manda agni find it easy to gain weight and hard to lose it.  They can often get by eating only one meal a day, and if they eat heavy, greasy food they may feel like it lingers in their stomachs for hours.  Those with manda agni should eat lightly and sparingly and favor Kapha-reducing foods.  It those with manda agni for whom standard western dietary advice is often most appropriate.

Stoking Agni
            According Ayurveda, a marked lack of appetite and chronic digestive issues are signs that agni is low.  Whatever your agni type (see above), low agni needs to be treated just as you would tend a tiny flame when trying to build a fire.  If starved for too long, any fire will go out.  Yet a small flame cannot handle too much fuel, or too heavy or wet fuel, at one time.  Just as you would build a fire by feeding it increasingly larger sticks, your internal fire needs to be fed conservatively at first, then with gradually more substantial foods until finally it burns hot and clean.  Let your appetite and intuition be your guide as you work on building your agni.  Practice eating light foods in moderate quantities, and stop eating before you feel completely full.  Favor warm, cooked foods, especially vegetables and whole grains.  Soups, stews and other one-pot meals are excellent food for agni.  Perhaps the best possible such dish is called kichari, made of split mung beans (mung dal) and basmati rice stewed together with spices and vegetables.
          A simple home remedy to boost agni is a home-made ginger pickle: grate a couple inches of freshly peeled ginger and season to taste with lemon or lime juice, honey, and rock salt (kaalo naamak).  Eat a small spoonful of this before meals, or treat it like a condiment.  A stronger herbal combo for lighting the fire of agni is chitrakaadi vati, while hingwashtak churna (along with some Shankha bhasma, perhaps) is the formula of choice for low agni with signs of Vata.

Source: Ayur Info 2067

The author can be reached at:

Friday, December 23, 2011

20. Amlapitta (Hyperacidity) in Ayurveda

Introduction:
Vitiation of agni in Amashaya (stomach) region due to various causes Amlapitta. Some of the common causes are - fasting, eating between meals, worry, hurry, spicy foods etc. are some pitta vitiating factors etc. These factors derange the pachaka pitta (digestive enzymes etc.) and as a result pachaka pitta vitiates. Thus developed condition is called Amlapitta.
Hydrochloric acid (HCl) when not utilized well, or when produced in large quantity in the stomach region causes inflammation of stomach (gastric = related to stomach), that is called gastritis. This can derange the digestive procedures. The increased or normal level of HCl can destroy the soft tissue (epithelium) lining of oesophagus, stomach,duodenum etc. If not managed on time this can give rise to ulceration (breech in tissue).
Usually the esophageal sphincter muscle contracts thus preventing the stomach acid from shooting  up into the esophagus, but if this muscle is not functioning properly, the acid can slip past it and this is when heartburn symptoms start, which is called Gastroesophageal reflux.


Classification:
    •    Adhoga Amlapitta (downward)
    •    Urdhwaga Amlapitta (upward)
    •    Vata predominant Amlapitt
    •    Pitta predominant Amlapitta
    •    Kapha predominant Amlapitta

Symptoms:
 

Symptoms of Adhoga Amlapita:
    •    Thirst
    •    Burning sensation
    •    Fainting
    •    Giddiness
    •    Dellusion
    •    Rashes on skin
    •    Poor digestion
    •    Perspiration

Symptoms of Urdhwaga Amlapitta:
    •    Vomiting of green, yellow, blue, black, slightly red or of bright red color having sour material
    •    Belching of similar nature
    •    Burning sensation in the throat, chest and upper abdomen
    •    Headache
    •    Burning sensation in the palms and soles
    •    Loss of appetite

Symptoms of Vata predominant Amlapitta
    •    Tremors
    •    Delirium
    •    Fainting
    •    Feeling of pins and needles
    •    Weakness of body parts
    •    Pain and darkness before eyes

Symptoms of Pitta Predominant Amlapitta
    •    Feeling of heaviness
    •    Weakness
    •    Coldness
    •    Vomiting
    •    Coating on tongue
    •    Burning sensation
    •    Itching of skin

Symptoms of Kapha predominant Amlapitta
    •    Fainting
    •    Loss of apetite
    •    Headache
    •    Salivation
    •    Sweet taste in the mouth

Causes:
    •    Eating of spicy and highly seasoned food like chilly, pickles, etc.
    •    Improper eating habits
    •    Prolonged ingestion of aspirin or some anti-inflammatory drugs
    •    Prolonged alcohol ingestion
    •    Heavy smoking
    •    Stress is also an important cause for hyperacidity
    •    Idiopathic etc.

Symptoms:
    •    Nausea, vomiting, and loss of desire to eat which may persist for 1-2 days
    •    Heartburn or sour belching
    •    A sense of abdominal distension
    •    Flatulence
    •    Vomiting of blood or blood in stools
    •    If gastritis persists there may be eventual development of anaemia etc.

Therapies:
    •    Home remedies
    •    Ayurvedic remedies
    •    Yoga asanas

Home Remedies
    •    Abstinence from smoking and alcohol is a must.
    •    Avoid stress.
    •    Papaya chewable tablets can be purchase in health stores and they are helpful reducing heartburn.
    •    Drink a large glass of water at the first sign of heartburn, if the symptoms are not too strong this will help. 
    •    Make a juice using raw potatoes. Wash the potato very well do not peel it, just place it in the juicer, mix it with some other juice for taste and drink immediately after juicing.
    •    Chew a few Tulsi leaves to get relief of the symptoms.
    •    Keep a small piece of gur in your mouth and suck it slowly. Repeat it every hour till the symptoms subside.
    •    Eat Watermelon, Banana or Cucumber every hour.
    •    Eat a few Almonds when symptoms are present.
    •    Drink Coconut water 4 – 5 times a day.
    •    Drink a glass of cold milk for fast relief.
    •    Keep a small piece of Harad in your mouth and chew it after every meals.
    •    Take one piece of Clove and suck it slowly.
    •    Sleep with your head and shoulder on a high pillow for elevation.
                                                        
 Ayurvedic Remedies : 
    •    Take 1 – 2 tablets of Amlapittantak Lauh with honey twice a day.
    •    Take 1 – 2 teaspoons of Avipattikar Churna ( powder ) with milk or water twice a day.
    •    Take 1 teaspoon ful of Dadim Avaleha with honey or water twice a day.
    •    Take 125 – 250 mg of Panchamrit Parpati with honey, curd or butter milk twice a day.
>> Other useful preparations are: Yastimadhu churna, Guduchi churna, Guduchi sattva, Aamalaki churna, Aamalaki tablet, Suta Shekhar Ras, Laghu Sutashekhar Ras,  Kamdudha Ras, Shankha Bhasma, Kapardak Bhasma, Mahashankha vati, etc.
 
Yoga Asanas
    •    Vajra Asana
    •    Yoga mudra
    •    Shitali Pranayama
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Amlapita in terms of Modern Medicine
    •    Gastritis
    •    Peptic Ulcers

Gastritis:
Gastritis is a type of Amlapitta. In this disease, inflammation of the epithelial lining of stomach takes place. Hydrochloric acid and some other digestive enzymes are secreted by the glands of the stomach. Inflammation of the stomach thus results in the impairment of these secretions leading to indigestion. It is a very troublesome condition which needs immediate treatment.

Causes:
    •    Over eating, fasting, spicy foods
    •    H. Pylori infection
    •    Excessive intake of alcohol, smoking, carbonated drinks
    •    Stress, hurry, worry
    •    Food poisoning
    •    Swallowing of acids and alkalies etc.

Symptoms:
    •    Loss of appetite
    •    Nausea
    •    Headache
    •    Giddiness
    •    Discomfort in stomach
    •    Sour eructations
    •    Frequent vomiting
    •    If chronic, then Anemia
    •    Coated tongue
    •    Foul breath
    •    Increased flow of saliva
    •    Scanty urine etc.

Food Plan:
    •    Fast for two or three days or more, depending on the severity of the condition.
    •    Drink only warm water during this period. This will give rest to the stomach and allow the toxic condition causing the inflammation to subside.
    •    After the acute symptoms subside, adopt an all fruit diet for the next three days and take juicy fruits like apples, pears, grapes, grapefruit, oranges, pineapple, peaches and melons.
    •   Thereafter gradually come to a balanced diet consisting of seeds, nuts, grains, vegetables and fruit.
    •   Avoid the use of alcohol, tobacco, spices, meat, red pepper, sour foods, pickles, strong tea and coffee. S/He should also avoid sweets, pastries, rich cakes and aerated waters.
    •    Avoid hot drinks and foods.
    •    It's better not to take spicy and oily foods.
    •    Curds and cottage cheese should be used freely.

Life Style:
    •    Avoid exposure to hard mental or physical work.
    •    Avoid anxiety, worry and anger.
    •    Take complete rest.
    •    A walk in the early morning for about a mile is very useful.

Peptic Ulcer:
Ayurveda considers this as another type of Amlapitta. This disorder is more generally classified as a grahani disorder, which is a disorder in the seat of agni in the stomach.  The actual ulceration of the stomach wall which is the classic description of a peptic ulcer is clearly due to an excessive amount of heat or agni or Pitta in the body. The question to ask before treating the increased Pitta is, why the Pitta is excessive. In the West we often relate gastric ulcers with stress and anxiety. This factor is not overlooked in Ayurveda and is properly handled with the eating and lifestyle changes.

Causes:
    •    Fasting
    •    Chronic or long time gastritis
    •    Eating during indigestion
    •    Over eating Irregular eating
    •    Intake of unsuitable food
    •    Faulty place, time and preparation of food
    •    Hereditary
    •    Smoking
    •    Alcohol consumption
    •    Certain drugs, long time illness
    •    Stress etc.

Symptoms:
    •    Epigastric pain: Pain is referred to the epigastrium and is often so sharply localized that the patient can indicate its site with two or three fingers-the ‘pointing sign’.
    •    Hunger pain: Pain occurs intermittently during the day, often when the stomach is empty, so that the patient identifies it as ‘hunger pain’ and obtains relief by eating.
    •    Night pain: Pain wakes the patient from sleep and may be relieved by food, a drink of milk, or antacids.
    •    Water brash: This is a sudden filling of mouth with saliva which is produced as a reflex response to a variety of symptoms from the upper GIT, e.g., peptic ulcer pain
    •    Burning during, after and between meals
    •    Gastric reflux, fatigue, increased stress, loose stools or constipation.

Food Plan:
    •    When condition is acute patient should be given a liquid diet of liquefied cooked vegetables and Khichari.
    •    Barley water can be taken throughout the day. Boil 1 cup of barley with 3 cups of water and boil down to 2 cups of water and drink as tea 3 times per day.
    •    Avoid onions, garlic and pungent, salty and sour foods.
    •    Increase consumption of bitter foods.

Amlapitta though a serious disease can be healed by the simple home remedies, Ayurvedic remedies, yoga asanas, diet plan and by doing some changes in normal lifestyle. So, one should adopt these things in life not only to heal Amlapitta but for every disease.

Reference:

Monday, December 12, 2011

19. Your Home, The Medicine Cabinet: What every home should have for all of life’s little accidents


Households all around the world are armed with standard first-aid kits that are there when someone gets a knick or scrap that can be easily managed. But what if the antibiotic cream is out-dated and band-aids just do solve the problem. Luckily for nature, there is a whole new realm of holistic cures that can offer relief, speed up healing, and be less harsh than alcohols.

Below is a list of a few common natural ingredients that are smart to place alongside your first-aid kit. These remedies range in effect and treatment of symptoms. Though these natural, alternative methods treat the everyday mishap, the practice of alternative and complementary treatments goes much deeper. There are more powerful therapies, which are normally complementary to allopathic medicines that can help treat certain cancers and other serious aliments. Many doctors suggest patients with any cancer prognosis to adopt a complementary therapy to help ease pain, promote natural healing, and reduce symptoms of conventional treatments.

Lavender: To receive the full effect of lavender, you must use true lavender (Lavandula angustifolia). Used as and oil or spray, this plant is very versatile and can be used to treat headaches, burns, insomnia, and reduce anxiety. The aromatherapy qualities of this plant are endless. Pillows stuffed with some lavender, make for a calming sleep as-well-as deterring insects. Throughout history, lavender was used to treat war-wounds and burns because of its analgesic, antibiotic, and antiseptic properties.

Peppermint: This holiday treat, when used as oil, can treat tension headaches. When you start to feel that pressure, a few drops of peppermint oil rubbed on the temples can help ease the pain and cure the headache. This oil and plant can also be used to treat indigestion, clear nasal passages, and relieve spasmodic pain.

Tea Tree: Though widely known for its antiseptic qualities, this oil is the teenagers’ dream. It helps treat many infections, like athlete’s foot and acne. Cold sores, warts, and shingles have also been treated with tea tree oil. Back in the 1920s, tea tree paste was used to dissolve pus and clean a wound perfectly for surgeries.

Garlic: This little seasoning is not only good for cooking, but is perfect for the winter and spring months when colds and flus are popular. The notable smell of garlic is due to the group of sulfur-containing compounds; most notable allicin, a natural antibiotic. Since these chemicals can only be excreted via sweating or through the lungs, it is helpful for lung infections and skin problems. Anyone suffering from colds, flu, bronchitis, lung infections, or a sore throat should include plenty of garlic in their diet. Garlic is also a good insect repellent.

Witch Hazel: This plant is perfect for sore muscles, backaches, bruises, and sprains; perfect for the athletes of the family. Witch Hazel used to be used a rub or a cold compress, but now you can find it in stores as lotion for burns and bug bites.

Saturday, December 10, 2011

18. Obesity- An Invitation of Disease


Dr. Shiva Narayan Gupta

Obesity means deposition of excess fat in the body. It is a result of some dietary imbalance, over nutrition and some diseases. In obesity there is excess accumulation or storage of adipose tissue in the subcutaneous tissues, skeletal muscles and internal organs such as the kidney, heart, liver and omentum. A body weight of 20% excess over ideal weight for age, sex, and height is considered as obesity. It is one of the Jaldobaldo health problems in the world. Similarly it is one of the main causes of non-communicable disease.

Obesity can be classified:-
1. On the basis of cause:
            1. Primary obesity- this obesity is result from dietary imbalance and over nutrition.
            2. Secondary obesity- This obesity results following a number of underlying diseases such as Cushing’s disease, insulinoma, hypothalamic disorders and hypothyroidism.

2. On the basis of Clinical feature:
            1. Mild obesity: 20-40 % over weight
            2. MOderate obesity: 41-100 % over weight
            3. Severe obesity: >100 % over weight
Obesity can be measured by Body Mass Index (BMI): BMI = Weight in kg/Height in m2. Value more than 25+ signifies nearing Obesity.

Etiology of Obesity:
  1. over nutrition or over Eating
  2. Inactivity and sedentary life style i.e. decreased physical activity
  3. Genetic factor e.g. inherited nature
  4. Psychological factor e.g. over eating or abnormal feeding behavior due to emotionally upset condition.
  5. Endocrine and metabolic factors e.g. hyper adrenocorticism
  6. Childhood over nutrition
  7. Greater energy intake than energy expenditure
  8. Developmental factors- e.g. hypertrophic obesity, Hyperplastic obesity, Hypertrophic-hyperplastic obesity.
  9. Neurogenic abnormaities
  10. Hypothalamus injury
  11. Excessive intake of sweet substances, cold and unctuous food
  12. Lack of exercise and day sleep
  13. Lack of thinking
  14. Certain therapeutic measures like santarpana, brimhna
  15. Some drugs such as tricyclic antidepressant drugs, sulphonyl urea drug, oral contraceptive pills, and corticosteroids
  16. A number of diseases such as hypothyroidism,Cushing’s disease, Insolinoma and hypothalamic disorders

Clinical sign and symptoms of Obesity:
  1. An increase in body weight and evident mass of fatty tissue
  2. Inability to work
  3. Mal dour in body
  4. Hypertension
  6. Amenorrhea and other menstrual disturbances in female
  7. Excessive perspiration and skin disorders
  8. Excessive hunger
  9. Cardiovascular related abnormalities are seen

Complications of Obesity (Invited diseases by Obesity)
   1. Related to Cardiology:
     -Ischemic heart diseases: Angina and Myocardial Infarction
     -Congenital heart failure
     -High blood pressure
     -Abnormal cholesterol levels
     -Deep vein thrombosis and pulmonary embolism
   2. Related to Endocrine and Reproductive:
     -Diabetes Mellitus
     -Polycystic ovarian syndrome
     -Menstrual disorders
     -Infertility
     -Complication during pregnancy
     -Birth defects
     -Intrauterine fetal death
  3. Related to Neurology:
     -Stroke
     -Meralgia peresthetica
     -Migraines
     -Carpel tunnel syndrome
     -Dementia
     -Idiopathic intracranial hypertension
     -Multiple sclerosis
  4. Related to Psychology:
     -Depression in women
     -Social stigmatization
  5. Related to Rheumatology and Orthopedics:
     -Gout
     -Poor mobility
     -Osteoarthritis
     -low back pain
  6. Related to Dermatology:
     -Stretch marks
     -Acanthosis nigricans
     -Lymphoedema
     -Cellulitis
     -Hirsutism
     -Intertrigo
  7. Related to Gastrointestinal:
     -Gastroesophageal reflux disease
     -Fatty liver disease
     -Cholelithiasis
  8. Related to Respirology:
     -Obstructive sleep apnea
     -Obesity hypoventilation syndrome
     -Asthma
     -Increased complication during general anaesthesia
  9. Related to Urology and Nephrology:
     -Erectile dysfunction
     -Urinary incontinence
     -Chronic renal failure
     -Hypogonadism
10. Related to Onchology:
     -Breast, ovarian
     -Oesophageal, colorectal
     -Liver, stomach
     -Endometrial, cervical
     -Prostate, Kidney, Non-Hodgkin’s lymphoma, Multiple myeloma

Preventive and Some Curative Measures:
  1. Weight management by yoga and pranayam, aerobics etc.
  2. Risk factor management such as substitute intake of junk food by natural healthy diet
  3. Adopt one day water dietary fasting per week (as recommended by physician, vaidya, or naturopath)
  4. Manage obesity caused diseases
  5. BMI assessment helps the person to undergo weight reduction therapy
  6. Screening of High Risk People to obesity
  7. Modification in lifestyle and reduction of calorie intake and increase physical activity
  8. Use of Tikta ans Katu rasa dravya such as Maricha, Pippali, Vidanga etc.
  9. Use of some drugs such as Amphetamine, Sibutramine
  10. Surgery

For the management of obesity, low calorie diet, regular yoga, pranayam or suitable physical exercise are the best choices.  

17. Care of the Pregnant Woman and Mothers


Description:
            During pregnancy and after delivary, woman may suffer from several ailments. Common complaints are nausea and vomiting, gas in abdomen, constipation, indigestion, urinary complaints, oedema, sleeplessness, bleeding from genital tracts, fever (specially after delivary), waeakness, and not having sufficient breastmilk.

Management:
            The following remedies should be used for the management of ailments:
     •      Nausea and vomiting during early pregnancy: give one teaspoonful (5 ml) of lemon juice with a pinch of salt or two to three times per day. Also ask the woman to chew cardamom (Elettaria cadamomum) three to four times per day.
     •      Gas in abdomen: give one teaspoonful (5 gm) of the powder of Trachyspermum amni with hot water twice daily after food or give half teaspoonful (2.5 gm) of the powder of Elettaria cadamomum three times per day with hot water.
     •      Constipation: give two teaspoonfuls (10 gm) of ispaghula (Plantago ovata) twice daily mixed with hot water or hot milk. Do not give juice with equal in quantity.
     •      Urinary complaints: give one teaspoonful (5 gm) of the powder of Tribulus terrestris with water.
     •      Oedema: give one teaspoonful (5 ml) of the juice of Boerhaavia diffusa twice daily with sugar, jaggary or honey. If it does not disappear within one week refer the patient to hospital.
     •      Sleeplessness: give one teaspoonful (5 gm) of the powder of the root of Piper longum or Nordostachys jatamansi at bed time with equal quantity of jaggary.
     •      Bleeding from genital tract: if it happens during pregnancy, give absolute rest to the patient and then give one teasponful (5 gm) of the powder of Mesua ferrea three times per day with water. If bleeding does not stop within 24 hours, refer the patient to the primary health centre or hospital.
            If bleeding continues after delivary, give one teaspoonful (5 ml) of the juice ofCynodon dactylon three times per day. If there is no satisfactory response after 24 hours of the treatment, refer the patient to primary health centre or hospital.
     •      Fever after delivary: give 1/2 teaspoonful of the paste or powder of Curcuma longa with milk or hot water three times per day or give one teaspoonful (5 ml) of each of the juice of ginger (Zingiber officinale) and Tinospora cordifolia. If the fever does not subside within 24 hours, refer the patient to primary health centre or hospital.
     •      Insuffient breastmilk: give one teaspoonful (5 gm) of the powder of Asparagus racemosus or Withania somnifera twice daily with milk.
     •      General weakness: give one teaspoonful of the powder of ginger, fenugreek (Trigonella foenum-graecum) or Withania somnifera with milk.

Diet and Regimens: Give nourishing, but easily digestible, food including milk, cheese, vegetables and fruits. Avoid curd and fried food. Garlic, ginger, turmeruc (Curcuma longa) and cumini (Cuminum cyminum) seeds are useful. The mother should bot exhaust herself and should take sufficient rest. She should not expose herself to strong sun, cold wind or rain. Mental worry and anxiety should be avoided. Frequent pregnancies and delivaries makes the mother very weak. She should be advised against frequent pregnancies and that there should be a gap of at least 4 years between two pregnances. c a

Reference:  WHO SEARO Regional Health Papers No 19
The Use of Traditional Medicine in Primary Health Care- A Manual for Health Workers in South East Asia, 1992

16. Triphala: A versatile Ayurvedic Formulations


Ashok K. Mahato

Triphala is an Ayurvedic herbal formaulation that is commonly used and best known among all ayurvedic preparations. It comprises the fruits of three trees: Aamalaki(Embelica officinalis), Bibhitaki (Terminalia belerica), and Haritaki (Terminalia chebula). These fruits are dried, powedered and then blended together according to ayurvedic principles. It is a general health tonic useful for all body types as well as in various health conditions. Each of the three herbs in triphala is a powerful and effective medicine in itself. Embelica officinalis is recommended for inflammatory conditions. Terminalia belerica is used for the treatment of cholesterol-induced ailments, digestive and liver disorders. Terminalia chebula is used to treat digestive problems. Triphala regulates bowel movements and is of great benefit in cleansing the large intestine or colon.
         
Aamaliki/Amala – Its fruits are highly nutritious and are important dietary sources of Vitamin C, minerals and amino acids. It is acrid, cooling, diuretic and laxative. The dried fruits are effective in treating haemorrhage, diarrhoea and dysentry. In combination with iron they are used as a remedy for anaemia and jaundice. E. officinalis readuces cholesterol levels and has also been studied for its anticancer effects in University of Pittsburg Cancer Institute.
         
Bibhitaki/Barro- The antibacterial properties of the fruit can be used for treating patients with piles and diarrhoea. Bibhitaki when used as herbal eye drops, has shown encouraging results in cases of myopia, corneal opacity, immature cataract and infective conditions and bellirica reduces cholesterol levels and has a protective effects on heart and liver. It has been used as a primary treatment for digestive and respiratory problems.
         
Haritaki/Harro- It has been used in Ayurvedic medicines as a digestive aid. The fruits are credited for its laxative and tonic properties. It is also a known hepatoprotective and antistress drug. It improves bowel regularity, thus making it a useful laxative. It is also effective in treating patients with diarrhoea and dysentry.

Benefits of Triphala:
       •    It regulates bowel movements, improves digestive, circulations and liver functions, and reduces serum cholesterol. It is commonly prescribed to tone and strengthen the digestive system, particularly in cases of weak digestion and constipation. Being a gentle laxative, it can be used daily. It balances the body’s metabolism, restores appetite, and regulates and detoxifies the bowel. As a digestive tonic and laxative, it is best taken in the evening just before bed time.
       •    Triphala is a good source of vitamin C and enhances immunity.
       •    An infusion of Triphala can be used as eye wash to reduce soreness and redness of eyes.
       •    Triphala has anticancer properties that prevent or slow growth of pancreatic cancer. According to the researches, triphala triggered the cancerous cells to die off and significantly reduced the size of the tumors without causing any side effects.

15. General Methods of Preparation of Herbal Medicine in Ayurveda


Mr. Laxmi Narayan Tiwari

Different parts of plants are used in medicine. In the case of small herbs or bushes, the whole plant is generally used along with the leaves, stems, roots and flowers. Different parts of big trees like flowers, fruits, seeds, barks, heartwood (pith) and leaves are used in medicine. The exact parts of the plant, which are therapeutically very efficacious and, therefore, should be used in medicines (are described in the respective monographs).

These plants and their parts are generally available from forests, fields, parks, road sides, grocer shops and even form the kitchen. Generally, these are naturally mixed with sand, mud, dust particles, extraneous material like stalks and leaves of the same plant or other plants. Sometimes, in grocer shops and the kitchen, these plants or parts of plants get mixed up, knowingly or unknowingly, with other harmful things. Therefore, before processing it is essential to clean these plants or plant-parts carefully by winnowing or hand-picking. Green herbs should be washed with clean water before use.
These plants and their parts are processed in several ways before administration to a patient. Those which can be done at home are described below.

PASTE:
The plant or plant-part should be soaked in water for sometime before making a paste. Green herbs, leaves and flowers generally contain a lot of water in them and, therefore, need not be soaked for long. Dry barks, fruits, roots and stems should be soaked for about half an hour and then crushed through a stone grinder (paste and mortar).
During grinding some more water should be added. The paste should be uniformly fine. Roots and barks take a long time to be reduced to a paste. It should be ensured that during grinding no extraneous matter, like dust and sweat fall, into the drug. The paste should be collected in a metallic or clay cup and covered with a lid. Generally such pastes should be used within 24 hours. For the next day, fresh paste of drugs should be prepared.

JUICE:
Generally juice of green herbs, leaves, flowers and juicy fruits is used in medicine. Leaves, etc. should be made to a paste in the first instance and this paste should be squeezed through a clean, but tough piece of clothes. The juice thus collected should be kept in a glass, metallic or clay container covered with a lid. Like paste, the juice should be prepared only for 24 hours, requirement because it gets spoiled thereafter.

INFUSION OR TEA:
Some leaves, barks and roots like Ocimum sanctum (tulsi), Terminalia arjuna (arjun), and ginger can be used in the form of a tea. For this purpose, these plant-parts are crushed and reduced to a coarse powder form and kept in a tea-strainer. Hot water is poured over it. To the liquor, thus obtained, adequate quantity of milk and sugar or salt as par taste can be added. The coarse powder of these plant-parts can also be added to water, boiled for a short time and then strained through a tea-strainer or clean cloth. To the liquor thus obtained adequate quantity of milk and sugar or salt can be added. Every time fresh tea should be prepared and given to the patient.

POWDER:
For preparing powder, the plant or the plant-part should be well dried. Generally, it is done by exposing to sun. But for better therapeutic efficacy some plants are required to be dried only in shade (this has been specified in the respective monograph). Unless, it is urgently required, exposure to fire through a frying pan should be avoided because such exposure spoils some of the useful medicinal components.
After proper drying, the plant should be pounded and fine powder should be prepared by sieving through a cloth or metallic sieve. This powder should be stored in a clean dry glass container properly corked. Such powder can be used up to three months.

DECOCTION:
The most common method of using the plant or plant-parts like barks, wood and seeds is by way of preparing a decoction. For this purpose three teaspoonfuls (15 g) of the coarse powder of the plant or plant-part should be boiled in a metallic or earthen pot by adding four ounces (120ml) of water and boiled over mild to moderate fire till one-fourth of the water remains. The powder should then be strained through a clean piece of cloth. The liquid, thus obtained, can be given to the patient. At a time, decoction required for 24 hours can be prepared. Next day it should be prepared a fresh.

OTHER METHODS:
Plants are also used in the form of a syrup, linctus (thick syrup), pills, tablets, medicated ghee (ghrita), medicated oil (taila) and medicated wine (aasava and arista). Such preparations of these medicinal plants are available with commercial manufacturers.

Reference:    WHO SEARO Regional Health Papers No 19
The Use of Traditional Medicine in Primary Health Care- A Manual for Health Workers in South East Asia, 1992

14. The Importance of pure Mustard Oil and Omega 3 Fatty Acids

Alden Towler, Fulbright Scholar in Nepal, from USA


• Pure mustard oil, pumpkin seeds, hemp seeds, and flax seeds all have the perfect ratio of omega 3 to omega 6 fatty acids required by our body for good health.  Other good sources of omega 3 fatty acids include fish, mustard greens, and kidney beans.
• Eating such foods in balance is associated with low incidence of diabetes, heart disease, high blood pressure, obesity and metabolic syndrome, rheumatoid arthritis, stroke, depression, and other diseases.
• These omega 3 rich foods also nurture the brain, improving memory and cognitive function. Omega 3s are also important for brain development and shown useful in increasing concentration power.
• Omega 3 fatty acids are a kind of fat.  Many foods and oils contain omega 3s, however the most important thing to know is the ratio between omega 3 and omega 6 fatty acids.
• The ideal ratio of omega 3 to omega 6 fatty acids is 1:3, meaning 1 part omega 3 for every three parts omega 6.  This is the exact balance found in mustard oil.
• Common vegetable oils like soybean oil, sunflower oil and margarine (dalda) have a dramatically skewed ratio closer to 1:20.  Care should be taken, because these oils are popular for cooking and are most common ingredients in popular packaged and street foods.  This omega 3-omega and omega-6 imbalance is a cause of diabetes, heart disease, high blood pressure, obesity and metabolic syndrome, rheumatoid arthritis, stroke, depression, and other diseases.
• “Edible Vegetable Oils” as an ingredient usually means a combination of omega 6 rich cottonseed, corn, soy, sunflower, safflower and/or palm oils.
• The use and consumption of such omega 6 rich oils must be minimized to achieve a healthy balance of omega-3s.

Other Dangers of Refined Oil

• During the refining process of popular modern cooking and edible oils, very harmful chemicals are created called ‘free radicals’ and ‘trans fatty acids’.
• Free radicals are very harmful compounds which, in excess, cause heart disease, cancer, accelerated aging and dozens of other degenerative diseases like kidney failure, nerve damage, blindness, and memory loss.
• Trans fatty acids are a type of fat found in “partially hydrogenated” oils.  Trans fatty acids increase total cholesterol levels, promote obesity and greatly increase chances of heart disease.  Trans fatty acids are so dangerous that they are being banned and made illegal in America (U.S.A.) and other countries.  With no regulation in India, China or Nepal large amounts of trans fatty acids are found in nearly all fried and packaged foods like chow chow noodles, samosas, donuts, puri, pokora, biscuits, sweets, chips, etc.
•  Mustard oil is an unrefined oil that is considered one of the world’s healthiest oils and great for preventing many disaeses. Pure mustard is low in free radicals and trans fatty acids and rich in antioxidants.  Mustard oil is also very good for the skin and can be used as a massage oil.
•  Antioxidants are very important micronutrients that combat the negative affects of free radicals in the body.  Important sources of such micronutrients are fruits and vegetables and other foods like: Indian goose berry (amala), oranges, spinach, broccoli, organ meats, uncooked tomatoes, carrots, and green leafy vegetables.
• "Pure mustard is low in free radicals and trans fatty acids and rich in antioxidants.”

Taken From: Ayur Info Special Issue 2067

The author can be reached at:



Friday, December 9, 2011

13. Who is responsible to bring exact statistics out?

As we have seen that there is a large contribution of so called alternative and complimentary medicine, and now some name it Integrative Medicine. The largest body of health care service, WHO, also accepts the fact.

But general people don't come to know about these services until they don't get easy relief from the problems they acquired.

Though they teach others to be fact based, unbiased, evidence based etc. But they seem biased in this respect. But I don't want to blame some health care statisticians, and of all the countries. In reality people are not provided the exact information about the kind of services. If they get anything, that is negative. For example some official bodies say that there is no good service in the so called alternative and complimentary sector. People get information form other alternative source.

Government bodies seem less interested to teach people the use of such medicines. It is the personal or social effort that people learn these and use them for health benefit of people.

It's high time responsible bodies devoted some time to encourage such medicines. Invest in research. Without being biased - if that is anything possible.

Thursday, November 17, 2011

12. Jaundice (Kamala) in Ayurveda

Most of the people prefer Ayurvedic treatment for jaundice condition. The therapy has been well accepted by many studies. In Ayurveda it is a problem related to Pitta, one of the three major dynamic factors concerned with human physiology in health and disease.


Kamala ( Jaundice in Ayurveda) 
It is a condition characterized by the yellowish staining of the skin, whites of eyes, mucous membranes and body fluids along with the excessive secretion of bile pigments in urine, faeces, and another body secretion due to various Pre Hepatic, Hepatocellular, and post hepatic causative factors. It may be easily curable (or self limiting on simple diet and rest), or severe cases like that of liver failure. Most of the cases can be treated using simple medication, suitable diet, some sorts of restriction to foods and habits, and rest. So timely consultation with the registered doctor or health worker nearby is very much required. (See the notice below).

Hetu and Lakshan (Causes and Symptoms) 
Causes may be varied. Infected water, infected food, chronic alcohol use, hemolysis or other conditions, and other sorts of problems in liver or associated tissue/organ may be the cause. Jaundice is the condition in which liver becomes inflamed known as hepatitis. In infection or obstructed bile duct due to cirrhosis, gall stone, pancreatic tumor etc., the liver cells fail to neutralize bile pigments (bilirubin, bilverdine ) . Then these pigments reach in the various part of the body through blood circulation and stain them.

The yellow colour first appears in the white of the eyes (sclera) and then spreads to the whole skin. Excess of bile pigment circulating in the blood gives the skin in Yellow colour. The bile does not go into the intestine as it should and so the stools of the jaundice patient lose their typical brownish colour and become clay white, in severe cases are almost whitish. There is loss of appetite and impairment of digestion. The liver is unable to digest fat and there may be sense of fullness at the time. Nausea may also be present in certain cases because of defective digestion. If the liver is inflamed, there is also pain in the region of the organ and it is tender to touch.

Diagnosis done by physician/doctor by:
1. History taking and physical examination by doctor. a. History: symptoms, events of symptoms,occupation, food and water, sanitation, alcohol, drugs, blood transfusion, other problems, family history, medical/surgical history etc. b. Physical Examination: General appearance, conscious level, eye, tongue, abdomen, legs etc. Temperature, Blood pressure, pulse, respiratory rate, chest etc.
2. Investigation: Ayurvedic doctors can also take support of laboratory or radiological investigation for proper scrutiny of the problem. Depending on the condition, doctor may ask for common lab investigation of blood profile, liver function test etc. If doctor suspects of gall stone or other liver pathology etc., s/he may ask for ultra sonogram of liver and whole abdomen. Depending upon the condition s/he may ask few other examinations.

After diagnosis, doctor will tell you the nature of problem and the nature of treatment: i.e. self limiting on rest and normal diet, or requiring medical or surgical support. If the doctor can not treat in the set up, s/he may refer you to a proper place.

Chikitsa (Treatment for Jaundice) Kamala:
Since liver is the largest gland, main site of metabolism and detoxification, the diet should be easily digestible, and waste materials are better removed from the intestine earlier during jaundiced condition. So Ayurvedic treatment contains those medicine that facilitate removal of waste substances from the gut and kidney, and provide instant energy.

The Treatment of Kamala (Jaundice) must start with purgation. The basic theory is that no burden be placed on the liver and for that, a daily purgative is recommended. Reduction of nitrogenous waste enables one to stay away from probable hepatic coma. A diuretic may also be administered to encourage the flow of urine, which will expel most of the bile from the system.

Probable Medication: (The doctor choses the combination of medication, not all the medicine will be used at a time, but only the required ones. In few condition medication is not required, just rest and few supplement will be sufficient. In some condition medical treatment is said not to work, surgical help may be required.)
  • Daily consumption of Triphala powder (10gm) Soaked in water overnight. (equivalent to Lactulose)
  • Regular intake of Guduchi Juice 10gm twice or thrice a day.
  • Daily intake of neem juice is also useful for jaundice. (If one is hypoglycemic and hypotensive, better not take it.)
  • Mix equal quantity of kutaki and chirayata and take about he 10gm of mixture soaked in water with sugar or mishri. 
  • Take regularly alum powder and sugar twice or thrice a day as a diuretic in jaundice.
  • Regular intake of Avipattikar churna about one- teaspoonful twice a day with hot water. 
  • Arogyavardhani vati 2-2 tablets regularly with hot water twice a day.
  • Rohitakyadi, Punarnava, Phalatrikyadi kwath, Dhatri Lauha… etc. may also be used. 
  • Some other well-accepted herbal medication may also be suggested. 
[Modern/Allopathic doctors may use antibiotics, antiprotozoal, anthelmintic, laxatives e.g. lactulose,  diuretics, IV fluids, Dextrose, Vit B, Vit K etc. or/and other measures e.g. surgery depending on the need.]
Duration of treatment: Depending on the condition 1-2 weeks to 1-2 months, in general.

Pathya ( Diet for the liver disorder )
  • Food should be Non oily and non spicy. 
  • It should be easy to digest. · Wheat , rice, java, green gram, redgram, is use full for jaundice. 
  • Green leaves of raddish are beneficial in the treatment of jaundice, the leaves should be Pounded and there juice expressed out through a piece of thin cloth. 
  • Lemon juice and water, beets tops and beet juice and dandelion or black radish extract are good for rebuilding and cleansing the liver. 
  • Coconut water, buttermilk with cumin seeds are also advisable in jaundice. 
  • Sugar cane Juice, Fruit Juice and dry grapes are also useful. 
  • Complete bed rest is also essential for the patient. 
Apathya (Diet restriction )
  • Avoid food items difficult to digest e.g. meat items. It is because during this condition liver, the largest gland, may have trouble to support proper metabolic activities in the body.
  • One should avoid maize, pearl millet, Bengal gram, black gram. 
  • The vegetables like potato, cauliflowers, brinjal. 
  • Fruits like Papaya, Guava, rose Apple and mango should be avoided. 
  • Curd coffee and tea should be restricted. 
Care: (Proper- Hygiene, Nutrition, Rest, Fluid etc.)
  • Always take Time to time food. 
  • Food should be non – oily and non spicy food.
  • Always have food, which is easy to digest. 
  • Have lots of green vegetables and fruits, be careful to wash them thoroughly.
  • Have plenty of water regularly, water should be clean. So purify by boiling and then take it when it cools to an tolerable temperature. 
  • Have small meals, many times a day, say 3-4 times. 
  • Have water in 2-3 glass quantity, many times, about 8-14 times a day. (According to the capacity). Don’t drink just after meal, rather after 30 minutes. 
Note:- This treatment is defined for very normal and average condition / symptoms, if the person with jaundice won’t get relief in quick time then there are other preparations of Ras/minerals and herbs in Ayurveda science.

Notice:
  • This is aimed to provide people with information in simple language. 
  • This is not to replace the professional checkup, investigation, and treatment. 
  • Take medication under the supervision of a registered doctor or health worker, to avoid improper medication. 
  • If you want to suggest or ask, write us at: ayurinfo11@gmail.com 
Reference:
 
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