We need Pathology and Psychology included in our curricula !!!

We live in a modern world, we are susceptible for forgetting our past, many of the present unexplained behavioural patterns, such as right handedness being predominant, are infact reminiscence of our ancient past if not remote ! I said this because, we will forget and leave everything that does not suit our present logic and understanding, so unless and untill ayurveda is going to be modernised, it is going to be forgotten,,,(to be expressed may be in our behaviours...or so !!! ), so...the matter is that while practising i find an increasing need for one to know the pathology, if not the symptomatology of the disease, for that case , while i am treating a case of inflammatory arthritis of knee, the effect of vasodilation will be known only if i had previously studied about the vascular changes in inflammation, so that i don't need any reaserch works to prove the efficacy of dharas and choorna swedas. The information regarding the transdermal action of oils has given me confidence to convince satisfactorily "logical patients", for others just a psychological relief will do. You cannot treat any disease with tridosas alone, and I think the NEED FOR INCLUDING PATHOLOGY is important as far as BAMS SYLLABUS is concerned. Dedicate a single paper on modern pathology alone, like you did for kriya and rachana sareera which occupy 4 papers. Not a single question regarding a pathology (pure pathology i mean) have i faced during the 33 papers of BAMS examinations that i have faced (with symphathy...ofcourse!!!). No wonder bams doctors are a failure ! They are made that way, its not the problem of ayurvedic medicines, its that students are provided with inadequate datas so as to level up with the reasoning of a common man ! Its a horrible scenario for a new doctor. But you must take interest to study pathology for the sake of "inquisitiveness" that will take you places. Give importance for clinics, practise and aquiring knowledge.

The next thing to be INCLUDED IN BAMS SYLLABUS, would be.....any guesses ? It would be the least expected, because we expect biochemistry, as we are aping the MBBS, common ....we are dealing with ayurvedic pharmacoepia, and I think daeling with chebulinic acid, and the likes is ...adequate as far as ayurvedic drugs are concerned. (For that, I think dravya guna vijnana is best ). It is nothing but PSYCHOLOGY/PSYCHOTHERAPY anyway you call it ! Yes, it is of primary importance, given the fact that a majority of the ayurvedic patients are psychologically affected which gives the more scope for placebos to act, anyway it works, who cares if it was a placebo effect or not ? Understanding the basics of human psychology and completing classes in counselling and psychotherapy will do a hell of good to all ayurvedic practitioners, no doubt. You will be able to converse with the patient better and understand his problems better, the root of the problems always lies in the hidden pores of the sub-conscious and un-conscious.

So I hope the concerned authorites take necessary action in implementing these changes in the curricula which I feel are an emergency requirement ! Psychology and Pathology !!!

SURGICAL LAMINECTOMY, A FAILURE ?

DATE : 16/5/2014

PLACE : TIRUCHIRAPPALLY

Due to the special shape, i mean an erect shape of the human vertebrae, he is prone to a special type of disease called the BACK PAIN ! 

Almost 90% of the cases that come to an Ayurvedic hospital invoves disease involving spine and joints, and majority of them being what is put in our diagnosis column as THE LUMBAR DISC DISEASE(LDD-we prefer shorter formatt for everything) or THE CERVICAL DISC DISEASE.

When I pass through my memory of taking cases , intriguing patients, writing down their history of presenting complaints (all in the typical medical stereotypical manner, no compromise for that !), one very strange fact came to my observation which was also pointed out by one of my senoir docs, about the failure of surgery in treating back pain related cases. (He strongly advices every patient that comes to him not to take surgery)

I remember one such instant where, a patient with L4L5 disc prolapse, complaining of thigh pain and calf pain for left lower limb, which suddenly aggravated after subsiding , posing a surprise for us (our assumption .....or rather my assumption was that , he would have aggravted his condition himself by forward bending, which is not advised in such cases!) !

He adamantly requested for a discharge, and almost lost the confidence in the treatment ! Dammit, I almost had my heart in my mouth ! But to my rescue, at that very same instance there were two other patients who had performed a laminectomy treatment, and got bilateral radiculopathy , which was then unilateral, before the treatment !

Our doctor introduced these patients to the complaintee and he seemed somewhat satisfied as there was no other go !

But Ayurveda Panchakarma showed its effects two days later when the pain was controlled, and the radiating pain was not present even when the patient was asked to sit and walk for more than half an hour.

NOTE : THE ABOVE SAID ARE JUST OBSERVATIONS AND THE EFFICACY OF PANCHAKARMA THERAPIES OVER SURGERY HAS NOT YET BEEN SCIENTIFICALLY PROVED !

ALS,,...ayurveda,,,,the effect of holistic healing ! "god sure lives in the neurons" !!!

Two years before during the initial stages of my clinical practise in hospital as an RMO I came to encounter the ALS, the amyotropic disease, but I did not know the disease was such rare and could become so severe, that the awareness created for it that is the ice bucket challenge spread like a wild fire, from the clebrities to the common man.

The patient, a short statured female of 46, had presenting complaints of, progressive weakness for both upper limb since 15 yrs, which worsened since the past 2 yrs or so, difficulty to lift both the hands and hold objects such as a glass tumbler, pain for the entire spine, non essential tremor for legs while carrying weight  or while standing for long time, pain for shoulder joint, wrist joint and knee, morning stiffness especially for neck and shoulders, difficulty in getting up from bed, numbness in thighs and generalised weakness. The onset was insidious.

Patients appetite was less and the sleep was disturbed. Blood pressure , pulse and other vitals were normal.

Gait was difficult due to LL weakness especially the instability of hip being the predominant symptom.Upper limb reflexes were diminished or absent while the lower limb reflexes were normal.The power of shoulder were 2/5, elbow were 3/5 and the wrist were 4/5, while that of hips were 3/5, knees and ankles were 4/5. The Creatinine phosphate and Creatinine phosphate cardiac marker values were 134 and 5 IU/ML resply which were within normal ranges.

The main challenge as far as the treatment were concerned was in returning the lost confidence of the patient who was anxious, depressed ( and why not ?) usually replying in trembled tones about her complaints and worried about her fate ! But to our aid, she was an ardent believer of Sathya sai baba, and when ever we entered her room , we could here songs of sai from her tape which she used to carry with her every where ! The treatments and medicines given were nothing different from what other ayurvedic hospitals give like abhyangam, choorna swedam, anuvasana vasti, njavara kizhi etc...vata samana and brmhana therapy with dhanada nayanadi kashayam and vidaryadi kashayam respectively, Dhanwantaram 101 avarti, Ksheerabala thailam for head etc...which is a common treatment schedule for an ayurvedic doctor ! But the patient needed her doubts to be cleared off ! Wether she could walk ? Is it possible to get better with this treatment ? But we ensured her 60% relief ! Two years after the treatment she is going good, and that is a good news for all patients with neuro-degenerative diseases including Multiple sclerosis, Demyelinating neuropathies, Poly neuropathies, GBS, Peripheral neuropathies etc !

Believe in god ! Be an theist if you have MND ! I have seen some theories as to "GOD LIVES IN NEURONS"...and so on.....but as far as MND is concerned, God exists and it sure lives in the neurons !
By Dr.Prasanth BAMS, Kerala Ayurveda Hospital, Trichy.
29/08/2014

AN OPEN LETTER TO NARENDRA MODI !

FATE OF AYURVEDA DOCTORS ???

This is in reference to your budget that was presented a week before or so, where Indian System of Medicine, Ayurveda was given the least or negligible importance. Ayurveda is India is under the regulation of AYUSH under the ministry of health. This is not only a concerned plea regarding the approach towards Ayurveda, which pioneered the whole concept of Medical Tourism in India, which in Kerala alone is to be worth 4billion $ by 2017, but regarding the fate of Health Sector in our country. Indian Health Care system is just a nominal health care system, there is not enough hospitals, doctors, medical staffs medicines or ambulance services available in the country.Quallity of care and accessibility is very poor. Most of the people depend on private hospitals for health care except very poor people, who depend upon government hospitals because they cant afford private out of pocket health care. This system cant be called a health care system on western perspective. Although the initiative of distributing free over the counter drugs is welcome, my concern is about providing expert care in rural areas. The role played by Traditional Chinese Medicine (TCM) in elevating the health status of China and the steps taken by Chinese governments to endorse it has benifitted it very well. The New Rural Cooperative Medical Care System , a 2005 initiative, with an investment of 2.4 billion US $ from the Chinese govt to be spent over a period of five years primarily was meant at over hauling the private medical systems, for which the TCM played a huge role in giving essential services to the rurals, with them being equppied with necessary western methods of treatment especially in handling emergencies.Today TCM continues to be a part of all major and minor hospitals in China even though the integration level varies in different hospitals and it is to be accepted that the process is still not smooth one. The Modern and Traditional methods don’t easily merge ! China is also a witness to mass mobilisation campaings for health and patriotic health campaigns for the eradication of epidemics. Barefoot doctors from people commune are a part of history ! They stand as a testimony to health care development in China with them being trained equally in Traditional and Modern medicine. Such a spate of affair is totally lacking in India. The Modern hospitals don’t have an Ayurvedic wing, and even government hospitals don’t have it ! Here Modern and Ayurvedic medicine are treated separately, and only MBBS graduates are considered to be fit for treating patients. They (allopaths in india)are totally ignorant of the theories of Ayurveda yet prescribe a wide variety of patent ayurvedic propreitary medicines for all sorts of diseases. There is no major hospital that exists in India that has its reputation for giving quality ayurvedic treatment , that is run by the central or state govts, other than that under the colleges which can be counted with our fingers. So the need for putting more hospitals all over the map is a genuine one, and the effect of ayurveda in treating chronic diseases of all kinds is now world famous. So it is a bit of a costly mistake to not to make quality ayurveda a reality, orlese just like the british took away our kohinoor, this system is also gonna be lost to foreigners who seem to welcome it with both hands. Steps must be taken to provide free and cheap treatment to the poor so they can affor d ayurvedic medicines. In the name of Medical tourism we must not sell Ayurveda to foreigners, we must first cater to the indigenous needs , then look up ! Strict controls and regulations for preparation of medicines,  their distribution, running hospitals, medical health centres, parlours must be brought into the control of government institutions. The ayurveda must be brought out from the clutches of big private companies and monopoly must be eliminated, by creating more govt run medicine production units and hospitals. Sure any measure in promoting ayurveda at the grassroots level will be welcome by the ayurvedic community, and we wish you all success in your endeavours. 

Dietary management, Exercise and Foot care in DM.

Dietary management

Goals of Medical nutrition therapy

1.       To achieve and maintain near normal glycemia

2.       To achieve and maintain optimal lipid profile , total cholestrol <150, triglyceride </= 120, HDL >50, LDL < 100

3.       To achieve and maintain normal blood pressure levels around 120-130 to 80-85 mmhg

4.       To adjust the nutrient intake to restore and maintain ideal body weight to avoid dyslipidemia, cardio vascular disease, hypertension and nephropathy. During childhood and pregnancy adjustment for growth should be provided

5.       For elderly patients, provision for proper nutrition and psychosocial needs

Diabetes Mellitus Type 2 – First step dietary management therapy + Exercise 50 % come under control.

Optimum daily intake needs in calorie intake per kg of desirable body weight.

                                          Sedentary           Moderate         Heavy

Obese                               20                           25                      30

Standard wt                      30                           35                      40

Underweight                     35                           40                      45

Total Calorie Intake :

Most important step while prescribing a diet

BMI( Basal Metabolic Index) = Weight in kg / Height in metre square

BMI between 22-25 ideal

Ideal body weight = Height in cm-100

Features of dietary management therapy :

-dietary management is not a reduction in diet , but modulation to suit particular need of individual . This concept will reduce psychological resistance against disease

-patient and spouse counselled together

-dietary articles prescribed in terms of weight

-better to prescribe foods in form of primary food articles like rice, meat, fish and others

-make understand reduction in food will not be beneficial

-quantity to diet and timing are important since other aspects of management such as medication and exercise are timed in relation to the diet

-vast majority of treatment failure can be avoided by proper dietary instructions

-need for strict adherence stressed during follow up

-patient should be involved in the formulation of the diet and such a participating instruction assures better compliance

-carbohydrates must make up 50-60% of the calories for good metabolic control, include more legumes, pulses, green leafy vegetables

-fats should make up 20-25% of total calories, saturated and mono & poly unsaturated fats should be equally distributed

-dietary cholestrol < 300 mg/day

-invisible fat : cereals, legumes, seeds, they contribute to 5 to 10 % of total energy intake

-milk & milk products 40 to 45 % of total fats

-milk fat is a saturated fat

-proteins 12-20%, must include lean meat and fish, strict protein restriction in renal failure

-dietary salt < 6gm/day, for hypertensives 3gm/day

-avoid smoking/alcohol completely

A SAMPLE DIETARY CHART ADVICED BY A DIABETES CLINIC

Morning 6 am : Tea / Coffee / Milk 200ml without fat and sugar.

Morning 8 am : Idli / Dosa / Chapathi / Upma / Pongal / Kichadi / Ada / Appam / Rice Puttu with Saambar 1 cup

Morning 11am : Butter milk / Coffee / Tea / Fat removed Milk 200ml + Marie biscuit / Dhal / Popcorn / Vada / Rusk / Cucumber salad- any one of these

Lunch 1 pm : Rice , with lots of vegetables and  green leafy vegetables, Sambar 1 cup, Rasam 1 cup, Butter Milk 1 cup

Non veggies : 100 gm fish or two pieces, 100gm chicken or two pieces, 100gm mutton or three pieces, egg white of one whole egg, only once in a week

Avoid : Egg yolk, fried fish, liver, brain, chest region of chicken, head of fish

Tea time 5pm : Coffee / Tea / Milk 200ml with Whole wheat mixed or Multi grain bread or same as said for 11 0’clock without sugar.

Night 8pm : same as breakfast or lunch

Night 10pm : 200ml of fat removed milk  without sugar.

Exercise therapy

Endocrine / Physiological responses during exercise

-suppression of insulin release directly as well as through epinephrine

-symphathetic system activation which inhibits insulin release and stimulates lipolysis

-non insulin dependant glucose uptake in periphery

Benefits of exercise

-lowers blood glucose concentration

-improves insulin sensitivity

-reduce triglycerides, increase HDL, reduce LDL

-reduce BP

-reduce body weight

-cardio vascular conditioning

-improves sense of well being and quality of life

Risks of unsupervised Exercise

-hypoglycemia may be caused due to over exercise, physical strain, untimely food, fasting, redcution in food as a part of dietary management etc

-symptoms of hypoglycemia are blurred vision, headache, confusion, giddiness, dizziness, increased craving for food, increased sweating, tremor, shivering

-hyperglycemia after very strenous exercise especially in poorly controlled patients

-precipitation or exacerbation of cardiovascular disease and acute cardiac events like arrythmias, sudden death and cardiac failure

-worsening of DM complications

Pre exercise check list for DM

-Duration and Intensity of the exercise must be planned with proper consultation of the diabetologist

-Review DM medications

-TMT/ Stress ECHO to rule out CAD and also to know individuals exercise tolerance capacity

-Ophthalmic fundoscopy to rule out proliferative retinopathy

-Biothesiometry to detect extent and severity of sensory loss

-Check blood glucose if < 100 mg/dl advice pre exercise snacks, 100-250 mg/dl can proceed with exercise, > 200 mg/dl check urinary ketones if positive, insulin should be started

For average middle aged DM patient

-walk 3km on level ground over a period of 45 mts

-swim for 30 mts at an average speed without cardiac distress

-cycle on level ground at 8 km/hr for 30 mts

Foot care in DM

-wash both the foot regularly in luke warm water with baby soap

-clean the foot clearly with bath towel making sure there is no water between the toes

-keep the toe nails clean, don’t allow them to get septic, cut the nails carefully

-always keep the moisture of the foot, don’t allow them to dry,apply suitable moisturising lotion and massage gently for some time, don’t allow moisture to stay between the toes

-always use suitable foot wears which are gentle and comfortable and clean, and use alwys clean socks

-when going outside don’t walk on naked foot especially around the fields and gardens, foot is a must every where

-check the foot wear for ant sand particles or thorn that may injure the foot

-walking around your house or garden with all vigour is necessary to maintain the blood circulation to the foot

-always keep your foot little higher than body level while at sleep to ensure suficient venous drainage

-while sitting for longer time don’t sit with putting legs over another legs

-immediately consult your doctor if you find any of these symptoms : numbness, prickling sensation, parasthesiae, tingling, oedema, foot crack, ulcers, corns, change in colour of skin and blisters

-if possible wear a different foot wear in morning and evening

-using canvas shoes with extra insole or MCR chappals are more helpful

-use always those shoes that are slightly bigger than you size

Also :

-Bath twice daily

-Over sweating areas apply talcum powder

-Dental hygiene is must

-Itching and skin diseases must be dealt with more seriosity

-If no proper control measures are taken DM might affect kidneys, heart, vessels and eyes.

 

    

   

   

    

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Experience, Listening, Clinics and Theory !

Experience, Listening, Clinics and Theory !

By Dr.Prasanth.K.P.

Not everybody is blessed with skills, like sachin or lata mangeshkar or messy, but these people are not the only successful people. The difference between them and other succesful people are talent, sheer talent. They posses such abundance of talent that nobody in the world cannot ignore them ! You people must very much be aware of the uproar created in the fb page of sharapova when she said that she did not know who sakhin was ? But keeping talent aside , its not the only factor that has given them the position that they are now, its also about some attitude that plays the key, its role is more than even hard work.

During a chat with my senior doc , who said when doing some arithmetics that even though I may be a good doctor (that which is he is aware of !) , I cant do certain things like writing it out, or do an extempore, he admits to have stage fear ! But I said its all about the doer –watcher phenomenon, when you are said to possess a talent at something you can be the doer and watcher at the same time, got my idea ? That is you can be aware of what you are doing, for example, even though Sachin may have a coach, from childhood, he needs no help of a coach ( an external watcher, observer, analytic supplement etc..) to correct his flaws or train, he can do without it,, its because of the cliché format followed that he “seems to have” a coach, he is in auto-pilot mode when on ! That part of the observation was proved by neuro scientists when they observed Neymar’s brain while on game, when they realised that he was literally on auto-pilot when on field. That’s the doer – watcher phenomenon I mentioned, being on auto pilot.

But that was my perception, my seniors take on that, pretty simplified, lay manly expalnation I say which every one would understand , is that , what you say the doer watcher , is nothing but the mistakes learned out of doing that helps you to get aware of what you do. It is impossible for any body of any quanta of talent to gain in confidence without experience. What ever type of genesis you may belong, as long as you are a theoritician, you cannot gain practise in the clinical field. That’s where I openly challenge the so called “purists” who demand a 100% ayurvedic system, to come out into the clinical arena. They are in their own cosy-comfotable field set up by their thoughts , that being in that gives them some sort of intoxication, they seldom venture into clinical side. What’s the use of such people ?

I share before you the difference that separates a person with a strong theoretical basis and one with a moderate theoretical basis but has got a strong base and is strong on the clinical side. Both of them say A and B, participates in a seminar on the application of takra dhara, that too presented before a scientific community of astronomers. A was a purist who knows nothing other than Ayurveda, he speaks only in Ayurvedic language, but B is a clinical person, who knows to speak the language of lay man ( other wise you are out in clinics !) . B knows about the value of A’s knowledge, which B lacks, so speaks for an hour or two with A, where A tells all about what he has prepared to present to B. B listened to it , and included majority of what A said in their conversation, but understood the practical side that the listeners were a scientific community, so presented in their language. But B clearly knows A was the better lot ! To his luck B got recognised by a scientific community and got the 1^st prize but A who got all the knowledge was ignored totally as the judges never heard of any tri dosas or ayurveda ! What a contardiction. The same is the case with our soceity. Nobody knows Ayurveda, but every body knows about a pain killer, an aspirin, an injection, a surgey, a by-pass, see how popular is allopathic medicine in the masses ? If you go on spitting slokas , you are gonna get alieanated from the soceity and the sience of life too ! DiD you get my point ? Here, as far as Tamil Nadu is concerned the Ayurveda IQ is literally zero, you say Dhara, Kizhi, they will scratch their heads ! You say aceclofenac gel, than they get you ! Such is the attitude of the patients. Be practical, speak the language of the patients, these Ayurvedic texts were not meant for students and researchers, but for the rogi’s or diseased persons !

Being a listener is one of the main traits in gaining knowledge. Know that empty vessels make more sound, was not a joke proverb ! Those who know, know that only while listening to others that they get to know, knowledge is in you, to such people and they do respect that knowldege.

So when you hear from the mouth of a vedanti, that “AHAM BRAHMASMI” or “TATTWAMASI”, don’t laugh, how I can be god ? It’s the knowledge present in you that they specify, not a stone sculpture holding a flute in his hand, bearing a peacock feather in his head. Don’t get disillusioned !

Good luck ye fellas !

Have a great day and an awesome weekend !! :) :) :)

The unpragmatic Ayurvedic Academia !

By Dr.Prasanth.K.P.

The biggest failure as far as Ayurvedic academia is concerned would be imitating the modern system right from the word go, the imitation has been pretty illogical one, done without any pragmatic approach. For anatomy you academics created a rachana sareera, and for physiology you created a kriya sareera, I doubt wether acharya says so, and in fact for all ye common masses,, there is no such thing as anatomy and physiology in ayurveda, its not a separatist approach, which I have been mentioning from the blog one, it’s a holistic one . Our very own Charaka, Susrutha and Vagbhata dedicates a section called Sareera Sthana, in which he describes about Obstetrics , Pregnanacy, Vital points, About the concept of Agni or digestive fire, About the inherent nature or prakruthi etc..Its beyond the perspective of anatomy and physiology. There is nothing such as a swasthavrittha mentioned in ayurvedics and there is no need for one, since allopaths study the preventive and social medicine, we for name sake study swasthavritha as two papers, which includes again soothrasthaana ( basics again ) in the second year also and a bit ( a tiny bit ) of yoga, which is injustice realising the importance of yoga, since the effect of pranayama on the body and breath controls is very vast as an ocean, its ridiculous, its bad. More importance should be given to Dravya Guna Vijnana, Yoga and Sutrasthaana must include both Soothra and Sareera. Anatomy and Physiology must be dealt with separate. That’s gonna be a hell of a challenge for the students, provided anatomy poses a nightmare for everyone alike !There is only one paper for Charaka, or is it needed ? Isn’t it a part of Kaya chikitsa ? Then why there was not a paper for Susrutha Samhita, its illogical ! Padartha vijnana and Sanskrit do good only provided all literatures are in Sanskrit and Sankhya philosophy forms the basement of all Ayurvedic thoughts. But that too must carefully be redacted, leaving out all those stories and things and Vaidyakeeya subhashita sahitya ! It does no good really ! Students may be introduced on a high note I say to the vedic philosophies and thoughts about sareera and atman, about the brahman etc which would be thought provoking and open their channels in the thought towards an Ayuvedic stream, an entirely Ayurvedic one. You cannot think of Ayurveda sans the vedas ! (any doubts on that ?) Second year is an empty one regarding an ayurvedic student , where the allopathic one scores highly , for the rest of his career, that’s what makes the real difference, the pathology and bio chemistry of the human body ! No Ayurvedic knowledge can equal its quanta of research and development. With quarter knowledge of human anatomy and physiology ayurvedic sub-consciously enters into an empty pool, then to go to the vast and wide ocean of chikitsa or treatment, he learns charaka, susrutha, astanga hrudaya ( that’s according to syllabus, while most of ‘em are satisfied with our popular A.H ) then all “relevant” points of commonly used MBBS texts, may be a 10 % just for the sake of passing out . How cann you treat a disease without knowing its pathology ? What do you know about pathology ? Ayurveda specifies a samprapti for every disease that is equal to pathology, but how much in use is that system ? How many of us know about nadi’s ? Well there’s plenty of topics to ponder and to debate ! 

Unique idea of ayurveda in uniting person and his environs .

By Dr.Prasanth.K.P.
Ayurveda is an Indian contribution towards the medical science and like every traditional healing systems such as the Traditional chinese Medicine, its way of out look towards healing is in a different way to that of what we now call as the Modern medicine or Allopathy which is actually a westernised product adopted universally. Since traditional healing systems existed 2000 or 3000 years ago, much before the advent of Christ or Buddha, in an era where there were no MRI's or CT's or X-RAY's, the only possible way of any progress in what is called science was by three processes of pratyaksha(observation), anumana(inference) and aaptopadesa(whatever the scholar says!) .More than viewing through a naked eye , intution was depended on more frequently, with the doctors then being saints or sages, with lots of experience in spirituality and meditation, and the drugs available being raw and processed natural products, with heat being the only processing element. Since such is the history of traditional healing systems many of its philosophies and theories are controversial much like a blind person describing an elephant by touching its limb, tail, trunk and tusk. For example , charaka, susrutha and vagbhata all differ in their opinion about number of bones, arteries, nerves etc. But modern science has been succesful in developing a universal model of health system I say, that serves its purpose , in emergency life or death situations, whatever the critics , the ignorant ones , of the allopathic system may say. The ayurvedics especially the purist ones keep on stressing the essence of vedas and ayurvedic sayings, in an awfully freakish manner, that the patieny would consider the vaidya or the doctor as a control freak or maniac ! Apart from ayurveda depending on herbs for procuring medicines for diseases, its approach in treating a disease is holistic and entire, not like the particulate and separatist approach of allopathic stream. The treatment is given based on assessing ten factors called the "ten examinations" or the "dasa vidha pareeksha" which are the patients vitiated tissue, place of residence and place of affected part in body, immunity and persons strength, time and seasons, nature of mind, allergies and that which is congenial to him/her, digestive capacity, age, genetic nature, etc...inorder so that treatment be done considering or uniting several factors, yukti or logic is to be used, and for it to be applied all these numerous factors must be expressed in a same language, inculding disease and drugs ! So that element or factor that is missing may be added and that which is excess may be eliminated ! Pretty simple arithmetic isn't it ? But the failure of ayurveda is in the inherent impossibility in quantifying such factors or elements like a bio chemical report .It was this unifying concept of "advaita" philosophy that gave rise to the phenomena of "pancha bhoota theory" and "tri dosa theory", the former one for all that exists and the latter one for the living matter alone !
Certain set of qualities have been identified to distinguish the five elements of a panchabhoota and the three elements of a tri dosa, for example : 

Qualities of solid substances – (Parthiva Dravya Laksana)-Earth has – Guru (heaviness, heavy to digest), Sthula (bulky), Sthira (stable) and Gandha (smell) qualities.Hence, substances that have Earth as the predominant element (Parthiva Dravya) have Gaurava (heaviness), Sthairya (stability), Samghata (compactness) and well nourished qualities – 5Qualities of liquid substances (Apya Dravya Laksana) –Liquid element has Drava (liquidity), Sheeta (cold), Guru (Heavy to digest), Snigdha (unctuous, oily, moisture), Manda (dull), Sandra (thickness, dense) and rasa (taste) qualities.Substances containing liquid as predominant element (Apya Dravya) have Snehana (lubrication, moistness), Avishyanda (secretion, moisture, production), Kleda (wetness), Prahlada (satiation, contentment, satisfaction) and Bandhakrut (cohesion, binding, holding together) qualities. 6.Agneya Dravya Laksana – (qualities of Agneya substances) :-Agni has qualities such as Ruksa (dry), Teekshna (penetrating, sharp), Ushna (hot), Vishada (non-slimy), Sookshma (minute) and Rupa (appearance, showing, from)Substances that have fire as the main element causes Daha (burning sensation), Bha (luster), Varna (expression of colour) and Pachana ( digestion, process of transformation, putrefaction etc.) 7.Qualities of airy substances –  Vayaviya Dravya Laksana –Air has Rooksha (dry), Visada (non-slimy, clear), Laghu (lightness) and Sparsha (touch tactile sensation) qualitiesAiry substances posses qualities such as Ruksa (dry), it produces dryness, Laghava (lightness), Vaishadya (transparency, clarity), Vichara ( movements, different kinds of activities) and exhaustion 8.Qualities of ether dominant substances – Nabhasa Dravya Laksana:-Ether has Sukshma (minuteness), Vishada (transparence, clarity), Laghu (lightness) and Shabda (sound, hearing) qualities.Substances with ether dominance  produce cavitation (hollowness) and lightness (weightlessness) 9

The above are the qualities of the substances containing a dominant element. Similarly the three basic elements of life the vata, pitta and kapha has been assigned certain qualities or gunas by which we can identify their function in body.

So pancha bhoota and tri dosas are unifying factor of non living and living matter. How do they co relate ?Rasa or blood plasma contains more of kapha dosa and jala element, so any deficiency of rasa tissue would be treated with substances containing more of that particular element, jala in this case, for which the identifying qualities are given above. How do you express a persons place in terms of health ? That is a tricky question for ann allopath, he does not consider it all ! But according to ayurvedic principles, since tropical places are hot and dry, they are mainly vata pitta predominant, and hot is agni, dry is vayu and akasha so naturally subsatances from that land would be dry, hot , pungent, so vata pitta aggravaters or kapha pacifiers according to opposite qualities !So the treatment module is pretty much simple to express everything around in terms of life so that we can take what is necessary and avoid the harmful. That is the reason why our acharya says there is nothing present in this world that is not medicine, jagatyevam anoushadham naati jagathi kinjith !!! What an idea sir ji !!!Since the above process of elucidating a process and disease is as a result of long term careful onservations on a macroscopical plane, it is ought to be imperfect in its diagnosis though it may treat a disease and cure it. So at all times modern and ayurveda are going to be at logger heads and modern medicine is going to find out the loop holes in our understanding of the body and diseases, but ayurveda has survived the modern tsunami and is gaining certification world wide ! Since researches are ever increasing and ever productive about the better under standing of human body and process in the modern medical arena, it being progressed from the aspect of cells to genes to molecules, and since more  of modernised researches are being carried out by pharma companies in the area of herbal medicine, it is not far away, the allopathic system of medicine gets a new arm of herbal medicine not as a part of graduation curricula but as an entire speciality branch for rehabilitation and palliative care ! Ayuvedics are too lazy and too ignorant for this system to see the sun rise, they were not trained so ! If you take a person of same IQ an ayurvedic one will be much lazier and igmorant than the allopathic one ! We like things to stay as such, not takin gmuch of an effort to develop our rudimentary system, we take pride in being an ayurvedic but seldom practise it in our lives, we are worse than our patients in obeying ayurvedic restrictions , ayurveda is not a treatment its a life style, its a religion very much backed by philosophy, a sect, a culture for health, science may go deeper and deeper but upon touching the soul it gets reflected , then all tiny droplets unite into one whole ocean called Ayurveda !

new blog for herbs !

created a new blog exclusively for medicinal plants in ayurveda as i thought it needed another page to mention to avoid confusion so i can discuss other relevant medical topics here related to medicine and ayurveda

blog name : healing herbs

site : www.healwithherb.blogspot.com

the link to this blog is available on the top right hand corner above archives !

thank you

good night

god bless you !

HANDLING OF EMERGENCIES BY AYURVEDIC DOCTORS DURING PANCHAKARMA ? HOW DO U DO IT ???

This advice was given to me , or given to us during our two months posting at an allopathic hospital, he was a supporter of Ayurvedic treatments, a soft hearted person to be specific, he repeatedlt kept advicing us, the internees, about the need for Ayurvedic docs to learn how to handle emergency ( this is a broad term, although he said was that, "every body must know how to insert a canula !" ) , as you don't know what would happen to a patient with a chronic illness, like RA or OA or IVDP etc being a known case of DM/HTN/CAD/HYPERCHOLESTREMIA usually old aged ! Even though they may not be admitted in a hospital for a disease that causes emergency management so as to put in an ICU, you never know ! So far as I have seen, the pancakarma therapies do hinder with the CVS, by reducing the blood volume due to sweat, so I have  attended one or two emergencies (rare mind you !) with patients complaining of a chest pain, a genuine chest pain that showed normal in an ECG when taken the first time and then when the patient reported same the next day, she was (again) taken to the emergency ward (of an allopathic hospital !) , where she was admitted to the ICU, so that the treatment was discontinued and handed over to the cardiologists ! I dont know what they do in other hospitals , cause there is no uniform code or any sort of protocol in managing ayurvedic hospitals, so that causes a concern as far as the health department is concerned regarding the quality of indigenous system of medicine ! How do you manage a sudden rise in blood pressure ? How long you gonna pacify the patient wihtout providing him any treatment other than lip service ? Something needs to be done to fill this void ! There is absolutely zero facility as far as emergency service are concerned other than the presence of the duty doctor. God be with us ! A panic attack , an epileptic attack , an accident , sudden maniac episodes in drug dependent patients, what you gonna do ? Whom you gonna run to ? What separates us from an mbbs graduate, the matter with specialisation is different, but we ought to know atleast the basics of emergency management, its quintessential.More and more patients with chronic illness are coming to ayurvedic therapies especially middle aged patients after their work related strain mostly with all sorts of diseases such as diabetes, hypertension, cholestreamia, hypothyroidism, wheezing etc. So the unexpected compplications, which might be rare or even rare of the rarest must be dealt with quickly so as save the patient, to provide with him the earliest possible treatment. Every body is behind discussing the various medicaments available , that is the evidence based drugs or patent medicines, but the fact that Ayurveda treats only the patients outside the circle of risk is a detrimental factor , we are so adept at playing the safe side. We fund crores and crores for unnecessary pharmocological research, but do absolutely nothing in governing the system better, with regular quality checks and controls. The future of ayurveda lies not in the drus research but in better systematic management of the available resources. Otherwise like many drugs and procedures that were washed away in the tide of business, to be more specific, production and demand, majority of classicall preparations are gonna perish among patent placebos. with formulations such as aristas deemed as alcohol and grithas deemed as cholestrealemic substances ! Ayuveda is gonna lose its form and purpose ! Maintain kashayas, aristas, gutikas, vatakas, choornas as such modernise the human resource not the medical formulation ! There is no ayurveda without pathya. It is a proved fact that most of the drugs are anti-oxidants and phytochemicals which function well in a fat free diet, with less of exercises ! Pathya invovlves with the biochemistry of body and cannot be ignored ! Every hospital gonna be equipped with all basic diagnostic tools like bio chemical labs, x ray units, ecg machines and other life saving kits ! Use of unambiguous terms are to be avoided like kati graha, vata, pitta, kapha which no one can understand ( do it in your exam papers dudes ) , there is gotta be a uniform code which is gonna be put in action sooner or later, such is the plight of doctors ! Sanskrit is not even our national language ! We are doctors , not hindu poojaris, chanting before a diety, and the patient is definitely not your diety, understand, change accordingly , to time !

WE NEED NO SANS-KRIT, WE NEEED AYURVEDA SANS SANSKRIT !!!

27/06/2014
Friday.

     

What is the role of sanskrit for an ayurvedic doctor, who comes into the medical arena treating the same patients as that of his allopathic counterpart , other than in aiding to pass out the degree and post graduations ? Sanskrit has affected me in more ways than one ! Since 90 % of the syllabus involves sanskrit in one form or the other, me being taught english in schools, forget about the regional languages, English is the official languages mind you ! It is only some crazy language maniacs who cling to prescribing in regional languages for Ayurvedic medicenes, that too, regional languages are given important only in Kerala , we doctors here in TamilNadu, ayurvedic to be specific dont prescribe in tamil ! What is so special for Kerala ? Yes I do agree the fact that the ayurvedic texts such as Sahasrayogam, Chikitsa Manjari, AstangaHrudayam were studied using translation of well known vaidyas, who happened to churn out good business with such publications, almost creating a monopoly in this arena for more than half a century, after India got independence, until the arrival of north indian authors like P.V.Sharma and the like, so that a vast majority of talents, I say talents because in Kerela the selection process is through a tough entrance examination process, that has produced abundance of talents in the feild of Medicene and Engineering, almost equalling the IITs and AIIMSs in our country, because the selection process is so very competitive, we as students then considered this to be secondary only to IITs and AIIMs, that much is the value of talents that churn out through this process ! The quality of ayurvedic academic provided in Kerela cannot be found anywhere in the world and I bet on this blindfoldedly ! Kerela is the cradle of Ayurveda, no doubt, and any development in this feild must include this little gods own country in the primary place , not the "north indian lobby ". I have my senior saying that he was second in the waiting list for Jamnager University and almost confirmed his place for post graduations, but due to the north indian lobby, very much seen in the Indian cricketing arena if you want to understand about that,  did not get any admissions ! He has no post graduations to his credit, but due to that he has become one of the leading practitioners here ! This incident , with many other supporting datas that I collected regarding the post graduation scenario in Ayurveda, Compelled me to quit trying for the MDs, even though many of my friends do ask why I did not even try for the MDs or the PSCs ? I have no regrets until now. 

Ayurveda,, no sanskrit has affected my reading habit like many others but I have successfully overcome that after passing out, I have never turned back to sanskrit ! It is a good language, some kind of religious language of the vedas and mantras and chanting and devotion and philosophy, not one meant for medicine, not surely for us "english spitting" kids , so well used at that time when students in state governmant schools used to prosper along with cbse with only regional language, conditions have changed, India is the country where english is spoken more than even in western countries, wake up to the realities you narrow mided freaks ! Don't blame the doctor for writing the prescription in regional language, the comment was seen in a malayalam daily, insulting the doctor, just to catch attention....other than in rural areas where the natives dont know english (i think such a condition exists only in tribal areas not rural areas, of attapadi and the like !), English is a must I say ! BAMS is a professional degree mind you , not some arts or commerce or science course, equalling with the prestigious "MBBS" for you ignorant fools, I say to that man who put a comment in the daily, MBBS=BAMS=BHMS=BSMS ! All treat the same patients ! If there seems to be any decrease in the dignity of the above degree , it is attributed to the quality of the patients, due to their mis understanding and ignorance ! They dont know even the basics of Ayurveda ! Ayurvedic Quotient or AQ must be made above 100 to all Indians, then Ayurveda would find its place among the dignified professions, not secondary dignification as now ! We do study anatomy and physiology ! We do study the Davidsons and hutchisons and parks and  das maqbools ! We can perform surgeries(minor) , use your medications, read an x ray or mri ! We are getting exposure into the modern techniques, its just the matter of exposure mind you, not our in efiicacy ! What talent do you expect from the money based institutions that churn out mbbs docs, how do they come forward, and how do ayurdocs who get on merit are pushed back , its exposure into the diseases and patients. The ratio of patients that visit ayurvedic and allopathic hospitals are not worth mentioning. I dont intend to find fault in any systems or situations, I am just speaking on behalf of that friend, who argued with me , when he said he took a wrong decision when he joined BAMS, that too after completing his MD, I did not agree with him citing his procrastination as reasons, but everybody knows what is the state of affairs in Ayurvedic academic arena, there must be a report or study on this, by an authentic committee, as a part of state govt of kerela or from the centre or from any independent but credible sources that will open the eyes of ccim, to cjange the syllabus, include relevant topics, not to include history and language and moral studies ! This is so disgusting trend ! Come on, why not biochemistry and pathology ? The disclaimer is that this is not intended to create any sort of controversies, just a blogging from a blogger, just read and take it to your mind, cause may be you can sort it out the solution ! If it causes any of hurt to anybody, it is not intentional !
TAKE THIS IN THE RIGHT SENSE !