Approach to Ayurveda Treatment
Prof. Muralidhar Sharma
based on the lecture available at–Approach to Ayurvedic Practice
A thorough clinical examination and diagnosis is the first step:
Absolutely no compromise in the clinical examination is essential. Up to a certain extent, my exposure to the contemporary system in terms of the surgical practice has helped me a lot to gain a hold on this area. The perception of clinical examination is a very important issue. Not compromising in the clinical examination is an important issue.
Investigations are done only to confirm clinical diagnosis and not to just have a general check-up or wide spectrum of investigations and picking up the findings from the investigations is not my practice. I would go for the investigations only when there is a clinical clue otherwise, I would not. This is my view on advising investigations and no intention to criticize others’ views.
It is quite natural that 90% of the patients who come to me would always have some previous records in a form of a big file. I’ll never touch those records till I examine the patient and till I make some perception about the condition. Only after having my assessment of the patient then I will go through the files or previous records. I may change my opinion or that’s all depending upon the situation. It is one of the important parts of the clinical discipline. Unless you have a definite perception about the disease, if you are going to depend upon the perception of some other person over the disease, the ayurvedic practice would not be possible. In the modern system, there are some specific guidelines resembling linear mathematical principles it may be possible but it is not possible for ayurvedic medicine. What are those factors which make this nonlinear is the example which we will try to see.
When it comes to a final selection of treatment it’s about Dosha assessment. All the investigations are necessary to predict the prognosis and to make your practice safe. One of the important issues is why people prefer a specific physician? There are hundreds of physicians but the patients prefer to go to one physician. This is a very hugely debated issue and lots of research work is done throughout the globe. The issue is not only about Ayurvedic practice but for all systems of medicine. The conclusion is when a patient feels safe about a physician that is the ultimate drawing force for the patient to come to the physician. All the other factors are also present but the final or utmost is a feeling of safety. The feeling of safety is possible when Ayurvedic practitioners would have a clear-cut knowledge of the possible limits of the contemporary system. My principle is not to harm the patient because the patient has come to me for the treatment. So whenever there is a better option in the contemporary system, I will direct the patient to the other system. When it is not possible with our system definitely will have to suggest the patient go to the other system. The patient may go to the other system in other hospitals. Otherwise, I may admit the patient to our institute hospital to give any other contemporary medicine. But in my clinic, I don’t give any allopathic prescriptions. It is one of the important clues that can make your practice successful.
- Investigations are done only to confirm the clinical diagnosis.
- Not to be carried away by the existing reports.
- Investigations to be interpreted from Ayurvedic view
- Dosha assessment is the key to Ayurvedic regime
In addition, you need to have a thorough clinical examination and thorough clinical perception. I would like to say that the Ayurveda practitioner/Vaidya should be more modern than a modern medicine doctor. We should be able to upgrade ourselves. We should be knowing the limitations as well as the achievements in the contemporary system that is the current one and then only we can address the patient properly. This kind of approach is necessary to develop. I do read to know about contemporary publications every day. Any of the guidelines released by the FDA, I will be knowing it within a week. But I try to make myself updated and that is one of the important issues which keeps my practice safe for the patient. This is one of the absolute necessities.
An example of a common cold is described here. So the questions would be How to do an assessment of common cold patients? How the whole principle of the Dosha assessment is done? What are our limitations? Patients come with the usual history of the common cold, fever, and other associated complaints that may be categorized as Jwara and Pratishyaya. Being an academician I would be trying to have some academic touch and it’s not only a gross practice. A very commonly seen condition is the patient may have some disturbance but not much of a discharge. After looking at the nose, the presence of mild inflammation of the nasal mucosa but not much of a discharge and low-grade fever would be the usual clinical symptoms. Most of the time it doesn’t need any medicine. If you do not overload your body with food and not much exercise then it can be managed. It can be used by Ayurveda practitioners. But if you advise the patient not to take any medicine and have fast for one day or have food like Ganji then it’s not viable. The medicine I would suggest would be Mrityunjaya Rasa, Arogyavardhini, and Amritarishta. This treatment may mimic the prescription of modern medicine that includes Paracetamol(acetaminophen) and Chlorpheniramine maleate. The cost factor would be 30% more than that of modern medicine prescription. Still, you have sufficient margin with the same charges which I charge.
It is the initial stages of Pratishyaya where discharge would not be too much, a patient would have a feeling of nasal bulging. A patient may feel that there is not much appreciation of the smell sensation, a common symptom. These conditions are considered either Pratishyay or Kaphaj Jwara. In both of these conditions duration of treatment is not much, a maximum of two days of prescription would be enough. These conditions can be managed with the above-prescribed medicine. Even without medication, we can manage it by simply using warm water or simple home remedies.
आनह्यते यस्य विधूप्यते च प्रक्लिद्यते शुष्यति चापि नासा |
न वेत्ति यो गन्धरसांश्च जन्तुर्जुष्टं व्यवस्येत्तमपीनसेन ||
तं चानिलश्लेष्मभवं विकारं ब्रूयात् प्रतिश्यायसमानलिङ्गम् |
Sushrut Uttartantra 22/6,7
गौरवं शीतमुत्क्लेशो रोमहर्षोऽतिनिद्रता |
स्रोतोरोधो रुगल्पत्वं प्रसेको मधुरास्यता ||
नात्युष्णगात्रता छर्दिरङ्गसादोऽविपाकता |
प्रतिश्यायोऽरुचिः कासः कफजेऽक्ष्णोश्च शुक्लता ||
Sushrut Uttartantra 39/33,34
Can be managed without specific medications
- Mrityunjaya Rasa 1BD
- Arogyavardhini 1BD
- Amritarishta 2 tsf BD 2 days
- Dosha —VATAKAPHA
Rhinitis with post nasal drip [I] Pratishyaya – Upadrava
A patient may come with similar clinical symptoms. In this condition the clinical examination is necessary. Patient may have exactly similar clinical symptoms, but the discharge is slightly more. There is more discharge and a tendency for occasional sneezing. When the discharge is more, naturally the reflexes get pronounced to cause sneezing.
शिरोगुरुत्वं क्षवथोः प्रवर्तनं तथाऽङ्गमर्दः परिहृष्टरोमता |
उपद्रवाश्चाप्यपरे पृथग्विधा नृणां प्रतिश्यायपुरःसराः स्मृताः ||
Su.Ut. 24/ 5
The symptoms like heaviness in the head, sneezing, and body ache are seen in Pitta Kaphaja Jvara.
Mrityunjaya Rasa 1BD
Arogyavardhini 1 BD
Amritarishta 2tsf BD – 4 days
Dosha – PITTAKAPHA
In the nasal examination, a few clear fluid droplets would be present. This suggests about Dosha Sansarga, I will consider it as Pittakaphja Jvara. In this case, my prescription would be the same but I would advise the patient to take the medicines for four days along with dietary restrictions. In rare cases treatment period may extend up to seven days but not more than that. All type of junk food has to be avoided. Most of the time it is junk food that aggravates the problem. Among the natural food, Bonda aggravates the problem. You can definitely manage the patients without any discomfort with help of ayurvedic medicines.