Regimental Therapy__ __ (Ilaj - bil - tadbeer) May be informative.

25 yr primi 4 months of amenorrhoea has come with generalised weakness ,continuous sweating, continuous nausea and vomiting for past 3 months (on and off).No Fever,chills and rigor.burning micturation and lower abd vage pain.weight has been drastically reduced from 55 kg to 45 kg for past 3 months. Bp-100/60mmhg ,PR- NORMAL. Kindly suggest what treatment and other investigations can be done for this patient.

Friends today I am discussing about a problem known as Thyroid Disease & Pregnancy. Thyroid disease is a group of disorders that affects the thyroid gland. The thyroid is a small, butterfly-shaped gland in the front of your neck that makes thyroid hormones. Thyroid hormones control how your body uses energy, so they affect the way nearly every organ in your body works—even the way your heart beats. The thyroid is a small gland in your neck that makes thyroid hormones. Sometimes the thyroid makes too much or too little of these hormones. Too much thyroid hormone is called hyperthyroidism and can cause many of your body’s functions to speed up. “Hyper” means the thyroid is overactive. Too little thyroid hormone is called hypothyroidism and can cause many of your body’s functions to slow down. “Hypo” means the thyroid is underactive. If you have thyroid problems, you can still have a healthy pregnancy and protect your baby’s health by having regular thyroid function tests and taking any medicines that your doctor prescribes. What role do thyroid hormones play in pregnancy? Thyroid hormones are crucial for normal development of your baby’s brain and nervous system. During the first trimester—the first 3 months of pregnancy—your baby depends on your supply of thyroid hormone, which comes through the placenta . At around 12 weeks, your baby’s thyroid starts to work on its own, but it doesn’t make enough thyroid hormone until 18 to 20 weeks of pregnancy. Two pregnancy-related hormones—human chorionic gonadotropin (hCG) and estrogen—cause higher measured thyroid hormone levels in your blood. The thyroid enlarges slightly in healthy women during pregnancy, but usually not enough for a health care professional to feel during a physical exam. Thyroid problems can be hard to diagnose in pregnancy due to higher levels of thyroid hormones and other symptoms that occur in both pregnancy and thyroid disorders. Some symptoms of hyperthyroidism or hypothyroidism are easier to spot and may prompt your doctor to test you for these thyroid diseases. Another type of thyroid disease, postpartum thyroiditis, can occur after your baby is born. Hyperthyroidism in Pregnancy Some signs and symptoms of hyperthyroidism often occur in normal pregnancies, including faster heart rate, trouble dealing with heat, and tiredness. Other signs and symptoms can suggest hyperthyroidism: fast and irregular heartbeat shaky hands unexplained weight loss or failure to have normal pregnancy weight gain Causes of hyperthyroidism in pregnancy Hyperthyroidism in pregnancy is usually caused by Graves’ disease and occurs in 1 to 4 of every 1,000 pregnancies in the United States.1 Graves’ disease is an autoimmune disorder. With this disease, your immune system makes antibodies that cause the thyroid to make too much thyroid hormone. This antibody is called thyroid stimulating immunoglobulin, or TSI. Graves’ disease may first appear during pregnancy. However, if you already have Graves’ disease, your symptoms could improve in your second and third trimesters. Some parts of your immune system are less active later in pregnancy so your immune system makes less TSI. This may be why symptoms improve. Graves’ disease often gets worse again in the first few months after your baby is born, when TSI levels go up again. If you have Graves’ disease, your doctor will most likely test your thyroid function monthly throughout your pregnancy and may need to treat your hyperthyroidism.1 Thyroid hormone levels that are too high can harm your health and your baby’s. Pregnant woman having her blood drawn If you have Graves’ disease, your doctor will most likely test your thyroid function monthly during your pregnancy. Rarely, hyperthyroidism in pregnancy is linked to hyperemesis gravidarum —severe nausea and vomiting that can lead to weight loss and dehydration. Experts believe this severe nausea and vomiting is caused by high levels of hCG early in pregnancy. High hCG levels can cause the thyroid to make too much thyroid hormone. This type of hyperthyroidism usually goes away during the second half of pregnancy. Less often, one or more nodules, or lumps in your thyroid, make too much thyroid hormone. Untreated hyperthyroidism during pregnancy can lead to miscarriage premature birth low birthweight preeclampsia—a dangerous rise in blood pressure in late pregnancy thyroid storm—a sudden, severe worsening of symptoms congestive heart failure Rarely, Graves’ disease may also affect a baby’s thyroid, causing it to make too much thyroid hormone. Even if your hyperthyroidism was cured by radioactive iodine treatment to destroy thyroid cells or surgery to remove your thyroid, your body still makes the TSI antibody. When levels of this antibody are high, TSI may travel to your baby’s bloodstream. Just as TSI caused your own thyroid to make too much thyroid hormone, it can also cause your baby’s thyroid to make too much. Tell your doctor if you’ve had surgery or radioactive iodine treatment for Graves’ disease so he or she can check your TSI levels. If they are very high, your doctor will monitor your baby for thyroid-related problems later in your pregnancy. An overactive thyroid in a newborn can lead to a fast heart rate, which can lead to heart failure early closing of the soft spot in the baby’s skull poor weight gain irritability Sometimes an enlarged thyroid can press against your baby’s windpipe and make it hard for your baby to breathe. If you have Graves’ disease, your health care team should closely monitor you and your newborn. How do doctors diagnose hyperthyroidism in pregnancy? Your doctor will review your symptoms and do some blood tests to measure your thyroid hormone levels. Your doctor may also look for antibodies in your blood to see if Graves’ disease is causing your hyperthyroidism. Learn more about thyroid tests and what the results mean. How do doctors treat hyperthyroidism during pregnancy? If you have mild hyperthyroidism during pregnancy, you probably won’t need treatment. If your hyperthyroidism is linked to hyperemesis gravidarum, you only need treatment for vomiting and dehydration. If your hyperthyroidism is more severe, your doctor may prescribe antithyroid medicines, which cause your thyroid to make less thyroid hormone. This treatment prevents too much of your thyroid hormone from getting into your baby’s bloodstream. You may want to see a specialist, such as an endocrinologist or expert in maternal-fetal medicine, who can carefully monitor your baby to make sure you’re getting the right dose. Doctors most often treat pregnant women with the antithyroid medicine propylthiouracil (PTU) during the first 3 months of pregnancy. Another type of antithyroid medicine, methimazole , is easier to take and has fewer side effects, but is slightly more likely to cause serious birth defects than PTU. Birth defects with either type of medicine are rare. Sometimes doctors switch to methimazole after the first trimester of pregnancy. Some women no longer need antithyroid medicine in the third trimester. Small amounts of antithyroid medicine move into the baby’s bloodstream and lower the amount of thyroid hormone the baby makes. If you take antithyroid medicine, your doctor will prescribe the lowest possible dose to avoid hypothyroidism in your baby but enough to treat the high thyroid hormone levels that can also affect your baby. Antithyroid medicines can cause side effects in some people, including allergic reactions such as rashes and itching rarely, a decrease in the number of white blood cells in the body, which can make it harder for your body to fight infection liver failure, in rare cases Stop your antithyroid medicine and call your doctor right away if you develop any of these symptoms while taking antithyroid medicines: yellowing of your skin or the whites of your eyes, called jaundice dull pain in your abdomen constant sore throat fever If you don’t hear back from your doctor the same day, you should go to the nearest emergency room. You should also contact your doctor if any of these symptoms develop for the first time while you’re taking antithyroid medicines: increased tiredness or weakness loss of appetite skin rash or itching easy bruising If you are allergic to or have severe side effects from antithyroid medicines, your doctor may consider surgery to remove part or most of your thyroid gland. The best time for thyroid surgery during pregnancy is in the second trimester. Radioactive iodine treatment is not an option for pregnant women because it can damage the baby’s thyroid gland. Hypothyroidism in Pregnancy Symptoms of an underactive thyroid are often the same for pregnant women as for other people with hypothyroidism. Symptoms include extreme tiredness trouble dealing with cold muscle cramps severe constipation problems with memory or concentration Woman with a coat shivering outdoors You may have symptoms of hypothyroidism, such as trouble dealing with cold. Most cases of hypothyroidism in pregnancy are mild and may not have symptoms. What causes hypothyroidism in pregnancy? Hypothyroidism in pregnancy is usually caused by Hashimoto’s disease and occurs in 2 to 3 out of every 100 pregnancies.1 Hashimoto’s disease is an autoimmune disorder. In Hashimoto’s disease, the immune system makes antibodies that attack the thyroid, causing inflammation and damage that make it less able to make thyroid hormones. How can hypothyroidism affect me and my baby? Untreated hypothyroidism during pregnancy can lead to preeclampsia—a dangerous rise in blood pressure in late pregnancy anemia miscarriage low birthweight stillbirth congestive heart failure, rarely These problems occur most often with severe hypothyroidism. Because thyroid hormones are so important to your baby’s brain and nervous system development, untreated hypothyroidism—especially during the first trimester—can cause low IQ and problems with normal development. How do doctors diagnose hypothyroidism in pregnancy? Your doctor will review your symptoms and do some blood tests to measure your thyroid hormone levels. Your doctor may also look for certain antibodies in your blood to see if Hashimoto’s disease is causing your hypothyroidism. Learn more about thyroid tests and what the results mean. How do doctors treat hypothyroidism during pregnancy? Treatment for hypothyroidism involves replacing the hormone that your own thyroid can no longer make. Your doctor will most likely prescribe levothyroxine , a thyroid hormone medicine that is the same as T4, one of the hormones the thyroid normally makes. Levothyroxine is safe for your baby and especially important until your baby can make his or her own thyroid hormone. Your thyroid makes a second type of hormone, T3. Early in pregnancy, T3 can’t enter your baby’s brain like T4 can. Instead, any T3 that your baby’s brain needs is made from T4. T3 is included in a lot of thyroid medicines made with animal thyroid, such as Armour Thyroid, but is not useful for your baby’s brain development. These medicines contain too much T3 and not enough T4, and should not be used during pregnancy. Experts recommend only using levothyroxine (T4) while you’re pregnant. Some women with subclinical hypothyroidism—a mild form of the disease with no clear symptoms—may not need treatment. Pregnant woman with a pill in one hand and a glass of water in the other Your doctor may prescribe levothyroxine to treat your hypothyroidism. If you had hypothyroidism before you became pregnant and are taking levothyroxine, you will probably need to increase your dose. Most thyroid specialists recommend taking two extra doses of thyroid medicine per week, starting right away. Contact your doctor as soon as you know you’re pregnant. Your doctor will most likely test your thyroid hormone levels every 4 to 6 weeks for the first half of your pregnancy, and at least once after 30 weeks.1 You may need to adjust your dose a few times. Postpartum Thyroiditis What is postpartum thyroiditis? Postpartum thyroiditis is an inflammation of the thyroid that affects about 1 in 20 women during the first year after giving birth1 and is more common in women with type 1 diabetes. The inflammation causes stored thyroid hormone to leak out of your thyroid gland. At first, the leakage raises the hormone levels in your blood, leading to hyperthyroidism. The hyperthyroidism may last up to 3 months. After that, some damage to your thyroid may cause it to become underactive. Your hypothyroidism may last up to a year after your baby is born. However, in some women, hypothyroidism doesn’t go away. Not all women who have postpartum thyroiditis go through both phases. Some only go through the hyperthyroid phase, and some only the hypothyroid phase. What are the symptoms of postpartum thyroiditis? The hyperthyroid phase often has no symptoms—or only mild ones. Symptoms may include irritability, trouble dealing with heat, tiredness, trouble sleeping, and fast heartbeat. Symptoms of the hypothyroid phase may be mistaken for the “baby blues”—the tiredness and moodiness that sometimes occur after the baby is born. Symptoms of hypothyroidism may also include trouble dealing with cold; dry skin; trouble concentrating; and tingling in your hands, arms, feet, or legs. If these symptoms occur in the first few months after your baby is born or you develop postpartum depression , talk with your doctor as soon as possible. What causes postpartum thyroiditis? Postpartum thyroiditis is an autoimmune condition similar to Hashimoto’s disease. If you have postpartum thyroiditis, you may have already had a mild form of autoimmune thyroiditis that flares up after you give birth. Woman holding her baby. Postpartum thyroiditis may last up to a year after your baby is born. How do doctors diagnose postpartum thyroiditis? If you have symptoms of postpartum thyroiditis, your doctor will order blood tests to check your thyroid hormone levels. How do doctors treat postpartum thyroiditis? The hyperthyroid stage of postpartum thyroiditis rarely needs treatment. If your symptoms are bothering you, your doctor may prescribe a beta-blocker, a medicine that slows your heart rate. Antithyroid medicines are not useful in postpartum thyroiditis, but if you have Grave’s disease, it may worsen after your baby is born and you may need antithyroid medicines. You’re more likely to have symptoms during the hypothyroid stage. Your doctor may prescribe thyroid hormone medicine to help with your symptoms. If your hypothyroidism doesn’t go away, you will need to take thyroid hormone medicine for the rest of your life. Is it safe to breastfeed while I’m taking beta-blockers, thyroid hormone, or antithyroid medicines? Certain beta-blockers are safe to use while you’re breastfeeding because only a small amount shows up in breast milk. The lowest possible dose to relieve your symptoms is best. Only a small amount of thyroid hormone medicine reaches your baby through breast milk, so it’s safe to take while you’re breastfeeding. However, in the case of antithyroid drugs, your doctor will most likely limit your dose to no more than 20 milligrams (mg) of methimazole or, less commonly, 400 mg of PTU. Thyroid Disease and Eating During Pregnancy What should I eat during pregnancy to help keep my thyroid and my baby’s thyroid working well? Because the thyroid uses iodine to make thyroid hormone, iodine is an important mineral for you while you’re pregnant. During pregnancy, your baby gets iodine from your diet. You’ll need more iodine when you’re pregnant—about 250 micrograms a day.1 Good sources of iodine are dairy foods, seafood, eggs, meat, poultry, and iodized salt—salt with added iodine. Experts recommend taking a prenatal vitamin with 150 micrograms of iodine to make sure you’re getting enough, especially if you don’t use iodized salt.1 You also need more iodine while you’re breastfeeding since your baby gets iodine from breast milk. However, too much iodine from supplements such as seaweed can cause thyroid problems. Talk with your doctor about an eating plan that’s right for you and what supplements you should take. Learn more about a healthy diet and nutrition during pregnancy . Homeopathy provides remedies which treat not just the above symptoms but the person as a whole. Sepia Officinalis: Used when the patient presents with the following symptoms. Weak, slightly yellow appearance Tendency to faint, especially when in cold temperatures Extreme intolerance to cold, even in warm surroundings Increased irritability Hair loss Increased menstrual flow that occurs ahead of schedule Constipation Increased desire for pickles and acidic foodstuff Calcarea Carbonica: This popular medicine is useful when patients present with the following symptoms. Fat, flabby, fair person Increased intolerance to cold Excessive sweating, especially in the head Aversion to fatty foods Peculiar food habits including craving for eggs, chalk, pencils, lime, Increased menstruation that is also prolonged and is associated with feet turning cold Lycopodium Clavatum: Useful in patients who present with these symptoms: Physically weakened Increased irritability Excessive hair fall Face is pale yellow with blue circles around the eyes Craving for foods that are hot and sweet Acidity that is worse in the evenings Gastric issues including excessive flatulence Constipation with painful, hard, incomplete stooling Graphites: Presenting symptoms where Graphites are mainly used include: Obesity Intolerance to cold Depressed emotionally, timid, indecisive, weeping, listening to music Bloated, gassy abdomen Chronic constipation with hard, painful stooling process Lodium: Good appetite but lose weight quickly Tendency to eat at regular intervals Excessive warmth and need to stay in a cool environment Anxiety about present Excessive palpitations Lachesis Mutus: These patient present with the following symptoms: Feeling extremely hot, so inability to wear tight clothes Generally sad with no inclination to do any work Tendency to stay aloof and alone Excessive talkativeness Women around menopausal age

#CCA update Bronchial Asthma - Tamaka swasa Difficulty in breathing or shortness of breath may be simply termed as Swasa (Asthma). It may be primary - originating from respiratory system, secondary - originating from other systems of the body but the impact is on respiratory system. Bronchial Asthma is a chronic inflammatory disease of airway. It leads to recurrent episodes of wheezing, breathlessness, tightness of chest and cough particularly at night or early morning. As per Ayurveda, Swasa is mainly caused by the Vata and Kapha doshas. Swasa is broadly classified into five types in Mahaswasa (Dyspnoea major), Urdhawaswasa (Expiratory Dyspnoea), Chinna swasa (Chyne- stroke respiration), Kshudra swasa (Dyspnoea minor), Tamaka swasa (Bronchial Asthma). Etiology: The causes of Asthma are divided in to two types. Inducing factors: Induce Asthma in susceptible persons. These are Genetic factors, Obesity, Viral infections in early life and exposure to tobacco smoke. Triggering factors: Can aggravate symptoms in a patient who is having Asthma. Inhalation of Allergens: House dust, pollen, mold, animal dander Environment: Cold and dry climate, cooking gas fumes, passive cigarette smoking, paints, sprays Infections: Upper Respiratory Tract infections, Viral infections Drugs: Aspirin, Pain killers (NSAIDs) Food: Colouring agents of food, food preservatives, ice creams Exercise: Vigorous exercise particularly on cold and dry day Psychological factor: Stress Occupation: Wood and cotton dust, chemicals. As per Ayurveda the causes of Tamaka Swasa are as follows: Intake of dry, cold , heavy, incompatible food and irregular intake of food Excessive Intake of black gram, beans, sesame, meat of aquatic animals. Intake of cold water and exposure to cold climate Exposure to dust, smoke and wind Excessive exercise, over indulge in the sexual activity Trauma to throat, chest and vital organs. Suppression of natural urges. pathology - Due to excessive intake of kapha aggravating food and regimen the kapha along with vata gets into pittasthana and causes swasa. Signs and symptoms: Breathlessness along with forcible expiration Cough Wheezing Tightness of chest Thick mucus sputum Aggravation of above symptoms during night and early morning Fainting during the bought of cough. Sleeplessness, discomfort increases when lied down on bed Gets comfort in sitting posture. Sweating on the forehead. Tamaka swasa is of two types namely Pratamaka swasa associated with fever, fainting, distention of abdomen and indigestion. Santamaka swasa is pacified by taking of cold regimen. Diagnostic tests in Bronchial Asthma: 1. Pulmonary function tests include Spirometry and peak flow which estimate the narrowing of the bronchial tubes and how fast an individual can breathe. 2. Chest X-ray is useful in differentiating the asthma from other lung diseases. 3. Allergy tests helpful in finding the allergen causing the asthma. 4. Methacoline challenge test and Nitric oxide tests are confirmatory tests in Bronchial asthma. Treatment modalities in Ayurveda: As per the Ayurveda Bronchial Asthma is Vatakaphaja disease, it begins in the stomach, progresses to the lungs and bronchi. Hence the aim of treatment is to move the excess Kapha back to stomach and then eliminate it. For this purpose following methods are adopted. 1. Swedana (Sudation) 2. Vamana (Therapeutic emesis) 3. Virechana (Therapeutic purgation) These procedures will be followed as per the need of individual patient. Practice of Pranayama, laxatives, light diet in the night and use of warm water will helps in the treatment of Asthma. Some of Useful Ayurvedic drugs for Asthma Talisadi Churna or Sitopaladi churna : 1 to 3 gms to be taken twice a day with honey Somalata churna : 1 to 3 gms to be taken twice a day with honey Kanakasava : 5 to 10 ml with equal quantity of Luke warm water after food Shringyadi churna : 1 to 3 gms to be taken twice a day with honey  Trikatu churna : 1to 2 gms with honey  Vasavalehyam : 12 to 24 gms twice daily  Kantakaryavalehyam : 12 to 24 gms twice daily  Vyaghriharitaki Avaleha: 12 to 24 gms twice daily  Agastya Haritaki Avaleha: 12 to 24 gms twice daily  Lavangadi vati: 1 tablet for chewing 3 times a day  Swasakutara ras : 125 to 250 mg twice daily  Mahalakshmivilas ras: 125 to 250 mg twice daily Useful medicinal plants for Asthma  Kantakari (Solanum xanthocarpum)  Vasa (Adhatoda vasica)  Sunthi (Zingiber officinalis)  Bharangi (Clerodendrum serratum)  Pushkaramoola (Innula racemosa)  Karkataka Shringi (Pistacia inergerrima)  Haridra (Curcuma longa) Do’s (Pathya):  Godhuma (wheat), Old rice, Mudga (green gram), Kulattha (Horse gram), Yava (barley), Patola (snake gourd)  Use of Garlic, Turmeric, Ginger, Black pepper  Luke warm water, Goat milk, Honey  Respiratory exercise, Pranayama, Yoga Don’ts (Apathya):  Heavy, cold diet, Masha (black gram), Deep fried items, Mustard leaves, Fish  Exposure to Cold & Humid atmosphere  Sweets, Chilled water, Stored food items, Curd  Suppression of natural urges  Excessive physical exertion  Exposure to Smoke, Dust and fumes, Pollutants and Pollens

AIDS Awareness Day 1 December 2018 AIDS (acquired immunodeficiency syndrome) is a disease caused by a virus called HIV (Human Immunodeficiency Virus). The illness alters the immune system, making people much more vulnerable to infections and diseases. HIV is found in the body fluids of an infected person, such as semen, vaginal fluids, blood and breast milk. The virus is passed from one person to another through blood or sexual contact. HIV can be transmitted in many ways, such as vaginal, oral sex, anal sex, blood transfusion and contaminated hypodermic needles. Causes Ineffective metabolism of food produces toxins that pollute the system and reduce body immunity (ojas). Stress, worry, overwork and excessive sexual indulgence also decrease ojas. If this diminished state of vitality is allowed to continue, coupled with high-risk exposure to infection, the body stands no chance of resisting disease. When all seven dhatus or body tissues are deteriorated and ojas is reduced, disorders symptomatic of AIDS can occur. Symptoms Diarrhea Weakness Weight loss Red rashes Enlarged glands Night sweating Sore throat Muscular pain Joint pain Chills Fever Ayurvedic AIDS Treatment According to Ayurveda, AIDS is primarily a disease of low ojas (immunity), the vital sap of the body. Ojas provides the physical and mental strength to resist disease. With a lowered immune system the body is susceptible to a host of opportune infections and disorders. There are millions of bacteria and viruses in our environment, many of which are contagious, that the body successfully fights off every day. But in a condition of low ojas or immunity level, these organisms are allowed to remain in the body and reproduce to cause disease. Ayurveda has many highly effective therapies for AIDS. There is a branch of Ayurveda known as rasayana, which specifically deals with increasing immunity and vitality through the use of various herbs, minerals and Ayurvedic techniques and practices. The line of treatment aims at the relief of current symptoms while addressing the underlying cause. After initial detoxification, the strength, immunity and vitality of the patient are increased through rasayanic therapies. Diet & Lifestyle Advice Ayurveda can help in preventing AIDS by strengthening the body's defence system through herbs and a supplementary code of conduct or achaar rasayana. Ayurveda recommends a whole range of herbs for the prevention of AIDS through strengthening the immune system. Herbs such as amla (emblica officinalis), bala (sida cordiolia), haritaki (terminalia chebula), nirgundi (vitex nirgundo) and amrita (tinospora wedifolia) have been found to be effective in the prevention of AIDS. However, the first step to stem the disease is emotional and moral support to the patient. The patient must be surrounded with well-meaning and loving family and friends for the healing to take place. The patient should be given nourishing food that are easily digestible and be engaged in fruitful activities. Ayurvedic tonic and rejuvenators (rasayanas) should be given to strengthen the system, boost immunity levels and stimulate appetite. After gaining some strength shodhana (elimination) techniques can be used to expel toxins from the body through enemas, steam bath, purgation and emesis. A nourishing diet along with medicated ghee preparations and soups is recommended. But spicy, oily and acidic foods are to be avoided. Also, chyavanprash, raktavardhak and triphala are recommended for AIDS patients Source : Jiva Ayurved

Panchakarma- Five Teatments -1 Pancha Karma is the cornerstone to Ayurvedic management of disease. Pancha Karma is the process which gets to the root cause of the problem and corrects the essential balance of 'Tridosha' in body. Pancha Karma is not only good for alleviating disease but is also a useful tool in maintaining excellent health. Ayurveda advises undergoing Pancha Karma at the seasonal changes to clean the body, improve the digestion and to improve the metabolic processes. Panchakarma is a Sanskrit word that means "five actions" or "five treatments ". This age-old science of purifying the body is an ancient branch of Ayurveda, The Treatment in Ayurveda consists of two main types. One is Shaman Chikitsa, used to subdue the vitiated Doshas, due to which any ailments may be produced. It is administered by using various medicinal herbo-mineral preparations. However, if the Doshas are vitiated beyond a particular level, they give rise to various endotoxins, which have a tendency to be accumulated in the minute channels. These are beyond the level of pacification and hence need to be eliminated or removed from the body. In such cases, the second type of treatment, which is Shodhan Chikitsa or cleansing therapy, is indicated. Since it consists of the five types of main therapies, it is known as the Panchakarma Chikitsa. Panchakarma has been given a special place in all the ancient Ayurvedic texts. Aacharya Charak, the author of the most important ancient text on internal medicine, has described a wide use of Panchakarma therapy for almost all the major diseases. Two separate sections, Kalpa Sthanam, and Siddhi Sthanam in Charak Samhita describe the details of special decoctions and other preparations used for Panchakarma therapy. Panchakarma includes three parts namely: Poorva Karma (Preparatory Methods)which includes : Paachan (Digestion) Snehan (Internal and external oleation) Swedan (Fomentation) Pradhan Karma (Main methods)which includes : Vaman (Induced vomiting) Virechan (Induced purgation) Basti (Medicated enema) Nasya (Nasal medicine) Rakta Mokshan (Artificial bloodletting) Pashchat Karma (Post-Therapeutic Measures)which includes: Sansarjan Krama (Specific dietetics), DhumaPana (smoking of medicinal cigars) and some rules to follow specific activities. Purvakarma : Pre-purification Measures Before the actual operation of purification begins, there is a need to prepare the body in prescribed methods to encourage the body to let go of the toxins. The two procedures are 'snehan' and 'swedan'. Snehan is the oil massage. Oil is applied to the entire body with a particular type of massage which helps the toxins to move towards the gastro-intestinal tract. Oil massage also makes the superficial and deep tissues soft and supple. Snehan is given daily for three to seven days, as indicated. Swedan is sudation or sweating and is given every day immediately following the snehan. An herbal concoction may be added to the steam to further loosen the toxins from the individual. Swedan liquefies the toxins and increases the movement of toxins into the gastro-intestinal tract. After three to seven days of snehan and swedan, the doshas become well "ripened". A particular panchakarma method is then given according to the individual's constitution and disorder, prakruti and vikruti, respectively. Panchakarma - Five Basic Shodhans: Cleansing Methods 1) Vaman : therapeutic vomiting or emesis 2) Virechan : purgation 3) Basti : enema 4) Nasya : elimination of toxins through the nose 5) Rakta moksha : detoxification of the blood Vaman: Emesis Therapy When there is congestion in the lungs causing repeated attacks of bronchitis, colds, cough or asthma, the Ayurvedic treatment is therapeutic vomiting, vaman, to eliminate the kapha causing the excess mucus. First, after the snehan and swedan, three to four glasses of licorice or salt water is administered, then vomiting is stimulated by rubbing the tongue which triggers the vomiting center through the gag reflex. One may alternatively take two to three glasses of salt water which will also aggravate kapha and then rub the tongue to induce vomiting. Once the mucus is released the patient will feel instantly relieved. It is likely that congestion, wheezing and breathlessness will disappear and that the sinuses will become clear. Therapeutic vomiting is also indicated in chronic asthma, diabetes, chronic cold, lymphatic congestion, chronic indigestion and edema. Emetic Substances: madan-emetic nut, madhuka-yastimadhu-licorice, neem-bitter leaf, bimbi, kutaj-kurchi- conessi bark, murva-clematis, triloba-devdaru-deodar, Cedrus deodara, Salt, NaCl, ela-cardamom, nux vomica. Indications for Vaman : used for all kapha type disorders good for pitta headache, dizziness, and nausea will help to release blocked emotions respiratory congestion bronchitis chronic cold sinus congestion kaphagenic asthma Contra-Indications for Vaman : below the age of 12 or over age 65 menstruation pre-menstrual period (one week prior) pregnancy emaciation delicate or sensitive person with too much fear, grief or anxiety hypoglycemia vata prakruti vata diseases heart diseases during vata season acute fever diarrhea obesity Virechan : Purgation Therapy When excess bile, pitta, is secreted and accumulated in the gall bladder, liver and small intestine, it tends to result in rashes, skin inflammation, acne, chronic attacks of fever, biliary vomiting, nausea and jaundice. Ayurvedic literature suggests in these conditions the administration of therapeutic purgation or a therapeutic laxative. Virechan is facilitated with senna leaves, flax seeds, psyllium husks or triphala in a combination that is appropriate for the individual person. Virechan Substances: Senna, prune, bran, flaxseed husk, dandelion root, psyllium seed, cow's milk, salt, castor oil, raisins, mango juice, triphala. Indications for Virechan: allergic rash skin inflammation acne, dermatitis, eczema chronic fever ascites biliary vomiting jaundice urinary disorder enlargement of the spleen internal worms burning sensation in the eyes inflammation of the eyes conjunctivitis gout Contra-Indications for Virechan: low agni acute fever diarrhea severe constipation bleeding from rectum or lung cavities foreign body in the stomach after enema emaciation or weakness prolapsed rectum alcoholism dehydration childhood old age ulcerative colitisAyurveda-Panchakarma Basti & Nasya -2 Basti: Enema Therapy Vata's predominant site is the colon. Ayurvedic basti involves the introduction into the rectum of herbal concoctions of sesame oil, and certain herbal preparations in a liquid medium. Basti, is the most effective treatment of vata disorders, although many enemas over a prescribed period of time are usually required. It relieves constipation, distention, chronic fever, cold, sexual disorders, kidney stones, heart pain, backache, sciatica and other pains in the joints. Many other vata disorders such as arthritis, rheumatism, gout, muscle spasms and headaches may also be treated with basti. Vata is a very active principle in pathogenesis. If we can control vata through the use of basti, we have gone a long way in going to the root cause of the vast majority of diseases. Vata is the main etiological factor in the manifestation of diseases. It is the motive force behind the elimination and retention of feces, urine, bile and other excreta. There are eight main types of basti, according to traditional texts, each with their own indications and contra-indications as listed below. 1. Anuvasana (oil enema) is used in pure vata disorders and when a person is having excess hunger or dryness related to vata imbalances. 2. Niruha-Asthapana (decoction enema) is used, among other conditions, for evacuation of vata, nervous diseases, gastro-intestinal vata conditions, gout, certain fever conditions, unconsciousness, certain urinary conditions, appetite, pain, hyperacidity and heart diseases. 3. Uttara Basti (through the urethra with men or vagina with women) is used for selected semen and ovulation disorders and for some problems involving painful urination or bladder infections. This is not to be used for someone with diabetes. 4. Matra Basti (daily oil enema) is used by someone emaciated by overwork or too much exercise, too much heavy lifting, walking too long of a distance, too much sexual activity or someone with chronic vata disorders. It does not need to be accompanied by any strict dietary restriction or daily routine and can be administered, in the appropriate cases, in all seasons. It gives strength, promotes weight and helps elimination of waste products. 5. Karma Basti (schedule of 30 bastis), 6. Kala Basti (schedule of 15 bastis; 10 oil + 5 decoction) 7. Yoga Basti (schedule of 8 bastis; 5 oil + 3 decoction). 8. Bruhana Basti (nutritional enema) is used for providing deep nutrition in select conditions. Traditionally, highly nutritive substances have been used, such as warm milk, meat broth, bone marrow soup and herbs like shatavari or ashwagandha. General Indications for Basti: constipation low back ache gout rheumatism sciatica arthritis nervous disorders vata headache emaciation muscular atrophy General Contra-Indications for Basti (include but are not limited to the following): Enema therapy should not be used if the patient is suffering from diarrhea, bleeding of the rectum, chronic indigestion, breathlessness, diabetes, fever, emaciation, severe anemia, pulmonary tuberculosis, old age or for children below the age of seven years. for oil enemas: diabetes, obesity, indigestion, low agni, enlarged liver or spleen, unconsciousness, tuberculosis and cough. for decoction enemas: debility, hiccough, hemorrhoids, inflammation of anus, piles, diarrhea, pregnancy, ascites, diabetes and some conditions involving painful or difficult breathing. for nutritional enemas: diabetes, obesity, lymphatic obstruction, ascites. for urethra or vaginal enemas: diabetes Nasya: Nasal Administration The nose is the doorway to the brain and it is also the doorway to consciousness. The nasal administration of medication is called nasya. An excess of bodily humors accumulated in the sinus, throat, nose or head areas is eliminated by means of the nearest possible opening, the nose. Prana, life force as nerve energy, enters the body through the breath taken in through the nose. Prana is in the brain and maintains sensory and motor functions. Prana also governs mental activities, memory, concentration and intellectual activities. Deranged prana creates defective functioning of all these activities and produces headaches, convulsions, loss of memory and reduced sensory perception. Thus nasal administration, nasya is indicated for prana disorders, sinus congestion, migraine headaches, convulsions and certain eye and ear problems. There are six main types of nasya, as listed below. 1. Pradhamana (virechan) Nasya (cleansing nasya) uses dry powders (rather than oils) that are blown into the nose with a tube. Pradhamana nasya is mainly used for kapha types of diseases involving headaches, heaviness in the head, cold, nasal congestion, sticky eyes, hoarseness of voice due to sticky kapha, sinusitis, cervical lymph adenitis, tumors, worms, some skin diseases, epilepsy, drowsiness, Parkinsonism, inflammation of the nasal mucosa, attachment, greed and lust. Traditionally, powders such as brahmi are used. 2. Bruhana Nasya (nutrition nasya) uses ghee, oils, salt, shatavari ghee, ashwagandha ghee and medicated milk and is used mainly for vata disorders. It is said to benefit conditions resulting from vata imbalances such as vata-type headaches, migraine headache, dryness of voice, dry nose, nervousness, anxiety, fear, dizziness, emptiness, negativity, heaviness of eyelids, bursitis, stiffness in the neck, dry sinuses and loss of sense of smell. 3. Shaman Nasya (sedative nasya) is used according to which dosha is aggravated but mainly for pitta-type disorders such as thinning of hair, conjunctivitis and ringing in the ears. Generally certain herbal medicated decoctions, teas and medicated oils are used. 4. Navana Nasya (decoction nasya) is used in vata-pitta or kapha-pitta disorders and is made from decoctions and oils together. 5. Marshya Nasya (ghee or oil nasya) 6. Prati Marshya (daily oil nasya) This helps to open deep tissues and can be done every day and at any time to release stress. Substances Used in Nasya: brahmi, ginger, ghee oils, decoctions, onion, garlic, Piper longum, black pepper, curry pepper, rose, jasmine, mogra flowers and henna. Indications for Nasya: stress emotional imbalances stiffness in the neck & shoulders dryness of the nose sinus congestion hoarseness migraine headache convulsions Contra-Indications for Nasya: sinus infections pregnancy menstruation after sex, bathing, eating or drinking of alcohol should not be used below 7 years or over 80 years of age Click here to read more about 'Nasyakarma' Raktamoksha : Traditional Ayurvedic Method for Purification and Cleansing of the Blood Toxins present in the gastro-intestinal tract are absorbed into the blood and circulated throughout the body. This condition is called toxemia, which is the basic cause of repeated infections, hypertension and certain other circulatory conditions. This includes repeated attacks of skin disorders such as urticaria, rashes, herpes, eczema, acne, leukoderma, chronic itching or hives. In such conditions, along with internal medication, elimination of the toxins and purification of the blood is necessary. Raktamoksha is also indicated for cases of enlarged liver, spleen and gout. Extracting a small amount of blood from a vein relieves the tension created by the pittagenic toxins in the blood. Bloodletting also stimulates the spleen to produce antitoxic substances which helps to stimulate the immune system. Toxins are neutralized enabling radical cures in many blood born disorders. Bloodletting is contraindicated in cases of anemia, edema, extreme weakness, diabetes and in children and elderly persons. Indications for Raktamoksha: urticaria rash acne eczema scabies leukoderma chronic itching hives enlarged liver or spleen gout Contra-Indications for Raktamoksha: anemia edema weakness young children old age during pregnancy during menstruation Read more about Various Diseases and Indicated Panchakarma procedures for them > @