AYURVEDA

Ayurveda, the oldest divine science, is composed of two terms ‘Ayush’ meaning life and ‘Veda’ meaning knowledge. Thus etymologically, Ayurveda means science of life. It also describes drugs, diet and disciplines, which promotes positive health and cures diseases. All these things are practised for the achievement of Dharma, Artha, Kama and Moksha. Health (Aarogya) plays the key role in the achievement of Purushartha Chatushtya.

Life in Ayurveda is conceived as the union of body, senses, mind and soul. The living man is a conglomeration of three humors (Vata, Pitta &Kapha), seven basic tissues (Rasa, Rakta, Mansa, Meda, Asthi, Majja & Shukra) and the waste products of the body i.e. mala, mutra and sweda. Thus the total body matrix comprises of the humors, the tissues and the waste products of the body. The growth and decay of this body matrix and its constituents revolve around food which gets processed into humors, tissues and wastes. Ingestion, digestion, absorption, assimilation and metabolism of food have an interplay in health and disease which are significantly affected by psychological mechanisms as well as by bio- fire (Agni).

According to Ayurveda all objects in the universe including human body are composed of five basic elements (Panchamahabhutas) namely, earth, water, fire, air and vacuum (ether). There is a balanced condensation of these elements in different proportions to suit the needs and requirements of different structures and functions of the body matrix and its parts. The growth and development of the body matrix depends on its nutrition, i.e. on food. The food, in turn, is composed of the above five elements, which replenish or nourish the like elements of the body after the action of bio-fire (Agni). The tissues of the body are the structural entities whereas humours are physiological entities, derived from different permutations and combinations of Panchamahabhutas.

Health or sickness depends on the presence or absence of a balanced state of the total body matrix including the balance between its different constituents. Both the intrinsic and extrinsic factors can cause disturbance in the natural equilibrium giving rise to diseases. This loss of equilibrium can happen by dietary indiscrimination, undesirable habits and non-observance of rules of healthy living. Seasonal abnormalities, improper exercise or erratic application of sense organs and incompatible actions of the body and mind can also result in creating disturbance of the existing normal balance. The treatment consists of restoring the balance of disturbed body-mind matrix by following proper diet, correcting life-routine and behavior, administration of drugs and resorting to preventive Panchkarma and Rasayana therapy.

In Ayurveda diagnosis and treatment of disease is always individual to each patient. The physician takes a careful note of the patients internal physiological characteristics and mental disposition. He also studies other factors such as the affected bodily tissues, humours, the site at which the disease is located, patients resistance and vitality, his daily routine, dietary habits, the clinical conditions, condition of digestion and details of personal, social, economic and environmental situation of the patient. The diagnosis also involves the following examinations:

General physical examination
Pulse examination
Urine examination
Examination of the faces
Examination of tongue and eyes
Examination of skin and ear including tactile and auditory functions.

The treatment approach in the Ayurveda system is holistic and individualized having preventive, curative, mitigative, recuperative and rehabilitative aspects. The principal objectives of Ayurveda are maintenance and promotion of health, prevention of disease and cure of sickness. Treatment of the disease consists in avoiding causative factors responsible for disequilibrium of the body matrix or of any of its constituent parts through the use of Panchkarma procedures, medicines, suitable diet, activity and regimen for restoring the balance and strengthening the body mechanisms to prevent or minimize re-occurrence of the disease. Normally treatment measures involve use of medicines, specific diet and prescribed activity routine. These three measures are used in two ways. In one approach of treatment the three measures antagonize the disease by counteracting the etiological factors and various manifestations of the disease. In the second approach the same three measures of medicine, diet and activity are targeted to exert effects similar to the etiological factors and manifestations of the disease process. These two types of therapeutic approaches are respectively known as Vipreeta and Vipreetarthkari Chikitsa.

For successful administration of a treatment four things are essential. These are-

The physician
The medicaments
The nursing personnel
The patient

The physician comes first in order of importance. He must possess technical skill, scientific knowledge, purity and human understanding. The physician should use his knowledge with humility, wisdom and in the service of humanity. Next in importance comes food and drugs. These are supposed to be of high quality, wide application, grown and prepared following approved procedures and should be available adequately. The third component of every successful treatment is the role of nursing personnel who should have good knowledge of nursing, must know the skills and be affectionate, sympathetic, intelligent, neat & clean and resourceful. The fourth component is the patient himself who should be cooperative and obedient to follow instructions of the physician, able to describe ailments and ready to provide all that may be needed for treatment.

Ayurveda has developed a very vivid analytical description of the stages and events that take place since the causative factors commence to operate till the final manifestation of disease. This gives this system an additional advantage of knowing that possible onset of disease much before the latent symptoms become apparent. This very much enhances the preventive role of this system of medicine by making it possible to take proper and effective steps in advance, to arrest further progress in pathogenesis or to take suitable therapeutic measures to curb the disease in its earliest stage of onset.

The treatment of disease can broadly be classified as:
1. Shodhana therapy (Purification Treatment)
2. Shamana therapy (Palliative Treatment)
3. Pathya Vyavastha (Prescription of diet and activity)
4. Nidan Parivarjan (Avoidance of disease causing and aggravating factors)
5. Satvavajaya(Psychotherapy)
6. Rasayana therapy (use of immuno-modulators and rejuvenation medicines)

Introduction

The Unani Medicine is one of the ancient medicines ever practiced in the world. The documentary evidences of Unani medicine date back to 460 B.C. The great Hippocrate was the first formal physician of Unani medicine who practiced and taught it. He was also the author of several treatise, one of them Fasoole Buqrat is available for ready reference. In this book he has clearly mentioned the role of environment on health and recognition of this role made him the first epidemiologist. Hippocrate was the man who liberalized the medicine from the domain of Demon, evil sprit and myth of primitive society. He first time emphasized the role of various exogenous and endogenous factors in disease causation. Hippocrate postulated the theory of humours, Tabiyat – an inherent quality responsible for initiation and maintenance of the attributed functions of any compound including human body and of human genesis and accepted the theory of Arkan to define the health and disease and thereby their treatment. Because of this pioneer work in the field of medicine in primitive days of imagination he is rightly the father of medicine. He first time started indoor patients care in a portion of his own house.

Education in early Period

In the period of Asclepius (before 460 A.D.) because disease were considered due to anger of god and goddess and evil sprit, so the treatment was appeasement of concern god and goddess. Hence educational centers were worship places where god and goddess relation with disease and treatment was taught. Asclepius taught his son and daughter what he had gained through his experience in the field of medical science. Familial heritage of medical education was his instruction. This familial heritage brought medical knowledge to Hippocrate who liberalized the medical education with Hippocrate oath to disciplines to avoid misuse. He compiled the medical knowledge of heritage and codes in bookish form and then started formal clinical teaching in hospital. Where he also appointed some skilled persons for patients care. The theoretical concepts of knowledge were imparted to disciples under the shade of a tree. This teaching was based on clinical notes prepared in hospitals. Galen compiled the knowledge of Hippocrate and started the practice in medical science. He added a lot of new knowledge to previous one. Formal institutional teaching of medical science is started in Madarsa Iskandaria(School of Alexandria) in Egypt. It was established by great Alexander at bank of Nile. In these schools eminent physicians were engaged and they prepared a Galen books based 16 books curriculum for teaching. Here the teaching was imparted in seven phases, each phase was based on teaching of a few book out of selected sixteen. Human body dissection was allowed legislatively. In these schools there was an animal house for experimentation. Erasistratus and Herophilus were the allumini of these schools and also become teachers.

Unani Medicine in India

During Mughal Empire and British Period; Unani Medicine flourished in India and several towering physicians ornamented this period. They served not only as court physicians but also as public physicians. Hakeem Azam Khan wrote Akseer Azam and Rumuze Azam on medicine and pharmacology respectively. Najmul Ghani wrote encyclopedia of pharmacology. Hakeem Shareef Khan serve the Delhi for long and at last Hakeem Ajmal Khan in the founder of modern Unani medicine and he first time analysed the R. serpentina to obtain ajmaline and ajmalinine alkaloids. Since then various medicinal plants alkaloids have been isolated and some of them are in therapeutic use. Recently artether is isolated for the treatment of malaria from the plant artemesia.

The Unani medicine was spreaded all over the Islamic dynasty and then it foothold in India with conquer of Muslim. In this period so many physicians practiced Unani in different part of India, but there is no evidence of formal education, it was limited to familial heritage and the skill physician explain his experience to his family male members and then they started the practice after the death of father. Important Hakeem of that period who served Unani medicine were Ali Gilani, Hakeem Hasan Gilani, Hakeem Shirazi, Hakeem Sidra, Hakeem Ruhullah, Hakeem Amanullah Khan, Akbar Arzani, Mohd. Ali Baksh, Mohd Aazam, Hakeem Alvi Khan, Hakeem Azam Khan, Hakeem Shareef Khan, Hakeem Najmul Ghani, Hakeem Mir Momin, Hakeem Ahmad Gilani, Hakeem Aziz and Lastly Ajmal Khan. Formal institutional education of Unani medicine started in 1883 by the name of madarsa tibbiya. This madarsa was founded by Hakeem Mehmood Khan in 1883 and it was inaugurated by Hakeem Abdul Majeed in 1889. In 1902 Takmeelutib Unani medical college was established in Lucknow by Hakeem Abdul Aziz. Here both theoretical as well practical knowledge were imparted to students. In 1904 Unani medical college in Allahbad was established by Hakeem Ahmad Hussain Usmani. Hakeem Ajmal Khan realized the need of Unani medical education to preserve the wealth of this knowledge. In 1909 Hakeem Ajmal Khan laid the foundation of Unani College for women along with a hospital in Chudiwalan, Delhi, and then in 1921 Unani medical college was established in Patna. In 1927 Ajmal Khan Tibbiya College was founded in AMU, Aligarh.

Basic Principles of Unani Medicine

Unani Medicine recognized the Hippocrates concept of tabiyat and there is excellent description of the factors integral to tabiyat. As the tabiyat is sole planner and initiator of every activity thus the factors integral to tabiyat are of survival value. These factors are called Umoore Tabiya namely-

Arkan. (Elements)
Mizaj. (Temperament)
Akhlat. (Humours)
A’za. (Organs)
Arwah. (Vital Spirit)
Quwa. (Powers)
Af’aal. (Functions)

Treatment Modules in USM

There are four modalities of treatment namely Ilaj bil Ghiza (Dietotherapy), Ilaj bil Dawa (Pharmacotherapy), Ilaj bil Tadbeer (Regimenal Therapy) and Ilaj bil Yad (Manual Surgery/Therapy) or manipulative therapy. Following regimes have been described in Unani medicine texts for the help of Tabiyat in its functions of restoration of normalcy. These collectively grouped under the head of Tadabeer (Ilaj Bit Tadabeer); most appropriately it should be called as Tadabeere Tabiyat.

Hijamah/Cupping
Leeching
Massage
Hammam/ HotBath/Turkish bath.
Fasd / Venesection
Sitz Bath
Huqna / Enema
Steam inhalation.
Purgation
Diuresis
Exercise
Diversion
Pain Production
Fumigation.
Cooling
Sitz bath for foot
Oiling
Wet fomentation.

Expectoration
Sun Bath
Sleeping Tranquilization.
Heating
Perspiration
Pasting
Dipping in oil
Dry fermentation
Pessaries
Dusting
Use of Tooth Powder
Smelling
Nutool
Pasting of ointment
Pasting of genital organ
Sneezing
Washing of part
Gargle

Source of Drugs

Drugs used in Pharmacotherapy are obtained from three sources; Plants, Animals and Minerals. These drugs are used singly or in compound formulations. The compound formulations are prepared in different dosage forms like solid, semisolid, liquid, powder and gases. Route of administration depends upon nature of disease and site as well as structure of affected organs. Details regarding compound formulation like composition, indications dose and contraindications are given in Unani Pharmacopieas. The important Pharmacopieas in India are Bayaze Kabir Vol III, Bayaze Khas, Qarabadeen Azam, Qarabadeen Majidi, and National formulatory of Unani Medicine. There are many Pharmaceuticals that are manufacturing compound Unani formulation as per Govt. of India approved standard.

Current Status of Unani Medicine in India

Unani practitioners are either graduate (BUMS) or Post Graduate (M.D. Unani) in the field of Unani medicine. The degree is awarded after completion of five years degree course, which is based on a prescribed curriculum. The academic institutions follow the curriculum prescribed by a statutory body constituted by Govt. of India for regulation of Unani medicine teaching in various colleges all over India. The body is central Council of Indian Medicine (CCIM). The curriculum, name and addresses of colleges and their intake can be downloaded from the website of the said council. The qualified candidates practice Unani Medicine as either private practitioner or Govt. of India appointed Medical Officers in PHC’s of Unani System of medicine. Govt. of India has established so many Unani dispensaries all over country where graduate and post graduate doctors are appointed through Public Service Commission. Inclusion of Unani graduates in NRHM & RBSK accepts its acceptance as parallel to modern therapy. The Govt. of India has established a Central Council for Research in Unani Medicine (CCRUM), the head office of this Council is in Janakpuri, New Delhi. The Council is engaging in conducting clinical trial at it different regional centers as well as Clinics spread all over country. The council is also working literary research. The detail can be had from the website of CCRUM. Recently PhD course in Moalajat has been started in NIUM, Bangalore in two departments. Govt of India inaugurated the second National Institute of Unani Medicine in Ghaziabad, U.P.

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