Management of rectal prolapse (Guda Bhramsa) through Kshara Karma (chemical cauterisation): a case study / Manejo do prolapso retal (Guda Bhramsa) usando Kshara Karma(cauterização química): um estudo de caso

Abstract Rectal Prolapse is a condition where the rectum protrudes beyond the anus. The explanation of this condition can be traced back to ancient Ayurveda text like Susruta Samhita, Ebers Pappyrus of 1500 B.C., etc. The exact cause of rectal prolapse is unclear but it is predominant on female gender and on people having constipation, previous anorectal surgeries etc. Both partial and complete varieties of rectal prolapse are extremely debilitating because of the discomfort of the prolapsing mass and variety of symptoms like rectal bleed, intermittent constipation or fecal incontinence. Although, diverse modalities of surgical management of rectal prolapse are present, no single optimal procedure is proved and the choice of operation is determined by the patient's age, sex, degree of incontinence, operative risk, as well as by the surgeon's experience. In Ayurveda, Guda Bhramsa (Rectal prolapse) is explained by Acharya Susruta under Kshudra Rogas (chapter of minor diseases) and has elaborated it's conservative management very beautifully. In this case, a female with partial rectal prolapse was treated with Kshara application and managed without complications. So, Kshara application can be a safe and effective alternative for the management of rectal prolapse.

Resumo O prolapso retal é uma condição em que o reto se projeta para além do ânus. A explicação desta condição foi relatada em antigos textos Ayurveda como Susruta Samhita e Ebers Pappyrus, datados de 1500 aC. A causa exata do prolapso retal não é clara, mas essa condição é predominante no sexo feminino e nas pessoas com constipação e histórico de cirurgias anorretais anteriores. Tanto o prolapso retal parcial quanto total são extremamente debilitantes devido ao desconforto da massa prolapsante e da variedade de sintomas como sangramento retal, constipação intermitente ou incontinência fecal. Embora diversas modalidades de tratamento cirúrgico para corrigir o prolapso retal tenham sido relatadas na literatura, nenhum procedimento é consensual; a escolha da operação é determinada pela idade, sexo, grau de incontinência, risco operatório e experiência do cirurgião. Na Ayurveda, Guda Bhramsa (prolapso retal) é explicado por Acharya Susruta no Kshudra Rogas (capítulo de doenças menores) e seu manejo conservador é descrito de forma bastante completa. No presente caso, uma paciente do sexo feminino com prolapso retal parcial foi tratada com aplicação de Kshara e administrada sem complicações. Assim, a aplicação de Kshara pode ser uma alternativa segura e eficaz para o manejo do prolapso retal.

Ayurveda - a medicina clássica indiana / Ayurveda - the classical indian medicine

O objetivo do presente artigo é apresentar de forma sucinta as bases da Medicina Clássica Indiana, o Ayurveda. A palavra sânscrita Ayurveda significa literalmente o conhecimento (veda) da longevidade (ayus). Apresentamos um histórico das principais influências de outras medicinas ancestrais que conviveram com o Ayurveda, principalmente graças às várias invasões que o território indiano sofreu ao longo de toda sua história. Diferenciamos o Ayurveda de caráter experimental e de refinada observação de sintomas e sinais das doenças de outras formas de medicina mística praticadas no mesmo território indiano por sacerdotes brâmanes ritualistas. São delineados os princípios fundamentais do Ayurveda, desde a Filosofia Samkhya que oferece suas bases metafísicas, passando pela doutrina dos três humores (tridosha vidya) e dos cinco elementos básicos, pela fisiopatologia com a descrição das várias etapas evolutivas das doenças e seus prognósticos e pela funcionalidade dos sete tecidos corporais, tanto na sua forma saudável como patológica. Descrevemos também os canais de circulação (srotamsi) com suas respectivas funções de conduzir materiais densos como o sangue, a transpiração, as fezes e a urina, bem como os canais de energia sutil responsáveis pela condução dos pensamentos e das funções mentais. As técnicas de diagnóstico são também apresentadas em conjunto com as variadas formas de tratamento, baseadas em terapias mente-corpo como as práticas de ioga e meditação.

The aim of this article is to introduce briefly the foundations of the Classical Indian Medicine, Ayurveda. The Sanskrit word Ayurveda literally means the knowledge (veda) of longevity (ayus). We present a history on the main influences of other ancient medicines that coexisted with Ayurveda, due to the several invasions that the Indian Territory suffered throughout all of its history. Ayurveda has an experimental character and a refined observation of symptoms and signs of diseases, distinct from other forms of mystic medicines practiced within the Indian Territory by orthodox Brahmins priests. The fundamental principles of Ayurveda go from the Samkhya Philosophy that offers its metaphysical bases, through the three humours (tridosha vidya) and five basic elements doctrines, the pathophysiology with the description of the numerous evolutionary steps of diseases and prognosis according to functionality of the seven basic body tissues, in both their healthy and pathological forms. Likewise, we describe the channels of circulation (srotamsi) with their respective functions of conducting dense materials such as blood, perspiration, feces and urine, as well as the subtle energy channels, responsible for the conduction of thoughts and mental functions.

Um estudo dos textos clássicos do Ayurveda em perspectiva histórico-antropológica / A study of classical texts of Ayurveda in a historical and anthropological perspective

Nas últimas duas décadas a racionalidade médica ayurvédica tornou-se popular no ocidente e está se expandindo rapidamente. Esta expansão é conseqüência do renascimento do Ayurveda na Índia no século XX. Apesar do crescente interesse neste sistema antigo de medicina pouco se tem explorado, no nosso meio, da sua gênese Histórica e das pesquisas dos textos clássicos, riquíssimos em informações sobre esta antiga medicina e suas ferramentas de diagnóstico e terapêutica prevalentes no subcontinente indiano há milhares de anos. O renascimento do Ayurveda se intensificou após a libertação da Índia da dominação britânica em 1947. Na década de 50 vários esforços foram realizados para promover o ensino e desenvolvimento desta racionalidade médica pelo governo indiano...

Um estudo dos textos clássicos do Ayurveda em perspectiva histórica-antropológica / A study of classical texts of Ayurveda in anthropological-historical perspective

Nas últimas duas décadas a racionalidade médica ayurvédica tornou-se popular no ocidente e está se expandindo rapidamente. Esta expansão é conseqüência do renascimento do Ayurveda na Índia no século XX. Apesar do crescente interesse neste sistema antigo de medicina pouco se tem explorado, no nosso meio, da sua gênese histórico e das pesquisas dos textos clássicos, riquíssimos em informações sobre esta antiga medicina e suas ferramentas de diagnóstico e terapêutica prevalentes no subcontinente indiano há milhares de anos. O renascimento do Ayurveda se intensificou após a libertação da India da dominação britânica em 1947. Na década de 50 vários esforços foram realizados para promover o ensino e desenvolvimento desta racionalidade médica pelo governo indiano. A Medicina Ayurvédica se expandiu rapidamente pelo subcontinente e posteriormente pelo ocidente, Europa e Estados Unidos. No Brasil o Ayurveda chegou a meados dos anos 80 e se desenvolveu principalmente em Goiânia com o Hospital de Medicina Alternativa. Nesta instituição as plantas medicinais brasileiras receberam uma leitura da racionalidade ayurvédica dos vários médicos indianos que lá estiveram. Esta tese de natureza teórico-conceitual, mas com um enfoque histórico-antropológico tem como objeto de estudo a gênese do Ayurveda e a análise crítica comparada dos textos clássicos nas suas fontes primárias e secundárias. O período de formação desta racionalidade médica na Índia antiga ainda é objeto de muitas discussões dos autores modernos, isto ocorre por que a transformação de uma medicina mágico-religiosa dos textos védicos em um sistema empírico-racional do clássico Ayurveda não foi totalmente esclarecida pelos historiadores e pesquisadores ayurvedistas...

Palăśa (Butea monosperma (Lamk.) Taub.) and its medico-historical study.

Palăśa (Butea monosperma (Lamk.) Taub.) is considered sacred both by Hindus and Buddhists. It is known to the Hindus under the Sănskrt name Palăśa as it possesses valuable medicinal properties. This sacred tree is being called the treasurer of the gods and of sacrifice. It grows throughout India except in very arid parts and is a medium sized deciduous tree. Parts used are bark, leaf, flower, seed and gum. It is mainly useful as antihelmenthic appetizer, aphrodisiac, laxative etc. Thus its medico- historical aspects are being presented in this paper.

Hastyăyurvĕda--a complete treatise on elephants.

Ayurvĕda, the oldest existing medical science of India, which is not only responsible for the health of human beings but also, plays an important in Veterinary sciences. In India, history of traditional Veterinary medicine dates back to the era of Mahăbhărata i.e.5000 B.C., recorded in the form of "Nakula Samhhită". Hastăyurvĕda is a treatise on elephants, Palkăpya wrote this Samhită. The present book is available as a complete Samhită, edited by Pandit Shivadutta Sharma. Hastăyurvĕda was printed at Anandăśrama press in 1894. Hastăyurvĕda has 160 Adhyăyăs. This Samhită is based on fundamental principles of Ayurvĕda, containing all aspects of Sharir including Anatomy & Physiology, Rog Vigyăna, Surgery and Treatment of elephants as well as their care. It is the one and only complete printed Samhită and rare book on Hastăyurvĕda by Palkăpya.

Introduction to Garudapurăna with reference to Ayurvĕda.

The Purănas are the encyclopedic works of the ancient and medieval Hindu religion, philosophy, history, politics, ethics, sciences etc. There are 18 (Astădaśa) purănas, which are, considered as mahăpurănas, among which Garudapurăna is popular one. The Garudapurăna is divided into two parts viz., Pŭrvakhanda and Uttarakhanda. The first part, which is also called Acărakhanda consists of 240 chapters. The greater part of the Pŭrvakhanda occupies the descriptions of Vratas (religious observances), sacred places dedicated to the Sŭrya (sun), Lord Siva and Lord Visnu. It also contains treatises on various aspects like astrology, palmistry, politics, Sănkhya, Yŏga, anatomy, precious stones and extensive information on vedic medicine i.e., Ayurveda. The Uttarakhanda consists of two khandas viz. Dharmakhanda and Brahmakhanda, which are divided into 42 and 29 chapters, respectively. The Dharmakhanda is also known as the Prĕtakalpa which contains directions for the performance of obsequies rites. The Prĕtakalpa portion of the Garudapurăna is generally recited during the period of mourning and so its importance is self-evident. It is almost impossible to narrate within such a small framework, the wide range of splendid truths scattered in the pages of this noble purănam. Little information is available from internal evidence to establish its exact period. However, it is supposed to be quite ancient in its origin.

Importance of Ananda kanda in the history of Indian alchemy.

Rasa Săstra is an important branch of Ayurvĕda developed for achieving therapeutic benefits from mineral materials. Ananda kanda is one of this subject text which gives an elaborate description of this subject. Dĕhavada concept of Rasa Săstra has been described elaborately along with Lŏha vada in this text. This book serves an important reference text. This book serves an important reference text for students and scholars of Rasa Săstra for teaching and training practical purposes.

Thirumŭlar--pioneer of the immunology concept.

Extraordinary longevity of life, made possible by repeated reading and following of the text Thirumandiram 3000 - written by great Siddhar Thirumŭlar. He the Prince of Mystics is one of the 18 luminous Siddhars and the first and foremost #1 Siva śiddhăndi. Historians and scholars predicted his life period between 5th to 8th centuries AD. In his teachings, he explained the kinds of 'Thavam' (Yoga) and he insisted the #2 'Kăya siddhi'. Thousands of years ago, he wrote in detail about Anatomy of microcosm, Siddha physiology, Humoural pathology, Science of pulse, Microcosmic Atom theory, Immunology concept and Immortalization of our body. His marvelous text Thirumandiram deals with Medical science, Life science, Natural science and Divine. In this article authors, discuss about the biography of Thirumŭlar and his medical works.

A prologue on "Vastuguna Dipika". The Andhra Ayurvĕda Nighantu of 1883 A.D.

Vastuguna Dipika is a Nighantu Grantha written in Telugu language on Ayurvĕda drugs, diets and deeds in an alphabetical order in Telugu language and it is a much popular book for more than a century. Yerra Venkata Swamy (retired district Munsif) has authored and published it on 23rd June, 1883 A.D. It is a period of printing facility introduced in India. It is edited and reprinted eight times by the successors of same "Yerra" family during a period of century. The subject content of the book has been slowly updated from edition to edition. Vastuguna Dipika comprising of 1148 pages in written. Drug like Coffee, Cabbage have been elaborately dealt with Ayurvĕda viewpoint. Certain drugs like Lasuna, Haridra also have been dealt very elaborately. In this book several drugs are grouped according to action and indications. Mineral drugs and mercurial preparations are also dealt in detail. Along with the properties of drugs and diet the properties and uses of certain routine deeds like bathing, sleeping exercise etc; are explained in the book. An alphabetical index of diseases in English in found along with the alphabetical indices of drugs in English, Telugu and Sanskrit languages.

Biography of Sŏdhala and his contribution to Ayurvĕda.

Sŏdhala was a scholar of Ayurvĕda as well as săhitya, Jyotisya, Vyakaraņa and also a good poet who belongs to Gujarat. Sŏdhala contributed two important works to Ayurvĕda literature namely 1. Sŏdhbala nighaņţu, 2. Gadanigraha. Sŏdhala nighaņţu consists of two parts and contains about 2,050 (790+1,260) verses. The section on synonyms, the Nămasangraha, and the other one is on properties and actions of drugs, the Guņasangraha. The arrangement of the material constitutes an unprecedented innovation in the literature of Nighaņţu (Ayurvĕda drug's lexicons or dictionaries). The Gadanigraha is composed of two distinct parts and contains about 10,054 (2,700+7,354) verses. The first part is a collection of formulae arranged according to the several types of pharmaceutical preparations and the second one is a comprehensive text dealing with both Nidăna and cikitsă, arranged as for the Aşţăngas (8 major divisions) of Ayurvĕda. The work seems to be later than Sŏdhalanighaņţu because most of the drugs mentioned in this work are not found in the Sŏdhalanighaņţu. The diseases are arranged in systematically, which is a new feature and their order is differ from Mădhavanidăna. From the available evidences we can assume that Sŏdhala might be belongs to 1200 A.D. The contributions of Sŏdhala are noteworthy and they are important landmark works in history of Ayurvĕda.

Medico-historical study of "aśvattha" (sacred fig tree).

Aśvattha (Ficus religiosa Linn.) is a tree which has got mythological, religious and medicinal importance in Indian culture since ancient times. As per Vedic Index Aśvattha means horse stand, a place or site or an object where or under which horses stand. Aśvattha is also known as Pipal and Bodhidrma. This tree is the oldest depicted tree in India. In Vedic times it was used to make fire by friction and considered sacred. Atharvavĕda associates it with the third heaven. It discusses medicinal properties of Aśvattha along with Soma and Kuştha. Aśvattha is associated with the triad of Gods-Brahma, vişņu and siva. Reference to Aśvattha is found in Rămăyaņa, Mahăbhărata, Bhagavadgĭta, Buddhistic literature, Arthaśăstra, Purănăs, Upanişads etc. non-medical literature also. According to Ayurvĕda it has several synonyms. Most of them symbolize its sacredness. Aśvattha is useful in various ailments like consumption, vomiting, ulcers in oral cavity, burns, gynaecological problems etc. Thus its medico-historical importance, regional nomenclature, morphological features in brief etc. are being presented in this article with few illustrations.

Vŗkşăyurvĕda of parăśara--an ancient treatise on plant science.

Vŗkşăyurvĕda of Parăśara is a great contribution to the Botany in ancient India. N.N. Sircar and Roma sarkar edited this text with English translation. Notes with comparative references of modern botany were added. This book can be placed in all probability in between 1st century B.C to 4th century A.D by its linguistic style. Many scientific branches of Botany including origin of life, ecology, distribution of forests, morphology, classification, nomenclature, histology and physiology were dealt in this ancient work. Though it is presumed that this book was written by Parăśara to teach Botany to preparatory to Ayurvĕda studies to ancient Ayurvĕda students, it is true to the Ayurvĕda personals and other disciplines related to Botany of present day as well. Aim of this article is to attract the attention of all scholars who are related to Ayurvĕda and Botany and to feel the depth of the knowledge of ancient Indian botany.

Vandhyatva--a medico historical study.

As per Ayurvĕda, important factors for conception are considered as rtu (fertile period), Kşĕtra (uterus and reproductive organs), Ambu (Proper nutrient fluid) and Bĭja (sukra-sŏnita) and also normalcy of Hŗdaya (Psychology). Abnormality of properly functioning Văyu and Satbhavăs (mătŗja, pitŗja, atma, satva, sătmaya and Rasa), any one of these causes infertility (Vandhyatva). From the time immemorial the phenomenon of infertility was prevalent through out the world and this may persist till the human race exists. Every human being has inherent, intense desire to continue his (one's) own race; to become a mother is one of the most cherished desires of every woman. Failure to achieve conception by a couple of mature age, having normal coitus during appropriate period of menstrual cycle regularly, at least for one year of their conjugal is termed as infertility. The historical importance of strĭ vandhyatva and a comparative study regarding its Nidăna, Samprăpti, Lakşaņa, Chikitsă etc compiled from various Granthăs are being presented in this paper.

Diet, dietetics and flora of the Holy Bible.

The study of history of medical science from non-medical sources needs no apology. At first the discussion of what was thought in the past rather than what is known now appears to be of merely antiquarian value. The knowledge of Diet, Dietetics, medicinal plants dates back to the remote antiquity of mankind. The Hebrews can be proud of having preserved in the Old Testament many old medical practices and traditions, which throw light on ancient medicine. The Bible is genuinely documented book representing the wisdom, medical knowledge and the culture, of a nomadic race. This article contains information of some medicinal plants, which are useful for treating different kinds of ailments and some with nutritious qualities.

Basic principles of pharmaceutical science in Ayurvĕda.

Pharmaceutical is one of the allied branches of science, which is closely associated with Medical science. Today pharmaceutical chemistry and pharmacognosy are playing important role in treatment for a disease and its prevention. Herbal medicines are being used by about 80% of the world population mostly in the developing countries in the primary health care. There has been an upsurge in demand for the Phyto-pharmaceutical products of Ayurvĕda in western nations, because of the fact that the synthetic drugs are considered to be unsafe. Due to this many national and multinational pharmaceutical companies are now concentrating on manufacturing of Ayurvĕdic Phyto-pharmaceutical products. Ayurvĕda is the Indian traditional system of medicine, which also deals about pharmaceutical science. The Ayurvĕdic knowledge of the pharmaceutical science is scattered in Ayurvĕdic classical texts. Săranghadhara Samhita, which is written by Săranghadhara, explain systematically about the information of the Ayurvĕdic pharmaceutical science and also updated it. Industrialized manufacturing of Ayurvĕdic dosage forms has brought in new challenges like deviation from basic concepts of medicine preparation. Săranghadhara Samrhită the devout text on pharmaceutics in Ayurvĕda comes handy to solve such problems, as the methods described are very lucid and easy to follow.

Some explorative information regarding 'Jwaratimirabhăskara' and its author Kăyastha Camunda.

Out of the treasure of Ayurvĕdic literature, a few texts have come in to lime light while some are in dark and available in incomplete form. But many names of the texts with unknown or known authors have been quoted by different subsequent authors in their texts or in the explications by their commentators, for which complete texts are not available at present. Among the texts on specific diseases, one notable work is 'Jwaratimirabhăskara' written by Kăyastha Camunda. Nowhere a detailed account of author's identity, time and place has been mentioned, while short references are available in some historical books. However, manuscripts of this text are available in many repositories of our country. In this article, an attempt has been made to establish the identity of the author, period of the text and also to highlight the salient features of this text.

Biography of Mădhavakara: his scholarly contribution.

Mădhavakara, the author of renowned work on 'Nidăna-Rŏgaviniścaya', popularly known as Mădhava Nidăna. It may be the first or earliest compendium detailed description of the diseases based on Nidăna Pancăkam (Five groups of subjects concerned to aetio-pathogenesis). He was the son of Indukara according to the colophon of a manuscript of Văcaspati's commentary on Mădhava Nidăna. He is probably lived between 700-800 A.D., because he is quoted by Vrnda, who belongs to 8th century A.D. The book Mădhava Nidăna was translated in to Arabic as evidenced by the writings of Ali Ibn Sahl 849-850 A.D. and other Arabic authors. Hence, he probably lived between 700-800 A.D. Madhava Nidana is a popular work on Nidăna (aetiopathogenesis) and it is the best in the field of ayurvĕda. "Nidăne Mădhavam srestah" and it is popularly known by the name of the author, but the title of the work is "Rugviniscaya" or "Rŏgaviniscăya". The subject matter explained in 73 chapters. The 1st chapter deals with Nidănapancakam and the other chapter's deals with diseases. The major contribution of Mădhava is the new order of arranging diseases, description of new diseases and recognizing some disorders as independent diseases. The other works attributed to Mădhava are Mădhavacikitsă, Paryăyaratnamăla etc. The important commentaries on Madhavanidana are "Madhukŏśa" by Vijayarakşita and Srĭkaņţhadatta and "Atankadarpana" by Vidyavăcaspati. The work is translated into English, Italian, Hindi, Bengali, Telugu etc., including some regional languages of India.

Ayurvĕda gleaned through Buddhism.

The Păli canon consists of three Pitakas (baskets), which replete the Buddhism and is known as Tripiţaka, viz, Vinaya, Sutta and Abhidhamma Piţakas. The original phase of Tripiţaka (Buddhisim started in 544 B.C. and lastly systematized up to 29 B.C. The Buddhist literature also possesses the esoteric material of Medical Science, which is practiced and conserved in India since centuries. It refers to the fundamentals of medicine, rules of good living, which lay considerable emphasis on the hygiene of body, mind. Internal Medicine, curative medicine including symptoms, methods of diagnosis, theories of causation, materia-medica, therapeutics and treatment and skills of Jivaka. Some famous and popular prescriptions are also dealt with.