Holistic Health Solutions for Common Diseases

Holistic Health
Solutions
Holistic Health
Solutions
Professor Adrian K
Adrian ennedy
ennedy,, P
Kennedy hD (CHP) USA.
PhD
Director
ector,, A
irector cademics
Academics
Dr. Bhargav
hargavaa Boddu. ND (O
Bhargav sm), MBA (H
(Osm), osp
osp.. Mgmt)
(Hosp
Director (Holistic Health)
Apollo H ospitals Educational & R

Hospitals esear
Resear ch F
esearch oundation
Foundation
Lifetime Wellness Rx IInternational
nternational Pvt. Ltd.
(An Apollo Hospitals Group Company)
Plot No: 34, Avenue 1, Sai enclave, Road No. 12
Banjara Hills, Hyderabad – 500034
Tel: +91-40-23301650/23388328, Fax: +91-40-23304334
Email: wellnessrx@apollolife.com www.ewellnessrx.com
MESSAGE FR
MESSAGE OM THE CHAIRMAN
FROM
A Holistic approach to Health
Apollo has been a trailblazer ever since its inception, not only of being a
pioneer in establishing world class multi-speciality corporate hospitals,
but also of establishing teaching institutions to train skilled human resources
to run these institutions.
Modern Medicine is rightly recognised for its brilliant solutions to complex
medical problems. It has received accolades not only for eradication of
several communicable diseases, but also for its pioneering work in cardiology,
cancer, gene therapy, etc. However a majority of the world’s population
still uses Complimentary therapies in order to maintain good health and
the benefit of Complimentary medicine lies in its vast reach and low costs.
Apollo, in starting the Holistic Health program, seeks to make available to
the Medical fraternity, those scientifically evaluated solutions from
Complementary therapies that meet Modern Medical scrutiny, thereby
empowering the physicians to select the best solutions for the patient.
DR. PRATHAP C. REDDY

Chairman, Apollo Hospitals Group & President
Apollo Hospitals E
Hospitals ducational and R
Educational esear
Resear ch F
esearch oundation
Foundation
Holistic Health Solutions
CONTENTS
Preface
Introduction
1. Gastrointestinal Diseases Page N Noo.

O Aphthous ulcers.......................................................... 2
O Gastrooesophageal reflux.............................................. 7
O Gastritis...................................................................... 12
O Peptic ulcer.................................................................. 17
O Hepatitis.................................................................... 24
O Irritable Bowel syndrome............................................ 33
O Amoebiasis................................................................. 39
O Gall stones................................................................. 43
O Diarrhoea................................................................... 49
O Constipation............................................................... 55
O Dyspepsia................................................................... 61
O Ulcerative Colitis......................................................... 67
O Hemorrhoids............................................................... 75
2. Respiratory Diseases
O Common cold..............................................................84
O Sinusitis...................................................................... 91
O Pharyngitis ................................................................. 98
O Bronchial asthma........................................................103
O Bronchitis..................................................................113
O Pulmonary Tuberculosis..............................................119
O Emphysema...............................................................126
3. Cardiovascular Diseases
O Hypertension.............................................................132
O Coronary Heart Disease..............................................141
O Arrhythmias...............................................................151
O Varicose veins.............................................................155
O Peripheral arterial disease............................................ 161
O Congenital diseases of heart........................................ 166
IV
4. Neurological Diseases
O Headache.................................................................. 174
O Migraine................................................................... 183
O Stroke...................................................................... 190
O Alzheimer’s disease................................................... 200
O Parkinsonism............................................................ 211
O Epilepsy.................................................................... 217
5. Orthopedic Diseases
O Rheumatoid arthritis................................................. 230
O Osteoarthritis............................................................ 241
O Gout......................................................................... 249
O Low back pain........................................................... 254
O Osteoporosis..............................................................268
O Fibromyalgia..............................................................277
O Sprains and Strains....................................................286
6. Endocrine Diseases
O Diabetes ................................................................... 292
O Hypothyroidism........................................................ 304
O Hyperthyroidism....................................................... 311
7. Skin Diseases
O Acne......................................................................... 318
O Psoriasis.................................................................... 324
O Eczema......................................................................332
O Alopecia.................................................................... 339
O Vitiligo......................................................................345
O Corns........................................................................ 349
8. E
Eyye Diseases
Diseases
O Refractive Eye Disorders............................................. 354
O Glaucoma.................................................................. 358
O Conjunctivitis............................................................365
O Cataract.....................................................................370
V
9. U
Urrogenital D iseases
Diseases
O Cystitis/UTI............................................................. 376
O Urolithiasis................................................................ 383
O Renal failure.............................................................. 391
O Benign Enlargement of Prostrate................................ 397
O Urinary Incontinence................................................. 405
O Impotence ................................................................ 411
O Infertility.................................................................. 419
10. Gynecological diseases
O Dysmenorrhea...........................................................434
O Amenorrhoea............................................................. 441
O Pelvis inflammatory disease.........................................449
O Endometriosis........................................................... 453
O Premenstrual syndrome............................................. 458
O Menopause............................................................... 465
11. Immunological disease
O AIDS........................................................................ 474
O Allergies.................................................................... 487
12. Cancer
Cancer............................................................................ 498
13. Nutritional diseases
O Anemia......................................................................514
O Obesity......................................................................518
O Anorexia.....................................................................526
O Bulimia......................................................................533
14. Psy
Psychological diseases
sychological
O Generalised Anxiety Disorder......................................540
O Depression.................................................................547
O Chronic Fatigue syndrome..........................................556
O Drug Addiction..................................................... 563
O Alcoholism................................................................ 573
O Insomnia................................................................... 582
15. The Rules of G
Rules ood H
Good ealth
Health
ealth.............................................. 594
Appendix
Appendix...................................................................... 679
B ibliography
ibliography.................................................................. 692
VI
PREFACE
PREFA
The Holistic Health program represents the latest trend in health care,
which is the increasing recognition of alternative and complementary
treatments by all countries.
Many of these therapies date back to thousands of years and have survived
for the reason that they are safe and effective for certain conditions. It is
also a fact that almost 50% of modern drugs are made from plants first
used traditionally.
According to WHO Fact sheet No 134, May 2003, in USA, 158 million
of the adult population use alternative and complementary medicines. 70%
of the Canada Population has used complementary medicine. In Africa, up
to 80% of the population uses traditional medicine for primary health
care. Traditional medicine is widely used in India, especially in rural areas
where 70% of the Indian population lives.
The Indian Government’s National policy on Indian systems of Medicine
has, as its objective, the starting of courses of long duration (of one to two
years) for Allopathic doctors from India and abroad who are interested in
learning about Ayurveda. We, at Apollo Hospital Education & Research
Foundation, also recognise the benefit that will emerge from the scientific
integration of ancient medical wisdom and modern medical sciences. As
modern and traditional medicines come together, a novel paradigm will
emerge that will enrich both patient and practitioner.
We are, however, not suggesting that our program will qualify doctors to
practice other systems of Medicine. This Program will, however, enable
the participant to become a Holistic Professional i.e. a professional who
has a comprehensive knowledge of all systems of medicine and therapies.
Our earlier book written by us for the Holistic Health Program students,
it dealt with various medical systems. This book, Holistic Health Solutions,
deals with the treatment of various diseases by these medical systems. Taken
together these books give the doctor a comprehensive knowledge of all
medical systems, and empowers him to select the best solutions for the
patient.
Professor A drian K
Adrian ennedy
ennedy,, P
PhD
Dir ector
ector,, (A
irector cademics)
(Academics)
Dr. Bhaargav
haargavaa Boddu.
Bhaargav
Course Director (Holistic Health)
VII
INTRODUCTION
INTRODUCTION
During the last decade, in many developed countries, there has been a
growing interest in traditional and alternative systems of medicine. Over
the years, the World Health Organisation has adopted a number of
resolutions drawing attention to the fact that most of the populations in
various developing countries around the world depends on traditional
medicine for primary health care, that the work force represented by
practitioners of traditional medicine is a potentially important resource for
the delivery of health care. Many of the traditional therapies go back
thousands of years and have survived for the reason that they are safe and
effective for certain diseases.
Traditional medicine has maintained its popularity in a number of Asian
countries, such as China, India, Japan and Pakistan. In USA, 158 million
of the adult population use complementary medicines. In Africa, up to
80% of the population uses traditional medicine for primary health care.
70% of the Canada Population has used complementary medicine at least
once. In China, traditional herbal preparations account for 30% to 50%
of the total medical consumption. Traditional medicine is widely used in
India, especially in rural areas where 70% of the Indian Population lives.
Approximately, 25% of modern medicines are made from plants first used
traditionally.
Many doctors are open to using integrated therapies in their practice. This
is because general allopathic practitioners deal with mostly chronic diseases
like diabetes, heart disease and arthritis, etc, where there are no lasting
solutions in Modern Medicine. Alternative medicine practitioners also are
interested in integrated medicine, because where as alternative medicine is
good with chronic ailments, there is no treatment for acute medical
conditions and emergencies in alternative systems of medicine.
The future will be shaped by a new era of more effective treatment. Diagnosis,
prevention and treatment will be linked more closely than ever before by
integrated strategies offering patients and healthcare providers highly
focused, individualised care.
A physician who has the knowledge of other medical systems is working
with a tremendous advantage. Physicians have begun to incorporate
VIII
centuries-old healing arts into their practice. A physician can enrich his
practice by including lifestyle and dietary advice in addition to standard
diagnostic and therapeutic regimens. He could advise stress management,
or meditation to reduce his stress levels. We are going back to basics and
studying more “natural” healing methodologies.
As popular interest has grown, even mainstream medical organizations have
expressed interest in alternative medicine. Meanwhile, more and more
Modern Medicine physicians are seeking training in alternative medicine.
Medical schools in the United States are conducting training in alternative
medicine. Among these are prominent schools such as Harvard Medical
School in Boston, Massachusetts; Cornell University in Ithaca, New York;
and the College of Physicians and Surgeons at Columbia University in
New York City. In India some Modern Medicine physicians have started
undergoing training in alternative medicines.
There remains considerable skepticism among practitioners of Modern
medicine and among biomedical researchers regarding the efficacy of
alternative medicine. They say that many of the claims made by practitioners
of alternative medicine have not been supported by rigorously controlled
scientific study. They also say that, in sharp contrast to the years of training
required to become a mainstream health-care provider, there are few or no
qualifications needed to practice some types of alternative medicine.
However, in recent years many scientists have begun to conduct studies to
evaluate alternative therapies. In USA, a division of the NIH, the National
Center for Complementary and Alternative Medicine (NCCAM), was
established by the Congress of the United States in 1992 to facilitate the
fair scientific evaluation of alternative therapies. The NCCAM seeks to
reduce barriers that may keep promising alternative therapies from gaining
widespread use. Physicians are also gaining more confidence in alternative
therapies. By the late 1990s, some U.S. medical schools had incorporated
courses in alternative medicine into their curricula. It is possible that what
was considered alternative in the past will become mainstream in years to
come.
In India, Central councils of Ayurveda, Unani, Homeopathy, Naturopathy
and Yoga are conducting various researches on these Medical systems.
(Practitioners of Allopathy, Ayurveda, Unani, Homeopathy and
IX
Naturopathy are registered under the same statue). There are many medical
colleges in India offering a regular 5 ½ year medical courses on these medical
systems. Every medical student takes equal training in anatomy, physiology,
pathology, social and preventive medicine, obstetrics and gynaecology.
Thereafter he is trained in his own medical system.
Unlike Europe and America whose clinics practice Integrated Medicine,
no such clinics exist in India. The Holistic health program is the first step
in the direction of bringing together professionals from different medical
schools to treat the patient under a single roof.
The Holistic Physician is knowledgeable about the advantages and
limitations of various medical systems and therefore most qualified to offer
the best choices that medicine has to offer to his client.
This book presents, for easy reference, the various treatments available for
the most common ailments. For easy reading and referral we have created
an appendix at the back of the book that explains more lucidly the various
terms used in each medical discipline, along with diagrams wherever
necessary.
For the client with no ailments, the last chapter of the book offers advice
on how to evaluate, achieve and retain good health.
Professor A drian K
Adrian ennedy
ennedy,, P
PhD
Dir ector
ector,, (A
irector cademics)
(Academics)
Dr. Bhaargav
haargavaa Boddu.
Bhaargav
Course Director (Holistic Health)
X
1
GASTROINTESTINAL DISEASES
Aphthous ulcers
Gastrooesophageal reflux
Gastritis
Peptic ulcer
Hepatitis
Irritable Bowel syndrome
Amoebiasis
Gall stones
Diarrhoea
Constipation
Dyspepsia
Ulcerative Colitis
Hemorrhoids
1
APHTHOUS (MOUTH) ULCERS

An Aphthous ulcer is an open sore in the mouth, which appears as a painful
white or yellow ulcer surrounded by a bright red area. An Aphthous ulcer
is a benign ulcer.
Causes, incidence, and risk factors

Aphthous ulcers are a common form of mouth ulcer. They occur in women
more often than in men. They may occur at any age, but usually first
appear between the ages of 10 and 40.
Aphthous ulcers usually appear on the inner surface of the cheeks and lips,
tongue, soft palate, and the base of the gums.
Aphthous ulcers often have the tendency to reoccur. There may be an

inherited tendency to develop Aphthous ulcers, as they often run in families.
There may also be an immune system link. Ulcers may develop in response
to a mouth injury such as dental procedures or aggressive tooth cleaning.
Aphthous ulcers may also occur at the site of a bite when the tongue or
cheek is bitten. They can be triggered by emotional stress, dietary deficiencies
(especially iron, folic acid, or Vitamin B-12), menstrual periods, hormonal
changes, food allergies, and similar situations. They occur most commonly
with viral infections. They may occur with no identifiable cause.
Symptoms
Skin lesion on mucous membranes of the mouth which begins as a red spot
or bump and then develops into an open ulcer.
The ulcer is usually painful, small, 1-2 mm to 1 cm, occasionally larger
than 1 cm, single or in clusters, often appears in groups (crops), center
appears white or yellow with fibrous texture, halo border is bright red (a
red halo may not always be present)
Less common symptoms, which may appear at the time of the canker but
may or may not be related, include: fever, general discomfort or uneasiness
(malaise) and swollen lymph nodes.
2
Gastro Intestinal Diseases
Signs and tests

A diagnosis is based on the distinctive appearance of the lesion. If Aphthous
ulcers persist or continue to return, tests have to be done to rule out other
causes of mouth ulcers. These include erythema multiforme, drug allergies,
herpes infection, pemphigus, pemphigoid, bullous lichen planus, and other
disorders. Oral cancer is not a complication of Aphthous ulcers, but if an
ulcer lasts more that 2 weeks, cancer may actually be the cause of the ulcer.
Therefore, any ulcer lasting over 2 weeks should be evaluated by a physician.
Squamous cell carcinoma may first appear as a mouth ulcer that does not
heal, but this is rare. A relatively new ulcer-like condition is hairy leukoplakia,
a condition that occurs with HIV infection and it may be mistaken for the
common canker. A skin lesion biopsy may be used to differentiate an
Aphthous ulcer from other causes of mouth ulcers.
Treatment
Treatment is usually not necessary. In most cases, the Aphthous ulcers go
away by themselves. Severe mouth ulcers (larger than 1 cm or lasting longer
than 2 weeks) may require evaluation and treatment.
MODERN MEDICINE
In these cases, topical or oral (by mouth) tetracycline suspension may be

given, with instructions to hold it in the mouth for 2-5 minutes before
swallowing. Tetracycline is usually not prescribed for children until after
all the permanent teeth have fully developed. Oral thrush or other Candida
infections may occur following the use of antibiotic treatment. Multiple,
painful mouth ulcers may treated with an antiviral agent such as acyclovir.
Topical or oral corticosteroids are rarely used, but they may reduce
inflammation. Dexamethasone suspension may be given with instructions
to rinse the mouth and spit it out; or dexamethasone, prednisone, or other
corticosteroid may be given systemically (in a pill or injection, for example).
Apart from this, cauterisation with 10% silver nitrate can be done. To relieve
pain lignocaine viscous can be applied locally.
3
AYURVEDA
Ayurveda suggests that Aphthous ulcers manifest in people with high pitta.
Follow a pitta-soothing diet and avoid hot, spicy and fermented food. Also,
it is advised to avoid strong alcoholic drinks as they may aggravate the
sores.
O Gargling with Triphala decoction, Sapthachathagadi Kashayam
reduces pain, inflammation and heals oral ulcers.
O Eat a mixture of rock candy powder (1/2 teaspoon) and cumin
powder (1/2 teaspoon). This will help reduce the pain, as well as
inflammation and irritation.
O Honey and Turmeric: Mix together 1 teaspoon honey with 1/4
teaspoon turmeric, and rub it on the sore. It will burn a little at
first, but the sore area will heal quickly.
O Application of fresh ghee over the ulcer relieves pain and promotes
healing.
O Gargling with triphala decoction thrice daily will helps in healing
the ulcers.
O Ayurvedic herb Kama Dudha: Mix 1/4 teaspoon of kama dudha
with 1 teaspoon fresh cream, rub it on the sore.
ACUPUNCTURE
To relieve stress, press Gall Bladder GB 21, the highest point of the shoulder
muscle, midway between the outer tip of the shoulder and the spine. If
you do this as soon as you notice a tingling in the mouth and before the
sore develops, it will help reduce its severity.
HOMEOPATHY
Homeopathic remedies can ease the pain of canker sores, reduce
inflammation, and help the tissues heal.
Arsenicum album: A person who breaks out in burning, painful mouth

sores, and also feels anxious and tired, is likely to benefit from this remedy.
Hot drinks often ease the pain, and the person feels best when keeping
4
warm. Arsenicum album is recommended when the mouth is dry and

burning, and the ulcers are soothed by warm water.
Borax: This remedy is often helpful when Aphthous ulcers feel hot and
sensitive. Sores may break out on the inside of the cheeks, on the gums,
and on the tongue. In spite of profuse saliva, the mouth still feels dry.
Calcar ea carbonica: This remedy is often indicated for infants and small
Calcarea
children who suffer from recurrent canker sores. Other indications are: head-
sweats during sleep, and delayed teething.
Hepar sulphuris calcar eum: This remedy may be indicated when a person
calcareum:
develops painful mouth sores that becomes infected-with pus formation.
Mer curius solubilis: This remedy is useful when bleeding gums, a swollen
ercurius
coated tongue, and offensive breath are seen along with canker sores.
Natr um muriaticum: Pearly sores that erupt inside the mouth, especially
atrum
on the gums or tongue, may respond to this remedy. Often troubled by
cold sores around the corners of the mouth or chin, and the person may
have chapped or cracking lips.
Nux vomica: A person who needs this remedy may break out in Aphthous
ulcers after overindulging in sweets, strong spicy foods, stimulants, or
alcoholic beverages. The person may have swollen gums, a coated tongue,
and bloody salivation.
NATUROPATHY
A soft bland diet without spices or chillies will be helpful. Soft foods like
curd rice, yoghurt, sago, wheat porridge, banana, etc. will be useful during
acute stage. All allergic foods should be avoided. Soft fruits or fruit juices,
especially citrus, 2 to 3 times a day should be given.
Add two kale leaves, a small handful each of parsley and spinach and four
or five carrots into a juicer. This drink is very nutritious and is a good
source of beta-carotene, which has been shown to heal mouth sores.
Other juices like Carrot and spinach juice, Orange juice, Cranberry juice
also help to heal ulcers.
5
Aloe Vera G el: Apply aloe vera gel, 2 tablespoons at the canker sore. Repeat
Gel:
the application 3 times a day.
Aloe Vera G el and N
Gel eem: Use a mix of aloe vera gel and Neem powder
Neem:
(Indian herb). Mix 1 teaspoon of aloe vera gel with a pinch of Neem powder,
and apply directly to the canker sore.
Tea Tree O il: Add 10 drops of tea tree oil to 1/3 cup of water. Mix it well.
Oil:
Swish the liquid in your mouth. The mild solution will act as an antiseptic
to help prevent secondary infection, and it will help to heal the sore.
YOGA THERAPY
Pranayamas such as Sheetkari and Sheetali help in healing the ulcers.
Meditation and yoga nidra help to reduce stress and prevent ulcers.
NUTRITION THERAPY
Supplementation with Vitamin C (400 mg/day), Zinc (25 mg/day),
Acidophilus (Lactobacillus acidophilus), and B-complex vitamins will be
helpful. As in naturopathy, eat a bland diet and take sufficient fresh uncooked
vegetables and fruits.
PSYCHOTHERAPY
Aphthous ulcers are often brought about and aggravated by stress. Learn to
meditate, do guided-imagery, and visualize yourself as a healthy, relaxed
person. Find a relaxation technique that you will enjoy doing and will keep
doing.
Prevention
Sodium lauryl sulfate (SLS), a component of some toothpaste, is a potential
cause of aphthous ulcers. SLS is thought to increase the risk of aphthous
ulcers by removing a protective coating (mucin) in the mouth. In one study,
most recurrent aphthous ulcers were eliminated just by avoiding SLS-
containing toothpaste for three months. Good oral hygiene will go a long
way in preventing ulcers in the mouth. Dialy brushing, in addition to
rinsing after each meal is important. Avoid sweet and sugary food and also
avoid smoking and eating tobacco, paan, supari etc.
6
GASTROESOP
GASTROESOPHA
OESOPHAGEAL REFL
HAGEAL UX
REFLUX
Gastroesophageal reflux disease (GERD) is a condition in which food or
liquid travels from the stomach back up into the esophagus (the tube from
the mouth to the stomach). This partially digested material is usually acidic,
and can irritate the esophagus, often causing heartburn and other symptoms.
Gastroesophageal reflux is a common condition that often occurs without
symptoms after meals. In some people, the reflux is related to a problem
with the lower esophageal sphincter, a band of muscle fibers that usually
closes off the esophagus from the stomach. If this sphincter doesn’t close
properly, food and liquid can move backward into the esophagus and may
cause the symptoms.
Symptoms
O Heartburn involves a burning pain in the chest (under the
breastbone), increased by lying down, or eating, relieved by antacids
and is more frequent or worse at night
O Belching and regurgitation of food
O Nausea and vomiting
O Hoarseness or change in voice
O Difficulty swallowing
O Cough or wheezing.
Signs and tests

O A positive stool guaiac
O Continuous esophageal pH monitoring showing reflux
O Endoscopy showing ulceration or inflammation of the esophagus
O Esophageal manometry showing abnormal sphincter pressure
O A barium swallow showing reflux
O A positive Bernstein test for gastric acid reflux.
7
Treatment
MODERN MEDICINE
Medications that alleviate symptoms include:
O Antacids and alginic acid—for symptom relief of mild GERD
O Prokinetics—for relief of heartburn. Eg, Cisapride
O H2 antagonists—relieves symptoms and can heal mild-to-moderate
esophagitis (inflammation of the esophagus); prevent relapse of mild
GERD eg. Ranitidine, cimetidine
O Proton-pump inhibitors—stop the secretion of gastric acid; relieve
severe symptoms and heals esophagitis. Eg. Omeprazole,
Lansoprazole, etc.
Anti-reflux operations (Nissen fundoplication) may help a small number
of patients who have persistent symptoms despite medical treatment. There
are also new therapies that can be performed through an endoscope (a
flexible tube passed through the mouth into the stomach) for reflux.
AYURVEDA
Since the disease is caused by variation of pitta, the best therapy is avoiding
pitta producing foods like hot, chilly, pungent, spicy foods.
O Sukumara Ghrita is a specific treatment to reduce the symptoms.
O Amla powder 3 grams mixed with 3 grams of powdered mishri (rock
candy) is very helpful mixture for acid reflux. Take a 6 grams dose at
one time.
O Vilvadi lehyam 1 tsp with pinch of shanka bhasmam reduces the
reflux oesophageatis and acid regurgitation.
O Guduchyadi Kashayam with 1 tsp Avipathi churnam also helps.
ACUPUNCTURE
Acupuncture may be helpful in reducing GERD. Use the following
acupuncture points:
O Baihui (Du 20.)
O Influential points: Ren 10, 11.
8
HOMEOPATHY
Some of the most common homeo remedies used for GERD are listed
below. Usually, the dose is 3 to 5 pellets of a 12X to 30C remedy every one
to four hours until your symptoms get better.
Arsenicum album: For burning pain that feels better with warmth.
Carbo vegetabilis: For bloating and indigestion that is worse when lying
down, especially with flatulence and fatigue.
Lycopodium: For heartburn that feels worse with eating.
Nux vomica: For heartburn with cramping and constipation.
NATUROPATHY
A bland diet low in fat and high in protein is good. Small frequent meals
should be taken instead of large meals. Cold milk, curd, buttermilk, banana,
curd rice provide good relief from heartburn. Drink plenty of liquids like
pure water, coconut water, buttermilk etc. Juices like watermelon juice,
Carrot juice, Cabbage juice, Potato juice help to reduce the heartburn.
The following herbs are used in Naturopathy to treat GERD.
Licorice (Glycyrrhiza glabra) is an anti-inflammatory and antispasmodic,
and relieves pain in the gastrointestinal tract. Chewable lozenges may be
the best form for treating GERD. Take 380 to 1,140 mg a day. Do not take
licorice if you have high blood pressure or use it for a prolonged period.
Slippery elm (Ulmus fulva) protects irritated tissues and promotes their
healing. Take 60 to 320 mg a day. You may mix 1 tsp. powder with water
and take three to four times a day.
YOGA THERAPY
O Bandha: Uddiyana bandha, Mula bandha
O Asanas: Standing poses like Tadasana, Trikonasana, Natarajasana;
forward bending poses like Shashankasana, paschimothasana, etc.
O Pranayamas such as Nadi shuddhi, Sheetkari, Sheetali, and Bhramari.
9
NUTRITION THERAPY
Dietary therapies may be helpful in treating mild or infrequent
Gastroesophageal Reflux Disease (GERD)/heartburn by improving the
constriction of the lower esophageal sphincter (LES), decreasing irritation
in the esophagus, and reducing the frequency and volume of reflux.
Improve Constriction of the Lower Esophageal Sphincter (LES):

The dietary suggestions below may help to improve the constriction of the
LES:
O Increase intake of protein to over 60gms/day.
O Decrease intake of fat to less than 30 grams a day, and avoid
particularly fatty or greasy foods.
O Avoid food and drink that is flavored naturally or artificially with
peppermint or spearmint.
O Avoid alcohol, coffee, chocolate, and strong tea.
Decrease Irritation in the Esophagus:

The following dietary tips may help to decrease irritation in the esophagus:
O Avoid ingesting potential irritants, such as alcohol, beverages
containing caffeine (coffee, chocolate milk, hot chocolate, colas,
tea), carbonated beverages, citrus juices, tomato-based products,
and spicy foods
O Select foods that are easy to digest, such as gelatins, puddings, and
yogurts.
Reduce the F
Frrequency and Volume of Reflux:
Reflux:
You may be able to reduce the frequency and volume of reflux by taking
the following preventative steps:
O Instead of eating three large meals daily, try smaller, more-frequent
meals (one every 2-3 hours)
O Eat slowly and chew food well. Get in the practice of putting down
your fork after every bite and chewing each mouthful at least 10
times
10
O Drink liquids one hour before or after meals instead of with meals.
If you must drink during a meal, sip only small amounts as you
eat
O Reduce your weight if you are overweight
O Include enough fiber in your diet to avoid constipation, which can
lead to an increase in intra-abdominal pressure.
PSYCHOTHERAPY
As stress can aggravate GERD, stress reduction through relaxation, behaviour
therapy and meditation can reduce the symptoms and effects of GERD.
Other methods of reducing stress include problem solving, Psychotherapy,
and mild exercise.
Lifestyle Change
Simple lifestyle changes may help in the treatment of mild or infrequent
Gastroesophageal Reflux Disease (GERD)/heartburn.
O Do not lie down for 2-3 hours after meals. This may help to reduce
the frequency and volume of reflux and, in turn, reduce irritation
in the esophagus
O When sleeping or resting, elevate the head of your bed approximately
four inches. (Try placing blocks under the legs at the head of your
bed.) This may also help to reduce the frequency and volume of
reflux and reduce irritation in the esophagus
O Wear comfortable clothing that is loose around the waist. Tight
clothing around the waist may have the effect of weakening the
lower esophageal sphincter (LES) and, in turn, increasing the
frequency and volume of reflux
O Avoid chewing gum, and avoid smoking immediately following
meals. The air that you swallow while chewing gum or smoking
may lead to belching and reflux
O Weight reduction in case you are overweight
O Avoid alcohol, smoking, and narcotics
O Have sufficient sleep and exercise daily.
11
GASTRITIS
Gastritis is an inflammation of the lining of the stomach. It is not a single
disease but rather a group of disorders. Gastritis can “eat away” the stomach
lining and cause bleeding. In some cases, gastritis does not damage the
stomach lining and does not have a specific cause. Gastritis can occur
suddenly (acute gastritis) or gradually (chronic gastritis).

Gastritis can be caused by bacterial or viral infection, autoimmune disorders,
or backflow of bile into the stomach (bile reflux).
Gastritis can also be caused by irritation from:
O Medications (such as aspirin or anti-inflammatory drugs)
O Alcohol
O Chronic vomiting
O Excess gastric acid secretion (such as from stress)
O Eating or drinking caustic or corrosive substances (such as poisons).
Symptoms
O Hiccups
O Abdominal indigestion
O Loss of appetite
O Vomiting blood or coffee-ground like material
O Dark stools.
Signs and tests

Tests vary depending on the specific cause. An upper GI X-ray, Endoscopy,
or other tests may be advised. A breath test may detect H. pylori, or samples
from your esophagus or stomach may be taken to look for this organism.
Treatment
MODERN MEDICINE
Medications to kill the infection and to decrease stomach acid secretion
may be recommended.
12
Helicobactor pylori infestation, a common bacterial cause of gastritis and

ulcers, is treated with a three-drug combination for two weeks: Pepto-Bismol,
metronidazole, and tetracycline (or amoxicillin if tetracycline cannot be
used).
O Antacids such as calcium carbonate, calcium carbonate with
magnesium hydroxide, and sodium bicarbonate
O H2 blockers such as ranitidine, cimetidine, nizatidine, and
famotidine
O Proton pump inhibitors such as omeprazole and lansoprazole
O Gastritis caused by pernicious anemia is treated with Vitamin B12
O Antiemetics like metoclopramide or domperidone are given to
control nausea and vomiting
O In cases of hemorrhagic gastritis, blood transfusion may be given.
AYURVEDA
Since the disease is caused by variation of pitta, the best therapy is purgation
in the first instance. Sukumara Ghrita is specific treatment of gastritis since
it reduces pitta. It is administered in doses of one to two teaspoonfuls mixed
with a cup of milk and given first thing in the morning.
Amalaki of amla (Emblica officinalis) in a powdered form is also helpful;
the standard dose is two teaspoonfuls administered four times a day.
Alternatively, Dhatri Lauha (calx of iron mixed with juice of amalaki) should
be given in one teaspoonful doses twice daily.
In case of persistent constipation in a case of gastritis, Avipittikara Churna
should be given in a dose of two teaspoonfuls at bedtime.
O Decoction of Tinospora cordifolia bark, bark of margosa tree, root of
leadwort and leaves of pointed gourd subdues the vitiated Pitta
Dosha. It should be taken in the dose of 15ml twice daily
O Powder of Cardamom, cinnamon bark, embelic myrobalan and sugar
reduce the burning sensation of chest and stomach by reducing
acid secretion
O Tablets made from raisins, chebulic myrobalan and sugar reduce the
burning sensation of chest and stomach by reducing acid secretion
13
O Powder of Piper longum should be taken with honey and lemon

juice
O Powder of chebulic myrobalan and Piper longum taken with jaggery
works as anti anorexic
O Fresh grated coconut should be cooked in milk and sugar and
cardamom powder should be added to it after it gets cool. Two to
three pieces of this recipe should be eaten everyday for hyperacidity
O For travelling sickness, a bud of clove should be kept in mouth and
chewed throughout the travelling.
Panchakarma Treatment - Emesis should be induced in the patients who
vomit very often. Vomiting can be done by using decoction of emetic nut
or margosa leaves (neem).
When accumulation of Doshas is in the lower part of body, purgation is
advised. This can be given by using Triphala kwath (a decoction of Embelic
myroblan, Chebulic myroblan and Belleric myroblan).
Internal oleation therapy is also advised. Various medicated Ghritas like
Shatavari Ghrita, Drakshadi Ghrita are also effective in the hyperacidity.
ACUPUNCTURE
Acupuncture may be helpful in reducing stress and improving overall
digestive function.
O Baihui (Du 20.)
O Local points: Weishu (U.B.21), Tianshu (St.25)
O Influential point: Zhongwan (Ren 12)
O Distal points: Zusanli (St 36), Neiguan (P.6), Liangqiu (St.34)
(Xi-Cleft point), Sanyinjiao (Sp.6)
Additional points according to symptoms:
O Infection: Quchi (L.I. 11)
O Flatulence: Zhangmen (Liv. 13), Jingmen (G.B. 25), Daimai (G.B.
26).
14
HOMEOPATHY
Homeopathy may be useful as a supporting therapy. There are three
remedies to consider: Nux vomica, Arsenicum album, and Lycopodium.
Nux is said to be indicated for those who experience heartburn or stomach
pain after eating; wake at night with stomach discomfort, including pain
or bloating; and often have constipation or diarrhea. Symptoms are worsened
by rich or spicy foods, and made better by warmth.
Lycopodium may be traditionally indicated when belching, bloating, and
easy fullness are prominent parts of the symptom picture, along with
indigestion related to social stress.
Pulsatilla is frequently recommended for emotional, clingy people, who
have rapidly changing symptoms, including heartburn and bloating,
particularly after eating rich foods.
NATUROPATHY
A bland diet low in fat and high in protein is good. Small frequent meals
should be taken instead of large meals. Cold milk, curd, buttermilk, banana,
curd rice provide good relief from heartburn. Drink plenty of liquids like
pure water, coconut water, buttermilk etc. Juices like watermelon juice,
Carrot juice, Cabbage juice, Potato juice help to reduce the gastritis. Other
foods recommended are: barley, wheat, rice, cucumber, bitter gourd,
pumpkin, pomegranate, and cow’s milk.
Spices and condiments, alcoholic drinks, sour foods, chillies and pungent
substances which are likely to aggravate acidity must be avoided.
The following herbs are used in Naturopathy to treat Gastritis:
O DGL (deglycyrrhizinated licorice), 250 mg four times per day 15
to 20 minutes before meals and one to two hours after the last
meal of the day, increases circulation and healing of stomach lining.
This preparation is safe for people with high blood pressure.
O Powders of slippery elm (Ulmus fulva) and marshmallow root
(Althaea officinalis) may be taken singly or together, 1 tsp. two to
15
three times per day, to decrease inflammation and encourage

healing.
O Ginger root tea (Zingiber officinale) increases circulation and
enhances digestion. Drink 2 to 3 cups per day with meals.
O For H. pylori, bismuth subcitrate (120 mg four times per day for
eight weeks) may be helpful in eliminating the bacteria and
reducing recurrence of gastritis. Do not use this long-term. Be
sure to take it under the supervision of your health care provider,
since you may still need antibiotics if the H. pylori is not gone after
eight weeks.
YOGA THERAPY
O Kriyas such as Jala Dhauti and Kapalabhati
O Asanas:
{ Sitting poses like Padmasana, Vajrasana, Konasana, Siddhasana
{ Backward bend poses like Bhujangasana, Shalabhasana,
Dhanurasana, Chakrasana, Matsyasana, Setubandha
sarvangasana, Setubandha Vipareeta Dandasana, Ustrasana
{ Relaxative asanas like Shavasana, and Makarasana
O Pranayamas such as Nadi shuddhi, Chandra bheda, Sheetkari,
Sheetali, and Bhramari
O Meditation, Yoga nidra.
All backward bends prevent over functioning of the digestive system.
NUTRITION THERAPY
O Avoid dairy products, caffeine, alcohol, and sugar. Coffee, even
decaffeinated, should be eliminated because it contains potentially
irritating oils. Eliminate any known food allergens from your diet.
O Include sulfur-containing foods such as garlic, onions, broccoli,
cabbage, Brussels sprouts, and cauliflower in the diet. Sulfur is the
basis for forming glutathione, which provides antioxidant protection
to the stomach lining.
O Vitamin C (250 to 500 mg twice per day) decreases nitrosamines,
substances that have been linked to stomach cancer.
16
O N-acetylcysteine (200 mg twice a day between meals) is also the

basis for forming glutathione.
O Zinc (30 to 50 mg per day) helps you heal.
PSYCHOTHERAPY
Stress reduction through relaxation techniques including yoga, tai chi, and
meditation can also be quite helpful. So also are other methods of stress
reduction including problem solving, sleep and mild exercises.
PREVENTIVE CARE AND LIFESTYLE CHANGE
Making lifestyle changes, such as avoiding the long-term use of irritants
(aspirin, anti-inflammatory drugs, coffee, spicy foods, stress and alcohol)
will go a long way to preventing gastritis and its complications like an
ulcer. Other important lifestyle consideration include a regular routine of
sleep, meals and exercise.
PEPTIC ULCER
Ulcers are erosions in the lining of the stomach or duodenum (the first part
of the small intestines). An ulcer in the stomach is called a gastric ulcer. An
ulcer in the duodenum is called a duodenal ulcer. Together, ulcers of the
stomach and duodenum are referred to as peptic ulcers.
Most ulcers are erosions of the first layer of the inner lining of the digestive
tract. If the hole goes all the way through, this is called a perforation of the
intestinal lining. This can cause shock and is a medical emergency.

Normally, the lining of the stomach and small intestines have protection
against the acids produced in your stomach. For a variety of reasons, the
protective mechanisms may become faulty, leading to a breakdown of the
lining. This results in inflammation (gastritis) or an ulcer.
The most common cause of such damage is a bacterium called Helicobacter
pylori. Most people with peptic ulcers have this organism living in their
gastrointestinal (GI) tract. On the other hand, other people have this
organism living in their GI tract but they don’t get an ulcer.
17
Other factors which are likely to cause ulcer, include:

O Using aspirin, ibuprofen, or naproxen
O Drinking alcohol excessively
O Smoking cigarettes and using tobacco.
In addition, if there is a family history of ulcers or if the patient is of blood
type O, he is more likely to get a duodenal ulcer. There is also a rare condition
called Zollinger-Ellison syndrome in which a tumor in the pancreas secretes
a substance that causes ulcers throughout the stomach and duodenum.
A once popular belief was that stress causes ulcers. This is not accepted by
all doctors. Stress may make a person experience more pain from an ulcer
and it may make it more difficult to heal. However, stress probably does
not cause an ulcer.
Symptoms
Abdominal pain is the main symptom. It may awaken the patient at night,
may occur 2-3 hours after meal, or get worse if the meal is skipped. The
pain may be relieved by antacids or milk.
Duodenal ulcers often cause pain with burning or gnawing sensations. This
pain often occurs after eating and is relieved by antacids and milk. Increased
pain, vomiting blood, tarry or red stools, or losing a lot of weight are signs
of serious complications.
Gastric ulcers also often cause gnawing or burning pain. One day the pain
may be relieved from food or an antacid and the next day these may not
help at all. The patient may have vomiting or nausea.
Signs and tests
To diagnose an ulcer, one of the following tests is done:
O A barium X-ray : A series of x-rays taken after the patient drinks a
substance called barium.
O An Esophagogastroduodenoscopy (EGD): A special test in which
a thin tube is inserted through the mouth into the gastrointestinal
tract to look at the stomach and small intestines. During an EGD,
a biopsy may be taken from the wall of the intestines to test for H.
pylori. Other less accurate ways to test for this organism include a
blood test and a breath test.
18
Treatment
MODERN MEDICINE
Medication often involves a combination of medications to kill the

Helicobacter pylori bacteria, reduce acid levels, and protect the GI tract.
This combination strategy allows the ulcer to heal and reduces the chance
of it recurrence. Ulcerogenic drugs like Non Steroidal Anti Inflammatory
Drugs (NSAIDS) are avoided.
The medications may include one or more of the following:
O Antibiotics to kill Helicobacter pylori. “Triple therapy” (including
acid-reducing drugs and antibiotics such as amoxicillin,
metronidazole, or tetracycline) is commonly used for the eradication
of H. pylori. H. pylori resistance to antibiotic treatment is a
worldwide problem.
O H2-receptor antagonists such as cimetidine (400 mg twice daily)
or ranitidine (150 mg twice daily) reduce gastric acid secretion.
O Proton-pump inhibitors such as omeprazole (20 mg daily) or
lansoprazole (30 mg daily) decrease gastric acid secretion.
O Sucralfate (1,000 mg four times daily) makes a protective coating
over the ulcer crater; can be used for up to two months.
O Colloidal bismuth compounds such as bismuth subcitrate (240
mg twice daily) or bismuth subsalicylate (500 mg four times daily)
are antacids that can also eradicate H. pylori.
Surgery and Other Procedures

Once hospitalized, if bleeding from an ulcer does not stop by using
medications and supportive care (like fluids and, possibly, blood transfusion),
it can usually be stopped via endoscopy. If the bleeding recurs after that
procedure or you have a perforated ulcer or an obstruction, surgery may be
required.
AYURVEDA
Ayurvedic medicine of choice in gastric ulcers is the Sukumara Ghrita. It
should be administered in doses of two teaspoonfuls on an empty stomach
with warm milk. If the patient is unable to digest ghee or if ghee does not
19
agree with him, the medicine should be given with warm water. The dose
should be gradually increased to six teaspoonfuls over a period. The pain of
the ulcer is reduced by Shanka Bhasma. In the caste of excruciating pain,
Maha Shankha Vati should be given.
ACUPUNCTURE
Acupuncture may be helpful in reducing peptic ulcer. In acute attacks,
needling may be performed two to three times a day at following points.
O Baihui (Du 20.)
O Local points: Liangmen (St. 21), Tianshu (St.25), Pishu (U.B.20),
Weishu (U.B. 21)
O Distal points: Zusanli (St 36), Neiguan (P.6), Sanyinjiao (Sp.6).
The Back-Shu (Weishu (U.B. 21) and the Mu-Front (Zhongwan (Ren 12)
Alarm points may be used, instead of Local and Distal points.
Where tenderness is observed over area of the dorsal vertebrae it would be
useful to needle the related Huatuojiaji points (Ex. 21) or the Ah-Shi points.
Catgut embedding therapy at Zhongwan (Ren 12) through to Liangmen

(St. 21.) may be tried in chronic cases.
HOMEOPATHY
Some of the most common remedies used for peptic ulcers are listed below.
Usually, the dose is 3 to 5 pellets of a 12X to 30C remedy every one to four
hours until your symptoms get better.
Argentum nitricum for abdominal bloating with belching and pain.
Arsenicum album for ulcers with intense burning pains and nausea;
especially for people who cannot bear the sight or smell of food and are
thirsty.
Kali bichromicum for burning or shooting abdominal pain that is worse in
the wee hours of the morning (that is, after midnight).
20
Lycopodium for bloating after eating with burning that lasts for hours;
especially for people who feel hungry soon after eating and wake hungry.
Nitric acid for sharp, shooting pain that worsens at night and is accompanied
by feelings of hopelessness and even fear of dying.
Nux vomica for digestive disturbances (including heartburn and indigestion)
that worsen after eating; particularly for those who crave alcohol, coffee,
and tobacco.
Phosphorus for burning stomach pain that worsens at night; those for whom
this remedy is appropriate tend to feel very thirsty, craving cold beverages.
Pulsatilla for symptoms that vary a lot (that is, change abruptly) and pain
that gets worse from fatty foods; appropriate people are distinctly not thirsty.
NATUROPATHY
Fried foods and spices, especially chilies should be totally prohibited. Bland,
easily digestible foods should be the mainstay of the patient’s diet.
Buttermilk and coconut water can be freely taken, preferably at intervals of
three to four hours during the day, because the pain of the ulcer occurs at
times when the stomach is empty. Foods that heal ulcers like banana,
plantains, cabbage juice, licorice, green tea, red beans, unpolished rice,
yoghurt, curd, buttermilk, honey are used more.
Raw Cabbage juice 250 ml 4 times a day is used to treat duodenal ulcers.
Raw potato juice is used to treat Gastric ulcers.
The following herbs are used in Naturopathy to treat Gastritis.
O Astragalus (Astragalus membranaceus) – used traditionally to treat
stomach ulcers.
O Powders of slippery elm (Ulmus fulva) and marshmallow root
(Althaea officinalis) may be taken singly or together, 1 tsp. two to
three times per day to decrease inflammation and encourage healing.
O Licorice (Glycyrrhiza glabra) - this herb is a demulcent (soothing,
coating agent) that has long been valued for its use in food and
medicinal remedies, including treatment of ulcers. DGL
(deglycyrrhizinated licorice), 250 mg four times a day 15 to 20
21
minutes before meals and one to two hours after the last meal of
the day, increases local circulation and speeds healing of the stomach
lining.
O Turmeric (Curcuma longa) -Turmeric has long been used in both
Ayurvedic and Chinese medicine to treat digestive disorders.
Scientific research has shown that extracts of turmeric root reduced
the release of acid from the stomach and protected against injuries
such as gastritis or inflammation of the intestinal walls and ulcers.
Hydrotherapy treatments like cold hipbath, cold abdominal packs, and
cold clay packs are advised.
YOGA THERAPY
O Kriyas such as Jala Dhauti and Kapalabhati
O Asanas:
{ Forward bend poses like Shashankasana, Paschimottanasana,
Baddha Konasana, Halasana,


sarvangasana, Setubandha sarvangasana on pillows, Vipareeta
Dandasana, Ustrasana
O Pranayamas such as Nadi shuddhi, Chandra bheda, Sheetkari,

Sheetali, and Bhramari
All forward bend poses improve digestion and backward bends prevent
over functioning of the digestive system.
NUTRITION THERAPY
Avoid dairy products, caffeine, alcohol, and sugar. Eliminate any known
food allergens.
Avoid fruits like lemons, grapefruit, oranges, pineapples, and tangerines, citrus
juices such as orange, pineapple and grapefruit juice, berries and figs
Avoid highly seasoned, meats, poultry or fish such as corned beef, luncheon
meats, frankfurter and other sausages, sardine anchovies.
22
Avoid carbonated beverages, coffee (regular or decaffeinated). Avoid strongly

flavored seasonings and condiments such as garlic, barbecue sauce, chilli
sauce, chilli pepper, horseradish, black pepper, chilli powder and other
highly spiced foods, pickles, alcoholic beverages and high fat foods.
Milk and cream feedings should not be used as antacid therapy. Although
milk protein has an initial neutralizing effect on gastric acid, it is also a very
potent stimulator. Hourly feedings of milk have been shown to produce a
lower pH than three regular meals.
Eat three small meals and three snacks evenly spaced throughout the day.
It is important to avoid periods of hunger or overeating.
Include sulfur-containing foods such as garlic, onions, broccoli, cabbage,
brussels sprouts, and cauliflower in diet. Sulfur is the basis of glutathione,
which provides antioxidant protection to the stomach lining. Bananas
contain potassium and plantain, both of which yield benefits.
Following supplements are helpful:
O Acidophilus (one capsule with meals) can help normalize bowel
bacteria and inhibit growth of H. pylori
O Essential fatty acids (1,000 to 1,500 mg two to three times per
day) reduce inflammation and inhibit the growth of H. pylori
O Vitamin C (250 to 500 mg two times per day) decreases
nitrosamines, which are linked to stomach cancer, and inhibits
growth of H. pylori
O Zinc (30 to 50 mg per day) enhances healing
O Vitamin E (400 IU per day) enhances healing
O Vitamin A (50,000 IU per day for 2 weeks followed by 10,000 to
25,000 IU per day) for longer term maintenance
O Glutamine (500 mg three times per day) promotes healing of ulcers
Cabbage juice (1 qt. per day) is high in glutamine.
PSYCHOLOGICAL THERAPY
Because stress is a major trigger, reducing stress level can reduce active
ulcers. Yoga, deep abdominal breathing, meditation, relaxation, visualisation,
and biofeedback can decrease stress.
23
Lifestyle Change
Doctors used to recommend eating bland foods with milk and only small
amounts of food with each meal. We now know that these eating habits are
not necessary for the treatment of ulcers. Dietary and other lifestyle measures
that should help, however, include:
O Eat a diet rich in fiber, especially from fruits and vegetables; this
may reduce the risk of developing an ulcer in the first place and
may speed recovery if one has ulcer. The vitamin A may be an
added benefit from these foods.
O Foods containing flavonoids, like apples, celery, cranberries
(including cranberry juice), onions, and tea may inhibit the growth
of H. pylori.
O Quit smoking
O Avoid alcohol abuse
O Cut down on coffee, including decaffeinated coffee, as well as
carbonated beverages all of which can increase stomach acid.
O Reduce stress with regular use of relaxation techniques such as yoga,
tai chi, Qi gong, or meditation. These practices may also help lessen
pain and reduce your need for the damaging NSAIDs.
HEPATITIS
HEPA
Hepatitis is a serious inflammation of the liver. Viral hepatitis, the most
common form, usually appears as type A, B, or C. Type A (HAV), the most
prevalent of these, and often affects schoolchildren. Type B (HBV) and
Type C (HCV) affect people of all ages.

The disease can be caused by:
O Infections from parasites, bacteria, or viruses
O Liver damage from alcohol, drugs, or poisonous mushrooms
O An overdose of acetaminophen, which is rare but deadly
O Immune cells in the body attacking the liver and causing
autoimmune hepatitis
24
Other medications that can cause damage to the liver include methyldopa
(used uncommonly for high blood pressure), isoniazide for tuberculosis,
seizure medications (like valproate and phenytoin), chlorpromazine,
amiodarone (for irregular heart rhythm), and certain antibiotics (including
trimethoprim-sulfamethoxazole and erythromycin).
Liver disease can also be caused by inherited disorders such as cystic fibrosis
and Wilson’s disease, a condition that involves retaining too much copper
in the body; the excess copper deposits in organs like the liver.
Hepatitis may start and resolve quickly (acute hepatitis), or cause long-
term disease (chronic hepatitis). In some instances, progressive liver damage,
liver failure, or even liver cancer may result.
The severity of hepatitis depends on many factors, including the cause of
the liver damage and any underlying illnesses. Hepatitis A, for example, is
generally short-lived, not leading to chronic liver problems. Fifty percent
of those with hepatitis C go on to have chronic liver disease and, possibly,
liver failure (cirrhosis) or liver cancer. Hepatitis C is the number one reason
for receiving a liver transplant today.
Common risk factors include:
O Intravenous drug use
O Acetominophen overdose
O Eating contaminated foods
O Travel to an endemic area, like Asia or Africa, South or Central
America
O Living in a nursing home or rehabilitation center
O Family member who recently had hepatitis A
O Alcohol use
O Organ transplant recipient
O AIDS
O Blood transfusion received prior to 1990 (before hepatitis C blood
test was available)
O Newborns of mothers with hepatitis B or C (can be transmitted
during delivery)
25
O Healthcare workers, including dentists and dental hygienists,

because of blood contact
O Receiving a tatoo
O Risky sexual behaviors (like having multiple sexual partners and
unprotected intercourse).
Symptoms
The symptoms of hepatitis include:
O Dark urine and pale or clay colored stools
O Loss of appetite
O Fatigue
O Abdominal pain or distention
O General itching
O Jaundice (yellowing of the skin or whites of the eyes)
O Low grade fever
O Weight loss
O Breast development in males.
Many people with hepatitis B or C do not have symptoms when first infected
and can still develop liver failure later.
Signs and tests

A physical examination may show yellowing of the skin, an enlarged and
tender liver, or fluid in the abdomen (ascites) that can become infected.
Laboratory tests include:
O Hepatitis virus serologies
O Liver function tests
O Autoimmune blood markers
O Abdominal ultrasound
O Liver biopsy to determine severity of the liver damage
O Paracentesis if fluid in your abdomen is present.
26
Treatment
MODERN MEDICINE
Treatment depends on the underlying cause of the hepatitis. Each case
should be reviewed to determine whether treatment would be helpful. New
therapies for viral infections are now able to stop or reverse some liver damage
caused by certain viruses.
HA
HAVV : Immune globulin administered within 2 weeks of exposure may
prevent infection.
HBV: Immune globulin following exposure and/or vaccine prior to exposure
may be used; the vaccine is given in 3 doses over a 7-month time course.
New medications such as lamivudine and famciclovir also appear to be
promising.
HCV: Combination of interferon and ribavarin is most effective for this
form of viral hepatitis.
AYURVEDA
The treatment of hepatitis starts with purgation. Trivari (Operculina
turpenthum) and Katuki (Picrorhiza kurroa) are the two major drugs which
are given initially. One to two teaspoonfuls of the powder of the drugs
may be administered with hot water twice daily.
Vasaguduchyadi Kashayam, Drakshadi lehyam, Bhumyamalaki Swarasa on
empty stomach is the age old proven remedy for hepatitis.
Other drugs used for the treatment of hepatitis are Avipattikar Churna and
Arogyavardhini Vati. The Churna should be given in one-teaspoonful doses
twice a day with hot water. Arogyavardhini Vati is available in 250 mg
strength, and two tablets should be given thrice daily with hot water or
with honey. Other drugs used in the treatment of hepatitis are Vasaka
(Adhatoda vasica), Kakamachi (Solanum nigrum), and Triphala (the three
myrobalans). Any or all the above drugs may be prescribed depending
upon the condition of the patient.
O Decoction of root and leaves of spreading hogweed (Punamava),
leaves of margosa tree (Neem), pointed gourd, ginger, Picrorrhiza,
Tinospora, Chebulic myrobalan and Indian barbery (Daru haridra)
should be taken in the dose of 30 ml twice daily
27
O Fresh decoction or powder of three myrobalans should be given in

the dose of 30 ml / 5gms daily
O Fresh juice of Tinospora cordifolia can be taken in the dose of 30
ml. twice daily
O Fresh juice of leaves of margosa tree should be given in the dose of
15 ml. twice daily
O Powder of three myrobalans, turmeric, bark of Indian berbery,
Picrorrhiza and purified iron should be given in the dose of 250
mg. along with honey and ghrita
O Powder of chebulic myrobalan should be given along with jaggery
and honey. It works as mild laxative and eliminates vitiated Pitta
Dosha
O Fresh juice of roots of Phyllanthus niruri (Bhuamlaki) should be
taken in the dose of 30 ml twice daily
O Fresh juice of castor leaves obtained by the paste prepared in mixer
and pulp squeezed by muslin cloth should be given in the dose of
10 ml. upto 6 times daily
O Decoction of root of Picorrhiza kurroa (Kutki) or tree turmeric
(Daruharidra) should be given in the dose of 30 ml. twice daily.
Patolamuladi Kashayam with 1tsp Avipathi churnam is ideal for purgation
and expulsion of excess pitta from the tissues (srotas).
Researches have proven that following Ayurvedic herbs are useful in treating
hepatitis: Kalmegh (Andrographis panniculata) Bhumyalaki (Phyllanthus
Amarus), Punarnava (Boerhavia diffusa), Bhringaraj (Eclipta alba), Chiretta
(Swertia Chirata), Baheda (Terminalia belerica), Guduchi (Tinospora
cordifolia), and Katuki (Picrorhiza kurroa). Bhumyalaki (Phyllanthus Amarus)
is proved by modern research that it is most effective in hepatitis A and B.
ACUPUNCTURE
Acupuncture may be helpful in reducing hepatitis. Research in China has
shown some promise in treating hepatitis B (HBV).
Following Acupoints are used:
O Baihui (Du 20)
28
Local points: (select from):

O Qimen (Liv. 14), Ganshu (U.B.18)
O Riyue (G.B.24) Danshu (U.B. 19)
O Zhangmen (Liv.13)
O Daimai (G.B. 26.)
O Zhongwan (Ren 12.)
O Liangmen (St. 21.)
O Pishu (U.B. 20.)
O Weishu (U.B.21).
Distal Points:
O Zhongdu (Liv. 6)
O Dannang (Ex. 35)
O Taichong (Liv. 3)
O Zusanli (St. 36)
O Sanyinjiao (Sp. 6)
O For severe jaundice: Yanglingquan (G.B. 34).
HOMEOPATHY
Aconitum: It is used during initial phases of hepatitis when the individual

has a fever, jaundice, and sharp pains in the liver; can be used in newborns
Belladonna: It is used in early stages of hepatitis when the individual has

occasional liver pains that are worsened by inhalation and movement
Chelidonium: For individuals with pain that originates in the liver and
extends to the back and right shoulder; this remedy is most appropriate for
individuals who have gray or yellow loose stools, fever, and jaundice; a
craving for milk may be present
China: For individuals with a tender liver and a sensation of fullness in the
stomach; the individual may burp frequently although it provides no relief
Lycopodium: One of the primary remedies for hepatitis in children and
adults; this remedy is most appropriate for individuals who feel tension in
29
the liver area, have difficulty standing up, and feel full after eating only
small amounts of food
Mercurius: For individuals with a swollen, tender liver and jaundice; the
tongue may also be yellow and swollen
Phosphorus: For individuals with burning pains under the right rib cage
and in the back between the shoulder blades that are relieved by cold drinks;
this remedy may be used in newborns with jaundice.
NATUROPATHY
Fasting for 3 to 7 days on skimmed buttermilk, vegetable and fruit juices
will help to remove toxins from the liver and blood and help the liver to
regenerate.
After fasting, a high carbohydrate, low fat, moderate-protein diet can be
given. Carbohydrates should be the major source of energy (calories) for
individuals with liver disease. The diet should provide adequate nutrition,
but protect the liver from overworking.
Juices like Carrot and spinach juice, Orange juice, Sugarcane juice (200 ml 3 to
4 times daily) are useful in reducing jaundice. Take barley water daily; it enhances
urination which helps eliminate excess bile pigments in the blood.
Herbs for liver support include the following.

O Milk thistle (Silybum marianum, 200 to 250 mg three times per
day) protects the liver
O Globe artichoke (Cynara scolymus) promotes liver regeneration
O Schisandra berry (Schisandra chinensis) protects liver health
O Eclipta (Eclipta alba), used with Phyllanthus
O Phyllanthus (Phyllanthus amarus) (200 mg three times per day)
O Turmeric (Curcuma longa, 250 to 500 mg three times per day)
Combine with bromelain (250 to 500 mg three times per day
between meals) to enhance its effects.
Hydrotherapy treatments like Enema or Coffee enema, cold hipbath are
given daily in the morning.
30
NUTRITION THERAPY
Small, frequent meals are suggested to optimize digestion. Increase intake

of grains, vegetables, fruits, vegetable proteins (legumes such as soy), and
omega 3 fatty acids (cold-water fish, nuts, and seeds). Foods that support
the liver are beets, artichokes, yams, onions, garlic, green leafy vegetables,
apples, and lemons.
Foods to exclude
exclude
Avoid the following foods:
O Full-cream milk, yoghurt, cream, cream cheese and fatty cheese
O Biscuits, cakes, pies, tarts, etc with a high-fat content
O Chocolate
O Animal foods including eggs
O Fatty salad dressings, mayonnaise, sour cream
O Fatty, fried meats, fatty fish, poultry skin, all processed meats and
sausages, bacon, fatty gravies, fish canned in oil (buy tuna or
pilchards canned in water or tomato sauce)
O Nuts, peanut butter, nut spreads
O Potato chips, vegetables smothered in butter or white/cheese sauces
O Fatty snacks or very spicy snacks
O All food preparation that increases the amount of fat contained in
meals, such as frying in butter, margarine or oil. Rather boil, poach,
grill, cook in a nonstick pan, and cook stews and soups the day
before, chill and skim off all the coagulated fat before serving.
O Reduce or eliminate alcohol, caffeine, refined foods, sugar and food
additives.
The following micronutrients are advised:

O Acidophilus supplements (one capsule with meals) help keep healthy
levels of the “good” bacteria in your body. Low vitamin K levels
may be supplemented with 100 to 500 mg per day or by eating
dark green, leafy vegetables.
31
O Vitamin C (250 to 500 mg twice daily), beta-carotene (100,000

IU per day), vitamin E (400 to 800 IU per day), and zinc (30 to
50 mg per day) strengthen your immune system.
O B complex (50 to 100 mg per day), especially folic acid (800 to
1000 mcg per day) and B12 (1000 mcg per day), are needed for
good liver function.
O Selenium (200 mcg per day) is needed to keep your liver healthy.
O Glutathione (500 mg twice a day) or N-acetylcysteine (200 mg
two to three times per day) provides liver cleansing and antioxidant
support.
Prevention
The following hepatitis vaccines are available:
Hepatitis A vaccine is available for people in high-risk groups, like day care
and nursing home workers, laboratory workers, and those traveling to
endemic parts of the world.
Hepatitis B vaccine is now given to all infants and unvaccinated children
under 18. The vaccine is available for adults at high risk, such as health care
professionals, IV drug users, and those with risky sexual behavior.
A shot of immunoglobulin may also prevent infection even after a person is

exposed to the infection. It may be given soon after a person had close
contact (like kissing) with someone who was diagnosed with hepatitis A
within the last two weeks. It should be given right away, along with the
hepatitis B vaccine, to an infant born to a woman with hepatitis B.
Other steps to take:

O Avoid contact with blood or blood products. Take precautions if
this is part of your work.
O Avoid sexual contact with a person infected with hepatitis or
unknown health history. Practice safe sex at all times.
O Wash your hands after going to the bathroom and before handling
food.
32
O Avoid sharing plates, utensils, or bathrooms with someone who

has hepatitis A.
O Do not share razors, needles, or toothbrushes.
O When traveling to endemic areas, do not eat uncooked or partially
cooked foods. Drink bottled water.
O Do not use recreational IV drugs. If you are already an IV drug
user, never share needles and seek help from a needle exchange or
drug treatment program.
O Be cautious when receiving tattoos or piercing.
O Do not drink alcohol.
IRRITABLE BO
IRRITABLE WEL SYNDR
BOWEL OME
SYNDROME
Irritable bowel syndrome refers to a complex disorder of the lower intestinal
tract. It is mainly characterized by a pattern of symptoms that is often
worsened by emotional stress. The condition involves pain in the gut,
combined with altered bowel habits resulting in diarrhea, constipation, or
both.

Irritable bowel syndrome is characterized by a combination of abdominal
pain and altered bowel function. There are many possible causes. For
instance, there may be a disturbance in the muscle movement of the intestine
or a lower tolerance for stretching and movement of the intestine. There is
usually no abnormality in the structure of the intestine.
Irritable bowel syndrome (IBS) can occur at any age, but often begins in
adolescence or early adulthood. It is more common in women. Predisposing
factors may include a low-fiber diet, emotional stress, use of laxatives, a
bout of infectious diarrhea, or other temporary bowel inflammation.
Irritable bowel syndrome is extremely common, but only a small proportion

of people seek treatment.
33
Symptoms
O Cramping pain in lower abdomen
O Bloating and gassiness
O Changes in bowel habits
O Chronic and frequent Diarrhea or constipation, or both alternately
O Immediate need to move bowels after waking up or during or after
meals
O Relief of pain after bowel movements
O Feeling of incomplete emptying after bowel movements
O Mucus in stool.
Signs and tests
Tests usually reveal no abnormalities. Not all patients require endoscopy,
especially if symptoms begin early in life and have been stable. Patients
who have irritable bowel symptoms beginning later in life usually require
endoscopy. Patients over age 50 should be screened for colon cancer. Younger
patients with persistent diarrhea may require endoscopy to look for
inflammatory bowel disease. Irritable bowel syndrome, by contrast, is not
an inflammatory condition, but the symptoms may be very similar to those
of inflammatory bowel disease.
Treatment
MODERN MEDICINE
The following are some of the drugs used in treating IBS
O Anticholinergic agents—reduce the pain from bowel spasm
O Antiflatulents—reduce gas
O Antidiarrheal medication—such as Loperamide
O Bulk-producing agents—such as psyllium and other fiber
supplements can help with diarrhea or constipation
O Promotility drugs such as tegaserod
O Antidepressants like amitriptyline is useful in IBS associated with
depression.
34
AYURVEDA
A light fast can be helpful taking only vegetable soups and a little basmati
rice and mung beans, (Kichari). Herbs that aid digestion like ginger, fennel
and cumin will improve digestion (Agni), absorption, and clear toxins (ama)
from the digestive tract.
Triphala, a mixture of Haritaki, Amalaki (Emblica Officinalis) and Bibhitaki
(Terminalia belerica) is a gentle bowel tonic excellent for chronic constipation
and IBS, for clearing toxins from the bowel and balancing the doshas.
Half a teaspoon of Hingwastaka, a mixture of asafoetida, ginger, black pepper,
and rock salt, taken in a little warm water 1 to 2 hours before lunch and
supper, increases agni and clears ama.
Hriberadi Kashayam with Ahiphena, Kutajarishtam and Mustharishtam are
proven remedies for IBS. Indukantha Ghritham and Sukumara Ghritham in
low dose on empty stomach early morning regulate “apanavayu” and thus
controls motion.
ACUPUNCTURE
Several small studies suggest that acupuncture improved general well-being
and symptoms of bloating in IBS patients. In the case of IBS, a Qi deficiency
is usually detected in the spleen and lung meridians. Moxibustion (a
technique in which the herb mugwort is burned over specific acupuncture
points) is frequently used for treatment of IBS because its effect is thought
to reach deeper into the body.
HOMEOPATHY
Following drugs are used in homeopathy to treat IBS:
Argentum nitricum: Digestive upsets accompanied by nervousness and
anxiety suggests the use of this remedy. Bloating, rumbling flatulence,
nausea, and greenish diarrhea can be sudden and intense. Diarrhea may
come on immediately after drinking water.
Asafoetida: A feeling of constriction all along the digestive tract (especially if
muscular contractions in the intestines and esophagus seem to be moving in the
wrong direction) strongly indicates this remedy. The abdomen feels inflated, but
the person finds it hard to pass gas from either direction to get relief.
35
Colocynthis: This remedy is indicated when cutting pains and cramping

occur, making the person bend double or need to lie down and press on the
abdomen.
Lilium tigrinum: This remedy is indicated when the person makes frequent
unsuccessful efforts to move the bowels all day and has sudden diarrhea the
following morning. A feeling of a lump in the rectum, worse when standing
up, is common. Hemorrhoids may develop.
Ly copodium: This remedy is often indicated for people with chronic

digestive discomforts and bowel problems. Bloating and a feeling of fullness
come on early in a meal or shortly after, and a large amount of gas is usually
produced.
Natr um carbonicum: This remedy is often indicated for people who have
atrum
trouble digesting and assimilating many foods and have to stay on restricted
diets. Indigestion, heartburn, and even ulcers may occur if offending foods
are eaten. The person may have cravings for potatoes and for sweets (and
sometimes also milk, but has learned to avoid it).
Nux vomica: Abdominal pains and bowel problems accompanied by tension,

constricting sensations, chilliness, and irritability can indicate a need for
this remedy. Soreness in the muscles of the abdominal wall, as well as painful
gas and cramps are common. Firm pressure on the abdomen brings some
relief.
Podophyllum: This remedy is indicated when abdominal pain and cramping

with a gurgling, sinking, empty feeling are followed by watery, offensive-
smelling diarrhea—alternating with constipation, or pasty yellow bowel
movements containing mucus.
Sulphur: This remedy is often indicated when a sudden urge toward diarrhea
wakes the person early in the morning (typically five a.m.) and makes them
hurry to the bathroom. Diarrhea can come on several times a day. At other
times, the person may be constipated and have gas with an offensive and
pervasive smell. Oozing around the rectum, as well as itching, burning,
and red irritation may also be experienced.
36
NATUROPATHY
will help to normalize the motility of the large intestine. After fasting, a
bland diet with more fruits and vegetables is advised.
Removal of known food allergens or irritants is important. The most
common food allergens are dairy products, wheat, corn, peanuts, citrus,
soy, eggs, fish, and tomatoes. An elimination/challenge trial may help uncover
sensitivities. Eliminate all suspected allergens from the diet for two weeks.
Add back one food every three days and wait for reaction to the challenge.
If you suffer from gassiness, eliminate beans, cabbages, and other “gassy”
vegetables from your diet, as well as apple juice, grape juice, bananas, nuts, and
raisins. Fiber supplementation can help reduce pain, cramping, and gas.
Some herbs used in Naturopathy:
Enteric-coated peppermint oil: one to two capsules (0.2 ml peppermint oil
per capsule) three times a day after meals.
A tea of fennel seed (Foeniculum vulgare) or ginger root (Zingiber officinale)
taken after meals promotes good digestion.
A tincture of equal parts of the following before meals (30 drops three
times per day): Valerian (Valeriana officinalis), passionflower (Passiflora
incarnata), anise seed (Pimpinella anisum) extract, meadowsweet (Filipendula
ulmaria), wild yam (Dioscorea villosa), and milk thistle (Silybum marianum).
YOGA THERAPY
Yoga reduces irritable bowel syndrome by normalizing bowel movements.

O Asanas:
{ Surya namaskaram – 10 rounds
{ Forward bending yoga asanas like Shashankasana,

Paschimottanasana, Baddha Konasana, reduce blood pressure,
and heart rate. Tie an Elastocrepe bandage around the eyes while
doing these poses, to relax the facial muscles and eyes.
37

Dhanurasana, Chakrasana, Chakrasana on the ladder stool
Matsyasana, Setubandha sarvangasana, Setubandha sarvangasana
on pillows, Vipareeta Dandasana, Viparita dandasana on the
chair, Ustrasana
{ Meditative asanas like Padmasana, Vajrasana, Siddhasana,
Konasana
O Pranayamas such as Nadi shuddhi, Ujjayi, Sheetkari, Sheetali, and

Bhramari
O Meditation, Yoga nidra
NUTRITION THERAPY
Changes in diet may help alleviate symptoms in some patients. No diet is

applicable to all patients. Increasing dietary fiber and eliminating
gastrointestinal stimulants such as caffeine may be beneficial. Low-fat diets
may relieve abdominal pain following meals.
Supplements include psyllium, flaxmeal, slippery elm powder, and
marshmallow root powder.
Digestive enzymes taken 20 minutes before meals can help enhance digestion
and normalize bowel function.
One teaspoon of raw bran with each meal, supplemented by extra fluids,
provides fiber reliably.
Pro-flora supplements such as acidophilus and lactobacillus species taken
two to three times per day can help to rebalance normal bowel bacteria and
reduce gas and bloating.
Magnesium (200 mg two to three times per day) and B-complex (50 to
100 mg per day) with extra B5 (pantothenic acid; 100 mg per day) may
help reduce the effects of IBS.
PSYCHOTHERAPY
Stress aggravates IBS. Counseling is useful in cases of IBS with severe anxiety
or depression. Progressive relaxation may reduce anxiety and help subdue
38
the symptoms of IBS. Hypnotherapy is one of the best known and most
widely used treatments for IBS. “Gut-directed hypnotherapy” for IBS has
been clinically tested and found to be very helpful to many IBS patients.
This type of hypnotherapy includes the general techniques of hypnotherapy
and applies them directly to the abdominal pain and digestive symptoms
which IBS sufferers struggle with.
PHYSICAL MEDICINE
Electric heating pads, hot water bottles, and long hot baths can relieve
painful spasms and cramping in the abdomen.
Regular exercise, such as walking, encourage bowel movements if you are

constipated.
Abdominal breathing helps to induce the relaxation response and may aid
normal physiological functioning (such as digestion).
AMOEBIASIS
Amebiasis is an infection of the intestine caused by the parasite Entamoeba
histolytica.
Entamoeba Histolytica can live in the large intestine (colon) without causing
disease. However, sometimes, it invades the colon wall causing colitis, acute
dysentery, or chronic diarrhea. The infection can also spread through the
blood to the liver and rarely, to the lungs, brain or other organs.
This condition can occur anywhere in the world, but it is most common in
tropical areas with crowded living conditions and poor sanitation. Africa,
Latin America, Southeast Asia, and India have significant health problems
associated with this disease.
Transmission occurs through ingestion of cysts in fecally contaminated food

or water, which is common when human excrement is used as fertilizer. It
can also be spread person-to-person, particularly via oral or anal contact.
39
Cockroaches and houseflies can also spread the cysts. There are an estimated
50 million cases worldwide of amebiasis with 40,000 to 50,000 deaths
annually.
Typical symptoms of intestinal amebiasis consist of frequent diarrheal bowel

movements with cramps or colicky abdominal pain. Pain on defecation is
common. The diarrhea may contain blood or mucus. Uncomplicated attacks
may last up to two weeks, and recurrences are common unless the diagnosis
is made and the individual is treated.
Spread of E. histolytica into the wall of the colon may occur in 8-10% of
cases and to the liver in approximately 1%.
Malnutrition, old age, pregnancy, use of steroids, malignancy (cancer), and

alcoholism predispose a person to more severe disease, as doe’s
immunosuppression. Recent travel to a tropical region is a risk factor. In
the US, amebiasis is most common among people who engage in anal
intercourse and residents of institutions.
Symptoms
Mild symptoms
symptoms:
O Diarrhea
O Passage of 3 to 8 semi formed stools per day
O Passage of soft stools with mucus and occasional blood
O Abdominal cramps
O Fatigue
O Unintentional weight loss
O Intestinal gas (excessive flatus)
Severe symptoms
symptoms:
O Bloody stools
O Passage of liquid stools with streaks of blood
O Passage of 10 to 20 stools per day
O Fever
O Vomiting
40
O Abdominal tenderness
Note: In 90% of people with amebiasis, there are no symptoms.
Signs and tests

Examination of the abdomen may show liver enlargement and abdominal
tenderness.
Tests include:
O Stool culture of 3 stool specimens several days apart
O Serology for amebiasis
O Sigmoidoscopy
Treatment
MODERN MEDICINE
Drugs used to treat amebiasis, called amebicides, are divided into two
categories:
L uminal amebicides: These drugs get their name because they act on
organisms within the inner cavity (lumen) of the bowel. They include
diloxanide furoate, iodoquinol, metronidazole, and paromomycin.
Tissue amebicides: Tissue amebicides are used to treat infections in the
liver and other body tissues and include emetine, dehydroemetine,
metronidazole, and chloroquine.
When the patient is vomiting, intravenous therapy may be necessary until
medications can be tolerated by mouth. Antidiarrheal medications are usually
not prescribed as they can make the condition worse. After treatment, the
stool should be rechecked to ensure that the infection has been cleared.
AYURVEDA
Kutaja (Holarrhena antidysenterica) is the drug of choice in Amoebiasis.
Powdered bark of the plant is administered thrice daily in one teaspoonful
doses. Patients suffering from amoebic dysentery are also liable to suffer
from chronic constipation and so, should take two tablespoonfuls of flea
seed husk at bedtime with milk or buttermilk.
41
The Ayurvedic preparation Rasaparpati should be given in at dose of 150

mg thrice daily in chronic cases. Rasaparpati is a preparation of mercury
and sulphur. While giving parpati therapy, the taking of salt and water
should be strictly prohibited. Diet should be limited to milk, boiled rice
and sugar.
O Decoction of coriander seeds and ginger powder is a good anti
dysenteric remedy, in the dose of 15 ml. thrice daily.
O Seeds of Ajwain, chebulic myrobalan, emeblic myrobalan, black pepper
powder, special types of salts like Saindhav and Sourvachal salts
should be added in buttermilk. This buttermilk should be used
when fermentation is complete. This remedy known as Takrarishta
is the best remedy for dysentery.
O Paste of pomegranate fruit, black pepper, long pepper, ginger, sugar
should be mixed together and cooked. This is known as
Dadimavaleha.
O Paste of bael fruit prepared in same way is known as Bilvavaleha.
Both these remedies can be used in the dose of 5 gm. twice daily.
O Powder of root of bael fruit, ginger powder and long pepper should
be taken in the dose of 500 mg. twice daily.
O Tablets of Kurchi seeds known as Kutajaghan Vati is the best
Aampachak in the dose of two tablets thrice daily.
ACUPUNCTURE

O Baihui (Du 20.)
O Local points: Daheng (Sp. 15), Tianshu (St. 25)
O Distal points: Zusanli (St 36), Neiguan (P.6).
HOMEOPATHY
Homeopathic medicines commonly used in cases of amoebiasis are Aloes,
Ars alb, Baptisia, Cinchona, Colocynth, Ipecac, Kali Birch, Lycopodium,
Mer cor, Nux vom, Podophyllum, Pulsatilla, Rhus tox, Sulphur,
Trombidium, Thuja, etc.
42
NATUROPATHY
Naturopathy advises preventive measures to prevent amoebiasis. Where poor
sanitation exists, drink purified or boiled water and do not eat uncooked
vegetables or unpeeled fruit. Public health measures include water
purification, water chlorination, and sewage treatment programs.
Safer sex measures, such as the use of condoms may help prevent infection.
In Naturopathy, following herbs are used to prevent and treat amoebiasis.
O Garlic (Allium sativum)
O Barberry (Berberis vulgaris)
O Goldenseal (Hydrastis canadensis).
NUTRITION THERAPY
Avoid simple carbohydrates such as are found in refined foods, avoid dairy
products, and all sugars. Eliminate caffeine and alcohol.
Eat more raw garlic, pumpkin seeds, pomegranates, beets, and carrots, all
of which have anti-worm properties. Drink a lot of water to promote good
bowel elimination.
Digestive enzymes will help restore your intestinal tract to its normal state,
which makes it inhospitable to parasites. Papain taken 30 minutes before
or after meals helps kill worms. Acidophilus supplements help normalize
bowel bacteria (one capsule with meals).
Vitamin C (250 to 500 mg two times a day) and zinc (20 to 30 mg per
day) support the immune system.
GALL STONES
STONES
Gallstones are formed within the gallbladder, an organ that stores bile
excreted from the liver. Bile is a solution of water, salts, lecithin, cholesterol,
and other substances. If the concentration of these components changes,
they may precipitate from solution and form gallstones.
Gallstones may be as small as a grain of sand, or they may become as large
as an inch in diameter, depending on how much time has elapsed from
their initial formation.
43

Gallstones often are asymptomatic and are usually discovered by a routine
x-ray, surgery, or autopsy.
Gallstones are a common health problem worldwide. They are more common
in women and people over the age of 40.
Other risk factors include ethnic and hereditary factors, obesity, diabetes,
liver cirrhosis, long-term intravenous nutrition (total parenteral nutrition),
and certain operations for peptic ulcers.
Symptoms
Symptoms usually start after a stone of sufficient size (larger than 8mm)
blocks the cystic duct or the common bile duct.
Following are some symptoms:
Abdominal pain in the middle of the upper abdomen, which may be
recurrent. The pain may be sharp, cramping, or dull and may radiate to
the back or below the right shoulder blade. The pain may be made worse
by fatty or greasy foods and occurs within minutes of a meal. Other
symptoms include:
O Jaundice
O Fever
O Clay-colored stools
O Heartburn
O Gas or excessive flatus
O Abdominal indigestion
O Abdominal fullness, gaseous
Signs and tests
There are numerous tests to detect the presence of gallstones or gallbladder
inflammation:
O Abdominal ultrasound
O Abdominal CT scan
44
O Abdominal x-ray
O Oral cholecystogram
O Gall bladder radionuclide scan
O ERCP (endoscopic retrograde cholangiopancreatography)
Treatment
Modern advances in surgery have revolutionized the treatment of gallstones.
In general, surgery is used only if a person has symptoms.
In the past, open cholecystectomy (gallbladder removal) was the usual
procedure for uncomplicated cases. However, a minimally invasive technique
called laparoscopic cholecystectomy was introduced in the 1980s which
uses small incisions and camera guidance to remove the gallbladder.
MODERN MEDICINE
In people with a functioning gallbladder, bile salts taken by mouth may
dissolve gallstones. However, the process may take 2 years or longer, and
stones may return after the therapy is ended.
Medical dissolution, using both high-dose and low-dose chenodeoxycholic
acids (CDCA, chenodiol) was an approach investigated in the early 1980s.
However, it was successful in only 14% of cases and required a long period
of administration and a lifetime of maintenance therapy. Urodeoxycholic
acid (UDCA, ursodiol) is successful in only 40% of cases. Both CDCA and
UDCA therapies are useful only for gallstones formed from cholesterol.
Lithotripsy: Extracorporeal shock wave lithotripsy (ESWL) has also been
used to treat gallstones. In this method, electromagnetic high-energy shock
waves break up the stones.
This approach was particularly popular in the mid to late 1980s, when
some studies found it to clear gallstones in up to 60% of patients. However,
its application is limited if there are a large number of stones present, if the
stones are very large, or in the presence of acute cholecystitis or cholangitis.
It can also be used in association with UDCA to improve its effect.
Gall stones can be successfully removed by surgery like laparoscopic
Cholecystectomy.
45
AYURVEDA
In Ayurveda the herb Gokshura, (Tribulus terrestris) is used to dissolve gall
bladder and kidney stones. Gokshura decoction or infusion and
Punarnavasavam are beneficial.
In acute cases, an initial purgation with liver cleansing herbs like Aloe,
Rhubarb root, Senna, Cascara sagrada, is good. Usually the more acute the
pain and the higher the fever, the stronger the purgative action can be
used.
Purgatives should be followed with the liver cleansing and cleaning herbs.
In chronic conditions, the treatment is like that for chronic hepatitis, and
strong purgatives should not be used.
Special herbs with stone-removing (lithotriptic) properties include Pashan
bheda, Gokshura, and Katuki
ACUPUNCTURE
Acupuncture may prove especially helpful in pain relief, reducing spasm,
and easing bile flow and proper liver and gallbladder function.
HOMEOPATHY
Following drugs are used in homeopathy to treat gallstones:
Berberis vulgaris: This remedy may be indicated when stitching pains extend
from the gallbladder region to the stomach and sometimes to the shoulder.
Sharp twinges radiating outward can be felt in the groin and pelvic bones
and may seem to come from the lower back. Pain can be worse when the
person is standing up, and from changing position.
Calcarea carbonica: When a person needing this remedy has gallbladder
problems, the abdomen may feel swollen on the right and be very sensitive
to pressure, with cutting pains that extend to the chest and are worse from
stooping, The person feels worse from standing, worse from exertion, and
better from lying on the painful side.
Chelidonium majus: This remedy is often indicated when pain extends to
the back, right shoulder, and shoulder blade. Pain is worse from motion,
and lying on the left with the legs drawn up may help.
46
Colocynthis: Cutting, cramping pains that make a person double over or

want to lie down and put hard pressure on the abdomen may indicate a
need for this remedy. Pain in the upper right abdomen, extending to the
shoulder, may also be seen.
Dioscor ea: This remedy is indicated when abdominal pain from gallstones
ioscorea:
is relieved by bending backward, and is worse when the person is bending
forward or lying flat. Standing up and moving around in open-air can bring
improvement. Pains can spread to the back, chest, and arms, or may shift
around.
Lycopodium: This remedy is often indicated for people who have chronic
digestive problems with abdominal bloating, flatulence, and discomfort.
Problems are worse from eating, and the pains may extend from the right
side to the left.
Nux vomica: Constricting pains that travel upward, stitching pains and a
swollen feeling in the upper right part of the abdomen suggest a need for
this remedy. Digestive cramps and nausea, along with a general feeling of
chilliness, are likely.
Podophyllum: This remedy is sometimes indicated in liver and gallbladder
problems when soreness is felt in the upper right part of the abdomen
along with a feeling of weakness, sinking, or emptiness. Heat may also be
felt in the area.
NATUROPATHY
Naturopathy advises a high fibre low fat diet to prevent and treat gall stones.
Choleretic herbs stimulate bile production and increase bile solubility.
Following herbs are used to dissolve gallstones:
Especially useful are milk thistle (Silybum marianum), dandelion root
(Taraxacum officinale), greater celandine (Chelidonium majus), globe artichoke
(Cynara scolymus), and turmeric (Curcuma longa). Use these herbs singly or
in combination as a tea or tincture (15 to 20 drops), two to three times per
day before meals.
Enteric-coated peppermint oil (Mentha piperita) may help dissolve stones
(0.2 to 0.4 ml three times a day between meals).
47
Grated black radish 2 tbs and 2 tbs olive oil – mixed and eaten 30 minutes
before breakfast for 40 days helps to dissolve stones.
Gallbladder flush: This is useful to flush out bile from the gall bladder and
very small gallstones. This is not advised for big stones (more than 5 mm),
as they can obstruct the ampulla of vater, and cause acute pancreatitis. Any
one of the following flushes can be used.
O Drink plenty of apple juice or grapefruit juice for 2 to 3 days before
starting the flush. Don’t eat anything in the evening after lunch.
Keep ready a pint (236 ml) of olive oil and the juice of 8 to 10
lemons. At 7 pm, drink four tablespoonfuls of olive oil followed by
one teaspoonful of lemon juice at 15-minute intervals until all the
oil is used. Then sleep on right side. The gallstones will be flushed
out within 24 hours.
O Drink ½ pint (118 ml) of olive oil and juice of two lemons at 8
am, 9 am, and 10 am. At 1 pm, take 2 tsp of epsom salt and lemon
juice in a glass of warm water.
O Drink a lot of fresh, raw apple juice or grapefruit juice in between
meals for 6 days. On seventh day morning, drink 60 ml of olive oil
and 60 ml of lemon juice on empty stomach. Lie on right side
with hips elevated for 2 hours.
Hydrotherapy:
Following treatments help:
O Apply hot packs to abdomen and lower back to reduce pain and colic
O Hot sitz baths to dilate the gall bladder and bile ducts
O Strong coffee enema in which 2 tbsp of Epsom salts are dissolved.
NUTRITION THERAPY
O Decrease total fat intake, especially saturated fats (meat and dairy
products)
O Eliminate food allergens. Eggs, in particular, may irritate the
gallbladder
O Eat more fiber. Consider fiber supplements such as flaxmeal (1
tsp. one to three times per day). Combine 1 heaping tsp. of flaxmeal
in 8 oz. of apple juice for a drink high in fiber and pectin.
48
O Lecithin (1,000 to 5,000 mg per day) for cholesterol excretion

O Choline (1,000 mg per day) and lipase (10,000 NF units with
meals) stimulate gallbladder function
O Vitamin E (400 to 800 IU/day) and vitamin C (1,000 mg two to
three times per day) promote bile production.
PHYSICAL THERAPY
Hot moist pack: Apply a clean hot moist soft cloth (such as flannel) and
plastic wrap. Place a heat source (hot water bottle or heating pad) over the
pack and let sit for 30 to 60 minutes. For best results, use for three
consecutive days. Apply to abdomen, especially the gallbladder area, to
help reduce swelling.
Prevention
There seems to be no known way to prevent gallstones. Eating a low fat
diet and losing weight may help.
DIARRHOEA
Diarrhea is loose, watery, and frequent stools. Diarrhea is considered chronic
(ongoing or prolonged) when there are loose or frequent stools longer than
4 weeks. Diarrhea in adults is usually mild and resolves quickly without
complication. Children with diarrhoea can become dehydrated quickly.
Common Causes
The most common cause of diarrhea is a mild viral infection that resolves
on its own within a few days. This is called viral gastroenteritis or “stomach
flu.” Viral gastroenteritis often appears in mini-epidemics in schools,
neighborhoods, or families.
Food poisoning and traveler’s diarrhea are two other common causes. They
occur from eating food or drinking water contaminated with bacteria or
parasites.
Certain medical conditions can also lead to diarrhea, such as:

O Malabsorption syndrome: Person is unable to absorb or digest certain
49
nutrients. Common examples include lactose intolerance, gluten

malabsorption, and intolerance to specific foods like beans or fruit.
O Inflammatory bowel diseases : Crohn’s disease and ulcerative colitis
are two recurring types of diarrhea that are generally bloody and
accompanied by abdominal pain.
O Irritable bowel syndrome (IBS) : A chronic form of stomach upset
that gets worse from stress. You generally have alternating diarrhea
and constipation.
O Immune deficiency
O Medications can also cause diarrhea, especially antibiotics, laxatives
containing magnesium, and chemotherapy for cancer treatment.
O High dose radiation therapy
Symptoms
O Frequent need to defecate
O Abdominal pain, cramping
O Fever, chills, general sick feeling
O Weight loss.
Diagnosis
Diagnosis is based on symptoms and stool culture. Additional tests may
include colonoscopy, electrolytes assay, etc.
Treatment
MODERN MEDICINE
The first line of treatment is to prevent dehydration by replacing fluids
and electrolytes. In many cases, diarrhea will disappear on its own. However,
there are various drugs to treat symptoms of diarrhea.
O Opioid derivatives: diphenoxulate with atropine sulfate, and
loperamide
O Adsorbents: Bismuth salt (for traveler’s diarrhea) and attapulgite
O Bulk-forming medications: Psyllium husk
50
AYURVEDA
Following are some of the Ayurvedic prescriptions for diarrhoea:
O Powder of Indrayav (Kurchi seeds or Holarrhena antidysenterica)
should be taken with Ghrita made from cow’s milk. It acts as
digestive and ‘Aampachak’. Also, decoction of Kurchi seeds is useful
in diarrhoea.
O Decoction of long pepper, piper root, and root of leadwort
(Plumabgo zeylancia) is very useful in mucoid diarrhoea in the dose
of 10 ml. twice daily.
O Paste of Bael fruit is best anti diarrhoeal. Some people make a
confection of Bael fruit pulp added with some flavoring excipient
and give in chronic diarrhoea and dysentery.
O One gm each of Kutaja Churna, Gangadhara Churna and
Hingavashtaka Churna to be taken with lukewarm water or
buttermilk.
O 240 mg each of Raman Churna and Mahagandhaka Yoga; and 120
mg of Sanjivani to be taken thrice with dried cumin seeds, aniseeds
and honey.
O 120 mg of Shankha Bhasma, with 1 gm each of Shunthyadi Churna
and Bhaskara Lavana to be taken thrice daily with water after meals.
O 240 mg of Piyushvalli Rasa and 500 mg of Kutaja Churna to be
taken thrice daily with flea seed husk.
O Dhadimashtika churnam 1-3 gm with butter milk to be taken thrice
daily.
O Agnitundi Vati 2 tab to be taken thrice daily.
ACUPUNCTURE
O Baihui (Du 20)
O Local points: Tianshu (St. 25), Qihai (Ren 6), Zhongji (Ren 3).
O Distal points: Zusanli (St 36), Shangjuxu (St. 37), Gongsun (Sp.
4), Sanyinjiao (Sp.6).
O Immune enhancing points: Quchi (L.I-11), Dazhui (Du 14).
51
Strong manual stimulation may be carried out at the Distal Points,

particularly at Zusanli (St. 36), Shangjuxu (St. 37). After stimulation, the
needles may be retained for about 30 minutes. In acute cases, the procedure
may be repeated 3-4 times a day.
The following points may be added according to the symptoms:
O Acute abdominal pain: Liangqiu (St. 34)
O Nausea and vomiting: Neiguan (P. 6).
O Fever: Dazhui (Du 14).
O Tenesmus: Changqiang (Du 1), Huiyin (Ren 1).
O Flatulence: Zhangmen (Liv. 13.), Jingmen (G.B. 25), Daimai (G.B.
26).
HOMEOPATHY
In a recent study of children with acute diarrhea, those who received an
individualized homeopathic treatment for five days had a significantly shorter
duration of diarrhea than children who received placebo. The following
remedies are used to treat the diarrhoea:
Arsenicum album : For foul-smelling diarrhea with a burning sensation in
the abdomen and around the anus; this remedy is most appropriate for
individuals who feel anxious, restless, and exhausted; symptoms tend to
worsen after midnight and in the cold; symptoms improve with warmth;
vomiting may also occur
Chamomilla : For greenish, frothy stool that smells like rotten eggs; used
primarily for children.
Calcarea carbonica : For children who fear being in the dark or alone and
who perspire heavily while sleeping; stools have a sour odor
Podophyllum : For explosive, gushing, painless diarrhea that becomes worse
after eating or drinking (even though the individual is often thirsty and
craves cold drinks); exhaustion often follows bowel movements and the
individual for whom this remedy is appropriate may experience painful
cramps in lower extremities
Sulphur : For irritable and weepy children; may have a red ring around the
anus and diarrhea with the odor of rotten eggs
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NATUROPATHY
A bland diet is advised. Cold milk, curd, buttermilk, banana, curd rice
provide good relief. Drink plenty of liquids like pure water, coconut water,
buttermilk etc.
Avoid over-the-counter diarrheal medications unless specifically instructed
to use one by the doctor. Certain infections can be made worse by these
drugs. When you have diarrhea, your body is trying to get rid of whatever
food, or virus is causing it.
In chronic form of diarrhea, like irritable bowel syndrome, try adding bulk
to your diet to thicken the stool and regulate bowel movements. Such
foods include rice, bananas, and fiber from whole-wheat grains and bran.
Psyllium-containing products such as Metamucil or similar products can
add bulk to stools.
The following herbs are used in Naturopathy
Swelling reducers:
O Quercetin (250 to 500 mg two to four times per day)
O Chamomile (Matricaria recutita)
O Marshmallow root (Althea officinalis) as cold-water tea. Soak 2 tbsp.
root in 1 quart of water overnight. Strain; drink throughout the
day.
Infection fighters:
O Barberry (Berberis vulgaris) 250 to 500 mg three times per day
O Goldenseal (Hydrastis canadensis) 250 to 500 mg three times per
day
O Licorice root (Glycyrrhiza glabra). Do not take if you have high
blood pressure.
Antidiarrheal herbs:
O Blackberry leaf (Rubus fruticosus) or raspberry leaf (Rubus idaeus) 1
heaped tsp. per cup. Drink ½ cup per hour.
O Carob powder; use 4 tsp. per 4 oz. of water or mix in applesauce.
Take ½ to 1 tsp. every 30 to 60 minutes.
O Slippery elm powder (Ulmus fulva) or marshmallow root powder
53
(Althaea officinalis); use 1 oz. powder to 1 quart of water. Make a

paste with the powder and a small amount of water. Gradually add
in the rest of the water and then simmer down to 1 pint. Take 1
tsp. every 30 to 60 minutes.
O Bael fruit powder 3 gm with jaggery daily twice.
NUTRITION THERAPY
Drink plenty of fluid to avoid becoming dehydrated. Start with sips of any
fluid other than caffeinated beverages. Milk may prolong loose stools, but
also provides needed fluids and nourishment. For moderate and severe
diarrhea, electrolyte solutions are usually best.
Avoid coffee, chocolate, dairy products, strong spices, and solid foods.
Introduce clear soup, crackers, white bread, rice, potatoes, applesauce, and
bananas as diarrhea gets better.
Rice or barley water, fresh vegetable juices (especially carrot and celery), miso
broth, or other clear broths help restore proper fluid and electrolyte balance.
Make rice and barley water using 1 cup of raw grain to 1 quart of boiling water.
Let steep for 20 minutes. Strain and drink throughout the day.
Lactobacillus taken as powder or in capsules helps normalize bowel flora
and may help cure diarrhea.
Glutamine (3,000 mg three times per day) is helpful in treating diarrhea
that is caused by irritation of the intestinal lining rather than infection.
Prevention
O Wash hands often, especially after going to the bathroom and before
eating.
O When taking antibiotics, also take Lactobacillus acidophilus, a
probiotic or healthy bacteria. This helps replenish the good bacteria
that are killed and distroyed when taking antibiotics.
When traveling to underdeveloped areas, follow the steps below to avoid
diarrhea:
O Drink only bottled water and do not use ice
O Do not eat uncooked vegetables or fruit without a peel
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O Do not eat raw shellfish or undercooked meat

O Do not consume non pasteurized dairy products.
CONSTIPATION
CONSTIPA
Constipation is a relative term. Normal patterns of bowel elimination vary
widely from person to person and some may not have a bowel movement
every day while others may. While some healthy people have consistently
soft or near-runny stools, others have consistently firm stools, with no
difficulty passing them.
Constipation refers to infrequent or hard stools, or difficulty in passing
stools. Constipation may involve pain during the passage of a bowel
movement, inability to pass a bowel movement after straining or pushing
for more than 10 minutes, or no bowel movements after more than 3 days.
The passage of hard, wide stools may tear the mucosal membrane of the
anus, especially in children. This can cause bleeding and the possibility of
an anal fissure.
Common Causes
Constipation is most often caused by a low-fiber diet, lack of physical activity,

not drinking enough water, or delay in going to the bathroom when you
have the urge to defecate. Stress and travel can also contribute to constipation
or other changes in bowel habits.
Other times, diseases of the bowel (such as irritable bowel syndrome),

pregnancy, certain medical conditions (like an underactive thyroid or cystic
fibrosis), mental health problems, neurological diseases, or medications may
be the reason for constipation. Colon cancer also can cause constipation.
Constipation in children often occurs if they hold back bowel movements

when they aren’t ready for toilet training or are afraid of it.
Symptoms
O Infrequent, passage of stools (fewer than three bowel movements a
week)
55
O Sudden decrease in frequency of bowel movements

O Stools harder than normal
O Bowel still feels full after bowel movement
O Bloated sensation.
Tests
The following tests may help diagnose the cause of constipation:
O Barium enema
O Blood tests such as a CBC, PT, or PTT
O Proctosigmoidoscopy (an examination of the lower bowel)
O Stool studies
O Upper GI series
O X-rays of the abdomen.
Treatment
Chronic constipation can usually be prevented with a combination of dietary
changes, extra fluid intake, exercise, and, when necessary, short-term use of
a laxative.
MODERN MEDICINE
There are more than 700 commercial laxative products available. They are
classified into:
O Bulk-forming agents (such as psyllium, bran and methylcellulose)
are generally effective and work by stimulating contractions of the
large intestine. They also tend to carry a low risk of adverse effects.
O Stool softeners (such as docusate sodium) increase the amount of
water in the stool, increasing bulk and stimulating natural
contractions of the large intestine.
O Saline laxatives (such as milk of magnesia, magnesium citrate,
sodium phosphate, lactulose, sorbitol, and alumina-magnesia)
stimulates movement of the colon.
56
O Stimulant laxatives, or irritant laxatives (such as senna, aloe, cascara,

phenolphthalein, bisacodyl) increase intestinal activity.
People with any bowel obstruction, abdominal inflammation, or kidney or
heart failure should not take the above laxatives.
AYURVEDA
Abhayarishtam or Kalyana gulam is most effective in treating chronic
constipation. In the case of children suffering from obstinate constipation,
a suppository made of macerated leaves of Harita manjari (Acalypha indica)
should be introduced into the rectum. An alternative is a suppository made
of the stalk of betel leaf and coated with castor oil. Alternatively, a poultice
made of the leaves of kidamari (Aristolochia bracteate) should be applied
over the abdomen of the child.
The other remedies which tend to relieve constipation are: Isabgol (flea
seed)-two heaped tablespoons taken with milk or water; Senna, one part,
and harada, half a part, finely powdered taken in one gram doses thrice
daily. Standard medicines available in the market are Swadishta Virechan,
Lasuna Kshira, and Avipattikar Churna.
ACUPUNCTURE
In the case of gastrointestinal conditions like constipation, a Qi deficiency
is usually detected in the colon and lung meridians. Following Acupoints
are used:
O Local points: Tianshu (St.25)
O Distal points (Strong manual stimulation): Baihui (Du. 20), Zhigou
(S.J.6), Zusanli (St. 36)
O Influential points: Zhongwan (Ren 12).
HOMEOPATHY
Calcarea carbonica: For constipation without the urge to have a bowel
movement; for children who often feel better when constipated rather than
when bowel habits are normal. The individual may also suffer from pica (a
craving for something not normally considered nutritional, such as dirt,
clay, or chalk) and milk sensitivity.
57
Nux vomica: For constipation accompanied by a constant urge to move

the bowels, but with little success; or for constipation associated with
overeating, alcohol, or drug use.
Silica: For constipation with the sensation that stool remains in the rectum
after bowel movements.
Bryonia: For constipation with large, hard, dry stools; food feels like a
lump in the individual’s stomach and he or she may suffer from headaches
with pain in both temples that may worsen with motion.
Lycopodium: For small, hard stools with flatulence and bloating following
a meal.
NATUROPATHY
and with daily enema during fasting will help to remove the toxins and
normalize the bowels. After fasting, a natural diet with high fibre, more
fruits and vegetables is advised.
A patient suffering from chronic constipation should be advised to take
leafy vegetables like spinach, cabbage, stalk of mustard (Sarson ka saag);
and fruits like musk melon, papaya, and mangoes. Vegetable juices like
Spinach juice or soup, mixed vegetable soup can reduce constipation.
Stewed or soaked prunes, 1 to 3 a day and prune juice is beneficial for
patients suffering from constipation because they stimulate intestinal
motility.
Flax meal, 1 heaping tsp. in 8 oz. of apple juice, provides fiber and soothes the
digestive tract. Warm lemon water taken before meals stimulates digestion.
For constipated infants:
Over 2 months old: try 2-4 ounces of fruit juice (grape, pear, apple, cherry,
or prune) twice a day.
Over 4 months old: if the baby has begun solid foods, try baby foods with
high-fiber content (peas, beans, apricots, prunes, peaches, pears, plums,
spinach) twice a day.
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Two glasses of warm water with honey taken in the morning also helps in
proper bowel habits.
Hydrotherapy treatments like enema, colon irrigation helps to reduce
constipation. However, frequent enemas are not advisable.
YOGA THERAPY
Yoga reduces constipation by normalizing the bowel movements and
strengthening the abdominal muscles.
O Asanas:

Paschimottanasana, Baddha Konasana.
Dhanurasana, Chakrasana, Matsyasana, Setubandha,

Setubandha Vipareeta Dandasana, Ustrasana.
{ Side bending asanas, such as Ardha Matsyasana and Trikonasana
aid bowel movement.

O Pranayamas such as Nadi shuddhi, Ujjayi, Sheetakari, Sheetali and
Bhramari.
NUTRITION THERAPY
Drink more water— six to eight glasses a day. Warm water or tea taken
early in the morning on an empty stomach activates the evacuation of the
bowel, and helps to ease constipation.
Eliminate refined foods, sugars, caffeine, alcohol, and dairy products from
your diet. Decrease intake of saturated fats (animal products) and increase
essential fatty acids (cold-water fish, nuts, and seeds).
Children and adults should get enough fiber in their diet. Eat 20 to 35
grams of fiber a day. A bowl of high fiber cereal is an effective way to start
the day. Vegetables, fresh fruits, dried fruits, and whole wheat, bran, or
oatmeal cereals are excellent sources of fiber. To reap the benefits of fiber,
drink plenty of fluids to help pass the stool. All fruits and vegetables with
59
skin are rich in fiber like peas, beans, lotus stem, cabbage, cauliflower,
apple, cherries, pears, peaches, plums and guavas.
PSYCHOTHERAPY
It is interesting to note that more and more medical studies are confirming
that stress and psychological disturbances are often related to chronic
constipation. Many psychologists concur with the Chinese system of
medicine which associates ‘inability to let go of past hurts or memories, or
difficulties in coming to terms with grief and loss as a common factor in
patients with chronic constipation.
Psychotherapy combined with relaxation and removal of stress, hypnotherapy
has been found to be useful in reducing constipation.
PHYSICAL THERAPY AND EXERCISE
Abdominal massage with extensive kneading gives good results. The massage
should be started from the area of short intestine, proceeding above the ascending,
transverse, and descending parts of large intestine towards the rectum.
Regular exercise is also important in establishing regular bowel movements.
If you are confined to a wheelchair or bed, change position frequently and
perform abdominal contraction exercises and leg raises. A physical therapist
can recommend exercises appropriate for your physical abilities.
Any exercise movement that uses the waist, such as toe touch, back bends,
waist rotation all aid in bowel movement.
Prevention and Lifestyle Change

Avoiding constipation altogether is easier than treating it, but involves the
same lifestyle measures:
O Eat lots of fiber.
O Drink plenty of fluids each day (at least 8 glasses of water per day).
O Exercise regularly.
O Go to the bathroom when you have the urge. Don’t wait.
O Enemas or laxatives should be reserved for severe cases only. Laxatives
should not be used over a long period because you can become
dependent on them.
60
DYSPEPSIA
Dyspepsia is a vague feeling of abdominal discomfort, possibly including a
feeling of fullness, belching, bloating, and nausea.
Considerations
Dyspepsia is rarely a serious health problem, unless it is accompanied by
other symptoms. Dyspepsia is a common problem. It may be triggered by
eating particular foods or after drinking wine or carbonated drinks. It may
also be caused by eating too fast or overeating. Some people may find that
spicy foods, high-fiber foods, fatty foods, or too much caffeine can all
aggravate this problem. Symptoms may be worsened by anxiety and
depression.
Tragically, sometimes, the discomfort of a heart attack is mistaken for

dyspepsia.
Common Causes
O Overeating
O Eating too fast
O Significant caffeine intake
O Eating fatty or greasy foods
O Overindulgence in alcohol
O Tobacco smoking
O Eating spicy foods
O Emotional trauma or nervousness
O Cholecystitis (inflammation of the gallbladder)
O Acute or chronic gastritis (inflammation of the stomach)
O Acute or chronic pancreatitis (inflammation of the pancreas)
O Duodenal ulcer
O Gastric ulcer
O Drugs such as antibiotics, aspirin, and nonsteroidal anti-
inflammatory drugs (NSAIDs).
61
Symptoms
O Vague feeling of abdominal discomfort
O A feeling of fullness after food,
O Belching,
O Bloating
O Nausea.
Tests
The physical examination will probably include emphasis on the abdominal
region and digestive system.
Diagnostic tests that may be performed include:

O Blood tests (depending on the suspected cause)
O Endoscopy (EGD)
O Upper GI and small bowel series (with barium)
O Abdominal ultrasound.
Treatment
MODERN MEDICINE
Several types of medications are available for managing the signs and
symptoms of non-ulcer dyspepsia. These may include:
Antacids. Multi-ingredient antacids in liquid or tablet form are a common
treatment for indigestion. Antacids neutralize stomach acid and can provide
fast pain relief.
Acid blockers. Drugs such as cimetidine, ranitidine, nizatidine and
famotidine decrease the amount of acid your stomach produces.
P r oton pump inhibitors. These types of medications shut down the acid
“pumps” within acid-secreting stomach cells. Proton pump inhibitors reduce
acid by blocking the action of these tiny pumps. They include the prescription
medications omeprazole, lansoprazole, rabeprazole and esomeprazole. A similar
drug, pantoprazole, can be taken orally or intravenously.
62
Prokinetic agents. These drugs help your stomach empty more rapidly and
may help tighten the valve between your stomach and esophagus, reducing
the likelihood of upper abdominal discomfort.
AYURVEDA
Ayurvedic medicine useful for dyspepsia is Hingvashtaka Churna, the major
ingredients of which are Hing (asafoetida), Shunthi (Zingiber Officinale), Pippali
(Piper longum), Marichi (Piper nigrum), Ajamoda (Carum roxburghianum) and
Jiraka (Cuminum cyminum) i.e. black cumin seed. The remedy acts best when
taken with buttermilk after food. Alternatively, it may be taken with the first
morsel of food. One teaspoon of the preparation may also be mixed with an
equal quantity of ghee and taken twice daily.
Indukantha Kashayam, Guduchyadi Kashayam are useful. In cases of pain
accompanying dyspepsia, another medicine is Mahashanka Vati, two tablets of
which should be taken thrice daily with warm water. Other drugs like Narayana
churnam, Jeerakarishtam, Draksharishta and Lasunadi Vati are also used.
O Powder made from the mixture of ginger powder, long pepper,
black pepper, seeds of ajowan, saindhav salt, cumin seeds, black
cumin seeds and asafetida is very good digestive and appetiser, in
the dose of 500 mg. thrice daily.
O Decoction of clove buds and chebulic myrobalan is digestive and
appetiser, in the dose of 15 ml. twice a day.
O Decoction of coriander seeds and ginger powder is good for patients
who have pain in abdomen along with indigestion. It should be
given in the dose of 30ml, twice daily.
O Combined preparation of powders of ginger, black pepper and long
pepper, black cumin seeds, cardamom, cinnamon bark and leaves,
Garcinia pedunculate (Amla vetas), pomegranate seeds, and all five
types of salts is very effective digestive and appetiser.
ACUPUNCTURE
O Baihui (Du 20.)
O Local points: Liangmen (St. 21), Tianshu (St.25), Pishu (U.B.20),
Weishu (U.B. 21)
63

O Distal points: Zusanli (St 36), Neiguan (P.6), Sanyinjiao (Sp.6).
HOMEOPATHY
Specific remedies to be given every 10-15 minutes for up to 7 doses during
acute attacks-
Carbo veg: Stomach feels full of wind even after eating plainest food, belching
gives some relief, digestion seems slower than usual, faint burning sensation
in stomach.
Nux: Heartburn ½ hour after eating, painful retching leaves putrid taste
in mouth, attack brought on by too much food, too much alcohol, or too
much work.
Pulsatilla: Attack brought on by rich food, beginning 2 hours after eating,
attacks worse in evening, feeling of pressure under breastbone, pounding heart,
bad taste in mouth, headache around eyes, nausea with or without vomiting.
Arsenicum: Heartburn after food, worse in small hours of morning, stomach
feels as if there is a stone weight in it, person retches and vomits until
exhausted, then feels chilly and restless, but better with warmth and small
sips of water, or if peptic ulcer is suspected.
Br yonia: Heavyness in the stomach’ feeling comes on soon after food, with
heartburn, nausea, and faintness, mouth fills with bitter tasting fluid
(waterbrash).
Anacardium: Indigestion comes on 1 to 2 hours after meals, though can be
delayed by eating again, foul taste in mouth, stomach feels blocked up, cold
drinks make things worse, urge to pass stool ineffectual, peptic ulcer suspected.
Argentum nit: A lot of belching, especially after sweet foods, alternating
constipation and diarrhoea, fluttery feeling in stomach, or if peptic ulcer is
suspected.
Sepia: Sudden empty feeling in stomach, especially in evening, relieved by
eating, craving for pickle and acid foods, tongue white-coated, sour taste in
mouth, a lot of flatulence, tenderness over liver, person nauseated by smell
of food, feels better lying on right side.
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Ly copodium: Heartburn, stomach bloated and full of gas, person quickly feels
full even when hungry, mainly because food causes almost instant indigestion,
discomfort not relieved by belching, constipation, or if peptic ulcer is suspected.
NATUROPATHY
A simple vegetarian diet with high intake of fibre and complex carbohydrates
is good for treating dyspepsia. Avoid foods known to exacerbate dyspepsia
like tea, chocolate, coffee, animal foods, spicy, oily food, fried food, pickles,
sauces etc. Avoid chewing gum as this causes aerophagy and hence abdominal
bloating. Avoid smoking and alcohol. Don’t drink more than a glass of
water with meals. Maintain proper food timings.
Hydrotherapy treatments like Alternate hot and cold abdominal packs,
Alternate hot and cold sitz baths and enema and colon irrigation helps to
reduce dyspepsia.
YOGA THERAPY
Yoga reduces dyspepsia by normalizing the intestinal motility.
O Asanas:

Paschimottanasana, Baddha Konasana

sarvangasana, Vipareeta Dandasana, Ustrasana
{ Side bending asanas like Ardha Matsyasana and Trikonasana,
help in the release of gas.

Bhramari
NUTRITION THERAPY
Eat smaller, more frequent meals. Having an empty stomach can sometimes
produce signs and symptoms similar to those of non-ulcer dyspepsia.
65
Nothing but acid in your stomach may make you feel sick. Try eating a
small snack, such as a cracker or a piece of fruit. Avoid skipping meals.
Avoid large meals and overeating. Eat smaller meals more frequently.
Avoid trigger foods. Some foods may trigger the signs and symptoms of
non-ulcer dyspepsia, such as fatty and spicy foods, carbonated beverages,
caffeine and alcohol. Avoid consuming more than three caffeinated beverages
a day.
Chew your food slowly and thoroughly. Allow time for leisurely meals.
Limit beverages during meals. If you feel full early on during the meal,
restrict your intake of beverages.
Take steps to avoid excessive air intake. To reduce excess gas and belching,
refrain from activities that result in excessive air swallowing, such as smoking,
eating rapidly, chewing gum and drinking carbonated beverages.
Don’t lie down right after a meal. Wait to lie down until at least two hours
after eating.
Maintain a healthy weight. Excess weight put pressure on your abdomen,

pushing up your stomach and causing acid to back up into your esophagus.
PSYCHOTHERAPY
Behavior therapy focuses on changing unwanted or unhealthy behaviours,

typically using a system of rewards and reinforcements of positive behaviour.
In the case of dyspepsia, for instance, if you tend to overeat or eat too
quickly, often causing you indigestion, you might be trained in ways to
stop such habits, therefore reducing your risk of abdominal discomfort.
PHYSICAL THERAPY AND EXERCISE
Massage to abdomen and spine reduces dyspepsia and gaseousness. Use

peppermint oil for massage. As in Yogasanas, abdominal and back exercises
reduce dyspepsia.
Regular exercise, especially walking or jogging accompanied by waist

rotation type exercises are good for relieving gas.
66
ULCERA
ULCERATIVE COLITIS
CERATIVE
Ulcerative colitis (UC) is a chronic, episodic, inflammatory disease of the
large intestine and rectum characterized by bloody diarrhea. In UC, swelling
typically occurs in the rectum and lower colon, but the inflammation can
spread throughout the entire colon. The ulcers bleed and produce pus and
mucus, and the inflammation causes the colon to empty frequently, resulting
in diarrhea.
UC is a rare, but serious disease that affects 50 out of every 100,000 people.
Although the condition most commonly affects those between the ages of
15 and 35, children and older adults may also develop the disease. Although
most people with UC can be successfully treated without surgery, roughly
25% will need a colectomy (surgical removal of the colon).
Causes
There are many theories regarding the cause of UC, but none have been
proven. The most likely theory is that UC is caused by a variety of factors
ranging from genetics, faulty immune system reactions, stress,
environmental influences, and even diet. For example, some people are
genetically at risk for UC (it runs in their family), and an infection or other
toxin may stimulate inflammation of the large intestine. In some cases,
stressful events or sensitivities to certain foods may trigger symptoms of
UC.
Risk Factors
Factors
O Family history of UC
O A diet high in sugar, cholesterol, alcohol and fat (particularly from
meat and dairy products)
O Stress
O Smoking.
Signs and Symptoms

The most common signs and symptoms of UC include abdominal pain
and bloody diarrhea. The symptoms can range from mild to severe and
may come on either very suddenly or more gradually.
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Other common symptoms of UC include:

O Frequent, even continuous diarrhea
O Bloody stool
O Urgent desire to defecate
O Abdominal cramps and pain
O High fever
O Rapid heartbeat
O Weight loss
O Anemia
O Loss of appetite
O Joint aches.
People with UC are at increased risk for malnutrition. UC can also cause a
host of other problems, including arthritis, liver disease, skin rashes, blood
clots, or gallstones. Although it is not clear why such problems occur outside
the colon, some researchers speculate that they may be linked to a faulty
immune response.
Diagnosis
Blood tests may reveal a high white blood cell count (a sign of inflammation
somewhere in the body). Stool samples may indicate whether there is
bleeding or infection in the colon or rectum.
A colonoscopy can reveal any inflammation, bleeding, or ulcers on the colon
wall. Tissue samples (biopsies) may be taken from the colon wall for
examination under a microscope in order to make a definitive diagnosis of
UC.
Treatment
Although these remedies still require extensive research, preliminary studies
indicate that lifestyle changes, including stress reduction, dietary adjustments
(such as including a rich variety of fruits and vegetables and maintaining
low levels of fat and sugar), specific herbs and supplements and mind/body
techniques (such as hypnosis) can help prevent and/or treat the disease.
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MODERN MEDICINE
The primary goal in treating UC is to control inflammation and replenish
lost nutrients. The choice of treatment for UC depends on the severity of
the disease. For example, people with mild to moderate UC are usually
treated with medications that reduce swelling and suppress the immune
response. More severe cases of UC may require surgery. In addition to
medications, many people with inflammatory bowel diseases such as UC
commonly turn to complementary and alternative remedies.
The following medications can help reduce the symptoms of UC and decrease
the likelihood of recurrences:
O Sulfasalazine—the most commonly used medication for UC; taken
orally; decreases inflammation, reduces frequency of recurrences
O Mesalamine—decreases inflammation; taken orally or as an enema
O Corticosteroids—reduce inflammation by decreasing the production
of prostaglandins (fatty acids that produce pain and inflammation);
taken orally, given intravenously in severe cases, or may be prescribed
as an enema
O Medications that suppress the immune system (such as azathioprine
and cyclosporine)
O Antibiotics.
Patients who have been taking ACTH or cortisone derivatives for colitis
should not discontinue their drugs suddenly, because withdrawal symptoms
can be life-threatening. Physicians should supervise the gradual reduction
of these dangerous drugs.
Medications used to treat diarrhea (such as diphenoxylate, loperamide, or
opiates) must be used only under medical supervision and with extreme
caution. These medications slow down the normal movements of the
gastrointestinal tract and, in severe cases of UC, may cause a complication
known as toxic megacolon.
Surgery and Other Procedures

Approximately 20% to 30% of people with UC must eventually have their
colons removed (colectomy) because of massive bleeding, severe illness,
69
rupture of the colon, or the risk of cancer. There are several different types
of surgery available for UC, and choosing the appropriate surgery depends
on the severity of the disease and the individual’s needs, expectations, and
lifestyle.
Many people with UC must have a proctocolectomy—a procedure in which
the colon, anus, and rectum are surgically removed. The surgery cures UC,
and removes any risk of colon or rectal cancer. When the intestines are
removed, however, the body needs a new way for waste to leave the body so
the surgeon creates a small opening (stoma) in the abdomen for stool to
pass through. A pouch is worn over the opening to collect waste, and the
individual empties the pouch as needed. Different types of procedures may
be performed depending on which parts of the intestines are involved:
Ileostomy: Colon and rectum are removed and the surgeon attaches the
bottom of the small intestine to the stoma; waste travels through the small
intestine and exits the body through the stoma.
Colostomy: Rectum is removed and the surgeon attaches the colon to the
stoma (a temporary colostomy may be performed when part of the colon is
removed and the rest needs to heal).
Ileorectal and ileoanal reservoir surgery: Diseased part of colon and/or rectum
is removed and the surgeon creates an internal pouch from the small
intestine. Waste is stored in the pouch and passed through the anus in the
usual manner; bowel movements occur more frequently (on average, 5 to 7
times per day).
AYURVEDA
Kutajarishtam, Mustharishtam with Vilwadi lehyam binds motion and reduces
bleeding. Shalmali Ghritham made up of Shalmali (Bombax malabaricum)
is useful. Shalmali contains a large proportion of tannic and gallic acids and
may be successfully used in cases requiring astringents.
Sallaki guggul (Boswellia serrata): Sallaki guggul is a traditional Ayurvedic
therapy used to treat symptoms of colitis. Findings from one study suggest
that this remedy may be as effective as sulfasalazine for the treatment of
UC. Side effects of Sallaki guggul use include nausea, abdominal fullness,
stomach pain, and anorexia.
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ACUPUNCTURE
Acupuncture is effective for treating colitis. Acupuncture can also be used
to treat the anxiety and depression which frequently accompany and
aggravate colitis. Most patients experience a feeling of well-being after the
first few treatments.
Following points are used:
Zhongwan (CV12), Pishu (BL20), Zhangmen (LR13), Tianshu
(ST 25), Shenshu (BL 23), Zusanli (ST 36), Tianzhu (BL 10), Shangjuxu
(ST 37), Weishu (BL 21), Guanyuan (CV 4), and Shenshu (BL 23).
Technique: Use tonic technique and leave the needles in place for 30 minutes.
Moxa may be applied with or without acupuncture.
O Diarrhea with excessive blood: Taichong (LR 3) and Quchi (LI
11)
O Diarrhea with excessive pus and mucus: Waiguan (TE 5), Yinbai
(SP 1), Tianzhu (BL 10), and Shenmai (BL 62)
O Severe diarrhea with rectal prolapse: Changqiang (GV 1) and moxa
Baihui (GV 20)
O Chronic incessant diarrhea: Hegu (LI 4), Zusanli (ST 36),
Yanglingquan (GB 34), Zhongwan (CV 12), Guanyuan (CV 4),
Tianshu (ST 25), Shenque (CV 8), and Zhongji (CV 3)
O Inability to eat or keep food in the stomach: Zhongwan (CV 12)
and Neiguan (PC 6)
O Abdominal pain and tenesmus: Zhigou (TE 6), Yanglingquan (GB
34), Taichong (LR 3), Changqiang (GV 1), and Zhonglushu (BL
29)
O Vomiting: Neiguan (PC 6) and Fenglong (ST 40).
HOMEOPATHY
After a first attack, constitutional homeopathic treatment is recommended.
Specific remedies to be given every 2 hours for up to 10 doses during acute
attack while constitutional treatment is being sought.
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Mercurius corr: Hot stools which smell offensive and have blood and mucus
in them, cutting pains on passing them, abdominal pain not relieved by
passing stools.
Arsenicum: Person chilly, restless, and anxious, burning pain in abdomen
accompanied by vomiting, symptoms worse after midnight, wanting warm
drinks and sipping them at frequent intervals.
Phosphorous: Blood in stools, passing stools relieves pain but anus feels
wide open afterwards.
NATUROPATHY
Initially the patient is kept on fasting for 3 to 10 days with carrot juice,
apple juice, and warm slippery elm tea. During fasting, regular enemas
should be given. In severe diarrhoea, ice-cold water enemas will reduce the
diarrhoea. At the end of the fast, break the fast slowly with ripe mashed
banana with slippery elm powder, steamed apples (no skin).
After fasting, a bland diet comprising of mashed ripe bananas, steamed
brown rice, curd, yoghurt, buttermilk, steamed potatoes (no skin), steamed
carrots and cabbage, tofu, papaya, apple juice, carrot juice, etc are given.
Once the symptoms are reduced, vegetables and fruits should be included
in the diet. Adequate fluids and electrolytes should be given to prevent
dehydration. Avoid milk, eggs, meat, allergy foods, etc.
Stewed or soaked prunes, one to three/day have a slightly laxative effect and
may help soften stools.
Flax meal, one heaping teaspoon in eight ounces of apple juice, provides
fiber and essential fatty acids to help relieve constipation. Follow with an
additional eight ounces of water.
The following herbs are advised:
O Psyllium seeds (Plantago ovata): Studies reveal that the fiber-based
supplement may be as effective as the prescription drug mesalamine
in decreasing recurrences of the disease.
O Marshmallow root (Althaea officinalis)
O Siberian ginseng (Eleutherococcus senticosus)
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O Turmeric (Curcuma longa)

O Ginger (Zingiber officinale)
O Bromelain (Ananas comosus)
O Wild yam (Dioscorea villosa)
O German chamomile flower (Matricaria recutita)
O Yarrow (Achillea millefolium).
YOGA THERAPY
Yoga reduces colitis by relaxing the sympathetic nervous system and mind.
O Asanas:

Konasana

Bhramari
NUTRITION THERAPY
Preliminary evidence suggests that certain dietary patterns may be associated
with UC. For example, some studies indicate that low fruit and vegetable
consumption and high fat and sugar consumption may increase an
individual’s risk for developing UC. Studies also suggest the following:
A bland, low-fiber diet is best during acute flare-ups. Regular intakes of
fruits and vegetables, and lowered fat and sugar consumption when UC is
not active may reduce the likelihood of flare-ups.
Finely ground flour of cereals can be included and also tender vegetables.
Avoid vegetable salad, dry fruits, papads, chutneys and pickles.
High intakes of fluids and foods rich in magnesium and vitamin C on a
regular basis may lower the risk of developing inflammatory bowel diseases.
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Certain foods may aggravate symptoms of UC (including chocolate, dairy

products, fats, and artificial sweeteners) and should be avoided by people
with the condition.
After surgery, people with UC should avoid foods high in organic acids
known as oxalates (for example, spinach, rhubarb, beets, coffee, tea, diet
sodas, and chocolate) because oxalates can increase the risk of kidney stones.
The following foods should also be avoided by people with UC because
they worsen symptoms of the disease: Milk (and milk products), spicy
foods, fats and sugars.
Vitamins and Minerals: Because many people with UC have vitamin and
mineral deficiencies (due to decreased nutritional intake and absorption by
the colon and excessive diarrhea), a multivitamin is recommended.
Omega-3 Fatty Acids: At least one study has found that, compared to
placebo, fish oil supplements containing omega-3 fatty acids may reduce
symptoms of UC and prevent recurrence of the condition.
Vitamin B9 (F olate): People with UC often have low levels of folate in their
(Folate):
blood cells and some experts suggest that this may be due, at least in part,
to sulfasalazine use. Some researchers speculate that folate deficiencies
contribute to the risk of colon cancer in those with UC. Preliminary studies
suggest that folate supplements may help reduce tumor growths in people
with UC
N-acetyl glucosamine: Preliminary evidence suggests that N-acetyl
glucosamine supplements or enemas may improve symptoms of UC in
children with IBD who did not improve after using other treatments.
Probiotics: Animal studies and preliminary human studies have found that
Probiotics, or “good” bacteria such as lactobacillus, may improve symptoms
of UC and help prevent flare-ups. Further research is warranted.
PSYCHOTHERAPY
Hypnosis: Studies have shown that hypnosis improves immune function,
increases relaxation, decreases stress, and ease feelings of anxiety. Many studies
74
have reported that symptoms of the disease improve with relaxation methods
such as hypnosis, meditation, and biofeedback.
Group therapy: Social support can often help with the stress of dealing
with illness, and support group members may also have useful tips for
finding the best treatment and coping with the condition.
Lifestyle
At least one study has shown that IBD often begins within 1 year of a very
stressful life event, such as the death of a family member. In addition,
people with UC report that stress worsens their symptoms. Therefore,
relaxation techniques, such as yoga, tai chi, and meditation are worth
considering, particularly for people with chronic stress in their lives.
Exercise may also be very helpful for those with UC. Although exercise is
generally considered safe for people with UC, those with the condition
must take certain precautions when exercising and should talk to their
healthcare practitioners before starting an exercise program. It is especially
important for people with UC to drink one to two glasses of water before
exercising and one glass of water every twenty minutes while exercising to
prevent dehydration. Exercise should be avoided during symptom flare-
ups or if the individual has a fever.
Preventive Care
A daily dose of sulfasalazine, one of the most common medications used to
treat UC, is an effective means of reducing the number of UC relapses.
Diet (especially a low-fat diet rich in fruits, fluids, magnesium, and vitamin
C), exercise, and stress reduction techniques (including hypnosis) may also
help prevent recurrences. Supplements and herbs are used successfully to
treat UC, but whether or not they can prevent recurrences or stave off the
disease in those who are genetically at risk is unknown.
HEMORRHOIDS
Hemorrhoids are a condition in which veins in the rectal or anal area become
swollen and painful and may bleed. Hemorrhoids may occur inside the
entrance to the anus (interior hemorrhoids) or outside the entrance to the
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anus (exterior hemorrhoids). A blood clot (thrombosis) may form in the

vein, making the hemorrhoid more painful.
This condition is very common, especially during pregnancy and after
childbirth. Hemorrhoids result from increased pressure in the veins of the
anus. The pressure causes the veins to bulge and expand, making them
painful, particularly when sitting.
The most common cause is straining during bowel movements. Hemorrhoids
may result from constipation, sitting for long periods of time, and anal
infections. In some cases, they may be caused by other diseases, such as
liver cirrhosis.
Symptoms
Symptoms of hemorrhoids include:
O Constipation
O Straining while defecating
O Anal ache or pain, especially while sitting
O Bright red blood on toilet tissue, stool, or in the toilet bowl
O Pain during bowel movements
O One or more hard tender lumps near the anus.
Signs and tests
A doctor can often diagnose hemorrhoids simply by examining the rectal
area. If necessary, tests that may help diagnose the problem include:
O Stool guaiac (shows the presence of blood)
O Sigmoidoscopy
O Anoscopy.
Treatment
MODERN MEDICINE
Over-the-counter corticosteroid creams can reduce pain and swelling.
Hemorrhoid creams with lidocaine can reduce pain. Witch hazel (applied
with cotton swabs) can reduce itching.
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Other steps to reduce anal itching include:

O Wear cotton undergarments.
O Avoid toilet tissue with perfumes or colors.
O Try not to scratch the area.
Stool softeners help reduce straining and constipation.
For cases that don’t respond to home treatments, a doctor may recommend
surgery, like rubber band ligation or surgical hemorrhoidectomy. These
procedures are generally used for patients with severe pain or bleeding who
have not responded to other therapy.
AYURVEDA
Sushruta has advocated surgery for curing piles, but Charaka, the physician,
has advised drug therapy. In the case of bleeding piles, the drug of choice
is Nagakesara (Mesua ferrea). The powder of the flower of this plant should
be administered to the patient in one-teaspoonful doses, thrice daily.
Haritaki (Terminalia chebula) is recommended when there is bleeding, as
well as inflammation and pain. One teaspoonful, given two to three times
a day with milk, is sure to relieve the condition.
Haritaki (small) fried in Castor oil and powdered. When 1-2 tsp of the
powder is taken with water at bedtime, it acts as a soft laxative. Castor oil
has the healing property for ulcers in the large intestine. For those who find
it difficult to get Haritaki fruits, they can mix Haritaki powder, Licorice
powder and Isabgol powder in equal proportion and take 2 tsp at bedtime,
with water. Licorice and Isabgol soften the stools and reduce the bleeding.
Isabgol is 100% fibre, helping elimination.
Abhayadi Ghanvati (2 Tabs with water) or Abhayarishta (15 ml with equal water),
Samashara Churna, Chirabilvadikashay, Soornadi lehyam, Chirivilwadi Kashayam,
Kankayana vati, Lavanottamadi Churna, Nagkesharayoga, and Samangadi Churna
are some of the other standard Ayurvedic remedies for both dry and bleeding
piles. These may be taken according to prescribed dosages.
Panchakarma therapies like matravasti help to soften stools and reduce
bleeding.
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Arshakuthar Ras and Arshoghni Vati are used in case of non-bleeding and
bleeding piles respectively. However, these should be used under supervision
of a Vaidya.
O Tablets made from black sesame seeds, chebulic myroabalans, jaggery
and purified marking nut (Bhallatak) should be given in the dose
of 20 mg daily.
O Tablets of black pepper, ginger, root of lead wort and root of
Amorphophallus
O Surankand should be made by mixing with equal amount of jaggery
and given in the dose of 250 mg. twice daily.
O For bleeding piles, powder of mesua and bark of Symplocos racemosa
(Lodhra) should be given in the dose of 1 gm. daily.
O Paste of root of Amorphophallus campanulatus should be given in
the dose of 5 gms along with oil and salt.
O Powder of ginger or chebulic myrobalan or long pepper should be
taken along with jaggery in the dose 1 gm. thrice daily.
O Cold infusion of red sandal wood powder, bark of margosa tree,
cinnamon and tree turmeric should be taken in the dose of 30 ml.
thrice daily for bleeding piles.
O Powder of chebulic myrobalan should be taken in the dose of 1 gm.
daily to relieve constipation.
Local application in case of external haemorrhoids -
O Paste of common milk hedge (Snuhi), madar, leaves of Indian beech
(Karanja patra) and bitter gourd should be applied on
haemorrhoids.
O Paste of seeds of staff tree (Jyotishmati) should be applied in bleeding
piles.
O Paste of milk of common hedge and turmeric powder should be
applied on bleeding piles.
Sathadhoutha Ghritham can be applied externally to reduce piles.

If piles have grown to large size, surgery is done by using Kshara-sutra
Chikitsa. Kshara-sutra (caustic thread) is a thread which is coated with
78
Alkaloid extracts of various plants like Euphorbia nerifolia, Achyranthes aspera,

Curcuma longa, etc. The thread is tied to the root of pile mass which slowly
cuts the pile mass and heals it.
ACUPUNCTURE
Acupuncture helps to reduce the pain associated with piles. Following
Acupoints are used:
O Local points: Changqiang (Du 1), Huiyin (Ren 1), Ciliao (U.B.
32), Zhibian (U.B. 54)
O Distal points: Baihui (Du 20), Yinjiao (Du 28), Sanyinjiao (Sp.
6), Jizhong (Du 6), Chengshan (U.B. 57).
HOMEOPATHY
Some of the most common remedies used for hemorrhoids are listed below.
O Aesculus for burning hemorrhoids with a sensation of a lump in
anus that feels worse when walking
O Aloe for a sensation of pulsation in the rectum with large, external
hemorrhoids
O Collinsonia for chronic, itchy hemorrhoids with constipation
O Hamamelis for large bleeding hemorrhoids with a raw feeling.
NATUROPATHY
and with daily enema during fasting will reduce the piles and pain. After
fasting, a natural diet with more fruits and vegetables is advised.
A high fibre diet with lots of fruits, vegetables and sprouts prevents and
reduces haemorrhoids. Wheat bran, psyllium seed and guargum
supplementation reduces the constipation and symptoms of haemorrhoids
like bleeding, and pain. Rice, wheat chapathi, green gram soup, all leafy
vegetables, butter, buttermilk, and amalaki juice can be taken.
Reduce as much as possible heavy to digest dairy items, fruits with milk,
jaggery with milk, sesame seeds with jaggery, sweets, soft flour items and
bakery items, potato, oils, chillies, spices, red meat, white meat.
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A root vegetable called Yam (Dioscorea spp) is especially noted to be good

for piles. Cook in pressure cooker, mash, add a little rock salt and eat. Take
this vegetable with buttermilk for 15 days.
Following ar
ollowing aree some of the herbs used in naturopathy to rreduce
naturopathy educe piles:
O Gotu kola (Centella asiatica) extract: 30 mg, 3 times/day. Gotu
kola enhances connective tissue structure, reduces sclerosis, and
improves blood circulation.
O Horse-chestnut (Aesculus hippocastanum) bark of root – 500 mg, 3
times/day. Horse chestnut increases venous tone, decreases capillary
fragility and swelling. It is especially useful in Hemorrhoids.
O Topical applications may relieve itching and burning, as well as
promote healing. Apply one of the following two to four times a
day.
O Witch hazel (Hamamelis virginiana) is an astringent that may reduce
swelling (commercially available as Tuck’s pads).
O A salve containing comfrey (Symphytum officinalis) and/or marigold
(Calendula officinalis) soothes and promotes healing.
O A poultice made from grated potato is astringent and soothing.
Hydrotherapy
Acute bleeding piles: Ice packs, direct ice application, ice cold sitz baths etc.
helps to reduce bleeding and pain.
Chronic piles: Hot compress, hot sitz bath with Neem decoction or baking
soda helps to reduce pain and swelling. Sitz baths can help you to feel
better. Sit in warm water for 10 to 15 minutes.
YOGA THERAPY
O Bandha: Uddiyana bandha, Mula bandha
O Asanas: Inverted poses like Sarvangasana, Sirsasana, or wall, Viparita
karani, Viparita karani on the pillows against the wall. Inverted
poses reduce pain and swelling.
O Pranayamas such as Nadi shuddhi, Sheetkari, Sheetali, and
Bhramari.
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NUTRITION THERAPY
O Eliminate refined foods, sugars, caffeine, alcohol, and dairy
products. Decrease saturated fats (animal products) and increase
polyunsaturated fats (cold-water fish, nuts, and seeds). Increase
fresh vegetables and whole grains, as well as water intake.
O Vitamin C (1,000 mg two to three times per day) supports the
integrity of connective tissue
O Vitamin E (400 to 800 IU per day) promotes healing.
Bioflavanoids, a constituent found in dark berries and some plants, help
restore the integrity of the vasculature. The following are bioflavanoids that
may be taken in dried extract form as noted
O Catechin (150 mg two to three times per day), quercetin (250 mg
three to four times per day), hesperidin (250 mg three to four
times per day), and rutin (250 mg three to four times per day)
O Rose hips (Rosa canina) and green tea (Camellia sinensis) are also
high in bioflavanoids and either one may be used as a tea. Drink
three to four cups/day.
PHYSICAL THERAPY
Kegel exercises: These are pelvic wall and rectal exercises. They increase the
blood circulation and prevent the pooling of the blood in that area. Pull
the rectum, and pelvic wall, contract them, and relax. Repeat 20 times
three times a day.
Prevention
You can help prevent hemorrhoids by preventing constipation. Avoid
straining during bowel movements. Drink plenty of fluids, at least eight
glasses per day. Eat a high-fiber diet of fruits, vegetables, whole grains.
Consider fiber supplements if necessary.
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2
RESPIRATOR
RESPIRATORY DISEASES
TORY
Common Cold
Sinusitis
Pharyngitis
Bronchial Asthma
Bronchitis
Pulmonary Tuberculosis
Emphysema
COMMON COLD
The common cold is an upper respiratory infection caused by a virus.
More than 200 different types of viruses cause colds. You get a cold by
touching a person with a cold (for example, by shaking hands with a person
with a cold) and then touching your nose or eyes. Colds are also transmitted
through the air. Exposure to cold outdoor air does not make you more
likely to get a cold, although psychological stress may.
People are most contagious for the first 2 to 3 days of a cold and usually
not contagious at all by day 7 to 10.
People more likely to get colds include:
O Children and those over 65
O Children who have parents who smoke
O Children who attend day care
O Smokers and those exposed to second hand smoke
O Those exposed to industrial smoke, toxic fumes, or other air
pollutants
O People with immune system disorders, like HIV, AIDS, or cancer,
or compromised immune function, like those taking steroids for a
long time
O People under a fair amount of stress.
In addition, colds are more likely during the winter months not because of
exposure to cold air but due to increased time spent indoors and in contact
with other persons.
The three most frequent symptoms of a cold are:
O Runny nose
O Nasal congestion
O Sneezing.
Adults and older children with colds generally have minimal or no fever.
Young children, however, often run a fever around 100-102°F.
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Respiratory Diseases
Within one to three days, the nasal secretions usually become thicker and
perhaps yellow or green. This is a normal part of the common cold and not
a reason for antibiotics.
Depending on which virus is the culprit, the virus might also produce:
O Sore throat
O Cough
O Muscle aches
O Headache
O Postnasal drip
O Decreased appetitie.
For children with asthma, colds are the most common trigger of asthma
symptoms.
Symptoms
O Sneezing and nasal congestion
O Sore throat, cough, or hoarseness
O Fever
O In children, sudden onset of fever (lasting two to three days),
irritability, restlessness, and sneezing
O Headache.
Diagnosis
The diagnosis will be made based on the symptoms. Tests are not necessary.
Colds generally clear up after about 7 to 10 days.
Treatment
MODERN MEDICINE
Antibiotics and antihistamines cannot help cure cold. Antibiotics should
not be used to treat a common cold. They will not help and may make the
situation worse!
New anti-viral drugs could make runny noses completely clear up a day
sooner than usual (and begin to ease the symptoms within a day). It’s
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unclear whether the benefits of these drugs outweigh the risks. Some
common drugs used for cold are:
Decongestants: May help prevent sinus and ear infections.
Nasal sprays: Aspirin and other pain relievers (like acetominophen or
ibuprofen) can be used for fever or aches.
AYURVEDA
Colds and flu are usually Kapha (phlegm) diseases. An anti-Kapha and
anti-Ama (detoxifying) diet is prescribed.
Lemon and ginger juice can be taken with warm water and honey. Fresh
ginger or other spice teas, cinnamon, basil and cloves, are good. Herbal
treatment includes diaphoretic, expectorant anti-cough herbs. After drinking
warm spice tea, the patient should sleep under a warm blanket. This causes
a mild sweat. Other sweating methods such as dry sauna or steam can also
be used.
Typical Ayurvedic herbs include ginger, cinnamon, long pepper, licorice,
basil, cloves, mint. The main drugs for cold are Sitopaladi power or Talisadi
powder which is taken with honey or ghee.
Ginger powder, black pepper and long pepper, cumin seeds powder should
be taken with ginger juice in the dose of one gram thrice daily.
Medicated Ghritas should be taken internally / orally.
For epistaxis, local application of amlaki fruit paste with Ghrita is used.
Kachur (Zedoary roof ), Phyllanthus niruri, black pepper, long pepper and
ginger powder should be mixed together and should be taken in Ghrita
and Jaggery in the dose of 500 mg. twice a day.
Chronic colds can be cured with Agastya Haritaki Rasayana in the dose of
one tea spoon twice daily with milk or honey. Agastya rasayanam with
Pravala bhasmam is effective in treating chronic cold and bronchitis.
Amritharishtam with Vasarishtam works good for common cold. Dashamula
rasayanam Talisadi Kashayam or Karpooradi Kashayam helps as an
expectorants.
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ACUPUNCTURE
Acupuncture may be helpful in managing a cold and the following points

may be utilized.
O Baihui (Du 20)
O Local Points: Dazhui (Du 14), Fengchi (G.B. 20)
O Distal point: Hegu (L.I. 4).
Further points may be added according to the symptoms present:
O Headache: Taiyang (Ex. 2), Touwei (St. 8)
O Blocked nose: Heliao (L.I. 19)
O Nasal Discharge: Yintang (Ex. 1), Yingxiang (L.I. 20)
O Sore throat: Shaoshang (Lu. 11)
O Fever: Dazhui (Du 14), Quchi (L.I. 11)
O Cough: Lieque (Lu 7).
HOMEOPATHY
A conitum: for symptoms including fever, anxiety, and thirst, that start
abruptly, often following exposure to a cold climate or draft; most effective
during the first 24 hours of the illness.
Allium cepa for colds with clear watery discharge that burns and/or irritates
the nostrils; red, burning eyes; and symptoms that worsens in warm rooms
and in the evening.
Arsenicum album for colds with watery, burning discharge from the nose,
throbbing headache, nasal congestion that is not relieved by sneezing, dry
mouth, sensitivity to cold, and a thirst for small sips of fluid.
Belladonna for colds with sudden onset of high fever, flushed face, watery
nasal discharge, sore throat, throbbing headache, earache, and cough that
tends to worsen at night.
Bryonia for chest colds with spastic cough that produces only a small
amount of mucus and sharp chest pain that worsens with inhalation and
while coughing; a dull headache, little to no nasal discharge, and sneezing
may also be present.
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Euphrasia for colds with excessive, non-irritating watery discharge that

tends to worsen in the morning and when the person is lying down.
Ferr um phosphoricum for the early stages of a cold with slight fever, flushed
errum
face (redness may be patchy), and fatigue; may also be used in children
with nosebleeds or bloody nasal discharge.
Gelsemium for colds that have gradual onset with watery nasal discharge
that causes irritation, a feeling of fullness or tickling in the nose and/or the
back of the throat, muscle aches, fatigue, lack of energy, lightheadedness
or spaciness, and a headache with pain in the back of the head.
Mercurius for fluctuating body temperature and thick, yellow nasal
discharge with a foul odor; symptoms may also include bad breath and a
swollen tongue.
Pulsatilla for coughs and nasal congestion with thick, yellow-green mucus
that does not burn the skin; symptoms tend to worsen in warm, stuffy
rooms and when the person is lying on his or her back.
NATUROPATHY
Initially fast for 2 to 3 days with citrus fruit juices, and herbal teas. Fasting
is often helpful if the individual is not too weak.
If there is severe mucous congestion, follow a mucous-cleansing diet for 3
days. In this diet, take oranges or grapefruit for breakfast, a lot of steamed
onions for lunch and supper and herbal teas or carrot juice or citrus juices
in between.
Diet should be light, warm and simple: for example, whole grains and
steamed vegetables in moderate quantities. Avoid dairy products, especially
cheese, yogurt and milk. Heavy, oily and damp food like meat, nuts, breads,
pastries, candies and sweet juices should not be taken.
For a good “cold tea,” combine equal parts of elder (Sambucus nigra),
peppermint (Mentha piperita), and yarrow (Achillea millefolium) and mix
1 to 2 tsp of the mixture in 1 cup hot water. Take it hot just before going
to bed. This will induce a sweat, and if the cold is caught early enough,
may stop it altogether. Other herbs that may be added to the infusion
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include Cayenne (Capsicum minimum), Cinnamon (Cinnamomum

zeylanicum) and Ginger (Zingiber officinalis).
Hydrotherapy:
O Steam inhalation: Mix 2 drops of eucalyptus oil or ½ tsp of turmeric
in steam water and inhale steam for 10 minutes
O Hot immersion bath: Make a decoction of eucalyptus, ginger, and
lavender, and mix this in bath water.
YOGA THERAPY
Kriyas such as Jala Nethi (nasal cleanse) helps to treat and prevent common
cold. However, Jalanethi is contraindicated during infection.
Pranayamas such as Nadi shuddhi, Ujjayi, Sheetkari, Sheetali, and Bhramari
are useful to prevent and also manage cold.
NUTRITION THERAPY
Good nutrition is essential for resisting and recovering from a cold. Take
plenty of fluids to flush toxic by-products out of the body as quickly and
efficiently as possible. The ideal liquids are water and fresh fruit juice.
Avoid drinks that have diuretic (fluid-eliminating) properties, such as tea
and coffee.
Foods should be as light and easily digestible as possible, with a strong
emphasis on vegetable soups, broths, salads and lightly cooked fish or
chicken. Avoid high-fat, indigestible foods such as cheese, red meat and
pastries.
Eat lots of fresh fruit for natural Vitamin A, B and C, and add plenty of
raw garlic to food. Grapefruit is a great food for fighting a cold. It is high
in vitamin C.

The following vitamin, mineral and herbal supplements help to shorten
the duration of the cold and reduce the severity of symptoms:
O Vitamin C, with bioflavonoids, 1,000 mg every few hours
throughout the day, up to bowel tolerance
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O Zinc lozenges, with 3 mg copper, every few hours, up to 70 mg

daily during a cold and 30 mg daily as a preventive
O Garlic, 2 capsules three times daily
O Vitamin A, 25,000 IU daily.
PSYCHOTHERAPY
A study of a small number of university students suggests that practicing
relaxation techniques on a regular basis may help reduce the number of
days that you have a cold or the flu. A similar study using relaxation
techniques and guided imagery reached the same conclusion for a group of
45 children. Some good stress reduction techniques include meditation,
deep relaxation, yoga, tai chi, and breathing exercises.
Prevention
O Wash hands: Children and adults should wash hands at key
moments — after nose-wiping, after diapering or toileting, before
eating, and before food preparation.
O Use instant hand sanitizers: A little dab will kill 99.99% of germs
without any water or towels. It uses alcohol to destroy germs. It is
an antiseptic, not an antibiotic, so resistance can’t develop.
O Disinfect: Clean commonly touched surfaces (sink handles, sleeping
mats) with an EPA-approved disinfectant.
O Use paper disposable towels instead of shared cloth towels.
Here are seven ways to support the immune system:
O Avoid unnecessary antibiotics: The more people use antibiotics,
the more likely they are to get sick with longer, more stubborn
infections caused by more resistant organisms in the future.
O Breastfeed: Breast milk is known to protect against respiratory tract
infections, even years after breastfeeding is done. Kids who don’t
breastfeed average 5 times more ear infections.
O Avoid second-hand smoke: Keep as far away from it as possible! It
is responsible for many health problems, including colds.
O Get enough sleep: Late bedtimes and poor sleep leave people
vulnerable.
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O Drink water: Your body needs fluids for the immune system to
function properly.
O Eat yogurt: The beneficial bacteria in some active yogurt cultures
help prevent colds.
O Take zinc: Children and adults who are zinc-deficient get more
infections and stay sick longer.
SINUSITIS
Sinusitis refers to inflammation of the sinuses. This is generally caused by
a viral, bacterial, or fungal infection.
The sinuses are air-filled spaces around the forehead, cheeks, and eyes that
are lined with mucous membranes. Healthy sinuses are sterile (meaning
that they contain no bacteria or other organisms) and open, allowing mucus
to drain and air to circulate.
When inflamed, the sinuses become blocked with mucus and can become
infected. Each year, over 30 million adults and children get sinusitis.
Sinusitis can be acute (lasting anywhere from 2 to 8 weeks) or chronic,
with symptoms lingering much longer.

Sinusitis can occur from one of these conditions:
O The small openings (ostia) from the sinuses to the nose become
blocked
O Small hairs (cilia) in the sinuses, which help move the normally
produced mucous out, are not working properly
O Too much mucous is produced.
When the sinus openings become blocked and mucous accumulates, this
becomes a great breeding ground for bacteria and other organisms.
Sinusitis usually follows respiratory infections, such as colds, or an allergic
reaction. Some people never get sinusitis, and others develop sinusitis
frequently.
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People more likely to get frequent sinusitis include those with cystic fibrosis
or a weakened immune system (such as people with HIV and those receiving
chemotherapy).
Other risks for developing sinusitis include:
O Having asthma
O Overuse of nasal decongestants (rather than continuing to relieve
congestion, the problem gets worse when these are used too often
or for too long)
O Having a deviated nasal septum, nasal bone spur, or polyp
O Presence of a foreign body in your nose
O Frequent swimming or diving
O Dental work
O Pregnancy
O Changes in altitude (flying or climbing)
O Air pollution and smoke
O Gastroesophageal reflux disease (GERD).
Symptoms
The classic symptoms of acute sinusitis usually follow a cold that does not
improve, or one that worsens after 5 to 7 days of symptoms. They include:
O Nasal congestion and discharge
O Sore throat and postnasal drip (fluid dripping down the back of
your throat, especially at night or when lying down)
O Headache — pressure-like pain, pain behind the eyes, toothache,
or facial tenderness
O Cough, often worse at night
O Fever (may be present)
O Bad breath or loss of smell
O Fatigue and generally not feeling well.
Symptoms of chronic sinusitis are the same as acute sinusitis, but tend to
be milder and last longer than 8 weeks.
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Signs and tests

Tests for sinusitis include:
O Tapping over a sinus area. Tenderness may indicate infection
O Shining a light against the sinus (called transillumination). If dark,
this indicates possible inflammation
O Viewing the sinuses through a fiberoptic scope
O Ultrasound
O X-ray of the sinuses
O Cultures of the material from the nose.
However, these tests are relatively insensitive for detecting sinusitis, and
are often considered unnecessary.
A CT scan of the sinuses is a much better test to help diagnose sinusitis. If
sinusitis is thought to involve tumor or fungal infections, an MRI of the
sinuses may be necessary.
Treatment
MODERN MEDICINE
Antibiotics are used to cure the particular infection causing sinus
inflammation. Common antibiotics include ampicillin, amoxacillin,
trimethoprim with sulfamethoxazole (Bactrim), Augmentin, cefuroxime,
and cefprozil.
Other antibiotics may be used depending on the type of organism present.
Acute sinusitis should be treated for 10 to 14 days, while chronic sinusitis
should be treated for 3 to 4 weeks.
Nasal corticosteroid sprays may be used to decrease swelling, especially if you
have swollen structures (such as nasal polyps) or allergies. These include
fluticasone (Flonase), mometasone (Nasonex), and triamcinolone (Nasacort AQ).
Surgery to clean and drain the sinuses may also be necessary, especially in
patients with recurrent episodes of inflammation despite medical treatment.
An ENT specialist, also known as an otolaryngologist, can perform this
surgery.
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Most fungal sinus infections require surgical intervention. Finally, surgical

repair of a deviated septum or nasal polyps may prevent the condition’s
recurrence.
Be careful with over-the-counter spray nasal decongestants. They can help
initially, but using them beyond 3-5 days can actually worsen nasal
congestion.
AYURVEDA
Ayurveda advises Panchakarma treatment to treat sinusitis. Special form of
cleansing is applied to the sinuses called nasya. Following the application
of oil and heat over the sinuses, the herbal oils are administered directly
into the nasal passages. This procedure not only eliminates ama but also is
helpful in the treatment of chronic allergic sinusitis and sinus headaches.
Nasya with Anu oil, Steam inhalation (Dhoopam) with turmeric reduces sinusitis.
Vasarishtam, Lakshmivilas Ras, Haridra khandam are commonly used.
Following are some of the Ayurveda medicines for sinusitis:
1. Mix equal quantities of Trikatu Churnam, Chitramoolam,
Thalisapatram, Jeerakam, Cardamom and Jaggery. Take 5 gm of
this powder thrice a day
2. Chitrakaharitaki lehyam – 2 tsp twice a day
3. Instill in nose Mahalaxmivilas Ras or Anu oil 2-4 drops thrice a
day
4. Vyoshaadirati 2-4 tab, take with 50 ml of hot water twice a day
5. Lakshmivilas Ras 1-2 tab with honey thrice a day
6. Kanchanara guggulu, 1-2 tab thrice a day
7. Tribhuvanakirthi Ras 1-2 tab twice a day.
ACUPUNCTURE
Acupuncturists usually describe sinusitis as “dampness” which creates
inflammation and congestion in the mucus membranes. This dampness is
cleared by strengthening the spleen meridian and by working with the
stomach meridian.
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O Baihui (Du 20)

O Local points: Yangbai (G.B.14) through to Yuyao (Ex.3), Quanliao
(S.I. 18)
O Distal point: Hegu (L.I. 4)
O Specific points for infection: Dazhui (Du 14), Quchi (L.I. 11),
Sanyinjiao (Sp. 6)
O Specific point for allergy: Zuehai (Sp. 10).
HOMEOPATHY
Hepar sulphuricum for the later stages of sinus inflammation when the
pain is concentrated between the eyes and is worsened by cold or motion;
nasal discharge tends to be thick and the individual may experience
sensitivity of the scalp.
Kali bichromicum this remedy is considered the first choice homeopathic
treatment for sinusitis; it is most appropriate for individuals who have
pain between the eyes or in the forehead above one eye; nasal discharge is
generally stringy; scalp and facial bones are tender to touch and the person
may feel dizzy or nauseated; pain is worse around noon and with cold and
motion, but improves with warmth and pressure.
Mercurius for sinusitis with thick, green, foul-smelling nasal discharge
which may be blood tinged; there may also be a gripping pain around the
head extending to the teeth; persons for whom Mercurius is appropriate
have symptoms that worsen with open air, sleeping, eating, drinking, and
extreme hot or cold; they may also have difficulty regulating their
temperature (the individual often fluctuates from feeling cold and chilled
to hot and sweaty).
Pulsatilla for individuals who have a thick, bland, yellow or greenish
discharge that is often accompanied by nausea and indigestion; symptoms
tend to improve with cool air, pressure, and cool compresses; symptoms
worsen when the individual is lying down, especially in a warm room.
Silicea for individuals with chronic congestion accompanied by head pain
that tends to be worse in the right eye; this pain is worsened by cold,
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movement, light, noise, and mental concentration (such as when studying)

but relieved by heat and pressure.
Spigelia for sinusitis with sharp pains on the left side of the face, generally
coming on after exposure to cold, wet weather; symptoms are aggravated
by warmth, light, noise, and movement, but are relieved by cold compresses
or cool water on the face and when the individual is lying down with the
head propped up
NATUROPATHY
Fasting for 3 to 7 days on citrus fruit (grapefruit) juices, and herbal teas
will help to remove the mucous. If there is severe mucous congestion,
follow a mucous-cleansing diet for 5 days. In this diet, take oranges or
grapefruit for breakfast, and a lot of steamed onions for lunch and supper,
and herbal teas or carrot juice or citrus juices or vegetable soups in between.
Juices like carrot juice, grapefruit juice, gorseradish and lemon juice are helpful.
Onion syrup with honey – 1 tsp per hour can be given in acute cases.
Following are some of the herbs used in Naturopathy to treat sinusitis:

O Wild indigo (Baptisia tinctoria): specific for sinus infections
O Eyebright (Euphrasia officinalis): reduces inflammation, specifically
for sinus problems
O Licorice (Glycyrrhiza glabra): antiviral, soothing, especially with
exhaustion or heartburn. Do not use if you have high blood pressure
O Coneflower (Echinacea purpurea): stimulates the immune system
O Goldenseal (Hydrastis canadensis): antiviral, antibacterial
O Garlic/ginger tea: Add to hot water two to three cloves of garlic
(Allium sativum) and two to three slices of fresh ginger (Zingiber
officinale). Steep 5 to 15 minutes and drink, breathing in the steam.
Stimulates immune system and drainage.
A combination of all of the above herbs, equal parts, may be very effective.
1 cup tea or 30 to 60 drops tincture every two to four hours.
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Hydrotherapy
O Steam inhalation: mix 2 drops of eucalyptus oil or ½ tsp of turmeric
in steam water and inhale steam for 10 minutes - daily 3 to 4
times and particularly when congested to promote drainage of
mucus. Eucalyptus (Eucalyptus globus), lavender (Lavandula
angustifolia), and thyme (Thymus vulgaris) are specific for upper
respiratory infections. Lavender and rosemary (Rosmarinus
officinalis) are also very calming.
O Contrast hydrotherapy: Alternate hot and cold applications. Apply
wet washcloths over the sinus area. Alternate three minutes hot
with one-minute cold. Repeat three times. This is one set. Do two
to three sets per day.
Nasal wash: Rinse each nostril by holding your head sideways over the
sink and letting water run from the upper nostril to the lower nostril.
Keep nostrils lower than throat to prevent salt water from draining into
the back of the throat.
YOGA THERAPY
O Kriyas such as Jala Nethi is a good treatment for sinusitis. It helps
to treat and prevent sinusitis. But don’t do it when there is infection
O Asanas:
Baddha Konasana, Halasana
Dhanurasana, Chakrasana, Matsyasana, Vipareeta Dandasana,

Ustrasana
O Pranayamas such as Nadi shuddhi, Surya bheda, Ujjayi, Sheetkari,
Sheetali, Bhastrika, and Bhramari.
NUTRITION THERAPY
O Avoid mucus-producing foods, such as dairy products, bananas,
and any known food allergens.
O Drink plenty of fluids and decrease sugar intake.
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O Vitamin C (250 to 500 mg two times a day), zinc (30 to 60 mg
per day), beta-carotene (15,000 IU per day) to support immunity
O Bromelain (500 mg three times a day between meals) and quercetin
(500 mg three times a day between meals) are anti-inflammatory.
PHYSICAL THERAPY
Short wave diathermy can be used in giving effective relief. Small disc
electrodes are used. They are obliquely placed over the face covering all the
sinuses. The warmth created by Short wave diathermy helps in discharging
the mucus from the glands.
Daily exercise of a physical nature may not prevent sinusites but strengthens
the body’s immunity and cleanses the sinus sacs and are therefore
recommended.
Prevention
The best way to prevent sinusitis is to avoid or quickly treat flus and colds:
O Wash your hands frequently, particularly after shaking hands with
others
O Eat plenty of fruits and vegetables, which are rich in antioxidants
and other vitamins that could boost your immune system and
help your body resist infection
O Avoid smoke and pollutants
O Use a humidifier to increase moisture in your nose and sinus areas
O Drink plenty of fluids to increase moisture within your body
O Take decongestants during an upper respiratory infection
O Treat allergies promptly and appropriately
O Apply a warm, moist wash cloth to your face several times per day.
PHARYNGITIS
PHARYNGITIS
Pharyngitis is an inflammation of the pharynx that frequently results in a
sore throat.
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Causes
Pharyngitis may be caused by a variety of microorganisms. Bacterial causes
include Group A streptococcus, which causes strep throat, in addition to
corynebacterium, arcanobacterium, Neisseria gonorrhoeae, Chlamydia
pneumoniae, and others are also causative factors. In up to 30% of cases,
no organism is identified.
Most cases of pharyngitis occur during the colder months. It often spreads
among family members.
Strep throat is a serious cause of pharyngitis. The complications of strep
throat can include acute rheumatic fever, kidney dysfunction, and severe
diseases such as bacteremia and streptococcal toxic shock syndrome.
Symptoms
The symptoms of pharyngitis include the following:
O Sore throat
O Pain when swallowing
O In rare cases, difficulty breathing
O Inflammation of the membrane lining your throat
O An extra membrane or the appearance of pus in your throat (can
appear as white patches on tonsils or back of throat)
O Fever
O Enlarged lymph nodes in your neck.
Tests
Tests include examination of the pharynx to look for drainage or coating.
The skin, eyes, and neck lymph nodes may be examined.
If there is suspicion for strep throat a streptococcal screen and/or throat swab
culture may be performed. Additional throat cultures or blood tests may be
done depending on the suspected organism (e.g., mononucleosis, gonorrheae).
Treatment
Strep infection should be treated with antibiotics. Alternative treatments
can be effective in cases of acute, chronic, or recurrent pharyngitis. Viral
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phryngitis has no specific medical treatment beyond self help, gargling

etc.
MODERN MEDICINE
A bacterial form of pharyngitis, requires antibiotic treatment. Penicillin,
250 mg 3 times a day, taken by mouth for 6 to 10 days is the most
commonly prescribed antibiotic. Occasionally an intravenous form may
be used. If the patient is allergic to penicillin, erythromycin 300 to 400
mg 3 times a day may be prescribed.
Viral form of pharyngitis, can be treated at home. Aspirin or other over-
the-counter pain medicines will help relieve the pain and soreness in the
throat. However, aspirin should not be given to children under 18.
AYURVEDA
Treatment involves Anti-Kapha diet and expectorant herbs. Good spices
for the throat include cloves and calamus; useful herbs are bayberry,
zedoaria. These herbs can also be smoked.
Pitta (fire) type is indicated by severe sore throat, yellow mucus, and fever.
Bitter herbs are used: Katuki, turmeric, barberry, prepared or taken with
ghee.
Vata (air) type is characterized by dry throat and low voice. It is more apt
to be chronic. Treatment involves the use of anti-vata diet and demulcent
herbs like shatavari or marshmallow. Ghee or sesame oil can be applied in
drops to the throat. Simple licorice tea is good.
Following are some of the ayurvedic drugs used for pharyngitis:
O Sitopaladi churnam 3-4 gm with honey twice a day
O Kadiradirati 2 tab thrice a day, chew or suck slowly.
ACUPUNCTURE
O Baihui (Du 20)
O Local points: Tianrong (S.I. 17), Lianquan (Ren 23)
O Distal point: Hegu (L.I. 4)
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O Specific points for infection: Dazhui (Du 14), Quchi (L.I. 11),
Sanyinjiao (Sp. 6).
The use of Taixi (K.3) is also helpful. The Kidney Channel is connected
internally to the throat.
HOMEOPATHY
Aconitum for sore throats that come on suddenly after exposure to cold
and are accompanied by a high fever and thirst; this remedy works best if
given immediately after symptoms begin.
Apis mellifica for shiny red, swollen throats with stinging, burning, and
dry pains; this remedy is most appropriate for individuals who feel better
with cold drinks but have little thirst; they may also have difficulty
swallowing and may have the sensation of a fishbone being stuck in the
throat; they also tend to be bothered by anything around the neck.
Belladonna- This is usually the first homeopathic remedy considered for
sore throats, particularly if there is sudden onset of intense pain on the
right side of the throat along with redness, swelling, and a feeling of
constriction; individuals also generally have a fever, may experience pain
when swallowing (although the individual wants to drink despite the pain),
and often describe a hot sensation in the throat; this remedy works best if
used during the first 24 hours of throat soreness.
Hepar sulphuricum for stinging throat pain that is often described as a
stick in the throat; throat pain is often accompanied by enlarged tonsils;
pain may extend to the ears and is generally better from warm drinks.
Lycopodium for throat pain with a choking sensation, as if having a ball
stuck in the throat; individuals for whom this remedy is appropriate often
have pain that begins on the right side and may spread to the left; symptoms
are relieved by warm drinks.
Phytolacca for a dark red, purple, or bluish swollen throat accompanied
by excessive aching, fever, and pain with swallowing; individuals for whom
this remedy is appropriate may also have a shooting pain that extends to
the ears, and an acute pain at the base of the tongue when protruded.
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Sulphur for a burning, lingering sore throat; symptoms are worsened by

warm drinks and food; tonsils tend to be swollen, breath may be foul, and
gums and nasal passages are dry.
NATUROPATHY
Fasting for 3 to 7 days on citrus fruit (grapefruit) juices, and herbal teas
will help to reduce the pharyngitis.
Juices like carrot juice, grapefruit juice, horseradish and lemon juice are
helpful. Onion syrup with honey – 1 tsp per hour can be given in acute
cases.
Following are some of the herbs used in Naturopathy to treat sinusitis:
O Licorice (Glycyrrhiza glabra): Antiviral and soothing to the throat.
Use as lozenge or tea. Do not take licorice if you have high blood
pressure.
O Coneflower (Echinacea purpurea): Stimulates the immune system.
O Goldenseal (Hydrastis canadensis): Antiviral, antibacterial.
O Garlic/ginger tea: Two to three cloves of garlic (Allium sativum)
and two to three slices of fresh ginger (Zingiber officinale). Steep 5
to 15 minutes and drink, breathing in the steam. Stimulates
immune system and drainage.
O Slippery elm (Ulmus fulva): Soothes irritated tissues and promotes
healing. Use as lozenge or tea.
O Tincture of two parts cornflower (Echinacea purpurea), two parts
goldenseal (Hydrastis canadensis), and one part propolis should be
taken every three to four hours. Place 30 drops in 1/4 cup water.
Gargle and swallow.
A combination of all of the above herbs, equal parts, may be very effective.
1 cup tea or 30 to 60 drops tincture every two to four hours.
Hydrotherapy:
Steam inhalation: Mix 2 drops of eucalyptus oil or ½ tsp of turmeric in

steam water and inhale steam for 10 minutes - daily 3 to 4 times and
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particularly when congested to promote drainage of mucus. Eucalyptus

(Eucalyptus globus), lavender (Lavandula angustifolia), and thyme (Thymus
vulgaris) are specific for upper respiratory infections. Lavender and rosemary
(Rosmarinus officinalis) are also very calming.
NUTRITION THERAPY

O Zinc (30 mg per day or lozenges) boosts the immune system and
relieves soreness.
O Vitamin C (250 to 500 mg two times per day) is needed for proper
immune function and to strengthen mucous membranes.
O Beta-carotene (50,000 to 100,000 IU per day) may help restore
the integrity of mucous membranes and supports immune function.
P reventive and Lifestyle

Pharyngitis that stems from a viral cause has no specific treatment beyond
bed rest and simple forms of self-treatment, such as gargling and aspirin.
Avoid any irritants that might affect your throat, such as smoke from
cigarettes, cigars, or pipes, and cold air. Avoid drinking alcohol. Gargling
several times a day with a ½ tsp. of salt in a glass of warm water will also
help reduce your discomfort, as will throat lozenges.
BRONCHIAL ASTHMA
BRONCHIAL
Asthma is an inflammatory disorder of the airways, characterized by periodic
attacks of wheezing, shortness of breath, chest tightness, and coughing.
The word asthma comes from the Greek word for “panting.” The panting
and wheezing sound characteristic of asthma occur because of the restricted
flow of air.

Asthma is a disease in which inflammation of the airways causes airflow
into and out of the lungs to be restricted. When an asthma attack occurs,
the muscles of the bronchial tree become tight and the lining of the air
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passages swells, reducing airflow and producing the characteristic wheezing

sound. Mucus production is increased.
Most people with asthma have periodic wheezing attacks separated by
symptom-free periods. Some asthmatics have chronic shortness of breath
with episodes of increased shortness of breath. Other asthmatics may have
cough as their predominant symptom. Asthma attacks can last minutes to
days, and can become dangerous if the airflow becomes severely restricted.
In sensitive individuals, asthma symptoms can be triggered by inhaled
allergens (allergy triggers), such as pet dander, dust mites, cockroach
allergens, molds, or pollens. Asthma symptoms can also be triggered by
respiratory infections, exercise, cold air, tobacco smoke and other pollutants,
stress, food, or drug allergies. Aspirin and other non-steroidal anti-
inflammatory medications (NSAIDS) provoke asthma in some patients.
Symptoms
O Wheezing which usually begins suddenly and is episodic. It may
be worse at night or in early morning, aggravated by exposure to
cold air, by exercise, by heartburn (reflux). It resolves spontaneously
and relieved by bronchodilators (drugs that open the airways)
O Cough with or without sputum (phlegm) production
O Shortness of breath that is aggravated by exercise
O Breathing that requires increased work
O Intercostal retractions (pulling of the skin between the ribs when
breathing).
Emergency symptoms:
O Extreme difficulty breathing
O Bluish color to the lips and face
O Severe anxiety due to shortness of breath
O Rapid pulse, sweating
O Decreased level of consciousness (severe drowsiness or confusion)
during an asthma attack
O Chest pain, tightness in the chest
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O Abnormal breathing pattern, in which exhalation (breathing out)

takes more than twice as long as inspiration (breathing in).
Signs and tests

Listening to the chest (auscultation) during an episode reveals wheezing.
However, lung sounds are usually normal between episodes.
Tests may include:
O Pulmonary function tests
O Peak flow measurements
O Chest X-ray
O Allergy testing by skin testing or serum tests
O Arterial blood gas
O Eosinophil (a type of white blood cell) count.
Treatment
Treatment is aimed at avoiding known allergens and respiratory irritants
and controlling symptoms and airway inflammation through medication.
Allergens can sometimes be identified by noting which substances cause
an allergic reaction.
MODERN MEDICINE
There are two basic kinds of medication for the treatment of asthma:
1. Long-term control medications — used on a regular basis to prevent
attacks, not for treatment during an attack
O Inhaled steroids prevent inflammation
O Leukotriene inhibitors
O Long-acting bronchodilators like salbutamol to help open airways.
O Cromolyn sodium or nedocromil sodium
O Combination of anti-inflammatory and bronchodilator, using either
separate inhalers or a single inhaler
O Anti-IgE therapy, a new injection treatment used in patients with
more severe asthma.
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2. Quick relief (rescue) medications — used to relieve symptoms during

an attack.
O Short-acting bronchodilators
O Oral or intravenous corticosteroids (prednisone, methylpred
nisolone) stabilize severe episodes.
A severe asthma attack requires a medical evaluation and may require
hospitalization, oxygen, and intravenous medications.
AYURVEDA
Panchakarma especially ‘Vaman’ (therapeutic vomiting) is a best long term

treatment for asthma. Before Vamana, certain medicated ghees are advised
for ingestion. Usually ghee like vasa ghrita, kantkari ghrita, bharngyadi ghrita,
yashtimadhu ghrita etc. is used. These are administered in an increasing
dosage schedule for not more than 7 days; after this vaman is done.
In acute stage, lukewarm mahanarayan taila mixed with saindhav salt is
used for gentle chest massage, which is followed by fomentation by vapours
of dashmoola decoction. It is a very effective remedy for reliving
bronchospasm. Sweating by means of dry valuka pottali, or hot water bag
is also useful in acute cases.
In an acute attack of asthma, massaging of chest with sesame oil and salt is
employed. This liquefies the mucus and helps in the expectoration of mucus.
Also, hot fomentation should be given which partially relives bronchospasm.
Once the attack subsides, the regimen of emesis (Vaman) may be employed
in physically fit individuals after thorough evaluation of his/her temperament
and endurance for long term benefits. This is carried out by first employing
preparatory procedures, and proper diet control of emesis, decoction of
liquorice powder is useful along with mixture of powder of emetic nut and
honey.
Since Pitta Dosha also gets vitiated in bronchial asthma or Tamak Shwasa,
purgation is advised to expel the alimentary metabolites /toxins, if any in
the periods of remmision. For this, powder of Indian Jalap I Operculina
terpathum is used.
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Emesis and purgation together expel the vitiated Doshas from the channels,
remove the blockage, clear the air passage and detoxify the whole body
system.
For acute cases, smoking of specially designed cigars (made from medicinal
herbs) is advised. For this, turmeric, long pepper, dried bark of deodara
tree, root of spike nut and purified mineral ores / compounds are used.
Nasal medicines are also given to patients of asthma.
O Decoction of Dashmool group (roots of the herbs), is given in the
dose of 30 ml thrice daily.
Following are some of the drugs used for asthma:

O Powder of incinerated and purified animal horns (such as deer horn)
along with the powder of long pepper, sugar, cinnamon bark,
cardamom powder and bamboosa manna known as Sitopaladi churna
is given in the dose of 1 gm thrice daily
O Powder made from Jaggery, black pepper, turmeric, Pluchea
lanceolata, long pepper; raisins should be mixed in oil and taken in
the dose of 500 mg. thrice daily
O Roots of Bharangi (Clerodendron serratum) and ginger powder
should be mixed in juice of fresh ginger and taken in the dose of 5
gms twice daily
O Decoction of leaves of Vasaka, turmeric, corainder seeds, bark of
Tinospora cordifolia, long pepper, black pepper and nut grass should
be taken in the dose of 30 ml thrice daily
O Lakshmivilas ras, 1 tab thrice a day with water
O Sitophaladi Churnam or Talisadi Churnam 3 gm thrice a day with honey
O Kanakasava 5-10 ml with water thrice a day (useful in productive cough)
O Vasarishtam 15-30 ml thrice a day after meals (useful in dry cough)
O Agasthyaharitaki rasayanam 12-24 gm twice a day (asthma with cough)
O Chyavanaprasha lehyam 12-24 gm twice a day
O Dashamoolaishta 10-20 ml + Malla sindooram + Abhrakabhasmam
(1 part) + Sitophaladi Churnam ( 4 part) + Lavangadi vati (4 part)
1 gm with honey 4-5 times.
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ACUPUNCTURE
Acupuncture has shown potential as an effective treatment for asthma.
One study found that acupuncture improved the immune response of
people taking anti-asthma medication compared to those who did not
receive acupuncture.
Acupuncture points like Feishu (B13), Zhongfu (L1), Danzhong (Ren
17), Tiantu (Ren 22), Dingchuan (Ex 41) are used for treating asthma.
Acute attack
attack: Insert a needle at the point Tiantu (Ren 22). This gives the
best relief in an acute attack. However, please note that this is one of the
dangerous points and care must be taken to make the insertion precisely.
It is not advisable to stimulate this point. Usually, relief is obtained within
five to ten minutes of the insertion.
In some cases it may not be easy to use Tiantu (Ren 22) during an acute
attack. A good alternative is the stimulation of the point Danzhong (Ren
17) or the XI-Cleft point Kongzul (Lu.66). In intractable cases, Yanglao
(S.I. 6) may be added. Good results may also be obtained by the stimulation
of Fuliu (K. 7).
Treatment betw een attacks: It is best to commence treatment with a small
between
group of points chosen on the basic principle of combining Local and
Distal points.
O Baihui (Du 20)
O Local points: Shanzhong (Ren 17)
O Specific points for soothing asthma: Dingchuan (Ex. 17)
O Distal point: Lieque (Lu. 7).
HOMEOPATHY
The most commonly used medications for Asthma and their indications are
Arsenicum album for asthma that generally worsens between midnight
and 2 am and is accompanied by restlessness, anxiety, chills, and thirst.
Ipecacuanha for those with asthma, particularly children, who have
significant tightness in the chest, a chronic cough with lots of phlegm that
may lead to vomiting, and worsening of symptoms in hot, humid weather.
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Pulsatilla for asthma with yellow or greenish phlegm that gets worse in the
evening, in warm, stuffy rooms, or after consuming rich, fatty foods.
Sambucus for asthma that awakens a person at night with a sensation of
suffocation; symptoms worsen when the person is lying down.
Hepar sulph Asthmatic attacks where the patient feels relieved by bending
head back and sitting and also useful in attacks aggravated by exposure to
cold drafts of air.
NATUROPATHY
Detoxification by fasting, Yogic kriyas (dhauti, Shanka-Prakshalana) and
Panchakarma (Vamana) helps to heal the asthma.
Fasting with carrot juice and herbal teas for a week or two can help to
detoxify the body. People who can’t fast should follow carrot mono diet for
2 to 3 weeks. In this diet, the patient takes only carrots as food either raw,
boiled or in juice form. They can add onions and garlic to this diet.
People who have excess mucous should follow mucus-cleansing diet for 3
to 7 days. In this diet a person takes a large plate of steamed onions at
lunch and supper, and carrot juice or grapefruits in between.
An allergy-free vegetarian diet, with more emphasis on vegetables, spices
and herbs like garlic, ginger, and onions, is good for asthma. All allergic
foods, food additives and animal foods should be avoided. Animal protein
and fats tends to be inflammatory and allergic. Avoid cow milk; instead
goat milk can be used. Diet should be of moderately low fat, low sugar,
and high complex carbohydrates.
Following are some of the herbs used to treat asthma:
O Thyme (Thymus vulgaris) breaks up mucus secretions in the bronchi
O Garlic (Allium sativum) and Onion (Allium cepa) are good mucus
solvents. Blend Garlic and honey and take 1tsp thrice a day
O Liquorice (Glycyrrhiza glabra) and dry Ginger (Zingiber officinale)
– take each 5 grams powder and make a decoction – 2 times a day
O Vasaka (Adhatoda vasica) – dried leaves powder 2 grams per day
with honey
O Holy Basil (Ocimum sanctum) decoction twice a day
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O Amla (Emblica officinalis) – powder 1tsp twice a day

O Herbal teas like chamomile, mint, green tea – in the morning and
2 to 3 times a day.
Hydrotherapy
Acute asthma:
O Steam inhalation with a few drops of eucalyptus oil in the water
helps to liquefy the mucus and dilate the bronchi
O Hot chest pack with hot foot bath
O Hot fomentation to thoracic spine.
Chronic asthma:
O Steam and Sauna baths
O Hot epsom salt immersion baths
O Hot chest packs daily at bedtime
O Cold water treading daily once strengthens the body and prevents
asthma.
YOGA THERAPY
Several studies of people with asthma have suggested that in addition to
general relaxation and reduction of stress, lung function and exercise capacity
may improve with the regular practice of yoga and that, eventually, the
amount of medication taken may be reduced.
Yogasanas help to correct distorted posture, and decrease the airflow
obstruction. Yoga kriyas like Jalanethi, Dhanda dhauti, Vamana dhauti,
Gaja karni, reduce the mucus secretion, and eosinophil count.
Yogasanas like Suryanamskara, Bhujangasana, Shalabhasana, Sarvangasana,
Halasana, Paschimottanasana, Dhanurasana, Chakrasana, Sarvangasana,
Viparita karani, etc. will improve respiratory health.
Pranayama (Nadi shuddhi, Surya bheda, Ujjayi), and breathing exercises
are helpful for asthmatics, because they increase the vital capacity, strengthen
respiratory muscles and eliminate inefficient use of accessory muscles of
respiration (such as abdominal or neck muscles). Asthmatics should practice
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abdominal breathing for proper ventilation of the lower zones of lungs,

which are under-utilized in asthma.
Meditation, relaxation, and visualizations reduce stress and helps in
preventing asthma attacks.
NUTRITION THERAPY
Eliminate all food allergens from your diet. Common food allergens are
dairy, soy, citrus, peanuts, tree nuts, wheat, fish, shellfish, eggs, corn, food
colorings, and additives. An elimination trial may help determine food
sensitivities. Remove suspected allergens from your diet for 2 weeks. Re-
introduce one food every 3 days. Watch for reactions such as gastrointestinal
upset, mood changes, headaches, and worsening of asthma.
Reduce pro-inflammatory foods in your diet such as saturated fats (meats,
especially poultry, and dairy), refined foods, and sugar. Increase intake of
vegetables, grains, legumes, onions, and garlic.
O Vitamin C (250 to 500 mg two times per day) taken one hour
before exposure to an allergen may reduce allergic reactions.
O B6 (50 to 200 mg per day) may improve symptoms. Pyridoxal-5-
phosphate (P5P), a form of B6, may be more readily used by body.
O Magnesium (200 mg two to three times per day) relaxes
bronchioles.
O N-acetylcysteine (50 to 200 mg three times per day) and selenium
(50 to 200 mcg per day) protect lung tissue from damage.
PSYCHOTHERAPY
Asthma can be made worse by stress, anxiety, and depression.
Psychologically, asthma is thought to be a manifestation of anxiety and
fear. In children, asthma may be due to repression of the feelings of longing
for more affection, and fear of losing the mother. Some of the personality
traits of the chronic asthmatic are anxiety, introversion, marked egocentricity,
impatience, domineering attitude, more need for love, and jealousy.
Relaxation and Cognitive therapy helps to reduce the anxiety and fear and
helps in preventing asthma attacks.
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PHYSICAL AND EXERCISE THERAPY

A few studies of small numbers of children and adults with asthma have
suggested that massage therapy may reduce anxiety associated with asthma,
improve symptoms, and even improve lung function and relieve aching
muscles of the back.
Mild aerobic exercises, such as swimming, skipping, and walking are best
for asthmatics. People who are prone to exercise-induced asthma should
avoid vigorous exercises.
However, in case you are not prone to exercise induced asthma, there are
numerous examples of individuals who have greatly benefitted from active
exercises such as swimming and running inspite of being asthmatic and
have reported great benefits. The conclusing is that mild exercise is good
for all asthmatic cases and that competative exercise is for those who are
not prone to Exercise Induced Asthma (EIA). However, as a caution, all
asthmatics should carry their inhalers.
Pursed lip breathing exercises should be practiced regularly to increase the
vital capacity and the pattern of breathing.
Prevention
Asthma symptoms can be substantially reduced by avoiding known
allergens and respiratory irritants. If someone with asthma is sensitive to
dust mites, exposure can be reduced by encasing mattresses and pillows in
allergen-impermeable covers, removing carpets from bedrooms, and by
vacuuming regularly. Exposure to dust mites and mold can be reduced by
lowering indoor humidity.
If a person is allergic to an animal that cannot be removed from the home,
the animal should be kept out of the patient’s bedroom. Filtering material
can be placed over the heating outlets to trap animal dander. Exposure to
cigarette smoke, air pollution, industrial dusts, and irritating fumes should
also be avoided.
Allergy desensitization may be helpful in reducing asthma symptoms and
medication use, but the size of the benefit compared with other treatments
is not known.
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According to certain studies on adults, apples and selenium-rich food in

the diet may protect against asthma, and moderate consumption of red
wine may be associated with less severe asthma attacks. These foods are
high in antioxidants (namely, flavonoids).
Lifestyle
O Quit smoking
O Lose weight if you are overweight and already have asthma. Excess
weight may put pressure on the lungs and trigger an inflammatory
response.
O Do mild aerobic type exercise like walking daily for 20 to 30
minutes
O Monitor your asthma every day using a peak flow monitor (a
portable device for measuring the highest exhalation flow, which is
an indicator of lung volume). Peak flow measurements can help
show when medication is needed, or other action needs to be taken.
Peak flow values of 50-80% of an individual’s personal best indicate
a moderate asthma attack, while values below 50% indicate a severe
attack.
O Keep a diary of respiratory complaints – this may help determine
triggers.
BRONCHITIS
BRONCHITIS
Bronchitis is a respiratory tract infection (viral or bacterial) that causes
inflammation of the mucous lining of the bronchial tubes. Acute bronchitis
generally is reversible. Chronic bronchitis, often referred to as smoker’s
cough, is not usually reversible. To be classified as chronic, a person must
have a cough with mucus most days of the month for three months out of
the year.

Acute bronchitis generally follows a viral respiratory infection. Initially, it
affects nose, sinuses, and throat and then spreads to the large bronchial
airway passages. Sometimes, it may cause a secondary bacterial infection.
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People at risk for acute bronchitis include:

O Infants, young children and elderly
O Smokers
O People with heart or lung disease.
Chronic bronchitis is a long-term condition of excessive mucus with a
productive cough. This ongoing condition causes inflammation but is not
infectious. It blocks air flow in and out of the lungs.
Chronic bronchitis, like emphysema, is also known as chronic obstructive
pulmonary disease. As these lung conditions progress over time, you become
increasingly short of breath, have difficulty walking or exerting yourself
physically, and may need oxygen on a regular basis. Cigarette smoke,
including long-term exposure to second-hand smoke, is the chief cause of
chronic bronchitis.
Factors that make it worse include air pollution, dust, certain occupations
(like coal mining, textile manufacturing, or grain handling), infection, and
allergies.
Symptoms
The symptoms of either type of bronchitis include:
O Cough that produces mucus; if yellow-green in color, you are more
likely to have a bacterial infection
O Shortness of breath worsened by exertion or mild activity
O Wheezing
O Fatigue
O Fever, usually low
O Chest discomfort.
Additional symptoms of chronic bronchitis include:
O Frequent respiratory infections (such as colds or the flu)
O Swelling of ankle, feet, and legs
O Blue-tinged lips from low levels of oxygen
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Signs and tests

O Rales (abnormal sounds in the lungs) or other abnormal breathing
sounds may be heard on lung examination with a stethoscope
O Pulmonary (lung) function tests provide information useful for
diagnosis and prognosis
O Pulse oximetry is a device connected to patient finger that tells the
amount of oxygen in patient’s blood
O Arterial blood gas is a more exact (but more painful and invasive)
measurement of oxygen and carbon dioxide levels
O Chest x-ray
O Sputum samples to check for evidence of inflammation or bacterial
infection may be taken.
Treatment
Acute bronchitis from a virus does not need antibiotics. The infection will
generally clear on its own within one week. Acute and chronic bronchitis
due to bacterial or other reasons will need medicines as follows.
MODERN MEDICINE
O Bronchodilators (such as albuterol)
O Corticosteroids (20 to 40 mg/day of prednisone or 100 to 200
mcg, 2 to 4 puffs/day of inhaled beclomethasone) to reduce mucus
and inflammation.
Cough suppressants.
O Expectorant medication (10 to 12 drops 3 times daily of potassium
iodide) or tracheal suction
O Antibiotics for bacterial infection (250 to 500 mg of penicillin or
tetracycline every 6 hours for 10 days) in complicated cases
O Oxygen for hypoxia (a lower-than-normal concentration of oxygen
in the blood): More than 12 hours/day is required for the treatment
to be effective.
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AYURVEDA
Panchakarma especially ‘Vaman’ (therapeutic vomiting) is a best treatment

for bronchitis. Before Vamana, certain medicated ghee is advised for
ingestion. Usually ghee like vasa ghrita, kantkari ghrita, bharngyadi ghrita,
yashtimadhu ghrita etc is used. These are administered in an increasing
dosage schedule for not more than 7 days, after this therapeutic vomiting
is done.
Following are some of the ayurved drugs used for bronchitis:
O Mahalakshmivilas ras, 1 tab thrice a day with water
O Sitophaladi Churnam or Talisadi Churnam 3 gm thrice a day with honey
O Kanakasava 5-10 ml with water thrice a day (useful in productive cough)
O Agarthyaharitaki rasayanam 12-24 gm twice a day
O Chyavanaprasha lehyam 12-24 gm twice a day
O Vasa Lehyam 2 tsp twice a day.
ACUPUNCTURE
Following acupoints are used in treating bronchitis: Feishu (B13), Zhongfu

(L1), Danzhong (ren 17), Tiantu (Ren 22), Dingchuan (Ex 41).
HOMEOPATHY
Aconitum for early stages of bronchitis; this remedy is most appropriate

for people with a hoarse, dry cough who complain of dry mouth, thirst,
restlessness, and being awakened by coughing; symptoms tend to worsen
in cold air or when when lying on one’s side.
Antimonium tartaricum for wet, rattling cough (although the cough is
usually too weak to bring up mucus material from the lungs) that is
accompanied by extreme fatigue and difficulty breathing; symptoms usually
worsen when the person is lying on his or her back.
Br yonia for dry, painful cough that tends to worsen with movement and
deep inhalation; this remedy is most appropriate for individuals who are
generally thirsty, chilly, and irritable.
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Hepar sulphuricum for later stages of bronchitis, accompanied by wheezing,

scant mucus production, and coughing that occurs when any part of the
body gets cold.
Ipecacuanha for the earliest stages of bronchitis accompanied by a deep, wet
cough, nausea and vomiting; this remedy is commonly prescribed for infants.
P hosphor us for several different types of cough but usually a dry, harsh cough
hosphorus
accompanied by a persistent tickle in the chest and significant chest pain.
NATUROPATHY
to 7 days. In this diet, take oranges or grapefruit for breakfast, and a lot of
steamed onions for lunch and supper, and herbal teas or carrot juice or
citrus juices in between.
Initially, follow carrot mono diet for 2 to 3 weeks. In this diet, take only
carrots as food either raw, boiled or in juice form. You can add citrus fruits
or juices, onions and garlic to this diet. Drink plenty of warm water, herbal
teas daily to liquefy and drain the mucous. Otherwise all fruit diet is
recommended for 4-5 days and then followed by diet of raw salads,
vegetables, and sweet fruit for 10-14 days.
Following are some of the herbs used to treat bronchitis:
O Garlic (Allium sativum) and Onion (Allium cepa) are good mucus
solvents. Blend Garlic and honey and take 1tsp thrice a day
O Liquorice (Glycyrrhiza glabra) and Ginger (Zingiber officinale) –
take each 5 grams powder and make a decoction – 2 times a day
O Vasaka (Adhatoda vasica) – dried leaves powder 2 grams per day
with honey
O Basil leaves juice 2 tsp with honey.
Hydrotherapy
Steam inhalation with a few drops of eucalyptus oil in the water helps to
liquefy the mucus and dilate the bronchi.
Hot fomentation to thoracic spine.
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YOGA THERAPY
Yoga kriyas like Jalanethi, Dhanda dhauti, Vamana dhauti, Gaja karni,
reduce the mucus secretion, and eosinophil count.
Yogasanas like Sarvangasana, Halasana, Viparita karani, etc. will drain the
mucous.
Pranayama (Nadi shuddhi, Surya bheda, Ujjayi), and deep breathing
exercises increase the vital capacity, and strengthen respiratory muscles.
NUTRITION THERAPY
Eliminate known allergenic foods (for example, eggs, milk, nuts, peanuts,
soy), food coloring, preservatives, and additives. Reduce intake of mucus-
producing foods such as dairy, citrus, wheat, and bananas. Onions and
garlic help to thin mucus.
Vitamin C (250 to 500 mg two times per day), zinc (30 mg per day), and
beta-carotene (50,000 to 100,000 IU per day) support the immune system.
Physical Medicine
O Hot moist pack: Apply a clean hot moist soft cloth (such as flannel)
and plastic wrap. Place a heat source (hot water bottle or heating
pad) over the pack and let sit for 30 to 60 minutes. For best results,
use for three consecutive days.
O Chest rubs with 3 to 6 drops of essential oil in 1 tbsp of food-
grade oil. Thyme, eucalyptus, and pine oils can ease bronchial
spasm and thin mucus.
O Humidifier with essential oils such as eucalyptus, tea tree, or
marjoram at night may help thin mucus and ease cough.
O Postural drainage can be of great help in relieving chest congestion.
Prevention
O Wash your hands (and your children’s hands) frequently to avoid
spreading viruses and other infections
O Do not smoke, or inhale side stream smoke
O Minimize exposure to air and other pollutants.
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PULMONARY TUBER
PULMONARY CUL
TUBERCULOSIS
CULOSIS
Pulmonary tuberculosis is a contagious bacterial infection caused by
Mycobacterium tuberculosis (TB). The lungs are primarily involved, but
the infection can spread to other organs.

Tuberculosis can develop after inhaling droplets sprayed into the air from
a cough or sneeze by someone infected with Mycobacterium tuberculosis.
Two other bacteria cause TB. They are M. bovis and M. africanum. M. bovis
is transmitted by milk from infected cows.
The disease is characterized by the development of granulomas (granular
tumors) in the infected tissues. The usual site of the disease is the lungs,
but other organs may be involved. The primary stage of the infection is
usually asymptomatic.
Pulmonary TB develops in the minority of people whose immune systems
do not successfully contain the primary infection. The disease may occur
within weeks after the primary infection, or it may lie dormant for years
before causing disease.
Infants, the elderly, and individuals who are immunocompromised (for
example, those with AIDS, those undergoing chemotherapy, or transplant
recipients taking antirejection medications) are at higher risk for progression
to disease or reactivation of dormant disease. In pulmonary TB, the extent
of the disease can vary from minimal to massive involvement, but without
effective therapy, the disease becomes progressive.
The risk of contracting TB increases with the frequency of contact with
people who have the disease, and with crowded or unsanitary living
conditions and poor nutrition. An increased incidence of TB has been seen
recently in the United States. Factors that may contribute to the increase
in tuberculous infection are:
O Increase in HIV infection
O Increasing number of homeless individuals (poor environment and
poor nutrition)
119
O The appearance of drug-resistant strains of TB.

Incomplete treatment of TB infections (such as failure to take medications
for the prescribed length of time) can contribute to the emergence of drug-
resistant strains of bacteria.
Individuals with damaged immune systems from AIDS have a higher risk
of developing active tuberculosis — either from new exposure to TB or
reactivation of dormant mycobacteria. In addition, without the aid of an
active immune system, treatment is more difficult and the disease is more
resistant to therapy.
Symptoms
Usually there is a time delay between infection and the development of
full-blown TB. Many who are infected with TB never develop the disease.
In some people, it is possible for the TB bacteria to remain inactive for a
lifetime without ever causing disease. Symptoms include:
O Initially minor cough and mild fever
O Fatigue
O Weight loss
O Coughing up blood
O Fever and night sweats
O Cough producing phlegm.
Additional symptoms that may be associated with this disease:
O Wheezing
O Sweating, excessive
O Chest pain
O Breathing difficulty.
Signs and tests
Examination of the lungs by stethoscope (auscultation) can reveal crackles.
Enlarged or tender lymph nodes may be present in the neck or other areas.
Fluid may be detectable around a lung (pleural effusion). Clubbing of the
fingers or toes may be present.
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Tests often include:

O Chest X-ray
O Sputum cultures
O Tuberculin skin test
O Bronchoscopy
O Thoracentesis
O Chest CT
O Rarely, biopsy of the affected tissue (typically lungs, pleura, or
lymph nodes) is required.
Treatment
MODERN MEDICINE
The goal of treatment is to cure the infection with antitubercular drugs.
Daily oral doses of multiple drugs that may include combinations of
rifampin, isoniazid, pyrazinamide, ethambutol, or occasionally others, are
continued until culture results showing the drug sensitivity of the
mycobacterial infection help to guide the selection of drugs.
There are two regimens of antitubercoulosis therapy: Nine months regimen
and 12 months regimen. Treatment is typically continued for 9 months,
but longer courses may be required for AIDS patients or those whose disease
responds slowly. For atypical tuberculosis infections, or drug-resistant
strains, other drugs and different durations of therapy may be indicated to
treat the infection.
Nine-month regimen:
O 2 months of Ethambutol or Streptomycin + Isoniazid + Rifampicin
O 7 months of Rifampicin + Isoniazid.
Twelve-month regimen:
O Daily Isoniazid + Thiacetazone
O Weekly twice Streptomycin + isoniazid + Pyrazinamide
O Pyridoxine 10 mg daily orally should be supplemented with
isoniazid.
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AYURVEDA
Ayurveda recommends Vasa (Adhatoda vasica) for tuberculosis. One ounce
of the juice from the leaves of the drug given thrice in the day with honey
provides relief. But the drug of choice is Naradiya Mahalakshmi Vilasa
Rasa which contains traces of gold. It should be administered in three
doses of three grains each in the day. Swarna Vasant Malati is the drug in
cases where there is excessive fever, sweating and burning sensation on the
palms of the hands and the soles of the feet. Rudanti (cressa crestca) given in
2 gm doses twice daily reduces the virulence of the disease.
Mainly the medicated ghritas are used for the purpose of increasing weight
and curing the disease. These include ghrita cooked with Asparagus
racemosus or Adhatoda vasica should be given in the dose of 2 grns. thrice
daily, to cure haemoptysis and cough. Paste of dates and resins should be
mixed in ghrita along with long pepper powder, honey and sugar and should
be given in the dose of 5 gms daily.
Powder of bamboosa manna, cardamom, cinnamon bark, sugar and long

pepper known as Sitopaladi churna should be given along with 1 gm of
liquorice powder in the dose of 1 gm thrice daily to reduce cough and
expectoration.
Powder of three myrobalans, long pepper, nut grass, jaggery and sugar should
be mixed in honey and ghrita and given in the dose of 5 gm. twice daily.
Decoction of coriander seeds, ginger, long pepper along with Dashmool

(roots of ten herbs) should be taken in the dose of 15 ml. thrice daily.
Powder of cardamom, cinnamon bark pieces, clove buds, liquorice, resins,

dates, long pepper and mesua should be taken in the dose of 1 gm thrice
daily along with honey.
Drakshasava should be administered in 15 – 20ml doses after meals. It
should be mixed with an equal quantity of water. Chyavanprasha Avaleha is
another wonderful remedy to give strength and sustenance to the patient.
The dosage in the beginning should be two spoonfuls with milk on an
empty stomach twice daily, but as the patient gains strength, it should be
increased. Long pepper powdered can be given in 1 – 2 grams twice daily.
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Garlic is another wonderful drug in the cure of TB. 5-8 pods of garlic
boiled in about 200ml of milk and reduced to 50 – 75 ml. It has to be
consumed immediately after preparation.
Ayurveda recommends Vasa for tuberculosis. One ounce of the juice from
the leaves of the Vasa (Adhatoda vasica) given thrice in the day with honey
provides relief.
Readily available preparations like dashmoolarishta, ashwagandhadi churna,
chyavanprashavaleha, pippalyasav etc. can be taken after consulting a
physician.
Garlic is another wonderful drug in the cure of TB. Thirty grains of garlic
boiled in about eight ounce of milk and two pounds of water should be
administered in two doses in the day. But the medicine is ready only when
the whole decoction has been reduced to one fourth of its original quantity.
Drakshasava should be administered in one-ounce doses after meals. It
should be mixed with an equal quantity of water. Chyavanprasha Avaleha is
another wonderful remedy to give strength and sustenance to the patient.
The dosage in the beginning should be two spoonfuls with milk on an
empty stomach twice daily, but as the patient gains strength, it should be
increased. Long pepper in powdered from should be given in one
teaspoonful doses twice daily.
In the initial stages of the disease, when there is dry cough, fever in the
night and weakness, the following medicines should be given : Suvarna
Vasanta - 250 mg, Malati Rasa, Praval Pishti - 500 mg, Amrita Satva - 250
mg. It should be administered with amla, thrice daily.
In cases of high temperatures of tuberculosis, the following drugs will be
helpful:
O Muktapanchamrita - 120 mg, Panchanana Rasa - 120 mg,
Amritasatva - 240 mg. This should be taken morning and
evening with honey.
O Chandramitra - 1 gm and Sitopaladi - 12 gm, to be mixed with
honey and to be used as linctus.
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HOMEOPATHY
Following drugs are used in the treatment of tuberculosis.
Arsenicum album for cough and chest pain, particularly from infectious
causes; symptoms worsen at night and are often accompanied by fever,
chills, weakness, exhaustion, and restlessness.
Calcarea carbonica for chills, drowsiness, perspiration (especially at night),
and swollen lymph nodes.
NATUROPATHY
Naturopathy advises following herbs to be used along with Modern
medicine in treating tuberculosis:
O Garlic (Allium sativum): A recent animal study indicated that garlic
oil inhibited M. tuberculosis, reducing TB lesions. A combination
of garlic extracts or garlic oil with anti-TB drugs may eventually
prove effective against the disease.
Other herbs that may be helpful include:
O Echinacea (Echinacea spp.)
O Tamarisk (Tinospora cordifolia)
O Elecampane (Inula helenium)—used traditionally by native
American Indians for lung disorders, including TB.
O Sweet coneflower (Rudbeckia subtomentosa)—test tube studies
suggest that active components of this herb inhibit the growth of
M. tuberculosis.
YOGA THERAPY
Yoga therapy helps to improve the general health in tuberculosis. It also
increases appetite, weight and immunity of the patient. Patients with
hemoptysis should avoid pranayama.
O Asanas:
o Surya namaskaram – 10 rounds
o Sitting poses like Padmasana, Vajrasana, Konasana, Siddhasana
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o Forward bending yoga asanas like Shashankasana,

o Backward bend poses like Bhujangasana, Shalabhasana,
o Meditative asanas like Padmasana, Vajrasana, Siddhasana,
Konasana
o Relaxative asanas like Shavasana, and Makarasana
Bhramari
NUTRITION THERAPY
During the acute stage of illness when fever is high, high protein, high
energy, and full fluid diet are given. As improvement occurs, this diet is
progressed to a soft and then a regular diet.
Most patients have a poor appetite. Meals should be made simple, easily
digestible, well prepared and tempting to encourage the patient to eat and
he should be administered a 6 meal pattern.
Force-feeding the patient to gain extra weight is known to be more harmful
than advantageous. Too much food especially fat frequently causes gastric
upsets and diarrhoea.
All meals should have cereal - pulse combination with some amount of
animal protein. Sources of vitamin C, such as guava, amla, sprouted pulses
must be given. Seasonal vegetables must be amply provided.
Patients at risk for vitamin deficiency (malnourished, alcoholics, elderly,
pregnant and nursing mothers) or for nerve degeneration (those with
diabetes, HIV, or chronic kidney failure) may need vitamin B6.
In addition, recent studies have suggested that a diet lacking in certain nutrients
may be linked to abnormalities in immune function, resulting in a poor response
to TB and to the BCG vaccine, especially among the elderly, children, alcoholics,
the homeless, and HIV-infected individuals. These nutrients include-Protein,
Zinc, Vitamin B12, Vitamin C and Vitamin D.
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PHYSIOTHERAPY
Physiotherapy in the form of postural drainage may be necessary to drain
the mucous from the bronchi. A graded program of exercises and Breathing
exercises is advised once the patient is ambulant. Breathing exercises are
contraindicated in the infective stage.
Prevention
TB is a preventable disease, even in those who have been exposed to an
infected person. Skin testing (PPD) is a screening test for TB used in high
risk populations or in those who may have been exposed to TB (such as all
health care workers).
A positive test indicates prior TB exposure and indications for preventive
therapy should be discussed with your doctor. Individuals exposed to
tuberculosis should be skin tested immediately and the skin test repeated
at a later date, if the initial test is negative.
Prompt treatment is extremely important in controlling the spread of
tuberculosis for those who have already progressed to active TB disease.
A BCG vaccination to prevent TB is given in some countries with a high
incidence of TB, but its effectiveness remains controversial.
EMPHYSEMA
Emphysema is a lung disease that involves damage to the air sacs (alveoli). The
air sacs are unable to completely deflate (hyperinflation) and are therefore unable
to fill with fresh air to ensure adequate oxygen supply to the body.

Cigarette smoking is the most common cause of emphysema. Tobacco smoke
and other pollutants are thought to cause the release of chemicals from within
the lungs that damage the walls of the air sacs. This damage becomes worse
over time, affecting the exchange of oxygen and carbon dioxide in the lungs.
A naturally occurring substance in the lungs called alpha-1 antitrypsin
may protect against this damage. People with alpha-1 antitrypsin deficiency
are at an increased risk for this disease.
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Symptoms
O Shortness of breath
O Chronic cough with or without sputum production
O Wheezing.
Additional symptoms that may be associated with this disease include the
following:
O Anxiety
O Unintentional weight loss
O Ankle, feet, and leg swelling
O Fatigue.
Signs and tests
A physical examination may show decreased breath sounds, wheezing, and/
or prolonged exhalation (exhalation taking more than twice as long as
inspiration). There may be an increased front-to-back diameter of the chest,
resemmbling a barrel shape. There may be signs of chronically insufficient
oxygen levels in the blood.
These tests help confirm the diagnosis:
O Pulmonary function tests
O Chest X-ray.
This disease may also alter the results of the following tests:
O Arterial blood gases showing reduced oxygen
O Pulmonary ventilation/perfusion scan
O Chest CT scan.
Treatment
MODERN MEDICINE
O Alpha1-antitrypsin—this is a protein found in the plasma of blood;
it is depleted when you have emphysema and may need to be
replaced.
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O Bronchodilators—increase airflow and help to make it easier to

breathe
O Corticosteroids—reduce inflammation; taken by inhaler
O Antibiotics—used to treat respiratory infections
O Influenza (flu) vaccines and Pneumovax (pneumonia vaccine).
Low-flow oxygen can be used during exertion, continuously, or at night.
Pulmonary rehabilitation can improve exercise tolerance and quality of life
in the short-term. Lung transplantation is an option for patients with severe
disease.
Carefully selected patients may be eligible for lung reduction surgery. This
procedure removes the damaged portions of the lung, which allows the
normal portions of the lung to expand more fully and take advantage of
increased aeration. When successful, those who undergo the surgery report
improvement in walking distance and quality of life.
AYURVEDA
Panchakarma especially ‘Vaman’ (therapeutic vomiting) is a best treatment
for emphysema. Following are some of the drugs used for emphysema:
O Maha Lakshmivilas Ras, 1 tab thrice a day with water
O Sitopaladi Churnam or Talisadi Churnam 3 gm thrice a day with honey
O Kanakasavam 5-10 ml with water thrice a day (useful in productive
cough)
O Agasthya haritaki rasayanam 12-24 gm twice a day
O Chyavanaprash lehyam 12-24 gm twice a day
O Vasa Lehyam 2 tsp twice a day.
HOMEOPATHY
Antimonium tartaricum for wet, rattling cough (although the cough is
usually too weak to bring up mucus material from the lungs) that is
accompanied by extreme fatigue and difficulty breathing; symptoms usually
worsen when the person is lying on his or her back.
Br yonia for dry, painful cough that tends to worsen with movement and
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deep inhalation; this remedy is most appropriate for individuals who are
generally thirsty, chilly, and irritable.
Hepar sulphuricum for later stages of emphysema, accompanied by
wheezing, scant mucus production, and coughing that occurs when any
part of the body gets cold.
NATUROPATHY
to 7 days. In this diet, take oranges or grapefruit for breakfast, and a lot of
steamed onions for lunch and supper, and herbal teas or carrot juice or
citrus juices in between.
Naturopathy advises following herbs to be used along with Modern
medicine in treating emphysema:
O Mullein (Verbascum thaspis): brings up phlegm, soothes irritation
O Ginger (Zingiber officinalis): dissolves secretions, relieves bronchial
spasms
O Fennel (Foeniculum fructus): dissolves secretions, mild anti-
spasmodic, calming digestive stimulant
O Licorice (Glycyrrhiza glabra): antiviral, soothing, reduces mucus
O Pineapple: Bromelain helps reduce mucus.
YOGA THERAPY
Yoga kriyas like Jalanethi, Dhanda dhauti, Vamana dhauti, Gaja karni,
reduce the mucus secretion.
Yogasanas like Sarvangasana, Halasana, Viparita karani, etc. will drain the
mucous.
Pranayama (Nadi shuddhi, Surya bheda, Ujjayi), and deep breathing
exercises increase the vital capacity, and strengthen respiratory muscles.
NUTRITION THERAPY
O Dairy products and bananas increase mucus buildup and should
be avoided. Garlic, onions, and horseradish may actually decrease
mucus production.
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O Some essential fatty acids- as an anti-inflammatory dose, 1000 to
2000 IU, mixed omega-3 and omega-6 oils (flaxseed, fish, borage,
and evening primrose oil; avoid vegetable oils and saturated fats)
O Coenzyme Q10, makes it easier to exercise without getting short
of breath. Dose is 10 to 50 mg three times a day.
O Other important antioxidants: selenium (200 mcg per day),
vitamin E (400 IU per day), vitamin C (1,000 mg three times per
day), L-carnitine (750 mg twice a day). Note that beta-carotene
may increase the risk of lung cancer in smokers.
O N-acetyl cysteine reduces mucus (400 mg three times a day).
O Magnesium promotes muscle relaxation in your lungs and blood
vessels (100 to 500 mg twice a day). Magnesium may cause
diarrhea if you are sensitive to it.
PHYSICAL THERAPY
pad) over the pack and let sit for 30 to 60 minutes. For best results
use for three consecutive days in one week. When placed over the
lungs, hot packs decrease inflammation and stimulate drainage.
O Postural drainage, yogic breathing, and pulmonary rehabilitation
programs may all be helpful.
Prevention
Avoiding smoking can greatly decrease risk for this disease and once it is
contacted smoking cessation is the most important and effective treatment.
Only quitting smoking of cigarette can stop the progression of lung damage
once it has started.
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3
CARDIOVASCULAR DISEASES
Hypertension
Coronary Heart Disease
Arrhythmias
Varicose veins
Peripheral arterial disease
Congenital diseases of heart
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HYPER
HYPERTENSION
ERTENSION
Hypertension is a silent killer. It is defined as an average systolic blood
pressure above 140 mm Hg, a diastolic blood pressure above 90 mm Hg,
or both. High blood pressure increases the risk of heart disease and stroke.
Pre-hypertension is when systolic blood pressure is between 130 and 139
or diastolic blood pressure is between 85 and 90 on multiple readings.
Blood pressure is determined by the amount of blood pumped by the
heart, and the size and condition of the arteries. Many other factors can
affect blood pressure, including volume of water in the body; salt content
of the body; condition of the kidneys, nervous system, or blood vessels; and
levels of various hormones in the body.
‘‘Essential” hypertension has no identifiable cause. Essential hypertension
comprises over 95% of all high blood pressure. The cause of this form of
hypertension is not known for certain, but is likely a combination of factors,
including:
O Genes
O Low levels of nitric oxide, a naturally occurring agent responsible
for the dilation of blood vessels (African Americans are believed to
have low levels of this substance)
O Insulin resistance
O Obesity
O Smoking
O Stress.
“Secondary” hypertension is high blood pressure caused by another disorder.
This may include:
O Adrenal gland tumors
O Cushing’s syndrome
O Kidney disorders like glomerulonephritis, renal vascular obstruction
or narrowing, renal failure
O Use of medications, drugs, or other chemicals
O Oral contraceptives.
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Cardiovascular Diseases
Symptoms
Usually, no symptoms are present. Occasionally, one may experience a mild
headache. Following are signs of malignant hypertension, a complication
from high blood pressure.
O Tiredness
O Confusion
O Vision changes
O Angina-like chest pain (crushing chest pain)
O Heart failure
O Blood in urine
O Nosebleed
O Irregular heartbeat
O Ear noise or buzzing.
Signs and tests

Hypertension may be suspected when the blood pressure is high at any
single measurement. It is confirmed through blood pressure measurements
that are repeated over time. Blood pressure consistently elevated over 140
systolic or 90 diastolic is called hypertension. Blood pressure is also estimated
both in standing and lying down position for elderly and diabetics.
Systolic blood pressure consistently between 130 and 139 or diastolic blood
pressure consistently between 85 and 89 is called pre-hypertension. This
can be treated by lifestyle changes including weight loss, exercise, and
nutritional changes.
Tests for suspected causes and complications may be performed. These are
guided by the symptoms presented, history, and results of examination.
Treatment
The goal in treating hypertension is to reduce the risk of serious
complications, including heart disease and stroke. While the optimum blood
pressure is 120/80 mm Hg, even partial reduction in blood pressure is
beneficial. Often, in the early stages of hypertension when blood pressure
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elevation is mild, lifestyle modifications alone for a period of 6 to 12 months

should be followed. After this time, if blood pressure is still high, medication
will likely be prescribed.
MODERN MEDICINE
Medications may include diuretics, beta-blockers, calcium channel blockers,

angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor
blockers (ARBs), or alpha blockers. Medications such as hydralazine,
minoxidil, diazoxide, or nitroprusside may be required if the blood pressure
is very high. Statins like simvastatin i.e, a lipid lowering drug are used in
combination with antihypertensives to reduce the risk of heart disease.
AYURVEDA
Following are some of the Ayurvedic herbs used in treating hypertension:

O Snakeroot (Rauwolfia serpentina) : This is the natural source of
reserpine, one of the first commercially available blood pressure
medications. It is used in the form of Sarpagandhadi Vati.
O Arjun (Terminalia arjuna) has been used in Ayurveda for cardiac
ailments since ancient times.
O Jatamansi (Nardostachys jatamansi) reduces stress.
O Garlic is most important substance helpful in alleviating vata
dosha controlling blood pressure.
The following drugs reduce hypertension: 60 mg of Rasaraja, 120 mg of
Pravalapishti Maheshwar, and 750 mg of Rasayana of Sarpagandha should
be taken thrice daily with amla or honey.
In severe hypertension drugs like Brihathvathachintamani ras 120 mg bid,
Triphala guggulu 2 tab bid or Gomutra shilajith 1 gm b.i.d is used.
Dhara therapy is also helpful in hypertension. Oil boiled with Bala (Side
cordifolia) and milk is allowed to drop in small droplets on the forehead of
the patient from a height. The vessel containing it may be suspended from
a hook or from the ceiling. The oil drips on the forehead of the patient
between the eyes. The same oil may be used for purposes of massage of the
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patient’s body, particularly the head. Satavartile Kshirabala Taila may be

given internally in five drop doses with a cup of milk.
ACUPUNCTURE
Acupuncture may be helpful in reducing stress and high blood pressure.

O Baihui (Du.20)
O Quchi (L.I.11)
O Zusanli (St.36)
O Sanyinjiao (Sp.6).
Treat daily or every other day for ten treatments and repeat after an interval
of one week, if necessary.
According to traditional Chinese medicine, symptoms commonly associated
with high blood pressure are related to the Liver and Kidney. If the response
is inadequate after using the above points, one or more of the following
points may be treated:
O Ganshu (U.B.18). Back-Shu point of the Liver
O Shenshu (U.B.23). Back-Shu point of the Kidney
O Taichong (Liv.3). Dangerous point
O Xingjian (Liv. 2)
O Taixi (K. 3).
If the blood pressure is very high, do not used points on the Liver Channel,
especially Taichong (Liv. 3), as an abrupt fall in blood pressure may occur.
HOMEOPATHY
Argentum nitricum: If blood pressure rises with anxiety and nervousness,
this remedy may be indicated. “Stage fright” or anticipation of a stressful
event can bring on dizziness, headache, diarrhea, and a pounding pulse.
Aur um metallicum: This remedy is sometimes indicated for serious people,
urum
focused on career and accomplishment, with blood pressure problems
related to stress. Worry, depression, or anger may occur, especially when
these people feel they have made a mistake or failed in some way.
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Belladonna: This remedy is indicated when symptoms come on suddenly,

with great intensity and heat. The person’s face is flushed, with dilated
pupils, and pulsations and throbbing may be felt in various parts of the
body. Despite the general heat, the person’s hands and feet may be cold.
Vertigo and pounding headaches, worse from jarring and worse from light,
may also occur.
Calcar ea carbonica: This remedy is often helpful to people with high blood
Calcarea
pressure who easily tire and have poor stamina. They are typically responsible
types, who feel overwhelmed when ill and fear a breakdown. Palpitations
and breathing problems can be worse from walking up a slope or stairs, and
also when lying down. A general chilliness with clammy hands and feet
(the feet may heat up in bed at night) and sweat on the head during sleep
are other indications.
Glonoinum: A flushed face with a pounding headache and visible throbbing
in the blood vessels of the neck may indicate a need for this remedy. The
chest can feel congested or hot, with a pounding or irregular heartbeat.
Lachesis: A person who needs this remedy typically is intense and talkative,
with inner passion and agitation that need an outlet—a “pressure-cooker.”
The person may have a strong fear of disease, and feelings of suspicion,
revenge, or jealousy are common. The person may also have heart or artery
problems, look flushed or purplish, and feel constriction in the chest, with
pulsations in many areas. Feeling worse after taking a nap or on waking in
the morning, and a strong intolerance of clothing around the neck (or any
kind of restriction) are other indications for Lachesis.
Natrum muriaticum: A person who needs this remedy seems reserved and
responsible, but may have very strong feelings (of grief, disappointment, anger,
lingering grudges, a fear of misfortune) inside. Headaches and palpitations are
common, as well as a feeling of tension (even coldness) in the chest.
Nux vomica: A person who needs this remedy is usually impatient and
driven—easily frustrated, angered, and offended. A strong desire for coffee
and other stimulants, sweets, strong foods, and alcohol or drugs may aggravate
blood pressure problems. Palpitations, constricting feelings in the chest,
constipation, and hemorrhoids are often seen. The person is typically sensitive
to light, noise, odors, and interference.
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Phosphorus: A person who needs this remedy usually is sensitive, suggestible,

and sympathetic, with a tendency toward weakness, dizziness, a “spaced-
out” feeling, and fearfulness. Nosebleeds, facial flushing, palpitations, and
a feeling of heaviness or pain in the chest, and left-sided problems are often
seen. A strong desire for cold drinks and refreshing things, and a marked
improvement after eating and sleeping are other indications for Phosphorus.
Plumbum: This remedy is indicated for people with degenerative problems
of the nerves and hardening of the arteries. Chest tightness and palpitations
are often worse when lying on the left side. Contractures, paralysis, and
nerve or muscle problems are also likely. The person may have a history of
heavy drinking and “high living”—becoming apathetic or depressed when
physical debility and memory problems develop.
Sanguinaria: A feeling that blood is rushing to the head, with flushed red
cheeks and pulsing in the neck, may indicate this remedy. The person may have
headaches or migraines (usually on the right and worse from light and noise).
Right-sided neck and shoulder problems, allergies, heartburn, and digestive
problems are often seen, and burning pains are typical. Symptoms are worse
from motion, and relief may come from being in the dark and sleeping.
NATUROPATHY
Fasting for 3 to 7 days with tender coconut water, fruit juices, banana stem juice
and buttermilk reduces the excess sodium and water through kidneys. It also
reduces the activity of sympathetic nervous system and reduces blood pressure.
Fasting is useful in obese hypertensives. However, people who have heart disease
and severe hypertension should not do fasting. Diet rich in fruits and vegetables
and potassium is usually advised. High sodium foods should be avoided.
Following herbs are used:
O Flaxseed (Linum usitatissimum) oil 2 tbsp daily
O Evening Primrose oil – 1 tsp daily
O Garlic (Allium sativum) –Take a few cloves of garlic, mixed with a
glass of buttermilk, twice a day
O Hawthorn (Crategus oxyacantha) - Dried berries: 3 to 5 grams. Fluid
extract: 1 tsp/day
O Banana stem juice 100 ml daily in the morning.
137
Hydrotherapy
O Cold spinal bath
O Neutral immersion bath (Add a few drops of sandalwood oil)
O Hot footbath
O Ice massage to head and ice cold spinal bath in severe hypertension.
YOGA THERAPY
Yoga reduces hypertension by relaxing the sympathetic nervous system and mind.
O Asanas:
and heart rate
Konasana

Bhramari
NUTRITION THERAPY
A landmark study known as the Dietary Approaches to Stop Hypertension

(DASH) trial determined that eating a balanced, healthful diet that is rich
in fruits, vegetables, and low-fat dairy products is very important for
prevention and reduction of high blood pressure. For some, when this diet
is combined with low salt intake (less than 2,400 mg per day) the
improvement in blood pressure may be as effective as taking a medication.
Potassium helps to prevent and control blood pressure. Be sure to get enough
potassium in the foods you eat. Some good sources are various fruits,
vegetables, dairy foods, and fish.
Foods included- bread/chapati, unsalted like maize, jowar, bajra, ragi,
unsalted oatmeal soups (only veg.) vegetables (no radish, beetroot, carrot).
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Avoid: Figs, rasins, sultanas, readymade curry powder, baking soda, canned
products, papads, pickles, chutneys and salt at table. Fluid restriction is
1500 ml/day if edema is present.
Nutritional supplements:
O Niacin – 200 mg/day
O Vitamin C – 1,000 mg/day
O Vitamin E – 400 IU/day
O Calcium citrate - 800 –1000 mg/day
O Selenium – 200 mcg/day
O Magnesium citrate – 500 mg/day.
PHYSICAL THERAPY
Massage may be particularly helpful for people with hypertension brought

on by stress. This is because the beneficial effects of massage are due at least
in part to a reduction in stress. In addition, massage tends to help people
stick with healthy behaviours such as eating healthfully and not smoking.
Being physically active is one of the most important steps you can take to
prevent or control high blood pressure. Aerobic exercises like walking at
60% to 80% of maximum heart rate, weekly 5 days is advisable.
Sample Walking Program
Total
Warm Up Activity Cool Down Time
WEEK 1 Walk slowly Then walk briskly Then walk 15 min.
5 min. 5 min. slowly 5 min.

139

AND 5 min. 30 min. slowly 5 min.
BEYOND
With walking, other exercises like Joint mobility and deep breathing exercises
are advised.
PSYCHOTHERAPY
Relaxation techniques may be helpful in alleviating feelings of stress, which
is often a contributing factor to hypertension. One study of older African
Americans living in an urban setting found that those who participated in
a transcendental meditation (TM) or progressive muscle relaxation (PMR)
program had a significant reduction in blood pressure compared to those
who did not.
In addition to TM and PMR, other mind/body techniques such as self-
hypnosis and biofeedback have shown promising results in recent studies.
Biofeedback in particular may reduce elevated blood pressure from stress
and help individuals achieve healthful lifestyle modifications, such as stopping
smoking and losing weight.
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Lifestyle
The same lifestyle modifications that help prevent hypertension are useful
in treating it. The following steps are recommended for people with
hypertension, regardless of whether they are taking prescription medications.
O Lose weight if overweight
O Limit alcohol intake to no more than 1 oz of ethanol per day for
men (this roughly equals 2 pints of beer, 2 glasses of wine, or 2
shots of 100-proof whiskey) and 0.5 oz for women and lighter-
weight individuals
O Increase and maintain aerobic physical activity (30 to 40 minutes
most days per week)
O Reduce salt intake to less than 2,400 mg sodium or 6,000 mg
sodium chloride per day
O Maintain adequate intake of calcium (1,000 to 1,500 mg per day
for adults) and potassium (approximately 2,000 mg per day for
adults) for optimum health
O Improve overall cardiovascular health by quitting smoking and
reducing saturated fat and cholesterol intake
O Reduce stress—since ongoing stressful circumstances, such as job
dissatisfaction, may contribute to the development of hypertension.
Stress management may lower elevated blood pressure.
CORONAR
CORONARY HEAR
ONARY T DISEASE
HEART
Coronary heart disease (or coronary artery disease) is a narrowing of coronary
arteries, the small blood vessels that supply blood and oxygen to the heart.
Coronary artery disease usually results from the build up of fatty material
and plaque inside the arteries. As the coronary arteries narrow, the flow of
blood to the heart can slow or stop.

Coronary heart disease (CHD) is the leading cause of death in the world
for men and women. The lifetime risk of having coronary heart disease after
age 40 is 49% for men and 32% for women. As women get older, the risk
increases almost to that of men.
141
There are many factors which increase the risk for CHD. Some of the risks
are based on family history (genetics), and others are more controllable.
Risk factors include the following:
O Family history of coronary heart disease (especially before age 50)
O Male gender
O Age (65 and greater)
O Tobacco smoking
O High blood pressure
O Diabetes
O High cholesterol levels (specifically, high LDL cholesterol and low
HDL cholesterol)
O Lack of physical activity or exercise
O Obesity
O High blood homocysteine levels
O Menopause in women.
Symptoms
The symptoms associated with coronary heart disease may be pronounced,
but they can also occur without any noticeable symptoms.
CHD can manifest as angina or Heart attack. Chest pain (angina) is the
most common symptom, and it results from the heart not getting enough
blood or oxygen. The intensity of the pain varies from person-to-person.
Chest pain may be typical or atypical. Typical chest pain is felt under the
sternum and is characterized by a heavy or squeezing feeling, it is precipitated
by exertion or emotion, and it is relieved by rest or nitroglycerin.
Atypical chest pain can be located in the left chest, abdomen, back, or arm
and is fleeting or sharp. Atypical chest pain is unrelated to exercise and is
not relieved by rest or nitroglycerin. Atypical chest pain is more common
in women.
In some cases, the first sign of CHD is a heart attack. This occurs when
atherosclerotic plaque or a blood clot blocks the blood flow of the coronary
artery to the heart. The coronary artery was most likely already narrowed
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from CHD. The pain associated with a heart attack is usually severe, lasts
longer than the chest pain described above, and is not relieved by resting or
nitroglycerin.
Signs and tests

There are many tests that may help to diagnose CHD. Usually, more than
one test will be done before a definitive diagnosis can be made. Some of the
tests include:
O Electrocardiogram (ECG)
O Serum Enzymes like Creatine Kinase MB (CK-MB)
O Exercise stress test
O Echocardiogram
O Coronary angiography/arteriography
O PET Scan.
Treatment
MODERN MEDICINE
The treatment for CHD varies depending on the symptoms and how much
the disease has progressed. The general treatments include lifestyle changes,
medications, and sometimes surgery.
Medications may include:
O Cholesterol-lowering medication
O Antiplatelet agents, such as aspirin, ticlopidine, or clopidogrel, to
reduce the risk of blood clots
O Glycoprotein IIb-IIIa inhibitors, such as abciximab, eptifibatide,
or tirofiban, to reduce the risk of blood clots
O Antithrombin drugs, such as blood-thinners (low-molecular
heparin, unfractionated heparin), to reduce the risk of blood clots
O Beta-blockers to decrease heart rate and lower oxygen use by the
heart
O Nitrates such as nitroglycerin to dilate the coronary arteries and
improve blood supply to the heart
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O Calcium-channel blockers to relax the coronary arteries and all

systemic arteries and thus reduce the workload for the heart
O ACE inhibitors, diuretics, or other medications to lower blood
pressure.
Percutaneous Coronary Interventions (PCI’s) include:
O Coronary angioplasty (Balloon PTCA)
O Coronary atherectomy
O Ablative laser-assisted angioplasty
O Catheter-based thrombolysis and mechanical thrombectomy
O Coronary stenting (placing a tube in the artery to keep it open).
Surgical procedures include:
O Coronary Artery Bypass Graft (CABG)
O Minimally invasive heart surgery.
AYURVEDA
Arjuna (Terminalia Arjuna, a relative of the Triphala herbs) is a special

powerful Ayurvedic herb for all kinds of heart diseases. One to three grams
of Arjuna powder can be taken daily. Arjuna combines well with
ashwagandha and guggul as an all-around heart tonic. Following are some
medicines used in Ayurveda to treat heart disease.
1. In general heart disease, the following drugs are useful:
O 20 mg of Nagarjunabha 240 mg of Prabhakar Vati, and 1 gm of
Kukumbhadi Churna to be taken twice daily with Pomegranate Syrup
O 24 mg of Parthadyarishta to be taken twice with rose water
after meals
O 500 mg of Arogyavardhini and 2 gm of Hingugragandhadi Churna
to be taken with water before sleep.
2. If heart disease is caused by vitiation of vata, the following drugs are
useful:
O 60 mg of Makardhwaja 120 ml of Chinthamani Rasa, and 240
mg of Shringa Bhasma to be taken twice, morning and evening
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O 1 gm of Pushkaramula Churna to be taken twice after meals

with Vallabhaka Ghrita or fermented carrots
O 120 mg each of Visheshwara Rasa and Hripatri Churna to be
taken with sugar candy (mishri) last thing at night.
3. If heart disease is caused by vitiation of pitta, the following drugs
are useful:
O 120 mg each of Panchanana Rasa and Vyomashma Pishti, and 2
gm of Drakshadi Churna to be taken with cold water in the
morning and evening
O 12 gm of Arjuna Ghrita to be taken once in the morning with
mishri and cow’s milk.
4. If the heart disease is caused by the vitiation of kapha, the following
drugs are useful:
O 120 mg each of Hridyarnava Rasa and Shankar Vati, and 500
mg each of Pipplimula Churna and powder of seeds of Cardamom
to be taken twice daily
O 1 gm of Arjuna Churna and 2 gm of Krishnadya Churna to be
taken with warm water after meals twice daily
O 60 mg of Makaradhwaja, 240 mg of Prabhakara Vati, and 50
mg of Arogyavardhini to be taken with decoction of Triphala
once before sleep.
5. If heart trouble is due to vitiation of all the three doshas, the following
drugs are useful:
O 120 mg each of Ratnakara Rasa and Mukta Pishti, and 500 mg
of Pushkaramula Churna to be taken with Arjuna Ghrita in the
morning and evening
O 60 mg of Chandrodaya, and 120 mg each of Yakuti powder to
be taken twice daily.
ACUPUNCTURE
Following acupuncture points are used in treating heart disease:
O Baihui (Du.20.)
O Local Points:
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o Mu Pericardium - Shanzhong (Ren 17)

o Shu Heart - Xinshu (U.B. 15)
o Bipay (U.Ex.)
O Distal points: Neiguan (P. 6), Shenmen (H.7)
O Influential point: Taiyuan (Lu. 9)
O Clinically effective point: Taiyang (Ex.30).
Other useful points are: Fengchi (G20), Taichong (Liv3), Renying (S9),
Taiyang (Ex.30).
HOMEOPATHY
Some homeopathic remedies useful for cardiovascular conditions include:
Aconitum napellus: Useful when anxious and impatient and the patient
imagines the worst happening. Feels that a strong pain envelops the heart
and left arm. The problem is worse at night and when warm, and feel
better with rest and fresh air.
Argentum nitticum: Useful when impulsive and fearful. Chest pain is

stronger at night, after eating and with stress.
Aurum metallicum: Indicated when the patient is depressed, feels worthless

and are very sensitive to pain. Other symptoms include depression and
night-time chest pain.
Baryta carbonica: Useful when you are suffering from hypertension,

palpitations and confusion, made worse with exposure to dampness or cold.
Cactus grandiflor us: When the patient is sad and in great pain. The pain
grandiflorus:
seems to be “squeezing” the chest, making it difficult to breathe. He feels
worse around noon and with exertion, but better with fresh air.
Carduus marianus: Useful for cases with a history of alcoholism and a

propensity for drinking beer. This remedy helps regulate the heart and can
slowly reverse symptoms.
Crataegus
Crataegus: A general remedy that helps regulates the heart.
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NATUROPATHY
Naturopathy uses lifestyle modifications to reverse heart disease. The success

of lifestyle modifications in treating CHD is proved scientifically by the
controlled studies conducted by Dean Ornish, M.D., at the Preventive
Medicine Research Institute, University of California, San Francisco, USA.
His controlled studies have proved that blockages in blood vessels can be
effectively reversed by comprehensive lifestyle changes and that the most
severely blocked arteries show the most improvement.
Following Lifestyle changes are used in Naturopathy:
O Losing weight if overweight
O A plant based diet which is rich in vegetables and fruits
O Regular exercise like walking
O Quitting smoking
O Daily yoga and meditation for stress management
O Love and family support.
Patients are kept on fruit and raw vegetable diet for one to two months to
reduce the atherosclerosis and to reduce the blood clotting.
Some herbs used to treat heart disease:
O Hawthorn (Crataegus monogyna): Used traditionally as a remedy
for cardiovascular diseases. Animal and laboratory studies
demonstrate that this herb has antioxidant properties that help
protect against the formation of plaques and may help control high
cholesterol and high blood pressure.
O Garlic (Allium sativum): Clinical trials have shown that fresh garlic
and garlic supplements may lower cholesterol levels, prevent blood
clots, and destroy plaque.
O Green Tea: (Camellia sinensis): Population studies indicate that the
antioxidant properties of green tea may prevent atherosclerosis,
particularly coronary artery disease.
O Pseudo ginseng root/notoginseng root (Panax notoginseng): Used
in Traditional Chinese Medicine to treat chest pain and coronary
artery disease. Laboratory studies suggest this herb may help
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prevent blood clots and protect against the formation of plaques.

O One capsule of herb Ginkgo Biloba three times a day.
YOGA THERAPY
Yoga helps in treating heart disease.

O Asanas:
o Forward bending yoga asanas like Shashankasana,
and heart rate
o Backward bend poses like Bhujangasana, Shalabhasana,
sarvangasana, Vipareeta Dandasana, Ustrasana increase blood
supply to heart
o Meditative asanas like Padmasana, Vajrasana, Siddhasana,
Konasana
o Relaxative asanas like Shavasana, and Makarasana
Bhramari
NUTRITION THERAPY
Even modest changes in diet and lifestyle can significantly reduce the risk
of heart disease.
In general, eat foods low in cholesterol, saturated fat and salt. Take vitamins
and supplements recommended or eat foods containing the essential vitamins
and minerals. Fatty acids in fish contain Omega 3 that was shown to be
effective in preventing heart diseases. Similarly, taking moderate quantities
of red wine was also found to be beneficial. (Caution: High intake of alcohol
is bad and should be avoided.) Maintain normal body weight by taking a
high fibre low calorie vegetarian diet.
Foods that can sav
savee ar teries and pr
arteries ev
prev ent hear
event heartt disease: Seafood, fruits,
vegetables, nuts, grains, legumes, onions, garlic, olive oil, alcohol in
moderation, foods high in vitamin C, E and beta carotene.
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Foods that can damage ar teries and the hear

arteries t: Meats and dairy foods high
heart:
in saturated fat, excessive alcohol, Red meat, whole milk, cream cheeses,
cakes, pastries, cookies, high fat biscuits, high fat cookies, egg noodles,
dressings made out of egg yolk.

O Coenzyme Q10 (120 mg per day) taken for 28 days following a
heart attack may reduce degree of damage to the heart and improve
heart function.
O A diet high in antioxidants (vitamin C, vitamin E, and beta-
carotene) and soluble dietary fiber, and low in fat is beneficial.
O Bromelain (400 to 800 mg per day) may help dissolve plaque.
O Bioflavonoids: These are a group of compounds that provide color
to citrus fruits and vegetables.
O 1,500-2,000 mg Calcium daily in divided doses after meals and at
bedtime, and 750-1,000 mg magnesium daily in divided doses
after meals and at bedtime. Take with 50 mg vitamin B6.
O 1000 milligrams of Vitamin C three times a day
O 400 IU of Vitamin E twice per day
O 200 micrograms of Selenium a day
O 50 milligrams of vitamin B6 a day
O 500 milligrams of carnitine three times a day.
PHYSICAL THERAPY
Exercise reduces body fat, blood pressure, increase bone density and HDL
cholesterol, and decrease triglycerides and the formation of blood clots.
Aerobic exercise like walking and swimming is good for people with heart
disease. The intensity of the exercise is based only upon the maximum
heart rate reached on the treadmill test. The intensity should never be
greater than the maximal heart rate attained during the treadmill test.
Patients should exercise below their threshold for angina or ST segmental
ischaemic changes. They should never exercise if they have complex
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arrhythmias, cardiac failure and severe hypertension. Coronary Heart disease

patients should exercise with lower intensity and compensate it by increasing
the duration of the exercise to achieve the desired training effect.
For example, if a heart patient has reached a maximum heart rate of 160 on
a treadmill test, to exercise between 45 and 80 percent of his maximum
heart rate is:
a) 45 percent of 160 is = 72
b) 80 percent of 160 is = 128
That means he should keep his pulse rate between 72 and 128 beats per
minute, to get training effect. The aerobic exercise should be done for at
least 30 – 45 minutes, 6 days in a week.
Walking is the best exercise and the sample walking program mentioned
under Hypertension can be used.
PSYCHOTHERAPY
Relaxation techniques may be helpful in alleviating feelings of stress, which

is often a contributing factor to heart disease. Techniques like meditation,
relaxation, self-hypnosis and biofeedback have shown promising results in
recent studies.
Counselling and behaviour therapy helps to reduce anxiety, depression and
in avoiding addictions.
Lifestyle changes
O Maintain appropriate body weight within acceptable range
O Reduce body fat, especially abdominal body fat to below 16 –
21%
O Maintain a vegetarian diet
O Avoid high fat foods like butter, ghee, etc.
O Avoid smoking
O Manage stress and tension
O Do daily moderate physical exercise.
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ARRHYTHMIAS
An arrhythmia is any disorder of heart rate or rhythm.

Arrhythmias are caused by a disruption of the normal electrical conduction
system of the heart. Normally, the four chambers of the heart (two atria
and two ventricles) contract in a very specific, coordinated manner.
The signal for the heart to contract in a synchronized manner is through an
electrical impulse that begins in the sinoatrial node (also called the SA
node), located in the heart. It is the body’s natural pacemaker.
The signal leaves the sinoatrial node and travels through the two atria,
stimulating them to contract. Then the signal passes through another node
(the AV node), and finally travels through the ventricles and stimulates
them to contract in synchrony.
Problems can occur anywhere along the conduction system, causing various
arrhythmias. There can be a problem in the heart muscle itself, causing it
to respond differently to the signal, or causing the ventricles to contract
independently of the normal conduction system.
Arrhythmias include tachycardias (the heartbeat is too fast), bradycardias
(the heartbeat is too slow), and “true” arrhythmias (a disturbed rhythm).
Arrhythmias can be life-threatening if they cause a severe decrease in the
pumping function of the heart. When the pumping function is severely
decreased for more than a few seconds, blood circulation is essentially stopped
to the organs, and organ damage (such as brain damage) may occur within
a few minutes.
Life-threatening arrhythmias include the following:
O Ventricular fibrillation (rapid, fibrillary movements of the ventricular
muscle that replace the normal contraction)
O Ventricular tachycardia that is rapid and sustained or pulseless
O Sustained episodes of other arrhythmias
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Other arrhythmias include the following:

O Atrial fibrillation (fibrillation in which the normal rhythmical
contractions of the cardiac atria are replaced by rapid irregular
twitchings of the muscular wall)
O Multifocal atrial tachycardia
O Paroxysmal supraventricular tachycardia
O Wolff-Parkinson-White syndrome
O Sinus tachycardia
O Sinus bradycardia
O Bradycardia associated with heart block
O Sick sinus syndrome
O Ectopic heartbeat.
People at higher risk for arrhythmias and complications from arrhythmias
include the following:
O Those who have a history of cardiac conditions such as coronary
artery disease or heart valve disorders
O Those with imbalances of blood chemistries.
Arrhythmias can also be caused by some substances or drugs. These include
beta blockers, psychotropics, sympathomimetics, caffeine, amphetamines,
and cocaine. Sometimes antiarrhythmic medications — prescribed to treat
one type of arrhythmia — can actually cause another type of arrhythmia.
Symptoms
O Sensation of feeling the heart beat (palpitations)
O Fainting
O Light-headedness, dizziness
O Chest pain
O Changes in the rate, rhythm, or pattern of the pulse
O Paleness
O Temporarily absent breathing.
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Note: The person may not have symptoms. The first symptom may be
sudden cardiac arrest (loss of heartbeat), which requires CPR.
Signs and tests
Tests that reveal arrhythmias and identify the type of arrhythmia include:
O ECG
O Ambulatory cardiac monitoring (for example, a Holter monitor is
used for 24 hours; other monitors may be worn for two weeks or
longer)
O Echocardiogram
O Electrophysiology study (EPS)
O Coronary angiography.
Various tests are appropriate to confirm or rule out suspected causes of the
arrhythmia. EPS testing may be performed to determine from where in the
heart the arrhythmia originates and the best treatment, especially if a
pacemaker or catheter ablation might be necessary.
Treatment
In cases where the only possible remedy is surgical, there is no better option
than utilizing the allopathic medical system in the case of mild and chronic
arrhythmias, however, some alternative therapy have been found to be useful
as a support system in addition to allopathy.
MODERN MEDICINE
When an arrhythmia is serious and not well-tolerated, there may not be

enough blood flow from the heart to vital organs, such as the brain or
kidneys or to the heart itself. In such cases, treatment is urgent and may
include electrical “shock” (defibrillation or cardioversion), the implantation
of a temporary pacemaker to interrupt the arrhythmia by fast pacing
(overdrive supression), or the administration of intravenous medications.
For long-term treatment of arrhythmias, daily medications may be necessary.

These include antiarrhythmic medications, medications to speed up or
slow down the heart rate, and others.
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Over the past decade, life-threatening arrhythmias have been increasingly

treated with an implantable cardioverter-defibrillator (ICD). As soon as an
arrhythmia begins, the ICD can detect it and send an automatic electrical
shock to terminate it, or it can activate a pacemaker function to overdrive
the arrhythmia.
Some patients may be better candidates to have a procedure called
radiofrequency catheter ablation. Radiofrequency catheter ablation can cure
many paroxysmal supraventricular arrhythmias as well as some ventricular
arrhythmias. This is performed at the time of EPS.
AYURVEDA
Aswagandharishtam combined with Saraswatharishtam in a dose of 15 to
20 ml is advised. Arjuna, ashwagandha, bala, Vidari taken in equal ratio
protects the heart.
Swarnamakaradhwaja, swarnamuktadi vati, prabhakara vati are also useful.

HOMEOPATHY
Spigelia: Difficult breathing, relieved by lying on right side with head well
raised, shuddering of whole body, person cannot bear to be touched
Cactus: Anginal pain and violent palpitations, made worse by lying on left
side, person has atherosclerosis
Naja: Sensation of blood surging up into head, pulse irregular but forceful,
angina pain, fear of dying
Lilium: Whole body pulsating, angina pain extending into right arm, warm
room makes symptoms worse
Iberis: Pulse loud but irregular, palpitations, feeling of heaviness and pressure
in heart region, with occasional sharp, stinging pains passing from front to
back, symptoms made worse by laughing, coughing, or slightest exertion.
Prevention
Methods of preventing other heart diseases (e.g., coronary artery disease)
may decrease the likelihood of developing an arrhythmia. These include
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not smoking; avoiding alcohol, eating a well-balanced, low-fat diet;

managing the stress and exercising regularly.
VARICOSE VEINS
Varicose veins are enlarged, twisted, painful superficial veins resulting from
poorly functioning valves. If ignored, varicose veins can cause not only
discomfort and cosmetic concerns, but also serious complications, such as
phlebitis (inflammation of the veins), skin ulcers, and blood clots.

In normal veins, valves in the vein keep blood moving forward toward the
heart. With varicose veins, the valves do not function properly, allowing
blood to remain in the vein. Pooling of blood in a vein causes it to enlarge.
This process usually occurs in the veins of the legs, although it may occur
elsewhere. Varicose veins are common, affecting mostly women.
Causes include congenitally defective valves, thrombophlebitis, and
pregnancy. Prolonged standing and increased pressure within the abdomen
may increase susceptibility to the development of varicose veins or aggravate
the condition.
Primary varicose veins occur because of congenitally defective valves, or
without a known cause. Secondary varicose veins occur because of another
condition, such as occurs when a pregnant woman develops varicose veins.
Symptoms
O Prominent dark-blue blood vessels, especially in the legs and feet
(not “spidery”-looking veins)
O Aching, tender, heavy, or sore legs
O Swelling in the ankles or feet, especially after standing
O Breaks in the skin
O Superficial blood clots
O Skin ulcers near the ankle.
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Signs and tests

The diagnosis is based primarily on the characteristic appearance of the
legs when the patient is standing or is seated with the legs dangling. At
times a physician may order a duplex ultrasound exam of extremity to see
blood flow and characterize the vessels, and to rule out other disorders of
the legs. Rarely, an angiography of the legs may be performed to rule out
other disorders.
Treatment
Treatment is usually conservative. The patient will be asked to avoid excess
standing, elevate the legs when resting or sleeping, and to wear elastic
support hose.
MODERN MEDICINE
Superficial varicose veins normally do not require medical attention. To

alleviate occasional swelling and pain, an over-the- counter anti-
inflammatory drug such as aspirin or ibuprofen are usually prescribed.
Surgery such as vein stripping and ligation (removal of the varicose vein),
or sclerotherapy of veins (injecting with a solution that causes scarring,
which closes the vein) may be recommended. Vein stripping is a very
extensive procedure, and it is usually reserved for patients who are
experiencing a lot of pain or who have skin ulcers. Radiofrequency ablation
is a new technique in which a catheter is threaded into the varicose vein to
heat the vein wall in order to obliterate the vein and improve the function
of its valve.
AYURVEDA
Ayurveda herb gotu kola is good in treating varicose veins. Gotu kola
strengthens the collagen lining of vein walls, enhances circulation, and
reduces inflammation to treat varicose veins. A series of studies published
in the International Journal of Angiology last in October 2004 tested gotu
kola’s ability to improve vascular health. In one study, researchers gave 40
patients with venous hypertension (thought to be a precursor to varicose
veins) either a placebo or 120 mg of gotu kola daily. After six weeks, the
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patients who took the herb experienced a significant reduction in leg

swelling, and most of their leg veins were able to constrict blood flow
properly.
Other drugs include Rasna erandadi Kashayam, Nirgundi eranda Kashayam,
Gandharva erandam Sahacharadi 7 avartanam are beneficial. Narayana
Thailam, Panchamla Thailam are used for external application.
ACUPUNCTURE
Following acupuncture points are used in treatment: SP 5, SP II, BL 38,

ST 32, ST 36, CV 1.
HOMEOPATHY
Arnica montana: When this remedy is indicated, the legs look bruised, or
black and blue, and the swollen veins are very sore to touch. The legs feel
deeply sore all over and are also worse from motion. Lying down may bring
relief.
Calcar ea carbonica: Varicose veins that hurt while the person is standing or
Calcarea
walking may respond to this remedy. People who need this remedy often
have poor circulation, with clammy hands and feet, and a general feeling of
chilliness. They may have weak or flabby muscles, and be easily tired by
exertion.
Carbo vvegetabilis:
egetabilis: Poor circulation with icy coldness of the extremities, and
mottled skin with distended veins and a bruised or “marbled” look, may
indicate a need for this remedy. The person’s legs feel weak and heavy, and
often itch and burn. Poor digestion, a feeling of faintness, and a craving for
fresh or moving air are strong indications for Carbo vegetabilis. This remedy
is often indicated for older people, or those who are slow to recover from an
illness.
Hamamelis: This remedy can help when varicose veins are large and sore,
and very weak and easily damaged, with a tendency to bleed. Pain is sore
and bruiselike, and the legs look bruised and purple. A stinging feeling
may be felt in the irritated veins. The muscles of the legs feel tired and are
often cold. People who need this remedy may also develop varicose veins in
the genital area or have a tendency toward bleeding hemorrhoids.
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Lycopodium: When this remedy is indicated, drawing or tearing pains are

felt in the legs, sometimes with a numb sensation. Symptoms are worse
when the person is keeping still, and the legs may cramp at night in bed.
People who need this remedy may have a worried facial expression along
with digestive problems, sluggish liver function, and poor circulation.
Pulsatilla: Swollen veins in the legs, and sometimes even in the arms and
hands, suggest a need for this remedy. Varicose veins in the legs feel hot
and painful at night, with heaviness and weariness. Symptoms are worse
when the legs are hanging down without support, and worse from warmth.
Cold applications, motion, and cool fresh air may help. Pulsatilla is often
helpful for varicose veins that develop during pregnancy.
Zincum metallicum: When this remedy is needed, the legs are fidgety and
restless, with weakness in the muscles, crawling sensations, and a tendency
to twitch. Large varicose veins may develop, with pain and soreness that are
worse from touch. The person may feel worse from alcohol, especially wine.
NATUROPATHY
Take a high fibre complex carbohydrate diet. Take more amounts of

proanthocyanidins rich foods like cherries, black berries, blueberries, etc.
Anthocyanins and proanthocyanidins tone and strengthen the walls of the
veins. Pineapples are rich in the enzyme bromelain, which helps prevent
blood clots, an uncommon but serious complication of varicose veins. Include
liberally fibrinolytic foods like pineapple, garlic, onion, ginger, and cayenne
in the diet. Obese people should follow a low calorie diet and reduce weight.
One or two glasses daily of fresh fruit or vegetable juices- especially any
combination of apple, beet, carrot, celery, citrus, parsley, or pineapple-and
dietary supplements may be helpful in preventing and treating varicosities.
Following herbs are used in Naturopathy.
O Horse chestnut (Aesculus hippocastanum) 500 mg three times per
day or standardized Aescin 10 mg three times per day
O Butcher’s broom (Ruscus aculeatus) standardized extract (9% to 11%
ruscogenin) 100 mg three times per day
O Gotu kola (Centella asiatica) 1,000 mg two to four times per day,
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or standardized extract (asiaticoside 40%, Asiatic acid 30%,

madecassoside 1% to 2%) 60 mg one to two times per day
O Bilberry (Vaccinium myrtillus) standardized extract (25%
anthocyanoside) 80 to 160 mg three times per day.
Combine the following in equal parts: yarrow (Achillea millefolium),
hawthorn (Crataegus monogyna), ginkgo (Ginkgo biloba), marigold
(Calendula officinalis), horse chestnut (Aesculus hippocastanum), and ginger
(Zingiber officinalis). Take 30 to 60 drops tincture two to three times per
day or drink three to four cups of tea daily.
Prepare a poultice of bruised cabbage leaves, apples, chopped brown onions,
or a half-and-half blend of cod liver oil and raw honey. Apply this overnight.
This is believed to heal varicose sores.
Hydrotherapy
Alternate between hot and cold baths stimulate circulation in the legs. Fill one
bucket with enough comfortably hot water to cover the lower legs and the other
bucket with the same amount of cold water. Add 2 tablespoons of epsom salts
per quart of water or you can add an aromatherapy oil to the water. Soak your
feet and legs in the hot water for about 3 minutes and then immerse them in the
cold water for about 30 seconds. Repeat 3 times, finishing with the cold soak.
Perform this treatment once a day for at least one month.
Sponging or spraying legs with cold water can relieve aches and pain from
superficial varicose veins.
YOGA THERAPY
Yoga’s stretching and relaxation techniques can be particularly beneficial

for varicose veins. Certain positions, such as the Halasana, Shavasana, and
sarvangasana promote circulation and the drainage of blood from the legs.
The deep-breathing exercises in yoga may further alleviate discomfort by
getting more oxygen into the bloodstream.
NUTRITION THERAPY
A high-fiber diet helps prevent straining during stool evacuation which can
build up pressure and aggravate varicose veins.
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O Vitamin A in the form of beta carotene 25,000 IU for skin integrity
and to speed varicose ulcer healing.
O Vitamin C and Bioflavonoids 1,000 to 5,000 milligrams of vitamin
C and 100 to 1,000 milligrams of bioflavonoids in divided daily
doses to aid circulation, promote the healing of sores, and strengthen
vein walls to prevent dilation.
O Vitamin E 300 to 800 IU in gradually increased dosages to improve
circulation, reduce susceptibility to varicose veins, relieve pain, and,
sometimes, correct varicosities.
O Topical applications of vitamin E squeezed from capsules often
relieves localized irritation and speeds the healing of varicose ulcers.
O Lecithin One tablespoon of granules daily (or two capsules with
each meal) to emulsify fats and aid circulation.
PHYSICAL THERAPY
Exercise
Maintaining overall fitness, both nutritionally and physically, is most
essential to preventing varicose veins from developing. Any program of regular
exercise stimulates circulation, improves muscle tone, and helps prevent
varicosities. Walking, cycling, jogging and swimming are considered
excellent therapy, as are gentle leg-muscle stretches.
Practice foot and ankle exercises in elevation and walk 1-2 miles a day, with
support stockings if necessary, to keep blood flowing through the deep veins.
Lying flat on the floor and resting the legs on a chair seat or straight up
against a wall for 2 minutes drains blood from swollen veins. Elevating the
feet higher than the hips with a recliner, and raising the foot of the bed a
few inches, helps blood flow back to the heart from the legs.
Massage
Regular massage can significantly alleviate discomfort associated with varicose
veins. A general leg massage can help reduce swelling in the veins. Massage
starting at the feet and legs up to the hips and along the lymphatic system,
mobilises congested body tissues.
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Prevention
Avoid prolonged standing if personal or family history indicates the risk of
developing varicose veins. Also ensured a daily one hour walk or some other
form of continuous leg movement in order to strengthen leg muscles and
improve vein integrety.
PERIPHERAL AR
PERIPHERAL TERIAL DISEASE
ARTERIAL
Peripheral artery disease is caused by arteriosclerosis or plaque build up in
the arteries that supply the extremities of the body. This causes a decrease
in blood flow that can injure nerves and other tissues. It is also known as
Intermittent Claudication.

Arteriosclerosis, or “hardening of the arteries,” commonly shows its effects
first in the legs and feet. The narrowing of the arteries may progress to total
closure (occlusion) of the vessel. The vessel walls become less elastic and
cannot dilate to allow greater blood flow when needed (such as during
exercise). Calcium deposits in the walls of the arteries contribute to the
narrowing and stiffness. The effects of these deposits may be seen on ordinary
X-rays.
This is a common disorder, usually affecting men over 50 years old. People
are at higher risk if they have a personal or family history of coronary artery
disease (heart disease) or cerebrovascular disease (stroke), diabetes, smoking,
hypertension (high blood pressure), or kidney disease involving hemodialysis.
Symptoms
Often, symptoms affect one limb. If arteriosclerosis exists in both limbs,
the intensity is usually different in each.
O Leg pain (intermittent claudication) occurs with exercise (such as
walking) and relieved with rest
O Numbness of the legs or feet at rest
O Cold legs or feet
O Muscle pain in the thighs, calves, or feet
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O Loss of hair on the legs and/or feet

O Change of color of the legs
O Paleness or blueness (cyanosis)
O Pulse, weak or absent in the limb
O Walking/gait abnormalities.
Signs and tests

An examination may show arterial bruits (whooshing sound heard with the
stethoscope over the artery), decreased or absent pulse in the extremities,
or decreased blood pressure in the affected limb.
Blood tests may show high cholesterol.
Peripheral artery disease may be revealed by:
O An abnormal ratio between the blood pressure of the ankle and
arm (ankle/brachial index, or ABI)
O A Doppler ultrasound exam of an extremity
O Angiography of the arteries in the legs (arteriography)
O Intravascular ultrasound (IVUS) of the extremity
O An MRI scan.
Treatment
Treatment focuses on the relief of symptoms and self-care to improve
circulation.
MODERN MEDICINE
Medications may be required to control the disorder, including pain
relievers, blood thinners, and medications to enlarge or dilate the affected
arteries.
Surgery is usually performed only on severe cases where the ability to work
or pursue essential activities is affected. Surgery may consist of removing
the lining of the artery (endarterectomy), or repairing or replacing the vessel
(grafting); most commonly, bypass surgery is performed, using a vein or
synthetic graft.
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Alternatives to surgery may include treatments such as balloon angioplasty

(a similar technique to that used to open the coronary arteries, but performed
on the blood vessels of the affected extremity), sometimes followed by stent
implantation, laser treatment, or other treatments.
AYURVEDA
Guggul lowers high cholesterol. It improves circulation, reduces pain,
removes accumulations and promotes healing. Take 1 gm. in the morning
and evening for three months.
Other useful herbs are: Garlic calamus, turmeric, elecampane, aloe vera gel
with turmeric or safflower, katuka, myrrh, saffron, motherwort, and hawthorn
berries.
Panchakarma treatments like dhara, Pizhichil, abhyanga helps to increase
blood circulation in legs and reduce pain.
ACUPUNCTURE
Following acupoints are used:
O Hands: Laogong (P. 8), Shaofu (H. 8), Yuji (Lu. 1)
O Feet: Taixi (K. 3.), Yongquan (K. 1)
O Influential point: Taiyuan (Lu. 9)
The Heart, Pericardium and Spleen are also involved in the circulation of
fluids.
HOMEOPATHY
Arsenicum album: This remedy can be useful when the tips of the extremities
are icy cold, with a burning sensation that is much relieved by heat. The
fingers or other affected areas may also look swollen and feel itchy. People
who need Arsenicum are often perfectionistic, restless, anxious, and feel chilly
generally.
Carbo vvegetabilis:
egetabilis: People who need this remedy have very cold extremities
and often look pale and feel weak or faint, with a strong desire for moving
air, and a tendency toward indigestion. Toes and fingertips may have a
cramping sensation and sometimes overreact to circulation problems by
turning red.
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Hepar sulphuris calcareum: Individuals who need this remedy are extremely
sensitive to cold, and often need to wear gloves and be warmly dressed, or
even to stay indoors, to prevent unpleasant symptoms.
Veratr um album: This remedy may be indicated for icy coldness and
eratrum
paleness—even blueness—with a sensation of cramping in the tips of the
extremities. People who need this remedy often feel extremely cold and
weak with other physical disorders, such as diarrhea and vomiting, or difficult
menstrual periods.
NATUROPATHY
Patients are kept on fruit and raw vegetable diet for one to two months to reduce
the atherosclerosis and to reduce the blood clotting. Regular mild aerobic exercise
combined with daily massage to legs can increase the blood circulation.
Herbs like Ginkgo biloba increases circulation. Two double-blind trials found
that 120 mg of Ginkgo biloba extract per day increased pain-free and total
walking distance among people with peripheral arterial disease.
A standardized extract of garlic has been tested as a treatment for peripheral
arterial disease. In a double-blind trial, the increase in walking distance
was significantly greater in people receiving garlic powder extract (400 mg
twice per day for 12 weeks) than in those given a placebo.
Hydrotherapy
Warm treatments like warm immersion bath, hot fomentations, hot leg
packs helps to increase the blood circulation.
Walking in a warm water pool or exercises in warm water can increase the
blood flow and reduce the pain. Avoid cold or ice applications as they can
reduce the blood supply further.
NUTRITION THERAPY

1. Nicotinic acid (B3) – 50 mg three times a day
2. Vitamin C – 1,000 mg/day
3. Vitamin E – 400 IU/day
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4. Flavanoids – 1,000 to 2,000 mg/day

5. Magnesium citrate – 500 mg/day
6. Evening Primrose oil – 1 tsp daily
7. Flaxseed (Linum usitatissimum) oil 2 tbsp daily.
PHYSICAL THERAPY
Massage increases the diameter of the blood vessels and increases blood
supply to the tissues. Massage assists removal of toxins and the accumulated
metabolic wastes from the muscles, and reduces pain. Deep tissue massage
is most useful.
Walking is important for patients with intermittent claudication. They
should walk 30 to 60 minutes per day, pushing themselves to walk beyond
the onset of pain. Patients are advised to rest when claudication becomes
moderate and walk some more when the pain subsides. In most patients 2
to 6 months of exercise increases the walking distance before pain begins.
Buerger’s exercises are also useful. This is a pattern of positions designed to
encourage the development of a collateral circulation in the legs.
The procedure is as follows:
1. The patient lies supine with the legs supported in elevation (at an
angle of 45o to the horizontal) until the skin blanches— about 2
minutes
2. The patient sits up with the legs dependent until the skin colour is
bright red- about 3 minutes
3. The patient lies with the legs horizontal until the skin colour returns
to normal- about 5 minutes.
This pattern of positions is repeated four or five times for three times daily.
Improvement is determined by the decreasing times required for the changes
in skin colour.
Prevention and Self-care

Exercise must be balanced with rest. Walking or other activity, performed
to the point of pain and alternated with rest periods, is often recommended.
Over time, circulation improves because of the development of collateral
(new, small) blood vessels.
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Smoking should be avoided as it constricts arteries, decreases the blood’s

ability to carry oxygen and increases the risk of forming clots (thrombi and
emboli).
Foot care is particularly important if diabetes is also present. Wear shoes
that fit properly. Pay attention to any cuts, scrapes or injury — the tissues
heal slowly when there is decreased circulation and are prone to infection.
If cholesterol is high, change the diet to a high fibre, low-cholesterol and
low-fat diet.
Control risk factors such as obesity, high blood pressure, sedentary life and
smoking.
CONGENITAL DISEASES OF HEAR

CONGENITAL T
HEART
Congenital heart diseases are abnormalities of the heart’s structure and
function caused by abnormal heart development before birth.

Congenital heart disease (CHD) is a broad term that can describe a number
of different abnormalities affecting the heart. Congenital heart disease is,
by definition, present at birth although its effects may not be obvious
immediately. In some cases, such as coarctation of the aorta, it may not
present itself for many years and a few lesions such as a small ventricular
septal defect (VSD) may never cause any problems and are compatible
with normal physical activity and a normal life span.
According to the American Heart Association, approximately 35,000 babies
are born each year with some type of congenital heart defect. Congenital
heart disease is responsible for more deaths in the first year of life than any
other birth defects. Many of these defects need to be followed carefully;
though some heal over time, others will require treatment.
Some congenital heart diseases can be treated with medication alone, while
others require one or more surgeries. The risk of death from congenital
heart disease surgery has dropped from approximately 30% in the 1970s
to less than 5% in most cases today.
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Congenital heart disease is often divided into two types: those with cyanosis
(blue discoloration caused by a relative lack of oxygen) and those without
cyanosis. The following lists cover the most common of the congenital heart
diseases:
Cyanotic:
O Tetralogy of Fallot
O Transposition of the great vessels
O Tricuspid atresia
O Total anomalous pulmonary venous return
O Truncus arteriosus
O Hypoplastic left heart
O Hypoplastic right heart
O Ebstein’s anomaly.
Non-cyanotic:
O Ventricular septal defect (VSD)
O Atrial septal defect (ASD)
O Patent ductus arteriosus (PDA)
O Aortic stenosis
O Pulmonic stenosis
O Coarctation of the aorta
O Atrioventricular canal (endocardial cushion defect).
These abnormalities may occur as single defects or in various combinations.
VSD is the most commonly diagnosed congenital heart defect (about one-
third of all cases) and it is seen almost three times as often as ASD and
PDA, which are the next two most common.
The majority of congenital heart diseases occur as an isolated defect and are
not associated with other diseases. However, they can also be a part of
various genetic and chromosomal syndromes, such as Down syndrome,
trisomy 13, Turner’s syndrome, Marfan syndrome, Noonan syndrome, Ellis-
van Creveld syndrome.
Drugs, chemicals, and infections during pregnancy can also cause congenital
heart abnormalities. Fetal rubella, maternal alcohol use (fetal alcohol
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syndrome), and use of retinoic acid (for acne) are some causes of congenital
heart disease in an infant.
Symptoms
Cyanosis is the main symptom. Cyanosis is a condition in which the lips,
fingers, and toes appear blue. It happens in people with congenital heart
defects that cause the blood to circulate abnormally.
In normal circulation, oxygen-poor blood enters the right side of the heart.
The right side of the heart pumps blood to the lungs, where the blood
picks up oxygen. From there, it enters the left side of the heart, which
pumps the oxygen-rich blood to the rest of the body.
In people with congenital heart defects, cyanosis can happen if the defect
allows oxygen-poor blood from the right side of the heart to enter the left
side of the heart directly, instead of traveling to the lungs for more oxygen.
In the left side of the heart, the oxygen-poor blood mixes with oxygen-rich
blood to be pumped through the body.
Although oxygen-poor blood is not blue, it is not as bright red as oxygen-
rich blood. The low oxygen level in the blood is what makes the lips, fingers,
and toes look blue.
Treatment
Many children with congenital heart and blood vessel defects may need
medical treatment such as diuretics, digoxin or other drugs. Diuretics help
the body excrete water and salts by promoting urination. Digoxin
strengthens the heart’s contractions, slows the heart rate and helps remove
extra fluid from body tissues. Some children may need surgery.
The following surgical procedures are used:
Arterial switch — A surgical procedure in which the major arteries are
switched in babies whose great arteries are transposed. The aorta is connected
to the left ventricle, which pumps oxygen-rich (red) blood to the body.
The pulmonary artery is connected to the right ventricle, which pumps
venous (bluish) blood to the lungs. This arterial switch may be done in the
first few weeks after birth or, depending on various factors, slightly later. If
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there’s a large ventricular septal defect or other defects related to the

transposition, the repair gets more complicated. Then other surgical
procedures may be needed.
Balloon atrial septostomy — A special procedure used during heart

catheterization to improve the body’s oxygen supply in babies whose great
arteries are transposed. It enlarges the atrial opening and helps reduce
cyanosis (blueness).
Balloon valvuloplasty — A procedure in which a special catheter (a tube
introduced into a blood vessel and threaded to the heart) containing a
deflated balloon is inserted into the opening of a narrowed heart valve.
When the balloon is inflated, the valve is stretched open; then the balloon
is removed. The procedure is used with favourable results to improve blood
flow in pulmonary stenosis. It’s also used in some cases of aortic stenosis,
where the long-term results are still being studied.
Damus-Kaye-Stansel procedure — A surgical technique used to repair
congenital transposition of the great arteries of the heart by dividing
(cutting) the pulmonary artery in two, and attaching the closest (proximal)
section to the ascending aorta and connecting the farthest (distal) section
to the right ventricle.
Fontan pr ocedur
oceduree or operation — A surgical procedure in which the right
procedur
atrium is connected to the pulmonary artery either directly or with a
conduit. This allows blood to bypass an incomplete or underdeveloped
right ventricle, as in tricuspid atresia and pulmonary atresia. The atrial
defect is also closed to relieve cyanosis (blueness).
Pulmonary artery banding — A procedure in which a surgeon places a
band around the pulmonary artery to narrow it and reduce the blood flow
and high pressure in the lungs. This is done to relieve such defects as
ventricular septal defect, atrioventricular canal defect, and tricuspid atresia.
When the child is older, doctors can remove the band and fix the defect
with open-heart surgery.
Ross pr ocedur
oceduree — A procedure in which a person’s diseased or abnormal
procedur
aortic valve is replaced with the patient’s own pulmonary valve (pulmonary
autograft). A homograft valve (valve from a human donor) is then placed
where the pulmonary valve was.
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Shunt or shunting procedure — An operation that forms a passage between

blood vessels to divert blood from one part of the body to another. It’s used
to reduce the cyanosis (blueness) in infants with severe tetralogy of Fallot
and those with tricuspid atresia or pulmonary atresia.
Venous switch or intra-atrial baffle — A procedure that creates a tunnel
inside the atria to help correct transposition of the great arteries. It redirects
oxygen-rich (red) blood to the right ventricle and aorta, and redirects venous
(bluish) blood to the left ventricle and pulmonary artery. In the Mustard
procedure, the intra-atrial baffle is made of tissue from the pericardium. In
the Senning procedure, the intra-atrial baffle is made of flaps from the
atrial wall.
ALTERNATIVE THERAPIES:
Modern Medicine rightly has the pride of place in relation to congenital
heart defects. Scattered references have been located in alternative therapies,
but none as comprehensive as Modern Medicine.
Prevention
Avoid alcohol and other drugs during pregnancy. Physicians should be made
aware that a woman is pregnant before prescribing for any medications for
her. The immune status for rubella should be evaluated early in the
pregnancy. If the mother is not immune, she must avoid any possible
exposure to rubella and should be immunized immediately following delivery.
There may be some hereditary factors that play a role in congenital heart
disease. It is rare but not impossible for more than one child in a family to
have a congenital heart defect. Experts believe that some prescription and
over-the-counter medications and street drugs used during pregnancy
increase the risk of heart defects.
There is, however, no definitive cause that can be identified for most
congenital heart defects. Congenital heart diseases continue to be investigated
and researched.
One of the most important factors in determining the outcome of a baby
born with a congenital heart disease is whether the defect was found and
followed during the pregnancy. Therefore, it is of the utmost importance
that expectant mothers receive good prenatal care. Many of these defects
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can be discovered on routine ultrasound examinations performed by an

obstetrician. The delivery can then be anticipated and the appropriate
medical personnel (such as a pediatric cardiologist, a cardiothoracic surgeon,
ans a neonatologist) can be present, ready to intervene as necessary. This
can make the difference between life and death for some babies.
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4
NEUROLOGICAL SYSTEM
Headache
Migraine
Stroke
Alzheimer’s disease
Parkinsonism
Epilepsy
HEADACHE
A headache is pain or discomfort in the head or scalp. Serious causes of
headaches are extremely rare. Most people with headaches can feel much
better by making lifestyle changes, learning ways to relax, and occasionally
by taking medications.
Causes
Tension headaches are due to tight, contracted muscles in shoulders, neck,
scalp, and jaw. They are often related to stress, depression, or anxiety.
Overworking, not getting enough sleep, missing meals, and using alcohol
or street drugs can make you more susceptible to them. Headaches can be
triggered by chocolate, cheese, and monosodium glutamate (MSG). People
who drink caffeine can suffer headaches when they don’t get their usual
daily amount.
Tension headaches tend to be on both sides of your head. They often start
at the back of your head and spread forward. The pain may feel dull or
squeezing, like a tight band or vice. Your shoulders, neck, or jaw may feel
tight and sore.
Migraine headaches are severe, recurrent headaches generally accompanied
by other symptoms like visual disturbances or nausea. They tend to begin
on one side of your head, although the pain may spread to both sides. You
may have an “aura” (warning symptoms that start before your headache)
and feel throbbing, pounding, or pulsating pain.
Other types of headaches:
O Cluster headaches are sharp, extremely painful headaches that tend
to occur several times per day for months and then go away for a
similar period. They are far less common.
O Sinus headaches cause pain in the front of your head and face.
They are due to inflammation in the sinus passages that lie behind
the cheeks, nose, and eyes. The pain tends to be worse when you
bend forward and when you first wake up in the morning. Postnasal
drip, sore throat, and nasal discharge usually occur with these
headaches.
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Neurological System
Other causes include:

O Holding your head in one position for a long time, like at a
computer, microscope, or typewriter
O Poor head and neck posture
O Poor sleep position
O Overexerting yourself
O Clenching or grinding your teeth.
Headaches may also occur due to cold, flu, fever, or premenstrual syndrome.
Rare causes of headache include:
O Brain aneurysm — a weakening of the wall of a blood vessel that
can rupture and bleed into the brain
O Brain tumor
O Stroke or Transient Ischemic Attack
O Brain infection like meningitis or encephalitis.
Diagnostic tests
Diagnostic tests that may be performed include the following:
O Head CT scan
O Head MRI
O Sinuses x-rays
O Temporal artery biopsy
O Lumbar puncture.
Treatment
Treatment of headaches remains challenging. Because the underlying
mechanisms remain unclear, specific medications to treat daily headaches
have not yet been developed. Treatment remains more an art than a science,
and for the most part depends on the history of how the daily headaches
developed. Most headache centers now use multidisciplinary approaches,
usually including medication, psychological support, and non-drug
approaches.
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MODERN MEDICINE
Analgesics like aspirin or acetaminophen and NSAIDs (nonsteroidal
antiinflammatory drugs) like ibuprofen are prescribed. In severe headache
codeine or other opiates are given.
Headaches due to intracranial pressure has to be investigated and treated
accordingly. In these cases, high doses of corticosteroids like dexamethasone
is given.
AYURVEDA
Panchakarma treatments like Nasyam (nasal inhalation of medicine) help
to treat headache. Nasyam with the mixture of saffron and ghee (Pitta
headache), or with Dry Ginger powder + milk 3-6 drops (kapha headache)
or Shadbindhu oil 3-6 drops (Vata headache) reduces headache. Thalam
with Kachoradi choornam, Ksheerabala oil, Rasnadi lepam reduces headache.
Shiro-dhara with bala oil or brahmi oil, ksheera-dhara also reduce headache.
The massage of the scalp with Brahmi oil, Balahatadi oil, Ksheerabala,
Rasnadasamooladi oil also relieves headache.
For kapha headaches Varanadi Kashayam and for pitta headaches Drakshadi
Kashayam are advised. Proper evacuation of bowels with Triphala and Avipathi
churnam are helpful.
Nasal insufflation of ginger powder and jaggery helps in subsiding the headache.
Local application on the forehead of the paste of sandalwood, nut grass,
Khaskhas grass, stem of lotus flower, liquorice reduces the pain.
Juice of leaves of Eclipta alba mixed with goat’s milk should be used as
nasal medicines in the dose of two to three drops in each nostril.
Paste of black pepper and leaf juice of Eclipta alba should be applied on
forehead.
Nasal drops of emetic nut, sugar and milk should be used in the dose of 2-
3 drops in each nostril.
Nasal drops of ginger powder and milk should be instilled for relief of pain.
Paste of Embelia ribes and black sesame seeds should be applied on forehead.
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Neurological System
Following are some of the medicines used to treat headache:

O Pathyadhikwatham 4-28 ml thrice a day
O Shirashuladirajra Ras 1 tab with honey twice a day
O Mahalaxmivilas Ras 60-120 mg with honey twice a day
O Laghusutashekara Ras 1-3 tab twice a day
O For vataja headache: Parasikayavani powder (2gm) +
Vathavidhwansini Ras (1gm) + 1 gm ghee thrice a day
O For Pittaja Headache: Sarpagandha Churnam (2gm) + Soothashekara
Rasa (1gm) + with milk thrice a day
O For Kaphaja headache: Tribhuvanakirthi (1gm) + Sarpagandha
Churnam (2gm) + Honey 1 gm thrice a day
O For tension headache: Jatamansi powder (1gm) + Swarnamakshika
+ Bhasmam (1gm) + Pravalabhasmam (1gm) + Sutaseka Ras (1gm),
500mg to 1 gm with honey thrice a day.
ACUPUNCTURE
The National Institutes of Health recommends acupuncture as a treatment
for headache. Acupuncturists diagnose tension headaches by paying careful
attention to the kidney and its associated meridians (bladder, small
intestine), as well as liver and gallbladder meridians.
In all types of headaches the points Baihui (Du 20) and Sishencong (Ex.
6), together with Hegu (L.I. 4) as a distal analgesic point, should be used.
If Ah-Shi pints are present, they should be precisely needled. Migraine
headaches respond well to Shaochong (H.9). Strong stimulation of
acupuncture points in the head area should be avoided. This may aggravate
the headache. If the headache is acute, manual stimulation of Hegu (L.I.
4) produces immediate relief. Hegu is not recommended for pregnant
women, because pressing the LI 4 points can cause uterine contractions.
Frontal headache:
O Baihui (Du 20.), and Sishencong (Ex. 6)
O Local Points: Ah-Shi points, Shangxing (Du 23), Touwei (St. 8),
Yangbai (G.B. 14), Yintang (Ex. 1), Taiyang (Ex. 2)
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O Distal Points: Hegu (L.I. 4), Neiting (St. 44), Yanglingquan (G.B. 34).
Temporal headache:
O Local Points: Ah-Shi points, Touwei (St. 8), Shuaigu (G.B. 8),
Sizhukong (S.J. 23)
O Distal Points: Hegu (L.I. 4), Neiting (St. 44), Foot-Linqi (G.B.
41), Waiguan (S.J. 5),Yanglingquan (G.B. 34).
Parietal headache:
O Local Points: Ah-Shi points, Touwei (St. 8), Shuaigu (G.B. 8)
O Distal Points: Hegu (L.I. 4), Zhongzhu (S.J.3).
Occipital headache:
O Local Points: Ah-Shi points, Fengchi (G.B. 20)
O Distal Points: Lieque (Lu. 7), Kunlun (U.B. 60).
HOMEOPATHY
Studies indicate that one of the most common reasons people seek
homeopathic care is to relieve the pain associated with chronic headaches.
Many homeopaths report that homeopathy helps treat and prevent
recurrent tension headaches.
The following remedies are commonly prescribed for tension headaches:
Belladonna for throbbing headaches that come on suddenly; symptoms
tend to worsen with motion and light, but are partially relieved by pressure,
standing, sitting, or leaning backwards.
Br yonia for headaches with a steady, sharp pain that occurs most often in
the forehead but may radiate to the back of the head; symptoms tend to
worsen with movement and light touch, but firm pressure alleviates the
pain; the person for whom this remedy is most appropriate is usually
irritable and may experience nausea, vomiting, and constipation.
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Neurological System
Gelsemium for pain that extends around the head and feels like a tight band
of constriction; pain usually originates in the back of the head and may be
relieved following urination; this remedy is most appropriate for individuals
who feel extremely weak and have difficulty keeping their eyes open.
Ignatia for pain that may be described as a feeling of something being
driven into the skull; these types of headaches tend to be triggered by
emotion, including grief or anxiety, and the treatment is appropriate for
both children and adults.
Iris versicolor for throbbing headaches that occur on one side of the head,
especially after eating sweets; visual disturbances may also occur; these
headaches are worse in the early morning, during spring and fall, and
symptoms tend to worsen with vomiting.
Lachesis for headaches that tend to occur on the left side of the head;
symptoms are typically worse in the mornings, before menstruation, and
with exposure to warmth and sunlight; symptoms tend to improve with
open air and firm pressure.
Nux vomica for headaches associated with hangovers, overindulgence in
foods or alcohol, and overwork; these types of headaches are often
accompanied by nausea and/or dizziness; this remedy is most appropriate
for individuals who tend to be constipated and irritable.
Natrum muriaticum one of the most common remedies used for migraine
headaches, particularly those that are described as “hammers beating the head;”
pain is relieved when the individual is lying down, alone, in a quiet dark room;
these migraines may be associated with either menstruation or a grieving
experience and are worse in the middle of the day; this remedy is most
appropriate for children who look pale and feel nauseated, nervous, and
emotional.
Pulsatilla for headaches triggered by eating rich, fatty foods, particularly
ice cream; pain tends to move but may be concentrated in the forehead or
on one side of the head and may be accompanied by digestive problems or
occur around the time of menstruation; children for whom this remedy is
appropriate often develop these symptoms while at school.
Spigelia for stinging, burning, or throbbing sinus pain that often occurs
on the left side of the head; symptoms tend to worsen with cold weather
179
and motion but may be temporarily relieved by cold compresses and lying
on the right side with the head propped up.
Sanguinaria for right-sided headaches that begin in the neck and move
upwards, recur in a predictable pattern (such as every seven days); pain is
aggravated by motion, light, or sun exposure, odors, and noise.
NATUROPATHY
Fasting with vegetable juices and daily enema for 3 to 5 days will help to eliminate
internal toxins. A plain warm-water enema relieves constipation and headache.
After fasting, follow a rotation diet, with no food being eaten more frequently
than once every four days. If fasting precipitates headache, follow a
detoxification diet consisting of raw salads, fruits, and vegetable juices for
one or two weeks. Following herbs reduce headache:
Peppermint (Mentha piperita) oil is effective against tension. Add two drops
of peppermint essential oil to 1 cup of water. Soak a cloth in the solution
and apply as a compress.
White willow bark (Salix alba) contains salicin, the pain reliever in aspirin.
Valerian (Valeriana officinalis) helps you relax and reduces spasms, and
helps relieve headache with anxiety or digestive discomfort.
Ginkgo (Gingko biloba) increases blood circulation to your brain, and can
help relieve tension headache.
Kava kava (Piper methysticum)—45 to 60 mg of kavalactone content three
times a day, has a calming effect if anxiety is prominent.
Hydrotherapy
During an acute headache, place an ice pack on the forehead. To increase
the pain-relieving effect, soak the feet in hot water at the same time. Mix
one tsp of dry mustard powder in hot foot bath water.
YOGA THERAPY
Yoga practises like Meditation, Yoga nidra reduces headache. During
headache take breathing through left nostril. Pranayamas such as Nadi
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Neurological System
shuddhi, Ujjayi, Sheetkari, Sheetali, and Bhramari also are helpful. In

addition inverted asanas like sabhandasana, ardhalasana and also halasana
are helpful in reducing headaches.
NUTRITION THERAPY
Elimination diet: Some tension headaches respond dramatically to this
approach. The most common allergic foods are wheat, dairy products, corn,
soy, and chocolate. Eliminate these foods completely for 2 weeks, then
reintroduce the foods one at a time, every 3 days, and note reactions. Citrus,
alcohol, red meat, flour products, spices, and carbonated drinks may also
aggravate headaches.
Replacing micronutrients depleted in times of stress is essential; the most
critical are the vitamins C, E, beta-carotene, B-complex, and the minerals
magnesium, potassium, calcium, zinc, manganese, and selenium.
Magnesium (aspartate or glycinate, up to 750 mg per day) is especially
critical because of its antispasmodic action. Vitamin E: 400 to 800 IU/day
may decrease muscle cramping. Calcium/magnesium: 1,000/500 mg per
day may help regulate muscle contraction and relaxation.
Essential fatty acids can improve blood flow. Reduce animal fats and increase
fish. A mix of omega-6 (evening primrose) and omega-3 (flaxseed) oils may
be best (2 tbsp. oil per day or 1,000 to 1,500 IU twice a day).
PHYSICAL THERAPY
A massage or heat applied to the back of the upper neck can be effective in
relieving tension headaches. TENS (Transcutaneous Electrical Nerve
Stimulation) reduces the headache and the frequency of attacks. TENS
controls secondary muscle spasm.
A daily round of exercise lasting for 30 minutes or more comprising of walking
or jogging, mobility exercises etc. are extremely helpful in reducing headaches.
Mobility exercises especially relevant are neck rotation, shoulder rotation. Face
stretching exercises and deep breathing 10 times is also helpful.
PSYCHOTHERAPY
Headaches respond well to psychotherapy. Behavioral approaches especially
benefits people who also suffer from anxiety or depression. Cognitive-
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behavioral therapy for headache patients generally involves developing skills

for identifying and controlling stress and thus minimizing the effects of
stress.
Relaxation techniques including deep breathing, meditation, autogenic
training, hypnosis, thermal biofeedback and progressive relaxation, are
effective in reducing and preventing headache. Relaxation techniques may
involve training in controlling muscle tension or may use mental relaxation
or visual imagery to reduce stress and tension.
Home Care
Keep a headache diary to help identify the source or trigger of your
symptoms. Then modify your environment or habits to avoid future
headaches. When a headache occurs, write down the date and time the
headache began, what you ate for the past 24 hours, how long you slept
the night before, what you were doing and thinking about just before the
headache started, any stress in your life, how long the headache lasts, and
what you did to make it stop. After a period of time, you may begin to see
a pattern.

The following healthy habits can lessen stress and reduce your chance of
getting headaches:
O Getting adequate sleep

O Eating a healthy diet
O Exercising regularly
O Stretching your neck and upper body, especially if your work
involves typing or using a computer
O Learning proper posture
O Quitting smoking
O Learning to relax using meditation, deep breathing, yoga, or other
techniques.
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Neurological System
MIGRAINE
Migraines are pounding or throbbing headaches that start suddenly, last
for hours and usually occur with other symptoms such as nausea. The
headaches usually occur between ages 10 and 30, often vanishing after age
50 or, in women, after menopause. They occur in women more often than
men.

Migraines are classified as either “common” or “classic”. Common migraines
do not have any warning symptoms, while classic migraines do have a
warning (the aura). Most migraine patients have the common type.
The exact cause of migraine is not known. Migraine headaches are related
to problems with blood flow through parts of the brain. At the start of a
migraine, blood vessels in certain areas of the brain constrict, leading to
symptoms like visual disturbances, difficulty speaking, weakness, or
numbness. Minutes to hours later, the blood vessels dilate, leading to
increased blood flow in the brain and a bad headache.
Why these changes in blood vessels and blood flow occur in the brain is
not understood. Certain triggers, however, make it more likely for you to
get migraines:
O Allergic reactions
O Bright lights, loud noises, and certain odors or perfumes
O Physical or emotional stress
O Changes in sleep patterns
O Smoking or exposure to smoke
O Skipping meals
O Alcohol or caffeine
O Menstrual cycle fluctuations, birth control pills
O Tension headaches
O Foods containing tyramine (red wine, aged cheese, smoked fish,
chicken livers, figs, and some beans), monosodium glutamate
(MSG), or nitrates (like bacon, hot dogs, and salami)
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O Other foods such as chocolate, nuts, peanut butter, avocado, banana,

citrus, onions, dairy products, and fermented or pickled foods.
Symptoms
Migraine headaches, which can be dull or severe, usually:
O Feel throbbing, pounding, or pulsating
O Are worse on one side of the head
O Last 6 to 48 hours.
Symptoms accompanying migraines include:
O Sensitivity to light or sound
O Loss of appetite
O Fatigue
O Numbness, tingling, or weakness.
Warning signs that a migraine is coming include seeing stars or zigzag
lines, having tunnel vision, or temporary blind spot.
Symptoms that may linger even after the migraine has gone away include:
O Feeling mentally dull, like your thinking is not clear or sharp
O Increased need for sleep
O Neck pain.
Signs and tests

Migraine headache may be diagnosed based on symptoms, history and
clinical examination.
Sometimes an MRI or CT scan is obtained to rule out other causes of
headache like sinus inflammation or a brain mass. In the case of a
complicated migraine, an EEG may be needed to exclude seizures. Rarely,
a lumbar puncture (spinal tap) might be performed.
Treatment
There is no specific cure for migraine headaches. The goal is to prevent
symptoms by avoiding or altering triggers.
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Neurological System
A good way to identify triggers is to keep a headache diary.

When migraine symptoms begin:
O Rest in a quiet, darkened room
O Drink fluids to avoid dehydration (especially if you have vomited)
O Try placing a cool cloth on your head.
MODERN MEDICINE
For mild migraines: Aspirin (600 to 1,000 mg every four hours), ibuprofen
(800 mg followed by 400 mg every 4 hours), naproxen (500 mg), and
codeine may be sufficient if taken early in attack.
For moderate migraines: NSAIDs, ergotamine (particularly ergotamine
combined with a medication to reduce nausea), and/or ergotamine
suppositories (1/2 up to 2 suppositories per attack) may relieve symptoms.
For severe migraines: Intravenous medications may be given and intranasal
lidocaine may be used.
Triptans like sumatriptan, rizatriptan, almotriptan, and zolmitriptan are
also used.
To prevent migraines following drugs are used:
O Beta-blockers, such as propranolol
O Anti-depressants, including tricyclics like amitriptyline or SSRIs
like fluoxetine, paroxetine, or sertraline
O Anti-convulsants, like valproic acid or divalproex sodium
O Calcium channel blockers, such as verapamil.
AYURVEDA
Panchakarma treatments like Nasyam (nasal inhalation of medicine) helps
to treat headache. Nasyam with cow ghee (Pitta headache), or Shadbindhu
oil 3-6 reduces migraine. The massage of the scalp with Brahmi oil or
shirodhara with brahmi oil also relieves headache.
Following are some of the medicines used to treat headache:

O Godanti Bhasmam (Karpoora Shilajita) 1 gm with milk twice a day
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O Tribhuvana Kirthi ras 1-2 tab twice a day with milk

O The juice of gudunchi (Tinospora cordifolia) in 1 to 2 oz doses is
given with honey.
ACUPUNCTURE
Migraine headaches respond well to Shaochong (H.9). Strong stimulation
of acupuncture points in the head area should be avoided. This may
aggravate the headache. If the headache is acute, manual stimulation of
Hegu (L.I. 4) produces immediate relief. Hegu is not recommended for
pregnant women, because pressing the LI 4 points can cause uterine
contractions.
Frontal headache:
O Local Points: Ah-Shi points, Shangxing (Du 23), Touwei (St. 8),
Yangbai (G.B. 14), Yintang (Ex. 1), Taiyang (Ex. 2)
O Distal Points: Hegu (L.I. 4), Neiting (St. 44), Yanglingquan (G.B. 34).
Temporal headache:
O Local Points: Ah-Shi points, Touwei (St. 8), Shuaigu (G.B. 8),
Sizhukong (S.J. 23)
O Distal Points: Hegu (L.I. 4), Neiting (St. 44), Foot-Linqi (G.B.
41), Waiguan (S.J. 5),Yanglingquan (G.B. 34).
Parietal headache:
O Baihui (Du 20.), and Sishencong (Ex.6)
O Local Points: Ah-Shi points, Touwei (St. 8), Shuaigu (G.B.8)
O Distal Points: Hegu (L.I. 4), Zhongzhu (S.J.3).
Occipital headache:
O Local Points: Ah-Shi points, Fengchi (G.B. 20)
O Distal Points: Lieque (Lu. 7), Kunlun (U.B. 60).
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Neurological System
HOMEOPATHY
Lachesis is given for headaches that tend to occur on the left side of the
head; symptoms are typically worse in the mornings, before menstruation,
and with exposure to warmth and sunlight; symptoms tend to improve
with open air and firm pressure.
Nux vomica is given for headaches associated with hangovers, overindulgence
in foods or alcohol, and overwork; these types of headaches are often
accompanied by nausea and/or dizziness; this remedy is most appropriate
for individuals who tend to be constipated and irritable.
Natrum muriaticum, one of the most common remedies used for migraine
headaches, particularly those that are described as “hammers beating the
head;” pain is relieved when the individual is lying down, alone, in a quiet
dark room. These migraines may be associated with either menstruation or
a grieving experience and are worse in the middle of the day; this remedy
is most appropriate for children who look pale and feel nauseated, nervous,
and emotional.
Pulsatilla for headaches triggered by eating rich, fatty foods, particularly
ice cream; pain tends to move but may be concentrated in the forehead or
on one side of the head and may be accompanied by digestive problems or
occur around the time of menstruation; children for whom this remedy is
appropriate often develop these symptoms while at school.
Spigelia for stinging, burning, or throbbing sinus pain that often occurs
on the left side of the head; symptoms tend to worsen with cold weather
and motion but may be temporarily relieved by cold compresses and lying
on the right side with the head propped up.
Sanguinaria for right-sided headaches that begin in the neck and move
upwards, recur in a predictable pattern (such as every seven days); pain is
aggravated by motion, light, or sun exposure, odours, and noise. This remedy
is appropriate for children who may have a craving for spicy or acidic foods,
despite having a general aversion to eating due to the headache.
NATUROPATHY
Fasting with vegetable juices with daily enema for 3 to 5 days will help to
eliminate internal toxins. A plain warm-water enema relieves constipation
and migraine.
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A balanced diet with plenty of fresh vegetables, and fruits, sprouts, vegetable
juices, is good for migraine. Certain foods like fish, fish oil, and ginger
relieve headaches. GLA in the form of evening primrose oil helps to reduce
the severity and frequency of migraines.
Following herbs reduce headache:
O Ginger (Zingiber officinale) or Chamomile (Anthemis nobilis) tea
can inhibit the migraine response
O Valerian (Valeriana officinalis) tea 2 to 3 times a day
O Feverfew (Tanacetum parthenium) - 25 mg dried leaves 2 times a
day or 250 mcg of parthenolide
O Valerian (Valeriana officinalis) helps you relax and reduces spasms,
and helps relieve headache with anxiety or digestive discomfort
O Ginkgo (Gingko biloba) increases blood circulation to your brain,
and can help relieve migraine headache
O Kava kava (Piper methysticum)—45 to 60 mg of kavalactone content
three times a day, has a calming effect if anxiety is prominent.
Hydrotherapy
During acute headache, put an ice pack on the forehead. To increase the
pain-relieving effect, soak feet in hot water at the same time. Mix one tsp
of dry mustard powder in hot foot bath water.
NUTRITION THERAPY
Avoid food allergens. Some common allergens are alcohol (especially red
wine), cheese, chocolate, citrus, cow’s milk, wheat, eggs, coffee, tea, beef,
pork, corn, tomato, rye, yeast, shellfish, food additives (preservatives and
coloring), and nitrates. Avoid caffeine because it is a vasodilator.
O Essential fatty acids (1,500 to 3,000 mg per day) may be helpful.
Supplementing with fish oil or flaxseed oil (1 to 3 mg twice a day)
may also be helpful
O Magnesium (500 mg per day) increases muscle relaxation
O Injection of 1,000 mg of magnesium by a physician can terminate
an acute migraine headache within minutes
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Neurological System
O Injection of folic acid (15 mg) in one study achieved total relief of
acute headache within one hour in 60 percent of patients
O Omega-3 oils (EPA and DHA, average dose 14 g daily) greatly
reduce intensity and frequency of migraines
O Vitamin B2 (riboflavin) (400 mg/day for three months) has been
shown to reduce migraine frequency by two-thirds
O Vitamin C (250 to 500 mg twice a day), vitamin E (400 to 600
IU per day), vitamin B6 (100 mg per day), choline (100 to 300
mg per day) and mixed flavonoids (1,000 mg per day)
O 5-hydroxytryptophan (300 mg twice a day) for migraine
prevention, enhanced by taking with 25 mg of vitamin B6.
PSYCHOTHERAPY
Psychological correlates with headache are a complex situation. It is generally
a mistake to “blame” the headaches on depression. However, anxiety and
depression are increased in the migraine and tension headache population.
Approximately 60% of headache patients have an anxiety disorder, usually
mild, and 20% have either recurrent major depression or dysthymia.
Psychotherapy, relaxation therapies help to reduce migraine.
Cognitiv
Cognitivee B ehavioral Therapy (CB
Behavioral (CBTT ): CBT is a type of psychotherapy
that focuses on changing dysfunctional thoughts, emotions, and behavior.
CBT combines two kinds of psychotherapy — cognitive therapy and
behavior therapy. Cognitive therapy teaches you how certain thinking
patterns are causing your symptoms — by giving you a distorted picture
of what’s going on in your life, and making you anxious, depressed or
angry. Behavior therapy helps you weaken the connections between
troublesome situations and your habitual reactions to them.
As a treatment for headaches, CBT may help to reduce chronic stress levels
- which may be beneficial in reducing the number and severity of migraine
headaches.
PHYSICAL THERAPY
TENS (Transcutaneous Electrical Nerve Stimulation) reduces the headache
and the frequency of attacks. TENS controls secondary muscle spasm.
Thermal biofeedback can help redirect blood flow out of dilated blood
vessels in the scalp and ease headache.
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O Avoid smoking, caffeine, and alcohol
O Exercise regularly
O Get 6 to 8 hours of sleep each night.
STROKE
STROKE
A stroke occurs when the blood supply to part of the brain is suddenly
interrupted due to the presence of a blood clot (ischemic stroke) or when
a blood vessel in the brain bursts, spilling blood into the spaces surrounding
brain cells (hemorrhagic stroke). Brain cells die when they no longer receive
oxygen and nutrients from the blood or when they are damaged by sudden
bleeding into or around the brain. This results in temporary or permanent
neurologic impairment.
Ischemic stroke, also known as cerebral infarction, accounts for 80 percent
of all strokes, while hemorrhagic stroke accounts for the other 20 percent.
In addition, some people suffer transient ischemic attacks (TIAs), which
are mini-strokes that last only 5 to 20 minutes. In almost all TIAs, the
symptoms go away within an hour.
Causes and risk factors
Most strokes are due to blood clots that block blood flow. Ischemic stroke
results from the following causes:
O A clot (embolus) forms in a part of the body other than the brain,
travels through blood vessels, and becomes wedged in a brain artery
O A blood clot (thrombus) forms in a brain artery and stays attached
to the artery wall until it grows large enough to block blood flow
O Atherosclerosis: Fatty deposits and blood platelets collect on the
wall of the arteries, forming plaques. Over time, the plaques slowly
begin to block the flow of blood. The plaque itself may block the
artery enough to cause a stroke.
Bleeding into the brain occurs if a blood vessel ruptures or there is a
significant injury. Hemorrhagic stroke results from the following causes:
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Neurological System
O A bleeding aneurysm—a weak or thin spot on an artery wall that

over time has stretched or ballooned out under pressure from blood
flow. The wall ruptures and blood spills into the space surrounding
brain cells.
O Artery walls lose their elasticity and become brittle and thin, prone
to cracking.
O Arteriovenous malformation (AVM)—a tangle of defective blood
vessels and capillaries within the brain that have thin walls that
can rupture.
Stroke Risks
Individuals with the following characteristics or health conditions are at a
higher-than-average risk for developing a stroke.
O More men suffer strokes than women
O African Americans are at higher risk
O TIAs, history of stroke
O Age (risk increases with age)
O Hypertension
O Heart disease
O Substance abuse (cocaine, alcohol)
O High total serum cholesterol (for older patients)
O Diabetes
O Increased blood viscosity (thickness)
O Use of oral contraceptives, especially in smokers
O Smoking.
Symptoms
The symptoms of stroke depend on what part of the brain is damaged. In
some cases, a person may not even be aware that he or she has had a stroke.
Usually, a sudden development of one or more of the following indicates a
stroke:
O Weakness or paralysis of an arm, leg, side of the face, or any part of
the body
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O Numbness, tingling, decreased sensation

O Vision changes
O Slurred speech, inability to speak or understand speech, difficulty
reading or writing
O Wallowing difficulties or drooling
O Loss of memory
O Vertigo (spinning sensation)
O Loss of balance or coordination
O Personality changes
O Mood changes (depression, apathy)
O Drowsiness, lethargy, or loss of consciousness
O Uncontrollable eye movements or eyelid drooping.
If one or more of these symptoms is present for less than 24 hours, it may
be a transient ischemic attack (TIA). A TIA is a temporary loss of brain
function and a warning sign for a possible future stroke.
Signs and tests

In diagnosing a stroke, knowing how the symptoms developed is important.
The symptoms may be severe at the beginning of the stroke, or they may
progress or fluctuate for the first day or two (stroke in evolution). Once
there is no further deterioration, the stroke is considered completed.
An examination may show changes in vision or visual fields, abnormal
reflexes, abnormal eye movements, muscle weakness, decreased sensation,
and other changes. A “bruit” (an abnormal sound heard with the
stethoscope) may be heard over the carotid arteries of the neck. There may
be signs of atrial fibrillation.
Tests are performed to determine the type, location, and cause of the stroke
and to rule out other disorders that may be responsible for the symptoms.
These tests include:
O Head CT or head MRI — used to determine if the stroke was
caused by bleeding (hemorrhage) or other lesions and to define
the location and extent of the stroke
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Neurological System
O ECG (electrocardiogram) — used to diagnose underlying heart

disorders
O Echocardiogram — used if the cause may be an embolus (blood
clot) from the heart
O Carotid duplex (a type of ultrasound) — used if the cause may be
carotid artery stenosis (narrowing of the major blood vessels
supplying blood to the brain)
O Heart monitor — worn while in the hospital or as an outpatient
to determine if a heart arrhythmia (like atrial fibrillation) may be
responsible for your stroke
O Cerebral (head) angiography — may be done so that the doctor
can identify the blood vessel responsible for the stroke. Mainly
used if surgery is being considered
O Blood work may be done to exclude immune conditions or
abnormal clotting of the blood that can lead to clot formation.
Treatment
A stroke is a medical emergency. Physicians have begun to call it a “brain
attack” to stress that getting treatment immediately can save lives and
reduce disability. Treatment varies, depending on the severity and cause of
the stroke. For virtually all strokes, hospitalization is required, possibly
including intensive care and life support.
The goal is to get the person to the emergency room immediately, determine
if he or she is having a bleeding stroke or a stroke from a blood clot, and
start therapy — all within 3 hours of when the stroke began.
MODERN MEDICINE
Immediate Treatment
Thrombolytic medicine, like TPA, breaks up blood clots and can restore
blood flow to the damaged area. People who receive this medicine are more
likely to have less long-term impairment. However, there are strict criteria
for who can receive thrombolytics. The most important is that the person
be evaluated and treated by a specialized stroke team within 3 hours of
when the symptoms start. If the stroke is caused by bleeding rather than
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clotting, this treatment can make the damage worse — so care is needed to
diagnose the cause before giving treatment.
In other circumstances, blood thinners such as heparin and coumadin are
used to treat strokes. Aspirin and other anti-platelet agents may be used as
well.
Other medications may be needed to control associated symptoms.
Analgesics (pain killers) may be needed to control severe headache. Anti-
hypertensive medication may be needed to control high blood pressure.
Nutrients and fluids may be necessary, especially if the person has
swallowing difficulties. The nutrients and fluids may be given through an
intravenous tube (IV) or a feeding tube in the stomach (gastrostomy tube).
Swallowing difficulties may be temporary or permanent.
Surgical and Other Procedures

Surgery can be used to prevent stroke, to treat acute stroke, or to repair
vascular damage or malformations in and around the brain. There are two
major types of surgery for stroke prevention and treatment.
O Carotid endarterectomy involves removing fatty deposits (plaque)
from the inside of one of the carotid arteries, which are located in
the neck and are the main suppliers of blood to the brain.
O EC/IC bypass surgery restores blood flow to a blood-deprived area
of brain tissue by rerouting a healthy artery in the scalp to the area
of brain tissue affected by a blocked artery.
For hemorrhagic stroke, surgery is often required to remove pooled blood
from the brain and to repair damaged blood vessels.
Life support and coma treatment are performed as needed.
Long-Term Treatment
Long-Term
The goal of long-term treatment is to recover as much function as possible
and prevent future strokes. Depending on the symptoms, rehabilitation
includes speech therapy, occupational therapy, and physical therapy. The
recovery time differs from person to person.
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Neurological System
Certain therapies, such as repositioning and range-of-motion exercises, are

intended to prevent complications related to stroke, like infections and
bed sores. People should stay active within their physical limitations.
Sometimes, urinary catheterization or bladder/bowel control programs may
be necessary to control incontinence.
The person’s safety must be considered. Some people with stroke appear to
have no awareness of their surroundings on the affected side. Others show
indifference or lack of judgment, which increases the need for safety
precautions. For these people, friends and family members should
repeatedly reinforce important information, like name, age, date, time,
and where they live, to help the person stay oriented.
Caregivers may need to show the person pictures, repeatedly demonstrate
how to perform tasks, or use other communication strategies, depending
on the type and extent of the language problems.
In-home care, boarding homes, adult day care, or convalescent homes may
be required to provide a safe environment, control aggressive or agitated
behaviour, and meet medical needs.
Behaviour modification may be helpful for some people in controlling

unacceptable or dangerous behaviours.
Family counselling may help in coping with the changes required for home
care. Visiting nurses or aides, volunteer services, homemakers, adult
protective services, and other community resources may be helpful.
Carotid endarterectomy (removal of plaque from the carotid arteries) may
help prevent new strokes from occurring in people with large blockage in
these important blood vessels.
AYURVEDA
Induced purgation (Virechan) is administered in the patients of hemiplegia
to subdue the vitiated Pitta Dosha.
Decoction of black grams, seeds of Mucuna pruriens, roots of Ricinus
communis, Sida cordifolia with asafoetida and rock salt is helpful if given
in the dose of 30-50 ml. thrice daily.
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External oleation of the affected part by using the medicated oils such as
Masha Taila is very helpful in regaining the mobility.
Use of garlic is recommended, as it is one of the best Vata Shamak herb
used in various musculoskeletal disorders.
Certain generic formulations such as Maharasnadi kwath, Mahabaladi
Kwath, Panchmooladi Kwath, Erandadi kwath, Mahavishgarbha taila and
Narayan taila are helpful.
Navaneeta churnam and bala choornam smeared in a mud pot applied as a
thalam reduces cerebral edema.
The following prescriptions, either singly or in combination with others,
may be tried:
O Maharasnadi Kwatham 30 ml bid to be taken daily
O 1 gm each of Ashwagandha Churna and Chopcheeni Churna; 60
mg of Valavidhwamsana Rasa and 1 gm of Pippali Churna to be
taken thrice daily
O Medicated Castor oil. 20 ml to be given in the morning with milk
O 50 ml Mashabaladi Quath, 60 mg Asafoetida, and 500 mg Rock
salt to be used as nasal drops opposite to the side affected
O 30 mg Brihat Vatachintamani Rasa and 1 gm Ashwagandha Churna
to be taken twice daily with meat soup
O Ksheerabala oil or Dhanwantharam oil (100) with milk bid.
Siddha Makaradhwaja, Malla Chandrodaya, Trailokya Chintamani,
Vatanashan Rasa, Navagrahi Shriroraja, Ekanga vir ras, Brihatvata
Chintamani, Vata Vidhwamsini, Vata Gajankusham, Samir pannaga ras are
some of the other standard Ayurvedic preparations helpful in dealing with
paralysis. If needed, they may be combined with any of the above
prescriptions.
Following Panchakarma treatments are helpful:
O Shiro-dhara and Sarvanga dhara for 2 weeks with Dhanwantharam
oil, or Ksheerabala oil or Prasarini oil
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Neurological System
O Abhyanga (massage) with Dhanwantharam oil daily

O Navarakhizhi for 2 weeks
O Yoga Vasthi which includes 5 oil Vasthis and 3 decoction Vasthis.
Oil Vasthi with Dhanwantharam oil or Ksheerabala oil, Kashaya
Vasthi with castor roots kwatham or Rasna roots kwatham or Bala
roots kwatham.
Acupuncture
Both the United Nations World Health Organization and the National
Institutes of Health endorse acupuncture as a treatment for stroke-related
disabilities. People who have suffered a stroke often have a deficiency of Qi
in the liver meridian and a relative excess in the gallbladder meridian. In
addition to a primary needling treatment on the liver meridian and the
supporting kidney meridians, moxibustion (a technique in which the herb
mugwort is burned over specific acupuncture points) may be used to
enhance therapy.
Following acupoints are used:

O Baihui (Du 20.), Fengfu (Du 16)
O Upper limbs: Jianyu (LI.15), Quchi (LI.11), Waiguan (S.J.5),
Hegu (L.I. 4)
O Lower limbs: Huantiao (G.B.30), Yanglingquan (G.B.34), Zusanli
(St.36), Jiexi (St.41).
HOMEOPATHY
Some of the most common acute homeopathic remedies for stroke are listed
below.
Acontitum napellus for numbness and/or paralysis after a cerebral accident
Belladonna for stroke that leaves person very sensitive to any motion, with
vertigo and trembling.
Kali bromatum for stroke resulting in restlessness, wringing of the hands
or other repeated gestures, insomnia, and night terrors.
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Nux vomica for cerebral accident with paresis (muscular weakness caused
by disease of the nervous system), expressive aphasia (language disorder),
convulsions, and great irritability.
Aurum muriaticum is good if your predominant symptom is depression.
Take one dose of Aurum muriaticum for up to three days, as needed. If you
notice an improvement before that time, stop taking the remedy.
Baryta carbonica is helpful for both physical and mental weakness and
fatigue following a stroke.
Gelsemium can help if you have numbness and trembling, and have lost
the ability to speak.
NATUROPATHY
Naturopathy advises daily massage, exercise therapy and rehabilitation in
long-term treatment of stroke.
Following herbs are used in Naturopathy in long-term treatment of stroke.
Gingko biloba, for depression and/or dementia following a stroke (60 to 80 mg
three times a day). It can be used for arterial occlusive disease. Medical advised
for hemorrhagic stroke patients.
Hawthorn (Crataegus species), for heart and vascular conditions
Mistletoe (Viscum album), to treat and prevent atherosclerosis.
NUTRITION THERAPY
To prevent stroke, eat a diet high in fiber, potassium, and magnesium;
decrease saturated fats and sodium; avoid alcohol (it increases risk of
hemorrhagic stroke). Use garlic and onion (help regulate lipids and prevent
atherosclerosis, which is fat deposits inside the arteries).

O Folate (400 to 800 IU a day)
O Essential fatty acids; a mix of omega-6 (evening primrose) and
omega-3 (flaxseed) may be optimal (2 tablespoons oil a day or
1,000 to 1,500 IU two times a day)
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Neurological System
O Vitamin E: 400 to 1,600 IU a day

O Coenzyme Q10: 10 to 50 mg a day
O Vitamin C: 250 to 500 mg two times a day
O Bromelain: 250 mg three times a day between meals.
PHYSICAL THERAPY
In acute stage, Passive movements and positioning should be carried out to

maintain the range of movement in all joints and to maintain muscle length.
Once the patient is able to sit out of bed a more active programme can be
started and may include following:
O Techniques for hypotonicity management

{ Repeated passive movements
{ Joint compression
{ Quick icing
{ Tapping and hacking
{ Faradic stimulation
{ Resistance exercises to increase strength.
O For hypertonicity management

{ Proper positioning
{ Slow passive movements
{ Sustained stretching
{ Stimulation of joint receptors
{ Cold therapy
{ Proprioceptive neuro-muscular stimulation
{ Faradic stimulation and Biofeedback
{ Relaxation with suspension therapy
{ Resistance exercises to increase strength
{ Walking in parallel bars and gait training: helps in relaxing and
re-educating the muscles.
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Regular massage prevents muscle atrophy and increases muscle strength.

Daily massage to the paralysed limbs and whole body fomentation is
indicated. Massage with simple sesame oil, or almond oil will improve the
circulation in the muscles and helps improve the muscular tone.
PSYCHOTHERAPY
Social support is also important in improving recovery from stroke. Close
relationships help reduce risk of stroke. Duke University researchers, after
studying 46 people who had been hospitalized for strokes, found that
those with the most social and emotional support recovered much more
quickly and fully from stroke as compared to those that had little or no
emotional support. Prayer and Spiritual healing had also been beneficial.
Hypnotherapy, guided imagery/visualization, meditation and yoga nidra
all can be useful for stroke. Some stroke victims working to restore lost
muscle control and motor function benefit from biofeedback
Prevention
To help prevent a stroke:
O Get screened for high blood pressure at least every two years,
especially if you have a family history of high blood pressure
O Have your cholesterol checked
O Treat high blood pressure, diabetes, high cholesterol, and heart
disease if present
O Follow a low-fat high-fibre diet
O Quit smoking
O Exercise regularly
O Lose weight if you are overweight
O Avoid excessive alcohol use (no more than 1 to 2 drinks per day).
ALZHEIMER’S DISEASE
Alzheimer’s disease (AD) is a progressive, degenerative brain disease that
results in impaired memory, thinking, and behaviour. It is the most
common cause of dementia in the elderly.
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Currently, there is no cure for AD, but studies suggest that medications,
herbs and supplements, and lifestyle adjustments may all help to slow the
progression and improve the symptoms of the disease.
People with AD experience gradual memory loss as well as impaired
judgement, difficulty concentrating, loss of language skills, personality
changes, and a decline in the ability to learn new tasks.
Memory loss usually begins at about age 65 and symptoms tend to become
severe within 8 to 10 years. In some cases, symptoms may appear earlier in life
and advance at a faster or slower rate, but most people who develop symptoms
before the age of 60 tend to have more severe forms of the disease. The older
you get, the greater your risk of developing AD, although it is not a part of
normal aging. Family history is another common risk factor.
In addition to age and family history, risk factors for AD may include:
O Longstanding high blood pressure
O High levels of homocysteine (a body chemical that contributes to chronic
illnesses such as heart disease, depression, and possibly AD)
O Female gender — because women usually live longer than men,
are more likely to develop AD
O Family history of AD
O Older age—20% to 40% of people with AD are older than 85
O History of head trauma—one or more serious blows to the head
may put a person at an increased risk
O Down Syndrome
O Aluminium or mercury poisoning
O Prolonged exposure to electromagnetic fields.
There are two types of AD — early onset and late onset. In early onset AD,
symptoms first appear before age 60. Early onset AD is much less common,
accounting for only 5 to 10% of cases. However, it tends to progress rapidly.
The cause of AD is not entirely known but is thought to include both
genetic and environmental factors. A diagnosis of AD is made based on
characteristic symptoms and by excluding other causes of dementia.
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Prior theories regarding the accumulation of aluminum, lead, mercury,

and other substances in the brain leading to AD have been disproved. The
only way to know that someone had AD is by microscopic examination of
a sample of brain tissue after death.
The brain tissue shows “neurofibrillary tangles” (twisted fragments of protein
within nerve cells that clog up the cell), “neuritic plaques” (abnormal clusters
of dead and dying nerve cells, other brain cells, and protein), and “senile
plaques” (areas where products of dying nerve cells have accumulated around
protein). Although these changes occur to some extent in all brains with
age, there are many more of them in the brains of people with AD.
The destruction of nerve cells (neurons) leads to a decrease in neurotransmitters
(substances secreted by a neuron to send a message to another neuron). The
correct balance of neurotransmitters is critical to the brain.
By causing both structural and chemical problems in the brain, AD appears
to disconnect areas of the brain that normally work together.
About 10 percent of all people over 70 have significant memory problems
and about half of those are due to AD. The number of people with AD
doubles each decade past age 70. Having a close blood relative who
developed AD increases your risk.
Early onset disease can run in families and involves autosomal dominant,
inherited mutations that may be the cause of the disease. So far, three early
onset genes have been identified.
Late onset AD, the most common form of the disease, develops in people
60 and older. Late onset AD may run in some families, but the role of
genes is less direct and definitive. These genes may not cause the problem
itself, but simply increase the likelihood of formation of plaques and tangles
or other AD-related pathologies in the brain.
Symptoms
In the early stages, the symptoms of AD may be subtle and resemble signs that
people mistakenly attribute to “natural aging.” Symptoms often include:
O Repeating statements
O Misplacing items
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O Having trouble finding names for familiar objects

O Getting lost on familiar routes
O Personality changes
O Losing interest in things previously enjoyed
O Difficulty performing tasks that take some thought, but used to
come easily, like balancing a checkbook, playing complex games
(such as bridge), and learning new information or routines.
In a more advanced stage, symptoms are more obvious:
O Forgetting details about current events
O Forgetting events in your own life history, losing awareness of who
you are
O Problems choosing proper clothing
O Hallucinations, arguments, striking out, and violent behavior
O Delusions, depression, agitation
O Difficulty performing basic tasks like preparing meals and driving.
At end stages of AD, a person can no longer survive without assistance.
Most people in this stage no longer:
O Understand language
O Recognize family members
O Perform basic activities of daily living such as eating, dressing, and
bathing.
Signs and tests
There is no definitive test for AD, and a true diagnosis of AD can only be
made after a person dies and an autopsy is performed on the brain. All
individuals with AD have an accumulation of abnormal deposits (called
plaque) and tangled nerve cells in their brains.
The following tests may also be used to aid in the diagnosis.
O Psychological tests—assess the individual’s memory and attention
span. They may also reveal difficulties in problem-solving, social,
and language skills.
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O Electroencephalograph (EEG)—traces brain-wave activity. This test

sometimes reveals “slow waves” in people with AD. Although other
diseases may reveal similar brain-wave activity, EEGs help
distinguish a person with AD from a severely depressed person,
whose brain waves are normal.
O Imaging tests (such as CT, MRI, or PET)—computerized
tomography (CT) or magnetic resonance imaging (MRI) can detect
the presence of stroke, blood clots, and tumors (problems that
cause AD-like symptoms but are not themselves related to AD).
MRI, positron emission tomography (PET) scans, and other
advanced imaging techniques may eventually be able to diagnose
AD by identifying altered blood flow patterns in the brain.
O Blood test for Apo E4—although the presence of Apo E4 gene in the
blood may suggest AD, it does not always make an accurate diagnosis.
Treatment
Unfortunately, there is no cure for AD. The goals in treating AD are to:
O Slow the progression of the disease
O Manage behavior problems, confusion, and agitation
O Modify the home enviroment
O Support family members and other caregivers.
The most promising treatments include lifestyle changes, medications,
and antioxidant supplements like vitamin E and ginkgo biloba.
MODERN MEDICINE
Several drugs are available to try to slow the progression of AD and possibly
improve the person’s mental capabilities. The following medications increase
the amount of acetylcholine, in the nervous system and slow the progression
of AD:
O Donepezil—slows progression of AD in 30% to 50% of people
with the disease; has few side effects
O Tacrine—10% to 20% of people who develop AD early in life
show a positive response to this medication; not beneficial for people
in the late stages of the disease; serious side effects include nausea,
vomiting, diarrhea, and addiction
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O Rivastigmine—side effects include dizziness, headache, nausea,

vomiting, and diarrhea.
The following medications may ease the symptoms related to AD:
O Selective serotonin reuptake inhibitors (SSRIs)—increases activity
of a brain chemical called serotonin; used to treat depression;
because symptoms of depression often precede AD, SSRIs may
slow the development of AD
O Methylphenidate—stimulates the brain to increase alertness; used
to treat withdrawal and apathy
O Risperidone, olanzapine, or haloperidol—acts as mood stabilizers
and works on improving social interactions, mood, delusions, and
paranoia; decreases aggression; haloperidol has serious side effects,
including impaired control of movement
O Carbamazepine (or other antiseizure drugs)—stabilizes sodium
levels in the brain; used to treat agitation.
AYURVEDA
The following Ayurvedic herbs are traditionally used to treat brain disorders
in elderly people:
O Ashwagandha (Withania somnifera): Demonstrates antioxidant and
anti-inflammatory properties in the laboratory; enhances the
tolerance of stress
O Brahmi (Herpestis monniera): improves motor skills as well as the
ability to learn and retain information
O Shankha pushpin (Convolvulus pluricaulis): It is also a good brain
tonic; it increases the memory power of the person.
Ayurveda drugs like Saraswatharishtam, Brahmi lehyam, Brahmi Ghritham,
Aswagandharishtam, Ashwagandha lehyam, Ashwagandha choornam,
Ashwagandha Ghritham, Chyavanprash, Mahakallyanaka Ghritham,
Brahatchagaladi Ghritham, and Manas Mitra Vatakam are also helpful.
Panchakarma treatments like Shiro-dhara with brahmi oil, Pizhichil with
Ksheerabala will be helpful. Thalapothichil with Panchagandha churnam,
brahmi, amlaki is useful.
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ACUPUNCTURE
Small studies have shown that transcutaneous electrical nerve stimulation

(TENS), a technique used in physical therapy and certain types of
acupuncture, may improve memory and daily living skills in people with
AD. Further studies are needed to confirm whether acupuncture may be
effective in the treatment of AD.
HOMEOPATHY
Homeopathic treatment of AD is an important option. The remedy alumina

was discovered by the founder of homeopathy, Dr. Samuel Hahnemann,
in 1829. Dr. Hahnemann found it highly effective in treating “Great
weakness or loss of memory” and in cases where “Consciousness of personal
identity is confused”.
Following are some homeopathy drugs used for AD:

O Alumina for dullness of mind, vagueness, slow answers to questions.
O Argentum nitricum for dementia with irritability, especially with
lack of control over impulses Cicuta for dementia after head injuries,
especially with convulsions.
O Helleborus for stupefaction, when a person answers questions slowly
and stares vacantly
O Silica for mental deterioration with anxiety over small details.
NATUROPATHY
A diet rich in antioxidants with an emphasis on whole fruits, vegetables,

grains, nuts, and seeds is useful for people with AD.
Ginkgo biloba is an herb widely used in naturopathy for treating AD. It
improves blood flow in the brain and contains flavonoids that act as
antioxidants. Ginkgo may improve thinking, learning, and memory in those
with AD has been promising.
Resveratrol
Resveratrol, a flavonoid or plant substance found in red wine and grape
juice, is an antioxidant that may benefit people with AD.
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YOGA THERAPY
Regular practice of Yogasanas particularly inverted postures like Sirasasana,
Sarvangasana has been shown to improves blood flow in the brain and may
improve thinking, learning, and memory. At any rate, daily yoga can only
be beneficial to AD patients, even if it may not reverse the ailment.
NUTRITION THERAPY
Regular consumption of cold-water fish increases essential fatty acid (EFA)
levels. EFAs are fatty acids (also known as Omega 3 and Omega 6 fatty
acids) which are essential to life, but which cannot be produced in the
body and must be taken in through diet. Essential fatty acids, such as
those found in alpha linolenic acid (ALA) and evening primrose oil, help
regulate certain types of blood cells, stabilize arterial walls and have anti-
inflammatory properties.
A diet rich in magnesium is recommended. Aluminum absorption can be
decreased by magnesium, because magnesium competes with aluminum
for absorption, not only in the intestines but also at the blood–brain barrier.
Focus on unprocessed foods, avoid milk and dairy products, and increase
the consumption of vegetables, whole grains, nuts and seeds – all good
sources of magnesium.
Folate is critical to the health of the nervous system. Together with some
other B vitamins, folate is also responsible for clearing homocysteine (a
body chemical that contributes to chronic illnesses) from the blood. High
levels of homocysteine and low levels of both folate and vitamin B12 have
been found in people with AD. Although the benefits of taking these B
vitamins for AD is not entirely clear, it may be worth considering them,
particularly if your homocysteine levels are high.

O Antioxidants are key—vitamin E (400 to 800 IU per day), vitamin
C (1,000 mg three times per day), and coenzyme Q10 (10 to 50
mg three times per day) Vitamins: biotin (300 mcg); B1 (50 to
100 mg), B2 (50 mg), B6 (50 to 100 mg), B12 (100 to 1,000
mcg). B12 may need to be administered through injection for
best results.
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O Minerals- Calcium and magnesium (1,000 and 500 mg per day,

respectively), zinc (30 to 50 mg per day); excess of manganese and
copper can increase the risk for dementia.
O Intravenous chelating agents such as ethylene diamine tetra acetic
acid (EDTA) may help restore normal circulation in the brain.
O Acetyl-L-Carnitine (ALC)- Effective in improving cognitive
performance in patients suffering from Alzheimer’s dementia.
O Phosphatidylserine (PS)- Low levels of phosphatidylserine in the
brain are associated with impaired mental function and depression
in the elderly. Supplementation with PS consistently benefits
memory, learning, concentration, word choice, and other
measurable cognition parameters, as well as mood and the capacity
to cope with stress. PS encourages the regrowth of damaged nerve
networks.
O Zinc- Zinc deficiency is one of the most common nutrient
deficiencies in the elderly and has been suggested to be a major
factor in the development of Alzheimer’s disease. Zinc
supplementation has good benefits in Alzheimer’s disease.
O Coenzyme Q 10- Improves mitochondrial energy production.
PHYSICAL THERAPY
The inability to communicate normally with language increases anxiety
and frustration in people with AD. Using touch, or massage, as a form of
nonverbal communication has been shown to benefit those with AD. In
one study, people with AD, who received massages and were spoken to in
a calming manner, had a reduction in pulse rate and in inappropriate
behavior. Massage may be beneficial for people with AD not only because
it is relaxing, but also because it provides a form of social interaction and a
moderate form of exercise. Moderate exercise like walking and mobility
exercises are helpful in enhancing overall body health and relaxation.
PSYCHOTHERAPY
Music therapy, the use of music to calm an individual, cannot slow or
reverse dementia, but it may improve quality of life for both a person with
AD and his or her caregiver. Clinical reports suggest that music therapy
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may reduce wandering and restlessness and increase chemicals in the brain
that enhance sleep and ease anxiety. For example, people with AD have
been shown to experience significant increases in levels of melatonin,
norepinephrine, and epinephrine after listening to live music regularly for
a month. Mood also improved after listening to the music.
Lifestyle Changes
The following steps can help people with AD:
O Walk regularly with a caregiver or other reliable companion. This
can improve communication skills and prevent wandering
O Use bright light therapy to reduce insomnia and wandering
O Listen to calming music. This may reduce wandering and
restlessness, boost brain chemicals, ease anxiety, enhance sleep,
and improve behavior
O Get a pet dog
O Practice relaxation techniques
O Receive regular massages. This is relaxing and provides social
interactions.
Prevention
Although there is no proven way to prevent AD, there are some practices
that may be worth incorporating into your daily routine, particularly if
you have a family history of dementia. Talk to your doctor about any of
these approaches, especially those that involve taking a medication or
supplement.
O Consume a low-fat diet. Reduce your intake of linoleic acid found
in margarine, butter, and dairy products
O Eat cold-water fish (like tuna, salmon, and mackerel) rich in omega-
3 fatty acids, at least 2 to 3 times per week
O Increase antioxidants like carotenoids, vitamin E, and vitamin C
by eating plenty of darkly colored fruits and vegetables
O Maintain a normal blood pressure.
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O Avoid exposure to aluminum as much as possible. Aluminum is

found in drinking water, processed cheese, baking powder, antacids,
antidiarrheal preparations, anti-perspirants, foods cooked in
aluminum pots and coffee made in aluminum-containing
percolators. Aluminum cans and aluminum-coated wax containers
can also transfer significant amounts of aluminum to the beverages
contained in them
O Stay mentally and socially active throughout your life
O Hormone-replacement therapy in postmenopausal women may
decrease production of chemicals that cause AD, stimulate growth
of brain cells, and improve blood flow in the brain. However, the
role of hormones in the prevention of AD is still controversial
O Some studies suggest that certain medications may prevent AD,
including “statin” drugs (such as pravastatin or lovastatin, used to
lower cholesterol) and nonsteroidal anti-inflammatories (NSAIDs),
with the exception of aspirin. More research is necessary, however,
to determine how effective these medications are in reducing the
risk of the disease
O Keeping mentally and socially active may help delay the onset or
slow the progression of AD
O In addition, early testing of a vaccine against AD is underway.
Support At Home
Someone with AD will need support in the home as the disease worsens.
Family members or other caregivers can help by trying to understand how
the person with AD perceives his or her world. Simplify the patient’s
surroundings. Give frequent reminders, notes, lists of routine tasks, or
directions for daily activities. Give the person with AD a chance to talk
about their challenges and participate in their own care.
Support for the Caregiver

Studies suggest that caregivers who receive emotional support tend to
experience an improvement in their quality of life, and those they are caring
for benefit as well.
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PARKINSON’S DISEASE
Parkinson’s disease is a disorder of the brain characterized by shaking
(tremor) and difficulty with walking, movement, and coordination. The
disease is associated with damage to a part of the brain that is involved
with movement.

Parkinson’s disease was first described in England in 1817 by Dr. James
Parkinson. The disease affects approximately 2 of every 1,000 people and
most often develops after age 50. Sometimes Parkinson’s disease occurs in
younger adults, but is rarely seen in children. It affects both men and
women and is one of the most common neurologic disorders of the elderly.
In some cases the disease occurs within families, especially when it affects
young people. Most of the late onset cases have no known cause. The term
“parkinsonism” refers to any condition that involves a combination of the
types of changes in movement seen in Parkinson’s disease, which is the
most common cause of these symptoms. Parkinsonism may be caused by
other disorders (secondary parkinsonism) or by external factors like certain
medications used to treat schizophrenia.
Parkinson’s disease is caused by progressive deterioration of the nerve cells
of the part of the brain that controls muscle movement. Dopamine, which
is one of the substances used by cells to transmit impulses, is normally
produced in this area. Deterioration of this area of the brain reduces the
amount of dopamine available to the body.
Insufficient dopamine disturbs the balance between dopamine and other
transmitters, such as acetylcholine. Without dopamine, the nerve cells cannot
properly transmit messages, and this result in the loss of muscle function.
The exact reason that the cells of the brain deteriorate is unknown. The
disorder may affect one or both sides of the body, with varying degrees of
loss of function.
In addition to the loss of muscle control, some people with Parkinson’s
disease become severely depressed. This may be due to loss of dopamine in
certain brain areas involved with pleasure and mood. Lack of dopamine
can also affect motivation and the ability to initiate voluntary movements.
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Although early loss of mental capacities is uncommon, with severe

Parkinson’s, the person may exhibit overall mental deterioration (including
dementia and hallucinations). Dementia can also be a side effect of some
of the medications used to treat the disorder.
Although rare, when Parkinson’s is found in children, it appears to be due
to decreased sensitivity of the nerves to dopamine rather than deterioration
of the area of the brain that produces dopamine.
Symptoms
O Muscle rigidity with stiffness and dfficulty bending arms or legs
O Unstable, stooped, or slumped-over posture
O Loss of balance
O Gait (walking pattern) changes like shuffling walk
O Slow movements
O Difficulty initiating any voluntary movement like dfficulty
beginning to walk and difficulty getting up from a chair
O Small steps followed by the need to run to maintain balance
O Freezing of movement when the movement is stopped, inability
to resume movement
O Shaking, tremors (varying degrees, may not be present)
characteristically occur at rest, may occur at any time, may become
severe enough to interfere with activities
O Changes in facial expression like reduced ability to show facial
expressions and “Mask” appearance to face
O Voice or speech changes like sow speech, low volume, monotone
and difficulty speaking
O Loss of fine motor skills like difficulty writing, may be small and
illegible, difficulty eating, difficulty with any activity that requires
small movements.
Note: Initial symptoms may be mild and nonspecific, for instance, a mild
tremor or a slight feeling that one leg or foot is stiff and dragging.
O Depression
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O Confusion
O Dementia
O Seborrhea (oily skin)
O Loss of muscle function or feeling
O Muscle atrophy
O Memory loss
O Drooling
O Anxiety, stress, and tension.
Signs and tests

The health care provider may be able to diagnose Parkinson’s disease based
on the symptoms and physical examination. However, the symptoms may
be difficult to assess, particularly in the elderly. For example, the tremor
may not appear when the person is sitting quietly with arms in the lap.
The posture changes may be similar to osteoporosis or other changes
associated with aging. Lack of facial expression may be a sign of depression.
An examination may show “cogwheel” rigidity (jerky, stiff movements),
tremors of the Parkinson’s type, and difficulty initiating or completing
voluntary movements. Reflexes are essentially normal.
Tests are not usually specific for Parkinson’s, but they may be required to
rule out other disorders that cause similar symptoms.
Treatment
There is no known cure for Parkinson’s disease. Treatment is aimed at
controlling the symptoms. Treatment must be tailored to the individual.
MODERN MEDICINE
Medications control symptoms primarily by increasing the levels of
dopamine in the brain.
O Levodopa—improves slowness of movement and rigidity; side
effects include severe nausea and vomiting, low blood pressure,
involuntary movements, restlessness
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O Carbidopa—used with levodopa to reduce its side effects

O Anticholinergics—such as benztropine or biperiden; used before
levodopa when symptoms are milder; side effects include dry
mouth, constipation, urinary retention, hallucinations, memory
loss, blurred vision, and confusion.
Surgery
Stereotactic thalamotomy is occasionally done in patients with severe
unilateral tremors not responding to drugs. Implantation of Foetal mid
brain or Adrenal cells into the basal ganglion in parkinsonian patients has
also been tried.
AYURVEDA
Treatment for this condition centers on the treatment of vata disturbance.
Oleation and fomentation form the basis of the constitutional treatment.
Oleation through massage (abhyanga) and enema (basti) are indicated as
well as the ingestion of oils. Naturally, jathargni must be strong enough to
support such as a heavy regiman. If the patient exhibits significant ama
and is strong enough, gentle purification procedures should be administered
first. Oils medicated with ashwagandha (withania somnifera) and bala (sida
cordifolia) are commonly used to pacify vata and build ojas. They are known
to be rejuvenative with a strong nourishing action on the nervous system.
Ayurveda advises the use of Cowhage or Atmagupta (Mucuna pruriens) in
treating Parkinsonism. Cowhage seeds have been found to contain naturally
occurring version of L-Dopa (L- dihydroxyl phenyl alanine). On nervous
system, the drug possesses stimulant effect at low doses and depressant
effect at high doses. Clinical studies have shown that Cowhage can reduce
the symptoms of Parkinson’s disease.
Combination of Cowhage, ashwagandha, bala with milk is recommended.
Brahmi (Herpestis monniera): Improves motor skills as well as the ability to
learn and retain information.
Ayurveda drugs like Saraswatharishtam, Brahmi lehyam, Brahmi Ghritham,
Aswagandharishtam, Ashwagandha lehyam, Kapikatchu rasayanam, and Manas
Mitra Vatakam are also helpful.
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Panchakarma treatments like Shiro-dhara with brahmi oil, Pizhichil with

Ksheerabala will be helpful. Dhanyamaladhara, Thalapothichil, Thalam are
advised.
ACUPUNCTURE
The following acupoints may be used:
O Baihui (Du 20), Sishencong (Ex. 6), Quchi (L.I. 11), Zusanli (St.
36), Waiguan (S.J. 5), Yanglingquan (G.B. 34) Shenmen (H. 7)
Jiexi (St. 41), Hegu (L.I. 4), Neiting (St.44).
Where there is increased salivation, the following points may be added:
O Dicang (St. 4), Yinlingquan (Sp. 9), Chengjiang (Ren 24),
Jiachengjiang (Ex.5), Lianquan (Ren 23), Fenglong (St. 40).
Usually improvement is slow, and 60 or more treatments may be necessary
for improvement to commence.
HOMEOPATHY
O Argentum nitricum for ataxia (loss of muscle coordination),
trembling, awkwardness, painless paralysis
O Causticum for Parkinson’s with restless legs at night, contractures.
O Mer curius vivus for Parkinson’s that is worse at night, especially
ercurius
with panic attacks
O Plumbum metallicum especially with arteriosclerosis
O Zincum metallicum for great restlessness, and depression.
NATUROPATHY
Naturopathy advises massage, exercise therapy and rehabilitation in long-
term treatment of parkinsonism.
Following herbs are used in Naturopathy:
O Gotu kola (Centella asiatica): Historic use in Parkinson’s. One cup
tea twice a day, or 30 to 60 drops tincture twice a day
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O Ginkgo (Ginkgo biloba): circulatory stimulant and an antioxidant

(as a supplement 120 mg per day)
O Hawthorn (Crataegus oxyacantha): circulatory stimulant,
antioxidant (2 to 5 g per day)
O St. John’s wort (Hypericum perforatum), skullcap (Scutellaria
laterifolia), oats (Avena sativa), and lemon balm (Melissa officinalis)
help support the structure of the nervous system.
NUTRITION THERAPY

O Essential fatty acids are anti-inflammatory. A mix of omega-6
(evening primrose, black currant, borage, pumpkin seed) and
omega-3 (flax seed and fish oils) may be best (2 tbsp. oil per day
or 1,000 to 1,500 mg twice a day)
O Antioxidants vitamin C (1,000 mg three times a day), vitamin E
(400 to 800 IU per day), and the trace mineral selenium (200
mcg) may slow progression of Parkinson’s. Other antioxidants are
alpha-lipoic acid, grape seed extract, and pycnogenol
O Vitamin B6 (10 to 100 mg per day) may help with symptom
control, but should be given with zinc (30 mg per day)
O Amino acids: Low-protein diets may help control tremors.
However, D-tyrosine (100 mg per kg per day) increases dopamine
turnover
O Glutathione: Antioxidant, (200 mg twice a day)
O Choline increases brain function; various forms include lecithin,
phosphatidyl choline, and DMAE (Dimethylaminoethanol)
O Neurotransmitters made from amino acids such as glutamic acid
and GABA (Gamma-aminobutyricacid) are used for Parkinson’s.
PHYSICAL THERAPY
Physical therapy, speech therapy, and occupational therapy may help to
reduce rigidity and to correct posture and to promote function and
independence. Exercise should continue, with the level of activity adjusted
to meet the changing energy levels that may occur. Regular rest periods
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and avoidance of stress are recommended, because fatigue or stress can

make symptoms worse.
Postural awareness training in lying, sitting, standing and walking may
also be included in the treatment programme particularly in the early
stages of the disease. The position of one part of the body in relation to the
adjoining part and to the body as a whole is a useful method to use. As the
disease progresses patients are often unaware of gross postural disturbances
and are therefore unable to correct them, themselves.
Relaxation can be a useful part of treatment particularly if the patient
complains of over anxiety or troublesome dyskinesias. Methods of relaxation
with a postural element to reinforce postural awareness are suitable, for
example physiological relaxation.
Simple aids, such as railings or banisters placed in commonly used areas of
the house or special eating utensils, may be of great benefit to the person
experiencing difficulties with daily living activities.
Social workers or other counseling services may help the patient cope with the
disorder and with obtaining assistance, such as Meals-on-Wheels, as appropriate.
Futuristic Treatment
Experimental or less common treatments may be recommended. For
example, surgery to destroy tissues responsible for tremors may reduce
symptoms in some people. Transplantation of adrenal gland tissue to the
brain has been attempted, with variable results.
EPILEPSY
Epilepsy is a brain disorder involving recurrent seizures. Epilepsy is generally
of following types:
Par tial seizur
artial es
seizures
Partial seizures begin in just one part of the brain. About 60% of people
with epilepsy have partial seizures. There are 2 types:
O Simple partial seizures may cause unusual feelings or sensations
that can take many forms, such as sudden, unexplained feelings of
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joy, anger, sadness, or nausea. It’s not uncommon to hear, smell,

taste, see, or feel things that are not real. During simple partial
seizures, patients remain alert and aware. These seizures usually
last just a few seconds.
O Complex partial seizures cause a change in or loss of consciousness.
Altered consciousness can produce a dreamlike experience. Strange,
repetitious behaviors such as blinks, twitches, mouth movements,
or even walking in a circle occur. Throwing objects or striking
walls or furniture, as if in anger or fear, may also occur. These
seizures usually last just 1 or 2 minutes.
Symptoms of partial seizures can be mistaken for other disorders. For
example, dreamlike perceptions of partial seizures may be mistaken for
migraine, which also can cause a dreamlike state. However, the progression
of symptoms tends to be the same or similar in each person, every time.
Generalized seizures
These seizures affect areas of both sides of the brain, usually with loss of
consciousness. There are 4 types:
O Tonic-clonic seizures (formerly called grand mal) cause the person
to cry out, stiffen, and fall. Shaking and tongue-biting is common.
O Absence seizures (formerly called petit mal) cause staring, blinking,
or twitching. They occur mainly in children, who are often mistaken
to be daydreaming.
O Atonic seizures (formerly called drop attacks) cause sudden loss of
muscle tone. This type of seizure can literally cause a person to
drop to the ground.
O Myoclonic seizures cause limbs to jerk suddenly, and often happen
just after waking.
Defining seizure type can sometimes be difficult—seizure patterns can
change, and some people experience more than one type of seizure, with
no clear pattern.

Epilepsy is a disorder involving repeated seizures of any type. Seizures
218
Neurological System
(“fits”) are episodes of disturbed brain function that cause changes in

attention and/or behavior. They are caused by abnormal electrical excitation
in the brain.
Sometimes, seizures are related to a temporary condition, such as exposure
to drugs, withdrawal from certain drugs, or abnormal levels of sodium or
glucose in the blood. In such cases, repeated seizures may not recur once
the underlying problem is corrected.
In other cases, injury to the brain (e.g., stroke or head injury) causes brain
tissue to be abnormally excitable. In some people, an inherited abnormality
affects nerve cells in the brain, which leads to seizures. In some cases, no
cause can be identified.
Some of the more common causes of seizures include:
O Idiopathic (no identifiable cause) - usually begin between age 5
and 20, can occur at any age, no other neurologic abnormalities
present
O Developmental or genetic conditions present at birth, or injuries
near birth — in this case, the seizures usually begin in infancy or
early childhood
O Metabolic abnormalities like diabetes complications, electrolyte
imbalances, kidney failure, uremia, nutritional deficiencies
O Brain injury - most likely to occur if the brain membranes are
damaged
O Tumors and brain lesions that occupy space (such as hematomas)
O Disorders affecting the blood vessels (such as stroke and TIA)
O Degenerative disorders (senile dementia Alzheimer type, or similar
organic brain syndromes)
O Infections.
Seizure disorders affect about 0.5% of the population. Approximately 1.5-
5.0% of the population may have a seizure in their lifetime. Epilepsy can
affect people of any age.
Risk factors include a family history of epilepsy, head injury, or other
condition that causes damage to the brain.
219
The following factors may present a risk for worsening of seizures in a

person with a previously well-controlled seizure disorder:
O Pregnancy
O Lack of sleep
O Skipping doses of epilepsy medications
O Use of alcohol or other recreational drugs
O Certain prescribed medications
O Illness.
Symptoms
The severity of symptoms can vary greatly from simple staring spells to
loss of consciousness and violent convulsions. For many patients, the event
is stereotyped (the same thing over and over) while some patients have
many different types of seizures that cause different symptoms each time.
The type of seizure a person experiences depends on a variety of factors,
such as the part of the brain affected, the cause, and individual response.
An aura consisting of a strange sensation (such as tingling, smell, or
emotional changes) occurs in some people prior to each seizure. Seizures
may occur repeatedly without explanation.
Symptoms of Par
Par tial SSeizur
artial eizures
eizures
Partial seizures affect only a portion of the brain.
Simple partial (focal) seizures:
O Muscle contractions of a specific body part
O Abnormal sensations
O May have nausea, sweating, skin flushing and dilated pupils
O May have other focal (localized) symptoms.
Complex partial seizures:
O Automatism (automatic performance of complex behaviors without
conscious awareness)
220
Neurological System
O Abnormal sensations
O May have nausea, sweating, skin flushing and dilated pupils
O May have other focal (localized) symptoms
O Recalled or inappropriate emotions
O Changes in personality or alertness
O May or may not lose consciousness
O Olfactory (smell) or gustatory (taste) hallucinations or impairments.
Symptoms of Generalized Seizures

Generalized seizures affect all or most of the brain. They include petit mal
and grand mal seizures.
Petit mal seizur es:
seizures:
O Minimal or no movements (usually, except for “eye blinking”) —
may appear like a blank stare
O Brief sudden loss of awareness or conscious activity — may only
last seconds
O Recurs many times
O Occurs most often during childhood
O Decreased learners (child often thought to be day-dreaming).
Tonic-clonic (grand mal) seizures:
seizures:
O Whole body, violent muscle contractions
O Rigid and stiff
O Affects a major portion of the body
O Loss of consciousness
O Breathing stops temporarily, then “sighing”
O Incontinence of urine
O Tongue or cheek biting
O Confusion following the seizure
O Weakness following the seizure (Todd’s paralysis).
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Signs and tests

The diagnosis of epilepsy and seizure disorders requires a history of recurrent
seizures of any type. A physical examination (including a detailed
neuromuscular examination) may be normal, or it may show abnormal
brain function related to specific areas of the brain.
An electroencephalograph (EEG), a reading of the electrical activity in the
brain, may confirm the presence of various types of seizures. It may, in
some cases, indicate the location of the lesion causing the seizure. EEGs
can often be normal in between seizures, so it may be necessary to do
prolonged EEG monitoring.
Tests may include various blood tests to rule out other temporary and
reversible causes of seizures, such test include:
O A CBC
O A blood chemistry, blood glucose
O Liver function tests
O Kidney function tests
O Tests for infectious diseases
O A CSF (cerebrospinal fluid) analysis.
Tests for the cause and location of the problem may include procedures
such as:
O A head CT or MRI scan
O A lumbar puncture (spinal tap).
Disorders that may cause symptoms resembling seizures include transient
ischemic attacks (TIAs), rage or panic attacks, and other disorders that
cause loss of consciousness.
Treatment
If an underlying cause for recurrent seizures (such as infection) has been
identified, the cause should be treated, and this may stop the occurrence
of further seizures. This may include surgical repair of tumors or brain
lesions, or other treatments.
222
Neurological System
MODERN MEDICINE
Oral anti-convulsants like Carbamazepine, Sodium valproate, Phenytoin sodium,
Ethisyxunudem, Tiagabine hydrochloride, Clonazepammay reduce the number
of future seizures. Response is individual, and the medication used and dosage
may have to be adjusted repeatedly. The type of medicine used depends on the
seizure type, as some seizure types respond well to one medication and may
respond poorly (or even be made worse) by others.
The need for follow-up depends on the seizure type and medications used.
Some medications need to be monitored for side effects and blood levels.
To work effectively, blood levels of anti-epileptic medications must be
maintained within a certain range. If the levels rise too high toxic symptoms
(drowsiness, unsteadiness on the feet) may appear: if levels fall too low,
epileptic control will be inadequate. Checking blood levels is a vital part of
treatment.
For some patients, the use of several medications may still be inadequate.
This is called refractory epilepsy. Some such people may benefit from brain
surgery to remove the abnormal brain cells that are causing the seizures.
For others, a vagal nerve stimulator is implanted in the chest, which can
help reduce the number of seizures.
Status Epilepticus: Prolonged or clustered seizures sometimes develop into
non-stop seizures, a condition called status epilepticus. Status epilepticus
is a medical emergency. It requires hospital treatment to bring the seizures
under control. A treatable cause of death in status epilepticus is hypoxia in
most cases. Full support of the patient eliminates this possibility. The
seizures themselves are not an imminent cause of mortality or morbidity
but, seizures kill brain cells.
Management consists of establishing airway, oxygenating and intravenous
injection of 50% of glucose, thiamin, diazepam or phenytoin and
dexamethasone.
AYURVEDA
The prescription regimen includes administration of cleansing medicines

and panchakarma depending on the predominance of vitiated doshas.
223
Nasal insufflation also finds an important place in the management of

epilepsy. Sprouted seeds of Vitex negundo, Asafoetida powder, powder of
sweet flag etc., are used for this purpose.
Intake of juice of seeds of Kushmanda with Yashtimadhu (liquorice powder)
helps in the management of epilepsy.
Certain generic formulations like Brahmi Ghrita, Rasayanbhairav, Kalyanak
Churna and Smrutisagar Rasa are also useful in long term management of
epilepsy.
Brahmi (Bocopa monniera) and Vacha (Acorus calamus) are the two drugs
which are of particular use in epilepsy. One teaspoonful of Brahmi juice or
the powder of the root of Vacha, or both of them together, should be mixed
with honey and given thrice daily. A compound preparation Brihat Vata
Kulantaka Rasa, which contains the calx of gold, is recommended in two-
grain doses thrice daily.
The following prescriptions are recommended in severe cases of epilepsy:
O 1 gm of Jatamansi Churna, 120 mg of Smritisagara Rasa, and I gm
of Vacha Churna to be taken twice daily with honey
O 10 gm of Mahakalyanaka Ghrita to be taken twice daily with
candied sugar and cow’s milk
O 20 ml of Saraswatarishta to be taken twice daily after meals with
water
O 120 mg of Apasmarantaka Rasa to be taken twice daily with honey
O After an epileptic attack Aswagandharishtam or Dasamoolarishtam,
Dhanwantharam Gulika or Gorochanadi Vati are given.
ACUPUNCTURE
Petit Mal : Specific points that may be used in Petit Mal epilepsy are:
Mal
O Baihui (Du 20), Neiguan (P.6), Yintang (Ex.1), Shenmen (H. 7),
Renzhong (Du 26) Shenmai (U.B. 62), Mu and Shu points of the
Heart and Pericardium.
Grand Mal : Acute fits can be brought under control by acupressure at
Renzhong (Du 26.) and, if necessary, needling at Yongquan (K.1).
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Neurological System
Where the patient develops repeated seizures and does not regain
consciousness between attacks, the condition is known as “status epilepticus”.
In such cases, points selected from the following may be used:
O Baihui (Du 20.), and / or Sishencong (Ex.6.), Yintang (Ex. 1),
Anmian I (Ex.8), Anmian II (Ex.9), Yaoqi (Ex. 20), Fenglong (St
40), Jizhong (Du 6), Xinshu (U.B.15), Neiguan (P.6), Shenmen
(H.7), Hegu (L.I.4), Shenmai (U.B. 62), Yanglingquan (G.B. 34.).
Psy chomotor ((T
sychomotor Temporal Lobe) E pilepsy : Here the fits are not as severe as
Epilepsy
in grand mal. Fits may be preceded by an aura of unreality and
hallucinations. The following points may be used:
O Baihui (Du 20.), and / or Sishencong (Ex.6), Shuaigu (G.B. 8),
Yangbai (G.B. 14) Touwei (St. 8), Shenmen (H. 7), Neiguan (P.
6), Shenmai (U.B. 62).
A press needle, placed at the ear point Shenmen, is useful for maintaining
continuous stimulation between treatment sessions.
In most cases of petit mal, the symptoms may be expected to disappear

with 10 to 15 treatments. The results are almost equally good in sensory
epilepsy and temporal lobe epilepsy. For grand mal, however, 30 or more
treatments may be required with weekly reinforcement for about 3 or 4
months or longer.
Note: Electrical stimulation is contraindicated, as it might precipitate

attacks.
HOMEOPATHY
Belladonna: For seizures that occur in individuals with a high fever.
Causticum: For individuals whose seizures may be triggered by receiving

bad news or by feelings of sadness such as from grief; this remedy is most
appropriate for individuals who tend to feel hopeless and fearful.
Cicuta: For individuals who develop seizures after a head injury.
Cuprum metallicum: For individuals whose seizures are accompanied by

mental dullness; may be triggered by menstruation or vomiting.
225
NATUROPATHY
In Naturopathy following herbs are used to reduce seizures:
O Passionflower (Passiflora incarnata): to both prevent and treat
seizures, may be effective without side effects, especially where
stress is a precipitating factor. Dose is 30 drops three to four times
per day
O Skullcap (Scutellaria lateriflora): antispasmodic and calmative herb.
O Valerian (Valeriana officinalis): spasmolytic, sedative.
The above herbs may be used singly or in combination as 1 cup tea three
times per day or 30 to 60 drops tincture three times per day. In addition,
use milk thistle (Silybum marianum) to protect the liver from effects of
medications (70 to 210 mg three times per day).
NUTRITION THERAPY
Some studies have shown a connection with food allergies and seizures in
children.
A High fat, low-protein, low-carbohydrate (ketogenic) diet may help control
the frequency of seizures. A ketogenic diet is very rich in lipids (fats) and
oils, but low in proteins and carbohydrates. This unusually high intake of
lipids and oils creates a condition in the body know as “ketosis”. The
metabolic shift that is created increases the seizure threshold for some.
This diet is also calorie and liquid restricted. The Ketogenic diet is mainly
effective in children. It requires careful preparation and strict adherence.
Although it takes a significant commitment to be successful, many children
have greater seizure control with this diet than with conventional (drug)
therapies. Some are able to reduce or eliminate anti-seizure medications.

O Taurine (500 mg three times per day): Amino acid that has been
shown in studies to inhibit seizures
O Folic acid (400 mcg per day): Depleted during seizures, although
higher doses than 400 mcg may actually precipitate some seizures;
should be taken with B12
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Neurological System
O B12 (100 to 200 mcg per day)

O B6 (20 to 50 mg per kilogram of body weight): Especially in
children may help control seizures
O Magnesium: 500 to 750 mg per day (should be in a 1:1 ratio in
persons taking calcium) for normal muscle and nervous system
function
O Manganese (5 to 15 mg per day): Depleted in people with epilepsy
O Zinc (30 mg per day): may be depleted by some medications
O Dimethylglycine (100 mg twice a day): May decrease medication
requirements
O Avoid alcohol, caffeine, and asparatime.
Prevention
Generally, there is no known way to prevent epilepsy. However, adequate
diet and sleep, and abstinence from drugs, stress and alcohol, may decrease
the likelihood of precipitating a seizure in people with epilepsy.
Reduce the risk of head injury by wearing helmets during risky activities;
this can help lessen the chance of developing epilepsy.
First Aid for Seizures

The appropriate behavior for helping someone who has a seizure depends
on the type of seizure. While a person experiencing a grand mal seizure
may require some first aid, in most cases there is little that can be done.
Tonic Clonic (Grand Mal ) - This type of seizure is often the most dramatic and
frightening, but it is important to realize that a person undergoing an epileptic
seizure is usually unconscious and feels no pain. The seizure usually lasts only a
few minutes, and the person does not need medical care. These simple procedures
should be followed:
1. Keep calm. You cannot stop a seizure once it has started. Let the
seizure run its course. Do not try to revive the person.
2. Ease the person to the floor and loosen tight clothing.
3. Try to remove any hard, sharp, or hot objects that might injure
227
the person. It may be necessary to place a cushion or soft item

under their head.
4. Do not put anything in the person’s mouth.
5. As the person relaxes after a fit, turn him gently onto his stomach
with the face to one side and the head extended so that the saliva
can flow from the mouth. It is important to make sure that he can
breathe freely.
6. After resting, most people carry on as before. If the person is not at
home and still seems groggy, weak, or confused, it may be better
to accompany him home.
7. In the case of a child having a seizure, contact the parent or
guardian.
8. If the person undergoes a series of convulsions, with each successive
one occurring before he or she has fully recovered consciousness,
or a single seizure lasting longer than 10 minutes, you should
immediately seek medical assistance.
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5
ORTHOPEDIC DISORDERS
Rheumatoid arthritis
Osteoarthritis
Gout
Low back pain
Osteoporosis
Fibromyalgia
Sprains and Strains
229
RHEUMATOID AR
RHEUMAT THRITIS
ARTHRITIS
Rheumatoid arthritis is a chronic inflammatory disease that primarily affects

the joints and surrounding tissues, but can also affect other organ systems.

The cause of rheumatoid arthritis (RA) is unknown. However, RA involves
an attack on the body by its own immune cells (autoimmune disease).
Infectious, genetic, and hormonal factors may play a role.
The disease can occur at any age, but it begins most often between the
ages of 25 and 55. The disease is more common in older people. Women
are affected more often than men. Approximately 1-2% of the total
population is affected. The course and the severity of the illness can vary
considerably.
The onset of the disease is usually gradual, with fatigue, morning stiffness
(lasting more than one hour), diffuse muscle aches, loss of appetite, and
weakness. Eventually, joint pain appears, with warmth, swelling, tenderness,
and stiffness of the joint after inactivity.
RA usually affects joints on both sides of the body equally — wrists, fingers,
knees, feet, and ankles are the most commonly affected.
When the synovium (the lining of the joint) becomes inflamed, it secretes more
fluid and the joint becomes swollen. Later, the cartilage becomes rough and
pitted. The underlying bone is eventually affected. Joint destruction may begin,
often within 1-2 years after the appearance of the disease.
Deformities result from cartilage destruction, bone erosions, and tendon
inflammation and rupture. A life-threatening joint complication can occur
when the cervical spine becomes unstable as a result of RA.
Other features of the disease that do not involve the joints may occur.
Rheumatoid nodules are painless, hard, round or oval masses that appear
under the skin, usually on pressure points, such as the elbow or Achilles
tendon. These are present in about 20% of cases and tend to reflect more
severe disease.
230
Orthopedic Disorders
On occasion, nodules appear in the eye where they sometimes cause

inflammation. If they occur in the lungs, inflammation of the lining of the
lung (pleurisy) may occur, causing shortness of breath and fluid
accumulation in the lung.
Anemia may occur due to failure of the bone marrow to produce enough
new red cells to make up for the lost ones. Iron supplements will not
usually help this condition because iron utilization in the body becomes
impaired. Other blood abnormalities can also be found, for example, platelet
counts that are either too high or too low.
Rheumatoid vasculitis (inflammation of the blood vessels) is a serious
complication of RA and can be life-threatening. It can lead to skin
ulcerations (and subsequent infections), bleeding stomach ulcers (which
can lead to massive hemorrhage), and neuropathies (nerve problems causing
pain, numbness or tingling).
Vasculitis may also affect the brain, nerves, and heart causing strokes, sensory
neuropathies (numbness and tingling), heart attacks, or heart failure.
Heart complications of RA commonly affect the outer lining of the heart.
When inflamed, the condition is referred to as pericarditis. Inflammation
of heart muscle, called myocarditis, can also develop. Both of these
conditions can lead to congestive heart failure characterized by shortness
of breath and fluid accumulation in the lung.
Eye complications include inflammation of various parts of the eye. These
must be screened for in RA patients.
Symptoms
O Fatigue
O General discomfort, uneasiness, or malaise
O Loss of appetite
O Low-grade fever
O Joint pain, joint stiffness, and joint swelling — often on both sides
of the body
O Joint pain may include wrist pain, knee pain, elbow pain, finger
pain, toe pain, ankle pain, or neck pain
231
O Limited range of motion

O Morning stiffness lasting more than one hour
O Deformities of hands and feet
O Round, painless nodules under the skin
O Skin redness or inflammation
O Paleness
O Swollen glands
O Eye burning, itching, and discharge
O Numbness or tingling.
Signs and tests

O Joint x-rays
O Rheumatoid factor test is positive in about 75% of people with
symptoms
O Erythrocyte sedimentation rate is elevated
O CBC may show low hematocrit (anemia) or abnormal platelet
counts
O C-reactive protein may be a positive indication for patients with
no detectable rheumatoid factor
O Synovial fluid analysis.
Treatment
RA usually requires lifelong treatment, including various medications,
physical therapy, education, and possibly surgery to relieve the symptoms
of the disease.
MODERN MEDICINE
Early, aggressive treatment for RA can delay joint destruction. The following
drugs are used to treat RA.
O Nonsteroidal anti-inflammatory drugs (NSAIDS): For example,
naproxen, reduce inflammation, morning stiffness and pain; side
effects include gastrointestinal irritation, bleeding, and ulceration.
232
O Cyclo-oxgenase-2 (COX-2) inhibitors: Such as celecoxib, reduce

pain and inflammation with fewer gastrointestinal side effects, but
various other possible side effects.
O Disease-modifying anti-rheumatoid drugs (DMARDs): Include
gold salts, antimalarial drugs, and sulfasalazine; DMARDs that
suppress the immune system include methotrexate or azathioprine;
DMARDs have serious side effects.
O Corticosteroids: Decrease inflammation and control pain; given
orally or intravenously; possibility of serious side effects.
O Combination therapy uses two or more DMARDs together.
O Experimental therapy uses newly developed drugs. Several of these
attack cells in your immune system that destroy joint tissues.
The benefits from these medications may take weeks or months to be
apparent. Because they are associated with toxic side effects, frequent
monitoring of blood tests while on these medications is imperative.
Other relatively new medications include Anakin, which blocks the
inflammatory protein interleukin-1, and leflunomide, which inhibits the
metabolism of nucleotides required for DNA synthesis in lymphocytes.
Other drugs that suppress the immune system, like azathioprine and
cyclophosphamide, are sometimes used in people who have failed other
therapies. These medications, which are associated with toxic side effects,
are usually reserved for severe cases of RA.
Surgery
Occasionally, surgery is performed for severely affected joints. The most
successful surgeries are those on the knees and hips. Usually, the first surgical
treatment is removal of the synovium.
A later alternative is total joint replacement with a joint prosthesis. Surgeries
can relieve joint pain, correct deformities, and modestly improve joint
function. In extreme cases, total knee or hip replacement can mean the
difference between being totally dependent on others and having an
independent life at home.
233
AYURVEDA
Decoction of Rasna (Pluchea lanceolata), Guduchi (Tinospora cordifolia), root
of castor plant, ginger powder and Cedrus deodara should be taken in the
dose of 15 ml. thrice daily.
Decoction of ginger powder and puncture vine should be taken in the dose
of 15 ml thrice daily.
Decoction of ginger powder and Tinospora cordifolia is advised in the dose
of 15 ml thrice daily.
Ginger powder should be taken in the dose of 500 mg twice. It neutralises
endotoxins.
Embelic myrobalan, chebulic myrobalan and belleric myrobalan along with
ginger should be taken in powder form in the dose of 500 mg. thrice daily
along with curd or warm water.
Castor oil is advised to be taken every day in the dose of 5 ml. If well
tolerated, the dose can be further increased up to 10 ml. This is the best
medicine for arthritis.
Tablets made from castor seeds, ginger powder and sugar should be taken
in the dose of 250 mg thrice daily.
For chronic cases, purification methods like enemata, purgation etc. can be
employed under the guidance of a physician along with drug therapy.
Some preparations available in market are Simhanada guggul,
Rasnasaptakkwath, Eranda pak, Mahayograj guggul etc.
Ayurveda advises guggulu (Commiphora Mukul) a gum resin obtained from
tree, guggulu tree. In research made at the Banaras Hindu University, it
proved to have anti-inflammatory and anti-arthritic properties. The juice
of Guduchi (Tinospora cordifolia) can also be given in a dose of one ounce
twice daily with 10 grams of dry ginger powder.
Either Yogaraja Guggulu or Mahayogaraj guggulu or Simhanada guggulu can
be administered internally in a dose of two tablets twice daily with hot
water. Eranda ksheera paka is found to be very beneficial in this disease.
Castor oil (1 to 2 tsp) mixed in dry ginger decoction can be given twice a
day.
234
Other drugs like Kokilaksha Kashayam, Kaishora guggulu are useful.

Panchakarma treatments like oil massage, herbal steam baths, Podikizhi,
Medicated enema (Vasti) are most effective in treating arthritis. Externally
Amavatahari oil, or Kottamchukkadi oil or Dhanwantara oil or Pinda oil
can be used for massage or pizhichil. Steam or external fomentation with
Nirgundi leaves, castor leaves and Eucalyptus leaves is useful.
ACUPUNCTURE
Acupuncturists treat people with rheumatoid arthritis based on an
individualized assessment of the excesses and deficiencies of Qi located in
various meridians. A Qi deficiency is usually detected in the spleen and/or
kidney meridians.
Local treatment to the painful areas and related sore points may be applied,
either with a needle or with moxibustion. Ah-Shi points and analgesic
point Hegu (L.I. 4) is mostly used.
Following are the points commonly used in arthritis:
Shoulder:
O Baihui (Du 20.)
O Local points: Jianyu (L.I. 15), Jianliao (S.J. 14), Jianzhen (S.I. 9),
Ah-Shi points
O Distal point and analgesic point: Hegu (L.I. 4).
At the first sitting, the use of Tiaokou (St. 38.) with fairly strong stimulation
is helpful in mobilizing the shoulder. In about 70-80% of cases significant
improvement is obtained immediately.
Elbow:
O Baihui (Du 20.)
O Local points: Chize (Lu. 5), Quze (P. 3), Shaohai (H. 3), Quchi
(L.I. 11), Ah-Shi points
Wrist:
O Baihui (Du 20.)
235
O Local points: Daling (P.7), Shenmen (H. 7),Taiyuan (Lu. 9), Ah-
Shi points
O Distal point and analgesic point: Hegu (L.I. 4) of the opposite
side, Neiting (St. 44).
Palms, Carpal JJoints:
oints:
O Baihui (Du 20)
O Local points: Yuji (Lu. 10), Laogong (P. 8), Shaofu (H. 8), Ah-Shi
points
O Distal point and analgesic point: Hegu (L.I. 4) of the opposite
side, Neiting (St. 44).
Sacroiliac Joints:
O Baihui (Du 20.)
O Local points: Tunzhang (U. Ex), Ciliao (U.B. 32), Ah-Shi points
O Distal point and analgesic point: Weizhong (U.B. 40), Kunlun
(U.B. 60), Hegu (L.I. 4).
Knee:
O Baihui (Du 20.)
O Local points: Heding (Ex. 31), Xiyan (Ex. 32), Dubi (St. 35),
Weizhong (U.B. 40), Ah-Shi points
O Distal point and analgesic point: Kunlun (U.B. 60), Hegu (L.I.
4) of the opposite side, Neiting (St. 44)
O Specific point for effusion: Yinlingquan (Sp. 9)
O Influential point for bone and cartilage: Dashu (U.B. 11).
Ankle:
O Baihui (Du 20)
O Local points: Kunlun (U.B. 60), Taixi (K. 3), Zhaohai (K. 6), Jiexi
(St. 41), Qiuxu (G.B. (40), Ah-Shi points
O Distal point and analgesic point: Hegu (L.I. 4) of the opposite side
236
Foot:
Dorsum of Foot:
O Baihui (Du 20)
O Local points: Ah-Shi points
O Distal point and analgesic point: Hegu (L.I. 4), Neiting (St. 44).
Sole of Foot
O Baihui (Du 20.)
O Local points: Taixi (K. 3), Yongquan (K. 1), Ah-Shi points
Joints of Toes:
O Baihui (Du 20.)
O Local points: Befeng (Ex.36), Ah-Shi points
HOMEOPATHY
Some of the most common remedies used for rheumatoid arthritis are listed
below.
O Rhus toxicodendron for arthritis that feels worse in the morning,
in damp, cold weather, or before a storm
O Bryonia alba for arthritis that feels better with pressure, feels worse
with any movement, or cold weather
O Ruta graveolens for arthritic pains that feel worse after exertion;
feels better after resting, especially with a history of strains or sprains
O Calcarea carbonica for arthritis that is associated with weakness.
NATUROPATHY
Naturopathy advises fasting for one to two weeks on fruit juices to reduce
arthritis. Fasting has been shown to decrease ESR, joint pain, stiffness and
need for medication. After a therapeutic fast, take a healthy vegetarian diet
rich in green leafy vegetables, raw vegetables, high potassium foods,
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vegetable juices, and high fibre. Maximize your intake of fresh vegetables,
fruits, fish, nuts, seeds, and whole grains. A vegetarian diet high in
antioxidants and flavonoids and low in saturated fats is useful.
Following are some of the herbs used in Naturopathy.
O Devil’s claw (Harpagophytum procumbens): Analgesic, anti-
inflammatory
O Ginseng (Panax ginseng): Adaptogen (tonic for long-term stress),
specific for chronic disease and the effects of suppressive medications
O Ginger (Zingiber officinale): Antispasmodic, digestive stimulant
O Valerian (Valeriana officinalis): Relaxant, reduces spasms
O Blue flag (Iris versicolor): Stimulates liver to process effects of
inflammation
O Wild yam (Dioscorea villosa): Specific for RA, helps reduce spasms
O Horsetail (Equisetum arvense): Diuretic, stabilizes connective tissue.
Devil’s claw and three to five of the above herbs can be mixed as either
tincture 30 to 60 drops three times per day, or 1 cup tea three times per
day.
Hydrotherapy
In acute inflammation: Apply ice packs, or cold packs on the affected joints.
In chronic inflammation: Apply warm or hot packs or moist compresses
on affected joints. General treatments like steam bath, sauna bath, whirlpool
bath, jet showers, hot or warm immersion baths, epsom salt baths, sulphur
baths, reduce pain and inflammation.
YOGA THERAPY
Yoga reduces arthritis by stretching the joints and strengthening muscles.

O Asanas:
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Konasana
Bhramari
NUTRITION THERAPY

Avoid allergic foods. The most common allergenic foods are wheat, corn,
and dairy. An elimination diet may identify whether these foods constitute
a problem: avoid allergenic foods completely for two weeks, then reintroduce
the foods one at a time, every three days, and note if the RA symptoms get
worse. Citrus, chocolate, alcohol, red meat, spices, and carbonated drinks
may also aggravate RA.
A small percentage of people respond dramatically to a diet free of
nightshades group of plants. These include peppers, eggplant, tomatoes,
and white potatoes. A month-long trial is recommended.
O One clinical study demonstrated that selenium combined with
vitamin E reduces RA symptoms. Dose is 50 to 75 mcg per day of
selenium and 400 to 800 IU of vitamin E
O Zinc (45 mg per day) and manganese (45 mg per day)
O Omega-3 fatty acids, such as alpha linolenic acid (ALA), keep white
blood cells from producing substances that cause swelling.
O Bromelain: Anti-inflammatory when taken between meals. Dose
is 2,000 to 2,500 mg twice a day
O Quercetin: Stabilizes mast cells, found in increased numbers in
the synovial membranes of affected joints. Dose is 250 to 500 mg
three times per day, on an empty stomach.
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PHYSICAL THERAPY
Physiotherapy has a major role in treating RA, as it reduces joint pain,
increases joint mobility, prevents joint deformity, and preserves joint and
muscle function. Treatments like Diathermy, paraffin wax baths,
Ultrasound, TENS and heating pads reduces stiffness and pain, relaxes
joints and muscles and increases range of motion. Cold treatments like ice
packs reduce acute inflammation.
Massage is very useful in chronic arthritis and should not be done in acute
arthritis.
EXERCISE THERAPY
Acute Rheumatoid Arthritis
O Passive range of movement exercises of both affected and unaffected
joints
O Isometric exercises for the muscles of joints
O Once the pain is reduced, patient is taught to walk with the aid of
walkers
O Stretching and strengthening exercises in a warm water pool.
Chronic Rheumatoid Arthritis
O Active range of movement exercises of all joints
O Stretching exercises for affected joints– 3 to 10 repetitions
O Isotonic strengthening exercises with or without weights for all
major muscles- 3 to 10 repetitions
O Stretching and strengthening exercises in a warm water pool.
OCCUPATIONAL THERAPY
Occupational therapists can construct splints for hand and wrist, and teach
how to best protect and use joints when they are affected by arthritis.
They also show people how to cope better with day-to-day tasks at work
and at home, despite limitations caused by RA.
Other Therapies
The Prosorba column is a device approved by the FDA, US in 1999 for the
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treatment of moderate to severe RA in adults with long-standing disease

(who have not responded to disease modifying anti rheumatoid drugs). It
works by removing inflammatory antibodies from the blood. The blood is
removed through a small catheter and then passed through a column that
binds the antibodies and removes them from the blood. The blood is then
given back.
The procedure takes 2-3 hours, and must be done once a week for 12
weeks. Studies have reported that in one third to one-half of the people
who receive this treatment may slow down, or even stop, the arthritis from
worsening. Side effects include anemia, fatigue, fever, low blood pressure,
and nausea. Some people have developed an infection from the catheter.
Often there is a flare-up of joint pain for several days after the treatment.
Prevention
Rheumatoid arthritis has no known prevention. However, it is often possible
to prevent further damage of the joints with proper early detection and
treatment.
OSTEOAR
OSTEOARTHRITIS
ARTHRITIS
Osteoarthritis is a slowly progressive musculoskeletal disorder that typically
affects the joints of the hand, spine and weight-bearing joints (hips, knees)
of the lower extremity. It is not associated with systemic symptoms or
joint inflammation. Joint pain and loss of function are due to defects in
articular cartilage and underlying bone. These defects arise because of
excessive loads on normal joints or normal loads on abnormal joints. It is
sometimes called degenerative joint disease (DJD).

For most people, the cause of osteoarthritis is unknown, but metabolic, genetic,
chemical, and mechanical factors play a role in its development. It is associated
with the aging process and is the most common form of arthritis.
It may first appear without symptoms between 30 and 40 years of age and
is present in almost everyone by the age of 70. Symptoms generally appear
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in middle age. Before the age of 55 it occurs equally in both sexes. However,
after 55 it is more common in women.
The cartilage of the affected joint is roughened and becomes worn out. As
the disease progresses, the cartilage becomes completely worn out and the
bone rubs on bone. Bony spurs usually develop around the joint.
The degeneration of the joint may begin as a result of trauma to the joint,
occupational overuse, obesity, or mal-alignment of the joints (for example
being bow-legged or knock-kneed). The joints of the hands and fingers,
hips, knees, big toe, and cervical and lumbar spine are commonly affected.
Symptoms
O Gradual and subtle onset of deep aching joint pain which is worsened
by movement or weight bearing and often relieved by rest
O Joint swelling
O Morning stiffness
O Joint pain in rainy weather
O Crunching or crackling noise when the joint moves (crepitation)
O Limited range of motion
O Abnormal growth of bony knobs near joints causing deformities
(such as Heberden’s nodes, in which bumps appear on the
outermost finger joints).
Signs and tests

A physical exam can show limited range of motion, crepitations (a crackling
noise that may be heard and sensation felt when bone is rubbing on bone
due to lack of cartilage), the presence of fluid in the joint.
An x-ray of affected joints will show loss of the joint space, and in advanced
cases, wearing down of the ends of the bone and bone spurs (osteophytes).
Treatment
The goals of treatment are to relieve pain, maintain or improve joint
mobility, increase the strength of the joints, and minimize the disabling
affects of the disease. The specific treatment depends upon the affected
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joints. A combination of conventional treatment and complementary and

alternative medicine (CAM) may be most effective.
MODERN MEDICINE
Medications used to treat osteoarthritis include a variety of nonsteroidal, anti-
inflammatory drugs (NSAIDs) such as ibuprofen, ketoprofen, and naproxen
sodium, as well as prescription medications, such as diclofenac, diflunisal,
etodolac, fenoprofen, indomethacin, nabumetone, oxaprozin piroxicam,
sulindac, salsalate and tolmetin. NSAIDs reduce pain and swelling.
A new class of drug called Cyclooxygenase 2 (COX-2) inhibitors that have
the anti-inflammatory effects of NSAIDs, but does not upset people’s
stomach in most of the cases are now commonly used.
Steroids, which are injected directly into the joint, may also be used to
reduce inflammation and pain. No more than two to three injections should
be administered in one year.
Artificial joint fluid can be injected into the knee and lead to temporary
relief of pain for up to six months.
Surgery
Surgery to replace or repair damaged joints may be needed in severe,
debilitating cases. Surgical options include:
O Arthroplasty (total or partial replacement of the deteriorated joint
with an artificial joint)
O Arthroscopic surgery to trim torn and damaged cartilage and wash
out the joint
O Osteotomy (change in the alignment of a bone to relieve stress on
the bone or joint)
O Arthrodesis (surgical fusion of bones, usually in the spine).
AYURVEDA
External massaging of the affected joint with medicated oils and internal
oleation therapy is the best treatment for subduing the vitiated Vata Dosha.
Local diaphoresis is also very effective in mobilisation of inflammed joints.
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Local application of various medicated oils and local fomentation by using

hot water bag or bottle is very useful in all arthritic conditions.
Medicated oils like Mahanarayan taila or Mahavishagarbha taila and

Balalakshadi taila, which are available in market, are used for external
oleation therapy.
Garlic paste, asafoetida, cumin seeds, saindhav salt, ginger powder, black
pepper powder, long pepper powder, should be mixed and tablets should
be made. These tablets should be taken along with decoction of root of
castor plant.
Leaves of Pluchea lanceolata mixed with gum guggul and ghrita should be
taken in the dose of 500 mg. thrice daily.
Castor oil should be taken daily in the dose of 5 ml daily for chronic
arthroses. Besides supplementing to the action of major ingredients, it
ensures clean bowels and improved general health.
Decoction of Tinospora cordifolia, embelic myrobalan chebulic myrobalan,

belleric myrobalan and gum guggul should be taken in the dose of 30 ml.
thrice daily.
Decoction of bark of sacred fig should be taken along with long pepper
powder.
Many preparations available in market like Yograj guggul, Mahayograj guggul,
Maharasnadi Kwath, Dashamularlshta, Mahavata vidhvansa, Rasa, Brihat
Vata Chintamani Rasa etc. These can be taken under the guidance of a
clinician.
Studies have shown that a combination containing the following herbs
significantly reduced pain and disability in people with OA: Ashwagandha
(Withania somnifera), Boswellia (Boswellia serrata) and Turmeric (Curcuma
longa).
Following are some Ayurvedic drugs for OA:
O Yogaraja guggulu 2 tab three times a day or Simhanada guggulu 2
tab three times a day
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O Vatagajankusham 2 tab twice a day

O Kaisora guggulu 4 tab twice a day
O Maharasnadi kwatham 28-56 ml three times a day before meals.
ACUPUNCTURE
Several controlled trials suggest that the ancient Chinese practice of
acupuncture is an effective treatment for pain associated with OA, as well
as for other aspects of the condition, including diminished joint function
and reduced walking ability. In fact, a few studies have shown that people
with OA experience better pain relief and improvement in function from
acupuncture than from NSAIDs. Following acupoints are used:
O Baihui (Du 20)
O Local points: Heding (Ex. 31), Xiyan (Ex. 32), Dubi (St. 35),
Weizhong (U.B. 40), Xuehai (Sp. 10), Liangqiu (St. 34), Ah-Shi
points
O Distal point and analgesic point: Kunlun (U.B. 60), Hegu (L.I.
4) of the opposite side, Neiting (St. 44)
HOMEOPATHY
Potential remedies for OA include:
O A topical homeopathic gel containing comfrey (Symphytum
officinale), poison ivy (Rhus toxicodendron), and marsh-tea (Ledum
palustre)
O A combination homeopathic preparation containing R.
toxicodendron, Arnica Montana (arnica), Solanum dulcamara
(climbing nightshade), Sanguinarra Canadensis (bloodroot), and
Sulphur
O A liquid homeopathic preparation containing R. toxicodendron,
Causticum (potassium hydrate), and Lac vaccinum (cow’s milk).
Other common homeopathic remedies for OA include:
O Calcarea carbonica (carbonate of lime or calcium carbonate)
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O Bryonia (wild hops)

O Graphites
O Guaiacum.
NATUROPATHY
Obese OA patients are kept on fasting for one to two weeks, after which
they will be prescribed a low calorie diet. Weight loss for overweight
individuals will decrease the mechanical strain placed on the joints of the
lower extremities. Antiinflammatory foods like papaya, pineapple, omega-
3 foods, etc. are recommended.
The following herbs are the most effective for OA:
O Devil’s claw (Harpagophytum procumbens)
O Willow bark (Salix spp.)
O Stinging nettle (Urtica dioica)
O A combination of aspen (Populus tremula), ash (Fraxinus excelsior),
and goldenrod (Solidago viraurea)
O A combination of willow bark (Salix spp.), black cohosh (Cimicifuga
racemosa), sarsaparilla (Smilax spp.), guaiacum (Guaiacum
officinale) resin, and poplar bark (Populus tremuloides)
O Capsaicin (Capsicum frutescens) capsaicin cream provided much
better pain relief than a placebo but no improvement in joint
swelling, grip strength, or function for people with OA. Pain
reduction generally begins 3 to 7 days after applying the capsaicin
cream to the skin.
YOGA THERAPY
In one clinical trial studying OA of the hand, the group practicing yoga
showed significant decrease in pain and improved range of motion compared
to those participating in non-yoga stretching and strengthening sessions.
Certain yoga “asanas” (postures) strengthen the quadriceps and emphasize
stretching, both of which benefit people with OA of the knee. People with
arthritis should begin asanas slowly and they should be performed only
after a warm up.
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O Asanas:

Dhanurasana, Matsyasana, Setubandha sarvangasana, Vipareeta

Dandasana, Ustrasana

NUTRITION THERAPY
A low calorie diet is advised to reduce weight in obese osteoarthritis patients.
Reduction in weight will reduce load on knee joints and reduce pain.
Glucosamine and Chondroitin:: Glucosamine sulfate and chondroitin sulfate
are two nutritional supplements that have been used currently to treat
osteoarthritis. Both glucosamine and chondroitin are produced within the
body and are used in the manufacture or repair of cartilage. For use in
supplements, they are derived from bovine and calf cartilage. Both
compounds have been shown to inhibit inflammation as well as diminished
narrowing of the joint space, suggesting that the supplement slowed the
progression of the disease.
Other Supplements are:
O S-adenosylmethionine (SAMe): SAMe reduce pain and
inflammation, diminish morning stiffness and decrease pain and
swelling
O Vitamin D is essential to bone and cartilage health. It prevents
breakdown of cartilage
O Omega-3 Fatty Acids decrease inflammation and reduce the activity
of enzymes that break down cartilage
O Bromelain (Ananas comosus): Compared favorably to NSAIDs for
pain reduction
O Boron: Population, animal, and preliminary human studies suggest
that this trace element may reduce occurrence of symptoms of OA
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O Collagen hydrolysate: May stimulate cells to make collagen,

although this theory is currently being tested.
PSYCHOTHERAPY
Chronic pain and disability can make daily functioning difficult. Many
people report that relaxation techniques, such as guided imagery and
meditation help to alleviate pain and other symptoms of OA.
PHYSICAL THERAPY
Physical therapy can be useful to improve muscle strength and the motion
at stiff joints. Therapists have many techniques for treating osteoarthritis,
each of which some patients find helpful. Ice Massage, Paraffin baths,
Superficial/Deep Heat/Cold, Transcutaneous Electrical Nerve Stimulation
(TENS), Shortwave diathermy, Electroacupuncture, etc. are used in physical
therapy to reduce the OA.
Exercises are important to maintain joint and overall mobility. Physical
therapists and occupational therapists can prescribe an appropriate home
exercise treatment. Exercise therapy reduces pain, improves functional
ability, improves walking distance and reduces need for knee surgery.
Exercises done in water are often effective for increasing mobility.
A simple yet complete, home mobility exercised program that should be
done daily is as follows:
O Neck rotation - 5 times each way
O Shoulder rotation - 5 times forward/reverse
O Elbow bends - 10 times
O Wrist rotation - 5 times each way
O Finger exercises - 10 times (stretch/clench)
O Waist rotation - 5 times each way
O Waist side bends - 5 times each side
O Hip rotation - 10 times each leg
O Knee bends - 10 times each leg
O Ankle rotation - 5 times each way.
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Walking is good for lubrication, walk a little every day within limits of
pain. Monitor pace and distance by recording effects. Use walking aids to
relieve pain and stress and to help balance.
Home care
O Weight loss can reduce the risk of developing knee osteoarthritis
in overweight persons. Weight should be kept under control.
O The patient should rest of 5-10 minutes every hour but should
avoid being in one position for longer than half an hour. If this is
not possible, e.g. when in a train or in car, then the patient should
practice isometric muscle contractions and also joint mobility
movements frequently.
O The patient should exercise daily. If bed rest is necessary, e.g.
because of ‘flu’, once the acute fever stage has passed and the joints
have stopped aching, the patient should try to move each joint in
every direction every half hour or so. Also, he should practice
isometric contractions.
O Sitting with the knees crossed should be avoided to prevent
deformity.
O The patient should avoid putting sudden strain on the joints, e.g.
lifting heavy loads, long spells of gardening or decorating.
O In cold weather the patient should wrap up well, cold predisposes
to muscle spasm. Exercise should not be carried out in cold weather;
use a rubber hot water bottle or electric heat pad to warm the
muscles in cold weather and prior to exercise.
GOUT
Gouty arthritis is the name for an attack of a metabolic disease marked by
uric acid deposits in the joints. The disorder causes pain, especially in the
joints of the feet and legs. Patients with chronic gout may have repeated
episodes of gouty arthritis.
Gout is caused by a defect in metabolism which results in an overproduction
of uric acid or leads to reduced ability of the kidney to eliminate uric acid.
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The exact cause is unknown. Risk is increased in males, postmenopausal

women, and people with hypertension. Heavy alcohol use, diabetes, obesity,
sickle cell anemia, and kidney disease also increase risk, so does lack of
preventative measures in people with prior attacks.
The condition may also develop in people who take drugs which interfere
with uric acid excretion.
Symptoms
O Extreme pain in a single joint, usually the base of the big toe, but
other joints can also be affected (such as the feet, fingers, wrists,
elbows, knees, or ankles)
O Joint is shiny red-purple, swollen, hot, and stiff
O Fever as high as 39°C (102.2° F) with or without chills
O Attack develops over a matter of hours and may get better over a
few days or weeks
O In later attacks, you may see lumps (called tophi) just under the
skin in the outer ear, hands, feet, elbow, or knee.
Signs and tests

There may be a current or previous medical history of acute arthritis in
one joint. A physical examination of joints shows arthritis and tophi.
Tests that indicate gouty arthritis include:
O Synovial fluid analysis that detects uric acid crystals
O Elevated uric acid level
O Joint x-rays which show damage consistent with gouty arthritis.
Treatment
MODERN MEDICINE
For pain relief in acute gout:
O Colchicine: For pain relief; can be taken orally or administered
intravenously; toxicity and severe side effects limit its IV use; can
prevent future attacks
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O Corticosteroids: Dramatic pain relief; can have severe side effects

O Analgesics: For severe pain; do not take aspirin at the same time
O NSAIDs like indomethacin to reduce inflammation and pain.
Uric acid reducing drugs:
O Uricosuric agents: Effectively reduce uric acid levels; various side
effects; do not take aspirin at the same time
O Allopurinol: Blocks the enzyme that produces uric acid.
A large ulcerating tophi may need surgical excision.
AYURVEDA
The initial treatment involves the administration of enema with guduchi

(Tinospora Cordifolia), Ashwatha and Kokilaksha (Astera Cantha
longifolialinn), along with Sesame oil. The decoction of the root bark of
Ashwatha tree (Ficus Religious) is very effective. It should be administered
in a dose of one ounce twice daily. The oil can also be prepared with the
same decoction along with sesame oil and it can be applied externally.
Pancha Tikta Ghrita guggulu should be administered in a dose of 2
teaspoonfuls twice daily with hot water or warm milk. It acts as a potent
blood purifier.
The blood of the patient of Vata Rakta (gout) should be let out, in small
quantities, at many times after oleation therapy
Purgation therapy should be given (oleation therapy first) and then
administered purgative drugs mixed with fats (medicated ghee / oil).
Eranda taila should be consumed mixed with milk to produce purgations
in the patient who has great increase of dosha; after it gets digested (and
after purgations) he should eat boiled rice along with milk.
There is nothing equal to basti (enema therapy) in the treatment of vatarakta
(gout), especially for those who have pain in the rectum, flanks, thighs,
joints, bones and abdomen.
Medicated oil prepared with madhu ucchista (bee’s vax), manjishta, sarjarasa
and sariva-known as pinda taila-used for abhyanga (anointing and massage)
relieves the pain of vatrakta.
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Application of medicines in the form of lepana (application of pastes),

abhyanga (anointing with fats) parisheka (pouring liquids on the body) and
avagaha (immersing the body in liquids) will relieve pain.
In gout, when there is predominance of pitta and rakta, cold application
are beneficial.
The following prepared medicines can also be given to the patient, either
alone or together in a suitable dosage.
O Maamanjistadi quatha, 1 ounce twice daily
O Amrithadi guggulu or Kaishora Guggulu or Punarnava guggulu, 2
tabs. twice daily
O Saribadyarista, 1 ounce twice daily
O Pinda Taila or Gudoochyadi Taila, for external use only.
ACUPUNCTURE
Acupuncture reduces pain and inflammation. Following acupoints are used:
O Baihui (Du 20)
O Local points: Befeng (Ex.36), Ah-Shi points
HOMEOPATHY
Some of the most common remedies used for gout are listed below. Usually, the
dose is 12X to 30C every one to four hours until your symptoms get better.
O Aconite for sudden onset of burning pain, anxiety, restlessness,
and attacks that comes after a shock or injury
O Belladonna for intense pain that may be throbbing; pain is made
worse by any motion and better by pressure; joint is very hot
O Bryonia for pain made much worse by any kind of motion; pain is
better with pressure and with heat
O Colchicum for pains made worse by motion and changes of weather,
especially if there is any nausea associated with the attacks
O Ledum when joints become mottled, purple and swollen; pain is
much better with cold applications and is worse when overheated.
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NATUROPATHY
Fasting for 3 to 4 days with vegetable juices and noncitrus juices, and
plenty of pure water helps to flush out uric acid from the body.
O Devil’s claw (Harpagophytum procumbens) reduces pain and
inflammation. Dose is one to two grams three times per day of
dried powdered root, four to five ml three times per day of tincture,
or 400 mg three times per day of dry solid extract during attacks.
O Bromelain (Ananas comosus): Proteolytic enzyme (anti-
inflammatory) when taken on an empty stomach. Dose is 125 to
250 mg three times per day during attacks.
Massage and hydrotherapy treatments are used to relieve pain. Ice cold
foot bath in acute gout and hot foot bath in chronic gout reduces pain and
inflammation.
NUTRITION THERAPY
Maintain a healthy weight. However, it is important to avoid crash dieting
and rapid weight loss. Drink plenty of water because dehydration may
make gout worse. Do not drink alcohol, especially beer. Oatmeal and
cauliflower should be avoided.
Foods that can be taken : Refined cereals and its products, cornflakes, white
bread pasta, flour, arrowroot, sago, tapioca, cakes, milk products, lettuce,
tomatoes and green vegetables, sugar and sweets, water, fruit juices,
carbonated drinks, tea, coffee, cola.
Restrict purines in your diet. Purines increase lactate production, which competes
with uric acid for excretion. Foods with high purine content include beef, goose,
organ meats, sweetbreads, mussels, anchovies, herring, mackerel, and yeast.
Foods with a moderate amount of purines include meats, poultry, fish and
shellfish not listed above. Spinach, asparagus, beans, lentils, mushrooms, and
dried peas also contain moderate amounts of purines.
Cherries: One half pound of cherries per day (fresh or frozen) for two
weeks lowers uric acid and prevents attacks. Cherries and other dark red
berries (hawthorn berries and blueberries) contain anthocyanidins that
increase collagen integrity and decrease inflammation. Cherry juice (8 to
16 ounces of per day) is also helpful.
253

O Vitamin C: 8 grams per day can lead to decreased blood uric acid
levels
O Folic acid: 10 to 75 mg per day inhibits xanthine oxidase, which is
required for uric acid production
O EPA (eicosapentaenoic acid) inhibits pro-inflammatory
leukotrienes. Dose is 1,500 mg per day.
PHYSICAL THERAPY
O Hot and cold compresses: Three minutes hot alternated with 30
seconds cold provide pain relief and increase circulation
O Bed rest for 24 hours after acute attack. However, prolonged bed
rest may make the condition worse
O Cryotherapy can be given to give pain relief. The inflammation that
occurs in the joints due to gout leads to pain this can be reduced in
accordance with the principle of ‘pain-gait theory’ using cryotherapy.
Cryotherapy involves the use of cold packs and ice cubes.
Prevention
Drugs that lower the serum uric acid concentration may prevent the
development of chronic gouty arthritis in susceptible people.
LOW BA
LOW CK P
BACK AIN
PAIN
Low back pain affects 60 to 90 percent of the adult population at one time
or another. Sciatica occurs in 1-3% of those with LBP. Low back problems
affect the spine’s flexibility, stability, and strength, which can cause pain,
discomfort, and stiffness. 75-90% of those with acute back pain will have
resolution of pain within 6 weeks.
Causes
Low back pain is usually caused by strain from lifting, twisting, or bending.
However, some low back pain can be a symptom of a more serious condition.
Other causes of low back pain include the following:
254
O Musculoskeletal pr oblems like degenerative joint disease (Facets),

problems
degenerative disc disease and muscular strain and spasm
O Radiculopathy like Herniated Nucleus Pulposis ( L4, L5, S1 in

95% of cases of radiculopathy)
O Compression F
Compression ractur
Fractures
ractures
O Inflammator
nflammatoryy Back D
Back iseases like Ankylosing Spondylitis, Reiter’s
Diseases
Syndrome, Arthritis of Inflammatory Bowel Disease, Psoriatic
Arthritis
O V isceral/Vascular problems like Abdominal Aortic Aneurysm

isceral/Vascular
(AAA), Perforating duodenal/gastric ulcer, Pancreatitis,
Endometrial disease and Ovarian disease
O Spinal Stenosis like Degenerative (seen in elderly; most common),

congenital, Pseudoclaudication/Neurogenic claudication
O I nfections like Mycobacterium Tuberculosis (Pott’s Disease),

Paravertebral Abscess, Intervertebral discitis or osteomyelitis,
Herpes Zoster, Pyelonephritis and Endocarditis
O M alignancy like Primary malignancy, Multiple Myeloma,

Lymphoma, Pancreatic, Metastatic, Prostate, Breast, Renal Cell,
Thyroid, Lung and Colon
O Others like Hip disease, Spondylolisthesis/Spondylolysis, Scoliosis,

Leg-length discrepancy, Scheuerman’s disease, Fibromyalgia, DIS,
Diabetic radiculopathy etc.
Risk factors:
O Occupations that require repetitive lifting
O Exposure to occupational vibrations.
O Cigarette smoking.
O Poor overall fitness
O Stress and general life dissatisfaction.
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Signs and tests

A physical examination and history of pain may be sufficient to diagnose
the disorder.
Acute Pain
O Defined as onset within 0-6 weeks
O 90% of patients with low back pain
O Only 10-20% can be given precise patho-anatomical diagnosis.
Chronic Pain
O Pain with onset > 3 months
O 5% of patients with low back pain
O 50% have clear structural diagnosis made for cause of their back pain.
A neurological examination will be performed to evaluate muscle reflexes,
sensation, and muscle strength. Often, examination of the spine will reveal
a decrease in the spinal curvature in the affected area.
Straight-leg-raising test that reveals leg pain is diagnostic of a herniated
lumbar disk.
A “foraminal compression test of Spurling” will be performed to diagnose
cervical radiculopathy. This is performed by bending the head forward
and to the sides while downward pressure is applied to the top of the head.
Increased pain or numbness during this test is usually indicative of cervical
radiculopathy.
Diagnostic Tests
O A spine X-ray may be performed to know causes of back pain
O HLA-B27 antigen test is positive in Ankylosing Spondylitis
O A spine MRI and/or spine CT will show the spinal cord structure
and can help in correct diagnosis
O A myelogram may be performed to define the size and location of
disk herniation
O An EMG may be performed to determine the exact nerve root(s)
that is (are) involved
O A nerve conduction velocity test may also be performed.
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Treatment
In general, low back pain can be relieved and prevented with lifestyle
changes. Exercising to strengthen your muscles, maintaining a healthy
weight, and practicing good posture lower your risk. Learning to bend and
lift properly, sleeping on a firm mattress, sitting in supportive chairs, and
wearing supportive shoes are important factors. In Acute LBP, bed rest for
2 to 7 days is helpful. Two days of bed rest is as effective as 7 days and
results in 45% less time away from work.
MODERN MEDICINE
O Nonsteroidal anti-inflammatory drugs (NSAIDS): For example,
ibuprofen, can help relieve pain
O Muscle relaxants
O Oral or epidural steroids: Reduce inflammation.
Surgery
Indications for surgery include:
O Progressive or severe neurologic deficit
O Persistent neuro-motor deficit despite 4-6 weeks conservative
therapy
O Persistent radiculopathy, sensory deficit or reflex loss after 4-6 weeks
conservative therapy with straight leg raising test, consistent clinical
findings and favorable psychosocial circumstances (no depression,
substance abuse or somatisation disorder).
ACUPUNCTURE
Reviews of scientific studies have found support for the use of acupuncture
for low back pain. Treating low back pain with acupuncture can be complex
because many meridians (including the kidney, bladder, liver, and
gallbladder) affect this area of the body. Local treatment to the painful
areas and related sore points is often performed as well, with needles and/
or moxibustion (a technique in which the herb mugwort is burned over
specific acupuncture points).
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In treating backache, it is best to commence therapy with a few points.

O Baihui (Du 20)
O Local points: Ah-Shi points
O Distal points: Weizhong (U.B. 40), Kunlun (U.B. 60), Du
and U.B. Channel points of the affected area
O Analgesic point: Hegu (L.I. 4).
If degenerative changes in the spine are present, use Dashu (U.B. 11). In
acute sciatica, Huantiao (G.B. 30.) with stimulation to produce Deqi is
very helpful in relieving pain. In very acute low backache, Renzhong (Du
26.) may be used to relieve the pain.
AYURVEDA
Castor oil from castor tree (Ricinus communis) is the drug of choice for back
pain. Eranda Paka is given in doses of two teaspoonfuls at bedtime with a
cup of warm water or milk. It helps patients with constipation because
castor acts as a laxative. Nirgundi eranda Kashayam also can be given.
Yogaraja Guggulu is another medicine which is administered in doses of
two tablets four times a day with water or milk. Guggulu Tiktaka Ghrita 50
ml and honey 10 ml. may be given as retention enema.
Mahavishagarbha oil should be used for massaging the affected part, after
which hot fomentation should be applied. The limb should be covered
with a warm cloth to maintain the heat.
The following prescriptions are recommended to complete the cure.
O Trayodashanga guggul 2 tab bid
O Maharasnadi Kwatham 12-28 ml bid
O Vathavidhwamsini ras (1) + Hingwastaka churnam + Parasika yavani
churnam (4) with honey bid
O 240 mg of Vataganjakusha and 3 gm of Vaishwanara Churna to be taken
twice daily after meals with warm water or decoction of Manjishta.
Panchakarma treatments like Pizhichil, Sarvanga Dhara, Kati vasti with
Dhanwantharam oil or Bala oil or Mahavishagarbha oil also reduce back
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pain. External fomentation with Nirgundi leaves, castor leaves and

Eucalyptus leaves is useful.
HOMEOPATHY
Some of the most common remedies for this condition are listed below.
O Aesculus for dull pain with muscle weakness
O Arnica montana especially with pain as a result of trauma
O Colocynthis for weakness and cramping in the small of the back
O Gnaphalium for sciatica that alternates with numbness
O Lycopodium for burning pain, especially with gas or bloating
O Rhus toxicodendron for stiffness and pain in the small of the back.
NATUROPATHY
Fasting has been shown to decrease ESR, pain, stiffness and need for
medication. A 3 to 5 days fasting with fruit and vegetable juices has been
shown to reduce back pain. After a therapeutic fast, take a healthy vegetarian
diet rich in green leafy vegetables, raw vegetables, high potassium foods,
vegetable juices, and fibre.
Following are some herbs to reduce back pain:
O Relaxants: Black haw (Viburnum prunifolium), petasites (Petasites
hybridus), valerian (Valeriana officinalis)
O Anti-inflammatory: turmeric; Jamaica dogwood (Piscidia piscipula),
St. John’s wort (Hypericum perforatum)
O Pain relief: White willow bark (Salix alba), Devil’s claw
(Harpagophytum procumbens).
Castor oil pack: Apply oil directly to skin, cover with a clean soft cloth and
plastic wrap. Place a heat source over the pack and let sit for 30 to 60
minutes. Do this for three consecutive days.
Hydrotherapy
Apply ice or a cold compress immediately after injury to reduce pain and
inflammation. Use cold for the first 48 hours after the back symptoms
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start. Apply a cold pack (or a bag of ice) to the painful area for five to ten
minutes every hour.
After 2 days, use heat to increase circulation, reduce pain, and relax tense
muscles. A heating pad, hot shower, steam bath, whirlpool, or hot immersion
bath can help relieve muscle tension and pain.
Contrast hydrotherapy: Alternate hot and cold applications. Alternate three
minutes hot with one-minute cold. Repeat three times to complete one
set. Do two to three sets per day.
Pool therapy is an excellent means of providing pain relief. It also improves
mobility and gives a feeling of fitness as the whole body is exercised.
YOGA THERAPY
Yoga reduces back pain by stretching and strengthening back muscles.
O Asanas:

Matsyasana, Setubandha sarvangasana, Setubandha
sarvangasana on pillows, Vipareeta Dandasana, Viparita
dandasana on the chair, Ustrasana
Konasana

Bhramari
Avoid all forward bending poses.
NUTRITION THERAPY
A low calorie diet is advised for obese people with back pain. Weight
reduction in obese people will immediately reduce backache and prevent
future pain.
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O B-complex: B1 (50 to 100 mg), B2 (50 mg), B3 (25 mg), B5
(100 mg), B6 (50 to 100 mg), B12 (100 to 1,000 mcg), folate
(400 mcg per day) reduces pain
O Vitamin E (400 IU per day), vitamin C (250 to 500 mg twice daily)
O Calcium (1,500 to 2,000 mg) and magnesium (700 to 1,000 mg)
to regulate muscle contraction and ease spasm
O Bromelain: (250 to 500 mg three times per day on an empty
stomach) anti-inflammatory, works especially well with turmeric.
PSYCHOTHERAPY
Psychotherapy is recommended for patients whose back pain is associated

with a somatoform, anxiety, or depressive disorder. Psychotherapy, relaxation
and medication therapies, biofeedback, and behavior modification may
also be employed to treat chronic pain.
Behaviour therapy is used for people who have chronic backache. Behaviour
therapy is based on the belief that the way we feel about our pain can make
our pain better or worse.
PHYSICAL THERAPY AND EXERCISE THERAPY

Low back stabilization exercises are commonly prescribed to patients
suffering from low back pain. These exercises are designed to teach the
patient a “neutral spine” position as well as subconsciously enhance the
muscles ability to stabilize and protect the spine from injury.
Pelvic tilt
(Purpose: Strengthens gluteal (buttocks) and abdominal muscles; flattens spine).
Lie on back with knees raised. Squeeze the buttocks tightly together, and
then pull in your stomach muscles. You will feel your low back go flat
against the floor. Hold for a count of 5. Relax and repeat 3 times, increasing
gradually to 10 times. Do a pelvic tilt often during the day also in sitting
and standing positions. The pelvic tilt is the most commonly recommended
exercise for the lower back.
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EXERCISES FOR THE L

EXERCISES OWER BA
LO CK
BACK
1. Partial Curl Up 2. Upper Body Extension With 3. Four P oint H

Point ip E
Hip xtension
Extension
Tilt pelvis to flatten Chin Tuck Keep neck in a neutral position
back. Grasp hands Place a pillow under your as you raise one leg up behind
behind head abdomen Clasp hands you. you Knee is kept stightly flexed.
supporting neck. Raise First pull shoulders back Do not arch your back. Hold 5
upper body until pinching shoulder blades. seconds. Relax. Gradually
shoulder blades clear Secondly, raise head and increase repetitions.
the floor. Hold 5 shoulders off the table with
seconds. Gradually chin tucked during exercise.
increase repetitions. Hold 5 seconds, relax.
Gradually increase repetitions.
4. Four P oint U
Point pper B
Upper ack
Back 5. Prone Push Up 6. Mad Cat
Extension Push up with your arms Hands directly under shoulders,
Keep neck in a neutral lifting upper body. Keep knees under hips. Tuck chin
position as you raise one hips in contact with the and tighten your abdominals
arm out in front of you. floor. Gradually increase to arch your back. Hold for 5
Keep back flat as you do repetitions. seconds Relax. Gradually
so. Hold for 5 seconds. increase repetitions.
Relax Gradualty increase
repetitions.
7. Double Knee To Chest 8. S ingle Knee To Chest

Pull both knees up to Pull one knee up to chest to 9. Pelvic Tilt
chest to feel a feel a comfortable stretch in low Flatten your back by
comfortable stretch in back and buttocks. Do the same tightening the muscles of your
low back and buttocks. with the opposite knee. stomach and buttocks.
Gradually increase Gradually increase repetitions. Gradually increase repetitions.
repetitions.
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Single-knee raise
(Purpose: Stretches low back and hamstrings)
Lie on your back, with both legs straight. Hold a pelvic tilt while you
perform the exercise.
Bend one knee and slowly bring it toward your chest. Use your hands to
gently pull your knee close to your chest. Hold for 5 seconds and then
lower your leg slowly. Repeat for a total of 3 times, increasing gradually to
10 times. Repeat the exercise with the other leg.
Double-knee raise
(Purpose: Stretches low back and hamstrings)
Begin with both knees bent. Hold a pelvic tilt while you perform the
exercise. Pull your knees to your chest. Use your hands to pull your knees
slowly toward your armpits. Hold for 3 to 5 seconds. Return to your starting
position and repeat 3 times, slowly increasing to 10 times.
Single-leg raise
(Purpose: Stretches low back and hamstrings. Strengthens stomach and
hip-flexing muscles)
Caution: If you have sciatica (pain down the leg), avoid this exercise.
Lie on your back with one knee bent and your other leg straight. Hold a
pelvic tilt while you perform the exercise. Slowly raise the straight leg,
keeping it straight. Keep your low back flat. Raise your leg as far as possible
without causing pain. Slowly lower your leg and flatten your low back as
your leg nears the floor. Repeat with the same leg for a total of 3 times,
increasing to 10 times. Repeat the exercise with your other leg.
Par tial curl-ups

artial
(Purpose: Strengthens low back and abdominal muscles)
Lie on your back on a soft or carpeted floor, knees bent. Hold a pelvic tilt
throughout the exercise. Slowly raise your head and neck, then shoulders,
as you extend your hands to your knees. Keep your low and middle back
on the floor. Hold for a count of 5. Return to starting position. Repeat for
a total of 3 times, increasing gradually to 10 times.
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Hip roll
(Purpose: Stretches low back and buttocks)
Lie on your back, your legs bent. Keep both shoulders against the floor.
Bring up your feet, with your knees somewhat together. Then lower your
bend knees toward your left hip, then your right hip. Hold for 3 to 5
seconds. Repeat 5 times, increasing gradually to 10 times.
Sitting bend
(Purpose: Strengthens and stretches the low back and hamstrings)
Sit in a chair, feet flat on the floor, knees no more than a foot apart, hands
at your sides. Perform a pelvic tilt so that you low back goes flat against the
chair. Repeat for a total of 3 times, increasing gradually to 10 times.
Performing some back exercises on an exercise ball is a great way to strengthen
many little stabilizer muscles that normally get no work, and may be very
helpful in maintaining back health and preventing back pain.
Exercises to avoid
It is best to avoid the following exercises because they strain the low back
O Legs raised straight and together
O Sit-ups with legs straight
O Hip twists
O Toe touches
O Any backward arching.
Other physiotherapy modalities are shortwave diathermy, traction,
ultrasound, soft laser and TENS treatments.
Traction
raction: Oscillatory traction is considered to be mobilizing, therefore is
appropriate where the neck is generally stiff. Continuous traction is used
to relieve nerve root pressure but if the target segment is stiff then is must
be mobilized first otherwise the traction force is distributed between the
other mobile segments. In addition, it is essential to ensure that the
paravertebral muscles are relaxed and lengthened (e.g. by heat, hold-relax,
passive stretching) prior to the application of traction.
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Some practitioners recommend the use of back braces to help support the
spine. However, overuse of these devices can weaken the abdominal and back
muscles leading to a worsening of the problem. Weight belts can be helpful in
preventing injuries in those whose work requires lifting of heavy objects.
A soft cervical collar may be prescribed for people with cervical
radiculopathy. The collar helps reduce the pain and muscle spasms by
limiting neck movements. A rigid neck collar may occasionally be necessary
to eliminate weight bearing on the cervical spine in people with severe
pain and muscle spasms.
MASSAGE THERAPY
Kneading to mobilize tethered fascia is helpful in reducing the neck and
back pain. In addition, kneading helps to release tightness in the muscle
fibres and localized thickenings in the paravertebral muscles. Picking up,
wringing and skin rolling achieve similar effects.
PROPER POSTURE AND HABITS
Another key ingredient to a successful low back pain treatment includes
the learning of proper postural habits and other techniques. Proper posture
is a significant factor in the health of the back and proper posture should
always be practiced. Techniques common to daily living and work also
play a major role in the development or lack of development of low back
pain. This includes proper lifting techniques, avoidance of repetitive
motions, avoidance of prolonged sitting, and much more.
The patients are advised to:
O Keep a healthy weight
O Use good posture. Stand with your head up, shoulders straight, chest
forward, and your weight on both feet and your pelvis tucked in
O Sit in a straight-backed chair and hold your spine against the back
of the chair
O Sit close to the pedals when driving. Use seat belt and a hard backrest
or pillow
O Use a footrest for one foot when standing or sitting in one spot for
a long time. This keeps the back straight
O Bend knees when bending over.
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POSTURE
1) At all times keep your spine in a straight alignment.

2) When you need to bend - bend from the knees.
HOW TO BEND
HOW TO STAND
WHILE RECLINING SUPPORT THE SPINE
RECLING SLEEPING
WHILE SLEEPING USE A FIRM MATTRESS & A LOW PILLOW
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POSTURE
LIFTING AND CARRYING SITTING
USE YOUR KNESS TO LIFT
KEEP YOUR SPINE STRAIGHT
DO NOT CARRY OBJECTS SIT UPRIGHT WITH

ABOVE SHOULDER A STRAIGHT SPINE
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Tips when need to lift or mo

movve heavy objects:
O Don’t push with your arms when moving a heavy object. Turn
around and push backwards so your legs take the strain.
O Keep your back straight when lifting a heavy object while carrying
it with your arms bent.
When asleep or lying down:
O Rest on a firm mattress. It may help to lie on the back with knees
raised or lie on side with knees bent.
O Put a pillow under your knees when you are lying down.
O Sleep without a pillow under the head.
Chiropractic and Osteopathy

Spinal manipulation is among the most extensively studied and accepted
forms of treatment for acute low back pain. Spinal manipulation consists
of a gentle, manually or mechanically applied force into the segments of
the spinal column. Spinal adjustments have been shown to decrease pain,
increase spinal range of motion, decrease muscle spasm, reduce
inflammation, optimize spinal biomechanics, and reduce the recurrence of
old injuries.
OSTEOPOROSIS
OSTEOPOROSIS
Osteoporosis is the thinning of bone tissue and loss of bone density over
time. Osteoporosis, which literally means “porous bone,” is a disease of the
skeleton in which the bones gradually lose density and begin to deteriorate.
People with osteoporosis have brittle bones and an increased susceptibility
to fractures of the hip, spine, and wrist.

Osteoporosis is the most common type of bone disease. Osteoporosis occurs
when the body fails to form enough new bone, or when too much old
bone is reabsorbed by the body, or both.
Calcium and phosphate are two minerals that are essential for normal bone
formation. Throughout youth, the body uses these minerals to produce
bones. If calcium intake is not sufficient, or if the body does not absorb
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enough calcium from the diet, bone production and bone tissues may
suffer.
As people age, calcium and phosphate may be reabsorbed back into the
body from the bones, which makes the bone tissue weaker. Both situations
can result in brittle, fragile bones that are subject to fractures, even in the
absence of trauma. Usually, the loss occurs gradually over years.
The leading causes are a drop in estrogen in women at the time of
menopause, and a drop in testosterone in men. Women, especially those
over the age of 50, get osteoporosis more often than men.
Other than age and menopause, causes of osteoporosis can include:
O Long term use of certain medications, particularly steroids and
thyroid medications
O Diseases of the thyroid or adrenal glands
O Deficiencies in calcium, vitamin D, vitamin A, vitamin K, and/or
magnesium (it is important to note that very high intake of vitamin
A may actually increase the risk of osteoporosis)
O Disease like Cushing’s syndrome, Anorexia nervosa,
Hypogonadism, Rheumatoid arthritis, Alcoholism, Epilepsy and
Kidney failure
O Rare genetic disorders such as osteogenesis imperfecta, Ehlers-
Danlos syndrome, and Marfan’s syndrome.
Women who are white, especially those with a family history of osteoporosis,
have a greater risk of developing osteoporosis. Other risk factors include
smoking, eating disorders, low body weight, low amount of calcium in the
diet, heavy alcohol consumption, early menopause, absence of menstrual
periods (amenorrhea), and use of certain medications, such as steroids and
anticonvulsants.
Symptoms
There are no symptoms in the early stages of the disease.
Symptoms occurring late in the disease include:
O Fractures of the vertebrae, wrists, or hips (usually the first
indication)
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O Low back pain

O Neck pain
O Bone pain or tenderness
O Loss of height over time
O Stooped posture.
Signs and tests
O Bone mineral density (BMD) testing — as performed in dual-
energy x-ray absorptiometry (DEXA) — measures the
demineralization of the bones. This has become the gold standard
for evaluation for osteoporosis. BMD testing should be performed
on all postmenopausal women with fractures, all women under 65
with an additional risk factor for osteoporosis (besides menopause),
and all women 65 and over.
O A spine CT can show demineralization. Quantitative computed
tomography (QCT) can evaluate bone density.
O A spine or hip x-ray may show fracture or vertebral collapse in
severe cases.
O Measuring the amount of calcium in your urine can provide some
evidence of increased bone turnover, but is of limited value. A
number of newer tests to evaluate bone turnover are becoming
available, including measurement of urinary N-telopeptide.
Treatment
Treatments for osteoporosis focus on slowing down or stopping bone loss,
preventing bone fractures by minimizing the risk of falls, and controlling
pain associated with the disease.
MODERN MEDICINE
Hormone replacement therapy (HRT) is the best-known way to prevent
osteoporosis in women. HRT is available in a variety of forms, including
tablets, patch, and cream. However, HRT as a combination therapy
(estrogen plus progestin) can result in serious side effects and health risks.
The Women’s Health Initiative (WHI) study, started in 1993, enrolled
161,809 women between the ages of 50-79 in 40 different medical centers.
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Part of the study was intended to examine the health benefits and the risks
of hormone replacement therapy, including the risks of breast cancer, heart
attacks, strokes, and blood clots.
The WHI study showed that women taking HRT had 34% fewer hip fractures
and 24% fewer fractures than women not receiving hormones. However, the
main reason for stopping the estrogen-progestin study was because of a 26%
increase in breast cancer in women taking HRT, as well as increases in heart
attacks, strokes, and thromboembolic events (blood clots).
Other drugs which slow bone loss and increase bone density over time is
mentioned below.
Bisphosphonates: Much like estrogen, this group of drugs can inhibit bone
breakdown, preserve bone mass and even increase bone density in spine
and hip. Bisphosphonates include Alendronate and Risedronate, which
are taken orally.
Ralo xifene: This medication belongs to a class of drugs called selective
Raloxifene:
estrogen receptor modulators (SERMs). Raloxifene mimics estrogen’s
beneficial effects on bone density in postmenopausal women, without some
of the risks associated with estrogen.
Calcitonin: A hormone produced by thyroid gland, calcitonin reduces bone
reabsorption and may slow bone loss. It may also prevent spine fractures,
although it doesn’t appear to protect against hip fractures. It is administered
as a nasal spray.
Tamo xifen: This synthetic hormone has been used to treat breast cancer
amoxifen:
for years. Although tamoxifen blocks estrogen’s effect on breast tissue, it
has an estrogen-like effect on other cells in body, including bone cells. As
a result, tamoxifen appears to reduce the risk of fractures, especially in
women over age 50.
AYURVEDA
Ayurveda advises Panchakarma treatment for detoxification and balancing
the doshas, especially vata dosha, using Purvakarma and Basti treatments.
The treatment consists of internal oleation, Snehana, Bashpa swedana,
Pizhichil, Sarvanga Dhara, Kati basti, and shiro dhara with Dhanwantharam
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oil or Bala oil, followed by purge to remove all the vitiated doshas from the
body systems. This is followed by basti with herbal oil (vata shamak or
dashmoola) for the vitiated vata dosha. Abhyanga or self massage using sesame
oil, for vata pacification.
Rejuvenators like Shatavari (Asparagus racemosus), Ashwagandha (Withania
somnifera), Vidari, and Bala (Sida cordifolia), Amalaki (Emblica officinalis)
should be taken in the powdered form in the dose of 2-3 gm daily. They
can also be cooked in milk with wheat flour and can be taken.
Shatavari and Vidari mixed in equal parts, or just shatavari taken on regular
basis (1/2 tsp twice daily) with warm milk, help to make up for oestrogen
in the metabolic cycle. These herbs are food precursors of oestrogen and
progesterone.
Amalaki is a rasayana for the bones, nourishing the bones, strengthening
the teeth, causing hair and nails to grow. A 5 gm powder in one cup water
twice a day is used as a general tonic. Triphala can be used on regular basis
as a tridoshic tonic.
Ashokarishta- Ashoka bark has silica, sodium, potassium, phosphate,
magnesium, iron, and calcium among others. It is used for many uterine
disorders and is a good herb for time of menopause.
Daily chewing a handful of sesame seeds in the morning provides at least
1200 mg of natural calcium. These seeds won’t clog arteries, as dependence
upon calcium from dairy products may do. One-part black or white sesame
seed along with half part shatavari with ginger and raw sugar added to
taste is good for the bones.
Externally Dhanwantharam oil, Mahamasha oil and Prabanjana oil are used
to strengthen the bones.
HOMEOPATHY
Following remedies are used for osteoporosis:
Calcar ea carbonica: This remedy is often helpful to individuals who are
Calcarea
easily tired by exertion and tend to feel anxious and overwhelmed from
work or stress. The person may be chilly, flabby or overweight, and feel
worse from cold and dampness. Back pain, swollen joints, and a sweaty
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head at night are often seen. People who need this remedy often have
strong cravings for both eggs and sweets.
Calcarea phosphorica: Stiffness, soreness, and weakness of the bones and
joints often are experienced by those who need this remedy. Aching in the
bones of the neck, upper back, and hips can be distressing. Deep tiredness
frequently is felt, especially after exercise. Calcium deposits and bone-spurs
may develop, even while general bone-loss is taking place, and fractures
may be slow to heal.
P hosphor us: This remedy is often helpful to people who are sensitive,
hosphorus:
suggestible, imaginative, but easily tired or weakened physically. Bones
may be less strong than normal, or be slow to heal after fractures. Weakness
is often felt in the spine, with burning pain between the shoulder blades.
Silicea (also called SSilica):
ilica): People who need this remedy are often nervous,
easily tired, very chilly, and tend to sweat at night. They have a refined or
delicate appearance, and often have weakness in the spine. Their injuries
are slow to heal, and they tend to have a low resistance to infection. Moderate
exercise often warms the person up and improves energy.
Symphytum: When osteoporosis is a problem, fractures often occur from
mild trauma. This remedy can be useful for strengthening and healing
bones when new fractures occur, and also helpful when pain persists in
old, healed fractures.
NATUROPATHY
Naturopathy suggests that diets rich in Calcium, Magnesium and
Potassium, Fruits and Vegetables may help prevent bone loss in both men
and women:
A vegetarian diet with high intake of green leafy vegetables, whole grains,
nuts, sprouts, and yoghurt is good in osteoporosis. Take adequate amounts
of calcium in your diet along with vitamin D, which allows your body to
absorb calcium.
The following herbs are advised for osteoporosis:
O Black cohosh (Cimicifuga racemosa): Contains phytoestrogens
(estrogen-like substances that help protect against bone loss); has
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been shown to relieve menopausal symptoms; used traditionally

by Native Americans for musculoskeletal disorders.
O Chaste tree (Vitex agnus castus): Used traditionally for menstrual
and menopausal symptoms; may prove to have benefits for
preventing or treating osteoporosis as well.
O Red clover (Trifolium pratense): Isoflavones extracted from this herb
may slow bone loss in women, but it is not clear whether the whole
herb has similar effects
O Wild yam (Dioscorea villosa): May be beneficial for menopausal
symptoms and osteoporosis but further studies are needed
O Horsetail (Equisetum arvense): Contains substances believed to
strengthen bone
O Kelp (Fucus vesiculosus L.): Used for disorders of the male and female
reproductive systems as well as for musculoskeletal disorders; rich
in minerals so may be an effective complementary treatment for
osteoporosis
O Oat straw (Avena sativa): Boosts hormone levels that stimulate cell
growth.
YOGA THERAPY
Following Yoga asanas helps to makes the bones strong.
O Surya namaskaram – 10 rounds
O Standing poses such as the Pranamasana, and the Natarajasana
O Forward bending yoga asanas like Shashankasana,
O Backward bend poses like Bhujangasana, Shalabhasana,
Dhanurasana, Chakrasana, Matsyasana, Setubandha sarvangasana,
Vipareeta Dandasana, Ustrasana.
NUTRITION THERAPY
A diet that includes an adequate amount of calcium, vitamin D, and protein
should be maintained. While this will not completely stop bone loss, it
will guarantee that a supply of the materials the body uses for bone formation
and maintenance is available.
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The best defense is to build strong bones during childhood and adolescence.
By about age 20, most women have already formed 98 percent of their
skeletal mass. Both men and women reach their peak bone mass in their
mid-30s. After that, the body takes more calcium and minerals from your
bones than it replaces. If your body doesn’t have enough calcium to support
your heart, muscles, and nervous system, it will take even more from your
bones to fill the need. Eating calcium when you are young results in stronger
bones and fewer fractures when older.
Supplemental calcium should be taken as needed to achieve recommended daily
calcium dietary intake. Current recommendations are for non-pregnant,
menstruating women to consume 1000mg/day, pregnant women need 1200mg/
day, and postmenopausal or nursing mothers should consume 1500 mg/day.
High-calcium foods include low-fat milk, yogurt, ice cream and cheese,
tofu, salmon and sardines (with the bones), and leafy green vegetables,
such as spinach and collard greens. Vitamin D aids in calcium absorption
and 400-800 IU per day should be taken by all individuals with increased
risk of calcium deficiency and osteoporosis.
Phytoestrogens are estrogen-like compounds found in certain foods, such
as soybeans and flaxseed. These phytoestrogens act like mild estrogens
within the body, helping to relieve many of the symptoms of menopause.
Phytoestrogens are also highly concentrated in cashews, peanuts, oats, corn,
wheat, apples, and almonds. Phytoestrogens appear to block the effects of
excess estrogen stimulation of the breasts and uterus; many researchers
believe that they have a protective action. Many researchers believe that
Japanese women have a lower incidence of hot flashes and other symptoms
because of their soy-based diets.
PHYSICAL THERAPY
Heat and ice
ice: Heat, in the form of warm showers or hot packs, can relieve
chronic pain or stiff muscles. Cold packs or ice packs provide pain relief by
numbing the pain-sensing nerves in the affected area. Cold also helps reduce
swelling and inflammation. Depending on which feels better, apply heat
or cold for 15 to 20 minutes at a time to the area where you feel the pain.
Warm towels or hot packs in the microwave for a quick source of heat.
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Freeze a plastic, resealable bag filled with water to make a good ice bag.
Exer cise Therapy
ercise
Regular exercise can reduce the likelihood of bone fractures associated with
osteoporosis. Studies show that exercises requiring muscles to pull on bones
cause the bones to retain and, perhaps, even gain density. Researchers found
that women who walk a mile a day have four to seven more years of bone in
reserve than women who don’t.
Weight-bearing exercise, such as walking and lifting weights, as well as
other exercises, including tai chi, can also help stave off the disease. Research
has shown that exercise early in life boosts bone mass, while exercise later
in life helps to maintain bone mass. Exercise also increases strength,
coordination and balance: important tools to help prevent falls that cause
fractures, especially in the elderly.
Some of the recommended exercises include:
O Weight-bearing exercises — walking, jogging, playing tennis,
dancing
O Resistance exercises — free weights, weight machines, rubber
stretch bands
O Balancing exercises — tai chi, yoga.
Any exercise that presents a risk of falling should be avoided!
Please see the appendix in a complete exercise programme comprising
walking, jogging, weight training etc.
Braces and supports
supports: Spinal supports or braces reduce pain and
inflammation by restricting movement, following a vertebral fracture. A
back brace or support will relieve pain and allow you to resume normal
activities while the fracture heals. However, continuous use of a back support
can weaken back muscles. For this reason, exercises to strengthen the muscles
in the back should be started as soon as possible.
Prevention
To help prevent osteoporosis, don’t smoke, and avoid drinking excess
alcohol. Regular exercise can prevent bone fractures. Exercises where muscles
pull on bones cause the bones to retain, and possibly gain, density.
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FIBROMYAL
FIBROMYALGIA
OMYALGIA
Fibromyalgia is a common condition characterized by widespread pain in
joints, muscles, tendons, and other soft tissues. Some other problems
commonly linked to fibromyalgia include fatigue, morning stiffness, sleep
problems, headaches, numbness in hands and feet, depression, and anxiety.
Fibromyalgia can develop on its own, or secondary to other musculoskeletal
conditions, such as rheumatoid arthritis, or systemic lupus.
Diagnosis of fibromyalgia requires history of at least three months of
widespread pain, and pain and tenderness in at least 11 of 18 tender-point
sites. These tender-point sites include fibrous tissue or muscles of the:
O Neck
O Shoulders
O Chest
O Rib cage
O Lower back
O Thighs
O Knees
O Arms (elbows)
O Buttocks.
The overwhelming characteristic of fibromyalgia is long-standing, body-
wide pain with defined tender points. Tender points are distinct from trigger
points seen in other pain syndromes. Unlike tender points, trigger points
can occur in isolation and represent a source of radiating pain, even in the
absence of direct pressure.
Fibromyalgia pain can mimic the pain that occurs with various types of
arthritis. However, the significant swelling, destruction, and deformity of
joints seen in diseases such as rheumatoid arthritis do not occur with
fibromyalgia syndrome alone.
The soft-tissue pain of fibromyalgia is described as deep-aching, radiating,
gnawing, shooting or burning, and ranges from mild to severe. Fibromyalgia
sufferers tend to wake up with body aches and stiffness.
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For some patients, pain improves during the day and increases again during
the evening, though many patients with fibromyalgia have day-long,
unrelenting pain. Pain can increase with activity, cold or damp weather,
anxiety, and stress.

The cause of this disorder is unknown. Physical or emotional trauma may
play a role in development of the syndrome. Some evidence suggests that
fibromyalgia patients have abnormal pain transmission responses.
It has been suggested that sleep disturbances, which are common in
fibromyalgia patients, may actually cause the condition. Another theory
suggests that the disorder may be associated with changes in skeletal muscle
metabolism, possibly caused by decreased blood flow, which could cause
chronic fatigue and weakness.
Others have suggested that an infectious microbe, such as a virus, triggers
the illness. At this point, no such virus or microbe has been identified.
Pilot studies have shown a possible inherited tendency toward the disease,
though evidence is very preliminary.
The disorder has an increased frequency among women 20 to 50 years old.
The prevalence of the disease has been estimated between 0.7% and 13%
for women and between 0.2% and 3.9% for men.
Symptoms
O Multiple tender areas (muscle and joint pain) on the back of the
neck, shoulders, sternum, lower back, hips, shins, elbows, knees
O Fatigue
O Sleep disturbances
O Body aches
O Reduced exercise tolerance
O Chronic facial muscle pain or aching
O Skin sensitivity
O Psychological disturbances
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O Pain after exertion

O Sleep disorders.
Signs and tests

A number of tests may be done to rule out other disorders. An examination
reveals multiple tender areas on the back of the neck, shoulders, sternum,
lower back, hips, shins, elbows, or knees.
Sometimes, laboratory and x-ray tests are done to help confirm the
diagnosis. The tests will also rule out other conditions that may have similar
symptoms.
Treatment
In mild cases, symptoms may go away when stress is decreased or lifestyle
changes are implemented. A combination of treatments including
medications, patient education, physical therapy, and counseling are usually
recommended. Many fibromyalgia sufferers have found support groups
helpful.
MODERN MEDICINE
The following drugs may be prescribed.
O Sleep disturbances are often treated successfully with low doses of
tricyclic antidepressants. Benzodiazepines may also be used
O Psychological disturbances can be treated with tricyclic
antidepressants and sedative-hypnotics.
Pain in the bones and muscles can be treated with lidocaine or procaine
(injected into points where pain is greatest) or with capsaicin (used
topically). Ibuprofen may also help briefly reduce muscle pain.
AYURVEDA
Ayurveda provides long lasting relief for pain in fibromyalgia. Panchakarma
procedures like massage, Sarvanga Dhara, Pizhichil, Navara khizhi, Swedana
(sweating) treatments help in treating fibromyalgia. An herbal concoction
may be added to the steam to further enhancement of effect. Daily herbal
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oil massage also provides a deeply soothing and balancing effect to the
entire nervous system.
Medicines like Dasamoolarishtam, Triphala guggul, Maharasnadi Kwath,
Vata Vidhwans Rasa, Ashwagandha rasayana helps in treating fibromyalgia.
HOMEOPATHY
Homeopathy can often provide relief from the unpredictable, sometimes
debilitating, aches and pains of fibromyalgia.
Arnica: This remedy is indicated when any body area feels bruised and
sore, after exertion, overuse of muscles, or injury. Sometimes Arnica is
enough to soothe a chronic condition; often, other remedies follow Arnica.
Bryonia: A person who needs this remedy tries to stay as still as possible,
since even the slightest motion aggravates the pain. People who need this
remedy often feel extremely irritable and grumpy, not wanting to be
touched or interfered with. Warmth often makes things worse and cool
applications may be soothing. Pressure on the painful parts (or lying on
them) often helps, because it minimizes movement.
Calcar ea carbonica: Muscle soreness and weakness that are worse from
Calcarea
exertion, and worse from getting cold and damp, may be relieved by this
remedy. The person often is chilly with clammy hands and feet, easily
fatigued, and has a tendency to feel overwhelmed and anxious.
Causticum: Soreness, weakness, and stiffness in the muscles: worse from
being cold and worse from overuse: suggests a need for this remedy. The
forearms often feel stiff, unsteady, and very weak. The muscles of the legs
can feel contracted and sore, and the person may have restless legs at night.
Problems tend to be worse when the weather is dry and better in rainy
weather (although getting wet aggravates the pain and stiffness). Warm
applications and warming up in bed often relieve discomfort.
Cimicifuga (also called A ctae racemosa): People who need this remedy are
Actae
often energetic and talkative, becoming depressed or fearful when physical
problems trouble them. Soreness and stiffness of muscles may be
accompanied by shooting pains and are usually aggravated by getting cold.
The neck and spinal muscles can be very tight, and the person may have
headaches and other problems during menstrual periods.
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Kalmia latifolia: Severe pain in the muscles, extending from higher areas
to lower ones, often responds to this remedy. Shooting pains may occur,
along with stiffness, neuralgia, and numbness or a cold sensation. Pains
can come on suddenly, and often shift around, being worse from motion
and worse at night.
Ranunculus bulbosus: This remedy is often helpful with fibrositis and
muscle stiffness, especially when the neck and back muscles are involved.
Stabbing pains and soreness may be felt near the spine and shoulder-blades,
especially on the left. Problems may be aggravated by cold damp weather,
walking, and alcoholic beverages.
Rhus toxicodendron: If a person feels very restless, with stiffness and soreness
that find relief in warmth and motion, this remedy should be considered.
Problems are aggravated in cold, damp weather. Stiffness and pain are worse
on waking in the morning, and after periods of rest.
Ruta grav eolens: Tremendous stiffness of the muscles, with lameness, pain,
graveolens:
and weakness (especially after overuse) may be soothed with this remedy.
The legs and hips are sore and weak, and the person may find it difficult to
stand after sitting in a chair. Muscles in the back and neck feel bruised, the
tendons may be sore, and the wrists and hands feel painful and contracted.
ACUPUNCTURE
There are a few well-designed studies showing that acupuncture can help
improve fibromyalgia symptoms and the National Institutes of Health
recommend acupuncture as a treatment for this condition. In the case of
fibromyalgia, a Qi deficiency is usually detected in the spleen and/or kidney
meridians. Acupuncture needles are inserted for 15 minutes and
moxibustion is used to warm the needles for 10 minutes. Following
Acupoints are useful:
O GV 14, UB 23
O GV 4, UB 20
O CV 6, SP 10
O UB 13, UB 17
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NATUROPATHY
Naturopathy advises regular exercise and healthy diet for treating
fibromyalgia. The following herbs may help increase resistance to stress
and strengthen the immune system: Siberian ginseng (Eleutherococcus
senticosus), schizandra berry (Schizandra chinensis), ashwaganda root
(Withania somnifera), gotu kola (Centella asiatica), and astragalus root
(Astragalus membranaceus).
Herbs that alleviate pain and nervous tension include the following: Black
cohosh (Cimicifuga racemosa), kava kava (Piper methysticum), skullcap
(Scutellaria lateriflora), passionflower (Passiflora incarnata), lavender
(Lavandula angustifolia), and valerian (Valeriana officinalis). Combine equal
parts and take as a tincture 20 to 30 drops two to three times per day.
YOGA THERAPY
Yoga exercise, breathing and relaxation/meditation techniques help in
treating fibromyalgia. Yoga exercises stretch and relax the major muscle
groups and help release tension and fatigue. In addition to strengthening
and limbering the muscles, Yoga exercises leave one revitalized.
Yoga breathing exercises counteract fatigue and lethargy and help to reduce
harmful stress reactions. Deep, rhythmic breathing helps to lift depression
and reduces anxiety and inertia. Following yoga practices are advised:
O Asanas:
Matsyasana, Setubandha sarvangasana, Setubandha
sarvangasana on pillows, Vipareeta Dandasana, Viparita
dandasana on the chair, Ustrasana
Konasana
Bhramari
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NUTRITION THERAPY
Eating a well-balanced diet and avoiding caffeine may help with problems
of sleeping, and may help reduce the severity of the symptoms. Eat whole
foods such as vegetables, whole grains, fruits, protein, and essential fatty
acids (cold-water fish, nuts, and seeds). Decrease carbohydrate intake;
increase protein; fats in moderation.
Eliminate all food allergens from the diet. Common allergenic foods are
dairy, soy, citrus, peanuts, wheat, fish, eggs, corn, and tomatoes. Try an
elimination trial: Remove suspected allergens from the diet for two weeks.
Reintroduce one food every three days. Watch for reactions such as
gastrointestinal upset, mood changes, flushing, fatigue, and worsening of
symptoms. A rotation diet, in which the same food is not eaten more than
once every four days, may reduce sensitivities.
Eliminate inflammatory foods such as refined foods, sugar, saturated fats
(meat and dairy products), alcohol, and caffeine.

O Vitamin C (250 to 500 mg twice per day) reduces swelling and
helps your immune system function better
O Coenzyme Q10 (50 to 100 mg one to two times per day) improves
oxygen delivery to tissues and has antioxidant activity
O Chromium Picolinate (200 mcg with meals) may reduce reactive
hypoglycemia which may make your symptoms worse
O Magnesium (200 mg two to three times per day) with malic acid
(1,200 mg one to two times per day) relieves pain and fatigue
O 5-Hydroxytryptophan (100 mg three times per day) may help
with depression and insomnia
O B vitamins help reduce the effects of stress: B-complex (50 to 100
mg per day), niacinamide (100 mg per day), and B6 (100 mg per
day)
O Zinc (30 mg per day) is essential for proper immune function
O Phosphatidyl choline and phosphatidyl serine (300 mg per day)
may help depression and improve memory.
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PHYSICAL THERAPY
Massage, TENS, Ultrasound, Cold laser, hot packs, Short wave diathermy,
Interferential therapy for deep muscles, Faradic stimulation, Careful
stretching and low-impact exercise, stress reduction, and improved sleep
patterns may offer relief.
Trigger points can be deactivated by direct pressure massage, Acupuncture,
Acupressure, Ice applications (Cryotherapy), Electrotherapy, by anaesthetic
injections or surgery.
MASSAGE THERAPY
The simple method to deactivate the trigger points is by deep pressure.
Press each muscle with the thumb at one-inch intervals. When you find a
tender spot, check whether it is a trigger point.
Apply deep pressure with the thumb on the trigger points for 10 seconds
and then don’t apply pressure for a further 5 seconds. Increase the pressure
according to the tolerance of the patient. Now repeat the same up to eight
full cycles of on and off pressure. After this, both the trigger and target are
has to be heated by superficial or deep heat. Warming up the soft tissues
relaxes them and they lengthen more easily. Then the involved muscle has
to be stretched to achieve a normal resting length.
Stretching of the involved muscle is necessary to ensure complete removal
of the trigger. Before stretching, heat application, massage, biofeedback or
joint traction or joint oscillation can be done to relax the muscles. Stretching
can be done by manual passive stretching and active inhibition.
Exercise
A daily, gentle, low-impact aerobic exercise program along with joint
mobility and muscles strengthening is of central importance in the
treatment of fibromyalgia. This is because deconditioned muscles are more
prone to microtrauma and can lead to further dysfunctional behavioural
problems.
A common misconception is that exercises increases pain and that rest is
better for fibromyalgia sufferers. But the opposite is true. Too much rest
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will lead to deconditioning that can lead to further problems that may
worsen the pain.
The best way to begin a fitness program is to start with mild exercises, like
walking and swimming.
PSYCHOTHERAPY
Fibromyalgia is found to affect mostly young women who lead busy, driven,
tense and particularly stressful lives. It is found in men who are very prone
to physical stress and occupational strain. Muscle pain and fatigue may
reflect emotional and physical stress.
Stress, anxiety, and fatigue can make fibromyalgia worse. The pain and
fatigue of fibromyalgia often cause stress and anxiety, which in turn can
increase the pain and fatigue, thus creating a vicious cycle.
Counseling and cognitive therapy helps to encourage self-empowerment
and self-care in fibromyalgia patients. Reducing stress and improving coping
skills may also help reduce painful symptoms.
The counseling helps in improving patient’s coping skills, improve pacing,
and avoid relapses. Many of the patients of fibromyalgia are perfectionists
and high achievers who experience frustration with the limitations of
fibromyalgia. Cognitive therapy helps them to reevaluate their standards
and values and, thereby, change their behaviors from those that continually
result in relapses to those that support recovery.
Negative perceptions and pessimism also seem to be symptoms of
fibromyalgia. Perhaps this is related to a mild neurotransmitter imbalance.
Research suggests that cognitive therapy can help patients overcome
negativity and pessimism and can thus be effective in the management of
fibromyalgia
Psychotherapy methods like relaxation, biofeedback, meditation, behaviour
therapy helps to reduce stress and relive from the symptoms of fibromyalgia.
Prevention
There is no proven prevention for this disorder. However, over the years,
the treatment and management of the disease has improved.
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SPRAINS AND STRAINS
Sprains and strains often result from sports or exercise, but can easily result
from any physical activity. Sprains result from an injury to a ligament (the
connective tissue that links bones together at joints), most often in the
ankle, knee, elbow, or wrist. Strains are tears in muscle tissue, commonly
occurring in the muscles that support the neck, thigh, groin, and ankle.
Causes
Sprains generally result from a twisting force applied to a joint while it is
bearing weight, which causes the ligament to stretch beyond its natural
limit. Muscle strains occur when the weight load on a muscle is greater
than what the weakest part of the muscle can bear. Strains usually occur
during activities that require a muscle to be stretched and bear weight at
the same time. Patients are at risk for a sprain or strain if they do the
following.
O Exercise without warming up properly
O Use athletic equipment that does not fit properly
O Participate in sports and activities that they are not conditioned for.
Signs and Symptoms

Sprains and strains cause:
O Joint pain or muscle pain
O Swelling
O Joint stiffness
O Discoloration of the skin, especially bruising.
Joint instability or disability can occur if the injury is serious, involving a
muscle or ligament tear.
Treatment
The best treatment for injury is RICE: Rest, Ice, Compression, and Elevation
of the affected area. Apply RICE as needed over the first several days
following the injury.
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Rest the affected joint for several days. Keep pressure off the injured area
until the pain subsides (usually 7 to 10 days for mild sprains and 3 to 5
weeks for severe sprains). Patient may require crutches when walking.
Apply ice immediately to help reduce swelling. Wrap the ice in cloth —
DO NOT place ice directly on the skin. Ice reduces pain, bleeding, and
inflammation. It may also reduce secondary damage to other parts of the
joint.
Try NOT to move the affected area. Wrap the affected area in elastic bandage
firmly, but not tightly. Cast may be required to stabilize injuries. Use a
splint if necessary. Keep the swollen joint elevated above the level of the
heart, even while sleeping.
MODERN MEDICINE
Over-the-counter pain relievers (analgesics) and anti-inflammatory agents
usually help; however, when injuries are more severe or chronic, however,
continued use of analgesics may lead to aggravation of the condition.
Analgesics should not be used to mask pain so that activity can be resumed
without proper immobilization.
O Aspirin: 325 mg, 1 to 2 tablets every four hours
O Naproxin: 210 mg, 2 to 3 tablets every 8 to 12 hours
O Ibuprofen: 200 mg, 2 to 3 tablets every 4 to 6 hours
O Analgesic balms spread over the affected area
O Acetaminophen: 325 mg, 1 to 2 tablets every 4 hours.
AYURVEDA
In Ayurveda turmeric poultice is applied to reduce pain and swelling. After
3 days of injury mild massage with oils like Narayana oil, Dhanwantharam
oil is done. Guggul preparations can be given to reduce the inflammation.
ACUPUNCTURE
Acupuncture appears to be effective for sprains and strains. One study of
20 people found that acupuncture improved feelings of soreness.
Acupuncturists often apply moxibustion (a technique in which the herb
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mugwort is burned over specific acupuncture points) in combination with

needling in order to strengthen or deepen the treatment for this condition.
Acupuncture is applied on the Ah-Shi points or on local points of injury.
Analgesic points like Hegu (LI.4) are also stimulated.
HOMEOPATHY
Arnica (topical): This remedy is generally considered the first choice
homeopathic treatment for acute injury; it is applied topically in addition
to an appropriate internal remedy; it should not to be used, however, if
skin the has open cuts over the injured area
Arnica (internal) for injuries with swelling, bruising, and inflammation;
individuals should switch to another appropriate remedy once swelling
has subsided
Bryonia for swollen injuries that are worsened with movement; this remedy
is especially useful for chest, shoulder, and hamstring injuries; often used
if Arnica or Rhus toxicodendron fails
Ledum is given for sprained ankles that feel cold or numb but improve
with cold applications (such as ice) but worsen with warm applications.
Rhus to xicodendr
toxicodendr on: This remedy is used after the initial symptoms of an
xicodendron:
injury have improved (such as from using Arnica); for pain during initial
movement that subsides with more movement; affected area generally feels
hot; this remedy is especially appropriate for lifting or overexertion injuries.
Ruta for tendonitis, torn ligaments and other injuries that feel hot to the
touch; especially useful as a treatment for overexertion such as with tennis
elbow and runner’s knee; symptoms tend to be worse with initial movement,
but continued motion does not bring relief.
NATUROPATHY
Flavonoids are found in dark berries and some plants. They help reduce
swelling and strengthen the tissues that are affected by sprains and strains.
The following may be taken in dried extract form as noted.
O Quercetin: 250 to 500 mg three times a day

O Hawthorn (Crataegus monogyna): 500 mg three times a day
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O Turmeric (Curcuma longa) makes the effect of bromelain stronger.

Take 250 to 500 mg each of turmeric and bromelain, three times
a day between meals.
The following combination of herbs reduces spasm and stimulates
circulation. Black cohosh (Cimicifuga racemosa), cramp bark (Viburnum
opulus), Jamaica dogwood (Piscidia piscipula), feverfew (Tanacetum
parthenium), poke root (Phytolacca americana), and valerian (Valeriana
officinalis). Combine equal parts in a tea (1 cup three to four times per
day), or tincture (15 drops every 15 minutes until you feel better, up to
eight doses; or 20 to 30 drops four times per day).
NUTRITION THERAPY

O Vitamin C (250 to 500 mg two times a day) to reduce swelling
and support connective tissue
O Bromelain (250 to 500 mg three times a day between meals)
helps reduce swelling
O Beta-carotene (50,000 IU per day) is needed to make collagen
O Zinc (15 to 30 mg per day) helps you heal faster
O Vitamin E (400 IU/day) has antioxidant effects
O Adequate protein intake is important.
PHYSICAL THERAPY
In acute sprains and strains, RICE is the best treatment. To reduce the
swelling and pain, apply ice pack for first 48 hours. After 48 hours, apply
a warm pack.
consecutive days.
Therapeutic massage is effective at increasing circulation and may relieve

spasm in surrounding muscle groups.
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Other therapies like joint manipulation, the use of ultrasound or electrical

muscle stimulation are used to treat sprains and strains. Stretching and
strengthening exercises are also often recommended to aid recovery and
rehabilitation.
Joint manipulation is as effective as the anti-inflammatory medication in

improving pain and flexibility, but it is more effective than the medication
in improving range of motion.
Prevention
O Wear protective footwear for activities that place stress on the ankle
and other joints
O Make sure that shoes fit the feet properly
O Avoid high-heeled shoes
O Always warm-up and stretch prior to exercise and sports
O Avoid sports and activities which not conditioned to.
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6
ENDOCRINE DISEASES
Diabetes
Hypothyroidism
Hyperthyroidism
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DIABETES MELLITUS
Diabetes mellitus is a life-long disease marked by high levels of sugar in the

blood. It can be caused by too little insulin (a hormone produced by the
pancreas to regulate blood sugar), resistance to insulin, or both.

To understand diabetes, it is important to first understand the normal
process of food metabolism. Several things happen when food is digested:
O Carbohydrates are broken down into sugars and a sugar called glucose
enters the bloodstream. Glucose is a source of fuel for the body
O An organ called the pancreas makes insulin. The role of insulin is
to move glucose from the bloodstream into muscle, fat, and liver
cells, where it can be used as fuel.
People with diabetes have high blood glucose. This is because their pancreas
does not make enough insulin or their muscle, fat, and liver cells do not
respond to insulin normally, or both.
There are three major types of diabetes:
Type 1 D iabetes is usually diagnosed in childhood. The body makes little
Diabetes
or no insulin, and daily injections of insulin are required to sustain life.
Without proper daily management, medical emergencies can arise.
Type 2 D iabetes is far more common than type 1 and makes up 90% or
Diabetes
more of all cases of diabetes. It usually occurs in adulthood. Here, the
pancreas does not make enough insulin to keep blood glucose levels normal,
often because the body does not respond well to the insulin. Many people
with type 2 diabetes do not know they have it, although it is a serious
condition. Type 2 diabetes is becoming more common due to the growing
number of older people, increasing obesity, and failure to exercise.
Gestational diabetes is high blood glucose that develops at any time during
pregnancy in a person who does not have diabetes.
There are many risk factors for diabetes, including:
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Endocrine Diseases
Type 1
O Family history of type 1 diabetes
O Mother who had preeclampsia (a condition characterized by a sharp
increase in blood pressure during the third trimester of pregnancy)
O Family history of autoimmune diseases, including Hashimoto’s
thyroiditis, Graves’ disease, Myasthenia gravis, Addison’s disease,
or Pernicious anemia
O Viral infections during infancy including mumps, rubella, and
coxsackie
O Child of an older mother
O Consumption of cow’s milk during infancy.
Type 2
O Family history of type 2 diabetes
O Age older than 40 years
O Excess body fat, particularly around the waist
O Sedentary lifestyle and high-fat, high-calorie diet
O Abnormal levels of cholesterol and/or triglycerides in the blood
O History of gestational diabetes or polycystic ovary syndrome (a
hormonal disorder that causes women to have irregular or no
menstruation).
All adults should be screened for diabetes at least every three years. A person
at high risk should be screened more often.
Symptoms
High blood levels of glucose can cause several problems, including frequent
urination, excessive thirst, hunger, fatigue, weight loss, and blurry vision.
However, because type 2 diabetes develops slowly, some people with high
blood sugar experience no symptoms at all.
Symptoms of type 1 diabetes:
O Increased thirst
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O Increased urination
O Weight loss in spite of increased appetite
O Fatigue
O Nausea
O Vomiting.
Symptoms of type 2 diabetes:
O Increased thirst
O Increased urination
O Increased appetite
O Fatigue
O Blurred vision
O Slow-healing infections
O Impotence in men.
Signs and tests

A urine analysis may be used to look for glucose and ketones from the
breakdown of fat. However, a urine test alone does not diagnose diabetes.
The following blood glucose tests are used to diagnose diabetes:
O Fasting blood glucose level — diabetes is diagnosed if higher than
110 mg/dL on two occasions
O Random (non-fasting) blood glucose level — diabetes is suspected
if higher than 200 mg/dL and accompanied by the classic symptoms
of increased thirst, urination, and fatigue. (This test must be
confirmed with a fasting blood glucose test)
O Oral glucose tolerance test — diabetes is diagnosed if glucose level
is higher than 200 mg/dL after 2 hours (This test is used more for
type 2 diabetes).
Patients with type 1 diabetes usually develop symptoms over a short period
of time, and the condition is often diagnosed in an emergency setting. In
addition to having high glucose levels, acutely ill type 1 diabetics have
high levels of ketones.
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Endocrine Diseases
Ketones are produced by the breakdown of fat and muscle, and they are
toxic at high levels. Ketones in the blood cause a condition called “acidosis”
(low blood pH). Urine testing detects both glucose and ketones in the
urine. Blood glucose levels are also high.
Treatment
There is no cure for diabetes. The goal of diabetes treatment is to achieve
and maintain blood glucose levels within or near the normal range. The
long-term goals of treatment are to prolong life, relieve symptoms, and
prevent long-term complications such as heart disease and kidney failure.
A recent major study, called the Diabetes Control and Complications Trial
(DCCT), found that diabetics who kept their blood glucose levels close to
normal reduced their risk of developing major complications from the
condition. Maintaining blood glucose levels is often very difficult, however.
People with diabetes must learn how to manage their condition on a daily
basis to prevent blood glucose levels from dropping too low (hypoglycemia)
or spiking too high (hyperglycemia). Treatment for type 1 diabetes requires
a strict regimen that typically includes a carefully calculated diet, planned
exercise, daily blood glucose testing at home (even several times per day),
and, most importantly, multiple daily insulin injections. Similarly, healthy
eating habits, physical activity, and daily blood glucose testing are the basic
tools that people with type 2 diabetes need to manage their condition.
Some people with type 2 diabetes (30% to 40%) also require insulin
injections.
MODERN MEDICINE
Medications for diabetes must always be used in conjunction with lifestyle

changes, particularly diet and exercise, to improve the symptoms of diabetes.
Gestational diabetes is treated with diet and insulin.
Insulin
All individuals with type 1 diabetes must use insulin to control their blood
glucose levels, and roughly, 40% of those with type 2 diabetes require
insulin. Insulin is injected into the fat under the skin where it is absorbed
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directly by the blood. As an alternative to injections, an insulin pump

(worn outside the body) can deliver insulin through a catheter in the tissue
below the skin of the abdomen. The pump eliminates the need for injections
and offers better control of blood sugar. Inhaled insulin is currently under
investigation.
There are many types of insulin, and they can be categorized according to
how quickly they work to lower blood sugar and how long they stay in the
bloodstream.
Common types of insulin include:
O Short-acting (regular) insulin—begins working within 30 minutes
after injection, works the hardest 2 to 4 hours later, and stays in
the blood for about 4 to 12 hours
O Rapid-acting insulin—begins working within 15 minutes after
injection, peaks 30 to 90 minutes later, and stays in the blood for
as long as 5 hours
O Long-acting (NPH) insulin—begins working within 1 to 3 hours
after injection, works the hardest 6 to 12 hours later, and stays in
the blood for 18 to 26 hours
Some insulin medications include a mixture of one or more types of insulin.
For example, it is possible to purchase regular and NPH insulins mixed
together in one bottle.
Other medications used to treat diabetes include:

Sulfonylureas (including glipizide, glyburide, and glimepiride)—also called
oral hypoglycemic agents, lower blood sugar by prompting the pancreas to
secrete insulin. These are most effective in individuals who still have some
working beta cells in the pancreas. Side effects may include nausea,
heartburn, and a feeling of fullness.
Meglitinides (including repaglinide and nateglinide)—are taken with meals
and reduce the elevation in blood sugar that generally follows eating. If
these drugs are not taken with food, blood sugar will drop dramatically
and inappropriately.
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Biguanides (including metformin)—lower blood sugar by improving the

response to insulin by cells in the body (this diminishes insulin resistance).
Side effects may include weight loss, nausea, abdominal discomfort, and
diarrhea.
Thiazolidinedione (including rosiglitazone and pioglitazone)—improves
uptake of glucose by cells in the body; usually used with insulin; side
effects include weight gain, anemia, edema (swelling), and liver damage.
Alpha-glucosidase inhibitors (including acarbose and miglitol)—
medications in this class lower the amount of sugar absorbed from the
intestines, thereby reducing the rise in blood glucose that occurs after a
meal. Side effects can include flatulence and interference with the body’s
absorption of iron.
AYURVEDA
A standard Ayurvedic preparation, Vasantkusumakara Rasa is particularly
prescribed for diabetes. Two grains of the preparation are mixed with half a
teaspoon of cream and one fourth teaspoon of sugar and given twice daily
on an empty stomach.
Decoction of chebulic myrobalan, nut grass and lodh bark (Lodhra) should
be taken in the dose of 15 ml. twice daily.
Decoction of red sandalwood, Arjuna tree bark, deodara bark and costus
root (Kushtha) can be taken in the dose of 15 ml twice.
Fresh juice of Tinospora cordifolia along with honey is advised in the dose of
30 ml twice.
Powder of three myrobalans, powder of purified asphalt (shilajit) and purified
iron calx should be taken in the dose of 1 gm twice daily.
Cold infusion of turmeric, three myrobalans and tree turmeric (Daruharidra)
should be taken in the dose of 30 ml daily along with honey.
Purified (Vanga bhasma) should be taken in the calx of tin dose of 250 mg
twice along with Tinospora cordifolia powder and honey or with powder of
fruits of puncture vine, sugar and milk.
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Pure asphalt (Shilajit) powder should be taken along with milk and sugar
in the dose of 250 mg daily.
Purified iron pyrites (Swarna makshik) calx should be taken with extract of
Tinospora cordifolia and honey.
Other remedies are:
O Chandraprabha Vati - 500 mg: The medicine should be mixed with
juice of bitter gourd or stone of rose apple and given thrice daily
O Shilajit - 240 mg and Nyagrodadhi Churna - 3 gm: These should be
given twice daily after meals
O Vasantkusumakara Rasa - 120 mg and pure Shilajit - 240 mg twice
daily
O Nag Bhasma - 120 mg, Haldi - 500 mg, Amalaki Churna - 500 mg
twice daily with honey
O The extract of Tinospora cordifolia, Guduchi extract is a very beneficial
remedy in diabetes; 20 grains of the extract mixed with 45 grains
of cow’s fresh ghee is given twice a day on an empty stomach.
Herbs such as Bael, Bitter gourd, Gurmar (Gymnema sylvestre) are used to
treat diabetes. Sushruta described Gurmar as a destroyer of diabetes mellitus
and other urinary disorders. Gurmar leaves, when chewed, block the taste
of sweetness.
ACUPUNCTURE
Some researchers speculate that acupuncture may trigger the release of

natural painkillers and reduce the debilitating symptoms of a complication
of diabetes known as neuropathy.
O Baihui (Du 20), Dazhui (Du 14)
O Jiaosun (S.J. 20)
O Neck-Futu (L.I. 18), Quchi (L.I. 11)
O Jianjing (G.B. 21)
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O Zusanli (St. 36)

O Zhangmen (Liv. 13), Taichong (Liv. 3).
A press needle at the pancreas point of the (left) ear is helpful.
HOMEOPATHY
Phosphorus to stabilize blood sugar and energy levels.
Codeinum
Codeinum: 3X four to six times daily for depression and skin irritation.
Syzygium
yzygium: 1X every eight hours as a general remedy.
Other remedies are:

Argenticum metallicum
metallicum, a remedy for emaciation and great weakness; pale
and sallow face and swollen feet.
Arsenicum album for dry, brittle scaly skin, dry mouth, unquenchable thirst,
no appetite, constipation. Often this patient “wastes away” and becomes
very dry and thin.
Carbo vegetabilis dryness of mouth in the early morning, pain in liver as if
bruised; sudden weakness and fainting, physical depression and lassitude.
Chionanthus Virginica for a pre-diabetic state in the patient with liver
disease; great thirst, dark, sugary urine; insulin resistant.
Moschus for diabetes which presents with impotency.
Natrum muriaticum for dry skin, itching all over body; restless; yawning
and acting dejected; needs to pass urine every hour.
Nux vomica for DM with stupor and vertigo, buzzing in ears, sleeplessness.
Phosphoric acid fits the nervous patient who has milk-colored urine; great
debility and bruised feeling in muscles; symptoms worse with grief, worry,
anxiety; early stage diabetes.
Phosphorus is for restlessness and dry mouth; the patient urinates copiously
- 4-5 pints in 24 hrs.
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Plumbum metallicum for DM with constipation, and protein overflowing

into the urine (which is determined by urinalysis).
Ratanhia for DM with scanty urine.
Uranium nitricum for DM due to defective assimilation; weak digestion,
languor, debility; enormous appetite but the stomach feels full.
NATUROPATHY
Naturopathy advises a high fibre, complex carbohydrate diet, regular exercise

and yoga therapy for the management of diabetes. A low calorie diet is
advised for obese diabetics. Reducing weight in obese Type 2 diabetes
patients can help to stop the medications including insulin.
The following herbs are used for treating diabetes:
O Bitter gourd (Momordica charantia Linn) fruit fresh juice – 50 ml
1 to 3 times per day (before meals)
O Gymnema (Gymnema sylvestre) leaves – 5 grams 3 times per day
O Fenugreek (Trigonella foenum graecum) seeds powder – 15 grams 3
times/day 30 minutes before meals
O Ginkgo biloba extract - 40 mg 3 times per day
O Green tea – 2 cups daily
O Jambul fruit (Syzygium cumini) seeds and fruits
O Take two tender leaves of Neem and Bael (Aegle marmelos) each, on
an empty stomach in the morning.
YOGA THERAPY
Studies done on Yoga have shown that regular practice of yoga can prevent
Type 2 Diabetes in susceptible individuals, and reduce blood sugar in both
Type 1 and 2 diabetes.
O Bandha: Uddiyana bandha, Mula bandha, Jalandhara Bandha
O Asanas:
Baddha Konasana, Halasana
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{ Inverted poses like Sarvangasana, Sirsasana, Sarvangasana with
the help of chair, or wall, Viparita karani

O Pranayamas such as Nadi shuddhi, Surya bheda, Ujjayi, Sheetkari,

Sheetali, Bhastrika, and Bhramari
NUTRITION THERAPY
People with diabetes can improve significantly from lifestyle changes—

particularly diet and exercise. Type 2 diabetics can even eliminate the need
for medications when they make adequate and appropriate lifestyle changes.
Diet
There is no special diet for diabetics except to avoid simple sugars. They
can consume normal diet with few modifications. They should consume a
healthy, low-fat diet, rich in grains and vegetables. A healthy diet typically
includes 10% to 20% of daily calories from protein (including poultry,
fish, dairy, and vegetable sources). Diabetics who also have kidney disease
should limit protein intake to 10% of daily calories. A low-fat diet typically
includes 30% or less of daily calories from fat—less than 10% from saturated
fats and up to 10% from polyunsaturated fats (such as fats from fish).
In addition, weight loss should be part of the plan for those with type 2
diabetes. Moderate weight loss (achieved by reducing calories by 250 to
500 per day and exercising regularly) not only controls blood sugars but
blood pressure and cholesterol as well. Diabetics who eat healthy, well-
balanced diets will not need to take extra vitamins or minerals to treat their
condition.
Foods that can Be taken liberally
O Green leafy vegetables
O All vegetables except for roots and tubers
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O Tomato juice or lime juice without sugar

O Sugarless green or black tea (without milk)
O Vegetable soups (without butter) or skimmed butter milk
O Salads, sprouts.
Foods to Avoid
O Jam, sugar, honey, jaggery, glucose
O Sweets and desserts
O Corn flour, custard powder, jelly etc
O Cakes and pastries
O Ghee, dalda, Vanaspathi, coconut oil, butter
O Organ meats like brain, liver, kidney, etc
O Fruits like banana, mango, grapes, dates, jack fruit etc
O Dry fruits, cooked carrots, sweet potato, tapioca
O Tender coconut, coconut water
O Nuts like cashew nuts, almonds, Pista
O Aerated drinks such as Coco cola, Pepsi, etc
O Horlicks, bournvita, boost etc.
Nutrition Supplements
O Vitamin E - 600 IU/day
O Zinc Picolinate – 25 mg/day
O Chromium - 300 mcg/day
O Fibre (guar, oat bran, pectin) – 30 g/day.
More than one-third of all people with diabetes develop a painful condition
known as diabetic neuropathy (nerve damage). Studies suggest that the
following antioxidant supplements may improve nerve communication in
damaged areas and reduce the symptoms of diabetic neuropathy:
O Alpha-lipoic acid
O Gamma-linolenic acid (evening primrose oil (Oenothera biennis) is
a rich source).
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EXERCISE THERAPY
Exercise plays an important role in controlling diabetes because it lowers
blood sugar and helps insulin to work more efficiently in the body. Exercise
also enhances cardiovascular fitness by improving blood flow and increasing
the heart’s pumping power. It also promotes weight loss and lowers blood
pressure. People with diabetes who exercise are less likely to experience a
heart attack or stroke than diabetics who do not exercise regularly. Exercise
should be done regularly at least three to four sessions per week for 30 to
60 minutes per session. People with type 2 diabetes who exercise regularly
have been shown to lose weight and gain better control over their blood
pressure, thereby reducing their risk for cardiovascular disease (a major
complication of diabetes). Studies have also shown that people with type 1
diabetes who regularly exercise reduce their need for insulin injections.
Choose an enjoyable physical activity that is appropriate for your current
fitness level. Exercise every day, and at the same time of day, if possible.
Monitor blood glucose levels before and after exercise. Carry food that
contains a fast-acting carbohydrate in case you become hypoglycemic during
or after exercise. Carry a diabetes identification card and a mobile phone or
change for a payphone in case of emergency. Drink extra fluids that do not
contain sugar before, during, and after exercise. Changes in exercise intensity
or duration may require changes in diet or medication dose to keep blood
sugar levels from going too high or low.
PSYCHOTHERAPY
Stressful life events can worsen diabetes in several ways. For example, stress
stimulates the nervous and endocrine systems in ways that increase blood
glucose levels and disrupts healthful behaviors (increasing the chances that
an individual may consume a high level of calories and limit his or her
physical activity—a pattern that leads to elevated blood glucose).
Studies have shown that diabetics who participate in biofeedback sessions
are more likely to reach target blood glucose levels than diabetics who do
not receive biofeedback. Biofeedback, tai chi, yoga, and other forms of
relaxation may help motivate people with diabetes to change their habits
in order to manage their condition.
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Foot Car
Caree
People with diabetes are prone to foot problems because of the likelihood
of damage to blood vessels and nerves and a decreased ability to fight
infection. Problems with blood flow and damage to nerves may cause an
injury to the foot to go unnoticed until infection develops. Death of skin
and other tissue can occur.
If left untreated, the affected foot may need to be amputated. Diabetes is
the most common condition leading to amputations.
To prevent injury to the feet, people with diabetes should adopt a daily
routine of checking and caring for the feet as follows:
O Check feet every day, and report sores or changes and signs of
infection
O Wash feet every day with lukewarm water and mild soap, and dry
them thoroughly
O Soften dry skin with lotion or petroleum jelly
O Protect feet with comfortable, well-fitting shoes
O Exercise daily to promote good circulation
O See a podiatrist for foot problems or to have corns or calluses
removed
O Remove shoes and socks during a visit to your health care provider
and remind him or her to examine your feet
O Stop smoking, which hinders blood flow to the feet.
Prevention
Maintaining an ideal body weight and an active lifestyle may prevent the
onset of type 2 diabetes. Currently there is no way to prevent type 1 diabetes.
HYPOTHYR
HYPOTHYROIDISM
THYROIDISM
Hypothyroidism is a condition in which the thyroid gland fails to produce
enough thyroid hormone.
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The thyroid gland, located in the front of the neck just below the larynx,
secretes hormones that control metabolism. These hormones are thyroxine
(T4) and triiodothyronine (T3).
The secretion of T3 and T4 is controlled by the pituitary gland and the
hypothalamus, which is part of the brain. Thyroid disorders may result not
only from defects in the thyroid gland itself, but also from abnormalities of
the pituitary or hypothalamus.
Hypothyroidism, or underactivity of the thyroid gland, may cause a variety
of symptoms and may affect all body functions. The body’s normal rate of
functioning slows, causing mental and physical sluggishness. The symptoms
may vary from mild to severe, with the most severe form called myxedema,
which is a medical emergency.
The most common cause of hypothyroidism is Hashimoto’s thyroiditis, a
disease of the thyroid gland where the body’s immune system attacks the
gland. Failure of the pituitary gland to secrete a hormone to stimulate the
thyroid gland (secondary hypothyroidism) is a less common cause of
hypothyroidism. Other causes include congenital defects, surgical removal
of the thyroid gland, irradiation of the gland, or inflammatory conditions.
Risk factors include age over 50 years, female gender, obesity, thyroid surgery,
and exposure of the neck to X-ray or radiation treatments.
Symptoms
Early symptoms:
O Weakness
O Fatigue
O Cold intolerance
O Constipation
O Weight gain (unintentional)
O Depression
O Joint or muscle pain
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O Thin, brittle fingernails

O Thin and brittle hair
O Paleness.
Late symptoms:
O Slow speech
O Dry flaky skin
O Thickening of the skin
O Puffy face, hands and feet
O Decreased taste and smell
O Thinning of eyebrows
O Hoarseness
O Abnormal menstrual periods.
O Overall swelling
O Muscle spasms (cramps)
O Muscle pain
O Muscle atrophy
O Uncoordinated movement
O Absent menstruation
O Joint stiffness
O Dry hair
O Hair loss
O Facial swelling
O Drowsiness
O Appetite loss
O Short stature
O Separated sutures
O Delayed formation or absence of teeth.
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Signs and tests

A physical examination reveals delayed relaxation of muscles during tests of
reflexes. Pale, yellow skin; loss of the outer edge of the eyebrows; thin and
brittle hair; coarse facial features; brittle nails; firm swelling of the arms
and legs; and mental slowing may be noted. Vital signs may reveal slow
heart rate, low blood pressure, and low temperature.
A chest X-ray may reveal an enlarged heart.
Laboratory tests to determine thyroid function include:
O T4 test (low)
O Serum TSH (high in primary hypothyroidism, low or low-normal
in secondary hypothyroidism).
Additional laboratory abnormalities may include:
O Increased cholesterol levels
O Increased liver enzymes
O Increased serum prolactin
O Low serum sodium
O A complete blood count (CBC) that shows anemia
Treatment
MODERN MEDICINE
The purpose of treatment is to replace the deficient thyroid hormone.

Levothyroxine is the most commonly used medication. The lowest dose
effective in relieving symptoms and normalizing the TSH is used. Life-long
therapy is needed. Medication must be continued even when symptoms
subside. Thyroid hormone levels should be monitored yearly after a stable
dose of medication is determined.
Myxedema coma is a medical emergency that occurs when the body’s level
of thyroid hormones becomes extremely low. It is treated with intravenous
thyroid replacement and steroid therapy. Supportive therapy of oxygen,
assisted ventilation, fluid replacement, and intensive-care nursing may be
indicated.
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AYURVEDA
Kanchanara (Bauhinia veriegata) (purple mountain ebony) is specific for

proper functioning of thyroid. The bark of the tree is given in the form of a
decoction. An ounce of the decoction is given twice daily on an empty
stomach. Among the other herbs Jatamansi and Brahmi guggulu and Shilajit
are also useful. Gokshura, Punarnava are useful herbs
Medicines like Kanchanar Guggulu, Mahayogaraj guggulu with Aswagandharishtam,
Amritadhaya Taila are helpful in hypothyroidism. Other drugs like Varanadi
Kashayam, Kaishora guggulu and Gomutraharitaki are useful.
Panchakarma treatments like Podikizhi, Dhanyamaladhara, Udwarthanam
balances the aggravated kapha doshas.
ACUPUNCTURE
Following Acupoints are used to treat hypothyroidism:

O Baihui (GV20), Fuliu (K 7), Sanyinjiao (Sp 6)
O Navel points: Locate eight points equidistantly around the navel
like points on a compass at a distance of 0.5 Cun from the center
of the navel
O Yintang (point midway between the medial ends of the two
eyebrows).
HOMEOPATHY
Homeopathy offers good prognosis to cases of hypothyroidism. Medicines

like Calcare phos, Calcarea carb, Lapis alb, Iodium, Thyroidinum, Spongia,
Lycopus, Calcarea iod etc. are often found indicated in cases of
hypothyroidism.
NATUROPATHY
Fasting for 3 to 14 days will help to reduce the weight and help in
normalizing the thyroid function. After fasting, eat foods that are high in
iodine like kelp, vegetables, and potatoes. Avoid foods that are antithyroid
like cabbage, brussels sprouts, broccoli, turnips, kale, spinach, peaches and
pears. Take vitamin A and B complex rich foods.
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Following herbs also helps in hypothyroidism.

Combine equal parts of the following herbs or a tea (3 to 4 cups per day) or
tincture (20 to 30 drops three times per day). Horsetail (Equisetum arvense), oat
straw (Avena sativa), alfalfa (Medicago sativa), and gotu kola (Centella asiatica).
Kelp (Alaria esculenta), bladderwrack (Fucus vesiculosis), and Irish moss
(Chondrus crispus) may be taken as foods or in capsule form.
Coleus foreskohlii (1 to 2 ml three times a day) stimulates thyroid function
with an increase in thyroid hormone production. Also, herbs such as guggul
(Commiphora guggul) (25 mg of guggul sterones three times a day) and
Hawthorne (Crataegus oxyacantha) (500 mg twice a day) are taken to
counteract high cholesterol, which often accompanies hypothyroidism.
HYDROTHERAPY
O Hot and cold packs on thyroid area
O Hot immersion bath
O Steam or sauna baths
O Contrast hydrotherapy (hot and cold applications) to the neck and
throat may stimulate thyroid function. Alternate three minutes
hot with one minute cold. Repeat three times for one set. Do two
to three sets per day.
YOGA THERAPY
Yoga reduces hypothyroidism by normalizing the thyroid hormones
secretion. Sarvangasana (shoulder stand) is the most suitable and effective
asana for the thyroid gland. Research studies have shown that Sarvangasana
increases thyroxine hormone secretion.
Following asanas are advised:
O Surya namaskaram – 10 rounds
O Forward bending yoga asanas like Shashankasana,
Paschimottanasana, Baddha Konasana, reduce blood pressure, and
heart rate
O Backward bend poses like Bhujangasana, Shalabhasana,
Dhanurasana, Chakrasana, Matsyasana, Setubandha sarvangasana,
Vipareeta Dandasana, Ustrasana.
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NUTRITION THERAPY
O Avoid foods that suppress thyroid function, including broccoli,
cabbage, Brussels sprouts, cauliflower, kale, spinach, turnips,
soybeans, peanuts, linseed, pine nuts, millet, cassava, and mustard
greens.
O Avoid refined foods, dairy products, wheat, caffeine, and alcohol.
O Essential fatty acids (1,000 to 1,500 mg three times per day) are
necessary for hormone production.
O Vitamin C (1,000 mg three to four times per day), vitamin A
(10,000 to 25,000 IU per day), B complex [50 to 100 mg/day,
augmented with vitamins B2 (riboflavin, 15 mg), B3 (niacin, 25 to
50 mg), and B6 (pyridoxine, 25 to 50 mg)], selenium (200 mcg
per day), iodine (300 mcg per day), vitamin E (400 IU per day),
and zinc (30 mg per day) are necessary for thyroid hormone
production.
O L-tyrosine (500 mg two or three times a day) also supports normal
thyroid function. May make high blood pressure worse.
O Calcium (1,000 mg per day) and magnesium (200 to 600 mg per
day) help many metabolic processes function normally.
PHYSICAL THERAPY
Regular aerobic and strength training exercise helps to increase body’s
metabolism and reduces weight. It also improves other symptoms of
hypothyroidism like lethargy, laziness, dullness etc. Rather than do one
hour exercise once daily it may be more beneficial to exercise for 30 minutes
twice daily. This by and large improves and increases the metabolism. One
could for example walk/jog in the morning and do strength exercises in the
evening.
Prevention
There is no prevention for hypothyroidism; however, screening tests in
newborns can detect congenital hypothyroidism.
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HYPER
HYPERTHYR
ERTHYROIDISM
THYROIDISM
Hyperthyroidism is an imbalance of metabolism caused by overproduction
of thyroid hormone.

The thyroid gland is located in the neck. It produces several hormones
which control the way that every cell in the body uses energy (metabolism).
The thyroid is part of the endocrine system.
Hyperthyroidism or thyrotoxicosis occurs when the thyroid releases too
many of its hormones over a short (acute) or long (chronic) period of time.
Many diseases and conditions can cause this problem, including:
O Graves’ disease
O Non-cancerous growths of the thyroid gland or pituitary gland
O Tumors of the testes or ovaries
O Inflammation (irritation and swelling) of the thyroid due to viral
infections or other causes
O Ingestion of excessive amounts of thyroid hormone
O Ingestion of excessive iodine
O Graves’ disease accounts for 85% of all cases of hyperthyroidism.
Symptoms
O Weight loss
O Increased appetite
O Nervousness
O Restlessness
O Heat intolerance
O Increased sweating
O Fatigue
O Frequent bowel movements
O Menstrual irregularities in women
O Goiter (visibly enlarged thyroid) may be present.
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O Weakness
O Sleeping difficulty
O Clammy skin
O Skin blushing or flushing
O Bounding pulse
O Lack of menstruation
O Itching - overall
O Heartbeat sensations
O Hand tremor
O Hair loss
O Diarrhea
O Breast development in men
O Protruding eyes (exophthalmos).
Signs and tests

Vital signs (temperature, pulse, rate of breathing, blood pressure) show
increased levels. Systolic blood pressure may be elevated. Physical
examination may reveal thyroid enlargement or goiter.
Laboratory tests that evaluate thyroid function:
O Serum TSH is usually decreased
O T3 and free T4 are usually elevated.
Treatment
MODERN MEDICINE
Several treatments for hyperthyroidism exist. The best approach depends

on age, physical condition and the severity of disorder:
Radioactiv
Radioactivee iodine: This is the most common treatment in the United
States. Taken by mouth, radioactive iodine is absorbed by thyroid gland,
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Endocrine Diseases
where it causes the gland to shrink and symptoms to subside, usually within
two to three months. Because this treatment causes thyroid activity to slow
considerably, patient may eventually need to take a medication every day
to replace thyroxine.
Anti-thyr oid medications: These medications gradually reduce symptoms
Anti-thyroid
of hyperthyroidism by preventing thyroid gland from producing excess
amounts of hormones. They include propylthiouracil and methimazole,
carbimazole. Symptoms usually improve in six to eight weeks, but treatment
with anti-thyroid medications typically continues for a year or more. For
some people, this clears up the problem permanently, but other people
may experience a relapse.
Beta blockers: These drugs are commonly used to treat high blood pressure.
They won’t reduce your thyroid levels, but they can reduce a rapid heart
rate and help prevent palpitations.
Surger
urgeryy (thyr oidectomy): Thyroid Surgery is done in patient who can’t
(thyroidectomy):
tolerate anti-thyroid drugs and does not want to have radioactive iodine
therapy, although this is an option in only a few cases.
G rav es
es’’ ophthalmopathy: In Graves’ ophthalmopathy, the following
raves
suggestions may help soothe eyes or skin:
O Apply cool compresses to the eyes. The extra moisture may provide
relief.
O Wear sunglasses. When eyes protrude, they’re more vulnerable to
ultraviolet rays and more sensitive to sunlight. Wearing sunglasses
helps protect them from both sun and wind.
O Use lubricating eyedrops. Eyedrops may help relieve dryness and
scratchiness.
O Elevate the head of the bed. Keeping head higher than the rest of
your body reduces blood flow to the head and may help relieve the
pressure on the eyes.
O Try over-the-counter creams for swollen skin. Over-the-counter
creams containing hydrocortisone or triamcinolone may help relieve
red, swollen skin on your shins and feet.
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Thyrotoxic crisis: Hyperthyroidism also places you at risk of thyrotoxic

crisis — a sudden intensification of your symptoms, leading to a fever, a
rapid pulse and even delirium. Medication like intravenous propanolol,
hydrocortisone are advised.
AYURVEDA
Hyperthyroidism can be compared with hypermetabolism (atyagni). In

this, vata and pitta are aggravated and they can be mitigated by internal
and external oleation, sweating and mild purgation.
Vidaryadi ghritham, nourishing (Brahmana) foods like ghee, milk,

ashwagandha, meat are useful.
ACUPUNCTURE
Following Acupoints are used to treat hypothyroidism:

O Tai yang (Extra 1), Jing ming (B 1), Tong zhi liao (G 1) and Hegu
(LI 4)
O Use filiform needles with purging method. Prick to bleed shao
shang (L 11), tai yang (Extra 1 and shang xing (Du 23).
HOMEOPATHY
Medicines like Calcare phos, Calcarea carb, Lapis alb, Iodium, Thyroidinum,
Spongia, Lycopus, Calcarea iod etc. are often found indicated in cases of
hyperthyroidism.
NATUROPATHY
Take a high carbohydrate and low protein diet. Take cold water baths and
practice meditation daily.
Following herbs help in reducing hyperthyroidism:
O Bugleweed (Lycopus virginica) and lemon balm (Melissa officinalis)
help to normalize the overactive thyroid. Motherwort (Leonurus
cardiaca) may relieve heart palpitations and passionflower (Passiflora
incarnata) reduces anxiety. Combine two parts of bugleweed with
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one part each of lemon balm, motherwort, and passionflower and

take in tincture form, 30 to 60 drops three to four times per day.
O Quercetin (250 to 500 mg three times per day) is an anti-
inflammatory.
O Turmeric (Curcuma longa) makes the effects of bromelain stronger
and should be taken between meals, 500 mg three times per day.
O Milk thistle (Silibum marianum) helps the liver provide proper
binding proteins, 300 to 600 mg three times a day.
O Hawthorn berry (Crataegus laevigata) helps protect the heart. Take
¼ tsp. of the solid extract, or 1,000 mg of the herb, three times a
day.
O Lemon balm inhibits the binding of thyroid-stimulating hormones
(TSH) receptors.
O Immune-suppressing herbs such as Stephania root (Stephania
tetranda) and Indian sarsaprilla (Hemidesmus indicus) help break
the circle of cellular damage.
O Anti-inflammatory herbs such as licorice (Glycyrrhiza glabra) and
Chinese foxglove (Rehmania glutinosa) support the adrenals as well.
Hydrotherapy
Apply icepacks or cold clay packs on neck and throat to reduce the activity
of thyroid gland and inflammation.
Ice cold immersion baths daily twice is advised.
YOGA THERAPY
Yoga reduces hyperthyroidism symptoms by relaxing the sympathetic

nervous system and mind. Pranayamas such as Nadi shuddhi, Ujjayi,
Sheetkari, Sheetali, and Bhramari and Meditation, Yoga nidra are advised.
NUTRITION THERAPY
Foods that depress the thyroid include broccoli, cabbage, brussels sprouts,
cauliflower, kale, spinach, turnips, soy, beans, and mustard greens. Avoid
refined foods, dairy products, wheat, caffeine, and alcohol.
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O Omega-3 fatty acids are anti-inflammatory and help immune
system function properly
O Bromelain (250 to 500 mg three times per day between meals)
reduces swelling
O Vitamin C (250 to 500 mg twice a day) supports immune function
and decreases inflammation
O Calcium (1,000 mg per day) and magnesium (200 to 600 mg per
day) are cofactors for many metabolic processes
O Vitamin E (400 IU twice a day) can help protect the heart
O Coenzyme Q10 (50 mg twice a day) can help protect the heart.
Prevention
evention
There are no general prevention measures to prevent hyperthyroidism.
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7
SKIN DISEASES
Acne
Psoriasis
Eczema
Alopecia
Vitiligo
Corns
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ACNE VULGARIS
VULGARIS
Acne is a skin condition characterized by whiteheads, blackheads, and
inflamed red pimples.

The condition occurs when tiny holes on the surface of the skin, called
pores, become plugged. Each pore is an opening to a canal called a follicle,
which contains a hair and an oil gland. Normally, the oil glands help keep
the skin lubricated and help remove old skin cells. When glands produce
too much oil, the pores can become blocked, accumulating dirt, debris,
and bacteria. The blockage or plug is often called a comedone.
The top of the plug may be white (whitehead) or dark (blackhead). If the
comedone ruptures, the material inside, including oil and bacteria, can
spread to the surrounding area and cause an inflammatory reaction. If the
inflammation is deep in your skin, the pimples may enlarge to form firm,
painful cysts.
Acne commonly appears on the face and shoulders, but may also occur on
the trunk, arms, legs, and buttocks.
Acne is most common in teenagers, but it can happen at an age, even as an
infant. Three out of four teenagers have acne to some extent, probably
caused by hormonal changes that stimulate oil production. It may persist
into a person’s 30’s and 40’s.
Acne tends to run in families and can be triggered by:
O Hormonal changes related to menstrual periods, pregnancy, birth
control pills, or stress
O Greasy or oily cosmetic and hair products
O Certain drugs (such as steroids, testosterone, estrogen, and
phenytoin)
O High levels of humidity and sweating.
Despite the popular belief that chocolate, nuts, and other foods cause acne,
this does not seem to be true.
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Skin Diseases
Symptoms and signs

There are various types of acne lesions:
O Comedones — general term for an enlarged hair follicle plugged
with oil and bacteria. This is the first and smallest type of lesion. It
is often referred to as a microcomedone because it cannot be seen
by the naked eye.
O Open comedones (blackhead) — a plugged follicle that reaches
the surface of the skin. Although dark in appearance, blackheads
do not indicate the presence of dirt.
O Closed comedones (whitehead) — a clogged follicle that stays
beneath the skin. Whiteheads usually appear on the skin as round,
white bumps roughly 1 to 2 mm in diameter.
O Papules — inflamed lesions that appear as small, pink bumps on
the skin.
O Pustules (pimples) — inflamed pus-filled lesions that are red at
the base.
O Cysts and nodules — large, inflamed, pus-filled lesions that are
lodged deep and can drain, causing pain and scarring of the skin.
Treatment
MODERN MEDICINE
Usually the first step is to try over-the-counter acne medications. These

creams and lotions are applied directly to the skin. They may contain
benzoyl peroxide, sulfur, resorcinol, or salicylic acid. They work by killing
bacteria, drying up the oil, and causing your skin to peel.
Prescription medicines include:
O Oral antibiotics (such as minocycline, doxycycline, and tetracycline)
O Topical antibiotics (applied to the skin), such as clindamycin or
erythromycin
O Synthetic vitamin A derivatives, called retinoids, for severe acne.
These include retinoic acid cream or gel and isotretinoin pills
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O Birth control pills can sometimes help clear up acne. (In some
cases, though, they may make it worse)
O Prescription formulas of benzoyl peroxide, sulfur, resorcinol,
salicylic acid.
Treatment may also include chemical skin peeling, removal of scars by
dermabrasion, or removal or drainage of cysts.
For the most severe acne, when antibiotics do not work, oral isotretinoin is
the best treatment. However, it can have very serious side effects. Isotretinoin
can harm a developing fetus, and women taking it must use strict
contraceptive measures so they do not become pregnant.
Sometimes large, inflamed nodules or abscesses are treated by injecting
corticosteroids into them.
Treatment of severe acne scars depends on their shape, depth, and location.
Individual scars of any depth may be cut out and the skin sewn back together.
Wide indented scars can be improved cosmetically in a procedure called subcision,
in which small cuts are made under the skin to release the scar tissue. This
procedure often allows the skin to resume its normal contours. Multiple shallow
scars may be treated with chemical peels or laser resurfacing.
Dermabrasion, a procedure in which the skin surface is rubbed with an
abrasive metal instrument to remove the top layer, also may help remove
small scars. Sometimes scars are injected with various substances such as
collagen, fat, or a variety of synthetic materials. These substances may raise
the scarred area to make it level with the rest of the skin.
AYURVEDA
Ayurveda advises fasting and virechana (Purging) for detoxifying the body.
After that medicines like Shanka Bhasma 500 mg with lemon juice bid or
Sharibadhyarishta – 30 ml with water after meals or Triphala guggulu 1-2
tab tid is given.
O The paste of nutmeg made with milk is an efficacious remedy for
removing pimples
O Systemic measures should be undertaken to relieve constipation
and indigestion
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Skin Diseases
O The paste of cumin seeds applied over the pimples gives relief
O The paste of red sandal wood and turmeric powder made with
milk is very efficacious
O The mixture made of one part of sandalwood oil and two parts of
mustard oil is used for local application
O Paste of thorn of silk cotton tree prepared in milk to be applied on
the acne
O Paste of equal part of Suddha Tankana (borax) and Shukti Bhasma
in honey, can be used for local application
O Paste made up of equal amount of nutmeg, Raktachandan and black
pepper powder is used for local application
O Compound formulations like “Kumkumadi Taila”,
“Mukhadushikahara lepa”, “Mukhadushikahara avachuma” and
Sarivadyarishta, help in the cure of acne vulagaris
O Externally sandalwood or Sukthi bhasma or turmeric is applied to
reduce pimples.
HOMEOPATHY
Antimonium tar taricum: This remedy may be helpful for acne with large
tartaricum:
pustules that are tender to touch, with bluish-red marks that remain on
the skin after active infection has passed.
Calcarea carbonica: If a person with frequent pimples and skin eruptions is
chilly with clammy hands and feet, easily tired by exertion, and flabby or
overweight, this remedy may help improve the skin’s resistance to infection.
Hepar sulphuris calcar eum: This remedy may be indicated when the skin
calcareum:
is easily infected, slow to heal, and painful eruptions like boils appear. The
pimples are very sensitive to touch and slow to come to a head; eventually,
offensive-smelling pus may form.
P ulsatilla: This remedy can be helpful if acne is worse from eating rich or fatty
foods, and aggravated by warmth or heat. It is indicated especially around the
time of puberty, or when acne breaks out near menstrual periods.
Silicea (also called Silica): A person with deep-seated acne along with a general
low immune resistance, swollen lymph nodes, and a tendency toward fatigue
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and nervousness may benefit from this remedy. Infected spots are slow to come
to a head, and also slow to resolve, so may result in scarring.
Sulphur: Itching, sore, inflamed eruptions with reddish or dirty-looking
skin often indicate a need for Sulphur. Itching may be worse from scratching,
and worse from any form of heat—especially bathing or washing.
NATUROPATHY
A short fast with fruit juices or vegetable juices for a few days to a week or
more will speed up the healing. People who can’t fast should take only
fruits and raw vegetables for a few days or at least once a day.
Topical Treatment
Make a paste of Neem leaves (Azadirachta indica), Basil and Menthol and
apply as a pack for half an hour and wash with warm water. This will
reduce the infection, inflammation, and speeds up the healing.
Tea Tree Oil help eliminate propionibacterium acnes (the bacterial strain
associated with acne), thereby potentially reducing inflammation associated
with the skin condition.
If there is no infection, black clay can be applied on lesions, exposed to sun
light and washed after half an hour. Clay removes the dead cells and speeds
up the healing.
Hot steam or hot fomentations help reducing inflammation. Apply hot
compresses to pustules and cysts.
NUTRITION THERAPY
Some people with acne report that certain drinks and foods (particularly
nuts) worsen their symptoms. Studies have yet to confirm a scientific link
between diet and acne, but people with this skin condition should avoid
substances that appear to aggravate their symptoms. In addition as in all
cases, a high fat commercial diet of additives, colouring, sugar and salt
should be avoided. Sufficient Vitamin C in the form of lime in lemon juice
is generally beneficial.
Studies indicate that the mineral zinc may be an effective treatment for
inflammatory acne.
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Skin Diseases
PSYCHOTHERAPY
Emotional stress can worsen acne. Studies have shown that relaxation therapies
such as biofeedback together with cognitive imagery may improve acne symptoms.
Hypnosis also may enhance the effectiveness of treatments for acne.
PHYSICAL THERAPY
O Sunlight is anti-inflammatory and can help briefly. However,
exposure to ultraviolet radiation results in ageing skin and can
eventually lead to skin cancer.
O Cryotherapy (freezing treatment) may be useful to control new
nodules.
O Comedones can be expressed or removed by cautery or diathermy.
O Microdermabrasion can help mild acne.
O Blue light and sometimes red light phototherapy systems are
marketed to treat superficial inflammatory acne and appear helpful
without adverse effects.
O Photodynamic therapy is also being used experimentally for acne
treatment but has some side effects.
Exer cise Therapy

ercise
The majority of acne cases happen during teenage years due to hormonal
changes. This is a period of life in which daily physical activity and exercise
is essential to ease the stress and energy surplus within the body. Daily
vigorous exercise is therefore beneficial at this stage not only to counter
balance hormonal stresses, but also since improved circulations and
perspiration will speed up an enhance removal of toxins through the skin
pores. Research studies have shown that teenages who exercise have a milder
outbreak of acne, than those who do not.
Self-care
Take the following self-care steps to lessen the effects of acne:
O Clean skin gently with a mild, non-drying soap (like Dove,
Neutrogena, or Basics). Remove all dirt or make-up. Wash once or
twice a day, including after exercising. However, avoid excessive or
repeated skin washing.
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O Shampoo hair daily, especially if it’s oily. Comb or pull hair back
to keep the hair out of your face. Avoid tight headbands.
O Try not to squeeze, scratch, pick, or rub the pimples. Although it might
be tempting to do this, it can lead to scarring and skin infections.
O Avoid touching your face with your hands or fingers.
O Avoid greasy cosmetics or creams. Look for water-based or “non-
comedogenic” formulas. Take make-up off at night.
PSORIASIS
Psoriasis is a common skin inflammation (irritation and swelling)
characterized by frequent episodes of redness, itching, and thick, dry, silvery
scales on the skin.

Psoriasis can appear suddenly or gradually. In many cases, psoriasis goes
away and then flares up again repeatedly over time. The disorder may affect
people of any age, but it most commonly begins between ages 15 and 35.
It is not contagious, to either other body parts or other people.
Psoriasis seems to be an inherited disorder, probably related to an
inflammatory response in which the immune system accidentally targets
the body’s own cells. Evidence of the condition is most commonly seen on
the trunk, elbows, knees, scalp, skin folds, or fingernails, but it may affect
any or all parts of the skin.
Normally, it takes about a month for new skin cells to move up from the
lower layers to the surface. In psoriasis, this process takes only a few days,
resulting in a build-up of dead skin cells and formation of thick scales.
Psoriasis may be aggravated by injury or irritation (such as cuts, burns,
rashes, insect bites). It may be severe in immunosuppressed people (like
those with AIDS or undergoing chemotherapy for cancer), or those who
have other autoimmune disorders (such as rheumatoid arthritis).
Medications, viral or bacterial infections, excessive alcohol consumption,
obesity, lack of sunlight, sunburn, stress, general poor health, cold climate,
and frequent friction on the skin are also associated with psoriasis flare-ups.
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Skin Diseases
Symptoms
O Skin patches which are dry or red usually covered with silvery scales
O Raised patches of skin accompanied by red borders which may
crack and become painful, usually located on the elbows, knees,
trunk, scalp, hands or nails
O Skin lesions, including pustules, cracking of skin, skin redness or
inflammation
O Itching
O Small scaling dots on the skin (especially in children)
O Joint pain or aching, which may be associated with a special type
of arthritis (psoriatic arthritis).
O Nail abnormalities
O Genital lesions in males
O Eye burning, itching, and discharge
O Increased tearing.
Signs and tests
The diagnosis is usually based on the appearance of the skin.
O A skin biopsy, or scraping and culture of skin patches, may be
needed to rule out other disorders.
O An x-ray may be used to check for psoriatic arthritis if joint pain is
present and persistent.
Treatment
Treatment is focused on control of the symptoms and prevention of
secondary infections. It varies with the extent and severity of the disorder.
Severe or resistant cases may require intensive treatment.
MODERN MEDICINE
Systemic drugs are taken orally and are used for more severe conditions:
O Methotrexate—an anti-cancer drug that reduces symptoms, but it
has serious side effects.
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O Nonsteroidal anti-inflammatory drugs (such as ibuprofen)—

reduces inflammation and pain especially for psoriatic arthritis;
has various side effects.
O Psoralen—used with UV therapy is the least toxic oral medication.
O Tegison—inhibits rapid cell growth, is more effective with UV
therapy but has numerous side effects.
O Vitamin A given in large doses may help.
Topical creams include the following:
O Corticosteroids—reduce inflammation and irritation; can only be
used for a short period of time at the beginning of treatment.
O Salicylic acid ointments—help the scales to shed.
O Capsaicin ointment—blocks chemicals in the skin that cause
inflammation; painful if used on open wounds.
O Calcitriol ointment—may be as effective as corticosteroids with
fewer side effects.
O Petroleum jelly—softens skin, helps it to retain moisture.
O Coal tar ointments and shampoos—relieves symptoms; helps UV
light therapy to work more effectively; possibly serious side effects.
O Etretinate—for severe cases that do not respond to other treatments
O Synthetic Vitamin A water based topical retinol gel is also effective.
Psoriasis lesions that cover all or most of the body is an emergency that
requires hospitalization. The disorder may be acutely painful. The body
loses vast quantities of fluid and is susceptible to severe secondary infections
that can become systemic, involve internal organs and even progress to
septic shock and death. Treatment includes analgesics, sedation, intravenous
fluids, and antibiotics.
For patients with severe disease, a newer option is treatment with medicines
such as Etanercept that target the cause of psoriasis on a cellular level.
Etanercept is used for the treatment of psoriatic arthritis as well as psoriasis.
Psoriatic arthritis, which occurs in a very small percentage of patients with

psoriasis, may be treated with non-steroidal analgesics in much the same
way as normal arthritis.
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Skin Diseases
AYURVEDA
The patient must be given Pancha Tikta Ghrita guggulu. It should be

administered in a dose of two tea-spoonfuls twice daily with warm milk or
warm water. The ghee will regulate the digestion and bowels and stimulate
the liver. It will also purify the blood. Manjishtadi (Rubia cordifolia) decoction
is found to be very useful and it should be administered in a dose of 1
ounce along with an equal quantity of water. Rasamanikya in a dose of 200
mgs twice daily with honey should be administered with the above decoction.
Other drugs like Vyathiharana Ras, Gandhaka rasayanam, and

Arogyavardhini tablets are also useful in reducing psoriasis.
External Application
The patient’s body must be anointed with Kushtarakshasa oil or Jatyadi Ghrita.
The oil should be applied over the body on the patches. It should be removed by
taking hot water bath. Green gram powder must be used instead of soap.
Panchakarma treatments like Thakra Dhara, Sarvanga Dhara are helpful in

treating psoriasis and arthritis.
ACUPUNCTURE
Following Acupoints are used in treating psoriasis:

O Baihui (Du 20)
O Local Points: Points in the affected area
O Homeostatic points: Quchi (L.I. 11), Zusanli (St. 36), Sanyinjiao
(Sp. 6)
O Specific point for allergy: Xuehal (Sp. 10)
O Related Channel points: Lieque (Lu. 7), Chize (Lu. 5).
Tapping the affected area with the plum blossom needle also gives good results.
In refractory cases, Chize (Lu. 5) should be bled once or twice a week.
HOMEOPATHY
Arsenicum album: People likely to respond to this remedy usually are anxious,
restless, and compulsively neat and orderly. They often feel very cold, experience
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burning pains with many physical complaints, and become exhausted easily.
The skin is dry and scaly and may tend to get infected. Scratching can make the
itching worse, and applying heat brings relief.
Calcar
Calcareaea carbonica: This remedy is suited to people who are easily fatigued
by exertion, sluggish physically, chilly with clammy hands and feet, and
often overweight. Skin problems tend to be worse in winter. Typically solid
and responsible, these people can be overwhelmed by too much work and
stress. Anxiety, claustrophobia, and fear of heights are common.
Graphites: People needing this remedy often have a long-term history of
skin disorders. The skin looks tough or leathery skin with cracks and soreness.
Itching is often worse from getting warm, and the person may scratch the
irritated places till they bleed.
Mer curius solubilis: People who seem introverted and formal—but are very
ercurius
intense internally, with strong emotions and impulses—may benefit from
this remedy. They tend to have swollen lymph nodes and moist or greasy-
looking skin, and are very sensitive to changes in temperature. The areas
affected by psoriasis may become infected easily.
Mezereum: A person who needs this remedy usually is serious, and often
feels strong anxiety in the region of the stomach. Scaly plaques may itch
intensely, thickening or crusting over if the person scratches them too much.
Cold applications relieve the itching (although the person feels generally
chilly and improves with warmth).
Petr oleum: This remedy is often indicated for people whose physical
etroleum:
problems are aggravated by stressful emotional experiences. It is especially
suited to individuals with extremely dry skin, and problems that involve
the palms and fingertips. The person may feel a cold sensation after
scratching, and the skin is easily infected and may look tough and leathery.
Itching will be worse at night, and from getting warm in bed.
Rhus toxicodendron: When this remedy is indicated for a person with
psoriasis, the skin eruptions are red and swollen, and often itch intensely.
Hot applications or baths will soothe the itching—and also muscle stiffness,
toward which these people often have a tendency. The person is restless,
and may pace or constantly move around. A craving for cold milk is often
seen when a person needs this remedy.
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Skin Diseases
Sepia: This remedy may be helpful to a person who feels dragged out and
irritable, often with little enthusiasm for work or family life. The person’s
skin may be look dry and stiff. Psoriasis may appear in many places on the
body, including the nails and genitals. Signs of hormonal imbalance are
often seen (in either sex), and problems with circulation are common.
Exercise often helps this person’s energy and mood.
Staphysagria: This remedy may be helpful to individuals whose psoriasis
has developed after grief or suppressed emotions. Any part of the body can
be involved but the scalp is often affected. People who need this remedy
often seem sentimental, meek and quiet, and easily embarrassed — but
often have a strong internal anger or deeply-buried hurt.
Sulphur: Intensely burning, itching, inflamed eruptions that are worse
from warmth and bathing suggest a need for this remedy. Affected areas
often look bright red and irritated, with scaling skin that gets inflamed
from scratching. This remedy is sometimes helpful to people who have
repeatedly used medications to suppress psoriasis (without success).
NATUROPATHY
Fasting for 1 to 4 weeks with vegetable juices, carrot juice, and tender
coconut water has been shown to markedly improve psoriasis. People who
cannot fast should be kept on raw food diet for 3 to 4 weeks. In this diet,
no cooked foods are allowed. Only fresh raw salads, fruits, fruit juices,
sprouts and vegetable juices are given. This diet removes the acidic toxins
in the body and reduces psoriasis.
Some herbs used for treating psoriasis:
O Milk thistle (Silybum marianum) stops breakdown of substances
that contribute to psoriasis and protects the liver
O Yellow dock (Rumex crispus), red clover (Trifolium pratense), and
burdock (Arctium lappa) are alternatives
O Sarsaparilla (Smilax sarsaparilla) can be effective in psoriasis
O Coleus forskohlii (tincture, 1 ml three times a day) has been
historically used for psoriasis.
Mix equal parts of the above herbs and use 1-cup tea three times per day or
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30 to 60 drops tincture three times per day. This is especially effective if

sipped. Take 5 to 15 minutes before meals to stimulate digestion.
Topical herbal creams may relieve discomfort. Chickweed (Stellaria media) relieves
itching, and marigold (Calendula officinalis) speeds healing of open lesions.
light and washed after half an hour. Clay removes the scales and speeds up
the healing.
Make a paste of raw coconut and Poppy seeds and apply on the skin to
reduce itching. Mix powder of gallnut in coconut oil and apply on lesions
to speed up the healing. Poultice of cabbage can also be applied on lesions.
Mahonia (Mahonia aquifolium) is applied topically and taken internally as
a remedy for psoriasis. The extract of the bark of Mahonia aquifolium is an
inhibitor of keratinocyte growth (abnormal skin cell growth).
Topically applied Aloe Vera extract in a hydrophilic cream is more effective
for treating psoriasis.
Hydrotherapy
O Epsom salt hot immersion baths daily once
O Steam baths with Neem water on alternate days
O Enema or colonic irrigation daily once
O Oatmeal baths may be soothing and may help to loosen scales.
Mix one cup of oatmeal into a tub of warm water.
YOGA THERAPY
Yoga reduces psoriasis by relaxing the mind and reducing the stress.
O Asanas:
{ Suryanamaskara - 10 rounds for general health and flexibility
Konasana
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Skin Diseases

Bhramari
NUTRITION THERAPY
Eliminate alcohol, simple sugars, inflammatory fats (meat, dairy). Avoid

acidic foods (pineapple, oranges, coffee, tomato) and any allergic foods
(wheat, citrus, milk, corn, eggs).

O Essential fatty acids: omega-3 (oily fish, flaxseed oil, 1,000 mg
two times per day)
O Vitamins: B12 (100 to 1,000 mcg) may need to be intramuscular
injections, folate (400 mcg per day), vitamin E (400 to 800 IU
per day)
O Minerals: zinc (30 mg per day), selenium (200 mcg per day)
O Quercetin: 500 mg three times per day before meals
O Digestive enzymes taken with each meal help with proper protein
digestion.
PHYSICAL THERAPY
Other treatments may include moderate exposure to sunlight or

phototherapy. The skin is sensitized by the application of coal tar ointment
or by taking oral psoralens (a medication that causes the skin to become
sensitive to light). The person is then exposed to ultraviolet light. Avoid
sunburn, which can worsen the condition.
PSYCHOTHERAPY
Psychosocial factors are important in the onset and/or exacerbation of

psoriasis in 40%-80% of cases. Yet psoriasis has received little attention in
the recent psychiatric literature. A subgroup of psoriatics appear to be “stress
reactors” and these patients may have a better long-term prognosis.
Identification of such patients early in the course of treatment and
incorporation of specific psychosocial interventions in their overall treatment
regimen may improve the course of illness. Psoriasis has also been associated
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with suicide and an increased prevalence of alcoholism. The disturbances

in body image perception and the effect of psoriasis on interpersonal, social,
and occupational functioning can further contribute to the overall morbidity,
especially if psoriasis first occurs during a developmentally critical period
like adolescence.
Psoriasis is a stress-related skin disorder, and it is therefore surprising that
stress management and relaxation techniques are not generally utilised in
conventional treatment which largely focuses on topical applications.
Psychologic treatments like stress management, guided imagery, and
relaxation have a beneficial effect on psoriasis.
Though emotions do not appear to cause psoriasis, they do seem to affect
the etiology and severity of the disease. Because the ramifications of psoriasis
vary widely both physically and emotionally from one individual to another,
and from one episode or flare to another within the same individual, it can
impact the lives of some patients quite significantly while affecting others
minimally and/or very differently.
Psychotherapeutically oriented group therapy sessions have the potential
to positively affect the way in which people with psoriasis make appraisals
and respond to physical and emotional effects of psoriasis. Through group
interaction, people with psoriasis may become cognizant of how they relate
to others, learn new coping skills, feel less alone, and may have suggestions
that offer relief to others. Group participation facilitates learning and growth.
Behaviour Therapy has shown to reduce social fears, avoidance and
helplessness and improve emotional status in psoriasis patients.
Prevention
No form of prevention is known. Keep flare-ups to a minimum by avoiding
anything that aggravates psoriasis.
ECZEMA
Atopic dermatitis, commonly referred to as eczema, is a chronic skin disorder
categorized by scaly and itching rashes. People with eczema often have a
family history of allergic conditions like asthma, hay fever, or eczema.
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Skin Diseases

Eczema is most common in infants, and at least half of those cases clear by
36 months. In adults, it is generally a chronic or recurring condition.
A hypersensitivity reaction (similar to an allergy) occurs in the skin, causing
chronic inflammation. The inflammation causes the skin to become itchy
and scaly. Chronic irritation and scratching can cause the skin to thicken
and become leathery-textured.
Exposure to environmental irritants can worsen symptoms, as can dryness
of the skin, exposure to water, temperature changes, and stress.
Symptoms
O Intense itching
O Blisters with oozing and crusting
O Skin redness or inflammation around the blisters
O Rash: In children under 2 years old, skin lesions begin on the cheeks,
elbows, or knees; in adults, the rash more commonly involves the
inside surfaces of the knees and elbows
O Dry, leathery skin: More or less pigment than their normal skin
tone, located commonly in the inner elbow or behind the knee
and may spread to the neck, hands, feet, eyelids, or behind the
knee
O Raw skin — from scratching.
Signs and tests

Diagnosis is primarily based on the appearance of the skin and on personal
and family history. The health care provider should examine the lesions to
rule out other possible causes. A skin lesion biopsy may be performed, but
is not always required to make the diagnosis.
Treatment
Treatment may vary depending on the appearance (stage) of the lesions —
acute “weeping” lesions, dry scaly lesions, or chronic dry, thickened lesions
are each treated differently.
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Anything that aggravates the symptoms should be avoided whenever

possible, including any food allergens and irritants such as wool and lanolin.
Dry skin often makes the condition worse. When washing or bathing, keep
water contact as brief as possible and use less soap than usual. After bathing,
it is important to trap the moisture in the skin by applying lubricating
cream on the skin while it is damp. Temperature changes and stress may
cause sweating and aggravate the condition.
Treatment of weeping lesions may include soothing moisturizers, mild soaps,
or wet dressings.
MODERN MEDICINE
O Topical and systemic corticosteroids—apply according to package

directions for skin lesions; high-potency topical steroid applied
early may stop the itching and the attack. One percent topical
hydrocortisone for children; use higher concentration in adults
O Disulfiram—recommended for nickel allergy or dyshidrotic eczem
O Oral cromolyn sodium—recommended for nickel allergy or
dyshidrotic eczema
O Zinc oxide—apply to areas of severe itching
O Topical psoralen with special UVA light sources—to treat hands
and feet.
The latest treatment for eczema is a new class of skin medications called
topical immunomodulators (TIMs). These medications are steroid-free. They
include tacrolimus and pimecrolimus. Studies have shown as high as an
80% success rate using these new medications.
AYURVEDA
Initially the patient is detoxified by Panchakarma treatment like virechana

(purging). A laxative which is specifically prescribed for skin diseases, like
Manibhadra lehya is given in a dose of two teaspoons at bed time.
Medicines like Maha Manjishtadi Kashaya are given one ounce twice daily
with water. Other drugs like Gandhaka Rasayana 2 tablets is given twice
daily with above Kashaya.
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Skin Diseases
Drugs like Arogyavardhini Ras 1 gm bid, or Panchathiktham guggulu Ghrita

10-20 gm, Nimbasavam, Aragwadharishtam, Kaishora guggulu are also
beneficial.
To reduce itching and eczema, Chakramarda oil or Rasadilepa is applied.
Alternatively, seeds of radish and Bakuchi can be macerated and applied
with sesame oil over the body. After an hour a hot water bath must be
given.
ACUPUNCTURE
Following Acupoints are used in treating eczema:

O Baihui (Du 20)
O Local Points: Points adjacent to (but not within) the affected area
O Specific points: Dazhui (Du 14), Quchi (L.I.11), Lieque (Lu.7),
Xuehai (Sp. 10).
Moderate stimulation at the point Dazhui (Du 14.) and at the other points
is used, if the response is inadequate.
O In the chronic stage use: Hegu (L.I. 4)
O For pruritus use: Dushu (U.B. 16), Xuehal (Sp.10) with strong
stimulation.
HOMEOPATHY
Antimonium cr udum: People likely to respond to this remedy have eczema

crudum:
with thick, cracked skin and are also prone to indigestion. They are usually
sensitive and sentimental, love to eat (craving pickles, vinegar, and other
sour things), and may be overweight. Itching is worse from warmth and
sun exposure. Antimonium crudum is often indicated for impetigo, plantar
warts, and calluses, as well as eczema.
Arsenicum album: People who need this remedy usually are anxious, restless,
and compulsively neat and orderly. The skin is dry, itches, and burns
intensely. Scratching can make the itching worse while applying heat brings
relief. Indigestion with burning pain and a general feeling of chilliness are
often seen when Arsenicum is indicated.
335
A rrum
um triphyllum: This remedy can be useful when allergic skin eruptions are
focused on the lower part of the face, especially around the mouth. The chin
may look chapped and feel hot and irritated. The lips are cracked (and usually
raw from the person picking them) and the nostrils may be sore. People who
need this remedy are often inclined toward throat irritation and hoarseness.
Calcar ea carbonica: This remedy is suited to people who are chilly with
Calcarea
clammy hands and feet, and tend to develop eczema and cracking skin that
is worse in the wintertime.
Calendula: This remedy (in potentised homeopathic form) can be helpful

if the irritated skin has a tendency to get infected. Topical use of the
unpotentised herb in lotion, gel, or tincture form is soothing to irritated
skin, and can often ease inflammation and prevent infection without
artificially suppressing it.
Graphites: People likely to respond to this remedy have tough or leathery

skin with cracks and soreness, and often have a long-term history of skin
disorders (impetigo, herpes, etc.) The areas behind the ears, around the
mouth, or on the hands are often cracked, with a golden oozing discharge
that hardens into crusts. Itching is worse from getting warm in bed, and
the person will often scratch the irritated places till they bleed.
Hepar sulphuris calcar eum: This remedy may be helpful to very sensitive,
calcareum:
chilly people whose eczema is extremely sore and becomes infected easily.
The skin, especially on the hands and feet, looks chapped and deeply cracked
and is very slow to heal.
Mezer eum: A person who needs this remedy often has strong anxiety, felt
ereum:
physically in the stomach. Intensely itching eruptions start as blisters, then
ooze and form thick crusts, and scratching can lead to thickened skin. Cold
applications often help the itch (although the person is chilly in general).
Rhus toxicodendron: A person whose eczema has blister-like eruptions that

look red and swollen, itch intensely, and are soothed by hot applications
may respond to this remedy.
Petroleum: This remedy is indicated for individuals whose skin is extremely
etroleum:
dry and tends to crack, especially on the fingertips and palms. Eczema is
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Skin Diseases
worse in winter, with deep, sore cracks that often bleed. The person feels a
cold sensation after scratching. Itching is worse at night and from getting
warm in bed. The skin is easily infected, and may get tough and leathery
from chronic irritation.
Sulphur: Intensely burning, itching, inflamed eruptions that are worse
from warmth and worse from bathing suggest a need for this remedy. Affected
areas may be red, with scaling or crusted skin. Eruptions can be either dry
or moist. This remedy is sometimes helpful to people who have repeatedly
used medications and ointments on their eczema without success.
NATUROPATHY
Fasting for 1 to 4 weeks on plain water or vegetable and fruit juices reduces
allergy and dermatitis. Give daily warm Neem (Azadirachta indica) decoction
enema during fasting.
After fasting, follow a balanced diet with high fibre. At least one meal
should consist of raw foods. Avoid all allergy-causing foods, and citrus fruits
including tomato. As the patient improves slowly introduce the allergy
foods one by one. If the foods produce symptoms, avoid them forever.
Herbs that help skin heal and increase lymphatic drainage are useful for
relieving eczema. The following herbs are advised in combination as a
tincture (15 to 30 drops three times per day) or tea (2 to 4 cups per day):
burdock root (Arctium lappa), yellow dock (Rumex crispus), red clover
(Trifolium pratense), cleavers (Galium aparine), yarrow (Achillea millefolium),
peppermint (Mentha piperita), and nettles (Urtica dioica). To prepare a tea,
steep the root elements for 10 minutes, then add the rest of the herbs and
steep an additional 5 to 10 minutes.
Topical treatment
treatment
Skin creams and salves containing one or more of the following herbs may
help relieve itching and burning, and promote healing: chickweed (Stellaria
media), marigold (Calendula officinalis), comfrey (Symphytum officinale),
and chamomile (Matricaria recutita).
Apply any one of below herbal pastes, and after 1 hour, wash the part with
warm water.
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O Paste of raw potatoes and cabbage

O Paste of gallnut powder and coconut oil
O Neem leaves + aloe.
light and washed after half an hour. Clay removes the dead cells and speeds
up the healing.
Hydrotherapy
Immersion bath: Add a cup of baking soda or powdered oats to warm water
in the bathtub and soak in it for 20 minutes.
Steam with water boiled with Neem leaves is also useful.
NUTRITION THERAPY
Avoid foods you are allergic to. Common allergenic foods are dairy products,
soy, citrus, peanuts, wheat, fish, eggs, corn, and tomatoes. A rotation diet,
in which the same food is not eaten more than once every four days, may be
helpful in treating chronic eczema.
Eat fewer foods that cause inflammation, such as saturated fats (meats,
especially poultry, and dairy), refined foods, and sugar. Increase intake of
fresh vegetables, whole grains, and essential fatty acids (cold-water fish,
nuts, and seeds).

O Flaxseed (3,000 mg twice a day), borage (1,500 mg twice a day),
or evening primrose oil (1,500 mg twice a day) to reduce swelling.
Children can be supplemented with cod liver oil (1/2 to 1 tsp. per
day), or any of the above oils, 500 mg, twice a day.
O Beta-carotene (25,000 to 100,000 IU/day), zinc (10 to 30 mg per
day), and vitamin E (100 to 400 IU per day) to strengthen your
immune system and help your skin heal.
O Zinc spray can heal the affected tissue in some patients.
O Vitamin C (250 to 500 mg two times per day) reduces your body’s
reponse to substances that cause allergies. Vitamin C from rose
hips or palmitate is citrus-free and hypoallergenic.
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Skin Diseases
O Selenium (50 to 200 mcg per day) helps regulate fatty acid
metabolism and keeps your liver healthy.
O Bromelain (250 mg two to four times per day, taken between meals)
reduces swelling.
Flavonoids, found in dark berries and some plants, help reduce swelling,
strengthen connective tissue, and help reduce allergic reactions. The following
are flavonoids that may be taken in dried extract form.
O Catechin (25 to 150 mg two to three times per day), quercetin
(100 to 250 mg two to three times per day), hesperidin (100 to
250 mg two to three times per day), and rutin (100 to 250 mg
two to three times per day).
O Rose hips (Rosa canina) are also high in flavonoids and may be
used as a tea. Drink 3 to 4 cups per day.
Prevention
Studies have shown that children who are breast-fed are less likely to get
eczema. This is also true when the nursing mother has avoided cow’s milk
in her diet. Other dietary restrictions may include eggs, fish, peanuts, and
soy.
Eczema tends to run in families. Control of stress, nervousness, anxiety,
and depression can be beneficial in some cases.
ALOPECIA
Partial or complete loss of hair is called alopecia. Alopecia is the absence or
slowing of hair growth in an area of the body where hair formerly grew. It
may be caused by physical damage to the hair itself or to the hair follicles,
but it is most often the result of changes in the natural growth cycle of hair.
In some types of alopecia, the growth cycle is disrupted by some temporary
situation such as a chemical imbalance or stress. However, the vast majority
(95 percent) of cases of hair loss in both men (male pattern baldness) and
women (female diffuse baldness) are genetic in origin. This is called
androgenetic alopecia.
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Considerations
Hair loss usually develops gradually and may be patchy or diffuse (all over).
Roughly 100 hairs are lost from your head every day. The average scalp
contains about 100,000 hairs.
Each individual hair survives for an average of 4-1/2 years, during which time it
grows about half an inch a month. Usually in its 5th year, the hair falls out and
is replaced within 6 months by a new one. Genetic baldness is caused by the
body’s failure to produce new hairs and not by excessive hair loss.
Both men and women tend to lose hair thickness and amount as they age.
Inherited or “pattern baldness” affects many more men than women. About
25% of men begin to bald by the time they are 30 years old, and about
two-thirds are either bald or have a balding pattern by age 60.
Typical male pattern baldness involves a receding hairline and thinning
around the crown with eventual bald spots. Ultimately, you may have only
a horseshoe ring of hair around the sides. In addition to genes, male-pattern
baldness seems to require the presence of the male hormone testosterone.
Men who do not produce testosterone (because of genetic abnormalities or
castration) do not develop this pattern of baldness.
Some women also develop a particular pattern of hair loss due to genetics, age,
and male hormones that tend to increase in women after menopause. The pattern
is different from that of men. Female pattern baldness involves a thinning
throughout the scalp while the frontal hairline generally remains intact.
Common Causes
Baldness is not usually caused by a disease, but is related to aging, heredity,
and testosterone. In addition to the common male and female patterns
from a combination of these factors, other possible causes of hair loss,
especially if in an unusual pattern, include:
O Hormonal changes (for example, thyroid disease, childbirth, or use
of the birth control pill)
O A serious illness (like a tumor of the ovary or adrenal glands) or
fever
O Medication such as cancer chemotherapy
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Skin Diseases
O Excessive shampooing and blow-drying

O Emotional or physical stress
O Nervous habits such as continual hair pulling or scalp rubbing
O Burns or radiation therapy
O Alopecia areata — bald patches that develop on the scalp, beard,
and, possibly, eyebrows. Eyelashes may fall out as well. This is
thought to be an immune disorder
O Tinea capitis (ringworm of the scalp).
Treatment
MODERN MEDICINE
O Male pattern baldness—minoxidil lotion, 2% to 5% applied twice

daily; finasteride, 1 mg per day orally. Either drug must be used
indefinitely to maintain regrown hair. Side effects should be
monitored.
O Female baldness—minoxidil lotion, 2% applied twice daily. Must
be used indefinitely to maintain regrown hair.
O Alopecia areata—the most effective treatments involve steroid drugs,
such as cortisone.
O Tinea capitis—antifungal mediations such as griseovulfin, orally
for 8 weeks, in combination with antifungal shampoo two to three
times per week for 8 weeks. Complete entire course of treatment to
prevent relapse.
AYURVEDA
Bhringaraja is the drug of choice for the treatment of the disease. Maha
bhringaraja taila or Nilibhringadi taila is commonly prescribed by the physicians.
This is to be gently massaged over the scalp about one hour before taking a
bath. By this massage some of the existing weak hair falls out. Therefore, in the
beginning, the hair will look thinner and the baldness would appear as if
increasing. In fact, it is better if the whole head is thoroughly shaved and then
this oil is used for massage. Powder of bhringaraja should be given to the patient
orally. One teaspoonful of this powder should be mixed with honey and given on
empty stomach, twice a day.
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Ashvakanchuki rasa is used by Ayurvedic physicians for this purpose. It is

basically a strong purgative. These tablets are crushed, mixed with honey
and externally applied. This is applied over the skull in afternoon and allowed
to dry up. The patient should go to bed without washing his head. In the
beginning, application of this medicine causes a little redness and irritation
in the skull but slowly hair begins to grow.
ACUPUNCTURE
O Local points: Baihui (Du 20), Sishencong (Ex. 6) and a few

additional points in the hairless area.
O Specific points: Taixi (K. 3), Lieque (Lu. 7).
O Distal points: Hegu (L.I.4.) (for front of head), Waiguan (S.J. 5.)
(for side of head), Lieque (Lu. 7.) (for back of head).
O Moxa Points for Hair Loss: GV 20, UB 10, UB 23, CV 12, CV 4,
LI 4.
Electrical stimulation of the head area along with the distal points is helpful.
Tapping the affected area with the plum blossom needle is also very effective.
HOMEOPATHY
Homeopathy offers a promising treatment for Alopecia Areata and the success
rate could be in the range of 50 to 70%. The duration of treatment varies
from 4 months to one year, depending of the chronicity and other factors.
Natrum muriaticum [Nat-m]: Has the symptoms of easy falling out of the
hair; it falls out when touched or combed. This is quite frequently seen in
nursing home. Carbo vegetabilis has falling of hair after parturition or severe
illness. Sepia has losing of hair after chronic headaches.
Phosphor
hosphorus us [P hos]: Bald spots on the head, which are dry and scaly, are
[Phos]:
characteristic of Phosphorus. Dandruff, roots of hair get gray and the hair
comes out in bunches. Graphites cure bald spots on the sides of the head.
The head sweats easily and is the most important remedy in alopecia areata.
Phosphoric acid [Ph-ac]: Falling of hair from general debility.
[Ph-ac]:
Arsenicum: Bald spots near the forehead; the scalp is covered with dry scales.
Fluoric acid: For brittle hair that falls out in small tufts.
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Skin Diseases
Ly copodium: For premature balding and graying, or hair loss after

childbirth. Eczema is often behind the ears.
Kali carbonicum: For dry, thinning hair.
Kali SSulphuricum:
ulphuricum: For yellow, flaking dandruff, which is moist or sticky.
Hair may fall out, leaving bald spots.
S elenium: For hair loss on the body and scalp. The scalp feels painful
when touched
NATUROPATHY
A wholesome diet, rich in silica, calcium and iron, will help reduce or
prevent hair loss. The diet should be balanced in vitamins, minerals and
proteins. Take foods rich in B complex, sulfur, silicon, zinc, iron and iodine.
Hair loss occurs when the diet is inadequate in the B vitamins - especially
B6, biotin, inositol and folic acid; and the minerals magnesium, sulphur
and zinc. The B vitamins, especially B5 (pantothenic acid and B3 (niacin),
are especially important for hair growth.
O Combine the following in equal parts and use as tea (2 to 3 cups per
day) or tincture (20 to 30 drops two to three times per day): ginkgo
(Ginkgo biloba), rosemary (Rosemarinus officinalis), prickly ash bark
(Xanthoxylum clava-herculis), black cohosh (Cimicifuga racemosa), yarrow
(Achillea millefolium), and horsetail (Equisetum arvense)
O Androgenetic alopecia: Green tea (Camelia sinensis), 2 cups per
day, and saw palmetto (Serenoa repens), 100 mg twice a day
O Hormone imbalance: Chaste tree (Vitex agnus cactus), 200 to 300
mg per day, has a normalizing effect on the pituitary
O Viral origin or immune system cause: Herbs that support immune
function can help treat the underlying cause of this type of alopecia.
Echinacea (Echinacea angustifolia), astragalus (Astragalus
membranaceus), and Siberian ginseng (Eleutherococcus senticosus).
YOGA THERAPY
Yoga postures can help to relieve tension in your neck and indirectly aid in
keeping hair healthy. Inverted postures like Sarvangasana, Shirsasana,
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Padhangushtasana etc. are increases the blood flow to the scalp and keep
hair healthy.
MASSAGE THERAPY
Therapeutic massage increases circulation and reduces stress. Scalp massage

using essential oils of rosemary, lavender, sage, thyme, and cedarwood may
be helpful in increasing circulation. Add 3 to 6 drops of essential oil to 1
tbsp of jojoba or grape seed oil. Massage into scalp daily.
Hydrotherapy
Apply alternate hot and cold packs to scalp or alternate hot and cold sprays
to scalp – 3 to 4 times. Always end with cold.
NUTRITION THERAPY
Reduce your intake of pro-inflammatory foods (saturated fats, dairy products,

and other animal products) and eat more fresh vegetables, whole grains,
essential fatty acids, and, in particular, protein (non-animal sources of
protein include nuts, legumes, and soy).
O Biotin (300 mcg per day) and trace minerals, such as those found
in blue-green algae (2 to 6 tablets per day), help hair growth.
O Androgenetic alopecia: vitamin B6 (50 to 100 mg per day), zinc
(30 mg per day), and gamma-linolenic acid (1,000 mg twice a
day) helps to inhibit 5-alpha reductase.
O Hormone imbalance: essential fatty acids (1,000 mg twice a day),
B6 (50 to 100 mg per day), vitamin E (400 IU per day), and
magnesium (200 mg twice a day) enhance hormone production.
Home Care
A wig, hat, or other covering may be desired until the hair grows back.
Hair weaves, hair pieces, or changes of hair style may disguise hair loss.
This is generally the least expensive and safest approach to hair loss. Hair
pieces should not be sutured to the scalp because of the risk of scars and
infection.
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Skin Diseases
VITILIGO
Vitiligo is a skin condition in which there is loss of pigment from areas of
skin resulting in irregular white patches with normal skin texture. Medically
speaking, leucoderma is a very harmless condition for it causes virtually no
pain or suffering and has no complications. Leucoderma or vitiligo is not
infectious. The patient is distressed only for cosmetic reasons and none
other.
Vitiligo appears to be an acquired condition and may appear at any age.
There is an increased incidence in some families. Vitiligo is more noticeable
in darker skinned people because of the contrast.
The cause of vitiligo is unknown, but autoimmunity may be a factor. In

addition, certain chemicals including cosmetics like cheap lipsticks; rubber
footwear, and some phenolic compounds can sometimes give rise to
leucoderma in the area of contact with the chemical.
There are some factors that can trigger or exacerbate vitiligo in a susceptible
individual. These include local injury, itching and friction, prolonged
‘stomach’ (gastrointestinal) upsets, emotional disturbances, psychological
trauma, pregnancy, delivery and any major surgery.
Lesions appear as flat depigmented areas with a darker border. The edges
are sharply defined but irregular. Frequently affected areas are the face,
elbows and knees, hands and feet, and genitalia.
Symptoms
O Family history of vitiligo
O Sudden or gradual onset of flat normally textured areas of skin
with complete pigment loss.
Signs and tests
Examination is usually sufficient to confirm the diagnosis. In some cases, a
skin biopsy may be needed to rule out other causes of pigment loss.
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Treatment
Vitiligo is difficult to treat. Patients tend to get frustrated while undergoing
treatment for leucoderma. But the treatment for this condition is a long
process and one has to be very patient.
MODERN MEDICINE
Treatment options include the following:

O Oral medications, such as Trisoralen (trimethylpsoralen)
O Topical medications include repigmenting agents such as
methoxsalen and Immunosuppressants such as pimecrolimus and
tacrolimus and corticosteroid creams.
Skin may be grafted, or removed from normal areas and placed into areas of
pigment loss. In the future, skin pigment cells may be grown in the
laboratory and used to treat areas of vitiligo.
AYURVEDA
Internally herbs like Khadira (Acacia catechu) and Amalaka (Embelia

Officinalis) and Bakuchi (Psoralea corylifolia) is given orally. Avalgujabeejadi
Churnam, Chithrakasavam are useful.
External Application: It has been found that the application of Bakuchi
along with the seeds of Radish (Raphanus sativuslinn) will cure the disease.
These two drugs are to be macerated and mixed with either water or cow’s
urine and should be applied externally. Alternatively, Switraghnavati can
also be applied externally with cow’s urine; or Shweta gunjadi oil which is
prepared from Gunjah (Abrus precatorius) may also be applied.
ACUPUNCTURE
Following Acupoints are used in treating vitiligo:

O Local points: Insert a fair number of needles into acupuncture
points in the affected area and follow with mild stimulation. Tap
the affected area softly with the plum blossom needle.
O Distal points: Dazhul (Du 14), Quchi (L.I. 11), Lieque (Lu. 7),
Xuehai (Sp. 10), Sanyinjiao (Sp. 6).
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Skin Diseases
HOMEOPATHY
Vitiligo in general is treatable with homeopathy. However, the treatment
becomes very difficult when it affects certain parts called mucocutaneous
junctions, such as lips, corner of the mouth, private parts, tips of fingers
and toes.
Arsenicum album: Skin chaffed around the genitals. Squamous eruptions
may accompany (low potencies are used).
Selenium: Itching around the ankles and between the fingers. Hair falls
from beard and genital area.
Sepia: For idiopathic leucoderma in young persons.
Manganum Aceticum: Suppuration with red spots, itching; better with
scratching. Chronic eczema associated with amenorrhea. Deep cracks at
the elbows.
NATUROPATHY
Initially patient is kept on fasting on wheat grass or vegetable juices for 3
to 7 days. After that, a fruit and vegetable diet is advised for 1 to 2 months.
Sour fruits are avoided.
Externally Clay packs are applied on the lesions. Cotton (Gossypium hirsutum)
seeds are made into paste with water and applied on the lesions. Banyan
tree latex (milk exudate from the trunk or roots) can also be applied. Neem
leaves can be taken internally and Neem oil can be applied externally to
reduce vitiligo.
Unani
The Unani System of Medicine is effective for vitiligo. Atrilal (Ammi majus
Linn) seed has been widely used by Greco-Arab physicians such as Ibn
Sina and Razi to cure vitiligo. Powder of Atrilal in a dose of 1.5 gm twice
daily were prescribed orally with local application of the same drug on
white patches after mixing it with vinegar in a ratio of 1:2 followed by sun
exposure for 10–20 minutes a day. Seeds of Atrilal (Ammi majus Linn)
contain an appreciable amount of Xanthotoxin, Psoralen and Furocoumarin,
347
which are potent photosensitizers and may be responsible to cause skin

reactions after sun exposure.
NUTRITION THERAPY
A nutritious, well-balanced, healthy diet is strongly recommended in cases

of vitiligo. It is even more important than supplements. It can help balance
the immune system and protect from disease. It will also help recover from
skin discoloration by providing essential vitamins & minerals that take
part in the process that leads to the formation of new pigment.
Nutritional deficiencies, both in animals and in humans, are known to

alter melanin production. Copper and zinc deficiencies have been reported
to induce hypopigmentation in various animals. Hypopigmentation of the
skin and hair results from copper deficiency in humans; the depigmentation
associated with chronic excessive molybdenum intake is related to a decreased
storage of copper in the liver. Copper would seem of prime importance
because tyrosinase is a known copper-requiring enzyme.
Abnormally low levels of Vitamin B12, Folic Acid and Vitamin C are found
in a large number of vitiligo patients. Folic acid and vitamin B12
supplementation combined with sun exposure can induce repigmentation
better than either the vitamins or sun exposure alone
Studies have suggested that vitamin B PABA (an element of folic acid) may
be effective in treating vitiligo. In one study, forty-eight people aged between
10 and 70 all suffering with vitiligo were given 100mg of PABA three or
four times daily. The rate of improvement was slow and so the researchers
began injecting the PABA and supplementing oral tablets. Within two
months, the researchers found that all forty-eight people had regained
normal pigmentation.
PHYSICAL THERAPY
Phototherapy like exposure to intense ultraviolet light therapy is advised.
The exact mechanism of action of ultraviolet light on various cutaneous
diseases is unknown, but probably through immunosuppressive effect or
direct phototoxic effect.
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Skin Diseases
Apply topical meladinine 30 minutes before radiation. Apply a thin layer

to the site of vitiligo only. Avoid the junction between the normal skin and
vitiligo. Avoid application to eyelids. Never dispense the topical meladinine
to patient for home application.
Start the dose of UVA with a frequency of two to three treatments per
week. Start with 30 seconds at a distance of 6 inches. Try PUVA for 3
months. If there is response, may continue up to one year. However if there
is no response, stop it. Patient should be fully informed about the limitation
and risk of this treatment modality to avoid over-expectation or false hope.
PSYCHOTHERAPY
Hypnotherapy and Psychotherapy are both excellent aids to help control
emotional stress associated with vitiligo and other skin diseases. In one
study conducted in Russia, not only were psychological problems eliminated
but the researchers also observed marked repigmentation in over 20% of
cases and that the period necessary to achieve marked repigmentation (i.e.
of more than 50%) was twice as fast with psychotherapy.
CORNS
Corns and calluses are thickened layers of skin caused by repeated pressure
or friction.

Corns and calluses are caused by pressure or friction on skin. A corn is
thickened skin on the top or side of a toe, usually from shoes that do not fit
properly. A callus is thickened skin on your hands or the soles of your feet.
The thickening of the skin is a protective reaction. For example, farmers
and rowers get callused hands that prevent them from getting painful blisters.
People with bunions often develop a callus over the bunion because it rubs
against the shoe.
Neither corns nor calluses are serious conditions.
Symptoms
O Thick and hardened skin
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O May be flaky and dry

O Located on hands, feet, or other areas that may be rubbed or
pressured.
Signs and tests

Diagnosis is done after observing the skin. In most cases tests are not
necessary.
Treatment
Usually, preventing friction is the only treatment needed. If a corn is the
result of a poor-fitting shoe, changing to shoes that fit properly will usually
eliminate the corn within a couple of weeks. Until then, protect the skin
with donut-shaped corn pads, available in pharmacies. If desired, use a
pumice stone to gently wear down the corn.
Calluses on the hands can be treated by wearing gloves during activities

that cause friction, such as gardening and weight lifting.
MODERN MEDICINE
If an infection or ulcer occurs in an area of a callus or corn, unhealthy tissue

may need to be removed and treatment with antibiotics may be necessary.
Calluses often reflect undue pressure placed on the skin because of an

underlying problem such as bunions. Proper treatment of any underlying
condition should prevent the calluses from returning.
AYURVEDA
Externally ghee mixed with rock salt is applied. To reduce the pain turmeric
is applied. The leaves or the bark of the Neem tree, Jojoba tree, Bala (Sida
cordifolia) can be applied. A warm poultice made from roasted onions,
turmeric and ghee is to be applied. Externally Gulguluthikthaka Ghritham
can be applied to reduce pain.
Cauterisation (Agni karma) and Alkali therapy (kshara Karma) is the best
remedy for corns.
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Skin Diseases
HOMEOPATHY
O Agaricus muscarius: With redness and irritation

O Carbo Vegetables: Improves general circulation of limbs when this
is a causative feature
O Hecla lava: The main remedy for reducing the swelling
lava:
O Nitricum acidum: When bunions become ulcerated
O Silicea: When the skin is cracked and the extremities are cold and
damp.
NATUROPATHY
Apply a paste made by mixing 1 teaspoon of aloe vera gel with ½ teaspoon
of turmeric. Once the paste is applied, cover the area with a bandage. The
treatment works best at night. In the morning remove the bandage and
soak your foot in a bucket of warm water for ten minutes. Then rub mustard
oil deeply into the corn or callus. Continue this treatment for several days,
and eventually, the corn or callus will fall off.
PHYSICAL THERAPY
O The shoes should be padded with micro cellular rubber

O Ultrasound can be used for pain relief.
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8
EYE DISEASES
Refractive Eye Disorders
Glaucoma
Conjunctivitis
Cataract
REFRACTIVE EYE DISORDERS
Refractive Eye disorders are of two types:
O Myopia: Nearsightedness is an error of visual focusing that makes

distant objects appear blurred. They can see near objects clearly.
O Hyper opia: Farsightedness is difficulty in seeing objects which are
yperopia:
nearby. They can see far objects clearly.
Normal vision occurs when light is focused directly on the retina rather
than in front or behind it. A person with normal vision can see objects
clearly near and faraway.
Nearsightedness results in blurred vision when the visual image is focused
in front of the retina, rather than directly on it. It occurs when the physical
length of the eye is greater than the optical length. For this reason,
nearsightedness often develops in the rapidly growing school-aged child or
teenager, and progresses during the growth years, requiring frequent changes
in glasses or contact lenses. A nearsighted person sees near objects clearly,
while objects in the distance are blurred.
Farsightedness is the result of the visual image being focused behind the
retina rather than directly on it. It may be caused by the eyeball being too
small or the focusing power being too weak. Farsightedness is often present
from birth, but children can often tolerate moderate amounts without
difficulty and most outgrow the condition. A farsighted person sees faraway
objects clearly, while objects that are near are blurred.
Astigmatism is a condition in which the cornea of the eye is asymmetrically
curved, causing out-of-focus vision. It is usually present from birth, and
often occurs together with nearsightedness or farsightedness.
Causes
The causes may lie in genetic or environmental factors.
Symptoms
O Blurred vision or squinting when trying to see distant objects (children
often cannot read the blackboard, but can easily read a book)
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O Eyestrain
O Headache while reading (in hyperopia).
Eye test
A general eye examination or standard ophthalmic exam may include:
O Visual acuity, both at a distance (Snellen), and close up (Jaeger)
O Refraction test, to determine the correct prescription for glasses
O Test of color vision, to test for possible color blindness
O Tests of the muscles which move the eyes
O Slit-lamp exam of the structures at the front of the eyes
O Measurement of the pressure of fluid in the eyes
O Retinal examination.
Treatment
MODERN MEDICINE
Refractive Eye Disorders can easily be compensated for by the use of

eyeglasses or contact lenses, which shift the focus point to the retina. There
are several surgical procedures that reshape the cornea, shifting the focus
point from in front of the retina to the retina.
Radial keratotomy is a surgical procedure popular in the recent past. Now
it has been almost completely replaced by LASIK, in which an excimer
laser is used to reshape the cornea.
AYURVEDA
Triphala is commonly used by Ayurvedic physicians for the treatment of

refractive problems. One tablespoonful of this powder is added to a glass
of water in the evening and kept overnight. In the early morning, the
powder should be strained through a clean cloth and the residue thrown
away. The water, thus obtained, should be used for sprinkling gently over
the eyeballs in the early morning. About 120 ml. of this water should be
taken internally. This dosage has to be continued for about 3 months for
tonic effect on the eye.
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Liquorice is also an effective remedy. The root or rhizome of this plant is

used for medicinal purpose. One teaspoonful of this should be mixed with
½ a teaspoon of pure ghee and one teaspoonful of pure honey. This mixture
should be taken twice daily on an empty stomach—once in the morning
before breakfast, and once in the afternoon before tea when the stomach is
nearly empty.
If myopia is caused because of nervous debility then a compound
preparation of this drug called Saptamrita lauha is used. In this medicine,
triphala, yashti madhu, lauha bhasma, ghee and honey are used. One
teaspoonful of this powder is added to a cup of milk and taken twice a day.
To check progressive myopia, one teaspoonful of Triphala ghee is taken twice
daily with milk. If there is constipation, then the dose of this medicine
should be increased up to 3 teaspoonfuls, two times daily.
Panchakarma treatment like Netra tarpanam with Mahatriphaladi Ghrita
is useful in treating refractive diseases.
ACUPUNCTURE
O Baihui (Du 20)

O Local points: Chengqi (St. 1), Qiuhou (Ex. 4),
Jingming (U.B. 1), Tongziliao (G.B. 1), Fengchi (G.B. 20)
O Distal points: Hegu (L.I. 4), Yanglao (S.I. 6), Yangxi (L.I. 5),
Guangming (G.B. 37), Yiming (Ex. 7), Feiyang (U.B. 58).
HOMEOPATHY
Lilium tigrinum: Useful in astigmatism, lachrymation and impaired vision.
Pain extends to the back of the head. Restores power to the weak ciliary
muscles.
Physostigma: It acts on the ciliary muscles of the lens. A peculiar dread of
cold water indicates this remedy.
NATUROPATHY
Naturopathy advises Vitamin A, B complex and C rich foods for refractive

disorders. A well-balanced diet with plenty of fresh fruits and vegetables
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can help keep the eyes healthy. Apply a cold pack or clay pack on eyes for
15 minutes to relax the eyes.
Following herbs also are helpful:
O Eyebright is beneficial for the eyes. It can be taken orally in capsule
or tea form. Eyebright tea can also be used as eyewash.
O Bilberry extract has been shown to improve both normal and night
vision.
O Bayberry bark, cayenne (capsicum), and red raspberry leaves, taken
orally is beneficial.
Practice eye exercises twice daily.
YOGA THERAPY
Yoga practices like Yoga nidra, Thrataka (Concentration in between eyebrows

or on tip of nose or on a candle light) helps in treating refractive disorders.
The Bates method

The Bates method is a technique for improving eyesight that was developed
by Dr. William Bates in the early 1900’s. According to him poor eyesight
is caused by the strain to see. So the way to better eyesight is through
relaxation of both mind and body. Rest makes vision better, strain or effort
makes vision worse. Studies done on Bates therapy are inconclusive on its
effect.
Palming: Palming was originally a yoga technique. After Bates noticed its
beneficial effects on the visual system, he borrowed it and incorporated
into his system of vision improvement. Palming works by calming the
visual system. Cover both eyes with the palms of your hands, your fingers
crossed on your forehead. Note: in order to be successful, you must be able
to relax while palming. Some people cannot do this, and palming becomes
counterproductive. The blacker the field you see, the more relaxed you are.
Swing: You can gently swing your whole body to the left and to the right,
and watch a distant tree swing to the right and to the left; you can move
just your head, or just your eyes. The better the vision, the shorter the
swing can be made to be.
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Practice with a test car d. Keep an eye chart on the wall. To practice, stand
card.
from 10 to 20 feet away, and read the smallest line that you can without
straining. Then look at one of the letters on that line and close your eyes.
Remember that letter — go over every detail in your mind; shift from part
to part, from curve to corner and so on. When you open your eyes, you
will see not only that letter better, but also the one below it. If you find
yourself staring at the letters, which results in the line becoming blurred
as soon as it comes into focus, it is best to close the eyes before this can
happen. When you open them, shift to another letter on the same line. If
you close your eyes for each letter, you will become able to read the whole
line. Practice every day for five minutes or more and keep a record of your
progress.
NUTRITION THERAPY
Take Vitamin A, B and C rich foods. Diet should include plenty of yellow and
yellow-orange foods such as carrots, yams, and cantaloupes. Zinc is one of the
most common trace minerals in the body and is highly concentrated in the
retina. Zinc allows vitamin A to be released from the liver and is used in the
process of metabolism in the retina. Take zinc rich foods.
Self Help
For complete eye care, children and adults need to have an annual eye
examination. The eye should be protected from dust, smoke, light, glare,
sparks etc. by the use of protective glasses. Unnecessary transmission of
infection should be avoided by keeping the eyes, hands, towels etc. clean.
Avoid eye strain by proper lighting, avoiding glare, reading in bright light
and not over straining the eyes. Eyes may be washed with clean cool water.
GLAUCOMA
GLA
Glaucoma involves increased fluid pressure inside the eye (intraocular
pressure), which damages the optic nerve and causes partial vision loss and
can progress to blindness.

Glaucoma is the third most common cause of blindness in the US. There
are four major types of glaucoma:
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O Closed angle (acute) glaucoma

O Open angle (chronic) glaucoma
O Congenital glaucoma
O Secondary glaucoma.
All four types of glaucoma are characterized by increased pressure within the
eyeball, and therefore all can cause progressive damage to the optic nerve.
Increased pressure occurs when the fluid within the eye (called aqueous humor)
does not drain properly. The pressure pushes on the junction of the optic nerve
and the retina at the back of the eye. This reduces the blood supply to the optic
nerve, which carries visual information from the eye to the brain.
This loss of blood supply causes the individual nerve cells to progressively
die. As the optic nerve deteriorates, blind spots develop in the field of
vision. Peripheral (side) vision is affected first, followed by or central (front)
vision. Without treatment, glaucoma can eventually cause blindness.
Closed angle (acute) glaucoma may occur in people who were born with a
narrow angle between the iris and the cornea (the anterior chamber angle).
This is more common in people who are farsighted (they see objects in the
distance better than those which are close up). The iris may slip forward
and suddenly close off the exit of aqueous humor, and a sudden increase in
pressure within the eye follows.
Symptoms of pain, redness, nausea, and vision loss develop rapidly. Angle
closure may be provoked in susceptible persons by the use of drops that
dilate the eyes. Attacks may also develop without any obvious triggering
event. This is more common in the evening because the eye’s pupils naturally
dilate in dim light.
Open angle (chronic) glaucoma is by far the most common type of glaucoma.
In open angle glaucoma, the iris does not block the drainage angle as it
does in acute glaucoma. Instead, the fluid outlet channels within the wall
of the eye gradually narrow with time. The disease usually affects both
eyes, and over a period of years the consistently elevated pressure slowly
damages the optic nerve.
Chronic glaucoma has no early warning signs, and the associated loss of
peripheral vision occurs so gradually that it may go unnoticed until a
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substantial amount of damage and vision loss have occurred. The only way
to diagnose glaucoma early is through routine eye examinations.
Secondary glaucoma is caused by other diseases, including eye diseases
such as uveitis, systemic diseases, and drugs such as corticosteroids.
Congenital glaucoma, which is present at birth, is the result of defective
development of the fluid outflow channels of the eye. Surgery is required
for correction. Congenital glaucoma is often hereditary.
Risk factors depend on the type of glaucoma. For chronic glaucoma, risk
factors include the following:
O Age over 40
O Family history of glaucoma
O Diabetes
O Nearsightedness.
People with a family history of open angle glaucoma have twice the risk of
developing open angle glaucoma as those who do not. African-Americans
have four times the risk of developing open angle glaucoma compared to
Caucasian Americans. It is estimated that 1% to 2% of people over 40
have chronic glaucoma, with about 25% of cases undetected.
The risk factors for acute glaucoma include the following:
O Older age
O Family history of acute glaucoma
O Farsightedness
O Use of systemic anticholinergic medications (such as atropine or
eye dilation drops) in a high-risk individual.
Acute, congenital, and secondary glaucoma are much less common than
chronic glaucoma.
Symptoms
ACUTE
O Severe eye pain, facial pain
O Loss of vision
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O Cloudy vision with halos appearing around lights

O Red eye
O Fixed, nonreactive pupil
O Nausea and vomiting.
CHRONIC
O Gradual loss of peripheral vision
O Blurred or foggy vision
O Mild, chronic headaches
O Seeing rainbow-colored halos around lights.
Note: Most people with chronic glaucoma have no symptoms until
peripheral visual loss is severe
CONGENITAL
O Tears
O Sensitivity to light
O Redness of the eye
O Corneal haziness
O Enlarged cornea.
Signs and tests

An examination of the eye may be used to diagnose glaucoma. However,
because intraocular pressure fluctuates, an examination when the pressure
is low would not reveal the condition. An examination of the junction of
the optic nerve and the retina with an instrument called an ophthalmoscope
is necessary.
A standard ophthalmic examination may include:
O Retinal examination
O Intraocular pressure measurement by tonometry
O Visual field measurement
O Visual acuity
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O Refraction
O Pupillary reflex response
O Slit lamp examination
O Optic nerve imaging (photographs of the interior of the eye).
Treatment
MODERN MEDICINE
The objective of treatment is to reduce the intraocular pressure. Depending

on the type of glaucoma, this is achieved by medications or by surgery.
Acute glaucoma is a medical emergency requiring immediate treatment by
an emergency center or an ophthalmologist. Intraocular pressure can usually
be lowered by medications that may be given orally, intravenously, or
topically (as eye drops).
Surgery
An emergency operation, called an iridotomy, may be required for the
treatment of acute glaucoma. This creates a drainage hole in the iris to
relieve the pressure that has build up. This technique can be performed by
laser surgery without making an incision in the eye.
People at high risk for closed angle glaucoma may opt to undergo iridotomy
before having an attack. Patients who have had an acute episode in the past
may undergo the procedure to prevent recurrence.
Laser treatment of the fluid drainage area in the eye may be used to treat
open angle glaucoma. In severe cases that are not responsive to medical
treatment, surgery can be done to create new outflow channels. Congenital
glaucoma is most often treated with surgery.
AYURVEDA
Ayurveda advises herbs like Ashwagandha and Punarnava to slowly reduce
pressure on the affected eye.
ACUPUNCTURE
Following Acupoints are used for treating Glaucoma:
O Baihui (Du 20)
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O Local points: Chengqi (St. 1), Qiuhou (Ex. 4), Taiyang (Ex. 2),
Yangbai (G.B.14) through to Yuyao (Ex. 3), Fengchi (G.B. 20),
Zanzhu (U.B. 2)
O Distal points: Hegu (L.I. 4), Ganshu (U.B. 18), Taichong (Liv. 3)
O Specific points for nausea and vomiting: Neiguan (P. 6), Zusanli
(St. 36)
O Specific points for oedema: Shuifen (Ren 9), Shimen (Ren 5),
Yinlingquan (Sp. 9), Pishu (U.B. 20).
HOMEOPATHY
Aconitum napellus
napellus: Indicated in the acute form of glaucoma.
Belladonna atropa: When the onset is sudden and the eyes are exquisitely
painful with acute inflammation, dryness and photophobia.
Bryonia alba: When the intraocular tension is raised and there is intense
soreness, continuous lachrymation and photophobia.
Gelsemium sempervirens: Most useful when the double vision (diplopia)
is continous; the vision is misty and severely diminished the eyes feel bruised
and under severe pressure.
O pium: The eyeballs feel expanded, swollen and under pressure. Vision is
misty and blurred; the pupils are contracted and fixed (no reaction to
light).
Phosphorus: Alleviates the pain and limits the degenerative changes.
Spigelia anthelmia: The eyeballs feel too large and pulled back into the
skull with sharp, shooting and stitching pains, which are particularly worse
by movements and at night. Palpitations are often associated.
NATUROPATHY
Following herbs are advised in treating Glaucoma:
O Bilberry (Vaccinium myrtillus) 100 to 200 mg two times per day
O Rutin 20 mg three times per day, for associated allergies
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O Hawthorn berries (Crataegus monogyna) 200 mg two times per

day, especially for high blood pressure
O Ginkgo (Ginkgo biloba) 120 mg two times per day to improve
circulation
O Combine equal parts of ginkgo, hawthorn, bilberry, and elderberry
(Sambucus nigra) in a tea (three cups per day) or tincture (60
drops two times per day) to strengthen vascular tissues and improve
circulation.
NUTRITION THERAPY
Eat foods rich in bioflavonoids and carotenes, such as dark berries, dark
leafy greens, and yellow and orange vegetables. Eliminate food allergens.
Reduce foods that may dramatically alter levels of sugar in your blood,
such as sweets, fruits, and refined foods. Potentially beneficial nutrient
supplements include the following.

O Vitamin C (500 to 1,000 mg three times per day)
O Vitamin E (400 to 800 IU per day) and vitamin A (10,000 IU
per day) or beta carotene (25,000 IU per day), thiamine (10 mg
per day)
O Coenzyme Q10 (100 mg one to two times per day), which may
minimize side effects of certain drug therapies
O Zinc (30 mg per day) and selenium (200 mcg per day)
O Omega-3 fatty acids (300 to 500 mg daily)
O Melatonin (2 to 5 mg before bed).
Prevention
There is no prevention for the development of open angle glaucoma. If
detected early, further vision loss and blindness may be prevented with
treatment. Patients with risk factors for closed angle glaucoma should be
evaluated and those at high risk should have laser iridotomy, which will
prevent acute attacks.
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Careful use of dilating eye drops and systemic anticholinergic medications

will minimize the risk of acute attacks in high-risk individuals.
Anyone older than 35 should have tonometry (a check of intraocular
pressure) and ophthalmoscopy examinations every 2 years. More frequent
examination is recommended for people who have a family history of
glaucoma or other risk factors.
CONJUNCTIVITIS
Conjunctivitis is inflammation or infection of the membrane lining the
eyelids (conjunctiva).

The conjunctiva is exposed to bacteria and other irritants. Tears help protect
the conjunctiva by diluting bacteria and washing it away. Tears also contain
enzymes and antibodies which kill bacteria.
There are many causes of conjunctivitis. Viruses are the most common
cause. Other causes include bacteria, Chlamydia, fungus, and rarely
parasitic agents.
“Pink eye” refers to a viral infection of the conjunctiva. These infections are
especially contagious among children. Handwashing is key to preventing the
spread of the virus, which is similar to the type which causes the common cold.
Bacteria is an uncommon cause of conjunctivitis. Many physicians give a
mild antibiotic eyedrop for pink eye to prevent bacterial conjunctivitis.
Conjunctivitis is also caused by allergies (allergic conjunctivitis), chemical
exposure, and certain systemic diseases.
Newborns can be infected by bacteria in the birth canal. This condition is
called ophthalmia neonatorum, and it must be treated immediately to
preserve sight. Use of contact lenses, particularly extended-wear lenses,
can cause conjunctivitis.
Symptoms
O Increased tears
O Eye pain
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O Redness in the eyes

O Gritty feeling in the eyes
O Itching of the eye
O Blurred vision
O Sensitivity to light
O Crusts that form on the eyelid overnight.
Signs and tests

O Examination of eyes
O Swab of conjunctiva for analysis.
Treatment
MODERN MEDICINE
Viral conjunctivitis: Cool compresses three times daily for 1 to 3 weeks;
may also use antihistamines to relieve inflammation. Trifluridine 1% drops,
every 2 hours. Oral and/or topical acyclovir may also be needed.
Allergic conjunctivitis: Avoid contact with allergen. Treat with cool
compresses, over-the-counter or topical antihistamines, NSAIDs
(particularly ketorolac), and possibly mild corticosteroids.
Bacterial conjunctivitis: Trimethoprim sulfate and polymixin B sulfate drops,
1 drop 3 times daily for one week, or polymixin B-bacitracin ointment.
Fluoroquinolones as second-line therapy. Tobramycin (0.3%) or gentamicin
as drops, or 10% sodium sulfacetamide as drops, every four hours.
AYURVEDA
The therapeutic regimen includes both, systemic as well as local measures.
In chronic cases of conjunctivitis, detoxification measures such as oleation
therapy, fomentation, blood letting, purgation, enema etc. are undertaken.
Local measur es include - Eye drops, application of medicinal paste on lids,
measures
fumigation, sprinkling of medicated liquids and eye bath.
The following remedies can be undertaken as a part of the therapeutic
regime-
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The root of ‘Daru haridra’(Berberis teristeris) is a very efficacious drug in

conjunctivitis; the decoction is used as a collyrium; it is mixed with honey
before it is used. The compress made of this mixture is equally efficacious.
The decoction of Haridra (turmeric) is a very cooling application in
conjunctivitis; either the eyes are washed with this decoction or the compress
made with the decoction is applied over the eyes. This decoction is
particularly useful in catarrhal and purulent opthalmia.
Take Ghrita (ghee) -12 to 24 gm with meal or with 5 gm raw sugar thrice a day.
Foment the eye with cotton dipped in warm ghee or goat’s milk or warm
sesame oil.
Solution of Shuddha Tankana (purified borax) in hot water is also used for
fomentation.
Milk processed with decoction of Triphala (three myrobalans) is taken twice
or thrice a day.
Milk processed with paste and decoction of Dalchini (Cinnamon bark) is
used for local instillation.
Some compound formulations such as “Aefra bindu”, “Netramrita”,
“Narikelanjana” and “Phulikadrava” are used for this particular disease.
The decoction of Amla with Haritaki and Bibhitaki is useful for washing
the eyes in conjunctivitis. Decoction prepared from coriander seeds (10
gms) in 60 ml of water is excellent eyewash in conjunctivitis.
In chronic conjunctivitis, Netra Tarpana with pure cow ghee or
Mahatriphala ghee is advised.
HOMEOPATHY
A pis mellifica: Puffy, pink, watery swelling that feels better from cold
applications is a strong indication for this remedy. Stinging, burning pain
may be experienced, and the eyelids may stick together.
Argentum nitricum: Swelling with yellowish or pus-like discharge, and redness
and inflammation of the whites and inner corners of the eyes, suggest the use of
this remedy. The person’s eyes may be tired and achy, worse from light and
warmth, and better from cool water, cold compresses, and fresh air.
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Hepar sulphuris calcareum: When the eyes feel sore or bruised, with
inflammation and burning pain or a feeling as if the eyes are being pulled
back into the head, this remedy may be indicated. Yellow discharge can
stick the eyelids shut, especially in the morning. Warm compresses and
warmth in general often ease discomfort. Extreme sensitivity to cold, as
well as to light and noise, is often seen.
Mer curius solubilis: People needing this remedy often feel ill and tired,
ercurius
with erratic body temperature and sensitivity both to heat and cold.
Discharge is greenish-yellow and can irritate the lids and margins of the
eyes. A person who needs this remedy often has swollen glands, offensive
breath, and excessive salivation.
Natrum muriaticum: Swollen lids with burning tears and a feeling that
the eyes are bruised suggest a need for this remedy. Mucus or pus forms
and can make the eyelids stick together.
P ulsatilla: Conjunctivitis with thick, yellow, itchy discharge (often
accompanying a cold) suggests a need for this remedy. The person is
emotional and sensitive, feeling worse from warmth and in stuffy rooms,
and relieved by cool fresh air.
Sulphur: This remedy may be helpful if the eyes are very red and irritated,
with burning, smarting, sticking pains and a nagging itch. The whites of
the eyes look red and bloodshot, and the tears feel hot. Symptoms are
worse from heat, and light will hurt the eyes.
NATUROPATHY
Following herbs are used as a compress for treating Conjunctivitis:

To make a compress, use five drops of tincture in ¼ cup water or steep 1 tsp.
herb in 1 cup hot water for 5 to 10 minutes and strain. Soak cloth or gauze in
solution and apply to the eyes for 10 minutes, three to four times a day.
O Eyebright (Euphrasia officinalis): Helps fight infection and dry up
excess fluid, specific for eyes
O Chamomile (Matricaria recutita): Helps fight infection
O Marigold (Calendula officinalis): Soothes irritation
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O Plantain (Plantago lanceolata, P. major): Astringent and soothing.

The fresh leaves are the most effective part of the plant
O Flaxseed (Linum usitat issimum): As a soothing poultice made with 1
oz. of bruised flaxseed steeped for 15 minutes in 4 oz. of water, wrapped
in cheesecloth and then applied directly to the affected eye
O Grated fresh potato has astringent (drying and disinfecting)
properties. Wrap in cheesecloth and apply.
Use above herbs singly or in combination: Mix equal parts together then
steep 1 tsp. herb in 1 cup of hot water to make a tea. Cool before
administering to the eye.
Eyewash: goldenseal (Hydrastis canadensis) and boric acid: 10 drops of
goldenseal tincture with 1 tsp. of boric acid in 1 cup of water.
Apply alternating hot and cold compresses to the eye area, with three to
four minutes of the hot application, followed by 20 to 30 seconds of cold.
Repeat 3 times in a day. In acute conjunctivitis, apply an icepack on eyes
to reduce pain and inflammation. Don’t apply hot compress during acute
inflammation.
NUTRITION THERAPY
Vitamin A (10,000 IU per day), vitamin C (250 to 500 mg two times per
day), and zinc (30 to 50 mg per day) strengthen immune system and help
heal faster.
Prevention
Good hygiene can help prevent the spread of conjunctivitis:
O Keep hands away from the eye
O Wash the hands frequently
O Change pillowcases frequently
O Replace eye cosmetics regularly
O Do not share eye cosmetics
O Do not share towels or handkerchiefs
O Handle and clean contact lenses properly.
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CATARA
CAT CT
ARACT
A cataract is a cloudy or opaque area in the lens of the eye. The lens of an
eye is normally clear. If the lens becomes cloudy, the condition is known as
a cataract.

A cataract develops when protein in the lens clumps together and blocks
light from reaching the retina. It is not clear what causes these proteins to
clump together, but some researchers speculate that cataracts may develop
as a result of chemical changes in the lens that occur with aging.
Rarely, cataracts may be present at or shortly after birth. These are called
congenital cataracts.
Adult cataracts usually develop with advancing age and may run in families.
Cataracts are accelerated by environmental factors, such as smoking or exposure
to other toxic substances, or they may develop at any time after an eye injury.
Metabolic diseases such as diabetes also greatly increase the risk for cataracts.
Certain medications, such as cortisone, can also accelerate cataract formation.
Congenital cataracts may be inherited. The gene for such cataracts is
dominant (autosomal dominant inheritance), which means that the defective
gene will cause the condition even if only one parent passes it along.
Approximately 50% of children in such families will be affected.
Congenital cataracts can also be caused by infections of the mother during
pregnancy such as rubella, or associated with metabolic disorders such as
galactosemia. Risk factors include inherited metabolic diseases, a family
history of cataracts, and maternal viral infection.
Adult cataracts are generally associated with aging. They develop slowly
and painlessly with a gradual onset of difficulty with vision.
Visual problems may include the following changes:
O Difficulty seeing at night
O Seeing halos around lights
O Being sensitive to glare.
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Vision problems associated with cataracts generally progress to decreased

visual acuity, even in daylight.
Adult cataracts are classified as immature, mature, and hypermature. A
lens that has some remaining clear areas is referred to as an immature
cataract. A mature cataract is completely opaque. A hypermature cataract
has a liquefied surface that leaks through the capsule and may cause
inflammation of other structures in the eye.
Most people develop some clouding of the lens after the age of 60. About
50% of people aged 65-74 and about 70% of those 75 and older have
visually significant cataracts.
Most people with cataracts have similar changes in both eyes, although
one eye may be worse than the other. Many people with this condition
have only minimal visual changes and are not aware of their cataracts.
Factors that may contribute to cataract development are low serum calcium
levels, diabetes, long-term use of corticosteroids, and various inflammatory
and metabolic disorders. Environmental causes include trauma, radiation
exposure, and excessive exposure to ultraviolet light (sunlight).
In many cases, the cause of cataract is unknown.
Symptoms
O Cloudy, fuzzy, foggy, or filmy vision
O Loss of color intensity
O Frequent changes in eyeglass prescription
O Impaired vision at night, especially while driving
O Problems with glare from lamps or the sun
O Halos around lights
O Double vision in one eye
O Decreased contrast sensitivity.
Signs and tests

O Standard ophthalmic exam, including slit lamp examination
O Ultrasonography of the eye in preparation for cataract surgery.
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Other tests that may be done (rarely) include:

O Glare test
O Contrast sensitivity test
O Potential vision test
O Specular microscopy of the cornea in preparation for cataract surgery.
Treatment
MODERN MEDICINE
Eye drops (containing phenylephrine and homatropine) may be prescribed

to dilate the pupil and provide better vision in some individuals. Aldose
reductase inhibitors may help prevent or delay cataract formation in people
with diabetes. Antibiotics and steroid eye drops may be prescribed following
the removal of cataracts.
Surgery
The best treatment for cataract is surgical removal. Cataract surgery consists
of removing the lens of the eye and replacing it with an artificial lens.
Lens R emo
emovval: There are 2 types of surgery that can be used to remove
Remo
lenses that have a cataract.
Extracapsular surgery consists of surgically removing the lens, but leaving
the back half of the capsule (the outer covering of the lens) intact. High-
frequency sound waves (phacoemulsification) may be used to soften the
lens to facilitate removal through a smaller incision.
Intracapsular surgery involves surgically removing the entire lens, including
the capsule. Today this procedure is done very rarely.
Lens R eplacement: People who have cataract surgery are usually fitted with
Replacement:
an artificial lens at the same time. The artificial lens is a synthetic disc
called an intraocular lens. It is usually placed in the lens capsule inside the
eye. Other options include contact lenses and cataract glasses.
AYURVEDA
Maha Triphala Ghrita consisting of ghee with Triphala is used for the
treatment of cataract. This medicine acts very well only in the first stage of
372
Eye Diseases
Diseases
the development of cataract. This medicated ghee is given to the patient in

a dose of two teaspoonfuls, twice daily, about one hour before taking food
mixed with a cup of warm milk.
Chandrodaya varti is used externally in this condition. Over a clean stone
it is rubbed with a little water and the paste is applied in the form of a
collyrium. It is a slight irritant, therefore, it promotes blood circulation
and lacrimation in the eyes. The collyrium also provides nourishment to
the tissues of the eye.
HOMEOPATHY
Calcar ea carbonica: This remedy may be indicated when a person developing
Calcarea
cataracts has the feeling of looking through a mist.
Calcar ea fluorica: This remedy is often indicated when tissues harden or
Calcarea
thicken abnormally. A person needing this remedy may also have a tendency
toward hard swollen lymph nodes, joint pains, fibrous growths, or bone-
spurs.
Causticum: This remedy has been helpful in some cases when the person
developing cataracts also had problems moving the eyes, as if the muscles
around the eyeballs were stiff or weak—especially after getting cold in the
wind or open air. The person may have a feeling of sand in the eyes. A
person who needs this remedy may tend to have muscular stiffness in many
body areas.
Natr um muriaticum: This remedy may be indicated when cataracts begin
atrum
to develop. The muscles around the eyes can feel bruised and weak, especially
when the person looks down. The person may have a feeling of gauze across
the eyes, and parts of the field of vision may be hard to focus on.
Phosphor us: People who need this remedy may have a feeling that dust or
hosphorus:
mist in the eyes is obscuring vision, or may experience soreness that feels
like eyestrain after very little use. They sometimes see little bright dots of
colored light when the eyes are closed.
Silicea (also called SSilica):
ilica): This remedy has been helpful to some individuals
who developed cataracts after extended periods of eyestrain.
373
NATUROPATHY
Naturopathy advises following herbs to prevent cataract formation:

B i l b e r r y is high in the Bioflavonoid complex anthocyanosides.
Anthocyanosides protect both the lens and the retina from oxidative
damage. This bioflavonoid also helps with adaptation to bright light and
improves night vision. The potent antioxidant activity of anthocyanosides
make it useful for reducing the risk of cataracts.
Cur cumin may also prevent cataracts. The lenses of the eyes of rats fed a
urcumin
diet supplemented with Curcumin are significantly more resistant to free
radical damage and the development of cataracts, according to researchers
from the University of Texas Medical Branch, Galveston.
NUTRITION THERAPY
Vitamin B2 deficiency is linked to cataracts. Vitamin B2 and vitamin B3

are needed to protect glutathione, an important antioxidant in the eye.
Older people taking vitamin B2 and vitamin B3 per day may be partly
protected against cataracts. Glutathionine supplements may protect against
UV light; selenium supplements also help keep glutathionine in its active
form.
Antioxidants may protect the lens against damage caused by free radicals.
Dark leafy greens, orange and yellow vegetables, vitamins A and C, and
beta-carotene are good sources of antioxidants. Dark berries, particularly
blueberries, may also help protect the lens. Vitamin E may also protect
the lens against free radical damage.
Prevention
The primary prevention involves controlling associated diseases and avoiding
exposure to factors known to promote cataract formation.
Wearing sunglasses when you are outside during the day can reduce the
amount of UV light your eyes are exposed to. Some sunglasses do not filter
out the harmful UV. An optician should be able to tell you which sunglasses
filter out the most UV. For patients who smoke cigarettes, quitting will
decrease the risk of cataracts.
374
9
UROGENITAL DISEASES
UROGENITAL
Cystitis/UTI
Urolithiasis
Renal Failure
Benign Enlargement of Prostrate
Urinary Incontinence
Impotence
Infertility
375
CYSTITIS/UTI
A urinary tract infection, or UTI, is an infection that can happen anywhere
along the urinary tract - the kidneys, the ureters, the bladder, or the urethra.

Cystitis, a common condition, is usually caused by bacteria from the anus
entering the urethra and then the bladder. This leads to inflammation and
infection in the lower urinary tract.
Certain people are more likely to get UTIs. Women tend to get them 10
times more often because their urethra is shorter and closer to the anus.
Elderly people (especially those in nursing homes) and people with diabetes
also get more UTIs.
In addition, the following risk factors increase the chances of getting a
UTI:
O Pregnancy and menopause

O Kidney Stones
O Sexual intercourse, especially if you have multiple partners or use
a diaphragm for birth control.
O Prostate inflammation or enlargement.
O Narrowed urethra
O Immobility (for example, during recovery from a hip fracture)
O Not drinking enough fluids
O Bowel incontinence
O Catheterization.
Some children develop UTIs. In boys, they are most common before the
first birthday. In young girls, UTIs are most common around age 3,
overlapping with the toilet training period. Cystitis in children can be
promoted by abnormalities in the urinary tract. Therefore, children with
cystitis, especially those under age 5, deserve special follow-up to prevent
later kidney damage.
376
Urogenital Diseases
Symptoms
The symptoms of a UTI include:
O Pressure in the lower pelvis
O Pain or burning with urination
O Frequent or urgent need to urinate
O Need to urinate at night
O Cloudy urine
O Blood in the urine
O Foul or strong urine odor.
Young children with UTIs may only have fever or even no symptoms at all.
Additional symptoms may include:
O Painful sexual intercourse
O Penis pain
O Flank (side) pain, vomiting
O Fever and chills (may be a sign of kidney involvement)
O Mental changes or confusion (in the elderly) often are the only
signs of a urinary tract infection; possible spread to the blood should
be considered).
Signs and tests

Tests generally include taking a urine sample:
O A urinalysis commonly reveals white blood cells (WBC) or red
blood cells (RBC).
O A urine culture (clean catch) or catheterized urine specimen may
be performed to determine the type of bacteria in the urine and
the appropriate antibiotic for treatment.
Treatment
MODERN MEDICINE
A mild case of cystitis may resolve on its own without treatment. Because
377
of the risk of the infection spreading to the kidneys, however, antibiotics

are usually recommended. In children, cystitis should be treated promptly
with antibiotics to protect their developing kidneys. In the elderly, prompt
treatment is recommended due to the greater chances of fatal complications.
Commonly used antibiotics include: Nitrofurantoin, Cephalosporins, Sulfa
drugs (sulfonamides), Amoxicillin, Trimethoprim-sulfamethoxazole,
Doxycycline (should not be used under age 8) and Quinolones (should
not be used in children).
A chronic or recurrent UTI should be treated thoroughly because of the
chance of kidney infection. Antibiotics may need to be given for a long
period of time (as long as 6 months to 2 years), or stronger antibiotics may
be needed than for single, uncomplicated episodes of cystitis.
Phenazopyridine hydrochloride (pyridium) may be used to reduce the
burning and urgency associated with cystitis. In addition, acidifying
medications such ascorbic acid may be recommended to decrease the
concentration of bacteria in the urine.
If an anatomical abnormality is present, surgery to correct the problem
may be recommended.
AYURVEDA
The most important drug used for this condition is Shilajit, followed by
the compound preparation Chandraprabha Vati. Other prescriptions for
painful or scanty urine are:
O 1 gm each of Eladi Churna and Shweta Parpat and 1/2 gm of
Yavakshara to be taken four times daily with decoction of
Pashanabhedada
O 240 mg of Mutrakrichhakantaka Rasa and 2 gm of Shweta Parpati
to be taken with Amritadi Quath six times daily.
If dysuria is due to vitiation of pitta or kapha, the following drugs should
be administered:
O 240 mg each of Trinetra Rasa and Chandrakala Rasa, and 2 gm of Sheetala
Parpati to be taken thrice daily with Trinapanchamula Quath
378
Urogenital Diseases
O 240 mg of Khasoraka Yoga and 500 mg each of Varundya Lauha

and powder of cardamom seeds to be taken thrice daily with honey
O 240 mg of Mutrakrichhantaka Rasa and 120 mg of Varitara Lauha
Bhasma to be taken thrice daily with honey
O 500 mg each of Shilajit and powder of cardamom seeds to be taken
thrice daily with honey.
In case there is discharge of blood with the urine, the following prescription
is the best:
O 120 mg of Rasa Sindura and 10 gm of honey or Trikantakadya
Ghrita to be taken thrice daily.
ACUPUNCTURE
O Baihui (Du 20)
O Local points: Zhongji (Ren 3), Guanyuan (Ren 4), Ciliao (U.B. 32)
O Distal points: Sanyinjiao (Sp. 6), Yinlingquan (Sp. 9), Zusanli
(St. 36), Weizhong (U.B. 40)
O Specific points for infection: Dazhui (Du 14), Quchi (L.I. 11).
HOMEOPATHY
Aconitum apellus: This remedy is often useful when a person feels anxious
both before and during urination, with hot, scanty urine, and a burning
or spasmodic feeling in the outlet of the bladder. It can also be helpful if
retention of urine occurs.
Apis mellifica: This remedy is indicated when the person frequently needs
to urinate, but only small quantities are passed. Stinging and burning
sensations are felt (especially with the last few drops) and the person may
also experience soreness in the abdomen.
Belladonna: This remedy may be beneficial if the urge to urinate is frequent
and intense, and the bladder feels very sensitive. A cramping or writhing
sensation may be felt in the bladder area. Small amounts of highly-colored
urine is passed often. (This remedy is sometimes helpful if a person passes
small amounts of blood and no serious cause can be found on medical
examination.)
379
Berberis vulgaris: Cystitis with twinges of cutting pain, or a burning feeling

that extends to the urethra and its opening, may indicate a need for this
remedy. The passage may also burn at times when no attempt at urination
is being made. After emptying the bladder, the person feels as if some
urine still remains inside.
Cantharis: Strong urge to urinate—with cutting pains that are felt before
the urine passes, as well as during and after—may indicate a need for this
remedy. Only several drops pass at a time, with a scalding sensation. The
person may feel as if the bladder has not been emptied, still feeling a
constant urge to urinate.
Borax: This remedy can be helpful for cystitis with smarting pain in the
urinary opening and aching in the bladder, with a feeling that the urine is
retained. Children may cry or shriek, afraid to urinate because they know
the pain is coming.
Chimaphila umbellata: If a person has a troublesome urge to urinate but
has to strain (or even stand up and lean forward) to make it pass, this
remedy may be useful. A scalding sensation may be felt while the urine
flows, with a feeling of straining afterward.
Clematis: This remedy may be indicated if a person has to urinate frequently
with only a small amount being passed. A feeling of constriction is felt in
the urinary passage, and the flow may be interrupted, or there may be
dribbling afterward. A tingling sensation may occur, lasting long after
urination is finished.
Equisetum: If cystitis is accompanied by dull but distressing pain and a
feeling of fullness in the bladder, even after urinating, this remedy may be
helpful. Urging and discomfort are more intense when the bladder has
recently been emptied, improving over time as the bladder become fuller.
Ly copodium: This remedy may be helpful if a person has to urinate
frequently during the night and passes large amounts of urine. Or the
person may feel a painful urge, but has to strain to make the urine flow.
Pain may be felt in the back before the urine passes. (If fever is present, the
urine has a reddish color, or discomfort is felt in the kidney region, the
person should see a doctor.)
380
Urogenital Diseases
Nux vomica: Irritable bladder with a constant need to urinate, passing

only small amounts, suggests a need for this remedy. Burning or cramping
pain may be felt in the bladder area, with an itching sensation in the
urethra while the urine passes.
Sarsaparilla: This remedy is often useful in cystitis and often helps when
symptoms are unclear, or if other remedies have not been effective. Frequent
urging is felt, with burning pain at the end of urination. Urine passes
when the person is standing up, but only dribbling occurs while sitting.
Flakes or sediment are sometimes seen in the urine. (Sarsaparilla is
sometimes helpful when stones are forming or the kidneys are involved;
however, these conditions need a doctor’s care.)
Sepia: This remedy may be helpful if a person has to urinate frequently,
with sudden urging, a sense that urine will leak if urination is delayed, and
small amounts of involuntary urine loss. The person may experience a
bearing-down feeling in the bladder region, or pressure above the pubic
bone. A person who needs this remedy often feels worn-out and irritable,
with cold extremities, and a lax or sagging feeling in the pelvic area.
Staphysagria: This remedy is often indicated for cystitis that develops in a
woman after sexual intercourse, especially if sexual activity is new to her, or
if cystitis occurs after every occasion of having sex. Pressure may be felt in
the bladder after urinating, as if it is still not empty. A sensation that a
drop of urine is rolling through the urethra, or a constant burning feeling,
are other indications. Staphysagria is also useful for cystitis that develops
after illnesses with extended bed rest, or after the use of catheters.
NATUROPATHY
A balanced diet with plenty of vegetables and fruits, whole grains, sprouts,
and enough fluids is necessary. Avoid all simple sugars, refined foods,
concentrated fruit juices. Take garlic and onion as they have antibiotic
properties. Drink plenty of water, at least 3 liters a day.
Drink Cranberry or blueberry juice – 2 to 4 glasses daily. Cranberries and
blueberries contain substances that inhibit the binding of bacteria to bladder
tissue. Drinking unsweetened cranberry juice regularly seems to help lower
the risk of UTIs and can help cure one if you drink it when you first feel
symptoms.
381
Following herbs helps in controlling cystitis:

O Urinary antiseptics are antimicrobial: uva ursi (Arctostaphylos uva
ursi), buchu (Agathosma betulina), thyme leaf (Thymus vulgaris),
and pipsissewa (Chimaphila umbellata)
O Urinary astringents tone and heal the urinary tract: horsetail
(Equisetum arvense), plantain (Plantago major)
O Urinary demulcents soothe the inflamed urinary tract: corn silk
(Zea mays), couch grass (Agropyron repens)
O Marshmallow root (Althaea officinalis) is best used alone in a cold
infusion. Soak 1 heaped tbsp. of marshmallow root in 1 qt. of cold
water overnight. Strain and drink during the day in addition to
any other herbal tea
O For advanced or recurrent infections prepare a tincture of equal
parts of goldenseal (Hydrastis canadensis) and coneflower (Echinacea
purpurea). Take 30 drops four to six times per day.
Hydrotherapy
Hot abdominal compress for 10 minutes 3 to 4 times a day.
Hot immersion bath, hot sitz bath relieves pain [add Neem (Azadirachta
indica) leaves decoction to water]
NUTRITION THERAPY
Drink a lot of fluids, such as herbal teas and water. Avoid sweetened fruit
juices and other sweetened drinks. Eliminate refined foods, fruit juices,
caffeine, alcohol, and sugar.

O Vitamin C (250 to 500 mg two times per day) makes urine acidic,
which inhibits bacterial growth
O Beta-carotene (25,000 to 50,000 IU per day) is necessary for
immune function and mucous membrane integrity
O Zinc (30 to 50 mg per day) supports immune function.
382
Urogenital Diseases
Prevention
O Keep your genital area clean. Wipe from front to back
O Urinate after sexual intercourse
O Avoid fluids that irritate the bladder, like alcohol and caffeine
O Do not douche or use similar feminine hygiene products
O Wear cotton undergarments.
UROLITHIASIS (KIDNE
UROLITHIASIS Y ST
(KIDNEY ONES)
STONES)
Urolithiasis is a condition in which one or more stones are present in the
pelvis or calyces of the kidney or in the ureter. These stones occur four
times more often in men than in women

Kidney stone formation may result when the urine becomes overly
concentrated with certain substances. These substances in the urine may
complex to form small crystals and subsequently stones. Stones may not
produce symptoms until they begin to move down the ureter, causing
pain. The pain is severe and often starts in the flank region and moves
down to the groin.
Kidney stones are common. About 5% of women and 10% of men will
have at least one episode by age 70. Kidney stones affect about 2 out of
every 1,000 people. Recurrence is common, and the risk of recurrence is
greater if two or more episodes of kidney stones occur. Kidney stones are
common in premature infants.
A personal or family history of stones is associated with increased risk of
stone formation. Other risk factors include renal tubular acidosis and
resultant nephrocalcinosis.
Some types of stones tend to run in families. Some types may be associated
with other conditions such as bowel disease, ileal bypass for obesity, or
renal tubule defects.
O Calcium stones are most common, accounting for over 75% of all
stones. They are two to three times more common in men, usually
383
appearing at age 20 to 30. Recurrence is likely. The calcium may

combine with other substances such as oxalate (the most common
substance), phosphate, or carbonate to form the stone. Oxalate is
present in certain foods. Diseases of the small intestine increase
the tendency to form calcium oxalate stones.
O Uric acid stones are also more common in men. They are associated
with gout or chemotherapy. Uric acid stones make up about 10%
of all stones.
O Cystine stones may form in persons with cystinuria. It is a hereditary
disorder affecting both men and women.
O Struvite stones are mainly found in women as a result of urinary
tract infection. They can grow very large and may obstruct the
kidney, ureter, or bladder.
Symptoms
O Progressive colicky (spasm-like) flank pain or back pain on one or
both sides. It may radiate or move to pelvis, groin, genitals
O Nausea, vomiting
O Urinary frequency/urgency, increased (persistent urge to urinate)
O Painful urination
O Excessive urination at night
O Urinary hesitancy
O Testicle pain or Groin pain
O Fever, Chills
O Blood in the urine.
Signs and tests
Pain may be severe enough. There may be tenderness when the abdomen
or back is touched. If stones are severe, persistent, or recurrent, there may
be signs of kidney failure.
O Straining the urine may capture urinary tract stones when they
are excreted
O Analysis of the stone shows the type of stone
384
Urogenital Diseases
O Urinalysis may show crystals and red blood cells in urine

O Uric acid elevated
Stones or obstruction of the ureter may appear on:
O Kidney ultrasound
O IVP (intravenous pyelogram)
O Abdominal X-rays
O Retrograde pyelogram
O Abdominal CT scan
O Abdominal/kidney MRI.
Tests may reveal high levels of calcium in the blood or urine.
Treatment
Treatment goals include relief of symptoms and prevention of further
symptoms. (Kidney stones usually pass on their own). Treatment varies
depending on the type of stone and the extent of symptoms and/or
complications. Hospitalization may be required if symptoms are severe.
When the stone passes, the urine should be strained and the stone saved
for analysis to determine the type.
Drink enough fluids to produce a high urinary output. Water is encouraged,
at least 6 to 8 glasses per day.
MODERN MEDICINE
Small calculi do not need any specific treatment and they may pass out
spontaneously. Bigger stones may need surgery. Analgesics (pain relievers)
may be needed to control renal colic (pain associated with the passage of
stones).
O Narcotics, analgesics and antispasmodics to control severe pain
O Allopurinol, 100 to 300 mg daily to control hyperuricemia
O Potassium citrate, 100 mEq tablets twice daily to raise urinary pH
O Hydrochlorothiazide, 25 to 50 mg daily for calcium type I stones
O Cellulose sodium phosphate 10 g daily for calcium type II stones;
to decrease bowel absorption
385
O Orthophosphates for calcium type III stones; to inhibit vitamin B

synthesis.
Surgery
Surgery is recommended for patients with severe pain that does not respond
to medications, for those with serious bleeding, and persistent fever, nausea,
or significant urinary obstruction. If no medical treatment is provided after
surgery, stones recur in 50% of patients within five years.
O Ureteroscopy—a diagnostic procedure for identifying stones in
lower third of ureter.
O Extracorporeal Shock Wave Lithotripsy (ESWL)—an outpatient
procedure in which shock waves are used to shatter stones under 2
cm.
O Percutaneous nephrolithotripsy—a surgical procedure for removing
large or dense kidney stones; instruments are inserted into the
kidney to break up stones.
AYURVEDA
Pashanabheda (Bergenia ligulata) is the herb of choice for the treatment of
stones in the kidney or the bladder. One teaspoonful of the powder of the
root of this drug is given thrice daily. A decoction of the drug may also be
given in 50 ml doses, thrice daily. Gokshura (Tribulus terrestries) is drug of
choice for this condition. Powder of the seed of the drug is administered
in one-teaspoonful doses twice a day. In case urine is obstructed by a stone
in the urinary tract, Gokshuradi Guggulu is the drug of choice.
Decoction of bark of three leaved caper (Varuna), ginger, puncture vine
(Gokshura), Chebulic myrobalan, bark of drum stick plant (Shobhanjan)
and Premna mucronata (Agnimantha) should be given in the dose of 30 ml
thrice daily.
Decoction of three leaved coper (Varun), ginger and puncture vine fruits
should be given along with purified Potassium carbonate (Yavakshar) and
jaggery in the dose of 30 ml thrice daily.
Decoction of root of Bergenia lingulata (Pashan bheda) should be given in
the dose of 30 ml. twice daily
386
Urogenital Diseases
Decoction of root of Asparagus racemosus should be given in the dose of 15

ml. thrice daily along with milk.
Paste of root of Katuki (Holarrhena antidysentrica) in curd should be taken
in the dose of 5 gms daily.
Powder of fruits of Puncture vine (Gokshur) should be given in the dose of
1 gm. thrice daily along with the honey.
Powder of turmeric should be taken with jaggery in the dose of 1 gm.
thrice daily.
Some preparations available in market are Gokshuradi Kwath, Gokshuradi
guggul, Varunadi ghrita etc.
Other medicines like Shwetha Parpati, Chandraprabhavati, Shilajit, Pravala
Bhasma, Vanga Bhasma are also useful.
ACUPUNCTURE
Strong manual stimulation should be done at Hegu (LI.4) and Shuiquan
(K.5) to reduce pain. After the pain is relieved, the needles should be
inserted at following Acupuncture points:
O Baihui (Du 20)
O Local points: Shenshu (UB 23), Yaoyangguan (Du.3), Dachangshu (U.B.
25), Pangguanshu (U.B. 28), Ciliao (U.B. 32), Zhibian (U.B. 54)
O Distal points: Sanyinjiao (Sp. 6), Weizhong (U.B.40), Zusanli
(St. 36), Taixi (K.3).
HOMEOPATHY
O Berberis for sharp sticking pains that radiate to your groin
O Colocynthis for restlessness and pain that feels better when you
bend forward
O Ocimum for nausea and vomiting from the pain
O Pennyr oyal for frequent urination and left-sided ureter spasm or
ennyro
stone
O Cantharis for urine that burns and is passed drop by drop.
387
NATUROPATHY
The basic principle in the treatment of kidney stones is to increase fluid
intake with fluids like water, barley water, coconut water, fruit juices, etc.
so that 3000 ml of urine is passed per day. Dilute urine also avoids
concentration of solids and precipitation of crystals.
Juices like banana tree stem juice, tender coconut water, watermelon juice
and radish juice helps in preventing and passing out the stones.
O For acute pain relief, combine tinctures of wild yam (Dioscorea
villosa), cramp bark (Viburnum opulus), kava (Piper methysticum),
and Jamaica dogwood (Piscidia piscipula). Take 15 drops every 15
minutes for up to 8 doses.
O Drink an infusion of equal parts of gravel root (Eupatorium
purpureum), corn silk (Zea mays), and kava. Use 1 tsp. of herb
mixture per 1 cup water. Drink 3 to 4 cups per day.
O Stone root (Collinsonia canadensis): Strong diuretic with a history
of use in acute and preventative treatment of kidney stones.
O Khella (Ammi visnagi): Has a long tradition in the treatment of
kidney stones. Scientific research has demonstrated that the herb
may work as a calcium channel blocker–type antispasmodic, which
targets and relaxes ureter tissue. This may allow easier passage of
small stones.
O Bearberry (Arctostaphylos uva-ursi): Acts as a diuretic and antiseptic
for the urinary tract.
Food rich in calcium, phosphates, oxalates and purines are mentioned below.
These cause kidney stones and should be avoided.
Calcium Phosphates Oxalates Purines
Leafy vegetables, Whole cereals, bran, Leafy vegetables, Meat, fish, animal
milk and its legumes, nuts, oil grapes, tea, tissues and organs
products, small fish seeds, banana, carrot, chocolates, cocoa, (kidney, liver,
with bones, prawns, meat, fish, egg, milk coffee, cola drinks, brain, heart).
crabs and ragi. and its products, eggs, beef, cashew nuts,
cheese, organ meat, beetroot, Yam.
soft drinks.
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Urogenital Diseases
When stones are composed of calcium, magnesium phosphate and carbons,

the urine is alkaline and hence acid ash diet is used. When calcium
phosphate urolithiasis is associated with hyperthyroidism or
hypothyroidism, the ash is of little relevance.
Acid producing Alkali producing Neutral producing
Bread, especially whole Milk, fruits, veg, almonts, Butter, coffee, fats,
wheat, cereals, cheese, apricots dried, beans, beet, sugar, tapioca, tea.
corn, eggs, lentils, macroni, greens, dates, figs, peas dried,
spaghetti, noodles, meat, raisins, spinach Food
fish, poultry, peanuts, rice prepared with baking
walnuts powder or baking soda.
Hydrotherapy
O Hot abdominal compress for 10 minutes 3 to 4 times a day.
O Hot immersion bath, hot sitz bath dilates the urinary tract, relieves
pain and helps in passing out the stones.
NUTRITION THERAPY
Reduce your intake of sugar, refined foods, animal products (meats and
dairy), caffeine, alcohol, soda, and salt. Drink more water and eat more
fiber, vegetables, whole grains, and vegetable proteins. Cut down on oxalate-
containing foods such as spinach, rhubarb, beets, nuts, chocolate, black
tea, wheat bran, strawberries, and beans. Include foods rich in magnesium
and low in calcium, such as barley, bran, corn, rye, oats, soy, brown rice,
avocado, banana, and potato.
A more detailed list of foods to avoid include:
Calcium: Leafy vegetables, milk products, fish with bones, ragi beans,
cauliflower, potatos, figs.
Oxalate: Leafy vegetables, grapes, tea, chocolates, cocoa, coffee, cold drinks,
beef cashew nuts, beetroot, gram, beans, plums, chickoo, custard apple,
ground nut, tomatos, strawberries.
Uric A cid: Fish, salmon, herring, sardines, kidney, liver, meat soups, sweet
Acid:
bread.
389
Proper hydration helps prevent the urine from becoming concentrated

with crystals, which can lead to stone formation; and reduces the risk for
urinary tract infections, which may lessen the risk for struvite stones. Urine
color can indicate the level of concentration: dark or bright yellow urine
indicates highly concentrated urine; pale or colorless urine indicates dilute
urine.

O Magnesium citrate (200 to 400 mg per day) may increase the
solubility of calcium oxalate and calcium phosphate
O Pyridoxine (B6, 10 to 100 mg per day) is essential for the
metabolism of oxalic acid, a component of some stones
O Folic acid (5 mg per day) helps break down uric acid stones.
PHYSICAL THERAPY
Castor oil pack: used externally, castor oil is a powerful anti-inflammatory.
Apply oil directly to skin, cover with a clean soft cloth (for example, flannel)
and plastic wrap. Place a heat source (hot water bottle or heating pad) over
the pack and let sit for 30 to 60 minutes. For best results, use for three
consecutive days.
Hot pack: Placed over the affected area, hot packs can relax muscles that
are tense from pain and spasm, allowing for easier passage of the stone. Use
caution in the elderly and diabetics, as they are less sensitive to heat and
may be burned.
Hot vinegar pack: Indicated for severe pain: use a 50:50 vinegar-water
solution and place over affected area.
Prevention
If there is a history of stones, fluids should be encouraged to produce
adequate amounts of dilute urine (usually 10 to 14 glasses of water per
day). Depending on the type of stone, in addition, a diet low in calcium,
oxalate and uric acid foods is advised. Medications or other measures may
be recommended to prevent recurrence.
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RENAL FAIL
FAILURE
AILURE
Acute renal failure is sudden loss of the ability of the kidneys to excrete
wastes, concentrate urine, and conserve electrolytes.

The kidneys filter wastes and excrete fluid by using the bloodstream’s own
natural pressure. There are numerous potential causes of damage to the
kidneys:
O Decreased blood flow — this may occur when there is extremely
low blood pressure caused by trauma, complicated surgery, septic
shock, hemorrhage, or burns; associated dehydration; or other severe
or complicated illnesses
O Acute tubular necrosis (ATN) — may occur when tissues aren’t
getting enough oxygen or when the renal artery is blocked or
narrowed
O Over-exposure to metals, solvents, radiographic contrast materials,
certain antibiotics, and other medications or substances
O Myoglobinuria (myoglobin in the urine) — this condition may
be caused by rhabdomyolysis, alcohol abuse, a crush injury, tissue
death of muscles from any cause, seizures, and other disorders
O Direct injury to the kidney
O Infections such as acute pyelonephritis or septicemia
O Urinary tract obstruction, such as a narrowing of the urinary tract
(stricture), tumors, kidney stones, nephrocalcinosis or enlarged
prostate with subsequent acute bilateral obstructive uropathy
O Severe acute nephritic syndrome
O Disorders of the blood, such as idiopathic thrombocytopenic
purpura (ITP), transfusion reaction, or other hemolytic disorders,
malignant hypertension and disorders resulting from childbirth,
such as bleeding placenta abruptio or placenta previa can damage
the kidneys
O Autoimmune disorders such as scleroderma can cause acute renal
failure
391
O In young children, hemolytic uremic syndrome is an increasingly

common cause of acute renal failure. A toxin-secreting bacterium,
Escherichia coli, found in contaminated undercooked meats, has
been implicated as the cause of hemolytic uremic syndrome.
Symptoms
O Decreased urine output and decreased urine volume (oliguria) or
no urine output (anuria)
O Urination, excessive at night (can occur in some types of renal
failure)
O Generalized swelling, fluid retention
O Decrease in sensation, especially the hands or feet
O Decreased appetite
O Metallic taste in mouth
O Persistent hiccups
O Changes in Mental Status or mood like agitation, drowsiness,
lethargy, delirium or confusion, com
O Slow, sluggish, movements
O Seizures
O Hand tremor
O Nausea, vomiting may persist for days
O Prolonged bleeding, bruising easily like blood in stools, nosebleed
O Flank pain
O Fatigue
O Breath odor
O Breast development in males
O High blood pressure.
Signs and tests

Examination and testing can reveal acute renal failure and help rule out
other disorders that affect kidney function. In this condition, there is
generalized swelling caused by fluid retention.
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With a stethoscope, a heart murmur or other sounds related to increased

fluid volume may be heard and crackles may be heard from the lungs.
Also, if inflammation of the heart lining (pericarditis) is present, a pericardial
friction rub may be heard with a stethescope over the heart.
Lab values may change suddenly (within a few days to 2 weeks):
O Urinalysis may be abnormal
O Serum creatinine may increase by 2 mg/dL or more over a 2-week
period
O Creatinine clearance may be decreased
O BUN may increase suddenly
O Serum potassium levels may be increased
O Arterial blood gas and blood chemistries may show metabolic
acidosis
O Kidney or abdominal ultrasound is usually the best test, but
abdominal X-ray, abdominal CT scan or abdominal MRI may also
reveal the cause of acute renal failure. Kidney size is usually normal
or slightly large
O Chemical tests of blood and urine may also help to distinguish the
causes. A clean catch urine specimen will indicate if the cause is
infection within the urinary tract. Renal angiography (renal
arteriography) may be used to diagnose causes within the blood
vessels of the kidney.
Treatment
The goal of treatment is to identify and treat any reversible causes of the kidney
failure (e.g., use of kidney-toxic medications, obstructive uropathy, volume
depletion). Treatment also focuses on preventing excess accumulation of fluids
and wastes, while allowing the kidneys to heal and gradually resume their normal
function. Hospitalization is required for treatment and monitoring.
Fluid intake may need to be severely restricted to an amount equal to the
volume of urine you produce. Patient may be given specific dietary modifications
to reduce build-up of toxins normally handled by the kidneys, including a diet
plan high in carbohydrates and low in protein, salt, and potassium.
393
Antibiotics may be used to treat or prevent infection. Diuretics may be

used to remove fluid from the kidney.
A major priority in treatment is to control dangerous hyperkalemia
(increased blood potassium levels). A variety of different medications may
be used, including IV (intravenous) calcium, glucose/insulin, and oral or
rectal administration of potassium exchange resin (Kayexalate).
Dialysis may be used to remove excess waste and fluids. This often makes
the person feel better and may make the kidney failure easier to control.
Dialysis may not be necessary for all people, but is frequently lifesaving,
particularly if serum potassium is dangerously high.
Common symptoms that require the use of dialysis include decreased mental
status, pericarditis, increased potassium levels, total lack of urine production,
fluid overload, and uncontrolled accumulation of nitrogen waste products
(serum creatinine > 10 mg/dl and BUN > 120 mg/dl).
AYURVEDA
In mild renal failure, Dashamula Kashayam and Punarnavadi Kashayam are useful.
Gomutra haritaki and Chandraprabha Vati are also sometimes used.
HOMEOPATHY
Reports by Homeopathy doctors say that patient response is better in
those who have not yet started with dialysis. Long-term constitutional
therapy as well as therapy aimed at improving kidney function helps to
keep the patient relatively free of symptoms and complications.
Remedies such as Solidago and Urea have been found useful in dealing
with chronic renal failure and its complications. Hipuric acid has been
found to be useful for the itching of skin arising from chronic renal failure.
NUTRITION THERAPY
Renal failure patients are prescribed diet which is usually low in protein
and may be low-sodium, and low-potassium. It may also involve fluid
restriction. In diabetic patients with renal disease, a low carbohydrate diet
may also be used.
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Urogenital Diseases
The purpose of a diet that restricts protein is to decrease the protein load
on the kidney and slow down progression of renal disease. Sodium may be
restricted to improve blood pressure control and to avoid fluid accumulation.
Potassium is restricted because if it is not excreted effectively, it can
accumulate and result in dangerous heart rhythms.
This diet controls the amount of protein, sodium, and potassium. The
controlled amounts of each of these nutrients are based on the person’s
blood levels of potassium, sodium, and urea, as well as the fluid balance,
creatinine clearance, and blood pressure.
If the blood levels indicate the need to adjust the intake of calcium and
phosphorus, then the amounts allowed in the diet are changed. Fluid is
only restricted in patients who accumulate excessive volume.
The amount of protein allowed in the diet is determined by checking the
amount of protein (and protein waste byproducts) in the person’s blood.
The suggested amount of protein in a low protein diet is 0.6g/kg/day.
In patients who are losing large amounts of protein in their urine in diseases
(such as nephrotic syndrome), the kidney specialist will recommend a
moderate protein restriction of 0.8g/kg/day.
The daily intake of potassium is also a concern. Controlling it helps prevent
hypokalemia as well as hyperkalemia (a high level of potassium, a common
problem for people with renal disease).
The mineral phosphorus is often controlled as well. When the amount of
phosphorus is decreased by the reduced intake of dairy products and other
foods high in phosphorus, there is a need to provide calcium supplements
to prevent bone disease. The amount of phosphorus in the diet is controlled
by the use of phosphorus binders (medications that bind the phosphorus
in the food and make them unavailable to the body). Vitamin D
supplements may also be provided to help control the calcium and
phosphorus balance in the body.
During renal failure, the amount of urine the body produces may be
decreased. The recommended daily amount of fluid is based on the amount
of urine produced in a 24-hour period. Other considerations are the amount
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of fluid retention present, the level of dietary sodium, the use of diuretics,
and the presence or absence of congestive heart failure.
People with renal disease are more prone to cardiovascular (heart) disease,
so a diet with most of the calories from complex carbohydrates is
recommended. Calories from fats should be from monounsaturated and
polyunsaturated fats.
The daily calorie intake needs to be adequate to maintain the person’s
nutritional status at an optimal level and to prevent the breakdown of
body tissue. The person’s weight and protein status should be monitored
regularly, even daily.
Vitamin supplementation is very individualized. It is dependent on the various
dietary restrictions and the extent of renal failure. The requirements for the fat-
soluble vitamins (A, D, E, and K) are usually met by the diet. Vitamin D may
need to be supplemented — this is an individual medical decision. The intake
of water-soluble vitamins is usually adequate until a patient begins dialysis.
The minerals that are also monitored include calcium, iron, and magnesium.
The recommended supplementation of daily calcium is 1,000 to 1,500
milligrams per day. Iron supplementation is based on the person’s need.
There have been a variety of trials of omega-3 fatty acid supplementation
in patients with a variety of renal disorders. These trials suggest that such
therapy may be of use in the treatment of IgA nephropathy and chronic
renal failure. Dietary polyunsaturated fatty acid manipulation results in
an anti-inflammatory status.
Fish oil supplementation is promising and does not produce the risks
associated with corticosteroid and immunosuppressive drug use.
Alternative Medicine
Generally, kidney failure does not respond to alternative therapies. However,
complementary and alternative therapies may help speed recovery of some
forms of kidney disease and may help lessen the severity of symptoms.
Dandelion root helps cleanse toxic metabolites from the kidneys.
Recommended in take is 500 mg twice a day for six weeks; stop for one
month and then repeat.
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Urogenital Diseases
Celery and parsley seeds are natural diuretics. Taken in combination, they
are especially helpful if high uric acid levels are present in the blood.
Other herbs that are beneficial for kidney problems include goldenrod tea,
juniper berries, marshmallow root, nettle, parsley, red clover, and
watermelon seed tea.
Prevention
Treating any causative disorders may help to prevent acute renal failure.
Medicines like NSAID’s, steroids, gold medicines can cause renal failure.
Some improperly purified metal drugs used in Ayurveda and Siddha
medicines have been shown to cause renal failure. Avoid all unnecessary
medicines.
Some ways to help prevent or slow down the onset of chronic renal failure
include:
O Monitoring blood pressure regularly
O Following recommended treatments for chronic diseases such as
diabetes, lupus, and hypertension
O Not smoking - for people with diabetes, smoking can speed up
the damage to the small blood vessels in the body
O Not abusing over-the-counter medications
O Getting treatment for urinary tract infections or any type of urinary
problems as soon as possible
O Reducing autoimmunity activity.
BENIGN ENL AR
ENLAR GEMENT OF PR
ARGEMENT OSTRA
PROSTRATE
OSTRATE
The prostate gland produces the fluid that carries sperm during ejaculation.
As the prostate enlarges, which happens to almost all men as they get
older, it can press on the urethra (the tube that empties urine from the
bladder). This causes problems with urination.
Prostate enlargement is often called benign prostatic hypertrophy or
hyperplasia (BPH). It is not cancer and it does not put you at increased
risk for prostate cancer.
397

The actual cause of prostate enlargement is unknown. In addition to age,
overgrowth of the prostate seems to require normal function of the testicles,
which produce testosterone. This is known because men who have had
their testicles removed at a young age (for example, for testicular cancer)
do not develop BPH. Similarly, if the testicles are removed after a man
develops BPH, the prostate begins to shrink in size.
The likelihood of developing enlarged prostate increases with age. In fact,
BPH is so common that it has been said, “All men will have an enlarged
prostate if they live long enough!” A small amount of prostate enlargement
is present in many men over age 40 and more than 90% of men over age
80. No risk factors have been identified other than having normally
functioning testicles.
Symptoms
Less than half of all men with BPH have symptoms of the disease, which
include:
O Slowed or delayed start of the urinary stream
O Weak urine stream
O Dribbling after urinating
O Straining to urinate
O Strong and sudden urge to urinate
O Incomplete emptying of bladder
O Need to urinate 2 or more times per night
O Urinary retention (complete inability to urinate)
O Incontinence
O Pain with urination or bloody urine (these may indicate infection).
Signs and tests

O A digital rectal exam (where your doctor inserts a finger into the
rectum to feel the size and shape of the prostate gland) may reveal
an enlarged, firm prostate
O Urine flow rate may be measured
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O The amount of urine left in your bladder after urination may be

measured (This is called post-void residual urine)
O Pressure flow studies will measure the pressure in the bladder as
you urinate
O An IVP (an x-ray study) may be done to confirm the diagnosis or
look for blockage
O Urinalysis may be done to check for blood or infection
O Urine culture may be used to evaluate for infection
O Voiding cystourethrogram (another x-ray study) may be performed
O A prostate-specific antigen (PSA) blood test may be performed to
screen for prostate cancer
O Cystoscopy may be performed to visualize the prostate and bladder
if surgery is required.
Treatment
MODERN MEDICINE
The choice of a treatment is based on the severity of the symptoms, the
extent to which they affect daily life, and the presence of any other medical
conditions. Treatment options include “watchful waiting,” lifestyle changes,
medication, or surgery.
If a person is are over 60, he is more likely to have symptoms. But many
men with an enlarged prostate have only minor symptoms. Self-care steps
are often enough to feel better.
Patients with BPH should have a yearly exam to monitor the progression
of the symptoms to determine if any changes in treatment are necessary.
Medications
O Finasteride lowers levels of hormones produced by the prostate,
reduces the size of the prostate gland, increases urine flow rate,
and decreases symptoms of BPH. It may take 3 to 6 months before
the patient notices a significant improvement in the symptoms.
Potential side effects related to use of finasteride include decreased
sex drive and impotence.
399
O Alpha 1-Blockers (like doxazosin, prazosin, tamsulosin, and

terazosin) are a class of medications also used to treat high blood
pressure. These medications relax the muscles of the bladder neck,
allowing easier urination. Two thirds of the people treated with
alpha 1-blocker medications report an improvement in symptoms.
O Antibiotics may be prescribed to treat chronic prostatitis
(inflammation of the prostate), which may accompany BPH. Some
men note relief of their BPH symptoms after a course of antibiotics.
Very elderly and debilitated patients in whom surgery is contraindicated
may be given conservative treatment with depot progesterone.
Surgery
The choice of a specific surgical procedure is usually based on the severity
of symptoms and the size and shape of prostate gland.
O TURP: Transurethral resection of the prostate (TURP) is the most
common surgical treatment for BPH. The TURP is performed by
inserting a scope through the penis and removing the prostate
piece by piece.
O TUIP: Transurethral incision of the prostate (TUIP) is similar to
TURP, but is usually performed in men who have a relatively small
prostate. This procedure is usually performed as an outpatient
without need for a hospital stay. Like the TURP, a scope is inserted
through the penis until the prostate is reached. Then, rather than
removal of the prostate, a small incision is made in the prostatic
tissue to enlarge the opening of the urethra and bladder outlet.
O Open Prostatectomy: An open prostatectomy is usually performed
using general or spinal anesthesia. An incision is made through
the abdomen or perineal area (i.e., through the pelvic floor,
including the region from the scrotum to the anus). Then, the
prostate is removed. This is a lengthy procedure, and it usually
requires a hospital stay of 5 to 10 days.
O Various other procedures are available, such as those that destroy
prostate tissue with heat generated by microwaves or lasers.
Photoselective Vaporization of the Prostate (PVP), one of the newer
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laser technologies, is typically done as an outpatient procedure.

The patient goes home on the same day. Another form of treatment
is prostatic stents.
AYURVEDA
Decoction of Tinospora cordifolia bark, ginger powder, embelic myrobalan

and calotrops is useful in urinary obstruction, in the dose of 15 ml. thrice
daily.
Coconut water along with jaggery and coriander seeds is a good diuretic
and clears up the infected urine.
Fresh juice of embelic myrobalan should be taken along with cardamom

powder in the dose of 15 ml. thrice daily.
Decoction of fruits of puncture vine (Tribulus terrestris) acts as a very good

diuretic in the dose of 30 ml. twice daily.
The best general Ayurvedic herb is Gokshura, particularly when combined

with Ashwagandha. Shilajit is also useful. Other good herbs are bala,
kapikacchu, guggul and marshmallow.
The following two prescriptions are particularly useful in treating

enlargement of the prostate gland:
O 500 mg of Chandraprabha, 1 gm of Shweta Parpati, and 500 gm
of Yavakshara to be taken thrice daily with decoction of Gokharu.
O 240 mg of Varunadi Lauha and 120 mg of Gokshuradyavaleha to
be taken every twelve hours with cow’s milk.
ACUPUNCTURE
O Baihui (Du 20)
O Local points: Zhongji (Ren.3), Yaoyangguan (Du.3), Dachangshu
(U.B. 25), Pangguanshu (U.B. 28), Ciliao (U.B. 32), Zhibian (U.B.
54)
O Distal points: Sanyinjiao (Sp. 6), Weizhong (U.B.40), Zusanli
(St. 36), Taixi (K.3).
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HOMEOPATHY
Apis mellifica: Stinging pain during urination that is worse when the final
drops are passing is a strong indication for this remedy. Discomfort may
also involve the bladder. The prostate area is swollen and very sensitive to
touch. The person may feel worse from heat and from being in warm rooms,
with marked improvement from being out in open air or from a cool bath.
Causticum: Urine loss when the person coughs or sneezes often indicates a
need for this remedy. Once urine has started passing, the person may feel
pressure or pulsation extending from the prostate to the bladder. Causticum
is also indicated when sexual pleasure during orgasm is absent or
diminished.
Chimaphilla umbellata: This remedy is often helpful when the prostate is
enlarged, with urine retention and frequent urging. The person may have
the feeling that a ball is lodged in the pelvic floor, or experience pressure,
swelling, and soreness that are worse when sitting down.
Clematis: This remedy is often indicated when swelling of the prostate
seems to have narrowed or tightened the urinary passage. Urine usually
emerges slowly, in drops instead of a stream, with dribbling afterward.
Lycopodium: This remedy may be helpful if urine is slow to emerge, with
pressure felt in the prostate both during and after urination. The prostate
is enlarged, and impotence may also be a problem. People who need this
remedy often suffer from digestive problems with gas and bloating, and
have an energy slump in the late afternoon.
Pulsatilla: Prostate problems with discomfort after urination and pains that
extend to the pelvis or into the bladder (often worse when the man is lying on
his back) suggest a need for this remedy. There may also be a bland, thick,
yellow discharge from the penis.
Sabal serrulata: A frequent urge to urinate at night, with difficulty passing
urine, and a feeling of coldness in the sexual organs, suggest a need for this
remedy. It is sometimes also used in lower potencies for urinary incontinence
in older men. This remedy is made from saw palmetto, which is also used
as an herbal extract for similar prostate problems.
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Urogenital Diseases
Staphysagria: This remedy may be indicated if a man feels burning pain in

his urinary passage even when urine is not flowing, and urine retention is
troublesome. Men who are likely to respond to Staphysagria may also have
problems with impotence.
Thuja: When the prostate is enlarged, and the person has a frequent urge to
urinate, with cutting or burning pain felt near the bladder neck, this remedy
may bring relief. After urine passes, a dribbling sensation may be felt. A forked
or divided urine stream is sometimes seen when this remedy is needed.
NATUROPATHY
Mild enlargement of prostrate can be treated by Naturopathy. Following
herbs are used:
O Saw palmetto (Serenoa repens)—160 mg twice a day is difficult to
achieve in tea or tincture; extract standardized for 85 percent to
95 percent of fatty acids and sterols is recommended. Saw palmetto
is widely used in Europe
O Stinging nettle root (Urtica dioica)—Increases urinary flow and
volume. Daily dose of 4 to 6 g of drug or equivalent preparation
Hydrotherapy
O Hot abdominal compress for 10 minutes 3 to 4 times a day
O Hot immersion bath, hot sitz bath dilates the urinary tract, relieves
pain and helps in passing out the urine
O Contrast sitz baths. Sit in hot water for three minutes, then in
cold water for one minute. Repeat it three times to complete one
set. Do one to two sets per day, three to four days per week.
NUTRITION THERAPY
O Avoid alcohol, especially beer, and saturated fats
O Pumpkin seeds can help maintain a healthy prostate.

O Zinc (60 mg per day)—to reduce the size of the prostate
O Selenium (200 mcg per day)—antioxidant in the prostate
403
O Essential fatty acids (1,000 to 1,500 IU one to two times per

day)—anti-inflammatory, for optimum prostaglandin
concentrations
O B6 (100 to 250 mg per day)—reduces the elevated levels of
prolactin found in people who have BPH
O Amino acids glycine, glutamic acid, and alanine (200 mg per day
of each)—provide relief from symptoms.
PHYSICAL THERAPY
Kegel exercises (contracting and releasing the pelvic muscles).
Self Care
For mild symptoms:
O Urinate when you first get the urge. Also, go to the bathroom
when you have the chance, even if you don’t feel a need to urinate.
O Avoid alcohol and caffeine, especially after dinner.
O Don’t drink a lot of fluid all at once. Spread out fluids throughout
the day. Avoid drinking fluids within 2 hours of bedtime.
O Try not to take over-the-counter cold and sinus medications that
contain decongestants or antihistamines. These medications can
increase BPH symptoms.
O Keep warm and exercise regularly. Cold weather and lack of physical
activity may worsen symptoms.
O Learn and perform Kegel exercises (pelvic strengthening exercises).
O Reduce stress. Nervousness and tension can lead to more frequent
urination.
Sit in an aisle seat at the theatre or on an airplane. This won’t reduce your
symptoms, but it may relieve your anxiety about having to urinate often or
suddenly.
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Urogenital Diseases
URINARY INCONTINENCE
URINARY
Urinary incontinence is the inability to control the passage of urine. This
can range from an occasional leakage of urine, to a complete inability to
hold any urine.
The two main types of urinary incontinence are:
O Stress incontinence — occurs during certain activities like coughing,
sneezing, laughing, or exercise
O Urge incontinence — involves a strong, sudden need to urinate
followed by instant bladder contraction and involuntary loss of
urine. You don’t have enough time between when you recognize
the need to urinate and when you actually do urinate.
Considerations
Incontinence is most common among the elderly. Women are more likely
than men to have urinary incontinence.
Infants and children are not considered incontinent, but merely untrained,
up to the time of toilet training. Occasional accidents are not unusual in
children up to age 6 years. Young (and sometimes teenage) girls may have
slight leakage of urine when laughing.
Nighttime urination in children is normal until the age of 5 or 6.
Normal Urination
Urination
The ability to hold urine is dependent on having normal anatomy and a
normally functioning urinary tract and nervous system. You must also
possess the physical and psychological ability to recognize and appropriately
respond to the urge to urinate.
The process of urination involves two phases:
O The filling and storage phase
O The emptying phase
Normally, during the filling and storage phase, the bladder begins to fill
with urine from the kidneys. The bladder stretches to accommodate the
increasing amounts of urine.
405
The first sensation of the urge to urinate occurs when approximately 200
ml (just under 1 cup) of urine is stored. A healthy nervous system will
respond to this stretching sensation by alerting you to the urge to urinate,
while also allowing the bladder to continue to fill.
The average person can hold approximately 350 to 550 ml (over 2 cups) of
urine. The ability to fill and store urine properly requires a functional
sphincter (the circular muscles around the opening of the bladder) and a
stable, expandable bladder wall muscle (detrusor).
The emptying phase requires the ability of the detrusor muscle to
appropriately contract to force urine out of the bladder. At the same time,
your body must be able to relax the sphincter to allow the urine to pass
out of the body.
Common Causes
Incontinence may be sudden and temporary, or ongoing and long-term.
Causes of sudden or temporary incontinence include:
O Urinary tract infection or inflammation
O Prostate infection or inflammation
O Stool impaction from severe constipation, causing pressure on the
bladder
O Side effects of medications (such as diuretics, tranquilizers, some
cough and cold remedies, certain antihistamines for allergies, and
antidepressants)
O Increased urine amounts, like with poorly controlled diabetes
O Pregnancy
O Weight gain
O Short-term bed rest — for example, when recovering from surgery
O Mental confusion.
Causes that may be more long-term:
O Spinal injuries
O Urinary tract anatomical abnormalities
O Neurological conditions like multiple sclerosis or stroke
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Urogenital Diseases
O Weakness of the sphincter, this can happen following prostate

surgery in men, or vaginal surgery in women
O Pelvic prolapse in women — falling or sliding of the bladder,
urethra, or rectum into the vaginal space, often related to having
had multiple pregnancies and deliveries
O Large prostate in men
O Depression or Alzheimer’s disease
O Nerve or muscle damage after pelvic radiation
O Bladder cancer
O Bladder spasms.
Diagnosis
O Urinalysis
O Urine culture to check for infection if indicated
O Cystoscopy (inspection of the inside of the bladder)
O Urodynamic studies (tests to measure pressure and urine flow)
O Uroflow (to measure pattern of urine flow)
O Post void residual (PVR) to measure amount of urine left after
urination.
Other tests may be performed to rule out pelvic weakness as the cause of the
incontinence. One such test is called the Q-tip test. This test involves
measurement of the change in the angle of the urethra when it is at rest and
when it is straining. An angle change of greater than 30 degrees often indicates
significant weakness of the muscles and tendons that support the bladder.
MODERN MEDICINE
Medications that may be prescribed include drugs that relax the bladder,
increase bladder muscle tone, or strengthen the sphincter.
O Antibiotics—for UI from urinary tract infections or sexually
transmitted diseases
O Anticholinergics—relieve symptoms of UI but have high instances
of intolerable side effects
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O Cholinergics—relieve symptoms of UI but have intolerable side effects

O Sympathomimetics—for stress incontinence; various side effects
O Hormone replacement therapy—for stress incontinence; various
potentially serious side effects.
Surgery
Surgery may be required to relieve an obstruction or deformity of the
bladder neck and urethra. Uterine or pelvic suspension operations are
sometimes needed in women. Men may require prostatectomy (removal of
the prostate gland). Incontinence can sometimes be managed by artificial
sphincters. These are synthetic cuffs that are surgically placed around the
urethra to help retain urine.
If you have overflow incontinence or cannot empty your bladder completely,
a catheter may be recommended. But using a catheter exposes you to
potential infection.
ACUPUNCTURE
Acupuncture for urinary incontinence also shows promise. Research in
Japan showed impressive results from needling points in the sacral foramina,
and UK studies have shown benefits from sanyinjiao, an acupuncture point
near the ankle.
The following acu-points are useful: BL23, 31, 32, 33, KI3, SP6 and
LI11, all bilaterally.
HOMEOPATHY
Causticum for stress incontinence, especially with retention from holding
the urine and frequent urges to urinate.
Natrum muriaticum for stress incontinence, vaginal dryness and pain during
sex, especially with a history of grief.
Par eira for retention of urine from an enlarged prostate.
areira
Sepia for stress incontinence with sudden urge to urinate, especially with
prolapsed uterus and vaginitis.
Zincum for stress incontinence, urinary retention from prostate problems
and unable to urinate while standing.
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Urogenital Diseases
NATUROPATHY
Naturopathy advises kegel exercises and electric stimulation for
incontinence. Applying a cold pack on lower abdomen helps in preventing
bedwetting in children.
YOGA THERAPY
Yoga asanas helps in strengthening pelvic muscles and reducing
incontinence.
O Asanas:
O Mudras like Maha mudra, yoga mudra, etc.
O Bandha; Uddiyana bandha.
NUTRITION THERAPY
Eliminate caffeine, alcohol, sweetener substitutes, and simple sugars.
Cranberries and blueberries contain substances that keep bacteria from
adhering to the bladder. This may help prevent infections that can make
incontinence worse, and helps deodorize urine.
O Vitamin C (1,000 mg three times a day) keeps bacteria from
growing in urine
O Beta-carotene (25,000 to 50,000 IU per day) helps your immune
system function properly and keeps mucous membranes healthy
O Zinc (30 mg per day) supports immune function
O Calcium (1,000 mg per day) and magnesium (500 mg per day)
taken together may improve control of the muscles used in
urination.
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PHYSICAL THERAPY
The following methods are used to strengthen the muscles of your pelvic floor:
O Bladder retraining — this involves urinating on a schedule, whether
you feel a need to go or not. In between those times, you try to
wait to the next scheduled time. At first, you may need to schedule
1 hour intervals. Gradually, you can increase by 1/2 hour intervals
until you are only urinating every 3-4 hours without leakage.
O Kegel exercises — contract the pelvic floor muscles for 10 seconds,
then relax them for 10 seconds. Repeat 10 times. Do these exercises
3 times per day. You can do Kegel exercises any time, any place.
To find the pelvic muscles when you first start Kegel exercises, stop your
urine flow midstream. The muscles needed to do this are your pelvic floor
muscles. Do not contract your abdominal, thigh, or buttocks muscles. In
addition, do not overdo the exercises. This may tire the muscles out and
actually worsen incontinence.
Two methods called biofeedback and electrical stimulation can help you
learn how to perform Kegel exercises. Biofeedback uses electrodes placed
on the pelvic floor muscles, giving you feedback about when they are
contracted and when they are not. Electrical stimulation uses low-voltage
electric current to stimulate the pelvic floor muscles. It can be done at
home or at a clinic for 20 minutes every 1 to 4 days.
Biofeedback and electrical stimulation will no longer be necessary once
you have identified the pelvic floor muscles and mastered the exercises on
your own.
Vaginal cones enhance the performance of Kegel exercises for women. Other
devices for incontinence are also available.
Home Care
For leakage, wear absorbent pads or undergarments. There are many well-
designed products that go completely unnoticed by anyone but you.
Other measures include:
O Regulate your bowels to avoid constipation. Try increasing fiber in
your diet
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Urogenital Diseases
O Quit smoking to reduce coughing and bladder irritation. Smoking

also increases the risk of bladder cancer
O Avoid alcohol and caffeinated beverages, particularly coffee, which
can over stimulate the bladder
O Lose weight if you need to
O Avoid foods and drinks that may irritate your bladder like spicy
foods, carbonated beverages, and citrus fruits and juices
O Keep blood sugars under good control if you have diabetes.
Prevention
Performing Kegel exercises while you are pregnant and soon after delivery
may help prevent incontinence related to childbirth.
Even while Kegel exercises are specific isometric contracting exercises for
the pelvis and therefore most beneficial, a normal daily exercise schedule
has in it many exercises that contract the pelvis. These include all abdominal
exercises (sit ups, leg raises etc.) and also all lower back exercises including
back raise, reverse leg raises etc.
IMPOTENCE
IMPOTENCE
An erection problem is the inability to get or maintain an erection that is
firm enough for a man to have intercourse. You may be unable to get an
erection at all, or you may lose the erection during intercourse before you
are ready. If the condition persists, the medical term is erectile dysfunction.
Considerations
Erection problems are common in adult men. In fact, almost all men
experience occasional difficulty getting or maintaining an erection. In many
cases, it is a temporary condition that will go away with little or no
treatment. In other cases, it can be an ongoing problem that can damage a
man’s self esteem and harm his relationship with his partner, and thus
requires treatment.
If there is difficulty having or keeping an erection more than 25% of the
time, it is considered a problem.
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In the past, erection problems were thought to be “all in the man’s mind.” Men
often were given unhelpful advice such as “don’t worry” or “just relax and it will
take care of itself.” Today, doctors believe that when the problem is not temporary
or does not go away on its own, physical factors are often the cause.
One way to know if the cause is physical or psychologic is to determine if
you are having nighttime erections. Normally, men have 3 to 5 erections
per night, each lasting up to 30 minutes. Your doctor can explain a test to
find out if you are having the normal number of nighttime erections.
In most men, erection difficulties do not affect their sex drive.
Premature ejaculation (when orgasm comes on too quickly) is not the same
as impotence.
Male infertility is also quite different from impotence. A man who is unable
to maintain an erection may be very capable of producing sperm that could
fertilize an egg. An infertile man is usually able to maintain an erection,
but he may be unable to father a child due to problems with sperm count
or other factors.
Common Causes
An erection requires the interaction of your brain, nerves, hormones, and
blood vessels. Anything that interferes with the normal process can become
a problem. Common causes include:
O Diseases and conditions such as diabetes, high blood pressure, heart
or thyroid conditions, poor circulation, low testosterone, depression,
spinal cord injury, nerve damage (for example, from prostate surgery),
or neurologic disorders (like multiple sclerosis or Parkinson’s disease)
O Certain medications such as blood pressure medication (especially
beta-blockers), heart medication (such as digoxin), some peptic
ulcer medications, sleeping pills, and antidepressants
O Nicotine, alcohol, or cocaine
O Stress, fear, anxiety, or anger
O Unrealistic sexual expectations, which make sex a task rather than
a pleasure
O Poor communication with your partner
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Urogenital Diseases
O A “vicious cycle” of doubt, failure, or negative communication that

reinforces the erection problems.
Erection problems tend to become more common as you age, but it can
affect men at any age and at any time in their lives. Physical causes are
more common in older men, while psychological causes are more common
in younger men.
Tests that may be performed include:
O Urine analysis
O Blood tests, including CBC, metabolic panel, hormone profile, PSA
O Penile ultrasound (to evaluate for blood vessel or blood flow
problems)
O Nocturnal penile tuemscence (NPT) to test if patient is having
nighttime erections and rigidity monitoring (Rigiscan)
O Neurological testing
O Psychometric testing.
Treatment
The treatment depends on the cause. For example, if the problem is caused
by a hormonal imbalance, medication to treat the underlying endocrine
disorder will be prescribed.
MODERN MEDICINE
The treatment options include medication, injections into the penis,
vacuum devices, and surgery including penis implants.
Sildenafil (Viagra) is an oral medication for mild to moderate erection
difficulties of either physical or psychological origin. Sexual stimulation
(visual, verbal, or tactile) is usually required to initiate an erection. Although
sildenafil has become extremely popular, it is not a “cure-all,” it is not an
aphrodiasiac (that is, it does not enhance sexual desire) nor does it enahnce
erections if you are not impotent, and it does have side effects. Sildenafil
should not be used at the same time as certain other medications.
Men who take nitroglycerin for a heart condition (as either tablets, spray,
or patches) should not take sildenafil. The two medicines, when combined,
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can significantly lower blood pressure. Some men have died from combining
sildenafil and nitroglycerin.
A newer drug called vardenafil (Levitra) has been approved, and other new
drugs are in development.
If oral medication does not work, various patches or injectable medications
(injected into the penis directly with a needle) are available. Drugs such as
papaverine hydrochloride, phentolamine, and alprostadil widen blood
vessels. Medications such as Prostaglandin E-1 can induce an erection when
injected into the penis.
A system for inserting a pellet of alprostadil into the urethra is marketed as
MUSE. The system uses a pre-filled applicator to deliver the pellet about an
inch deep into the urethra at the tip of the penis. An erection will begin within
8 to 10 minutes and may last 30 to 60 minutes. These drugs may create unwanted
side effects, however, including persistent erection (known as priapism).
Testosterone may be prescribed by either skin patch or injection, especially
if the problem is related to age. For some patients, a vacuum pump or
penile prosthesis (implant) may be recommended.
AYURVEDA
Ayurveda has good treatment for impotence. Herbs like cinnamon, saffron,
sandalwood, cloves, garlic and ashwagandha have aphrodisiac action.
Following medicines are useful:
O Gokshura Churnam 1-3 gm with milk
O Ashwagandha Churnam 1-3 gm with milk bid
O Kapikachu seeds Churnam 1-3 gm with milk bid
O Cloves or Nutmeg with milk for early ejaculation
O Makaradhwaja vati 1-2 tab with milk bid
O Ashwagandha lehyam 10-20 gm with milk bid.
ACUPUNCTURE
Following acupoints are used in treating impotence:
O Baihui (Du 20)
O Qugu (Ren 2), Zhongji (Ren 3), Guanyuan (Ren 4), Qihai (Ren 6)
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O Mingmen (Du 4)
O Shenshu (U.B. 23)
O Zusanli (St. 36)
O Taixi (K. 3)
O Ququan (Liv. 8).
HOMEOPATHY
Agnus castus: This remedy may be helpful if problems with impotence
develop after a man has led a life of intense and frequent sexual activity for
many years. A cold sensation felt in the genitals is a strong indication for
Agnus castus. People who need this remedy are often very anxious about
their loss of abilities, and may have problems with memory and
concentration.
Argentum nitricum: This remedy may be helpful if a man’s erection fails
when sexual intercourse is attempted, especially if thinking about the
problem makes it worse. People who need this remedy are often nervous
and imaginative. A person who needs Argentum nitricum is usually warm-
blooded, with cravings for both sweets and salt.
Caladium: This remedy may be helpful to a man whose genitals are
completely limp, despite having sexual interest. Nocturnal emissions can
occur without an erection, even if dreams are not sex-related. A person
who needs this remedy often craves tobacco.
Causticum: This remedy may be indicated if physical pleasure during sex
has diminished and sexual urges are reduced. The person feels tired and
weak, and may experience memory loss, with a compulsive need to check
things (to see that doors are locked, etc.) Prostate problems may be
associated with impotence, and urine may be lost when the person coughs
or sneezes.
Ly copodium: People who need this remedy may have problems with
erections because of worry, and can also be troubled by memory loss. They
often lack self-confidence (though some may overcompensate by acting
egotistically).
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S elenium metallicum: This remedy is often helpful to men who have

diminished sexual ability, especially if the problem starts after a fever or
exhausting illness. The person feels weak and exhausted, but interest is
usually still present. Unusual hair-loss (body hair or eyebrows) can also
suggest a need for Selenium.
Staphysagria: Gentle-natured, quiet men with deep emotions may respond
to this remedy. Problems with impotence often occur from embarrassment
or shyness. People who need this remedy often have a history of emotional
suppression.
NATUROPATHY
A balanced natural diet with emphasis on whole grains, vegetables, fruits,
sprouts, is good in impotence. Foods like black gram, onion, garlic, nuts
(almond, cashew, pistachio), yeast, tofu, pumpkin seeds, bottle gourd seeds,
wheat germ, omega-3 oils, cow milk, cow ghee, seafood and spices like
Nutmeg (Myristica fragrans) flowers and seeds, poppy seeds, cardamom,
cloves, saffron, helps to improve impotence.
Beneficial herbs include Sarsaparilla, which contains a testosterone-type
substance for men, Damiana is good for improving blood flow to the genital
area, Dong Quai, Gotu Kola, Hydrangea Root, Pygeum, Saw Palmetto,
and Syberian Ginseng.
For sexual dysfunction related to poor circulation:
O Ginkgo (Ginkgo biloba, 50 to 100 mg per day) increases peripheral
circulation and may improve sexual function
O Hawthorn (Crataegus monogyna), rosemary (Rosmarinus officinalis),
ginger root (Zingiber officinalis), and prickly ash bark (Xanthoxylum
clava-herculis) are circulatory stimulants. Use singly or in combination,
3 cups of tea per day or 20 to 30 drops tincture three times per day.
For sexual dysfunction secondary to hormonal imbalance:
O Saw palmetto (Serenoa repens) may help hormone balance
O Damiana (Turnera diffusa) may support testosterone levels. It also
tones the central nervous system and may help relieve anxiety
O Milk thistle (Silybum marianum), dandelion root (Taraxacum
officinale), and vervain (Verbena officinalis) support the liver and
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may help restore hormone ratios. Use equal parts in a tea (1 cup
before meals), or tincture (15 to 20 drops before meals).
For sexual dysfunction associated with depression or anxiety:
O St. John’s wort (Hypericum perforatum), kava kava (Piper methysticum),
skullcap (Scutellaria lateriflora), lemon balm (Melissa officinalis),
passionflower (Passiflora incarnata), and gotu kola (Centella asiatica).
Combine equal parts in a tea (1 cup twice a day) or tincture (20 to 30
drops twice a day). May take six weeks for results.
Hydrotherapy
O Alternate hot and cold hipbath twice a day
O Ice cold hipbath for 3 minutes in the morning.
NUTRITION THERAPY
Eat a healthy, well-balanced diet. Include seeds, bee pollen, or royal jelly;
caution: bee pollen may cause an allergic reaction in some individuals, so
start with small amounts, and discontinue use if a rash, wheezing,
discomfort, or other symptom occurs.
Avoid alcohol, particularly before sexual encounters. Do not consume animal
fats, sugar, fried food, or junk foods.
A combination of green oats and stinging nettle may alleviate the problem.
Stinging nettle is full of vital minerals and is also good for allergies,
depression, hypoglycemia, prostate and urinary tract disorders, and a host
of other problems. Wild Yam contains natural steroids that rejuvenate and
give vigor to lovemaking.

O Essential Fatty Acid Complex: Aids in the formation of sperm and
seminal fluid in the prostate gland; Evening Primrose Oil is an
excellent source of essential fatty acids
O Iodine or Kelp: Iodine is a component of the thyroid hormones
and necessary for the development of reproductive organs; Kelp is
an excellent source of iodine
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O Selenium: Found in high concentration in the testicles

O Zinc: Important in prostate gland function and reproductive organ
growth; also helps boost testosterone levels
O Vitamin C (250 to 500 mg one to two times per day) supports
vascular integrity
O Vitamin E (400 IU per day), B6 (50 to 100 mg per day), and zinc
(30 mg per day) to support hormone production
O Magnesium (200 mg twice a day) supports hormone production
O B-complex (50 to 100 mg per day) helps reduce stress.
PSYCHOTHERAPY
Psychological problems account for 60 per cent of cases of impotence.
Psychotherapy and counnselling have been found to be beneficial in treating
men’s impotence. Although the majority of causes of impotence problems
in men are physical, there are quite frequently underlying psychosocial
factors involved as well. Psychotherapy may be helpful in individuals whom
no organic cause for male impotence has been detected. Mental treatment
therapy often focuses on complications surrounding sexual performance
anxiety, sexual dysfunctional relationships, loss of a sexual partner, psychotic
disorders, substance abuse problems, etc.
Psychotherapy includes techniques that decrease anxiety associated with
intercourse. The patient’s partner can help apply the techniques, which
include gradual development of intimacy and stimulation. Such techniques
also can help relieve anxiety when physical impotence is being treated.
A caring and sympathetic partner is important. He or she is an invaluable
support during the investigation and treatment of the partner’s impotence.
A partner who mocks or ridicules (or even feels overly sorry for) a man’s
performance is making the problem worse and may even have contributed
to it in the first place.
Home Care
For many men, lifestyle changes can help:
O Cut down on smoking, alcohol, and illegal drugs
O Get plenty of rest and take time to relax
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O Exercise and eat a healthy diet to maintain good circulation

O Talk openly to your partner about sex and your relationship. If
you are unable to do this, counseling can help.
INFERTILIT
INFERTILIT
TILITYY
Infertility is the inability to achieve a pregnancy after 12 months of
unprotected intercourse.

Primary infertility is the term used to describe a couple that has never
been able to conceive a pregnancy, after at least 1 year of unprotected
intercourse. The term secondary infertility describes couples who have
previously been pregnant at least once, but have not been able to achieve
another pregnancy.
Causes of infertility include a wide range of physical as well as emotional
factors.
Male factors
Approximately 30% to 40% of all infertility is due to a “male” factor, such
as retrograde ejaculation, impotence, hormone deficiency, environmental
pollutants, scarring from sexually transmitted disease, or decreased sperm
count. Some factors affecting sperm count are heavy marijuana use or use
of prescription drugs such as cimetidine, spironolactone, and nitrofurantoin.
Sperm are easily damaged and need a carefully controlled environment to
develop normally. Any factor that has an adverse effect on spermatogenesis
will lower the sperm count and significantly affect fertility. There are
many simple things a man can do to optimize the quality and quantity of
his sperm. This is particularly important in the six months before trying to
conceive a child.
It takes around 100 days to make a sperm from start to finish:
O 74 days division and growth within the testis
O 20 days to pass through the epididymis
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O 6 days travelling through the vas deferens before ejaculation.

That’s 100 days in which the sperm are vulnerable to many dietary and
environmental factors.
A low ambient temperature is essential for normal spermatogenesis.
Testicular temperature needs to be from 4 - 7°C cooler than core body
temperature. This is why the testes are designed to drop out of the abdomen
into the scrotal sac. Even if the testes heat up by as little as 2°C, sperm
formation is adversely affected. Sperm count will drop, the number of
normal sperm will fall and the number of abnormal sperm will increase.
Even taking a hot bath (43 - 45°C/110 - 115°F) for half an hour per day
can significantly lower sperm counts as can wearing tight underpants or
athletic scrotal supports.
Female factors
This includes scarring from sexually transmitted disease or endometriosis,
ovulation dysfunction, poor nutrition, hormone imbalance, ovarian cysts,
pelvic infection, tumor, or transport system abnormality from the cervix
through the fallopian tubes are responsible for 40% to 50% of infertility
in couples. The remaining 10% to 30% may be caused by contributing
factors from both partners, or by no cause that can be identified.
It is estimated that 10% to 20% of couples will be unable to conceive after
1 year of attempting to become pregnant. It is important that pregnancy
be attempted for an extended period (at least 1 year). The chance for
pregnancy occurring in healthy couple who are both under the age of 30
and having intercourse regularly is only 25% to 30% per month. A woman’s
peak fertility occurs in her early 20s. As a woman ages beyond 35 (and
particularly after age 40), the likelihood of conceiving diminishes to less
than 10% per month.
In addition to age-related factors, increased risk for infertility is associated
with having:
O Multiple sexual partners, increasing the risk for STDs
O A sexually transmitted disease
O A past history of PID (pelvic inflammatory disease) — after a single
episode, 10% to15% of women may become infertile
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Urogenital Diseases
O A past history of orchitis or epididymitis in men

O Mumps (men)
O A varicocele (men)
O A past medical history
O Eating disorders (women)
O Anovulatory menstrual cycles
O Endometriosis
O Abnormalities of the uterus (myomas) or cervical obstruction
O A chronic disease such as diabetes.
Symptoms
O Inability to become pregnant
O A range of emotional reactions by either or both members of the
couple. In general, such reactions are greater among childless
couples. Having at least one child tends to soften these painful
emotions.
Signs and tests

A complete history and physical examination of both partners is essential.
Tests may include:
O Semen analysis — the specimen is collected after 2 to 3 days of
complete abstinence to determine volume and viscosity of semen
and sperm count, motility, swimming speed, and shape
O Measuring basal body temperature — taking the woman’s
temperature each morning before arising in an effort to note the
0.4 to 1.0 degree Fahrenheit temperature increase associated with
ovulation
O Monitoring cervical mucus changes throughout the menstrual cycle
to note the wet, stretchy, and slippery mucus associated with the
ovulatory phase
O Postcoital testing (PCT) to evaluate sperm-cervical mucus
interaction through analysis of cervical mucus collected 2 to 8
hours after the couple has intercourse
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O Measuring serum progesterone (a blood test)

O Biopsying the woman’s uterine lining (endometrium)
O Biopsying the man’s testicles (rarely done)
O Measuring the amount of luteinizing hormone in urine with home-
use kits to predict ovulation and assist with timing of intercourse
O Progestin challenge when the woman has sporadic or absent
ovulation
O Serum hormonal levels (blood tests) for either or both partners
O Hysterosalpingography (HSG) — an x-ray procedure done with
contrast dye that looks at the route of sperm from the cervix through
the uterus and fallopian tubes
O Laparoscopy to allow direct visualization of the pelvic cavity
O Pelvic exam for the woman to determine if there are cysts.
Treatment
MODERN MEDICINE
Treatment depends on the cause of infertility for any given couple. It may
range from simple education and counseling, to the use of medications
that treat infections or promote ovulation, to highly sophisticated medical
procedures such as in vitro fertilization.
Medicines used in infertility treatments include:
Bromocriptine is used specifically to treat women with hyperprolactinemia,

a condition in which women fail to ovulate because the pituitary is
producing too much of the hormone called prolactin. Hyperprolactinemia
is the cause of menstrual disturbance in about 10% of anovulatory women.
Clomiphene for inducing ovulation. Clomiphene is an antiestrogen and it

acts by “fooling” the pituitary into believing that estrogen levels in the
body are low as a result of which the pituitary starts producing more FSH
and LH - the gonadotropin hormones which in turn leads to stimulation
of the ovaries. Only women who produce estrogen will respond to
clomiphene.
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Danaz ol: This is a synthetic hormone, prescribed as one type of treatment

anazol:
for endometriosis. It acts by suppressing the brain’s production of follicle
stimulating hormones and hence suppresses ovarian function. This is similar
to an artificial menopause and results in the shrinking of not only the
endometrium in the uterus (and hence no periods); but also hopefully the
misplaced patches of endometrium outside the uterus found in patients
with endometriosis, causing them to disappear.
Human M enopausal G
Menopausal onadotr
Gonadotr opins (H.M.G): When the pituitary doesn’t
onadotropins
release FSH and LH or releases them in an improper balance, HMG (Human
Menopausal Gonadotropin) substitutes for them and acts directly on the
ovaries to stimulate the development of the follicle. HMG is a natural
product containing both human FSH and LH.
Follicle SStimulating
timulating Hormone (FSH)
(FSH):: It is a purified form of HMG which
contains mostly FSH and negligible amounts of LH.
Human Chorionic Gonadotrophin (HCG): HCG is produced by the

placenta during pregnancy. Because it is very similar biologically to LH it
is used to trigger ovulation by mimicking the natural LH surge at mid
cycle. It can be used in combination with Clomid and also HMG/FSH to
induce ovulation.
G nRH analogues: These drugs may be used for the treatment of

endometriosis and fibroids.
GnRH antagonists: Currently, most in-vitro fertilization (IVF) centres use

pituitary down-regulation with gonadotrophin-releasing hormone (GnRH)
agonists to prevent premature luteinization. However, this requires at least
7–14 days of GnRH agonist pretreatment. A more rational approach would
be to use the newer GnRH antagonists, which cause an immediate blockage
of the GnRH receptors on the pituitary gland. Thus , treatment with the
antagonist can be limited to only those 2-3 days when high oestradiol
levels may induce an LH surge.
Medical Procedures:
Intrauterine insemination: Sperm is injected into the woman’s uterus. A

tube is used to get the sperm inside the uterus past the cervix.
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In vitro fer
vitro tilization: The egg is fertilized with the sperm in a lab dish and
fertilization:
the fertilized embryo is implanted into the uterus.
Gamete intrafallopian transfer: The eggs and sperm are inserted directly
into the fallopian tubes in the hope that a resulting embryo will travel to
the uterus and implant there.
Zygote intrafallopian transfer: The eggs are fertilized in a lab dish and any
resulting fertilized eggs are transferred to a fallopian tube.
Froz en embr
ozen embryyo transfer: When too many embryos have resulted from an
IVF cycle the extra embryos are frozen and stored so that they can later be
thawed and implanted in the uterus.
Donor eggs: In women who do not produce viable eggs, eggs from another
woman’s ovaries are fertilized by the man and then transferred to the infertile
woman’s uterus.
AYURVEDA
Ayurveda treats infertility due to functional problems. Herbs like Shatavari

(Asparagus racemosus), Ashwagandha, Saffron, Amla (Emblica officinalis),
Gokshura (Tribulus Terrestris) and Kapikacchu Seeds increase fertility.
Laboratory studies have found that Gokshura increases sperm count after
being taken for 30 days and can result in better than 50% increase in
testosterone levels.
The most effective remedy for sterility among females is Phala Ghrita. It
should be given in doses of two teaspoonfuls each, twice daily, preferably
on an empty stomach, with milk. Another drug of choice is Vanga Bhasma.
It should be given in doses of 150 mg each, twice daily with honey. Shilajit
is another effective drug in the treatment of this condition: it should be
given in doses of one teaspoonful twice daily.
ACUPUNCTURE
Of all the alternative therapies, acupuncture has been shown in controlled

scientific studies to be effective in helping treat male and female infertility
problems. Acupuncture has, of course, traditionally been successfully
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employed in China to treat most illnesses, but, in recent years, there have
been several interesting controlled scientific studies demonstrating the
clinical value of acupuncture for both male and female infertility problems.
Good candidates for trying medical acupuncture are people who have a
functional, rather than a structural reason for infertility (for example,
damaged fallopian tubes are structural). Men or women with functional
infertility would be encouraged to try acupuncture in addition to their
standard medical treatment.
A study involved 45 infertile women suffering from oligoamenorrhea (27

cases) or luteal insufficiency (18 cases). Following a complete gynaecologic—
endocrinologic examination, the women were treated with auricular
acupuncture (treatment of points on the ear). Results were compared to
those of 45 women who received hormone treatment. Both groups were
matched for age, duration of infertility, body mass index, previous
pregnancies, menstrual cycle and tubal patency. Women treated with
acupuncture had 22 pregnancies whereas women treated with hormones
had 20 pregnancies. It was also noted that side-effects were observed only
during hormone treatment and various disorders of the autonomic nervous
system normalized during acupuncture.
Acupuncture treatment has also been demonstrated to improve quantity

and quality of sperm. Another study in treating subfertility by acupuncture
was carried out on 28 men. Each patient received 10 treatments for a
period of three weeks. Several spermiograms were made and the
spermiograms and hormone levels were checked before and after
acupuncture. Total count, concentration and motility were evaluated and
in all cases the researchers observed a statistically significant improvement
of sperm quality. There is therefore little doubt that acupuncture and
Traditional Chinese Medicine would be an appropriate alternative treatment
to consider for both male and female infertility.
HOMEOPATHY
Remedies for Women for G eneral IInfer

General nfer tility IInclude:
nfertility nclude:
Borax: Pale in appearance, weak and timid. Excess white discharge. Sterility.
Vaginal dryness. Painful menstruation.
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Ferr um P
errum hosphoricum: Excitable, moody. Patient is pale due to decreased
Phosphoricum:
iron in blood. Hemorrhages. Chilly. Averse to sex or desire reduced.
Menstruation irregular, late or absent, flow is bright red and dark and lasts
a long time. Bearing down sensation, dull pain in ovarian region.
Natr um M
atrum uriaticum: Emotionally vulnerable leading to introversion. Vagina
Muriaticum:
is sensitive and dry with a sensation of pins pricking inside. Averse to sex,
which is painful from dryness. Menses irregular, usually profuse. For sterility
where the uterus is intensely sore. Inflammation of endometrium.
Sepia: Introverted, indifferent to loved ones. Infertility. Exhaustion after
sex. PMS. Habitual abortions from 3rd to 5th month. Prolapse of uterus.
Bearing down sensation is better sitting with legs crossed.
Remedies for Male Infertility Include:
Agnus castus: If impotence develops after a man has led a life of intense
and frequent sexual activity for many years. A cold sensation felt in the
genitals is a strong indicator. Men who are anxious about their health and
loss of abilities. Problems with memory and concentration.
Argentum nitricum: If a man’s erection fails when sexual intercourse is
attempted, especially if thinking about the problem makes it worse. Men
who need this are often nervous and imaginative.
Lycopodium: For men with erection problems because of worry and maybe
troubled by memory loss. Often lack self-confidence (some may
overcompensate by acting egotistically).
Staphysagria: Gentle-natured, quiet men with deep emotions may respond
to this remedy. Problems with impotence often occur from embarrassment
or shyness. Men who need this remedy often have a history of emotional
suppression and very sensitive feelings.
NATUROPATHY
A balanced diet with emphasis on whole grains, vegetables, fruits, dry
fruits, nuts (almond, cashew, and pistachio), black gram, sprouts, yeast,
tofu, pumpkin seeds, wheat germ, omega-3 oils, cow milk and cow ghee,
seafood and spices helps to improve general health and improve impotence.
Eat 1/4 cup of raw sunflower seeds or pumpkin seeds each day.
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Urogenital Diseases
Limit intake of refined sugars as it affects the body’s ability to manufacture

reproductive hormones. Eliminate artificial sweeteners as most sweeteners
are not natural substances and their safety is questionable.
Eliminate coffee, tea, cola, cocoa. Caffeine for women can decrease the
chance of conception by nearly a third. Here’s a twist however…caffeine
for men can actually stimulate sperm motility. Reduce alcohol consumption.
Drink bottled water or use a water filter to reduce toxins from lead pipes.
O Vitex or Chaste tree berry (Agnus Castus) is the herb of choice for
helping to restore hormone imbalance and increasing fertility. Agnus
castus is particularly helpful for those women who have a luteal phase
defect (shortened second half to the cycle) or those with high prolactin
levels, because it stimulates the proper functioning of the pituitary
gland which controls the hormones.
O Red Clover Flower: Rich in vitamins and minerals, nourishes the
uterus, relaxes the nervous system, balances the hormonal system and
may make the pH of the vagina and uterus more conducive to pregnancy.
O Nettle Leaves: Act as a tonic for the uterus, the hormone system,
the kidneys and the adrenals.
O Red Raspberry Leaves: Rich in nutrients (especially calcium) and
contain an effective uterine tonic. Some sources say red raspberry
should not be used during the first trimester of pregnancy.
O Don Quai Root: Rich in vitamin E, cobalt and iron as well as
compounds called coumarins (relax smooth muscle such as uterine
tissue) that promote fertility. Don Quai is best used between
ovulation and menstruation. Note: Some sources recommend it
not be used during pregnancy.
O False Unicorn R
Unicorn oot: Acts as a uterine tonic and may remedy ovarian
Root:
dysfunction.
O Black Cohosh: Contains Phytoestrogens and is a potent uterine
tonic used to balance hormones. Note: Black Cohosh is not
recommended for use during pregnancy.
O Kelp: Rich in trace minerals essential for regulating hormones.
427
Kelp’s iodine content may be helpful in preventing miscarriage

caused by under-active thyroid.
O W ild Yams: Different from the common store variety, contain
steroid-like substances that trigger Follicle Stimulating Hormone
(FSH) and stimulate the ovaries to release an egg.
O Ginseng: Can stimulate testosterone production in men.
O Pumpkin Seeds: Rich in zinc, a nutrient that affects sperm count.
O Bee P ollen: Rich in B-complex, has been shown to improve sperm
Pollen:
production. Note: Not to be used by anyone allergic to pollen.
O Saw P almetto B
Palmetto err
Berr y: Used as a male tonic and may improve fertility.
erry:
Clinical trials show it has a positive effect on the prostate gland.
O Sarsaparilla Root: Contains substances used in the production of
synthetic steroids and is used as both a male and female tonic.
Hydrotherapy
Men
O Cold or ice-cold hip baths daily for 30 minutes twice a day
O Cold immersion baths
O Cold pelvic packs
O Apply an ice pack around scrotum for 10 minutes thrice a day
O Men should avoid taking hot baths.
Women
O Alternate hot and cold sitz baths (3 minutes hot: 30 seconds cold,
repeated 3 times) twice a day
O Hot immersion baths.
YOGA THERAPY
Yoga’s effectiveness at promoting fertility is due to its emphasis of a healthy

diet and lifestyle as well as its ability to balance hormonal problems,
stimulate, and strengthen the reproductive organs.
Other recent evidence echoes the positive effects of yoga for infertile women.
In 2000, Harvard Medical School researcher Alice Domar, Ph.D., published
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Urogenital Diseases
the results of a study in Fertility and Sterility (Vol. 73, No. 4) that showed
women who participated in her program, which included relaxation and
yoga, were almost three times more likely to get pregnant than women
who didn’t.
Certain yoga poses can help with infertility; increase the blood flow and
rebalance hormones. Some poses will also help to stimulate ovaries. Yoga
poses like Salamba Setu Bandha Sarvangasana (Supported Bridge Pose, done
with the sacrum on a bolster and the knees bent) and Viparita Karani
(Legs-Up-the-Wall Pose), Salamba Baddha Konasana (Supported Bound
Angle Pose) help to gently stimulate ovary and uterus, as well as increase
micro-circulation in the reproductive tract.
The low impact posturing, breathing exercises and meditation are also
useful for relaxation and stress relief.
NUTRITION THERAPY
Eat Whole grains, legumes, vegetables, fruits, nuts, and seeds. Eat a healthy
diet with at least five servings of fruits and vegetables a day, along with whole
grains and some good quality protein such as meats, fish, eggs, or milk. It is
especially critical for men with a low sperm count to have an optimal nutritional
intake since sperm formation is so closely linked to diet.
An increased intake of essential fatty acids found in foods like oily fish, fish
liver oils, seeds, almonds, hazelnuts, pumpkin seeds, yogurt, evening
primrose oil and unrefined vegetable oils stimulate sex hormone production.
Avoid alcohol: Alcohol reduces sperm count in men and can prevent a
fertilized egg from becoming implanted in the uterus in women. Avoid
caffeine: Caffeine may prevent some women from becoming pregnant.

O Important nutrients for both men and women trying to conceive
include vitamins E, B6, as well as zinc, selenium, and essential
fatty acids. For men vitamin C is also important.
O Vitamin A: A deficiency can result in male infertility as this vitamin
is essential to sperm production.
429
O Folic A cid: A ‘B’ vitamin necessary for brain and nervous system
Acid:
development for the growing fetus. It affects the pituitary and
hypothalamus glands which regulate sex hormones. A deficiency
can increase the risk of miscarriage, premature birth and birth
defects. Adequate Folic acid before conception leads to a decrease
of birth defects such as spina bifida.
O Vitamin B6: A deficiency raises estrogen at the expense of
progesterone and may be the culprit in some cases of unexplained
infertility and chronic miscarriage. Insufficient quantities of this
vitamin have been shown to raise serum prolactin, a hormone that
can interfere with ovulation. Substances depleting B6 include birth
control pills, alcohol and caffeine.
O Vitamin B-12: Improves sperm count and motility rates that are
very low. B-12 should be taken sublingually (under the tongue) or by
injection so digestive juices do not destroy them in the stomach.
O Vitamin C & Bioflavonoids: Strengthen blood vessels lining the
uterine wall. Note: when C is too high it can decrease absorption
of copper, a mineral necessary for ovulation and increase the risk of
infertility and miscarriage. Vitamin C can enhance sperm quality
and prevent sperm sticking together.
O Vitamin E: Supports development of a healthy uterine wall and
placenta. May help prevent miscarriage. Caution should be used
when supplementing as E can accumulate in the liver and become
toxic. Vitamin E has been shown to improve sperm quality.
O Calcium: A deficiency can result in decreased estrogen output that
affects egg production as well as ovulation. Note: excessive calcium
prevents absorption of magnesium and some sources suggest we
need as much magnesium as calcium.
O Iron: A deficiency affects the menstrual cycle. Note: too much
iron (and thus too much vitamin C which enhances iron absorption)
can cause infertility in people who suffer from a common disorder
called hereditary hemochromatosis.
O Magnesium: Relaxes smooth muscles (e.g. in the uterine wall).
Helps the body utilize B vitamins and helps inactivate excess
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Urogenital Diseases
estrogen. Magnesium deficiency is widespread (especially in women

with PMS) and supplementation may help cases of infertility and
repeated miscarriage. Magnesium is depleted by chronic stress,
alcohol, high intake of phosphorus and excess salt, vitamin D and
calcium. Note: women with kidney disease should see a health
practitioner’s permission before taking magnesium.
O Z inc: A deficiency, even a marginal one, can cause male infertility.
Supplementation increases sperm production and motility. Note:
continued use over the long term may interfere with copper absorption.
O Amino A cid L-Arginine: Improves sperm count and motility. Note:
Acid
men with liver or kidney disease should get a health practitioner’s
approval before taking Arginine supplements.
PSYCHOTHERAPY
It is important for the couple to recognize and discuss the emotional impact
that infertility has on them as individuals and together, and seek
psychological advice and counselling from a psychotherapist.
Psychotherapy prepares couples for Artificial Reproductive Therapy
procedures such as IVF & donor eggs or sperm and cope with them. It
teaches how to control the stress, anxiety and depression that often
accompany infertility. Psychotherapy helps to reduce the impact of
infertility on self-esteem and sexuality and achieve a greater degree of peace
with decisions and outcomes.
As new treatments are announced, couples may either experience new hope
or have to deal with old wounds being reopened. Support groups for
infertile couples may be an important source of strength and comfort.
Lifestyle Changes
O Get regular exercise: While you should avoid vigorous training programs,
regular and moderate exercise helps you maintain a healthy body weight,
helps control stress, and gives you a healthier overall body.
O Perform relaxation exercises: Since infertility and life in general
can be stressful, learn to relax. Stress is sometimes responsible for
certain infertility problems such as hormonal problems.
431
O Maintain a healthy weight: Not too under or overweight since

weight influences estrogen and testosterone levels.
O Watch your body temperature: Avoid vigorous exercise, hot tubs,
and saunas since they raise the body temperature and may cause
changes in ovulation and reduced sperm count.
O Check for exposure to heavy metals: Heavy metal toxins may affect
ovulation. A hair analysis can determine exposure.
O Consider age when planning children: A woman’s fertility begins
to decrease after she is thirty so consider this when deciding when
to have children.
Prevention
Because infertility is frequently caused by sexually transmitted diseases,
practicing safer sex behaviors may minimize the risk of future infertility.
Gonorrhea and chlamydia are the two most frequent causes of STD-related
infertility. STDs are often asymptomatic at first, until PID or salpingitis
develops. These inflammatory processes cause scarring of the fallopian tubes
and decreased fertility, absolute infertility, or an increased incidence of
ectopic pregnancy.
Mumps immunization has been well proved to prevent mumps and its
male complication, orchitis. Immunization prevents mumps-related sterility.
Some forms of birth control, such as the intrauterine device (IUD), carry a
higher risk for future infertility. However, IUDs are not recommended for
women who have not previously had a child. Women selecting the IUD
must be willing to accept the very slight risk of infertility associated with
its use. Careful consideration of this risk, weighed with the potential benefits,
should be reviewed and discussed with both partners and the health care
provider.
432
10
GYNECOLOGICAL DISEASES
Dysmenorrhea
Amenorrhoea
Pelvis inflammatory disease
Endometriosis
Premenstrual syndrome
Menopause
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DYSMENORRHEA
Dysmenorrhea or painful menstruation is when menstrual periods are
accompanied by either sharp, intermittent pain or dull, aching pain, usually
in the pelvis or lower abdomen.
Considerations
Painful menstruation affects many women. For a small number of women,
such is the discomfort that it makes it next to impossible to perform normal
household chores, job, or school-related activities for a few days during
each menstrual cycle. Painful menstruation is the leading cause of lost
time from school and work among women in their teens and 20’s.
The pain may begin several days before or a day or two before menstrual
flow. It generally subsides as menstrual bleeding tapers off. Although some
pain during menstruation is normal, excessive pain is not. Dysmenorrhea
refers to menstrual pain severe enough to limit normal activities or require
medication.
There are two general types of dysmenorrhea:
O Primary dysmenorrhea refers to menstrual pain that occurs in
otherwise healthy women. This type of pain is not related to any
specific problems with the uterus or other pelvic organs. Discomfort
tends to decrease over time and after pregnancy.
O Secondary dysmenorrhea is menstrual pain that is attributed to
some underlying disease process or structural abnormality either
within or outside the uterus.
Activity of the hormone prostaglandin, produced in the uterus, is thought
to be a factor in primary dysmenorrhea. This hormone causes contraction
of the uterus and levels tend to be much higher in women with severe
menstrual pain than in women who experience mild or no menstrual pain.
Common Causes
O Premenstrual syndrome (PMS)
O Stress and anxiety
O Endometriosis
434
Gynecological Diseases
O Pelvic inflammatory disease

O Multiple sexual partners
O History of sexual abuse
O Fibroids
O Ovarian cysts
O Intrauterine Device (IUD), but usually only for the first three
months after insertion
O Tampons can aggravate menstrual pain in some women.
Symptoms
Symptoms and degree of pain vary, but may include the following:
O Abdominal cramping or dull ache that moves to lower back and
legs
O Heavy menstrual flow
O Headache
O Nausea
O Constipation or diarrhea
O Frequent urination
O Vomiting (not common).
Tests
O Blood tests including CBC
O Ultrasound
O Dilation of the cervix
O Laparoscopy
O Cultures (may be taken to rule out sexually transmitted diseases
such as gonorrhea, primary syphilis, or chlamydia infections).
Treatment
MODERN MEDICINE
O Strong pain relievers (even narcotics like codeine, for brief periods)
435
O Anti-inflammatory agents such as ibuprofen (800 mg to start; 400

to 600 mg every six hours)
O Gonadotropin-releasing hormone (GnRH) or oral contraceptives
O Antibiotics are necessary for pelvic inflammatory disease
O Estrogen or oral progestins (for example, norethindrone for 12
months brings relief in 80 percent of patients; however, there may
be side effects).
Surgery may be necessary for women who are unable to obtain adequate
pain relief or pain control. Procedures may range from removal of cysts,
polyps, adhesions, or fibroids to complete hysterectomy in cases of extreme
endometriosis.
Prescription medications may be used for endometriosis. For pain caused
by an IUD, removal of the IUD and alternative birth control methods
may be needed.
AYURVEDA
Antispasmodic, muscle relaxing, analgesic and pain relieving herbs are used
along with emmenagogues. Cyperus is a special Ayurvedic and Chinese
herb for menstrual cramping pain and can be used for all types. Myrrh or
guggul are also useful.
Treatments consist of anti-Vata diet.
‘Apana Vata’ (one of the 5 types of Vata Dosha) is responsible for the
elimination of menstrual blood, stool, urine, ovum and sperm (in males).
Women suffering from constipation are prone to this disorder. Therefore
rectifying the cause of constipation is the best treatment.
Kumari (Aloe vera) is the drug of choice for the treatment of this condition.
The juice of this plant is given orally, sometimes it is dehydrated and the
stuff that is obtained by this is used as the medicine.
Mint is supposed to check irregular uterine contractions and thus help to
relieve the pain in menses - for this purpose fresh mint chutney or mint
decoction is used.
Hing (asafoetida) is mixed with jaggery and taken daily in the morning for
three to five days during menstrual period.
436
Heat or warm sesame oil should be applied to the lower abdomen. Sesame
oil or shatavari can be used as douche.
Ayurveda prescribes the following medicines in cases of amenorrhoea and
dysmenorrhoea:
O 500 mg of Raja Pravartini, and 500 mg of Voladi Vati or
Nashtapushpantaka Rasa to be taken with decoction of black sesame
leaves or garlic, and jaggery
O 20 ml of Kumaryasava and 240 mg of Shuddha Tankana to be
taken twice daily, preferably after meals
O Rajapravasthani vati – 2-4 tab with water seven days before meals
O Ashokarishta 14-28 ml with water twice daily
O Kumari Asava 14-28 ml with water twice daily.
ACUPUNCTURE
Acupuncture has become a popular treatment for dysmenorrhea.

Acupuncturists treat people with dysmenorrhea based on an individualized
assessment of the excesses and deficiencies of Qi located in liver and spleen
meridians.
O Baihui (Du 20)
O Local points: Qihai (Ren 6), Guanyuan (Ren 4), Zhongji (Ren
3), Zhongwan (Ren 12), Ciliao (U.B. 32)
O Distal points: Sanyinjiao (Sp. 6), Zusanli (St. 36)
O Specific points for pain: Hegu (L.I. 4), Neiting (St. 44)
O Specific points for nausea and vomiting: Neiguan (P. 6), Zuansali
(St. 36).
HOMEOPATHY
Belladonna: For acute menstrual pain that often resembles labor pains;
pain is often described as sharp, throbbing pressure in the pelvis
accompanied by heavy bleeding; pain may extend to the back and is
generally tends to worsen with walking or moving.
437
Chamomilla: For menstrual pain with mood changes including irritability

and anger; pain may occur after bouts of anger and be relieved by warmth;
the individual may have the sensation of a weight on her pelvis.
Cimicifuga: For pains that move from one side of the abdomen to the
other and that are worsened by movement.
Colocynthis: For sharp pains accompanied by anger and irritability.
Lachesis: For pain and pressure that extend to the back; symptoms tend to
worsen at night.
Magnesia phos: For cramps or sharp, shooting pains that are relieved by
warmth, pressure, and bending forward.
Nux vomica: For cramping pains that extend to the lower back; these
pains are often accompanied by nausea, chills, irritability, and sensitivity
to light, noise, and odors.
P ulsatilla: For menstrual pains accompanied by irritability, moodiness
(including feelings of sadness), dizziness, fainting, nausea, diarrhea, back pain,
and headaches. There may be more pain when there is no menstrual flow.
NATUROPATHY
Increase intake of fresh fruits and vegetables, proteins, and whole grains.
Eliminate refined foods, sugar, dairy products, and methylxanthine foods
like coffee and chocolate.
Following herbs help to treat dysmenorrhoea:
O Chaste tree (Vitex agnus-cactus) and black cohosh (Cimicifuga
racemosa), 30 drops each, twice a day, to reduce dysmenorrhea
O Red raspberry (Rubus idaeus) tea strengthens uterine tissue
O Tea of chamomile (Matricaria recutita) and ginger root (Zingiber
officinale) can help reduce ovarian cyst pain
O Tinctures of cramp bark (Viburnum opulus), black cohosh, Jamaica
dogwood (Piscidia piscipula), and wild yam (Dioscorea villosa) can
be used together in equal parts to relieve pain and cramping. Use
20 drops every half hour for four doses, then as needed up to eight
doses per day for seven days.
438
HYDROTHERAPY
Moist heat packs or warm tub baths relaxes uterine muscles and reduces
menstrual cramps. Apply hot pack on lower abdomen for 5 to 10 minutes
2 to 3 times a day. Avoid hot treatments if there is heavy menstrual bleeding.
Contrast sitz baths: Use two basins that you can comfortably sit in. Sit in
hot water for three minutes, then in cold water for one minute. Repeat
this three times to complete one set. Do one to two sets per day three to
four days per week.
YOGA THERAPY
Yoga normalizes endocrine and reproductive function.

O Asanas:
Konasana
Bhramari
NUTRITION THERAPY
Increase intake of essential fatty acids, which are found in cold-water fish,
nuts, and seeds. Reduce intake of saturated fats (meat and dairy products).
Eliminate refined foods, sugar, dairy products, and methylxanthines (coffee
and chocolate). Increase intake of fresh fruits and vegetables, proteins, and
whole grains.
439

O Magnesium (400 mg per day) with B6 (100 mg per day)
throughout cycle to promote hormone production and induce
relaxation. Can be used at higher doses during your period
(magnesium up to 600 mg per day, and B6 up to 300 mg per
day) for pain relief
O Vitamin E (400 to 800 IU per day) to improve blood supply to
muscles
O B-complex (50 to 100 mg per day) to reduce the effects of stress.
O Essential fatty acids (Omega-3 and Omega 6 oils such as flaxseed,
evening primrose, or borage oil) to reduce inflammation and/or
support hormone production
O Niacinamide (50 mg twice a day) to reduce pain. Begin seven
days before your period until the end of flow. Add rutin (60 mg
per day) and vitamin C (300 mg per day) to increase effects.
PHYSICAL THERAPY
consecutive days. Hot packs can be applied on back for 15 – 20 minutes
can give relief.
PSYCHOTHERAPY
Relaxation therapies can help to reduce the pain and stress associated with
dysmenorrhoea. Practice relaxation techniques like meditation or yoga nidra.
Home Care
The following steps may allow you to avoid prescription medications:
O Apply a heating pad to your lower abdomen (below your navel).
Be careful NOT to fall asleep with it on
O Take warm showers or baths
O Drink warm beverages
440
O Do light circular massage with your fingertips around your lower

abdomen
O Walk or exercise regularly, including pelvic rocking exercises
O Follow a diet rich in complex carbohydrates, like whole grains,
fruits, and vegetables, but low in salt, sugar, alcohol, and caffeine
O Eat light but frequent meals
O Try vitamin B6, calcium, and magnesium supplements, especially
if your pain is from PMS
O Keep your legs elevated while lying down. Or lie on your side
with knees bent.
AMENORRHOEA
Amenorrhea is the absence of menstruation. When a girl reaches age 16
and has not begun menstruating, she may have primary amenorrhea. When
a woman who has had menstrual cycles misses three periods in a row, she
is considered to have secondary amenorrhea. A hormone imbalance can
cause hypoestrogenic amenorrhea. Amenorrhea can also occur due to
pregnancy, lactation and menopause.
Common Causes
Primary Amenorrhea
O Imperforate hymen
O Drastic weight reduction
O Congenital abnormalities of the genital system
O Chromosomal abnormalities
O Extreme obesity.
Secondary Amenorrhea
O Anxiety over pregnancy may cause a missed period, thereby
increasing the anxiety even further
O Drastic weight reduction
441
O Vigorous athletics
O Obesity
O Emotional distress
O Menopause (normal for women over age 45)
O Endocrine disorders such as thyroid disease or pituitary disease/
tumor
O Drugs such as busulfan, chlorambucil, cyclophosphamide, oral
contraceptives, phenothiazines, and non-oral contraceptives (such
as Norplant and Depo-Provera)
O Dilation and curettage (D and C).
Increased risk of amenorrhoea is associated with extreme and prolonged
exercise (particularly without adequate conditioning), body fat content
less than 15% to 17%, extreme obesity, and taking hormonal supplements.
Signs and Symptoms

Symptoms sometimes related to primary amenorrhea include headaches,
abnormal blood pressure, vision problems, acne, excessive hair growth,
and perhaps either a short, stubby physique or extremely tall stature.
Symptoms sometimes related to secondary amenorrhea include nausea,
swollen breasts, headaches, vision problems, unusual thirst, goiter (an
enlarged thyroid gland), skin darkening, extreme weight loss, alcoholism,
liver disease, and kidney failure. Hot flashes, mood changes, depression,
and vaginal dryness are common with estrogen deficiency.
Tests
A physical examination, including a pelvic examination, will be performed.
In patients with secondary amenorrhea, physical and pelvic examinations
must rule out pregnancy before diagnostic testing begins. The patient may
be encouraged to discuss her fears and, if indicated, may be referred for
psychological counseling.
O Endometrial biopsy
O Progestin withdrawal
442
O Prolactin level
O Serum hormone levels such as testosterone levels
O Thyroid function studies
O Pregnancy test (serum HCG)
O FSH (follicle stimulating hormone level)
O LH (luteinizing hormone level)
O TSH (thyroid stimulating hormone; other thyroid function tests)
O Karyotype to rule out the presence of Y chromosome abnormality
O CT scan of the head may be done if a pituitary tumor is suspected.
Treatment
MODERN MEDICINE
Treatment depends on the cause of the amenorrhea. If it is caused by another

systemic disorder, normal menstrual function usually returns after the
primary disorder is treated. For example, if the primary disorder is
hypothyroidism, then amenorrhea will be cured when the thyroid disorder
is treated with thyroid supplements.
Oral contraceptives or hormones are used to cause menstruation to start.

Progesterone is given to treat ovarian cysts and some intrauterine disorders.
Estrogen replacement for low levels of estrogen caused by ovarian disorders,

hysterectomy, or menopause; greatly reduces risk of cardiovascular disease
and inhibits osteoporosis; conjugated estrogens 0.625 to 1.25 mg per day;
or on days 1 to 25 of calendar month (0.3 mg per day prevents bone loss).
Women with an intact uterus should receive progestin (medroxy

progesterone acetate (MPA), a progestin, is given 5 to 10 mg per day on
days 16 to 25 of calendar month to reduce risk of estrogen-induced
endometrial cancer).
Estrogen replacement: Includes ethinyl estradiol (20 or 50 mcg); estradiol

(0.5, 1, 2 mg); Selective Estrogen Receptor Modulators (SERMs) such as
raloxifene if individual refuses estrogen but is at-risk for osteoporosis
443
Pituitary tumors, which also cause anemorrhea, are usually treated with
bromocriptine, a drug that inhibits prolactin secretion. Surgery removal
may also be suggested. Radiation therapy is usually reserved for situations
where other medical or surgical treatment regimens are not successful.
A progestin challenge may be used to determine a course of treatment. In

this test, daily estrogen supplements are given in conjunction with
intermittent progestin for 10 to 14 days per month every 1 to 3 months.
Hormonal supplements are commonly utilized for those women who do
not bleed in response to the progestin challenge test.
Women who bleed in response to the progestin challenge test are anovulatory
— they do not menstruate because they do not ovulate. This common
cause of amenorrhea is treated by inducing ovulation with medication such
as clomiphene citrate — but only if the patient desires pregnancy. In
patients who have no immediate plan for pregnancy, on the other hand,
oral contraceptive pills may be prescribed to induce cyclic menstruation to
prevent uncontrolled growth of the endometrial lining.
Young women with primary amenorrhea, found to be caused by

developmental abnormalities, may require hormonal supplementation,
surgery, or both.
AYURVEDA
Herbs to promote menstruation are specific, often along with tonics to

rebuild the reproductive system. Myrrh by itself is often good for
amenorrhea, particularly taken as a tincture.
A decoction of ten grams of seeds of carrot and jaggery should be taken for
about a week.
Another remedy is to boil six gm of Embelia ribes, three gm of dried ginger

and twenty gm of jaggery in five hundred ml of water till half of the water
is left. The decoction should be taken for a few days.
A decoction of 20 gm each of flowers and leaves of the cotton plant (five
hundred ml of water boiled to half its quantity) mixed with twenty gm of
jaggery is also effective in inducing the menstrual flow.
444
Another remedy is to steep ten-gm of black sesame seeds and an equal

quantity of small calotrops (Gokhru) in two hundred and fifty ml of water
and to grind them in the same water. It should be sweetened with sugar,
and drunk.
Warm sesame oil can be applied to the lower abdomen or used as a douche.
A mild laxative can be taken such as Triphala, aloe gel or castor oil in lower
dosages.
Herbs like ginger, turmeric, black pepper, cinnamon, rosemary, asafoetida,

myrrh, black pepper, Ashoka, ashwagandha, shatavari are helpful.
An anti-Vata diet is indicated consisting of dairy, meat, nuts, oils, whole

grains and other nourishing foods. Iron supplements or Ayurvedic iron ash
preparations are important. Warm sesame oil can be applied to the lower
abdomen or used as a douche. A mild laxative can be taken such as Triphala,
aloe gel or castor oil in lower dosages.
Herbs like ginger, turmeric, black pepper, cinnamon, rosemary, asafoetida,
myrrh, black pepper, ashoka, ashwagandha, shatavari are helpful.
Ayurveda prescribes the following medicines in cases of amenorrhoea:
O 500 mg of Raja Pravartini, and 500 mg of Voladi Vati or
Nashtapushpantaka Rasa to be taken with decoction of black sesame
leaves of Lasora, and gur.
O 20 ml of Kumaryasava and 240 mg of Shuddha Tankana to be
taken twice daily, preferably after meals.
ACUPUNCTURE

O Baihui (Du 20)
O Local points: Qihai (Ren 6), Guanyuan (Ren 4), Zhongji (Ren
3), Zhongwan (Ren 12), Ciliao (U.B. 32)
O Distal points: Sanyinjiao (Sp. 6), Zusanli (St. 36).
445
HOMEOPATHY
Aconitum napellus: Due to over-exposure to the cold or damp weather.
Belladonna atropa: Colicky lower abdominal pain; exhaustion and loss of
appetite are commonly present. The mood is nearly always one of agitation.
Br yonia alba: From chill or fright.
Calcarea carbonica: Due to anemia; accompanied by a poor posture (fat
and flabby patient).
Ferr um metallicum: Associated with anemia, diarrhea and malnutrition.
errum
Ignatia amara: Due to grief or disappointments in love.
Natrium: The periods are scanty, delayed ar absent.
Muriaticum: The patient is rather timid, nervous and always tired. Craves
for salty and seasoned foods.
Pulsatilla nigricans: Period always very irregular and variable.
Sepia: Agonizing pain; depression, wishes to be left alone.
Sulphur: Irregular periods followed by amenorrhea.
NATUROPATHY
Eat nutritious well balanced diet. Supplement food with iron-rich vegetables
like spinach and green leafy vegetables and folic acid and multivitamins.
Reduce your weight not by diet control alone but by regular exercises like
swimming, cycling, walking. Foods like pineapple juice, green unripe papaya
juice, banana stem juice and horse gram soup helps to start menstruation.
Following herbs are used to treat amenorrhoea:

O Chaste tree (Vitex agnus-cactus) helps normalize ovarian and uterine
function, but must be taken for 12 to 18 months
O Black cohosh (Cimicifuga racemosa), licorice (Glycyrrhiza glabra),
and squaw vine (Mitchella repens) help to balance estrogen levels.
O Chaste tree, wild yam (Dioscorea villosa), and lady’s mantle
(Alchemilla vulgaris) help balance progesterone levels.
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O Kelp (Laminaria hyperborea), Bladderwrack (Fucus vesiculosus), Oat

straw (Avena sativa), and Horsetail (Equisetum arvense) are rich in
minerals that support the thyroid.
O Milk thistle (Silybum marianum), dandelion root (Taraxacum
officinale), and vervain (Verbena officinalis) support the liver.
HYDROTHERAPY
Hot hip baths for 15 minutes daily twice or hot fomentation to lower
abdomen, lower back and thighs will bring menses within 2 to 3 days.
this three times to complete one “set.” Do one to two sets per day, three to
four days per week.
YOGA THERAPY
Yoga normalizes endocrine and reproductive function.
O Asanas:
Konasana
Bhramari
NUTRITION THERAPY
Eat fewer refined foods and limit animal products. Limit the cruciferous
family of vegetables (cabbage, broccoli, brussel sprouts, cauliflower and
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kale). Eliminate methylxanthines (coffee, chocolate). Eat more whole grains,

organic vegetables, and omega-3 fats (cold-water fish, nuts, and seeds). In
addition, you may take the following supplements.

O Calcium (1,000 mg per day), magnesium (600 mg per day),
vitamin D (200 to 400 IU per day), vitamin K (1 mg per day),
and boron (1 to 3 mg per day)
O Iodine (up to 600 mcg per day), tyrosine (200 mg one to two
times per day), zinc (30 mg per day), vitamin E (800 IU per day),
vitamin A (10,000 to 15,000 IU per day), vitamin C (250 to 500
mg two times per day), and selenium (200 mcg per day)
O B6 (200 mg per day) may reduce high prolactin levels
O Essential fatty acids: Flaxseed, evening primrose, or borage oil
(1,000 to 1,500 mg one to two times per day).
PHYSICAL THERAPY
O Therapeutic massage may improve endocrine function by relieving stress.

O Castor oil pack: Apply oil to skin of abdomen, cover with a clean
soft cloth and plastic wrap. Place a hot water bottle or heating pad
over the pack and let sit for 30 to 60 minutes. Use for three days.
PSYCHOTHERAPY
In amenorrhoea, psychosocial support and counseling for the patient is

necessary to address specific concerns and provide guidance.
Lifestyle
The lifestyle factors involved in amenorrhoea include obesity, anorexia,
over exercise and stress.
O Obesity may be reduced by briefing the client to a 1000 calorie
diet along with exercise of one hour twice daily till normal body
weight is reached.
O Anorexia (or body weight below normal) could result from low
calorie intake or from bulimia (vomiting). In case of inadequate
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food into this will need to be increased to above 1500 calories per
day. Psychological help will need to be sought to overcome bulemia.
O Over exercise frequently is part of anorexia and any exercise program
in excess of 60 minutes once a day its too much. In cases of anorexia,
a 30 minute, 3 days a week program is advised which is not to be
exceeded.
O Stress depression and anxiety may be treated by a psychotherapist.
PELVIC INFL
PELVIC AMMA
INFLAMMA TOR
AMMAT Y DISEASE
ORY
Pelvic inflammatory disease is a general term for infection of the lining of
the uterus, the fallopian tubes, or the ovaries. Acute PID comes on suddenly
and tends to be more severe, whereas chronic PID is a low-grade infection
that may cause only mild pain and sometimes backache. If not treated
promptly, PID can result in infertility and, in rare cases, death.

The same organisms responsible for bacterial sexually transmitted diseases
(such as chlamydia, gonorrhea, mycoplasma, staph, strep) cause about 90%
to 95% of all cases of pelvic inflammatory disease (PID). Although sexual
transmission is the most common cause of PID, bacteria may enter the
body after gynecological events or procedures such as IUD insertion
(intrauterine device used for contraception), childbirth, spontaneous
abortion, therapeutic or elective abortion, and endometrial biopsy.
Risk factors include sexual activity during adolescence, multiple sexual
partners, a past history of PID, a past history of any STD (sexually
transmitted disease), and the use of non-barrier type contraceptives. Use
of an IUD (intrauterine device) may increase the risk of developing PID at
the time of IUD insertion.
Oral contraceptives are thought in some cases to enhance cervical ectropion, a
condition that allows easier access to tissue where bacteria may thrive. However,
oral contraceptives may in other cases have a protective role against developing
PID because they stimulate the body to produce a thicker cervical mucous,
which is harder for semen (which may contain bacteria) to penetrate. This
makes it harder for semen to transmit bacteria to the uterus.
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Symptoms
The most common symptoms of PID include:
O Vaginal Discharge with abnormal color, consistency or odor
O Abdominal pain either localized or generalized
O Fever (not always present).
Other nonspecific symptoms that may be seen with PID include:
O Chills
O Irregular menstrual bleeding or spotting
O Increased menstrual cramping
O Absent menstruation
O Increased pain during ovulation
O Painful sexual intercourse
O Bleeding after intercourse
O Low-Back Pain
O Fatigue, nausea, with or without vomiting
O Frequent urination, pain with urination
O Point tenderness.
People who experience ectopic pregnancies or infertility are often found to
have so-called “silent” PID, which is usually caused by chlamydia infection.
Signs and tests
A general examination may reveal fever and abdominal tenderness. Pelvic
examination may reveal cervical discharge, cervical motion tenderness (pain
with movement of the cervix during a pelvic exam), a friable cervix (bleeds
easily), uterine tenderness, or adnexal (ovarian) tenderness.
Tests include:
O WBC and ESR
O Wet prep or wet mount microscopic examination
O Serum HCG (pregnancy test)
O Endocervical culture for gonorrhea, chlamydia, or other organisms.
O Laparoscopy
O Pelvic ultrasound or CT scan.
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Treatment
MODERN MEDICINE
Early diagnosis of mild PID may be treated on an outpatient basis with

antibiotics and close follow-up.
More complicated cases or those involving widespread or well-established
infection may require hospitalization. Intravenous antibiotics are used, and
usually followed with a course of oral antibiotics. Surgery may be considered
for complicated, persistent cases that do not respond to adequate antibiotic
treatment. Concurrent treatment of sexual partner(s) and the use of
condoms throughout the course of treatment are essential.
AYURVEDA
Treatment requires anti Pitta diet and regime, avoiding all spices excluding
turmeric, coriander and saffron, also refraining from salt, alcohol and refined
sugar, and all oils but coconut and sunflower. Good herbs include shatavari,
aloe gel, sarsaparilla, gotu kola, dandelion, myrrh, echinacea, katuki, golden seal,
gentian or uva ursi. Shatavari and Manjishta in equal proportions work well.
In chronic conditions, shatavari can be taken with aloe gel, one teaspoon of
the powder per one tablespoon of the gel twice a day on an empty stomach.
Ashoka (Saraca indica) and Lodhra (Symplocos racemosa) are the two drugs
of choice in the treatment of this condition. Ashoka ghritam with Shringa
Bhasmam reduces PID. Preparations like Ashokarishta and Lodrasava are
widely prescribed. Pradarantaka Lauha, a compound of some calxes, of
which iron is also a useful medicine. Lodhra (Symplocos racemosa) bark is
another substance, the decoction of which can be used for douching the
vaginal tract of a leucorrhoea patient.
ACUPUNCTURE

O Baihui (Du 20)
O Local points: Qihai (Ren 6), Guanyuan (Ren 4), Zhongji (Ren 3),
Shangliao (U.B. 31), Guilai (St. 29), Zhongwan (Ren 12), Ciliao
(U.B. 32), Zhongliao (U.B. 33), Xialiao (U.B 34)
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O Distal points: Sanyinjiao (Sp. 6), Zusanli (St. 36), Dazhui (Du
14), Quchi (L.I. 11), Hegu (L.I. 4)
O Specific points for low backache: Shenshu (U.B.23)
O Specific points for leucorrhoea: Daimai (G.B.26)
HOMEOPATHY
Aconitum: Vagina is hot, dry and sensitive. Menses too profuse.
Napellus: Where menses is protracted or too late. Ovaries congested and
painful. Sharp shooting pains in the pelvic area. Restlessness.
Belladonna A tr
Atr opa: Vagina hot and dry; bright red menses occurring too
tropa:
early, too profuse and offensive. Pain in the breasts; breasts feel heavy, hot
and red. Pain over the sacrum.
Ferr um phosphoricum: Menstruation occurs with bearing down sensation
errum
and pain on the vertex of head. Vagina is dry, hot and painful.
Magnesium Phosphoricum: When there is an excruciating pain.
Sulphur: Vagina burns; very offensive perspiration. Menses too late, short,
scanty, difficult; blood thick and acrid smelling. The vaginal area is sore.
Menstruation is preceded by headaches. Nipples cracked.
NATUROPATHY
Intially, fasting on vegetable and fruit juices for 1 to 2 weeks is advised.

After fasting a high fruit and vegetable diet is advised. Regular hydrotherapy,
massage and yoga helps to treat inflammation.
Hydrotherapy
Hot hipbaths for 15 minutes daily twice or hot fomentation to lower

abdomen, lower back and thighs.
this three times to complete one “set.” Do one to two sets per day, three to
four days per week.
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NUTRITION THERAPY
Eat whole foods such as fresh vegetables, whole grains, and essential fatty
acids (nuts, seeds, and cold-water fish). Avoid sugar, refined foods, and
saturated fats (animal products, especially dairy)

O Vitamin C (1,000 mg three to four times per day), zinc (30 mg
per day), selenium (200 mcg per day), vitamin E (400 IU per
day), B-complex (50 to 100 mg, especially folic acid 800 mcg per
day), and vitamin A (25,000 IU one to two times per day) or beta
carotene (50,000 IU one to two times per day)
O Bromelain (500 mg three times per day between meals)
O Anti-inflammatory oils (for example, flax, borage, evening primrose)
1,500 mg two to three times per day
O Acidophilus (one capsule with meals).
Prevention
Preventive measure include following safer sex behaviors; following the
health care provider’s recommendations after gynecological events or
procedures; and getting prompt treatment for sexually transmitted diseases.
Sexual partners should also get adequate treatment.
The risk of PID can be reduced by getting regular STD screening exams,
and by couples being tested before initiating sexual relations. Testing can
detect STDs that may not be producing symptoms yet.
ENDOMETRIOSIS
Endometriosis is a condition in which the endometrium, tissue that
normally lines the uterus, grows in other areas of the body, causing pain,
irregular bleeding, and frequently infertility.
The tissue growth typically occurs in the pelvic area, outside of the uterus,
on the ovaries, bowel, rectum, bladder, and the delicate lining of the pelvis,
but it can occur in other areas of the body as well.
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The cause of endometriosis is unknown. However, a number of theories
have been proposed. The retrograde-menstruation theory proposes that
endometrial cells (loosened during menstruation) may “back up” through
the fallopian tubes into the pelvis, where they implant and grow in the
pelvic and/or abdominal cavities.
The immune-system theory suggests that a deficiency in the immune system
allows menstrual tissue to implant and grow in areas other than the uterine
lining. Another theory suggests that the cells lining the abdominal cavity
may spontaneously develop endometriosis. A genetic theory proposes that
certain families may exhibit predisposing factors that lead to endometriosis.
Once the endometrial cells implant in tissue outside of the uterus, they
may become a problem. Each month the ovaries produce hormones that
stimulate the cells of the uterine lining to multiply and prepare for a
fertilized egg (swell and thicken).
The endometrial cells outside of the uterus also respond to this signal, but
they lack the ability to then separate themselves from the surrounding
tissue and slough off during the next menstrual period. They sometimes
bleed a little bit, but they heal and are stimulated again during the next
cycle.
This ongoing process can cause scarring and adhesions in the tubes and
ovaries, and around the tubal fimbriae (fingerlike projections at the end of
the fallopian tubes). These adhesions can make transfer of an ovum from
the ovary to the fallopian tube difficult or impossible. They can also stop
passage of a fertilized egg down the fallopian tube to the uterus.
Once in a while the growing cells will penetrate the tough covering of the
ovary and begin to multiply. These cells can collect large amounts of blood
and form what is called, appropriately, an ovarian blood cyst
(endometrioma).
Ovarian blood cysts have been known to grow to the size of a hen’s egg or
even an orange, and are usually painful. Over time the collected blood
darkens and, for this reason, the cysts are frequently called “chocolate cysts.”
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Endometriosis is a common problem. It occurs in an estimated 10% of

women during their reproductive years. The prevalence may be as high as
35% among infertile women. Although endometriosis is typically diagnosed
between the ages of 25 and 35, the problem probably begins about the
time that regular menstruation begins.
A woman who has a mother or sister with endometriosis has a risk of
developing endometriosis that is 6 times greater than that of the general
population. Other possible risk factors include early onset of menstrual
periods and periods lasting 7 or more days.
Symptoms
O Increasingly painful periods
O Lower abdominal pain or pelvic cramps that can by felt for a week
or two before menstruation and/or during menstruation (the pain
and cramps may be steady and dull or quite severe)
O Pelvic or low-back pain that may occur at any time during the
menstrual cycle
O Pain during or following sexual intercourse
O Pain with bowel movements
O Premenstrual spotting
O Infertility.
Note: Frequently, symptoms may not be present. In fact, some women
with severe cases of endometriosis have no pain at all, while some women
with only a few small adhesions have severe discomfort.
Signs and tests
A pelvic examination may reveal the presence of tender nodules, with a
lumpy consistency. These are often found in the posterior vaginal wall or
adnexa (ovary regions), and they may sometimes be felt in healed wound
scars (especially those from episiotomy and C-section). There may be pain
with uterine motion.
The uterus may be fixed or retroverted. A pelvic ultrasound test may detect
an endometrioma on an ovary. A laparoscopy is necessary for a definite
diagnosis, but most patients can start treatment without this.
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Treatment
Treatment depends on the the degree of symptoms experienced, the extent
of the disease (determined through laparoscopy), the woman’s desire for
future childbearing, and the woman’s age.
MODERN MEDICINE
O Oral contraceptives— relieve symptoms; various side effects.

O Hormone-suppressing drugs—stop menstruation, thus reducing
symptoms; for example, Danazol provides symptom relief for 80%
to 90% of patients; do not take if pregnant; various side effects.
“Pseudomenopause” (a state resembling menopause) was developed as a

means of treatment because of the observation that endometriosis regresses
after menopause. Danazol, a weak androgenic (male characteristic) hormonal
drug may be used to reduce natural levels of estrogen and progesterone to
low levels.
A new class of antigonadotropin drugs has been developed that also produces
a “pseudomenopausal” state in women. These drugs prevent stimulation
of the pituitary for the production of FSH (follicle stimulating hormone)
and LH (luteinizing hormone). This stops the ovary from producing
estrogen.
Surgery
Surgery (either laparoscopy or laparotomy) is usually reserved for women
with severe endometriosis, including adhesions and infertility. Conservative
surgery attempts to remove or destroy all of the outside endometriotic
tissue, remove adhesions, and restore the pelvic anatomy to as close to
normal as possible. Nerve removal (neurectomy) may rarely be performed
during surgery as a means of relieving the pain associated with endometriosis.
Total hysterectomy (removal of uterus and ovaries and any remaining

adhesions or endometriotic implants) is recommended when necessary and
when childbearing is no longer desired. It relieves pain most of the time,
but is not a guarantee that symptoms will end.
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AYURVEDA
Endometriosis tends more towards Kapha, with the excess growth of the
uterine membrane. Anti-Kapha, anti-tumour and general detoxifying and
reducing approach is useful with typical herbs like guggul, myrrh, turmeric
and dandelion. Black pepper and katuka or golden seal can be taken with
honey.
HOMEOPATHY
O Belladonna for menstruation with sensation of heaviness and heat
O Calcarea phosphoricum for excessive periods with backache
O Chamomilla for heavy menses with dark clotted blood and pains
O Cimicifuga racemosa for unbearable pain radiating from hip to
hip.
NUTRITION THERAPY
Eliminate all known food allergens. Eliminate alcohol, caffeine, chocolate,

refined foods, food additives, sugar, and saturated fats (meats and dairy
products).
Eat preferably organic poultry and produce. Increase intake of whole grains,
fresh vegetables, essential fatty acids, and vegetable proteins. Include liver-
supporting foods such as beets, carrots, onions, garlic, leafy greens,
artichokes, apples, and lemons.

O Vitamin C (1,000 mg three times per day) decreases inflammation
O Zinc (30 to 50 mg per day) and beta-carotene (50,000 to 100,000
IU per day) support immune function and enhance healing
O Vitamin E (400 IU per day) is necessary for hormone production
O Selenium (200 mcg per day) is needed for fatty acid metabolism
O Iron supplementation may be necessary if bleeding is severe
O Calcium (1,000 to 1,500 mg per day) and magnesium (200 mg
two to three times per day) are needed for hormone metabolism
O Essential fatty acids (1,000 to 1,500 mg twice a day).
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PHYSICAL THERAPY
O Contrast sitz baths. You will need two basins that you can
comfortably sit in. Sit in hot water for three minutes, then in cold
water for one minute. Repeat this process three times to complete
one set. Do one to two sets per day, three to four days per week.
(Do not perform this during menstrual flow.)
pad) over the pack and let sit for 30 to 60 minutes. For best results,
use for three consecutive days.
O Kegel exercises (contracting and releasing the pelvic muscles).
Prevention
There is no proven prevention for endometriosis. Women with a strong

family history of endometriosis may consider taking oral contraceptive pills,
as this treatment may help to prevent or slow down the development of
the disease.
PREMENSTRUAL SYNDR
PREMENSTRU OME
SYNDROME
Premenstrual syndrome (PMS) involves symptoms that occur in relation

to the menstrual cycle and which interfere with the woman’s life. The
symptoms usually begin 5 to 11 days before the start of menstruation.
Symptoms usually stop when menstruation begins, or shortly thereafter.
An exact cause of PMS has not been identified. However, it may be related
to social, cultural, biological, and psychological factors. PMS can occur
with apparently normal ovarian function (regular ovulatory cycles).
PMS is estimated to affect up to 75% of women during their childbearing

years. It occurs more often in women between their late 20s and early 40s,
those with at least one child, those with a family history of a major depression
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disorder, or women with a past medical history of either postpartum

depression or an affective mood disorder. As many as 50-60% of women
with severe PMS have an underlying psychiatric disorder.
Symptoms
A wide range of physical or emotional symptoms have been associated
with PMS. Such symptoms must occur during the second half of the
menstrual cycle (14 days or more after the first day of the menstrual period)
and be absent for about 7 days after a menstrual period ends (during the
first half of the menstrual cycle).
The most common symptoms include:
O Headache
O Swelling of ankles, feet, and hands
O Backache
O Abdominal cramps or heaviness
O Abdominal pain
O Abdominal fullness, feeling gaseous
O Muscle spasms
O Breast tenderness
O Weight gain
O Acne flare-ups
O Nausea, Bloating
O Constipation or diarrhea
O Decreased coordination
O Food cravings
O Less tolerance for noises and lights
O Painful menstruation.
Other symptoms include:
O Anxiety or panic
O Confusion
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O Difficulty concentrating
O Forgetfulness
O Poor judgment
O Depression
O Irritability, hostility, or aggressive behavior
O Increased guilt feelings
O Fatigue
O Slow, sluggish, lethargic movement
O Decreased self-image
O Sex drive changes, loss of sex drive
O Paranoia or increased fears
O Low self-esteem.
Signs and tests

There are no physical examination findings or lab tests specific to the
diagnosis of PMS. It is important that a complete history, physical
examination (including pelvic exam), and in some instances a psychiatric
evaluation be conducted to rule out other potential causes for symptoms
that may be attributed to PMS.
A symptom calendar can help women identify the most troublesome
symptoms and to confirm the diagnosis of PMS.
Treatment
A “symptom diary” should be kept for a minimum of 3 months in order to
correlate symptoms with the menstrual cycle. The diary will greatly assist
the health care provider not only in the accurate diagnosis of PMS, but
also with the proposed treatment methods.
MODERN MEDICINE
O Diuretics, for bloating and water retention
O Analgesics, for headaches and cramps
O Beta-blockers and calcium-channel blockers, to prevent the
onset of migraine headaches
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O Prostaglandin inhibitors for painful menstruation

O Spironolactone for skin conditions
O Medications that block ovulation
O Bromocriptine for breast soreness
O Progesterone, for relief of symptoms.
Women who are planning to become pregnant should avoid medications
such as prostaglandin inhibitors, diuretics, spironolactone, and danazol.
Psychiatric medications and or therapy may be used for women who exhibit
a moderate to severe degree of anxiety, irritability, or depression.
Hormonal therapy may include a trial on oral contraceptives, which may

either decrease or increase PMS symptoms. The use of progesterone vaginal
suppositories during the second half of the menstrual cycle is still
controversial.
AYURVEDA
The best herbs for treating PMS are Chitrak mool (Plumbago zeylanica)
and Nirgundi (Vitex negundo).
Spices to promote menstruation, such as turmeric, coriander, fennel, saffron

and safflower combined with antispasmodic spices such as nutmeg, can be
taken. Other Ayurvedic herbs good for PMS include aloe gel, shatavari,
turmeric, cyperus, saffron, manjishta, lodhra, gotu kola ginger, calamus and
bhringaraj.
Drugs like Sundarikalp, Rajahpravartini Bati, Kumariasava are helpful in

relieving PMS.
HOMEOPATHY
Chamomilla: for intense menstrual pain; this remedy is most appropriate

for individuals who are extremely irritable, angry, and have frequent mood
swings
Cimicifuga: for feelings of hysteria, frustration, and being overwhelmed;

this remedy is most appropriate for individuals who have labor-type pains
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that migrate from one side of the body to the other and may involve the
back or even sciatic nerve (the largest nerve in the body; extends from the
lower back down through the legs and knees)
Colocynthis: for cramps that are relieved by bending forward, abdominal
massage, and warmth (such as a heating pad); this remedy is most
appropriate for individuals who are extremely irritable and restless.
Ignatia: for emotional symptoms such as grief, panic, and mood swings.
This remedy is most appropriate for individuals who feel particularly
vulnerable.
Lachesis: for individuals who tend to be annoyed, caustic, talkative, and
envious and whose pain and bloating is worse on the left side; symptoms
tend to worsen upon awakening in the morning and with exposure to heat
or light pressure; symptoms improve dramatically when menstruation
begins.
Lycopodium: for bloating with backaches and gas that are the worst during
early evening and in warm weather.
Magnesia phos: for sharp cramps that are relieved by warmth (such as a
heating pad), but are worsened by cold air.
Nux vomica: for individuals who are extremely irritable, confrontational,
and feel nauseous.
Pulsatilla: for irregular periods with cramps, bloating, and/or mood swings
as the predominant symptoms; an appropriate candidate for Pulsatilla is
gentle and yielding but clingy and cries easily; may have nausea and water
retention that is aggravated by heat.
Sepia: for bloating, mood swings, constipation, drowsiness, and irritability.
NATUROPATHY
A balanced diet that is high in fibre, moderate in fat and protein and low in salt,
sugar, caffeine, and alcohol is good. Include lots of fresh fruits and vegetables,
starches, raw seeds and nuts, and whole grains in the diet. Watermelon juice or
Watermelon seed infusion – 2 times a day helps to reduce water retention. The
following herbs may be helpful in alleviating symptoms.
O Chaste tree (Vitex agnus castus) 175 mg a day
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O Black cohosh (Cimicifuga racemosa) 100 to 600 mg a day

O Valerian (Valeriana officinalis) 150 to 300 mg one to four times a
day, or before bed for insomnia or kava kava (Piper methysticum)
200 mg one to four times a day, or before bed. Reduce dose of
either herb if drowsiness occurs
O Milk thistle (Silybum marianum) 200 to 600 mg a day
O Dandelion (Taraxacum officinale) root and/or leaves as a tea or
tincture can be used as a diuretic. If you have liver problems, consult
with an experienced practitioner before using dandelion
O St. John’s wort (Hypericum perforatum) 300 mg two to three times
per day for depression associated with PMS. Must be taken
consistently throughout the month; direct sun exposure may cause
rashes in some people.
YOGA THERAPY
Yogasanas can be very helpful in relieving menstrual cramping. They
accomplish this by aligning body structure, helping body fluids to circulate,
and relieving nerve pressure. Also, they relieve pent-up stress, and often
that lessens physical and emotional pressure, thereby helping to relieve
many PMS symptoms.
O Asanas:
Konasana
{ Relaxative asanas like Shavasana and Makarasana
Bhramari
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NUTRITION THERAPY
Decreasing or avoiding caffeine (including chocolate), saturated fats, sugar,

salt, dairy, meat, poultry, and alcohol can help reduce the intensity and
duration of symptoms. Nutritional deficiencies may be addressed with
these supplements.

O Vitamin B6 (100 to 200 mg a day) with B-complex (50 to 100
mg a day)
O Magnesium (400 mg a day)
O Vitamin E (400 to 600 IU a day), especially with breast tenderness
O Essential fatty acids: omega-3 and omega-6 (3,000 to 4,000 mg a
day for three months, then decrease dose by 1,000 mg every two
months)
O Chromium (250 mcg one to two times per day) to reduce sugar
cravings.
Evening primrose oil (EPO): Women with PMS may have a deficiency of
gamma-linoleic acid (GLA) which is found in EPO.
PSYCHOTHERAPY
Stress may exacerbate PMS. One study found a 58% improvement in the
relaxation response group in 46 women with PMS. Relaxatory practices
like jacobson’s relaxation, meditation, and biofeedback help to reduce
symptoms. Counselling and Cognitive behavioural therapy helps to reduce
anxiety and depression associated with PMS.
Prevention and Lifestyle

Some of the lifestyles changes often recommended for the treatment of
PMS may actually be useful in preventing symptoms from developing or
getting worse.
The majority of PMS symptoms including headache, smelling, cramps,
muscle spasm, nausea, constipation painful mensuration, depression,
irritability, fatigue, sluggishness, and decreased sex drive etc. are all greatly
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relieved by lifestyle factors including sufficient exercise, relaxation, a balance

diet and avoiding smoking and alcohol.
Regular exercise and a balanced diet (with increased whole grains,
vegetables, fruit, and decreased or no salt, sugar, alcohol, and caffeine) will
prove beneficial.
The body may have different sleep requirements at different times during
a woman’s menstrual cycle, so it is important to get adequate rest.
MENOPAUSE
MENOPA
Menopause is a normal biological event that marks the end of a woman’s
reproductive years. It is the transition period in a woman’s life when her ovaries
stop producing eggs, her body produces less estrogen and progesterone, and
menstruation becomes less frequent, eventually stopping altogether. Menopause
is a natural event that normally occurs between the ages of 45 and 55.

Menopause is the last stage of a gradual biological process in which the ovaries
reduce their production of female sex hormones. Estrogen production in the
body diminishes slowly over a period of years, commonly resulting in hot flashes,
night sweats, mood swings, and memory loss. This gradual phase before the
permanent cessation of menstrual periods is sometimes called perimenopause.
The process of menopause is considered complete when a woman has not
menstruated for an entire year. Another type of menopause, known as
surgical menopause, occurs if both ovaries are removed for medical reasons.
This is done at the time of a hysterectomy.
The symptoms of menopause are caused by changes in estrogen and
progesterone levels. As the ovaries become less functional, they produce
less of these hormones and the body responds accordingly. The specific
symptoms you experience and how significant (mild, moderate, or severe)
varies from woman to woman.
In some women, menstrual flow comes to a sudden halt. More commonly,
it tapers off. During this time, menstrual periods generally become either
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more closely or more widely spaced. This irregularity may last for 1 to 3
years before menstruation finally ends completely.
A gradual decrease of estrogen generally allows the body to slowly adjust
to the hormonal changes. When estrogen drops suddenly, as is seen when
the ovaries are removed surgically (called surgical menopause), symptoms
can be more severe.
Living without the protective effects of estrogen increases a woman’s risk
for developing serious medical conditions, including osteoporosis and
cardiovascular disease.
Symptoms
The potential symptoms include:
O Hot flashes and skin flushing
O Night sweats
O Insomnia
O Mood swings including irritability, depression, and anxiety
O Irregular menstrual periods
O Spotting of blood in between periods
O Vaginal dryness and painful sexual intercourse
O Decreased sex drive
O Vaginal infections
O Urinary tract infections.
In addition, the long-term effects of menopause include:
O Bone loss and eventual osteoporosis
O Changes in cholesterol levels and greater risk of heart disease.
Signs and tests
Blood and urine tests can be used to measure hormone levels that may
indicate when a woman is close to menopause or has already gone through
menopause. Examples of these tests include:
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O Estradiol
O FSH
O LH.
A Pap smear may indicate changes in the vaginal lining caused by changes
in estrogen levels. A bone density test may be performed to screen for low
bone density levels seen with osteoporosis.
Treatment
Menopause is a natural process. It does not require treatment unless the
symptoms, such as hot flashes or vaginal dryness, are particularly
bothersome.
MODERN MEDICINE
Hormone Replacement Therapy

Replacement
For years, hormone replacement therapy (HRT) was the main treatment
for menopause symptoms. Many physicians believed that HRT was not
only good for reducing menopausal symptoms, but also reduced the risk
of heart disease and bone fractures from osteoporosis. However, the results
of a major study called the Women’s Health Initiative, has led physicians
to revise their recommendations. In fact, this important study was stopped
early because the health risks outweighed the health benefits. Women taking
the hormones did see some benefits. But they greatly increased their risk
for breast cancer, heart attacks, strokes, and blood clots.
AYURVEDA
The general treatment is similarly anti-Vata. Many herbs which tones the
female reproductive system become helpful again, including aloe gel,
shatavari, saffron, kapikacchu, ashwagandha, taken in milk decoctions, if
possible, or in their different preparations like shatavari compound.
Aloe gel is specific for maintaining the youthfulness of the female

reproductive organs. Chyawanprash is useful here for its general rejuvenative
effect.
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Pitta (fire) type menopause symptoms are anger, irritability and short
temper, with more frequent or pronounced, hot flashes. Treatment is anti-
Pitta, including aloe gel and shatavari tonics or a saffron milk decoction or
shatavari compound.
Kapha (water) type menopause involves feelings of heaviness, sleepiness,
lack of motivation, weight gain or holding of water. Treatment is anti-
Kapha. Hot spices are used like the Trikatu formula along with aloe gel.
The following herbs are useful in ayurveda:
O Shatavari (Asparagus racemosus) - 20 grams of crushed roots boiled
with water or milk daily for a few months
O Ashwagandha (Withania somnifera) – 1 tsp of root powder with a
hot glass of milk at night
O Ashoka (Saraca indica) Decoction 10 ml. 3 times per day.
ACUPUNCTURE
Since the early seventies, studies around the globe have suggested that
acupuncture and Chinese herbal medicine are effective treatments for hot
flashes, anxiety, insomnia, vaginal dryness and many other symptoms
associated with menopause. Recent studies show extremely positive results.
United Nations World Health Organization has approved acupuncture as
a treatment for symptoms associated with menopause.
Common acupuncture points used for menopause are Guanyuan (REN.
4), Quchi (LI. 11), Sanyinjiao (SP.6), Taixi (KID.3), Yinlingquan (SP.90,
and other points are added as appropriate for the treatment of that
individual.
HOMEOPATHY
O Lachesis (venom of the bushmaster) - hot flashes, irritability
O S epia (cuttlefish) - low energy, mood swings, vaginal dryness,
irritability
O Pulsatilla (windflower) - mood swings, insomnia
O Sulfur (sulfur) - hot flashes, irritability
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O Lycopodium (club moss) - bloating, flatulence, pain with intercourse

O Argentum nitricum (silver nitrate) - anxiety, nervousness, irritability,
insomnia
O Calcarea phosphorica (calcium phosphate) - improves bone density
O Belladonna (deadly nightshade) - hot flashes, especially if they begin
abruptly.
NATUROPATHY
A lifestyle of low fat eating, not smoking, and exercising regularly will
usually help to face menopausal changes without any problems. Take high
amounts of plant foods that contain phytoestrogens like carrot, tomato,
garlic, yam, fennel, celery, parsley, soy, nuts, flax seeds, cabbage, broccoli,
apples, and alfalfa. Following herbs help to reduce menopausal problems.
O Chaste tree (Vitex agnus-castus) liquid extract -1 ml twice a day for
1 to 3 months
O Liquorice (Glycyrrhiza glabra) - dried root or as tea, 2 gram/day
O Flaxseed Oil may help relieve breast pain and tenderness associated
with menstruation
O Ginger tea is safe and may help in relieving mild nausea and other
minor symptoms of PMS
O Black cohosh (Cimicifuga racemosa) relieves symptoms of
menopause including hot flashes, irritability, mood swings, and
feelings of depression
O Dong quai (Angelica sinensis), in combination with other herbs, has
been used for thousands of years in Traditional Chinese Medicine
to relieve symptoms of menopause
O Red clover (Trifolium pratense) contains high quantities of plant-
based estrogens called isoflavones that may improve menopausal
symptoms, reduce the risk of bone loss, and lower the risk of heart
disease by improving blood pressure and possibly by increasing
HDL cholesterol (the “good” kind of cholesterol)
O Wild yam (Dioscorea villosa) improves menopausal symptoms,
particularly vaginal dryness.
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YOGA THERAPY
Yoga can be very helpful in relieving menopausal symptoms and problems.
It accomplishes this by strengthening and stretching connective tissue,
reducing bone loss and by relaxation. Yoga relieves pent-up stress, and
often that lessens physical and emotional pressure, thereby helping to relieve
menopause symptoms.
O Asanas:
Konasana
Bhramari
NUTRITION THERAPY
The right diet can help a woman battle many of the risks and discomforts
associated with menopause. A low-fat, low-cholesterol diet, for example,
may diminish the risk of heart disease in menopausal women by providing
the following benefits:
O Less of a rise in LDL cholesterol and triglycerides
O At least short-term lowering of blood pressure
O Diminished weight gain.
Antioxidants, such as vitamins C and E, help women prevent serious medical
conditions associated with menopause. Large population studies also
strongly suggest that intake of food sources of vitamin E (such as wheat
germ, nuts [particularly walnuts, almonds, and hazelnuts], vegetable oil
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[including canola, corn, soybean, and safflower], spinach, kale, sweet

potatoes, and yams) also decreases the risk of a stroke after menopause.
In addition, soy-based foods like tofu have been shown to help minimize
certain symptoms of menopause, including hot flashes. Adding plenty of
calcium to the diet can also help menopausal women avoid bone loss.
Foods rich in calcium include dairy products, leafy green vegetables,
almonds, and dried beans. High fiber meals may also help lower a woman’s
risk of high cholesterol and heart disease.
PHYSICAL THERAPY
Exercise
Regular aerobic and strength training exercises has shown to improve the
health in menopausal women. The benefits of regular exercise include:
O Slowing the rate of bone loss (through weight-bearing exercises)
O Reducing hot flashes
O Enhancing memory and concentration
O Improving cholesterol
O Improving pelvic muscle tone through Kegel exercises
O Maintenance of general health and strength, particularly for elderly
who are better able to maintain independence if they exercise.
PSYCHOTHERAPY
Many menopausal women may not be able to cope with menopausal
changes resulting in depression. These people will bebenefitted by
counselling, relaxation and cognitive behaviour therapy.
Preventive Care
The following preventive measures may help diminish symptoms and reduce
the risk of serious complications (such as osteoporosis and cardiovascular
disease) associated with menopause:
O Quitting smoking - smokers tend to begin menopause 1 to 2 years
earlier than nonsmokers; smokers are also at an increased risk for
heart disease and osteoporosis
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O Taking calcium supplements - helps protect against bone loss

O Exercising - slows the rate of bone loss, reduces hot flashes, and
improves mood
O Consuming low-fat diets - helps prevent cardiovascular disease by
decreasing LDL “bad” cholesterol and by lowering the chances of
weight gain
O Taking certain medications (such as estrogen or non-hormonal
medications) - prevents long-term illnesses associated with
menopause, such as osteoporosis
O Avoiding caffeine - some studies suggest that caffeine consumption
may be a risk factor for osteoporosis in postmenopausal women
O Continued sexual activity - this not only enhances the endorphins
and pleasure hormones but also enhances self esteem and social
integration.
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11
IMMUNOLOGICAL DISEASES
AIDS
Allergies
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AIDS
AIDS (Acquired Immune Deficiency Syndrome) is the final and most
serious stage of HIV disease, which causes severe damage to the immune
system.
According to the Centers for Disease Control and Prevention, AIDS begins
when a person with HIV infection has a CD4 cell count below 200. (CD4
is also called “T-cell”, a type of immune cell.) AIDS is also defined by
numerous opportunistic infections and cancers that occur in the presence
of HIV infection.

AIDS is the fifth leading cause of death among persons between ages 25
and 45 in the United States. About 50 million people worldwide have
been infected with HIV since the start of the epidemic.
Human immunodeficiency virus (HIV) causes AIDS. The virus attacks the
immune system and leaves the body vulnerable to a variety of life-
threatening infections and cancers.
Common bacteria, yeast, parasites, and viruses that ordinarily do not cause
serious disease in people with fully functional immune systems can cause
fatal illnesses in people with AIDS.
HIV has been found in saliva, tears, nervous system tissue, blood, semen
(including pre-seminal fluid), vaginal fluid, and breast milk. However,
only blood, semen, vaginal secretions, and breast milk have been proven to
transmit infection to others.
Transmission of the virus occurs:
1. Through sexual contact — including oral, vaginal, and anal sex
2. Through blood — via blood transfusions (now extremely rare in
most developed countries) or needle sharing
3. From mother to child — a pregnant woman can transmit the virus
to her fetus through their shared blood circulation, or a nursing
mother can transmit it to her baby in her milk.
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Immunological Diseases
Other transmission methods are rare and include accidental needle injury,
artificial insemination with donated semen, and through a donated organ.
HIV infection is not spread by casual contact such as hugging, by touching
items previously touched by a person infected with the virus, during
participation in sports, or by mosquitoes.
It is not transmitted to a person who donates blood or organs. Those who
donate organs are not in direct contact with those who receive them.
Likewise, a person who donates blood is not in contact with the person
receiving it. In all these procedures, sterile needles and instruments are
used.
However, HIV can be transmitted to a person receiving blood or organs
from an infected donor. This is why blood banks and organ donor programs
screen donors, blood, and tissues thoroughly.
Those at highest risk include persons engaging in unprotected sex, the
sexual partners of those who participate in high-risk activities (such as anal
sex), intravenous drug users who share needles, infants born to mothers
with HIV, and people who received blood transfusions or clotting products
between 1977 and 1985 (prior to standard screening for the virus in the
blood).
AIDS begins with HIV infection. People infected with HIV may have no
symptoms for ten years or longer, but they can still transmit the infection
to others during this symptom-free period. Meanwhile, if the infection is
not detected and therefore not treated, the immune system gradually
weakens and AIDS develops.
Acute HIV infection progresses over time to asymptomatic HIV infection
and then to early symptomatic HIV infection. Later, it progresses to AIDS
(i.e. very advanced HIV infection with T-cell count below 200).
Most individuals infected with HIV, if not treated, will develop AIDS.
There is a small group of patients who develop AIDS very slowly, or never
at all. These patients are called non-progressors and many seem to have a
genetic difference which prevents the virus from attaching to certain immune
receptors.
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Symptom
Symptomss
Primary or initial infection: generally, a flu-like syndrome that occurs in
50 to 80% of those who contract HIV within 2 to 6 weeks, including a
combination of the following symptoms:
O Fever
O Sore throat
O Swollen lymph nodes
O Joint pain
O Muscle aches
O Rash
O Mouth ulcers
O Nausea
O Diarrhea
O Headache.
Early HIV infection: generally occurs when the CD4 count is below 500/
microliter; sometimes called pre-AIDS or AIDS-related complex (ARC);
there is a long latency phase (median time of 10 years) between the initial
contraction of HIV and early infection.
O Swollen lymph nodes throughout the body
O Lesions on the tongue or mouth, which may represent a fungal
infection called Candida or one called Hairy Leukoplakia
O Low platelet count, which may manifest as easy bruising, bleeding
gums, or nose bleeds
O Herpes lesions of the mouth or genitals
O Shingles
O Skin infection
O Genital warts.
Advanced stage HIV, often called AIDS: generally occurs when the CD4
count is below 200/microliter and is usually marked by the development
of opportunistic infections (those that occur with a weakened immune
system).
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O Pneumonia, including Pneumocystis carinii (PCP)

O Tuberculosis
O Extreme weight loss and wasting; exacerbated by diarrhea which
can be experienced in up to 90% of HIV patients worldwide
O Meningitis and other brain infections
O Fungal infections
O Syphilis
O Malignancies such as lymphoma, cervical cancer, and Kaposi’s
sarcoma (KS) (affects the skin and oral mucosa and may spread to
the lungs; KS can actually occur in earlier stages of HIV as well).
Signs and tests

In the early stages of infection, HIV often causes no symptoms and the
infection can be diagnosed only by testing a person’s blood. Two tests are
available to diagnose HIV infection - one that looks for the presence of
antibodies produced by the body in response to HIV and the other that
looks for the virus itself.
Antibodies are proteins produced by the body whenever a disease threatens
it. When the body is infected with HIV, it produces antibodies specific to
HIV. The first test, called ELISA (Enzyme Linked Immunosorbent Assay),
looks for such antibodies in blood.
If antibodies are present, the test gives a positive result. A positive test has
to be confirmed by another test called Western Blot or Immunoflouroscent
Assay (IFA). All positive tests by ELISA need not be accurate and hence
Western Blot and repeated tests are necessary to confirm a person’s HIV
status. A person infected with HIV is termed HIV- positive or seropositive.
As ELISA requires specialized equipment, blood samples need to be sent
to a laboratory and the result will be available only after several days or
weeks. To cut short this waiting period, RAPID TESTS , that give results
in 5 to 30 minutes, are increasingly being used the world over. The accuracy
of rapid tests is stated to be as good as that of ELISA. Though rapid tests
are more expensive, researchers have found them to be more cost effective
in terms of the number of people covered and the time the tests take.
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The HIV- antibodies generally do not reach detectable levels in the blood
till about three months after infection. This period, from the time of
infection till the blood is tested positive for antibodies, is called the Window
Period . Some times, the antibodies might take even six months to show
up. Even if the tests are negative, during the Window Period, the amount
of virus is very high in an infected person. Hence, if a person is newly
infected, the risk of transmission is higher.
If a person is highly likely to be infected with HIV and yet both the tests
are negative, a doctor may suggest a repetition of the tests after three months
or six months when the antibodies are more likely to have developed.
The second test is called PCR (Polymerase Chain Reaction), which looks for
HIV itself in the blood. This test, which recognizes the presence of the virus’
genetic material in the blood, can detect the virus within a few days of infection.
There are also tests like Radio Immuno Precipitation Assay (RIPA) , a
confirmatory blood test that may be used when antibody levels are difficult
to detect or when Western Blot test results are uncertain. Other available
tests are Rapid Latex Agglutination Assay, a simplified, inexpensive blood
test that may prove useful in medically disadvantaged areas where there is
a high prevalence of HIV infection, and p24 Antigen Capture Assay.
The following is a list of AIDS-related infections and cancers that people
with AIDS acquire as their CD4 count decreases. Previously, having AIDS
was defined by having HIV infection and acquiring one of these additional
diseases, but now it is simply defined as a CD4 count below 200. Many
other illnesses and corresponding symptoms may develop in addition to
those listed here.
Common with CD4 count below 350/ml:
O Herpes simplex virus - causes ulcers in the mouth or genitals,
occurring more frequently and more severely than previously
O Tuberculosis - infection by the tuberculosis bacteria that
predominately affects the lungs
O Oral or vaginal thrush - yeast infection of the mouth or genitals
O Herpes zoster - ulcers over a discrete patch of skin caused by this
virus
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O Non-Hodgkins lymphoma - cancer of the lymph glands - CD4

count below 200/ml
O Pneumocystis carinii pneumonia, “PCP pneumonia”
O Candida esophagitis - painful yeast infection of the esophagus -
CD4 count below 100/ml
O Cryptococcal meningitis - infection of the brain by this fungus
O AIDS dementia - worsening and slowing of mental function caused
by HIV itself
O Toxoplasmosis encephalitis - infection of the brain by this parasite
O Progressive multifocal leukoencephalopathy - a viral disease of the
brain caused by a virus (called the JC virus) that results in a quick
decline in cognitive and motor functions
O Wasting syndrome - extreme weight loss and anorexia caused by
HIV - CD4 count below 50/ml
O Mycobacterium avium - a blood infection by a bacterium related
to tuberculosis
O Cytomegalovirus infection - a viral infection that can affect almost
any organ system, especially the eyes.
In addition to the CD4 lymphocyte count, chest x-rays, Pap smears, and other
tests are useful in managing HIV disease. Persons who engage in receptive anal
sex may wish to consider anal Pap smears to detect potential cancers.
Treatment
There is no cure for AIDS at this time. However, several treatments are
available that can delay the progression of disease for many years and improve
the quality of life of those who have developed symptoms.
MODERN MEDICINE
Antiviral therapy suppresses the replication of the HIV virus in the body.
A combination of several antiretroviral agents, termed Highly Active Anti-
Retroviral Therapy (HAART), has been highly effective in reducing the
number of HIV particles in the bloodstream, as measured by a blood test
called the viral load. This can help the immune system bounce back for a
while and improve T-cell counts.
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O Antiretrovirals (e.g., zidovudine, lamivudine, efavirenz, ritonavir,

indinavir) - help slow the progression of HIV; must be taken as
directed to avoid development of viral strains that no longer respond
to the medication.
O Prophylaxis - medicines used to prevent opportunistic infections;
started when the CD4 count drops to a certain number (e.g., CD4
< 200/microliter, medication to prevent PCP is begun).
Other antiviral agents are in investigational stages and many new drugs are
in the pipeline. Growth factors that stimulate cell growth, such as Epogen
(erthythropoetin) and G-CSF are sometimes used to treat anemia and low
white blood cell counts associated with AIDS.
AYURVEDA
Ayurveda does not cure HIV infection. However, it helps in improving

their immunity and preventing secondary infections.
Initially, the patient is given tonics and rejuvenators (Rasayanas) to boost

immunity levels and to strengthen the system and stimulate appetite. After
gaining some strength, elimination (shodhana) techniques are used to expel
toxins from the body through enemas, purgation and emesis. The
medications administered at this stage are not hard or drastic, but soft,
ghee-based so that the patient withstands them with ease.
Foods which strengthen immunity (Ojas) like almonds, chick peas, milk,
yogurt, ghee (clarified butter), black gram, meat soups are advised.
Typical Ayurvedic herbs for building immunity (Ojas) include

Ashwagandha, Shatavari, Gokshura, Bala, and Kapikacchu. Shilajit is excellent
tonic for AIDS, taken 1-3 gms twice a day with milk and ghee. Guduchi is
excellence for clearing deep seated fevers and strengthening the immune
system. Drugs like Ashwagandha lehyam, Brahmi rasayana, Chyavanprash
Amrita lehyam, Indukantha Ghritam etc are given.
A typical Ayurvedic AIDS formula could be made with gotu kola, sarsaparilla,
ashwagandha, shatavari, gokshura, sandalwood and coriander. Guduchi, guggul
and shilajit can be added if available.
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The Ayurvedic special preparation, diamond ash (Hira bhasma) is important.

A Mercury compound, Makaradhwaj, is also good for restoring immunity
but should not be taken in acute infections.
ACUPUNCTURE
Acupuncture does not cure HIV infection. People with HIV have used
acupuncture to improve general well being, alleviate symptoms such as
fatigue, insomnia, headache, and night sweats, and to minimize side effects
from medications.
Following Acupoints are used in HIV infection: LI-4, ST-36, RE-6, Ear-
Spleen.
Acupuncture when combined with Chinese immune enhancing herbs have
shown to increase CD4 count and improved general wellbeing.
HOMEOPATHY
Homeopathic medicines have been found to be effective in checking the
growth of certain infections in HIV positive patients by improving their
immune system. The homeopathy medicines differ according to symptoms
and constitution of patient.
NATUROPATHY
Naturopathy does not cure HIV infection. However, it helps in improving
their immunity, general health and preventing secondary infections.
Naturopathy advises a healthy diet, regular exercise and immunity
enhancing herbs in treating HIV.
Recent studies show that some plant like Mellisa Officinale, Mentha
Piperita, Cichorium Intybus, Aloe Vera, Glycyrrhiza Glabra and Punica
Granatum have direct action of inhibition on HIV.
There are certain phyto-chemicals, which are known anti-HI Virus:
Catechin, Curcumin, Chicoric Acid, Elagesic Acid, Glycyrrhizin, Punicalin,
Quercetin, Rosmarinic Acid.
There is large evidence that some of the herbs are capable of strengthening
the human immune system. Herbs like Ashwagandha (Withania somnifera),
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Shatavari (Asparagus racemosus), Guduchi (Tinospora cordifolia), Pepper (Piper

longum) Garlic (Allium sativum), Neem (Azadirachta indica), Liquorice
(Glycyrrhiza glabra), Turmeric (Curcumin), Vacha (Acorus calamus), Basil
(Ocimum sanctum) have been shown to strengthen immunity.
Garlic has antiviral activity. AIDS patients taking five to ten grams of aged
garlic (equivalent to two to three small cloves) per day developed normal
natural killer cell activity after twelve weeks which was associated with
clinical improvement. Turmeric depresses trans-activation of HIV1 LTR.
It also increases the survival of CD4 cells and prevents their apoptosis thus
inhibiting HIV replication.
Some herbs may not be good for HIV. Herbs like echinacea and astragalus,
two substances touted to enhance immune function in people with HIV,
should not be used because they may actually enhance replication of the
HIV virus. An Herb like St. John’s wort decreases the effectiveness of certain
prescription medications for HIV.
Hydrotherapy
Hot tub baths have been shown to kill HIV. In 1988 and 1989, natural
health clinic of Bastyr University, USA has conducted a “Healing Aids
Research Project”. In this project, AIDS patients were given a series of 12
hyperthermia baths at 1020F for 40 minutes, twice weekly, for a year. The
HIV virus is a heat sensitive virus and it is inactivated at higher temperatures
above the normal body temperature. After 30 minutes heating in water at
107.60F, there is a 40% deactivation of HIV; at 132.80F, there is a 100%
deactivation of HIV. Participants of this project have reported increased
sense of well being and a decrease in night sweats and in the frequency of
secondary infections.
YOGA THERAPY
Yoga helps in increasing general health and immunity in AIDS patients.
Regular yoga practices can increase appetite and weight.
O Asanas:
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Konasana

Bhramari
NUTRITION THERAPY
Eating a nutritious, balanced diet is an important part of treating human
immunodeficiency virus. Good nutrition can help your immune system
stay strong, which in turn may help your body fight HIV. Knowing the
best way to nourish your body will help keep it strong and allow your HIV
medications to work effectively.
It is important to maintain lean muscle mass while fighting HIV.
Maintaining a healthy weight can be a challenge, since weight loss is
common with HIV and is a side effect of some HIV medications. Patients
may also have digestive problems associated with HIV or its treatment.
Getting enough protein and calories may help immune system fight the HIV
infection and improve overall health. Nutritional counselling has been shown
to improve your health while living with HIV, and it is now recommended that
your diet be periodically assessed after you are diagnosed with HIV.

A study published in November 1999 supports the use of certain
supplements for those with HIV, particularly for help in maintaining body
weight. In a well-designed study comparing the use of a daily supplement
regimen that included the amino acid glutamine (40 g per day), vitamin
C (800 mg), vitamin E (500 IU), beta-carotene (27,000 IU), selenium
(280 mcg), and N-acetylcysteine (2400 mg) to placebo, people who took
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the supplements gained significantly more weight after 12 weeks than

those who took the placebo.
The antioxidant vitamins C and E may reduce cell damage and viral load.
The antioxidant selenium (100 to 400 mcg per day) and a vitamin B
complex (75 to 100 mg per day) may also be useful because of the physical
stress of HIV. Cobalamin (vitamin B12) levels are occasionally low with
HIV, in which case monthly injections of vitamin B12 may be helpful.
Amounts generally used in the case of HIV are:
O Vitamin C 1000 mg per day
O Vitamin E 400 to 800 IU per day
O Selenium 100 to 400 mcg per day
O Vitamin B complex 75 to 100 mg per day.
The specific nutrients which improve immune function are EFAs, protein,
zinc, vitamin A, vitamin B6, folic acid and iron. Among the healthy elderly,
immune boosting benefits have been demonstrated for anti-oxidants like
zinc, selenium, vitamin E and beta-carotene.
PSYCHOTHERAPY
People who are infected with HIV have a greater risk of developing
depression. Psychotherapy helps you deal with the emotional aspects of
the disease. Grief counselling helps you deal with end-of-life issues.
During psychotherapy, a qualified counsellor helps the patient cope with
or change his thoughts, feelings, or behaviours regarding HIV infection.
Patient’s family and caregivers may also benefit from psychotherapy.
The effectiveness of psychotherapy varies. Some people respond very well
while others find minimal relief. Studies suggest that psychotherapy can
effectively treat people with HIV who also have problems with depression.
Reducing stress can help you better manage the HIV illness. Some methods
of stress reduction include: Relaxation, Guided imagery, Biofeedback and
Problem solving.
Grouptherapy helps HIV patients. Support groups are often good places to
share information, problem-solving tips, and emotions related to HIV infection.
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EXERCISE THERAPY
Exercise cannot control the HIV infection. However, exercise strengthen
the body’s systems. Exercise also helps the immune system work better.
Exercise enhances sense of well-being and may help stabilize or prevent
declines in CD4+ cell counts.
The ability of a person who has HIV to improve his or her fitness through
training is similar to that of a person who does not have HIV. However,
people with HIV may find it harder to continue with a training program
because of fatigue or muscle wasting.
Participation in competitive sports does not pose a risk of spreading HIV
to other athletes or coaches. In sports in which exposure to blood can
occur, the risk of HIV spread is very small. However, if a person (HIV-
infected or not) does start to bleed, he or she should be taken out of the
game and the wounds should be covered before returning to the game.
Siddha Medicine
Siddha medicine has emerged as an effective way to control the HIV-AIDS
virus when prescribed with allopathy drugs. Pilot tests using a combination
of Siddha and allopathy drugs on HIV patients at the TB Sanatorium in
Tambaram, Chennai which is Asia’s largest AIDS care center, showed
promising and consistent results in fighting the HIV virus.
Drugs consisting of ‘‘Rasagandi Milagu’’ (processed mercury and sulphur),
‘‘Amukkara Churnam’’ (Withania Somniferum), and ‘‘Amla Legiyam’’ (Indian
gooseberry), which are cost-effective Siddha preparations, were administered
along with opportunistic infection controlling drugs to AIDS patients.
The results showed a considerable reduction in the viral load and increase
in CD8 and CD4 count. Besides, they also showed signs of clinical
improvement like control of symptoms, fever, diarrhea, and gaining weight.
There are no side effects noticed in over 80,000 patients who have received
these drugs since 1992.
Currently Siddha researchers are studying herbs such as:
O Seen kottai (Semecarpus anacardium)
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O Kandankaththiri (Solanum surattense)

O Pappara mulli (Podophyllum hexandrum)
O Karkataga singi (Rhus succedanea)
O Asoka (Saraca indica)
O Ashwagandha (Withania somnifera)
O Seendhil (Tinospora cordifolia)
O Garlic (Allium sativum)
O White arsenic.
Research on herbal and mineral preparations using inorganic, metallic
substances (such as mercury, zinc, silver, copper, sulphur and mica) is
underway. Siddha researchers are optimistic about finding a way to control
AIDS.
Prevention
The following steps may seem personally restrictive, but they are effective
and can save your life.
1. Follow safe sex (i.e. a mutually monogamus sexual relationship) to
reduce the chance of acquiring or spreading HIV and other sexually
transmitted diseases.
2. Do not use intravenous drugs. If IV drugs are used, do not share
needles or syringes. Many communities now have needle exchange
programs where used syringes can be disposed of and new, sterile
needles obtained for free. These programs can also provide referrals
to addiction treatment.
3. Avoid contacting blood from injuries or nosebleeds where the HIV
status of the bleeding individual is unknown. Protective clothing,
masks, and goggles may be appropriate when caring for people
who are injured.
4. Anyone who tests positive for HIV may pass the disease on to
others and should not donate blood, plasma, body organs, or sperm.
An infected person should warn any prospective sexual partner of
their HIV-positive status, should not exchange body fluids during
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sexual activity, and must use whatever preventative measures (such

as condoms) will afford the partner the most protection.
5. HIV-positive women who wish to become pregnant should seek
counseling about the risk to unborn children and medical advances
which may help prevent the fetus from becoming infected. Use of
certain medications can dramatically reduce the chances that the
baby will become infected during pregnancy.
6. Mothers who are HIV-positive should not breast feed their babies.
7. Safe-sex practices, such as latex condoms, are highly effective in
preventing HIV transmission. However, there remains a risk of
acquiring the infection even with the use of condoms. Abstinence
is the only sure way to prevent sexual transmission of HIV with a
HIV positive partner.
If you believe you have been exposed to HIV, seek medical attention
immediately. There is some evidence that an immediate course of anti-
viral drugs can reduce the chances that you will be infected. This is called
post-exposure prophylaxis (PEP), and it has been used to treat health care
workers injured by needlesticks for years.
ALLERGIES
ALLERGIES
An allergy is an exaggerated immune response or reaction to substances
that are generally not harmful.

Allergy is caused by an oversensitive immune system, which leads to a
misdirected immune response. The immune system normally protects the
body against harmful substances, such as bacteria and viruses. In contrast,
an allergic reaction is when the immune system reacts to substances
(allergens) that are generally harmless and in most people do not cause an
immune response.
In a person with allergies, the first exposure to the allergen triggers the
immune system to recognize the substance. Any exposure after that will
usually result in symptoms.
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When an allergen enters the body of a person with a sensitized immune

system, histamine and other chemicals are released by certain cells. This
causes itching, swelling, mucus production, muscle spasms, hives, rashes,
and other symptoms.
Symptoms vary in severity from person to person. Most people have
symptoms that cause discomfort without being life-threatening. A few people
have life-threatening reactions called anaphylaxis.
The part of the body contacted by the allergen will, in part, affect the
symptoms. For example, allergens that are inhaled often cause nasal
congestion, itchy nose and throat, mucus production, cough, or wheezing.
A food allergen can cause nausea, vomiting, abdominal pain, cramping,
diarrhea, or a severe, life-threatening reaction. Allergies to plants often
cause skin rash. Drug allergies usually involve the whole body.
Some disorders may be associated with allergies. These include eczema
and asthma, among others.
Common allergens include those that contact the skin, breathing passages,
or the surface of the eye (such as pollen, mold, dander, dust). Food allergies
and drug allergies are common. Allergic reactions can be caused by insect
bites, jewelry, cosmetics, and almost any substance that contacts the body.
Some people have allergic-type reactions to hot or cold temperatures,
sunlight, or other physical stimuli. In some persons, friction (rubbing or
vigorously stroking the skin) will cause symptoms.
Allergies are relatively common. Both hereditary and environmental factors
have been found to play a role.
Sympt oms
Symptoms
Allergy symptoms vary depending on what is causing the reaction and the
part of the body where the reaction occurs. Symptoms can include:
O Runny nose
O Watering, burning or itching eyes
O Red eyes, conjunctivitis
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O Swollen eyes
O Itching nose, mouth, throat, skin, or any other area
O Wheezing
O Coughing
O Difficulty breathing
O Hives (skin wheals)
O Skin rashes
O Stomach cramps
O Vomiting
O Diarrhea
O Headache.
Signs and tests

The history of symptoms is important in diagnosing all allergies, including
whether the symptoms vary according to time of day, season, exposure to pets
and other potential allergens, and diet changes. Severe reactions often develop
very quickly after exposure, such as eating nuts or getting stung.
Allergy testing may be required to determine if your symptoms are an

actual allergy or caused by other problems. For example, eating
contaminated food (food poisoning) may cause symptoms that resemble
food allergies. Some medications (such as aspirin, ampicillin, and others)
can produce non-allergic reactions, including rashes, that resemble drug
allergies but are not true allergies.
Tests that may reveal the specific allergens include:
O Skin testing — the most common method of allergy testing. This
may include intradermal, scratch, patch, or other tests. Skin testing
may even be an option for young children and infants, depending
on the circumstances.
O Blood test — also called RAST (radioallergosorbent), this measures
the levels of allergy antibody, IgE, produced when the blood is
mixed with a series of allergens in a laboratory. If allergic to a
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substance, the IgE levels may increase in the blood sample. The
blood test may be used if the person has an existing skin problems
like eczema, he is on medications that are long-acting or cannot be
stopped, if he has a history of anaphylaxis, or if he prefers not to
have a skin test.
O “Use” or “elimination” tests — suspected items are eliminated and/
or introduced while the person is observed for response to the
substance. This is often used to check for food or medication
allergies.
O Eyelid — Occasionally, the suspected allergen is dissolved and
dropped onto the lining of the lower eyelid (conjunctiva) as a means
of testing for allergies. (This test should only be done by a physician,
never the patient, since it can be harmful if done improperly.)
O Reaction to physical stimuli — application of heat, cold, or other
stimulation, and then look for an allergic response.
Other tests that may reveal allergies include:
O Antibody/immunoglobulin (particularly IgE) levels — when these
are elevated, it indicates a “primed” immune system.
O Complete Blood Count — may reveal an increase in eosinophils.
O Complement levels — may be abnormal.
Treatment
The goal is to reduce the symptoms caused by inflammation of the affected
tissues.
Of course, the best “treatment” is to avoid what causes allergies in the first
place. It may be impossible to completely avoid everything one is allergic
to, but steps can often be taken to reduce exposure. This is especially
important for food and drug allergies.
MODERN MEDICINE
Medications that can be used to treat allergies include the following:
O Short-acting antihistamines, which are generally non-prescription,
often relieve mild to moderate symptoms but can cause drowsiness.
An example is diphenhydramine. One formerly prescription
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medication, loratadine, is now available over the counter. It does

not tend to cause drowsiness.
O Longer-acting antihistamines cause less drowsiness and can be
equally effective. These medications, which require a prescription,
include fexofenadine and cetirizine.
O Nasal corticosteroid sprays are very effective and safe for people
with symptoms not relieved by antihistamines alone. These
prescription medications include fluticasone, mometasone, and
triamcinolone.
O Decongestants may also be helpful in reducing symptoms such as
nasal congestion. Nasal spray decongestants should not be used
for more than several days, because they can cause a “rebound”
effect and make the congestion worse. Decongestants in pill form
do not cause this effect.
O Cromolyn sodium is available as a nasal spray for treating hay fever.
Eye drop versions of cromolyn sodium and antihistamines are
available for itchy, bloodshot eyes.
O Leukotriene inhibitors — montelukast is a prescription medicine
approved to help control asthma and to help relieve the symptoms
of seasonal allergies.
The most appropriate medication depends on the type and severity of
symptoms. Specific illnesses that are caused by allergies (such as asthma,
hay fever, and eczema) may require other treatments.
Allergy shots (immunotherapy) are occasionally recommended if the allergen
cannot be avoided and symptoms are hard to control. Regular injections of
the allergen are given, with each dose slightly larger than the previous
dose. Allergy shots keep your body from over-reacting to the allergen. They
do not work for everybody and require frequent doctor’s visits.
Severe reactions (anaphylaxis) require epinephrine, which can be life saving
when administered soon after exposure by patients themselves.
AYURVEDA
Ayurveda advises to avoid incompatible foods according one’s constitution
to prevent allergies. For example, pitta people should avoid pitta aggravating
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foods like chillies, brinjal, papaya, etc. In Ayurveda, herbs like ginger,
ashwagandha, shatavari, bala, gotu kola and licorice are used for treating
allergy.
ACUPUNCTURE
Specific point for allergy is Xuehai (Sp.10). Distal points like Hegu (L.I.
4), Lieque (Lu.7) are used. Other points are used according to the symptoms
or allergic manifestatons.
HOMEOPATHY
Allium cepa: Indications for this remedy include watery eyes and a clear
nasal discharge that irritates the upper lip, along with sneezing and a tickling
cough.
Arsenicum album: A burning, watery, runny nose with a stuffy, tickling
feeling during allergy attacks suggests a need for this remedy. Swelling
below the eyes and a wheezy cough are common.
Euphrasia: This remedy can be helpful if the eyes are swollen and irritated
with acrid tears or pus. The nose also runs, but with a blander discharge.
Symptoms are often worse in the daytime and worse from warmth, and
the eyes may hurt from too much light. The person can also have a cough
in the daytime, which improves at night.
Ferr um phosphoricum: This is a very useful remedy in the early stages of
errum
any inflammation. Taken when allergy symptoms start, it often slows or
stops an episode. Symptoms include runny eyes with a burning or gritty
feeling, facial flushing, watery nose, and short, hard, tickling cough.
Gelsemium: A tired, droopy feeling during allergies with a flushed and
heavy-feeling face suggest a need for this remedy. A sensation of dryness or
of swollen membranes may be felt inside the nose—or the nose may run
with irritating watery discharge, with the person sneezing frequently. Aching
in the back of the head and neck, a trembling feeling, and chills along the
spine are often seen when a person needs Gelsemium.
Natrum muriaticum: Allergy attacks with sneezing, watery eyes, clear nasal
discharge that resembles egg white, and a loss of taste and smell will all suggest
a need for this remedy. The person may have dark circles under the eyes.
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Nux vomica: If the nose is alternately stuffed up (especially outdoors or at

night) and running (indoors and in the daytime), this remedy may bring
relief. Other symptoms include a teasing cough, a scraped or tickly feeling
in the throat, and headache.
Sabadilla: Long paroxysms of sneezing, itching in the nose with irritating
runny discharge, a feeling of a lump in the throat, and watery eyes will all
suggest a need for this remedy. The person may feel nervous during allergy
attacks, and trying to concentrate can bring on drowsiness or headache.
Wyethia: Intolerable itching felt on the roof of the mouth and behind the
nose—sometimes extending into the throat and ears—strongly suggests
the use of this remedy. Everything in the person’s head feels dry and irritated,
but the nose may still be runny.
NATUROPATHY
Naturopathy advises intial fasting on fruit juices or vegetable juices for 3

to 7 days to detoxify the body and to reduce the symptoms of allergy. After
that an elimination diet is advised.
An elimination diet can help to determine the particular foods to you are
most allergic or sensitive. Once you have identified them, you can eliminate
from diet the things that cause trouble.
Begin by eliminating foods you think may be the source of your symptoms.
If you are not sure exactly where to start, start with the foods that most
commonly cause a reaction like wheat, citrus fruits and juices, nuts
(including peanut butter), dairy products, corn, soy products, and eggs.
Eliminate the suspect foods for a two-week period. After the elimination
period, test a food, or class of foods, by putting it back on menu. For three
days, observe how you react. To make sure you can identify precisely which
is the offending food, add only one food or class of foods every three days,
and take it in as pure a form as possible.
Several studies have shown that herbs may help prevent anaphylaxis and
other allergic responses in susceptible individuals. These herbal remedies
include:
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O Sweet chestnut tree (Castanea crenata)—used in Asian countries

to treat whooping cough and lacquer poisoning; inhibited skin
and blood vessels reactions related to anaphylaxis in animal studies.
Quercetin is the active component
O Spreading sneezeweed (Centipeda minima)—used in Traditional
Chinese Medicine for anti-inflammatory and anti-allergy purposes;
appears to inhibit the release of histamine, a substance that causes
many common allergy symptoms. Contains flavonoids as one of
the active components
O Danshen root (Salviae miltiorrhiza)—used traditionally for treatment
of allergies; inhibited skin related allergic reactions in rats
O Asian rose (Rosa davurica)—traditionally used to regulate immune
response; inhibited anaphylaxis in an animal study
O Hardy orange (Poncirus trifoliata)—used traditionally for treatment
of allergies; animal studies have shown inhibition of anaphylaxis
O Skullcap root (Scutellaria baicalensis)—thought to have anti-allergy
activity
O Licorice roots (Glycyrrhiza glabra or G. uralensis)—thought to have
anti-allergy activity
O Reishi mushroom (Ganoderma lucidum)—thought to have anti-
allergy activity.
NUTRITIONAL THERAPY
An elimination/challenge trial may help uncover sensitivities. Remove

suspected foods from the diet for two weeks. Reintroduce one at a time
and watch for reactions. Do not perform a challenge with peanuts if there
is history of anaphylactic shock.
A rotation diet, in which the same food is not eaten more than once every
four days, may be helpful in minimizing allergic reactions.
Reduce pro-inflammatory foods in the diet including saturated fats (meats,
especially poultry, and dairy), refined foods, and sugar. If you are sensitive
to antibiotics, eat only organic foods.
Increase intake of vegetables, whole grains, and essential fatty acids (cold-
water fish, nuts [unless allergic to them], and seeds).
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O Omega 3 and certain Omega 6 essential fatty acids, such as flaxseed,
borage, or evening primrose oil can be anti-inflammatory. Children
should be supplemented with cod liver oil (1/2 to 1 tsp. per day)
O Zinc (10 to 30 mg per day) helps to support immune function
O Vitamin C (250 to 500 mg twice per day) inhibits histamine
release. Vitamin C from rose hips or palmitate is citrus-free and
does not cause allergic reactions
O B-complex vitamins (25 to 100 mg per day) help immune function
O Selenium (50 to 200 mcg per day) helps metabolism
O Bromelain (100 to 250 mg between meals) decreases inflammation
O Pancreatin (8X USP) one to two tablets with meals for digestion
O Pro-flora supplements (one to three capsules per day) can help
normalize bowel flora.
Prevention
Children who have been breastfed are less likely to have allergies. In
addition, a mother who avoids cow’s milk, eggs, nuts, and peanuts while
breastfeeding can prevent allergy-related conditions, including eczema, in
some children.
If there is a family history of eczema and allergies it is wise to discuss the
implications for infant feeding with your child’s doctor. The timing of
introduction of solid foods in general, as well as of several specific foods,
can help prevent some allergies.
There is also evidence that infants exposed to certain airborne allergens
(such as dust mites and cat dander) may be less likely to develop related
allergies. This is called the “hygiene hypothesis” and sprang from
observations that infants on farms tend to have fewer allergies than those
who grow up in environments that are more sterile.
Once allergies have developed, treating the allergies and carefully avoiding
those things that cause reactions can prevent allergies in the future.
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12
CANCER
CANCER
Cancer involves the uncontrolled growth of abnormal cells that have
mutated from normal tissues. This abnormal growth of cells can be fatal to
life when these cells prevent normal function of vital organs or spread
throughout the body, damaging essential systems.

There are many different kinds of cancers. Cancer arises out of normal cells
in the body, and can develop in almost any organ or tissue, such as the
lung, colon, breast, skin, bones, or nerve tissue.
In general, cancer appears to be caused by abnormal regulation of cell
division. Cancers can occur when cells divide too rapidly or when cells
“forget” how to die.
There are multiple causes of cancers such as:
O Radiation
O Sunlight
O Tobacco
O Certain viruses
O Benzene.
However, the cause of many cancers remains unknown.
The three most common cancers in men in the U.S. are prostate cancer,
lung cancer, and colon cancer. In women here, the three most frequently
occurring cancers are breast cancer, lung cancer, and colon cancer.
The most common cause of cancer-related death is lung cancer.
Certain cancers are more common in particular geographic regions. For example,
in Japan, there are many cases of gastric cancer, while in the US this type of
cancer is relatively rare. In India there are many cases of oral cancer due to
eating paan. Dietary and social differences may account for the variance.
Symptoms
Symptoms of cancer depend on the type and location of the tumor. For
example, lung cancer can cause coughing, shortness of breath, or chest
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Cancer
pain, while colon cancer often causes diarrhea, constipation, and blood in
the stool.
Some cancers may not have any symptoms at all. However, the following
symptoms are common with most cancers:
O Fever
O Chills
O Night sweats
O Weight loss
O Loss of appetite
O Fatigue
O Malaise.
Signs and tests

Like symptoms, the signs of cancer vary based on the type and location of
the tumor. Common tests include the following:
O CT scan
O Complete blood count (CBC)
O Blood chemistries
O Biopsy of the tumor
O Bone marrow biopsy (for lymphoma or leukemia)
O Chest x-ray.
Most cancers are diagnosed by biopsy. Depending on the location of the
tumor, the biopsy may be a simple procedure or a serious operation. Most
patients with cancer undergo CT scans to determine the exact location of
the tumor or tumors.
Treatment
MODERN MEDICINE
Treatment also varies based on the type of cancer and its stage. The stage of
a cancer refers to how much it has grown and whether the tumor has
spread from its original location.
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If the cancer is confined to one location and not spread, it is treated by

surgery. If the tumor has spread to local lymph nodes only, sometimes
these can also be removed. If cancer cannot be removed completely with
surgery, the options for treatment include radiation, chemotherapy, or both.
Some cancers require a combination of surgery, radiation, and
chemotherapy.
Surgery
Surgery is the first treatment of choice for about 67% of cancer patients.
By 1600 B.C., Egyptian physicians were excising tumors using knives or
red-hot irons. By physically removing the obvious tumor, physicians feel
that they have the best chance for overall success. Unfortunately, many
tumors are so entwined with delicate body organs, such as brain and liver,
that the tumor cannot be resected. Another concern is that partial removal
of a cancer mass may open the once-encapsulated tumor to spread, like
opening a sack of dandelion seeds on a lawn.
Chemotherapy
Chemotherapy is the treatment of cancer with drugs that can destroy cancer
cells. These drugs often are called “anticancer” drugs. Anticancer drugs are
grouped into several categories: alkylating agents, antimetabolites, plant
alkaloids, antitumor antibiotics, enzymes, hormones, and biologic response
modifiers. Often, two or more drugs are used in combination.
Normal cells grow and die in a controlled way. When cancer occurs, cells
in the body that are not normal keep dividing and forming more cells
without control. Anticancer drugs destroy cancer cells by stopping them
from growing or multiplying. Healthy cells can also be harmed, especially
those that divide quickly. Harm to healthy cells is what causes side effects.
These cells usually repair themselves after chemotherapy.
Radiotherapy
Radiotherapy, also called radiation therapy, is the treatment of cancer and other
diseases with ionizing radiation. Ionizing radiation deposits energy that injures
or destroys cells in the area being treated (the “target tissue”) by damaging their
genetic material, making it impossible for these cells to continue to grow.
Although radiation damages both cancer cells and normal cells, the latter are
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Cancer
able to repair themselves and function properly. Radiotherapy may be used to

treat localized solid tumors, such as cancers of the skin, tongue, larynx, brain,
breast, or uterine cervix. It can also be used to treat leukemia and lymphoma
(cancers of the blood-forming cells and lymphatic system, respectively). Radiation
therapy is usually performed with equipment called a linear accelerator.
Brachytherapy, or interstitial radiation therapy, places the source of radiation
directly into the tumor, as an implanted seed.
Stereotactic Radiotherapy: High single doses of radiation are delivered to
small intracranial targets. Larger targets are delivered multiple fractionated
doses. Computerized treatment planning systems, relocating stereotactic
frames and a dedicated stereotactic linear accelerator make all this possible.
AYURVEDA
The ayurvedic synonym for tumor is arbuda or granthi. Ayurveda does not
have specific medicines to kill cancer cells, but works more as a supplemental
therapy towards overall management of the disease. Some ayurvedic
physicians claim having achieved positive results in cancer treatment with
Heerak bhasma (a medicine prepared from diamonds.) Ayurveda also helps
in reducing body reactions to chemotherapy and radiotherapy to a certain
extent. Praval Pishti, a preparation made from sea coral has a cooling effect
and thus reduces the intensity of reactions to these procedures.
Strong patients with ama require Panchakarma treatments in accordance
with their strength and disease level. These Panchakarma treatments reduce
ama along with excess dosha. By cleansing the srotas and the subtle nadis of
the body, prana can flow freely and support the healing process.
Patients who are weak should undergo strengthening or tonification therapy.
These therapies attempt to build up the strength (ojas) of patient. Consisting
primarily of oil therapies and rejuvenative herbs these therapies are not directly
beneficial for destroying cancer cells but do invigorate the immune system. A
strong immune system is required for controlling the growth of cancer cells.
In addition to the management of ama and ojas, the most important system
of the body to manage is the digestive system. Considered the root of physical
disease, a healthy digestive system supports the healing of all tissues of the
body. The digestive system is managed though the removal of ama, proper
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diet and herbs as well as vamana, virechana and basti applied appropriately
with due regard for prakruti and vikruti.
Complaints like nausea, vomiting, etc. can also be effectively controlled by
some ayurvedic combinations like shredded ginger, lemon juice and honey.
A mixture prepared from equal parts of these ingredients taken before food
usually helps to reduce nausea and vomiting.
Ayurvedic tonics like shatavari kalpa, ashwagandha lehyam, and Chyavanprash
also help in coping with the disease.
Recent studies have shown that Panch Gavya medicines are helpful in the
treatment of cancer. Panch Gavya medicines may be termed as ayurvedic
chemotherapy and they prevent the tumor cells from growing further. In
Sanskrit, Panchagavya means the blend of five products obtained from cow.
(All these five products are individually called Gavya and collectively termed
as Panchagavya) It contains ghee, milk, curd, cow dung and cow’s urine.
Studies have shown that cow urine distillate fraction acts as a bioenhancer
of commonly used antibiotics and anti-cancer drugs. Conjugated linoleic
acid in cow milk prevents the uncontrolled spread of cancer-affected cells.
Ayurvedic herbs like Amla, Turmeric, Ashwagandha, liquorice, Basil have anti-
oxidants and prevent cancer. Turmeric’s active principle curcumin has been
shown to have anticarcinogenic property and has been shown to prevent leukemia.
Studies done by Ayurvedic VCP Cancer Research Foundation, Dehradun
has shown that Medicines prepared from purified mercury have beneficial
effect in treating cancer. A medicine known as Valipani which is prepared
from a mixture of metals, including mercury, sulfur, iron as well as ginger
and honey have been shown to reduce Hodgkin’s lymphoma and acute
lymphoblastic leukemia. Other medicines like Navjeevan and Kamdudha
have been shown to reduce cancer.
ACUPUNCTURE
Acupuncture is useful in reducing cancer pain and in aiding and hastening
recovery from the side effects of the various therapies. Acupuncture is
effective for control of pain, of local swelling post-operatively, for shortening
the resolution of hematoma and tissue swelling and for minimizing use of
medications and their attendant side effects.
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Cancer
Various studies have shown that acupuncture was an effective pain reliever
without any side effects when compared with other medication or methods
of analgesia.
The nausea and vomiting which commonly occurs in some patients
undergoing chemotherapy can often be worse than the disease itself. The
National Institutes of Health recently recommended acupuncture as an
effective tool for the treatment of nausea and vomiting related to
chemotherapy. Its effectiveness helps in minimizing the use of standard,
expensive multi-drug anti-nausea regimens with their attendant side effects,
given along with the chemotherapeutic agents. Acupuncture before and
after chemotherapy treatments, can help to decrease nausea and vomiting
without the side effects of antiemetics. In addition, the combination of
acupuncture and antiemetic therapy allows for greater relief without as
many of the unpleasant side effects of the antiemetic therapy.
Needling a variety of trigger and painful points, percutaneous electrical
nerve stimulation, and osteo-puncture, along with whole body energetic
acupuncture support are used in cancer treatment.
HOMEOPATHY
According to homeopathy, cancer is a mixed miasm. Cure is impossible
where irreversible changes have taken place. Palliation and relieving the
local agonizing pain can be achieved without any side effects.
Following drugs are used according to symptoms:
O Euphorbium: Palliative pain
O Sulphur: Benign tumour turning to malignant
O Phosphorous: Bleeding from cancer
O C admium sulphate: Side effects of chemotherapy and radiation
therapy
O P hosphorous: Jaundice after cancer
O K ali birch, conium, calc. phos: Metastatic lesions
O C alc. Sulph: General prevention
O Ruta: Rectal cancer inoperable
O G raphitis: Scar of old growth of cancer.
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NATUROPATHY
Naturopathy and other Natural therapies are used complimentary to
modern medicine in treating cancer. Natural therapies are used during
and after cancer treatments like surgery and radiation, as they also help to
reduce the side effects of radiation and medicines.
Certain Natural Therapies have been proved effective in treating cancer.
Gerson therapy of Dr. Max Gerson, Dr. Stainslaw Burzynski’s
Antineoplastin Therapy, Dr. Donald Kelley’s and Dr. Gonzalez’s
Nutritional-Metabolic Therapy are some Natural therapies that are
successfully used to treat cancer.
Antineoplastin therapy consists of injection of cancer cell inhibiting
polypeptides (Antineoplastons), which are extracted from blood serum,
urine or manufactured synthetically. Antineoplastin therapy has been shown
to be effective in lymphoma, breast cancer, leukemia, bone cancer, prostate
cancer, lung cancer, colon, and bladder cancer.
Gerson therapy consists of low-salt vegan diet, fresh juices of fruits (apple)
and vegetables (carrot) given 10 times a day, coffee enemas 3 to 4 times a
day, and nutritional supplements like pepsin, potassium, Lugol’s solution
(iodine), niacin, pancreatin, and thyroids extracts.
Dr. G onzale
onzalezz’s N
Gonzale utritional M
Nutritional etabolic therapy is based on the research of
Metabolic
Dr. Donald Kelly. This treatment consists of appropriate diet for each
patient, nutritional supplements, digestive aids, carrot and apple juices,
detoxification through coffee enemas and liver flush.
Herbs have been used to treat cancer for centuries and many seem to be of
considerable value. Periwinkle plant is now the very acceptable cancer drug,
vincristine. Botanicals used to fight cancer include Pau D’Arco (LaPacho),
ginseng, green tea, mistletoe, echinacea, astragalus, chaparral, bloodroot,
garlic and various mushroom extracts.
Some herbs used for treating cancer are:
O Astragalus (Astragalus membranaceus) – this Chinese herb is a powerful
herb for stimulating and strengthening the immune system. It has the
effect of increasing the production of interferon and enhancing natural
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Cancer
killer cell activity. Astragalus has been used in combination with Panax
ginseng as an adjunctive treatment to chemotherapy, radiotherapy and
immunotherapy. It reduced the toxic effects of the chemotherapy and
increased patient body weight.
O Cat’s Claw (Uncaria tormentosa) – Cat’s claw has potent anti-
inflammatory, antioxidant and immune-stimulating effects. The
bark extract stimulates the production of white blood cells and is
useful in countering the effects of chemotherapy.
O Dandelion (Taraxacum officinale) – the root is an effective detoxifying
herb, cleansing the blood and strengthening the liver. The leaf is an
excellent diuretic, which can be beneficial with those undergoing
chemotherapy as the body tends to retain high amounts of fluid.
O Green Tea (Camellia sinensis) – Green tea contains significant levels
of polyphenols which are believed to have a cancer-inhibiting effect.
A substance called epigallocatechin gallate (EGCG) has been
isolated from green tea. It is thought to inhibit cancer growth, in
particular in the skin, gastrointestinal tract, lung and liver.
O Panax Ginseng – like Astragalus, Panax ginseng has a tonic, adaptogenic
action and is therefore good for the stress, fatigue and debility that
usually accompany chemotherapy. Ginseng also has an immune
stimulating effect, enhancing phagocytosis and non-specific immunity,
and increasing natural killer cell and macrophage activity.
O Pau D’Arco (Tabebuia spp): Pau D’arco also has immune
stimulating and anti-inflammatory properties as well as having a
cleansing, detoxifying action. It appears that a key constituent,
lapachol, inhibits the growth of tumour cells by preventing them
from metabolizing oxygen.
O Ashwagandha (Withania somnifera) – This Ayurvedic herb also has
potent tonic and adaptogenic properties. The withanolides in the
herb are anti-inflammatory and inhibit the growth of cancer cells.
The use of Ashwagandha concurrently with the chemotherapy drug
cyclophosphamide significantly increased white blood cell and
neutrophil counts both before and after treatment with
cyclophosphamide.
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Hydrotherapy
Heat Therapy (hyperthermia): Cancer cells seem to be more vulnerable to
heat than normal healthy cells. Since the time of Hippocrates and the
Egyptian Pharoahs, heat therapy has been valued. Experts have shown
that applying heat to the patient elevates immune responses. Temperatures
of 42 degrees Celsius or 107 degrees Fahrenheit will kill most cancer cells,
but can be quite stressful on the patient also.
Whole body hyperthermia involves a very sophisticated hot tub device,
general anesthesia and medical supervision. Regional hyperthermia can
involve either a miniature device applied to the tumor or focused
microwaves. Major cancer research centers, including Stanford and Duke,
have found that this therapy is useful by itself, or used synergistically to
improve the response to chemo and radiation therapy.
YOGA THERAPY
Yoga does not kill cancer cells, but works more as a supplemental therapy
towards improving general wellbeing. Studies revealed that cancer patients
(on radiotherapy and chemotherapy) practicing yoga have significant
improvement in effective state of mind, less distress and improved quality
of life as compared to the control group.
Systemic/Organ toxicity and side effects during chemotherapy was significantly
decreased in the yoga group as compared to controls. Subjects in the yoga
group had lower levels of IgA indicating reduced disease activity and higher
levels of soluble interlukin 2 receiptor (slL2R) and CDS6 counts envisaging
effective anti tumor immune response. The results suggest that a possible use of
yoga therapy as a psychotherapeutic intervention reduces psychological
morbidity; treatment toxicity and improves quality of life and anti-tumor immune
responses in breast cancer patients undergoing conventional treatment for cancer.
Pranayamas such as Nadi shuddhi, Ujjayi, Sheetkari, Sheetali, Bhramari
and Meditation, Yoga nidra has been shown to improve the physical and
mental wellbeing of the patient.
NUTRITION THERAPY
According to scientific studies, improper diet account for 60% of cancer
cases in women and 40% in men. Healthy diet also helps to reduce cancer.
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Cancer
A good anticancer diet is a low-fat, low-calorie, high-fiber diet that includes

many of the nutrient-rich foods, such as organically grown fresh vegetables,
fruits, whole grains, legumes, seeds, nuts, and little fat and no meat.
Diets should stress whole foods including whole grains, vegetables, fruits,
nuts and seeds and moderate amounts of animal products, such as eggs,
yogurt, fish, poultry and meat. Some patients will do better with the
elimination of most, if not all, animal products. Whole foods such as whole
grains, fruits and vegetables contain dietary fiber.
Whenever possible, eat foods and drink beverages that have been grown
without pesticides—so-called organic foods. Avoid foods that are highly
processed and contain white sugar and starch (the refined carbohydrates),
artificial sweeteners such as aspartame and saccharine, artificial colors and
flavors, preservatives, hydrogenated fats and other artificial chemicals.
Alcoholic beverages and caffeinated drinks, such as coffee or soda should
be drastically reduced or eliminated.
People with cancer are at risk for developing nutritional deficiencies. The
deficiencies may be the result of the cancer itself, or the side effects of common
cancer treatments such as surgery, chemotherapy, and radiation therapy.
People with cancer frequently require a high calorie diet to prevent weight
loss. They may also need a diet that is high in protein content to prevent
muscle wasting. Foods that are high in calories and protein include peanut
butter, whole milk, milkshakes, meats and cheese.
Following foods can be taken:

ollowing
O Brassica genus (Brussel sprouts, broccoli, cauliflower, kale, cabbage
and turnip) contain indoles, which have anti-cancer, antioxidant
properties; indoles, which protect against breast and colon cancer;
and sulphur, which has antibiotic and antiviral characteristics.
O Carrots are very rich in the antioxidant beta-carotene and contain
an essential oil which kills parasites and unhealthy intestinal
bacteria.
O Onions and garlic contain the powerful anti-cancer bioflavonoid
quercetin. Garlic also contains antiviral, antibiotic and antifungal
compounds such as allicin.
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O Green leafy vegetables are excellent sources of vitamins, minerals

and chlorophyll.
O Sprouts are readily digestible and nutrient rich. They are rich in
nitrilosides, which break down in the body into chemicals
(benzaldehyde) that selectively destroy only cancer cells.
O Cereal grasses such as barley and wheat grass. These are rich in
antioxidants, enzymes and a full spectrum of vitamins and minerals.
O Algae such as Spirulina. Spirulina is packed with nutrients,
including protein that is easy to digest and absorb. Good protection
against malnourishment if solid food is hard to take.
O Mushrooms (Shitake, Reishi, Maitake, Button) which are often
rich in germanium, an element which oxygenates the tissue thereby
limiting the growth of cancer.
O Pigment rich fruit such as berries (raspberries, strawberries,
blueberries, elderberries) and cherries. These contain valuable
substances that protect against DNA damage and help to induce
tumour cell death.
Foods to avoid:
avoid:
O Sugar (including refined carbohydrates) - sugar feeds cancer cells
and causes insulin production, which stimulates cancer growth.
It demineralises and acidifies the body fluids.
O Processed dairy foods and conventionally raised meats – likely to
contain pesticides, hormones and antibiotics.
O Vegetable oils (especially hydrogenated oils found in margarines)
– these are easily oxidised, causing peroxidised lipids which are
carcinogenic. (Use cold pressed organic oils for cooking and flaxseed
oil for salads)
O Alcohol, cigarette smoke and drugs.
Oral Nutritional Supplements

Oral nutritional supplements can play a major role in both the prevention
and treatment of cancer. For those cancer patients receiving chemotherapy
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Cancer
or radiation or those recovering from surgery, oral supplements can reduce

side effects and speed the healing process. Anti-oxidant vitamins, such as
vitamin C, beta-carotene, vitamin A and vitamin E in moderate to high
doses should be used by everyone, in my opinion. The B complex and
especially folic acid play a role in improving energy and reducing cancer
risk.
Oral minerals that should be considered are selenium, zinc, copper,
chromium, molybdenum, manganese, magnesium, germanium and
calcium. Proteolytic enzymes, such as bromelain and pancreatic enzymes
help to digest food when given with meals. When taken on an empty
stomach, they help to dissolve the protective coating of cancer cells, making
them more vulnerable to the body’s attack.
Diet during radiation and chemotherapy

Radiation and chemotherapy can cause vomiting, mouth ulcers, loss of
appetite, and weight loss. During this stage, it is necessary to give a soft,
bland, high calorie diet.
O Add 2 spoons of milk powder to half liter of milk and use this in
drinks and cooking.
O Add dals, lentils to soups.
O Eat snacks like fruits, dry fruits, sprouts, and yoghurt, etc.
O Chapathi dough can be made with milk than water.
O Include plenty of fibre rich foods like chapathi, Khichdi, dry fruits,
etc.
O Take bananas, prunes, figs, apples, oranges, etc.
O Take ginger and liquorice tea to fight both nausea and indigestion.
O Thick consistency liquids such as milkshakes or semi-solid foods
like mashed potatoes and gravy may be easier to swallow and will
help prevent aspiration.
O Give bland foods. Avoid strong flavors like spices, acidic foods, and
sour tasting foods.
O Provide cold foods; avoid hot or warm foods.
O Eat smaller, but more frequent meals.
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O Lie down immediately after eating.

O Restrict fluids to 30 minutes before a meal and 30-60 minutes
after a meal.
Macrobiotics
This program is based on the writings of a Japanese physician, Sagen
Ishizuka (1850-1910) who cured himself of cancer by abandoning the
refined diet of affluent Japan and reverting back to the unpurified Japanese
diet of brown rice, soybeans, fish, miso soup, sea vegetables and other
traditional oriental foods. Some proposed mechanisms why the macrobiotic
diet helps some cancer patients:
O Low in fat
O High in fiber
O High vegetable intake
O Improved sodium to potassium ratio
O Ability to change an acid (cancer) environment back toward alkaline
(healthy) environment
O Potent anti-cancer agents found in soybeans, sea vegetables and
other fresh produce
O Thyroid stimulating substances found in sea vegetables.
Macrobiotics includes an Eastern philosophy of balancing yin and yang,
which are opposing forces. There are varying levels of intensity in complying
with macrobiotic principles, with the ultimate level being a diet of 100%
whole cereals.
PHYSICAL THERAPY
Exercise
Exercise is essential for prevention or treatment of cancer. It must be
individualized to the person’s level of health and fitness. Since oxygen is
the single most important nutrient to survival, an aerobic exercise program,
which improves oxygen usage, is recommended. Rapid walking, jogging,
bicycling, swimming, Nordic track activity, rowing, aerobic dancing and
other activities are great. Ideally, you should build up to a minimum of 30
minutes, at least every other day. This is of course impossible for the
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Cancer
advanced cancer patient until he or she is well on the way to recovery.

Stretching and limbering up exercises are also helpful.
The basic philosophy to keep in mind as regards the cancer patients and
exercises is the current physical fitness capability of the patient. Usually
these are rated as active, moderate or sedentry. The patient who is capable
of high activity level may do all the exercises of a healthy individual.
Moderate capacity is where strenous activity cannot be undertaken due to
radiation, chemotherapy or due to weakness. In this level, walking,
swimming, yoga etc. are advised. In the sedently level, the patient is more
or less incapable of exercise and in these cases activities of daily living are
all the suggested till the patient improves. For bed confined patients,
isometrics and joint mobility is encouraged.
PSYCHOTHERAPY
Psychotherapy particularly group therapy has been shown to improve the mental
wellbeing. Developing strategies for coping with stress or even thriving in a
stressful environment is essential for the cancer patient since receiving such a
diagnosis is probably as stressful an event as one could experience. Relaxation
techniques, meditation and visualization exercises are all useful. Both individual
and group counseling based on the work of Bernie Siegel, the Simontons, LeShan
and others are helpful to cancer patients.
Visualization is similar to imagery. With visualization, you create an inner
picture that represents your fight against cancer. Some people getting
chemotherapy use images of rockets blasting away their cancer cells or of
knights in armor battling their cancer cells. Others create an image of their
white blood cells or their drugs attacking the cancer cells.
Other Adjunctiv
djunctivee Therapies
Adjunctiv
Many other adjunctive therapies can benefit the cancer patient. These
include therapeutic massage, chiropractic manipulation, detoxification
procedures, the therapeutic use of permanent magnets and many others.
One of the best ways to prevent cancer is to not smoke or chew tobacco.
Many cancers can be prevented by avoiding risk factors such as excessive
exposure to sunlight and heavy drinking.
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In addition, a high fat commercial diet, comprising fast foods, preservatives,

chemicals and colouring need to be avoided.
Many occupations are also cancer prone. Working with chemicals, dust,
gas, petroleum, smoke and radiation place you at risk.
Also several cancers are genetic. In those families were cancer exists, the
remaining family members must avoid all conventional risk factors
including:
O Tobacco
O Alcohol
O Paan, betel nut
O Commercial foods
O Risky occupations
O Exposure to radiation
O Compromised environment (smoke, dust etc.)
Cancer screenings, such as mammography and breast examination for breast
cancer and colonoscopy for colon cancer, may help catch these cancers at
their early, most treatable stages. Some people at high risk for developing
certain cancers can take medication to reduce their risk.
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13
NUTRITIONAL DISEASES
Anemia
Obesity
Anorexia
Bulimia
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ANEMIA
NEMIA
Anemia is condition where hemoglobin or red blood cells is less. These
deficiencies are caused by either decreased production or increased
destruction of red blood cells. Anemia is most common among women in
their reproductive years (5.8 percent), infants (5.7 percent), and the elderly
(12 percent). Because one of the major functions of red blood cells is to
transport oxygen, a decrease in red blood cells decreases the amount of
oxygen delivered to the body’s tissues, which results in the symptoms of
anemia.
Causes
Anemia may have the following causes.
O Pregnancy and breast-feeding

O Iron, folic acid, vitamin B12, or other vitamin deficiencies
O Certain chronic conditions
O Gastrointestinal blood loss (caused by ulcers, cancer, parasites)
O Genitourinary blood loss (such as from heavy menstruation)
O Excessive blood loss (after surgery or regular blood donations)
O Excessive alcohol or drug use
O Malabsorption syndromes (for example, celiac disease)
O Congenital diseases (for example, sickle-cell anemia)
O Malnutrition.
Signs and Symptoms

O Tiredness
O Paleness
O Lightheadedness
O Headache
O Heart palpitations and chest pain.
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Nutritional Diseases
Diagnosis
Anemia can be confirmed by a red blood count or hemoglobin level. Other
tests depend on the type of anemia. Normal value of hemoglobin in males
is 13.8 to 17.2 gm/dl and Females is 12.1 to 15.1 gm/dl.
Treatment
Treatment depends on the cause and severity of the anemia. Because anemia
is often the result of nutritional deficiencies, a diet that contains all of the
nutrients needed for healthy blood formation such as vitamin B12, iron,
and folic acid is advised. If anemia is the result of an underlying disease,
that disease must first be successfully treated.
MODERN MEDICINE
Drug Therapies
O Erythropoietin plus iron—for anemia caused by chronic kidney
failure
O Corticosteroid medications (such as prednisone)
O Immunosuppressant medications (such as azathioprine)
O Surgical and Other Procedures
O Removal of the spleen (splenectomy)—may be necessary in cases
of hereditary spherocytosis
O Transfusions—may help treat certain types of anemia, such as
sickle-cell anemia.
AYURVEDA
The treatment of anaemia consists of Snehana Karma (Oleation therapy).
For this purpose either Dadimadya ghrita or Pancha tikta ghrita must be
given in a dose of one ounce per day.
Laxatives such as Trivritta churna or Triphala churna should be administered.
The main treatment or the operative procedure lies in the administration
of medicines like Navayasa churna in a dose of 30-40 gm. twice daily with
honey and butter milk.
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Compounds such as Punamava mandura; Mandur vatak, Dhatriavaleh,

Swamkshidari Yoga are administered orally for relieving anaemia.
Ayurveda advises following medicines for treating anemia:
O Punarvara mandoor 2 tab bid with milk
O Lohabhasmam 250 mg bid
O Lohasaram 30 ml tid after meals
O Dhatriloham 2-4 tab with milk tid
O Kumaryasaram 14-28 ml with water after meals tid
O Other drugs like Dadimadi Ghritham, Draksharishtam are also
useful.
HOMEOPATHY
Arsenicum album
album: Useful when there is a combination of severe weakness,
anxiety and restlessness. Helpful in pernicious anemia.
Calcarea carbonica: Useful in the chalky pallor of the Calcarea make-up
(Calcarea phospphorica) when the patient is less obese.
Cinchona (China) officinalis: When due to loss of fluids as in excessive
hemorrhage; a useful remedy for extreme pallor.
Ferr um metallicum: Useful when there is accompanying loss of weight,
errum
breathlessness, depression, palpitations and constipation.
Natrium muriaticum: The patient suffers from oedema and there is craving
for salt.
Phosphorus: Indicated for the tall, pale, sensitive, stoop shouldered and
weak person, with little resistance, often short of breath, under-weight,
with a tendency to be overactive and rarely able to rest adequately.
NATUROPATHY
Naturopathy advises iron and vitamin rich foods in treating anemia.
Iron rich foods: Rich sources of iron are molasses, cocoa, liver, wheat germ,
dried fruits (prunes, dates, figs, raisins, peaches), apples, seaweed, wheat
grass, and dark green vegetables like spinach.
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Folic acid rich foods: Fresh green leafy vegetables, liver, yeast, lentils, grains,
spirulina, fish, avocados, whole meal bread, eggs, bananas, oranges, bran,
beetroot and peanuts. Cooking, prolonged heating and canning can destroy
the vitamin.
Vitamin B12 rich foods: Meat, fish, eggs, liver, dairy products, yoghurt,
cheese, cottage cheese, sunflower seeds, and spirulina.
Wheat grass juice: Wheat grass juice has been shown to improve even
aplastic anemia.
Following herbs also reduce anemia.
O Blackstrap molasses, also known as pregnancy tea (1 tbsp. per day
in a cup of hot water), is a good source of iron, B vitamins, minerals,
and is also a very gentle laxative.
O Spirulina, or blue-green algae, has been used successfully to treat both
microcytic and macrocytic anemias. Dose is 1 heaping tsp. per day.
O Alfalfa (Medicago sativa), dandelion (Taraxacum officinale) root or
leaf, burdock (Arctium lappa), and yellowdock (Rumex crispus) have
long been used to fortify and cleanse the blood. For mild cases of
anemia, they may help bring levels of hemoglobin into normal
range. Dosage is 1 tbsp. per cup of water. Simmer roots for 20
minutes and leaves for 5 minutes. A single herb, or a combination
of these four herbs, may be used.
NUTRITION THERAPY
Ferrous fumerate, glycerate, or glycinate (100 mg per day for three to six
months) are the most absorbable forms of iron. Ferrous sulfate 325 mg per
day is poorly absorbed and more frequently causes problems with
gastrointestinal upset and constipation.
Dietary sources of iron include meat, beans, green leafy vegetables, beet
greens, blackstrap molasses, almonds, and brewer’s yeast.
O Vitamin C—250 to 500 mg twice a day to aid in absorption of iron
O Vitamin B12—cyanocobalamine, 1,000 IU via injection twice a day
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for one week, then weekly for a month, then every two to three months
Dietary sources include organ meats, meats, eggs, fish, and cheese.
O Folic acid (1 to 2 mg per day)—for folic acid deficiency Good food
sources include green leafy vegetables and grains
O Omega-3 and omega-6 essential fatty acids (1,000 to 1,500 IU)
have been shown to decrease the frequency of sickle-cell crisis. EFAs
can increase clotting times, so patient taking anticoagulants should
be monitored.
OBESITY
Obesity is defined as an excess of body fat. An adult male is considered
obese when his weight is 20% or more over the maximum desirable for
their height; a woman is considered obese at 25% or more than this
maximum weight. Anyone more than 50 kgs overweight is considered
morbidly obese.
Being overweight is different from being obese. Overweight refers to excess
body weight compared to normal standards. The excess weight may come
from muscle, bone, fat, and/or body water. Obesity refers specifically to
having an abnormally high proportion of body fat.
Obesity is also defined as a BMI (body mass index) over 30 kg/m2. Body
mass index, or BMI, is the measurement used to assess whether a person is
overweight or obese. BMI is calculated using a mathematical formula that
takes into account both a person’s height and weight. A person is considered
overweight if they have a BMI of between 25 and 29.9. A BMI of more
than 30 is generally considered a sign of moderate to severe obesity.
Causes
While there is no single underlying cause of obesity, the bottom line is
that excessive weight reflects an imbalance between energy input and energy
output.
The basic nutritional needs of most people are approximately 2,000 calories a
day for women and 2,500 for moderately active men. However, people who are
very active, such as professional athletes or manual laborers may need 3,500 or
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more. Pregnant women and nursing mothers require about 300-500 more
calories/day than women who are neither pregnant nor nursing.
The body cannot store protein or carbohydrates, so excess protein or
carbohydrate intake is converted to fat for storage. One pound of fat
represents about 3,500 excess calories.
Both genetic and behavioral factors play a role in the development of
excessive weight. For example, an individual’s total number of fat cells
(which may predispose an individual to weight gain) is determined
genetically, but behavioral factors, such as a high-calorie, high-fat diet and
lack of physical activity, must be present in order for weight gain to occur.
Other causes of obesity include:
O Rare congenital disorders (conditions present at birth), such as
Prader-Willi syndrome and Laurence-Moon-Biedl syndrome
O Hormonal disorders such as Cushing’s Syndrome and polycystic
ovary syndrome
O Insulinoma (tumors of the pancreas)
O Hypothyroidism (diminished production of hormones from the
thyroid gland)
O Brain injury (or lesion) from trauma or surgery
O Certain prescription medicines, including steroids, tricyclic
antidepressants, anti-epilepsy drugs, or drugs used for high blood
pressure.
Obesity increases a person’s risk of illness and death due to diabetes, stroke,
coronary artery disease, hypertension, high cholesterol, and kidney and
gallbladder disorders. Obesity may increase the risk for some types of cancer.
It is also a risk factor for the development of osteoarthritis and sleep apnea.
Diagnosis
Skin fold measurements may be taken to assess body composition. Electronic
fat analyser can measure the body fat percentage and help in assessing and
monitoring the fat loss. Blood studies to test endocrine function may be
performed.
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Treatment
The primary goal in treating obesity is to reduce overall body weight and
maintain the lower weight. This usually involves a combination of diet,
exercise, and other lifestyle modifications, but the specific method of
treatment depends on the severity of obesity. Factors such as general health
and motivation to lose weight are also important considerations.
MODERN MEDICINE
Medications are usually not recommended to aid intentional weight loss.
They often cause harmful side effects or adverse reactions. At best, the
drugs control appetite only for short time periods and don’t help change
eating habits.
Sibutramine—boosts metabolism, enhances energy level, and promotes a
feeling of fullness; studies have found it to be effective for weight loss, but
side effects include dry mouth and insomnia; cannot be taken by people
with a history of stroke, seizures, or heart, liver, or kidney diseases.
Orlistat—reduces the absorption of fat from foods, causing weight loss and
lowered cholesterol; also reduces absorption of essential fat-soluble vitamins
A,D, E, and K; should not be used by people with a history of kidney stones.
Phentermine—suppresses appetite; serious potential side effects include
pulmonary hypertension and heart valve defects (these conditions are much
more likely to occur when used in combination with fenfluramine, also
known as fen-phen; fortunately, medications containing fenfluramine have
been removed from the market); phentermine should not be used with
antidepressant medications.
Amphetamine derivatives (benzphetamine, diethylpropion, phendimetrazine,
and mazindol)—elevate mood and reduce weight moderately over the short
term (3 to 12 weeks); can cause addiction, agitation, and insomnia, consequently
the use of these medications is not recommended.
Surgery
Surgery may be necessary for individuals who are extremely obese (those
who have a BMI of 40 or higher). Physicians carefully select individuals for
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surgery, and appropriate behavioral and social support are required before
the surgical procedure. Some options include:
Roux-en Y procedure—reduces the size of the stomach, creating a feeling
of fullness (satiety); vomiting is the most common side effect.
Gastric banding—passes an adjustable silicone band around the stomach,
which creates feeling of satiety; gastric bands can be removed if necessary.
Liposuction—removes fat deposits from specific body areas; weight gain is
more likely in other areas of the body after the procedure.
AYURVEDA
Guggulu (Commiphora mukul) is a common ingredient found in several
Ayurvedic medicines used to treat obesity. Studies have shown that
overweight individuals who receive these Guggul-containing Ayurvedic
remedies lose a significant amount of weight compared to those who do
not receive such medicines. These Ayurvedic remedies also caused substantial
decreases in cholesterol.
Ayurvedic massage with Sudarshan churnam is advised in obesity.
HOMEOPATHY
Calcarea carbonica: A craving for eggs. The appetite is generally capricious
Calcarea
and sometimes bizarre. An underlying depression makes any form of dieting
more difficult because of a tendency to compensate by eating particularly
warm food.
Calcarea flourica: For middle aged, obese, and mild or moderate diabetics.
Calcarea
Natrium: When retention of fluid contributes to the excessive weight.
Muriaticum: Remedy usually causes profuse urination.
Phytolacca berr y: Used daily as a mother tincture. This helps to substantially
berry:
reduce the constant craving for snacks.
NATUROPATHY
Fasting or very low-calorie diets (less than 400 kcal a day) are recommended
for obese people for short-term, under medical supervision. This is not
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advised for a longer time as body adjusts to these diets by reducing its
metabolic rate. When the dieter goes back to the normal or even below
normal calorie intake, the weight is quickly regained. After fasting a 1000-
calorie diet is advised until normal weight is reached. During this time, a
high intake of vegetables and fruits is advised.
Obesity is a lifelong problem, hence obese patients are advised a healthy
optimum calorie diet and regular exercise to maintain their weight.
YOGA THERAPY
Yoga reduces obesity by normalizing the endocrine function and burning
the extra fat.
O Asanas:
{ Dynamic asanas such as a combination of paschamottasana -
Halasana, Shavasana - Naukasana, Hasthasana - Padhasthasana,
Surya namaskara, Kapalbhatti pranayam, speed up metabolism
and burn calories
Konasana
Bhramari.
NUTRITION THERAPY
Diet plans are enormously popular today. They range from traditional
low-fat, high-carbohydrate diets to the more controversial high-protein,
high-fat, low-carbohydrate diets. The truth is, no specific diet works for
everyone, and no diet works without the other essential components of
weight loss—exercise and stress management.
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In general, studies have shown that diets limiting fat intake are safe and
effective for weight loss. Although high protein diets (more popular in
recent years) have also shown promise in helping overweight individuals
reduce cholesterol and blood sugar levels as well as weight, it is not known
if this diet is safe and effective for weight loss over the long term.
Foods to Restrict or A
Restrict Avvoid:
High-Fat Foods: Butter, margarine, cheese, chocolate, cream, ice cream,
fat meat, fatty fish, or fish canned in oil, fried foods of any kind such as
doughnuts and potato chips, gravies, nuts, oil, pastries, and salad dressing.
High–Carbohydrate Foods: Breads of any kind, candy cake, cookies, corn,
cereal products such as macaroni, noodles, spaghetti, pancakes, waffles,
sweetened or dried fruits, legumes such as lima beans, navy beans, dried peas,
potatoes, sweet potatoes, honey, molasses, sugar, syrup, rich puddings, sweets.
Beverages: All fountain drinks, including malted milks and chocolates, carbonated
beverages of all kinds, rich sundaes, alcoholic drinks, sweetened drink mixes.
A single dinner in a restaurant can nullify careful adherence given to a diet
for several days. Usually it is possible to select a clear soup, broiled or
roasted meat without sauces, vegetables without sauces, and salad without
dressing. Meat portions are likely to be larger than those allowed, and the
dieter will need to restrict intake to that allowed. The diet will not be
exceeded too much if one foregoes the rolls, butter, and dessert.
Low Calorie Diet

For any person to lose weight and reduce obesity, the food and calorie in
take will need to be less than the body activity calorie output. Even while
very specific calculations abound, a simple formula is that in order to lose
weight the daily calorie in a take for a male should not exceed 1500 calories
for day and in a female this may go as low as 1000 calories for day.
A more precise calculation is body weight in kgs x 24 - 500 is the maximum
calories allowed per day subject to a maximum of 2000 calories per day
and mimumum of 1000 calories per day. However, keep in mind that in
any calorie - based weight loss diet to be successful, a compulsory 300-
500 calories must be expended per day in exercise (i.e. 1 hour of moderately
active exercise activity).
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EXERCISE
Exercise is the single most important component of a permanent, weight
loss plan. Aerobic exercise, Exercises like brisk walking; jogging, swimming,
cycling and aerobic dances can be performed at least 30-45 minutes every
day. These exercises quickly get the blood flowing, the metabolism and
temperature rising and the fat going.
Exercise is also beneficial in weight maintenance after weight loss because
it ensures maintenance of lean tissue.
Increasing physical activity may help a person lose weight, primarily in
the first 6 months, as well as maintain a desirable weight in the long-term.
Exercise not only contributes to weight loss, it also decreases abdominal
fat and increases cardiorespiratory fitness, which can reduce complications
associated with overweight and obesity such as high blood pressure, diabetes,
and heart disease.
It is important for people who are not used to exercising to begin with a
gentle regimen that increases in intensity over time. The long-term goal is
to participate in a moderately intense exercise routine for at least 30
minutes, 5 to 7 days a week. Ideally, an exercise program should combine
aerobic activity such as walking, running, or swimming with a program of
strength training, such as lifting light weights.
PSYCHOTHERAPY
A diet prescription is worthless unless the patient is motivated for losing
weight, such as the maintenance or recovery of health. The patient must
have the capacity for self-discipline, patience, and perseverance.
Although the motivation must come from within the patient, the physician,
nurse, and dietitian can be of immeasurable help toward initiating this
motivation, and subsequently by providing encouragement and guidance
at frequent follow-up visits.
The patient needs to understand that a calorie intake in excess of needs is
the cause of overweight and that weight loss is accomplished only when
the calorie intake is reduced below the patient’s needs. However, this
explanation is not enough. The patient also needs to gain insight into the
reasons he or she is overeating, and to work at correcting these.
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Counseling and Group Sessions Individual counseling is essential to determine

the goals that are realistic for the patient and to initiate dietary regimen that is
appropriate for the patient’s food habits and patterns of living.
It also helps to eliminate or reduce the stress that leads to overeating by
practicing relaxation exercises, such as yoga, meditation, or tai chi.
Cognitiv
Cognitivee B ehavioral Therapy
Behavioral
Excessive food intake is a learned response that can be changed. By
modifying the behaviour, the individual learns to focus attention on the
environmental factors that influence his or her food intake and gradually
to modify these so that a change in eating habits and subsequent weight
loss occurs. These practices include setting reasonable weekly or monthly
goals—how much exercise or how much weight loss is desired, for instance—
and establishing rewards for successes in ways other than with food.
Initially, the patient is asked to keep a detailed record of food intake and
activity patterns. From this, the patient and counselor identify problem
areas and outline strategies to overcome them. Emphasis is on changing
eating patterns rather than on caloric intake or pounds lost. For example, if
the problem is too much unstructured eating, such as frequent snacking
while watching television, knitting or other activities might be
recommended as a diversion.
Home Care and Lifestyle
To help prevent an increase in weight:
O Avoid the following - excess alcohol consumption, stress, depression,
boredom and frustration.
O Avoid a sedentary lifestyle by increasing your activity level by
performing aerobic exercise for at least 30 minutes a day, 3 to 6
times a week.
O Increase physical activity in general by walking rather than driving.
O Reduce consumption of food that is high in fat and sugar.
For additional help in losing weight:
O Join a support group. Many people find it easier to follow a reduction
diet and exercise program if they join a group of people with similar
problems.
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O Avoid over-the-counter drugs that claim to aid in weight loss —

most are ineffective, and some can be dangerous.
O Also, be sure to set realistic goals for weight reduction. A loss of 1
to 2.5 pounds a week may seem slow, but losing weight too fast
often does not work. Weight lost quickly is usually regained quickly.
ANOREXIA
Anorexia nervosa is an eating disorder characterized by refusal to maintain
a minimally accepted body weight, intense fear of weight gain, and distorted
body image. Inadequate calorie intake or excessive energy expenditure
results in severe weight loss.
Anorexia is a severe emotional disorder that is increasingly common,
especially among young women in industrialized countries where cultural
expectations encourage women to be thin. Fueled by popular fixations
with thin and lean bodies, anorexia is also affecting a growing number of
men, particularly athletes and those in the military. People with anorexia
are terrified of becoming obese and refuse to maintain a normal weight,
putting themselves in danger of starvation.
The condition usually occurs in adolescence or young adulthood. It is
more common in women, affecting 1-2% of the female population and
only 0.1-0.2% of males.
Causes
The exact cause of anorexia nervosa is not known, but social attitudes towards
body appearance and family factors are believed to play a role in its
development.
There is no specific cause of anorexia. Medical experts agree that several
factors work together in a complex fashion to lead to the eating disorder.
These may include:
O Severe trauma or emotional stress (such as the death of a loved one
or sexual abuse) during puberty or pre-puberty.
O Abnormalities in brain chemistry. Changes in serotonin levels, a
brain chemical that regulates appetite, may contribute to other
526
symptoms of anorexia nervosa such as depression, impulsiveness,

obsessive behaviors, or other mood disorders. In addition, the
process of purging may deplete tryptophan, an amino acid
necessary for the production of serotonin, leading to further
imbalances.
O A cultural environment that puts a high value on thin or lean bodies.
O Overbearing, controlling, and critical parents who do not show
emotional warmth.
O A tendency toward perfectionism, fear of being ridiculed or humiliated,
a desire to always be perceived as being “good.” A belief that being
perfect is necessary in order to be loved. Because perfection is
impossible, the inability to attain perfection reinforces the person’s
sense of being unworthy of being loved. Not eating, according to some
experts, is a passive act of revenge directed toward those who will
never love the person because of his or her lack of perfection.
O Family history of anorexia. About one-fifth of those with anorexia
have a relative with an eating disorder. In fact, it is common to
discover that someone with anorexia has a mother or sister with
this eating disorder as well. If one identical twin has anorexia, the
other has more than a 50% chance of also developing it. It is not
clear, however, to what extent this family connection is due to
heredity and or to learned behavior.
O Infection. Some researchers report an association between beta-
hemolytic streptococcal infection or Epstein Barr virus (the virus
that causes mononucleosis) and development of anorexia.
There are two main types of anorexia nervosa:
O Restricting Type—characterized by dieting, fasting, and/or excessive
exercise.
O Binge-Eating/Purging Type (anorexic-bulimic)—characterized by
self-induced vomiting and/or misuse of laxatives, enemas, and/or
diuretics. Binge eating may or may not occur; purging is common
even after small amounts of food have been eaten. This type carries
greater medical risk.
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Signs & Symptoms

Physical Signs
O Scanty or absent menstrual periods
O Thinning hair
O Dry skin
O Cold or swollen hands and feet
O Bloated or upset stomach.
Psychological SSigns
sychological igns
O Distorted perception of self (that is, a great difference between
how an individual believes he or she looks and his or her actual
physical appearance)
O Inability to remember things
O Poor judgment
O Refusal to acknowledge the gravity of the illness
O Obsessive-compulsive behavior (excessive need to control personal
environment)
O Depression (feelings of ineffectiveness; loss of interest in friends
and former activities; lack of spontaneity; rigid thinking; lack of
initiative; flattened emotional response; irritability; insomnia;
diminished interest in sex).
Behavioral Symptoms
O Unusual behaviors related to food or eating (for example, hoarding or
concealing food, refusing to eat in public, eating only one type of food,
ritually cutting food into tiny pieces, intense study of diets and calories,
planning and preparing elaborate meals for others)
O Compulsive exercising
O Preoccupation with body size or body image
O Preoccupation with weight control, dieting.
Diagnosis
Diagnosis is based upon ruling out other causes of endocrine, metabolic,
digestive, and central nervous system abnormalities to explain the weight
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loss. This could include celiac disease, inflammatory bowel disease, Addison’s
disease, and many other possible conditions.
The SCOFF questionnaire, developed in Great Britain, is proving to be a
very reliable method for diagnosing anorexia. A “yes” response to at least
two of the following questions is a strong indicator of an eating disorder:
O S “Do you feel sick because you feel full?”
O C “Do you lose control over how much you eat?”
O O “Have you lost more than 13 pounds of weight recently?”
O F “Do you believe that you are fat when others say that you are
thin?”
O F “Does food and/or thoughts of food dominate your life?”
Tests that may be used to assess cause of or damage from weight loss include:
O Chem-20
O Urinalysis
O Thyroid function tests
O Other blood and urine tests
O ECG.
This disease may also alter the results of the LH response to GnRH test.
Treat ment
eatment
Anorexia demands a multipronged treatment plan that addresses both the
physical and psychological aspects of this disorder. Cognitive-behavioral
therapy, often in combination with antidepressants, is a very effective
therapeutic approach for treatment of eating disorders.
The biggest challenge in treating anorexia nervosa is having the person
recognize that their eating behavior is itself a problem, not a solution to
other problems. However, most people who suffer from anorexia nervosa
deny that they have an eating disorder. Therefore, most individuals enter
treatment when their condition is fairly advanced.
The purpose of treatment is first to restore normal body weight and eating
habits, and then attempt to resolve psychological issues. Hospitalization
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may be indicated in some cases (usually when body weight falls below
30% of expected weight).
Supportive care by health care providers, structured behavioral therapy,
psychotherapy, and anti-depressant drug therapy are some of the methods
that are used for treatment. Severe and life-threatening malnutrition may
require intravenous feeding.
MODERN MEDICINE
Anorexia nervosa in some ways resembles other major psychiatric disorders
such as depression and obsessive-compulsive disorder, because some of the
symptoms of these disorders, for example obsessive behavior, lack of
enjoyment from life, and severely distorted perception of reality (in this
case, of the body), are exhibited by people with anorexia. This has led to
the use of antidepressants for anorexia, particularly selective serotonin
reuptake inhibitors (SSRIs) like Fluoxetine, because these drugs are first-
line treatments for OCD and depression.
Medications, however, do not work alone and must be used in conjunction
with a multidisciplinary approach that includes nutritional interventions
and psychotherapy.
AYURVEDA
Ayurveda advises appetite stimulating herbs and medicines like
Hingvashtaka Churnam to increase appetite. Tonics like Ashwagandha
lehyam, Chyavanaprash are advised.
HOMEOPATHY
Argentum nitricum: When a phobic element is present.
Natr um M
atrum uriaticum: Generally effective in most cases.
Muriaticum:
Silicea: In a thin, pale, chilly person, when the extremities are usually cold
and sweaty. Loss of libido.
NUTRITION THERAPY
Anorexic Diet
In the context of an anorexic diet, the nutritionist or dietician must also
have a psychologist’s approach and convince the patient that any food
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eaten will contribute to the patient’s survival and non consumption will
result in the clients ultimate demise.
The most important emphasis must be that food eaten will not result in
the anorexic becoming fat, but merely achieving the healthy weight required
for survival.
Rather than intravenous foods or food substitutes, the anorexic should be

given small portions of day to day food and rather than a 3 meal structure
perhaps 6 smaller meals will be better tolerated by the system.
The calories advised/given should be equal to metabolic meals at the outside

and the logic of this explain to the patient. Even a start at 800 calories per
day will be good, with a 100 or 200 calorie increase each week such that
when the patient reaches the minimum weight, the diet can continue as a
maintainance no weight gain diet.
In addition, the food must be balanced and come from all food groups.
Since the diet is low in calories, the food should not be bulky, but dense in
calories. In order to ensure that the right quantities and calories are eaten,
food must be measured and served as a compulsory protocol to ensure
precise calorie and nutritional needs.
Anorexics with low body weight, low BMI, and low serum albumin (the
main protein in blood) levels are at increased risk for vitamin and mineral
deficiency. Vitamin abnormalities may contribute to cognitive difficulties
such as poor judgment or memory loss and other psychiatric conditions.
These deficiencies can often be corrected with dietary interventions.
Therefore, an important part of treatment is to include a multivitamin
with minerals (particularly calcium).
Other supplements like zinc, essential fatty acids, antioxidants, vitamins E

and C, beta-carotene, coenzyme Q10, and selenium are helpful.
PHYSICAL THERAPY
Regular aerobic exercise like walking or jogging helps to increase the appetite
and general well-being. Exercise helps to reduce stress and improves health.
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Massage appears to be a helpful component of treatment for anorexia nervosa.

In one study, a group of adolescents with anorexia received massages twice
weekly for one month, in addition to standard daily group therapy. The
massaged adolescents reported lower anxiety levels and improved body
image compared to adolescents with anorexia receiving only standard daily
group therapy. Measurably reduced cortisol (a marker of stress) and
increased dopamine (a brain chemical associated with relaxation)
concentrations were also observed in the treatment group.
PSYCHOTHERAPY
Cognitiv
Cognitivee Behavioral Therapy
Behavioral
Cognitive-behavioral therapy is reported to be one of the most effective
therapies for anorexia. It is based on the assumption that anorexia develops
in response to life stresses. Treatment is aimed at confronting the individual’s
fears and avoidance behaviors and cultivating new problem-solving skills.
It also aims to increase awareness of negative thought processes and to
change them.
Family Therapy
Family therapy is recommended for both children and adults, in addition
to individual therapy for the person with anorexia. Parents and other family
members often have intense feelings of guilt and anxiety that they need to
address. They may actually support the individual’s eating disorder out of
these feelings or perhaps they, too, put a premium on being thin. Family
therapy is aimed, in part, at helping the parents or partner (in the case of
an adult) understand the medical gravity of this illness and the ways in
which they may be inadvertently contributing to it.
Hypnosis
Hypnosis has been shown to be successful as part of an integrated treatment
program for anorexia nervosa. Evidence suggests that purging anorexics are
more likely to benefit from hypnosis than restrictive anorexics. Hypnosis
reportedly strengthens both self-confidence and the ability to cope, which
may result in healthier eating, improved body image, and greater self-
esteem. Whether or not the treatment is successful may depend on the
number of sessions; individual programs have generally involved 1-hour
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per week for 3 months followed by bi-weekly sessions until treatment is no

longer needed.
Prevention
The most effective prevention strategy is the development, from an early
age, of healthy eating habits and a strong body image. Cultural values that
place a premium on lean or thin bodies need to be questioned. Education
about the life-threatening nature of anorexia is also an important part of
prevention.
In those who have already been diagnosed and treated for anorexia, avoiding
recurrence of the eating disorder is the primary goal.
Family and friends should be urged not to focus on the patient’s condition
or on issues of food or weight. Mealtimes, for example, should be reserved
for social interaction and relaxation, without any discussion of the disease.
Careful and frequent monitoring of weight and other physical signs by the
healthcare provider can reveal signs of a relapse.
Cognitive or other forms of psychotherapy can help the person to develop
coping skills and change the unhealthy thought processes that underlie
anorexia nervosa.
Family therapy is helpful in addressing underlying contributing factors in
the home environment and in enlisting the support and understanding of
family members.
BULIMIA
Bulimia nervosa is an eating disorder characterized by periods of binge
eating. In some cases, the person will compensate for this overeating by
forcing vomiting; misusing laxatives, diuretics, or enemas; fasting; or
excessive exercising. People with bulimia cannot control their eating and
have a paralyzing fear of becoming fat. Bulimia is associated with depression
and other psychiatric disorders and shares symptoms with anorexia nervosa.
Because many individuals with bulimia maintain a normal or above-normal
body weight, they are able to keep their condition a secret for years.
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Someone with bulimia may also suffer from anorexia nervosa, an eating
disorder involving severe, chronic weight loss that proceeds to starvation,
while other bulimics may not suffer from anorexia.

In bulimia, eating binges may occur as often as several times daily for
many months. These binges cause a sense of self-disgust, which leads to
compensatory behaviors like self-induced vomiting or excessive exercise. A
person with bulimia may also abuse laxatives, diuretics or enemas in order
to prevent weight gain.
Such behaviors can be quite dangerous and may lead to serious medical
complications over time. For example, the stomach acid which is introduced
into the esophagus (the tube from the mouth to the stomach) during
frequent vomiting can permanently damage this area.
Women are much more commonly affected than men. The affected person
is usually aware that her eating pattern is abnormal and may experience
fear or guilt associated with the binge-purge episodes. Although the behavior
is usually secretive, clues to this disorder include overactivity, peculiar eating
habits or rituals, and frequent weighing. Body weight is usually normal,
although the person may perceive themselves as overweight. If bulimia is
accompanied by anorexia, body weight may be extremely low.
The exact cause of bulimia is unknown, but factors thought to contribute
to its development are family problems, perfectionist personalities, and an
overemphasis on physical appearance. Bulimia may also be associated with
depression and occurs most often in adolescent females.
Symptoms
O Binge eating of high-carbohydrate foods, usually in secrecy
O Loss of control over eating, with guilt and shame
O Body weight that goes up and down
O Constipation, diarrhea, nausea, gas, abdominal pain
O Dehydration
O Blood-tinged vomit
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O Irregular menstruation or cessation of menstrual periods

O Eroded tooth enamel
O Throat irritation and inflammation
O Depression
O Substance abuse, especially alcohol.
Signs and tests

A dental exam may show dental cavities or gum infections (such as
gingivitis). The enamel of the teeth may be eroded or pitted because of
excessive exposure to acid in vomitus.
A chem-20 may show an electrolyte imbalance (such as hypokalemia) or
dehydration.
Treatment
Treatment focuses on breaking the binge-purge cycles. Outpatient treatment
may include behavior modification techniques as well as individual, group,
or family counseling.
MODERN MEDICINE
Fluoxetine, a selective serotonin reuptake inhibitor (SSRI) is the drug for
bulimia. Other antidepressants may also be prescribed. Antidepressant
drugs like such as SSRIs, tricyclic antidepressants, or monoamine oxidase
(MAO) inhibitors may be used in cases that coincide with depression.
HOMEOPATHY
Homeopathy has an effective treatment for bulimia. The remedies vary
according to the patient’s symptoms and constitution.
NATUROPATHY
Naturopathy advises following herbs to alleviate stress, restore normal

digestion and decrease anxiety:
O Licorice root (Glycyrrhiza glabra)
O Skullcap (Scutellaria lateriflora)
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O Oatstraw (Avena sativa)

O Passionflower (Passiflora incarnata)
O Lemon balm (Melissa officinalis).
Additional herbs may be considered to treat particular symptoms such as

St. John’s wort (Hypericum perforatum) for depression.
NUTRITION THERAPY
Nutrition therapy is as important as psychotherapy in treating bulimia.
Nutritional management included information on the effects of bulimia,
techniques to avoid binge eating, and advice about making meals and eating.
Some people with eating disorders are deficient in zinc. Variations in levels
of zinc can affect taste, smell, appetite, and response to stress. Zinc
deficiency may play a role in eating disorders and altered self-image. Taking
zinc supplements may help with treatment.
PHYSICAL THERAPY
Massage
Therapeutic massage can be an effective part of a bulimia treatment plan.
In one study, adolescent women with bulimia were assigned at random
either to receive massage therapy for 5 weeks or to be in a control group
(not receiving massage therapy). The 24 women receiving massage improved
immediately, while the control group did not improve. Women in the
massage group were less anxious and depressed right after their initial
massages. They also had better scores on the Eating Disorder Inventory,
which helps providers assess psychological and behavioral traits in eating
disorders.
PSYCHOTHERAPY
Psychotherapy is a cornerstone of bulimia treatment. Using biofeedback

may also help to manage stress better. Other mind-body and stress-reduction
techniques, such as yoga, tai chi, and meditation, may help become more
aware of body and form a more positive body image. Stress management
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including analysis of stressful situations; short-term stress management

strategies such as relaxation, self-encouragement, and self-distraction; and
training in planning, problem solving, and communication is helpful.
A 6-week clinical trial showed that guided imagery helped people with
bulimia reduce bingeing and vomiting and improve their feelings about
their bodies and eating.
Prevention
Less social and cultural emphasis on physical perfection may eventually
help reduce the frequency of this disorder.
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14
PSYCHOLOGICAL DISEASES
Generalised Anxiety Disorder
Depression
Chronic Fatigue Syndrome
Drug Addiction
Alcoholism
Insomnia
GENERALIZED ANXIETY DISORDER

Generalized anxiety disorder (GAD) is characterized by a pattern of
frequent, persistent worry and anxiety, about several different events or
activities. The symptoms last for at least 6 months.

Generalized anxiety disorder (GAD) is a common condition. It is
characterized by excessive anxiety and worry, which is out of proportion to
the impact of the event or circumstance that is the focus of the worry.
For example, while college students often worry about tests, a student who
constantly worries about failure — despite getting consistently good grades
— has the pattern of worry typical of this disorder.
The person finds it difficult to control the worry. The cause of GAD is not
known, but biological and psychological factors play a role. Stressful life
situations or maladaptive behavior, acquired through learning, may also
contribute to GAD.
The disorder may start at any time in life, including childhood. Most
patients with the disorder report that they have been anxious for as long as
they can remember. GAD occurs somewhat more often in women than in
men.
Symptoms
Anxiety and worry are often associated with the following symptoms:
O Restlessness or feeling keyed up or “on the edge”

O Being easily fatigued
O Difficulty concentrating
O Irritability
O Muscle tension : Headaches
O Sleep disturbance (difficulty falling or staying asleep; or restless,
unsatisfying sleep)
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Psychological Diseases
O Excessive sweating, palpitations, shortness of breath, and various

gastrointestinal symptoms
O Dizziness or impaired concentration.
Signs and tests

A physical examination and a psychological evaluation should be completed
in order to rule out other causes of anxiety. Physical disorders that may
mimic an anxiety state should be ruled out, as well as drug-induced
symptoms. Various diagnostic tests may be done in this process.
Treatment
MODERN MEDICINE
Treatment may involve specific medications that provide a sedative (sleep-
inducing) or calming effect. Other drugs that have the favorable side effect
of reducing anxiety may be used, such as antihistamines.
Antianxiety Medications
O Benzodiazepines—a group of drugs that help to reduce anxiety
and have sedating properties; may cause drowsiness, constipation,
or nausea; it should not be taken if the patient has narrow-angle
glaucoma, apsychosis, or if pregnant.
Antidepressant Medications
O Tricyclic antidepressants—a group of drugs that relieve depression
(which can accompany anxiety); these medications tend to have
numerous side effects.
AYURVEDA
Panchakarma treatments like massage, Dhara reduce anxiety and promote
relaxation. Dhara is considered as the best therapy for this condition.
Normally Brahmi oil or medicated buttermilk is used in Dhara. This oil is
kept in a vessel over the forehead of the patient and the vessel is adjusted in
such a way that continuous drops of this medicated oil fall from the bottom
of the vessel onto the place between the two eyebrows of the patient. This
should be done once daily.
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By this process the patient sleeps well and recovers from the disease slowly.
Herbs like Ashwagandha, Brahmi, Jatamansi, Vacha and Sarpagandha are
used for this disease. In powder form, these are given to the patient in a
dose of one teaspoonful three times a day with milk or cold water.
ACUPUNCTURE
Many people report feeling less stressed after receiving acupuncture therapy.
This finding has led researchers to speculate that acupuncture may have
some beneficial effect when used to treat anxiety directly. In a study of 55
healthy volunteers, acupuncture applied to a “relaxation” point in the ear
led to a greater reduction in anxiety than sham acupuncture (needling
inactive points).
The most useful points in treating anxiety are:
O Baihui (Du 20)
O Shenmen (H.7)
O Neiguan (P.6)
O Shenmal (U.B.62).
In these points, Baihui and Shenmen are specific points for reducing anxiety.
HOMEOPATHY
Aconitum
Aconitum: For anxiety accompanied by irregular or forceful heartbeat,
shortness of breath or fear of death.
Arsenicum album : For excessive anxiety that has no clear cause and is
accompanied by restlessness, especially after midnight; also for perfectionists,
including children, who worry about everything.
Phosphorus : For an impending sense of doom and anxiety when alone;
also for impressionable adults and children who are easily influenced by
the anxiety of others.
Lycopodium : For performance and other types of anxiety in those who are
insecure, yet hide their low self-esteem with arrogance and bravado; also
for children with anxiety accompanied by bedwetting.
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Gelsemium : For performance anxiety resulting in diarrhea, headache,

dizziness, weakness, shakiness and trembling, or trouble speaking.
Argentum nitricum : For performance anxiety (such as before tests in school-
age children) with rapid heart rate, feeling of faintness, diarrhea, or flatulence.
NATUROPATHY
Following herbs are used in Naturopathy to treat anxiety
O Kava kava (Piper methysticum) for mild to moderate anxiety

O St. John’s wort (Hypericum perforatum) for anxiety associated with
depression
O Passionflower (Passiflora incarnata) for anxiety with insomnia
O Oatstraw (Avena sativa) nourishes the nervous system
O Lemon balm (Melissa officinalis) for anxiety with depression and
heart palpitations
O Lavender (Lavandula angustifolia) for nervous exhaustion and
restoring the nervous system
O Skullcap (Scutellaria lateriflora) relaxes and revitalizes the nervous
system.
Kava kava (100 to 200 mg two to four times a day) and St. John’s wort
(300 mg two to three times per day) may be taken as dried extracts to
maximize effectiveness in moderate anxiety.
Essential oils of lemon balm, bergamot, and jasmine are calming and may
be used as aromatherapy. Place several drops in a warm bath or atomizer,
or on a cotton ball.
Hydrotherapy
Flotation tank bath or sensory deprivation bath: floating in a solitude
isolation and confinement tank produced deep relaxation.
This bath is usually done in a light proof and soundproof floatation tank.
It is filled with water with a temperature between 93 degrees F to 95
degrees F. Epsom salt (MgSO4 7H2O) is dissolved in it at a solution density
543
of 1.30 grams per cubic cm. The salt makes the water heavy so body pops
up and floats like a cork or like an astronaut in space. People with anxiety,
tension, depression, hypertension, insomnia, will be benefited by this bath.
However, people who have claustrophobia should avoid it.
YOGA THERAPY
Yoga reduces anxiety by relaxing the sympathetic nervous system and mind.
O Asanas:

and heart rate. Tie an Elastocrepe bandage around the eyes while
doing these poses, to relax the facial muscles and eyes

Konasana

Bhramari
NUTRITION THERAPY
Avoid caffeine, alcohol, sugar, refined foods, and cut down on foods that
are known to cause allergies (common food allergens are dairy, soy, citrus,
peanuts, tree nuts, wheat, fish, wheat, fish, eggs, corn, food colorings, and
additives). Fresh vegetables, whole grains, and protein nourish the nervous
system, so eat more of these.
Calcium (1,000 mg per day), magnesium (400 to 600 mg per day), and B
complex (50 to 100 mg per day) help support the nervous system and
minimize the effects of stress.
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PSYCHOTHERAPY
Two kinds of therapy have been effective in treating GAD. Behavioral
therapy uses relaxation training (a systematic relaxation of the major muscle
groups in the body). Cognitive behavioral therapy helps patients identify
cognitions — thoughts — that contribute to anxiety. Cognitive behavioral
therapy includes techniques as desensitizing patients to the triggers of
anxiety, and requiring them to confront their fears.
Mind-body techniques like progressive muscle relaxation, diaphragmatic
breathing, biofeedback, meditation, and self-hypnosis can help you relax
and reduce anxiety.
Family support is important to the recovery process, but there is no magic
cure. Some things family members can do to help a loved one diagnosed
with an anxiety disorder are:
O Learn about the disorder

O Recognize and praise small accomplishments
O Modify expectations during stressful periods
O Measure progress on the basis of individual improvement, not
against some absolute standard
O Be flexible and try to maintain a normal routine.
It is also important for family members to keep in mind that the recovery
process is stressful for them too. They should build a support network of
relatives and friends for themselves.
Support Groups
Patient support groups may be helpful for some patients suffering from
GAD. Patients have the opportunity to learn that they are not unique in
experiencing excessive worry and anxiety. Support groups are not a
substitute for effective treatment, but can be a helpful addition to it.
Coping Statements for Anxiety

Coping statements put a stop to the thoughts that lead to anxiety, and to
replace those thoughts with realistic, rational thoughts. Then, when these
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self-statements are practiced and learned, the brain takes over automatically.
This is a form of conditioning, meaning that brain chemistry
(neurotransmission) actually changes as a result of new thinking habits.
First, use thought stoppage. Be gentle but firm about it. “STOP! These
thoughts are not good for me. They are not healthy or helpful thoughts,
and I have decided to move in a better direction and learn to think
differently.”
Then, pick two or three statements from the list below that seem to help
you, and repeat them to yourself OUT LOUD each day.
When Anxiety is near:
O I’m going to be all right. My feelings are not always rational. I’m
just going to relax, calm down, and everything will be all right.
O Anxiety is not dangerous — it’s just uncomfortable. I am fine; I’ll
just continue with what I’m doing or find something more active
to do.
O Right now, I have feelings I don’t like. They will be over with soon
and I’ll be fine. For now, I am going to focus on doing something
else around me.
O I feel a little anxiety now. SO WHAT? It’s not as if it’s the first
time. I am going to take some nice deep breaths and keep on
going. This will help me continue to get better.”
Statements to use when preparing for a Stressful Situation
O I’ve done this before so I know I can do it again.

O This may seem hard now, but it will become easier and easier over
time.
O I think I have more control over these thoughts and feelings than
I once imagined. I am very gently going to turn away from my old
feelings and move in a new, better direction.
Statements to use when feel overwhelmed
O I can be anxious and still focus on the task. As I focus on the task,
my anxiety will go down.
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O At first, my anxiety was powerful and scary, but as time goes by it

doesn’t have the hold on me that I once thought it had. I am
moving forward gently and nicely all the time.
O I don’t need to fight my feelings. I realize that these feelings won’t
be allowed to stay around very much longer. I just accept my new
feelings of peace, contentment, security, and confidence.
PHYSICAL THERAPY (MASSAGE AND EXERCISE)
Therapeutic massage can be helpful in reducing anxiety and alleviating
stress. Massage was shown to promote relaxation and alleviate pain and
anxiety in hospitalised cancer patients Massage reduced anxiety and lowered
stress hormone levels in children with asthma, resulting in fewer asthma
attacks.
A daily routine of physical exercise, whether yoga or simply a walk or jog
followed by exercise activity, or even a higher level gym program depending
upon capability will have a beneficial effect on the GAD. Exercise activity
results in a relaxation response at the end of exercise, in which the
endorphins released during exercise reduce blood pressure, heart rate,
respiration etc. resulting in the opposite response that anxiety induces.
DEPRESSION
Depression may be described as feeling sad, blue, unhappy, miserable, or
down in the dumps. Most of us feel this way at one time or another for
short periods. However, true clinical depression is a mood disorder in which
feelings of sadness, loss, anger, or frustration interfere with everyday life for
an extended time.
The main types of depression include:
O Major depression : Five or more symptoms listed must be present

for at least 2 weeks, but major depression tends to continue for at
least 6 months. (Depression is classified as minor depression if less
than five depressive symptoms are present for at least 2 weeks.)
O Dysthymia : A chronic, generally milder form of depression but

lasts longer, usually as long as two years.
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O Atypical depression: Depression accompanied by unusual

symptoms, such as hallucinations (for example, hearing voices that
are not really there) or delusions (irrational thoughts).
Other common forms of depression include:
O Postpartum depression : Many women feel somewhat down after
having a baby, but true postpartum depression is rare.
O Premenstrual dysphoric disorder (PMDD) : Depressive symptoms
occur one week prior to menstruation and disappear after you
menstruate.
O Seasonal affective disorder (SAD) : Occurs during the fall-winter
season and disappears during the spring-summer season. Likely to
be due to lack of sunlight.
Depression may also occur with mania (known as manic-depression or
bipolar disorder). In this condition, moods cycle between mania and
depression.
Depression is more common in women than men and it is especially common
during the teen years. Men seem to seek help for feelings of depression less
often than women. Therefore, women may only have more documented
cases of depression.
Causes
Depression often runs in families. This may be from heredity, learned
behavior, or both. Even with a genetic predisposition, it is usually a stressful
or unhappy life event that triggers the onset of a depressive episode.
Depression may be brought on by:
O Heredity—a recently identified gene called SERT that regulates
the brain chemical serotonin, has been linked to depression
O Chronic stress (such as from loss, abuse, or deprivation in early
childhood)
O Amount of exposure to light
O Nutritional deficiencies (especially folate [vitamin B9] and omega-
3 fatty acids)
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O Serious medical conditions, such as heart attack or cancer

O Certain medications, including those for high blood pressure, high
cholesterol, or irregular heartbeat
O Death of a friend or relative
O Prolonged pain or having a major illness
O Medical conditions such as hypothyroidism (underactive thyroid),
cancer, or hepatitis
O Social isolation (common in the elderly)
O Sleeping problems.
Symptoms
Depression is generally ranked in terms of severity — mild, moderate, or
severe. Symptoms of depression include:
O Trouble sleeping or excessive sleeping
O A dramatic change in appetite, often with weight gain or loss
O Fatigue and lack of energy
O Feelings of worthlessness, self-hate, and inappropriate guilt
O Extreme difficulty concentrating
O Agitation, restlessness, and irritability
O Inactivity and withdrawal from usual activities
O Feelings of hopelessness and helplessness
O Recurring thoughts of death or suicide.
Low self-esteem is common with depression. So are sudden bursts of anger
and lack of pleasure from activities that normally make people happy,
including sex.
Depressed children may not have the classic symptoms of adult depression.
Watch especially for changes in school performance, sleep, and behavior.
Tests
Psychotherapists will often administer a screening test, such as the Beck
Depression Inventory or the Hamilton Rating Scale, which consists of about
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20 questions that assess an individual’s risk for depression. Even before

these psychological screening tests, however, several blood tests will be
performed to determine whether nutrient deficiencies or underlying
medical conditions (such as a thyroid disorder) may be causing or
contributing to depression.
Treatment
Treatment will vary according to the cause and severity of depressive
symptoms, as well as patient’s personal preference.
For mild depression, counseling and self-care measures without medication
may be enough. For people who are so severely depressed as to be unable
to function, or who are suicidal and cannot be safely cared for in the
community, psychiatric hospitalization may be necessary.
MODERN MEDICINE
Antidepressant medications are very effective; reports indicate that they
are 90% successful in treating depression. In general, medications are taken
for at least 4 to 6 months to assure complete and effective treatment. Most
antidepressants cause withdrawal symptoms if they are not discontinued
slowly over time.
There are several classes of antidepressant medications, including:
O Selective Serotonin Reuptake Inhibitors (SSRIs): SSRIs increase
the activity of a chemical in the brain called serotonin. Drugs
classified as SSRIs include Fluoxetine, Sertraline, Paroxetine,
Fluvoxamine and Citalopram.
Another group of antidepressant medications (which are similar
to SSRIs, but target other brain chemicals in addition to serotonin)
may cause fewer negative sexual side effects. These include
Bupropion, Nefazodone, Venlafaxine, Mirtazapine and
Maprotiline.
O Tricyclic Antidepressants: They increase the activity of the brain
chemicals serotonin and norepinephrine. They are as effective as
SSRIs, but are usually prescribed only to those who do not respond
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well to SSRIs because side effects are quite common and are usually
less tolerable. Tricyclic antidepressants include Amitriptyline,
Amoxapine, Clomipramine, Desipramine, Doxepin, Imipramine,
Nortriptyline, Protriptyline and Trimipramine.
O Monoamine Oxidase Inhibitors (MAOIs): MAOIs boost the levels
of norepinephrine, dopamine, and serotonin in the brain. MAOIs
are generally prescribed only when other antidepressants have not
been effective, which may occur in people with atypical depression.
People who take MAOIs may experience a sharp increase in blood
pressure after consuming food or drink containing the amino acid
tyramine (found in such foods as aged cheeses and red wine).
MAOIs include Phenelzine, Isocarboxazid and Tranylcypromine.
Electroconvulsiv
oconvulsivee Therapy
lectroconvulsiv
Electroconvulsive therapy, or ECT,, is a procedure in which of an electric
current is used to produce a seizure in the patient. It is believed that ECT
results in the release of chemicals in the brain that aid communication
between nerves. It is one of the fastest and most effective ways to relieve
symptoms in severely depressed or suicidal patients, or patients who are
suffering from mania. ECT is used when severe depression is unresponsive
to other forms of therapy. It also is used when medication is considered
unsafe.
Although it is safe and effective, ECT remains the most controversial
treatment for psychiatric illnesses because of potential risks from incorrect
administration, and because of misconceptions about ECT. ECT is usually
followed by psychotherapy and medication under a psychiatrist’s care. On
occasion, ECT is prescribed on a regular basis (monthly-quarterly) to
prevent further episodes of depression. It may cause temporary confusion,
memory impairment, headache, muscle aches, irregular heart rhythm, or
nausea.
Magnetic Resonance Imaging (MRI)-Guided Cingulotomy involves the
application of an electrical current to a specific part of the brain; the MRI
is used as a guide for an exact placement. Long-term improvement has
been reported using this technique in over 50% of people with depression
who have not responded to other modes of therapy.
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AYURVEDA
Panchakarma treatments like massage, Dhara reduce depression and
promote relaxation. Normally Brahmi oil or medicated buttermilk is used
in Dhara.
Herbs like Ashwagandha, Brahmi, Jatamansi (Nardostachys jatamansi), Vacha

(Acorus calamus) and Jyotismati (Celastrus panniculata) are used for this
disease. In powder form, these are given to the patient in a dose of one
teaspoonful three times a day with milk or cold water. Drugs like Jatamansi
choornam, Saraswatharishtam, Brahmi Ghritham, Aswagandharishtam are
useful.
ACUPUNCTURE
Two randomized, controlled, clinical trials suggest that electroacupuncture

may reduce symptoms of depression as effectively as amitriptyline, a tricyclic
antidepressant medication.
The most useful points in treating depression are:
O Baihui (Du 20)
O Zhusanli (St.36)
O Sanyinjiao (Sp.6)
O Qihai (Ren.6).
HOMEOPATHY
Ignatia
Ignatia: For a sudden sense of grief or disappointment following the death
of a loved one, the end of a romantic relationship, or an unexpected loss of
one’s job. This remedy is most appropriate for individuals who are very sad
and have frequent crying spells.
Natrum muriaticum
muriaticum: For grief following the death of a loved one or sadness
from the end of a romantic relationship. This remedy is most appropriate
for individuals who grieve silently and desire to be alone, avoid being
comforted, and are reluctant to cry in public.
Aur um metallicum
urum metallicum: For depression and a suicidal tendency.
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Medusa
Medusa: Excellent for adolescent depression.
Sepia
Sepia: Depressed, irritable and unable to cope with the cares and
responsibilities of the daily chores. Indifferent to those who should be
loved best. Dreads to be alone, weeps when telling symptoms.
NATUROPATHY
Naturopaths advise following herbs in treating depression:
O St. John’s wort (Hypericum perforatum) is effective as tricyclic
antidepressants, but with fewer side effects.
O Valerian root (Valerian officinalis) may improve symptoms of
insomnia associated with depression.
O Ginseng (Panax ginseng) may help the body resist stress.
YOGA THERAPY
Yoga reduces depression by normalizing the nervous system and mind.

Pranayamas such as Nadi shuddhi, Ujjayi, Sheetkari, Sheetali, and Bhramari
and Meditation, Yoga nidra has been shown to reduce depression.
NUTRITION THERAPY
Studies suggest that people with depression who eat a healthy diet that
includes fatty fish (such as salmon, mackerel, herring, and sardines) two to
three times per week may significantly reduce their feelings of depression
and anxiety. Fatty fish contain omega-3 polyunsaturated fatty acids (PUFAs),
and many individuals with depression are deficient in this substance. Some
studies suggest that dietary supplementation with docosahexaenoic acid
(DHA), one type of PUFA, may help prevent depression.
Diets rich in fruits and vegetables, particularly leafy green vegetables, are
also recommended for people with depression. For those who have difficulty
maintaining a balanced diet, supplementation with a multivitamin may
also be recommended.
O ther supplements like Folate (Vitamin B9), S-Adenosinemethionine
(SAMe), Selenium, Inositol and Vitamin C reduce depression.
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PSYCHOTHERAPY
Counseling may help you through times of grief, stress, or low mood.
Family therapy may be particularly important for teens who feel blue.
Cognitive-behavioral therapy is a type of psychotherapy in which individuals
learn to identify and change distorted perceptions about themselves and
adapt new behaviors to better cope with the world around them. This
therapy is frequently considered the treatment of choice for people with
mild to moderate depression, but it may not be recommended for those
with severe depression. Studies of people with depression indicate that
cognitive-behavioral therapy is at least as effective as tricyclic antidepressants.
Compared to those treated with antidepressants, people treated with
cognitive-behavioral therapy demonstrated similar, or better, results and
lower relapse rates.
Other therapeutic approaches that may be useful include:
O Psychodynamic psychotherapy: Based on Freud’s theories about
unresolved conflicts in childhood and depression as a grief process.
O Interpersonal therapy: Acknowledges childhood roots of depression,
but focuses on current problems contributing to depression;
considered very effective treatment for depression
O Supportive psychotherapy: Nonjudgmental advice, attention, and
sympathy; this approach may improve compliance with taking
medication.
O Relaxation: One study suggests that relaxation techniques, such as
yoga and tai chi, may improve symptoms of depression in people
with mild depression.
O Meditation: Some researchers theorize that mindfulness meditation
may prevent depression from recurring in people who once had
the condition.
PHYSICAL THERAPY
Exercise
Studies have consistently shown that regular exercise (either aerobic or
strength/flexibility training) significantly reduces depressive symptoms in
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people with mild to moderate depression and improves the mood of people
with major depression. Some even suggest that exercise may be as effective
as psychotherapy for people with mild to moderate depression, although
additional research is needed to confirm this encouraging finding. In the
meantime, exercise can be used safely in conjunction with medication for
those with depression.
Keeping in mind that depression results in a lowered metabolism and

lethargy, the objective of exercise should be to stimulate the individual
thus reversing the effects of depression. To that end, the exercise program
should be activity oriented i.e. jogging or brisk walking in lieu of slow
walking, intensive and dynamic movements and weight training as opposed
to static stretches. Accordingly, an exercise program of 6 days per week 30
mimutes walk/jog, followed by 30 minutes weight training is advised. As
often as possible this can be replaced with a 45-60 minute game of football,
basket ball, badminton, tennis etc.
Massage
Studies of formerly depressed adolescent mothers, children hospitalized
for depression, and women with eating disorders, suggest that massage
decreases stress hormone levels, feelings of anxiety, and symptoms of
depression. Giving massage may also be beneficial for people who are
depressed. Elderly volunteers with depression showed notable improvement
in their symptoms when they massaged infants.
evention
Healthy lifestyle habits can help prevent depression, or lessen the chances
of it happening again. These habits include eating properly, sleeping
adequately, exercising regularly, learning to relax, and not drinking alcohol
or using drugs.
For elderly or others who feel socially isolated or lonely, volunteering or
getting involved in some group activities helps fight depression.
If depression occurs in the fall or winter months, light therapy using a
special lamp that mimics the sun helps.
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CHRONIC FA
CHRONIC TIGUE SYNDR
FATIGUE OME
SYNDROME
Chronic fatigue syndrome is a condition of prolonged and severe tiredness
or weariness (fatigue) that is not relieved by rest and is not directly caused
by other conditions. To be diagnosed with chronic fatigue syndrome, the
tiredness must be severe enough to decrease ability to participate in ordinary
activities by 50%.

The exact cause of chronic fatigue syndrome (CFS) is unknown. Some
researchers suspect it may be caused by a virus, such as Epstein-Barr virus
or human herpes virus-6 (HHV-6). However, no distinct viral cause has
been identified.
Recent studies have shown that chronic fatigue syndrome may be caused
by inflammation of pathways in the nervous system, and that this
inflammation may be some sort of immune response or autoimmune
process. CFS may occur when a viral illness is complicated by an inadequate
or dysfunctional immune response. Other factors such as age, prior illness,
stress, environment, or genetic disposition may also play a role. CFS most
commonly occurs in women ages 30 to 50.
The Centers for Disease Control (CDC) describes CFS as a distinct disorder
with specific symptoms and physical signs, based on the exclusion of other
possible causes. The number of patients with CFS is unknown.
Symptoms
Symptoms of CFS are similar to those of most common viral infections
(muscle aches, headache, and fatigue), often developing within a few hours
or days and lasting for 6 months or more.
Main symptoms:
O Fatigue or tiredness, never experienced to this extent before (new
onset), lasting at least 6 months and not relieved by bed rest
O Fatigue that is severe enough to restrict activity (serious fatigue
develops with less than one-half of the exertion compared to before
the illness).
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Other symptoms:
O Fatigue lasting more than 24 hours after an amount of exercise
that would normally be easily tolerated
O Mild fever (101 degrees F or less)
O Sore throat
O Lymph node tenderness in the neck or armpit
O Muscle weakness, all over or multiple locations, not explained by
any known disorder
O Muscle aches (myalgias)
O Feeling unrefreshed after sleeping an adequate amount of time
O Headaches, different from previous headaches in quality, severity,
or pattern
O Joint pain, often moving from joint to joint (migratory arthralgias),
without joint swelling or redness
O Forgetfulness or other similar symptoms including difficulty
concentrating, confusion, or irritability.
Signs and tests

Physical examination may confirm the fever, lymph node tenderness, lymph
node swelling, or other symptoms. The throat may appear red without
drainage or pus.
A diagnosis of chronic fatigue syndrome (CFS) is done only after ruling
out all other known possible causes of fatigue, such as:
O Infections
O Immune or autoimmune disorders
O Tumors
O Muscle or nerve diseases (such as multiple sclerosis)
O Endocrine diseases (such as hypothyroidism)
O Psychiatric or psychological illnesses, particularly depression (since
CFS itself may be associated with depression, a diagnosis of
depression does not rule out CFS but fatigue related to depression
alone must be ruled out for CFS to be diagnosed)
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O Drug dependence
O Other illnesses (such as heart, kidney, liver diseases).
A diagnosis of CFS must include:
O Extreme, prolonged fatigue
O Absence of other causes of chronic fatigue (excluding depression)
O At least 4 of the other symptoms listed.
There are no specific tests to confirm the diagnosis of CFS, though a variety
of tests are usually done to exclude other possible causes of the symptoms.
There are some typical findings on tests that, while not specific enough to
diagnose CFS, are seen consistently in people who are eventually diagnosed
with the disorder. These include:
O Higher levels of specific white blood cells (CD4 T cells) compared
to other types of white blood cells (CD8 T cells)
O Brain MRI showing swelling in the brain or destruction of part of
the nerve cells (demyelination)
O Specific white blood cells (lymphocytes) containing active forms
of EBV or HHV-6.
Treatment
MODERN MEDICINE
There is currently no treatment that has been proven effective in curing
CFS. Instead, the symptoms are treated. Many people with CFS experience
depression and other psychological problems that may improve with
treatment.
Some of the proposed treatments include:
O Antidepressants—depending on type, in addition to relieving
depression, they can reduce fatigue, muscle tension, or insomnia;
various side effects
O Benzodiazepines—help reduce anxiety; various side effects
O Histamine blockers—block production of stomach acid, improving
energy
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O Non-sedating antihistamines—relieve allergy symptoms; side effects

include drowsiness and headache
O Immune system boosters—to activate or enhance the immune
system; some of these drugs are experimental.
AYURVEDA
Ayurvedic practitioners manage CFS by improving digestion and eliminating
toxins and allergies. Diet modification and cleansing programs are used to get
rid of toxins. They also improve sleep patterns by their action on the
psychosomatic elements. Ayurveda advises Panchakarma and Rasayana Chikitsa
for treating CFS. Panchakarma treatments like massage, Dhara, navarakizhi,
help to remove the toxins from the body. Rasayana (tonic) herbs like Ashwagandha,
Amrita, Bala, Shatavari helps to energise the body.
ACUPUNCTURE
The following points are used: Du 20, Du 14, He.7, St.36, UB.15, P.6,
Sp.6, Ren 6 and Liv.3.
HOMEOPATHY
Kali phos is useful for fatigue with trembling, due to stress or nervous
exhaustion from overwork. Symptoms include irritability, anxiety, fear of
losing control and muscle fatigue upon exertion.
Arsenicum: For restlessness and fatigue accompanied by chills and burning
pains that are worse at night.
Gelsemium: For mental exhaustion, including drowsiness and indifference,
and physical weakness, such as heaviness of the limbs and eyelids.
Pulsatilla: For people who are moody and emotional, although usually
with a calm and gentle disposition.
Sulphur: For people who feel fatigue and tend to be lazy and unproductive;
usually not as emotionally sensitive as those requiring Pulsatilla.
NATUROPATHY
Naturopathy advises intake of farm fresh vegetables and fruits as they contain
life energy which activates the body’s energy.
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Herbs like Siberian ginseng (Eleutherococcus senticosus), schizandra berry

(Schizandra chinensis), Ashwagandha root (Withania somnifera), gotu kola
(Centella asiatica), and astragalus root (Astragalus membranaceus) are useful
in treating CFS.
Herbs that support overall vitality and relieve exhaustion include licorice
root (Glycyrrhiza glabra), skullcap (Scutellaria lateriflora), passionflower
(Passiflora incarnata), lavender (Lavandula angustifolia), and rosemary leaf
(Rosmarinus officinalis).
Hydrotherapy
Hyperthermia: Several doctors have reported success using artificial
hyperthermia as the central element in a treatment program for CFS. The
treatment involves artificially inducing fever in order to augment the body’s
ability to fight viral infections. Patients must commit to a three-week course
of treatment during which they stay home, get total bed rest, and undergo
the fever treatment three times daily.
To induce hyperthermia, the patient soaks in a bath (as hot as is tolerable)
for a full five minutes, while drinking a twelve-ounce glass of tepid water
mixed with two thousand milligrams of vitamin C.
YOGA THERAPY
Yoga is excellent for Chronic Fatigue Syndrome. Yoga’s gentle stretching

exercises does not consume too much energy; so the participants feel refreshed
after the exercise. This is important because the victims of CFS are already
on a deficit for energy. A daily routine that combines 5 minutes of the
complete breath exercise, 10 to 20 minutes of meditation and your choice
of three or four yoga poses are recommended. The poses will push more
oxygen through your system and release muscle tension. The meditation
will teach you how to conserve energy and build self-confidence.
Yoga particularly pranayama and meditation increases the body energy
levels and prevent fatigue.
O Asanas:
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Konasana
Bhramari
NUTRITION THERAPY
Avoid refined foods, sugar, caffeine, alcohol, saturated fats, dairy products, and
gluten-containing grains. Eat more fresh vegetables, legumes, whole grains,
protein, and essential fatty acids found in nuts, seeds, and cold-water fish.

O Beta-carotene (50,000 IU per day) to strengthen immune function
O Vitamin C (250 to 500 mg two times per day) to increase endurance
O B-complex (50 to 100 mg per day or 2 ml by injection one to two
times per week) with additional B6 (100 mg per day) and B5
(100 to 250 mg per day) to reduce the effects of stress
O Pantothenic acid (4 to 7 mg per day)
O Magnesium aspartate (400 to 1,000 mg per day) to support energy
production
O L-carnitine (330 mg one to three times per day) to support energy
production in the cells.
PHYSICAL THERAPY
Exercise is the most important treatment for chronic fatigue syndrome.
The persons who suffer from CFS are almost always in a vicious downward
cycle. They are fatigued with muscle pains and they have been getting a
great deal of rest. A cycle develops whereby rest leads to muscle wasting,
which leads to decreased performance, which leads to pessimism, which
leads to disinterest in exercise, which in turn leads to even more rest.
Daily exercise can end that downward cycle and replace it with an upward,
positive cycle. When a person exercises, a new cycle develops consisting of
exercise that leads to muscle enlargement, which leads to increased performance,
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which leads to optimism, which leads to interest in exercise, which in turn

leads to even more exercise. Studies have demonstrated that exercise has anti-
anxiety and antidepressant properties. The reason may be a combination of
producing endorphins (the pleasure hormone that our brains make when we
exercise) and attaining a sense of accomplishment at having reversed the loss of
function that befalls people with chronic fatigue syndrome. Of course, exercise
is also beneficial for the cardiovascular system.
Accordingly, a general daily exercise program must be followed comprising
30 minutes of brisk walking followed by 30 minutes of exercise. These
exercises could be yoga on alternate days for 30 minutes and gym exercises
on the other days for 30 minutes.
PSYCHOTHERAPY
One of the challenges faced by CFS patients is the great deal of coping
they have to undertake. CFS is very stressful. Therapy can be very helpful
in reminding the patient to respect his limits, that symptoms are transitory,
that healing is possible, and to follow through with self-help practices. By
keeping all these challenges in perspective, the quality of day-to-day living
can be much improved over living in a state of constant despair or fear.
Support Groups
A support group can be very helpful for chronic fatigue syndrome patients.
It must be led by a professional therapist, otherwise such a group may not
be worth expending effort upon or may actually be harmful. In a support
group, patients have a chance to deal with the stress of being affected by a
chronic illness. Support groups are also helpful in overcoming the isolation
and lack of social support which so many people with CFS experience.
And they can be a source of reinforcement for continuing on your path of
self-empowerment. Patients learn how to:
O Recognize and avoid situations that lead to exacerbation of
symptoms
O Seek help from other people
O Relate better to their loved ones and understand the effects of the
illness on their entire support system
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O Attempt to enjoy life even while having this disabling condition.

Support each other in adhering to treatment regimens such as
exercise etc.
DRUG ADDICTION
Drug dependence (addiction) is compulsive use of a substance despite
negative consequences which can be severe; drug abuse is simply excessive
use of a drug or use of a drug for purposes for which it was not medically
intended.
Physical dependence on a substance (needing a drug to function) is not
necessary or sufficient to define addiction. There are some substances that
don’t cause addiction but do cause physical dependence (for example, some
blood pressure medications) and substances that cause addiction but not
classic physical dependence (cocaine withdrawal, for example, doesn’t have
symptoms like vomiting and chills; it is mainly characterized by depression).
Drug abuse can lead to drug dependence or addiction. Drug dependence
may also follow the use of drugs for physical pain relief, though this is rare
in people without a previous history of addiction.
The exact cause of drug abuse and dependence is not known. However, the
genetic make-up of the individual, the pharmacology of the particular drug,
peer pressure, emotional distress, anxiety, depression, and environmental
stress are all factors which seem to be involved.
Risk factors that predispose people to drug dependence are different from
those that predispose to use or abuse. Peer pressure may lead to use or
abuse, but at least half of those who go on to addiction have depression,
attention-deficit disorder, post-traumatic stress disorder or another
psychological problem.
Children who grow up in an environment of illicit drug use may first see
their parents using drugs. This may put them at a higher risk for developing
an addiction later in life for both environmental and genetic reasons.
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Signs of drug use in children include but are not limited to:
O A change in the child’s friends, a new group

O Seclusive behavior
O Long unexplained periods away from home
O Lying
O Stealing
O Involvement with the law
O Deteriorating family relations
O Obvious intoxication (e.g., drunk), delirious, incoherent, or
unconscious
O Distinct changes in behavior and normal attitude
O Decreased school performance.
Commonly abused substances include:
O Opiates and narcotics are powerful painkillers with sedative and

euphoric qualities. These include heroin, opium, codeine,
meperidine (Demerol), hydromorphone (Dilaudid), Oxycontin
and others.
O Central nervous systemstimulants include amphetamines, cocaine,
dextroamphetamine, methamphetamine, and methylphenidate
(Ritalin). The most commonly used stimulants are caffeine and
nicotine. These drugs have a stimulating effect and can produce
tolerance.
O Central nervous system depressants include barbiturates
(amobarbital, pentobarbital, secobarbital), benzodiazepine (Valium,
Ativan, Xanax), chloral hydrate, and paraldehyde. The most
commonly used, by far, is alcohol. These substances produce a
soothing sedative and anxiety-reducing effect and can lead to
dependence.
O Hallucinogens include LSD, mescaline, psilocybin (“mushrooms”),
and phencyclidine (PCP or “Angel Dust”). They have
hallucinogenic properties and can produce psychological
dependence.
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O Tetrahydrocannabinol (THC) is the active ingredient found in

cannabis, marijuana, and hashish. Although used for their relaxing
properties, THC-derived drugs can also lead to paranoia and anxiety.
Drug intoxication and drug overdose may be accidental or intentional.
Drug withdrawal symptoms can occur when use of a substance is stopped
or reduced. Withdrawal symptoms vary, depending on the abused
substance. The onset of withdrawal symptoms depends on the length of
time the drug normally stays within the body. Drug intoxication, overdose,
and withdrawal can be life-threatening in some situations. While opiates,
stimulants and depressants have withdrawal symptoms, no symptoms are
reported in hallucinogens.
Symptoms
Opiates and Narcotics
Symptoms of use:
O Needle marks on the skin in some cases (called “tracks”)
O Scars from skin abscesses
O Rapid heart rate
O Constricted pupils (pinpoint)
O Relaxed and/or euphoric state (“nodding”)
O Respiratory depression leading to coma and death in high doses.
Symptoms of withdrawal:
O Anxiety and difficulty sleeping
O Sweating
O Goose bumps (piloerection)
O Runny nose (rhinorrhea)
O Stomach cramps or diarrhea
O Dilated pupils
O Excessive sweating
O Increase in blood pressure, pulse, and temperature.
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Central Nervous System stimulants

Symptoms of cocaine use:
O Euphoria (exaggerated feeling of well-being)
O Dilated pupils
O Rapid heart rate
O Restlessness and hyperactivity.
Symptoms of cocaine withdrawal:
O Fatigue and malaise
O Depression
O Vivid and unpleasant dreams.
Central Nervous System Depressants
Symptoms of alcohol use:
O Slurred speech
O Lack of coordination
O Decreased attention span
O Impaired judgment.
Symptoms of alcohol withdrawal:
O Anxiety
O Tremors
O Seizures
O Increase in blood pressure, pulse, and temperature
O Delirium.
Hallucinogens
Symptoms of LSD use:
O Anxiety
O Frightening hallucinations
O Paranoid delusions
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O Blurred vision
O Dilated pupils
O Tremor.
Signs and tests

Toxicology screens (drug testing) done on blood and urine specimens can
reveal the presence of many chemicals and drugs in the body. The sensitivity
depends upon the substance itself, when the substance was taken, and the
testing laboratory. Blood tests are more likely to detect the presence of an
abused substance than urine tests, however, urine drug screens are more
frequently done.
Opiates and narcotics are usually present in the urine 12 to 36 hours after
the last use, depending on the amount used and the frequency.
CNS stimulants such as cocaine can be detected in urine anywhere between
1 to 12 days, again depending in frequency of use.
CNS depressants such as Valium and Xanax are detected up to 7 days after
the last day of use, mostly depending on the substance used and how
quickly it is eliminated by the body (half-life).
Most hallucinogens are also detectable in the urine up to 7 days after the
last use. However, cannabis can be detected up to 28 days in regular users.
Treatment
Treatment for the person with drug abuse or dependence begins with the
recognition of the problem. However, previously “denial” was considered a
symptom of addiction, recent research has shown that this symptom can
be dramatically reduced if addicts are treated with empathy and respect,
rather than told what to do or “confronted.”
MODERN MEDICINE
Treatment of drug dependency involves detoxification, support and
abstinence. Emergency treatment may be indicated for acute intoxication
or drug overdose. Often, there may be a loss of consciousness and the
person may need to be on a mechanical respirator temporarily. The specific
treatment depends on the drug.
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Detoxification is the gradual withdrawal of an abused substance in a

controlled environment. Sometimes a drug with a similar action is
substituted during the withdrawal process to reduce the unpleasant
symptoms and risks associated with withdrawal. The process can be managed
on an inpatient or outpatient basis.
Rehabilitation is the process that occurs after detoxification and is often
needed to prevent relapse. Inpatient and outpatient programs are available.
Individual, group, or family therapy is usually part of this process, and
may continue for a month or longer. Information/support may also be
sought from local support groups, such as Alcoholics Anonymous (AA)
and Narcotics Anonymous (NA).
If depression or other mood disorder exists, it should be treated
appropriately. In the past, addiction treatment providers discouraged use
of antidepressant medications and this actually made relapse to addiction
more likely. Very often drug abuse develops from efforts to self-treat mental
illness.
Aftercare often involves life-long abstinence from drug abuse. Self-help
groups such as Narcotics Anonymous can offer support. For heroin addicts,
long-term methadone maintenance is the treatment with the best track
record of cutting relapse, improving functioning and restoring health.
AYURVEDA
Ayurveda has proven its efficacy in recovery from drugs, alcohol, overeating
and smoking. The uniqueness of Ayurveda is that it not only helps one
remove the cause of addiction (ie. anxiety can cause smoking), but it helps
remove the toxins from the body so there is little to no discomfort from
withdrawal symptoms.
The main therapies that Ayurveda employs are Panchakarma therapies,
herbs, nutrition and spiritual counselling.
Ayurveda advises Vata and Pitta reducing foods like celery, barley, clarified
butter.
Gotu Kola is best to cleanse hallucinogens and the toxins produced by
marijuana from the liver and brain. Ashwagandha is the best nervous system
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tonic. Shatavari helps restore emotional sensitivity and balance. Vacha

(Calamus) restores mental faculties of perception and self-expression,
removing dullness, depression and vegetative states. Valerian is a sedative
which counters stimulants. Jatamansi does not sedate, but improves mental
alertness and calm.
Guggul and Myrrh cleanse and rejuvenate the deeper tissue levels. Zizyphus
seeds nourish and tone damaged brain tissues.
ACUPUNCTURE
Chinese neurosurgeon HL Wen in 1972 discovered that acupuncture pain
treatments in post-surgical, opiate addicted patients seemed to alleviate
withdrawal. He used Ear Acupuncture of lung point in 40 patients with
opiate addiction found uniform decreases in opiate withdrawal symptoms.
Pomeranz et al found Ear Acupuncture in rats significantly reduced the
signs of morphine withdrawal.
Michael Smith, a psychiatrist in the Bronx, NY, modified Wen’s protocol
by stimulating five auricular needles. Needles are inserted in 5 points in
bilateral auricles, left in place for 40 minutes, and removed. The points are
Shen Men, Sympathetic, Lung, Liver and Kidney. This prescription was
not designed for withdrawal from any particular drug, but instead designed
to reduce anxiety, craving, and dysphoria during the early weeks of
withdrawal.
HOMEOPATHY
Avena sativ a: Antidotes the addiction to opiates and alcohol.
sativa:
Capsicum: Craves coffee which nauseates, weakness, diminished vitality,
opposed to any exertion, generally unclean and peevish, desires solitude,
disposed to suicide. Sometimes headache and swelling occurs behind the
ears.
Nux vvomica:
omica: The great drug that antidotes the effects of tobacco, alcohol
and other drugs. Provides a general detoxification of the system and is
often used as a first remedy before prescribing for more specific symptoms.
Irritable, cannot bear noises or light, does not want to be touched, time
passes too slowly. Craves stimulants.
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Quercuse Glandibus
Glandibus: Antidotes the effects of alcohol and takes away the
craving.
NATUROPATHY
In addition to psychological support, a wholesome, well-balanced diet and
nutritional supplements are advised. During the transition, fasting or at least a
cleansing diet is helpful to enhance purification and lessen the severity and
length of the withdrawal period. Fasting is very empowering and allows them to
clarify their plan and goals while strengthening their willpower.
The key to dietary detox support is in increasing alkalinity and reducing
acidity. Cravings and withdrawal are more intense with an acid state
generated from an intake of acid-forming foods such as meats, milk
products, and refined flours and sugars. All the fruits and vegetables are
alkaline-forming in the body. A fruit and vegetable diet, juices and soups,
or even water can be used temporarily.
General increase in nutritional supplements is usually helpful in
detoxification from drugs, with or without a change in diet; though better
with, of course. Vitamin C and the other antioxidants-A and zinc, E and
selenium, L-cysteine and other amino acids are all useful, in addition to
the basic vitamins and minerals. Glutathione, which is formed from L-
cysteine in the body, helps to decrease the toxicity of most drugs and
chemicals through its function in detoxification enzymes.
Supplements for drug detoxification includes the B vitamins, minerals, a high
amount of vitamin C, antioxidants, and L- amino acids. These work better with
a food diet than with fasting, so the alkaline, fruit-and vegetable-based diet is
best used with a high nutrient intake. With a more liquid diet, minimizing
supplements is suggested, maybe using just vitamin C, some minerals, and an
antioxidant formula, along with some herbs and chlorophyll.
Many people find the use of herbs beneficial in drug detoxification.
Goldenseal root powder is probably the most important here. Its alkaloids
help clear toxicity, and it stimulates the liver to better perform its detox
function. One large or two small capsules three times daily before meals
for one or two weeks can be helpful. Herbs that work as laxatives, diuretics,
and blood or lymph cleansers can also be used in specific formulas. Valerian
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root and other tranquilizing herbs may also be very useful during excitatory
withdrawal symptoms, such as anxiety or insomnia. Chlorophyll, taken as
tablets or liquid, has a mild purifying and rejuvenating quality.
Herbs associated with detoxifying and strengthening the liver and digestive
tract:
M ilk Thistle (Silybum marianum seed)- Milk Thistle has displayed remarkable
healing properties for the liver. European research has shown that it is effective
in treating cirrhosis, chronic hepatitis, and alcohol induced fatty liver. Milk
Thistle extract actually has hepato-protective properties; it protects the liver
cells from damage by environmental and internal toxins. This herb can be used
as a liquid extract, tablet, or capsule in most cases. However, the more serious
recovery case should consider the standardized extract.
Goldenseal (Hydrastis canadensis)-- Goldenseal is a superior liver and blood
detoxifier. A natural antibiotic, it is known to help reverse liver damage
and effectively treat a variety of infections.
Dandelion (Taraxacum officinale)- Dandelion is known as an excellent liver
detoxifier and mild diuretic. It increases the flow of bile and encourages
both the transformation and transportation of nutrients. It has been used
historically to treat liver disorders, arthritis and gout.
Herbs associated with relaxing and strengthening the nervous system:
Scullcap ((Scutellaria lateriflora)-
)- Scullcap is a broad spectrum nervine tonic.
This herb has been used successfully in cases of depression, anxiety, insomnia,
and headaches. Scullcap is considered one of the preferred herbs to help
ease withdrawal symptoms during recovery. During the first 72 hours of
withdrawal, it may be taken every couple of hours.
Valerian (Valeriana officinale)- Valerian is another strong nervine. It is known
to be beneficial for individuals who have a history of cocaine and/or alcohol
use and suffer from nervous disorders.
Passion Flo
Flo wer ((Passiflora incarnata)-
low )- Passion Flower is another great nervine.
Milder than Valerian, it is excellent for relieving tension and for insomnia.
Chamomile (Matricaria recutita blossom)- Chamomile is known as a mild
relaxant as well as a stomachic used for improving digestion. It contains
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the two compounds azulene and guaiazulene, which have been shown to
stimulate growth of liver tissue in rats. Chamomile may also be helpful
when prepared as a homeopathic remedy.
NUTRITION THERAPY

Vitamin C: Vitamin C is considered one of the primary nutrients useful in
the treatment of addiction. It helps to eliminate toxins from the body as
well as lessen withdrawal symptoms. A dose of 10 grams daily can prevent
cravings from returning. The preferred form of C is buffered with calcium
and magnesium or ester C.
Selenium: This important antioxidant plays a role in the body’s utilization
of oxygen. Selenium also has a role in detoxifying poisonous phenols,
formaldehyde, acetaldehyde, hydrocarbons, and chlorine. A safe therapeutic
dose is about 100 mcg daily. Green leafy vegetables and several herbs, such
as American and Siberian Ginseng, have bio-available forms of selenium.
Zinc: The mineral zinc plays an important role in carbohydrate metabolism.
Low zinc levels can cause liver deterioration and diminished functioning of
the reproductive organs, immune system, and skin. Zinc picolinate is
probably the most bio-available form, with a safe therapeutic dose between
15 - 20 mg, once or twice daily.
Chr omium: The recovering addict may benefit from chromium, as it helps
Chromium:
to regulate the blood sugar pattern. GTF chromium and chromium
picolinate are considered the most bio-available. A dose of 100 mcg, two
times daily is a good to begin with.
S.O.D: To the recovering addict, S.O.D. is important because it helps to
speed the elimination of poisons from the body. It is one of the most
abundant enzymes in the body, helping the liver to break down poisons
and free radicals.
PSYCHOTHERAPY
Counselling and psychotherapy form integral parts of most forms of
treatment. They aim at initiating and maintaining behavioural and lifestyle
changes, and help to control urges to use illicit substances.
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Counselling is an intensive interpersonal process concerned with assisting

people in achieving their goals or functioning more effectively. It uses a
variety of methodologies and techniques, including motivational
interventions, cognitive-behavioural approaches (social skills training, stress
management, anger management), relapse prevention, provision of
incentives, community reinforcement therapies and family interventions.
Psychotherapy is generally a longer-term process concerned with
reconstruction of the person and larger changes in more fundamental
psychological attributes, such as personality structure.
Support Groups
Many support groups are available in the community. They include
Narcotics Anonymous (NA), Ala-Teen, and Al-Anon.
Prevention
The same way as sex education has unable teenagers to make educated
choices about the use of condoms, about restriction on multi partners and
abortion. So also durg education and drug enforcement has had an
appropriate impact on educating the teenagers on the risk of drug
association. As a consequence of education and also restriction, the use and
abuse of drugs has improved since the 60’s when it first started.
ALCOHOLISM
Alcoholism is an illness marked by consumption of alcoholic beverages at a
level that interferes with physical or mental health, and social, family, or
occupational responsibilities. Alcoholism is divided into 2 categories:
dependence and abuse.
People with alcohol dependence, the most severe alcohol disorder, usually
experience tolerance and withdrawal. Tolerance is a need for markedly
increased amounts of alcohol to achieve intoxication or the desired effect.
Withdrawal occurs when alcohol is discontinued or intake is decreased.
Alcohol dependents spend a great deal of time drinking alcohol, and
obtaining it.
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Alcohol abusers are “problem drinkers”, that is, they may have legal
problems, such as drinking and driving, or binge drinking (drinking 6 or
more drinks on one occasion). People who are dependent on or abuse alcohol
return to its use despite evidence of physical or psychological problems.
Those with dependence have more severe problems and a greater compulsion
to drink.

Alcoholism is a type of drug addiction. There is both physical and
psychological dependence with this addiction. Physical dependence reveals
itself by withdrawal symptoms when alcohol intake is interrupted.
Alcohol affects the central nervous system as a depressant, resulting in a
decrease of activity, anxiety, tension, and inhibitions. Even a few drinks
can result in behavioral changes, a slowing in motor performance, and a
decrease in the ability to think clearly. Concentration and judgment become
impaired. In excessive amounts, intoxication may result.
Alcohol also affects other body systems. Irritation of the gastrointestinal
tract can occur with erosion of the lining of the esophagus and stomach
causing nausea and vomiting, and possibly bleeding. Vitamins are not
absorbed properly, which can lead to nutritional deficiencies with the long-
term use of alcohol. Liver disease, called alcoholic hepatitis, may also develop
and can progress to cirrhosis. The heart muscle may be affected. Sexual
dysfunction may also occur, causing problems with erections in men and
cessation of menstruation in women.
Alcohol affects the nervous system and can result in nerve damage and
severe memory loss. Chronic alcohol use also increases the risk of cancer of
the larynx, esophagus, liver, and colon. Alcohol consumption during
pregnancy can cause severe birth defects. The most serious is fetal alcohol
syndrome, which may result in mental retardation and behavior problems.
A milder form of the condition which can still cause lifelong impairment is
called fetal alcohol affects.
The social consequences of problem drinking and alcohol dependence can
be as serious as the medical problems. People who abuse or are dependent
on alcohol have a higher incidence of unemployment, domestic violence,
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and problems with the law. About half of all traffic deaths are related to
alcohol use.
The development of dependence on alcohol may occur over a period of
years, following a relatively consistent pattern. At first, a tolerance of alcohol
develops. This results in a person being able to consume a greater quantity
of alcohol before its adverse effects are noticed. Memory lapses (black-
outs) relating to drinking episodes may follow tolerance. Then, people
may lose control over drinking and find it difficult or impossible to stop if
they try. The most severe drinking behavior includes prolonged binges of
drinking with associated mental or physical complications. Some people
are able to gain control over their dependence in earlier phases before a
total lack of control occurs. The problem is, no one knows which heavy
drinkers will be able to regain control and which will not.
Withdrawal develops because the brain has physically adapted to the
presence of alcohol and cannot function adequately in the absence of the
drug. Symptoms of withdrawal may include elevated temperature, increased
blood pressure, rapid heart rate, restlessness, anxiety, psychosis, seizures,
and rarely even death.
There is no known common cause of alcoholism. However, several factors
may play a role in its development. A person who has an alcoholic parent
is more likely to become an alcoholic than a person without alcoholism in
the immediate family. Research suggests that certain genes may increase
the risk of alcoholism but which genes or how they exert their influence is
controversial. Psychological factors may include a need for relief of anxiety,
ongoing depression, unresolved conflict within relationships, or low self-
esteem. Social factors include availability of alcohol, social acceptance of
the use of alcohol, peer pressure, and stressful lifestyles. The incidence of
alcohol intake and related problems is increasing.
Symptoms
Men who consume 15 or more drinks a week, women who consume 12 or
more drinks a week, or anyone who consumes 5 or more drinks per occasion
at least once a week are all at risk for developing alcoholism. (One drink is
defined as a 400 ml bottle of beer, a 200 ml glass of wine, or a 60 ml shot
of liquor).
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The following questions are used to screen for alcohol abuse or dependence:
O Have you felt that you should cut down on your drinking?
O Do you ever drive when you have been drinking?
O Is someone in your family concerned about your drinking?
O Have you ever had any blackouts after drinking?
O Have you ever been absent from work or lost a job because of
drinking?
O Do you have to drink more than before to achieve intoxication or
the desired effect?
Some of the symptoms associated with alcoholism include:
O Solitary drinking
O Craving for alcohol
O Inability to control drinking habits
O Need for daily or frequent use of alcohol for adequate function
O Lack of control over drinking, with inability to discontinue or reduce
alcohol intake
O Episodes of violence associated with drinking
O Secretive behavior to hide alcohol related behavior
O Hostility when confronted about drinking
O Neglect of food intake
O Neglect of physical appearance
O Nausea and vomiting, Abdominal pain
O Numbness and tingling
O Confusion
O Malnutrition, anorexia
O Central nervous system disorders—unsteady gait or stance; cognitive
impairment; psychiatric manifestations (for example, mood, anxiety,
psychotic disorders); blackouts; coma; sleep disruptions.
Symptoms may vary.
Alcohol withdrawal symptoms may vary from mild to severe:
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O Rapid heart rate and sweating

O Restlessness or agitation
O Loss of appetite, nausea, or vomiting
O Confusion or hallucinations
O Tremors and seizures.
Signs and tests

All physicians should ask their patients about their drinking. A history
may be obtained from family if the affected person is unwilling or unable
to answer questions. A physical examination is performed to identify physical
problems related to alcohol use.
O A toxicology screen or blood alcohol level confirms recent alcohol
ingestion, which does not necessarily confirm alcoholism
O Liver function tests can be elevated. GGPT (glutaryl transaminase)
is often elevated more than other liver function tests
O CBC (complete blood count) - MCV can be elevated (mean
corpuscular volume or size of the red blood cells)
O Serum magnesium, uric acid, total protein, and folate tests may
be abnormal.
Treatment
Three general steps are involved in treating the alcoholic once the disorder
has been diagnosed. They are intervention, detoxification, and rehabilitation.
Research finds that the traditional confrontational intervention - where
the employer or family members surprise the alcoholic and threaten
consequences if treatment is not begun - is NOT effective. Studies find
that more people enter treatment if their family members or employers are
honest with them about their concerns, and try to help them to see that
drinking is preventing them from reaching their goals.
Once the problem has been recognized, total abstinence from alcohol is
required for those who are dependent; for those who are problem drinkers,
moderation may be successful. Since many alcoholics initially refuse to
believe that their drinking is out of control, a trial of moderation can often
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be an effective way to deal with the problem. If it succeeds, the problem is

solved. If not, the person is usually ready to try abstinence. Because
alcoholism affects the people closely related to the alcoholic person,
treatment for family members through counseling is often necessary.
MODERN MEDICINE
Detoxification is the first phase of treatment. Withdrawal from alcohol is

done in a controlled, supervised setting in which medications relieve
symptoms. Detoxification usually takes 4 to 7 days. Examination for other
medical problems is necessary. For example, liver and blood clotting
problems are common. A balanced diet with vitamin supplements is
important. Complications associated with the acute withdrawal of alcohol
may occur, such as delirium tremens (DT’s), which could be fatal.
Depression or other underlying mood disorders should be evaluated and
treated. Often, alcohol abuse develops from efforts to self-treat an illness.
Medications are sometimes prescribed to prevent relapses.
Tranquilizers called benzodiazepines which are used during the first few
days of treatment to help patients safely withdraw from alcohol.
Antipsychotic medications for people who do not respond to

benzodiazepines.
Naltrexone is a recently approved medication to help people remain sober.

When used in combination with counseling, this medication may lessen
the craving for alcohol and help prevent return to heavy drinking.
Disulfiram, an older medication, discourages drinking by causing nausea,
vomiting, and other unpleasant physical reactions when alcohol is used.
AYURVEDA
Ayurveda advises Panchakarma therapy and liver tonic herbs for alcoholism.
Herbs like Aloe, Gotu kola, Kalmegh (Andrographis panniculata) Bhumyalaki
(Phyllanthus Amarus), Punarnava (Boerhavia diffusa), Bhringaraj (Eclipta alba),
Chiretta (Swertia Chirata), Baheda (Terminalia belerica), Guduchi (Tinospora
cordifolia), and Katuki (Picrorhiza kurroa) are effective in treating alcoholism.
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Herbal wines, date syrup or Draksharishta can be given as substitutes for

alcohol and they will reduce dependency.
Apples help in removing intoxication of alcohol and reduce the craving.
Juice of bitter gourd leaves works as antidote for alcohol intoxication and
rectifies the liver damage; 3-4 spoons of bitter gourd juice in half a glass of
water / butter milk can be taken in early hours. Soak 4-5 dates in a glass of
water and drink twice daily. It reduces the intoxication of alcohol.
ACUPUNCTURE
Acupuncture has shown potential as an effective treatment for addiction,
according to a 1997 Consensus Statement by the National Institutes of
Health. While at least two studies have found that acupuncture may reduce
the desire to drink alcohol and the lower the number of admissions to
alcohol detoxification centers, other studies have failed to duplicate these
findings.
HOMEOPATHY
Asarum europaeum: A very useful remedy for intoxicated persons.
Avena sativ a: Antidotes the addiction to opiates and alcohol.
sativa:
Nux vvomica:
omica: The great remedy that antidotes the effects of tobacco, alcohol
and other drugs. Provides a general detoxification of the system and is
often used as a first remedy before prescribing for more specific symptoms.
Quercus e Glandibus: Antidotes the effects of alcohol and takes away the
craving.
Sulphuricum Acidum: Helps to overcome the craving for alcohol.
NATUROPATHY
A balanced diet with vitamin supplements with emphasis on stabilization
of blood sugar levels is most important. Many nutritional deficiencies are
caused by excessive alcohol ingestion, and deficient nutrient intake is
commonly associated with alcoholism. A balanced diet not only prevents
some of the diseases associated with alcoholism, but also reduces both
alcohol craving and the symptoms of alcohol withdrawal.
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Following herbs help in treating alcoholism:

O Milk thistle (Silybum marianum): 80 to 200 mg three times a day,
to support the liver.
O Dandelion (Taraxacum officinale): 2 to 8 g of root three times a
day in tea, or 5 ml three times a day of leaf tincture helps to
detoxify the liver. Works well with milk thistle.
O Kudzu (Pueraria lobata) reduces cravings.
O Skullcap (Scutellaria lateriflora): historic use for hysteria, tension,
and nervous disorders, especially anxiety; a cup of tea before bed
can help insomnia.
NUTRITION THERAPY
A well-balanced, nutritionally adequate diet helps to stabilize alcohol-
induced blood-sugar fluctuations and decrease cravings. Following these
tips can help reduce symptoms.
O Eliminate simple sugars
O Increase complex carbohydrates
O Consume adequate protein
O Increase essential fatty acids
O Decrease saturated fats and fried foods
O Avoid caffeine
O Avoid alcohol on an empty stomach.
O Vitamin A (25,000 IU a day)
O Vitamins B1 (50 to 100 mg a day), B2 (50 mg a day), B3 (25 mg
a day), B5 (100 mg a day), B6 (50 to 100 mg a day), B12 (100 to
1,000 mcg a day)
O Vitamin C (250 to 500 mg two times a day)
O Vitamin E (400 IU a day) to protect the heart
O Magnesium (250 mg bid) to decrease withdrawal symptoms
O Selenium (200 mcg a day) to protect the liver
O Zinc (15 mg a day) to aid metabolism
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O Amino acids: carnitine (500 mg two times a day) to protect the

liver, glutamine (1 g a day) to decrease cravings, glutathione (300
mg a day) to protect liver and heart
O Chromium (250 to 500 mcg twice a day) helps reduce sugar
cravings and reduces low blood sugar related to alcohol cravings.
PSYCHOTHERAPY
Alcohol recovery or rehabilitation programs support the affected person after

detoxification to maintain abstinence from alcohol. Counseling, psychological
support, nursing, and medical care are usually available within these programs.
Education about the disease of alcoholism and its effects is part of the therapy.
Many of the professional staff involved in rehabilitation centers are recovering
alcoholics who serve as role models. Programs can be either inpatient, with the
patient residing in the facility during the treatment, or outpatient, with the
patient attending the program while they live at home.
Support Groups
Alcoholics Anonymous is a self-help group of recovering alcoholics that
offers emotional support and an effective model of abstinence for people
recovering from alcohol dependence. There are more than 1 million
members worldwide, and local chapters are found throughout the world.
Al-Anon is a support group for spouses and others who are affected by someone
else’s alcoholism. Alateen provides support for teenage children of alcoholics.
SMART recovery uses research-based cognitive techniques to help alcoholics
recover. Life Ring recovery and SOS are two other secular programs. Women
For Sobriety is a self-help group just for women - many female alcoholics
have different concerns than men. Moderation Management is a program
for problem drinkers seeking to moderate their drinking - it recommends
abstinence for those who fail at such attempts.
Prevention
Educational programs and medical advice about alcohol abuse have been
successful in decreasing alcohol abuse and its associated problems. Alcohol
dependency requires intensive management.
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The National Institute on Alcohol Abuse and Alcoholism recommends

that women have no more than 1 drink per day and men no more than 2
drinks per day. One drink is defined as a 12-ounce bottle of beer, a 5-
ounce glass of wine, or a 1 and 1/2-ounce shot of liquor.
INSOMNIA
Insomnia is the inability to sleep during a period in which sleep should
normally occur. Sufficient and restful sleep is a human necessity.
People with insomnia tend to experience one or more of the following
sleep disturbances: (1) difficulty falling asleep at night, (2) waking too
early in the morning, or (3) waking frequently throughout the night.
Considerations
Insomnia may stem from a disruption of the body’s circadian rhythm, an
internal clock that governs the timing of hormone production, sleep, body
temperature, and other functions. While occasional restless nights are often
normal, prolonged insomnia can interfere with daytime function, and may
impair concentration, diminish memory, and increase the risk of substance
abuse, motor vehicle accidents, headaches, and depression.
Most adults do best with about 8 hours of sleep each night until age 60,
after which 6 hours may be adequate. Even though the elderly need less
sleep, almost one half of people over 60 experience some degree of insomnia.
The best measure of the amount of sleep needed is how we feel. If we
awaken feeling refreshed, we are getting enough sleep. For some people,
this may take only 6 hours. Others can need up to 9 hours to feel rested.
Using long-acting or high-dose sedatives as a “cure” for insomnia can make
the problem worse, not better, over time. Antihistamines (the main
ingredient in over-the-counter sleeping pills) can lead to similar difficulties.
Using antihistamines over time may also lead to reversible memory
impairment.
Strong, prescription sedatives do not produce a natural, restful sleep. In
addition, you can develop tolerance or dependence on these drugs. In this
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case, the same dose of the drug no longer produces sleep, which may lead
you to try a higher dose. The circular situation becomes worse. Higher
doses worsen the chance of dependence, tolerance, and side effects. Stopping
these medications can cause a rebound insomnia and withdrawal.
A life-threatening disease is rarely the cause of problems with sleep. For
many people, poor sleep habits are the cause. However, because insomnia
is a key symptom of depression, you should be evaluated for depression if
you are having sleeping difficulties.
Insomnia may cause a reduced energy level, irritability, disorientation, dark
circles under the eyes, posture changes, and fatigue. Nightmares and dreams
that interfere with sleep may also respond to counseling.
Common Causes
Insomnia is occasionally a symptom of an underlying medical or
psychological condition, but it may also be caused by stress (from work,
school, or family) or lifestyle choices, such as excessive coffee and alcohol
consumption. About 50% of insomnia cases have no identifiable cause.
Some conditions or situations that commonly lead to insomnia include:
O Substance abuse—consuming excessive amounts of caffeine, alcohol,
recreational drugs, or certain prescription medications; smoking
can cause restlessness and smoking cessation may also result in
temporary insomnia.
O Disruption of circadian rhythms—shift work, travel across time
zones, or vision loss; circadian rhythms are regulated, in part, by
release of melatonin from the brain.
O Menopause—between 30% and 40% of menopausal women
experience insomnia; this may be due to hot flashes, night sweats,
anxiety, and/or fluctuations in hormones.
O Hormonal changes during menstrual cycle—insomnia may occur
during menstruation; sleep improves mid-cycle with ovulation.
O Advanced age—biological changes associated with aging,
underlying medical conditions, and side effects from medications
all contribute to insomnia.
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O Medical conditions—gastroesophageal reflux (return of stomach

contents into the esophagus; frequently causes heartburn),
fibromyalgia or other chronic pain syndromes, heart disease,
arthritis, attention deficit hyperactivity disorder, and obstructive
sleep apnea (difficulty breathing during sleep).
O Psychiatric and neurologic conditions—anxiety, depression, manic-
depressive disorder, dementia, Parkinson’s disease, restless leg
syndrome (a sense of indescribable uneasiness, twitching, or
restlessness that occurs in the legs after going to bed), post-
traumatic stress disorder.
O Certain medications—decongestants, bronchodilators, and beta-
blockers.
O Excessive computer work and TV.
O Partners who snore.
In Infants
Most newborn babies wake several times during the night, but by the age
of 6 months they typically sleep through the night. At one year, babies
will sleep an average of about 16 hours in every 24. Two to three hours of
this sleep will be during the day.
Causes of sleeplessness in infants may include:
O Desire for parental attention
O Infantile Colic or other digestive problems
O Indigestion
O Hunger
O Teething
O Fever or other illness.
Tests for IInsomnia
nsomnia
O Sleep log record
O Psychological tests
O Thyroid tests (TSH, T3, T4)
O Sleep study (polysomnography).
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Treatment
MODERN MEDICINE
Generally, medications may be helpful for short-term insomnia, but they
are not recommended for insomnia that persists for more than 4 weeks.
These medications include:
O Over-the-counter sleeping pills such as diphenhydramine promote
sleep if insomnia occurs only occasionally.
O Antidepressants such as trazodone may be prescribed in low doses
at night to promote sleep.
O Benzodiazepines such as triazolam and lorazepam often very successful
for resolving insomnia in the short term; long-term use may have serious
side effects including daytime drowsiness, depression, sleep walking,
and addiction; must not be used with alcohol.
O Non-benzodiazepine short-acting hypnotics such as zoldipam and
zaleplon fewer side effects and less likely to cause addiction than
benzodiazepines. They are particularly effective for elderly and
depressed people.
AYURVEDA
Brahmi (Bacopa monniera) and Vacha (Acorus calamus) and, of course,
Amalaki (Emblica officinalis) are the drugs of choice for insomnia. Powders
of these drugs, individually or in combination, in doses of one teaspoonful,
are given thrice a day with water or milk.
Panchakarma therapies like massage and Dhara relieve insomnia. Two liters
of buffalo milk is boiled with two ounces of Musta (Cyperus rotundus) powder
and then converted into curd. The curd us then churned and the butter
removed. The buttermilk left mixed with an equal quantity of decoction of
amalaki is dripped between the eyebrows of the patient when he lies flat
on his back. The dripping is continued for 15 to 20 minutes in the morning
followed by a bath. The following standard preparations are also
recommended.
Other drugs like Vatakulantaka, Nidrodaya Rasa, and Ashwagandha Churana are
helpful. Cow’s ghee should be used for massaging the soles of the feet at night.
585
A common home remedy for insomnia is the banana. A teaspoonful of

fried powder of cumin seeds should be mixed with the pulp of a ripe
banana and taken last thing at night.
ACUPUNCTURE
Some reports suggest that acupuncture may have a nearly 90% success
rate for the treatment of insomnia. Through a complex series of signals to
the brain, acupuncture increases the amount of certain substances in the
brain, such as serotonin, which promote relaxation and sleep. Studies of
elderly people with sleep disturbances suggest that acupressure enhances
sleep quality and decreases awakenings during the night.
Following Acupoints are stimulated:
O Baihui (Du 20)
O Sishencong (Ex. 6), Anmian I (Ex. 8), Anmian II (Ex. 9)
O Neiguan (P. 6), Shenmen (H. 7), Shenmai (U.B. 62)
O Additional points: Shenting (Du 24.), Taixi (K. 3)
O Where sleep is disturbed by dreams, use: Xinshu (U.B. 15),
Shendao (Du 11).
HOMEOPATHY
Aconitum: For insomnia that occurs as a result of illness, fever, or vivid,
frightening dreams; commonly used for children.
Argentum nitricum: For impulsive children who are restless and agitated
before bedtime and cannot fall asleep if the room is too warm.
Arsenicum album: For insomnia that occurs after midnight due to anxiety
or fear. This remedy is most appropriate for demanding individuals who
are often restless, thirsty, and chilly.
Chamomilla: For insomnia caused by irritability or physical pains. Sleep
may be disturbed by twitching and moaning. This remedy is appropriate
for infants who have difficulty sleeping because they are teething or colicky;
older children may demand things then refuse them when they are offered.
Coffea: For insomnia due to excitable news or sudden emotions. This remedy
is most appropriate for individuals who generally have difficulty falling
586
asleep and tend to be light sleepers; often used to counteract the effects of
caffeine, including in infants exposed to caffeine by way of breastfeeding.
I gnatia: For insomnia caused by grief or recent loss. This remedy is most
appropriate for individuals who yawn frequently or sigh while awake.
Kali phosphoricum: For night terrors associated with insomnia. This
remedy is most appropriate for individuals who are easily startled and
restless, often with fidgety feet; anxiety is often caused by both nightmares
and events in the individual’s life.
Nux vvomica:
omica: For insomnia caused by anxiety, anger, irritability, or use of
caffeine, alcohol, or drugs. This remedy is most appropriate for individuals
who wake up early in the morning, for children who often have dreams of
school or fights and may be awakened by slight disturbances; nux vomica
may also be used to treat insomnia that occurs as a side effect of medications.
Passiflora: For the elderly and young children, whose minds are often
overactive.
Pulsatilla: For women and children who are particularly emotional and do
not like sleeping alone. Sleeping in a warm room tends to worsen insomnia
and the individual may cry due to the inability to fall asleep.
Rhus toxicodendron
toxicodendron: For restlessness and insomnia caused by pains that
occur, when the individual is lying down.
NATUROPATHY
Eat a balanced diet with high intake of complex carbohydrates, fruits and
vegetables. Eat light supper with high complex carbohydrate foods, steamed
vegetables together with some fat. Avoid coffee, chocolate, tea, alcohol,
cola, cigarettes, etc. Avoid all food additives and simple sugars. Following
herbs promote sleep.
O Valerian (Valeriana officinalis) acts as a mild sedative and improves
both the ability to fall asleep and the quality of sleep. A typical
dose of valerian ranges from 150 to 450 mg per day
O Kava kava (Piper methysticum) is effective for insomnia. According
to a recent study, kava kava and diazepam (one of the
benzodiazepines) induce similar changes in brain wave activity
O Passionflower (Passiflora incarnata)
587
O Lemon balm (Melissa officinalis)

O German chamomile (Matricaria recutita)
O Skullcap (Scultellaria lateriflora).
Hydrotherapy
O Hot footbath for 15 minutes before going to bed
O Warm shower or immersion bath in the evening.
YOGA THERAPY
Yoga reduces insomnia by relaxing the sympathetic nervous system and
mind. Pranayamas such as Nadi shuddhi, Ujjayi, Sheetkari, Sheetali, and
Bhramari and Meditation, Yoga nidra help to get optimum sleep.
NUTRITION THERAPY
Carbohydrate snack of cereal or crackers with milk before bed may help because
foods rich in carbohydrates and low in protein and fat may boost the production
of serotonin and melatonin, brain chemicals thought to promote sleep.
The following dietary supplements may also be helpful in promoting sleep:
L-tryptophan and 5-hydroxytryptophan (5-HTP): L-tryptophan is
thought to bring on sleep by raising levels of serotonin, a body chemical
that promotes relaxation. Studies also suggest that 5-hydroxytryptophan,
made from tryptophan in the body or available in supplement form, may
be useful in treating insomnia associated with depression.
Melatonin: Melatonin supplements appear to be most useful for inducing
sleep in certain people, particularly those with disrupted circadian rhythms
(such as from jet lag or shift work) or those with low levels of melatonin
(such as some people with schizophrenia). Generally, when melatonin is
used, 1 to 3 mg of the supplement is recommended for sleep, but as little
as 0.3 mg has been used successfully.
PSYCHOTHERAPY
A variety of behavioral techniques have proved helpful in treating insomnia.
These methods, with the guidance of a sleep specialist or a sleep specialty
team, are singly used to treat insomnia, but they may also be combined
with other methods of treatment. These methods include:
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Sleep Diary
Diary: Keeping a daily/nightly record of sleep habits (including the
amount of sleep, how long it takes to fall asleep, the quality of sleep, the number
of awakenings throughout the night, any disruption of daytime behaviors,
attempted treatments and how well they worked, mood, and stress level) can
help a person understand and, consequently overcome his or her insomnia.
Stimulus Contr ol Techniques: This technique involves learning to use the
Control
bedroom only for sleeping and sexuality. Individuals using this technique
learn to go to bed only when tired and leave the bedroom when not asleep.
They must also wake up at the same time every day, including weekends
and vacations, regardless of the amount of sleep they had.
Sleep R estriction: This method involves improving sleep “efficiency” by
Restriction:
attempting to spend at least 85% of time in bed asleep. The time spent in
bed is decreased each week by 15 to 20 minutes until the 85% goal is
achieved. Once accomplished, amount of time in bed is increased again on
a weekly basis.
Relaxation Training Techniques: Progressive relaxation, meditation, yoga,
guided imagery, hypnosis, or biofeedback can break the vicious cycle of
sleeplessness by decreasing feelings of anxiety about not being asleep. Studies
indicate that these therapies significantly reduce the amount of time it
takes to fall asleep, increase total sleep time, and decrease the number of
nightly awakenings.
Cognitiv e-B
Cognitive-B ehavioral Therapy: This therapy is intended to re-establish
e-Behavioral
healthy sleep patterns by helping an individual cope with his or her sleep
problem. One cognitive-behavioral approach, called paradoxical intention,
helps to retrain an individual’s fears of sleep by doing the opposite of what
is causing the anxiety. For example, a person with insomnia worries long
before going to bed about not being able to sleep and the difficulty he or
she will have at bedtime. Rather than preparing to go to sleep, therefore,
the person in reality is preparing to stay awake.
PHYSICAL THERAPY
Regular daily aerobic exercises like walking, jogging, swimming and running
and strength training exercises are necessary in treating insomnia. Walking
for at least 45 minutes in the evening helps to have a good sleep at night.
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Massage has long been known to enhance relaxation and improve sleep
patterns. While massage alone is an effective method for relaxation, studies
suggest that massage with essential oils, particularly lavender (Lavandula
angustifolia), may result in improved sleep quality, more stable mood,
increased mental capacity, and reduced anxiety. In one recent study,
participants who received massage with lavender felt less anxious and more
positive than participants who received massage alone.
Lifestyle
Studies reveal that healthy sleep habits are essential for treating insomnia.
The following healthy sleep habits (in addition to the steps mentioned in
the Preventive Care section) may help treat the condition:
O Avoid using alcohol in the evening. Avoid caffeine for at least 8
hours before bedtime. Give up smoking, because nicotine is a
stimulant.
O Establish a regular bedtime, but don’t go to bed if you feel wide
awake. Use the bedroom for bedroom activities only. Once in bed,
use creative imagery and relaxation techniques to keep your mind
off unrestful thoughts. Avoid staying in bed for long periods of
time while awake, or going to bed because of boredom.
O Take your TV or computer out of your bedroom. Otherwise, your
brain becomes used to the stimulation and starts to expect it when
you are there. This makes it harder for you to fall asleep.
O Relax by reading, taking a bath, or listening to soothing music
before getting to bed.
O A snack before bedtime helps many people. Foods such as warm
milk or turkey have a natural sleep inducer called L-tryptophan.
O Exercise regularly, but not in the last two hours before going to
bed. Exercise, especially aerobic exercise, has been show to make
people fall asleep faster and benefit from deeper and more restful
sleep.
O Sex can be a natural sleep inducer and helps some people.
O Avoid emotional upset or stressful situations prior to bedtime.
O Avoiding naps, especially in the evening.
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O Keeping the bedroom cool, well-ventilated, quiet, and dark.

O Avoiding looking at the clock; this promotes anxiety and obsession
about time.
In Infants and Children
O Avoid being readily available to a child during the night. Otherwise,

the child may become dependent on attention and become sleepless
if deprived of it.
O For children who have trouble falling asleep, try to make sure that
the child is not disturbed by unnecessary noise. Leaving a radio
playing soft music may help cover up disturbing noises.
O Avoid sending a child to bed as punishment which can result in
poor sleep caused by fear.
O Never give a child sleeping medicine without consulting the doctor
first. Generally, it is unwise to treat the problem with drugs.
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15
THE RULES OF GOOD HEALTH
HEALTH
THE RULES OF GOOD HEAL

RULES TH
HEALTH
Over the centuries the cause of death has changed. In early civilizations
the major cause of death was violence due to natural calamities and war.
With the dawn of civilization man began to live in communities and due
to poor sanitation and living conditions, the major killer became infectious
disease such as cholera, plague etc. With the advent of antibiotics, we have
reached a situation where most communicable diseases are eradicated. With
the dawn of the 19th century, a new spectrum of death became epidemic
and the major killer was not natural calamities, war and infection. The
major killer was modern lifestyle due to high levels of stress, low levels of
activities, high levels of obesity etc. manifesting itself in diseases such as
heart attacks, cancer, high blood pressure, diabetes etc.
With the scenario being what it is, what are the solutions? To my mind the
solutions for each individual as well as the general population is to follow
certain rules of Lifestyle, which will lead to abundant health and which if
not followed will result in disease. These rules are:
1. Annual health check: It is important for all of us including children
to have a medical check up at leaser once a year. The reason is that the
human body is capable of 100% efficiency even with 99% debility
and most of the modern ailments such as blood pressure, diabetes,
cholesterol etc. are all silent and have no symptoms. A medical checkup
helps the individual to identify his current health status and lifestyle
ailments if detected early can be controlled but if left untreated can
result in heart attacks and other killers.
2. Eat the right food: the second rule of good health is to eat the right
food in the right quantities. We all know that too much of sugar is
associated with diabetes, too much of salt is associated with high blood
pressure, too much of fat is associated with heart attacks, eating
commercial foods is associated with cancer. We also know that the
high fiber diet comprising vegetables and fruits is protective against
all these ailments. Accordingly we should eat a balanced diet
comprising of white meat, lentils and grains, fruits and vegetables
and dairy products such as skimmed milk etc. and should avoid excess
sugar, salts and commercial foods. It is also important to eat less rather
594
The Rules of Good Health
than more and the best way to do is to eat a large breakfast a moderate
lunch and dinner should be very light.
3. Moderate and regular exercise: Excess food intake results in obesity
which in turn causes blood pressure, diabetes, arthritis and other
ailments and even while it is important to eat less it is equally important
that one should do exercises every day in order to keep the body healthy
and fit. A fit and healthy body ensures that we do not get any ailments
like cardiac ailments etc. The daily exercise program may be for about
an hour and should comprise according to age and capacity, walking
or jogging to strengthen the heart and lungs, free hand exercises for
the muscles and joints (for those who know yoga, free hand exercises
may be substituted with yoga). The younger age group must most
certainly go in for weight training and gym exercises.
4. Rest and relaxation: If physical activities are important for good health,
then mental relaxation is as important. Mental tension and stress causes
a whole range of psychosomatic ailments including headaches,
insomnia, asthma, ulcers, blood pressure, sexual dysfunction etc. Stress
is caused due to problems relating to work, home, daily routine crisis
and even personality. While stress can be managed by daily exercises,
the more acknowledge method of stress management is meditation.
In case you do not know how to meditate then simple relaxations
techniques such as listening to music etc. will also reduce stress. In
addition, sleep is perhaps the most important means of relaxation.
5. Avoid smoking, alcohol and paan: The major cause of cancer is smoking.
Other causes include an inappropriate diet, excessive alcohol intake,
environmental pollution and occupational hazards including dust,
radiation, chemicals etc. Certainly these must be avoided, but giant
steps can be taken to reduce cancer by simply managing alcohol to
not more than one drink a day and quitting smoking completely.
6. Safety: While the older age groups usually succumb to heart attacks
and cancer, younger age groups, below 30 years will probably succumb
to automobile accidents, which is the major killer for this group. Safety
compliance such as wearing helmet, using a seat belt, keeping within
the speed limits, not utilizing alcohol before driving will go a long
595
way in reducing automobile accidents. If automobile safety is important

than sexual safety is perhaps more important, and lack of sexual safety
has resulted in spectrum of AIDS, which promises to be the biggest
killer of the century. In order to contain this menace it is important
that we adhere to monogamous sexual relationship and the use of
condoms in those situations where we fail. Keep in mind that more
than 50% of commercial sex workers are HIV positive.
Conclusion: The simple rules of good health are to have a medical check
up, to eat the right foods, to do some exercise, to manage stress, to quit
smoking and adhere to the rules of safety. Let us consider each of these
separately.
RULE NO. 1 A QUICK HEALTH CHECK

HEALTH
Anywhere in the world when people meet, after wishing each other the
time of day, the most frequently asked question is, how are you? The reply
almost always is- I am fine, thank you. Do you ever wonder how close you
are to the truth? How fine are you in fact? In order to give you an indication
of your wellness, health specialists have put together a simple test, but
before you do the test, a few explanations.
Tests 1 and 2 relate to your medical status.
1. Genetics: Our health is not determined by us alone. Very often health
and illness are genetically determined through parentage or example
ailments such as Heart Attack, Cancer, High Blood Pressure, Diabetes
etc. run in families. Meaning that if any family member (grandparents,
parents, siblings) has these ailments, you are at some risk of this
ailment. For the purpose of this test, you fail the first test. Others
without a family history of these ailments pass.
2. C urr ent medical situation: For example if you are currently
urrent
hospitalized, or are currently under medication, or if you are currently
under some medical treatment you fail this test.
Tests 3 to 9 evaluate your physical fitness.
3. Height / Weight ratio: People who are over weight tend to have more
medical ailments than those who are not; High Blood Pressure,
596
Diabetes, Heart Attacks, Cancer, Depression, are all ailments associated

with obesity. A simple test to identify whether you are overweight is
to convert your height into Cms. (for eg. If height is 183cms) from
this minus 100 and in case your weight in Kgs is excess of the balance,
you are considered over weight.
Height Weight Char
Chartt of IIndian
ndian Adults
Adults
Height Male Female
Cms. Inches Min. Kgs Max.Kgs Min. Kgs Max.Kgs
152 5’-0" 55 65 45 55
155 5’-1" 56 66 46 56
157 5’-2" 57 67 47 57
160 5’-3" 58 68 48 58
162 5’-4" 59 69 49 59
165 5’-5" 60 70 50 60
167 5’-6" 61 71 51 61
170 5’-7" 62 72 52 62
172 5’-8" 63 73 53 63
175 5’-9" 65 74 54 64
177 5’-10" 65 75 55 65
180 5’-11" 66 76 56 66
182 6’-0" 67 77 57 67
European adults are allowed 5 kgs additional due to larger structures.
1. Muscle fat ratio: Being overweight is bad but being over fat is worse.
Slim people may be underweight but over fat. Fat located in the
abdominal area is especially bad as it predispose you to a higher risk of
Cardiac disease. To do this test use a tape and measure your chest and
stomach. If your stomach is bigger than your chest your fail. For ladies
measure stomach and hip. If the stomach exceeds the hip, you fail.
Better, if a fat caliper is available, use it to measure the roll of fat at
your abdomen. Men within 18 mm and women within 25 mm pass
this test.
2. P ulse rate: This test helps you determine whether you have a fit healthy
heart. Take your pulse for one minute. If it exceeds 72 beats per minute
597
you fail. A heart rate of less than 72 beats per minute indicates a fit, strong
healthy heart and you pass. Of course there are certain medications that
slow down heart rate. So, if you are on medication, you fail this test.
3. Lung Capacity: To pass this test, you must be in a position to hold
your breath for 60 seconds. If you are unable to succeed, it is indicative
that you have insufficient lung capacity.
4. Muscular str ength: Can you do single sit up? To do this test lie on the
strength:
ground on your back, hand behind your head. Your feet must not be
held or hooked onto anything Constrict your abdominal muscles and
raise your body 90 degrees towards your feet. Your hands must remain
behind your head, and your legs must not rise from the ground. If
you can, you pass this test, and it is indicative of overall strength.
5. Spinal F lexibility: Standing with your feet together, without bending
Flexibility:
your knees, can you touch your toes? If you can’t, you fail, and it is
indicative of joint ailments arthritis, spondylosis, etc. in later years.
6. Balance and Coordination: While standing, close your eyes. Lift one
leg 12’’ off the ground and balance yourself, such that the foot on the
ground does not move. (Get a friend to time you) If you can balance
your self for 30 seconds, it means that you are well coordinated and
you pass the test. Remember to close your eyes.
Tests 10 to 15… relate to your Nutrition and diet.
7. Dietary fibre: Is vitally relevant in our daily diet, since it cleans the
digestive tract, removing impurities, toxins etc from the system. Do
you eat sufficient fibre in the form of a daily intake of green vegetable
salad and one or two fruits? If so you pass this test. Remember fibre,
reduces your risk of digestive cancers.
8. Dietar
ietaryy fats: We all know that too much of dietary fat, clogs the arteries
and causes heart attacks. Where does this come from? It comes form
meats like mutton, beef, pork, whole cream milk, butter, cheese, ghee,
vegetables oils including dalda and margarine etc. If you eat any of
these foods frequently. (i.e. more than twice a week. You fail this test.
598
9. Sugar: As we all know is associated with diabetes a daily intake of

more than the equivalent of 4 teaspoons of sugar will make you fail
this test. Those of us who eat puddings, pastries, mithai, chocolates
and ice creams etc. daily certainly fail this test.
10. Salt: In excess, increases hypertension. Do you add salt to your food?
Do you eat salted foods such as wafers, salted nuts, etc. daily? If so
you fail this test.
11. Fluid: In order to keep the body’s homeostasis and electrolyte balance,
you must drink not less than 6 glasses of water each day. Beer, soft
drink, tea and coffee are not substitutes as they increase toxin levels. If
you do not drink six glasses of water daily. You fail this test.
12. Additives: Commercial foods, as contained in the super market (sauces,
jams, pickles, soft drinks, frozen foods) and foods eaten in restaurants
and fast food centers (Burgers, pizzas, milk shakes etc) contain high
levels of chemicals, preservatives, coloring etc. These increase your
risk of cancer. Incase you consume these frequently, or eat out more
than twice a week, you fail this test.
Tests 16-21 evaluates your stress levels
13. Symptoms: Stress manifests itself in what is termed as psychomatic
ailments. These ailments include headaches, sleeping problems,
asthma, digestive problems, high blood pressure, diabetes, allergies,
skin rashes, joint and body pain, sexual dysfunction etc. Do any of
these problems occur to you more than once a week? If so, you fail
this test.
14. Personality: People who are ambitious, competitive, result oriented,
time pressured etc., are usually achievers. They strive for success and
are known as type A personalities. If you have these personality traits,
you fail this test. Persons who are type A personalities, usually have
heart attacks pre retirement.
15. Occupation: Are you happy in your job. If so, you pass this test.
Factors such as inadequate salary, long working hours, boring and
repetitive work, all add up to occupation stress.
599
16. Home related Stress: Are the problem at home in surmountable. (In-
law problem, children problems, spouse problems etc.) If so, you fail
this test.
17. Daily routine: Not less that 8 hours sleep, not more than 8 hours
work and at least one hour for daily exercise. If you do not conform to
these timings, you fail this test.
18. Crisis: Any problem that has no immediate solution is a crisis. Legal
problems, financial problems, Emotional problems, Health Problems
are all crises, if they have no immediate solution. If so, you fail this
test.
Test Nos. 22 to 25 relate to dependencies and safety.
19. Alcohol: A safe limit to alcohol is one small peg. You fail this test if
you exceed this ever; even if you drink only on occasion. Remember,
alcohol affects the personality in such a way as to cause accidents.
Also, in case you drink daily, you all fail this test.
20. Smoking: If you smoke you fail this test, not only you, but if you
smoke at home, your spouse and other family members also fail the
test. Remember, passive smoking is also relevant to cancer.
21. Paan: All paans, supari, paan parag etc. cause oral disease and even
cancer. If you eat paan more than once or twice a week, you fail this
test.
22. Automobile safety: If you drive a car, do you religiously wear a safety
belt? If you use a two wheeler do you use a helmet? If you don’t, you
fail this test. Also if you use public transport and spend more than
one hour in commuting daily, you fail, since risk of accident has been
found to increase with usage.
600
How Ar
Aree You?
(An on the spot Health Check Up)
Genetic/Medical/Physiological /Nutritional /Stress/Dependency/Safety Assessment
Sl. No. Test (Pass) R
(Pass) esult (F
Result ail)
(Fail)
1. Genetics & Hereditary ———————
2. Medical ———————
3. Height/Weight ratio ———————
4. Muscle/Fat ratio ———————
5. Pulse rate ———————
6. Lung capacity ———————
7. Muscular Strength ———————
8. Spinal Flexibility ———————
9. Coordination ———————
10. Dietary Fibre ———————
11. Dietary Fat ———————
12. Sugar ———————
13. Salt ———————
14. Fluid & Water ———————
15. Additives & Chemicals ———————
16. Symptoms ———————
17. Personality ———————
18. Occupation ———————
19. Home ———————
20. Daily Routine ———————
21. Crisis ———————
22. Alcohol ———————
23. Smoking ———————
24. Paan ———————
25. Automobile safety ———————
Total Tests Passed
Passed ———————
Scoring Key
how
To find out ho w yyou aree – use this key. Add up all the tests passed.
ou ar
If 20 or more tests passed - you are very well
well. 15 to 19 tests you are well
well.
14 or less tests passed - you are not w ell
well
ell. So now, when you are greeted
with a How ar aree yyou?
ou? You know what to say.
601
RULE NO. 2 EAT THE RIGHT FOOD

EAT
The first rule of good health is to have an Annual Medical Checkup since
many ailments such as High blood pressure, Diabetes, Cardiac problems
and Cancers etc. are silent and only discernable by a doctor utilizing medical
diagnostics and equipments. If the first rule of good health is to have a
medical check up then most certainly the second rule is to have a Balanced
Diet since food is connected to several ailments. For e.g., excessive salt is
correlated with Hypertension, Excessive Sugar is contra indicated in
diabetics. Sufficient fiber (vegetables and fruits) are essential to combat
Cancer and excessive fat and oily foods are contra indicatory in cardiac
problems.
Eating a balanced diet, in moderation, therefore is vital to good health.
To ensure a balanced diet keep the following in mind.
1. Grain and Cereal eaten daily should form 40% of diet and be preferably
unmilled. Unmilled grain in addition to other nutrient properties also
contains fiber and roughage. This is the indigestible portion of plants
that cleanses the internal digestive tract of toxins and bacteria which is
so necessary in preventing cancers of digestive tract. Accordingly, since
white bread is made from milled flour it is not as beneficial as products
made from unmilled wheat such as brown bread etc. Other beneficial
products from wheat include chapattis etc.
2. Vegetables and fr uits taken daily, eaten in their cooked and uncooked
fruits
form should form 35% of diet. The reason for this once again is fiber
but in addition to fiber, uncooked vegetables and fruits also contain
minerals and vitamins that are essential for the over all well being of
the body. These minerals and vitamins are the pharmacy of the human
body. Therefore fruits eaten whole are certainly better then fruit juice
since the fruit juice contains very little fiber and far too much of sugar
which is correlated with diabetes. In addition to fruit, an uncooked
fresh salad should be eaten daily along with cooked vegetables.
3. Dairy products such as milk should be skimmed. Eggs should be
avoided by adults, and for children not to exceed 3 to 4 per week.
Milk is certainly an important food because it is the richest source of
calcium which is so important for strong bones. However milk cream
602
contains a large amount of fat laden cholesterol which results in blockage

of arteries and precipitation of heart attacks. Certainly cream should
be removed from the milk. Whole milk and cream based products
such as butter, cheese etc. should be avoided. Eggs are certainly
important in growing children but since the yolk of the egg contains
large amounts of cholesterol, it is inappropriate for adults. However,
since children are abundantly energetic they will most certainly utilize
this cholesterol in physical activity and may therefore take the benefit
of 3 or 4 eggs a week.
4. Oil - Unsaturated vegetable oils not to exceed 35 gm per day i.e., (2
table spoons per person), ghee, butter, margarine etc., to be avoided.
The difference between an unsaturated oil and a saturated oil is that
the saturated oils lodge themselves in the arteries causing blockages
where as the unsaturated oils clear such blockages. Unsaturated oils
include oils that are liquid at room temperature such as sunflower oil,
suffola, peanut oil, mustard oil etc. Saturated oils include ghee, dalda,
coconut oil etc. and should be avoided.
5. Meat - red meats (mutton, beef, pork) to be avoided in preference to
fish and poultry. Vegetarianism is the best for good health. However,
vegetarians will need to balance the lack of proteins caused by not
eating meat and therefore will need to supplement this with vegetable
proteins as contained in beans, dal, gram, pulses etc. As a matter of
fact 1 or 2 katories of dal either masoor, rahar, urad, etc. eaten daily is
sufficient to meet the bodies protein requirements.
6. Sugar & SSalt
alt - usage in absolute moderation. Avoid commercial foods,
cakes, ice creams, salty snacks, canned foods etc. The reason for this is
that commercial foods contains high levels of chemicals, coloring,
preservatives, sugars, sodium etc. and 30% of cancers world wide are
caused by these dietary factors. In addition, as mentioned earlier,
sugar is contra indicated in diabetes and salt is contra indicated in
hypertension. My best advice is not to eat out at commercial places
more than twice a week and most certainly as a general rule to avoid
eating commercial foods at home.
7. Fluid - 6 to 8 glasses per day, preferably water, avoid soft drinks, tea,
coffee, alcohol, etc. Water is essential for flushing out various toxins
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and impurities from the body and the reason why soft drinks, tea,
coffee, alcohol etc. are not a replacement for fluid is because they
themselves contain various toxins and chemicals such as tannin, caffeine,
saccharine etc. The maximum intake of tea or coffee should not exceed
4 cups a day and as far as alcohol is concerned nothing more than 1
peg or a glass of beer or wine on occasion.
A moderate food intake for adults is between 1000-1750 calories per day;
specific requirements are related to body weight and the maximum calorie
intake should not exceed current body weight in kgs x 24 with a minimum
@ 1000 calories (for eg. a person weighing 70 kgs will require 70 x 24 =
1680 calories per day). Incase you wish to lose weight then you need to
eat 500 cal less subject to the minimum 1000 calories and incase you wish
to gain weight you need to eat 500 calories more along with a daily exercise
routine.
Growing children should be discouraged from dieting, for them the rule is
sufficient food with sufficient exercise.
Plan your own nutrition prescription

Weight
Your weight should confirm to your height as per the height/weight chart.
If necessary you should reduce by a combination of exercises and diet.
Calories
O Calorie sheet follows for day to day foods
O Your maximum calorie intake should not exceed you current weight
in kgs x 24
O If you want to lose weight, do an hour’s exercise daily and reduce
your calorie intake to between 1000 – 1500 calorie daily. Exercise/
calorie chart follows
O Do not reduce your calorie intake by more than 500 calories daily
from your maximum intake in case you are to lose weight, therefore
maximum intake e.g., (weight = 80 kgs, therefore maximum calorie
intake = 80 x 24 = 1920; therefore prescribed reduction = 1920 –
500 1420 calories
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O Do not get below 1000 calories ever

O When you achieve you correct weight your consumption of calories
should be correct weight x 24 and you must continue your daily
exercise.
Diet
O Sample diet plan of 1500 calorie follows.
Foods to avoid
avoid
Sugar: Puddings, cakes, sugar in beverages, ice creams, milk shakes,
‘mithai’ etc.
Fats: Butter, margarine, ghee, dalda, fat, meats (mutton, beef, pork),
eggs, cream (i.e. saturated fats).
Drinks: Alcohol, aerated drinks.
Additives: Salt, sauces, pickles, excess (more than 4 cups) tea / coffee,
commercially prepared foods.
Recommended foods / ratio
Grain & Cereal - 40% of daily diet (preferably unmilled)

Vegetables & Fruits - 35% of daily diet (cooked & uncooked)
Diary Products/oil - 10% of daily diet (skim milk products & unsaturated
vegetable oils
Meat/Pulses/Beans - 10% of daily diet (lean meat, fish, assorted pulses,
beans)
Oil (for cooking) - 30 ml / day (i.e. 2 tablespoons) of unsaturated vegetable oils.
Other Foods - mineral/vitamins if prescribed
Water - 6/8 glasses daily (besides other fluids)
For specific dietary requirements for gas, acidity, constipation, HBP,
diabetes, anemia, gout, etc. refer to the nutrition component in the relevant
ailment.
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Calories Sheet
Item Quantity Caloric Item Quantity Caloric
Value Value
(approx) (approx)
Breakfast
Beverages
Egg, boiled 1 80
Tea, black, with no sugar 1 cup 10
Egg, poached 1 80
Coffee, black, with no sugar 1 cup 10
Egg, fried 1 110
Tea with milk & sugar 1 cup 45
Egg, omelet 1 120
Coffee with milk & sugar 1 cup 45
Bread slice 1 45
Milk without sugar 1 cup 60
Bread slice with
Milk with sugar 1 cup 75
butter 1 90
Milk with sugar & Horlicks1 cup 120
Chappati 1 60
Fruit juice, concentrated 1 cup 120
Puri 1 75
Soft drinks (Thums Up etc) 1 bottle 90
Paratha 1 150
Beer 1 bottle 200
Subji 1 cup 50
Soda 1 bottle 10
Idli 1 100
Alcohol, neat 1 peg,small 75
Dosa, plain 1 120
Dosa, masala 1 250
Miscellaneous
Sambar 1 cup 150
Porridge 1 cup 150
Lunch / Dinner Jam 1 tsp. 30
Cooked rice, plain 1 cup 120 Butter 1 tsp. 50
Cooked rice, fried 1 cup 150 Ghee 1 tsp. 50
Chappati 1 60 1 tsp.
Sugar 30
Puri 1 75
Biscuit 1 30
Paratha 1 150
Fried nuts 1 cup 300
Naan 1 150
Puddings 1 cup 200
Dal 1 cup 150
Ice-cream 1 cup 200
Sambar 1 cup 150
Milk shake 1 glass 200
Curd 1 cup 100
1 cup 150 Wafers 1 pkt. 120
Curry, vegetable
1 cup 175 Samosa 1 100
Curry, meat
Salad 1 cup 100 Bhel puri/pani puri 1 helping 150
Papad 1 45 Kebab 1 plate 150
Cutlet 1 75 Indian sweet (mithai) 1 pc. 150
Pickle 1 tsp. 30 Pickle 1 tsp. 30
Soup, clear 1 cup 75 Soup, clear 1 cup 75
Soup, heavy 1 cup 150 Soup, heavy 1 cup 150
Fruit 1 helping 75 Fruit 1 helping 75
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Sample Diet (Indian)

Meal Item Total Calories
Bed Tea 1 cup tea with no sugar 20

Breakfast 2 Chappatis
1 katori Curry, OR
1 Masala dosa / 2 idlis 275
Lunch 1 cup Cooked rice, OR 3 Chappatis
1 cup Dal / Sambar
1 cup Curry
1 cup Salad / Curd
1 Fruit 600
Evening Tea 1 cup Tea with milk, no sugar 20
Dinner 1 cup Cooked rice, OR 3 Chappatis
1 cup Dal or Sambar
1 cup Curry
1 cup Salad / Curd 500
Nightcap 1 cup Milk 75
Health Foods
Foods
Eat one / some food(s) from each of these groups daily
a) Fruits — Apple, Banana, Papaya, Mango,
Guava, Pear, Bel, Amla, Grape,
Orange, Watermelon
b) Vegetables — Potato, Onion, Ginger, Garlic,
Beetroot, Tomato, Lime, Radish,
Turnip, Cabbage, Cauliflower,
Lettuce, Cucumber, Carrot,
Asparagus, Spinach, Saag, Coconut,
Karela
c) Grains & Pulses — Beans, Peas, Gram, Dal, Wheat,
Brown Rice, Peanuts, Nuts
d) Dairy Products — Skimmed Milk, Curd
e) Miscellaneous — Honey, Dry Fruit, Vegetable Oils
f) Fluids — Water, Fruit Juices, Vegetable Juices,
Lassi
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RULE NO. 3 MODERATE AND REGUL

MODERATE AR EXER
REGULAR CISE
EXERCISE
One of the most important rules of good health is Exercise activity and we
will help you chart out a basic exercise program.
Moderate exercise done regularly for half an hour 3-5 days a week is one of
the best methods for achieving good health. Any exercise program should
be started gradually in consultation with a doctor and fitness specialist
such that the entire body including heart, respiratory system, muscles,
joints, etc. is totally benefited. Exercises may be done at any convenient
time, one or two hours after a meal and should include components for
stamina, strength, mobility and flexibility as follows:
Stamina includes walking, jogging, cycling, swimming, active games

etc. This aspect of exercise activity is important for strengthening the heart
and lungs. Heart rate during exercise should be approx. 220 (-) double
your age, subject to minimum of 110 beats per minute (e.g. for a 40 years
old - 220 - 80 = 140 bpm). Never exercise to breathlessness and do 10
repetitions of deep breathing at the end of each such session for the lungs.
The benefit of this aspect of exercise is for strengthening the heart, prevention
of Heart Attacks, reducing Blood Pressure, Diabetes etc.
Strength can be achieved by doing between 10-20 repetitions of the

following exercises. Strength exercises are important not only for increasing
the strength of the muscles but also important for giving the body its
appropriate shape and are helpful in reducing back pain etc. Younger age
groups below 50 years and those individuals’ male and female who are
gym exercisers may add gym exercises to their program 3 days a week.
Flexibility and M obility: These exercises can be achieved by doing 10

Mobility:
repetitions of the following exercises. These exercises are extremely
important in keeping the joints completely functional and are vitally
relevant in preventing Arthritis, Spondylosis and other joint ailments.
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Make your own exercise prescription

Stamina: Heart / Circulatory / Respiratory systems
Jogging/Swimming/Cycling/Games
a. 30 - 45 minutes 3 days a week for fitness
b. Daily, for weight/fat reduction
c. Do not undertake Jogging/Cycling/Games etc. with specific
clearance
d. Deep Breathing - 10 repetitions daily.
Strength: (muscular system)

Exercises as per exercise sheet overleaf and details below.
3 days a week
Exercises Below 40 years 40/50 years Above 50 years

Pushups - 10 repetitions x 3 sets 10 x 2 10 modified sit ups.
Situps - 10 repetitions x 3 sets 10 x 2 10 modified sit ups.
Back lift - 10 repetitions x 3 sets 10 x 2 10 x 1
Squat - 10 repetitions x 3 sets 10 x 2 10 x 1
Calf raise - 10 repetitions x 3 sets 10 x 2 10 x 1
Please note- each exercise in the sequence mentioned above is to be done

10 times and then the next exercise is to be done and so on. After all 5
exercises have been done, repeat the exercises as required.
Mobility: ((JJoints) Exercise as per exercise diagrams and details below. To

be performed 3 days a week or daily as preferred.
O Neck rotation - 10 repetitions(both ways)

O Shoulder rotation - 10 repetitions(both ways)
O Elbow bends - 10 repetitions(both ways)
O Wrist rotation - 10 repetitions(both ways)
O Waist rotation - 10 repetitions(both ways)
O Toe touch - 10 repetitions
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O Hip mobility - 10 repetitions (each leg)

O Thigh stretch - 10 repetitions (each leg)
O Calf stretch - 10 repetitions (each leg)
O Ankle rotation - 10 repetitions (both ways each leg)
STAMINA EXERCISES
Walking: Excellent cardiovascular benefits for the advanced age groups.

Should be done briskly with swinging of the arms. Wear comfortable shoes.
May be done mornings or evenings for between 30-60 minutes.
Jogging: Suitable for younger age groups below fifty. Thirty minutes is all
that is required, and it may be done continuously; or jog, and walk in
between when fatigued. The pace of jogging is equal to that of a brisk
walk. Preferably use thick solid comfortable shoes and run on soft or grassy
surfaces. Wear comfortable clothes and breathe freely.
S wimming: For those who know how to swim, twenty minutes of

continuous swimming is sufficient. Alternatively, swim the length of a
pool (i.e., 10-20 mtrs.), rest at the end for 30 seconds, swim back. Ten
such lengths is good. Use any stroke you know; they are all of almost equal
cardiovascular and muscular benefit.
Cycling: For any age group. Minimum time 45-60 minutes of continuous
controlled fast cycling. Cycling up slopes gives added benefits. Ordinary
cycles are good enough; indoor stationary exercycles may also be used at
low resistance for 45 minutes.
Games: For the fitter, younger age group. Get fit first before playing games
such as squash, badminton, tennis, handball, basketball, football, etc. Warm
up before the game. 30-45 minutes of the game is sufficient. Weekend or
once-a-week games is to be avoided unless other fitness programs are done
on other days. Play within your capacity.
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STRENGTH & CALLISTHENIC EXERCISES

EXERCISES
MODIFIED SIT-UP
MODIFIED PUSH-UP
PUSH-UPS FOR SHOULDERS SITUPS FOR ABDOMINAL

CHEST, ARMS MUSCLES
BACK LIFT FOR

STRENGTHENING BACK
CALF RAISES
SQUATS FOR THIGHS
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FLEXIBILIT
FLEXIBILITYY & MOBILIT
MOBILITYY EXERCISES
EXERCISES
NECK ROTATION
SHOULDER
WRIST ROTATION
ELBOW BENDS
WAIST ROTATION TOE TOUCH
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FLEXIBILIT
FLEXIBILITYY & MOBILIT
MOBILITYY EXERCISES
EXERCISES
HIP MOBILITY
FRONT THIGH STRETCH
CALF STRETCH
ANKLE ROTATION
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CALORIES UTILIZED IN EXER

CALORIES CISE
EXERCISE
Activity Calories used per hour approx
Sleeping 75
Sitting 100
Office work 150
Walking 250
Free hand Exercises/Yogasanas 300
Gardening 300
Housework 300
Manual Labour 350
Gym Exercises 400
Cycling 450
Tennis 450
Badminton 450
Squash 450
Swimming 550
Running 550
Gym E
Exxer cise/W
ercise/W eight Training
cise/Weight
The points to keep in mind in weight training are as follows:
1. Weight training should not be done every day. The ideal schedule is
on alternate days with a complete rest on weekends.
2. Even while there are several systems of weight training which advocate
the exercising of different muscle groups on different days, the best
system for non-competitive sportsmen is to exercise the entire body in
each session.
The muscle groups are:
a. Shoulders
b. Arms
c. Chest
d. Back
e. Abdomen
f. Legs
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3. Weight training is basically for strengthening and building up the

muscles. In order to convert this into an all-round program, it would
be advisable to do some stretching exercises and cardio-vascular exercises
such as running.
4. Suppleness and stamina can also be built up through weight training by
following a body builder-type schedule. The weights are also used to stretch
the muscles, and muscle, muscular endurance and cardio-vascular stamina
are built up by repeating each exercise using lighter weights.
5. The normal repetitions of any exercise for the upper body, i.e. shoulders,
arms, chest and back are 8 times. And for the lower body, i.e. legs
including the abdomen are 15 times.
6. In order to get the best benefit out of the 8 or 15 repetitions, as the
case may be, the last one or two repetitions should be somewhat
strenous and difficult. In case it is done too easily, it means the weight
used is too little. And in case it is not possible to complete the
repetitions, it means the weight carried is too heavy.
7. We prescribe three sets of exercises for each muscle group. However, there
are several systems of weight training which we will mention briefly which
prescribe different repetitions as well as different sets.
8. A repetition is one complete exercise movement from the starting point
of the exercise up to the finish and then back again to the starting
point. A set is a group of repetitions of the same exercise. Therefore,
for the upper body 8 repetitions of any one exercise form one set. And
15 repetitions of one exercise for the lower body forms one set.
9. Some systems of weight training are :
a. Conv entional: This is the system of weight training as mentioned
Conventional:
above. In this system each muscle group such as shoulders, arms
chest, etc. are exercised separately by completing all the exercise
and sets of that muscle part consecutively with rest periods in
between each set. After completing that muscle group, we proceed
to the next muscle group.
b. Super-sets system: In this system, two to three muscle groups are
exercised together, e.g. one could exercise the shoulders, arms and
chest at a time by doing one set of shoulder exercises then immediately
proceeding to one set for arms and one set for the chest. And since
normally three sets of each exercise are done, this cycle is rotated
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three times before moving to the next combination of muscles. The

advantage in this system, over the conventional system is that no time
is wasted between exercises and there is no rest period between the
sets. In the conventional system a rest period is required between each
set since the same muscle group has to be exercised and since each set
causes fatigue to the muscle, one ought to rest. Whereas in the super-
set system, each muscle group gets rest while the other muscle group is
being exercised. This system is especially convenient for those who do
not have much time.
c. Split-system: This system of weight training is normally used by
the serious body builders. In this system, the entire body is not
exercised in one day and the muscle groups are split in two or
three large groups, e.g. on the first day several exercises are done
only for the shoulders and arm muscle groups. On the second
day, several exercises will be concentrated on the back and the
chest. On the third day, the concentration of exercises will be on
the legs and abdomen muscles. This cycle is repeated once more
during the week with the seventh day as the day of rest.
d. Cir cuit Training: This system of exercises is usually done by active
Circuit
sportsmen and is helpful for building up muscular and cardio-vascular
endurance. In this system, all the exercises are done continuously one
after another without any rest. After one set of all the exercises are
completed, the trainee proceeds directly to the second circuit of
exercises comprising a continuing series of sets for each muscle group.
In this system, all muscle groups of the body are exercised consecutively
one after the other in three or four circuits.
e. Progressive: In all the previous systems of exercises, the weights
used for each muscle group for all the sets are constant. However, in
this system of weight training which is used by the active body builders
and sportsmen, the weights are increased for each set of exercises for
the body part. As a result the repetitions are reduced. For example, if
the arms are being exercised, the first set may comprise eight repetitions
with a given weight, the second set will comprise 5 repetitions with an
increased weight and the third set will comprise only two repetitions
with almost a maximum weight-load.
In addition to these basic systems, there are several other variations created
by advanced exponents of weight training which are only minor variations
of the above systems.
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GYM EXERCISES/WEIGHT TRAINING

EXERCISES/WEIGHT
CURL
BENCH PRESS
SHOULDER PRESS
BACKHYPER HALF SQUAT

SIT UP EXTENSION
CALF RAISE BENTARMPULLOVER
ALTERNATE
DUMBBELL
PRESS
WRIST CURL
DEAD LIFT
617
SIDE BENDS TRICEP STRETCH

ALTERNATE
DUMBELL CURL
LEG RAISES
LEGPRESS
CALF RAISE LEG EXTENSION

LEG CURL
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RULE NO. 4 STRESS MANAGEMENT

GEMENT,, REL
MANAGEMENT AXA
RELAXA TION AND
AXATION
MEDIT
MEDITAATION
In these modern times, due to automation and mechanization, we have
too little physical activity. However, we also have too much of mental activity.
Excess mental activity, causes stress.
Stress is almost everywhere. The death or illness of a loved one, family
problems, work problems, financial problems, legal problems, constant
daily hassles, all cause stress. Our attitudes and personality can also cause
stress. An ambition, competitive, time pressured executive has stress, but
so does a passive, helpless, victimized housewife.
Most ailments are either caused by or affected by stress. Stress or mental
tension causes the body to malfunction resulting in irritability, headaches,
insomnia, respiratory disorders, high blood pressure, heart attacks, digestive
disorders, ulcers, sexual dysfunction etc. and has even been associated with
cancer. These are referred to as psychosomatic disorders, or mental tensions,
that affect the body.
Creating your own stress defense systems as follows will help you manage
stress better.
O A stable home, family and friends
O Occupation and job satisfaction
O Financial security
O Realistic goals and proper planning
O Stress identifcation and problem solving
O An assertive and balanced personality
O A sense of humour and philosophical attitude
O Good health and appropriate nutrition
O Sufficient sleep, relaxation, prayer and meditation
O Physical activity and daily exercise.
The first step in managing stress is to develop a stress free personality. A high
self-esteem, assertive behaviour and a positive attitude help in building stress
free perception. It also helps to focus on areas where control and change are
possible. Thereby reducing stress.. A few tips to change stressful behavior::
619
O Plan and little idleness each day

O Listen without interruption
O Compartmentalize
O Know your stress points
O Enrich & update yourself
O Priorities jointly with significant persons
O Plan time and activities
O Delegate and Support
O Maintain a detached overview
O Nurture a support group
O One task at a time – slow down.
Any exercise program done regularly utilities the bodies excess stress
hormones. Exercise not only makes the body fit, but it also acclimatizes
the heart and lungs to increased activity, as in stressful situations. Relaxation
and meditation techniques result in calming brain waves, and reducing
the effects of stress. This is especially effective with stress related ailments
and regular meditation helps over come addiction to tranquilizers, reduces
hypertension, insomnia, depression, anxiety and other psychosomatic
illnesses.
BENEFITS OF REL
BENEFITS AXA
RELAXA TION SLEEP AND EXER
AXATION CISE
EXERCISE
Heart Brain Blood Muscle
Techniques Respiratory rate waves pressure tension
Meditation
« «
« «
« «
« «
« «
Yoga
Auto suggestion
« « « « «
« « « « «
« « « « «
« « « « «
« « « « «
Progressive relaxation
Hypnosis
After exercise
Sleep
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Physiological Measurement
MEDITATION
MEDITA
The easiest way to meditate is by either lying down, sitting on the ground,
or sitting on a chair in a comfortable position. Eyes should be closed and
noise eliminated to reduce internal stimulation. Soft music aids in relaxation.
You may like to practice relaxation techniques, different forms of meditation,
yoga, auto suggestion, muscular practice etc.
In simple terms, Meditation can be defined as total relaxation of the body mind
complex. The word ‘Body Mind’, may look strange because ordinarily we think
that the body and mind are separate things. In fact, they are not. The mind is
the subtle part of the body and body is the gross part of mind. That is why,
when the body is sick, the mind also becomes sick and when the mind is sick,
the body also suffers. By practicing meditation rest can be given to the mind
and roots of diseases can be removed from the mind.
Healing effects of Meditation
Health is the balance, harmony, rhythm and natural flow or pulsation of
life energy, through every part of our body. Diseases occur when this joyful
flow is interrupted. Poor lifestyle, emotional conflict, mental tension with
consequent energy depletion or inherited predispositions are the main
causes of poor health. A number of physical diseases are often related to
these subtle problems. Meditation is very helpful in overcoming these
problems. Medication heals the body from outside, where as meditation
heals it from inside.
Regular meditation helps to overcome addictions to tranquillizers, reduces
Hypertension, Insomnia, Migraine, Depression, Anxiety and other
Psychosomatic illness. It also expands brain function by enhancing a balance
between the two separate hemispheres of the brain, promoting creativity,
love, compassion etc.
Meditation Methods
Any method that creates awareness with relaxation is the right method.
The methods may vary from person to person, and one has to find out his
or her own method. While all methods overlap, they can be classified under
three heads.
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O Active Methods ( Body Oriented ): Hatha Yoga.

O Passive Methods ( Mind Oriented ): Raja Yoga.
O Heart Oriented :Bhakti Yoga.
a) Active Methods: In the active meditation techniques the body is used a
lot. These methods are primarily to activate the polar opposite body energy
resulting in a deep cleansing of the body. Many blocks created in the body
by mental repressions are also removed.
b) Passiv
assivee M
Passiv Methods:
ethods: These are basically mind oriented techniques and
minimum body activity is involved.
c) Heart Oriented Methods: In these methods the Heart; emotions are

used. Deeply emotional and devotionally inclined people can be easily
benefited through this method.
RELAXA
RELAXA TION
AXATION
As far as relaxation is concerned, it can be achieved through deep sleep, the
period of total oblivion, without any awareness; and that is what deep
sleep or good sleep is all about for most of us, certainly it refreshes,
rejuvenates and also helps the body mind to heal itself. However, in these
modern times, many of us suffer from sleep disorders and insomnia, and
do not get sufficient sleep and rest. In such cases, meditation provides the
well needed rest.
Most of us do not getup in the morning with full vigor and freshness even
after sleeping 6 to 8 hours, this is so because we do not enter into sleep
without resolving our physical, mental and emotional tensions. The sleep
of a mediator has a different quality. From this it gradually enters into
deeper states leaving out all the tensions. The quality of relaxation
experienced is very deep and refreshing. Meditation before entering into
sleep helps out all the tensions. The quality of relaxation experienced is
very deep and refreshing. Meditation before entering into sleep helps us to
dive deep in to the depths of sleep a nd we can come out refreshed and
rejuvenated in the morning.
SLEEP - HYGIENE
O Bed time same time daily
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O Wake up same time daily

O Bed only for sleep
O Warm drink, warm bath, light dinner before sleep
O Do not take you problems to bed
O Comfortable bed, pillow
O Soft and low sound, decor, lights
O Regular exercise
O Relaxation technique
O Avoid sleeping pills without medical advice.
RULE NO. 5 DEPENDENCIES MANAGEMENT

A dependency is something, we cannot live without. Alcohol, tobacco and
pann and their usage in varied forms such as beer, wine, cigarettes, cigars,
pipes, beedies, supari, paan parag etc are all addictive and many of us
cannot do without them. In addition they are all harmful to the body. In
this article, we discuss these dependencies.
Alcohol
Several research studies have pointed out that an alcoholic consumption of
the equivalent of 1 peg of spirits ( 50ml alcohol or 200 ml of beer or wine)
is not harmful. However, the same studies have cautioned against the
devasting effect of larger dosages in terms of personality disorders, accidents,
damage to the nervous system, heart and liver etc.
There are three phases in alcohol drinking. Complete the quiz and find
out which phase you are in.
a. Social Phase.
1. Do you drink alcohol ? * Yes * No
2. Do you drink every day ? * Yes * No
3. Do you drink at home ? * Yes * No
4. When you drink-do you ever * Yes * No
exceed 2 drinks?
A score of all “No” is excellent and indicates that basically you are a non-
drinker. A score of even one “Yes” indicates that you are a casual/social
drinker. A score of more than one “Yes” indicates that you are more than
623
just a casual drinker. Please go on to the next set of questions to find out if
you are in the risk phase.
b. Risk Phase.
1. Are you impatient for the first * Yes * No
drink of the day
2. Do you drink alone if you * Yes * No
do not have company
3. If your spouse restricts your * Yes * No
drinking-do you sneak
in an extra peg secretely?
4. Do you look for a drink after * Yes * No
a bad day?
All “No” answers are excellent and indicates that you are not at all dependant
on alcohol. Even a single “Yes” answer indicates that even while you are
still in control-the fact that you answered “Yes” indicates that you are in
the “Risk Phase”. More than one “Yes” indicates that you are beyond the
risk phase and potentially alcoholic. Move on to the next questionnaire.
c. Critical Phase.
1. Do you drink in the morning? * Yes * No
2. Do you feel more confident * Yes * No
only after a couple of drinks?
3. Do you drink more than * Yes * No
3 pegs a day daily ?
4. Have you tried to stop * Yes * No
earlier and failed?
“No” answers are excellent and indicates you have no alcoholic dependency.
A single “Yes” answer indicates that you are alcoholic dependent. More
than one “Yes” answer indicates that you must seek immediate help or the
consequences to you and your family could be devastating.
Even while I do not advocate the drinking of alcohol-incase the following
points are kept in mind, alcoholic drinking can become safer.
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O Drink slowly – at the rate of one drink an hour.

O Always dilute your alcohol with water. Soda or any other
bicarbonated drink speeds up absorption.
O A safe limit is one peg, or one bottle of beer, or half a bottle of
wine. Never exceed this.
O Eat before drinking. Best of all – drink during your meal.
O The best cure for a hangover is to sleep if off and drink lots of
water. The practice of one more drink or taking aspirin is extremely
dangerous.
In order to prevent alcoholism, the following points would need to be

adhered to :
O Never exceed two pegs
O Avoid drinking daily
O Avoid drinking alone
O Avoid drinking under pressure (anger, depression)
O Take a decision to stop
O Enlist the support of your family
O If you fail. Try again.
Smoking
Nothing beneficial to the body can be obtained from smoking or paan -

both these have been associated with cancer; and smoking in addition is
associated with strokes, high blood pressure, cardiac problems, circulatory
disorders etc.
We are all aware of the effects of passive smoking. We are now beginning
to learn that not only do children learn these inappropriate behaviors from
parents and elders but also, several infant become addicted in childhood,
to these products are thereafter doomed to a lifetime of dependency.
There are two ways to give up smoking. One is to reduce or cut down for
sometime and then to stop completely and the second is to stop completely
right away. A few suggestions as far as cutting down is concerned.
625
O Smoke fewer cigarettes

O Never smoke more than half the cigarette
O Break a cigarette in half and then smoke it
O Avoid inhaling
O Smoke mild, low tar cigarettes
O Never leave a cigarette dangling in your mouth
O Make it a practice never to smoke in the office
O Make it a habit never to smoke at home
O Never smoke in a public place, it is unhealthy for others
O Smoke the first cigarette of the day ½ an hour later every day (for
30 days).
A fe
feww suggestion on how to quit smoking right away
how away..
O Understand the effect of smoking on your body
O Identify why you smoke
O Seek expert advice on how to quit
O Take a decision to stop immediately
O Enlist the support of family and friends to prevent restarting
O If you fail, keep trying till you quit.
Paan
Chewing ‘Paan’ is very common among us Indians, and has been part of
Indian culture for centuries. Studies have shown that chewing paan is
detrimental to health and is the major cause of oral cancer. The paan leaf
by itself has no addicitive qualities, but the nut and other ingredients are
addictive and narcotic. The effect of chewing paan is similar to that of
chewing tobacco, consequently smoking of tobacco and chewing of paan
are both equally dangerous for health. Lip, Tongue, Cheek and Throat
cancer are consequences of long term 7/10 years daily usage of paan and
paan products, i.e, paan paraag etc.
Paan eaters should quit, either by cutting down slowly, ie eating less daily
and finally quitting or by cutting out completely immediately.
626
RULE NO. 6 SAFETY

The major cause of deaths in the younger age groups, is accidents, especially
automobile accident. As a matter of fact, 40% of deaths in the younger age
group below 30 years is automobile accident and 60% of these accidents are
due to drinking alcohol and driving . Accident do also take place at home and
in the work place with fatal consequence. A few tips on day to day safety.
Home Safety
The following will make your home safer:
O Fit safety railings and guards on balconies, large windows, and
stairways.
O Ensure safe electrical sockets and wiring.
O Attach non-slip backing to rugs and toilet mats, and install non-
slip flooring.
O Provide a guard to fireplaces and radiators.
O Locate conveniently fire extinguishers, etc.
O Ensure safe gas and hot water connections.
O Do not leave toys, etc. lying about on the floor or stairs on which
you could fall over.
O Position ladders safely during usage, and avoid standing on chairs,
tables, etc.
O Put away safely plastic bags, medicines, poisons, insecticides, sharp
tools, power equipment, etc.
O Ensure safety in the kitchen to prevent spillage of hot cooked foods
and in handling of hot utensils, water, etc.
O Do not smoke in bed or keep lighted cigarettes unattended.
O Observe pool safety around the home swimming pool.
O Dismantle firearms for storage and keep out of reach of children.
O Keep matches away from children.
O Supervise children and aged adults in the bathroom, especially
during usage of bathtubs and hot water.
O Have emergency telephone numbers of fire brigade, ambulance,
doctors, police, etc. handy.
627
Workplace SSafety
orkplace afety
O The first rule of occupation safety is to know and implement all
safety standards required by law.
O In addition, prepare specific safety rules for your organization and
follow these rules of safety practice.
O Frequently attend safety training schemes of your organization to
become specifically aware of safety hazards of your occupation.
O Pay special attention to the following safety hazards if relevant to
your occupation.
O Hazards relating to machinery and equipment.
O Hazards relating to slipping and falling in relation to walkways,
uneven pathways, slippery surfaces, ladders, and wearing of
appropriate footwear, helmets, etc.
O Hazards relating to lifting and injury to the back, and also from
inappropriate seating.
O Hazards relating to temperature, wearing of protective clothing,
warm or cold air jets for temperature control, etc.
O Hazards relating to high pressure boilers, etc.
O Hazards relating to electricity, use of quality equipment and
qualified electricians.
O Hazards relating to fire — usage of automatic fire detectors, fire
extinguishers, and fire drills.
O Hazards relating to toxic substances — proper identification,
storage, handling, disposal, etc.
O Explosion hazards reduction — by prohibiting smoking in the
vicinity, elimination of electric sparks, appropriate ventilation, good
housekeeping, etc.
O Reduction of radiation hazards by use of personal monitoring
devices, marking of radiation areas, proper storage, handling of
disposal, etc.
O Reduction of noise hazards by use of sound level monitors,
conduction of audiometry tests, etc.
628
Travel And Vehicle SSafety

ravel afety
O Ensure repair, maintenance and road-worthiness of your vehicle,
i.e., brakes, lights, tyres, etc.
O Pay full attention while driving.
O Observe all traffic rules, traffic signals, etc.
O Drive at safe speeds.
O Do not drink and drive, or drive while taking medications.
O Do not drive continuously for long durations without a break for
rest.
O Ensure the use of safety belts.
O Back the car slowly with full vision and view.
O Never leave children alone in the vehicle, they could play with the
gears; never leave the keys in the ignition.
O On a warm day, roll the windows half down before leaving children,
pets etc. inside the car.
O Pedestrians should also observe road rules of crossing, walking on
the pavement, etc.
Recreation Safety
O Know the safety rules of your recreational activities.
O Ensure the supervision of children and adolescents to keep
enthusiasm within safe limits.
O Teach children to swim as a life-saving rule.
O Always use beaches patrolled by life-saving personnel.
O In open waters, stay with a group.
O Do not enter unexplored waters.
O Use water with caution of underwater currents, rocks, etc.
O In case of emergency in water, call for help; avoid panic.
O If boating, wear life jackets.
O Be cautious of the weather.
O Keep sufficient fuel and supplies handy.
O Keep the coastguard and others aware of your schedule.
629
O If hiking, do so preferably in a group with at least one experienced

person.
O Wear clothing to protect against sun, wind, rain, cold, etc.
O Keep authorities informed of your plans and route.
O Carry sufficient water and medical provisions.
O If lost, wait for help and avoid straying.
SOME ADDITIONAL INFORMATION ON HEAL

INFORMATION TH
HEALTH
A. DO’S & DONT ’S (ENT
DONT’S (ENT))
1) Ears
O Have periodic examination of your ears, especially if you notice
your hearing decreasing.
O Do not put drops, oil, etc. in your ears without consulting your
doctor.
O Do not clean the ears with pins, keys, pens, etc.
O Do not remove foreign objects from the ear without a doctor’s
assistance.
O Do not unnecessarily clean ears after a bath with ear buds, etc.
O Loud noises are harmful for the ears.
O Do not slap children/others on the ears.
O Do not allow dirty water to enter into the ears.
O In all cases of ear ache, ringing in the ears, discharge from the ears,
giddiness, vertigo, nausea, vomiting etc., consult your doctor
immediately.
II) Nose
O Do not squeeze a boil or pimple around the area of the nose.
O Do not try and remove a foreign object from the nasal passage
without a doctor’s assistance.
O Do not blow the nose vigorously.
O Do not unnecessarily pick the nose.
O Avoid unnecessary misuse of nasal drops inhalers, etc. without a
doctor’s approval.
630
O Consult your doctor immediately in case of injury and breathing

difficulty.
III) Throat
O Avoid the use of irritants to the throat such as smoking, chewing
tobacco/paan, etc.
O Avoid putting coins, marbles, pins, etc. in the mouth.
O Do not shout, scream etc. this causes hoarseness. In case of
hoarseness, rest the throat without misuse till hoarseness passes.
O If hoarseness persists for more then 7 days, consult your doctor.
O Avoid taking excessively cold/hot spicy foods.
O Avoid talking when food/water is in the mouth.
O Eat food calmy - avoid hurry.
O In case of glandular swelling in the neck, consult your doctor.
IV) Teeth
O Brush your teeth once/twice a day prior to sleeping using a medium
tooth brush.
O Massage your gums once a day with your finger for one minute.
O Avoid using abrasive tooth powers, salt, tobacco, etc. for cleaning
the teeth.
O Avoid use of any other person’s tooth brush.
O Change your tooth brush atleast once every 90 days.
O Use dental floss for removing food particles, avoid the use of pins,
etc.
O Do not smoke, use tobacco, chew gum, eat chocolate, candy etc.
O Eat plenty, crunchy fresh vegetables and fruit.
O In case of irregular, sharp, broken teeth, contact your dentist.
O Do not apply medicine without consulting your doctor.
O In case of tooth ache, gum bleeding, ulcers of the gum and cheek,
white patches, etc., consult your dentist.
O Regular dental check ups every six months; especially for growing
childeren is essential.
631
V) E
Eyyes
O Breast feeding of infants and sufficient vitamin A for others from
fresh fruits and vegetables benefits the eyes.
O Eyes of school going children should be examined annually as also
eyes of adults.
O Sharp objects, fire works, etc. should be carefully handled.
O Protective glasses should be worn while working in situations of
heat, light, dust & smoke etc.,
O Use protective glasses while riding two wheelers.
O Avoid using another person’s soap, towel or handkerchief, etc.
O Do not use eye make up.
O Do not touch the eyes with dirty fingers, cloth, etc.
O If dust particles fall in the eye, splash with cold, clean water &
consult your doctor.
O Avoid self medication.
O Avoid reading very small print & read in clear light avoiding dim
lights for reading.
O Preferably read sitting & avoid reading lying down.
O Avoid reading in moving vehicles.
O While watching TV., do so from a distance of 10 feet. Every 20
minutes or so rest the eyes, so also while reading.
O Looking at distant objects, rest the eyes.
Eye E
Exxercise
ercise
Exercises that benefit the body-benefit the eyes also. However, here are a
few exercises that directly strengthen the muscles of the eye and lens; and
improve circulation of blood to the eye. The exercises if done faithfully not
only maintain healthy eyes and good vision-but in many cases help in
improving vision to the point where the use of spectacles are not necessary.
Do not wear spectacles or contact lenses while doing these exercises and
while in the process of doing these exercises daily reduce as far as practicable
your dependency on spectacles.
632
The exercises are done while standing with the arm/arms held straight out
in front of you, fist closed-thumb pointing up-wards. Your thumb is the
point on which your eyes concentrate for the exercises. Move the thumb as
directed. Keeping the head firm and moving the eyes only.
O Side to Side
O Up & down
O Diagonally
O Circles
O Bring the thumb close to the eyes and then extend back, do
continuously.
O Place one thumb close to the eye, and the other one arm length
away. Quickly shift your gaze from one to the other, repeat.
Each exercise is done not less than eight to ten times, daily or on alternate
days as prescribed.
VI) Skin & Hair
O In hot weather, bathe daily. In colder weather twice or thrice a
week is sufficient.
O Oil massage the scalp one or twice a month.
O In hot weather wash the hair, at least on alternate days. In colder
weather at least once each week.
O Wash the face, hands, feet, under arms & genitals daily.
O When washing / bathing use tepid (never too hot water) use mild
soap & Shampoos preferably.
O Remove all make up at night & brush hair before sleeping.
O In case of dry skin, use a moisturizer.
O Avoid excessive exposure to sun, heat, dust and water.
O Dress appropriate for the weather, neither to much exposure in
the cold, nor too much in hot weather.
633
O In cases of dandruff, shampoo regularly with a mild shampoo &

gently massage the scalp while shampooing to loosen flakes.
O In addition avoid toxic food such as meat & spices etc. Drink
sufficient water & eat sufficient fresh fruit & vegetables. Eat citrus
fruits & drink Lemon juice.
O Do not forget your daily exercise.
B. HO
HOWW TO DO BREAST SELF – EXAM:
Cancer of the breast is one of the most common female cancer. And a
monthly breast self exam, as explains below, will help you curate early any
lump sets. Early detection results in a 95% cure rate of breast cancer.
O Lie down and put a pillow under your right shoulder. Place your
right arm behind your head. Use the finger pads of your three
middle fingers on your left hand to feel for lumps or thickening.
Your fingers pads are the top third of each finger. Now examine
your left breast using right band finger pads. If you find any
changes, see your doctor right away.
O Press firmly enough to know how your breast feels. If you’re not
sure how hard to press, ask your health care provider. Or try to
copy the way your health care provider uses the finger pads during
a breast exam. Learn what your breast feels like most of the time.
A firm ridge in the lower curve of each breast is normal.
O Move around the breast in a set way. You can choose either the circle
(A), the up and down line (B), or the wedge (C). Do it the same way
every time. It will help you to make sure that you’ve gone over the
entire breast area, and to remember how your breast feels.
O You should also check your breast while standing in front of a
mirror right after you do your breast self exam each month. See if
there are any changes in the way your breasts look: dimpling of
the skin, changes in the nipple, or redness of swelling.
634
A B C
O You might also want to do a breast self-exam while you’re in the

shower. Your soapy hands will glide over the wet skin making it
easy to check how your breasts feel.
C. YOUR HEARTA
HEART T TACK/STR
AT OKE RISK
CK/STROKE
Yes No Don’t know
1. Has any member of your close family
(parents, grandparents, siblings) had
any of the following conditions before
the age of 60? { { {
Heart Attack {
High Blood Pressure {
Diabetes {
Hyper Cholesterol {
2 Do you have a Cardiac problem?

(Angina, Heart Attack, Angioplasty, Bypass) { { {
3 Do you have High Blood Pressure? { { {
4 Do you have High Blood Sugar levels? { { {
5 Do you have high Cholesterol / Triglycerides? { { {
No Sometimes Yes
6 Are you sedentary and not doing any { { {
exercise program three days a week?

7 Do you feel fat and overweight? { { {
8 Are you frequently faced with stress

& tensions? { { {
No Occasionally Yes
9 Do you smoke? { { {
The more yes assures the greater your risk of heart attacks
635
D. YOUR CANCER RISK ASSESSMENT Yes No

1 Has any member of your close family
(parents, grandparents) had cancer? { {
2 Have you been drinking more than

two pegs (60 ml) of alcohol almost daily
for the last 7-10 years? { {
3 Have you been smoking about a

packet of (10) cigarettes almost
daily for the last 7 -10 years? { {
4 Have you been chewing paan, tobacco,

supari, etc. almost daily for the last 7 years? { {
5 Do you eat excessively salty/fried/oily,

commercially prepared foods/snacks/jams,
spicy foods/pickles, etc. daily? { {
6 If fair-skinned, do you frequently expose

your skin to sunlight for long hours and
suffer sunburn, etc? { {
7 In your work etc., are you frequently

exposed to chemicals, fumes, radiations, etc.
(since the last 7- 10 years)? { {
8 Do you currently have cancer, or have

you had cancer in the past? { {
9 Have you undergone a cancer check-up

during the last 1-2 years? { {
The more yes assures the greater your risk of CANCER

E. SOME INFORMATION ON HIV/AIDS
INFORMATION
Acquired Immune Deficiency Syndrome is an Immunodeficiency disease. It
affects the body’s ability to ward off infections and disease. Therefore, the AIDS
patient usually falls victim to several opportunistic infections and is frequently
ill, loses weight, frequently has diarrhea, is short of breath, has respiratory
problems, glandular fever, etc. in most cases, AIDS is fatal. It be detected by
taking HIV blood tests (i.e. Human Immunodeficiency Virus).
636
How it is spread:
AIDs is contracted in the following ways from those individuals who are
HIV+:
1. Sexual Intercourse-from seminal and vaginal fluids, anal intercourse,
sex with prostitutes, multiple partner sex.
2. BLOOD-through use of infected needles and syringes (IV drug
use), infected skin-piercing equipment, infected blood and organs
3. Mother / child – An HIV+ mother may pass on the infection to
her child prior to and during birth
How it is not spread:

AIDS is not spread through food, water, furniture, toilet seats, hugs,
handshakes, saliva, coughing, sneezing, light kisses and sex with an
uninfected person.
Protection
1. Faithful, monogamous sex
2. Use of condom beyond a monogamous relationship
3. Avoid prostitutes as they are hig risk
4. Avoid sharing needles, syringes, skin piercing instruments, shaving
razors, etc
5. Avoid donating blood except with disposable equipment, and avoid
untested donated blood and organs
6. Consult your doctor for fuller details.
637
YOGA
1
12 2
11
10
4
9 5
6
8
7
Suryanamaskara
678
Appendix
SITTING POSES
Padmasana Siddhasana
Vajrasana Baddhakonasana
679
STANDING POSES
STANDING
Tadasana Ekapadasana Natarajasana
Trikonasana Gomukhasana Virabhadrasana

680
Appendix
FORWARD BENDING POSES

FORW
Paschimottanasana
Shashankasana
Padahastasana Padangushtasana
Adhomukhasana
681
INVERTED POSES
INVERTED
Shirsasana Sarvangasana
Halasana
Halasana on chair
682
Appendix
BACKW
BACKWARD BENDING POSES
CKWARD
Ushtrasana Chakrasana
Bhujangasana Dhanurasana
Sethubandhasarvangasana
683
LYING POSES
Suptha Vajrasana
Matsyasana
Shalabhasana
Suptavirasana
Supta Baddhakonasana
Sethubandha
Sarvangasana on pillows
684
Appendix
REL AXA
RELAXA TION ASANAS
AXATION
Shavasana
Makarasana
PRANAYAMAS
PRANAYAMAS
Pranayama Abdominal Breathing

685
YOGA THERAPY GLOSSAR

GLOSSARY
OSSARY
Ahimsa: Non-violence, harmlessness (one of the Yamas).
Aparigraha: Non-greed (one of the Yamas).
Asanas: Yoga postures. Probably the most famous pose is the lotus position,
which can really tangle up beginners. Don’t do this one without professional
help.
Ashtanga yyoga
oga
oga: Physically challenging yoga to build strength, flexibility,
and stamina. Also called power yoga.
Asm ita
Asmita
ita: Ego, individuality, I-am-ness.
Asteya
Asteya: Non-stealing (one of the Yamas).
Brahmachar ya: Purity, chastity, non-lust (one of the Yamas).
rahmacharya:
Brahman: The absolute. Divinity itself, God as creator.
Buddhi: The intellect.
Chakras
Chakras: Centers of radiating life force or energy those are located between
the base of the spinal column and the crown of the head. Sanskrit for
“wheels.” There are seven chakras that store and release life force (prana).
Dharana: From the word dhri meaning “to hold firm,” this is concentration
or holding the mind to one thought.
Dharma: Self-discipline, the life of responsibility and right action.
Dhyana: Meditation or contemplation. The process of quieting the mind.
Hatha yoga: Many yoga styles spring from hatha. It is the yoga of physical
well-being, designed to balance body, mind, and spirit.
Iyengar yyoga
oga
oga: This yoga style focuses on the body and how it works. It is
noted for attention to detail, precise alignment of postures, and the use of
props.
Jnana yyoga
oga
oga: The path of knowledge or wisdom.
Karma yyoga
oga
oga: The path of action.
686
Appendix
Kundalini
Kundalini: A cosmic energy in the body that is often compared to a snake
lying coiled at the base of the spine, waiting to be awakened. Kundalini is
derived from kundala, which means a “ring” or “coil.”
Mandala
Mandala: A circular geometric design that represents the cosmos and the
spirit’s journey. It is a tool in the pilgrimage to enlightenment.
Mantra
Mantra: Sacred chant words.
Meditation
editation: Technique of inward attention.
Mudras
udras: Hand gestures that direct the life current through the body.
Niyamas
iyamas: In the Yoga Sutras, Patanjali defined five niyamas or observances
relating to inner discipline and responsibility. They are purity, contentment,
and self-discipline, study of the sacred text, and living with the awareness
of God.
Prana
rana: Life energy, life force, or life current. The Chinese call this life force
chi.
Pranayama: Method of controlling prana or life force through the regulation
of breathing.
Pratyahara
Pratyahara: Withdrawing the senses in order to still the mind as in
meditation.
Raja yyoga:
oga: The path of physical and mental control.
Samadhi
Samadhi: State of absolute bliss, super consciousness.
Svadhyaya
adhyaya: Self-study. The process of inquiring into your own nature, the
nature of your beliefs, and the nature of the world’s spiritual journey (one
of the niyamas).
Tantra yyoga
oga
oga: This yoga uses visualization, chanting, asana, and strong
breathing practices to tap highly charged Kundalini energy in the body.
Yamas: In the Yoga Sutras, Patanjali defined five yamas or ways to relate to
others — moral conduct. They are non-violence; truth and honesty; non-
stealing; moderation; and non-possessiveness.
Yogi: Someone who practices yoga. (A female yogi is called yogini.)
687
PSYCHO
PSYCHOTHERAPY GL
CHOTHERAPY OSSAR
GLOSSARY
OSSARY
Adlerian: A holistic approach which emphasizes goals, including ways of
developing a sense of competence and establishing relationships with others.
Ar t/E
Art/E xpr
t/Expr essiv
essivee Ar
xpressiv ts Therapy: Art and various creative processes are used as
Arts
a means of reconciling emotional conflicts and of fostering self-awareness
and personal growth. This approach is applicable to a wide range of issues/
populations/mental health settings. It is particularly useful for individuals
who are unable to speak or have trouble expressing verbally.
Asser tiv
Assertiv eness Training: A therapeutic technique usually involving behaviour
tiveness
rehearsals, in which people are taught frank, honest, and direct expression
of feelings, both positive and negative.
Behavioral: Uses theories of how people learn to help promote change,
usually of a specific troublesome symptom or behaviour.
Bio-Energetics: A body-centered therapeutic approach which utilizes
exercises such as strong expressive movements, stress postures, and breathing
techniques to allow the release of repressed emotions and to promote the
full experience of feelings.
Bo
Boww en N atural: A “Family Systems” therapy in which healthier family
Natural:
relationships are promoted by encouraging constructive ways of relating in
one family member.
Brief Therapy: Time-limited therapy usually no more than fifteen sessions,
which is goal-oriented, focused and directed toward specific problems and
solutions.
Client-Centered (Rogerian): A humanistic therapy which relies on a safe,
non-judgmental relationship between the therapist and the client to help
the client realize his/her own values. The client retains the right of choice
in the solutions to his/her problems.
Cognitiv e: Works on the assumption that feelings and behaviour can be
Cognitive:
changed if ideas are changed. Cognitive therapy focuses on correcting
learned misconceptions.
Dream Interpretation: A psychoanalytic technique in which clients report
their dreams as accurately as possible, and the therapist interprets the
elements of the dreams as symbols of desires and conflicts.
688
Appendix
Eclectic: Uses techniques/concepts/ideas from several different schools. The

therapist may use gestalt techniques with particular kinds of issues and/or
transactional analysis concepts with other kinds of issues. The goal is to
use the most appropriate response to each issue that arises in treatment.
Eye M
Mo ovement D esensitization and R
Desensitization epr
Repr ocessing (EMDR): This is an
eprocessing
intensive psychotherapy method involving conscious imitation of
involuntary eye movements made during deep sleep (the “rapid eye
movement” phase). EMDR can allow greater access to the thought
processes of deep sleep: this can be useful for working through the “stuck”
memories of trauma or loss that may be at the root of problems like Post
Traumatic Stress Disorder, anxiety, depression, anger, and stress. Although
EMDR is fairly new, many studies have already shown that it can increase
both the speed and effectiveness of treatment.
Ericksonian: Based on the work of Milton Erickson, this therapeutic
orientation often includes hypnotherapy techniques, including self-
hypnosis.
Existential: A humanist therapeutic orientation that “takes the unfolding
of the client’s genuine self as its goal.”
Family Systems: An orientation in which individuals are seen as part of,
and affected by, their families. Family history and interaction is made a
part of the individual’s therapy. Family Systems therapists often suggest
that the entire family be seen together, but some therapists will work with
an individual and use the “systems” perspective when working with that
individual.
Feminist: Feminist therapy is therapy of any orientation, using any
technique, which attempts to acknowledge and address the effect of gender
roles and societal pressures on personal growth for both sexes.
Gestalt: Promotes increased awareness and integration of the self as a whole,
including aspects of self that are often feared or misunderstood. The goal is
to understand and create a “working relationship” with these aspects of
self. Techniques such as role playing are used to help in the process.
Holistic H ealth: In holistic health therapy, an individual is seen in the
Health:
context of his or her life. This approach is based on the belief that the
various parts of our lives - work, family, etc. - are related, and affect each
689
other. Problems arising in one or more of these areas may be linked to

problems in other areas.
Holistic D epth P
Depth sy
Psychology: A process through which the individual learns
sychology:
to work with progressively deepening layers of his or her psyche. Presumes
that people have conscious and unconscious aspects of their being.
Humanistic: A mode of therapy which identifies interpersonal environments
as the source of emotional problems. The role of the therapist is one of
support and reinforcement of the person’s sense of self.
Hypnotherapy: Utilizes relaxation to access the unconscious mind - the
part of the mind in which memories are stored. Through the imagination,
it is possible to tap into the mental programming which is normally beneath
conscious awareness. With the understanding of this information comes
the capability of altering the sometimes negative effects this programming
can have on both mind and body.
Imago: based on the belief that couples often unconsciously bring unfinished
business from childhood into our romantic partnerships, placing the burden
of meeting these childhood needs on their partners. Imago Relationship
therapists seek to help couples identify their unconscious agendas in the
relationship, and work to resolve those issues constructively.
Jungian: A psychoanalytic orientation which stresses the role of spirituality
and spiritual needs in dealing with emotional disorders. Based on the work
of psychoanalyst Carl Jung.
Neur olinguistic P
eurolinguistic Prrogramming: This is based on the observation that all
internal processing of experience is represented in neurological channels
that correspond to the major sensory channels, i.e. kinesthetic, visual, and
auditory. The therapist and client strive to find out which channel the
client is best at communicating through and then build a therapeutic
rapport focused on that communication.
Play Therapy: A psychodynamic technique which encourages children to
explore their conflicts through symbolic play rather than through verbal
expression.
Psy choanalytic: This approach attempts to help a person understand his
sychoanalytic:
or her thoughts, feelings, and behaviours in terms of unconscious inner
drives. Sigmund Freud was the originator of psychoanalytic thought but
690
Appendix
other analytic theories have since been developed, including Jungian,

Adlerian, and others.
P s yychodynamic:
chodynamic: A variation on the Freudian approach: like classical
psychoanalytic therapy, psychodynamic theory views thoughts, feelings, and
behaviours as manifestations of inner drives. However, psychodynamic therapy
involves more direct interaction between the therapist and the client, and in
general assigns a more active role to the client than in psychoanalysis.
Rational-E motiv
motivee Therapy: This therapy is generally briefer than
Rational-Emotiv
psychoanalysis. Based on the belief that disturbances are caused by “should”
about oneself, others, and the surrounding world, RET is an action-oriented
approach that focuses on examining such unconscious assumptions and
working to change them. By challenging faulty beliefs with rational
thoughts, clients are led to re-order their self-perceptions and decision-
making processes.
R eality Therapy: It emphasizes personal responsibility for one’s actions;
the therapist acts as a coach, helping the client learn how to get desired
results in life by changing his or her actions. Reality therapy stresses
understanding and accepting the consequences of one’s actions as cause
and effect.
S elf P
Pss yychology:
chology: An analytic psychotherapy, utilizing empathy and
interpretation, to promote greater self-cohesion and self-esteem. The
approach addresses experiences in the past and present which have been
emotionally injurious or enhancing to self-esteem.
Spiritual: Presupposes that human beings have an inner spirit, which
through various practices may be aligned with a higher power, however,
that is defined.
Tr ans
a ns act iional
onal Ana lysis: Focuses on an individual’s interactions
(“transactions”) with others; analyzes them for insight into the client. The
goal is to help clients respond more consciously and intentionally to
situations and people.
Transpersonal: Emphasizes spiritual growth. Eastern philosophy often
informs this discipline.
Transtheor etical: Uses a combination of orientations and techniques,
ranstheoretical:
“tailoring” therapeutic method to the client.
691
BIBLIOGRAPHY
Ayurveda
O Dr. Avinash Lele, Prof Dr. Subhas Ranade, Dr. Abbas Qutab,
Pancha Karma and Ayurvedic Massage, International Academy of
Ayurveda. Pune 1997.
O Deepak Chopra, Perfect Health, Bantam press, 1994.
O J. H. Morrison, The Book of Ayurveda, Simon & Schuster, 1995
New Mexico.
O Kaviraj Ambika Dutta Sastri, Sushruta Samhita, Chukhambha
Sanskrit Sansthan, 1976 Varanasi.
O Dr. K. M. Nadkarni, Indian Materia Medica, Popular Publisher,
1993 Calcutta.
O Satya Narayana Sastri, Charak Samhita, Chukhambha Sanskrit
Sansthan, 1975 Varanasi.
O Dr. Vasant Dattatray Lad, Secrets of Pulse, The Ayurvedic Press
1996, New Mexico.
Acupuncture
O Acupuncture A Comprehensive Text: Shanghai College of
Traditional Medicine: Eastland Press Inc, December 1981.
O Ernst, Edzard; White, A.R Acupuncture A Scientific Appraisal.
Paperback: Elsevier, July 1999.
O Hopwood Acupuncture in Physiotherapy: Key Concepts and Evidence-
Based Practice: Paperback Elsevier, June 2004.
O Jayasuriya, Anton, Clinical Acupuncture: B. Jain Publishers Pvt Ltd:
December 2002.
O Mann, Felix, Reinventing Acupuncture: Elsevier August 2000.
Modern Medicine
O American College of Physicians Complete Home Medical Guide, DK
Publishing, Inc, New York, 1999.
692
Appendix
O Bailey & Love’s Short Practice of Surgery By R.C.G. Russell, Norman

S. Williams, Christopher J.K. Bulstrode Bulstrode, Hodder Arnold,
March 2004
O Bertram G. Katzung, Pharmacology, 5th edition, Appleton & Lange,
1993
O Davidson’s Principles and Practice of Medicine Hardback Edition,
19th Edition Churchill Livingstone Published January 2003
O D. C. Dutta, Textbook of Obstetrics, New central Book agency (P)
Ltd. New Delhi, 2001.
O Gray’s Anatomy, 38th edition, Churchill Livingstone.
Homeopathy
O Allen H.C., Allen’s Keynotes and Characteristics with comparisons, B.
Jain publishers (P) Ltd. New Delhi, 2002.
O Boericke W., New Manual of Homoeopathic Materia Medica &
Repertory B. Jain publishers (P) Ltd. New Delhi, 2002.
O Boericke W. The 12 Tissue Remedies of Schuessler, B. Jain
publishers (P) Ltd. New Delhi, 2002.
O Hahnemann S, .Hahnemann’s Materia Medica, Materia Medica Pura
and Chronic Diseases Combined & Rearranged (3 Vols.), B. Jain
publishers (P) Ltd. New Delhi, 2002.
O James Tyler Kent, Lectures on Materia Medica, B. Jain publishers
(P) Ltd. New Delhi, 2002.
O Sirker Cap. K, .A Handbook of Repertory, B. Jain publishers (P)
Naturopathy
O Joseph E Pizzorno Jr. ND, Michael T Murray ND, Clinician’s Handbook
of Natural Medicine, Bastyr University, WA; Herb Joiner-Bey, Churchill
Livingstone Published September 2001.
O Joseph E Pizzorno Jr. ND, President Emeritus, Bastyr University,
Kenmore, WA; Michael T Murray ND, Textbook of Natural Medicine
(2 Volumes) Churchill Livingstone – 1999.
693
O William A. Mitchell, ND, Applications of Botanical Remedies in

Naturopathic Medicine, Bastyr University.
Yoga therapy
O B.K.S. Iyengar: Light on Yoga, Harper Collins, India, 1992.
O Dr. H. R. Nagendra: Yoga its basis and Applications, Vivekananda
Kendra, Bangalore, India, 1986.
O Herbert Benson, MD: The Relaxation Response, 1976. Avon Books,
USA.
O Dr. Krishna Raman, A matter of Health, East west Books (Madras)
Pvt. Ltd, 1998.
O Sri Swami Sivananda: Science of yoga, volumes 1 to 8, Divine Life
Society, Sivananda Nagar, India, 1987.
O Swami Sathyananda Saraswati: Asana Pranayama Mudra Bandha,
Bihar School of Yoga, 1989, Bihar, India.
O Swami Vivekananda: Complete works, Advaita Ashram, Calcutta,
1999.
O Swami. Digamber & Dr. Gharote: Yoga therapy, Kaivalyadhama
SMYM samiti, Lonavala 1978.
Nutrition Therapy
O Davidson and Passmore’s Human nutrition and dietetics, 8 edition
Elsevier Science Health Science div: January 1986.
O Frances J. Zeman, Clinical Nutrition and Dietetics, Macmillan
Publishing Company, US 1991.
O Phyllis Balch, James Balch, Prescription for Nutritional Healing,
Avery Penguin Putnam; 3rd edition (October 2000).
Psychotherapy
sychotherapy
O Kaplan & Saddock, “Health psychology”, BI Waverly Publishers
O Kaplan & Saddock, “Synopsis of Psychiatry, Counselling”, BI
Waverly Publishers Ltd. New Delhi, India, 1999.
694
Appendix
O M. B. Ghorpade, Introduction to Modern Psychotherapy,

Himalayan Publications.
O Shelly Taylor, Health Psychology, McGraw Hill Publications.
Physical Therapy
O Clayton’s Electrotherapy, P.M. Scott, Bailliere Tindall, 2000.
O Hollis, M., Practical Exercise Therapy, Blackwell 1976.
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Publishers, New Delhi, India, 2000.
O Porter, Stuart, Tidy’s Physiotherapy: Elsevier : 0750632119 : May
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695

Holistic Health Solutions for Common Diseases

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Holistic Health Solutions for Common Diseases

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Holistic Health

Apollo H ospitals Educational & R

A Holistic approach to Health

DR. PRATHAP C. REDDY

1. Gastrointestinal Diseases Page N Noo.

APHTHOUS (MOUTH) ULCERS

Causes, incidence, and risk factors

Aphthous ulcers often have the tendency to reoccur. There may be an

Signs and tests

In these cases, topical or oral (by mouth) tetracycline suspension may be

Arsenicum album: A person who breaks out in burning, painful mouth

warm. Arsenicum album is recommended when the mouth is dry and

Signs and tests

Improve Constriction of the Lower Esophageal Sphincter (LES):

Decrease Irritation in the Esophagus:

Causes, incidence, and risk factors

Signs and tests

Helicobactor pylori infestation, a common bacterial cause of gastritis and

O Powder of Piper longum should be taken with honey and lemon

three times per day, to decrease inflammation and encourage

O N-acetylcysteine (200 mg twice a day between meals) is also the

Causes, incidence, and risk factors

Other factors which are likely to cause ulcer, include:

Medication often involves a combination of medications to kill the

Surgery and Other Procedures

Catgut embedding therapy at Zhongwan (Ren 12) through to Liangmen

{ Forward bend poses like Shashankasana, Paschimottanasana,

Baddha Konasana, Halasana,

Dhanurasana, Chakrasana, Matsyasana, Setubandha

O Pranayamas such as Nadi shuddhi, Chandra bheda, Sheetkari,

Avoid carbonated beverages, coffee (regular or decaffeinated). Avoid strongly

Causes, incidence, and risk factors

O Healthcare workers, including dentists and dental hygienists,

Signs and tests

O Fresh decoction or powder of three myrobalans should be given in

Local points: (select from):

Aconitum: It is used during initial phases of hepatitis when the individual

Belladonna: It is used in early stages of hepatitis when the individual has

Herbs for liver support include the following.

Small, frequent meals are suggested to optimize digestion. Increase intake

The following micronutrients are advised:

O Vitamin C (250 to 500 mg twice daily), beta-carotene (100,000

A shot of immunoglobulin may also prevent infection even after a person is

Other steps to take:

O Avoid sharing plates, utensils, or bathrooms with someone who

Causes, incidence, and risk factors

Irritable bowel syndrome is extremely common, but only a small proportion

Colocynthis: This remedy is indicated when cutting pains and cramping

Ly copodium: This remedy is often indicated for people with chronic

Nux vomica: Abdominal pains and bowel problems accompanied by tension,

Podophyllum: This remedy is indicated when abdominal pain and cramping

Yoga reduces irritable bowel syndrome by normalizing bowel movements.

{ Sitting poses like Padmasana, Vajrasana, Konasana, Siddhasana

{ Forward bending yoga asanas like Shashankasana,

{ Backward bend poses like Bhujangasana, Shalabhasana,

O Pranayamas such as Nadi shuddhi, Ujjayi, Sheetkari, Sheetali, and

Changes in diet may help alleviate symptoms in some patients. No diet is

Regular exercise, such as walking, encourage bowel movements if you are

Transmission occurs through ingestion of cysts in fecally contaminated food

Typical symptoms of intestinal amebiasis consist of frequent diarrheal bowel

Malnutrition, old age, pregnancy, use of steroids, malignancy (cancer), and

Signs and tests