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  1. 1. AYURVEDIC MANAGEMENT OF MALNURITION <ul><li>Presented By: </li></ul>Dr. Harish Kumar Singhal Dr. Pawan Vishkarma Dr. C.M. Jain Associate Professor & Head M.D. (Ay.) Scholar Department of Kaumarbhritya, National Institute of Ayurveda, Jaipur
  2. 2. Introduction <ul><li>Malnutrition is the most wide spread condition affecting mainly the health of Children. </li></ul>It is defined as 'A pathological state resulting from a relative or absolute deficiency or excess of one or more essential nutrients. So the term (WHO) comprises four forms- Definition This is a pathological state resulting from the consumption of excessive quantity of food over an extended period of time. The incidence of obesity, athroma and diabetes is attributed to overmutrition. Undernutrition This is a condition which results when insufficient food is eaten over an extended period of time. Overnutrition
  3. 3. Imbalance <ul><li>It is a pathological condition resulting from a relative or absolute lack of an individual nutrient. </li></ul><ul><li>Malnutrition, main victims are children under the age of 15 year. But children under the 5 year age are affected more. The malnutrition makes the child immunodificient (Oja Kshaya) so it makes child more susceptible to infection. </li></ul><ul><li>On global scale the five principal nutritional deficiency diseases that are being accorded the highest priority action are Kwashiorkar, Marasmus, Xeropthelmia, Nutrional anaemias and endemic goiter (WHO, 1963). </li></ul><ul><li>A much larger population are affected by hidden malnutrition which is not easy to diagnose. </li></ul><ul><li>In more developed countries in the world nutritional problems are some what different. Over nutrition is more frequently than under nutrition. The health hazards of over nutrition are obesity, diabetes, hypertension, C.Vascular and renal diseases, liver diseases & gall bladder. </li></ul>Resulting from a disproportion among essential nutrients with or without the absolute deficiency of any nutrient. Specific Deficiency
  4. 4. Malnutrition in Ayurveda <ul><li>Malnutrition like condition described in Ayurveda are – </li></ul><ul><li>1. GARBHASHOSHA </li></ul><ul><li>vkgkjekIuksfr ;nk u xHkZ% 'kks&quot;ka lekRuksfr ifjlzqfra ok A </li></ul><ul><li>ra L=h izlwrs lqfpjs.k xHkZ iq&quot;Vks ;nk o&quot;kZ x.kSjfiL;kr~ AA ¼p-'kk- 2@15½ </li></ul><ul><li>It occurs due to deficiency of nutrition during foetal life. </li></ul><ul><li>2. NAGODAR – Causes are - </li></ul><ul><li>miokl ozr deZijk;k% iqu% dnkgkj;k% Lusg}sf&quot;k.;k A </li></ul><ul><li>okr izdksi.kksDrkU;k lsoekuk;k xHkksZ o`f) u izkIuksfr AA </li></ul><ul><li>ifj'kq&quot;dRokr~ l pkfi dky Hkofr&quot;Brs·frek=e~ A </li></ul><ul><li>vLiUnu'p Hkofr ra rq ukxksnjfeR;kp{krs AA ¼p-'kk- 3@28½ </li></ul><ul><li>It indicates that fasting more work leads to NAGODARA . </li></ul>
  5. 5. <ul><li>3. FAKKAROGA – (Kashyapa Samhita Fakka Chikitsa) – Symptoms are - </li></ul><ul><li>cky% laoRljk ¼iUu%½ --------------- ikf.ktkuqxeks·fi ok A </li></ul><ul><li>The causes are FAKKA in Kashyapa as </li></ul><ul><li>vukFk% fdy';rcky% ---------------- </li></ul><ul><li> ekr`dsuSo -------------------- A ---------------- eukFkkuka fo'ks&quot;kr% </li></ul><ul><li>Indicates that FAKKA patients are ANATH and have GRAHANI ROGA. They eat more but due to Mandagni they are malnourished due to malabsorption. </li></ul><ul><li>4. BALASHOSHA – (A.S.Ut. 2 & A.H.Ut. 2) – Symptoms are - </li></ul><ul><li>vjkspd% izfr';k;ksa Toj% dkl'p tk;rs A </li></ul><ul><li>dqekj% 'kq&quot;;fr rr% fLuX/k 'kqDy eq[ks{k.k% AA </li></ul><ul><li>Snigdha, Shukla Mukhekshna may indicate oedema. The cause of Balashosha according to Acharya Vagbhatta. </li></ul><ul><li>vR;g% LoIu 'khrkEcq 'ysf&quot;ed LrU;lsfou% A </li></ul><ul><li>Shows that the possible pathology in Balshodha is “ SROTORODHA ” </li></ul>
  6. 6. <ul><li>5. PARIGARBHIK : </li></ul><ul><li>Causes - </li></ul><ul><li>ekrq% dqekjks xfHkZ.;k% LrU; izk;%·ficUufi A </li></ul><ul><li>Symptoms - </li></ul><ul><li>dk;kfXulkn o;Fkq rUnzk dk';ksZ:fp izeS% A ;qT;rs dks&quot;B o`);k p rekgq ikfjxfHkZde~ AA ¼v-l-m-1@1½ ¼v-â-m- 2@64½ </li></ul><ul><li>These conditions develop in the child due to feeding milk of pregnant mother. The symptoms of it like vomiting. TANDRA, ARUCHI, BHRAMA & KARSHYA indicate under nutrition. </li></ul><ul><li>6. STHAULYATA AND KARSHYATA : </li></ul><ul><li>Cause of STHAULYATA told by Acharya Charaka are - over eating of GURU, MADHUR, SNIGDHA food and not doing exercise, copulation etc. These are absolutely correct in this time. </li></ul>
  7. 7. <ul><li>Causes of KARSHYATA are (Ch.Su. 21/10) </li></ul><ul><ul><li>lsok :{kkUu ikukuka y?kqua izferk'kue~ </li></ul></ul><ul><ul><li>fØ;kfr;ksx% 'kksd'p funzkosx fofuxzg% A </li></ul></ul><ul><li>It indicates under nutrition. For both condition Acharyas Saya that:- </li></ul><ul><li>lrr% O;kf/krkosrkofrLFkwy d`'kkS ujkS A </li></ul><ul><li>(Ch.Su. 21/13) </li></ul><ul><li>means these always suffer with diseases as in Malnutrition which leads to infection and other disorders like liver disorders, obesity, cardiac disorders, hypertension etc. </li></ul>
  8. 8. Prevention and Management : <ul><li>Acharya Charaka says that human and disease both are the product of Ahara- </li></ul><ul><li>vkgkj lEHkoa oLrq jksx'pkgkj lEHknk% A </li></ul><ul><li>(Ch.Su. 28/45) </li></ul><ul><li>The Nourishment of the body by Ahara depends upon AGNI so it is necessary to maintain AGNI. </li></ul><ul><li>The Ahara of malnurished patient should be - </li></ul><ul><li>The food taken skilfully act as life other wise if can also cause death if taken in wrong manner. </li></ul><ul><li>1. Srotoshodhak - Ahara should be used with srotoshodhak Aushadhi, so the formation of all DHATU will become correctly. In the condition of over nutrition the main cause is SROTORODHA due to MEDA DHATU. </li></ul><ul><li> In Balshosha as told by Vagbhatta the main pathology is SROTORODHA. So, in the diet allium sativum, may be add. </li></ul>By Ahara
  9. 9. <ul><li>2. Deepaniya and Pachaniya - In malnurished children salivary gland become atrophied, liver show fatty infiltration, pancreatic acini are atrophied. In intetsinal mucosa villus hight reduced. Total absorption surface reduced, so these are necessary to promote digestion and absorption for example food is given fried with Hingu and Jeeraka. </li></ul><ul><li>3. Balya, Brimhana and Jeevniya - They suppliment nutrients for growth and function of the body. example - Milk, Phaseolus mungo, Soyabean, Asparagus racemosus, meat. </li></ul><ul><li>4. Harddya - The work load for heart is increases in under nourished. For example when Hb% goes below to 5 gm% the condition of C.C.F. may taken place so HARDDYA Ausadhu Ahara also promote nourishment. </li></ul><ul><li>These DRAVYA may be Mango, Urginia indica, MATULUNGA etc. </li></ul><ul><li>Meddya - Brain growth extends from 30 th week of gesttaion to about the end of the second year of life. Under nutrition during early part of the period i.e. about six month of life affect adversly to development of brain. So this is necessary to promote MEDHA Dravyas are - GHEE, KUSMANDA, etc. </li></ul>
  10. 10. How Ahara should be taken ? <ul><li>Now a days many person are malnurished inspite of taking food. These are given by our Acharyas thousands of years ago. </li></ul><ul><li>Acharya Charaka says that - </li></ul><ul><li>izk.k% izk.kHkzrkHkUua rn~;qDR;k fguLR;lwu A </li></ul><ul><li>(Ch.Chi 12) </li></ul><ul><li>Now people wants to tasty, convinience, more refined processed and preserved food so the importance of the follow these rulus as told by Ayurdedacharyas increases. </li></ul><ul><li>According to Acharyas Charaka MATRA, KALA, KRIYA, BHUMI, DEHA, DOSHA are PATHYAPATHYA regulator. </li></ul><ul><li>AHARA VIDI VISHESHAYATANA - (C.Vi. 1) </li></ul><ul><li>These are eight factors which should be follow during taking meal - </li></ul><ul><li>1. PRAKRATI - The natural property of DRAVYA like GURU, LAGHU, SHEETA, USHNA should be considered during taking food. </li></ul>
  11. 11. <ul><li>2. KARAN - also called SANSKAR (preparation) </li></ul><ul><li>For example - </li></ul><ul><li>(a) Frying of oil or ghee increases the absorption of Vit A. </li></ul><ul><li>(b) Ghee becomes more property full if it is processed by many useful drugs for example – SAMVARDHANA GHRITA (K.Su. Lehaddyay). </li></ul><ul><li>3. SANYOGA - Milk and CHYAVANPRASH may become good for under nourished children. </li></ul><ul><li>4. MATRA - two types </li></ul><ul><li>(a) SARVAGRAH - all ingredients are taken combindly in normal balanced diet. </li></ul><ul><li>(b) PARIGRAH - e.g. in Kwashiorkar proteins should be preferred. </li></ul><ul><li>5. DESH - The Ahara which produces in particular area is suit for the person of that area. It is cheap and best and assimilate more readily than other. </li></ul>
  12. 12. <ul><li>6. KALA - two type </li></ul><ul><li>(a) NITYAG - Ahara should be according to Ritu. </li></ul><ul><li>(b) AVASTHIG - According to disease state Ahara should be changed. </li></ul><ul><li>For example in scurvy Vit. C containing food is necessary. </li></ul><ul><li>7. UPYOKTA - Ahara should be used according to patient Prakrati, Bala & Satmya etc. </li></ul><ul><li>8. UPYOGA SANSTHA (Rules of User)- These are 10 principals </li></ul><ul><li>(Ch. Vi. 1/7) </li></ul>(a) USNAMASNIYAT - Warm food is tasty and indirectly promotes digestion. (b) SNIGDHAMASHNIYAT - This is Vatanuloman & Balya. (c) MANTRAVADASNIYAT - Food is according to digestion power, season, prakriti etc. correct food prevent abdomind distension pressure on cerdiac portion of chest & ensures efficient functioning of all organ. (d) JEERNEASHNIYAM - (e) BIRYAVIRUDHASHNIYAT - (f) Food needs to be taken in pleasant surroundings with proper equipment. (g) NATIDRUTAM - should be chewed throughly. (h) AJAIPAN AHASAN TAN MANASH CH BHUNJEET - it is best to focus on food while eating. (i) ATMANAM ABHISAMIKSHYA - Fat only that food which is nourishing to ones particular constitution and which suits ones mental and emotional temperament.
  13. 13. Vihar in Malnutrition <ul><li>These may be - </li></ul><ul><li>DINCHARYA - It is necessary to follow Dincharya some are rising early in the morning after deciding that food is digested completely. </li></ul><ul><li>CHANKRAMAN is beneficial for under nourished person. </li></ul><ul><li>Massage of skin daily with medicated oils. For example by RAJ TAILA in PHAKKA. BALA Tail in Shosha. </li></ul><ul><li>Do not bath after eating because it leads to Kapha vridhi, which may produce srotorodha. </li></ul><ul><li>2. RITU CHARYA - Ahara vihara should be according to ritu for example Guru Ahara may be given in Hemant and Shishir Ritu because the agni is in more intensity. </li></ul><ul><li>3. AASANA - Those type of Aasana should be used which promotes digestion and absorption. Some Aasana are given below - </li></ul><ul><li>In Amaatisar - Badhapadamasan, Kukkutasan. </li></ul><ul><li>In Mandagni - Uttanpadasan, Dhanurasan, Shirshasan, Halasan. </li></ul><ul><li>In Ajirna - Pawanmuktasan. </li></ul><ul><li>In Flatulence - Bajrasan, Pawanmuktasan. </li></ul>
  14. 14. <ul><li>4. AACHAR RASAYANA - </li></ul><ul><li>Auyurveda says that without use of Ahara and Aushadha of RASAYANA quality, SADVRITA can gives RASAYANA like effect for our body some are given below- </li></ul><ul><li> Use of sleep and awakness should be taken normally - </li></ul><ul><li>Do not become angry </li></ul><ul><li>Avoid alcoholism </li></ul><ul><li>Avoid SHOKA, KAM because SHOKA is also the cause of kshaya. </li></ul><ul><li>5. Vegetarian is better than Non-vegetarian - </li></ul><ul><li>Although non-vegetarian diet is rich of protein, fat and some essential nutrients but this is difficulty to digestion, may support to grow dangerous disease, makes mind aggressive. By mixing soyabean, pulses, grita, fruit in larger amount the vegetarian diet also become balanced and nutrious. It is cheap and people may get it easily. </li></ul>
  15. 15. <ul><li>So for preventing maluntrition locally produced food material should be promoted for using and to follow the rules of taking Ahara as Ayurveda. </li></ul>CONCLUSION Thank You