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Articles by Dr. Devidasan Vellodi

Have a (healthy) heart!

Heart diseases and the related risk factors like high and low blood pressure, cholesterol, obesity and diabetes affecting a major chunk of the population day by day. The prevention and controlling of these factors at the earliest is the best remedy. The symptoms creep in silently leading to the collapse of the body parts one by one, finally the premature and painful death. Try the Ayurveda way to have a (healthy) heart! 

Concept on heart

“Hrudaye moordhni vasthow cha nrunam prana prathjistitha” - (Charaka Samhita)

Ayurveda considers heart as one of the three vital organs in the body. The sloka means that any injury or damage to these vital organs will be fatal.

The term ‘Hrdya’ is derived from three Sanskrit words - hri, da and in, which means harana, dana and ayana respectively. It means, receipt, giving way and enables to execute the two earlier functions.

Harana(receive), Dana(give away) are the two functions. ‘ayana’ means to execute the two functions.

Ancient acharayas have clearly described the size and shape of the heart.

'kapharaktha prasadal syal hrudayam stanamojasa: mamsapesee cha yo raktha padmakaramadhomukham’ (astanga hrudayam-sareeram). The sloka means that heart is the boon of kapha and raktha dathus. It is the place of ojus (vitality), made up of muscle and shaped like an upside down lotus bud. 

How it functions?

Thorasic heart receives and ejects the blood (rasa-raktha complex) by continuous contractions and relaxations for maintaining the circulation to perform the `preenana' (exchange of oxygen & carbon dioxide) and `jeevana kriyas'(exchange of water, salts, nutrients between the blood and the surrounding body tissues)  

What happens?

Obstruction to the coronary arteries is the root cause of heart diseases. The coronary arteries are the blood vessels, which travel through the wall of the heart and nourish the heart muscle.

Since the heart muscle spends a huge amount of energy, it needs ceaseless nourishment. It naturally demands a good supply of blood. Any impairment of these blood vessels interferes with the adequate blood flow to the heart muscles. If this blood flow is significantly diminished then the heart signals its difficulties by registering pain or discomfort in the chest.

A heart attack is when the blood supply to part of the heart is cut off and that part of the muscle dies (infarction). Angina can be a helpful warning sign if it makes the patient seek timely medical help and avoid a heart attack. Prolonged or unchecked angina can lead to a heart attack or increase the risk of having a heart rhythm abnormality. Either of those could lead to sudden death

It is very difficult to diagnose heart disease in the early stages. Elevated blood pressure, cholesterol, diabetes and obesity may lead to heart diseases. There may not be even a chest pain in some cases, but in most of the cases chest pain is the main symptom. Later, the pain may spread towards the left side or right side of the chest.

Often, the pain will be on the left side. Then, it may spread to the arms, neck, jaws and even the upper part of the abdomen. The left shoulder and the left arm are the mostly affected areas.

Symptoms

Dyspnoea (kashtawasa), fever (jvara), cough (kasa), thirst (trishna), bad taste (asyavairasya), discolouration (vaivarnya), syncope (moorcha), hiccup (hikka), nausea (kapha utklesa) and stupor (pramoha) are the main symptoms.

How it occurs?

Improper diet and stressful lifestyle, may lead to the thickening of the arteries (dhamani pratichaya) or hardening of the arteries (dhamani kadinya) resulting in angio-obstruction (vata dosa) and angina (ruja) are the main causes of the heart diseases.

Sage Susrutha describes the causes as follows.

“Vegakhathoshnarookhaannairathimathropasevithai

Virudhadyasayanajeernairasathmaischathibhojanai

Dooshayitwa rasam dosha viguna hrudayam gatha

Hrudi badam prakurvanthi hrdrogam tham prachakshathe”

The sloka means that suppression of natural urges, indigestion of food of hot potency, dry food, use of incompatible food, consumption of more food than required, eating of uncooked food, excessive grief, excess fear or psychological stress (pressure) will aggravate tridoshas and vitiate the rasa present in the heart and create pain in the heart. This condition is known as heart diseases or hrdroga.

Different types of heart diseases

According to the imbalance of doshas and characteristic nature of pain Ayurveda has classified heart diseases in to five.

Sage Sushruta has classified heart diseases into four - Vathaja hrdroga, pittaja hrdroga, kaphaja hrdroga and sannipatija hrdroga (tridosha). And renowned sages Charaka,Vagbhata and Madhavakara added one more type - krimija hrdroga

Vataja hrdroga

Causes

Fasting, dry food, insufficient food quantity, lack of exercise etc will aggravate vata and spread into cardiac region and produce vata-related diseases. Pain is the most important symptom in vathaja hrdroga. According to Sage Susrutha, the patient will feel pain like pricking, twisting, tearing and exploding or splitting.

Symptoms

In angina pectoris casesthe site of the pain is restrosternal (center of sternum), constricting or crushing pain radiates across the chest, both arms and shoulders (commonly on left side), then on neck, jaw, fingers and epigastric region.

Angina, or angina pectoris, is the medical term used to describe the temporary chest discomfort that occurs when the heart is not getting enough blood

When the heart does not get enough blood, it can no longer function at its full capacity. When physical exertion, strong emotions, extreme temperatures, or eating increase the demand on the heart, a person with angina feels temporary pain, pressure, fullness, or squeezing in the center of the chest or in the neck, shoulder, jaw, upper arm, or upper back. This is angina, especially if the discomfort is relieved by removing the stressor. The discomfort of angina is temporary, meaning a few seconds or minutes, not lasting hours or all day.

An episode of angina is not a heart attack. Having angina means you have an increased risk of having a heart attack.

While unstable angina occurs anytime even during rest without any precipitating factor in the myocardial infarction the chest pain is accompanied by profuse sweating, breathlessness and complaints of discomfort of heaviness.

Treatment

Normally, samana chikitsa (pacification therapy) and rarely sodhana chikitsa (elimination by cleansing) is prescribed in these cases. If the patient’s stamina or energy level is less, samana is more suitable. ‘Panchakarma’ are not advisable in heart diseases.  Even though heart is one of the main site for kapha, vamana and swedana are not recommended. Rarely ‘Ksheeravastis (enema with special mixture of milk,

Decotion, ghee, honey etc.)’ and mild ‘virechana’(purging) are performed.

The usually prescribed medicines

1. Pippalyadi churnam 1-2 gm thrice in dadima swarasa (pomegranate juice).

2. Gundi kwatha (dried ginger decoction) with little rock salt at the time pain and heart burn.

3. Panchamoola kwatha as internal, making thailam for nasya and vasti

Valiya panchamoola are the first five roots among Dasamoolam (the ten roots known as Dasamoola)

1)Vilva    -( Aegle marmelos)
2) Kashmarya    -( Gmelina arborea)
3)Takkari     -( Premna serratifolia )
4) Patala     - (Steriospermum colais )
5) Dunduka     - (Oroxylum indicum)

GENERAL MEDICINAL PROPERTIES:
Pacify vitiated tridosha, pain, arthritis, fever, cough, bronchitis, general weakness, neuropathy, nervine weakness, and urinary tract diseases and boosts immune power.
As ‘panchamoola’ has the  tridosha pacifying and immune boosting properties, it is widely used in diseased related to lungs and heart. ‘Thailam’ made by ‘panchamoolam’ decotion is used for nasya(administration of medicines through the nose-one among the panchakarma therapy) and vastis(ksheeravasti-an enema with a combination of milk, dasamoola decoction, ghee, honey etc.) Water boiled with ‘panchamoola’ with sundi(dried ginger) may be used for drinking propose which will pacify the vatha and pitha

4. Dasamoolaristam, jeerakadyaristam, vayu gulika, saptasaram kashayam, hrudyam kashayam, dasamoolam kashayam, vidaryadi kashayam, dadimathi gritham.

5. Ksheerabala (101) times and danwadaram (101) times internally and externally, danwadaram thailam, bala thailam etc. for external use over the chest.

Pithaja hrdroga

Causes

“Ushnamlalavanakhara kadukajeernabhojanai madya krodha aathapa paichasu hrudi pitham prakupyathi”

(Charaka Samhita)

The sloka means that by the intake of heat-producing food, sour, salty, alkaline and spicy food, consumption of alcohol, over exposure to sunlight etc pitha will get elevated in heart. “Trishnoshadahachosha syu pithike hrudaye klama

Doomayanam cha moorcha cha sweda sosho mukhasya cha”

(Susrutha Samhita)

Symptoms

 Thirst, burning sensation, sucking pain, exhaustion, feeling of hot fumes coming out, fainting, perspiration and dryness of mouth.

Treatments

Virechana(purgation) with Avipathi churna. Generally, pitha balancing drugs are recommended along with shitala pralepa (external application).  

Medicines 1. Decoction of dried grapes, sugarcane juice, dates mixed with honey and sugar for drinking.

2. Milk boiled with ‘madhuka’-Madhuca longifolia (Synonym Madhuca India)( with honey and sugar for drinking.  3. Extract of  ‘guluchi’ (Tinospora cordifolia)with milk. Guluchi is an effective immune-stimulant.

4. Ksheera vasti (enema) Ksheera vasti(enema) is a specific vasti(enema) with a combination of suitable decotion+milk,Suitable ghee,Thailam,honey etc. Ksheeravasti is a wonderful therapy which pacifies the pitha dosha instantly.Ksheeravasti can be administered without elaborate poorva karmas (pre treatments like internal & external oilation, sudation)

Dosage: according the ‘bala’ (vitality) of the patient

5. Drakshavaleha at bedtime, drakshadi kashayam with milk, ghee prepared with ‘pithahara’ drugs.

6. Dasamoola hareethaki lehyam

Content:dasamoola roots,Harithaki(Terminalia Chebula),Jagery,Honey,etc. As an anti-inflammatory, immunomodulator and cardiac tonic, this formula is recommended for improving the immune system, liver and spleen. As a diuretic and laxative, it is also useful for edema and obesity.

Dosage: 10-15gm twice daily preferably after food.

Kaphaja hrdroga

Causes

“Athyadanam gurusnigdha achinthanamachestanam nidrasukham chabhyathikam kapha hrdroga karanam” (Charaka Samhita)

Over-eating, eating of more oily food, lack of exercise, over-enjoyment, over-sleeping are the reasons for kaphaja hrdroga.

Symptoms

“Gowravam kaphasravo aruchi stabho agnimardhavam

Maduryamapi chasyasya valasavathathe hrudi”

(Susrutha Samhita)

Feeling of heaviness, kapha srava from mouth/nose, anorexia/dull digestive fire, stiffness of the body, sweet taste in the mouth are the main symptoms.

Treatment

If the patient’s energy level is high, then after purva karma (internal and external oilation & sudation) ,vamana (emesis) is recommended.

For Virechana: Trivrith lehya or trivrith churnam with honey may be given.

“Vacha nimba kashayabyam vantham hrudi kaphothithe

Vathahrudrogahruth churna pippalyadi cha yojayeth” (Chakraduttam)

Sage Chakradutta says that one should do emesis with the decoction of vacha (acorus calamus) or nimba (bark of neem) and then should take pipplyadi churnam indicated in vathaja hrdroga.

Other medicines

Dasamoola hareethaki lehyam, agasyarasayanam, aswagandharistam, mahadawandaram gulika etc.

Tridoshaja hrdroga

The causes of vathaja-pithaja-kaphaja hrdroga together lead to tridoshaja hrdroga.

Treatment

According to the predominance of doshas the treatment methods are prescribed.

Medicines prescribed

1. Siddha Majkaradwaja 300 mg twice daily

(Siddha Makaradwaja is a ‘Siddha’ preparation in fine powder form. It is humanized mercuric sulfide (with camphor, nutmeg and some other ingredients)

It has a Rasayana (tonic effect) on heart.)

2. Puskaramoola churna 2gm twice daily.  It reduces LDL and triglycerides.

3. Arjunaristam + amrutharistam 30ml twice daily.

It lowers the blood pressure and improves Cholesterol profile.

Krimija hrdroga

Susrutha describes the symptoms of krimija hrdroga as follows.

“Uthklesa shteevanam thodha soolo hrullasakathama

Praruchi syavanetratwam sodhascha krimijo bhaveth”

Nausea, spitting, pricking pain, colic, drowsiness, anorexia, blue color of eyes and emaciation are the main symptoms in Krimija hrdroga.

Treatment

Krimignamoushadham sarvam krimije hrudayamaye”

(Astanga hrudayam)

All the therapies and medication useful for parasitic worms(anthelmintic) are recommended in krimija hrdroga. Sodhana chikitsa (cleanising), langhana (fasting) and pachana (digestive) lines of treatment should be followed.

Medicines prescribed

1. Virechana (purgation) after giving sweets with sesamum.

2. Vidangasavam 30ml twice a day.

 Vidanga(Embelia ribes, Embelia Indica)

The nature of the herb is anthelmintic, carminative and stimulant. Good remedy for abdominal disorders and constipation. It cures the problems like gas, indigestion.

Recommended for fungus infections. This remedy also applicable for head ache, heart disease, insanity and hemorrhoids. It removes tape worms from stomach.

3. Vidanga churam mix with the cow urine may be given for drinking.

4. Pomegranate juice with rock salt.

Apart from the five types of heart diseases, Sage Susrutha describes problems like hrthsoolam(heart pain, which is same as angina),’HrdVidradhi’( inflammation ,and infection to heart), ‘Amavatha’ ( known as rheumatic heart, where the due to rheumatoid arthritis the function of the heart is also getting affected), ‘Apathatrakam’(a type of convulsion occurring due to tetanus or pre Eclampsia ( an acute and life-threatening complication of pregnancy which is characterized by the appearance of seizures before or during delivery).

Tips to keep healthy heart

1. Vegetarian, low-fat diet is good. Use less salt. Take dinner at least three hours before going to bed.

2. Avoid taking coffee as it may increase the blood pressure. Coffee, which contains caffeine, enhances the action of adrenaline and noradrenalin, which increases blood pressure. Noradrenalin or norepinephrine as a stress hormone, affects parts of the brain where responding actions are controlled. Along with adrenaline, norepinephrine also underlies the ‘fight to fight’ response directly increasing heart rate, triggering the release of glucose from energy stores.

3. Smokers tend to have high blood pressure. Nicotine increases the resting heart rate and increases the release of the adrenaline substances that tends to increase blood pressure. Smoking alone significantly increases risk of having heart attack.

4. Should take exercise daily. It will help to eliminate body fat, lower the total cholesterol and raise HDL cholesterol that prevents fatty-cholesterol deposits.

5. Be cool. Speaking loudly and rapidly can significantly raise blood pressure. Chronic anger produces elevation in blood pressure and it can be a serious risk factor for coronary heart disease.

6. Laugh, a best medicine: Laughter is as good as relaxation therapy. Study shows that laughter decreases adrenaline and cortisol production.

7. Meditation: Try to ease yourself with meditation and by performing yogic asanas like Shavasana.

Box 1: Size of the heart

It is the same size of our fist.

Kasyapa Samhitha describes about the circulatory system in detail:

"Hrudayal sampradayanthe siranam dasamathara

puna puna parnanamiva seevanya saranascha siramatha"

(Kasyapa Samhitha)

There are ten main veins which originate from the heart - upwards 4, downwards 4, transverse 2. It is branching likes the veins in the leaf to all parts of the body. The word sira (capillaries) came from the activity - saranam (spreading).

Box 2: The doshas in the heart

Vyana vayu, controls the rhythmic movements and the blood circulation

Prana vayu, gives life to the heart

Apana vayu, gives stability to the heart

Arthasadakam pitha, enhances intelligence, memory power and ego.

Avalambakam kapha, gives smoothness and strength to heart.


DANDRUFF

(IN AYURVEDA MENTIONED AS DARUNAKA)

Dandruff is the shedding of dead skin cells from the scalp at an excessive rate. It can be due to insufficient hair care. It is another kind of dermatitis (dry eczema) found in the scalp. Thin mica like scaling (exfoliation) on scratching with acute burning and itching sensation without discharge are found. Dandruff scales appears dry, white or grayish.

DARUNAKA: Susrutha says: when ground of hair becomes hard, itchy and rough with crakes it is known as ‘darunaka. The description is the same as dandruff. It is caused by the aggravation of doshas(bio-energies) pitha and kapha.

Usually dandruff is seasonal. During the winter it will be severe and less in summer. Scaling can occur anywhere- on the scalp, in the hair, on the eye brows, the bread and can be even spread to the neck and shoulders.

Mild dandruff can be caused by the over action of sebaceous gland (oil glands).

 

SEBACEOUS GLANDS:

Sebaceous glands produce sebum, which is composed of fatty acids. The oily substances give moisture and shine to the hair and also protect the hair from drying. While sebum is produced in excess, the hair will be oilier, greasy, darker and may be sticky.

But in severe cases it can be due to pityrosforum-ovle micro organisms or fungus malasezia. These organisms are present in everybody’s scalp. Symptoms generally aggravated when we expose to dust, chemical based shampoo and winter.

There is a misconception that dandruff is caused by the dryness of the hair. So dandruff is also called dry scalp. Using shampoo to dry the hair will increase the problem. Dandruff will be more to the people those having oily skin and hair.

Dandruff is a natural process. Scaling is a part of our metabolic activities which we won’t notice with our naked eyes. On an average the scap skin replaces itself about every 28days. If ternover speeds up to every 11 days, the net result is obvious dandruff. So it can’t be eliminated, only be managed or controlled. When it is associated with sebarhoeic dermatitis, if not treated can lead to ailments like eczema. Excess scaling can be a symptoms associated with psoriasis. Dandruff if not treated result in skin lesions, hair damage and even baldness.

TYPES OF DANDRUFF:

Depending on the severity, symptoms and area of spreading, dandruff can be classified in to three, common dandruff or pityriasis –capitis, seborrhea dermatitis and psoriatic dandruff.

1. pityriasis-capitis: Also known as common dandruff. The very common dandruff with dry flakes falling from the scalp. Pityrosporum yeasts which are normal in habited in the skin are making this problem. Only seen in scalp. In ayurveda, dandruff with the same symptoms is described as ‘darunaka’ by susrutha.

2. Sebarhoeic Dermatitis: If the scalp is very greasy, oily, scaly, wheeling, yellow or mild red in color. It is known as seborrhea dermatitis. It can be seen in scalp, face, forehead, eyebrows, eyelashes, eye lids are rarely even in the neck.

Susrutha says: small ulcer with many openings manifested on the skin of the scalp with kapha-raktha irigin is known as –‘arumshika’.

3. Psoriasis: itchy thicker scales, silvery scales, which can also occur in the knee, lower back. It is an auto immune disease. Kapha origin and need special care with panchakarma therapies like vamana and treatments like thakra dhara.

TREATMENT:

Hair care is the main remedy for dandruff. Regular use of anti fungal and anti microbial medicated oils and shampoo will reduce dandruff. Always use clean combs and towels individually. Don’t share the combs and bathing towels, it can spread the dandruff to other peoples.

In psoriatic dandruff cases, since it is an auto immune disease, we need internal cleansing medicines, treatments like thakra dhara and panchakarma like ‘vamama’. External medicated oil like’dismagna thailam’ has to be used.

1. Gel taken from the aloevera leaves may be applied over night and washed next day morning.

2. Daily head bath, wash the scalp thoroughly after wash and dry the hair.

3. Keep your hair well oiled

4. Use special medicated hairoil for scalp massage like dhurdhhorapatradi coconut oil or Pamanthaka thailam

5. Use antidandruff shampoo or shampoo with shikakai (fruit of soap pod tree) or hibiscus leaves.

6. Dandruff will increase with stress and anxiety, so practice pranayama and yoga.

7. Boil neem leaves in water and use this water to rinse hair.

8. Siro lepas (hair packs):  make a paste of leaves of neem (azadirachta indica) and apply over the scalp for 2 hours for 7 days.

Make a paste of tusli leaves and amla powder mixed with water and apply over the scalp for two hours daily for 7 days.

9.. Internal medicines: punarnavasam 25ml twice daily after food.

     Triphala churnam- 5gm at bed time with warm water.

FEW MORE HOME REMEDIES:

1. Rub lemon juice mixed with cosmetic vinegar (1:2 ratios) in to the scalp. Then gently massage the scalp. After 30mts wash the hair with egg shampoo.

2. Boil 5 teaspoons of dried and used tealeaves in lime water. After anti dandruff shampoo, use this lotion to the scalp for rinsing. It will also help for the shining of the hair.

3. In the severe case wash the hair daily with neem decoction for 14 days.

DHURDHOORA PATRADI COCONUT OIL:

How to prepare: The oil is prepared in coconut oil and coconut milk with juices of dhurdhoora patra(dhatura stramonium), dhorva(desmodium gangeticum), guluchi(tinospera cordifolia) and kimsuka(butea monosperora).

How to use: apply the dhurdhoora patradi coconut oil over the scalp and hair and gently massage for 15 mts-30mts. Then shower with herbal shampoo

PAMANTHAKA THAILAM: in severe dandruff pamanthakal thailam will be more useful.

How to prepare;This oil is prepared in coconut oil with brahmi(bacopa monniera) and curry leaves(murraya koenigii).

Usage: apply over the scalp for 20-30mts and gently massage. Then shower using  herbal shampoo

DIET:

Avoid spicy and oily food.

It is better to be vegetarian. While taking non-veg. food the symptoms are aggravated.

Add more vegetables and fruits. Fibrous food will regularize the bowels.

Avoid strong tea, coffee , curd , ice creams and cooled and aerated drinks.

Use butter milk. Drink at least two liters of water/a day.

ABOUT THE SHAMPOO:

Generally shampoo is used for the removal of oil, dirt, dandruff and other contaminated particles from the hair. Now there are anti dandruff shampoos available in the markets. The advertisements and unwanted claims always confuse the customers.

Contents of the shampoo:

Normal shampoos contain chemicals like surfactants. (Sodium lureth sulfate or sodium lauryl sulfate. It also contains sodium chloride (salt) which is used to adjust viscosity. Shampoo also has fragrance and preservative. Recently they are adding vitamin-E and Proteins (amino-acids) which they claim to strengthen the hair and reduce the hair lose.Scientifically there are no evidence for this claim. Proteins are unable to penetrate to the skin or hair. Vitamin E will give only temporary cosmetic effect.

Sodium laurite commonly known as SLS is very dangerous and can lead to skin damage, dryness, permanent eye damage in children.

Antidandruff shampoo: anti dandruff generally contain anti fungicides like ketoconazole and zinc pyrithine. But these are comparatively safe with chemical shampoo.

Herbal shampoo if not contain the chemicals are more safe and effective. Herbal shampoo which contains soap nuts with dried gooseberry and hibiscus leaves are very effective and safe.