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{{#seo:Emergency medicine in Ayurveda

{{#seo:Emergency medicine in Ayurveda

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|keywords= Principles, diagnosis,management, medical emergencies, life-threatening condition, medical system healthcare, symbiohealth, charak samhita, caraka samhita, Indian system of medicine, alternative medicine, complementary medicine

|keywords= Principles, diagnosis, management, medical emergencies, life-threatening condition, medical system healthcare, symbiohealth, charak samhita, caraka samhita, Indian system of medicine, alternative medicine, complementary medicine, Upendra Dixit, atyayika chikitsa, 

|description= Principles of diagnosis and management of medical emergencies in Ayurveda are described.   

|description= Principles of diagnosis and management of medical emergencies in Ayurveda are described.   

|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg

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|data6 = carakasamhita@gmail.com

|data6 = carakasamhita@gmail.com

|label7 = Date of first publication:

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|data7 = December 10, 2021

|data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India

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|label8 = Date of first publication:

|data8 = Under process

 

|label9 = DOI

|data9 = 10.47468/CSNE.2021.e01.s09.076

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}}

==References of emergency conditions in Ayurveda texts==

==References of emergency conditions in Ayurveda texts==

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The word ‘atyaya’ is used to denote destruction or death. [Chakrapani Cha.Sa. [[Sharira Sthana]] 1/50] [Dlahana Su. Sha.10/19-20]. The word ‘atyayika’ denotes the quickest possible treatment done to protect life without any delay. [Dallhana Su.Sa. Sharira Sthana. 8/5] [Hemadri A.Hr.Sutra Sthana 2/33] Therefore, the medicines to be used in medical emergencies shall be ready with the physician for first aid emergency treatment, even if the patient is to be referred to higher critical care centers.  

The word ‘atyaya’ is used to denote destruction or death. [Chakrapani, Cha.Sa. [[Sharira Sthana]] 1/50] [Dlahana, Su.Da. Sharira Sthana 10/19-20].<ref name=SU>Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.</ref> The word ‘atyayika’ denotes the quickest possible treatment done to protect life without any delay. [Dallhana, Su.Sa. Sharira Sthana. 8/5]<ref name=SU /> [Hemadri A.Hr.Sutra Sthana 2/33]<ref name=AH /> Therefore, the medicines to be used in medical emergencies shall be ready with the physician for first aid emergency treatment, even if the patient is to be referred to higher critical care centers.  

The word niratyaya explains how diet, various activities, and treatments can be performed in such a safe way that complications leading to severe consequences and emergencies can be prevented.   

The word niratyaya explains how diet, various activities, and treatments can be performed in such a safe way that complications leading to severe consequences and emergencies can be prevented.   

From all textual references, it can be understood that certain factors cause most emergencies. They are as below:

From all textual references, it can be understood that certain factors cause most emergencies. They are as below:

*Marma (vital organs)

*[[Marma|Marma (vital organs)]]

*[[Rakta]] (blood)

*[[Rakta]] (blood)

==Concept of prana in [[Ayurveda]]==

==Concept of prana in [[Ayurveda]]==

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The term prana is used for the vitality of life or life force. It is essential to understand the concept of prana and its importance in life-threatening emergency conditions.There are twelve sites of vitality (prana).  Ayurvedic texts use the word ‘Prana’ as a synonym for certain body constituents. Prana is also used as a prefix to the names of certain body constituents.This indicates these body constituents are most vital, for saving a life. [[Agni]], Soma, Vayu, Sattva, Rajas, Tamas, [[Atma]] and [[Pancha mahabhuta]].[Su.Sa.Sharira Sthana 4/3]  

The term prana is used for the vitality of life or life force. It is essential to understand the concept of prana and its importance in life-threatening emergency conditions.There are twelve sites of vitality (prana).  Ayurvedic texts use the word ‘Prana’ as a synonym for certain body constituents. Prana is also used as a prefix to the names of certain body constituents.This indicates these body constituents are most vital, for saving a life. [[Agni]], Soma, Vayu, Sattva, Rajas, Tamas, [[Atma]] and [[Pancha mahabhuta]].[Su.Sa.Sharira Sthana 4/3]<ref name=SU />

   

   

The two temples, the three vital organs, the throat, rakta dhatu (blood), shukra dhatu (reproductive tissue), oja (the vital essence), and the anus are ten sites of life forces (prana).[Cha.Sa.[[Sutra Sthana]] 29/3]

The two temples, the three vital organs, the throat, rakta dhatu (blood), shukra dhatu (reproductive tissue), oja (the vital essence), and the anus are ten sites of life forces (prana).[Cha.Sa.[[Sutra Sthana]] 29/3]

Prana vayu is one of the five types of [[Vata dosha]][Cha.Sa. [[Chikitsa  Sthana]]28/234].Food (anna)[Cha.Sa.[[Chikitsa Sthana]].24.60], water (udaka)[A.S.Sutra Sthana.6.11], and strength or immunity (balam) are factors influencing vitality[Dalhana on Su.Sa.Sutra Sthana 17/13].  

Prana vayu is one of the five types of [[Vata dosha]][Cha.Sa. [[Chikitsa  Sthana]] 28/234].Food (anna)[Cha.Sa.[[Chikitsa Sthana]]24/60], water (udaka)[A.S.Sutra Sthana.6.11]<ref name=AS>Vridha Vagbhata, Ashtanga Sangraha. Edited by Shivaprasad Sharma. 3rd ed. Varanasi: Chaukhamba sanskrit series office;2012.</REF> and strength or immunity (balam) are factors influencing vitality[Dalhana, on Su.Sa.Sutra Sthana 17/13].<ref name=SU />

The vitality from external sources or nature (bahya prana) and internal vitality (abhyantara prana) sustain human life. The vitality from external sources or nature is converted into internal vitality through channels of transportation and transformation of vitality (pranavaha srotasa) [Su.Sa.Sutra Sthana 17/13]. The vitality especially depends on blood tissue (rakta)[Cha.Sa.[[Sutra Sthana]] 24/4], essence ([[oja]]) (Chakrapani on Cha.Sa.[[Sutra Sthana]]28/4], digestion, and metabolism ([[agni]])[Cha.Sa.[[Chikitsa Sthana]]15/3,4]. It is presented through sensory and motor organs (indriya)[Cha.Sa.[[Sutra Sthana]]1/48].  

The vitality from external sources or nature (bahya prana) and internal vitality (abhyantara prana) sustain human life. The vitality from external sources or nature is converted into internal vitality through channels of transportation and transformation of vitality (pranavaha srotasa) [Su.Sa.Sutra Sthana 17/13].<ref name=SU/> The vitality especially depends on blood tissue (rakta)[Cha.Sa.[[Sutra Sthana]] 24/4], essence ([[oja]]) (Chakrapani on Cha.Sa.[[Sutra Sthana]]28/4], digestion, and metabolism ([[agni]])[Cha.Sa.[[Chikitsa Sthana]]15/3,4]. It is presented through sensory and motor organs (indriya)[Cha.Sa.[[Sutra Sthana]]1/48].  

Injury to the umbilicus (nabhi)[Su. Sa.Sharira Sthana 7/5], channels carrying nutrient fluid (rasavaha srotasa)[Su. Sa.Sharira Sthana 9/12], blood vessels (sira) can lead to sudden death(Dalhana on Su.Sa.Sharira Sthana 7/5].  

Injury to the umbilicus (nabhi)[Su. Sa.Sharira Sthana 7/5]<ref name=SU /> , channels carrying nutrient fluid (rasavaha srotasa)[Su. Sa.Sharira Sthana 9/12]<ref name=SU/>, blood vessels (sira) can lead to sudden death(Dalhana on Su.Sa.Sharira Sthana 7/5].<ref name=SU/>

Commonly observed clinical features in an emergency:  

Commonly observed clinical features in an emergency:  

* Acute organ failure  

* Acute organ failure  

* Clinical features of the affliction of vital organs can cause death within seven days (sadya pranahara marma) like loss of perception, sudden vomiting, excess perspiration, a sudden feeling of heaviness [A.Sa.Sharira Sthana 7/47]

* Clinical features of the affliction of vital organs can cause death within seven days (sadya pranahara marma) like loss of perception, sudden vomiting, excess perspiration, a sudden feeling of heaviness [A.Sa.Sharira Sthana 7/47]<ref name=AS/>

The clinical features of near-death patients are described in chapters of [[Indriya Sthana]].

The clinical features of near-death patients are described in chapters of [[Indriya Sthana]].

* Dehydration status – can be understood from the clinical features of affection of channels of transportation and transformation of udaka (udakavaha srotasa). [Cha.Sa.[[Vimana Sthana]] 5/8]

* Dehydration status – can be understood from the clinical features of affection of channels of transportation and transformation of udaka (udakavaha srotasa). [Cha.Sa.[[Vimana Sthana]] 5/8]

* Consequences of excessive emesis and purgation  (atiyoga of vamana and virechana) are described showing emergency conditions. Effects ranging from mild degrees like dryness in the throat to severe effects like dilatation of pupil as precursor to death are described. [A.Sa.Sutra Sthana 27/20]

* Consequences of excessive emesis and purgation  (atiyoga of vamana and virechana) are described showing emergency conditions. Effects ranging from mild degrees like dryness in the throat to severe effects like dilatation of pupil as precursor to death are described. [A.Sa.Sutra Sthana 27/20]<ref name=AS />

* Status of consciousness and orientation

* Status of consciousness and orientation

==Consequences of the affliction of marma ==  

==Consequences of the affliction of [[Marma|marma]] ==  

Injury to different vital structures (marma) can have various consequences. Certain marma called 'sadyopranahara marma’  can lead to death instantaneously or within a week. General signs and symptoms can guide about injury to marma, and accordingly the patient can be cared for. The clinical features are numbness of the body (deha supti), heaviness, confusional state,  desire of cold things, excess perspiration, syncope, vomiting, dyspnoea, [A. Sa. Sharira sthana 7/47]

Injury to different vital structures ([[Marma|marma]]) can have various consequences. Certain [[Marma|marma]] called 'sadyopranahara marma’  can lead to death instantaneously or within a week. General signs and symptoms can guide about injury to [[Marma|marma]], and accordingly the patient can be cared for. The clinical features are numbness of the body (deha supti), heaviness, confusional state,  desire of cold things, excess perspiration, syncope, vomiting, dyspnoea, [A. Sa. Sharira sthana 7/47]<ref name=AS/>

Injury to marma causes vasodilatation and profuse bleeding. This may lead to death. [A.Hr.Sharira Sthana 4/65]

Injury to [[Marma|marma]] causes vasodilatation and profuse bleeding. This may lead to death. [A.Hr.Sharira Sthana 4/65]<ref name= AH/>

==Clinical assessment - Nadi (pulse examination)==

==Clinical assessment - Nadi (pulse examination)==

==Medical ethics in critical conditions==

==Medical ethics in critical conditions==

   

   

The patient on the death bed may not survive due to his predestined life span. However, the physician shall treat the patient till the last breath with a hope of life. Proper consent shall be taken from the close relatives of the patient after informing them of details about the critical condition. [A.Sa.Sha.7/75]  

The patient on the death bed may not survive due to his predestined life span. However, the physician shall treat the patient till the last breath with a hope of life. Proper consent shall be taken from the close relatives of the patient after informing them of details about the critical condition. [A.Sa.Sharira Sthana 7/75] <ref name=AS />

==Management of emergency conditions==

==Management of emergency conditions==

The principles of management of emergency conditions include:  

The principles of management of emergency conditions include:  

* Protecting prana and marma (vital organs and structures) especially heart, brain, and urinary system  

* Protecting prana and [[Marma|marma]] (vital organs and structures) especially heart, brain, and urinary system  

* Use of antidotes or medicines used in poisoning (agada)

* Use of antidotes or medicines used in poisoning (agada)

==Importance of food==  

==Importance of food==  

Food plays an essential role in maintaining vitality in critical conditions. If the food is not given as per the digestive capacity ([[agni]]) of the patient, then it leads to the formation of toxic metabolites ([[ama]]). This further blocks the channels of transportation of nutrients ([[srotasa]]) and worsens the condition. Therefore, easy-to-digest food like green gram soup (mudga yusha) is advisable to be given in critical cases. The wholesome food that is suitable to the patient and helpful in treating underlying disease conditions is advised.

Food plays an essential role in maintaining vitality in critical conditions. If the food is not given as per the digestive capacity ([[agni]]) of the patient, then it leads to the formation of toxic metabolites ([[ama]]). This further blocks the channels of transportation of nutrients ([[srotas]]) and worsens the condition. Therefore, easy-to-digest food like green gram soup (mudga yusha) is advisable to be given in critical cases. The wholesome food that is suitable to the patient and helpful in treating underlying disease conditions is advised.

==Experience-based evidence ==  

==Experience-based evidence ==  

There is a wide scope of research on the role of Ayurveda medicines in the treatment of critical and medical emergency conditions. It can be helpful to provide a safe, cost-effective, and better solution to extend life with a higher survival chance.

There is a wide scope of research on the role of Ayurveda medicines in the treatment of critical and medical emergency conditions. It can be helpful to provide a safe, cost-effective, and better solution to extend life with a higher survival chance.

==References==

==References==