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===Importance of [[agni]], ama===
 
===Importance of [[agni]], ama===
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[[File:Fig_8-_Importance_of_amapachana_in__vitiligo.jpg|500px|'''Fig 8: Importance of amapachanain  vitiligo'''|thumb]]
    
The assessment of [[agni]] (digestion and metabolism) and ama (accumulated undigested biological waste in the digestive tract) is vital for treating a skin disorder. The importance of treating [[ama]] is shown in figure 7. The [[ama]] aggravates by the treatment for vitiligo without amapachana (digestion of [[ama]]). When [[ama]] is treated, the vitiligo also decreases. So if [[ama]] is present, treatment to remove it should be given at the beginning.
 
The assessment of [[agni]] (digestion and metabolism) and ama (accumulated undigested biological waste in the digestive tract) is vital for treating a skin disorder. The importance of treating [[ama]] is shown in figure 7. The [[ama]] aggravates by the treatment for vitiligo without amapachana (digestion of [[ama]]). When [[ama]] is treated, the vitiligo also decreases. So if [[ama]] is present, treatment to remove it should be given at the beginning.
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Fig 8: Importance of amapachanain  vitiligo
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Integrative therapies should not compromise biomedical pathology, neither the principles of Ayurveda.  Table 9 shows that mutual dialogue between the systems of medicine leads to the integrated treatment protocol
 
Integrative therapies should not compromise biomedical pathology, neither the principles of Ayurveda.  Table 9 shows that mutual dialogue between the systems of medicine leads to the integrated treatment protocol
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The rotating ankle movements as a Yoga exercise (Gulphachakrasana) are practised for lymphoedema patients. An increase in radioisotope clearance from lymphatics of lower limbs with even small-amplitude ankle movements is reported by Prof Peter Mortimer.<ref>Mortimer PS, Simmons R, Rezvani M. The measurement of skin lymph flow by isotope clearance –reliability, reproducibility, injection dynamics and the effect of massage. J Invest Dermatol 1990; 95: 677–682.</ref>  Yoga and asana bring mobility,joint and muscle pump activation and dermal stretch. It is hypothesized that Yoga may induce drainage of lymph.<ref>Narahari SR, Ryan TJ, Aggithaya MG. How Does Yoga Work in Lymphedema? J Yoga Phys Ther 2013; 3:135. doi: 10.4172/2157-7595.1000135</ref>   
 
The rotating ankle movements as a Yoga exercise (Gulphachakrasana) are practised for lymphoedema patients. An increase in radioisotope clearance from lymphatics of lower limbs with even small-amplitude ankle movements is reported by Prof Peter Mortimer.<ref>Mortimer PS, Simmons R, Rezvani M. The measurement of skin lymph flow by isotope clearance –reliability, reproducibility, injection dynamics and the effect of massage. J Invest Dermatol 1990; 95: 677–682.</ref>  Yoga and asana bring mobility,joint and muscle pump activation and dermal stretch. It is hypothesized that Yoga may induce drainage of lymph.<ref>Narahari SR, Ryan TJ, Aggithaya MG. How Does Yoga Work in Lymphedema? J Yoga Phys Ther 2013; 3:135. doi: 10.4172/2157-7595.1000135</ref>   
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The above approach to chronic disease care leads to better treatment not provided by a single system alone. Figure 9 below shows the response of Lymphatic Filariasis (lymphoedema) following integrative medicine treatment. A clinic to lab research-based developed from such studies might provide new treatments for chronic disease.<ref>Karayi AK, Basavaraj V, Narahari SR, Aggithaya MG, Ryan TJ, Pilankatta R. Human skin fibrosis: up-regulation of collagen type III gene transcription in the fibrotic skin nodules of lower limb lymphoedema. Trop Med Int Health. 2020;25:319-327. doi:10.1111/tmi.13359</ref>
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[[File:Fig_9-The_patient_arrived_for_treatment.jpg|500px|'''Fig 9: The patient arrived for treatment on June 2 2017 (left), and returned for follow up on January 21 2018 (right)'''|thumb]]
 
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The above approach to chronic disease care leads to better treatment not provided by a single system alone. Figure 9 below shows the response of Lymphatic Filariasis (lymphoedema) following integrative medicine treatment. A clinic to lab research-based developed from such studies might provide new treatments for chronic disease.<ref>Karayi AK, Basavaraj V, Narahari SR, Aggithaya MG, Ryan TJ, Pilankatta R. Human skin fibrosis: up-regulation of collagen type III gene transcription in the fibrotic skin nodules of lower limb lymphoedema. Trop Med Int Health. 2020;25:319-327. doi:10.1111/tmi.13359</ref>
Fig 9: The patient arrived for treatment on June 2 2017 (left), and returned for follow up on January 21 2018 (right).
      
==Conclusion==
 
==Conclusion==
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