Changes

=== ''Vidhi Vimarsha'' ===

=== ''Vidhi Vimarsha'' ===

 

In contemporary medical system, the curable and incurable signs and symptoms of diseases are well understood but the criteria for deciding the prognosis are different than [https://en.wikipedia.org/wiki/Ayurveda Ayurveda]. There is availability of advanced technology in the form of imaging, biochemical, immunological, molecular and genetic studies etc. for diagnosis and assessment of prognostic factors of diseases.

In contemporary medical system, the curable and incurable signs and symptoms of diseases are well understood but the criteria for deciding the prognosis are different than [https://en.wikipedia.org/wiki/Ayurveda Ayurveda]. There is availability of advanced technology in the form of imaging, biochemical, immunological, molecular and genetic studies etc. for diagnosis and assessment of prognostic factors of diseases.

Inspite of such sophisticated tools, prognostic criteria are limited to diseases only. Overdependence on these studies has caused enormous increase in the cost of medical care. On the other hand, assessment of prognostic criteria of [https://en.wikipedia.org/wiki/Ayurveda Ayurveda] based on understanding ''prakriti'' (body type) with ''dosha, dhatu, mala, agni,'' and ''indriya'' are for both health and disease. These are entirely clinical and fairly accurate depending upon the clinical acumen of Ayurvedic physician. The concept of personalized medicine known to modern medicine is very limited at this time and is helpful in certain cancers and genetic diseases only. In future, it will be helpful to use a combination of prognostic criteria of both systems to provide better care at less expense.

Inspite of such sophisticated tools, prognostic criteria are limited to diseases only. Overdependence on these studies has caused enormous increase in the cost of medical care. On the other hand, assessment of prognostic criteria of [https://en.wikipedia.org/wiki/Ayurveda Ayurveda] based on understanding ''prakriti'' (body type) with ''dosha, dhatu, mala, agni,'' and ''indriya'' are for both health and disease. These are entirely clinical and fairly accurate depending upon the clinical acumen of Ayurvedic physician. The concept of personalized medicine known to modern medicine is very limited at this time and is helpful in certain cancers and genetic diseases only. In future, it will be helpful to use a combination of prognostic criteria of both systems to provide better care at less expense.

[https://en.wikipedia.org/wiki/Ayurveda Ayurveda] holds the view that some diseases are incurable right from the beginning and also provides the details of the factors that cause such diseases. Therefore, it is irrational to apply therapeutic measures for such diseases. However, research shows that incurable diseases such as  type-1 Diabetes mellitus or ''Vataja prameha'' can become less severe with treatment factoring in all prognosis outcomes. Type-1 diabetes meets all the criteria described above for incurability, like vitiation of all three ''doshas'', affliction of ten ''dushyas'' with the nature of involved ''dosha'' and ''dushya'' are same (''kapha dosha'' and ''meda dushya'') along with ''prakriti'' compatibility of patient (predominance in ''kaphaja prakriti'', like in an obese patient). Again due to genetic predisposition, ''kapha'' loses its natural characteristics, becoming liquefied and  losing its usual properties. There is vitiation of ''vata dosha'' due to depletion of all ''dhatus'', especially ''oja'' (the ultimate resultant of all seven ''dhatu'' metabolism). The pathogenesis of the disease starts with the admixture of vitiated ''kapha'' and ''meda'' and progression successively to involve other ''dhatus'' like ''mamsa, kleda'' etc. The ''dhatus'' are depleted so quickly that the body is unable to replenish it, ultimately leading to death. Thus, Diabetes Mellitus, is not merely a disease but a syndrome, proves to be fatal due to many complications like diabetic neuropathy, nephropathy, microangiopathy, cardiomyopathy, retinopathy, skin complications, as well as emergency crises such as hypoglycemic shock and diabetic ketoacidosis. There is successive involvement of all body tissues involving connective tissues, nerve tissues, muscle tissue etc, leading to severe depletion of insulin due to autoimmune degeneration of beta pancreatic cells. Genetic abnormalities cause impaired glucose, lipid and protein metabolism. Type-1 diabetes mellitus is an autoimmune disorder and destruction of body tissues by autoantibody is very fast causing loss of immune- intolerance and immune-component (''oja'') thus impairing body defense mechanism. There is disturbance in production and clearance of lipoprotein causing hampered functioning of insulin resulting in hyperglycemia and producing microvascular complications like retinopathy and nephropathy. However, for macrovascular complications, including neuropathy, pathogenesis starts before the onset of diabetes i.e. at the stage of lipid abnormalities. These factors make Type 1 Diabetes mellitus difficult to treat. The treatment consists of life-long insulin replacement by exogenous insulin. This is an example of an incurable disease although there is a lot of research work going on to find an effective remedy for this ailment. Recent research has shown some herbs have effect on beta pancreatic cells to induce endogenous insulin production. ''Meshashringi'' (Gymnema Sylvester (Retz.) R.Br.; Gurmar) [4-7], ''Kutaki'' (Picrorrhiza kurroa)[8],''Kiratatikta'' (Swertia chirata (Roxb.) Buch.-Hum [9-12], ''Mamejjaka'' (Enicostema littorale Blume) [13-14] and Pterocarpus marsupium [15-18] have proven to reduce blood glucose levels by modifying the prognostic factors of type 1 diabetes in experimental animals. Thus yearly detection and treatment of an incurable disorder like diabetes mellitus, by means of addressing prognostic factors at an early stage of disease, may prevent the progression of the ailment further into becoming incurable.  

[https://en.wikipedia.org/wiki/Ayurveda Ayurveda] holds the view that some diseases are incurable right from the beginning and also provides the details of the factors that cause such diseases. Therefore, it is irrational to apply therapeutic measures for such diseases. However, research shows that incurable diseases such as  type-1 Diabetes mellitus or ''Vataja prameha'' can become less severe with treatment factoring in all prognosis outcomes. Type-1 diabetes meets all the criteria described above for incurability, like vitiation of all three ''doshas'', affliction of ten ''dushyas'' with the nature of involved ''dosha'' and ''dushya'' are same (''kapha dosha'' and ''meda dushya'') along with ''prakriti'' compatibility of patient (predominance in ''kaphaja prakriti'', like in an obese patient). Again due to genetic predisposition, ''kapha'' loses its natural characteristics, becoming liquefied and  losing its usual properties. There is vitiation of ''vata dosha'' due to depletion of all ''dhatus'', especially ''oja'' (the ultimate resultant of all seven ''dhatu'' metabolism). The pathogenesis of the disease starts with the admixture of vitiated ''kapha'' and ''meda'' and progression successively to involve other ''dhatus'' like ''mamsa, kleda'' etc. The ''dhatus'' are depleted so quickly that the body is unable to replenish it, ultimately leading to death. Thus, Diabetes Mellitus, is not merely a disease but a syndrome, proves to be fatal due to many complications like diabetic neuropathy, nephropathy, microangiopathy, cardiomyopathy, retinopathy, skin complications, as well as emergency crises such as hypoglycemic shock and diabetic ketoacidosis. There is successive involvement of all body tissues involving connective tissues, nerve tissues, muscle tissue etc, leading to severe depletion of insulin due to autoimmune degeneration of beta pancreatic cells. Genetic abnormalities cause impaired glucose, lipid and protein metabolism. Type-1 diabetes mellitus is an autoimmune disorder and destruction of body tissues by autoantibody is very fast causing loss of immune- intolerance and immune-component (''oja'') thus impairing body defense mechanism. There is disturbance in production and clearance of lipoprotein causing hampered functioning of insulin resulting in hyperglycemia and producing microvascular complications like retinopathy and nephropathy. However, for macrovascular complications, including neuropathy, pathogenesis starts before the onset of diabetes i.e. at the stage of lipid abnormalities. These factors make Type 1 Diabetes mellitus difficult to treat. The treatment consists of life-long insulin replacement by exogenous insulin. This is an example of an incurable disease although there is a lot of research work going on to find an effective remedy for this ailment. Recent research has shown some herbs have effect on beta pancreatic cells to induce endogenous insulin production. ''Meshashringi'' (Gymnema Sylvester (Retz.) R.Br.; Gurmar) [4-7], ''Kutaki'' (Picrorrhiza kurroa)[8],''Kiratatikta'' (Swertia chirata (Roxb.) Buch.-Hum [9-12], ''Mamejjaka'' (Enicostema littorale Blume) [13-14] and Pterocarpus marsupium [15-18] have proven to reduce blood glucose levels by modifying the prognostic factors of type 1 diabetes in experimental animals. Thus yearly detection and treatment of an incurable disorder like diabetes mellitus, by means of addressing prognostic factors at an early stage of disease, may prevent the progression of the ailment further into becoming incurable.  

This chapter has emphasized the importance of understanding the prognosis of diseases and the factors causing them. Recent research in the field of [https://en.wikipedia.org/wiki/Ayurveda Ayurveda] has shown that incurable diseases can be controlled by addressing the prognostic factors and there is a need for both [https://en.wikipedia.org/wiki/Ayurveda Ayurveda] and Modern medicine researchers to work together.

This chapter has emphasized the importance of understanding the prognosis of diseases and the factors causing them. Recent research in the field of [https://en.wikipedia.org/wiki/Ayurveda Ayurveda] has shown that incurable diseases can be controlled by addressing the prognostic factors and there is a need for both [https://en.wikipedia.org/wiki/Ayurveda Ayurveda] and Modern medicine researchers to work together.

=== Future Scope for Research ===

=== Future Scope for Research ===