Changes

The chapter deals with importance of ''dehabala'' (physical strength) and ''sattvabala'' (psychological strength) in assessing the severity and prognosis of diseases. If a physician masters the art of assessing properly the physical and psychological strength, he never fails in proper prognosis and management of patients.

The chapter deals with importance of ''dehabala'' (physical strength) and ''sattvabala'' (psychological strength) in assessing the severity and prognosis of diseases. If a physician masters the art of assessing properly the physical and psychological strength, he never fails in proper prognosis and management of patients.

*Parasitology and Bacteriolgy in Ayurveda –Oldest recording of classification and  treatment of ''krimi'' (parasites and microbes) is found in [[Charak Samhita]]. It is obvious that they had knowledge of parasites and invisible microorganisms and their role in pathogenesis and symbiosis. Details of ''krimis'' is described under seven subheadings i.e., aetiology, nomenclature, site, morphology, colour, pathogenesis and treatment, in the text total number of ''krimi'' is mentioned as twenty.

*Parasitology and Bacteriolgy in [[Ayurveda]] –Oldest recording of classification and  treatment of ''krimi'' (parasites and microbes) is found in [[Charak Samhita]]. It is obvious that they had knowledge of parasites and invisible microorganisms and their role in pathogenesis and symbiosis. Details of ''krimis'' is described under seven subheadings i.e., aetiology, nomenclature, site, morphology, colour, pathogenesis and treatment, in the text total number of ''krimi'' is mentioned as twenty.

*Classification – The ''krimis'' are classified as external and internal. Internal type has been further classified under three subtypes i.e. ''raktaja'' (originating in blood), ''shleshmika'' (originating due to ''kapha'' predominant factors), and ''purishaja'' (originating in feces).

*Classification – The ''krimis'' are classified as external and internal. Internal type has been further classified under three subtypes i.e. ''raktaja'' (originating in blood), ''shleshmika'' (originating due to ''kapha'' predominant factors), and ''purishaja'' (originating in feces).

*Pathogenesis – ''Raktaja krimi'' are invisible and produce the symptomatology like ''kushtha'' hence they are to be treated like the disease ''kushtha''. However, The ''shleshmika'' and ''purishaja'' variety has more academic importance than therapeutic as their etiological factor and treatment are the same but the presenting symptomatology is different.

*Pathogenesis – ''Raktaja krimi'' are invisible and produce the symptomatology like ''kushtha'' hence they are to be treated like the disease ''kushtha''. However, The ''shleshmika'' and ''purishaja'' variety has more academic importance than therapeutic as their etiological factor and treatment are the same but the presenting symptomatology is different.

*Treatment - In this section the management principle has been described which is unique and applicable to the management of most diseases. Treatment is described predominantly for intestinal parasites. Long list of plants is mentioned for the treatment of parasites and their expulsion from the body. Per the advancement in technology and pharmaceuticals, the parasites and micro-organisms are studied in detail in modern medicine. Specific ante-helminthics and anti-microbial drugs with good clinical efficacy are available. The description of  methods of removal of parasites in Ayurveda seems to be inconvenient in today’s era, where convenient therapeutic modalities are developed by modern science. The ayurvedic drugs also need to be used in larger doses. Modern medicine drugs, for removal of common parasites are effective with convenient dosage schedule. However, these drugs are potentially toxic and are to be used with careful watch of physician.

*Treatment - In this section the management principle has been described which is unique and applicable to the management of most diseases. Treatment is described predominantly for intestinal parasites. Long list of plants is mentioned for the treatment of parasites and their expulsion from the body. Per the advancement in technology and pharmaceuticals, the parasites and micro-organisms are studied in detail in modern medicine. Specific ante-helminthics and anti-microbial drugs with good clinical efficacy are available. The description of  methods of removal of parasites in [[Ayurveda]] seems to be inconvenient in today’s era, where convenient therapeutic modalities are developed by modern science. The ayurvedic drugs also need to be used in larger doses. Modern medicine drugs, for removal of common parasites are effective with convenient dosage schedule. However, these drugs are potentially toxic and are to be used with careful watch of physician.

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==== Part B: ''Krimi'' (parasitology) ====

==== Part B: ''Krimi'' (parasitology) ====

Ayurveda describes two kinds of organisms, namely ''prakrita'' (non-pathogenic), and ''vaikrita'' (pathogenic). Also described are two categories of pathogens/parasites, namely, external and internal. The internal organisms are mainly of three categories in terms of their natural environments: those that thrive on mucus (''shleshma''), those thriving in fecal matter, and those thriving in blood. Some of these, particularly the ones thriving in fecal matter seem to be intestinal parasites while others simulate microbes. The texts repeatedly advocate protecting surgical wounds from these organisms. There is also a clear description of vector borne diseases and that diseases such as leprosy, tuberculosis, conjunctivitis and fever as contagious diseases spread by contact with other patients or vectors.

[[Ayurveda]] describes two kinds of organisms, namely ''prakrita'' (non-pathogenic), and ''vaikrita'' (pathogenic). Also described are two categories of pathogens/parasites, namely, external and internal. The internal organisms are mainly of three categories in terms of their natural environments: those that thrive on mucus (''shleshma''), those thriving in fecal matter, and those thriving in blood. Some of these, particularly the ones thriving in fecal matter seem to be intestinal parasites while others simulate microbes. The texts repeatedly advocate protecting surgical wounds from these organisms. There is also a clear description of vector borne diseases and that diseases such as leprosy, tuberculosis, conjunctivitis and fever as contagious diseases spread by contact with other patients or vectors.

It is interesting to note that these ancient texts recognized the existence of “friendly” non-pathogenic organisms and their functions  - something that is only now being considered the greatest discovery in  microbiology. It is claimed by modern scientists that our living body is made up of 10 trillion somatic cells and is home to some 100 trillion friendly microbes. This “empire” of microbes is called Microbiome. Understanding the relationship between the microbiome and the human being, the animal and the environment - is as important as unravelling human genome. The microbiome is like a well-structured organ with unique functions and hence needs to be protected in the same way as we protect our other vital organs like liver, heart or kidney.  

It is interesting to note that these ancient texts recognized the existence of “friendly” non-pathogenic organisms and their functions  - something that is only now being considered the greatest discovery in  microbiology. It is claimed by modern scientists that our living body is made up of 10 trillion somatic cells and is home to some 100 trillion friendly microbes. This “empire” of microbes is called Microbiome. Understanding the relationship between the microbiome and the human being, the animal and the environment - is as important as unravelling human genome. The microbiome is like a well-structured organ with unique functions and hence needs to be protected in the same way as we protect our other vital organs like liver, heart or kidney.  

This recognition of the existence of these friendly ''prakrita'' (non-pathogenic organisms) by Ayurveda thousands of years ago is of great historical significance.

This recognition of the existence of these friendly ''prakrita'' (non-pathogenic organisms) by [[Ayurveda]] thousands of years ago is of great historical significance.

==== Management of ''krimi roga'' ====

==== Management of ''krimi roga'' ====

One day [[Panchakarma]] has been used for removal of ''krimi'' but because of availability of effective oral anti-parasitic agents, it is seldom used.

One day [[Panchakarma]] has been used for removal of ''krimi'' but because of availability of effective oral anti-parasitic agents, it is seldom used.

In comparison to modern medicine, the removal of parasites in Ayurveda seems to be inconvenient to the patient. The drugs are to be used in larger doses with limited efficacy. Modern medicine drugs, for removal of common parasites are effective with convenient dosage schedule. However, these drugs are potentially toxic and are to be used with careful watch of physician.  

In comparison to modern medicine, the removal of parasites in [[Ayurveda]] seems to be inconvenient to the patient. The drugs are to be used in larger doses with limited efficacy. Modern medicine drugs, for removal of common parasites are effective with convenient dosage schedule. However, these drugs are potentially toxic and are to be used with careful watch of physician.  

''Prakritivighata'' (creation of unfavorable condition preventing recurrence)- ''Prakritvighata'' means to create the environment so that ''dosha'' cannot lodge themselves in the ''dhatus''/''krimi''. This includes measures promoting ''agni'' and nourishing ''dhatus'' with ''rasayana'' therapy. The role of the ''rasayana'' is to create the healthy tissues so that vitiated ''dosha'' cannot lodge (''sthana samshraya''). As per the Ayurvedic concept, increased ''dosha'' circulates in the body and on finding a weak and suitable tissue they lodge there causing the initiation of disease process. Use of certain herbs like ''Shigru, Paribhadra'', etc. may create an environment to prevent growth of parasitic ova/cyst.

''Prakritivighata'' (creation of unfavorable condition preventing recurrence)- ''Prakritvighata'' means to create the environment so that ''dosha'' cannot lodge themselves in the ''dhatus''/''krimi''. This includes measures promoting ''agni'' and nourishing ''dhatus'' with ''rasayana'' therapy. The role of the ''rasayana'' is to create the healthy tissues so that vitiated ''dosha'' cannot lodge (''sthana samshraya''). As per the Ayurvedic concept, increased ''dosha'' circulates in the body and on finding a weak and suitable tissue they lodge there causing the initiation of disease process. Use of certain herbs like ''Shigru, Paribhadra'', etc. may create an environment to prevent growth of parasitic ova/cyst.

The spread of such diseases can be prevented by observing personal hygiene and promoting ''vyadhiksamatva'' or immunity with the help of leading a healthy lifestyle, following good nutrition and through administration of ''rasayana'' therapy.

The spread of such diseases can be prevented by observing personal hygiene and promoting ''vyadhiksamatva'' or immunity with the help of leading a healthy lifestyle, following good nutrition and through administration of ''rasayana'' therapy.

Ayurveda recognizes and describes a less-known concept of ''ojas'' (vital essence of the body) which gives biological strength (including immunity). ''Ojas'' is the final product of tissue nourishment and is the final product of all the seven ''dhatus'' namely ''rasa, rakta, mamsa, meda, asthi, majja,'' and ''shukra''. ''Ojas'' is of two types called ''para ojas'' and ''apara ojas''. ''Para ojas'' is subtle and present in very minute quantity in the heart while ''apara ojas'' is gross and amounts to handful in quantity, spread all over the body. ''Para ojas'' is vital to life and any damage or vitiation to it can result in sudden death. ''Apara ojas'' gives gross immune strength to the body and can be compared to immunity described by modern medical science. This immune strength is also called ''ojabala'' and is categorized to be of three kinds: ''sahaja bala'' or primary immunity, ''kalaja bala'' or acquired immunity through environmental factors and ''yuktikrita bala'' or artificially-induced immunity by ''rasayana'', lifestyle and suitable diet. The classics prompt to utilize these three resources to enhance the bala/immunity in order to prevent all ailments especially chronic diseases and contagious diseases.  

[[Ayurveda]] recognizes and describes a less-known concept of ''ojas'' (vital essence of the body) which gives biological strength (including immunity). ''Ojas'' is the final product of tissue nourishment and is the final product of all the seven ''dhatus'' namely ''rasa, rakta, mamsa, meda, asthi, majja,'' and ''shukra''. ''Ojas'' is of two types called ''para ojas'' and ''apara ojas''. ''Para ojas'' is subtle and present in very minute quantity in the heart while ''apara ojas'' is gross and amounts to handful in quantity, spread all over the body. ''Para ojas'' is vital to life and any damage or vitiation to it can result in sudden death. ''Apara ojas'' gives gross immune strength to the body and can be compared to immunity described by modern medical science. This immune strength is also called ''ojabala'' and is categorized to be of three kinds: ''sahaja bala'' or primary immunity, ''kalaja bala'' or acquired immunity through environmental factors and ''yuktikrita bala'' or artificially-induced immunity by ''rasayana'', lifestyle and suitable diet. The classics prompt to utilize these three resources to enhance the bala/immunity in order to prevent all ailments especially chronic diseases and contagious diseases.  

Three categories of ''bala-dosha'' or immune disorders are described in the Ayurvedic texts which are comparable to three categories of immune disorders described in modern medical system:

Three categories of ''bala-dosha'' or immune disorders are described in the Ayurvedic texts which are comparable to three categories of immune disorders described in modern medical system:

#''Oja-kshaya'' (immunodeficiency).  

#''Oja-kshaya'' (immunodeficiency).  

There are specific methods and approaches to tackle the categories of immune disorders. It is evident from the description of ''ojabala'' and ''bala-dosha'' that immunology was highly advanced in ''samhita'' period of Ayurveda and the knowledge in this field was comparable to the current knowledge of immunology.

There are specific methods and approaches to tackle the categories of immune disorders. It is evident from the description of ''ojabala'' and ''bala-dosha'' that immunology was highly advanced in ''samhita'' period of [[Ayurveda]] and the knowledge in this field was comparable to the current knowledge of immunology.

==== Microbiology in Ayurveda ====

==== Microbiology in [[Ayurveda]] ====

Even though microscopy became available in 17th century, microbiology and parasitology was known and described in Ayurvedic classics in the context of immunity and body resistance. For an individual to possess immunity adequate ''ojas, bala'' and ''vyadhiksamatva'' is necessary. Role of microbes in causing disease became known to modern medicine in the last two centuries and since then discovery of antibiotics and vaccination there has been rapid advancements in the field of infectious diseases and saved millions of lives. However, indiscriminate use of antibiotics has caused change in body microbiome with resultant increase in various chronic and autoimmune diseases. Use of vaccination is also under cloud these days. Ayurvedic knowledge of ''yuktikrit bala'' or artificially-induced immunity by ''rasayana'', lifestyle and suitable diet can be very useful in prevention and treatment of microbial diseases.

Even though microscopy became available in 17th century, microbiology and parasitology was known and described in Ayurvedic classics in the context of immunity and body resistance. For an individual to possess immunity adequate ''ojas, bala'' and ''vyadhiksamatva'' is necessary. Role of microbes in causing disease became known to modern medicine in the last two centuries and since then discovery of antibiotics and vaccination there has been rapid advancements in the field of infectious diseases and saved millions of lives. However, indiscriminate use of antibiotics has caused change in body microbiome with resultant increase in various chronic and autoimmune diseases. Use of vaccination is also under cloud these days. Ayurvedic knowledge of ''yuktikrit bala'' or artificially-induced immunity by ''rasayana'', lifestyle and suitable diet can be very useful in prevention and treatment of microbial diseases.

===See Also ===

===See Also ===

Video by Prof.M.S.Baghel on Parasitology in Ayurveda available on [http://ayushguru.org/video/135/ayurvedic-classics-unexplored-wisdom-of-ancient-india] retrieved on May 30, 2019  

Video by Prof.M.S.Baghel on Parasitology in [[Ayurveda]] available on [http://ayushguru.org/video/135/ayurvedic-classics-unexplored-wisdom-of-ancient-india] retrieved on May 30, 2019  

=== References ===

=== References ===

=== Further reading ===

=== Further reading ===

#Charak Samhita, Shri Cakrapani viracita Ayurveda deepika vyakhya, Yadavaji Trikamji Acharya Sampadita, Choukhamba Surabharati Prakashana.

#Charak Samhita, Shri Cakrapani viracita [[Ayurveda]] deepika vyakhya, Yadavaji Trikamji Acharya Sampadita, Choukhamba Surabharati Prakashana.

#Charak Samhita, Shri Cakrapani viracita Ayurveda Deepika tatha Shri Gangadhara viracita Jalpakalpataru Teeka, Choukhamba publishers.

#Charak Samhita, Shri Cakrapani viracita [[Ayurveda]] Deepika tatha Shri Gangadhara viracita Jalpakalpataru Teeka, Choukhamba publishers.

#Charak Samhita, Edited with Vaidyamanorama Hindi commentary by Acharya Vidyadhara Shukla and Prof Ravidatta Tripathi, Choukhamba Sanskrit Pratishthana.

#Charak Samhita, Edited with Vaidyamanorama Hindi commentary by Acharya Vidyadhara Shukla and Prof Ravidatta Tripathi, Choukhamba Sanskrit Pratishthana.

#Charak Samhita, Edited with Caraka Chndrika Hindi commentary by Dr. Brahmanand Tripathi, Chaukhamba Surbharati Prakashan.

#Charak Samhita, Edited with Caraka Chndrika Hindi commentary by Dr. Brahmanand Tripathi, Chaukhamba Surbharati Prakashan.