Dr.NPP Namboothiri - Techno Ayurveda
Dr.NPP Namboothiri - Techno Ayurveda
Dr.NPP Namboothiri - Techno Ayurveda
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Excellence in traditional<br />
eyecare systems<br />
<strong>Dr</strong>.N.P.P <strong>Namboothiri</strong><br />
Managing Director & Chief Physician<br />
Sreedhareeyam Ayurvedic Eye Hospital<br />
and Research centre<br />
Koothattukulam
INTRODUCTION<br />
• Although modern ophthalmology is no doubt touching<br />
the sky with ultra modern advances yet the health is<br />
facing newer critical problems.<br />
• Certain new disease entities of eye are posing<br />
challenges to the ophthalmologists.<br />
• Such patients when presents with their diagnosis for<br />
alternate treatment then a Vaidya has to evaluate the<br />
problem on own parameters of diagnosis and possible<br />
therapeutic measures.
• Netra roga Vigyana the major field<br />
of shalakya tantra among Ashtanga<br />
<strong>Ayurveda</strong>, was one of the developed<br />
branch of life science since ancient<br />
times.
Contd..<br />
• Vivid account of 90 eye diseases in total are<br />
available in <strong>Ayurveda</strong> literature.<br />
• It was Rajrishi Nimi a pionner in the field of<br />
Shalakya who did non phaco ECCEs through<br />
temporal incision approach centuries earlier<br />
to christen era.
Importance of Netra<br />
• Chakshurakshayam sarvakalam manushyr-<br />
Yatnatha karthavyo jeevithe yavadiccha |<br />
Vyartholokaoyam thulyarathrindivanam<br />
Pumsamandhanam vidyamanepi vithe||<br />
(AH Ut 13/98)
Importance of Netra<br />
• Chakshurakshayam sarvakalam manushyr-<br />
Yatnatha karthavyo jeevithe yavadiccha |<br />
Vyartholokaoyam thulyarathrindivanam<br />
Pumsamandhanam vidyamanepi vithe||<br />
(AH Ut 13/98)
Nethraraksha prakarathvam<br />
• ̧ÉTüsÉÉÂÍkÉUxÉëÑÌiÉ: AxÉëÌuÉxÉëÑÌiÉ: ÌuÉzÉÑÍkÉ<br />
qÉïlÉxÉÉåÌlÉuÉëÑïÌiÉUleÉlÉqÉç xÉlÉxrÉqÉç<br />
zÉMÑülÉÉzÉlÉiÉÉ xÉmÉÉSmÉÔeÉÉ<br />
bÉëÑiÉmÉÉlÉqÉç cÉ xÉSæuÉ lÉå§ÉU¤ÉÉ<br />
(AH Ut 13/99)<br />
• “Sarvadaa ca nisheveta svastho pi nayana priyah|<br />
Aata patram padatraanam vidhivad dosha<br />
shodhanam||”<br />
(AH.Ut 16/60)
“<br />
Continued…….<br />
• “Samkshepatah kriya yogo nidana parivarjanam|<br />
Vataadeenaam prateeghato proktha vistharathah<br />
punah||”<br />
(Su Ut 1/24)<br />
Treatment of eye disorders, as is in any other<br />
disease, is in short abstaining from aetiological<br />
factors. In detail it is treatment vaataadi doshas.
DoshaKopain Eye Disorders<br />
Kaphaja lakshanas – Aavilatha, excessive<br />
lacrimation,itching in the eyes, discharge from the<br />
eyes and heaviness of the eyelids.<br />
Pittaja lakshanas – Reddish discolouration of the<br />
eyes, burning sensation of the eyes and<br />
inflammatory signs.<br />
Vataja lakshanas – Roughness,dryness and pain in<br />
the eyes, blurrness of vision, difficulty in<br />
movements of the eye.
Vataja netra roga and shodhana therapies<br />
Disorders<br />
Vathika<br />
Abhishyanda &<br />
Adhimandha<br />
Anyathovata<br />
Vata paryaya<br />
Shushkakshipakam<br />
Kacham<br />
Nimesham<br />
Hatadimandham<br />
Therapies<br />
Purvakarma – Snehapana<br />
Snehadhara<br />
Shiro vasti<br />
Pradhana karma –<br />
Virechana,<br />
sneha vasti,<br />
kashaya vasti
Pittaja netra roga and shodhana therapies<br />
• Disorders<br />
<br />
<br />
<br />
<br />
<br />
<br />
<br />
<br />
Pittaja Abhishyanda<br />
& Adhimandha<br />
Amladhyushitam<br />
Shukthika<br />
Dhuma darshi<br />
Pitta Vidagdha<br />
drushti<br />
Paitika Thimiram<br />
Hraswa jadyam<br />
Jalasravam<br />
Therapies<br />
Purvakarma - Snehapana<br />
Pradhanakarma - Sramsana<br />
Raktha mokshana<br />
Nasya<br />
• Raktha Pitta Chikitsa<br />
• Pitta Visarpa Chikitsa
Kaphaja netra roga and shodhana therapies<br />
• Disorders<br />
Kaphaja Abhishyanda<br />
&<br />
Adhimandha<br />
Valasa Gradhita<br />
Pishtaka<br />
Kapha Vidagdha<br />
Praklinna Vartma<br />
Kaphaja Timiram<br />
• Therapies<br />
Purvakarma – Swedana<br />
Snehana<br />
Pradhanakarma –<br />
Vamana<br />
Virechana<br />
Nasya<br />
Raktha Mokshana
Shodhana in management of Chronic<br />
Eye Disorders<br />
Vartmavalekham bahusah tadvat sonita mokshanam/<br />
Punah punah virekam ca pilla rogaaturo bhajed//<br />
(AH.Ut 16/47)<br />
( Pillaroga-deerghanubandhi-chronic eye diseases )
• Myopia<br />
• Conjunctivitis<br />
• Cataract<br />
• Diabetic Retinopathy<br />
• Retinitis Pigmentosa<br />
• Keratoconus<br />
• Galucoma<br />
CONTENTS<br />
• Age Related Macular degeneration<br />
• Optic Atrophy
MYOPIA<br />
• Ususally treated in the line of pradhama patalagata timiram<br />
Treatment<br />
• Snehapanam with vainatheya ghritam, mahaneela ghritam,<br />
kasyapa ghritam<br />
• Virechanam with Avipathy choornam<br />
• Nasyam with Anuthailam,Ksheerabala 21 Avarthy<br />
• Internal kashayam with Nethraraksha kashayam,<br />
Akshabeejadi kashayam, Dhanadarasnadi<br />
kashayam,Sameerapanchakam kashayam
• Anjana Chandanadi,Mukulanjana,Sunethra<br />
• Aschyothana<br />
Anjana ghritam,vinayakanjanam<br />
• Sekam with Kasyapam kashayam<br />
• Eye massage with Ksheerabala 21 Avarthy and Mahakukkutamamsa<br />
thailam<br />
• Sirodhara with Sasanka thailam,Bhujanga pathra thailam,<br />
Aswagandha thailam<br />
• Pichu with Bhujanga pathra thailam,Sasanka thailam<br />
• Annalepanam<br />
• Eye exercise<br />
• Thalam with Bhujanga patra thailam<br />
• Tharpanam with Mahaneela ghritam,Thriphala ghritam,Anantha<br />
ghritam
CONJUNCTIVITIS<br />
Inflammation of conjunctiva characterized<br />
by redness of the eye & conjunctival<br />
discharge is known as conjunctivitis.
ABHISHYANDA<br />
Explained under Sarva gata Roga<br />
Abhi – means from four sides (all angles).<br />
SYANDA – means discharge<br />
Abhishyanda is a Sankramika vyadhi &<br />
becomes the cause for the most of the eye<br />
diseases. In this disease watery or sticky eye<br />
discharge comes from all the angles of eye.
Types<br />
Vaataja<br />
Pittaja<br />
Kaphaja<br />
Raktaja
Signs and symptoms of Vaataja<br />
Nistodana,<br />
Stambhana,<br />
Romaharsha,<br />
Sankharsha,<br />
Paarushya,<br />
Shirobhitaapa,<br />
Visushkabhava,<br />
Sisiraasrutha<br />
Abhishyanda
Chikitsa<br />
Nidana Parivarjana<br />
InSaama Dosha, 4 days Lankhana etc.<br />
Treatment principles.<br />
Sneha paana :- In take of medicated milk &<br />
ghee prepared with thriphala, Vidaeiyaandhadi<br />
drugs, dasamoola.<br />
Mridu Sweda ;- Seka withVaatahara <strong>Dr</strong>avya<br />
Kashayas<br />
Rakta Mokshana
Chikitsa<br />
Sneha Virechana<br />
Sneha Niruha Vasti<br />
Sneha Tarpana<br />
Sneha Putapaka<br />
Sneha Dhooma<br />
Sneha Nasya<br />
Aschyotana<br />
Sneha Parisheka<br />
Shiro Vasti<br />
Pradeha<br />
Abhyanga<br />
Sneha Anjana<br />
Pindika<br />
Bidalaka
Signs & Symptoms of Pittaja<br />
Abhishyanda<br />
It is Pittaja Vyadhana Saadhya Vyadhi.<br />
Daaha, paaka, Dhumabashpa Samuchraya,<br />
Ushnaasru, Peeta Netra, Sisiraabhinanda,<br />
Varthma shopha, Syava Varthma, Antha<br />
Kleda
Chikitsa<br />
Lankhana for ama pachana<br />
Snehapaana<br />
Rakta Mokshana<br />
Virechana (1 to 4 for systemic treatment)<br />
Seka yogas like chandana, Nimba patra, Yashti<br />
madhu, saindhava lavana, Rasaanjana<br />
Aschotana<br />
Pindi (Amalaki or Maha Nimba patra pindi)<br />
Vidalaka<br />
Anjana
Signs & Symptoms of Kaphaja<br />
Abhishyanda<br />
It is Kaphaja Vyadhana Saadhya Vyaadhi.<br />
Guruthwa, Shopha, Kandu, Upadeha,<br />
Pichila Srava, Ushnaabhinanda, Nidra,<br />
Aruchi.
Chikitsa<br />
Lankhana<br />
Swedana Nasya<br />
Thikta bhojana,<br />
Theekshna<br />
pradhamana Nasya<br />
Teekshna Upanaaha<br />
RukSha teekshna<br />
Virechana<br />
Dhumapaana
Chikitsa<br />
Seka<br />
Pralepa<br />
Kavala Graha<br />
Pindi<br />
Ashchotana<br />
Vidalaka<br />
Anjana
Signs & Symptoms of Raktaja<br />
Abhishyanda<br />
It is Raktaja Vyadhana Saadhya Vyaadhi.<br />
Signs & symptoms are similar to Pittaja<br />
Abhishyanda<br />
Lohitaasru netra, Taamrasru, Raktaraaji
Definition<br />
CATARACT<br />
It can be defined as any opacity in the lens<br />
or its capsule whether developmental or<br />
acquired.
Types<br />
Developmental<br />
Acquired<br />
Senile Cataract
Cataract and its management<br />
According to <strong>Ayurveda</strong>, cataract is considered as a<br />
disease due to the vitiation of doshas in different<br />
patalas .<br />
Different stages of cataract can compared with<br />
Thimiram, Kaacham and Linganaasham. It is due<br />
to the vitiation of doshas in the<br />
Prathama,,Dvitheeya,Thritheeya and Chathurtha<br />
patalas.
“Thimiram kaacham vaa yathi kaacho<br />
aapyaupekshayaa<br />
Netrarogeshyatho khoram thimiram<br />
saadhayed gritham”<br />
If thimira is not treated in proper time It<br />
leads to Kaacham, in this stage also if not<br />
treated leads to complete loss of vision<br />
called Linganaasham.
Prognosis (Saadhyaasadhyadha)<br />
Six types of Thimira is considered as<br />
Oushada saadhya.<br />
5 types of Linganaasha are Asaadhya
Saamanya chikitsa for thimiram<br />
Explained both bahya and abyanthara<br />
chikitsa:<br />
Anjanas explained in bahya chikitsa are<br />
Elaneer Kuzhambu<br />
Karpooradi Kuzhambu<br />
Chandrodaya Varthi<br />
Vimalavarthy Anjanam
In abyanthara chikitsa explains usage of grithas<br />
like<br />
Patoladi grita<br />
Jeevanthyadi gritha<br />
Triphala gritha etc.<br />
In Nasya Yogas explained<br />
Jeevanthi Thailam<br />
Erandadi Thailam<br />
Tila Thailam etc
Tharpana yogas like<br />
Ksheera sarpi etc is also indicated<br />
Vasti karma and Raktha mokshana also<br />
advised according to the condition of the<br />
patient
DIABETIC RETINOPATHY<br />
Treatment Plan<br />
Largely aimed at prevention and<br />
strict metabolic control of<br />
• blood sugar<br />
• blood pressure<br />
• dyslipidemia<br />
This reduces the progression of<br />
diabetic retinopathy.
Medicines for Glycemic Control<br />
- Sameera panchakam kashayam<br />
- Nisakathakadi kashaya<br />
- Nishaamalaki yoga<br />
- Kataka khadiradi kashayam<br />
- Phala trikaadi kashayam<br />
- Vara choornam<br />
Medicines for control of blood pressure<br />
1. Ashwangandha choornam<br />
2. Shankhpushpi swarasa<br />
3. Dasamoola kashayam<br />
4. Rudraksha<br />
5. Partharishtam<br />
6. Punarnavadi kashayam<br />
7. Pravala Bhasma
Medicines for Dyslipidemic control<br />
1. Varanadi Kashayam<br />
2. Rasonadi kashayam<br />
3. Thriodasanga guggulu<br />
4. Kaisora guggulu<br />
5. Chitrakadi vati<br />
6. Arogyavardhani Rasa<br />
7. Rasa Sindhur and its compounds<br />
Exercise and Yogi kriya<br />
1. Ardhamatasyandrasna 2. Madhukasana<br />
3. Kapala Bhati Pranayama 4. Uttan Padasana<br />
5. Anuloma Viloma Pranayama 6. Vahya Pranayama<br />
7. Sarvangasana
External Therapies<br />
• Thakradhara with vasa guloochyadi kashayam<br />
• Aschyothanam with Vinayakanjanam<br />
• Pindi with Amalaki leaf,guduchi leaf or vasa leaf<br />
• Anjanam with Chandanadi anjanam<br />
• Nethradhara with darvyadi ksheera kashayam<br />
• Tharpanam with Jadaveda ghrita
RETINITIS PIGMENTOSA<br />
• Normally treated as 4 stages<br />
-Kapha Vishama<br />
<strong>Dr</strong>ushti<br />
- Kapha vidagdha drushti<br />
- Kapha pitta vidagdha<br />
drushti<br />
-<strong>Dr</strong>ushtiHata<br />
• 30 - 40 % managable<br />
• Purely Rasayana Chikitsa<br />
Steps<br />
• SHODANA CHIKITSA<br />
• BRIMHANA CHIKITSA
Treatment<br />
Shodhana chikitsa involves<br />
- Snehanam with Vidaryadighritam, vainatheya<br />
ghritham<br />
or Mahathriphala ghritham<br />
-Virechanam with Avipattikara choornam<br />
Bramhana Chikitsa involves<br />
- Samana kashayas like Dhanada rasnadi, sameera<br />
panchakam,Nethraraksha etc<br />
External applications like<br />
- Anjana with nakulanjanam,aschothanam with<br />
mahapadma ghritam,Sekam with kasyapam<br />
kashayam
Treatment contd….<br />
• Tharpanam with Jataveda ghritham,Kashyapa<br />
ghritham.<br />
• Sirodhara with Sasanka thailam<br />
• Pichu with mahadasamoola thailam,bhujanga<br />
pathra thailam<br />
• Sirovasti with bhujanga pathra thailam<br />
• Putapaka with swarasam
Treatment is aimed at :-<br />
- Relieve discomfort<br />
- Provide smooth optical surface.<br />
- Prevent structural corneal damage.<br />
- Restoration of natural tear film.
Local<br />
1. Aschyotana with <strong>Dr</strong>aksha, Chandana processed<br />
and filtered out of Tandulodaka + Honey alleviates<br />
lacrimation and burning.<br />
2. Irrigation of eye with cold unboiled milk + bit of<br />
Saindhava (Nacl).<br />
3. Anjana prepared from Shunthi rubbed with Ghrita<br />
and Stanya.<br />
4. Keshanjana.<br />
5. Nasya with Ksheerabala thaila or Anu taila.<br />
6. Tarpana with Jeevnthyadi ghrita,Kasyapa ghritha<br />
7. Putapaka with putapaka swarasa.<br />
8. Oral Ghirta pana after meals, Jeevanthyadi<br />
ghrita,Mahathriphala ghrita and Kashyapa ghrita.<br />
9. Basti with milk processed in Madhuka, Shatavaha,<br />
Ghrita.
KERATOCONUS<br />
• Vata & Rakta seems to major pathological factors.<br />
• Structural changes are said to occur in superficial type of<br />
vata – rakta —by Acharya Charaka.<br />
Line of treatment<br />
Preventive :- Antenatal and Postnatal<br />
Vata & Rakta vitiating diet & requirements to be avoided<br />
Nutritious diet along with specific emphasis on liver<br />
functions<br />
Basti chikitsa<br />
Guduchi, Amalaki, Madhuyashti, Satavari, Milk, Ghee, Shali<br />
Chawal, Mansa rasa.
Curative:-<br />
Following line can be adopted as ocular therapeutic measures<br />
from Vata-Rakta Chikitsa (Charaka Samhita)<br />
<br />
<br />
<br />
<br />
<br />
<br />
Blood letting<br />
Shodhana - Snehana – Virechana<br />
Repeated Anuvasana and Niruha Basti.<br />
Parisheka, Pradeha (Vidalaka)<br />
Food and Ghee made out of non irritant drugs<br />
Superficial type of vata rakta should especially be managed by<br />
Aalepa (Vidalaka), abhayanga, parisheka, upanaha (Pindi)
GLAUCOMA<br />
• Treated in the line of Adhimandha<br />
• In open angle glaucoma seetha and<br />
sthambhana is done<br />
• In closed angle glaucoma swedana,rechana<br />
and sroto vishodhana are employed
Treatment<br />
- Snehapanam with Thriphaladi<br />
Ghritam,Tilwaka Ghritam,Vainatheya<br />
ghritam<br />
- Virechanam with Avipattikara choornam,<br />
triphala choornam with triphala kashaya,<br />
Nimbamruthadi eranda<br />
- - Nasyam with Anu thailam<br />
- Shirodhara with Sasanka thailam,<br />
Gugguluthikthakam thailam<br />
- Shiro Vasti with sasanka thailam
Treatment Plan (Yukthi)<br />
ARMD<br />
• Macular/Retinal function simulates to that of<br />
Alochaka Pitta (Chakshu vaisheshika).<br />
• Old age macular degeneration, dry type should be<br />
treated on the line of vata dominating pittaja.<br />
• Wet/ neovascular type should be treated on the line of<br />
pure pittaja disease.
Medicines<br />
• Virechana with Trivrit ghrita, Dashmoola ghrita<br />
• Saptamarita loha, Shatavaryadi choorna, Amalaki<br />
churna<br />
• Vasant kusumakar rasa, Shuddha vanga (ca.<br />
compound), Arogyavardhani vati, Basantmalini<br />
laghu<br />
• Bhallataka rasayana<br />
• Dhanadarasnadi kashayam,<br />
Pathyakshadhathryaadi kashayam
OPTIC ATROPHY<br />
• Treated in the line of Abhighataja linga nasa<br />
• Internally Dhanada rasnadi kashayam, Vidaryadi<br />
kashayam<br />
• Nethra dhara with darvyadi ksheera kashayam<br />
• Siro dhara with Bhujanga apthra<br />
thailam,Aswagandha thailam<br />
• Tharpanam with Jeevanthyadi ghritam, Anantha<br />
ghritam
Commonly Used Kashayas for Internal<br />
Use in Eye Disorders<br />
• Nethraraksha kashayam<br />
• Akshabeejadi kashayam<br />
• Dhanadarasnadi kashayam<br />
• Sameerapanchakam kashayam
Commonly Used Ghritas for Tharpana<br />
and Internal Use<br />
• Anatha Ghrutham<br />
Jeevanthi,Ghrutham,Dugdham,Ikshu,Harithaki,Saindh<br />
avam<br />
• Jathaveda Ghrutham<br />
adolam,Nimba,Katuki,Harithaki,AmalakiVibhithaki<br />
,Yashtimadhu,ghritam<br />
• Vainatheya Ghritham
Commonly used thailas for sirodhara,<br />
Pichu and siro vasti<br />
• Dhanada Thailam<br />
Rasana , Eranda, Sunti,Mustha,Sahachara,Varuna<br />
• SasankaThailam<br />
Nimba,Gudeechi,Patola,Vasa,Padha,Devatharu,Gajapi<br />
ppali,Sunti,Darvee,Manjishta
Aswaganthadi Thailam<br />
Vidari,Rasna,Bala,Aswagantha,Laksha,Harenuka<br />
m,Kachooram<br />
Bhujanga Pathra<br />
Thailam,Kulatha,Kola,Yava,Bala,Aswagandha,A<br />
garu,Ela,Punaranava,Natha,Kushta,Vacha,Saraba
THANK YOU
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