AyurvedGuru

Life`s Life is Heart
Dr. Ramakrishna

Cardiology as a specialized branch of modern medicine is comparatively a recent innovation.  The ancient scholar, Susruta was the first surgeon who studies the anatomical. Aspects of hrudaya many centuries back and who described. It as an organ in the shape of inverted lotus. The article below given the ayurvedic  perspective of treating heart diseases.

Our ancient scholars described heart as Hrudaya. `Hru` means to bring back forcibly. `Daya` means to need. Our body including heart is composed of approximately 6000 Billion cells of various structures. Their life is maintained by nutrients and oxygen. Our heart pumps a vehicle that is blood which gives these lying substances at its own level of each cell and that brings back the total waste products for each cell and eliminated  through lungs, liver and kidneys. This total network consists of 60000 miles throughout the body connected with a lot of blood vessels.  This heart is “Chetanatmaka“ which means it maintains every moment of human body a minute to the maximum. Heart is though a little larger than your first it originates the endless emotions, ceanful thoughts, mountains like desires and  all your moments at cellular level or organic level. Do you know by any  reason it  stops less than a minute that causes death. As from  sixth month of embryotic  life till your last  moments it  never haults even a second . It is a fact that today heart disease has reached  epidemic proportions and it is now leading  cause of death through out the world. It is estimated that nearly half of this country will die prematurely because of this disease. Modern medicine works on relatively surfacial levels.

Because modern cardiology focuses on fixing or replacing the parts of a person such as dieases arteries, valves instead of reversing the imbalance of the root of the disease. The conventional medicine approach to the heart disease treats you as a collection  of tubes and valves albeit highly sophisticated collection  with switches and feedback mechanism but ignores you as a whole person. Ayurveda, the great Indian medical  science defines Heart as `Hrudaya` an organ which graps and controls. The ancient scripture like Veda, Upanishads,Mantra-Pishpa etc. recognized the  importance of the heart  and  human body. Studies of ancient scholars:- Cardiology as a specialized branch of modern medicine is comparatively a recent innovation. The ancient scholar, Susruta was the first surgeon who studies the anatomical aspects of  hrudaya many centuries back and who described it as an  organ in the shape of inverted lotus. He also located its place to be in the thorax, in between  the breasts and  described it as chethana  sthana ( Place for  all movements). It is seat for the all activities of mind and body. According to Charaka, the heart  starts  functioning in the third Foetal  month and heart  sounds are recorded by the forth foetal month. They have described various diseases of the heart  some 5000 years ago and treated them. The word Hrudaya is synonym for the heart. Embryologically , it originates from the essence of blood  and kapha tissues and develops into a muscular organ.

The endocardium ( Innermost layer of the Heart) is derived  from mamsa  and pericardium is  derived fpr meta (fatty and connective tissue). It has own  inherent rhythm for contraction  and relaxation. The automatic  nervous  system (Vyana vayu) also  controls it srhytmicity. Ayurveda described eight basic elements of the heart . These elements bear marked resemblance to modern  concepts such as enzymes, plasmas, Chronobiology. The eight basic  elements;-1. Rasa: it is a fluid  in the body derived from diet. Food after digestion and  absorption is converted into rasa. The heart pumps rasa along with Raktha thus nourishment, growth and development  of  tissues and organs depends upon rasa.

2. Raktha: it means red blood corpuscles. Raktha  is derived from  rasa and  carries oxygen  to all the tissues .   OJA :The heart is seat of this vital fluid . The nutrients in rasa which cannot be directly utilized but the tissues are modified by the liver and converted into  OJA. Oja supplies energy to disturbances of the internal mileu gave rise to different diseases of the cardiovascular system. A few example will suffice.

Disturbance of Rasa. : Vitiation of Rasa (Rasadushti); digestive disturbances, electrolyte Disturbance, hyper cholesterolaemia. Increase in Rasa (Rasavridhi):

Hypertension, congestive  cardiac failure. Decrease in Rasa (Rasa kshaya): dehydration, shock. Disturbances of Raktha: Raktha dushti: Cyanosis, splenomegaly, bleeding disorder, Methahaemoglobia.

Raktha vridhi: hypertension, congestive cardiac failure. Raktha kshaya: Anaemia, heart failure due to chronic anemia. Disturbances of oia:

Oja  vyapat: excess sleep, drowsiness, wasting, and  heaviness of the body. Oja visramsa: loss of skill, exhaustion and looseness of joints.
Oja kshaya: weakness, exhaustion, constant worry, fear, fainting and delirium.
Disturbances of muscle: Mans adushti: atrophy tumour, oedema, cardiomegaly, cardiac hypertrophy and poor pumping as in congestive cardiac failure.
Disturbances of oxygen: Hunger,  exertion, tissue wasting can affect the passages carrying oxygen  and  result in difficulty in  breathing, cough hiccup, clouding  of consciousness. Blocking of the passage of oxygen in the coronary artery result in heart attacks.

Disturbances of vyana vayu: It results in disturbance of forc and rhythm of heart. Valvular disorders are also encountered as movements of valves are regulated by vyana vayu. Abnormal vyana vayu can result in spasm of the coronary arteries leading to angina pectoris.

Disturbances of sudhaka pitta: It leads to weak function and failure of the heart.

Disturbances of Avalambaka kappa:
It leads to disorders like pericardial effusion pulmonary oedema etc.In addition to these basic elements, Ayurveda also stressed that natural urges and` various tastes` influence the function of the heart indirectly through  their effect on  VATA, PITTA  AND  KAPHA (called TRIDOSHAS).

Natural urges: Flatulence, belching, defecation, micturition, thirst, cough, sexual urge etc. are controlled by vata.

Suppression or artificial induction of these urges leads to disturbances of  the  autonomic nervous system  and can also  lead to symptoms like pain, compression  or even result  in disease.

Various tastes: Sweet items (madhura) increase kapha and  decrease pitta. Salty

(Lavana) and amia  (sour) items increase pitta  and  kappa  and decrease vata.

Pungent  (tikta) items increase vata and pitta and decrease kappa .

Bitter (kadu)  and  astringent (kashaya) items  increase vata  and decrease kappaand pitta.  This is  because they are derived from corresponding biological  elements. Thus, depending  upon the dominance  of  a given  dosha in the cardac

Disorder, ultilization of the food items of various tastes  in the diet is  advised.

In modern terms, Ayurveda recognized that dietary factors influenced and sometimes precipitated heart diseases. A few  examples of  heart diseases where  one  of these doshas is  affected are.

Kaphaja heart  diseases- endocranial  fiber-elastosis,  cardiac  hypertrophy, pericardial  thickening , atherosclerosis  off  the  coronary  arteries.

Pitta  heart  disease- bacterial  endocarditis , myocarditis,  coronary  arteritis.

Vataja heart  diseases- valvular diseases, atrophic diseases, angina pectoris  due to  coronary  spasm .

The aetiology   of heart  disease   according  Ayurveda

1.     Causes  directly acting on the  heart;

2.     Causes affecting the basic elements.

3.     Heart disease as  a complication of other disease.

Causes directly acting on the heart

These include diet,  activity, sex alcohol, microorganisms, drugs and

Psychological   factors. These factors in turn , vitate doshas and  rasa

And give rise to heart  disease.

Disturbances of basic elements

Since these basic elements  (as discussed earlier) are important in structure, integrity and  function of the heart  when  disturbed lead to heart disease.

As a complication of other diseases

For example, anemia, diabetes, chronic respiratory diseases diphtheria,

Rheumatic fever etc.

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It is  indeed remarkable that over  five  thousand years ago the  manifestation of  heart diseases Their a etiology, their a etiology, their consequences and  remedial  measures were   so thoroughly expounded. Therapies for treatment of the acute and chronic

Phases as well as during convalescences are also detailed in their explanation.

Enumerated in these treatises are diseases such as Ischemic   Heart Disease coronary

Thrombosis, Angina pectoris, Rheumatic Heart Disease congenital Heart Disease, congestive cardiac failure and a host of others. The following are responsible for haridaya vyadhis :Gluttory

Broiling food;

Food i.e not easily digestible  Also the food having bitter and astringent properties;

Too much thinking Extreme physical walk; Injury to Heart;

Veganirodha  i.c  not emptying the bladder and bowels when it is needed;

The following examples of various measures advocated in I.H.D underscore the deep understanding of the disease processes and management.

Treatment  of Pain                      s

When it is of a severe, pricking, tearing, or splitting type and associated with tachycardia,

Then vataja Hrudashavia treatment is give agents like Arjuna, Bilva, Bala, panchmoola are used. These agents are vatashamak and are often combined with agents like Pushkarmoola,

Shakti etc. which cause relaxation of smooth muscles. The vehicle for these agents is usually decoction  of Yava or wine. Some analgesic like Ahiphen (crudeopium) bhang,erandamoola are used to relieve pain. If pain is associated with flatulence and belching, agents like asafetida, ginger, bidalavana, kachalavana are administered, If there is association of kaphaja element i.e.

Dull aching pain with bradycardia, then agents useful in kaphaja Hrudshalvia are added.

Diet

Juices of lemon, pomegranate,

Orange, sweet lime, amalaka are given . Coconut water, butter milk,

Mutton soup, rice kanji, old wines are advised.

Agents to maintain patency of vasculature:

Ksharas  of  Utpalavala Ambhoja ,   Priyangu, Glycerrhiza and Haritaki are mixed with honey and  ghee. They helpsss in dissolution of clots. Tamra bhasma has a cleansing action  on the heart  and its strata. Survarna bhasma is   administered subsequently as rasayna. Yavakshar, Saindhava,

Bibheetoka and Hritaki   can enter even the smallest channel and exert a lytic effect on Kapha molecules which  are obstructing the passage.

Management of convalescent phase

Agents capable of improving cardiac function and coronary perfusion are used (Rasayanas and Hrudaya medicines.) They include Arjuna, Bala Shatavan, patola, Dadima, Eranda, Abhrak etc. Some other agents like Hritaki, Bibheetaka are used in term management  because of their lytic effect on haphass molecules causing obstruction. Agents like patola,

Mimba, triphala, kutaja can digest local doshas in ischeamic areas, improve muscle function

And hasten recovery .

Management of Shock

Agents like Hamagrabha, Ananasuta, laxmivila guti, survarnasutashekhar etc., are ursful. Similary, for hypertension, C.C.F., atherosclerosis, oedema and other conditions numerous tested therapies are recommended. The importance tested therapies are recommended.

The importance of Yogic exercises in the relief of stress and rehabilitation of the patient are also explained in great details.

Apart from  the above,  Hrudroga has classified five groups viz., vatika , paittika , kaphaja, sannipatika, and signs, symptoms and treatment of each are as follows .

Vatika hrudroga (signs and symptoms) in Vatika hrudroga patient has ACUTE PAIN IN THE heart area: the pain is like that of cutting, chumming, or stretching. Other symptoms are palpitation, arrhythmia, heart and fainting. Treatment- simple preparation power if equal part of fruit rind of haritaki (cherubic myrobalag) and rhizome of vaca (sweet flag) – 1 gms. To be taken with 4 to 6 gms. Honey twice a day.

Power of equal part of fruit rind of haritaki (chebulic myrobalan) rhizome of vaca (sweetflag) root of rasana  (Indian groundsel ), sati (zedoary )and puskara (cosutus), fruit of pi((ali (long pepper ), and (zedoary) and puskara (cosutus), fruit of pippali (long pepper )and (zedoary)and pusker (cosutus)  ,fruit of pippali (long pepper )and aonthi (driend ginger ) 3 to 6 gms . to be taken with 100to 250 ml milk twice a day .

Power of equal if pippali (longpepper ),seed of ela ( cardamom) rhizome of (sweetflag), hingu (asafetida) fried in ghee,Yavaksara, Saindhava (rock- salt) sauvarcala lavana, sonthi (dried ginger) and fruit of ajmola (anise)-1 to 3gms to be taken.  With fruit juice of dadima or of Bijapurta (lemon ) or of Naranga (orange) or honey to make a paste twice a day.

Decoction of Dasmula-4 to 28 mls to be taken with 4 to 6gms honey twice a day .

Decoction of dasamula – 14 to 28 mls . To be taken with taila (gingerly oil )- 6 to 12 hms and lavana 1 gm twice a day.

Paittika Hrudroga-signs and symptoms

Felling of heaviness and fatigues in the heart, thirst burning sensation, sweating, dryness of mouth and finting are the symptoms of Paittika Hrudroga.

Treatment- single drug.

Powder bank of Arjuna- 3 to 6gms. To be taken with3 to 6 gms of guda (jaggerey) 50 mls water twice a day.

Powder of triphala- 1 to 3 gms to be taken with fruit juice of draksha (rasin or grape fruit) and parusaka (Asiatic grewia) and honey in equal weight- 14 to 28 mls. Twice a day.

Powder of fruit rind of haritaki (chebulic myrobalan) fried in eranda talla (castor oil ) to be taken in 1 to 43 gms. Dose with equal part of draksha (rasin or grape fruit), sarkara (raw sugar), fruit of parusaka (Asiatic grewia and honey twice a day.

Powder of equal part of root of Yastimadhu (glycyrrhiza) and rhizome of Katuki- 1 to 3 gms * bruised in 50 ml. Water to be taken with 5 to 10 gms. Sarkara twice  a day .

Dugdha Sidha with equal part of bark of Arjuna, Laghu Panchmula, roots of Bala (country mallow) and Yastimadhu(glycyrrhiza)- 100 to 250 mls. To be taken with 5 to 10 gms. Sarkara (raw sugar) twice a day.

Kaapheja Hrudroga – Signs and symptoms

Felling of seizure of the heart, heaviness in the body ; excessive secretion of phlegm, loss of appetite, sweet taste in the mouth are the symptoms of Kapheja Hrudroga.

Treatment- Simple preparations:

Powder of equal part of seed of Ela (cardamom)and root  of Pippali (long pepper)-3 to 6 gms to be taken with 5 to 6 gms ghee or 4 to 7 gms. Honey twice a day .

Powder of equal part of roots of Trivert * (turpeth), Sati (zedoary), Bala (country mallow), and Puskara (costus ), Sonthi (dried ginger), and  fruit rind of Haritaki (chebulic myrobalan)- 3 to 4 gms to be taken with 7 to 14 mls. Gomutara (cows` s urine) or 50 mls. War, water twice a day .

Sannipatika Hrudroga – Signs and symptoms

All the symptoms described in Vatika, Paittika and Kapheja types of Hrudroga are present in Sannipatika Hrudroga.

Treatments- Signle drugs

Powdered brk of Arjuna- 1 gm to be taken with 100 to 250 mls. Warm milk twice a day .

Powder Nagabala- 2 to 3 gms to be taken with 100 to 250 mls warm milk twice a day.

Krimija Hrudroga- signs and symptoms

Acute pain and itching in the heart area are the main symptoms of Krimija Hrudroga other symptoms are nausea, cardiac insufficiency, headache, loss of  appetite and oedema.

Treatment-Simple preparations:

Powder of fruit rind of Haritika (chebulic myrobalan) fried in Eranda Taila (castor oil) – 1 part and mixed with Saindhave lavana (rock salt)-1 part, fruit of sveta jriaka (cumia)- 1 part, to be taken in 2 to 6 gins .

Does with 5 to 10 gins. Sarkara(raw sugar) twice a day .

Powder of Vidanga-2 parts, root of Kustha (koot)-1 part of be taken in 2 to 4 gins. With Gomutra (cow` s urine) twice a day.

Kalka of seed of Kapikacchu (cowage), roots of * Rasabhaka, Meda, Jevanti, Satavari (wild asparagus) and * Ruddhi, fruit of Draksha (rasin or grape fruit), whole plant of  Mundi, and Mrunala (lotus stem) 6 to 12 gins. Boiled with milk to be taken with 50 mls. Warm water or 100 to 250 mls. Milk twice a day.s

Compound preparation s:

(for all types of hrudroga)

Vardhamana  Pippali: it is to be taken  under the guidance of a specialist.

Dasmula kvatha: 14 to 28 mls. To be taken  twice a day .

Punarvavastaka kvatha:

14 to 28 mls. To be taken  twice a day . It is useful  to  reduce  the odeama.

Ajamodadi  Vati : 1 to 2 vati to be taken  with 4 to 6 gms honey twice a day it is useful for  dyspnoea due to Hrudroga. Arogyavardhini vati: 1 to 2 vati  to be taken  with 50 mls. Water twice a day . It is  useful  to reduce  oedema.

Javahar Hohara  Rasa: 120 to 250 gms . To be taken with  4 to 6 gms honey twice a day.

Brihat- Vata- Chintamani Rasa: 60 to 120 mgs. To be taken with 4 to 6 gms. Honey twice a day. Ayur Veda and All