Ayurveda Approach towards Respiratory Illness in Children

Abstract

Preventable diseases such as pneumonia, diarrhoea, and other infections are the leading causes of morbidity in children, therefore each child\'s physical and emotional needs differ according to their age, personality, and developmental stage. 15% of children suffer from RRTIs. Predisposing variables include immune system inadequacies, anatomic and functional changes in the respiratory tract, air pollution exposure, and poor socioeconomic conditions. RRTIs are a prevalent disorder, especially in children under the age of six, and are usually caused by poor environmental conditions. 60% of patients had bacterial growth but RRIs begin as a viral respiratory tract infection and symptoms of infection for at least 10 days. URTI is most common known cause of morbidity in children, which causes limiting daily activities and causing school absence.

Introduction

I. INTRODUCTION

The most common respiratory tract morbidities include tonsillitis, cough, and cold. According to surveys, every child in under developing nations accounts least five incidents of acute respiratory infections each and every year, about 30% – 50% of all paediatric outpatient visits in hospital and 20% – 30% of disease burden in paediatric hospital admissions.[i] Children, according to Ayurveda, have underdeveloped Prana, Dosha, Dhatu, Bala, and Ojas making them the most susceptible to recurrent infection. Therefore they are the most vulnerable group in terms of illness.

Not all children are same. They vary in terms of their vyadhikshamatva. Therefore they should be supported externally to potentiate their immune system

Therefore, young children should receive external support to strengthen their immune system. Immunity plays an important part in the body's survival and the prevention of illnesses.

As per recent population based study from a systematic data analysis respiratory disease contributes 70 percent of the overall of childhood morbidity in children under five. [ii].

A number of adrenergic agonists, anti-cholinergic, anti allergic, anti-histamine medicines,  anti-tussives, and expectorants are available on the market for this purpose. Despite the fact that they relieve symptoms but there is no any solid proof that they reduce duration of disease or symptoms.[iii],[iv] The Food and Drug Administration recently published an advisory statement alerting  against the use of over-the-counter URTI medicines in children under the age of two.[v] Now a day, over use of antibiotics is seen in general practice. Excessive and misuse of antibiotics causes anti-biotic resistance and emergence of superbugs which pose potent threat to mankind.

Yuktikrita bala that is represents acquired immunity so Rasayana promotes health and rejuvenates the entire physiology, resulting in physical and mental resistance to disease. Rasayana is defined as a natural element that enhances the optimal strength and vitality of the complete body organism, not just one isolated tissue or system. According to Ayurveda concept of immunomodulator is closer to Bala or Prakrita Kapha. Different therapies like Rasayana, Lehana, Orjaskara, Jeevniya, Balya etc. are focused to modulate the immunity or increase the Vyadhikshamatva., Yuktikrita bala that is represents acquired immunity. Immune enhancers are safe, efficient supplements that can be used in conjunction with vaccines to boost or regulate the patient's innate immune response and prevent further infections.

II. AIMS AND OBJECTIVES OF STUDY

The present research study has been planned to rule out causative factors and highlight the possiple preventable factors to lower down the disease burden.

Table No. 1-Causative Factors for Respiratory Illness- Described in Ayurvedic Text

III. CONCEPT OF VYADHIKSHAMATVA (IMMUNITY) IN AYURVEDA

Better status of immune system is the most important pilgrim of the healthy life. Ayurveda has the unique concept of Vyadhikshamatva to potentiate or modulate the immune system in such a view. So, it can well fight with disease.

In Ayurvedic literature Vyadhikshamatva has been referred as the power of resistance compentent enough to arrest the progress, occurrence and recurrence of disease (Vyadhibalavirodhitam, Vyadhyutpadak pratibandhakatvam).[lxxx]

Individuals who are either obese or too emaciated or having improperly developed muscle, blood and bone or are weak nourished with Asatmaya ahara or are accustomed to take Alpahara (Less food) or having Alpa-satva (weak mental power) are unable to resist diseases.

Thus immunity of an individual depends on his body configuration, nature of food intake, nature of the tissues formed and emotional and mental status.[lxxxi]

Literally, Vyadhishmatva means status of the Bala of the body. Acharya Sushruta has told that Bala is nothing but Oja of the body.[lxxxii]

Acharya Dalhana explains that Abhyantara prana, Bala of the body is basically derived from Oja. Thus, vyadhikshmatva is related to Bala and Bala related to Oja.

Properly developed Bala pacifies vitiated Doshas and also subdues the strength of the disease.[lxxxiii] Bala depends on the Dhatus.

IV. DEVELOPMENT OF OJA

At the time of conception, first of all origin of Ojus takes place.[lxxxiv] As the honey bee collects honey from nectar of different flowers and fruits likewise Guna present in human being by their karma collects Ojas in our body.[lxxxv]

Para and Apara Ojas nourishes all and help in constitution of life without which no can survive. Being situated in the heart, it is the seat of Prana. It is the essence of life and also provides of nutrition to the embryo.[lxxxvi]

Thus, Oja develops at the very onset of life of an individual by which Sahaja Bala is initiated.

A. Functions of Oja

Acharya Kashyapa says that when quantity of Ojas in our body increase, then only body increases, then only body increases in size and when Ojas decreases in quantity then our body become inactivated.[lxxxvii]

Similarly Acharya Sushruta told that Ojas is the base of our Pranas. Due to Kashaya of Oja our body get destroyed.[lxxxviii]

B. Kashaya of Oja

There are certain causes due to which Oja Kshaya occurs ex. Immunity declines, like Dhatu-Kshaya, anger, worry, exertion, anxiety etc. similarly, all the causes of  mental and physical exhaustion or disturbance, cause Oja-Kshaya.[lxxxix]

There are 3 types of abnormalities of Oja:

• Visransa- In this type, dislocation of joints, body ache, and Prasara (Movement of vitiated doshas) of Doshas from their sites, physical and mental loss of function occurs.
• Vyapada- In this type the symptoms are heaviness and loss of functions of organs of body, vatic shotha, discoloration of body, malaise, drowsiness and excessive sleep.

It is very much similar to the anaphylactic reaction.

• Kshaya- In this type, fainting, giddiness, emaciation of muscle, confusion, delirium and death may occur.[xc]

After digestion of food is converted in Poshaka rasa, the primary nutritive pool, which get transformed into the first Dhatu, Rasa dhatu with the help of Rasagni, the specific metabolic Agni located in existing Rasa dhatu. The vital essence of Sapta-Dhatus is called Oja.[xci] As per Acharya Sushruta it is extreme apex power of all the Dhatus and is possible for biological strength, vitality and immunity against disease.

C. Seat of Oja

Acharya Bhela has enumerated 12 seats of Oja such as Shonita, Mamsa, Meda, Asthi, Majja, Sukra, Shukla, Sweda, Pitta, Sleshma, Mutra and Purisha.

V. BALA

The term Bala as described in Ayurveda, means resistance power of body. As per Acharya charaka arogya depends on Bala or body resistance.[xcii]

Acharya Sushruta says; always try to maintain the Bala or resistance of a person. If restored it arrest the progress of disease.[xciii]

The term Bala has been referred to signify both Oja and Bala in Sushruta- samhita which can be considered as power, force, vigour, strength and vitality.

A. Classification of Bala

There are 3 types of Bala in the body.[xciv]

1. Sahaja Bala:[xcv]

a. Situated in the body since formation of embryo, so it is called as natural Bala of body.

b. Its status depends upon the quality of Shukra Artava, Garbhashyaya, Rasa and Satmya.

c. Physical and mental status of parents plays a vital role in the formation of this type of Bala.

d. It remains unaffected by external environment.

e. This type of Bala is inherited.

2. Kalaja Bala:[xcvi]

a. This type of Bala changes with environment and influenced by seasonal variations and maturity of age.

b. Susceptibility to a disease changes with progressive seasonal variations.

c. Maturation gained with passage of time. Ex. Bala, Kaumara, Yuva and Vridhha stages of life also influenced susceptibility to diseases e.g. upper respiratory infections are more prevalent in the childhood.

d. Bala turns more prominent during young age and later decreases as the age advances.

3. Yuktikrit Bala (Yogaj Bala):[xcvii]

a. It can be achieved through the proper Balanced diet, proper life style and activities (Mental and spiritual) and also by use of certain medicines like Rasayana, Ojovardhaka etc.

b. The Bala can also be classified on the basis of Satva  (mental strength).[xcviii]

• Pravara (High)
• Madhyama (Moderate)
• Avara (Low)

• Pravara satva: This is attainment of greater capacity to tolerate pain and mental torture without being discouraged or demoralized.
• Madhyam Satva: The individual with Madhyam satva initially get disturbed but recollect the morale by getting solace and words of sympathy from others.
• Avara Satva: These individuals have lower capacity to bear any distress either physical or mental and get annoyed out of proportion with slightest disturbing situation or physical trouble pain etc.

B. Changes in status of Bala[xcix]

1. According to Seasons

2. Based on diurnal variation/ Dominance of Doshas

3. According to Age

C. Factors that Decreases Bala[c]

1. Abhighata (Injury)
2. Kshaya (Wasting)
3. Krodha (Anger)
4. Shoka (Grief)
5. Chinta (tension)
6. Sharma and vyayama (Physical exertion)
7. Bhutopghata (Severe Infection)
8. Ativrartana of kapha, sonata, sukra, mala ( Excessive loss of body fluids)
9. Prajagrana (Prolonged awakening)
10. Anashana, Atilanghana ( Nutritional deprivation)
11. Kala, vatatapa,jara (Season, environment and age)
12. Doshavega (Severe humoral upset)

D. Factor increasing Bala (Immunity)[ci]

These Factors potentates the inborn Sahaja Bala or attained Yuktikrit Bala and thereby increases the immunity-

1. Birth in the country where people are naturally strong (Balwaan desha) e.g. Punjab
2. Favourable disposition of time or born in the balwaan kala e.g. Visarga kala
3. Excellence of genetic factors (Beeja-shetra guna sampat)
4. Excellence of ingested food (nutritious diet) e.g. fruits, milk, ghee etc.
5. Excellence of Satmya- Accustomed for all 6 Rasas.
6. Excellence of Satva (mentally Strong)
7. Favourable disposition of race and species (Sambhava samsiddha)
8. Physical exercise (Karma)
9. Cheerfulness (Samharsha)

E. Assesment of Bala

As per Acharya Vaghbhata, the function of Udanavayu is  provide the strength to the body and the mind.[cii]

Bala can be examined by Anumana Pareeksha and can be measured by analysing ten factors Prakriti, Vikriti, Sara, Samhanana, Pramana, Satva, Satmya, Ahar-shakti, Vyayama shakti and Vaya. Constitutional Bala in Oja and Prakrit kapha is responsible for Sahaja Bala.[ciii] ‘PrakritasthyaBalam Shleshma’.[civ]

F. Characteristics & Abnormalities of Pranavaha Srotas

The Pranavaha Srotas anomalies as represented in classics are, frequent breathing linked with sound and discomfort, exertion on mild activity and symptoms like Akrosa, Vinaman, Moha, Brhaman, Vepana, and Marana or likely to precipitated when there is out or other traumatic lesions in Pranavaha Srotas

Conclusion

Ayurveda science promotes the concept of Vyadhikshamtva . It is the body\'s immunity and has a significant relevance in our daily lives, as well as for the well-being of all living beings, not only for disease prevention but also for disease rehabilitation, based on the concept of Ojas , or Vyadhikshamatva or Bala (Prakrit Kapha),. According to Ayurveda, prevention play as the fundamental role to the fight against disease and its treatment, therefore strengthening the immune system is essential; it aids the body for fight towards disease-causing factors. Acharya emphasised the use of Rasayana (Rejuvenation) to improve Ojas and Vyadhikshamatva throughout ancient times. Conflict of Interst: Author do not have conflict of interst.

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