Article on Ayurvedic Ophthalmology Part -1

[Guest guest]

Dear Friends,

It will be quite interesting to know that Ayurveda do contains a

branch known as 'SHALAKYATANTRA' which deals with treatment of eye,

ear, nose ,throat disorders & diseases of head &

neck.'NETRAROGA'(ayurvedic ophthalmology) is a specialised branch of

this Shalakyatantra.

 

I would like to spread this message of Ayurvedic Ophthalmology

through simple article.So from today I will be sending this article

in parts as a part of Ayurvision Bulletin of my site

www.ayurvision.com

 

AYURVISION BULLETIN AUG.2004

 

Article : INTRODUCTION TO AYURVEDIC OPHTHALMOLOGY PART - I

 

INTRODUCTION TO AYURVEDIC OPHTHALMOLOGY

 

Dr.Aashish Phadke.

 

Introduction

 

" Doctor, please let me know , whether Tina will be able to see

again ?..... " ,a difficult question was asked to me by Tina's mom….!!

Tina , just completed her 2nd year in microbiology & started

complaining that she could not see properly since last few

weeks, even while looking through the microscopes she was not that

comfortable as

she was before.naturally her parents took her to family doctor & then

he referred her

to an ophthalmologist.He saw her fundus ( retina of her eyes ) &

said she needs to be

visited to a vitreo retinal surgeon ( a super specialist eye surgeon

with the speciality

with retina ), he told that Tina's retina started degenerating, there

are patches on the retina of her both eyes, as well there is a start

of degeneration of macula of one of her

eye, so in nutshell she was diagnosed as a case of `Retinitis

Pigmentosa' (R.P.)of both eyes with `Macular Degenarative changes' in

one of her eye. Also did he mentioned that there is practically no

successful treatment so far to treat this condition of R.P. & let

Tina & her parents accepts this fact soon !

When Tina's mom heard that, there was a great disappointment for

them. When they knew about possibility of treatment with Ayurveda ,

they have brought her to my clinic.

Basically being a post graduate in Ayurveda ( M.D.Ayurveda) & having

qualified in modern ophthalmic sciences I am treating different eye

conditions which are left out by modern ophthalmologist. Only where

there is an absolute requirement of intervention of surgical

procedure then I do recommend those cases to my fellow colleagues

opthalmic surgeons. So when Tina came to my clinic , her vision (

visual acuity ) was less than 4 feet with right eye & 6/60 partial

that means the first line of the vision chart that to be blurred)in

her left eye. Her mom was asking me , " Doc, please tell me know, can

our Tina see again ? Will it be possible to stop the degeneration at

least in her better eye? Can we reverse the changes of her retina due

to R.P? " " Doctor, please don't feel bad, but whether is it true that

Ayurveda has any remedies even for Eye Disorders ? " ……

Yes, this is just a representative questions, but similar kinds of

several questions are being asked even by our medico friends,

basically because they are really ignorant about the fact that

Ayurveda not only treats diseases like asthma, diabetes, psoriasis or

arthritis but also speaks in length & treats Eye Disorders ! In fact

there are separate chapters devoted to the description of eye

diseases, about their diagnosis & also about their therapeutic

procedures in different ancient classical texts of Ayurveda. Many of

us might not be aware of the fact that in Ayurvedic curriculum ( of

B.A.M.S.- Bachelor of Ayurvedic Medicine & Surgery course, in the

last year) there is a separate paper on `Netraroga' (Ayurvedic

ophthalmology), along with the second paper on Disaeases of E.N.T. &

Oral cavity and head region ( `Karna nasa mukha & shiroroga')., along

with concerned practicals & case takings ( oral examinations on

patients).

 

 

 

 

Ashtang Ayurveda

 

Many a times there is a misconception that Ayurveda doesn't have any

knowledge about surgical disciplines, moreover there is absolutely no

mention about eye disorders, but this is not true.Ayurveda do have

separate specific specialties with references to different eight

disciplines.That is the reason Ayurveda is also known to be Ashtanga

ayurveda.The eight branches constitutes study of the following

disciplines, viz. –

1.Kayachikitsa – General Medicine or Internal Medicine.

2.Balachikitsa – Paediatrics as well as Gynaecology & Obstetrics.

3.Grahachikitsa – Psychiatry & Parapsychology.

4.Urdhwangatantra or Shalakyatantra

– Diseases of Eye, Ear, Nose

Throat & Head region.

(Ayurvedic

Ophthalmology,Ayurvedic Oto-rhino-laringology

& Ayurvedic Neurology. )

5.Shalyatantra- General Surgery, Orthopedic Surgery, Plastic Surgery.

6. Danshtrachikitsa – Toxicology.

7. Jarachikitsa –Geriatrics.

8.Vrishyachikitsa- Including Rasayan & vajeekaran therapy – Prohost

therapy,

Aphrodisiac therapy,

rejuvenation therapy, Immunomodulation

Therapy.

 

What is Shalakyatantra ?

 

According to the definitions of `Vagbhatacharya'

& `Sushrutacharya',Shalakyatantra can be defined as that branch of

Ayurveda, in which there is a provision for management of disorders

of the parts situated above the level of the clavicles

(urdhwajatrugata vikara ), namely that of Ear- Nose – Throat

(Shravana – vadana ghranadi ) i.e.Otorhinolaryngology & Eyes

(Nayanadi ). At other rference it has been stated by Dalhanacharya,

that this branch is known to be Shalakyatantra , because while doing

the examinations of these regions as discussed before , one need to

take help of a small instrument – a probe or thin metallic structure

known to be Shalaka, & hence the name of the branch is Shalakyatantra.

Synonyms Of Eye

Various synonyms of eye have been discussed in Ayurveda , they are as

follows – Nayana, Netra, Budbuda, Akshi, Chakshu, Netragolaka etc

Concept of Anatomy & Physiology of Eye in Ayurveda

In certain texts of Ayurveda, like in Sushrut samhita, anatomy &

physiology of eye has been discussed in great details. They have

mentioned thousands of years before that the shape of eye is oblong &

not a perfect round , ( Gostanakaram ) thickness of the eyeball is

close to the thickness of ones own thumb ( swangushthdara

sammitam ) , they have even discussed about different coats / layers

(patal) , various junctions( sandhi), about pupil (drishti) , inner

canthus(kaninak), outer canthus(apanga) , about lens, eye lids, eye

lashes & many more such relevant things in Ayurvedic anatomy of

eyeball(Netrasharira).

 

While discussing about Ayurvedic physiology of eye , they have

mentioned that the main dosha that is responsible for the very basic

function of eye that is nothing but sight, to see , is no other than

Pitta & that to again a subtype of Pitta known as `Alochaka Pitta'.I

am sure all of us would salute to our ancient masters who knew that

there were two distinctive components were responsible for the act of

seeing , one in the eye itself ( may be in the retina ) & other in

the brain as a optic centre, which they have clearly mentioned then

as the `Chakshurvaisheshika Alochaka Pitta' & `Buddhirvaisheshik

Alochaka Pitta' respectively.

The clinical application of this anatomical background of eye was

reflected clearly in the area of classification of eye diseases

mentioned in those days by `Sushrutacharya' in his samhita.One may

see description as Pakshma roga ( Diseases of Eye lashes ),

Vartmaroga ( Diseases of Eye lids ),which is having a striking

similarity with the that of the classification of eye disorders being

accepted by the contemporary modern ophthalmology !

Etiology Of Eye Disorders (In General)

(Netraroga, Samanya Hetu)

 

Ushnabhitaptasya Jalapraveshat

Dooreshanat swapnaviparyayat chal I

……………………………………….

Bashpagrahat Sookshma Nirikshanat chall

Netre vikaran janayanti ghoran II Ref.

(Su.Samtita / Uttar ; Ch 26/4)

- Ushnabhitaptasya Jalapraveshat -After coming from (hot

environment) outside especially in the afternoon, and to jump in a

river / water / for swimming, on in today contest to take cold water

bath / shower on even a step ahead, one may interpret it, as a sudden

change of temperature zone. eg. from heat zone, if one enters

suddenly to a Air- Conditioned chilled chamber.

- Dooreshanat -means to see object at for constantly eg. in

professions like astronomers / Scientists in the observatories,

personnel from military at boarder, personnel from Railway Merchant

Navy to see signals.

- In all these cases, one may have increased strain on eyes,

leading to ocular disorder.

Swapnaviparyayat cha:- means alteration of the pattern of sleep.

Usually seen with those on shift duties. Workers, Engineers, Nurses &

even Doctors on well by everyday havit of sleeping at daytime

biorhythm & can leads to strain on eyes leading to ocular disorders.

Prasakta, Samrodan, Kopa, Shoka, Klosha

By taking too much of tensions for crying for a longer period, by

becoming very angry on by taking excessive efforts out of capacity

all these things may lead to increase in vitiated Vata Dosha leading

to ocular disorders.

 

Abhigatat (i.c. due to traumatic injury)

These exists seven ocular emergencies.

Atimaithunat Cha :- By having excessive sex, again these will be

vitiation of essential vital tissue Shukra & even of Ojas & will be

increase in vitiated Vata leading to ocular disorders.

Shukta, Aranal, Amla - are all sour preparations having them in

excess may lead increase of vitiated Pitta & Rakta leading to ocular

disorders.

Kulatha, Masha- these again leads to increase in vitiated Vata dosha,

leading to ocular disorders.

By controlling essential urges (Vega vinigrahana) like passing urine,

or defecating stools, (these are 13 such urges which should not be

controlled as per Ayurveda)

By taking increased amount of Sudation( swedan) : eg. to sit more in

a Saunna bath.

Dhoomranishevana : By smoking excess is one way of interpreting if &

other way may be contact of eyes to Gas / Fumes / eg. pollutant on

roadways / industries etc.

Having excessive procedures in Purificatory measures (Panchakarma)

viz. Vamanatiyogat Excessinve induced emesis (Vamanatiyogat)etc.

Sookshma Nirikshanat cha-means to observe microscopic objects for a

longer period. May lead stress eyes, leading to ocular disorders e.g.

Pathology technicians, Diamond Cutter, Wrist watch repairers etc.

In a current situation, in 21st century more & more number of people

are getting introduced to Personal Computers, even starting from

school going children to the office attending executive, has to work

in front of computer screen for a longer period , similarly kids/

teenagers one spending hours together staring at computer screen

while playing with computer games also in front of television screen

all these also can be considered to be modern hetu (Reasons) for

increasing ocular disorders.

In Traumatic Eye Disorders Aghatajanya Netravyadhi ,there exists

traumatic lesion first, & the doshasushti latter (Vitiation of dosha

follows thereafter.)

 

How do these Eye Disorders takes place ? ( Samanya Samprpapti –

Pathophysiology of Netraroga)

According to Sushrutacharya -

Due various reasons, dosha gets vitiated & increased (Prakopa)

leading to their way upwards towards eye, & gets entered in different

Channels / Vessels( sira) of Eye, creating

vitiation (Dooshti) of different organels of an eye. In this way

there exists eitiopathogenesis of an eye disorders in general.

Total number & the classification of Eye Disorders

Discussion with regards to classification of an eye disorders

according to different scholars of Ayurvedic Opthalmology number of

eye disorders mentioned according to different masters ( Acharyas)

are as follows -

Sushrutacharya & Vagbhatacharya 76 types

of Eye diseases

Charakacharya 96 types of

Eye diseases

Madhav Nidanakar

78 types of Eye diseases

Different Approaches of the classification of an Eye disorders

according Ayurveda.

- A. Based on Dosha type

- B. Based on Therapeutic approach.

- C. Based on Anatomical Approach.

 

Out of which the last option i.e. based on anatomical approach is

still followed by contemporary ophthalmologist in their standard

texts on ophthalmology (eg. Diseases of lids, disease of cornea,

diseases of sclera etc.,)

A. Classification of eye disorders according to Dosha type.

In this approach surprisingly a great efforts have been taken to sub

classification of diseases ,according to their tentative prognostic

values ,such as easily manaageble/completed curable ie. Sadhya,

difficult as treat ie, Yapya & Untreatable ie. Asadhya apat from its

doshik classification such as Vataj, Pittaj, Kaphaj etc.

B. Classification of eye disorders based on Therapeutic Approach

1) Cheddya ( to be incised) - 11 4) Vedhya ( to be

punctured -15

2) Lekkhya ( to be scraped ) - 9 5) Asadhya ( Non treatable)

-24

3) Bheddya ( to be punctured ) -5 6) Shamanarha(conservative line

of therapy)1-

 

( Next part will be mailed latter)

Please do communicate with your views

With warm regards,

Prof.Dr.A.S.Phadke,India