Introduction:

Rasayana, or rejuvenation, is a therapy through which one can achieve the aim of Ayurveda. It not only helps in maintaining health, it also enhances the bala (strength), thus developing the Vyadhiksamatwa?(immunity).

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Sushurata?s school of Surgery emphasizes Rasayana chikitsa (rejuvenation therapies) for repairing wear and tear of the body due to aging or disease. This treatment is planed in three ways,

Preoperative

Postoperative

Adjuvant therapy

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Importance of Rasayana in Shalya Tantra

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?Bala (strength) in a person depends on Vyadhikshmatwa (immunity), Rasayana boosts ojas (life span) and the immune system. If the person?s bala (Strength or immunity) is less i.e. alpabalavan Shastra karma (surgery) is contraindicated.

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Rasayana as a Preoperative:

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Here the importance of eliciting Rasadi datus (plasma tissues) is given through Bruhana karma?(nourishment therapy), in Vrinita?(Wounds) ?and Shoshi (emaciation). Even though ??Brunhana differs from rasayana still we can consider here giving importance to the nutrition.

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Malnourishment:

Protein energy malnourishment interferes with the wound healing.

Wt. loss than 20% than ideal body weight.

S. Albumin less than 30mg/dl.

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Anemia:

No operation is conducted with Hemoglobin less than 10 gms. Because the oxygen carrying capacity of blood is less, which results in delayed wound healing

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Vitamin deficiency:

Vit. C - helps in Collagen formation

B complex ? Carbohydrate metabolism

Vit. K ? Synthesis of prothrombin

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Different vitamins are involved in wound healing. Eliciting these vitamins is a very important preoperative measure. Deficiency of these vitamins can be considered as lsjaua avastja (muscle wasting) of Sapta dhathus (seven tissue layers). Improving these values can be considered as Rasayana Chikitsa.

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Kshara (alkali) as Pre-operative:

If the patients bala and agni (digestive fire) are less or weak we must increase the patient?s agni. Paneeya (liquid) kshara is given for 2-3 days. Thus by increasing agni and bala the patient is made fit for surgery.

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Rasayana Post operatively:

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As there will be Rakta dathu loss and patient will loose strength in a post-operative care. Some times it may take more time to gain the strength and resume the normal duties. In such case different rasayanas according to need, help patient in regaining the strength also he can resume back duties soon.

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Rasayana as an adjuvant therapy:

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For surgical disorders where the patient is unfit for surgery or they don?t want to undergo the surgery, rasayana with respect to specific disease helps a lot. Some of them are as follows.

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A) Vardhamana (increasing order) Pippali Rasayana: (Pippali given in increasing order) [Su.Su.5^th Chap Mahavatavyadhi Chikitsa]

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Indications

Arochaka (anorexia), Pandu (anemia),?Pleehodara (splenomegaly), Udara (ascities), Yakritodara (Hepatomegaly), Swasna (difficult breathing), and Kasa (cough)

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Action: Promoting nutrition through improving Agni.

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B) Bhallataka:

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Bhallataka is teelsjma dravua (potent drug) . It is very effective for different carcinomas. It is used in different forms as,

Bhallataka Taila

Bhallataka Ksheera paka

Bhallataka? Leha

Bhallataka Gutika

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Indications: Arshas, Carcinoma of Esophagus, Carcinoma of Larynx, ?Carcinoma of Pharynx

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??????????? ?If the carcinoma is kapha sthana (Site of Kapha or Uraha pradesha) it has good results. Other than kapha sthana no much results are observed. Besides it is used locally with Danti and Chitraka in Arbuda (cancer) and granthi (small, hard, benign tumors) (Bhi. Rat.).

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C) Guggulu: (resin)

Indications:

Gulma (abdominal tumors), Prameha (diabetes), Udavarta?(gaseous abdominal distension), Bhagandara (fistula-in-ano), Arbuda (cancers) and Udara (abdominal diseases or collection of fluid in the peritoneal cavity ).

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Action: by promoting competency of srotas.

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D) Yasthimadhu

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Widely used drug both systemic and local application, either alone or in combination. Achrya Sushuruta has advocated local application in Pittaja vrana (wounds with burning or infection), Sadoya vrana (fresh wounds), Dagda vrana (burns), and Bhagna (fracture). In Granthi Arbuda (cancerous tumor) both local application and systemic administration are advised. Many researchers have found very good results with yasti as an immunomodulatory, anti-inflammatory, and for wound healing.

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D) Rohitaka:

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It is well known pleehanga (used in spllenomegaly) . Many research works have proved its anti-leukemic and anti-cancer properties.

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E) Ayaskriti:? (Name of a compound with iron as main ingredient)

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It is mentioned in Su. Chi. Mahakustha chikitsa and Prameha pidika (diabetic carbuncle). Even though Premeha Chikitsa? does not come under Shalya tantra , but? bhedavasta (complication) like prameha pidika(Diabetic carbuncle) is Shalya?adhikarana (disease should be treated by a surgeon). Here there will be dhatu kshaya (decreased rasadi sapta dahus/nutritional status) and requires Rasayana .

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Indications: Pandu (anemia), prameha pidika (diabetic carbuncle), and kushtha (obstinate skin conditions).

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F) Ksheerapaka:?(Medicated Milk): Milk processed with herbs

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Ksheera (Milk) is nitya (consumed daily) rasayana. Ksheera paka is used according to the need of patient and the disease.

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• Yastimadhu ksheera paka in amlapitta (acid gastritis) and pittaja shoola?(abdominal pain with burning)
• Yastimadhu ksheera basti (enema) in shoola (abdominal pain)
• Bhallataka ksheera paka in Carcinoma
• Ashwagandha ksheera paka as pre operative and post operative

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Rasyana in arbuda (cancer):

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Cancer is not a single diseases rather a syndrome. It is the largest killer disease in the world. Due to change of life style and food habits, its prevalence has been increased. The Ayurvedic line of supportive therapies is highly beneficial. It helps in reducing the adverse effect of chemotherapy and radio therapy. Some of the herbs have proven anti cancer activity.

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Some of the rasayanas used: amalaki rasayana, shatavari guda, chayavana prasha, triphala rasayana, gandhaka rasayana etc.

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Achara rasayana: (good conducts)

Acharya Sushruta has clearly advocated the importance of pathya (do?s) and apathya (don?t?s) for? vrinta (injury) & before and after surgery. One should avoid vyayama (exercise) and vyavaya (sexual indulgence)

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Conclusion

• Ayurvedic drugs have rasayana effect even used single.?
• Rasayana drugs are the best immuno-modulatars.
• Better healing of wounds can be achieved by administration of rasayanas.
• Rasayana drvyas?(medicines) may not cure the carcinoma but helps the patients to live the near normal life.???????????