|Year : 2019 | Volume
| Issue : 3 | Page : 139-141
Ayurveda episteme on quality of life parameters
Department of Kaumarabhritya, Mahatma Gandhi Ayurved College, Hospital and Research Centre, Datta Meghe Institute of Medical Sciences (DMIMS-DU), Wardha, Maharashtra, India
|Date of Submission||31-Jan-2020|
|Date of Decision||07-Feb-2020|
|Date of Acceptance||03-Feb-2020|
|Date of Web Publication||19-Feb-2020|
Dr. Srihari Sheshagiri
Department of Kaumarabhritya, Mahatma Gandhi Ayurved College, Hospital and Research Centre, Datta Meghe Institute of Medical Sciences (DMIMS-DU), Wardha, Maharashtra, 442001.
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sheshagiri S. Ayurveda episteme on quality of life parameters. J Indian Sys Medicine 2019;7:139-41
Sense of well-being in every domain of health is appraised as quality of life (QOL). Understanding the level of satisfaction of a patient towards his response to a particular treatment or a therapy remains the prime purpose of assessing QOL. It is either assessed by a physician/third person or self through a structured questionnaire, the findings of which are purely subjective.
The term QOL, first originated in medical literature of contemporary medicine in 1960. However, QOL assessment has become more popular only in recent decades. The first article based on QOL assessment was published on spinal cord injury. An overview on the development of the need of assessing QOL dates back to 1949, when the benefits of new chemotherapeutic agent used in the treatment of cancer and its impact on patients were studied.
| What Does QOL Really Assess?|| |
In 1947, World Health Organization (WHO) defined health as a “state of complete physical, mental and social well-being and merely not the absence of disease and infirmity.” This definition of health and QOL has a thin line of difference, and had created confusion and controversies in differentiating them. The factors which necessitated the relevance of QOL assessment are the implications of the treatment or therapies on the state of physical, mental and social well being in the patient and not merely recovery from the disease or enhancing the life span, or increasing the period of remission. Hence, the methodology that assesses QOL includes at least the aforementioned three dimensions of health. Different models of QOL were developed since its inception, and currently WHOQOL models are in use.
The utility of QOL parameters has gained significant importance in all types of research studies, which involves therapeutic, diagnostic, or preventive interventions in humans. Being subjective in nature, defining QOL is also subjective as it is determined by the feeling of a patient toward a treatment and the extent to which it is fulfilled. Similarly, it is difficult to fix a specific model or approach to assess health-related QOL. QOL can also be determined as the consideration of patient’s current state after undergoing a treatment against something, which they consider as ideal.
| Ayurveda Episteme|| |
Ayurveda, the traditional medical system, which originated some 5000 years ago from India, is one of the most systematically documented sciences of medicine. It has laid down many fundamental concepts of health and disease, which are relevant even in current era. There are various interpretations of the term “Ayurveda,” the literary one being “knowledge of life.” On understanding the concepts described in the classical literatures, the most appropriate interpretation of Ayurveda would be “knowledge about scientific way of leading life.”
Like any medical system, the preservation of health is the high-end of Ayurveda. It would be highly impossible to understand the concept of Ayurveda without understanding its basic fundamentals. The system considers man to be analogous with the nature. The basic five elements (earth, water, fire, air, and space), which form the nature, are considered to be responsible for the creation of Purusha (human) too. The inherent characteristic features that make an individual distinct from one another are termed as Sharirika Prakriti (physical constitution), which are seven in number, and Manasika Prakriti (mental constitution), which are three. Three basic functional units constitute the core of health and disease in every individual, which are Vata, Pitta, and Kapha. Seven are the structural entities (Dhatus), which support the body, and three are the biological wastes, which are produced by the body.
Swasthya (healthy) is said to be those individuals, who have balanced state of Dosha (humors), Agni (metabolism), Dhatu (body tissue), Samyak Malakriya (proper excretory functions), and Prasanna Atma, Indriya, and Mana (pleasant state of soul and mind, clarity of intelligence, and sense organs). This definition of Swasthya by Acharya Sushruta incorporates the well-being of an individual at physical, mental, and spiritual echelons. In the same context, imbalance of the aforementioned factors is termed as the cause for Vyadhi (diseases). Therapeutics in Ayurveda are based on balancing the factors responsible for health, without hampering the normalcy of the other. For this purpose, two main treatment principles are suggested to be used, that is, pacification (Shamana) and purification (Shodhana). These varieties of treatment principles again have different subdivisions among them. Medicine (Bheshaja) is said to be of two types as per Acharya Charaka, the primary type is known as Urjaskara (invigorators) and the secondary type is known as Roganuth (disease/symptoms alleviators). The classification of medicines in the aforementioned types suggests the multidimensional approach of the system toward health and its very scientific nature. Invigorators are the special contribution of Ayurveda to the welfare of mankind, which is wanting in contemporary medicine.
State of being healthy is understood by the ability of a person to utilize his life span to full potential and without any hindrance to perform his desired activities. Acharya Charaka, in his treatise, has elaborated the Dashavidha Parikshya (10 types of examination), which are as follows:
- Kaarana (responsible to bring about action): is a physician, whose actions are responsible for bringing balance of Dosha and Dhatu in the body
- Karana (instrument for action): is a drug, which is used to achieve the required effect
- Karyayoni (source/cause for action): etiology (imbalance of Dosha and Dhatu)
- Karya (action): treatment measures, which cause equilibrium of Doshas
- Karyaphala (fruits/results of action): effect of therapy
- Karya Anubhandha (subsequent manifestation): seen after treatment such as drug causing longevity
- Karya Desha (place): site of disease and place of patient residence
- Kala (time): stage of the disease, time of administration of medicine, and season of the year
- Pravrutti (stimulus/initiation/endeavor): initiation of action as a means (therapeutic actions) to achieve the objective
- Upaya (path/means of action): includes excellence of the Kaarana and Karya
Among the aforementioned 10 examination factors, the parameters used to assess Karya, Karyaphala, and Karya Anubhandha can be taken up as the measures of QOL in a patient who has undergone specific therapy or treatment.
| KARYA|| |
Maintaining the equilibrium of Dosha and Dhatu and the alleviation of Vikara (suffering) is said to be the main purpose of Karya. The effectiveness of which can be assessed as based upon the features observed in the factors mentioned below,
Rugupashamana: alleviation of pain
Swara Varna Yoga: enhancement of texture, luster of skin, and clarity of voice
Sharira Upachaya: nourishment of the body
Balavriddhi: increase in strength
Abhyavaharana Shakti: consumption of appropriate quantity of food
Ruchi Aharakale: better taste perception of the food consumed
Jarana Shakti: improved digestive capacity
Vata Mutra Retasam Mukti: timely evacuation of flatus, urine, bowels, and seminal fluids
Nidra Labho Yathakalam: sufficient timely sleep
Sukhena Cha Pratibodhanam: feeling of well-being
Vaikarikanam Cha Swapnanam Adarshanam: absence of discomforting dreams
Mano Buddhi Indriya Avyapatti: uninterrupted perception of knowledge through sense organs and mind by which routine activities and interaction with the people remains unaffected
| Karyaphala and Karya Anubanda|| |
The fruits of the action are said to be the feeling of Sukha (containment) and Mana Buddhi Indriya and Sharira Tushti (satisfaction in the functioning of the sense, motor organs, and body). Attainment of longevity is said to be the subsequent manifestation of any Karya. These two examination points also indicate the posttreatment effect in a patient that indirectly has relation with his QOL.
Subjectivity of the aforementioned Ayurveda parameters, which encompasses the physical, psychological, and social tenants when observed critically, is the very reason behind comparing them with health-related QOL parameters. Limited published clinical research data are available in public domain, which have incorporated the Ayurveda QOL parameters as one of the measures of the treatment’s efficacy/success. Future studies incorporating assessment of these parameters would be of significant benefit in the field of clinical research in understanding the effectivity of the treatment/therapy.
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Conflicts of interest
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| References|| |
Post MW. Definitions of quality of life: What has happened and how to move on. Top Spinal Cord Inj Rehabil 2014;20:167-80.
Crewe NM. Quality of life: The ultimate goal in rehabilitation. Minn Med 1980;63:586-9.
Karnofsky DA, Burchenal JH. The clinical evaluation of chemotherapeutic agents in cancer. In: MacLeod CM, editor. Evaluation of Chemotherapeutic Agents. New York: Columbia University Press; 1949. p. 191-205.
World Health Organization. Constitution of the World Health Organization. Chron World Health Organ 1947;1:29-34.
Calman KC. Quality of life in cancer patients: An hypothesis. J Med Ethics 1984;10:124-7.
Carr AJ, Higginson IJ. Are quality of life measures patient centred? BMJ 2001;322:1357-60.
WHOQOL Group. The development of the WHO quality of life assessment instrument (the WHOQOL). In: Orley J, Kuyken W, editors. Quality of Life Assessment: International Perspectives. 1st ed. Berlin, Germany: Springer-Verlag; 1994. p. 41-57.
Agnivesha, Charaka, Dhridhabala, Chakrapani. Rogabhishagjithiya adhyaya: Verse 95. In: Gaur BL, Karawatiya R, Chahar D, Gaur V, editors. Charakasamhita: Vimana Sthana. 1st ed. Vol. 2. New Delhi, India: Rashtriya Ayurveda Parishad;2014. p. 515.
Kashyapa MM, Vrddha Jivaka, Vatsya. Vividha ashita pitiya adhyaya: Verse 8-9. In: Tewari PV, editor. Kashyapa Samhita (Vrddhajivakiya Tantra): Sutra Sthan. Reprint ed. Varanasi, India: Chaukhambha Visvabharati; 2008. p. 81.
Agnivesha, Charaka, Dhridhabala, Chakrapani. Dheerghajeevethiya adhyaya: Chapter 1, verse 57. In: Gaur BL, Karawatiya R, Chahar D, Gaur V, editors. Charakasamhita: Sutra Sthana. 1st ed. Vol. 1. New Delhi, India: Rashtriya Ayurveda Parishad; 2014. p. 75.
Agnivesha, Charaka, Dhridhabala, Chakrapani. Grahani chikitsa adhyaya: Chapter 15, verse 15-16. In: Gaur BL, Karawatiya R, Chahar D, Gaur V, editors. Charakasamhita: Chikitsa Sthana. 1st ed. Vol. 3. New Delhi, India: Rashtriya Ayurveda Parishad; 2014. p. 806.
Agnivesha, Charaka, Dhridhabala, Chakrapani. Grahani chikitsa adhyaya: Chapter 15, verse 17-18. In: Gaur BL, Karawatiya R, Chahar D, Gaur V, editors. Charakasamhita: Chikitsa Sthana. 1st ed. Vol. 3. New Delhi, India: Rashtriya Ayurveda Parishad; 2014. p. 810.
Agnivesha, Charaka, Dhridhabala, Chakrapani. The charakasamhita, chikitsa sthana, abhayamalaki adhyaya: Chapter 1, pada 1, verse 4. In: Pranjivan Manekchand Mehta, Harshavantray Lalshanker Dholakia, Balwant Sharma Maganlal Dixit, Harilal Kalidas Shastri, Prabhudas Kalidas Vyas, Chandrakant Prabhushanker Shukla, et al
, editors. Charaka Samhita. Reprint ed. Vol. 3. Jamnagar, India: Shree Gulabkunverba Ayurvedic Society,2008. p. 1278.
Sheshagiri S. Evincing the role of rasayana (rejuvenation) therapy in managing cancer and the side effects of chemotherapy and radiation. J Res Tradit Med 2016;1:1-4.
Sushruta, Dalhana. Susrutasamhita, sutra sthana, doshadhatumalakshayavriddhivijnaniya adhyaya: Chapter 15, verse 41. In: Sharma PV, editor. Reprint ed. Varanasi, India: Chaukhambha Visvabharati; 2004. p. 173.
Agnivesha, Charaka, Dhridhabala, Chakrapani. Rogabhishagjithiya adhyaya: Chapter 8, verse 84. In: Gaur BL, Karawatiya R, Chahar D, Gaur V, editors. Charakasamhita: Vimana Sthana. 1st ed. Vol. 2. New Delhi, India: Rashtriya Ayurveda Parishad; 2014. p. 500-1.
Agnivesha, Charaka, Dhridhabala, Chakrapani. Rogabhishagjithiya adhyaya: Chapter 8, verse 89. In: Gaur BL, Karawatiya R, Chahar D, Gaur V, editors. Charakasamhita: Vimana Sthana. 1st ed. Vol. 2. New Delhi, India: Rashtriya Ayurveda Parishad; 2014. p. 508-9.
Agnivesha, Charaka, Dhridhabala, Chakrapani. Rogabhishagjithiya adhyaya: Chapter 8, verse 90. In: Gaur BL, Karawatiya R, Chahar D, Gaur V, editors. Charakasamhita: Vimana Sthana. 1st ed. Vol. 2. New Delhi, India: Rashtriya Ayurveda Parishad; 2014. p. 509.
Agnivesha, Charaka, Dhridhabala, Chakrapani. Rogabhishagjithiya adhyaya: Chapter 8, verse 91. In: Gaur BL, Karawatiya R, Chahar D, Gaur V, editors. Charakasamhita: Vimana Sthana. 1st ed. Vol. 2. New Delhi, India: Rashtriya Ayurveda Parishad; 2014. p. 509.