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Books > Ayurveda > Ayurveda > Heart Disorders and Their Care in Ayurveda
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Heart Disorders and Their Care in Ayurveda
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Heart Disorders and Their Care in Ayurveda
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About the Book

The book “Heart Disorders & their care in Ayurveda” written by the well known author Professor Ajay Kumar Sharma is a complete and comprehensive treatise on the subject. This is the first book in English which deals with the subject in all completeness and clarity covering all aspects of “Hrdroga” as described in various treatise of Ayruveda. The entire text is richly supported with original references from Ayurvedic classics. Latest information regarding various aspects of modern Cardiology have been in cooperated with the objective of providing basic knowledge to readers especially to Ayurvedic students, physicians and teachers for creating awareness among masses about the important possible role which Ayurveda may play for preventing various Cardiac Disorders.

Separate chapters have been added on aetiopathology of Hrdroga in Ayurveda with their principles of management, clinical approach in the examination of a cardiac patient, investigations recommended, some important cardiac disorders with their Ayurvedic approach of management, Ayurvedic approach of dietary management of cardiac disorders and role of Yoga and life style modifications in preventing Hrdroga (Cardiac Disorders). Most valuable information is presented in the chapter on “Tips for preventing heart diseases and prolonging life span”.

The author of the book being a senior Professor of Ayurvedic Medicine in National Institute of Ayurveda, Jaipur and being a reputed physician and researcher, this book has been richly benefited by his scholarship and professional experience. It is expected that this book will be useful for prosperous readers.

 

About the Author

Born on May 31st, 1954 Professor Ajay Kumar Sharma graduated in Ayurveda with Medicine and Surgery from A & U. Tibbia College, New Delhi in 1976 with throughout top rank career. He received many awards and prizes for his outstanding career. He did his M.D. (Ay.) and Ph. D. from B.H.U. under the guidance of his illustrious mentor Professor R.H. Singh.

Prof. Sharma is now the senior most Professor and Head of the P.G. Department of Kdyacikitsä and Deputy Medical Superintendent of the Hospitals at National Institute of Ayurveda, Jaipur. He is the Chief Ayurvedic Physician in the Institute. In the capacity of a reputed Ayurvedic physician, a capable teacher and an outstanding researcher, Professor Sharma has published several standard books on Ayurveda and over 110 research papers in various Journals of National and International reputation. He has contributed a chapter to the prestigious book “Scientific Basis for Ayurvedic Therapies” published by CRC Press, USA. He has produced 35 M.Ds and 5 PhDs under his dynamic supervision. He is the expert member of several communities and learned societies in India. Prof. Sharma has been short listed as an Ayurvedic expert for short term deputation to University of Natal, South Africa to help them in drawing course curriculum and setting up faculty for starting diploma Graduate degree course in Ayurveda.

 

Preface

The incidence of various Cardiac Disorders is increasing at an alarming rate in our country largely due to absolute changed concepts of diet & lifestyles. Of the total deaths, 33% deaths are reported to have been caused by heart diseases alone. It has been observed that about 15% of patients who sustain heart attacks are below the age of 40 yrs. Such a high incidence is related to the severe stressful situations existing in the modern ways of life and also due to the increased incidence of consumption of tobacco and improper control of hypertension and other underlying Cardiac disorders. Various heart diseases can be prevented by measures like regular exercise, control of hypertension, changing the dietary habits from high cholesterol to low cholesterol diet, stopping of smoking cigarettes and avoiding tobacco in any form.

In Ayurvedic classics very brief description of Hrdroga is available in various texts. In Caraka and Suruta Samhitã five types of Hrdrogas are described viz. Vãtika. Paittika, Kaphaja, Tridosaja and Krimija. While reviewing A yurvedic manifestations of Hrdrogas, it appears that broadly the description of Hrdroga covers mainly the description of Hricchula (Angina). Vyãna Vãyu, Sãdhaka Pitta and Aviambaka Kapha are described to be situated in the heart. The main function of these three humors is the maintenance of normal physiology of heart. Any imbalance in their equilibrium may lead to various Cardiac disorders.

Not many books are available on Hrdrogas giving Ayurvedic concepts with their critical analysis on modern lines. It has been observed that many research Centers and Post Graduate Institutes in India have developed various newer strategies in the management of Hrdroga. Such advances prompt to the need of producing newer literature incorporating the recent advances in terms of conceptual and strategic clarity and scientific development. It is with this background that the present book was launched.

It is observed that many Ayurvedic scholars including physicians, students & teachers are not acquainted with several modern Cardiac Disorders which are found so frequently in day to day practice. One of the most important reasons for this is quoted to be inability of Ayurvedic System of medicine in controlling several emergency conditions of Cardiac Disorders. That is why most of Ayurvedic Scholars ignore Cardiac Disorders. It is true that the dependent treatment of several Cardiac emergencies in time remains only modem system of medicine. But author feels that Ayurvedic Scholars must be competent enough to diagnose various Cardiac Disorders / Cardiac emergencies so that they may diagnose the condition early and if the underlying Cardiac Disorders cannot be managed properly by them, largely because of non availability of fast acting Ayürvedic drugs, the patient may be referred to appropriate places for saving his life. This is one of the important reasons of incorporating latest information about the subject in the present book.

This book is presented with chapters on Cardiology in Ayurveda General considerations, Clinical Approach in the Examination of a Cardiac patient, Laboratory Investigations recommended, Hrdroga in Ayurveda, Heart Failure, Shock, Inflammatory Diseases of Heart, Rheumatic Heart Diseases, Ayurvedic approach of Dietary management of Hrdroga, Role of Yoga and Life Style Modifications in preventing Hrdroga etc. All topics have been written with emphasis on the uniqueness and distinction of Ayurvedic Concepts with an attempt to evaluate the relevance and validity of the same in modern times.

The author of this book being teacher, physician and researcher in this field has utilized his professional experience with clinical medicine of Ayurveda in compiling the present book. It is hoped and believed that this small effort will prove to be of some benefit to the prospective readers to provide them glimpses of “Hrdroga - Cardiac Disorders” and their care in Ayurveda.

Opinions and suggestions to improve the book are welcome.

 

Foreword

Cardiac diseases constitute a major group of diseases which at times, are fatal. Modern Cardiology has advanced to a great extent which helps in treating Cardiac emergencies efficiently. In Ayurvedic literature we get a clear cut description of various Cardiac disorders by the term “Hrdroga”. But on screening ‘Ayurvedic test it appears that the description of Hrdroga in Ayurveda is very concise. Efforts are needed to revalidate the Ayurvedic description of Hdroga in Modern light. Very few books are available on Ayurvedic Hdroga which deal with the subject with scientific temperament. The present book “Heart Disorders and Their Care in Ayurveda” is a good attempt in that direction.

The author has tried to describe various concepts of Hrdroga by collaborating them with Modern Concepts on the basis of various references as quoted in various Ayurvedic texts. It appears that the author has considered Hdroga as described in various Samhitãs to be equivalent to Hcchü1a which needs further clarification. Critical analysis of the descriptions of Hrdroga as described in various Samhitãs was expected to be done on more broader basis. More emphasis has been laid down on modern descriptions, probably because of the impact of present times. As stated by Acãrya Caraka in the 1t4-c1:”, it is clear that the knowledge about Hidya was not so much limited to them as described in reference to Hrdya (The Heart - Clinical Concepts). The author has also tried to justify this fact later in the description of “Hyperlipidaemia in Ayurveda” who deserves appreciation for providing good critical analysis of the subject matter in this context logically.

The chapters on “Clinical Approach in the examination of a Cardiac patient” and “Laboratory Investigations Recommended in Cardiac Patients” are of great importance in the diagnosis of a Cardiac patient. The author has probably taken the lead from Modern Medical Science in this regard. Sophisticated laboratory investigations help to a larger extent in pin pointing the diagnosis of the underlying Cardiac disease which may affect the prognosis significantly.

The Ayurvedic description of the treatment of Hrdroga points towards While discussing the management of Hrdroga on Ayurvedic principles, emphasis has been laid down on dietary restrictions (Ahãra) and specific life styles ( Vihãra) which is most relevant in current situations. Indulgence in incompatible dietary factors and improper lifestyles leads to various stress induced Cardiac disorders which could be effectively prevented by adequate and proper administration of Pathya i.e proper diet and life style measures.

Over all“Heart Disorders and Their Care in Ayurveda” is a good piece of literary work. The author has shown great courage and competence in dealing the topic of Hrdroga, which is very important, useful and needs scientific explanations and clarifications of Ayurvedic concepts of Hrdroga, in modern light with scientific background. Prof. Ajay Kumar Sharma,who is a dynamic, hard working and intelligent person, has done full justice with the subject. He has covered a wide range of topics and aspects of Hrdroga and modern Cardiology and has dealt with the matter comjrehensively and systematically about the classical concepts and recent advances on the subject. I congratulate Prof. Sharma for his outstanding contribution to Ayurvedic literature. I appreciate his efforts in bringing out this useful book and wish him all success for this publication.

 

Acknowledgements

I desire to express my deep gratitude and indebt ness to Prof. B.L. Gaur, Director, National Institute of Ayurveda, Jaipur, an eminent scholar of Ayurveda, who has always been a source of inspirations and encouragements to me. I am extremely thankful to Prof. Gaur for having agreed to write the “Foreword” to this work.

This book is dedicated to my revered benevolent teacher Prof. R.H. Singh, Vice Chancellor, Rajasthan Ayurveda University, Jodhpur,who has always inspired me to work for globalization of useful knowledge of Ayurveda.

While compiling this book I received invaluable help from my post graduate scholars who inspired me to develop the subject with due rationality and clarity. I am especially thankful to Seema Bhadora, Sandeep Agarwal, Parshuram Singh Yadav, Komal Kankarana, Shreesh Mishra, Sandeep Pal Singh, Rajesh Gupta and Gaurish Gupta.

With profound reverence, appreciation and affection I wish to express my deep gratitude to my father (Late) Sh. S.L. Sharma, my mother Smt. Bimla Devi, my elder brother Mr. Ashok Kumar Sharma, my sister in law Smt. Neelima Sharma, my brother in law Dr. Y.N. Sharma ‘Arun’ and my elder sister Smt. Asha Sharma and all my friends and colleagues for their constant inspirations and blessings for completion of this work

It is my humble desire to express my deep gratitude and indebt ness to my wife Dr. (Smt.) Praveen Sharma, the main source of my inspirations and strength, my son Amit Sharma and my daughter Gauri Sharma for their love and support (without which this book could have never been completed) manifested in several ways but in particular through their patience and understanding.

Lastly I wish t acknowledge my obligations and sincere thanks to Mr. Sunil Gupta, my publishers M/s Indian Books center, 40/5 Shakti Nagar, Delhi -110007 (India) for his splendid cooperation and for printing the book so nicely and in time.

 

Contents

 

Chapter One  
Cardiology in Ayurveda: General Considerations: 1
Hrdya (The Heart)—Clinical Concepts, Ayurvedic and Modern Anatomical and Physiological Considerations. Dosika involvement in Hrdya. Hj-droga in various Samhitãs of Ayurveda  
Chapter Two  
Clinical Approach in the Examination of a Cardiac Patient: 12
History, Symptoms of Cardiac Patients, General Examination of a Cardiac Patient, Examination of Precordium  
Chapter Three  
Laboratory Investigations Recommended in Cardiac Patients: 21
Haematology, Biochemical Investigations, Liver Function Tests, Thyroid Profile, Urine Examination, Chest Radiograph, Pericardial Aspiration, E.C.G., Ambulatory Electrographic Monitoring, Tread Mill Test, Echo Cardiography and Doppler Study, C-T Scan, M.R.1., Nuclear Cardiology, Positron Emission Tomography, External Pulse Recording and Phono Cardiography, Cardiac Catheterization, Angiography, Coronary Angiography, Radio nuclide Techniques  
CHAPTER Four  
Hrdroga in Ayurveda: 29
Nidãna, Generalised aetiological factors of Hdroga according to various Acãiyãs, Specific Dosãnusãra Nidãna, Samprãpti, Pathogenesis, Role of aetiological factors in the development of Hdroga, Diagramatic representation of Samprãpti of Hrdroga, Pürva Rãpa, Rüpa, Clinical features of Doãnusãra I-Irdroga, Specific clinical features of Hrdroga, Classification of Hrdroga as described in Ayurveda, Complications, Arista Lakaña, Prognosis,General Principles of management of Hrdroga, Nidãna Parivarjana, Rest, Samsodhana Therapy, Samsamana Therapy, Pathyäpathya, Vihãra (Life Styles), Home Remedies—Medicinal Practices for prevention, Curative aspects of Hrdroga, Specific Treatment of Dosaja Hrdroga— Vãtaja, Pittaja, Kaphaja, Tridosaja and Krmija Hrdroga  
Chapter Five  
Heart Failure: 89
Definition, Pathophysiology, Grading, Types, Clinical Features,Symptoms and Physical Signs, Prognosis,Complications, Ayurvedic Concepts, Treatment, Principles, Samsodhana Therapy, Sam samana Therapy  
Chapter Six  
Shock: 97
Definition, Types, Causes, Classifications, Clinical Features, stages of Shock, Ayurvedic Concepts, Ojas, Para Oja, Apara Ojai, Vyãdhi Kamatva and Immunity, Precipitating Factors of Oja Ksaya (Shock), Disorders of Oja (Bala), Treatment  
Chapter Seven  
Inflammatory Diseases of the Heart:Aupsargika Hrdroga, Infective Endocarditis Hrdaantartwacã Sotha 111
Oupsargika Hdroga, Infective Endocarditis— Hdaantartwacã otha—Definition, Clinical features, Signs, Complications, prophylaxis. Pericarditis—Hrdãvarña .otba, Dry Pleurisy—Symptoms, Signs, Pericarditis with effusion—Symptoms, Signs, Chronic Constrictive Pericarditis— Definition, Clinical Features, Signs, Myocarditis Hrdamãnsa Pesi otha—Definition, Clinical Features, Signs.Ayurvedic Concepts—P athogenesis of Inflammatory Diseases of Heart, Prognosis, Treatment of Lacterial Endocarditis—Hda antartwacã otha, Treatment of Myocarditis—Hdamãnsapeái otha, Treatment of Pencarditis—Hrdã—varaña Sotha  
Chapter Eight  
Rheumatic Heart Diseases: 123
Definition, Types, Mitral Stenosis, Mitral Regurgitation,Aortic Stenosis, Aortic Regurgitation, Tricuspid Stenosis, Tricuspid Regurgitation—Their definitions, symptoms,Principles of Management of Valvular Incompetence or Valvular Regurgitation  
Rheumatic Fever—Säma Sannipãtika Sandhigata Jwara Definition, Clinical Features, Ayurvedic Concepts, Symptoms, Treatment  
Rheumatoid Arthritis—Ama vãta Definition, Criteria for the diagnosis of RheumatoidArthritis, Clinical Features, Articular features, Other manifestations,Radiological progression of Rheumatoid Arthritis, Salient points for disease activity assessment  
Ayurvedic Concepts—Amavata, Concept of Ama in Ayurveda, Characters, Properties, Definition of Amavata, Pathogenesis, Symptoms, Systemic Manifestations, Classification, Prognosis, Complications, Principles of Management, Medicines and Procedures Commonly Used in Amavata  
Chapter Nine  
Ischaemic Heart Diseases—Hrchchüla: 151
Definition, Causes, Risk Factors for Coronary Artery Disease (CAD), Clinical Presentations, Angina Pectoris— Definition, Risk Factors, Clinical Situations Precipitating Angina, Types, Clinical Manifestations, Grading of effort Angina by the Canadian Vascular Society, Myocardial Infarction—Definition, Clinical Manifestations, Ayurvedic Concepts, Hrchchüla, Treatment, Srotorodhajanya Hdroga, Clinical Manifestations, Treatment  
Chapter Ten  
Hyperlipidaemia in Ayurveda: 161
Alimentary Hyperlipidaemia. The role of Unsaturated Fatty Acids, Concepts of Ama and Hyperlipidaemia, Physical Properties and actions of Ama, Roga Marga, Treatment of Hyperlipidaemia  
Chapter Eleven  
Prevention of Ischaemic Heart Diseases (1.H.D.): 167
Primary Prevention, Secondary Prevention, Prevention of I.H.D. in Children, Community Approach for prevention of 1.H.D.  
Chapter Twelve  
Hypertension: 171
Blood Pressure—Definition, Hypertension—Definition,Factors Influencing H.T., Types, Clinical Features, Complications, Non-Pharmacological Treatment, Concept of H.T. in Ayurveda—Nidãna, Samprãpti, Cikitsã of H.T.  
Chapter Thirteen  
Introduction to Congenital Heart Diseases: 183
Early detection of Congenital Heart Diseases, Various Symptoms  
Chapter Fourteen  
Ayurvedic Approach of Dietary Management of Hdroga (Cardiac Disorders) 186
Chapter Fifteen  
Role of Yoga and Life Style Modifications in Preventing Hrdroga (Cardiac Disorders) 199
Chapter Sixteen  
Conditions Warranting a Physician for referring a patients to Cardiologist 206
Chapter Seventeen  
Tips for Preventing Heart Diseases and Prolonging Life Span 209
Chapter Eighteen  
Use of Some Herbal Drugs in Cardiovascular Disorders: 213
Naimittika Rasãyana in Hrdroga, Antihypertensives and Cardiotonics, Hypocholastraemic Drugs  
Bibliography 217

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Heart Disorders and Their Care in Ayurveda

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2005
ISBN:
8170308275
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About the Book

The book “Heart Disorders & their care in Ayurveda” written by the well known author Professor Ajay Kumar Sharma is a complete and comprehensive treatise on the subject. This is the first book in English which deals with the subject in all completeness and clarity covering all aspects of “Hrdroga” as described in various treatise of Ayruveda. The entire text is richly supported with original references from Ayurvedic classics. Latest information regarding various aspects of modern Cardiology have been in cooperated with the objective of providing basic knowledge to readers especially to Ayurvedic students, physicians and teachers for creating awareness among masses about the important possible role which Ayurveda may play for preventing various Cardiac Disorders.

Separate chapters have been added on aetiopathology of Hrdroga in Ayurveda with their principles of management, clinical approach in the examination of a cardiac patient, investigations recommended, some important cardiac disorders with their Ayurvedic approach of management, Ayurvedic approach of dietary management of cardiac disorders and role of Yoga and life style modifications in preventing Hrdroga (Cardiac Disorders). Most valuable information is presented in the chapter on “Tips for preventing heart diseases and prolonging life span”.

The author of the book being a senior Professor of Ayurvedic Medicine in National Institute of Ayurveda, Jaipur and being a reputed physician and researcher, this book has been richly benefited by his scholarship and professional experience. It is expected that this book will be useful for prosperous readers.

 

About the Author

Born on May 31st, 1954 Professor Ajay Kumar Sharma graduated in Ayurveda with Medicine and Surgery from A & U. Tibbia College, New Delhi in 1976 with throughout top rank career. He received many awards and prizes for his outstanding career. He did his M.D. (Ay.) and Ph. D. from B.H.U. under the guidance of his illustrious mentor Professor R.H. Singh.

Prof. Sharma is now the senior most Professor and Head of the P.G. Department of Kdyacikitsä and Deputy Medical Superintendent of the Hospitals at National Institute of Ayurveda, Jaipur. He is the Chief Ayurvedic Physician in the Institute. In the capacity of a reputed Ayurvedic physician, a capable teacher and an outstanding researcher, Professor Sharma has published several standard books on Ayurveda and over 110 research papers in various Journals of National and International reputation. He has contributed a chapter to the prestigious book “Scientific Basis for Ayurvedic Therapies” published by CRC Press, USA. He has produced 35 M.Ds and 5 PhDs under his dynamic supervision. He is the expert member of several communities and learned societies in India. Prof. Sharma has been short listed as an Ayurvedic expert for short term deputation to University of Natal, South Africa to help them in drawing course curriculum and setting up faculty for starting diploma Graduate degree course in Ayurveda.

 

Preface

The incidence of various Cardiac Disorders is increasing at an alarming rate in our country largely due to absolute changed concepts of diet & lifestyles. Of the total deaths, 33% deaths are reported to have been caused by heart diseases alone. It has been observed that about 15% of patients who sustain heart attacks are below the age of 40 yrs. Such a high incidence is related to the severe stressful situations existing in the modern ways of life and also due to the increased incidence of consumption of tobacco and improper control of hypertension and other underlying Cardiac disorders. Various heart diseases can be prevented by measures like regular exercise, control of hypertension, changing the dietary habits from high cholesterol to low cholesterol diet, stopping of smoking cigarettes and avoiding tobacco in any form.

In Ayurvedic classics very brief description of Hrdroga is available in various texts. In Caraka and Suruta Samhitã five types of Hrdrogas are described viz. Vãtika. Paittika, Kaphaja, Tridosaja and Krimija. While reviewing A yurvedic manifestations of Hrdrogas, it appears that broadly the description of Hrdroga covers mainly the description of Hricchula (Angina). Vyãna Vãyu, Sãdhaka Pitta and Aviambaka Kapha are described to be situated in the heart. The main function of these three humors is the maintenance of normal physiology of heart. Any imbalance in their equilibrium may lead to various Cardiac disorders.

Not many books are available on Hrdrogas giving Ayurvedic concepts with their critical analysis on modern lines. It has been observed that many research Centers and Post Graduate Institutes in India have developed various newer strategies in the management of Hrdroga. Such advances prompt to the need of producing newer literature incorporating the recent advances in terms of conceptual and strategic clarity and scientific development. It is with this background that the present book was launched.

It is observed that many Ayurvedic scholars including physicians, students & teachers are not acquainted with several modern Cardiac Disorders which are found so frequently in day to day practice. One of the most important reasons for this is quoted to be inability of Ayurvedic System of medicine in controlling several emergency conditions of Cardiac Disorders. That is why most of Ayurvedic Scholars ignore Cardiac Disorders. It is true that the dependent treatment of several Cardiac emergencies in time remains only modem system of medicine. But author feels that Ayurvedic Scholars must be competent enough to diagnose various Cardiac Disorders / Cardiac emergencies so that they may diagnose the condition early and if the underlying Cardiac Disorders cannot be managed properly by them, largely because of non availability of fast acting Ayürvedic drugs, the patient may be referred to appropriate places for saving his life. This is one of the important reasons of incorporating latest information about the subject in the present book.

This book is presented with chapters on Cardiology in Ayurveda General considerations, Clinical Approach in the Examination of a Cardiac patient, Laboratory Investigations recommended, Hrdroga in Ayurveda, Heart Failure, Shock, Inflammatory Diseases of Heart, Rheumatic Heart Diseases, Ayurvedic approach of Dietary management of Hrdroga, Role of Yoga and Life Style Modifications in preventing Hrdroga etc. All topics have been written with emphasis on the uniqueness and distinction of Ayurvedic Concepts with an attempt to evaluate the relevance and validity of the same in modern times.

The author of this book being teacher, physician and researcher in this field has utilized his professional experience with clinical medicine of Ayurveda in compiling the present book. It is hoped and believed that this small effort will prove to be of some benefit to the prospective readers to provide them glimpses of “Hrdroga - Cardiac Disorders” and their care in Ayurveda.

Opinions and suggestions to improve the book are welcome.

 

Foreword

Cardiac diseases constitute a major group of diseases which at times, are fatal. Modern Cardiology has advanced to a great extent which helps in treating Cardiac emergencies efficiently. In Ayurvedic literature we get a clear cut description of various Cardiac disorders by the term “Hrdroga”. But on screening ‘Ayurvedic test it appears that the description of Hrdroga in Ayurveda is very concise. Efforts are needed to revalidate the Ayurvedic description of Hdroga in Modern light. Very few books are available on Ayurvedic Hdroga which deal with the subject with scientific temperament. The present book “Heart Disorders and Their Care in Ayurveda” is a good attempt in that direction.

The author has tried to describe various concepts of Hrdroga by collaborating them with Modern Concepts on the basis of various references as quoted in various Ayurvedic texts. It appears that the author has considered Hdroga as described in various Samhitãs to be equivalent to Hcchü1a which needs further clarification. Critical analysis of the descriptions of Hrdroga as described in various Samhitãs was expected to be done on more broader basis. More emphasis has been laid down on modern descriptions, probably because of the impact of present times. As stated by Acãrya Caraka in the 1t4-c1:”, it is clear that the knowledge about Hidya was not so much limited to them as described in reference to Hrdya (The Heart - Clinical Concepts). The author has also tried to justify this fact later in the description of “Hyperlipidaemia in Ayurveda” who deserves appreciation for providing good critical analysis of the subject matter in this context logically.

The chapters on “Clinical Approach in the examination of a Cardiac patient” and “Laboratory Investigations Recommended in Cardiac Patients” are of great importance in the diagnosis of a Cardiac patient. The author has probably taken the lead from Modern Medical Science in this regard. Sophisticated laboratory investigations help to a larger extent in pin pointing the diagnosis of the underlying Cardiac disease which may affect the prognosis significantly.

The Ayurvedic description of the treatment of Hrdroga points towards While discussing the management of Hrdroga on Ayurvedic principles, emphasis has been laid down on dietary restrictions (Ahãra) and specific life styles ( Vihãra) which is most relevant in current situations. Indulgence in incompatible dietary factors and improper lifestyles leads to various stress induced Cardiac disorders which could be effectively prevented by adequate and proper administration of Pathya i.e proper diet and life style measures.

Over all“Heart Disorders and Their Care in Ayurveda” is a good piece of literary work. The author has shown great courage and competence in dealing the topic of Hrdroga, which is very important, useful and needs scientific explanations and clarifications of Ayurvedic concepts of Hrdroga, in modern light with scientific background. Prof. Ajay Kumar Sharma,who is a dynamic, hard working and intelligent person, has done full justice with the subject. He has covered a wide range of topics and aspects of Hrdroga and modern Cardiology and has dealt with the matter comjrehensively and systematically about the classical concepts and recent advances on the subject. I congratulate Prof. Sharma for his outstanding contribution to Ayurvedic literature. I appreciate his efforts in bringing out this useful book and wish him all success for this publication.

 

Acknowledgements

I desire to express my deep gratitude and indebt ness to Prof. B.L. Gaur, Director, National Institute of Ayurveda, Jaipur, an eminent scholar of Ayurveda, who has always been a source of inspirations and encouragements to me. I am extremely thankful to Prof. Gaur for having agreed to write the “Foreword” to this work.

This book is dedicated to my revered benevolent teacher Prof. R.H. Singh, Vice Chancellor, Rajasthan Ayurveda University, Jodhpur,who has always inspired me to work for globalization of useful knowledge of Ayurveda.

While compiling this book I received invaluable help from my post graduate scholars who inspired me to develop the subject with due rationality and clarity. I am especially thankful to Seema Bhadora, Sandeep Agarwal, Parshuram Singh Yadav, Komal Kankarana, Shreesh Mishra, Sandeep Pal Singh, Rajesh Gupta and Gaurish Gupta.

With profound reverence, appreciation and affection I wish to express my deep gratitude to my father (Late) Sh. S.L. Sharma, my mother Smt. Bimla Devi, my elder brother Mr. Ashok Kumar Sharma, my sister in law Smt. Neelima Sharma, my brother in law Dr. Y.N. Sharma ‘Arun’ and my elder sister Smt. Asha Sharma and all my friends and colleagues for their constant inspirations and blessings for completion of this work

It is my humble desire to express my deep gratitude and indebt ness to my wife Dr. (Smt.) Praveen Sharma, the main source of my inspirations and strength, my son Amit Sharma and my daughter Gauri Sharma for their love and support (without which this book could have never been completed) manifested in several ways but in particular through their patience and understanding.

Lastly I wish t acknowledge my obligations and sincere thanks to Mr. Sunil Gupta, my publishers M/s Indian Books center, 40/5 Shakti Nagar, Delhi -110007 (India) for his splendid cooperation and for printing the book so nicely and in time.

 

Contents

 

Chapter One  
Cardiology in Ayurveda: General Considerations: 1
Hrdya (The Heart)—Clinical Concepts, Ayurvedic and Modern Anatomical and Physiological Considerations. Dosika involvement in Hrdya. Hj-droga in various Samhitãs of Ayurveda  
Chapter Two  
Clinical Approach in the Examination of a Cardiac Patient: 12
History, Symptoms of Cardiac Patients, General Examination of a Cardiac Patient, Examination of Precordium  
Chapter Three  
Laboratory Investigations Recommended in Cardiac Patients: 21
Haematology, Biochemical Investigations, Liver Function Tests, Thyroid Profile, Urine Examination, Chest Radiograph, Pericardial Aspiration, E.C.G., Ambulatory Electrographic Monitoring, Tread Mill Test, Echo Cardiography and Doppler Study, C-T Scan, M.R.1., Nuclear Cardiology, Positron Emission Tomography, External Pulse Recording and Phono Cardiography, Cardiac Catheterization, Angiography, Coronary Angiography, Radio nuclide Techniques  
CHAPTER Four  
Hrdroga in Ayurveda: 29
Nidãna, Generalised aetiological factors of Hdroga according to various Acãiyãs, Specific Dosãnusãra Nidãna, Samprãpti, Pathogenesis, Role of aetiological factors in the development of Hdroga, Diagramatic representation of Samprãpti of Hrdroga, Pürva Rãpa, Rüpa, Clinical features of Doãnusãra I-Irdroga, Specific clinical features of Hrdroga, Classification of Hrdroga as described in Ayurveda, Complications, Arista Lakaña, Prognosis,General Principles of management of Hrdroga, Nidãna Parivarjana, Rest, Samsodhana Therapy, Samsamana Therapy, Pathyäpathya, Vihãra (Life Styles), Home Remedies—Medicinal Practices for prevention, Curative aspects of Hrdroga, Specific Treatment of Dosaja Hrdroga— Vãtaja, Pittaja, Kaphaja, Tridosaja and Krmija Hrdroga  
Chapter Five  
Heart Failure: 89
Definition, Pathophysiology, Grading, Types, Clinical Features,Symptoms and Physical Signs, Prognosis,Complications, Ayurvedic Concepts, Treatment, Principles, Samsodhana Therapy, Sam samana Therapy  
Chapter Six  
Shock: 97
Definition, Types, Causes, Classifications, Clinical Features, stages of Shock, Ayurvedic Concepts, Ojas, Para Oja, Apara Ojai, Vyãdhi Kamatva and Immunity, Precipitating Factors of Oja Ksaya (Shock), Disorders of Oja (Bala), Treatment  
Chapter Seven  
Inflammatory Diseases of the Heart:Aupsargika Hrdroga, Infective Endocarditis Hrdaantartwacã Sotha 111
Oupsargika Hdroga, Infective Endocarditis— Hdaantartwacã otha—Definition, Clinical features, Signs, Complications, prophylaxis. Pericarditis—Hrdãvarña .otba, Dry Pleurisy—Symptoms, Signs, Pericarditis with effusion—Symptoms, Signs, Chronic Constrictive Pericarditis— Definition, Clinical Features, Signs, Myocarditis Hrdamãnsa Pesi otha—Definition, Clinical Features, Signs.Ayurvedic Concepts—P athogenesis of Inflammatory Diseases of Heart, Prognosis, Treatment of Lacterial Endocarditis—Hda antartwacã otha, Treatment of Myocarditis—Hdamãnsapeái otha, Treatment of Pencarditis—Hrdã—varaña Sotha  
Chapter Eight  
Rheumatic Heart Diseases: 123
Definition, Types, Mitral Stenosis, Mitral Regurgitation,Aortic Stenosis, Aortic Regurgitation, Tricuspid Stenosis, Tricuspid Regurgitation—Their definitions, symptoms,Principles of Management of Valvular Incompetence or Valvular Regurgitation  
Rheumatic Fever—Säma Sannipãtika Sandhigata Jwara Definition, Clinical Features, Ayurvedic Concepts, Symptoms, Treatment  
Rheumatoid Arthritis—Ama vãta Definition, Criteria for the diagnosis of RheumatoidArthritis, Clinical Features, Articular features, Other manifestations,Radiological progression of Rheumatoid Arthritis, Salient points for disease activity assessment  
Ayurvedic Concepts—Amavata, Concept of Ama in Ayurveda, Characters, Properties, Definition of Amavata, Pathogenesis, Symptoms, Systemic Manifestations, Classification, Prognosis, Complications, Principles of Management, Medicines and Procedures Commonly Used in Amavata  
Chapter Nine  
Ischaemic Heart Diseases—Hrchchüla: 151
Definition, Causes, Risk Factors for Coronary Artery Disease (CAD), Clinical Presentations, Angina Pectoris— Definition, Risk Factors, Clinical Situations Precipitating Angina, Types, Clinical Manifestations, Grading of effort Angina by the Canadian Vascular Society, Myocardial Infarction—Definition, Clinical Manifestations, Ayurvedic Concepts, Hrchchüla, Treatment, Srotorodhajanya Hdroga, Clinical Manifestations, Treatment  
Chapter Ten  
Hyperlipidaemia in Ayurveda: 161
Alimentary Hyperlipidaemia. The role of Unsaturated Fatty Acids, Concepts of Ama and Hyperlipidaemia, Physical Properties and actions of Ama, Roga Marga, Treatment of Hyperlipidaemia  
Chapter Eleven  
Prevention of Ischaemic Heart Diseases (1.H.D.): 167
Primary Prevention, Secondary Prevention, Prevention of I.H.D. in Children, Community Approach for prevention of 1.H.D.  
Chapter Twelve  
Hypertension: 171
Blood Pressure—Definition, Hypertension—Definition,Factors Influencing H.T., Types, Clinical Features, Complications, Non-Pharmacological Treatment, Concept of H.T. in Ayurveda—Nidãna, Samprãpti, Cikitsã of H.T.  
Chapter Thirteen  
Introduction to Congenital Heart Diseases: 183
Early detection of Congenital Heart Diseases, Various Symptoms  
Chapter Fourteen  
Ayurvedic Approach of Dietary Management of Hdroga (Cardiac Disorders) 186
Chapter Fifteen  
Role of Yoga and Life Style Modifications in Preventing Hrdroga (Cardiac Disorders) 199
Chapter Sixteen  
Conditions Warranting a Physician for referring a patients to Cardiologist 206
Chapter Seventeen  
Tips for Preventing Heart Diseases and Prolonging Life Span 209
Chapter Eighteen  
Use of Some Herbal Drugs in Cardiovascular Disorders: 213
Naimittika Rasãyana in Hrdroga, Antihypertensives and Cardiotonics, Hypocholastraemic Drugs  
Bibliography 217

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