Text Book of Swasthavritta (Course Curriculum for Second Professional BAMS Prescribed by NCISM New Syllabus)

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Sarangadhar's quote that "no individual in this world is immortal and death is unavoidable, but diseases can be prevented" stresses the need of preventive medicine. Charaka clearly defined that utility or benefit (prayojanam) of Ayurveda is to help for maintaining the health of a healthy individual and cure of diseases of a patient. The very object of Ayurveda is the maintenance of equipoise of biological hu-mors and tissues (Dhatusatmyata). The disturbance of the equilibrium of Dhatus is the disease, while the maintenance of equilibrium is the health. The body and mind constitute the substrata of diseases and happiness (i.e positive health). Balanced utilisation (of time, mental faculties and object of sense organs) is the cause of happiness. Pathogenic factors of the body are bio humors ie Vata, Pitta and Kapha while Rajas and Tamas are considered as the pathogenic factors of mind.

Atma (soul) is devoid of pathogenecity (nirvikar) and its association with body and mind engenders disease or happiness. Soul contributes for consciousness through the agency of mind, the specific qualities of basic elements (mahabhootas) as well as sense organs. Soul observes all the activities of life and designated as observer. It is advocated that one should regularly take such articles which are conducive to the maintenance of good health and are also capable of preventing attacks of diseases.

Ayurveda classics described certain regimes for maintaining positive health un-der Swasthavritta (Regimen for health). Life style measures are broadly classified into - food, exercise, sleep, suppression of natural urges (vegadharana), code of ethics (Achara rasayana) and life pursuits (Eashana). Ahara, Nidra, Brahmacharya are designated as Upasthambhas (sub pillars/ posts) for maintenance of positive health. Swasthavritta mainly deals with these three aspects of life styles. By following the prescribed course, one is able to possess healthy long life. A healthy person should therefore, follow a course of lifestyles conducive for the maintenance of good health. Charaka advocates to follow rules of Swasthavritta (Swasthavritta paro bhavet) for prevention of diseases. Discussing the various lifestyle modifications according to changing seasons, Charaka suggests to follow Sodhana measures (purificatory procedures) and intake of Rasayana and Vajeekarana yogas with due regard to the temporal property which are conducive for maintaining homeostasis (Dhatusamyata) and preventing endogenous diseases.¹

During the last century Ayurvedic scholars formulated Swasthavritta as a separate subject and incorporated in the teaching programme to focus the importance of preventive medicine. Keeping in view the cotemporary changes in lifestyles and needs of the society, CCIM designed the curriculum for this subject by including certain toples from modern social and preventive medicine. The present book deals with the subject of Swasthavritta with available recent updates about the validation of the principles mentioned in Ayruvedic classics. On the request of Mr. Sachin Gupta, Chaukhambha Sanskrit Series Office, Varanasi, I have taken up the task of preparing this text book with the meticulous help of my sincere students Dr. Vidya Unnikrishnan, Assistant professor, VPSV Ayurveda college, Kottakkal and Dr. Vrinda. Hope this text book renders an iota of help to students and practitioners of Ayurveda to understand and appreciate the concepts of Ayurvedic preventive medicine.

Prevention of diseases and cure of the diseases are the two main objects of any healthcare system including Ayurveda. Susruta defined the healthy state as the equilibrium state of Doshas, Agni, Dhatu and Malas with tranquil state of Atma, Indriyas and Mana. Ayurvedic classics described certain methods to remain healthy always under Dinacharya (regimen during day), and Ritucharya (regimen during different sea-sons). These methods are compiled into the subject of Swasthavritta and being taught to the students of Ayurveda. Under this subject the details about lifestyle adaptation to remain healthy and various modifications of these methods to acclimatize the body to the changing seasons for prevention of various seasonal diseases are dealt in detail. but of all the factors of maintenance of normal health, three factors are identified namely Ahara (food), Nidra (Sleep), and Brahmacharya (Celibacy or regulated sexual life) which are referred as Triaupasthambha (three sub pillars). Food taken in proper quantity plays a major role in preserving positive health. Quantity to be eaten depends upon the power of digestion and metabolism. The power of digestion varies according to the season as well as age of the individual. Physical exercise also influ-ence it. Keeping this in view diet modifications to be adopted during different sea-sons are suggested under Ritucharya. Ayurvedic health concept is mainly based on Panchamahabhoota. It is stated that both body and food are constituted by Panchamahabhootas. By nature light food (Laghu ahara) is said to be conducive to good health. Heavy food on the other hand is detrimental to health. Light food is domi-nated by the qualities of Vayu and Agni mahabhoota and acts as stimulant of appetite, while heavy food (Guru ahara) articles are dominated by the qualities of Prithwi and Jala mahabhootas and are heterogeneous in character in relation to appetite. They are exceedingly harmful if taken in excessive quantity. So one has to balance the food intake by taking into consideration the proper combination of food in terms of quality and quantity of food articles of Laghu and Guru dominant nature. In this context Charaka promulgated the concept of Trividha kukshiya (arbitraly dividing the stomach into three parts), where in one part is to be filled by solid food substances, an-other part with liquid food articles, leaving the rest for easy flow of Vayu. Dietetic rules comprehensively elaborated in Ayurvedic classics for maintenance of positive health. The most common etiological factor for many diseases is hypofunction of Jatharagni (Mandagni) associated with intake of improper food (Mithyaahara). If one wishes to remain healthy, it is mandatory to evaluate the state of Agni and adopt suitable food substances to address the process of vitiation of Tridoshas. Regular in-take of food (diet) consisting of all tastes (Shadrasas) promotes the strength and intake of food having only one taste (Ekarasa) causes weakness. Fasting reduces lon-gevity and intake of irregular meal causes irregularity in digestive power.

Sleep (Nidra) is nothing but the location of mind in a place unconnected with the sensory or motor organs. Happiness, misery, nourishment, emaciation, strength, weak-ness, virility, sterility, knowledge, ignorance, life and death-all these occur depending on the proper or improper sleep. A proper adaptation of sleeping habits brings happiness and longevity in human beings. Sleeping during the day time (Diwaswapna) is discour-aged, but can be allowed for those who are exhausted by walking long distance, suffering from wasting diseases, insanity etc, those who are too old, too young, weak and emaciated. In summer season nights become shorter and vata gets aggravated in the body due to the absorption of fluid (Adana). Therefore, during this season, sleep during day time is prescribed for all. Those who are accustomed to sleep during day time should not give up this habit all of a sudden as it might lead to undesirable consequences.

Charak opines that celibacy (Brahmacharya) contributes for longevity and adul-tery reduces longevity. Excessive indulgence in sexual act causes sosha (consumption) and suppression of the urge of seminal ejaculation causes impotence. Bhavamishra quotes desire of copulation manifests in the body of men every day, not indulging in copulation leads to Prameha, medovriddhi and looseness/weakness of the body. Men who copulate with women in a proper manner obtain long life, slows the development of old age, body endowed with good complexion and strength with strong and well grown muscles. The rules regarding the performance of sexual act in various seasons are suggested in Ayurvedic classics. Brahmacharya which plays an important role in maintenance of positive health can be understood as leading a controlled sexual life involving certain ethics.

In addition to Trayaupasthambhas, Ayurveda stresses to follow Sadachara (Rules of good conduct) for maintenance of positive health.

Yoga and meditation notably contribute for positive health. Personal hygiene is discussed under dinacharya and lifestyle modifications according to changing seasons under Ritucharya. All these principles and procedures contribute for social, preventive and public health aspects. The chapters from Charakasamhita and Susrutasamhita namely Janapadadhwamsa and Dundubhi swaneeya respectively indicate about the concept of water, soil and air pollution were known in ancient India.

Central Council of Indian Medicine (CCIM) has designed the syllabus and subject of Swasthavritta by incorporationg the concepts of Ayurveda and modern medical social and preventive medicine. The concepts related to yoga and naturopathy are also incorporated in the syllabus which contribute for maintenance of positive health. The judicious adaptation of combination of all these perspectives facilitates for building of healthy and efficient society.