Regeneration and Wound Healing (Perspectives from Ayurveda)

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About the Book Original word in Ayurveda are available in Sanskrit, the language of science and knowledge in ancient India. An attempt is made in the book to explore the concepts of tissue regeneration with special reference to wound healing in Ayurveda.

The Book highlights reference to cell, stem cell, tissue, surgical procedures, healing methods and regenerative concepts in varied Ayurvedic and non-medical Sanskrit literature spanning almost 5000 years from the Vedic period to contemporary times. The concepts and therapies associated with tissue repair, regeneration, remodeling and healing are revisited here.

A conceptual framework for regeneration of tissues from Ayurvedic perspectives is constructed over the panchmahabhut siddhanta based on the motto of dhatusamyata that Ayurveda strives to achieve. As wounds present a potential condition for regeneration and/or repair of tissues a theoretical framework for wound healing from Susrta’s Sashti upakramas on the line of time framework is conceptualised. The strengths of Ayurveda with regard to its potential contribution to the science of regenerative medicine are focused for their clinical applications.

This Book has been written keeping in mind the research needs of Ayurveda graduates and researchers from morden science. Near English equivalents to scientific and technical terms mentioned in Ayurveda are provided along with the text for easy understanding.

About the Author Dr. P. N. Vinaya is an Ayurvedic Phusician with twenty-five years of professional experience. She started his career as a medical officer at CGHS Dispensary, New Delhi. She was awarded Ph.D. by the university of Hyderabad. She has participated in a number of national and international seminars and conferences and has over twenty research papers to her credit, She has also contribute to the academic field by teaching a course on “History, Philosophy and science of Ayurveda” to international students at study India Program (SIP), Univercity of Hyderabad. She is on the editorial board of reputed journals like Journal of Pharmaceutical and Scientific Innovations (JPSI) and International Ayurvedic Medical Journal (IAMJ) and is apeer reviewer for Journal of Ayurveda and Integrative Medicine(J-AIM).

Currently, she is practicing Ayurveda at her private clinic and is also a Consultant Ayurveda Physician at international Institute of Information Technology (IIIT), Hyderabad.

Preface Dhatusamya kriya cokya tantrasyasya prayojanam/

Caraka Sutrasthana 1.53

The whole purpose of this science is restoration of homeostasis The human body is resilient. It always strives to restore its equilibrium. Medicines or therapies simply aid the process. What is it about Ayurvedic medicines or therapies that aid in restoration of equilibrium or homeostasis as it is know? Is it the concepts backing them that in effect are responsible for the moments of discovery that physicians may experience? Or result that are purely based on the drugs administered. The whole aim of this science i.e. restoration of bodily equilibrium would not be meaningful if repair, regeneration and healing were not attempted to restore homeostasis. Healing is an important goal of Ayurveda. It is an outcome of regeneration and a promoter of restoration of homeostasis. An attempt is made in this book to explore the relevance of the concepts of tissue regeneration in Ayurvedic literature in the context of modern day researches that centre on stem cell transplantation and tissue engineering. Original works in Ayurveda are available in Sanskrit, the language of science and knowledge in ancient India. In post-independent India English has been the language of the intellectual. The wealth isknowledge is mostly unavailable or rather beyond comprehension to the present day scientific community. I am sure nobody would disagree with me if I were to state that barriers of communication and language should not come in the way of application of Ayurveda concepts for the contemporary society.

References to cell, stem cell, tissue, surgical procedures, healing methods and regenerative concepts in varied Sanskrit literature starting from the Vedas to contemporary research paper of the subject spanning almost 5000 years, a broad outline of Dhatu Vikrti (degeneration) as conceived in Ayurveda, the concept of Sotha (inflammation) and Vrana (wounds) are discussed. Regenerative medicine is a relatively young field of medicine in the still evolving modern system of medicine. The focus so far has been stem cell engineering. Indegenous system like Ayurveda which are known as healing sciences have not been critically examined for potential contribution to medicine like natural stimulation of stem cells, etc.

Among the wound healing and wound management techniques, susta’ Sasthi Upakramas (sixty measures) from a modern scientific perspective, references from Caraka and Vagbhata have been presented. The Sasthi Upakramas have been classified and represented schematically to bring to light the relevance of these concepts and their applicative potential that might be incorporated into contemporary medical practives. Four main factors as being central to regeneration are metabolism, nutrition, micro-channel perfusion and immunity. The Sasthi Upakramas are an extension of the core principles of regeneration. Sodhana (cleansing) and Ropana (healing) principles are complete in themselves and present some of the most innovative approaches towards tackling chornic wounds. The common ground is the time Framework (Tissue-Inflammation/Infection-Moisture-Edge Advancement) as the Tissue Management, Infection and Inflammation Management have been found to be in line with the Sodhana therapy while Moisture management and Edge advancement were found to be the hallmark of Ropana therapy. Considering these issues, fundamental concepts behind treatment in degeneration conditions are explored with a modern perspective for better understanding in present times. Focus is laid on management of wounds, an important area meriting research. The wealth of information in non-Ayurveda Sanskrit texts led me to embark on this path of self-discovery and make a miniscule contribution to bringing to light the utility of this science for tissue repair and regeneration. The exploration and evaluation of concepts spans from very ancient times to present day a focus on their application for contemporary times. Since the original Sanskrit terminology had to be interpreted for present times, an attempt was made to look into it from a modern light with aid from modern pathology texts. Current notions of regeneration are sought to be compared with ancient concepts in a general manner as well with a focus on wound healing.

This book has been written keeping in mind the research needs of Ayurveda graduates, post graduates and researchers from modern science. It would also be helpful to modern and Ayurveda clinicians and surgeons looking for insights from Ayurveda literature in field of wound healing. An attempt is made in this book to provide near English equivalents scientific terms mentioned in Sanskrit Literature. These are reflected in the texts, figures and tables throughout the book. However, it is to be noted that the Sanskrit terms convey a larger connotation than rheir near English equivalents. A select glossary is also provided at the end as a quick reference to the Sanskrit scientific term. This book also refrains from mention of any date of classical literature since there is no unanimity among scholars with regard to date and the sole aim of this book is to appreciate and apply the scientific thoughts mentioned in the texts therein. This Books follows three level of referencing – footnotes, citations and bibliography. Referencing in footnotes are used for verses from classical literature; the citations embedded in the main text throughout the book refer to contemporary works and the bibliography is the books referred to. The author hopes that similar work would be undertaken by the scientific community in collaboration with Sanskrit experts to explore the hitherto unexplored manuscripts of Sanskrit and other Indian language in the field of medicine and their complete applicative potential for contemporary times is realized.

Organization of the books The first chapter Introduction starts with an overview of the area of discipline of research in contemporary times in regenerative medicine such as the stem cells, stem cell transplantation, tissue engineering being carried out by scholars and looks at th potential of Ayurveda and their relevance to the science of regeneration and wound healing. It introduces the key Ayurveda terms and terminologies in reation to regeneration in relation to regeneration and healing. It also discusses contemporary researches on this subject by Indian scholars od Ayurveda on the subject.

The second chapter, History of Regenerative Science in Ayurvedic Literature, all information pertaining to the subject from vedic literature to the Ayurveda samhitas Viz., Brhattrayi, Kasyapa Samhita, Madhava Nidana and Sarngadhara Bhela Samhita are Discussed. The existence of cell concept, and origin of tissues from available literature as well as the examination of specific pointers to regeneration in Vedic literature are presented. Important breakthroughs in modern science and contemporary research on concept in Ayurveda, knowledge regarding the existence of certain therapies and surgeries in medical and non medical texts, documentation of the procedures in medical texts Ayurveda and modern medicine or a possible tracing and discovery modern concepts in Sanskrit literature has been extensively referred to. It also provides an insight into health medicine and surgery in ancient India chronologically as well as concepts in vogue right from the Vedic literature. Contemporary works are also presented. In addition the concepts related to regeneration are analysed.

The third chapter Tissues and Regeneration looks at regeneration, repair and healing from the fundamental philosophical concepts to their etymological and historical significance. A comparison is made between the Ayurveda Approaches and with stem cell engineering of modern science and the potential application of thee concepts and therapies to degenerative Diseases is discussed in broad based manner.

The fourth chapter titled Degeneration of tissues brings out the concepts of degeneration and degenerative diseases in both Ayurveda and modern science.

The fifth chapter titled Inflammation discusses Sotha, the prodromal symptom of wounds according to Ayurveda. According to modern science the inflammatory response is the first step towards wounds healings. Hence a comparative study of Sotha vis-à-vis inflammation is attempted. When inflammatory process finds no resolution, wounds result.

The sixth chapter Wounds and Wound Healing is on Vrana or wounds, their history, types, etiology, pathogenesis and their healing. A corelatory approach towards the subject from Ayurveda and modern science is employed to bring out the similarities and differences.

The seventh chapter Wounds Management Present the management of wounds both, medically and surgically, in Ayurveda and modern medicine. Its purpose is to emphasize the unique aspects of wound management in Ayurveda which could be of potential utility for contemporary times. A comparison is sought to be drawn with the TIME frame work.

The eighth chapter Applications in Practice presents the potential applicability of all the concepts and therapies from Sanskrit literature in contemporary clinical practice. A theoretical framework for regeneration of tissues and wound healing as applicable from Ayurveda texts is highlighted.

Contents

	Preface	v
	Acknowledgements	xi
	List of Tables	xiv
	List of Figures	xv
1	Introduction	1
2	History of Regenerative Science In Ayurvedic Literature	6
3	The Tissues and Regeneration	39
4	Degeneration of Tissues	59
5	Inflammation	72
6	Wounds and Wound Healing	84
7	Management of Wounds	95
8	Applications in Practice	133
	Works Cited	144
	Bibliography	153
	Appendix	155

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