KAUMARABHRTYAM (Paediatrics in Ayurveda)

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Prof. Vruddhula Lakshmi Narasimha Sastry is well known for his valuable contributions and services in the field of Ayurveda since 1980. He was born in Nagpur on 18-09-1953. He is the sixth son of Late Sri Saravanna and Late Smt. Venkatanarasamma. He is the native of Visakhapatnam, Andhra Pradesh and brought up by his eldest brother Late Sri. Parvathesam, former Principal and advocate.

He took his BAMS degree of Andhra University in 1976 by graduating at Govt. Ayurvedic College, Vijayawada. He did his M.D. (Ayurveda) in the Speciality of 'Prasutitantra and Kaumarabhrityam' (1980-1983) at IMS, B.H.U., Varanasi.

He is a first class LL.B degree holder of Osmania University and first class Post-Graduate of M.Sc. (Psychology) of University of Madras, Chennai. He passed in first class the course of Hospital Administration (Post-Graduate Diploma in Hospital & Health Management) of IGNOU. Presently he is the 'Principal of Sri Jayendra Saraswathi Ayurveda College, Nazarathpet, (Thiruvallur District) Chenni- 602 103, Tamilnadu, a unit of Sri Chandrasekharendra Saraswathi Viswa Mahavidyalaya (Deemed University), Enathur, Kanchipuram. He joined the Dept. of AYUSH, Govt. of Andhra Pradesh in the year 1979 and held different positions, viz., (i) UG Professor of PSB department, (ii) PG Professor of SSP Department, (iii) Research Officer & Medical Superintendent. He guided about 70 Post- Graduate Theses he is a renowned teacher of UG & PG courses and-a known clinician. As a professional, he has several papers published and participated in many seminars of national and international repute. He received national best thesis award organized by Arya Vaidya Shala, Kottakkal, Kerala in the year 1993 on the topic "Infectious diseases & Ayurvedic treatment". In 1994, he was awarded second prize for his thesis on "Role & Scope of psychic factor in Ayurvedic treatment". He delivered several talks in AIR and Television. He authored Telugu Text- Book of Paediatrics in Ayurveda in the year 1988.

Right from his school education he has innumerable prizes in literary and cultural activities. Viz. Elocutions, Debates, Essay- Writing, Mono-Actions etc. He is a proficient poet in Telugu, both classical and non- classical. He is a good mimicry artiste, actor of Stage and Television and efficient script- writer too.

Lord Brahma infused meticulously three intrinsic desires i.e. pranaisana (desire to live), putraisana (desire to procreate) and dhanaisana (desire for wealth) in his every living creation. To fulfill these an eternal divine tradition i.e. ayurveda emanated from the creator himself. Initially stream of ayurveda concurrently flowed with another preaching of creator i.e. vedas and some interaction did take place between them, which propounded an idea that ayurveda has its basic roots in vedas or is an upaveda of atharvaveda. Accepting this preposition on the analogy that ayurveda being 'veda' or knowledge of 'ayu' is worshiped by the erudites of vedas, Maharsi Kasyapa has advanced the hypothesis that ayurveda is fifth veda, more important and strong like thumb of the palm in comparison to other four vedas which are like four fingers of palm; because vedas can be read, understood, memorized and preached only by mentally and physically healthy individuals, a domain of ayurveda.

Whether the creator preached ayurveda in the form of trisutra/ triskandha (hetu, linga and ausadha) or astanga (eight branches), the astanga ayurveda, a division based on practical application became acceptible and probably treatises on all these specializations were written, most of which are now lost in oblivion. The presently available eternal literature written by rare instinctive, inspired, original and intellectual rsies with great penance is fountain head of all future literatures even today.

The knowledge is never static, stagnation is detremental it has to flow continuously, descarding old or unacceptible ideas and incorporating newer ones, so is the case with ayurveda, rather with every branch of ayurveda. Multitude of advances in medical science have necessitated reorganisation or rethinking about teaching, training, research and practice of ayurveda. The horizon of 'Kaumarabhrtya' the branch dealing with mother and child (obsterics gynecology, neonatology and pediatrics of today) has spread so much that it has been refabricated by the planners of ayurvedic education and now obstetrics with gynecology and pediatrics are being considered as distinct specialities to a certain extent. Yet one must proceed with great caution because the basic precincts were drawn by sages with great precision. Psychosomatic health of the mother even before conception, during pregnancy, delivery and lacatation periods respectively influence the achievement of conception, its maintenance, growth and development of embryo-s fetus-s neonate-s infant- and then the child, the future of the nation vis-a-vis health of the child taxes on the mother; thus a compact and comprehensive programme for maintenance of health of mother and child both together has to be formulated; present days 'Reproductive and child health care programme' is quite near to concept of 'Kaumarabhrtya'.

In ayurvedic classics all aspects of health i.e. preventive, promotive, protective, rehabilitative and curative of every specialization are given albeit in some what obbreviated form, one has to elaborate incorporating new knowledge without destorting basic philosophy or presincts of ayurveda. The classics are written in sanskrit the language not understood by many, which has been a major blockadge in transmission of knowledge of ayurveda. To popularize basic concepts of ayurveda for the benefit of ailing humanity, appropriate literature is acute necessity'. The book 'Kaumarabhrityam' written by V.L.N. Sastry is the step in right direction.

Dr. V.L.N. Sastry a very well known figure in ayurveda has presented the pediatrics in ayurveda rearranging the subject under intellegible and acceptible headings, incorporating it from almost all major ayurvedic classics, enriching that with modern advances in english, which will be helpful in spreading the massage of ayurveda not only in India but abroad as well. I hope that the book would prove to be an asset to teachers and taughts both. I congratulate Dr. sastry for his this endeavour and wish that he brings much more literature with his hard work.

[Kasyapa mentioned different remedial measures against various diseases for the welfare of children]. Even though ancient scholastic physicians like Vrddha-traya handled all faculties of Ayurveda, Caraka attained fame as a specialist of internal Medicine; Susruta became a popular surgeon whereas Kasyapa is recognized as a paediatrician. This indicates the concept of necessity of specialization and commitment towards research. With the same spirit, the subsequent Ayurvedists like Vagbhatas, Nagarjuna and so on advanced the science of Ayurveda. In the current medical era, the clinical technological advancements in the fields of obstetrics and paediatrics for about past five decades substantially reduced the 'infantile and maternal mortality rate' .

The field of Ayurveda is no exception to constitute 'fundamentalists, rationalists and revolutionists. However, all of these groups are to survive in the clutches of a peculiar culture prevalent in Ayurvedic institutions shackled by complacency, cynicism and dogmatism. Ayurvedic scientists have to cross over such barriers to make a mark of absolute progress. No doubt, the past glory of Ayurveda remains nostalgic. The purpose of medical practice is the welfare of mankind. It bears no value without applied significance. This shall be the area of research in Ayurveda to become practical and popular in the present standards of fast changing socio medical factors. Certain concepts of Ayurveda, related to philosophy and medicine, far from applied strategies, do require a scientific review and research, either to consolidate for implementation or to discard. An Ayurvedist whether a practitioner, teacher, researcher or an entrepreneur shall remain honest without hypocrisy with perfect knowledge of his limitations. A teacher must not override the students when they seek clarification at several Ayurvedic principles and practices, ex. "(i) whether Immunization Schedule of allopathy for children can be completely ignored in the. wake of swarna-prasana as per Ayurveda? (ii) what is the significance of morphological description of the GRAHAS and (ill) scientific authenticity of PUMSAVANA? etc". Students shall never be put to confusion lest they lose confidence in their innovative and research activities.

The branch of kaumarabhrtya even excluding obstetrics and gynaecology is actually very vast and exhaustive. It is possible to be understood analytically at depth only when one does have the knowledge of allopathic paediatrics. But many of the Ayurvedists themselves consider the said branch is very small and confine the same only to "graha-rogas, stanya- rogas & phakka-roga"; also there is a belief that no specialist is required for its teaching as well as for clinicals. It is very unfortunate and far from reality, This is the time when Ayurveda needs the compilations in the model of Text-books concerning with the particular branch and speciality but not of 'SAMHITA' model. In this branch too exist many contents purely theoritical in nature without applied significance, if not obsolete for implementation; ex. vitiated breast-milk:- This is linked to mother's ill- .. health alarming to stop the feeding to the child. In the olden days, breast- milk as such was subjected for clinical testing to decide its nature of vitiation and approptiate correction. But now-a-days, the developed techniques of diagnosing the mother's ill-health are plenty with specifications as to when mothers have to desist from offering the breast to the child; ie. contra- indications of breast feeding. Hence the so-called STANYA-SODHANA measures automatically include the over-all management of the mother suffering from any diseases; similarly the medication accords the clinical features, if any, had by the child. Thus clinical study of the breast -milk as such is obsolete. Regarding GRAIIA-ROGAS, "clinical features of the child and relevant medication besides asepsis and antisepsis" are only of significance. Hence the morphological personifications of different GRAHAS endowed with pauranic background described in the ancient classics can be undoubtedly discarded. One should be; sensible to understand that GRAHAS correlate microbes and GRAHA-ROGAS are infectious diseases.

Obviously handling of paediatric cases warrants skill and caution, as it is prone that a supposed cold case may become serious within no time and there lies no chance for the attending doctor to rectify his mistakes, if arty. One must be wise enough to know the fertile and dominant area of Ayurvedic remedies in paediatric practice especially where the knowledge of purification and administration of certain herbs & minerals besides the selection of ideal RASAYANAS in acute & chronic diseases is a boon to an Ayurvedic paediatrician. It is a great service of a doctor if he knows to what extent he can detain the case under his control and when he has to refer the case to an appropriate specialist.

Keeping the above said details in view, I have felt the necessity of a comprehensive textbook on KA UMARABHRTYAM in order to serve the science, students, teachers clinicians and researchers of Ayurveda. The material of paediatrics scattered in the various SAMHITAS of Ayurveda as well as non-medical religious texts is properly compiled, categorized, classified and then focused in a methodical way. The order in which contents are presented is the author's choice. The book constitutes grossly two parts. viz. PART-A: PRAKRTA VIJNANAM (Normal paediatrics) (chapters I to VII) and PART-B: VIKRTA VIJNANAM (Abnormal paediatrics)( chapters VIII TO XVII).

In both the parts, diacritical (transliterary) marks are used for the Sanskrit terms written in the script of English to ensure correct pronunciation and understanding. Italic style of letters are used for all the Sanskrit as well as non-English vocabulary. Maximum possible references in Sanskrit script and language are figured as footnotes.

The author's comments including correlative aspects are placed in separate paragraphs. Western concepts wherever necessary are briefed separately. I sincerely feel' that this much of allopathic information stands essential in the instance; hence useful as ready reckonor- Modem books may be referred to for further details.

The ancient classics like Caraka Samhita, Susruta Samhita & Vagbhata Samhitas etc., are abbreviated as C.S, S.S, A.H & A.S. etc. Similarly BR, YR, HS and KS etc. should be understood as Bhaisajya Ratnavali, Yoga Ratnakara, Harita Samhita & Kasyapa Samhita etc. Various Sthanas of the Samhitas are abbreviated by their starting letters. viz (i) S.Sth. for Sutra Sthana (ii) V.Sth. for Vimana Sthana ete. Due to certain constraints, I may not have made the book completely comprehensive. In spite of my massive efforts of authoring and proof reading, some mistakes could have rolled on in the book. The absence of APPENDIX including word-index at the end of the book is a definite deficiency. Therefore I pray for excuse by the readers for the inconvenience and cardially solicit their invaluable suggestions and directions to further potentiate the book in subsequent editions.