Text Book of Bal Roga Kaumarbhritya (Multifaceted Ayurvedic and Modern Paediatrics)

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The Book "Text Book of Balroga Kaumarbhritya — Multifaceted Ayurvedic and Modern Pediatrics" written by Prof. B. M. Singh is based on the new syllabus of BAMS-Part-A and part of D. Ch. (Ay) and MD (Ay) of Kaumarbhritya subject in accordance to CCIM, New Delhi. The author has incorporated Ayurvedic concepts specific to Navajata Shishu (neonatology), Bala (Infants) and Kumara (pediatrics). Author has made an effort to explain various terminologies used in] Kaumarbhritya, collected hither and thither dispersed information about the Navajata Shishu Paricharya and Navajata Shishu Pariksha (Neonatal Examination) very systematically. Author has also justified the correlation of Ayurvedic diseases, concepts with modern medical knowledge, brief description of various diagnostic & therapeutic procedures and importance of Samskara scientifically. This book will be very useful to the BAMS, MD [Ay], PG-Diplomas [PGDNC (Ay); D. Ch.- Ay] students as well as the teachers for getting logical and scientific explanation of many Ayurvedic terms, various unsolved concepts, drug dose determination, and better understanding of neonatal diseases with their rational treatment.

Dr. Brij Mohan Singh was born on January 01, 1964. He did BAMMS in 1989 from the prestigious State Ayurvedic College, Lucknow University Lucknow; and MD (Ay) Kaumarbhritya in 1993 & PhD in 1996 from Banaras Hindu University, Varanasi (UP). Dr. Singh joined the Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi in 2002 as a lecturer in Kaumarbhritya after completing five year service as a lecturer in Prasuti-Stri and Balroga at State Ayurvedic College, Gurukul Kangri, Haridwar. Presently, He is working as Professor & Head, Department of Kaumarbhritya/ Balroga, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanas} .

He has produced many PGDNC (Ay), MD (Ay) and PhD scholars, published more than 40 research papers, monograph, book and authored many chapters in various books. He is associated with many academic and administrative bodies of important research and academic institutions of Ayurveda. He is expert member of several committees. Dr. Singh is a renowned personality in the field of Neonatology & Ayurvedic pediatrics (Balroga-Kaumarbhritya).

Ayurveda, the earliest systematized medical system is considered as eternal, since it emanated from the mouth of god of creation i.e. God Brahama, who preached Tri-aphorismic i.e. Hetu (etiology), Linga (clinical features) and Aushadha (therapeutics). Ayurveda, solely devoted to its main object i.e. protection/prevention of health of healthy and elimination/ alleviation of ailments of ailing human being. Others opine that actually Ayurveda descended from celestial to terrestrial stage with its eight specialities. What-so-ever may be the form of its descend, it was accepted and taught as eight specialities. In ancient period the teaching was done at the hermitage of preceptor and students use to be in the state of pupilage with him (C.S. Vi. 3/3). The preceptors used to take their disciples with them to teach in close association of nature and natural products and emphasize that "Nanaushadhibhutam Jagati". The society was mainly administered by kings who have also provided subsistence to those hermitages.

Though initially Ayurveda was divided under eight clinical branches and probably experts with their treatises of all these specialities might have existed. Yet those being lost in oblivion could not be transmitted to future generation due to some circumstances prevailing then, and the treatises of mainly two branches i.e. Kayachikitsa (internal medicine) and Shalya with Shalakya, albeit one incomplete treatise of Kaumarbhritya are available. Today amongst available books are mainly of Kayachikitsa which have some description of other branches also, only one book of each speciality i.e. Sushruta Samhita and Kashyapa Samhita are considered specific books respectively of Shalya with Shalakya and Kaumarbhritya. In all these classics, the authors have described the specific topics or subjects being dealt within these specialities.

Though word Kaumarbhritya appears to be related only to the care etc. of child, yet, it includes physiopathologies of female reproductive system, because in event of any abnormality, the women may not conceive. There could be two reasons for this-

(i) The society being ruled-by king and his legal heir i.e. a male child being most craved, entire physiopathologies revolved around child as a pivot.

ii) In ancient period, educated and trained accouche use were probably not present, the deliveries were conducted by experienced attendants. Naturally entire obstetrics, gynecology, neonatology and paediatrics was considered under Kaumarbhritya, albeit obstructed labour (Mudha Garbha) fell in domain of Shalyavida (Surgeon).

In twentieth century education of Ayurveda went a sea change, it became institutionalized, which maintained training of all these eight branches. As more and more institutions came in the field, majority of those changed the name of Kaumarbhritya to Prasuti Tantra in tune with modern medicine and management of neonate and child was done either by obstetrician or physician, paediatrics as speciality was established in later half of twentieth century.

In BHU after abolishing the Ayurvedic college PGIIM was established which also had Dep’t of Prasuti Tantra which dealt with obstetrics, gynaecology and paediatrics. Late Professor Chandan Chaturvedi fought relentlessly single handed to establish Kaumarbhritya as distinct speciality, with stepwise advancement towards goal in 2006 the governing body of education of Ayurveda accepted it and now it is bearing good fruits. The book "Text book of Balroga- Kaumarbhritya" by Prof. B.M. Singh is one such fruit.

"The book starts with detailed history of Ayurveda specially concerning specific subject, various references from Vedas, ‘other ancient literature and then from almost all available Ayurvedic classics have made the history complete one.

In tune with name of the book it deals with factors of conception» conception growth and development of fetus—> its expulsion in a very sequential order, discussing congenital anomalies, postnatal injuries or ailments, growth and development, nourishment of child, various Samskaras etc all in great details within its eighteen chapters.

Available Ayurvedic classic describing the subject of Kaumarbhritya was written thousands of years back. In medieval period though some literature of Ayurveda was made, yet that was mainly concerned with treatment, nothing has been added in concepts or description of diseases. Today, the scenario has entirely changed, new diseases have crept in, diagnostic tools, and other equipments for treatment are available. Any system of medicine cannot survive without taking help of these.

Prof. B.M. Singh in his book Kas fully utilized modern advances, albeit with an attempt to explain those from the concepts mentioned in Ayurvedic classics. Mention of exact quotation increases the faith of students in Ayurveda. Illustrations, diagrams and photographs of patient . undergoing specific procedure or having some demonstrable abnormalities increase manifold intelligibility of the book.

The students of Ayurveda of entire country are not so well versed with Hindi language, thus the books written in Hindi becomes difficult to understand, realizing this Prof. Singh has written his book in English. It is a unique book, which is in line with the didactic statement of Vagbhata about his book ‘Ashtanga Samgraha’ that is ‘Yuganurupa Karishyamah’ as Prof B.M. Singh has also made his book Yuganurupa. I am sure that Prof. B.M. Singh an enthusiastic, energetic and intelligent teacher will March forward with vigorous speed and bring other similar books to quench the thirst of learning Kaumarabhritya of his students. I wish him all success in future life.

I have great satisfaction in introducing a comprehensive text book on Kaumarbhritya (Ayurvedic pediatrics) as "Balroga- Kaumarbhritya-Ist Part" to the students of BAMS, MD (Ay), PG diploma courses and for those who are ready to learn Kaumarbhritya (Ayurvedic pediatrics) subject in its original form with a scientific explanation through the knowledge gathered from various researches carried out in Ayurveda, modern medical sciences and basic sciences globally.

I felt a lacuna in subject of Kaumarbhritya to have a text book in English which can provide the subject matter in details with scientific explanations of many verse of the Ayurveda written after considering the child, a future of family and country, at a place in a complete, informative and a systematized manner in a text book for the BAMS, MD and Diploma courses running in the Kaumarbhritya subjects in accordance to CCIM syllabus.

To fulfill this lacuna and to create the interest of students in Kaumarbhritya subject, the present text book was started to write in 2006, with simultaneous inception of independent Kaumarbhritya Dep’t in faculty of Ayurveda under Institute of Medical Sciences, Banaras Hindu University.

The text book of Balroga —Kaumarbhritya was planned to publishe initially in one book, but when I read the subject materials dispersed enormously in various Ayurvedic text books, research medical journals and spiritual text books viz. Veda, Upnishada etc, the idea of subject writing in one book had been changed and producing first part out of two parts

As its title implies, first part of text book integrate detail information about the care of the Bala/Kaumar given in the Ayurvedic classics and paediatrics. Main emphasis has been given to the basic terminologies essential to understand the subject Kaumarbhritya, posology, principles of treatment, Anupana, twin to twin transfusion, management of Kumaragara (NICU), management of neonatal disorders, scientific explanation of fetal nourishment and principles used for the Prana Pratyagamana, Navjata Shishu Paricharya including Jatkarma Samskara, why right breast should be offered to child at birth? Why one end of the umbilical cord should be tied in neck of the child? and many more answer of unsolved questions are given with scientific explanation and references.

This book has been combined with critical analysis, comments, suggestions and author’s own thoughts hither and thither to understand the hidden or unsolved message of Sanskrit verse given in original Ayurvedic classics with the help of existing scientific and spiritual literature viz. Veda, Grihyasutra, Upnishada, Manusmriti, dictionaries of Sanskrit to English, Sanskrit to Hindi, English to English and medical dictionaries, relevant research papers and many reference text books.

Book has been enriched with many guidelines & programmes released by the different organization and government bodies like WHO, AAP, IAP, AHA, UNICEF, AYUSH, Ministry of Health and Family Welfare etc.

In the beginning of the book, each chapter, title of chapters are kept under contents while a list of main heading & subheadings in the box at the beginning of each chapter; and at last, index has been given. I suggest that any topic of interest may be searched directly either from the index of this book or from the topics given in the box at the beginning of chapter, which will help the students to save the time by fast search of matter, especially during the examination

The scientific analysis of subject makes this text book immensely useful and valuable for the students, teachers and research scholars of all Ayurvedic colleges, institutions, and Universities.

Through the completion of first part of this text book, I have learnt also many conceptual, diagnostic and therapeutic facts. This text book will really be helpful to understand more about the use of the subject in treatment of the sick infants.

**Contents and Sample Pages**