A Text Book of Kayacikitsa (Kayachikitsa)- Set of 3 Volumes

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This book is the basic book intended as a course supplements to students, researchers, medical officers, and practitioners of Ayurveda. The text covers principles of treatment including management of jwara. This textbook describes all vital topics related to Kayacikitsa paper I as per CCIM syllabus. It is the unique book written in English by a Vikrti Vijnana and Roga Vijnana specialist and Kayachikitsa specialist. Treatment principles and their elaborate description were described in this book.

Dr. P.S. Byadgi is working as a teacher in the area of Roga Nidan (Ayurvedic diagnostics) since 11 years. Dr. Byadgi began his teaching since 2000 and has been writing books and publishing many articles. Dr. Byadgi earned BAMS degree in the year 1995 and completed internship in the year 1997, post graduate degree in the year 2000 and post doctor degree in the year 2003. Reviewer for articles published in European journal of clinical nutrition JAIM, AYU and STM journals. Dr. Byadgi published 50 papers and 13 full papers in seminar proceedings and serving as an editorial board member and Advisory board member of repute journals. He also published 5 books and wrote 4 chapters in a book and contributed significantly for MD scholars research work as a supervisor as well as co-supervisor and guided them to publish their work in reputed journals. Presently working as an Assistant Professor in the Department of Vikriti Vigyan, Faculty of Ayurveda, Instituted of Medical Sciences, Banaras Hindu University, Varanasi since 2005.

Dr. A. K. Pandey is working as a teacher, researcher and practioner in the area of Kayachikitsa (Medicine) since 10 years. Dr. Pandey achieved B.Sc. degree in the year 1991, BAMS degree in the year 2000, MD (Ay) degree in the year 2003, CCYP and Dip. Yoga in the year 2002-2003 and completed post doctor degree in the year 2012. He published more than 54 papers in national and international journals and 10 full papers in seminar proceedings and serving as an editorial board member and Advisory board member of reputed journals. He also published one book and contributed 4 chapters in Geriatric manual (Pub. By Dept of Ayush, Govt of India), 9 chapters in the manual for Ayurvedic therapy (Pub. By NIOS, Ghaziabad functioning under MHRD) and 6 chapters in books related to Ayurveda. Presently working as an Assistant Professor in the Department of Kayachikitsa, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi since 2007.

It was really a pleasure to go through the prepress format of the textbook of Kayachiktsa authored by Dr. P.S. Byadgi and Dr. A.K. Pandey of the Faculty of Ayurveda Institute of Medical Sciences Banaras Hindu University, Varanasi. The book has been designed according to the existing UG Courses of Ayurveda. It is hoped that the book will be helpful to the students preparing for the final BAMS examinations. Dr. Byadgi who is an Assistant Professor in Roga vijnan-Vikriti vijnan at BHU has already written certain books in the past in the area of his specialization. It is nice that now he is joining hands with Dr. A.K. Pandey who is Assistant Professor in Kayachikitsa. This particular volume seems to present the reading material for paper I of Kayachikitsa, which deals with the basic tenets of the subject. Besides definitions and scope of the subject the prominent topics dealt with in this volume are the concept of Kriyakala, CIkitsa Sutra in general, treatment modalities, Diagnosis and treatment of Fevers and febrile diseases, National Health program and the scope of Ayurveda besides a brief account of different systems of Traditional medicine.

I take this opportunity to remind the prospective readers of this book that they should study the subject with open mind also looking beyond the syllabi and curricula because a syllabus outlines only the minimum requirement of learning. Moreover, the syllabi are merely the rolling document and are liable to frequent changes, sometimes-yearly changes, which seem to be mandatory in the interest of growth of knowledge and updated training of the students. It is also advisable that a graduate student should adopt an innovative mind-set and try to discover newer approaches to the diagnosis and treatment of different diseases including many newer diseases, which might not have been described in Ayurveda. In the age of science of today, technology is occupying the central place. Earlier it was believed that Technology emanates from science but now we see that science emanates from technology. In the absence of appropriate technology, growth of new science is retarded. Our students should be equipped to be able to identify appropriate technologies applicable to the task of "Reverse Innovation" and "Translational Studies" which is the key of success in this sector. Merely repeating the texts without fuller application and contemporary usage of the traditional knowledge, is not enough to make a graduate competent for good practice of Ayurvedic medicine today.

Ayurvedic medicine is quite different from conventional western modern medicine both in terms of its principles as well as in terms of its practices. The Tattva (science) as well as the Vidhi (technology) of Ayurveda are distinctly different from modern biomedical sciences. And hence it is not easy to search parallels between the two. However, the final goal of both the sciences being the same ie life, health, disease and cure, meeting grounds cannot be denied if appropriate technologies are applied with a genuine trans-disciplinary approach. Ayurveda is a complete biomedical science with a long history of thousands of years and it has remained in an unbroken professional practice since antiquity with support of a rich dynamic primary evidence-base in the form of its Sastra and the cumulative experience-base. Ayurveda has its own biology with quantum logic, own pathology, its own diagnostics and own pharmaceutics with richly safe and cost-effective green pharmacy and principles of treatment. With this strength, Ayurveda even today stands as a lively system of positive health care.

The Unique Features of Ayurveda
As I have also deliberated in the past in my earlier writings it cannot be overemphasized that inspite of being thousands of years old knowledge system, Ayurveda is being rediscovered today and is liked by millions as the first option of health care. The main attractions seem to be its unique principles, its promise for safety, its green pharmacy and cost-effectiveness. The three important unique features of Ayurveda are: 1. Pronature, 2. Holistic, 3. Individualized care approach.

1. In its entire approach Ayurveda is a pro-Nature system of health care. In Ayurvedic practice, no diagnostic or therapeutic interventions are prescribed which may have anti-Nature impact because Ayurveda believes that our body-mind system is a miniature replica (microcosm) of the Nature (macrocosm) and therefore the health as well as the disease both are the products of the joint action of the two. The moment the microcosm is afflicted with a disease or disorder the Nature starts its protective actions for healing. The Ayurvedic theory of Svabhaoparamvada teaches us that the Nature and our own body are the first rank healers, which are already helping the victim. The doctor-drug duo as external aides should assist the Nature, they should not interfere the ongoing natural healing process. This is why Ayurveda does not prescribe fast acting toxic medications and prefers nutraceuticals and soft medications in the treatment of a patient. In contrast, the entire approach of western modern medicine is anti-Nature as is obvious from its medications like antibiotics, analgesics, anti-inflammatory, antipyretics, beta-blockers, calcium channel blockers and so on. All the medications are designed to counteract the Nature's action with the ambition to overpower the Nature. Now gradually the modern science is also realizing the hollowness of its ambitions. Although antibiotics have helped many victims of fulminating, infections but they have done much more harm. Now it is known that the healthy human body harbors Trillions of nonpathogenic microbes on our body who help us with extremely useful symbiosis in the life process. The estimated number of these microbial cells is ten times more than our body cells. This is called "Microbiome" which in fact is an important invisible organ of our body deserving all efforts of organ protection like any other organ of our body like liver, kidney, heart or brain. Scientists have argued that the concept of human genome should now be revised considering genome, epigenome and microbiome as a combined unit as all the three intimately interact together. The antibiotics and similar other chemical drugs heavily damage the "organ microbiome" and make us weak to take care of our day-to-day physiology and defense from all range of diseases. This is why Ayurveda teaches us to use minimum medication and put more emphasis on lifestyle management and dietary care. In medications too we use soft medicines and nutraceuticals often drawn from the Green resource of the Nature. The Nature also warns us to prevent a disease rather than waiting to treat a disease when it has really emerged which may not be always easy. This is why Ayurveda while deliberating on its objectives emphatically states: "Swasthasya Swasthya Raksanam, Aturasya Vikara Prashamanam " (Caraka).

2. Ayurveda is essentially a Holistic and subjective science in contrast to conventional biomedical sciences which are critically reductionist boasting to be objective and scientific. The classics consider Ayurveda as Holistic because it considers life process in totality encompassing the body, the mind and the Soul all the-three in one sweep. Ayu or life is a three-dimensional entity comprising of body-mind-spirit as a continuum. Further, the so conceived Ayu is in continuum with the universe of the Nature. This is the meaning of the Ayurvedic theory of Loka-Purusaha Samya ie microcosm-macrocosm continuum. On the other hand, the so conceived holism also reflects on the holistic approach to diagnostics and medications practiced in Ayurveda. An Ayurvedic doctor diagnoses and treats his patients in totality encompassing promotion of health, prevention of disease and healing of his ailments not merely by drugs but through comprehensive life style management, dietary care and soft supportive medications wherever needed. Thus the entire intervention is comprehensively holistic in Nature and the entire strategy is "patient centered", not merely "disease centered" as is the case in Allopathy.

It is pertinent to mention here that holistic and subjective approach is the most scientific approach because the Nature itself is a complex and holistic phenomenon. It can be comprehended only through holistic subjective experience, not by mere study of parts and then to try to sum the parts to comprehend the 'whole'. The 'whole" is not merely the sum of the parts. The 'whole' has its own entity. Thus, the modern science too is holistic because science is nothing but a way to understand the Nature, which is a holism. The difficulty comes at the level of technology and artificially designed methods of application of Science to decode its mysteries. Thus science is holistic, though modern technology is reductionist. There is a need to transform modern technology too into a holistic and pronature enterprise, then only one could understand the secrets of Nature in true sense. In the words of Nobel laureate BD Josephson the basic premise of modern bio-science and technology is to reduce the Reality/Nature into a measurable formula to suit the process of measurement. But the Reality/Nature is so complex that it can- not be truly reduced to a measurable formula. Hence, most of the predictions of modern science are merely presumptions still to be proved by better science and subjective experience, which was the approach of ancient Hindu scientists of India.

3. Individualized or personalized health care is another important feature of classical Ayurveda. Ayurveda is practiced on the principle of specificity of Prakrti and Vikrti. Every patient has his own genetically determined Prakrti or Constitution. So also every disease has also its specific Prakrti ie Dosa- Dusya-Adhisthana pattern which is to be addressed during the curati ve treatment. The Deha Prakrti may be modified to a limited extent in its epi-genomic dimensions but cannot be changed fundamentally in one lifetime. In view of such features, each patient is a separate entity and needs to be treated individually. Ayurveda does not prescribe the same treatment to all patients suffering from a particular disease as is often done in Allopathy. The current trends show that conventional modern medicine is also now gradually converging towards this age-old approach of individualized health care advocated by Ayurvedic classics-Purusam Purusam Viksya (Caraka). In the opinion of many activists in the field of genomic medicine Allopathy is not a full science, it is only a half science until it develops its real individualized health care strategy. If so Ayurveda is the only full science at least in its theoretical understanding. There is an urgent need to generate new scientific evidence for it.

I have known both the young authors of this new book for many years in different capacities. Both of them are good teachers, researchers and practitioners of Ayurvedic medicine. Their attempt to compile a textbook is commendable. I wish this new publication all success.

There has been a long left need to have a textbook on Kayacikitsa (Internal medicine) in English as per CCIM norms, which is relevant to the students, teachers and practitioners of Ayurveda. During my postgraduate graduate days, Prof. R.H. Singh-Distinguished Professor, Banaras Hindu University, former Vice Chanceller, Rajasthan Ayurveda University, Jodhapur, Rajasthan, has given me opportunity to interact with Late Prof. P.V. Sharma, former Director of Post Graduate Institute of Indian Medicine, BHU; on different aspect of health, disease and management pertaining to Ayurveda. He pointed out that dear Dr. Pandey you feel proud that you belong to Kayacikitsa discipline of Ayurveda, which is most fertile and viable branch of Sodasanga Ayurveda. Because Ayurveda means Kayacikitsa and vice-versa, while others are offshoots of the same that is designed for its development. Ayurveda is one of the recognized official systems of medicine in India. In ancient times, Ayurveda is flourished through Guru-Sisya tradition in Gurukula system and it based on self-study (Addhyayana), teaching (Adhyapana) and discussion (Tadvidyasambhasa).

Ayurveda is based on the holistic logic of the creation, life process, health, disease-diathesis as well as management of diseases. Ayurveda disagrees the target or organ oriented approach of biomedical science. It adopts function-oriented approach through its alternative theories of Loka-purusa samya, Pancamahabhuta, Tridosa, Samanya-visesa, Dhatuposana, Agnivyapara, Ama, Ojas, Srotasas etc. Besides this, the concept of Prakrti/Vikrti, clinical sense of Tridosika diagnosis in terms of Rogi-roga pariksa and pulse examination are important tools and techniques for the diagnosis, prognosis and management of ailments. The concept of Ras, Guna, Virya, Vipaka and Prabhava of drugs projects unique holistic pharmacology and pharmacodynamics of the Ayurvrdic drugs. The entire knowledge of Ayurveda seems to have been developed and validated through rigorous fourfold testing methods, viz- 1. Pratyaksa pramana- direct observation, 2. Anumana pramana- inferential evidence, 3. Aptopadesa pramana- scriptural evidence and 4. Yukti pramana-planned rational experimental evidence.

Ayurveda believes in the humoral (Dosika) theory of health and disease. If body humors are in a state of equilibrium body is normal and as soon as they get imbalanced a disease is produced. Medicine is known to be the amalgamation of science and art. First and foremost thing the physician has to do is to win the confidence of his patent otherwise; he failed to threat his patient because so many times patient may not reveal many his ailments and personal problems which may be directly related with the disease process. Caraka has emphasized that if a physician by virtue of his knowledge is not able to enter in the mind of his patients, he cannot threat him successfully.

At the time of management, clinical examination by descent manner, suitable conversation, selection of suitable therapeutic measures including diets and drugs are required to win the confidence and treat him successfully and safely. Now with the change in concepts of health and disease, attention has been drawn to Ayurveda once again.

With these background authors of this book, felt that text-books should contains all the necessary information, which should be comprehensive, clear and concise, not have too many details and should be understood easily by the graduate students. Keeping this thought in mind, this book is written jointly with Dr. P.S. Byadgi, Assistant Professor, Department of Roga Vigyana and Vikriti Vigyana, IMS, BHU, Varanasi; primarily at graduate level students as per prescribed syllabi of CCIM. We believe it will also be useful to post-graduate students, residents, Ph.D scholars and practicing physicians of Ayurveda.

The book Kayacikitsa part-I is divided into eight chapters starting from basic tenets of Kayacikitsa of National health programme. Every effort has however been made to avoid needless repetition. The common format of each chapter is brief description of the same followed by details of the chapters. It is my hope and believes that this tiny effort will find favourable response from medical students of Ayurveda, teachers, researchers and offer significant help to the Ayurvedic practitioners.

It has been my endeavour to keep the book error free; however, there may be some typographical errors. If the reader comes across any such error, or wants to send any comment/suggestion, please do write or send an –email at the address given below. It will be dully acknowledged in the subsequent edition.

I offer our sincere thanks and deep sense of gratitude to Prof. R. H. Singh, Distinguished Professor, Banaras Hindu University, Varanasi and Dr. S. K. Joshi, Reader in Shalya Tantra, Govt. Ayurvedic College, Gurukul Kangri, Haridwar, UK for their inspirational thoughts, scientific encouragement and motivations to be I am in the field of Ayurveda specially Kayachikitsa.

I am grateful to our dynamic Director Prof. R. G. Singh, IMS, BHU, Prof. C.B. Jha, Dean, Faculty of Ayurveda, Prof. N.P. Rai, H.O.D. Kayachikitsa, Faculty members such as Prof. M. Diwedi, Prof. V.K. Joshi, Prof. M. Shahu, departmental colleague such as Dr. J.S. Tripathi, Dr. O.P. Singh, Dr. K.N. Murthy, Dr. V.K. Srivastava for their constant encouragement. During compiling this book, I have received generous assistance and good help from my graduate students, PG scholars, researchers, practitioners, many friends, well-wishers and family members including my wife Dr. Madhu Pandey and son Mr. Mridul Pandey. They are too numerous to be mentioned individually, but we offer them all our sincere thanks.

My revered Guru ji Professor R. H. Singh, Distinguished Professor, Banaras Hindu University, the noted scholar Ayurveda specially Kayachikitsa has written the foreword which added attraction to this book for which the author is extremely grateful.

This book is dedicated to the unfading memory of revered and visionary Pt. Madan Mohan Malaviya ji, Founder of Banaras Hindu University.

I am thankful to Jauhari process for their kind co-operation while composing my book. I am extremely thankful to Chaukhambha Sanskrit Sansthan for publishing my book.

I had the opportunity to review the format of the book Kayacikitsa Vol. II authored by Dr. PS Byadgi and Dr. AK Pandey. I find this book a good reading material written as per the syllabi of the undergraduate courses of the subject of Kayacikitsa. The book covers a wide range of diseases described in Ayurveda, their etiopathogenesis, clinical features and treatment. The book also simultaneously describes the comparable modern diseases in continuation for easy reading although for comprehension of the subject readers are advised to study the subject with the help of independent books also.

The trends of education, teaching and learning have changed tremendously in recent years which have become inevitable because of continued explosion of information in all fields of knowledge and the pressing demand of real empowerment of the learners. The traditional teacher-centered teaching is being replaced by student-centered teaching. Till recently the teacher used to be the central figure in the teaching process playing the role of a designed performer in the class room, almost dictating the student clients and conducting the teaching sessions in an unidirectional manner, keeping the learner students in the periphery and the only motivation for the student used to be the completion of the rigid curriculum and passing the examination as a passive receiver of information. Gaining real knowledge, wisdom and skill is left behind. In such a educational set up the inherent natural urge of learning and the talent of the student is suppressed. In new trends the leadership of teaching and learning remains with the student who is the active participant in the process of teaching. The teacher plays the role of a positive and innovative helping hand. The goal is not merely gathering information rather is learning how to learn and how to convert the information into knowledge and wisdom as the real strength to get success in divergent field of activity in life.

In conventional traditional teaching often the teacher limits his class room instructions to a package of information related to the concerned subject. A teacher has to realize that mere information is not the real knowledge-base. A learner has to grasp the delivered information and has to convert the same into knowledge. Knowledge is the real intellectual capital of an individual. Information is largely a borrowed commodity and is liable to change frequently as the knowledge base grows. It is this capital of knowledge which makes education and in turn generates culture and human value in a seeker which is necessary to transform the man and the society generation after generation. We teachers are not merely meant to transact information trading, rather we are expected to generate and transmit innovative knowledge. Further in the age of fast growing information technology it has not remained any more difficult to handle information. Information can be accessed by self study if the learner has learned how to learn.

In this globally accepted new pattern of education the traditional class rooms are being transformed into seminar rooms and the teaching sessions are being run more as learning sessions in bilateral interactive sessions. The role of strereotyped syllabus bound books is largely reduced. The days of syllabus bound books are now gone and time is emerging for knowledge-based books. It may be pointed out that syllabus bound books and question-answer based writings and examination aids pouring in the book market limit the comprehension of the knowledge of a particular subject in its natural unfolding and evolution of the knowledge base in totality. This kind of aid also hampes the intellectual growth of a student and his instinct of learning and innovative skill. Further one has to note that no syllabus and course curriculum is ever complete, it is a dynamic rolling document warranting frequent periodical change. All good students should be encouraged to study the subject beyond the syllabi.

In view of such trends a teacher has to evolve new methodology of teaching, the purpose of which should be to promote learning skill in the student rather than mere repetitive teaching to push a package of information in the mind of a student. The teaching sessions should be interactive and practice oriented. The following is the eye opening remark of a brilliant student like Albert Einstein addressing his teacher “Tell me I will forget, show me I may remember, involve me I shall understand.” This innocent utterance of a learner should guide our action today.

It is hoped that the two young emerging authors will think of producing many more books also beyond the artificial boundaries of a syllabus and will promote modern learner-friendly style of teaching in their class rooms. I have known doctors PS Byadgi and AK Pandey for several years. They are competent professionals in the respective fields. They are good teachers and researchers in the field of Vikriti Vijnana and Kayachiktsa reskpectively. I congratulate them for their collaborative effort to produce new literature in the area of their specialization. I wish this publication a good success.

Now with the change in concepts of health and disease, attention has been drawn to Ayurveda once again, and new waves of research have begun. The awareness and curiosity of Ayurveda and its different branches are increasing gradually not only in India but also throughout the world. However, a review of there search outcomes during last few decades reveals that there has not been any major breakthrough. Further, the methodology adopted for such research has been efited more the conventional system of medicine than Ayurveda itself. There has been a long felt need to have a textbook on Kayachikitsa (Internal medicine) in English as per CCIM norms, which is relevant to the students, teachers and practitioners of Ayurveda. Kayachikitsa is most fertile and viable branch of Sodasanga Ayurved which attracted more attention than any other branches.

No doubt, modern medicine has found a way to solve the problems of various ailment upto some extent through its target or organ oriented approach. At the same time conventional medicine may also leads to various unwanted, toxic effect or even drug failure during the course of treatment of disorders. By virtue of this the ailing one is enjoying the fruits of modernization but at the same time he is paying more and more money for the same. This warrants many scientists and researchers to inclined towards others systems of medicine specially Ayurveda for providing better health care and cure. Ayurveda dis-agrees the target or organ oriented approach of biomedical science. It adopts function-oriented approach and practiced through its alternative theories of Loka-purusasamya, Pancamahabhuta, Tridosa, Samanya-visesa, Dhatuposana, Agnivyapara, Ama, Ojas, Srotasas.

Ayurveda have its own comprehensive methodology of research and development and it is valited time to times through rigorous fourfold testing methods, viz- 1. Pratyakshapramana- direct observations, 2.Anumnapramana- inferential evidences, 3. Aptopadesapramana- scriptural evidences and 4. Yuktipramana- planned rational experimental evidences. At the time of management, clinical examination by descent manner, suitable conversation, selection of suitable therapeutic measures including diets & drugs are required to win the confidence and treat him successfully and safely. The first and foremost thing the physician has to do is to win the confidence of his patent otherwise; he failed to treat his patient because at many times patient may not reveal many his ailments and personal problems which may be directly related with the process of disease. In this regard, Caraka has emphasized that if a physician by virtue of his knowledge is not able to enter in the mind of his patients, he cannot treat him successfully (C.Vi. 4/12).

With these background authors have felt that there is an emergent need of a book on Kayachikitsa which should fulfill the all basic necessary information in comprehensive, clear and concise way. Keeping this thought in mind, this book is written jointly with Dr. P.S. Byadgi, Assistant Professor, Department of RogaVigyana &Vikriti Vigyana, IMS, BHU, Varanasi; primarily at graduate level students as per prescribed syllabi of CCIM. The book Kayachikitsa part-II is divided into 65 chapters and covered principles and management of common diseases.

We the authors therefore feel that this book explaining all the detail accounts pertaining to Kayachikitsa-II and every effort has however been made to avoid needless repetition. The common format of each chapter is brief description of the same followed by details of the chapters with an attempt to evaluate the relevance and validity of the same in modern time. It is our hope and believes that this tiny effort will find favourable response from medical students of Ayurveda and offer significant help to all healing professionals of Ayurveda.

It has been my endeavor to keep the book error free; how- ever, there may be some typographical errors. If the reader comes across any such error, or wants to send any comment/suggestion, please do write or send an e-mail at the address given below. It will be dully acknowledged-in the' subsequent edition.

I offer our sincere thanks and deep sense of gratitude to Prof. R.H.Singh, Distinguished Professor, Banaras Hindu University, Varanasi and Dr. S.K. Joshi, Reader inShalya Tantra, Govt. Ayurvedic College, Gurukul Kangri, Haridwar, UK for their inspirational thoughts, scientific encouragement and motivation to be I am in the field of Ayurveda specially in Kayachikitsa.

I am grateful to our dynamic Director Prof. R.G. Singh and Prof. M. Sahu, Dean Faculty of Ayurveda, IMS, BHU, Varanasi, for their constant encouragement and support. I offer my sincere regards to the Departmental colleagues, Prof. N.P Rai (Head), Prof. B.N. Upadhyay, Prof. S.K. Tiwari, Dr. J.S. Tripathi, Dr. O.P. Singh, Dr. K.N. Murthy, Dr. Rajendra Prasad and Dr. V, K. Srivastava, for their continuous encouragement and support.

I am sincerely thankful to the learned and versatile faculty members specially Prof. M. Dwivedi, Prof. V.K. Joshi, Prof. C.B. Jha, Prof. P.K. Bhardwaj, Prof. K. N. Dwivedi, Prof. A. C. Kar, Prof. B. K. Dwivedi, Prof. P. K. Goswami, and many more colleagues, for their goodwill and support.

During compiling this book, I have received generous assistance and good help from my graduate 'students, PG scholars, researchers, practitioners, many friends, well-wishers and family members including my wife Dr. Madhu Pandey and son Mr. Mridul Pandey. They are too numerous to be mentioned individually, but we offer them all our sincere thanks.

Professor R. H. Singh, Distinguished Professor, Banaras Hindu University, the noted scholar Ayurveda specially Kayachikitsa has written the foreword which added attraction to this book for which the author is extremely grateful.

This book is dedicated to the unfading memory of revered and visionary Pt. Madan Mohan Malaviyaji, Founder of Banaras Hindu University.

We thank the Publishers Chaukhambha Sanskrit Sansthan for their help in various ways. Our thanks also go to Mr. Jitendra (typist), for their constant help in preparing this book in final shape.

There has been a long felt need to have a textbook on Kayachikitsa (Internal medicine) in English as per CCIM norms, which is relevant to the students, teachers and practitioners of Ayurveda, Kayachikitsa is most fertile, viable and vibrant branch of Shodashanga Ayurved, which attracted more attention worldwide.

Ayurveda is the holistic way of living being, which is not only concerned with the treatment ailments of the body and mind but also provides fundamental aspects to in tune oneself with the environment. The world's oldest system of medicine, Ayurveda, is now divided into sixteen branches. Of these, the first is Kayachikitsa, which is the equivalent to the internal medicine of conventional system of medicine. Kayachikitsa mainly deals with the diagnosis and treatment of a variety of general disorders including body and mind. It includes the basic principles oftreatment, various types of therapies and biourification. Kayachitikitsa delves deep into ascertaining the root cause of the illness. The entire Ayurvedic therapeutics is based on the concept of Agni. The concept of Kaya (Agni) is unique and is responsible for bio- transformation. As it is known that energy, neither can be created nor can it be destroyed. In human body, Kaya provides the necessary energy for all bodily activities.

The energy provided is derived from the food we eat and the air we breathe. The biological system of the body transforms this energy to one, which is utilized by the cells.

There are six stages of the development of disease are described in Ayurveda such as stage of accumulation, vitiation, spread/overflow, localization, manifestation of symptoms and appear as recognizable disease. In Kayachikitsa, there is always an opportunity to stop the disease at each stage by their respective therapeutic measures described in classics, thereby preventing its full manifestation. No doubt, modern medicine has found a way to solve the problems of various ailments up to some extent through its target or organ oriented approach. Ayurveda always disagree the target or organ oriented approach of biomedical science and adopts function-oriented approach. The concepts of Loka-purusha samya, Panchamahabhuta, Tridosha, samanya-vishesha, Dhatuposhana, etc are the basic tenets of Ayurveda on which Kayachikitsa resides.

At the time of management, clinical examination by descent manner, suitable conversation, selection of suitable therapeutic measures including diets & drugs are required to win the cnfidence and treat them successfully and safely. The first and foremost thing the physician has to do is to win the confidence of his patent otherwise; he failed to treat because at many times patient may not reveal many of his ailments and personal problems, which may be directly 'related with the process of disease.

In this regard, Charaka has emphasized that if a physician by virtue of his knowledge & good conduct; is not able to enter in the mind of his patients, he cannot treat him successfully.

With these background authors have felt that there is an emergent need of a book on Kayachikitsa which should fulfill the all basic necessary information in comprehensive, clear & . concise way. Keeping this thought in mind, this book is written jointly with Dr.P.S. Byadgi, Assistant Professor, Department of Roga Vigyana & Vikriti Vigyana, IMS, BHU, Varanasi; primarily at graduate level students as per prescribed syllabi of CCIM. The book Kayacikitsa Vol-III is divided into 16 chapters. The book is started with principles and management of Yatika disorders in general & specific too and end with the different formulation described in the Ayurvedic classics, which is commonly used in clinical practice. Rasayana, Vajaikarana, Vatavyadhis, geriatric disorders, genetic disorders, medical emergencies etc are the beauty of this volume. Besides this, Dr. K. N. Murthy, Assistant Professor, Department of Kayacikitsa has contributed two chapters, which is related to General concepts of mental disorders in Ayurveda and principles & management of mental disorders.

We the authors therefore feel that this book explaining the detail accounts pertaining to Kayachikitsa-III and every effort has however been made to avoid needless repetition. The common format of each chapter is brief description of the same followed by details of the chapters with an attempt to evaluate the relevance and validity of the same in modern time. It is our hope and believes that this tiny effort will nullify the thirst of Ayurvedic scholars pertaining to this field and find favorable response from medical students of Ayurveda. It has been my endeavor to keep the book error free; however, there may be some typographical errors. If the reader comes across any such error, or wants to send any comment/suggestion, please do write or send an e-mail at the address given below. It will be dully acknowledged in the subsequent edition.

I offer our sincere thanks and deep sense of gratitude to Prof. R. H. Singh, Distinguished Professor, Banaras Hindu University, Varanasi and Dr: S. K. Joshi, Reader in Salya Tantra, Govt. Ayurvedic College, Gurukul Kangri, Haridwar, UK for their inspirational thoughts, scientific encouragement and motivation to be I am here & in the field of Ayurveda specially in Kayachikitsa.

I am grateful to our dynamic Director Prof. R. G. Singh & Prof. M. Sahu, Dean Faculty of Ayurveda, IMS, BHU, Varanasi, for their constant encouragement and support. I offer my sincere regards to the Departmental colleagues, Prof. N.P. Rai (Head), Prof. B.N. Upadhyay, Prof. S.K. Tiwari, Dr. J.S. Tripathi, Dr. O.P. Singh, Dr. K.N. Murthy, Dr. Rajendra Prasad and Dr. V. K. Srivastava, for their continuous encouragement and support.

I am sincerely thankful to the learned and versatile faculty members specially Prof. M. Dwivedi, Prof. V.K. Joshi, Prof. C.B. Jha, Prof. P.K. Bhardwaj, Prof. K. N. Dwivedi, Prof. B.M. Singh, Prof. A. C. Kar, Prof. B. K. Dwivedi, Prof. P. K Goswami, and many more colleagues, for their goodwill and support. Besides, I am grateful to the learned scholars of Kayachikitsa specially Prof. G. S. Tomar, Prof. H.M. Chandola, Prof. A.K. Sharma, Prof. Y.K. Sharma, Prof. :U.S. Nigam, Dr. Sanjeev Rastogi, Dr. K.K. Sharma and many more for their constant encouragement, time to time support and help.

During compiling this book, I have received generous as sistance and good help from UG & PG scholars, authors of different book's, researchers, practitioners, many friends, well wishers and family members including my wife Dr. Madhu Pandey & son Mr. Mridul Pandey. They are too numerous to be mentioned individually, but we offer them all our sincere thanks.

Professor R. H. Singh, Distinguished Professor, Banaras Hindu University, the noted scholar Ayurveda specially Kayachikitsa .has written the foreword which added attraction to this book for which the author are extremely grateful.

This book is dedicated to the unfading memory of revered & visionary Pt. Madan Mohan Malaviyaji, Founder of Banaras Hindu University.

We thank the Publishers Chaukhambha Sanskrit Sansthan for their help in various ways. Our thanks also goes to Mr. litendra (typist), for their constant help in preparing this book in final shape.