Malavika Kapur

Basic Principles of Ayurveda

Ayurveda means the science of life. The scientific methodology of Ayurveda consists of the knowledge passed on by the sages, direct observation, inference and deductive logic as well as experimentation. The physical body is made of five prime elements. These are Prithvi (earth), Tejas (fire), Vayu (air) and Akasha (sky). These five elements are present in different proportions in different structures and functions of the body, as well as the universe outside. There are triads of constitutional physical and psychological correlates termed Tridosha and Triguna. Treatment of disorders in Ayurveda is holistic in nature and consists of medicine, diet, lifestyle changes and psychological counselling.

Disorders of the Newborn

Under the disorders of the newborn, unconsciousness, aspiration, pneumonia and painless swelling of head are described. In addition, five kinds of complications due to mismanagement of the umbilical cord are described and these are umbilical sepsis, inflammation, granuloma, rawness and hernia. Nutritional disorders are attributed to vitiated breast milk due to the doshas. Eight disorders are attributed to vitiated breast milk. The treatment is given to the mother and not to the infant who is wholly on breast milk. The physical examination of the child is given in detail along with what should be ideal.

Gleanings from Unani Medicine

Unani has Greek, Arabic and Persian origins. Upon its arrival in India, it also got integrated with the time tested Ayurvedic treatment components. Developmental approach is highlighted in the care of the newborn and children. However, lifespan approach is part of Unani system appears to have started from the point of conception to old age and death. The diet and treatments seem to be products of the geographical region and culture of the Middle East where the system took roots. Though core concepts are identical, the actual number of elements, humours and temperaments are four each in number unlike the other three systems, but along the lines of Greek medicine.

Gleanings from Ayurveda

This chapter has some observations on the care of the newborn, rites of passage of samskaras, disorders of newborns and children, and serious disorders called balagrahas. An empirical study of the author is also cited. The origins of Kaumarabhritya and the strong link with folk healing traditions are also highlighted.

Reflections on Childcare Across Systems

There are major differences within each of the systems between the phenomenology, aetiology and treatments. The core concepts remain the same. Some of the key themes in the childcare systems that are common are qualities of a child physician, embryology, care of the mother and the child as a symbiotic unit, salience of breast milk, rites of passage, childcare systems, scientific methodology, prognosis or predictions. Most importantly, the care and healing practices are anchored to the folk medicine, religious, social and magical practices. Because of these differences in the contexts of childcare, there are a number of dissimilarities among the four systems, especially in childcare practices.

Serious Disorders of Childhood and Treatments

The serious disorders described with detailed list of symptoms are facial palsy, polio, encephalitis, epilepsy, dehydration, diarrhoea, respiratory infections, rabies, vitamin B deficiency, Koh’s abdomen, impetigo and Indian childhood cirrhosis. But these are named after supernatural beings or grahas who seize the children. These disorders are treated with medicine but the mainstay of the treatment is pacification of the grahas through prescribed rituals and offerings.

Common Childhood Disorders and Treatments

The physician characteristics and observation of the symptoms in infants who cannot speak are detailed with great clinical acumen. Details of care of normal care are described at length. The common disorders related to head, ears, eyes, epiglottis, throat, mouth are described. Symptoms of fever, drooling, breathing difficulty, vomiting, diarrhoea, rashes, abdominal pain, constipation, pica are described. Urinary problems and bladder stones are described. Bed wetting, jaundice, dehydration, weakness, heart disease rickets, etc., are described. These are followed by treatments. The disorders have parallels in modern paediatric practice.

Implications for Theory, Practice and Research

The history of the different healthcare practices reveals the roots to be embedded first in the religious aspects of healing, then in philosophy, psychology and empirical medical practices of the period. Childcare practices in all the four systems are rooted to folk traditions even today. These follow the same core constructs of the system but vary enormously in actual practice, especially in attributing supernatural aetiology for serious disorders. These practices lead to a number of research questions. These constructs and practices need to be examined empirically, but not in piecemeal manner following Western methodology but by adopting a holistic approach which is inherent in these systems. The developmental context embedded in these childcare practices is the most astounding aspect of this study.

Gleanings from Tibetan Medicine

The history of Tibetan medicine reveals multiple influences from different health, philosophical and spiritual frameworks rendering it very complex. Childcare also consists of these influences, especially plant-based treatments and warding off and pacificatory rituals. All the serious disorders are attributed to evil spirits. The combination of Tibetan medicine astrology and Buddhist philosophy and practices offers explanation that go beyond time and space dimensions.

Diseases of Children and Some Common Treatments

The description of common diseases of childhood is somewhat similar and follows the lines of Al-Qanun Fial Tibb of Ibn Sina. The management of the child consists of management of the mother. Restoring humoral imbalance, treating symptoms of constipation, fever, diarrhoea, respiratory problems were corrected by regulating food and drinks of the nursing mother. All the disorders are described along with treatments albeit briefly.