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Ancient Science of Life, Vol No. X No.

1 July 1990, Pages 21 31

EFFICACY OF AYURVEDIC HEALTH CARE SYSTEM : A STUDY IN


A COMMUNITY
V. NAGARAJU and P. SRIRAM

N.L.C. Hospitals Training Complex, Neyveli Lignite Corporation Limited, Neyveli 607 801,
India.

Received: 16 January, 1990 Accepted: 22 March, 1990


ABSTRACT: This study is aimed at evaluating the efficacy of the Ayurvedic system, especially
for chronic diseases. Assessment of the subjective relief feed back was done on the lines as
suggested in Caraka Samhita, one of the oldest classical Ayurvedic texts. An inter-disciplinary
research work involving ancient medical learning and hi-tech modern electronic data processing
unit evaluate the efficacy of the Ayurvedic treatment in a closed community. 80 percent of the
respondents were in the relief range of 75% to 100%, while overall relief in terms of regaining
positive health in addition to attending complaint relief is over 70% in all diseases groups, as
reported by the respondents in this Programme.

INTRODUCTION

The Neyveli Lignite Corporation Limited, a 25,000 employees plus their dependents and
Government of India Enterprise, is operating other citizens in and around the township.
a huge integrated industrial complex at This vast well-laid township of 30 square
Neyveli in the South Arcot district of Tamil km. is provided with five peripherals
Nadu. This public sector undertaking is dispensaries to cater out patient services in
involved in Lignite mining. Thermal power addition to 350 bedded general hospital,
generation, besides fertilizer and Leco with all departments efficiently managed by
production. The complex, located 200 km. about 70 doctors, of various medical
south of Madras covers an area of 470 disciplines.
square kms., and is accessible by road, rail,
and air too. Geographically it is located Health Care by Ayurveda
between 11o37 and 11o39 north latitudes
and 79o26 and 79o32 east longitudes. A N.L.C. management is pleased to include
well laid town ship caters to a population of ayurvedic system as a part of its medical
1.25 lakhs people. Afforestation services. Since June85 a department of
programme, health care and recreative Ayurvedic health care services came into
facilities have helped to make it a vibrant existence and receives the patronage and
community. With a tree population of 11.15 encouragement, as the same has been well
million trees it exceeds 500 trees to one received and accepted by the society in this
family ratio. township. At present O.P. service is
available under the department, where high
There is a well equipped sophisticated quality medicines procured and stored are
General Hospital to provide medicate to the being dispensed free across the counter. Of

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late a Panchakarma unit also has been
started where O.P. procedures like - Data obtained from 100 respondents
Abhyanga, Patrbhanga sveda valuka sveda, selected at random, who are
Ruksa sveda, siro vasti, Karna purana, receiving Ayurvedic treatment for
Nasya karma, etc., are being under taken. various chronic ailments.
Since there is a well equipped effectively
served general hospital, matching to a Method
teaching institute in all its standards, where
sophisticated high quality medicate is 1. From the O.P. registers maintained
available, only chronic patients who seek average daily turnover of patients
alternative medicate system are turning up to were calculated for the past four
ayurvedic O.P.D. (out-patient department). years (July June).
In fact, Ayurvedic health care services is
located in a dispensary where allopathic 2. Disease wise break-up of Ay.
O.P.D. runs parallel to ayurvedic. Enthused O.P.Ds attendance was calculated
by the general response of clientele from the mean of 100 random days
receiving ayurvedic treatment we felt a feed observation from January to August
back analysis to ascertain the rate of cure 1989.
according to Carakas cure criteria may be
undertaken. According to Caraka Samhita 3. 100 patients selected at random from
the result of therapeutic action is attainment O.P.D are requested to fill in a feed
of the pleasure | satisfaction of mind, back analysis questionnaire. They
intellect, senses and body1. were asked o quantify their relief |
satisfaction on a five point scale.
Caraka laid criteria to examine whether a
patient is cured of a diseae2. We have 4. From the Date so obtained analyses
prepared a questionnaire on that criteria regarding their
basis and asked the respondents to fill in the
data. They were advised to quantify their - Age & sex distribution
relief | satisfaction on a five point scale.
- Education level profile
Date so obtained is computerized for
analysis. The present paper focuses on the - Occupational profile
performance of A.H.C.S. (Ayurvedic
- Incidence of various ailments
Health Care System) in a closed community
like ours. Feed back analysis of their - Chronicity of their ailments
subjective relief from a cross section of
- Follow-up under A.H.C.S.
beneficiaries is projected.
- Regularity in treatment
Material
- Compliance
- NLC Employees & Dependents - Simultaneous use of allopathic
medicine are undertaken.
- Population covered 1.25 Lakhs

- Questionnaire based on Carakas 5. 100 cases taken up for the study are
cure-criteria grouped disease wise into 7.

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6. Quantified relief reported by the Interpretation of Actual Results
each of the respondent to Q.1 in
different groups constituted their After an initial drop in the turn over of
relief from attending compliant. patients in the second year, there was an
Mean of each individuals answers to upward trend in the graph of daily average
all questions is taken as his over all of the O.P. turn over in the past four years
relief. Mean relief of the (Table-1). Medically amenable ailments of
respondents attending complaint in respiratory, of G.I. musculoskeletal and skin
each of the groups also is calculated diseases form the bulk of Ay. O.P. (Table-
(mean 1) x 25 gives the Percentage 2).
of relief.

Results

Table 1
Showing the patient turnover of AHCS in the past Four YEARS (July June)

Year Total Number Average per day


1985 86 40737 155
1986 87 29806 115
1987 88 37425 136
1988 89 39207 141

Table 2
Showing Disease wise break-up based on the mean of 100 random days observation from
January August 89.

Group Disease Incidence Group total


Tamaka Svasa 6
(Broch, Asthma)
Kasa 8 22
A. (Bronchitis, URI, LRI)
Pratisyaya 8
(All-Rhinitis)
Amlapitta 7
(Acid Peptic Disease)
Ajirna, Agnimandya 8
(Digestive Disturbance)

B. Grahani 2 22
(Dysentery)
Vibandha 3

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(Constipation)
Arsas 2
(Piles)
Mutra Krichra 4
(Dysurea)
Asmari 1 8

C. (Renal Calculi)
Pradara
(Leucorrhea) 2
Artavavyapat
(Menstrual Disorder) 1
Vicharchika 9
(Eczema)
Pama, Kaccho 8 20

D. (Dermophytosis)
Kitibha 1
(Psoriasis)
Svitra 2
(Vitiligo)

E. Rasa Dhatuksaya 6 10
Sirassola
(Chronic Headache) 4

F. Amavata & Sandhivata 12


(Arthritis)
Prishta Soola 2 22
(Back ache)
Angamarda 8
(Myalgia)

G. Hyper Tension 1

H. Paksaghata 2
(Paralysis)

I. Madhumeha 1
(D.M)

J. Miscellaneous
Obesity
Cracks in Foot
Dental Problems
Earache 23

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Injuries
Hair Fall
Greying
Dandruff
Pimples
Lactation
Dysmenorrhe
Tinea Versicolar, etc.

From the results of the feed back analysis it


is evident that among the respondents two- Regarding the incidence of diseases among
thirds were males and one-third were the 100 participants Sandhivata
females in the sample under taken for the (Arthritis), Tamaka svasa (Bronchial
study. Majority of the patients fall under 21 asthma). Amlapitta (Acid Peptic disease),
60 age group (Table 3). From the Pratisyaya (All. Rhinitis), Sirassola
literacy profile there is not even a single (Chronic headache) and Vicharchika
cases of illiterate while approximately 50% (Eczema) are predominant while other
are upto the level of Secondary education entities numbers 23 are there (Table 6).
and among the rest, majority (41) happened
to be professionally qualified while 10 Chronically table shows that less than one
happened to be graduates (Table 4). The year cases are fewer while patients suffering
occupational statistics shows maximum from more than 1 to 3 years and 3 to 5 years
respondents are executives while equal are in plenty. Five patients are suffering
number of housewives and supervisory staff from more than 20 years and 12 are there in
participated in the study (Table - 5). the bracket of more than 10 to 20 years.

TABLE 6
Showing the incidence of various diseases among respondents

Diseases Incidence
Sandhivata (Arthrtis) 18
Tamakasvasa. (Bonch. Asthma) 17
Amlapitta (Acid. Pept. Dise) 14
Pratisyaya (All. Rhinitis) 12
Sirassoola (Chronic Headache) 11
Vicharchika (Eczema) 5
Agnimandya (Dyspepsia) 3
Angamarda (Myalgia) 2
Arsas (Piles) 3

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Gandhajnana (Anosmia) 1
Grdhrasi (Sciatica) 1
Kamala (Hepatitis) 3
Kasa (Bronchitis) 1
Ksaya (TB Treated Resistant) 1
Pravahika (Amoebiasis) 2
Tundikeri (Tonsilitis) 4
Suptata (Numbness) 1
Madhumeha (D. M) 1

100

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TABLE 7
Showing the chronicity of ailments disease group wise

CHRONICITY GROUPS DISEASEWISE TOTAL


(YEARS) A.P P.S S.V S.S T.S V.C O.T
<-1 3 1 3 1 - - 7 15

13 2 5 8 2 1 2 6 26

35 3 6 3 4 3 - 6 25

5 10 2 - 3 1 5 3 3 17

10 20 4 - 1 1 6 - - 12

> - 20 - - - 2 2 - 1 5

There is not even a single case of Tamaka of allopathic medicine only 17 patients are
svasa has turned up within one year. taking allopathic medicines out of 100
Maximum number of cases in Tamaka svasa (Table 11). Among them 7 are Tamaka
are in the chronically range of more than 10 svasa patients while the other 10 patients are
to 20 years while numerous are of taking allopathic treatment for some other
Pratisyaya are reported in the chronicity unrelated diseases other than attending
bracket of more than 3 to 5 years and compliant such as Hypertension, Diabetes
Sandhivata cases in 1 to 3 years chronicity mellitus etc.
(Table 7). In all a total of 24 cases are
followed up to 6 weeks while up to 3 Regarding the relief assessment it is felt that
months 19 cases upto 6 months 16 cases, if the same is done according to ayurvedic
upto 1 year 20 and upto 3 years 18 cases are lines it is more appropriate. On scanning the
followed up. 3. Tamakasvasa cases have literature it is found that Caraka has clearly
been followed up more than 3 years (Table laid down in his treatise a criteria to assess
8). Regarding the regularity, 88 cases were whether the disease is cured. In the same
found regular in receiving treatment (Table context he states that the result of the
9). There is patient compliance in all therapeutic action is attainment of spiritual
hundred cases of which 15 are moderately happiness which is characterized by the
compliant and the rest strictly compliant pleasure | satisfaction of mind, intellect,
(Table 10). As regards simultaneous use senses and body.

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TABLE 8
Showing the duration of follow up disease wise

FOLLOW-UP DISEASE WISE TOTAL


DURATION A.P P.S S.V S.S T.S V.C O.T
Up to 6 wks. 4 4 4 4 - - 8 24

6 wks 3 mts - 1 7 1 4 - 6 19

3 mts 6 mts. 2 1 1 3 3 3 3 16

6 mts 1 yr. 4 4 4 1 3 1 3 20

1 yr. 3 yrs. 4 2 2 2 4 1 3 18

> 3 yrs. - - - - 3 - - 3

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TABLE 9 TABLE - 10
Showing regularity of respondents Showing patient compliance

Regularity Incidence Compliance Incidence


Regular 88 Strict 85
Irregular 8 Moderate 15
Occasional 4 100
100

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Keeping this in view a questionnaire is criteria measure the positive health of the
prepared with the Carakas cure criteria to individual in addition to quantifying the
be filled in by respondents on a 5 point relief of the complaint for which treatment is
scale. Grade 5 stands for the satisfaction of sought. It may not be out of place to
particular factor of cure criteria and I stands mention here that the definition of Svastha
for no change while 2 for below average 3 (Healthy individual) according to ayurveda
for average and 4 for above average for Q.2 is a person with optimum level of dosha,
to Q. 17. Regarding the relief of the agni, dhatu and mala in their physiological
attending complaint in Q.1 patients were limits, pleasant soul, mind and sense organs
advised to mark 5 if they had 100% relief, 4, of the body fits into the cure-criteria.
3, 2 for 75%, 50% and 25% relief
respectively. Obviously Carakas cure-

TABLE 11
Showing simultaneous use of allopathic treatment

Simultaneous use Incidence


No 83

Yes 17

TABLE 12
Showing simultaneous use of allopathic treatment

Disease Respondents Reported % of Relief


Total 100% 75% 50% 25%
A. P. 14 7 7 - -

P.S. 12 2 8 2 -

T.S 17 3 10 4 -

S.S 11 3 4 4 -

S.V 18 6 9 3 -

V.C 05 2 2 1 -

O.T 23 11 6 5 1
Total 100 34 46 19 1

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TABLE 13
Showing the mean relief of attending complaint and mean overall relief disease wise

Disease Mean Relief (%) Mean over all Relief (%)


Amlapitta 4.5 4.02
(Acid Peptic Disease) (87.5) (75.41)

Pratisyaya 4.0 4.39


(All Rhinits) (75.0) (84.76)

Tamaka Svasa 3.94 4.28


(Bronch. Asthma) (73.53) (82.03)

Sandhivata 4.17 4.16


(Arthritis) (79.17) (79.08)

Sarassola 3.90 4.26


(Chronic head ache) (72.7) (81.55)

Vicharchika 4.2 4.19


(Eczema) (80.0) (79.87)

Others 4.17 4.46


(79.25) (86.48)

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TABLE 14
Showing Chronicity Vs Relief (100)

Chronicity Years No. of Cases 50% 75% 100%


<1 15 3 4 8

13 26 5 12 9

35 25 5 11 9

5 10 17 3 10 4

10 20 12 2 6 4

> 20 5 1 1 2

100 19 44 36

TABLE 15
Showing Chronicity Vs Relief (77) (Excluding OT)

Chronicity Years No. of Cases 50% 75% 100%


<1 8 1 3 4

13 20 4 10 6

35 19 4 10 5

5 10 14 2 08 4

10 20 12 2 6 4

> 20 4 1 1 2
77 14 38 25

In our questionnaire Q.4, Q.5 denote the same to ascertain whether therapeutic action
status of dhatu while Q.5, Q.6, and Q.7 has resulted in bringing positive health in
denote the status of agni and Q.11, Q.12 the individual in addition to measuring the
and Q.13 speak about the malakriya, while relief of main complaint is justified. All the
Q.15, Q.16 and Q.17 are indices of manas, analysis including numerical analysis were
buddhi and indriyas. Thus this done using computer. Relevant statistical
questionnaire fulfils the definition of a methods were used.
healthy person and thus making use of the

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From the results of the analysis it is clear followed by Tamakasvasa 82.03% and
that in all the groups 34 patients got 100% Sirasola 81.55% Vicharchika 79.87%
relief of their complaint while 46 got 75% and Sandhivata 79.08% (Table 13).
and 19 patients got 50% relief. Among 14
Amlapitta cases half have got cent percent Regarding the chronicity versus relief, it is
relief while another half got 75% relief. Out observed that out of 15 cases reported less
of 17 Tamaka svasa cases 10 got 75% while than 1 year 50% i.e., 8 have got cent
4 got 50% another remaining 3 got 100% percent relief while among the remaining 85
relief. Among Sandhivata cases 9 got patients roughly 40 have got 75% relief and
75% relief while 6 got 100% and 3 got 50% 28 got cent percent relief (Table 14). It is
relief (Table -12). If you look at the to be noted that Tamakasvasa has been
attending complaint relief of different mentioned as incurable or for that matter
disease groups Amlapitta has got a relief almost all the diseases encountered in the
rate of 87.5% to be followed by present study with an exception of
Vicharchika 80% and Sandhivata, Amlapitta. Under suitable circumstances
Pratisyaya and Tamakasvasa in respect these incurable diseases may be palliated. In
of mean percentage of relief to the patients. the present study efforts have been made to
When the mean of overall relief in rationalize therapy keeping respective lines
considered for various diseases Pratisyaya of treatment in mind and using high quality
has got maximum relief that is 84.76% to be Ayurvedic medicines and regimen.

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Conclusion

1. In this pilot study subjective relief feed


back may be taken as reliable since most 4. Relief from the attending complaints in
of the respondents happened to be all the groups outreached 70%.
academically and occupationally high
placed. 5. According to Carakas cure criteria it
has been observed that the above disease
2. Regularity and compliance among the groups the cure rate is over 75%.
patients attending ayurvedic health care
services were extremely good. 6. It may be concluded that in addition to
subjective relief from the attending
3. Ayurvedic medicine is found to be complaint positive health of the
effective as an alternative medicine in individuals have been restored by the
ailments with decades of chronicity such Ayurvedic system.
as Bronchial Asthma (Tamakasvasa),
Alergic rhinitis (Pratisyaya). Arthritis Acknowledgements
(Sandhivata). Chronic headache
(Sirassola). Acid peptic diseases Thanks are due to Dr. K. Soundarapandian,
(Amlapitta) and Eczema Chief General Superintendent (Medical)
(Vircharchika). General Hospital, N.L.C. and Shri. Major

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K.N. Moorthy, Chief of Training and facilities to conduct this study meticulously.
Development, for providing necessary

REFERENCES

1. Carak Samhita, Agnivesa, English Translation Vol. II, R.K. Sharma & Vd. Bhagavandash
Chowkhamba Sanskrit series 219 (1985).

2. Ibid.

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