Swasthavritta evam Yoga स्वस्थवृत्त एवं योग

Preventive medicine, public health and yoga · Second Professional (Dwitiya Varsha) · AyUG-SW

Papers

• Paper I — Swasthavritta (Ayurvedic preventive medicine and Yoga)
• Paper II — Community medicine, epidemiology, national health programmes

Units in this subject

Study notes

Swasthavritta is the regimen of the well. Ayurveda's stated purpose is given in two halves — to preserve the health of the healthy, and then to cure the diseased — and this subject is the first half. It is examined alongside modern community medicine, and the two are not merged: the classical regimen and the epidemiology sit side by side.

Dinacharya — the day

• Brahma muhurta: rise about 96 minutes before sunrise, if the digestion of the previous meal is complete.
• Ushapana, malotsarga, danta dhavana, jihva nirlekhana, gandusha and kavala, nasya, anjana, abhyanga, vyayama, udvartana, snana, in that order.
• Abhyanga contraindications: immediately after eating, in ama, in acute fever, in kapha aggravation. Not contraindicated in age or dry skin — those are indications.
• Vyayama should be to ardhashakti — half capacity, judged by sweat on the forehead and nose and by breathing through the mouth.

Ritucharya — the seasons

• Adana kala (Shishira, Vasanta, Grishma): the sun takes strength; bala declines. Visarga kala (Varsha, Sharad, Hemanta): the moon returns it; bala rises.
• Dosha across the year: kapha accumulates in Shishira and aggravates in Vasanta; pitta accumulates in Varsha and aggravates in Sharad; vata accumulates in Grishma and aggravates in Varsha.
• Hemanta has the strongest agni and the greatest bala, so the heaviest diet is prescribed then.
• Ritusandhi: the fortnight spanning two seasons, in which the old regimen is tapered and the new introduced.

Ahara — food

• Ashtavidha Ahara Vidhi Visheshayatana: prakriti, karana, samyoga, rashi, desha, kala, upayoga samstha, upayokta.
• Ahara vidhi vidhana: eat warm, unctuous, in proper quantity, after the previous meal has digested, without conflict, in a pleasant place, not too fast, not too slow, without talking or laughing, with attention.
• Viruddha ahara: by desha, kala, agni, matra, satmya, dosha, samskara, virya, koshtha, avastha, krama, parihara, upachara, paka, samyoga, hridaya, sampad, vidhi.
• Milk with fish is samyoga viruddha and the standard example.

Sadvritta and Achara Rasayana

• Sadvritta is a code of conduct — social, personal and ethical — described as producing health and long life.
• Achara Rasayana is Charaka's statement that truthfulness, freedom from anger, abstention from alcohol and violence, calmness, cleanliness, charity and regularity produce the benefits of rasayana WITHOUT any drug. It is worth quoting in an answer.
• Dharaniya and Adharaniya vega: the urges that must be suppressed (greed, grief, fear, anger, pride, envy) and those that must not (urine, faeces, flatus, vomiting, sneezing, thirst, hunger, sleep, cough, breath, yawning, tears, semen).

Yoga

• Patanjali's Ashtanga, in order: Yama, Niyama, Asana, Pranayama, Pratyahara, Dharana, Dhyana, Samadhi. The order is examinable.
• Five yama (ahimsa, satya, asteya, brahmacharya, aparigraha) and five niyama (shaucha, santosha, tapas, svadhyaya, ishvara pranidhana).
• Shatkarma: dhauti, basti, neti, trataka, nauli, kapalabhati.
• Common asana, their technique and contraindications; pranayama types.

Janapadodhwamsa and epidemiology

• Charaka's Vimanasthana chapter 3 names four factors whose vitiation destroys communities: Vayu, Udaka, Desha and Kala. This is the classical account of an epidemic and should be quoted as such.
• Modern: incidence is new cases over a period; prevalence is all cases at a point. Confusing them is the commonest error in this paper.
• Epidemiological triad; levels of prevention (primordial, primary, secondary, tertiary); modes of transmission.
• Study designs: descriptive, case-control, cohort, randomised controlled trial, and what each can and cannot show.

Public health in practice

• National programmes: NTEP (tuberculosis), NVBDCP (vector-borne), NPCB (blindness), RMNCH+A (maternal and child), NPCDCS (non-communicable), Ayushman Bharat.
• Immunisation schedule under the Universal Immunization Programme.
• Water: sources, purification, residual chlorine of about 0.2 mg/L at the consumer end after one hour's contact.
• Nutrition: protein-energy malnutrition, vitamin A deficiency (night blindness first), iron deficiency anaemia, iodine deficiency disorders.
• Waste, sanitation, housing, occupational health.

Ratricharya

• The night regimen: the timing and quantity of the evening meal, and the rule against sleeping immediately after it.
• Sleep as one of the three upastambha, with ahara and brahmacharya.
• Divaswapna permitted in Grishma, and for children, the aged, the exhausted, the injured and the ill. Prohibited in kapha conditions and in Vasanta.
• Consequences of ratrijagarana (night waking): described as ruksha and vata-aggravating.

Communicable and non-communicable disease

• Communicable: tuberculosis, malaria, dengue, HIV, hepatitis, diarrhoeal disease, ARI — modes of spread, incubation, prevention.
• Aupasargika roga — the classical account of communicable disease in Sushruta, naming contact, breath, shared bed, clothes and food as routes. Worth quoting because it predates germ theory by centuries while describing transmission accurately.
• Non-communicable: diabetes, hypertension, cardiovascular disease, cancer, COPD — risk factors and population-level prevention.
• The epidemiological transition and why it matters for India specifically.

Satmya and okasatmya

• Satmya is what suits a person — what they are habituated to and can take without harm, even where it would harm another. It is one of the ten examinations of Dashavidha Pariksha.
• Okasatmya is satmya acquired by habit: something unsuitable in itself that long use has made tolerable. It is why a regimen is withdrawn gradually and not stopped in a day.
• Asatmya is the opposite, and satmya is assessed before any shodhana, because a person of pravara satmya tolerates a strong measure that would break a person of avara satmya.
• Satmya is desha, kala and jati dependent. The food that is satmya in a cold country is not in a hot one, and the texts say so explicitly rather than giving one diet.
• It is confused with prakriti. Prakriti is fixed at conception and does not change; satmya is acquired and can be built, which is the whole basis of the graded return to normal food in samsarjana krama.

Where the texts disagree

• The thirteen adharaniya vega are agreed; the list of dharaniya vega differs between Charaka and Vagbhata.
• The ritu are six in the Ayurvedic reckoning, but the assignment of months to ritu differs between north and south Indian practice.
• The duration of sutika kala is given as a month and a half by some and until the return of artava by others.

Commonly confused

• Dinacharya (daily) and Ritucharya (seasonal).
• Adharaniya vega (must not be suppressed, thirteen) and Dharaniya vega (should be restrained).
• Adana kala (strength declines) and Visarga kala (strength returns).
• Chaya, prakopa and prashama - accumulation, aggravation and pacification, one season apart.

Practise it, and prove it