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Arbhudha : Epidemiology And Prognosis
ZACHARIA JACOB, Director,
Athulya Ayurvedic Medical Research Centre (AAMRC),
Mundikkalthazham, Kottamparamba P.O.,
Medical College - Karanthur Road,
Calicut - 673008, Kerala, India,
Tel: 0495-2358016, 2356391
Arbhudha is a vedic numerical term meaning innumerable numbers. This has been true when one notices development as well as destruction of innumerable cells in Arbhudha (cancer) patients.
There has been an alarmingly increased incidence of Arhbudha since the latter part of the twentieth century. The current higher rate of incidence of this maharoga has been attributed to change in life style, dietary habits, exposure to toxins, microbial infections, lethal radiations, etc. In the modern system of medicines, concerted research in epidemiology, prognosis and treatment have been done but no absolute cure has been possible till today. Thus, status of the disease as a Maharoga still remain unconquered. In this context, it is worthwhile to understand what ayurvedic science has to contribute to the modern mankind.
In general the epidemiology and prognosis of Arbhudha is similar to the disease of vidhradhi and grandhi. However, the symptoms of Rhekhtharbhudha and mamsarbhudha are different. Table 1 shows the classification of different types of Arbhudha, vidhradhi, and grandhi based on the prominence of humors.
|Disease||Number of types||Prominent humors (Thridhosha / dhadhu)|
|Arbhudha||6||Vata, Pita, Kapha, Rhektha, Mamsa, Medhasu|
|Vidhradhi||6||Vata, Pita, Kapha, Sannipatha, Kshadha, Rhektha|
|Grandhi||9||Vata, Pita, Kapha, Rhektha, Mamsa, Medhasu, Siraha, Asthi, Vranaha|
Gathra pradhese kwachi deva dosha:
Sammoorchitha mamsa masruck Pradhooshya
Vrutham sthiram mandharucham mahantha-
Manalpa moolam chiravrudhi paakam
Kuruvanthi mansoch chrayamathyaghatham
Thadharbhudham Sasthra vid ho vadanthi
Vathena pithena kaphena chapi
Rakthena mamsena cha- medasa cha
Thajjayathe thasya cha lakshanani
Grandhe ssa manani thadha Bhavanthi
The predisposing factors of Arbhudha cause to creat impure Vata, Pita, Kapha, Mamsa and Medhasu. The impure humors thus formed are either systemic or exogenous. They are primarily benign ad metamorphosed to tumerous, cyst or plaque like structures. As the impure humors increase in quantity, the abnormally formed structures become malignant.
As mentioned earlier, epidemiology of Arbhudha is similar to that of vidhradhi and Grandhi. The following verses from Ashtangahridhayam give an account of the epidemiology
Bhukthaai : Paryooshitha thyushna ruksha vidhahibi:
Jhinhama sayyavi cheshtabhi sthy sthy shcha srukku pradhooshanai:
Dhushta thwangh mamsa medhosthi snava srukhandharasrya:
Yasso pho bhaheer andharava mahamoolo maharuja:
Vruthassya dhayadho yo va smritha: shoda sa vidhradhi:
Dhoshai pradhak samudhi thai shonithena kshthena cha
Consumption of old rotten foods, dried and over spicy foods and food that create gastric burning, unnatural postures of laying and working, unethical deeds that affects constitution and development of the body and exposure to toxins affecting the functions of thwak, rekhtha, mamsam medasu, asthi, khandhara and snanu are the reasons for Arbhudha. The humors thus formed are expressed as spherical or oblong oedema (sopha) as a defensive mechanism of the body either externally or internally. These abnormal structures are classified as vata, pita, kapha, sannipatha, kshadha, rhektha and vidhradhi, on the basis of prominence of dhoshas.
The symptoms of grandhi is explained as follows.
Vata dhayo mamsamasruk pradheeshta:
Samdhooshya medhascha thadha sirascha
Vruthonnatham vigradhi thanthu sopham
Sarvamthyratho grandhi reethi pradhooshtah:
The impure humors of vata, pitta and kapha affect mamsa, rhekhtha, medhasu and sirah to form spherical tumors and they are called grandhi.
As mentioned earlier, let us examine how rhekhtharbhudha and mamsarbhudha are different from other Arbhudhas.
Dhosha: pradhushto rudhiram sirahascha
Samkoojjya sampindhya thatha sthwa pakam
Samsrava munnahhyathi mamsapindham
Mamsankoorairachitha masu virdheem
Karothyajasram rhudhira pravruthi
Ma sadhyajetha dhrudhira lmakanthu
In rhekhtharbhudha the impure humors of vata, pitta or kapha engulf or amalgamate to form tumors with many raised heads. These tumors grow suddenly in size and ooze out blood and serum. According to acharys, this type rhekhtharbhudha patients are anaemic and untreatable.
Let us examine how rhekhtharbhudha is characterized
Mushti praharaadhi bhirardhi themgay
Mamsa pradhushtam jhanayadhi sopam
Avethanam snikdtha manannya varna-
Ma paka masoshmapama mapra chalyam
Pradhushta mamsa ssasrya narassya ghadha
Medhalbha ve nmamsa parayannsya
Mamsarbhudhudhandhwa thadha sadhya muktham
Sardhaye shwa pee mani thu varjja yecha
Fist fighting and accidents cause trauma and oedema. The swollen mamsa (the traumatic injuries) initially is painless, non-ulcerous with normal skin color and texture and oleaginous. These structures gradually become stone like hardened mass. Mamsarbhudha occurs in those who eat excess quantities of meat and to whose mamsa filled with humors. Acharyas also mentioned that this type of disease is untreatable.
Both rhekhtharbhudha and mamsarbhudha are untreatable and a learned doctor should avoid such cases.
Recurrence of Arbhudha happens in the secondary phase of the disease.
Yajjaya thyel ghalu poorvajhathae
Knajyam thadhyarbhudha marbhudha kjnay
Yal dhwandhwa jhatham yugpath kramadhwa
Dhwirarbhudham thacha bhavadha sadhyam
Recurrence of malignant tumors at the same point of earlier tumors is called Adhyarbhudham and to those adnexa is called dhwirarbhudham.
A hypothesis has been reported earlier (Jacob 1998) regarding epidemiolgy and prognosis of arbhudha (cancer). Arbhudha can be defined as a deficiency syndrome expressed as an allergic manifestation wherin certain predisposing complaints of impure vata, pita, kapha, rekhta, mamsa and medhasu develop primarily benign and painless spherical or deep rooted plaques. This gradually spread and form excruciating pain.
The above hypothesis is expressed mathematically as follows :
BMA (Balanced Metabolic Activities) :Normal stage
IBMA (Imbalanced Metabolic Activities) :Diseased stage
ie: IBMA 1/ BMA :Diseased stage
ie: IBMA = k/BMA Where k is the balancing constant
Therefore k is a function of IBMA
The progress of the disease can be expressed as follows.
To arrive at the above hypothesis mainly four aspects, viz., balanced metabolic activities (BMA), imbalanced metabolic activities (IBMA), Maladhosha of Thridhosha and dhadhu and presence of factor k have been considered. Normal individuals have sufficiency in all factors responsible for non-allergencity to carcinogenic agents and the maladhosha are cleared from the system in normal fashion. While in cancer patients who are insufficient in certain factors and possessing factor k responsible for alleginicity to various agents and the maladhoshas are not cleared properly.
In primary stage patients who are exposed to allergic agents, the body system acts defensively resulting in elevated body temperature, gas, high density fluids (neoplasmic fluid, phlegm, or mucosal fluids) so that the maladhosha could be excreted through sweat, urine or stool. All the cancer patients are allergic to any of the chemical based drugs like sulphadrugs, antibiotics, exposure to chemicals, radiations or microbial agents in nature and eatables like fish, meat, milk and so on. But, when this physiological abnormality of allergencity is not effectively controlled the intensity of the maladhosha production and retention would be multiplied in many folds and thereby affecting the other vital metabolic activities to a stand still. The maladhosha are excreted partially in cancer patients. The high density neoplasmic fluids rich in protein and salts are of no use to the system and cannot be translocated fully to the kidneys for filteration. In primary stage patients, some degree of filtration might be possible but it progressively ends with calculi formations. Similar observations can also be made with in the functions of galol bladder, pancreas, spleen etc. In certain other instance the maladhoshas while translocation gets localized or circulated in the system through blood or lymph and develop regional lymph nodes or vessel nodes. As the situation progresses more number of similar nodes are thus formed and they gradually develop ulceroproliferative lesions with severs pain. In other instances, obnoxious gas, phlegm, or mucus secretion are blocked their passage in regions of injury and trauma affected aspects, develop severe pain and sufferings to the patient. Thus, depending on the intensity of maladhosha (deficiencies caused by impurities discharges on account of Thridhosha and Dhadhudhoshas) retention and excretion of maladhosha the prognosis can be classified as primary, secondary and advanced stages.
The expression of factor k can be delayed by giving simultaneous samana chikilsa proper anti-allergic medication and medicines for balancing Thridhosha and Dhadhus. Therefore the above protocol has to be repeated periodically as and when required in patients with deficiency factor k. This tell the importance of Ayurveda in the treatment of cancer. Therefore a general protocol can be advocated which may have samana chikilsa as the primary step. As a next step a clever Ayurvedic physician would therefore diagnose the prime dhoshas (either of Thridhosha or Dhadhudhoshas) and effectively treat patients with sodhana chikilsa and hence it would be possible to cure most of thecancer patients.
Everybody aspires for prolonged sound health (disease frees state) and it is possible when the value of factor k is zero. According to great ayurvedic pandits disease free state could be maintained by observing the following.
Incidence of disease happens when one does not practice apt and hygienic food style, logical thinking and action, unethical sexual interest and involvement, offertory, honesty, compassion and endurance.