On the earliest descriptions of the uremic syndrome in medical literature.

Uremic syndrome refers to the clinical manifestations of renal failure (acute or chronic) that results from the accumulation of several endogenous toxins normally excreted by the kidneys and can be fatal unless the primary cause is addressed and the toxins removed by dialysis. A historical description of the syndrome is traditionally believed to start in the 18th - 19th century through seminal works in the field of experimental medicine. This account, however, ignores the possibility of clinical apperception of this syndrome in ancient medical literatures. The Sushruta Samhita (SS), a Sanskrit text whose authorship is attributed to the legendary ancient Indian surgeon Sushruta (6th century BC), is well known for its pioneering descriptions of several surgical procedures, even though its contribution to the fields of internal medicine and especially nephrology is detailed. Prameha, a term that first appears in the SS, and subsequently in later historical Ayurvedic (traditional Indian medicine) texts, denotes a multi-systemic disease syndrome impacting the neurological, cardiac, dermatological, and gastrointestinal systems that is recognized through its intimate association with urinary abnormalities such as hematuria, frothy urine, or glycosuria. This construct is highly consistent with uremic syndrome originating from multiple renal disease processes such as acute glomerulonephritis, nephrotic syndrome, diabetes mellitus, etc. Furthermore, medical treatment of prameha, as detailed in the original text, reflects several recently validated approaches to managing chronic kidney disease, supporting the hypothesis that this historical entity may be one of the earliest descriptions of uremic syndrome in medical history.

Do Ayurveda students need a course in Medical Astrology?

Ayurveda is based largely upon two classics - Charaka-Samhita, representing the school of medicine, and Sushruta-Samhita representing that of surgery. These two texts mark the historic switch in the Indian medical tradition, from faith-based therapeutics to its reason-based variant [1]. The Charaka-Samhita, which acquired its present form in circa 1st century CE, uses two remarkable terms to designate the distinctness of these approaches: daiva-vyapashraya (literally, dependence on the unobservable) and yukti-vyapashraya (dependence on reason) [2].

[The "jivaniya class of herbs" (Shi Tian Yao) in the Bower Manuscript (Bao Wei Er Xie Ben)].

The Bower Manuscript (Bao Wei Er Xie Ben) is a Sanskrit document unearthed in Xinjiang in the 19th century. The ten drugs, which tasted sweet, and used widely were named as the "jivaniya class of herbs" (Shi Tian Yao) in this document . It was found that "jivaniya" tasted sweet, felt cold and was often used in tonic decoction for relieving serious vata (Feng), with references to the ancient medical book Ayurveda and the modern Ayurvedic pharmacopoeia. "Jivaniya" was constructed with different dossage forms, such as butter, oil, enema, ointment. It can treat some diseases of consumption of the lungs, epilepsy, consumptive diseases and fever of children in Bower Manuscript (Bao Wei Er Xie Ben). The theories of "jivaniya" came from Ayurveda. Compared with the theories of traditional Chinese Medicine, the theory that "jivaniya" can treat consumptive diseases appears similar to the theories in Su Wen about "Feng Xiao". The theories of Traditional Indian medicine and Chinese medicine appear resemblant, such as the commonalities in terms of using sweet tonics with liquorice and Fritillaria cirrhosa to treat comsumptive diseases.

Management of rectal prolapse (Guda Bhramsa) through Kshara Karma (chemical cauterisation): a case study / Manejo do prolapso retal (Guda Bhramsa) usando Kshara Karma(cauterização química): um estudo de caso

Abstract Rectal Prolapse is a condition where the rectum protrudes beyond the anus. The explanation of this condition can be traced back to ancient Ayurveda text like Susruta Samhita, Ebers Pappyrus of 1500 B.C., etc. The exact cause of rectal prolapse is unclear but it is predominant on female gender and on people having constipation, previous anorectal surgeries etc. Both partial and complete varieties of rectal prolapse are extremely debilitating because of the discomfort of the prolapsing mass and variety of symptoms like rectal bleed, intermittent constipation or fecal incontinence. Although, diverse modalities of surgical management of rectal prolapse are present, no single optimal procedure is proved and the choice of operation is determined by the patient's age, sex, degree of incontinence, operative risk, as well as by the surgeon's experience. In Ayurveda, Guda Bhramsa (Rectal prolapse) is explained by Acharya Susruta under Kshudra Rogas (chapter of minor diseases) and has elaborated it's conservative management very beautifully. In this case, a female with partial rectal prolapse was treated with Kshara application and managed without complications. So, Kshara application can be a safe and effective alternative for the management of rectal prolapse.

Resumo O prolapso retal é uma condição em que o reto se projeta para além do ânus. A explicação desta condição foi relatada em antigos textos Ayurveda como Susruta Samhita e Ebers Pappyrus, datados de 1500 aC. A causa exata do prolapso retal não é clara, mas essa condição é predominante no sexo feminino e nas pessoas com constipação e histórico de cirurgias anorretais anteriores. Tanto o prolapso retal parcial quanto total são extremamente debilitantes devido ao desconforto da massa prolapsante e da variedade de sintomas como sangramento retal, constipação intermitente ou incontinência fecal. Embora diversas modalidades de tratamento cirúrgico para corrigir o prolapso retal tenham sido relatadas na literatura, nenhum procedimento é consensual; a escolha da operação é determinada pela idade, sexo, grau de incontinência, risco operatório e experiência do cirurgião. Na Ayurveda, Guda Bhramsa (prolapso retal) é explicado por Acharya Susruta no Kshudra Rogas (capítulo de doenças menores) e seu manejo conservador é descrito de forma bastante completa. No presente caso, uma paciente do sexo feminino com prolapso retal parcial foi tratada com aplicação de Kshara e administrada sem complicações. Assim, a aplicação de Kshara pode ser uma alternativa segura e eficaz para o manejo do prolapso retal.

Akarnan: The Stethoscope and Making of Modern Ayurveda, Bengal, c. 1894-1952.

The histories of modern medical technologies have largely been studied exclusively within the biomedical context. Yet historians of medicine have increasingly demonstrated that a number of non-biomedical therapeutic traditions-Ayurvedic and Chinese medicine to name only two-have attained their own distinctive modernity. How has the incorporation of various medical technologies affected these neo-traditional medicines? What is the relationship between technologies and the body knowledge in non-biomedical therapeutics? Do shared technologies such as the stethoscope reveal the same bodily facts in biomedical and Ayurvedic contexts? These are some of the questions explored in this article by focusing on the uptake of the stethoscope in modern Ayurvedic medicine in Bengal. In the process the article also describes the emergence of a new sonic body in modern Ayurveda.

New insights and rethinking of cinnabar for chemical and its pharmacological dynamics.

Cinnabar is an attractive mineral with many different uses. It is reported that cinnabar is one of the traditional Chinese's medicines extensively use. The main objective of this critical review is to identify the current overview, concept and chemistry of cinnabar, which includes the process developments, challenges, and diverse options for pharmacology research. It is used as a medicine through probable toxicity, especially when taking overdoes. This review is the first to describe the toxicological effects of cinnabar and its associated compounds. Nuclear magnetic resonance (NMR) dependent metabolomics could be useful for examination of the pharmaceutical consequence. The analysis indicated that the accurate preparation methods, appropriate doses, disease status, ages with drug combinations are significant factors for impacting the cinnabar toxicity. Toxicologically, synthetic mercury sulfide or cinnabar should be notable for mercuric chloride, mercury vapor and methyl mercury for future protection and need several prominent advancements in cinnabar research.

Medical Cannabis: A plurimillennial history of an evergreen.

The history of Cannabis goes along that of humankind, as speculated based on geographical and evolutionary models together with historic data collected to date. Its medical use is several thousand years old, as attested both by archeobotanical evidence of Cannabis remains and written records found in ancient texts from the sacred Vedic foundational texts of Ayurvedic medicine (about 800 before current era [BCE]) to the first known Pharmacopoea, the Chinese "Shen Nung Pen Ts'ao Ching" (1 century BCE). In this paper, we retrace the history of Cannabis traveling through the key stages of its diffusion among the most important ancient cultures up to our days, when we are facing a renaissance of its medical employment. We report through the centuries evidence of its use in numerous pathologic conditions especially for its anti-inflammatory, antiseptic, and anticonvulsing properties that support the requirement to direct our present research efforts into the definitive understanding of its efficacy.

Ancient Indian concepts about phenomenology, biology, and therapeutics of epilepsy.

This article discusses etiology, pathogenesis, symptoms, and treatment of epilepsy, as described in Charaka Samhita (translation: Charaka's Compendium) and Sushruta Samhita, the two core texts of Ayurveda, an ancient system of medicine. Ayurveda emphasized amnesia and loss of consciousness as core features of epileptic seizures (Sanskrit: apasmar; translation: apa negation, smaran memory) and recognized that seizures occur due to a disturbance in brain function or flow of "humors" to the brain. Semiology of various seizure types was well described. Epilepsy was attributed to both internal and multiple exogenous factors. Treatment of epilepsy with formulations of naturally occurring substances, their compounding and use, is described in remarkable detail. Lifestyle modifications to protect people with epilepsy are also documented. Cognitive comorbidities of epilepsy were recognized. Although none of the Ayurveda formulations have any empirical evidence supporting their safety or efficacy in the treatment of epilepsy, studies are needed to generate relevant evidence, to recognize their hazards, and to integrate traditional and complementary systems of medicine with modern health care in an informed and safe manner.

Between the Bazaar and the Bench: Making of the Drugs Trade in Colonial India, ca. 1900-1930.

This article analyzes why adulteration became a key trope of the Indian drug market. Adulteration had a pervasive presence, being present in medical discourses, public opinion and debate, and the nationalist claim for government intervention. The article first situates the roots of adulteration in the composite nature of this market, which involved the availability of drugs of different potencies as well as the presence of multiple layers of manufacturers, agents, and distributors. It then shows that such a market witnessed the availability of drugs of diverse potency and strengths, which were understood as elements of adulteration in contemporary medical and official discourse. Although contemporary critics argued that the lack of government legislation and control allowed adulteration to sustain itself, this article establishes that the culture of the dispensation of drugs in India necessarily involved a multitude of manufacturer-retailers, bazaar traders, and medical professionals practicing a range of therapies.

[Textual research on relationship between traditional Chinese medicine and medical prescriptions in the Sanskrit formulary Bower Manuscript excavated in Xinjiang].

This paper introduces the Bower Manuscript in Sanskrit written on birch bark excavated in Xinjiang, which was bought in Kuqa by a British India army lieutenant Bower, hence its title. Then, it was researched, annotated, and published in 7 volumes by a German British lieutenant and orientalist Honer. The first three volumes are devoted to medical prescriptions. It is first verified that its "Dazi Xiangye San" is the "Dujuan Dachen San" in Tibetan medicine. By comparing it with other traditional medical systems, such as Chinese, Tibetan, Mongolian, and Uyghur medical systems, we found that Bower Manuscript is closer to Tibetan medicine and Mongolian medicine, while it has less relation with Chinese medicine and Uyghur medicine. However, it also exerts some influence on TCM.

Psychological symptoms and medical responses in nineteenth-century India.

The article documents medical approaches to mental illness in mid- to late-nineteenth-century India through examining the Indian Medical Gazette and other medical accounts. By the late nineteenth century, psychiatry in Europe moved from discussions around asylum-based care to a nuanced and informed debate about the nature of mental symptoms. This included ideas on phrenology and craniometry, biological and psycho-social causes, physical and drug treatments, many of which travelled to India. Simultaneously, indigenous socio-medical ideas were being debated. From the early to the mid-nineteenth century, not much distinction was made between the Western and the native 'mind', and consequently the diagnosis and investigation of mental symptoms did not differ. However, by the late nineteenth century Western medicine considered the 'Western mind' as more civilized and sophisticated than the 'native mind.

Compromised: making institutions and indigenous medicine in Mysore State, circa 1908-1940.

This is a study of the emergence of new institutional arenas for ayurveda and yunani medicine, collectivized at the time as 'indigenous medicine,' in a semi-autonomous State (Mysore) in late colonial India. The study argues that the characteristic dimensions of this process were compromise and misalignment between ideals of governance and modes of pedagogy and practice. Running counter to a narrative that the Princely States such as Mysore were instrumental for the 'preservation' of ayurveda, this study analyzes the process of negotiation and struggle between a variety of actors engaged with shaping the direction of institutionalized 'indigenous medicine'. In examining the entanglements over the priorities of the state administration and the conflicting desires and ideals of protagonists, the study problematizes the idea of studying the encounter between the 'state' and 'indigenous medicine,' in order rather to highlight their co-production and the tensions which were generated in the process. While institution-making for ayurveda and yunani in Mysore State assumed distinctive translocal forms, themes of divergence that were unresolved during the time of this study, over the role of the state, the politics of validation, appropriate curricula and pedagogy, and their relation to practice and employment, continue to inform the trajectories of state-directed health provision through 'indigenous medicine' on larger scales [India, health-care, ayurveda, yunani, education].

[The traditional Ayurvedic medicine about pseudo-doctoring as exemplified by "Charaka Samhita"].

The article considers the findings about pseudo-doctoring represented in one of the most ancient medical sources on our planet--treatise "Charaka Samhita" (Carakasamhita). This treatise is the most important text of Ayurveda, a traditional medical system developed in the Hindustan sub-continent during millenniums.

Soma, food of the immortals according to the Bower Manuscript (Kashmir, 6th century A.D.).

ETHNOPHARMACOLOGICAL RELEVANCE: Food is medicine and vice versa. In Hindu and Ayurvedic medicine, and among human cultures of the Indian subcontinent in general, the perception of the food-medicine continuum is especially well established. The preparation of the exhilarating, gold-coloured Soma, Amrita or Ambrosia, the elixir and food of the 'immortals'-the Hindu pantheon-by the ancient Indo-Aryans, is described in the Rigveda in poetic hymns. Different theories regarding the botanical identity of Soma circulate, but no pharmacologically and historically convincing theory exists to date. We intend to contribute to the botanical, chemical and pharmacological characterisation of Soma through an analysis of two historical Amrita recipes recorded in the Bower Manuscript. The recipes are referred therein as panaceas (clarified butter) and also as a medicine to treat nervous diseases (oil), while no exhilarating properties are mentioned. Notwithstanding this, we hypothesise, that these recipes are related to the ca. 1800 years older Rigvedic Soma. We suppose that the psychoactive Soma ingredient(s) are among the components, possibly in smaller proportions, of the Amrita recipes preserved in the Bower Manuscript. MATERIALS AND METHODS: The Bower Manuscript is a medical treatise recorded in the 6th century A.D. in Sanskrit on birch bark leaves, probably by Buddhist monks, and unearthed towards the end of the 19th century in Chinese Turkestan. We analysed two Amrita recipes from the Bower Manuscript, which was translated by Rudolf Hoernle into English during the early 20th century. A database search with the updated Latin binomials of the herbal ingredients was used to gather quantitative phytochemical and pharmacological information. RESULTS: Together, both Amrita recipes contain around 100 herbal ingredients. Psychoactive alkaloid containing species still important in Ayurvedic, Chinese and Thai medicine and mentioned in the recipe for 'Amrita-Prâsa clarified butter' and 'Amrita Oil' are: Tinospora cordifolia (Amrita, Guduchi), three Sida spp., Mucuna pruriens, Nelumbo nucifera, Desmodium gangeticum, and Tabernaemontana divaricata. These species contain several notorious and potential psychoactive and psychedelic alkaloids, namely: tryptamines, 2-phenylethylamine, ephedrine, aporphines, ibogaine, and L-DOPA. Furthermore, protoberberine alkaloids, tetrahydro-ß-carbolines, and tetrahydroisoquinolines with monoamine oxidase inhibitor (MAO-I) activity but also neurotoxic properties are reported. CONCLUSIONS: We propose that Soma was a combination of a protoberberine alkaloids containing Tinospora cordifolia juice with MAO-I properties mixed together with a tryptamine rich Desmodium gangeticum extract or a blending of Tinospora cordifolia with an ephedrine and phenylethylamine-rich Sida spp. extract. Tinospora cordifolia combined with Desmodium gangeticum might provide a psychedelic experience with visual effects, while a combination of Tinospora cordifolia with Sida spp. might lead to more euphoric and amphetamine-like experiences.