Consumer pathies

The public should be aware of mass advertising and avoid adopting mass prescriptions, writes Dr KK Aggarwal.

Allopathy is a modern medicinal science, which deals with prescription medicines and cannot be advertised by law. It involves one to one prescription between doctor and a patient and also involves specific instructions on how to take a particular medicine. These restrictions, however, as on today are not applicable to sciences like Ayurveda, Homeopathy, Naturopathy, Yoga, Meditation, Pranayama, etc. These pathies where the drug or device can be available without the medical prescription can be called consumer pathies.

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Even in earlier times, daadi ma ke nuskhe used to come from daadi maa of that particular family and not from the daadi maa of a neighbor. The advice for kitchen pharmacy passes on to one family from the other rather vertically and not horizontally.

But today proponents of all the consumer pathies are advertising and misusing electronic media. They create mass hysteria in the public about the preventive strategies. One of them is water therapy promoted by naturopathy. It says as you get up you should drink two to three litres of water preferably from Copper vessel. The very fact it is called as therapy, means it cannot be for the masses and has to be practiced under supervision. In the elderly with renal dysfunction and in patients with water retention this form of therapy done without supervision can be risky and can even be lethal.

He advocates both Bhasrika and Kapalbhati as a form of pranayama. These can be very harmful to susceptible individuals. Pranayama for simplification can be classified in 2 types in terms of physiology, Hypo Ventilating Pranayamas and Hyperventilating pranayamas. Kapalbhati, Bhasrika and fast breathing are hyperventilation types, which increases Oxygen and reduces carbon dioxide.

On the other hand deep and slow breathing, alternate nostril breathing, Bhramari, Shitali, Sitkari is the hypoventilation types where oxygen level remains mostly same but the speed of respiration is lower. While in the first one body's sympathetic system is stimulated in the other body's parasympathetic system takes over. Kapalbhati, Bhasrika and fast breathing exercises are to be practiced by people suffering from obesity and kapha disorders. They normally increase the lung capacity and help burning fats but can be harmful in patients with coronary artery disease or with tendencies for Brady arrhythmias (slower heart rates).

Bhasrika (bellow's breath), literally means one has to operate lungs like the bellow, fast inhalation and fast exhalation, followed by inhaling through right nostril and performing kumbhaka with bandhas and exhaling through left nostril. This rhythmic inhalation and exhalation stimulates the circulation of cerebral fluid, creating compression and decompression in the brain. Rhythmic diaphragm movements stimulate heart and lung muscles. Kumbhaka (Retention of air) along with Bandhas (energy locks) are important components of Pranayama.

They have long lasting effects on nervous system, brain and other parts of the body, but again can be harmful for the heart patients. Therefore, guidance of Guru/teacher/doctor is essential for practicing Pranayama. The practice of Kumbhaka increases the CO2 in the blood, which stresses the nervous system and can harm the heart in susceptible individuals. In the language of modern medicine, true pranayama is any process that involves deeper and slower breathing, which shifts the body from sympathetic mode to parasympathetic mode.

If the body is taken to parasympathetic mode acutely, which occurs in breath holding techniques kumbhak and yogic bandhs, it can worsen many heart failures, precipitate angina, increase blood pressure, precipitate dangerous brady arrhythmias or irregularities of the heart, in susceptible individuals. Also taking the body into hyperventilation mode acutely or suddenly stimulating the sympathetic mode can precipitate heart attacks in susceptible individuals.

A patient with first onset angina often will have some pre angina-warning signals. The patient often ignore these symptoms as gas or acidity. If he or she continue procedures like bhastrika and kapalbhati during this period they run the risk of sudden death as these types of breathing involves taking rapid full expiration and inspiration or both with or without breath holding, which can precipitate dangerous slow irregularities of the heart in such situations, which can even cause death.

The very fact some breathing exercises can harm patients with blood pressure, diabetes and heart ailments they should not be done without proper medical supervision. Anything, which cannot be done without a proper medical supervision, cannot be advertised or treated as a part of consumer pathy.

Alternate nostril pranayama, populary known, as anulom-vilom is the only pranayama, which has no medical contraindication, by any system of medicine including allopathy. This should be the only procedure taught to the people as far as consumer pathy is concerned.

Regarding food and nutrition Ayurveda has its own principles and they are based on a specific dosha, predominant in an individual. Vata, pitta and kapha specific diets are separate and any mixing can lead to chronic lifestyle disorders according to Ayurvedic philosophy. Diet therapy, therefore, cannot be a part of consumer pathy.

Learning meditation also requires a teacher or a doctor and hence cannot be advertised or taught in masses. Learning the wrong way of meditation can cause disturbance in the mind of a learner.

Cycling, swimming, jogging, brisk walking, etc. also require medical clearance especially if started after the age of 40. The only part of consumer pathy can be that one should remain active in daily routine life as far as possible and if one wants to indulge into brisk walking or muscle building exercise medical clearance should be done.

There have been mass prescriptions to people to drink ghiye ka juice. The same cannot be given as a prescription to an elderly with compromised renal functions, to patients with a tendency for water retention or who is on fluid restriction, as excessive intake of any liquid may worsen their conditions.

The public should be aware of these ways of mass advertising and avoid adopting mass prescriptions.

(The writer is Senior Consultant, Moolchand Medcity; President, Heart Care Foundation of India; President, Delhi Medical Association; Member, Delhi Medical Council.)