Int J Ayu Pharm Chem REVIEW ARTICLE www.ijapc.com e-ISSN 2350-0204

Rakshakarma inChild Health Care- A Review

Kalpana Patni1* and Gaurav Sinha2

1State Ayurvedic College and Hospital, Lucknow, Uttar Pradesh, India

2Primary Health Center, Udham Singh Nagar, UKD, India

Abstract Rakshakarma means protective measures. It is one of the important procedures extensively used in Ayurveda. It is one of the procedures involved in the resuscitation of the newborn. The concept of Rakshakarma in Ayurveda is quite efficient for providing a complete physical and psychological protective shield to the newborn. Protective measures for the new born baby are taken to prevent the infections and to clean the environment, as well as to increase humoral immunity. The fumigation (dhupana) of the Sutikagara(sanatorium/labour room) by various drugs is mentioned to protect the baby from various opportunistic infections. Ayurvedic acharyas have advocated the use of clean and fumigated clothes, beddings etc. The various drugs mentioned in dhupana karma have antiseptic and antimicrobial properties which have been also proved experimentally in various studies. Plants protect by secreting natural phenols, flavonoids, isoflavones, glucosinolates, etc. These different chemicals are usually bitter, pungent or astringent in taste. In addition to their bactericidal or biological activity these substances may provide a defense against predators. Chanting hymns and practicing and Niyama provide a psychological support to the patient, which is helpful for quick recovery and rehabilitation. Thus we can say that Rakshakarma procedure provides a complete physical and psychological protection to the mother and the child.

Keywords Rakshakarma, Immunity, Protective Measures, Antisepsis, Vrana

Greentree Group Received17/02/17Accepted28/02/17Published 10/03/17

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INTRODUCTION patient. Protective measures for the new Raksha and its various derivatives occur born baby are taken to prevent the infections predominantly in the Vedic texts means – to and to clean the environment, as well as protect, guard, take care of, govern, to keep, toincreasehumoral immunity. to preserve, save, to avoid, to observe or to Under Rakshakarma, AcharyaCharaka gives beware of, an evil spirit, a demon1. detailed description related to protection of Rakshakarma means protective measures. It newborn (rakshakaram) related to antisepsis is one of the important procedures of clothing, beddings, and aseptic measures extensively used and talked about in to prevent infections from surroundings. All Ayurveda on different subjects. Charaka and around the Sutikagara (the place where Vagbhata spoke about Rakshakarma mother and child both resides after especially during child care. Rakshakarma is delivery), the twigs of Adani, Khadira, one of the procedures involved in the Karakndu, Pilu, Parushakas hould be hung, resuscitation of the newborn. and Sarshapa(yellow mustard), Atasi, AcharyaSushruta explained in detail about Tandulakan-kanika(rice particles) should be Rakshakarma in the management of wound scattered on its floor. “Tandul Bali Home” and also patient going through surgery in should be done twice a day i.e, morning and pre-operative, operative and post operative evening. The musal (pestle) should be phase. Rakshakarma is one of the sixty placed obliquely at the entry door. The fire Upkrama (procedures) involved the should always lit by putting the dry wood of management of Vrana (wound) in kana-kantak(ingudi) and Tinduka wood in SushrutaSamhita. Dhupana, , Yama, the Sutikagara.A packet containing Vacha, and Niyama are the procedures performed Kustha, Kshomka, Hingu, Sarspa, Atasi, for the Rakshakarma as described by Lasuna, Guggulu etc. raksoghana dravyas Sushruta.Again during the chapters related should be hung on the door and similar with pregnancy there is a description about dravyas should be tied around the neck of Rakshakarma for mother and baby care. mother and the child. Well wishing skilled It was thus found, that the concept of care taker women should be remain vigilant Rakshakarma in Ayurveda is quite efficient and attentive continuously in the for providing a complete physical and sutikagarafor the initial 10-12 days i.e, the psychological protective shield to the baby should not be kept alone. The ______Patni and Sinha 2017 Greentree Group © IJAPC Int J Ayu Pharm Chem 2017 Vol. 6 Issue 2 www.ijapc.com 165 [e ISSN 2350-0204] Int J Ayu Pharm Chem

Sutikagarashouldbe fulfilled with gifts, should be ensured by reciting hymns. Again auspicious recitations, blessings, praises, Sushruta says, the wound should be playing of music and musical instruments, fumigated with a mixture of powders of foods and drinks, along with devoted, loyal Guggulu, Agaru, Sarjarasa,Vacha, and delighted persons. The person having Sarshapa, Saindhavaand the leaves of the knowledge of should Nimbatree along with Ghrita. The left over perform „Shanti-Patha or Home’ in the Ghrita then applied over the region of heart morning and evening for the wefare of the and other vital parts of the patients. mother and baby2. Afterwards protective hymns should be Acharya Sushruta directed the neonate to be recited as – May and other gods wrapped in kshauma (linen) cloth and made counteract sorcery (Kritya) and the dread of to sleep on a bed covered with soft linen. evil spirits (Raksasa), serpent Twigs of pilu-badar-nimba-parushaka are to (Naga), devils (Pishacha), celestial be used to gently fan the baby. A cotton musicians (), souls of paternal tampon impregnated with oil (tailapichu) ancestors (Pitra), spirits (), evil should be applied over the baby‟s head spirits (Nishachara) etc. In the same context daily. Fumigation with Rakshoghana Sushruta further spoke about the protection dravyas should be done in the Sutikagara. of strength, intellect, psyche, and These Rakshoghana drugs should be tied understanding from the blessing of god over the hands, feet,head and neck. Tila, , anu, Atsi, Sarshapa and Kana (rice particles) GandharvaandVarunarespectively5. should be scattered all over the Sutikagara. In ChikitsaSthan, Sushruta says thatwounds The fire should be lit in the place. Else and patients should be protectedfrom should be followed as described in invisible creatures (Nishachara) Vranitopasniya context3. byprocedures like Dhupanaand There are sixty procedures for the protectiveenergy of the prophylactic prayer. management of wound, mentioned by He furtheradvocatedYama and Niyamaas a

Sushruta. Rakshakarmaor Rakshavidhanis part of Rakshakarma3.(Five Yama are non- one of them4. The wound should be violence, truthfulness, non-stealing, celibacy fumigated by pain relieving and and abstinence fromlitigation.Five Rakshoghanafumes and the protection Niyamaare cleanliness, satisfaction, ______Patni and Sinha 2017 Greentree Group © IJAPC Int J Ayu Pharm Chem 2017 Vol. 6 Issue 2 www.ijapc.com 166 [e ISSN 2350-0204] Int J Ayu Pharm Chem penance, spiritual study, service of the birth to 6th days period, babies are most preceptor)6. susceptible to various infections and other Acharya Vagbhata described similar complication. After one week, the incidence rakshakarama as described by Charaka7 in of infections and complication reduce, addition,Vagbhatta has also counselled use therefore the chances of survival increase. of herbs as Brahmi, Indryana, Jivakaand According to Aroyakalpdruma, Rishbhakato be tied around hands or neck of Kumaramaragara should be fumigated. The the newborn. Dhupan should be done by horns, hooves of , Saralu, Laya, Avi- Gugglu ,Agru , Sarjrasa and GauraSarspa Dears and Gandaka along with Gojihva and .Vagbhatta also mentions use of Balvachafor ShewtaSharshapa(white mustard) are taken it promotes medha(intelligence), in equal amount, powdered and mixed with smriti(memory), health and longevity of the butter and heated. The fumes generated baby8. In Astangasamgraha, Vagbhata (Dhupana) helps to protect the child10. described to tie a cotton pouch containing Hingu, Vacha, TuruskaandSarshapa, on the Properties of Raksha karma drugs: upper frame of door and head side of bed The phytochemical screening demonstrated and also in the neck of infant and mother. the presence of different types of Further there is mention of Dhupanafor compounds like terpenoids, tannins, deoxy baby‟s apartment consisting of dried crow sugars, saponins, phenolic compouns, and feathers along with Trivrta, Vacha, Kustha, flavonoids which may contributefor the 8 Srivesta, Sarshapa, added with little Ghrita . antimicrobial action of the above medicinal AcharayaVagabhata has also advised the use plants.Themethanolic extract ofAcacia of protective measures on the 6th night of catechu (Khadira)was found to have birth (SasthiRatri). He says that on 6th night antimicrobial activities against six species of of birth of the newborn, all family members pathogenic and non-pathogenic and friends remain awaken and microorganisms: Bacillus rakasakarma should be performed by subtilis, Staphylococcusaureus, Salmonella offering sacrifices. Ancient scholars have typhi, Escherichia coli, Pseudomonas 11 observed very closely about the most crucial aeruginosa and Candidaalbicans . Mustard period of infancy and marked it up to six can be used as an effective antimicrobial 9 days . Care of 6th night indicates that from agent. Mustard Essential Oil affects the ______Patni and Sinha 2017 Greentree Group © IJAPC Int J Ayu Pharm Chem 2017 Vol. 6 Issue 2 www.ijapc.com 167 [e ISSN 2350-0204] Int J Ayu Pharm Chem concentration of intracellular component, tannins, fixed oils and fats and glycosides in such as ATP in both Pseudomonasand methanol extracts whereas saponins, fixed Staphylococcus aureus,bacterias and affects oils and fats, alkaloids and triterpenoids the pH suggesting that cytoplasmic were found in the aqueous membrane is involved in the antimicrobial extracts17.Aconitumheterophyllum(Ateesa) action of mustard EO12,13. The ethanolic also contains potent antibacterial properties. extract of ZizyphussativaGaertn (Badri) fruit Two new aconitine-type norditerpenoid contains anti-inflammatory, analgesic, alkaloids 6-dehydroacetylsepaconitine (1) antipyretic, bronchodilator and antimicrobial and 13-hydroxylappaconitine (2), along with activities14. The essential oil, chloroform three known norditerpenoid alkaloids extract and seven sesquiterpenoids lycoctonine, delphatine and lappaconitine compounds newly isolated from the oleo- were isolated from the roots of the gum-resin of Commiphoramukul(Guggul) Aconitum heterophyllum Wall. These showed a wide range of inhibiting activity compounds exhibited significant against both Gram (+) and Gram (−) antibacterial activity. The structure of bacteria. This suggests the antibacterial compound 1 and 2 were deduced on the activity C. mukul15. Acoruscalamus Linn. basis of their spectral data18. The essential Rhizomes(Vacha) was found to have oils of Ferula asafetida have potent antimicrobial activities on various antibacterial effect19. microorganisms including bacteria, yeasts and filamentous fungi16.The aqueous and DISCUSSION methanol extracts From the above description, it is evident that ofAquilariaagallochaRoxb.(Agaru) along with respect to Rakshakarma, Ayurvedic with dry powder of leaf and bark of the plant acharyas have advocated measures which was screened for the presence of aim to protect the newborn baby from phytochemicals. Also they were tested for various infections as with the use of clean antibacterial activity against pathogenic clothes, beddings etc. The fumigation bacteria such as Shigellaflexneri, Bacillus (dhupana)of the brevis, Pseudomonas aeruginosaandBacillus Sutikagara(sanatorium/labour room) by subtilis. The result indicates the presence of various drugs is mentioned to protect the alkaloids, anthroquinones, triterpenoids, baby from various opportunistic infections. ______Patni and Sinha 2017 Greentree Group © IJAPC Int J Ayu Pharm Chem 2017 Vol. 6 Issue 2 www.ijapc.com 168 [e ISSN 2350-0204] Int J Ayu Pharm Chem

The various drugs mentioned in dhupana give enough importance to safe guard the karma have antiseptic and antimicrobial patient from visibly present creatures, as properties which have been also proved insects etc. What we found interesting in experimentally in various studies. As per Ayurvedic literature is the use of different ancient text, room should be kept warm by kinds of herbs during preparing different fire, lighting in the room. Now a days kinds of decoction or placing them near the Radiant warmer are available for this mother and the child‟s body or spreading purpose. them over the room andalso fumigating with Present neonatal care includes special their smoke. Here we need to look for the aseptic measures to be adopted aiming to antimicrobial properties of these different prevent any infection of the newborn. Right herbs based on their ayurvedic and modern from the initiation of birth process, measures pharmacological properties. In a recent for sepsis and antisepsis such as clean hands, study it was found that plants also protect clean surface, use of sterile surgical themselves against being eaten by secreting instruments (blade/scissor), clean handling natural pesticides and other toxins, phenols, of the cord, use of surgical mask, gloves etc. flavonoids, isoflavones, glucosinolates, etc. are to be religiously followed until handling These different chemicals are usually bitter, and resuscitation of the newborn baby. pungent or astringent in taste. In addition to Appropriate hygiene is advised throughout their bactericidal or biological activity these the newborn care to decrease infection substances may provide a defense against episodes during infancy. predators20. Proper sterilization is helpful in early When we look up the herbsused for different recovery and fumigation with different purpose of Rakshakarmain ayurveda, we chemicals is one of the methods to achieve found that most of theseherbs are bitter, sterilization. Same principle also applies astringent and pungent intaste, because of during mother and child care. From the presence of differentchemical literature review it is clear that from ancient constituents in them. These herbs have Ayurvedic medicine there was concept of bactericidal and insecticidal activities which safety of diseased person with regards to safeguard the patient from infections. In a evil spirits. Ayurveda speaks about care of recent clinical study,it was found that diseased person from evil spirits and also fumigation with a mixture of traditional ______Patni and Sinha 2017 Greentree Group © IJAPC Int J Ayu Pharm Chem 2017 Vol. 6 Issue 2 www.ijapc.com 169 [e ISSN 2350-0204] Int J Ayu Pharm Chem

Chinese medicine promoteswound healing about the use of Dhupana(Fumigation) of and prevents the wound ofpostoperative different herbs aroundthe wound and complications, including painrelief, reduce patients and the room of thepatient. After swelling and infection etc.Wound Healing delivery the mother and the newborn baby, on the 1st Fumigation on the Mixed both can be well compared with a wounded Hemorrhoid Complications of Postoperative person and need special care. Ayurvedic Wound Healing and Postoperative Pain Acharyas have advocated measures which Edema21. aim to protect the newborn Another aspect is related with hymn baby from various infections as in use chanting and homa in the room of the patient ofclean clothes, beddings etc. probablya kind of psychological counseling Dhupana(fumigation)of the Sutikagaraby to thepatient, so she can feel well, safe and various herbs is mentioned to protectthe cared. This isto provide a positive baby from various infections. It is probably environment for the healing of wound and because ofthe antiseptic and antimicrobial also support to themother in post partum property of Dhupan karma. This procedure phase to avoid any kind of stress. Recent can be correlated with that of fumigation studies add to growing evidence that procedure ofsterilization in current modern psychology impacts wound repair, and medical practices.Chanting hymns and highlight in particular the positive role of practicing Yama and Niyamaprovide a social support on modulating the negative psychological support to the patient, which effects of stress22. is helpful forquick recovery and rehabilitation of the patients. Thus we can CONCLUSION say that Rakshakarmaprocedure provides a From the above description it is evident that, complete physical and psychological Rakshakarmawas used extensively in the protection to the mother and the child. cases of mother and child care.In earlier times there were different kinds ofdecoctions of herbs were used for cleaningthe wound. Same context Sushruta also give enough importance to Rakshakarmaprocedure, where he spoke ______Patni and Sinha 2017 Greentree Group © IJAPC Int J Ayu Pharm Chem 2017 Vol. 6 Issue 2 www.ijapc.com 170 [e ISSN 2350-0204] Int J Ayu Pharm Chem

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