An Ayurvedic perspective about Autism - Literary Review

Ashwini Ashokrao Patil; Rutuja Rahul Kate; Shubhangi Sanjay Jadhav

An Ayurvedic perspective about Autism - Literary Review

Ashokrao Patil A.^1*, Rahul Kate R.², Sanjay Jadhav S.³

DOI:

^1* Ashwini Ashokrao Patil, Assistant Professor, Department of Kaumarabrutya, Govt. Ayurved College, Nanded, Maharashtra, India.

² Rutuja Rahul Kate, Post Graduate Scholar, Department of Kaumarabrutya, Govt. Ayurved College, Nanded, Maharashtra, India.

³ Shubhangi Sanjay Jadhav, Post Graduate Scholar, Department of Kaumarabrutya, Govt. Ayurved College, Nanded, Maharashtra, India.

Autism is a complex neurodevelopmental disorder that impacts on the normal functioning of brain, challenging child development particularly in the field of language and communication, social and emotional with presence of unusually strong narrow interest and personal occupation by repetitive stereotype mannerism. Western medicine and research have seemingly stalled in respect to the management of autism however early intervention and behavioral therapies have shown improvement in some extent. Ayurveda understand the nature of human brain in a completely different manner from modern psychiatric and physiological theories. Autism has close similarities to the features of that Unmada which is described in Ayurveda. The condition may be due to Khavaigunya (disrrangements) of Srotas (channels) which nurtures Manas (mind) as a consequences of many Agantuja (epigenetic and toxic insults and post-natal environmental factor) and Sahaja (genetic) factors. Among the various type of treatment modalities Yuktivyapashrya Chikitsa plays a vital role in managing the symptoms of autism in children.

Keywords: Unmada, Autism, Poorvakarma, Yuktivyapashrya Chikitsa, Agantuja, Manas

Corresponding Author	How to Cite this Article	To Browse
Ashwini Ashokrao Patil, Assistant Professor, Department of Kaumarabrutya, Govt. Ayurved College, Nanded, Maharashtra, India. Email:	Ashwini Ashokrao Patil, Rutuja Rahul Kate, Shubhangi Sanjay Jadhav, An Ayurvedic perspective about Autism - Literary Review. J Ayu Int Med Sci. 2023;8(2):133-137. Available From https://jaims.in/jaims/article/view/2148

Introduction

Autism is one of the main concern of pediatrics in the present era. This neurodevelopmental disorder of unknown etiology begins in early childhood. The main characteristic features of Childhood Autism are impairment in communication skills, social interactions and reciprocity, and imagination and play. The features of Autism are much similar to that of Unmada (disease of mind characterized by mental confusion etc.), a disease condition mentioned in Ayurvedic classics. Due to various etiological factors, the conjunction between Atma (the self) and Manas (mind) is disrupted resulting in the vitiation of Manovaha Srotas (channels of consciousness). Along with this, the vitiation of three Doshas (Vata, Pitta, and Kapha) will end up in the manifestation of Unmada. Manovaha Sroto-Dushti together with Tridosha Dusti is the basic cause of Childhood Autism. Due to etiology of vitiation Dhee, Dhriti and Smriti that causes imbalance of Kala and Karma which results into improper contact of the senses with their objectives (Asatmendriyartha Samyoga) and give rise to inattention, hyperactivity and impulsivity A systematic Ayurvedic treatment consisting primarily of Vata-Pittahara Chikitsa (treatment for pacifying Vata and Pitta) along with Deepana-Pachana (drugs for enhancing digestive power), Snehana-Swedana (oleation with lipophilic drugs and sudation therapies), Sroto-Sodhana (cleansing of channels which corrects the metabolism and does modulation of gut microbiome), Brumhana (nourishing treatments) and Medhya Rasayana (drugs for promoting intellectual and cognitive functions) and Pathya Karma (congenial diet and habits) should be considerable relief of the condition.^[1],[2]

The Prevalence rate of Autism among primary school children was found to be 11.32%. The ADHD subtype is rare (about 2%), while the ADHD subtype is the predominant one and is associated with severe impairment. There is no satisfactory treatment in any other system of medicine except in Ayurveda, where a lot of description about its etiopathogenesis and treatment is available right from the Vedic and Samhita period. Hence it is necessary to study this disease thoroughly.^[3]

Objective of the study

To study literature review of Autism through Ayurveda.

Material and Methods

All relevant Ayurvedic and modern science literature along with internet databases is referred for study. A literature review to evaluate the effect of Ayurveda modalities, modern medicines, association of biochemical parameters, other interventions in Autism.

Method of data source: Google scholar, MEDLINE (Pubmed), Cochrane and Ayurveda were searched.

Literature Review

Definition of Unmada^[5]

According to Acharya Charak, Unmada, is the Manasvyadhi is which understood as the unsettled condition of the Manas (mind), Buddhi (understanding), Samjna (consciousness), Gnana (perception), Smriti (memory), Bhakti (inclination), Sheela (character), Chesta (behaviour), and Achara (conduct).

Classification of Unmada^[4],[6],[7]

Classification is based on the prognosis, the knowledge of which is very essential in treating any disease is focusing on aetiology, mode of manifestation, prognosis and principles of treatment he offers two more classifications as Nija and Agantu Nija Unmada is further divided into four kinds. They are also known as Doshaja Unmaadas (those arising from the morbidity of Doshas. Out of these the fourth kind namely Sannipataja Unmada is said to be incurable according to Acharya Shushruta and Vagbhata.

Nidana^[9]: The Hetu of the Unmada are given as:

1. Aaharaja Hetu

2. Viharaja Hetu

Aaharaja Hetu: Incompatible, dirty, impure food like fruits and milk, heavy diet like non-veg, Dhadhi, bakery products etc. increases Tridoshas.

Viharaja Hetu: disrespect of Dev (God), Guru (Teachers), Brahmins (learned), excessive Bhaya (fear), Harsha (joy) to produce Manobhighata disturbing all the normal mental functions increases Rajas and Tamas Mansik Doshas. Agantu Unmaadas arising Himsa (cruelty) the Rati (lust) and Abhyarchana (extortion).

Etiopathogenesis

Samprapti of Autism as per Ayurveda^[8]

As per Ayurvedic classics, the acquisition of knowledge takes place by a sequence of events where the conjunction of Atma (the self), Manas (mind), Indriya (sense organ), Indriyartha (object of perception). Atma (the self) is responsible for the cognition, and Manas is the substratum of Indriyas (sense organs) to perceive Indriyartha (object of perception). The factors responsible for the mental constitution of the foetus are Satwa (mind) of mother and father, the objects of hearing, actions of the pregnant mother and past deeds. In children with Autism, the conjunction between Atma and Manas is disrupted. i.e.; Manovaha-Sroto-Dusti (vitiation of channels of consciousness that flows through mind) along with Tridosha Dusti (vitiation of three doshas) is the characteristic feature of Childhood Autism. As per Ayurvedic classics, the same etiopathology is explained in the context of Unmada (Disease of mind characterized by mental confusion etc.).

Characteristics^[10]: The features of Unmada as per Ayurvedic classics are:

1. Manovibhrama (perversion of mind) - Due to this, the subject does not think about such matters which are worth thinking, and he/she also indulge in thinking about the matters which he/she is not supposed to think about.

2. Budhi Vibhrama (perversion of intellect) - Due to this, the subject understands the eternal things as noneternal and advantageous as disadvantageous.

3. Samjnajnana Vibhrama (impaired sensory perception)

4. Smruti Vibhrama (impairment of memory)

5. Bhakti Vibhrama (abnormal desires)

6. Sheela Vibhrama (inappropriate manners andbehaviors)

7. Cesta Vibhrama (abnormal activities)

8. Achara Vibhrama (loss of learned skills) By analyzing the etiopathology and clinical features of Autism, it can be included under the broad spectrum of Unmada. As per Ayurvedic classics, Garbhopaghatakara bhavas (the prenatal factors which harm the product of conception) (8) are considered as major etiological

factors in its causation. Among cases of childhood Autism, etiopathogenic factors and line of treatment varies from individual to individual.^{[11],[12],[13]}

Etiopathogenesis of Autism as Modern science

Autism is a neurodevelopmental disorder of unknown aetiology. The cardinal features of Autism are impairment of social interaction, communication and imagination, and restricted interests and repetitive behaviour. Childhood autism has its manifestations usually at around 18-24 months of age and is well established by 3 years of age. World Health Organization has estimated that worldwide 1 in 160 children has Autism Spectrum Disorder (ASD). Latest survey by Autism and Developmental Disabilities Monitoring (ADDM) Network of Centre for Disease Control and Prevention (CDC) suggest a 15% increase in prevalence that 1 in every 59 children are being identified with Autistic Spectrum Disorder in the United States and is about 4 times more common among boys than in girls. These statistics calls for the urgency of evaluating this condition in scientific backgrounds.^[14]

The exact cause of Autism is unknown. However, the various causes which are believed to contribute to the occurrence of Autism are genetic factors, various environmental factors, perinatal brain injury, hormonal imbalance etc. Abnormalities in brainstructure and function have also recommended by neuro -radiological and neurochemical studies. But, the findings of various studies are conflicting and there is no diagnostic imaging or other tests specific for Autism. The factors like emotionally distant parenting styles (refrigerator mothers) and MMR vaccination were previously thought as etiological factors for Autism. But currently, the causation of Autism by above-mentioned factors stays invalid.^[15],[17]

Treatment (Chikitsa)

Treatment of Autism as per Ayurveda^[18],[19]

The classical management of Unmada mentioned in Ayurvedic classics is found to be very effective in the management of Autism. Deepana and Pachana which are the procedures in which various drugs are used for promoting digestion, Snehapana (oral intake of medicated ghee preparation), Mridu Sodhana (Mild purification of body by emesis or purgation), Niruha Basti (decoction enema) and Sneha Basti (oil enema), Siro Virechana

or Nasya (medicated nasal drops), Samjna Prabodhana (medication to stimulate the mind). Apart from the Sodhana (purificatory) therapies mentioned in Ayurvedic classics, Abhyanga (oil massage of head and body), Siro-Pichu (Overhead application of a piece of cotton dipped in medicated oil), Sirodhara (pouring of medicated oil over the forehead as a continuous stream), Sirolepam (Overhead application of medicinal paste), and Takra Dhara (pouring of medicated buttermilk over forehead as a continuous stream) are various treatment modalities aimed to promote the development of brain and to reduce or control the troublesome behaviours found with Autism Spectrum Disorders. As per Charaka Samhita, the avoidance of Meat and intoxicating drinks, intake of Hitahara (compatible foods), following cleanliness and possessing a good mental strength can prevent the disease Unmada and, the person cured of Unmada will attain clarity of Indriyartha (objects of senses), Buddhi, Atma, Manas and normalcy of Dhatus. Autism is regarded as a lifelong condition due to Bija Dosha (genetic predisposition). But, by adopting Unmada Chikitsa as a long-term intervention the triggering elements of Autism can be eliminated thereby the quality of life can be improved.

Ayurveda approach^[20]: Unmada in a holistic approach with due importance to the logic based pharmacotherapy, Panchakarma interventions and psychotherapy in the form of spiritual and psychological interventions.

Daiva-Vyapashraya Chikitsa (Spiritual therapy)

Ayurveda considers individuals as part of the supreme conscience and the role of spirituality has been explained in detail in various contexts. Logical use of Mantra, Aushadhi, Mani (wearing gems), Bali (auspicious offerings), Upahara (gifts to deserving people), Homa (oblations), Niyama (observance of scriptural rules), Prayashchitta (atonement), Upavasa (fasting), Svastyayana (chanting of auspicious hymns), Pran-Patagamana (obeisance to the Gods, going to pilgrimage), etc. are aimed at boosting the self-confidence and mental strength to the individuals.

Satvavajaya Chikitsa: Satvavajaya Chikitsa literally means controlling the mind, in such a way that it is not acted upon by

various stressors making it prone to Prajnaparadha. Acharya Charaka, defines Satvavajaya as withdrawal of mind from unwholesome objects. It includes:

Mano Nigraha: Regulating mind/subjugating mind from unwholesome interactions
Dhee-Dhairyaatmadi Vijnanam: It is providing a deeper level of understanding which helps ultimately in better control of mind. Acharya Charaka also explains the utility of replacing negative emotions with that of positive emotions that is beneficial to psyche. Thus, Satvavajaya encompasses various aspects that deal with mind - its physiology, morphology, morbidity and also management of Psychological as well as Psychosomatic diseases.

Yuktivyapashraya Chikitsa: This includes treatment through logical use of medicines and modification of Ahara and Vihara to suit the needs of the person. The patient should be encouraged to follow proper dietary regimen, follow rules of Sadvrita, to use Medhya Rasayana (medicines that boost psyche) and Doshahara Ousadha (medicines) to control the imbalanced mind.

Dietary Management^[16]: Most of ADHD affected patients have the proper nutrients deficient that’s why, parents who are troubled with medicating their children are often more comfortable with the initiative of dietary interventions. Proper nutrition is essential for growing children, and children who eat a diet high in “junk food” in early childhood are more likely to exhibit hyperactivity by age seven; this may reflect a long-term nutritional imbalance. So advised the parents to refined, carbohydrates, sugars, and processed foods containing additives should be completely eliminated from the diet.

Conclusion

Psychiatric disorder is well explained in Ayurvedic Samhita. That ancient knowledge of Ayurveda will helps in diagnosis and management of Unmad in present era very well. In Ayurveda it may be correlated to Unmad (Autism) disease. So, line of treatment such as neuro-protective medications along with Panchakarma therapies have definitely shown outcome on the disease and thus pave way to further researches in employing Ayurvedic methods towards the management of Autism. So, this review article is an attempt to highlighting on details of Unmada with co-relating with Autism.

Reference

1. Brahmanada Tripathi, Charak Samhita of Maharshi Charak, Chukhambha Prakashan, Varanasi, 2010, nidansthan, chapter 7, verse no.5, p640

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5. Brahmanada Tripathi, Charak Samhita of Maharshi Charak, Chukhambha Prakashan, Varanasi, 2010, nidansastan, chapter 7, verse no.3, page no.639.

6. Anant Ram Sharma, Acharya Priyavat Sharma Sushruta Samhita. Chaukhambha Surbharti Prakashan, Varanasi. Uttartantra, chapter 62, verse 4, p504.

7. K.R. Srikantha Murthy. Ashtanga Hryadium of Vaghbhata. Chaukhamba Orientalia, Varanasi. edition, 2002; Uttartantra, Chapter 6, Verse 1.

8. Brahmanada Tripathi. Charak Samhita of Maharshi Charak. Chukhambha Prakashan, Varanasi. 2011, Chikitsastan, chapter 9, verse 6, p376.

9. Ajay Kumar. Madhavnidan an Android book. chapter 67, verse 20/4

10. https://www.nhs.uk/.../symptoms (22 nov.2018: 12.30 am)

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13. Pradhan, S.N., K. Ray, R. Hazra and R.D. Ghua, Inhibitory role of Acorus calamus in ferric chloride induced epileptogenesis in rat, Hum. Exp. Toxicol., 2007; 27(12): 947- 953.

14. Prashant L Patil, Pravin W Bonde, An Overview and Approach towards Autism and its management.

15. www.imedpub.com

16. C. Dwarkanath, Digestion and Metabolism in Ayurveda, Chaukhamba Krishanadas Academy, Varanasi, Orientela Publishers 2010.

17. Giulia Enders, GUT, Speaking Tiger Publishing pvt. Ltd. New Delhi 2015.

18. Mohammed, Ebtehag. (2020). Explanatory Factor analysis to determining the risk factors of cardiovascular disease. Journal of Medical Research and Health Sciences.

19. https://doi.org/10.15520/jmrhs.v3i8.228

20. Acharya Vidyadhar Shukla, Ravidutt Tripathi. Charaka Samhita, Vaidya Manorama Hindi Commentary, Sutra 1/53, Chaukhamba Sanskrit Pratisthan, Delhi. 2006;p25.

Manuscript Received	Review Round 1	Review Round 2	Review Round 3	Accepted
2022-12-24	2022-12-27	2023-01-03	2023-01-10	2023-01-17
Conflict of Interest	Funding	Ethical Approval	Plagiarism X-checker	Note
Nil	Nil	Yes	19%

Review Article

Autism

Journal of Ayurveda and Integrated Medical Sciences