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AAMJ / Vol. 2 / Issue 5 / September – October 2016
A A M J Anveshana Ayurveda Medical Journal
www.aamj.in ISSN: 2395-4159
Review Article
Clinical Implementation of the Satvāvajaya Chikista in Ayurvedic
Paediatric Practice
Devendra Kumar 1 Shrinidhi K Acharya 2
A b s t r a c t
Satvāvajaya Chikista is the third form of the treatment in Ayurveda which form a rational treatment for
disturbances of the mind. Satva is the synonym of the mind and treatment aimed to optimse its different
facets are called as Satvāvajaya Chikista. The definition of the Satvāvajaya Chikista is– Satvāvajayo
punar ahithebhyo arthebhyo mano nigraha, i.e. the treatment is mainly aimed to control, regularize
motivate, guide to right inclination of the mind. This is also related with prevention of mind being gets
exposed to unusual, abnormal unethical life style, proper education training, desensitization against
which are unwholesome factors. In total mind should be prepared to differentiate between good
and bad immediately after its exposal to external environmental hazards, unconfused and able to
take a decision by keeping interest of healthy status of body Daivavyāpāśraya Chikista is basic pre-
requisite before any kind of disease or treatment which is aimed to prepare the mind towards positivity,
faith and hope. Faith towards a visible or invisible entity cuts off many undue negative feeling of the
mind. Similarly fixing the mind to an invisible power like Daivikaśakti not only restrict the flow of
negativity but also reduces the stress and creates a new hope. Practical implementation of principles
of Satvāvajaya Chikitsa and Daiva Vyāpāśraya chikitsa are very beneficial although now it is followed
on a randomized way without a fixed protocol. Although it is quite challenging as psychological pa-
rameters of individuals vary a lot from person to person there should be some fixed guideline in the
form of protocol with scope of modification is quite essential. Hence this article highlights certain points
which should be kept in mind to prepare clinical protocol and counseling module as per principles
Satvāvajaya Chikitsa which can be effectively practiced in clinical practice.
Key words – Ahita, counseling, Daiva Vyāpāśraya Chikitsa, Daivika Śakti, faith, Satvāvajaya chikitsa
1 PG Scholar, Assistant Professor, Department of P.G. Studies in Kaumarabhritya, National Institute of
Ayurveda, Jaipur.
CORRESPONDING AUTHOR
Dr. DEVENDRA KUMAR
PG Scholar,
Department of P.G. Studies in Kaumarabhritya,
National Institute of Ayurveda,
Jaipur, Rajasthan, (India).
Email: [email protected]
Devendra & Shrinidhi: Clinical Implementation of the Satvāvajaya Chikista in Ayurvedic Paediatric Practice
AAMJ / Vol. 2 / Issue 5 / September – October 2016 995
INTRODUCTION
ccording to Ayurveda, Chikista Puruṣa is the
adhiṣṭāna for all types of Roga and obviously
treatment should be aimed to same. Chikista
Puruṣa is the combination of physical and the mental
elements with soul as administrator guided and motivat-
ed by Manas. Combination of above with integrated
functioning of Indriya establishes the homeostasis of
the body. As Manas guides the physical body treat-
ment for motivating the same in the right path to bring
back the equilibrium of mental facets of Chikista Puruṣa
is the key factor which ultimately results even in normal-
cy of physical derangements. Combination of Satva,
Indriya and the Ātma is also called as Anthakaraṇa
which always guard the mental stability of the Puruṣa [i].
Ātma from whom the creation of universe begins, simi-
larly inside the physical body too, all manifestations are
related with Ātma. The Śārīrika and the Mānasika
Doṣas are mutually inter-related; hence a single psycho-
somatic existence of the life is made possible. Manas
plays a very significant role in maintaining psycho so-
matic existence of the life as it is mediator in this unit
and acts like a guide for Ātma. It not only scrutinizes
the matters (Viṣaya), but also motivates the Ātma to-
wards the positivity, hence called as Satva
(Pravarthaka). Ātmaguṇa i.e Buddhi has got direct in-
fluence of Manas hence obviously knowledge of good
and bad, and all sort of perception ,happiness
and grief experienced by the Ātma depends on accu-
racy, ability, inclination, observation, positivity, orienta-
tion and functional capacity of the Manas. However,
physical body always responds to the commands of
the mind hence variations in magnitude of qualities of
mind like Satva, Raja, Tama leads to reciprocal chang-
es in Pitta, Vāta and Kapha. Hence it is rightly told that
Mana is responsible cause (Kāraṇa) for Bandha and
Mokśa.[ii]
So efforts of keeping the mind under normalcy and
equilibrium is the best possible remedy to combat all
possible Dhukhās of the body (that is disease). Con-
trolling the fluctuating mind from its abnormal deviation
towards unhealthy physical and psychological activities,
unhealthy food and life style and directing the same in
the right path is the ultimate solution to all existing
problems of the mankind. Rightly psycho somatic ap-
proach in the treatment has been explained by Ayur-
veda as evidenced by Chikista Prakāra (Treatment
modules) Daiva, Yukthi and the Satvāvajaya. Two of
them are for mental faculty and one for physical faculty
(Yukthi).[iii]
Daivavyāpāśraya Chikitsa is basic prerequisite before
any kind of disease or treatment which is aimed to pre-
pare the mind towards positivity, faith and hope. Faith
towards a visible or invisible entity cuts off many undue
negative feeling of the mind. Similarly fixing the mind
to an invisible power like Daivikaśakti not only restrict
the flow of negativity but also reduces the stress and
creates a new hope. Once the mind has been lifted
towards positivity by faith, later it is easy to correct the
homeostasis of mind, in turn that of body. Same has
been achieved in Ayurveda by following Daiva
Vyāpāśraya Chikitsa in Ayurveda through different
Mantras, Maṇi, Mala auspicious and religious ceremo-
nies, like Bali, Homa, Havana, Japa, and Swasthi
Vāchana. Etc. Rudra pūja in Unmāda and Apasmāra.
Jwara, Viśnusahasranāma in Viṣama Jwara, Bali, Homa
etc. in Graha Rogas are few of the examples[iii]. This
has been the right approach to deal with disorders of
psycho somatic nature, and as per Ayurveda all disor-
ders carry tendency of same.
Yukthi Vyāpāśraya is like a rational treatment based on
the reasoning and with necessary planning. Causative
factors and symptoms and pathological changes in
the disease is identified and a suitable treatment to
bring back the body elements to normalcy has been
employed. Fundamental principles of the Ayurveda like
Sāmānya – Viśeṣa Siddhānta, Loka Puruṣa Vāda[v] were
kept in the mind during management.
General description
Satvāvajaya Chikista is the third form of the treatment in
Ayurveda which form a rational treatment for disturb-
ances of the mind Satva is the synonym of the mind and
treatment aimed to optimse its different facets is called
as Satvāvajaya Chikista[vi]. The definition of the
Satvāvajaya Chikista is – Satvāvajayao punar
ahithebhyo arthebhyo mano nigraha, i.e. the treatment
is mainly aimed to control, regularize motivate, guide to
right inclination of the mind. This is also related with
prevention of mind being gets exposed to unusual, ab-
normal unethical life style, proper education training,
desensitization against which are Ahitas (unwhole-
some factors) . In total mind should be prepared to dif-
ferentiate between good and bad immediately after its
exposal to external environmental hazards, unconfused
and able to take a decision by keeping interest of
healthy status of body and mind [vii].
The word ‘Artha’ carries a wide range of meaning
and covers all possible knowledge acquired by the
sense organs including Manas which is
Ubhayendriya. Gandha is the special Artha of the
A
Devendra & Shrinidhi: Clinical Implementation of the Satvāvajaya Chikista in Ayurvedic Paediatric Practice
AAMJ / Vol. 2 / Issue 5 / September – October 2016 996
Ghraṇendriya and if Rasanendriya is not able to
avoid itself from excess eating and violate all the rules
of Mātrāvath Āhāra Lakśaṇa, then the same is referred
as Ati yoga of Rasanendriya Artha and this may be
root cause of certain disorders. Meanwhile abnormal
functioning of Rasanendriya leads to the Mithyā yoga
of Rasanendriya Artha. On conveying this knowledge
of Athi and Mithyā Yogas to the mind, it should take a
final decision and proceeds further. An error commit-
ted by the mind, at this stage leads to Pragñyāparādha
and becomes a cause of the future disease. As Mans is
Ubhayendriya it has got its control over both sen-
sory and the motor functions. Right decision taken by
mind in spite of a strong sensory perception for
Athiyoga, denote a healthy thinking mind which refuse
to react it by withholding the motor response to it .
An unhealthy, disturbed mind can commit an error at
this juncture and leads to squeal of manifestations in
future. Same is also true for the other objects of
Indriya. Similarly when a person is exposed to loud
sound for long time and mind fail to take a decision to
avoid it and gets acquainted with it in due course
of time may leads to stress and psychological disturb-
ances . Meanwhile habit of perception of low frequency
and less audible sounds leads to Hīna yoga. Listening
high frequency sounds with variable frequency very
close to ear like mobile head phones leads to
Mithya yoga of the Śabda Artha. When these varia-
bles are accepted by the mind, becomes the cause of
the disease. The factors which helps the mind to take a
stable, firm and right decision with interest of healthy
body and mind i.e. Samyak Artha Grahaṇa is nothing
but Dhī, Dhṛti, and Smṛti[viii].
Dhī or true knowledge (Samam Buddhi hi Paśyathi)
helps the mind to identify the actual fact and its conse-
quences on body, when any matter is presented before
it. This is the tool for the formation of right thought,
which later leads to right decision. So this is a cogni-
tive ability of the mind which constitute the thought
by proper reasoning, planning, attention and the anal-
ysis which further leads to proper decision. Excess
consumption of alcohol where the mind fails to make
right thought as result it may take wrong decision. In
paranoid personality mind identify a person with false
knowledge and wrong thought and suspect everybody.
When person refuses offer of an illegal activity is right
thought and decision with well identified truth of its
bad effects. So when each objects are proposed in
front of mind should able to perform this highly cogni-
tive function failing which will leads to disequilibrium
in the status of Mind[ix]. Therefore it is told that Samam
Buddhi hi Paśyathi that is objects should be perceived
with their true knowledge.
Dhṛti (Dhṛti hi niyamāthmaka) once the true knowledge
is identified and decision has been taken same has to
be retained, supported, and stabilized further. Mind is
constantly gets exposed to lot of sensory and motor
stimulus in every second and original decision need not
to be tampered. To prevent the hurdles to already en-
coded thought and truth, mind has to fight constantly
with other secondary level thought process which arises
from continuous flow of Artha (objective knowledge.) to
mind and prevent its manipulation. So Dhṛti does the
function of thought integration and process it and guid-
ance for its external representation. Depending on the
capacity of Dhṛti, personality and the behavior of the
individual changes. Control offered by Dhṛti regulates
the out bursting of emotions by clearing confusion
which hurdles in the path of true knowledge .A person
who know that alcohol is dangerous to health, some-
time fail to retain and stabilize and permanently inte-
grate this truth in absence of Dhṛti & become alcohol-
ic. Attitude and behavior of person will be always vul-
nerable to fluctuate in the deficiency of Dhṛti as occur
in case of behavioral problems. Person with right per-
ception may also commit mistakes in execution if Dhṛti
is not controlling the mind. Therefore it is told that Dhṛti
hi niyamāthmaka.[x]
Third entity which guides the Manas to take the proper
decision is Smṛti. Basically when a stimuli is presented
in front of the Manas its response depends on
knowledge and past experience about that matter
which is already get coded in the mind . Recollection
or recalling of same knowledge when needed is called
as Smṛti. Past experiences many times clear the confu-
sion and help to gain the true knowledge and hence it
is also called Tatwajnyāna. Already existing Smṛti criti-
cally analyses the new matter in the light of past expe-
riences which leads to definite knowledge. When Smṛti
is active, person never motivates to do actions which
cause harmful effects. Person doesn’t touch fire or
friends will be identified soon as Smṛti is active. Person
never consumes unwholesome food due to memory of
bad past experience. But when Smṛti element fails, per-
son commits the same mistakes again and again due
Tama and Raja which mask the true knowledge (
Tatwajnyāna )[xi]
Hence proper functioning and integrity of these
three cognitive elements of mind enables the mind to
work its best , in contrary in the absence of same
Mind fails to make right decision .This situation of the
mind is called Dhī, Dhṛti and Smṛti Vibhramśa which
Devendra & Shrinidhi: Clinical Implementation of the Satvāvajaya Chikista in Ayurvedic Paediatric Practice
AAMJ / Vol. 2 / Issue 5 / September – October 2016 997
ultimately forcing the individual to commit the
Pragñyāparādha. So preventing a person from com-
mitting Pragñyāparādha and preservation of Dhī,
Dhṛti and Smṛti of patient is the main Objective of
Satvāvajaya Chikista.
Satvāvajaya deals also with Mano nigraha that means
the control of the mind. This is concerned with control
of voluntary and the involuntary and internal as well as
external thrust of the mind. It has to control and direct
the sense organs to obtain the true knowledge. This
has to take control over all the function of then the
body to lead it from front . This is also the meaning of
the word Abhigraha (rule with dominance). The same is
called as Indriyābhigraha [xii].
Similarly it has to control the self, which is a very diffi-
cult task. Self-regulation and self-monitoring is quite dif-
ficult where Yoga etc. procedures are explained by
classics to assist Mana to achieve the same. One has
to indulge in an object firmly by rejecting all the oth-
er bad objects ,restrain itself it for long time .Certain
external and the internal stimulus disturbing the mind
can lead s to failure of this chain system of mind .
Self-restraining or protecting self from the disturbances
of the unwanted objects is a stress inducing phenome-
non when it is done force fully.
This area of Manonigraha is real topic of Satvāvajaya,
and need to be identified Basically the Vishay’s of
the mind that is Chintya ( Thought process)
Vichārya (Critical analysis of a thought for its posi-
tive and negative effect) Ūhya ( Further objective
analysis of a particular topic and channeling ) Dheya
( further confirming the objectives ) Sankalapa ( taking
a decision to attain the objectives ) are gets disturbed
and method of correction of this process and modulat-
ing the Mano Viṣayas in the positive direction is the
subject of Satvāvajaya. By considering above all facets
related to Daiva Vyāpāśraya and Satvāvajaya Chikitsa
a clinical protocol has been made which include follow-
ing factors
Correction of Dhī – Dhī refers to the intellectual capacity
to differentiate between good and bad things. Child
as well as parents both should be cleared off all confu-
sion regarding the origin, causative factors, and mani-
festation of the disease. Failure to distinguish the exact
causative factors and consumption of the same may
further exaggerate the condition. All myths and misun-
derstanding regarding the disease and its manifesta-
tions should be cleared so that child has fair idea of
pathological changes so that it can prepare his mind
accordingly giving rise to formation of clear, true
thoughts. Counseling should be directed to correct
the problems in Dhī after asking certain questions to
child to know level of derangement of Dhī. Dhī may be
affected at mild, moderate and maximum levels.[xiii]
Correction of Dhṛti
Dhṛti has been explained as the controlling factor of
the Buddhi (Dhṛti manaso niyamātmaka buddhi).[xiv]
Mind is constantly gets exposed to lot of sensory and
motor stimuli’s in every second and original decision
may be tampered by them. A physically or psycho-
logically ill child patient constantly gets exposed to
variety of stimulations which disturbs him emotionally
and confuse him to react to a situation He may also
have such confusion while reacting with family
members . Any negative reinforcement behavior by the
parents may land – up depression where Dhṛti [xiv] will
be in totally collapsed state. Further fluctuation in the
state of Dhṛti may result in alternative positive and neg-
ative attitude of the child regarding confidence, faith
and hope as well as knowledge and prognosis of the
disease process. So fixing the Dhṛti at positive mode
should be done by counseling the child.
Correction of the Smṛti factor
Smṛti plays a very important role in prevention of the
disease. Past experience gained by personal experi-
ence, bookish knowledge, observational knowledge
helps the patient to prevent himself from the disease by
avoiding the causative factors [xv]. In case of loss of
memory by disease process, ignorance, innocence, or
intentional or unknowingly may leads to the state of
Pragñyāparādha and need to be corrected. Effort
should be done to help the child to recollect the previ-
ous memory by different illustrations, examples, model
presentations, storytelling, referring the books etc. Such
an effort by physician by proper counseling by using
different modes helps a lot in treatment and also gives a
scope to modulate the status and future guidelines in the
management.
Correction of the Dhiarya factor - Dhairya is considered
as one of the best method of treating Mana - Doṣas.
Ensuring the Dhiarya to the patient prevent many mental
disorders and acts as a barrier against the same. Pres-
ence of Dhairya itself indicates the positivity of the
child. Correction of Dhairya refers to sense of patience,
reassurance, encouragement and support provided by
the physician the child. So Dhairya in the form of re-
assurance will definitely bring back the positive thinking
and helps to filter the confusions. Similarly child should
be kept away from such an environment or a person,
who discourages, give confusing statements, induces
Devendra & Shrinidhi: Clinical Implementation of the Satvāvajaya Chikista in Ayurvedic Paediatric Practice
AAMJ / Vol. 2 / Issue 5 / September – October 2016 998
the stress, and make the child afraid. Child’s attitude
to a given situation also depends on the level of Satva.
Hīna Satva child may show complete let loose behavior
while medium and the Pravara Satva may able to show
some tolerance and confidence. Physician to carry on
counseling by encouraging words, previous success
stories of the child , stories depicting the positive gain
due to adventure and courage, certain live examples ,
parental back-up, well-wishing’s, belief in god etc.
Correction of the Pragñyāparādha
Pragñyāparādha is the state where there will be aberra-
tions (Vibhramśa) in Dhī, Dhṛti and Smṛti Combined
effect of aberrations of these three may be different
from m individual effect of aberration and more severe,
although all the three are actually interrelated.
Pragñyāparādha includes all the cognitive and behav-
ioral problems in the child which leads to wrong per-
ception and assessment of given situations. Parents may
also show the Pragñyāparādha by their perverted be-
havior and altered love and concern to the child due
to existence and the progress and failure gets improve-
ment in disease status. This has to be checked by cer-
tain questionnaires aiming to assess the level of
Vibhrmaśa. Faults done by the child should be pointed
out during counseling. Different movies, clips of the
drama, etc highlighting errors committed by a person
due to ignorance can be shown to realize the effect of
Pragñyāparādha to the child. Child should be enquired
for possible internal thrust, complicit as well as exter-
nal triggering factors which made him to commit
Pragñyāparādha, and more focus has been given to
correct the same.
Correction of thought process (Chintya) or establishment
of the thought process is the first step in Mano nigraha.
Wrong establishment of the thought process is the root
cause for all and attempt has to be done to check
whether origin of the thought process carries positivity
or not. In case if it is vice versa, it should be converted
it in to positivity through Satvāvajaya technique. If
basic understanding of the disease and child’s inbuilt
thought regarding the diseases or a given situation is
negatively reinforced, then treatment never get suc-
ceed. Child due to a negative thought if believes that
‘proceedings not under my control’ or ‘nobody can help
me’ ‘can’t do anything.’ Is the major hindrance in
treatment etc. Child has to be educated , assisted to
change seeded negative thought process so that he
can able take a firm decision of overcoming it.
(Sankalpa). Skill fully while doing counseling pediatri-
cian should adopt all those techniques which van effec-
tively change the thought process, like art of controlling
the mind, practice yoga and Dhyāna , traṭaka, wor-
shiping the god, service to the public , respecting adults
etc.
Regulating the process of analyzing the thought
(Vichārya)
At times thought process might have been rooted posi-
tively and regular, but fails to concrete the same on
flow of many good and bad thoughts, which end-up in
improper analysis and confusions. Hence child should
be assisted for filtering out good, bad thoughts.
Meanwhile at times child may have problems into be
firm on one good thought among many, which was
most appropriate. So effort has to be done under-
stand level of confusion and analyzing deficit exist-
ing in the child and methods has to be employed to
correct it.
Increasing the knowledge of the self (Ātmādi Vignyāna)
Many times child may not be aware of self-capacity in
comparison to surrounding situations, resulting in nega-
tive attitude and behavior about self. So it is very
important to realize the child about his capacities
strength, ability and even weakness (to prevent haz-
ards of over confidence) so that child can take the
right decision . So child should be made realize the
role Manas and other day to day activities in
origin of fear, anger , frustration and disappointment
and methods to avoid them . Child should be educated
to have comprehensive accurate knowledge which is
devoid of confusion and other apprehensions. Once
child realize the significance once own mind , body
and Ātma and Indriya s in attaining the right
knowledge errors will be minimized leading to posi-
tive changes in the child.
Creating the faith
Faith plays an important factor in the success of the
treatment and always creates a positive attitude. Faith
therapy is now days becoming more and more popu-
lar which was explained by Ayurveda long back
with name of Diva Vyapāśraya treatment. Faith
guides the man in the track goal by removing obses-
sions present in its way. Faith with physician and coun-
selor, medicines and self are very important for success.
Understanding the desire and complicit of the child-
Understanding the desire and the complicit of the child
is very important step in Satvāvajaya chikitsa without
which the purpose of the treatment cannot be achieved.
It is told that Iśṭasya alābha and aniśṭasya lābha is
main cause of psychological disorders. In order to
Devendra & Shrinidhi: Clinical Implementation of the Satvāvajaya Chikista in Ayurvedic Paediatric Practice
AAMJ / Vol. 2 / Issue 5 / September – October 2016 999
understand the Iśṭa and Aniśṭa (desire and complicit)
of the child or likes and dislikes , thorough interroga-
tion of the child and the parents is very crucial .Child
may dislike the association of certain person around
him or at times vice versa.. Child may not be comfort-
able with certain friends whom he has been compelled
to go and play. Child might have been prevented from
watching his favorite T.V Chanel. Child may not like
certain teachers and certain relatives to whom he will
be constantly exposed and unavoidable Child might
have been nurtured forcefully in disliking family envi-
ronment. Limitation of parents in providing desired
playing toys , eatables due to economic, security or
causes or providing the alternative one which un liked
by the child, may be the root cause of the problem. To
understand this complicit of the child certain questions
to be asked for both parents and the child.
CONCLUSION
Satvāvajaya Chikista is the third form of the treatment in
Ayurveda which form a rational treatment for disturb-
ances of the mind. As mind plays vital role in control-
ling both physical as well as Psychological integration
of the body keeping the mind in healthy state is the mo-
to of Satvāvajaya Chikitsa. Although we often highlight
the importance of Satvāvajaya Chikitsa in treatment, no
fixed protocol be followed has been prepared so for.
Nevertheless, practical implementation of principles of
Satvāvajaya Chikitsa is challenge and need an inte-
grated approach. This article high light certain points
based up on which Satvāvajaya Chikitsa can be practi-
cally implemented. However this should be considered
as Ayurvedic method of counseling the child which co-
vers larger area when compared to contemporary med-
ical sciences. Many psychological disorders of the child
like Śayyā mūtra, Habit disorders, learning disorders,
depression, phobia, separation anxiety, adjustment
problems, bipolar disorders, rumination disorders, veg-
etative disorders, behavioral problems can be effective-
ly managed by this specialty of treatment. This should
be extended not only to psychological disorders but
also to the physical disorders. Different questionnaires
should be prepared to assess the severity of derange-
ment of each facet.
ΛΛΛΛ
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Source of Support: Nil.
Conflict of Interest: None declared
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How to cite this article: Devendra & Shrinidhi: Clinical Im-
plementation of the Satvāvajaya Chikista in Ayurvedic
Paediatric Practice. AAMJ 2016; 5:994 – 1000.