Āyurvedic Doctor: Educational Outline for Competency

Transcription

1 Āyurvedic Dctr: Educatinal Outline fr Cmpetency SECTION 1: FOUNDATION OF ĀYURVEDA NAMA Scpe Descriptin: The dctr has a strng understanding f the histry, philsphy, fundamental principles and basic vcabulary f Āyurveda. Understands Definitin f Āyurveda, Histry f Āyurveda, Aṣṭāṅga Āyurveda, Bṛhat Trayī, Laghu Trayī Related Pre-requisite r Cmplementary Knwledge f: - Origin myths f Āyurveda accrding t Susrut, Charak, Kasyapa and the Puranas - Origins f Āyurveda in the pre-vedic era - Histry f herbalism and healing in the Vedic perid - Vedas in brief and Āyurveda being Upaveda f Atharvaveda - Ashtanga Āyurveda in brief - Śad-Darshana in brief - Histry and backgrund f Brihad Trayi - Imprtant cmmentatrs: Jejjat, Chakrapannidutta, Dalhana, Gangadhar, Ygendranath Sen - Histry f Laghu Trayi - Histry f the Nighantu - Current cntext f Āyurveda in India and America Understands Sāṁkhya Philsphy: - Prakṛti, Puruṣa - Mahat - Ahaṁkāra - Manas Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 1

2 - Pañca tanmātras - Pañca jñānendriyas - Pañca karmendriyas - Pañca mahābhūtas - Relatinship f jñānendriyas, karmendriyas, tanmātras and mahābhūtas SECTION 2: CONCEPTS OF ĀYURVEDA Twenty Qualities (Guṇas) NAMA Scpe Descriptin: The dctr has skills and cmpetence in determining which guṇas are predminant in prakṛti and vikṛti and demnstrates the fllwing abilities: T determine the rle and influence f the 10 pairs (r 20 ttal) f ppsing qualities (gurvādi guṇas) in the prakṛti and vikṛti thrugh the data received frm the histry and examinatin f the client. Related Pre-requisite r Cmplementary Knwledge f: - The 10 pairs f ppsing qualities (gurvādi guṇas) assciated with the five elements (pañca mahābhūtas) and the three dṣas and thse that vitiate the dṣas. - The guṇas causing dṣas t accumulate and becme aggravated. - Hw diet, climate, seasn and age impact the guṇas and subsequently cntribute t the cause f disease. - What cnstitutes excess, deficiency and the imbalance f the guṇas in dṣa vikṛti. - The thery f similar and dissimilar and balancing the guṇas thrugh prper daily and seasnal rutines fr a persn f each cnstitutinal type. Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 2

3 Prakṛti and Vikṛti NAMA Scpe Descriptin: The dctr has the skills required t assess the physical and mental prakṛti and dṣhic imbalance using Āyurvedic methdlgy (trividha, aṣṭavidha and daśavidha parīkṣā). The dctr has knwledge f: Three-fld Diagnstic Methd (Trividha Parīkṣā) Observatin (Darśana) Tuch (Sparśana) Questining (Praśna) Eight-fld Diagnstic Methd (Aṣṭavidha Parīkṣā) Pulse assessment (Nāḍī parīkṣā) Urine assessment (Mūtra parīkṣā) Stl assessment (Mala parīkṣā) Tngue assessment (Jihvā parīkṣā) Speech and vice assessment (Śabda parīkṣā) Skin assessment (Sparśa parīkṣā) Assessment f eyes (Drika parīkṣā) General appearance f external features: face, nse (Ākṛti parīkṣā) Ten-fld Diagnstic Methd (Daśavidha Parīkṣā) Dūṣyam Structural and functinal abnrmalities f the bdy Deśam Gegraphical nature f the place where client lives Balam Physical strength Kālam The seasn and climatic cnditins Analam The digestive system f the client Prakṛti Cnstitutin Vayas Age f the client Sattvam Psychlgical nature f the client Sātmyam General and persnal habits f the client (e.g. smking) Āhāram Nature f the patient s diet and sensry intake (e.g. vegetarian r nn-vegetarian) Additinal Items Quality f dhātus (sāra) Physical build (samhanana) Measurement f bdy: height, weight, psture, circumference f head (pramāṇa) Ability t adapt (satmya) t diet (āhāra), herbs (dravya) and lifestyle and behavir (vihāra) Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 3

4 Ability t digest (āhāra śakti) Stamina, endurance and capacity t exercise (vyāyāma śakti) Related Pre-requisite r Cmplementary Knwledge f: - Tridṣa thery including the 10 pairs f ppsite qualities (gurvādi guṇas) - Physical and mental attributes in a prakṛti, including but nt limited t height, weight, clr f eyes, skin, mental abilities, memry, intellect, diet, tastes, digestive fire, quality f skin, temperature, hair, appetite, eliminatin, stress factrs - Physical and mental attributes that change with time: diet, climate, seasn, stress and envirnment - Changes in vikṛti due t changes in agni, guṇas resulting in digestive disrders, appetite and eliminatin changes - Attributes (guṇas) that cause the dṣas t accumulate and becme aggravated - Diet (āhāra) and lifestyle (vihāra); hw diet, climate, seasn and age impact the prakṛti and subsequently cntribute t dṣa vikṛti and cause f disease - What cnstitutes excess, deficient and the imbalance f dṣas within their wn site - Thery f similar and dissimilar and balancing the dṣa vikṛti thrugh a prper daily rutine, seasnal rutine and basic six tastes (rasa) fr a persn f each cnstitutinal type Dṣas, Sub-dṣas, Dhātus, Srtas NAMA Scpe Descriptin: The dctr is able t shw skill and cmpetency in determining the state f dṣas, sub-dṣas, dhātus, upadhātu and srtas, then able t assess the fllwing: The dctr is able t assess the state f dṣas, and sub-dṣas, dhātus, upadhātus, and srtas invlved thrugh bservatin (darśana) asking questins (praśna) and palpatin (sparśana) and is able t interpret the infrmatin received. Interview/Questining (Praśna) Asking questins abut the current state f digestin, eliminatin, sleep, stress level, energy level and emtinal level. Observatin (Darśana) The ability t interpret infrmatin that has been received upn bservatin (darśana) t determine the invlvement (vitiatin) f dṣas, sub-dṣas, dhātus and srtas. Palpatin (Sparśana) The ability t interpret infrmatin that has been received upn palpatin (sparśana) t determine the invlvement (vitiatin) f dṣas, sub-dṣas, dhātus and srtas. Related Pre-requisite r Cmplementary Knwledge f: - Healthy dhātus (dhātu sārata). Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 4

5 - Hw t prperly examine the client utilizing the methds f trividha, aṣṭavidha, daśavidha parīkṣā - Definitin, qualities, lcatins, actins and functins f the three dṣas and 15 sub-dṣas - Causes f imbalance, signs f imbalance f the three dṣas and 15 sub-dṣas - Definitin, lcatin and functin f the dhātus and hw they are frmed. - Definitin f upadhātus and dhātu malas - Relatinship between dhātus, upadhātus and dhātu malas - Definitin, types, qualities and functins f jas - Relatinship f dṣas and dhātus - Definitin, rigin and functin f the srtas - Factrs causing abnrmality f dhātus - Aggravatin (vṛddhi) and depletin (kṣaya) f the dṣas and dhātus - Nrmal and abnrmal functins f strtāṁsi Agni, Āma, Malas NAMA Scpe f Descriptin: The dctr is able t assess the state f the malas, agni and āma thrugh questining (praśna) and bservatin (darśana). In rder t be cmpetent, the dctr has the fllwing skills: Ability t determine the state f agni by questining the client upn intake (rugṇa patrakam). Questining abut appetite, digestin and eliminatin Ability t recgnize the signs and symptms f āma in the bdy Questining abut digestin Observatin f tngue, stls and bdy dr Ability t recgnize the signs and symptms f nrmal and vitiated mala Questining abut urinatin, eliminatin and sweat patterns Observatin f the urine stls and sweat t include clr, vlume, dr, clarity Related Pre-requisite r Cmplementary Knwledge f: - Symptms and signs f the fur states f agni - Definitins f āma, agni and mala - Hw āma is frmed Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 5

6 - Types agni and āma - Functins f agni - Signs and symptms f the altered states f agni - Signs and symptms f āma in the urine (mūtra), feces (purīṣa), sweat (sveda), n the tngue (jihvā), eyes (netra), nails, skin, etc. - Functins f the malas - What cnstitutes the nrmal and abnrmal quantity and qualities f malas Prāṇa, Tejas, Ojas NAMA Scpe Descriptin: The dctr is able t determine the state f prāṇa, jas and tejas. In rder t be cmpetent, the dctr is able t assess the fllwing: The state f prāṇa, tejas and jas thrugh bservatin and the interview prcess (cnsultatin), which explres the state f prāṇa, tejas and jas. Related Pre-requisite r Cmplementary Knwledge f: - Definitin f prāṇa, tejas and jas - Relatinship f prāṇa, tejas and jas t vata, pitta and kapha - Signs f healthy r balanced prāṇa, tejas and jas - Symptms f high jas - Symptms f lw jas - Displaced jas - Factrs causing imbalance in jas, tejas and prāṇa Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 6

7 SECTION 3: SKILLS AND COMPETENCIES NAMA Scpe f Practice: The dctr has the necessary skills t prvide cunseling. In rder t be cmpetent, the dctr has the fllwing abilities: Asks questins that gather the apprpriate infrmatin necessary t understand the prakṛti and vikṛti f the client. Related Pre-requisite r Cmplementary Knwledge f: - What the chief cmplaint is, based n initial cnsultatin and the imprtance f mitigating factrs such as: rigin, duratin, prgress and factrs that aggravate and relieve the symptms. - Past medical histry, including: Illness, injuries, surgeries, hspitalizatins - Family histry affecting vikṛti f the client - Scial histry affecting vikṛti f the client - Rles f wrk relatinships and hme envirnment affecting vikṛti f the client - Medicatins and supplements a client is taking - Any allergies r intlerances the client has t drugs r fds - Client s nutritin habits - Gd listening skills, eye cntact and develps rapprt with client - Hw t ask pen ended questins with each client - The imprtance f btaining a gd health histry and demnstrates this ability - Accurate assessment and plan f actin - Client s satisfactin f Āyurveda methdlgy - Imprving the understanding f the cnsultatin - Imprvement f client cmpliance t any suggestins r guidelines given Persnal and Family Health Histry NAMA Scpe f Practice: The dctr has the necessary skills t be able t effectively take a detailed current and past persnal and family health histry. In rder t be cmpetent, the dctr has the fllwing abilities: Asks questins which gather the apprpriate infrmatin necessary t understand the prakṛti and vikṛti f the client and refers a client fr disease management care, when necessary. Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 7

8 Related Pre-requisite r Cmplementary Knwledge f: - What the chief cmplaint is, based n initial cnsultatin and the imprtance f mitigating factrs such as: rigin, duratin, prgress and factrs that aggravate and relieve the symptms. - Past medical histry, including: Illness, injuries, surgeries, hspitalizatins - Family histry affecting vikṛti f the client - Scial histry affecting vikṛti f the client - Rles f wrk relatinships and hme envirnment affecting vikṛti f the client - Medicatins and supplements a client is taking - Any allergies r intlerances the client has t drugs r fds - Client s nutritin habits - Gd listening skills, eye cntact and develps rapprt with client - Hw t ask pen ended questins with each client - The imprtance f btaining a gd health histry and demnstrates this ability - Accurate assessment and plan f actin - Client s satisfactin f Āyurveda methdlgy - Imprving the understanding f the cnsultatin - Imprvement f client cmpliance t any suggestins r guidelines given Vital Signs NAMA Scpe Descriptin: The dctr has the skills t be able t effectively taking basic vital signs such as bld pressure (raktacāpa). These abilities are demnstrated by: Assessing a client s height and weight Taking a client s pulse Taking the bld pressure Related Pre-requisite r Cmplementary Knwledge f: - Pulse Able t interpret pulse rate, rhythm and vlume Taking pulse at apprpriate sites Nrmal and abnrmal pulses - Bld Pressure Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 8

9 Determining what is bld pressure The systlic and diastlic pressure (nrmal, abnrmal, physilgy) Measuring bld pressure - Respiratin Determining respiratin: Nrmal and abnrmal respiratin Etilgical Factrs (Nidāna) NAMA Scpe f Practice: The dctr is able t determine the etilgical factrs (nidāna) respnsible fr the dṣhic imbalance and the disease. In rder t be cmpetent, the dctr has the ability t: Interpret and understands the case histry f the client Interpret the case histry t determine the specific etilgical factrs assciated with each symptm and disease Related Pre-requisite r Cmplementary Knwledge f: - The three fundamental causes f disease: asātmyendriyārtha saṁyga, prajñāparādha, pariṇāma - Hw the senses might be misused (ver-used, under-used r wrngly used) in a manner that causes the dṣas t becme aggravated - Hw daily and seasnal rutines impact the flw f the dṣas - Qualities that cause the dṣas t g thrugh the six stages f pathgenesis - Hw cnstitutin, climate, seasn and age impact the mvement f the dṣas - Additinal causative factrs (nidānas) in the disease prcess - Hw the suppressin f natural urges cntributes t the disease prcess - Knwledge f the specific etilgical factrs f each symptm and disease. Pathlgy (Vikṛti Vijñāna) NAMA Scpe Descriptin: The dctr is cmpetent t be able t understand the pathgenesis f varius diseases and diagnse them accurately. (PLEASE NOTE: The translatins f the Sanskrit disease names are bnrad crrelatins f cnventinal diagnses but nt exclusive t thse pathlgies. Other cnditins which present with similar symprtms and pathlgies may als be included under sme f the Āyurvedic disease names. There are many recent pathlgies that may nt have specific names in Āyurveda, but can be understd by the pathlgical changes in the dṣas and rt cause etilgy) In rder t be cmpetent, the dctr is able t: Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 9

10 Identify dṣa vṛddhi and kṣaya Identify dhātu vṛddhi, kṣaya, and duṣṭi Identify mala vṛddhi and kṣaya Understand dṣa gati: - Ūrdhvaga (upwards), adhga (dwnwards), and tīryak (hrizntally) - Frm kṣṭha t śākha and frm śākha t kṣṭha - In the six stages f samprāpti Understand causes f dṣas mving frm kṣṭha t śākha and frm śākha t kṣṭha Understand relatinship between the dṣas, dhātu, and malas Knwledge f srtāmsi: - Causes f srtvaiguṇya - Causes and signs f srt duṣṭi Knwledge f āvaraṇa pathlgy and its signs Knwledge f varius vyādhis: - Identify vyādhi lakṣaṇas (signs f disease) - Identify vyādhi avastha: sāma r nirāma state f dṣa, dhātu, and malas Knwledge f vyādhi classificatins: 1. Nija, āgantu, and mānasika 2. Santarpaṇa and apatarpaṇa janya 3. Accrding t rga mārga: bāhya, ābhyantara, r madhya 4. Sāmānyaja r nānātmaja 5. Sukha sādhya, kaṣṭa sādhya, yāpya, r asādhya Knwledge f the nanatmaja vikaras: vataja, pittaja and kaphaja In-depth knwledge f the classical diseases listed belw; including hw they are described in Madhav Nidhan, any differences seen in the samhitas regarding these diseases and the pinins f the chief cmmentatrs Knwledge f the fllwing diseases: - Accrding t srtas: Prāṇavaha srtas: kāsa, śvāsa, hicca Annavaha srtas: ajīrṇa, aruci, cardi, amlapitta, ānāha, udara śūla, kṛmi, grahaṇi, Atisāra, arśhas Ambuvaha srtas: tṛṣṇa, prameha, śtha Rasavaha srtas: jvara, pāṇdu Raktavaha srtas: raktapitta, dāha, vātarakta, kāmala Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 10

11 Mamsavaha srtas: granthi, galaganda, gandamala Medvaha srtas: staulya (med rga) Asthivaha strtas: asthigata vāta, sandhigata vāta, āma vāta Majjavaha srtas: pakṣāvadha, ākṣepaka, kampavāta, apasmāra, gṛdrasi Śukravaha srtas: klaibya Ārtavavaha and stanyavaha srtas: yni vyāpat, pradara, stanya rgas Manvaha srtas: unmāda, smṛtibhramṣa - Accrding t rgan: Hrid rga Tvak: visarpa, kaṇdu, kuṣṭha Vṛkka: aśmari *Additinal diseases: gulma, arbuda Overview understanding f the western diseases listed belw, including a general appreciatin f epidemilgy, causatin, pathgenesis and clinical presentatin: - Jwara Influenza Lyme Disease STIs Visham jwara Sannipataka jwara Rajayakshma - Cmmn infectius diseases RSV Gastrenteritis Fd pisning - Emerging infectius diseases Lyme Disease & c-infectins Babesisis Bartnella Ehrlichisis Mycplasmsis Tularemia West Nile HIV - Annavaha srtas & purishavaha srtas Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 11

12 Chrnic diarrhea Candidiasis Parasitic infectins (krumi) Fd allergies Chrnic gastritis GERD Irritable bwel syndrme Gluten sensitivity and celiac disease Hemrrhids. Inflammatry bwel disease (ulcerative clitis, Crhns, micrscpic clitis) - Ambuvaha srtas Diabetes Dehydratin - Pranavaha srtas Sinusitis Chrnic brnchitis Brnchial asthma Allergies/hay fever Walking pneumnia - Rasavaha srtas Hyperlipidemia Eczema Psriasis Urticaria Acne - Raktavaha srtas Hypertensin Ischemic heart disease, Arrhythmias Peripheral vascular disease Anemia Chrnic liver diseases: Hepatitis B & C and nn-alchlic fatty liver disease Thrmbphlebitis - Mamsavaha srtas Chrnic pain syndrmes Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 12

13 Fibrmyalgia Chrnic fatigue syndrme Tendinitis Plantar fasciitis - Medvaha srtas Obesity - Astivaha srtas Ostearthritis Rheumatid arthritis Psriatic arthritis Gut Osteprsis Sclisis - Majjavaha srtas Sleep disrder Migraine MS Headaches Epilepsy - Shukravaha srtas Prstatitis Prstate cancer Erectile dysfunctin Infertility - Artavavaha srtas Menrrhagia Dysmenrrhea Amenrrhea PMS Supprt fr nrmal pregnancy Menpause - Manvaha srtas Anxiety Panic attacks Stress Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 13

14 PTSD Eating disrders (anrexia nervsa, bulimia) Alchlism Majr depressin Biplar Schizphrenia - Sthanyavaha srtas Supprt fr lactatin Tender breasts Fibrcystic breast disease Breast cancer - Mutravaha srtas UTI Irritable bladder syndrme Incntinence - Metablic disrders Thyrid diseases Adrenal fatigue Diabetes Pathgenisis (Samprāpti) NAMA Scpe Descriptin: The dctr is cmpetent t determine the full samprāpti f disease cnditins. In rder t be cmpetent, the dctr is able t: Describe the pathlgy in terms f the stage f disease alng with the invlvement f the dṣa, sub-dṣa, dhātu and srtas in the disease and als determine the state f agni in the disease. Related Pre-requisite r Cmplementary Knwledge f: - All stages f disease (śaḍ kriyā kāla) - Signs f disease at each stage including relcatin, manifestatin and diversificatin. - Specific pathlgy related t disease cnditins. Cunseling Skills NAMA Scpe f Practice: The dctr has the necessary skills t prvide cunseling with the fllwing abilities: Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 14

15 Cnveys infrmatin and ideas crrectly (t educate) Listens and understands Supprts a client t make psitive changes in his/her life Earns the client s trust Related Pre-requisite r Cmplementary Knwledge f: - Cmmunicating effectively - Demnstrating effective skills fr cunseling - Recmmending changes in diet and lifestyle as necessary, due t dṣhic tendencies and hw they relate t challenges - Supprting each persn t make successful changes based n their cnstitutinal type - Supprting a rājasika and tāmasika client t make changes - Demnstrating gd bedside manner The fllwing areas f knwledge are generalized and n specific methdlgy has been determined. Schls are encuraged t include their wn methdlgies in their curriculum. N cmpetencies will be evaluated in these areas: Understanding bdy language Understanding tne f vice Asking relevant questins Ability t paraphrase and summarize Demnstrates active listening Discern nnverbal cmmunicatin Referring clients t thery references including bks and ther reference materials that supprt self learning Medical Reprts NAMA Scpe Descriptin: The dctr is able t interpret basic Western diagnstic and medical reprts. In rder t be cmpetent, the dctr is able t: Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 15

16 Understand the diagnstic assessments f physician, chirpractr, physical therapists and ther health and medical prfessinals. Related Pre-requisite r Cmplementary Knwledge f: - Nature f the diagnstic test (what it is) and why the test is perfrmed. - Nrmal and abnrmal tests. Nted Limitatin: The dctr is nt required t be able t interpret raw data r the test results, but t understand the interpretatin f the test frm the expert wh has reprts the results. Skills and Cmpetencies Recgnize when test results might indicate can t affrd t miss diagnses that require referral Recgnize when tests, althugh technically nrmal, indicate less than ptimal health, (such as a higher than ptimal TSH r a lwer than ptimal vitamin D) Understand hw t use tests t crrbrate r supprt their Ayurvedic diagnstic methds Cmprehend medical recrds brught in by a patient and grasp their significance in the verall histry Be aware f which tests shuld be rdered t exclude a serius illness Knw hw t write a specific, targeted referral letter t supprt their patient in excluding r cnfirming imprtant diagnses requiring medical attentin Bld Tests Basic Chemistry Screen - Glucse - Urea nitrgen - Creatinine - EGFR - Serum sdium - Serum ptassium - Serum chlride - Serum magnesium - Serum calcium - Serum phsphate - Serum uric acid - Serum albumin - Serum glbulin - Ttal serum prtein - Bilirubin (ttal * direct* indirect*) - Alkaline phsphatase - Serum irn Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 16

17 - Ferritin - GGT/GGTP - Serum LD - AST (SGOT) - ALT (SGPT) - Chlesterl - Triglycerides - HDL - LDL - Hmcysteine (understand why it is nt, but shuld be, a basic screen) - Apalipprteins (understand why it is nt, but shuld be, a basic screen) Basic Hematlgy Tests - White bld cunt and differential - Hemglbin - Hematcrit - Red bld cell indices: MCV MCH MCHC RDW (red bld cell distributin width) Reticulcytes - Platelet cunt Cmmnly-assessed Hrmne Tests - TSH - T3 T4 - Crtisl - Teststerne - LH - FSH Vitamin D Level Inflammatry Markers - CRP - Rheumatid factr - ANA HbA1c Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 17

18 Tumr Markers - PSA - AFP - Ca 125 Standard Urinalysis - Vlume, clr, turbidity - Specific gravity - Ph - Prtein - Glucse - Ketnes - Bilirubin - Heme Stl Tests - Fecal fat - Stl culture and sensitivity, O&P - FOB Imaging - Reasns fr perfrming ultrasund studies - Abdminal ultrasngraphy - Echcardigraphy - Fetal ultrasund - Pelvic and transvaginal ultrasngraphy - Dangers, pitfalls & uses f CT scans - Calcium cunt/heart scan - Reasns fr perfrming MRI & type f infrmatin btained - Dangers & uses f x-rays - Dexascan fr bne density Endscpy - Reasns fr perfrming upper GI & clnscpy and type f infrmatin btained Pathlgy - Understand cancer staging, grading reprt and hrmne sensitivity Client Strengths and Assets Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 18

19 NAMA Scpe Descriptin: The dctr is able t assess and determine the client s strengths and willingness t fllw recmmendatins. In rder t be cmpetent, the dctr is able t: Assess the client s cmpliance Assess the memry f the client Related Pre-requisite r Cmplementary Knwledge f: - Hw the qualities nted abve influence the utcme f a case. Research Skills NAMA Scpe Descriptin: The dctr is an infrmed cnsumer f research pertaining t the Ayurvedic field and able t evaluate, discuss and integrate cntemprary research within the cntext f Ayurvedic knwledge. The dctr is able t make significant cntributins t the prfessin such as cntributing t r participating in riginal research, review articles, cnference teaching r presentatin f case studies. In rder t be cmpetent, the dctr is able t: Participate in riginal research Write schlarly review articles f the literature Present their research, reviews and case studies at cnferences Critically read the reprted data Identify flaws in studies (sample size, persnal bias, etc) Related Pre-requisite r Cmplementary Knwledge f: - Hw t read research abstracts - The purpse f research - Basic research methds - Hw different types f research are cnducted Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 19

20 SECTION 4: RECOMMENDATIONS, TREATMENT AND OTHER INTERVENTIONS NAMA Scpe Descriptins Fd/Diet Recmmendatins: The dctr is able t recmmend r prescribe the apprpriate fd chices and prper eating behavirs (āhāravidhi) in accrdance with the prakṛti, vikṛti, guṇas, rasa, seasn (ṛtu), digestive strength (agnibala) and age (vaya) f the patient. Treatment and Interventin: The dctr is able t demnstrate the selectin and preparatin f apprpriate fds and spices accrding t prakṛti, vikṛti, guṇas, rasa, seasn (ṛtu), digestive strength (agnibala) and age, and demnstrate prper eating behavirs (āhāravidhi). In rder t be cmpetent, the dctr demnstrates the fllwing cmpetencies: General Knwledge f the six tastes - Six tastes, their elemental make up and qualities - Rasa, vīrya and vipāka f the tastes - The 10 pairs f ppsite qualities (gurvādi guṇas) f each taste - Effects f each taste n dṣas, dhātus and malas - Tastes that are nurishing (bṛṁhaṇa) and thse that are reducing (laṅghana) - Effect f the tastes and fds n agni and āma - Elemental make up f fds (mahābhutika āhāra) Dietary guidelines - Suggest prper guidelines fr healthy eating Specific fds and spices - Fds in each majr categry (grains, meats, dairy, etc.) and their effect n their actins n the three dṣas - Spices and their effect upn the dṣas Fasting - Able t ffer types f fasting - Liquid, juice, fruit, ne meal per day Preparatin f fd - Hw prcessing fd changes its qualities - Hw t prepare basic fds such as kichari, ghee and buttermilk Rituals f eating - Imprtance f eating mindfully and with gratitude Other Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 20

21 - Imprtance and intake f warm water in the mrnings (uṣāpāna) NAMA Scpe Descriptins Lifestyle Skills and Cmpetencies: The dctr is able t recmmend r prescribe apprpriate daily (dinacaryā), seasnal (ṛtucaryā) and life cycle rutines accrding t prakṛti, vikṛti, and guṇas. The dctr shuld als be able t recmmend at-hme preventive and prmtive (svasthavṛtta) measures, and psitive cnduct (sadvṛtta) measures. Treatment and Interventin: The dctr shuld be able t demnstrate the apprpriate daily (dinacaryā), seasnal (ṛtucaryā) and life cycle rutines accrding t prakṛti, vikṛti, and guṇas. Demnstrating at-hme preventive and prmtive (svasthavṛtta) measures, and psitive cnduct (sadvṛtta) measures. In rder t be cmpetent, the dctr is able t recmmend, prescribe r demnstrate the fllwing: Recmmend Daily Rutines (review techniques with client) - Recmmend prper ral hygiene (tngue cleaning, teeth brushing and flssing) - Taking care f Eyes (eye wash) - Self abhyaṅga - Drinking warm water in the mrning (uṣāpāna) - Tngue cleaning - Netī - Activities t prmte sleep befre bed Recmmend adjustments t the daily rutine based n seasn Supprt the client t make lifestyle changes - Adjusting bed times and wake up times accrding t dsha, as well as seasn - Times t take fd - Instruct the client in mdifying lifestyle in accrdance with the seasns Prper cnduct (sadvṛtta) - Encurage devtinal and spiritual practices - Encuraging mindfulness thrughut the day - Encurage t cultivate lving kindness, cmpassin, jy and equanimity The dctr is able t mdify the daily, seasnal and lifecycle rutines f the patient in accrdance with their underlying disease. Related Pre-requisite r Cmplementary Knwledge f: - Dṣas increasing r decreasing during different times f the day and seasn Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 21

22 - Age affecting the dṣas and agni - Influence f apprpriate physical, devtinal, spiritual practices n dṣas and guṇas - Twenty guṇas, dṣas, agni, āma, jas - Three primal states (mahāguṇas: sattva, rajas, tamas) - Drinking warm water in the mrning (uṣāpāna) - Lifestyle impacting digestin and eliminatin - A regular rutine influencing the dṣas - Practice f abhyaṅga, the ils t be used fr abhyaṅga, different types f abhyaṅga - Effective use f daily rutine - Effective use f seasnal rutine - Devtinal and spiritual practices affecting the mind and bdy - Evening rutine (rātricaryā) - Transitin f the seasns (ṛtusandhi) - Rasāyana fds - Vājīkaraṇa fds - Resisting and nt resisting urges - Knwledge f hw specific diseases alter general lifestyle recmmendatins NAMA Scpes Descriptins Senses Recmmendatins: The dctr is able t recmmend r prescribe the apprpriate use f sight, smell, tuch, taste and hearing (sātmyendriyārthasaṁyga) and administer the apprpriate treatments. Treatment and Interventin: The dctr is able t prescribe the apprpriate use f sight, smell, tuch, taste and hearing in the management f disease. In rder t be cmpetent, the dctr is able t recmmend, prescribe and/ r demnstrate the fllwing: Armatic Therapy The dctr is able t identify excessive utilizatin, deficient utilizatin and mis-utilizatin f the sense f smell and instruct the client t make adjustments t their armatic envirnment t supprt the healing prcess.this might include identifying substances such as turpentine r Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 22

23 fabric sftener that are disturbing the sense f smell as well as recmmending the use f dshically apprpriate armatic herbs such as rse r sandalwd. Taste Therapy (Diet and Herbs) The dctr is able t identify excessive utilizatin, deficient utilizatin and mis-utilizatin f the sense f taste and instruct the client t make adjustments t their gustatry envirnment (fr mre infrmatin see the fd sectin) t supprt the healing prcess. This might include crrecting a diet that is t salty, t pungent, t sweet, etc. and recmmending a dshically apprpriate balance f tastes. Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 23

24 Tuch Therapy (Self Massage) The dctr is able t identify excessive utilizatin, deficient utilizatin and mis-utilizatin f the sense f tuch and instruct the client t make adjustments t their tactile envirnment t supprt the healing prcess, such as by instructing the client in Āyurvedic self-massage. Sund Therapy The dctr is able t identify excessive utilizatin, deficient utilizatin and mis-utilizatin f the sense f hearing and instruct the client t make adjustments t their auditry envirnment t supprt the healing prcess.this might include identifying expsure t lud music r wrkrelated nise as well as recmmending methds t mitigate such expsures. Visual Therapy The dctr is able t identify excessive utilizatin, deficient utilizatin and mis-utilizatin f the sense f visin and instruct the client t make adjustments t their visual envirnment t supprt the healing prcess. Related Pre-requisite r Cmplementary Knwledge f: - Sensry and mtr faculties - The relatinship f five elements (pañca mahābhūtas) t each sensry and mtr faculty - Effect f apprpriate, excessive and absence f sensry stimuli n each f the five sensry faculties and mind - Sensry stimuli affecting the dṣas - Apprpriate and inapprpriate use f senses - Different ils used fr nasya - Tuch therapy including different frms f abhyaṅga and apprpriate ils used fr abhyaṅga - Different tastes and influence n dṣas - The mind is and its functins - Relatinship between the five elements and their respective tanmātra, sense and mtr rgans NAMA Scpe Descriptins Herbs and Minerals Recmmend: The dctr is cmpetent t safely recmmend individualized herbal frmulas, predesigned herbal medicines, minerals and ther natural substances fr internal r external use with cnsideratin f the dse (mātra), vehicle (anupāna) and timing (auśadha kāla) fr the purpse f balancing agni, eliminating āma while supprting the malas and prtecting and building jas, and treating disease. In additin, the dctr is aware f and able t negtiate herb-drug interactins. Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 24

25 Treatment and Interventin: The dctr is cmpetent t administer, cmbine, prvide, cmpund, and dispense herbal medicines, minerals, r ther natural substances. Herbs may be used fr internal r external use fr the purpse f balancing agni and eliminating āma while supprting the malas and prtecting and building jas, as well as fr treating specific diseases affecting any dhātu, upadhātu, malas r srtas in any stage f the disease pathlgy. In rder t be cmpetent, the dctr is able t make the fllwing recmmendatins and prvide the fllwing treatments and interventins: The dctr is able t recmmend r prescribe the apprpriate herbs t balance agni, eliminate āma and supprt the malas while prtecting and building jas. The dctr is able t recmmend pre-designed herbal frmulas r create custm herbal frmulatins that include the use f herbs, minerals r ther natural substances fr internal r external use with cnsideratin f dse (mātra), vehicle (anupāna) and timing (auśadha kāla). Prescribe herbal and related medicines fr the purpse f treating disease. Related Pre-requisite r Cmplementary Knwledge f: - Herb classificatin and their energetics based n taste (rasa), ptency (vīrya), pstdigestive effect (vipāka), quality (guṇa) and unique actin (prabhāva) - The actins f herbs (karma). The dctr is well-versed in the karmas f each herb. When Western terminlgy matches the Saṁskṛta terminlgy, the Western terms shuld be knwn. When a unique actin is described in Saṁskṛta that has n simple translatin int English, then the Saṁskṛta terminlgy fr that actin shuld be knwn. - The effect an herb has n the agni, āma, dṣas, and malas - Hw t prepare pwdered mixtures (cūrṇa) - Apprpriate dsage (mātra) based n age, strength, dṣas, agni and pattern f eliminatin (kṣṭha) - Indicatins fr using herbs and cntraindicatins t assure safe use - Herbs based n strage, prcessing, purity and gvernment regulatins - Apprpriate herb and herbal related medicines fr the management f specific disease cnditins. - Effect an herb has n dhātu and srta - Different anupānas t target different dṣas and dhātus. - Basic FDA regulatins that affect daily practice (Example Sectin 201 (g)(1)(b) f the Federal Fd, Drug, and Csmetic Act (the Act) [21 U.S.C. 321(g)(1)(B) states that herbs cannt make claims f supprt] Herbs restricted by the the FDA - The fllwing herbs: Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 25

26 Saṁskṛta Name Latin Name Cmmn Name Āmalakī Emblica fficinalis Indian gseberry Anantamūla Hemidesmus indicus Sariva, upalsari Arjuna Terminalia arjuna Aśka Saraca indica Aśvagandha Withania smnifera Balā Sida crdiflia Bhṛṅgarāja Eclipta alba Bhūmyāmalakī Phyllanthus amarus Bhui-avala Bilva Aegle marmels Bael fruit Brahmī Bacpa mnnieri, centella asiatica (active debate n this) Citraka Plumbag zeylanica Dāruharidrā* Berberis aristata Daruhalad Devadāru* Cedrus dedara Dedar Dhānyaka Criandrum sativum Criander Elā Elettaria cardammum Cardamm Eraṇḍa Ricinus cmmunis Castr il Gkṣura Tribulus terrestris Gkharu Gudūcī Tinspra crdiflia Gulvel, amrita Guggulu Cmmiphra mukul Guggul Haridrā Curcuma lnga Turmeric Harītakī Terminalia chebula Chebulic myrbalan Hiṅgu Ferula assa-fetida Asafetida Jaṭāmāmsī* Nardstachys jatamansi Indian spikenard Jātīphalā Myristica fragrans Nutmeg Jīraka Cuminum cyminum Cumin Jytiṣmatī* Celastrus paniculatus Kalamegha* Andrgraphis paniculata King f bitters Kapikacchu Mucuna pruriens Kaṭukī* Picrrhiza kurra Kutki Kirātatikta* Swertia chirata Kade chirait Kumārī Ale barbadensis Ale Kuṭaja Hlarrhena antidysenterica Kuda Laśuna Allium sativum Garlic Lavaṅga Syzygium armaticum Clve Ldhra* Symplcs racemsa Maṇḍūkaparṇī Centella asiatica Gtu kla Mañjiṣṭhā Rubia crdiflia Marica Piper nigrum Black Pepper Meṣaśṛṅgī Gymnema sylvestre Gurmar, shardunika Methikā Trignella fenum-graeceum Fenugreek Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 26

27 Saṁskṛta Name Latin Name Cmmn Name Miśreya Feniculum vulgare Fennel Mustā Cyperus rtundus Nagarmtha Nimba Azadirachta indica Neem Padmaka Nelumb nucifera Ltus Pippali Piper lngum Lng Pepper Punarnavā Berhaavia diffusa Rājikā Brassica juncea Mustard seeds Rakta candana Ptercarpus santalinus Red sandalwd Raktapuṣpi Hibiscus rsa Hibiscus Rāsnā Alpina fficinarum Galangal Saindhava lavaṇa Śallakī Śaṅkhapuṣpī Bswellia serrata Evlvulus alsinides Mineral salt Sat Isabgl Plantag psyllium Psyllium husks Śatāvarī Asparagus racemsus Asparagus rt Śilājitu Asphaltum Mineral pitch Śuṇṭhī Zingiber fficinale Ginger Svarṇapatrī Senna alexandrina Senna Tagara Valeriana wallichi Valerian Tarunī Rsa centiflia Red rse petals Tavakṣīrī Maranta arundinacea Arrwrt Tila Sesamum indicum Sesame Tulasī Ocimum sanctum Hly basil Tvak Cinnammum cassia Cinnamn Uśīra Vetiveria zizaniides Vetiver Vacā Acrus calamus Sweet flag Vasaka Adhatda vasica Malabar nut Vibhītakī Terminalia belerica Beleric Viḍaṅga Embelia ribes Vidārī kanda Ipmea digitata Indian ginseng Yaṣṭi madhu Glycyrrhiza glabra Licrice rt Yavānī Carum cpticum Ajwain r wild celery *Herbs are difficult t btain due t being prtected species r endangered. - Varius preparatins f herbs and hw they are made including: Infusins Decctins (kaṣāya) Fresh juice (svarasa) Jam (avalehya, lehyam) Medicated ghee (ghṛta) Pwders (cūrṇa) Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 27

28 Medicated ils (taila) Pills (vaṭi) Mist blus (kalka) Fermented preparatins (āsava, ariṣṭa) - The fllwing specific cmpund frmulatins: Tablets (Vaṭi) Decctins (Kashaya) Oil (Taila) Ghee (Ghṛta) Fermented Preparatins (Āsava, Ariṣṭa) Jams (Lehyam) Avipattikara *Ārgyavardhinī vaṭi *Indukantham *Aṇu taila Aśvagandha ghṛta Abhaya ariṣṭa Cyavanprāśa Daśamūla *Candraprabhā vaṭi Dashamulam Aśvagandha bala taila Śatāvarī ghṛta Arjuna ariṣṭa Brahmiprash Hiṅgvāṣṭaka Citrakādi vaṭi *Amruttharam Lavaṇa bhāskara Eraṇḍa harītakī Bhṛṅgarāja/ mahābhṛṅ garāja taila Brāhmī taila Triphala ghṛta Yaṣṭi madhu (licrice) ghṛta Aśka ariṣṭa Aśvagandha ariṣṭa Draksha avelaha Ashwagandha avelaha Gkṣurādi guggulu Eraṅḍa (castr) taila Bala ariṣṭa Adrak avelaha Sitpalādi Kaiṣra guggulu *Kṣāra taila *Candana āsava Pippali rasayana Tālīsādi Khadirādi vaṭi *Mahāmari cyādi taila Daśamūla ariṣṭa Trikaṭu Laśunādi vaṭi Mahāṇārāyan taila Drakṣa āsava Triphala Lavaṅgādi vaṭi Mahāviṣa garbha taila Kumārī āsava *Lākṣādi guggulu Nīlgiri (eucalyptus) taila Lhāsava Mahāsudarśana vaṭi Nimba (Neem) taila *Maricyādi vaṭi *Saindhavādi taila Punarna guggulu *Ṣaḍbindu taila Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 28

29 Tablets (Vaṭi) Decctins (Kashaya) Oil (Taila) Ghee (Ghṛta) Fermented Preparatins (Āsava, Ariṣṭa) Jams (Lehyam) *Sārivādi vaṭi Simhanāda guggulu *Śaṅkha vaṭi *Traydaśāṅga guggulu Ygarāj guggulu Nte: Thse marked with * are either nt easily available in USA r cannt be used as it is an herbmineral cmpund cntaining heavy metal. It is imprtant t have knwledge f these prducts, but students wuld nt be tested regarding the same. Pacificatin f Dṣas (Laṅghana/Śamana) NAMA Scpe Descriptins Recmmendatins: The dctr is able t recmmend pacificatin (shamana) therapies t balance the dṣas and eliminate āma Treatment and Inventin: The dctr is able t design, implement and manage a plan fr pacifying the dṣas and eliminating āma. In rder t be cmpetent, the dctr is able t make the fllwing recmmendatins and implement the fllwing therapies with the gal f pacificatin f the dṣas. Herbs and Spices: Thse that increase agni (dīpana) and metablize āma (pācana) Diet: See fd sectin (kṣudhā nigraha) Sensry Therapies: See sensry therapy sectin. Exercise (vyāyāma) Heat Therapies (agni and anagni cikitsā) Related Pre-requisite r Cmplementary Knwledge f: - Seven traditinal frms f palliative therapy: Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 29

30 Dīpana: Herbs/spices that increasing agni Pācana: Herbs/spices that digest āma Kṣudhā nigraha: Cntrl ver diet including the use f fasting Tṛṣṇā nigraha: Cntrl ver water and il intake Vyāyāma: Use f exercise Ātāpa sevana: Frms f creating heat withut directly increasing agni such as sunbathing Māruta sevana: Ways t cl the bdy t prtect pitta dsha such as mn walks - Āyurveda anatmy and physilgy (qualities, elements, dṣas, sub-dṣas, dhātus, upadhātus, malas, srtas, agni, āma, jas) - Indicatins and cntraindicatins fr palliatin therapy - Hw t design a palliatin prgram t crrect an imbalance in each dṣa - Effective applicatin f each therapy nted abve - Assessing the client s state f agni, āma and jas - Assess digestin, tngue, stls and bdy dr as a means f identifying āma in the bdy - Assessing dṣa vikṛti - Use f herbs and spices fr balancing agni and eliminating ama - Effective, safe and apprpriate, applicatin f diet, herbs, sensry therapies, exercise and heat treatments Eliminatin f Aggravated Dṣas (Laṅghana: Pañcakarma) NAMA Scpe Descriptins Recmmendatins: The dctr is able t recmmend pañcakarma prgrams as well as individual treatments (shdhana chikitsa), including classical pañcakarma, treatments fr individual cnditins, and specialized traditinal bdy treatments. Treatment and Interventin: The dctr is able t design, implement and manage pañcakarma prgrams as well as individual treatments (śdhana cikitsā), including classical pañcakarma and treatments fr individual cnditins, specialized traditinal bdy treatments, pūrva karma, pradhāna karma (diet, lifestyle and herbs). In rder t be cmpetent, the dctr is able t make the fllwing recmmendatins and prvide apprpriate case management: Pūrva Karma The dctr is able t prperly design a pūrva karma prgram and t mnitr the patient t lk fr signs f ver and under leatin. Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 30

31 The dctr is able t manage the administratin f the fllwing therapies - Pūrva karma diet - Abhyanga - Udvartana (as needed) - Swedana - Shirdhara - Katibasti (As needed) - Hridbasti (As needed) - Udarabasti (As needed) - Netrabasti (As needed) Pradhāna Karma The dctr is able t prperly design a pradhāna karma prgram and t manage the patient as he/she ges thrugh the prgram. - Vamana (medicated emesis, nt dne rutinely in US) - Virechana (medicated purgatin) - Basti (medicated enemas) - Nasya (medicated nasal drps) - Rakta mksha (bld letting, nt dne rutinely in US) Paścāt Karma The dctr is able t prperly design a paścāt karma prgram and t manage the patient as he/she ges thrugh the prgram. This includes restratin f strng digestive fire t nurish, strengthen and balance the newly detxified tissues by recmmending rasayana herbs accrding t prakriti. Related Pre-requisite r Cmplementary Knwledge f: - Āma pācana - The prcess f pūrva karma - The prcess f pradhāna karma - Each pūrva karma practice including indicatins and cntraindicatins - Each pradhāna karma practice including indicatins and cntraindicatins. - The signs f successful and unsuccessful administratin f each practice - Hw t adjust the prgram if the administratin f a therapy is nt successful. - The ils and medicines t be used in each practice. - Hw t design a cmplete pañcakarma prgram including pūrva, pradhāna and paścāt karma. Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 31

32 - Hw t mdify the cmplete pañcakarma prgram fr patients with a vāta, pitta and kapha vikṛti. - Hw t mdify the cmplete pañcakarma prgram fr patients with varius diseases. - Hw t mdify a pañcakarma prgram with cnsideratin f the patient s respnse t the therapies, including but nt limited t changes in appetite, eliminatin pattern and verall strength. NAMA Scpe Descriptins Rejuvenatin (Rasāyana) Recmmendatins: The dctr is able t a recmmend a pst pañcakarma rejuvenatin prgram (paścāt karma). Treatments and Interventins: The dctr is able t design, implement and manage a pst pañcakarma rejuvenatin (paścāt karma). In rder t be cmpetent, the dctr is able t make the fllwing recmmendatins and prescribe the apprpriate treatments and interventins. Pst pradhāna karma care (paścāt karma) fr the purpses f rejuvenating the bdy and mind. Related Pre-requisite r Cmplementary Knwledge f: - The principles and prcess f samsarjana krama; including hw restre healthy agni while reintrducing fds int the diet. - The use f herbs and herbal frmulas in the rejuvenatin prcess. - The apprpriate timing fr the administratin f rejuvenative herbs fllwing pradhāna karma. - Hw t prperly mnitr a patient during the perid f paścāt karma and hw t adjust a patients prgram in accrdance with their respnse t care. Tnificatin (Bṛṁhaṇa) NAMA Scpe Descriptins Skills and Cmpetency: The dctr is cmpetent t recmmend tnificatin (bṛṁhaṇa) therapy fr the bdy and mind. Treatment and Interventin: The dctr is cmpetent t design, implement and manage a prgram f tnificatin (bṛṁhaṇa) fr sustaining the health f the bdy and mind. In rder t be cmpetent, the dctr is able t make the fllwing recmmendatins and prvide the fllwing treatments and interventins: Dietary therapies that prmte tnificatin. Herbal therapies that prmte tnificatin. Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 32

33 Internal and external il therapies (snehana). Daily rutines and lifestyle that prmte tnificatin. Related Pre-requisite r Cmplementary Knwledge f: - Indicatins and cntraindicatins fr tnificatin therapy. - Designing a tnificatin prgram in accrdance with the dṣa vikṛti. - Managing a tnificatin prgram and making adjustments t the prgram in accrdance with the client s prgress. - Assessing the state f agni, āma and jas. - Assessing the dhātus and the signs f depletin. Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 33

34 SECTION 5: CATEGORIES OF CIKITSĀ NAMA Scpe Descriptin: The dctr has a brad understanding f the different categries f cikitsā as listed belw: Ekavidha 1. Nidāna parivarjana (remving the cause) Dvividha 1. Santarpaṇa and apatarpaṇa (strengthening and depleting) 2. Śdhana and śamana (purificatin and pacificatin) 3. Śīta and uṣṇa (cling and heating) 4. Urjaskara (synnymus with rasyana, preventive treatment) - Rasayana chikitsa t build ptimum dhātus, strng agni and immune system fr lng healthy life, increase strength and stamina, and sharpen memry. - Vajikarana t have strng vigr and vitality, and shukra dhātu t have healthy prgeny. 5. Curative treatment - Rgaprashamana chikitsa Palliative treatment by dsha shamana. Disease may recur if the cause is repeated. - Apunarbhava Cmplete cure. Disease will nt recur. 6. Rga praśamana (management f disease) - Dshapratyanika - Vyadhipratyanika - Ubhayapratyanika - Apunarbhava (permanently curative) 7. Dṣa pratyanīka (dsha specific treatment) - Use f therapies with ppsite qualities f dshas, e.g. licrice (demulcent herb) t balance vata dryness; cling herbs t balance heat quality f pitta 8. Vyādhi pratyanīka (disease specific treatment) - E.g. Astringent herbs (patha r kutaja) fr diarrhea; turmeric in prameha 9. Ubhaya pratyanīka (dsha and disease specific treatment) - Use f dashamul decctin fr vataja swelling (shtha) balances vata and reduces swelling Trividha 1. Sattvavajaya (mind therapy r psychtherapy) - Sattvic mental lifestyle, mind calming herbs, etc. 2. Yukti vyapashray (lgical treatment) - Treat the disease by knwing the samprapti: dsha, dhātu, srtas invlvement, state f agni, underlying nidan, etc. 3. Daiva vyapashraya (spiritual healing/faith healing) - Japa, Mantra Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 34

35 - Tantra therap - Gem therapy - Rituals Caturvidha 1. Śdhana 2. Śamana 3. Āhāra 4. Ācāra Pañcavidha 1. Vamana 2. Virecana 3. Basti 4. Nasya 5. Raktamkṣaṇa Saḍvidha 1. Bṛṁhaṇa (building dhātus r tnifying) 2. Laṅghana (lightening/depleting excess dhātus) 3. Snehana (Oiling r mistening) 4. Rūkṣaṇa (drying) 5. Stambhana (stpping utflw) 6. Svedana (Sweating) Saptavidha 1. Dīpana (strengthen agni) 2. Pācana (digest ama) 3. Kṣudhā nigraha (fasting, limit fd intake) 4. Tṛṣā nigraha (limit liquids) 5. Vyāyāma (exercise) 6. Ātapa sevana (being in the sun, warm weather) 7. Māruta sevana (being in a cl breeze) Gynaeclgy (Stri Vignan) NAMA Scpe Descriptin: The dctr is able t ffer apprpriate recmmendatins fr the specific needs f wmen f childbearing, menpausal and pst-menpausal age. In rder t be cmpetent, the dctr is able t make the fllwing recmmendatins and prvide the fllwing treatments and interventins: Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 35

36 Prescribe and prepare the prper herbal frmulas Prescribe, administer prper Āyurvedic therapies Prescribe mdificatins in the diet Prescribe life style changes Mnitr patients' prgress and make the apprpriate adjustments t the treatment plan Related Pre-requisite r Cmplementary Knwledge f: - Menstrual cycle frm Western and Ayurvedic standpint - Nrmal and abnrmal menpausal transitin frm Western and Ayurvedic standpint - Able t take a menstrual histry - Able t take a reprductive histry - Able t take a sexual histry and assess issues with drive, desire, rgasm pain affecting sexual functining - Cmmn diseases affecting the female reprductive system: Vaginal infectins and bacterial vaginsis Fibrids Endmetrisis Ovarian cysts Ovarian cancer Uterine hyperplasia PCOS Amenrrhea Dysmenrrhea Menrrhagia Dysfunctinal uterine bleeding Cervical dysplasia & HPV Cervical cancer - Specific treatments fr the female reprductive system: Herbal duches (uttarabasti) Vaginal applicatin f medicated ghees Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 36

37 NAMA Scpe Descriptins Pre-natal, Natal, Pst-natal (Prasūti Tantra) Skills and Cmpetency: The dctr is able t recmmend diet (ahāra), lifestyle (vihāra), herbs (dravya) and treatments (cikitsā) t manage pre-natal, natal, pst-natal health and pathlgies and care f newbrns. Treatment and Interventin: The dctr is able t design, implement and manage diet (ahāra), lifestyle (vihāra), herbs (dravya) and treatments (cikitsā) t manage pre-natal, natal, pst-natal health and pathlgies and care f newbrns. In rder t be cmpetent, the dctr is able t make the fllwing recmmendatins and prvide the fllwing treatments and interventins: The dctr is able t safely and supprtively apply these practices t the pre-natal, natal and pst-natal wman. See sectins n fd and lifestyle. Supprt cuples experiencing infertility t restre nrmal prcreative abilities Utilize herbs t supprt and treat pre-natal, natal and pst-natal wmen Treat pre-natal, natal and pst-natal wman wh are experiencing illness Prvide supprtive care fr newbrn infants Prvide treatment fr newbrn infants wh are experiencing illness. Related Pre-requisite r Cmplementary Knwledge f: - Dṣas increasing r decreasing during different times f the day and seasn - Age affecting the dṣas and agni - Influence f apprpriate physical, devtinal, spiritual practices n dṣas and guṇas - Twenty guṇas, dṣas, agni, āma, jas - Three primal states (mahāguṇas: sattva, rajas, tamas) - Drinking warm water in the mrning (uṣāpāna) - Lifestyle impacting digestin and eliminatin - A regular rutine influencing the dṣas - Practice f abhyaṅga, the ils t be used fr abhyaṅga, different types f abhyaṅga - Effective use f daily rutine - Effective use f seasnal rutine - Devtinal and spiritual practices affecting the mind and bdy - Evening rutine (rātricaryā) - Transitin f the seasns (ṛtusandhi) Āyurvedic Dctr: Educatinal Outline fr Cmpetency Updated 09/25/18 37