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Cost effectiveness of integrated medicine

Dr. Swaati DhawanWednesday, March 5, 2008, 08:00 Hrs  [IST]

Medicine since time immemorial has gone through various transitions and transmutations in terms of acceptability and adaptability by the general population at large, fighting the stringent resistance to the technology boom in medicine in the 1970s, then the advent of Third Party Administrators regulating the health insurance scenario in early 1990s and confluence of genetics and robotics being the new adage now. All this has sort of sidetracked the common person because every new technology manufacturer, the insurance company acting as regulators were looking at curtailing the cost paid by them to the common person and now genetics and robotics can effectively cater to the needs of the upper cream of wealthy people in any society. Many healthcare professionals have started behaving like capitalists and are becoming more and more commercially oriented. With the changing times to reduce the burden on healthcare costs, following the age old maxim "prevention is better than cure" is the only solution to the current crisis and burden of disease and ill health that our times are experiencing. Show me one person on earth who does not want to live a healthy, happy and disease free life, and the philosophy and an ancient belief and faith will loose its worth. The busy lifestyles and the tryst of earning their livelihood and maintaining their own lifestyle and especially status, has left people short of time and energy to devote to themselves and their families. What in such a situation could be the solution? The answer lies with 'integrated medicine'. Integrated medicine means using alternative and complementary forms of medicine and therapies like ayurveda, homoeopathy, reiki, music therapy, colour therapy, acupressure, acupuncture, naturopathy, yoga and meditation in building a healthy lifestyle and maintaining an optimum state of functional health. These therapies are more preventive in nature and cost effective and can be intertwined with the lifestyle in such a way that an individual can accommodate it in his/her lifestyle and it gradually becomes a habit. This can reduce the cost burden on the individual's income and also the cost burden on health of the country making any country a healthier country with a better and productive workforce and would soon fulfill our dream of becoming a healthy globe with better quality of life and not just putting efforts at reducing global warming and saving the earth from its carbon footprint. Living and surviving The difference between living life and surviving life is very different. Surviving life means living life like corpses and blaming the world for all your problems, troubles and the like and giving credit of all your victories and all successes to yourselves and becoming more and more egoistic. Eating, sleeping, mating and defending are the most basic animalistic instincts. Rising above this is being human or homosapiens. Human beings are creators of their own future; a person himself/herself decides what he/she wishes to achieve in life, what is the vision or mission of his/her life. Dedicating life to a higher purpose beyond the needs of self and being a beacon of happiness and joy and contentment is a life lived in the most worth while manner as re-iterated by the wise and the great of all cultures across continents. The following words are a few quotes of Hippocrates: a) Let your food be your medicine and medicine be your food. b) We dig our graves with our knives and forks. c) Many dishes, many diseases. As per ancient Vedic scriptures human body is divided into three parts: 1) The outer physical or gross body (Sthula Sharira) - It consists of Annamaya and Pranamaya Kosha. 2) The middle subtle astral body (Sukshma Sharira) - It consists of Manomaya and Vijnanmaya Kosha. 3) The inner spiritual causal body (Karana Sharira) - It consists of Anandamaya Kosha. Anything that we consume through our five senses is food for our existence. It can range from the gross food and water that we eat or drink to the music we listen, to the newspaper or magazines we read to the air that we inhale, the odours that we smell or the quality of clothes we wear or air and sunlight that we take in through the skin is also food. The following are the factors, which play an important role in selection of food: A] Physical parameters Age Sex Height Weight Exercise or activity ratio Metabolic rate B] Mental parameters Taste Habit Life style Occupational C] Environmental factors Climate Resources - manpower and financial Cultural Social customs Availability Besides the metabolic needs of the body for growth and repair, the mind also creates needs of food where the body becomes a victim to the mind. The subtlest essence of food becomes the mind and affects our consciousness, emotions, cognition and experiential patterns. Our body is made up of five elements or Panchmahabhutas which are air, water, fire, earth and ether give rise to the three doshas which consist of Vata (ether+air), Pitta (fire+water), Kapha (water+earth). The three doshas are physiological units in all animate and inanimate forms. Vata rules the area in homosapiens below the umbilicus and is responsible for elimination of waste such as urine, faeces, menses, spermatic fluid and vaginal discharges. Pitta rules the area between the heart and the umbilicus and is responsible for the circulatory system and digestion. Kapha rules above the heart area and creates synovial fluid, saliva, mucous discharges in all sensory organs and creates lubrication for various joints. A yogic diet which is nutritious and sattvic causes development of air and ether (Vata) and hence causes increase in passage of flatus, abdominal bloating, belching and physometra. It causes detoxification of the body and also amplifies our psychological and cognitive capabilities, skills and talents because mind or brain and prana are composed of Vata. Hence ingestion of organic diet and frequent fasts or a diet of moderation causes a reduction of corporeal toxicity resulting in expansion of psychological and cognitive and intellectual capacities by increasing detachment and increasing the spiritual consciousness. Overcooked, processed, synthetic, artificially flavoured and coloured, spicy food disrupt the sensitive internal milieu and cause somatic and psychosomatic discomfort and disease. Our ancient scriptures traditionally classified food according to its effect on the mind using the three Gunas: 1) Sattvic - the quality of light, love and life 2) Rajas - the quality of activity, passion, lack of stability 3) Tamas - the quality of darkness, inertia, dragging us into ignorance and attachment. A sattvic diet aims purification, non-agitation, non-irritation, easy digestion and assimilation, elimination and activation. According to yoga our internal organs such as kidney, liver, heart are capable of functioning for 300 years, improper food intake and wrong lifestyle decreases their life span. Fasting (anshan) was advocated to relax and rejuvenate the digestive system and excrete foreign and undesired toxins from the body. Restrained eating (unodari) and forging the desire of the taste buds (ras parityag) are other ways of detoxifying mind and body through the body. The seven Dhatus which make the gross body are plasma (rasa), blood (rakta), muscle (mamsa), fat (meda), bone (asthi), marrow/nerves (majja) and sperm /eggs (shukra). Modern medicine or science has only been able to diagnose and devise tests and medicines to reach the annamaya kosha and the diseases classified by modern medicine are only of this kosha which is within the reach of the five senses. Pranamaya Kosha-Pana, Apana, Vyana, Udana, Samana, Upaprana are - Nag, Kurma, Krukal, Devdutta and Dhananjaya. Psychology describes conscious, subconscious and unconscious mind. In the conscious state it intakes information, in subconscious state it contemplates or processes the intake of information and in unconscious state it dreams. Mind, intellect and ego make the Antahkaran as per the scriptures. Positive thoughts make a persons' mind healthy and negative thoughts make a person a victim of psychosomatic disorders. Negative thoughts arise from the seeds of lust, anger, greed, clinging, and animosity, which are a part of the unconscious mind. Vigyanmaya Kosha consists of ignorance (avidya), craving (raag), aversion (dvesha), ego (asmita), abhinivesha (clinging to physical form or fear of death). Depending on the development of this kosha one either become a karmayogi, gyanyogi or bhaktiyogi and stops pursuing material pleasures and adventures. Most of the time Annamaya, Pranamaya and Manomaya Kosha are awake and Vigyanmaya and Ananadamaya Koshas are asleep. The health of the other four Koshas depends on the development and integration capabilities of Vigyanmaya Kosha. Classification of modes of treatment or therapies and the Koshas that they have an effect on: A} Annamaya Kosha - Hydrotherapy, nature therapy or naturopathy, dietetics, herbal medicine, batch flower therapy, chelation therapy, urine therapy B] Manomaya Kosha - Hypnotherapy, past life regression, emotional freedom technique, psychotherapy C] Pranamaya Kosha - Acupressure, acupuncture, Reiki, Shiatsu, Tai Chi, magnet therapy, physiotherapy, Feng shui, Vaastu, Aura clearing, Craniosacral therapy, Crystal healing D] Vijnanmaya Kosha - Neuro linguistic programming, rational emotive behavioural therapy, Music therapy, Colour therapy, Aromatherapy, Candle therapy, Psychoanalysis, Auto suggestions, Affirmations, Cognitive behavioural therapy E] Anandmaya Kosha - Zen meditation, homoeopathy F] Soul -Vipassana meditation (it is an abstract science. It can only be experienced and can neither be put into words nor taught. The purpose of practice of any spiritual science is enlightenment or moksha/mukti or union of individual consciousness with the cosmic consciousness and whatever corporeal benefits that are derived only byproducts). Aerobics, asanas, exercise techniques like gymnastics, swimming, cycling, jogging, dancing, shopping therapy, chocolate therapy, mantra yoga, laya yoga, tantra yoga, yantra yoga , mantra yoga, laughter therapy, massage therapy, art therapy, therapeutic astrology using stones, gems, donations, reading of certain scriptures are intertwining various koshas like manomaya kosha, vijnanmaya kosha and pranamaya kosha. Vipassana meditation produces the similar effects or results as gene therapy without the side effects and aggressive external intervention going against the laws of nature and universe. Disease /disorder understanding: Social and spiritual perspective 1) Genetic disorders/disabilities and congenital defects (Karma indriya vikaar i.e: five functional organs) - completely under the purview of Vipassana because they are acquired because of past life Karma. 2) Accidental or habitual disorders or disabilities (eg: myopia, deafness, or any other five sense disorders (i.e: gyanindriya vikaar) due to past life karma and this life karma - combined effect, controllable but not curable. 3) Psychosomatic disorders like diabetes mellitus-type II and essential hypertension, etc are again karmic in origin but can be controlled and even cured when the root causes, taints or afflictions (kleshas) are removed which are ignorance (avidya), ego (asmita), attachment, attraction or desire (raag), repulsion, grudge, spitefulness, malevolence or hatred or aggression (dvesha), fear of disease, suffering or death or clinging to corporeal life forms (abhinivesha), etc need Vipassana and some medications - mostly homoeopathy, naturopathy and ayurveda are best and major lifestyle changes are essential. Controlling their worsening is within our control by taking the right steps towards self evolution. 4) Infectious diseases - they are more related to lifestyle and environmental factors and originate from the same. This means nutritional status and physical, emotional, moral and social well-being. They are created by our karma in present life and can be altered and corrected by correcting the same. 5) Lifestyle diseases - media plays a major role in the development of such diseases across the globe. Here comes in the role of intake of information through eyes and ears, which can again be controlled and regulated by mature and informed, intelligent human action. Obesity, hypertension, diabetes, respiratory and oral disorders due to smoking and inhalation of toxic gases, addictions of any kind from internet and mobile addiction to substance abuse and its effects, alcohol consumption and its effects. Inculcating exercise and healthy habits and avoiding and evading psychological and psychosocial stressful events and factors, as it is the key to leading a healthy and happy life. As we have all noted the limited purview of modern medicine, the need of developing a wider perspective of health is the need of the century rather than the myopic view of medicine long held for healthcare professionals and policy makers across the globe. This call for the need of awareness and models for delivery where the patient's needs are understood and the correct treatment administered to save a well deserved productive life and facilitating it to reach its own higher calling. (The author is a consultant for Healthcare management and Holistic wellness)

 
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