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    Treating Down Syndrome With The Help Of Ayurveda

    The presence of extra genetic material from chromosome 21 in some or all of an individual's cells can cause a genetic disorder called Down syndrome [1] . This disorder leads to a decline in one's cognitive ability. It also affects certain characteristic physical features. This disorder causes abnormalities in other body systems of the individual leading to high chances of vision problems, heart defects, ear infections, gastrointestinal problems, memory loss, thyroid dysfunctions and breathing difficulties [2] .

    Studies reveal that about 1 in 800 children are born with Down syndrome [3] . The age of the mother is one factor, among few others, that plays a role in determining the occurrence of Down syndrome in the child [4] .

    Syndrome

    On this 'World Down Syndrome Day', know how embracing an Ayurvedic approach can help in dealing with this disorder.

    What Causes Down Syndrome

    The nucleus of each cell in the human body contains DNA. This encodes the genetic information that one inherits from his or her parents. When additions, deletions or mistakes occur in DNA, it affects the cellular activity and can lead to problems on the organismal (highest level of organization) level. When extra genetic information is present, it leads to the observed symptoms that are associated with Down syndrome disorder [5] .

    The most common form of this disorder is known as Trisomy 21. This type is characterized by an extra copy of chromosome 21 in all cells in an individual's body [6] .

    Signs And Symptoms Of Down Syndrome [7]

    • Slow development
    • Distinct facial appearance
    • Decreased intellectual levels
    • Flat face
    • Broad forehead
    • Protruding tongue
    • Small head and ears
    • Short neck
    • Small hands and feet, tiny fingers
    • Speech impairment
    • Memory loss later in life
    • Breathing difficulties (due to muscle weakness)
    Syndrome

    Ayurvedic Interpretation Of Down Syndrome

    People in the olden days would dismiss disorders such as Down syndrome as insanity (Unmada) or possession by evil spirits (Bhutonmada), and thus classical Ayurvedic texts do not mention remedies for Down syndrome.

    However, modern-day Ayurveda recognizes this illness and classifies it under the Adhyatmika [8] branch of diseases (this kind includes ailments that show features relating to a spiritual cause, especially coming from a past life).

    It is mentioned by Ayurvedic experts that Adhyatmika disorders are basically known to affect one's intellect (Buddhi), learning capacity (Dhruti) and memory (Smruti). Adhyatmika diseases include several congenital and genetic disorders. In particular, the term Anuvamshika Roga [9] is used to refer to genetic ailments.

    Down syndrome can be categorized as Adhi Bala Pravrutta. This means that they occur before conception. The classical Ayurvedic text Charaka Samhitā states that the cause of Down syndrome is Karmaja (born out of effort) [10] . The belief lies in the fact that such diseases occur as a manifestation of Sanchitta Karma that gets accumulated from past lives. In Down syndrome, the patient will have a weak head (Manasmandyam - a term used for mental retardation) [11] .

    Syndrome

    Pathogenesis (Samprapti) Of Down Syndrome [12]

    • Vata Samprapti

    Vata (governs all movement in the mind and body) gets accumulated in the Purushavaha Srotas (in charge of excreting solid waste and absorbing glucose, minerals and liquid) and then overflows into the Rasa (primary waters of the body) and Rakta Dhatus (primary fire of the body). When there is low digestive Agni (digestive fire in the intestine), Samana Vayu (governs the stomach) will relocate to the Annavaha Srotas (channel for transportation, digestion and absorption of food). This causes malabsorption [13] .

    In the case of gastro-oesophageal reflux, there is an obstruction in the downward flow of Apana Vayu (governs the downward motion). This causes the Vata dosha to move upward. This brings the Pitta (governs heat, metabolism and transformation in the mind and body) contents of the stomach into the oesophagus [14] . The large intestine gets dried out when there is a downward flow of Vata caused by the Apana Vayu in the Rasa Dhatu of the Purishavaha Srotas.

    Vyana Vayu (oversees circulation and pulsation in the body) relocates even deeper into the Raktavaha Srotas (channels of circulation). Here, it affects the vascular tissue which has formed as an Upadhatu (sub-tissues of the body) of the Rakta Dhatu. When Udana Vayu (located in the chest) relocates into the Pranavaha Srotas (in charge of taking Prana into the body), it causes weakness of the respiratory muscles [15] .

    When Prana (life energy), Samana (aids in digestion and absorption of food) and Vyana Vayu (oversees circulation and pulsation) relocate to the Majja Dhatu (includes marrow and nerve tissue) and the Manovaha Srotas (channels responsible for mental functions), it results in memory loss and the inability to learn.

    When the body system is in the Manovaha Srotas, it leads to fear and anxiety. With the Down syndrome disorder, it gets difficult to separate the physiological roles of the brain (Majjavaha Srotas) and the mental functions (Manovaha Srotas). Vata provoking factors such as dry diet, lack of routine etc., can further exacerbate this genetic condition.

    • Kapha Samprapti

    In the case of Down syndrome, the imbalance caused in the Vata pushes the Kapha out of balance [16] . This results in the occurrence of Kapha symptoms. When Kapha relocates to the large intestine, it blocks Apana Vayu (governs the downward motion) causing gastro-oesophageal reflux. Kapha gets accumulated in the Annavaha Srotas, then overflows into the Rasa and Rakta Dhatus, and finally relocates into the thyroid gland.

    When secondary symptoms arise, Kapha begins to relocate into additional Srotas and tissues. Mucus build-up happens when Kapha relocates into the Pranavaha Srotas. This causes vitiation of the Avalambaka Kapha (governs the moisture of the stomach lining) resulting in the painless build-up of sticky fluid in the middle ear (called glue ear). When Kapha relocates into the Medas Dhatu (relates to sebum and the omentums), it causes obesity [17] .

    Treatment (Chikitsa) Of Down Syndrome

    Being genetic in origin, Down syndrome does not have a known cure. The root cause of this disease cannot be treated, however, therapies can be made use of to treat the symptoms that are associated with this disorder [18] .

    As the primary cause of Down syndrome is the vitiation of Vata, the treatment methodology should be based on building and strengthening abilities to increase the life energy (Prana) of the person.

    Ayurvedic drugs with Medhya properties (aims enhancement in strength, immunity, Ojas, will power and determination of the body along with optimum strength of physique and sense organs) can be used to treat the mental retardation symptom of this condition. Medhya drugs work by enhancing mental functioning abilities [19] .

    Studies reveal that compounds such as Ashtanga Ghrita and Ashtamangala Ghrita and also combinations of herbs such as Yasthimadhu, Guduchi, Mandukaparni, Shakhapushpi and Jyotishmati are highly effective in treating children with mental retardation.

    Children with learning disabilities can be helped with the use of herbs such as Kushtha, Guduchi, Shankhpushpi and Abhaya [20] .

    1. Herbal formulations

    • Brahmi [21] : This herb can improve mental functioning abilities by modulating neurotransmission. When the functions of the neural receptors are restored, the memory span is increased along with a decrease in anxiety. This herb also helps in correcting speech defects and improving concentration.
    • Research reports have revealed that Brahmi is capable of enhancing the protein activity and synthesis aspects, especially that of the brain. This results in an increase in longevity, intelligence and memory. Due to the presence of antioxidant properties, Brahmi serves as an anticonvulsant, a blood purifier, a muscle relaxant, a stress reliever, an antipyretic, carminative and digestive agent. This herb is highly efficient in pacifying all the three doshas.
    • Ashwagandha [22] : The roots of the Ashwagandha shrub can improve health by increasing mental activity and also by invigorating the body. Research says that many elements of Ashwagandha are antioxidant in nature. This property is responsible for facilitating cognition, increasing Ojas, resisting ageing and reducing inflammation. Studies reveal that this herb can enhance memory and increase the growth of the axons and dendrites of neurons.

    2. Enhancement of the nervous system

    • Treating dysfunction: Eating soaked and unpeeled almonds, black pepper and fennel seeds which have been sweetened with honey and butter shows wonderful results when eaten over a period of 15 days on empty stomach [23] .
    • Rejuvenation and detoxification: When equal quantities of Gaduchi, Brahmi and Ashwagandha are taken twice a day along with ghee, hot water and honey [24] , one can see drastic improvements in the overall wellness of the system.
    • Calming and strengthening: Jatamansi, Shankpushpi and Brahmi [25] need to be combined in equal quantities. Consuming half a teaspoon of this mix can be quite beneficial for health. Vacha can also be added to this mix.

    3. Meditation

    Meditation is known to clear the mind and increase Prana (energy) [26] .

    • Pranayama [27] : The techniques used here move Prana, thus increasing the availability of Prana for the functions of the body. Alternate nostril breathing (Anulom Vilom) is suggested for Down syndrome. This provides a balancing effect on the flow of Prana, in turn increasing the qualities of fire and water.
    • Panchakarma [28] : This therapy cleanses and rejuvenates the body. Apart from detoxifying the cells in the body, this therapy also allows an individual to gain insight into his or her true consciousness.
    • Abhyanga [29] , Shirodhara [30] and Swedhna [31] (Bliss Therapy) : These therapies calm the mind and allow disturbances to subside. When these therapies are combined with an Ayurvedic diet, all the present obstruction (between the patient's individual awareness and universal consciousness) is removed. The mind is strengthened through the oil therapy of Shirodhara.
    • Basti [32] : Hrud Basti can nourish, strengthen and regulate heart functions. This is therefore useful to deal with congenital heart problems that are common in children with Down syndrome.
    • Nasya (using Brahmi Ghee) [33] : When Nasya is performed using Brahmi Ghee, the nasal passages and sinuses are cleared. Nasya is best used for treating diseases of the head. This is because of the therapy's ability to make a direct action on the brain and Prana. Nasya is known for its ability to maximize the absorption of Prana.
    Syndrome

    4. Colour therapy [34]

    Ayurveda believes in using the energies that are constitutional of the colours of the spectrum. This serves to restore balance. Each colour of the spectrum is associated with specific healing properties. Using various colours for calming the nervous system, providing clarity, promoting communication and acquisition of knowledge has been proven to be quite beneficial in treating Down syndrome patients.

    • Violet, indigo and green are used to calm the nervous system
    • Yellow works as a sensory stimulant. This also enhances clarity and wisdom
    • Blue is associated with communication and knowledge acquisition

    Patients are usually wrapped in coloured cloth which is ideal for their therapeutic purpose. Few experts choose bathing the patient in a colour-filtered light source in order to enhance the healing effects of the treatment. Another technique used is to treat the water with the colour and then drink the water in order to attain its healing properties.

    5. Marma Therapy [35]

    Pressure is applied to the sensitive energy points in the body. This technique is known as Marma and is considered a therapy that harnesses energy. This therapy works brilliantly in clearing blocked energy channels (Strotas) and pacifying Vata and Vyana Vata. Marma therapy is considered a promising remedy for the treatment of people with Down syndrome as this disorder is primarily caused by Vata vitiation.

    This therapy focuses on activating the subconscious mind by permitting deep reprogramming that helps the individual connect in a better way with the world around them.

    6. G-Therapy [36]

    Homeo-biochemic formulation therapy (G-therapy) combines homoeopathic formulation techniques and body salts with Ayurvedic herbs. G-therapy has been successfully used in over 1,799 children with various mental and learning disabilities. It is believed that the body salts bring the required changes in neurotransmission, whereas the herbal extracts work as a catalyst.

    7. Rejuvenation (Rasayana) therapies for Down syndrome

    Rejuvenation or Rasayana therapies are meant to build the Ojas and healthy Rasa in the body [37] . Brahmi-based mixtures can be used to perform Rasayana therapies.

    • Aromatherapy [38] - Sattvic form of aromatherapies performed using rose or sandalwood can calm and clear the mind.
    • Mantra therapy - Mantras that calm the mind (such as 'om' or 'sham') facilitate clearing of the mind [39] . This therapy is particularly important for pacifying the Udana Vayu.
    • Diet - Mental Ojas can be increased through a Sattvic diet. This also helps in balancing the doshas. Dry, light and cold food aggravates Vata and hence should be avoided.

    To Conclude...

    Down syndrome is predominantly a disorder wherein the Vata is vitiated and the Kapha is pushed out of balance. This makes this disorder a dual doshic condition. To manage this disorder, the lifestyle changes should be such that it focuses on pacifying the Vata and Kapha doshas.

    Being a genetic (karmic) disease, Down syndrome cannot be cured completely. However, the steps mentioned above can be used to alleviate the effects of the multiple symptoms that are common with such patients.

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    Story first published: Thursday, March 21, 2019, 9:00 [IST]
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