Psychological Perspectives on Childcare in Indian Indigenous Health Systems

Malavika Kapur

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Psychological Perspectives on Childcare in Indian Indigenous Health SystemsWith a Foreword by B.V. Subbarayappa

Malavika KapurNational Institute of Advanced Studies Indian Institute of Science Campus BangaloreKarnatakaIndia

ISBN 978-81-322-2427-3 ISBN 978-81-322-2428-0 (eBook)DOI 10.1007/978-81-322-2428-0

Library of Congress Control Number: 2015937013

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In the West, the tradition of medicine owed a great deal to the new ideas and methods enunciated by the Greek savant, Hippocrates of Cos (b. 430 BCE), which set aside the then prevalent faith cure as well as superstitious healing prac-tices, and emphasised the importance of meticulous observation and inference of the causes of diseases. The Hippocratic approach was in the main related to its concept of the ‘four humours’, and the four ‘elements’ as well as their four pri-mary qualities, namely hot and cold, dry and moist, as expounded by an earlier Greek philosopher, Empedocles (c. 500–430 BCE). This tradition had undergone some modifications around the second century CE by the exposition of Galen of Pergamum (who lived mostly in Rome), who thought of the basic principle of life in terms of a spirit, or pneuma: natural spirit in the liver; vital spirit in the left ventricle, and the arterial animal spirit. The Galen–Hippocratic medical tradition held fort for nearly 1500 years in the West, but had to yield place in the eight-eenth century to the vibrant rationale of the scientific method in understanding the human physiology and the causes of diseases.

However, the Galen–Hippocratic ideas had already found new adherents among the Arabic men of medicine between the eighth and twelfth centuries, leading to what came to be known later as the Graeco-Arabic or ‘Unani’ medi-cine in the Eastern Islamic countries. The greatest authoritative text on the Unani system of medicine is Al-Qanun (Canon of Medicine) by Ibn Sina (980–1037), or Avicenna, of Bokhara, a Central Asian Muslim scholar who was a contempo-rary of the well-known encyclopaedic mind, Al-Biruni (973–1048). A century ear-lier came a great Arabic physician, Al-Razi (865–925), who lived in Baghdad and whose work under the name, Kitab al-Hawi, dealt with the Greek, Persian and also some aspects of Indian medicinal practices. This comprehensive treatise was trans-lated into Latin with the name Liber Continens by Moses Farachi in the thirteenth century, and it emerged as the torch-bearer of the medical tradition in medieval Europe.

In the East, Asian traditional systems of medicine, notably those of India, China, Tibet and Islamic Central as well as West Asia have not lost their sheen even amidst the advent and multi-dimensional practice of modern medicine and

Foreword

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surgery over the past century or more. On the other hand, not only have they carved a niche for themselves in their own regions but also some of their treat-ments have begun to find acceptance in several Western countries. The innate strength of the major Asian systems of medicine lies in their holistic approach towards body–mind harmony as part of their philosophic, triple-stranded man-spirit-cosmos view—the ‘outer’ man with his physiological system being in har-mony with his mind, the body–mind harmony being perfectly in tune with the spirit within, and all of them in equilibrium with the cosmos or the universe.

India has been the home of what may be termed as medical pluralism. Apart from the expanding and sophisticated curative practices of modern medicine and surgery, Ayurveda, Unani, Siddha, homeopathy, naturopathy, folk medicine as well as Tibetan and Chinese medical practices here and there, have been playing a sig-nificant role in the medical treatment of vast masses of the subcontinent. Ayurveda is an indigenous system with Indian philosophical roots going back to about the sixth century BCE, while Unani entered India from Islamic Central Asia around the thirteenth century CE, and received subsequently great encouragement from the Mughal rulers. The seed ideas of the Siddha system (mostly prevalent in Tamil Nadu and among Tamils) came from the Chinese Taoist philosophy and its yin (female) and yang (male) concepts, which developed perhaps around the sixth–seventh century CE. However, in course of time it also adopted the Ayurvedic con-cepts of five elements and three humours. The core ideas of Tibetan medicine too were influenced by Ayurvedic ideas and practices. Both the Siddha and the Tibetan systems have also the tantric as well as yogic imprint on their healing methods.

In a well-structured presentation in her book on childcare in the Indian health systems from a psychological perspective, Prof. Malavika Kapur has wisely brought out the basic principles of Ayurveda, Unani, Siddha as well as the Tibetan system and has critically examined them before she has discussed their ideas and practices of childcare, since they are of fundamental importance for understand-ing the latter. She has discernibly dealt with the developmental approach to child-care, diseases and disorders of childhood as well as their treatments according to the four systems, and thoughtfully reflected upon childcare across these systems. It may be noted that Ayurveda deals with eight specialities (ashtangas) of which kaumarabhritya (obstetrics, gynaecology, neonatology and paediatrics) is an important one. The Ayurvedic treatises, particularly the Kashyapa Samhita, shed light on mother and child care as well as the associated aspects. The other three systems, too, deal with them in their own manner. Prof. Malavika Kapur has dil-igently brought to the fore and discussed the approaches of the four systems to childcare and allied treatments as presented in their medical texts.

An admirable aspect of Prof. Kapur’s work relates to the perspectives from the standpoint of the psychology of child development as gleaned from the four systems. The last chapter rightly focuses on important issues which will be of great interest and concern to development psychologists, paediatricians and oth-ers involved in the care of disabled children. I have no doubt that this book, with

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its clear and precise expositions of childcare in all of its dimensions as conceived and practised in the four Asian traditional health systems, is a valuable addition to the extant literature on this fascinating subject. The comparative method of understanding systems of different thoughts and practices, as traversed by Prof. Malavika Kapur, is indeed an exemplary one.

B.V. SubbarayappaFormer President

International Union of History and Philosophy of Science (ICSU-UNESCO)

Retired Executive Secretary Indian National Science Academy

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Preface

The term ‘indigenous health systems’ in the title needs some clarifications. There are many indigenous healing traditions in India of great antiquity that include the folk healing traditions. In the present book four indigenous health systems are included. These are Ayurveda, Unani, Siddha and Tibetan medicine. These sys-tems come under the mandate of the Department of AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy), Government of India. AYUSH actively promotes research, practice and training in these systems. The author has not included homeopathy, which is included in the AYUSH umbrella and is widely practised in India. However, it is of recent German origin and obviously not indig-enous to India. On the other hand, Tibetan medicine is practised in some centres in India and owes its origin to Ayurveda.

As I got down to compiling the material for the four segments of the indig-enous healing systems of Ayurveda, Unani, Siddha and Tibetan medicine, I made an alarming discovery that I had no access to material due to my lack of knowl-edge of Urdu, Tamil and Tibetan languages. Fortunately, Ayurveda, as exemplified by the Kashyapa Samhita, has a vast number of texts translated into English. In the Unani and Siddha very little on paediatrics is available in English translation, while in Tibetan medicine none is available. As I started gathering the material I discovered that the narratives in the four systems varied a great deal. I stayed on with the original formats examining phenomenology, aetiology and treatment and found that prevention is the most important aspect in all the systems. The clas-sifications, unlike in modern medicine, were based on aetiological speculations. Though the systems emerged out of humoral theories as brought out by Ayurveda, language, religion, philosophy, geography, social and cultural influences modified the systems enough to mark them apart as separate systems. This was most appar-ent in the childcare systems.

First, the basic framework for each system, basic principles of care of adults is dealt with, albeit briefly. Second, the developmental approach to childcare focusing on normal development and, third, on the minor and major disorders, their phenomenology, aetiological speculations and treatment are discussed. The

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treatments are covered in a sketchy manner as this is not meant to be a self-help book for a lay reader.

As a developmental child psychologist it has been an interesting discovery for me to know that in the history of indigenous medicines, some of the greatest physicians were indeed child prodigies! Vriddha Jivaka, the scribe of Kashyapa Samhita, Ibn Sina in the Unani system, and several physicians in the Tibetan medi-cine were child prodigies.

I have presented the narratives as they emerged in each of the systems based on my reading and interactions with practitioners. If I were to make the style uni-form, it would have failed to highlight the richness of narratives in each of the systems. My most rewarding and touching experience in this exploration has been with Dr. Tenzin Lhundup, the young Tibetan lady physician who orally translated the Tibetan paediatric texts for me.

Malavika Kapur

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Acknowledgments

I am grateful to Dr. R.N. Dorjee and Dr. T. Lhundup of the Men Tsee Khang Branch Clinic, Bangalore for their compassion and generous sharing, Men Tsee Khang, Dharamsala (HP) for support through publications, museum, the con-ference in June 2013 and for the audience with His Holiness, the Dalai Lama. I am thankful to Dr. Siddiqui M.K. and his team at the National Institute of Unani Medicine, Bangalore for translating the paediatric section from Arabic/Urdu texts. Thanks also go to Drs. Svapna and Samir Sabnis, the paediatricians in my family; Dr. Shridhar B.N. Former Director, National Ayurveda Dietetics Research Institute Bangalore, for putting me in touch with key people who could help me, and for the generous use of the library; and Prof. Gilles Bibeau for his valuable input into the Unani section.

I greatly appreciate the efforts made by Rajalakshmi and Poornima Bhola in going through the manuscript through a fine toothcomb, slogging through lan-guage barriers, fuzzy sentences and elusive concepts—in short, sharing my own struggle in writing this book.

Professor B.V. Subbarayappa, a renowned scholar and editorial fellow of the Project on History of Science, Philosophy and Culture in Indian Civilisation (PHISPC), Centre for Studies in Civilisations, graciously wrote the foreword to this book and I owe him my deep gratitude.

Finally, I thank the anonymous Springer reviewer for the candid and critical com-ments that has led to greater clarity in the relevant sections.

Malavika Kapur

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Contents

Part I Indigenous Systems of Medicine

1 Introduction: Indigenous Healthcare Systems in India . . . . . . . . . . . . 31.1 Ayurveda . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71.2 Unani . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81.3 Siddha . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91.4 Tibetan (Buddhist) Medicine (Sowa Rigpa) . . . . . . . . . . . . . . . . . 9References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

2 Basic Principles of Ayurveda . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152.1 Some Key Concepts in Ayurveda . . . . . . . . . . . . . . . . . . . . . . . . . 16

2.1.1 Svasthya (Health) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162.1.2 Tridosha (Triad of Constitutional

Functional Correlates) . . . . . . . . . . . . . . . . . . . . . . . . . . 182.1.3 Triguna (Three Temperamental

or Personality Traits) . . . . . . . . . . . . . . . . . . . . . . . . . . . 202.1.4 Sapta Dhatu (Seven Basic Body Tissues) . . . . . . . . . . . 212.1.5 Vyadhi (Disease) and Its Aetiological Factors . . . . . . . . 22

2.2 Treatment of Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232.2.1 Chikitsa (Treatment of Disorders) . . . . . . . . . . . . . . . . . 24

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

3 Developmental Approach to Childcare . . . . . . . . . . . . . . . . . . . . . . . . . 313.1 Concept of Child Health in Ancient India . . . . . . . . . . . . . . . . . . 313.2 Childcare System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

3.2.1 Qualities of the Physician . . . . . . . . . . . . . . . . . . . . . . . 323.2.2 Embryology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 323.2.3 Development of the Foetus According

to the Charaka Samhita . . . . . . . . . . . . . . . . . . . . . . . . . 333.3 Diet of the Expectant Mother . . . . . . . . . . . . . . . . . . . . . . . . . . . . 353.4 The Emotional State of the Expectant Mother . . . . . . . . . . . . . . . 35

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3.5 Care of the Newborn Infant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 363.5.1 Bath . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 363.5.2 Cleaning of Oral Cavity . . . . . . . . . . . . . . . . . . . . . . . . . 363.5.3 Removal of Amniotic Fluid . . . . . . . . . . . . . . . . . . . . . . 37

3.6 Feeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 373.6.1 Normal Feeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

3.7 Physical Care of the Infant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 393.7.1 Psychological Care of the Infant . . . . . . . . . . . . . . . . . . 393.7.2 Importance of Play . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

3.8 Teething . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 403.8.1 Time of Teeth Eruption and Prediction . . . . . . . . . . . . . 403.8.2 Disorders of Dentition (Dantodbheda Roga) . . . . . . . . . 413.8.3 The Rites of Passage and Rituals . . . . . . . . . . . . . . . . . . 41

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

4 Disorders of the Newborn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 474.1 General Examination of Children. . . . . . . . . . . . . . . . . . . . . . . . . 47

4.1.1 Unconsciousness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 474.1.2 Ulvaka (Aspiration Pneumonia) . . . . . . . . . . . . . . . . . . 474.1.3 Upashiraska (Painless Swelling of the Head) . . . . . . . . 484.1.4 Complications of the Umbilical Cord . . . . . . . . . . . . . . 484.1.5 Nutritional Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

4.2 Abnormalities of Breast Milk and Their Management . . . . . . . . 494.3 Nutritional Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

5 Common Childhood Disorders and Treatments . . . . . . . . . . . . . . . . . . 555.1 Kashyapa (K.S.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

5.1.1 Characteristics of the Physician . . . . . . . . . . . . . . . . . . . 555.1.2 The Importance of Clinical Observation as a Tool . . . . 55

5.2 Prediction of Outcome Through Dreams in the Kashyapa Samhita . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 625.2.1 Developmental Stages in Childhood in Ayurveda . . . . . 635.2.2 Care of the Child . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

5.3 Fundamental Principles for the Treatment of Disorders in Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 655.3.1 Unwholesome Diet and Activities . . . . . . . . . . . . . . . . . 655.3.2 Diet of Incompatible Combination . . . . . . . . . . . . . . . . 665.3.3 Drinking Water at Dawn . . . . . . . . . . . . . . . . . . . . . . . . 665.3.4 Avoiding Exposure to Sun, Heat or Drafts of Air . . . . . 665.3.5 Dosages or Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

5.4 Treatment of Common and Uncommon Disorders in Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

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6 Serious Disorders of Childhood and Treatments . . . . . . . . . . . . . . . . . 716.1 Influence of the Grahas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86

Part II Indigenous Systems of Medicine: Unani Medicine (Altib)

7 Basic Principles of Unani System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 897.1 Origin of the Unani System of Medicine . . . . . . . . . . . . . . . . . . . 897.2 Fundamental Concepts in Unani . . . . . . . . . . . . . . . . . . . . . . . . . 90

7.2.1 Material Causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 917.2.2 Efficient (F’lia) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 917.2.3 Formal (Souriya) Causes in Health . . . . . . . . . . . . . . . . 927.2.4 Final (Tamamiya) Causes and Functions . . . . . . . . . . . . 92

7.3 Elements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 927.4 Temperaments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92

7.4.1 Temperament of Drugs . . . . . . . . . . . . . . . . . . . . . . . . . 937.4.2 Temperament of the Organs . . . . . . . . . . . . . . . . . . . . . . 93

7.5 General Description of Diseases . . . . . . . . . . . . . . . . . . . . . . . . . 937.5.1 The Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 947.5.2 Prevention of Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . 947.5.3 Therapeutics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95

8 Developmental Approach to ChildCare . . . . . . . . . . . . . . . . . . . . . . . . 978.1 Care of Pregnant Women in Unani Medicine . . . . . . . . . . . . . . . . 98

8.1.1 Signs of Pregnancy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 998.1.2 Diet and Supplements . . . . . . . . . . . . . . . . . . . . . . . . . . 998.1.3 Sleep and Rest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 998.1.4 Hammam (Bath) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 998.1.5 Dalak (Massage) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 998.1.6 Common Ailments of Pregnancy . . . . . . . . . . . . . . . . . . 100

8.2 Care of the Newborn Infant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1008.2.1 Care of the Umbilical Cord . . . . . . . . . . . . . . . . . . . . . . 1008.2.2 Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1008.2.3 Wet Nurse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1018.2.4 Swaddling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1018.2.5 Eyes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1018.2.6 Bathing and Skin Care . . . . . . . . . . . . . . . . . . . . . . . . . . 1028.2.7 Sleeping Quarters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1028.2.8 Weaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102

8.3 Care of the Child . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103

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9 Diseases of Children and Some Common Treatments . . . . . . . . . . . . . 1059.1 Teething . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1059.2 Diarrhoea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1059.3 Constipation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1069.4 Gingivitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1069.5 Infantile Convulsions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1069.6 Convulsions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1069.7 Rigidity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1079.8 Cough . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1079.9 Dyspnoea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1079.10 Stomatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1079.11 Ear Discharge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1089.12 Ear Ache . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1089.13 Meningitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1089.14 Conjunctivitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1089.15 Corneal Ulcer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1099.16 Fevers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1099.17 Colic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1099.18 Excessive Sneezing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1099.19 Multiple Boils . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1099.20 Umbilical Hernia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1109.21 Inflammation of the Navel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1109.22 Insomnia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1109.23 Nightmares . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1109.24 Hicoughs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1119.25 Excessive Vomiting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1119.26 Weak Digestion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1119.27 Inflammation of Throat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1119.28 Abnormal Snoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1119.29 Prolapse Ani . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1119.30 Dysentery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1129.31 Intestinal Worms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1129.32 Abrasions on Thigh . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114

Part III Indigenous Systems of Medicine: Siddha Medicine

10 Basic Principles of Siddha System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11710.1 Basic Principles of Siddha Medicine . . . . . . . . . . . . . . . . . . . . . . 119

10.1.1 Systems of Examination . . . . . . . . . . . . . . . . . . . . . . . . . 11910.1.2 Concept of Disease and Cure . . . . . . . . . . . . . . . . . . . . . 12010.1.3 Treatments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122

Contents xvii

11 Developmental Approaches to Childcare (Balavagadam) . . . . . . . . . . 12311.1 Qualities of a Physician . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12311.2 Embryology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12411.3 Description of the Paruvams for Male and Female Children . . . . 125References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127

12 Disorders of Childhood and Treatments . . . . . . . . . . . . . . . . . . . . . . . . 12912.1 Causes of Diseases of Origin (In Utero) . . . . . . . . . . . . . . . . . . . 130

12.1.1 Intrinsic Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13012.1.2 Extrinsic Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130

12.2 Clinical Manifestation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13012.2.1 Treatment (Internal) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13012.2.2 Thodam (Dhosham) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131

12.3 Common Features and Treatment . . . . . . . . . . . . . . . . . . . . . . . . 13112.3.1 Parvai Thodam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13212.3.2 Pul Thodam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13212.3.3 Etchi Thodam (Demoness) . . . . . . . . . . . . . . . . . . . . . . . 13212.3.4 Male Thodam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133

Appendix: Plants and Other Materials Used in Siddha Medicine (from Subbarayappa 2001) . . . . . . . . . . . . . . . . . . . . 138References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142

Part IV Indigenous Systems of Medicine: Tibetan Medicine

13 Basic Principles of Tibetan Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . 14713.1 Origins of Tibetan Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14713.2 The Basic Tantra . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149

13.2.1 Where the Medicines Come from . . . . . . . . . . . . . . . . . 14913.3 The Explanatory Tantra . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150

13.3.1 Types of Health and Disease . . . . . . . . . . . . . . . . . . . . . 15613.4 The Qualities of a Physician . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15713.5 Brief Description of 7 Parameters of the Human Body . . . . . . . . 159

13.5.1 Embryology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15913.5.2 Similes of the Body . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16013.5.3 Human Anatomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16113.5.4 Physiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16313.5.5 Action of the Body . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16413.5.6 Classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16513.5.7 Signs of Death . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165

13.6 The Human Body in Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16613.7 Treatment in Tibetan Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . 167References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168

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14 Developmental Approach to Child Care . . . . . . . . . . . . . . . . . . . . . . . . 16914.1 Embryology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169

14.1.1 Causes of Conception . . . . . . . . . . . . . . . . . . . . . . . . . . . 16914.1.2 Conception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17014.1.3 Signs of Conception . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17014.1.4 Instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171

14.2 Childcare in Tibetan Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . 17214.2.1 Neonatal Care up to One Year . . . . . . . . . . . . . . . . . . . . 17314.2.2 Childcare for Three Days of Birth . . . . . . . . . . . . . . . . . 174

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177

15 Common Childhood Disorders and Treatments . . . . . . . . . . . . . . . . . . 17915.1 History of Child Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179

15.1.1 Causes and Conditions . . . . . . . . . . . . . . . . . . . . . . . . . . 17915.1.2 Types of Disorders in Child . . . . . . . . . . . . . . . . . . . . . . 17915.1.3 Symptoms: General and Specific . . . . . . . . . . . . . . . . . . 18715.1.4 Treatments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188

16 Serious Disorders of Childhood and Treatments . . . . . . . . . . . . . . . . . 189Appendix: Some Plant-Based Treatments in Paediatric Practice . . . . . . . 193

Part V Gleanings from a Developmental Perspective

17 Gleanings from Ayurveda . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19717.1 Care of Newborn Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19717.2 Physical Features of the Child and Predictions . . . . . . . . . . . . . . 20217.3 Disorders of the Newborn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20217.4 Common Childhood Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . 20317.5 Serious Disorders of Childhood (Balagraha) . . . . . . . . . . . . . . . 20417.6 The Origins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208

18 Gleanings from Unani Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20918.1 Developmental Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20918.2 Origins of Unani Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21218.3 Developmental Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214

19 Gleanings from Siddha Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21519.1 Embryology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21519.2 Care of the Infant and the Child and the Developmental Phases . . . 216

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19.3 Childhood Disorders in the Developmental Context . . . . . . . . . . 21719.4 Treatments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221

20 Gleanings from Tibetan Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22320.1 History of Tibetan Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22320.2 Key Concepts in Tibetan Medicine . . . . . . . . . . . . . . . . . . . . . . . 22420.3 Time and Space Dimensions in Tibetan Medicine . . . . . . . . . . . . 22520.4 Developmental Context in Tibetan Medicine . . . . . . . . . . . . . . . . 22620.5 Childcare in Tibetan Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . 22620.6 Care of the Infant for the First Three Days . . . . . . . . . . . . . . . . . 22720.7 Naming Ceremony . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22720.8 Piercing of Ears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22720.9 Common Disorders of Childhood . . . . . . . . . . . . . . . . . . . . . . . . 22820.10 Under the Most Severe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 228References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231

21 Reflections on Childcare Across Systems . . . . . . . . . . . . . . . . . . . . . . . 23321.1 Qualities of a Physician . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23421.2 Embryology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23521.3 Care of the Mother and Child . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23621.4 Breast Milk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237

21.4.1 Feeding of Breast Milk . . . . . . . . . . . . . . . . . . . . . . . . . 23721.4.2 Quality of Breast Milk . . . . . . . . . . . . . . . . . . . . . . . . . . 238

21.5 Rites of Passage and Childcare . . . . . . . . . . . . . . . . . . . . . . . . . . 23821.6 Childcare Practices Across Systems . . . . . . . . . . . . . . . . . . . . . . . 24121.7 Scientific Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24321.8 Prognosis or Prediction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24421.9 Linkages to Folk Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24521.10 Highlights and Differences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 246References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248

22 Implications for Theory, Practice and Research . . . . . . . . . . . . . . . . . 24922.1 Ancient Practices and Concepts and Their Relevance

to Contemporary Psychology and Paediatrics . . . . . . . . . . . . . . . 25122.2 Holistic Approaches in the Indigenous Medical Practice . . . . . . . 25422.3 Child-Rearing Practices from the Indigenous

Systems to the Present Day . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25422.4 Developmental Perspective and Ancient

Child-Rearing Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25422.4.1 Age Context . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25522.4.2 Gender Context . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25522.4.3 Cultural Context . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255

22.5 Indigenous Practices and the Scientific Methodology . . . . . . . . . 256

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22.6 Indigenous Approaches and Social Context of the Time . . . . . . . 25622.7 Treatment Strategies in the Indigenous Systems . . . . . . . . . . . . . 25622.8 Straddling Western Psychology

and Ancient ChildCare Practices . . . . . . . . . . . . . . . . . . . . . . . . . 25722.9 Research in the Indigenous Systems . . . . . . . . . . . . . . . . . . . . . . 26022.10 Theoretical Constructs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26122.11 Linkages to Physician Qualities and Folk Practices . . . . . . . . . . . 26222.12 Need for a Paradigm Shift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26222.13 Research Methodology Suited to Indigenous Systems . . . . . . . . 26322.14 Treatment Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 263References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264

Erratum to: Disorders of Childhood and Treatments . . . . . . . . . . . . . . . . . E1

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About the Author

Malavika Kapur is a Visiting Professor at the National Institute of Advanced Studies, Bangalore. Earlier, she was the Professor and Head of the Department of Clinical Psychology at the National Institute of Mental Health and Neurosciences, Bangalore. She has a Ph.D. in Clinical Psychology and has 12 books and over 120 publications in peer-reviewed journals to her credit. She is a Fellow of the Indian Association of Clinical Psychologists and the Indian Association of Child and Ado-lescent Mental Health and the British Psychological Society. Recently, she has been honoured by the National Academy of Psychology with an honorary fellowship and a lifetime achievement award. She has been a consultant for organizations such as the World Health Organization, University Grants Commission, Government of India; the National Council for Educational Research and Training; National Insti-tute of Public Cooperation and Child Development; the Indian Council of Medical Research; and the Indian Council of Social Science Research. She has been twice awarded a scholar in residency at the Study and Conference Centre in Bellagio, Italy, by the Rockefeller Foundation. She has been on the advisory group of the ICD revision of child psychiatric disorders at the WHO Mental Health and Substance Abuse Division, Geneva, from March 2010.

Professor Kapur has deep interest in culturally embedded psychological assess-ments and interventions for children with mental health problems. She also works with disadvantageous school children in urban, rural and tribal areas to promote their psychosocial development, using child-centred play way methods. She writes fiction for adults and children and has recently published a fictionalised version of the Kashyapa Samhita as a novel.