1. Preventive medicine and Ayurvedic lifestyle
   • Types of prevention
   • Dinacharya
   • Dharaniya vegas
   • Food hygiene
2. Seasonal regimen (Ritucharya)
   • Aadan kala and Ritushodhana
   • Varsha ritucharya
   • Hemant ritucharya
   • Ritusandhi and Yamadamshtra kala
   • Classification of kaala
3. Ayurvedic nutrition and rejuvenation
   • Ushna jalapana
   • Rasayana classification and examples
   • Aahara and vihara
4. Modern nutrition
   • Vitamin A: functions, metabolism, deficiency disorders, and treatment of night blindness

1. All SAQs
2. Dinacharya LAQ
3. Ritucharya and Ritushodhana LAQs
4. Vitamin A LAQ

SAQs

a. Types of prevention

1. Primordial prevention
   • Prevention of development of risk factors in the community.
   • Example: Health education, promoting balanced diet, exercise, avoiding tobacco and alcohol.
2. Primary prevention
   • Done before onset of disease to prevent its occurrence.
   • Includes:
     • Health promotion: Proper diet, personal hygiene, exercise, Dinacharya, Ritucharya.
     • Specific protection: Immunization, safe water, sanitation, use of protective equipment.
3. Secondary prevention
   • Early diagnosis and prompt treatment to halt progression.
   • Example: Screening for hypertension, diabetes, anemia; early treatment of tuberculosis.
4. Tertiary prevention
   • Reduction of disability and rehabilitation after disease has occurred.
   • Example: Physiotherapy after stroke, rehabilitation of a disabled person, vocational rehabilitation.
5. Quaternary prevention
   • Prevention of unnecessary medical interventions and over-treatment.

b. Ushah Jalapana: time, quantity and benefits

• In Brahma muhurta or early morning.
• It should be taken on an empty stomach after evacuation of natural urges.

• About 1 to 2 glasses of clean, lukewarm or room-temperature water.
• Classical texts mention approximately 8 anjali of water; practically, the amount should be individualized according to age, digestion, season, and constitution.

• Helps bowel evacuation and prevents constipation.
• Improves digestion and appetite.
• Helps maintain hydration.
• Cleanses the gastrointestinal tract.
• Supports urinary function.
• May help in obesity, skin health, and general well-being when combined with proper diet and lifestyle.

c. Aadan kala and Ritushodhana in Aadan kala

Aadan kala

• Aadan kala is also called Uttarayana.
• It includes Shishira, Vasanta and Grishma ritu.
• During this period, the sun and wind become progressively strong and absorb moisture and strength from the earth and body.
• There is gradual increase in rukshata and decrease in bala.
• The predominant rasa are:
  • Shishira: Tikta
  • Vasanta: Kashaya
  • Grishma: Katu

Ritushodhana in Aadan kala

• In Vasanta ritu, kapha becomes liquefied and aggravated.
• Therefore, Vamana karma is advised for elimination of aggravated kapha.
• After Vamana, light diet, exercise, Udvartana, Dhumapana and Gargling may be advised according to the individual.
• Strong purification should generally be avoided in Grishma because body strength is low.

d. Aahara and vihara in Varsha ritucharya

Aahara

• Old cereals such as old rice, wheat and barley.
• Light and warm freshly prepared food.
• Sour, salty and unctuous food in moderate quantity.
• Vegetable soup, meat soup, pulses, curd preparation in moderation.
• Honey may be used in suitable quantity.
• Boiled and cooled water or medicated water.

• Excessively heavy, cold, dry and stale food.
• Excessive watery food and overeating.
• Untreated river water.
• Excessive leafy vegetables and foods that cause indigestion.

Vihara

• Stay in a clean, dry, well-ventilated house.
• Wear clean and dry clothes.
• Use perfumes, fumigation and protection from dampness.
• Gentle exercise and adequate rest.
• Keep body and feet dry.

• Day sleep.
• Excessive exercise, sexual activity and exertion.
• Exposure to rain, cold wind and damp environment.
• Walking barefoot in wet places.

e. Ritusandhi and Yamadamshtra kala

Ritusandhi

• Ritusandhi is the transitional period between two seasons.
• It includes the last 7 days of the ending ritu and first 7 days of the succeeding ritu.
• During this period, the regimen of the previous season should be withdrawn gradually and the regimen of the next season should be adopted gradually.
• Sudden alteration in diet and lifestyle can cause disease due to improper adaptation.

• Gradual change prevents dosha aggravation.
• Helps maintain agni, bala and immunity.
• Prevents seasonal diseases.

Yamadamshtra kala

• Yamadamshtra kala refers to the vulnerable period around seasonal transition, when diseases and complications may occur easily due to unstable environmental conditions and altered doshas.
• It is considered a period requiring strict observance of Ritucharya, proper diet, adequate sleep, and avoidance of incompatible food and excessive exertion.
• Special attention should be given to children, elderly persons, pregnant women and weak individuals.

f. Dharaniya vegas

Mental urges to be controlled

1. Lobha - greed
2. Shoka - grief
3. Bhaya - fear
4. Krodha - anger
5. Mana - excessive pride
6. Irshya - jealousy
7. Mada - intoxication or arrogance
8. Raga - excessive attachment
9. Dvesha - hatred
10. Matsarya - envy

Verbal and physical urges to be controlled

1. Harsh speech
2. False speech
3. Backbiting
4. Excessive speech
5. Violent acts
6. Stealing
7. Adultery or improper sexual conduct

g. Food hygiene

• Prevent food contamination.
• Prevent food-borne infections and food poisoning.
• Preserve nutritive value and quality of food.

1. Maintain personal hygiene of food handlers:
   • Hand washing, clean clothes, trimmed nails and covering hair.
   • Avoid handling food during illness, diarrhea, skin infection or respiratory infection.
2. Use safe water and raw materials:
   • Use potable water.
   • Wash vegetables and fruits properly.
   • Use fresh, unadulterated food.
3. Keep clean:
   • Clean kitchen, utensils, cutting boards and food-contact surfaces.
   • Protect food from flies, insects, rats and dust.
4. Separate raw and cooked food:
   • Use separate utensils and cutting boards.
   • Prevent cross-contamination from raw meat, eggs or vegetables.
5. Cook food thoroughly:
   • Especially meat, poultry, eggs and seafood.
   • Reheat cooked food adequately before serving.
6. Store food safely:
   • Keep hot food hot and cold food cold.
   • Refrigerate perishable foods promptly.
   • Avoid consuming stale or spoiled food.

h. Classification of Rasayana with examples

1. According to mode of administration

• Rasayana administered while staying in a specially designed kuti (cottage) under strict regimen.
• It is intensive therapy and gives maximum benefits.
• Example: Chyavanaprasha, Amalaki Rasayana, Brahma Rasayana.

• Rasayana taken while continuing normal daily activities, with suitable dietary restrictions.
• Easier and more commonly practiced.
• Example: Amalaki, Guduchi, Haritaki, Ashwagandha, Chyavanaprasha.

2. According to purpose

• Used to promote health and fulfill desirable aims.
• Types:
  • Prana-kamya: Promotes longevity, e.g., Amalaki.
  • Medha-kamya: Improves intellect and memory, e.g., Brahmi, Shankhapushpi, Mandukaparni.
  • Shri-kamya: Improves complexion and beauty, e.g., Amalaki, Bhringaraja.

• Used as an adjuvant in specific diseases.
• Examples: Guduchi in fever and metabolic disorders; Bhallataka Rasayana in skin diseases; Pippali Rasayana in respiratory disorders.

• Daily use of wholesome foods that maintain health.
• Examples: Milk, ghee, honey and a balanced nutritious diet.

1. SAQ 1(a): Types of prevention
   • Primordial, primary, secondary and tertiary prevention, with examples.
2. SAQs on Swasthavritta and seasonal regimen
   • Ushah jalapana
   • Aadan kala and ritushodhana
   • Varsha ritucharya
   • Ritusandhi and Yamadamshtra kala
   • Dharaniya vegas
   • Rasayana classification
3. SAQ: Food hygiene
   • Definition, objectives and practical measures for safe food handling.
4. LAQ: Dinacharya
   • Sequence according to Vagbhata
   • Brahma muhurta in modern life
   • Effects of early rising on sleep, health, alertness and memory.
5. LAQ: Hemant ritucharya
   • Features of the season, bodily effects and recommended aahara.
6. LAQ: Kaala classification and ritushodhana
   • Nityaga and avasthika kaala, plus seasonal purification for disease prevention.
7. LAQ: Vitamin A deficiency and night blindness
   • Identification of vitamin A
   • Metabolism, functions, deficiency disorders and treatment.

1. Preventive medicine and Ayurvedic lifestyle
   • Types of prevention
   • Dinacharya
   • Dharaniya vegas
   • Food hygiene
2. Seasonal regimen (Ritucharya)
   • Aadan kala and Ritushodhana
   • Varsha ritucharya
   • Hemant ritucharya
   • Ritusandhi and Yamadamshtra kala
   • Classification of kaala
3. Ayurvedic nutrition and rejuvenation
   • Ushna jalapana
   • Rasayana classification and examples
   • Aahara and vihara
4. Modern nutrition
   • Vitamin A: functions, metabolism, deficiency disorders, and treatment of night blindness

1. All SAQs
2. Dinacharya LAQ
3. Ritucharya and Ritushodhana LAQs
4. Vitamin A LAQ## SAQs

a. Types of prevention

1. Primordial prevention
   • Prevention of development of risk factors in the community.
   • Example: Health education, promoting balanced diet, exercise, avoiding tobacco and alcohol.
2. Primary prevention
   • Done before onset of disease to prevent its occurrence.
   • Includes:
     • Health promotion: Proper diet, personal hygiene, exercise, Dinacharya, Ritucharya.
     • Specific protection: Immunization, safe water, sanitation, use of protective equipment.
3. Secondary prevention
   • Early diagnosis and prompt treatment to halt progression.
   • Example: Screening for hypertension, diabetes, anemia; early treatment of tuberculosis.
4. Tertiary prevention
   • Reduction of disability and rehabilitation after disease has occurred.
   • Example: Physiotherapy after stroke, rehabilitation of a disabled person, vocational rehabilitation.
5. Quaternary prevention
   • Prevention of unnecessary medical interventions and over-treatment.

b. Ushah Jalapana: time, quantity and benefits

• In Brahma muhurta or early morning.
• It should be taken on an empty stomach after evacuation of natural urges.

• About 1 to 2 glasses of clean, lukewarm or room-temperature water.
• Classical texts mention approximately 8 anjali of water; practically, the amount should be individualized according to age, digestion, season, and constitution.

• Helps bowel evacuation and prevents constipation.
• Improves digestion and appetite.
• Helps maintain hydration.
• Cleanses the gastrointestinal tract.
• Supports urinary function.
• May help in obesity, skin health, and general well-being when combined with proper diet and lifestyle.

c. Aadan kala and Ritushodhana in Aadan kala

Aadan kala

• Aadan kala is also called Uttarayana.
• It includes Shishira, Vasanta and Grishma ritu.
• During this period, the sun and wind become progressively strong and absorb moisture and strength from the earth and body.
• There is gradual increase in rukshata and decrease in bala.
• The predominant rasa are:
  • Shishira: Tikta
  • Vasanta: Kashaya
  • Grishma: Katu

Ritushodhana in Aadan kala

• In Vasanta ritu, kapha becomes liquefied and aggravated.
• Therefore, Vamana karma is advised for elimination of aggravated kapha.
• After Vamana, light diet, exercise, Udvartana, Dhumapana and Gargling may be advised according to the individual.
• Strong purification should generally be avoided in Grishma because body strength is low.

d. Aahara and vihara in Varsha ritucharya

Aahara

• Old cereals such as old rice, wheat and barley.
• Light and warm freshly prepared food.
• Sour, salty and unctuous food in moderate quantity.
• Vegetable soup, meat soup, pulses, curd preparation in moderation.
• Honey may be used in suitable quantity.
• Boiled and cooled water or medicated water.

• Excessively heavy, cold, dry and stale food.
• Excessive watery food and overeating.
• Untreated river water.
• Excessive leafy vegetables and foods that cause indigestion.

Vihara

• Stay in a clean, dry, well-ventilated house.
• Wear clean and dry clothes.
• Use perfumes, fumigation and protection from dampness.
• Gentle exercise and adequate rest.
• Keep body and feet dry.

• Day sleep.
• Excessive exercise, sexual activity and exertion.
• Exposure to rain, cold wind and damp environment.
• Walking barefoot in wet places.

e. Ritusandhi and Yamadamshtra kala

Ritusandhi

• Ritusandhi is the transitional period between two seasons.
• It includes the last 7 days of the ending ritu and first 7 days of the succeeding ritu.
• During this period, the regimen of the previous season should be withdrawn gradually and the regimen of the next season should be adopted gradually.
• Sudden alteration in diet and lifestyle can cause disease due to improper adaptation.

• Gradual change prevents dosha aggravation.
• Helps maintain agni, bala and immunity.
• Prevents seasonal diseases.

Yamadamshtra kala

• Yamadamshtra kala refers to the vulnerable period around seasonal transition, when diseases and complications may occur easily due to unstable environmental conditions and altered doshas.
• It is considered a period requiring strict observance of Ritucharya, proper diet, adequate sleep, and avoidance of incompatible food and excessive exertion.
• Special attention should be given to children, elderly persons, pregnant women and weak individuals.

f. Dharaniya vegas

Mental urges to be controlled

1. Lobha - greed
2. Shoka - grief
3. Bhaya - fear
4. Krodha - anger
5. Mana - excessive pride
6. Irshya - jealousy
7. Mada - intoxication or arrogance
8. Raga - excessive attachment
9. Dvesha - hatred
10. Matsarya - envy

Verbal and physical urges to be controlled

1. Harsh speech
2. False speech
3. Backbiting
4. Excessive speech
5. Violent acts
6. Stealing
7. Adultery or improper sexual conduct

g. Food hygiene

• Prevent food contamination.
• Prevent food-borne infections and food poisoning.
• Preserve nutritive value and quality of food.

1. Maintain personal hygiene of food handlers:
   • Hand washing, clean clothes, trimmed nails and covering hair.
   • Avoid handling food during illness, diarrhea, skin infection or respiratory infection.
2. Use safe water and raw materials:
   • Use potable water.
   • Wash vegetables and fruits properly.
   • Use fresh, unadulterated food.
3. Keep clean:
   • Clean kitchen, utensils, cutting boards and food-contact surfaces.
   • Protect food from flies, insects, rats and dust.
4. Separate raw and cooked food:
   • Use separate utensils and cutting boards.
   • Prevent cross-contamination from raw meat, eggs or vegetables.
5. Cook food thoroughly:
   • Especially meat, poultry, eggs and seafood.
   • Reheat cooked food adequately before serving.
6. Store food safely:
   • Keep hot food hot and cold food cold.
   • Refrigerate perishable foods promptly.
   • Avoid consuming stale or spoiled food.

h. Classification of Rasayana with examples

1. According to mode of administration

• Rasayana administered while staying in a specially designed kuti (cottage) under strict regimen.
• It is intensive therapy and gives maximum benefits.
• Example: Chyavanaprasha, Amalaki Rasayana, Brahma Rasayana.

• Rasayana taken while continuing normal daily activities, with suitable dietary restrictions.
• Easier and more commonly practiced.
• Example: Amalaki, Guduchi, Haritaki, Ashwagandha, Chyavanaprasha.

2. According to purpose

• Used to promote health and fulfill desirable aims.
• Types:
  • Prana-kamya: Promotes longevity, e.g., Amalaki.
  • Medha-kamya: Improves intellect and memory, e.g., Brahmi, Shankhapushpi, Mandukaparni.
  • Shri-kamya: Improves complexion and beauty, e.g., Amalaki, Bhringaraja.

• Used as an adjuvant in specific diseases.
• Examples: Guduchi in fever and metabolic disorders; Bhallataka Rasayana in skin diseases; Pippali Rasayana in respiratory disorders.

• Daily use of wholesome foods that maintain health.
• Examples: Milk, ghee, honey and a balanced nutritious diet.Your paper is best divided into the following answer units:

1. SAQ 1(a): Types of prevention
   • Primordial, primary, secondary and tertiary prevention, with examples.
2. SAQs on Swasthavritta and seasonal regimen
   • Ushah jalapana
   • Aadan kala and ritushodhana
   • Varsha ritucharya
   • Ritusandhi and Yamadamshtra kala
   • Dharaniya vegas
   • Rasayana classification
3. SAQ: Food hygiene
   • Definition, objectives and practical measures for safe food handling.
4. LAQ: Dinacharya
   • Sequence according to Vagbhata
   • Brahma muhurta in modern life
   • Effects of early rising on sleep, health, alertness and memory.
5. LAQ: Hemant ritucharya
   • Features of the season, bodily effects and recommended aahara.
6. LAQ: Kaala classification and ritushodhana
   • Nityaga and avasthika kaala, plus seasonal purification for disease prevention.
7. LAQ: Vitamin A deficiency and night blindness
   • Identification of vitamin A
   • Metabolism, functions, deficiency disorders and treatment.

Section B: SAQs

1(a). Types of prevention

1. Primordial prevention
   • Prevents emergence of risk factors in the population.
   • Examples: health education, healthy diet, exercise, anti-tobacco measures, healthy school environment.
2. Primary prevention
   • Done before the onset of disease.
   • Health promotion: balanced diet, personal hygiene, exercise, Dinacharya, Ritucharya.
   • Specific protection: immunization, safe water, sanitation, food hygiene, use of protective equipment.
3. Secondary prevention
   • Early diagnosis and prompt treatment to stop disease progression.
   • Examples: screening for hypertension, diabetes, anemia and cancer; early treatment of tuberculosis.
4. Tertiary prevention
   • Limits disability and provides rehabilitation after disease occurs.
   • Examples: physiotherapy after stroke, rehabilitation after polio, vocational rehabilitation.
5. Quaternary prevention
   • Avoids unnecessary investigations, drugs and over-treatment.

1(b). Ushah Jalapana: time, quantity and benefits

Time

• Taken after waking in Brahma muhurta or early morning.
• Preferably after attending natural urges and before food.

Quantity

• About 1-2 glasses of clean water.
• Traditionally, 8 anjali water is mentioned.
• In practice, quantity should be adjusted according to age, digestive capacity, season and medical condition.

Benefits

• Helps proper bowel evacuation and relieves constipation.
• Maintains hydration.
• Improves digestion and appetite.
• Helps in proper urinary elimination.
• Supports healthy skin and metabolism.
• Promotes general health when combined with wholesome diet and lifestyle.

1(c). Aadan kala and Ritushodhana in Aadan kala

Aadan kala

1. Shishira ritu
2. Vasanta ritu
3. Grishma ritu

Features

• The sun and wind become progressively strong.
• They absorb moisture, unctuousness and strength from the body and environment.
• There is gradual increase in rukshata and reduction in body strength.
• The body becomes relatively dry and weak by Grishma.
• Predominant rasas are:
  • Shishira: Tikta
  • Vasanta: Kashaya
  • Grishma: Katu

Ritushodhana in Aadan kala

• In Vasanta, accumulated kapha liquefies and gets aggravated.
• Therefore, Vamana karma is indicated in a suitable person to eliminate aggravated kapha.
• After purification, light diet, exercise, Udvartana, Dhumapana and Kavala may be advised as appropriate.
• Strong purification should not be done in Grishma because body strength is reduced.

1(d). Aahara and vihara in Varsha ritucharya

Aahara

• Light, warm, freshly prepared and easily digestible food.
• Old rice, wheat and barley.
• Soup of pulses, vegetable soup and meat soup where suitable.
• Slightly sour, salty and unctuous food in moderation.
• Honey in suitable quantity.
• Boiled and cooled drinking water.

• Heavy, stale, cold and excessively dry food.
• Excessive liquid food and overeating.
• Untreated water.
• Food that causes indigestion, flatulence or kapha aggravation.

Vihara

• Reside in a clean, dry and well-ventilated place.
• Wear dry clothing.
• Use fumigation and protect oneself from dampness.
• Mild exercise and adequate rest.
• Keep the body and feet dry.

• Day sleep.
• Exposure to rain, cold wind and damp surroundings.
• Excessive exercise, sexual activity and exertion.
• Walking barefoot on wet ground.

1(e). Ritusandhi and Yamadamshtra kala

Ritusandhi

• It includes the last 7 days of the previous season and first 7 days of the next season.
• During this period, the regimen of the previous season should be discontinued gradually.
• The regimen of the succeeding season should be adopted gradually.
• Sudden changes in food and lifestyle may cause dosha aggravation and disease.

• Maintains equilibrium of doshas.
• Protects agni and bala.
• Prevents seasonal diseases.

Yamadamshtra kala

• Yamadamshtra kala is a highly vulnerable seasonal transitional period.
• It is traditionally described around the transition from Sharad to Hemanta, commonly as the last 8 days of Kartika and first 8 days of Margashirsha.
• Due to abrupt environmental change, people are more prone to disease and complications.

• Follow gradual seasonal adaptation.
• Avoid incompatible food, exposure to cold and rain, night awakening and excessive exertion.
• Maintain proper diet, sleep, hygiene and protection from climatic changes.

1(f). Dharaniya vegas

Mental urges to control

1. Lobha - greed
2. Krodha - anger
3. Shoka - grief
4. Bhaya - fear
5. Irshya - jealousy
6. Dvesha - hatred
7. Matsarya - envy
8. Raga - excessive attachment
9. Mana or mada - pride and arrogance

Verbal and physical urges to control

1. False speech
2. Harsh speech
3. Backbiting
4. Excessive or untimely speech
5. Violence
6. Stealing
7. Improper sexual conduct

1(g). Food hygiene

Objectives

• Prevent food contamination.
• Prevent food poisoning and food-borne diseases.
• Preserve the nutritive value and quality of food.

Measures of food hygiene

1. Personal hygiene of food handlers
   • Wash hands before cooking and eating, and after toilet use.
   • Keep nails short, wear clean clothes and cover hair.
   • Persons with diarrhea, skin lesions or infections should not handle food.
2. Use safe water and raw materials
   • Use potable water.
   • Wash vegetables and fruits thoroughly.
   • Use fresh, clean and unadulterated food.
3. Prevent cross-contamination
   • Keep raw and cooked food separate.
   • Use separate knives and cutting boards for raw meat and cooked food.
4. Cook food thoroughly
   • Cook meat, poultry, eggs and seafood completely.
   • Reheat stored cooked food properly.
5. Safe storage
   • Protect food from flies, insects, rodents and dust.
   • Refrigerate perishable food promptly.
   • Avoid stale and spoiled food.

1(h). Classification of Rasayana with examples

1. According to mode of administration

a. Kutipraveshika Rasayana

• Rasayana therapy administered while residing in a specially designed kuti under strict rules.
• It is an intensive method and gives maximum benefit.
• Examples: Amalaki Rasayana, Chyavanaprasha, Brahma Rasayana.

b. Vatatapika Rasayana

• Rasayana used while continuing daily life with proper diet and regimen.
• It is simpler and more commonly practiced.
• Examples: Amalaki, Guduchi, Haritaki, Ashwagandha and Chyavanaprasha.

2. According to purpose

a. Kamya Rasayana

• Prana-kamya: promotes longevity, e.g., Amalaki.
• Medha-kamya: promotes memory and intellect, e.g., Brahmi, Mandukaparni, Shankhapushpi.
• Shri-kamya: promotes complexion and beauty, e.g., Amalaki and Bhringaraja.

b. Naimittika Rasayana

• Used as an adjuvant in a particular disease.
• Examples: Guduchi in fever, Pippali in respiratory disorders, Bhallataka in certain skin disorders.

c. Ajasrika Rasayana

• Daily use of wholesome food and habits that preserve health.
• Examples: milk, ghee, honey and balanced nutritious diet.

Section C: LAQs

2(a). Dinacharya

i. Sequence of Dinacharya according to Vagbhata

1. Brahma muhurte uttishthate
   • One should wake during Brahma muhurta after adequate sleep.
2. Malotsarga
   • Attend to natural urges of urine and stool without suppression.
3. Dantadhavana
   • Clean teeth with a suitable herbal twig or toothbrush.
4. Jihva nirlekhana
   • Clean the tongue to remove coating and improve taste perception.
5. Gandusha and Kavala
   • Hold oil or medicated liquid in the mouth, or gargle.
   • Helps oral hygiene, strength of teeth and clarity of voice.
6. Anjana
   • Application of collyrium for eye care, as appropriate.
7. Nasya
   • Nasal instillation of suitable oil or medicine in indicated individuals.
8. Dhumapana
   • Medicated smoke inhalation only where classically indicated and under guidance. It should not be confused with tobacco smoking.
9. Abhyanga
   • Daily oil massage, especially to head, ears and feet.
   • Promotes softness of skin, strength and sound sleep.
10. Vyayama

• Exercise up to half of one's capacity.
• Followed by rest.

1. Udvartana

• Powder massage, especially useful in kapha and meda predominance.

1. Snana

• Bathing improves cleanliness, freshness and comfort.

1. Ahara

• Take wholesome food at the proper time, only after digestion of the previous meal.

ii. Concept of Brahma muhurta in the present scenario

• Brahma muhurta is traditionally considered approximately one and a half hours before sunrise.
• It is considered favorable for study, meditation, prayer, exercise and evacuation.
• In modern life, its practical use should be individualized.
• Early rising is beneficial only when a person obtains adequate sleep.
• Adults usually need about 7-9 hours of sleep regularly.
• Students, shift workers, elderly people and those with illness should not sacrifice sleep merely to wake before sunrise.
• A regular sleep-wake schedule, exposure to morning light and avoidance of late-night screens are more important than an exact clock time.

iii. Effect of early rising on health, sleep, alertness and memory

Health

• Helps maintain regular circadian rhythm.
• Allows time for bowel routine, exercise, breakfast and planning the day.
• May improve mood and daily discipline.

Sleep

• Early rising is beneficial only if accompanied by early sleeping and adequate sleep duration.
• Sleep deprivation causes fatigue, irritability, poor immunity and impaired performance.

Alertness

• Morning daylight helps synchronize the biological clock.
• A consistent sleep schedule can improve daytime alertness and reduce sleepiness.

Memory

• Adequate nighttime sleep is essential for memory consolidation and learning.
• Early-morning study may be useful due to fewer distractions, but reduced sleep harms attention, learning and memory.

2(b). Hemanta ritucharya

i. Features of Hemanta ritu

• Hemanta is the early winter season.
• It generally corresponds approximately to mid-November to mid-January.
• It is marked by cold climate, cold winds, mist or dew and shortened days.
• The environment becomes cold and relatively dry.
• It occurs during Visarga kala, when body strength is good.
• The digestive fire becomes strong because external cold prevents dissipation of body heat.

ii. Effect on the body

• Agni is strong.
• Appetite increases and heavy food can be digested better.
• If adequate food is not taken, the strong agni may consume body tissues and aggravate vata.
• Body strength is generally high in Hemanta.
• Skin may become dry due to cold and wind.

iii. Aahara in Hemanta

• Sweet, sour and salty food in suitable quantity.
• Unctuous, nourishing and warm food.
• Wheat, new rice, black gram and other nourishing cereals and pulses.
• Milk, ghee, oils, sugarcane products and milk preparations.
• Meat soup or meat of suitable animals for non-vegetarians.
• Warm water and warm beverages.

• Fasting and inadequate food intake.
• Excessive light, dry and cold food.
• Excessive exposure to cold wind.
• Cold drinks and food that aggravates vata.

2(c). Classification of kaala and Ritushodhana for prevention of diseases

Classification of kaala

1. Nityaga kaala

a. Day and night

• Dosha predominance changes during different parts of day and night.
• Kapha predominates in the early part, pitta in the middle part and vata in the later part.

b. Ritu or seasonal time

• Six seasons occur in a year:
  1. Shishira
  2. Vasanta
  3. Grishma
  4. Varsha
  5. Sharad
  6. Hemanta

c. Age

• Childhood: kapha predominance.
• Middle age: pitta predominance.
• Old age: vata predominance.

2. Avasthika kaala

• Stage of disease: onset, aggravation, complication and recovery.
• Stage of digestion: before food, during digestion and after digestion.
• Condition of doshas: accumulation, aggravation and alleviation.
• Time related to hunger, sleep, strength, seasons and individual constitution.

Importance of kaala

• It guides selection of diet, drugs, purification therapy, exercise and sleep.
• Following suitable regimen according to kaala prevents disease and maintains dosha equilibrium.

Ritushodhana for prevention of diseases

Principles

• Purification should be done only after assessing age, strength, agni, dosha, disease and season.
• Purvakarma, pradhana karma and paschat karma should be followed.
• It is contraindicated or postponed in very young children, frail persons, pregnancy, severe illness and other unsuitable states.
• Proper Ritushodhana may help prevent dosha accumulation, seasonal disorders and recurrence of disease.

2(d). Night blindness due to vitamin deficiency

Diagnosis

i. Metabolism of Vitamin A

1. Sources
   • Animal sources: liver, egg yolk, milk, butter and fish liver oil contain preformed vitamin A.
   • Plant sources: green leafy vegetables, carrot, mango, papaya and pumpkin contain beta-carotene.
2. Absorption
   • Absorbed in the small intestine along with dietary fat.
   • Requires bile salts and normal fat absorption.
3. Transport
   • Retinol is incorporated into chylomicrons and transported through lymphatics to the liver.
4. Storage
   • Mainly stored in the liver as retinyl esters.
5. Release and utilization
   • Released from liver bound to retinol-binding protein.
   • Retinal is required for visual pigment formation.
   • Retinoic acid regulates epithelial growth, differentiation and gene expression.

ii. Functions of Vitamin A

1. Vision
   • Essential for formation of rhodopsin in rod cells.
   • Necessary for dark adaptation and vision in dim light.
2. Epithelial integrity
   • Maintains normal epithelium of conjunctiva, cornea, respiratory tract, gastrointestinal tract and urinary tract.
3. Growth and development
   • Supports normal growth, bone development and cellular differentiation.
4. Immunity
   • Supports immune function and resistance to infections.
5. Reproduction
   • Has a role in normal reproductive function.

iii. Deficiency disorders

Ocular manifestations: Xerophthalmia

1. Night blindness or nyctalopia
2. Conjunctival xerosis
3. Bitot's spots
4. Corneal xerosis
5. Corneal ulceration or keratomalacia
6. Corneal scarring and permanent blindness

Extraocular manifestations

• Dry, rough skin and follicular hyperkeratosis.
• Growth retardation.
• Increased susceptibility to infections, particularly measles, diarrhea and respiratory infections.
• Reduced immunity.

iv. Treatment

Therapeutic vitamin A

• Vitamin A 200,000 IU orally immediately
• 200,000 IU on the next day
• 200,000 IU after 2 weeks to 4 weeks

Additional measures

• Give a diet rich in vitamin A and carotene:
  • Green leafy vegetables
  • Carrot, pumpkin, mango and papaya
  • Milk, egg yolk and liver where acceptable
• Treat associated diarrhea, measles, protein-energy malnutrition or malabsorption.
• Urgent ophthalmic referral is needed if there is corneal dryness, ulceration, pain or reduced vision.