chikitsa

sankeern arth mein, rogon se aakraant hone par rogon se mukt hone ke liye jo upachaar kiya jaata hai vah chikitsa (Therapy) kahalaata hai. par vyaapak arth mein ve sabhi upachaar 'chikitsa' ke antargat aa jaate hain jinse svaasthya ki raksha aur rogon ka nivaaran hota hai.

anukram

chikitsa (Therapeutics)

chikitsa, roganivaaran aur rogaharan ki ek vidhi evam kala tatha vaidyak ke mahatva ki ek shaakha hai. iske uddeshya svaasthyarakshan, roganivaaran, rogaunmoolan, rogon ke upadravon aur dushparinaamon ke niraakaran aur yadi niraakaran na ho to yathaashakti shaman hai.

praacheen greek chikitsakon ka kathan hai ""chikitsak chikitsa karta hai aur prakruti rogaharan karti hai"". rogon se bachane ki rogiyon mein shakti hoti hai, jisse dava na karne par bhi asankhya rogi neerog ho jaate hai. chikitsa aisi honi chaahiye ki vah rogaharan ki shaktiyon mein koi baadha na daale, varan usamein sahayog de. iske liye chikitsaakarm mein atyant vyagrata na dikhaani chaahiye aur na rogiyon ko naisargik shakti ke bharose hi chhodna, ya utsaahaheen chikitsa karni, chaahiye.

svaasthya ko banaae rakhana aur rog tatha mahaamaariyon ko utpann na hone dena rog nivaarak chikitsa (preventive therapy)ke antargat aata hai. rog ho jaane par uske naash ke liye ki jaanevaali chikitsa ko rogahaarak chikitsa (curative therapy) kehte hain. jab rogavijnyaaan, vikrutivijnyaaan, dravyagun vigyaan ityaadi vishyon ke samyak gyaan par chikitsa adhishthit hoti hai tab use yuktimoolak chikitsa (rational therapy) kehte hain. paramparaagat anubhav chikitsa ka aanubhaavik (empirical) chikitsa kehte hain. chikitsa rogahaarak (radical), laakshanik (nonspecific) ho sakti hai.

paribhaasha tatha pariseeman

chikitsa vigyaan falasamanvit aisa shaastr hai, jismein aise upaayon ke upayogon ka varnan hai jo lokasvaasthya tatha vaiyaktik svaasthya ki drushti se, shareer sambandhi sabhi avasthaaon mein aavashyak hota hai, jaise

  • (1) rogonmoolak tatha nivaarak,
  • (2) ghatna niyantrak tatha sudhaarak,
  • (3) abhaavapoorak,
  • (4) vikaarak tatha vikrut angon ke nishkaasak,
  • (5) kuroopata tatha asamarthata ke nivaarak,
  • (6) kshataangon ke pratisthaapak evam viklaangon ke punarvaasak aur vibhinn prakaar ki aantr yakshma tatha fuffus yakshma ki chikitsa tatha anya naidaanik kaaryon mein upayogi,
  • (7) sujanan, suposhan susantaan tatha parivaaraniyojan

chikitsa shikshan mein bhautiki, saankhyiki, rasaayan, vanaspati, praani tatha sookshmajeev vigyaan, maanaveeya shareerarachana, kaayiki-vikrutivijnyaaan, pratirkshan vigyaan, ityaadi pratyaksh:, tatha anya sabhi vigyaan parokshat:, sahaayak hote hain.

moolat: siddhaant par aadhaarit chikitsa ke teen prakaar hain : yauktik chikitsa (reshanal thiraipi), manodaihik chikitsa (psychophysical therapy) tatha aanubhavik chikitsa (Empiric therapy). yauktik chikitsa mein rog ke kaaranon evam rogi ke kaayik tatha maanasik parivrtanon ko samajhakar, gyaat prabhaav ki oshadhiyon athva saadhanon ka upayog kiya jaata hai. manodaihik chikitsa mein vishisht man:chikitsa aur vishvaasamoolak chikitsa donon sanmilit hain. pratham ke vistaaron mein naana prakaar ke manovishleshan vaividhya hai tatha doosare mein plaisebo (Placebo) sadrush nishprabhaav oshadhiyaaain aur jhaad-fooaink prabhruti prayog aate hain. aanubhavik chikitsa mein gyaat laakshanik prabhaavon ke bal par oshadhiyon ka prayog karte hain, kintu shareer mein dava kis prakaar kaam karti hai, isak pata naheen hota. chikitsa shabd ke saath vishesh saadhanon ke naam lagaane se vishesh oshadheeya prayogon ka bodh hota hai, jaise jalachikitsa, vidyuchchikitsa, daayatharmi (Diathermy) chikitsa aadi.

itihaas

shabd ke arth tatha itihaas ke anusaar yathesht kaal tak chikitsa keval rogon ko door karanevaale upachaaron ki sangruheet vidya thi. ismein saadhaaran shalyakarm aur prasavakarm tak ke liye koi sthaan naheen tha tatha lokasvaasthya ki to kalpana bhi asambhav thi.

ati praacheen kaal mein chikitsa ki neenv aise upachaaron par padi, jinmein rogaharan ke liye bhoot preton ki baadha ko door karna aavashyak samjha jaata tha. in upachaaron se shareer ki avastha athva uske ghaavon ityaadi ka koi sambandh naheen hota tha. kabhi-kabhi chikitsak anubhavasiddh oshadhiyon ka prayog bhi karte the. kaalaantar mein gyaat oshadhiyon ki sankhya badhti gayi aur jhaad fooaink ke prayog dheele padne lage. isa se 500 varsh poorv ke, misr desh sthit piraamidon se praapt "ibars paipaairas (Ebers Papyrus) naamak lekh aise hi samay ka prateek hai.

chikitsa mein pehla vyaapak parivartan buddhapoorv Bhaarat ki divodaas sushrut parampara dvaara hua. ismein oshadhiyon ke prayog ke saath saath shavon ke vyavachhedan se praapt gyaan ka upayog praarambh hua aur donon prakaar ki chikitsaaon ko ek hi pankti mein rakha gaya. is parampara ke prakhyaat chikitsakon mein buddhakaaleen jeevak ka naam ullekhaneeya hai, jinhonne shalyakarm aur vaidyak ko samaan mahatva dekar unhe poornat: samakaksh banaaya. iske pashchaat anek bhaaratetar deshon ne bhi shalyakarm ko chikitsa ka abhinn ang banaana aarambh kiya tatha isi prasang mein prasavakarm bhi chikitsa ke bheetar aaya.

isa poorv 460 varsh ke pashchaat vikhyaat chikitsak hipaakretij hue, jinhonne chikitsa ko dharmanirpeksh tatha paryavekshanaanveshanamukhi vyaapak vyavasaaya banaaya. misr ka sikandariya naamak nagar us samay is vidya ka kendra tha. yahaaain is parampara ko 200 varshon tak prashraya mila, kintu iske baad yeh lupt hone lagi. isa pashchaat 1400 varsh tak dharmaandhata ke praabalya ke kaaran vaigyaanik chikitsa ka vistaar naganya raha, kintu Europe ke punarjaagaran par vigyaan ki chaturdik vruddhi hone lagi, jisne chikitsa ko vishaalata di tatha vibhinnataaon ko hataaya.

chikitsa ki shaakhaaeain

praacheen kaal mein manushya sooryaprakaash, shuddh hava, jal, agni, mitti, khanij, vanaspatiyon ki jad, chhaal, patti aadi dravyon se anubhav ke aadhaar par chikitsa karta tha. inke gunadharm use maaloom na the. isi prakaar, rogon ka gyaan na hone se, ve rogon ke utpann hone ka kaaran devataaon ka kop samajhte the aur unhein prasann karne ka mantra-tantron se prayatn karte the. peechhe jaise jaise rogon ka gyaan badha, daivi chikitsa ka jor ghatata gaya aur aanubhavik chikitsa ka vistaar hota gaya. peechhe mairkeji (Mackenzie), kokh (Koch), eralich (Ehrlich) ityaadi ke parishram aur sookshm avlokan se aanubhavik chikitsaadravyon ki moolakata siddh ho gayi aur anek nae dravya aavishkrut hue. 20veen shataabdi tak chikitsa bahut adhik viksit ho gayi. aaj chikitsa ki anek shaakhaaeain ban gayi hain, jinmein nimnalikhit vishesh ullekhaneeya hain :

roganivaarak chikitsa

ismein svachhata, jalashodhan, moreepanaale ke paani aur mal ka vinaash, makkhi, machhar tatha rogavaahak anya keeton ka vinaash, rogiyon ko alagaaya jaana, visoochikaadi rogon ke teeke, trutijnya rogon ke liye truti dravyon ka vitran, yakshma, rati rog, garbhini striyon tatha baalakon ke liye nidaanikaaon (chinics), ki sthaapana, bachchon ke liye doodh ke vitranaadi ka samaavesh hota hai.

manashchikitsa (Psychotherapy)

maanasik vikaaron se utpann shaareerik vikaaron ke liye yeh chikitsa hoti hai. anek shaareerik rog maanasik chikitsa se door ho jaate hain. iske liye ishvar par shraddha rakhana, pooja paath par vishvaas rakhana, manorajannaarth gaayan, vaadan, ramya-drushya-darshan aadi man ko shaant aur prasann rakhanevaale upaaya achhe hote6m56hain.

aushadhi chikitsa (Drug therapy)

ismein vividh oshadhiyon ka sevan karaaya jaata hai. anek asaadhya rogon ki achook oshadhiyaaain aaj ban gayi hain aur nirantar ban rahi hain.

aahaar chikitsa (Dieto therapy)

anek rog, jaise madhumeh, brukkashoth, sthoolata, jatharabran ityaadi aahaar se sambandh rakhate hain. inka nivaaran khaadyon evam peyon ke niyantran se kiya ja sakta hai.

rasachikitsa (Chemotherapy)

ismein aise rasadravyon se chikitsa ki jaati hai jo manushya ke liye vishaile naheen hote, par rogaanuon ke liye ghaatak hote hain.

ant:sraavi chikitsa (Endocrine therapy)

ismein ant:sraav ya sanshlisht ant:sraav dvaara rogon ka nivaaran hota hai.

yaantrik chikitsa (Mechano therapy)

ismein maalish, kanpan, vividh vyaayaam, sveedeeya angaayaam (Swedish movement) ityaadi dvaara chikitsa hoti hai.

jeevachikitsa (Biotherapy)

ismein seeram, vaikseen, prativish ityaadi dvaara chikitsa hoti hai.

anya chikitsaaeain

inmein shalyakarm, dahan chikitsa, vidyudvaara chikitsa (Electro shock therapy), snaan chikitsa, vaayudaab chikitsa (Aerotherapy), sooryarashmi chikitsa, (Helio therapy) ityaadi aati hain.

chikitsa ki reetiyaaain aur praavidhiki

chikitsa ki sabhi kriyaaon ke aath vibhaag kiye ja sakte hain :

praathamik krutya

ismein taatkaalik ya sthitik nidaan, praathamik upachaar, chikitsa-kshetr-nirdhaaran, chhutahe rogiyon ka pruthakkaran ityaadi hain.

aspataaleekaran

ismein ghaatak tatha kathin rogon ke rogiyon ko uchit sthaan mein rakhakar jeevanaraksha ke aavashyak upaayon ke prayog, niyamit paryavekshan tatha prayog aur yantron ki sahaayata se nidaan ka prabandh kiya jaata hai. rogiyon ka aspataaleekaran unke ghar par bhi hota hai.

visankraman

sabhi prakaar ki shalyakriyaaon, injekshanon tatha prasav kaaryon ke poorv chikitsakon ki tvacha tatha haathon ko rogaanuviheen banaaya jaata hai. kate hue sthaanon mein shvaas tatha sparsh se rogaanuon ki pahuainch rokane ke liye shalyakaaron ka vishesh pahanaava, dastaane ityaadi pahanana aavashyak hota hai. lokasvaasthaya ke hitkaari upachaaron mein bhi vividh prakaar ke visankramanon ka bahut mahatva hai.

bheshajasevan

sheegra prabhaav ke liye vibhinn sthitiyon mein oshadhiyon ka uchit maatra mein tatha uchit reeti se sevan karaaya jaata hai. sevan ki saat prachalit reetiyaaain hain : aantretar (Parenteral) injekshan, mukh, praakrutik guhaaon, shvasanamaarg tatha tvacha dvaara aur kirnon tatha vikirn se. yaantrik bheshajasevan chh: prakaar ke hote hain : adhichrmeeya, ant:charmeeya, adhastvakeeya, shiraamaargeeya, maansamaargeeya tatha antarangagat. inmein se shiraamaargeeya aur antarangagat reetiyaaain bahut nikat hain tatha asaadhaaran sthitiyon mein prayukt hoti hain.

shastropachaar tatha hastakaushal

inke prayog rugn angon ko kaatkar nikaalne athva kuroopata ko sudhaarane ityaadi mein shalyakaaron dvaara tatha prasavakaaryon mein iske vijnyaon dvaara kiye jaate hain.

aarogyaankan

chikitsaadheen rogiyon ki saadhaaran reeti se, athva yantron ya prayogashaala ki sahaayata se, jaaainch kar unki avastha ka pata lagaate rahana chikitsa ka mahatvapoorn ang hai.

punarvaasan

nirog hue, kintu seemit saamarthyavaale logon evam viklaangon ke liye bhavishya mein svaasthyapoorn jeevanayaapan ke upaaya nishchit karna bhi chikitsa ka aavashyak ang hai.

chikitsoparaant sanparkasthaapan

aadhunik star ki poorn chikitsa mein neerog hue manushya se sampark rakh, usaki avastha ki jaankaari rakhana tatha aavashyak saavadhaani ke aadesh dena bhi sanmilit hain.

visheshajnyaata aur chikitsa parichaalan

pehle vaidyak, shalyakarm, tatha prasootividya pruthak-pruthak theen. baad mein inhein ek saath sootrabaddh kiya gaya. kintu gyaan ka vistaar aur takaneeki mein aashcharyajanak vruddhi hone ke kaaran, vartamaan kaal mein vishishtakaran (speshalaaijeshan) anivaarya ho gaya. fir bhi sankraman tatha vinsakraman ke vichaar, adyatan dhangon se oshadhiyon ke prayog, vishraam tatha vyaayaam ke prayog, vishraam tatha vyaayaam ke prayog ityaadi baatein sab rogon ya vikrutiyon ke upachaar mein ek se hi siddhaanton par aadhaarit hain.

chikitsa aur prakruti ki shakti

rog door karne mein prakruti ki shakti hi mukhya hai. hipaakreteej ke kaal se aaj tak roganivaaran ke liye chikitsak isi shakti ka upayog karte aae hain. ve aadhunik saadhanon ka tabhi prayog karte hain, jab vein dekhte hain ki prakruti ko sahaare ya sahaayata ki aavashyakta hai.

bhaaratamein prachalit chikitsa paddhatiyaaain

Bhaarat mein is samay chikitsa ki chaar paddhatiyaaain prachalit hain :

1. ailopaithik, 2. homiyopaithik 3. aayurvaidik aur 4. yoonaani.

angrejon ke Bhaarat mein aagaman ke saath-saath ailopaithik paddhati yahaaain I aur british raajyakaal mein shaasakon se protsaahan paane ke kaaran iski jad is desh mein jami aur panapi. aaj svatantr Bhaarat mein bhi is paddhati ko maanyata praapt hai aur iske adhyaapan aur anveshan ke liye anek mahaavidyaalaya tatha anven sansthaaeain khuli hui hain. prati varsh hajaaron daaktar in sansthaaon se nikalkar is paddhati dvaara chikitsaakaarya karte hain. desh bhar mein is paddhati se chikitsa karne ke liye aspataal khule hue hain aur uchch koti ke chikitsak unamein kaam karte hain.

angrejon ke shaasanakaal mein hi homiyopaithik paddhati is desh mein I aur shaasakon se protsaahan na milne ke baavajood bhi yeh panapi. iske adhyaapan ke liye bhi aaj anek sansthaaeain desh bhar mein khul gayi hain aur niyamit roop se unamein homiyopaithi ka prashikshan diya ja raha hai. angreji shaasanakaal mein yeh raajamaanya paddhati naheen thi, kintu ab ise bhi shaasakeeya maanyata mil gayi hai.

aayurvaidik paddhati Bhaarat ki praacheen paddhati hai. ek samay yeh bahut unnat thi, par anek shataabdiyon se musalmaanon aur british raajyakaal mein shaasakon ki or se protsaahan ke abhaav mein iski pragati ruk gayi aur yeh pichhad gayi. par iski jad itni gahari hai ki aaj bhi desh ke adhikaansh vyaktiyon ki chikitsa isi pranaali se hoti hai. Bhaarat ko svatantrata milne ke baad aayurved ke adhyayan mein shaasan ki or se kuchh protsaahan mil raha hai aur vaigyaanik aadhaar par iske adhyaapan or anveshan ke liye prayatn ho rahe hain.

yoonaani chikitsa paddhati musalamaani shaasanakaal mein I aur kuchh samay tak musalamaani raajyakaal mein panapi, par british shaasanakaal mein protsaahan ke abhaav mein yeh shithil pad gayi. fir bhi kuchh sansthaaeain aaj bhi chal rahi hain, jinmein yoonaani paddhati ke pathan paathan ka vishesh prabandh hai.

inhein bhi dekhein

baahari kadiyaaain

References