Work in progress:
Musical Medicine and case based reasoning around Raga Bahudari a lecdem in musical and medical cognition
The different cases are contained in this musical melange by Sindhusha
vocalized by her in an engaging manner here: https://youtu.be/mYkOQ9qccDM
The first... minutes from... to... is alapana aka the introduction to the learning objectives of the presentation followed by:
Alapana (Introduction and also abstract with learning objectives)
Aa aaa re ne re naa
We shall be presenting a few cases that apparently appear to have a common diagnosis where their life events reflect similar frequencies spread out and recurring in a similar scalar as well as vectoral pattern over time.
The pattern verbalized by Sindhusha is called raga Bahudari and the disease pattern is anatomically round the serosal covering of our abdominal and thoracic viscera that embryologically originate from an intraembryonic coelom and often associated with a notorious and infamous microorganism discovered in 1882 and awarded a Nobel Prize in 1905 around 50 years after the death of Thyagaraja and the first case being rendered by Sindhusha here through Thyagaraja's musical score and lyrics is a classic presentation of the disease.
All the lyrics of the first case by Thyagaraja is quoted (aka borrowed and stolen) from Mr Shiv Kumar here:
Right after the alapana Sindhusha chooses to sing the anupallavi introducing the case.
"Anupallavi:
Sri Vasudeva! Andakotla Kukshini Yunchukoleda? Nannu"
Literal translation:
"Sri Vasudeva! Have you not absorbed and preserved (“yunchukoleda”) the entire cosmos (“kukshini”) within your stomach (“Andakotla”)
Medical translation:
"Vasudeva, a 60-year-old retired farmer started experiencing gradual distension of the abdomen (andakotla) since last 3 months along with low grade fever and significant weight loss.
More here:
"Pallavi:
Brova Bharamaa? Raghuraama!
Bhuvanamella Nivai Nannokani"
Literal translation:
"Raghurama! You are the omnipresent Prop (“Neevu”) of the sprawling (“ella”) world (“bhuvana”). Will protecting (“Brova”) this frail (“nann Okkani”) Tyagaraja prove an intolerable burden (“Bhaaramaa?”) on you"
Medical translation:
Vasudeva starts looking inward at another of his anonymized virtual avatars called "Raghurama" and asks the avatar for his support to resolve his current problem.
Charanam:
Kalashaambudhilo Dayato Namarulakai Yadigaaka
Gopikaalakai Konda Lettaleda ? Karunaakara Tyagarajuni
Literal translation:
Did you not kindly (“dayato”) to support the Mandara mountain under the ocean on behalf of the celestial (“Namarulakai”) during the churning of the ocean (“kalashambudhilo”) for nectar?
And did you not (“leda”) lift (“Letta”) the Govardhana hill (“konda”) to protect Gopis and cows. Ocean of mercy!
And did you not (“leda”) lift (“Letta”) the Govardhana hill (“konda”) to protect Gopis and cows. Ocean of mercy!
Medical translation:
He was investigated and an ascitic tap initially revealed straw colour fluid with ascitic fluid biochemistry, suggesting an exudate, and ascitic fluid cytology revealing lymphocytic pleocytosis.
He was sent home on presumptive antitubercular therapy with an official document that would help him to receive directly observed therapy (DOT) from his local health centre. He was lost to our follow-up and on recent questioning admitted that he had not taken antitubercular therapy as his ascites had subsided spontaneously. However, he admitted to a continuing low grade fever. When he finally returned 2 weeks later he related that he had developed sudden abdominal distension one week previously. Repeat ascitic tap revealed a milky fluid.
An ultrasound done soon after revealed multiple enlarged rounded mesenteric lymph nodes, few of which were conglomerated. Ultrasound guided FNAC from the lymph nodes showed acid fast bacilli on Ziehl–Nielsen stain. The patient was started on antitubercular therapy again with the DOT program and this time we will follow him up more meticulously to ensure compliance.
