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Human Hair and Modern Science

Kundan Singh

During the last few decades, science has made tremendous impact on the thinking and living habits of human beings. Every event is interlinked with several others and influences life in several ways. Modern scientific discoveries have dealt a severe blow to old traditions of human race, especially the religious beliefs. We often forget that man is only an investigator of the universe, whereas the creator is someone else. Whatever human beings have accomplished, they have done only by using the pre-existing materials and have themselves created nothing new. Almightly God has created everying in this universe by applying highly subtle and perfect principles which are not understood to a great extent by humans. So, He has created such a perfect and complete human body in which nothing is superflous or unwanted.

Many a Sikh youth have miserably failed in maintaining their traditional shape due to lack of preaching, predominance of western influence and senseless pursuit of fashion. It is a cause of constant worry for devout Sikhs here and abroad. Thus far, the human hair has been the victim of fashion’s fun and fury. All this has happened due to ignorance about the usefulness of hair that has been revealed by modern science, and one gets convinced that science has rather been confirming the truthfulness of instructions issued by the Sikh Gurus through sacred revelation (Gurbani) hundreds of years back, which needs to be explained in a separate write-up.

Guru ji ordained the Sikhs to maintain unshorn hair, and strictly prohibited their removal, because Guru ji knew the usefulness of hair and considered it to be a gift of Almighty to human beings. Guru ji has mentioned that only whatever is seen by him is revealed in Gurbani, as is evident from the stanza below:

sMqn kI suix swcI swKI ] so bolih jo pyKih AwKI ]

Guru Granth Sahib, p. 894

Recently several articles have been published about the philosophical aspects of human hair including ones written by S. Sarup Singh Alag, Dr Chanda Singh and several other authors and one whole issue has been devoted to this topic in the Sada Virsa Sada Gaurav. But here an effort has been made, mainly to highlight the modern scientific findings. Another point needs a bit of discussion here. Some people contest that if we carry full grown hair why should we trim our nails which are also mother Nature’s gift. Wear and tear is a constant process going on in the body. Even epithelium (superficial layer) of skin is being perpetually shed off, so are the hair. For removing various dead parts of the body, different methods are adopted. We remove non-living nails only and no one trims the living ones. Similary we comb out the shed off hair.

Philosophical background
There has been a definite link between spiritualism and growth of hair. Almost all the prophets (men of God) had full grown hair and beards, as is evident from contemporary writings and paintings. Hinduism is one of the oldest religions of the world, and the ancient Hindus bore unshorn hair. Hair flowing over the shoulders indicated priests called Brahmans. Hair locks twirled over the head were a symbol of soldiers or Kashatryas. Sacred Ganges flowed from the heavens into the luxuriant hair (Keshas) of Lord Shiva to reach the earth. There are stories that Hindus were forced to part with their hair. During recent times, noble laureate Rabindra Nath Tagore, Guru Golwalkar and many Rishis are other examples. Lord Budha’s paintings depict his hair and beard. A great power was vested in the hair of Samson. Prophet Mohammad’s hair is preserved as a relic in a Mosque in Srinagar. Jewish priests also grow hair and beard.

Unshorn hair is a part and parcel of Sikh personality. There are many references to this fact in holy Sri Guru Granth Sahib, viz.,

nwpwk pwku kir hdUir hdIsw swbq sUriq dsqwr isrw ] (pMnw 1084)
sy dwVIAW scIAw ij gur crnI lgMin@ ] (pMnw 1419)

Kes, Kesha’s or full-grown hair all over the body is one of the five “K's”, or external symbols of every Sikh. Guru Gobind Singh Ji held the hair in great esteem and ordained:

fjj? w'o nkfrnk ;[B' j/ fgnko/ ..
fpBk s/r e/;/ fdt' B dhdko/ ..

This is my order, listen O ! dear ones: Do not show me your face without sword and hair.

When Guru Gobind Singh Ji left the fortess of Chamkaur, during a serve winter night, he decided to go barefooted, since many Sikhs had fallen martyrs in the battle field and in the darkness, Guru Ji did not want to commit the sacrilege by treading over martyrs’ hair with his shoes on, though Guru Ji had to undergo a great hardship in passing through jungle bare-footed. In olden times philosophers, men of wisdom and even scientists grew hair and beard. Sayyed Waris Shah, a respected Punjabi poet has described the moustaches and beard as symbols of self respect and wisdom, respectively:

fpBk Fow w[Sk, fpBk neb dkjVh fpBk sbp c"iK, Gowku Bkjh ..

Dignity without mustachios, wisdom without beard, army without wages, do not look impressive.

Growing beard and moustache in one form or the other has been the liking of soldiers and warriors all over the world. Interested readers may refer to Reynolds book entitled “Beards”.

Attempts have been made to explain the functions of hair on different parts of the body as indicators of age and maturity, and distinguishing features between male and female. Hair on the scalp and beard afford protection against injury, heat and cold. Those in the nostrils and eye lashes protect against dust and other environmental pollutants.

Reynold (1950) has quoted from other authors that most shaven men lose their teeth before time, or at least suffer from toothache (p. 699), also shaving has been said to weaken a man physically and prove injurious to his health. This author has further quoted an American correspondent reporting a higher death rate in shaven men than the ones with beards, and has advocated that insurance compaines should consider this point (p. 273).

Despite all this, the hair has generally been considered as a superfluous appendage. But modern scientific investigations have brought out the importance of hair much more clearly than ever before.

Hair as Diagnostic Material
A number of studies have revealed interesting relationship between trace element metabolism of the body and its concentration in hair and also with several diseases in human beings. Hair analysis has become an established method in clinical pathology and Medical jurisprudence (Klevay), 1972). He has stressed the advantages of using hair as a biopsy material for clinical and epidemiological studies. This material has not been exploited to its full potential, since many workers have attempted to correlate the concentration of certain elements in human hair with environmental exposure. Only a few have attempted to identify the factors that influence the concentration of these elements in hair. Human hair is a potentially reliable index of trace mineral nutritional deficiencies, sufficiencies and toxicity, and the use of hair for this purpose has been a subject of a number of recent reports (Hambidge et al 1972). Hambidge and Baurn (1972) have claimed that their investigations have provided a strong evidence for potential value of hair chromium determinations as index of chromium nutritional status. Lazar (1974), while serving a note of caution, has remarked that hair could be more useful diagnostically, provided analysis was done under standard conditions. Need for elimination of physica1 and chemical factors like waving, straightening, dyeing, bleaching, hair tonics and spraying before analysis has been stressed.

Trace elements occur in the body in very low concentrations (less than 0.1% of body weight). Despite their such low concentrations, many of them have important effect on functioning of different body systems, and are known to be essential for human health, while others, even in trace concentrations, are harmful. An excess or a deficiency of any trace element can be wholly or partly responsible for a number of disorders. Thus, it is important to accurately determine the trace element levels in the body. Modern techniques have made it possible to determine accurately the concentrations of trace elements as low as 0.1 ppm or even less. To obtain representative picture of trace element status it must be decided as to which part of the body should be taken as a specimen.

The main sources are blood and urine (Laker, 1982). These two methods reflect body trace element status over different scales of time. Concentrations in blood are transient, related to supply of trace elements during previous hours or days, offering information on immediate levels. Urine gives information only about what the body has lost but not about the amount retained. Hair on the other hand takes up certain trace elements and retains them providing a lasting record of their levels over the previous few months.

Traditionally people have relied on blood for sampling which is acceptable for trace elements like zinc giving information about the amount available for immediate use. For elements as heavy metals, where cumulative intake needs to be known, blood gives very little information. Similar arguments apply to testing for arsenic and mercury. When a factory released some arsenic compound into a residential area, it was sometime before residents were examined and blood levels had declined to normal, but hair has been successfully used to determine the presence of those contaminants, and blood has been found to be a less reliable index of exposure to Mercury or Arsenic than hair. Several workers have emphasized that blood is of no help in determining trace elements, and even other elements are inadequately represented by blood analysis. In view of above stated difficulties limitations of using blood as a specimen are clear, hair provides a good and reliable alternative. It offers following advantages and provides better assessment of normal trace element concerntrations, because short-term variations are averaged out.

1. By taking, different lengths of hair equal to a few weeks or months and measuring bulk concerntrations which can be averaged and concentration over that period may be found.

2. Hair offers a good way of discerning long-term variation in trace element concentration. This may be done by measuring the variations alongwith the length of hair equal to several months, or by taking samples periodically, say monthly. This approach has been used successfully to demonstrate cases of abnormal zinc metabolism in pregnant women who subsequently gave birth to spina bifida children and alleged poisoning of Napolean Bona Parte by periodic doses of arsenic.

3. The concentrations of most trace elements are relatively high in hair, compared to the rest of the body, especially the blood. Average concentration of chromium for example is about 50 times higher in hair while that of cobalt is about 100 times higher (under-wood 1997).

4. Hair provides a record of past as well as present trace element levels. Samples may be taken retrospectively after a woman has been diagnosed pregnant, for instance samples can be taken to discover the conditions prior to conception.

5. Specimen can be collected more quickly and easily than specimens of brood, urine or any other tissue. Taking of samples, requires no special training or equipment and can be done without pain or embarrassment to the patients. (Sikhs could take samples from combed out hair.)

6. Samples can be kept indefinitely without need for special storage conditions as they do not deteriorate.
Prasad (1966) reported that mineral contents of hair ranges upto 2% in human beings, varying with sex, diet and season etc. It is noteworthy that a person shaving off 100 gms of hair loses 2 gms of trace elements which may be difficult to replenish especially under poor nutritional conditions. Changes in the composition of hair provide a record of alterations of the mineral metabolism of a person and this can be applied to measure deficiencies and sufficencies.

Hair as store house of trace elements
(i) Hair Zinc and its functions:
A particular attention has been paid to zinc as a trace element in human body due to its involvement in a number of functions. Hair zinc levels indicate the changes better than serum zinc, and zinc levels of hair have been reported to be exactly twice those of bone, which deserves attention; since much zinc storage takes place in the bone. Prasad (1966) has also reported a seasonal variation in zinc levels of hair with marked increase in summer. This could not be attributed to increased dietary zinc content but to some unknown seasonal influence. Due to increased hair zinc levels during summer, a remission of diseases like seborrhoea, acne and figer infections has been observed.

Decreased hair zinc levels have been found in young male dwarfs in Middle East, and on supplementation with zinc sulphate such individuals showed increased growth (Passed, 1966). The mechanism of growth retardation is not fully understood at persent. But hypopitutarism, leading to growth failure, retarded osseous developments, hypogonadism, depression of endogenous adrenocorticotropic hormone production are supposed to be the cause. Zinc is also essential for Deoxyribonucleic acid (DNA) synthesis, which is involved in protein metabolism and is essential for growth. Hair zinc of women is higher than men, may be this provision has been made by mother-nature to enable the mothers to share it with their progeny. Low zinc level during early pregnancy in women has been associated with congential malformations, abnormal deliveries and prolonged gestation. Low hair zinc levels during gestation and postpartum were found to be good predictors of pregnancy complications and abnormal labour.

Volkow, (cited by Prasad, 1966) found a significant decrease in zinc content of plasma, aorta, liver, myocardium and pancreas in patients suffering from atherosclerosis. These findings were confirmed by Prasad (1966) who observed hair zinc levels of atherosclerosis patients to be much lower than normal.

Cadmium in minute quantities produces permanent sterility in rats and later on tumor formation. But administration of zinc protects them from this damage’ (Prasad 1966). A good correlation between hair zinc levels and rate of wound healing has also been shown to exist. Healing rate constantly increases with increasing zinc levels in hair, with zinc sulphate supplementation. Further, a striking decrease in the hair zinc content was demonstrated in all patients suffering from burns, Hair zinc levels following burn, decreased, and later on slowly increased over a period of time, thus indicating that hair zinc is mobile and is in balance with rest of the body zinc stores. It is not permanently fixed to hair and can be shared with the rest of the body in the hout of need. Plasma zinc level steeply falls 48 hours after the onset of angina pectoris.

Zinc has been reported to play a vital role in the normal functioning of human body, and its deficiency causes a number of diseases. Amador et al (1975) reported much higher hair zinc in healthy children (111.47+12.7) ug/gm than in diabetic (14+6.1 ug/gm). Zinc is a constituent of several metalloenzymes, and actually 70 such enzymes have been identified (Burch and Sullivan, 1976) and holds insulin in granules of Beta cell islets. Thus Aksoy (cited by Amador et al1975) suggested that diabetes could be the result of zinc depletion.

Abnormalities of zinc metabolism have also been reported in cirrhosis of liver and acute myocardial infarction, idiopathic loss of taste and smell with subsequent reversion to normalcy or marked improvement following zinc supplementation. Hambidge et al (19 72) stated that levels of zinc were not directly related to age, but reflected the zinc nutritional status at any age. Consistent improvement in appetite, dietary intake and increase in growth were observed following dietary zinc supplementation.

Children with low zinc content in hair had impaired sense of taste which was corrected on zinc supplementation. Sever and Emamel (cited by Burch and Sullivan 1976) suggested that congenital malformation of central nervous system in man may be related to maternal zinc deficiency during pregnancy. Amador et al (1975) have reported low hair zinc concentrations in acrodermatitis entero-pathica patients and several other diseases.

Hambidge and Droege-mueller (1974) found that trace mineral deficiencies are not limited to subjects who are economically deprived. Increased demands for micro nutrients are imposed by pregnancy and low concentrations of certain elements in plasma and hair can result. For example, zinc content of hair is depressed during pregnancy. Eads and Lambdin (1973) observed significantly higher zinc content in the dark coloured hair of both sexes. Gupta and Miglani (1977) also reported lower hair zinc levels in cases of Indian childhood cirrhosis of liver. Zinc level in the basal half of hair was relatively lower than that of the apical half. Gupta et al (1978) found that serum and hair zinc in these patients of cirrhosis were markedly diminished as compared to normal subjects. Misra et al (1989) reported similar findings, and found that hair analysis was a reliable and simple method for available zinc status and tissue zinc levels. Also, hair zinc content is the reflection of chronic zinc status over the period hair has been growing. Atmaca et al (1989) found that zinc was involved in many eye functions, such as dark adaptation which required retinal reductase enzymes that have zinc as the activating constituent. In patients with retinitis pigmentosa zinc levels in plasma and hair were found to be low.

(ii) Chromium
Chromium is another useful trace element whose sufficiency or insufficiency is reflected by hair. Hambidge and Baurn (1972) observed high mean concentrations of hair chromium during early post-natal life parallel to higher concentrations of chromium in other new born tissues. Occasionally individual newborn hairs’ chromium levels were found to be low similar to low individual findings observed in other tissues.

Chromium deficiency has been implicated in disorders of carbohydrate metabolism in a number of human diseases. Hambdige et al (1968) have shown that juvenile diabeters mellitus patients have lower amount of chromium in hair.

A glucose tolerance factor (GTF) in which chromium is a co-factor for insulin activity has been identified by Mirtz (1967, cited by Chan et al1973). Burch and Sullivan (1976) also found significantly lower hair chromium levels in juvenile diabetes as compared to normal controls. Studies of these workers also revealed significant reduction in hair chromium levels in multiparous women as compared to nulliparous women. Further work may provide useful information in cases of steely and kinky hair which are copper deficiency syndromes. There also appears to be a link between the growth of hair and presence of sufficient copper in the system. Selenium, another useful trace mineral linked with vitamin E in the body is also stored in the hair.

(iii) Harmful Elements
Waldron and Stofen (1974) found that hair concentrates more lead per unit weight than any other tissue in the body and the union with hair follicular protein is so strong that it is almost impossible to remove it from there. Similar is the story with arsenic. There is no known useful function of these elements in the body, hence the hair with-hold these harmful elements and remove them from the circulation, thus, preventing them from producing harmful effects.

Nutritional Deficiency Diseases and Hair
Bradfield (1974) reported the use of hair tissue as a medium for differential diagnosis of protein-calorie malnutrition. Distinct morphological defects are provoked in hair root by nutritional deficiencies, and the same could be used as a measure for the determination of frequency and severity of protein calorie malnutrition in public health practice. A marked difference in the appearance of hair, particularly the root has been observed in Marasmus (chronic condition due to deficiency of both protein and calories) and Kwashiorkor (due to a protein deficient but calorie sufficient diet). It has been suggested that different patterns are found in these two clearly different types of stress on the hair follicles. Changes in hair shaft colouration, thickness and appearance have long been recognized in Kwashiorkar and are a part of clinical diagnosis of this condition. With protein calore malnutrition (Marasmus) lustrous hair becomes fine textured, dry, dull and lusterless in appearance. In addition, dark hair may exhibit patches of red or white discolouration. The shaft of the hair provides a readily available history. The duration of a nutritional insult may be calculated by measuring the shaft length of the area of depigmentation as the rate of growth of hair is 0.2 m.m. per day (Bradfield and Jelliffe 1974). Repeated bands of lightened hair colour suggest distinct periods of malnutrition and it is a useful measure of chronicity.

Hair roots are’ preferable to hair shaft as a more recent indicator of nutritional status. Also acute and dronic conditions may be distinguished by the use of hair roots, hair shaft. Johnson and Roe (1975) used hair root morphology for determination of nutritional status of children and observed this method to be useful to distinguish between well nourished and severally malnourished ones.

Hair decolouration or discolouration has been reported to be an early symptom of malnutrition. Pearson (1974) observed loss of hair and skin pigment in African patients of tuberculosis and Kwashiorkor.

Hair Patterning and Brain Development:
Smith and Gong (1973) observed that hair patterning over the scalp (head) and upper face provide a rather indelible record in relation to growth and topography of the brain and upper facial structures during early foetal period (from 10 to 16 weeks). Aberrant scalp hair patterning in patients with severe defects of early brain development, which must have been present prior to hair follicular development have been reported to fit with the hypothesis that hair patterning conforms to the presumed shape and size of the brain at the time of hair follicle growth. Further, the other defects of brain development in which the age of onset of problems is not obvious, hair patterning may provide an important clue to the timing of the defects, implying altered growth and/or shape of the brain prior to 16 weeks of foetal life. This has been said to be especially true for cases of severe microcephaly. Such observations have great prognostic value.

Scalp hair pattern serves as a permanent mark of brain development. Abnormalities in brain growth are associated with abnormal hair whorl patterning: for example, counter Clock wise scalp hair whorls are indicative of schi-zophrenia (Alexander et al 1992).

Hair Trace Minerals and Learning Ability
Pihl and Parkes (1977) were able to distinguish between 31 learning disabled and 22 normal learning children by trace element analysis of the hair alone, and obtained an accuracy of 98% with this procedure. Tests revealed unexpectedly high levels of cadmium, lead, lithium and cobalt in the hair of children with learning disabilities as compared to the group of normal learning children. In the opinion of these workers, trace element pattern of hair may provide answer pertaining to etiology and treatment of learning disability in addition to being a fruitful diagnostic procedure.

Hair and Drug Abuse:
Self-reported histories of drug abuse are inaccurate and mis-leading since the subjects often deny the use of drugs. Reproductive effects of cocaine use by mothers are a cause of public anxiety in the western world. Hair analysis for cocaine use in previous months is the most dependable procedure for verfication of material exposure or non exposure to cocaine, during pregnancy Babies of women who used cocaine during pregnancy also have proved positive for cocaine on their hair analysis (Graham & Karen, 1989).
Hair analysis for methamphetamine content coincided with self reported drug abuse histories (Nakahara et al 1990).
Maternal cigarettee smoking during pregnancy is associated with foetal risks in short and long terms. Women who smoked 5-25 cigarettes per day during pregnancy had hair concentration of nicotine and its break-down product continine to the extent of 21 + 18 and 3.7+8.8 ng per milligram, respectively, and the hair of their babies had a bit lower concentrations (Klein et al 1993). There was a significant correlation between material and infant hair concentration of both nicotine and cotinine. These workers have concluded that hair estimation of nicotine etc. may provide a better clue to long term systemic exposure, to the toxic constitutents of cigarettes and provide a better prediction of fetal risk.

Miscellaneous Information about Hair
Ear Canal Hair and Coronary Heart Disease: Combined presence of ear canal hair and ear lobe crease was found to be significantly associated with coronary heart disease. This combination yielded high sensitivity (90%) and the lowest false negative rate (10%). Association between ear canal hair and coronary artery disease may be due to long-term exposure to high androgens to cause both ear canal hair growth and coronary artery disease. Another androgen sensitive trait, i.e. male pattern baldness has been recognized as a predictor of coronary thrombosis in men (Hagner et al, 1984). Verma et al (1988) confirmed the above findings in Indian population.

Wells (1989) observed that grey hair illuminated at one end emit light at the other side. Reduction in light intensity was noted with increased hair length, but by far the most important factor was hair colour, almost no light was transmitted by brown hair. Grey hair acts as a natural fibre optic which can transmit light to its matrix, follicular epithelium and dermis. What effect light transmission down the hair produces needs investigation. It may be concerned with maturity and wisdom, is any body’s guess. Blood groups have been determined by hair analysis. High sulphur proteins in hair have been used for forensic hair comparison, and so on. It can be hopefully expected that further scientific work shall uncover more things about hair, which may be unknown at present.

Above observations vividly show that hair is not a superfluous appendage, but has important functions to perform, of which most of us are not aware. It is as responsive to the assault of diseases and malnutrition as any other part of body. Considering the shaving and having full grown hair one could argue that anything which grows needs energy to do so (hair growth needs proteins especially) which should be true of hair as well. Unshorn hair of a person stops growing after attainings a certain maximum length, but the hair of a shaven person keeps on growing; the more frequently he shaves, the more it grows. In other words, if the cut hair of such a person be placed end to end through-out his life time and the length be compared to the hair of an unshaven person, it shall be observed that the shaven off person grew much more hair than the unshven person. Hence a shaven off person spends much more energy on growing extra hair, which could have been utilized by the body for some other useful purpose. Supposedly, the shaven person should become wrinkled earlier than an unshaven person. But no controlled studies are available to prove or disprove this supposition.
In view of Parsad’s (1966) observations, a person loses 2 grams of trace minerals per 100 grams of hair he shaves, and it may be hard to recoup especially under conditions of poor nutrition.

Chromium content of distal (ends) segments of hair has been found to be significantly higher than proximal ends (Hambridge and Baun, 1972) which may be true of other minerals as well, but that is the portion to be shaven off. Zinc plays a vital role for the well being of human body, and work of Prasad (1966) indicates that hair serves as a rich pool of zinc which gets mobilized into the general body system in the hour of need (e.g. in case of burns and wounds etc.), and. protects against dangerous diseases like angina pectoris and diabetes, and get replenished later on. Studies of Bruch and Sullivian (1976) and Hambridge and Droege-muller (1974) indicate that pregnant mothers share chromium and zinc with the foetus which are essential for its healthy development.
The need for trace minerals during prenatal stage cannot be over-emphasized which are so essential for the development of different organ system including the central nervous system. Even a short period of trace mineral deficiency during pregnancy may have adverse effects on the development of young one. These are equally important during post-natal and later life, as these are very essential for normal growth and development (Dwarfs have low hair zinc). But full grown hair serves as a reservoir of essential trace minerals, and helps the body to tide over the adversities.

These may be the reasons why Sikhs are taller statured and more hardy compared to their co-habitants who enjoy similar or better nutritional status. Sikh athletes and players have made a name at national and international levels even though their population is a mere fraction compared to others. Being non-smokers may be another reason.

Hair is also the graveyard of harmful minerals. Thus far no function is ascribed to lead in the body. Rather it is known as one of the poisonous heavy metals. The hair concentrates more lead per unit weight than any other tissue of the body and it is rather impossible to remove it from that tissue (Haldron and Stofar, 1974). Same is the case of arsemic. Hence the hair plays protective role against lead and arsenie poisoning etc., by eliminating these from general metabolism, whereas it shares the useful minerals like zinc and chromium with the body in the hour of need.

It was strict adoption of Sikh code of conduct (having unshorn hair included), which shaped the Sikh personality and prom plied Sir James to remark as under:

“One is not surprised to find that the English, who first described these Sikhs in terms of enthusiasm, material qualities, independent character and their marked superiority, physical and mental, over the people around them and spoke of them as men whose very frames had grown and dilated from’ the effects of their religion and their manly independence.” (Sir James, 1882).,

Whatever the Gurus have ordained, is evergreen truth, and we should follow it in letter and, spirit. They have instructed us on all aspects of life, so that we may not go astray. Wherever we may go off the track, we must seek guidance from Gurbani to retrace our path:

G[b/ f;y r[o{ ;wMkJ/ ..
T[MfV ikd/ wkofr gkJ/ ..

So that we may try not to make mistakes in future:
wkJh ;fs ;fs jfo ;fs ;fs ;fs ;kXk ..
puB[ r[o{ i' g{o/ efjU w? Shfe rKmoh pkXk ..

So the youth who have gone astray, should know that whatever Guru Ji told us to do, hundreds of years back, is being fully supported by the modern science.

The author is highly thankful to the library staff of Christian Medical College, Ludhiana, and PGI, Chandigarh, for their cooperation and willing help.




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