Gajachikitsa: The Treatment of Elephants in Ancient and Modern Medicine

in Article
Published on: 24 September 2019

Dr Syam K. Venugopal and Dr V. Sunil Kumar

Dr Syam K. Venugopal, an expert in mixed animal practice, is trained in small animal orthopaedics, ophthalmology and endoscopy and interested in zoo and wild animal practice. Currently, he is in charge of the proposed Veterinary Nursing Programme of Kerala Veterinary and Animal Sciences University and is the Professor in charge of the University Veterinary Hospital at Kokkalai.

Dr Sunil was the Thrissur Zoo Veterinarian from 2004 to 2009 and Forest Veterinary Officer of the Kerala Forests and Wildlife Department from 2009 to 2012. He has a wide experience in the treatment, health management, tranquilization and translocation of captive and free ranging elephants and other wild animals. At present, Dr Sunil Kumar is engaged as a Consultant Veterinarian for planning Elephant Rehabilitation Centre at Thiruvananthapuram.

India is home to more than 50 per cent of the free-range Asian elephant (Elephas maximus) population and about 20 per cent of the captive elephant population. As elephants came to be tamed for various purposes, extensive records also had to be developed regarding their management and treatment in the wild and in captivity. However, the copies of these records that are currently available are either corrupt or incomplete. An elaborate explanation of Ayurveda techniques has been given in Hastyayurveda or Hasti Ayurveda (Elephant Ayurveda) by the sage Palakapya (fifth century BC). It is recorded in the Nakula Samhita that these traditional veterinary medicines were used during the era of the Mahabharata (c. 5000 BC); legend has it that Prince Nakula himself was the author of treatises like the Nakula Samhita and Asva Sastra (Science of Horses). Other major works on domestication of animals and their treatment include Shalihotra’s Asvayurveda and Palakapya’s Gajayurveda. Prince Sahadeva is said to have authored the text, Gavyayurveda.

The Asvayurveda by Shalihotra, Asva-Vaidyaka by Jayadatta, Asva Sastra and Nakula Samhita by Nakula, Asvavaidyaka by Dipankar, Siddappadesa-Samgraha by Gana, Shalihotra by Bhojas, Gavyurveda by Sahadeva, Mrigapada Sastra by Hamsadeva and Manasollasa by Someshvara III deal with the management of animals. The most famous among the treatises on elephants are Hastayurveda by Palakapya, Gajalakshana by Brahaspati, Matanga Leela by Nilakantha and Gaja Darpana by Hemadri. Unfortunately, many of the treaties mentioned above are not available today; a few are available only in the form of manuscripts (pandulipis). Historians believe that Palakapya, the author of Hastayurveda, lived during the eleventh century.

Hastyayurveda is one of the more prominent ancient texts on elephant management. Written in Sanskrit, it is based on the fundamental principles of Ayurveda. The book deals with several aspects of the elephant, including its anatomy, behaviour, diseases, surgical treatments, management, breeding, capture, musth and training. The literature also describes the characteristic features of a good elephant and a good mahout. The text, also known as Palakapyam, is written in the form of a discussion between Ramapada, the king of Chambapuri, and Sage Palakapya. Hastayurveda is written over 160 chapters (adhyayas), divided into the four sthanas (divisions)—Maharogasthanam, Kshudrarogasthanam, Sallyasthanam and Utharasthanam. In total, it comprises 12,000 verses.

The first sthanam, Maharogasthanam, describes the major diseases that affect elephants. It describes the feeding habits of elephants as well as the medication that should be given to them. It talks about the different illnesses that elephants can contract, including diseases involving glands, vitiligo, digestive and urinary diseases, fainting and fever, diseases of the head, oedema of the foot and diseases of the eye.

Kshudrarogasthanam deals with minor diseases; its 72 chapters cover issues such as nausea, diseases affecting the blood, food poisoning, poisons delivered through arrows, snake venom, cardiac fibrillation, gas accumulation, dwarfism, methods to soothe the mental state of newly captured elephants, worm infestations, problems in geriatric elephants, epilepsy, sternal injury, lesions of skin, exhaustion from excessive work and travel, foot rot, psychosis, paediatrics, indigestion, dentistry, tuberculosis, musth, eye diseases, heart diseases, diseases of the joints and neck, dysphagia, pregnancy, parasites on the eye lashes and so on.

Sallyasthanam has 34 chapters and talks about conditions requiring surgical treatment, including different types of wounds and injuries involving blood vessels and nerves. The sthanam also deals with issues related to pregnancy, colic, surgical instruments and their use, dental problems, burns, spider and insect poisons, carnivore mauling, descriptions of body parts, fractures and abortions.

Utharasthanam is an epilogue which describes the uses and administration of medicated oils, electuaries, different types of enemas and inhalants. It also describes seasonal management, tusk trimming, fodder for different seasons, water requirements, and feeding of sugar cane, salt, tamarind, milk, ghee, meat and alcohol. It also covers signs of death, management during musth and the therapeutic use of leeches. It also describes measures to handle evil spirits in elephant stables, elephant welfare and the mantras and procedures for the same.

Matangaleela (the play or game of elephants), written by Neelakanta, is another classic written in Sanskrit on elephant mythology. Matangaleela has 12 chapters with 253 stanzas. The first chapter deals with the origin of elephants. The second chapter describes the characteristic features of a good elephant in the service of the king, desirable qualities in working elephants and also that of war elephants.

The third chapter deals with unfavourable marks on an elephant, including incorrect number of toenails, the presence of external testes and very short trunk fingers. The fourth chapter discusses marks of longevity that can be seen on an individual elephant’s head, tail, spine, as well as the presence of certain colours on specific parts. The fifth chapter describes an elephant from infancy to its old age. The sixth chapter, titled ‘Decisions of Measurements’, goes over the various measurement protocols for each class of elephants. The seventh chapter is the shortest and deals with the trade-related aspects of elephants including the criteria to be used to ascertain their value. Chapter eight describes the various marks that may indicate differences in the physical and mental status of elephants. The ninth chapter deals with musth and the subsequent behavioural changes that it causes in males. The 10th chapter describes various techniques to capture elephants. The various types of sounds produced by elephants are also detailed in these chapters.

The longest chapter is the 11th one, which discusses the management of elephants. Daily protocols to be followed for the care of elephants, with respect to seasonal changes, are also given. This chapter reminds readers of the freedom that wild elephants are used to and goes on to say that this has to be taken into consideration when they are kept in captivity. The elephants should be allowed to graze and browse and both cooked and raw grain in the prescribed quantity are to be provided. The chapter also deals with the medicines to be administered to elephants and the nutrition to be given in times of illness. The 12th chapter describes the ideal qualities of elephant managers, mahouts and trainers. Various commands, and the context in which they should be used, are also given in detail. The chapter also warns readers that the methods described in the text must be examined, tested and corrected.

Manasollasa (Gajavahyali-Abhilashitarta Chintamani)
Manasollasa (Gajavahyali-Abhilashitarta Chintamani) was authored by Bhulokamala or Someshvara III (1126–38 AD), a king of the Chalukya dynasty. The book is devoted mainly to royal games; the word manasollasa means ‘entertainment’. The book has five parts, each containing 20 chapters. One section deals with the habitat of elephants and methods to capture and train them. Another section gives details of various diseases and their treatment. The work talks a great deal about the optimal medication for increasing performance and exciting aggression, the different signs of health, stages of intoxication, preparation for arena performances, preparation of the arena itself, announcements for games, preparation in the stable, arrival at the arena and grading of participants. The book also carries several descriptions about the different races of elephants and horses, their riders and mahouts, types of seats, role of attendant mahouts, codes of communication, posture of elephants for fights, races related to mahouts and elephants, hazardous situations caused by unruly elephants, fights between elephants, various attacking modes, general precautions and rewards.

Gaja Sastra (Science of Elephants)
Gaja Sastra (Science of Elephants) is part of a series of texts on elephants at the Saraswathi Mahal Library of Tanjore and was compiled at the insistence of Raja Serfoji II (1788–1832). The book provides a summary of the masterpiece, Palakapyam. It was designed to be used for the education of a young prince under the tutelage of Rakhmaji Pundit. The book was commissioned by the heir apparent of the dynasty, Sivaji, in AD 1812, and was completed in AD 1822. The text starts with an invocation to Vigneswara (Ganapathy—the elephant god). Its chapters deal with the characteristics of elephants and are separated into different lakshanas (attributes). Nakha Lakshana, Dantha Lakshana, Gajadanta, Cheda Lakshana and Danthavridhiprakar deal with matters related to the tusks. The training of elephants, the ideal qualities of a gajadhikari (officer in charge of elephants), gajavaidya (elephant veterinarian), mahouts and their assistants are dealt with in the Gaja Shikshaprakar. Various methods of capturing elephants are detailed and the different noises they make identified. The book also describes the seven types of comeliness when in musth and also describes the various issues related to eyes and body odour under the Saptha Sobha, Gajanethravarna Lakshana and Gajagandha Lakshana.

Arthashastra, an ancient treatise on statecraft, economics and military strategy, written by Chanakya (350–283 BC), also deals with the management of forests. This includes a detailed account of elephants, including their protection, capture, training and management. The chapters also deal with other issues such as the ideal season for capturing wild elephants, the preferred age for captured elephants, the need to have separate stables for males, cows and calves, daily protocols for bathing and the feeding requirements of different animals. Details regarding the training of elephants for domestic use, riding and war are given in detail. The qualities and duties of all those involved in elephant management, from the grass cutter to the veterinarian and the manager, are given.

Two other ancient texts that talk about elephants are Brihat Samhita, written by Varahamihira, who lived in Ujjain during AD 505–587, and a Jain text Yasastilaka by Somadeva.

Signs of Health in Elephants
Although some of the texts provide a mythic explanation for the origins of elephants, the Hastyayurveda’s descriptions of diseases, treatment regimes, management and other subjects are comparable to modern medicine. Now we come to the modern understanding of elephant health, the common diseases they suffer and their treatment.

Elephants are naturally very timid, suspicious and difficult for strangers to handle. Their bodies’ vital processes are slow, and hence, diseases tend to linger over long periods. It is also difficult to administer medicine, especially through oral means. Because of these factors, elephants are generally considered difficult to care for.

A healthy elephant will be in constant motion—flapping its ears, swinging its tail or trunk and swaying its body from side to side. It often swings its legs or rubs the opposite pairs against each other. A healthy elephant will also have clear and bright eyes, with a small amount of clear discharge. The mucous membrane of the oral cavity (palate and tongue), the internal lining of the trunk and the conjunctival membrane of the eyes will be a rosy pink colour. The tip of the trunk will be moist, with soft and resilient skin. The base of the nails will be moist. Healthy elephants will have a very good appetite. Their dung will be well-formed and the colour of the dung will vary depending on the diet; usually, it is of brownish colour. Healthy animals will be able to urinate without any strain and the urine will be copious and of a faint yellow colour with pleasant odour. Healthy elephants will lie down and sleep at night.

Signs of Ill Health
An unhealthy elephant will be restless with decreased movement and will show unusual behaviour. It will have dull or sunken eyes and increased tear flow with a thick discharge. Other signs include pale mucous membranes within the oral cavity and trunk. The eyes will be pale, muddy and bright red. The skin will be dry with a loss of elasticity. The tip of the trunk will be dry and the trunk itself will present a shrivelled appearance. There will be an intolerance to exercise with abnormal respiratory sounds and oral respiration. Occasional coughing may also be observed as well as weight loss, a sunken abdomen, prominent ribs with decreased food intake, pyrexia and so on. There will be changes in the urine or faeces in quantity, colour and consistency. Unhealthy elephants will strain while urinating and defecating. The lower flap of the ears will be cold.

In modern veterinary medicine, diseases are categorised systematically according to causative agents and the treatment required. However, diagnoses of diseases and the quality of medicines administered have not advanced in the case of elephant treatment. This is because of the highly specialised morphology of elephants. As such, several diagnostic innovations cannot be effectively used for the diagnosis of diseases in elephants. We are also facing a dearth of scientific studies on topics such as immunisation against contagious diseases and the appropriate dosage regime for elephants—especially in the case of anti-microbial drugs. This has affected the health management of elephants in captivity.

The major infectious diseases encountered in elephants are discussed below.

Elephant Endotheliotropic Herpes Virus (EEHV) Infection is a significant disease that is rapidly emerging, with two distinct clinical presentations. In the peracute form of the disease, the animal dies within a few hours of contracting the disease. In the acute form, the signs are severe and the disease has a short duration of hours to days. In both forms, the symptoms lead to sudden death. The elephant shows lethargy, dullness, anorexia, mild colic, oedema of the head, neck, trunk and thoracic limbs, ventral oedema and swollen tongue with cyanosis. As the disease progresses, drooling of saliva, reduced trunk movement, ataxia, recumbency, weak thready pulse and unresponsiveness to commands are also seen. The majority of deaths occur in young elephants. The diagnosis includes haematology, lesions at post mortem, polymerase chain reaction (PCR), electron micrography, enzyme-linked immunosorbent assay (ELISA).

Foot and Mouth Disease (FMD) is caused by a virus of the Aphthovirus genus of the family Picornaviridae. Symptoms include fever, depression, anorexia, lameness, vesicles at the tongue, palate, cheeks, mucous membrane of the trunk, at the coronary bands and inter-digital space, with mucoid exudate from the nares. Feet may be hot and oedematous with tenderness of skin around the toenails and margins of the slipper. In cases without added complications, the course of the disease may last about 10–20 days. In severe cases, slippers may slough off. This would require months of highly dedicated management and nursing. The ulcers, if not properly looked after, may become complicated with secondary bacterial infections and myasis. The vesicles in the oral cavity and trunk will also cause difficulties in eating and drinking water. In young animals, these lesions can occur in the myocardium and intestine. Intestinal lesions can result in diarrhoea, dehydration and sudden death when the myocardium is affected, due to myocarditis. The diagnosis includes virus isolation, ELISA, RT-PCR, complement fixation test (CFT) and so on. Though regular vaccination is done for most domestic animals, a specific vaccination protocol has not been developed for elephants.

Rabies is caused by the Lyssa virus of the family Rhabdoviridae. The reported incidence of rabies is very low in elephants. The disease presents as anorexia, pyrexia, salivation, shifting of weight on the limbs, behavioural changes and sometimes as neurological signs. These signs will vary depending on the area of encephalitis in different animals. Therefore, symptoms will include neurologic excitement, sudden aggression (in the case of furious form), swaying movement, pica, convulsions and so on. In the dumb form, a paralytic phase may follow the excitement phase or it may also present as the paralytic phase alone; the elephant will show symptoms like lethargy, paresis, incontinence, tenesmus, flaccidity of tail, ataxia, asymmetrical paralysis, and finally coma and death. The diagnosis includes antemortem screening, skin biopsy, florescent antibody test (FAT) with saliva and corneal impression, histopathology of sections of brain stem, hippocampus and cerebellum, microscopic examination for Negri bodies, tissue culture, animal inoculation (virus isolation) tests, PCR and ELISA.

Elephant Pox is caused by a virus of the genus Orthopoxvirus. Incidence of this disease is rare. The symptoms of this disease include mild to severe conjunctivitis, dysphagia, salivation, pustules in the oral cavity, pharynx and tongue, ventral aspect of the trunk, temporal region, lower abdomen, thorax, perineum and vulva. Pustules are also seen around the toenails and slipper corium, leading to necrosis and a foul smell. In severe cases, the toenails may get sloughed off. Pustules appear to be greyish-yellow in colour with a central haemorrhagic area. Lesions may be 1–2 cm in diameter. The skin lesions may coalesce and become necrotic and slough off. The lesions in the skin start as rashes, changing to papules, and then to vesicles and pustules which will ulcerate, followed by scab formation. The diagnosis includes haematology, virus culture, histopathology, electron microscopic examination.

Encephalomyocarditis (EMC), of which the causative agent is a virus from the genus Cardiovirus of the Picornaviridae family. Sporadic incidence is reported in both domestic and wild animals. Rodents are natural carriers of this virus. Clinical signs in less acute cases include anorexia, lethargy and moderate to severe dyspnoea. In acute cases, sudden death is observed. Its diagnosis includes identification of the virus in tissue culture cells, Hemagglutination and PCR.

Important Bacterial Diseases

Elephant Tuberculosis is primarily caused by the bacteria Mycobacterium tuberculosis. Infection by M. bovis has also been reported. Clinical symptoms in elephants vary. Most of the affected elephants will not show any antemortem symptoms. Exercise intolerance, anorexia, general weakness, trunk discharge, which may sometimes be foul-smelling, and chronic weight loss are often noticed. Though the disease primarily affects the pulmonary system, extra-pulmonary infection alone or concurrently is also observed. Any condition causing stress to the TB-affected elephant can also contribute to the worsening of the health of the elephant. The diagnosis includes culturing trunk wash for any abnormal trunk discharge, PCR and serum antibody detection tests.

Anthrax, of which the causative agent is Bacillus anthracis, occurs as a peracute or acute febrile disease. An outbreak can be suspected when sudden deaths occur within a herd in a short span of time. General symptoms will be pyrexia, shivering, swollen trunk and so on. These symptoms occur depending upon the route of infection. If the route of infection is inhalation, the animal will show symptoms of pneumonia and dyspnoea. If it is through ingestion, there will be severe colic and haemorrhagic enteritis. The disease can also occur in a cutaneous form. In this, localised or diffuse swelling beneath the skin is noticed. The swellings may be initially hot, painful and doughy and could later become cold and painless. Swellings are also commonly seen behind the jaw, between the limbs, on the front of the shoulders and across the belly and hindquarters. If the nervous system is affected, there will be wild excitement, spasms, listlessness, tottering gait and convulsions.

In the gastrointestinal form, the symptoms noticed are colic, dysentery and bleeding from the mouth. The elephant becomes extremely weak within a few hours and dies within the next 24 hours. The carcass will be bloated and rigor mortis may be absent. Putrefaction will set in rapidly. The carcass will have an appearance of a sawhorse. There will be oozing of unclotted tarry-coloured blood through all the natural orifices. The clinical signs, sudden death and the appearance of the carcass should alert the veterinarian regarding the possibility of anthrax. Such carcasses should not be opened without examining the blood smear for the presence of anthrax bacteria. Blood smear examination, culture and PCR can be used for a more complete diagnosis of the disease.

Tetanus is caused by a Clostridium tetani infection, which usually occurs through a deep anaerobic cut or through puncture wounds. The symptoms include pyrexia, inappetence, stiff gait, lock jaw, difficulty in eating or swallowing, salivation, prolapse of the third eye lid, hyper sensitivity to sounds, slow movement, weakness of trunk, stiff and oedematous limbs, jerky movements, recumbency and death. Usually it can be diagnosed from the history and symptoms shown.

Salmonellosis, of which Salmonella typhimurium is the most common causative agent seen among Asiatic elephants. Other agents include S. blocley, S. montevideo and S. london. The disease usually occurs due to suppression of immune response followed by stress. Young elephants are the most affected. The disease has a high mortality risk among elephants. Pyrexia, inappetence, lethargy, severe foul-smelling watery diarrhoea and colic are seen in elephants affected by this condition. Faeces may show presence of blood and mucous. Culturing of the faeces and blood and serotyping through PCR are the diagnosis processes.

Haemorrhagic Septicaemia/Pasturellosis is usually caused by bacteria including Pasteurella multocida and P. haemolytica. The infection may occur through ingestion, aerosol, the bite of ticks, or through contaminated wounds. Stress is also a major factor that contributes to the occurrence of the disease. The symptoms include pyrexia, anorexia, frequent yawning, dyspnoea and oedema present in the ventral aspect between the jaws, abdomen, and base of the tail. Symptoms can also include hot, painful swellings in the region of the throat, spreading to the face. The respiratory difficulties are acute towards the end, resulting in suffocation and death. The membrane lining of the mouth will be coated with sticky saliva. The palate will be dark with mulberry coloured spots. In some cases, the elephant may vomit, and in prolonged cases, there will be colic and dysentery. Weakness of the hind quarters with staggering gait is observed in some cases.

Leptospirosis is caused by one or more serovars of the species Leptospira. Symptoms include pyrexia, anorexia, chronic weight loss, hypopyon, uveitis, marked icterus of mucus membrane, ventral oedema, ulcerative lesions of the vulva and various areas of the skin and tip of the skin will become necrosed due to vasculitis. Blood and serum examination is the basic diagnosis in this case.

Other bacterial infections of lesser incidence include colibacillosis, clostridial diseases, mycoplasmosis and so on.

Parasitic Diseases are common in captive and free-ranging elephants with incidences of external and internal parasites.

Gastrointestinal Helminthiasis

Nematodes are the most common and detrimental endoparasites to affect an elephant. Most adult forms are located in the gastrointestinal tract of elephants. The disease may manifest either in peracute, acute and chronic forms. The elephant shows unthriftiness and, in long-standing cases, emaciation results. Initially, there will be inappetence progressing to anorexia. This will result in poor immunity, leading to secondary infections. In young elephants, this may lead to retarded growth and delayed maturity. The elephant may or may not show diarrhoea, depending upon the organs affected. Colic, foul-smelling diarrhoea, mud-eating, oedema on the lower abdomen, the neck region, and mandibles, anaemia and a lack of vitality of the skin have been noted.

Trematodes (Amphiostomes, Paramphiostomes): Liver flukes such as Fasciola jacksoni are unique to elephants. Fasciola hepatica and the blood fluke Bivitellobilharzia nairi have also been reported. The symptoms in acute form are anorexia, constipation, diarrhoea, anaemia and icterus. In chronic form, the elephant will show unthriftiness, anorexia, anaemia, icterus, ventral oedema due to hypoproteinaemia, weight loss and diarrhoea/constipation. If the lungs are affected, the elephant will show exercise intolerance and respiratory distress. The symptoms will be severe in young animals.

Cestodes are parasitic worms of the Anoplocephala species. Usually no clinical signs are apparent. Heavy infestation may cause impaction/diarrhoea and colic. Diagnosis is based on the symptoms and microscopical examination of the dung for the presence of the ova of the parasites. Blood and serum evaluation is also mandatory.

External parasites: Elephants may be infested by biting louse, fleas (Myiasis) and ticks. Symptoms shown in disease condition caused by ectoparasites are pruritus, restlessness and so on.

Important blood protozoan diseases reported in elephants include Trypanosomiasis (Surra) which is caused by Trypanosoma evansi. The symptoms include intermittent fever, dullness, sluggish movements, lacrimation, dry skin, oedema of the trunk, neck and lower abdomen, and constipation with intermittent diarrhoea. Diagnosis is through PCR.             

Cutaneous filariasis is caused by Indo filaria pattabhiramani and Indo filaria elephantis. Symptoms include nodules of approximately 1–2 cm diameter and 1.0 cm thickness, commonly seen on the sides and ventral aspect of the abdomen and less frequently on the neck, chest and outer aspects of the thigh. The nodules are soft and whitish in appearance. The nodules rupture at the centre, causing blood to ooze from the nodules (haemorrhagic dermatitis). The nodules will become fibrosed and will remain for years. Diagnosis is through the examination of peripheral blood or blood from the nodules.

Common Surgical Affectations in Elephants
Wounds include both closed and open wounds. They may be perforated wounds, abrasions, lacerated wounds, haematoma, abscesses, sinuses, tumours and cysts, necrosis and gangrene. Other issues include arthritis, fractures, dislocations, temporal adenitis, fracture of the tusks, split tusks, shedding of the tusks, pulp decay of the tusks, otitis, keratitis, corneal ulcers, cataract, hernia, prolapse of viscera, foot rot, pododermatitis, sun and other burns and myiasis.

Non-Infectious Diseases
Impaction of the colon is a common disease seen in elephants in Kerala. The disease occurs due to defective management practices, mainly in the feeding of the elephants. In Kerala, elephants are mainly fed with palm leaves (coconut and fish tail palm), which are rich in thick fibre. There is a genuine lack of grass, which restricts grazing, and leads to the concentration of palm leaves in their diet. The thick middle portion and the rib of the palm leaves are difficult to chew and digest. In most cases, elephants are provided with water at inappropriate times, mainly after a procession in hot weather and before their body is allowed to cool. These factors lead to the formation of a large faecal bolus, resulting in the blockage of the gastrointestinal tract. Other factors like defective teeth and a lack of exercise also contribute adversely to the condition. Elephants are naturally slow eaters with poor digestion. The symptoms that present are usually colic, restlessness, stretching, rolling, bowing posture, distended abdomen, non-passage of dung, biting the trunk tip, anorexia, groaning and dehydration. Diagnosis is from checking the patient’s history, symptoms and serum evaluation.

Other non-specific disease conditions that are seen in elephants include stress due to various reasons, heat stroke, sunstroke and snakebite. Common disease conditions of neonates include diarrhoea, constipation, sunburn, dry skin, umbilical infection, trauma, EEHV, rickets and wounds.

The ancient Indians contributed some of the most detailed treatises on elephant health and medicine, however, the treatment of elephants in India today has a long way to go. This is especially true in terms of the development of modern diagnostic aids suitable for elephants, which will automatically improve the standard of treatment. There is also an urgent need for a proper protocol in the management and treatment of diseases in this field.


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