A R O G Y A M A N D I R P A T R I K A

Vishayapravesh

Sandhi Vikar

he word 'Sandhi' means where 2 parts come together or connect with each other. According to Ayurved, the term 'Sandhi' is identified by the site where two or more bones connect with each other.

In this issue of Arogyamandir Patrika, we will discuss about the joints which generally get affected causing joint disorders. For the treatment of such disorders people generally turn towards Ayurvedic treatment as no such complete treatment is hardly available with other pathies.

The differential diagnosis of these disorders, their specific condition, treatment and

complications have been put forward together in this issue.

'Joint' or 'Sandhi' is the part which connects two or more bones, which helps in proper & smooth movement of joints as well as body.

The Asthi dhatu or bone is the part which gives proper shape & firmness to the body as well as it protects the internal organs.

'Asthi' & 'Sandhi' both are known as the moolasthana or origin of Majjavaha Srotas. Vatadosha is mainly situated in Asthi & Sandhi hence due to vitiation of Vatadosha there are changes or deformity in these Asthi & Sandhi.

Similarly vitiation of Asthivaha & Majjavaha Srotas gives rise to vitiation or abnormality in these organs causing joint disorders.

The main site of Vatadosha in the body being Kandara, Mamsa, Sira, Snayu, Asthi & Sandhi, Sandhivikar are incorporated under Vatavyadhi. Vayu is also related with Vatanadi i.e. nerves, therefore Nervine disorders or disorders developed due to vitiation of vatanadi are also incorporated in Vatavyadhi.

e are thankful for your responses to the

earlier Arogyamandir Patrikas viz.

special issues on ̀ Digestive Disorders'

(April 2007) and `Skin Disorders' (July 2007)

published by Shree Dhootapapeshwar Ltd.

Your written appreciations have surely

boosted our confidence.

We agree with your valued

suggestions that many

a diseases are on

the rise now-a-days

and need special

p u b l i c a t i o n s

covering them.

Keeping that in

mind, we have

come up with this

s p e c i a l i s s u e o n

`Sandhivikar'.

Many diseases pertaining to Joints (Sandhi)

clubbed as `New diseases' are becoming

more and more common, but if we take into

consideration the Siddhant of Charakacharya

and understand it in the correct perspective of

the Dosha-Dushya Sangraha, then instead of

taking recourse to the modern names, we can

differentiate, diagnose and treat them with

ease and that too with great success, based

on the Ayurvedic principles themselves.

Our efforts through 'Arogyamandir Patrika'

have been in the same direction. By adopting

this methodology and looking at the condition

of the patients on the basis of Ayurvedic

Siddhant, we can surely give relief to the

suffering person.

We hope that this Visheshank on "Sandhi

Vikar" comes upto your expectations and will

be appreciated.

We humbly request you to continue sending

your suggestions in writing so that we can

carry forward this work in the interest of

`Ayurved Chikitsa' in appropriate direction.

Yours Sincerely,

Vd. Shailesh Nadkarni

EDITORIAL December 2007

Disordersof Joints

WT

Is it not essential to think of this?Use of painkillers or medicines that are considered painkillers is common in patients suffering from Joint Disorders to give them relief from the pain they suffer of. With the use of these medicines, the patient feels, that the pain has been relieved and considers himself normal or near normal.

Even though the person feels that the pain has got relieved, it is not actually gone. It's just that he does not realize it.

In fact, the pain is the sensation that gives the signal that the part needs to be given either rest or less mobility.

Is it then correct to misinterpret the word 'Vedanashamak' and allow the joint to continue to be in action rather than giving it the required rest?

Is it in the interest of the patient to allow the affected joint to remain functional due to the misinterpretation of the word 'Vedanashaman' given in the text?

Is it, therefore not, essential for us - the Ayurvedic physicians - to think on this point?

2

Causes of vitiation of Majjavaha Srotas Functions of Asthidhatu ● ● ● ● Crushing of bones Injury and compression of bones or Gives firmness & stability to body Gives shape to body

●● ● Giving support to muscles & other organs of body bone marrow Excessive decalcification Intake of mutually ● ●Maintenance of balance & weight of body Protecting contradictory food

●important internal organs like heart, brain etc. With help of Symptoms of vitiation joints it performs activity or movements easily & without any ● ● ●Sandhishoola (Pain in joints) Parvashoola, Asthishoola friction.●Bhrama (Giddiness) Moorchha (Fainting) Vataprakopa Sushrutacharya has mentioned 300 bones in the human body.

●(Aggrevation of Vata) Tama pravesh (Darkness in front of Modern medicine mentions it as 206. Ayurved has also ● incorporated 'Kurchasthi' (Cartilage) in Asthi. Due to eyes) Shotha (Oedema)

difference in classification there is difference in quantity.Disorders of Majjavaha Srotas vitiation

SandhiVatavyadhi, Pakshaghata, Grudhrasi, Bhrama, Moorchha DemLveevleg mevOeÙees åÙesles kesâJeuee: heefjkeâerefle&lee: ~

Treatment hesMeer mveeÙeg efmejeCeevleg meefvOemebKÙee ve efJeÅeles ~ meg.Mee. 5ceppeeMeg›eâmeceglLeeve Deew<eOeb mJeeogefleòeâkeâced

Sandhi is formed with the union of 2 or more bones. There are DeVeb JäÙeJeeÙe JÙeeÙeeceew Megefæ: keâeues Ûe cee$eÙee ~~ Ûe.met. 28-26 2 types of Sandhi as per their movement.1. Sthira (Immovable Joints)The treatment for the disorders of Majja Shukra vitiation is diet

with Madhur & Tikta rasa, proper purification, proper exercise 2. Cheshtavanta (Movable Joints)& proper sexual activity.

MeeKeemeg nvJees: keâšÙee_Ûe Ûes<šeJevlemleg mevOeÙe: ~ Mes<eemleg mevOeÙe: meJex efJe%esÙee efn efmLeje yegOew: ~~ meg.Mee. 5-25Immovable Joints AsthiThe joints which are fixed and not movable are called as DemÙeles Fefle DeefmLe ~ ‘Sthira' Sandhi. e.g. Tunnasevani, Samudga.

The part which lasts even after the destruction of body is Movable Joints known as Asthi or bone. The joints that take part in movement and are freely movable efmLejkeâef"veeJeuecyevee Oeeleg: keâeÙemÙe are called Movable Joints i.e. Cheshtavanta Sandhi.

In movable joints Shleshmadhara Kala (Synovial ÙeceeefßelÙe mece«eb MejerjceJeefle<"les ~ membrane) is situated. The Synovial fluid present in them

Asthi or bone is the most strongest, hard and firm part of body helps in proper & free movement of the joint. Also the joint which balances the weight of body. It is also known as stays firm & does not get dislocated. It acts as a lubricant.'Dehasara'.

mvesneYÙeòesâ ÙeLee lJe#es Ûe›ebâ meeOeg ØeJele&les ~lemceeefÛÛejefJeve<šs<eg lJe*dceebmes<eg MejerefjCeeced ~ mevOeÙe: meeOeg Jele&vles mebefMue<še: Mues<ceCee leLee ~ meg.Mee. 4 DemLeerefve ve efJeveMÙeefvle meejehÙesleeefve osefnveeced ~ meg.Mee. 5-22 Joints are 210 in number.

Sandhi - Ghatak Vivaran

Majjavaha Srotas-Asthi & Sandhi

1. Kora Sandhi (Hinge Joint) 5. Tunnasevani Sandhi (Sutures)This sandhi or joint is like hinges of the The joints which have teeth like door e.g. Manibandha Sandhi (Wrist margins joining with each other which joint), Gulpha Sandhi (Ankle joint), look like sutures are 'Tunnasevani' Koorpara Sandhi (Elbow joint), Janu e.g. Joints in head.Sandhi (Knee joint), Parva Sandhi (Carpellar joints)

2. Udukhala Sandhi (Ball & Socket 6. Vayastunda Sandhi -Joint) These have structure similar to Joint which look like mouth or beak of ball & socket. One bone get fixed in crow e.g. Hanu Sandhi joint of cheen other bone with socket like structure. e.g. Ansa Sandhi (Shoulder joint), Vankshana Sandhi (Hip joint) 7.Pratara Sandhi

(Plane or Gliding Joints) The even 3. Samudga Sandhi - planes or flat articular surfaces of 2 These joints are like casket bones connects with each other to with lesser movements. form this joint. e.g. Cervical & Lumbar e.g. Shroni, Ansapeeth vertebrae

4. Mandal Sandhi - 8. Shankhavarta Sandhi -Joints made up of cartilage which are round in Joints like a conch shell e.g. joints in the shape e.g. Trachea ear.

Types of Sandhi (Joints) as per structure

In case of Sandhivikar i.e. Joints Disorders it is most Movement of joint is to be assessed by means of 'ROM' necessary to examine the basic part Sandhi & Asthi alongwith (Range of Motion of joint). Instrument to measure this is General or systemic examination. Goniometer.

The Most symptoms in joint disorders are functional or action Passive movement To be done with the help of physician based symptoms. Therefore, their analysis is to be done on check for end feel of joint movement. the same basis. Movement - Painful / not Painful

- complete / not completeIn Pratyaksha Pareekshan i.e. direct examination, the size & Active Movement - To be done by patient himself. shape of Sandhi (joints) & the related organs is most Compare Passive ROM with Active ROM.important. Also both the joints of opposite extremity are to be examined simultaneously.

Size & Shape of joint

Before treatment After treatmentExamination of Joint- MethodSize -1. Observation /InspectionShape of joint -2. PalpationEfficacy - Walking time Grip strength3. Examination Corelation with clinical tests

Laboratory Test - Investigations1. Pain in joints - Big joints -Small joints X-ray of joint, CT scan, MRI etc.

2. Location of painThese modern investigations are certainly helpful in diagnosis of joint disorders. But with the help of these Right side Left side Duration investigations, Vaidya has to evolve Ayurvedic point of view Shoulder jointin the treatment. e.g. Arthoscopy reveals degeneration of Elbow jointcartilage attached with joints then Snehan & Swedan are to

Wrist jointbe thought of.

Carpel jointMetacarpel joint Sacral jointHip jointKnee jointAnkle jointTarsal joint

Cervical vertebraeLumbar vertebrae

1. Observation● Skin colour● Redness● Discolouration-Trauma● Pigmentation● Skin hair loss, shiny skin (in muscular dystrophy)● Swelling● Deformity● Muscle wasting Muscular atrophy (Comparision with opposite extremity)

2.Palpation● Temperature - Thermostrip● Oedema pitting or non pitting● Tenderness ● Stiffness● Nerve tenderness● Numbness/Loss of sensation● Tingling sensation

3. Examination● Difficulty in activity● Immobility● Stiffness

Examination of Joints - Method & Necessity

3

Mahayogaraj Guggul

Hejb Jeelenjb•Αn excellent Guggulkalpa with

Bhasmas acting in chronic conditions of Vatavyadhi

•Acts as Rasayan, Deepan, Pachan, Amanashak, Vataghna & Dhatuposhak

•Useful in Sandhigata Vata, Jeerna Vatavyadhi, Vatarakta, Kushtha, Grahani, Shukradosha,

Maharasnadi Kadha•Well known remedy of Vatavikar with

famous Vataghna dravya 'Rasna'

•Amapachak, Amanashak & Shoolahar action

•Useful in Sandhivata, Ardhangavata, Ardita, Ekangavata, Amavata, Grudhrasi

•Useful as an adjuvant with Vataghna Guggul kalpas

Examination with Goniometer

Disease Pratyatmak Lakshan Disease Pratyatmak Lakshan

Sandhigata Vata Vatapoorna Druti Sparsha Pakshaghata Karmendriyahani (Loss of sensation & function)(feeling of joints like filled with

air, pain in joints), Shoola Grudhrasi Pain starting from lumbar region on

back and spreads downwards on Margavarodhjanya Vata Severe tenderness in jointsbackside of thigh & knees, leg to the feet

Manyakasherukagata Manyashoola, Bhrama, (pain in Amavata Vrushchika Damshavata VedanaVata neck region, giddiness)

(Excruciating Pain like sting of Scorpio, fleeting type of pain in big joints)

4

Joint Disorders - Specific Symptoms & Differential Diagnosis

Yogaraj Guggul•Excellent Amapachak & Vatanashak

Kalpa acting as Srotorodhanashak in Upastambhit Vatavyadhi

•Alleviates irritation of nerves & tones up the nervine system

•Useful in symptoms of Vatavyadhi such as pain, tenderness & oedema

Chaturmukh Rasa•Excellent Vatashamak, Balya, Deepak,

Pachak, Kshayaghna, Rasayan Suvarnakalpa

•Useful in Majjakshayajanya Vatavikar, Mastishkavikar, Moorchcha, Pakshaghata, Unmada, Apasmar, Kshaya, Jeerna Vatavyadhi

•Effective in nervine irritation developed after acute stage of Pakshaghata

Pratyatma or special characteristic feature of particular disease is important for diagnostic purpose.

Differential Diagnosis on the basis of symptoms

Pain in Joints

Sthayi Vedana (Continuous pain) Sanchari Vedana (Fleeting Pain)

Chala Sandhi Achala Sandhi Vrushchikdamshavat Vedana

Origin Trayodashang Guggul

Small Big

Joints Joints

Mild oedema Noise

Redness while movement

Local burning

sensation Yes No

Vataprakopa

Kaishor Guggul

DhatukshayajanyaNiramata

Mahayograj Guggul

AgnimandyaLocalizedrednessIncrease intemperature

Upastambhit Vata

Yogaraj Guggul

DhathukshayajanyaShosha

Mahayograj Guggul

Starting from thigh, ankle joints

Fatty Body Lean BodyTriphala Guggul Trayodashang Guggul

Localised increase in temperature

Prakrut Vruddhi

Nootan Jeerna Amavata Amavata

Sinhanad Gokshuradi Guggul Guggul

Constant (continuous) pain

Manyashoola (Neck pain) Osteoporotic changes/Hastasuptata (Numbness in hands) After fractureChimchimayan (Tingling sensation) Bhrama (Giddiness) Lakshadi Guggul

Manyakasherukagata Vata

Panchamrut Loha Guggul

CervicalVertebrae

Samata

5

Differential Diagnosis

Sandhigata Vata Amavata Vata Rakta1. Sandhishoola (Joint Pain) Present Present Present 2. Sandhishotha (Oedema/Inflammation of joints) Present Present Present3. Painful actions Present Present Present

Less actions & Immobility4. Starting from Big joints Big joints Parvasandhi

(Carpellar joints)5. Associated with fever Yes/No Yes Yes6. Tenderness Present/Absent Severe +++ Present7. Ushna Sparsha (hot sensation) Present/Absent Present Present8. Sanchari Vedana (fleeting pain) Absent Present Absent9. Dosha-Dushya Vata Vata + Ama Vata+Rakta10. Other symptoms Stiffness in joints Vruschikadamshaavata Vedana Manifestation of

(Pain like sting of Scorpio) papules in parvapradesh (carpels)

11. Relif from snehan Yes/No No Yes/No12. Swedan Sneha/Rooksha Sweda Rooksha Sweda Anupashaya

from Swedan

Vatavyadhi

Vayu or Vata dosha is associated with Asthi & Majja by Symptoms of Asthigata VataAsrayashrayi bhava. When Vatadosha is predominant in

YesoesÓefmLeheJe&Ceeb meefvOeMetueb ceebmeyeue#eÙe: ~Samprapti or etiopathology of a disease they are termed as 'Vatavyadhi'. DemJehve: meblelee ®keâd Ûe ceppeeefmLekegâefhelesÓefveues ~ cee.efve.In Vatavyadhi, the symptoms related to Asthigata Vata &

Aggrevation of Vayu in the bones & bone-marrow gives rise to Majjagata Vata are very much similar.cracking of bones & joints, piercing pain in the joints, Sandhivikar & Vatavyadhi are related with each other. As in diminution of muscle tissue & strength, causing weakness, Sandhidushti there is vitiation of Vatadosha predominantly. insomnia & constant painVatavyadhi manifests by getting sited in Sandhi (Joints) &

Vatanadi (Nerves).Symptoms of Snayugata Vata Aggrevation of Vayu in the Snayu gives rise to Stambha Causes (stiffness), Kampa (Tremors), Shoola (Pain) & Akshepa, ● Intake of dry, cold, light, Katu (Pungent), Tikta (bitter), Antarayama, Bahirayama, Khalli (neuralgic pain in feet, Kashaya (astringent) food, less intake of foodshoulders etc), hunch back & Vatavikar either Sarvangagata ● Excessive exercise, exertion, sexual indulgenceor Ekangagata i.e. pertaining to the entire body or part thereof.

● Weakness or emaciation ● Excessive use of purificatory methods

Symptoms of Sandhigata Vata ● Dhatushaithilya

nefvle meefvOeiele: mevOeerved Metueešesheew keâjesefle Ûe ~ cee.efve.● Suppression of natural urges● Excessive swimming, travelling Aggrevation of Vayu in joints gives rise to severe pain in joints, ● oedema or inflammation of joints, stiffness or looseness in Fall from horse, elephant, vehicle etc.

joints.● Injury to vital organs or marmas like Basti, Hrudaya, Shira`Atopa' - Joints on palpation appears like a leather bag filled ● Injury to sandhi or bonewith air.

In Vatavyadhi 2 types of Samprapti has been mentioned. `Gatatva' The normal tendency of Vayu is to travel throughout Dhatukshayajanya & Margavarodhajanya the body.

Due to vitiation or improper diet & lifestyle, Vayu gets vitiated in JeeÙeesOee&leg#eÙeelkeâeshees ceeie&mÙeeJejCesve Jee ~ Ûe.efÛe. 28quantity (Pramana) and or quality (Guna) and goes into dhatu and this phenomenon is called 'Gamitva'.According to the Nidan as Dhatukshayajanya or

Margavarodhajanya, the treatment will be different. Normally, it is felt that 'gatatva' of Vayu is only of academic importance. However, in day to day practice Ayurvedic physicians do come across cases where the diseases cannot be 'defined' in the usual way the modern science does. However, what the patient need is relief which can be provided only if the diagnosis is perfect.

Based on some specific symptoms, most commonly found gatatva cases can be treated with success. For differential diagnosis, couple of commonly seen gatatva symptoms are given below.

Bruhat Vata Chintamani Rasa•The well known Vatanashak kalpa

specially effective for heart & brain•Useful in Dhatukshayajanya Vatavikar,

Sandhigata Vata, Restricted movements or loss of activity in Pakshaghata, Ardita, Unmada, Apasmar & in symptoms of Hrudroga such as Palpitation, dyspnoea on exertion, feeble pulse

I had the pleasure of meeting Vd Shailesh Nadkarni adjustment whose pain was never shown. Hardworking

in around the year 1999. Its amazing now to mention at all times and dedicated to the task at hand.

that it has been only 7 years while in actuality it seems

he has been with us the whole of 135 years. He came A display of his depth of Knowledge is experienced

across as a young Ayurvedic Physician who had no when he navigates through his hours of study and

qualms of being introduced as Vaidya in an era of brings forth the wisdom in practice. A successful

Doctor. This is one of the first aspects regarding his physician is one who enters the treatment through the

personality that strikes you and makes a lasting mind of the patient. Medicine, diet, lifestyle are mere

impression. His background of BSc with BAMS and tools when this mental state is a bond between

then later MD in Kayachikitsa only goes on to refurbish Physician and Practitioner. Vd. Nadkarni's success in

his credentials as a man of science and a health care practice is this unique feature which distinguishes him

practitioner. apart from his peers and teachers. You have to be born

with people skilCd he is probably living his nth life on this

One is initially taken aback with the observation that gift of influencing and charging positively all that comes

his life has been scheduled 24x7. Even in the time in contact with him. In his current life we see this

without Shree Dhootapapeshwar in his life, his every strength of fusing people and teams, in perfection. This

day and hour ( 0800 hrs to 2200 hrs) was allocated to an facilitates the ground work for good delivery of health

activity. Multi centric Ayurvedic practice, associate care and naturally his patients enjoy the fruits of

teaching faculty, University teaching courses, Ayurved in this approach.

editorship of an upcoming Ayurvedic journal and

sufficient time to do 'good' for all around is what is seen. Patience to listen, allowing the patient to talk at

Joining Shree Dhootapapeshwar overturned his life in length during his first interview, never rushed and

many ways but he coped with it with élan and always attentive with retentive memory of details is what

makes him a satisfying health care

experience. Its bad enough to be a

patient of whatever ailment but to get

his magic touch is a relief that the

phase of ill health is short lived. There

are instances of chronic disorders

being treated and numerous

examples of an Ayurvedic approach

at work. He has never claimed magic

nor siddhi but delivered relief. He has

never barked on a telephone inspite

of being incessantly disturbed or

irrationally tapped. Seemingly

incurable and tired patients cursed to

a life of sufferance have gained from

his insight and approach. Families

have been blessed with extensions

and scores of us have benefitted from

a more suited approach to our health

issues.

Knowledge Hardwork Dedication & Service

An Ayurvedic Physician by the name Vd. Shailesh Nadkarni

6

Vd. Shailesh Nadkarni receiving the Vd. M.V. Kolhatkar Sanshodhan Puraskar at the hands of Vd. Shriram Guruji at Pune in presence of Dr. Mrs. Shubha Rawool, Mayor of Mumbai & Vd. S.P. Sardeshmukh, Chairman, Bharatiya Sanskruti Darshan Trust, Pune

You need to be honest and disclosing to gain and Vd. P.Y. alias Dada Khadiwale of Vaidya Khadiwale

we all have. In many ways he represents that security Vaidyak Sanshodhan Sanstha, a giant of our times,

that a family requires in health care and the best part is successful practitioner, teacher, manufacturer, role

that he is 100% Ayurvedic. model and motivator in the Ayurvedic sector has been in

contact with Vd. Nadkarni for the past few years. He has

observed and rightly recognised Vd. Nadkarni by Understanding limitation in self and practice and

bestowing him the Vaidya M.V. Kolhatkar never hesitant to cross refer to a more relevant and

Sanshodhan Puraskar 2007 for notable contribution suited line of treatment. Safe effective and a true

in the field of Research and Development of proponent of the wisdom the seers compiled to meet the

Ayurvedic Medicines. Its timely, deserving and an challenges of today with ease and relevance, as if

honour for Vd Nadkarni and all of us in Shree Ayurved was written with this individual patient in mind.

Dhootapapeshwar to be beside him in receiving this What more does one want from a family Physician who

prize. Its not the first time Vd Shailesh Nadkarni has is shastra shuddha.

been recognised and is certainly not the last.

'Students' a very major association in his life. Closer

Thank you and our gratitude to Vd Khadiwale and than relatives and almost family. Out and out teaching

his team of counsellors who made this right choice. all the time in one way or the other. Taking sheer

pleasure of accomplishment in the achievement of his

students. Guiding and counselling a good mind set and Congratulations Vd Nadkarni from all of us at Shree

supporting hard work. Not just associating with students Dhootapapeshwar, you make us proud. Deepest of

when they are students but to even participate in their appreciation to Devang, (Swapna) and Vd Devki

victories as their practice takes grip and when their life Nadkarni, who stand rock solid in support of Vd

takes the strangest of up's and down's, this Professor Nadkarni whilst he rises from strength to strength.

Nadkarni is something a student knows is there -

Ranjit Puranikbeside, behind and in front. Some of us from the outside

CEOcan only hope in the next life we will be fortuned with Shree Dhootapapeshwar Ltd.

such a guide. Till then it is better to just relish our current

association.

“Never hesitate from stating your mind and beliefs”,

“truth will prevail”, “stay calm and face the situation”, “if

there has been a mistake / lapse, admit it and move

on...” are the oft repeated sentiments of this colleague

at work. Vd Nadkarni assimilated himself in corporate

stream with minimum of hiccup. In his first few months

we often heard him asking the basics of “how” and

“what” but never “why”, in following a corporate policy

which he did not understand nor completely agreed

with. Never hesitating to speak to all at work and never

understanding the rungs of the invisible corporate

ladder this “friend” assimilated himself in the office

environ like a perfect fit. High energy, scrupulous

detailing and ready to learn still learning, all new skills

required to excel. Its been a treat and promises to be a

feast in the coming times to be alongside.

7

Vd. P.Y. Khadivale

A personality Dedicated to Ayurved

Founder

Vd. Khadivale Vaidyak Sanshodhan Sanstha, Pune

Sandhigata Vata giddiness.

PakshaghatJeelehetCe& ÂeflemheMe&: MeesLe: meefvOeielesÓefveues ~ØemeejCe Deekegâ_ÛeveÙees: ØeJe=efòeßÛe mebJesovee ~~ Ûe.efÛe. 28

ie=nerlJeeOeË& leveesJee&Ùeg: efmeje: mveeÙetefJe&Mees<Ùe Ûe ~The disease in which joints become oedematous & on he#ecevÙelejb nefvle meefvOeyevOeeefvJecees#eÙeved ~ cee.efve.palpation appears as if it is a leather bag inflated with air.

Paksha is hand, foot or one side of the body. Vitiated Vayu Joints are painful during extention & contraction, is termed as vitiates Sira, Snayu and Kandara in half of the body. It looses Sandhigata Vata.the muscle tone in one part of body.Vayu gets aggrevated in 2 ways;There is difficulty in movements of hands & limbs & loss of i)by the diminution of tissue elements (Dhatukshayajanya)sensation in either whole or half part.ii)by the occlusion of srotas (Margavarodhajanya)

Nirupstambhit Upastambhit Symptoms (Dhatukshayajanya) (Margavarodhajanya) Difficulty in movements in either hands or limbs, slurred Symptoms - speech, loss of control on excretory organs.•Vatapurnadrutisparsha Affects most of the large &

movable joints Ardit•Shoola Severe tenderness in joints `Ardita' is the disorder which is affecting half part of the face. It •Restricted movements Dourbalya manifests with attacks & during attacks there is pain.•Immobility of joints Araktavarna (Redness or The Vata situated in face & head gets aggrevated & affects

Inflammation in joints) one half part of face. Consequently face & neck gets crooked, trembling of head, tremors, slurred speech, pain in teeth & •Dourbalya Ushna sparsha, Jwara,

(Warmness felt over joint) neck, causing stiffness or locked jaw.

•Loss of activity Sanchari Vedana Amavata Treatment of Pakshaghat(fleeting type of pain)

Chikitsa-Treatment mJesoveb mvesnmebÙegòebâ he#eeIeeles efJejsÛeveced ~ Ûe.efÛe. 28Snehan Rooksha Sweda

External Snehan (massage with oil) locally as well as whole Swedan Mrudu Anulomanbody & internal snehan is advisable in Pakshaghata.Shaman Niruha BastiFor external massage Bala Taila, Narayan Taila. Brumhan GuggulkalpaSwedan (Fomentation) Bashpa SwedaUse of Bhasma & balya drugs Yogaraj Guggul

Mahayogaraj Guggul Vatavidhwansa Sneha Virechan - The main treatment of pakshaghata is to Maharasnadi Kadha maintain proper direction of Prana i.e. downward direction. Its

Suvarnakalpa dushya are Sira, Kandara, Pitta & Rakta whose treatment is Bruhat Vata Chintamani Chaturmukh Rasa virechan. Therefore Sneha Virechan is advised in

pakshaghata. e.g. Erandasneha or Gandharvaharitaki

Useful products Bruhat Vata Chintamani Rasa, Mahayogaraj Guggul,Yogendra Rasa, Chaturmukh Rasa, Sameerpannag

Manyakasherukagata Vata

Spondylysis, the disease as the name given by modern medicine is most common & known as Manyakasherukagata Vata by Ayurvedic fraternity.This Vatavyadhi is very common disorder seen nowadays due to dysfunctioning or abnormality in cervical vertebrae & nervine irritation. The manifestation of symptoms like pain in neck, tingling sensation in hands alongwith loss of sensation or numbness,

8

Yogendra Rasa●Suvarnakalpa with pure, safe & standardized

Suvarna Bhasma & Vanga Bhasma●Most effective in all vatavikar with action

as Rasayan & Bala, Veerya & Smrutivardhak

• Useful in Jeerna Vatavyadhi, Ardita, Pakshaghata, Prameha, Unmada, Apasmar

●Useful in sensory loss

Rasaraj Rasa

`meJe&JeeleefJekeâejs<eg jmejepe: Øekeâerefle&le: ~'•The best rasayan & tonic (balya) for

Vatanadis (nerves) specially effective in disorders of Vertebral column

•The Suvarnakalpa effective in chronic &

Dhatukshayajanya Vatavyadhis with action on Majjavaha Srotas & Mastishka

Vatavyadhi

Panchamrut Loha Guggul• Manyakasherukagata Vata-

Panchamrut Loha Guggul + Dashamoolarishta

• Avabahuk - Panchamrut Loha Guggul + Maharasnadi Kadha + Sthanik Swedan

• Grudhrasi - Panchamrut Loha Guggul + Vatavidhwansa + Maharasnadi Kadha + Sthanik Snehan, Swedan

Sandhigata Vata Manyakasherukagata Vata

Grudhrasi VataraktaThe disease in which person walks like vulture is named as Vatarakta is the disease caused by vitiation of Vata & Rakta. Grudhrasi. In this disease, the first symptom is stiffness, pain Both Vata & Rakta get aggrevated due to their own etiological specially pricking pain in 'Sphik Pradesh' hip region (i.e. waist, factors. Vata gets obstructed by the vitiated blood & gets back, thigh, knee & calf region) hence, it is called as 'Sphik localized in the phalanges & toes and thereafter other joints Purva' are afflicted. It develops Shotha

(oedema/swelling in joints), pain, Heeef<Ce&ØelÙeÓ*iegueerveeb leg keâC[je ÙeeÓefveueeefo&lee ~ tenderness, redness & warm touch. In this disease small joints are mainly affected. It MekeäLve: #eshes efveie=åCeerÙeeod ie=OeÇmeerefle efn mee mce=lee ~ meg.efve. 1/74is also described as Adhyavata or

The sthoola kandara (tendon) below ankle joint related to Vatashonita.ankle & toes get affected with Vatadosha & stops action of limbs is called as Grudhrasi.

Symptoms ●Severe pain in joints

Symptoms ●Pain starts from carpellar joints i.e. from fingers or toes and

●Pain in hip/lumbar region which spreads through back, hip, then spreads to all other jointsthigh, knee ankle upto soles

●Swelling, pricking pain, redness, itching in the joints region●Stiffness in hip & knee joint

●Joints are warm in touch●Pricking pain

●Severe tenderness or insensibility to touch●Immobility or restricted movements

●Jwara●Deformity in joints

●Twitching sensation or tremors●Discolouration of skin & appearance of circular patches over

Treatment the bodySnehan - Vishagarbha TailaSwedan - Nadisweda, Avagaha Sweda General Treatment Vedana Prashama - Vatavidhwansa Snehan, Virechan, Basti, RaktamokshanBasti, Agnikarma - Sushrutacharya has specifically Virechan - Mruduvirechan (mild purgative)

mentioned treatment like Siravedha Basti - Anuvasana, Niruha& Agnikarma in certain Vatarogas. Raktamokshan - Siravedha/JalaukavacharanGrudhrasi is one of them. Parishek

In Grudhrasi Siravedha & Agnikarma is to be performed in Pradehabetween Kandara & Gulfa.

Types of VataraktaUseful products

Uttana Gambheera ●Trayodashang Guggul●Vatavidhwansa Symptoms●Vatavidhwansa (Maha) Rasa (Jayapalyukta) ● Itching Oedema

● Burning sensation Stiffness● Pain Hardness● Extension Excruciating pain● Pricking pain Burning sensation● Throbbing sensation Pricking pain● Black or coppery Twitching sensation colouration of skin

TreatmentApplication of ointmentsAlepana (Pradeha, Lepa) Virechan (purgation)Abyanga (massage) Asthapana BastiParisheka Snehapana(kwath/swaras) (affusion)

9

Trayodashang Guggul

•The most admirable vatashamak & balya, rasayan Guggulkalpa

Amayik Prayog Grudhrasi - Trayodashang Guggul + Maharasnadi KadhaSandhivata - Trayodashang Guggul + Vatavidhwansa + DashamoolarishtaSandhigraha - Trayodashang Guggul + Vatavidhwansa (Maha) Rasa

Vatavidhwansa (Maha) Rasa (Jayapalyukta)•The best Amashoshak, Vedananashak,

Shothaghna & Vatashamak kalpa

•Useful in Vatavyadhis like Grudhrasi, Amavata, Vishwachi, Avabahuk, Manyagraha with symptoms like Stambha (stiffness), Shoola (pain) & Shofa (Oedema)

•Useful for virechan in pakshaghata due to ingredient Jayapala

Kaishor Guggul

•The potent Vatahar & Raktagata doshapachna action due to Amruta Vishesh Shodhit Guggul

•Helpful in Vatarakta with Shoolahar & Vedanasthapan actionAmayik PrayogVatarakta - Kaishor Guggul + Guduchi Choorna + DashamoolarishtaKushtha - Kaishor Guggul + Mahamanjishthadi Kadha

Vatavyadhi

Release of the book, `Ayurvediya Aushadhikaran' at the hands of Union Health Minister, Dr. Ambumani Ramadoss at World Ayurved Congress organized by Pune University (Left to Right Vice Chancellor, Pune University, Dr. Narendra Jadhav; Vd. Shailesh Nadkarni, General Manager, Healthcare Services, Shree Dhootapapeshwar Ltd., Dean of Ayurved Faculty, Dr. V.V. Doiphode and Shri. Ranjit Puranik, Chief Executive Officer, Shree Dhootapapeshwar Ltd.

Shree Dhootapapeshwar Ltd. being given the Nagarjuna Award for its Standardised and Best Quality medicine production. The award being received by Chief Executive Officer, Mr. Ranjit Puranik, from the then Vice President, Mr. Bhairavsingh Shekhawat (Left to Right Vd. Devendraji Triguna and Vd. Shriramji Sharma the then President, C.C.I.M.)

Release of Clinic Management System (C.M.S.) C.D. at the hands of the then Governor Rajasthan, Smt. Pratibhatai Patil at the 57th Plenary of All India Ayurved Congress (Left to Right Vd. R.H. Singh, Vice Chancellor, Rajasthan Ayurved University; Vd. Devedraji Triguna and Ex-Chief Minister of Rajasthan, Mr. Gehalot)

Ex-Chief Minister Rajasthan, Mr. Gehalot, Smt. Pratibhatai Patil visited Shree Dhootapapeshwar Ltd. stall at 57th All India Ayurved Congress and gave compliments to Swamala Compound (Left to Right Ex-Chief Minister Mr. Gehalot and then Governor of Rajasthan Her Honour Pratibhatai Patil)

Memorable Moments

10

Shree Dhootapapeshwar Ltd. stall at "Arogya 2007" an event and exhibition organized at Pragati Maidan, New Delhi on 26th to 29th October 2007

Shree Dhootapapeshwar Ltd. stall at "Arogya 2008" an event and exhibition organized at Lal Bagh Palace, Indore on 4th to 7th January

Release of `Arogyamandir Patrika - Skin Disorders' at "Arogya 2008", Indore, Madhya Pradesh, at the hands of (Left to Right) Dr. S.K. Sharma, Respected Advisor, Ayush Department, New Delhi and The Minister for Medical Education Dr. Gauri Shankar Shejwar

Memorable Moments

11

In this issue of 'Arogyamandir Patrika’ , we have Maharasnadi Kadha, Dashamular ish ta , discussed the different cause, sign and symptoms of Ashwagandharishta are the products from our “Sandhivikar” with the line of treatment proved to be Standarised ‘Asava Arishta Kadha’ range which beneficial along with Ahar Vihar. offers the great benefit for such conditions in

‘Sandhivikar’. As you are aware that in such conditions we offer you the range of ‘GuggulKalpa’ like ‘Mahayograj Doctor, you have the experience of the quality Guggul, Yograj Guggul, Panchamrut Loha Guggul, medicines of Shree Dhootapapeshwar Limited in your Kaishor Guggul, Trayodashang Guggul’ which not only day to day practice and continuing your patronage for guarantee better results but also ensures a) Fast the same for which we are thankful and oblige. disintegration (less than 30 min.) & absorption b)No We reconfirm and resolve to be in the service in the side effects like gastric irritation or skin rashes. Ayurved being the manufacturer of ‘Authentic,

Products from our 'Suvarnakalpa’ range useful for Standardised, Safe and Efficacious’ products as we such conditions like Brihat vata Chintamani Ras, have been for last 125 years.Chaturmukh Ras, Rasaraj Ras not only has Survanra

With warm regardsBhasma containing more than 97% Survarna but also P. N. Joardargives you the confidence of being non toxic and safe

Sales Manager even when used for prolonged duration.

Upanaha (hot poultice)Guduchi (Vyadhipratyanik drug)

Useful product Kaishor GuggulAmavata, the disorder caused due to Rasavaha Srotas

Osteoporosisvitiation, similarly the symptoms developed due to Rasadushti.

The process of bone thinning or degeneration (Osteoporosis) But as the manifestation & is a natural part of aging. Still after certain limit the bones localization is in joints, showing become porous or their density is less, causing the fractures of symptoms as Sandhishoola &

Sandhishotha (pain & oedema bones or bone loss.in joints) it has been included in Sandhivikar for purpose of differential diagnosis. Symptoms -This is the acute disease in which there is vitiation of vata &

•Back painformation of Ama both at the same time with manifestation in joints. •Loss of height & stooped posture

ÙegiehelkegâefheleeJevleefŒekeâmeefvOeØeJesMekeâew ~ •A curved upper back (dowager's hump)

mleyOeb Ûe kegâ®lees iee$eceeceJeele: me GÛÙeles ~ cee.efve. •Bone get cracked (fracture) even with minor injury, especially in the hip, spine & wrist

The disease can occur at any age but mainly it affects in middle age. It is very painful & serious disease.

Treatment - Symptoms -

The early diagnosis of Asthikshaya (Osteoporosis) is very ● Body ache, Loss of taste, thirst

important as far as treatment is concerned. If the treatment is ● Lack of enthusiasm, heaviness in the body

given early, one may be able to stop or slow the progress of ● Fever

bone loss.● Oedema, Indigestion● Pain & inflammation in big joints of hands & legs like hip,

Ahara -knee, ankle, elbow, wrist etc.● Milk, Wheat, Ragi, Severe tenderness, redness, warm touch● Immobility of organs of body● Fleeting pain shifting from joint to joint Vihara -

Regular proper exercise, Prevent fractures, Maintain or Treatment - increase bone thickness, Increase physical abilityuebIeveb mJesoveb efleòeâoerheveeefve keâšgefve Ûe ~

Aushadhi -efJejsÛeve mvesnheeveb yemleÙeMÛeececee®les ~Useful for increasing Bone Mass Density.

The main treatment is to destroy Ama. For Amapachan, Asthiposhak Dravya - Laksha, Shatavari, Praval, Langhana (Fasting) with use of Tikta (bitter) & Katu (pungent) Kukkutandatwak Bhasmadrugs are advised.

●Amapachan - Langhan, Tikta-Katu Rasatmaka DravyaSnehan - Mrudu Snehan

●Swedan - Rooksha Sweda, Valukasweda Sneharahit Upanaha●Virechan - Erandsneha Vyadhipratyanik

DeeceJeele iepesvõmÙe MejerjJeveÛeeefjCe: ~SkeâcesJee«eCeern&efvle Sjb[mvesnkesâmejer ~

Erandsneha or Castor oil is the first line of treatment in Amavata.●Basti - Vaitaran Basti Prayog●Herbal drugs - Erandasneha, Guduchi, Shunthi,

Bhallatak, Karaskar, Suvarna

Useful products -Sinhanad Guggul, Vatavidhwansa, Vatavidhwansa (Maha) Rasa (Jayapalayukta)

In the Jeernavastha (chronic condition) of Amavata & in Dhatukshayajanya Amavata Suvarnakalpas are best Rasayan which prohibits recurrence.

12

Shree Dhootapapeshwar Ltd.

135, Nanubhai Desai Rd., Khetwadi, Mumbai - 400 004Tel. No: 91-22-3003 6300 Fax: 91-22-2388 1308e-mail: healthcare@sdlindia.comwebsite: www.sdlindia.com

For more details please contact:Health Care Services

Amavata

Sinhanad Guggul●The wellknown remedy of Amavata with

Vyadhipratyanik Erand taila●Excellent Vatahar, Shothahar, Shoolahar

& Amanashak Kalpa●Beneficial in Amavata with main action of

virechan

Lakshadi Guggul

• Useful Asthisoushiryajanya Sandhishool & Asthibhagna

• Beneficial in Asthibhagnottar Sandhishool

Asthisoushirya - Lakshadi Guggul +Praval Panchamrut + Kukkutandatwak Bhasma

Asthibhagna - Lakshadi Guggul + Kukkutandatwak Bhasma + Ashwagandharishta

Asthibhagnottar - Lakshadi Guggul + Shool Dashamoolarishta