Upload
jyothi-p
View
343
Download
4
Tags:
Embed Size (px)
DESCRIPTION
detailed descriptive information on vata rakta/gouty arthritis treatment gathered from different ayurvedic classics
Citation preview
By:
Dr. P. Jyothi P.G. Scholar
Kaya Chikitsa department
Dr.BRKR Govt.Ayurvedic Medical College
Hyderabad.
A Presentation
on
Vãta Rakta Chikitsa
Introduction : A chronic disease or a chronic illness is defined as a condition which develops
gradually through years because of frequent and continuous exposure to abnormal dietary, lifestyle or environmental factors.
Initially there may be absence of diseased symptoms but at later stages, complex
manifestations involving one or more organs leading to derangement of bodily functions will be seen in chronic diseases.
Vãta Rakta in Ayurveda is considered as one such chronic illness which is
commonly seen affecting nearly 14-17 percent of population every year.
It is caused by vitiated Vãta and Rakta. Vitiated Vãyu obstructs the path of vitiated Rakta in the beginning and then gets vitiated by Rakta further this complete process is known as Vãta- Rakta.
Types of Vãta Rakta mainly include Uttãna, Gambhira, Vãta Pradhãna, Pitta Pradhãna, Kapha Pradhãna, and Rakta Pradhãna.
Clinical Features of Vãta Rakta ranges from mild inflammation and discoloration of skin to complete derangement of bodily organs depending up on its type and chronicity. Chronic and later stages of Vãta Rakta also cause complications like mamsa kotha, murcha, marma graham, anguli vakrata etc.
Though Vãta Rakta is mentioned to be as kriccha sãdhya vyãdhi, by strictly following the protocol of Vãta Rakta chikitsa as mentioned in various Ayurvedic classics a physician can boldly treat this condition.
Keeping this in view, through this presentation an effort of highlighting various important Ayurvedic treatment measures which can be used for effective management of Vãta Rakta has been made.
Objectives :
To review effective ayurvedic treatment measures of Vãta Rakta.
To increase scope of Vãta Rakta management through various treatment modalities as mentioned in Ayurvedic classics.
Vãta Rakta Chikitsa Sutra : Sãmãnya Chikitsa वि�रे�च्य: स्ने�हयियत्� दौ� स्ने�ह य�क्तै� र्वि��रे�चने�: रूक्क्षै��� म्रु�दुभि�शस्त मसक्रु� द्वस्तिस्तकम� च || स�क भ्यग्ङ प्रदौ�ह न्न स्ने�ह: प्र य+ अवि�दौ विहने: � तरेक्तै� प्रश्स्यम्त� वि�श�षम0 त� विनेबो+ध म� || (च.चिच. 29/42)
Uttãna and Gambhiraja Chikitsa बो ह्य म ले�पने भ्यन्ग्ङ0 परिरेष�क+पने हने� वि�रे�क स्था पने स्ने�हप ने�र्ग�म्भी;रेम चरे�त0 || (च.चिच.
29/43)
Vãta Pradhãnaja Chikitsa `
सर्विप�स्त�ले �स मज्जा प ने भ्यग्ङ �स्तिस्तभि�: स�क+ष्णै� रुपने ह�श्च � त+थ्तरेम�प चरे�त0 || (च.चिच. 29/44)
Pitta and Rakta Pradhãnaja Chikitsa वि�रे�चने�र्घ्रु��तक्षै;रेप ने� स्स�क� श्च �स्तिस्तभि�: श;त�र्विने�� �पणै� श्च विप रेक्तै विपत्तो+त्तोरेम0 जय�त0 || (च.चिच. 29/45)
Kapha Pradhãnaja Chikitsa �मनेम0 म्रु�दु ने त्यध�म0 स्ने�हस�क वि� लेग्ङनेम0 क+ष्णै ले�प श्च शस्यम0 त� � तरेक्तै� कफो+त्तोरे� || (च.चिच.
29/46)
Vãta rakta chikitsa upakrama:
Treatment measures of Vãta Rakta include both Antah Parimãrjana and Bahir Parimãrjana Chikitsa as shown in the figure.
ANTAH PARIMãRJANA CHIKITSA
SHODANA Chikitsa:Ãma Pãchana and Agni Deepana It is carried out Prior to Shodana chikitsa with Tikta, Katu rasa and Rũksha
guna prãdhãnya drugs according to Rogi and Roga bala for a duration of 3 to 5 days.
1. Shaddarana ch rna ṹ
(Gambhira and pittaja)
Dose - 3 to 6gm, bid, before food
Anupãna – Honey/Ushna jala
2. Pancasama ch rnaṹ (vãtaja)
3. Guduchyãdi or Amrutottara
kvãtha (pittaja, kaphaja)
Dose – 15 to 20ml, bid, before food 4. Dashamoola kvãtha
(Vãtaja) Anupãna – Ushna Jala
Sneha Pãna
Sneha Pãna is carried out according to koshta bala and prakruti of patient and also according to predominant dosha present i.e.
1. Vãta Prãdhãna Vãta Rakta - Sadphala ghritam, Madhu yashtyãdi tailam,
Ksheera balã tailam, Dhanvantari ghritam
→ All these sneha dravyas does Brimhana and Vãta hara Karma
2. Pitta Prãdhãna Vãta Rakta - Mahã tiktaka ghritam
→ This ghrita promotes Rakta prasãdana and pitta Shãmaka karma
3. Kapha Pradhãnya Vãta Rakta - Guggulu tiktaka ghritam
- Madhu yashtyãdi tailam and Dhanvantari ghritam
(Only in selected cases)
→ All these sneha dravyas does Ushna guna and kapha hara Karmas
Sneha Pãna is given in a dose of 40 to 60 ml, twice daily, before food for a duration of 5 to 7 days.
Sneha Pãna is Contra indicated in medo mãrgãvarana janya Vãta Rakta.
Svedana Usually Svedana is contraindicated in Vãta Rakta but just for the purpose Of
Virechana we can go for “Mrudu Svedana”. Potalam and Sekam measures are followed to promote svedana in Kapha
pradhãna Vãta Rakta. In few Vãta Pradhãna Vãta Rakta conditions, very mild Upanãha Svedana is
advised.
ss
Vamana In Gambhira and Kapha pradhãna type of Vãta Rakta and in few Pitta Pradhãna Vãta
Rakta cases associated with severe complications,
“Mrudu Vamana Karma” is carried out with Madanaphala, Yashti madhu and Ksheera (Ãkantabharitha) according to koshta bala of rogi and roga avastha.
Virechana In Gambhira, Pitta, Kapha and Rakta prãdhãnya Vãta Rakta “Mrudu Virechana
Karma”with 25ml Eranda tail or Nimbha Amrutha Eranda tailam given with milk is carried out according to rogi and roga bala.
Vasthi Specifically in Vãta Pradhãna type of Vãta Rakta and in presence of symptoms like
Basti sh la, Vankshana shṹ ũla, Pãrswa shũla and Udara shũla, “Vasthi Karma” is considered to be as a best treatment of choice.
विनेह�रे�द्व मलेम0 तस्य स र्घ्रु�त�: क्षै;रे�स्तिस्त भि�: ने विह �स्तिस्त समम0 विकन्चिन्चद्व तरेक्तै चिचविकस्तित्सतम0 || �स्तिस्त �क्षैणै प रे0�श्वो+रुप� �स्थिस्था जठरे र्वित�श� | (च.चिच.
29/88) Administration of Ksheera Vasti/ Balã Gud cyãdi Ksheera Vasti ṹ is widely
emphasized in all types of Vãta Rakta and especially in Vãta Pradhãna condition.
→ Ingredients of Ksheera Vasti include: Mãkshika – 100ml Sneha (mahã tiktaka ghritam and balã tailam 100ml each) – 200ml and Gud cyãdi Ksheera kvãtha – 200mlṹ
Apart from ksheera vasti, Gud chyãdi yãpana vasti in Kapha Pradhãna Vãta Rakta ṹand Pancha tiktaka vasti in Pitta Pradhãna Vãta Rakta are also preferred to some extent.
→ Ingredients of Gud chyãdi Yãpana vasti include:ṹ
Mãkshika – 100ml, Lavana - 15 gm, Sneham (madhu yashtyãdi tailam and tiktaka ghritam 100ml each) – 200ml, Kalkam (satãhva) – 30gm and Kvãtham (gud chyãdi) – 400mlṹ
→ Ingredients of Pancha tiktaka vasthi include:
Mãkshika – 100ml, Sneha (Pancha tiktaka ghritam) – 200 ml and
Gud cyãdi Ksheera kvãtha – 200ml ṹ
For Ksheera vasti, Guduchyãdi Yãpana vasti and pancha tiktaka vasti, either yoga
or Kãla vasti protocol can be followed.
Rakta mokshana
In bhrihatrayee“Rakta mokshana” was mentioned as first line of treatment to be opted for chronic Vãta Rakta condition.
Prior to Rakta mokshana certain measures like snehana, mrudu virechana n
vasti should be followed.
Rakta mokshana according to types of Vãta Rakta
1. Uttãna – Shringi, Jalauka, Alãbu and Prãcchanna
2. Gambhira – Sirãvyadhana
3. Vãtaja – Shringi
4. Pittaja and Raktaja – Jalauka
5. Kaphaja – Alãbu
If lesions are small and if pain moves from one part of the body to the other
then bloodletting should be done by pracchana.
SHAMANA CHIKITSA:
Gud ci is considered as Agra ṹOushada for Vãta Rakta. It is administered in many forms.
Shamana chikitsa of Vãta Rakta include administration of drugs like
Shamana oushada Drugs Dose Anupãna
Rasa or Bhasma Rasa mãnikya ras- kaphaja; Mahã tãleshwar ras; Tãla bhasma; Gandhaka bhasma - Pittaja
125-250 mg, od/bid Madhu
Vati or Guggulu Ārogya vardhini vati- Tridoshaja; Goksh rãdi guggulu- ṹVãtaja; Kaishore guggulu and Amruthãdi guggulu- Gambhira,Pittaja,Kaphaja and Raktaja; Punarnava,Yoga raja and Simhanãda guggulu-Kaphaja
250-500 mg, bid Gud ci kvãtha, ṹ Ushna jala
Shamana oushada Drugs Dose Anupãna
Ch rnaṹ Hareetaki, Manjishtãdi, Nimbãdi, Chopchinyãdi
3-6 gm, bid Ushna jala or Madhu
Āsava or Arista Sãribhyãdãsava, Manjishtyãdarishta,Amrutãrishta
20-40 ml, bid Jala
Kvãtha Dashamoola- Vãtaja; Manjishtãdi- Tridoshaja; Amrutãdi/ Amruttotara- Gambhira, Pittaja and Raktaja; Rãsnã saptaka and Guggulu tiktaka- Kaphaja
20-30ml,bd,before food
Jala or Madhu
Shamana oushada Drugs Dose Anupãna
Ghrita Gud chyãdi- ṹTridoshaja; Satãvari, Sukumãraka,Jeevaniya, Bhallataka- Kaphaja
10-20ml,bd Ksheera
Taila Pinda, Madhu parnyãdi,Balã and Dhanvantari- Vãtaja; Gud cyãdiand ṹNãrãyana- Pittaja; Kottam chukkãdi and cinchyãdi- Kaphaja
Depends on mode of administration
Depends on mode of administration
Rasãyana Chyavana prãsa- Vãtaja and Pittaja; Vardhamãna pippali-Kaphaja and Vãtaja; Bhallataka- Kaphaja; Shilãjith- Tridoshaja
20gm,bd Ksheera
bahir PARIMãRJANA
CHIKITSA
Bahir Parimãrjana Chikitsa is followed as general measure of treatment for all types of Vãta Rakta but it is specifically considered as a main line of treatment for Uttãna Vãta Rakta.
It includes External measures like
1. Avagãhana – Nimbha patra or Gud ci patra are used for Avagãhana karma ṹ(fumigation)
2. Lepa – Madhuchista, Dashãnga, Tagarãdi, Pra Poundarikãdi/Sata doutha ghrita,
Krishna tila etc are used for ext.application on Vãta Rakta affected joints.
3. Upanãha – Mainly advised for Uttãna, Vãtaja and Kaphaja Vãta Rakta.
- Vãtagna Snigdha upanãha and Tila pinda upanãha are advised.
4. Seka
5. Abhyanga Carried out with Pinda/Balã/Dhanvantari/Gud cyãdi tailamṹ
6. Dhãra
Single drugs
Gud ciṹ Sãribha Guggulu Shilajith Bhallãtaka Erandamoola Patola Sunti etc
PATHYA -aPATHYA
Pathya Apathya
Āhãraja: Sh ka dhãnyaṹ - Shashtika shãli, Yava, Lãja, Godhuma Shami dhãnya- Mudga, Kulttha, Mãsha Mãmsa varga- Grãmya mãmsa, jãngala mãmsa Jala varga- Ushna jala Ksheera varga- Goksheera, Ajã kseera
Katu, Ushna, Guru, Lavana, Madhya, Dadhi, Kshãra, Kulutta, Āmla, Pinyãka,Abhishyandi, Moolikãdi
Vihãraja: Abhyanga and Parishekana etc Divã swapna, Ātapa Sevana, Ati Vyãyãma, Ati Maithuna etc
Ideal treatment plan :
1. Nidãna Parivarjanam 2. Samsodhana Chikitsa (Yathochita)3. Bahir Parimãrjajana Chikitsa (Yathochita)4. Samshamana Chikitsa • Rasa mãnikya Ras – 125mg + Gud ci Satva – 500mgṹ + Ārogyavardhini Vati – 250mg 1- bd with Honey, before food + Chopchinyãdi Ch rna – 2gmṹ• Kaishore guggulu : 2- bd to tid with Luke warm water , before food • Manjishtyãdarishta : 20ml- bd with equal quantity water, after food • Satãvari Ghrita : 20ml- bd with milk, after food • Pinda tailam : for external application 5. Pathya-Apathya
Conclusion:
Thus the descriptive presentation on Vãta Rakta chikitsa is concluded.
An attempt of presenting Vãta Rakta Chikitsa in a detailed manner is
made expecting it to be beneficiary for Ayurvedic research scholars and hence providing further scope to carry out even more research on this aspect.
References:
Charaka Samhita, Chikitsa Sthãna.29th chap Sushruta Samhita, Chikitsa Sthãna.5th chap Ashtãnga Hridaya, Chikitsa Sthãna.22nd chap Bhãva Prakãsha Samhitha, 29th chap Bhaisajya Ratnãvali, Vãta Rakta Chikitsã Prakaran Sãrangadhara Samhitha Rasendra Sãra Sangraha L. Mahadevan’s Clinical methods of Ayurveda book, vol.2 Prof. Ajay Kumar Sharma’s Hindi text of Kaya Chikitsa, vol.2
Thank You..