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{{#seo:

{{#seo:

|title=Rheumatic diseases

|title=Rheumatic diseases

|label1 = Section/Chapter/topic

|label1 = Section/Chapter/topic

|data1 = [[Concepts and Contemporary Practices]] -[[Nidana]] [[Chikitsa]] / [[Vyadhi]] / Psychiatric diseases  

|data1 = [[Concepts and Contemporary Practices]] -[[Nidana]] [[Chikitsa]] / [[Vyadhi]] / Rheumatic diseases  

|label2 = Author

|label2 = Author

|data2 = Rammanohar P. ¹

|data2 = Ram Manohar P. ¹

|label3 = Reviewer  

|label3 = Reviewer  

|data3 = Basisht G.²

|data3 = [[Gopal Basisht|Basisht G.]]²

|label4 = Editors

|label4 = Editors

|data4 = Deole Y.S.³, Aneesh E. G.²  

|data4 = [[Yogesh Deole|Deole Y.S.]]³, Aneesh E. G.⁴  

|label5 = Affiliations

|label5 = Affiliations

|data5 = ¹ Research Director, Amrita School of Ayurveda, Amritapuri, Kollam, Kerala, India.

|data5 = ¹ Research Director, Amrita School of Ayurveda, Amritapuri, Kollam, Kerala, India.

²[[Charak Samhita Research, Training and Development Centre]], I.T.& R.A., Jamnagar, Gujarat, India 

 

²Rheumatologist, Orlando, Florida, U.S.A.

³ Executive Editor and Professor in Kayachikitsa, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India  

³ Executive Editor and Professor in Kayachikitsa, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India  

|label6 = Correspondence emails

|label6 = Correspondence emails

|data6 = carakasamhita@gmail.com

|data6 = rammanoharp@gmail.com,

carakasamhita@gmail.com

 

|label7 = Date of first publication:

|label8 = Date of first publication:

|data7 = January 24, 2022

|data8 = January 24, 2022

|label8 = DOI

|label9 = DOI

|data8 = Under process

|data9 = 10.47468/CSNE.2022.e01.s09.084

}}

}}

<div style='text-align:justify;'>  

<p style="text-align:justify;">This article is based on a lecture delivered by Vd. P. Ram Manohar, Research Director, Amrita School of Ayurveda, Amritapuri, Kollam, Kerala, India. in Prof. M. S. Baghel Memorial Lecture Series on November 09, 2021.</p>

This article is based on a lecture delivered by Vd. P. Rammanohar, Research Director, Amrita School of Ayurveda, Amritapuri, Kollam, Kerala, India. in Prof. M. S. Baghel Memorial Lecture Series on November 09, 2021.

==Rheumatism & Rheumatology==

==Rheumatism & Rheumatology==

==Joint diseases in [[Ayurveda]]==

==Joint diseases in [[Ayurveda]]==

   

   

A careful study of the classical Ayurvedic texts reveals that joint and connective tissue disorders can be broadly divided into three categories viz ‘[[Amavata]]’, ‘Vatarakta’ and ‘Sandhivata’. These disease entities are quite comprehensive as they represent the possible pathologies that can arise in the joints due to the derangement of [[kapha]], [[pitta]], and [[vata dosha]] respectively. There are other ailments of the joints to be considered like inflammatory swelling of the knee joint (kroshtukashirsha). An accurate fixed modern correlation is not at all possible in any of these conditions. ‘[[Amavata]]’ is correlated to rheumatoid arthritis, but the concept is much broader than that. It includes many other conditions like rheumatic fever, ankylosing spondylitis etc. In ankylosing spondylitis, when there is axial spondyloarthropathy the symptoms resemble [[amavata]].[M.Ni. Amavatanidana/5]<ref name=Madava/> There will be stiffness in the entire spine. It’s an assortment of conditions put together because it mainly affects musculoskeletal diseases or due to the involvement of autoimmune pathologies. Rather than a fixed correlation, it is always beneficial to keep a separate diagnosis system. A diagnosis in conventional medical system is based on the available criteria. Parallelly, Ayurvedic diagnosis of the same condition can be done based on classical clinical features.

A careful study of the classical Ayurvedic texts reveals that joint and connective tissue disorders can be broadly divided into three categories viz ‘[[Amavata]]’, ‘Vatarakta’ and ‘Sandhivata’. These disease entities are quite comprehensive as they represent the possible pathologies that can arise in the joints due to the derangement of [[kapha]], [[pitta]], and [[vata dosha]] respectively. There are other ailments of the joints to be considered like inflammatory swelling of the knee joint (kroshtukashirsha). An accurate fixed modern correlation is not at all possible in any of these conditions. ‘[[Amavata]]’ is correlated to rheumatoid arthritis, but the concept is much broader than that. It includes many other conditions like rheumatic fever, ankylosing spondylitis etc. In ankylosing spondylitis, when there is axial spondyloarthropathy the symptoms resemble [[amavata]].[M.Ni. Amavatanidana/5] <ref name=MNi/> There will be stiffness in the entire spine. It’s an assortment of conditions put together because it mainly affects musculoskeletal diseases or due to the involvement of autoimmune pathologies. Rather than a fixed correlation, it is always beneficial to keep a separate diagnosis system. A diagnosis in conventional medical system is based on the available criteria. Parallelly, Ayurvedic diagnosis of the same condition can be done based on classical clinical features.

===[[Amavata]]===

===[[Amavata]]===

===Vatarakta===

===Vatarakta===

Vatarakta is usually seen in middle age. [[Pitta dosha]] dominance is observed in this age. It manifests due to vitiation of blood ([[rakta dhatu]]) and [[vata dosha]] at the same time. It affects not only the joints but also the skin and blood vessels. Typically the disease starts with the symmetrical involvement of smaller joints of both  hands and feet. [Cha.Sa.[[Chikitsa Sthana]] 29/12] [A.Hr.NidanaS thana 16/7]<ref name=Hridaya/> Symmetrical arthritis is also a typical feature of rheumatoid arthritis described in conventional medicine.  

Vatarakta is usually seen in middle age. [[Pitta dosha]] dominance is observed in this age. It manifests due to vitiation of blood ([[rakta dhatu]]) and [[vata dosha]] at the same time. It affects not only the joints but also the skin and blood vessels. Typically the disease starts with the symmetrical involvement of smaller joints of both  hands and feet. [Cha.Sa.[[Chikitsa Sthana]] 29/12] [A. Hr. Nidana Sthana 16/7]<ref name=Hridaya/> Symmetrical arthritis is also a typical feature of rheumatoid arthritis described in conventional medicine.  

In later stage, it spreads all over and systemic involvement is seen. [A. Hr. [[Nidana Sthana]] 16/7]<ref name=Hridaya/> In advanced stages, severe deformity of the joints is seen. When the skin is involved, it shows cutaneous manifestations. When blood vessels are involved, it can cause damage to the blood vessels, extreme pain, and even death.

In later stage, it spreads all over and systemic involvement is seen. [A. Hr. [[Nidana Sthana]] 16/7]<ref name=Hridaya/> In advanced stages, severe deformity of the joints is seen. When the skin is involved, it shows cutaneous manifestations. When blood vessels are involved, it can cause damage to the blood vessels, extreme pain, and even death.

====Treatment principles====

====Treatment principles====

   

   

Vatarakta is said to be a condition where the body is in a state of anger against its systems. [A. Hr. Chikitsa Sthana 22/18]<ref name=Hridaya/>    It is suggestive of autoimmune disorder. Just like anger cannot be appeased suddenly, the treatment of vatarakta also requires patience and an abundant amount of time. The flare-ups are unpredictable. After removing the [[ama]] and the body is purified the treatment should be continued for a long period to prevent a recurrence. This principle of treatment is very relevant in autoimmune diseases.  

Vatarakta is said to be a condition where the body is in a state of anger against its systems. [A. Hr. Chikitsa Sthana 22/18]<ref name=Hridaya/>    It is suggestive of autoimmune disorder. Just like anger cannot be appeased suddenly, the treatment of vatarakta also requires patience and an abundant amount of time. The flare-ups are unpredictable. After removing the [[ama]] and the body is purified the treatment should be continued for a long period to prevent a recurrence. This principle of treatment is very relevant in autoimmune diseases.

===Sandhivata===

===Sandhivata===

Pain associated with movement is the typical feature of this condition. Swelling of the affected joint is present. On palpation, the joint feels as if filled with air. It may affect any joint.

Pain associated with movement is the typical feature of this condition. Swelling of the affected joint is present. On palpation, the joint feels as if filled with air. It may affect any joint.

Osteoarthritis is prevalent in old-aged persons. [[Vata dosha]] dominance is seen in this age group. In sandhivata, the main focus is on [[Vata dosha]]. It is usually correlated to osteoarthritis. Apart from this, other degenerative joint conditions like lumbar and cervical spondylitis also come under the umbrella of sandhivata.  

Osteoarthritis is prevalent in old-aged persons. [[Vata dosha]] dominance is seen in this age group. In sandhivata, the main focus is on [[Vata dosha]]. It is usually correlated to osteoarthritis. Apart from this, other degenerative joint conditions like lumbar and cervical spondylitis also come under the umbrella of sandhivata.

==Ayurvedic perspective of rheumatoid arthritis==

==Ayurvedic perspective of rheumatoid arthritis==