Charak Samhita

Vatavyadhi Chikitsa: Difference between revisions

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| ''Gati'' of ''vata'' is obstructed
| ''Gati'' of ''vata'' is obstructed
| ''Gati'' of ''vata'' is aggravated
| ''Gati'' of ''vata'' is aggravated
|-
| ''Purnata''(fullness) in ''srotas/marga''
| ''Riktaka''(emptiness) in ''srotas''
|-
| ''Vata'' shows ''svakarma hani'' (decreased function)
| ''Vata'' shows ''svakarma vriddhi'' (increased function)
|-
| ''Dhatu'' are in ''vriddhi'' (increase) or ''saama''
| ''Dhatu daurbalya'' (decrease) present
|-
| ''Avarana'' possible with other ''dosha/anna/mala''/individual components of ''vata''
| Not possible
|-
| ''Avarana'' by ''avayava''(body part) or ''ashaya''(organ) not possible
| ''Gatatva'' in ''ashaya'' and ''avayava'' explained
|-
| ''Avaraka'' gets importance in treatment
| ''Vata'' gets importance in treatment
|-
| Diagnosis made with ''upashaya anupashaya'' (hit and trial)
| Diagnosis with ''rupa''
|-
| Complications of ''avarana'' possible
| None
|-
| Successive diminution of ''rasadi dhatu'' possible
| None
|}
|}


As āvarana proceeds it may end up in dhātukṣaya as the āvr̥ta will block rasadhātu which give nourishment. This is commonly observed. This is possible in many other disorders also. The best example is rajayakshma.  
As ''avarana'' proceeds it may end up in ''dhatukshaya'' as the ''avrita'' will block ''rasadhatu'' which give nourishment. This is commonly observed. This is possible in many other disorders also. The best example is ''rajayakshma''.  


Prognosis: Exclusive vata disorders are serious and have poor prognosis. The symptoms / diseases explained manifest when vitiated vāta affects vital parts. The therapeutic approaches should be cautious and extra efforts are essential for a better recovery. As the disease becomes chronic the curability rate drastically declines. The physical strength of the patient is also very important in determining prognosis. (verse 72-74)  
'''Prognosis''': Exclusive ''vata'' disorders are serious and have poor prognosis. The symptoms / diseases explained manifest when vitiated ''vata'' affects vital parts. The therapeutic approaches should be cautious and extra efforts are essential for a better recovery. As the disease becomes chronic the curability rate drastically declines. The physical strength of the patient is also very important in determining prognosis. (verse 72-74)
General principles of management: The general line of management of Vātavyādhi applies to absolute vāta vitiation only. If there is any association or obstruction of other dosha in Vātavyādhi, the treatment will be different. Kevalam term indicates pathology of vitiation of exclusive vata. Nirupastambha is condition without any association of other dosha. This pathology shall be primarily treated with oleation therapy.
As in exclusive vātaja disease the major gunavriddhi is rūkṣa which leads to riktatā in srotas and dhātu and more avakāsha (space) for vāta; Snēhana is essential and ideal. Various methods for snēhana are employed depending on avastha (stage), sthāna (site) and bala (strength) of the diseases and as well as patient.
'''General principles of management''': The general line of management of ''vatavyadhi'' applies to absolute ''vata'' vitiation only. If there is any association or obstruction of other dosha in ''vatavyadhi'', the treatment will be different. ''Kevalam'' term indicates pathology of vitiation of exclusive ''vata''. ''Nirupastambha'' is condition without any association of other ''dosha''. This pathology shall be primarily treated with oleation therapy.
Following snēhana, swedana is also mandatory. Here the ushṇā  guna (hot property) operates to control śītā (cold).  Repeated snēhana and swedana imparts high grade of flexibility.  
 
Snēha is a good medium to control vāta as well as vāta-pitta. Generally, this line of treatment can be counted as a part of brimhana. (verse 75-83)
As in exclusive ''vataja'' disease the major ''gunavriddhi'' is ''ruksha'' which leads to ''riktata'' in ''srotas'' and ''dhatu'' and more ''avakasha'' (space) for ''vata''; ''snehana'' is essential and ideal. Various methods for ''snehana'' are employed depending on ''avastha'' (stage), ''sthana'' (site) and ''bala'' (strength) of the diseases and as well as patient.
Repeated snēhana and swedana therapies can control vāta well. However, samshodhana (purification) therapies are executed to remove the residual dosha. As shodhana has a definite chance for causation of vāta prakopa, the approach should be cautious, so mridu samshodana (mild purification) is done. Snēha virēchana is done by tilwaka ghrita or erand taila etc. Eraṇḍataila is very effective in treating vāta prakopa due to udāvarta. If virēchana is not possible, anulomana diet should be adviced. If the patient is extremely weak niruha is better option. Even after shodhana; recurrent application of snēhana and swedana are essential.(verse 83-88)  
 
Management of vata at different sites:
Following ''snehana, swedana'' is also mandatory. Here the ''ushna guna'' (hot property) operates to control ''sheeta'' (cold).  Repeated ''snehana'' and ''swedana'' imparts high grade of flexibility.  
 
''Sneha'' is a good medium to control ''vata'' as well as ''vata-pitta''. Generally, this line of treatment can be counted as a part of ''brimhana''. (verse 75-83)
 
Repeated ''snehana'' and ''swedana'' therapies can control ''vata'' well. However, ''samshodhana'' (purification) therapies are executed to remove the residual ''dosha''. As ''shodhana'' has a definite chance for causation of ''vata prakopa'', the approach should be cautious, so ''mridu samshodana'' (mild purification) is done. ''Sneha virechana'' is done by ''tilwaka ghrita'' or ''eranda taila'', etc. ''Eranda taila'' is very effective in treating ''vata prakopa'' due to ''udavarta''. If ''virechana'' is not possible, ''anulomana'' diet should be adviced. If the patient is extremely weak ''niruha'' is better option. Even after ''shodhana''; recurrent application of ''snehana'' and ''swedana'' are essential.(verse 83-88)  
 
===== Management of ''vata'' at different sites =====
Treatment of disorders of vāta, when located in different sites, habitat (sthāna) is more important in comparison to the invaded (āgantu) dosha e.g in kōṣṭhagata vāta, kōṣṭha is given preference in treatment, and so kshara is used which helps in digestion (pāchana). But when vāta is located in pakvāśaya or guda which is vātasthāna, udāvartahara treatment is selected, which includes vāta anulomana, basti, varti etc. In āmashayagata vāta, shodhana in the form of vamana is done.  
Treatment of disorders of vāta, when located in different sites, habitat (sthāna) is more important in comparison to the invaded (āgantu) dosha e.g in kōṣṭhagata vāta, kōṣṭha is given preference in treatment, and so kshara is used which helps in digestion (pāchana). But when vāta is located in pakvāśaya or guda which is vātasthāna, udāvartahara treatment is selected, which includes vāta anulomana, basti, varti etc. In āmashayagata vāta, shodhana in the form of vamana is done.  
Hridya anna (favourite food) is typically indicated in tvakgata vāta because, rūkṣatā in tvak is a result of rasakṣaya caused by overworrying.17  
Hridya anna (favourite food) is typically indicated in tvakgata vāta because, rūkṣatā in tvak is a result of rasakṣaya caused by overworrying.17  
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