9,091
edits
Changes
Jump to navigation
Jump to search
Line 1,817:
Line 1,817: + − + + + + + − + + − + + + + + + − + − + − + − Vatashonita occurs when aggravated vata is afflicted with vitiated shonita. Vata is the constantly moving and shonita is also constantly flowing tissue, both need clear passage for uninterrupted movement. There is simultanous aggravation of vata, vitiation of rakta and damage to patency of channels (arteries and veins). When channels pass through narrow and circuitous path of small joints, vitiated rakta and aggravated vata gets seated there to start inflammation of local tissues.+ − A combination of vata aggravating factors and pitta-rakta vitiating factors gives rise to vata-rakta. + − Etiological factors of vāta vitiation are virudha āhār (incompatible food), adhyasana (taking food before complete digestion of previous one), rātri jāgrana (vigil in night), kasāya (astringent), katu (pungents), tikta (bitter), alpabhojana (inadequate quantity of food), ruksha bhojana (food substances of low nutritional values), abhojana (starvation), excess travelling in uncomfortable vehicles, sporting in water, jumping, leaping, excessive walking in hot season, excessive sexual intercourse and suppression of natural urges.+ − Pitta, shonita and shonita vaha srotasa, vitiating factors are lavana, amla, katu, ksara, uṣṇa bhojana, ajīrna bhojana (salty, sour, pungent, alkaline, fatty substances, very hot food, taking food during indigestion), various pulses (kulattha, māṣa etc), various beverages having quite good percentage of alcohol, excess walking in hot season, vigil during night are responsible for vitiation of pitta dosha as well as shonita and shonita vaha srotasa.+ − Pitta prdominant person leading a delicate life style is more susceptible for early progression of vatarakta.+ − There are two types of vatashonita, 1. Uttan or superficial, located in blood vessels between skin and muscles. It manifests as itching, burning, piercing pain in skin, constricting and expanding sensation of skin, black red and coppery boils of skin.+ + + + + + + + + − Based on dosha, vatshonita is classified into four types, three of them due to one dosha and one due to three dosha, the last one is incurable.+ − Treatment is four-fold with six types of blood letting, therapeutic purgation, purifying enema and palliative treatment for vata. + − In vatarakta, rakta obstructs pathway of vata and vice-versa i.e. vata obstructing pathway of rakta. Bloodletting helps in the movement of vata. + − The purgation should be mild because strong purgation may cause vataprakopa. + − After proper oleation, vatarakta paitent shall be treated with mild therapeutic purgation with unctuous substances or with dry substances (in case of excess oleated patient). After purgation, the patient should be given frequent basti (enema of medicated substances) including anuvāsana basti (unctuous enema) and niruha Basti (enema made from decoction of medicinal herbs). Besides foementation, massage, ointments, food and sneha (unctuous substances) be given to the patient which do not cause burning sensation. + − In case of uttana vata shonita affecting superficial tissues only, the patient should be treated with alepana (affected part is covered with medicinal paste), abhyanga (massage), parisheka (bathing in warm decoction or unctuous substances) and upanaha (application of poultice). + − In the case of gambhira vāta rakta the patient should be treated with purgation, asthapana basti (enema with decoction of medicinal plants) and snehapana (drinking medicated oil/ghee).+ − In the disease where the vata is predominant, one should over come the disease with medicated ghee, taila, vasa, majja (ghee, oil, fat, and bone marrow of animals) either by intake or massage or enema and the diseased part should be treated with warm upanaha (warm poultice).+ − Where the rakta and pitta both are predominant, patient should be treated by mild purgation, after ghrita pana (intake of medicated ghee), intake of milk, bathing in decoction made from medicinal plants and basti (enema). The raktapitta should be treated with cold and refrigerent alepam (paste of herbs).+ − Where the kapha is predominant, patient of vata rakta should be treated with mild emesis and avoid excessive oleation, sudation and fasting. Luke warm lepa (pastes of herbs) are useful. + − External application of unctuous substances like ghee and oil processed with herbs having cold potency, sweet and bitter tastes are effective to reduce burning sensation. + − If vata is vitiated due to obstruction either by excessive aggravated meda or kapha, one should not apply unctuous and stouting drugs in the beginning. Instead kapha and meda subjugate with physical exercises, shodhana (purification), virechana (purgation), and intake of arishta (fermentated preparation of medicinal herbs etc.) and butter milk with abhaya.+ − + + − + +
→Summary
तत्र श्लोकाः-
तत्र श्लोकाः-
हेतुः स्थानानि मूलं च यस्मात् प्रायेण सन्धिषु |
हेतुः स्थानानि मूलं च यस्मात् प्रायेण सन्धिषु |
कुप्यति प्राक् च यद्रूपं द्विविधस्य च लक्षणम् ||१६३||
कुप्यति प्राक् च यद्रूपं द्विविधस्य च लक्षणम् ||१६३||
पृथग्भिन्नस्य लिङ्गं च दोषाधिक्यमुपद्रवाः |
पृथग्भिन्नस्य लिङ्गं च दोषाधिक्यमुपद्रवाः |
साध्यं याप्यमसाध्यं च क्रिया साध्यस्य चाखिला ||१६४||
साध्यं याप्यमसाध्यं च क्रिया साध्यस्य चाखिला ||१६४||
वातरक्तस्य निर्दिष्टा समासव्यासतस्तथा |
वातरक्तस्य निर्दिष्टा समासव्यासतस्तथा |
महर्षिणाऽग्निवेशाय तथैवावस्थिकी क्रिया ||१६५||
महर्षिणाऽग्निवेशाय तथैवावस्थिकी क्रिया ||१६५||
tatra ślōkāḥ-
tatra ślōkāḥ-
hētuḥ sthānāni mūlaṁ ca yasmāt prāyēṇa sandhiṣu|
hētuḥ sthānāni mūlaṁ ca yasmāt prāyēṇa sandhiṣu|
kupyati prāk ca yadrūpaṁ dvividhasya ca lakṣaṇam||163||
kupyati prāk ca yadrūpaṁ dvividhasya ca lakṣaṇam||163||
pr̥thagbhinnasya liṅgaṁ ca dōṣādhikyamupadravāḥ|
pr̥thagbhinnasya liṅgaṁ ca dōṣādhikyamupadravāḥ|
sādhyaṁ yāpyamasādhyaṁ ca kriyā sādhyasya cākhilā||164||
sādhyaṁ yāpyamasādhyaṁ ca kriyā sādhyasya cākhilā||164||
vātaraktasya nirdiṣṭā samāsavyāsatastathā|
vātaraktasya nirdiṣṭā samāsavyāsatastathā|
maharṣiṇā'gnivēśāya tathaivāvasthikī kriyā||165||
maharṣiṇā'gnivēśāya tathaivāvasthikī kriyā||165||
tatra shlokAH-
tatra shlokAH-
hētuH sthAnAni mUlaM ca yasmAt prAyeNa sandhiShu |
hētuH sthAnAni mUlaM ca yasmAt prAyeNa sandhiShu |
kupyati prAk ca yadrUpaM dvividhasya ca lakShaNam ||163||
kupyati prAk ca yadrUpaM dvividhasya ca lakShaNam ||163||
pRuthagbhinnasya li~ggaM ca dośadhikyamupadravAH |
pRuthagbhinnasya li~ggaM ca dośadhikyamupadravAH |
sādhyaM yApyamasādhyaM ca kriyA sādhyasya cAkhilA ||164||
sādhyaM yApyamasādhyaM ca kriyA sādhyasya cAkhilA ||164||
vātaraktasya nirdiShTA samAsavyAsatastathA |
vātaraktasya nirdiShTA samAsavyAsatastathA |
maharShiNA~agniveshAya tathaivAvasthikI kriyA ||165||
maharShiNA~agniveshAya tathaivAvasthikI kriyA ||165||
In this chapter of vātarakta the aetiological factors, location and root, reason for its prevalence of aggravation in general in joints, prodromal symptoms, clinical features, symptoms of both types (uttāna and gambhira), different symptom produced by the doshic predominance and complications, prognostic description of different stages of the disease (sādhya, yāpya and asādhya), management of sādhya vātarakta (curable vātarakta) and symptomatic treatment of all stages as well has been described in brief and details by the great sage Atreya for Agnivesha.
Thus ends the twenty ninth chapter of vātashonita in chikitsāsthana in treatise composed by Agnivesa, redacted by Charaka and reconstructed by Drīdhabala. (163 – 165)
In this chapter of ''vatarakta'' the etiological factors, location and root, reason for its prevalence of aggravation in general in joints, prodromal symptoms, clinical features, symptoms of both types (''uttana'' and ''gambhira''), different symptom produced by the ''doshic'' predominance and complications, prognostic description of different stages of the disease (''sadhya, yapya'' and ''asadhya''), management of ''sadhya vatarakta'' (curable ''vatarakta'') and symptomatic treatment of all stages as well has been described in brief and details by the great sage Atreya for Agnivesha.
Tattva vimarsha:
Thus ends the 29th Chapter ([[Vatarakta Chikitsa]]) in [[Chikitsa Sthana]] in treatise composed by Agnivesha, redacted by Charaka and reconstructed by Dridhabala. [163–165]
=== ''Tattva Vimarsha'' ===
''Vatashonita'' occurs when aggravated vata is afflicted with vitiated shonita. Vata is the constantly moving and shonita is also constantly flowing tissue, both need clear passage for uninterrupted movement. There is simultanous aggravation of vata, vitiation of rakta and damage to patency of channels (arteries and veins). When channels pass through narrow and circuitous path of small joints, vitiated rakta and aggravated vata gets seated there to start inflammation of local tissues.
A combination of vata aggravating factors and pitta-rakta vitiating factors gives rise to vata-rakta.
Etiological factors of vāta vitiation are virudha āhār (incompatible food), adhyasana (taking food before complete digestion of previous one), rātri jāgrana (vigil in night), kasāya (astringent), katu (pungents), tikta (bitter), alpabhojana (inadequate quantity of food), ruksha bhojana (food substances of low nutritional values), abhojana (starvation), excess travelling in uncomfortable vehicles, sporting in water, jumping, leaping, excessive walking in hot season, excessive sexual intercourse and suppression of natural urges.
Pitta, shonita and shonita vaha srotasa, vitiating factors are lavana, amla, katu, ksara, uṣṇa bhojana, ajīrna bhojana (salty, sour, pungent, alkaline, fatty substances, very hot food, taking food during indigestion), various pulses (kulattha, māṣa etc), various beverages having quite good percentage of alcohol, excess walking in hot season, vigil during night are responsible for vitiation of pitta dosha as well as shonita and shonita vaha srotasa.
Pitta prdominant person leading a delicate life style is more susceptible for early progression of vatarakta.
There are two types of vatashonita, 1. Uttan or superficial, located in blood vessels between skin and muscles. It manifests as itching, burning, piercing pain in skin, constricting and expanding sensation of skin, black red and coppery boils of skin.
2. Gambhir or deep: Located in blood vessels of small joints of extremities but more in lower extremities and big toe is most affected. Manifested inflammation, hard, non- shifting and painful, pulsating inflammation with coppery black color and cause of disability.
2. Gambhir or deep: Located in blood vessels of small joints of extremities but more in lower extremities and big toe is most affected. Manifested inflammation, hard, non- shifting and painful, pulsating inflammation with coppery black color and cause of disability.
Based on dosha, vatshonita is classified into four types, three of them due to one dosha and one due to three dosha, the last one is incurable.
Treatment is four-fold with six types of blood letting, therapeutic purgation, purifying enema and palliative treatment for vata.
In vatarakta, rakta obstructs pathway of vata and vice-versa i.e. vata obstructing pathway of rakta. Bloodletting helps in the movement of vata.
The purgation should be mild because strong purgation may cause vataprakopa.
After proper oleation, vatarakta paitent shall be treated with mild therapeutic purgation with unctuous substances or with dry substances (in case of excess oleated patient). After purgation, the patient should be given frequent basti (enema of medicated substances) including anuvāsana basti (unctuous enema) and niruha Basti (enema made from decoction of medicinal herbs). Besides foementation, massage, ointments, food and sneha (unctuous substances) be given to the patient which do not cause burning sensation.
In case of uttana vata shonita affecting superficial tissues only, the patient should be treated with alepana (affected part is covered with medicinal paste), abhyanga (massage), parisheka (bathing in warm decoction or unctuous substances) and upanaha (application of poultice).
In the case of gambhira vāta rakta the patient should be treated with purgation, asthapana basti (enema with decoction of medicinal plants) and snehapana (drinking medicated oil/ghee).
In the disease where the vata is predominant, one should over come the disease with medicated ghee, taila, vasa, majja (ghee, oil, fat, and bone marrow of animals) either by intake or massage or enema and the diseased part should be treated with warm upanaha (warm poultice).
Where the rakta and pitta both are predominant, patient should be treated by mild purgation, after ghrita pana (intake of medicated ghee), intake of milk, bathing in decoction made from medicinal plants and basti (enema). The raktapitta should be treated with cold and refrigerent alepam (paste of herbs).
Where the kapha is predominant, patient of vata rakta should be treated with mild emesis and avoid excessive oleation, sudation and fasting. Luke warm lepa (pastes of herbs) are useful.
External application of unctuous substances like ghee and oil processed with herbs having cold potency, sweet and bitter tastes are effective to reduce burning sensation.
If vata is vitiated due to obstruction either by excessive aggravated meda or kapha, one should not apply unctuous and stouting drugs in the beginning. Instead kapha and meda subjugate with physical exercises, shodhana (purification), virechana (purgation), and intake of arishta (fermentated preparation of medicinal herbs etc.) and butter milk with abhaya.
Vidhi Vimarsha :
=== ''Vidhi Vimarsha'' ===
Vatarakta is a group of inflammatory rheumatic diseases. Pathogenesis of these ailments is related to aggravation of vata dosha due to vitiation of rakta dhatu. The primary sites of involvement are small joints of hands and feet.
Vatarakta is a group of inflammatory rheumatic diseases. Pathogenesis of these ailments is related to aggravation of vata dosha due to vitiation of rakta dhatu. The primary sites of involvement are small joints of hands and feet.
Etiological factors:
Etiological factors:
Diet: Excess intake of salty, sour and pungent foods with spices and deep fried in oil are observed to cause the disease. The soft drinks with alkalis, excess consumption of fatty substances, alcohol, aquatic animals, dried flesh are known to vitiate rakta. A study carried on 178 participants revealed that excess intake of amlarasa could be a risk factor for joint inflammation, dentine hypersensitivity, stomatitis, halitosis, heartburn and papules. Consumption of astringent, pungent, bitter, ruksha food items (grains of low nutritional values and those with dry property) vitiate vata dosha. Consumption of tikshna (sharply acting) and vidahi (which causes burning) are other factors responsible for vitiating rakta.
Diet: Excess intake of salty, sour and pungent foods with spices and deep fried in oil are observed to cause the disease. The soft drinks with alkalis, excess consumption of fatty substances, alcohol, aquatic animals, dried flesh are known to vitiate rakta. A study carried on 178 participants revealed that excess intake of amlarasa could be a risk factor for joint inflammation, dentine hypersensitivity, stomatitis, halitosis, heartburn and papules. Consumption of astringent, pungent, bitter, ruksha food items (grains of low nutritional values and those with dry property) vitiate vata dosha. Consumption of tikshna (sharply acting) and vidahi (which causes burning) are other factors responsible for vitiating rakta.
The dietary habits like intake of food during indigestion (ajirna), incompatible food (viruddhahar), eating food before proper digestion of previous meal (adhyashana) are causes of vitiation of vata due to improper digestion and metabolism.
The dietary habits like intake of food during indigestion (ajirna), incompatible food (viruddhahar), eating food before proper digestion of previous meal (adhyashana) are causes of vitiation of vata due to improper digestion and metabolism.