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'''Diagnosis and Management of Neurological Diseases in Ayurveda'''

'''Diagnosis and Management of Neurological Diseases in Ayurveda'''

 

This article is based on the lecture delivered by Prof. (Dr.) S.H. Acharya in Prof. M. S. Baghel Memorial Lecture Series on July 09, 2021.

This article is based on the lecture delivered by Prof. (Dr.) S.H. Acharya in Prof. M. S. Baghel Memorial Lecture Series on July 09, 2021.

 

== [[Vata]] and Neurological Diseases==

== [[Vata]] and Neurological Diseases==

Neurological diseases are generally considered under the umbrella of diseases of [[vata]] [[dosha]] (vata vyadhi). However, diseases of [[Vata]] does not limit to neurological disorders. Similarly, certain neuropathological conditions are beyond the limits of pure [[vata]] disorders.

Neurological diseases are generally considered under the umbrella of diseases of [[vata]] [[dosha]] (vata vyadhi). However, diseases of [[Vata]] does not limit to neurological disorders. Similarly, certain neuropathological conditions are beyond the limits of pure [[vata]] disorders.

===Physiological boundaries of [[Vata]] ===

===Physiological boundaries of [[Vata]] ===

[[Vata]] is an essential factor for the sustenance of life and cognitive functions. [Cha. Sa. [[Sutra Sthana ] 25/40]. [[Vata]] is responsible for all activities in living beings, and its derangement can result in many diseases and even fatality. [Cha. Sa. [[Sutra Sthana]] 17/ 118]

[[Vata]] is an essential factor for the sustenance of life and cognitive functions. [Cha. Sa. [[Sutra Sthana ] 25/40]. [[Vata]] is responsible for all activities in living beings, and its derangement can result in many diseases and even fatality. [Cha. Sa. [[Sutra Sthana]] 17/ 118]

All voluntary and involuntary body movements, including natural physiological impulses (somatic & psychosomatic), are executed by neural pathways. These activities with cranial nerve impulses are outcomes of activities of vata.  Respiratory functions, cardiac and circulatory activities are invariably done by [[vata]]. All somatic systems and their regulatory functions and integration are governed or maintained by [[vata]].[ Cha. Sa. [[Sutra Sthana]] 12/ 8] It also controls and regulates the activities of the mind ([[manas]]). [ Cha. Sa. [[Sutra Sthana]] 12/ 8] The perception, cognition, and thought process is under the control of [[vata]].

All voluntary and involuntary body movements, including natural physiological impulses (somatic & psychosomatic), are executed by neural pathways. These activities with cranial nerve impulses are outcomes of activities of [[vata]].  Respiratory functions, cardiac and circulatory activities are invariably done by [[vata]]. All somatic systems and their regulatory functions and integration are governed or maintained by [[vata]].[ Cha. Sa. [[Sutra Sthana]] 12/ 8] It also controls and regulates the activities of the mind ([[manas]]). [ Cha. Sa. [[Sutra Sthana]] 12/ 8] The perception, cognition, and thought process is under the control of [[vata]].

So, the vegetative nervous system, central nervous system or higher nervous system, brain behavior, and mental functions are all governed by [[Vata]] itself.

So, the vegetative nervous system, central nervous system or higher nervous system, brain behavior, and mental functions are all governed by [[Vata]] itself.

The physiology of [[vata]] cannot be limited to neurophysiology. Instead, it can be extended to molecular biology in addition to the neuronal or cellular functions.

The physiology of [[vata]] cannot be limited to neurophysiology. Instead, it can be extended to molecular biology in addition to the neuronal or cellular functions.

=== Anatomical considerations of [[vata]] ===

=== Anatomical considerations of [[vata]] ===

Even though [[vata]] is ubiquitous all over the body, its specific location is the large intestine (pakwashaya) by Ayurvedic classics. The skin (twak), auditory system (shrotra) and bone (asthi) are additional locations.

The Sanskrit terms like mastishka, mastulunga, murdha represent the cerebrum and its components. Some other terms like “merudanda” (vertebral column), “sushumna” (spinal cord), “nadi”(nerves), brahmavari(cerebro spinal fluid)  show the anatomical components. .

Even though [[vata]] is ubiquitous all over the body, its specific location is the large intestine (pakwashaya) by Ayurvedic classics. The skin (twak), auditory system (shrotra) and bone ([[asthi dhatu]]) are additional locations.

The terms like “sira (blood vessels), snayu (tendons) and kandara (ligaments) describe the pathology of seizures (akshepaka, dandaka) and palsies (ardita, pakshaghata). Their description in vata vyadhi confirms the connection of vata dosha disorders with the nervous system.  

 

Head (shiras) :

The Sanskrit terms like mastishka, mastulunga, murdha represent the cerebrum and its components. Some other terms like “merudanda” (vertebral column), “sushumna” (spinal cord), “nadi”(nerves), brahmavari(cerebro spinal fluid)  show the anatomical components.

The head is the most vital organ in the body (uttamanga). The roots of all the sensory and motor organs ([[indriya]]) are located in the head. [ Cha. Sa. [[Sutra Sthana]] 17/12]

 

The terms like sira (blood vessels), snayu (tendons) and kandara (ligaments) describe the pathology of seizures (akshepaka, dandaka) and palsies (ardita, pakshaghata). Their description in vata vyadhi confirms the connection of vata dosha disorders with the nervous system.  

 

'''Head (shiras) :'''

 

The head is the most vital organ in the body (uttamanga). The roots of all the sensory and motor organs ([[indriya]]) are located in the head. [Cha. Sa. [[Sutra Sthana]] 17/12]

Several vital points (marma) are located in the head. Any damage to these areas (marma sthana) can produce symptoms similar to neurological disturbances.  

Several vital points (marma) are located in the head. Any damage to these areas (marma sthana) can produce symptoms similar to neurological disturbances.  

The location of mind is described as between the top of the skull and palate by Acharya Bhela. It is precisely where the cortex and limbic system, i.e., the higher nervous system related to the functions of the mind is located.

The location of mind is described as between the top of the skull and palate by Acharya Bhela. It is precisely where the cortex and limbic system, i.e., the higher nervous system related to the functions of the mind is located.

In Ayurveda, more importance is given to functional aspects than the neuro-anatomical structures.  

In Ayurveda, more importance is given to functional aspects than the neuro-anatomical structures.  

== Ayurvedic  terminologies resembling  neurological diseases ==

== Ayurvedic  terminologies resembling  neurological diseases ==

A number of diagnostic terminologies related to the disorders of [[vata]] can be correlated with neurological diseases.

A number of diagnostic terminologies related to the disorders of [[vata]] can be correlated with neurological diseases.

These are some conditions related to  Neurovascular, neuro degenerative, myelopathic and radiculitis disorders which may affect pyramidal or extrapyramidal tract, both peripheral and central nervous system:

 

• Padabhramsha-(Foot drop)

These are some conditions related to  neurovascular, neuro degenerative, myelopathic and radiculitis disorders which may affect pyramidal or extrapyramidal tract, both peripheral and central nervous system:

• Padasuptata (Loss of sensation in  feet)

 

• Pindikodveshtanam (Cramps in calf muscle)

* Padabhramsha-(Foot drop)

• Gridhrasi (Radiculitis /Sciatica)

 

• Urustambha (Myelopathy/sensory palsies)

* Padasuptata (Loss of sensation in  feet)

• Urusada (Asthenia of lower limbs)

 

• Pangulya(Loss of strength in one leg)

* Pindikodveshtanam (Cramps in calf muscle)

• Khanjattva (paraesthesia)

 

• Bahu shosha (atrophy of upper limb)

* Gridhrasi (Radiculitis /Sciatica)

• Mukatva (Aphasia)

 

• Vaksanga(Dysarthria)

* Urustambha (Myelopathy/sensory palsies)

• Ghrana nasha (Anosmia)

 

• Badhirya (Auditory loss)

* Urusada (Asthenia of lower limbs)

• Timira (Retinal blindness)

 

• Ardita (Transient ischemia/facial palsy)

* Pangulya(Loss of strength in one leg)

• Ekanga Roga(Monoplegia)

 

• Sarvanga Roga (Quadriplegia)

* Khanjattva (paraesthesia)

• Pakshaghata (Hemiplegia)

 

• Akshepaka - (Seizures/convulsions)  

* Bahu shosha (atrophy of upper limb)

• Dandaka-(Decerebrate rigidity/clonic)

 

• Tama (Fainting)

* Mukatva (Aphasia)

• Bhrama (Vertigo)

 

• Vepathu (Tremors)

* Vaksanga(Dysarthria)

 

* Ghrana nasha (Anosmia)

 

* Badhirya (Auditory loss)

 

* Timira (Retinal blindness)

 

* Ardita (Transient ischemia/facial palsy)

 

* Ekanga Roga(Monoplegia)

 

* Sarvanga Roga (Quadriplegia)

 

* Pakshaghata (Hemiplegia)

 

* Akshepaka - (Seizures/convulsions)  

 

* Dandaka-(Decerebrate rigidity/clonic)

 

* Tama (Fainting)

 

* Bhrama (Vertigo)

 

* Vepathu (Tremors)

 

Neuropsychotic conditions:

Neuropsychotic conditions:

• Vishada (Depression)

 

• Pralapa (incoherent speech)  

* Vishada (Depression)

• Anavasthitha Chitta (fleeting thoughts)

 

Radiculopathies: It includes Gridhrasi (Sciatica), Khalli (twisting pain in

* Pralapa (incoherent speech)  

 

* Anavasthitha Chitta (fleeting thoughts)

 

'''Radiculopathies:''' It includes Gridhrasi (Sciatica), Khalli (twisting pain in

the extremities), Vishwachi (shoulder pain), Apabahuka (frozen shoulder), Ansa shosha (atrophy of scapular muscles)

the extremities), Vishwachi (shoulder pain), Apabahuka (frozen shoulder), Ansa shosha (atrophy of scapular muscles)

Ayurveda classics have mentioned clinical features like spasticity (sankocha), rigidity (dandaka), tremor(vepathu) and atrophy (shosha) related to neurological diseases.  Various motor palsies and sensory palsies specifically related to tactile-thermo-deep-proprioceptors are also mentioned.

Ayurveda classics have mentioned clinical features like spasticity (sankocha), rigidity (dandaka), tremor(vepathu) and atrophy (shosha) related to neurological diseases.  Various motor palsies and sensory palsies specifically related to tactile-thermo-deep-proprioceptors are also mentioned.

== Diagnostic and Therapeutic approach in Ayurveda ==

== Diagnostic and Therapeutic approach in Ayurveda ==

=== Cerebrovascular accidents ===

=== Cerebrovascular accidents ===