Changes

khuDaM vātabalAsAkhyamADhyavātaM ca nAmabhiH ||11||

khuDaM vātabalAsAkhyamADhyavātaM ca nAmabhiH ||11||

Excess intake of salty, sour, pungent, alkalies and fatty substances, hot food, consumption of rotten and dried flesh, fleshes of aquatic animals like fish, animals living in the area where there are dense forest and heavy rainfall, cake of oil seeds after extraction of oil (pindyaka), raddish (Raphanus sativus), red gram, black gram, green vegetables, palala (gratted flesh), sugarcane, curd, sour gruel, sauvira and shukta (vinegar), butter milk, sura and asava (alcohol and medicinal preparations having high concentration of alcohol), intake of food inspite of indigestion (ajirna), incompatible food (viruddhahar), eating food before proper digestion of previous one (adhyashana), anger, sleeping in daytime and vigil during the night; in general the delicate persons who are indulged in sweet and delicious food substances  and are not in habit of physical activities, the vata and shonita vitiates.  

Excess intake of salty, sour, pungent, alkalies and fatty substances, hot food, consumption of rotten and dried flesh, fleshes of aquatic animals like fish, animals living in the area where there are dense forest and heavy rainfall, cake of oil seeds after extraction of oil (''pindyaka''), radish (Raphanus sativus), red gram, black gram, green vegetables, ''palala'' (grated flesh), sugarcane, curd, sour gruel, ''sauvira'' and ''shukta'' (vinegar), butter milk, ''sura'' and ''asava'' (alcohol and medicinal preparations having high concentration of alcohol), intake of food inspite of indigestion (''ajirna''), incompatible food (''viruddhahara''), eating food before proper digestion of previous one (''adhyashana''), anger, sleeping in daytime and vigil during the night; in general the delicate persons who are indulged in sweet and delicious food substances  and are not in habit of physical activities, the ''vata'' and ''shonita'' vitiates.  

Due to injuries, not purifying the body (by shodhana karma) and indulged in consuming astringent, pungent, bitter, ruksha food items (grains of low nutritional values), starvation, travelling by horses, camels and carts, sporting in water, jumping, leaping, excessive walking in hot season, excessive sexual intercourse and suppression of natural urges are responsible for vitiation of vata.  

 

Due to aetiological factors described earlier and obstruction in passage by vitiated rakta the vata aggravates, which again vitiates the rakta and known as vatashonita, having synonyms as khuda, vatabalasa and adhyavata. (5- 11)

Due to injuries, not purifying the body (by ''shodhana karma'') and indulged in consuming astringent, pungent, bitter, ''ruksha'' food items (grains of low nutritional content), starvation, traveling by horses, camels and carts, sporting in water, jumping, leaping, excessive walking in hot season, excessive sexual intercourse and suppression of natural urges are responsible for vitiation of ''vata''.  

Sites of affliction:

 

Due to etiological factors described earlier and obstruction in passage by vitiated ''rakta'' the ''vata'' aggravates, which again vitiates the ''rakta'' and known as ''vatashonita'', having synonyms as ''khuda, vatabalasa'' and ''adhyavata''. [5-11]

 

==== Sites of affliction ====

 

तस्य स्थानं करौ पादावङ्गुल्यः सर्वसन्धयः |   

तस्य स्थानं करौ पादावङ्गुल्यः सर्वसन्धयः |   

कृत्वाऽऽदौ हस्तपादे तु मूलं देहे विधावति ||१२||   

कृत्वाऽऽदौ हस्तपादे तु मूलं देहे विधावति ||१२||   

tasya sthānaṁ karau pādāvaṅgulyaḥ sarvasandhayaḥ|   

tasya sthānaṁ karau pādāvaṅgulyaḥ sarvasandhayaḥ|   

kr̥tvā''dau hastapādē tu mūlaṁ dēhē vidhāvati||12||   

kr̥tvā''dau hastapādē tu mūlaṁ dēhē vidhāvati||12||   

tasya sthAnaM karau pAdAva~ggulyaH sarvasandhayaH |   

tasya sthAnaM karau pAdAva~ggulyaH sarvasandhayaH |   

kRutvA~a~adau hastapAde tu mUlaM dehe vidhAvati ||12||   

kRutvA~a~adau hastapAde tu mUlaM dehe vidhAvati ||12||  

Its sites are hands, feet, fingers and all other joints. At first it settles its root (initial involvement) in hands and feet and then spread all over the body. (12)

   

Its sites are hands, feet, fingers and all other joints. At first it settles its root (initial involvement) in hands and feet and then spread all over the body. [12]

 

सौक्ष्म्यात् सर्वसरत्वाच्च पवनस्यासृजस्तथा |   

सौक्ष्म्यात् सर्वसरत्वाच्च पवनस्यासृजस्तथा |   

तद्द्रवत्वात् सरत्वाच्च देहं गच्छन् सिरायनैः ||१३||   

तद्द्रवत्वात् सरत्वाच्च देहं गच्छन् सिरायनैः ||१३||   

पर्वस्वभिहतं क्षुब्धं वक्रत्वादवतिष्ठते |   

पर्वस्वभिहतं क्षुब्धं वक्रत्वादवतिष्ठते |   

स्थितं पित्तादिसंसृष्टं तास्ताः सृजति वेदनाः ||१४||   

स्थितं पित्तादिसंसृष्टं तास्ताः सृजति वेदनाः ||१४||  

   

करोति दुःखं तेष्वेव तस्मात् प्रायेण सन्धिषु |   

करोति दुःखं तेष्वेव तस्मात् प्रायेण सन्धिषु |   

भवन्ति वेदनास्तास्ता अत्यर्थं दुःसहा नृणाम् ||१५||

भवन्ति वेदनास्तास्ता अत्यर्थं दुःसहा नृणाम् ||१५||

saukṣmyāt sarvasaratvācca pavanasyāsr̥jastathā|   

saukṣmyāt sarvasaratvācca pavanasyāsr̥jastathā|   

taddravatvāt saratvācca dēhaṁ gacchan sirāyanaiḥ||13||   

taddravatvāt saratvācca dēhaṁ gacchan sirāyanaiḥ||13||   

parvasvabhihataṁ kṣubdhaṁ vakratvādavatiṣṭhatē|   

parvasvabhihataṁ kṣubdhaṁ vakratvādavatiṣṭhatē|   

sthitaṁ pittādisaṁsr̥ṣṭaṁ tāstāḥ sr̥jati vēdanāḥ||14||   

sthitaṁ pittādisaṁsr̥ṣṭaṁ tāstāḥ sr̥jati vēdanāḥ||14||   

karōti duḥkhaṁ tēṣvēva tasmāt prāyēṇa sandhiṣu|   

karōti duḥkhaṁ tēṣvēva tasmāt prāyēṇa sandhiṣu|   

bhavanti vēdanāstāstā atyarthaṁ duḥsahā nr̥ṇām||15||  

bhavanti vēdanāstāstā atyarthaṁ duḥsahā nr̥ṇām||15||  

saukShmyAt sarvasaratvAcca pavanasyAsRujastathA |   

saukShmyAt sarvasaratvAcca pavanasyAsRujastathA |   

taddravatvAt saratvAcca dehaM gacchan sirāyanaiH ||13||   

taddravatvAt saratvAcca dehaM gacchan sirāyanaiH ||13||  

   

parvasvabhihataM kShubdhaM vakratvAdavatiShThate |   

parvasvabhihataM kShubdhaM vakratvAdavatiShThate |   

sthitaM pittAdisaMsRuShTaM tAstAH sRujati vedanAH ||14||

sthitaM pittAdisaMsRuShTaM tAstAH sRujati vedanAH ||14||

karoti duHkhaM teShveva tasmAt prAyeNa sandhiShu |   

karoti duHkhaM teShveva tasmAt prAyeNa sandhiShu |   

bhavanti vedanAstAstA atyarthaM duHsahA nRuNAm ||15||

bhavanti vedanAstAstA atyarthaM duHsahA nRuNAm ||15||

Due to subtleness and pervasiveness of vata, and liquidity and flowing property of rakta, they travel all over the body through blood vessels.  

 

Near the parva sandhis (small joints of fingers), as blood vessels are in slanting pattern, the vitiated blood is stagnated there and thereafter the vitiated vata and rakta alongwith pitta etc. produce different types of vedana (unpleasant sensation like pain etc.) so that there are dukha (pain and other abnormal sensation) in the joints. The vedana (pain) is so severe, which is difficult to tolerate. (13 – 15)

Due to subtleness and pervasiveness of ''vata'', and liquidity and flowing property of ''rakta'', they travel all over the body through blood vessels.  

Premonitory symptoms:

 

Near the ''parva sandhis'' (small joints of fingers), as blood vessels are in slanting pattern, the vitiated blood is stagnated there and thereafter the vitiated ''vata'' and ''rakta'' along with ''pitta'' etc. produce different types of ''vedana'' (unpleasant sensation like pain etc.) so that there are ''dukha'' (pain and other abnormal sensation) in the joints. The ''vedana'' (pain) is so severe, which is difficult to tolerate. [13–15]

 

==== Premonitory symptoms ====

 

स्वेदोऽत्यर्थं न वा कार्ष्ण्यं स्पर्शाज्ञत्वं क्षतेऽतिरुक् |   

स्वेदोऽत्यर्थं न वा कार्ष्ण्यं स्पर्शाज्ञत्वं क्षतेऽतिरुक् |   

सन्धिशैथिल्यमालस्यं सदनं पिडकोद्गमः ||१६||   

सन्धिशैथिल्यमालस्यं सदनं पिडकोद्गमः ||१६||   

जानुजङ्घोरुकट्यंसहस्तपादाङ्गसन्धिषु |   

जानुजङ्घोरुकट्यंसहस्तपादाङ्गसन्धिषु |   

निस्तोदः स्फुरणं भेदो गुरुत्वं सुप्तिरेव च ||१७||   

निस्तोदः स्फुरणं भेदो गुरुत्वं सुप्तिरेव च ||१७||   

कण्डूः सन्धिषु रुग्भूत्वा भूत्वा नश्यति चासकृत् |   

कण्डूः सन्धिषु रुग्भूत्वा भूत्वा नश्यति चासकृत् |   

वैवर्ण्यं मण्डलोत्पत्तिर्वातासृक्पूर्वलक्षणम् ||१८||

वैवर्ण्यं मण्डलोत्पत्तिर्वातासृक्पूर्वलक्षणम् ||१८||

svēdō'tyarthaṁ na vā kārṣṇyaṁ sparśājñatvaṁ kṣatē'tiruk|   

svēdō'tyarthaṁ na vā kārṣṇyaṁ sparśājñatvaṁ kṣatē'tiruk|   

sandhiśaithilyamālasyaṁ sadanaṁ piḍakōdgamaḥ||16||   

sandhiśaithilyamālasyaṁ sadanaṁ piḍakōdgamaḥ||16||   

jānujaṅghōrukaṭyaṁsahastapādāṅgasandhiṣu|   

jānujaṅghōrukaṭyaṁsahastapādāṅgasandhiṣu|   

nistōdaḥ sphuraṇaṁ bhēdō gurutvaṁ suptirēva ca||17||   

nistōdaḥ sphuraṇaṁ bhēdō gurutvaṁ suptirēva ca||17||   

kaṇḍūḥ sandhiṣu rugbhūtvā bhūtvā naśyati cāsakr̥t|   

kaṇḍūḥ sandhiṣu rugbhūtvā bhūtvā naśyati cāsakr̥t|   

vaivarṇyaṁ maṇḍalōtpattirvātāsr̥kpūrvalakṣaṇam||18||

vaivarṇyaṁ maṇḍalōtpattirvātāsr̥kpūrvalakṣaṇam||18||

svedo~atyarthaM na vA kArShNyaM sparshAj~jatvaM kShate~atiruk |   

svedo~atyarthaM na vA kArShNyaM sparshAj~jatvaM kShate~atiruk |   

sandhishaithilyamAlasyaM sadanaM piDakodgamaH ||16||   

sandhishaithilyamAlasyaM sadanaM piDakodgamaH ||16||  

   

jAnuja~gghorukaTyaMsahastapAdA~ggasandhiShu |   

jAnuja~gghorukaTyaMsahastapAdA~ggasandhiShu |   

nistodaH sphuraNaM bhedo gurutvaM suptireva ca ||17||   

nistodaH sphuraNaM bhedo gurutvaM suptireva ca ||17||   

kaNDUH sandhiShu rugbhUtvA bhUtvA nashyati cAsakRut |   

kaNDUH sandhiShu rugbhUtvA bhUtvA nashyati cAsakRut |   

vaivarNyaM maNDalotpattirvātasRukpUrvalakShaNam ||18||

vaivarNyaM maNDalotpattirvātasRukpUrvalakShaNam ||18||

There is excessive or absence of perspiration, blackishness of the body, poor or lack of tactile sensation, high intensity of pain on trauma, laxity of joints, lassitude, malaise, appearance of boils, feeling of heaviness, numbness and itching in knee, thigh, waist, shoulder, hands, legs and other joints of the body, appearance of pain in the joints and abatement (without treatment), discoloration of body, appearance of mandala (circular skin lesions) are the premonitory symptoms of vata shonita. (16 – 18)

 

Types of vata-rakta:

There is excessive or absence of perspiration, blackishness of the body, poor or lack of tactile sensation, high intensity of pain on trauma, laxity of joints, lassitude, malaise, appearance of boils, feeling of heaviness, numbness and itching in knee, thigh, waist, shoulder, hands, legs and other joints of the body, appearance of pain in the joints and abatement (without treatment), discoloration of body, appearance of mandala (circular skin lesions) are the premonitory symptoms of ''vatashonita''. [16–18]

 

==== Types of ''vatarakta'' ====

 

उत्तानमथ गम्भीरं द्विविधं तत् प्रचक्षते |   

उत्तानमथ गम्भीरं द्विविधं तत् प्रचक्षते |   

त्वङ्मांसाश्रयमुत्तानं गम्भीरं त्वन्तराश्रयम् ||१९||

त्वङ्मांसाश्रयमुत्तानं गम्भीरं त्वन्तराश्रयम् ||१९||

uttānamatha gambhīraṁ dvividhaṁ tat pracakṣatē|   

uttānamatha gambhīraṁ dvividhaṁ tat pracakṣatē|   

tvaṅmāṁsāśrayamuttānaṁ gambhīraṁ tvantarāśrayam||19||

tvaṅmāṁsāśrayamuttānaṁ gambhīraṁ tvantarāśrayam||19||

uttānamatha gambhIraM dvividhaM tat pracakShate |   

uttānamatha gambhIraM dvividhaM tat pracakShate |   

tva~gmAMsAshrayamuttānaM gambhIraM tvantarAshrayam ||19||   

tva~gmAMsAshrayamuttānaM gambhIraM tvantarAshrayam ||19||   

As this is said there are two types vata shonita– uttana (superficial) and gambhira (deep). The uttana is located in twaka (skin) and mamsa (muscles) while the gambhira is located in the deep tissues. (19)

 

Clinical features of uttana vatarakta (superficial type):

As this is said there are two types of ''vatashonita'' - ''uttana'' (superficial) and ''gambhira'' (deep). The ''uttana'' is located in ''twaka'' (skin) and ''mamsa'' (muscles) while the ''gambhira'' is located in the deep tissues. [19]

 

==== Clinical features of ''uttana vatarakta'' (superficial type) ====

 

कण्डूदाहरुगायामतोदस्फुरणकुञ्चनैः |   

कण्डूदाहरुगायामतोदस्फुरणकुञ्चनैः |   

अन्विता श्यावरक्ता त्वग्बाह्ये ताम्रा तथेष्यते ||२०||

अन्विता श्यावरक्ता त्वग्बाह्ये ताम्रा तथेष्यते ||२०||

kaṇḍūdāharugāyāmatōdasphuraṇakuñcanaiḥ|  

kaṇḍūdāharugāyāmatōdasphuraṇakuñcanaiḥ|  

anvitā śyāvaraktā tvagbāhyē tāmrā tathēṣyatē||20||   

anvitā śyāvaraktā tvagbāhyē tāmrā tathēṣyatē||20||  

   

kaNDUdAharugAyAmatodasphuraNaku~jcanaiH |   

kaNDUdAharugAyAmatodasphuraNaku~jcanaiH |   

anvitA shyAvaraktA tvagbAhye tAmrA tatheShyate ||20||   

anvitA shyAvaraktA tvagbAhye tAmrA tatheShyate ||20||  

Symptoms of uttana vata shonita are itching, burning sensation, pain, stretching sensation, piercing pain, fasciculation, feeling of constricting and the colour of skin becomes blackish, red or coppery. (20)

   

Clinical features of gambhira vatarakta (deep type):

Symptoms of ''uttana vatashonita'' are itching, burning sensation, pain, stretching sensation, piercing pain, fasciculation, feeling of constricting and the color of skin becomes blackish, red or coppery. [20]

 

==== Clinical features of ''gambhira vatarakta'' (deep type) ====

 

गम्भीरे श्वयथुः स्तब्धः कठिनोऽन्तर्भृशार्तिमान्| श्यावस्ताम्रोऽथवा दाहतोदस्फुरणपाकवान् ||२१||   

गम्भीरे श्वयथुः स्तब्धः कठिनोऽन्तर्भृशार्तिमान्| श्यावस्ताम्रोऽथवा दाहतोदस्फुरणपाकवान् ||२१||   

रुग्विदाहान्वितोऽभीक्ष्णं वायुः सन्ध्यस्थिमज्जसु |   

रुग्विदाहान्वितोऽभीक्ष्णं वायुः सन्ध्यस्थिमज्जसु |