Changes

==== Types of [[vata]] [[dosha]] ====

==== Types of [[vata]] [[dosha]] ====

In Vedic literature, as a medical system, the important five types of [[vata]] are explained with their locations and functions. The word ''tantrayate'' is used to explain the functional quality of [[vata]] and ''sharira'' (physical body) is ''yantra'' for functioning of ''tantra''. The [[vata]] [[dosha]] on basis of its functions is classified into five types. They reside in the ''sharira'' at the level of ''sharira parmanu'' (cell) and also at gross level. Five types of [[vata]] work together in a synchronized manner for the normal functioning of the sharira ([[vayu]] tantrayantra dhara). [verse 5-11]

In Vedic literature, as a medical system, the important five types of [[vata]] are explained with their locations and functions. The word ''tantrayate'' is used to explain the functional quality of [[vata]] and ''sharira'' (physical body) is ''yantra'' for functioning of ''tantra''. The [[vata]] [[dosha]] on basis of its functions is classified into five types. They reside in the ''sharira'' at the level of ''sharira paramanu'' (cell) and also at gross level. Five types of [[vata]] work together in a synchronized manner for the normal functioning of the sharira ([[vayu]] tantrayantra dhara). [verse 5-11]

=== General etiological factors and basic pathogenesis of ''vata'' disorders ===

=== General etiological factors and basic pathogenesis of ''vata'' disorders ===

   

   

The etiological factors can be divided into two:

The etiological factors can be divided into two:

#which cause direct [[vata]] vitiation and  

#which cause direct [[vata]] vitiation and  

#which cause indirect [[vata]] vitiation.  

#which cause indirect [[vata]] vitiation.  

The three characteristics of [[vata]] vitiation viz. ''svatantra dushti'' (vitiation due to independent specific causes), gata [[vata]] (increased movement of [[vata]]) and ''avarana'' (obstruction to movement of [[vata]]). imply three possible modes of pathogenesis in [[vata]] diseases. These can be further analyzed as follows; due to the following three important properties of [[vata]], it is regarded entirely different from other [[dosha]][Cha. Sa. [[Sutra Sthana]] 12/3]

The three characteristics of [[vata]] vitiation viz. ''svatantra dushti'' (vitiation due to independent specific causes), gata [[vata]] (increased movement of [[vata]]) and ''avarana'' (obstruction to movement of [[vata]]). imply three possible modes of pathogenesis in [[vata]] diseases. These can be further analyzed as follows; due to the following three important properties of [[vata]], it is regarded entirely different from other [[dosha]][Cha. Sa. [[Sutra Sthana]] 12/3]

#''Asamghata'' (Incorporeal)

#''Asamghata'' (Incorporeal)

#''Anavasthita'' (Unstable)

#''Anavasthita'' (Unstable)

There is depletion of periarticular and articular tissue by vitiated [[vata]] in sandhigata [[vata]]/osteoarthritis, empty spaces are occupied by [[vata]] which is felt as crepitus on palpation. [[Vata]] also causes hypertrophic tissue in the form of osteophytes and causes painful flexion and extension movements. This is the characteristic feature of swelling in sandhigata [[vata]].  

There is depletion of periarticular and articular tissue by vitiated [[vata]] in sandhigata [[vata]]/osteoarthritis, empty spaces are occupied by [[vata]] which is felt as crepitus on palpation. [[Vata]] also causes hypertrophic tissue in the form of osteophytes and causes painful flexion and extension movements. This is the characteristic feature of swelling in sandhigata [[vata]].  

''Ardita'':  

'''Ardita''':  

''Ardita'' is a disease of episodic origin. It may lead to facial paralysis or hemiplegia or both. In other classics ''ardita'' is explained as facial paralysis only. [verse 38-42]

''Ardita'' is a disease of episodic origin. It may lead to facial paralysis or hemiplegia or both. In other classics ''ardita'' is explained as facial paralysis only. [verse 38-42]

''Antarayama'' (emprosthotonous) and ''bahirayama''(ophisthotonous):  

'''Antarayama (emprosthotonous) and bahirayama(ophisthotonous):'''

These diseases are tetany like conditions in which the body is sharply bent forward and backward respectively. [verse 43-48]

These diseases are tetany like conditions in which the body is sharply bent forward and backward respectively. [verse 43-48]

''Hanugraha'':  

'''Hanugraha''':  

It is a lockjaw like condition that may be persistent or intermittent or recurrent due to vitiation of [[vata]] affecting the mandibular joint. [verse 49]

It is a lockjaw like condition that may be persistent or intermittent or recurrent due to vitiation of [[vata]] affecting the mandibular joint. [verse 49]

''Dandaka'':

'''Dandaka''':

''Dandaka'' is a condition in which the muscles are hypertonic but without convulsions. When it further manifests as tonic clonic convulsions it is referred as ''danda akshepaka''. This condition is caused due to vitiation of [[vata]] simultaneously in muscle groups.  [verse 51]

''Dandaka'' is a condition in which the muscles are hypertonic but without convulsions. When it further manifests as tonic clonic convulsions it is referred as ''danda akshepaka''. This condition is caused due to vitiation of [[vata]] simultaneously in muscle groups.  [verse 51]

Episodic nature of various [[vata]] disorders:

'''Episodic nature of various [[vata]] disorders'''

The disorders mentioned from ''ardita'' onwards are ''vegavana'' (episodic). All ''vegavana'' disorders have two phases, ''vega'' and ''vegantara''. ''Vegantara'' is the symptom free period and is considered as right time for medication. [verse 52]

The disorders mentioned from ''ardita'' onwards are ''vegavana'' (episodic). All ''vegavana'' disorders have two phases, ''vega'' and ''vegantara''. ''Vegantara'' is the symptom free period and is considered as right time for medication. [verse 52]

''Pakshaghata'':  

'''Pakshaghata''':  

Three diseases namely ''pakshaghata''(hemiplegia), ''ekangaroga'' (monoplegia) and ''sarvangaroga'' (quadriplegia) are explained. In ''pakshaghata'' no painful symptoms are explained. ''Sira'' and ''snayu'' are considered as ''dushya'' in ''ekangaroga'' and ''sarvangaroga''. ''Sira'' is the ''upadhatu'' of [[rakta]] and ''snayu'' is the ''upadhatu'' of meda, therefore ''meda'' and ''rakta'' have vital role in pathogenesis of these diseases. [verse 53-55]

Three diseases namely ''pakshaghata''(hemiplegia), ''ekangaroga'' (monoplegia) and ''sarvangaroga'' (quadriplegia) are explained. In ''pakshaghata'' no painful symptoms are explained. ''Sira'' and ''snayu'' are considered as ''dushya'' in ''ekangaroga'' and ''sarvangaroga''. ''Sira'' is the ''upadhatu'' of [[rakta]] and ''snayu'' is the ''upadhatu'' of meda, therefore ''meda'' and ''rakta'' have vital role in pathogenesis of these diseases. [verse 53-55]

''Gridhrasi'':  

'''Gridhrasi''':  

''Gridhrasi'' is a ''snayugata'' (affecting tendon) ''roga''. The word ''gridhrasi'' is derived from ''ghridhra'', which means vulture, the typical gait of the disease is highlighted by the name.  The patient’s gait is changed like a vulture due to affected tendons by vitiated [[vata]].   

''Gridhrasi'' is a ''snayugata'' (affecting tendon) ''roga''. The word ''gridhrasi'' is derived from ''ghridhra'', which means vulture, the typical gait of the disease is highlighted by the name.  The patient’s gait is changed like a vulture due to affected tendons by vitiated [[vata]].   

''Khalli'' is the term given to severe painful twisting conditions of tendons. [verse 56-57]

''Khalli'' is the term given to severe painful twisting conditions of tendons. [verse 56-57]

Nomenclature of diseases:  

'''Nomenclature of diseases:'''

All the [[vata]] disorders cannot be named or explained. They should be understood on the basis of site of affliction as well as nomenclature. [verse 58]

All the [[vata]] disorders cannot be named or explained. They should be understood on the basis of site of affliction as well as nomenclature. [verse 58]

'''Diagnosis of [[dhatu]]kshaya (degenerative pathology) and ''avarana'' (obstructive pathology) induced vitiation of [[vata]]:'''  

'''Diagnosis of [[dhatu]]kshaya (degenerative pathology) and avarana (obstructive pathology) induced vitiation of [[vata]]:'''  

[[Vata]] can be vitiated due to [[dhatu]]kshaya and ''margavarana'' types of pathogenesis. [[Dhatu]]kshaya leads to depletion of tissues and more space for [[vata]] to move. This leads to gata[[vata]] phenomenon. ''Avarana'' of [[vata]] can be caused by other [[dosha]] or [[dhatu]]. So the differences between ''avarana'' and gata[[vata]] should be understood.

[[Vata]] can be vitiated due to [[dhatu]]kshaya and ''margavarana'' types of pathogenesis. [[Dhatu]]kshaya leads to depletion of tissues and more space for [[vata]] to move. This leads to gata[[vata]] phenomenon. ''Avarana'' of [[vata]] can be caused by other [[dosha]] or [[dhatu]]. So the differences between ''avarana'' and gata[[vata]] should be understood.

#In ''avarana'', generally the vitiation of [[vata]] is passive. When vitiated [[dosha]] or any other thing obstructs the pathway of [[vata]], avarana happens. Normal state of [[vata]] gets vitiated as ''avarana'' progresses. The substance which obstructs the pathway of [[vata]] is called as ''avaraka'' and the [[dosha]] ([[vata]] in general or its components) affected by ''avarana'' is called as ''avariya'' or ''avrita''. Normally the ''avarana'' is caused by the etiological factors for the vitiation of ''avaraka''. Etiological factors for the vitiation of [[vata]] (''sva nidana'') will be absent. In case of gata[[vata]] the vitiation of [[vata]] will be active. Here its own etiological factors are operating in the vitiation of [[vata]] in the pathogenesis and the vitiated [[vata]] adopts specific pathway and abnormally localizes at particular sites.

#In ''avarana'', generally the vitiation of [[vata]] is passive. When vitiated [[dosha]] or any other thing obstructs the pathway of [[vata]], avarana happens. Normal state of [[vata]] gets vitiated as ''avarana'' progresses. The substance which obstructs the pathway of [[vata]] is called as ''avaraka'' and the [[dosha]] ([[vata]] in general or its components) affected by ''avarana'' is called as ''avariya'' or ''avrita''. Normally the ''avarana'' is caused by the etiological factors for the vitiation of ''avaraka''. Etiological factors for the vitiation of [[vata]] (''sva nidana'') will be absent. In case of gata[[vata]] the vitiation of [[vata]] will be active. Here its own etiological factors are operating in the vitiation of [[vata]] in the pathogenesis and the vitiated [[vata]] adopts specific pathway and abnormally localizes at particular sites.

#In the process of ''avarana chala'' property of [[vata]] is diminished due to obstruction. Other properties are not involved in the process of obstruction. But in case of ''gatatva'' the vitiation of [[vata]] takes place by involvement of other properties like ''ruksha, laghu, khara, vishada'' etc along with ''chala''.

#In the process of ''avarana chala'' property of [[vata]] is diminished due to obstruction. Other properties are not involved in the process of obstruction. But in case of ''gatatva'' the vitiation of [[vata]] takes place by involvement of other properties like ''ruksha, laghu, khara, vishada'' etc along with ''chala''.

#In ''avarana'' the ''gati'' of [[vata]] is obstructed partially or fully. Once gets obstructed the [[vata]] may simply get lodged there (''baddha marga, margarodha''), try to nullify the obstruction, may get covered by the obstructing substance (''avrita''), adopt an opposite direction (''pratiloma'') or alter the direction (''viloma''). The different terminologies have been used to denote ''avarana'' in different contexts according to the nature of ''avarana'' and the state of [[vata]] and ''marga'' (passage). In case of ''gatatva'' the ''gati'' of vitiated [[vata]] aggravated and starts moving abnormally leading to localization at particular sites.''Avarana'' is caused by ''purnata'' (filling) of other [[dosha]] in the ''srotas/marga'' (passage) of [[vata]]. In ''gatatva'' the ''srotas'' or sites of occupation of [[vata]] are ''rikta'' (unfilled or spacious) and the aggravated [[vata]] fills the ''srotas''/site.

#In ''avarana'' the ''gati'' of [[vata]] is obstructed partially or fully. Once gets obstructed the [[vata]] may simply get lodged there (''baddha marga, margarodha''), try to nullify the obstruction, may get covered by the obstructing substance (''avrita''), adopt an opposite direction (''pratiloma'') or alter the direction (''viloma''). The different terminologies have been used to denote ''avarana'' in different contexts according to the nature of ''avarana'' and the state of [[vata]] and ''marga'' (passage). In case of ''gatatva'' the ''gati'' of vitiated [[vata]] aggravated and starts moving abnormally leading to localization at particular sites.''Avarana'' is caused by ''purnata'' (filling) of other [[dosha]] in the ''srotas/marga'' (passage) of [[vata]]. In ''gatatva'' the ''srotas'' or sites of occupation of [[vata]] are ''rikta'' (unfilled or spacious) and the aggravated [[vata]] fills the ''srotas''/site.

#In ''avarana'' of [[vata]], swakarma vriddhi (exaggerated activities) of ''avaraka'' (covering [[dosha]]) is manifested. The ''avrita'' (i.e. [[vata]]) will show ''swakarma hani'' (diminished activity). This is the general feature of ''avarana''. Here the excessively increased strong ''avaraka'' suppresses the normal action of ''avrita'' (i.e.[[vata]]). Therefore, when the obstruction is complete it may lead to the ''prakopa'' of [[vata]] resulting in the presentation of [[vata]] vitiated symptoms as well as its disorders[ Cha. Sa. [[Chikitsa Sthana]] 28/215, Chakrapani]. In case of ''gatatva'' the symptomatology will be predominantly of [[vata]] vitiation and pain is a common and chief complaint in all the conditions of ''gatatva''.

#In ''avarana'' of [[vata]], swakarma vriddhi (exaggerated activities) of ''avaraka'' (covering [[dosha]]) is manifested. The ''avrita'' (i.e. [[vata]]) will show ''swakarma hani'' (diminished activity). This is the general feature of ''avarana''. Here the excessively increased strong ''avaraka'' suppresses the normal action of ''avrita'' (i.e.[[vata]]). Therefore, when the obstruction is complete it may lead to the ''prakopa'' of [[vata]] resulting in the presentation of [[vata]] vitiated symptoms as well as its disorders[ Cha. Sa. [[Chikitsa Sthana]] 28/215, Chakrapani]. In case of ''gatatva'' the symptomatology will be predominantly of [[vata]] vitiation and pain is a common and chief complaint in all the conditions of ''gatatva''.

#Obstruction or covering of [[vata]] is possible by body components like [[dosha]] ([[pitta]] and [[kapha]]),tissues,food,  excretory products or mutual affliction of [[vata]] types. Gatatva of [[vata]] (affection) is happening in empty spaces or hollow cavities of tissues, their elements, organs and other body parts. In ''avarana'', the body component is in increased state causing fullness in respected channels, while in ''gatatva'' pathology, the body components are in depleted state casusing emptiness in the respected channels. Dhatugata [[vata]] will be presented with decreased quality of tissues associated with signs of vitiated [[vata]]. Obviously, exceptions are possible according to the complexities of process of ''avarana'' or ''gatatva''.

#Obstruction or covering of [[vata]] is possible by body components like [[dosha]] ([[pitta]] and [[kapha]]),tissues,food,  excretory products or mutual affliction of [[vata]] types. Gatatva of [[vata]] (affection) is happening in empty spaces or hollow cavities of tissues, their elements, organs and other body parts. In ''avarana'', the body component is in increased state causing fullness in respected channels, while in ''gatatva'' pathology, the body components are in depleted state casusing emptiness in the respected channels. Dhatugata [[vata]] will be presented with decreased quality of tissues associated with signs of vitiated [[vata]]. Obviously, exceptions are possible according to the complexities of process of ''avarana'' or ''gatatva''.

#In case of ''avarana'' of [[vata]], the ''avaraka'' is important for  treatment since vitiation of [[vata]] is passive. When ''avarana'' is removed vitiated [[vata]] gets pacified. But in cases of ''gatatva'', the vitiated [[vata]] has to be treated first along with correction of ''adhisthana''.

#In case of ''avarana'' of [[vata]], the ''avaraka'' is important for  treatment since vitiation of [[vata]] is passive. When ''avarana'' is removed vitiated [[vata]] gets pacified. But in cases of ''gatatva'', the vitiated [[vata]] has to be treated first along with correction of ''adhisthana''.

#Diagnosis of ''avarana'' is made with the help of ''upashaya–anupashaya'' (pacifying and aggravating factors) method. Diagnosis of ''gatatva'' is made according to the ''rupa'' (symptomatology).  

#Diagnosis of ''avarana'' is made with the help of ''upashaya–anupashaya'' (pacifying and aggravating factors) method. Diagnosis of ''gatatva'' is made according to the ''rupa'' (symptomatology).  

#Complications of ''avarana'' are explained in case of improper diagnosis and delayed treatment like ''hridroga, vidradhi, kamala'' etc. No known complication occur in ''gatatva''.

#Complications of ''avarana'' are explained in case of improper diagnosis and delayed treatment like ''hridroga, vidradhi, kamala'' etc. No known complication occur in ''gatatva''.

#''Avarana'' of [[vata]] may cause depletion of nutrition to [[dhatu]] ([[dhatu]]gata sama) leading to successive diminition of rasadi [[dhatu]](''rasadimscha upasosayet'').[Cha. sa. [[Sutra Sthana]] 28/61]  No such reference is available in case of ''gatatva''.  

#''Avarana'' of [[vata]] may cause depletion of nutrition to [[dhatu]] ([[dhatu]]gata sama) leading to successive diminition of rasadi [[dhatu]](''rasadimscha upasosayet'').[Cha. sa. [[Sutra Sthana]] 28/61]  No such reference is available in case of ''gatatva''.  

Treatment of disorders of [[vata]], when located in different sites, habitat (''sthana'') is more important in comparison to the invaded (''agantu'') [[dosha]] e.g in koshthagata [[vata]], koshtha is given preference in treatment, and so ''kshara'' is used which helps in digestion ([[pachana]]). But when [[vata]] is located in ''pakvashaya'' or ''guda'' which is [[vata]]sthana, udavartahara treatment is selected, which includes [[vata]] anulomana, [[basti]], varti'' etc. In amashayagata [[vata]], shodhana in the form of [[vamana]] is done.  

Treatment of disorders of [[vata]], when located in different sites, habitat (''sthana'') is more important in comparison to the invaded (''agantu'') [[dosha]] e.g in koshthagata [[vata]], koshtha is given preference in treatment, and so ''kshara'' is used which helps in digestion ([[pachana]]). But when [[vata]] is located in ''pakvashaya'' or ''guda'' which is [[vata]]sthana, udavartahara treatment is selected, which includes [[vata]] anulomana, [[basti]], varti'' etc. In amashayagata [[vata]], shodhana in the form of [[vamana]] is done.  

''Hridaya anna'' (favourite food) is typically indicated in tvakgata [[vata]] because, rūkṣatā in tvak is a result of rasakṣaya caused by overworrying.[ Cha. Sa. [[Vimana Sthana]] 5/13 ]

''Hridaya anna'' (favourite food) is typically indicated in tvakgata [[vata]] because, rūkṣatā in tvak is a result of rasakṣaya caused by overworrying.[Cha. Sa. [[Vimana Sthana]] 5/13]

Bahya [[snehana]] in the form of ''abhyanga'' or ''dhara'', etc are very effective in [[asthi dhatu]]gata and [[majja dhatu]]gata [[vata]]. Abhyantara [[snehana]] replenishes [[meda dhatu]] and subsequently [[asthi dhatu]] and [[majja dhatu]]. It is worthy to note the utility of ''tikta ghrita'' in [[asthi dhatu]]kshaya.  

Bahya [[snehana]] in the form of ''abhyanga'' or ''dhara'', etc are very effective in [[asthi dhatu]]gata and [[majja dhatu]]gata [[vata]]. Abhyantara [[snehana]] replenishes [[meda dhatu]] and subsequently [[asthi dhatu]] and [[majja dhatu]]. It is worthy to note the utility of ''tikta ghrita'' in [[asthi dhatu]] kshaya.  

   

   

In ''shukrakshaya'' (depletion of ''shukra''), ''harshana'' (pleasure) and ''vrishya annapana'' (aphorodisiac diet) is very useful. <ref>Vagbhata, Sharira Sthana Chap 5 , Angavibhaga Adhyaya, Verse 67. In: Bhishagacharya Harisastri Paradikara Vaidya (eds.) 9th ed. Varanasi: Chaukhambha Orientalia; 2005. P798</ref>

In ''shukrakshaya'' (depletion of ''shukra''), ''harshana'' (pleasure) and ''vrishya annapana'' (aphorodisiac diet) is very useful. <ref>Vagbhata, Sharira Sthana Chap 5 , Angavibhaga Adhyaya, Verse 67. In: Bhishagacharya Harisastri Paradikara Vaidya (eds.) 9th ed. Varanasi: Chaukhambha Orientalia; 2005. P798</ref>

=== Avagaha (immersion) sweda ===

=== Avagaha (immersion) sweda ===

Avagaha is typically indicated in apana vaigunya (defects due to apana [[vata]] vitiation), it is a type of drava sweda (liquid fomentation). Nādisweda is also an excellent option for all types of vātarōga. Poultices (upanāha) of different types  provide self generated heat to cause swedana. It is by virtue of various dhanya (cereals) and kinwa (yeast) available in it.  [verse 109-118]

Avagaha is typically indicated in apana vaigunya (defects due to apana [[vata]] vitiation), it is a type of drava sweda (liquid fomentation). Nadisweda is also an excellent option for all types of vataroga. Poultices (upanaha) of different types  provide self generated heat to cause swedana. It is by virtue of various dhanya (cereals) and kinwa (yeast) available in it.  [verse 109-118]

=== Different formulations===

=== Different formulations===

Different medicated ghrita, taila, vasa, majja and maha sneha ( combination of all four sneha) are indicated for various conditions in the form of oral ingestion, inhalation, enema and external application etc. Maha sneha is guru (heavy to digest) and ultimately indicated in disorders like convulsions, tremor etc. [verse 119-136]

Different medicated ghrita, taila, vasa, majja and maha sneha (combination of all four sneha) are indicated for various conditions in the form of oral ingestion, inhalation, enema and external application etc. Maha sneha is guru (heavy to digest) and ultimately indicated in disorders like convulsions, tremor etc. [verse 119-136]

Pinyaka taila is a preparation in which ruksha [[guna]] is imparted to taila and is highly useful in [[kapha]] associated [[Vata]]vyadhi. [verse 136-137]

Pinyaka taila is a preparation in which ruksha [[guna]] is imparted to taila and is highly useful in [[kapha]] associated [[Vata]] vyadhi. [verse 136-137]

=== Importance of oil in treatment of [[vata]]===  

=== Importance of oil in treatment of [[vata]]===  

By virtue of vyavayi [[guna]] (pervading/diffusive), it reaches the different interior parts of the body without any metabolic changes. By processing taila can adopt any type of qualitative changes.  The drugs are potentiated by repeated processing in its own media. Drugs like ksheerbalā (101 āvartita), dhanwatharam (21 āvartita) etc. are worth mentioning here. This approach of samskāra makes snēha as sukshma snēha (with better bio-availability and penetration) .[verse 181-182]

By virtue of vyavayi [[guna]] (pervading/diffusive), it reaches the different interior parts of the body without any metabolic changes. By processing taila can adopt any type of qualitative changes.  The drugs are potentiated by repeated processing in its own media. Drugs like ksheerbala (101 avartita), dhanwatharam (21 avartita) etc. are worth mentioning here. This approach of samskara makes sneha as sukshma sneha (with better bio-availability and penetration). [verse 181-182]

=== Management of avrita [[vata]] ===

=== Management of avrita [[vata]] ===

In [[pitta]]vr̥ta [[vata]], hot and cold should be applied alternately.  Jīvanīya sarpi is also very [[brimhana]]. [[Brimhana]] is the ideal pacifying line of treatment for [[vata]] and [[vata]]-[[pitta]].   

In [[pitta]]vritta [[vata]], hot and cold should be applied alternately.  Jivaniya sarpi is also very [[brimhana]]. [[Brimhana]] is the ideal pacifying line of treatment for [[vata]] and [[vata]]-[[pitta]].   

 

In [[kapha]]vr̥ta [[vata]], ruksha is given importance. In association of [[kapha]] along with [[pitta]] in [[vata]]roga, [[pitta]] should be given importance in management. It is because of the fact that [[pitta]] makes the disease process as ‘ashukari’(instantaneous).  

In [[Kapha]]vritta [[vata]]; tikshna sweda, niruha and [[vamana]] which reduces [[kapha]] is indicated followed by [[virechana]] intended for [[vata]] anulomana and also useful for [[kapha]].

In [[Kapha]]vritta [[vata]]; tīkṣṇā sweda, niruha and [[vamana]] which reduces [[kapha]] is indicated followed by [[virechana]] intended for [[vata]] anulomana and also useful for [[kapha]].

Jirna/purana sarpi (old ghee) which has [[kapha]]ghna quality has to be used; tila and sarshapa which are [[kapha]] [[vata]]ghna are to be used. Warm drinks of yava, jangala mamsa rasa which gives strength to the patient without increasing kapha are to be administered. [verse 183-188]

Jirna/purāna sarpi (old ghee) which has [[kapha]]ghna quality has to be used; tila and sarshapa which are [[kapha]] [[vata]]ghna are to be used. Warm drinks of yava, jāṇgala mānsa rasa which gives strength to the patient without increasing kapha are to be administered. [verse 183-188]

Kshara [[basti]] (gomutrayukta [[basti]]) in case of [[kapha]]-[[vata]] and ksheera [[basti]] in [[pitta]]-[[vata]] is recommended. [[Rakta]]vruta [[vata]] is similar to uttana-vatarakta and treatment is accordingly same. [[Rakta]] avruta [[vata]] is one of the phases of vatarakta. Thus [[raktamokshana]] and [[basti]] chikitsa which is useful in vatarakta is also helpful in rakta avruta [[vata]].

Prameha samprapti mentioned in Sutra sthana 17th chapter explains [[kapha]], [[pitta]], [[meda dhatu]] and [[mamsa dhatu]] which when increased causes avarana of [[vata]]. Therefore, pramehagna cikitsa is helpful in meda avruta [[vata]] and also in mamsavrutta [[vata]]. Hence in mamsavrutta [[vata]] the pipilika iva sanchara (tingling sensation) reduces, if prameha is treated. Similarly, in obesity, medasavruta [[vata]] ([[vata]] obstructed by excess meda) [Cha.Sa.[[Sutra Sthana]] 21/5] and meda and mamsa ativridhi [Cha.Sa.[[Sutra Sthana]] 21/9] is observed.  These conditions are best treated on the principles of management of prameha, sthaulya associated with vitiated [[vata]]. Therapeutic emesis to expel out the intoxicated food in stomach is advised in condition of annavrita [[vata]] ( [[vata]] obstructed by food). [[Pachana]] and [[deepana]] helps in digestion and also pacifies [[vata]].

Prameha samprapti mentioned in Sutra sthana 17th chapter explains [[kapha]], [[pitta]], [[meda dhatu]] and [[mamsa dhatu]] which when increased causes avarana of [[vata]]. Therefore, pramehagna cikitsa is helpful in meda avruta [[vata]] and also in mamsavruta [[vata]]. Hence in mamsavruta [[vata]] the pipilika iva sanchara (tingling sensation) reduces, if prameha is treated. Similarly, in obesity, medasavruta [[vata]] ([[vata]] obstructed by excess meda) [Cha.Sa.[[Sutra Sthana]] 21/5] and meda and mamsa ativridhi [Cha.Sa.[[Sutra Sthana]] 21/9] is observed.  These conditions are best treated on the principles of management of prameha, sthaulya associated with vitiated [[vata]]. Therapeutic emesis to expel out the intoxicated food in stomach is advised in condition of annavrita [[vata]] ( [[vata]] obstructed by food). [[Pachana]] and [[deepana]] helps in digestion and also pacifies [[vata]].

Hot fomentation reduces urethral pressure. A study done by Shafik A.  showed that sitting in warm water helps in micturition which seems to be initiated by reflex internal urethral sphincter relaxation. A thermo sphincter reflex is likely to be involved.

Hot fomentation reduces urethral pressure. A study done by Shafik A.  showed that sitting in warm water helps in micturition which seems to be initiated by reflex internal urethral sphincter relaxation. A thermo sphincter reflex is likely to be involved.

This includes hrudroga, vidradhi, plīhā, gulma, atisara. Hrudroga is a common complication of ill treated avarana of prana and udana. Vidradhi and pliha are caused by wrongly managed avarana of vyana. Gulma and atisara are common complications of avarana of samana and apana.  

This includes hrudroga, vidradhi, plīhā, gulma, atisara. Hrudroga is a common complication of ill treated avarana of prana and udana. Vidradhi and pliha are caused by wrongly managed avarana of vyana. Gulma and atisara are common complications of avarana of samana and apana.  

Srotoshodana is an important line of management in Avarana. It ensures unobstructed movement of [[vata]]. All abhishyandi(increasing discharges in body) food causes srotorodha (obstruction of channels). Yapana [[Basti]] is ideal for all age group and safe to severe clinical presentations. It protects all marma points. As it is neither lekhana (reducing body components), nor [[brimhana]], it is useful for managing [[vata]] as well as avaraka [[kapha]] or [[pitta]]. Guggulu rasāyana and shilajatu rasāyana is ideal for many clinical conditions of avarana.

Srotoshodhana is an important line of management in Avarana. It ensures unobstructed movement of [[vata]]. All abhishyandi(increasing discharges in body) food causes srotorodha (obstruction of channels). Yapana [[Basti]] is ideal for all age group and safe to severe clinical presentations. It protects all marma points. As it is neither lekhana (reducing body components), nor [[brimhana]], it is useful for managing [[vata]] as well as avaraka [[kapha]] or [[pitta]]. Guggulu rasāyana and shilajatu rasāyana is ideal for many clinical conditions of avarana.

=== Related chapter ===

=== Related chapters ===

* [[Vatakalakaliya Adhyaya]]

[[Vatakalakaliya Adhyaya]], [[Basti]], [[Snehana]], [[Panchakarma]]

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