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|title=Vatavyadhi Chikitsa

|title=Vatavyadhi Chikitsa

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<big>'''[[Chikitsa Sthana]] Chapter 28.Management of diseases caused by [[vata]] [[dosha]] </big>'''

<big>'''[[Chikitsa Sthana]] Chapter 28.Management of diseases caused by [[vata]] [[dosha]] </big>'''

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<big>'''Abstract </big>'''

<big>'''Abstract </big>'''

<div style="text-align:justify;">

<p style="text-align:justify;">[[Vatavyadhi Chikitsa]] deals with diseases particularly caused by [[vata]] [[dosha]]. It is an important chapter as it encompasses a large spectrum of disorders especially concerned with neurological system, musculoskeletal system, reticulo-endothelial system and further pervades to all other systems in the body. The chapter highlights the five sub classifications of [[vata]], their habitat and functions. The etiological factors of [[vata]]vyadhi are enlisted and two major pathology viz, [[dhatu]]kshaya and ''avarana'' are detailed. In [[dhatu]]kshaya, vitiated [[vata]] assumes the status of gatavata (increased movement of [[vata]]) and occupies various sites leading to [[dhatu]]gata (affecting tissues) [[vata]], ashayagata (affecting various sites) [[vata]] and ''avayava'' (organs) gata[[vata]]. ''Avarana'' (obstruction by covering) is a distinct pathology of [[vata]] in which the free mobility of [[vata]] is hampered. Accordingly, ''avarana'' may happen either due to two other [[dosha]], [[dhatu]] ([[rakta]], etc.) or [[mala]] (waste). ''Avarana'' may also happen in between two subtypes of [[vata]] as the direction of movement of various types of [[vata]] differ. This is called ''anyonyavarana''. The symptomatology, pathology and management strategies of ''avarana'' as well as gata[[vata]] are detailed in the chapter. The most common neurological disorders like ''pakshaghata'' (stroke), ''ardita'' (facial palsy), ''gridhrasi'' (sciatica), ''avabahuka'' (frozen shoulder), ''viswachi'' (cervico brachial neuralgia) etc. are described. Various formulations including medicated oils and ghee etc. are also included in the chapter. The chapter confirms the difficulty in curability of chronic ''vatavyadhi'' affecting debilitated individuals.  

[[Vatavyadhi Chikitsa]] deals with diseases particularly caused by [[vata]] [[dosha]]. It is an important chapter as it encompasses a large spectrum of disorders especially concerned with neurological system, musculoskeletal system, reticulo-endothelial system and further pervades to all other systems in the body. The chapter highlights the five sub classifications of [[vata]], their habitat and functions. The etiological factors of [[vata]]vyadhi are enlisted and two major pathology viz, [[dhatu]]kshaya and ''avarana'' are detailed. In [[dhatu]]kshaya, vitiated [[vata]] assumes the status of gatavata (increased movement of [[vata]]) and occupies various sites leading to [[dhatu]]gata (affecting tissues) [[vata]], ashayagata (affecting various sites) [[vata]] and ''avayava'' (organs) gata[[vata]]. ''Avarana'' (obstruction by covering) is a distinct pathology of [[vata]] in which the free mobility of [[vata]] is hampered. Accordingly, ''avarana'' may happen either due to two other [[dosha]], [[dhatu]] ([[rakta]], etc.) or [[mala]] (waste). ''Avarana'' may also happen in between two subtypes of [[vata]] as the direction of movement of various types of [[vata]] differ. This is called ''anyonyavarana''. The symptomatology, pathology and management strategies of ''avarana'' as well as gata[[vata]] are detailed in the chapter. The most common neurological disorders like ''pakshaghata'' (stroke), ''ardita'' (facial palsy), ''gridhrasi'' (sciatica), ''avabahuka'' (frozen shoulder), ''viswachi'' (cervico brachial neuralgia) etc. are described. Various formulations including medicated oils and ghee etc. are also included in the chapter. The chapter confirms the difficulty in curability of chronic ''vatavyadhi'' affecting debilitated individuals.  

 

'''Keywords''': Akshepaka, Anyonyavarana, Apana, Ardita, Avabahuka, Avarana, [[Ayurveda]], Convulsive disorders, [[Dhatu]]kshaya, Facial palsy, Gata[[vata]], General Line of treatment of ''Vatavyadhi, Gridhrasi,'' Neurological disorders, ''Pakshaghata, Prana, Samana,'' Sciatica, Specific treatments of ''Vatavyadhi'', Stroke, ''Udana, Vishwachi, Vyana.''

'''Keywords''': Akshepaka, Anyonyavarana, Apana, Ardita, Avabahuka, Avarana, [[Ayurveda]], Convulsive disorders, [[Dhatu]]kshaya, Facial palsy, Gata[[vata]], General Line of treatment of ''Vatavyadhi, Gridhrasi,'' Neurological disorders, ''Pakshaghata, Prana, Samana,'' Sciatica, Specific treatments of ''Vatavyadhi'', Stroke, ''Udana, Vishwachi, Vyana.''

</div>

</p>

[[Vata]] is the prime [[dosha]]. Owing to its incorporeal nature and instability it is inaccessible in comparison to other two [[dosha]]. The inaccessibility is characterized in regard to its functional and physical attributes but is more relevant regarding the therapeutic aspect. [[Vata]] is also explained as ''achintyaveerya'' (inconceivable prowess) and ''doshaanaam netah'' (propeller of all functional elements in the body).<ref>Dalhana, Sushruta. Nidana Sthana, Cha.1 Vatavyadhi Nidana Adhyaya verse 8. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1. </ref>

[[Vata]] is the prime [[dosha]]. Owing to its incorporeal nature and instability it is inaccessible in comparison to other two [[dosha]]. The inaccessibility is characterized in regard to its functional and physical attributes but is more relevant regarding the therapeutic aspect. [[Vata]] is also explained as ''achintyaveerya'' (inconceivable prowess) and ''doshaanaam netah'' (propeller of all functional elements in the body).<ref>Dalhana, Sushruta. Nidana Sthana, Cha.1 Vatavyadhi Nidana Adhyaya verse 8. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1. </ref>

Before discussing the importance and implications of [[vata]], the references on [[vata]] and neurological elements in vedic literature is to be highlighted. In vedic science two terminologies namely ''prana'' and ''pranaja'' were used to denote nerve impulses. ''Prana'' is ''kriyashakti'' (power for action) and may be compared with motor impulse. ''Pranaja'' is also same as ''prana'' but conveys sensation of taste, smell, vision, sound, coitus, reproduction, pleasure and pain. It can be compared with sensory afferent impulse. Both ''prana'' and ''pranaja'' leave body at death. The entire neural axis is explained as ''sushumna'' (spinal cord) and it extends from the mid-perineum to inside of cranium runing through the middle of the spine to reach the cerebrum, twelve fingers breadth from nose. The shape of ''sushumna'' is compared with flower of ''datura alba'' with two dilatations at thoracic and lumbar areas. The cross section of spinal column is compared with the letter ''Aum'' in which grey matter and white matter is identified as ''chitrini'' (name for grey matter) and ''vajra'' (name for white matter). The neural net works are compared with ''luta tantu'' (spider web)<ref>B C Joshy, Neurology in Ancient India – some evidences, Indian journal of History of science, 19(4):366-396(1984)</ref>. Ten subtypes of ''vata'' are explained and ''dhananjaya'' (the tenth and last subtype) does not leave the body even after death. This is responsible for tissue transplantation after death. The description of ''shadchakra'' (six ''chakras'') is also very striking with latest functional modern neurology. The difference between vedic and ayurvedic neurology is that vedic science used it to attain higher level of consciousness through control of one’s nerve impulses. Ayurvedic science is meant for academic advancement or therapeutics. In [[Ayurveda]] it can be seen that practical utilization of vedic knowledge for therapeutic purpose by modification through experiments and experiences is done. Detailed descriptions of features of [[vata]] are available in various chapters of [[Charak Samhita]] including [[Deerghanjiviteeya Adhyaya]], [[Vatakalakaliya Adhyaya]] and [[Rogabhishagjitiya Vimana]], etc. The pathology and therapeutic aspects of [[vata]] is explained in this chapter. There is no separate chapter for diseases of [[pitta]] and [[kapha dosha]]. [[Vatavyadhi Chikitsa]] is an exclusive chapter dealing with [[vata]] janita vishesha vyadhi (diseases caused by [[vata]] vitiation). It is because of the supremacy of [[vata]]. The chapter is kept just after [[Urusthambha Chikitsa]] since in that particular disease ama, [[kapha]], meda, etc. are associated to cause [[vata]]prakopa and ''urustambha''. On application of strenuous [[rukshana]] chikitsa in urustambha, [[vata]]prakopa alone may also happen. Even though in ''nanatmaja'' (single [[dosha]]) [[vata]]vyadhi the presence of other [[dosha]] can be traced, the disease cannot manifest without the vitiation of [[vata]].  

Before discussing the importance and implications of [[vata]], the references on [[vata]] and neurological elements in vedic literature is to be highlighted. In vedic science two terminologies namely ''prana'' and ''pranaja'' were used to denote nerve impulses. ''Prana'' is ''kriyashakti'' (power for action) and may be compared with motor impulse. ''Pranaja'' is also same as ''prana'' but conveys sensation of taste, smell, vision, sound, coitus, reproduction, pleasure and pain. It can be compared with sensory afferent impulse. Both ''prana'' and ''pranaja'' leave body at death. The entire neural axis is explained as ''sushumna'' (spinal cord) and it extends from the mid-perineum to inside of cranium runing through the middle of the spine to reach the cerebrum, twelve fingers breadth from nose. The shape of ''sushumna'' is compared with flower of ''datura alba'' with two dilatations at thoracic and lumbar areas. The cross section of spinal column is compared with the letter ''Aum'' in which grey matter and white matter is identified as ''chitrini'' (name for grey matter) and ''vajra'' (name for white matter). The neural net works are compared with ''luta tantu'' (spider web)<ref>B C Joshy, Neurology in Ancient India – some evidences, Indian journal of History of science, 19(4):366-396(1984)</ref>. Ten subtypes of ''vata'' are explained and ''dhananjaya'' (the tenth and last subtype) does not leave the body even after death. This is responsible for tissue transplantation after death. The description of ''shadchakra'' (six ''chakras'') is also very striking with latest functional modern neurology. The difference between vedic and ayurvedic neurology is that vedic science used it to attain higher level of consciousness through control of one’s nerve impulses. Ayurvedic science is meant for academic advancement or therapeutics. In [[Ayurveda]] it can be seen that practical utilization of vedic knowledge for therapeutic purpose by modification through experiments and experiences is done. Detailed descriptions of features of [[vata]] are available in various chapters of [[Charak Samhita]] including [[Deerghanjiviteeya Adhyaya]], [[Vatakalakaliya Adhyaya]] and [[Rogabhishagjitiya Vimana]], etc. The pathology and therapeutic aspects of [[vata]] is explained in this chapter. There is no separate chapter for diseases of [[pitta]] and [[kapha dosha]]. [[Vatavyadhi Chikitsa]] is an exclusive chapter dealing with [[vata]] janita vishesha vyadhi (diseases caused by [[vata]] vitiation). It is because of the supremacy of [[vata]]. The chapter is kept just after [[Urustambha Chikitsa]] since in that particular disease ama, [[kapha]], meda, etc. are associated to cause [[vata]]prakopa and ''urustambha''. On application of strenuous [[rukshana]] chikitsa in urustambha, [[vata]]prakopa alone may also happen. Even though in ''nanatmaja'' (single [[dosha]]) [[vata]]vyadhi the presence of other [[dosha]] can be traced, the disease cannot manifest without the vitiation of [[vata]].  

[[Vata]] as explained earlier is the biological force present in the body which recognizes and stimulates all the activities. Instability of [[vata]] makes it inaccessible. It is characterized by an increase in the ''chala'' (motion) property, which is favored and contributed by other properties also. The ''chala guna'' is directional in nature and termed as ''gati''. ''Gati'' is the distinct quality of [[vata]], very important on physiological and pathological aspects. The ''gati'' of individual components of [[vata]] is to be analyzed according to the intensity, direction and area; depending upon the particular function it is carrying out. When the ''gati'' is aggravated (''gatatva'') or obstructed (''avarana'') the functional normality’s of [[vata]] are impaired. The ''gati'' or ''gatatva'' have two implications, one subjected to activity (to move, carry out or reach-gata) and the second subjected to abode of activity (pathway). ''Gatatva'' is an essential part of any [[vata]]ja samprapti'' (pathogenesis). ''Gatatva'' of [[vata]] is possible in [[dhatu]], upadhatu, asaya'' (sites or hollow cavities of organs), ''avayava'' (part or organ), etc. Consumption of ''ahara'' of relatively higher ''kittansa'' (waste products) leads to diminution of [[dhatu]] and aggravation of [[vata]][ Cha. Sa. [[Sutra Sthana]] 28/4]. It leads to ''riktata'' (emptiness) and more ''avakasa'' (space) in [[dhatu]], makes the engorgement and hyper movement of aggravated [[vata]] in the site. [[Dhatu]]gatavata and [[dhatu]]avrita [[vata]] are also distinct pathologies as in ''avarana'' the vitiation of [[vata]] is passive and the ''gati'' is obstructed.

[[Vata]] as explained earlier is the biological force present in the body which recognizes and stimulates all the activities. Instability of [[vata]] makes it inaccessible. It is characterized by an increase in the ''chala'' (motion) property, which is favored and contributed by other properties also. The ''chala guna'' is directional in nature and termed as ''gati''. ''Gati'' is the distinct quality of [[vata]], very important on physiological and pathological aspects. The ''gati'' of individual components of [[vata]] is to be analyzed according to the intensity, direction and area; depending upon the particular function it is carrying out. When the ''gati'' is aggravated (''gatatva'') or obstructed (''avarana'') the functional normality’s of [[vata]] are impaired. The ''gati'' or ''gatatva'' have two implications, one subjected to activity (to move, carry out or reach-gata) and the second subjected to abode of activity (pathway). ''Gatatva'' is an essential part of any [[vata]]ja samprapti'' (pathogenesis). ''Gatatva'' of [[vata]] is possible in [[dhatu]], upadhatu, asaya'' (sites or hollow cavities of organs), ''avayava'' (part or organ), etc. Consumption of ''ahara'' of relatively higher ''kittansa'' (waste products) leads to diminution of [[dhatu]] and aggravation of [[vata]][ Cha. Sa. [[Sutra Sthana]] 28/4]. It leads to ''riktata'' (emptiness) and more ''avakasa'' (space) in [[dhatu]], makes the engorgement and hyper movement of aggravated [[vata]] in the site. [[Dhatu]]gatavata and [[dhatu]]avrita [[vata]] are also distinct pathologies as in ''avarana'' the vitiation of [[vata]] is passive and the ''gati'' is obstructed.

The chapter begins with praising of powerful [[vata]] followed with five subtypes of [[vata]]. After these descriptions, the etiopathological and therapeutic aspects of [[vata]] are explained. In the present chapter the two distinct pathology of [[vata]] is explained with possible causative factors. In the context of ''gatavata'', the pathology is related to the various [[dhatu]], ashaya'' or ''avayava'' involved in ''gatatva''. The same way different ''avarana'' of [[vata]] by other two [[dosha]], [[dhatu]], [[mala]], anna, etc. are explained. Since different subtypes of [[vata]] possess different ''gati'' mutual ''avarana'' among subtypes are also possible. The chapter also explains various disorders like ''pakshaghata, ardita, akshepaka, avabahuka'' etc. The general line of treatment of absolute [[vata]] vitiation is detailed in the chapter by giving importance to [[snehana]], [[swedana]], samshodana, etc.  An ample amount of medications including various ''taila yoga, ghr̥ita yoga,'' etc. are also given in the chapter. The specific treatment approaches in exclusive conditions are also explained.

The chapter begins with praising of powerful [[vata]] followed with five subtypes of [[vata]]. After these descriptions, the etiopathological and therapeutic aspects of [[vata]] are explained. In the present chapter the two distinct pathology of [[vata]] is explained with possible causative factors. In the context of ''gatavata'', the pathology is related to the various [[dhatu]], ashaya or ''avayava'' involved in ''gatatva''. The same way different ''avarana'' of [[vata]] by other two [[dosha]], [[dhatu]], [[mala]], anna, etc. are explained. Since different subtypes of [[vata]] possess different ''gati'' mutual ''avarana'' among subtypes are also possible. The chapter also explains various disorders like ''pakshaghata, ardita, akshepaka, avabahuka'' etc. The general line of treatment of absolute [[vata]] vitiation is detailed in the chapter by giving importance to [[snehana]], [[swedana]], [[samshodhana]], etc.  An ample amount of medications including various ''taila yoga, ghr̥ita yoga,'' etc. are also given in the chapter. The specific treatment approaches in exclusive conditions are also explained.

[[Vata]]vyadhi are group of disorders which are very commonly encountered by ayurvedic physicians. In many diseases like ''pakshaghata, ardita, gridhrasi, kateegraha,'' etc. ayurvedic physicians are claiming better results and it is widely accepted also. Critical understandings of pathology, types, prognostic factors etc. are very important for academic and clinical success. Thus, thorough understanding of [[vata]] roga is essential for every treating physician.

[[Vata]] vyadhi are group of disorders which are very commonly encountered by ayurvedic physicians. In many diseases like ''pakshaghata, ardita, gridhrasi, kateegraha,'' etc. ayurvedic physicians are claiming better results and it is widely accepted also. Critical understandings of pathology, types, prognostic factors etc. are very important for academic and clinical success. Thus, thorough understanding of [[vata]] roga is essential for every treating physician.

== Sanskrit Text, Transliteration and English Translation ==

== Sanskrit Text, Transliteration and English Translation ==

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Vitiated [[vata]] causes various symptoms like contractures, joint stiffness, splitting of bones and joints, horripilation, delirium,  spasticity of hands, back and neck; limping, paraplegia, hunch back; organ atrophy, insomnia, intrauterine death of embryo and fetus, diminishing sperms and menstruation  fasciculation, generalized numbness, twitches of head, nose, eyes, supraclavicular part and neck; splitting, pricking or aching type of pains; convulsions, loss of consciousness, fatigue etc. Different specific diseases of [[vata]] are caused by specificity in etiological factors and site of affliction. [20-24]

Vitiated [[vata]] causes various symptoms like contractures, joint stiffness, splitting of bones and joints, horripilation, delirium,  spasticity of hands, back and neck; limping, paraplegia, hunch back; organ atrophy, insomnia, intrauterine death of embryo and fetus, diminishing sperms and menstruation  fasciculation, generalized numbness, benumbing or paralysis of muscles of head, nose, eyes, supraclavicular part and neck; splitting, pricking or aching type of pains; convulsions, loss of consciousness, fatigue etc. Different specific diseases of [[vata]] are caused by specificity in etiological factors and site of affliction. [20-24]

=== Clinical features of vitiation of [[vata]] at different sites ===

=== Clinical features of vitiation of [[vata]] at different sites ===

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लिङ्गं पित्तावृते दाहस्तृष्णा शूलं भ्रमस्तमः [१] ||६१|| <br />

लिङ्गं पित्तावृते दाहस्तृष्णा शूलं भ्रमस्तमः [१] ||६१||  

कट्वम्ललवणोष्णैश्च विदाहः शीतकामिता | <br />

कट्वम्ललवणोष्णैश्च विदाहः शीतकामिता | <br />

शैत्यगौरवशूलानि कट्वाद्युपशयोऽधिकम् ||६२|| <br />

 

 

शैत्यगौरवशूलानि कट्वाद्युपशयोऽधिकम् ||६२||

लङ्घनायासरूक्षोष्णकामिता च कफावृते | <br />

लङ्घनायासरूक्षोष्णकामिता च कफावृते | <br />

रक्तावृते सदाहार्तिस्त्वङ्मांसान्तरजो भृशम् ||६३|| <br />

 

 

रक्तावृते सदाहार्तिस्त्वङ्मांसान्तरजो भृशम् ||६३||  

भवेत् सरागः श्वयथुर्जायन्ते मण्डलानि च | <br />

भवेत् सरागः श्वयथुर्जायन्ते मण्डलानि च | <br />

हर्षः पिपीलिकानां च सञ्चार इव मांसगे | <br />

हर्षः पिपीलिकानां च सञ्चार इव मांसगे | <br />

चलः स्निग्धो मृदुः शीतः शोफोऽङ्गेष्वरुचिस्तथा ||६५|| <br />

 

 

चलः स्निग्धो मृदुः शीतः शोफोऽङ्गेष्वरुचिस्तथा ||६५||  

आढ्यवात इति ज्ञेयः स कृच्छ्रो मेदसाऽऽवृतः | <br />

आढ्यवात इति ज्ञेयः स कृच्छ्रो मेदसाऽऽवृतः | <br />

स्पर्शमस्थ्नाऽऽवृते तूष्णं पीडनं चाभिनन्दति ||६६|| <br />

 

 

स्पर्शमस्थ्नाऽऽवृते तूष्णं पीडनं चाभिनन्दति ||६६||

सम्भज्यते सीदति च सूचीभिरिव तुद्यते | <br />

सम्भज्यते सीदति च सूचीभिरिव तुद्यते | <br />

मज्जावृते विनामः [२] स्याज्जृम्भणं परिवेष्टनम् ||६७|| <br />

 

 

मज्जावृते विनामः [२] स्याज्जृम्भणं परिवेष्टनम् ||६७||

शूलं तु पीड्यमाने च पाणिभ्यां लभते सुखम् | <br />

शूलं तु पीड्यमाने च पाणिभ्यां लभते सुखम् | <br />

शुक्रावेगोऽतिवेगो वा निष्फलत्वं च शुक्रगे ||६८||<br />

शुक्रावेगोऽतिवेगो वा निष्फलत्वं च शुक्रगे ||६८||<br />

   

   

भुक्ते कुक्षौ च रुग्जीर्णे शाम्यत्यन्नावृतेऽनिले | <br />

भुक्ते कुक्षौ च रुग्जीर्णे शाम्यत्यन्नावृतेऽनिले | <br />

मूत्राप्रवृत्तिराध्मानं बस्तौ मूत्रावृतेऽनिले ||६९|| <br />

मूत्राप्रवृत्तिराध्मानं बस्तौ मूत्रावृतेऽनिले ||६९|| <br />

चिरात् पीडितमन्नेन दुःखं शुष्कं शकृत् सृजेत् | <br />

श्रोणीवङ्क्षणपृष्ठेषु रुग्विलोमश्च मारुतः ||७१|| <br />

 

 

चिरात् पीडितमन्नेन दुःखं शुष्कं शकृत् सृजेत् |

 

श्रोणीवङ्क्षणपृष्ठेषु रुग्विलोमश्च मारुतः ||७१||

अस्वस्थं हृदयं चैव वर्चसा त्वावृतेऽनिले |७२|<br />

अस्वस्थं हृदयं चैव वर्चसा त्वावृतेऽनिले |७२|<br />

li~ggaM pittAvRute dAhastRuShNA shUlaM bhramastamaH [1] ||61|| <br />

li~ggaM pittAvRute dAhastRuShNA shUlaM bhramastamaH [1] ||61|| <br />

shaityagauravashUlAni kaTvAdyupashayo~adhikam ||62|| <br />

shaityagauravashUlAni kaTvAdyupashayo~adhikam ||62|| <br />

raktAvRute sadAhArtistva~gmāṁsantarajo bhRusham ||63|| <br />

raktAvRute sadAhArtistva~gmāṁsantarajo bhRusham ||63|| <br />

kaThinAshca vivarNAshca piDakAH shvayathustathA ||64|| <br />

kaThinAshca vivarNAshca piDakAH shvayathustathA ||64|| <br />

calaH snigdho mRuduH shItaH shopho~a~ggeShvarucistathA ||65|| <br />

calaH snigdho mRuduH shItaH shopho~a~ggeShvarucistathA ||65|| <br />

sparshamasthnA~a~avRute tUShNaM pIDanaM cAbhinandati ||66|| <br />

sparshamasthnA~a~avRute tUShNaM pIDanaM cAbhinandati ||66|| <br />

majjAvRute vinAmaH [2] syAjjRumbhaNaM pariveShTanam ||67|| <br />

majjAvRute vinAmaH [2] syAjjRumbhaNaM pariveShTanam ||67|| <br />

śukravego~ativego vA niShphalatvaM ca śukrage ||68|| <br />

śukravego~ativego vA niShphalatvaM ca śukrage ||68|| <br />

mūtrapravRuttirAdhmAnaM bastau mūtravRute~anile ||69|| <br />

mūtrapravRuttirAdhmAnaM bastau mūtravRute~anile ||69|| <br />

varcaso~ativibandho~adhaH sve sthAne parikRuntati | <br />

varcaso~ativibandho~adhaH sve sthAne parikRuntati | <br />

vrajatyAshu jarAM sneho bhukte cAnahyate naraH ||70|| <br />

vrajatyAshu jarAM sneho bhukte cAnahyate naraH ||70|| <br />

cirAt pIDitamannena duHkhaM shuShkaM shakRut sRujet | <br />

cirAt pIDitamannena duHkhaM shuShkaM shakRut sRujet | <br />

shroNIva~gkShaNapRuShTheShu rugvilomashca mArutaH ||71|| <br />

shroNIva~gkShaNapRuShTheShu rugvilomashca mArutaH ||71|| <br />

asvasthaM hRudayaM caiva varcasA tvAvRute~anile |72| <br />

asvasthaM hRudayaM caiva varcasA tvAvRute~anile |72| <br />

liṅgaṁ pittāvr̥tē dāhastr̥ṣṇā śūlaṁ bhramastamaḥ [1] ||61|| <br />

liṅgaṁ pittāvr̥tē dāhastr̥ṣṇā śūlaṁ bhramastamaḥ [1] ||61|| <br />

śaityagauravaśūlāni kaṭvādyupaśayō'dhikam||62|| <br />

śaityagauravaśūlāni kaṭvādyupaśayō'dhikam||62|| <br />

raktāvr̥tē sadāhārtistvaṅmāṁsāntarajō bhr̥śam||63|| <br />

raktāvr̥tē sadāhārtistvaṅmāṁsāntarajō bhr̥śam||63|| <br />

kaṭhināśca vivarṇāśca piḍakāḥ śvayathustathā||64|| <br />

kaṭhināśca vivarṇāśca piḍakāḥ śvayathustathā||64|| <br />

calaḥ snigdhō mr̥duḥ śītaḥ śōphō'ṅgēṣvarucistathā||65|| <br />

calaḥ snigdhō mr̥duḥ śītaḥ śōphō'ṅgēṣvarucistathā||65|| <br />

sparśamasthnā''vr̥tē tūṣṇaṁ pīḍanaṁ cābhinandati||66|| <br />

sparśamasthnā''vr̥tē tūṣṇaṁ pīḍanaṁ cābhinandati||66|| <br />

majjāvr̥tē vināmaḥ [2] syājjr̥mbhaṇaṁ parivēṣṭanam||67|| <br />

majjāvr̥tē vināmaḥ [2] syājjr̥mbhaṇaṁ parivēṣṭanam||67|| <br />

śukrāvēgō'tivēgō vā niṣphalatvaṁ ca śukragē||68|| <br />

śukrāvēgō'tivēgō vā niṣphalatvaṁ ca śukragē||68|| <br />

bhuktē kukṣau ca rugjīrṇē śāmyatyannāvr̥tē'nilē| <br />

bhuktē kukṣau ca rugjīrṇē śāmyatyannāvr̥tē'nilē| <br />

mūtrāpravr̥ttirādhmānaṁ bastau mūtrāvr̥tē'nilē||69|| <br />

mūtrāpravr̥ttirādhmānaṁ bastau mūtrāvr̥tē'nilē||69|| <br />

varcasō'tivibandhō'dhaḥ svē sthānē parikr̥ntati| <br />

varcasō'tivibandhō'dhaḥ svē sthānē parikr̥ntati| <br />

vrajatyāśu jarāṁ snēhō bhuktē cānahyatē naraḥ||70|| <br />

vrajatyāśu jarāṁ snēhō bhuktē cānahyatē naraḥ||70|| <br />

cirāt pīḍitamannēna duḥkhaṁ śuṣkaṁ śakr̥t sr̥jēt| <br />

cirāt pīḍitamannēna duḥkhaṁ śuṣkaṁ śakr̥t sr̥jēt| <br />

śrōṇīvaṅkṣaṇapr̥ṣṭhēṣu rugvilōmaśca mārutaḥ||71|| <br />

śrōṇīvaṅkṣaṇapr̥ṣṭhēṣu rugvilōmaśca mārutaḥ||71|| <br />

asvasthaṁ hr̥dayaṁ caiva varcasā tvāvr̥tē'nilē|72| <br />

asvasthaṁ hr̥dayaṁ caiva varcasā tvāvr̥tē'nilē|72| <br />

</div></div>

</div></div>

== Vidhi Vimarsha (Applied Inferences ) ==

== Vidhi Vimarsha (Applied Inferences ) ==

=== Importance of ''vata dosha'' in overall health and disease ===

=== Importance of [[vata]] [[dosha]] in overall health and disease ===

This text highlights the grandness of ''vata'' as a humor. ''Vata'' is equated to ''ayu''. Life is sustained by ''vayu'' only. Even though ''ayu'' is previously defined as conglomeration of ''sharira'' (physical body), ''indriya'' (sensorium), ''satva'' (mind) and ''atma'' (soul), [Cha. Sa. [[Sutra Sthana]] 1/42] here it is mentioned equivalent to ''vayu''. The sense organs, mind and soul in physical body are manifested through the functions of ''vayu'' only. The strength of the individual is also provided by ''vayu''. These two usages of ''ayu'' and ''bala'' are later explained as, ''prana'' is life and ''udana'' is strength. (verse 3)

This text highlights the grandness of [[vata dosha]]. [[Vata]] is equated to [[ayu]]. Life is sustained by [[vayu]] only. Even though [[ayu]] is previously defined as conglomeration of [[sharira]] (physical body), [[indriya]] (sensorium), [[sattva]] (mind) and [[atma]] (soul). [Cha. Sa. [[Sutra Sthana]] 1/42] Here it is mentioned equivalent to [[vayu]]. The sense organs, mind and soul in physical body are manifested through the functions of [[vayu]] only. The strength of the individual is also provided by [[vayu]]. These two usages of [[ayu]] and bala are later explained as, ''prana'' is life and ''udana'' is strength. [verse 3]

''Vata'' performs all its activity for a healthy long life subject to status of its three functions. They are ''akupita''(not increased, decreased or vitiated), ''sthanastha'' (located in its own place) and ''avyahatagati''(nothing is interfering with its movement or ''gati'').

[[Vata]] performs all its activity for a healthy long life subject to status of its three functions. They are ''akupita''(not increased, decreased or vitiated), ''sthanastha'' (located in its own place) and ''avyahatagati''(nothing is interfering with its movement or ''gati'').

=== Nature of ''vata'' ===

=== Nature of [[vata]] ===

''Pitta'' and ''kapha'' are relatively compact and in corporeal form. On the contrary ''vata'' is incorporeal (''avayavasamghātarahita''). It can be termed as rarified in nature. The ''vata'' is ''anavasthita'' (unstable) too. These two properties are due to its composition formed by ''akasha'' and ''vayu'' predominantly<ref> Indu, Vagbhata, Sutra sthana Chap 20 Doshabhediya Verse 2, In: Sreekumari Amma (eds.) 1st ed. Trivandrum: Publication Division; Ayurveda College, 2000.</ref>  which are incorporeal (''amurta''). ''Chalatva'' (mobility) and ''apratighata'' (unobstructability) are characteristics of ''vayu'' and ''akasha'' perceptible by the tactile sense organ[ Cha. Sa. [[Sharira Sthana]] 1/29-30]. The biological ''vata'' (which is present in the living being) is self originated (''svayambhu''), subtle (''sukshma'') and all pervasive (''sarvagata''). It is invisible (''avyakta'') but its activities are patent or manifest (''vyaktakarma'').<ref>Dalhana, Sushruta. Nidana Sthana, Cha.1 Vatavyadhi Nidana Adhyaya verse 5. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref>

[[Pitta]] and [[kapha]] are relatively compact and in corporeal form. On the contrary [[vata]] is incorporeal (''avayavasamghatarahita''). It can be termed as rarified in nature. The [[vata]] is ''anavasthita'' (unstable) too. These two properties are due to its composition formed by [[akasha]] and [[vayu]] predominantly<ref> Indu, Vagbhata, Sutra sthana Chap 20 Doshabhediya Verse 2, In: Sreekumari Amma (eds.) 1st ed. Trivandrum: Publication Division; Ayurveda College, 2000.</ref>  which are incorporeal (''amurta''). ''Chalatva'' (mobility) and ''apratighata'' (unobstructability) are characteristics of [[vayu]] and [[akasha]] perceptible by the tactile sense organ. [Cha. Sa. [[Sharira Sthana]] 1/29-30] The biological [[vata]] (which is present in the living being) is self originated (''svayambhu''), subtle (''sukshma'') and all pervasive (''sarvagata''). It is invisible (''[[Avyakta|avyakta]]'') but its activities are patent or manifest (''vyaktakarma'').<ref>Dalhana, Sushruta. Nidana Sthana, Cha.1 Vatavyadhi Nidana Adhyaya verse 5. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref>

Anavasthita (unstable) is due to chala property of ''vata''.  This continuous moving nature of ''vata'' is explained with other terminologies also like ''sheeghravata''(swift movement)[Cha. Sa. [[Vimana Sthana]] 8/98] , ''ashukari'' (instantaneous action), ''muhushchari'' (rhythmic movement).<ref>Dalhana, Sushruta. Nidana Sthana, Cha.1 Vatavyadhi Nidana Adhyaya verse 9. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref>. It abounds in the fundamental quality of ''raja'' (the principle of cohesion and action). The predominance of ''raja'' is responsible for the instability of ''vata''. The quality of ''chalatva'' is directional in nature, which is explained by the term ''gati''. ''Vata'' convenes all bodily activities by this important feature.

Anavasthita (unstable) is due to chala property of [[vata]].  This continuous moving nature of [[vata]] is explained with other terminologies also like ''sheeghravata''(swift movement)[Cha. Sa. [[Vimana Sthana]] 8/98], ''ashukari'' (instantaneous action), ''muhushchari'' (rhythmic movement).<ref>Dalhana, Sushruta. Nidana Sthana, Cha.1 Vatavyadhi Nidana Adhyaya verse 9. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref>. It abounds in the fundamental quality of ''raja'' (the principle of cohesion and action). The predominance of ''raja'' is responsible for the instability of [[vata]]. The quality of ''chalatva'' is directional in nature, which is explained by the term ''gati''. [[Vata]] convenes all bodily activities by this important feature.

Owing to its incorporeal nature and instability ''vata'' is ''anasadhya'' (inaccessible) also. The inaccessibility is characterized in regard to its functional and physical attributes but more relevant regarding the therapeutic aspect. Above explained cardinal features make ''vata achintya veerya'' (inconceivable prowess) and ''doshanam neta'' (propeller of all functional elements in the body).[Cha. Sa. [[Sutra Sthana]] 1/8]

Owing to its incorporeal nature and instability [[vata]] is ''anasadhya'' (inaccessible) also. The inaccessibility is characterized in regard to its functional and physical attributes but more relevant regarding the therapeutic aspect. Above explained cardinal features make [[vata]] achintya veerya (inconceivable prowess) and [[dosha]]nam neta (propeller of all functional elements in the body).[Cha. Sa. [[Sutra Sthana]] 1/8]

=== Properties of ''vata'' ===

=== Properties of [[vata]] ===

In [[Vatakalakaliya Adhyaya]], questions have been raised about exciting and alleviating factors regarding qualities of ''vata''. ''Ruksha''(dry), ''laghu''(light), ''sheeta''(cool), ''daruna'' (dreadful), ''khara'' (rough) and ''vishada'' (clean) have been explained as qualities of ''vata''. Repeated use of substances with these qualities and actions of such similar qualities causes aggravation and excitation of ''vata'' and is alleviated by use of substances possessing contrary qualities. This brings out the phenomenon of two mutually interrelated and inseparable of ''sharira vayu'' viz.  

In [[Vatakalakaliya Adhyaya]], questions have been raised about exciting and alleviating factors regarding qualities of [[vata]]. ''Ruksha''(dry), ''laghu''(light), ''sheeta''(cool), ''daruna'' (dreadful), ''khara'' (rough) and ''vishada'' (clean) have been explained as qualities of [[vata]]. Repeated use of substances with these qualities and actions of such similar qualities causes aggravation and excitation of [[vata]] and is alleviated by use of substances possessing contrary qualities. This brings out the phenomenon of two mutually interrelated and inseparable of sharira [[vayu]] viz.  

#that, the ''sharira vayu'' is a biophysical force and  

#that, the sharira [[vayu]] is a biophysical force and  

#that it is closely associated with material substances which form part of the structure of the body for example, functions of nervous system. It is a chemical reaction sequence which occurs during the course of life. This chemical reaction –sequence, can be accelerated (excited) or inhibited by substances with similar properties (''dravya samanya''), qualities (''guna samanya'') and actions (''karma samanya'') and inhibited by substances with opposite properties. In other words, it may be concluded that the bio – physical force – the ''sharira vayu'' – is closely linked with some material structural factors. These can be influenced by diet and medicine on the basis of similar increase and opposite decrease.

#that it is closely associated with material substances which form part of the structure of the body for example, functions of nervous system. It is a chemical reaction sequence which occurs during the course of life. This chemical reaction –sequence, can be accelerated (excited) or inhibited by substances with similar properties (''dravya samanya''), qualities (''guna samanya'') and actions (''karma samanya'') and inhibited by substances with opposite properties. In other words, it may be concluded that the bio – physical force – the ''sharira vayu'' – is closely linked with some material structural factors. These can be influenced by diet and medicine on the basis of similar increase and opposite decrease.

Therefore, the biological energy produced by this ionic movement is the cause for ''sharira vayu'' and as per modern science too their concentration depends on ''ahara'' and ''vihara''.

Therefore, the biological energy produced by this ionic movement is the cause for ''sharira vayu'' and as per modern science too their concentration depends on ''ahara'' and ''vihara''.

The continuous, controlled movement of the ions is responsible for cell activity which together at the level of cells contributes to tissue activity which together contributes to the organ, system and in turn whole body. (verse 4)

The continuous, controlled movement of the ions is responsible for cell activity which together at the level of cells contributes to tissue activity which together contributes to the organ, system and in turn whole body. [verse 4]

==== 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 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:

Day sleep (''divaswapna'') do not directly lead to vitiation of ''vata''. However, it leads to formation of ''ama'' and cause ''vata'' vitiation indirectly by obstructing ''vata''. ''Vegasandharana'' (suppression of natural urges) and ''marmabhighata'' (trauma to vital organs) etc. are examples of direct vitiation. The pathogenesis is also bi-fold. The initial pathology is aggravation of ''vata'' and diminution of ''dhatus'' and vice versa. One augments the other. This ultimately causes emptiness in channels and rarity in tissues which gives more space for movements of ''vata''. The second pathology is by increase in ''dhatus'' leading to excessive filling in channels to cause their clogging and blocking ''vata''. (verse 15-19)

 

Day sleep (''divaswapna'') do not directly lead to vitiation of [[vata]]. However, it leads to formation of ''ama'' and cause [[vata]] vitiation indirectly by obstructing [[vata]]. ''Vegasandharana'' (suppression of natural urges) and ''marmabhighata'' (trauma to vital organs) etc. are examples of direct vitiation. The pathogenesis is also bi-fold. The initial pathology is aggravation of [[vata]] and diminution of [[dhatu]] and vice versa. One augments the other. This ultimately causes emptiness in channels and rarity in tissues which gives more space for movements of [[vata]]. The second pathology is by increase in [[dhatu]] leading to excessive filling in channels to cause their clogging and blocking [[vata]]. [verse 15-19]

==== Premonitory signs and symptoms ====

==== Premonitory signs and symptoms ====

Clinical manifestations may not be apparent because of vague manifestation of symptoms (''Avyaktam lakshanam''). This occurs in two situations, either the pathogenesis is extremely slow or it is abrupt. In the initial case, it is unable to appreciate the prodromal symptoms and presenting complaints separately. If it is an abrupt pathology the clinical presentation immediately follows the prodromal symptoms without appreciable gap. (verse 19-20)

Clinical manifestations may not be apparent because of vague manifestation of symptoms (''Avyaktam lakshanam''). This occurs in two situations, either the pathogenesis is extremely slow or it is abrupt. In the initial case, it is unable to appreciate the prodromal symptoms and presenting complaints separately. If it is an abrupt pathology the clinical presentation immediately follows the prodromal symptoms without appreciable gap. [verse 19-20]

==== Clinical features ====

==== Clinical features ====

The clinical presentations vary according to the specificity of ''hetu'' (cause) and ''sthana'' (location). The treatment options also vary accordingly. For example if ''vata prakopa'' takes place due to ''ruksha vriddhi'' in ''pakvashaya'' it may lead to habitual constipation in which ''snigdha, ushna'' and ''tikshna aushadha'' like ''mishraka sneha'' may be a good treatment option.  

The clinical presentations vary according to the specificity of [[hetu]] (cause) and ''sthana'' (location). The treatment options also vary accordingly. For example if [[vata]] prakopa takes place due to ''ruksha vriddhi'' in ''pakvashaya'' it may lead to habitual constipation in which ''snigdha, ushna'' and ''tikshna aushadha'' like ''mishraka sneha'' may be a good treatment option.  

If the same ''vata'' gets vitiated in ''amashaya'' due to ''snigdha vriddhi'', it leads to gastro-esophageal reflux disease (GERD), ''ruksha ushna'' and ''tikshna'' like ''gomutra bhavita shaddharana'' is the ideal treatment option. ''Anuvasana'' is the ideal therapy in ''vata'' vitiated in ''pakwashaya'', whereas ''vamana'' is the best therapy in ''vata'' vitiated in ''amashaya''. (verse 20-24)

If the same [[vata]] gets vitiated in ''amashaya'' due to ''snigdha vriddhi'', it leads to gastro-esophageal reflux disease (GERD), ''ruksha ushna'' and ''tikshna'' like ''gomutra bhavita shaddharana'' is the ideal treatment option. ''Anuvasana'' is the ideal therapy in [[vata]] vitiated in ''pakwashaya'', whereas [[vamana]] is the best therapy in [[vata]] vitiated in ''amashaya''. [verse 20-24]

==== Three modes of pathogenesis of ''vata'' diseases ====

==== Three modes of pathogenesis of [[vata]] diseases ====

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]

#''Asamghāta'' (Incorporeal)

 

#''Asamghata'' (Incorporeal)

#''Anavasthita'' (Unstable)

#''Anavasthita'' (Unstable)

#''Anāsādhya'' (Inaccessible)

#''Anasadhya'' (Inaccessible)

=== Pathogenesis of various conditions ===

=== Pathogenesis of various conditions ===

All the verses explain a specific type of ''samprapti'' (pathogenesis) like ''koshthagata vata'' (''vata'' affecting alimentary tract), ''amashayagata vata'' (''vata'' affecting stomach.) etc. They are not to be considered as a single disease. These specific diseases may lead to many disease presentations in which the treatment strategies can be generalized. Any ''dosha'' may occupy any particular site or area and lead to diseases. This type of pathology of vitiated ''vata'' is called as ''gatavata''.  Normally in all ''gatavata'', the affected ''dushya''(vitiated body components) will be ''kshina'' (depleted) and affected ''srotas'' will be ''rikta'' (empty). The concept of ''gatavata'' can be further explored physiologically. ''Dhatu'' are classified into two types’ ''asthayi'' (temporary) ''dhatu'' and ''sthayi'' (permanent) ''dhatu''. ''Asthayi dhatu'' are the ones which are ''dravaswarupa'' (liquid state) and undergoing conversion (''parinam apadyamananam'') and they are being ''vikshepita'' (circulated) from their ''mulasthana'' (origin) throughout the ''sharira'' (''abhivahana'') for the purpose of ''poshana'' (nourishment) of the ''sthayi dhatu''. This ''parinamana'' (conversion) and ''abhivahana prakriya''(transportation) takes place in ''marga'' (channel) which are known as ''srotas''; hence ''marga'' is one of the synonym used for ''srotas'' along with ''sira'' (vein), ''dhamani'' (artery), ''rasayani'' (capillary), ''rasavahini'' (channels carrying nutrient fluid), ''nadi'' (nerve), ''panthana'' (pathway), ''sharira chhidra'' (perforated channel), ''samvrita-asamvritani'' (covered or uncovered), ''sthana'' (site), ''ashaya'' (organ), ''niketa'' (habitat), ''shariradhatu avakasha'' (hollow space in body tissues).

All the verses explain a specific type of ''samprapti'' (pathogenesis) like koshthagata [[vata]] ([[vata]] affecting alimentary tract), amashayagata [[vata]] ([[vata]] affecting stomach.) etc. They are not to be considered as a single disease. These specific diseases may lead to many disease presentations in which the treatment strategies can be generalized. Any [[dosha]] may occupy any particular site or area and lead to diseases. This type of pathology of vitiated [[vata]] is called as gata[[vata]].  Normally in all gata[[vata]], the affected dushya(vitiated body components) will be ''kshina'' (depleted) and affected ''srotas'' will be ''rikta'' (empty). The concept of gata[[vata]] can be further explored physiologically.[[Dhatu]] are classified into two types’ ''asthayi'' (temporary) [[dhatu]] and sthayi(permanent) [[dhatu]]. Asthayi [[dhatu]] are the ones which are ''dravaswarupa'' (liquid state) and undergoing conversion (''parinam apadyamananam'') and they are being ''vikshepita'' (circulated) from their ''mulasthana'' (origin) throughout the ''sharira'' (''abhivahana'') for the purpose of ''poshana'' (nourishment) of the sthayi [[dhatu]]. This ''parinamana'' (conversion) and ''abhivahana prakriya''(transportation) takes place in ''marga'' (channel) which are known as ''srotas''; hence ''marga'' is one of the synonym used for ''srotas'' along with ''sira'' (vein), ''dhamani'' (artery), ''rasayani'' (capillary), ''rasavahini'' (channels carrying nutrient fluid), ''nadi'' (nerve), ''panthana'' (pathway), ''sharira chhidra'' (perforated channel), ''samvrita-asamvritani'' (covered or uncovered), ''sthana'' (site), ''ashaya'' (organ), ''niketa'' (habitat), ''shariradhatu avakasha'' (hollow space in body tissues).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

''Prakupita''(vitiated) ''dosha'' have the capacity to further vitiate both ''sthanastha dhatu'' (fixed tissue element) as well as ''margagata'' (circulating tissue elements) ''sharira dhatu''. When ''prakupita vata'' vitiates the ''dhatu'', it is called as ''gatavata''. In this condition, vitiated ''vata'' affects the specific site due to specific etiological factors. While designing treatment protocol, in this context specific etiological factors for each and every ''gatavata'' related diseases must be observed to clarify why vitiated ''vata'' goes to specific part of the body or to specific ''dhatu'' to develop ''kosthagata vata, raktagata vāta'' etc. In this condition, ''dhatu'' is ''dushya'' (getting vitiated).

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]].  

''Koshthagata vata'': ''Vata'' getting vitiated in the ''koshtha'' (alimentary tract) is explained as ''koshthagata vata''.

'''Ardita''':

''Gudagata vata:'' It can also be explained that ''gudagata vata'' and ''pakvashayagata vata'' are different clinical entities. In ''gudagata vata'', obstruction of stool, urine and flatus is observed, whereas in ''pakvashayagata vata'' there is painful defecation, micturition with ''antrakujana'' (gurgling sound), ''atopa'' (distension) and ''anaha'' (constipation). ''Ashma sarkara'' (urolith) is exclusively present in ''gudagata vata'' with pain and atrophy in calf muscles, thighs, sacram, feet and back. This can be compared with lumbo-sacral plexopathy. It may be understood as in case of ''pakvashaya gatavata'', proximal part of large intestine along with ascending, transverse and descending colon is involved; whereas in ''gudagata vata'', involvement of sigmoid colon, rectum, anus and their nerve supply.

''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]

'''Amashayagata vata''': This is a typical presentation of ''vata'' leaving its own site and vitiating other site. Here the local ''dosha'' is considered important because it is more virulent than the external ''dosha'' coming from other sites. The clinical entities originating from ''amashaya'' (stomach) are caused due to vitiated ''vata'' entering into ''amashaya''. It increases emptiness of stomach leading to indigestion or ''ama pradoshaja vikara'' like ''visuchika'' (diarrhea) etc.

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

''Indriyagata vata'': ''Indriyagata vata'' is applicable to any sense organ. ''Indriya vadha'' may be interpreted as complete, partial or minimal loss of sensation. ''Shrotra''(ears) has specific importance among other ''indriya'', in which inherent ''dosha'' of ''shrotra'' is ''vata'' itself. So ''vata prakopa'' in ''shrotra'' is more impacting. It is worthy to remember the notion in ''vatakalakaleeya'' that ''vata'' is ''sarvendriyanam udyojaka'' (motivating factors for all sense organs).

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

''Twakgata vata'': ''Tvak'' (skin) is referred as somatic organ even though it is a sensory organ. ''Supti'' (numbness) and ''toda'' (pricking sensation) are not symptoms specific to ''tvakindriya.'' Here ''tvak'' represents ''rasa dhatu''. ''Rasa'' does not have cellular pattern and hence not included in ''shakha''. The ''tvak'' is derivative of ''rasa'' and is included in ''shakha''. ''Tvakindriya gatavata'' should be understood under ''indriyagatavata.''

'''Hanugraha''':

''Siragata vata'': When ''vata'' afflicts ''sira'' (blood vessel) it may broaden or narrow the sirā. Widening may lead to ''shopha'' and narrowing may lead to ''shosha'' or vice versa as per the site of affliction. Two different conditions of vascular diseases i.e. aneurysym (''mahat'') and atherosclerosis / venous thrombosis (''tanu'') are examples.

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]

''Sandhigata vata'' (osteoarthritis): 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''.

'''Dandaka''':

''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)

''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]

''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)

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

''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)

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]

''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)

'''Pakshaghata''':

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)

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]

''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)

'''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: 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)

'''Nomenclature of diseases:'''  

Diagnosis of ''dhatukshaya'' (degenerative pathology) and ''avarana'' (obstructive pathology) induced vitiation of ''vata'': ''Vata'' can be vitiated due to ''dhatukshaya'' and ''margavarana'' types of pathogenesis. ''Dhatukshaya'' leads to depletion of tissues and more space for ''vata'' to move. This leads to ''gatavata'' phenomenon. ''Avarana'' of ''vata'' can be caused by other ''dosha'' or ''dhatu''. So the differences between ''avarana'' and ''gatavata'' should be understood.

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]

The word, ''avarana'' means obstruction or resistance or friction to the normal ''gati'' of ''vata''. Hence when its normal movement is hampered or vitiated, it becomes ''avrita'' and leads to different disorders. The ''gatatva'' and ''avritatva'' are entirely different phenomenon. Here an attempt is being made to differentiate the both physio-pathologies. [16]

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

#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 ''gatavata'' 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 ''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''.

 

#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 ''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 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 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'' 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''.

#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'' (''dhatugata 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''.  

The discussed points are briefly enlisted in the table below:

The discussed points are briefly enlisted in the table below:

{| class="wikitable"

{| class="wikitable"

|-

|-

! scope="col"| ''Avrita''(obstructed) ''vata''

! scope="col"| ''Avrita''(obstructed) [[vata]]

! scope="col"| ''Gata'' (excess movement) ''vata''

! scope="col"| ''Gata'' (excess movement) [[vata]]

|-

|-

| Vitiation of ''vata'' is passive

| Vitiation of [[vata]] is passive

| Vitiation of ''vata'' is active

| Vitiation of [[vata]] is active

|-

|-

| Normally ''svanidana''(specific causes for vitiation) of ''vata'' are not responsible

| Normally ''svanidana''(specific causes for vitiation) of [[vata]] are not responsible

| Vitiation of ''vata'' by ''svanidana''

| Vitiation of [[vata]] by ''svanidana''

|-

|-

| Only ''chala'' property of ''vata'' is involved and it is diminished in the phenomenon

| Only ''chala'' property of [[vata]] is involved and it is diminished in the phenomenon

| Other properties of ''vata'' are also involved and the ''chala'' property aggravated in the phenomenon

| Other properties of [[vata]] are also involved and the ''chala'' property aggravated in the phenomenon

|-

|-

| ''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''

| ''Purnata''(fullness) in ''srotas/marga''

| ''Riktaka''(emptiness) in ''srotas''

| ''Riktaka''(emptiness) in ''srotas''

|-

|-

| ''Vata'' shows ''svakarma hani'' (decreased function)

| [[Vata]] shows ''svakarma hani'' (decreased function)

| ''Vata'' shows ''svakarma vriddhi'' (increased function)

| [[Vata]] shows ''svakarma vriddhi'' (increased function)

|-

|-

| ''Dhatu'' are in ''vriddhi'' (increase) or ''saama''

| [[Dhatu]] are in ''vriddhi'' (increase) or ''saama''

| ''Dhatu daurbalya'' (decrease) present

| [[Dhatu]] daurbalya (decrease) present

|-

|-

| ''Avarana'' possible with other ''dosha/anna/mala''/individual components of ''vata''

| ''Avarana'' possible with other [[dosha]]/anna/[[mala]]/individual components of [[vata]]

| Not possible

| Not possible

|-

|-

|-

|-

| ''Avaraka'' gets importance in treatment

| ''Avaraka'' gets importance in treatment

| ''Vata'' gets importance in treatment

| [[Vata]] gets importance in treatment

|-

|-

| Diagnosis made with ''upashaya anupashaya'' (hit and trial)

| Diagnosis made with ''upashaya anupashaya'' (hit and trial)

| None

| None

|-

|-

| Successive diminution of ''rasadi dhatu'' possible

| Successive diminution of rasadi [[dhatu]] possible

| None

| None

|}

|}

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''.  

As ''avarana'' proceeds it may end up in [[dhatu]]kshaya as the ''avrita'' will block [[rasa dhatu]] 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 ''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)

'''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 ''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.

'''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.

    

    

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.

As in exclusive [[vata]]ja 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.

 

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.  

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]

''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]

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 [[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 ''vatasthana, 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'' and ''majjagata vata''. ''Abhyantara snehana'' replenishes ''meda dhatu'' and subsequently ''asthi'' and ''meda''. It is worthy to note the utility of ''tikta ghrita'' in ''asthikshaya''.  

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>

=== Management of ''ardita'' (facial palsy) ===

=== Management of ''ardita'' (facial palsy) ===

Poultice prepared from flesh of marshy animals is used for ''brimhana'' in atrophy of muscles. ''Vamana'' is indicated in ''ardita'', when it is associated with ''shopha'' and ''raktamokshana'' is indicated when associated with ''daha'' (burning) and ''raga'' (redness).

The line of treatment of ''ardita'' aims at ''mastishkya'' (brain), therefore, [[nasya]] is indicated. [[Nasya]] is explained to be the direct entrance to the cranial vault. [[Nasya]] may be ''shodhana, shamana'' or [[brimhana]] as the case may be. But there is an opinion that since the word ''navana'' is used, it means snaihika [[nasya]]. ''Murdhni taila'' is absolutely meant for treatment in head region and is of four types viz. ''abhyanga'' ( head massage), ''seka'' (pouring liquid on head), ''pichu'' ( therapeutic unctuous swab on head) and ''shirobasti''. ''Tarpana'' (nourishment therapy) is ''akshitarpana'' (nourishing eyes) and ''shrotratarpana'' (nourishing ears). ''Nadisweda'' is very specific in ''ardita'' and ''ksheeradhooma'' (medicated fumes of milk).

In ''pakshaghata, swedana,'' fomentation mixed with unctuous material and ''virechana'' or purgation therapy with unctuous substance is indicated. ''Virechana'' is the line of treatment in ''pakshaghata'' and outweighs ''basti'' which is said to be ideal for ''vatakopa''. ''Pakshaghata'' may be understood as a concealed ''urdhwaga raktapitta'' (bleeding from upper orifices of body) in which the only and effective choice is ''adho-shodhana'' (purgation). ''Gridhrasi'' is a tendon and ligament disorder and ''shastra, kshara,'' and ''agnikarma'' are the main line of treatment. Therefore ''siravyadha'' (blood letting) and ''dahakarma'' (cauterization) is advised. ''Basti'' is also a good choice since ''pakvashayagata vata'' leads to ''kateegraha'' and ''gridhrasi''.  

 

In ''pakshaghata, [[swedana]], fomentation mixed with unctuous material and [[virechana]] or purgation therapy with unctuous substance is indicated. [[Virechana]] is the line of treatment in ''pakshaghata'' and outweighs [[basti]] which is said to be ideal for [[vata]]kopa. ''Pakshaghata'' may be understood as a concealed ''urdhwaga raktapitta'' (bleeding from upper orifices of body) in which the only and effective choice is ''adho-shodhana'' (purgation). ''Gridhrasi'' is a tendon and ligament disorder and ''shastra, kshara,'' and ''agnikarma'' are the main line of treatment. Therefore ''siravyadha'' (blood letting) and ''dahakarma'' (cauterization) is advised. [[Basti]] is also a good choice since pakvashayagata [[vata]] leads to ''kateegraha'' and ''gridhrasi''.  

''Agnikarma'' and ''siravyadha'' are the two line of treatment which are useful in acute phase to relieve the pain in ''gridhrasi'' and also in ''khalli''. ''Agnikarma'' relieves muscle spasm thereby reducing pain whereas ''siravyadha'' may be helpful by reducing the blood stasis. Improved circulation removes cytokines and other inflammatory factors thereby reducing pain. (99-103)

''Agnikarma'' and ''siravyadha'' are the two line of treatment which are useful in acute phase to relieve the pain in ''gridhrasi'' and also in ''khalli''. ''Agnikarma'' relieves muscle spasm thereby reducing pain whereas ''siravyadha'' may be helpful by reducing the blood stasis. Improved circulation removes cytokines and other inflammatory factors thereby reducing pain. (99-103)

=== Importance of site of affliction in treatment ===

=== Importance of site of affliction in treatment ===

=== Management of ''avrita vata'' ===

 

 

 

 

 

 

 

 

 

 

 

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

 

 

 

 

 

 

 

 

 

 

 

=== Rehabilitation of [[vata]]===

 

 

 

 

 

 

=== Related chapters ===

In pittāvr̥ta vāta, hot and cold should be applied alternately.  Jīvanīya sarpi is also very brimhana. Brimhana is the ideal pacifying line of treatment for vāta and vātapitta. 

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

Prameha samprapti mentioned in Sutra sthana 17th chapter explains kapha, pitta, meda and mānsa which when increased causes āvarana of vāta. Therefore, pramehagna cikitsā is helpful in meda āvr̥ta vāta and also in mansāvr̥ta vāta. Hence in mansāvr̥ta vāta the pipilika iva sanchar (tingling sensation) reduces, if prameha is treated. Similarly, in obesity, medasāvr̥ta vāta (vata obstructed by excess meda) [Cha.Sa.[[Sutra Sthana]] 21/5] and meda and mānsa 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). Pāchana and deepan helps in digestion and also pacifies vāta.

Movements of vata and concept of anyonyavarana:As discussed earlier avyāhatagati (free movement) is a cardinal feature of vāta to perform normally. In āvarana certain obstacles like dosha, dhātu or anna etc which are immobile, occupy the pathway of mobile vāta. It is not mandatory that such immobile articles only cause obstruction to vāta. If the individual sub types of vāta are considered prāna, udāna, vyāna, samāna and apāna are mobile and has some specific direction for their gati. For example, prāna has movement from murdha (head) to downwards. Udāna has movement from uras(chest) to upwards.  Vyāna moves upward downward and sidewards like rasa. Samāna moves around jatharāgni. Apāna move downwards from pakvāśaya. This can be further analysed as follows.  Udāna possess upward movement.  Likewise ‘apāna’  has downward direction.  Vyāna vāyu moves in horizontal direction (vyāpanat vyāna uccyate) along with upward and downward directions as rasa samvahana (circulation) is concerned.[19]Samāna is also having such qualities to equally distribute the nutrients through out the body.  Prāna has multi directional gati. So, the movements of individual subtypes of vāta are directional in nature. When these meet in opposite direction it makes anyonyāvarana. For example prāna and udāna meet opposite and interfere with mutual normal movements leads to difficulty in inspiration as well as expiration which is comparatively irreversible. This concept is called anyonyāvarana. It is of 20 types taking into account of 5 diiferent types making 4 particular combinations. Anyonyāvarana are comparatively difficult situations. (verses 199-206)

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* [[Vatakalakaliya Adhyaya]]

== References ==

== References ==