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Ayurvedic Approach to Rheumatologic Disorders
Amala Guha
University of Connecticut School of Medicine and Dentistry

Recommended Citation
Guha, Amala, "Ayurvedic Approach to Rheumatologic Disorders" (2007). SoM Articles. Paper 26.

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The genetic composition inherited from one's parents at the time of conception is represented by the biological constitution of Vata. Pitta and Kapha known as Tridosha and constitute one's physical and biological makeup. Symptoms may involve pain. All vata disorders may start in the colon. the diseases of joints. . Vayu/anil (Air). 'Tilak Ayurvedic Medical School and Seth Tarachand Rarnanath Hospital. stiffness of joint. Prithavi (Earth). Pune. Although many of the diseases under this category resemble rheurnatologic diseases classified under western medicine.Ayurvedic Approach to Rheurnatologic Disorders Amala Guha" and Sadanand Deshpande' "The University of Connecticut School of Medicine. ligaments and associated structures characterized by pain. seasons. stiffness. Improper Agni contributes to ill health. Jala/Apa (Water). 3). wrong life style and repressed emotions all lead to an imbalance of Agni. ankylosing spondylitis etc. The case presentation of Amavafa provides greater understanding of how Ayurvedic differential diagnosis is made in context of its western counterpart. These elements are present in all living beings in varying ratios as Vata. change cell membrane composition (7. "Rogo sarvyapi mandagni" (root cause of all diseases is "manda Agni" low Agni or impaired Agni). Cold. diet and life style influences the bodily ratio of doshas (Prakirti) and may alter one's prakriti. Constitution (Sharira): According to Ayurveda every man is a miniature of nature and a product of universal consciousness. their presence is more striking at specific sites or organs. disrupt cellular communication and membrane functions. Pita and Kapha (VPK) or Tridosha and is known as Prakirti. the rheumatoid arthritis. inhibit shedding of membrane vesicles (7-13). This altered ratio of VPK is known as Vikriti (2-4) Although VPK are present throughout the body. These sites are more susceptible to vitiation of respective doshas. Most common conditions under this category are osteoarthritis. Famington. the diseases of joints. rheumatoid arthritis. Constant exposure to outer environment. At an atomic level all living and nonliving things are made of five gross elements (Panchamahabhutam): Akash (Ether). The attributes of the universal consciousness such as Satva the clarity. inflammation around the joints with varying degrees of disability. Further aggravation (prakopa) of doshas will spread the doshas(s) to the weak sites and accumulate (sthansanchaya) to manifest (vyakti) disease(s) and may bring about disease oriented complications (bheda). the gastric fire or ones digestive capacity plays an important role in the above described pathogenesis. Rheumatology in western medical terms involve diseases affecting joints. and involves Asthi (bones) and Majja (connective) dhatus (tissues). absorption and assimilation and leads to the formation of ama (toxin) (2. the small intestine is more dominant in pitta and kapha is centered in the stomach. The colon is the main seat of vata.physiology and psychopathology. Agni (Fire). Tridosha plays an important role in maintaining health and influences patho. Wrong diet. Ama not only clogs the digestive flow but because of its obstructive nature. swelling and fever as a result of immune dysfunction and dhatu kshyaya (tissue damage) (2. frozen and incompatible food contributes to improper digestion. Movement of dosha or irregular Prana (vata) is governed by agni(metabo1ic fire) and production of ama (toxin) (2-6 ). At a cellular level ama may disrupt the cellular movement. Agni and Arna: Agni. Rajas the movement and Tamas the inertia are present in all living and non living things. CT. (1). tendons. For greater understanding of Ayurvedic concept of rheurnatologic diseases only few diseases are discussed here. clogs bodily channels (srotas) and disrupts physiology including the formation and excretion of waste and it adversely influences the formation and functions of the tissues (dhatus). the approach to differential diagnosis may be different. muscles.8). Rheumatology is described in detail in ancient Ayurvedic texts under 'Sandhigat Roga'.3). USA. pitta in the intestine and kapha in the stomach. India Abstract: In Ayurvedic texts rheumatologic diseases are described under 'Sandhgat Roga". alter antigen antibody interaction and leads to improper antigen presentation causing derangement of the immune system resulting in autoimmunity andlor autoimmune like symptoms (13-15).

Neck & skull . and their qualities are also influenced by Agni and Ama. described 210 joints in the body in the following order: Upper limbs . fatigue. nishthiva (repeated spitting-due to increased salivation). apakti (indigestion).Chala . tendons and muscles. loss of interest. not only denotes joints of bone tissue (Asthi) but also indicates joints of muscles. embolisms. aruchi (anorexia) and klam (exhaustion without any work).59. body ache due to the accumulation of Ama and enhance further build up of Ama. congestion. anila mudhata (decreased activity of vata). mental confusion and restlessness. In Ayurveda joints. Ancient Ayurvedic texts describe seven types of tissues Ras (plasma. Dthatus /Tissues: Formation of bodily tissues.34 Trunk . Sushrut. the Ayurvedic physician around 700 BC. tingling and numbness. laziness. sense of heaviness and restriction of movements may occur. balabhramsha (decreased physical and immunological strength). these may create flatulence. serum and Lymphatics) Rakta (red Blood Cells) Mamsa (Muscle) Meda (Adiposelfat tissues) Asthi (bone or cartilage) Majja (marrow. and inactiveness occurs due to improper physiologic functions. and venous engorgements may occur due to the clogging by Ama.15).Immobile joints. The ama may accumulate in joints causing kapha dosha and result in fluid accumulation and inflammation (2-4. When vata channels are blocked the vata moves into other available channels or any open and available empty space. Joints are further classified as Cheshtavanta .According to Ayurveda Ama contributes to Srotorodha bala bhramsha gauravanila mudatah Alasyapakti nishthiva malasangaruchi klamah Ashtang Hridaya 13. Total . the dhatus. b) . Lack of taste and loss of appetite may result into exhaustion and fatigue. Building of autoantibodies or toxins may result in improper dhatu formation (2-4).83. malasanga (inadequate removal of wastes from the body). alasya (lassitude). cartilage.210 joints. Accumulation of fluid may also result from such obstructions (15).body channels).Mobile joints a) Sthira . chronic fatigue syndrome and weakness may result from this condition. and mental illusions. Nerve and connective tissues) Shukra (Reproductive) Dhatus carry important functions and play a vital role in the maintainence of proper physiology and join with ligaments cartilage and tendons to maintain proper functions.23 Srotorodha (obstruction in srotasas.34 Lower limbs . gaurav (feeling of heaviness). Ama can contribute to various doshic disturbances and many of these symptoms are present in rheumatologic diseases. 'Sandhi'. occlusions.low energy. constipation. and creates pressure where it has stagnated creating breathlessness. tendons cartilage etc.may result in uremia. vessels. Components of joint include Tissues (bone tissue).Achala .

mobile. cold weather will aggravate vata by its cold and mobile qualities. diabetes. Margavirodha (Clogging of channels). lifestyle and emotions. dry food and dry weather will increase vata by its dry qualities similarly damp. Mamsa (muscles. Tarunasthi(Cartilage). Vyan vayu is responsible for the movements of the joints. Mamsa dhatu gives strength to the joints. Snayu (ligaments) and Twacha (skin) -Shleshmadhara Kala(synovia1 membrane) -Vata (Vyana). Dhatu kshyaya (depletion and degeneration of tissues) and is common in old age (vata phase of the life) giving rise to degerative arthritis. oily. Constituents of Sandhi (joints) include Dhatu (tissues)- ~ahucheshta jts. working conditions. tendons) Rakta(blood) -Kandara. According to Ayurveda vata dosha and Asthi (bones and cartilages) are intimately associated and is nourished by the minerals absorbed by the mucus membrane of the GI tract. Vitiation of any of the constituents gives rise to abnormalities of the joints such as Kaphakshaya (diminished Kapha either in quantity andlor quality)and leads to sandhishaithilyata (tenderness of joints). Arthritis is further classified as Sandhigat vat (osteo-arthritis) Asthigat vat (degerative arthritis) . There are two main internal causes of vata aggravation.: spine & intra tarsal jts etc. obesity. with varied range of movements: shoulder jt hip jt. According to the Ayurvedic principles of "like attracts like". etc Upadhatu (tissue-components) Kala (membrenous) Dosha (VIPIK) Asthi (Bone). and subtle and is aggravated by diet. the clogging of the channel may be initiated by wrong diet.Sandhi (Joints) Cheshtavanta (Mobile) Sthira (Immobile) Alpacheshta Joints. Increased vata dosha will accumulate in the colon as it is the main seat of Vata dosha. Diseases of joints:Vata dosha is dry. cold. Psorisis or increased uric acid build up. rough. Kapha (shleshak Kapha) Under normal conditions the shleshmadhara kala along with the kapha dosha (shleshak kapha) acts as a nutrient and avoids joint friction. Limited movements of Jts. nervous and connective tissue channe1s)leads to pain in the joints of phalanx similarly diminished medoagni (altered adipose tissue metabolism) leads to a feeling of Sandhisphutan (popping of joints or crackling of joints)(l5-19). sira (vessels). vitiation of Maja vaha srotas (bone marrow. light.

severe pain in the big joints. taking meals while one is having indigestion. dried meat & cereal preparations.This is also one of the 80 Vata vyadhis (vata conditions). eating incompatible food. One feels that the joints are filled with vayu (air) and even crackling sounds in the joints are heard. the small joints of hands and the feet. Vata Kantaka :. slackness of joints. indolence & malaise (local). loss of sense of touch. administration of inappropriate therapeutic measures (Panchakarma & other). excessive physical exercise. excessive swimming. When vitiated vayu afflicts the bone and bone marrow (Majja dhatu)and splitting pain may occur in the bones. Since both vayu and rakta (blood) are aggravated in this disease. Etiology of Vatavvadhis in aenera1:Dry (non-fatty). increased temperature will be present in the joints Asthimaiiaaata Vata :. Increased vata dosha accumulates in the colon and initiate vata vyadhi (disease). eating before the previous meal has been digested. Aamvata (Rheumatoid Arthritis): Etiology: When a person of sedentary habits with low digestion indulges in incompatible diet. alkaline. light food in insufficient quantities. contaminated by ama. appearance of eruptions on the knees. This condition can be correlated with 'Gout' described in modern science (15-16). ama. wine. fatty food. If the condition is due to the obstruction in the channels with ama. It then takes on multiple colors. thighs. the disease advances to give rise to symptoms of swelling spreading to the joints and then moving all over the body. tearing pain heaviness numbness. camels. The amrasa. long journeys on foot. excessive sexual intercourse. blackish discoloration.Sandhi~ata Vata (osteoarthritis): . insomnia and persistent pain anywhere in the body are observed.It is one of the 80 vata vyadhies or vata diseases. day sleep & keeping awake at night and in intake of heart-burn producing diet cause improper digestion of food leading to vitiation of blood which then gravitates & accumulates in the feet. obstructs the normal path of vayu. becomes . Vat Rakta (Gout): Compliance to the harmful habits causes blood impurities in the body. worry. sour. radish. tingling sensations.Walking on uneven ground or strenuous exercise lead to vitiation of vata in the region of the ankle joint to produce pain in the feet and this condition is called as vatakantaka. pungent. or does physical exercise after taking fatty food. keeping awake at nights for long periods. curried or fried preparations of meat of aquatic or swampy animals. Due to the obstruction vayu intensifies and contaminates blood. physical and mental stress etc aggravate vata and give rise to various generalized diseases or to those localized to a part of a body. When vitiated vata afflicts the joints it leads to a painful swelling and ultimately destruction of the joints. Impure blood. leafy vegetables. emaciation due to diseases. excessive riding on elephants. eating when angry. grief. pitta and kapha is circulated all over the body through the vessels. Profuse perspiration. All vata doshas are due to the aggravation of vata dosha. excessive loss of doshas (VPK) dhatu (tissue) & malas (excretion). the ama is formed & propelled by deranged vayu & reaches to the site of kapha. it is known as "vat rakta" vyadhi. intermittent pain as well as pricking. twitching. horses. At the same time unhealthy dietary habits aggravate vat. legs. yogurt. The disease spreads all over the body like a violent rat poison beginning from the root of the feet (metatarso phalangeal joint region) or sometimes from the hands. This condition is usually seen in the case with calcaneus spur. burning and hot sensation in the joints. serve pricking pain. suppression of natural urges. fever. fast moving vehicles. excessive starvation. (Ras dhatu contaminated with ama) on being completely processed & very much vitiated by vata. cold. trauma. Blood gets saturated with the deranged vayu on account of the predominance of vatarakta (15-29). wasting of muscles and depletion of strength. Etioloav Excessive intake of salty. coppery-red discolorations (effect of rakta dosha where vata dosha is predominant). rubar. itching and splitting pain in the joints with periodic exacerbation & remission are the prodromal signs of vata vyadhi (vata diseases)(5) Starting with initial symptoms of itching.

heaviness. malaise. intense thirst. Swedan (Sudation therapy) should be applied as per requirement using various steaming procedures. Cardiac involvement and strictures in joints are some of the serve complications (2123). arthritis etc are the general signs & symptoms of amavata. increases the vitality & life span. heaviness. In antarvegi jawara (high grade fever). constipation. If there is a simple provocation of vata without any kind of occlusion. acid. oil and marrow. indigestion & inflammation of the body parts e. swelling and similar other conditions. fibrositis. cold. knees & thighs. It produces painful swellings in the joints of hands & feet. fever. fainting. Treatment for vata Vyadhi: Most of the diseases with joint involvement are vata vyadhy. anorexia. thirst. feet and elbow causing joint pain and fever In vata-pittaja Jwara (fever) along with fever. milk pudding mixed with salt & acid. . stiffness. Body ache. All diseases due to vata provocation are always to be continually treated with sweet. The oleation and Swedan therapy replenishes the body elements. burning sensation. it should be treated with oral administration of unctuous preparations such as ghee (clarified butter). - The ama produced in the disease gets lodged in the joints. polyuria. are the common symptoms along with pain in the joints & bones. burning. Aamvata (Rheumatoid Arthritis): Exacerbation of amavata. pericardial discomfort. the condition is known as amavata (21). When the aggravated ama simultaneous afflicts the pelvic & shoulder girdles & the other joints making the body stiff.when amavata is exacerbated it becomes the most distressing of all diseases. In vata Kaphaja jwara along with excessive sleep. stiffness. a feeling of heaviness. The affected part is excessively painful. vertigo. In Sannipatik Jwara (when all three doshas are involved) pain in all the joints is seen along with jwara & other symptoms of all the doshas. cervical region. muscle tendons of hand. wet land & aquatic animals. Here with the joints of bones. Thus 'ama' is the cause of many distressing diseases. loss of sleep. When overstrained by the snehan or oleation therapy. myositis. It gives rise to hypo functioning of the digestive system excessive salivation. it should be treated with internal and external oleation therapy. reversal of normal sleeping habits. When the osseous tissues or bone marrow is affected. Ama can also manifest into painful swellings over bones. aches. colicky pain. thirst. which is the origin of vata. breathlessness. spastically. hardness in the abdomen.g. the joints of muscles. This condition can be compared with rheumatoid arthritis according to modern science. tendons are also affected & in the cardiac involvement the joints of the heart muscles and valves are considered in the pathogenesis. vomiting. It renders the patient weak in no time & produces a feeling of heaviness in the pericardial region. A Case study of AMVAT is attached for a better understanding of the Ayurvedic approach to Rheumatoid Arthritis. mixed with unctuous articles. relieves pricking pain. fat. Therefore it is necessary to understand the broad range of treatments of vatav yadhies. Basti or medicated enema is again the specific treatment for vata vyadhi as it acts on the "pakvashaya"/colon. & temp pain the phalangeal joints is observed.excessively mucoid & gets accumulated in the small channels. Parvabheda or pain in the phalangeal joints is observed. anorexia. gurgling intestinal sounds etc are some of the complications. salty & unctuous article of diet. thirst. cough. a patient should rest for a while and should again be oleated with milk or thin gruels of meat of domestic.

JR Sporn. P Mason.1039-44 19. 10. Sci. GD Singal. Modulation of Hematopoiesis by lymphocyte membrane by lymphocyte membrane derived components. Murthy RKS: Ashtang Hridaya. Chapter 16. 453-457. Sharma KR. Murthy RKS: Ashtang Hridaya. Ann. Arthritis Rheum. A Guha. Chaukhmba Sanskrit Pratishthan. Interferon-induced growth arrest is mediated by membrane structural changes. M. Delhi lndia 22. A Guha.KR Sharma. Brandtzaeg P.Chaukhambha. 425-447. Sootra Sthan 28 . RE Cone. Delhi 6.formulation for Kidney and Bladder Health Holy Basil Plus . KR Sharma.1991. The Negative Regulators of Hematopoiesisfrom fundamental Aspects of Clinical Application. 2001 2. N Dainiak.Detoxification and Rejuvenation formula 1 1 A professional line of classical massage oils: I Anu Thailam.146:1858-1861. Interferon-gamma retards the turnover of H-2Dd antigens by splenic lymphocytes.Choukhamba Surbharati Prakashan Varanasi I I I Edition Edition 4. Singal GD. 1990 20. Varanasi. Tripathi. Charak Samhita. Interferon-induced growth arrest is mediated by membrane structural changes. GD Singal. viman Sthan 5 . The gut-joint axis: Cross reactive food antibodies in rheumatoid arthritis. Panush RS. 23. 628:354-361.. fauchi. NY Acad.Varanasi. Pattison DJ. vol-1 . Marine Drive Vancouver! BC V5X 2S5 T: (604) 323-1 198 E: neelam@sewanti. Kottamchukkadi and more to come. Guigon M. D Primorae. Schechter A. A y u ~ e d i c lndia 7. Delhi lndia 17. Chapter 22. Fraser D. RE Cone. Krishnadas Academy. A Guha and RE Cone. lnterferon and cytokines. J Miller. Diet Therapy for the patient with rheumatoid arthritis? Rheumatology (Oxford) 1999.50.. Hallgren. 11.FarreQ. Pittick MP: Rheumatology 11. 17:701-706.=handanad. A Guha. Sci. Dainiak N. 187.formulation for Joint and Muscle Health Stressnil . D Primorae. 376-426. Chapter 22. 13. N Dainiak. 1991. 158-165.38. Chapter 25. J 164-233. PR Mason. Colloque lnserm 229:201. Vol-1 .Karpoorad. NY Acad. lndia 23. Chapter 22. 12. lnterferon and cytokines. Varanasi 17Ih Edition - Classical Ayurvedic formulations manufactured in Canad Approved by the Health Canada and FDA regulations: Diarid . Varanasi 17Ih~ d i t i o n Clinical Diagnosis.The Power of Holy Basil and Ayurveda Rheumat .Choukhamba Surbharati Prakashan Varanasi lllra 5.E.13. Unit 4-350 S. SN Tripathi. M Silva. Food induced (allergic) arthritis: clinical and Serological Studies.Choukhamba Sanskrit Sansthan. Chaukhambha Sanskrit Pratishthan. Symmons DP. SN Tripathi.. A Guha. 1994. Yog . Dhanwamtharam. SN. J. Contact: Padmashri Natural Healthcare products Suite#488. Can Med Association.Lunt M et al. Leukemia 8:S227. Chaukhambha Sanskrit Pratishthan. Charak samhita. J. 17... 626:212. R.Choukhamba Surbharati Prakashan. Charak samhita. 1991 9. vol-1. Evaluation of the Patients with pain all over. viman Sthan 8 .Ratnakar Choukhambha Sanskrit Sansthan. Hvagum. A y u ~ e d i c Clinical Diagnosis: Gout. J lmmuno1. 291-94. N Dainiak. 1997 8.McGraw-Hill. BF Haynes. A Guha . A Guha. 17:701-706. N Dainiak. Inhibition of MHC class-l antigen on lymphocyte cell surface I . Madhav Nidan . LeMoine FM. Anthony S. Hougen M. 16. 1993. Harrison's Rheumatology. 2004 21. Physical interaction of negative regulator of erythropoiesis with the membrane lipid bilayer.References: Continued From page 16 1. PR Mason.NY 15. John Libbey Eurotext Montrouge. Dietary risk factors for the development of inflammatory polyarthritis evidence for a role of red meat consumption. 1997 14. J Miller. Introduction to the Immune System. 3804-12. vol-1. Mahanarayana. DP Tuck. JR Sporn.. Kanerud L. Voll. P Mason. Ayurvedic Clinical Diagnosis: Amavat Nidan. and Najman A (eds).Chaukhambha.Ayurvedic Inner Peace formula Triphala Plus . Expression of negative regulator of human erythropoiesis of fluidized lymphocyte plasma membranes. Varanasi lllra Edition ~ 3. Krishnadas Academy. 22 october 2007 18. India. S Sorba.

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Present ltioloav (Hetu) : A) Dietary Cause i) Spicy food 217 days ii) Stale Food . Yellow.Tanu. Bodyach iii) Kapha Vruddhi .S1S2 Normal iii) Trachea . lnsomnia Dushya Agni. male child J) lndriyavaha Strotas (Sense Organs) .central B) Udakvaha Strotas i) Excessive Thirst Shosh) ii) Dryness of mouth (Jivha.Neg N-63%. Rasa.E-2%.4 mg0/0 BSL (R) .4-5 1 hpf ALB .07.29mmlhr P. Anorexia.Once 12 days. Fissure ii) Stools . Fever i)Vata vruddhi .AEBE. iii) Diva-swap (Irregular sleeping habits) Poorvarupa (Premonitary Signs) i) Fever ii) Morning Stiffness Roopa (Signs 8 Symptoms) i) Pain of migratory nature in joints iv) Abdominal tenderness vii) Feeling of tasteless x) lnsomnia xi) Fever ii) Joint effusion v) Bodyache viii) Somnolence iii) Joint stiffness vi) Anorexia ix) Thirst Dasha Involved ii) Pitta Vruddhi . Characters taken together in irregular quantities) ii) lrregualr bowel habits.Thirst.64. D) Rasavaha Strotas (CVS) i) Feeling of tastelessness (Aruchi) (Aalasya) iii) Nausea iv) Fever (Jwar) ii) Somnolence E) Mansavaha Strotas i) Upachay .M-Z%. .Joint effusion & Stiffness. 2 times Inight.RA Factor . hard stools M) Mootravaha Strotas (Renal System) i) Micturition 6-8 times I day. Annavaha Strotas .02.Strotas Parikshana: A) Pranavaha Stotas (Respitary system) i) RS .Positive RBCs . Udak. Abdominal tenderness. . buttocks 0) Aarta-vaha Strotas i) Menses regular.9.NAD K) Manovaha Strotas i) Heena Satva ii) lnsomnia L) Purishvaha Strotas (Rectum) i) No Hlo Piles.07.07 .22. Aalasya. Majja Purish. Uric acid .0.7 mg% ESR .Spleenomegaly absent iv) Sira .Avagadha G) Medovaha Strotas i) Fairly nourished ii) No Fat deposition over abdomen. Singha F) Raktavaha Strotas i) Nails .Mild Paalor iii) Hepato .Daily iii) Fast Food (Vidhahi) 1-2 1 15 days iv) Salty fried food (Chips etc.5 mgldl 10. Fish.07 . yellowish N) Swedavaha Strotas . Pandur (Pale) ii) Eyes .C. Talu I) Shukravaha Stotas i) Issue 3 female & 1.3 gm % 16.07 mill I cmm Hb .Snigdha.3.NAD H) Asthivaha IMajjavaha Strotas i) Pain of migratory nature in joints ii) Joint effusion iii) Joint Stiffness (Graha) iv) Pain in cervical region.9200lcmm Sr.L-35%.5light trace 17.) 1-2 17 days v) Meat.Urine (R) Ca-oxalate .B-O% BUL . Backach v) lnsomnia (Nidry .6-8 hrs.Elisa for HIV . sama vi) Time taken for digestion .Madham ii) Skin .C. Aruchi.1-2 Ihpf 8) Life Style i) Vishmashan (Irregular Food Materials of opp. Sr. eggs 2-3 1 7 days vi) Sprouty Food l l 7 days WBCs .6 mg % E.1-2 1 hpf amorphous material . 4/28 days. Asthi.3.moist. Clear ii) CVS .07 .Viparyay) C) Annavaha Strotas (GIT) i) Feeling of tasteless ii) Nausea iii) Anorexia iv) Abdominal tenderness v) Tongue . Somnolence.Pain of Migratory nature. Creat .

. Swedan. Udar gaurav. Deepan. Vid hahiseva Agnimandya Vishamashan.Vidhahi. Virechan. swelling. Shotha. Tikta.Samprapti Hetu . Vatanuloman. i) Singhnad Guggul 500mg Vatavidhvansa rasa 250 250rng Amapachal vati Thrice a day with lukewarm water ii) Samasharkara Churna 500 mg Sootshekar vati 250 rng After meals with lukewarm water iii) Gandharva . Upnah.Nirgundi + Erandpatra iv) Hirva Lep . Snigdha ahar with divaswap which aggravates vata 8 Kapha dasha leading to agnimandya which resulted in formation of sarna-vayu that sama-vayu got ashray at Amashaya and sandhi causing sandhi Shoola.Hastyadi Erandsneha 2 teaspoonful at night with lukewarm water As mentioned in Yog . The first stage of treatment consisted of abolishing sama-vayu by way of Pachan. The oil used for external application also served the same purpose by reducing local pain. Kaphaprakopa +I accumulation) Amottpati (Toxin I Sama-Vayu andhi ashray Patient followed a faulty diet consisting of paryushittanna. Graha. Chikitsa for which above preparation were given. Katu rasa sevan. Thus forms Arnavata.Sevan Vata Prakopa Vishamashan. they help in samprapti .bhang. .Ratnakar main treatment in amavat is Langhan.Local application at joints. Treatment A) Internal Medication 6) External application i) Massage with lukewarm Vishgarbha Taila ii) Hot fomentation iii) Patra Pottali . Snehhan.

Rashtriya Shiksha Mandal. Jaipur. Puna. ii) Sweet gourd. grapes. University of Connecticut School of Medicine.5 cm 33. lukewarm water.5~~1 30.5 crn 32. Farmington. USA.Professor of Ayurvedic Pediatrics.08 A 33. iv) Patient had satisfactory passage of bowels v) Patient was fresh for longer period. CT.5 crn 32 cm C 29cm 29 cm 28. jackfruit. spinach. starchy food Diet t o be taken: i) Rice. pineapple. vi) Sleep pattern also improved bouts of insomnia due to arthralgia reduced. Amala Guha University of Connecticut School of Medicine.President.0 cm Joint pain Assessment on VAS Outcome / Proanosis 1) Patient's Knee joint swelling showed on average reduction of 0.5 -1 cm ii) Patient's joint pain was reduced by 2-3 as recorded by VAS scale iii) Morning stiffness (Graha) improved greatly patient had no longer complaint of morning stiffness.5 cm B 33cm 32. lndia and Dr. Abhimanyu Kumar. masoor.National Institute of Ayurveda.CT. professor of Immunology. green gourd. Ayurvedic Medical School. vii) Patient was able to carry on his daily chores with less difficulty. USA. Dr. pea iii) Fish. For The Revision of the manuscript and their helpful suggestions. N. Amala Guha is an Assistant profe sor of immunology and the Director of Complementary and alternative Supportive Care at the University of Connecticut School of Medicine and the founding president of International Society for Ayurveda and Health (ISAH). Acknowledgement: Authors would like to thank Dr Suhas Parchure. Gangal. his appetite also showed marked improvement. Corresponding Author Dr. Seth Tarachand Ramanath Hospital. W Doiphode Dean. R E Cone.Puna India. paneer vi) Tapioca.DIETARY RESTRICTIONS Diet to be avoided: i) Corn.5 cm 33 cm 32. Sadanand Deshpande is a Professor 8 Head of the Department of Kaya-chikitsa (Ayurvedic Internal medicine) at Tilak Ayurved College and head of Kayachikitsa (Internal Ayurved Medicine)at the Seth Tarachand R.07 4. University of Pune. About Authors: Dr. duck.5 cm 29. iv) Almonds v) Buttermilk.5 cm 32. curds. India.5 cm 32 cm C 30.5 cm 33 cm B 33cm 32. for the use of departmental resources. Professor and Superintendent. Dr.07 28. iii) Green gram. R. ii) Black gram. cereals. v) Milk. Phone: 860-5614857 References: on page 12 . ragi. bengal gram.07 2 1. lndia Dr. whey vi) Knee ioint measurements - 14. Hospital Pune.5 cm 28 cm A 34cm 34 cm 33. snake-gourd. bacon iv) Banana. gram dal. cheese. lndia and Dr.5 cm 29.

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