MANAGEMENT OF AMAVATA WITH AYURVEDIC FORMULATION: A CASE STUDY

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Date of Acceptance : 29 May 2024

Date of Publication : 29 Jun 2024

Article ID : SD-IJAY_081

How to cite this article : http://doi.org/10.55552/SDNJAY.2024.2203

Abstract

According to Ayurveda, Agni plays a remarkable characteristic in maintaining the equilibrium of the body, the impairment of which finally ends up withinside the formation of Ama. So, any elements both dietary, environmental or mental which reasons impairment of Agni turn out to be answerable for the formation of Ama also. The Ama is a causative thing for lots ailments such as Amavata1. Amavata is precipitated on the equal time because the Ama with assist of Vata actions quick and get lodged in Dhamanis and in Kaphasthanas especially Sandhi’s2. Current case study is carried out at Shri Ayurved Mahavidyalaya Nagpur to evaluate the efficacy of Ayurvedic treatment. A 40 year, female came to O.P.D of Kayachikitsa with chief complaints of Sandhishula at both Hastanguliparvasandhi, Manibandhsandhi, Karpursandhi, Padanguliparvasandhi, Gulf sandhi, Janu sandhi (pain in both Interphalangeal joints of hand, wrist joint, elbow joint, Interphalangeal joints of feet, ankle joint and Knee joint), Sandhishoth at both Hastanguliparvasandhi, Manibandhsandhi, Karpursandhi, Padanguliparvasandhi, Gulf sandhi, Janu sandhi   (pain in both Interphalangeal joints of hand, wrist joint, elbow joint, interphalangeal joints of feet, ankle joint and Knee joint.), Angamarda (body ache), Agni Mandya (loss of digestive fire), Aalasya (lethargy) and Apaka (Indigestion). So, she had taken Ayurvedic treatment for 42 days which include Shodhana, Shamana Chikitsa. Clinical signs have been appreciably reduced. The response to this treatment was recorded and therapeutic effect were evaluated through symptomatic relief.

KEY WORDS:- Agni, Amavata, Ama, Shodhana, Shamana Chikitsa.

Introduction

The disease Amavata is first described by Acharya Madhavakara in Madhavanidana. Ayurvedic control of Amavata contains of Langhana, Swedana, and use of katu, tikta Dravya, Deepana, Virechana, Snehapana and Basti, giving earlier significance to the causative factor Ama3. While the modern treatment goal focuses on suppressing the inflammation and controlling symptoms, using DMARD’s (Disease Modifying Anti Rheumatic Drugs) and NSAID’s (Non-steroidal Anti- inflammatory Drugs) & biologic therapy4 frequently which have negative impact on immune system and gives only temporary relief. However, until date no first-rate present day clinical control has been evolved for this problem.

Hence the control of this ailment is simply inadequate in different structures of medicine and sufferers are constantly searching with a desire in the direction of Ayurveda to conquer this challenge. Hence for Ayurvedic scholar it is a challenging disease, so it becomes duty of scholars to work on various aspect of this disease. Usage of NSAID’s in Rheumatoid Arthritis reduces the inflammation and pain but they can only control the symptoms; and continuous use can cause side effects like gastro intestinal ulcers etc. DMARDs can reduce joint erosion but they have slow onset and they do not have analgesic activity. Also, all these treatments are advised for a long period which influences the economical and emotional status of patients which plays an important role in the management of disease. Due to any of the above reasons if patient fails to continue the treatment there are chances of complications including structural deformities which doubles the difficulty of treatment and also increases the need of joint replacement surgery.

This shows the importance of a short, cost-effective treatment for the cure of Amavata which will prevent the disease going into its complicated stages. So here is an attempt to evaluate the effectiveness of Shunthi Guda(jaggary) churna 5 in the management of Amavata with special reference to Rheumatoid Arthritis.

Discussion

Response to treatment was recorded, and treatment effectiveness was evaluated through relief of patient’s symptoms. It was observed that the patient's clinical symptoms gradually decreased during the treatment period. Improvement of Jatharagni and removal of Ama were the therapeutic goals of Amavata along with treatment of Vatahara. The abovementioned patient came to the OPD with Vyakti Avastha, so all the medicines given to the patient have the properties of Vata Kapha Hara, Pachana, Rochana, Dipana, Rechana, Vibandha-Anaha, Shulaghna, Shothaghna and Jwaraghna, Vata Pitta Hara, Balya and it helps to cure Amavata.

Mode of Action: -

• Langhana: The patient was advised by Langhana in the form of Laghu Ahara. This helps digest Aam.
• Valuka Pottali Sweda: Swedana appears especially in places where Stambha, Gaurava and Shula are present. In Amavata, Ruksshasveda is recommended in the form of Valuka Pottali due to the presence of ama. Helps soothe damaged Vata Dosha, relieving pain and stiffness.
• Vaitaran basti:7 Acharya Chakradatta has mentioned the Vaitaran Basti of Niruha Basti Adhikara.

Ingredients of Vaitaran Basti - Guda 1 tola, Saindhava 1 tola, Amlika 2 pala, Shatakhwa 1 tola, Gomutra 8 pala. Purana Guda: Ushana Virya Guda can help you in Dosha Pak. Saindhava Lavana: Due to its Kapha Vilayana or Kapha Vichkhedana qualities, it helps in dissolving and destroying painful Kapha and Ama Dosha. Amlika: Ruksha Guna and Ushna Virya help Strotovishodhana thanks to Tikshana Guna. Additionally, the properties of Ruksha Guna, Tridoshhgna, Agnideepaka and Vatanulomana are beneficial to Amavata. Amapachana. Satahva: Kutu-Tikta, Ushna Virya and Katu Vipaka. The properties of Satawwa help digest Ama and return Agni. Gomutra: Contains Katu Rasa, Katu Vipaka, Ushna Virya and helps calm Kapha Dosha. and Laghu, Tikshna Guna. He also helps Strotovishodhana through Tikshna Guna. furthermore, Internal ayurvedic medicine Like Shunthi Guda Churna, Mentioned in Yogratnakara. Nagara churna is having properties like katu Rasa, Ushna virya, Madhura Vipaka and Guda Churna is having properties like Madhura Rasa, Ushna Virya, Madhura Vipaka, Vata Kapha Hara, Pachana, Rochana, Dipana, Rechana, Vibandha-Anaha, Shulaghna, Shothaghna and Jwaraghna. Shunthi is told to be Amavatanut specially. Guda Churna is Vata Pitta Hara, Balya. When used with Shunthi it helps to cure Amavata. Because of the Katu Rasa, and Ushna Virya Agni Dipana occurs; Agni Dipana along with Pachana properties of drugs helps in digestion of already formed Ama and helps to prevent further formation also. Amavata is an autoimmune disease, due to Madhura Rasa it helps to increase the body tissues and as a consequence it enhances the Ojas or the vital energy reserve of the body and mind. This taste therefore aids in increasing not only immunity but also the general health of

an individual and keeps ageing at a distance. Since Ama is the main cause of the disease Ama Pachana itself is the first aim in the treatment protocol. In the Chikitsa Sutra itself it is told that after Langhana we should administer Tikta, Katu Rasa and Dipana. Katu Rasa have Lekhana and Stroto Shodhana properties. So, they remove the Ama from Strotas and do Stroto Shodhana. With the Ushna Virya it causes Vilayana of Doshas accumulated in Strotas. In Amavata, Vata and Kapha are involved, and both Nagara and Guda are Kapha hara and Vata hara in nature.

Conclusion

It is concluded that this treatment completely or partially relieves symptoms in Amavata This medicine can be utilised in treating patients who are suffering from Amavata to reduce both sign and symptoms successfully with greater effectiveness. It is proposed that the therapy may be accepted as a treatment method of Amavata.

References

1. Madhavakara, Madhavanidana (Rogavinishchayam) Amavata Nidanam 25/1-12, Translated to English by Prof. K.R. Srikantha Murthy, Chaukhamba Orientalia, 7th Edition 2005, pg. 95-96.
2. Madhavakara, Madhavanidanam (Rogavinishchayam) Amavata Nidanam 25/1-5, Translated to English by Prof. K.R. Srikantha Murthy, Chaukhamba Orientalia, 7th Edition 2005, pg. 95.
3.  Bhavamishra, Bhavprakasha Samhita, Madhyamakhanda, Vidyotini Hindi Commentary, Amavatadhikara Adhyaya 26, edited by Sri Bhrahma Sankara Misra Vol 2, Chaukamba Sanskrit Bhavan Varanasi, edition 2013, pg. 285.
4.  A.S. et al. (2012) Disorders of Immune Mediated Injury, In Longo.et al.(eds.) Harrison’s Principle of Modern Medicine. Vol II, Cenveo publisher service, pg. 2738.
5. Yogratnakara, Amavatanidan, by Vaidya Laxmi Patil Sastri edited by Agratna Brahma Sankar Sastri, Chaukhamba Prakashan, Posi Box No.1150k.37/116, Gopal Mandir, Lane, Varanasi Pg.No.567.
6. Acharya Vidyadhar Shukla, Professor Ravi Datta Tripathy, Charak Samhita, vol.2. Chaukhamba Sanskrit Prakashan, Delhi. Edition, Chapter 9th, Sidhisthana, Trimarmiyaadhyaya, 2009; 956: 75.
7. Sushrut Samhita, Sushrutvimarshini, Anantram Sharma, Uttar Tantra, Chaukhamba Sur Bharati Prakashan, Varanasi, Edition, Chapter 25, Shiroroga vidyaniya, 2015; 188: 15.