Amavata (Rheumatoid Arthritis)

Nidana

According to Haritha samhitha chikitsa sthana

• Excess intake of guru aahara
• Due to aama by mandagni (indigestion)
• Excess intake of tubers like potato, beetroot (except soorana)

Acc. to Madhava nidana

• Viruddhahara chesta (incompatible food and regimen)
• Mandagni (low digestive fire)
• Nischala (lack of exercise)
• Exercise immediately after food intake

Samprapti

Acc. to Madhava nidana

• Vata aggravates
• Takes or produces aama
• Settles at kaphaja sthanas (esply sandhi etc)
• Following this, doshas get further vitiated and moves to other parts of body by dhamanis

Lakshana

Acc. to Madhava nidana

• Angamarda (body ache)
• Aruchi (lack of taste)
• Trishna (thirst)
• Aalasya (lethargy)
• Gauravam (feeling of heaviness)
• Jwara (fever)
• Shoonatanganam (swelling)
• Mainly characterised by sthabdata at different joints, especially trika sandhi

Pravriddha Lakshanam

Severe pain with shotha (swelling) at

• Hasta (hands)
• Paada (feet)
• Gulpha (ankle joint)
• Trika (sacrum)
• Jaanu (knee joint)
• Pain similar to vrishchika viddhavat (scorpion sting)
• Bahumootrata (polyurea)

Upadrava

• Trishna (thirst)
• Chardi (vomiting)
• Bhramam (giddiness)
• Hridgraha (cardiac distress)
• Vidbandha (constipation)
• Sthabdha anga (stiffness of joints)
• Peculiar sounds from intestine
• Aanaha (abdominal distension)

Saadhyasadhyata (prognosis)

Acc. to Madhava nidana

• If only 1 dosha involved - saadya (krichra saadya)
• If 2 doshas are involved – yaapya
• If sannipataja - anupakrama

Chikitsa Sootra

“Langhanam Swedanam Tiktham Deepanani Katooni Cha. Virechanam Snehapanam Bastayashchaamamaaste” - (BHAI.RAT.)

 

1. Langhanam (fasting)
2. Swedanam (fomentation)
3. Deepana pachana (digestives and carminants)
4. Shodhanam – virechanam (purgation)
5. Snehapanam (internal administration of unctuous medicaments)
6. Vasti (enema)

As a general treatment modality,

• First aamahara chikitsa is adopted
• And when it becomes niraama, kevala vaata chikitsa should be done.

Langhanam

It is of 3 types

• Upavasa – fasting
• Laghu bhoojana – less amount
• Shushka paaneeya – ushnoodaka paana or takra paanam

Mode Of Action

“Langhanam Kapha Medhoghnam Aama Jwaraharam Laghu”

Hence it helps reduce aamatwa and kapha.

Swedana

“Vaata Shleshmani Vaate Va Kaphe Va Sweda Ishyate” - (CHA.SU.22)

Thus indicated in vaata, kapha or vaata kaphaja condition

• Vaalooka pinda swedam
• Choorna pinda swedam (eg.kolakulathadi choornam)
• Upanaham (medicines for lepa can also be used)
• Eranda patra taapa swedam
• Dhanyamla dhaara

Vaalooka Sweda
“Rooksha Sweda Prakarthavyo Vaaluka Putakaisthatha” - (Chakra Dutta)

Rooksha sweda indicated in the form of vaalooka sweda for aamavata.

Upanaha Sweda
Upanaha sweda without snehamsha (snehamsha increases aama)

Deepana Paachana Oushadhas

Katu , Tiktha , Rasa Yukta Medicines

• Katu is deepana
• Tiktha is pachana eg.

1. Gandharvahastadi kashayam (with saindhava or guda)
2. Vaiswanara choornam (with hot water)
3. Lashoona shunti nirgundi ksh
4. Shunti gokshoora kashayam (1: 3 ratio)
5. Shatyaadi ksh.
6. Vyosha chitrakaadi ksh.
7. Amrutottaram ksh.

Virechanam

• Eranda tailam
• Dasamoola ksh. or shunti ksh. with eranda tailam
• Trivrt choornam with trivrt ksh

Snehapaanam

• Kaaraskaraadi ghrtam
• Indukantham ghrtam
• Dasamoola shadpalam ghrtam
• Shunti ghrtam (shunti kalkam – 1p, ghrtam – 4p, shunti ksh – 16p)

Vasti

• Dwipanchamooladi tailam
• Kshara vasti and vaitarana vasti can also be advised.

Shamana Oushadhis

Kashayam

• Rasna sapthakam ksh
• Rasna panchakam ksh
• Rasna tamalakyadi ksh
• Rasna dasamoola ksh
• Sahachara baladi ksh
• Dasamoola ksh
• Panchakolam ksh
• Rasna erandadi ksh
• Arishtas and asavas
• Amrutarishtam
• Nimbamrutasavam
• Panchakolasavam
• Vidangarishtam

Choorna Kalpana

• Panchakola Choornam
• Shaddharanam Choornam
• Vaiswanara Choornam

Vati Kalpana

• Rasnadi guggulu
• Yogaraja guggulu
• Punarnava guggulu
• Trayodasanga guggulu

Ghrtam And Lehyam

• Dasamoola hareetaki lehyam
• Guggulu tiktakam ghrtam
• Indukantham ghrtam

Shesha Karmam

Lepanam

• Jatamayadi choornam (with suitable drava dravyam, eg.dhanyamlam or ushna jalam)
• Nagaradi choornam (usna jalam or kanji)
• Kottamchukkadi choornam

Abhyangam

• Kottamchukkadi tailam
• Karpooradi tailam
• Saindhavadi tailam

Pathya Apathya

• Pathyam
• Yavam, kulattha, kodrava, raktha sali, usnodakam, lasoonam
• Panchakolam
• Patola, karavella, ardrakam, gokshuram
• Apathya
• Dadhi, gudam, ksheeram, masham,
• Viruddhaharam
• Matsyam, dushta jalam
• Poorva vata
• Asatmya aaharam
• Vega dharanam
• Raatri jaagaranam