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Disorders

of Joints A R O G YA M A N D I R PATRIKA

EDITORIAL December 2007

W e are thankful for your responses to the


earlier Arogyamandir Patrikas viz.
Vishayapravesh

T
special issues on `Digestive Disorders' he word 'Sandhi' means where 2 parts come together or connect with each other.
(April 2007) and `Skin Disorders' (July 2007) According to Ayurved, the term 'Sandhi' is identified by the site where two or more
bones connect with each other.
published by Shree Dhootapapeshwar Ltd.
Your written appreciations have surely In this issue of Arogyamandir Patrika, we will discuss about the joints which generally get
boosted our confidence. affected causing joint disorders. For the treatment of such disorders people generally
turn towards Ayurvedic treatment as no such complete treatment is hardly available with
We agree with your valued other pathies.
suggestions that many
a diseases are on The differential diagnosis of these disorders, their specific condition, treatment and
complications have been put forward together in this issue.
the rise now-a-days
and need special
publications Sandhi Vikar
covering them. 'Joint' or 'Sandhi' is the part which connects two or more bones, which helps in proper &
Keeping that in smooth movement of joints as well as body.
mind, we have The Asthi dhatu or bone is the part which gives proper shape & firmness to the body as
come up with this well as it protects the internal organs.
special issue on
'Asthi' & 'Sandhi' both are known as the
`Sandhivikar'.
moolasthana or origin of Majjavaha Srotas.
Many diseases pertaining to Joints (Sandhi) Vatadosha is mainly situated in Asthi & Sandhi
clubbed as `New diseases' are becoming hence due to vitiation of Vatadosha there are
more and more common, but if we take into changes or deformity in these Asthi & Sandhi.
consideration the Siddhant of Charakacharya Similarly vitiation of Asthivaha & Majjavaha
and understand it in the correct perspective of Srotas gives rise to vitiation or abnormality in
the Dosha-Dushya Sangraha, then instead of these organs causing joint disorders.
taking recourse to the modern names, we can
The main site of Vatadosha in the body being
differentiate, diagnose and treat them with Kandara, Mamsa, Sira, Snayu, Asthi & Sandhi,
ease and that too with great success, based Sandhivikar are incorporated under Vatavyadhi.
on the Ayurvedic principles themselves. Vayu is also related with Vatanadi i.e. nerves,
Our efforts through 'Arogyamandir Patrika' therefore Nervine disorders or disorders
have been in the same direction. By adopting developed due to vitiation of vatanadi are also
this methodology and looking at the condition incorporated in Vatavyadhi.
of the patients on the basis of Ayurvedic
Siddhant, we can surely give relief to the Is it not essential to think of this?
suffering person. Use of painkillers or medicines that are considered painkillers is common in patients
suffering from Joint Disorders to give them relief from the pain they suffer of. With the
We hope that this Visheshank on "Sandhi use of these medicines, the patient feels, that the pain has been relieved and
Vikar" comes upto your expectations and will considers himself normal or near normal.
be appreciated. Even though the person feels that the pain has got relieved, it is not actually gone. It's
We humbly request you to continue sending just that he does not realize it.
your suggestions in writing so that we can In fact, the pain is the sensation that gives the signal that the part needs to be given
carry forward this work in the interest of either rest or less mobility.
`Ayurved Chikitsa' in appropriate direction. Is it then correct to misinterpret the word 'Vedanashamak' and allow the joint to
continue to be in action rather than giving it the required rest?
Yours Sincerely, Is it in the interest of the patient to allow the affected joint to remain functional due to
the misinterpretation of the word 'Vedanashaman' given in the text?
Is it, therefore not, essential for us - the Ayurvedic physicians - to think on this point?
Vd. Shailesh Nadkarni
2

Majjavaha Srotas-Asthi & Sandhi


Causes of vitiation of Majjavaha Srotas Functions of Asthidhatu
● Crushing of bones ● Injury and compression of bones or ● Gives firmness & stability to body ● Gives shape to body
bone marrow ● Excessive decalcification ●
Intake of mutually ● Giving support to muscles & other organs of body
contradictory food ● Maintenance of balance & weight of body ● Protecting
important internal organs like heart, brain etc. ● With help of
Symptoms of vitiation joints it performs activity or movements easily & without any
● Sandhishoola (Pain in joints) ●
Parvashoola, ●
Asthishoola friction.
● Bhrama (Giddiness) Moorchha (Fainting) Vataprakopa Sushrutacharya has mentioned 300 bones in the human body.
(Aggrevation of Vata) ●Tama pravesh (Darkness in front of Modern medicine mentions it as 206. Ayurved has also
eyes) ●
Shotha (Oedema) incorporated 'Kurchasthi' (Cartilage) in Asthi. Due to
difference in classification there is difference in quantity.
Disorders of Majjavaha Srotas vitiation
Vatavyadhi, Pakshaghata, Grudhrasi, Bhrama, Moorchha Sandhi
DemLveevleg mevOeÙees åÙesles kesâJeuee: heefjkeâerefle&lee: ~
Treatment hesMeer mveeÙeg efmejeCeevleg meefvOemebKÙee ve efJeÅeles ~ meg.Mee. 5
ceppeeMeg›eâmeceglLeeve Deew<eOeb mJeeogefleòeâkeâced
Sandhi is formed with the union of 2 or more bones. There are
DeVeb JäÙeJeeÙe JÙeeÙeeceew Megefæ: keâeues Ûe cee$eÙee ~~ Ûe.met. 28-26 2 types of Sandhi as per their movement.
The treatment for the disorders of Majja Shukra vitiation is diet 1. Sthira (Immovable Joints)
with Madhur & Tikta rasa, proper purification, proper exercise 2. Cheshtavanta (Movable Joints)
& proper sexual activity.
MeeKeemeg nvJees: keâšÙee_Ûe Ûes<šeJevlemleg mevOeÙe: ~
Sandhi - Ghatak Vivaran Mes<eemleg mevOeÙe: meJex efJe%esÙee efn efmLeje yegOew: ~~ meg.Mee. 5-25
Asthi Immovable Joints
The joints which are fixed and not movable are called as
DemÙeles Fefle DeefmLe ~ ‘Sthira' Sandhi. e.g. Tunnasevani, Samudga.
The part which lasts even after the destruction of body is Movable Joints
known as Asthi or bone. The joints that take part in movement and are freely movable
efmLejkeâef"veeJeuecyevee Oeeleg: keâeÙemÙe are called Movable Joints i.e. Cheshtavanta Sandhi.
ÙeceeefßelÙe mece«eb MejerjceJeefle<"les ~ In movable joints Shleshmadhara Kala (Synovial
membrane) is situated. The Synovial fluid present in them
Asthi or bone is the most strongest, hard and firm part of body helps in proper & free movement of the joint. Also the joint
which balances the weight of body. It is also known as stays firm & does not get dislocated. It acts as a lubricant.
'Dehasara'.
mvesneYÙeòesâ ÙeLee lJe#es Ûe›ebâ meeOeg ØeJele&les ~
lemceeefÛÛejefJeve<šs<eg lJe*dceebmes<eg MejerefjCeeced ~
mevOeÙe: meeOeg Jele&vles mebefMue<še: Mues<ceCee leLee ~ meg.Mee. 4
DemLeerefve ve efJeveMÙeefvle meejehÙesleeefve osefnveeced ~ meg.Mee. 5-22 Joints are 210 in number.

Types of Sandhi (Joints) as per structure


1. Kora Sandhi (Hinge Joint) 5. Tunnasevani Sandhi (Sutures)
This sandhi or joint is like hinges of the The joints which have teeth like
door e.g. Manibandha Sandhi (Wrist margins joining with each other which
joint), Gulpha Sandhi (Ankle joint), look like sutures are 'Tunnasevani'
Koorpara Sandhi (Elbow joint), Janu e.g. Joints in head.
Sandhi (Knee joint), Parva Sandhi
(Carpellar joints)

2. Udukhala Sandhi (Ball & Socket 6. Vayastunda Sandhi -


Joint) These have structure similar to Joint which look like mouth or beak of
ball & socket. One bone get fixed in crow e.g. Hanu Sandhi joint of cheen
other bone with socket like structure.
e.g. Ansa Sandhi (Shoulder joint),
Vankshana Sandhi (Hip joint) 7.Pratara Sandhi
(Plane or Gliding Joints) The even
3. Samudga Sandhi - planes or flat articular surfaces of 2
These joints are like casket bones connects with each other to
with lesser movements. form this joint. e.g. Cervical & Lumbar
e.g. Shroni, Ansapeeth vertebrae

4. Mandal Sandhi - 8. Shankhavarta Sandhi -


Joints made up of cartilage which are round in Joints like a conch shell e.g. joints in the
shape e.g. Trachea ear.
3

Examination of Joints - Method & Necessity


In case of Sandhivikar i.e. Joints Disorders it is most Movement of joint is to be assessed by means of 'ROM'
necessary to examine the basic part Sandhi & Asthi alongwith (Range of Motion of joint). Instrument to measure this is
General or systemic examination. Goniometer.

The Most symptoms in joint disorders are functional or action Passive movement To be done with the help of physician
based symptoms. Therefore, their analysis is to be done on check for end feel of joint movement.
the same basis. Movement - Painful / not Painful
- complete / not complete
In Pratyaksha Pareekshan i.e. direct examination, the size & Active Movement - To be done by patient himself.
shape of Sandhi (joints) & the related organs is most Compare Passive ROM with Active ROM.
important. Also both the joints of opposite extremity are to be
examined simultaneously.
Size & Shape of joint
Examination of Joint- Method Before treatment After treatment
1. Observation /Inspection Size -
2. Palpation Shape of joint -
3. Examination Corelation with clinical tests Efficacy - Walking time Grip strength

1. Pain in joints - Big joints - Laboratory Test - Investigations


Small joints X-ray of joint, CT scan, MRI etc.
2. Location of pain
These modern investigations are certainly helpful in
Right side Left side Duration diagnosis of joint disorders. But with the help of these
Shoulder joint investigations, Vaidya has to evolve Ayurvedic point of view
Elbow joint in the treatment. e.g. Arthoscopy reveals degeneration of
cartilage attached with joints then Snehan & Swedan are to
Wrist joint
be thought of.
Carpel joint
Metacarpel joint
Examination with Goniometer
Sacral joint
Hip joint
Knee joint
Ankle joint
Tarsal joint

Cervical vertebrae
Lumbar vertebrae

1. Observation
● Skin colour
● Redness Mahayogaraj Guggul
● Discolouration-Trauma Hejb Jeelenjb
● Pigmentation

Αn excellent Guggulkalpa with
● Skin hair loss, shiny skin (in muscular dystrophy)
Bhasmas acting in chronic conditions
● Swelling of Vatavyadhi
● Deformity

Acts as Rasayan, Deepan, Pachan,
● Muscle wasting Muscular atrophy
Amanashak, Vataghna &
(Comparision with opposite extremity) Dhatuposhak

Useful in Sandhigata Vata, Jeerna
2.Palpation Vatavyadhi, Vatarakta, Kushtha, Grahani, Shukradosha,
● Temperature - Thermostrip
● Oedema pitting or non pitting
● Tenderness Maharasnadi Kadha
● Stiffness •
Well known remedy of Vatavikar with
● Nerve tenderness famous Vataghna dravya 'Rasna'
● Numbness/Loss of sensation

Amapachak, Amanashak & Shoolahar
● Tingling sensation
action

Useful in Sandhivata, Ardhangavata,
3. Examination
Ardita, Ekangavata, Amavata, Grudhrasi
● Difficulty in activity

Useful as an adjuvant with Vataghna
● Immobility
Guggul kalpas
● Stiffness
4

Joint Disorders - Specific Symptoms & Differential Diagnosis


Pratyatma or special characteristic feature of particular disease is important for diagnostic purpose.
Disease Pratyatmak Lakshan Disease Pratyatmak Lakshan

Sandhigata Vata Vatapoorna Druti Sparsha Pakshaghata Karmendriyahani (Loss of


(feeling of joints like filled with sensation & function)
air, pain in joints), Shoola
Grudhrasi Pain starting from lumbar region on
Margavarodhjanya Vata Severe tenderness in joints back and spreads downwards on
backside of thigh & knees, leg to the feet
Manyakasherukagata Manyashoola, Bhrama, (pain in
Vata neck region, giddiness) Amavata Vrushchika Damshavata Vedana
(Excruciating Pain like sting of Scorpio,
fleeting type of pain in big joints)

Differential Diagnosis on the basis of symptoms


Pain in Joints

Sthayi Vedana (Continuous pain) Sanchari Vedana (Fleeting Pain)


Chala Sandhi Achala Sandhi Vrushchikdamshavat Vedana
Origin Trayodashang Guggul Localised increase in temperature

Small Big Cervical Prakrut Vruddhi


Joints Joints Vertebrae
Nootan Jeerna
Amavata Amavata
Mild oedema Noise
Redness while movement Starting from thigh, ankle joints Sinhanad Gokshuradi
Local burning Guggul Guggul
sensation Yes No Fatty Body Lean Body
Triphala Guggul Trayodashang
Vataprakopa Dhatukshayajanya Guggul
Niramata Constant (continuous) pain
Kaishor Guggul
Mahayograj Guggul
Manyashoola (Neck pain) Osteoporotic changes/
Samata Hastasuptata (Numbness in hands) After fracture
Agnimandya Chimchimayan (Tingling sensation)
Dhathukshayajanya
Localized Bhrama (Giddiness) Lakshadi Guggul
Shosha
redness
Increase in Manyakasherukagata Vata
Mahayograj Guggul
temperature
Panchamrut Loha Guggul
Upastambhit Vata

Yogaraj Guggul

Yogaraj Guggul Chaturmukh Rasa



Excellent Amapachak & Vatanashak •
Excellent Vatashamak, Balya, Deepak,
Kalpa acting as Srotorodhanashak in Pachak, Kshayaghna, Rasayan
Upastambhit Vatavyadhi Suvarnakalpa

Alleviates irritation of nerves & tones up •
Useful in Majjakshayajanya Vatavikar,
the nervine system Mastishkavikar, Moorchcha,

Useful in symptoms of Vatavyadhi such Pakshaghata, Unmada, Apasmar,
as pain, tenderness & oedema Kshaya, Jeerna Vatavyadhi

Effective in nervine irritation developed
after acute stage of Pakshaghata
5

Vatavyadhi
Vayu or Vata dosha is associated with Asthi & Majja by Symptoms of Asthigata Vata
Asrayashrayi bhava. When Vatadosha is predominant in
Samprapti or etiopathology of a disease they are termed as YesoesÓefmLeheJe&Ceeb meefvOeMetueb ceebmeyeue#eÙe: ~
'Vatavyadhi'. DemJehve: meblelee ®keâd Ûe ceppeeefmLekegâefhelesÓefveues ~ cee.efve.
In Vatavyadhi, the symptoms related to Asthigata Vata &
Majjagata Vata are very much similar. Aggrevation of Vayu in the bones & bone-marrow gives rise to
Sandhivikar & Vatavyadhi are related with each other. As in cracking of bones & joints, piercing pain in the joints,
Sandhidushti there is vitiation of Vatadosha predominantly. diminution of muscle tissue & strength, causing weakness,
Vatavyadhi manifests by getting sited in Sandhi (Joints) & insomnia & constant pain
Vatanadi (Nerves).
Symptoms of Snayugata Vata
Causes Aggrevation of Vayu in the Snayu gives rise to Stambha
● Intake of dry, cold, light, Katu (Pungent), Tikta (bitter), (stiffness), Kampa (Tremors), Shoola (Pain) & Akshepa,
Kashaya (astringent) food, less intake of food Antarayama, Bahirayama, Khalli (neuralgic pain in feet,
● Excessive exercise, exertion, sexual indulgence shoulders etc), hunch back & Vatavikar either Sarvangagata
● Weakness or emaciation or Ekangagata i.e. pertaining to the entire body or part thereof.
● Excessive use of purificatory methods
● Dhatushaithilya Symptoms of Sandhigata Vata
● Suppression of natural urges nefvle meefvOeiele: mevOeerved Metueešesheew keâjesefle Ûe ~ cee.efve.
● Excessive swimming, travelling Aggrevation of Vayu in joints gives rise to severe pain in joints,
● Fall from horse, elephant, vehicle etc. oedema or inflammation of joints, stiffness or looseness in
● Injury to vital organs or marmas like Basti, Hrudaya, Shira joints.
● Injury to sandhi or bone `Atopa' - Joints on palpation appears like a leather bag filled
with air.
In Vatavyadhi 2 types of Samprapti has been mentioned. `Gatatva' The normal tendency of Vayu is to travel throughout
Dhatukshayajanya & Margavarodhajanya the body.
Due to vitiation or improper diet & lifestyle, Vayu gets vitiated in
JeeÙeesOee&leg#eÙeelkeâeshees ceeie&mÙeeJejCesve Jee ~ Ûe.efÛe. 28 quantity (Pramana) and or quality (Guna) and goes into dhatu
According to the Nidan as Dhatukshayajanya or and this phenomenon is called 'Gamitva'.
Margavarodhajanya, the treatment will be different.
Bruhat Vata Chintamani Rasa
Normally, it is felt that 'gatatva' of Vayu is only of academic
importance. However, in day to day practice Ayurvedic •
The well known Vatanashak kalpa
physicians do come across cases where the diseases cannot specially effective for heart & brain
be 'defined' in the usual way the modern science does. •
Useful in Dhatukshayajanya Vatavikar,
However, what the patient need is relief which can be provided Sandhigata Vata, Restricted
only if the diagnosis is perfect. movements or loss of activity in
Based on some specific symptoms, most commonly found Pakshaghata, Ardita, Unmada,
gatatva cases can be treated with success. For differential Apasmar & in symptoms of Hrudroga
diagnosis, couple of commonly seen gatatva symptoms are such as Palpitation, dyspnoea on
given below. exertion, feeble pulse

Differential Diagnosis
Sandhigata Vata Amavata Vata Rakta
1. Sandhishoola (Joint Pain) Present Present Present
2. Sandhishotha
(Oedema/Inflammation of joints) Present Present Present
3. Painful actions Present Present Present
Less actions & Immobility
4. Starting from Big joints Big joints Parvasandhi
(Carpellar joints)
5. Associated with fever Yes/No Yes Yes
6. Tenderness Present/Absent Severe +++ Present
7. Ushna Sparsha (hot sensation) Present/Absent Present Present
8. Sanchari Vedana (fleeting pain) Absent Present Absent
9. Dosha-Dushya Vata Vata + Ama Vata+Rakta
10. Other symptoms Stiffness in joints Vruschikadamshaavata Vedana Manifestation of
(Pain like sting of Scorpio) papules in
parvapradesh
(carpels)
11. Relif from snehan Yes/No No Yes/No
12. Swedan Sneha/Rooksha Sweda Rooksha Sweda Anupashaya
from Swedan
6

Knowledge Hardwork Dedication & Service


An Ayurvedic Physician by the name Vd. Shailesh Nadkarni
I had the pleasure of meeting Vd Shailesh Nadkarni adjustment whose pain was never shown. Hardworking
in around the year 1999. Its amazing now to mention at all times and dedicated to the task at hand.
that it has been only 7 years while in actuality it seems
he has been with us the whole of 135 years. He came A display of his depth of Knowledge is experienced
across as a young Ayurvedic Physician who had no when he navigates through his hours of study and
qualms of being introduced as Vaidya in an era of brings forth the wisdom in practice. A successful
Doctor. This is one of the first aspects regarding his physician is one who enters the treatment through the
personality that strikes you and makes a lasting mind of the patient. Medicine, diet, lifestyle are mere
impression. His background of BSc with BAMS and tools when this mental state is a bond between
then later MD in Kayachikitsa only goes on to refurbish Physician and Practitioner. Vd. Nadkarni's success in
his credentials as a man of science and a health care practice is this unique feature which distinguishes him
practitioner. apart from his peers and teachers. You have to be born
with people skilCd he is probably living his nth life on this
One is initially taken aback with the observation that gift of influencing and charging positively all that comes
his life has been scheduled 24x7. Even in the time in contact with him. In his current life we see this
without Shree Dhootapapeshwar in his life, his every strength of fusing people and teams, in perfection. This
day and hour ( 0800 hrs to 2200 hrs) was allocated to an facilitates the ground work for good delivery of health
activity. Multi centric Ayurvedic practice, associate care and naturally his patients enjoy the fruits of
teaching faculty, University teaching courses, Ayurved in this approach.
editorship of an upcoming Ayurvedic journal and
sufficient time to do 'good' for all around is what is seen. Patience to listen, allowing the patient to talk at
Joining Shree Dhootapapeshwar overturned his life in length during his first interview, never rushed and
many ways but he coped with it with élan and always attentive with retentive memory of details is what
makes him a satisfying health care
experience. Its bad enough to be a
patient of whatever ailment but to get
his magic touch is a relief that the
phase of ill health is short lived. There
are instances of chronic disorders
being treated and numerous
examples of an Ayurvedic approach
at work. He has never claimed magic
nor siddhi but delivered relief. He has
never barked on a telephone inspite
of being incessantly disturbed or
irrationally tapped. Seemingly
incurable and tired patients cursed to
a life of sufferance have gained from
his insight and approach. Families
have been blessed with extensions
Vd. Shailesh Nadkarni receiving the Vd. M.V. Kolhatkar Sanshodhan Puraskar at the
and scores of us have benefitted from
hands of Vd. Shriram Guruji at Pune in presence of Dr. Mrs. Shubha Rawool, Mayor of a more suited approach to our health
Mumbai & Vd. S.P. Sardeshmukh, Chairman, Bharatiya Sanskruti Darshan Trust, Pune issues.
7

You need to be honest and disclosing to gain and Vd. P.Y. alias Dada Khadiwale of Vaidya Khadiwale
we all have. In many ways he represents that security Vaidyak Sanshodhan Sanstha, a giant of our times,
that a family requires in health care and the best part is successful practitioner, teacher, manufacturer, role
that he is 100% Ayurvedic. model and motivator in the Ayurvedic sector has been in
contact with Vd. Nadkarni for the past few years. He has
Understanding limitation in self and practice and observed and rightly recognised Vd. Nadkarni by
never hesitant to cross refer to a more relevant and bestowing him the Vaidya M.V. Kolhatkar
suited line of treatment. Safe effective and a true Sanshodhan Puraskar 2007 for notable contribution
proponent of the wisdom the seers compiled to meet the in the field of Research and Development of
challenges of today with ease and relevance, as if Ayurvedic Medicines. Its timely, deserving and an
Ayurved was written with this individual patient in mind. honour for Vd Nadkarni and all of us in Shree
What more does one want from a family Physician who Dhootapapeshwar to be beside him in receiving this
is shastra shuddha. prize. Its not the first time Vd Shailesh Nadkarni has
been recognised and is certainly not the last.
'Students' a very major association in his life. Closer
than relatives and almost family. Out and out teaching Thank you and our gratitude to Vd Khadiwale and
all the time in one way or the other. Taking sheer his team of counsellors who made this right choice.
pleasure of accomplishment in the achievement of his
students. Guiding and counselling a good mind set and Congratulations Vd Nadkarni from all of us at Shree
supporting hard work. Not just associating with students Dhootapapeshwar, you make us proud. Deepest of
when they are students but to even participate in their appreciation to Devang, (Swapna) and Vd Devki
victories as their practice takes grip and when their life Nadkarni, who stand rock solid in support of Vd
takes the strangest of up's and down's, this Professor Nadkarni whilst he rises from strength to strength.
Nadkarni is something a student knows is there -
beside, behind and in front. Some of us from the outside Ranjit Puranik
can only hope in the next life we will be fortuned with CEO
Shree Dhootapapeshwar Ltd.
such a guide. Till then it is better to just relish our current
association.

“Never hesitate from stating your mind and beliefs”,


“truth will prevail”, “stay calm and face the situation”, “if
there has been a mistake / lapse, admit it and move
on...” are the oft repeated sentiments of this colleague
at work. Vd Nadkarni assimilated himself in corporate
stream with minimum of hiccup. In his first few months
we often heard him asking the basics of “how” and
“what” but never “why”, in following a corporate policy
which he did not understand nor completely agreed
with. Never hesitating to speak to all at work and never
understanding the rungs of the invisible corporate
ladder this “friend” assimilated himself in the office Vd. P.Y. Khadivale
environ like a perfect fit. High energy, scrupulous A personality Dedicated to Ayurved
detailing and ready to learn still learning, all new skills
Founder
required to excel. Its been a treat and promises to be a
feast in the coming times to be alongside. Vd. Khadivale Vaidyak Sanshodhan
Sanstha, Pune
8

Vatavyadhi
Sandhigata Vata giddiness.
JeelehetCe& ÂeflemheMe&: MeesLe: meefvOeielesÓefveues ~ Pakshaghat
ØemeejCe Deekegâ_ÛeveÙees: ØeJe=efòeßÛe mebJesovee ~~ Ûe.efÛe. 28
ie=nerlJeeOeË& leveesJee&Ùeg: efmeje: mveeÙetefJe&Mees<Ùe Ûe ~
The disease in which joints become oedematous & on he#ecevÙelejb nefvle meefvOeyevOeeefvJecees#eÙeved ~ cee.efve.
palpation appears as if it is a leather bag inflated with air.
Joints are painful during extention & contraction, is termed as Paksha is hand, foot or one side of the body. Vitiated Vayu
Sandhigata Vata. vitiates Sira, Snayu and Kandara in half of the body. It looses
Vayu gets aggrevated in 2 ways; the muscle tone in one part of body.
i)by the diminution of tissue elements (Dhatukshayajanya) There is difficulty in movements of hands & limbs & loss of
ii)by the occlusion of srotas (Margavarodhajanya) sensation in either whole or half part.
Nirupstambhit Upastambhit Symptoms
(Dhatukshayajanya) (Margavarodhajanya) Difficulty in movements in either hands or limbs, slurred
Symptoms - speech, loss of control on excretory organs.
•Vatapurnadrutisparsha Affects most of the large &
movable joints Ardit

Shoola Severe tenderness in joints `Ardita' is the disorder which is affecting half part of the face. It

Restricted movements Dourbalya manifests with attacks & during attacks there is pain.

Immobility of joints Araktavarna (Redness or The Vata situated in face & head gets aggrevated & affects
Inflammation in joints) one half part of face. Consequently face & neck gets crooked,

Dourbalya Ushna sparsha, Jwara, trembling of head, tremors, slurred speech, pain in teeth &
(Warmness felt over joint) neck, causing stiffness or locked jaw.

Loss of activity Sanchari Vedana Amavata
(fleeting type of pain) Treatment of Pakshaghat
Chikitsa-Treatment
Snehan Rooksha Sweda
mJesoveb mvesnmebÙegòebâ he#eeIeeles efJejsÛeveced ~ Ûe.efÛe. 28
Swedan Mrudu Anuloman External Snehan (massage with oil) locally as well as whole
Shaman Niruha Basti body & internal snehan is advisable in Pakshaghata.
Brumhan Guggulkalpa For external massage Bala Taila, Narayan Taila.
Use of Bhasma & balya drugs Yogaraj Guggul Swedan (Fomentation) Bashpa Sweda
Mahayogaraj Guggul Vatavidhwansa Sneha Virechan - The main treatment of pakshaghata is to
Maharasnadi Kadha maintain proper direction of Prana i.e. downward direction. Its
Suvarnakalpa dushya are Sira, Kandara, Pitta & Rakta whose treatment is
Bruhat Vata Chintamani Chaturmukh Rasa virechan. Therefore Sneha Virechan is advised in
pakshaghata. e.g. Erandasneha or Gandharvaharitaki

Useful products
Bruhat Vata Chintamani Rasa, Mahayogaraj Guggul,
Yogendra Rasa, Chaturmukh Rasa, Sameerpannag
Rasaraj Rasa
`meJe&JeeleefJekeâejs<eg jmejepe: Øekeâerefle&le: ~'
Sandhigata Vata Manyakasherukagata Vata

The best rasayan & tonic (balya) for
Vatanadis (nerves) specially effective in
Manyakasherukagata Vata disorders of Vertebral column
Spondylysis, the disease as the name given by modern •
The Suvarnakalpa effective in chronic &
medicine is most common & known as Manyakasherukagata Dhatukshayajanya Vatavyadhis with
Vata by Ayurvedic fraternity.This Vatavyadhi is very common action on Majjavaha Srotas & Mastishka
disorder seen nowadays due to dysfunctioning or abnormality
in cervical vertebrae & nervine irritation.
The manifestation of symptoms like pain in neck, tingling
sensation in hands alongwith loss of sensation or numbness,
Yogendra Rasa
Suvarnakalpa
● with pure, safe & standardized
Panchamrut Loha Guggul Suvarna Bhasma & Vanga Bhasma
• Manyakasherukagata Vata- Most effective in all vatavikar with action

Panchamrut Loha Guggul + as Rasayan & Bala, Veerya &
Dashamoolarishta Smrutivardhak
• Avabahuk - Panchamrut Loha Guggul + •
Useful in Jeerna Vatavyadhi, Ardita,
Maharasnadi Kadha + Sthanik Swedan
Pakshaghata, Prameha, Unmada,
• Grudhrasi - Panchamrut Loha Guggul +
Apasmar
Vatavidhwansa + Maharasnadi Kadha
Useful in sensory loss

+ Sthanik Snehan, Swedan
9

Vatavyadhi

Grudhrasi Vatarakta
The disease in which person walks like vulture is named as Vatarakta is the disease caused by vitiation of Vata & Rakta.
Grudhrasi. In this disease, the first symptom is stiffness, pain Both Vata & Rakta get aggrevated due to their own etiological
specially pricking pain in 'Sphik Pradesh' hip region (i.e. waist, factors. Vata gets obstructed by the vitiated blood & gets
back, thigh, knee & calf region) hence, it is called as 'Sphik localized in the phalanges & toes and thereafter other joints
Purva' are afflicted. It develops Shotha
(oedema/swelling in joints), pain,
Heeef<Ce&ØelÙeÓ*iegueerveeb leg keâC[je ÙeeÓefveueeefo&lee ~ tenderness, redness & warm touch. In this
MekeäLve: #eshes efveie=åCeerÙeeod ie=OeÇmeerefle efn mee mce=lee ~ meg.efve. 1/74 disease small joints are mainly affected. It
is also described as Adhyavata or
The sthoola kandara (tendon) below ankle joint related to Vatashonita.
ankle & toes get affected with Vatadosha & stops action of
limbs is called as Grudhrasi.
Symptoms
●Severe pain in joints
Symptoms
●Pain starts from carpellar joints i.e. from fingers or toes and
● Pain in hip/lumbar region which spreads through back, hip, then spreads to all other joints
thigh, knee ankle upto soles
●Swelling, pricking pain, redness, itching in the joints region
● Stiffness in hip & knee joint
●Joints are warm in touch
● Pricking pain
●Severe tenderness or insensibility to touch
● Immobility or restricted movements
●Jwara
● Deformity in joints
●Twitching sensation or tremors
●Discolouration of skin & appearance of circular patches over
Treatment the body
Snehan -
Vishagarbha Taila
Swedan -
Nadisweda, Avagaha Sweda General Treatment
Vedana Prashama Vatavidhwansa - Snehan, Virechan, Basti, Raktamokshan
Basti, Agnikarma -
Sushrutacharya has specifically Virechan - Mruduvirechan (mild purgative)
mentioned treatment like Siravedha Basti - Anuvasana, Niruha
& Agnikarma in certain Vatarogas. Raktamokshan - Siravedha/Jalaukavacharan
Grudhrasi is one of them. Parishek
In Grudhrasi Siravedha & Agnikarma is to be performed in Pradeha
between Kandara & Gulfa.
Types of Vatarakta
Useful products
● Trayodashang Guggul Uttana Gambheera
● Vatavidhwansa Symptoms
● Vatavidhwansa (Maha) Rasa (Jayapalyukta) ●Itching Oedema
●Burning sensation Stiffness
●Pain Hardness
Vatavidhwansa (Maha) Rasa (Jayapalyukta) ●Extension Excruciating pain

The best Amashoshak, Vedananashak, ● Pricking pain Burning sensation
Shothaghna & Vatashamak kalpa ●Throbbing sensation Pricking pain
Black or coppery Twitching sensation


Useful in Vatavyadhis like Grudhrasi,
colouration of skin
Amavata, Vishwachi, Avabahuk,
Manyagraha with symptoms like Treatment
Stambha (stiffness), Shoola (pain) & Application of ointments
Shofa (Oedema) Alepana (Pradeha, Lepa) Virechan (purgation)

Useful for virechan in pakshaghata due Abyanga (massage) Asthapana Basti
to ingredient Jayapala Parisheka Snehapana
(kwath/swaras) (affusion)
Trayodashang Guggul
• The most admirable vatashamak & balya, rasayan Kaishor Guggul
Guggulkalpa • The potent Vatahar & Raktagata doshapachna action
due to Amruta Vishesh Shodhit Guggul
Amayik Prayog • Helpful in Vatarakta with Shoolahar &
Grudhrasi - Trayodashang Guggul
Vedanasthapan action
+ Maharasnadi Kadha
Amayik Prayog
Sandhivata - Trayodashang Guggul
Vatarakta - Kaishor Guggul + Guduchi
+ Vatavidhwansa
Choorna + Dashamoolarishta
+ Dashamoolarishta
Kushtha - Kaishor Guggul +
Sandhigraha - Trayodashang Guggul +
Mahamanjishthadi Kadha
Vatavidhwansa (Maha) Rasa
10

Memorable Moments

Release of the book, `Ayurvediya Aushadhikaran' at the


hands of Union Health Minister, Dr. Ambumani Ramadoss at
World Ayurved Congress organized by Pune University (Left
to Right Vice Chancellor, Pune University, Dr. Narendra
Jadhav; Vd. Shailesh Nadkarni, General Manager,
Healthcare Services, Shree Dhootapapeshwar Ltd., Dean of
Ayurved Faculty, Dr. V.V. Doiphode and Shri. Ranjit Puranik,
Chief Executive Officer, Shree Dhootapapeshwar Ltd.

Shree Dhootapapeshwar Ltd. being given the Nagarjuna


Award for its Standardised and Best Quality medicine
production. The award being received by Chief Executive
Officer, Mr. Ranjit Puranik, from the then Vice President, Mr.
Bhairavsingh Shekhawat (Left to Right Vd. Devendraji
Triguna and Vd. Shriramji Sharma the then President,
C.C.I.M.)

Release of Clinic Management System (C.M.S.) C.D. at the


hands of the then Governor Rajasthan, Smt. Pratibhatai Patil
at the 57th Plenary of All India Ayurved Congress (Left to
Right Vd. R.H. Singh, Vice Chancellor, Rajasthan Ayurved
University; Vd. Devedraji Triguna and Ex-Chief Minister of
Rajasthan, Mr. Gehalot)

Ex-Chief Minister Rajasthan, Mr. Gehalot, Smt. Pratibhatai


Patil visited Shree Dhootapapeshwar Ltd. stall at 57th All
India Ayurved Congress and gave compliments to Swamala
Compound (Left to Right Ex-Chief Minister Mr. Gehalot and
then Governor of Rajasthan Her Honour Pratibhatai Patil)
11

Memorable Moments

Shree Dhootapapeshwar Ltd. stall at "Arogya 2007" an event


and exhibition organized at Pragati Maidan, New Delhi on
26th to 29th October 2007

Shree Dhootapapeshwar Ltd. stall at "Arogya 2008" an event


and exhibition organized at Lal Bagh Palace, Indore on
4th to 7th January

Release of `Arogyamandir Patrika - Skin Disorders' at


"Arogya 2008", Indore, Madhya Pradesh, at the hands of
(Left to Right) Dr. S.K. Sharma, Respected Advisor, Ayush
Department, New Delhi and The Minister for Medical
Education Dr. Gauri Shankar Shejwar

In this issue of 'Arogyamandir Patrika’ , we have Maharasnadi Kadha, Dashamularishta,


discussed the different cause, sign and symptoms of Ashwagandharishta are the products from our
“Sandhivikar” with the line of treatment proved to be Standarised ‘Asava Arishta Kadha’ range which
beneficial along with Ahar Vihar. offers the great benefit for such conditions in
As you are aware that in such conditions we offer ‘Sandhivikar’.
you the range of ‘GuggulKalpa’ like ‘Mahayograj Doctor, you have the experience of the quality
Guggul, Yograj Guggul, Panchamrut Loha Guggul, medicines of Shree Dhootapapeshwar Limited in your
Kaishor Guggul, Trayodashang Guggul’ which not only day to day practice and continuing your patronage for
guarantee better results but also ensures a) Fast the same for which we are thankful and oblige.
disintegration (less than 30 min.) & absorption b)No We reconfirm and resolve to be in the service in the
side effects like gastric irritation or skin rashes. Ayurved being the manufacturer of ‘Authentic,
Products from our 'Suvarnakalpa’ range useful for Standardised, Safe and Efficacious’ products as we
such conditions like Brihat vata Chintamani Ras, have been for last 125 years.
Chaturmukh Ras, Rasaraj Ras not only has Survanra
Bhasma containing more than 97% Survarna but also With warm regards
gives you the confidence of being non toxic and safe P. N. Joardar
even when used for prolonged duration. Sales Manager
12

Amavata
Upanaha (hot poultice)
Guduchi (Vyadhipratyanik drug)
Useful product Kaishor Guggul
Amavata, the disorder caused
due to Rasavaha Srotas
vitiation, similarly the symptoms Osteoporosis
developed due to Rasadushti.
But as the manifestation & The process of bone thinning or degeneration (Osteoporosis)
localization is in joints, showing is a natural part of aging. Still after certain limit the bones
symptoms as Sandhishoola & become porous or their density is less, causing the fractures of
Sandhishotha (pain & oedema bones or bone loss.
in joints) it has been included in Sandhivikar for purpose of
differential diagnosis. Symptoms -
This is the acute disease in which there is vitiation of vata &
formation of Ama both at the same time with manifestation in • Back pain
joints. • Loss of height & stooped posture
ÙegiehelkegâefheleeJevleefŒekeâmeefvOeØeJesMekeâew ~ • A curved upper back (dowager's hump)
mleyOeb Ûe kegâ®lees iee$eceeceJeele: me GÛÙeles ~ cee.efve. • Bone get cracked (fracture) even with minor injury,
especially in the hip, spine & wrist
The disease can occur at any age but mainly it affects in
middle age. It is very painful & serious disease.
Treatment -
Symptoms -
● Body ache, Loss of taste, thirst The early diagnosis of Asthikshaya (Osteoporosis) is very
● Lack of enthusiasm, heaviness in the body important as far as treatment is concerned. If the treatment is
● Fever given early, one may be able to stop or slow the progress of
● Oedema, Indigestion bone loss.
● Pain & inflammation in big joints of hands & legs like hip,
knee, ankle, elbow, wrist etc. Ahara -
● Severe tenderness, redness, warm touch Milk, Wheat, Ragi,
● Immobility of organs of body
● Fleeting pain shifting from joint to joint Vihara -
Regular proper exercise, Prevent fractures, Maintain or
Treatment - increase bone thickness, Increase physical ability
uebIeveb mJesoveb efleòeâoerheveeefve keâšgefve Ûe ~
efJejsÛeve mvesnheeveb yemleÙeMÛeececee®les ~ Aushadhi -
Useful for increasing Bone Mass Density.
The main treatment is to destroy Ama. For Amapachan,
Langhana (Fasting) with use of Tikta (bitter) & Katu (pungent) Asthiposhak Dravya - Laksha, Shatavari, Praval,
Lakshadi Guggul
Kukkutandatwak Bhasma
drugs are advised.
• Useful Asthisoushiryajanya Sandhishool & Asthibhagna
Amapachan
● - Langhan, Tikta-Katu Rasatmaka Dravya
Snehan - Mrudu
• Beneficial Snehan
in Asthibhagnottar Sandhishool
Swedan
● - Rooksha Sweda, Valukasweda Sneharahit
Upanaha
Virechan
● - Erandsneha Vyadhipratyanik Asthisoushirya - Lakshadi Guggul +
Praval Panchamrut +
DeeceJeele iepesvõmÙe MejerjJeveÛeeefjCe: ~ Kukkutandatwak Bhasma
SkeâcesJee«eCeern&efvle Sjb[mvesnkesâmejer ~ Asthibhagna - Lakshadi Guggul +
Erandsneha or Castor oil is the first line of treatment in Kukkutandatwak Bhasma
Amavata. + Ashwagandharishta
● Basti - Vaitaran Basti Prayog Asthibhagnottar - Lakshadi Guggul +
● Herbal drugs - Erandasneha, Guduchi, Shunthi, Shool Dashamoolarishta
Bhallatak, Karaskar, Suvarna
Useful products -
Sinhanad Guggul, Vatavidhwansa, Vatavidhwansa (Maha)
Rasa (Jayapalayukta) For more details please contact:
Health Care Services
In the Jeernavastha (chronic condition) of
Amavata
Sinhanad &Guggul
in Dhatukshayajanya Amavata
Suvarnakalpas
● The wellknown areremedy
best Rasayan
of Amavatawhich
with Shree Dhootapapeshwar Ltd.
prohibits recurrence.Erand taila
Vyadhipratyanik 135, Nanubhai Desai Rd., Khetwadi, Mumbai - 400 004
● Excellent Vatahar, Shothahar, Shoolahar Tel. No: 91-22-3003 6300 Fax: 91-22-2388 1308
& Amanashak Kalpa e-mail: healthcare@sdlindia.com
● Beneficial in Amavata with main action of website: www.sdlindia.com
virechan