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तमक श्वास (asthma/ दमा रोग) – कारण, लक्षण एवं चिकित्सा

Asthma क्या है?

अस्थमा श्वसन तंत्र (respiratory system) का रोग है जो वायुमार्गों के संकुचित होने के परिणामस्वरूप होता है। ठंडी हवा, प्रदूषित हवा, भावनात्मक तनाव, अत्यधिक व्यायाम, अनुवांशिक  आदि कारणों के प्रतिक्रिया स्वरुप जब हमारे श्वसन तंत्र के वायुमार्ग संकीर्ण हो जाते हैं तो छाती की जकड़न, सीटी की आवाज जैसी सांस चलना, खाँसी और पूरी सांस ना आना आदि लक्षण दिखने लगते हैं। इस लेख में अस्थमा की चिकित्सा का संक्षिप्त वर्णन है (Asthma Ayurvedic View)

Asthma के बारे में आयुर्वेद क्या कहता है? (Asthma Ayurvedic View)

आयुर्वेद में श्वास रोगों के बारे में विस्तृत वर्णन प्राप्त है, जिसके अंतर्गत तमक श्वास रोग के लक्षण asthma के सादृश्य है।

श्वास रोग के कारण एवं संप्राप्ति

धूल,  धुआं, तेज धूप, ठंडी हवा, फेफड़ों या सीने में अभिघात (चोट लगना), ठंडा पानी पीना, संक्रमण, अनुवांशिक इत्यादि। इन कारणों की वजह से कफ दोष श्वासनलिकाओं, जो कि प्राणवायु का मार्ग है, को अवरुद्ध कर देता है। जिसके परिणामस्वरूप वात दोष कुपित होकर प्राणवह, उदकवह तथा अन्नवह श्रोतसों को दूषित कर श्वास रोगों को जन्म देता है।

तमकश्वास रोग के लक्षण

  • शिर, गर्दन, सीने में जकड़न एवं दर्द युक्त खांसी
  • गले में घुरघुराहट, अरुचि, पीनस, तृष्णा
  • कष्टदायक तीव्र वेगयुक्त सांस चलना, आँखों के आगे अँधेरा छाना
  • लेटने पर सांस लेने में तकलीफ एवं बैठकर सांस लेने में सहजता महसूस करना

तमक श्वास चिकित्सा

यह प्रायः याप्य होता है, परन्तु बलवान रोगी का नया तमक श्वासरोग साध्य है।

तमक श्वास में सामान्य औषधीय व्यवस्था पत्र

  1. नायोपायम क्वाथ 10 ml + दशमूलकटुत्रयम क्वाथ 10 ml + 60 ml सुखोष्ण जल, प्रातः सायं नाश्ते एवं भोजन से 1 घंटे पहले
  2. Shwasan Capsules, Septivite Capsules, Ayurvite Rudanti Capsules, तीनो से 1-1 कैप्सूल प्रातः सायं भोजनोपरांत
  3. च्यवनप्राश अवलेह 10 gm (1 चम्मच) प्रातः नाश्ते से 1 घंटे पहले। (c.i. Diabetes)
  4. अगस्त्य हरीतकी/ दशमूल हरीतकी 10 gm (1 चम्मच) रात में सोते समय सुखोष्ण जल से। (c.i. diabetes)

रोग एवं रोगी के बलाबल एवं अवस्थानुसार अन्य औषध निर्देश

  • लक्ष्मीविलास रस
  • श्वास कुठार रस
  • अगस्त्य हरीतकी लेह्य
  • दशमूल हरीतकी लेह्य
  • सितोपलादि चूर्ण- कफ की अधिकता में
  • श्वासकास चिंतामणि रस (स्वर्णयुक्त)- रोग की तीव्रता में, दौरा दूर होने के बाद पित्त की प्रधानता पर, अजीर्णजनित तमक श्वास में, हृदयरोग के साथ होने पर, वृद्धावस्था में, तम्बाखू व्यसनी में, श्वास कृच्छ्ता में, वंशानुगत में, दुर्बलता में।
  • चतुर्भुज रस- श्वास कृच्छ्ता में।
  • श्रृंगाराभ्र रस- कफाधिक्य में, अधिक बलगम आने पर।
  • स्वर्णबसंत मालती रस- श्वसनतंत्र सम्बन्धी सभी रोगों में विशेषतः वातपित्तज भेद में, वृद्धावस्था में, वंशानुगत में, दुर्बलता में।
  • कफकेतु रस- कफाधिक्य होने पर।
  • कनकासव- पित्त प्रधानता एवं पित्तज प्रकृति वालों को न दें।
  • चन्द्रामृत रस- सूखी खांसी या खांसी के साथ खून आने पर।
  • वासावलेह- केवल कफज अवस्था या रक्त आने पर प्रयोग करें, सूखी खांसी में न दें। वातानुबंध अवस्था एवं वृद्ध रोगी में इसका प्रयोग सतर्कता से करें अन्यथा खांसी बढ़ सकती है।
  • तालीसादि चूर्ण- शुष्ककास युक्त श्वास रोग
  • रसमाणिक्य- संक्रमण एवं शोथ में, राजयक्ष्मा के साथ।
  • रसकर्पूर- तीव्र वेग में।

रसौषधियों एवं स्वर्ण रजत मुक्त युक्त बहुमूल्य औषधियों का अन्नावश्यक प्रयोग न करें। यह अवधारणा निकाल दें कि सिर्फ स्वर्णघटित योग या रसयोग ही रोगमुक्ति का उपाय है। रोग की तीव्रता, तत्काल लाभ या अन्य औषध प्रयोग के विफल होने पर ही इनका प्रयोग करें।

तमक श्वासरोग में पंचकर्म चिकित्सा निर्देश

  1. सर्वप्रथम वमन या विरेचन हेतु रोगी परीक्षण करें। यदि योग्य हो तो स्नेहपान से पूर्व रुक्षणार्थ 3 दिन त्रिकटु चूर्ण 5 gm या Ayurvite Trikatu Capsule 1 प्रातः सायं सुखोष्ण जल से दें।
  2. चौथे दिन से उचित स्नेह का निर्धारण कर स्नेहपान विधि अनुसार 5 से 7 दिन स्नेह पान करवाएं।
  3. सम्यक स्निग्ध लक्षण आने पर स्नेहपान बंद कर 2 दिन अभ्यंग एवं वाष्प स्वेदन करें। इसके बाद एक दिन विश्रामकाल के लिए छोड़कर प्रातः अभ्यंग, वाष्प स्वेदन कर वमन या विरेचन कर्म करें। सम्यक शुद्धि लक्षण अनुसार 3 या 5 दिन संसर्जन कर्म करें।
  4. यदि रोगी वमन या विरेचन के योग्य ना हो तो श्वासरोग हर यथाविधि वस्ति भी दी जा सकती है।

आयुर्वेद में अन्य अनेक औषधीय एवं पंचकर्म प्रयोग वर्णित हैं। हमने यहाँ हमारे चिकित्सा केन्द्रों में प्रयोग किये जाने वाले योगों का वर्णन किया है। आपके सुझाव एवं प्रतिक्रियाएं सादर अपेक्षित है।

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Osteoarthritis (संधिवात) – Sign, Symptoms, Treatment in Ayurveda (Hindi)

Osteoarthritis (संधिवात) क्या है

Osteoarthritis या degenerative joint disease, एक जीर्ण संधिगत रोग है जो कि arthritis का ही एक प्रकार है। हमारे शरीर के सभी संधि (joints) स्नायु एवं पेशियों  से कसे हुए रहते हैं जिससे उनकी सुरक्षा एवं गतिशीलता सुनिश्चित हो सके। इन्हीं स्नायुवों को आधुनिक विज्ञान में cartilage कहा जाता है। Cartilage हड्डियों एवं जोड़ों के चारों तरफ लिपटकर गद्दे की तरह उसकी सुरक्षा करता है।

जोड़ों के स्नायुं तंत्र में क्षरण (degeneration) की स्थिति होने पर स्नायु की कोशिकाएं टूटने लगती हैं जो कि osteoarthritis की प्रमुख वजह होती है। Cartilage के क्षरण (Cartilage breakdown) के कारण हड्डियाँ आपस में रगड़ने लगती हैं जिसकी वजह से दर्द एवं गतिशीलता की कमी जैसे लक्षण देखने को मिलते हैं।

सामान्यतः उम्र के मध्य में एवं बुजुर्गों को osteoarthritis की तकलीफों का सामना करना पड़ता है। इसका प्रभाव मुख्य रूप से घुटनों, हाथों, कमर एवं गर्दन के जोड़ों पर होता है।

सामान्य बोलचाल में rheumatoid arthritis, gouty arthritis एवं osteo arthritis तीनों रोगों को arthritis कह दिया जाता है, परन्तु ये तीनों अलग अलग रोग हैं एवं तीनों रोगों के कारण, लक्षण एवं चिकित्सा अलग अलग होती है। सिर्फ जोड़ों या हड्डियों में दर्द होना ही एकमात्र समानता है।

Osteoarthritis के बारे में आयुर्वेद क्या कहता है?

आयुर्वेद के अनुसार osteoarthritis वातदोष के प्रकुपित होने पर होने पर होता है, एवं इससे मुख्यतः हमारे जोड़ या संधि प्रभावित होते हैं। इसीलिए इसे संधिवात रोग कहा जाता है।

वात दोष हमारे शरीर में वायु तत्व या हवा का प्रतिनिधित्व करता है जो शरीर के सभी गतियों, प्रवाह एवं मष्तिष्क को नियंत्रित करता है।

संधिवात में वात दोष विशेषतः संधियों में बढ़ने लगता है। चूंकि रुक्षता वात का प्रधान गुण है, वह शरीर के स्नेह (fluidity) का अवशोषण करता है। वात शरीर का क्षरण एवं अपचय (destructive & catabolic) भी करता है। इन्हीं गुण एवं कर्मों की वजह से वात दोष का संधियों में प्रकुपित या बढ़ने की स्थिति पर वह संधियों से cartilage का क्षरण एवं synovial fluid का क्षय करता है। एवं जोड़ों में दर्द आदि लक्षण उत्पन्न होते हैं।

संधिवात के कारण (Causes of osteoarthritis)

रुक्ष या सूखा, ठंडा या बासी भोजन, अत्यधिक शीत एवं शुष्क मौसम, व्यवसाय की वजह से जोड़ों का अधिक इस्तेमाल होना, मोटापा, जोड़ों में चोट, आनुवंशिकता और बुढ़ापा।

संधिवात के लक्षण (Symptoms of osteoarthritis)

  • जोड़ों में दर्द
  • जोड़ों में सूजन
  • संधियों के हिलने या चलने पर कट कट की आवाज आना
  • संधियों की अकर्मण्यता या कठोरता

संधिवात चिकित्सा (Osteoarthritis treatment in Ayurveda)

संधिवात की आयुर्वेदिक चिकित्सा ना सिर्फ संधियों या स्नायुओं के क्षरण एवं क्षय को रोकता है बल्कि ये क्षीण हुए स्नायु एवं संधि के नवकोशिकाओं के निर्माण में भी मदद करता है। आयुर्वेदिक औषधियों एवं पंचकर्म चिकित्सा द्वारा संधियों में स्नेहांश की वृद्धि होकर उनकी गतिशीलता बढ़ती है एवं जोड़ों को मजबूती मिलती है।

आयुर अमृतम क्लीनिक में हम दोषों की प्रधानता, कारण, लक्षण, काल एवं रोगी के वय की समीक्षा करने के पश्चात आयुर्वेदिक औषधियों एवं आवश्यकतानुसार पंचकर्म चिकित्सा का प्रयोग कर संधिवात की चिकित्सा करते हैं।

यूँ तो आयुर्वेद में वात रोगों की चिकित्सा हेतु अनेक योग एवं परिकल्पनाएं वर्णित हैं, किन्तु इस लेख में सिर्फ हमारे चिकित्सा केन्द्रों में प्रयोग की जाने वाली औषधियां एवं चिकित्सकीय क्रियाओं का वर्णन कर रहें हैं।

नोट: स्वचिकित्सा हानिकर हो सकती है। पाठकों से निवेदन है कि किसी भी प्रकार की स्वास्थ्य समस्या होने पर चिकित्सक से अवश्य संपर्क करें।

संधिवात में सामान्य औषधीय व्यवस्था पत्र (Ayurvedic prescription for osteoarthritis)

  1. आयुरअमृतम वातहर गुगुल/ योगराज गुगुल/ महायोगराज गुगुल/ रास्नादि गुगुल (सभी प्रकार के दर्द में)/ सिंहनाद गुगुल (दोषों के आमावस्था की स्थिति में)/ त्रयोदशांग गुगुल या Ayurvite Arthrozyl Capsules (कमर दर्द, गर्दन के दर्द जिनमें वातनाड़ियां/ nerves भी आक्रांत होती हैं। हाथों अथवा पैरों में झुनझुनी या radiating pain की स्थिति में) – 1-1 प्रातः सायं भोजन के बाद
  2. चंद्रप्रभा वटी – 1-1 प्रातः सायं भोजन के बाद
  3. पुनर्नवादि वटी/ दशमूल घन सत्व टेबलेट – 1-1 प्रातः सायं भोजन के बाद

– मोटापे की स्थिति में Size Zero capsules 1-1 प्रातः सायं भोजन से आधे घंटे पूर्व अवश्य दें।

– कब्ज होने पर एरण्ड तेल 10-20ml रोगी के बलाबल का विचार कर रात में सोते समय गुनगुने दूध या पानी से दें।

जीर्ण संधिवात में उपरोक्त औषधियों के साथ निम्नलिखित औषधियों का भी प्रयोग किया जा सकता है-

  1. आयुरअमृतम वातहर चूर्ण 60gm, गोदंती भस्म 10gm, पुनर्नवा चूर्ण 60gm, त्रिफला चूर्ण/ एरण्डमूल चूर्ण 60gm, दशमूल चूर्ण/ अश्वगंधादि चूर्ण/ शतावर्यादि चूर्ण 60gm – 1-1 चम्मच (4-5gm) प्रातः सायं भोजन से 1 घंटे पूर्व गुनगुने जल से लें।

संधिवात में पंचकर्म चिकित्सा (Panchakarma in osteoarthritis)

  1. आमावस्था होने पर उद्वर्तनं अथवा चूर्ण पिण्ड स्वेद 1-3 दिन या निरामावस्था होने तक
  2. अभ्यंगम, सर्वांग वाष्प स्वेदन या पत्र पिण्ड स्वेद, योग वस्ति या काल वस्ति
  3. जानू वस्ति या पिचु, कटि वस्ति या पिचु
  4. उपनाहम या लेपम
  5. कषाय या तेल धारा (काय सेकम)
  6. क्षेत्रीय नाड़ी स्वेदन
  7. अग्निकर्म

आयुर्वेद में अन्य बहुत से औषधीय योग एवं पंचकर्म चिकित्सा व्यवस्था हैं जिनका निर्धारण चिकित्सक रोग एवं रोगी की अवस्था के अनुसार अपने अनुभव से करता है। ֍֍֍

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Psoriasis (किटिभ) – Sign, Symptoms, Treatment in Ayurveda (Hindi)

Psoriasis क्या है?

त्वचा रोगों में अप्रत्याशित लक्षणों वाला जटिल रोग Psoriasis सबसे अधिक कष्टदायक होता है। सामान्यतः त्वचा की अंतर्निहित कोशिकाएं नियमित रूप से बनती एवं बढ़ते रहती हैं । वे त्वचा की सतह तक पहुंचती हैं और फिर नष्ट हो जाती हैं । Psoriasis में त्वचा की कोशिकाएं सामान्य से लगभग 10 गुना तेज़ी से बढ़ने लगती हैं। उनकी मात्रा में एकाएक वृद्धि होने की वजह से सफेद, रुक्ष उभार युक्त लाल या कत्थे रंग के चमकीले या धूसर व्रण (patches) उत्पन्न हो जाते हैं।   रुक्षता बढ़ने पर व्रण के उपरी सतह की त्वचा छिलके की तरह निकलने लगती है। सोरायसिस आमतौर पर घुटने, कोहनी और सिर पर होता है।  यह शरीर के अन्य हिस्से जैसे छाती, पेट, पीठ, हथेलियों और पैरों के तलवों को भी प्रभावित कर सकता है। Psoriasis संक्रामक रोग नहीं है। इस लेख में हम सोरायसिस के कारण, लक्षण, आयुर्वेदिक चिकित्सा एवं पंचकर्म के बारे में संक्षिप्त में (Psoriasis treatment in Ayurveda) चर्चा करेंगे।

Psoriasis के बारे में आयुर्वेद क्या कहता है?

आयुर्वेद में Psoriasis का वर्णन कुष्ठ रोगाधिकार में किया गया है। “कुष्ठ” रोग में सभी प्रकार के त्वचा रोगों को समाहित किया गया है। आयुर्वेद मनीषियों ने कुल 18 प्रकार के त्वचा रोगों को कुष्ठ रोगाधिकार में विस्तार पूर्वक वर्णित किया है। इन 18 प्रकार के कुष्ठ रोगों में से किटिभ एवं एककुष्ठ के लक्षण Psoriasis से काफी मिलते जुलते हैं। ये दोष निर्दिष्ट निदान (कारण) जैसे विरुद्ध आहार (उदाहरण – दूध के साथ नमक या खट्टे खाद्य पदार्थ, ठंडे के गर्म खाद्य पदार्थ इत्यादि), तैलीय खाद्य पदार्थों का निरंतर सेवन करने, मानसिक तनाव, छर्दि (उल्टी) के वेग को रोकने के कारण विषाक्त पदार्थों के त्वचा में संचय होने से प्रकुपित होते हैं। ये विषाक्त पदार्थ रस (nutrient plasma), रक्त (blood), मांस (muscles) और लसिका (lymphatic) जैसी गहरी ऊतकों में जमा होते हैं। ये विषाक्त पदार्थ गहरे ऊतकों के प्रदूषण का कारण बनते हैं, जो सोरायसिस को जन्म देती हैं।

दोषों की प्रधानता, समय एवं कारणों के अनुसार बदल सकती है। इसी वजह से कई बार एक कुष्ठ कालातीत होने पर किटिभ के लक्षणों से युक्त हो जाता है अथवा किटिभ, एक कुष्ठ के समान निर्दिष्ट होने लगता है। सभी प्रकार के कुष्ठ रोग त्रिदोषज होते हैं परन्तु दोषों के बलाबल का लक्षणों के अनुसार विचार कर ही चिकित्सा करनी चाहिए।

Psoriasis treatment in Ayurveda (सोरायसिस की आयुर्वेदिक चिकित्सा)

लक्षणों एवं दोष प्रधानता की सही परख एवं अवलोकन करने के पश्चात ही सोरायसिस की चिकित्सा की जानी चाहिए। सोरायसिस के मामलों में आयुर्वेदिक उपचार का प्राथमिक उद्देश्य रक्त और ऊतकों का शुद्धिकरण है। शरीर से विषाक्त पदार्थों को साफ किया जाता है और आगे के संचय को रोकने के लिए आयुर्वेदिक औषधियों का प्रयोग किया जाता है। धातुपोषक, व्रणहर एवं वर्ण्य औषधियों को लेप अथवा तेल के रूप में  त्वचा के पूर्ण उपचार को बढ़ावा देने, ऊतकों को मजबूत एवं सुदृढ़ करने के लिए प्रयोग किया जाता है।

यूँ तो आयुर्वेद में कुष्ठ रोगों की चिकित्सा हेतु अनेक योग एवं परिकल्पनाएं वर्णित हैं, किन्तु इस लेख में सिर्फ हमारे चिकित्सा केन्द्रों में प्रयोग की जाने वाली औषधियां एवं चिकित्सकीय क्रियाओं का वर्णन कर रहें हैं। स्वचिकित्सा हानिकर हो सकती है। पाठकों से निवेदन है कि किसी भी प्रकार की स्वास्थ्य समस्या होने पर चिकित्सक से अवश्य संपर्क करें।

Psoriasis में पंचकर्म

वमन, विरेचन, वस्ति कर्म, रक्तमोक्षण, तक्रधारा, सर्वांग कषाय धारा इत्यादि

दोष, काल, वय एवं रोगी बल का विचार कर उपरोक्त पंचकर्म एवं उपकर्म में से निर्देशित कर रोगी पर प्रयुक्त कराया जाता है। इन कर्मों के पूर्वकर्म एवं पश्चातकर्म का भी चिकित्सक के निर्देशानुसार पालन करना आवश्यक होता है।

Psoriasis की आयुर्वेदिक औषधियाँ

आरग्वाधादि कषायं, मजिष्ठादि कषायं, शोणितअमृतादि कषायं, पटोलादि कषायं, गंधक रसायन, रसमाणिक्य, तालसिंदूर, आरोग्यवर्धिनी वटी, पुनर्नवादि वटी, गिलोय, पंचनिम्बादि चूर्ण, ब्राह्मी, शंखपुष्पी, महातिक्तकम घृतं/ कषायं, गुगुलुतिक्तकम घृतं/ कषायं, Skinzyl Capsules, Septivite Capsules, Livy Capsules, Shayanam Capsules इत्यादि

Psoriasis में सामान्य चिकित्सा व्यवस्था पत्र

पित्त की प्रधानता में

  1. मंजिष्ठादि कषायं, गुगुलुतिक्तकम कषायं – 15-15 ml औषधि 60 ml जल में मिलाकर प्रातः सायं भोजन से 1 घंटे पूर्व
  2. गंधक रसायन, पंचतिक्तघृत गुगुल, Skinzyl Capsules – 1-1 वटी/ कैप्सूल प्रातः सायं भोजन के पश्चात
  3. मणिभद्र गुड़म – 10 ग्राम रात्रि भोजनोपरांत सुखोष्ण जल के अनुपान से
  4. विरेचन कर्म, तक्रधारा

कफ की प्रधानता में –

  1. आरग्वधादि कषायं, निम्बादि कषायं – 15-15 ml औषधि 60 ml जल में मिलाकर प्रातः सायं भोजन से 1 घंटे पूर्व
  2. कैशोर गुगुल, आरोग्यवर्धिनी वटी, Skinzyl Capsules – 1-1 वटी/ कैप्सूल प्रातः सायं भोजन के पश्चात
  3. वमन कर्म, कषाय धारा

वात की प्रधानता में

  1. पटोलादि कषायं, गुगुलुतिक्तकम कषायं – 15-15 ml औषधि 60 ml जल में मिलाकर प्रातः सायं भोजन से 1 घंटे पूर्व
  2. कैशोर गुगुल, आरोग्यवर्धिनी वटी, Skinzyl Capsules – 1-1 वटी/ कैप्सूल प्रातः सायं भोजन के पश्चात
  3. महातिक्तकम घृतं – 10 ग्राम रात्रि भोजनोपरांत सुखोष्ण जल के अनुपान से
  4. वस्ति कर्म, शिरोधारा

नोट- मानसिक तनाव कि स्थिति में शयनम कैप्सूल्स एवं पाचन क्रिया सम्बन्धी अनियमिता में लिवी कैप्सूल्स  का प्रयोग किया जाना लाभप्रद पाया गया है।

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Chikungunya – An Ayurvedic Approach

Chikungunya treatment or Chikungunya joint pain is a common query during and after a monsoon or rainy season. Chikungunya is a viral disease. Its initial sign and symptoms are very similar to dengue fever. Its symptoms include severe and persistent joint pain, body rashes, headache and fever. It is NOT a life threatening disease. In some parts, Chikungunya has also spelt Chicken Guinea, but there is no relation of chikungunya with chicken or guinea. Chicken guinea is just a misspelt word of Chikungunya. In Ayurveda, Sandhi Jwara is found to be quite similar to chikungunya on the basis of their symptoms.

In this article, I will explain about Chikungunya covering following topics –

  1. Introduction to chikungunya
  2. History
  3. Cause – Infection by Chikungunya Virus
  4. Sign & symptoms
  5. Diagnosis
  6. Treatment in Modern Medical Science (Allopathic)
  7. Prevention & Control
  8. Chikungunya - An Ayurvedic approach
  9. Chikungunya Treatment & Management in Ayurveda
  10. Home remedies
  11. Dietary & Lifestyle advice

Introduction to Chikungunya

Chikungunya is a viral disease spread by a mosquito Aedes egypti, the same which is also responsible for dengue fever. Sudden onset of high-grade fever with or without chill accompanied by joints pain is the main symptom of Chikungunya. Fever lasts for 2 to 7 days while joints pain may last for several weeks to several months. Other associated symptoms are skin rashes, fatigue, digestive problems, nausea and vomiting.

History

Chikungunya is first observed in 1952 in Markonde Plateau, along with the border between Tanganyika and Mozambique. The term Chikungunya was first described by W.H.R. Lumsden. According to Lumsden, Chikungunya word is derived from a root verb “Kungunyala”. Markonde people use it to describe a condition “to become contorted” or a condition “which bends up”. By the meaning, it is clear that the arthritic condition is so acute or painful which is reflected through a patient’s posture.

Cause – Infection by Chikungunya Virus

Chikungunya virus (CHIKV) belongs to the family Togaviridae and genus Alphavirus. The vector of this disease is Aedes aegypti mosquito, which is the same responsible vector for Dengue and Yellow fever.

Sign & Symptoms

The incubation period of Chikungunya virus can be 2-12 days, but usually 3-7 days. After this period there is a sudden onset of high-grade fever (>40° C or 104° F) associated with chills, arthralgia (bone, joints and muscle pain), skin rashes, nausea, vomiting, headache, conjunctival suffusion, mild photophobia etc. may be seen. There might be swelling and tenderness of joints of extremities (fingers and toes).

Diagnosis

Clinically, sudden onset of high-grade fever with arthralgia (bone and joints pain) in epidemic condition gives a clue to suspect Chikungunya.

Pathologically, decreased lymphocytes count, with viraemia, virus-specific IgM antigen by ELISA is done to confirm the diagnosis.

Chikungunya Treatment in Modern Medical Science (Allopathic)

Till date, there is no specific treatment available for Chikungunya in modern medical science. The vaccine is under investigation and is not available in the market. Supportive care and symptomatic treatment are recommended which includes NSAIDs (non-steroidal anti-inflammatory drugs) such as naproxen, paracetamol, and fluids. Aspirin is avoided to prevent increased risk of bleeding.

Prevention and control

Chikungunya virus is transmitted to human through a mosquito bite. The best method of its prevention is protection against the bite of virus carrier mosquitoes and controlling their breeding.  The Aedes mosquito lives in fresh stagnant water and bites mostly in the day time.

To prevent mosquito bites, following measures should be followed –

  1. Use mosquito repellant on exposed skin.
  2. Wear long sleeved shirt and full pant to cover the body.
  3. Use mosquito bed net while going to sleep or during day rest time.
  4. Use mosquito repellant devices or vaporisers.
  5. Stay in well-screened

The prevention of mosquito breeding may be done by source reduction, use of larvicide and biological controls.

  1. Source reduction may be done by eliminating all water containing open sources at home or nearby areas like a cooler, open water tanks, flower pot etc. We should not allow water to store more than a week.
  2. Pyrethrum extract (0.1% ready-to-use emulsion) may be sprayed in rooms (not outside) to kill the adult mosquitoes hiding in the house.
  3. Biological controls include the introduction of larvivorous fish, namely Gambusia and Guppy in water tanks and other water sources.

Chikungunya Treatment - An Ayurvedic approach

The concept of communicable disease is very well defined under Janapadodhwamsa (by Maharishi Charaka) and Oupasargik Roga (by Maharishi Sushruta). In Ayurveda, Chikungunya term is not described directly or we can say that there is no direct reference of Chikungunya, but the condition when Jvara/ Jwara (fever) is associated with arthritis or arthralgia can be equated with it. Sandhigat Sannipata Jwara described by Bhava Prakash can be better correlated with Chikungunya. Fever, swelling and inflammation over joints, nausea and vomiting, sleeplessness, cough and body ache are the main symptoms of Sandhigat Sannipata Jwara.

Chikungunya Treatment and Management in Ayurveda

As we know that Chikungunya is not a life threatening disease. Ayurveda is the best choice to manage Chikungunya effectively. Ayurvedic medicines act as a symptoms modifier and general health promoters.

Single Herbs which can be used in Chikungunya treatment are as follows-

  1. Guduchi (Tinospora cordifolia)
  2. Shunthi (Zingiber officinale)
  3. Bhunimba (Andrographis paniculata)
  4. Patha (Cissampelos pariera)
  5. Tulasi (Ocimum sanctum)
  6. Nimba (Azadirachta indica)
  7. Haritaki (Terminalia chebula)
  8. Vibhitaki (Terminalia belerica)
  9. Amalaki (Emblica officinalis)
  10. Manjishta (Rubia cordifolia)
  11. Musta (Cyperus rotundus)
  12. Kutaki (Picrorrhiza Kurroa)
  13. Rasna (Pluchea lanceolata)
  14. Guggulu (Commiphora wightii)
  15. Haridra (Curcuma longa)
  16. Sallaki( Boswellia serrate)
  17. Nirgundi (Vitex negundo)
  18. Ashwagandha (Witahnica somnifera)
  19. Yastimadhu (Glycyrrhiza glabra)

Ayurvedic polyherbal/ herbo-mineral/ metallic formulations used in Chikungunya treatment are as follows -

  1. Amritottara Kvatha – fever and joint pain, health promoter
  2. Gandharvahastadi Kvatha – pain and inflammation, laxative
  3. Chhinnodbhavadi Kvatha - fever
  4. Dasamula Kvatha – fever and chest pain
  5. Darunagaradi Kvatha – acute and chronic fever
  6. Nimbadi Kvatha – fever with a cough
  7. Patoladi Kvatha - fever
  8. Panchatikta Kvatha – fever, immunomodulator, detoxifier
  9. Rasnadi Kvatha – joint pain and inflammation
  10. Rasna erandadi Kvatha – swelling and tenderness of small joints
  11. Maharasnadi Kvatha – joints pain and stiffness
  12. Shadanga kvatha – fever
  13. Amritarishtam – fever, appetiser, general health promoter
  14. Mahasudarshan Gulika - fever
  15. Maha Yogaraj Guggulu – arthritis, joint pain and inflammation
  16. Yogaraj Guggulu - arthritis, arthralgia, joint pain and inflammation
  17. Sudarshan Churna - fever
  18. Ananda bhairava Rasa - fever
  19. Arogyavardhani Gutika – chronic fever and skin rashes
  20. Vettumarana Gulika – fever and pain
  21. Tribhuvana kirti rasa- fever, cold, cough
  22. Eladi Gulika – nausea vomiting
  23. Bilwadi gulika – nausea, vomiting, abdominal gas, diarrhoea
  24. Jatamayadi Churna Lepanam – for local application in joints pain, tenderness and swelling
  25. Kottamchukadi Churna Lepanam - for local application in joints pain, tenderness and swelling

Chikungunya Ayurvedic Medicines by Ayurvite Wellness

  1. Defence Capsules – Recommended for Chikungunya treatment and management of its symptoms like fever, low platelets count, lethargy, and weakness. Buy Now
  2. Arthrozyl Capsules – It is found to be very effective in Chikungunya arthritis and joint pain. Buy Now
  3. Arthrozyl Liniment - A massage oil, highly effective in chikungunya joint pain. Buy Now

For Vector control, Dhoopan (fumigation) is described in Ayurveda.

  1. Astanga Dhuma – Nimba Patra, Haritaki, Yava, Vacha, Kushta, Sarsapa and Guggulu are taken in coarsely grounded They all are mixed together along with Ghrita and burnt.
  2. Aparajitha Dhooma Churna – Vacha, Arka, Devadaru, Gandha trina, Sarja, Nimba, Agaru and Guggulu are taken in coarsely grounded They all are mixed together and burnt.

Home Remedies

  1. Take 2-3 Papaya leaves, remove its base branch. Clean it with water. Make its juice in a grinder by adding little amount of water. Filter and collect it in a bowl. Add 2 teaspoon honey, mix well and drink 2- 3 spoons two to three times a day. This is a very effective remedy for chikungunya treatment.
  2. Make decoction (Kwatha) of Giloy stem, and take 100 ml twice daily. To prepare Giloy decoction, take 40 gm of grated Giloy Boil it in 400 ml water and reduce till it becomes 100 ml. Filter and drink lukewarm. 1-2 teaspoon honey may be added.
  3. Take Tulasi leaves- 7 PC, Ginger- ½ inch, Black pepper- 2 PC. Crush all three and boil in 2 cups of water and reduce it up to 1 cup. Filter it and add1/4 teaspoon turmeric powder, 2 teaspoon honey. Mix well and drink lukewarm. This can be taken twice daily.

Dietary & Lifestyle advice

  1. Always prefer freshly prepared homemade food.
  2. Drink plenty of water and consume more and more liquids or fluid.
  3. Always have light, easily digestible and warm diet.
  4. Don’t forget to use ginger and turmeric while preparing food.
  5. Always avoid cold drinks, carbonated drinks, alcohol, beverage etc.
  6. Avoid visiting the epidemic areas or disease prevalent areas.
  7. Always follow proper sanitation measures.
  8. Prevent skin exposure to the fullest.

This is all about Chikungunya, it’s sign and symptoms, prevention, chikungunya treatment and management. Hope you liked this article. Feel free to let me know about your queries and suggestions in the comment box below.

 

Best Ayurvedic Medicines Recommended in Chikungunya

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Diabetes in Ayurveda – Symptoms and Treatment (Prameha)

Diabetes in Ayurveda

Diabetes is a chronic metabolic disease condition involving the disorder of carbohydrate metabolism. You can find a lot of information on diabetes in various books, journals and on the internet. In this article, I will focus more on what Ayurveda describes diabetes by the term Prameha or madhumeha, its history, types, symptoms and treatment. In short, we can say this article is all about diabetes in Ayurveda. The clinical condition is similar to that of Madhumeha described in Ayurveda under Prameha Roga. Diabetes is a long-term disease with variable clinical manifestation and progression.

Best glucometer to ckeck your sugar level at home

The word, Prameha is derived from the root ‘mih sechane’ meaning ‘watering’. In reference to disease of human beings, many have a meaning of passing urine, qualified by prefix ‘Pra’ meaning excess in both frequency and quantity.

Historical Aspects of Madhumeha

The majority of the description available in the context of Prameha such as Nirukti, samanya Nidana (general causes), Samanya samprapti (pathogenesis) suits Madhumeha if we compare diabetes in Ayurvedic contexts. As Madhumeha is one among 20 types of Pramehas and all the pramehas in due course, if neglected or not treated attain the stage of Madhumeha. Considering all the above points, the description of prameha will also be made along with Madhumeha. Many types of research done so far on Madhumeha in various Ayurvedic centres have equated it to Diabetes Mellitus. So a very brief description of Diabetes Mellitus will be made along with the description of Prameha and Madhumeha in particular.

Mythological Review of Prameha

  • Daivika Yuga- The Adhya Devata Lord Gajanana (Ganesha) suffered from this disease. He had suffered from the disease because of his dietary and working habits. He used to consume the excess of sweets (Modaka) and work continuously in sitting position and his body was also obese. After the attack of this disease, he started to take Kapittha, Jambuphala and Shiva Gutika on the advice by his father Lord Shiva. (As described in Chakradutta Rasayana).

Literary Reviews of Prameha

  • Vedic period- In Atharva Veda (2500 BC) the disease is mentioned as Ashravam, which means Mutra Atisara i.e. excessive urination (polyuria).
  • Samhitha Period- Charaka has described the disease madhumeha in the chapters of sutra stana 17th, Nidanastana 4th, and Chikitsasthana 6th. Sushruta Samhita describes it as Kshaudra Meha in which one passes urine, which resembles honey. It is described in the chapters of Nidana Sthana 6thand chikitsa sthana 11th, 12th and 13th. An exclusive chapter for Madhumeha Chikitsa is available only in Sushruta Samhita In Ashtanga Hridayam, the descriptions of Madhumeha are available in Nidanasthana chapter 10th and Chikitsasthana chapter 12th. In Astanga Sangraha the descriptions of madhumeha are available in the chapters of Nidanasthana 10th and Chikitsasthana 14th, same as Charaka and Sushruta with slight modifications.

Diabetes Mellitus in Modern Medical History

  • Madhumeha can be literally translated as diabetes mellitus as both of them mean honey urine. Diabetes is derived from a Greek word, which means ‘to siphon through’ Mellitus a latin word which means‘Honey’. It had been known to Chinese as a wasting thirst decrease for many centuries and they observed that the urine was so sweet that it attracted dogs.
  • Abrus papyrus- An Egyptian medical compilation (1000 bc) has referred to a condition called polyuria.
  • Celsus (2ndAD) - first clinical clear description of diabetes was given.
  • Aratars of Cappadocia (150AD) - Has mentioned polyuria and thirst. He rightly quoted “mysterious affection not very frequent among man, being a melting down of flesh and limbs into urine, life is short, disgusting and painful, thirst unquenchable, death is inevitable”
  • Thomas Willis (1670AD) - First mentioned the sweet taste of diabetic urine.
  • Mathew Dobson (1776AD) - Demonstrated sugar in urine.
  • Johan Leonard (1682AD) - First thought that pancreas was the cause of polyuria. He experimented on dogs to prove this.
  • Claude Bernard (1813AD -1878AD) - First said about Diabetes. He punctured the 4thventricle of dog’s brain and produced glycosuria.
  • Paul Langerhans (1869AD) - Identified Islets of Langerhans.
  • Kunhana & Lea (1893AD) - Discovered anti-diabetic hormones.

Nirukti (Etymology) of Prameha and Madhumeha

  • Prameha - is derived form Pra + Miha. A condition characterised by the excessive outflow of urine (Acc. To Shabda Kalpadruma).
  • Madhumeha is a compound word made up of Madhu and Meha.
  • Madhu - The word ‘Madhu’ is derived from the root ‘Mana’ and meaning ‘manae bodhane’- which gives Psychic contentment.
  • Meha - The word ‘Meha’ is derived form the root ‘Miha’ which is employed in the sense of sinchana (to moisten), ksharana to flow, prasrava - excessive excretion.

Definition of Madhumeha

Madhumeha is a disease in which urine of the patient is sweet like honey and quantitatively increased as well as astringent, pale and rough (ruksha guna) in quality and the whole body of madhumehi becomes sweet. Many Acharyas also opines the same (Ashtanga Sangraha, Nidana- 10/14; Ashtangahridayama, Nidana- 10/18, 21; Charaka Samhita, Nidana- 4/44; Sushruta Samhita, Nidana- 6/14; Madhava Nidana- 33/26).

Synonyms of Prameha

  • Prameha- Means ‘ Prakarshena Mehati’ - excessive urine outflow.
  • Meha- is referred to as Prameha by Amarakosha.
  • Mootradosha- A urinary disorder.
  • Bahumootrata- a disease where here is excessive urination.
  • Madhumeha- Excess urination resembling honey either in colour or taste.
  • Kshaudrameha- Kshaudra is a synonym of madhu (honey).
  • Ojomeha- Ojas is considered as Tejas or essence of all dhatus, which is a casualty in Madhumeha.

Diabetes Mellitus

  • Definition- Sir William Osler in his book ‘The Principles & Practice of Medicine’ published in 1923 defined Diabetes Mellitus as “a disorder primarily of carbohydrate and secondarily of fat and protein metabolism due to the failure of the system to burn sugar and dependent on the deficiency or absence of internal secretion of pancreas resulting from functional or organic disease of islet cells of Langerhans.
  • According to WHO - A state of chronic hyperglycemia (i.e. a state of having an excessive concentration of glucose in the blood) which may result from many environmental & genetic factors often acting jointly. For more details on diabetes, you may visit WHO website.

Incidence & prevalence of Diabetes

Of late, India has seen a substantial rise in the number of diabetic patients.

  • In the year 1984- 4 million diabetes cases.
  • In the year 1999 – 30 million diabetes cases.

Besides this, there was 1.02 lakh diabetes-related deaths in India in 1999-2000. According to an ICMR survey, it is estimated that between 1995 & 2005, India will name 3.2 crore diabetics.

The prevalence of non-insulin dependent diabetes mellitus is seen in pima Indians where obesity is common. Obesity has a major role in the pathogenesis of diabetes mellitus. About 25% of over weight has a 3 fold risk and 50% of over weight has a 12 fold increased the risk of developing diabetes compared to normal weight individual.

For Country specific and regional data on diabetes, you may consider visiting WHO report.

Nidana (causes) of Madhumeha

The only Charaka explains specific Nidanas for Madhumeha. The samanya Nidanas of pramehas and Vataja prameha may attribute to Madhumeha, as it is one of the types of Vataja prameha.

Samanya nidana of Madhumeha

The key words in samanya nidana of prameha are the hetus (causes), which cause Kapha vriddhi. It becomes contextual here to take note of the fact that kapha is the main dosha involved in prameha and hence all the hetus that cause kapha vriddhi, automatically become the hetus for prameha.

Ahara sambandhi hetu (Causes related to food habit)

  • Adhyashana (intake of food without digestion of previously taken food)
  • Excessive intake of Guru, Snigdha, Sheeta, Manda, Shlakshna, Sandra, Sthira and Pichchhila Guna ahara.
  • Excessive intake of Madhura, Amla, and Lavana Rasa ahara.
  • Excessive intake of Navanna (new grains).
  • Excessive intake of Gudavikara (jaggery based food items).
  • Excessive intake of Dadhi(curd).
  • Excessive intake of Anupa, Oudaka, Gramya mamsa (meat).
  • Excessive intake of Medovardhaka ahara (high-calorie diet).
  • Excessive intake of Kaphakara ahara.

These nidana increases Kapha in turn affects meda and kleda leading to Madhumeha due to avaran (Charaka Samhita, Sutra- 17/79; Charaka Samhita, Chikitsa- 6/4; Sushruta Samhita, Nidana- 6/2; Ashtangahridayam, Nidana- 10/1, 2, 3; Ashtanga Samgraha, Nidana-  10/3).

Vihara sambandhi hetu (causes related to daily and seasonal regimen)

The following viharas have been implicated as Kapha-medo kara (which increases Kapha and Meda)-

  • Divasvapna (day sleep)
  • Avyayama (lack of exercise)
  • Aasya atisukha (foody)
  • Alasya (lazyness)
  • Chinta tyaga (a person who does not worry at all)
  • Samshodhana varjana (not undergoing detoxification processes)

These ahara and viharas that aggravate kapha dosha are to be considered as Madhumeha nidana. Above factors are explained in the text are considered for prameha in general. The same factors are held responsible for the causes of Madhumeha also. Above said nidanas can be classified under Apathyanimitaja Madhumeha (Sushruta Samhita, Chikitsa- 11/3).

  • Apathya Nimittaja is believed to be acquired later in life due to habits such as over indulgence in food or sweets. Maharishi Bhela termed this as "swa krittaja'.
  • Vagbhatta describes the nidana of prameha as which increases the bodily Medas, Mutra and Kapha. Such as navadhanya (new grains), sura (an alcoholic beverage), anupa mamsa (specific meat), ikshu (sugarcane) and guda (jaggery). (Ashtanga Samgraha Nidana 10/3).
  • Asya sukham (satisfying tongue - the sense of taste) vitiates sleshma and meda. Shayyanam vidhivajitam as put forward by Vagbhata means sleeping in the daytime, even in ritus other than grishma (summer).
  • Diwasvapna (habit of day sleep) is Kapha Pitta kara and Snigdha.
  • Vyayama (exercise) is necessary for all at least chankramana (brisk walk) which is deepana, ayushya and vatanulomana. So avyayama (lack of exercise) will contribute to the manifestation of Madhumeha (premeha).
  • Tyakta chinta (devoid of worries) is another nidana suggested by Charaka i.e. achinta has the property of brumhana (increase heaviness property of body).

Vishesha nidana of Madhumeha

Though the Kapha is the arambhaka dosha (primary) in the Samprapti (pathogenesis) of Madhumeha (diabetes), Pitta and Vata play an important role in complicating the disease. It is worthwhile to note the textual reference that Madhumeha will occur after when, if the prameha are untreated at the same time. It is better to note that Madhumeha is a tridoshaja vyadhi. Hence the following nidanas that are explained in the texts are to be studied carefully-

Kaphaja prameha nidana

These are as the same as explained in the samanya nidana.

Pittaja prameha nidana

  • Ahara sambandhi- More intake of Ushna guna ahara (warm or hot potency food) atisevana, Amla (sour), lavana (salty), katurasa (acrid), Ajeernashana (taking meal without considering digestion of previous meal), Vishama ahara sevana (intake of food items which are non-similar in quality and not recommended to take together).
  • Vihara sambadhi- Ati atapa sevana (excess sunbath), Ati santapa (excess irritability), Shrama (excess labour), Krodha (anger).

Vataja prameha nidana

The causes for aggravation of Vata can be mainly grouped into two categories - margavarana and dhatu kshaya.

  • Ahara sambandhi- Katu, kashaya, tikta rasa ahara atisevena; Laghu ruksha, sheeta guna ahara atisevana.
  • Vihara sambandhi- vyavaya atiyoga, vyayama ati yoga, vamana ati yoga, virechana atiyoga, asthapana ati yoga, shirovirechana atiyoga, anashana, abhighata, atapa atisevana, udvega, shoka, ratri jagarana, vegasandharana.

Sushruta has categorised the existence of sthula (obese) and krisha (thin) varieties of pramehis (diabetic) and Charaka has prescribed different lines of treatment for the sthula and krisha pramehis. He has also asserted that whenever a patient presents with madhupama mutra, a wise physician should always consider the possibilities of madhumeha due to vata as a result of ksheenata of doshas and Madhumeha due to kapha as a result of santarpana.

It is very clear from Charaka’s explanation that Madhumeha in krisha occurs in the event of a relative vata vridhi in comparison to the other doshas. These persons may have been sthula in beginning but would have become krusha due to dhatu kshaya.

On the other hand, krusha madhumehis are usually rogis with beejadosha (congenital/ genetic disorder). Hence when such a rogi consumes nidanas of vatavridhi, he develops Madhumeha sooner than a sthula rogi who always indulges in tarpana ahara.

In brief, the madhura rasa, sneha dravya etc. along with the sedentary habits are having the direct bearing on the provocation of kapha dosha, which attains ‘aparipakva avastha’ which in turn affects meda and kleda leading to cause Madhumeha due to avarana.

Samprapti of Madhumeha (Pathogenesis of Diabetes in Ayurveda)

Madhumeha is considered as mahagada and as anushangi vyadhi. This is because, in Madhumeha, vyadhikshamatva (immunity) is a major casualty. Bala derived from Ojas characterises vikara vighata bhava and its deficiency characterises vikar avighata abhava. Hence, the study of the involvement of ojas in the disease warrants a top priority.

Ojas- Oja plays an active part as dushya in the samprapti of Madhumeha. Sushruta has mentioned that oja is a supreme extract of all the dhatu and strength of the body (Sushruta Samhita, Sutra- 14/11). Charaka mentions that life depends on Oja and therefore without Oja, one can’t live. Such oja remains in the heart and called as shareera rasa sneha (ch su 30/4). In the commentary, Chakrapani has described two varieties of oja i.e. para and apara oja. Para oja is a supreme and remains in the heart, while its pramana is ashta bindu (8 drops). Apara oja is of ardha anjali pramana, which is also called as shleshmika in nature and not the para oja kshaya. Pathological conditions regarding oja are 3 types.

  1. Oja visramsa – sandhi vishlesha, gatra sada, dosha chyavana, kriyasannirodha.
  2. Ojavyapth – sthabda gurugatrata, vatashopha,varna bheda, glani, tandra, nidra.
  3. Ojokshaya – murcha, mamsa kshaya, moha, pralapa, marana (su su 15/24).

In Madhumeha, oja is excreted through the urine leading to oja kshaya, so the symptoms of ojakshaya like murcha, mamsa kshaya, moha may manifest. Vagbhata has mentioned some additional symptoms of oja kshaya like bibheti (excessive fear), abhiksna daurbalya (excessive weakness, vyathita indriya, rukshata etc. (Ashtangahridayam, Sharira- 11/40).

  • In madhumeha, though the pathology regarding oja is of kshaya nature, the other two pathological conditions may also be met with, if the samprapti remain unbroken for prolonged time with continuous nidana sevana or due to improper treatment.
  • Madhumeha originated from suddha vata may manifest any of the above pathological conditions very easily. Hence the pathological aspect of the oja is very necessary to be observed to know the severity of the disease.
  • Any vikara is a mutual interaction of nidana, dosha and dushya under the influence of prakriti, desha, kala, bala and vaya. The extent of this dosha dushya sammurchana is dependent on the vikara vighata bhava and its abhava. Ojas is an important vikar vighatakara bhava and one of the main dushya in Madhumeha which is eliminated through mutra leading to dhatu kshaya. Hence Madhumeha is also called “Ojomeha”
  • The patient who has the specific body tendency for premeha onset which means it may be due to genetic predisposition, prakruti manifestation or sedentary habit have the specific meda bahulyata preferably with abaddhatva. If these patients consume excessive vata provocative ahara, vihara or mano abhigatkara bhava, then vata gets provocated. This provocated vata further gets implicated by meda. Now this provocated meda complex leads to transfer of either vasa, majja, lasika, oja to mutravaha srotas. When oja due to influence for vata adopts kshaya and ruksha guna and excrete through urinary treat is termed as Madhumeha.

Samprapti of Madhumeha due to shuddha Vata

Charaka mentions the samprapti of Madhumeha due to shudda vata. Due to Vata kara nidana, vata dosha provocated leading to kshaya of other two doshas and sarabhoota dhatus like vasa, majja, lasika and oja. Due to kshaya of dhatus vata further gets provocated. This highly provocated vata draws oja towards basti and leads to madhumeha. This is asadhya to treat due to its arambhaka dosha vata and resultant further provocation due to dhatukshaya (Charaka Samhita, Chikitsa- 6/34).

Dhatukshaya janya Madhumeha samprapti

The kshya of gambhira and sarabhuta dhatus like majja, vasa, oja and lasika leads to vata prakopa vata dosha gets vitiated leading to ksharana of sarabhuta dhatus through mutra pravritti in such a quantity that this ksharana of sarabhuta dhatus itself acts as etiological factor again for vata prakopa hence this vicious circle goes on. But due to ashukaritva of vata all the stages of samprapti proceeds so fast that, it leads to asadhya stage of the disease very quickly

Apratikarita vatanu-bandita Madhumeha samprapti

This type of Madhumeha is actually not a separate entity but it is the further stage of kaphaja or pittaja prameha due to deerga kalanu bandha or this may be called as ignored stage of prameha due to lack of proper treatment. Kaphaja and pittaja prameha which are present from quite longer period they do get anubandha of vata to chronicity i.e. they get converted into vataja prameha (Charaka Samhita, Nidana- 4/37).

Avarana janya Madhumeha samprapti

The description of avarana janya samprapti of madumeha is a unique contribution of charaka to the clinical medical knowledge. Here one can see that nidana is same as that of kaphaja prameha but still the resulting disease in Madhumeha. Guru snigdhadi ahara, avyayamadi vihara etc. leads to the provocation of kapha and pitta dosha inturn increases in quantity inside meda and mamsa. All these increased factors obstruct the gati of vata leading to the provocation of Vata. This provocated Vata withdraws Oja from the body and takes it towards basti and leads to Madhumeha, which is krichra sadya for treatment due to its origin from Kapha and Pitta doshas.

Initially, the Vata dosha remains innocent in the pathology. The vata, pitta and kapha doshas start manifesting their symptoms intermittently depending on their extent of dushti. Subsequently, Pitta and Kapha attain kshayavastha compared to vata due to kshaya of dhatus. This process of margavarana of vata due to kapha and pitta occurs in two kinds of people. First in those who are sthula and secondly in those who are not sthula but have indulged in kapha- medokara ahara and vihara. If the nidana for pitta are significant then it also gets dushti. In sthula people, the sthaulya is the result of two reasons. First, it is due to excess indulgence in kaphakara ahara viha. If the nidana for pitta are significant then it also gets dushti. In sthula people, the sthulya is the result of two reasons. First, it is due to excess indulgence in kaphakara ahara vihara and second is due to beeja dushti. In the former case, the upachaya of medas occurs due to the nidana sevana, where as in the later case, the medo upachaya occurs even in the absence of kapha medokara ahara vihara.

Samprapti of sthaulya (obesity) and its role in causing Madhumeha

Sthaulya can be caused by tarpana (nourishing diet) as well as beeja dosha (hereditary problem). The nidanas (causes) for sthaulya are same as those described for Madhumeha as “kapha krit cha sarvam” (all those which cause an abnormal increase in kapha dosha).

Samprapti Ghataka of Madhumeha

On the basis of various references the samprapti ghataka of Madhumeha is described as follows-

Dosha

Kapha-

  • Kapha- bahu and abaddha – in avaranjanya Madhumeha.
  • Kapha- kshina in kshayajanya Madhumeha.

Pitta-

  • Vriddha – in avaranajanya madhumeha.
  • Kshina- in kshaya janya madhumeha.

Vata-

  • Avritta – in avaranajanya Madhumeha.
  • Vriddha – in kshaya janya Madhumeha.

Dushya- rasa, rakta, mamsa, meda, majja, vasa, shukra, oja, lasika, kleda (Charaka Samhita, Nidana- 4/4) and sweda (Ashtangahridayam, Nidana- 10/4).

Srotas- annavaha, mutravaha, udakavaha, medovaha srotas.

Srotodushti- atipravritti, sanga, vimarga gamana.

Agni- vaishamya in all agnis.

Ama- in Madhumeha the amaroopi kapha causes samata of medodhatu first, leading to increased kledata subsequently, this results in saamata of other dhatus as well including the ojas. Hence dushyas are presenting in the form of ama in Madhumeha.

Udbhavasthana- amashaya

Sanchara Sthana- sarva shareera

Adhisthana- basti

Vyakta Sthana- mootravaha shrotas and sarva shareera.

Vyadhi Swabhava- chirakari

Madhumeha is a kapha vata dosha pradhana vyadhi in which the vata dushti occurs in two different pathologic mechanisms.

Samprapti of Madhumeha w.r.t. Kriyakala

1st Kriya kala – Sanchaya avastha- In this stage the samhathi roopa vriddhi of kapha occurs in svasthana i.e. amashaya, presenting the following symptoms

  1. Agnimandya (lack of digestive fire)
  2. Gaurava (heaviness)
  3. Alasya (laziness)

These are as a result of guru and manda guna of kapha. The occurrence of these symptoms has been inferred after studying the poorva roopa and roopas of Madhumeha.

2nd Kriyakala – Prakopa avastha- In the event of the patient continuing with the nidana sevana, disease proceeds to prakopa avastha where the kapha undergoes vilayana roopa vriddhi and can be understood as presenting with the following symptoms

  1. Annadvesha (anorexia)
  2. Hridayotklesha (nausea or unpleasant feeling) - due to amaroopi kapha

3rd Kriyakala – Prasara avastha- If unhindered, the prakupitha doshas attain prasaravastha where the unmarga gamana kapha along with the other two doshas from the svasthana occurs. The doshas pervade the body and it can be inferred that the following symptoms are presented.

  1. Arochaka
  2. Avipaka
  3. Angasada- due to kapha along with vata and pitta

The importance of first 3 kriyakalas in preventing Madhumeha – any disorders in these 3 stages often goes unrecognised, as these symptoms are mild enough for the patient to ignore.

Moreover, the symptoms are so vague and varied that it becomes difficult to ascribe them as per to Madhumeha in these 3 stages. By suitable modification in the ahara and vihara in the form of laghu ahara sevana and vyayama etc, we can control as well as prevent the onset of Madhumeha.

4th Kriyakala – Sthana samshraya avastha- By repeated nidana prekupita doshas lodges in the srotas where khavigunya exists. The medhovaha sroto vaigunya in the vapavahana due to apathya sevana or beeja upatapa causes the dusti of kapha and vata & attains sthana ssamshraya initiating the process of dosha dushya sammurchana. The poorva roopas manifest in this kriyakala

5th Kriyakala – Vyakta avastha- Dosha dushya sammurchana takes place actively during this kriyakala. The pratyatma lakshanas of Madhumeha i.e. prabhoota mutrata and aavila mutrata along with sarvadaihika lakshanas manifest during this stage.

6th Kriyakala – Bheda avastha- In this stage, Madhumeha is no more new. It would have attained sub acute or chronic stage. This disease proceeds into more severe forms in th event of increasing dhatukshaya. It also starts manifesting the pittaja and vataja lakshanas rendering the disease yapya. The disease essentially attains asadhyatha in this stage. Hence forth, upadrava and arishta lakshas start appearing.

Madhumeha Chikitsa (Treatment of Diabetes in Ayurveda)

The principles of treatment of diabetes in Ayurveda can be studied under-

  • Nidana parivarjana (Avoid the causative factors)
  • Apakarshana
  • Prakriti Vighatana

These principles of treatment are to be studied separately with respect to Dhatu Kshaya Janya Madhumeha and marga Varana Janya Madhumeha (Charaka Samhita, Vimana- 7/ 28-29).

Sushruta has described to select drugs, which are having bitter, pungent, astringent taste, katuvipaka, ushna veerya and shoshaka, chhedana properties in the treatment of Madhumeha (Sushruta Samhita, Chikitsa- 13/8). Shilajatu, guggula, loharaja are the best medicines in madhumeha, either in krusha or sthula, as they are virukshana and chedaneeya, which is good for kapha, as well as rasayana, which is good for dhatukshaya & vata vriddhi. Sushruta has described some medicinal remedies for all types of prameha and advised to use after purification therapy (Panchakarma).

Following are some herbs and Ayurvedic medicines which are used to treat diabetes - 

  1. Extracted juice of amalaka mixed with haridra powder.
  2. A decoction of triphala, vishala, devadaru and musta.
  3. Powders of the flower of kutaja, rohitha, kapittha and vibhitaka should be taken together with haridra and extracted juice of amalaki.
  4. Decoction of roots, leaves, barks, flowers and fruits of nimba, aragvadha, saptaparna, murva, kutaja, somavriksha, palasha should be given to the patients (Sushruta Samhita, Chikitsa- 11/8).
  5. The decoction of chitraka, triphala and indrayava.
  6. Extracted juice of guduchi mixed with extracted juice of amalaka fruit and honey (Ashtanga Hridayam, Chikitsa- 2/5, 6).
  7. Few effective preparations for the management of Madhumeha have been recommended by sharngdhara are- Amruta swarsa, triphala churna, nyagrodhadi kashaya, Dhatriswarasa, tryushnadi churna, lavangadi churna, Kalyanaka ghrita, vasant kusumakara rasa, Manduradi vatika, Chandraprabha vati, Yogaraja guggulu, Kaishora guggulu, Gokshuradi guggulu.
  8. Bhavaprakasha recommended – phalatrikadi kwatha, trikatukadhya modaka, nygrodhadi churna, lodhradi churna, guduchi swarasa.

Read: 10 Best Ayurvedic Medicine for Diabetes & Classical and Patent

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Fever in Ayurveda – Symptoms & Treatment (Jwara)

Introduction of Fever and Jwara (Jvara)

Fever in Ayurveda is described as Jwara. You may search a lots of information on fever, types of fever, sign and symptoms of fever, treatment of fever and many more related information on fever. In this article, we tried to present what Ayurveda has explained about fever by the name of Jwara. Jwara is a independent disease, also it is an important symptom in many diseases & it is found as a complication of many diseases. Almost all human being have experienced this disease in one or other way.

Jwara affects both Shareera (body) as well as Manas (mind/ psyche). The different synonyms are given to Jwara which are mentioned in this article. In Ayurveda, Jwara is superior among all diseases and hence given much importance in its detailed explaination in Ayurvedic texts.

Jwara is called as  Kshaya because it destroys body as well as Dhatu. Jwara is also called as Tama because it produces moha which is the function of tama. Jwara is also called as Yamatmaka  because it kills the person like that of Yamaraja.

As per mythology explained in Ayurveda, Jwara is originated due to the Rudrakopa (anger of Lord Shiva) for the first time and second time by the production of lobha-parigraha.

Burning sensation of body and mind, tastelessness, thirst, bodyache, hridvyatha (uneasiness of heart) are considered as the prabhava of Jwara. At the time of janma (birth) as well as mrityu (death) Jwara is commonly seen.

Note- Do not try any of the formulations mentioned in this article without consultation with Ayurveda doctor.

Origin of Jwara according to Indian mythology

  • In yajna performed by Daksha Prajapati, Lord Shiva was insulted. By this insult, anger in the form of a demon evolved. Lord Shiva ordered demon to destroy the yajna. After destroying yajna the demon asked Lord Shiva what shall I do now ? Then Lord Shiva told him to ail the human beings in the form of fever, whenever their previous sinful actions will mature. So Rudrakopa is one of the main viprakrishta nidana (cause) for Jwara.
  • According to Acharya Charaka, Jwara is one of the synonyms of Roga.
  • An increase of body temperature is also denoted by the word Jwara.
  • According to Charaka, Jwara produces santapa (increase in temperature/ temperament), sandeha (suspicion) in hridaya (heart) & manas (mind).
  • According to Sushruta, Jwara is that disease in which manifestation of obstruction of sweda (sweat), santapa (temperature rise) & angamarda (body ache) are seen simultaneously.
  • It is the king of all the other diseases.
  • It is also believed that occurrence of Jwara is also seen in animals, birds, plants, mountain, earth etc.

Synonyms of Jwara- 

  • Jwara- A disease which alleviates body temperature.
  • Rogapati- Superior among all diseases.
  • Rogaraja- King of various diseases.
  • Paapma- Disease caused by previous sins.
  • Mrityu- Disease which may end in death.
  • Antaka- Disease which may end in death.
  • Ojakshaya- Disease which destroys ojas.
  • Krodha- Fever is caused by krodha (anger) & associated with krodha.

Nidana (general causes) of Jwara- 

According to Vagbhatta-

  • Sannikrishta nidana- Vatadi dosha
  • Viprakrishta nidana- Mithyaahara

According to Sri Gananatha Sena mithya ahara vihara & dhatu vaishamya are the causative factors of Jwara.

Samprapti (pathogenesis) of Fever in Ayurveda (Jwara)- 

For the manifestation of any disease mithya aahar & vihara are the main causative factors. The generation of ama is root cause of Jwara.

Due to hypo-functioning of ushma or kayagni (digestive fire), food which is not properly digested results in formation of immature rasa (poorly digested chyle) in amashaya (stomach) and this rasa is spoken as ama. Ama is unable to nourish the dhatu. Then the causative factors of Jwara will increase Vata, Pitta & Kapha in the body. These increased doshas reach the Aamashya, they combine with ama along with rasa dhatu & circulates all over the body by the kaphagni will also mixed with this rasa dhatu and circulates all over the body along with  increased doshas & produces the fever. Because of the properties of Ama such as snigdha, pichchhila it will obstruct the swedavaha strotas. The absence of sweating (swedavarodha) also increases the body temperature (ushmata).

Samprapti Ghataka-

  • Udbhava sthana- Amashaya
  • Dosha- Pitta PradhanTridoshaj
  • Dushya- Rasa, Rakta
  • Shrotas- Swedavaha shrotas, rasavaha shrotas
  • Shroto dushti prakar- Samya
  • Vyakta sthan- Sarvanga (All over the body)
  • Ama- Jataragni janya ama
  • Roga marga- Bahiroga marga

Samanya Purvarupa (general prodromal sign) of Jwara- 

  • Shrama- Exhaustion without any reason
  • Arati- Restlessness, not interested in anything
  • Vivarnatva- Discolouration of body
  • Asya vairasya- Difficult to diffrentiate the taste
  • Nayan plava- Watering of eyes
  • Ichcha dwesha, Sheeta vata tapa dishu- Alternating desire & aversion for cold & hot environment
  • Jrimbha- yawning
  • Angamarda- Bodyache
  • Guruta- Heaviness of the body
  • Romaharsha- Horripilation
  • Aruchi- Tastelessness
  • Tama- Darkness in front of the eyes
  • Apraharsha- There is no interest to take any kind of food & feeling of chills.

Vishishta purvarupa (specific prodromal sign) lakshana of Jwara-

  • In case of Vata dominance- yawning excessively.
  • In case of Pitta dominance- Burning sensation in eyes.
  • In case of Kapha dominance- aversion to take food.

Roopa (sign and symptoms) of Jwara- 

Absence of sweating, raise in body temperature and body pain are symptoms of jwara.

Pratyatma Lakshana of Jwara (only found in jwara)-

Burning sensation over body & mind are cardinal symptoms of jwara.

Types of Jwara- 

  1. Nija Jwara- 7 sub types- Vataj, Pittaj, Kaphaj, Vaat Pittaj, Pitta Kaphaj, Kapha Vataj and Tridoshaj (Sannipata Jwara).
  2. Agantuja Jwara- 4 sub types- Abhighataj, Abhicharaj, Abhishapaj and Abhishangaj.

Abhishangaj Jwara is further devided in to 7 sub types- Vishajanya, Oshadigandhaja, Kamaja, Shokaja, Bhayaja, Krodhaja and Bhutaj.

Jwara is also classified on the basis of following-

  • Veganusar- 4 types- Antarvega, Bahirvega and Avisargi, Visargi.
  • Dushyanusar- 7 types- Rasaj, Raktaj, Mansaj, Medaj, Asthij, Majjajanya, Shukraj.
  • Types of Visham Jwara- Santata, Satataka, Tritiyaka, Chaturthaka, Anyedushka.
  • Based on Ama- Sama Jwara, Pachyamana Jwara, Nirama Jwara.
  • Based on Adhisthana- Sharir, Manas
  • Based on Kala- Prakrita, Vaikrita

Sannipata Jwara is further classified in to 13 types based on dominance of Dosha-

  1. Vatolbana
  2. Pittolbana
  3. Kapholbana
  4. Vatapittolbana
  5. Vatakapholbana
  6. Pitta kapholbana
  7. Heenavata- Pitta Madhya- shleshmadhika
  8. Heenavata- Madhyakapha- Pittadhika
  9. Heenapitta- Madhyakapha- Vatadhika
  10. Heenapitta-Vatamadhya- Kaphadhika
  11. Heenakapha-Pittamadhya-Vatadhika
  12. Heenakapha –Vatamadhya-pittadhika
  13. Sarvadosholbana

Lakshana of different types of jwara-

  • Vataja jwara- Rigors, fever is irregular with sudden rise & fall in temperature, dryness of throat & lips, loss of sleep, suppression of kshawathu (spit), dryness of the body, headache, chest pain,  body ache, loss of taste, constipation, pain in abdomen, adhmana, yawning.
  • Pittaja jwara- Intensity of fever is high, diarrhoea, sleeplessness, vomiting, ulceration over throat, lips, mouth & nose, their will be sweating, irrelevant speech, feeling of katu rasa, giddiness, burning sensation, yellowish discoloration of stool, urine & eyes.
  • Kaphaja jwara- Feeling as if body is covered with wet cloth, mild temperature, laziness, sweetish taste in mouth, whitish color of urine, stool, stiffness of joints, aversion for food, heaviness of body, feeling of coldness & utklesha of kapha i.e. hrillasa & excessive salivation, horripilation, excessive sleep, running nose, tastelessness, cough, whitish coloration of eyes.
  • Vata pitta jwara- Thirst, fainting, delusion, burning sensation, loss of sleep, headache, dryness of throat & mouth, vomiting, horripilation, tastelessness, pain in smaller joints, yawning.
  • Vata shleshma jwara- As if body is covered with wet cloth, pain in smaller joints, excessive sleep, heaviness of head, headache, running nose, cough. In Vata kaphaja jwara there is sweating because of vikriti vishama samavaya. 
  • Kaphapittaja jwara- Coating over tongue & feeling of tikta rasa in the mouth, tandra, moha, murchha, aruchi, kasa, trishna, feeling of cold & hot alternatively.
  • Sannipata Jvara lakshana- Alternate feeling of hot & cold due to involvement of three dosha, pain in the joints, bone & in head, redness of the eyes or sunken eyes with watery discharge, tinnitus, earache, feeling of some foreign body present in the throat, tandra , trishna, moha, murchha, pralapa, kasa, shwasa, aruchi, shrama, paridagdha, the tongue will be very rough just like gojihva (tongue of cow), spitting of rakta or pitta along with kapha, the rolling of head, thirst, nidranasha, chest pain, delayed & reduced quantity of excretion of sweda, mutra, purisha. There will be no much emaciation of the body, there will be frequent sounds, urticaria and blackish red colored rashes, loss of speech, inflammation of the nose and ear etc.
  • Ama jwara- Indigested rasa due to the durbalata of jatharagni (diminished digestive fire) and the rasa which is doshayukta, situated in amashaya is called as ama. This dushita rasa spreads all over the body & causes ama jwara. The symptoms are mixed as in Pitta kaphaj jwara. In the aspect of treatment we should see the condition of ama and deepana pachana principle of treatment is opted. Because in this treatment the administration of medicines are avoided. If the shodhana or shamana aushadhis are administered it converts ama jwara to Vishama jwara.
  • Pacchyamana jwara- The vega of jwara will be teevra, excessive thirst, pralapa, shwasa, bhrama (giddiness), etc. are the lakshanas of pacchyamana jwara.
  • Nirama jwara- Hunger, emaciation, laghuta, mala mutra pravritti. In 8 days jwara comes to normal.
  • Shareera jwara- Trishna, Santapa, angamarda, manasika glani.
  • Manasa jwara- Chanchalata, glani of mind & Santapa is called as manasa jwara.
  • Avisargi jwara- Jwara remains in the body till its wish & it never produces any disturbance in body temperature is called as avisargi jwara. It is of 2 types.- Samvegi and Vishamvegi.
  • Samavegi jwara: It is also called as continuous fever. In this the body temperature is raised in day as well as night time.
  • Vishamavegi jwara: It is also called as remittent fever. In this, within 24 hours there will be variation of 2°c temperature, but the temperature never comes to normal.
  • Visargi jwara- In this type, jwara means fever get down in one ahoratra (24 hours/ 1 day and night), once the temperature comes to normal then again rise in temp is seen. It is called as Visargi jwara. It is of 2 Types- Muktanubandhi and Punaravartaka jwara.
  • Muktanubandhi jwara- It is also called as Intermittent fever. In this type, the temperature comes to normal once or several time.
  • Punaravartaka jwara- Before the cure of fever or before the ascertainment of prakrita bala, if one does the vyayama, snana or traveling, then the re-occurrence of fever is seen. This is called as punaravartaka jwara. This fever will remain for longer time, gives peedana for longer time. In case of durbala and Ojas ksheena person this jwara may leads to death.
  • Agantuja jwara- The term agantuj means external. The jwara caused by external factors is called as agantuja jwara. In this, jwara occurs first & vitiation of the dosha occurs later. There are 4 types of agantuja jwara- Abhighataja, Abhishangaja, Abhishapaja and Abhicharaj.
  • Abhigataja jwara- In this type, fever is caused by abhighata means injuries like chhedana (cut) and daha (burns). These causes vitiation of Rakta by Vata dosha and gives rise to jwara, shoola, shotha and discolorations of tvacha (skin) at the site of the injury.
  • Abhishangaja jwara- Fever caused by germs, virus and influence of ghost (Pishacha badha). Grahabadha - fever due to the influence of dushtagrahas. Fever raised due to contact of visha is called as vishajanya jwara. Jwara also occurs due to psychological factors like krodha (anger), shoka and bhaya (fear) comes under this type.
  • Abhishapaja jwara- The fever caused by the curse of gurus, saint & elders is called abhishapaja jvara. Here the fever effects first the mind & later to the body.
  • Abhicharaja jwara- Fever which is caused by the mantra tantra comes under abhicharaja type. Here the mantra tantra are used to produce the fever in enemies. First it causes fever to the manas/ psyche & later it affects the body and produces symptoms like visphota (boils), trishna (thirst), daha (burning sensation), murchha and there will be regular increase of temperature.
  • Vishama jvara- The word vishama means irregular. In case of fever the word vishama applies for its irregular onset, irregular site of manifestation, irregular nature and irregular periodicity or interval. Vishama arambha means the fever will start from the different parts of the body i.e. some times it may starts from Murdha ( head), sometimes it may starts from prishtha (back). The irregular nature means vishama kriya means sometimes there will be high temperature or sometimes severe chills (rigors), irregular periodicity means Vishama kala means the fever may appear in the morning or in the noon or in afternoon or in the night means this fever persists for long period.

Samprapti of Vishama Jwara- In the initial stage there will be alpa dosha (less dosha) or soon after the recovery from the fever, if a person indulges in unwholesome food or activity, again the dosha will aggravate further and get lodged in Dhatu and produce the vishama jwara. The aggravated Vata dosha due to its irregular nature produces Vishama jwar.

The salient features of Vishama jwara- 

  • Fever settles for a few hours or 2-3 days & reappears again.
  • The patient suffers from chill and in another time experiences the sensation of heat in the body.
  • The fever rises suddenly & fall down suddenly.
  • The fever doesn't appear or reoccurs at fixed time.
  • Fever is sometimes mild and sometimes very high.

Classification of vishama jwara- 

  1. Santata jwara- rasa dhatu is involved.
  2. Satataka jwara- rakta dhatu is involed.
  3. Anyedyushka- mamsa dhatu is involved.
  4. Tritiyaka- meda dhatu is involved.
  5. Chaturthaka- asthi and majja dhatu are involved.
  • Santata jwara- The fever in which there will be continuous rise of temperature for the period of 7 or 10 or 12 days is known as Santata jwara (ref: Madhava Nidan- 2/34). In this type, there will be vitiation of all other dhatu, mutra, purisha and vata simultaneously. Because of the vitiation of all 3 dosha, features of sannipataja jwara like moha, pralapa etc. are observed. As in Santata jwara, there will be more vitiation of rasa dhatu, hence the vitiated doshas will spread throughout the body through rasa vaha shrotas. So the features like stabdhata (stiffness) and santapa (high grade fever) are present all over the body. It is extremely very difficult to tolerate this type of fever.
  • Satataka jwara- In this, the fever appears twice a day. Satataka Jwara is Krichchha sadhya (difficult to cure, but curable). The vitiated dosha are present in amashaya and the fever rises once in day time & once in night. The increase in temperature is observed during dosha prakopa kala.
  • Anyedyushka- The fever which appears once in 24 hours is called as Anyedyushka jwara. The increase or decrease of temperature appears once in day and night. But there is no particular time. The site of this jwara is hridaya (heart). The doshas present in hridaya usually take 24 hrs to reach amashya. So the fever will appear on next day.
  • Tritiyaka jwara- The fever appears once in three days or on alternate days. First day the fever will be present, no fever on next day and than fever reoccur on third day.
  • Chaturthaka jwara- Fever appears once in every fourth day. If there is vitiation of kaphadosha  it effects jangapradesha (thighs, calf). If there is vitiation vata dosha it affects head.

What is Jeerna jwara- Jeerna jwara is a term given for chronic fever. This can be explained as below-

  • It remains for 27 days.
  • Remains for 3 week continuously in mild degree.
  • Spleenomegaly (enlargement of spleen) is found.
  • Jatharagni dourbalya (loss of appetite) is seen.

Jwara upadrava (complications)- Cough, Giddiness, Tastelessness, Thirst, Vomiting, Diarrhoea, Constipation, Hiccup,Difficulty in breathing, Angabheda (unbearable body ache)

Sadhya jwara Lakshana (sign)- The sadhya jwara should have the following features-

  • The patient have some strength.
  • There will be alpadosha involvement.
  • Should not have any complication( upadrava).

Lakshana of Asadhya jwara- 

  • Which is having many symptoms.
  • Which is having many causative factors.
  • In which the debility of sense organs are seen.
  • Which remains for long time
  • In which antardaha (internal burning of body), thirst, hikka (hiccup), shwasa, obstructions of mala and apanvayu are seen.
  • In which the loss of complexion, Nishkriya of Indriya, ksheenata and aruchi are seen.

If all the above symptoms are seen in a fever then that fever is incurable (asadhya).

Arishta lakshanas (early death sign) of jwara- 

In Ayurveda, there is a description of Arishta lakshana of various disease which we can say as early death sign in common word. Likewise, following Arishta lakshanas are described for Jwara-

  • If the patient is dreaming like he is drinking madira (a type of alcoholic beverage) along with preta (devil/ demon) or moving towards dakshina direction then that patient will die soon because of fever.
  • The person along with fever, if suffers from shushka kasa & jwara before 12 o'clock in day time then he will die very soon.
  • The person who suffers from fever after 12 o'clock in day time and he is balamamsa hina (emaciated) then he will die very soon.
  • Who is having teevra jwar (acute high grade fever), trishna (thirst), murchha (fainting) and shithilata of sandhi (weakness in joints) then he will die soon.

Purvarupa (prodromal sign) of jwaramoksha / daruna moksha (recovery)- 

When there is relief of jwara then the body of the person experiences following signs-

  • Burning sensation
  • Sweating
  • Giddiness
  • Thirst
  • Tremors
  • Diarrhoea
  • The loss of sense and perception
  • Kujana (sound)
  • The bad odor from the mouth.

Types of Jwaramoksha- It may occurs in 3 types

  1. Daruna moksha (By crisis)
  2. Adaruna moksha (By Lysis)
  3. Vishama gati moksha

Jwaramukta Lakshana (After Signs of fever)- 

  1. Sweating
  2. Lightness of body
  3. Itching over head
  4. Mukha paka (stomatitis)
  5. Sneezing

Chikitsa Sutra (Line of Treatment) of Fever in Ayurveda (Jwara) - 

  • During nava jwara, one should avoid sleep during day time, bath, massage, heavy food, anger, exposure to wind and exercise.
  • Langhana or fasting- In the first stage of jwara, langhana or fasting is prescribed. It is however, not indicated in the jwaras caused by consumption of agents whch vitiate vata like Vata vardhaka aahara, fear, anger, grief and physical exertion.
  • Intake of Shadanga paniya- For the alleviation of thirst and jwara, the patient should be given water boiled with Musta, Parpataka, Ushira, Chandana, Udeecchya & Nagar. After boiling, the water should be made lukewarm every time before administration.
  • Administration of Vamaka Dravya (emetics)- If the jwara is dominated by kapha and if this kapha located in the amasaya, then kapha should be removed by administered of emetics (Vamaka dravya). The state of kapha should be carefully ascertained before the administration.
  • Use of Yavagu- After the patient has been administered emetic therapy and after he is kept on fasting he should be given yavagu (gruel) processed with some herbs).
  • Use of kashaya- The patient should be administered decoctions of herbs (single or in combination) which are either pachana or shamana.
  • Langhana Karma (Light diet intake)- For the alleviation of jwara, up to the 10th day, the patient should be given to eat light diet along with Yusha (soup) prepared of vegetables, pulses, or Jangala Mamsa-Rasa (soup of meat of animals dwelling in the forests). These yushas and rasas may or may not be added with sour things.
  • Intake of ghee- The ghee should be given to the patient suffering from jwara when there is dominance of Vata and Pitta. Ghee and Mamsa rasa should not be administered to the patient even after the 10th day, if Kapha predominates and if the signs and symptoms of well accomplished Langhana karma have not appeared.
  • Intake of milk- When there is excess burning sensation and thirst; when the patient is suffering from jwara predominated by Vata and Pitta; when the doshas are either Baddha (obstructed) or prachyuta (loose) or when there is nirama stage of the doshas, intake of milk (processed with herbs or unprocessed) may be given.
  • Administration of purgation- When the fever doesn’t subside by the therapies described earlier then for its alleviation Virechana karma (purgation therapy) should be provided to the patient who is not emaciated, weak, depleted of muscle tissue and devoid of digestive power.
  • Administration of Anuvasana Vasti (Therapeutic oil based enema)- In chronic fever Anuvasana Vasti should be given in the conditions- when Vata and pitta are alleviated, when there is strong power of digestion and when there is an unctuousness and adhesion in the feces.
  • Administration of Nasyam (Nasal administreation of medicine)- In chronic fever, it should be administered in conditions when there is heaviness and pain with head, and when there is inactivity of the sense organs as a result of which senses are not able to perceive their objects.
  • Administration of external therapies- In chronic fever the physician may advise Abhyangam, pradeha, parisheka and avagahana.
  • Use of Yusha- For some patients suffereing from jvara yusha is wholesome. For the preparation of this yusha, mudga, masur, chanak, kulatta & makushta etc are used.
  • Vegetables- The leaves and fruits of patola, patha, karkotaka and rakta punarnava are useful in jwara if taken as vegetable/ curry.
  • Meat soup- The soup prepared of lava (a bird), kapinjala (a bird), yena, chakora, kuranga, harina (deer) and shashaka (rabbit) are alleviate jwara.
  • The decoction of parpataka, kiratatikta, musta, guduchi and visha bheshaja are taken oraly in jwara.
  • The decoction of patha, ushira along with udeecchya is also recommended in jwara.

Herbs Useful in fever (Jwara)- 

  • Agasti (Agastya)- The juice of the leaves dropped in to nostrils alleviates chaturthaka jwara (Bhavaprakasha chikitsa- 1/ 771).
  • Ahiphena- In a combination of other herbs in Yavaanyaadi kwatha is useful in jwara associated with kasa (fever with cough) (Bhavaprakash Chikitsa 1/ 383).
  • Amalaki- The juice of amalaka fruits fried with ghee alleviates fever ( C.S. Ci. 3/ 230)
  • Aaragwadha-  Aragwadha with milk or grape juice is recommended in jwara (Charaka Samhita Chikitsa Sthana- 3/232).
  • Shunthi- One afflicted with fever associated with diarrhoea should take liquid gruel of parched paddy added with Shunthi and honey. ( Ashtangahridayam Chikitsa sthana- 1/27).
  • Upakunchika (prithvika, kalajaji)- Kalajaji taken with jaggery controls irregular fever (Bhavaprakash chikitsa sthana- 1/753).
  • Upodika- In fever with burning sensation, the leaves of upodika pounded with sour juice or vinegar are applied extrenaly as paste. (Sushruta Samhita Uttara Tantra- 39/284)
  • Ushira- Ushira forms an ingredient of the shadanga paniya commonly used in fever associated with thirst. (Charaka Samhita Chikitsa Sthana- 3/145).
  • Katuka- Fine powdered katuka mixed with sugar alleviates fever caused by pitta. (Ashthanga Samgraha Chikitsa Sthana- 1/76).
  • Kiratatikta- The intake of paste of kiratatikta root mixed with cow’s ghee destroys fever in Filaria (Bhavaprakasha Shlipada chikitsa- 10).
  • Kasamarda- Pittaja jvara:  The cold decoction of kashmarya mixed with sugar pacifies excessive thirst & burning sensation ( S.S.U. 39/ 79-80).
  • Kulattha- To  check excessive perspiration, powder of parched Kulattha is rubbed in the body.
  • Guduchi- Decoction of Guduchi should be taken in all types of fever. (Sushruta, Chikitsa- 39/ 170).
  • Guduchi juice alone checks fever caused by Vata (Ashtanga Samgraha Chikitsa- 1/70).
  • Guduchi- In case of fever with vomiting, cold decoction of Guduchi mixed with honey taken. (Bhavaprakasha, Chikitsa- 1/857).
  • Jiraka- Jiraka (cumin seed) combined with jaggery alleviates irregular fever. It also improves digestion and destroys diseases caused by Vata.
  • Jeevanti- It is used in fever with Burning sensation. Decoction of Jeevanti root mixed with ghee removes burning sensation and fever.
  • Dadima (Pomegranate)- In severe fever caused by pitta one should take parched grain flour mixed with fruit juice of dadima.
  • Devadaru-  Decoction of devadaru is useful in fever ( Sushruta Samhita, Uttara- 39/204).
  • Dronapushpi- The juice of dronapushpi is efficacious in malarial fever.
  • Dhanyaka- The cold infusion of dhanyaka (coriander) mixed with sugar and taken in morning alleviates even severe burning sensation immediately (Bhavaprakash, Chikitsa- 1/356).
  • Nimba- Vomiting should be induced in patients having burning sensation and fever with leaf juice of nimba mixed with honey and liquid jaggery (Sushruta, Uttara- 39/282).
  • Pippali- Decoction of pippali made in four times of water should be taken (Ashtangasamgraha, Chikitsa- 2.41).
  • Pippali mula- One who takes pippali mula mixed with ghee and honey (non equal ratio) followed by intake of cow’s milk becomes free from heart disease, cough & malarial fever.
  • Mustaka : Mustaka and Parpataka are excellent herb for fever (Ashtangahridayam, Uttara- 40/48).
  • Vasa- The juice of Vasa leaves mixed with honey alleviates fever caused by pitta and kapha (Ashtanga Samgraha, Chikitsa- 1/92).
  • Vidari- Milk oil, ghee, juice of Vidari and sugar cane and honey all mixed together is suggested in malarial fever.
  • Haritaki- Linctus made of Haritaki, ghee and honey (unequal proportion) removes all types of fever.
  • Hingu- Quartan fever is checked by snuffing hingu mixed with old ghee.
  • Amalaki- The patient of fever in case of loss of sweat & asleep accompanied by excessive thirst, should take liquid ghee processes with shunti & amalaka added with sugar & fried with ghee. It alleviates fever ( C.S. Ci. 3/187).
  • Amra- Hot infusion prepared of tender leaves of amra and jambu, leaf buds and hanging roots of vata (banyan tree), Ushira mixed with honey cures fever.
  • Shunthi- Milk cooked with shunti, draksha and kharjura and added with ghee, honey (unequal ratio) allays thirst & fever. (Charaka Samhita, Chikitsa- 3/ 237).
  • Decoction of mahabala root and shunthi checks malaria fever. (Bhavaprakasha, Chikitsa- 1/ 750).
  • Shunti, jiraka and jaggery pounded together and taken with hot water, old wine or buttermilk checks fever with rigor. (Bhavaprakash, Chikitsa- 1/ 756).
  • Eranda- By taking milk cooked with Eranda root recovers from constipated bowels OR tender Bilwa in diarrhoea with blood and mucus attended with thirst, pain and tenesmus.(Ashtangahridayam, Chikitsa- 1/112).
  • Katphala- In fever, caused by kapha, the formulation consisting of katphala, pushkaramula, karkatashringi and Pippali mixed with honey is efficacious. It alleviates kapha and its associated symptoms like dyspnoea, cough and fever.
  • Kantakari- In condition of pain in pelvic region, sides and head, liquid gruel of parched paddy processed with kantakari and gokshura should be given. (Ashtangahridayam, Chikitsa- 1/28).
  • Kantaki karanja- Seed kernel of karanja, ativisha and maricha each 1 part and tulasi leaves 3 parts all pounded together and made in to pills of the size of a Bengal gram. It is useful in fever, diarrhoea and loss of digestive power.
  • Karvellaka- The soups of karvellaka, karkotaka, moolak, parpatak, nimba pushpa, patola are useful in jwara (Ashtangahridayam, Vimana- 1/75).
  • Kiratatikta- Infusion of kiratatikta mixed with dhanyaka leaves alleviates fever immediately.
  • Kutaja- Decoction of Kutaja (Indrayava) and kutaki in rice water or that of yasti madhu alleviates fever caused by pitta.
  • Kupilu- Purified kupilu with equal quantity of maricha powder is rubbed with decoction of Indrayava fruits and made into pills. It removes constipation and fever caused by Vata.
  • Kumud (Utpala)- In fever with diarrhoea, Utpala, seed of pomegranate and stamens of lotus pounded together should be taken with rice water. (Bhavaprakasha, Chikitsa- 3/11).
  • Kulattha- Soups of light pulses such as green gram etc as well as kulattha are whole some in fever (Ashtangahridayam, Chikitsa- 1/ 24).
  • Guduchi- Decoction of triphala and juice of Guduchi is useful (Charaka, Chikitsa- 3/299).
  • Guduchi- Ghrita and oil cooked with juice and paste of Guduchi, Triphala, Vasa, Draksha and Bala alleviate fever (Ashtangahridayam, Chikitsa- 2/22).
  • Jeemutaka- It should be given with the juice of Jivaka, Rishabhaka and Ikshu (Sugarcane) or Shatavari in fever caused by Pitta Kapha or Vata Pitta ( Charaka, Kalpa- 2/12).
  • Jeeraka- In Malaria with rigor, the patient should take Jeeraka powder with jaggery or guduchi juice with jaggery (Ashtangasamgraha, Chikitsa- 2/93).
  • Krishna jeeraka- Intake of Krishna jeeraka with equal jaggery and a bit of maricha checks Chaturthaka Jwara (quotidian fever) immediately (Bhavaprakasha, Chikitsa- 1/ 755).
  • Jyotishmati- In drowsiness in fever, Jyotishmati and pindaraka root used as snuff to remove drowsiness in fever.
  • Tulasi- In Malaria fever, the juice of tulasi or dronapushpi mixed with maricha powder should be taken to check malaria fever.
  • Triyamana- In chronic fever, intake of Trivrit or triyamana with milk is good. (Charaka, Chikitsa- 3/232).
  • Triphala- In chronic fever, Triphala, guduchi and pippali each separately should be given according to the prescribed method or Bhallataka mixed with jaggery may be used (Ashtangasamgraha, Chikitsa- 2/112 and Ashtangahridayam, Chikitsa- 1/152).
  • Dashamula- Pippali should be used with decoction of dashamula in case of jwara (Sushruta, Uttara- 39/ 216).
  • Draksha- Juice of draksha and amalaki should be given in jwara which acts as mild purgative and detoxify the body. (Charaka, Chikitsa3/ 230 And Ashtangasamgraha, Chikitsa- 2/28).

Pharmaceutical Preparations for Fever in Ayurveda (Jwara)- 

  1. Aasavarishta - Amritarista (In all stages of jwara), Kiratarishta (saviram jwara, vishama jwara), Kutajarishta (jwaratisar), Panchatiktarishta (jwarahar-raktashodhaka).
  2. Kwatha- Dashamula kwatha, Panchatikta kwatha, Shadanga kwatha, Dashamulatriguna kwatha. Amruttotaram kashayam.
  3. Churna - Sudarshana churna, Mahasudarshana churna.
  4. Vati or Rasa - Mahasudarshan Vati, Tribhuvankirti rasa, Vettumarana Gulika, Sanjeevani vati, Bhedijwarankusha rasa, Jwaramurari rasa, Jwarankusha rasa, Kalakuta rasa, Jayamangal Rasa, Vishamjwarantaka Rasa, Sarvajwarhar Lauha, Lakhshminarayana rasa, Mrityunjaya rasa, Narayana jwarankusha rasa.

 

Our Recommendations

At Ayurvite Wellness, we do prepare some medicines which are very much useful in different conditions of fever, its associated symptoms and post recovery management.

  1. Defence Capsules - It increases blood platelets count and increases immunity power.
  2. Septivite Capsules - It is an herbal antibiotic which helps to fight against harmful microorganisms. It also prevents recurrence of fever and infections.
  3. Loheme Capsules - It is an Ayurvedic hematinic supplement. It increases RBC, haemoglobin and other blood cells and ensures fast recovery in fever causing destruction of blood cells.
  4. Livy Capsules - It is a natural liver protective and corrective. It protects the liver from harmful microorganisms, reduces liver toxicity due to hepatotoxic drugs and improves digestion.

Summary- 

Jwara (fever in Ayurveda) can be produced as an independent disease or may be found as symptom in many other diseases. Several types of fever is told in this context but clinically it is very difficult to diagnose the various types. In  general jwara is nothing but fever in which increase of the body temperature takes place.

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Abscess- An Ayurvedic View

An abscess is a collection of pus in any part of the body, along with swelling and inflammation around it (in most of the cases). An abscess is an infection characterized by a collection of pus underneath a portion of the skin (commonly) or any part of body. Bacteria commonly causing abscesses are Staphylococcus aureus and Streptococcus. These bacteria enter the skin through any cracks or injury to the skin. That area of skin then becomes red, tender, warm, and swollen over days to 1–2 weeks and a fever may develop. Most abscesses causes local pain and tenderness. If they are close enough to the surface of the skin, there is likely to be redness and swelling. Deeper abscesses can cause fever, fatigue, and loss of appetite. If an internal organ is involved, there can be symptoms resulting from disruptions in the functioning of that organ.

According to Ayurveda:

In Ayurveda a term “Vidradhi is described as abscess. Vidradhi is a shalya kriya sadhya roga (surgical ailment). In start of the abscess it may be cured by medicines orally or local application but surgical management is necessary after pus formation.

TYPES & SYMPTOMS

According to affected region abscess may be classified in following types:

  1. Breast abscess
  2. Lung abscess
  3. Brain abscess
  4. Liver abscess
  5. Bone abscess
  6. Testicle abscess
  7. Tonsil abscess
  8. Skin abscess
  9. Tooth abscess
  10. Colon abscess
  11. Appendix abscess
  12. Eyelid abscess
  13. Sebaceous abscess
  14. Dental abscess
  15. Bartholin abscess
  16. Pilonidal abscess
  17. Anorectal abscess
  18. Spinal cord abscess
  19. Epidural abscess

There are six types of Vidradhi described in Ayurveda (Acc. To Sushruta Samhita):

  1. Vataj:    Blackish red colored, irregular borders, very painful
  2. Pittaj:    Udumber phala varna (ficus fruit colored), burning sensation, fever may present, suppurative (pus formation)
  3. Shleshmaj (Kaphaj):       Pandu varna (pale yellow colored), cold in touch, pain is less, takes time for suppuration
  4. Sannipataj:         mixed symptoms of above three
  5. Raktaj:  Highly suppurative and painful, resembles with pittaj type.
  6. Abhighataj (Agantuj):    It is caused due to any external trauma or accident.