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Vatrakta (Gout)

Introduction
This ailment expounded by Ayurveda, VataRakta is a combination of two
words Vata & Rakta. In Charak Sanhita, Ashtang Hridaya
& Madhav Nidan VataRakta has been elaborated in great details.
Synonyms
- Khuda
Khuda means small joints. Since in this disease, the small joints are
inflicted it is called as Khuda Vata
- Adhayavata
Adhaya means the rich class of people & those who are delicate.
Since this class of people is generally inflicted with the disease, it
is also called as Adhayavata.
- Vatabalasaka
The aggravated vata having been obstructed in its passage by aggravated
blood, affects the entire blood.
Hetu (causes)
- Intake of diet consisting of an excess of
sour, pungent, alkaline, fatty, hot & uncooked articles, moist
or dried things, meat of aquatic & marshy animals, oil-cakes,
radish, horse gram, black gram, nishpava and other leguminous.
Vegetables, seasum paste, sugar cane, curd, sour gruel, sauvira, shukta
(vinegars), butter milk, sura are asava also the causative factors
- Incompatible food
- Eating during indigestion
- Anger
- Day-sleep
Poorvarupa (Premonitory symptoms)
- Swedo Atyartham Na Vaa- Excess or absence
of perspiration.
- Karshnya- Blackness
- Sparshaagyatvam- Anaesthesia
- Shate Atiruk- Severe pain on injury
- Sandhi Shaithilyam- Laxity in joints
- Aalasyam- Lassitude
- Sadanam- Malaise
- Pidakodgam- Appearance of boils
- Janujangha Uru Katayam Sa hastapada and
Sandhishu Nistoda Sfurnam
- Bhedo Gurutvam Supti Kandu - piercing
pain, quivering, tearing, heaviness
- Numbness & itching in knee,
shanks, thigh, waist, shoulder, hands,, feet & joints of body.
- Sandhishu Rug Bhutva- unstable pain in
joints.
- Vaivarnam & Mandalotpatt-
abnormal complexion & appearance of patients.
Classification & Rupa (clinical
features)
- Based on the seat (root) /
location
- Uttana (superficial)
This is located in the twak (skin) & mamsa (muscle).
- Gambhir (deep)
This is located in the deeper dhatus.
- According to the Doshas involved
(predominance)
- Predominance of Vata
(Vatadhika)
Sira aayam shul Sfuran Todanam Shothasya Karshnyam. Raukshyam Shyavata
Vruddhi haanaya meaning:
- Dilatation of vessels
- Pain
- Quivering & piercing pain
- Blackness
- Roughness
- Blackishness
- Aggravation & diminution
- Dhamanya anguli
Sandhinam Sankocha Anggraho Atiruk
Contraction in Dhamanis (arteries), fingers & joints
Stiffness in body parts
Intense pain
- Kunchan Stambhane Sheeta
Pradvesha
Contracture & stiffness
Aversion to cold
- Predominance of Rakta
(Raktadhika)
- Shwayatu Brusha Ruka
Toda Tamrashcha Chim Chimayate
Swelling with severe distress
Pierceing pain
Coppering with pricking sensation
- Snigdha Rukshaiya Shaman
Na ati Kandu Kledanvito
Not subsiding by either unctuous or rough applications &
associated with itching & moistening.
- Predominance of Pitta
(Paitika)
- Vidaho Vedana Murchha
Swed Trshna Mada Bhrama
Burning after meals
Pain
Fainting
Sweating
Thirst
Narcosis
Giddiness
- Raga Pakashcha Bhedascha
Shoshashcha
Redness
Inflammation
Tearing
Dryness
- Predominance of Kapha
- Steymityam Gauravam
Sneha Supti Manda Ruk
Feeling of wetness
Heaviness
Unctuousness
Numbness & mild pain
There are certain upadrava (complications) that musty be kept in mind
while treating this ailment, which are a follows:
- Asvapna- Sleeplessness
- Arochaka- Anorexia
- Swasa- Dyspnoea
- Mansa kotha- Gangrene
- Shiro graha- Stiffness in head
- Murchhaya- Fainting
- Mada- Narcosis
- Ruk- Distress
- Trushna- Thirst
- Jwara- Fever
- Moha- Mental confusion
- Pravapaka- Trembling
- Hikka- Hiccup
- Pangulya- Lameness
- Visarpa- Erysipalas
- Paka- Inflamation
- Toda- Piercing pain
- Angulivakrata- Crookedness in fuigen
- Sfota- Blisters
- Daha- Burning Sensation
- Marmagraha- Stiffness in Vital parts
- Arbuda- tumour
- Etaivupadrava Vaivarjyam Mohen Ekan Vaa
Api Yata - Even on complication, mental confusion is enough to make the
disease incurable
- Samprastavi Vivarnam Cha Stabhdham Arbuda
Kruchcha Varjayet Cha Eva Sankoch Karmendriya Tapanam
- Akrutsna Upadravam Yapyam Sadhyam Syat
Niru padravam - The one having less than all symptoms i.e. least no of
symptoms is pallative & that which is free from complications
is curable.
Treatment
- The blood of the patient of Vata Rakta
(gout) should be let out, in small quantities, at many times after
oleation therapy
- Protecting him from (aggravation of) vata
- Bloodletting beingappropriate to the dosha
- When pain, redness, pricking pain and
burning sensation are present, blood should be got sucked by jalauka
(leeches).
- When tingling sensation, itching, pain
and burning sensation are present, the use of srnga-alabu (sucking horn
or gourd) is indicated.
- When the disease / lesion is found
spreading from place to place, either pracchana (scratching the skin)
or siravyadha (venesection) is recommended.
- Blood should not be let out when there is
debility of the body, dryness and predominance of vata; vata getting
aggravated (increased) by loss of blood (from blood-letting) produces
profound swelling, stiffness, tremors, diseases of tendons, and veins,
debility and many other disorders of vata origin.
- Purgation therapy should be given
oleation therapy first and then administered purgative drugs mixed with
fats (medicated ghee / oil).
- In Vatarakta (gout) having predominance
of vata, the patient should be made to drink old ghee. Ghrta prepared
with decoction of Draksha and
- Madhuka, added with Sitopala (sugar
candy) should be consumed; or milk boiled with addition of fresh juice
of Guduchi; or drink the mixture of taila (oil), milk and sarkara
(sugar) boiled together.
- In Vatarakta caused by pitta, decoction
of vari, tikta, patola, triphala and amrta should be consumed. Also
ghee or milk boiled with drugs of sweet and bitter tastes (be consumed)
- Eranda taila should be consumed mixed
with milk to produce purgations in the patient who has great increase
of dosha; after it gets digested (and after purgations) he should eat
boiled rice along with milk.
- The malas (doshas) may also be removed by
kshirabasti (milk enema) added with grtha (ghee).
- There is nothing equal to basti (enema
therapy) in the treatment of vatarakta (gout), especially for those who
have pain in the rectum, flanks, thighs, joints, bones and abdomen.
When kapha is predominant, the decoction of musta, dhatri and haridra
or of triphala or of guduchi, whichever is suitable, should be consumed
mixed with kshaudra (honey)
- After administering the appropriate sneha
(fat) to drink, he should be given mild vamana (emetic) drugs and then
rukshana (therapy creating dryness inside).
- Decoction of kokilaksha consumed followed
by partaking its leaves only as food, cures gout just like the practice
of compassion cures anger.
- Medicated oil prepared with madhu
ucchista (bee's vax), manjishta, sarjarasa and sariva-known as pinda
taila-used for abhyanga (anointing and massage) relieves the pain of
vatrakta.
- The Uttana kind of vatrakta (gout) should
be treated with lepana (application of pastes), abhyanga (anointing
with fats) parisheka (pouring liquids on the body) and avagaha
(immersing the body in liquids), the gambhira kind of gout by vireka
- (Purgation), Asthapana (decoction enema)
and snehapana (drinking of fats). · When vata and kapha are
predominant, warm applications of pastes etc. are beneficial; if cold
applications are made, burning sensation, swelling, pain and itching
will increase, due to rigidity (caused by cold).
- In gout, when there is predominance of
pitta and rakta cold application are beneficial, plosha (blisters,
blebs) osha (localised burning sensation) pain, redness, sweating and
avadarana (laceration, abrasion) will develop by heat (of warm
applications).
Commonly used drugs
- Guggul
- Gokhshuradi (Sharngdhar Sanhita)
- Kaishor (Sharngdhar Sanhita)
- Panch Tikta Ghurta (Bhaisajya
Ratnavali)
- Mahayograj (Sharngdhar Sanhita)
- Yograj (Bhaisajya Ratnavali)
- Sinhnad (Bhaisajya Ratnavali)
- Bhasma
- Shrung (Ras Tarangini)
- Shankha (Siddha Yog Sangraha)
- Swarna Makshik (Rasendra Saar
Sangraha)
- Praval (Ayurved Saar Sangraha)
- Arishtha / Asava
- Dashmularishtha (Bhaisajya Ratnavali)
- Chandanasava (Bhaisajya Ratnavali)
- Maha Manjishthadyarishtha (Siddha Yog
Snagraha)
- Rasa Kalpa /Vati / Mandur
- Samshamni (Siddha Yog Sangraha)
- Gandhak Rasayan (Ayurved Prakash)
- Punarnavadi Mandur (Ayurved Saar
Sangraha)
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