Daradavati sandhivata rs005-gdg

“THE PREPARATION, PHYSICO-CHEMICAL ANALYSIS OF DARADA VATI AND EVALUATION OF ITS CLINICAL EFFICACY ON

SANDHIGATA VATA (Osteoarthritis)”

By

DR. KALLAPPA .M. JAGGAL

B.A.M.S

DISSERTATION SUBMITTED TO THE

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA,

BANGALORE

IN PARTIAL FULFILLMENTS FOR THE DEGREE OF “DOCTOR OF MEDICINE”

(AYURVEDA)

In

RASASHASTRA

GUIDE CO-GUIDE DR.M.C.PATIL DR. GIRISH.N.DANAPPAGOUDAR M.D.(R.S) M.D(R.S) Prof. Head of the Department Lecturer. Department of Rasashastra. of Rasashastra.

DEPARTMENT OF RASASHASTRA, POST GRADUATE STUDIES &

RESEARCH CENTER,

D.G.M. AYURVEDIC MEDICAL COLLEGE. GADAG –582103 FEBRUARY- 2005

ENDORSMENT BY THE HOD, PRINCIPAL/HEAD OF THE

Ayurmitra

TAyComprehended

INSTITUTATION

Department of Post Graduate Studies in RASASHASTRA

Post Graduate cum Research Center, D.G.M.Ayurvedic Medical College Gadag –582103

J.S.V.V. SAMITE’S

ENDORSEMENT ΕΡΤΙΦΙΑΧ

I here by declare that this dissertation entitled “THE PREPARATION, PHYSICO-

CHEMICAL ANALYSIS OF DARADA VATI AND EVALUATION OF ITS

CLINICAL EFFICACY ON SANDHIGATA VATA(Osteoarthritis)” is a bonafide and

genuine research work done by Dr.Kallappa.M.Jaggal under the guidence of

Dr.M.C.Patil Professor, HOD Department of Post Graduate Studies &

Dr.Girish.N.Danappagoudar Lecturer, Department of Rasashastra, Post Graduate

Studies in D.G.M.Ayurvedic Medical College, Gadag.

Seal & Signature of the

Principal:

Name:

Date:

Place:

Seal & Signature of the HOD. Name: Date:

Place: Gadag.

Department of Post graduate Studies in RASASHASTRA

Post Graduate cum Research Center, D.G.M.Ayurvedic Medical College Gadag –582103

J.S.V.V. SAMITE’S

CERTIFICATE



CLINICAL EFFICACY ON SANDHIGATA VATA(Osteoarthritis)” is a bonafide and

genuine research work done by Dr.Kallappa.M.Jaggal in partial fulfillment of

the requirement for the degree of Ayurveda Vachaspati (M.D) in Rasashastra of

Rajiv Gandhi University of Health sciences, Bangalore, Karnataka.

Date:

Place: Gadag.

Guide Dr.M.C.Patil. M.D.(RS) Head of the department Rasashastra, Post Graduate cum Research Center D.G.M. Ayurvedic Medical College Gadag –582103

Department of Post graduate Studies in RASASHASTRA

D.G.M.Ayurvedic Medical College & Post Graduate cum Research Center Gadag –582103 Dist: Gadag

J.S.V.V. SAMITE’S

CERTIFICATE



CLINICAL EFFICACY ON SANDHIGATA VATA(Osteoarthritis) ” is a bonafide

and genuine research work done by Dr.Kallappa.M.Jaggal in partial fulfillment

of the requirement for the degree of Ayurveda Vachaspati (M.D) in Rasashastra of

Rajiv Gandhi University of Health sciences, Bangalore, Karnataka.

Date:

Place: Gadag.

Co-Guide Dr.Girish.N.Danappagoudar M.D.(RS). Lecturer Rasashastra Post Graduate cum Research Center D.G.M. Ayurvedic Medical College Gadag –582103

J.S.V.V. SAMITE’S

DECLARATION

I here by declare that this dissertation entitled “ THE PREPARATION, PHYSICO-

CHEMICAL ANALYSIS OF DARADA VATI AND EVALUATION OF ITS CLINICAL

EFFICACY ON SANDHIGATA VATA (Osteoarthritis)” is a bonafide and genuine research

work carried out by me under the guidance of Dr.M.C.Patil. Professor &

HOD, Department of Post Graduate Studies in Rasashastra, Post Graduate cum Research

Center, D. G. M Ayurvedic Medical College, Gadag –582103

Date:

Place: Gadag.

Dr.Kallappa.M.Jaggal P.G.Schalor,

Dept. of Rasashastra, Post Graduate cum Research Center, D.G.M Ayurvedic Medical College Gadag –582103

COPYRIGHT

I here by declare that the Rajiv Gandhi University of Health Sciences,

Karnataka shall have the rights to preserve, use and disseminate this dissertation in

print or electronic format for academic / research purpose.

Date:

Place: Gadag

Dr.Kallappa.M.Jaggal P.G.Schalor,

Dept. of Rasashastra, Post Graduate cum Research Center, D.G.M. Ayurvedic Medical College Gadag –582103

© Rajiv Gandhi University of Health Sciences, Karnataka

ACKNOWLEDGEMENT

My father & mother is the only Inspiration. This work carries some sweat

memories to express & record about some distinguished personalities by whom I had been

inspired during the course of this thesis.

I express my deep sense of gratitude to my respected guide Prof.Dr.M.C.Patil. MD(Ayu)

Head of Dept. of RS, DGMAMC & PGSRC, Gadag. He has been very kind to guide me in the

preparation of thesis & for who extraordinary efforts, tremendous encouragement & most

valuable thought provoking critical suggestions, made me to complete this work.

I am extremely greatful & obliged to my co-guide Dr.Girish .N

.Danappagiudar.MD(Ayu). Lecturer in Rasashastra, PG studies & Research center DGMAMC,

Gadag, for patiently going through the draft of thesis & correcting with precious remarks which

have been very useful.

I am thankful to Dr.G.B.Patil principal, DGMAMC, PGSRC,Gadag, for

providing all necessary facilities for this research work.

I wish to convey thanks to my teacher Prof.Dr.R.K.Gachchinamath

HOD,Rasashastra dept,(UG) DGMAMC, Gadag, for being kind & affectionate through his

valuable suggestions & advises.

It gives me immense pleasure to express my gratitude to Dr. Dilipkumar B.

MD (Ayu). Asst. Prof. PGSRC for kind advise encouragement during the study.

I acknowledge the valuable help given to me by my best friends Dr.

Jagadish Mitti MD(Ayu). Lecturer & Dr. Shashikant Nidagundi MD(Ayu) Lecturer, for

their support during my PG study.

I am greatful for the support and advise given by Dr. S.H.Doddamani MD

(Ayu). Asst. Prof. PGSRC. DGMAMC, Gadag, during my clinical trail and encouraged me

all the time during this work.

I express my deep gratitude to Dr. B.M.Mulkipatil MD (Ayu), Lecture,

PGSRC, Gadag, for his fullhanded whole hearted, co-operation and suggestions in this

study, for which I will be ever greatful to him.

I wish to convey thanks to all UG & PG lectures of DGMAMC, Gadag, for

their timely help & constant co-operation during my PG work.

I sincerely thank my beloved classmates Dr. K.S.Santoji, Dr. P. Koteshwar

Rao, Dr. V.S.Hiremath, Dr. R.B.Paattanashetti, for their deep co-operation and involvement

in the study.

I am also thankful to scholars of PG Dept. of Rasashastra who have directly

or indirectly helps my thesis work. & expected their co-operation & support during my PG

work.

I am glad to express my heartiest thanks to Dr. Chandur Medical pharma .

J.T.College Gadag, having helped me in carrying out analytical works, and for giving kind

suggestions.

I wish to convey my thanks to beloved librarian, Sri. V.M.Mundinamani,

Asst. S.B.Sureban for providing many valuable references in the study. I am thankful to Sri.

B.S.Tippanagouda, Lab technician, who extended this co-operation in investigations.

I tender my sincere thanks to Nandakumar, statistician for his help in

statistical evaluation & results.

I wish to thank the physicians , House surgeons, Hospital staff, nurses &

non teaching staff for their timely assistance in completion of this work.

Let me express my thanks to all patients, those were on trial for their

consent for enrolling in this clinical study & obedience to advises.

I am highly indebted to my beloved parents brothers sisters & other family

members for their love & affection rendered through out my career.

I am thankful to computer operator in bringing out the computer presence

of my thesis in such a elegant way.

I express my thanks to all the persons who have helped me directly &

indirectly with apologies for my ability to identify them individually.

Lastly I prey my deep homage & tribute to my grand parents for the love &

affection rendered through out my career.

Gadag February 2005 Dr: K.M.Jaggal

PREPERATION, PHYSICOCHEMICAL STUDY OF DARADAVATI & ITS CLINICAL EFFICACY ON SANDHIGATA VATA

4

CONTENTS

• Acknowledgement

• List of Tables

• List of Photographs And Diagrams

• Abbreviations

ABSTRACT Chapter name Page No.

1. Introduction 1-3

2. Objectives 4

3. Review of Literature’s 5-59

4. Materials and Methods 60-83

5. Results 84-98

6. Discussion 99-108

7. Summary and Conclusion 109-111

• References

• Appendix


5

INTRODUCTION

Kaya Vagbuddhi Vishayo ye malaha Samupasthita ⎜

Chikitsa laxanaadyatma shastrai stesham vishuddhaya⎜⎜ (V.P)

Kaya, Vak, Buddhi, Doshas can be Corrected by chikitsa, Vyakarana, Adhyatma

respectively, which are studied under the roof of Ayurveda.

Ayurveda is one of the most ancient systems of health science based on its own unique

original concepts, fundamental principles. The development of Science is by Brihatrayis and

laghutrayis. These texts have described well developed eight clinical specialties for the

purpose of chikitsa

In this chikitsa, vanaspathija dravyas are most dominant and next pranja dravya, very

few metal minerals were used.

In Bouddhika kala the practice of shalya and panchakarma were declined, as they were

the followers of “ahimsho paramu dharma”. These leads to development of alternative

medicinal remedies with use of metals and minerals keeping in view that “yatha lohe tatha

dehe.”

Mahaboutika compositions of metal and minerals will differ, than the tissue element of

the body; these raw heterogeneous and toxic properties are removed by shodhana, maranadi

samskaras, according to the nature of the dravya and the diseases for which they are to be

used, such drugs become more potent thus they can be used in minimal dose.

The rasa dravyas are classified differently by various authors on the basis of

therapeutic effect and process makes fit for uses.


6

In these parada is supreme one because of “kastoushadhyo nage nago vangasta

vangamapi shulbe ⎜ shulbam tare taram kanake kanakam cha liyate cha suthe⎜⎜”1 and it

has the power to assimilate all the other metal and minerals, and preventing from the jara,

akalamrityu, curing diseases when it processed in proper way.

Parada can be extracted by darada, so darada is one of the measure sources of parada.

Parada extracted from this is called Hingulottha parada. This has the property of ashta

samskarita parada, gandhaka jarita parada.

Hingula can be studied under sadaranarasa as well as maharasa, uparasa rasadhatu

varga, according to different opinion.

Shodhita hingula act as a Sarvarogaghna, Sarvadoshaghna, Rasayana, Balavardhaka,

Medhya, Agnivardaka, and Yakritaplehavikaranashaka, Meha, and Kushta etc.vikara nashaka.

According to Rasamritakara shodhita hingula should be subjected to bhavana with

Lasuna, Palandu, Tambula, and Ardraka sawrasa seven times with each. The vati prepared by

it may be act on all vatakaphaja vikara especially sandhigatavata, puranapinasa, by virtue of

properties like agnideepaka, balya, tridoshaghna, rasayana property.

Sandhigata vata is explained in almost all Ayurvedic classics in vata vyadhi adhyaya,

they explained about sign and symptoms those are sandhishoola, shotha, atopa, etc. and also

mentioned different chikitsa procedures like abhyanga, swedana, snehana, basti and drugs in

single, compound drug formulations like kashaya, guggulu kalpa, and churana etc.

According to modern signs and symptoms resembles like osteoarthritis, osteoarthritis is

a degenerative inflammatory joint disease characterized by destruction of articular cartilage

and formation of new bone at the joint surface and margin, in this pain is universal problem,

which has an unpleasant sensory and emotional experience associated with actual or potential

tissue damage, it does not lead to mortality but it definitely causes morbidity.


7

Radiological and autopsy surveys shows that a steady rise in degenerative changes

in the joint from the age 30 yrs, 65% of people have radiographic evidence of osteoarthritis,

35% may have symptoms, male and female both were affected but more generalized, more

severe in older women’s.

Geographical survey show different in both the prevalence of osteoarthritis and

pattern of joint involvement, cold and damp climates are associated with more symptoms

but not in greater radiological.

Now a day this common disease affecting in 25% of population and more

generalized. The disease treated by many drugs, there is no satisfactory treatment is

established. In this view the rule of Darada Vati may be as an effective drug.

Plan of study The study has been planed as below

1. Objectives

2. Review of literature – Drug review and Disease review

3. Methodology- Pharmaceutical study, Analytical study, Clinical study.

4. Results

5. Discussion

6. Summary

7. Conclusion


8

Aims and Objectives of the Study

1. Preparation of Darada vati

2. Physicochemical analysis of darada vati

3. Clinical evaluation of Darada vati on sandhigatavata


9

Drug Review

HINGULA

Histrological aspect:

The possible available references regarding hingula since, ancient period to present

day are as follows.

There is no reference in Prevedic, Vedic, Purana, Upanishad period.

Samhita kala (100 B.C):-

All the literatures which are written during the Samhita kala are not available at

present, the leading Samhita available are charaka, sushruta, kashyapa, etc. In these texts

also there is no reference of hingula is found. In these Samhita only use of parada available.

Kautilya arthashastra (200 B.C):

Chanukya has mentioned hingula in his text for the first time. But the usage of

hingula as a medicine is not described by him. He has mentioned hingula with swarnadi

dhatu. “Ghanasushire vaa roope swarna mrit valuka hingula kalko vaa

taptovatishthate”(Kou Arth 2/14/40) Another reference of hingula is found in the methods

for testing of various metals. He has mentioned four types of testing methods namely

1. Parikuttanam (hammering), 2. Avachahedana (cutting),

3. Ullekhana (scratching), 4. Parimardana (rubbing),

Here hingula is mentioned in the parimardana (Kou Arth 2/14/54)

Nighantu period:

In Dhanwantari, Raja, Kaideva, in these nighantu reference of hingula available in

bhouma dhatu varga.

Rasakala (6th-8th century A.D):


10

I.Rasarathanakara (6th century): Rasarathanakara tantra written by nagarjuna,

nagarjuna was first time mentioned the hingula for therapeutic purpose

II. Rasendramangala2 (8th century A.D): The oldest text of rasashastra rasendramangala

as per the first time descried about shodhana and the therapeutic usage of hingula is

discussed, and this is also used for the preparation of loha bhasma. He has considered

Hingulottha Parada is the satwa of hingula.

III.Rasa hridaya tantrakara (10th century A.D): Acharya bhagvata govinda pada has

mentioned in the list of eight rasa dravyas.

IV. Rasarnava3 (12th century A.D): He has considered hingula as a maharasa; he also

described the synonyms varieties properties and satwapatana of hingula. He utilized the

term “Rasagandasombhotam”. From this world it is understood that he was aware of

chemical composition of hingula.

V. Rasaratnakara4 (15th century A.D): Rasaratnakara described the hingula and also

mentioned the artificial preparation of hingula; this indicates they were well known about

chemical composition.

VI. Other rasagranthas (6th – 20th century A.D)

Rasa ratna samuchchaya5, Rasa prakasha sudakara, Rasendra Sara sangraha6,

Rasendra chudamani, etc. and Naveena rasa grandha like

Rasa tarangin7i, rasamritakara, Ayurveda prakasha8, siddha bhaishajya manimala, etc

mentioned the Synonyms, varieties, properties, shodhana, grahyalakshana and uses, these

texts also mentioned the artificial preparation of hingula

.


11

VII. Modern Historical Aspect9& 10:

Before 3000 yrs hingula was collected from mines situated near by Konia in

minor Asia for colouring purpose. Reference of hingula can be found in the text on stones

written by Theofiastice (300 B.C). He has described a method for the separation of mercury

from hingula by adding copper powder and vinegar, Diokaridase used iron powder instead

of copper for the same purpose.

Hingula is being obtained from almond (Spain) since 2000 yrs.

Classification: Hingula was classified into different groups in different texts according to author’s

opinions is given below.

Table No. 1 Showing the class of Hingula according to different text

Sl.no Classification Rasagranthas

1 Rasa Rasa Hridaya tantra

2 Maharasa Rasarnava11, Rasaratna samucchaya12,

Rasakalpa, Rasakamadhenu13, Goraksha

Samhita, Rasaviveka

3 Uparasa Anandakanda, Rasaratnakara, Rasaprakasha

sudhakara, Rasasarasangraha14, Rasamanjari,

Rasendra chintamani, Ayurveda prakasha15,

Bavaprakasha, Rasapradeepeka, Rasoddhara

tantra, Brihatyogatarangini.

4. Sadharana

rasa

Rasaratna samuchchaya16, Rasaendra

chudamani, Rasajalanidhi17, Rasachandansh,

Rasadhatuprakash, Bharatiyarasashastra18,

5 Suvarnadi Dhanwantarinighantu, Rajanighantu19,

6 Rasadhatu Rasamrita20, yogaratnakara21

7 Bhouma

uparasa

Dravyagunavignan.


12

Vernacular names22&23

Sanskrita ---- Hingula, Darada, Churnaparada, Mlechch

Hindi----- Hingula, Singarpha,

Latin name –Sulphuatumhydragyrium

English------ Cinnabara, Redsulphide of Mercury

Kannada----- Ingalika,

Marathi----- Hingula, Assami----- Janophar

Telagu------ Ingulikam, Gujarati--- Hingula

Malyali------- Sedilengam, Arabic----- Zunjefer

Nepal------- Sabita, Persian---- Shengherf

Synonyms Rasaganda sambuta, Maniragaja, Kandarasa24

Hinguala, Hingulik, Hingoola, Ingalika, Mlecch, Rakth, Suranga, Chitranga, Churnaparada,

Rasodbhava, Rasasthana, Ranjani, Kapishirshaka25, Raktakaya, Hamsapada. Shukatunda,

Pravalabha, Bimbiphala. Kuravinda, Gandhika.

Table No. 2 Showing different synonyms of Hingula according to content place colour

similarity uses

Orig

in26-

M

ythol

ogic

al

story

Content Place Colour(similarity) Uses

Rasodbhava Hingula Rakta,,raktakaya Ratnaragakari

Churnaparda Darada Suranga,,hamsapada lohaghna

Rasagandhasambuta Mleccha Chitranga,,japakusum Ranjani

Rasagarbha Chinipisti Daityarakta,,shukatund hingula

Lagukandarasa Bimbiphala Maniragaja

charmargandika pravalabha kuravinda


13

has been described that hingula is virya of lord shiva which was recived by god Agni but

due to its high intensity he vomited it, this vomited material fell in daradadesh and become

mixed with the earthy material, this mixture is known as hingula.

Chemical composition27 (HgS):

According to rasarnava “Rasagandha samnbutham”by this hingula is a compound of

parada and gandaka,

Chemically it is called as red sulphide of mercury; it contains 86.2%of parada and 13.8% of

gandaka and trace amount of arsenic, iron pyrite, clay, gypsum, black earthy materials

occurrence28&29:

It is obtained from the mines as a natural mineral and also prepared artificially

In ancient days hingula was available in darada desh.at present it can be found at

many places all over the world i.e., Spain(almandine), Italy, Russia, Yugoslavia,

Jechoslovia, Germany (idria mines), Japan, china, USA,Austraila,Nepal etc….

But now a day no deposit of cinnabar can be detected in India. For that purpose

artificial hingula is prepared in Surat and Calcutta.

The hingula what we get from market is almost artificial prepared.

Preparation of artificial hingula

Preparation of artificial hingula prepared since rasaratnakara30 period, next after this

number of text also mentioned the artificial preparation of Hingula. Here the ratio of parada

and gandaka is differing from text to text.

According to Rasa tarangini31---- 42 part parada and 8 part gandaka subjected to paka in

mrudangayantra

According to rasakamadhenu and Ayurveda prakasha32

1 part ashuddha parada and 4 part ashuddha gandaka, subjected to pachana in loha

patra.after paka 1/10 part manashila was added and make mardana fill in kachakupi

After filling kept in valuka yantra and subjected to paka karma (mridu, madyam, teevra)

According to Materiaindica33,


14

Red sulphide of mercury may be obtained from the block sulphurent by heating it

red hot in a flask, and then gray sublimate is produced.

The cinnabar is compound of about eight parts of mercury with one part of sulpur is

manufactured to a great extent in Holland as a red pigment.

Varieties

Ancient rasagranthas like Rasa Hirudaya Tantra, Rasa Prakasha Sudakara34, Rasendra

chudamani35 etc. considered two varieties. 1. Shukatunda 2. Hamsapada

According to Rasamrita36- 1. Hamsapada 2. Mlecchaka

Rasagranthas of middle period like Anandakanda, Rasakamadhenu37, Ayurveda

prakasha38, etc. considered three varieties

1. Charmara 2. Shukatunda 3. Hamsapada

Modern rasagranthas like Rasatarangini39, Rasamritha described two varieties according to its

origin 1. Kritrima (artificial) 2. Khanija (natural)

According to Haridatta shastri commentator of Rasa Tarangini further classified artificial

hingula into two types in his prasadini commentary i.e. 1. Mrisrina 2. Kathina

According to Bharatiya Rasa shastra40 kritrima hingula again classified into two types

1) Rumi Hingula(Rakta Varna) 2) Katha Hingula (Krishna Hingula)

Table No. 3 showing classification of hingula according to ancient period.

Ancient

acharya

Middle period Modern rasagranthas

RHT, RPS, RC, RK, AU PR,

AK

RT, RA

1. shukatunda

2. hamsapada

1. charmara

2. shukatunda

3. hamsapada

1. Kritrima

2. khanija

1. Mrisrima

2. katina


15

Properties of Standard Quality Hingula:

According to Rasaprakasha sudhakara41, Hamspada is the best variety of 3 types

According to Rasendrasarasangraha42 Bimbi pahal samana rakta varana

According to Rasatarangini43 Japakusumavarnayukta, Mritsna, Shlakshna, Bhara, is the

best.

Shodhana44, 45, 46, 47

Rasagranthas have described different methods of hingula shodhana and drugs also differ in

this process.

Yantra used for the shodhana are only two yantras i.e

1. Khalva yantra, 2. Dola yantra

Methods used for shodhana are Bhavana, Swedana, Prakshalana with Swarasa of herbal drugs

and pranija dravyas like Dugdha, Mutra of, etc some authors told that Prakshalna has to be

carried out after bhavana. Bhavana is suggested after swedana karma.

Shodhana drugs according to origin

1. Animal origin – Dugdha and Mutra of Go, Aja, Mahisha, Meshi,

2. Plant origin – Amla vargiya dravya swarasa like Jambira, Nimbu,

Matulunga,Lakucha, and Drakshaphala swarasa, Kusmandu swrasa, Ardraka swarasa,

Shunti kashaya,Jayanti swarasa , Laksha rasa, Taila, Ksharajala,Laksh rasa

Almost all reference mentioned Bhavana Method with Amlavargia dravya swarasa,

Ardraka swarasa.

According to Rasa mrita, shodhana is by Meshi Dugdha for one times after this seven

times Nimbu swarasa Bhavana.

Matra48, 49:

½ to 2 ratti (62.5mg to 250mg)

Anupana50:

Maricha, Guda, Pipali, Guduchi swarasa, Madhu, Ardraka swarasa, Tambula Swarsa

Properties:


16

The properties of shodhita Hingula equal to property of Rasasindura and parada extracted

from this equal to Gandhaka jarita parada.

Rasa; We have different opinions regarding the rasa of hingula

1. Most of the authors have towards the Tikta Katu Kashaya rasa51

2. Some other opinions Madhura Tikta rasa52

3. Least reference is available about only katu and only Tikta rasa53.

Table No. 4 showing rasa of hingula according to different grantha

Guna: Ushna Guna54

Veerya: Ushna Veerya54

Vipaka: Katu vipaka54

Doshaghnata: Tridoshaghna55, Vatakaphaghna, Kaphaghna, kaphapittaghna56

Sl.no Rasa Rasagranthas

1. Katu

Tikta

Kashay

B.P., A.P., Aryuveda Chintamani, Parada Samhita

Rasendra purana, Rasadhatu Prakasha, Brihat Yoga

Tarangini

2. Madhura

Tikta

Rasarnava, Basavarajiya, Danwantharinighantu,

Rajanighantu

3. Tikta Rasendra Chintamani,

4. Katu Gadatimir bhaskara,


17

Table No. 5 showing Doshaghnata of Hingula according to different text

Sl.No Doshaghnata Rasagranthas

1. Vata

Pitta

Kapha

Basavarajiya, Rasendra Chudamani, Rasendra

Sara sangraha, RSS, Danwantharinighantu,

Rasamrita, Rasachandanshu, Rasadhatu prakasha

2. Kapha

Pitta

B.P., A.P., Aryuveda Chintamani, Parada

samhita, Rasendra Bhaskara, rasoddhara tantra,

Si.Bh.Ma.Ma. Bha.Ra.Sha, Bri YoTarangini,

3. Kapha Rasatarangini

Krama: Sarvadoshaghna, Aghivardhaka, Rasayana Balya, Medhya, Kantivardhaka,

Garavishnashaka, Netraroga, Pramehahara, Ruchikaraka, Hriudayotsadaka,

Jawaranashaka, Aruchinashaka, Hrillashanashaka.

Upayoga57,58,59: Prameha, Jwara, Hridroga, Kusta, Garavisha, Amlapitta, Kamala,

Pleehavraddi, Mandagni, Aruchi, Amavati, Sandhivata, Hrillasha Lohamarnarta,

Lohajanarta, Parada niskarshanartha, etc.

According to Brandus manual of chemistry volume 2 this has been consider has

Alternative, Deobservent and at one time was much used in Rheumatic Affection, Leprous

cases and also in Worm cases Arabians knew that fumigating the Hingula in old venereal

complaints.

Hindus knew how to prefer it in a course manner and considered it as

Antispasmodic and also as valuable remedy for cuetaneous affection and for fumigating in

such a case of the Venereal diseases as are attained with ulcers in the mouth, throat.


18

Table no.6 shows the properties of hingula according to different text.

Ashuddha and asamykashuddha hingula dosha60

Rasagranthas have given description about ashuddha and Asamykashuddha Hingula

Dosha; Ashuddha Hingula administration may produce dangerous toxic symptoms,

Klama. Moha Bhrama, Klaibya, Kusta, Kshinatha, Andatha, Murcha, Prameha, according to

Unani Dravy Guna some toxic symptoms like Hridspandana, Akulath, Vishadatha,

Properties RJN RPS AP RC RSS RRS RT RP RM BRS

sarvadoshaghna + + KP + - + KV - + KP

Deepana + + - + - + - - + +

Atirasayana + + - + - + - - + +

Sarvarogahara + + - + - + - - + -

Vrishya + - - + - + - + + -

Jaranartha + - - - - + - + - +

Meha + - + - + - + + - +

Kusta + - + - + - + + - +

Aruchi + - + - + - - + - +

Medhya + - + - + - + + - +

Balya + - + - + - + + - +

Agnivardhaka + - + - + - + + - -

netraroga - - + - - - + - - +

Hrillasa - - + - - - - + - +

jwara - - + - - - - + - +

Kamala - - + - - - + + - +

Pleeha - - + - - - + + - +

Amavata - - + - - - + + - +

Garavisha - - + - - - + - - -

Dehakanti - - - - - - + - - -

lohamaranarta - - - - - - - + - -

Dravanarta - + - - - - - - - -


19

Table no. 7 shows that complications according to different text

Name of Text 1 2 3 4 5 6 7 8

Basava Rajiya - - + + + + + -

Ayurveda prakash + + - + + + - -

Yogaratanakar + + - + + + - -

Parada Samhita - + - + + + - -

Rasa Chandanshu - - + + + + + -

Rasa Jalanidhi - - + + + + + -

Rasendhara Purana - - + + + + + -

Rasa Tarangini + + - + - + - -

Rasa Dhatu Prakash - - + + + + + -

Br,Ra,Ra,Su - - - + + + + -

Unani Dravya Guna - - - - - - - +

1. Andhata, 2.Kshinata, 3.Kusta, 4.Klama, 5.Bhrama, 6.Moha, 7 Klaibhya,

8 Hridayavasada.

Chikithsa of complication caused by Ashuddha and asamykashuddha hingula dosha61

Rsabhaskara mention the treatment about this here management should be done as

per the management of apakva parada bhasma asamykashuddha parada sevan

“Tpadhayat yat vyadhi daradasayani sevan nuth / tat sutavat sarvh kuryat shanthi

prati kriya // 13/41”

Shuddha gandhaka should be administered till the complication subsided.

Marana: - Most of the Rasagranthas have not described mrana for hingula.very list

reference available about marana62, 63, & 64

Hingula bhasma is red sulphide ash is prepared by taking

Hingula (Red Sulphide) 4 Part

Haratala (Orpiment) 1 Part

Lavanga (Cloves) 4 Part


20

The Powder of Shodhita Hingula, Haratala and Lavang all these are mixed and making a

bolus in the Juice of fresh ginger, After drying kept in the crucible subjected to puta.

Hingula Bhasma Matra: - 1/3 – ½ grain

Upayoga65: Atyanta Agni deepaka with Tambul swrasa anupana. Kamottejaka, Medhya,

Atyanta Rasayan,

Satwapatana66, 67, 68, 69&70:

Extracted Parada from Hingula has considered as Satwa of Hingula

This Satwa can be extracted by different methods

1. Urdvapatana Yantra Vidhi

2. Adhapatana Yantra Vidhi

3. Kanduka Yantra Vidhi

4. It is also extracted by Candle method according to Siddh Bhaishajya

Manimala.

Preparations

Anandha Bhairava Rasa, Hingulehsawar Rasa, brihat hinguleshwara rasa. 71 Tribhuvana Kirtirasa, Kanak Sundar Rasa, Atisara Haravati

Kasturi Bhairava Rasa Jwaramurari Rasa72, Vasanth Malik Rasa

Rasa Garbha Potali73iDarada Vati 74

Darada Sudha Bhasma, Hinguladhigutika75

Hingula rasasindoor, Srisiddhadaradamritarasa, Hingulia Manikya Rasa

Hinguladyamalahara, Hingulamrutamalahara, Srisiddhahinguleshwar rasa76

Dradeshwar rasa77.


21

Modern aspect of Hingula78&79 Cinnabar is only important ore of mercury, it is, massive or oarthy, it some times occurs

beautifully crystlised in small complex and highly modified hexagonal crystals; usually the

crystals are rhombohedral or prismatic in habit. it is also transparent, translucent or opaque,

sometime cochineal red in colour often inclining to brown its streak is scarlet to reddish

brown. Adamantine to luster prefect prismatic cleavage. Sometimes with an earthy

coatings.

Varieties

The varieties are made according to colour and percentage of HgS in it.

1. Cinnabar native – This is one of the most important ore of mercury. As mentioned

previously, chemically it is contain 95% mercury sulphide. It is bright and dark red in

colour it contains other impurities like Carbon, Silica, Quartz etc. are present.

2. Hepatic cinnabar – When percentage of carbon impurities are higher in cinnabar, its

colour becomes darker like liver colour such, an ore is called as hepatic cinnabar.

3. Meta cinnabar – This type contains muddy dust is more percent and that makes its

colour still darker almost to a black shade.

4. Coral ore – This ore especially occurring in Germany and Italy. This ore in the form of

rose colour earthen material, when mercury sulphide in coral ore is separated. it is rosy in

colour, it contains about 5% of mercury..

5. Idrialate – The variety called idrialate, always occurs cinnabar at Idria, as white and

crystalline in structure when toward and it is found in impure with clay, pyrite, gypsum as a

brownish black earthy material because of its combustibility and presence of mercury it is

called inflammable cinnabar.

Physico chemical property

1. Cinnabar is a red or whitish red coloured mineral. This ore is a red crystalline mass that

is easily distinguishable from all other red minerals by its peculiar shade of colour and its

great weight.

2. It is heavy and its specific gravity is 8.01 to 8.9.

3. Hardness of this mineral is 2-2.5.

4. It is insoluble in water and acids but dissolve in aquaragia (mixture of HCl and HNO3)

and forms mercuric chloride.


22

In the presence of a strong oxidizing agents like potassium chlorite forming

mercuric chloride

5. Roasting – usually the unconcentrated ore is roasted in air cinnabar is oxidized to

mercuric oxide and sulphur dioxide is released at the temperature of the furnace and

mercuric oxide so forms decomposes to give mercury and oxygen.

2HgS + 3O2 2SO2 + 2HgO

2HgO 2Hg + O2

The mercury obtained by above method is the purest mercury.

6. Mercury Sulphide reacts with concentrated potassium sulphide solution to give a

complex thio salt.

HgS + K2S K2HgS2

On sublimation mercuric sulphide becomes red.


23

DISCRIPTION OF BHAVANA DRAVYA

MESHI DUGDHA80& 81

Varga-Dugdha Varga

Synonyms- Dugdha Ksheera

Vernacular names-English-milk, Hindi, Guja, Moha-Dudh

Tamil Telgu –Palu, Malyali-Musu, Kannada- Halu.

Source-Mammary glands of eves

Description: white emulsive faintly alkaline fluid little more viscous than water tastes

is sweet land blond, odour faint) and peculiar specific gravity-1.027-1.034 under

microscope, numerous minute fat globules are seen floating in the form at emulsion

milk because spoiled after 10-12 hours, after which it is indigestible and harmful and

acts as poison to the system such milk should be avoided milk contains all the elements

necessary for the growth and nutrition of bones nerves muscle and other tissue milk

contains also vitamins which are natural antidotes to rickets, scurvy and other results of

defective nutrition.

According to Astanga Sangraha- Ushna Vata Vyadhinashaka the milk of eve which is

supposed to resemble cow (metria indica)

Pharmaco dynamics –Rasa-Madhura, Guna-Snigdha, Guru.

Veerya-Ushna, Doshaghna-Vataghna.

Uses: eves or sheeps milk is bone ficial in obesty flatulence and gonorrhoea is a good

diet in rheumatism and hectic cough milk of red eve increases too much both the bile

and phlegma.

NIMBUKA82, 83& 84 Botanical Name-Citrus Limon (Linn)

Family-Rutaceae

Gana-Charaka-Phala Varga, Amla Varga, Susruta and Vagbhata-Phala

Varga

Synonyms-Nimbu-Nimbuka, Dantsatha


24

Verncular Names-Hindi-Nimbu, Kannada-Nimbe Hannu, English-Lemon, Telgu-

Nimma Chettu.

Description: a strangling, bussy, small tree 3-4 meter high with thorny branches,

Leaves- ovate, Petiole margined or winged flowers –small white or pinkish

sweet scented fruit-oblong or ovoid, usually with a nipply shaped extremely bright

yellow rind thick pulp acid pale yellow.

Distribution: cultivated/grown in U.P. Maharashtra Tamil Nadu and Karnataka, found

wild in the North West regions of India.

Phyto chemistry: citric richer juice 90% and the average amount of citric acid

available 3.7% from 100 cc lemon juice (chopra I,D of I pp 123/124 a pale

yellow volatile oil derived either by distillation or by sample expression from the fresh

outer part of the pericarp.

Pharmaco dynamics: Rasa-Amla, Katu. Guna-Laghu, Tikshana,

Virya-Ushna, Vipaka_Amla

Doshakarma_Vala kaphahara

Karma- Dipana, pachana chaksusya Agnimandya, gulya sheel amlapitta visuchi

vataroga vatashlesma vibandhagna.

Uses-agnimandya,Aruchi,Netra roga,amlapitta,Vataja roga,Vibandha,etc.According to

modern science,Medicinal claims includes uses for treatment

forHighbloodpressure,Dyspepsia,Anemia,Acne,Arthritis, lemon juice used for making

vit C concentration.Vit C is essential for the normal functioning of living cells and is

involved in many enzymatic reaction.It is required for the development of cartilage

,bone and teeth. It also help for wound healig, for absorption of iron from the intestine

.It has reducing and antioxidant properties, the Vit C are utilized in the food industries,

& in the formulations formulation of some pharmaceutical preparation.

Part used – fruit

Dosage – fresh juice 10-20 ml

Formulation – Jambiradi Panaka, Nimbuka tail


25

RASONA85 & 86 Botanical Name – Allium sativa lina

Family – Liliaceae

Sanskrit name –Rasona, Lasuna, Yavanesta Ugragandha

Vernacular names- English –Garlic

Hindi –Lasuna

Marathi –lasuna

Punjabi- Thum Thum

Malayalam - Lahasan

Description

Glabrous bulbous herb with pungent odour.

Leaves radical some times sheathing the scape. Scapes erect bearing a terminal umbel

of small flowers surrounded by an iguolucre of 2 or 3 thin membranous bracts. some

times united to from a spathe perianth bell shaped or rotate 6 parted stamens, 6 at the

base of the segments, ovary 3 shelled 3 angled, style straight stigma, minute terminal

ovule, few capsule 3 valved seeds 1-2 inches, 5 black bulbils bulb covered with white or

light pinkish papery layer or covering consisting 5-12 bulbils or cloves.

Distribution – Plant is cultivated widely throughout the country.

Photochemistry - Bulb contains an acrid yellow volatile oil which is the active

principal consisting organic sulphur compounds (allyl, propyl disulphide and other). It

also contains starch mucilaginous matter (29% carbohydrate) albumin (56% protein,

0.1% fat) and calcium, vitamin C and iron, copper.

Pharmaco dynamics

Rasa – Pancharasa Katu (Dominating taste) Amla rahita,Root – Katu,

Leaves – Tikta, Stalk –kashaya, stalktop (valagra)-lavana Seeds –madhura

Guna – Snigdha, Tikshna, Picchila, Guru, Sara.

Veerya – Ushna

Vipaka – Katu

Doshakarma –Vata Kaphashamaka


26

Properties – Vedana, Sthapaka, Vataghna, Shothahara, Depan, Pachana, Anulomuna,

Yakrduuejaka, Hridayottejaka, Mutrajanana, Rasayana Kothaprashamana, Svedajanana

Jvaraghna,

Rogaghnata – Vatavyadhi, Sandhivata, Gradhrasi, Ardita, Manystambha, Shotha,

Vedanayuktavikar, Agnimandhya, Aruchi, Ajirna, Vibhandha, Asthibhagna Jvara

Jeernajvara etc.

Therapeutic uses –

Vedana sthapana (Analgesic), Uttejaka (stimulates), vatahara, It is allaying

provoked vata and kapha dosha. It is appreciated as rasayana and medhya, specially

increasing or promoting functional power of indriya.

Much used for cardiac disorders, chronic fever, gout, ossification of fractured bones.

Anathematic: Aphrodisiac cardiac stimulant and atherosclerosis, High blood pressure. It

is used in anorexia cough, Consumption. Rasona is internally administered as a single

drug and a major ingredient of several formulations and recipes recommended in a

number of disease. The drug is effective in several disease of nervous. Circulatory,

Respiratory, Urinary reproductive, Digestive system and whole body. Rosona is a major

rasayana drug used in geriatrics

Parts used- Bulbis, Tuber. Oil

Dose paste -3-5gm oil 1-2 drops

Formulations - Lasonacdi vati, Rosona panda, Lasunastaka votiyoga,

Rasona staka yoga, Rasona vati Rasonadi kashaya, Rasona pinda Lasunadya ghrta,

Lasuna tail Rasona vataka, Lasona Ksheerapaka

Current research

1. Allin – A change in the mucoprotien levels & ESR was observed by (Sreenivasa

Murthy at 1962)

2. Allisatin (200mg / 100gm / day) showed inhibitory activity against formalin induced

arthritis. (Prasad at 1966)

3. Anti-inflammatory activity (Bhakumi at 1969)

4. Diallyn trisulphide showed antimicrobial activity (Chem. Abst 1981)

5. Ajoehe showed strong inhibition of plateht aggeration ()

6. Allicin inhibited human platelet aggregation in vitro without affecting

cyclooxyginase.


27

PALANDU87, 88 & 89 Botanical name: Allium cepa

Family: Liliaceae

Sanskrita name: Palandu Durgandha.Ulli, Tikshnakandha: Yuvanesta, Mukhadusaka,

Visvagandha: Sukanda, Durdruma, Rochana Sudrapriya,

Vernacular Name:- Hindi : Pyaja, Piaj, English : Bulb Onion

Kannada: Ullagaddi, Telugu : Niruli

Marthi : Kandha Konrha, Tamil : SInrulli

Arabic: Vasi, Panjabi : Piyaj

Description:

A glabrous bulbous herb possessing a strong pungent aromatic odour.

Leaves: Subdistichous fistular shorther than the inflated scape head bearing. Flower:

Pedicels shorter than the stellate flowers. Sepal’s linear oblong filaments exerted simple

of the linear two tooth at the base, bulb free solitory. Sometimes bulbils along with

flowering on spadix.

Fruit: Tri cellular with small block seeds.

Distribution: It is cultivated throughout India. Farming on wide scale commonly for

producing onion having dictory utility.

Verities: Palandu has two kinds of bulbs viz. Red and White

Bulb of bigger size and white in colour is known as sveta palandu.

Rajapalandu and ksira palandu (Nighantu)

phyoto chemistry: Bulb contains protein 1.2% carbohydrate 11.6% Calcium, Iron,

Vitamin A, B&C. Bulb and green fresh herb yield a pungent volatile oil with unpleasant

smell fixed oil contains Allyl propyldisulphate.

Pharmaco dynamics: Rasa: Madhura, Katu

Guna: Guru, Snigdha, Tikshna

Virya: Isat ushna (Isadusna)

Vipaka: Madhura

Doshakarma: Vata kaphahara pittavardhaka


28

Properties: - Vedanasthopana shothara Dipana pacana Rochana. Anulomana.

Rogaghnata: Vatavyadhi Nadisula vranasotha Ekangika sotha. Agnimandhya Aruchi

vibhandha, Hridourbalya sotha, Mutrajanana sukrodourbaly klaibya, Dourbalya

Ojaksaya.

Therapeutic uses:

The blub are used in various vatavikara such as neuralgia, sciatic joints,

swelling, convulsions, hysteria other ailments caused by provocation of vata dosa.

In various gastro intestinal disease. It is given frequently. It is take in piles,

prolaps of rectum jaundice and constipation. Palandu is specifically indicated in

visucika (Siddhbhaisajya manimala 4-273)

Palandu is aphrodisiac, diuretic, expectorant, and stimulant. It is used in anorexia, and

Anasarca. It is a cardiac depressant.

Palandu is an effective vatahara, drug as indicated by vrddha vagabhata.

Palandu is useful in impotency, Jaundice nervine neurological diseases.

The drug is vedanasthapana and vatahara.

Parts used: - Bulb, Seeds, and Leaves.

Dose: Bulb juice 10-30ml. Seed powder 1-3gm.

Current research

1. Essential of oil of onion-decrease in coagulation time and fibrinolitic activity

(Bordia-1974)

2. Antitumer effect (Chem abstr 1961)


29

TAMBULA90, 91

Botanical Name: Piper betel Linn

Family : Pipcraceae

Classical Name : Tambula

Sanskrit Name : Tambula, Saptasira, Tambulavalli Nagini, Tambulavallari.

Vernacular Names: Hindi : Pan, English : Betel

Marati: Nagbel, Gujarathi: Nagarbel

Tamil : Vittilai, Kannada: Vilydele

Description:

A perennial dioeciously creeper. (Probably native of Malaysia and

cultivated in India since ancient times) its leaves for tambula charvan bhakshan

belonging to I heritage) stems semi woody climbing by short adventitious roots.

Leaves: 5-20 cm long broadly ovate. Slightly cordate and often unequal at the base.

Shortly acuminate acute entire with an undulate margin glabrous yellowish or bright

green shining on both sides. Petiole stout 2.0-2.5cm long. Flower: Male spikes dence

cylindrical. Female spikes 2.5-5.0 cms long pendulous.Fruits: Rarely produced often

sunk in the fleshy spike forming nodule like structure.

Distribution: Plant is grown in warm and moist regions especially Southern India.

Bengal, Bihar, Orissa and Srilanka.

Varieties: There are many betal types which are grown in various regions throughout

the country under highly specialized cultivation practice. There are more than 35

cultivated types of betel in different zones of India.

In classical texts of India medicine Tambula or nagavalli is well described

covering different aspect of tambula patra and its utilisation as medicine as well as

masticatory aromatic. Several classical names of varieties are mentioned. Eg. Srivati

amlavati. Satsa Saptasira Amlasara Patulika Hresaniya Parna Sira, Sirnatumbala. Krsna

sulohra parna (Raja Nighantu Amradivarga 249-255)

Phyoto chemistry: Analysis of sample of fresh leaves.

Moisture: 8.54mg, Protein: 3.1mg Carbohydrate 6.1mg Fat: 0.8mg


30

Fibre: 2.3mg , Mineral matter 2.3mg, calcium230mg phosphorous 40mg,

Iron 7mg, Potassium Nitrate 0.26-0.42%,

A light aromatic and volatile oil known as betel oil and chavicol a very volatile pale

essential oil

Leaves yield an aromatic pungent and sharp taste essential oil about 0.7-2.6% which

contains phenol and teprene and sesquiterpene.

Pharmacodynamics: Rasa - Katu tikta

Guna - Laghuruksh tikshna

Veerya - Ushna

Vipaka - Katu

Dosakarma - KaphavataShomaka, pitta vardkaka

Properties

Hridayottejaka, Balya, Mukha Vishuddhkaraka, Durgandhahora, Dipana, Pachana,

Anulomana, Kamoddipana, Vajakarana, Kaphaghna, Jvaraghna Katupoustika,

Vedhanasthapana

Rogaghnata: Mukharoga. Asyavairasya, Mukhadourgandhya, Aruci,

Agnimandya.Vibandha, Krimi, Pratishya, Swarabedh, kasa, swasa, parshva shoola,

Hriddorbalya,Hridayarasada,Granthi, Shotha,Vrunshotha,Stamshotha, Dhvaja bhang,

Klaibya, Dourbalya.

Therapeutic uses:

The drug Tambula is aromatic anthelmintic & aphrodisiac. It is used in Anorexic

Dyspepsia foul smell of mouth & intestinal worms.acording to Vrindamadhava 12-31

medha prakarsana leaf with 10gm maricha/day up to 2 months. Bhavaprakasha

madhyam 45-120 in slipada. Tambula is suggested to be used regularly in the form of

leaves paste mixed with salt along with water. Sharangadhar & Gadanigraha for

external application particularly prescribed for use in skin disease and conjunctivitis.

Tambula patra posses an antioxidant action. The essential oil and extracts of the leaves

possess an antimicrobeal activity against several gram positive and negative bacteria.


31

Antiseptic activity is probably due to the presence of chavicol. The essential oil and leaf

extracts also showed antifungal activity.

Parts Used - Leaves

Dosage - Juice 5-10ml

Formulation - Tambulasava, tambula Savarasa

Ardraka92, 93 Botanical Name: Zingiber officinale Rose

Family: Zingiberaceae

Gana Charaka-Triptighna, Dipaniya, Shulaprashamana, Trishnanigrahana,

Sushruta,-Pippalyadi, Trikatu, Vagbhata- Pippalyadi,

Classical Name: Ardraka

Sanskrit Name: Ardraka Vishvabhesaga Sringvera Mohoushrada.

Vernacular names: Hindi : Sonth Sounth, English: Ginger

Telgu : Ardrakama, Allaem, Tamil : Chukku, Inzi

Marathi: Ale, Gujarati: Sunth,

Urdu : Adraka, Arab : Zingabil

Persi : Janjabl Kannada: Shunthi.

Description:

A perennial erect herb with a creeping fibrous rhizome.Root stock horizontal tuberous

aromatic stout rhizome with erect leafy stems 0.6-1.4meter high, stem elongated, leafy 15-

150cm tall. Leaves narrow, linear sessile sub-sessile on the sheath with an alternative base

acuminate glabrous 10-15cm long lower part surrounding the stem 5-10inches long smooth

ligulae glabrous, sheaths glabrous.Flowers: - Spike terminating the leafy system up to

3inchs long bracts 2.5 x 2 cm greenish. Stalks slender, enveloped by membranous 1mtr

long bracts, corolla greenish yellow. Corolla lobes yellowish lip dark purple often spotted

yellow 3 lobed flowers greenish & a small dark purple or purplish black lip in radical spike

3.8 - 7.5cm long and 2.5cm on peduncle 15-30cm long lip often 3 lobed orbicular dull

purple with creamy blotches anthers appendage dark purple. Stamens dark purple as long

as the lip rather shorter than the corolla.


32

Rhizome

The outer most layer of the rhizome is single cell epidermis. Next is cork with irregularly

arranged tangentially elongated cells and an inner zone of rectangular tangentially

elongated cells cork cambium is not distinct. Below the cork is the cortex cortical cells

thick walled polygonal parenchyma cells packed with starch grains. Large oil globules are

yellowish orange colour oil. Cells are scattered in cortical region. Vascular bundle is

composed of an outer phloem and inner Xylem. Phloem consists of thin walled polygonal

cells with sellve tubes. The cortex is singly layered endodermis with thin walled

rectangular cells pericycle consists of thin tangentially elongated cells. The inner stele

consists of parenchyma cells with starch grains and oil globules.

There are various varieties categories & qualities of ginger as of market drug.

Fresh rhizome in green state is Ardraka. The fresh ginger and dry rhizome is known as

Sunthi or Sounth the dry ginger.

Distribution: Found throughout tropical Asia and India, warm and moist zones. Widely

cultivated in India with many rhizome producing regions.

Phyto chemistry:

Rhizomes contain yellowish colored volatile oil 1-5% and yellow bitter substance,

Gingerol and oily resinous substance as main active principle. Ginger in and other resins,

starch (40-60%), fat (10%), protein (10%) in organic material (6%) and other contents,

Gengerol is not volatile with oil.

Phormadymamics: Rasa - Katu

Guna - Shunti,-Laghu, Snigdha, Ardraka- Guru Tikshna

Veerya- Ushna

Vipaka -Madhura

Doshakarma - Kaphavatashamaka

Action (Karma)

Ruchan, Dipana, Pachana, Triptighana, Vatanulomana, Shulaprasamana,. Pittashamaka,

Raktashodhaka, Hridayottejaka,. Shothahara, Kaphaghna, Svasahara, Kasaghna, Vrisya,

Uttejaka. Balya, Vedhanasthapaka, Nadyuttejaka.


33

Rogaghnata:-

Abhyuntara – Vatavyadhi, Aruchi, Hrillasa, Chardi, Mukhavairasya, Agnimandhya,

Ajirna, Adhmana, Andya, Visharoga , Shula, Kostastabdhata, Hriddourbalya, Anaha,

Udara, Hricchula, Shoth, Amavata, Dourbalya, Prasavattara dourbalya.

Uses

The fresh ginger is cut into pieces and mixed with little common salt is recommended to be

taken just before meal or the ginger fresh pieces are chewed before consuming food or any

other time This kind of use is very appetizer.

Stomachic and helps to relish the food and also its digestion and silugogue,

Stimulant check the bad taste and smell affection of mouth, tongue and throat.

The Rhizomes are useful in heart disease. It is given in heart palpitation cardiac

pain and as cardiac tonic and also in edema

The juice is used in dropsy ascites and. liver enlargements and it also acts as good

diuretic. It is used in abdominal disease dyspepsia

Jaundice and Vomiting

The part of ginger rhizomes is a local stimulant and rubefacient in case of headache,

toothache.

The root skin is considered useful in corneal opacity. Rhizomes are considered useful in

eye diseases.

The rhizomes powder and infusion are used by mothers after delivering in debility and pur

aliments.

Part used: Rhizomes fresh and dry ginger

Doses: Juice 2-5ml, powder 10-20grains, Infusion 8-10ml.

Formulation

Adrakakhanda. Soubhagya Shunti, Rasnadikwatha, Saindhuvaditaila, Sunthi

ghritama Nayarachurna.


34

Disease Review Historical review

Sandhigatavata is one among those diseases that was told in Veda purana and major

ayurvedic classics.

In Veda Rigveda – one of the mantra describes that “I am removing your disease from

each organ hair and joints. Yajurveda- also one of mantra chikitsa destroy the

pakshaghata, sandhigata vata, Katishula, Shirubhighata,Vataja shula, Murcha,

Atharvaveda- vata vikara are mentioned “Destroy the Balasa created on the organ and

joints which is responsible for loosing bones and joints”.

In Purana: Agnipurana -total no of joints in human body and treatment for

Sandigatavata is mentioned.

In Samhita:

1. Charaka mentioned about Sandigatavata as sandhigata anila in chikitsa sthana94

2. Sushruta under Vatavyadhi Nidana. He has mentioned about Sandigatavata95.

3. Astang Sangarah & Hridaya same view of Charaka & Susruta96.

4. Bhela under Asthimjjaghata vatavyadhi a description sandhivichyuti is available97.

5. Hareeta also mentioned the treatment aspect of Sandigatavata.

Madhyam Kala & Adhunika kala some of the Acharyas mentioned about this

disease.Madhava supposed to be the best in Nidana aspect has clearly explained this

disease98.Bhavaprakash: Under Vatavyadhi chapter Sandigatavata lakshan are explained

with its treatment 99.

In other Ayurvedic granthas like Yogaratnakar, Gadanigraha, Vangasena, etc11. Both

the treatment aspect and clinical entity has been found100

Now days, in ayurvedic field lot of research studies were conducted on this disease in

various research centers and post graduates research centers. 101,

Modern aspects of disease history102

Sandhigatavata can be correlated with osteoarthritis in modern science. This is due to

the nature of disease & similarity of cardinal symptoms. Osteoarthritis is the most

common joint disease in human beings and other vertebrates.In early ages Hippocrates


35

the Father of modern medicine observed the prevalence of osteoarthritis in aged

individuals (Benard 1944) due to the detailed study of this disease by Heberden (1803),

the osteoarthritis nodes on the fingers was named after him Osteoarthritis was

differentiated from rheumatoid arthritis and named as degenerative arthritis by Nicholas

and Richardson (1909) on morbid anatomical grounds.

The appearance of Herberdons nodes in relation age sex & hereditary factors was

mentioned by Strecher 1940. Intermitted claudication in the osteoarthritis of lower limb

including hip knee and ankle was observed by Byod (1949)

The term osteoarthritis was used due to the absence of synovial thickening or

inflammatory infiltration in uncomplicated condition by Kellgrem (1961). The term

Osteoarthritis, Hypertrophic arthritis are mentioned under degenerative arthritis by

Samuel .L. Turek (1989)

Etymology of Sandigatavata

Sandhigatavata is one among the vatavadhis explained by acharyas. Its word meaning is

the disease which originates when vata resides in sandhi. The term Sandigatavata is

combination of 3words ie Sandhi + Gata + Vata.

Sundhi: - this is formed by Sam+ Dha + Kihi103

Nirukti – “Sandhinaam Samyoga” “Asthidwya Samyogasthana”

According to Sushruta there are various type of sandhi in the body like those of Peshi,

Snayu, and Sira. Sandhi etc. but in this context we have to consider asthisandhi as the

meaning of sandhi104

Sandhi can be correlated as junction, joint, connection, combination, union, with

containing, conjunction, transition; from one to another is the term for junction.

Gata: The word formed by the combination of GUM+KTHA. The meaning of this

word indicates the movements.

Vata: The term is derived from the root “Va-Gati Gandhanayo” ie to move105

Bhela – States that so long as vata lasts as long does life exists106 vagbata - vata has its

control over the functions of the body swift actions, strength, capacity to vitiate other

factors independent movement and large number of disease produced due to its

vitiation107.


36

The chalatva (mobilises) has been qualified to be very swift108 Chakrapani explains vata

is Amurta (Adrashya) and Anavasthita (Unstable) 109

Normal functions enthusiasm, inhalation, exhalation, movement of body parts etc110

According to Vagbhata vata is located on the asthi with relation to Ashrayashrayi

sambandha. Generally the doshas & dathus are inter related when doshas are increased

particular dathu related with it also increases and viceversa. But in case of vata and

asthi, when vata increases asthi decreases111

Osteoarthritis: It is the combination of 3 words Osteon, Arthron and Itis, means

bone joints inflammation. The meaning of the word is inflammation of bony joint and it

is the most common form of arthritis. The cartilage lining the end of the bones forming

the joint or the shock absorber gradually erode over a period of time. The bone ends

thickens and over grow. This process occurs primarily in weight bearing joints and is

associated with inflammation.

Definition:

In almost all Ayurvedic treatises Sandhigatavata is mentioned in Vatavyadhi adhyaya.

Charaka has mentioned that when vitiated vayu reaches in one or more sandhi it is

called as Sandhigatavata. In this disease the joints gets vitiated by vayu & palpation is

felt like a bag filled with air. There will be pain during extension and flexon. 112

Sushruta: When vata dosha is vitiates in the joints it produces shoola & shotha. 113others

support same Madhavacharya adds one extra symptoms “Atopam” than other

symptoms. This can be considered as the classical symptoms of Sandhigatavata. 114

Osteoarthritis: is defined as a degenerative non inflammatory joint disease

characterised by destruction of articular cartilage and formation of new bone at the joint

surface and margins.115steoarthritis also anonymously called degenerative joint disease

represents failure of diarthrodial joint. In primary Osteoarthritis at the most common

form of the disease no predisposing factor is apparent. Secondary Osteoarthritis

pathologically indistinguishable from idiopathic but is attributed to an underlying

cause116


37

Epidemiology:

Sandhigatavata (Osteoarthritis) is the most common joint disease of human among the

elders. Knee Osteoarthritis is the leading cause of chronic disability. Under the age of

55yrs the joint destruction at Osteoarthritis in men & women is similar. In older

individuals hip Osteoarthritis is more common in men while Osteoarthritis of

interphalangeal joints & the thumb base are more common in women.

The racial difference exists in both the prevalance of osteoarthritis & the pattern of

joints involvement. The Chinese in HonKong have a lower incidence of hip than the

whites & osteoarthritis is more frequent in Native Americans than in whites.

Interphalangeal joint osteoarthritis especially hip osteoarthritis is much less common in

South Africans blacks than white in the same population117

Anatomy and Physiology

As mentioned earlier this study was given more importance concentration to knee joint

osteoarthritis for that detailed information about this particular joint is very much

essential.

Acharys Sushruta was the first person to dissect the human body and became the

authority of early anatomy. All these aspects can be well discovered from his works. He

in his classic has described each and every point of the human body anatomy in detail.

In Sushruta Sharirasthana he has classified the joints into eight divisions named as the

objects which they respectively resemble in shape. The knee joint was described under

Kora types of Sundhi hinged or lap shaped118

Acharaya vagbhata in Astanga hriudaya while describing about the divisions of kupha

has mentioned about the properties and functions of sleshaka kapha. The kapha which

resides in sandhis which gives firmness to it is called as sleshaka kapha119

Acharya sushruta has described about the sleshaka kapha. He states that the kapha

situated in the joints keeps them firmly united protects their articulation. It opposes their

separation and disunion and also nourishes the sandhi120


38

Knee Joint

Anatomy and Physiology121

The knee joint is a synovial joint of the condylar variety. It is a compound joint having

two distinct articular surfaces on the medial and lateral condyles of femur for

articulation with corresponding surface on medial & lateral condyles of the tibia. The

anterior aspect of the lower end of the femur articulates with the posterior surface of the

patella. Knee joint is complex because its cavity is partially divided into upper and

lower parts by plates, cartilages called the medial and lateral menisci.

The proximal articular surface covers the anterior, inferior and posterior aspects of

medial and lateral condyles of femur. Anteriorly the medial and lateral articulates

surfaces are continuous with each other but posteriorly they are separated by

intercondylar notch. The part of the femural articular surface situated on the anterior

aspects of its lower end, articulate with the patella. It is concave from side to side and is

subdivided by a verticular groove in too larger part and a smaller medial part. A small

part of the inferior surface of the medial condyle adjacent to the interior part of the inter

condular notch comes in contact with the patella in extreme flexion of the joint.

The distal articular surface of the knee joint is present on the upper surface of the

medial and lateral condyle of tibia. These surfaces are slightly concave centrally and flat

at the periphary where they are covered by corresponding menisci.

The posterior surface of the patella bears a large articular area for the femur. It is

convex and is subdivided by a ridge into a large lateral part and small medial part. The

attachment of capsule of the facet that anteriolrly the capsule bends in distinguishably

with the lower tendinous part of the quadriceps femoris muscle.

Anertiorly below the patella, the capsule is replaced by the ligamentum patella. This

ligament is attached above to the non articular lower part of the posterior surface of the

patella and below to the upper smooth part of the tibial tuberosity. Posterior aspect of

the capsule is strengthened by the oblique popletial ligament. The anterior cruciate

ligament is attached below the anterior part of the intercondular area of the tibia. The

posterior cruciate ligament is attached below to the posterior part of the intercondular

area of the tibia. Medial and lateral menisci of the knee joint are intra- acrticular disc

made of fibro cartilage. They have a thick peripheral border and a thin inner border.


39

The synovial membrane of the knee joint covers all the structure within the joint

except the articular surface and surface of the menisci. It lies in the inner side of the

tendenous expansion of quadriceps femoris and some part of the tibia and femur

enclosed within the capsule just above the patella. The synovial membrane forms a

pouch called the supra patellar bursa.

The arteries supplying the joint are the descending genicular. The genicular branch of

poplitial. The recent branches of anterior tibial and the descending branches of the

lateral circumflex, femoral branch of the arteria profunda femors.

The nerves are derived from the abturator femoral tibial and common peroneal nerve.

Muscle producing the movement of the knee joint.

Flexion: - Biceps femoris. Semitendenous and semi membranous assisted by gracilis.

Sartorius and popliteus.

When the foot is on the ground gastro-nimus and planteris are capable of participating

in the movement.

Extension: - Quadriceps femoris with some assistance from tensor fascia late.

Medial rotation of the fledged leg- popliteus semi membranous and Semitendenosus

assisted by sartorius and gracilis.

Lateral rotation of the fledged leg: - Biceps femoris alone.

Joints are surrounded by membrane called the synovial membrane (Synovium) which

forms a capsule around the ends of the bone involved. The membrane secretes a liquid

called synovial fluid. It has many functions all of them are important. Among these it

serves as a lubricant, a shock absorber and nutrient carrier.

As a lubricant it is without equality when the joint is healthy. It makes the joint slicker

than wet ice. When our body cannot produce enough glucose amine and chondrotin.

However the normally thick synovial fluid becomes thin and watery. In this state it

cannot do the job it was intended to do as a lubricant as shock absorber. Our cartilage

immersed in the synovial fluid protects our bones from the tremendous compact. They

would receive when we walk, run, jump etc. This fluid also has a remarkable property

as a shock absorber or hydraulic fluid.

It belongs to a rather unusual group of liquids known as dilatent liquids. These liquids

are characterised by the rare quality of becoming thicker that is more viscous. When

shear is applied to them. Thus the synovial fluid on our knee and hip assume a very


40

viscous nature at the movement of shear in order to protect the joints and then it turns

out again to its normal viscosity instantaneously. To resume its lubricating function

between shock. All this happens again and again very rapidly during the course of

vigorous exercise. Such as during an engagement in sports, dancing, walking etc.

When our body cannot produce enough glucose amine and chondroitin. This whole

mechanism breaks down. The viscosity is dramatically reduced giving thin watery

synovial fluid which then fails as the shock absorber and lubricant. It normally excels.

As this results in the pain stiffness and decreased mobility that characterized

osteoarthritis.

Now we will discuss the role of synovial fluid as a nutrient carrier when we take

knee cases. We get the building blocks needed to rebuild cartilage. Now we have to get

those building blocks to the cartilage. So the rebuilding can take place. Cartilage itself is

avascular i.e it does not have blood vessels.

Hence the synovial fluid is the liquid that must carry the raw material from the blood

to the cartilage. This can happen by a number of mechanisms. First it can be diffusion

which is a slow process. In this situation, a second and efficient process is convection

which is achieved through exercise. One way to visualise what happens in convection is

to thicken our cartilage as a sponge immersed in synovial fluid. When we exercise our

knee for eg. It is like repeatedly squeezing that sponge out in a basket of synovial fluid.

Another method viewing convection would be as a pumping action produced by

exercise in which nutrients containing synovial fluid are constantly washing over the

cartilage. In this way our cartilage is constantly getting supplied by nutrients dissolved

in synovial fluid when we exercise our joint.


41

Nidan Panchaka of Sandhigatavata.

Nidan:-

Sandhigatavata is disease caused by vata and is included under the vata vyadhies by all

acharayas. There is a no much difference in the case of nidanas among vatavyadhies.

The difference is occurs mainly in the case of samprapti that is in all the vata vyadhies

vata prakopaka karanas are almost same and the different forms of appearance like

sandhigatavata gridhrasi. Pakashaghat etc. are only due to the samprapti vishesh of

vitiated vata.

Aharaja nidan-- Tikta. Katu. Kashaya122 rasa pradana dravya and Ruksha. Sheeta.

Laghu guna123 pradana dravya increases vata. They are Chanaka, Harenu, Uddalaka,

Jambu, Tinduka, Mususra, Vatarka, Mudga, and Adhaki. Ahara sevana vidhi is

important. Abojana Heenabhojana, Sushkabhojana, Trushitabhojana, Kshatitambupana,

Adhyasana, Vishamasana, Pramitaasana, etc vitiates vata.

Viharajanidana: Ayurvedic classics have given importance to proper vihar like

Vyayam, Swapna, Vyavaya, etc. The vihara which vitiates vata are Ativvayama,

Ratrijagarna, Ativyavaya, Plavana, Atyuchobhashana, Upavasa, Adharaniya

Vegadharana, Vishamopchara and Marmaabhighata, Atiraktsravana, Abhigata.

Manasika Karana: Direction of sense organs is one of the functions of vata. Therefore

vata is said to be the controller and conductor of mind124. Therefore mental factors like

chinta, shoka, krodha, bhaya etc are the causes for upset of mind and relatively as

consequence of it vataprakopa in the indriya ayatana as well as in the body which

simultaneously can produce the psychic as well as the somatic disorders125.

Vayakarana: As per the ayurvedic theories. In the later stages of human life vata will be

predominant126. During this period there will be natural tendency to vitiate vata.

Alpavatakara, aharavihara, causes vata prakopa. This causes kaphakshaya in the body.

Due to this process the shleshaka kapha situated in the sandhi shows kshaya causing

vata prakopa in the particular part.


42

Other nidanas:

a) Desha: The desha where vata dosha is predominant is called jangaladesha127.

Those who live in these deshas will be having the predominance of respective doshas.

This is the cause for predominance of vata roga for those who stay in jangaladesha

when compared to other disease.

b) Kala: Kala is an important factor in the production of disease. According to rutus

vatachaya in grishmarutu, kopa in vrsharutu and shamana in sharadrutu so more vata

vikaras can be seen in varsharutu128.

According to Ayuavasata vriddhavastha is vatapradana.

c) Prakruti: Among the seven prakrutis mentioned vataprakurti is considered as

heenaprakruti129. One who is born with vataprakruti will be most susceptible for getting

vatikaroga. And it will be very difficult for its cure130.

d) Satwa: Satwa is considered as the capacity of mind to withstand things going

wrong. A person who is having a good satwabala131 will be easy for treating. Therefore

vatavyadhi will be more in Heenasatwa. According to Charaka pepole who are more

susceptible to manodoshas like bhaya, shoka, krodha etc will be prone to disease132.

e) Satmya:-The qualities which are equal to dosha, dhatu, mala, increases and which

are opposite decreases. This is a general principle of nature133. Ruksha, Laghu, Sheeta

etc are the qualities of vata. Tikta, katu, kashaya are the rasa causes vitiation of vata134.

One who is satmya with all these definitely vata will vitiation and further causes’ vata

vyadhi.

According to modern

Risk factors of Osteoarthritis135

Age- Age is the most powerful risk factor for Osteoarthritis. Radiological survey of

women less than 45yrs old only 2% and 45 to 64yrs the prevalence was 30% and those

older than 65yrs it was 68%. In males the figures were similar but some what lower in

the old age group.

Sex: It is told that women are at high risk than male. In developing osteoarthritis

particularly after menopause. Most of the epidemiological studies suggest that hormone


43

replacement therapy confirms a protective on the development of knee and hip

Osteoarthritis. The effect of sex hormone on cartilage may vary with menopausal status

and stage of osteoarthritis.

Hereditary Factors: The relation of heredity is less ambiguous. Thus the mother and

sister of women with distal interphalangeal joint osteoarthritis are respectively twice

and thrice as likely to exihibit osteoarthritis in these joints as the mother and sisters of

unaffected women. Point mutation in the cDNA coding for articular cartilage collagen

have been identified in families with chondrodysplasia and polyarticular secondary

osteoarthritis.

Race: Racial difference exists in both the prevalence of osteoarthritis and the pattern of

joint involvement. The Chinese in Hong Kong have a lower incidence of hip

osteoarthritis than hhe whites. Osteoarthritis is more frequent in Native Americans than

in whites Interphalangeal joint osteoarthritis & especially hip osteoarthritis are much

less common in South Africans blacks than white in the same population whether these

differences are genetic or are due to difference in joint usage related to lifestyle.yet to

be understood

Occupational Factor: Repetitive movements may lead excessive strain leading to

erosion and joint damage. Vocational activities such as those performed by jackhammer

operators, cotton mill and shipyard workers and coalminers may lead to osteoarthritis in

the joints exposed to repetitive occupational use. Men whose jobs require knee bending

and atleast medium physical demand had a higher rate of radiological evidence of knee

osteoarthritis and more severe radiological changes than men.

Obesity: Obese persons have a high risk of osteoarthritis. For those in the highest

quintile for body mass index at baseline. The relative risk for developing knee

osteoarthritis in above 30yrs was 1.5 for men and 2.1 for women. For severe knee

osteoarthritis the realitive risk factor is 1.9 for men and 3.9 for women suggesting that

obesity play an even larger rule in the etology of the most serious cases of knee

osteoarthritis.

Traumatic factor136: Trauma to the joint seems to enhance the occurrence of arthritis. It

disturbs the ligaments of the joints and over a period of time. The mal ligament may

lead to excessive wear and tear leading to arthritis. In both human and animals model

anterior cruciate ligament insufficiency and meniscus damage lead to knee


44

osteoarthritis. Although damage to the articular cartilage may occur at the time of injury

with the use of affected joint. Even normal cartilage will degenerate. If the joint is

unstable a person with a trimaleolar fracture will almost certainly develop ankle

osteoarthritis.

Abnormal enzyme factors: Though not conclusively proved, it is suspected that some

abnormal enzyme released by the cartilage cells may lead to cartilage breakdown and

joint destruction.

From all the above nidana factors obesity is aharaja and viharaja factors sounds

predominant. So nidana parivarjana should be done before starting the treatment. Even

nidana parivarjana helps in relieving the disease in the early stages.

Pathology137

The changes in ostheoarthiritics are usually seen in load bearing of the articular

cartilage in the early stages the cartilage is thicken than normal but with progression of

otheoarthitics the joint surface thins. the cartilage softens. The integrity of the surface is

beached and vertical cleft develop deep cartilage ulcers. Extending to bone appears.

areas of fibrocartelageneous repair develop but the repair tissue is inferior to pristine

hyaline articular cartilage in its ability to withstand mechanical stress. all of the

cartilage is metabolically active and the chondrocytes replicate forming cluster later the

cartilage become hypocellular.

Remodeling and hypertrophy of bone are also major features of OA, appositional bone

growth occurs in the subchondral region. Leading to the bony sclerosis, seen

radiographically. The abraded bone under a cartilage ulcer may take on the appearance

of very. Growth of cartilage and bone at the joint margins leads to osteophytes which

after the contour of the joint and may restrict movement cular muscle wasting is

common and may play a major role in symptoms and in disability

Pathogenesis138

Current consepts of the pathogenesis of osteoarthritis, based on the assumption that

whatever the provoking cause. The pathway of changes in articular cartilage will be

identical. Two mechanical hypothesis merit consideration. The first suggest that the

inifiating event is fatigue fracture of the collagen fibre net work which is followed by

increased hyderation of the articular cartilage with unraveling of the profeoglycans and


45

loss of profeoglycans in to the synovial fluid. There is some tentative supportive

euidence of augmented natural protease and collagenolytic activity but collagen may

also be lost simply as a result of mechanical attriation.

The alternative hypothesis suggests that the intial leasions are microfractures of the

subchondral bone following repatative loading. healing of micro fracture leads to

signification loss of resilience of subchondral bone which in turn creats a shear stress

gardiant in the adjacent articular cartilage. As the process evolves. The cartilage surface

becomes fibrillated and deep clefts appear with reduplication and proliative changes

commence at the joint margins with formations of osteophytes. Eventually articular

cartilage is last altogether in areas of maximum mechanical stress and the underlying

bone becomes hardend and eburnate, cysts may form but bony allcylosis does not occur.

Table no. 8 shows that pathogenisis of osteoarthritis

Increased hydration of the articular

cartilage unraveling of protepglycons

Fracture of the collagen fiber network

And loss of proteoglycons in to synovil

fluid.

Increased natural protease and

Collagenolyticactivity

Collagen last simply as a result of

mechanical attriation.

Rpeatative loading

Micro fracture of the subchondral bone

Significant loss of resilience of

subchondral bone

Which in turn creats a shear stress

gralient in adjacent articular cartilage

The cartilage surface become fibrillated

and deep cletts appear

Reduplication and proliferation of

condrocytes within things

Formation of osteophytes due to

proliferative changes at the joint margins.


46

Clinical feutures139-The joint most frequently involved are those of the spine, hips,

and knee.the disease is confermed to one or onely few joints in the majority of patients.

The symptoms are gradual in onset. Pain is at first intrimittent, aching and provoked by

the use of the joint and relieved by rest. As the disease progress. Movement in the joint

becomes increasingly limited, initially as a result of pain and musculars spasm, but later

because of capsular fibrosis osteophyte formation and remodeling of bone. They may be

repeated effusions in to joints especially after minor twists or injuries crepitus may be

felt or even heard. Associated muscle wasting is an important factor in the progress of

the disease as in the absence of normal musculars control the joint, pain becomes more

prone to injury, pain areas from trabecular microfactures tramatic leasions in the

capsule and particular tissue and a low grade synovitis. Nocturnal aching may be

attribuatable to hyperaemia of subchondral bone.

Pooravaroopa of Sandhigatavata.

Pooravaroopa is the prodromal symptoms of a forthcoming disease which do not clarify

the peculiarity of the dosha taking part in the samprapti of the disease. These symptoms

are few and not clear.

According to Madhavanidana poorvaroopa are the symptoms which are produced

during the process sthanasamsraya by vitiated doshas. When samprapthi has not been

completed the disease is not manifested. Sandhigatavata being one of the vata vyadi the

poorvaroopa of vata vyadhi can be considered as the pooraroopa of sandhigatavata.

Here archaryas are specifying that the unmanifested symptoms of the particular

vatavadhi should be considered as poorvaroopa.

From recorded data of the paitents we can say that the poorvaroopa of sandhigatavata

is manifested with guruthwa (heaviness) of joints occasional twinkling sensation and

pain which is ignored by the patient and finally it turns to roopavastha.


47

Roopa

When symptoms in the stage of poorvaroopa become fully or clearly manifested when

these are called as roopas. Samsthana, Vyanjana, Linga, Lakshana, Chinha and Akruthi

are the synonyms of the roopa.

The cardinal symptoms mentioned by acharayas for sandhigatavata

1. Sandhisoola (Joint Pain)

2. Sandhishotha (Joint inflammation)

3. Sandhisthabdhata (Stiffness)

4. Vatapurnadrutisparsh (Air filled bag to touch)

5. atop (Crepitation)

6. Gamane ativedana (Pain after excess movement)

7. Prasarna akunchanavedana (Restricted range of joint movement)

8. Sandhi vishleshan (Looseness of joints)

9. Nisha ruk (Nocturnal Pain)

Sandishoola: In sandhigatavata joint pain is mentioned by all the acharayas.

Sandhishotha: Almost all the acharayas have mentioned about the presence of shotha.

Vatapurnadrutisparsha: Charaka, Vagbhata have mentioned the typical characteristic of

Shoph. The Shoph resembles like an air filled bag to touch.

Atopa: Especially Madhava has mentioned

Table No. 9 shows the Laxana of Sandhigata Vata according to different achary.

Sl No Samhita Laxana

1 Charaka Vatapoornadrutisparsha. Shopha

Prasaranaakunchanapravrathivedhana.

2 Sushruta Sandhisoola, Sandhishopha

3 Ashtanga

hridaya

Vatapoornadrutisparsh. Shopha

Prasarana akunchana pravratti

vedhana.

4 Madhavanidan Sandhishoola Atopa

5 Bhavaprakash Sandhisoola, Sandishopha


48

Symptoms of Osteoarthritis

Pain, Stiffness, Restricted range of joint movement, swelling of the joint, Tenderness,

Crepitation

Pain: Joint pain in Osteoarthritis is often described as a deep ache and is localised to the

involved joint. Typically the pain is aggravated by joint use and relived by rest. But as

the disease progresses it may become persistent. Nocturnal pain interfering with sleep is

also seen.

Swelling: The physical examination of the joint may reveal soft tissue swelling and

synovial effusion palpation may reveal some warmth over the joints.

Stiffness: Stiffness of the involved joint is seen in the morning or after period of

inactivity.

Restricted range of movements: Due to pain and stiffness of the joint movements will

be restricted and difficult. If there is loose bodies in a joint there will be lacking or

giving away of joints.

Tenderness: Localised tenderness will be present during the physical examination

Crepitation: Bony crepitus is a characteristic sign of osteoarthritis. The growth of

cartilage and bone at the joint margins leads to ostephytes, which when comes into

contact produces the crepitation.

Upashaya Anupashaya.

The ahara, vihara and aoushadhi, constitute upashaya when it produces the relief in the

symptoms and anupashaya when it aggravates the symptoms. It is a trial and error

method. These are very mch important especially during the treatment. Usually drugs

having properties like Shnigdha, Ushna etc are prescribed in vata vadhi. Due to their

efficacy to pacify the qualities of vata such as Sheetatwa, Rukshatwa etc. This should be

adopted only in the condition of niramavastha of vatavadhi which helps in subsiding

vata.

This is the upshaya method. When same drugs are prescribed in samavastha of

vatavadhi the disease aggrivates causing complication. This is anupashaya.


49

Samprapti

Several etiological factors contributing to disease & the vitiation of doshas attack the

body. Some of them can be avoided by taking proper precautionary measures, while

some factors like kala, desh, are mostly inevitable. If the body’s resistance power

(Vyadhikshamatwa) is high, the Dhatus, Srotasis, Agni are functioning well and the

body fights against the etiological factors successfully there by maintaining health. But

if the etiological factors are stronger than the resistance power of the body they vitiate

the doshas, indirectly the dushya also and the process of disease starts, manifestetion of

disease is from Hetus to the Vyaktata of laxana is samprapti.

Sandhigata vata. The samprapti of vata vyadhi should be considered. Charaka

mentioned that due to the vatakara aharavihara vata vitiates and travels through the

body channels. The vitiated vata finally enters and settle in srotamsi riktani resulting in

the production of different types of vatavyadhis pertaining to the region140.

Acharaya Charaka and vagbhata state that dhatukshaya and margavarodha are the two

causative factors of vata vyadhi141. Acharya vagabhata states that due to intake of

excess dhatukshayakara ahara and vihara the vata travels throughout that srotasis. It fills

the srotasas and due to the avarana by other dosha in the srotas the vata becomes

stronger and vitiation takes place142. Achary charaka states that vayu which is vitiated

by its nidana and due to its respective sites different varieties of vata vyadhis are

produced.

While explaining the five divisions of vata by vagabhata. Vyanavata one of the

divisions of vata resides in the heart and travels all over the body. It helps in functioning

like walking, body movements etc143. In sandhigata vata the function of vyanavayu is affected. I.e. difficulty in moving the

joints. It is specifically told by charaka that in nanatmaja vata vyadhis anubandha of

kapha or pitta should be considered and also specifies that the knowledge of it depends

on understanding of specific dosha laxanas144.

It is mentioned that kapha helps in binding the joints and maintaining its strength. In the

specific properties of pancha kapha shleshaka kapha resides in the sandhis. By these

statements it is clear that in the sandhi kapha is also important for its functioning. It is

very important to discuss the changes happening during the dosha kshaya. The


50

decreased doshas become incapable of performing their normal functions of the body.

This state is manifested in the form of decreased activity of that particular dosha.

Acharya Charaka has mentioned that when the kshaya of particular dosha occurs,

natural functioning of dosha is not seen. According to vagbhata, when kaphakshaya

occurs lakshana like Bhrama, Sleshmashayanam Shunyatwam, Hridrava and

shlathasandhi take place. Here the slathasandhi is due to kaphakshaya in the sandhi i.e.

shleshaka kaphakshaya. So as per acharays reference in sandhi gata vata. Vataprakopa

(Vyanavayu) and kaphakshaya, (shleshaka kaphakshaya) is taking place.

SAMPRAPTI (Etiopathogenisis)

Pactice of Vatavardhaka Ahara Vihara

Manas Karana, Sthoulya, vaya prikriti

Nidana sevana Dhatukshaya

Chayavastha Avarana

Vitiation of vata at its own places (mainly pakvashaya)

PrakopavasthaTransmission of vitiated vata through body channels

PrasaravasthaAccumulation of vata in sandhi due to Khavaigunya

Sthana samsraya Diminutions of Shleshaka kapha and destructive change in

asthi (Doshadushya sammurchana)

Yakta Manifestation of sign and symptoms of sandhi gata vata

Sandhigata vata


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Samprapti ghatakas

Dosha -Vata, Vyanavata vrudhi, Kapha shleshakakaphakshaya

Dushya -Asthi, Majja, Snayu

Srotas -Astivaha, Majjavaha, Medovaha, Mamsavaha

Agni - Jataragni, Dhatwagni

Ama-Jataragnimandyajanya, Medagnimandyajanya, Astiagnimandyajanya

Udbhavasthana - Pakwashaya

Vyaktasthana - Sandhi

Sankhya samprapti: - Only one variety

Vikalpa samprapti: - Increased vayu guna like Ruksha, Laghu.

Pradhanya samprapti: - Vata pradhana can be seen other than two dosha

Bala samprapti: - mostly occours in vriddhavastha due to heena bala.

Kala samprapti: - The symptoms aggrivated at night after digestion and

Vriddhavastha

Sadhyasadhyata:

Before starting the treatment it is necessary for to know the sadhyasadhyata of the

diseases. A physician must know the avastha of disease, whether it is curable or not or

is it difficult to cure, by the lakshana etc, plan the treatment accordingly which helps in

fast recovery. So knowledge about sadhyasadhyata helps in the treatment.

Vatavyadhis are considered as one of the mahagadas by Brihatrayees, the vatavyadhis

which is old and if the rogi bala is less than the rogabala then that vatavyadhi is

kastasadhya 145. Generally vatavyadhis are very difficult to cure due to the deep seated

nature of the disease. Sandhigata vatavyadhi is one of the vatavyadhi which usually

occurs in vraddhvastha. The kala which is predominant of vata. Which is purana, having

long history, which is originated in the jangala pradesha146 and also that which is having

a family history, will also be difficult in curing. So which comes under these categories

can be called as asadhya.


52

Vyavacchedakanidana:- Vyavachedakanidana helps a physician to establish accurate diagnosis of the disease.

Sandhigata vata is mainly a disease of bony joints. So virtually every disease that

affects the joints enters into the differential diagnosis of sandigata vata. The most

common differnetation that has to be made in between Sandhigata vata, Vatarakta,

Amavata, Koshtruka shershaka 147.

according to modern, the most common differentiation that has to be made are

between Osteoarthritis, Rheumatoid arthritis, Gout, Tubercular arthritis, Gonococal

arthritis, Rheumatic fever.

In view of asrayasrayee bhava, particularly between Asthi and Vata the effect is more

pronounced on the bones of the affected joints. It should also be noted that the disease,

Sandhigata vata is one of a vata vikara so it will be have the similar characters of other

vatika rogas148, which affects on the sandhi. The most common joint affected is the knee

joint. But other joints may also be affected depending upon the wear and tear due to the

excessive use. Erosion and degeneration of the cartilage and bone in the joints is the

common.


53

Detailed Vyavachedaka Nidana of sandhigata vata and other related disease are given below in the table.

Sandhigata vata Vatarakta Amavata Kroshtuka sheersha

1. Nidana Vatakara Ahara Vihara

Vata Rakta prakopaka, Viruddhaahara, Atimaithuna,

Viruddha cheshta Vatakara Ahara Vihara

2. Poorvaroopa Vatakopa lakshanas

Kshuta, Sama, Sada, Slathangata, Sfuranam Sandhishoola, Kandu,

Hridaya dowrbalya gowrava

Vatakopa lakshanas

3. Roopa

Sandhisoola, Sopha Prasarana akunchana vedana,Vatapoorna druti sparsha

Teevra ruja, Gradhita paki swayadhu

Vrischika damshtravat soola, Pidaka yukt sopha

Maharuja, Janu Sopha

4. Adhishtana Sandhi Padamoola,Hastamoola Hasta, Pada, Shira, Gulpha,

Trika, Janu, Uru Sandhies Janu madhya

5. Doshas Vata Vata, rakta Kapha, vata Vata, raktHa

6. Upashaya Ushna, Snigdha Sheetha Rooksha, ushna Snigdha, sheeta


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Investigation

Lab Investigation:- Usually in primary Osteoarthritis the ESR may be normal or slightly accelerated. Anemia

and leukocytosis are absent. Rheumatic factors studies are absent. Synovial fluid analysis

reveals minimal abnormalities useful in the different diagnosis. Viscosity is good and

mucin clot formation with glacial acetic acid is normal. Slight increase in cell count are

noted14 9.

X-Ray reveals:-

• Loss of joint space (Due to destruction of articular cartilage)

• Sclerosis (Due to increased cellularity and bone deposition)

• Subchondral cyst (Due to synovial fluid intrusion into the bone)

Osteophytes (Due to revascularisation of remaining cartilage and capsular traction)

• Bony Collapse (Due to compression of weakened bones)

• Loose bodies (Due to fragmentation of osteochondral surface)

• Deformity and mlalalignment (Due to destruction of capsules and ligaments)

Bone Scan shows increased uptake of technetium-99m, MRI and CT scan also helps to

diagnose Subchondral cyst, Osteophytes etc150.

CHIKITSA

The word chikitsa was derived from the root word “KITH”. It means to cure the

disease; Chikitsa is also called as the kriya done against roga or kriya done for

vyadhiharana.

Charaka states that Chikista is not only removing the causative factor of the disease but

also to bring back the equilibrium of doshas. Vata vyadhies are occurred due to

dhatukshaya or avarana151

In the aspect of Ckikista the line of treatment of vatavyadhi is the use of Sarpi, Taila,

Vasa, Majja and treatments like Seka, Abhyanga and Basti are indicated by Charaka.


55

In Pancha karma Basti is told as important treatment for vata vyadhies. It is also

mentioned as sampoorna Chikista.

Other treatments are vatahara oushadhas, ahara and vihara.

Principles of treatment:-

Our Acharyas have designed a particular treatment for a particular disease, which is

known as Chikista siddhanta. In this disease, Sushruta has more emphasised the

treatments like local applications like Agnikarma,Lepa etc rather than the internal

medication.

As per Acharya Suhsruta the treatment of Sandhigata vata is snehana, upanahana,

agnikarma, bandhana and mardana152.

In other classics like Ashtanga hridaya, Chakradatta, Bhavaprakasha,

Bhaishajyaratnavali, Yogaratnakara etc, the treatment principles of Sushruta has been

adopted for sandhigata vata.

Among all Acharyas Sushruta is the only person who mentioned the specific line of

treatment for sandhigata vata.

1. Snehana: The qualities of sneha are Drava, Sukshma, Sara, Snigdha, Pichila, Guru,

Sheetala, Manda and Mrudu. All these qualities are just opposite to Vata properties. So

by theory opposite qualities subsides and similar qualities increases, thus above qualities

will definitely pacify Vata.

Snehaha nourishes the dhatus as well as does balavardhana (strengthens) and

agnivardhana (proper digestion). One who is adopting snehana in the right manner will be

having good jataragni, koshtashudhi, nourished dhatus, good bala and Varna, jitendriya,

devoid of premature ageing and even he lives for hundred years. These are the gunas of

snehana are according to acharya Vagbhata.

In the treatment of sandhigata vata Achrya Dalhana states that both bhaya and

abhyantara snehas should be administrated.

2. Upanahana: Upanahana is a type of swedana. In persons who are having shula in

janu pradesha and sopha also this type of sweda can be done. Charaka has described

Upanahana as a variety of Swedana.


56

Sushruta acharya has described and divided sweda into four groups and in that he has

told about the upanaha sweda. It is a kind of sweda done by applying herbal paste over

the affected part. Vagbhata is having the opinion that vatahara Patras should be used for

upanahana. Charaka while explaining vatavyadhi chikitsa says that the drug which is

mixed with snehana should be used for upanahana karma. Sushruta mentions that

vatahara drug’s roots should be made into paste with kanji in that saindhavalavana and

sneha should be mixed to from a paste. The paste should be heated and applied in the

affected parts.

3. Bandhana: Upanaha sweda is divided into three by Susrutha. They are pradeha,

sankara and bandhana. In the bandahana sweda the upanaha dravyas are tied into the

affected part and there by the action of the medicine is attained.

4. Mardana: - Mardana is usually done in vatavyadhis. It is a form of bhaya

sneha by applying oil externally and massage is done by gentle pressure. This helps the

oil to absorb and improves the blood circulation and lymph drainage from the part.

5. Agnikarma: - Agnikarma is a surgical procedure, so it is mentioned by Acharya

sushruta. He states that agnikarma is of twagdagda, mamsadagda, sirasnayudagda and

sandhidagda. According to Dalhana in sira, snayu, asthi and sandhi vikaras even

dahanakarma of mamsa itself gives good relief. Sushruta states that when vitation of

twak, mamsa, sira, snayu, asthi and sandhies by vata, which causes pain, agnikarma gives

good relief.

6. BASTI:-

Basti is one among the panchakarmas and it has given much importance in vatavyadhi

Chikista due to its ability to pacify vata. Charaka has told Basti as balavardhaka,

brimanam and vatanashanam. According to Ashtanga hridaya, basti is important in

vatadhika samsarga, sannipataja diseases and kevalavatavyadhi. It is the best treatment

than other treatments for vata vitation. Vata is the cause for vitation of other dosha so that

vata is considered as sarvarogakaraka. For this vitiated vata the only remedy is Basti. So


57

it is mentioned that if we are taking all the treatments is depending on Basti i.e. Basti can

even cure the disease where all other treatment methods failed.

Shamanoushadhies in Sandhigata vata:-

Kwatha : Maharasnadi Kwata Dhanwantaram Kwata

Sahacharadi Kwata, Rasna Saptaka Kwata

Kalka : Tagaramoolakalka with takra

Choorna : Alambushadya Choorna, Abhadi Choorna

Vati : Ajamodadi vati

Guggulu preperations: Kaisora guggulu, Yogaraja guggulu, Brihat Yogaraja

guggulu, Trayadashanga guggulu, Adityapake uggulu, Simhanadaguggula,

Rasoushadi: Panchananarasa Louha, Darada Vati, Vriddha Vata Gajankushu

Rasa, and Vatarakshasa Rasa.

Sneha: Dhanwatharamtailam,Phalatrikadi Sneha,Majja Sneha,Prasarni tailam,Sidhartha

tailam,Nakula tailam, Shatatuspadi taila, Amruthadi taila, Bala taila, Bala Aswagandhadi

taila, Ksheera Bala taila, Pinda taila, Gandha taila, Rasonadhi talai, Gandharva Hastha

taila, Guggulu Tiktaka ghrita, Rasna Dashamoola ghrita.

Asavarista: Dashamoola rishta, Bala rishta, Ashwagandha rishta,

Pathyaapathya:-

Treatment is nidana privarjana and samprapti vighatana. Pathya is termed as ahara and

vihara, which prevents the aggravation of the disease and helps in curing the disease.

Charaka states that is which is suitable to the body and mind during the healthy and in

diseased condition. Samanya vatavyadhi pathyapathya should be adopted for it.

Pathya Ahara:

1.Rasavarga – Madhura, Amla, Lavana.

2.Shukadhanyavarga – Naveena godhuma, Sali Samvatsarothitha,

Rakthasali, Shashtikasali

3.Shimbi varga- Naveena Tila, Naveena Masha, Kulatha

4.Shaka varga – Patola, Shigru, Lasuna.

5.Phala varga – Draksha, Pakwamra, Parushaka, Jambeera, Dadima, Pakvatala

phala.


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6.Mamsa varga - Ushtra, Go, Varaha, Mahisha, Mayura, Bheka, Nakula, Chataka,

Kukkuta, Titira, Sheelindra, Kurma, Rohita etc.

7.Jalavarga – Ushna Jala, Shritasheetala Jala, Narikela Jala

8.Dugdha varga – Go, Aja, Dadhi, Ghritha, Kilata, Kurchila

9.Mutra varga – Gomutra

10. Madhya – Dhanyamla, Sura

11. Sneha – Tila, Ghrita, Vasa, Majja

Vihara

Bhushayya, Snana, Samvahana, Slightly walking, Slight swimming, Steam bath,etc

Apathya Ahara: - Rasa – Katu, Tikta, Kashaya

Shimbi dhanya – Rajamasha, Mudga,

Shuka dhanaya – Truna Dhanya, Trunaka Kangu, Koradhusha,

Neevara, Shamaka, Chanaka

Phalavarga – Jambu, Udumbara, Karmuka, Tinduka

Mamsa varga – Suska Mamsa, Kapota, Pravata

Jalvarga – Sheetambu, Tadakajala

Ksheera – Gardhaba Ksheera

Vihara

1.Manasa – Chinta, Shooka,Bhaya

2.Shareeika – Jagarana, Shrama, Vyayama, Chankrama, Vegadharana, Long standing,

Sitting, Automobile driving, staying in A.C etc.

Now a days due to the change in life style and culture, people are exposed to

modernised foodstuffs. This does a severe impact especially to Sandhigata vata patients.

Management of Osteoarthritis:-

Treatment of Osteoarthritis is aimed at reducing pain, maintaining mobility and

minimising disability. The vigor of the therapeutic intervention should be detected by the

severity of the condition in the individual patient. For those with only mild disease,

reassurance, instruction in joint protection and occasional analgesic may require. For


59

those with severe Osteoarthritis a comprehensive program comprising a spectrum of non

pharmacological measures supplemented by an analgesic or anti inflammatory drug is

appropriate.

Non-pharmacological measures, reduction of joint loading, correction of poor posture

and a support for excessive lumbar lordosis can be helpful. Patients with Osteoarthritis of

knee or hip should avoid prolonged standing, kneeling and squatting. Obese patients

should be loose weight.

Rest periods during the day may be helpful. But complete immobilisation of the painful

joints is rarely indicated. In patients with unilateral osteoarthritis of the hip or knee, a

cane held in the contra lateral hand may reduce joint pain by reducing the joint contact

force. Bilateral diseased may necessitate use of crutches or a walker.

Physical therapy, application of heat to the joint may reduce pain and stiffness. A hot

water shawer is also preferable. Occasionally a better analgesic effect may be obtained

with ice than with heat.

Drug therapy of osteoarthritis today is palliative, no pharmacologic agent has been

shown to prevent, delay the progression of or reverse the pathologic changes of

osteoarthritis in humans.

Intra or periarticular injection of a depot gluco corticoid preparation may provide marked

symptomatic relief for weeks to months. Because studies in animals models have

suggested that glucocorticoids may produce cartilage damage, and frequent injection of

large amounts of steroids have been associated with joint breakdown in humans, the

injection sould generally not be repeated in a given joint more often than 4-6 months.

Joint replacement surgery should be reversed for patients with advanced osteoarthritis

in whom aggressive medical management has failed. Osteotomy, which is surgically

more conservative, can eliminate concentration of peak dynamic loading and may

provide effective pain relief in patients with hip or knee osteoarthritis. Arthroscopic

removal of loose cartilage fragments can prevent locking and relive pain. Chondroplasty

also has some popularity as treatment for Osteoarthritis, but well controlled of its efficacy

are laking.


60

Internal Medication

Indomethacin tab - 25mg. 2-3 time daily

Piroxicam tab - 10-30Mg. daily

Ibufrofen tab - 1.2 – 1.8g / day in 3-4 divided doses after food

Diclofenac tab - 50Mg. Bid

Nimesulide tab - 100-200 Mg bid

Rehabilitation:-

Simple changes around the home and daily activities cause dramatic improvement in the

symptomatology of Osteoarthritis.

a) Use of higher chair, which require less effort to get in and get out, should be

considered.

b) Patients are advised to limb the stairs leading the good leg taking one stair at a time

and to descent the stairs leading with the bad leg, again taking one stair at a time.

c) To reduce the force acting across the injured joint patient is advised to use a

walking stick, which acts as a third limb. The stick should be held in the hand opposite to

the affected part. A walking stick, by providing a third limb through which forces can be

transmited, enables the reduction of forces across the injured joint.

d) Footwear with hard soles and high heels should be avoided.

e) Mental and physical support from the family members will be useful in the

rehabilitation of the patient.

Exercises:-

Mainly two types of exercises are mentioned. They are flexibility exercise and

strengthening exercise.

Flexibility exercise – Sit in a chair and rest the foot on another chair, then gently press the

knee towards the floor.

Strengthening exercise – To strengthen the knee straight the leg and press the knee on to

the bed, hold for 6 seconds , repeat 5-10 times.


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Yoga:-

Yoga is the one of the ancient science of our land, which inters relates with our culture.

Its practices in daily lifes restore the health and relief to disease. The Asanas which give

relief to Arthritis is the Pavanamukthasana. These Asanas are very easy to practice and

help him relieving stress by loosening the joints.


62

MATERIALS AND METALS

Materials and methods studied mainly under 3 headings

1. Pharmaceutical study

2. Analytical study

3. Clinical study

Pharmaceuticals Study

Materials

The following material and instruments are necessary for this study.

1. Hingula, 2. Meshikshira, 3. Nimbu swarasa, 4. Rasona swarasa,

5. Palandu swarasa, 6. Tambula swarasa, 7. Ardraka swarasa.

Instruments like khalva yantra, ulukalu yantra, vastra etc.

Methods:

The preparation of Darada vati includes the following procedures

I. Darada Shodhana

A. Darada shodhana with Meshi Kshira- 1 bhavana

B. Darada shodhana with Nimbu swarasa- 7 bhavana

II Darada Bhavana

A. Darada bhavana with Lashuna –7 bhavana

B. Darada bhavana with Palandu swarasa 7 bhavana

C. Darada bhavana with Tambula swarasa 7 bhavana

D. Darada bhavana with Adraka swarasa 7 bhavana

III Darada vati nirmana -1 Gunja pramana.

Darada vati is one of the khalvi rasayana. This preparation includes three

pharmaceutical procedures. Those are

1. Shodhana, 2. Bhavana, 3. Vati nirmana


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Khalvi rasayana- The medicines, which are prepared by khalva yantra, are said to be

khalvi rasayana.

All the Rasa and Vanaspatija dravya are taken in Khalva and Drava darvya is

added and trituration is carried out till the drug dries. The product obtained by this

procedure is known as Khalvi rasayana

: Shodhana is the process, which makes metal and minerals fit for

therapeutic use. Shodhana is done by many processes like Mardana, Swedana, Bhavana,

Pachana, Prakshalana, Nirvapa, Dhalan etc with some vanaspati dravya swarasa. Taila,

kshira and pranija dravya like mutra, rakta, ghrita, dugdha etc for a specific period.

Concept of shodhana

Shodhana makes heterogeneous into homogeneous form

Shodhana reduces the hardness of the mineral and metal

Shodhana reduces the particle size and increase the absorption rate

Shodhana enhances drugs property

Shodhana convert the toxic metal and mineral into non-toxic.

Shodhana eliminates, separate the unwanted toxic things form the drug.

Bhavana (Triturating with some liquid for a specified time.)

Various metallic and mineral drugs, which are subjected to marana process, have

to pass through a number of stages and bhavana is the must important of them. Before

subjecting them to actual bhavana process the materials are to be purified and made in to

powder and then if necessary, they are to be mixed with certain marana drugs mentional

especially for particular substance. A liquid juice or decoction is then added to it and

triturated well for a specified period, till the liquid added is dried. Now the whole mass is

divided into small pieces, even in micro particle size.

Concept of bhavana

1. Bhavana makes the sanghata bhedan of drugs and finally make particles finer in size.

2. Bhavanaa induces the new properties into the main drugs through various liquids used

during the process.

Shodhana


64

3. Bhavanaa enhances original property of drugs.

4. Bhavanaa also helps in the biochemical action of the drugs and living cells.

Vati kalpana -

Vati kalpana is the upakalpana of kalka kalpana

Vati’s are prepared with the combination of kashtaoushadhis drugs churna and shodhita

marita, rasoparas, sadharana, rasa etc with adding of guda, swarasa, mutra guggalu,

sarkara etc as binding agents.

On the basis of shape, dose. Root of administration. These are named as Gutika,

Vati, Modaka, Vatika, Pindi, Varti etc.

Darada vati

Yavanesta palandunam tambuly ardrakajaih rasaih I

Daradam saptavarani bhavayitva vatium karet ll55ll

Gunjaduayomita hanti rogan vatokapho dbhavana l

Sandhivatam visheshen puranum pinasam tatha ll56ll

Shodhita Darada should be subjected to bhavana with, Lasuna Palandu; Tambula

& Ardraka juice seven times with each, and after prepare its vati measuring 2 ratti each. It

may be used to cure all types of vata kaphaja diseases specially sandhigata vata & purana

pinas.


65

Practical No. 1 Title – Darada shodhana

Reference – Rasamrita Chap-1/55S

Date of commencement – 1. 11.2003

Date of completion – 1-11-2003

Time taken – 4hrs

Material required – khalva yantra, measuring glass, vastra

Drugs used – Darada 250gms,

Meshi kshira – Sufficient Quantity

Method – Darada was taken in a khalva yantra and powdered nicely.

Sufficient quantity of Meshi Kshira was added &Mardana was done for till

The end product dries up (approximant 4 hur’s)

After the process Darada attained completely powder form.

Observation -

1 While powdering of Darada white shining lines were seen.

2 The drage will have red colour after completion of Meshi kshira bhavana

3 weight of Darada after Bhavana was 255 Gms

Precautions -

Initially powdering should be done slowly, to avoid the spoilage of Darada. After

it attains semisolids consistency, the mardan should be done firmly and continuously.

Dugdha should be heated and filtered


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Practical No.2 Title – Darada shodhana

Reference – Rasamrita Chap-1/55

Date of commencement – 2-11-03,

Date of completion - 8-11-03

Time taken – 4hrs

Material required – khalva yantra, knife, Juice extractor,

Measuring glass

Drugs required – Meshi kshira bhavita darada –255gms

Nimbu swarasa- Sufficient Quantity

Method –

Nimbu swarasa was added to meshi kshira bhavita darada and Bhavan was given for

4 hur’s then darada became completely dry.This method was continued for 7 times.

Observation –

1. Slight silvery shining colour appears around the edge of the powder after adding of

lemon juice

2. Colour of the darada after complete mixing of juice turn to red more than pervious.

3. Lemon juice odour was observed after completion and during the Mardana process.

4. Weight of darada after complete of 7th bhavana 270 Gms

Precautions: Initially powdering should be done slowly, to avoid the spoilage of Darada.

After it attains semisolids consistency


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Practical No.3

Title –Darada Bhavana


Date of commencement – 9-11-2003


Time taken – 6hrs

Material required – Khalva yantra, Vastra, Measuring glass

Drug required – Shodhita darada –270 Gms

Rasona swarasa- Sufficient Quantity

Method –

Shodhita darada taken in khalva yantra then sufficient quantity of Rasona swarasa is

added and subjected to Bhavana. This process was done for 6 hrs, after completion of

bhavana.Same procedure repeted for seven times.

Observations –

1. After adding of Rasona swarasa the powder become sticky shining and bright

yellowish red colour is obtained.

2. The process of mardana becomes difficult when darada is in the state of semisolid and

last stage of dying.

3. Garlic odour is dominant and lemon odour reduced.

4. Weight of darada after completion of 7th bhavana is 290gms.




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Practical No. 4 Title – Darada bhavana


Date of commencement – 16-11-03


Time taken – 6 hrs

Material required – Khalva yantra, Vastra, Measuring glass.

Drugs required –Rasona swarasa bhavita darada 290gms.

Palandu swarasa – Sufficient Quantity

Method –

Rasona swarasa bhavita darada was taken in Khalva yantra and palandu swarasa was

added and subjected to Bhavana process for 6 hrs, this process continued for seven times.

Observations –

1. Phalandu swarasa make the Rasona bhavita darada less bright colour.

2. At the time of mardana and after completion of process the odour of the darada now is

combination of Rasona and palandu.

3. Weight of darada after completion of 7th bhavana 303gms.




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Practical No.5

Title – Darada Bhavana


Date of commencement -23-11-03 to

Date of completion -29-11-03



Drugs required – Plandu swarasa bhavita darada 303gms

Tambula swarasa Sufficient Quantity

Method –

Palandu swarasa bhavita darada is taken in Khalva yantra added sufficient quantity

of fresh tambula swarasa and sjubected to bhavana precess up to 6hur’s after drying,

again added fresh swarasa then the same proceduer is continued for 7 times .

Observations-

1. The brightness of the darada completely losses after 7 bhavana with Tambula swarasa

and become greenish red colour.

2. Odour become mixture of Rasona palandu tambula

3. Weight of darada – after completion of 7th bhavana 320gms.




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Practical No. 6

Title – Darada Bhavana


Date of commencement -30-11-03




Drugs required –Tambula swarasa bhavita darada 320gms.

Adraka swarasa sufficient Quantity

Method –

Tambula rasa bhavita darada was taken in khalva yantra added 75ml of Adraka

swarasa after adding subjected to mardana process upto 6 hrs and the same procedure is

continued for 7 times.

Observations –

1. The colour of darada become brick red colour

2. Odour becomes mixture of all bhavita dravya.

3. Weight of darada – after completion of 7th bhavana 342gms.




71

Practical No.7 Title – Darada vati nirmana

Reference – Rasa mrita Chap-1/56

Date of commencement – 7 –12- 2003


Material required - Khalva yantra, Vastra, Measuring glass.

Drug required –Bhavita darada-340gms.

Adraka satwa-30gms

Adraka swarasa- 50ml

Method –

After completion of 7th bhavana with Ardraka swarasa,30gm of Ardraka satwa and

50ml of Adraka swarasa is added to the bhavita Darada and next subjected to bhavana

process till the consistency become sutable for vati preparation after consistency seen

then the vati is prepared measuring about 1 ratti (125mg)

Observation –

1. The colour of the vati like brick red colour

2. Odour – Mixture of bhavita dravya especially Rasona Palandu dominant odour.

3. Taste – Madhura rasa pradhana, katu rasa.

Precautions – Initially powdering should be done slowly, to avoid the spoilage of

Darada. After it attains semisolids consistency

While preparing the vati Adraka satwa was coted to the varti because darada stick to

the hands.


72

Table no. 10 shows the weight and observation of darada

Sl.No Practicals Wt. of

darada B.P

Wt. of

darada A.P

Colour Odour

1. Shodhana I 250gms 255gms Red Sligh milky

2. Shodhana II 255gms 270gms Thick red Lemon

3. Bhavana I 270gms 290gms Yellowish

red

Garlic

4. Bhavana II 290gms 303gms Red Mixed

5. Bhavana III 303gms 320gms Greenish

red

Mixed

6. Bhavana IV 320gms 340gms Brick red Very

pungent

7. Vati nirmana 340gms 375gms Brick red Mixture of

all


73

ANALYTICAL STUDY

Qulitative Analysis of Mercury 1. Solution of Mercury salts with hydrogen sulphide make black precipitate

which is insoluble in ammonim sulphide solution and in boiling dilute nitric acid.

2. Solution of Mercury salts are free from an excess of nitric acid, deposit a

coating of mercury on bright copper foil, the deposit becomes bright when it is rubbed

and may be volatilized from the foil by heat and obtained in globules.

3. Solution of mercury salts when treated with stannous chloride solution yields

a white precipitate, which rapidly becomes gray with an excess of the reagent.

4. Neutral solution of mercury salts when treated with potassium iodide solution

yield a scarlet precipitate, which is soluble in excess of the any agent and in a

considerable excess of the solution of the mercury salt.

5. Solution of mercuric salt when treated with sodium hydroxide solution yield a

yellow precipitate

Quantity estimation of mercury present as sulphide In the presence of the organic matter Transfer an aliquate of the well mixed

(sample expected to contain 0.1-0.15 grams of mercury)to kjeldahl standard joint flask

of 300ml capacity and 7ml concentrated nitric acid and 15ml of concentrated sulphuric

acid attached to a standard joint condenser and heated under reflex gently at first and then

more strongly for about 30 minutes, so that all the organic matter is dissolved,

cooled,then 12ml of concentrated nitric acid is added and boiled , continue the addition of

nitric acid and boiling until the liquid becomes colourless or pale yellow in colour and

continue boiling, cooled and wash down the condensor with 100ml of water remove the

flask and 1% of potassium permanganate solution is added drop by drop until a pink

colour persists, one drop of 6% hydrogen peroxide solutions is added to remove excess

of permanganate followed by 3ml of concentrated nitric acid and titrated with N/10

ammonium thiocyanate using ferric alum as a indicator.

1ml of N/10 thiocyanate =0.01003 gram of mercury


74

Qualitative analysis of sulphur Sulphates

1. Solution of sulphates when treated with barium chloride solution yields a white

precipitate which is insoluble in hydrochloric acid.

2. Solution of sulphates when treated with lead acetate solution yield a white precipitate

which is insoluble in ammonium acetate solution and in sodium hydroxide solution

Quantity analysis of sulphur

Total sulphur

Transfer a weighed quantity of the well mixed sample of a long necked flask of 250ml

capacity (a kjeldahl flask may be used). Added 10ml of saturated solution of bromine in a

carbon tetra chloride covered and let stand for about 30 minutes, stirring several times,

(added 15ml of concentrated nitric acid covered and let stand for about 30 minutes

stirring several times). Heated over a low flame, adding small quantities of concentrated

nitric acid, from time to time untill the solution is clear and does not darken on standing.

Transfered the solution quantitatively to 250 ml beaker with the full of water, evaporation

on a hot plate to about 15ml (complete the determination as a given under free sulphur)

Free Sulphur: Extract a suitable quantity of the sample accurately weighed, with carbon

disulphide in a soxhlet extraction apparatus lefting the extraction thimble drain at least 12

times transfer the extract to a 250 ml beaker evaporate carbon disulphide in a draught at

room temperature, added 10 ml of saturated solution of bromine in carbon tetrachloride

covered and let stand for about 30minutes stirring several time, added 15 ml of

concentrated nitric acid covered and let stand for about 30 minutes stirring several times

evaporate on a hot plate at about 5 minutes, about 50 ml of water is added filtered and

washed with 2 percent hydrochloric acid.

Added 2 drops of bromophenol blue (0.1 g +1.5 ml N/10 NaoH in25 ml of water) and

then ammonia to first colour change added Hcl drop wise until distinctly acid then add 5

drops in excess. dilute to 150 ml with water heated to boiling and 10% barium chloride

solution is added drop wise until 50% excess in present covered the beaker and digested

on steam both for one hour cool to room temperature filter through quantitative filter

papear (what man No.42) wash 10 minutes with hot water, ignite residue in a weighed

porcelain silica crucible at 500 0c cool in a desicator and weigh as BaSo4


75

Ash value – Incinerate about 2-3 gm of accurately weight of prepared shample in a

platinum or silica dish at a low temperature until free from carbon, cooled and weighted.

if a carbon free ash cannot be obtained in this way extract the charred mass with hot

water, collect the residue on and ashless filter paper. Incinerate the residue and filter

papers add the filtrate, evapourate to dryness and ignite to constant weight at a low

temperature.

Calculate the percentage of ash with reference to moisture free drug.

30-40% w/w

Acid insoluble ash: Boil the ash for five minutes with 25ml of dilute hydrochloric acid

(6N) collected the insoluble matter in a gooch crucible or on an ashless filter paper

washed with hot water and igniated to constant weight at a low temperature and the

percentage of acid insoluble ash is calculated with reference to the moisture free drug.

The finess of particle test: The particle size can be measured by microscope and with

the help of occulominometer, in this particle size measuring in the range 0.1 to 100 micro

meters

Method: - before measuring, the standardization of occulominometer was carried out by

coinciding the lens of both occulominometer and style minometer and standardized by

using the formula SM/OMX10= -micrometer after the coinciding the style minometer

was removed the fine powder was sprinkled on the slide and covered with covering slip

this mounted slide was placed on mechanical stage and focused, the particles are

measured an orbitary chosen fixed lines covered by the particles using the

occulominometer

Loss on drying 1100c-1gram of accurately weighed and heated on electric oven up to

1100c and again weighed, the difference in weighed was calculated by Initial weighed-

weighed after 1100c=- gram


76

Post – compression parameters: Shape of tablets:

Uncoated tablets were examined under a lens for the shape of the tablet.

Uniformity of thickness:

Ten tablets were picked from each formulation randomly & thickness was

measured individually.It is expressed in mm & standered deviation was also

calculated.The tablet thickness was measured using dial caliper (Mitutoyo, Japan)

Hardness test:

Hardness indicates the ability of a tablet to withstand mechanical shocks while

handling. The hardness of the tablets were determined using Monsanto hardness tester.

It is expressed in kg / cm2. Ten tablets were randomly picked & hardness of the same

tablets from each formulation were determined.The mean & standered deviation values

were also calculated.

Friability test:

The friability of tablets were determined using Roche Friabilator.It is expressed in

percentage.Ten tablets were initially weighed( Wt initial )& transeferred into

friabilator.The friabilator was operated at 25 rpm for 4 minutes or run up to 100

revolutions.The tablets were weighed ( Wt final ) again.The % friability was then

calculated by,

Wt initial – Wt final F = ------------------------- x 100 Wt initial


77

Weight variation test:

Ten tablets were selected randomly from each formulation & weighed

individually to check for weight variation. A little variation is allowed in the weight

of a tablet by the US Pharmacopoeia. The following % deviation in weight variation

is allowed:

Average weight of a tablet Percentage deviation

130 mg or less 10

More than 130 mg & less than 324 mg 7.5

324 mg or more 5

In all the formulations the tablet weight is more than 324 mg, hence 5%

maximum difference allowed.

6. In vitro Disintegration Test:

The process of break down of a tablet into smaller particles is called as

disintegration. The in-vitro disintegration time of a tablet was determined using

disintegration test apparatus as per I.P. specifications.

Place one tablet in each of the 6 tubes of the basket. Add a disc to each tube & run

the apparatus using PH 6.8 (simulated saliva fluid) maintained at 370 + 20 c as the

immersion liquid. The assembly should be raised & lowered between 30 cycles per

minute in the PH 6.8 maintained at 370 + 20 c. The time in seconds taken for complete

disintegration of the tablet with no mass remaining in the apparatus was measured &

recorded.


78

Clinical Study

1. Research approach: The present study the investigators objective is to evaluate the

therapetic effect of Darada Vati in the management of Sandhigata Vata; efficacy can be

determine by finding out of difference between the base line data and assessment data.

2. Research design: This study was for a period of one year, bemographic data and data

regarding the disease Sandhigata Vata, are collected according to the case record from

given in the appendix.

3. Population: 30-60year patients with Sandhigata Vata, attainding the out patients

division of DGM Ayurvedic college and hospital Gadag, were included under the study.

4. Samples: The sample for the present study consists of 30 patients with Sandhigata

Vata, reporting to DGM Ayurvedic College OPD and selected as per selection criteria.

5. Selection criteria: The cases were selected as per the inclusion criteria and were

treated, age limit for the selection of the patients were are between 30 to 60years

irrespective of sex.

Inclusive criteria: pain and tenderness over the knee joint,

Swelling of the knee joint, crepitation of the knee joint,

Age of the patient’s 30-60years.

Exclusive criteria: patients below 30 and above 60 years of age

Patient developed deformity, pregnant women and lactating mother

6 Duration of the study: The duration of the study was one year data was collected from

the first week of December 2003; individual patients were monitored for 30 days and

follow up 15 days for the efficacy of the trial drug.


79

7. Posology: - Internal Darad Vati 1 Ratti (125mg) BID

8. Anupana: - Ushna Jala

9. Data collection: Patients selected are thoroughly examined both subjectively and

objectively; detailed general history and physical examination findings are noted, routine

investigation of blood are done to exclude other pathology

10. Examination of knee joint: Osteoarthritis is the common nest kind of knee joint

disorder found in elderly peoples, a thorough physical examination is necessary for the

patients with the knee joint pain

Before taking history a glance is given at the overall picture presented by the patients, the

patients will be having the pain and swelling on the knee joint a) history: knee joint pain

is a system hard to evaluate, hence detailed history in chronological sequence is the first

stand, a patient with knee problems usually presents with the following complaint:

1. Pain- This may be acute or chronic and there may be a history of trauma.

2. Swelling- This could be due to the effusion or synovial membrane thickening;

localized swelling could be due to bursal enlargement.

3. Limp- This may be due to pain muscular spasm stiffness or arthritis.

4. Risticted movement locking- It could be due to meniscal tear or loose bodies, in

locking patient’s complaint of inability to complete the last few degrees of extension,

rigid block suggest loose bodies or fixed flexion deformity.

Deformity- In Genuvalgum, Vaurm and Precuvatum. Patient’s usualy presents with

deformity.

B. Physical examination – As in the other parts of the body examination of knee joint

consists of Inspection, Palpation Measurements, and Movements. And stability tests

particular to the lence. Examination of the knee is carried out form the front. Sides and

back.

A. Inspection.

First look at the hight and weight of the patient


80

Looks for the standing aligument of the knee which should be 3-7 degrees valgus

Look for the abnormality of the feet like flate feet .etc which may be contribute to the knee

problem.

Wasting of the thigh and leg muscle are to noted

Swalling this could be due to intraarticular or extraarticular cause. If all natural depre ssions

above, below and by the sides of putell are obeterated. The cause could be intra articular in

extra articular causes. All the natural fossae will not be obliterated and the swelling usually

extends over the patella.

Dffusion hacmarthrosis beyond knee could be due to bursitis exostases. Or osteophytes.

Knee flextion test-

This is to detect the cause of genu Valgues whether it lies in the femur or fibia .It the

detormity disappears with flexion of the knee. The cause lies in the lower end of the

femur and if it persists on flexion the cause lies in the upper end of tibia.

Genu varum is difined as lateral angulation of the knee. The longitudinal axis of femur

and tibia deviates medially.

Type

Unilateral – Due to growth abnormalities of opper tibial epiphysis.

Infections like osteomyelitis etc.

Trauma near the growth epiphysis of femur tumours affecting the lower end of femur and

upper end of tibia.

Bilateral – Physiological gets corrected by four years. Phothological – congenital causes.

Postural abnormalities. Developmental disorders.Metabolic disorders. Endocrine

dissordes. Degenerative disorder (Osteoarthritis of knee this is a common cause)

Occupational.disorders, Idiopathic Pagets’ disease blounts disease.

The ankle of Varum is calculated on a standing radiograph of the whole limb.


81

Genuvarum Complex- The priming deformity in genuvarum is lateral angulation of

knee. In response to this secondary deformities in the tibia and the foot. These together

are known as genuvarum complex.

Genu reccurvatum is defined as back word bending of the knee. Up to 5 degree of genux

reccurvatum is some times seen in women with lax

Ligaments and is usually generalised.

Features- Limitation of knee flexion form mild to severe.

Effusion and evidence of knee abnormality is absent.

Some times a dence band that becomes tens during flexion of the knee could be palpated

in the proximal part of the patella, patella is always located more proximally and some

time latterly

Causes: congenital disorders, Quadriceps contracture is the most common cause in

acquired genue reccurvatum, Neurological disorder,

Malunited fractures around the knee.

During the inspection look for old scars, sinuses etc. as evidences of injury, surgery

trauma, or infection also should look for the position of patella wether latral high or low .

b) Palpation:

Temperature: Local rise of temperature felt with the dorsum of the hand

Tenderness: Tenderness should be eliciated and graded, proced from normal area to the

affected part for better patients complaients grading can be done as 0- No tenderness, 1-

patients says the joint is tender, 2-patient winses on pressure, 3-patient winces and with

draw, 4 patient will not allow to touch.

Swelling: Swelling of the joint is usually due to effusion within the joint which indicates

damage to joints and the presence of major cause must always be ruled out, synovial

membrane thikness is the other common cause.

Types of swelling:

Small: In these causes there will be bulging of the sides of the patellar ligaments and

obliteration of the hollows of the medial and lateral adjust of patellar

Large-Distention of the supra patellar pouch

Localised- This is due to Osteophytes. Exostosis bursae cyst etc.


82

Swelling due to synovial membrane thickness is almost always due to chronic

inflammatory disorders.

The features of the swelling are prominent. Usually above the patellar near the supra

patellar pouch

Baggy to feel

Local rise of temperature

Test- the following test helps to evaluate the swelling of the knee.

Patellar top test:

StepI: - In the horizontal position considerable amount of excessive synovial fluid

gravitates in to the supra patellar pouch. From 6 inch above the patellar excess fluid in

the supra patella pouch is driven back in to the joint by sliding down firmly with index

finger the thumb.

Step II:- The tips of the three fingers and the thumb of the free hand is placed over the

articular surface of the patella and quick jerk is given downword. If the fluid is presented

a click sound is heared as the patella can be felt to strike on the femoral condyle and

bounces back. The patella tap is not always reliable. It is negative in tense swelling due

too much fluid, small swelling due to too little fluid it is positive only in moderate knee

effusion.

Crepitation: Crepitation derived from a joint can be detected by feeling the joint with one

hand while it is moved passively with the other.It is usually felt in osteoarthritis joints.

Walking time: The patients were asked to walk a distance of 60 feet, the time take to

reach the mark of 60 feet was recorded by using stop watch this was recorded before

treatment and after treatment.

Examination of movements: The important movements taking place at the joint are

flexion and extension. In semi flexed position slight side to side and rocking movements

are possible.

Flexion: The normal range of knee flexion is 130-150 degrees

Muscle testing: The patient is prone, examiner places one hand over the pelvis to stabiles

it while the offer graded rsistance with the other hand at the ankle as the patient attempts


83

to flex the knee flexion is tested with the ankle externally rotated biceps femoris is tested

and if the ankle roatated medially semimembranosus and semitendinous are tested.

Extension: The knee should normally extended to a straight line (0 degree) occasionally

can hyper extended to 15 degree in some women.

Muscle testing: Patient site with the legs hanging over the edge of table the examiner then

stabilized the thigh by one hand over the pelvis or proximal thigh against the resistance

provided examiner the patient slowly extends the knee through its range of motion.

Stability test: valgus stress test-the patient is in supine position with the knee extended

stand on the ipsilateral side of the patellar palce one against the medial aspect of the knee.

Grip the ankle with the other hand and attempt to drag the leg laterally to open the medial

side of the knee joint if there is evidence of pain above, below or at the joint line the test

is positive for medieo colateral ligaments.

Varus stress test –patients is in supine position with the knee extended, standing on the

ipsilateral side of the patellar place one against the medial aspect of the knee. Grip the

ankle with the other hand and draw the leg medially in one attempt to open the lateral

side of the knee joint. if the patient is complaints of pain above, below or at the joint line

the test is positive.

Investigation: The patients who are selected randumely with intial data collecting from

the DGM Ayurvedic college hospital will be subjected to undergo lab investigation and

X-ray.

Labinvestigations: TC.DC.ESR.Hb%, SAP, RBS

Blood investisgations like TC, DC, &ESR, Hb% were investigate to rull out

Anemia, blood sugar was investigated to rule out systemic disease diabities. SAP was

investigated to rollout osteopytis deformans osteomalasia matastatic bone disease etc.

X-ray: X-ray at lateral and AP views of affected knee were taken rsduction of joint space

formation of osteopytis, lose bodies etc. were taken out to consideration for the diagnosis

post treatment X-ray was not adovocated because past studies shows there will not be any

change in X-ray within 30 days.


84

10. Assessment of response to treatment: In this study Ayurvedic and modern

approaches were utilized in the selection of patients, there classification and final

analysis of results, the results were assessed on the basis of clinical signs and symptoms

and functional capacity of the patient. Functional capacity measuring by walking time, as

patient’s impression gives much important to the final conclusion it was taken to draw a

conclusion regarding the efficacy of the treatment

a) Clinical assessment:

1. Pain: pain of the joint- grade

No pain 0

Mild pain + 1

Moderate pain + + 2

Severe pain + + + 3

The report of the patient was taken in to consideration for the duration of pain

2. Stiffness of the joint Grade

No stiffness 0

Mild stiffness for 5-30 minutes 1

Moderate stiffness for 30-2hrs 2

Severe stiffness more than 2hrs 3

3. Tenderness of the joint garde

No tender 0

Patient says the joint is tender 1

Patient winces 2

Patient winces and with draw the affected part 3

The patient will not allow the joint to be touched 4


85

4. Swelling of the joint grade

No swelling 0

Mild swelling slightly obvious 1

Moderate swelling covers well the bony prominence 2

Severe swelling much elevated 3

5. Crepitation of joint grade

Absent 0

Present 1

6 Walking time (60feet distance) grade

Within 20 sec 0

20-40 sec 1

40-50 sec 2

50-60 sec 3

60 and above 4

11. over all assessment of the treatment: for assessing the over all effect of the therapy

certain criteria were adopted the result are classified in to four groups as listed below:

Excellent: absence of pain, stiffness, tenderness, swelling, crepitation and walking time

normal.

Good: more than 60% reduction in pain 60% and reduction instiffness

More than 60% reduction in the tenderness

More than 60% reduction in the swelling

Walking time reduced to more than 60%.

Crepitation absent

Responded: 25% reduction in all criteria

Not responded: pain persists as such or increased stiffness and tenderness swelling

walking time not improved or increased.

Plan for data analysis:

All the data were statically analysed before and after the treatment and comparison was

done t- test was employed to find out the level of the significance.


86

Clinical Study Results

In the clinical trial subjective and objective changes were considered for the

assessment in the management of sandhigata vata. Total 45 patients were reported with

clinical symptoms. Among these 35 patients were included in the study. Satisfying the

diagnostic criteria 10 patients were excluded due to age and systemic disorders,

deformity. Among 35 patients 5 patients were discontinued and 30 patients completed the

treatment and follow up successfully.

Table No.14 showing the criteria of exclusion in the 10 excluded patient

Sl.No. Reason No. of patient

1 Above 5 years history 1

2 Above 65 years age 3

3 Hypertension 2

4 Diabetes 2

5 Trauma 1

6 Muscle wasting 1

The total data was collected as follows sections:

Section-A Demographic data

Section-B Data related to disease sandhigata vata

Section-c Data related to response to the treatment


87

Section-A

1. Age and sex

Table No.15 Shows distribution of patient in age and sex among 30 treated cases

Sl.No. Age Male % Female % Total %

1 30-40 2 6.66 3 10.00 5 16.66

2 41-50 5 16.66 4 13.33 9 30.00

3 51-60 7 23.33 9 30.00 16 53.33

Total 14 46.65 16 53.33 30 100

In 30 cases 2 male (6.66%) and 3female (10%) were in 30-40 years age group. 5 male

(16.66%) and 4female (13.33%) were in 41-50 years age group. 7 male (23.33%) and 9

female (30%) were in 51-60 years age group. More patients were recorded in 51-60 yrs

age group. Females were dominant in these study 16 cases (53.33%).

Histogram 1

0123456789

10

30-40 41-50 51-60

Age and sex

No

of P

atie

nts

MaleFemale


88

2. Social and Economical Status

Table No.16 Shows the socio economical status of 30 treated patients

Sl.No. Socio Economical Status No. of Patients %

1 Poor 9 30.00

2 Middle class 15 50.00

3 Upper class 6 20.00

Total 30 100

The incidence of sandhigata vata is prevalent in the middle class group. 15 out of 30

case (50%), poor in group is having 9 out of 30 cases (30%), and upper class group 6 out

of 30 cases (20%) was recorded.

Histogram 2

02468

10121416

Social and Economical status

No.

of P

atie

nts

PoorMiddle classUpper class


89

3. Nature of work

Table No.17 Shows the nature of occupation among the 30 treated patients

Sl.No. Occupation No. Patients %

1 Sedentary 10 33.33

2 Active 14 46.66

3 Labour 6 20.00

Total 30 100

10 patients out of 30 (33.33%) of cases were in sedentary group, 14 patents out of 30

(46.66%) cases were in active group, 6 out of 30 (20%) of cases were in labour group.

Histogram 3

02468

10121416

Nature of Work

No.

of P

atie

nts

SedentaryActiveLabour


90

4. Food habit

Table No.18 Shows the food habit a among the 30 treated patients

Sl.No. Food Habit NO. Patients %

1 Vegetarian 18 60

2 Mixed 12 40

Total 30 100

According to the food Habits 18 out of 30 cases were vegetarians reaming 12 (40%)

patients were using mixed diet.

Histogram 4

02468

101214161820

Food habit

No.

Of P

atie

nts

VegetarianMixed


91

5. Religion

Table No.19 Shows the religion among the 30 treated patients.

Sl.No. Religion N No. Patients %

1 Hindu 14 46.66

2 Muslim 10 33.33

3 Christian 4 13.33

4 Other 2 6.66

Total 30 100.00

According to religion 14 (46.66%) of 30 cases are Hindu. 10(33. 33) out of 30 cases

are Muslim, 4 (13.33) out of 30 cases are Christian, 2 (6.66) out of 30 cases are other.

Histogram5

02468

10121416

Religion

No.

of P

atie

nts

HinduMuslimChristianOther


92

Section –B

Data related to disease sandhigata vata

1. Chief complaints

Table No. 20 Showing the Chief complaints among the 30 treated patients

Sl.No. Presenting Complaints No Patients %

1 Sandhi shoola 30 100.00 2 Sandhi shopha 20 66.66 3 Prasaranakunchan vedana 28 93.33 4 Sandhi Sankocha 18 60.00 5 Sandhi stabdata 22 73.33 6 Gamane ativedana 30 100.0 7 Vatapurana druti sparsha 6 20.00 8 Nisharuk 12 40.00 9 Sandhi vishleshana 1 3.33

Among the 30 treated patients all are having Sandhi shoola and Gamane ativedana30

(100%) . 28 patients are having Prasaranakunchna vedana (93.33%) 22 patients are

having Sandhi stabdata (73.33%), 18patients are having Sandhigati sankocha (60%),

20patients are having Sandhi shopha (66.66%),12 patients are having Nisha ruka(40%),6

patients are having vata purana druti sparsha(20%),1patient having Sandhi

vishleshana(3.33%).

Histogram 6

0

5

10

15

20

25

30

35

Chief complaints

No

of P

atie

nts

Sandhi shoola

Sandhi shopha

PrasaranakunchanvedanaSandhi shopha

Sandhi stabdata

Gamane ativedana

Vatapurana druti

2 .Duration


93

Table no. 21 –Showing the chonicity among 30 treated patient

Sl, No Chonicity No patient %

1 1-6months 6 20.00

2 6-1 years 3 10.00

3 1-2years 4 13.33

4 2-3years 5 16.66

5 3-4years 5 16.66

6 4-5years 7 23.33

Total 30 100.00

The duration for which the patients had there illness ranged from 1 month to 5 years, 7

patients (23.33) are having duration ranged from 4 to 5years, 6 patients (20%) are having

the duration of 1 to 6 month, 5 patients (16.66%) are having the duration 3 to 4 years and

5 patients (16.66%) are having the duration 2 to 3 years, 4 patients (13.33%) are having

the duration 1 to 2 years, 3 patients (10%) are having the duration 6 month to 1 year.

Histogram 7

012345678

Duration

No

of p

atie

nt

1-6months6-1 years1-2years2-3years3-4years4-5years


94

3. Involvement of joints

Table no.22 – Showing the pattern of joint involved among the 30 Treated patients

Sl.No pattern No patient %

1 unilateral 20 66.66

2 bilateral 10 33.33

Among the 30 patients 20 patients (86.66%) are affecting the unilateral joint at the 4

patients (13.33%) are involved in the bilateral joint of the knee.

Histogram 8

0

5

10

15

20

25

Involvement of joints

No

of P

atie

nt

unilateralbilateral


95

4. Nidana

Table no.23- Showing the Nidana among the 30 treated patients

Sl.No Aharaja Nidana No

pts

% Viharaja Nidana No

pts

%

1. Rooksha Bhojana 26 86.66 Nishajagarana 3 10

2. Tiktaoshana Kashaya 16 23.33 Ativyayama 20 66.66

3. Alpamatra Bhojana 14 80.00 Atyuchchabhashana 4 13.33

4. Pramita Bhojana 8 26.66 Bhaya dukha chinta 5 15.66

Among the30 patients 26 patients(86.66%)having the history of consumption of Rooksha

bhojana,16patients (23.33%)having the H\O taking of Tiktoshana kashaya,14patients

(80%)having H\OAlpamatra bhojana and 8patients(26.66%)having H\O taking

Pramitabhojana.In vihara 3patients(10%)belongs toNishajagarana,20 patients (66.66%)

belongs to the Ativyayama, 4patients (13.33%) belongs the group Atyuchchbhashana

and5 patients (15.66%)comes under the group Bhaya, dukha,chinta etc.


96

Section C

The subjective and objective data of all the patients is assessed before and after the

treatment ie the cordinal symptoms of sandhigata vata like pain, stiffness, tenderness

also the factors such as swelling, crepitation, time taken for 60feet walk is considered and

also it is statistically analysed by paired t- test.

Table no 24-Showing the % of clinical symptoms before and after treatment Subjective

parameters

Gradation of Pain Gradation of Stiffness Gradation of Tenderness

0- No pain 0- No stiffness 0- No tenderness

I- Mild pain I- Mild stiffness I- The patient says the

5-30 minutes joint is tender.

II- Moderate pain II- Moderate stiffness II-Patient winces

30-2 hrs

III- Sever pain III- Sever stiffness III- Withdraw the joint

More than 2 hrs IV- Patient will not

Allow the joint to be

Touched

Pain Stiffness Tenderness

GR BT % AT % GR BT % AT % GR BT % AT %

III 5 16.66 - - III 4 13.33 - - IV 4 13.33 - -

II 16 53.33 2 6.66 II 8 26.66 6 20.00 III 8 26.66 2 6.66

I 9 30.33 16 53.33 I 10 33.33 10 33.33 II 16 53.33 8 26.66

0 - - 12 40.00 0 8 26.66 14 46.66 I 2 6.66 10 33.33

0 0 0 10 33.33


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1. Pain - It is observed that 5 patients (16.66%) are in grade 3 and 16 patients

(53.33%) are in grade 2, 9 patients(30.00) are in grade 1, this is to say that after

treatment 2 patients (6.66%) are in grade 2, 16 patients (53.33%)are in grade in 1 and

12 patients (40.00%) are in grade 0 or relived.

2. Stiffness- It observed that before treatment 4 patients (13.33%) are in grade 3. 8

patients (26.66%) are in grade 2. 10 patients (33.33%) are in grade and 8 patients

(26.66%) are in grade 0.it is observed that after the treatment 6 patients (20%) are in

grade1. 14 patients(46.66%) are in grade 0 or relived.

3. Tenderness- It is observed that 4 patients are (13.33%) in grade 4. 8 patients (26.66%)

are in grade 3,16 patients (53.33%) are in grade 2, 2 patients (6.66%) are in grade 1,

after treatment it is observed that 2 patients (6.66%) were in grade 3,8 patients (26.66) are

in grade 2.10 patients (33.33%) are in grade 1,and 10 patients (33.33%) are in grade 0 or

relived.


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Table no.25 showing the % of objective parameters before and after the treatment

Objective parameters

Gradation of Swelling Criptation Walling Time

0-No Swelling 0-Nil I – 20-40 Second

I Mild swelling I – Present’ II – 40-50Second

II Moderate swelling III – 50-60second

III Severe IV – 60-Above

Swelling Criptaion Walking time

Gr BT % AT % Gr BT % AT % Gr BT % AT %

III 4 13.33 0 I 18 60.00 5 16.66 IV 1 3.33 0 0

II 8 26.66 6 20.0

0 0 12 40.00 25 83.33 III 3 10.00 0 0

I 8 26.66 8 26.6

6 II 6 20.00 4 13.333

0 10 33.33 16 53.3

3 I 8 36.66 6 20

0 12 40.00 20

66.666


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1. SWELLING---- It is observed that before treatment 4 patients (13.33%) are in grade

III, 8 patients (26.66%) are in grade II , 8 patients (26.66%) are in grade II,10 patients

(33.33%) are in grade I , 10 patients (33.33%) are in grade 0. After treatment 6 patients

(20.00%) were in grade II, 8 patients (26.66%) were in grade I and 16 patients (53.33%)

were in grade 0.

2. CRIPATION: It is obsevered that before treatment 18 patients(60%) are in grade I ,

and 12 patients(40%) are in grade 0, , after treatment 5 patients(16.66%) are in grade I,

and 25 patients(83.33%) are in grade 0,

3. WALKING TIME------ It is observed that before treatment 1 patient (3.33%) are in

grade IV,3 patients (10.00%) are in grade III, 6 patients (20.00%) are in grade II,8

patients (26.66%) are in grade I, 12 patients (40.00%) are in grade 0,after treatment it is

observed that 4 patients(13.33%)are in grade II.6 patients(20.00%) are in grade II, and 20

patients (66.66%) are in grade 0.


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STATISTICAL ANALYSIS

Table no.26 showing the statistical analysis of 30 patients

Parameter Mean S.D S.E t-value p-value Remarks

Pain 1.2 0.407 0.074 16.216 <0.001 H.S

Stiffness 0.566 0.504 0.092 6.152 <0.001 H.S

Tenderness 1.4 0.563 0.102 13.725 <0.001 H.S

crepitation 0.433 0.504 0.092 4.706 <0.001 H.S

Swelling 0.566 0.568 0.103 5.495 <0.001 H.S

Walking

time

0.633 0.556 0.102 6.205 <0.001 H.S

Conclusion: All the parameters shows highly significant by using paired t-test

.The parameter pain shows highly significance (as P<0.001) in parameter, and tenderness

is have the net more mean effect .

The swelling has more variation, the effect in the parameter stiffness and swelling is

same.

The variation stiffness and crepitation is same,

The parameter pain is having uniform net effect on the patient (by comparing co-

efficient of variations)


101

DISCUSSION

The study “preparation physco chemical anylasis of darada vati and evaluation of

its clinical efficacy on sandhigatavata (osteoarthritis). Is presented in four chapters:

1. Literary study 2. Pharmecitical study,

3. Anylitical study, 4. Clinical study.

Literary study: this included drug and diseases review

Drug review: in drug review hingula is reviewed in detail and herbal (shodhana and

bhavana) drugs also reviewed.

Hingula: Historical ascepts – Hingula was known since koutilya period but in that day it

was used only for loha vada. In Samhita, sangraha kala no reference available about

hingula. However in this period only reference for parada is available.

In a rasakala and nighantu kala therapatic uses of hingula was available.

Rasagrantha written by nagarajuna i.e rasarathanakara was first mentioned the properties

and therapatic uses, and also used for marana process of other hard metals like iron,

copper, gold etc.

Later number of rasagranthas mentioned properties uses availability, varieties, shodhana,

satvapatana (hingulakrista parada) and they also mentioned artificial preparation.

Class: hingula kept in different classes according to different opinions of rasagranthas. As

it is classed under maharasa and rasa class. The important of hingula can be thought

hingula is major source of parada, later some acharyas kept hingula in uparasa because

the sources of hingula became less and they got native parada, After this some acharya

considered hingula in sadharana rasa varga in this period natural source became very less

and artificial preparation has brought into practice. This lead to consider it as

sadharana rasa.Dathu varga: according to nighantu these consider as a one of dathu for

that reason kept in dathu varga.

Rasa dathu varga: rasaamritakara has classified drugs according to their main ingredient.

As hingula is containing main ingredient as parada so this is considred in rasadathu

varga.


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Synonyms: indicate the source, composition uses and colour of the drug.

According to the name chinipisti, mleccha, darada, hingula etc. shows place of origin and

availability. Rasagarbha, churna parada etc, these name show presence of parada,

rasagandha sambhuta, gandhika by this we know the presence of gandhaka. lohaghna,

rathnaragakari, ranjani, these name indicate uses of hingula, hamsapada, charmara,

shukatunda, bimbiphala, pravalaba, kunkuma,raktakaya, rakta, etc. indicate colour of

hingula and also other materials present in that. In this colouring temperature has main

role in formation of compound.

Origin: In this point rasaratna samucchaya in first chapter mentioned the origin of

hingula.

Shodhana : the concept of shodhana is to make the hingula to easy absorption and it

separates the other foreign materials present in that.By swedhana it sperats the foreign

metriel and hingula.After again subjected to bhavana to check the bad effect by those

organic acids and organic sulpphur compounds and other elements present in herbal juice

. They also enhance the property of hingula by adding their property to that.

Marana: Very least references are available for marana of hingula.as the shodhita hingula

attains properties like rasasindhura and as it contains gandaka marana is not told.

However marita hingula may have more properties than shodita hingula. The actions like

atyantaagni deepaka, kamottejaka, dorubalya nashaka, atimedhya, atirasayana are in the

maritha hingula.

Artificial preparation: After 13th century artificial preparation of hingula was mentioned

because the deficiency of natural source of it. In that period they were known about

chemical composition. To prepare hingula different authors mentioned.

Anupana: guduchji, tambula, maricha, guda, pipali, are maintained.

Matra: a matra of hingula is similar to parada yoga like rasa sindura, kajjali, parada

bhasma; here the matra is ½ to 2 ratti (62.5- 250 mg) in divided dose per day.

Uses: Hingula in shodhita avasta, acts on gastro intestinal, geneto urinary and nervous

system it also have the actions like agnideepaka, yakrita plihavikara, mehaghna,

kamottejeka, balya, medhya, rasayana and sarva rogahara.etc.

Marita hingula: this is having more penetrating property than the shodita hingula. It has

properties like atyantaagni deepaka, kamottejeka, ati rasayana property.


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Preparation: Nomber of preparations of hingula are available in many text,preparations

like , Hinguladya rasasindura, Hinguliya manikya rasa , Darada bhasma, Darada vati,

Ananda bhairava rasa, Shatarka darada, Shree Siddha daradaamrita etc

Herbal drugs: Used for shodhana and bhavana of hingula.

Shodana dravyas are meshi dugdha and nimbu swarasa, Meshi dugdha it

reduceses the tikshnata of hingula by madhura rasa seetaveerya, madhura vipaka and it

also contains much nutrients which are helpful in nourishment

Nimbhu swarasa is rich of citric acid and vitamin c these help in much enzymatic action

of cells and also by oxidation property it prevents the complications caused by hingula

and there by maintain normal functions of cells.

Other bhavana drugs.1 Rasona – Rasona is one of the pathya dravya in sandhigata vata. It

contains 55% carbohydrates 29% protein vitamin c, organic sulphur and their

compounds. It also contain other elements like calcium, iron, copper, all these are helpful

in diseases, helps in promoting the digestion and absorption of yoga. The oil present in

rasaona.there by it enhances the property of hingula and cures the disease

2. Phalandu: It has similar property of rasona. It also contains organic sulphur

compounds vit A, B and C and also contains like calcium, iron, potassium, but

carbhohydrate is less percentage.

3. Tambula- Tambula is an important anupana dravya mentioned in classic for parada

and hingula. It also contains many elements like calcium, phosphorus, iodine, potassium

nitrate, and vit A, C and also has anti-oxydant property. It enhances the propery of

hingula and checks the complications.

4. Ardraka – Ardraka contains rich starch and protein, gingerol present in that is major

principal. Ginger acts as the adsorbent, carminative. Adsorbent property of ginger on GI

tract causes adsorption of toxin and acids. It enhances the gastric motility by carminative

properties. It blocks the hyper reaction of gastric cells

All the herbal drugs used for the prepartion of darada vati have the similar

poperties of hingula by this they enhance the property of hingula. Those properties are

vatakaphashamaka, vedhanashamaka, shothaghna, balya, rasayana, agnideepaka, hridya,

pachaka.vatanulomaka etc. These properties are explained in nighantu.samhita and they


104

also suppress the complications may be caused by hingula the complications may arised

from hingula are moha, brama, hriudaya avasadhaka, klaibhya, klama, prameha etc.

Diseases review: Sandhigata vata is well known to the Ayurvedic authorities since from

the good hold period Rugveda, Yujarveda, Athranaveda, Purana, Brihatrayi, Lagutrayi,

and other samhita, Rasa granthas.All authoretis considerd Sandhigata vata under the

heading of vatavyadhi so the Nidana of Vatavyadhi is to be considerd as a Nidana of

Sandhigata vata.(Dhatu kshayajanya and Margavarodhajanya).The common signs and

symptoms are Sandhishoola,Sandhishotha,Gamaneativedhana,Sthabdhataetc,

Madhavakara was the first person who mentioned one more laxana ie Atopha and

Ashtanga sangrakara mentioned special laxana ie Vata purana driti sparsha.

The signs and symptoms of Sandhigata vata resembles the Osteoarthritis characterized by

pain, stiffnes, swelling and tenderness, which is the resultant of Degenarative and

Inflamation of joint. Most of the Ayurvedic autheraties differentiated with Vatarakta,

Amavata, and Kroshtuka sheersha.Even modern authorites differentiated with rheumatoid

arthities, Gout, Tubecular arthritis, Gonococal arthritis, and Rheumatic fever. Now days

this diseas becomes common due to change in life style.

Sushruta acharya was the first person who correlated Sadhigata vata with Vata rakta

where the Nidana and treatment is same in both diseas but samprapthy is differs. The

common line of treatment is Snehana, Swedhana, Abhynga, Basti fallowed by

Shamanoushadhi.Sushruta acharya being a Shalya karma specialist mentioned one more

special treatment ie Agni Karma.

.

Pharmaceutical Study: In preparation of Darada Vati Shodhana, Bhavana, and Vati

Nirmana these are the procedure adopted here

1. Shodhana of Darada: Shodhana process is done by one meshikshira Bhavana and

seven nimbu swarasa bhavana in some texts shodhana is mentioned with seven

meshikshira bhavana and seven nimbu swarasa bhavana or any amla dravya swarasa

bhavana. Now a days used hingula is artificial preferred one this does not have any

other materials, so one meshikshira Bhavana and seven nimbu swarasa bhavana

sufficient, for shodhana karma of hingula. Rasa taranginikara has told that after

nimbu swarasa bhavana prakshalana is to be done with jal up to complete niramlatva.


105

But here prkshalana is not done because bhavana dravya help full in disease this

contains citric acid, vitamin C, and other organic things. After this shodhana colour of

hingula becomes kunkum varana or pravalavarana, after shodhana it gians becous of

the weight of bhavana dravya

2. Bhavana: Shodhita hingula is again subjected to bhavana with Lasuna, Palandu,

Tambula and Ardraka swarasa seven times with each sawrasa .Here shodhita hingula

is fit for use in any disease but bhavana dravyas make hingula potential against the

pathology of sandhigata vata and other vata kaphaja diseases.

Lasuna bhavana becomes very difficult due to very thick and sticky nature of its

swarasa. It takes more time then nimbu swarasa bhavana. The colour of hingula is

bright yellowish red colour, odour is in garlic nature. palandu bhavana reduces the

stickiness of lasuna bahavitha hingula. Tambula patra swarasa also reduces the

stickiness. The colour becomes greenish red colour; odour is mixture of previous

bhavitha dravya. Ardraka swarasa bhavana Here ardraka is also rich in starch and

fibers makes the hingula to fit for vati nirmana and also enhance the property of

hingula.The use of these drugs enhance the vyadhi shamaka and rasayana property

of hingula

3. Vati nirmana: when seventh Ardraka bhavana is given and paste becomes fit for

preparation of vati then stop the bhavana process make varti and prepared vati about

one ratti pramana. These vatis were not dried even after seventh day. Later kept in

sunlight then they became again very smooth due to sun rays. Again Ardraka satwa

(30 gm) is added to it and Ardraka sawrasa bhavana was given till it attain the

consistency to prepare vati. Then the vati is prepared. The vati are gradually dried

completely and preserved in air tight container

Anylatical study:

Organaleptic text of vati shows the odour and taste of vati were pungent (mixture

of all herbal smell and taste), appearance, shape and colour property are shiny, spherical,

brick red in colour.All these properties were seen due to shodhita and bhavita dravya

swarasa.

Particle size - The partical size of shodhita hingula 112 micron and after completion of

bhavana it become 34 mircon. This test indicate the process of bhavana reduces the


106

particle size of hingula.This reduced particle may enter in to very minute channels of

tissues.

Loss on drying 1100C – Here vati losses the weight 7% , this indicates 7% of moisture

and volatile oil present is present in the vati, therefore these vatis always preserved in air

tight container and kept in moisture free condition

Hardness: The hardness of vati is 7.5 ± 0.5 kg. It indicates Darada vati has good

machanical strength so it can resist the transportation and manual handling damage.The

hardness value of vati is moderate (maximum10kg), so its dissolution rate is also

moderate.

Weight in variation: Vati prepared manualy so this is necessary to find out the weight

variation of vati, by this test we confirm that ±6.67mg % variation is present

(125±6.67mg). Which is more than the Pharmocopheal standerd value but to prepare the

vati 10% Ardraka satwa is added so this value can be taken as a standerd one when it is

compaired with the only concentrated drug.It indicates this vati contains 95%of

potenciated drug.

Shape and size: Shape of vati is spherical; by measuring the diameter of vati 4.41mm

length and four readings are taken from each tablet we confirmed that ±0.14mm variation

present in diameter. This value is comes under the Pharmaco pheal stander value ( +

5%).It indicates even though vati is prepared manualy but the standerd dose is maintaind

very perfectly means vati is prepared in standerd manar.

Friability Test: The rate was 1.57 % weight loss. It indicates in packing system friction

between container and vati, it may because the 1.57%weight of variation in each tablet

this value is slightly greater than the Pharmacopheal standerd value (0.5-1%). It might be

due to over dring of trhe drug, so during dispening it should be paked completly by

putting some amount of cotton in container so that it can resist the mechanical damage.

Assy for mercury: assy for mercury was done the value obtained indicate each vati

contain 20% of mercury w/w.

Assy for sulphur: The value obtained indicates 9.21 % of total sulphur w/w.

Ash value: The ash value determined after complete removal of carbon from the sample.

This carbon removed at about 4500C. The remaining material may be some inorganic

elements. The value is 6.42% ash w/w.which comes under the Pharmcopheal standerd

value (13 to15%w/w).


107

Acid insoluble ash: Darada vati has the Acid in solubale ash value 2.13%w/w .Which is

less than the Pharmacopheal standerd value (2.5%w/w), it indicates it does not contain

any Silicus matter so it does damage the vital organs.

Clinical Study:

Plan of study: In this study a specific plan and design was adopted for better analisation.

total 45 patient were reported with clinical symptoms of Sandhigata Vata among 35

patients included in the study, satisfying the diagnostic criteria, 30 patient are completed

the course of treatment.

The excluded cases are above 60 year, Diabetic, Trauma, Hypertension, Muscle wasting

and above 5 years history.

Selection: The disease was diagnosed as sandhigata vata based on the sign and

symptoms explained in classical Ayurvedic and modern text, routine blood text were

conducted to rule out infection and other pathologies.

General Description of patient: Age and sex- In total 30 patient more patients 16 (33.33)

are in 50-60 years. Females were dominant 16 (53.33) this in indicates the disease more

predominant in female and during the period after 50 years

Socio Economical: In this 15 patients are in middle class the areas were the study is

conducted was dominated by business people; here there is no relation between social

and economical status with sandhigata Vata.

Nature of work: In this 14 patient (46.66%) are in active group due to the continues stress

affecting on joints due to activeness at the particulars joint become degenerated causing

Sandhigata Vata, 10 patient (33.33%) were in sedentary in this mostly the house wife and

table worker.

Food habit: 18 patient (60%) are vegetarian, remaining 12patient (40%)are belongs

mixed food habit , in this locality the availability of vegetarians are more due to the

vegetable cultivation and highly populated by Hindus those who are strict in taking

vegetarian diet

Religion: 14 patient (46.66%) are belongs to Hindu, 10 patient (33.33%) are Muslim,6

patients belongs to other religion there is no relation between religion because the

population dominancy.


108

Nidan: Among 30 patient Aharaja Nidan-- Roksh Bhojan Sevena is noted in 26 patients

(86.66%) and Katu Tikata Kashaya rasa pradhana bhojana is noted in 16 patients

(23.33%). In study conducted place the people are more used to take Roksh Bhojan,

TiktaKatuKashaya bhojana. Viharaja Nidana-- Ativyayamaja 20 patient (66.66) is

present, due to excess use of joint leads to degeneration of joint

Presenting complaints: In this 30 treated patient all were (100%) presented with

Sandhishoola and Gamane ativedhana. 28 (93.33%) are in Prasarana Akunchana Vedana,

22 patient (73.33%) are Sandhi Stabdata, 20 patient (66.66%) are in Sandhi shopha and

12 patient (40%) are in Nisharuk only few patient complaints, 6 patient (20%) are in Vata

Purana Druti Sparsha, 1 patient (3.33%) having Sandhi vshleshana.

Chonicity- In this 30 treated patient 7 patient (23.33%)are having H/O 4-5 years, 5

patients (16.66%) are having H/O 2-4years, 5 patient (16.66) are having H/O 2-3 years, 4

patient are (13.34%) having H/O 1-2 years from this it is highlighted the chonicity

increase towards the later stages of age.(50-60)

Probable of mode of action of Darada Vati in Sandhigata Vata;

Sandhi gata vata is caused by the vitiation of Vata and Kapha (vyana vayu vriddhi,

shleshaka kapha kshaya) here kapha kshaya means Shleshaka kapha loses its normal

gunas(shnigdh, guru,manda,etc)ther by it does not performes its normal function leading

to Pain, Stiffness, Tenderness,Swelling etc in joint.

This theory is also belived by the modern authority ie in Asteo arthritis when our body

does not produces enough amount of Glucosamine and Chondrotin the synovial fluid

loses its viscocity and convert into watery solution which does not perform its normal

functions ie Lubrication , Shearing, Nourishment of cartilage etc resulting in to

Degenration and leading to same pathology.

The Darada Vati can reduces the symptoms as well as degenerative process due to

action of Darada, Meshikshira, Nimbu Swarasa, Lasuna, Palandu, Tambula, and Ardraka

Swarasa,

It is very difficult to draw the exact mechanism of action of Darada Vati but by observing

the theoraphitic effect hypotheses can be presumed for the mechanism.The drugs of the

Vati all are VataKapha Shamaka, Agnivardhaka Balya, Rasayana, Vedanashamaka,

Shothghna etc.


109

Darada which is the main content. of the preparation, the property of the Darada equal to

the Rasa Sindoor ie the properties are Tridoshaghna, Atirasayana, Agniverdhaka, Balya,

etc.

As Darada is purified by giving Bhavana with Meshidhugdha, and Nimbu Swarasa, these

will check the toxic effect of Darada, Nimbu Swarasa is rich in citric acid and vitamin c,

this normalize the functioning of living cells and involves in many enzymatic function in

the body, it also play main role in the development of cartilage, bones and in wound

healing, it also has the antioxidant property which counteract the Degenration.

The other bhavana drugs like Lasuna ,Plandu,Tambula, Ardraka Sawrasa are

havingVataKaphahara, Rochaka,Pachaka,Agnipradeepaka,Rasayana,Vedana Sthapaka,

Shothaghna,etc property will help in enhancing the absorption of Darada,even Rasona,

Tambula,Ardraka having atioxydent property which conteract the Degenaration, so this

potentiated Darada, mitigates the Kapha Dosha(bringes the normal gunas ie snigdha,guru,

sthira, manda etc) by its Ushna Veerya it clears off the blockages of channels and give

strength to Sandhi by proper nursing of cartilage , bone, synovial fluid .


110

SUMMARY The present study titled “Preparation, physico chemical analysis of Darada vati and

evaluation of its clinical efficacy on Sandhigata Vata (Osteoarthritis)

This study includes the following chapter that is

1. Introduction

2. Objective

3. Review of literature

4. Methodology, which contains pharmaceutical study, analytical study and

Clinical study.

5. Results.

6. Disscusion,

7. Conclusion

1. Introduction - In the introduction part, importants of Ayurveda, aim and objective of

Rasa Shastra, importants of Parada and properties of Darada, Discription of Sandhigata

Vata, and necessity for the assortment of this research work is explained in brief.

2. Aim and objectives of the present study are mentioned in the objective chapter

3. Review of literature is dealt in two main headings 1.Drug review 2.Disease review.

Drug review- Historical first referance of hingula, synonyms, classification, occurance,

properties, standard qualities of hingula, ashuddha, agrahy hingula dosha and chikatsa,

shodhana, marana, satwapatana, uses, anupana, matra. Modern view of Hingula physical

proerties and chemical properties, verities.

Disease Reviewed- Deals about Historical, Etymology, Defination, Nidana Panchaka and

Line of treatment according to various authorities.

Modern aspects also review.

Materials and Methods This deals about pharmaceutical, analytical, clinical study. 1.

Pharmaceutical study includes Daradashodana, Darada Bhavana, and Daradavatinirmana

2. Analytical study deals about Physico chemical analysis of Dharadavati carried out in

Indian bureau of mines, regional ore dressing laboratory, Bangalore and some physical

analysis carried out in J.T.Pharmacy College, Gadag. 3. in clinical study-special camps

was conducted by post graduate department of Rasashastra DGM Ayurvedic medical


111

colage and hospital Gadag. The patient of sandhigata vata after the complete diagnosis

were selected, clinical trial was done administering Darada Vati 125mg bid with

Ushnajala Anupana for 30day and the patients were assessed for the same criteria

In the clinical results the patients were assessed according to the subjective and objective

criteria and results are given with the help of statistical value P-value,t –value, S.D, S.E

etc.

In the chapter discussion first drug and disease discussion has been done in both the view

that is Aryuveda as well as modern aspect. In the part of pharmaceutical discussion

Shodhana, Bhavana, rationalities were discussed.

In analytical discussion role of Physico chemical analysis of Darada Vati is discussed and

in clinical discussion of Sandhigata Vata patients as well as probable mode of action of

Darada Vati explained.

CONCLUSSION

1) Parada and Gandhaka yogas are consided superior in Rasa shastra, so Hingula is

compound of Parada and Gandhaka has the properties similar to the Rasasidhura hance

Darada vati is to be considerd suprim in Sandhigata vata.

2) After pharmaceutical procedure Hingula become non toxic and theraphatically

effective, the specific drugs used in procedure may check the pathogensis and normalizes

the function of tissue.

3) Procedure bhavana make the partical size of the Hingula in very micro form

(34micron).

4) Physico-chemical analytical study of vati passes all the Pharmcopheal standerd value

and assy of Mercury is 21%, Sulphar is 9.1%.

5) By clinical evaluation we conclude that it reduced the subjective and objective

parameters of disease.


112

SCOPE OF STUDY 1) Comparative study is necessary between other Parada Gandhaka yogas (kajjali, rasa sindhura, rasa perpati ) in degenarative joint disease . 2) Hingula is considerd as ati rasayana so how for it encounters the Degenaration in Osteo arthritis or in Degenarative disorders is to necessary to analyze it by experimental study.


113

REFERENCE

1. Srimad Govindbhagavatpada-Rasa Hridaya tantra, Chaturbhuja mishra edition 2, 2001

Choukambha publisher varanasi,chap 1 sloka 12 page 9

2. Nagarjuna-Rasendra Mangala-Kaviraj H.S Sharma Edition I, 2003 Chouknumbha

Orientalia Varnasi Chap 1,3,4,Sloka 43,56,189

3. Inderdev Tripati Rasarnava-Edition 4th, 2001, Choukhumba Sanskrit Series Office

Varanasi Chap 6, 7, Slok103, 46, Page79,109

4. Nithayanath Sidda- Rasaratnakara, Swaminath Mishra –Edition 1, 1991,

Choukambha Orientalia Varnasi Chap21,Sloka41-45,Page301

5. Sri. Vagbhatacharya- Rasaratna Samucchaya, Sri Dharmananda Sharmana Edition

2ndReprint 1996 Motilala Baanarasidasa Publication Chap3 Sloka147-154 Page60-61

6. Sri. Gopalkrishnabhatta-Rasendra Sara Sangraha, Interdev Tripati Edition 3rd 2003

Choukambha orientalia Varnasi Chap1 Sloka114-115, 226-231 Page86-87, 140-144

7. Sri. Sadanad Sharma- Rasa Tarangini, Kashinath Shastri Edition-11.2000 Motilal

Banarasi Dass Varnasi Chap9 Page 198-208

8. Acharya Madhava- Ayurveda Prakasha, Sri. Gulrajsharma Mishra. Edition 2nd reprint

1999, Choukambha Bharti Academy Varnasi Chap2 Sloka69-86 Page273-277

9. White Law Ainslie – Materia indica –Volume 2 Chapter 2 X1Xpage 540 -546


2ndReprint 1996 Motilala Baanarasidasa Publication Chap Hingula prakaran Page 208

11. Rasarnava-Indradeva Tripati Edition 4th , 2001, Choukhumba Sanskrit Series Office

Varanasi Chap 7, Sloka2 Page86


2ndReprint 1996 Motilala Baanarasidasa Publication Chap6 Sloka45Page113

13. Vaidy Sri Chudamani --Rasakamadhenu Part I Vaidy Sri Yadavaji Trikamaji

Acharya 1990 Choukambha Orieostalia Varanasi , Dvitiya Dhatu Sangraha Pada

Tritiyodhikar page233-234


Choukambha orientalia Varnasi Chap1Sloka114-115Page86-87


114


1999, Choukambha Bharti Academy Varnasi Chap2Sloka1Page252


2ndReprint 1996 Motilala Baanarasidasa Publication Chap3Sloka126Page55

17. Bhudev Mukerjee-Rasa Jala Nidhi Vol-2 Edition 2nd 1984 Sri. Gokul Mudranalaya

Varnasi Chap3Page224

18. Acharya Vishwanatha Dvivedi Bharatiya Rasashastra Edition 2nd, 1987, Shri, Sharma

Ayurveda Mandira Datia Jhansi Varanasi Nagpur Chap11Page318

19. Sri Manura-hari Raja-nighantu, Indra Dev Thripati 1998 Shri Krishnadeva Academy

Varnasi, Swarnadi Dhatu Prakarna.

20. Yadavji Trikamji Achary-Rasamrta. Dr. Damodhar Joshi Edition-1st 1998

Choukambha Sanskrit Sansthan Varanasi Chap1Page26-27

21. Yoga Ratnakara- Yoga Ratnakara Purvarda, vidya Lakshmi pathi Shastri Edition 4

1958 Chaukamba vishwa Bharthi Varanasi Page 159-160

22. Dr.K.M Nadakrani – Indian Materia Medica Volume II – A.K Nadakarni Edition 3rd

Reprint 2002 Popular Prakashana Bombay ,page72

23. Yadavji Trikamji-Rasamrta. Dr. Damodhar Joshi Edition-1st 1998 Choukambha

Sanskrit Sansthan Varanasi Chap1Page26


Choukambha orientalia Varnasi Chap1Sloka226Page140-141


Banarasi Dass Varnasi Chap9Sloka12Page198


2ndReprint 1996 Motilala Baanarasidasa Publication Chap1Sloka88Page14.

27. Damodar joshi –Rasashastra, Dr. K.P.Sreekumari, edition1,1986. Kerala Govt

Ayurvedic publication series, Kerala. page 174

28. BR Puri- Inorganic Chemistry Edition -1 1981 Shoban Lal nagni chand and company

Delhi, page 1106


2ndReprint 1996 Motilala Baanarasidasa Publication Chap11Page206-210

30. Nithayanath Sidda- Rasaratnakara, Swaminath Mishra –Edition 1, 1991,

Choukambha Orientalia Varnasi Chap19Sloka41-45Page301


115


Banarasi Dass Varnasi Chap9Sloka5-10Page199-200


1999, Choukambha Bharti Academy Varnasi Chap2Sloka78-85Page275-277

33. White Law Ainslie – Materia indica –Volume 2 Chapter 2 X1X page 540 -546

34. Acharya Yashodhara- Rasaprakash Sudakara, Siddinandanmishra Edition 2nd 1998

Choukambha orientalia Varnasi Chap6 Sloka85 Page130

35. Acharya Sumadheva, Rasendra Chudamani, Dr. Siddnanandan Mishra Edition-2nd -

1999 Choukambha Orientalia Varanasi Chap11Sloka107Page195

36. Yadavji Trikamji Achary-Rasamrta. Dr. Damodhar Joshi Edition-1st 1998

Choukambha Sanskrit Sansthan Varanasi Chap1Page26-27

37. Vaidy Sri Chudamani -- Rasakamadhenu Part I Vaidy Sri Y T Acharya 1990

Choukambha Orieostalia Varanasi , Dvitiya Dhatu Sangraha Pada Tritiyodhikar


1999, Choukambha Bharti Academy Varnasi Chap2 Sloka70-71 Page272-273


Banarasi Dass Varnasi Chap9 Sloka4 Page199

40. Acharya Vishwanatha Dvivedi Bharatiya Rasashastra Edition 2nd, 1987, Shri, Sharma

Ayurveda Mandira Datia Jhansi Varanasi Nagpur Chap11 Page327-328






Banarasi Dass Varnasi Chap9 Sloka3 Page199

44. Rasarnava-Indradeva Tripati Edition 4th , 2001, Choukhumba Sanskrit Series Office

Varanasi Chap 7, Sloka52 Page94


Choukambha orientalia Varnasi Chap1 Sloka227-230 Page143


2ndReprint 1996 Motilala Baanarasidasa Publication Chap3 Sloka 152-153 Page47


116


Banarasi Dass Varnasi Chap9 Sloka12-17 Page201-207

48. Krishna Gopal-Rasa Tantra sara I Part –Edition 9th 2000, Krishnagopal Ayurveda

Bhavana Ajmira Page60

49. Yoga Ratnakar-Yoga Ratnakara Purvardh Vaidya Laximipati Shastri Edition 4 1988

Choukambha Vishawabharti Varanasi sloka 4 page 160


Banarasi Dass Varnasi Chap9 Page200


1999, Choukambha Bharti Academy Varnasi Chap2 Sloka72 Page274

52. Sri Manohari-Rajanighantu, Inderdev tripati 1998 Sri. Krishnadas Academy Varanasi

sloka 58 page 440


1999, Choukambha Bharti Academy Varnasi Chap2 Sloka77Page275

54. Damodar Joshi-Rasashastra, Dr.K.P.Sri.Kumari Edition 1st !986 Kerala Govt.

Ayurvedic Publication series Kerala Section 2 Page 176


2ndReprint 1996 Motilala Baanarasidasa Publication Chap3 Sloka150 Page60


1999, Choukambha Bharti Academy Varnasi Chap2 Sloka72Page274




Banarasi Dass Varnasi Chap9Sloka18-24Page202,203

59. White Law Ainslie – Materia indica –Volume 2 Chapter 2 X1Xpage 540 -546


Banarasi Dass Varnasi Chap9Sloka11Page200

61. Pundit Ram Prasad-Rasendra Purana-2000 Khemaraj, Sri Krishnadas Prakashan,

Mumbai chap5sloka35page143

62. Dr.K.M Nadakrani – Indian Materia Medica Volume I And II – Ak Nadakarni

Edition 3rd Reprint 2002 Popular Prakasha Bombay ,page 72


117


1999, Choukambha Bharti Academy Varnasi Chap2Sloka72Page274

64. Niranjan Prasad -Parad Samhita 1997 Choukambha publication Varnasi chap 51

page 444

65. Pundit Ram Prasad-Rasendra Purana-2000 Khemaraj, Sri Krishnadas Prakashan,

Mumbai chap5sloka10page140-142


Choukambha orientalia Varnasi Chap1Sloka47.48Page50




Choukambha orientalia Varnasi Chap3Sloka2,5Page52

69. Sri.Krishnarum, Bhatt, Siddha Bhaishajya Manimala Sri.K.Kaludhara Bhatt Edition

3rd .2003. Choukambha Krishnadas Academy Varanasi Chap5Sloka3,6page 353

70. Nithayanath Siddha- Rasaratnakara, Swaminath Mishra –Edition 1, 1991,

Choukambha Orientalia Varnasi Chap2Sloka48-53Page20-21

71. Sri Govindadasa- Bhaishajya ratnavali-Kaviraja Sri Ambhikadatta Shastra Edition-17

2002 , Choukhumbha Sansthan varanasi, Chap5,6Sloka473,474,482,76,78,Page82


Choukambha orientalia Varnasi Chap3Sloka3-4Page315


Choukambha orientalia Varnasi

74. Yadavji Trikamji-Rasamrta. Dr. Damodhar Joshi Edition-1st 1998 Choukambha

Sanskrit Sansthan Varanasi Chap1Sloka55-56Page27

75. Pundit Dutaaram Choube Rasa Tantra Sara Editon3rd 2000 Choukambha orientalia

Varanasi page 24 and 553


Banarasi Dass Varnasi Chap9Sloka25-62Page203-209

77. Vaidy Sri Chudamani --Rasakamadhenu Uttardha Vaidy Sri Yadavaji Trikamaji

Acharya 1990 Choukambha Orieostalia Varanasi , Chap33 Sloka242-244 Page




118



80. Dr.K.M Nadakrani – Indian Materia Medica Volume II – A.K Nadakarni Edition 3rd

Reprint 2002 Popular Prakasha Bombay ,page 185

81. Vagbhatacharya- Astanga Sangraha, Sutrasthana Dr. Ravi Datta Tripatia Edition 2nd

1992, Choukambha Sanskriti pratisthana varanasi Chap6Sloka59Page100

82. Dr. Gynandries Pandya- Dravya Guna Vignana Value 1 Edition 2nd 2002 Section 2

79-191, Page 459

83. Dr. J L N Shastri- Dravya Guna Vignana Volume 3 2nd Edition, 2002 Page 105-107

84. Trease and Evans-Pharmacognosy Edition 14th 2001, WB Sunders company Ltd.

London Page 445-450

85. Dr. Gynandries Pandya- Dravya Guna Vignana Value3 Edition 2nd 2002 Section 238-

248

86. Dr. J L N Shastri- Dravya Guna Vignana Volume 3 2nd Edition, 2002 Page 531-535

87. Dr. Gynandries Pandya- Dravya Guna Vignana Value 3 Edition 2nd 2002 Page 11-16

88. Dr. J L N Shastri- Dravya Guna Vignana Volume 3 2nd Edition, page 996-997

89. Kartika Chandrbhosa-Pharmacopoeia Indica Edition 1st 1984, the book company Ltd.

College Square Calcutta,

90. Dr. Gynandries Pandya- Dravya Guna Vignana Volume 3, Edition 2nd 2002 page

602-607

91. Kartika Chandrbhosa-Pharmacopoeia Indica Edition 1st 1984, the book company Ltd.

College Square Calcutta. page-135-136

92. Dr. Gynandries Pandya- Dravya Guna Vignana Volume 1 Edition 2nd 2002 Section 2,

page 179-191,

93. Dr. J L N Shastri- Dravya Guna Vignana Volume 3, 2nd Edition, page 519-526

94. Agni Vesha, Charaka- Charaka Samhita ,chikitsa stana, Pt. Kashinatha Shastri

Edition 6th , 2000 Choukambha Publication New,Delhi,Chapt28, Sloka 39, Page 783

95. Sushruta Acharya-Sushruta Samhita, Nidana stana Dr. Ambhika Datta Shastri

Edition 13 , 2000, Choukambha Publication Chapter 1, Sloka 28, Page 230

96. Vagbhatacharya- Astanga Sangraha, Nidana Prof.K.S.Srikanta Murthi Edition 1st

1996 Choukambha publication Varnasi Chap 15, Sloka 14, Page243-4


119

97. Bhelacharya- Bhela Samhita Chikitsa Stana – Sri Girija Dayalushukla Edition 1, 1959

the Choukambha Vidya Bhavana Varanasi Chapter 26, , Sloka 3,Page 220

98. Madhava Kara – Madhava Nidana – Purvardha , Ayurveda Charya, Sri

Yadunanndana Upadaya , Edition 13th , 1994 Choukambha Sanskrit Sansthana

Varanasi , Chapter 22, Sloka 21, page 418.

99. Sri Bhava Mishra–Bhava Prakasha,chikitsa, Uttar Tantra, Sri Brahama Shankara

Mishra Edtion 6,1984 Choukambha Sanskrita Sansthana Varanasi, Chap24,Page 227

100. yogarathanakara – yogarathanakara purvardha, vaidhya- lakshmipati shastri edtion 4,

1988, Choukambha vishwa bharathi, varanasi, sloka 1,page 505.

101. Ayurveda samivalana oct 2003

102. W.N Kelly el al , The text book of Rheumatology, edition 5, 1995,

103. Bhattayacharya TT – sabdastomamahanidhi 1997 choukamba series varanasi

104. Sushruta Acharya-Sushruta Samhita, sharira stana Dr. Ambhika Datta Shastri Edition

13 , 2000, Choukambha Publication Chapter 5, Sloka28-34, Page 46

105. Bhattayacharya TT – sabdastomamahanidhi 1997 choukamba series varanasi

106. Bhelacharya- Bhela Samhita Chikitsa Stana – Sri Girija Dayalushukla Edition 1st

1959 the Choukambha Vidya Bhavana Varanasi Chapter 26, Page 220,

107. Vagbhatacharya- Astanga Sangraha, Dr. Ravi Datta Tripatia, edition 2nd, 1992,

Chap 19, sloka 3, page 358

108. Agni Vesha, Charaka- Charaka Samhita, vimana stana Pt. Kashinatha Shastri Edition

6 , 2000 Choukambha Publication New,Delhi,Chapt 8, Sloka 98, .Page 773

109. Agni Vesha, Charaka- Charaka Samhita,sutra stana Pt. Kashinatha Shastri Edition 6th

, 2000 Choukambha Publication New,Delhi,Chapt12 , Sloka 7, .Page245

110. Vagbhatacharya- Astanga Sangraha,sutra stana Dr. Ravi Datta Tripatia, edtion 2nd ,

1992, Chap19, sloka 3, page 357

111. Vagbhatacharya- Astanga Sangraha, Dr. Ravi Datta Tripatia edtion 2nd , 1992,

Chap19, sloka13, page 364

112. Agni Vesha, Charaka- Charaka Samhita, chikitsa Pt. Kashinatha Shastri Edition 6 ,

2000 Choukambha Publication New,Delhi,Chapt 28, sloka 39, page 783

113. Sushruta Acharya-Sushruta Samhita, Nidana stana, Dr. Ambhika Datta Shastri

Edition 13 , 2000, Choukambha Publication Chapter 1 , sloka, 28, page 230.


120

114. Madhava Kara–Madhava Nidana, Purvardha , Sri Yadunanndana Upadaya , Edition 13th

, 1994 Choukambha Sanskrit Sansthana Varanasi , Chapter 22, sloka 21, page 418

115. Samuel L Turek orthopedics principals and their applications edition IV 1989, Jaypee

brothers New-Delhi

116. Harrison’s, principals of internal medicine Volume 2 Part 12 section3 Kenneth P.

Brandt edition 14th 1984, Asian student. singpur page 1935,1936


Brandt edition 14th 1984, Asian student. singpur page 1939,1941

118. Sushruta Acharya-Sushruta Samhita, sharira Dr. Ambhika Datta Shastri Edition 13,

2000, Choukambha Publication Chapter 5 sloka 29, page 46.

119. Vagbhatacharya- Astanga Sangraha, sutra stana Dr. Ravi Datta Tripatia, edition 2,

1992, Chap 20, Sloka6, page 380.

120. Sushruta Acharya-Sushruta Samhita, sutra stana, Dr. Ambhika Datta Shastri Edition

13, 2000, Choukambha Publication Chapter 21, sloka 14, page 90.

121. Indrabirsingh – text book of anatomy, vol. 1, edition 2, Jaypee brothers, New Delhi

122. Vagbhatacharya- Astanga Sangraha, sutra stana, Dr. Ravi Datta Tripatia edition 2nd,

1992, Chap1, sloka 36, page 15.

123. Vagbhatacharya- Astanga Sangraha, sutra stana, Dr. Ravi Datta Tripatia, edition 2nd,


124. Sushruta Acharya-Sushruta Samhita, sutra stana, Dr. Ambhika Datta Shastri Edition

13, 2000, Choukambha Publication Chapter 21, sloka 5, page 87.

125. Vagbhatacharya- Astanga Sangraha, sutra stana Dr. Ravi Datta Tripatia, edition 2 ,

1992,Chap1, sloka 25, page 9.

126. Vagbhatacharya- Astanga Sangraha, sutra stana Dr. Ravi Datta Tripatia edition 2nd ,

1992,Chap1, sloka 25, page 9.

127. Vagbhatacharya- Astanga Sangraha, sutra stana Dr. Ravi Datta Tripatia edition 2nd,


128. Vagbhatacharya- Astanga Sangraha, sutra stana Dr. Ravi Datta Tripatia edition 2nd,


129. chap1,sloka27,page20


121

130. Agni Vesha, Charaka- Charaka Samhita,vimana stana Pt. Kashinatha Shastri Edition

6th ,2000ChoukambhaPublication,NewDelhi,Chap6,Sloka6,Page718,

131. Vagbhatacharya- Astanga Sangraha, sutra stana Dr. Ravi Datta Tripatia

Edition2,1992 ,Chap1,Sloka49,Page20

132. Agni Vesha, Charaka- Charaka Samhita, vimana stana Pt. Kashinatha Shastri Edition

6th , 2000 Choukambha Publication New,Delhi,Chapt8 Sloka119 Page780

133. Vagbhatacharya- Astanga Sangraha Sutra Stana, Dr. Ravi Datta Tripatia edition II

1990 Chap1 Sloka34 Page14

134. Vagbhatacharya- Astanga Sangraha Sutra Stana, Dr. Ravi Datta Tripatia edition II

1990 Chap1 Sloka36 Page15


Brandt edition 14th 1984, Asian student. singpur page 13941,

136. Osteoarthritis – Nicholas Piramial India Ltd. Mumbai


Brandt edition 14th 1984, Asian student. singpur page 13941,

138. Davidson’s –principals and practice of medicine edition 18, 1992 ELV publication

London, Chap 12 page 88,

139. Davidson’s –principals and practice of medicine edition 18, 1992 ELV publication

London, Chap 12 page,90

140. Madhava Kara – Madhava Nidana – Purvardha, Sri. Sudarshna Shastri Edition 18,

1989, Choukambha publication Varanasi chap 22 sloka 21 page 418

141. Agni Vesha, Charaka- Charaka Samhita Chikitsa stana, Pt. Kashinatha Shastri Edition


142. Agni Vesha, Charaka- Charaka Samhita Chikitsa stana, Pt. Kashinatha Shastri Edition


143. Vagbhatacharya- Astanga Sangraha, Nidana Stana Prof. K.S.srikantmurthi Edition 1st

Choukambha publication Varnasi Chap15Sloka15Page243,244

144. Agni Vesha, Charaka- Charaka Samhita Chikitsa stana , Pt. Kashinatha Shastri

Edition 6th , 2000 Choukambha Publication New,Delhi,Chapt28 Sloka23 Page775

145. Vagbhatacharya- Astanga Sangraha Sutra Stana, Dr. Ravi Datta Tripatia

edition2,1992,Chap 20.Sloka 4 Page377


122

146. Agni Vesha, Charaka- Charaka Samhita, chikitsa stana Pt. Kashinatha Shastri Edition


147. Agni Vesha, Charaka- Charaka Samhita Sutra Stana , Pt. Kashinatha Shastri Edition


148. Sushruta Acharya-Sushruta Samhita, chikitsa stana, Dr. Ambhika Datta Shastri

Edition 13, 2000, Choukambha Publication Chapter4 Sloka5-8 Page78.

149. Robert berkow – the merk manual of diagnosis and therapy, edition 13, 1997, merk

sharp and dohme research laboratory.

150. John Ebenezer 2, 2000, Jaypee brothers New Delhi. - The text book of orthopedics,

151. Agni Vesha, Charaka- Charaka Samhita chikitsa stana, Pt. Kashinatha Shastri Edition

6th , 2000 Choukambha Publication New, Delhi, Chapt29 Sloka104 Page785

152. Sushruta Acharya-Sushruta Samhita, chikitsa stana , Dr. Ambhika Datta Shastri

Edition 13 , 2000, Choukambha Publication Chapter4 Sloka8 Page26


123

Master Chart - Subjective & Objective parameter & effect of Darada vati on

Sandhigata vata

Subjective parameter Objective parameter

Pain Stiffness Tenderness Swelling Creptation W.time

Sl.No

OPD.No

BT AT BT AT BT AT BT AT BT AT BT AT

Results

1 3760 3 2 3 2 4 3 3 2 1 1 4 2 Responded 2 4277 2 1 2 1 3 1 2 1 0 0 2 1 Responded 3 4505 2 0 2 1 2 1 0 0 1 0 0 0 Good 4 270 3 2 3 2 4 2 3 2 1 1 3 2 Responded 5 1253 2 1 2 1 3 1 2 1 1 0 1 0 Good 6 1282 1 0 0 0 2 0 1 0 0 0 0 0 Good 7 1295 2 1 2 2 3 2 2 1 1 0 2 1 Responded 8 1296 2 1 1 1 3 1 2 1 0 0 2 1 Responded 9 1299 2 1 1 0 2 0 1 0 1 0 1 0 Good 10 1306 1 0 0 0 2 0 0 0 0 0 0 0 Good 11 1311 1 0 0 0 2 1 1 1 0 0 0 0 Responded 12 1313 3 1 3 2 4 2 3 2 1 1 3 2 Responded 13 1310 2 1 1 0 2 1 2 1 1 0 1 0 Good 14 1341 2 1 2 1 3 2 1 0 1 0 0 0 Good 15 1362 2 1 1 0 2 1 1 1 1 0 1 0 Good 16 1430 2 0 1 0 2 0 0 0 1 0 0 0 Excellent 17 1435 1 0 1 1 2 1 0 0 0 0 0 0 Good 18 2234 3 1 2 1 3 2 2 1 1 1 2 1 Responded 19 2450 3 1 2 1 3 2 2 1 1 1 2 1 Responded 20 2766 2 0 1 1 2 0 0 0 1 0 0 0 Good 21 2790 1 0 0 0 1 0 1 1 0 0 1 0 Good 22 2816 1 0 1 1 2 1 0 0 0 0 0 0 Responded 23 3019 2 1 2 1 3 2 1 1 1 0 2 1 Responded 24 3104 1 0 0 0 2 1 0 0 0 0 0 0 Good 25 3215 2 1 2 2 2 0 1 0 1 0 1 0 Good 26 3260 1 0 0 0 2 0 1 0 0 0 0 0 Excellent 27 3347 2 1 1 0 3 2 1 1 1 0 2 1 Responded 28 3504 2 1 1 0 2 0 1 0 0 0 1 0 Good 29 3759 2 1 1 1 2 2 1 0 1 0 1 0 Responded 30 3813 1 0 0 0 2 1 0 0 0 0 0 0 Good


124

Special case sheet proforma for Sandhigata vata(Osteoarthritis)

Post graduate and research center (Rasashastra)

Shri D.G.M. Ayurvedic Medical College, Gadag.

Guide: Dr.M.C.Patil M.D (Ayu) Scholar: K.M.Jaggal P.G.Scholar

Co - guide: Dr.G.N.Danappagoudar .M.D (Ayu)

01.Name : Sl.No.:

02.Father’s/Husband’s Name: O.P.D.No. :

03.Age : D.O.A:

04.Sex : D.O.D:

05.Religion :

06.Occupation :

07..Ecconomical

Status :

08. Address :

Telephone:

09. Result :

10. Consent : I ------------------------- , I giving my consent to be included as

subject in the clinical trail and fully convinced with the disease drug and , I am also

aware of my right to quit the trail at any time during the course of trail.

Hindu Muslim Christian Others

Sedentary Active Labour

Poor class Middleclass Upper class

Excellent Good Responded Not Responded

Years

M F


125

Patient’s Signature

11. Presenting Complaints

Sl.No. Complaints P / A 0 10thday 20thday 30thday

01. Sandhi shoola

02. Sandhi shopha

03. Vata purana druti sparsha

04. Prasaranakunchana vedana

05. Sandhigati sankocha

06. Sandhi stabdhata

07. Nisharuk

08. Gamane ativedhana

09. Sandhi vishleshana

12. History of present illness:

1. Joint involved: 2. Mode of Onset:

3. Nature of Disease:

4. Routine activities affected

5. Nature of pain: 6. Severity of pain:

7. Variation of pain:

8. Aggrivating factors:

Gradual Suddenly

Progressive Regressive Constant Intermittent

Yes No

Mild Moderate Severe

Increase on use Increase on disease


126

9. Relieving factors:

13. History of Post illness: H/O Episodes of similar complaints: 14. Family History: 15. Treatment History: Moderate medicine: Ayurvedic medicine: Relief with previous treatment: 16. Personal History:

Diet: Appetite: Bowels: Urine: Sleep: Habit: Menstrual cycle: 17. General Examination: Appearance: Nutrition: Memory:

Yes No

Present Absent

Yes No

NSAID’S Steroids Local injection

Guggula Rasoushadhi Others Antheropy

Complete Partial Temporary No

Mixed Veg

Poor Moderate Good

Free Constipated

Normal Abnormal

Normal Less More Distrubed

Smoking Alcohol Tobacco No habits

Regular Irregular Menopause

Healthy Un well Ill

Absence Moderate Poor

Normal Subnormal Poor

Height cms Weight kg Temperature 0 F

Pulse rate times/min Heart rate times /min


127

18. Dasha vidha pareeksha:

Dosham

Dhushy:

Desham:

Balam:

Kala:

Analam:

Prakruti:

Vayas:

Satwam:

Satmyam:

Aharam:

19. Sroto pareeksha:

Mamsa -

Medha -

Asthi -

Majja -

Respiratory rate times/min B.P mm Hg

Vata Pitta Kapha

Rasa Rakta Mamsa Meda Asthi Majj Sukra

Pureesham Mutram Swedan

Jangalam Anupam Sadharanam

Rogi bala Prauaram Madhyam Awaram

Vasanta Greeshma Varsha Sharad Hemanta Shishira

Mandam Teekshna Vishamam Samam

V P K VP PK VPK

Bala Madhyama Jeerna

Pravaram Madhyamam Avaram


128

20. Special examination of joints:

I. Inspection

Deformity:

Flexion:

Joint swelling:

Grade:

Muscular wasting:

II. Palpation: 1. Local rise of temperature:

2. Tenderness:

Site:

3. Movements:

a) Active:

b) Passive:

4. Crepitation:

5. Degree of limitation:

a) Range of extension:

Present Absent

Present Absent

Present Absent

0 1 2 3

Present Absent

Above the affected joint Below the affected joint

Present Absent

0 1 2 3 4

Refropatelor Medical comportment Lateral comportment

Restricted Limited Free

Restricted Limited Free

Present Absent


129

b) Range of flexion:

21. Nidan:

22. Upashaya / Anupashaya:

23. Lab investigation:

Sl.No Name of the test Value

01. ESR 1st hour

02. HB% mg %

WBC 03. Total count

RBC

Per cms

N E B M L 04. Differential count

05.

Blood glucose mg/dl

06.

Serum Alkaline phosphatase Unit/L

Ahara Vihara Others

Rooksha Bhojana

Alpamatra Bhojana

Tiktosna Kashaya

Pramita Bhojan

Nisha Jagarana

Atyucha Bhojana

Antivyayacha

Bhaya Dukhe Chinta


130

24. Radiological Examination:

X-ray of affected joint AP / Lateral view.

Joint space:

Formation of Osteophyte:

Subchondral sclerosis:

Loose bodies:

Degree of virus –present:

25. Treatment protocol:

Started on:

Dose:

26. Assessment of Result:

Sl.No Particulars Day – 0 Day– 10 Day – 20 Day-30

1.

2.

3.

4.

5.

6.

Pain

Stiffness

Tenderness

Swelling

Walking time

Crepitation

Investigative Note.

Signature of supervisor

Reduced Increased Unaltered Unicomposition

Present Absent

Present Absent

Present Absent

Present Absent


131

Note: Clinical Assessment:

1. Assessment of pain: Grade

No pain 0

Mild + 1

Moderate + + 2

Sever + + + 3

2. Assessment of Stiffness: Grade

No stiffness of the joint 0

Mild stiffness (for 5 to 30 mins) 1

Moderate stiffness (for 30 to 2 hours) 2

Severe stiffness (More than 2 hours) 3

3. Assessment of Tenderness: Grade

No tender 0

The patient says the joint is tender. 1

The patient winces. 2

The patient winces and with draw the affected part. 3

The patient will not allow the joint to be touched. 4

4. Assessment of Swelling: Grade

No swelling 0

Mild swelling (Slightly obvious) 1

Moderate swelling (covers well the bony prominence) 2

Severe swelling (much elevated ) 3

5. Assessment of Crepitus: Grade

Absent 0

Present 1

6. Assessment of Walking time (60 feet distance): Grade

Normal(within 20 second) 0

20 – 40 seconds 1

40 – 50 seconds 2

50 – 60 seconds 3


132

60 and above

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Daradavati sandhivata rs005-gdg