Dr.R.Krishnakumar. MD(Ay)

Medical Officer

Govt .Ayurveda Dispensary , Vallikunnam

SELECTION OF YOGAS

w.s.r

RHEUMATOLOGY

CSM model of drug selection in the

Ayurvedic Management of

Rheumatologic conditions Howard Leventhal introduced the common

sense model (CSM) of self regulation of health

and Illness.

The CSM concept is adopted here in principle

, the term common sense refers to adherence

to basic principles of Ayurveda in simple

straight forward way, rather than hair splitting

juggleries .

Rheumatology

The term refers to branch of

medicine that which deals with the

medical disorders of the musculo-

skeletal system.

Rheumatology = Confusion

Rheumatoid arthritis = ? Vātarakta / Āmavāta

Āmavāta = Rheumatic fever ???????

Comparisons and Confusion ?????????

Concept of disease in routine

ayurvedic clinical practice ……….

कः पुनरसौ रोग इति । ऄवस्थातवतिष्टो दोषः। नरतसंहभाष्यम्.१-१

kaḥ punarasau roga iti. avasthāviśiṣṭo

doṣaḥ.

narasiṁhabhāṣyam. 1-1

बुद्ध्वा स्थानतविेषांश्च दोषाणां च बलाबलम् ।

तचतकतससितमद ंकुयाादहूापोहतवकल्पतवि् ॥

चरकसंतहिा तचतकससास्थानम् २९-१५५

Message from Caraka for

Dravyaguṇa experts

मात्राकालाश्रया युतिः तसतियुािौ प्रतितष्ििा ।

तिष्िसयुपरर युतिज्ञो द्रव्यज्ञानविां सदा ॥

चरक संतहिा सूत्रस्थानम् २-१६

Line of treatment………………

न यकु्तमवधारणममदमवे प्रधानममद ंनमेि मिमित्साया ंमह प्रधानमवस्थानमुवधानम ।्

R.V.Su.१-९३

PHARMACEUTICAL PARADIGM VERSUS

THERAPEUTIC PARADIGM

PHARMACEUTICALISATION OF AYURVEDA

coinage by Dr.Madhulika Banerjee.

Dr.Harilal Madhavan puts forth a very relevant

question for us : the future of therapeutic āyurveda

Rheumatology and Ayurveda

Daniel E Furst, Manorama M Venkatraman, B G

Krishna Swamy, P.Rammanohar et al

“Well controlled, double-blind, placebo-controlled

trials of classical Ayurvedic treatment are possible

in rheumatoid arthritis”

The major strength of this study was that the

Ayurvedic doctor was free to individualize treatment.

Rheumatoid arthritis

Diagnostic criteria

At least four of the following criteria should be present for the

diagnosis of rheumatoid arthritis:

Morning stiffness for ≥ 1 hour

Arthritis of ≥ 3 joints

Arthritis of hand joints (wrist, metacarpo-phalangeal joints or proximal interphalangeal joints)

Symmetric arthritis

Rheumatoid nodules

Positive serum rheumatoid factor. (Anti citrullinated peptide [ anti-CCP] andtibodies have high specificity and sensitivity for RA.)

Radiographic changes

The methodologies for research and evaluationof traditional medicine should be based on thefollowing basic principles.

On the one hand, the methodologies shouldguarantee the safety and efficacy of herbalmedicines and traditional procedure-basedtherapies.

On the other hand, however, they should notbecome obstacles to the application anddevelopment of traditional medicine. Thiscomplex issue has been a concern for nationalhealth authorities and scientists in recent years.

(p.2 Guidelines for methodologies on researchand evaluation of traditional medicine,WHO, 2000)

Ayurvedic Approaches to RA

1) Compare this to any of the Ayurvedic disease

state and randomly select medicines indicated for

that .(vyādhijnama hetu saṃprāpti)

2) Analyze the condition without ignoring its subtler

nuances. (dosetikartavyatarūpa saṃprāpti). This

approach is followed by most of the traditional

vaidyas of Kerala.

Vātarakta model

vāyurvivr ̥ddho vr ̥ddhena raktenāvāritaḥpathi.

kruddhaḥ sa dūṣayedraktaṃ taṃ jñeyaṃvātaśoṇitaṃ. Cikitsāmañjari .1

kṣipraṃ raktaṃ duṣṭimāyāti tacca vāyor

mārgaṃ saṃruṇddhyāśu……S.S.Ni.1.43

ऄमृिा संग्राहणीय दीपनीय वािश्लेष्मिोतणितवबन्धप्रिमनानाम् । A.S.Su

ऄमृिा संग्रातहक वािहर दीपनीय श्लेष्मिोतणितवबन्धप्रिमनानम्। c.s.

गुडूची वािास्रे । A.H

तवबन्धः स्रोिोतभभूािानामवहनम् ।

Stage which requires Pāncana

ऄमृिानागरधान्याककषात्रयेण पाचनं तसिम् ।

जयति सरिं वािं सामं कुष्िान्यिेषातण ॥ चक्रदत्तम्-३

ṣaḍaṃgaṃ cukku kūṭṭāte sāmr̥taṃ pibatāṃ

nr̥ṇāṃ.

panikkuṃ vātaraktatte ttaṭukkuṃ novumillayāṃ . Cikitsāmañjari. 16

Aṣṭavaidya tradition ṣaḍdharaṇacūraṇa modified as citrakādi kvātha

Two yogas……………….

śatāvarī chinnaruha amalatvak balekṣu rāsnāvihita

kaṣāyaḥ.

dugdhena vātāsravikāra śāntyai martyena peyaśca

tatha aṅgamardde.

śatāvarī chinnaruha amalatvak balekṣukāṇḍekṣura

saṃbhr̥tāṃbhaḥ.

kalkena yaṣṭīmadhukasya miśraṃ dhunoti

vātāśramathāśrapittaṃ

balā nālamr̥tā ṣaḍ ca dāru raṇḍu kazñcumāyi.

sapāl kaṣāyaṃ pātavyaṃ vātarakta aṅgamarddajit.

Cikitsāmañjari.17

Rāsnairandādi kaṣāyam

Vaṅgasena

Sahasrayoga

Single drugs

Duḍūcī :

kātu, tiktā, madhuravipāka,rasāyanā, saṃgrāhiṇī, kaṣāya, uṣṇa,laghu, balya, agnidīpani, tridoṣahara,amahara, tr̥ṣṇahara, mehahara,kāsahara, kāmala paṇḍuharaṃ,kuṣṭhahara, kr̥mihara, vātāraktahara,jvarahara, vāmihara.

Haritaki:

uṣṇa,laghu,br̥haṃana, anulomana, kaṣāya,rūkṣa, medhya, dīpana, sarā, madhura vipāka,rasāyani, cakṣuṣya, srotovibandhahara,śvāsa,kāsa,prameha, arśas, kuṣṭha, śopha,udara, kr̥mi, vaisvarya, grahaṇi, roga,vibandha, viṣmajvara, gulma, ādhmana

haritakī jayet vyādhīṃstāstāśca kaphavātajān

sarveṣu ca guḍaharītakīmāseveta

Bodhivr̥kṣa : durjara,hima, rukṣa, pittahara

ślesmahara, vr̥ṇahara, asrahara, guru, kaṣaya

rasa,varṇya, yoniviśodhana.

Kokilakṣa: śītala, vr̥ṣya, madhura,amla,

picchila, tikta, śophahara, āmahara,

vātahara, tr̥ṣṇahara, netrarogajit,

vātaraktahara.

guḍūcī vā yathā tathā

guḍa harītakī

pippalī vardhamānaṃ

स्ममृिमान ् हिेयुमुक्तज्ञो मििात्मप्रमिऩमिमान।्मिषगौषधसयंोगमैिमित्सा ंिि ुमुहमुि॥ ि-स-ंस-ू २-३६smṛtimān hetuyuktijño jitātmapratipattimān|bhiṣagauṣadhasaṁyogaiścikitsāṁkartumarhati|| ca-saṁ-sū- 2-36

śubhaṃ