Amavata (Rhumatoid Arthritis)
Introduction
In terms of medicine ama refers to the events that follow and the
factors that arise as a consequence of impaired functioning of 'kayagni'
whereas in literal terms the word "Ama" means unripe, immature
and undigested.
This diseased condition is not specifically mentioned in Charak
Samhita, Sushrut Samhita or Vagbhata Samhita. But the signs and
symptoms of sama tridosha are mentioned in different chapters.
According to Vagbhata (A .H. Su. 13/25) due to the hypo
functioning of ushma (Agni), the first dhatu viz. the rasa or chyle, is
not properly formed and the anna-rasa undergoes fermentation or
putrefaction (dushta) being retained in the amashaya. This state of rasa
is 'Ama' where the impaired vatadi doshas being mixed up with one
another lead to the ama-dosha.
The disease 'amavata' is formed due to such vitiated ama-doshas.
'Madhav-nidana' explains this disease descriptively.
In Charak Samhita (Viman Sthana, Adhyaya 2), there is
description of the causes of over-production of ama due to deficient and
excessive consumption of food where Charak. ·
- Vata produces colic pain, body ache, distension of abdomen,
dryness of mouth, fainting, giddiness, irregularity of digestion,
stiffness of back and waist, constriction and spasm of blood
vessels.
- Pitta produces fever, diarrhea, thirst, internal heat, giddiness
and delirium.
- Kapha produces vomiting, anorexia, indigestion, fevers with cold,
lassitude and heaviness in body.
Hetu- Etiological Factors
- Indulgence in incompatible foods and habits.
- Lack of physical activity after taking fatty foods.
- Those with poor digestive capacity, even normally, also produce
ama (improperly digested food) in the body.
Classification
- Vata
In this situation vata is predominant and pain is severe.
- Pittanubandhi
In this situation pitta is predominant and burning sensation,
redness of the affected joints is present.
- Kaphanubandhi
In this situation kapha is predominant and loss of movement and
itching is seen
Roopa- Signs and Symptoms
- Pain all over the body.
- Loss of taste.
- Thirst.
- Lack of enthusiasm.
- Heaviness
- Fever.
- Indigestion.
- Swelling of body parts
Treatment
Following are the lines of treatment:
Langhana (fasting)
- Swedana (fomentation)
- Katu-tikta deepan- bitter medicines to promote digestive power
- Virechan (purgatives).
- Snehpana (ingestion of unctuous substances)
- Basti (enema).
- Dry fomentation-using sands like dry substances
- Upanaha (local application) of non-unctuous substances
Shaman Chikitsa
- Langhanum (fasting)
- Swedanum (fomentation)- local hot fomentation using sand etc.
Shodhana Chikitsa
- Mild purgatives, which digest ama also such as eranda sneha,
drugs like gandharva haritaki can be given.
- Enema or basti- Kshara basti such as vaitarana basti.
Decoction
- Decoction of rasna, guduchi, erandamula, devadaru, nagar known as
rasna-panchak kwatha. Rasna saptak and rasna dwadashak kwatha are
used.
- Decoction of shunthi, shathi, haritaki, vacha, devdaru, ativisha,
guduchi.
- Decoction of panchakol
- Dashmool kwatha with eranda taila.
- Decoction of shunthi and guduchi
- Panchakol choorna with lukewarm water
- Shunthi choorna with kanji as anupana
- Eranda beej majja with shunthi and sugar
- Taking eranda sneha for purgation which also digest ama
- Uses of various medicated ghrita promotes digestive power
- Upanaha (poultice)- root of kuchala, sahijan, ahimstra, valmik
mruttika and gomutra (cow's urine).
Commonly used drugs
- Kadha
- Rasna saptak
- Rasna panchak
- Shatyadi kadh
- Pippalyadi kadha
- Dashmool kadha
- Rasnadi panchadashak kadha
- Mahaushadhadi kadha
- Maharasnadi kadha
- Choorna
- Shatapushpadya Choorna
- Hingwadya choorna
- Almabushadya choorna
- Vaishwanar choorna
- Bhallatakadi choorna
- Ajamodadya choorna
- Panchakola choorna
- Nagaradi choorna
- Vati / Guggulu
- Simhanad guggulu
- Vatari guggulu
- Brihat yogaraj guggulu
- Rasna pinda
- Ajamodadi vatak
Ghrita
- Shunthi ghrita
- Shringaberadya ghrita
- Taila
- Eranda taila
- Saindhavadya taila
- Vijay bhairav taila
- Brihat saindhavadya taila
- Prasarani taila
- Lepa
- Shatapushpadi lepa
- Ahimstradi lepa
- Rasaushadhi
- Amavatari rasa
- Amavatari vatika
- Amavatadi vajra rasa
- Amavatavidhvanasana rasa
- Loha
- Trifaladi loha
- Vidangadi loha
- Panchanan rasa loha
Pathya-apathya (dos
and don'ts)
- Pathya
- Yava (barley), kulattha (horse gram), raktashali (rice),
vastuk, shigru (drum sticks), punarnava, karvellak (bitter
gourd), parawar, ardrak (ginger), hot water, rasona or ginger
(shodhit with takra), jangal mansa (meat).
- Apathya
- Curd, fish, jaggery, milk, flour of mash (black gram), dushit
jala (contaminated water), viruddha bhojan (incompatible food),
asatmya food, control of natural urges (vegavrodh), visham
bhojan, heavy, slimy foods (pischhil).
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