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