Chapter 26 - Symptoms and treatment of Amavata (gout and rheumatism)

Its causes and indications:—

If persons of low digestive power happen to take, generally, articles of food-stuff, injurious by combination (see page 9, Vol. IV), resort to unhealthy activities (such as physical and mental exercise in excess, sleeping in day-time, keeping late hours at night), remain idle, take physical exercise (without rest for the prescribed period of forty-eight minutes, at least) just after taking food cooked or mixed with fatty substance^[1], the ama or undigested part of the chyle is carried away by the vayu or wind (growing increasingly in the stomach in the shape of gas due to fermentation of food) and deposit at places where phlegm is accumulated. The ama is thus putrefied in contact with the phlegm and is then carried through the arteries. This makes the ama again come in contact with vayu, pitta, and kapha, and tarn more putrefied. It pollutes, then, the fluid-carrying passages, assumes various colours, turns slippery, and causes weakness and heaviness of the heart. It is the root-cause of several diseases, and is not easily to be destroyed. In case the two things stated above, viz. ama and vayu, get turbulent, they simultaneously enter into the inner part of the hip-joint or causes numbness in some parts of the body, giving rise to what is called amavata or rheumatism.

The following are the general symptoms of rheumatism:—pain in the body, aversion to food, thirst, lethargy, heaviness of the body, fever, constant pain in the waist, swelling of the joints, inability to stand np and move properly, and especially, loss of power of digestion. It is most painful in its malignant state. In proportion to its virulence, it causes pain accompanied with swelling in the arms, feet, head, heels, hip-joints, and the knee-joints. These parts ache bitterly as after scorpion-bite.

The following also are the symptoms of this disease in its malignant state:—weakness of digesting power, discharge of water through the mouth and the nostrils, aversion to food, heaviness of the limbs, loss of enthusiasm, insipidity of taste, heating sensation, profuseness of urine, hardness of the abdomen, colic pain, reverse in the time of sleep (i.e., sleepiness in day time, and want of sleep at night), thirst, vomiting, vertigo, swoon, pain in the heart, constipation, inertness, rumbling noise in the intestines, anaha (see page 386, vol. IV), and other painful symptoms.

In amavata, predominance of pitta, vayu, and kapha causes, respectively:—(a) sensation of heat and redness of the skin, (b) colic pain, and (c) numbness, heaviness, and itches.

Treatment of Rheumatism: simple remedies.

(1) The following are to be resorted to in rheumatism:—fasting, fomentation, taking of bitters, pungents, and increasers of power of digestion purgation, drinking of castor oil or some such medicated oil as saindhavadya taila, and application of douches.

(2) The following are efficacious in amavata:—fomentation, without rubbing with oil, by means of a heated bundle containing sand and such external application as stated below in (3).

(3) The following are to be taken in equal quantities, pestled together with cow’s urine, and applied on that part of the body which is especially affected:—kokilaksha,roots of kebuka, roots of shigru, and soil raised by white ants.

(4) Food or drinks boiled with two fifths of a tola of each of the following, taken together, may be taken by the patient, for the cure of amavata;—pippali, roots of pippali, chavya, roots of chitraka, and shunthi.

(5) Drinking of castor oil alone cures rheumatism.

(6) Decoction of punarnava, mixed with shati and shunthi, pestled together, may be drunk every morning. This generally cures amavata in a week.

(7) One karsha (tola) of powdered shunthi, drunk every day with kanji, cures amavata and ailments due to an excess of vayu and kapha.

(8) Decoction of garlics, shunthi, and nirgundi cures rheumatism.

(9) Powdered haritaki (in doses of one fourth of a tola, each) mixed with castor oil is to be drunk for some time, for the cure of rheumatism, sciatica, and hydrocele.

Iatro-chemical medicines in rheumatism.

Chandra-natha modaka.

One prastha (64 tolas) of powdered shunthi, thirty-two tolas of jamani, eight tolas, each, of jira and dhanya, four tolas each, of satapuspa, lavanga, borax, maricha, trivrit, triphala, javakshara, pippali, shati, ela, tejapatra, chavya, mica, iron, and tin, and refined molasses, three times in weight Of all the above combined (i.e. 172 x 3 tolas)—all these are to be heated by a mild heat in an iron cauldron, till the whole thing turns into a semi-solid. It is then to be mixed with a suitable quantity of clarified butter. When cooled, a suitable quantity of honey is also to be mixed with it. It is now a kind of modaka (sweet medicine). This medicine cures amavata, sciatica, colic, hemoptysis, acidity, and biliousness, if taken in doses of one tola, a day, mixed with clarified butter. A little of water is to be drunk after taking this medicines.

Amavatari rasa.

One part, each, of mercury, sulphur, iron, copper (or mica according to a different text), copper-sulphate, borax, and rock-salt; fourteen parts of purified guggulu, and three and half parts, each, of the bark of the roots of trivrit and chitraka are to be rubbed together with clarified butter. This medicine cures amavata, if taken in doses of twelve raktis, a day, with the decoction of triphala. It is digesting and serves as a purgative. It also cures gulma, shula, diseases affecting the belly (including enlargement of spleen, liver, and asthila), jaundice, anemia, acidity, swelling, philaria, tumour, pain in the joints and in the head, paralysis, sciatica, goitre, scrofula, worms, leprosy, boils, gardabha, anaha, and hernia.

Amavatesvwara rasa.

Two tolas, each, of sulphur and copper, and one tola, each, of mercury and iron are to be rubbed together, and subjected to bhavana for several (say seven) times with the decoction of roots of eranda; for twenty times with the decoction of pippali, roots of pippali, chavya, roots of chitraka, and shunthi; and for ten times with the decoction of guduchi. With this compound, the following are to be mixed purified borax, equal in quantity to the compound itself, vira salt, and maricha, each, half in weight of borax; one tola, each, of alkali prepared from bark of tamarind and roots of danti, and one tola, each, of trikatu, triphala, and lavanga. (Dose, one rakti, each, to be taken foar times, a day, with a few drops of honey only). This medicine cures rheumatism and increases power of digestion. If taken with suitable adjuncts, it also cures obesity, thinness, gulma, piles, chronic diarrhoea, swelling, anemia, and fever.

Vata-gajendra-simha rasa.

One part, each, of mica, iron, mercury, sulphur, copper, lead, borax, aconite, rock-salt, lavanga (cloves), hingu, and jatiphala, and half apart, each, of tri-sugandha (i.e., guratvak, tejapatra, and ela, combined), triphala, and jira are to be rubbed together with the juice of kanya, and made into pills, three raktis in weight each. This medicine cores all sorts of diseases, (and especially rheumatism), emaciation, lameness and hunch-backedness. It is a very good tonic.

Vatari rasa.

One part of mercury, two parts of sulphur, three parts of triphala, four parts of roots of chitraka, and five parts of guggula are to be rubbed together with castor oil, and made into pills, one tola in weight, each. This medicine cures amavata, if taken in the morning with a little of hot water and castor oil. (After about an hour of taking this medicine), the whole of the body of the patient is to be rubbed well with castor oil, and fomentation (by a bundle containing salt) is to he made on the back. This will be followed by movements of the bowels, after which proper diet, mixed with clarified butter, while the former is still comfortably hot, is to be given to the patient. While taking this medicine, the patient is to live in a place not disturbed by drafts of air, and he is to abstain from sexual intercourse.

Anilari rasa.

One part of mercury and two parts of sulphur are to be rubbed together, for one day, with the juices of the roots of eranda and of the leaves of nirgundi, confined in a puta made of two basins of copper, and heated by the third kind pf the Valuka-yantra, by means of fire made of dried and powdered cow-dung. When cooled, the contents of the puta are to be powdered and subjected to bhavana with the juices of the leaves of nirgundi, roots of eranda, and roots of chitraka. Pills are then to be made, three metis in weight, each. This medicine cures rheumatism, if taken with (a) castor oil mixed with guggula, or (b) trikatu mixed with rock-salt.

Phalatrikadi lauha.

Four tolas, each, of triphala, musta, trikatu, vidanga, puskaramula, vacha, roots of chitraka, and jastimadhu, and 32 tolas, each, of iron and guggula are to be rubbed together with forty-eight tolas of honey. This medicine cures rheumatism, parinama shula, swelling, and visama-jvara, if taken in the morning (in doses of one fourth of a tola, each).

Vriddha-daradya, lauha.

One part, each, of vriddha-dara, roots of trivrit, danti, gajapippali, tuber of mana, trikatu, triphala, and trimada (i.e., roots of chitraka, musta, and vidanga),^[2] and eight parts of iron are to be mixed together. This medicine cures rheumatism and other diseases.

Aparnaranjana rasa.

Twenty tolas of excellent iron (preferably, load-stone) and ten tolas, each, of mica and mercury, duly incinerated, are to be mixed together and boiled by means of a mild heat in a cauldron, made of iron or copper, with forty tolas, each, of clarified butter and juice of the roots of shatavari, eighty tolas of milk, and a decoction of 120 tolas of triphala by boiling it previously with sixteen times its weight (i.e., 120 x 16 tolas) of water and reduced to one eighth its quantity (i.e., 210 tolas). In course of the boiling, the whole thing is to be rolled all along by means of an iron ladle. When the substance will turn semi-solid by boiling, all the articles named below are to be thrown into it, and mixed together:—vidanga, shunthi, dhanya, essence of guduchi, jira, seeds of palasha, maricha, pippali, gaja-pippali, trivrit, triphala, danti, ela, castor seeds, chavya, roots of pippali, roots of chitraka, musta, and vriddhadaraka—each 30/19th tola in weight—total thirty tolas, This medicine cures rheumatism.

Vaneshvara rasa.

Five palas, each, of iron and guggulu and two and half palas of mica are to be boiled, by mild heat, in a vessel made of iron or earth, with a decoction prepared from fifteen palas of triphala previously boiled with 240 palas of water and reduced by boiling to 30 palas. When the watery portion is almost dried up, twelve and half palas, each, of clarified butter and juice of shatavari, and twenty five palas of milk are to mixed With the compound and heated slowly, as before. An iron ladle is to be used for turning and rolling the compound in course of the boiling. When the compound turns semi-solid, half a pala of each of the following, duly powdered, is to be thrown into the compound, mixed together, and rolled by means of the ladle, till the boiling is completed:—vidanga, shunthi, dhanya, essence of guduchi, jira, panchakola, trivrti, danti, triphala and musta. Kajjali or black powder made of two and half tolas, each, of mercury and sulphur is to be rubbed together with the compound, a little before it is completely cooled. The compound' is then to be kept in an earthen pot with its inner side smeared with clarified butter. (Dose, according to age and strength, say, one fourth of a tola for an adult). This medicine is to be taken, rubbed with a little of clarified butter and honey. A decoction of guduchi, shunthi, and roots of eranda (⅔ tola, in weight, each, total two tolas, to be boiled with 32 tolas of water and reduced by boiling, as usual, to 8 tolas) is to be drunk after taking this medicine. This medicine cures rheumatism, gout, sciatica, pain in the intestine, thighs, feet, and the finger -joints; lameness, gulma, swelling, and anemia.

Vata-viddhamsana-rasa.

Four parts, each, of mercury and sulphur made into a black powder, and one part of aconite are to be rubbed together with decoction of roots of chitraka. Pills are then to be made, three raktis in weight, each (to be taken three or four times, a day), This medicine cures epilepsy, insanity, and rheumatism.

Diet and deeds salutary in rheumatism:—

Fomentation without rubbing of oil, fasting, drinking of oil, application of douche, external application of prescribed drugs duly pestled, purgation, entering into the rectum of prescribed drugs duly pestled, old shall rice and kulattha grams, old wine, soup of meat of wild animals, all sorts of things having the property of pacifying vayu and kapha, butter-milk, punarnava, castor oil (for internal and external use), garlics, patola, leaves of shalincha, karabella, bartaku, shigru, hot water, paribhadra leaves, gokshura, vriddha-daraka, bhallataka, cow’s urine, ginger; pungents, bitters, and those which increase power of digestion.

Diet and deeds injurious in rheumatism.

Curd, fish, molasses, milk, white basil, masha-grams, (Phased lous Radiatus) cake prepared of rice, unfiltered water, wind blowing from eastern horizon, incongenial foods, unwholesome diet and deeds, heavy food, keeping late hour at night, suppression of calls of nature.

Footnotes and references:

[1]:

 Physical exercise is ordinarily beneficial to those who take fatty food. What is objectionable is taking physical exercise before the fat is digested, partially at least Physical exercise increases vayu which evaporates the fat if undigested.

[2]:

Some physicians suggest “trijata” (i.e., guratvak, ela, and tejapatra) in place of “trimada”.