Conceptual study on Nidana of Pakshaghata

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REVIEW ARTICLE Nov-Dec 2019 Journal of Ayurveda and Integrated Medical Sciences | Nov - Dec 2019 | Vol. 4 | Issue 6 223 Conceptual study on Nidana of Pakshaghata Urooj Fatima 1 , Shashikala Patil 2 , Shubhangi 3 , Seema Shinde 4 1,4 Post Graduate Scholar, 3 Assistant Professor, Dept. of Roga Nidana, N.K. Jabshetty Ayurvedic Medical College, Bidar, 2 Professor & HOD, JCGO Ayurvedic Medical College, Ghataprabha, Karnataka, INDIA. I NTRODUCTION Ayurveda is a science of life. Its first and foremost aim is to preserve the health and prolong the life, secondly to combat the diseases. To fulfill the aim of Ayurveda nidana plays a very important role in diagnostic as well as Preventive aspect of the diseases. The term Pakshaghata literally means paralysis of one half of the body, here impairment of Karmendriyas , Gnyanendriyas and Manas seen. Gnyanendriyas are considered as part of the sensory system and Karmendriyas are considered a part of the motor system. Pakshaghata is a Vatavyadhi of Nanatmaja [1] variety & Mahavatavyadhi. [2] Pakshaghata can be correlated with hemiplegia which results after stroke. Stroke is defined as sudden onsets of neurologic deficit from vascular mechanism Address for correspondence: Dr. Urooj Fatima Post Graduate Scholar, Dept. of Roga Nidana, N.K. Jabshetty Ayurvedic Medical College, Bidar, Karnataka, INDIA. E-mail: dr.urooj 06@gmail.com Submission Date: 08/11/2019 Accepted Date: 11/12/2019 Access this article online Quick Response Code Website: www.jaims.in Published by Maharshi Charaka Ayurveda Organization, Vijayapur, Karnataka (Regd) under the license CCby-NC-SA 85% are ischemic and 15% are primary hemorrhages [3] According to the World Health Organization, 15 million people suffer stroke worldwide each year, of these, 5 million die and another 5 million are permanently disabled [4] The prevalence of stroke in India is approximately 200 per 100000 people [5] N IDANA In Ayurveda the word Nidana has been used in two ways: As the Causative Factor of the disease and as diagnosis. Nidana, the causative factor of a disease. Can be broadly classified as general and specific. In case of disease Pakshaghata no specific causes have been mentioned. As Pakshaghata comes under Nanatmaja Vata Vyadhi, the general causative factors mentioned for the Vata Prakopana by different Acharya are enlisted in detail here after. Table 1: General causative factors mentioned for the Vata Prakopana. AAHARAJA (Dietetic) CS [6] SS [7] A.S [8] AH [9] Dravyatah (Substantial) Aadhaki (Cajanuscajan) - + - - A B S T R A C T Health and ailing, pleasure and pain, ease and disease are inborn properties of human life, centuries and centuries succeeded in struggle between man and disease. The infliction of pain, either on mind or body or both is what Vyadhi means. Pakshaghata is one such Vyadhi where mind and body both are inflicted Pakshaghat can be correlated with hemiplegia (due to hypertension). Hemiplegia is paralysis of one half of the body i.e. upper & lower limbs of the same side. It may be associated with weakness of facial muscle on the same side (ipsilateral hemiplegia) or opposite side (contralateral hemiplegia) . . . . Here in the present study an effort is made to better understand nidana of Pakshaghata (hemiplegia) Key words: Hemiplegia, Paralysis, Pakshaghata

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Urooj Fatima et al. Conceptual study on Nidana of Pakshaghata ISSN: 2456-3110 REVIEW ARTICLE Nov-Dec 2019 Journal of Ayurveda and Integrated Medical Sciences | Nov - Dec 2019 | Vol. 4 | Issue 6 224 Bisa (Nelumbuo nucifera) - + + - Chanaka (Cicerarietinum) - - + - Chirbhata (Cuccumusmelo) - - + - Harenu (Pisumsativum) - + - - Jambava (Eugenia jambolena) - - + - Kalaya (Lathyrus sativus) - + + - Kalinga (Holarrhena antidysenterica) - - + - Kariya (Cappaaris deciduas) - - + - Koradusha (Paspalum scrobiculatum) - + - - Masoora (Lens culinaris) - + - - Mudga (Phaseolus mungo) - + - - Nishpaava (Hygroryza aristata) - + - - Neevara (Hygroryza aristata) - + - - Shaluka (Nelumbium speciosum) - - + - Shushkashaaka (Dry vegetable) - + - - Shyamaka (Setaria italica) - + - - Tinduka (Diospyros tomentosa) - - + - Tumba (Lagenana valgaris) - - + - Uddalaka (Paspalum scrobiculatum variety ) - + - - Varaka (Carthamus tinctorius) - + - - Viroodhaka (Germianated Seed) - - + - Gunatah Rukshaanna (ununctous diet) + + + + Laghvanna (light diet) - + + - Gurva anna (heavy diet) - - + + Sheetanna (cold diet) + - + - Rasatah Kashaayaanna (astringent taste) - + + + Katvanna (acidic taste) - + + + Tiktaanna (Bitter taste) - + + + Karmatah Vishtambhi (constipative diet) - - + - Viryatah Sheeta (cold) - - - - Maatratah Abhojana (fasting) + + - - Alpashana (dieting) + - + + Vishmashana (Taking unequal food) - + - - Kaalatah Adhyashana (eating before proper digestion) - + - - Jeernanta (After digestion) - + + + Pramitashana (eating in improper time) - - + + VIHARAJA (Behavioral) Mithyayogatah Ashmabhramana (Whirling stone) - - + -

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Urooj Fatima et al. Conceptual study on Nidana of Pakshaghata ISSN: 2456-3110 REVIEW ARTICLE Nov-Dec 2019 Journal of Ayurveda and Integrated Medical Sciences | Nov - Dec 2019 | Vol. 4 | Issue 6 225 Ashmachalana (Shaking of stone) - - + - Ashmavikshepa (Throwing of stone) - - + - Ashmotkshepa (pulling down stone) - - + - Balavat vigraha (wrestling with trained one ) - + + - Damyagaja nigraha (subduing unteameable elephant) cow and horse - - + - Divasvapna (day sleep) + + - - Dukha asana (uncomfortable sitting) + - - - Dukha shayya (uncomfortable sleeping) + - - - Ghadhotsadana (strong rubbing) - - + - Kashtachalana (shaking of wood) - - + - Kashta vikshepa (throwing of wood) - - + - Kashtotkshepa (pulling down wood) - - + - Lohabhramana (whirling of metal) - - + - Lohachalana (shaking of metal) - - + - Lohavikshepa (Throwing of metal) - - + - Lohotkshepa (pulling down metal) - - + - Paragatana (strike with others) - - + - Shilabhtamana (Whirling of rock) - - + - Shilachalan (Shaking of rock) - - + - Shilavikshepa (Throwing of rock) - - + - Shilotkshepa (Pulling down rock) - - + - Bhaaraharana (Head loading) - + + - Vegadharana (Voluntary suppression of natural urges) + + + + Vegodeerana (Forceful drive of natural urges) - - + + Vishamopachara (Abnormal gestures) + - - - Atiyogatah Atigamana (excessive walking) + - + - Atihaasya (Loud laughing) - + + + Atijrumbha (Loud yawning) - + - - Atikharacapakarshana (Violent stretching of the bow) - - + + Atilanghana (Leaping over ditch) + + + - Atiplavana (Excessive bounding) + + - - Atiprabhashana (Continous talking) - - + + Atipradhavana (Excessive running) + + - - Atiprajagarana (Excessive awakening) + + + + Atiprapatana (Leaping from height) - + - -

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Urooj Fatima et al. Conceptual study on Nidana of Pakshaghata ISSN: 2456-3110 REVIEW ARTICLE Nov-Dec 2019 Journal of Ayurveda and Integrated Medical Sciences | Nov - Dec 2019 | Vol. 4 | Issue 6 226 Atiprapidana (Violent pressing blow) - + - - Atipratarana (Excessive swimming) - + + - Atiraktamokshana (Excessive Blood letting) - - - - Atishrama (Over exertion) - - - - Ati Sthaana (Standing for a long period) - + - - Ativyayama (Violent exercise) + + + + Ativyavaya (excessive sexual intercourse) + + + + Atiadhyayana (excessive study) - + + - Adyashana (sitting for a long period) - + - - Atyuchabhashana (speaking loudly) - - - + Gajaticharya (excessive riding on elephant) - - + + Kriyaatiyoga (excessive purification therapy) - - + + Padaticharya (walking long distances) - + - - Ratha aticharya (excessive riding on chariot) - + - - Turangaticharya (excessive riding on horse) - + - - Aganthuja (External factors) Abhighata (trauma) + - - - Gaja, Ushtra, Ashvas ighrayanapatamsana (Falling from speedy, running + - - - animals) Manasika (Mental factors): Bhaya (fear) + - + + Chinta (worry) + - + - Krodha (Anger) + - - - Mada (Intoxication) - - - - Shoka (Grief) + - + + Utkantha (Anxiety) - - + - Kalaja (Seasonal factors): Abhra (cloudy season) - + - - Aparahnna (evening) - + + + Aparatra (the end of the night) - - + + Greeshma (summer season) - - + - Pravaata (windy day) - + + - Sishira (winter day) - - - - Sheetakala (early winter) - + - - Varsha (rainy season) - + + - Anya Hetuja (Miscellaneous causes) Aama (undigested article) + - - - Asrikshaya (loss of blood) + + + - Dhatukshaya (loss of body elements) + - - - Doshakshaya (depletion of Dosha) + - - - Rogatikarshana (Emaciation due to disease) + - - -

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Urooj Fatima et al. Conceptual study on Nidana of Pakshaghata ISSN: 2456-3110 REVIEW ARTICLE Nov-Dec 2019 Journal of Ayurveda and Integrated Medical Sciences | Nov - Dec 2019 | Vol. 4 | Issue 6 227 1. Aharaja (Dietic factors): Excessive consumption of Tikta, Katu, Kashaya Rasa; substances having Ruksha, Sheeta, Laghu Guna, and Adhaki, Chanaka, Kalaya and Alpa Bhojana, Vishmashana leads to Vata Prakopa and Dhatukshaya. 2. Viharaja (Habit and regimens): The factors like Vegadharana, Ratrijagarana, excessive indulgence in exercise, traveling, walking, talking, swimming, sexual intercourse are highlighted. Excessive indulgence in these Nidanas may lead to Dhatukshaya and Vata Prakopa. 3. Agantuja factors (External factors): Marmaaghata, Abhighata, Bhagna are also considered under Agantuja factors. 4. Manasika (Mental factors): The Manasika factors like Bhaya, Chinta, Krodha, Shoka, and Utkantha will also result in Vata Prakopa. 5. Kalatah (Seasonal factors): Over exposure to air, cold climate, Varsha kala, summer season, cloudy atmosphere may also cause Vata Prakopa. 6. Anya Hetu (Miscellaneous causes): All the other Nidanas that cannot be included in any of the above groups are considered here, like excessive hemorrhage (Asrikshaya), Rogatikarshana, Vishal, Dhatukshaya, Ama and Margavarodha. All the above Nidana can further be classified into three types of Nidana of Vata Vyadhi viz. Dhatukshayakara, Avaranakara and Svanidana. CONCLUSION By studying the Nidana of Pakshaghata we have observed that there is not a single specific causative factor for pakshaghata there could be a multiple cause to produce pakshaghata as we have seen above that it would be cause due to aharaja nidana or due to viharaja or due to kalaja nidana or by all so foremost important thing is prevention and later on for treatment purpose we should first diagnose the cause and then treat the patient so hence it shows the importance of nidana that’s why a study is made to understand the nidana of pakshaghata. REFERENCES 1 Charaka Samhita - Sutrasthana 20/11 H.S.Kushwaha- Chaukhamba orientalia- 2011 2 Sushrut Samhita - Nidanasthana 1/75 Trivikram Yadav- Choukhamba Surbharti- 2008 3 Harrisons Principles of Internal medicine- Chapter 17 Fauci and others 18 th edition 2009 4 www.strokecenter.com 5 WWW.AHA. Guidelines for stroke and heart disease. 6 Edited with ’vaidyamanorama’ By Acharya Vidyadhar Shukla and prof. Ravi Dutta Tripathi, CARAKASAMHITA OF AGNIVESA eloborated by caraka and reducted by drdhabala (vol.1),chaukhamba sanskrit pratishthan Delhi. 7 Edited with Ayurvedtatwa-sandipika by kaviraj Ambikadutta shastri, SUSRUT SAMHITA OF MAHARSI- SUSRUTA-part-1, chaukhambhaSanskrit sansthan Varanasi. Reprint 2010. 8 Edited by Prof K.R. srikant murthy, ASTANGA SAMGRAHA OF VAGBHATA (text English translation) vol. 2, chaukhamgha orientaliya fifth edition 2005, nidan sthana 9 Edited with ‘vidyotini’ Hindi commentary by kaviraj atrideva gupta, vaidya yadunandan upadhyaya, Astangahrdayam of Vaghata, chaukhambha prakashan, Varanasi. Reprint 2009. How to cite this article: Urooj Fatima, Shashikala Patil, Shubhangi, Seema Shinde. Conceptual study on Nidana of Pakshaghata. J Ayurveda Integr Med Sci 2019;6:223- 227. Source of Support: Nil, Conflict of Interest: None declared.

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Nidana, Ayurveda, Abhighata, Bhagna, Karmendriya, Pakshaghata, Manasika, Vatavyadhi, Agantuja, Dhatukshaya, Vataprakopa, Ratrijagarana, Kalaja, Mahavatavyadhi, Roganidana, Causative factor, Specific cause, Internal medicine, Hemiplegia, Aharaja, Specific causative factors, World Health Organization, Ayurvedic Medical College, Stroke, Diagnostic aspect, Vegadharana, Viharaja, Preventive aspect, Conceptual study, Nanatmaja vata Vyadhi, Motor system, Sensory system, Diagnostic, Gnyanendriya, General causative factors.