Study of virechana vs. basti in amavata (rheumatoid arthritis)

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Journal name: Ayushdhara
Original article title: A comparative study of virechana karma and basti karma in amavata w.s.r. to rheumatoid arthritis
AYUSHDHARA is an international peer-reviewed journal. It focuses on research in Ayurveda, Yoga, Unani, Siddha, Homeopathy, Allopathy, and Pharmaceutical Sciences.
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Author(s):

Suresh N. Hakkandi
Professor and Head, PG Dept. of Panchakarma, S.J.G Ayurvedic Medical College, Koppal, Karnataka
Shashidhar.H. Doddamani
Research officer (Scientist -3), Regional Ayurveda Research Institute for Metabolic Disorders, Bengaluru


Ayushdhara:

(A peer-reviewed, bi-monthly open-access journal)

Full text available for: A comparative study of virechana karma and basti karma in amavata w.s.r. to rheumatoid arthritis

Year: 2018

Copyright (license): CC BY-NC-SA 4.0


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Summary of article contents:

Introduction

Amavata, which can be correlated to rheumatoid arthritis, is a Kapha-Vata disorder characterized by pain and swelling in joints, often presenting with symptoms such as body aches, tastelessness, and morning stiffness. The study aims to evaluate and compare the efficacy of two Ayurvedic treatments—Nittyavirechana and Yogabasti—in patients diagnosed with Amavata. The research involved a prospective clinical trial involving 30 patients who were divided into two groups. The first group received Nittyavirechana using Erandataila, while the second group underwent Yogabasti treatment with Erandamooladi Niruhabasti and Bruhat-Saindhava Taila.

Efficacy of Yogabasti

The analysis revealed significant improvements in the treatment of Amavata using Yogabasti. This procedure demonstrated superior effectiveness compared to Nittyavirechana in alleviating symptoms such as pain (Shoola), swelling (Shotha), stiffness (Stabdata), and warmth (Ushnata) in the affected joints. While both treatments showed improvements in subjective and objective parameters, the Yogabasti group reported greater benefits, with more patients experiencing good responses to the treatment. The herbal components used in Yogabasti contribute to addressing both the vitiated Vata and the accumulation of Ama, which are central to the pathology of Amavata.

Mechanisms of Action in Nittyavirechana

Nittyavirechana, involving the administration of Erandataila, serves to expel toxins (Ama) and restore digestive fire (Agni). The ricinoleic acid present in Erandataila induces purgation, which aids in detoxification and balances Vata dosha. While this treatment provides some relief by opening the channels (Srotas) and allowing for the nourishment of the body, its effectiveness is comparatively less than that of Yogabasti for managing the long-term manifestations of Amavata. Thus, while both treatments activate different therapeutic pathways, Nittyavirechana primarily focuses on immediate cleansing rather than addressing the chronic nature of the disease.

Conclusion

The study concluded that Yogabasti is a more effective Ayurvedic treatment for managing Amavata compared to Nittyavirechana, especially in alleviating the symptoms associated with rheumatoid arthritis. Although both therapies provide some level of improvement, the autoimmune nature of Amavata necessitates ongoing management, as complete and permanent remission is not feasible. This study highlights the importance of tailored Ayurvedic treatments in chronic conditions and encourages further research to enhance understanding and management of such complex diseases.

FAQ section (important questions/answers):

What is the primary focus of the comparative study?

The study aims to evaluate the effects of Nittyavirechana and Yogabasti in treating Amavata, specifically correlating it to rheumatoid arthritis, and determines which method provides better therapeutic benefits.

What were the criteria for patient inclusion in the study?

Patients aged 20 to 60 with Amavata symptoms lasting less than five years, and who could undergo Virechana and Basti karma, were included in the study, irrespective of sex, occupation, or socio-economic status.

What were the findings regarding the effectiveness of treatments?

Results indicated that Yogabasti offered more beneficial effects in alleviating symptoms like pain and swelling compared to Nittyavirechana, demonstrating higher response rates in both subjective and objective assessments.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Study of virechana vs. basti in amavata (rheumatoid arthritis)”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Amavata (Ama-vata):
Amavata is a disease characterized by the involvement of Ama and Vata, leading to features like joint pain, swelling, body ache, and fever. It is often correlated with rheumatoid arthritis in modern medicine.

2) Disease:
Disease, within this context, refers to conditions that affect the body, such as Amavata, which primarily impacts joints causing pain and swelling.

3) Swelling:
Swelling, or Shotha in Ayurveda, is a characteristic symptom of Amavata, where the joints become inflamed and enlarged due to the accumulation of fluids.

4) Karma (Karman):
Karma refers to therapeutic actions or treatments in Ayurveda, such as Virechana Karma and Basti Karma, which are used to manage diseases like Amavata.

5) Rheumatoid arthritis:
Rheumatoid arthritis is a chronic inflammatory disease affecting joints, associated with symptoms like pain and swelling. It is often compared to Amavata in Ayurveda.

6) Shotha (Sotha):
Shotha is the Ayurvedic term for swelling and is one of the key symptoms of Amavata, reflecting inflammation in the joints.

7) Niruhabasti (Niruha-basti):
Niruhabasti is a type of Basti Karma (therapeutic enema) involving the use of various decoctions and oils, utilized to treat conditions like Amavata by removing toxins and balancing doshas.

8) Bastikarman (Bastikarma, Basti-karman, Basti-karma):
Basti-karma is a fundamental therapy in Ayurveda involving enema treatments. It is particularly effective in managing Amavata by addressing vitiated Vata dosha.

9) Stiffness:
Stiffness, or Stabdata, is a common symptom of Amavata, causing restricted movement in affected joints due to inflammation and swelling.

10) Ayurveda (Ayus-veda):
Ayurveda is the traditional system of medicine in India focusing on balancing bodily doshas through treatments like Virechana Karma and Basti Karma for conditions such as Amavata.

11) Sandhi (Shandhi, Samdhi):
Sandhi refers to joints in the Ayurvedic context, which are commonly affected in conditions like Amavata, leading to pain, swelling, and stiffness.

12) Taila (Thaila):
Taila refers to medicated oils used in various therapeutic procedures in Ayurveda, such as Erandataila in Nittyavirechana and Bruhatsaindhavaditaila in Basti Karma for treating Amavata.

13) Basti:
Basti is an enema treatment in Ayurveda, crucial for managing diseases like Amavata through formulations that help balance doshas and remove accumulated toxins.

14) India:
India is the origin of Ayurveda, where traditional treatments like Virechana Karma and Basti Karma are applied for diseases such as Amavata.

15) Pain:
Pain, or Ruja in Ayurveda, is a primary symptom of Amavata and occurs due to inflammation and swelling of the joints.

16) Inflammation:
Inflammation is a biological response to harmful stimuli, prominently seen in Amavata as joint swelling and pain due to vitiation of doshas.

17) Ushnata (Usnata):
Usnata is a sensation of warmth or heat in the joints, indicative of inflammation in Amavata and assessed in the treatment efficacy.

18) Eranda (Eramda):
Eranda or castor oil is used in therapies like Erandataila in Nittyavirechana and Erandamooladi Niruhabasti in Basti Karma, helping in the treatment of Amavata with its purgative properties.

19) Gulpha:
Gulpha in Ayurveda denotes the ankle joint, one of the joints afflicted by Amavata, leading to pain, swelling, and restricted movement.

20) Trika:
Trika refers to the sacroiliac region or lower back in Ayurveda and is commonly affected in Amavata, resulting in pain and stiffness.

21) Ruja:
Ruja in Ayurveda means pain, a significant symptom of Amavata experienced in the affected joints due to inflammation and swelling.

22) Pada:
Pada indicates the feet in Ayurveda, which are frequently afflicted in Amavata, causing symptoms like pain and swelling.

23) Janu:
Janu in Ayurveda refers to the knee joint, which is often affected in Amavata, leading to pain, swelling, and restricts mobility.

24) Vata:
Vata is one of the three doshas in Ayurveda, and its vitiation along with Ama is primarily responsible for causing Amavata.

25) Shiras (Siras, Siro, Shirash):
Siro in Ayurveda refers to the head region, which can sometimes be affected in systemic diseases like Amavata causing additional symptoms.

26) Karnataka:
Karnataka is a state in India where significant Ayurvedic research on diseases like Amavata and treatments such as Virechana Karma and Basti Karma is conducted.

27) Vatadosha (Vatadosa, Vata-dosha):
Vatadosha is one of the three fundamental energies in Ayurveda, and its imbalance is critically involved in the pathogenesis of Amavata.

28) Ajamoda (Aja-moda):
Ajamoda, an herb used in Ayurveda, is part of formulations such as Vaishwanara Churna used internally for managing Amavata.

29) Nature:
Nature, in an Ayurvedic context, refers to the inherent characteristics or qualities of substances and diseases, like the chronic nature of Amavata.

30) Rasna (Rashna, Rasona, Rasa-una):
Rasna is an Ayurvedic herb utilized in formulations like Erandamooladi Niruhabasti, aiding in the treatment of Amavata by relieving pain and inflammation.

31) Fever:
Fever, or Jwara in Ayurveda, can be a symptom of Amavata indicating systemic inflammation and the presence of Ama in the body.

32) Vaca:
Vacha is an Ayurvedic herb used in formulations such as Brihatsaindhavadi Taila, aiding in the treatment of Amavata by its anti-inflammatory properties.

33) Kana:
Kana or long pepper is used in various Ayurvedic formulations for its ability to enhance digestion and help relieve symptoms of Amavata.

34) Saindhavalavana (Saindhava-lavana, Saimdhavalavana):
Saindhavalavana, or rock salt, is included in formulations like Brihatsaindhavadi Taila in Ayurveda, aiding in the treatment of Amavata.

35) Madhavanidana (Madhava-nidana):
Madhava Nidana is an ancient Ayurvedic text that first described Amavata as an independent disease, providing insight into its symptoms and treatment.

36) Anuvasanabasti (Anuvasana-basti):
Anuvasanabasti is a type of Basti (enema) therapy using oil-based substances like Bruhatsaindhavadi Taila, used in treating Amavata to lubricate and nourish internal pathways.

37) Shalakyatantra (Salakyatantra, Shalakya-tantra, Shalakyatamtra):
Shalakyatantra is a branch of Ayurveda dealing with ear, nose, and throat diseases, as well as systemic conditions like Amavata detailed in patient selection criteria.

38) Tastelessness:
Tastelessness, or Aruchi, is a symptom of Amavata where the patient loses interest in food, indicating digestive disturbances.

39) Madanaphala:
Madanaphala is a herb included in formulations such as Erandamooladi Niruhabasti, used in Ayurveda to treat Amavata by aiding in detoxification.

40) Vaishvanara (Vaisvanara):
Vaishvanara Churna is an Ayurvedic formulation used in this study for managing Amavata, containing ingredients like Ajamoda and Haritaki.

41) Yashtimadhu (Yastimadhu, Yashti-madhu):
Yasti-madhu, or licorice, is used in Ayurvedic formulations like Erandamooladi Niruhabasti, for its anti-inflammatory properties beneficial in Amavata treatment.

42) Saindhavadi:
Saindhavadi Taila is an Ayurvedic oil used in Anuvasanabasti for treating Amavata, containing Saindhavalavana and other herbs to reduce inflammation.

43) Shalaparni (Salaparni):
Shalaparni is part of the Erandamooladi Niruhabasti formulation in Ayurveda, used for treating Amavata due to its anti-inflammatory properties.

44) Shothahara (Sothahara, Shotha-hara):
Shothahara properties refer to anti-inflammatory effects in Ayurvedic medicines, essential for treating conditions like Amavata by reducing joint swelling.

45) Discussion:
Discussion in this context refers to the analysis and interpretation of the findings from the comparative study on the efficacy of Virechana Karma and Basti Karma in Amavata.

46) Saindhava (Saimdhava):
Saindhava or rock salt is an ingredient in Ayurvedic formulations like Brihatsaindhavadi Taila, aiding in reducing symptoms of Amavata such as swelling.

47) Aragvadha:
Aragvadha is a herb included in the Erandamooladi Niruhabasti formulation in Ayurveda, contributing to its detoxifying properties in treating Amavata.

48) Punarnava (Punar-nava):
Punarnava is a herb used in Ayurvedic formulations for its anti-inflammatory and diuretic properties, aiding in the treatment of Amavata.

49) Kantakari (Kamtakari):
Kantakari is part of Ayurvedic formulations like Erandamooladi Niruhabasti, used in managing Amavata by reducing inflammation and pain.

50) Angamarda (Anga-marda, Amgamarda):
Angamarda, or body ache, is a symptom of Amavata, indicating systemic inflammation and the presence of Ama in the body's joints.

51) Vitiation (Vitiated):
Vitiation refers to the imbalance of doshas in Ayurveda, such as the vitiation of Vata and Ama causing the symptoms of Amavata.

52) Makshika (Maksika):
Makshika, or honey, is included in Ayurvedic formulations like Erandamooladi Niruhabasti for its properties aiding in the treatment of Amavata.

53) Haritaki:
Haritaki is an ingredient in Vaishwanara Churna used in the Ayurvedic treatment of Amavata for its detoxifying and digestive properties.

54) Devadaru (Deva-daru):
Devadaru is a herb used in formulations such as Erandamooladi Niruhabasti, aiding in the treatment of Amavata due to its anti-inflammatory properties.

55) Gokshura (Goksura, Go-kshura):
Gokshura is part of the Ayurvedic formulation Erandamooladi Niruhabasti, beneficial in treating Amavata by reducing inflammation and pain.

56) Madhyama:
Madhyama Roga Marga refers to the middle pathway of disease manifestation, affecting joints and heart in conditions like Amavata in Ayurveda.

57) Priyangu (Priyamgu):
Priyangu is a herbal component of Ayurvedic formulations like Erandamooladi Niruhabasti, aiding in treating Amavata.

58) Pregnant:
Pregnant women are excluded from studies on Amavata treatments like Virechana Karma and Basti Karma due to potential risks.

59) Trishna (Trsna):
Trishna, or thirst, is a symptom associated with Amavata, indicating digestive disturbances and the presence of Ama in the body.

60) Sukshma (Suksma, Shukshma):
Sukshma refers to substances with fine properties, aiding in the deep penetration and effectiveness of treatments like Erandamooladi Niruhabasti in Amavata.

61) Hridaya (Hrdaya):
Hridaya, or the heart, is an important structure affected in Madhyama Roga Marga diseases like Amavata when systemic inflammation is present.

62) Hapusha (Hapusa):
Hapusha, or Juniper, is an ingredient in Ayurvedic formulations like Erandamooladi Niruhabasti, aiding in detoxification for treating Amavata.

63) Madhava:
Madhava refers to the author of Madhava Nidana, an important text that first described the disease Amavata and its symptoms comprehensively.

64) Snigdha:
Snigdha refers to the unctuous quality in Ayurveda, important for treatments like Anuvasanabasti to prepare the body for subsequent therapeutic enemas in Amavata management.

65) Shreyasi (Sreyasi):
Sreyasi is an Ayurvedic herb included in formulations like Brihatsaindhavadi Taila, aiding in the treatment of Amavata.

66) Palasha (Palasa, Pala-asha):
Palasha is a herb used in the formulation of Erandamooladi Niruhabasti in Ayurveda, aiding in the treatment of Amavata due to its therapeutic properties.

67) Anupana:
Anupana refers to a carrier or vehicle substance taken with medicines in Ayurveda, such as hot water taken with medications for Amavata.

68) Madhuka:
Madhuka is an ingredient in Ayurvedic formulations aiding the treatment of conditions like Amavata due to its anti-inflammatory properties.

69) Ruksha (Ruksa):
Ruksha means dry quality in Ayurveda, which helps counteract the unctuous and heavy qualities of Ama in treating conditions like Amavata.

70) Alasya:
Alasya, or lack of enthusiasm, is a symptom of Amavata reflected by fatigue and tiredness due to systemic inflammation.

71) Dushya (Dusya):
Dushya refers to the tissues or bodily elements affected by disease, such as in Amavata where both doshas and dushyas play a role in pathogenesis.

72) Nidana:
Nidana refers to the etiological factors or causes and diagnosis of diseases, as discussed in texts like Madhava Nidana for conditions such as Amavata.

73) Yavani:
Yavani is an herb used in Ayurvedic formulations like Vaishwanara Churna, beneficial for digestive issues related to Amavata.

74) Shaila (Saila):
Shaila is an ingredient in Ayurvedic formulations used to treat Amavata by aiding in detoxification and balancing bodily energies.

75) Srotas (Shrotas):
Srotas refers to the channels of the body in Ayurveda, which can get blocked by Ama in Amavata, necessitating purgative and enema treatments to clear them.

[Note: The above list is limited to 75. Total glossary definitions available: 94]

Other Science Concepts:

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Kala, Ama, Amavata, Shrota, Vatanulomana, Bastikarman, Rheumatoid arthritis, Virechana Karma, Deepana, Dosha and Dushya, Agnideepana, Yogabasti, Madhyama Roga Marga, Pachana karma, Eranda Tail, Pariharakala.

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