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Amavata by Dr.Swatika Sharma
1.
2. references
Amavata was first described by Madhukosakara in Madhava
nidana.
Later in books like yogaratnakara, bhaishyaja ratnavali etc quoted .
Madhava nidana- 25th chapter
3. आमवातस्य निदाि
ववरुद्धाहारचेष्टस्य मन्दाग्िेनििश्चलस्य च |
स्स्िग्धं भुक्तवतो ह्यन्िं व्यायामं कु वितस्तथा ||१||
Virudha ahara- means unwholesome foods or combination of food
which affects adversely.
Poor digestion power , defective metabolism
Sedentary lifestyle and also too much exercise
Consumption of sticky food followed by exercise.
4. पूविरुप
The only text which describes the premonitory signs and
symptoms is Vangasena Samhita namely-
गात्ररुजा
शिरोरुजा
6. Due to ingestion of etiological factors it disturbs the normal function of agni as a
result food not properly digested, yields immature rasa in the amashaya and this
undergoes fermentation and /or putrefaction because of its retention for longer
duration , manifest ama.
Then it absorbed in the system and it is taken up by the aggravated and vitiated
vayu specially to the kapha sthana mainly amashaya, sandhi, uras , kantha etc.
and same undergoes in the above mentioned sites and enter the dhamini by
circulation with the help of vata.
Here it amalgamates with the existing dosas and vitiated further in excess and
produces distress in the body channels due to excess of snigdha nature and some
other qualities of amarasa.
This leads to general weakness and heaviness in the precordial region and this
amarasa is responsible for genesis of symptoms complex .
12. Painful swelling of joints i.e hands , feet, ankle , knee, hip and spinal
column.
Nature of pain is like that of scorpion sting.
Stiffness
Hindered digestive mechanism
Excessive salivation
Anorexia
Heaviness
Lack of enthusiasm
Distaste in the mouth
Burning sensation
excessive urination
Hardness and pain in the abdomen
Disturbed sleep
14. आमवातस्य वविेिलक्षर्णानि
वपत्तात ् सदाहरागं च, सिूलं पविािुगम् |
स्स्तशमतं गुरुकण्ूं च कफदुष्टं तमाठदिेत ् ||११||
Totally 7 types of amavata mentiomed according to dominancy of dasa in
Madhava nidana and yogaratnakara.
1. Vataja amavata – characterised by pain in the affected areas
2. Pittaja amavata – characterised by burning sensation and redness in the
affected area
3. Slaismika amavata – characterised by rigid, heaviness, itching of the
affected area.
4. Vata- pittaja amavata- combination
5. Pitta kapahaja amavata-combination
6. Vataja –kapahaja amavata – combination
7. Sannipataja amavata
15. आमवातस्य साध्यासाध्यववचारिः
एकदोिािुगिः साध्यो, द्ववदोिो या्य उछयते |
सविदेहचरिः िोथिः स कृ छरिः सास्न्िपानतकिः ||१२||
Single Dosha – Sadhya
Two Dosha Involvement- Yapya
Tridosha with sotha in full bodyS - Krucha Sadhya
16. Differential diagnosis
VATARAKTA KROSTUKA SIRSA AMAVATA SANDHIGATAVATA
SANDHISHULA PRESENT PRESENT(MAHARUJ
A)
PRESENT PRESENT
SANDHISOTHA PRESENT PRESENT PRESENT PRESENT
ARAMBHA SANDHI PARVA SANDHI KEVALA JANU
SANDHI
BRUHATA SANDHI BRUHATA SANDHI
JVARAAS ARAMBH
LAKSHANA
MAY BE ⁄ MAY BE
NOT
PRESENT PRESENT NOT PRESENT
SPARSH-
ASAHTVAM
PRESENT PRESENT TIVRA MAY BE/ MAY BE
NOT
USHNA SPARSHA PRESENT PRESENT PRESENT PRESENT /MAY NOT
BE PRESENT
ITAR LAKSHANA SANDHI PRADESH
PIDIKO-UTAPATTI ,
SPREAD LIKE
AKHU VISHA
KNEE JOINT LOOK
LIKE JACKAL’S
HEAD
PAIN LIKE
SCORPION BITE
VATA PURNA
DHRUTI SPARSHA-
PRASARAN ,
AKUNCHAN SA-
VEDANA
18. definition
Rheumatoid arthritis is an autoimmune disorder (body immune system
starting attacking own healthy cells) in which Immune system identifies
the synovial membrane as "foreign" and begins attacking it.
Rheumatoid Arthritis (RA) is a chronic inflammatory disorder that may
affect many tissues and organs, but mainly attacks the joints producing an
inflammatory synovitis.
NOTE- Synovial membrane is also known as –synovial stratum, synovium
19. Overview of ra
The cause of rheumatoid arthritis is not known.
In rheumatoid arthritis, multiple joints are usually , but not always,
affected in a symmetrical pattern.
Rheumatoid arthritis can affect people of all ages.
The "rheumatoid factor" is an antibody that can be found in the
blood of 80% of people with rheumatoid arthritis.
20. Hallmark feature of ra
Is persistentsymmetricpolyarthritis (synovitis) that affect the hands and feet.
21. Risk factors
Idiopathic
Sex – women>men
Positive family history
Smoking
Bacterial and Fungal Infection
Herpes simplex virus infections
Epstein-Barr virus (EBV)
Vitamin D deficiency
22. Incidence rate
Females > males 3:1
People of any age can be affected
Peak age 45-65 yrs but onset early from age 20-45 yrs
About 75% of these are women.
The disease strikes women three times more often than men
23.
24.
25. Clinical features
Tender, warm, swollen joints
Morning stiffness that may last for hours
Firm bumps of tissue under the skin on your arms (rheumatoid
nodules)
Fatigue
Fever
Weight loss
26. RA can affect many non joint structures, including –
Skin
Eyes
Lungs
Heart
Kidney
Blood vessels
28. Swan neck deformity- is deformed position of the finger , in which the
joint closet to the fingertips is permanently bent toward the palm while
the nearest joint to the palm is bent away from it.
Cock up toe deformity – extension of the toes
Rheumatoid Nodules – are firm lumps that develop under the skin,
unique symptom to rheumatoid arthritis and usually occur near joints
affected by condition.
Z deformity of thumb – hyperextension of the interphalangeal joint
Button hole deformity- (boutonniere deformity)
38. QUESTIONBANK
10 MARKS
1. AMAVATA IN DETAIL WITH NIDANA PANCHAKA .
2. EXPLAIN AMAVATA WITH MODERN CORELATION.
5 MARKS –
1. AMAVATA SAMPRAPTI
2. AMAVATA NIDANA
3. RA