Amavata (Rheumatism)




Introduction


The term “Ama” means unripe, immature and undigested. It is resulted as a consequence of impaired functioning of ‘kayagni’. According to vagbhata; due to the hypo functioning of ushma (Agni), the anna-rasa undergoes fermentation and or putrification (dushta). It is this state of Rasa, which is known as ‘Ama’. The vitiated doshas along with Ama causes Amavata.



Hetu-Etiological Factors



Indulgence in incompatible foods and habits.
Excess of physical activity immediately after taking fatty foods.

Those with poor digestive capacity.
Use of food and drink, which are heavy to digest.
Use of food, which is rough, cold, dry, unclean, antagonistic in nature.


Emotional factors such as passion, anger, greed, confusion, envy; grief, excitement, fear etc.
Is responsible for Amavata.



Signs and symptoms of Amavata

cardinal symptoms of amavata are

(Vriscik damsha vata vedana)Morning pain severe in nature

(Sanchari Vedana)shifting pain

(Stambha) stiffness of joints

(Jwara )Increase temperature

(Karmahani) loss of movements

(Sandhi Vikruti) joint deformity.

(Kshudhamandya) Loss of appetite


Signs and Symptoms of Amavata according to doshik dominance

Vitiated Vata produces colicky pain, body ache, abdominal distension, giddiness, stiffness of back and waist, constriction and spasm of blood vessels.


Vitiated Pitta produces fever, diarrhea, thirst, giddiness and delirium.


Vitiated Kapha produces vomiting, anorexia, indigestion, fevers with cold, lassitude and heaviness in body.



Classification

Vataj - Where vata is predominant (pain is severe in this type).


Pittanubandhi - Where pitta is predominant (burning sensation and redness of the affected joints is present).


Kaphanubandhi - Where kapha is predominant (loss of movement and itching is seen in this type).



Sadhyasadhyata - Prognosis


Disease with early onset and single dosha prominence in young individual can be cured with proper treatment and with religiously following the do's and don'ts.

As the disease become chronic it involves multiple systems, which makes the disease uncurable. If it is present with signs of complications then it may produce serious threats to life.



Chikitsa - treatment

Line of treatment:



Shodhan-:

Snehpana (Ingestion of unctuous substances -: various oils specially prepared with Rasna, Dashmoola, Nirgundi are used for this purpose. Especially castor oil is considered as the best oil to be used in the treatment of amavata.


Langhana (fasting )-: it is done by means of complete absence of food, or by giving preparations of Mudga Yusha, laja Manda, Peya(rice water soup), kulith(horse gram) and Yava (barly).


Swedana (fomentation) is very useful mode of treatment in amavata. Specially complete dry sweda in the form of Ruksha kuti sweda (sauna bath), Dry fomentation-using sands like dry substances, Upanaha (local application) of non-unctuous substances are very effective in relieving the pain.


Virechan (Purgatives)-: Virechan with castor oil is very useful in treating amavata.


Basti (medicated enema) various medicated enemas
like Vaitaran Basti, Dashmoola Kwath Basti, Kshar Basti, Erandmoola Yapan Basti are useful in relieving the pain in amavata



Shaman Chikitsa -: commonly used drugs

Decoctions


Rasna-panchak kwatha.

Rasna saptak kwatha

Panchakol kwatha.

Dashmool kwatha with eranda taila.

Churna-:


Ajamodadya choorna

Panchakol choorna with lukewarm water

Shunthi choorna

Almabushadya choorna

Vaishwanar choorna

Vati / Guggulu

Simhanad guggulu

Brihat yogaraj guggulu

Ghrita

panchakola ghrita

rasnadi ghrita

Taila

Eranda taila

Saindhavadya taila

Lepa

Shunthi lepa

Bachang-tentu lepa

Rasaushadhi

Amavatari rasa

Rasraj ras