Changes

''Prakupita''(vitiated) ''dosha'' have the capacity to further vitiate both ''sthanastha dhatu'' (fixed tissue element) as well as ''margagata'' (circulating tissue elements) ''sharira dhatu''. When ''prakupita vata'' vitiates the ''dhatu'', it is called as ''gatavata''. In this condition, vitiated ''vata'' affects the specific site due to specific etiological factors. While designing treatment protocol, in this context specific etiological factors for each and every ''gatavata'' related diseases must be observed to clarify why vitiated ''vata'' goes to specific part of the body or to specific ''dhatu'' to develop ''kosthagata vata, raktagata vāta'' etc. In this condition, ''dhatu'' is ''dushya'' (getting vitiated).

''Prakupita''(vitiated) ''dosha'' have the capacity to further vitiate both ''sthanastha dhatu'' (fixed tissue element) as well as ''margagata'' (circulating tissue elements) ''sharira dhatu''. When ''prakupita vata'' vitiates the ''dhatu'', it is called as ''gatavata''. In this condition, vitiated ''vata'' affects the specific site due to specific etiological factors. While designing treatment protocol, in this context specific etiological factors for each and every ''gatavata'' related diseases must be observed to clarify why vitiated ''vata'' goes to specific part of the body or to specific ''dhatu'' to develop ''kosthagata vata, raktagata vāta'' etc. In this condition, ''dhatu'' is ''dushya'' (getting vitiated).

'''Koshthagata vata''': ''Vata'' getting vitiated in the ''koshtha'' (elimentary tract) is explained as ''koshthagata vata''.  

''Koshthagata vata'': ''Vata'' getting vitiated in the ''koshtha'' (alimentary tract) is explained as ''koshthagata vata''.  

''Gudagata vata:'' It can also be explained that ''gudagata vata'' and ''pakvashayagata vata'' are different clinical entities. In ''gudagata vata'', obstruction of stool, urine and flatus is observed, whereas in ''pakvashayagata vata'' there is painful defecation, micturition with ''antrakujana'' (gurgling sound), ''atopa'' (distension) and ''anaha'' (constipation). ''Ashma sarkara'' (urolith) is exclusively present in ''gudagata vata'' with pain and atrophy in calf muscles, thighs, sacram, feet and back. This can be compared with lumbo-sacral plexopathy. It may be understood as in case of ''pakvashaya gatavata'', proximal part of large intestine alongwith ascending, transverse and descending colon is involved; whereas in ''gudagata vata'', involvement of sigmoid colon, rectum, anus and their nerve supply.

''Gudagata vata:'' It can also be explained that ''gudagata vata'' and ''pakvashayagata vata'' are different clinical entities. In ''gudagata vata'', obstruction of stool, urine and flatus is observed, whereas in ''pakvashayagata vata'' there is painful defecation, micturition with ''antrakujana'' (gurgling sound), ''atopa'' (distension) and ''anaha'' (constipation). ''Ashma sarkara'' (urolith) is exclusively present in ''gudagata vata'' with pain and atrophy in calf muscles, thighs, sacram, feet and back. This can be compared with lumbo-sacral plexopathy. It may be understood as in case of ''pakvashaya gatavata'', proximal part of large intestine along with ascending, transverse and descending colon is involved; whereas in ''gudagata vata'', involvement of sigmoid colon, rectum, anus and their nerve supply.

'''Amashayagata vata''': This is a typical presentation of ''vata'' leaving its own site and vitiating other site. Here the local ''dosha'' is considered important because it is more virulent than the external ''dosha'' coming from other sites. The clinical entities originating from ''amashaya'' (stomach) are caused due to vitiated ''vata'' entering into ''amashaya''. It increases emptiness of stomach leading to indigestion or ''ama pradoshaja vikara'' like ''visuchika'' (diarrhea) etc.

'''Amashayagata vata''': This is a typical presentation of ''vata'' leaving its own site and vitiating other site. Here the local ''dosha'' is considered important because it is more virulent than the external ''dosha'' coming from other sites. The clinical entities originating from ''amashaya'' (stomach) are caused due to vitiated ''vata'' entering into ''amashaya''. It increases emptiness of stomach leading to indigestion or ''ama pradoshaja vikara'' like ''visuchika'' (diarrhea) etc.

''Twakgata vata'': ''Tvak'' (skin) is referred as somatic organ even though it is a sensory organ. ''Supti'' (numbness) and ''toda'' (pricking sensation) are not symptoms specific to ''tvakindriya.'' Here ''tvak'' represents ''rasa dhatu''. ''Rasa'' does not have cellular pattern and hence not included in ''shakha''. The ''tvak'' is derivative of ''rasa'' and is included in ''shakha''. ''Tvakindriya gatavata'' should be understood under ''indriyagatavata.''

''Twakgata vata'': ''Tvak'' (skin) is referred as somatic organ even though it is a sensory organ. ''Supti'' (numbness) and ''toda'' (pricking sensation) are not symptoms specific to ''tvakindriya.'' Here ''tvak'' represents ''rasa dhatu''. ''Rasa'' does not have cellular pattern and hence not included in ''shakha''. The ''tvak'' is derivative of ''rasa'' and is included in ''shakha''. ''Tvakindriya gatavata'' should be understood under ''indriyagatavata.''

''Siragata vata'': When vāta afflicts sirā (blood vessel) it may broaden or narrow the sirā. Widening may lead to śōpha and narrowing may lead to shosha or vice versa as per the site of affliction. Two different conditions of vascular diseases i.e. aneurysym (mahat) and atherosclerosis / venous thrombosis (tanu) are examples.

''Siragata vata'': When ''vata'' afflicts ''sira'' (blood vessel) it may broaden or narrow the sirā. Widening may lead to ''shopha'' and narrowing may lead to ''shosha'' or vice versa as per the site of affliction. Two different conditions of vascular diseases i.e. aneurysym (''mahat'') and atherosclerosis / venous thrombosis (''tanu'') are examples.

Sandhigata vata (osteoarthritis): There is depletion of periarticular and articular tissue by vitiated vata in sandhigata vata/osteoarthritis, empty spaces are occupied by vata which is felt as crepitus on palpation. Vata also causes hypertrophic tissue in the form of osteophytes and causes painful flexion and extension movements. This is the characteristic feature of swelling in sandhigata vata.  

''Sandhigata vata'' (osteoarthritis): There is depletion of periarticular and articular tissue by vitiated ''vata'' in ''sandhigata vata''/osteoarthritis, empty spaces are occupied by ''vata'' which is felt as crepitus on palpation. ''Vata'' also causes hypertrophic tissue in the form of osteophytes and causes painful flexion and extension movements. This is the characteristic feature of swelling in ''sandhigata vata''.  

Ardita: Ardita is a disease of episodic origin. It may lead to facial paralysis or hemiplegia or both. In other classics ardita is explained as facial paralysis only. (verse 38-42)

''Ardita'': ''Ardita'' is a disease of episodic origin. It may lead to facial paralysis or hemiplegia or both. In other classics ''ardita'' is explained as facial paralysis only. (verse 38-42)

Antarayama (Emprosthotonous) and bahirayama(ophisthotonous): These diseases are tetany like conditions in which the body is sharply bent forward and backward respectively. (verse 43-48)

''Antarayama'' (emprosthotonous) and ''bahirayama''(ophisthotonous): These diseases are tetany like conditions in which the body is sharply bent forward and backward respectively. (verse 43-48)

Hanugraha: It is a lock jaw like condition that may be persistent or intermittent or recurrent due to vitiation of vata affecting the mandibular joint. (verse 49)

''Hanugraha'': It is a lockjaw like condition that may be persistent or intermittent or recurrent due to vitiation of ''vata'' affecting the mandibular joint. (verse 49)

Dandaka:Daṇḍaka is a condition in which the muscles are hypertonic but without convulsions. When it further manifests as tonic clonic convulsions it is referred as daṇḍa akshepaka.This condition is caused due to vitiation of vata simultaneously in muscle groups.  (verse 51)

''Dandaka'':''Dandaka'' is a condition in which the muscles are hypertonic but without convulsions. When it further manifests as tonic clonic convulsions it is referred as ''danda akshepaka''. This condition is caused due to vitiation of ''vata'' simultaneously in muscle groups.  (verse 51)

Episodic nature of various vata disorders: The disorders mentioned from ardita onwards are vegavān (episodic). All vegavān disorders have two phases, vega and vegāntara. Vegāntara is the symptom free period and is considered as right time for medication. (verse 52)

Episodic nature of various ''vata'' disorders: The disorders mentioned from ''ardita'' onwards are ''vegavana'' (episodic). All ''vegavana'' disorders have two phases, ''vega'' and ''vegantara''. ''Vegantara'' is the symptom free period and is considered as right time for medication. (verse 52)

Pakshaghata: Three diseases namely pakṣāghāta(hemiplegia), ekāngarōga (monoplegia) and sarvāngarōga (quadriplegia) are explained. In pakṣāghāta no painful symptoms are explained. Sirā and snāyu are considered as dushya in ekāngarōga and sarvāngarōga. Sirā is the upadhātu of rakta and snāyu is the upadhātu of meda, therefore meda and rakta have vital role in pathogenesis of these diseases. (verse 53-55)

''Pakshaghata'': Three diseases namely ''pakshaghata''(hemiplegia), ''ekangaroga'' (monoplegia) and ''sarvangaroga'' (quadriplegia) are explained. In ''pakshaghata'' no painful symptoms are explained. ''Sira'' and ''snayu'' are considered as ''dushya'' in ''ekangaroga'' and ''sarvangaroga''. ''Sira'' is the ''upadhatu'' of ''rakta'' and ''snayu'' is the ''upadhatu'' of meda, therefore ''meda'' and ''rakta'' have vital role in pathogenesis of these diseases. (verse 53-55)

Gridhrasi: Gr̥dhrasī is a snāyugata (affecting tendon) rōga. The word gr̥dhrasī is derived from ghridhra, which means vulture, the typical gait of the disease is highlighted by the name.  The patient’s gait is changed like a vulture due to affected tendons by vitiated vata.   

''Gridhrasi'': Gr̥dhrasī is a snāyugata (affecting tendon) rōga. The word gr̥dhrasī is derived from ghridhra, which means vulture, the typical gait of the disease is highlighted by the name.  The patient’s gait is changed like a vulture due to affected tendons by vitiated vata.   

Khalli is the term given to severe painful twisting conditions of tendons. (verse 56-57)

Khalli is the term given to severe painful twisting conditions of tendons. (verse 56-57)