Changes

''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)

''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'': ''Gridhrasi'' is a ''snayugata'' (affecting tendon) ''roga''. The word ''gridhrasi'' 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)

Nomenclature of diseases: All the vāta disorders cannot be named or explained. They should be understood on the basis of site of affliction as well as nomenclature. (verse 58)

Diagnosis of dhatukshaya (degenerative pathology) and avarana (obstructive pathology) induced vitiation of vata: Vata can be vitiated due to dhātukṣaya and margāvarana types of pathogenesis. Dhātukṣaya leads to depletion of tissues and more space for vāta to move. This leads to gatavāta phenomenon.  Avarana of vāta can be caused by other dosha or dhātu. So the differences between āvarana and gatavāta should be understood.

Nomenclature of diseases: All the ''vata'' disorders cannot be named or explained. They should be understood on the basis of site of affliction as well as nomenclature. (verse 58)

The word, avarana means obstruction or resistance or friction to the normal gati of vāta. Hence when its normal movement is hampered or vitiated, it becomes Āvr̥ta  and leads to different disorders. The gatatva and āvr̥tatva are entirely different phenomenom. Here an attempt is being made to differentiate the both physio-pathologies. [16]

Diagnosis of ''dhatukshaya'' (degenerative pathology) and ''avarana'' (obstructive pathology) induced vitiation of ''vata'': ''Vata'' can be vitiated due to ''dhatukshaya'' and ''margavarana'' types of pathogenesis. ''Dhatukshaya'' leads to depletion of tissues and more space for ''vata'' to move. This leads to ''gatavata'' phenomenon. ''Avarana'' of ''vata'' can be caused by other ''dosha'' or ''dhatu''. So the differences between ''avarana'' and ''gatavata'' should be understood.

1. In Āvarana, generally the vitiation of vāta is passive. When vitiated dosha or any other thing obstructs the pathway of vāta, āvarana happens. Normal state of vāta gets vitiated as āvarana progresses. The substance which obstructs the pathway of vāta is called as ‘āvaraka’ and the dosha (vāta in general or its components) affected by āvarana is called as āvariya or āvr̥ta. Normally the āvarana is caused by the etiological factors for the vitiation of āvaraka. Etiological factors for the vitiation of vāta (sva nidāna) will be absent.

The word, ''avarana'' means obstruction or resistance or friction to the normal ''gati'' of ''vata''. Hence when its normal movement is hampered or vitiated, it becomes ''avrita'' and leads to different disorders. The ''gatatva'' and ''avritatva'' are entirely different phenomenon. Here an attempt is being made to differentiate the both physio-pathologies. [16]

In case of gatavāta the vitiation of vāta will be active. Here its own etiological factors are operating in the vitiation of vāta in the pathogenesis and the vitiated vāta adopts specific pathway and abnormally localizes at particular sites.

 

2. In the process of āvarana ‘chala’ property of vāta is diminished due to obstruction. Other properties are not involved in the process of obstruction. But in case of gatatva the vitiation of vāta takes place by involvement of other properties like rūkṣa, laghu, khara, vishada etc along with chala.

#In ''avarana'', generally the vitiation of ''vata'' is passive. When vitiated ''dosha'' or any other thing obstructs the pathway of ''vata, avarana'' happens. Normal state of ''vata'' gets vitiated as ''avarana'' progresses. The substance which obstructs the pathway of ''vata'' is called as ''avaraka'' and the ''dosha'' (''vata'' in general or its components) affected by ''avarana'' is called as ''avariya'' or ''avrita''. Normally the ''avarana'' is caused by the etiological factors for the vitiation of ''avaraka''. Etiological factors for the vitiation of ''vata'' (''sva nidana'') will be absent. In case of ''gatavata'' the vitiation of ''vata'' will be active. Here its own etiological factors are operating in the vitiation of ''vata'' in the pathogenesis and the vitiated ''vata'' adopts specific pathway and abnormally localizes at particular sites.

3. In āvarana the ‘gati’ of vāta is obstructed partially or fully. Once gets obstructed the vāta may simply get lodged there (baddha mārga, mārgarodha), try to nullify the obstruction, may get covered by the obstructing substance (āvr̥ta), adopt an opposite direction (pratiloma) or alter the direction (viloma). The different terminologies have been used to denote āvarana in different contexts according to the nature of āvarana and the state of vāta and mārga (passage). In case of gatatva the gati of vitiated vāta aggrevated and starts moving abnormally leading to localization at particular sites.

#In the process of ''avarana chala'' property of ''vata'' is diminished due to obstruction. Other properties are not involved in the process of obstruction. But in case of ''gatatva'' the vitiation of ''vata'' takes place by involvement of other properties like ''ruksha, laghu, khara, vishada'' etc along with ''chala''.

4. Āvarana is caused by purnata (filling) of other dosha in the srotas/mārga (passage) of vāta. In gatatva the srotas or sites of occupation of vāta are rikta (unfilled or spacious) and the aggrevated vāta fills the srotas/site.

#In ''avarana'' the ''gati'' of ''vata'' is obstructed partially or fully. Once gets obstructed the ''vata'' may simply get lodged there (''baddha marga, margarodha''), try to nullify the obstruction, may get covered by the obstructing substance (''avrita''), adopt an opposite direction (''pratiloma'') or alter the direction (''viloma''). The different terminologies have been used to denote ''avarana'' in different contexts according to the nature of ''avarana'' and the state of ''vata'' and ''marga'' (passage). In case of ''gatatva'' the ''gati'' of vitiated ''vata'' aggravated and starts moving abnormally leading to localization at particular sites.

*''Avarana'' is caused by ''purnata'' (filling) of other ''dosha'' in the ''srotas/marga'' (passage) of ''vata''. In ''gatatva'' the ''srotas'' or sites of occupation of ''vata'' are ''rikta'' (unfilled or spacious) and the aggravated ''vata'' fills the ''srotas''/site.

5. In āvarana of vāta, swakarma vriddhi (exaggerated activities) of āvaraka (covering dosha) is manifested. The āvr̥ta (i.e. vāta) will show swakarma hāni (diminished activity). This is the general feature of āvarana.  Here the excessively increased strong āvaraka suppresses the normal action of āvr̥ta (i.e. vāta). Therefore, when the obstruction is complete it may lead to the prakopa of vāta resulting in the presentation of vāta vitiated symptoms as well as its disorders14.

5. In āvarana of vāta, swakarma vriddhi (exaggerated activities) of āvaraka (covering dosha) is manifested. The āvr̥ta (i.e. vāta) will show swakarma hāni (diminished activity). This is the general feature of āvarana.  Here the excessively increased strong āvaraka suppresses the normal action of āvr̥ta (i.e. vāta). Therefore, when the obstruction is complete it may lead to the prakopa of vāta resulting in the presentation of vāta vitiated symptoms as well as its disorders14.

In case of gatatva the symptomatology will be predominantly of vāta vitiation and pain is a common and chief complaint in all the conditions of gatatva.

In case of gatatva the symptomatology will be predominantly of vāta vitiation and pain is a common and chief complaint in all the conditions of gatatva.