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Vatavyadhi Chikitsa (view source)

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All the verses explain a specific type of ''samprapti'' (pathogenesis) like koshthagata [[vata]] ([[vata]] affecting alimentary tract), amashayagata [[vata]] ([[vata]] affecting stomach.) etc. They are not to be considered as a single disease. These specific diseases may lead to many disease presentations in which the treatment strategies can be generalized. Any [[dosha]] may occupy any particular site or area and lead to diseases. This type of pathology of vitiated [[vata]] is called as gata[[vata]]. Normally in all gata[[vata]], the affected dushya(vitiated body components) will be ''kshina'' (depleted) and affected ''srotas'' will be ''rikta'' (empty). The concept of gata[[vata]] can be further explored physiologically.[[Dhatu]] are classified into two types’ ''asthayi'' (temporary) [[dhatu]] and sthayi(permanent) [[dhatu]]. Asthayi [[dhatu]] are the ones which are ''dravaswarupa'' (liquid state) and undergoing conversion (''parinam apadyamananam'') and they are being ''vikshepita'' (circulated) from their ''mulasthana'' (origin) throughout the ''sharira'' (''abhivahana'') for the purpose of ''poshana'' (nourishment) of the sthayi [[dhatu]]. This ''parinamana'' (conversion) and ''abhivahana prakriya''(transportation) takes place in ''marga'' (channel) which are known as ''srotas''; hence ''marga'' is one of the synonym used for ''srotas'' along with ''sira'' (vein), ''dhamani'' (artery), ''rasayani'' (capillary), ''rasavahini'' (channels carrying nutrient fluid), ''nadi'' (nerve), ''panthana'' (pathway), ''sharira chhidra'' (perforated channel), ''samvrita-asamvritani'' (covered or uncovered), ''sthana'' (site), ''ashaya'' (organ), ''niketa'' (habitat), ''shariradhatu avakasha'' (hollow space in body tissues).

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''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).

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''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 gata[[vata]]. 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 gata[[vata]] 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 [[vata]] etc. In this condition, [[dhatu]] is ''dushya'' (getting vitiated).

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

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

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''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.

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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.

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'''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.

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'''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.

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''Indriyagata vata'': ''Indriyagata vata'' is applicable to any sense organ. ''Indriya vadha'' may be interpreted as complete, partial or minimal loss of sensation. ''Shrotra''(ears) has specific importance among other ''indriya'', in which inherent ''dosha'' of ''shrotra'' is ''vata'' itself. So ''vata prakopa'' in ''shrotra'' is more impacting. It is worthy to remember the notion in ''vatakalakaleeya'' that ''vata'' is ''sarvendriyanam udyojaka'' (motivating factors for all sense organs).

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'''Indriyagata [[vata]]''': Indriyagata [[vata]] is applicable to any sense organ. ''Indriya vadha'' may be interpreted as complete, partial or minimal loss of sensation. ''Shrotra''(ears) has specific importance among other ''indriya'', in which inherent [[dosha]] of ''shrotra'' is [[vata]] itself. So [[vata]] prakopa in ''shrotra'' is more impacting. It is worthy to remember the notion in vatakalakaleeya that [[vata]] is ''sarvendriyanam udyojaka'' (motivating factors for all sense organs).

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''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~~.''

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'''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 indriyagata[[vata]].

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''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.

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'''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.

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''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''.

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'''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)

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''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)

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''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)

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''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)

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''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)

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''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)

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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)

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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)

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''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)

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''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'': ''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''.

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''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)

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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)

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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)

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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.

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

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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]

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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]

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#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.

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#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 gata[[vata]] 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.

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#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''.

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#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''.

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#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.

+

#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.

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#In ''avarana'' of ''vata, swakarma vriddhi'' (exaggerated activities) of ''avaraka'' (covering ''dosha'') is manifested. The ''avrita'' (i.e. ''vata'') will show ''swakarma hani'' (diminished activity). This is the general feature of ''avarana''. Here the excessively increased strong ''avaraka'' suppresses the normal action of ''avrita'' (i.e. ''vata''). Therefore, when the obstruction is complete it may lead to the ''prakopa'' of ''vata'' resulting in the presentation of ''vata'' vitiated symptoms as well as its disorders[ Cha. Sa. [[Chikitsa Sthana]] 28/215, Chakrapani]. In case of ''gatatva'' the symptomatology will be predominantly of ''vata'' vitiation and pain is a common and chief complaint in all the conditions of ''gatatva''.

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#In ''avarana'' of [[vata]], swakarma vriddhi (exaggerated activities) of ''avaraka'' (covering [[dosha]]) is manifested. The ''avrita'' (i.e. [[vata]]) will show ''swakarma hani'' (diminished activity). This is the general feature of ''avarana''. Here the excessively increased strong ''avaraka'' suppresses the normal action of ''avrita'' (i.e.[[vata]]). Therefore, when the obstruction is complete it may lead to the ''prakopa'' of [[vata]] resulting in the presentation of [[vata]] vitiated symptoms as well as its disorders[ Cha. Sa. [[Chikitsa Sthana]] 28/215, Chakrapani]. In case of ''gatatva'' the symptomatology will be predominantly of [[vata]] vitiation and pain is a common and chief complaint in all the conditions of ''gatatva''.

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#Obstruction or covering of ''vata'' is possible by body components like ''dosha'' (''pitta'' and ''kapha''),tissues,food, excretory products or mutual affliction of ''vata'' types. ''Gatatva'' of ''vata'' (affection) is happening in empty spaces or hollow cavities of tissues, their elements, organs and other body parts. In ''avarana'', the body component is in increased state causing fullness in respected channels, while in ''gatatva'' pathology, the body components are in depleted state casusing emptiness in the respected channels. ''Dhatugata vata'' will be presented with decreased quality of tissues associated with signs of vitiated ''vata''. Obviously, exceptions are possible according to the complexities of process of ''avarana'' or ''gatatva''.

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#Obstruction or covering of [[vata]] is possible by body components like [[dosha]] ([[pitta]] and [[kapha]]),tissues,food, excretory products or mutual affliction of [[vata]] types. Gatatva of [[vata]] (affection) is happening in empty spaces or hollow cavities of tissues, their elements, organs and other body parts. In ''avarana'', the body component is in increased state causing fullness in respected channels, while in ''gatatva'' pathology, the body components are in depleted state casusing emptiness in the respected channels. Dhatugata [[vata]] will be presented with decreased quality of tissues associated with signs of vitiated [[vata]]. Obviously, exceptions are possible according to the complexities of process of ''avarana'' or ''gatatva''.

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#In case of ''avarana'' of ''vata'', the ''avaraka'' is important for treatment since vitiation of ''vata'' is passive. When ''avarana'' is removed vitiated ''vata'' gets pacified. But in cases of ''gatatva'', the vitiated ''vata'' has to be treated first along with correction of ''adhisthana''.

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#In case of ''avarana'' of [[vata]], the ''avaraka'' is important for treatment since vitiation of [[vata]] is passive. When ''avarana'' is removed vitiated [[vata]] gets pacified. But in cases of ''gatatva'', the vitiated [[vata]] has to be treated first along with correction of ''adhisthana''.

#Diagnosis of ''avarana'' is made with the help of ''upashaya–anupashaya'' (pacifying and aggravating factors) method. Diagnosis of ''gatatva'' is made according to the ''rupa'' (symptomatology).

#Complications of ''avarana'' are explained in case of improper diagnosis and delayed treatment like ''hridroga, vidradhi, kamala'' etc. No known complication occur in ''gatatva''.

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#''Avarana'' of ''vata'' may cause depletion of nutrition to ''dhatu'' (~~''dhatugata~~ sama'') leading to successive diminition of ''rasadi dhatu'' (''rasadimscha upasosayet'').[Cha. sa. [[Sutra Sthana]] 28/61] No such reference is available in case of ''gatatva''.

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#''Avarana'' of [[vata]] may cause depletion of nutrition to [[dhatu]] ([[dhatu]]gata sama) leading to successive diminition of rasadi [[dhatu]](''rasadimscha upasosayet'').[Cha. sa. [[Sutra Sthana]] 28/61] No such reference is available in case of ''gatatva''.

The discussed points are briefly enlisted in the table below:

{| class="wikitable"

|-

−

! scope="col"| ''Avrita''(obstructed) ''vata''

+

! scope="col"| ''Avrita''(obstructed) [[vata]]

−

! scope="col"| ''Gata'' (excess movement) ''vata''

+

! scope="col"| ''Gata'' (excess movement) [[vata]]

|-

−

| Vitiation of ''vata'' is passive

+

| Vitiation of [[vata]] is passive

−

| Vitiation of ''vata'' is active

+

| Vitiation of [[vata]] is active

|-

−

| Normally ''svanidana''(specific causes for vitiation) of ''vata'' are not responsible

+

| Normally ''svanidana''(specific causes for vitiation) of [[vata]] are not responsible

−

| Vitiation of ''vata'' by ''svanidana''

+

| Vitiation of [[vata]] by ''svanidana''

|-

−

| Only ''chala'' property of ''vata'' is involved and it is diminished in the phenomenon

+

| Only ''chala'' property of [[vata]] is involved and it is diminished in the phenomenon

−

| Other properties of ''vata'' are also involved and the ''chala'' property aggravated in the phenomenon

+

| Other properties of [[vata]] are also involved and the ''chala'' property aggravated in the phenomenon

|-

−

| ''Gati'' of ''vata'' is obstructed

+

| ''Gati'' of [[vata]] is obstructed

−

| ''Gati'' of ''vata'' is aggravated

+

| ''Gati'' of [[vata]] is aggravated

|-

| ''Purnata''(fullness) in ''srotas/marga''

| ''Riktaka''(emptiness) in ''srotas''

|-

−

| ''Vata'' shows ''svakarma hani'' (decreased function)

+

| [[Vata]] shows ''svakarma hani'' (decreased function)

−

| ''Vata'' shows ''svakarma vriddhi'' (increased function)

+

| [[Vata]] shows ''svakarma vriddhi'' (increased function)

|-

−

| ''Dhatu'' are in ''vriddhi'' (increase) or ''saama''

+

| [[Dhatu]] are in ''vriddhi'' (increase) or ''saama''

−

| ''Dhatu daurbalya'' (decrease) present

+

| [[Dhatu]] daurbalya (decrease) present

|-

−

| ''Avarana'' possible with other ''dosha/anna/mala''/individual components of ''vata''

+

| ''Avarana'' possible with other [[dosha]]/anna/[[mala]]/individual components of [[vata]]

| Not possible

|-

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|-

| ''Avaraka'' gets importance in treatment

−

| ''Vata'' gets importance in treatment

+

| [[Vata]] gets importance in treatment

|-

| Diagnosis made with ''upashaya anupashaya'' (hit and trial)

Line 3,409: Line 3,409:

| None

|-

−

| Successive diminution of ''rasadi dhatu'' possible

+

| Successive diminution of rasadi [[dhatu]] possible

| None

|}

−

As ''avarana'' proceeds it may end up in ~~''dhatukshaya''~~ as the ''avrita'' will block ~~''rasadhatu''~~ which give nourishment. This is commonly observed. This is possible in many other disorders also. The best example is ''rajayakshma''.

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As ''avarana'' proceeds it may end up in [[dhatu]]kshaya as the ''avrita'' will block [[rasa dhatu]] which give nourishment. This is commonly observed. This is possible in many other disorders also. The best example is rajayakshma.

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'''Prognosis''': Exclusive ''vata'' disorders are serious and have poor prognosis. The symptoms / diseases explained manifest when vitiated ''vata'' affects vital parts. The therapeutic approaches should be cautious and extra efforts are essential for a better recovery. As the disease becomes chronic the curability rate drastically declines. The physical strength of the patient is also very important in determining prognosis. (verse 72-74)

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'''Prognosis''': Exclusive [[vata]] disorders are serious and have poor prognosis. The symptoms / diseases explained manifest when vitiated [[vata]] affects vital parts. The therapeutic approaches should be cautious and extra efforts are essential for a better recovery. As the disease becomes chronic the curability rate drastically declines. The physical strength of the patient is also very important in determining prognosis. (verse 72-74)

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'''General principles of management''': The general line of management of ''vatavyadhi'' applies to absolute ''vata'' vitiation only. If there is any association or obstruction of other dosha in ''vatavyadhi'', the treatment will be different. ''Kevalam'' term indicates pathology of vitiation of exclusive ''vata''. ''Nirupastambha'' is condition without any association of other ''dosha''. This pathology shall be primarily treated with oleation therapy.

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'''General principles of management''': The general line of management of ''vatavyadhi'' applies to absolute [[vata]] vitiation only. If there is any association or obstruction of other dosha in ''vatavyadhi'', the treatment will be different. ''Kevalam'' term indicates pathology of vitiation of exclusive [[vata]]. ''Nirupastambha'' is condition without any association of other [[dosha]]. This pathology shall be primarily treated with oleation therapy.

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As in exclusive ~~''vataja''~~ disease the major ''gunavriddhi'' is ''ruksha'' which leads to ''riktata'' in ''srotas'' and ''dhatu'' and more ''avakasha'' (space) for ''vata''; ''snehana'' is essential and ideal. Various methods for ''snehana'' are employed depending on ''avastha'' (stage), ''sthana'' (site) and ''bala'' (strength) of the diseases and as well as patient.

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As in exclusive [[vata]]ja disease the major ''gunavriddhi'' is ''ruksha'' which leads to ''riktata'' in ''srotas'' and [[dhatu]] and more ''avakasha'' (space) for [[vata]]; [[snehana]] is essential and ideal. Various methods for [[snehana]] are employed depending on ''avastha'' (stage), ''sthana'' (site) and ''bala'' (strength) of the diseases and as well as patient.

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Following ''snehana, swedana'' is also mandatory. Here the ''ushna guna'' (hot property) operates to control ''sheeta'' (cold). Repeated ''snehana'' and ''swedana'' imparts high grade of flexibility.

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Following [[snehana]], [[swedana]] is also mandatory. Here the ''ushna guna'' (hot property) operates to control ''sheeta'' (cold). Repeated [[snehana]] and [[swedana]] imparts high grade of flexibility.

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''Sneha'' is a good medium to control ''vata'' as well as ''vata-pitta''. Generally, this line of treatment can be counted as a part of ''brimhana''. (verse 75-83)

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''Sneha'' is a good medium to control [[vata]] as well as [[vata]]-[[pitta]]. Generally, this line of treatment can be counted as a part of [[brimhana]]. (verse 75-83)

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Repeated ''snehana'' and ''swedana'' therapies can control ''vata'' well. However, ''samshodhana'' (purification) therapies are executed to remove the residual ''dosha''. As ''shodhana'' has a definite chance for causation of ''vata prakopa'', the approach should be cautious, so ''mridu samshodana'' (mild purification) is done. ''Sneha virechana'' is done by ''tilwaka ghrita'' or ''eranda taila'', etc. ''Eranda taila'' is very effective in treating ''vata prakopa'' due to ''udavarta''. If ''virechana'' is not possible, ''anulomana'' diet should be adviced. If the patient is extremely weak ''niruha'' is better option. Even after ''shodhana''; recurrent application of ''snehana'' and ''swedana'' are essential.(verse 83-88)

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Repeated [[snehana]] and [[swedana]] therapies can control [[vata]] well. However, ''samshodhana'' (purification) therapies are executed to remove the residual [[dosha]]. As ''shodhana'' has a definite chance for causation of [[vata]] prakopa, the approach should be cautious, so ''mridu samshodana'' (mild purification) is done. Sneha [[virechana]] is done by ''tilwaka ghrita'' or ''eranda taila'', etc. ''Eranda taila'' is very effective in treating [[vata]] prakopa due to ''udavarta''. If [[virechana]] is not possible, ''anulomana'' diet should be adviced. If the patient is extremely weak niruha is better option. Even after ''shodhana''; recurrent application of [[snehana]] and [[swedana]] are essential.(verse 83-88)

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==== Management of ''vata'' at different sites ====

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==== Management of [[vata]] at different sites ====

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Treatment of disorders of ''vata'', when located in different sites, habitat (''sthana'') is more important in comparison to the invaded (''agantu'') ~~'''~~dosha~~'''~~ e.g in ''koshthagata vata, koshtha'' is given preference in treatment, and so ''kshara'' is used which helps in digestion (''pachana''). But when ''vata'' is located in ''pakvashaya'' or ''guda'' which is ~~''vatasthana~~, udavartahara'' treatment is selected, which includes ''vata anulomana, basti, varti'' etc. In ''amashayagata vata, shodhana'' in the form of ''vamana'' is done.

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Treatment of disorders of [[vata]], when located in different sites, habitat (''sthana'') is more important in comparison to the invaded (''agantu'') [[dosha]] e.g in koshthagata [[vata]], koshtha is given preference in treatment, and so ''kshara'' is used which helps in digestion ([[pachana]]). But when [[vata]] is located in ''pakvashaya'' or ''guda'' which is [[vata]]sthana, udavartahara treatment is selected, which includes [[vata]] anulomana, [[basti]], varti'' etc. In amashayagata [[vata]], shodhana in the form of [[vamana]] is done.

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''Hridaya anna'' (favourite food) is typically indicated in ''tvakgata vata'' because, rūkṣatā in tvak is a result of rasakṣaya caused by overworrying.[ Cha. Sa. [[Vimana Sthana]] 5/13 ]

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''Hridaya anna'' (favourite food) is typically indicated in tvakgata [[vata]] because, rūkṣatā in tvak is a result of rasakṣaya caused by overworrying.[ Cha. Sa. [[Vimana Sthana]] 5/13 ]

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''Bahya snehana'' in the form of ''abhyanga'' or ''dhara'', etc are very effective in ''asthi'' and ~~''majjagata~~ vata''. ''Abhyantara snehana'' replenishes ''meda dhatu'' and subsequently ''asthi'' and ~~''meda''~~. It is worthy to note the utility of ''tikta ghrita'' in ~~''asthikshaya''~~.

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Bahya [[snehana]] in the form of ''abhyanga'' or ''dhara'', etc are very effective in [[asthi dhatu]]gata and [[majja dhatu]]gata [[vata]]. Abhyantara [[snehana]] replenishes [[meda dhatu]] and subsequently [[asthi dhatu]] and [[majja dhatu]]. It is worthy to note the utility of ''tikta ghrita'' in [[asthi dhatu]]kshaya.

In ''shukrakshaya'' (depletion of ''shukra''), ''harshana'' (pleasure) and ''vrishya annapana'' (aphorodisiac diet) is very useful. <ref>Vagbhata, Sharira Sthana Chap 5 , Angavibhaga Adhyaya, Verse 67. In: Bhishagacharya Harisastri Paradikara Vaidya (eds.) 9th ed. Varanasi: Chaukhambha Orientalia; 2005. P798</ref>

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