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== Tattva Vimarsha (Fundamental Principles) ==

== Tattva Vimarsha (Fundamental Principles) ==

#''Vatashonita'' occurs when aggravated ''vata'' is afflicted with vitiated ''shonita''. ''Vata'' is the constantly moving and ''shonita'' is also constantly flowing tissue, both need clear passage for uninterrupted movement. There is simultaneous aggravation of ''vata'', vitiation of ''rakta'' and damage to potency of channels (arteries and veins). When channels pass through narrow and circuitous path of small joints, vitiated ''rakta'' and aggravated ''vata'' gets seated there to start inflammation of local tissues.

#''Vatashonita'' occurs when aggravated [[vata]] is afflicted with vitiated ''shonita''. [[Vata]] is the constantly moving and ''shonita'' is also constantly flowing tissue, both need clear passage for uninterrupted movement. There is simultaneous aggravation of [[vata]], vitiation of [[rakta]] and damage to potency of channels (arteries and veins). When channels pass through narrow and circuitous path of small joints, vitiated [[rakta]] and aggravated [[vata]] gets seated there to start inflammation of local tissues.

#A combination of ''vata'' aggravating factors and ''pitta-rakta'' vitiating factors gives rise to ''vatarakta''.   

#A combination of [[vata]] aggravating factors and [[pitta]]-[[rakta]] vitiating factors gives rise to vatarakta.   

#Etiological factors of ''vata'' vitiation are ''virudha ahara'' (incompatible food), ''adhyasana'' (taking food before complete digestion of previous one), ''ratri jagrana'' (vigil in night), ''kashaya'' (astringent), ''katu'' (pungents), ''tikta'' (bitter), ''alpabhojana'' (inadequate quantity of food), ''ruksha bhojana'' (food substances of low nutritional values), ''abhojana'' (starvation), excess travelling in uncomfortable vehicles, sporting in water, jumping, leaping, excessive walking in hot season, excessive sexual intercourse and suppression of natural urges.

#Etiological factors of [[vata]] vitiation are ''virudha ahara'' (incompatible food), ''adhyasana'' (taking food before complete digestion of previous one), ''ratri jagrana'' (vigil in night), ''kashaya'' (astringent), ''katu'' (pungents), ''tikta'' (bitter), ''alpabhojana'' (inadequate quantity of food), ''ruksha bhojana'' (food substances of low nutritional values), ''abhojana'' (starvation), excess travelling in uncomfortable vehicles, sporting in water, jumping, leaping, excessive walking in hot season, excessive sexual intercourse and suppression of natural urges.

#''Pitta, shonita'' and ''shonita vaha srotasa'', vitiating factors are ''lavana, amla, katu, kshara, ushna bhojana, ajeerna bhojana'' (salty, sour, pungent, alkaline, fatty substances, very hot food, taking food during indigestion), various pulses (''kulattha, masha'' etc), various beverages having quite good percentage of alcohol, excess walking in hot season, vigil during night are responsible for vitiation of ''pitta dosha'' as well as ''shonita'' and ''shonita vaha srotasa''.

#[[Pitta]], shonita and ''shonita vaha srotasa'', vitiating factors are ''lavana, amla, katu, kshara, ushna bhojana, ajeerna bhojana'' (salty, sour, pungent, alkaline, fatty substances, very hot food, taking food during indigestion), various pulses (''kulattha, masha'' etc), various beverages having quite good percentage of alcohol, excess walking in hot season, vigil during night are responsible for vitiation of ''pitta dosha'' as well as ''shonita'' and ''shonita vaha srotasa''.

#''Pitta'' predominant person leading a delicate life style is more susceptible for early progression of ''vatarakta''.

#[[Pitta]] predominant person leading a delicate life style is more susceptible for early progression of ''vatarakta''.

#There are two types of ''vatashonita'':  

#There are two types of ''vatashonita'':  

##''Uttana'' or superficial, located in blood vessels between skin and muscles. It manifests as itching, burning, piercing pain in skin, constricting and expanding sensation of skin, black red and coppery boils of skin, and  

##''Uttana'' or superficial, located in blood vessels between skin and muscles. It manifests as itching, burning, piercing pain in skin, constricting and expanding sensation of skin, black red and coppery boils of skin, and  

##''Gambhira'' or deep: Located in blood vessels of small joints of extremities but more in lower extremities and big toe is most affected. Manifested inflammation, hard, non- shifting and painful, pulsating inflammation with coppery black color and cause of disability.

##''Gambhira'' or deep: Located in blood vessels of small joints of extremities but more in lower extremities and big toe is most affected. Manifested inflammation, hard, non- shifting and painful, pulsating inflammation with coppery black color and cause of disability.

#Based on ''dosha, vatshonita'' is classified into four types, three of them due to one ''dosha'' and one due to three ''dosha'', the last one is incurable.

#Based on [[dosha]], vatshonita is classified into four types, three of them due to one [[dosha]] and one due to three [[dosha]], the last one is incurable.

#Treatment is four-fold with six types of blood letting, therapeutic purgation, purifying enema and palliative treatment for ''vata''.  

#Treatment is four-fold with six types of blood letting, therapeutic purgation, purifying enema and palliative treatment for [[vata]].  

#In ''vatarakta, rakta'' obstructs pathway of ''vata'' and vice-versa i.e. ''vata'' obstructing pathway of ''rakta''. Bloodletting helps in the movement of ''vata''.  

#In ''vatarakta, rakta'' obstructs pathway of [[vata]] and vice-versa i.e. [[vata]] obstructing pathway of [[rakta]]. Bloodletting helps in the movement of [[vata]].  

#The purgation should be mild because strong purgation may cause ''vataprakopa''.  

#The purgation should be mild because strong purgation may cause ''vataprakopa''.  

#After proper oleation, ''vatarakta'' patient shall be treated with mild therapeutic purgation with unctuous substances or with dry substances (in case of excess oleated patient). After purgation, the patient should be given frequent ''basti'' (enema of medicated substances) including ''anuvasana basti'' (unctuous enema) and ''niruha basti'' (enema made from decoction of medicinal herbs). Besides fomentation, massage, ointments, food and ''sneha'' (unctuous substances) be given to the patient which do not cause burning sensation.  

#After proper oleation, ''vatarakta'' patient shall be treated with mild therapeutic purgation with unctuous substances or with dry substances (in case of excess oleated patient). After purgation, the patient should be given frequent [[basti]] (enema of medicated substances) including anuvasana [[basti]] (unctuous enema) and niruha [[basti]] (enema made from decoction of medicinal herbs). Besides fomentation, massage, ointments, food and ''sneha'' (unctuous substances) be given to the patient which do not cause burning sensation.  

#In case of ''uttana vata shonita'' affecting superficial tissues only, the patient should be treated with ''alepana'' (affected part is covered with medicinal paste), ''abhyanga'' (massage), ''parisheka'' (bathing in warm decoction or unctuous substances) and ''upanaha'' (application of poultice).  

#In case of uttana vata shonita affecting superficial tissues only, the patient should be treated with ''alepana'' (affected part is covered with medicinal paste), ''abhyanga'' (massage), ''parisheka'' (bathing in warm decoction or unctuous substances) and ''upanaha'' (application of poultice).  

#In the case of ''gambhira vata rakta'' the patient should be treated with purgation, ''asthapana basti'' (enema with decoction of medicinal plants) and ''snehapana'' (drinking medicated oil/ghee).

#In the case of gambhira vata rakta the patient should be treated with purgation, asthapana [[basti]](enema with decoction of medicinal plants) and [[snehapana]] (drinking medicated oil/ghee).

#In the disease where the ''vata'' is predominant, one should over come the disease with medicated ghee, ''taila, vasa, majja'' (ghee, oil, fat, and bone marrow of animals) either by intake or massage or enema and the diseased part should be treated with warm ''upanaha'' (warm poultice).

#In the disease where the [[vata]] is predominant, one should over come the disease with medicated ghee, taila, vasa, majja(ghee, oil, fat, and bone marrow of animals) either by intake or massage or enema and the diseased part should be treated with warm ''upanaha'' (warm poultice).

#Where the ''rakta'' and ''pitta'' both are predominant, patient should be treated by mild purgation, after ''ghrita pana'' (intake of medicated ghee), intake of milk, bathing in decoction made from medicinal plants and ''basti'' (enema). The ''raktapitta'' should be treated with cold and refrigerant ''alepam'' (paste of herbs).

#Where the [[rakta]] and [[pitta]] both are predominant, patient should be treated by mild purgation, after ''ghrita pana'' (intake of medicated ghee), intake of milk, bathing in decoction made from medicinal plants and ''basti'' (enema). The ''raktapitta'' should be treated with cold and refrigerant ''alepam'' (paste of herbs).

#Where the ''kapha'' is predominant, patient of ''vatarakta'' should be treated with mild emesis and avoid excessive oleation, sudation and fasting. Luke warm ''lepa'' (pastes of herbs) are useful.   

#Where the [[kapha]] is predominant, patient of ''vatarakta'' should be treated with mild emesis and avoid excessive oleation, sudation and fasting. Luke warm ''lepa'' (pastes of herbs) are useful.   

#External application of unctuous substances like ghee and oil processed with herbs having cold potency, sweet and bitter tastes are effective to reduce burning sensation.  

#External application of unctuous substances like ghee and oil processed with herbs having cold potency, sweet and bitter tastes are effective to reduce burning sensation.  

#If ''vata'' is vitiated due to obstruction either by excessive aggravated ''meda'' or ''kapha'', one should not apply unctuous and stouting drugs in the beginning. Instead ''kapha'' and ''meda'' subjugate with physical exercises, ''shodhana'' (purification), ''virechana'' (purgation), and intake of ''arishta'' (fermentated preparation of medicinal herbs etc.) and butter milk with ''abhaya''.

#If [[vata]] is vitiated due to obstruction either by excessive aggravated [[meda dhatu]] or [[kapha]], one should not apply unctuous and stouting drugs in the beginning. Instead [[kapha]] and [[meda dhatu]] subjugate with physical exercises, ''shodhana'' (purification), [[virechana]] (purgation), and intake of ''arishta'' (fermentated preparation of medicinal herbs etc.) and butter milk with ''abhaya''.

== Vidhi Vimarsha (Applied Inferences ) ==  

== Vidhi Vimarsha (Applied Inferences ) ==