Vatarakta also known as Vatasonita is caused by the vitiated vata dosha and rakta which impedes the gati (movement) of each other. This condition mainly affects people who are not physically active and indulge in factors that vitiate rakta. People of pitta prakriti are more prone to this condition.
Vatarakta is a group of inflammatory disorders which include gouty arthritis, rheumatoid arthritis, connective tissue disorders, inflammatory polyarthritis, vasculitis, etc.
The rakta vitiating factors impair agni at jatharagni and dhatvagni level of digestion. With Vatarakta, the vitiated vata dosha affects jatharagni by causing visamagni (irregular digestion) and directly affects the rakta dhatvagni (nourishment of blood).
The process of raktadhatvagni includes the sira (vessels) and kandara (tendons) which are by products. The impairment of raktadhatvagni leads to disorders of the deep vessels and connective tissues. This indicates Vatarakta also covers diseases like vasculitis along with thrombosis, embolism, and Raynaud’s disease.
Ayurvedic Management for Vatarakta
It is a chronic deep seated systemic disease in which the joints of the body are the target. Rakta dushti and vata kopa are the causative factors. Rakta circulates throughout the body and rakta dushti is caused by the aggravated pitta and/or kapha dosha.
Nidana
- Vata Vriddhi – sita is most important
- Rakta Dushti – vidaha (burning), ushna and snigdha are most important
Pathogenesis
- Simultaneously vata and rakta dushti (vitiation of vata and rakta) occur due to the sukshma (subtle) and sarva sara qualities of vata and the drava (liquid) and sara (mobility) qualities of rakta.
- Anyonya Avarana (occlusion within same type of dosha) of vata and rakta and sthana samsraya (amalgamation of dosha and dhatu) in sandhi due to vakratwa (twist).
Prognosis
- With recent onset and predominance of single dosha, it is sadhya (curable).
- The disease arising from predominance of two dosha is yapya (palliable).
- The disease arising from predominance of all three dosha and has developed upadrava (complications) as well, is asadhya (incurable).
Relation of Agni and Rakta
- Rakta Kshaya = Manda Agni = Rakta Dushti
- Rakta suddhi (purification of blood) = Deepthagni (increased digestive fire)
Role of Exercise in Nidana And Chikitsa
- Lack of exercise causes Prameha and Vatarakta
- Management of Prameha requires exercise
- Management of Vatarakta exercise is contraindicated due damaged inflamed joints.
Treatment
- Rakta Prasadana (blood nourishment) and vata samana
- Langhana when sadhya roga
- Shodhana when deep seated roga
Importance of Shodhana
-
Vatarakta = Shodhanarha (eligible for detoxification) Roga
- Samana treatments done in the beginning without discriminating guruthwa (heavy) and laghuthwa (light) of vyadhi will exacerbate the symptoms.
-
Uttana - Twak Mamsa Ashrita (residing)
- Lepana, Abhyanga, Parisheka (shower), Avagaha (tub bath)
-
Gambhira - deep-seated
- Virechana, Asthapana (type of basti), Snehapana
Why Rakta Mokshana in the first stage
- Because Rakta Dushti is ushna and snigdha and Vata Vriddhi is sita and ruksha which are conditions that cannot be pacified by the Shadupakramas (sita - ushna, snigdha - ruksha, laghu - guru).
Administering Raktamokshana
- Leech therapy is indicated if symptoms are burning pain and pricking sensation.
- Shringa (animal horn) or alabu (hollow gourd) is indicated if symptoms are itching, and tingling.
- Siravyadha (venesection) is indicated if symptoms are not localized to a specific body part and fleeting in nature.
- If there is shosha (atrophy), dryness, and symptoms of vata dominance, the bloodletting should not be done.
Snehapana
- Snigdha varchas – sign of samyak snigdhatha
- Snehamsha of Purisha (presence of oil in stool) – mala (waste) of majja dhatu (bone marrow) can be taken as sign of snehapana reaching majju dhatu.
Sweda
- Generally contradicted
- Drava sweda can be done
- Dashamoola kshaya or Dhanyamla (herbal decoction) dhara in first stage
- Dashamoola ksheera dhara – relieves pain
- Thaila seka (shower)
Virechana
- Indicated for kapha pitta hara and vatanulomana
-
Eranda taila with ksheera
- Ushna tiksna guna of eranda is managed by soumya guna of ksheera
- The medicine becomes suitable for dosha and dushya
- Ghrita Bharjitha Haritaki Kwath (haritaki processed in ghee) – ruksha of Haritaki compensated by snigdha of ghrita
- Trivrit Choorna with ksheera can also be used
Importance of Vasti
- Ksheera vasti with Guduchi Ksheera Kwath
- Vasti is best treatment for vata
- Applied at the site of vata by processing with Rakta Prasadana (blood nourishment) medicine acts against dushya also vasti arrests progression even in Gambhira condition when major joints like hip and sacroiliac are affected.
Single Herbs and Product Recommendations
- Guduchi - Tinospora cordifolia = Vata Samana + Rakta Prasadana
- Sangrahi (absorbent), dipana, sleshma sonita vibandha prasamana (subsides kapha and rakta)
- Anupana - eranda taila
- Guluchyadi Kwatham with eranda taila + Guggulu
- Punarnavadi Kwatham + Rasnairandadi Kwatham
- Shaddharna Churnam
- Dasamulaharitaki Leham
Rasayana
To prevent reoccurrence dhatu vikriti must be corrected and rasayana serves as deeper level correction.
- Chyavanaprasam for vata pitta predominance
- Vardhamana Pippali (intake of pippali in an increasing amounts) for vata kapha predominance
Ahara
- Old shali, godhuma, yava and shashtika
- Seasonal vegetables and fruits
- Yousha - mudga and masoora
- Aja mamsa rasa
- Milk - gavyam and ajam
Special Considerations
- Prodromal symptoms closely resemble kushta which indicates common rakta dushti in both conditions.
- Recurrence is the rule due to deep seated pathology.
- Treatment resembles kustha chikitsa more than vata vyadhi.
- When rakta prasadana is brought out then vata is pacified since its yogavāhi.
Conditions Where Vata Rakta Chikitsa Is Indicated
- Arthritic spectrum
- Rheumatic fever
- Ankylosing, Cervical and Lumbar Spondylosis
- Peri arthritis
- Plantar Fascitis
- Systemic lupus erythematosus (SLE)
- Fibromyalgia
References:
- Caraka Chikitsa Sthana Chapter 29 - Management of diseases involving vata and rakta.
- Kusum Lata Bhatt, and Dr. Abdul Khader. “Understanding Vatarakta w.s.r. To Gout through Ayurveda”. Journal of Ayurveda and Integrated Medical Sciences, Vol. 5, no. 05, Oct. 2020, pp. 477-81, https://www.jaims.in/jaims/article/view/1086.
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