E-ISSN:2456-3110

Review Article

Ardhavabhedaka

Journal of Ayurveda and Integrated Medical Sciences

2022 Volume 7 Number 1 Jan-Feb
Publisherwww.maharshicharaka.in

A conceptual understanding on the Sannikrushta Nidana of Ardhavabhedaka with special reference to Migraine

Deeksha R.1*, Abhijith H.2, K Simon A.3, Vidyasagar Badisa S.4
DOI:

1* R Deeksha, Final year PG Scholar, Department of Shalakya Tantra, SDM College of Ayurveda and Hospital, Hassan, Karnataka, India.

2 H N Abhijith, Associate Professor, Department of Shalakya Tantra, SDM College of Ayurveda and Hospital, Hassan, Karnataka, India.

3 Anuja K Simon, Final year PG Scholar, Department of Shalakya Tantra, SDM College of Ayurveda and Hospital, Hassan, Karnataka, India.

4 S Vidyasagar Badisa, Final year PG Scholar, Department of Shalakya Tantra, SDM College of Ayurveda and Hospital, Hassan, Karnataka, India.

Ardhavabhedaka is one of the Shirorogas characterized by severe pain in one half of the head. It is periodic in occurrence. If poorly treated or when not treated properly it can damage eyes and ears. As the etiology and symptoms of both Ardhavabedhaka and Migraine are similar, Ardhavabedhaka can be correlated to Migraine. Migraine makes an individual socially handicapped. It is a common medical condition of the adult population having a significant loss in job productivity and causes significant socio-economic impact. There is a need to prevent this condition at the earliest. It is important to understand the etiological factors, triggers and course of Doshas in Ardhavabhedaka. Nidana Parivarjana (getting rid of the causative factors) is the first line of treatment in all diseases. Hence this article is an attempt to thoroughly understand the Sannikrushta Nidanas of Ardhavabhedaka with special reference to Migraine.

Keywords: Ardhavabhedaka, migraine, Nidana

Corresponding Author How to Cite this Article To Browse
R Deeksha, Final year PG Scholar, Department of Shalakya Tantra, SDM College of Ayurveda and Hospital, Hassan, Karnataka, India.
Email: 		R Deeksha, H N Abhijith, Anuja K Simon, S Vidyasagar Badisa, A conceptual understanding on the Sannikrushta Nidana of Ardhavabhedaka with special reference to Migraine. J Ayu Int Med Sci. 2022;7(1):279-281.
Available From
https://jaims.in/jaims/article/view/1722

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2022-01-25 2022-01-27 2022-02-03 2022-02-10 2022-02-17
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 18%

© 2022by R Deeksha, H N Abhijith, Anuja K Simon, S Vidyasagar Badisaand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

Journal of Ayurveda and Integrated Medical Sciences 2022;7(1)279
Deeksha R. et al: A conceptual understanding on the Sannikrushta Nidana of Ardhavabhedaka

Introduction

Ardhavabhedaka is one among the 11 types of Shiroroga.[1] The word Ardhavabhedaka is a combination of three words. Ardha meaning half, Ava (Antarbhage) from within and Bhedaka meaning cutting type of pain. All Acharyas have explained its cardinal symptom as Ardha Mastaka Vedana i.e., pain in one half of the head. Pain is seen specifically in nape of neck, eyebrows, temples, ears and eyes. It will be like that of head being cut by a sharp weapon, or of churning [2] or pricking type.[3]

Ardhavabhedaka can be correlated to Migraine. According to data from the World Health Organization, Migraine is the third most prevalent medical condition in the world, affecting 14.7% of the population annually.[4] It is the second most common cause of headache, it afflicts approximately 15% of women and 6% of men worldwide.[5] Its prevalence is the highest during young and middle adulthood and peaks between the age of 30 and 39, in this period 28.1 % of women and 9.0 % of men will suffer from migraine.[6]

Etiological factors include faulty practices like intake of Rukshahara (dry foods), Adhyasana (intake of food before proper digestion of previous meal), long term exposure to strong winds and mist, Atimaithuna (excessive copulation), Vegasandharana (suppression of natural urges) and Athivayama (excessive exercise).[1] This disease when left untreated or when not treated properly will lead to damage of eyes and ears.[1] Hence it is important to treat it in the right way. This is based on proper understanding of Sannikrushta Nidanas of the disease.

Viprakrushta Nidana in Ardhavabhedaka

  • Ruksha Ahara (Consuming foods that are dry)
  • Adhyashana (Consuming food even before previous meal is digested)
  • Atyashana (Intake of food beyond one’s capacity)
  • Ayasa (excessive exertion)
  • Pragvata (strong winds blowing from opposite direction)
  • Avashyaya (exposure to mist)
  • Atimaithuna (indulgence in excessive sexual activity)
  • Vega Sandhara (suppression of natural urges)

Sannikrushta Nidana in Ardhavabhedaka

Different authors opine differently regarding the Dosha involved in the Samprapti of Ardhavabhedaka. All opinions have been clinically found in different cases of Ardhavabhedaka. Understanding the course of Doshas and the reason as to why it has triggered a headache is quite a challenging attempt.

The main Dosha involved in Ardhavabhedaka according to different authors.

  • According to Charaka - Vata or Vata + Kapha.
  • According to Sushrutha - Tridoshaja
  • According to Vagbhata - Vataja
  • According to Dalhana - Vata + Pitta
  • According to Videha - Vata + Kapha
  • According to Satyaki - Vataja
  1. Kevala Vataja Ardhavabhedaka - Ardhavabhedaka with the involvement of only Vata Dosha would probably be caused by Ati Vruddhi of Vata Dosha in the Shiras.

For instance,

Aharaja Nidana - Ruksha Ahara i.e., Excessive intake of pulses, millets, biscuits and inadequate intake of ghee, butter in food will lead to Vata Prakopa in the Koshta. This Vata can interfere with the process of Ahara Rasa formation. The Rasa and Rakta Dhatu which are getting formed might get vitiated by Vata Dosha. Such Rasa and Rakta when it reaches the Shiras might trigger pain resulting in Ardhavabhedaka.

One of the theories of pathophysiology of migraine i.e., vascular theory opines that the vasoconstriction followed by a vasodilatation will trigger an adjacent nerve root resulting in pain. The Rasa and Rakta flowing together in a blood vessel which would have been vitiated by Vata Dosha would result in such pathology wherein there could be a sudden vasoconstriction by Vata Dosha. Hence triggering a Kevala Vataja Ardhavabhedaka.

Viharaja Nidana - Pragvata being one of the Viharaja Nidana of Ardhavabhedaka refers to the strong wind those preceeds thunderstorms. Such winds have Ruksha property. On continuous exposure to such strong winds, it can result in Vata Prakopa in the Shiras. Prakupita Vata gives rise


Journal of Ayurveda and Integrated Medical Sciences 2022;7(1)280
Deeksha R. et al: A conceptual understanding on the Sannikrushta Nidana of Ardhavabhedaka

to pain. According to the American Migraine foundation, cold and dry air in the winter may result in dehydration and lead to migraine attacks. Also, a high barometric pressure of the wind might cause vasoconstriction and consecutive vasodilatation when the pressure drops down. This could trigger a migraine headache.

Lack of sleep is one of the triggers of migraine. Melatonin hormone helps in falling asleep. Low levels of melatonin have been linked to migraine. Raatri Jagarana according to Ayurveda results in Vata Prakopa. This Vata triggers a headache.

  1. Sakapha Vataja Ardhavabhedaka - Here, the involvement of both Kapha and Vata is present. Videha explains this Samprapti in detail. He says that Vata which is vitiated by its particular Nidana would be obstructed by Kapha and thus resulting in Ardhavabhedaka with symptoms such as Sphutana(bursting type of pain), Dalana (Splitting type of pain) and Avadaarana (Cracking type of pain).

For instance

Atyashana - Eating in excess quantity will lead to Agnimandya and Ama Dosha. Kapha gets vitiated because Ama and Kapha have similar properties. Similarity is a cause for increase. This vitiated Kapha blocks the minute Srotas in the Shiras, resulting in Sthanika Vata Prakopa and Shirashoola.

  1. Sapitta Vataja Ardhavabhedaka - Sapitta Vataja line of Samprapti which Dalhana says is probably an Avaranajanya Samprapti i.e., Avarana of Vata Dosha by Pitta. The Lakshanas told in the context of Pittavruta Vata like Bhrama (Dizziness), Tama (Blacking out), Daha (Burning sensation) and Shoola (Pain) can also be seen in cases of Sapitta Vataja Ardhavabhedaka. Due to the Marga Aavarana of Vata Dosha by Pitta, the Rasaadi Dhatu Poshana and its movement would be hampered and it might cause further Vata Vruddhi resulting in severe pain.

For instance

  • Adhyashana - According to principles of Ayurveda, one should consume food only after the previous meal is completely digested. Adhyashana is an incorrect pattern of eating and will lead to formation of Ama(partially digested food). Ama reduces
  • the strength of Agni, thus resulting in further formation and accumulation of Ama. This will lead to vitiation of all three Doshas. Pitta gets vitiated as the undigested food which stays in the Amashaya for a long time attains Shuktatva(fermentation). Shukta Ahara Rasa will attain Amlatva and increase the Drava Pitta in the Koshta. This again leads to Agnimandya and further formation of Vidagdha Pitta. Later vitiated Pitta along with Vata lodges in the Shiras, resulting in Shirashoola.
  • Kshut Vegadharana - Kshut Vegadharana (suppression of hunger) will result in Prakopa of Vata and Pitta which in due course might end up in Ardhavabhedaka when these attain Sthanasamshraya in Shiras.
  1. Tridoshaja Ardhavabhedaka - Tridoshaja Ardhavabhedaka is probably because of combined vitiation of all three Doshas.

For instance

Exposure to Avashyaya will increase Sthanika Kapha Dosha. If a person who is doing Adhyashana and consuming Ruksha Ahara might have an increase of Vata and Pitta Dosha in the Koshta. Now these two Doshas might attain Sthanasamshraya in the Shiras by attaining Urdhwagati if that person does prolonged Vega Dharana of any of the Apana Vegas.

Conclusion

In today’s changing lifestyle and eating habits, Ardhavabhedaka has become quite a common disease which affects the life of a person to a major extent. Hence it is important to understand the causative factors and reduce suffering among the patients. Medication is only a part of the management. Major portion of management includes avoidance of cause and triggering factors. For Samprapti Vighatana of Ardhavahedaka, it is important to understand the causative factors.

Reference

  1. Bhisagacharya PHS, editor, Ashtanga Hrudaya of Vagbhata, Uttarasthana; Shirorogavijnaneeya; Chapter 23, Verse 8. Varanasi; Chaukhamba Prakashana, 2010; 859
  2. Acharya YT, editor, Charaka Samhitha of Agnivesha, Siddhisthana; Trimarmeeyasiddhi; Chapter 9, verse 74-8. Varanasi: Chaukhamba Krishnadas Academy,2010; 721

Journal of Ayurveda and Integrated Medical Sciences 2022;7(1)281
Deeksha R. et al: A conceptual understanding on the Sannikrushta Nidana of Ardhavabhedaka
  1. Acharya YT, editor, Sushrutha Samhitha of Sushrutha, Uttara Tantra; Shirorogavijnaaneeya; Chapter 25, Verse 15. Varanasi: Chaukhambha Krishnadas Academy, 2009; 655
  2. Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990– 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;280:2163–96.
  3. Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. Harrison's principles of internal medicine. 17th ed. New york: The Mc Graw Hill Companies; 2008.p.96-8.
  4. Smitherman AT, Clinician’s Manual on Migraine, chapter 1, Springer International Publishing Switzerland; 2016.pg1-2.

Journal of Ayurveda and Integrated Medical Sciences 2022;7(1)282