A comprehensive classical review on Ardita w.s.r. to Bell’s palsy

Gangaram Kannoje; Preeti Chaturvedi; Nupur Namdeo

A comprehensive classical review on Ardita w.s.r. to Bell’s palsy

Kannoje G.^1*, Chaturvedi P.², Namdeo N.³

DOI:

^1* Gangaram Kannoje, Post Graduate Scholar, PG Department of Panchkarma, Pt. Khushilal Sharma Government (Autonomous) Ayurveda College & Institute, Bhopal, Madhya Pradesh, India.

² Preeti Chaturvedi, Reader, PG Department of Panchkarma, Pt. Khushilal Sharma Government (Autonomous) Ayurveda College & Institute, Bhopal, Madhya Pradesh, India.

³ Nupur Namdeo, Post Graduate Scholar, PG Department of Panchkarma, Pt. Khushilal Sharma Government (Autonomous) Ayurveda College & Institute, Bhopal, Madhya Pradesh, India.

Facial function plays an integral part in everyday lives disability of both verbal communication and facial expression are hampered in Ardita. Acharya Charaka has considered Ardita as one among the 80 Vataja Nanatmaja Vyadhi in Sutra Sthana. Ardita can be result of long-term suppression of natural urges like sneezing & Pandiculation. The features of Ardita mostly resemble with palsy of 7th nerve such as deviation of face, loss or decreased function of the affected muscles, Numbness of the particular area. Main causative Dosh of Ardita is Vata, so the line of treatment is mainly based on the principal treatment of Vata.

Keywords: Ardita, Facial paralysis, Vata Vyadhi, Ayurveda, Nasya, Tarpana

Corresponding Author	How to Cite this Article	To Browse
Gangaram Kannoje, Post Graduate Scholar, PG Department of Panchkarma, Pt. Khushilal Sharma Government (Autonomous) Ayurveda College & Institute, Bhopal, Madhya Pradesh, India. Email:	Gangaram Kannoje, Preeti Chaturvedi, Nupur Namdeo, A comprehensive classical review on Ardita w.s.r. to Bell’s palsy. J Ayu Int Med Sci. 2022;7(8):116-119. Available From https://www.jaims.in/jaims/article/view/2035

Introduction

The word “Ardita” implies a person afflicted or troubled. (Acc. to Shabdakalpdruma) The word Ardita is derived from the word “Ardana” which means pain or discomfort, or trouble.^[1]

Ardita is a disease is which there is a deviation leading to deformity of one side of the face alone or along with one side of the body.

“Ardhe Tasmin Mukhaardhe Va Kevale Syaattadarditam”

Sushruta says that the mouth and other regions e.g. The head are affected, while the Vagbhatta says half of the face is involved with or without involvement of half of the body. Acharya Charaka has described 80 types or Vataj Nanatmaj Vyadhi, Ardita is one among them.^[2] It can be correlated with the disease Bell’s palsy most common cause of unilateral facial paralysis first described by Sir Chales Bell.

As mentioned above Ardita is one of the Vata Vyadhi. It is also correlated with facial palsy or 7^th Nerve palsy. In Ayurveda it is explained as a specific disease afflicting the Urdhavanga (Jatrurdhwa) part above the neck particularly the face. And it is also an established fact that Nasya is one of the best measures to treat diseases manifested in Jatruvrdhwa. Ushna, Snigdha, Guru Gunas needed for the treatment of Ardita can easily attained by Navana, Tarpana, Moordha Taila, Nadi Sweda & Upanah Sweda which is required to counter the Ruksh, Sheeta, Laghu Gunas of Vata which is predominate Dosha in the Ardita.

Facial nerve is the 7^th cranial nerve situated in pons lateral to root of 6^th nerve. Bell’s palsy is a LMN disease. Characterized by ache in the region of the stylomastoid foramen result in pressure on the nerve causing paralysis of function.

The main synonym of the condition is paralysis of facial nerve, as per Ayurveda in Ardita Vata Dosha vitiation in Uttamanga, the line of treatment is focused on Vata Shamana in Uttamanga.

Aim and Objective

To critically analyse the statement - Ardita Navana Moordha Tail Tarpana Mev Cha.

Materials and Methods

Brihtrayi and Laghuatriya were screened to compile reference. Davidson, Harrison’s medicine was screened for the word facial palsy.

Definition of Ardita

1. The disease is localized in half of the face with or without involvement of body. (Acc. to Charaka)^[3]

2. The Vata vitiated gets localized in the half of the face. (Acc. to Sushruta)^[4]

3. Half of the face get distorted along with or without the involvement of half of the body. (Acc. to Vagbhatta )^[5]

4. Ardita is also known as Ekayam.

5. Sharangadhara - Condition affecting half of the face.^[6]

5. Arundatta - affecting half of the face.

Modern view: Paralysis of any structures innervated by facial nerve is known as facial palsy. Word ‘Palsy’ implies an abnormal condition where loss of motor or sensory function is impaired ⁸. Bell’s palsy is the most common cause of unilateral facial Paralysis. First described by Sir Charles Bell. Facial paralysis is due to the lesion of the pyramidal tract b/w the cortex and middle of the pons (UMN) paralysis & the 7^th cranial nerve (LMN) paralysis.

Feature of Bell’s Palsy

Onset is sudden.

Eyelid droops.

Eyebrow rising is in possible.

Absence of Nasolabial fold.

Paralysis of muscle of facial expression.

Deviation of half of face, nose, eyebrows, forehand.

Escape of food & fluids from angle of the mouth.

Nidana: Specific Nidana for Ardita are not described general Nidanas of Vata Dosha can be considered as a causative factor of Ardita. Acharya Charaka - Nidana of Vata Vyadhi as Nidana of Ardita, also is Siddhi Sthana specific Ardita is complication arising due to suppression of the urge of sneeze.

General Nidana of Vata Vyadhi (Acc. To Acharya Charaka):

Intake of Ruksha(dryness), Sheeta(cold), Alpa (less quantity) and Laghu Anna (light to-digest food), Ati Vyavaya (Excessive sexual indulgence), Prajagarana (Remaining awake at night in excess),

Vishama Upachara (Inappropriate panchakarma/ other therapies), Ati Dosha Sravana (excess of panchakarma therapies) , Ati Asruk Sravana(excess Raktamokshana treatment or excess bleeding), Ati Plavana (Excessive swimming), Ati laghana (Excessive fasting), Atyadhav (Walking for long distance), Ati Vyayama (Resorting to wayfaring, exercise and other physical activities in excess),Dhatu Samkshayaat (Depletion of body tissues, loss of Dhatus), Chinta Shoka Karshana (Weakening due to excess stress, grief and worries), Roga Ati Karsana (Excessive emaciation because of affliction of diseases), Dukha Shyyasana (Sleeping over uncomfortable beds and sitting), Vega Vidharana (Suppression of natural urges),Krodha (Anger), Diwa Swapna (sleep during day time, Bhaya (fear),Formation of Ama (product of improper digestion and metabolism), suffering from trauma and abstention from food), Marmaghata (injuries to Marma (vital spots) and riding over an elephant, camel, horse or fastmoving vehicles and vehicles. because of the above-mentioned factors, the aggravated Vata fills up the empty body channels (Srotas).

Acharya Sushruta (Su.Ni.1/68) Listed Nidan of Ardita & Vagbhatta (Vg.Ni 15&16) Ardita is due to vitiated of Pranavata.

Physical factors

1. Churning hard food stiffly.

2.Carrying heavy loads on the head.

3. Sleeping in uneven postures.

4. over exercise.

5. 5. Cold bath.

6. Continue & Excessive laugh.

7. Talking & speaking loudly.

8. Yawning.

Pathological factors

Asamyak Prasooti.

Sutika Dosa.

Emaciated person.

Psychological: Fear, Grief etc.

Dietic factors: Anashana. Tikta, Katu, Kasaya Rasa seven. Excessive intake of the Laghu Ruksha, Shita, Ahara.

Yogaratnakara added some specific Nidana

Excessive tongue scraping. Siravyodhana (improper), Excessive rubbing of the eyes, ears, & nose, Injury to Marma.

Samanya Samprapti

Acc. to Acharya Charaka Vata gets vitiated by the various etiological factors, in the Rakta Srotas and affects the whole body or some specific part of the body.

Vishista Samprapti

Samprapti of Ardita (With Flow chart)

Due to Nidan Sevan

↓

Vata Dosha get vitiated

↓

Get localized in the regions of head, nose, chin, forehead, eyes

↓

Result of Shoshan Rakta Dhatu (reduce blood supply)

↓

Ardita

Samprapti Ghataka

Dosha: Vata
Dushya: Rasa, Rakta, Sira, Mansha
Adhistana: Mukhardha
Srotasa: Rasavaha, Rakta Vaha, Mansavaha, Pranavaha
Sroto Dusti: Sang, Sira Granthi
Agni: Vishamagni
Vyadhi Savbhava: Navin-Mardhu, Girna - Daruna
Sadhyasadhya: Navin- Sadhya, Girna-Yapya /Ashadhya

Chikitsa

“Ardita Navana Moordha Tail Tarpana Mev Cha

Naadiswedo Upnaahashchaapya Anupapishitairhitaah”

Prior to Nasya Abhanga and Mridu Swedana is essential. Snuffing of any Snehana is called Nasya Karma.

1. Navana: Nasal instillation of medicated oil. Navana medicine reaches to Shrungatka Marma from where spreads into Srotas. This type of Nasya provides strength of neck, shoulder, chest, improving the vision. Nasya provides nourishment to nervous system by neural diffusion and vascular pathway. The drug administered through the nose as Nasya reaches the Brain eliminates the morbid Doshas responsible for producing the disease.

2. Tarpana: (filling oil to eyes) Nourishment & strength to the eye.

3. Moordha Tail: (Holding medicated oil on head) Help in stimulating the nerve & sense organs control vitiated Dosha of head. Moordha Tail has Vatahara properties thereby improving the motor function of the facial nerve.

4. Nadi Sweda: (fomentation) or tubal sudation enhance the local microcirculation by dilation of blood vessel & increases blood flow.

5. Upnaha (Poultice): Poultices with meat of animals. (Poultice is made by the paste of medicinal drug is applied and Bandhan is done.)

Nasya and Tarapana with Snehana provides relief in Vata obstruction specially, the flow of Vyana Vata. Eye blinking is hampered by the Chal Guna of Vata relieved by the Sthira Guna of Sneha.

This regimen providers strength to facial muscles, strengthens the nerve, improve the blood circulation improved the motor function by stimulating and strengthens the facial nerve and muscles. By the collective effect of therapy relieve compression and ischemia of the nerve.

Discussion

Abhyanga with Navneet (Mukha Pradesh) followed by Dashmool Siddha Ksheera, Dhooma, Nasya Karma with Ksheerbala Taila, Tarpana, Shirolepa (Rasnadi Churna + Amalaki + Ksheerbala Taila). Repeated course as per needed.

Conclusion

Bell’s palsy can be correlated with Ardita in Ayurveda as compared with the signs and symptoms Ardita can be managed with comprehensive application of Ardita Navana Moordha Tail Tarpana Mev Cha…this combined treatment pacifies the vitiated Vata in the body, provide nourishment to the sense organ. Hence, by the above said point it can be concluded that Ardita Navana Moordha Tail Tarpana Mev Cha… is the best line of treatment for Ardita.

Reference

1. http://en.wikipedia.org/wiki/Obesity.in.Indiadated-27|03|2017.

2. http://WHO.int>nutrition>topicics>obesitydated-30|03|2017.

3. Madhava Nidanam of Madhavakara by Prof. K. R. Srikantha Murthy published by Chaukhamba Orientalia, Varanasi 2016,pg.121.

4. Acharya Vridha Vagbhatta, Astanga Samgraha, edited with saroj Hindi commentry by Ravi Dutt Tripathi, publishedby Chaukhamba sanskrit Pratishthana, Varanasi,UP, Edition2003, Sutrasthana,chap.3:63,pg50.

5. Bhavamishra, Bhavaprakasha edited with Vidyotini hindi commentary by Bhisagratna. Brhamasankar Mishra’, published by Chaukhambha Sanskrit Sansthan, Varanasi, UP, 11th Edition-2012, MadhyamaKhanda, chap.39, Medorogadhikara Pg.407.

6. Swami Muktibodhananda Hatha Yoga Pradipika published 2011.pg 67,82.

7. BKS. Iyengar forwarded by Yehudi Menuhin, Light on yoga 2000, PG 66to74,111 to 112,237to 242.

Manuscript Received	Review Round 1	Review Round 2	Review Round 3	Accepted
2022-08-01	2022-08-02	2022-08-09	2022-08-16	2022-08-23
Conflict of Interest	Funding	Ethical Approval	Plagiarism X-checker	Note
Nil	Nil	Yes	18%

Review Article

Ardita

Journal of Ayurveda and Integrated Medical Sciences