E-ISSN:2456-3110

Review Article

Pathya Apathya Aahar

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 9 September
Publisherwww.maharshicharaka.in

A systemic review on probable role of Pathya Apathya Aahar in Vaatrakta with special references to Gouty Arthritis

Jha S1*, Raghuwanshi V2, Singh V3
DOI:10.21760/jaims.8.9.23

1* Sushil Kumar Jha, Post Graduate Scholar, Department Of Kayachikitsa, Govt Ayurvedic College And Hospital Kadamkuan, Patna, Bihar, India.

2 Vivek Raghuwanshi, Post Graduate Scholar, Department of Kayachikitsa, Govt Ayurvedic College and Hospital Kadamkuan, Patna, Bihar, India.

3 Vijay Bahadur Singh, Associate Professor HOD, Department of Kayachikitsa, Govt Ayurvedic College and Hospital Kadamkuan, Patna, Bihar, India.

Pathya Aahar is a conducive diet which has beneficial effect over the body and mind without causing any untoward effect. Apathya Aahar is a deleterious diet which is harmful to physical and mental well being. In Ayurveda, Pathya has been described according to Dosha, Dushya, Deha Prakriti and Vyadhi.[1] When we choose a diet for a disease based on Pathya Kalpna that pacify vitiated Doshas, improve the action of the Aushadhi, fight against pathogens, and clear the Srotas. It is very much necessary for the patients to have the food which will keep their Dhatu in healthy state and will not let them get vitiated more from Doshas. Vatarakta is the disease which is caused by vitiation of Vata as well as Rakta. Aggravated Vata is blocked by vitiated Rakta, in turn leading to further aggravation of Vata. Gout[2] is a common form of inflammatory arthritis that is very painful. Gout[3] happens when urate, builds up and forms needle-shaped mono sodium urate crystals in the joints. Urate comes from purines, which are found in body’s tissues and many foods. Dietary adjustments based on nutrient composition should be an important component of routine care for gout. Wholesome Diet play a vital role in prevention and treatment of Vatrakta (Gout).

Keywords: Pathya, Apathya, Vaatrakta, Gout, Dosha, Uric Acid.

Corresponding Author How to Cite this Article To Browse
Sushil Kumar Jha, Post Graduate Scholar, Department Of Kayachikitsa, Govt Ayurvedic College And Hospital Kadamkuan, Patna, Bihar, India.
Email: 		Jha S, Raghuwanshi V, Singh V, A systemic review on probable role of Pathya Apathya Aahar in Vaatrakta with special references to Gouty Arthritis. J Ayu Int Med Sci. 2023;8(9):145-148.
Available From
https://jaims.in/jaims/article/view/2670

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-07-11 2023-07-17 2023-07-24 2023-07-31 2023-08-23
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None declared. Nil Yes 22.67%

© 2023by Jha S, Raghuwanshi V, Singh Vand 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].

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Sushil Kumar Jha et al. Role of Pathya Apathya Aahar in Vaatrakta w.s.r. to Gouty Arthritis

Introduction

Pathya is derived from the word ‘Patha’- means the path. Pathya is a Sanskrit word that means -“belonging to a particular way” or being healthy. Appropriate Pathya, is the Aahar-Vihar that calms the mind, is beneficial to the body, and provides nutrients. To stay healthy, Pathya Kalpana must be used in Dinacharya, Ritucharya.[4] It is also very much necessary for the patients to have the food which will keep their Dhatus in a healthy state. Pathya is that which brings the vitiated Doshas to normal and Apathya are those which causes vitiation and abnormalities in the Doshas. Vata and Rakta are Dosha and Dushya of Vatarakta.[5]

The Viprakrista Nidana of Vatarakta are those factors which are responsible for vitiation of Vata and Rakta. Gout is a type of arthritis that causes intense pain, swelling, and stiffness, often in the joint at the base of the big toe. The main cause is having too much uric acid in the body, possibly due to dietary factors. Purines, a common chemical compound found in foods and drinks are metabolized by the body and turned into uric acid. Uric acid is then filtered out of the bloodstream by the kidneys. If excess uric acid builds up in the bloodstream, it can lead to the formation of uric acid crystals in one or more joints, resulting in gout.[6] Limiting the consumption of purine rich foods and drinks may help treat hyperuricemia and reduce the risk of gout flare-ups.

Aim of the study

To study the Pathya-Apathya in Vatarakta (Gout).

Discussion

Pathya (wholesome) is that which is not harmful to paths (of the body) and is according to liking. The entities have their effects according to dose, time, preparation, place, body constitution, pathology and properties. Acharya Charaka mentions the word Pathya as synonym of Chikitsa (treatment). This shows if wholesome food is taken in right time, quantity etc. can help to recover from disease condition either alone or with other medications.

“Pathye Sati Gadaarthasya Kimoushadha Nishevanaih

Pathye Asati Gadaarthasya Kimoushadha Nishevanaih”

Vaidya Lolimbiraja indicated the importance of wholesome food (Pathya Aahar) by stating that if a patient intakes wholesome food then there is no need of medicine and if a patient continuously consumes unwholesome food then also there is no need of medicine. In the latter case, medicine will not be effective.

The illnesses produced by the unification of vitiated Vata and Rakta cause several health disorders. Vatarakta[7] is one of them. Vata Prakopa, Rakta Dushti and obstruction in the Path of Vata is the core pathology in the disease. The pathology of this disease originates in blood, spreads through blood vessels and nerves and then finally get settled in the joints. Excessive consumption of foods articles which are Lavana (salty), Amla (sour), Katu (astringent, pungent) in taste, Kshara (alkaline) and Snigdha (unctuous) properties, Ushnaahara (food stuffs having Ushnavirya), Ajirnabhojana (eating food prior to digestion), Klinna-Anoop-Shushka Mamsa (excessive use of aquatic or marshy land animals or of desert region which are dry in nature), use of Pinyaka (tilpishta), Mulaka (raddish), Kulath (horse gram), Masha (black gram), Shaka (leafy vegetables), Palala (mutton), Ikshu (sugar-cane), Dadhi (curd), Arnala, Souviraka, Shukta, Sura, Asava (all fermented drinks) are the causative factors of Vata-Rakta. Habit of taking Virudhaahara (incompatible diet), Adhyashana (intake of food prior to digestion of meal earlier taken), Krodha (anger), Diva Swapana (sleeping in day hours) and Prajagarana (nocturnal awakening) are also said to be the causative factor.[8]

Vatarakta as mentioned in Ayurvedic texts have very close resemblance with Gout. Gout[9] is both an inflammatory and a metabolic disease. Gout affects about 1 to 2% of adults in the developed world at some point in their lives. It has become more common in recent decades. This is believed to be due to increasing risk factors in the population, such as metabolic syndrome, and changes in diet and lifestyle. Dietary causes account for about 12% of gout, and include a strong association with the consumption of foods richest in purines yielding high amounts of uric acid. The crystallization of uric acid, often related to relatively high levels in the blood, is the underlying cause of gout. This can occur because of diet, genetic predisposition, or underexcretion of urate, the salts of uric acid. Uric acid increased accumulation and or reduced excretion in human bodies is closely


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Sushil Kumar Jha et al. Role of Pathya Apathya Aahar in Vaatrakta w.s.r. to Gouty Arthritis

related to pathogenesis of gout and hyperuricemia. It is highly affected by the high intake of food rich in purine.

Diets provide abundant raw materials of purine, which is mainly metabolized in the liver, promoting uric acid production. Meanwhile, it can interfere with the intestinal environment, homeostasis, and urate transport to induce high levels of uric acid, leading to hyperuricemia and ultimately to gout. Dietary modification can reduce serum urate by 15% and delay the need for drugs that reduce serum urate levels.

Pathyahar (wholesome) for Gout[10,11]

The Pathyahar in Vatarakta (gout) are following

1. Dhanya Varga (Cereals)
Cereals like Yava (old barley), Sathi, Nivar (a type of wild rice), Kalam Chawal, Lal Shali as well Sastika type of rice, Godhum (wheat) these are Pathyahar as mentioned in Bhaishajya Ratnavali and Yog Ratnakar. In Sushrut Samhita, Annapanvidhi properties of all of above is described. So, we see that these all Dhanya are Tridosh Shamak and specially works in Pitta Dosha and Laghu for digestion, Balya, Medohar. Acharya Sushrut describe Godhuma (Wheat) as Bhagnasthi Samyojaka, Yava as Rakta Pitta Prasadaka, Lekhan, Medohar, Rakta Shali said to be Jwar and Vishnashak. So, these all Dhanya are wholesome for the Vatrakta.
2. Shimbi Varga (Pulses)
Chana (chickpea), Moong (green gram), Arhar (pigeon pea), Makustha these all pulses described in Charak Samhita, Bhaishjya Ratnavali and Yog Ratnakar. Acharya Charaka mentioned the use of Shimbi Varga with liberal quantity of Ghrita.[12] Acharaya Sushrut said that these all pulses are Pitta Shamak and Rakta Prasadaka.
3. Mansa Varga
Soup of meat of Viskira (gallinaceous) and Pratuda (pecker) birds like Lava (king quail), Teetar (partridge), Kukkuta (chicken), Kapota (pigeon) etc. Lava and Teetar Mansa is described as Tridosh Shamak, Lava Mansa have Katu Vipak, work as Agni Deepak, Kukkuta Mansa described as Snigdha and Brihana, so these all are Pathya according to Bhaisajya Ratnavali and Yog Ratnakar.
4. Dugdha Varga
Goat and cow milk both described as Pathya by Bhaishjya Ratnavali and Yog Ratnakar. Acharya Sushrut said these milks are
Snigdha, Rasayan, Raktapittahar,

Vatapitta Nashak, Sarvarognashak.
5. Shaak Varga
Leafy vegetables like Poi, Makoya, Ventagra, Bathua, Kareli, Chaurai, Adrak, Patolpatra, Surankanda, Shweta Kushmanda these are Pathya by Bhaishajya Ratnavali and Yog Ratnakar. Acharya Sushrut described these Shaak as Kaphapittahar, Laghu, Prameh, Jwar, Kushtha Nashak.
6. Phala Varga
Amla, Munakka are Pathya as mentioned in Bhaishajya Ratnavali and Yog Ratnakar.
7. Others
Ghee, Butter, Erand, coffee.
Apathyahar (unwholesome) for Gout[13,14]
Katu, Lavan Ras, Ushna, Viruddha Anna, Masha, Kulthi, Sem, Nishpav, Kshar, Mooli (Radish), Kanji, Tila Tail etc.
1. Salty diet - Excessive intake of salty diet causes impairment in proper excretion of water and proper flushing of uric acid through the urine. Salty diet causes dehydration so excessive intake of salty diet provoke the gout.
2. Shaak Varga like spinach, mushroom, and cauliflower increase the risk of gout because these vegetables are highly rich in purine.
3. Pulses like Kultha, Masha, Nishpav are rich in purine. These purines metabolize and results in uric acid as endproduct.
4. Dairy product - Dadhi (curd) or Takra (buttermilk) are rich in protein.
5. Sea foods - Meat of aquatic animals, Sea foods like mussels, crab, shrimps and other shellfish, fish roe, caviar are strictly restricted in gout due to high purine contain.
6. Alcohol - Especially beer cause increase in purine level.
7. Fructose rich diet - Ikshu and all sweet items like cake, pastries etc. - these food items are rich in fructose. Fructose increases uric acid production during its phosphorylation by increasing adenosine triphosphate (ATP) decompose to adenosine monophosphate (AMP), a uric acid precursor. So, in very short time after intake of fructose, uric acid concentration is increased.
8. Shuska Anna - water is responsible for proper functioning of kidney. It removes acidic waste from body. Decreased amount of water inside the body causes retention of acidic wastes in the blood including uric acid, which should be flush out from the body, causing hyperuricemia.
These all factors are responsible for Vatarakta, so these things should be avoid by the patient suffering from Vatarakta.


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Sushil Kumar Jha et al. Role of Pathya Apathya Aahar in Vaatrakta w.s.r. to Gouty Arthritis

Conclusion

Ayurveda emphasises on importance of wholesome food in maintaining health and curing diseases for promoting good health. Gout is a disorder of purine metabolism. The recognition of diet-induced systemic metabolic pathways has provided new mechanistic insights and potential interventions on gout progression. However, the dietary recommendations for gouty patients generally focus on food categories, with few simultaneous considerations of nutritional factors and systemic metabolism. Dietary modification might represent an appropriate nutritional regulation for gout patients or for potential patients to effectively reduce the incidence of gout.[15]

References

1. Agnivesh, Charaka Samhita vol. 2, by Acharya Vidyadhar Shukla, Prof. Ravi Dutt Tripathi, foreword by Acharya Priy Vrata Sharma, reprint edition 2012, Chaukhambha Sanskrit Pratishthan, Delhi.

2. Davidson’s principles & practice of Medicine, edition 22nd, edited by Brian R. Walker, Nicki R. College, stuart H. Ralton, Ian d. Penman.

3. Davidson’s principles & practice of Medicine, edition 22nd, edited by Brian R. Walker, Nicki R. College, stuart H. Ralton, Ian d. Penman.

4. Agnivesh, Charaka samhita vol. 1, by Acharya Vidyadhar Shukla, Prof. Ravi Dutt Tripathi, foreword by Acharya Priy Vrata Sharma, reprint edition 2012, Chaukhambha Sanskrit Pratishthan, Delhi.

5. Agnivesh, Charaka samhita vol. 2, by Acharya Vidyadhar Shukla, Prof. Ravi Dutt Tripathi, foreword by Acharya Priy Vrata Sharma, reprint edition 2012, Chaukhambha Sanskrit Pratishthan, Delhi.

6. Davidson’s principles & practice of Medicine, edition 22nd, edited by Brian R. Walker, Nicki R. College, stuart H. Ralton, Ian d. Penman

7. Agnivesh, Charaka Samhita vol. 2, by Acharya Vidyadhar Shukla, Prof. Ravi Dutt Tripathi, foreword by Acharya Priya Vrata Sharma, reprint edition 2012, Chaukhamba Sanskrit Pratishthan, Delhi.

8. Agnivesh, Charaka Samhita vol. 2, by Acharya Vidyadhar Shukla, Prof. Ravi Dutt Tripathi, foreword by Acharya Priy Vrata Sharma, reprint edition 2012, Chaukhamba Sanskrit Pratishthan, Delhi.

9. Davidson’s principles & practice of Medicine, edition 22nd, edited by Brian R. Walker, Nicki R. College, stuart H. Ralton, Ian d. Penman

10. Bhaisajya Ratnavali of Kaviraj govind das Sen, by siddhi Nandan Mishra, Chaukhambha Surbharti Prakashan, Varanasi.

11. Yogaratnakara by Vaidya Lakshmipati Sastri, edited by Brahmasankar Sastri, edition reprint 2015, Chaukhambha Prakashan.

12. Agnivesh, Charaka samhita vol. 2, by Acharya Vidyadhar Shukla, Prof. Ravi Dutt Tripathi, foreword by Acharya Priy Vrata Sharma, reprint edition 2012, Chaukhambha Sanskrit Pratishthan, Delhi.

13. Bhaisajya Ratnavali of Kaviraj govind das Sen, by siddhi Nandan Mishra, Chaukhambha Surbharti Prakashan, Varanasi.

14. Yogaratnakara by Vaidya Lakshmipati Sastri, edited by Brahmasankar Sastri, edition reprint 2015, Chaukhambha Prakashan.

15. Robert L, wortman & William M Kelley, 2001- Kelley’s Textbook of Rheumatology vol-2 6th edition W.B. Saunders company. p. 1339-1376.


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