E-ISSN:2456-3110

Review Article

Review on Janusandhigata Vata

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 2 February
Publisherwww.maharshicharaka.in

A review on Janusandhigata Vata

Swetha Bm1*, Kulkarni M2, Hullur Y3
DOI:10.21760/jaims.9.2.39

1* Swetha Bm, Post Graduate Scholar, Dept of Kayachikitsa, Ayurveda Mahavidyalaya and Hospital, Hubballi, Karnataka, India.

2 Madhusudhan Kulkarni, Associate Professor, Dept of Kayachikitsa, Ayurveda Mahavidyalaya and Hospital, Hubballi, Karnataka, India.

3 Yaseen Hullur, Assistant Professor, Dept of Kayachikitsa, Ayurveda Mahavidyalaya and Hospital, Hubballi, Karnataka, India.

Janusandhigata Vata is explained in concise form in our Samhitha. The symptoms includes Vatapoorna-Dritisparsha, Sandhi Shotha, Prasarana Acuchanayo Vedana, Atopa, Sandhi Hanti. Various treatment modalities have been employed such as Bahya and Abhyantara Snehana, Basti Prayoga, Upanaha, Agnikarma, Bandhana, Unmardana. Aetiology and symptomology of Sandhigata Vata mentioned in Samhitha, mimics with the symptoms of osteoarthritis of contemporary science. Osteoarthritis is defined as a non-inflammatory degenerative joint disease marked by degeneration of articular cartilage, accompanied by pain and stiffness of joints. When left untreated this disease makes the person crippled and dependent on others for attending normal daily activities.

Keywords: Janusandhigata Vata, Sandhigata Vata, Vata Dosha, osteoarthritis

Corresponding Author How to Cite this Article To Browse
Swetha Bm, Post Graduate Scholar, Dept of Kayachikitsa, Ayurveda Mahavidyalaya and Hospital, Hubballi, Karnataka, India.
Email: 		Swetha Bm, Kulkarni M, Hullur Y, A review on Janusandhigata Vata. J Ayu Int Med Sci. 2024;9(2):258-262.
Available From
https://jaims.in/jaims/article/view/3134

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-12-15 2023-12-30 2024-01-05 2024-01-15 2024-01-23
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None declared Nil Yes 20.85

© 2024by Swetha Bm, Kulkarni M, Hullur Yand 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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Swetha BM et al. A review on Janusandhigata Vata

Introduction

Vata Dosha governs all types of actions in the Shareera. Vata, due to its Sukshma and Chala Guna can even enter the minute channel, influence and control the Manas (Niyanta Praneta Ca Manasah, Sarvendriyam Udyojakah).[1] As Acharya Sharngdhara quotes, “Pittam Pangu Kapham Pangu Pangavo Mala Dhatavah, Vayuna Yatra Niyante Tatra Gacchanti Meghavat”[2] which means Pitta, Kapha, Mala and Dhatu are lame without Vata. If Vata is vitiated then the whole controlling system and normal functioning of the Dosha, Dhatu, Mala will be hampered leading to innumerable manifestation of the diseases in the Shareera, Indriya and Manas.

Among the Sapta Dhatu, the Asthi Dathu is the one which is bestowed with the supreme function of Shareera Dharana (Support). Ayurveda considers Dosha reside in Dathu or there is Ashraya Ashrayi Bhava in Dosha and Dhatu.[3] For example, Rakta Dhatu and Sweda are the residing sites for Pitta Dosha. Like that Vata Dosha resides mainly in Asthi Dhatu. Considering this, Vata Dosha vitiation plays an important role in the pathogenesis of Asthi Dathu Dushti. i.e., the Vriddhi of Vata Dosha leads to Kshaya of Asthi Dathu.

Sandhigata Vata[4] is explained under Vata-Vyadhi in Charaka Samhita. The change in the today’s life style, dietary habits, excessive mobility of joints, stress, strenuous work and suppression of natural urges due to busy schedule have influenced the health of an individual leading to early aging process and thereby, causing degeneration of the body tissue.

Further, continuously indulging in Vata aggravating factors lead to Sthana-Samshraya of Prakupita Vata in Kha-Vaigunya Yukta Sandhi. Shleshaka Kapha in these joints also depletes resulting in the Kshaya of Asthi Dhatu and other components. This localized Vayu, due to its Ruksha, Laghu, Kharadi Guna result in Sandhigatavata and if not treated, leads to Vaikalyata of Sandhi.

The symptoms of Sandhigata Vata includes Vatapoornadritisparsha, Sandhi Shotha, Prasarana Acuchanayo Vedana.[4] Sandhi Hanta,[5] Sandhi Atopa.[6] Various treatment modalities have been employed for the treatment of Sandhi-Gata Vata, such as Bahya and Abyantara Snehana, Basti

Prayoga, Upanaha, Agnikarma, Bandhana, Unmardana,[7] etc,.

Aetiology and symptomology of Sandhigata Vata mentioned in Samhitha, mimics with the symptoms of osteoarthritis of contemporary science. Osteoarthritis is defined as a non-inflammatory degenerative joint disease marked by degeneration of articular cartilage, accompanied by pain and stiffness of joints.

There is a steady rise in the prevalence from age 30, such that 65.80% of people have radio-graphic evidence of osteoarthritis, though only 25%–30% are symptomatic8. According to World Health Organization (W.H.O), Osteoarthritis is one of the most common musculoskeletal disorders in the world population which accounts for about 30 %.

Contemporary medicine aims at Exercises, Analgesics, NSAIDS, and Steroidal Injections and also in severe Osteoarthritis, Surgeries like Osteotomy, Total Knee Replacement is done.

Hence an attempt has been made to critically analyse the Nidana, Samprapti and Chikitsa of Janusandhigata Vata.

Nidana Panchaka

Nidana

Aharaja NidanaViharajaNidanaManasikaNidanaUpacharaja NidanaAnyaNidana
Ruksha AnnaAti VyayamaChintaVishama UpacharaRogati Karshana
Sheeta AnnaPrajagaraShokaAti Asruk SravanaAbhighata
Alpa AnnaVega SandharanaKrodhaAti Dosha NirharanaMarmaghata
Laghu AnnaAti VyavayaBhaya--
­-Ati Langhana---
-Ati Plavana---
-Ati Adhva---
-Ati Chesta---
-Dhukka Shayya and Asana---
-Gaja, Ushtra, Shwasa Yana or Sheeghra Yana---

All these Nidana like Ati Vyayama, Ati Bharavahana, Ati Chankramana causes Vata Prakopa and Kapha Kshaya.


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Samprapti

Dhatu Kshaya Janya and Avaranajanya are the two important factors in the Samprapti of Janusandhigatavata.

Dhatukshyajanya Sandhigatavata occurs due to continuous intake of Vatakara Ahara and Vihara which in turn leads to Sthanasamshraya in Rikta Srotas (Sandhi) and due to this, there is a depletionofDhatu.

Avaranajanya Sandhigatavata-Usually Sandhivata occurs in weight-bearing joint and in Sthoola person Medo Dhatu produced in excess produces Margavarana of Vata. Prakupita Vata due to Margavarana starts to circulate in the body. While circulating, it settles in the joint where Khavaigunya already exists. After Sthanasamshraya, it produces the disease Sandhigata Vata.

Purvarupa

Avyakta Purvarupa (Indistinct manifestations of signs and symptoms) or

Alpa Vyakta Lakshana - Sandhi Shoola.

Rupa

LakshanaAcharya CharakaAcharya SusrhutaAcharya Madhava
Vatapoornadhriti Sparsha+--
Shoola+++
Shopha++-
Hanthi Sandhi-++
Atopa--+

Chikitsa

According to Charaka Samhitha,

Samanya Vatavyadhi Chikitsa

केवलं निरुपस्तंभमादौ स्नेहैरुपाचरेत्।

वायुं सर्पिर्वसातैलमज्जपानैः नरं ततः।। च. चि. 28/75

In case of Kevala Vatavyadhi (Shuddha Vatavyadhi/ Avarana Rahita Vatavyadhi) Snehana should be administered using Sarpi, Taila, Vasa and Majja.

बाह्याभ्यन्तरतः स्नेहैरस्थिमज्जगतं जयेत् ।। च. चि. 28/ 93

If the [vitiated] Vayu is located in the Asthi and Majja then the patient should be given Bahya and Abhyantara Snehana.

According to Sushrutha Samhitha

स्नेहोपनाहाग्निकर्मबन्धनोन्मर्दनानि च |

स्नायुसन्ध्यस्थिसम्प्राप्ते कुर्याद्वायावतन्द्रितः ||Su.Chi.4/8

Snehana

Bahya Snehana

In the form of Abhyanga using Nirgundi Taila, Bala Taila or any Vatahara Taila. Helps in relieving pain and helps in restoration of movements.

Abhyantara Snehana

Can be administered in the form of Pana, Bhojana, and Basti using Panchatikta Ghrita, Ashwagandadhya Ghrita.

Upanaha

It is one of the four types of Sweda explained in Sushruta Samhita. It reduces pain, stiffness, swelling and helps in restoring the movements. Upanaha can be done using Koladi Upanaha, Kushtadi Upanaha.

Agnikarma

It is indicated in Asthi-Sandhigata Vata. Where in Kshoudra, Guda, Sneha are used to perform Agnikarma in joints. It helps to relieve pain.

Bandhana

Is bandaging tightly with leaves of Vata Shamaka drugs on affected joint. It helps in relieving Shotha.

Unmardana

It is a kneading type of massage in which pressure is excerted on diseased Sandhi. It promotes blood circulation and there by reduces swelling.

Discussion

Sandhi are seat of Shleshaka Kapha. The nature of Kapha is Sīta, Snigda. Here in Janusandhigata Vata there is Rūkşa Vrddhi and Kapha Kşhaya. Vāta and Kapha are Sita in nature. So, the medicine must be Usņa, Bhrimhaņa and Anulomana.

In case of Dhatukshayajanya Janusandhigata Vata, it is treated by Snehana, Swedana, Virechana, Basti, Rasayana.

Snehana having properties like Sara, Snigdha, Manda, it pacifies Vata. Snehana when administered provides nourishmnent to emaciated tissue.


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Swedana

After Samyak Snehana, Sthanika Abhyanga to be done on the affected Sandhi then Nadi Sweda, Prastara Sweda to be done. The utility of combined application of Snehana and Swedana has been narrated with the simile of a dry wood attaining the ability of bending after the application of Snehana and Swedana.

Upanaha Sweda has been specified in treating the Janusandhigata Vata which is the best Sthanika Chikitsa to pacify Vata, it reduces stiffness, restoration of movements.

Virechana

After attaining Mridu Koshta by Snehana and Swedana then Snehayukta Mridu Virechana Karma is indicated with Tilvaka Ghrita, Eranda Taila. It does Agni Deepana and Sroto Shodana.

Basti Karma

Among the different Chikitsa Upakrama, Basti Karma is mentioned as an important treatment modality of Vata Vyadhi. Pakvashaya is the main site of Vata Dosha. Basti when administered, it reaches Pakvashaya and spread throughout the body and removes the Sanchita Dosha from the Koshta. It includes Sneha Basti, Niruha Basti and Ksheera Basti. As Dhatu Kshaya is the main pathology involved in Sandhigata Vata, and it is a degenerative joint disease; Basti with Ksheera and Sarpi processed with Tikta Dravya is the line of treatment in Astivaha Sroto Dushti Prakara. Ksheera Basti has the Bhrimana action thus limiting the degenerative changes in the joints and arresting the pathogenesis. It is also Rasayana, Balakara and indicated in all the Vata Vikara.

Acharya Charaka explains the mode of action of Basti by giving a simile-The tree is nourished when the water is regularly sprinkled at its roots. The tree always remains healthy and green. It will be enriched with attractive green leaves, and timely appearance of flowers and fruits. Similarly when the Anuvasana Vasti is administered through Guda, all the Siras will get nurtured and the body as a whole will be nourished. All the Dhatu including Shukra will be nourished with enriched qualities.

In Avarana Janya Janusandhigata Vata

1) Treating the

2) Normalising the Vata Gati.

These two are the main objectives in managing Avarana Janya Sandhigata Vata by using the treatment modalities like, Ruksha Sweda, Snehana, Swedana, Basti.

In condition of Avarana the treatment should be done to the Avaraka first; i.e., Medas. After the Avaraka Dosha get normalized then Vata Hara measures should be adopted. Swedana is Vata Kapha Hara; so Rooksha Sweda (Valuka Sweda or Churna Pinda Sweda) can be adopted to reduce the vitiated Medas (Avarana Nirharana) and Vata. It also acts as Sthanika Amapachana.

After Avarana Nirharana, the above said procedures like Snehana, Basti should be employed.

Conclusion

The present scenario of lifestyle is prone to cause many lives deteriorating conditions. Janu Sandhigata Vata is Madhyama Rogamarga Vataja Vyadhi affecting the middle-aged, obese and elderly population. Following Dinacharya and Ritucharya that are mentioned in our Samhitha are beneficial in preventing many diseases. The Vatahara Chikisa like Snehana, Swedana, Mridu Samshodana, Basti, Agni Karma are beneficial in treating Janusandhigata Vata. Rasayana therapy i.e., Lashuna Rasayana, Chyawanprasha Rasayana are helpful by nourishing the Dhatu and overcoming Dhatukshaya.

References

1. Charaka Samhita of Agnivesha, Elaborated by Charaka and redacted by Drdhabala. New Delhi: Chaukhamba Sanskrit Pratishtan; 2017. Vol I. Sutra sthana 12, verse 7. Page No. 185.

2. Sharangadhara samhita. Varanasi: Chaukamba Orientalia; 2012. Reprinted. Pratamakhanda, 5 chapter, verse 25. Page No. 50.

3. Pandit Bhisagacharya Harishastri Paradkar Vaidya. Astangahrdayam by Vaghbata with the commentaries Sarvangasundara of Arundatta and Ayurveda Rasayana of Hemadri. Varanasi: Krishnadas Academy; 2000. Reprint. Sutrasthana, Chapter 11/26, Doshadividyaniyam Adhyaya. Page No. 186.

4. Charaka Samhita of Agnivesha, Elaborated by Charaka and redacted by Drdhabala.


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New Delhi: Chaukhamba Sanskrit Pratishtan; 2012. Reprinted. Vol II. Chikitsa sthana 28, chapter 37. Page No. 694.

5. Madhava Nidhanam of Sri Madhavakara with Madhukosa Commentry by Srivijayarakshita and Srikantadatta. Varanasi: Choukambha Prakashana. Revised and Edited by Prof Yadunandana Upadhyaya; Part 1. 22 chapter, verse 21. Page No. 463.

6. Sushruta Samhita with Nibandhasangraha Commentary of Sri Dalhanacharya. Varanasi: Chaukambha Surbharati Prakashan; nidana sthana 1, chapter, verse 28. Page No. 261.

7. Sushruta Samhita. Varanasi: Chaukambha Surbharati Prakashan; chikitsa sthana 4, chapter verse 8. Page No. 420.

8. Davidsons principles and practice of medicine. 20th Edition. Edited by Nicholas A Boon, Nikhi R Colledge, Brian R Walker. Churchilll Livingstone Elsevier; Page No. 1096-1100.

9. Paradakara HS, editor. Vagbhata, Ashtanga Hrudaya, Uttharasthana, Rasayana Vidhi. Varanasi: Chaukhambha Sanskrit Sansthan; 2014. Reprint. Chapter 39, verse 113-118. Page No. 931.


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