Introduction

Amavata is the chronic disease which can occur to any age group of people.^[1] It occurs due to impairment of Agni, formation of Ama and vitiation of Vata Dosha. Incomplete digestion of Rasadi Dhatu leads to the formation of Ama. Ama is carried by aggravated Vata to the Kapha Sthanas i.e., Sandhi producing Lakshanas of Amavata.^[2]

Madhavakara was the first one who mentioned the Amavata as an independent disease entity.^[3] He has given detailed description regarding Nidan, Samprapti and Lakshanas of Amavata in Madhava Nidhana text. The Nidanas like Viruddhahara, Viruddhachesta, Mandagni, Nischalata and exercise immediately after taking Snigdha Ahara will cause production of Ama and vitiation of Vata Dosha.

Ama gets together with Vata and circulates all over the body through Sira and Dhamani and get lodged in Sandhi producing Lakshanas like Angamarda, Aruchi, Trushna, Gourava, Alasya, Angashunata, Jwara and Apaki along with Sandhi Shoola, Sandhi Shotha and Gatra Stabdata.^[4]

In modern science, it is been correlated to Rheumatoid arthritis. It is a chronic disease that causes inflammation in the body producing symptoms like pain, stiffness & swelling in joints.^[5]

In Ayurveda, the treatment for Amavata goes like Langhana, Swedana, Tikta Katu Deepana, Virechana, Snehapana and Basti Karma.^[6] Here an effort is made to access the efficacy of Panchakarma treatment in managing Amavata and its mode of action.

Materials and Methods

Single case report of 50 year old female patient having signs and a symptom of Amavata since 2 years is discussed. Assessment was done with subjective parameters and investigations before and after the treatment. Treatment was given for 12 day which included Panchakarma procedures followed by Shamana Aushada for 10 days after taking consent from the patient.

Case report

A 50 year old female patient came to us with chief complaints of

Diagnosis: Amavata is the diagnosis which is confirmed after assessment of subjective parameter, investigations and the etiopathogenesis

Table 2: Grading for pain

Table 3: Grading for swelling

Table 6: Vaitarana Basti contents

Table 7: Dashamoola Kashaya Basti contents

Results

Improvement was seen after 12 days of treatment. Pain, swelling and stiffness were remarkedly reduced. Range of movements was improved. Appetite got improved & constipation was relieved.

Table 9: Subjective parameter before and after treatment

Table 10: Investigation before and after treatment

Figure 1: investigation before treatment

Figure 2: investigation after treatment

Here it acts on Samana Vayu, which lies near the site of Jataragni leads to ignition of Jataragni.^[14]

Dashamoola Kashaya is having properties like Vatahara and Shothahara and is mentioned in the Amavatarogadhikara.^[15] Pippalyadi Anuvasana Taila is having Deepana and Vatahara action. Rasna and Shatapushpa are Amapachani, Deepani and Kaphavatajit and hence reducing the symptoms of Amavata.

Mode of action of Abhyanga: Abhyanga is said to be Vatahara and Kottamchukkadi Taila was used for this. It is having Amavata relieving action along with analgesic, anti-inflammatory, antioxidants, antispasmodic, antiarthritis, immunomodulator activities. Due to its properties, it acts as Amapachaka, Shothahala and Shoolahara.^[16]

Mode of action of Jambeera Pinda Sweda^[17]:It is a type of Pinda Sweda mainly applied in Vata Kapha predominant conditions. It is Shophahara, Rooksha and Teekshna. Hence it relieves pain, stiffness and swelling.

Mode of action of Shamana Aushadis:Amritha Guggulu has Deepaniya, digestive, anti-inflammatory properties so it is very helpful in Amavata, Agnimandya.^[18] Sudharshana Ghana Vati is Kaphavata Hara, Ama Nashaka, Deepana Pachaniya. Amritarista corrects the Rasa metabolism and reduces the Ama.

Conclusion

In Amavata, Ama and Vata plays an important role. Mandagni is the main cause of Ama formation and in the other hand Vata Dosha is vitiated due to indulgence in Vataprakopaka Nidana. The study proved the combined effect of Panchakarma treatment along with Shamana Aushadis helped in reducing pain, stiffness, swelling and increasing the range of movements.

It also helped in increasing digestive fire and reducing constipation there by increasing of quality of life.

Acknowledgement

The authors would like to thank the Department of Panchakarma, Sri Dharmasthala College of Ayurveda and Hospital, Hassan, Karnataka for their assistance in data collection and other aspects of this research.