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Håfa i dosha na predominant guato ennao?
Håfa i dosha na predominant guato ennao?
Håfa i mala na maolek para i amavata?
Håfa i mala na maolek para i amavata?
Håfa i symptom general na makåtalek na amavata?
Håfa i symptom general na makåtalek na amavata?
Håfa i vyakthi sthana para i amavata?
Håfa i vyakthi sthana para i amavata?
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Håfa i symptom advanced para i amavata?
Håfa i symptom advanced para i amavata?
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What does the term 'amavatha' refer to?
What does the term 'amavatha' refer to?
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What are the two main causative factors of amavatha?
What are the two main causative factors of amavatha?
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What is 'mandagni' in relation to amavatha?
What is 'mandagni' in relation to amavatha?
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Which of the following is a symptom of amavatha according to the Saamavaatha lakshana?
Which of the following is a symptom of amavatha according to the Saamavaatha lakshana?
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What does 'viruddhahara' refer to in the context of amavatha?
What does 'viruddhahara' refer to in the context of amavatha?
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Study Notes
Presentation Topic: Amavatham
- Presenter: Dr. Neethu k, Assistant professor, Roganidana, VPSV Ayurveda College, Kottakakal
- Topic: Amavatham
Learning Objectives
- Understand the concept of amavatha
- Simplify the nidana and samprapthi of amavatha
- Understand the lakshana of amavatha
- Learn the types of amavatha
- Learn the sadhya and asadhyatha of amavatha
Concept in Classics
- Madhavanidana
- Yogaratanakara
- Bhavaprakasha
- Charaka Samhita
- Haritha Samhita
- Anjana Nidana
- Ashtanga Hridaya
- Chakradatta
Etymology
- (आमोऽपाकहेतुः वात) "स्वनामाख्यात् रोगविशेषः ।"
- आमवात ऐ आमयति पीडयति आम
- अजीर्णान्तरसोह्यम तेन दूषितो वात आमवात
- आम च वातं आमवातम्
- आमेन संहि तु वातं आमवातम्
Saamavaatha lakshana
- वायु सामो विबन्धो अग्निसाद तन्त्रान्त्रकूजनैः
- वेदना शोथ निस्तोदैः क्रमशो अन्गानि पीडयेत्
- विचरेत् युगपत् चापि गृह्णाति कुपितो भृशम्
- स्नेहायैः वृद्धिमाप्नोति सूर्यमेघोदये निशि
Etiology
- Causative Factors: Ama and vatha (causes of ama and causes of vatha prakopa)
- Predisposing Factors: Causes of vyadhi
Nidanam
- “विरुद्धाहारचेwटस्य मन्दाग्नेः निश्चलस्य च।
- स्निग्धं भुक्तवतो ½न्नं व्यायामं कुर्वतस्तथा
- II"(M.Ni)
- “गुर्वन्नाहारपुष्टेन मन्दाग्निना व्यवायिनः।
- तर्पितैः कन्दशाकैस्तु......” (ह.सं)
Ama - Samavayee Nidanam
- विरुद्धाहार - व्यभिचारी निदान
- निश्चलत्व - व्याधि हेतु
- स्निग्धभुक्तवततॊ व्यायामं - व्याधि हेतु
Precondition: Mandagni
-
Dietary factors:
- Viruddhahara
- Guruanna
- Snigdhaahara
- Adhyashana
- Madhura rasa
- Kandaasaka
-
Physical factors:
- Viruddhacheshta: vegasandharana, diwaswapnam, bhuktwa(ajeerna ae) vyayamam, jalapratharanam
- Nishchalatwam
- Snigdhabhuktavatho vyayamam
Pathogenesis
- “वायुना प्रेरिततॊ हि आमः श्लेष्मस्थानं प्रधावति
- तेनात्यर्थ विदग्धोऽसौ धमनीः प्रतिपध्यते ॥
- वातपित्तकफ़ैर्भूयो दूषितः सोऽन्नजो रसः ।
- स्रोतांस्यभिष्यन्दयति नानावर्णोऽतिपिच्छिलः
- II(M.Ni)
- आमो वायुसमीरितः
- श्लेष्मस्थाने प्रपच्यैव जायते ..."।। (ह.सं)
Janayatyaशु दौर्बल्यं गौरवं हृदयस्य च।
- व्याधीनामाश्रयो हि ऐष आमसंऽतिदारुणः॥
Samprapthi Ghatakas
- Dosha: tridoshas with predominance of vatha (vata: samana, vyana & apana, kapha: Kledaka, sleshaka. Bodhaka, pitta: pachaka)
- Dushyas dhathu: rasa, asthi, majja
- Mala: pureesha, mutra
- Srothas: annavaha, udakavaha, rasavaha, Majjavaha, pureeshavaha, mutravaha
Srotho dushti: sanga, vimargagamanam
- Agni: all types, manda
- Udbhava sthana: amasaya
- Adhisthana: sleshma sthana, especially sandhi
- Vyakthi sthana: sandhi
- Rogamarga: madhyama
Definition
- “युगपत्कुपितावन्तस्त्रिकसन्धिप्रवेशकौ ।
- स्तब्धं च कुरुतो गात्रमामवातः स उच्यते
- II(M.Ni)
- “युगपत्कुपितावामवातौ स्वीयप्रकोपनैः।
- आमवातं जनयतः सशोथं सन्धिरुग्ग्रहम् ॥" (A.N
- मन्यापृष्टकटीजानुत्रिकसन्धीन्विकुञचयन्।
- सशब्दः स्रस्तगात्रश्च आमवातः सोच्यते ॥" (यो.र)
Clinical Manifestations
- सामान्य लक्षण
- प्रवृद्ध लक्षण
- दोषानुबन्ध लक्षण
General Symptoms
- अङगमर्दोऽरुचिस्तृष्णा हि आलस्यं गौरवं ज्वरः।
- अपाकः शूनताऽङगानामामवातस्य लक्षणम् II(M.Ni)
- सर्वाङगैकाङगसन्धिस्थशोथार्तिग्रहगौरवम्।
- ज्वरापाकाग्निमान्ध्ये च तृष्णा चामानिकृतिः॥
Advanced Symptoms
- “स कष्टः सर्वरोगाणां यदा प्रकुपिततॊ भवेत् ।”
- “हस्तपादशिरोगुल्फ़त्रिकजानूरुसन्धिषु ।
- करोति सरुजं शोथं यत्र दोषः प्रपध्यते ॥
- स देशो रुज्य्तेऽत्यर्थं व्याविद्धिव
- वृश्चिकैः।” (M.Ni)
On examination
- Site: polyarthritis (hastha, pada, sirah, gulpha, trik, janı)
- Fleeting type
- Insp: swelling
- Palp: grade 3 tender ROM: affected
- Nature of pain: vrishchikaviddavat (throbbing and cutting pain, upward spreading similar to scorpion bite)
Pravriddha amavatha lakshanas
- Articular symptoms
- Symptoms of GIT
- Symptoms of brain
Dosanubandha lakshanas
- “पित्तात्सदाहरागं च सशूलं पवनानुगम् ।
- स्तिमितं गुरुकण्डूं च कफ़दुष्टं
- तमादिशेत् ॥" (M.Ni)
- “आमवाताधिके वातॆऽतिरुग्दाहस्तु पित्ततः।
- कफ़ात्स्तैमित्यगुरुत सर्वलक्ष्ण त्रिदोषतः॥”
Upadravas
- “जाड्यान्त्रकूजनानाहतृटश्च्छर्दि बहुमूत्रताः।
- शूलं शयननाशो अष्टोपद्रवा आमवातजा॥” (A.Ni)
- “अङगवैकल्यमायाति आमवाते" । (ह.सं)
Classification
- Based on dosa predominance:
- एकदोषजं-३
- द्विदोषजं-३
- सान्निपातिकं-१
- According to Sarangadhara:
- वातज, पित्तज, कफ़ज, सन्निपातिक
- According to severity:
- सामान्य आमवात
- प्रवृद्ध आमवात
- According to Haritha samhita:
- विष्टम्भि
- गुल्मि
- स्नेहि
- पक्व
- सर्वाङग
Prognosis
- “एकदोषानुगः साध्यो द्विदोषो याप्य
- उच्यते।
- सर्वदेहचरः शोथः स कृच्छ्रः
- सान्निपातिकः ॥"
Relieving and aggravating factors
- Upaśay: उष्णप्रयोग, उष्णाहार, लघु आहार, दीपन, तिक्त-कटु रस
- Anupaśay: शीतै, स्निग्ध, गुरुआहार्, मेघ, शीत, वर्षा काल
Treatment principle
- “लङघनं स्वेदनं तिक्तदीपनानि कटूनि
- च।
- विरेचनं स्नेहपानं बस्तिश्च
- आममारुते" ॥
Pathya-apathya
- “वर्जयेत्द्विदलं गौल्यं तैलं पिच्छिलमेव च।
- शीतोदकेन न स्नानमामवाते भिषग्वर ॥
- न सेवनीयं चोष्णं च द्रवं द्रावं विशेषतः।"
- “ज्वरे प्रोक्तानि पथ्यानि तानि चात्र
- प्रयोजयेत्॥”
Rheumatic Fever - Additional Information
- Acute rheumatic fever (a systemic disease of childhood)
- Often recurrent, following group A beta-hemolytic streptococcal infection
- Diffuse inflammatory disease of connective tissue
- Primarily involves heart, blood vessels, joints, subcutaneous tissue & CNS
Clinical Features of Rheumatic Fever
- Arthritis: fleeting migratory polyarthritis (commonly knee, ankle, elbow, wrist)
- Carditis: pericarditis, endocarditis, valvulitis (acute phase), fibrosis/calcification (chronic phase)
- Sydenham chorea: 1-15 years, clumsiness, deteriorating handwriting, emotional lability, grimacing
- Erythema marginatum: pale center with red irregular margin, more on trunks & limbs, nonitchy
- Subcutaneous nodules: painless, pea-sized nodules over extensor surfaces (joints, spine, scapulae, scalp)
- Other features: arthralgia, pallor, anorexia, loss of weight
Diagnosis
- Primarily a clinical diagnosis
- No single diagnostic sign or specific lab test
- Diagnosis based on Modified Jones Criteria
Jones Criteria (Mnemonic: JONES CAFE PAL)
-
Major Criteria:
- Joint Involvement
- O-looks like heart (myocarditis)
- Nodules- subcutaneous
- Erythema marginatum
- Sydenham chorea
-
Minor Criteria:
- CRP increased
- Arthralgia
- Fever
- Elevated ESR
- Prolonged PR Interval
- Anamnesis of Rheumatism -Leukocytosis
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Håfa i amavata na tema? Håfa i symptom yan causative factors? I quiz esta para hensen i información gi amavata yan i aspetton un na klasi. Sigi este para un mejor na klärifikasion.
