Human body develops autoimmune diseases when it is attacked by its own immune system: that is, when the cells and antibodies of the immune system, designed to seek and destroy invaders of the body, target their own body tissues. When the immune system is attacked, it can affect multiple organs of the body.
Ayurveda counts autoimmune diseases, which include the dreaded rheumatoid arthritis, among those diseases which have their origin in vitiated Vata. Once they set in, these diseases will subject the patient to severe pain, inflammation, stiffness and even deformity of the joints for the rest of life.
Rheumatism in Ayurveda can be identified by symptoms such as severe pain and swelling in the muscles, joints, tendons and ligaments.According to the classical texts of Ayurveda, muscle pain and joint pains are a result of the increase in toxins (ama) in the joints and aggravation of Vata. Ama means an item which is not ripened, cooked and digested or metabolized properly.
When improper digestion takes place, this ama combines with Vata, the force of movement in the body. Wherever Vata finds closed channels, it leaves the ama there which causes different kinds of diseases. When ama gets deposited in the joints, it leads to aggravation of Vata and results in the inflammation of muscles, causing intense pain.
Rheumatoid arthritis, or sandhigata Vata, is a common rheumatic disease, afflicting people all over the world. The disease can begin at any age, but it most often starts after the age of 40 and before 60. Research has found that genetic factors are a major cause of this disease and that women are affected more often than men.
Metabolism, in Ayurveda, is referred to as deepana-pachana (deepana: the process of breaking down of food materials into parts; pachana is their absorption by the body). Undigested food will contaminate blood, and later the body, and vitiate Vata, the nervous force of activity. So, rheumatoid arthritis is a metabolic disease which prevents the proper movement of the limbs on account of either pain, swelling or stiffness.
• Accumulation of ama (toxins) in the joints, formed due to improper digestion, metabolism or excretion.
• Aggravated Vata by exposure to cold weather.
• Genetic factors
• Pain and stiffness of joints
• Feeling feverish and anemic
• Structural deformities
The treatment for rheumatic diseases comprises both samana chikitsa (pacification therapy) and sodhana chikitsa (purification therapy.)
Ayurveda says the disturbed balance of the doshas (humors) could set off a chain reaction, troubling the other body elements such as dhatus (basic bodily tissues) and malas (waste products). There can be many reasons why the doshas are vitiated—some may be natural, such as seasonal variations, and some man-made, such as the abuse or misuse of the functions of sense organs, wrong body and food habits and suppression of natural bodily urges. But once the process is set in motion, the body begins to suffer. Ayurvedic physicians use samana and sodhana procedures to return the humors to normalcy.
Samana chikitsa attempts at restoring the normality of the vitiated humors by pacifying them through medication.
Sodhana chikitsa, or purification therapy, is practiced when the doshas are so vitiated that they cannot be treated with medicines and require to be expelled from the body. Ayurveda employs panchakarma (five purificatory procedures)for this. The doctor decides on the treatment based on the stage at which the doshas are at a particular time.
Panchakarma is a complex and time-taking treatment regime, which should be practised with utmost care. Performed under a knowledgeable and experienced physician and executed by trained therapists, pachakarma can give excellent results in the treatment of many chronic diseases, including rheumatic diseases.
Panchakarma, or five processes, is performed necessarily in three stages: purva karma (pre-treatment), pradhana karma (primary treatment) and paschat karma (post-treatment).
The purva karma prepares the patient’s body and mind to undergo a treatment which he/she is not used to. This includes snehana (oleation), swedana (sudation), massage and fomentation therapy. Together they loosen the toxins stuck inside the body.
The pradhana karma involves pancha karma, or all the five processes: nasya (nasal therapy), vamana (medicated emesis), virechana (medicated purgation) and two kinds of vasti (therapeutic enema), nirooha vasti (enema with herbal decoctions) and sneha vasti (enema with herbal oils).
Once the body has passed through the panchakarma, it would take some time for it to return to normal. This also is a slow process. One of the main aspects of paschat karma is a proper and carefully decided diet.
Depending on the nature and stage of the disease, treatment for rheumatoid arthritis may be carried out in consecutive phases. It will be more difficult to treat patients with Vata constitution compared to those with Pitta or Kapha constitution.
The first phase of the treatment will comprise Amapachanam (detoxification) with medicines having deepana (stomachic)
and pachana (digestant) properties, along with local sweda kriyas (sudation therapy). This will help correct digestion and metabolism. Local sweda kriyas will be applied on joints for reducing pain and inflammation.
The second phase will begin when the digestive system becomes normal. In this stage, the patient will be given anti-inflammatory medicines and he will undergo sodhana chikitsa (purification therapy). This will eliminate the toxic antigen-antibody complex. In due course, the treatment may be switched to samana chikitsa or pacification therapy and external therapies like dravaswedam (dhara), pindaswedam (kizhi) and upanaham (poultice).
Snehana (oleation therapy – internal or external administration of oil, ghee, etc) combined with sweda kriyas will help relieve the patient of pain, swelling and stiffness.
In phase three, raktha prasadm or immune modulator and swedana and Vata samana (Vata Pacifying) medicines will be given. At this stage, concentration will be on the prevention of the recurrence of the disease. It will be a two-pronged approach. One is oral intake of medicines that helps develop immunity and two, rejuvenation therapies like shashtika pindaswedam (navarakizhi) and kayasekam (pouring luke warm medicated oil onto the body) followed by simultaneous soft massage.
After this, the patient becomes symptom-free and he can lead a normal life, provided he follows certain rules regarding lifestyle and diet. They include:
• Change to vegetarian food. (If not possible, limit non-vegetarian items to a maximum of 25 percent)
• Avoid food which causes indigestion
• Always drink lukewarm water
• Do not sleep during daytime
• Do not miss sleep in the night for any reason
• Keep warm always
• Have bath using warm water only
• Take immunity-enhancing drugs during season change.
It is very important that the patient seeks the advice of the physician at regular intervals so that the disease is managed well and the patient leads a normal life.
Vata shows all the properties of air such as force, vacuum, dryness, coldness, lightness, wind and dehydration. It is active in bodily movements: contraction and relaxation of muscles, breathing and the internal transportation and flow of body materials such as blood, lymph, sweat, urine, nutrients and other fluids.
Five types of Vata: The humor Vata is divided into five types called panchavayus They are prana, apana, vyana, udana and samana.
Prana vayu functions mainly in the head, neck and chest region and it acts from the atmosphere to the inside of the body. It carries out the functions of the sensory organs in the head and stimuli.
Udana vayu, also located in the head, neck and chest, acts opposite to prana vayu. Its direction is upward and outward, enabling the body to vomit, spit and throw off substances such as carbon dioxide and water during expiration.
Vyana vayu functions at the chest and the heart region. It acts like a pacemaker, controlling the activity of the heart and initiates actions and movements everywhere in the body. It is responsible for the circulation of substances in the body to activate muscular movements andmental activities.
Samana vayu is present in the area of the abdomen. Its main function is to ignite the digestive fire and activate the process of digestion by creating peristalsis in intestinal movements. It also helps in the separation and absorption of digested food and carries excretory wastes to the large intestine.
Apana vayu is located in the pelvic region. Its functions are seen in the excretory organs for defecation, in the kidneys and urinary systems and in the area of reproductive organs. It activates and mobilizes sperm, enables performance of sexual activities, ovulation and menstruation. So, once Vata gets disturbed it will affect the whole body seriously.