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Disorders of Joints A R O G Y A M A N D I R
Disorders
of Joints
A R O G Y A M A N D I R
P A T R I K A
EDITORIAL W e are thankful for your responses to the earlier Arogyamandir Patrikas viz. special

EDITORIAL

W e are thankful for your responses to the earlier Arogyamandir Patrikas viz.

special issues on `Digestive Disorders' (April 2007) and `Skin Disorders' (July 2007) published by Shree Dhootapapeshwar Ltd. Your written appreciations have surely boosted our confidence.

We agree with your valued suggestions that many a diseases are on the rise now-a-days and need special p u b l i c a t i o n s covering them. Keeping that in mind, we have come up with this

o n

them. Keeping that in mind, we have come up with this o n s p e

s p e c i a l `Sandhivikar'.

i s s u e

Many diseases pertaining to Joints (Sandhi) clubbed as `New diseases' are becoming more and more common, but if we take into consideration the Siddhant of Charakacharya and understand it in the correct perspective of the Dosha-Dushya Sangraha, then instead of taking recourse to the modern names, we can differentiate, diagnose and treat them with ease and that too with great success, based on the Ayurvedic principles themselves.

Our efforts through 'Arogyamandir Patrika' have been in the same direction. By adopting this methodology and looking at the condition of the patients on the basis of Ayurvedic Siddhant, we can surely give relief to the suffering person.

We hope that this Visheshank on "Sandhi Vikar" comes upto your expectations and will be appreciated.

We humbly request you to continue sending your suggestions in writing so that we can carry forward this work in the interest of `Ayurved Chikitsa' in appropriate direction.

Yours Sincerely,

Vd. Shailesh Nadkarni

December 2007

Vishayapravesh

he word 'Sandhi' means where 2 parts come together or connect with each other. According to Ayurved, the term 'Sandhi' is identified by the site where two or more bones connect with each other.

In this issue of Arogyamandir Patrika, we will discuss about the joints which generally get affected causing joint disorders. For the treatment of such disorders people generally turn towards Ayurvedic treatment as no such complete treatment is hardly available with other pathies.

T

The differential diagnosis of these disorders, their specific condition, treatment and complications have been put
The differential diagnosis of these disorders, their specific condition, treatment and
complications have been put forward together in this issue.
Sandhi Vikar

'Joint' or 'Sandhi' is the part which connects two or more bones, which helps in proper & smooth movement of joints as well as body.

The Asthi dhatu or bone is the part which gives proper shape & firmness to the body as well as it protects the internal organs.

'Asthi' & 'Sandhi' both are known as the moolasthana or origin of Majjavaha Srotas. Vatadosha is mainly situated in Asthi & Sandhi hence due to vitiation of Vatadosha there are changes or deformity in these Asthi & Sandhi.

Similarly vitiation of Asthivaha & Majjavaha Srotas gives rise to vitiation or abnormality in these organs causing joint disorders.

The main site of Vatadosha in the body being Kandara, Mamsa, Sira, Snayu, Asthi & Sandhi, Sandhivikar are incorporated under Vatavyadhi. Vayu is also related with Vatanadi i.e. nerves, therefore Nervine disorders or disorders developed due to vitiation of vatanadi are also

incorporated in Vatavyadhi.

vitiation of vatanadi are also incorporated in Vatavyadhi. Is it not essential to think of this?

Is it not essential to think of this?

Use of painkillers or medicines that are considered painkillers is common in patients suffering from Joint Disorders to give them relief from the pain they suffer of. With the use of these medicines, the patient feels, that the pain has been relieved and considers himself normal or near normal. Even though the person feels that the pain has got relieved, it is not actually gone. It's just that he does not realize it. In fact, the pain is the sensation that gives the signal that the part needs to be given either rest or less mobility. Is it then correct to misinterpret the word 'Vedanashamak' and allow the joint to continue to be in action rather than giving it the required rest? Is it in the interest of the patient to allow the affected joint to remain functional due to the misinterpretation of the word 'Vedanashaman' given in the text? Is it, therefore not, essential for us - the Ayurvedic physicians - to think on this point?

2
2

Majjavaha Srotas-Asthi & Sandhi

Causes of vitiation of Majjavaha Srotas Functions of Asthidhatu

Crushing of bones Injury and compression of bones or Gives firmness & stability to body Gives shape to body

bone marrow

contradictory food

Symptoms of vitiation

Sandhishoola (Pain in joints) Parvashoola, Asthishoola

Bhrama (Giddiness) Moorchha (Fainting) Vataprakopa

(Aggrevation of Vata)

eyes) Shotha (Oedema) incorporated 'Kurchasthi' (Cartilage) in Asthi. Due to

difference in classification there is difference in quantity.

Sandhi DemLveevleg mevOeÙees åÙesles kesâJeuee: heefjkeâerefle&lee: ~ hesMeer mveeÙeg efmejeCeevleg meefvOemebKÙee ve efJeÅeles ~ meg.Mee. 5

Sandhi is formed with the union of 2 or more bones. There are 2 types of Sandhi as per their movement. 1. Sthira (Immovable Joints) 2. Cheshtavanta (Movable Joints)

MeeKeemeg nvJees: keâšÙee_Ûe Ûes<šeJevlemleg mevOeÙe: ~ Mes<eemleg mevOeÙe: meJex efJe%esÙee efn efmLeje yegOew: ~~ meg.Mee. 5-25

Immovable Joints The joints which are fixed and not movable are called as ‘Sthira' Sandhi. e.g. Tunnasevani, Samudga. Movable Joints The joints that take part in movement and are freely movable are called Movable Joints i.e. Cheshtavanta Sandhi. In movable joints Shleshmadhara Kala (Synovial membrane) is situated. The Synovial fluid present in them helps in proper & free movement of the joint. Also the joint stays firm & does not get dislocated. It acts as a lubricant.

mvesneYÙeòesâ ÙeLee lJe#es Ûe›ebâ meeOeg ØeJele&les ~ mevOeÙe: meeOeg Jele&vles mebefMue<še: Mues<ceCee leLee ~ meg.Mee. 4

Joints are 210 in number.

known as Asthi or bone.

The part which lasts even after the destruction of body is

Asthi DemÙeles Fefle DeefmLe ~

Sandhi - Ghatak Vivaran

The treatment for the disorders of Majja Shukra vitiation is diet with Madhur & Tikta rasa, proper purification, proper exercise & proper sexual activity.

ceppeeMeg›eâmeceglLeeve Deew<eOeb mJeeogefleòeâkeâced DeVeb JäÙeJeeÙe JÙeeÙeeceew Megefæ: keâeues Ûe cee$eÙee ~~ Ûe.met. 28-26

Treatment

Disorders of Majjavaha Srotas vitiation Vatavyadhi, Pakshaghata, Grudhrasi, Bhrama, Moorchha

Giving support to muscles & other organs of body Maintenance of balance & weight of body Protecting important internal organs like heart, brain etc. With help of joints it performs activity or movements easily & without any friction. Sushrutacharya has mentioned 300 bones in the human body. Modern medicine mentions it as 206. Ayurved has also

Excessive decalcification Intake of mutually

Tama pravesh (Darkness in front of

efmLejkeâef"veeJeuecyevee Oeeleg:

ÙeceeefßelÙe mece«eb MejerjceJeefle<"les ~

keâeÙemÙe

Asthi or bone is the most strongest, hard and firm part of body

which

balances the weight of body. It is also known as

'Dehasara'.

lemceeefÛÛejefJeve<šs<eg lJe*dceebmes<eg MejerefjCeeced ~ DemLeerefve ve efJeveMÙeefvle meejehÙesleeefve osefnveeced ~ meg.Mee. 5-22

Types of Sandhi (Joints) as per structure 1. Kora Sandhi (Hinge Joint) This sandhi or
Types of Sandhi (Joints) as per structure
1. Kora Sandhi (Hinge Joint)
This sandhi or joint is like hinges of the
door e.g. Manibandha Sandhi (Wrist
joint), Gulpha Sandhi (Ankle joint),
Koorpara Sandhi (Elbow joint), Janu
Sandhi (Knee joint), Parva Sandhi
(Carpellar joints)
5. Tunnasevani Sandhi (Sutures)
The joints which have teeth like
margins joining with each other which
look like sutures are 'Tunnasevani'
e.g. Joints in head.
2. Udukhala Sandhi (Ball & Socket
Joint) These have structure similar to
ball & socket. One bone get fixed in
other bone with socket like structure.
e.g. Ansa Sandhi (Shoulder joint),
Vankshana Sandhi (Hip joint)
6. Vayastunda Sandhi -
Joint which look like mouth or beak of
crow e.g. Hanu Sandhi joint of cheen
3. Samudga Sandhi -
These joints are like casket
with lesser movements.
e.g. Shroni, Ansapeeth
7.Pratara Sandhi
(Plane or Gliding Joints) The even
planes or flat articular surfaces of 2
bones connects with each other to
form this joint. e.g. Cervical & Lumbar
vertebrae
4. Mandal Sandhi -
Joints made up of cartilage which are round in
shape e.g. Trachea
8. Shankhavarta Sandhi -
Joints like a conch shell e.g. joints in the
ear.
3
3

Examination of Joints - Method & Necessity

i.e. Joints Disorders it is most

necessary to examine the basic part Sandhi & Asthi alongwith General or systemic examination.

In case of Sandhivikar

Movement of joint is to be assessed by means of 'ROM'

(Range of Motion of joint). Goniometer.

Instrument to measure this is

action

based symptoms. Therefore, their analysis is to be done on the same basis.

The Most symptoms in joint disorders are functional or

Passive movement

check for end feel of joint movement.

To be done with the help of physician

- To be done by patient himself.

Movement

-

Painful / not Painful

-

complete / not complete

Active Movement

In Pratyaksha Pareekshan i.e. direct examination, the size &

shape of Sandhi (joints) & the related organs is

important. Also both the joints of opposite extremity are to be examined simultaneously. Size & Shape of joint

most

Compare Passive ROM with Active ROM.

Examination of Joint- Method

1. Observation /Inspection

2. Palpation

3. Examination Corelation with clinical tests

 

Before treatment

After treatment

Size Shape of joint Efficacy

-

-

-

Walking time

Grip strength

1.

Pain in joints

-

Big joints

-

 

Small joints

2.

Location of pain

 

Right side

Left side

Duration

Shoulder joint

     

Elbow joint

Wrist joint

Carpel joint

Metacarpel joint

Sacral joint

Hip joint

Knee joint

Ankle joint

Tarsal joint

Cervical vertebrae

Lumbar vertebrae

1. Observation

Skin colour

Redness

Discolouration-Trauma

Pigmentation

Skin hair loss, shiny skin (in muscular dystrophy)

Swelling

Deformity

Muscle wasting Muscular atrophy (Comparision with opposite extremity)

2.Palpation

Temperature - Thermostrip

Oedema pitting or non pitting

Tenderness

Stiffness

Nerve tenderness

Numbness/Loss of sensation

Tingling sensation

3. Examination

Difficulty in activity

Immobility

Stiffness

Laboratory Test - Investigations X-ray of joint, CT scan, MRI etc.

These modern investigations are certainly helpful in diagnosis of joint disorders. But with the help of these investigations, Vaidya has to evolve Ayurvedic point of view in the treatment. e.g. Arthoscopy reveals degeneration of cartilage attached with joints then Snehan & Swedan are to be thought of.

Examination with Goniometer

Swedan are to be thought of. Examination with Goniometer Mahayogaraj Guggul Hejb Jeelenjb ∑ n excellent
Swedan are to be thought of. Examination with Goniometer Mahayogaraj Guggul Hejb Jeelenjb ∑ n excellent

Mahayogaraj Guggul

Hejb Jeelenjb

n excellent Guggulkalpa with

Hejb Jeelenjb ∑ n excellent Guggulkalpa with

Bhasmas acting in chronic conditions of Vatavyadhi Acts as Rasayan, Deepan, Pachan, Amanashak, Vataghna & Dhatuposhak Useful in Sandhigata Vata, Jeerna Vatavyadhi, Vatarakta, Kushtha, Grahani, Shukradosha,

Maharasnadi Kadha known remedy of Vatavikar with famous Vataghna dravya 'Rasna' Amanashak & Shoolahar
Maharasnadi Kadha
known
remedy
of
Vatavikar
with
famous Vataghna dravya 'Rasna'
Amanashak
&
Shoolahar
action
in
Sandhivata,
Ardhangavata,
Ardita, Ekangavata, Amavata, Grudhrasi
as
an
adjuvant
with
Vataghna
Amavata, Grudhrasi as an adjuvant with Vataghna ∑ Well ∑ Amapachak, ∑ Useful ∑ Useful Guggul

Well

Amapachak,

Useful

Useful

Guggul kalpas

4
4

Joint Disorders - Specific Symptoms & Differential Diagnosis

Pratyatma or special characteristic feature of particular disease is important for diagnostic purpose.

Disease

Pratyatmak Lakshan

Disease

Pratyatmak Lakshan

Sandhigata Vata

Vatapoorna Druti Sparsha (feeling of joints like filled with air, pain in joints), Shoola

Pakshaghata

Karmendriyahani (Loss of sensation & function)

Grudhrasi

Pain starting from lumbar region

on

Margavarodhjanya Vata

Severe tenderness in joints

back and spreads downwards on backside of thigh & knees, leg to the feet

Manyakasherukagata

Manyashoola, Bhrama, (pain in neck region, giddiness)

Vata

Amavata

Vrushchika Damshavata Vedana (Excruciating Pain like sting of Scorpio, fleeting type of pain in big joints)

Differential Diagnosis on the basis of symptoms Pain in Joints

Diagnosis on the basis of symptoms Pain in Joints Sthayi Vedana (Continuous pain) Sanchari Vedana (Fleeting
Diagnosis on the basis of symptoms Pain in Joints Sthayi Vedana (Continuous pain) Sanchari Vedana (Fleeting

Sthayi Vedana (Continuous pain)

of symptoms Pain in Joints Sthayi Vedana (Continuous pain) Sanchari Vedana (Fleeting Pain) Chala Sandhi Achala
of symptoms Pain in Joints Sthayi Vedana (Continuous pain) Sanchari Vedana (Fleeting Pain) Chala Sandhi Achala

Sanchari Vedana (Fleeting Pain)

Chala Sandhi

Achala Sandhi

 

Origin

Trayodashang Guggul

Small

Big

Cervical

Joints

Joints

Vertebrae

Mild oedema

Cervical Joints Joints Vertebrae Mild oedema Noise Redness while movement Local burning
Cervical Joints Joints Vertebrae Mild oedema Noise Redness while movement Local burning

Noise

Redness

while movement

Local burning

sensation

Yes

No

Fatty Body

Vataprakopa

   

Dhatukshayajanya

 

Niramata

Kaishor Guggul

 

Samata

 

Agnimandya

 

Dhathukshayajanya

Shosha

Localized

redness

 

Increase in

Mahayograj Guggul

temperature

 

Upastambhit Vata

 

Yogaraj Guggul

Mahayograj Guggul

Starting from thigh, ankle joints

Lean Body

Triphala Guggul Trayodashang

Guggul

Vrushchikdamshavat Vedana

Localised increase in temperature

Prakrut

Nootan

Amavata

Sinhanad

Guggul

Vruddhi

Jeerna

Amavata

Gokshuradi

Guggul

Constant (continuous) pain

Jeerna Amavata Gokshuradi Guggul Constant (continuous) pain (Neck pain) Manyashoola Hastasuptata (Numbness in hands)
Jeerna Amavata Gokshuradi Guggul Constant (continuous) pain (Neck pain) Manyashoola Hastasuptata (Numbness in hands)

(Neck pain)

Manyashoola

Hastasuptata (Numbness in hands) Chimchimayan (Tingling sensation) Bhrama (Giddiness)

Osteoporotic changes/ After fracture

Lakshadi Guggul

Manyakasherukagata Vata

Panchamrut Loha Guggul

Guggul Manyakasherukagata Vata Panchamrut Loha Guggul Yogaraj Guggul ∑ Excellent Amapachak & Vatanashak

Yogaraj Guggul

Excellent Amapachak & Vatanashak Kalpa acting as Srotorodhanashak in Upastambhit Vatavyadhi Alleviates irritation of nerves & tones up the nervine system Useful in symptoms of Vatavyadhi such as pain, tenderness & oedema

symptoms of Vatavyadhi such as pain, tenderness & oedema Chaturmukh Rasa ∑ Excellent Vatashamak, Balya, Deepak,

Chaturmukh Rasa

Excellent Vatashamak, Balya, Deepak, Pachak, Kshayaghna, Rasayan Suvarnakalpa Useful in Majjakshayajanya Vatavikar, Mastishkavikar, Moorchcha, Pakshaghata, Unmada, Apasmar, Kshaya, Jeerna Vatavyadhi Effective in nervine irritation developed after acute stage of Pakshaghata

5
5

Vatavyadhi

Vayu or Vata dosha is associated with Asthi & Majja by Symptoms of Asthigata Vata

Asrayashrayi bhava. When Vatadosha is predominant in Samprapti or etiopathology of a disease they are termed as 'Vatavyadhi'.

In Vatavyadhi, the symptoms

Majjagata Vata are very much similar. Sandhivikar & Vatavyadhi are related with each other. As

diminution of muscle tissue & strength, causing weakness, insomnia & constant pain

Vatanadi (Nerves).

Causes

Intake of dry, cold, light, Katu (Pungent), Kashaya (astringent) food, less intake of food

Excessive exercise, exertion, sexual indulgence

Weakness or emaciation

Excessive use of purificatory methods

Dhatushaithilya

Suppression of natural urges

Excessive swimming, travelling Aggrevation of Vayu in joints gives rise to severe pain in joints,

oedema or inflammation of joints, stiffness or looseness in joints. `Atopa' - Joints on palpation appears like a leather bag filled with air. `Gatatva' The normal tendency of Vayu is to travel throughout the body. Due to vitiation or improper diet & lifestyle, Vayu gets vitiated in quantity (Pramana) and or quality (Guna) and goes into dhatu

and this phenomenon is called 'Gamitva'.

Fall from horse, elephant, vehicle etc.

Injury to vital organs or marmas like Basti, Hrudaya, Shira

Injury to sandhi or bone

In Vatavyadhi 2 types of Samprapti has been mentioned. Dhatukshayajanya & Margavarodhajanya

JeeÙeesOee&leg#eÙeelkeâeshees ceeie&mÙeeJejCesve Jee ~ Ûe.efÛe. 28

According

Margavarodhajanya, the treatment will be different.

shoulders etc), hunch back & Vatavikar either Sarvangagata or Ekangagata i.e. pertaining to the entire body or part thereof.

(stiffness), Kampa (Tremors), Shoola (Pain) & Akshepa, Tikta (bitter), Antarayama, Bahirayama, Khalli (neuralgic pain in feet,

Symptoms of Snayugata Vata Aggrevation of Vayu in the Snayu gives rise to Stambha

Sandhidushti there is vitiation of Vatadosha predominantly. Vatavyadhi manifests by getting sited in Sandhi (Joints) &

YesoesÓefmLeheJe&Ceeb meefvOeMetueb ceebmeyeue#eÙe: ~ DemJehve: meblelee ®keâd Ûe ceppeeefmLekegâefhelesÓefveues ~ cee.efve.

related to Asthigata Vata

& Aggrevation of Vayu in the bones & bone-marrow gives rise to cracking of bones & joints, piercing pain in the joints,

in

Symptoms of Sandhigata Vata

nefvle meefvOeiele: mevOeerved Metueešesheew keâjesefle Ûe ~ cee.efve.

to

the

Nidan

as

Dhatukshayajanya

or

Bruhat Vata Chintamani Rasa

The well known Vatanashak kalpa specially effective for heart & brain Useful in Dhatukshayajanya Vatavikar, Sandhigata Vata, Restricted movements or loss of activity in Pakshaghata, Ardita, Unmada, Apasmar & in symptoms of Hrudroga such as Palpitation, dyspnoea on exertion, feeble pulse

Pakshaghata, Ardita, Unmada, Apasmar & in symptoms of Hrudroga such as Palpitation, dyspnoea on exertion, feeble

Normally, it is felt that 'gatatva' of Vayu is only of academic importance. However, in day to day practice Ayurvedic physicians do come across cases where the diseases cannot be 'defined' in the usual way the modern science does. However, what the patient need is relief which can be provided only if the diagnosis is perfect.

Based on some specific symptoms, most commonly found gatatva cases can be treated with success. For differential diagnosis, couple of commonly seen gatatva symptoms are given below.

Differential Diagnosis Sandhigata Vata Amavata Vata Rakta 1. Sandhishoola (Joint Pain) Present Present Present 2.
Differential Diagnosis
Sandhigata Vata
Amavata
Vata Rakta
1. Sandhishoola (Joint Pain)
Present
Present
Present
2. Sandhishotha
(Oedema/Inflammation of joints)
Present
Present
Present
3. Painful actions
Less actions & Immobility
Present
Present
Present
4. Starting from
Big joints
Big joints
Parvasandhi
(Carpellar joints)
5. Associated with fever
Yes/No
Yes
6. Tenderness
Present/Absent
Present
7. Ushna Sparsha (hot sensation)
Present/Absent
Present
8. Sanchari Vedana (fleeting pain)
Absent
Absent
9. Dosha-Dushya
Vata
Vata+Rakta
10. Other symptoms
Stiffness in joints
Yes
Severe +++
Present
Present
Vata + Ama
Vruschikadamshaavata Vedana
(Pain like sting of Scorpio)
Manifestation of
papules in
parvapradesh
(carpels)
11. Relif from snehan
Yes/No
No
Yes/No
12. Swedan
Sneha/Rooksha Sweda
Rooksha Sweda
Anupashaya
from Swedan
6
6

Knowledge Hardwork Dedication & Service

An Ayurvedic Physician by the name Vd. Shailesh Nadkarni

I had the pleasure of meeting Vd Shailesh Nadkarni in around the year 1999. Its amazing now to mention that it has been only 7 years while in actuality it seems

he has been with us the whole of 135 years. He came A display of his depth of Knowledge is experienced

when he navigates through his hours of study and brings forth the wisdom in practice. A successful physician is one who enters the treatment through the mind of the patient. Medicine, diet, lifestyle are mere tools when this mental state is a bond between Physician and Practitioner. Vd. Nadkarni's success in practice is this unique feature which distinguishes him

practitioner. apart from his peers and teachers. You have to be born

with people skilCd he is probably living his nth life on this gift of influencing and charging positively all that comes in contact with him. In his current life we see this strength of fusing people and teams, in perfection. This facilitates the ground work for good delivery of health care and naturally his patients enjoy the fruits of Ayurved in this approach.

One is initially taken aback with the observation that his life has been scheduled 24x7. Even in the time without Shree Dhootapapeshwar in his life, his every day and hour ( 0800 hrs to 2200 hrs) was allocated to an activity. Multi centric Ayurvedic practice, associate teaching faculty, University teaching courses, editorship of an upcoming Ayurvedic journal and

sufficient time to do 'good' for all around is what is seen. Patience to listen, allowing the patient to talk at

Joining Shree Dhootapapeshwar overturned his life in many ways but he coped with it with élan and

always attentive with retentive memory of details is what makes him a satisfying health care

experience. Its bad enough to be a patient of whatever ailment but to get his magic touch is a relief that the

phase of ill health is short lived. There are instances of chronic disorders being treated and numerous examples of an Ayurvedic approach

at work. He has never claimed magic

nor siddhi but delivered relief. He has

never barked on a telephone inspite of being incessantly disturbed or irrationally tapped. Seemingly

incurable and tired patients cursed to

a life of sufferance have gained from his insight and approach. Families

have been blessed with extensions and scores of us have benefitted from

across as a young Ayurvedic Physician who had no qualms of being introduced as Vaidya in an era of Doctor. This is one of the first aspects regarding his personality that strikes you and makes a lasting impression. His background of BSc with BAMS and then later MD in Kayachikitsa only goes on to refurbish his credentials as a man of science and a health care

adjustment whose pain was never shown. Hardworking at all times and dedicated to the task at hand.

length during his first interview, never rushed and

i e w , n e v e r r u s h e d a

Vd. Shailesh Nadkarni receiving the Vd. M.V. Kolhatkar Sanshodhan Puraskar at the hands of Vd. Shriram Guruji at Pune in presence of Dr. Mrs. Shubha Rawool, Mayor of Mumbai & Vd. S.P. Sardeshmukh, Chairman, Bharatiya Sanskruti Darshan Trust, Pune

a more suited approach to our health issues.

7
7

You need to be honest and disclosing to gain and Vd. P.Y. alias Dada Khadiwale of Vaidya Khadiwale

Vaidyak Sanshodhan Sanstha, a giant of our times, successful practitioner, teacher, manufacturer, role

that he is 100% Ayurvedic. model and motivator in the Ayurvedic sector has been in contact with Vd. Nadkarni for the past few years. He has

Understanding limitation in self and practice and never hesitant to cross refer to a more relevant and suited line of treatment. Safe effective and a true proponent of the wisdom the seers compiled to meet the challenges of today with ease and relevance, as if Ayurved was written with this individual patient in mind. What more does one want from a family Physician who

is shastra shuddha. prize. Its not the first time Vd Shailesh Nadkarni has

we all have. In many ways he represents that security that a family requires in health care and the best part is

observed and rightly recognised Vd. Nadkarni by bestowing him the Vaidya M.V. Kolhatkar Sanshodhan Puraskar 2007 for notable contribution in the field of Research and Development of Ayurvedic Medicines. Its timely, deserving and an honour for Vd Nadkarni and all of us in Shree Dhootapapeshwar to be beside him in receiving this

been recognised and is certainly not the last.

'Students' a very major association in his life. Closer

than relatives and almost family. Out and out teaching Thank you and our gratitude to Vd Khadiwale and

all the time in one way or the other. Taking sheer pleasure of accomplishment in the achievement of his

students. Guiding and counselling a good mind set and Congratulations Vd Nadkarni from all of us at Shree

supporting hard work. Not just associating with students when they are students but to even participate in their victories as their practice takes grip and when their life takes the strangest of up's and down's, this Professor Nadkarni is something a student knows is there - beside, behind and in front. Some of us from the outside can only hope in the next life we will be fortuned with such a guide. Till then it is better to just relish our current association.

Ranjit Puranik CEO Shree Dhootapapeshwar Ltd.

Dhootapapeshwar, you make us proud. Deepest of appreciation to Devang, (Swapna) and Vd Devki Nadkarni, who stand rock solid in support of Vd Nadkarni whilst he rises from strength to strength.

his team of counsellors who made this right choice.

his team of counsellors who made this right choice. “Never hesitate from stating your mind and

“Never hesitate from stating your mind and beliefs”,

“truth will prevail”, “stay calm and face the situation”, “if there has been a mistake / lapse, admit it and move ”

are the oft repeated sentiments of this colleague

at work. Vd Nadkarni assimilated himself in corporate stream with minimum of hiccup. In his first few months we often heard him asking the basics of “how” and “what” but never “why”, in following a corporate policy which he did not understand nor completely agreed with. Never hesitating to speak to all at work and never understanding the rungs of the invisible corporate ladder this “friend” assimilated himself in the office environ like a perfect fit. High energy, scrupulous detailing and ready to learn still learning, all new skills required to excel. Its been a treat and promises to be a feast in the coming times to be alongside.

on

Vd. P.Y. Khadivale

A personality Dedicated to Ayurved

Founder

Vd. Khadivale Vaidyak Sanshodhan Sanstha, Pune

8
8

Vatavyadhi

Sandhigata Vata

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on

palpation appears as if it is a leather bag inflated with air. Joints are painful during extention & contraction, is termed as

Sandhigata Vata.

Vayu gets aggrevated in 2 ways; the muscle tone in one part of body.

i)by the diminution of tissue elements (Dhatukshayajanya)

ii)by the occlusion of srotas (Margavarodhajanya) sensation in either whole or half part.

The disease in which joints become oedematous &

giddiness.

Pakshaghat

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Paksha is hand, foot or one side of the body. Vitiated Vayu vitiates Sira, Snayu and Kandara in half of the body. It looses

There is difficulty in movements of hands & limbs & loss of

Nirupstambhit

Upastambhit

(Dhatukshayajanya)

(Margavarodhajanya)

Symptoms - Vatapurnadrutisparsha

Affects most of the large & movable joints Severe tenderness in joints Dourbalya Araktavarna (Redness or Inflammation in joints) Ushna sparsha, Jwara, (Warmness felt over joint) Sanchari Vedana Amavata (fleeting type of pain)

Rooksha Sweda

Shoola Restricted movements Immobility of joints

Dourbalya

Loss of activity

Chikitsa-Treatment Snehan Swedan Shaman Brumhan Use of Bhasma & balya drugs Mahayogaraj Guggul

Mrudu Anuloman

Niruha Basti

Guggulkalpa

Yogaraj Guggul

Vatavidhwansa

 

Maharasnadi Kadha

Suvarnakalpa Bruhat Vata Chintamani

Chaturmukh Rasa

Sandhigata Vata
Sandhigata Vata
Manyakasherukagata Vata
Manyakasherukagata Vata

Manyakasherukagata Vata

Spondylysis, the disease as the name given by modern medicine is most common & known as Manyakasherukagata Vata by Ayurvedic fraternity.This Vatavyadhi is very common disorder seen nowadays due to dysfunctioning or abnormality in cervical vertebrae & nervine irritation. The manifestation of symptoms like pain in neck, tingling

sensation in hands alongwith loss of sensation or numbness,

sensation in hands alongwith loss of sensation or numbness, Panchamrut Loha Guggul • Manyakasherukagata Vata-

Panchamrut Loha Guggul

• Manyakasherukagata Vata- Panchamrut Loha Guggul + Dashamoolarishta

• Avabahuk - Panchamrut Loha Guggul + Maharasnadi Kadha + Sthanik Swedan

• Grudhrasi - Panchamrut Loha Guggul + Vatavidhwansa + Maharasnadi Kadha + Sthanik Snehan, Swedan

Symptoms Difficulty in movements in either hands or limbs, slurred speech, loss of control on excretory organs.

Ardit

`Ardita' is the disorder which is affecting half part of the face. It manifests with attacks & during attacks there is pain. The Vata situated in face & head gets aggrevated & affects one half part of face. Consequently face & neck gets crooked, trembling of head, tremors, slurred speech, pain in teeth & neck, causing stiffness or locked jaw.

Treatment of Pakshaghat

mJesoveb mvesnmebÙegòebâ he#eeIeeles efJejsÛeveced ~ Ûe.efÛe. 28

External Snehan (massage with oil) locally as well as whole body & internal snehan is advisable in Pakshaghata. For external massage Bala Taila, Narayan Taila. Swedan (Fomentation) Bashpa Sweda

Sneha Virechan - The main treatment of pakshaghata is to maintain proper direction of Prana i.e. downward direction. Its dushya are Sira, Kandara, Pitta & Rakta whose treatment is virechan. Therefore Sneha Virechan is advised in pakshaghata. e.g. Erandasneha or Gandharvaharitaki

Useful products

Bruhat

Vata

Chintamani

Rasa,

Mahayogaraj

Guggul,

Yogendra Rasa, Chaturmukh Rasa, Sameerpannag Rasaraj Rasa

`meJe&JeeleefJekeâejs<eg jmejepe: Øekeâerefle&le: ~'

The best rasayan & tonic (balya) for Vatanadis (nerves) specially effective in disorders of Vertebral column The Suvarnakalpa effective in chronic & Dhatukshayajanya Vatavyadhis with action on Majjavaha Srotas & Mastishka

Vatavyadhis with action on Majjavaha Srotas & Mastishka Yogendra Rasa ● Suvarnakalpa with pure, safe &
Vatavyadhis with action on Majjavaha Srotas & Mastishka Yogendra Rasa ● Suvarnakalpa with pure, safe &

Yogendra Rasa

Suvarnakalpa with pure, safe & standardized Suvarna Bhasma & Vanga Bhasma Most effective in all vatavikar with action as Rasayan & Bala, Veerya & Smrutivardhak Useful in Jeerna Vatavyadhi, Ardita, Pakshaghata, Prameha, Unmada, Apasmar Useful in sensory loss

Smrutivardhak ∑ Useful in Jeerna Vatavyadhi, Ardita, Pakshaghata, Prameha, Unmada, Apasmar ● Useful in sensory loss
9
9

Vatavyadhi

Grudhrasi

The disease in which person walks like vulture is named as

pain

specially pricking pain in 'Sphik Pradesh' hip region (i.e. waist, back, thigh, knee & calf region) hence, it is called as 'Sphik Purva'

Grudhrasi. In this disease, the first symptom is stiffness,

Heeef<Ce&ØelÙeÓ*iegueerveeb leg keâC[je ÙeeÓefveueeefo&lee ~ MekeäLve: #eshes efveie=åCeerÙeeod ie=OeÇmeerefle efn mee mce=lee ~ meg.efve. 1/74

The sthoola kandara (tendon) below ankle joint related to ankle & toes get affected with Vatadosha & stops action of limbs is called as Grudhrasi.

Symptoms

Pain in hip/lumbar region which spreads through back, hip, thigh, knee ankle upto soles

Stiffness in hip & knee joint

Pricking pain Immobility or restricted movements Deformity in joints

Treatment

Snehan

-

Vishagarbha Taila

Swedan - Nadisweda,

Vedana Prashama

Basti, Agnikarma - Sushrutacharya has specifically mentioned treatment like Siravedha & Agnikarma in certain Vatarogas. Grudhrasi is one of them. In Grudhrasi Siravedha & Agnikarma is to be performed in between Kandara & Gulfa.

Avagaha Sweda

- Vatavidhwansa

Useful products Trayodashang Guggul Vatavidhwansa Vatavidhwansa (Maha) Rasa (Jayapalyukta)

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Vatavidhwansa (Maha) Rasa (Jayapalyukta)

The best Amashoshak, Vedananashak, Shothaghna & Vatashamak kalpa Useful in Vatavyadhis like Grudhrasi, Amavata, Vishwachi, Avabahuk, Manyagraha with symptoms like Stambha (stiffness), Shoola (pain) & Shofa (Oedema) Useful for virechan in pakshaghata due to ingredient Jayapala

Trayodashang Guggul ∑The most admirable vatashamak & balya, rasayan Guggulkalpa Amayik Prayog Grudhrasi -
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Guggulkalpa
Amayik Prayog
Grudhrasi
-
Trayodashang Guggul
+
Maharasnadi Kadha
Sandhivata
- Trayodashang Guggul
+
Vatavidhwansa
+ Dashamoolarishta
Sandhigraha - Trayodashang Guggul +
Vatavidhwansa (Maha) Rasa

Vatarakta

Vatarakta is the disease caused by vitiation of Vata & Rakta. Both Vata & Rakta get aggrevated due to their own etiological factors. Vata gets obstructed by the vitiated blood & gets localized in the phalanges & toes and thereafter other joints are afflicted. It develops Shotha (oedema/swelling in joints), pain, tenderness, redness & warm touch. In this disease small joints are mainly affected. It is also described as Adhyavata or Vatashonita.

affected. It is also described as Adhyavata or Vatashonita. S y m p t o m

Symptoms Severe pain in joints Pain starts from carpellar joints i.e. from fingers or toes and then spreads to all other joints Swelling, pricking pain, redness, itching in the joints region Joints are warm in touch Severe tenderness or insensibility to touch Jwara Twitching sensation or tremors Discolouration of skin & appearance of circular patches over the body

General Treatment Snehan, Virechan, Basti, Raktamokshan

Virechan

Basti

Raktamokshan

Mruduvirechan (mild purgative) Anuvasana, Niruha - Siravedha/Jalaukavacharan

-

-

Parishek

Pradeha

 

Types of Vatarakta Uttana Symptoms Itching Burning sensation Pain Extension Pricking pain Throbbing sensation Black or coppery colouration of skin

Gambheera

Oedema

Stiffness

Hardness

Excruciating pain

Burning sensation

Pricking pain

Twitching sensation

Treatment Application of ointments Alepana (Pradeha, Lepa) Abyanga (massage) Parisheka

Virechan (purgation) Asthapana Basti Snehapana

(kwath/swaras) (affusion)

Asthapana Basti Snehapana (kwath/swaras) (affusion) Kaishor Guggul ∑ The potent Vatahar & Raktagata

Kaishor Guggul The potent Vatahar & Raktagata doshapachna action due to Amruta Vishesh Shodhit Guggul Helpful in Vatarakta with Shoolahar & Vedanasthapan action Amayik Prayog Vatarakta - Kaishor Guggul + Guduchi Choorna + Dashamoolarishta Kushtha - Kaishor Guggul + Mahamanjishthadi Kadha

10
10

Memorable Moments

Release of the book, `Ayurvediya Aushadhikaran' at the hands of Union Health Minister, Dr. Ambumani Ramadoss at World Ayurved Congress organized by Pune University (Left to Right Vice Chancellor, Pune University, Dr. Narendra Jadhav; Vd. Shailesh Nadkarni, General Manager, Healthcare Services, Shree Dhootapapeshwar Ltd., Dean of Ayurved Faculty, Dr. V.V. Doiphode and Shri. Ranjit Puranik, Chief Executive Officer, Shree Dhootapapeshwar Ltd.

Puranik, Chief Executive Officer, Shree Dhootapapeshwar Ltd. Shree Dhootapapeshwar Ltd. being given the Nagarjuna Award
Puranik, Chief Executive Officer, Shree Dhootapapeshwar Ltd. Shree Dhootapapeshwar Ltd. being given the Nagarjuna Award

Shree Dhootapapeshwar Ltd. being given the Nagarjuna Award for its Standardised and Best Quality medicine production. The award being received by Chief Executive Officer, Mr. Ranjit Puranik, from the then Vice President, Mr. Bhairavsingh Shekhawat (Left to Right Vd. Devendraji Triguna and Vd. Shriramji Sharma the then President, C.C.I.M.)

Release of Clinic Management System (C.M.S.) C.D. at the hands of the then Governor Rajasthan, Smt. Pratibhatai Patil at the 57th Plenary of All India Ayurved Congress (Left to Right Vd. R.H. Singh, Vice Chancellor, Rajasthan Ayurved University; Vd. Devedraji Triguna and Ex-Chief Minister of Rajasthan, Mr. Gehalot)

Triguna and Ex-Chief Minister of Rajasthan, Mr. Gehalot) Ex-Chief Minister Rajasthan, Mr. Gehalot, Smt. Pratibhatai
Triguna and Ex-Chief Minister of Rajasthan, Mr. Gehalot) Ex-Chief Minister Rajasthan, Mr. Gehalot, Smt. Pratibhatai

Ex-Chief Minister Rajasthan, Mr. Gehalot, Smt. Pratibhatai Patil visited Shree Dhootapapeshwar Ltd. stall at 57th All India Ayurved Congress and gave compliments to Swamala Compound (Left to Right Ex-Chief Minister Mr. Gehalot and then Governor of Rajasthan Her Honour Pratibhatai Patil)

Swamala Compound (Left to Right Ex-Chief Minister Mr. Gehalot and then Governor of Rajasthan Her Honour
11
11

Memorable Moments

11 Memorable Moments Shree Dhootapapeshwar Ltd. stall at "Arogya 2007" an event and exhibition organized at

Shree Dhootapapeshwar Ltd. stall at "Arogya 2007" an event and exhibition organized at Pragati Maidan, New Delhi on 26th to 29th October 2007

at Pragati Maidan, New Delhi on 26th to 29th October 2007 Release of `Arogyamandir Patrika -

Release of `Arogyamandir Patrika - Skin Disorders' at "Arogya 2008", Indore, Madhya Pradesh, at the hands of (Left to Right) Dr. S.K. Sharma, Respected Advisor, Ayush Department, New Delhi and The Minister for Medical Education Dr. Gauri Shankar Shejwar

Shree Dhootapapeshwar Ltd. stall at "Arogya 2008" an event and exhibition organized at Lal Bagh Palace, Indore on 4th to 7th January

organized at Lal Bagh Palace, Indore on 4th to 7th January issue of 'Arogyamandir Patrika’ ,

issue of 'Arogyamandir Patrika’ , we have M a h a r a s n a d i K a d h a , D a s h a m u l a r i s h t a ,

our

Kadha’ range which

beneficial along with Ahar Vihar. offers the great benefit for such conditions in ‘Sandhivikar’.

you the range of ‘GuggulKalpa’ like ‘Mahayograj Doctor, you have the experience of the quality

Guggul, Yograj Guggul, Panchamrut Loha Guggul, Kaishor Guggul, Trayodashang Guggul’ which not only guarantee better results but also ensures a) Fast

disintegration (less than 30 min.) & absorption b)No We reconfirm and resolve to be in the service in the side effects like gastric irritation or skin rashes. Ayurved being the manufacturer of Authentic,

Products from our 'Suvarnakalpa’ range useful for such conditions like Brihat vata Chintamani Ras, Chaturmukh Ras, Rasaraj Ras not only has Survanra Bhasma containing more than 97% Survarna but also gives you the confidence of being non toxic and safe even when used for prolonged duration.

P. N. Joardar Sales Manager

Standardised, Safe and Efficacious’ products as we have been for last 125 years.

discussed the different cause, sign and symptoms of “Sandhivikar” with the line of treatment proved to be

In this

Ashwagandharishta Standarised ‘Asava

are

the

products

from

Arishta

As you are aware that in such conditions we offer

medicines of Shree Dhootapapeshwar Limited in your day to day practice and continuing your patronage for the same for which we are thankful and oblige.

With warm regards

day to day practice and continuing your patronage for the same for which we are thankful
12
12

Amavata

Upanaha (hot poultice) Guduchi (Vyadhipratyanik drug)

Useful product Amavata, the disorder caused due to Rasavaha Srotas vitiation, similarly the symptoms developed due to Rasadushti. But as the manifestation &

localization is in joints, showing symptoms as Sandhishoola &

Sandhishotha (pain & oedema

in joints)

differential diagnosis.

This is the acute disease in which there is vitiation of vata

formation of Ama both at the same time with manifestation in

joints.

&

it has been included in Sandhivikar for purpose of

Kaishor Guggul

been included in Sandhivikar for purpose of Kaishor Guggul Osteoporosis The process of bone thinning or

Osteoporosis

The process of bone thinning or degeneration (Osteoporosis) is a natural part of aging. Still after certain limit the bones become porous or their density is less, causing the fractures of bones or bone loss.

Symptoms - Back pain Loss of height & stooped posture A curved upper back (dowager's hump)

Bone

especially in the hip, spine & wrist

ÙegiehelkegâefheleeJevleefŒekeâmeefvOeØeJesMekeâew ~ mleyOeb Ûe kegâ®lees iee$eceeceJeele: me GÛÙeles ~

cee.efve.

get

cracked

(fracture)

even

with

minor

injury,

The disease can occur at any age but mainly it affects in middle age. It is very painful & serious disease. Symptoms -

Body ache, Loss of taste, thirst

Lack

Fever

Oedema, Indigestion

Pain & inflammation in big joints of hands & legs like hip, knee, ankle, elbow, wrist etc.

Severe tenderness, redness, warm touch Milk, Wheat, Ragi,

Immobility of organs of body

Fleeting pain shifting from joint to joint Vihara -

Treatment - The early diagnosis of Asthikshaya (Osteoporosis) is very important as far as treatment is concerned. If the treatment is given early, one may be able to stop or slow the progress of bone loss.

Ahara -

of enthusiasm, heaviness in the body

Treatment -

uebIeveb mJesoveb efleòeâoerheveeefve keâšgefve Ûe ~ efJejsÛeve mvesnheeveb yemleÙeMÛeececee®les ~

The main treatment is to destroy Ama. For Amapachan, Langhana (Fasting) with use of Tikta (bitter) & Katu (pungent) drugs are advised.

Amapachan -

Swedan

Langhan, Tikta-Katu Rasatmaka Dravya Rooksha Sweda, Valukasweda Sneharahit Upanaha - Erandsneha Vyadhipratyanik

-

Virechan

DeeceJeele iepesvõmÙe MejerjJeveÛeeefjCe: ~ SkeâcesJee«eCeern&efvle Sjb[mvesnkesâmejer ~

Erandsneha or Castor oil is the first line of treatment in Amavata.

Basti

-

Vaitaran Basti Prayog

Herbal drugs

-

Erandasneha, Guduchi, Shunthi, Bhallatak, Karaskar, Suvarna

Useful products - Sinhanad Guggul, Vatavidhwansa, Vatavidhwansa (Maha) Rasa (Jayapalayukta)

In the Jeernavastha (chronic condition) of

Amavata Sinhanad & Guggul in Dhatukshayajanya Amavata

Suvarnakalpas The wellknown are remedy best Rasayan of Amavata which with

prohibits Vyadhipratyanik recurrence. Erand taila

Excellent Vatahar, Shothahar, Shoolahar & Amanashak Kalpa Beneficial in Amavata with main action of virechan

● Beneficial in Amavata with main action of virechan Regular proper exercise, Prevent fractures, Maintain or

Regular proper exercise, Prevent fractures, Maintain or increase bone thickness, Increase physical ability

Aushadhi - Useful for increasing Bone Mass Density.

Asthiposhak

Dravya

-

Laksha,

Shatavari,

Praval,

Beneficial in Asthibhagnottar Sandhishool

- Lakshadi Guggul +

Kukkutandatwak Lakshadi Guggul Bhasma

Useful Asthisoushiryajanya Sandhishool & Asthibhagna Snehan - Mrudu Snehan

Asthisoushirya - Lakshadi Guggul + Praval Panchamrut + Kukkutandatwak Bhasma

Asthibhagna

Kukkutandatwak Bhasma + Ashwagandharishta Asthibhagnottar - Lakshadi Guggul + Shool Dashamoolarishta

Asthibhagnottar - Lakshadi Guggul + Shool Dashamoolarishta For more details please contact: Health Care Services Shree

For more details please contact:

Health Care Services

Shree Dhootapapeshwar Ltd.

135, Nanubhai Desai Rd., Khetwadi, Mumbai - 400 004 Tel. No: 91-22-3003 6300 Fax: 91-22-2388 1308 e-mail: healthcare@sdlindia.com website: www.sdlindia.com