Amavata Vigyan Science of Rheumatology

Amavata Vijnana or rheumatology isn’t a specialty of the classic Ayurveda but of Neo- Ayurveda. The word “rheuma” comes from Greek and means “flow” that circulates through the channels. In ancient times, when medicine was based in the theory of “humours” (Hippocrates), it was believed that rheumatic diseases appeared by the "flow” (or rheuma) of a humour from the brain to the joints (black bile: vata).

Ama together with Vayu spreads through the body and stays in Kapha or Pitta places (it is said that Rheumatic Fever or Amavata Jwara, "licks the joints but bites the heart"). Joint pain, fatigue, indigestion, inflammation, vascular and cardiac disorders, are signs that appear in the three Doshas, but it depends on the specific Dosha how the rheumatism is expressed:

Vata amavata
• severe and travelling pain,
• cracking joints,
• worse in winter,
• with greater deformity,
• constipation, gas,
• fear, anxiety and insomnia.

Pitta Amavata
• with possible fever,
• gastritis,
• infections,
• worse in summer,
• itching,
• irritability and anger.

Kapha Amavata
• with diarrhoea and loss of mobility,
• obesity, oedema,
• worse in damp cold,
• numbness,
• depression and congestion.

As a causal factor we examine the possible influences like diet (Ahara Karana), lifestyle (Vihara Karana), trauma (Aghataja Karana), infections (Krmija Karana), hormonal (kulaja karana) and hereditary (Sahaja Karana)

Briefly on Sandhivata, osteoarthritis in General

It's when Vata gets into Sandhi and Sleshaka Kapha (joints, synovial fluid) drying and degenerating (osis) the joint. It affects all doshas, without manifestations other than the joints, with just a few joints affected and in the Vata age. It can go with osteopenie even without changes in blood tests. Amongst other causes that have influence there is heredity and santarpana (overeating), little or too much exercise. As Chikitsa it is particularly important to have the right weight, the more weight the joints have to support, more osteoarthritis there will be. As Vihara, gentle exercise (swimming, yoga) is very important because exercise stimulates the muscle, this is where the periosteum is, which stimulates the synovial membrane to release more liquid and thus lubricate the joint. A sedentary lifestyle promotes osteoarthritis as there is no muscular stimulation of the synovial membrane; on the other hand excessive sports lead to wastage. As Dravyas poultices with laurel berries in olive oil maceration or any lukewarm Snehana in the area are very good, either with Dhara or Abhyanga. And so we could number the 200 rheumatic or soft tissue

30 diseases (like fibromyalgia) in which the basic treatment is very similar: this is according to Dosha, place, time, balance, mental status, strength, digestive power, economic status and so on. All treatment associated with rheumatism begins with losing weight first, then not further increasing the Ama (correcting constipation and the digestive fire). Only then purification through either Panchakarma, fasting, Ahara, Vihara, Doshacharya, play therapy, long term weight control Vastu, relaxation, Pranayama, meditation, yoga, music swimming or hydrotherapy is recommended. The idea is not to strengthen, but to increase the joint range. Pillars of treatment: vegetarianism, not being overweight, weekly fasting with only liquids, eat half of appetite, walking twice every day, laughing three times a day on a regular basis.

Sandhigata Griva Vata means spondyloarthrosis

Human beings are still not adapted fully to the standing posture and gait; and osteoarthritis is a proof of it (as well as varicose veins, painful childbirth, the meniscus in the knee, flat feet and many more). Many times osteoporosis presents itself with back pain, which is nothing else than the body simply defending itself, the bone in osteoporosis is a healthy bone, so there are no alterations in the blood, Samprapti is when Vata enters Asthi Vaha Srota— it will increase the intraosseous space, the vertebrae gets weakened and can no longer support the spine so the muscles contract to prevent the vertebrae from flattening. The therapist, who does not know this, will massage and do everything possible to remove the contraction, thus aggravating the pain and the problem. On the other hand, osteophytes and disc abnormalities lead to instability of the spine which is compensated by the muscles that contract to protect. Leukemia and blood dyscrasias also come with low back pain (vertebrae are flat bones such as the entire trunk and head, ergo they make blood) and muscle pain through the same mechanism. The proper diagnosis of what is happening is very important in all respects; if the diagnosis is wrong, the treatment will invariably be wrong, even if it is well implemented. Asthi Vaha Srota needs space and air for the pores and micro circulation; otherwise it begins to accumulate in the principal seat of Vata—the colon.

The signs and symptoms of Vata imbalance accumulation start as intestinal gas, abdominal pain, constipation and a dry mouth. It may also increase as a result of fear and anxiety. It can be also the product of heredity, repressed emotions, karma, trauma, climate, addictions, age and so on.

Amavata: rheumatism Amavata is rheumatism with Samprapti Ajeerna, meaning with an evolution on the indigestion (among other factors such as heredity, biotype, lifestyles, etc.). The Ama is then propelled by Vata to Kapha sites (Sthana Kapha) and predominates in wrists, knees and ankles (Sleshaka Kapha). It can be Avara: severe. Madhya: moderate. Pravara: mild. Extra- articular manifestations: nodules, anemia, osteoporosis, Ajeerna, pleurisy, lack of faith in therapy and / or mystical search for therapies. Disability at some point. Loss of family support (very important if you have a partner or not) possible economic instability. Rheumatism goes with possible anxiety and depression (Tamas). They are usually Vata imbalances (Vata Vyadhi) or at least Vata related. Rheumatic diseases often have similar symptoms, especially in the beginning; often it is the evolution, which allows you to define a diagnosis. Asthi needs space and air for the pores and microcirculation. Vata penetrates Mamsa Dhatu and causes rigidity or fibromyalgia. Vata gets into Rasa-Rakta Dhatu and gives cold hands and feet. Vata enters into Rakta Dhatu (fujuice fasting beneficial in weightcontrol and detoxification els the fire). Vata penetrates Asthi and causes osteoporosis, simultaneously penetrating the vertebrae and discs, drying and degenerating them. The primary cause is the accumulation of Ama for not following a correct Ahara and/or its combination, followed by the mind (Pragna Aparadha). Inadequate quality, quantity, harmony, and Vihara Ahara adequacy: Trikalacharya or times of life, season, climate, Dosha and Subdosha, etc. make that Ama in the colon ends up settling in Asthi Dhatu.

Briefly on Amavata Chikitsa Addressing constipation as a first step. Gentle light mobility on the joints (ideally swimming). Local wet fomentation (nadi sweda) with sesame, ginger, parsley, garlic, turmeric, comfrey (see later). If there is edema, dry fomentation, Churnas, Abhyanga and fomentation with plant leaves (Ela Kizhi). It is shown now in the West that fasting is beneficial in arthritis and reduces in subjective and objective form the activity indices of the disease. Same goes for Vegetarianism in the inflammation of the soft tissues such as fibromyalgia. Constipation and cold beverages or foods worsen the picture and Vata symptoms. It is always important to normalize the function of the digestive system. By normalizing Agni, Ama no longer occurs. Ama that has been generated already and is now stationed in the affected joints should be eliminated by purification programs such as Pancha Karma and the use of Dipana Pachana. Proper diet after the purification. Castor oil is heavy, oily and strong. Its actions are those of being a purgative and analgesic. It's good for the treatment of Vata imbalances. Ginger, cinnamon, anise, angelica (a bath prepared with 100 g. of roots, leaves and seeds is very relaxing) Swedana accordingly purifies the Srotas and eliminates Ama.

Snehana or oleation: oil the body prior to Swedana (castor, ghee, hot milk, ripe banana, baked apple, plums!, compotes, flax seeds, soaked figs, not dried) Kati Basti (lumbar Dhara). Abhyanga, Marma therapy, Shirodhara. Aharah-Vihara-Aushadi Vata (Vagbhata laws in everything Trikalacharya). Mobility, vegetarianism (be careful with anemia) and fasting, the best thing for rheumatism (... and for all). Dravyas: You can mix 7 ml of castor oil with tea or ginger. Other: Nettle, Rosemary, Rue, Chamomile, Dandelion. Local wet fomentation (nadi sweda) with sesame, ginger, parsley, garlic, turmeric, comfrey. If there is edema, then dry fomentation, Churnas, Abhyanga and fomentation with plant leaves (Ela Kizhi). It is shown now in the West that fasting is beneficial in arthritis as it reduces subjective and objective indices of disease activity. Same goes for Vegetarianism in the inflammation of soft tissue such as fibromyalgia.

Nitamba sandhi, sacroiliac joint Today we know that it is the seat of three diseases that start with sacroiliitis. Ankylosing Spondylitis: (Dandaka), although it is diagnosed seronegative, it predisposes HLA B27: more common in men. Comes with stiffness of the column and the limbs. Paget's osteitis deformans. Increases the alkaline phosphatase of the osteoblast, the bone grows in size, it becomes increasingly hard and at the same time brittle. Rheumatic Fever (Amavata Jwara) caused by streptococcus. It is diagnosed according to the Jones Rheumatic Criteria. Below: Vedana Shamana is the Sanskrit name for relaxing or antispasmodic analgesic plants

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