role of gunja patra lepa in amavata

ROLE OF GUNJA PATRA LEPA IN AMAVATA RELATED JOINT PAIN: A LITERARY REVIEW

Authors:

Surbhi Rajiv Kadu1, Dr.Minakshi A.Urkude*2 , Dr. Manoj Patil3

1: Intern(B.A.M.S), Mahatma Gandhi Ayurved College Hospital & Research Centre, Salod (H), Wardha-442001, Datta Meghe Institute of Medical Sciences (DU), Nagpur, Maharashtra

India

2 Assistant Professor, Agadtantra Department, Mahatma Gandhi Ayurved College Hospital & Research Centre, Salod (H), Wardha-442001, Datta Meghe Institute of Medical Sciences

(DU) Nagpur, Maharashtra India

3Research Consultant, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha.

*Corresponding author-

Dr. Minakshi Urkude

Assistant Professor, Agadtantra Department, Mahatma Gandhi Ayurved College Hospital & Research Centre, Salod (H), Wardha-442001, Datta Meghe Institute of Medical Sciences

(DU) Nagpur, Maharashtra India

Email: [email protected]

[email protected]

Wutan Huatan Jisuan Jishu

Volume XVI, Issue XII, December/2020

ISSN:1001-1749

Page No:991

ABSTRACT

Summary:In today’s modern era, everybody is busy in fast life schedule and living a stressful life with several problems in their biological system. Pain is an agonising symptom experienced by human beings which is many time inducing distress. Amavata is one of the most commonest disease which is found in this era, due to weakness in Agni, Adhaya rasa becomes immature and improperly metabolized substance called ‘Ama’ which manifest in Amasaya. Ama which is manifested due to vikrut Agni that is Mandagani get lodged in Kapha Sthana with the help of vitiated Vyan vayu producing stabhana (stiffness), shoth (swelling) and tenderness in the joint which is correlated with Rheumatoid arthritis. Amavata is a chronic systemic disease of multiple joint involvement.In this disease, pain may begin to migrate from one place to another with a vrishchika damshavat vedana and burning sensation. In joint disorder,Amavata is very distressing disease. By world-wide population, female should be more prone than male. In Ayurveda, Amavata is treated by Ahara (means diet), Vihar (means lifestyle), Aushadhi chikitsa (drugs) and Panchkarma therapy. Gunja patra Lepa is one of formulation for Amavata which is mentioned in Rasatarangini as Shothahara and Vedanahara. Gunja is one of toxic plant mentioned as upavisha. But it have many therapeutic uses. According to Rasa, Guna, Veerya, Vipaka, Gunja is a Tikta kashayarasatmak, Laghu, Ruksha guna, Katu vipaka and Ushna Veerya, these factors reduced the vitiatedKapha and Vata Dosha and reduced the Amavatic Ruja means pain and swelling.

Keywords: Amavata, Rheumatoid arthritis, Gunjapatra lepa, Mandagni, Vrishchika damshavat vedana

INTRODUCTION:

Now-a-days,Amavata is a commonest disorder occurring due to changes in the lifestyle. On the basis of sign and symptoms in Ayurveda, Amavatais described first by Madhavakara1, it can be correlated with Rheumatoid arthritis by modern. Amavata has caused by the impairment of Agni, formation of Ama(biotoxin)and vitiation of Vata(bio-physical force)2. The word ‘Ama’ means incomplete digestion or undigested food result may lead to impure or toxic formation of Annarasa which may circulate in the whole body by the weakening of digestive fire. This impure or toxic Ama circulate by vitiated ‘Vayu’ and it may travels throughout the whole body and accumulates in the joints of body. Continuing of this process, all the joints are gradually affected one by one, which may result in severe pain and swelling in the joints. Vata, Pitta and Kapha plays important role in Amavata, pain and swelling may develop by vitiated Vata,and Kapha respectively.Burning sensation around the joints may develop by aggravated pitta.3

Definition:- The condition in which Vitiated Ama and Vata simultaneously lodge in Trika and Sandhi (Joints) leading to Stabdhata (Stiffness) of the body is known as Amavata. 4By modern science, it may correlate with RA (Rheumatoid arthritis). This is a chronic inflammatory, multisystemicinvolvement of joints of unknown origin.It is autoimmune disease.



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Inflammatory synovitis is the main feature of Rheumatoid Arthritis involving symmetricl distribution of peripheral joints.5

Basic Concept:- Main factors of the disease are Ama, Agni, Vata and involvementof Sandhi. In Ayurvedic classics, Ama is a stage which is due to hypo functioning of Pachakagnii.e. Mandagni as a consequence of Ahara, which can’t be digested properly. This undigested food material remains as an intermediate product of digestion in Amashaya. It is a type of toxic material, which is called Ama is strong enough to cause inflammation in the various body parts like synovial joints. 6

Etiology of Amavata: Mandagni (Weak digestive power), Guruahara (Heavymeal), Avayayam (Sedentary lifestyle),Viruddha Ahara (incompatible food).7

Samprapti of Amavata: When a person of sedentary habits with hypo functioningof digestive mechanism indulge in incompatible diet and regimen like Virrudhaaahara –vihar,the toxic Ama will formed and carried by vitiated Vayu and reaches the site of Sleshma or Kapha.By the vitiation of Vata, Pitta, and Kapha, Amarasais then circulated through the vessels (Dhamini) in whole body. By accumulatingin the small channels& joint pores result may produces a feeling of

Intake of etiological factor

Agni Dushti

Improper

digestion/indigestion of even

light food

Formation of toxin (Amavisha) GIT

Circulation of Amavisha in blood with

help of vitiated Vata

Dushti of Dhatwagni and Bhutagni

Sthansanshraya of Ama in Sandhi

Manifestation of

DiseaseAmavata



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heaviness& stiffness in whole body and produces the symptoms of Amavata. This toxicAma is the main cause of so many distressing diseases like Amavata.8

Sign & Symptoms of Amavata:- Acharaya Madhavkara has clearly stated the Rupas (sign & symptoms) of Amavata in Madhav Nidana. The Pratyatma Laksana (Main symptoms) are Gatra stabdhata, Sandhishula, Sandhishoth, Sparshasahyata and Samanya Laksana(General symptoms) are Angmarda, Aruchi, Trishna, Alashya, Gaurav,Jvara, Apaka, Angasunnata.9

In modern science, symptoms of Rheumatoid Arthritis are Anorexia, weightloss and fatigue, stiffness and pain in joints(Athralgia) are the most common symptoms that occurs throughout the disease course and many precede the assets of articular symptoms by weeks or months.10

Samprapti Ghatak of Amavata:-11

Dosha Tridoshaj mainly Kapha (Kledak, Bhodhak, Sleshak)and vata (Vyana, Samana, Apana)

Dushya Rasa dhatu, Mamsa dhatu, Asthi dhatu, Majja dhatu

Agni Jatharagni

Upadhatu Snayu, Kandara

Srotodusti Sanga, Vimargagaman

Udbhavsthana Ama Pakvasayottha

Amasaya chief site of production of toxic Ama

Pakvasaya Main siteof Vata.

Adhisthan Sandhi (joint of whole body)

Rogmarga Madhyam

Complications of Amavata:-

In Madhav Nidana the Upadrava (complications) are stated as Jadya(Stiffness), Antrakujana(Blotting), Trit(Dypsia), Chardi(Chardi), Bahumutrata (Polyuria), Shula(Pain), Samkocha (Contraction),Khanjata(Limping)etc.12 In modern science, complication of RA (Rheumatoid arthritis) are septic arthritis, amyloidosis, swelling and pain behind the knee joint may be caused due to extension of inflamed synovial into the popliteal space called as Baker’s cyst. Gunja Patra Lepa: Gunja patra lepa is one of formulation for Amavata which is mentioned in Rasatarangini as Shothahara and Vedanahara. This Lepa contains only fine paste of Gunja Patra which may apply on joints of Amavata Patients.13

Name of Drug

Part used

Guna Rasa Veerya Vipaka Karma Pharmacological Activity

Gunja14 / Abrus precatorius

Leaf Laghu, Sheetal, Rooksha

Tikta, Kashaya

Ushna Katu Sthothahar, Vedanahara

Anti-inflammatory activity15,16, anti-arthritic activity, analgesic activity17



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DISCUSSION: By contemporary science, treatment modalitiesare by giving pharmaco-therapies likenon-steroidal Anti Inflammatory Drugs, Intra articular injection and Surgery. There has been less response to the therapy with increased side effects. The Shamana procedure like Snehana, Swedana, Lepa, Bandhana, Agnikarma and Raktamokshana are emphasized in Ayurveda to provide better relief from the pain and swelling and restore the mobility.

Mode of Action of Gunja patra lepa: Gunja patra lepa is explained by Rasataranginiinashaman therapy to relieve shotha and act as vedanahara. Gunja Patra (leaves) are pasted with warm water applied over the affected part, it helps to reduce the local pain (vedana), swelling (shoth), tenderness and stiffness of the affected joints of the whole body and also help to break down the Sthanik (locally) Samprapti (pathogenesis) of the disease.

Gunja is commonly known as Abrus precatorius Linn which may found in all over India. All the parts of this plant like roots, leaves and seeds are useful for various therapeutic use.Its chemical constitute are abrin, glycosides, alkaloids, triterpene, flavonoids and.[18]By modern researches, the plant is reported anti-inflammatory activity, analgesic and anti- arthritic activity. Few articles related to arthritis and arthropathies of different joints with allopathic remedies were reviewed 19,20,21. Labour work related and sports related musculoskeletal morbidities have been reported 22,23for which this remedycan be a cheaper option. Evidences from Global burden of disease are reported 24,25.

Gunja is considered as toxic plant. Mostly seeds and roots are very toxic in nature. For medicinal use, seeds and roots should be used after their proper Shodhana procedure. But when we useleaves for external,Shodhana is not needed. Gunjais easily available plant. According to pharmacodynamics of Gunja, itis a Tikta kashayarasatmak, Laghu, Ruksha gunatmak, Katu vipaka and Ushna Veerya means hot potency, so all these factorreduces the vitiated Kaphaand ultimately pacify the Ama , so that toxin will be reduced and cleared all the micro-channels. Circulation will be normal by reducing Amavatic Ruja means pain and swelling.

CONCLUSION:

As result of this, we mayuseGunja Patra Lepa in Amavata associated joint pain. Due to physiological effect of heat locally applied Lepa work fast on the skin. In today’s era, Bahirparimarjana or local application in the form of Lepa or ointment may be the selection of choice for fast relief.

Acknowledgement- I would express my sincere gratitude to Dr. Minakshi Urkude and Dr. Poonam Sawarkar for their generous support.

Funding support- Nil.

Conflict of interest- Nil.

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role of gunja patra lepa in amavata

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