E-ISSN:2584-0002

Review Article

Panchakarma

International Journal of Ayurveda and Herbal Research

2023 Volume 1 Number 1 April
Publisherwww.a2zjournals.com

Efficacy of Mashadi Upanaha Sweda in Niramavastha of Janusandhigata Vata- A Review

Borkar S.1*, Damle A.2
DOI: 10.54060/ijahr.v1i1.1

1* Susmita Borkar, Assistant Professor, Department of Panchakarma, Ashvin Rural Ayurveda College Manchi Hill, Sangamner, Ahmednagar, Maharashtra, India.

2 Anjali Damle, Assistant Professor, Department of Panchakarma, Tilak Ayurveda Mahavidyalaya, Rasta Peth, Pune, Maharashtra, India.

Abstract: Sandhigata Vata is form of Vata vyadhi mainly affecting knee joint (Janusandhi), because it is weight bearing organ of body. Due to day- to- day sedentary lifestyle and Vata prakop causes Doshavaigunya and Dhatuvaigunya. When the vitiated Vata aggravates in Janusandhi called as Janusandhigata vata. In Janusandhigata vata Shoola (pain), Shotha (swelling), Akunchana Prasaranayoho Savedana Pravrutti (pain during movements), Vatapurna druti sparsha (crepitus) of the joint are common clinical features. In Niramavastha of Sandhigata vata, dhatukshaya is a major event. Upanaha sweda or poultice application is one of the chikitsa described in the management of Sandhigatavata under samanya chikitsa sutra of swedana. Mashadi Upanaha sweda is of Guru, Snigdha, Brumhana, Vataghna by property, mixed with Masha,Godhuma, Devodar choorna,Kanji, Tilataila, Godugdha, Saindhava decrease vitiated Vata dosha and gives strength to the joints. This article is an initiation to study its efficacy of Mashadi Upanaha sweda in the management of Janusandhigatavata Niramavastha.

Keywords: Janusandhigatavata, Niramavastha, Mashadi Upanaha, Swedana

Corresponding Author How to Cite this Article To Browse
Susmita Borkar, Assistant Professor, Department of Panchakarma, Ashvin Rural Ayurveda College Manchi Hill, Sangamner, Ahmednagar, Maharashtra, India.
Copyright © 2023 The Author(s).
Email: 		Susmita Borkar, Anjali Damle, Efficacy of Mashadi Upanaha Sweda in Niramavastha of Janusandhigata Vata- A Review. IJAHR. 2023;1(1):1-5.
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Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-02-22 2023-04-01 2023-04-04 2023-04-07 2023-04-10
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 16 16

© 2023by Susmita Borkar, Anjali Damleand Published by A2Z Journals. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Introduction

Health is not merely an absence of disease, it is physical, mental and social wellbeing as told by “WHO” in its definition [1]. According to Ayurveda, Sushrutacharya has mentioned the Swastha vyakhya-State of equilibrium of Doshas, Agni, Dhatu, Mala, as well as gratification of Atma, Indriya, Mana is called Health [2]. Following proper diet (Ahara), practicing wholesome regimen (Vihara), and taking adequate sleep (Nidra) helps to maintain equilibrium of Dosha, Dhatu, Mala. According to Tridoshas, Vata is most important to doing cheshtha and responsible for all diseases when it gets vitiated. It has control over all the movements of body and mind including the nervous system too. Remaining Doshas (Pitta and Kapha) and other ailments of body are dependent on Vata Doshas for the movememts of body [3]. Now a days, Health is hampered due to many urbanization issues which creates disturbed lifestyle habits leads to health deteoriation causing Doshavaigunya and Dhatuvaigunya. Sandhigatavata stands top in the list. The cause of pain in Sandhi’s by prakupita vata dosha is the chief phenomena in the Samprapti of Sandhigatavata. Janusandhi is one of the types of Marma and comes under the Madhyama rog marga and thus involvement of the Madhyama rog marga, Vata dosha and Dhatukshaya make disease kashtasadhya. In this Ayurveda has two approaches [4].

a.Nirupastambhita vata (Dhatukshayajaneeta) 

b.Upastambhita vata (Margavarodhjanya)

In Nirupastambhita Vatavyadhi, Vata is only karak dosha while in Upastambhita vatavyadhi there is a presence of Aam and rest dosha. Sandhigata vata is more prone to be affected to knee joint, because it is the most frequently involved joint in daily routine work. It can be correlate with osteoarthritis because of similarity in clinical features as Sandhishool (Pain), Akunchana Prasaranayoho Savedana pravrutti (pain during movements), Vatapoorna Druti Sparsha (Crepitus), Sandhi Shotha (Swelling) [5].                                                

Panchakarma is a very unique therapeutic procedure because of it is preventive, promotive, prophylactic and rejuvinative properties as well as providing a radial cure. Acharya Sushruta mentioned the treatment for Sandhigatavata

clearly i.e.Snehana, Upanaha, Agnikarma, Bandhana and Unmardana in chronological order [6]. Swedana is one of the chikitsa in the Vatavyadhi samanya chikitsa sutra.

Etymology-Upanaha is Charamapatta i.e.Bandage [7]. The word Upanaha is of masculine gender, derived by adding the Upasarga ‘Upa’ to ‘Nah’ dhatu which means Bandhana.

In Upanaha sweda, medicated paste is applied over the knee joint, tied around and kept for some time.These procedure were described in Sushruta Samhita [8]. and Sharangdhara Samhita [9]. In Niramavastha of Sandhigatavata, dhatukshaya is a major event, so it becomes necessary to select some Vataghna, Guru, Brumhana, Ushna, Snigdha Upanaha sweda.

Table 1. Ingredients of Mashadi Upanaha [10]

Drugs Name Using part Guna Latin name
Masha [5] Seed  Vatashamaka Phaseolus mungo Linn.
Godhuma [11] Seed  Vatanashaka,  Kaphaprada Triticum aestivum Linn.
Devodara [12] Moola  Kaphavatashamaka Cedrus Deodara (Roxb.) Loud.
Tilataila [14] Sesame oil Vatakaphaghna Sesamum indicum
Godugdha [13] Cow milk Vatakaphahara Milk of Bos Taurus indicus
Saindhava [14] Rock salt Tridoshaghna Sodii choridum imura
Kanji [14] Dhanyamla Vatakaphahara -

 

As a Upanaha sweda found to be decrease vitiated Vata dosha and gives strength to the Janusandhi. In order to study the effectiveness of Mashadi Upanaha sweda and treat the patients of Janusandhigatavata Niramavastha.

 

Sandhigatavata Niramavastha Samprapti [15]

Samprapti Ghataka-

Nidana- Vataprakopaka Nidana

Dosha- Vyana vayu and Shleshaka Kapha

Dushya- Mamsa, Meda, Asthi, Majja

Srotasa-Asthivaha, Majjavaha


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Rogmarga- Madhyama Marga

Udbhavasthana- Pakwashaya

Adhisthana- Asthi Sandhi (Janu Sandhi)

Sandhigata Vata Niramavastha Samprapti

IJAHR V001 Iss001 SN 001 Im 2.jpg

Upanaha Sweda is the only type of Sweda which comes under both Agni and Niragni type of sweda. Preparation of Upanaha Sweda as per Standerd Procedure according to the Sharandhara Samhita [9].

Procedure of Upanaha Swedana [9][14]

Poorva Karma

  1. Masha Choorna, Godhuma Choorna, Devodar Choorna each weighing 80gms were mixed together.
  2. Mixture was taken in a bowl and Saindhava 10gm, Tila taila 100 ml, Godugdha 200ml, Kanji 100ml were added.
  3. All ingredients were mixed well with uniform consistency.
  4. 5 ml Oil were taken in pan and heated for 2min. Prepared paste was added and heated for 3 min until it became soft.

 Pradhana Karma

  1. Sthanika Abhyanga was done for 5 min over affected knee joint with Tila taila.
  2. Now the warm paste layer of 1 cm thickness was applied on Manjarapaat kapada and placed on affected knee joint of the patient.
  3. The warm Upanaha Sweda was tied over knee
    joint, covering it completely in its circumference as well as 6 cm below and above the midpoint of the joint and leave it for 6 hrs.

Pashchat Karma

Upanaha was removed after 6 hrs and knee joints were cleaned with warm water and asked to have a rest. Upanaha sweda was given for continuous 7 days and follow up was done on 14 days.

Discussion

Janusandhigatavata is common at the old age group due to Dhatukshaya which leads to Vataprakopa. Because of Ashrayashrayi Sambandha, Vata which resides in Asthi starts aggravating due to Dhatushosha via-a-vis causes Degeneration. In Niramavastha of Janusandhigatavata,due to Vata prakopa and Shleshaka Kapha kshaya, the Ruksha, Khara, Parusha gunas are increased in sandhi. Mashadi Upanaha sweda decreases all gunas with its Guru, Snigdha gunas and pacifies Vata. Mashadi Upanaha sweda is composed of Masha, Godhuma, Deodar choorna, Saindhava, Kanji, Tilataila, Godugdha which is Ushna, Guru, Snigdha, Brumhana, Balya. It helps in the caesation of pathogenesis. Properties of materials have Madhura, Katu predominant rasa and Madhura vipaka it acts as a Brumhana so,ultimately dhatukshaya was reduced. Specific action of the contents, they predominantly act on Mamsa, Medo, Asthi, Majja Dhatu.

Mode of action of Mashadi Upanaha sweda in Janusandhigatavata [16]

  1. Upanaha Sweda is Vatashamaka due to its Snigdha and Ushna gunas.
  2. The drugs selected in Mashadi Upanaha are having most of the properties of Swedana dravyas contributing mainly Vedanasthapana, Shothahara, Vatashamaka.
  3. The inner temperature rises affect the function of pituitary gland. By heat, the pituitary accelerates the body metabolism and affects several internal hormones.
  4. Hot fomentation causes dilatation of the vessels and induces hyperemia. Due to this capillary pressure increases and decreases the congestion of internal organs, eliminating the toxins and tissue relax.

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Increase peripheral circulation provides transport to help to reduce oedema which can help in inflammation, decrease pain and speedy healing. Warming of the body has been shown to exhibit sedative effect via sensory nerve ending.

Observations

Parameters for Assessment [14]

The following Parameters were assessed on Day 0 (screening), Day 7 (On completion of treatment) and Day 14 (follow up day).

  1. Sandhi Shoola was assessed using VAS scale.
  2. Akunchana Prasaranayoho Savedana Pravrutti was assessed through WOMAC index.
  3. Vatapoorna Druti Sparsha was assessed through WOMAC index.
  4. Sandhi Shoola was assessed by measuring tape in cm.
  5. Walking Time- The patient was asked to walk a distance of 100m and the time required for the same was noted.
  6. Goniometry- knee joint angle was measured with the help of goniometry.

Table 2. Average Relief in Percentage

Sr. No. Symptoms Relief on 7 Day Relief on 14 Day
1. Shoola 54.59% 57.47%
2. Vatapoorna druti Sparsha 40.71% 45.54%
3. Prasaranaa Akunchanayoho Savedana Pravrutti 55.71% 59.56%
4. Shotha 6.46% 6.81%
5. Walking Time 17.18% 20.22%
6. WOMAC INDEX 29.92% 32.85%
7. Goniometry 32.83% 32.91%
8. VAS SCALE 46.69% 49.96%

 

 

Conclusion

Present study reveals that the selected management have effect on Niramavastha of Janusandhigatavata with no side effects. Thus, we can conclude that Mashadi Upanaha sweda is very effective in the management of Niramavastha of Janusandhigatavata.

References

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