Randomized comparative clinical study to evaluate efficacy of virechan karma using Kashmaryadi kashay and Ardhamatrik niruh basti in vaatrakta with special reference to gout.

Vatarakta is a great medical problem throughout the world. It is a great enemy in the society, because it distresses the human life. In Ayurvedic context, various treatment modalities have been suggested to get rid of this disease. In Vatarakta, both Vata and Rakta get aggravated and vitiated by their hetus and ultimately vayu gets obstructed by vitiated Rakta.

The classical texts lay down ample importance to the functions and characteristics of vata. At the same time, rakta being the foremost body tissue also plays an important role in sustaining the healthy life style of a person. Vatarakta is a disease where both VataandRakta are afflicted by distinct etiological factors. The disease characterized by the abnormality of raktadhatu due to morbidity of vatadosha is called as Vatarakta. “Vatadushitamraktam yatra rogavisheshah”

Vata dosha becomes enraged by frequent use of Kashaya(astringent), katu (pungent), Tikta (bitter), Alpahara(scanty diet), RukshaAhara(dry food articles), Abhojana(abstinence of food) or by regular riding on Ashva(horse), Ushtra(camel) or Yana(vehicle) etc;this agitated Vataenters into blood through carrying channels of the body and gets obstructed in its passage by vitiated Rakta Dhatu, thus affecting the entire blood and leading to Vatarakta.

Once again Acharya Charaka described that Vata due to its Sukshmatva (subtleness), Sarvasaratva (pervasiveness) properties and Rakta due to its Dravatva(liquidity), Saratva (flowing nature) properties; circulate through the body and blood vessels (RaktavahaSrotasa) and get obstructed in Sandhi(joints). Due to torsion nature of its course in joints;Rakta and Vata again get agitated. After localization and in combination with Pitta Dosha they cause different types of Shula (pain) according to predominance of Doshas. Vatarakta is an age old common condition prevalent all over the world.

On the basis of symptomatology and chronicity of disease, this can be correlated with a similar condition of modern medicine named as Gout.Gout is a clinical syndrome and is a group of metabolic diseases in which clinical manifestation is associated with tissue deposition of crystals of monosodium urate monohydrate from Hyperuricemia body fluids.

Incidence of Gout appears to have increased over in a few decades due to increasing industrialization,urbanization,faultydietary habits,radiation, drug toxicity and other factors responsible directly or indirectly for the disease Gout. Hyperuricemia and Gout may result from increased urate production or decreased uric acid excretion or both.

Reported prevalence of Gouty Arthritis is 2.0 to 2.6 per 1000 patients, usually between the age group of 25-50 years.

Sushruta explained Vatarakta entity in ‘Mahavatavyadhichikitsa’. Hence it is an identical one among all other vatavyadhyi. It is also known as vatashonita, khhuddavata, vatabalas, and aadhyavata.

Panchakarma is treatment modality used very extensively and effectively in Ayurveda. It plays an important role in Vatarakta. Acharya Charaka elaborate virechan as Shodhan karma in vaatrakta specifically in pittaj and raktaj type.

A medicine which is clinically viable, cost effective, easy to administer, gives early recovery and minimize the discomfort to the patient is in high demand. Kashmaryadi kashayas virechan kalpa is one of the preparations especially mentioned by charak. Acharya Charak has clearly mentioned the relevance of Kashmaryadi kashay as virechan kalpa in VataraktaChikitsa. So in the present study Kashmaryadi kashay as virechan has been selected.With this, NidanaParivarajana and PathyaApathya will be advised to the patients.Out of which I have selected Kashmaryadi kashay as virechan in one group and Ardhamatrik niruh basti in another group for given duration in Vataraktavya.