Vatarakta: Causes, Pathogenesis, Types, Treatment

Article by Dr Raghuram Y.S. MD (Ay)
Vatarakta is a disease explained in Ayurveda involving Vata Dosha imbalance affecting Rakta Dhatu – blood tissue. 

Causes

Causes of VataRakta –
Lavana – Excessive consumption of salts or salty foods
Amla – excessive consumption of sour foods
Katu – excessive consumption of pungent foods
Kshara – excessive consumption of alkaline foods
Snigdha – excessive consumption of unctuous or oily foods
Ushna – excessive consumption of hot foods
Ajeerna bhojana – consumption of food in presence of indigestion or when the previously taken food has not been digested
Klinna – moist food in excess
Shushka – excessive consumption of dry foods
Ambuja mamsa – excessive consumption of meat of aquatic animals
Anupa mamsa – excessive consumption of meat of animals living in marshy areas
Pinyaka – excessive consumption of foods prepared with paste of sesame
Moolaka – radish
Kulattha – horse gram
Masha – black gram
Nishpava – flat beans
Shaka – excessive consumption of green leafy vegetables
Palala – excessive intake of dry meat
Ikshu – sugarcane
Dadhi – curds
Takra – buttermilk
Aranala, sauveera, shukta, sura, asava – different forms of fermented herbal drinks
Viruddha ahara – mutually incompatible foods
Adhyashana – excessive intake of food, frequently
Krodha – anger
Divaswapna – regular habit of sleeping during day time
Prajaagaraihi – regual habit of awakening during night time
Mithya ahara – wrong choices of foods
Mithya vihara – erratic lifestyle practices
Sukumara – people of delicate nature who are exposed to the above said causes
Sthula, sukha – fat and people who live in luxury who consume the above said causes

Pathogenesis

Pathogenesis of Vatarakt –
When a person takes excessive foods and exposes to lifestyle activities which aggravate Vata and also is used to long distance rides on animals like elephants, camels, horses, the vata gets severely aggravated by its own causes. On the other hand rakta or blood gets vitiated by the consumption of lavana, amla, katu, kshara etc causes mentioned above. The vitiated rakta quickly blocks the passages of vayu and interferes with its smooth movements. The vata, whose passages are blocked by rakta further undergoes vitiation and further contaminates the rakta or blood. The blood vitiated by vayu later burns the whole blood in the body. The blood contaminated by vitiated Vayu leaves its place and gravitates towards the foot. This vicious amalgamation of vitiated vata and rakta is called vatarakta. This is said to be a dangerous amalgamation which causes serious painful symptoms comprising of a disease called vatarakta. Later the pitta and kapha join this amalgamation and make the clinical picture of the disease even more complicated.

The symptoms are first manifested in the small joints of the foot. Later it gradually spreads to the upper portions of the body causing itching, pain and numbness etc symptoms in all the joints of the hands and foot. The other joints of the body are also involved in the painful picture. In association of kapha, this vatarakta spreads all through the body in quick time like a poison.

Types

Types of Vatarakta:
Vata pradhana Vatarakta – When Vata is severely vitiated in Vatarakta symptoms like pain, twitching, pricking pain, swelling which is dry and black, stiffness of body parts, aversion or aggravation of symptoms by cold, numbness etc will dominate the picture

Rakta pradhana Vatarakta – When Rakta is severely vitiated in Vatarakta, the symptoms like swelling, severe pain and pricking pain, copper colour of the skin, itching and moistness predominate

Pitta pradhana Vatarakta – When Pitta is severely vitiated in Vatarakta, the symptoms like severe burning sensation, sweating, fainting, thirst, tenderness, pain, swelling and suppuration will be predominantly found

Kapha pradhana Vatarakta – When Kapha is severely vitiated in Vatarakta, the symptoms like numbness, heaviness, moistness, unctuousness and coldness will prevail

Vatarakta is also of 2 types based on its location –

Uttana Vatarakta – the disease pathology afflicts the superficial tissues i.e. skin and muscles, the symptoms are also limited to the skin. In this type, the symptoms moreover look like a skin disease or Kushta with skin lesions and muscle pain.

Gambhira Vatarakta – the disease pathology involves blood and other deeper tissues like bone and joints and also the internal viscera. This is moreover a systemic illness and the symptoms are more complicated. This moreover looks like a joint pathology because the joint symptoms are more than the skin presentation.

Uttana Vatarakta Chikitsa

Treatment of Uttana Vatarakta –

Uttana Vatarakta can be effectively handled with:

• Lepa – external application of medicinal pastes
• Abhyanga – herbal oil massage
• Parisheka – stream pouring or sprinkling or showering of medicinal liquids like decoctions, medicated milk, oil etc over the afflicted areas
• Avagahana – dipping the afflicted parts or joints in the medicinal liquids mentioned below
• Upanaha – poultice

Gambhira Vatarakta Chikitsa

Treatment of Gambhira Vatarakta –
Since the other deeper tissues like blood, bone, fat, bone marrow etc and multiple organs will be involved in gambhira vatarakta as the disease pathology has penetrated into deeper tissues, the simpler treatments which have been mentioned above shall not be very useful, though they can be considered as external therapies and complimentary treatments (along with main treatments) in gambhira vatarkta also. This is because the external treatments, at any stage of the disease come in handy to relieve the local symptoms of the disease, to relive pain, swelling, inflammation, catches and also to strengthen the bones, joints and other soft tissues like muscles, ligaments and tendons.

Gambhira Vatarakta shall be managed by:

• Snehapana – internal consumption of medicated ghee, oil or both
• Virechana – therapeutic purgation
• Asthapana vasti – decoction enemas
• Anuvasana vasti – medicated oil or ghee enema
• Ksheera vasti – herbal milk enema etc measures

Vataja Vatarakta Chikitsa

Managing Vata type of Vatarakta (Vata predominance in Psoriatic arthritis) –
Vata predominant Vatarakta should be managed by Snehadi kriyas i.e. treatment strategies comprising of:

• Snehana – oleation or external (massages etc) and internal administration of medicated ghee and or oils
• Swedana – sudation or steaming, sweating treatment, fomentation etc
• Virechana – therapeutic purgation
• Asthapana Vasti / Niruha vasti – enemas with medicated decoctions
• Anuvasana / Sneha Vasti – enemas with medicated oils / ghee etc

These strategies shall be followed when Vata symptoms including pain are predominant in psoriatic arthritis

Raktaja Vatarakta Chikitsa

Managing Rakta type of Vatarakta (Rakta predominance in Psoriatic arthritis) –
Rakta predominant Vatarakta should be managed by Raktamokshanadi kriyas i.e. treatment strategies comprising of:

Raktamokshana – Bloodletting by various methods like:

• Jalauka (leech application),
• Suchivedha (pricking),
• Shrunga (suction through horns),
• Alabu (Suction through hollowed out cucumber etc),
• Prachchana (scraping),
• Ghatiyantra (suction to vacuum filled small earthen pots)

Virechana – Therapeutic purgation
Asthapana Vasti – decoction enemas
Ksheera Vasti – herbal milk decoctions
Anuvasana Vasti – herbal oil or ghee enemas

Pittaja Vatarakta Chikitsa

Managing Pitta type of Vatarakta (Pitta predominance in Psoriatic arthritis) –
Pitta predominant Vatarakta should be managed by Virechanadi kriyas i.e. treatment strategies comprising of:

• Virechana – therapeutic purgation
• Raktamokshana – bloodletting
• Asthapana Vasti / Niruha vasti – enemas with medicated decoctions
• Anuvasana / Sneha Vasti – enemas with medicated oils / ghee
• Ksheera Vasti – herbal milk enemas etc

These strategies explained in handling pitta and rakta predominant vatarakta shall be followed when pitta and or rakta symptoms are predominant in psoriatic arthritis, i.e. when the signs of inflammation are more

Kaphaja Vatarakta Chikitsa

Managing Kapha type of Vatarakta (Kapha predominance in Psoriatic arthritis) –
Kapha predominant Vatarakta should be managed by Vamanadi kriyas i.e. treatment strategies comprising of:

• Vamana – Therapeutic emesis
• Swedana – sudation or steaming, sweating treatment, fomentation etc
• Virechana – therapeutic purgation
• Asthapana Vasti / Niruha vasti – enemas with medicated decoctions
• Anuvasana / Sneha Vasti – enemas with medicated oils / ghee etc

These strategies shall be followed when kapha symptoms including stiffness and swelling are predominant in psoriatic arthritis

Samanya Chikitsa

General line of treatment of VataRakta with reference to Psoriatic arthritis –
Vasti – According to Ayurveda, in any type of Vatarakta, there is no treatment which can better administration of medicated enemas. Thus Vasti becomes unparalleled treatment strategy in the line of treatment of Vatarakta.

Vasti, in Vatarakta are given in many forms depending on the condition of the disease and diseased. Various types of Vasti are also effectively combined. They are:

Asthapana Vasti / Niruha vasti – enemas with medicated decoctions
Anuvasana / Sneha Vasti – enemas with medicated oils / ghee
Ksheera Vasti – herbal milk enemas etc
The same types of vastis can be effectively combined in treatment of psoriatic arthritis.

Raktamokshana – Bloodletting is an important strategy in handling Vatarakta cases. There are many types of Raktamokshana which needs to be skilfully selected according to the necessity depending on the nature of the disease and diseased.

Classical remedies

Classical remedies for Vatarakta –
Internal medication:
Vasadi Kwatha – Decoction made from Vasa (Adhatoda vasica), Guduchi (Tinospora cordifolia), Aragwadha (Cassia fistula) mixed with Eranda Taila (castor oil)

Navakarshika Kwatha – Decoction prepared from Daruharidra (Berberis aristata), Guduchi (Tinospora cordifolia), Katuki (Picrorrhiza kurroa), Vacha (Acorus calamus), Manjishta (Rubia cordifolia), Nimba twak (neem bark), Amalaki (Emblica officinalis), Haritaki (Terminalia chebula) and Bibhitaki (Terminalia bellirica) is beneficial in Vatarakta. This is a common remedy for Kushta and Vatarakta. Thus it is beneficial in warding off psoriasis and psoriatic arthritis.

Guduchyadi Kwatha – Decoction of Guduchi (Tinospora cordifolia) mixed with Guggulu (Commiphora mukul), specially used in Vata predominant Vatarakta

Kasmaryadi Kwatha – Decoction prepared from Kashmarya (Gmelina arborea), Draksha (raisins), Aragwadha (Cassia fistula), Chandana (sandal wood), Yashtimadhu (Glycyrrhiza glabra) and Ksheerakakoli (Roscoea purpurea / Lilium polyphyllum) mixed with sugar and honey, especially used in Pitta predominant Vatarakta

Patoladi Kwatha – Decoction prepared from Patola patra (leaves of pointed gourd), Guduchi (Tinospora cordifolia), Katuki (Picrorrhiza kurroa), Amalaki (Emblica officinalis), Haritaki (Terminalia chebula) and Bibhitaki (Terminalia bellirica), highly beneficial in Pitta predominant Vatarakta presenting with severe burning sensation

Kokilakshyadi Kwatha – Decoction of Kokilaksha (Asteracantha longifolia) and Guduchi (Tinospora cordifolia)

Laghu Manjishtadi Kwatha – Decoction of Manjishta (Rubia cordifolia), Guduchi (Tinospora cordifolia), Katuki (Picrorrhiza kurroa), Vacha (Acorus calamus), Nimba twak (neem bark), Amalaki (Emblica officinalis), Haritaki (Terminalia chebula) and Bibhitaki (Terminalia bellirica)

Amrutadi Avalehika – confection prepared from Guduchi (Tinospora cordifolia), Katuki (Picrorrhiza kurroa), Shunti (ginger), Yashtimadhu (Glyzyrrhiza glabra) mixed with honey cures kapha predominant Vatarakta, after the intake of the decoction one should consume Gomutra (urine of cow)

Guduchi (Tinospora cordifolia) in various forms – Guduchi swarasa (juice of Tinospora cordifolia), Guduchi Kalka (paste of Guduchi), Guduchi Churna (powder of Guduchi) and Guduchi Kwatha (decoction of Tinospora cordifolia) should be taken for longer durations to get rid of Vatarakta.

External medicines –
Prapaundarikadi lepa – Paste of Prapaundarika (lotus variety), Manjishta (Rubia cordifolia), Daruharidra (Berberis aristata), Yashtimadhu (Glycyrrhiza glabra), Chandana (sandalwood), Sitopala (sugar candy), ela (cardamom), Yava sattu (flour of barley), Masura (lentil), Ushira (Vetiveria zizanioidis), Padmakashta (stalk of lotus)

Tila lepa – paste of fried sesame ground in milk
Atasyadi lepa – paste of Atasi (flaxseed) and Eranda beeja (seeds of castor) ground in milk
Shatahva lepa – paste of Shatahva (Dill seeds) made in milk
Grihadhumadi lepa – paste made of Grihadhuma (soot of chimney), Vacha (Acorus calamus), Kushta (Saussurea lappa), Shatapushpa (Dill seeds), Haridra (turmeric), Daruharidra (Berberis aristata)
Shatadhouta Ghrita – Ghee that had been washed for 100 times
Sahasradhauta Ghrita – Ghee that had been washed for 1000 times

Effective decoctions for Gout from Sahasrayogam

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S

1. Vataraktahara Kashayam

Ref – Sahasrayogam, Kashaya Prakaranam, 62

a. Varyadi Kashayam

Ingredients	Botanical Name	Method of using	Indications
Shatavari	Asparagus racemosus	The decoction prepared with these ingredients should be served fresh	1.Gout
Guduchi	Tinospora cordifolia

b. Shatavari Chinnaruhadi Kashayam

Ingredients	Botanical Name	Method of using	Indications
Shatavari	Asparagus racemosus	The decoction prepared with these ingredients should be served fresh mixed with powder of Glycyrrhiza glabra	1.Gout 2.Bleeding disorders
Guduchi	Tinospora cordifolia
Amlaki	Emblica officinalis
Bala	Sida cordifolia
Ikshu kanda	Stem of Saccharum officinarum
Ikshu rasa	Juice of Saccharum officinarum / sugarcane juice

2. Manjishtadi Kashayam

Ref – Sahasrayogam, Parishishta Prakaranam, 100

Ingredients	Botanical Name	Method of using	Indications
Manjishta	Rubia cordifolia	The decoction prepared with these ingredients should be served fresh.	1.Gout 2.Scabies 3.Kapala skin disorder 4.Contamination and infection of blood 5.Mandala skin disorder
Triphala	Fruits of – Terminalia chebula Terminalia bellirica Emblica officinalis
Guduchi	Tinospora cordifolia
Katuki	Picrorhiza kurrooa
Vacha	Acorus calamus
Devadaru	Cedrus deodara
Turmeric	Curcuma longa
Guduchi	Tinospora cordifolia
Neem	Azadirachta indica

3. Vasa Guduchyadi Kashayam

Ref – Sahasrayogam, Parishishta Prakaranam, 102

Ingredients	Botanical Name	Method of using	Indications
Vasa	Adhatoda vasica	The decoction prepared with these ingredients should be served fresh with castor oil	1. Cures all types of gout
Guduchi	Tinospora cordifolia
Aragwadha	Cassia fistula

Yogas from Sahasra Yoga Text book

1. Vataraktahara kashaya
2. Pancha tiktaka guggulu ghrita
3. Dhatryadi Ghrita
4. Dhanwantari Ghrita
5. Mahakushmanda Ghrita
6. Ksheerbala Avartana Taila
7. Balaguduchyadi Taila
8. Trimisrita Taila
9. Aranaladi Taila
10. Pinda taila
11. Chandanadi Taila
12. Vranabhairava Taila
13.Dhatryarishta
14.Brihat Madhusnuhi Rasayana
15. Amruta guggulu
16. Kaisora guggulu
17. Manjishtadi kashaya
18.Karaskara Ghrita

Pathya – apathya according to Yogaratnakara

Wholesome herbs, diet and habits according to Yogaratnakara

Barley, Rice that harvested in sixty days, Neevara, Kalama and Aruna variety of rice, wheat, bengal gram, green gram, pigeon pea, moth bean, milk of sheep, goat, buffalo and cow, malabar spinach, Indian nightshade, four-leaf clover, Mexican tea, bitter gourd, thorny amaranth, pointed gourd, Indian gooseberry, ginger, elephant foot yam, sugar candy, dry grapes, old pumpkin, butter, fresh ghee, meat of animals like common quail, partridge, female bustard, cock, gallinaceous bird, packer birds, parrot, jacobin cuckoo, pigeon, sparrow, camphor, agarwood, cedarwood, chir pine, bitter substances etc.

Unwholesome herbs, diet and habits according to Yogaratnakara

Day sleeping, heat of fire, exercise, exposure to sunlight, sexual activity, black gram, horse gram, cow pea, ground nut, alkali, meat of animals born from egge, meat of animals living in marshy lands, diet combinations which interrupts tissue metabolism, curd, sugarcane, radish, alcohol, betel, fermented gruel, sesame, foods which are pungent, hot, heavy to digest, foods which cause obstruction in the channel, salty foods, powder of fried grains etc.

Click to consult Dr Raghuram