Madhava Nidana Chapter 24 Urustambha Nidanam

This article explains Madhava nidana 24th chapter “Urustambha Nidanam”. Causes, pathology and symptoms of Urustambha are explained in this chapter.

Read – Acharya Madhavakara: His Work ‘Madhava Nidana’, Legacy, Amazing Facts

Nidana of Urustambha

Causes of Urustambha – stiffness of the thigh

  • Excessive indulgence in foods and other activities which are mixture of opposites such as cold and hot, watery and dry, heavy and light, fatty (unctuous) and non-fatty (non-unctuous), cooked and uncooked (eating food when the previously taken food is not digested or partially digested), etc.
  • Severe exertion, mental strain, over-sleeping or keeping awake and such other factors
    Read – Charaka Urusthambha Chikitsa – 27th Chapter

Samprapti

Pathogenesis
Due to the above said factors – the aggravated vata getting associated with excessively accumulated ama (intermediate products of digestion or products formed due to sluggish digestion in the stomach), kapha and meda (adipose tissue) taking the pitta together with them, moves downwards and accumulate in the thigh. The thick consolidated kapha fills up the bones of the thighs and causes stiffness of the thighs.

Lakshanas of Urusthambha

Symptoms of Urustambha
This condition causes stiffness of lower limbs (thighs), coldness and loss of sensation (loss of control).
The patient feels heaviness in his lower limbs, as if his legs are not his own and his legs have been replaced by someone else’s legs (he feels as though his legs belong to somebody else and that is why they are heavy to him).
He will also experience severe pain in the lower limbs.
The patient also experiences grief or anxiety, pain in the body parts, immobility of lower limbs (as if his limbs are covered by wet clothes),
stupor, vomiting, anorexia, fever, weakness in the legs (lower limbs),
difficulty in lifting the legs and loss of sensation in the lower limbs.

This disease is known as Urustambha. Others call the same condition as Adhyavata. (1-5)
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Purvarupa

Premonitory symptoms of urustambha
The premonitory symptoms of urustambha are – excessive sleep, too much worry, loss of movements, (feeling as if the body or affected parts have been covered by a wet leather or cloth), fever, horripilation, anorexia, vomiting, and weakness in the legs and thighs. (6)

Sanskrit Verses

Anupashaya, Sadhyasadhyata

Conditions in which the symptoms of urustambha get aggravated, symptoms of curability and incurability (prognosis)

Without knowing the specific features of this disease (urustambha) and suspecting it to be a disease of vata (on observing vata predominant symptoms like numbness, contracture, tremor etc), if unctuous remedies like oil massage etc. are done (considering that oil remedies are the best in treating vata disorders and vata symptoms), the symptoms will exacerbate (increase) quickly, causing severe debility in the legs, and loss of sensation, difficulty in lifting the lower limbs, severe exhaustion (tiredness) of the legs and thighs, constant mild burning sensation (heat) and pain. The patient gets pain on placing the foot on the ground, and he (his feet) will not be able to appreciate cold touch.
The patient suffering from urustambha will be unable to stand (keep the leg in any one posture), press something from his foot, move the foot, walk around or do any type of activity. The patient will feel that his thigh and feet has been replaced by someone else’s thighs or that his thighs have been fractured. (7-9)
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If urustambha is associated with complications like burning sensation, severe pain, pricking pain and tremors in the legs it is considered as incurable. At the same time if urustambha is not associated with these symptoms (complications) and if it has developed very recently, it is curable. (10)

Thus ends the chapter on Urustambha Nidanam in Madhava Nidana text written by Acharya Madhavakara.

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