Panchakarma Department [OPD No 02]
Amavata [Rhuematoid Arthritis] Chikitsa
Patient Profile:
A 55-year-old female from Bihar, homemaker, presented to the Department of Panchakarma with severe pain, stiffness, and swelling in multiple joints persisting for 15 years. The symptoms were aggravated in cold weather and associated with weakness, disturbed sleep, and poor digestion.
Medical History:
The patient had taken Allopathic and Homeopathic treatments with only temporary relief. She used painkillers and antacids frequently. Pain was continuous, pulling in nature, and restricted daily movements.
Clinical Findings:
- Multiple joint pain & swelling
- Morning stiffness (lasting 1 hour)
- ESR: 110 mm/hr
- RA Factor: 25.5 IU/ml
- Hb: 10.1 gm/dl
Ayurvedically diagnosed as Amavata, correlating to Rheumatoid Arthritis.
Treatment Approach (Ayurvedic Protocol)
1. Deepana & Pachana (Ama Pachana)
- Agnikumara Rasa – to ignite Agni and digest Ama.
2. Snehapana & Swedana (Oleation & Sudation)
- Indukantha Ghrita and Guggulu Tiktaka Ghrita – internal oleation.
- Abhyanga with Ksheerabala Taila and Bashpa Sweda – to reduce stiffness.
3. Virechana (Purgation Therapy)
- Trivrut Lehya with Triphala Kashaya – to cleanse doshas and eliminate Ama.
- Madhyama Shuddhi achieved, followed by Samsarjana Krama (dietary restoration).
4. Basti & Local Therapies
- Janu Basti with Ksheerabala Taila + Karpuradi Taila
- Vaitarana Basti – to pacify Vata and clear Srotosanga (obstruction).
5. Shamana Chikitsa (Palliative Care)
- Kaishora Guggulu, Amavatari Rasa, Naradeeya Lakshmi Vilasa Rasa, Avipattikara Churna for continued management.
- Local application of Karpuradi Taila recommended.
Results After 6 Weeks
| Parameter | Before Treatment | After Treatment |
|---|---|---|
| ESR | 110 mm/hr | 64 mm/hr |
| RA Factor | 25.5 IU/ml | 8.65 IU/ml |
| Pain & Swelling | Severe | Significantly reduced |
| Morning Stiffness | >1 hour | <10 minutes |
| Sleep & Appetite | Disturbed | Improved |
Patient Outcome:
The patient experienced remarkable reduction in joint pain, swelling, and stiffness, along with improved sleep and digestion. She regained mobility and resumed daily activities comfortably.
Conclusion
This case highlights the success of an integrated Ayurvedic management protocol in treating Amavata (Rheumatoid Arthritis). Panchakarma procedures like Virechana and Basti, combined with specific herbal formulations, effectively removed Ama, balanced Vata, and restored the patient’s functional ability.
Treating Consultant: Dr. Sanghamitra Patnaik – Professor & Medical Superintendent, Dept. of Panchakarma
Shalya Tantra Department
Dushta Vrana [Non Healing Ulcer] Management
Patient Profile:
An 83-year-old male, retired postmaster from Jigani, approached our Department of Shalya Tantra with complaints of a non-healing ulcer on the left lower limb for 26 years, associated with pain, swelling, and discharge. The wound severely affected his mobility and daily comfort.
Medical History:
The patient had undergone stripping and ligation surgery for varicose veins 22 years ago but continued to suffer from recurrent ulceration. Despite multiple treatments and regular dressings at various hospitals, healing remained incomplete, and amputation was even advised by a physician. Seeking a holistic solution, he visited our hospital for Ayurvedic management.
Clinical Findings:
- Large ulcer on the medial aspect of the left calf (14.5 × 14 × 1 cm)
- Pain, tenderness, swelling, and hyperpigmentation of the affected limb
- ESR: 78 mm/hr, Hb: 8 gm/dL
- Associated: Benign Prostatic Hyperplasia
- Diagnosed as Dushta Vrana (Varicose Ulcer) – a chronic, non-healing wound due to vitiation of Rakta and Pitta dosha.
Ayurvedic Management Protocol
1. Shodhana Chikitsa (Purification Therapy)
- Deepana-Pachana: Agnitundi Vati and Chitrakadi Vati for improving digestion and metabolism.
- Snehapana: Internal oleation with medicated ghee (60–120 ml).
- Abhyanga & Swedana: Ksheerabala Taila massage followed by Nadi Sweda to enhance circulation.
- Virechana: Trivrut Lehya induced therapeutic purgation — 9 vegas achieved.
- Samsarjana Krama: Post-detox dietary regimen for 3 days.
2. Shamana Chikitsa (Palliative Therapy)
- Kaishora Guggulu (anti-inflammatory, wound healing)
- Manjishtadi Kashaya (Rakta shodhana, detoxifier)
- Viscovas Tablets (for vascular health)
- Bhoomi Amalaki Ghana Vati and Zincovit (for immunity and regeneration)
3. Local Therapies
- Patra Dana with Haridra (Turmeric) leaves followed by Gaadha Bandha (tight bandaging technique similar to compression therapy).
- Jalauka Avacharana (Leech Therapy) to purify local blood, improve circulation, and accelerate healing.
- Conservative Care: Foot-end elevation, active and passive exercises to enhance venous return.
Outcome After 4 Months of Treatment
| Parameter | Before Treatment | After Treatment |
|---|---|---|
| Pain | Present | Absent |
| Tenderness | Present | Absent |
| Swelling | Marked | Significantly Reduced |
| Hyperpigmentation | Prominent | Noticeably Reduced |
| Ulcer Status | Non-healing | Healthy granulation tissue, progressing to complete healing |
Patient Outcome:
The chronic ulcer that persisted for over 26 years began to heal significantly within weeks of Ayurvedic management. Pain and discharge subsided, swelling reduced, and mobility improved. The patient was able to walk comfortably without dependence on painkillers or dressings.
Conclusion
This case exemplifies the power of Shalya Tantra and Ayurvedic wound management in treating chronic, non-healing ulcers.
Through a combination of Virechana, Jalauka Avacharana, Haridra Patra Dana, and Shamana Aushadhi, the condition of Dushta Vrana (Varicose Ulcer) was successfully managed.
The integrated Ayurvedic approach not only healed the ulcer but also improved overall vascular health, preventing recurrence.
Treating Consultant: Dr. Shalini U.A. – Associate Professor, Dept. of Shalya Tantra
