INTERNATIONAL
AYURVEDIC
MEDICAL JOURNAL
Case Report ISSN: 2320-5091 Impact Factor: 6.719
EFFECT OF PATHYA PALAN/ DIET, PANCHAKARMA AND AYURVEDA MEDICINE
IN AAMVATA- A CASE STUDY
Neerja R. Sharma1, Preeti2, Parvesh Kumari3
1
Prof. and H.O.D. dept. Of Swasthavritta and Yoga, Shri Dhanvantari Ayurveda College, Chandigarh,
2
Assistant Professor, Dept. of Swasthavritta and Yoga, National College of Ayurveda Hisar, Haryana, India
3
Assistant Professor, Dept. of Panchakarma, National Collge of Ayurveda Hisar, Haryana, India
https://doi.org/10.46607/iamj4909082021
(Published Online: August 2021)
Open Access
© International Ayurvedic Medical Journal, India 2021
Article Received: 28/07//2021 - Peer Reviewed: 06/08/2021 - Accepted for Publication: 07/08/2021
ABSTRACT
The menopausal stage is the condition where a female wants to be at ease but if other ailments occur where she has
to face continuous pain and agony make is more uncomfortable along with the psychological disturbances. The
present case is a female patient who came with the symptoms of Aamavata (R.A.) in her menopausal age and was
diagnosed with the same (Aamvata). She received Dietary guidelines along with lifestyle modification (Pathya
Palan), Panchakarma therapy i.e. Vaitran Basti (medicated enema) for 7 days, Ruksha Swedana (dry sudation),
Aamvatari Rasa, Trivrata Avleha, Ajmodadi churna, Giloy Satva for 1 month, later only Ajmodadi Churna and
dietary guidelines for 2 months.
The application of the Ayurvedic principle shows remarkable results in this case where other treatment options are
limited.
Keywords: Aamvata, R.A., Pathya Palan
INTRODUCTION
Aamvata is a disease described in classical Ayurvedic as multifactorial causation of the disease, due to which
texts as a consequence of various factors or can be said unmetabolized material (Aam) is deposited in joints as
Preeti et al: Effect Of Pathya Palan/ Diet, Panchakarma And Ayurveda Medicine In Aamvata- A Case Study
a resultant1. As described in the classics there are 13 Hence owing to the symptoms of bodyache (Anga-
types of Agni which are responsible for the whole me- marda), anorexia (Aruchi) stiffness (Stambha)and se-
tabolism at different levels, that diminishes because of vere tenderness in joints bring it out as a case of
various factor that became the reason for the formation Aamvata5. It was a case of R.A. according to the crite-
of Aam. Aamvata is correlated with Rheumatic Arthri- ria given by the American College of Rheumatology
tis which is a multisystem disorder with a specific fea- (and European league against rheumatism (EULAR)
ture of inflammatory synovitis, which can damage car- 20106.
tilage and bones in chronic condition2. Further dis- Treatment
cussed patient is a known case of RA shown classical The patient received Dietary guidelines, along with
symptoms of Aamvata/R.A., which shows R.A. posi- lifestyle modification, In Shaman Aushadh Ajmodadi
tive, CRP positive, ESR raised significantly. The pa- Churanam 3gm twice daily after food with Lukewarm
tient is a middle-aged female, psychologically dis- water, Aamvatari Rasa 2 bd Giloy Satva 1/4tsf twice
turbed because of the continuous stage of pain and ag- daily after a meal, Rasnasaptaka Kwatha 10 ml with
ony and didn't get precise benefits because of previous equal water thrice daily, Trivrut Avleha 1tsf at night
treatment she was taking, which brings her here to get with warm water. The patient had gone for Pan-
maximum benefit in overall health. chakarma procedure, Ruksha Baluka Swedan, along
She was diagnosed as a case of Aamavata and treated with later Vaitran Basti (including Sarvanga Ab-
according to Ayurveda Principles i.e. Pathya Palan, hyanga with Erand tail and Sarwanga swedan with
Shodhan and Shaman i.e. dedicated dietary and life- Dashmool infused steam) formed with (guda/ jaggery
style guidelines, Vaitran Basti (for 7days), Ruksha 24gm, Amlika 50gm, Til tail 50ml, Saindhav 12gm,
Swedan and Medication3. A considerable improve- Gomutra 200ml), Vaitran Basti is given for 7 days.
ment had been noticed in joints pain, morning stiffness Later the patient was discharged with an indication of
within 10 days, patient didn't find a need for analgesics Pathya and Medicines Due to Covid patient was una-
which were needed previously. Quantitative R.A. fac- ble to come to the hospital for 3 months but was in
tor, ESR, decreased gradually touch telephonically and regularly following given
CASE REPORT guidelines. Guidelines are given to the patient
A 55-year-old female patient came with C/O Pain and (Pathya)- Daily body massage with Tripahala powder
swelling in all joints (more intense in knee, elbow and (Udvartana) 5-10 minutes, eat food only when felt
metacarpophalangeal joints) with morning stiffness hunger, intake only lukewarm water, hot fomentation,
which lasts up to 1-2 hours, loss of appetite and indi- or dry sudation for 5-10 minutes. In breakfast – intake
gestion from 2 years, according to the patient symp- of aged grains like mung beans/ Moth beans(steamed
toms persists whole day but intense in the morning. or boiled), sprinkled with rock salt and Panchkol pow-
On examination- it shows tenderness and restricted der, fruits can be taken according to the availability
mobility in joints. On investigation, it was Hb 10.5gm, Pomegranate, Amalaki, Cheeku, Papaya etc, in Lunch
ESR – 40mm 1st hour, R.A. positive 350.65 IU/mL, have to take Chapati (Yava, Godhum) 1-2 according to
CRP- positive. digestive fire, rice cooked with the infusion of La-
Diagnosis – It was a case of Aamvata according to vanga and Jeerak ½ to small 1 bowl, Daal, Vegetable
Ayurveda with differential diagnosis of Sandhi- suitable – Karela, Parmal, Baingan, Sehjan Phali,
gatavata (osteoarthritis) and Vatarakta (Gout), as per Bathua, Palak, 1 glass of Takra with roasted Jeerak/
the examination, there is the involvement of small and Yavani powder. Evening - Dashmool decoction
big joints but no specific symptoms of vitiation of (herbal tea) mixed with jaggery, sporadically cooked
Rakta which brings a conclusion to rule out of Vata- Shayamak/ roasted Chana, Dinner must be between
rakta. The absence of the symptom i.e. Vatapurna 6.30-7.30 (preferable before sunset) – aged grains/ rice
Druti Sparsha helps in rule out Sandhigatavata4. to be avoided at night, vegetable cooked with Rason,
doi:10.46607/iamj4909082021 | IAMJ August 2021 | www.iamj.in 1909
Preeti et al: Effect Of Pathya Palan/ Diet, Panchakarma And Ayurveda Medicine In Aamvata- A Case Study
milk boiled wit Pipalli churanam. At night 30 minutes kept as a priority in managing the condition just be-
before sleeping usually around 9-9.30 pm 10ml Erand cause Doshas were vitiated extremely so there was
Tail with warm water. need of Shodhan and Shaman chikitsa also which was
However, this patient was well adapted to the dietary later shifted to Pathya palan only and patient benefit-
regimen but in another case-patient complain about ted tremendously. Ama is defined as an outcome of
Pitta Vriddihi because of Erand tail intake at night that unmetabolized material which is later deposited in dif-
was resolved by intake of Amalaki Churanam or other ferent areas and resultant in Amaja Vyadhi9. In the cur-
Pittashaman or Rechan food articles. rent case, the female was in her menopausal age which
Treatment outcome was another factor that can be considered responsible
At the end of the first 10 days of oral medication and for the occurrence of the disease because of the physi-
Ruksha Baluka Swedan there was a slight reduction in ological vitiation of Vata Dosha. The treatment prin-
pain and swelling and the patient stopped the intake of ciple given is ancient classics was adopted for the
analgesics from day 3rd, which she was taking for a treatment as due to intake of less food and only when
long. After that Vaitran Basti was planned and given needed/ extreme hunger arousal helps in increasing di-
for consecutive 7days, morning stiffness was reduced gestive fire which help in digestion of Aam Dosha,
to 15-20 minutes which was initially at around 1-2 along with that in Diet there is addition of Panchkol
hours, anorexia is reduced, body ache stiffness and powder which helps as Agnideepan as well as Aampa-
pain was reduced. After completion of a total of 17 chana10, Udvartan with Triphala coarse powder helps
days of panchakarma and oral medicine, the patient in passive exercise, melting Kapha and Aama along
shows remarkable improvement.in continuation of with metabolism of Aam present in extremities, en-
Pathya i.e. dietary regulation and modification along hance blood circulation to remove toxins also11, dry
with oral medicine for 127 days the patient hot fomentation helps in metabolism of Aam and re-
(16/03/2021 -20/07/2021), there was a marked im- moval of toxins and brings lightness & soothing ef-
provement in the symptoms, ESR within limits, CRP fects12, Nitya Virechana was given in the form of
– negative, R.A. Factor below 20 IU, morning stiffness Trivrut Avleha (Sukha Virechananam)13 and later
is sporadically present for few minutes, body aches Erand Tail which helps in management of vitiated
joint pain is not present for now, there is no aggrava- Vata as well as Rechan of extra Doshas in diet, aged
tion of the diseases till July 2021. food grains i.e. Godhum, Yava, Mung, Moth etc were
advised because they are light to digest and don’t viti-
DISCUSSION ate Kapha Dosha and prevent formation of ama, Hot
The worldwide prevalence of RA is estimated between water intake had effect in Pachana/ metabolism of
0.3% and 1% and is commonly seen in women in de- Aama and increased digestive fire, other vegetables
veloped countries7. In India, the prevalence is esti- and fruits which are added had Tikta rasa predomi-
mated to be 0.75%8. However, there is no specific nance and had Rechak properties along with Balya
cause that can be clearly understood, disability be- properties which are helpful in this condition and
cause the condition can lead towards mental agony and which are easily available in local and no specific need
later psychological condition. However, in Ayurveda, of out of pocket expenditure. Viatran Basti was given
there is no marked demarcation that the prevalence as per the principle of Kshar Basti indicated by Chak-
rate is high in women or men. In the present case, the radutta because it directly works in Lekhana i.e. scrap-
female is suffering from the condition diagnosed as ping and Rechan, Removal of Doshas14. Ajamodadi
Aamvata with clear symptoms as defined in classics. Churnam is given for Pachan of Dosha, removal of
In Ayurveda, we consider Aamvata as Rasavaha Stro- inflammatory swelling15 and removal of chances of oc-
tasa Dusti Vyadhi which means the major effect of di- currence of the condition again, Giloy satva was given
etary habits, its metabolism and lifestyle which was to give rejuvenation and along with it due to its Tikta
doi:10.46607/iamj4909082021 | IAMJ August 2021 | www.iamj.in 1910
Preeti et al: Effect Of Pathya Palan/ Diet, Panchakarma And Ayurveda Medicine In Aamvata- A Case Study
rasa it helps in the metabolization of Ama, stiffness and swelling16. Dashmool decoction with jag-
Rasanasaptaka kwatha works on Kapha Dosha as well gery was added to the diet as a replacement of tea to
as Vata Dosha which was added in Shaman Ausadh. ensure its Tridosha Sahamaka effect and it had a great
Aamavatari Ras reduces inflammation manage pain effect on Sotha and Shool Parashamana17.
due to the condition and helps in the reduction of
Table 1
Treatment outcome
No. Timeline Morning stiffness Anorexia Joints pain R.A. factor(IU/ml)
1. Baseline- mid-March 2021 Severe last for 1-2 hours Present Severe 350.56
2. 10 days after treatment Slightly reduced Absent Slight reduced Not done
3. 17 days after treatment Markedly reduced last Absent Markedly re- >120
for 20-30 minutes duced
4. 127 days after treatment Absent Absent Absent >20
CONCLUSION 5. Vaidya Sastri laxmipati, edited by Sastri Bra-
In the present scenario, we had negatively changed our hamasankar, Yogaratnakara ‘Vidyotini’, Chaukhamba
lifestyle due to various factors for which we have to Prakshan, Varanasi, Aamvata Lakshana verse 1, ,2017,
p 565
pay off in terms of ill health, and one consequence is
6. https://www.rheumatology.org/Por-
Aamvata which is a result of different factors some of
tals/0/Files/2010_revised_criteria_classifica-
which are modifiable and preventive and with the help tion_ra.pdf
of Ayurveda principles even along with treatment and 7. https://europepmc.org/article/med/23327517
after that, we can provide curative services as well as 8. https://link.springer.com/article/10.1007/BF00301258
preventive and avoidance of reoccurrence. This effect 9. Vagabatha Acharya, Prof Tripathi Ravidutta, Astanga
is seen with the treatment and Pathyapalan. More Hridayam (Sutra Sthanam), Chaukhamab Sanskrit
studies are needed to be done to find sustainable ef- Pratisthan, Delhi, 2016, Astanga HridyamaAstanaga
fects on Aamvata. Hridyama Sutra 13, verse25,27, p 212
10. Vaidya Sastri laxmipati, edited by Sastri Bra-
hamasankar, Yogaratnakara ‘Vidyotini’, Chaukhamba
REFERENCES
Prakshan Varanasi, aamvata Nidana verse 1,2017, p
1. Vaidya Sastri Laxmipati, edited by Sastri Bra-
568
hamasankar, Yogaratnakara ‘Vidyotini’, Chaukhamba
11. Maharishi Susrut, Shastri AmbikaDutta kaviraj, Su-
Prakashan Varanasi, aamvata Nidana verse 1-3,2017, p
surut Samhita ‘Ayurved-Tattava- Sandipika’ Susrut
564-565
chikista 24-verse 51, p 135
2. lipskyPeter E Rheumatoid Arthritis, In LongoDL,
12. Agnivesa, Charaka Samhita, with ‘Ayurvedveddipika
Kapsa DL, Fauci AS, etc Harrison's Principles of Inter-
commentary by Chakarapanidutta’elaborated by
nal Medicine, 18th edition, Vol II, Macgrew Hill,2012,
Charaka & Drdhabala, edited by Acharya Trikamaji
p2738-52
Yadavaji, Chaukhamba Surbharati Prakshana, Vara-
3. Vaidya Sastri laxmipati, edited by Sastri Bra-
nasi,2019, Charaka Sutra 14, verse13,9, p88
hamasankar, Yogaratnakara ‘Vidyotini’, Chaukhamba
13. Agnivesa, Charaka Samhita, with ‘Ayurvedveddipika
Prakshan Varanasi, Aamavata Chikitsa verse 1,2 ,2017,
commentary by Chakarapanidutta’elaborated by
p 566
Charaka & Drdhabala, edited by Acharya Trikamaji
4. Agnivesa, Charaka Samhita, with ‘Ayurvedveddipika
Yadavaji, Chaukhamba Surbharati Prakshana, Vara-
commentary by Chakarapanidutta’elaborated by
nasi,2019 Charak Sutra 25, verse 40, p132
Charaka & Drdhabala, edited by Acharya Trikamaji
14. Sri Cakrapani Dutta, Vaidya Sastri Ravidatta commen-
Yadavaji, Chaukhamba Surbharati Prakshana, Vara-
tary, Chakradatta, Chaukhamba Surbharti Prakshan,
nasi,2019 Charak chikitsa 28, verse 37, p618
Varanasi, 2012, Niruhadhikara 73, verse34-38, p313
doi:10.46607/iamj4909082021 | IAMJ August 2021 | www.iamj.in 1911
Preeti et al: Effect Of Pathya Palan/ Diet, Panchakarma And Ayurveda Medicine In Aamvata- A Case Study
15. Vaidya Sastri laxmipati, edited by Sastri Bra-
hamasankar, Yogaratnakara ‘Vidyotini’, Chaukhamba
Prakshan Varanasi, aamvata Nidana verse 1-3,2017, p
568
16. Dassen Govind, Prof Mishra Siddhi Nandan, Bhaisjya
Ratnavali, Chaukhamba Surbharati Prakshan, Vara-
nasi,2017, Aamavatadhikar 29/69-70, p601
17. Maharishi Susrut, Shastri AmbikaDutta kaviraj, Su-
surut Samhita ‘Ayurved-Tattava- Sandipika’ Susrut
Sutra 38-verse 72, p 189
Source of Support: Nil
Conflict of Interest: None Declared
How to cite this URL: Preeti et al: Effect Of Pathya Palan/ Diet,
Panchakarma And Ayurveda Medicine In Aamvata- A Case
Study. International Ayurvedic Medical Journal {online} 2021
{cited August 2021} Available from:
http://www.iamj.in/posts/images/upload/1908_1912.pdf
doi:10.46607/iamj4909082021 | IAMJ August 2021 | www.iamj.in 1912
