Articles

The Hurting Toe

By - Dr. Prashant Sawant, M.D (Ayu.)

Article Published in “The Times Of India” on Saturday, January 17, 2004  

He immediately consulted his family physician, who prescribed a course of analgesics and advised for blood investigations. As suspected, Mr. Jagdish had an acute attack of “Gout”, which was evident from the abnormally elevated uric acid levels in his blood.   

Gout is one of the most common forms of arthritis (joint inflammation). It appears as an acute attack often coming on overnight. Gout usually affects only one or two joints at a time - most often the feet and the ankles. The ball of the big toe is the commonest site. While it is most commonly seen in the males between fifty and sixty years of age, gout does occur in younger males and in females too.

The attack of gout subsides in a week or so. Initially there may be intervals of many months or even years between the two attacks. However, as time goes by, these attacks become more frequent and severe.

Gout occurs as a result of the build-up of uric acid in the body and the joint fluid, which occurs when the body has difficulty in the processing of certain protein substances called ‘purines’, found naturally in our diet. The actual build-up of uric acid can result when the body has difficulty in eliminating uric acid through the kidneys and urine, or in some cases, when the body produces too much of uric acid.

The following are some of the common causes:

• Heredity

• Obesity

• High alcohol intake

• High intake of food containing purines (e.g. fish, shellfish, red meat, etc.)

• Some of the drugs used to treat high blood pressure.

• Longstanding kidney disease

• Minor trauma, overindulgence in purine-rich food or alcohol, surgery, fatigue, emotional stress, infection, etc., may precipitate acute attacks of gout

The conventional treatment off gout consists of painkillers, prevention of recurrent attacks, and prevention of further deposition of urate crystals.

In ayurveda, signs and symptoms similar to that of gout are described in a condition called “vata-rakta”. As the name suggests, this condition is caused by the simultaneous vitiation of the vata dosha (one of the three body humors) and the rakta dhatu (one of the seven basic body tissues). Such vitiation is caused by factors like eating viruddha ahara (incompatible food combinations like fish with curd, milk with fruits, etc.), semi-cooked food, inappropriate sleeping habits, trauma, exposure to extreme cold, not employing the purificatory therapies (panchakarma) when required, etc. The treatments that corrects this vitiation of the vata dosha and the rakta dhatu, is the key to the successful management of gout.                

Mr. Jagdish, when he visited the clinic, had an excruciating pain in his left big toe, which was badly swollen and red. He was advised immediate raktamokshana (one of the panchakarma therapy), in which a small quantity of blood is carefully withdrawn, to eliminate the toxins related with the rakta dhatu. For this purpose, two leeches on the either sides of the big toe were applied. The result was dramatic and instant. His pain and swelling became considerably less within 20-25 minutes of the application of the leeches. He was also advised a course of sixteen ‘basti’ (one of the panchakarma therapy, medicated enema), on consecutive days, for correcting the vitiation of vata dosha. Further, he was also recommended tablet vatari rasa and tablet kaishor gugul, in a two-is-two dosage, to be taken after the meals.

Following the course of basti, Mr. Jagdishhad had a negligible pain for a few days, which eventually subsided. As a prophylaxis, he was advised to continue with the same medicines for six months. He was also advised to repeat the ‘raktamoksahna’ every four months and a course of eight ‘basti’, every three months during the first year of the treatment.

Do’s and Don’ts:

• Avoid excessive amounts of red meat, liver, kidneys, etc.

• Avoid fish, shellfish, scallops, etc.

• Avoid peas, lentils and beans.

• Avoid Alcohol.

• Avoid vigorous exercises.

• Try to keep your weight down.

• Avoid fried foods, curd, sour buttermilk, etc.

• Have old rice, wheat, green gram, garlic, onions, bitter gourd, papaya, etc. 

Useful Tips:

• Drinking 6-8 glasses of water each day

• Have half a teaspoon of dry ginger powder (suntha) mixed with a teaspoon of castor oil before meals.

• Have a spoonful of castor oil mixed with a cup of warm milk before meals.

• Some Generic medicines useful in gout are, vatari gugul, panchatiktaghrita guggul, kaishora gugul, amrutadi gugul, etc. However, these should be taken under medical supervision only.

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Pressure Tactics

By - Dr. Prashant Sawant, M.D (Ayu.)

Article Published in “The Times Of India” on Saturday, January 24, 2004  

Mr. Nabar, the thirty-eight year old businessman, who came to the clinic with a complaint of general fatigue, was surprised when he was told that he had a high blood pressure. The reason - he never had any major or minor complaints, what so ever, except for the weakness, since last the few days.   

Like Mr. Nabar, in most of the cases, high blood pressure (hypertension) does not cause any symptoms, until it causes complications. It is one of the major causes of disability and death. It ravages circulatory system and causes heart attacks, strokes, kidney failures and other disorder, if it is neglected or remains untreated.

In only about 10% of people, hypertension occurs as a symptom of another disease (secondary hypertension). In such cases, when the root cause is treated, blood pressure usually returns to normal. However, in the other 90% of the cases, the cause of hypertension is not known (primary hypertension). Although the specific cause is unknown, some of the factors recognized as contributing to hypertension are:

• Old age.

• Heredity.

• Obesity

• High sensitivity to sodium (salt)

• Alcohol, in those who are sensitive to it.

• Birth control pills, in case of some women.

• A sedentary lifestyle and lack of exercise.

• Certain drugs, such as amphetamines (stimulants), diet pills, and some medicines used for cold and allergy symptoms

 What is blood pressure?

Blood pressure is the force exerted by the blood, against the wall of the blood vessel. When the heart contracts, the pressure reaches to a peak point and is called as “systolic pressure”. Pressure in the arteries drops steadily as the blood flows out the arteries, until the next contraction of the heart. The lowest pressure level is called as  “diastolic pressure”.  Although the range is quite wide, in normal condition, one should have the systolic blood pressure around 110 mm. of Hg. and the diastolic blood pressure around 70 mm. of Hg (usually written as 110 / 70 mm. of Hg.). Hypertension in an adults is defined as a consistently elevated systolic blood pressure of 140 mm. of Hg. and the diastolic blood pressure of 90 mm. of Hg. or higher.

According to ayurved, the blood circulation in directly under control of vyana vayu (one of the five sub-types of vata dosha, a body humor). The degenerative (atherosclerotic) changes in the blood vessels, which lead to hypertension, are also caused by vitiation of the vata dosha. Further, the abnormal metabolism of the meda dhatu (one of the seven basic tissues - similar to fat), which results because of the deranged medadhatwagni (digestive fire responsible for fat metabolism), lends a hand to the development of pathology leading to hypertension. Therefore, the medicines that correct the vitiation of vata dosha (especially the sub-type- vyana vayu) and normalize the metabolism of the meda dhatu are used to treat hypertension.   

Mr. Nabar was advised a course of panchakarma treatment which included abhyanga, shirodhara and sixteen sittings of basti, to correct the vitiation of the vata dosha.

He was recommended sarpagandha ghanavati in a two-is-two dosage and arjunarishta and punarnavasav, in a dosage 4 teaspoon each, to be taken after the breakfast and the dinner

After a month of treatment, Mr. Nabar’s blood pressure came down from 170 / 100 mm. of Hg. to 140 / 84 mm. of Hg. However, he was advised to continue with the medicines and monitor his blood pressure on a regular basis. 

Dos and Don’ts:

• Avoid salty foods like pickles, chuttnies, papad, salted nuts, salted popcorns, wafers, etc.

• Avoid coffee, alcohol and quit smoking.

• Avoid over eating. Avoid eating sweets, chocolates, ice creams, cheese, paneer, sugar, non-vegetarian food, fried food, etc.

• Eat sufficient amount of fruits and vegetables

• Exercise regularly.

• Adopt stress management and relaxation techniques like, yoga and meditation.

Useful Tips:

• Have a paste of about 5-6 cloves of garlic, mixed with half a glass of buttermilk after breakfast.

• Have chapattis made from mixing equal quantities of wheat flour and jav (barley) flour.

• Have a teaspoon of Haritaki (Terminalia chebula) powder after breakfast and dinner.

• Niruha basti, shirodhara, shirobasti (panchkarma procedures), etc. are beneficial in the treatment of hypertension

• Some generic medicines like saraswatarishta, dashamoolarishta, sarpagandha ghanavati, punarnavasava, arjunarishta, etc. are useful to treat hypertension. However, these should be taken strictly under medical supervision.

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