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Today we are looking at Gout/ Vatarakta from an Ayurvedic perspective

Synonyms for Vatarakta/ Gout
Adhya Vata – a disease which affects the people with comfort and royalty
Kudha Vata – A disease, which is most commonly seen in kudha desha, near the ankle or the smaller joints

Gout is a common and painful condition that affects the joints. Small crystals form in and around the joint, causing inflammation, pain and swelling. These crystals are made of one of the body’s normal waste products, uric acid. Normally the body rids itself of extra uric acid through the kidneys into the urine however this does not happen fast enough in people with gout. This causes uric acid levels to build up and the crystals to form.

In Ayurveda Gout is described as disease called Vatarakta

Vatarakta is described in Charaka (author of classical text) as a disease caused by Vata prakopa (aggravated Vata) and dushta Rakta (vitiated blood), which spreads in the Raktavahasrotas to afflict the small joints of the body. Mostly it starts in the big toe of a foot or the thumb of a hand. It may later affect other joints if left untreated.

The lakshanas/symptoms manifesting in the patient/Rogi, as well as the line of treatment, depends on the predominant dosha/s involved in the manifestation.

A patient with vatarakta will have severe pain in the joint.
The differential diagnosis for Vatarakta are Amavata, Sandhigata Vata and Raktavata.

Acharya Vagbhata mentioned the following symptoms:
1. Sparsakshamatwa – tenderness
2. Ruk – pain
3. Raga – redness
4. Sopha – swelling
5. Paka and Ushma – local temperature

Vatarakta is described as being of two varieties: Uttana (superficial) or Gambhira (deep seated).

1. Uttana lakshanas are kandu, daha, aching, toda, and throbbing, contracting and brownish black, red or coppery discolouration of twak. (Itch, burning, throbbing, pain, red discolouration of the skin)

2. Gambhira Vatarakta will have shotha, stabdha, kathina, excruciating pain, daha, toda, twitching & suppuration; blackish brown or coppery coloration of twak/skin.

Charaka identifies these as separate diseases, whereas Sushruta describes uttana as a precursor of gambhira vatarakta.

Uttana Vatarakta is residing in the skin and muscles and Gambhira Vatarakta is spreading to all the tissues.

Further classification of Vatarakta are
1. Vata, Pitta, Kaphaja
2. Raktaja
3. Sannipatika

Nidana/ Causative factors for Vatarakta are
* Excess lavana, amla, katu, kshara, snigdha, ushna and uncooked food
* Raw food and dried meats,
* Curd, sugar cane,
* Viruddha ahara/ incompatible food
* Krodha/ anger
* Divaswapna/ day sleeping
* Mithya ahara/ improper diet
* Mithya vihara/improper lifestyle

Disease profile according to Ayurveda (Samprapti ghatakas)

Dosha: Vata pradhana, Pitta anubandha
Dushya: Rakta, Asthi
Upadhatu: Snayu, Sandhi
Srotas: Rasavaha and Asthivaha
Udbhavasthana: Pakvashaya
Adhisthana: Sandi
Rogamarga – Madhyama

Treatment principles
1. Vata Pitta shamana and raktaprasadana

Panchakarma chikitsa
* Raktamokshana (blood letting), Charaka mentions that in severe aggravation of Vata raktamokshana should not be done. Another type of Raktamokshana is Jalauka/ leech therapy
* Snehana – it is Vatahara and is also used as a poorvakarma for the treatments to follow
* Virechana with Trivruth choornam or Kalyana Gulam
* For Krisha: Sneha virechana with Eranda taila
* For sthoola (kapha medavritha) – ruksha virechana by trivrit
* Bastikarma is the best therapy for Vatarakta (Ksheerabasti with ghrta. Both niruha and anuvasana basti with Vatahara dravya Pathya/ Apathya Ahara Vihara
* Rasayana treatment (Jeevaneeya ghrita)

External applications
1. Dhara made out of Balaguloochyadi kashyam, milk and Triphala kalka
2. Lepana with Jatamayadi lepa choorna
3. Parisheka with ksheerivriksha twak kashayam

Herbs and drug of choice are Formulations containing Guduchi. Guduchi is daha hara, Pitta hara and agni promoting.
A great combination is Guduchi and Shatavari.

Classical formulations
Guluchyadi kashayam (Agni deepana)
Balaguluchyadi kashayam (Vatapitta shamana)
Kaishore guggulu and Pinda Thailam for Massage

Foods to avoid:
Tomatoes, cabbage, mushrooms, and spinach
Hot and spicy foods
Day sleep, exposure to heat, salty and sour food
Anger

Foods to favour:
Barley, rice
Ghee, milk, goats milk
Bitter, sweet
Not to spicy
Not to cold

For more information email: info@lakshmiayurveda.com.au.
We wish you a beautiful Sunday. With love from Lakshmi Ayurveda

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