The 25th chapter of Madhava Nidana deals with Amavata Nidana which is the diagnosis of Rheumatism. Rheumatoid arthritis is a chronic inflammatory disorder that can affect more than just your joints. An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body’s tissues.
Causes of Amavata —
विरुद्धाहारचेष्टस्य मन्दाग्नेर्निस्चलस्य च |
स्निग्धं भुक्तवतो ह्यन्नं व्याव्यामं कुर्वत्स्तथा || १ ||
वायुना प्रेरितो ह्यामः श्लेष्मस्थानं प्रधावति |
तेनात्यर्थं विदग्धो असौ धमनिः प्रतिपध्यते || २ ||
वात – पित्त – कफैर्भूयो दूषितः सो अन्नजो रसः |
स्रोतांस्यभिष्यन्दति नानावर्णो अतिपिच्छिलः || ३ ||
जनयत्याशु दौर्बल्यं गौरवं हृदयस्य च |
व्याधिनामाश्रयो ह्योष आमसंज्ञो अतिदारुणः || ४ ||
युगपत्कुपितावन्तस्त्रिकसन्धिप्रवेशकौ |
स्तब्धं च कुरुतो गात्रमामवातः स उच्यते || ५ ||
viruddhāhāracēṣṭasya mandāgnērniscalasya ca |
snigdhaṁ bhuktavatō hyannaṁ vyāvyāmaṁ kurvatstathā || 1 ||
vāyunā prēritō hyāmaḥ ślēṣmasthānaṁ pradhāvati |
tēnātyarthaṁ vidagdhō asau dhamaniḥ pratipadhyatē || 2 ||
vāta – pitta – kaphairbhūyō dūṣitaḥ sō annajō rasaḥ |
srōtānsyabhiṣyandati nānāvarṇō atipicchilaḥ || 3 ||
janayatyāśu daurbalyaṁ gauravaṁ hr̥dayasya ca |
vyādhināmāśrayō hyōṣa āmasañjñō atidāruṇaḥ || 4 ||
yugapatkupitāvantastrikasandhipravēśakau |
stabdhaṁ ca kurutō gātramāmavātaḥ sa ucyatē || 5 ||
Such activities like indulgence in incompatible eatables and habits, lack of
physical activities generate aama (improperly digested eatables) in the body. This condition could appear also when one indulges in performing
strenuous exercises after taking fatty eatables and when no one has poor
digestive capacity. It has been noticed that, even normally also, there could generate ama in the body. This, ama associating itself with vata, moves
quickly to the different seats of Kapha in the body and fills them and the
dhamanis (blood vessels) with waxy material. Thus, the bad product of
digestion associated with vata, pitta and kapha assuming different colours, blocks the tissue pores and passages with thick waxy material. It renders
the patient weak in no time and produces a feeling of heaviness in the
pericardial region. This substance named ama is the cause of so many
distressing diseases. When provoked aama simultaneously afflicts the
pelvic, shoulder, and girdles and makes other joints of the body stiff. This
condition has been identified as Aamavata. 1-5
General Symptomatology of Amavata —
अङ्गमर्दो अरुचिस्तृष्णा ह्यालस्यं गौरवं ज्वरः |
अपाकः शूनता अङ्गानामामवातस्य लक्षणम् || ६ ||
aṅgamardō arucistr̥ṣṇā hyālasyaṁ gauravaṁ jvaraḥ |
apākaḥ śūnatā aṅgānāmāmavātasya lakṣaṇam || 6 ||
Clinical features of Ama Vata include —
- Pain all over the body and joints
- Loss of taste
- Thirst
- Lack of enthusiasm
- Heaviness
- Fever
- Indigestion and
- Swelling of the joints. 6
Advanced stage of Amavata –
स कष्टः सर्वरोगाणां यदा प्रकुपितो भवेत् |
हस्त – पाद – शिरो – त्रिक – जानूरुसन्धिषु || ७ ||
करोति सरुजं शोथं यत्र दोषः प्रपध्यते |
स देशो रुज्यते अत्यर्थं व्याविद्ध इव वृश्चिकैः || ८ ||
जनयेत् सो अग्निर्दौर्बल्यं प्रसेकारुचि गौरवम् |
उत्साहहानिं वैरस्यं दाहं च बहु मूत्रताम् || ९ ||
कुक्षौ कठिनतां शूलं तथा निद्राविपर्ययम् |
तृट् – छर्दि – भ्रम – मूर्च्छाश्च हृद्ग्रहं विड्विबद्धताम् |
जाड्यान्त्रकूजमानाहं कष्टांश्चान्यानुपद्रवान् || १० ||
sa kaṣṭaḥ sarvarōgāṇāṁ yadā prakupitō bhavēt |
hasta – pāda – śirō – trika – jānūrusandhiṣu || 7 ||
karōti sarujaṁ śōthaṁ yatra dōṣaḥ prapadhyatē |
sa dēśō rujyatē atyarthaṁ vyāviddha iva vr̥ścikaiḥ || 8 ||
janayēt sō agnirdaurbalyaṁ prasēkāruci gauravam |
utsāhahāniṁ vairasyaṁ dāhaṁ ca bahu mūtratām || 9 ||
kukṣau kaṭhinatāṁ śūlaṁ tathā nidrāviparyayam |
tr̥ṭ – chardi – bhrama – mūrcchāśca hr̥dgrahaṁ viḍvibaddhatām |
jāḍyāntrakūjamānāhaṁ kaṣṭānścānyānupadravān || 10 ||
This aamavata becomes severe when it aggravates and affects all the joints of the hands, feet, head, heels, waist, knee, and thighs causing painful
swelling that shifts from place to place (joint to joint) when the doshas
move from one place to another. It causes painful swelling (inflammation)
in the joints of hands, legs, head,ankle, sacrum, knees, and thighs and
places wherever the morbid substance (aama) gets seated.
Specific features of amavata when it is associated with pitta, vata and kapha
पित्तात् सदाह – रागं च, सशूलं पवनानुगम् | स्तिमितं गुरु – कण्डुम च कफदुष्टं तमादिशेत् || ११ ||
pittāt sadāha – rāgaṁ ca, saśūlaṁ pavanānugam |
stimitaṁ guru – kaṇḍuma ca kaphaduṣṭaṁ tamādiśēt || 11 ||
If pitta becomes the predominant dosha, there could be
- Burning sensation and
- Redness of the affected part (joint)
If vata, is predominant, pain could be very severe.
If kapha is predominant,
- A feeling of being covered with wet clothes
- Heaviness and
- An itching sensation are present. 11
Prognosis of Amavata —
एकदोषानुगः साध्यो, द्विदोषो याप्य उच्यते |
सर्वदेहचरः शोथः स कृच्छ्रः सान्निपातिकः || १२ ||
ēkadōṣānugaḥ sādhyō, dvidōṣō yāpya ucyatē |
sarvadēhacaraḥ śōthaḥ sa kr̥cchraḥ sānnipātikaḥ || 12 ||
The disease is easy to cure if only one dosha is involved therein; it is
difficult to treat if two doshas are involved in it. The disease could be
considered incurable if all the three doshas are involved. It is impossible to manage if it is also associated with swelling at the joints of the body. 12
इति श्रीमाधवकरविरचिते माधवनिदाने आमवातनिदानं समाप्तम् || 25 ||
iti śrīmādhavakaraviracitē mādhavanidānē āmavātanidānaṁ samāptam || 25 ||
Thus concludes the chapter of Amavata Nidana.
Source —
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I’m Dr. Malini Bhat MD (Ayu); an Ayurvedic Doctor and a health blogger. Follow me on social media to get daily health tips which you can easily adapt to a healthy lifestyle.