PAKHSHAGHA TA PRESENTED BY DR HIMMAT DHAKER M

PAKHSHAGHA TA PRESENTED BY DR. HIMMAT DHAKER M. D. SCHOLAR (R&VV VIBHAG)

Important References n Ch. Su. 12 n Ch. Su. 20 n Ch. Chi. 28 n Ch. Si. 9 n Su. Ni. 1 n Su. Chi. 1 n A. Hr. Ni. 15 n A. Hr. chi. 21

GENERAL INTRODUCTION n PAKHSHAGHATA MENTIONED AS VATA NANATMAJA VYADHI IN CHARAK SAMHITA n SYN : PAKHSHAVADHA , EKANG ROGA , SARVANG ROGA n IT IS CHARACTRISED BY VITIATION OF VATA DOSHA RESULTING IN FUNCTION LOSS OF WHOLE BODY , HALF OF BODY OR A PERTICULAR ORGANE

NIDANA : {k’khrk. Yiy/o. Uu. O; ok; kfriztkxj. S%A fo’keknqipkjk. Pp nks’kkl`d~lzo. kknfr. AA ya? ku. Iyouk. R; /o. O; k; kekfrfopsf’Vr. S %A /kkrquka la{k; kf. Pp. Urk’kksdjksxkfrd’k. Z. kkr~AA nq%[k’k; klukr~ dzks/kkfnok. Lo. Iukn~Hk; knfi. A osxl. U/kkj. kknkeknf. Hk? kkrkn. Hkkstukr~AA eek. Zck/kkn~xtks’V~jk’o’kh? kz; kukiralukr~A p- fp- 28@15&18

AHARAJ NIDANA n n n n n Ruksha ahara Laghu ahara Sheeta ahara Alpa ahara Khara ahara Pramitashana Langhana Kashaya-Katu-Tikta ahara Adhyashana Vishamashana

VIHARAJ NIDANA n Excessive walking n Excessive swimming n Excessive exercise n Suppression of natural urges n Lifting heavy weights n Grishma & Varsha Ritu n Diwaswapna n Abnormal activities n Habitual use of hard beds & seats

Contd… n Abhighata n Marmaghata n Riding on or falling from an elephant, camel, horse or other fast running animals Wrong treatment Ati Adhyayan n Prapidana n Prasarana

Contd… n Last part of the day & night n Kriyatiyoga n Ati Uccha Bhashana

MANAS NIDANA n Excessive worries n Excessive grief (Feeling of sadness) n Excessive anger n Excessive fear

NIDANARTHAKARA ROGA n Excessive loss of blood n Excessive loss of dhatu n Excessive loss of Purisha n Debility by other diseases n Ama

PURVA ROOPA: v. O; Dra y{k. ka rslka ---------A p- fp- 28@19 AVYAKT MEANS FEW OR MILD SYMPTOMS (CHA KRAPANI) No Purva Roopa are mentioned in SUSHRUT and VAGBHATTA

SOME COMMEN TERMS: SIRA : - It is updhatu of rakta dhatu, main function is supply of rasatmaka ojodhatu from hridaya to whole body and cheshta is depends on it. SNAYU : - It is updhatu of meda dhatu. main function is t 0 bound all sandhi , peshi , asthi etc. Due to this structure all sandhi can bear the body weight.

DHAMNI : - According to sushrut all body functions like senses, activities of all srotasas are regulated by dhamni.

SAMANYA SAMPRAPTI: n ACHARYA CHARAK has mentioned two main reason of vitiation of VATA DOSHA i. e. n Okk; ks/kk. ZRkq{k; k. Rk~ dksiks ekx. ZL; koj. ksu p. A n on account of various aetiological factors, Vata gets vitiated and it fills up the rikta srotas of the body n causing various kinds of vatavyadhi, which affects the whole body or some specific part of it

VISHISHT SAMPRAPTI AND LAKHSHAN g. Ro. Sda ek: r% i{ka nf{k. ka okeeso ok AA dq; k. ZPps’Vkfuo`f. Rra fg : Tka Okkd~Lr. EHk. Ekso p A Xk`gh. Rokv/k. Za ’kjhj. L; fljk% Luk; wfo. Z’kks’; p AA Ikkna ladksp; R; sda g. Lra ok rksn’kwyd`r~ A , dkaxjksxa ra fo|kr~ lok. Zaxa lo. Z nsgte~ AA p- fp- 28@53&55

ACCORDING TO CHARAK n Vayu beholds either side – right or left of the body Dries up SIRA and SNAYU of that part Loss of function Symptoms: - Chestanivriti - Vakstambha - Ruja

VISHISHT SAMPRAPTI AND LAKHSHAN v/kksxek % lfr; ZXxk /keuh: /o. Znsgxk % A ; nk izdqfirks. R; Fk. Za ekrfj’ok izi|rs AA rnk. U; rji{k. L; laf/kca/kku~ foeks{k; u~ A gf. Ur i{ka rekgqfg. Z i{kk? kkra f. Hk’k. Xojk AA ; L; d`RLua ‘’kjhjk/k. Zede. Z. ; epsrue~ A rr % ir. R; lu~ ok vfi tgk. R; fuyihf. Mr %AA lq- fu- 1@60&63

ACCORDING TO SUSRUT n n Excessive Vitiated VATA Holds the Adhog Tiryag Urdhva Dhamni Sandhi Bandhan Vimokhshayan of either half - Akarmanyata - Achetanam

VISHISHT SAMPRAPTI AND LAKHSHAN j. Drekf. JR; iou% dq; k. ZUew)Z/kjk fljk%AA : {kk% losnuk% d`’. kk% lks vlk/; % L; kf. Rljkxzg%A x`gh. Rok v/k. Za ruksok. Z; q% fljk%Luk; qfo. Z’kks. L; p AA i{ke. U; rja gf. Ur lf. U/kc. U/kku~ foeks{k; u~A d`Rluks v/k. Zdk; Lr. L; L; knde. Z. ; ks fopsru%AA v- g`- fu- 15@37&40

ACCORDING TO VAGBHATTA Raktashrita vata holds moordha dhara sira Siragraha develop n Vayu beholds either side – right or left of the body Dries up SIRA and SNAYU of that part Sandhi Bandhan Vimokhshayan of either half - Akarmanyata - Achetanam

ACCORDING TO MADHAVA NIDANA Same as VAGBHATTA. Specially mentioned according to DOSHANUBANDHA PITTANUBANDHI n Daha n Santapa n Murchchha KAPHANUBANDHI n Shaitya n Shotha n Gaurava

SAMPRAPTI GHATAK DOSHA - VATA (SP. PRANA , UDANA, VYANA) n DUSHYA –RASA , RAKTA, MANSA, MEDA, SIRA, SNAYU, DHAMNI n SROTASA : Rasavaha, Raktavaha, Mamsavaha and Medovaha srotasa SROTODUSHTI: Sanga, and Vimargagamana n Udbhava Sthana : Pakvashaya n Adhisthana : Ardhsharira n

SADHY-ASADHYATA ’kq)okrgra i{ka d`PN`lk/; rea fonq% A Lkk/; e. U; su lal`’Velk/; a {k; gsrqde~AA lq- fu- 1@63 Only Vatika – krichhsadhya Combined with other doshas – Sadhya Khshaya hetuk - Asadhya

CHIKITSA NIDANA PRIVARJAN SAMANYA VAT VYADHI CHIKITSA n SNEHAN n SWEDAN n MRIDU SNSHODHANA n ABHYANG n MARDANA n SNIGDHA USHNA BASTI n MADHUR AMLA LAVAN BHOJAN

VISHISHT CHIKITSA Losnua Lusgla; q. Dra i{kk? kkrs fojspue~ AA p- fp- 28@100 Lusgua Lusgla; q. Dra i{kk? kkrs fojspue~ A v- g`- fp- 21@44 Charak and Vagbhatta discribed almost same tratment for Pakhshaghat

ACCORDING TO SUSHRUT n SNEHAN n SWEDAN n MRIDU SNSHODHANA n ANUVASANA, ASTHAPANA n AKHSHEPAKA [APTANAK(DALHAN)] VIDHANENOPCHARET – AVPEEDA NASYA n MASTISHKYA (SHIROBASTI) n SHALVANA UPNAHA

IMPORTANCE OF SNEHANA & SWEDANA n For give the power to dried and weak sira and snayu n To relieve the pain n To increase the vital power n To relieve any obstruction from vata marga

IMPORTANCE OF VIRECHNA n For regulate gati of vata (specially of PRAN VAYU) n For controll the RAKTDUSHTI n For reduced the MASTISHK GAT DABAV (ICP)

SINGLE DRUGS n ASHWAGANDHA n BALA n DASHMOOLA n SHUNTHI n RASNA n ERAND n MASH n PRASARANI n NIRGUNDI

TAILA YOGAS n BALA TAILA n SAHCHARA TAILA n NARAYAN TAILA n VISHAGARBH TAILA n PRASARANI TAILA n NIRGUNDI TAILA n MAHAMASH TAILA n AMRITADYA TAILA

GHRITA YOGAS n DASHMOOLADI GHRITA n CHITRAKADYA GHRITA n CHATUH SNEHA n SNEHA LAVAN

KASHAYAS n MASHBALADI n MASHA ATMGUPTADI n RASNASAPTAK n RASNA DASHMOOLA n DASHMOOLA KWATH+ MADHU

AVELEHAS n KALYANAVELEHA n RASON PINDA n SHAD DHARAN YOG

GUGGULU n YOGRAJ n KAISHOR n SINGHNAD n TRAYODASHANG

RASAS n EKANG VEER n VAT GAJANKUSH n VRIHAD VAT CHINTAMANI RAS n YOGENDRA RAS n RAS RAJ RAS

ASAVA ARISHTA n ASHVNDHARISHT n BALARISHT n DASHMOOLARISHT

Emergency management of … Cerebrovascular Disorders: § Examine the patient thoroughly. § Identify the patient whether he is in stupor or coma. § If coma look for vitals and send to hospital (can be treated basing on severity and investigation). § In acute conditions first 48 hrs must be kept in a well equipped hospital under the supervision of Specialist.

Emergency management of Cerbrovascular diseases… § § § First go for differential Diagnosis whether it is haemorrhagic (vata, pitta), thrombotic (kaphaja), embolitic (vata, kaphaja) and TIA ( vata vegaja) Check the B. P. it may low in acute hemorrhage conditions also, in such conditions BVC 125 mg + KDR 125 mg + AP 125 mg apply on the tongue with honey. If B. P and pulse is low Bruhadkasturyadi vati 1 -2 pills apply on the tongue with

Emergency management of Cerbrovascular diseases… § Incase of thrombo embolic (kapha, vata) phenomenon : BVC 125 mg + Akeekapisti 250 mg along with aswagandhaksheera twice or thrice daily according to the condition. § After passing of acute phase treatment, follow up must be given according to doshadooshya vivechana and after that only sneha abhyanga, sweda karmas may be initiated.

Emergency management of Cerbrovascular diseases… § If malignant Hypertension: Swarnasutashekararas 120 mg + kamaduda with muktha 250 mg with honey. Sarpagandhaghanavati 1 -2 pills + akeekapisti 200 mg apply on the tongue with honey. § In case of Khaphaja (thrombotic condition): Vachachurna 500 mg + yastichurna 1 gm along with lashunaksherapaka twice or thrice daily is highly

PATHYA APATHYA Separate Pathya and Apathya of Pakshaghata are not described, but those of Vatavyadhi can be taken as granted for Pakshaghata also.

PATHYA Ahara : n Anna varga : Kulthi, Masha, Godhuma, Raktashali, Navina Tila, n Puranashalyodana. n Phala varga : Amla rasayukta Phala, Dadima, Draksha, Jambira, n Badara. n Shaka varga : Vartaka, Patola, Shigru, Rasona. n Dugdha varga : Kshira, Ghrita, Navneeta. n Drava varga : Mamsa rasa, Mudaga yusha, Dhanyamla. n Taila varga : Tila taila, Sasharpa taila, Eranda taila.

PATHYA n Vihara : n Sukhoshna Parisheka, Nirvata Sthana, Samvahana, Avagahana, n Abhyanga, Brahmacharya, Ushna Pravarana, Agni Aatapa Sevana, n Snigdha Ushna Lepa.

APATHYA Ahara : Kalaya, Chanaka, Kanguni, Kodrava, Shyamaka, Nivara, Nishpava beeja, Rajmasha, Karira, Jambu, Trinaka, Tinduka, Shushka Mamsa, Dushita Jala, Vihara : Vegadharana, Vyavaya, Vyayama, Vamana, Raktamokshana, Prajagarana, Diwaswapna, Adhva, Ati. Gaja, Ashwa, Ushtra, Yana

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