Ancient Indian views on GI impairment in rheumatoid arthritis (amavata)
Journal name: Ancient Science of Life
Original article title: Studies on ancient indian concept of ‘role of impaired gastro � intestinal function � enteropathy�, in the pathogenesis and treatment of rheumatoid arthritis - amavata
The ANSCI is a peer-reviewed, open-access journal focused on Ayurveda and traditional medicines. It publishes original research, reviews, and literary studies linking traditional knowledge with modern science, covering disciplines like botany, ethnomedicine, pharmacology, and clinical research.
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Prem Kishore, M. M. Padhi
Ancient Science of Life:
(A quarterly multi-disciplinary scientific research journal in Ayurveda)
Full text available for: Studies on ancient indian concept of ‘role of impaired gastro � intestinal function � enteropathy�, in the pathogenesis and treatment of rheumatoid arthritis - amavata
Year: 1987
Copyright (license): CC BY-NC-SA
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Summary of article contents:
Introduction
This paper examines the ancient Indian Ayurvedic perspective on rheumatoid arthritis, known as Amavata, in conjunction with modern medical understandings of the condition. It encompasses the disease's etiopathogenesis, clinical features, and therapeutic interventions, including a detailed analysis of clinical trials involving the Ayurvedic herb Sunthi (Zingiber officinal). The study underscores the historical understanding of rheumatoid arthritis, tracing its origins and descriptions from ancient medical texts, while simultaneously engaging with contemporary theories regarding its systemic nature and multifactorial etiology, including genetics and autoimmune responses.
The Role of Impaired Gastrointestinal Function
A central theme presented in the paper is the role of impaired gastrointestinal function, or enteropathy, as a significant contributor to the pathogenesis of Amavata. Ayurvedic literature posits that gastrointestinal disturbances lead to the production of "Ama," an incomplete product of digestion that interacts with the body's doshas (humors) and contributes to inflammatory processes. Modern medical perspectives have recently begun to recognize parallels in this theory, suggesting connections between gastrointestinal dysfunction and rheumatoid arthritis. Studies indicate a high prevalence of gastrointestinal symptoms among rheumatoid arthritis patients, reinforcing Ayurveda's emphasis on digestive health. The clinical trials conducted within the study evaluate the efficacy of Sunthi preparations, which aim to regulate gastrointestinal function and, consequently, mitigate the symptoms of rheumatoid arthritis.
Conclusion
The findings from the trials conducted on Sunthi highlight the potential for Ayurvedic approaches to contribute valuable insights into the management of rheumatoid arthritis. By framing the disease's etiology through the lens of gastrointestinal impairment, the study offers support for the Ayurvedic claim that enhancing digestive health can alleviate the disease's symptoms and possibly prevent its progression. The research underscores the importance of integrating traditional wisdom with contemporary medical practices, aiming for a holistic understanding and treatment of rheumatoid arthritis that takes into account both historical and modern perspectives on health and disease.
FAQ section (important questions/answers):
What is the focus of the study on rheumatoid arthritis?
The study evaluates the ancient Indian Ayurvedic concept of impaired gastrointestinal function, known as enteropathy, in relation to the modern medical understanding of rheumatoid arthritis, also termed Amavata.
What is the role of Sunthi in treating rheumatoid arthritis?
Sunthi, derived from Zingiber officinal, has been identified as having gastro-intestinal stimulant properties. Clinical trials showed that it significantly alleviates symptoms of rheumatoid arthritis by addressing the underlying gastrointestinal dysfunction.
How does Ayurveda explain the cause of rheumatoid arthritis?
Ayurveda attributes rheumatoid arthritis to impaired gastrointestinal function, where the incomplete processing of food results in Ama, which interacts with the body's systems, causing inflammatory joint conditions.
What were the results of the clinical trials conducted?
The trials indicated that treatments involving Sunthi showed better clinical improvement in patients compared to traditional Ayurvedic preparations, reinforcing the significance of gastrointestinal health in managing rheumatoid arthritis.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Ancient Indian views on GI impairment in rheumatoid arthritis (amavata)�. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Shunthi (Åšuṇá¹hÄ«, Åšuṇá¹hi, Sumthi, Shumthi):
Sunthi, derived from Zingiber officinale (ginger), is an important herbal remedy in Ayurveda used for its digestive properties. It regulates bowel movement, alleviates gastrointestinal issues, and mitigates 'Ama', which is considered a primary causative agent of rheumatoid arthritis (Amavata). Its pharmacological profile supports its use for various ailments linked to impaired digestion.
2) Guggulu:
Guggulu refers to a resin obtained from the Commiphora mukul tree, widely used in Ayurvedic formulations. Known for its anti-inflammatory and rejuvenating properties, Guggulu is commonly prescribed for joint disorders like rheumatoid arthritis. It aids in the management of 'Kapha' and 'Vata' imbalances, enhancing overall therapeutic efficacy when combined with other herbs.
3) Rheumatoid arthritis:
Rheumatoid arthritis is a chronic autoimmune disorder characterized by inflammation of the joints. It leads to stiffness, swelling, and potential joint damage. The Ayurvedic perspective, particularly through the lens of Amavata, emphasizes gastrointestinal dysfunction as a contributing factor, highlighting a holistic approach to understanding and treating this condition.
4) Drug:
In this context, 'Drug' refers to medicinal compounds derived from plants or minerals targeted toward treatment. Ayurveda emphasizes the synergy of herbal formulations, where each ingredient contributes to the overall effect. The trials discussed evaluate the efficacy of specific Ayurvedic drugs like Sunthi and Guggulu in managing rheumatoid arthritis symptoms.
5) Kvatha (KvÄtha):
Kvatha is a traditional Ayurvedic decoction made by boiling herbs in water, producing a concentrated liquid. This method of preparation increases bioavailability and therapeutic potency. Kvathas, such as Rasanadi Kvatha, are often prescribed for their specific health benefits, particularly in treating conditions associated with inflammation and digestive disorders.
6) Rasa (RasÄ, Rasha):
Rasa in Ayurveda denotes the taste and therapeutic properties of a substance. It plays a crucial role in determining a drug's action on the body. Understanding the 'Rasa' of a drug helps practitioners tailor treatments, especially in disease management, ensuring that each formulation effectively addresses the patient's specific imbalances.
7) Ayurveda (Ä€yurveda, Ayus-veda):
Ayurveda is the ancient Indian system of medicine that emphasizes a holistic approach to health. It integrates physical, mental, and spiritual well-being. Ayurvedic concepts such as Dosas, Dhatus, and Agni elucidate the balance necessary for health, guiding treatment protocols aimed at restoring equilibrium in patients suffering from chronic conditions like rheumatoid arthritis.
8) Amavata (Ä€mavÄta, Ama-vata):
Amavata is the Ayurvedic term for rheumatoid arthritis, characterized by joint pain and inflammation believed to arise from the accumulation of 'Ama', a toxic byproduct of improper digestion. It embodies the core Ayurvedic principle that dysfunctional gastrointestinal function directly contributes to various systemic diseases, including chronic inflammatory conditions.
9) Yogaraja (YogarÄja, Yoga-raja):
Yogaraja Guggulu is a specific Ayurvedic formulation combining Guggulu and several herbs renowned for their anti-inflammatory and analgesic properties. It is particularly effective in treating joint disorders by balancing 'Kapha' and 'Vata', thus addressing symptoms associated with rheumatoid arthritis and enhancing overall joint mobility and function.
10) Guduci (Guá¸uci, Guá¸Å«ci, Guá¸Å«cÄ«, Guá¸ucÄ«):
Guduci, also known as Tinospora cordifolia, is revered in Ayurveda for its immunomodulatory and anti-inflammatory properties. It is often combined with other herbs, such as Sunthi, to enhance therapeutic outcomes in conditions like rheumatoid arthritis, addressing both systemic inflammation and gastrointestinal health.
11) Swelling:
Swelling refers to the inflammatory response often seen in rheumatoid arthritis, where fluid accumulates in joint spaces. In Ayurveda, this is conceptualized as 'Shleshaka Kapha' disturbance. Understanding and managing swelling through dietary and lifestyle adjustments, along with appropriate herbal treatments, remain key strategies in Ayurvedic therapy.
12) Amavatari (Ä€mavÄtÄri, Amavata-ari):
Amavatari Rasa is a traditional Ayurvedic formulation intended for the treatment of Amavata (rheumatoid arthritis). It typically contains a blend of potent ingredients that work synergistically to reduce inflammation, improve joint function, and restore balance to the body's natural systems.
13) Medicine:
Medicine refers to substances used in treatment to restore health. In the context of Ayurveda, medicine is holistic, integrating herbs, minerals, and lifestyle practices. The focus is on treating the root cause of disease, such as impaired digestive function in conditions like rheumatoid arthritis.
14) Dosha (Dosa, Doá¹£a, DosÄ, Doá¹£Ä�, ḌosÄ):
Dosa in Ayurveda represents the bioenergetic forces that govern physiological processes. The three primary Doshas—Vata, Pitta, and Kapha—are crucial for understanding individual constitutions and their imbalances. Treatments aim to restore balance among these Doshas, particularly in chronic conditions like rheumatoid arthritis.
15) Inflammation:
Inflammation is the body's response to injury or disease, manifesting as redness, heat, swelling, and pain. In rheumatoid arthritis, inflammation is chronic and systemic. Ayurveda addresses inflammation not just through symptomatic relief but by correcting underlying digestive dysfunction and restoring bodily balance.
16) Evolution:
The evolution of the understanding of diseases, particularly rheumatoid arthritis, spans centuries and illustrates advancements in both modern and traditional medicine. Ayurveda has documented conditions like Amavata for millennia, exploring its etiopathogenesis, which reflects a rich historical context contributing to contemporary treatment modalities.
17) Grahani (Grahaṇ�):
Grahani refers to the proper functioning of the digestive system or intestines in Ayurveda. It emphasizes the relationship between gut health and overall well-being. In the context of rheumatoid arthritis, impaired Grahani function is connected to the pathogenesis of Amavata, underlying the importance of digestive health.
18) Science (Scientific):
Scientific approaches in medicine aim to explore, validate, and substantiate traditional medical practices. By employing research methodologies, recent studies correlate Ayurvedic principles with modern physiology, enhancing the understanding of diseases like rheumatoid arthritis (Amavata) and supporting the integration of traditional remedies into contemporary treatments.
19) Sharman (Åšarma, SarmÄ, Sarma, Sharma, Åšarman):
Sharma likely refers to a notable Ayurvedic practitioner or researcher who has contributed to the understanding of Amavata and its treatment. Such contributions include exploring the relationship between gastrointestinal health and rheumatoid arthritis, emphasizing the traditional roots of contemporary treatment protocols.
20) Kapha:
Kapha is one of the three Doshas in Ayurveda, associated with the bodily elements of water and earth. Its balance is essential for maintaining health. In conditions like rheumatoid arthritis (Amavata), the aggravation of Kapha leads to symptoms such as swelling and stiffness of joints, necessitating targeted therapies.
21) Grahanidosha (Grahaṇīdoṣa, Grahani-dosha):
Grahanidosa characterizes various gastrointestinal disorders leading to absorption issues. In Ayurveda, its implications extend to systemic effects, including joint conditions like rheumatoid arthritis. Addressing Grahanidosa involves optimizing digestive health to alleviate symptoms characterized by inflammation, emphasizing the interconnectedness of bodily systems.
22) Stiffness:
Stiffness is a common symptom in rheumatoid arthritis, resulting from inflammation and joint damage. In Ayurveda, this is viewed as a manifestation of 'Ama' accumulation and Kapha imbalance. Addressing stiffness involves holistic treatment strategies, focusing on inflammation reduction and digestive health restoration.
23) Nirgundi (Nirguṇá¸Ä«, Nirgumdi):
Nirgundi, or Vitex negundo, is an Ayurvedic herb known for its anti-inflammatory and analgesic properties. Often combining with other ingredients like Sunthi, it aims to relieve rheumatic conditions by decreasing pain and swelling, thus aiding in the management of symptoms associated with rheumatoid arthritis.
24) Samhita (SaṃhitÄ, Saṃhita):
Samhita refers to ancient texts that compile Ayurvedic knowledge, practices, and theories. Texts like Charaka Samhita provide foundational concepts for understanding diseases, their treatment, and the principles of Ayurveda. They serve as crucial references for practitioners in diagnosing and addressing conditions like Amavata.
25) Nidana (NidÄna):
Nidana signifies the diagnosis or identification of disease causes in Ayurveda. It emphasizes understanding the root of ailments, including the identification of contributing factors to rheumatoid arthritis, such as impaired gastrointestinal function and its interplay with the body's Doshas, paving the way for targeted treatment strategies.
26) Agni:
Agni represents the digestive fire in Ayurveda, essential for the proper metabolism of food and nutrients. A balanced Agni is vital for preventing 'Ama' formation, which is central to conditions like rheumatoid arthritis. Strengthening Agni supports overall health, enhancing the body's ability to combat disease.
27) Vata (VÄá¹a, Vaá¹a, VÄta, Vaá¹Ä�):
Vata is one of the three Doshas in Ayurveda, linked to air and space elements, governing movement and communication in the body. Its imbalance can lead to various health issues, including joint disorders like rheumatoid arthritis. Treatments often focus on pacifying Vata to alleviate symptoms and restore harmony.
28) Sama (Åšama, SÄmÄ, SÄma, Shama, SamÄ):
Sama pertains to refined or pure states in Ayurveda, often related to the proper functioning of bodily systems. In the context of rheumatoid arthritis, achieving 'Sama' is crucial for recovery, emphasizing the need to address both symptomatic relief and underlying gastrointestinal dysfunction.
29) Hand:
In the context of rheumatoid arthritis, 'hand' refers to a commonly affected joint area, where symptoms like pain and swelling manifest. The involvement of hand joints reflects the systemic nature of the disease, necessitating a comprehensive treatment strategy to restore function and relieve discomfort.
30) Shleshakakapha (Åšleá¹£akakapha, Shleshaka-kapha):
Shleshaka-Kapha is a subcategory of the Kapha Dosha in Ayurveda, specifically involved in lubrication and support of joints. Its dysfunction is often linked to conditions like rheumatoid arthritis (Amavata), where increased Shleshaka-Kapha leads to swelling, pain, and stiffness, emphasizing the need for targeted treatments.
31) Madhavanidana (MÄdhavanidÄna, Madhava-nidana):
Madhava-nidana is an ancient Ayurvedic text focused on clinical diagnosis and pathology. It provides vital insights into diseases like Amavata, detailing their characteristics, etiopathogenesis, and therapeutic interventions. Texts like this serve as a reference for practitioners in understanding and managing chronic conditions.
32) Accumulation (Accumulating, Accumulate):
Accumulation refers to the buildup of substances in the body, such as 'Ama' in Ayurveda, which can lead to disease. In rheumatoid arthritis, the accumulation within joints contributes to swelling and inflammation. Understanding accumulation dynamics is crucial for holistic treatment strategies aimed at restoring balance.
33) Bhallataka (BhallÄá¹aka, BhallÄtaka):
Bhallataka, or Semecarpus anacardium, is an Ayurvedic medicinal plant known for its anti-inflammatory properties. It has been utilized in treating joint disorders like rheumatoid arthritis. Its effectiveness supports Ayurvedic principles related to managing 'Kapha' and 'Vata' imbalances, further enriching treatment modalities.
34) Discussion:
Discussion involves analyzing and synthesizing findings related to Ayurvedic treatment methods and their scientific underpinnings. In the context of rheumatoid arthritis, discussions evaluate the efficacy of various herbal combinations, the relationship between gastrointestinal health and disease, and suggestions for future therapeutic approaches.
35) Similarity:
Similarity in this context refers to parallels identified between traditional Ayurvedic concepts and modern medical understanding of diseases like rheumatoid arthritis. Recognizing these similarities fosters collaboration between disciplines, leading to more holistic patient care that integrates beneficial practices from both frameworks.
36) Vatarakta (VÄtarakta, Vata-rakta):
Vatarakta refers to a specific type of rheumatic condition discussed in Ayurveda, characterized by joint involvement with a predominance of Vata and Rakta (blood). This term highlights the historical understanding of rheumatic diseases and their complexities, influencing modern interpretations and treatment strategies.
37) Shleshaka (Åšleá¹£aka):
Shleshaka denotes the Kapha component responsible for lubrication and nourishment in the joints. Adequate Shleshaka is vital for healthy joint function; its imbalance leads to conditions like rheumatoid arthritis. Ayurvedic treatments aim to restore Shleshaka balance to alleviate symptoms such as pain and swelling.
38) Dhatvagni (DhÄtvagni, Dhatu-agni):
Dhatvagni represents the metabolic fires associated with the transformation of nutrients within bodily tissues in Ayurveda. The health of Dhatvagni is crucial for preventing 'Ama' formation. Dysfunction can lead to systemic issues, including rheumatoid arthritis, emphasizing the importance of maintaining optimal metabolic functions.
39) Mahabhuta (MahÄbhÅ«ta, Maha-bhuta):
Mahabhuta refers to the five great elements—earth, water, fire, air, and space—that form the basis of Ayurvedic philosophy. The balance of these elements reflects in bodily health and is crucial in understanding conditions like rheumatoid arthritis, where elemental imbalances play a significant role in disease manifestation.
40) Amatisara (Ä€mÄtisÄra, Ama-atisara):
Amatisara typically refers to digestive disorders marked by the improper processing of food. In Ayurveda, this condition is closely linked to the formation of 'Ama', the foundational cause of diseases such as rheumatoid arthritis. Understanding Amatisara helps practitioners customize treatments that restore optimal digestive function.
41) Katurasa (Kaá¹urasa, Katu-rasa):
Katurasa relates to the classification of tastes in Ayurveda, specifically the bitter taste that aids digestion and detoxification. Recognizing the influence of Katurasa on bodily functions helps in formulating comprehensive treatment plans, especially for conditions like rheumatoid arthritis that stem from digestive imbalances.
42) Madhura (MadhurÄ, MÄdhura):
Madhura denotes the sweet taste in Ayurveda, associated with nourishment and soothing properties. While generally beneficial, excessive Madhura can contribute to imbalances leading to conditions like rheumatoid arthritis. Nutrition plays a critical role in maintaining the balance of tastes to promote overall health and prevent disease.
43) Harita (HÄrÄ«ta, HÄrita, HÄritÄ, HaritÄ):
Harita could reference Harita Samhita, a classical Ayurvedic text exploring diseases and their treatments. Insight from texts like this helps practitioners correlate symptoms and pathophysiology, particularly for conditions like rheumatoid arthritis, facilitating a deeper understanding of effective therapeutic strategies.
44) Rasona:
Rasona, or garlic, is a potent herb in Ayurveda renowned for its anti-inflammatory and immune-boosting properties. It is frequently used in Ayurvedic formulations to treat conditions like rheumatoid arthritis, enhancing therapeutic outcomes by reducing inflammation and improving digestive health.
45) Dushya (Dūṣya, Dūśya):
Dusya represents the materials that are affected by disease in Ayurveda, similar to the concept of Dushya. When DLusya are compromised, they lead to various ailments. Understanding the interplay between Dusya and Dosas is essential for effectively addressing conditions such as rheumatoid arthritis.
46) Shukla (Åšukla, ÅšuklÄ, SuklÄ, Sukla):
Shukla in Ayurveda may relate to purity and clarity. In the context of treatments, this concept emphasizes the importance of using pure, high-quality ingredients to ensure the effectiveness and safety of medicinal preparations, particularly when addressing complex conditions such as rheumatoid arthritis.
47) Vipaka (VipÄka):
Vipaka denotes the post-digestive transformation of food in Ayurveda, determining how substances affect the body after digestion. Understanding Vipaka allows for targeted treatments, ensuring that medicinal substances interact beneficially with the body's metabolism, particularly in managing chronic conditions like rheumatoid arthritis.
48) Rasana (RaÅ›anÄ, Rashana, RasanÄ, RÄsana):
Rasana refers to the sense of taste in Ayurveda, which influences nourishment and health. The balance of tastes, particularly in food and medicine, is essential in preventing and treating diseases like rheumatoid arthritis by ensuring proper digestion and nutrient absorption.
49) Srotas (Åšrotas, Shrotas):
Srotas pertains to the channels within the body responsible for the flow of nutrients, energy, and bodily functions. Proper functioning of Srotas is crucial for health, and any blockage or dysfunction can contribute to diseases like rheumatoid arthritis, emphasizing the need for effective therapies.
50) Tikshna (TÄ«kṣṇÄ, TÄ«kṣṇa):
Tiksna, meaning sharp or penetrating, refers to the properties of certain herbs and substances in Ayurveda. Such properties are essential for effectively breaking down 'Ama' and rectifying digestive issues. In treating rheumatoid arthritis, Tiksna elements contribute to alleviating symptoms and promoting healing.
51) Nirama (NirÄma):
Nirama signifies the stage of disease when 'Ama' is absent from the body. Achieving Nirama state is a goal in Ayurvedic treatments, as it indicates the restoration of health and balance within the body's systems, especially in chronic conditions like rheumatoid arthritis.
52) Edema (Oedema):
Oedema refers to the swelling caused by excess fluid accumulation in tissues, commonly seen in inflammatory conditions like rheumatoid arthritis. In Ayurveda, addressing the root cause of oedema involves balancing the Doshas and improving gastrointestinal function to prevent 'Ama' accumulation.
53) Sveda:
Sveda denotes sweating or fomentation in Ayurveda, a therapeutic practice aimed at alleviating muscular tension and enhancing circulation. In the treatment of rheumatoid arthritis, Sveda is used as a supportive therapy to reduce stiffness and promote overall joint mobility.
54) Roga:
Roga denotes disease in Ayurvedic texts, encompassing a wide range of ailments. Exploring the principles of Roga helps practitioners diagnose and treat conditions, including rheumatoid arthritis, by identifying underlying dysfunctions in the body and restoring equilibrium.
55) Lepa:
Lepa refers to therapeutic pastes applied externally in Ayurveda to treat localized conditions. In managing rheumatoid arthritis, Lepa preparations can provide direct relief to inflamed joints, complementing internal treatments by addressing localized symptoms and enhancing overall therapeutic outcomes.
56) Yoga (YogÄ):
Yoga represents the ancient practices that integrate physical movements, mindfulness, and spiritual principles aimed at achieving holistic health. In rheumatoid arthritis treatment, Yoga aids in improving flexibility, reducing stiffness, and promoting mental well-being, forming an essential adjunct to traditional Ayurvedic therapies.
57) Vida (Viá¸a):
Vida relates to knowledge or wisdom, emphasizing the importance of understanding Ayurveda's principles. With deep insights into health and treatment methodologies, practitioners can effectively address complex diseases like rheumatoid arthritis by holistically integrating various therapeutic strategies.
58) Vayu (VÄyu):
Vayu denotes the air element within the Ayurvedic framework, associated with movement and communication. In patients with rheumatoid arthritis, Vayu imbalance can lead to symptoms like joint pain and stiffness. Balancing Vayu through herbal treatments and therapeutic interventions is vital in managing such conditions.
59) Ushna (Uṣṇa, UṣṇÄ):
Usna refers to warmth or heat, an important quality in Ayurveda connected to various herbs and treatments that stimulate digestion and metabolism. Utilizing Usna properties in managing rheumatoid arthritis helps in alleviating 'Ama', thus addressing both gastrointestinal dysfunction and inflammatory symptoms.
60) Diet:
Diet is a critical aspect of health management in Ayurveda, as food choices directly impact the balance of Doshas and overall well-being. In rheumatoid arthritis, an appropriate diet helps mitigate inflammation and supports optimal digestive function, thereby reducing the risk of 'Ama' formation.
61) Salt (Salty):
Salt (in moderation) plays a significant role in physiological processes and maintains fluid balance in the body. In Ayurvedic practices, the type and amount of salt affect 'Kapha' and 'Vata' dosas, potentially influencing conditions like rheumatoid arthritis, where a proper balance is essential for health.
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