Critical review on Vatavyadhi Samprapti

INTRODUCTION

The Tridosha- Vata, Pitta and Kapha are derivatives of the five basic elements (Panchamahabhoota) which acts as a shock absorber, responsible for both health and disease in the human body.Among the three,Vatadosha, by virtue of its Chalaguna (movement), is considered exceptionally important especially in disease, as it also regulates the other two Dosha.

VATAVYADHI: The group of diseases primarily caused by vitiated Vata are collectively called Vatavyadhi, which constitute the majority of diseases affecting mankind. Hence, a comprehensive understanding of Vatavyadhi becomes crucialin clinical practice.

NIDANA: The etiology of Vatavyadhi is attributed to various dietary factors like excessively dry, cold and scanty food habits; activities like excessive walking,exercise and sleep deprivation at night; psychological factors like overthinking, grief, fear and anger; and other factors like improper posture, chronic diseases and so on1 .

SAMPRAPTIVISHESHA:Etiopathologically, Vatavyadhican be subdividedinto Dhatukshayaja nya&Margavaranajanya² .

DHATHUKSHAYA: The etiological factors lead to depletion of structural and/or functional integrity ofthe channels of the body (Srotoriktata –srototucchata), creating an environmentnonconducive for the sustenance of different dhatu and there by leading to Vata Prakopa³ . The clinical manifestation of this pathological process varies in different individuals depending on the specific etiological factor and location of Srotoriktata.

Here, the term ‘Dhatu’indicates ‘that which does Dehadharana’⁴ . Hence, it implies all the structural entities of the body. ‘Dhatukshaya’ implies depletion of Dhatusara (excellence of Dhatu). i.e; there is qualitative or quantitative depletion of Dhatu. Dhatukshaya leads to Karmakshaya(impairment in normal functions of Dhatu)

Dathukshayais further classified into:

1.SadyaKshaya

2.ChiraKshaya

SadyaKshaya: Among the etiological factors such as excessive external bleeding (Shonitaatipravrutti), excessive fluid loss as in case of excess shodhana or Atisara/chardi disease (Mala atipravrutti) sudden loss of dhatu takes place. This phenomenon of sudden loss ofvolume is called as Sadyaksheena and this phenomenon of dhatukshaya provokes Vatadosha suddenly.

Chirakshaya: The etiological factors such as habituation of intake of non-nutrient/less-nutrient foods such as Ruksha, Sheeta, AlpaAharaetc; and constant excess utilization of the nutrients such as Ratrijagarana, Ativyayama, Ativyavayaetc will result in depletion of dhatu formation /dhatu formed.These phenomenon of depletion ofdhatu are called as Chiraksheena and are known to provoke Vatadosha gradually.

MARGAVARANA: The word ‘Margavarana’ is a combination of the terms‘ Marga’ and ‘Avarana’. ‘Marga’ means ‘channel’ and ‘Avarana’ means ‘to cover’ or ‘to obstruct’. Due to the disruption of flow of Rasadiposhakadhatu distal to the obstruction leads to dathukshaya and thereby causes Vatayadhi5 . Gati is the unique feature of Vatadosha, and whenever this Gati is disturbed due to Margavarana, it leads to Vataprakopa.

MargavaranaSthanavishesha: The terms ‘Srotorodha’ and ‘Margoparodha’ can be seen in CharakaSamhita and SusruthaSamhita respectivelyunder ‘RasapradoshajaVikara.^6,7 This clearly suggests that Margavarana is a pathological process that primarily occurs in RasavahaSrotas. According to Chakrapani, the term Rasa signifies Rakta and all other Dravadhatu. Hence, it can be inferred that Margavarana occurs in the channels carrying RasaraktadiDhatu⁸ .

MargavaranahetuVishesha:  Among Vatavyadhinidana, Ama is the factor which causes Vataprakopa by means of Margavarana⁹ . Ama refers to Sama pitta or SamaKapha. Atisantarpanais responsible for Srotolepa¹⁰ (Atherosclerosis). Maximally vitiated Kaphadosha can produce Dhamanipraticaya (Atherosclerosis)¹¹ . Similarly,maximally vitiated Pitta (Vasculitis) or the Kapha (Atherosclerosis) can bring about Margavarana¹² .

MargavaranaVikaravishesha: Clinical manifestationsof Margavaranajanyavyadhi are most often acute/ sudden in onset13 . Margavaranasamprapti can be observed in the description of various diseases in Samhita, some of which are Hrtshoola, Sthoulya, Vatavyadhi, Vatarakta, Unmada and Mutroukasada.^{14,15,16,17,18,19}

MARMABHIGATAJA AGANTUJA HETUVISHESHA: In addition to the internal mechanisms which cause Dhatukshaya and Margavarana, various exogenous causes of Vatavyadhi have been mentioned in Samhita like Abhighata, Marmaghata, Gaja- AswaSheeghrayanaApatamsana etc²⁰. which implies all kinds of traumaticinjuries.

VYADHIKARSHANA – HETUVISHESHA:  Vatavyadhi may occur as a consequence of another disease (Upadrava)²¹. Vyadhikarshana ultimately results in dhatukshaya and there by Vataprakopa. The clinical manifestation could be sudden or gradual depending upon the nature of illness that resulted in Vatavyadhi.

CONCLUSION

Vatavyadhi constitutes the group of diseases primarily caused by vitiated Vatadosha. Etiopathologically, it is classified into Dhatukshayajanya and Margavaranajanaya.

Dhatukshaya can be either Sadyakshaya or Chirakshaya. Ayurvedic classics have enumerated various food habits, activities and psychological factors which lead to Dhatukshya.

Margavarana occurs in the channels carrying Raktadidravadhatu and is commonly characterized by an acute onset. The specific Nidana identified for MargavaranaareAma, Atisantarpana, Dusta pitta and or DustaKapha.

Vatavyadhi may be a consequence of another disease. In such occasion it belongs to the category of Dhatuksaya but the clinical onset may be gradual or sudden depending on the nature of primary illness.

In addition to these intrinsic mechanisms, exogenous factors like trauma can also result in Vatavyadhi.