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बुधवार, 5 अक्तूबर 2011


Shatavari is considered to be the most helpful herb for women as it helps in balancing the female hormonal system. The main herbal rejuvenative for women, Shatavari nourishes and cleanses the blood and the female reproductive organs thus supporting the body's natural fertility. It nourishes the womb and ovum and supports the female organs for pregnancy. It also promotes body's natural lactation. Shatavari contains phyto-estrogens, the precursors of estrogen and is very useful for women who suffer from low natural estrogen levels as a result of menopause.

Family Name : LILIACEAE

Shatavari is a climbing plant which grows in low forests throughout India. It is mainly the roots of the plant that are used for medicinal purposes. The roots are bitter, sweet, emollient, cooling, nervine, tonic, constipating, opthalimic, anobyne, aphrodisiac.

Shatavari has been mentioned in Ayurvedic texts like the Charak Samhita, Susruta Samhita, and Astanga Samgraha. Pandit Hem Raj Sharma, in the Kashyap Samhita, has clearly stated that shatavari promotes maternal health and noted its particular use as a galactagogue (enhances breast milk secretion in lactating mothers).

Ayurveda has called Shatavari the Queen of herbs and is the foremost herb recommended for female health. Among the three Ayurveda Doshas of ‘Vata’, ‘Pitta’ and ‘Kapha’ , Shatavari helps in balancing 'Pitta Dosha'. Shatavari's rasas are sweet "madhura" and bitter "tikta". It is a natural coolant.
Shatavari nourishes the female reproductive organs and prepares them for conception. It also prevents miscarriages and is useful as a post partum tonic. A clinical study performed in the Dept. of Gynecology & Obstetrics, Ayurveda Hospital, Nepal on The Effect of Shatavari in Threatened Abortion and High Risk Pregnancy, showed 90% of the mothers had successful, healthy pregnancies and deliveries when using shatavari..
Rashmi Chaturvedi


Rheumatological  disorders  described  in Ayurvedic texts, as ‘Ama-vata’, is a popular Ayurvedic term for any inflammatory disorder that causes pain and stiffness, in joints, muscles and connective tissues, including minor aches and twinges as well as disorders like rheumatoid arthritis, osteoarthritis etc.. In many texts, ‘Ama-vata’ has been referred as an  “auto-immune disorder” and “exogenous non-compatibility”  & “endogenous intoxication” as its main aetiological factors.

Due to complete abstinence from food, indigestion, over eating, irregular dietary  habits,  indulgence  in  incompatible articles of food, excessive consumption of cold substances, ill-effects of  ‘Virechana’(purgation), ‘Vamana’ (disgorgation), ‘Snehan’ (oleation), the wasting of tissues, states induced  by  faults or changes in place, climate & season, suppression of natural urges, impaired  ‘Pachak-pitta’ (digestive heat),  excessive  use  of dehydrated, over-hydrated or ‘Guru-Madhur-Amal’ (heavy, sweet & alkaline) food; physical stresses like excessive exercises, over indulgence in sexual pleasures, swimming etc.; mental stresses like rage, grief & hunger; and due to accumulation of ‘Mala’ (body’s waste products), ‘Ama’(unassimilated or undigested food juice) is  produced  &  collected in the gastrointestinal tract. A part  of it may be absorbed in the system causing systemic manifestations of certain ‘Ama’ related diseases. 

The already vitiated ‘Vata’ transports this ‘Ama’ to all parts of the body and carries it to the sites of‘Shleshak-kapha’ which has a common resemblance with ‘Ama’. With the effect of place, climate & season, the ‘Ama’ is motivated by vitiated ‘Vata’ and established at the already vitiated site of ‘Shleshak-kapha’. This ‘Ama’ associated with vitiated ‘doshas’, gets localised in a particular ‘Dhatu’ (tissue) to produce several types of endog­enous diseases like ‘Ama-vata’. In this disease, ‘Ama’ observed from the gastrointestinal tract reaches to ‘Kapha-sthana’ (site of ‘Kapha’) through the respective channels and gets modified and recirculated in the system causing capillaritis and synovitis. Probably some immunological mechanisms are also involved in this process.

General langour or debility of the body, disgust for food, thirst, lethargy, heaviness of the limbs, fever, indigestion and swellings are the common symptoms of ‘Ama-vata’ or rheumatism. The acute phase of‘Ama-vata’ is generally very painful with appearance of swellings in the hands, feet, head, ankles, waist, knees, thighs, and generally , in all the joints. These places, in  which the vitiated ‘Ama’ accumulates, become subject to piercing pains. Loss of appetite, watery secretions from the mouth & nose, loss of energy, loss of taste in the mouth, burning of  the  skin, copious or scanty urine, deep-seated pain and hardness of the abdomen, sleep at day-time but want of it at night, thirst, vomiting, vertigo, swoons, pain in the chest, constipation, dullness  of  the  body,  rumbling noise in the stomach, obstruction of the intestines or a sluggish condition of bowels; are the associated symptoms.

The excited ‘doshas’ according to their characteristics cause particular symptoms like excited ‘Vata’ causes excessive pains; excited ‘Pitta’ causes burning of the skin and redness of the complexion; excited ‘Kapha’causes wet sensation, heaviness of the limbs and continuous itching manifestations; besides the other symptoms. If the disease be due to the vitiation of two of the ‘doshas’, or all the three of them, the specific symptoms of each of the ‘dosha’ appear collectively.

There are many remedies prescribed in Ayurveda, some of which are:

1. Yograj Guggulu‘Guggulu’ processed with 27 extremely useful herbs, it nourishes the ‘Dhatus’, corrects vitiated ‘Vata’, destroys ‘Ama’, enkindles the ‘Agni’ (Ayur.Sars. pp-521-22); cures acute rheumatism, pain in the bones & joints, paraple­gia, acts as a tonic and enhances strength & vigour (Sen Gupta N.N.,1984); is well tolerated and shows marked im­provement in cases of morning stiffness, hotness, feverish­ness & tenderness of joints (Antarkar D.S., 1993).

2. Trayodashang Guggulu‘Guggulu’ processed with 12 extremely useful herbs, it is esteemed in all kinds of ‘Vata-vyadhi’ (neurological disorders) by correcting the  vitiated ‘Vata’ and used in colic-neuritis, gouty arthritis, paraplegia, hemiplagia, sciatica & other neuralgias (Ayur.Sars., p-516); cures the pains in the arms, back, knees, calves, waist, bones & the bone-joints and also relieves dislocation of the cheek bone and other ailments caused by the vitiated ‘Vata’ (Sen Gupta N.N. 1984).

3. Vyosadi Guggulu‘Guggulu’ processed with 9 extremely useful herbs, it corrects the vitiated ‘Kapha & Vata’ and destroys ‘Ama’; regarded to cure ‘Medoroga’ (Obesity), & ‘Ama-vata’ (Rheumatological disorders) (A.F.I., 5:9, p-59).

4. Haritkyadi Guggulu‘Guggulu’ processed with 3 extremely useful herbs, it nourishes the ‘Dhatus’, corrects vitiated ‘Vata’, stimulates ‘Pachak-pitta’, destroys ‘Ama’, enkindles the ‘Agni’, to relieve from ‘Vata-vyadhi’, low back pain, lumbago, constipation,  & ‘Ama-vata’ (Ayur. Sars. p-524).

5. Lakshadi Guggulu‘Guggulu’ processed with 5 extremely useful herbs & minerals, it nourishes the‘Asthis’ (bones) & dhatus’ and is  useful in  osteoarthritis,  lumbago and rheumatism. It also enhances healing  of fractured bones and decreases inflammation from the fractured part. (Ayur. Sars. p-523; Bhar.Ay.Yog Sang. Part-I, 1984).

6. Maharasnadi Kwath: Maharasnadi Kwath is a decoction (obtained from of 50 parts of Vanda roxburghii, and one part each of Ricinus communis, Adhatoda vasica, Pinus deodara, Curcuma zerumbet, Hedysarum alhagi, Cyperus rotundus, Zingiber officinalis, Sida cordifolia, Aconitum heterophyllum, Terminalia chebula, Tribulus lanuginosus, Cassia  fistula,  Foeniculum  vulgare,  Coriandrum  sativum, Boerhaavia diffusa, Physalis flexuosa, Tinospora cordifolia, Piper longum, Lettsomia nervosa, Asparagus racemosus, Acorus calamus, Barleria cristata, Piper chaba, Solanum indicum and  Solanum xanthocarpum). To make its Kwath (decoction):
  • all these herbs are crushed & added to water taken 8 times w/v,
  • boiled to evaporate to obtain 1/8 decoction v/v under controlled heat at  optimum  temperatures;
  • strained & mixed  with  finely  pulverised  dried  extract  of Sonth (Zingiber officinalis).
Maharasnadi Kwath  is esteemed in all kinds of ‘Vata-vyadhi’ by correcting the  vitiated ‘Vata’ and destroying ‘Ama’. It is useful in generalised pains, hemiplagia, lumbago, sciatica, elephantiasis (A.F.I. 4:28, p-51); highly esteemed to alleviate all symptoms and  problems associated with rheumatism, lock-jaw, paralysis, facial paralysis and the diseases produced by vitiated wind (Sen Gupta N.N. 1984).

In Ayurveda this plant is used to cure inflammations, rheumatic pains (Dr.Kaushik,P., 1983),and in Greek system of medicines this orchid plant is given to lessen inflammation & heal fractures (Kirtikar & Basu 1975).

Maharasnadi kwath  a good long term Ayurvedic agent helping the patients to manage their chronic illness in osteoarthritis (Dr Pai Dhungat, M.D., 1993). This kwatha is fairly effective in the treatment of ‘Ama-vata’ (Kishore & Basu 1988).

Ayurvedacharya P NaGrath


Ayurveda- science of life: whether our scholars said Ayurveda an eternal truth?

Continous change is rule of nature. Even Ayuveda has changed a lot during last 7500 years. Ayurveda gained many of its knowledge and ideas from Atharva Veda, our scholars with thorough research added many diseases, its etiology, pathophysiology, symptoms, prognosis and treatment in detail, added use and properties of many herbs, but they did not copy everything from Atharva Veda. Since last 1000 year Rasa shastra was added to Ayurveda, considering the history of Ayuveda this addition is very recent one. In Laghu samhithas they added many new diseases like Amavatha, Phiranga roga, Soma roga etc.
We are in different era, many things have been changed since last 200 years and it seems that this is the right time for Ayurveda also to adopt new knowledges in our science for the benefit of patents.
Yes basic principles and many explanations described in different Ayurvedic text is under debate. I met many great Ayurvedic scholars, many great Ayurveda teachers of different colleges, but during discussion I have noticed a common agenda in most of them, that all the principles explained in Ayurveda, basic principles like Vatha, Pitta, Kapha are eternal truth and we have no right to change these principles.
But I don’t know why many scholars think in that way. We study Padartha vijnana for one and half year during our first professional year, unfortunately a most boring subject for most of us during college days. In that, we study regarding Pramanas, means process of obtaining knowledge, or knowing truth. Such knowledge of truth when undergoes Thadvidya sambhasha etc through different scholars and when this is accepted as Pramana by such group, is called as SHASTRA or SCIENCE or KNOWLEDGE OF TRUTH.

1. Pratyaksha- knowledge gained through sense organs, or knowledge which is felt through sense organs.
2. Anumana- Knowledge gained by inference
3. Upamana- Knowledge gained by comparison
4. Vyuthpatti (arthapatti) (?Upameya)- Knowledge gained through one’s experience, his skill etc
5. Apthopadesha- Textual references, which is still considered as Shastra, here we can not depend on outdated shastras or out dated knowledge(which can be proved as out dated PRAMANAS- for example- explanation of MUTHROTHPATTI in our texts)
Even today, so called modern science, Allopathy system etc also follows the same principle. All the methodology followed in any modern science come under any one among the above five.
So whatever may be the knowledge, if that can be proved as per the standard methodology may be modern methodology or Ayurveda methodology that should be accepted and adopted wherever necessary. Bothe Ayurveda and modern science follows the same methodology, but the only difference is that present methodology is explained depending upon new tools, inventions etc., for eg. today we have electron microscope to see the micro organisms, body cells, even we can see minutest nano particles using advanced microscopes. So definitely there will be lot of difference in prathyksha pramana of olden days and present days. Jvara disease explained in Ayurveda is a very good example for that, most of the jvara explained as Asadhya is Sadhya today, that is because of new inventions.
Our scientists explained body as SHAREERA and DEHA, means which continuously gets destroyed and grows. Continuation of the same knowledge is seen in modern science as CATABOLISM and ANABOLISM with much elaborated explanation. But we can not say that whatever explained in present modern text is eternal truth, when anybody if succeeds in disproving the present knowledge using the same methodology then that knowledge is considered as outdated.
This is a natural process for any shastra and this is essential part of evolution.
About three years back I read one interesting article in a medical journal regarding recurrent renal stones, their new observation regarding recurrent renal stone is that 80% of recurrent renal stone is because of adenoma of parathyroid gland, they confirmed this with the help of color tomograhpy. Since then I have stopped recommending low calcium diet for any of recurrent renal stone patients because that may lead to osteoporosis if the cause is adenoma of parathyroid gland where calcium rich diet is necessary. We have added Kanchanara and other anti tumor drugs to our combination and treated many patients with that drug (Calculus 16 tablet). A patient with recurrent renal stone for last 20 years who took medicines from all system of medicines without any improvement, has no recurrent stone since last one and half years with the treatment started as per new concept. He is still under treatment due to fear of recurrence. Reason to mention this particular case is because the same person took medicine for one year from me 6 years back, but still had recurrent stone, now after adding potent anti tumor drugs and long term treatment with the same he has compete remission.
I came across with one Ayurveda scholar, initially he had the same view of eternal truth, but after a debate he agreed that Ayurveda has many out dated theories and principles but finally he had a view that people strongly believe in such theories, so if we change those theories then no body will accept Ayurveda. But my view is that Ayurveda is an applied science, where people and patients need results not just theories. So we should follow very strong theories and principles where each and every doctor can apply the same with ease while he treats the patient and most of Ayurveda doctor should succeed in curing many ailments, then only Ayureda will gain importance and people will accept Ayurveda with ease globally.
I have written all the above from one angle only, on the other hand even today we have lot of applicable theories, medicines and treatment plans which is proved to be better than any other system. But combining the new knowledge with our ancient time tested therapies benefits the patient.
For eg in Ayurveda there are five types of shirashula Vathaja, Pittaja, Kaphaja, Sannipathaja and Krimija and other diseases like Ardhavabhedaka, Sooryavartha and Shankhaka are other diseases where headache is the leading symptom. If we consider the same from modern point of veiw we have to think of Migraine headache, Tension headache, Sinusitis, Trigeminal and other neuralgias, Cervical radiculopathy, Meningitis, Brain tumours etc. Pittaja shirashoola can be well corelated with Sinusitis, Ardhavabhedaka with sinusitis or Migraine headache, Vathaja shirashoola with Tension headache or Neuralgias, Sooryavartha with Migraine headache and so on. By corelating in this way this helps us to select specific combinations from our text for newly understood diseases.
Please comment your view on this. I welcome both positive and negative comments. Many times negative comments help us to modify and strengthen our views.
Jayagovinda Ukkinadka

Intervertebral disc prolapse (IVDP)

The most visited cases to Ayurvedic doctors and if we select the appropriate cases for treatment, success rate will be 100%!!!. Earlier this condition was identified as Sciatica syndrome (before MRI era, similar explanation in Ayurveda- GRIDHRASI), and now diagnosed under different headings depending up on the exact cause. Disc prolapse in turn may compress the nerve roots, spinal cord, or may reduce the spinal canal circumference resulting in canal stenosis. Symptoms will be different in all these cases. Another fact regarding IVDP is that almost 95% of cases resolve spontaneously by taking moderate rest for 3 to 6 weeks.

SELECTION OF CASE: After confirming the diagnosis of IVDP, we should be very careful in selecting the cases for Ayurveda treatment. Always try to avoid the below said cases for Ayurveda treatment.

1. IVDP with radiating pain with lower motor neurone paralysis in the affected limb (may be of toe-flexar and extensor movements, ankle etc) which constantly persists for more than three weeks without any improvement with Ayurveda treatment.
2. IVDP with canal stenosis which does not subside even after 3 week’s treatment. (The main clinical feature of canal stenosis is bilateral intermittent claudication along with other symptoms).
3. IVDP with upper motor neurone symptoms like urine retention, bowel incontinence, positive ankle clonus, exaggerated deep tendon reflexes, extensor plantar reflex (positive Babinski’s sign) etc. are surgical emergency. Here discectomy and other surgical treatment is treatment of choice. But we can consider Ayureda treatment in chronic cases where the damage has reached the irreversible phase.
4. If we can not see any improvement, or if the condition aggravates after 6-10 weeks of treatment, then also it is better to refer the patient for further management.

If we consider Differential diagnosis of IVDP
Lumbo sacral disc injuries
Lumbo sacral discogenic pain syndrome
Lumbo sacral facet syndrome
Lumbo sacral acute bony injuries
Lumbo sacral spine sprain/strain injuries
Lumbo sacral spondylolysthesis
Lumbar spondylosis
Pott’s spine
Lumbar disc degeneration-usually seen in athletes
And also Sacro eleitis, peripheral vascular obstruction at superficial femoral artery level if bilateral sometimes mimic canal stenosis, etc.

Here aim of the treatment is
1. Healing of damaged disc (Mamsa Bhagna)
2. Reduce inflammation (vathahara)
3. Reduce pain (vedanahara)
4. Prevent recurrence

The initial approach is to heal the disc damage, inflammation and in turn radiating pain.
Here disc herniation should be considered as AVARAKA, Nerve root is AVRITHA and hence disc herniation should be treated first and the vathaja symptoms subsides.
In acute cases we prefer Inpatient treatment for 3 weeks, where success rate is excellent. Other moderate and mild cases can be managed in OP levels.

Panchakarma and other treatments:
1. Alepa- Whole body application with herbs having anti inflammatory property, vedanahara property. We also use some herbs which are specially used in Mamsa Bhagna in Kerala Ayurveda Practice. (All lipid soluble molecules can be absorbed through skin in very low rate. We observed many herbs having pain killer and anti inflammatory property when applied all over the body intermittently- It is just like sub coetaneous injection). But the only problem is development of skin allergy with potent drugs like Gunja phala. As per our observation Gunja phala is one of the best drug, even though toxic, we have not observed any toxic symptoms except skin allergy which is seen in almost 40% of patients after 4-10 days of external application. Skin allergy was totally reversible when we removed gunja phala from our lepa formula.
2. Pathra pindasweda or Shastikashali pindasweda Along with very mild massage to low back. (Avoid vigorous massage to low back in IVDP). Katibasti and other snigdha and ruksha swedana can also be adopted.
3. Basti Karma- usually for 5-7 days.
4. Total bed rest for 1st three weeks
5. Skin traction in selected cases if found necessary
6. Yogasanas for IVDP after 2nd or 3rd week depending upon the improvement. We avoid any type of Yogasanas in Acute phase. Yogasana is mainly to strengthen the paraspinal muscles and to improve blood supply to disc(stretching exercises).
7. Internal medicines. It is better to take internal medicines till patent recovers to expected level. Usually we suggest 6 months of treatment in majority of cases. Again the internal medicines should contain antioxidant rich combination for better healing, vedanahara drugs and anti inflammatory drugs.

In our hospital we have treated hundreds of IVDP patients in IP and thousands in OP level, and result is excellent.

Jayagovinda Ukkinadka

Irritable bowel syndrome

Irritable bowel syndrome is a non inflammatory condition of unknown etiology. It is now believed that it is a functional disease related with hyper or hypo movement of intestine which results in diarrhea or constipation. Some believe that this disease is an outcome of communication error between brain and intestine.
            Main clinical features are mucous mixed stools, abdominal pain, abdominal bloating, symptoms aggravated by taking wheat and products, dairy products, leafy vegetables, pulses and spicy food items, no symptom after getting in to sleep or never awakened by IBS symptoms, and also fibromyalgia, depression are common co morbidity.
            There are many differential diagnosis for IBS, important are Ulcerative colitis, Crohn’s disease, other Inflammatory bowel disease, giardiasis, amoebiasis, celiac sprue, colon malignancies, chronic mesenteric ischemia etc are some of main DD’s.
            There are mainly four sub varieties of IBS- they are 1) IBS-D, with diarrhea,    2) IBS-C, with constipation, 3) IBS-M, mixed, 4) IBS-A alternating diarrhea and constipation.
            Another condition which is called as post infectious IBS, where there will be micro inflammation in large and small intestines,an atypical variety of IBS, usually with severe symptoms which usually initiated after gastroenteritis.In our place we come across with such many cases and many IBS condition becomes worst after they suffer from gastroenteritis.
            Being a chronic relapsing condition most of the patient suffer from severe form of depression many times with suicidal tendencies.

Treatment adopted in Ukkinadkas Ayurveda:

The success rate widely varies from patient to patient. Most of the patient being a chronic condition we get after 10-15 years after the onset of symptoms.
-         first part of the treatment is DIET.
We advise to avoid wheat, milk products, most of the vegetables and pulses, spicy food, fried food etc.
We allow only taking rice, some specific vegetables like peel of pomegranate, ash guard, bottle guard, tender leaves of cashew nut plant, kakamachi leaves, dhathaki kusuma bheda leaves(in our place called as enjiru in Tulu), and other food which the patient is confident of harmless as per his experience. This strict diet is for 45 days, and then onwards he can take wide range of food.

-         Kwatha prepared out of Kutaja, Chithramula, Pata, Amalaki, Punarnava, Shunti, etc along with Ananda Bhairavi, Agnitundi or Lahsunadi vati etc
-         We have not tried with any Panchakarma till now because most of the patient refused to undergo Panchakarma treatment and many were poor patients.

We have treated many cases of IBS with above line of treatment, many patients get result to some extent and then once again relapses, in some patients we get no result, but in few patients we get very good result. Most of the patients who come to us are chronic, after few years most of IBS patients become depressed and while on treatment they become more depressed with varied symptoms and becomes difficult to make them to stay on treatment.
I have one special case, a female of 30 years of age now 43, took treatment for 3 years and got relieved of all the symptoms. After some time she took medicine for some other illness and that doctor gave her Chyavana prasha leha, immediately after starting the Leha symptoms reccured and once again she came to my clinic, I gave her the same medicine and got relived of the symptom and this time she continued the same for 5 years. Afterwards till now for any kind of illness she comes to us for treatment due to the fear of relapse. She is the only one IBS case who is under my treatment from day one of my practice. My father was practicing the strict diet method in all Grahanis and many other GIT diseases wherever AMA was there. Even today I follow the same diet plan for IBS patients with satisfactory result. Now a day it becomes very difficult to make the patient to stay on that diet for 45 days. Many patients arise the question of nutritional deficiency and afraid to follow the strict diet. But as per our experience afterwards absorption will be better and condition improves a lot.
But with all these we are not satisfied with the result because most of the patients they fail to continue the treatment. Many times we don’t get satisfactory result etc etc.
Jayagovinda Ukkinadka

Diabetes type 2 can be cured

ype 2 diabetes is characterized by peripheral insulin resistance with an insulin-secretory defect that varies in severity. For type 2 diabetes mellitus to develop, both defects must exist: all overweight individuals have insulin resistance, but only those with an inability to increase beta-cell production of insulin, proportionate to insulin resistance develop diabetes type 2.

For eg if the required insulin is 100% and if there is no insulin resistance, no need of additional insulin secretion by pancreas, on the other hand if there is 30% insulin resistance then beta cells has to secrete additional 30%, so total insulin will be 70% normal insulin, 30% resistance insulin and other 30% additional insulin, so totally 130%. Usually beta cells can produce up to 60-80% additional insulin, when the insulin resistance crosses this level diabetes type 2 results in.

This process is influenced by genetic factor, life style, occupational hazards, stress, and many other multi factors.

How the modern medicine works in Diabetes type 2:
Most of the modern medicines by enzymatic actions influence the excess synthesis of insulin. The main drawback is normally insulin is released once in 5 minutes, immediately after taking food etc. But when hypoglycemic drugs were taken this will be released at once, that is why even today controlling diabetes just by taking hypoglycemic drug is always not so easy.

What should be the treatment?
Improving the insulin resistance is the treatment.

How this can be achieved?
By starvation and exercise.

Whether this will harm?
If this starvation is done systematically, this can be achieved without harming our body.

What exactly starvation means?
Here starvation means reducing carbohydrate to less than 40% in our diet. Only complex carbohydrates should be taken those with low glycemic index and high fibre content. Proprotionat mono unsaturated fat and protein should be added to the diet.
Here fat should be in higher side to protect brain. Those who are lean must take excess of fat to protect brain. Other than glucose, ketone body is the only source of energy for brain. When scarcity for carbohydrate occurs, at first insulin stimulates fat breakdown, which releases fatty acids, triglycerides and ketone bodies. Hence in obese patients no need to take excess fat.
Diet must include atleast 350 to 550 ml of milk in vegetarians and fish or meat in non vegetarians. Red meat is better but taking fish with little red meat is better.
Abundant green vegetables and low calorie vegetables should be taken.
Direct glucose, sucrose etc should be reduced to zero. Daily exercise brisk walking for more than 20 minutes.
The above diet should be continued for 1.5 years, positive result can be seen within three weeks, reversal can be seen after 6th or 8th month. But we don’t know exactly in whom reversal is possible and in whom it is not possible.

Is there any patients who already did this diet?
Yes we have totally four patients who got cured of the condition.
One is myself. I found diabetic at the age of 32. I became panic and started aggressive diet. My RBS was 240. Immediately after starting diet it came to 160-180, fasting ot 128-135 mg/dl. I continued the diet and I was observing my FBS almost on alternate days and PPBS once in 15 days. Gradually my FBS started falling down like 124 for 15-30 days then to 110-115 level, then to 100-110 level and after 8th month FBS was always between 70 and 80mg/dl. I continued the same diet for 1.5 years. During this period my weight fell down to 58 kg form 72kg. Then I stopped the diet and started taking all sweets and normal foods and in the same diet since then. Now my weight is 66-66.5 kg. Now FBS usually between 90-102, and PPBS always between 110-128mg/dl. Along with diet I also took Diabenil tablet our own preparation with more than 18 herbs and Jasada bhasma.

We conducted free diabetes cure camp about 1.5 years back. 70 patients were attended and only 16 patients could start the diet and only 3 patients could continue the diet beyond 3 weeks. All the three got cured, aged 51, 53 and 65 yr old - female, female and male patient.

But this can not be applied for Type 1 diabetes where only external insulin is the hope for the patient.
Jayagovinda Ukkinadka

KAMALA/ Jaundice can not be a disease but a symptom

In Ayurvreda Kamala is considered as a disease, where there will be yellowish discoloration of skin, urine and mucosa. In Ayurveda Pandu and Kamala is explained in a same chapter. It is explained as, Pandu in due course if not treated will result in Kamala. This is excellent explanation available in Ayurveda. In Ayurveda mainly two types of Jaundice is explained, but in the modern science three types of Jaundice is explained.

In Ayurveda Kamala is a disease but as science advanced now Kamala is considered as just a symptom, where this condition is seen in different diseases like Malaria, Dengue fever, Leptosopirosis, Haemolytic anaemia, Amoebic liver abscess, Viral and bacterial hepatitis, Hydatid cyst, Cirrhosis of the liver, Hepatoma, Metastasis in Liver, Malignancy of head of pancreas obstructing the common bile duct, gall stone impacted in common bile duct and so on.


It is very important to understand the mode of production and function of bilirubin.

Haemoglobin when breaks down will form Haem+globin. Where haem is iron, which is partially reutilised for the production of haemoglobin, and rest is excreted. Globin is a protein, after breakdown one of the end products is biliverdin and after four levels of enzymatic action will be converted in to unconjugated bilirubin. This unconjugated bilirubin is not soluble in water and commonly known as indirect bilirubin.

The unconjugated bilirubin, in blood stream when enters liver will be converted in to conjugated bilirubin commonly known as direct bilirubin, which is water soluble and some portion of Bilirubin is destroyed in the liver. This conjugated bilirubin will be secreted into intestine through common bile duct and is called as stercobilinogen. Here this will color the stool and 95% of the same will be reabsorbed to blood stream. This in turn in circulation will enter the kidney and is called as urobilinogen and here also this will colour the urine and other 95% will be reabsorbed to blood stream and later most of it will be destroyed in the liver.

So the main function of Bilirubin is colouring the stool and urine. But this is a very good marker to identify Liver diseases, to asses over destruction of RBCs and any obstruction in common bile duct. Further to understand this it is very important to understand three types of Jaundice.

Three types of Jaundice:

Prehepatic Jaundice- Here due to over destruction of RBCs there will be excess production of unconjugated biiirubin and liver fails to convert this excess uncojugated to conjugated one, so there will be high indirect bilirubin in the blood stream. But direct bilirubin will be normal or slightly elevated. In this variety usually color of urine will be normal because unconjugated bilirubin is not water soluble.

Hepatic Jaundice- Here liver fails to completely conjugate the unconjugated bilirubin and fails to destroy the conjuagated bilirubin due to liver disorder, so both direct and indirect bilirubin will be elevated
Post hepatic jaundice- Here unconjuagated bilirubin will be normal but destruction of conjugated bilirubin will be delayed because of obstruction in common bile duct, so only direct bilirubin will be elevated. Colour of stool will be whitish, thick and sticky.

By understanding the above differences it is very easy to understand the site of pathology. After identifying the type of jaundice we have to search for the root cause of jaundice.

In diseases like Malaria, Dengue fever, the cause for jaundice is excess destruction of RBCs, but in Leptospirosis cause is hepatitis, so it is very important to identify the type of jaundice along with other criteria in patients with suspected dengue or leptospirosis. In amoebic liver abscess there will be high fever along with tenderness over liver area, fever will be usually along with rigors. In all viral hepatitis the typical onset will be with fever and vomiting followed by jaundice, fever and vomiting usually persists for 3-5 days, afterwards which subsides spontaneously and in Hepatitis A jaundice will subiside within 15-20 days, in Hep B, 50% will be subsided and cured in the same way and other 48% will continue as carriers, and 2% will die due to hepatic failure, in Hep C immediate fatal rate is low but carrier possibility is same as in Hep B, in Hep D it is same as A, and in Hep E Jaundice will usually last for 3 months and then subsides.

In our area we come across with many jaundice patients because almost all people both educated and illiterate people of this place believe that Ayurveda is the only remedy for Jaundice and I had to refer many cases of Malaria, some of dengue, one case of Leptospirosis and amoebic liver abscess to higher instituition and many other condition we could manage with Ayurveda medicines.

But in Viral hepatitis really we treat the self limiting condition with Ayurveda medicines and people believe that Jaundice is cured because of our medicine, even many Ayurvedists claim in that way. But any how even in hepatitis A 0.07% of patients die due to hepatic failure, so complete bed rest low fat, low protein and carbohydrate rich diet should be advised to the patient for fast recovery and even we many times feel that patient recovers fast when treated with Ayurveda medicines. I have treated three cases of Hepatitis E during last 12.5 years, in all the three jaundice recovered after 1.5 to 3 months period, which is really the normal course of the illness. I have treated many cases of chronic carriers of Hepatitis B, but I have not seen even single patient with negative HBsAg after Ayurveda treatment. (here we can consider only chronic carriers, not the recent below one year, because in many carriers HBsAg becomes negative after one year spontaneously)

But we have seen very good result in many cases of Cirhosis of the liver. I can give two very good eg of Cirhosis, one patient with cirrhosis of liver with portal hypertension took treatment for one year and had very good symptomatic recovery and the condition recovered after 7 years and that time his condition became worse and died after 3 months. In this case, doctors in KMC Mangalore had given 6 months deadline for his survival, but with Ayurvedic medicines he recovered miraculously and survived for the next seven years without any problem. But he was not in the state of hepatic failure during the first visit. I have also advised him to take vaso dilators for long time to prevent easophageal varices, and advised for endscopy twice during the seven years, but he has had not developed oesophageal varices even after seven years, but he died due to hepatic failure. Another important thing is he was not alcoholic nor he was obese, his lipid profile tests were normal, so the cause could be genetic.

In another case, he was alcoholic very young of about 34years of age, when he visited my clinic he was in stage of hepatic failure and was using antibiotics continuously to prevent intestinal infection and his haemoglobin level used to fall down below six once in twenty days, was regularly going for blood transfusion. After 5.5 months treatment he required no blood transfusion, he started doing his work of catering, recovered well and he could manage his work for next 6 months, but in between he started taking alcohol and once again the condition aggravated came back for treatment but this time condition became worst and died in modern hospital.

As per our record these two are the best observed result in cirrhosis of the liver. We have treated number of cases of cirrhosis, but most of the cases in end stage, but in above two cases we got very good result in end stage. In the second case he could stop blood transfusion after 5.5 months of treatment; even I could not believe that.

So we have very good scope in treating cirrhosis like organ failure illness and can improve the condition. But mere two or 3 case is not sufficient to prove the efficacy of drug, we need lot of research activities to prove the action of drug in liver diseases. There are more than 50 herbs identified as liver tonics, and we have to show the real efficacy of these herbs through evidence based analysis, which will help not only the patients but also the Ayurvedic doctors.

I remember a word of one scholar he was of the opinion that, if we conduct such research activities and prove the efficacy of such herbs then modern physicians can easily prescribe Ayurveda medicines in many diseases, but what I say is, if this really happens then we have to consider this as our victory, because our treatment should be acceptable by all and should be result oriented. Otherwise prescribing Ayurveda medicines will be difficult, not only to allopathic physicians but also for Ayurvedic doctors.

Jayagovinda Ukkinadka

A tough disease to treat: FIBROMYALGIA

"Fibromyalgia is a name in search of a meaning."
-Anonymous Canadian rheumatologist

Fibromyalgia syndrome (FMS) is a specific, chronic non-degenerative, non-progressive, noninflammatory, truly systemic pain condition. Diseases have known causes and well-understood mechanisms for producing symptoms. FMS is a syndrome, which means it is a specific set of signs and symptoms that occur together. This in no way means that fibromyalgia is any less serious or potentially disabling than a disease. Rheumatoid arthritis, lupus, and other serious afflictions are also classified as syndromes.

Sleep disorders. Inflammatory cell abnormalities. A small fiber neuropathy. There is evidence suggesting that these conditions, along with many others, are associated with what is often diagnosed as fibromyalgia. In particular, sleep apnea and chronic hypoxia to the brain's pain centers were frequently proposed by readers as potential inciters of fibromyalgia symptoms, and a number of commenters recommended ordering a sleep study in patients in whom the condition is suspected.

A family practice doctor of osteopathy wrote: "After finishing residency I was bombarded with patients who had tender points and the diagnosis of fibromyalgia. I started to screen [them] for sleep apnea and was flabbergasted at the number of patients who had hypoxic/apneic episodes at night. Now, after several years of screening patients, about 75% of my patients diagnosed with fibromyalgia have nocturnal oxygen or a CPAP [continuous positive airway pressure] machine."
And then there was inflammation. As one reader pointed out, a 2010 article from Clinical Rheumatology suggests that mast cells (MCs) may play a key role in the condition. The study reported significantly increased MC counts in the papillary dermis of patients with fibromyalgia. The authors wrote: "MCs are present in skin and mucosal surfaces throughout the human body, and are easily stimulated by a number of physical, psychological, and chemical triggers to degranulate, releasing several proinflammatory products which are able to generate nervous peripheral stimuli causing CNS [central nervous system] hypersensitivity, local, and systemic symptoms."
A recent abstract presented at the International Association for the Study of Pain's 2010 conference in Montreal, Quebec, Canada, reported that patients with fibromyalgia have more symptoms of depression and alterations in peripheral and central nervous pain pathways compared with healthy individuals. A neurologist commented, "[Fibromyalgia] symptoms are the same as in small fiber neuropathy, and amenable to the same treatments. [This] study reports that patients with fibromyalgia have decreased epidermal nerve fiber density, as in small fiber neuropathy." Another neurologist suggested "testing patients for small fiber neuropathy before telling them anything."
Fibromyalgia is considered as pain due to over stimulation, over sensitivity to pain.

(copied from emedicine artilcles (, small portion of article)

Even though there is no definite criteria for diagnosis, eleven tender points out of 18 points, sleepless ness, extreme bodyache, anxiety, triggering of pain by infection, stress etc, spontaneous remission and exacerbation makes the diagnosis.

In Ukkinadkas Ayurveda:

We have treated number of fibromyalgia cases some with good results, some with temporary results, some with satisfactory results and some with no results. We have treated many patients in OP and in IP levels.
Shastikashali pindasweda gives imminent result but later usually pain reccurs after heavy work.
We have also tried with Pindasweda and Dhara, and shodhana treatments in many, the immediate response from patient was excellent in most of the patients, some patients had good recovery, there was no recurrence of pain and they could manage their routine without much pain, but some patients with all these medicines and follow up medicines, their pain aggravated when they started their routine works.

But recently surprisingly we got very good result with our new product developed for skin allergies, tablet Ukkinadkas Alaril. Accidentally we came to know that this works in fibromyalgia, we have treated more than six cases of FMS with this tablet with satisfactory result. None of the patients had undergone any of pre panchakarma or panchakarma procedures. But to conclude this result we need another 50 to 60 patients of Fibromyalgia. We have administered tablet Ukkinadkas Alaril aong with other vathahara combinations(usually we prescribe Maharasnadi, Rasnadi, Sahacharadi, Prasaranyadi, Erandadi gana kwatha, Vamshatwagadi kwatha, …….. depending up on the severity and symptoms, many times we also add herbal antipsychotic and tranquilisers with good result, guggulu preparations, sometimes rasa preparations, in case if we note mild inflammatory signs which is not a common sign in FMS)
Also it is very difficult to find a similar disease mentioned in Ayurveda. But we can well correlate with the Samanya lakshana of AMAVATHA for Fibromyalgia. I request all the doctors to share your experience and your view regarding Fibromyalgia.

Jayagovinda Ukkinadka

Rheumatoid Arthritis/ Rakthavatha of Charaka

Approximately 12 to 15 million people in India are suffering from RA
70 to 90 million suffering world wide
Female to male ratio is 4:1
Age of onset is usually 25 to 50 years, peak during 4th and 5th decade
Juvenile arthritis, named when occurs below the age of 16, 3 phases- polyarticular, pauciarticular, and systemic.

Rheumatoid arthritis (RA) is a chronic inflammatory disease of unknown etiology involving primarily the synovial membrane and articular structures of multiple joint.
Associated factors may include
  1. Genetic predisposition
  2. Female sex
  3. Psychological stress
  4. Immune response
  5. Hormone interaction
  6. Viral infection

In short
Patho physiology of RA is not well understood
Factors associated with RA include possibility of
  1. Infectious triggers
  2. Genetic predisposition
  3. Autoimmune response
The disease course may be short and limited or progressive and severe

Pain & morning stiffness in the smaller joints of the hands & feet.
Joints of wrist, elbows, shoulders, knees & ankles are also affected.
Symmetrical involvement of the joints.        
Patient feels tired & unwell.
Pain & stiffness are worse in morning & patient gets little relief with gentle activity.
Disturbed sleep.
Joints will be warm & tender with swelling.
Deformities & rheumatic nodules develop as the disease progresses.
Other extra articular symptoms may develop.

Morning stiffness for more than 1 hour.
Arthritis of 3 or more joints with tenderness & symmetric involvement.
Arthritis of hand joints & wrists
Above symptoms for 6 weeks or more.
Subcutaneous nodules & deformities.
Positive serum RA factor.
Radiographic evidence of RA.
Presence of four or more above criterias – confirms the diagnosis of RA.


Systemic Lupus Erythematosus
Rheumatic fever
Gout and Pseudogout
Inflammatory Bowel Disease
Carpal Tunnel Syndrome
Sjogren Syndrome
Osteoarthritis (erosive)
Polyarteritis nodosa
Viral arthritis (eg, rubella, hepatitis B, parvovirus)
Paraneoplastic syndromes
Multicentric reticulohistiocytosis
Cauda Equina Syndrome
Polymyalgia Rheumatica

These are the main there are still more

Indomethacin etc
Disadvantage: Risk of gastritis, internal bleeding, nephrotic syndrome, glmerulo nephritis by short term or long term use.
Cox-2 inhibitors
Celecoxib: action similer to NSAID’s but with less adverse affects.
Disadvantage: Dermatitis, stomatitis, protenuria, cytopenia. Exacerbation after due course.
Comparitively safe but action seen is not the same in all, very slow, majority of the patients not benefited.
Methotrexate: A well known, said to be the most effective immune modifying agent , widely used in present practice.
Disadvantage: MTX has toxic effects on hematologic, renal, GI, pulmonary, and neurologic systems. So should be used with caution. May become fatal if co administered with NSAID’s
Sulfasalazine: Another immune modifying agent usually co administered with methotrexate.
Disadvantage: weak action, but toxic.
TNF alfa inhibitors:
Eg: Infliximab, Etanercept
T-cell inhibitor
Disadvantage: Although these medicines improves the clinical symptoms, and stops the progression, the major disadvantage is serious infection and malignancies.
Disadvantage: Reduces the symptoms, but not the damage and progression.Risk of serious side affects makes it very difficult to administer for long term and also this will not check the progression.

All the medicines mentioned do not give definite improvement. Exacerbation of the symptoms during the course of treatment is very common, and the same medicine may not work further.
Adverse affects of DMRD drugs like Methotrexate which is hepatotoxic, neurotoxic and nephrotoxic many times forced to stop medication du to adverse reactioins.
Immuno modulators like TNF alfa inhibitors, T cell inhibitors etc almost always ends with severe infection, and sometimes malignancy.


n      Role of genetic factors in the regulation of RF isotype level production
n      HLA-DR3 & DR4 antigen was associated with low IgA RF
n      HLA-DR1 & DR2 antigen was associated with high IgA RF, IgM RF, AND IgE RF
n      IgM RF was positive in almost all sero positive patients and most of seronegative.
n      IgA RF was negative in sero negative patients but was mostly positive in other groups .
n      Patients with negative IgM and IgA RF had incactive or recent RA.
n      Anti nucleic antibodies with the highest values were significantly associated with high levels of IgM and IgA RF.
n      Almost all patents with extra articular features had higher level positive IgA, IgM, IgE RF when compared with RA without extra articular symptoms
n      Most of the researchers believe that IgA RF is associated with RA with poor prognosis and systemic symptoms.
n      IgE RF is associated with poor prognosis but without extra articular involvement.

n      IgG RF
n      IgM RF
n      IgA RF
n      IgE RF
n      COMBINED ISOTOPES (IgA & IgG etc.)
n      HLA DR 1
n      HLA DR 2
n      HLA DR 3
n      HLA DR 4
We have filtered these to 16 varieties to consider the treatment. Right now, no facility to do Ig RF tests in near by place.

n      VATHARAKTHA & AMAVATHA are the two diseases where we see many similarities with the symptomatology.
n      Amavatha is a disease mentioned only in laghu thrayees that is after the 7th century, not mentioned in the previous texts.
n      Vatha raktha is the only disease mentioned in Brihath thrayees that can be co related with RA.

n      It seems that explanation regarding vatharaktha in Charaka and Sushrutha school of thought is different.
n      Lot of difference is there in the symptomatology.
n      Charaka mentions a joint condition whereas Sushrutha explains Vatharaktha briefly, but he has not given importance to the involvement of multiple joints nowhere mentioned the involvement of joint, but explains symptoms related with skin lesion, which is painful, reddish, with swelling and burning sensation or whitish with itching. But the main site of lesion is mainly feet, but sometimes hands, and symptom may spread to whole body as poisonous rat bite.
n      While explaining the symptoms he says that there may be severe tenderness at the site of lesion or sometimes numbness.
n      Sushrutha while explaining incurable vathashonitha, says that, if the lesion spreads up to knee (from foot), and ulcerates with secretion of serum, blood and pus & in case of muscle wasting & in a debilitated person,it is incurable. So here he clearly mentions ulceration in the leg, from foot up to knee as a complication and also incurable.
GAMBHIRA and UTHANA Vatharaktha are not two types according to Sushrutha
n      Sushrutha says that gambhira and Uthana are not two types of vatharaktha, but two stages of disease. This may be because Sushrutha was explaining skin condition with regards to ulcer and its stage as superficial and deep. Charakas two types depending upon the severity of illness as seen in RA.
n      So Sushruthas explanation may not be related with RA, or he may not have given much importance to vathashonitha as his main subject was surgery.
n      Hence explanation of Sushrutha holds good for Gout, Pseudogout, Peripheral vascular obstruction,ischemic ulcers,  venous ulcers etc.
n      Hence here we consider Vatharaktha of charaka as a co relative study to RA and also AMAVATHA.


n      Leading symptoms seen in sandhis, mainly phalangeal joints and toes, and then multiple joints.
n      Multiple joint pain
n      Pricking pain
n      Tenderness
n      Reccurent exacerbation and remission
n      Malaise
n      Formation of nodules
n      Skin rashes, excessive or no sweating, tingling and itching sensation over joints.
n      Joint deformities, stiffness, rigidity
n      In gambhira vatharaktha, pain is severe and paka usually occurs.
n      Almost all the features of RA is explained except morning stiffness and symmetrical involvement, which is also a diagnostic criteria to consider RA.
n      Extra articular symptoms like necrotic ulcers(paka) as seen in vasculitis, mandalothpatti (butterfly rash in sle), visarpa (skin lesions with bullous ulcers, necrotic or gangrenous ulcers with systemic symptoms)
n      So considering all the criterias, RA comes under vatharaktha of Charaka and all differential diagnosis of RA should also be considered under vatharaktha.

n      Bodyache, anorexia, malaise, heavyness, fever, lightness of the body are the common features.
n      Paka is not the symptom of amavatha (apakaha)
n      Multiple joint pain
n      Excessive urination
n      Abd distension etc are the other features.

Amavatha is mild and mild to moderate RA (and also fibromyalgia)
n      In amavatha extra articular symptoms with systemic involvemnt is not explained as in vatharaktha
n      But grahani (?enteric arthritis), abdominal pain, vomitting is said as upadrava
n      Amavatha with involvement of almost all the joints, swelling, and tridosha are considered as difficult to cure. With single dosha as sadhya, and two dosha as yapya.
n      So there is no asadhya amavatha explained in the text as in vatharaktha, vatharaktha with tridosha involvement and upadravas are asadhya.

RA AND Ukkinadkas Ayurveda
n      In our hospital we have treated more than 2800 cases of RA since last 13 years, and started keen observation since 8 years. But detailed documentation was not done. 90% of the observation is in OP level, and few of the patients might have belonged to Ankylosing spondylitis and such other collagen disorders.
For the better management we have classified RA under 3 catagories.
n      MILD (laghu) RA
n      MODERATE (madhyama) RA
n      SEVERE (theevra)RA

n      The symptoms are similar as explained before, but the deformity of joints will not be seen even after a very lengthy course of the disease. And response to the Ayurvedic treatment is very fast, like 1 to 3 weeks. The symptoms will be reduced to ¾ th with in 1 or 3 weeks.  (? NEGATIVE IgA & IgM RF TYPE OF RA)

n      In this condition also the symptoms are similar as explained earlier, but the severity of pain & other symptoms will be severe. In this case also there will not be any deformities even after a very lengthy course, but the response to the Ayurvedic treatment is slow when compared with mild RA. (? Ig E RF TYPE OF RA)
n      In this condition the signs & symptoms are very severe & most of the times deformity is seen within 6 months of onset of symptoms & the sufferings (pain & systemic manifestations) are more in this variety of RA. The response to Ayurvedic treatment is poor & slow. (? IgA RF TYPE OF RA)

n      In our Hospital, mild & moderate RA cases are treated as out patients.
    In mild & moderate cases we prescribe-Kashaya powder or Liquid kashayas, Herbal & Herbo-mineral tablets internally, and in moderate cases we add lehyas and herbal powder according to the need. For external application we use Lepa powders or oils  according to the need.         
n      In these types of patients we hospitalise the patient for three weeks in our hospital for the panchakarma treatments, which gives very good result particular group of the severe and severe to moderate cases of RA.
n      Internally we prescribe-Kashaya powder or concentrated Liquid kashayas, Herbal & Herbo-mineral tablets, lehyas and herbal powder according to the need. For external application we use Lepa powders or oils according to the need.
n      60% of RA patients visiting our hospital comes under this group
n      Shamanoushadhis & patient education
n      Short course, multi drug combination is preferred, low dosage is usually sufficient.
n      Result is seen within 3 weeks in almost all cases (90-100%).
n      Course of the treatment usually varies from 3 months up to 1 year.

MODERATE RA           
n      25% of the patients visiting our hospital comes under this group
n      Shamanoushadhi, preferably combinations with potent medicines like rasna panchaka , in higher dose, but not multi drug combinations like maharasnadi.
n      In moderate to severe cases panchakarma is preferred.
n      Good result was seen within 1.5 to 4 months in 60-80% of the patients.
n      Course of the treatment usually varies from 6 months up to 2 years or more.

15% of total RA cases visiting our hospital come under this group.
n      Very difficult to treat.
n      As deformities occur very fast, risk of systemic involvement, organ damage, and delayed action makes the treatment much difficult.
n      But still with the shamanoushadhis we get very good result in about 15 to 20 % of severe RA and moderate result in other 20% of cases. But rest of the severe RA patients develop joint deformities very fast and in such patients we have tried with the combination of shamanoushadhis and panchakarma, the response was very good and many patients who had no response earlier started improving, so now a days in severe RA we start with panchakarma treatment and the overall result raised up to 40%.
n      In rest of the severe RA patients prognosis was poor with Ayurvedic medicines alone. But integrated approach was beneficial in about another 30% of the patient
n      Course of the treatment is 2 to 5 years, may extend up to life time also in this group.

n      Since last 2 years in severe RA trying with integrated approach with DMRD(under rheumatologists prescription), presently we have such many patients under treatment, symptomatic improvement is excellent, but complete withdrawal of modern medicine is not possible in most of the cases because of fear of aggravation. But we noted remarkable improvement with the symptoms, HB and ESR in all cases after starting Ayurvedic medicines.
n      In a female patient aged 28 years, we have successfully reduced the dose of DMRD drugs to 100% with very good result. She was taking TNF alfa inhibitor and suffered from TB. So switched over to other mild DMRD, her symptoms aggravated, then she approached us, treated initially with panchakarma followed by shamanaushadhis for next two years. Now she is working in London without any symptoms and medicines. Another important thing is she had deformity in left elbow, the progression could be stopped and she is devoid of any symptoms of RA now except for the damage which already happened

n      In many cases of severe RA with unsatisfactory result, we have tried our medicines along with NSAID’s (Indomethacin 25 mg, 1 OD or BD),.
n      We have observed positive result in many cases after a very long course of treatment, in few cases we could stop the NSAID after long time.
n      Some patients had intermittent exacerbation and required NSAID’s in between.

As per our observation over all –by Ayurvedic management we can control 60% of RA cases very easily with simple treatments, other 25% of patients with some long duration. But another 15% of the patients are the most unfortunate patients with greater difficulties & still we can control the disease in 40% of the severe RA cases.
None of the system gives or claims cure or standardised treatment for RA.
Ayurvedic treatment many times proved to be a superior treatment. But evidence based study in terms of both Ayurveda and modern parameters in a vast group of patient are necessary to assess the effectiveness and safety of the treatment.    

n      In modern medicine there is no remedy for mild, mild to moderate and moderate types of RA. Other than NSAID’s, no other medicines are advisable in this stage, none of the medicines reverse the process of auto immunity, but just blocks the chain of auto immunity as well as normal immunity, so it’s systemic adverse affect restricts the use at this stage.(Now a days Rheumatologists suggest use of immunosuppressive from beginning!!)
n      If not treated some mild to moderate & moderate RA may turn in to moderate or moderate to severe RA in due course.
n      So Ayurveda is a treatment of choice for those with mild and mild to moderate and moderate RA.
n      In moderate to severe and severe cases, the main disadvantage of ayurveda.treatment is lack of effective pain killer, controlling  the pain is very important to improve the patients work efficiency.
n      In severe RA- controlling the fast progressive nature and early deformity as early as possible is a challenge in getting good result.
n      Getting result in 30 to 40% of severe RA is really not bad.
n      But in many patients the trial & error method of drug selection & delayed action makes it difficult to treat severe RA cases as the deformity is fast.
n       So by considering the various gene isotopes and other factors, we can try to make the 40% success rate of severe RA to even more. By administering the medicine in a vast group of RA patients, we can study the action of different groups of medicine in patients with different groups of gene isotopes and other factors.
n      Hopefully this may give us some guide to use specific group of medicine in particular type of RA to achieve fast and accurate result in large number of RA patients.

Jayagovinda Ukkinadka