a review on concept of disease- gridhrasi
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Jalawadi. European Journal of Pharmaceutical and Medical Research
254
.
A REVIEW ON CONCEPT OF DISEASE- GRIDHRASI
*Dr. Poornima Jalawadi
Assistant Professor, Dept. of Shalya Tantra, JSS Ayurveda Medical College.
Article Received on 23/07/2020 Article Revised on 13/08/2020 Article Accepted on 03/09/2020
INTRODUCTION
The one physical attribute making man unique among his
vertebrate cousins is his upright stature. Other primates
may enjoy the canopy of the tropical forest, sometimes
climbing, sometimes semi-upright, but man alone is
comfortable and confident with the upright bipedal
stance. Spinal anatomy is a remarkable combination of
strong bones, flexible ligaments and tendons, large
muscles and highly sensitive nerves. The harmony of all
these structures enables man to run with the pace of time.
He is taking the juxtaposition of strength, structure and
flexibility of the spine for granted in everyday life. But
all this ultimately may lead to numerous spinal disorders,
one of such agonizing and painful condition is „Sciatica‟.
Modern science describes „Sciatica‟ as a benign
syndrome characterized especially by pain beginning in
the lumbar region and spreading down the back of one
lower limb to the ankle and sometimes the foot. The
disorder apparently seems to be non-serious but it
cripples the patient and results in apprehension of social
responsibilities of the patient. It has been mentioned that
„Though Sciatica and lumbago carry little threat to life,
they interfere greatly with living‟.
Ancient Acharyas had identified this problem long back
and named it „Gridhrasi‟. The word „Gridhrasi‟ itself
suggests the gait of the patient which is similar to
Gridhra (vulture) due to pain. All the Ayurvedic classics
including those written in medieval period have
described the aetiopathogenesis and symptomatology of
Gridhrasi in concise form. Surprisingly, the description
narrated in these classics exactly coincides to the
description of „Sciatica‟ including the important
diagnostic test SLR which is described as
„Sakthinuthkshepanigraha‟ by acharyas.[1]
Gridhrasi is a gift of the Modern age of Machines and
Materialism, the industrialization, stress during the work.
Sciatica is one among disease which is gaining more and
more attention of scientists at global level. Many
institutions and Medical schools are making efforts to
find a perfect remedy for this burning problem. Curiosity
is one of the noblest instincts of man, the endless desire
of man for his knowledge. Many theories have been put
forward with many new hypothesis describing the exact
aetiopathogenesis.
Historical Glimpses
‘To understand science it is necessary to know its
history.’
- Auguste Comte
Ayurveda is the ancient medical science and we can find
its references in the Vedas so while studying Gridhrasi,
let‟s have a look at its historical background from Vedas
till date. Gridhrasi is the most obstinate and prominent
one amongst the 80 types of Nanatmaja disorders, of
Vata. Here an attempt has been made to trace out the
references regarding Vatavyadhi in general and Gridhrasi
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ejpmr, 2020,7(10), 254-266
ABSTRACT
Pain is the chief cause of visiting a doctor in most patients. It is known as Ruja which is one of the synonyms of
disease. It disturbs physical and mental status of a patient. Pain is cardinal symptom in most of the Vatavyadhis.
Owing to multiple factors related with changing lifestyle, undue pressure to spinal cord plays key role in low back
ache which later extents to radiating pain. Gridhrasi is such a Ruja Pradhaana Vatavyadhi. In Gridhrasi intense
shooting pain equated with the disease sciatica in modern science. Gridrasi one among the Nanatmaja Vikara,
specific Nidana and Samprapti is not explained in classics so the general Vata Vyadhi Nidhana Samprapthi. All the
Ayurvedic classics including those written in medieval period have described the aetiopathogenesis and
symptomatology of Gridhrasi in concise form. Surprisingly, the description narrated in these classics exactly
coincides to the description of „Sciatica. Sciatica is one among disease which is gaining more and more attention of
scientists at global level. Hence in this paper an attempt is made to review the concept of Gridhrasi from various
classical texts and compile them.
KEYWORDS: Gridhrasi, Sciatica, Shoola, Stambha.
*Corresponding Author: Dr. Poornima Jalawadi
Assistant Professor, Dept. of Shalya Tantra, JSS Ayurveda Medical College.
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Jalawadi. European Journal of Pharmaceutical and Medical Research
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in particular available till now beginning right from the
Vedic era.
Vedic kala (2500 B.C. TO 500 B.C.)
Ayurveda is the Upaveda of Atharvaveda. The references
of Vatavyadhi are found in Atharvaveda only. The word
„Vatakrita‟ is used for Vatavyadhi. But no specific
mention of Gridhrasi is found.
Pauranika kala
Garada Purana deals with Ayurveda related subjects here
Vatavyadhi are described in a separate chapter and
Gridhrasi is described as an entity.
Samhita kala
Charaka Samhita (600 B.C.)
Charak Samhita being the best book for Chikitsa,
describes various references, regarding Gridhrasi along
with symptomatology and its management Su. 5 -
Matrasheetiya adhyaya – Gridhrasi is mentioned among
various indications for padabhyanga[2]
(Su. 5/92)
Su. 14 –Swedadhyaya[3]
– Gridhrasi is mentioned as an
indication for Sweda (Su.14/22) Su. 19-
Ashtodariyadhyaya[4]
– While describing the diseases
having two types Gridhrasi is mentioned with types,
Vataja and Vatakaphaja (Su. 19/7) Su. 20 –
Maharogadhyaya[5]
– Gridhrasi is enumerated in the 80
Nanatmaja Vatavyadhies (Su. 20/11) Ch. 28 –
Vatavyadhi Chikitsa[6]
– Detailed symptomatology along
with treatment of Gridhrasi has been described. (Ch. Chi.
28/56, Ch. Chi. 28/101)
Sushruta Samhita (600-400 B.C.)
In Sushrut Samhita, the description of Gridhrasi is found
at following places. Ni.1- Vatavyadhi nidan[7]
-
Symptomatology and pathogenesis have been described.
The symptom „Sakthiutkshepa nigraha‟ has been
described for the first time which can be correlated to the
SLR test in Modern medicine. (Ni.l /74) Chi. 5 –
MahaVatavyadhi chikitsitam[8]
– Siravyadha is described
as Chikitsa for Gridhrasi (Chi. 5/23). Sh. 8-
Siravyadhavidhi Sharira[9]
– The site of Siravyadha in
Gridhrasi is indicated (Sh. 8/17)
Ashtanga samgraha (5th Century)
Su. 20 – Doshabhediya adhyaya[10]
– Gridhrasi is
included under 80 types of Vatavikaras (Su. 20/13)
Su. 36 – Siravyadhavidhirnama adhyaya[11]
– The
site of Siravyadha in Gridhrasi has been indicated
(Su .36/9)
Ni. 15- Vatavyadhi Nidana[12]
– Gridhrasi is
described with its symptoms (Ni. 15/56)
Ashtanga Hridaya (5th Century)
Su. 27 – Siravyadhavidhi adhyaya[13]
– Site for
Siravyadha in Gridhrasi has been mentioned (Su.
27/14)
Ni. 15 – Vatavyadhi Nidana[14]
– Symptomatology
and pathogenesis of Gridhrasi is described which is
similar to that of Ashtanga Samgraha (Ni. 15/54).
Kashyapa samhita (7th Century)
Although doubtful, the period of Kashyapa samhita
is supposed to be 7th Century.
In this Samhita, Gridhrasi is considered under 80
types of Vatavikaras, but no details are described[15]
(Su. 27/21).
Bhela Samhita (7th Century)
Chi. 26 – In this chapter Basti and Raktamokshana
chikitsa are described for Gridhrasi.[16]
(Chi. 26/44-
45)
Harita samhita
As Acharya Harita belonged to the Agnivesha era, the
origin and time period of Harita samhita available is
doubtful.
Gridhrasi is described as a Vyanaprakopaja Vyadhi
(Tritiyasthana 20/31). The 22nd Chapter of Tritiya
sthana deals with the symptomatology and treatment of
Gridhrasi.
Samgraha kala
Madhava Nidana (7th Century)
In Vatavyadhi Nidana, Gridhrasi is described with its
symptoms. Some symptoms like Dehasyapravakrata in
Vataja and Mukhapraseka, Bhaktadwesha in
Vatakaphaja type of Gridhrasi are described firstly. (M.
N. 22/55-56)
Kalyanakaraka (8th Century) 8th
Chapter –
Vatarogadhikara – Gridhrasi is described with
pathogenesis and symptomatology. 12th chapter –
Treatment for Gridhrasi is described.
Chakradatta (11th Century) - The text deals with the
treatment part of various diseases Gridhrasi has been
described in the Vatavyadhi chikitsa chapter. Various
Churna, Gutika, Kwatha have been quoted. One of these
combinations has been selected for the present study.
Also Bastikarma, Shastrakarma, Siravyadha for
Gridhrasi are described.[17]
Chakrapanidatta (11thCentary) - In his commentary
on Charaka Samhita, Acharya Chakrapani explains the
specific type of pain in Gridhrasi which starts from Sphik
Pradesha and then radiates downwards to Kati., Prishtha
Uru, Janu, Jangha and Pada in order.
Gadanigraha (12th Century) - In Prayogakhanda – 4th
chapter – Gutikadhikara explains the treatment of
Gridhrasi.[18]
In Kayachikitsa Khanda – 19th chapter –
Vatarogadhikara Basti Chikitsa, Agnikarma and
Raktamokshana have been described for Gridhrasi.[19]
Dalhana (12th Century) - Dalhana, on its commentary
on Susrutha Samhita mentions Gridhrasi as Randhini and
also describes the meaning of „Sakthikshepanigraha‟.
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Arunadatta (12th Century) - In his Sarvangasundari
commentary on Ashtanga Hridaya, again explained the
symptom Sakthikshepanigraha.[20]
Vangasena (12th Century) - In this Samhita, Gridhrasi
is described with its two types where Vatabalasa word is
used for Vatakaphaja Gridhrasi. The treatment part is
also explained in details.
Indu (13th Century) - In the Shashilekha commentary
on Ashtanga samgraha, Acharya Indu described
Gridhrasi as having similar symptoms as that of
Vishwachi.
Sharangadhara Samhita (13th Century)
In Purvakhanda[21]
– 7th
Chapter – Rogaganana -
Gridhrasi is counted in Nanatmaja Vatavyadhies.
In Madhyamakhanda- Various preparations for
treatment of Gridhrasi have been described.
Qwatha kalpana[22]
and Kalka kalpana[23]
Rasaratnasamuchchaya (13th Century)
In 30th
Chapter treatment of Gridhrasi is mentioned[24]
Aadhunika kala
Bhavaprakasha (16th Century)
Gridhrasi is considered under 80 Vatavyadhies in
Madhyam khanda. Specific treatment for Vatakaphaja
Gridhrasi is mentioned.[25]
Yogaratnakara (17th Century)
Gridhrasi is described with its symptoms and
classification under Vatavyadhi. The treatment part is
dealt by describing some preparations, Siravyadha and
Agnikarma.[26]
Bhaishajya Ratnavali (18th Century)
In 26th
Chapter, Vata Vyadhi Chikitsa Prakarana,
Gridhrasi Chikitsa is Described.[27]
Harita Samhita
22nd
Chapter explains nidana, Symptammatology,
Chikitsa of Gridhrasi is mentioned.[28]
Vrinda Madhava
In Vata vyadhi Chikitsa, chiktsa for Gridrasi is
Mentioned.[29]
Vaidya Vinod
In this text, the types and symptomatology of Gridhrasi
have been described.
Nidana Chikitsa Hastamalaka (20th Century)
Gridhrasi has been mentioned in Tritiya Adhyaya of
Prathama Khanda.
In Dwitiya Khanda –12 Adhyaya – Different causes of
Katishoola along with treatment are described.
Chikitsa Pradeep (20th Century)
It deals with the treatment part only. Hence Snehana,
Swedana, Shamana and Brimhana etc. are described as
general line of treatment of Vatavyadhies along with
some special combinations for Gridhrasi.
Gridhrasi as a disease - ayurvedic concept Vyuttpathi
of Gridhrasi
The word Gridhrasi is a feminine gender. Which is
derived from „Gridhna‟ dhatu means to desire, to strive
after greedily or to be eager for. By the rule of
„Susudhangridhangridhi bhyaha kran‟ by adding
„karana‟ pratyaya i.e. „gridh + kran‟ followed by lopa of
„k‟ and „n‟ the word „gridh + ra‟ the word „gridhra‟ that
means Vulture is derived.
This word is also formed in another grammatical method
as „Grudhra‟+sho-atonupasargitcha adding „kah‟
pratyaya leads to Gridhra+sho+ka, further by lopa of „o‟,
„k‟ and „sha‟ is replaced by „sa‟ by rule „Datvadeshu‟
„Sah‟ „Sah‟ to get the word Gridhraus. Finally for this
word Gridhraus which is in female gender by adding
„Dis‟ Pratyaya the word Gridhrasi is derived.
गधृ्यति अभिकाङ्ग्क्षति माांसानोति |
पक्षषविशेषः गधृ्रनखी गधृ्रस्य नख इिाकारोऽस्थयाः इति ||
Nirukti
“गधृ्रांऽवप स्याति सो”[30]
As the gait has the resemblance with that of Vulture‟s
gait, it is termed as Gridhrasi. स्याति means throwing
action.
गधृ्रो माांसऱोऱुप मनुष्य िां स्यति पीडयति नाशयति िा |[31]
Gridra is bird called as vulture in English. This bird is
fond of meat and it eats flesh of an animal in such a
fashion that it deeply pierce its beak in the flesh then
draws it out forcefully, exactly such type of pain occurs
in Gridhrasi and hence the name.
गधृ्रांऽवप स्याति सो अन्िः कमााणि अिोनुपसगा | चन्िा गधृ्र इि स्याति पीडयति ,गधृ्र इि स्यति िक्ष्यति ||
Gridhrasi is characterized by severe pain experienced by
the patient is similar to the one experienced by prey of
vulture while being eaten up.
Paryaaya of Gridhra
Following are the synonyms of Gridhrasi
1. Ringhini
2. Randhrinee
3. Randhana
1) Ringhini[32]
– This term is used by Vachaspati Misra
to denote Gridhrasi. According to Shabdakalpadruma the
term refers to „Skhalana‟ which means displacement of
particularly a Pichila material.
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2) Randhrinee[33]
- The word is used by Dalhana to
denote Gridhrasi. The meaning of which is a weak point
or rupture of a material.
Randhana[34]
- This word is used by Kasirama and
Aadamalla in their Gudartha Deepika, commentary on
Sarangadhara Samhita which means pressing,
compressing or destroying.
Nidana Panchaka of Gridhrasi Nidana Panchaka is the combination of parameters,
which are used in the diagnosis of a disease. They are –
1) Nidana
2) Purvarupa
3) Rupa
4) Upashaya-Anupashaya
5) Samprapti
Nidana
For some of the Vathavyadhis specific causative factors
are available, for example, Manyasthambha, Arditha,
Hanugraha, Vatakandaka etc and for the diseases like
Gridhrasi, Pakshaghata, Apabahuka, Kroshtukasheersha
etc specific causative factors are not mentioned. So we
have to consider general causative factors for Vata
Vyadhi.
The aetiological factors are classified into the following
headings,
1. Aharaja
2. Viharaja
3. Kalaja
4. Nidanarthakara Roga
A) Aharaja – The causative dietetic factors included
under this group have been again subdivided into the
following groups.
1. Dravyataha: In this group all the dietetic articles have
been included.
2. Gunataha: This group includes the quality of dietetic
articles like Ruksha, Laghu, Sheeta are included.
3. Rasataha: The various tastes of the dietetic articles,
the excessive use of which lead to the Prakopa of Vata
and hence to the disease Gridhrasi e.g Tikta, Katu,
Kashaya.
4. Karmat: Excessive use of Vishtambi articles lead to
Vata prapokapa
5. Matrath: Less food or fasting
6. Mithyopayogatah
B) Viharaja (habits and regimen)
Factors like Vega Dharana, Ratrijagarana, Atyadhva,
Atiyana, provokes Vata Dosha and also leads to
Gridhrasi. Also over indulgence in Vyayama, Vyavaya,
Plavana, Bharaharana etc results in aggravation of Vata
and results Gridhrasi.
Agantuja (External factors) Patana, Pidana, Abhighata,
Marmaghata, are considered as external causative or
Agantuja factors for the provocation of Vata and
Manasika Bhavas (Mental factors) Chinta, Soka, Bhaya
result in Vataprakopa are also included here.
C) Kalaja (Seasonal factors)
Table no. 5: The Nidanas of Gridhrasi[35,36,37,38,39,40]
NIDANA C.S. S.S. A.S. A.H. M.N B.P.
AHARAJA
Rasa Katu, Tikta, Kashaya - + + + - +
Guna
Laghu + + + - + -
Ruksha + + + + + -
Sheeta + + + - + -
Dravya
Adhaki - + + - - -
Bisa - + - - -
Harenu - + - - - -
Chanaka - + - - -
Kalaya - + - - - -
Koradusha - + - - -
Masura - + + - - -
Mudga - + + - - -
Nivara - + - - - -
Nishpava - + + - - -
Salaka - - + - - -
Sushkashaka - + - - - -
Shyamaka - + - - - -
VIHARAJA
Atigamana + + - + +
Atihasya - + + - - -
Atilanghana + + + - - -
Atiplavana + + - - - -
Atipradharana - + - - - -
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Atiprajagarana + + + + + +
Atiprapatana - + - - - -
Atiprapidana - + - - - -
Atipratarana - + + - - -
Atiraktamokshana - - - - + +
Atishrama - - - - - +
Ativichestitam + - - - + +
Ativyayama + + + + + -
Atiadhyana - + + - - -
Kriya atiyoga + - + + + +
Padaticharya - + - - - -
Asanna,chalana,vikshepa,
asamotkshepa - + - - - -
Balavat vighraha - + + - - -
Bhara harana - + + + - -
Diva swapna + - - - + -
Dukhasana sayya + - - - + -
Kashta bhramana chalana vikshepa - - + - - -
Vegadharana + + + + + +
Vishamopchara + - - - - -
Gaja, ushtra, ashva sheegrayaana
patina - + - - + -
Marmaghata - + - - + -
Dosha asrik sravana - + - - + -
Dhatu kshaya + - - - + +
Ama + - - - + +
Rogati karshana + - - - + +
MANASIKA
Bhaya, shoka, chinta + - + + + +
Krodha + - - - + -
Mada - - - - - +
KALAJA
Aparahna - + + + - +
Apararatra - - + + - -
Grishma - - + + - -
PraVata - + - - - +
Shishira - - - - - +
Seeta kala - + - - - +
Varsha - + + - - +
Purvarupa of Gridhrasi
As Gridhrasi is a Vata Vyadhi and as separate Purvarupa
are not mentioned for Gridhrasi. Vata Vyadhi Purvarupa
can be considered for Gridhrasi also. These Purvarupa
usually are exhibited during the stage of „Sthana
Samsraya‟ of the „Shadkriyakala‟. At that time when
Dosha-Dushya Sammurcchana takes place, some specific
sign and symptoms are observed in particular disease
which are not clearly manifested, are termed as
Purvarupa. It is important to diagnose and treat the
disease at this stage so that patient may be saved from
the complete manifestation of the disease.
Charaka has mentioned that Avyakta Lakshana are the
Purvarupa of the Vatavyadhi. Chakrapanidatta
commenting on the word Avyakta mentions that few
mild symptoms are to be taken as the Purvarupa54
. But
Vijayarakshita, the commentator of Madhava Nidana has
given the clear meaning of the term Avyakta, according
to which symptoms not exhibited clearly are Purvarupa
and they are due to-
1) Weak causative factors.
2) Very less or mild symptoms.
3) Less Avarana of Doshas.
Roopa and Poorva roopa are interrelated with chronicity.
Rupa
The clear manifestation of signs and symptoms of the
disease is called as Rupa. Expressions of clear symptoms
occur at a stage when Dosha–Dushya Sammurchana has
been completed. Rupa is also indicative of the site of
affliction or actual pathology as well as to identify the
type of disease. Here an attempt have been made to
convert Lakshanas to most equalent modern translations.
Acharya Charaka, while describing Gridhrasi has listed
Ruk (pain), Toda (pricking sensation), Stambha
(stiffness), Grahana (restricted movements) and
Spandana (pulsating ) commencing from the spik (waist),
and descending through the posterior part of Kati (hip),
Prusta(thigh), Janu(knee), Janga(foreleg), and
Pada(foot). These are the cardinal symptoms of Vataja
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Gridrasi. In Vata kaphaja type of Gridhrasi in addition to
the above symptoms Tandra (stupor), Gaurava
(heaviness) and Arochaka (loss of appetite) will be
present.
Sushruta have mentioned „Sakthi uthkshepa nigraha‟ ie
one finds difficulty in raising the leg due to severe pain.
Madhavakara has mentioned the same symptoms as
mentioned by Charaka. In addition to this, in
Madhavanidana, he had mentioned symptoms of Vata
and Vatakaphaja Gridhrasi. Some signs and symptoms
like Dehasyapravakrata(irregular shape of body part)
Janu, kati, Uru Sandhi Spurana have been defined as
Vatika Lakshanas by Bhavaprakasha, Madhavakara and
Yogaratnakara.
The symptoms Vataja Gridhrasi are described in details
here:
Ruk
The word „Ruk‟ denotes pain. Any kind of pain is always
associated with Vayu. It is included under
Vataprakopaka Lakshanas by Vagbhata. When Vata
alone is vitiated, it is severe and continues but when
coupled with Kapha it may be less severe. The pain in
Gridhrasi is described to a definite area. It starts from
Sphik and then radiates through Kati, Prishtha, Uru,
Janu, Jangha upto Pada. The track of pain explained by
Charaka exactly corresponds to the pathway of sciatic
nerve. Hence Gridhrasi is correlated with Sciatica.
Toda
Toda means pricking sensation. It is caused by vitiated
Vayu and is included under Vataprakopaja Vyadhis by
Madhava. Also Vagbhata mentioned it in Vataprakopaja
Lakshanas.
Stambha
Stambha means stiffness felt throughout the leg.
Arundatta defines it as inability of the limbs to flex.
While Hemadri interprets it as loss of movement.
Especially the Sheeta and Ruksha Guna of Vata affects
the muscles of the leg, the movements of leg are
restricted. Also they are restricted due to pain, especially
flexion at the hip joint and extension at the knee joint.
When Vitiated Doshas affects the Snayu, Sira and
Kandara then Stambha, Sphurana and Supti are
produced.
Spandana
These are the twitching sensation felt in the affected leg.
By the word Spandana, Chakrapani signifies Kampana
while Dalhana explains it as Chalana i.e. certain kind of
movement is felt. It is also due to Vitiated Vayu
particularly Vyana Vayu. Chala Guna of Vayu is
responsible for Spandana.
Sakthnikshepa Nigraha
Sushruta explains the restricted movement of the affected
limb. The patient is unable to extend the leg i.e.
Prasarana of the leg is difficult. Dalhana explained that
because of the ill effect on Parshnikandara the movement
of the leg is forbidden. Vagbhata modified the term
Kshepa as Utkshepa which means upward movement or
rising.
Arundatta clearly defined this by „Pada uddharane
ashakti‟ meaning the disability to lift the leg.[60]
If we
analyse the symptoms in the light of modern medicine, it
appears very similar to the restricted SLR (Straight Leg
Raising) test which is done to assess the degree of
limitation of the limb (hip) flexion, when knee is
extended.
Dehasyapravakrata
This sign is mentioned in Laghu trayi but not is
Brihattrayi. Because of extreme pain felt in the limb, the
patient assumes a typical posture. He keeps his leg
slightly flexed at the hip and knee hence his body
appears to be in tilted position mostly to the affected
side. This is described as the “sciatic tilt” or “sciatic
scoliosis” in modern medicine.
Suptata
Bhavaprakasha and Yogaratnakara have only mentioned
this symptom. Chakrapani explains it as loss of
movement of the leg and also loss of sensation. Supti is
produced by Sheeta Guna. As Vata and Kapha both
possess the property of Sheeta Guna, both are
responsible for producing Supti.
Vatakaphaj Gridhrasi
Tandra
The inability of the sense organs to grasp their subject,
associated with heaviness of the body, and easy fatigue
are the Lakshanas of Tandra. It is due to Vata and Kapha
Dosha along with Tamo Guna. It is produced by Guru
Guna of Kapha. Tandra is included under and also under
Rasapradoshaja Vikaras.
Gaurava
Gaurava means feeling of heaviness. It is due to Kapha
especially Guru Guna. Patient feels heaviness all over the
body especially in the leg. This makes the movement of
the leg further difficult.
Arochaka
Charaka, Madhavakara and Yogaratnakara have included
this symptom. Although the patient has proper appetite
but still he can‟t enjoy the food due to loss of taste.Here
mainly Bodhaka Kapha Dushti is found. Also, it is
produced due to Rasadushti.
Mukhapraseka
It is described by Laghutrayi. It is also known as
Lalapraseka. It is a symptom of Kapha Dushti specially
Bodhaka Kapha. But also occurs due to presence of Ama
in the body.
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Bhaktadwesha
It is the dislike for food. When Kapha is vitiated along
with Vata in Gridhrasi, the power of Agni is suppressed.
This leads to Ama formation which causes feeling of
heaviness in the abdomen. Hence the patient develops
dislike for food.
Sthaimitya
It is one of the twenty Shleshma Vikara. Patient feels that
some wet cloth is wrapped around his body. Hemadri
interprets it as Alasya.Sthira, Sheeta guna of Kapha are
responsible for producing Staimitya. This symptom is
described by Yogaratnakara only.
Vahnimardava
Because of vitiated Kapha as Anubandhadosha, the
properties of Agni especially Jatharagni will diminish, as
a result Agnimandya takes place. This again leads to
production of Ama which aggravates the Vyadhi.
Table No. 6: Symptoms of Gridhrasi in Ayurvedic Classics.
Symptoms C.S S.S A.H A.S B.P MN Y.R Sa.S H.S
Sphika Purva Kati, Pristha,
Uru, Janu, Jangha, Pada
Kramat Vedana
+ - - - + + + - -
Ruk + - - - + + + + -
Toda + - - - + + + + -
Stambha + - - - + + + + -
Muhuspandana + - - - + + - + -
Sakthikshepanigraha - + - - - - - - -
Sakthiutkshepanigraha - - + + - - - - -
Janu Madhya Vedana - - - - - - - - +
Uru Madhya Vedana - - - - - - - - +
Kati Madhya Vedana - - - - - - - - +
Dehasyapravakrata - - - - + + + - -
Janusandhispurana - - - - + + + - -
Urusandhispurana - - - - + - - - -
Katisandhispurana - - - - + + + - -
Janghaspurana - - - - - + - - -
Suptata - - - - + - + - -
Additional Symptoms in Vata-kaphaja Gridhrasi
Tandra + - - - + + + + -
Gaurava + - - - + - + + -
Arochaka + - - - - - + + -
Vahni Mardava - - - - + + + - -
Mukhapraseka - - - - + + + - -
Bhaktadwesha - - - - + + + - -
Staimitya - - - - - - - - +
Upashaya and anupashaya Upashaya are the medicines, diets and regimens which
are similar to the causative factors and disease or are
dissimilar/opposite to the causative factors and disease
which gives relief to the patient Upashaya for Gridhrasi
has not been mentioned particularly in classics. But we
have seen some factors which aggravate the disease and
some factors which gives relief to the patient. For
example, Physical exertion like walking, lifting heavy
weights, standing, exercises, Increases pain in patient.
These are Anupashaya.
Taking rest by avoiding physical exertions, application
of oil, there is relief in pain in patient. These are
Upashaya.
In the same way, in Shaithya (cold climate), and in rainy
season patient feels discomfort. These are Anupashaya.
On the other hand, in summer season, Ushnata or
exposing to hot gives a feeling of relief in patient, called
as Upashaya in Gridhrasi.
Samprapti of gridhrasi
Samprapti is applied to express the course of aggravated
Doshas due to causative factors from the beginning till
the end of manifestation of disease is called Samprapti.
Or the way of aggravation, circulation and manifestation
is called Samprapti.
Susruta in Nidana Sthana has explained that Aggravated
Vata affects the Kandara (ligaments/tendons), related to
posterior part of Paada, as a result of that patient is not
able to lift his leg.
According to Astanga Sangraha, aggravated Vata gets
located in Kati and lower extremities and Snayu and
produces Gridhrasi.
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On the basis of symptomatology given in classics, the
probable Samprapti of Gridhrasi can be traced out as
below –
Dosha - Vata (Vyana and Apana), Kapha
Dushya - Rakta, Mamsa, Asthi, Majja, Sira, Kandara,
Snayu
Srotas - Raktavaha, Mamsavaha, Medovaha, Asthivaha,
Majjavaha
Srotho Dushti Prakara - Sanga
Agni - Jataragni and Dhatwagni
Ama - Jataragnijanya and Dhatwagnijanya
Udbhavasthana - Pakwashaya
Sanchara Sthana - Rasayanis
Adhisthana - Kandaras of Parsani and Pratyanguli and
Sphika, Kati, Uru, Janu, Jangham, Pada
Vyakta sthana- Sphika, Kati, Uru, Janu, Jangham, Pada,
Prishta
Rogamarga - Madhyama
1) Dosha
According to the texts, Vata is the essential Dosha for the
manifestation of disease „Gridhrasi‟. Kapha is in the
form of Anubandha. It is also well known that the
Prakopa of Vata may occur in two ways - due to
Dhatukshaya and Margavarodha. In case of
Dhatukshaya, continuous ingestion of food materials
which are Ruksha, Laghu, Sheeta, Sushka in nature
Ratrijagarana, Vegavidharana, Pramitasana and all such
causes lead to Dhatukshaya and it leads direct Sanchaya
and Prakopa of Vayu. In the case of Margavarana, Kapha
is an important factor, particularly for producing Vata-
kaphaja type of Gridhrasi.
According to Sushruta, in Gridhrasi Sakthi uthkshepa
Nigrahaniyat is found. The Kshepana, Utkshepana are
the Karma of Prakruta Vyana Vayu. Causes and
Adhisthana of Gridhrasi resemble to causes and
Adhisthana of Apana Dushti. Hence, out of five types of
Vata, Vyana and Apana are the especially vitiated.
2) Dushya
Acharya Sushruta says that, in Gridhrasi the vitiated
Doshas affects the Kandara and thus manifestation of the
disease occurs. According to Charaka, Kandaras are the
Upadhatu of Rakta Dhatu.
Chakrapani mentions that Sthula Snayu may be taken as
Kandara (tendon). Now, according to Charaka,
Mulasthana of Mamsa is Snayu and Snayu is an
Upadhatu of Meda.
Sthana of Vayu has been mentioned as Asthi and there is
an inverse relation between Vayu and Asthi. For
example, increasing Vayu causes Asthikshaya and it
leads to the further Prakopa of Vata.As Gridhrasi Nadi
vitiated in this disease, some Acharyas correlate nervous
tissue with Mastulunga and thus to Majja. So, in disease
Gridhrasi Rakta, Mamsa, Meda, Asthi, Majja, Sira,
Kandara and Snayu may be taken as Dushya.
3) Srotas
As mentioned above, here Rakta, Mamsa, Meda, Asthi
and Majja Dhatus are vitiated. So, their respective Srotas
may also be vitiated in this disease. Hence, the Srotas
involved may be taken as Raktavaha, Mamsavaha,
Medavaha, Asthivaha and Majjavaha Srotas.
4) Agni
Jatharagni and Dhatwagni of Rakta, Mamsa, Meda, Asthi
and Majja Dhatu may be vitiated in this disease.
5) Ama
When the Agni is vitiated automatically respective Ama
is formed. So, in this disease Jatharagnijanya and
Dhatwagnijanya Ama of Rakta, Mamsa, Meda, Asthi and
Majja Dhatu is produced.
6) Udbhavasthana
The main Udbhavasthana of this disease is Pakvashaya
because it is a Nanatmaja Vatavyadhi – Amashaya may
be considered as an Udbhavasthana of Vatakaphaja type
of Gridhrasi.
7) Sanchara Sthana
Here, Sancharasthana of the vitiated Dosha is the
Kandara which is situated in either side of the limb
between Parshni and Anguli as mentioned by Sushruta.
8) Adhisthana
According to Charaka, Kati and Sphika are the initial
sites from where the disease starts and then respectively
affects Uru, Janu, Jangha and Pada. According to
Sushruta, vitiated Dosha affects Kandara of Parshani,
Pada and Anguli. Thus, Sphik, Kati, Uru, Janu, Jangha,
Pada and Kandara of Parshani, Pada and Anguli may be
taken as Adhisthana of the disease Gridhrasi.
Sadhya – asadhyata
Acharya Charaka, in Chikitsa Sthana, has explained that
if Vata vyadhi more than one year or chronic is difficult
to cure or considered as incurable for treatment
(Asadhya) He further explains that, Vata Vyadhi should
be treated if they are in strong patient, newly originated
or less than one year and also free from complications
(Upadrava). They are Sadhya for treatment.[41]
Acharya Sushruta says that if the patient of Vata Vyadhi
develops the complications like Sunam
(edema/inflammation), Suptatvacha (tactile
senselessness), Bhagna (Fracture), Kampa (tremors),
Adhmana (distention of abdomen with tenderness) and
pain in internal organs, then it‟s Asadhya.
According to Acharya Charaka, if Vatavyadhi is
connected with Sandhichuti, Kunjanam, Kubjata, Ardita,
Pakshaghata, Angasamshosha, Pangutva and those which
are Majja and Asthigata are usually cured with difficulty
or even incurable for treatment.
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Vyavachedaka nidana
Every disease is unique and has its own cardinal signs
and symptoms. But certain diseases have resemblance in
their clinical presentation. Hence it is obligatory to rule
out the disease and initiate a correct line of treatment.
Vyavachedaka Nidana is not separately mentioned in
classics. It‟s not a part of Nidana Panchaka. Ancient
scholars did not have confusion regarding diagnosis.
Recent scholars find difficult to diagnosis due to lack of
sound knowledge regarding the symptomatology of
diseases. So they have introduced differential diagnosis.
Therefore, here an attempt has been made for the
differential diagnosis of the disease Gridhrasi.
Few disease are considered here for differential diagnosis
because of presence of similarity and also dissimilarity in
Nidana (dosha-dushya), Purvarupa, Rupa, Samprapti,
Sthana.
Gridhrasi presents with pain in lower limbs radiating
from Sphik, Kati, Prishtha and affecting Uru, Janu,
Jangha and Paada in order. „Sakthiutkshepanigraha‟ is
mentioned as a cardinal sign by Sushruta and Vagbhata.
But other symptoms such as Stambha, Toda, Sphurana,
Ruk. are also found in other diseases like Urustambha,
Khalli, Kalayakhanja and Vatakantaka.
Urustambha[75]
is a disease affecting one or both the legs
with symptoms of pain and coldness of leg associated
with Toda, Sphurana, Stabdhata and systemic
manifestations like Chardi, Jwara are found in
Urustambha which are absent in Gridhrasi. Also, a
patient of Gridhrasi will never have such a strange
feeling that the leg doesn‟t belong to him, which is
common in Urustambha. The typical radiating type of
pain is found in Gridhrasi only.
In Khalli,[76]
pain is in Pada, Jangha, Uru and Hasta.
Charaka has specified the type of pain as Avamotana i.e.
Mardanavat. Harita opines that Gridhrasi and Vishwachi
when originate together is called Khalli, while Vagbhata
gives importance to the severity of pain. But Khalli can
be differentiated from Gridhrasi by the nature of the pain
i.e. originating from Sphik, Kati and then radiating to the
leg.
Khanja is a disorder where vitiated Vayu gets lodged at
Kati affecting the Kandara of one leg, and when it affects
both the legs it is Pangu. In Gridhrasi also, the Kandara
of leg is affected but in Khanja there is no pain instead
there is wasting in leg. Kalayakhanja is caused due to
ingestion of certain kind of peas (Kalaya). In this disease
there is difficulty in walking and trembling gait.
In
Gridhrasi Kampana or Sphurana is present but not
specially related to walking. Also, Sandhi Shaithilya is
seen in Kalayakhanja but absent in Gridhrasi.
Vatakantaka is a disease affecting Gulpha Sandhi and
localised pain is the main symptom. In Gridhrasi, pain
may be present at Gulpha Sandhi but the whole leg is
affected which is not seen in Vatakantaka.
Chikitsa
Chikitsa is not only at the radical removal of the
causative factors of the disease, but also the restoring the
equilibrium of doshas.
General line of management of Vatavyadhi
1. Nidanaparivarjana
2. Samshamana
3. Samshodhana
Nidanaparivarjana: Nidana which are Vata Prakopaka
or causing kapha vitiation leading to Margavarodha
should be strictly prohibited.
Samshamana: Among the Shad Upakramas, Swedana,
Sehana and Brimhana can be adopted accordingly. If the
Dosha Prakopa is very less Langhana Chikitsa is enough,
if the intensity of Dosha Prakopa is moderate Langhana
and Pachana treatment is given. If however Dosha
Prakopa is severe, Shodhana treatment is decided.
Samshodhana: Vamana, Virechana and Basti are
advised in Gridhrasi. Raktamokshana is also indicated in
Gridhrasi.
Gridhrasi being a Vata vyadhi, the general line of
treatment for Vatavyadhi is indicated for Gridhrasi also.
Upakramas such as Snehana, Swedana, Utsadana,
Parisheka, Asthapana and Anuvasana Basti are indicated.
Basti is described as one of the best line of treatment for
Vata Dosha.
Vagbhata prescribes Sneha, Sweda, Mrudusamshodhana
along with Madhura, Amla and Lavana Dravyas,
Veshtana, Trasana, Madhya, Sneha siddha with Deepana
and Pachana drugs, Mamsa Rasa and Anuvasana Basti to
pacify the Vata.
Snehana
Snehana or oleation therapy is used externally and
internally in case of Gridhrasi. Externally Snehana may
be performed in the form Abhyanga, Pizhichhil,
Avagaha, Parisheka.
Swedana
Shoola and Stambha in the lower extremities are the
cardinal symptoms of Gridhrasi and is best treated by the
Swedana Chikitsa. Swedana also helps in the
liquification of the Dosha there by assisting clearing the
Srotas, or else rectifying the Margaavarana. Among the
different forms of Swedana procedures, Avagaha Sweda,
Pizhiccil, Nadisweda, Patrapindasweda, Pindassweda
and Upanaha Sweda, Sankara sweda may be exclusively
performed in patients of Gridhrasi.[81]
But in Vatakaphaja
Gridhrasi, Ruksha Sweda is a better option.
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Gridhrasi being a Vata vyadhi, the general line of
treatment for Vata vyadhi is indicated for Gridhrasi also.
Upakrama such as Snehana, Swedana, Utsadana,
Parisheka, Asthapana and Anuvasana Basti are indicated.
Specific treatment for gridhrasi
Table No 07: Chikitsa According to Different Authors
Acharyas Chikitsa Sutra
Charaka Sira vyadha, Basti, Agni karma
Sushrutha Sira vyadha
Vaghbhata Sira vyadha
Vangasena
Dipana, Pachana, Swedana,
Mardana, Upanaha, Vamana,
Virechana, Asthapana Basti, Sneha
Basti, Agnikarma
Chakradatta Pachana, Shodhana, Basti, Shastra
karma
Yogaratnakara Sira vyadha, Agni karma
Bhava
Prakash Virechana, Vamana, Basti
Charaka Samhita: Acharya Charaka has mentioned the
site of Siravyadha as Antara khandara gulpha and Basti,
Agnikarma is also indicated.
Susruta Samhita: Acharya Susruta has mentioned Vata
vyadhi Chikitsa for Gridhrasi, and if rakta avarana is
present even after the treatment then Sira Vyadhi should
be done. In Gridhrasi Siravyadha is mentioned four
Angula above and four Angula below at the site of knee
joint. It is a general rule that, when the regular treatment
with Shadvidhopakrama fails to give any relief in any
disease, one should consider the involvement of Rakta
Dhatu in the pathogenesis and is best treated by
Raktamokshana. This rule is also applicable in Gridhrasi
Roga.
Vagbhata: Chikitsa sutra for Gridhrasi is not mentioned.
Indu the commentator of Astanga Sangraha explained
Sira vyadha in Gridhrasi is four Angula above and four
Angula below at the site of knee joint.
Chakradatta: He has mentioned Pachana, Shodana,
Basti. Shodhana includes Vamana, and Virechana. The
physician should have proper knowledge regarding the
Nirama Avastha and Agni of the patient before giving
Basti and Virechana Chikitsa.
He has explained Shastra karma as line of treatment of
Gridhrasi ie., a small operation with prior Snehana and
Swedana to remove Granthi in Gridhrasi. Sira vyadha
should be carried out four Angula below IndraBasti
Marma. Agni karma should be done in Pada Kanistika
Anguli (little toe of the affected leg).[42]
Vangasena: He has explained Dipana, Pachana,
Swedana, Mardana, Upanaha, Vamana, Virechana,
Asthapana Basti, Sneha Basti, Agnikarma. He has
clearly mentioned application of warm Taila and Isthika
sweda. He also mentioned Mardana and Upanaha
measures for Gridhrasi. Agni karma should be done in
Pada Kanistika Anguli.
Yogaratnakara: Siravyadha and Agnikarma is
explained.
Bhava Prakasha : Virechana and Basti is explained.
Pathya – apathya
Acharya Charaka has defined Pathya as that type of food
article, drug and regimen which do not affect the body
and mind adversely and that which adversely affects the
body and mind are considered as Apathya. Thus
Ayurveda ascribes the importance of regulations in daily
living to maintain good health ie. Dinacharya, Ritucharya
and Achara Rasayana. Pathya is given equal importance
to that of Chikitsa and it is termed as a synonym for
Chikitsa too.
Gridhrasi, being a Vatavyadhi, the Pathyapathya
mentioned for Vatavyadhi should be followed. Ahara
having the basic quality of Madhura, Amla and Lavana
Rasa, Snigdha, Ushna guna and Brimhana property
should be advised. Chakradatta, Bhaishajya ratnavali and
Yogaratnakara have the description of Pathyapathya in
detail.
It can be presented as:
Anna varga : Rakta shali, Purana Shashtika shali,
Kulatha, Masha,
Godhuma, Lavana.
Dugdha varga : Dugdha, Ghrita, Dadhi,
Matsyandika, Dadhikurchika.
Shaka varga : Patola, Shigru, Vartaka, Lashuna,
Tambula
Phala varga : Dadima,Parushaka, Badara, Draksha,
Jambira
Mamsa varga: Gramya, Anupa, Audaka Mamsa,
Chataka, Kukkuta,
Tittira, Nakra mamsa.
Drava Varga : Taila, VasaMajja, Yusha, Mamsarasa,
Sura, Naladambu
Aushadha : Prasarini, Gokshura, Nimba,
Kshirkakoli.
Pathya Vihara Snigdha swedana, Abhyanga, Basti, ShiroBasti,
Sirahsneha, SnaihikaDhuma, Sneha Nasya, Sneha
Gandusha, Sukhoshna Parisheka, Samvahana are the
upakramas to be followed.
Apathya Ahara Chanaka, Kalaya, Shyamaka, Nivara, Kangu, Mudga,
Rajamashaka, all Trina Dhanyas, Nishpavabija, Bimbi,
Kasheruka etc. should be avoided. Also Tadaga and
Tatini Jala.
Upadrava
Upadravas are produced as a sequel of the disease
proper. Their emergence increases the graveness and
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complexity of treatment. Their description in various
classics is as follows
Sushruta has elaborately described Upadravas of eight
Maharogas including Vatavyadhi in general as well as
that of Vata-vyadhi independently.
Upadravas of Eight Mahavyadhi
1. BalaKshaya
2. Mamsa Kshaya
3. Shosha
4. Trishna
5. Chardi
6. Jwara
7. Atisara
8. Moorcha
9. Hikka
10. Shwasa
Specific Upadrava of Vatavyadhi 1. Shotha
2. Suptata
3. Bhagna
4. Kampa
5. Adhmana
6. Ruja
DISCUSSION
The Ayurvedic treatises in the context of Vata Vyadhi
explain a painful condition afflicting the lower limbs
called ‘Gridhrasi’ wherein the pain along with stiffness,
sensation of pins and needles, gripping and pulsations
start in the Spik or the buttocks [gluteal region] initially
and gradually encroach the regions of the posterior
aspect of Kati (pelvis and lumbo sacral regions), Uru
(thigh), Jaanu (behind the knee), Jangha (leg) and Pada
(foot) in order. This occurs due to the vitiation of Vata.
But when Kapha gets involved with Vata stupor,
heaviness of the body and anorexia are also associated
with the above said complaints.
Gridhrasi can be compared with the ‘Sciatica’ explained
in the modern texts due to a close resemblance in the
manifestations of both the conditions.
Sciatica is a term used to explain a set of symptoms
including pain numbness tingling and weakness starting
from the low back and or buttocks and radiating towards
the foot through the back of the thigh, knee joint and the
leg when one or more of the 5 nerve roots forming the
sciatic nerve or the sciatic nerve itself is either
compressed or irritated.
CONCLUSION
Gridhrasi a Shoola Pradhana Nanatmaja Vata Vyadhi
manifest owing to multiple factors related with changing
lifestyle, which is commonly seen as a prominent
problem. Specific Nidana and Samprapti is not explained
in classics so the general Vata Vyadhi Nidhana
Samprapthi can be considered.
With the Chikitsa part concerned, Sneha, Sweda, Basti,
Siravyadha, and Agni karma is explained. Basti Karma is
Sarvarthakari, superior most in the management of Vata,
and it seems to be the radical treatment of this disease.
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No.1008, Varanasi (UP), Page No403
13. Acharya Vagbhata, Astanga Hrdaya, Sutra Sthana,
Chapter 27, Shloka no. 17, Edition: annotated by Dr.
Anna Moreswar Kunte and Krsna Ramchandra
Sastri Navre, edited by Pt. Hari Sadasivasastri
Paradakara Bhisagacarya, Chaukhamba Sanskrit
Sansthan, K.37/116, Gopal Mandir lane, Varanasi,
Reprint, 2009, Page no.328.
14. 71)Acharya Vagbhata, Astanga Hrdaya, Nidana
Sthana, Chapter 15, Shloka no.54, Edition:
annotated by Dr. Anna Moreswar Kunte and Krsna
Ramchandra Sastri Navre, edited by Pt. Hari
Sadasiva sastri Paradakara Bhisagacarya,
Chaukhamba Sanskrit Sansthan, K.37/116, Gopal
Mandir lane, Varanasi, Reprint, 2009, Page no.535.
15. Sri Satyapala Bhishagacharya edited Kashyapa
Samhita, Sutra Sthana, Chapter 27, Shloka No. 21,
Edition: Reprint 2006, Pub: Chaukhambha Sanskrit
Sansthan, Varanasi, Page No. 68.
16. Prof. Priyavrat Sharma edited Bhela Samhita,
Chikitsa Sthana, Chapter 24, Shloka no.44
Edition:Reprint 2005, Pub: Chaukambha
Visvabharati, Varanasi (UP), Page No.454.
17. Proff.K.R.Sreekandamurthy Translated Madhava
nidana,Chapter 22, Sloka no.54 Pub: Chaukhamba
Surbharati Prakashan, K.37/117, Gopal Mandir lane,
Post box No.1129, Varanasi (UP), Edition: Reprint
1995, Page No.142.
18. Acharya Chakrapanidatta, Chakradatta, Chapter
Vata Vyadhi Chikitsa, Shloka No.43,44,45,51,53,
Edited by Priyavrat Sharma, Pub:Chaukhambha
Publishers, Varanasi(UP), Edition: Second1998,
Page No.136-137.
19. Sri Vaidhya Sodhala, Gadanigraha edited by Shri
Ganga Sahaya Pandeya, Prayoga Khanda, 4th
Chapter, Shloka no.322,352, Pub: Chaukhambha
Sanskrit Sansthana, Varanasi, Edition: 2003, Page
no.271.
20. Sri Vaidhya Sodhala, Gadanigraha edited by Shri
Ganga Sahaya Pandeya, Kayachikitsa Khanda, 19th
Chapter, Pub: Chaukhambha Sanskrit Sansthana,
Varanasi, Edition: 2003, Page no.505-506.
21. Dr. Rajjev kumar Roy edited Vangasena Samhita,
Chapter Vata vyadhi Adikara, Shloha No.115, 1st
edition 2004, Pub: Chawkhambha Sanskrit Series
office, Varanasi (UP), Page No.267.
22. Pandit Parashurama Shastri Vidyasagar edited,
Sharangadhara Samhita, Deepika commentory by
Adamalla on Poorvakhanda, Chapter 7, Shloka
No.108, 3rd edition 1983, Pub:Chawkambha
Orientalia, P.B.32, K, 37/109, Gopal Mandir lane,
Varanasi (UP), Page No.40.
23. Pandit Parashurama Shastri Vidyasagar edited,
Sharangadhara Samhita, Deepika commentory by
Adamalla on Poorvakhanda, Chapter 2, Shloka
No.84, 3rd edition 1983, Pub:Chawkambha
Orientalia, P.B.32, K, 37/109, Gopal Mandir lane,
Varanasi (UP), Page No.66.
24. Pandit Parashurama Shastri Vidyasagar edited,
Sharangadhara Samhita, Deepika commentory by
Adamalla on Madhyama Khanda, Chapter 5, Shloka
No.6, 3rd edition 1983, Pub:Chawkambha
Orientalia, P.B.32, K, 37/109, Gopal Mandir lane,
Varanasi (UP), Page No.81.
25. Vagbhatacharya, Rasa Ratna Sammuchaya, Edited
by, Dr.Kapidev Giri, Chapter 30,Shloka no.71, Pub:
Chaukhambha Sanskrit Sansthana K.37/116, Gopal
Mandir Lane, Varanasi, Edition Reprint, 2009, Page
no.410.
26. Bhavamishra, Bhavaprakasha, Edited by
Dr.Sreekanda Moorthy, Vol 2, Madhyama Khanda,
Chapter 24, Shloka no.129, Pub: Chaukhambha
Krishnadas Academy, Varanasi, Edition, 2009, Page
no. 331.
27. Yogaratnakara, Edited by Dr.Ashakumari and
Dr.Premvathi Tewari, Part 1, Chapter, 25, Shloka
no.68-71, Pub: Chaukhambha Viswabharati,
Varanasi, Edition , 2010, Page no.581.
28. Shri Govinda Dasji, Bhaishajya Ratnavali, Edited by
Bhisagratna Shri Brahma Shankar Mishra, Vol 2,
Chapter 26, Sloka No.37, Pub: Chaukhambha
sankrit samsthan, Edition: Reprint 2009, Page
No.135.
29. 8Vaidya Jamini Pandey, Harita Samhita, Chapter 22,
Shloka No.2-9, Pub: Chaukhambha Viswabharati,
K. 37/109, Gopal Mandir Lane, Varanasi, Edition,
2006, Page no.381.
30. Vrindamadhava or Siddha Yoga,Edited by
Dr.Premvati Tewari, Part one, Chapter, 22, Shlok a
no, 69, Pub: Chaukhambha Viswabharati, K.
37/109, Gopal Mandir Lane, Varanasi, Edition,
2006, Page no.316.
31. Amarakosa sloka no.2015.
32. Prof. P.V Tewari edited Kashyapa Samhita by
Acharya Vruddha Jivaka, Redacted by Vatsya,
Kilasthana, Chapter 8, Sloka-41-45 Reprint 2008,
Pub: Chaukhamba surabharati prakashan, K.37/117,
Gopal Mandir lane, Post box No.1129, Varanasi
(UP), Page No.271-272.
33. Vaidya Jadavaji Trikamji Acharya edited Charaka
Samhita, Revised by Charka and Drdhabala, with
Ayurvedic commentry by Chakrapanidatta on
Siddistana, chapter 1, Sloka No. 7, Edition Reprint
2009, Pub: Chaukhamba surabharati prakashan,
K.37/117, Gopal Mandir lane, Post box No.1129,
Varanasi (UP) page No.678.
34. Vaidya Jadavaji Trikamji Acharya edited susrutha
Samhita with commentary Nibandha sangraha of
Dalhana, Chapter-38, Sloka No. 5, Edition:Reprint
2009. Pub: Chaukhamba Sanskrit sansthan
K.37/117, Gopal Mandir lane, Post box No.1129,
Varanasi (UP) Page No.540
www.ejpmr.com
Jalawadi. European Journal of Pharmaceutical and Medical Research
266
35. Vaidya Jadavaji Trikamji Acharya edited Susrutha
Samhita with commentary Nibandha sangraha of
Dalhana, Chapter-38, Sloka No. 19, Edition:Reprint
2009. Pub: Chaukhamba Sanskrit sansthan
K.37/117, Gopal Mandir lane, Post box No.1129,
Varanasi (UP) Page No.541.
36. Vaidya Jadavaji Trikamji Acharya edited Charaka
Samhita, Revised by Charka and Drdhabala, with
Ayurvedic commentry by Chakrapanidatta on
Siddistana, chapter 1, Sloka No.46, Edition Reprint
2009, Pub: Chaukhamba surabharati prakashan,
K.37/117, Gopal Mandir lane, Post box No.1129,
Varanasi (UP) page No.684.
37. Vaidya Jadavaji Trikamji Acharya edited Susrutha
Samhita with commentary Nibandha sangraha of
Dalhana,Chikitsa Stana, Chapter-37, Sloka No.9,
Edition:Reprint 2009. Pub: Chaukhamba Sanskrit
sansthan K.37/117, Gopal Mandir lane, Post box
No.1129, Varanasi (UP) Page No.541.
38. Vaidya Jadavaji Trikamji Acharya edited Charaka
Samhita, Revised by Charka and Drdhabala, with
Ayurvedic commentry by Chakrapanidatta on
Siddistana, chapter 3, Sloka No. 70, Edition Reprint
2009, Pub: Chaukhamba surabharati prakashan,
K.37/117, Gopal Mandir lane, Post box No.1129,
Varanasi (UP) page No.698.
39. Vaidya Jadavaji Trikamji Acharya edited Charaka
Samhita, Revised by Charka and Drdhabala, with
Ayurvedic commentry by Chakrapanidatta on
Siddistana, chapter 1, Sloka No. 21, Edition Reprint
2009, Pub: Chaukhamba surabharati prakashan,
K.37/117, Gopal Mandir lane, Post box No.1129,
Varanasi (UP) page No.680.
40. Pt. Harisadashiva shastri paradakara edited Astanga
Hrudaya of Vagbhata with commentary
Sarvangasundare of Arunadatta and Ayurveda
Rasayanam of Hemadri, chapter No. 19, Sloka
No.51, Reprint 2010, Pub: Chaukhamba surabharati
prakashan, K.37/117, Gopal Mandir lane, Post box
No.1129, Varanasi (UP) page No.81.
41. Prof. Priyavrat Sharma edited Bhela Samhita,
Chikitsa Sthana, Chapter 24, Shloka no.44
Edition:Reprint 2005, Pub: Chaukambha
Visvabharati, Varanasi (UP), Page No.454.
42. Vaidya Jamini Pandey, Harita Samhita, Chapter 22,
Shloka No.2-9, Pub: Chaukhambha Viswabharati,
K. 37/109, Gopal Mandir Lane, Varanasi, Edition,
2006, Page no.381.
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