Ayurvedic Literature Review of Vataja Pratishyaya WSR Allergic Rhinitis
The basic life of a human is dependent on air and water but the natural sources also serve as the source of infection. Due to modern civilization, there is increasing evidence of the negative health impact resulting from environmental air pollutants. Ayurveda science mentioned air pollutants like Raja, Dhooma as causative factors of respiratory illness including Allergic Bronchitis (Shwasa), Allergic rhinitis (Pratishyaya), Cough (Kasa) and Hiccough (Hikka). Vataja pratishyaya/Allergic rhinitis occurs much more frequently than before. Pratishyaya has been considered as a separate clinical condition in Uttar tantra of Sushruta Samhita. Allergic rhinitis can be correlated with the Vataja Pratishyaya due to similarities in the sign and symptoms. Allergic rhinitis is an inflammation of nasal membranes, characterized by watery nasal discharged, nasal obstruction, sneezing and nasal itching. Many treatment modalities are explained in modern system of medicine like corticosteroids, antihistaminic, inhalers etc. but none of them are totally effective in curing the disease as well as preventing its recurrence, more over they have their own side effects.
Introduction
Allergic rhinitis is one of the most common allergic conditions, and occurs when the nasal cavity is exposed to foreign particles such as pollen, dust etc.[1, 2]. Sign and symptoms include a runny or stuffy nose, sneezing, red, itchy and watery eyes and swelling around the eyes. The fluids from the nose are usually clear. Symptom’s onset is often within minutes following exposure and they can affect sleep, the ability to work and the ability to concentrate at the school. Those whose symptoms are due to pollen typically develop symptoms during specific times of the year. many people with allergic rhinitis also have asthma, allergic conjunctivitis, or atopic dermatitis.
Pratishyaya is described since Samhita kala in Brihattrayee as well as Laghutrayee. It is described as a premonitory symptoms/purvarupa of Tuberculosis/ rajyakshma and as a symptom of vega vidharanaj, kshayaja and vishamasanaja yakshma. In sushruta Samhita, it is given in more detailed as a separate chapter. Ayurveda describes Pratishyaya as one of the most important disease among Nasa roga defined as the condition where the secretion produced due to vitiation of Vata and Kapha at the root of nose, which flows down through the nose against the inspired air [3].
Over the last decade allergic rhinitis represents a global health issue affecting between 1 0%-25% of world population [4], with increasing prevalence day by day. According to World Allergy Organisation (WAO), 400 million persons worldwide have allergic rhinitis [5]. Prevalence of allergic rhinitis in approximately 20% of the population in India [6]. The disease is not life threatening but significantly affect quality of life due to its symptoms which hampers routine activity of the patient [7]. If these symptoms are ignored or not cured properly the complications may be very severe.
Classification
Acharya Sushruta, Vagbhatta, Madhavakar, Bhava Mishra, Sharangadhara have described five types of Pratishyaya .Vataja, Pittaja ,Kaphaja, Sannipataja, Raktaja. Acharya Charaka and Kashyapa have not accepted Raktaja Pratishyaya [8, 9]. According to rasa ratna samuchaya, there are six types of Pratishyaya. Acharya Dalhana described two stages of Pratishyaya as [10]
- Amavastha
- Pakwavastha
Importance of Pratishyaya;
- Pratishyaya is the causative condition for all the other disease of nasal cavity and hence it is explained with priority in the nasa rogas.
- Pratishyaya is the only disease explained in Shalakya tantra which develops complication even before the sign and symptoms occur, hence if treated when the purvaroops are seen, the further pathology can be stopped.
Nidan of Pratishyaya
- Sadyojanak nidan
- Kalantrajanak nidan
| Viharaja | Manasika | |
|---|---|---|
| Mandagni | Vega sandharana | Atikrodh |
| ajeerna, vishmasana | rajahdhumarasevan | |
| atijalapan after meal | atisambhasanam | |
| ati guru Madhura sheeta ruksha sevan | rituvaishmya | |
| atisheetambupaan | shirasoabhitapam | |
| atisheetambupaan | divasyanam | |
| atisheetambupaan | atapa sevan, snan in ajirna. |
Table 1: The etiological factors can again be classified following.
Samprapti
The disease process starts by the aggravation of Tridoshas by multifarious factors i.e., exogenic & endogenic. The proper functioning of dosha, agni, malas & balanced status of atma, mana and indriya bring about health, whereas disturbance of equilibrium leads to disease.
According to Acharaya Sushruta Samprati of Pratishyaya, when vata, pitta, kapha singly or together as also rakta are accumulated in the region of the head and get vitiated due to several aggravating factors give rise to disease Pratishyaya [11].
Purvaroopa
It has been stated by Sushruta, Madhava nidana and Bhavprakash have followed Sushruta in describing the purvarupa [12].
- Shirogurutvam (heaviness in head)
- Kshvathu pravatanam (sneezing)
- Angamarda (bodyache)
- Parihristaromta (generalised horripilation)
Rupa
1.1.a. Clinical features of Vataja Pratishyaya according to Acharya Charaka (Ch. Chi26/105)
- Ghranarti toda (pricking pain sensation in nose)
- Kshavathu (sneezing)
- Jalabhsrava (watery nasal discharge)
- Swarabheda (hoarseness in voice)
- Shirashoola (headache) 1.1.b. Clinical features according to Sushruta(Su.Utt.24/6- 7), Madhava nidan and Bhava Mishra
- Anaddhapihita nasa (nasal obstruction and stiffness)
- Tanusrava pravartini (watery nasal discharge)
- Galtalvoshath shosha (dryness in throat, palate, lips)
- Shankh nistoda (pricking sensation in temporal region)
- Swaropghata (hoarseness in voice)
Chikitsa of Pratishyaya
The first step in the treatment is nidan -parivarjan. As only local treatment is not enough to treat the disease, oral medication is also necessary which helps to removes the pathology and also improve the immunity status.
Samanya Chikitsa
Five days of langhana is advised in Pratishyaya before going for further treatment. (Chakra.59/3). All type of except nav Pratishyaya are to be treated with Grittapana, Swedana, Vaman, Avpidan nasya chikitsa. Vishesh Chikitsa Acharya Sushruta specifically mentioned the treatment regime of vataja pratishyaya. • Ghritapana: Oral administration of Panch lavan siddha grita and vidarigandhadi gana siddha grita.
- Nasya
- Arditoka chikitsa: Shirobasti, nasya, Dhooma, Upnaha, Sneha and Nadi swedana, Ksheera taila pana and Abhayang.
Upadrava
Vataja pratishyaya leads to dushta pratishyaya if left untreated. Following are the complications which may be be seen if not treated in the right time deafness, blindness, anosmia, severe eye disease, cough, loss of appetite and oedema.
Certain Instructions to be Followed-
- The patient suffering from allergic rhinitis should avoid cold water and polluted air.
- Regular nasal douching should be done with saline water to reduce crusting of nasal mucosa.
- It is advisable to use a mask or cover the face and nose to pollutants and causative organisms to enter the nose.
Conclusion
Ayurvedic formulations can be adopted for more effective, non-chemical treatment for allergic rhinitis/vataja pratishyaya. All formulations are proposed to be taken up for evaluation of their effect in vataja pratishyaya /allergic rhinitis to come up with safe and cost-effective treatment for this ailment.
References
-
Acharya VYT (2007) Agnivesh Charak Samhita with Ayurved Dipika commentary, Choukhambha Orientalia, Varansi Chikitsasthana 17/13.
-
Vd Yadav TJ, Vd Tukaram CS (2017) A randomized controlled clinical study on the efficacy of chitrakaharitaki avaleha in vataj pratishyaya W.S.R. to allergic rhinitis in children. PIJAR 1(3): 68.
-
Bousquet J, Van Cauwenberge P, Khaltaev N, Aria Workshop Group, World Health Organization(2001) Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol 108(5 Suppl): S147-334.
-
Aggarwal AN, Chaudhry K, Chhabra SK, D Souza GA, Gupta D, et al. (2006) Asthma Epidemiology Study Group. Prevalence and risk factors for bronchial asthma in India adults: a multicentre study. India J Chest Dis Allied Sci 48(1):13-22.
-
Acharaya VYT (2005) Agnivesh charaka Samhita elaborated by charaka and dridbala, with ayurved Deepika commentary by chakrapanidatta Published by chaukhmba publication, Varanasi, chikitsasthan 26/110- 114: 604-605.
-
Rajguru N, Sharma PH (2004) Maharshi mareecha kashyapa, Vriddhajeevaka Tantra Revised by vatsya with Sanskrit introduction with the vidyotani hindi commentary & hindi translation of Sanskrit introduction by ayurvedalankara shri satyapala bhishagacharya, varansi 9th (Edn.), chaukhmba Sanskrit samthan publication, Ka, Chi 12/5, pp: 222.
-
Acharaya VYT, Tirtha NRAK (2005) Sushruta Samhita with nibandha sangraha commentary of shree Dalhanacharya and the Nyaya Chandrika panjika shri govindacharya on nidana sthana, Uttara Tantra 24/16- 17, pp: 652.
-
Shastri KA (2019) Sushruta, Nagarjun, Sushruta Samhita, Uttara Tantra, Pratishyaya Adhyaya 24/4, Chaukhamba Sanskrit Sansthan, Varanasi.
-
(2003) Sushruta Samhita, commentaries by shastri, kaviraja ambikadutta Ayurveda Tattva Dipika, chaukhambha Sanskrit sansthan, varansi, India, Uttars Thana 24/5,pp: 153.
-
Shastri KA (2019) Sushruta, Nagarjun,Sushruta Samhita, Uttara Tantra, Pratishyaya Adhyaya 24/18, Chaukhamba Sanskrit Sansthan, Varanasi.
-
Shastri KA (2019) Sushruta, Nagarjun, Sushruta Samhita, Uttara Tantra, Pratishyaya Adhyaya 24/25, Chaukhamba Sanskrit Sansthan,Varanasi.
-
Shastri KA (2019) Sushruta, Nagarjun, Sushruta Samhita, Uttara Tantra, Pratishyaya Adhyaya 24/16-17, Chaukhamba Sanskrit Sansthan, Varanasi.
- Management of Ear Keloid with Ksharsutra: A Case Study
- Yoga and Global Sustainability: A Holistic Path to One Earth, One Health
- Autoimmune Diseases in Ayurveda: A Narrative Review with Classical and Modern Perspectives
- Management of Cluster Headache Associated with Pituitary Apophysitis by CERT (Chakrasiddh Energy Release Technique): A Case Report on Energy Rebalancing
- Zygophyllum Geslini Coss : Biochemicals and Antioxidant Activity
- Observations of a Beginner Vaidya