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1. The Role of Panchakarm in theThe Role of Panchakarm in the
management of joint disorders andmanagement of joint disorders and
Vatvyadhi (Neurological disordersVatvyadhi (Neurological disorders))
Dr. U.S. Nigam,Dr. U.S. Nigam,
M.D. Ph.D (Ayu.)M.D. Ph.D (Ayu.)
EX PRINCIPIAL/PROFESSOR KAYCHIKITSAEX PRINCIPIAL/PROFESSOR KAYCHIKITSA
GOVT AYU COLLEGE UJJAIN (M.P.)GOVT AYU COLLEGE UJJAIN (M.P.)
-G.B MEMBER OF RAV NEW DWLHIG.B MEMBER OF RAV NEW DWLHI
-G.B MEMBER OF C.B.P.A.I NEW DELHIG.B MEMBER OF C.B.P.A.I NEW DELHI
-PRESIDENT N.P.A.RPRESIDENT N.P.A.R

2. Introduction
Ayurved is the world’s oldest existing health-care system. It
is a science of health based on universal principles and
profound insights into the connection between mind and
body and the laws of nature which structure all progress in
life.
The miracle of the human body is that it has a natural
healing intelligence which is capable of constantly
rejuvenating itself.
However, when doshic imbalance and weakend digestive
capacity allow toxic impurities to form, this natural capacity
of the body gets blocked. To remady this situation,
Ayurveda offers the gift of Panchakarm, the “Science of
rejuvenation”.

3. Joint diordersders &Vatvyadhi (Neurological
disorders) indicates a group of diseases
charecterised with a number of feature like
contratures, stiffness,pain etc. of the body parts.
 These disease of chronic in nature where the
prognosis usually is not good.
 I have concentrated over some specific features
of Vatvyadhi viz.Vedana, sankoch, stambha and
stabdhata.

4. In the present study clinical trail was conducted
to evaluate the effect of Panchakarm therapy in
some selected joint & neurological disorders.
These cases were selected from the patients
attending O.P.D. and I.P.D. of YMT Ayurvedic
College & hospital Navi Mumbai.
All the selected cases were admitted in the indoor
of this hospital for observation treatment, and
follow-up.

5. Selected Vatvyadhi for present
clinical study
Sandhivat (osteo-arthritis).
Ababahuk (frozen shoulder joint).
Greeva stambha (cervical spondylitis).
Paksha vadha (paralysis).
Griddharasi (sciatica).
Kampavat (Parkinson’s)

6. SANDHIVAT (O.A.)
Treatment –
1. Kalvastikram (16 vasti)
* Anuwasan vasti - Prasarni tail 30 ml + 10 gms of Shatpushpa
churn , It has been given After meal..
* Niruh vati –
- Yava 20gms yavakut, add 800 ml.
- Kulthi 20gms water boil it.
- Bilva guda 20gms 200 ml decoction
- Arandmool 20gms + 20 ml Prasarni tail
- Sarivan 20 gms + 20 ml Honey
+ 10 gms sandhava lavan
 As per references of classics the kalvasti kram has been given – Total vasti = 16

7. * Janu vasti is given by the prasarni tail for
50 minutes followed by
patrapind swed for 15 minutes.
* Shudha shilajeet given in the dose of 500
mg with milk.
* Total treatment period = 30 days
* Total Number of patient = 40 (between 40
to 70 years)

8. 100
50
87.5
100 100
0
20
40
60
80
100
%ofpatients
Percentage
Symptoms
Cardinal Symptoms reported in 40pts.
Sandhishool Sandhishoth Hanti sandhi Vedana Sandhisphutan

9. Cardinal
symptoms
Mean score Relief in % Paired ‘t’ test
B.T. A.T S.D.(±) S.E.(±) t p
Sandhishool 3.4 2.5 73.52 0.87 0.27 0.33 < 0.01
Sandhishoth 3.0 2.0 66.66 0.81 0.26 3.85 < 0.01
Hanti sandhi 3.5 2.0 77.14 0.63 0.23 3.25 < 0.01
Akunchne
prasarne vadana
3.0 2.0 66.67 0.81 0.26 3.85 < 0.01
Sandhisphutan 3.2 2.2 68.75 0.82 0.26 3.84 < 0.01
Effect of therapy on cardinal symptoms of sandhivat

10. 60
65
70
75
80
Percentage
Sandhishool Sandhishoth Hanti sandhi Akunchne
prasarne
vadana
Sandhisphutan
Symptoms
Effect of therapy on cardinal symptoms of sandhivat

11. 10
60
30
0
0
10
20
30
40
50
60
%ofRelief
Overall effect of treatment
- Complete remission
- Major improvement
- Minor improvement
- Unimproved

12. ABABAHUK
* Anshmoolsthito vayuh sira sankochya tatragah.
Bahupraspanditharaha janyatya abababahukam.. v-g-fu-15@43
* Ababahau hitam nasyam, Snehach uttarbhaktikah- a v-g-fu-21@44
* Nasyakarma – Apamarg Avapidan nasya – 8 drops in each nostrils.
Shaman sneh Nasya – vacha tail 4 drops in each nostrils.
(Shaman sneh nasya – 1st
day, Avapidan Nasya – every 3rd
day.
Total course of nasya – 21 days.
•Patrapinda sweda – Erand patra + Nirgundi patra + Ark patra and
Nirgundi tail – 50 ml. For 21 days.

13. Triphala quath – 100 ml. Vasti has been
Gomutra 50 ml. Prepared with
Madhu 20 ml. Proper way and
Yavakshar 10 gms. is given MT STOMACH
Trikatu churn 10 gms. Total vasti - 21days
* Total course of treatment – 21days
* Total pts. between the age of 20 to 60 yrs – 20
Lekhan vasti

14. 100
26.6
16.6
83.3
100
50
93.3
0
20
40
60
80
100
%ofRelief
Chestanivriti Ruja Sandhi
shaithilya
Sankoch
Symptoms
Incidence of cordinal symptoms of Ababahuk.

15. Cardinal symptoms Mean score Relief in
%
Paired ‘t’ test
B.T. A.T S.D.(±) S.E.(±) t p
Ansh vedana 2.75 0.36 86.91 0.8 0.25 9.56 < 0.001
Ansh sankoch 2.71 1.11 59.04 0.49 0.16 10.00 < 0.001
Ansh cheshta hani 1.69 0.43 74.56 0.53 0.17 7.41 < 0.001
Ansh shoph 2.35 0.70 70.21 0.78 0.25 6.60 < 0.001
Effect of therapy on the cardinal symptoms of Ababahuk (20pt)

16. 86.91
59.04
74.56
70.21
0
20
40
60
80
100
Percentage
Percentage
Effect of therapy on the cardinal symptoms of
Ababahuk (20pt)
Ansh vedana
Ansh sankoch
Ansh cheshta hani
Ansh shoph

17. Overall effect of treatment
40
50
10 0
- Complete remission - Major improvement
- Minor improvement - Unimproved

18. GREEVA STAMBHA( Cervical
spnodylitis)
* Diwaswapna asan asthan nivrittordhwa nirikshanaih |
Manyastambham Prakurutey sa ava shleshmana-avratah || (su.ni. 1/67)
* Skandha vakshastrik praptam vayum manyagatam tatha |
Vamanam hantinasyam cha kushalen prayojitam || (Su. Chi. 4/18)
Treatment:-
* Vaman:- by leukwarm water with salt.
* Greeva vasti by Nirgundi tail for 50 minutes followed by patrapind Sweda
for
15 minutes.
* Avapidan nasya by pippali swaras 8 drops in each nostrils and sneha nasya
by
shadvindu tail 4 drops in each nostrils, Total course – 21 days

19. * Niruh vasti:-
• Brahat Panchmool Kwath - 200 ml.
• Pippali churna - 10gms.
• Madhu - 20gms.
• Nirgundi tail - 20gms.
• Sandhava lavan - 10gms.
•Anuwasan vasti - with nirgundi tail in the dose of 30 ml
* Total course of treatment - 30 days.
* Total number of pts. - 20

20. Incidence of cardinal symptoms of cervical
spondylitis
100
100
75
50
Pain in neck Stiffness Giddiness Pain radiating to hands.

21. Cardinal
Symptoms
Mean score Relief
in %
S.D.
±
S.E.
±
t P
B.T A.T.
Pain in neck 2.4 0.6 75 0.32 0.32 5.632 <0.001
Stiffness 2.4 0.6 75 0.32 0.32 5.632 <0.001
Giddiness 2.4 0.8 66.67 0.966 0.305 5.245 <0.001
Pain radiating to
hands
1.9 0.8 55.55 1.247 6.394 2.536 <0.005
Effect of therapy on cardinal symptoms of cervical spondylitis.

22. 75 75
66.67
55.55
0
20
40
60
80
Percentage
Effect of therapy on cardinal symptoms of cervical
spondylitis
Pain in neck Stiffness
Giddiness Pain radiating to hands

23. Overall result of therapy
30%
60%
0% 10%
Cured Major improved Improved unchanged

24. PAKSHAVADHA (Paralysis)
Grahitwardha Tanorvayuh sirah snayu vishoshya cha |
Pakshyamanyatarma hanti sandhibandhanwimokshayan || Su. Nid –1
Kritsno ardhakayastasya syad karmandyo vichetanaha |
Swedanam Snehasanyuktam Pakshaghate virechanam | Ch. Chi 28/10
Treatment :-
• For Abhyanter snehpan - murchit til tail
• For medicated fomentation- sarwang sweda with dash mool qwath
•For Virechana Karma - Erand Mool - 20gms.
Haritki – 20gms. Yavakut
Nishoth – 20gms.
100 ml. Decoction + 30 ml Arand tail
after Mantrocharan verechan kalp has
been given.

25. After samsarjan kram - kalvastikram was given (16 vasti
course)
- madhutailik Niruh vasti
- Anuwasan vasti of bala tail 30ml.
Nasyakarma - sneh navan - Anu tail – 4 drops
- Shodhan navan - vacha tail- 6 drops
Vahya Abhyang and Sarwang washp swedan is continue for 30 days.
Shudha shilajeet - 500 mg twice a day with leukwarm milk
after virechan karma for 15 day
Total treatment course - 30 days
Total no. of pts. - 30

26. 100
26.6
16.6
83.3
100
50
93.3
0
20
40
60
80
100
Percentage
Chestanivriti
Achetan
Ruja
Vakstambha
Sandhi
shaithilya
Bhrama
Sankoch
Symptoms
Cardinal symptoms found in 30 pts of pakshawadh

27. Symptoms Mean Score Relief
In %
Paired test
B.T. A.T. S.D.± S.E.± t P
Chestahani 3.1 1.2 61.3 0.57 0.18 10.59 <0.001
Achetana 3.0 2.0 66.66 0.81 0.26 3.85 <0.001
Ruja 2.5 1.8 72.00 0.48 0.15 4.67 <0.001
Vakstambha 2.5 1.1 56.0 0.84 0.26 5.25 <0.001
Sandhi shaithilya 1.9 0.4 78.9 0.71 0.22 6.71 <0.001
Sankoch 1.7 0.6 64.7 0.32 0.1 11.0 <0.001
Effect of therapy in pakshavadh

28. Effect of therapy in pakshavadh
61.3
66.66
7256
78.9
64.7
Chestahani Achetana Ruja
Vakstambha Sandhi shaithilya Sankoch

29. Overall effect of therapy in 30 pts. of
Pakshawadha
10
70
20 0
Complete remission Major remisson
Minor improvement Unchanged

30. Gradhrasi (sciatica)
Sphikpurva katiprashtoru janu jangha padam kramat |
Gridhrasi stambha ruk todai grahanati spandatey muhuhu || Ch.chi 28/56
Antarakandaragulpham shira vastyagnikarm cha |
Gridharasishu prayunjeet khalyam trishnopnahanam || Ch. Chi. 28/101
Treatment :-
• Katiwasti from Nirgundi tail for 21 days followed by patrapinda sweda.
• Parijat patra quath 30 ml. + Trikatu 5 gms. – twice a day in M.T. stomach.
• Madhutailik vasti has been given for 11 days only
Contains of madhu tailik vasti :-
Arandmool quath -200 ml
Madhu - 20 ml
Murchit til tail - 20 ml
Madan phal - 1
Sandhava lavan - 10 gms.
Shatpushpa churna - 20 gms.
Total treatment course - 30 days
Total patient taken in this study- 30

31. Symptoms Mean score Relief in % SD ± SE ± t p
B.T. A.T.
Pain in buttock 3.5 1.2 65.71 1.06 0.33 6.87 <0.001
Pain in thigh 2.12 0.62 70.75 0.48 0.17 9.53 <0.001
Pain in calf 3.3 1.2 63.64 0.74 0.23 9.00 <0.001
Pain in foot 2.0 0.25 87.5 0.43 0.21 9.52 <0.001
Numbness 2.0 0.71 64.50 0.52 0.21 6.32 <0.001
Stiffness 2.0 0.25 87.5 0.43 0.21 9.52 <0.001
Effect of therapy on cardinal symptoms of Gridharasi.

32. Effect of therapy on cardinal symptoms of
Gridharasi
65.71
70.75
63.64
87.5
64.5
87.5
Pain in buttock Pain in thigh Pain in calf
Pain in foot Numbness Stiffness

33. Overall effect of therapy
33.33
50
16.6 0
Cured Markedly improvement Improved unchanged

34. KAMPVAT (Parkinson’s)
• Snayu praptah stambhkampo …….. Su. Nis 1/27
• Sarvangkampah shirso vayuh vepathu sangyakah | (Madhava Nidan)
Treatment:-
• Sarvangdhara from mahamash tail (2 kg) for 30 days.
• Siddha vasti
• Kal vastikram 16 vasti
Kenwanch beej
- 30 gms
Ashwagandha mool
- 30 gms.
Yava
- 10 gms.

35. 100 100
62.5
93.75
100
0
20
40
60
80
100
Percentage
Kampa Gatisang Vakvikriti Stambhata Chestahani
Symptoms
Incidence of cardinal symptoms of Kampvat

36. Symptoms Mean score Relief in % S.D. ± S.E.± P t
B.T. A.T.
Kampa 3.14 2.28 27.39 0.53 0.20 2.83 <0.02
Gatisang 1.85 1.00 46.33 0.69 0.26 3.29 <0.02
Vakvikriti 2.00 1.28 36.00 0.49 0.18 3.87 <0.01
Stambhata 2.71 1.57 42.07 0.38 0.14 8.00 <0.001
Chestahani 2.00 1.66 17.00 0.52 0.21 1.50 <0.005
Effect of therapy on Kampvat

37. Effect of therapy on Kampvat
27.39
46.33
36
42.07
17
Kampa Gatisang Vakvikriti Stambhata Chestahani

38. Overall effect of therapy
0
50
37.5
12.5
Complete remission Markedly improved
Improved Stable

39. ConclusionConclusion
 In the present day society the disease joint disorders
& vatvyadhi such as Sandhivat, Ababahuk,
Greevastambha, Pakshavadha, Gridhrisi and Kampvat
are with an increasing trend. Ayurvedic scholars have
advocated Panchakarm therapy for their management
effectively.
 Considering the important in clinical features of joint
disorders & Vatvyadhi of this series established
different Panchakarm therapy were selected for trial.
Different selected Panchakarm therapy given on
particular Vatvyadhi was found to be very effective,
evaluated mainly on subjective criterias.

40. ConclusionConclusion
This work is a pioneer one where a new formulation of
panchakarma therapy done on the basis of their
properties on selected Neurological problems.
This clinical trial has undoutebly produce positive
response in all the above cases of joint disorders
&Vatvyadhi in varying degrees with a minimum
duration of treatment without help of any other
medicine of internal or external use. Further work in
this direction with a good number of patients and better
laboratory facilities will create a new era in the
treatment of Vatvyadhi or neurological disorders.