THE COMPARATIVE STUDY OF VIRECHANA KARMA AND BASTI KARMA IN THE MANAGEMENT OF PAKSHAGHATA W.S.R TO C.V.A

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1 Research Aricle Inernaional Ayurvedic Medical Journal ISSN: THE COMPARATIVE STUDY OF VIRECHANA KARMA AND BASTI KARMA IN THE MANAGEMENT OF PAKSHAGHATA W.R TO C.V.A Sharma Brahma Nand 1 Sharma Radhey Shyam 2 1 Assisan Professor, Dearmen of Kaya Chikisa, Universiy College of Ayurved, Dr. R. Rajashan Ayurved Universiy, Jodhur, Rajashan, India 2 Honurable Vice chancellor, Dr. R. Rajashan Ayurved Universiy, Jodhur, Rajashan, India ABSTRACT In Ayurvedic ex here are 80 nanamaj vyadhies which are aribued o vaa dosha, Pakshaghaa is one of hem. Pakshaghaa is a disabling disease which is manifesed as aralysis of one side of he body caused by viiaion of vaa dosha. Hemilegia also caused by a wide secrum of disease rocesses like vascular disorders, infecive disorders of brain issue, umours, rauma ec. Virechana is a rocess by which he viiaed dosha are exelled hrough he adhomarga. Basi heray covers more han half of he reamen of all he disease. Considering boh line of reamens, resen sudy was lanned o comare he efficacy of Virechana & Basi in Pakshaghaa affeced aiens. For his sudy 60 aiens saisfying he selecion crieria were randomly seleced from he OPD & IPD of Panchakarma Dearmen of Naional Insiue of Ayurved (N.I.A), Jaiur, Rajashan, India and equally divided ino hree grous viz., Grou A- Virechana karma wih casor oil, Grou B- Basi karma wih Erandmooladi Niruhana Basi (dose 950 ml) and Maha Masha Taila Anuvasan Basi (lowes dose has been seleced i.e.60 ml) in he form of karma basi for 30 days while in Grou C- boh Virechana and basi wih Erandamooladi Niruhana Basi and Maha Masha Taila Anuvasana basi in he form of karma basi) was adminisered. I is concluded from he sudy ha Grou C shows saisically highly significan resul as comared o Grou A and Grou B. Keywords: Pakshaghaa, Hemilegia, Virechana & Basi karma INTRODUCTION: Pakshaghaa is a mos disressing disease among vaa nanamaja vyadhi. 1 The ahological henomena of vaa laying cenral role in he manifesaion of Pakshaghaa are Suddha vaa rakoa, Anyadosha Samsirsa vaa rakoa and dhaukshayajanya vaa rakoa. 2 Akin o Pakshaghaa, Hemilegia also caused by a wide secrum of disease rocesses like vascular disorders, infecive disorders of brain issue, umors, rauma ec. Among hese vascular acciden or sroke is he commones cause of hemilegia. 3 There are wo major caegories of brain damage in sroke viz-ischemia and hemorrhage, which resul in he desrucion of brain issue via abnormaliies in he blood suly of brain. 4 Sroke is he clinical erm for acue loss of circulaion o an area of he brain, resuling in ischemia and a corresonding loss of neurologic funcion. Classified as eiher hemorrhagic or ischemic, srokes yically manifes wih he sudden onse of focal neurologic deficis, such as weakness,

2 Sharma Brahma Nand & Sharma Radhey Shyam: Sudy of Virechana Karma and Basi Karma in Pakshaghaa W.s.r o C.V.A sensory defici, or difficulies wih language. Whereas diagnosic ar of Pakshaghaa (hemilegia) is srong in modern science, here as no comlee cure is available ill oday now. Here subsanial reasoning for comlee reamen of hemilegia by ayurveda has o be esablished. In Ayurveda disease is reaed by wo mehods as Sodhan (urificaion of dosha by secific rocedures) and shaman (alliaive) reamen. 5 Sodhan eliminaes excessively viiaed doshas ou of he body and mainains homeosasis among doshas. Shodhana heray no only cures he disease bu also eliminaes he causaive facors where as shaman does alliaion of viiaed doshas roviding symomaic relief. 6 Shodhana of body is done by anchakarma (enaurificaion) heray viz Vaman (emesis), Virechana (urgaion), Anuvasana, Niruha Basi (medicaed enema) and Nasaya Karma (inhalaion heray). 7 By Virechana, doshas are eliminaed hrough he adhomarga from body. 8 Basi is he mos imoran consiuen of he Panchkarma due o is mulile effecs. Basi eradicaes morbid vaa from he roo along wih oher dosha and in addiion rovides nuriens o he body issue. 9 Therefore; basi heray covers more han half of he reamen of all he disease 10 while some auhors consider i as he comlee remedy for all he ailmens. Basi is considered he bes remedy for morbid Vaa bu according o Sushrua, i can also be used in Kahaja and Piaja disorders by using differen ingrediens. 11 There fore, keeing his view of Charaka & Sushrua in mind, auhor has seleced boh rocedures; Virechana & basi 12,13 for he comaraive sudy in he managemen of Pakshaghaa w.s.r o cerebral vascular accidens (CVA) AIMS & OBJECTIVES To sudy he effec of virechana karma To sudy he effec of Basi karma To sudy criically abou akshaghaa w.s.r. o CVA. To comare he effec of virechana karma and Basi karma in managing akshaghaa. MATERIAL AND METHODS A. Subjec 60 subjecs saisfying he selecion crieria were randomly considered for he resen sudy & equally divided ino hree grous A, B & C. B. Source of Subjec Selecion of he aiens was made from he O.P.D & I.P.D of Panchakarma dearmen of Naional Insiue of Ayurved (N.I.A), Jaiur, Rajashan, India. C. Selecion Crieria i. Inclusion crieria Subjecs wih less han 2 year chroniciy of disease. Subjecs wih age grou years. Only Hemilegia due o C.V.A. ii. Exclusion crieria Unconscious aiens Paiens of unconrolled diabees Age above 70 years Hemilegia due o rauma, Todd's aralysis Hemilegia due o Inracranial Infecion and SOL. Hyseria 191

3 Sharma Brahma Nand & Sharma Radhey Shyam: Sudy of Virechana Karma and Basi Karma in Pakshaghaa W.s.r o C.V.A Associaed cardiac disease like IHD and M.I D. Sudy design Randomized clinical rial during year in Jaiur, Rajashan. E. Drug Adminisraion Grou A - In 20 aiens virechana karma wih Eranda Thaila (dose 60 ml) has been given afer abhyanara samyaka snehana and swedana Grou B - In 20 aiens Basi karma wih Erandmooladi Niruhana 2. Assessmen Crieria Basi (dose 950 ml) and maha masha aila Anuvasan Basi (dose 60 ml) in he form of karma basi which has been given afer smayaka snehana (exernal) and swedana. Grou C - In 20 aiens boh virechana and basi (wih Erandamooladi Niruhana Basi and Maha masha aila Anuvasana basi in he form of karma basi) have been given afer smayaka snehana (exernal) and swedana. SUBJECTIVE PARAMETERS Objecive Parameer 1. Chesa Nivrii Comlee blood coun (CBC) 2. Rujam (Pain) Liid rofile 3. Vaksambha (Seech) RBS 4. Acheana (Loss of sensaion) CT/ MRI (Oional in re diagnosed aiens) 5. Gouravaa (Heaviness) 6. Shoha (Oedema) 7. Vibandha (Consiaion) 8. Daha (Burning sensaion) OBRVATION Observaion Maximum Percenage 1. Age 51-60yrs Religion Hindus Sex Male Marial Saus Married Educaion Graduaion Occuaion Business Socioeconomic saus Middle

4 Sharma Brahma Nand & Sharma Radhey Shyam: Sudy of Virechana Karma and Basi Karma in Pakshaghaa W.s.r o C.V.A 8. Dieary aern Vegearian Habia Urban Sharirka Prakrai Pia kahaja Manas Prakrai Rajas Sara Twak Sava Madhyam Samhanana Madhyam Samya Madhyam Kosa Krura Jahragni Manda Vyayam Shaki Avara Desha Sadharana Addicion Tea/ Coffee Naure of lesion Infarcion RESULTS - All resuls were saisically analyzed by alying Tes. Table no 1. Effec of heray on Cardinal Symoms of Grou A Symoms N Mean Dif. % of T 1. Ruja < Vaksambha > Acheana < Gurua < Vibandha < Shoha < Daha < Shirahshula >0.05 Table no 2. Effec of heray on Cardinal Symoms of Grou B 193

5 Sharma Brahma Nand & Sharma Radhey Shyam: Sudy of Virechana Karma and Basi Karma in Pakshaghaa W.s.r o C.V.A Symoms N Mean Dif. % of 1. Ruja < Vaksambha < Acheana < Gurua < Vibandha < Shoha > Daha < Shirahshula <0.05 Table no 3. Effec of heray on Cardinal Symoms of Grou C Symoms N Mean Dif. % of 1. Ruja < Vaksambha < Acheana < Gurua < Vibandha < Shoha < Daha < Shirahshula <0.05 Table no 4. Effec of reamen on Liid Profile level & Blood Sugar Invesigaions N Mean Dif. % of 1. Serum Choleserol < HDL > LDL < VLDL >

6 Sharma Brahma Nand & Sharma Radhey Shyam: Sudy of Virechana Karma and Basi Karma in Pakshaghaa W.s.r o C.V.A 5. Triglyceride < Blood sugar >0.05 Table 5 Effec of reamen on Liid Profile & Blood sugar of Grou B Invesigaions N Mean Dif. % of 1. Serum Choleserol < HDL > LDL < VLDL > Triglyceride < Blood sugar >0.05 Table No 6.Effec of reamen on Liid Profile & Blood sugar of Grou C Invesigaions N Mean Dif. % of 1. Serum Choleserol < HDL < LDL < VLDL < Triglyceride < Blood sugar >0.05 Table no 7. Effec of heray on Chesa Nivrii (Loss of funcion) of Lower exremiies in Grou A Symoms N Mean Dif. % of 1. Abiliy o si on he bed 2. Abiliy o sand from siing > >0.05 P P 195

7 Sharma Brahma Nand & Sharma Radhey Shyam: Sudy of Virechana Karma and Basi Karma in Pakshaghaa W.s.r o C.V.A osiion 3. Abiliy o ge down from bed 4. Abiliy o walk 5. Time required o walk 10 mr > > >0.05 Table 8. Effec of heray on Chesa Nivrii (Loss of funcion) of Uer exremiies in Grou A Symoms N Mean Dif. % of 1. Srengh of Gri 2. Pressing ower 3. Abiliy o wear dress 4. Abiliy o handle he book 5. Abiliy o ick in > < > > >0.05 Table 9: Effec of heray on Chesa Nivrii (Loss of funcion) of Lower exremiies in Grou B Symoms N Mean Dif. % of 1. Abiliy o si on he bed 2. Abiliy o sand from siing osiion > <

8 Sharma Brahma Nand & Sharma Radhey Shyam: Sudy of Virechana Karma and Basi Karma in Pakshaghaa W.s.r o C.V.A 3. Abiliy o ge down from bed 4. Abiliy o walk 5. Time required o walk 10 mr < > <0.05 Table 10: Effec of heray on Chesa Nivrii (Loss of funcion) of Uer exremiies in Grou B Symoms N Mean Dif. % of 1. Srengh of Gri < Pressing ower < Abiliy o wear dress 4. Abiliy o handle he book 5. Abiliy o ick in > < >0.05 Table 11: Effec of heray on Chesa Nivrii (Loss of funcion) of Lower exremiies in Grou C Symoms N Mean Dif. % of 1. Abiliy o si on he bed 2. Abiliy o sand from siing osiion 3. Abiliy o ge down from bed < < < Abiliy o walk < Time required <

9 Sharma Brahma Nand & Sharma Radhey Shyam: Sudy of Virechana Karma and Basi Karma in Pakshaghaa W.s.r o C.V.A o walk 10 mr. Table 12: Effec of heray on Chesa Nivrii (Loss of funcion) of Uer exremiies in Grou C Symoms N Mean Dif. % of 1. Srengh of Gri < Pressing ower < Abiliy o wear dress 4. Abiliy o handle he book 5. Abiliy o ick in > < >0.05 Table no. 13 Comaraive effec of heraies on Tone (Hand) Grous N Mean Dif. % of 1. A < B < C <0.05 Table 14 Comaraive effec of heraies on Tone (Leg) Grous N Mean Dif. % of 1. A > B < C <0.05 Table 15 Overall effec of heraies in ercenage Overall effec of heray Grou A Grou B Grou C 1. Comlee Remission 0% 5% 10% 2. Marked Imrovemen 20% 20% 50% 198

10 Sharma Brahma Nand & Sharma Radhey Shyam: Sudy of Virechana Karma and Basi Karma in Pakshaghaa W.s.r o C.V.A DISCUSSION Moderae Imrovemen 45% 55% 30% 4. No Imrovemen 35% 20% 10% Grou A: Grou A, saisically significan (P<0.05) resul found in Ruja, Acheana, Gurua, Vivandha, Shoha and Daha, while saisically insignifican (P>0.05) resuls were observed in vaksambha. (Table 1).Imrovemen in Chesa Nivrii of lower exremiies was saisically insignifican (>0.05). Imrovemen in Chesa Nivrii of uer exremiies in ressing ower, was saisically significan (P<0.05), while remaining uer exremiies were saisically insignifican (>0.05). (Table 4&5). Imrovemen in one of uer Limb (hand) was saisically significan (P<0.05), while in Lower limb (Leg) i was saisically insignifican (P>0.05). (Table 13&14) Imrovemen in serum choleserol, LDL, & Triglyceride were saisically significan (P<0.05). (Table 10). In his grou, no aien showed comlee remission, 20% aiens were markedly imroved, moderae imrovemen is found in 45% aiens and no imrovemen was observed in 35% of aiens. (Table 15) Grou B:Grou B saisically significan (P<0.05) resul found in Ruja, Vaksambha, Acheana, Gurua, Vibandha, Daha and Shirashula, while saisically insignifican (P>0.05) resul was observed in shoha. (Table 2). In Chesa Nivrii of lower exremiies, saisically significan (P<0.05) resuls were found in abiliy o sand from siing osiion, abiliy o ge down from bed and ime required o walk 10 meer, while saisically insignifican (P>0.05) resuls were observed in abiliy o si on he bed abiliy o walk. (Table 6). In Chesa Nivrii of uer exremiies, saisically significan (P<0.05) resuls were found in Srengh of gri, Pressing ower and Abiliy o handle he book, while saisically insignifican (P>0.05) resuls were observed in abiliy o wear dress and ick u a in. (Table 7). Imrovemen in one (uer limb) was saisically highly significan (P<0.01) and saisically significan (P<0.05) was found in lower limb. (Table 13&14) Imrovemen in Serum choleserol LDL and riglyceride were saisically significan (P<0.05). (Table 11). In his grou 5% aiens showed comlee remission 20% aiens were markedly imroved, moderae imrovemen was found in 55% aiens and No imrovemen was observed in 20% of aiens. (Table 15) Grou C: Grou C saisically highly significan (P<0.01) resul found in Ruja, Acheana Vibandha and Daha, while saisically significan (P<0.05) resuls were observed in Vaksambha, Gurua, Shoha and Shirahshula. (Table 3). Imrovemen in Chesa Nivirii of lower exremiies were saisically highly significan (P<0.01) in abiliy o ge down from bed, while saisically significan (P<0.05) resul were observed in abiliy o si on he bed. (Table 8). Imrovemen in Chesa Nivirii of uer exremiies in srengh of gri, ressing ower and abiliy o handle he book were saisically significan (P<0.05), and saisically insignifican (P>0.05) resuls were observed in Abiliy o wear dress and Abiliy o ick

11 Sharma Brahma Nand & Sharma Radhey Shyam: Sudy of Virechana Karma and Basi Karma in Pakshaghaa W.s.r o C.V.A in. (Table 9). Imrovemen in one were saisically significan (<0.05). Imrovemen in serum choleserol and VLDL were highly significan (P<0.01). (Table 13&14) Significan (P<0.05) changes observed in HDL, LDL and Triglyceride. (Table 12). In his grou, 10% aiens showed comlee Remission. 50% aiens were markedly imroved, moderae imrovemen found in 30% aien and No imrovemen was observed in 10% of aiens. (Table 15) CONCLUSION I is concluded by above sudy ha Grou A and Grou B show saisfacory resuls bu comaraively Grou C shows higher ercenage of relief. So, he oal effec of heraies shows ha in comarison o Grou A and Grou B, Grou C shows beer resuls which could be due o he cumulaive effec of Virechana & Basi karma. Presen work concludes wih he meaning ha combined use of Virechana & Basi karma will be more beneficial and effecive, so i is advisable o use boh heraies ogeher (resec ively) in he managemen of Pakshaghaa. Acknowledgemen: The auhors acknowledge he hanks o Dr. Harish Kumar Singhal, Assisan Professor, Dearmen of Kaumarbhriya, Dr S R Rajashan Ayurved Universiy, Jodhur for conribuing valuable suggesions. REFERENCES 1. Charka samhia edied wih Vidyoini, Hindi commenary by Pandi Kashinah Panday and Dr. Gorakhnaha Chaurvedi, Chaukhambha Bhari Acadamy, Varanasi, Rerin ediion , Sura shana, Verse no.20/11, Susrua Samhia edied wih Ayurveda- Tawa- Sandiika, Hindi commenary by Kaviraja Ambika Dua Shasri, Chaukhamba Sanskri Sanshan, Varanasi, India, Rerin 2005, Nidana shana, verse no 01/63, Davidson s Princile & Pracice of Medicine by Nicholas A. Boon, Nicki R. Colledge, Brian R. walker and John A. A. huner,chuchill Livingsone Elsevier ublicaion 20 h ediion 2006, Davidson s Princile & Pracice of Medicine by Nicholas A. Boon, Nicki R. Colledge, Brian R. walker and John A. A. huner,chuchill Livingsone Elsevier ublicaion 20 h ediion 2006, Asanga Hridaya of Vagbhaa edied wih Ayurveda- Vidyoani, Hindi commenary by Kaviraja Aridev Gu, Chaukhambha Sanskri Sanshan, Varanasi, India, Rerin 2005, Sura shana, verse no. 1/25, Charka samhia edied wih Vidyoini, Hindi commenary by Pandi Kashinah Panday and Dr. Gorakhnaha Chaurvedi, Chaukhambha Bhari Acadamy, Varanasi, Rerin ediion 2008, Sura shana, Verse no.16/20, Charka samhia edied wih Vidyoini, Hindi commenary by Pandi Kashinah Panday and Dr. Gorakhnaha Chaurvedi, Chaukhambha Bhari Acadamy, Varanasi, Rerin ediion 2008, Sura shana, Verse no.7/47-48,.169.

12 Sharma Brahma Nand & Sharma Radhey Shyam: Sudy of Virechana Karma and Basi Karma in Pakshaghaa W.s.r o C.V.A 8. Charka samhia edied wih Vidyoini, Hindi commenary by Pandi Kashinah Panday and Dr. Gorakhnaha Chaurvedi, Chaukhambha Bhari Acadamy, Varanasi, Rerin ediion 2008, Sura shana, Verse no. 16/20, Asanga Samgraha of Vagbhaa, English ranslaion by Prof. K.R. Srikanha Murhy, Vol-I Chaukhambha Orienalia, Varanasi, India, 1999, Sura Shana, verse no. 28/ Charka samhia edied wih Vidyoini, Hindi commenary,pandi Kashinah Panday and Dr. Gorakhnaha Chaurvedi, Chaukhambha Bhari Acadamy, Varanasi, Rerin ediion 2008, Siddhi shana, Verse no. 1/40, Susrua Samhia edied wih Ayurveda- Tawa- Sandiika, Hindi commenary by Kaviraja Ambika Dua Shasri, Chaukhamba Sanskri Sanshan, Varanasi, India, Rerin 2005, Chikiasa shana, verse no 35/6, Charka samhia edied wih Vidyoini, Hindi commenary by Pandi Kashinah Panday and Dr. Gorakhnaha Chaurvedi, Chaukhambha Bhari Acadamy, Varanasi, Rerin ediion 2008, Chikiasa shana, Verse no.28/100, Susrua Samhia edied wih Ayurveda- Tawa- Sandiika, Hindi commenary by Kaviraja Ambika Dua Shasri, Chaukhamba Sanskri Sanshan, Varanasi, India, Rerin 2005, Chikiasa shana, verse no 5/19,.33. CORRESPONDING AUTHOR Dr. Brahma Nand Sharma Assisan Professor, Dearmen of Kaya Chikisa, Universiy College of Ayurved, Dr. R. Rajashan Ayurved Universiy, Jodhur, Rajashan, India Source of suor: Nil, Conflic of ineres: None Declared 201