Ayurvedic Management of Stroke (Hemiplegia)

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About the Author:

Name: K. Nishteswar
Date of Birth: 6-6-1955
Academic Qualifications: B.A.M.S., M.D., PhD., C.F.N., Sanskrit Vichakhana
Merit Awards: 12 Merit Awards
Professional Occupations: Lecturer, Research Assistant, Clinical Registar
Books Published: 20
Paper Published in Standard Journal: 60
Seminars/ Workshops/ Conferences/ Guest Lectures
Attended: 24
Associated Editor: Journal; of Indian Medicine
Radio Talks: 10 for Propogation of Ayurveda
Research Projects: 2

The term stroke or cerebro-vascular accident (CVC) have fallen into disrepute: the first because it carries no information the second because of concern about whether the disorder is actually' accidental'. Stroke is defined as a rapidly developed clinical signs of focal disturbance of cerebral functions of presumed vascular origin and it may be due to cerebral haemorrhage, thrombosis, or embolism. There is more or less sudden paralysis affecting one side of the body; motor, sensory visual or speech functions are affected. The term paksha means half of the body and loss of function of paksha is seen in pakshaghata. It is mianly a vata vyadhi and pitta and kapha doshas also associate vata in the causation of the disease. Charaka observes that sira snayu vishoshana leads to pakshaghata, but sushruta notes the involvement of dhamani in the pathogenesis of pakshaghata. Chakrapani says that without understanding the prakruti (physiology) correct knowledge of vikruti (pathology) is not possible. The implications of sira, dhamani and srotas are very essential to under- stand the pathogeness of pakshaghata. A critical and careful study of Ayurvedic classics confirms that the structures like sira and dhamani convey vascular structures of the body.

Any treatment undertaken without the correct knowledge of the disease meets with success only accidentally. The knowledge of the disease is to be obtained through the study of nidana, pragrupa, lakshana, upasaya and samprapti. The descriptions of Nidana etc., of the few diseases in the text are not exhaustive. They explain only the fundamental approach to be adopted. Whatever is not stated explicitly is to be inferred by the intelligent physician. Sastra aided with one's intelligence makes a physician successful in the art of healing. The in- volvement of dosha and dushyas, the site and mode of onset are the three important things to be taken into account to plan rational therapy. Though in understanding a disease the five aspects of nidana, purvarupa, lakshana, upasaya and samprapti are important the last one is most important as the treatment is only to negativate or destroy samprapti. The assessment of samprapti depends on the assessment of certain important pathological factors like agnidushti, ama, srotodushti etc.

Vata seems to be important dosha in pakshaghata and dushyas involved are rasa, rakta or rasa rakta complex. Stroke may be due to degenerative, inflammatory and atherosclerotic changes in vascular structures which correspond to condition of vata, pitta and kapha dominance respectively. Though vasti karma is recommended mainly for vata dosha among sodhana measure, virechana is recommended by acharyas for pakshaghata. Snehana and swedana measures are very useful for subduing vata dosha and drugs like shilajit and guggulu suggested by Acharyas in the conditions of vat a prakopa due to avarnam should be given prime importance while planning a rational treatment for pakshaghata.

Anti-hypertensive and anti-coagulant agents are used in management of strok depending upon the etiology and recent researches have recorded some potent Anti - Hypertensive and Anti-Coagulant agents from indigenous systems of Medicine. Lasuna and palandu are having significant fibrinolytic property. Guggulu significantly reduces elevated values of choles- terol and is very useful in the conditions of Hyper- Cholesteremia and hyperlipidemia. Sankhapushpti, japa kusuma and Iatamansi, are found to possess significant anti- hypertensive property. Sarpagandha which shares a common name nakuli with rasna is some what akin to rasna in rasa, guna, virya, vipaka etc., such being the case whyrasna was given important place among vata hara durgs as Rasna vata haranam. Rasna is extensively used in number of vat a disease including pakshaghata, ardita etc., which are precipitated by hyperntension. Compared to sarpagandha, rasna is safer drug free from any side effects. For prevention of hypertensive vas- cular disease and cerebra vascular accidents it will be highly beneficial to follow the principles of acharya rasayana, sadvritha and general rasayana measures which minimise the impact of excessive stress so characteristic of modern society. An attempt is made in the following pages to describe the above pertaining to understanding and treatment of pakshaghata. A review about single and compound preparations indicated in different vata disorders. including Pakshaghata is made in the following pages with a critical analysis. The observations of a clinical study with sunthi churna consiting of sunthi and lasuna in the management of pakshaghata is also discussed separately.