ISSN: 2322 - 0902 (P)

ISSN: 2322 - 0910 (O)

International Journal of Ayurveda
and Pharma Research

Review Article

A COMPREHENSIVE STUDY OF VATA RAKTA W.S.R. TO GOUT

Vikas Rana1*, Anjana Mishra2, B.L.Mehra3
*1Kayachikitsa, 2Reader, 3H.O.D., P.G. Department of Kayachikitsa, R.G.G.P.G.Ayu.College & Hospital, Paprola, H.P., India.
ABSTRACT
The rapid modernization in India, fast food culture, stressful and speedy life, prevalent in urban areas is
spreading its wings in remote villages too. Nowadays human beings are vulnerable to many disorders due
to their altered life style and food habits. Among such metabolic disorders Vatarakta is one of them.
Vatarakta is more distressing and common metabolic disorder prevalent in present era. It is characterised
by severe pain, tenderness, inflammation and burning sensation in the affected joints. It is a Vatapradhana
tridoshaja vyadhi where Rakta is main Dushya. Vatarakta is an illness where both Vata and Rakta are
afflicted by distinct aetiological factors. Sedentary lifestyle along with mental stress, consumption of non-
vegetarian and highly protein diet, excessive alcohol intake are some of the precipitating factors which
causes acute exacerbation of Vatarakta. The aetiological factors responsible for Gouty arthritis, pathology
and clinical features are quite similar with the Vatarakta.
Due to excruciating pain, inflammation, joint deformity and restricted joint movements with the risk of
various complications like urate nephropathy and urate nephrolithiasis its necessary to have a complete
overview on all aspects of disease for treatment. Management of Vatarakta is a challenge as it is a disease of
severe morbidity, chronicity and incurable to certain extent with associated complications. With certain life
style modifications like low protein diet etc. and certain Ayurveda modalities viz. Shodhana and Shamana
Chikitsa its can be cure and prevented.
KEYWORDS: Ayurveda, Vatarakta, Vata, Rakta, Gouty arthritis.
INTRODUCTION
The health of an individual depends solely on the affected joints. It has two stages i.e., Uthana and
his/her diet and lifestyle. Nowadays human beings are Gambhira.[1,3] Gambhira Vatarakta mainly affects
more vulnerable to metabolic disorders due to their faulty Asthidhatu and Causes Ruja which spreads as Aakhorvisha
dietary habits and life style. These disorders may be (rat poison).[2] Intense painful condition, initial site of
causing functional impairment or crippling disorders like manifestation i.e. involvement of hands and feet, and other
Vatarakta. The disorder produced by conjugation of clinical features can be compared with gout described in
vitiated Vata and Rakta generate multiple health ailments modern medicine. The gout is also known as “disease of
and most important of them is Vatarakta.[1] Hence it has kings” and also “king of diseases” in modern medicine.(7)
been described as a separate disease entity in Charaka Gout is a metabolic disorder and inflammatory response to
Samhita. There are many references along with description monosodium urate crystals formed secondary to
of this disease in classical texts under the name of hyperuricemia.[9] In 21st century, gout remains the most
Vatarakta, Adhyavata, Vatabalasa and Khuddavata. [1,3] The common inflammatory arthritis in men over 40 years old
rich those who have plenty of resources and are delicate, and in post–menopausal women, although more common
are mostly affected with the disease so it also named as in men (10:1). The number of cases rise with age, from
Aadhyavata. Similarly, “Khudda” means joint and small, 2/1000 in males aged 18 - 44 and 34/1000 in males of age
hence the disease affecting mostly the smaller joints of the 45-65 years. Number of self-reported cases of gout in
body is called as Khuddavata. U.S.A. increased from 2.1 million to 3.0 million over a ten
Both Vataprakopak and Raktaprakopaknidan are year period (from 1990-99) making it more prevalent than
involved in Samprapti of the disease.[2] When a person R.A.[11] Its prevalence is increasing; more over it is a
does not opt for purification processes like Vamana and potential signal for unrecognized comorbidities like
Virechana or due to trauma, Raktadhatu gets vitiated. The obesity, metabolic syndrome, diabetes mellitus,
same individual with vitiated Raktadhatu when starts hypertension and renal disease etc. Patients of gouty
taking Vata-prakopakahara and Vihara, become prone to arthritis land up in severe joint destructions. The common
Vata-vridhhi. Already vitiated Raktadhatu obstructs the complications in patients of gout are urate nephropathy,
path of Vridhhvata, in which the Vata has to flow. Vitiated uric acid nephropathy and nephrolithiasis.[8] Due to its
Vata becomes Aavrut with vitiated Raktadhatu. Vridhh and remittent and relapsing nature and complications, there
obstructed Vata inturn vitiates the whole Rakta and is no permanent cure of this disease, which is a
manifests as Vatarakta.[1,14] It is characterised by severe challenge for 21st century. Management of Vatarakta is a
pain, tenderness, inflammation and burning sensation in challenge as it is a disease of severe morbidity, chronicity

IJAPR | September 2017 | Vol 5 | Issue 9 93

 Int. J. Ayur. Pharma Research, 2017;5(9):93-96
and incurable to certain extent with associated - Excessive intake of oil-cake preparations or raddish.
complications. Though a number of drug regimens have - Excessive intake of Kulatha (Macrotyloma uniflorum),
been advised for the management of gout in the modern Masha (Vigna mungo), Nishpavshaak (Dichous lablab),
medicine like NSAIDs, Colchicine, Corticosteroids, Pinyak (Sesamum Indicum), leafy vegetables and
Antihyperuricemic drugs and Uricosuric agents. [9] The sugarcane (Saccharum).
entire above are associated with adverse effects and - Excessive intake of curd, Aranala (kanji), Sauvirak,
certain limitations. So there is need to understand the Sukta (vinegar), Takra (butter milk), alcohol and wine.
pathogenesis of the disease to break down the vicious
Viharajanidana [1,2]
circle of Doshas. In Ayurvedic texts, two types of treatment
of Vatarakta are mentioned such as Samanya Chikitsa -Excessive anger, Divaswapan, Ratrijagran, Abhighata,
(General management) and Vishishtha Chikitsa (Specific Ashuddhi, Acankramanasilata.
treatment according to classification). In Vishishtha -Riding on elephant, horse and camel.
Chikitsa after careful diagnosis on the basis of stages of -Excessive swimming, excessive sexual indulgence.
disease i.e. Uthana or Gambhira specific treatment is Mansiknidana: [1]
planned. -Akrodha, Acinta and Harshanityatva.
AIMS AND OBJECTIVES Prkruti based Nidana[1,2]
- To review the available literature in Ayurvedic text and - The individuals who are Sukumaar, obese and
its correlation with modern literature on Gout. consuming unwholesome diet are mainly affected.
- To review the Vatarakta in context of Gout. Overweight person also surrenders the exercise
- To review the role of diet and life style in the prevention schedule so chances of getting Kaphamedasdusti are
of Vatarakta. increased. Kaphamedasdusti further add up to the
MATERIALS AND METHODS etiology of this disease.
Conceptual Review Agantuja Nidana (Miscellaneous factors)
Description of disease Vatarakta is given in - Exogenous factors which vitiate the Dosha and Dhatu.
Brihattrayi and in all successive texts. From the period of Nidana of Vatarakta vis-à-vis Etiology of Gouty
Charaka onwards, the disease Vatarakta has been Arthritis
described as a separate disease entity. The comparison of etiology of the disease according
Etymology to Ayurvedic as well as modern view is as follows.
The disease which occurs due to the derangement 1. Lavana rasa- Dehydration is discussed as provocating
of Vata and Rakta is known as Vatarakta (Shabda-Kalpa cause of gout attacks and salt is the leading cause of
Druma). The disease caused due to Vatadohsa and dehydration. Excess salty food does not allow water to
Raktadhatu is called as Vatarakta (Chakrapaniteeka).[1] The excrete out of the body and no flushing of uric acid from
vitiated Raktadhatu obstructs Vata results in Vatasonita the body occurs. So Lavana rasa precipitate the gout.
(Ashtanga Hridaya). [3] The disease which is resulted due to 2. Shaak- The intake of high purine rich diet like spinach
vitiation of Vatadosha and Raktadhatu leading to the or asparagus, cauliflower etc. vegetables can cause gout
specific Samprapti, is known as Vatarakta (Madhukosha attack. [13]
teeka).[4] 3. Mulak, Kulath, Masha, Nishpaav- Raddish, legumes
Synonym (dried beans, peas), pulses (along with testa) are rich in
Aadhya Vata, Khudda Vata, Vata Balasa, Vatashonita, purine which on metabolism form uric acid as end
Vatarakta. [1,3] product. [7]
Nidana / Etiology 4. Dadhi, Takra- These dairy products are also rich in
Different Nidana of Vatarakta have been mentioned in protein content so they can also increase the uric acid
Ayurvedic texts and can be classified into following groups: level but according to recent researches, dairy products
helpin reducing serum uric acid.
1. Aharaja Nidana - Causes related to dietary habits.
5. Anoopdeshiyamansa, Ambujamansa- All non-
2. Viharaja Nidana - Causes related to individual habits vegetarian foods mainly seafood like salmon, mackerel
and environmental factors.
and red meat contain large amount of purines. [8]
3. Mansika Nidana- Causes related to psychological 6. Arnala, Souvira, Shukta, Sura, Asava-These fermented
factors. drinks also contain high purine content. According to
4. Agantuja Nidana- Exogenous factors. modern science, alcohol consumption is a significant
5. Prakriti based Nidana - Miscellaneous factors. risk factor for gout because it reduces urate excretion
Aharaja Nidana ¹ ( ) and increases urate production in blood. [8]
- Excessive intake of foods and drinks that are having 7. Anashana, Langhana– As in starvation like condition,
Lavana, Amla and Katu rasa or Snigdha, Ushna, Klinna, body starts metabolizing its own tissues (purine rich)
Ruksha, Ushna, Vidahi and Ksara in quality. for energy. So in this condition, amount of purine
- Excessive intake of saline, sour, pungent, alkaline, converted to uric acid is raised. Starvation like stress
unctuous (oil, greasy), hot and uncooked food. condition also hampered the kidney’s ability to excrete
uric acid due to competition for transport between uric
- Intake of flesh of aquatic and marshy land inhabiting acid and ketones. [8]
animals.
Available online at: http://ijapr.in 94
 Vikas Rana, Anjana Mishra, B.L.Mehra. A Comprehensive Study of Vata Rakta w.s.r. to Gout
8. Mithyahara, Virudhhashan- Ingestion of food/drinks retention of acidic wastes in the blood including uric
kept in lead lined container or its inhalation when acid, which should be flush out from the body, causing
handling it on daily basis (occupationally like in hyperuricemia.
plumbers, painters etc.) leads to chronic lead poisoning, 11. Achankraman–Gout is also known as “Disease of
which is also an etiology factor for gout (V. Batuman et. Kings” or “Rich man’s Disease” since long time, because
al, 1968). Other than this, excessive ingestion of certain it is linked with sedentary lifestyle. Though the disease
drugs like aspirin, diuretics can be included in Mithya affects anyone in society but found to be more
Ahara. [10] prevalent in persons with sedentary lifestyle. [10]
9. Ikshu, Mishthannabhojana– These food items are rich 12. Abhighataj–Trauma like stress full conditions is also a
in fructose. Fructose rich diet (fruit juices and fructose trigger factor for gout attacks. [8]
rich sweetened soda) is found to be the common cause 13. Ativyayam, Ativyavaya–Excessive muscular exertion
for gout attacks. It increases uric acid production (by doing heavy work) leads to increased degradation
during its phosphorylation by increasing adenosine of ATP into AMP, which helps in raising the uric acid
triphosphate (ATP) degradation to adenosine level. [8]
monophosphate (AMP), a uric acid precursor. So within 14. Sthaulya–Obesity, in present days, is not an
minutes after ingestion of fructose infusion, uric acid independent cause but main risk factor of gout.
concentration is increased. [10] According to Campion EW.et al, 1987, Body Mass Index
10. Shushkaahara –Water is responsible for diuresis in the (BMI) is a significant predictor for the development of
body so removes acidic wastes from the body. gout. [10]
Decreased amount of water inside the body causes
Samprapti
Samprapti of Vatarakta

Doshaparkopak Dhatudaurbalyakara Agni mandyakara

Nidana Nidana Nidana

Katu, Tikta, Alparuksa Lavana, Amla, Katu, Ksara, Misthanasukhbhojinam,

Aharasevan, Annasana alp, Snigdha, Ahara sevana, Klinna, Virudhadhyasana,
Rukshaharaadhayustrayan, Susaka and anupa mamsa Asudhaya, Acakaraman,
Ambukrida, Ratrijagran, Palvan, Pinyaka, mulaka, Kulathi, Masa, Sheeltanam
Vegavidharanratrijagrana Nispava sevana dadhi, Sauvira,
Amala, Sukta, Takra, Sura, Asava

Vata Parkopa Rakta Dhatu Dushti Ama Uttpatti

Sancharan of vitiated Vata & Rakta in the whole body

Khaivagunaya in Raktavahstrotas

Obstruction in the path of vata and sthanasanshraya

Vatarakta

Uttana (superficial) Gambhira (deep seated)

Twaka mamsa ashrita Sandhigataashrita

IJAPR | September 2017 | Vol 5 | Issue 9 95

 Int. J. Ayur. Pharma Research, 2017;5(9):93-96
Pathya- Apathya Vatarakta. Pathya and Apathya are very important factors
Pathya for Vatarakta: The cereals like the old Barley, in the management of gout like metabolic disorder. So
wheat, Sali as well as Shashtika types of rice should be along with medicine disease can be better controlled by
included in diet. Leafy vegetables like Kakamachi (Solanum avoiding all such precipitating factors.
nigrum), Vastuka (Chenopodium album), Soup of Adhaki CONCLUSION
(Cajanus indicus), Chanaka (Cicer arietinum), Masura The prevalence of life style disorders is rising
(Lentil), Mudga (Psoralea radiatus) added with Ghrita in rapidly. The best thing which can be done in current
liberal quantity should be taken. Milk of cow, buffalo and scenario is to prevent it rather than cure. Vatarakta is also
goat is Pathya for Vatarakta patients. [1,3] a life style disorder of today world. Excessive purine diet
Apathyafor Vatarakta: Vatarakta patients should avoid and sedentary life style are the causative factor of the
meats, seafood, high purine vegetables such as asparagus, disease. Disease can be controlled by adopting certain life
spinach, peas, cauliflower or mushrooms and alcohol. style changes like excessive water intake, reducing body
Persons should also not take hot, heavy Abhishyandiguna weight and low purine diets. In advance cases there may
and Ushna veeryas food ingredients as Masha, Kullatha, be need of some herbal drugs which can remove excess
curd, sugarcane, radish, alcohol, Tilataila, Kanji, Saktu, uric acid present in the body and alleviate symptoms of the
jackfruit and brinjal etc. Also avoid sleep during day time, disease.
exposure to heat, intercourse, excessive exercises and REFERENCES
excessive intake of pungent, saline and alkaline taste. 1. VaidyaJadavaji Trikamji Acharya. Charaka Samhita of
Incompatible diets should be avoided by the patients Chakrapanidutta (1992) edited by Publishers Munshi
suffering from Vatarakta. Ram ManoharLal Pvt. Ltd. New Delhi.
Management:-Two types of treatment of Vatarakta are 2. Kaviraj Dr. Ambika Dutta Shastri commentary.
described. Sushruta Samhita (1987) Vol-I and Vol-II,
a) Samanya Chikitsa (General management) Chaukhambha Sanskrit Sansthan Varanasi.
b) Vishishtha Chikitsa (Specific treatment according to 3. Sharma Shiv. Ashtanga Hridaya Deepika Hindi Tika
classification) (1996) by Publishers Khem Raj, Krishan das
Samanya Chikitsa Prakashan Bombay.
i. Shodhana Chikitsa 4. VaidyaLal Chandra Shastri. AshtangaSamgraha,
Antahparimarjana Chikitsa
ii. Shamana Chikitsa Sarvanga Sundari Vyakhya Sahit (1982) Ist edition.
iii. Rakta-mokshana karma 5. Inderdeva Tripathi. Chakradutta (1994) Chaukhambha
iv. Lepa Chikitsa Bahiparimarjana Chikitsa Sanskrit Bhawan Varanasi.
Shodhanachikitsa includes Snehana karma, 6. Upadhyay Yodunanda. Madhav Nidanam Madhukosha
Virechana karma and Basti.[1] Most commonly used drugs Sanskrit Commentory (1993) 22nd edition by
for Shamanachikitsa in Vatarakta are Gokshura, Guduchi, Publishers Chaukhambha Sanskrit Bhawan.
Madhuka, Punarnava, Trivrita etc. [1] and various Guggulu 7. Goldman and Bennet. Cecil Text Book of Medicine
preparations. Predominant Dosha is recognized and 2004 Vol. II, Publication-Elsevier p.1703-1708.
specific treatment is planned keeping the general principle 8. Braun Wals, Fauci. Harrison’s Principles of Internal
of management in view. Most of these drugs have Medicine, 18th edition, 2010.
Vatashamaka properties and Mutra-virechaka quality so 9. Sidharth N. Shah Chief editor. API Textbook of
help in excretion of excess uric acid present in the body. Medicine vol.1, 8th edition 2008, Chief Association of
Some formulations found to be effective are Manjishthadi Physicians of India, Mumbai. p. 283-287.
Kvatha, Suranjana churana, Sukumaraka taila, Guduchadi 10. Robert L, Wortman & William M. Kelley (2001) -
ghrita, Kaishore guggulu, Gokshuradi guggulu, Panchtikta Kelley’s Textbook of Rheumatology vol-II 6th edition
ghrita guggulu, Simhanada guggulu and Punarnavamrita W.B. Saunders Company. p. 1339-1376.
guggulu. [5] 11. Clinical Spectrum of Gout in South India, J Indian
DISCUSSION Rheumatol Assoc 2002:10.
The main causative factors for Vatarakta are 12. Bhardwaj S.et al. 2012 (P.G.Thesis)-Comprehensive
excessive use of alcohol, high purine diet, non-vegetarian study of "vayuvridho vridna raktanavarita pthi”in
diet, acidic and astringent foodstuffs, person leading reference to aetiopathogenesis of vatarakta and its
sedentary life, excessive anger and emotional distress. management.
Both Vata and Rakta play a major role in the pathogenesis 13. Nafria S.et al. 2014 (P.G.Thesis)-A Clinical Study to
of Vatarakta. Vitiated Raktadhatu obstructs the path of Evaluate the Effect of Guduchyadi Ghrita in the
Vridhhvayu, in which the Vayu has to flow. Vridhh and management of Vatrakta w.s.r. to Primary& Secondary
obstructed Vata inturn vitiates the whole Rakta and this Hyperuricaemia.
Dosha-dushya sammurchhana in joints manifests as
*Address for correspondence
Cite this article as: Dr. Vikas Rana
Vikas Rana, Anjana Mishra, B.L.Mehra. A Comprehensive Study of Vata Dept. of Kayachikitsa
Rakta w.s.r. to Gout. International Journal of Ayurveda and Pharma R.G.Govt. P.G. Ayu. College & Hospital,
Research. 2017;5(8):93-96. Paprola, H.P., India.
Source of support: Nil, Conflict of interest: None Declared Email: [email protected]
Mobile: 09418884849

Available online at: http://ijapr.in 96