IJRAR2002287

© 2020 IJRAR June 2020, Volume 7, Issue 2 www.ijrar.
org (E-ISSN 2348-1269, P- ISSN 2349-5138)
A SYSTEMIC REVIEW OF VATARAKTA AND

ITS MANAGEMENT
1
Dr. Rimpaljeet Kaur*, 2Dr. Chinky Goyal, 3Dr.Rajpreet Singh, 4Dr. Shivali Chopra, 5Dr. Amrit Malik
1,2,3,4
Assistant Professor, 5Associate Professor
1
Assistant Professor, Department of Roga Nidan, Dayanand Ayurvedic College & Hospital, Jalandhar (Punjab)
Abstract- The illnesses produced by the conjugation of vitiated Vata and Rakta cause several health ailments.
Vatarakta is one of them; Vata prakopa, rakta dushti and obstruction in the path of vata is the core pathology in
the disease. The pathology of this disease originates in blood, spreads through blood vessels and nerves and then
finally get settled in the joints. The disorder has been considered for the study keeping in mind the dire need of
the hour to find some safe, sure and permanent cure effective for the disease. The present review deals with
glimpses of historical aspect of vatarakta (Gout) extending from vedic era to the present century, etymology of
vatarakta with its Nidana, samprapti, purva-rupa, rupa, sadhyata-asadhyata, sapeksha nidana, updrava,
chikitsa and pathya apathya.
Index Terms- Vatarakta, Vatashonita, Khudd-vata, Vatabalasa, Adhyavata

Introduction- Vatarakta is named on the basis of the vata dosha & rakta dhatu which have their own
independent derivations & are the main samprapti ghataka involved in the Vatarakta. Rakta which is vitiated by
vata is derived as Vatarakta.1 The disease which manifest as a result of marga-avarodha of vata by rakta is
vatashonitha2 in which vata and rakta are involved3.The illness which is resulted due to vitiation of vata dosha
and rakta dhatu leading to the specific samprapti is known as Vatarakta.4Vatarakta is one of the diseases which
undergoes progressive evolution through the ages. History reveals some of the references which are available
regarding etiology, presentation, treatment & complications of Vatarakta. So, it can be divided into below four
Kaal:- 1. Vedic Kaal (Ancient Period)
2. Samhita Kaal (Classical Period)
3. Sangraha Kaal (Medieval Period)
4. Adhunika Kaal (Modern Period)
1.VEDIC PERIOD (5000 B.C. - 800 B.C.): There is no description of Vatarakta in any of the four Vedas. In
Atharvaveda, only few scattered references of Sakthi (hip joint), Shroni (sacroiliac joint) and Janu (knee joint)
are narrated.5 In Atharvaveda, Sandhi vikriti term used for joint disorder, which is caused by shleshma vikriti and
can be treated by prayers only, but there is no explanation of any disease related to joints like Vatarakta.6
PURANIC PERIOD (4000 B.C.- 1000 B.C.)- With the exception of Garuda and Agni Purana, a lot of
information is available in the literatures of Purana kala.
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© 2020 IJRAR June 2020, Volume 7, Issue 2 www.ijrar.org (E-ISSN 2348-1269, P- ISSN 2349-5138)
GARUDA PURANA- The description of Vatarakta as a rakta-pradhana vyadhi is worth mentioning in the
chapter “VATARAKTA NIDAN”, Use of Vardhamana Pippali along with pathya like Guda, Patola, Triphala and
Katuki have been prescribed to alleviate the burning sensation in Vatarakta.7
AGNI PURANA- A precise description of Vatarakta is quoted in Agni Puran and various food items like
Raktashali, Godhuma (wheat), Yava (barley), Mudga (green gram) and Madhu (honey) have been advised as
pathya for patients suffering from Vatarakta.8
2-SAMHITA PERIOD (2000 B.C.-800 A.D.)- The main classical text of this era is Brihatrayi. Entire aspect of
the illness vatarakta from etiologyto treatment is described at full length in the books of samhita kaal as follows:
CHARAKA SAMHITA: (2000 B.C.)- Vatarakta explained in 29th chapter of Chikitsa sthana“Vatashonita
chikitsam Vyakasyam”. The information of the disease included Nidana, Samprapti, Bheda, Upadrava,
Sadhyaasadhyatva, Pathya-apathya, Chikitsa sutra & Chikitsa as Bahya & Abhyantara like Shodhana, Shamana
as well as Rasayana. The treatment of Vatarakta included Shilajatu, Eranda, Sneha, Lepas, Ghrita, Kashaya,
Guggulu, Tailas etc. Other than medicinal treatment, few surgical procedures like Rakta- visravana (blood-
letting) by Siravedh, Shring, Jalauka, Suchior Alabu Yantra are also mentioned.
SUSHRUTA SAMHITA: (1000-1500 B.C.)- Sushruta samhita's understanding of Vatarakta is different

regarding its types. It states that the Uttana and Avagadha Vatarakta are not the types of this illness rather they
are its avasthavishesh. In Sushruta Samhita, the disease has been described in 2 chapters, under Vatavyadhi
Nidan sthana 1st Chapter and Mahavatavyadhi Chikitsa sthana 5th chapter where all aspects of disease are
described in detail.
BHELA SAMHITA (1000 B. C.)- In Bhela Samhita Chikitsa sthan, brief description of vatarakta is found in
chapter 15 i.e. Visarpa Vatashonita adhyaya and in chapter 24 i.e. vatavyadhi chikitsit adhyaya.
HARITA SAMHITA (1000 B.C.)- The disease is mentioned in Harit Samhita, Tritiya sthana chapter 23, after
‘Gridhrsi chikitsa Adhyaya’, where the etiology and symptoms have been described briefly along with the use of
internal as well as external medication.
ASHTANGA SAMGRAHA (400 A.D) / ASHTANGA HRIDAYA (500 A.D)- In Ashtanga Samgraha
(Vatashonita nidana adyaya” & Vatashonita Chikitsama,16th & 24th chapter) & Ashtanga Hridaya (“Vatashonita
Nidana Adyaya” & “Vatashonita chikitsa Adyaya ”16th & 22nd chapter respectively) elaborate description about
Nidana, Samprapti, Bheda, Upadrava, Sadhya-asadhyatva, Pathya-Apathya, Chikitsa sutra & Chikitsa is
available in these texts. Ashtanga Hridaya has also added the management of sama and nirama stage of
Vatarakta.
In ayurveda dipika few lines of Kharanada Samhita is quoted in relation to types of Vatarakta. In this context it
is said that kharanada Samhita accepts 36 types of Vatarakta.
Nidana, Samprapti, Lakshana, Sadhya-asadhyata & Chikitsa of Vatarakta in full length in Gadnigraha.9 In the
similar manner, the whole description of Vatarakta is found in Vatarakta adhikara in Vangsena Samhita.10 3-
SAMGRAHA PERIOD:
MADHAVA NIDAN (800 A. D.)- Madhava explains Vatarakta Nidana, Samprapti, Purvarupa, Upadrava and
Asadhya lakshana in chapter 23rd “Vatarakta Nidana”.
CHAKRADATTA(1100A.D.)- Chakradatta in 23rdchapter “Vatarakta chikitsa” has explained both Bahya &
Abhyantara Chikitsa like Kwatha, Churna, Ghrita, Taila & Guggulu Kalpa.
SHARANGDHAR SAMHITA (1300A.D)- Saptamadhyaya “Roga Ghanna” of Purvakhanda explains about the
saptaprakara of Vatarakta as Vataja, Pittaja, Kaphaja, Raktaja, Samsargaja & Sannipataja. While explaining
Niruha Basti, Vatarakta is mentioned as one of the conditions for Niruha Basti in the 6th chapter.
BHAVA PRAKASHA (1500 A.D)- In uttarardha 29th chapter “Vatarakta adikara”, Acharya has explained all
about Nidana, Samprapti, Purvarupa, Rupa, Bheda & Chikitsa.
YOGA RATNAKARA (1600 A.D)- In Yoga Ratnakara, Purvaardha, under Vatarakta Nidana.Acharya has
explained details of Nidana, Samprapti, Purvarupa, Dosha-pradhana rupa, Upadrava & Asadhya lakshana of
Vatarakta. While under Vatarakta chikitsa, Acharya has explained separate combinations like Kwatha, Guggulu,
Taila, Ghrita and Rasa.
BHAISHJYA RATANAVALI (1600 A. D.)- In “Vatarakta chikitsa prakrana” chapter 27th, description about
Samprapti, Bheda, Pathya-apathya, and Chikitsa is available.
NIDANA / ETIOLOGY: Various etiological factors of this disease has been described in Charaka Samhita. It
has been mentioned that excessive consumption of foods articles which are lavana (salty), amla(sour), katu
(astringent, pungent) in taste, kshara (alkaline) and snigdha (unctuous) properties, Ushnaahara(food stuffs
having ushnavirya), ajirnabhojana (eating food prior to digestion), klinna-anoop-shushka mamsa (excessive
use of aquatic or marshy land animals or of desert region which are dry in nature), use of pinyaka (tilpishta),
mulaka (raddish), kulath (horse gram), masha (black gram), shaka (leafy vegetables), palala (mutton), ikshu
(sugar-cane), dadhi (curd), arnala, souviraka, shukta, sura, asava (all fermented drinks) are the causative factors
of vata-rakta. Habit of taking virudhaahara (incompatible diet), adhyashana (intake of food prior to digestion of
meal earlier taken), krodha (anger), diva swapana (sleeping in day hours) and prajagarana (nocturnal
awakening) are also said to be the causative factors.
Acharya Charaka mentioned that those persons, who have tender constitution, not accustomed to do hard work
and indulge in mithyaahara-vihara are prone to this disease.11
This is well cleared by Acharya Chakrapani that aetiological factors started from intake of saline ( Lavnadi) are
the aggravating factor of Rakta dhatu and aetiological factors initiated from intake of astringent (Kashayadi) are
predominately causes aggravation of Vayu. Combination of these two types of aggravating factor leads to
Vatarakta.12
Similarly in Sushruta Samhita many aetiological factors have been described like excessive grief, over
indulgence in sexual act, excessive physical exertion, taking wine in large quantity regularly, consumption of
foods incompatible to one’s own temperament are the factors which vitiate Rakta and Pitta of individual.
Simultaneously they also agitate Rakta and Vata to produce Vata-Rakta. It further states that both the persons
having tender constitution (sukumar prakriti) and those who disobey the dietary and seasonal regimens are
affected with the disease. These factors vitiate vata and rakta to cause vatarakta.13
NIDANA OF VATARAKTA VIS-À-VIS ETIOLOGY OF GOUTY ARTHRITIS- Vatarakta can be compared

with gouty arthritis because of similar etiology. The comparison of etiology of the disease according to
Ayurvedic as well as modern view is as follows-
1) Lavana rasa- Dehydration is main cause of gout attacks & salt is the leading cause of dehydration. Excess salty
food does not allow water to excrete out of the body & no flushing of uric acid from the body occurs.
2) Mulak, Kulath, Masha, Nishpaav- Pulses (along with testa), radish, legumes (dried beans, peas) are rich in
purine which metabolize to form uric acid as end product.
3) Shaak - Intake of high purine vegetables like spinach or asparagus, cauliflower etc. can trigger gout attack.
.
4) Anoop deshiya mansa,Ambuja mansa - All non-vegetarian diets mainly seafood i.e. almon, mackerel and red
meat contain large amount of purines.
5) Arnala, Souvira, Shukta, Sura, Asava- These preparations come under fermented drinks. According to recent
research, alcohol consumption is a significant risk factor which reduces urate excretion and increases urate
production in blood.
6)Dadhi, Takra - As both these preparations are rich in protein content,they should have increase the uric acid
level, but according to recent researches, dairy products helpin reducing serum uric acid.
7) Mithyahara, Virudhhashan -Ingestion of food/drinks kept in lead lined container or its inhalation when
handling it on daily basis (occupationally, like in plumbers, painters etc.) leads to chronic lead poisoning which
cause gout. Other than this, excessive ingestion of certain drugs like aspirin, diuretics can be included in
MITHYA AHARA.
8) Annashana, Langhana – As in starvation, body starts metabolizing its own (purine rich) tissues for energy. So
in this condition, amount of purine converted to uric acid is raised. Starvation also impairs the ability of the
kidney to excrete uric acid due to competition for transport between uric acid and ketones.
9) Shushkaahara –Water intake removes acidic wastes from the body. Excess dehydration leads to retention of
acidic wastes in the blood including uric acid which needs to be flush out of the body, causing hyperuricemia.
10) Ikshu, Mishthanna Bhojana– In Present era, Fructose rich diet (Fruit juices and fructose rich sweetened
soda) is found to be the common culprit for gout attacks. It induces uric acid production during its
phosphorylation by increasing adenosine triphosphate (ATP) degradation to adenosine monophosphate (AMP),
a uric acid precursor.
So within minutes after ingestion of fructose infusion, uric acid concentration is increased.
11) Achankramana – As the disease is known as Disease of Kings since long time, it has very aristocratic
lineage. Though the disease affects anyone but found to be more prevalent in persons with sedentary lifestyle.
12) Ativyayam, Ativyavaya – Excessive muscle exertion (by doing heavy work) leads to increased degradation
of ATP into AMP which help in raising the uric acid level by the same mechanism as in excess fructose intake.
13)Abhighataj– Trauma is found to be the trigger factor for gout attacks.
14) Sthoulya – Obesity, in present days, is not an independent cause but main risk factor of gout. According to
Campion EW.et al, 1987, Body Mass Index (BMI) is a significant predictor for the development of gout.
SAMPRAPTI / PATHOGENESIS: Acharya Charka, while describing samprapti of Vatarakta, mentioned
samanya as well as vishishtasamprapti. In samanyasamprapti, causative factors which are responsible for
vitiation of vata and raktadosha have been specified and the disease progress is explained in brief.14
Vishishta samprapti explains the pathogenesis of Vatarakta in very minute way. In addition, vishishta samprapti
enables us to understand the nature of vatadosha and rakta dhatu and also about the srotas involved in the
disease. SAMANYA SAMPRAPTI OF VATARAKTA- Generally, Vatarakta arises in persons of tender and
delicate physique, who indulge in unhealthy food and activities which are mentioned earlier in etiological factor.
From these etiological factors vata and rakta aggravated from their aggravating factors. Aggravated vitiated
Rakta quickly obstructs the path of already aggravated vata. On obstruction of passage of vata its gatiis hindered
making it greatly aggravated. This vitiates the whole rakta and manifest as Vatarakta.
Because of the above-mentioned factors which cause mainly aggravation of Vayubeing obstructed in its course
by the vitiated rakta (caused by factors responsible for aggravation of rakta).The excessively aggravated
Vayuvitiated the entire rakta (blood). The disease is thus called Vatarakta.15
PREDOMINANCE OF VATA IN VATARAKTA- In pathology of Vatarakta both vataand rakta are equally
responsible. Beside this, vatais more predominant because vata is dosha and dosha is independent than that of
dushya so, due to predominance of vata this disease named as Vatarakta not Raktavata.16 According to Sushruta,
the vitiated rakta is combined with greatly aggravated vata, which is very predominant; the disease is called as
vatarakta.17
VISHISHTHA SAMPRAPTI OF VATARAKTA- To explain vishishta samprapti, Acharya Charka has put
forth the theory that Vayu is sukshma i.e. subtle in nature and has the capacity or quality to move in all the
joints and channels (srotasa) of the body and rakta is drava (liquid ) in nature and has the quality to flow in all
srotasa of the body. Vitiated vataand rakta moves with speed through sira marga (circulatory channels) in the
whole body because of these qualities. While moving through joints both of them face obstruction, because of
the complex anatomical structure of joint. Hence vitiated or agitated vata and rakta stays in joints causing
different types of pain sensations. Different types of pain sensations are because of its association with either
pitta or kapha dosha.18
SAMPRAPTI GHATAKA19-
Dosha - Vata Pradhan Tridosha
Dushya - Rakta
Agni - Jatharagni and Dhatavagnidushti
Srotasa - Rasavaha, Raktavaha
Srotodushti - Sanga (stasis of dosha), atipravritti
Adhisthana - Tvaka, Mamsa, Sandhi,
Vyadhi - Pakwashayotha and Chirkari
SITES OF VATARAKTA: According to Acharya Charka, vitiated vata and rakta affects the joints of hands,
feet, fingers and other joints slowly. Hands and feet are the sites of first attack and there-after whole body
comes under the grip of the disease.62 According to Acharya Sushruta, disease usually starts from feet and
sometimes starts from hands and spreads to other parts of body in a similar way the rat poison spreads i.e.
“Akhora Vishamiva”.
Fig. 1.Schematic Representation of Samprapti

Dosaprakopakanidana Dhatu DaurbalyakaraAgni Mandyakaranidana
Ingestion of Katu,
tikta, alpa Lavana, amia, katu, ksara,
Misthanabhojana, snigdha, ahara, sevana,
ruksaahara, annasana acakaramansilta, klinna, susaka and anupa
(fasting) riding on animals or asodhana
modern vehicles walk in hot mamsa, pinyaka, mulaka,
weather excessive sexual kulathi, masa, nispava,
Indulgencevegavidharan sevana, dadhi, sauvira,
ratrijagrana amala, sukta, takra, sura,
asava etc.
VataPrakopa + Rakta Dusti + Amautpatti
Rakta Dusti by Vata,

raktadusti resulting in
khavaigunya in the rakta
vaha srotasa
Ciruclation of the vitiated vata and dusta rakta in
the whole body
Contaminated rakta blocks the way of vata in

the sandhis, Resulting sthanasansraya of dosha
Excessive aggravation of vata dosa which results in

precipitation of clinical features
Vata Rakta
Uttana Gambhira
PURVA – RUPA/ PREMONITORY SYMPTOMS: In the following table purva-rupa mentioned by different
Acharya are tabulated below-
TABLE 1: SHOWING PURVA-RUPA OF VATARAKTA20-27
Types C.S. S.S A.H A.S. M.N G.N B.P Y.R.
. .
Atisweda + - + + + + + +
Asweda + - + + + + + +
Karhnyata + - - - + + + +
Sparshgnata + - - - + + + +
Ksateatiruk + - - - + + + +
Sandhi shaithily + + + + + + + +
Alasya + - - - + + + +
Sadana + - + + + + + +
Pidakodgama + - - - + + + +
Nistoda + + + + + + + +
Spurana + - + + + + + +
Bheda + - + + + + + +
Gourava + + + + + + + +
Supti + + + + + + + +
Kandu + - + + + + + +
Sandhi ruk + - - - + + + +
Vaivarnya + + + + + + + +
Mandalotpatti - + + + + + + +
Sheetalata - + - - - - - -
Osha - + - - - - - -
Daha - + + + + + + +
Shopha - + - - - - - -
TwakParushya - + - - - - - -
Sira dourbalya - + - - - - - -
Atislakshnasparsh - - + + + - + +
Kharasparsha - - + + + - + +
Shrama - - + + + - - -
Vranaadikasula - - + + + - - -
Vranachirasthiti - - + + + - - -
Roma harsha - - + + + - - -
Asrijakshaya - - + + + - - -
Shram - - + + + - - -
N. B. + Denotes description available
- Denotes description not available
BHEDA AND RUPA OF VATARAKTA: In Ayurvedic literature, Vatarakta is classified on the basis of doshaja
variation and site of affection and further, description of rupa of vatarakta is given according to the classification
of the disease:
1. According to the site of origin
2. According to the predominance of dosha
1. ACCORDING TO THE SITE OF ORIGIN – In Charka Samhita, Vatarakta has been classified on the
basis of dhatu affected in two forms-
• Uttana Vatarakta (Superficial)

• Gambhira Vatarakta (Deep seated )
Acharya Sushruta disagrees and put forth an explanation that these are not the types but different stages like
Kushtha. In the beginning, it affects superficial structures like tvaka and mamsa but later on, it becomes
gambhira i.e. deep seated and affects deep structures28.
2. ACCORDING TO THE PREDOMINANCE OF DOSHA- On the basis of doshic variations, Vatarakta
can be classified as follows:
TABLE2: SHOWING CLASSIFICATION OF VATA-RAKTA (GOUT)29-35

S. Types of Vatarakta C. S AH A MN HS Bh. Y
N S S S P R
A According To site of Origin-
1 UttanaVatarakta + - + + + - - -
.
2 GambhiraVatarakta + - + + + - - -
.
3 UbhayashritaVatarakt + - - - + - - -
. a
B Acc. To Dosha-
1 VatajaVatarakta + + + + + - + +
.
2 PittajaVatarakta + + + + + - + +
.
3 KaphajaVatarakta + + + + + - + +
.
4 Vata- + + + + + - + +
. PittajaVatarakta
5 Pitta- + + + + + - + +
. KaphajaVatarakta
6 Vata- + + + + + - + +
. KaphajaVatarakta
7 RaktajaVatarakta + + + + + - + +
.
8 SannipatajaVatarakt + + + + + - + +
. a
Various Rupa (signs and symptoms) of Vata-Rakta according to different classical texts are given in the Table 3.
TABLE 3: SHOWING RUPA OF VATARAKTA

S.No Rupa C S AS A M H B Y
S S H N S P R
A-I On the basis of affected site Uttana Vatarakta36-39
Kandu + - + + + - - -
Daha + - + + + - - -
Ruka(pain ) + - - - + - - -
Ayama (stretching ) + - + + + - - -
Toda (Pricking Pain ) + - + + - - - -
Sphurana + - + + - - - -
Akunchana + - - - - - - -
Anvita + - - - - - - -
Vivarnata- 1)ShyavaTvaka + - + + + - - -
2)TamraTvaka + - + + + - - -
Osha - - + + - - - -
2. Gambhira Vatarakta40-43
Svathu + - + + + - - -
Stabdhata(Stiffness ) + - - - - - - -
Arti (pain ) + - - - + - - -
Tamratwakvivarnata + - - - + - - -
Shyavata + - - - + - - -
Daha(Burning in feet ) + - + + + - - -
Toda + - - - + - - -
Sphurana + - - - + - - -
Paka + - + + + - - -
Granthi - - + + - - - -
ChhedanvatPida in Sandhi, Asthi - - + + + - - -
Khanjata - - + + + - - -
Pangulya - - + + + - - -
B. According to Predominance ofDosha
1. Vataja Vatarakta44-51
Ayama(mainly in Sira ) + - - - - - + +
Shoola(pain ) + + + + + + + +
Sphurana(Throbbing sensation ) + - + + + + + +
Toda (pricking pain) + + + + + + + +
Shotha of Shyava /bluish colour + - + + - + + +
Change in colour of Shothaand vridhhi or - + + + + - + +

hani
Ruksha + - + + + - + +
AnguliDhamni Sandhi sankocha + - + + + - + +
Angagraha(Stiffness in body) + - + + + - + +
ShitaDvesha + - + + + - + +
Kunchana + - - - - - - -
Stambhana + - + + + - + +
Vepathuavinas - - + + + - + +
Supti(numbness ) - - + + + - + +
Shosha(wasting) - + - - - + - -
Vaivarnya(discolouration) - - - - - + - -
Mandaloutpatti - - - - - + - -
SparshaAsahyata(tenderness) - - + - - - - -
Sparshajanya Harsha - - + - - - - -
2. Pittaja Vatarakta52-59
Vidaha(Burning sensation ) + + + + + + + +
Vedana (pain ) + + + + + - + +
Murchha + - + + + - + +
SvedaAdhikya(Excessive sweating) + - + + + - + +
TrishnaAdhikya + - + + + - + +
Mada(Narcosis) + - + + + - + +
Bhrama(Giddiness) - + - - - - - -
Raga (Redness) + + - - - - + +
Paka + + + + + - + +
Bheda(Tearing pai + - - - - - + +
Shosha + - + + - - - -
Osha - + - - - - + +
Sammoha - - + + + - + +
SparshaAkshmatvama - + + + + - + +
Ubhaya Pada Mriduta - + - - - - - -
3. Kaphaja Vatarakta60-67
Staimitya + - + + + - + +
Gauravama + - + + + - + +
Sneha Snigdhata + - + + + - + +
Supti + - + + + - + +
Manda Vedana + - + + + - + -
Shitalta + + + + - - + +
Kandu + + + + + + + +
Shwetata + - - - - - - -
Stabdhata + - - - - - - -
4. Raktaja Vatarakta68-75
Shwayathu - + - - + + + +
Atiruka (Acute pain ) - + + + + + + +
Toda (pricking pain ) - + + + + + + +
Tamra Varna - + + + + + + +
Chimchimayata (tingling sensation ) + + + + + - + +
SnigdhaRuksha Sama Abhava + - + + + - + +
Kandu + - + + + - + +
Kledata + - + + + - + +
5. Dvandaja Vatarakta76-81
I. Vata-Pittaja + - + + + - + +
II. Pitta-Kaphaja + - + + + - + +
III. Vata-Kaphaja + - + + + - + +
6. SannipatajaVatarakta + - + + + - + +
(Ref: Ch.Chi. 29/21-29, Su.Ni.1/45, AS.Ni.16/11-18, AH.Ni.16/9-16, MN.V/R/N 23, HS.Tritiyasthan 23/8-12,
Bh.P.M/KVRA 29/9-14, YR.Purvaardh V/R/N 29)
UPDRAVA / COMPLICATIONS: In Vatarakta after anyonya avarana of dosha & dushya it leads to
formation of upadravas.
TABLE 4: SHOWING UPDRAVA (COMPLICATIONS)
S.No Updrava82-86 C S A AH MN HS B Y
. S S S P R
1. Aswapna + - - - + - + +
2. Arochaka + + - - + - + +
3. Shwasa + + - - + - + +
4. Mamsakoth + - - - + - + +
a
5. Shirograha + - - - + - + +
6. Murchha + - - - + - + +
7. Mada + - - - + - + +
8. Ruka + - - - + - + +
9. Trishna + + - - + - + +
10. Jwara + + - - + - + +
11. Moha + - - - + - + +
12. Klama + - - - + - + +
13. Pravepaka + - - - + - + +
14. Hikka + - - - + - + +
15. Sphota + - - - + - + +
16. Daha + - - - + - + +
17. Paka + - - - + - + +
18. Toda + - - - + - + +
19. Bhrama + - - - + - + +
20. Angulivakrat + - - - + - + +
a
21. Pangulya + - - - + - + +
22. Marmagrah + - - - + - + +
a
23. Visarpa + - - - + - + +
24. Arbuda + - - - + - + +
25. Mamsakshay + - - - + - + +
a
26. Kasashwasa - + - - + - - -
27. Stambha - + - - - - - -
28. Avipaka - + - - - - - -
29. Prana - + - - - - - -
kshaya
30. Visarana - + - - - - - -
31. Sankocha - + - - - - - -
(Ref.: Ch.Chi. 29/31-32, Su.Chi. 5/6, M.N. V/R/N 23/15-16, Bh.P. M.K. V/R /A 29/15-16, Y.R. Purvardha
V/R/N
29 )
SADHYA – ASADHYATA- The sadhya-asadhyata of vatarakta is divided on the basis of following 3 categories:
1. On the basis of vitiated doshas
2. On the basis of presence or absence of upadravas 3. On the basis of kaal

(time)
TABLE 5: SHOWING SADHYA – ASADHYATA OF VATARAKTA

S Sadhya– Asadhyata87-90 C.S S A.S A.H M. BP Y
. . . . . N . R
N S .
o .
1 Sadhya( Curable )
.
A Nirupdrava + + - - + + +
)
B Ekadoshaja + - + + + + +
)
C Nava + - + + + + +
)
2 Yapya
.
A Dvidoshaja + - + + + + +
)
B Akritsnoupdrava + - - - + + +
)
C Samvatsarothitta - + - - + - -
)
3 Asadhya( Incurable )
.
A Tridoshaja + - + + + + +
)
B Upadravayukta + + + + + + +
)
C Sravi + + + + + + +
)
D Vaivarnya + - - - - - -
)
E Stabdhata + - + + - + -
)
F Arbuda + - + + + + -
)
G Samkocha + - - - - - -
)
H IndriyaSantapa + - - - - - -
)
I) AjanuSphutitama - + - - + + -
J Prabhinna - + - - + + -
)
K Prana- Kshaya - + - - + - -
)
L Mamsa- Kshaya - + - - + - -
)
M Moha - + - - + - -
)
(Ref.: Ch. Chi. 29/30 – 34, Su. Ni. 1/49, Su. Chi. 5/6, A.H. Ni. 16/17, A.S. Ni. 16/19, M.N. V/R/N 23/14-18,
Bh.P. M/K VRA 29/17-19, Y.R. Purvardha V/R N 29)
CHIKITSA: Charaka has described two types of principle of management for Vatarakta:91
A) Samanya Chikitsa
B) Vishishta Chikitsa
A) SAMANYA CHIKITSA: -Various procedures explained under samanya chikitsa are as follows:-
1) Rakta Mokshana- Almost all the classical texts have advocated raktamokshana for management of vatarakta.
Acc. to Vagabhatta,snehan should be given to the patient before raktamokshana.92 Then the procedure should be
performed but the state ofvatadosha must be assessed carefully whileAcharya Charak has advocated use of
raktamokshan in the treatment of vatarakta by means of shringi, jalouka, suchi, Alabu, prachchhanorsiravedha
according to the degree of vitiation of doshas and strength of disease.93
Specific Indication- Procedure is applied according to the predominance of doshas. If prevalent features are
pain, burning sensation, cutting and pricking type of pain then jalukashould be applied. Shring or Tumbi should
be applied if predominant features are numbness, pruritus and tingling sensation. 94-95According to severity of pain
where it moves from one place to another, Acharya Charaka has indicated siravedha/prachchhan.96 2) Shodhana
Karma- In management of Vatarakta, Shodhana Chikitsa is of utmost importance:
1-Snehana: Snehana or oleation therapy is advocated to patients of Vatarakta before administration of
Virechana.
2-Virechana: After oleation, virechana should be administered to the patient. Snigdha virechana dravyas should
be advised to the patient with ruksha sharir. Similarly ruksha mridu virechana dravyas should be advised to the
patients having snigdha sharir. There is specific indication for mridu virechana as tikshna virechana may cause
aggravation of Vata.97
3-Basti Chikitsa: According to Charaka, Basti is par excellence in management of Vatarakta98. It has been
advised to administer Basti after giving virechana. Anuvasana and Niruha Basti should be given frequently.99
3] Shamana Karma- Principle of Shamana Chikitsa is to establish the state of homeostasis of doshas by
pacifying the vridha doshas & bringing the vitiated doshas to the normal level.
4] Lepa: Bahiparimarjan Chikitsa or Lepa Chikitsa is used specifically in patients suffering from uttana or
ubhaya shrita vatarakta. Decoction of drugs capable of alleviating daha (burning sensation) should be used.
Other than alepa; parisheka and abhyanga has also been described in charak samhita.100
B] VISHISHTA CHIKITSA- Acharya Charaka has given specific line of treatment for all types of Vatarakta
keeping in view the doshic predominance and the site of the disease.
1) Uttana Vatarakta: In Uttana Vatarakta when doshas remain confined to twaka and mamsa, external local
applications are the choice. Drugs can be applied in the form of lepa, abhyanga, parisheka and
upanaha.101Ushnalepa application has contraindicated in Rakta Pradhan Vatarakta, similarly in Kapha and
Vatapradhan Vata-Rakta, sheetala lepa has contraindicated as sheetala lepa in these situations brings about
stambhana of doshas.102
2) Gambhir Vatarakta: When doshas are deep seated i.e. seated in the sandhi’s, treatment of choice is
shodhana chikitsa involving Snehana, Virechana and Basti.103
3) Vata Pradhan Vatarakta: In Vata pradhan Ghrita, Tail, Vasa and Majja should be administered in the
form of snehapana and abhyang. The same should be used for Basti. Lukewarm fomentation should be
applied.104 4) Rakta and Pitta Pradhan Vatarakta: In such a setting Ghrita pana, Dugdha pana and Mridu
Virechana should be administered. Parisheka with decoction of Vata shamaka dravyas and Anuvasan Basti
should be used. Sheetala pralepa are also advocated by Acharya Charaka in this condition.105
5) Kapha Pradhan Vatarakta: In this type of Vatarakta, Mridu Vamana is ideal treatment. Snehana, swedana
and langhana should be used judiciously. Lukewarm pralepa may be helpful. Too cold or too hot pralepas must
not be applied.106
Discussion- According to Ayurvedic texts, Vata is the most significant among tridosha due to its six-fold
distinguishing features like Vibhu (spreading), Aashukari (quick action), Balli (powerful), Anaya-Kopanata
(capability to vitiate other doshas, Savtantratva (acting independently), and Bahurogtva (the power to produce
the many of diseases).107 At the same time, Rakta being the foremost body tissue also plays an important role in
sustaining the health and life of a person. 108 In Vatarakta, the symptom which disturbs day-today life of the
patients i.e. severe joint pain, which primarily seen in Hasta-Pada-Mulagata sandhi109 and then migrates to other
joints in a way similar to Akhuvisha.110 Vatarakta is described in almost all Ayurvedic classics like Brihatrayi and
Laghutrayi. Acharya Sushruta has described it along with other Vatavyadhies but due to its specific Nidana,
Samprapti and Chikitsa, Acharya Charaka has described it separately.
Conclusion- Morbid vata dosha when obstructed by vitiated rakta dhatu, further becomes virulent and once
again adds to the abnormality of rakta dhatu, this illness is called as vata shonita.111 Vatarakta as mentioned in
Ayurvedic texts have very close resemblance with Gout available in modern science.
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© 2020 IJRAR June 2020, Volume 7, Issue 2 www.ijrar.

org (E-ISSN 2348-1269, P- ISSN 2349-5138)

A SYSTEMIC REVIEW OF VATARAKTA AND

Index Terms- Vatarakta, Vatashonita, Khudd-vata, Vatabalasa, Adhyavata

SUSHRUTA SAMHITA: (1000-1500 B.C.)- Sushruta samhita's understanding of Vatarakta is different

NIDANA OF VATARAKTA VIS-À-VIS ETIOLOGY OF GOUTY ARTHRITIS- Vatarakta can be compared

Fig. 1.Schematic Representation of Samprapti

VataPrakopa + Rakta Dusti + Amautpatti

Rakta Dusti by Vata,

Contaminated rakta blocks the way of vata in

Excessive aggravation of vata dosa which results in

• Uttana Vatarakta (Superficial)

TABLE2: SHOWING CLASSIFICATION OF VATA-RAKTA (GOUT)29-35

TABLE 3: SHOWING RUPA OF VATARAKTA

Change in colour of Shothaand vridhhi or - + + + + - + +

2. On the basis of presence or absence of upadravas 3. On the basis of kaal

TABLE 5: SHOWING SADHYA – ASADHYATA OF VATARAKTA

16. Upadhyaya Y. (2012) Madhavanidana (Reprint); Varanasi: Chaukhambha Prakashan. Ch.23.p.500.

Vol.-II; Chikitsa Sthana.ch.29. p.827. sh.no.45.

(Reprint). Varanasi: Chaukhambha Prakashan. Sutra Sthana.ch.24.p.144.sh.no.4.

Varanasi: Chaukhambha Sanskrit Sansthana. Vol.-I; Nidana Sthana.ch.1. p.232. sh.no.48.

Chikitsa Sthana ch.29.p.984. sh.no.10.

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