Avarana is one of the least understood concepts among the basic mechanisum of ayurvedic fundamentals. Avarana is one of the mechanisms mentioned in the science of Ayurveda to explain the pathogenesis of diseases, peculiarly due to the vitiation of vata . But now a days in clinical practice, we are not focusing on this area for diagnosis as well as management strategies. In Ayurveda, the vitiation of a srotus is essential for the manifestation of each and every disease. In any disease or disorder, the nidana or causative factors will lead to dosha dushti, the vitiated dosha gets accumulated in the particular srotuses, leading to the manifestation. If a Possible condition arises, the disease commences. The Various reasons of vitiation of srotas are also explained. The difference in the pathology of the srotuses leads to the different diseases
All the function of the body is controlled by three fundamental factor called Tridosha. As per Ayurveda they are the pillar of the body. They all in equilibrium and located in their places perform their normal functions by which the body is sustained free from disorders. If they move on wrong path or are unbalanced they afflict the body with disorders relating to their location and functions and take away life shortly. Any disturbance to their equipoise state leads to diseases. Among these 3 doshas,Vata has very much significance. It plays a key role behind maintenance of body in normal healthy state. Vata is strongest of all dosha & it causes large number of diseases. It is also be quick in causing emergency condition
Concept of Avarana
According to Ayurvediya shabdakosha the word avarana means avarodha, gatinirodha ie. Obstruction to the normal gati of vata. Vata dosha is the gatyatmak dravya within the sharer, it generally possesses the quality of Chala which is responsible for all its function. If vata get obstructed then, its function gets hampered and results in to vata vyadhi.
Pathological conditions of vata
Sushruta has mentioned three pathological conditions of Vata viz.
- Kevala Vata,
- Dosha-Yukta Vata
- Avrita Vata.
The word Kevala refers to Dosha-Asamsrista i.e. pathological state of Vata without association of other Dosha. The etiological factors of Vata are depletion in nature, due to that decrease in the body tissues occurs resulting in increase of Akasha (vacuum) and to fill this vacuum; Vata is increased leading to its Prakopa. In suchcondition the Hetu are of Vata, symptoms are of Vata and Upashaya and Anupashaya are of Vata. The treatment also consists of management of Vata only, though certain care has to be taken for the site also. By this path of pathogenesis, it may produce both Nanatmaja and Samanyaja types of its disorders. Its Nanatmaja type of diseases can be initiated and produced only by Vata and no other Dosha can produce it. On the other hand, its Samanyaja type of disorders can be initiated and produced by the other Dushya, which may be of Vata type only or may be due to Samsarga and Sannipata with other Dosha.
Dosha-Yukta Vata (Samsarga and Sannipata)
Doshayukta Vata refers to association (Samyoga) with other Dosha, which is different to Avarana. It is a pathological state of Vata due to the association of Pitta or Kapha or both, which may be caused by the combined Hetu. Clinical manifestations of Vata as well as of the associated Dosha as Anubandha may be there. In that case, generally the primary Dosha i.e. Vata dominates in all the sphere of Hetu, symptoms and treatment. Generally, with the Vishama Samaveta then there may be some peculiar symptoms, which may not be belonging to either of the Dosha.
Avrana of Vata occurs in Avrana of Vata occurs in two ways
1) By Avarana of Ama, Kapha, pitta, Mala etc. It is general or samanya avarana and,
2) Second type of avarana is by other vata of pancha vidha vata. This Avarana of vata by other vata is a specific or vishishtaavrana producing severe symptoms.
In any type of avarna there are two components one is Avrutt Dosha , the dosha whose function get affected by obstruction or covering & the second component is the Avarak which causing avarana of peculiar dosha. Often the symptoms manifested are comprised of disturbed function of, the obstructing factor as well as the obstructed Vata. The symptoms produced are based on the principles of Karma Hani, Karma Vriddhi which depend upon the intensity of the obstruction i.e. partial or complete; functional or organic; acute or chronic; transient or persistent etc. For instance, less strong obstruction of Vata will leads its provocation, where as the very powerful obstruction may make it weak and likewise. The symptomatology of the Avarana depends up on the place wherever Dosha-Dushya Sammurchchharna has taken place. For instance, the symptom of Shula of Avrita Vata may occur in the different parts like head, ears, abdomen, back, depending upon the organ involved in the process of Avarana. Similarly clinical manifestations are primarily depend on the direction of the movement of which is obstructed, anatomical limitation of particular Dosha or sub type of Vata which is involved in the pathogenesis, nature of obstruction i.e Dosha, Dathu, Mala etc.
Vishesha sthan has been explained for each vayu prakar but at each cellular level we can understand their functional activity such as assimilation of pran vayu, excretion of apan vayu, circulation and transportation of vyan vayu agnisandukshan or digestion & metabolism stimulants of saman vayu and prayatna of udan vayu. The concept is important because in case of paraspara avarana some symptoms have been explained which are not specific to their sthan for e.g in saman avrita apana hridroga has been explained. There is interplay between gati of different vata prakar. In normal condition they help each other to carry out various function but when theregati gets vitiated due to above hetu the balwan vata prakar impedes the gati of other leading to paraspara avarana.
Different pathology occurred in different strotas for the disease appearance. Awarana is one of the the pathogenesis in the appearance of diseases. Avaran plays an important part in understanding the samprapti of many disease. When dosha or dhatu obstruct a particular dosha then it will give rise to sign and symptoms related to function of that particular dosha or dhatu. Which has obstructed the entity which gets obstructed will show less sign and symptomsrelated to its normal function. For instance if pitta obstructs vata then person will suffer in daha, trishna, shoola, bhram, tama, vidah, sheetkamta which are symptoms of ptta and karmhani is observed which is a vata symptoms. Acharyas has explained many avaranas and its sign and symptoms will give clue to the diagnosis of avarana. The increased sign and symptoms will suggest the Avaraka and decresed sign and symptoms suggest avarutta. Once the diagnosis confirmed then the treatment is expected.
Many references are available regarding avarana as pathology in different disorder. Ex:- In majjavrutta vata the majjadhatu impedes the gati of vata (nerve conduction) leading to symptoms like pain etc. Difuse bulging of cord may be consider as well spinal canal stenosis, In pittavrutta vata, symptom like heat stroke where failure of heat regulating mechanism urusthambh is also been considered as medasavrutta vata pathogenesis of kasa is also due to avarana between prana vata and udan vata similarly many disorders are produced due to Avarana. So identification so avarana is must. In the pathogenesis of Avarana Atipravrutti leads to sangha. Which intern leads to vimargagaman due to this hridroga, vidradhi, pleeha, gulm like complication, so diagnosis of Avarana is very much important.
Treatment principles of Avarana
Treatment of Avarana should aim towards cleansing the srotas with different medicaments which possess Anabhishyandi, Snigdha, Kapha pitta Aviruddham and vatanuloman property. Administration of Yapan basti, Sramsana chikitsa, and Rasayan dravya may be considered after analyzing the bala of patient and the stage of disease. Anya Avarana can be treated successfully after adopting these treatment modalities, where as treatment of Anyonya Avarana is not simple. Different varities of Panchakarma treatments are planned in order to remove the obstruction and put the specific variety of Vata in its own path. So symptoms and treatment of Avrana can be considered as below-
Symptoms & Treatment of Parasparavana Vata
1) Pranavrutta vyana vata: Loss of thefunctions of the senses, loss of memory &loss of strength.
Treatment- This condition should be treated by the administration of therapies prescribed for supra-clavicular diseases.
2) Vyanavrutta prana vata: Excessive sweating, Horripilation, skin diseases & numbness in body.
Treatment - To such patients, purgation therapy with medicated oil should be administered.
3) Pranavrutta samana vata: Difficulty inspeech, slurring speech & even dumbness.
Treatment - For such patients, yapana basti & administration of medicated fat in four different ways are beneficial.
4) Samanavrutta apana vata: diseases of grahani, sides of the chest & heart, & colic pain in stomach.
Treatment -To such patients, Dipana sarpi should be given.
5) Pranavrutta udana vata: Stiffness of the head, rhinitis, obstruction to inspiration & expiration, heart diseases & dryness ofthe mouth.
Treatment-For such patients, therapies prescribed for the treatment of the diseases of head & neck should be given, & the patient should be comforted.
6) Udanavrutta prana vata: Loss of the functions, ojas, strength & complexion. There may be even the death of the patient.
Treatment- He should be slowly sprinkled with cold water, consoled & comforted.
7) Udanavrutta apana vata: Vomiting & diseases like asthma.
Treatment- To such patients, medicated enema & food as it would cause downward movement of vayu should be given.
8) Apanavrutta udana vata: Unconsciousness, suppression of the power of digestion & diarrhea.
Treatment- To such patients, emetic therapy, digestive stimulants & astringent ingredients should be given.
9) Vyanavrutta apana vata: Vomiting, abdominal distension, udavarta, gulma & parikartika.
Treatment- To such patients, unctuous therapies should be given for the downward movement of the wind in the stomach.
10) Apanavrutta vyana vata: Excessive discharge of stool, urine & semen.
Treatment-For such patients, all types of astringent therapies should be given.
11) Samanavrutta vyana vata: Fainting, Drowsiness, delirium, prostration, diminutionof Agni, ojas as well as strength.
Treatment- Such patients should perform physical exercise and eat light food.
12) Udanavrutta vyana Vata: Stiffness, less of Agni, less of sweating, lack of efforts & closure of the eyes.
Treatment- To such patients, wholesome & light diet should be given in limited quantity
Avarana by Dosha and its Treatment
When a peculiar dosha is obstructed byanother dosha i.e. it will result in aggravated symptoms of that dosha. But the dosha which gets obstructed by the other shows decline in their normal functions.
The patients should be treated with anabhisyandi therapies, which are unctuous & help in cleansing of channels of circulation. If all vayu gets avrutta in all its location, then prompt administration of therapies which are not antagonistic of kapha and pitta but which cause downward movement of vayu is beneficial. Yapana basti prepared of sweet drugs accompanied with anuvasana is useful. In strong patient mild laxative is also beneficial. Administration of all types of rejuvenating recipes, shilajita & guggulu along with milk is useful. Chyavanprasha is also beneficial. If the occlusion occurs due to apana vayu, then all therapies which are stimulant of digestion, which are astringent, which cause downward movement of vayu & which cleanse the colon should be given.
Other Types of Avrutta
1) Raktavrutta Vata: When Obstructed by Blood (Rakta), there is burning sensation, severe pain inside skin & Muscles, appearance of red swelling & red patches on skin
Treatment- When enveloped by Rakta (Blood), Tratment prescribed for vatashonit (gout) should be done.
2) Mamsavrutta Vata: When Obstructed by Mamsa (Muscle), there is hard swelling & eruption of various colours, horripilation & feeling of ants crawling on the body (Formiculation)
Treatment- When enveloped by Mamsa (Muscle), sveda (sudation), abhyanga (oil massage), ingestion of meat soup, milk as food, sneha (oleation therapy) are beneficial
3) Medavrutta Vata: Swelling on body which is movable, unctuous, soft & cold, Loss of taste/ appetite are the symptoms when covered by Meda (Fat). This condition
is known as Adhyavata & is difficultto cure .
Treatment - In Adhyavata (Vata enveloped by Meda/Fat, producing adhyavata/stiffness of the thighs) treatment prescribed for diabetes, obesity & Vata are best suited .
4) Asthyavrutta Vata: When obstructed by Asthi (bone tissue), the body is very hot totouch, finds comfort by squeezing (massaging, pressing), feels as though being pricked by needles severely, weak & painful.
5) Majjavrutta Vata: When Obstructed by Majja (Marrow), there is bending of the body parts, more of yawning (feeling of) encircling the body (by rope, cloth etc.) & pain, which subsides by pressing withhands.
Treatment - When enveloped by Asthi & Majja (Bone & Bone marrow) administration of Mahasneha (mixture of four fats).
6) Shukravrutta Vata: When Obstructedby Shukra (Semen), the ejaculation (of semen) occurs with great force or not at all, or it may become fruitless (not producing
the embryo) .
Treatment- When enveloped by Shukra (Semen), praharsha (great pleasure vis a vis sexual intercourse) & food which increase strength & semen are beneficial, In
case the passage of semen is found obstructed, virechana (purgation) should be given first followed the regimen of diet; after these the treatment mentioned above should be administered .
7) Annavrutt Vata: When Vata is obstructed by Anna (Food), there is pain in the abdomen soon after consuming food,subsiding after digestion .
Treatment- When enveloped by Anna (Food) administration of pachana (digestive), vamana (emesis), dipana (carminatives) & laghu (drugs & food which are
easily digestible) are ideal .
8) Mutravrutta Vata: When Obstructed by Mutra (Urine), there is no elimination of urine, but distension of the urinary bladder.
Treatment- When enveloped by Mutra (Urine), drugs which are mutrala (diuretic), sveda (sudation) & uttarbasti (Urethraldouche) are to be administered .
9) Malavrutta Vata: When Obstructed by Mala (Faeces), there is obstruction down below (constipation) & so cause cutting pain in its own place (in the large intestine & rectum), fat (administered by mouth as part of oleation therapy) gets digested quickly, the person develops flatulence bypartaking food, the faeces thus troubled by food, is expelled with difficulty in dry condition (scabellous) & after long period.
Treatment- When enveloped by Mala (Faeces) drinking of eranda taila, basti (enema) & fats (medicated oil or ghee) which produce purgation are ideally suited.
10) Sarvadhatavavrutta Vata: When vata is obstructed by all the Dathu (Tissues), there is pain in the pelvis, groin & back; it begins to move in wrong direction, causesillhealth & severe pain in the heart.
Treatment- When Vata is enveloped in all the places (of the body by all the tissues) the treatments which are not opposed to kapha & pitta & which are Vatanulomana (make vata move downward) should be done immediately. Foods & drugs which are anabhishyandi (not producing more moisture inside the body tissues), snigdha (unctuous), which purifies the channels, yapanbasti (enema therapy), anuvasana (oil enema) prepared from drugs of sweet taste, milk, virechana(purgations) should be administered based upon the good strength of the person. Use of Rasayana (rejuvenat or) always is highly desirable, especially of shilajau or purified guggulu along with milk; or Bhargavaleha