A REVIEW ON CONCEPT OF DISEASE- GRIDHRASI

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Jalawadi. European Journal of Pharmaceutical and Medical Research

254

.

A REVIEW ON CONCEPT OF DISEASE- GRIDHRASI

*Dr. Poornima Jalawadi

Assistant Professor, Dept. of Shalya Tantra, JSS Ayurveda Medical College.

Article Received on 23/07/2020 Article Revised on 13/08/2020 Article Accepted on 03/09/2020

INTRODUCTION

The one physical attribute making man unique among his

vertebrate cousins is his upright stature. Other primates

may enjoy the canopy of the tropical forest, sometimes

climbing, sometimes semi-upright, but man alone is

comfortable and confident with the upright bipedal

stance. Spinal anatomy is a remarkable combination of

strong bones, flexible ligaments and tendons, large

muscles and highly sensitive nerves. The harmony of all

these structures enables man to run with the pace of time.

He is taking the juxtaposition of strength, structure and

flexibility of the spine for granted in everyday life. But

all this ultimately may lead to numerous spinal disorders,

one of such agonizing and painful condition is „Sciatica‟.

Modern science describes „Sciatica‟ as a benign

syndrome characterized especially by pain beginning in

the lumbar region and spreading down the back of one

lower limb to the ankle and sometimes the foot. The

disorder apparently seems to be non-serious but it

cripples the patient and results in apprehension of social

responsibilities of the patient. It has been mentioned that

„Though Sciatica and lumbago carry little threat to life,

they interfere greatly with living‟.

Ancient Acharyas had identified this problem long back

and named it „Gridhrasi‟. The word „Gridhrasi‟ itself

suggests the gait of the patient which is similar to

Gridhra (vulture) due to pain. All the Ayurvedic classics

including those written in medieval period have

described the aetiopathogenesis and symptomatology of

Gridhrasi in concise form. Surprisingly, the description

narrated in these classics exactly coincides to the

description of „Sciatica‟ including the important

diagnostic test SLR which is described as

„Sakthinuthkshepanigraha‟ by acharyas.[1]

Gridhrasi is a gift of the Modern age of Machines and

Materialism, the industrialization, stress during the work.

Sciatica is one among disease which is gaining more and

more attention of scientists at global level. Many

institutions and Medical schools are making efforts to

find a perfect remedy for this burning problem. Curiosity

is one of the noblest instincts of man, the endless desire

of man for his knowledge. Many theories have been put

forward with many new hypothesis describing the exact

aetiopathogenesis.

Historical Glimpses

‘To understand science it is necessary to know its

history.’

- Auguste Comte

Ayurveda is the ancient medical science and we can find

its references in the Vedas so while studying Gridhrasi,

let‟s have a look at its historical background from Vedas

till date. Gridhrasi is the most obstinate and prominent

one amongst the 80 types of Nanatmaja disorders, of

Vata. Here an attempt has been made to trace out the

references regarding Vatavyadhi in general and Gridhrasi

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EUROPEAN JOURNAL OF PHARMACEUTICAL

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ABSTRACT

Pain is the chief cause of visiting a doctor in most patients. It is known as Ruja which is one of the synonyms of

disease. It disturbs physical and mental status of a patient. Pain is cardinal symptom in most of the Vatavyadhis.

Owing to multiple factors related with changing lifestyle, undue pressure to spinal cord plays key role in low back

ache which later extents to radiating pain. Gridhrasi is such a Ruja Pradhaana Vatavyadhi. In Gridhrasi intense

shooting pain equated with the disease sciatica in modern science. Gridrasi one among the Nanatmaja Vikara,

specific Nidana and Samprapti is not explained in classics so the general Vata Vyadhi Nidhana Samprapthi. All the

Ayurvedic classics including those written in medieval period have described the aetiopathogenesis and

symptomatology of Gridhrasi in concise form. Surprisingly, the description narrated in these classics exactly

coincides to the description of „Sciatica. Sciatica is one among disease which is gaining more and more attention of

scientists at global level. Hence in this paper an attempt is made to review the concept of Gridhrasi from various

classical texts and compile them.

KEYWORDS: Gridhrasi, Sciatica, Shoola, Stambha.

*Corresponding Author: Dr. Poornima Jalawadi

Assistant Professor, Dept. of Shalya Tantra, JSS Ayurveda Medical College.

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255

in particular available till now beginning right from the

Vedic era.

Vedic kala (2500 B.C. TO 500 B.C.)

Ayurveda is the Upaveda of Atharvaveda. The references

of Vatavyadhi are found in Atharvaveda only. The word

„Vatakrita‟ is used for Vatavyadhi. But no specific

mention of Gridhrasi is found.

Pauranika kala

Garada Purana deals with Ayurveda related subjects here

Vatavyadhi are described in a separate chapter and

Gridhrasi is described as an entity.

Samhita kala

Charaka Samhita (600 B.C.)

Charak Samhita being the best book for Chikitsa,

describes various references, regarding Gridhrasi along

with symptomatology and its management Su. 5 -

Matrasheetiya adhyaya – Gridhrasi is mentioned among

various indications for padabhyanga[2]

(Su. 5/92)

Su. 14 –Swedadhyaya[3]

– Gridhrasi is mentioned as an

indication for Sweda (Su.14/22) Su. 19-

Ashtodariyadhyaya[4]

– While describing the diseases

having two types Gridhrasi is mentioned with types,

Vataja and Vatakaphaja (Su. 19/7) Su. 20 –

Maharogadhyaya[5]

– Gridhrasi is enumerated in the 80

Nanatmaja Vatavyadhies (Su. 20/11) Ch. 28 –

Vatavyadhi Chikitsa[6]

– Detailed symptomatology along

with treatment of Gridhrasi has been described. (Ch. Chi.

28/56, Ch. Chi. 28/101)

Sushruta Samhita (600-400 B.C.)

In Sushrut Samhita, the description of Gridhrasi is found

at following places. Ni.1- Vatavyadhi nidan[7]

-

Symptomatology and pathogenesis have been described.

The symptom „Sakthiutkshepa nigraha‟ has been

described for the first time which can be correlated to the

SLR test in Modern medicine. (Ni.l /74) Chi. 5 –

MahaVatavyadhi chikitsitam[8]

– Siravyadha is described

as Chikitsa for Gridhrasi (Chi. 5/23). Sh. 8-

Siravyadhavidhi Sharira[9]

– The site of Siravyadha in

Gridhrasi is indicated (Sh. 8/17)

Ashtanga samgraha (5th Century)

Su. 20 – Doshabhediya adhyaya[10]

– Gridhrasi is

included under 80 types of Vatavikaras (Su. 20/13)

Su. 36 – Siravyadhavidhirnama adhyaya[11]

– The

site of Siravyadha in Gridhrasi has been indicated

(Su .36/9)

Ni. 15- Vatavyadhi Nidana[12]

– Gridhrasi is

described with its symptoms (Ni. 15/56)

Ashtanga Hridaya (5th Century)

Su. 27 – Siravyadhavidhi adhyaya[13]

– Site for

Siravyadha in Gridhrasi has been mentioned (Su.

27/14)

Ni. 15 – Vatavyadhi Nidana[14]

– Symptomatology

and pathogenesis of Gridhrasi is described which is

similar to that of Ashtanga Samgraha (Ni. 15/54).

Kashyapa samhita (7th Century)

Although doubtful, the period of Kashyapa samhita

is supposed to be 7th Century.

In this Samhita, Gridhrasi is considered under 80

types of Vatavikaras, but no details are described[15]

(Su. 27/21).

Bhela Samhita (7th Century)

Chi. 26 – In this chapter Basti and Raktamokshana

chikitsa are described for Gridhrasi.[16]

(Chi. 26/44-

45)

Harita samhita

As Acharya Harita belonged to the Agnivesha era, the

origin and time period of Harita samhita available is

doubtful.

Gridhrasi is described as a Vyanaprakopaja Vyadhi

(Tritiyasthana 20/31). The 22nd Chapter of Tritiya

sthana deals with the symptomatology and treatment of

Gridhrasi.

Samgraha kala

Madhava Nidana (7th Century)

In Vatavyadhi Nidana, Gridhrasi is described with its

symptoms. Some symptoms like Dehasyapravakrata in

Vataja and Mukhapraseka, Bhaktadwesha in

Vatakaphaja type of Gridhrasi are described firstly. (M.

N. 22/55-56)

Kalyanakaraka (8th Century) 8th

Chapter –

Vatarogadhikara – Gridhrasi is described with

pathogenesis and symptomatology. 12th chapter –

Treatment for Gridhrasi is described.

Chakradatta (11th Century) - The text deals with the

treatment part of various diseases Gridhrasi has been

described in the Vatavyadhi chikitsa chapter. Various

Churna, Gutika, Kwatha have been quoted. One of these

combinations has been selected for the present study.

Also Bastikarma, Shastrakarma, Siravyadha for

Gridhrasi are described.[17]

Chakrapanidatta (11thCentary) - In his commentary

on Charaka Samhita, Acharya Chakrapani explains the

specific type of pain in Gridhrasi which starts from Sphik

Pradesha and then radiates downwards to Kati., Prishtha

Uru, Janu, Jangha and Pada in order.

Gadanigraha (12th Century) - In Prayogakhanda – 4th

chapter – Gutikadhikara explains the treatment of

Gridhrasi.[18]

In Kayachikitsa Khanda – 19th chapter –

Vatarogadhikara Basti Chikitsa, Agnikarma and

Raktamokshana have been described for Gridhrasi.[19]

Dalhana (12th Century) - Dalhana, on its commentary

on Susrutha Samhita mentions Gridhrasi as Randhini and

also describes the meaning of „Sakthikshepanigraha‟.

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Arunadatta (12th Century) - In his Sarvangasundari

commentary on Ashtanga Hridaya, again explained the

symptom Sakthikshepanigraha.[20]

Vangasena (12th Century) - In this Samhita, Gridhrasi

is described with its two types where Vatabalasa word is

used for Vatakaphaja Gridhrasi. The treatment part is

also explained in details.

Indu (13th Century) - In the Shashilekha commentary

on Ashtanga samgraha, Acharya Indu described

Gridhrasi as having similar symptoms as that of

Vishwachi.

Sharangadhara Samhita (13th Century)

In Purvakhanda[21]

– 7th

Chapter – Rogaganana -

Gridhrasi is counted in Nanatmaja Vatavyadhies.

In Madhyamakhanda- Various preparations for

treatment of Gridhrasi have been described.

Qwatha kalpana[22]

and Kalka kalpana[23]

Rasaratnasamuchchaya (13th Century)

In 30th

Chapter treatment of Gridhrasi is mentioned[24]

Aadhunika kala

Bhavaprakasha (16th Century)

Gridhrasi is considered under 80 Vatavyadhies in

Madhyam khanda. Specific treatment for Vatakaphaja

Gridhrasi is mentioned.[25]

Yogaratnakara (17th Century)

Gridhrasi is described with its symptoms and

classification under Vatavyadhi. The treatment part is

dealt by describing some preparations, Siravyadha and

Agnikarma.[26]

Bhaishajya Ratnavali (18th Century)

In 26th

Chapter, Vata Vyadhi Chikitsa Prakarana,

Gridhrasi Chikitsa is Described.[27]

Harita Samhita

22nd

Chapter explains nidana, Symptammatology,

Chikitsa of Gridhrasi is mentioned.[28]

Vrinda Madhava

In Vata vyadhi Chikitsa, chiktsa for Gridrasi is

Mentioned.[29]

Vaidya Vinod

In this text, the types and symptomatology of Gridhrasi

have been described.

Nidana Chikitsa Hastamalaka (20th Century)

Gridhrasi has been mentioned in Tritiya Adhyaya of

Prathama Khanda.

In Dwitiya Khanda –12 Adhyaya – Different causes of

Katishoola along with treatment are described.

Chikitsa Pradeep (20th Century)

It deals with the treatment part only. Hence Snehana,

Swedana, Shamana and Brimhana etc. are described as

general line of treatment of Vatavyadhies along with

some special combinations for Gridhrasi.

Gridhrasi as a disease - ayurvedic concept Vyuttpathi

of Gridhrasi

The word Gridhrasi is a feminine gender. Which is

derived from „Gridhna‟ dhatu means to desire, to strive

after greedily or to be eager for. By the rule of

„Susudhangridhangridhi bhyaha kran‟ by adding

„karana‟ pratyaya i.e. „gridh + kran‟ followed by lopa of

„k‟ and „n‟ the word „gridh + ra‟ the word „gridhra‟ that

means Vulture is derived.

This word is also formed in another grammatical method

as „Grudhra‟+sho-atonupasargitcha adding „kah‟

pratyaya leads to Gridhra+sho+ka, further by lopa of „o‟,

„k‟ and „sha‟ is replaced by „sa‟ by rule „Datvadeshu‟

„Sah‟ „Sah‟ to get the word Gridhraus. Finally for this

word Gridhraus which is in female gender by adding

„Dis‟ Pratyaya the word Gridhrasi is derived.

गधृ्यति अभिकाङ्ग्क्षति माांसानोति |

पक्षषविशेषः गधृ्रनखी गधृ्रस्य नख इिाकारोऽस्थयाः इति ||

Nirukti

“गधृ्रांऽवप स्याति सो”[30]

As the gait has the resemblance with that of Vulture‟s

gait, it is termed as Gridhrasi. स्याति means throwing

action.

गधृ्रो माांसऱोऱुप मनुष्य िां स्यति पीडयति नाशयति िा |[31]

Gridra is bird called as vulture in English. This bird is

fond of meat and it eats flesh of an animal in such a

fashion that it deeply pierce its beak in the flesh then

draws it out forcefully, exactly such type of pain occurs

in Gridhrasi and hence the name.

गधृ्रांऽवप स्याति सो अन्िः कमााणि अिोनुपसगा | चन्िा गधृ्र इि स्याति पीडयति ,गधृ्र इि स्यति िक्ष्यति ||

Gridhrasi is characterized by severe pain experienced by

the patient is similar to the one experienced by prey of

vulture while being eaten up.

Paryaaya of Gridhra

Following are the synonyms of Gridhrasi

1. Ringhini

2. Randhrinee

3. Randhana

1) Ringhini[32]

– This term is used by Vachaspati Misra

to denote Gridhrasi. According to Shabdakalpadruma the

term refers to „Skhalana‟ which means displacement of

particularly a Pichila material.

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2) Randhrinee[33]

- The word is used by Dalhana to

denote Gridhrasi. The meaning of which is a weak point

or rupture of a material.

Randhana[34]

- This word is used by Kasirama and

Aadamalla in their Gudartha Deepika, commentary on

Sarangadhara Samhita which means pressing,

compressing or destroying.

Nidana Panchaka of Gridhrasi Nidana Panchaka is the combination of parameters,

which are used in the diagnosis of a disease. They are –

1) Nidana

2) Purvarupa

3) Rupa

4) Upashaya-Anupashaya

5) Samprapti

Nidana

For some of the Vathavyadhis specific causative factors

are available, for example, Manyasthambha, Arditha,

Hanugraha, Vatakandaka etc and for the diseases like

Gridhrasi, Pakshaghata, Apabahuka, Kroshtukasheersha

etc specific causative factors are not mentioned. So we

have to consider general causative factors for Vata

Vyadhi.

The aetiological factors are classified into the following

headings,

1. Aharaja

2. Viharaja

3. Kalaja

4. Nidanarthakara Roga

A) Aharaja – The causative dietetic factors included

under this group have been again subdivided into the

following groups.

1. Dravyataha: In this group all the dietetic articles have

been included.

2. Gunataha: This group includes the quality of dietetic

articles like Ruksha, Laghu, Sheeta are included.

3. Rasataha: The various tastes of the dietetic articles,

the excessive use of which lead to the Prakopa of Vata

and hence to the disease Gridhrasi e.g Tikta, Katu,

Kashaya.

4. Karmat: Excessive use of Vishtambi articles lead to

Vata prapokapa

5. Matrath: Less food or fasting

6. Mithyopayogatah

B) Viharaja (habits and regimen)

Factors like Vega Dharana, Ratrijagarana, Atyadhva,

Atiyana, provokes Vata Dosha and also leads to

Gridhrasi. Also over indulgence in Vyayama, Vyavaya,

Plavana, Bharaharana etc results in aggravation of Vata

and results Gridhrasi.

Agantuja (External factors) Patana, Pidana, Abhighata,

Marmaghata, are considered as external causative or

Agantuja factors for the provocation of Vata and

Manasika Bhavas (Mental factors) Chinta, Soka, Bhaya

result in Vataprakopa are also included here.

C) Kalaja (Seasonal factors)

Table no. 5: The Nidanas of Gridhrasi[35,36,37,38,39,40]

NIDANA C.S. S.S. A.S. A.H. M.N B.P.

AHARAJA

Rasa Katu, Tikta, Kashaya - + + + - +

Guna

Laghu + + + - + -

Ruksha + + + + + -

Sheeta + + + - + -

Dravya

Adhaki - + + - - -

Bisa - + - - -

Harenu - + - - - -

Chanaka - + - - -

Kalaya - + - - - -

Koradusha - + - - -

Masura - + + - - -

Mudga - + + - - -

Nivara - + - - - -

Nishpava - + + - - -

Salaka - - + - - -

Sushkashaka - + - - - -

Shyamaka - + - - - -

VIHARAJA

Atigamana + + - + +

Atihasya - + + - - -

Atilanghana + + + - - -

Atiplavana + + - - - -

Atipradharana - + - - - -

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Atiprajagarana + + + + + +

Atiprapatana - + - - - -

Atiprapidana - + - - - -

Atipratarana - + + - - -

Atiraktamokshana - - - - + +

Atishrama - - - - - +

Ativichestitam + - - - + +

Ativyayama + + + + + -

Atiadhyana - + + - - -

Kriya atiyoga + - + + + +

Padaticharya - + - - - -

Asanna,chalana,vikshepa,

asamotkshepa - + - - - -

Balavat vighraha - + + - - -

Bhara harana - + + + - -

Diva swapna + - - - + -

Dukhasana sayya + - - - + -

Kashta bhramana chalana vikshepa - - + - - -

Vegadharana + + + + + +

Vishamopchara + - - - - -

Gaja, ushtra, ashva sheegrayaana

patina - + - - + -

Marmaghata - + - - + -

Dosha asrik sravana - + - - + -

Dhatu kshaya + - - - + +

Ama + - - - + +

Rogati karshana + - - - + +

MANASIKA

Bhaya, shoka, chinta + - + + + +

Krodha + - - - + -

Mada - - - - - +

KALAJA

Aparahna - + + + - +

Apararatra - - + + - -

Grishma - - + + - -

PraVata - + - - - +

Shishira - - - - - +

Seeta kala - + - - - +

Varsha - + + - - +

Purvarupa of Gridhrasi

As Gridhrasi is a Vata Vyadhi and as separate Purvarupa

are not mentioned for Gridhrasi. Vata Vyadhi Purvarupa

can be considered for Gridhrasi also. These Purvarupa

usually are exhibited during the stage of „Sthana

Samsraya‟ of the „Shadkriyakala‟. At that time when

Dosha-Dushya Sammurcchana takes place, some specific

sign and symptoms are observed in particular disease

which are not clearly manifested, are termed as

Purvarupa. It is important to diagnose and treat the

disease at this stage so that patient may be saved from

the complete manifestation of the disease.

Charaka has mentioned that Avyakta Lakshana are the

Purvarupa of the Vatavyadhi. Chakrapanidatta

commenting on the word Avyakta mentions that few

mild symptoms are to be taken as the Purvarupa54

. But

Vijayarakshita, the commentator of Madhava Nidana has

given the clear meaning of the term Avyakta, according

to which symptoms not exhibited clearly are Purvarupa

and they are due to-

1) Weak causative factors.

2) Very less or mild symptoms.

3) Less Avarana of Doshas.

Roopa and Poorva roopa are interrelated with chronicity.

Rupa

The clear manifestation of signs and symptoms of the

disease is called as Rupa. Expressions of clear symptoms

occur at a stage when Dosha–Dushya Sammurchana has

been completed. Rupa is also indicative of the site of

affliction or actual pathology as well as to identify the

type of disease. Here an attempt have been made to

convert Lakshanas to most equalent modern translations.

Acharya Charaka, while describing Gridhrasi has listed

Ruk (pain), Toda (pricking sensation), Stambha

(stiffness), Grahana (restricted movements) and

Spandana (pulsating ) commencing from the spik (waist),

and descending through the posterior part of Kati (hip),

Prusta(thigh), Janu(knee), Janga(foreleg), and

Pada(foot). These are the cardinal symptoms of Vataja

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Gridrasi. In Vata kaphaja type of Gridhrasi in addition to

the above symptoms Tandra (stupor), Gaurava

(heaviness) and Arochaka (loss of appetite) will be

present.

Sushruta have mentioned „Sakthi uthkshepa nigraha‟ ie

one finds difficulty in raising the leg due to severe pain.

Madhavakara has mentioned the same symptoms as

mentioned by Charaka. In addition to this, in

Madhavanidana, he had mentioned symptoms of Vata

and Vatakaphaja Gridhrasi. Some signs and symptoms

like Dehasyapravakrata(irregular shape of body part)

Janu, kati, Uru Sandhi Spurana have been defined as

Vatika Lakshanas by Bhavaprakasha, Madhavakara and

Yogaratnakara.

The symptoms Vataja Gridhrasi are described in details

here:

Ruk

The word „Ruk‟ denotes pain. Any kind of pain is always

associated with Vayu. It is included under

Vataprakopaka Lakshanas by Vagbhata. When Vata

alone is vitiated, it is severe and continues but when

coupled with Kapha it may be less severe. The pain in

Gridhrasi is described to a definite area. It starts from

Sphik and then radiates through Kati, Prishtha, Uru,

Janu, Jangha upto Pada. The track of pain explained by

Charaka exactly corresponds to the pathway of sciatic

nerve. Hence Gridhrasi is correlated with Sciatica.

Toda

Toda means pricking sensation. It is caused by vitiated

Vayu and is included under Vataprakopaja Vyadhis by

Madhava. Also Vagbhata mentioned it in Vataprakopaja

Lakshanas.

Stambha

Stambha means stiffness felt throughout the leg.

Arundatta defines it as inability of the limbs to flex.

While Hemadri interprets it as loss of movement.

Especially the Sheeta and Ruksha Guna of Vata affects

the muscles of the leg, the movements of leg are

restricted. Also they are restricted due to pain, especially

flexion at the hip joint and extension at the knee joint.

When Vitiated Doshas affects the Snayu, Sira and

Kandara then Stambha, Sphurana and Supti are

produced.

Spandana

These are the twitching sensation felt in the affected leg.

By the word Spandana, Chakrapani signifies Kampana

while Dalhana explains it as Chalana i.e. certain kind of

movement is felt. It is also due to Vitiated Vayu

particularly Vyana Vayu. Chala Guna of Vayu is

responsible for Spandana.

Sakthnikshepa Nigraha

Sushruta explains the restricted movement of the affected

limb. The patient is unable to extend the leg i.e.

Prasarana of the leg is difficult. Dalhana explained that

because of the ill effect on Parshnikandara the movement

of the leg is forbidden. Vagbhata modified the term

Kshepa as Utkshepa which means upward movement or

rising.

Arundatta clearly defined this by „Pada uddharane

ashakti‟ meaning the disability to lift the leg.[60]

If we

analyse the symptoms in the light of modern medicine, it

appears very similar to the restricted SLR (Straight Leg

Raising) test which is done to assess the degree of

limitation of the limb (hip) flexion, when knee is

extended.

Dehasyapravakrata

This sign is mentioned in Laghu trayi but not is

Brihattrayi. Because of extreme pain felt in the limb, the

patient assumes a typical posture. He keeps his leg

slightly flexed at the hip and knee hence his body

appears to be in tilted position mostly to the affected

side. This is described as the “sciatic tilt” or “sciatic

scoliosis” in modern medicine.

Suptata

Bhavaprakasha and Yogaratnakara have only mentioned

this symptom. Chakrapani explains it as loss of

movement of the leg and also loss of sensation. Supti is

produced by Sheeta Guna. As Vata and Kapha both

possess the property of Sheeta Guna, both are

responsible for producing Supti.

Vatakaphaj Gridhrasi

Tandra

The inability of the sense organs to grasp their subject,

associated with heaviness of the body, and easy fatigue

are the Lakshanas of Tandra. It is due to Vata and Kapha

Dosha along with Tamo Guna. It is produced by Guru

Guna of Kapha. Tandra is included under and also under

Rasapradoshaja Vikaras.

Gaurava

Gaurava means feeling of heaviness. It is due to Kapha

especially Guru Guna. Patient feels heaviness all over the

body especially in the leg. This makes the movement of

the leg further difficult.

Arochaka

Charaka, Madhavakara and Yogaratnakara have included

this symptom. Although the patient has proper appetite

but still he can‟t enjoy the food due to loss of taste.Here

mainly Bodhaka Kapha Dushti is found. Also, it is

produced due to Rasadushti.

Mukhapraseka

It is described by Laghutrayi. It is also known as

Lalapraseka. It is a symptom of Kapha Dushti specially

Bodhaka Kapha. But also occurs due to presence of Ama

in the body.

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Bhaktadwesha

It is the dislike for food. When Kapha is vitiated along

with Vata in Gridhrasi, the power of Agni is suppressed.

This leads to Ama formation which causes feeling of

heaviness in the abdomen. Hence the patient develops

dislike for food.

Sthaimitya

It is one of the twenty Shleshma Vikara. Patient feels that

some wet cloth is wrapped around his body. Hemadri

interprets it as Alasya.Sthira, Sheeta guna of Kapha are

responsible for producing Staimitya. This symptom is

described by Yogaratnakara only.

Vahnimardava

Because of vitiated Kapha as Anubandhadosha, the

properties of Agni especially Jatharagni will diminish, as

a result Agnimandya takes place. This again leads to

production of Ama which aggravates the Vyadhi.

Table No. 6: Symptoms of Gridhrasi in Ayurvedic Classics.

Symptoms C.S S.S A.H A.S B.P MN Y.R Sa.S H.S

Sphika Purva Kati, Pristha,

Uru, Janu, Jangha, Pada

Kramat Vedana

+ - - - + + + - -

Ruk + - - - + + + + -

Toda + - - - + + + + -

Stambha + - - - + + + + -

Muhuspandana + - - - + + - + -

Sakthikshepanigraha - + - - - - - - -

Sakthiutkshepanigraha - - + + - - - - -

Janu Madhya Vedana - - - - - - - - +

Uru Madhya Vedana - - - - - - - - +

Kati Madhya Vedana - - - - - - - - +

Dehasyapravakrata - - - - + + + - -

Janusandhispurana - - - - + + + - -

Urusandhispurana - - - - + - - - -

Katisandhispurana - - - - + + + - -

Janghaspurana - - - - - + - - -

Suptata - - - - + - + - -

Additional Symptoms in Vata-kaphaja Gridhrasi

Tandra + - - - + + + + -

Gaurava + - - - + - + + -

Arochaka + - - - - - + + -

Vahni Mardava - - - - + + + - -

Mukhapraseka - - - - + + + - -

Bhaktadwesha - - - - + + + - -

Staimitya - - - - - - - - +

Upashaya and anupashaya Upashaya are the medicines, diets and regimens which

are similar to the causative factors and disease or are

dissimilar/opposite to the causative factors and disease

which gives relief to the patient Upashaya for Gridhrasi

has not been mentioned particularly in classics. But we

have seen some factors which aggravate the disease and

some factors which gives relief to the patient. For

example, Physical exertion like walking, lifting heavy

weights, standing, exercises, Increases pain in patient.

These are Anupashaya.

Taking rest by avoiding physical exertions, application

of oil, there is relief in pain in patient. These are

Upashaya.

In the same way, in Shaithya (cold climate), and in rainy

season patient feels discomfort. These are Anupashaya.

On the other hand, in summer season, Ushnata or

exposing to hot gives a feeling of relief in patient, called

as Upashaya in Gridhrasi.

Samprapti of gridhrasi

Samprapti is applied to express the course of aggravated

Doshas due to causative factors from the beginning till

the end of manifestation of disease is called Samprapti.

Or the way of aggravation, circulation and manifestation

is called Samprapti.

Susruta in Nidana Sthana has explained that Aggravated

Vata affects the Kandara (ligaments/tendons), related to

posterior part of Paada, as a result of that patient is not

able to lift his leg.

According to Astanga Sangraha, aggravated Vata gets

located in Kati and lower extremities and Snayu and

produces Gridhrasi.

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On the basis of symptomatology given in classics, the

probable Samprapti of Gridhrasi can be traced out as

below –

Dosha - Vata (Vyana and Apana), Kapha

Dushya - Rakta, Mamsa, Asthi, Majja, Sira, Kandara,

Snayu

Srotas - Raktavaha, Mamsavaha, Medovaha, Asthivaha,

Majjavaha

Srotho Dushti Prakara - Sanga

Agni - Jataragni and Dhatwagni

Ama - Jataragnijanya and Dhatwagnijanya

Udbhavasthana - Pakwashaya

Sanchara Sthana - Rasayanis

Adhisthana - Kandaras of Parsani and Pratyanguli and

Sphika, Kati, Uru, Janu, Jangham, Pada

Vyakta sthana- Sphika, Kati, Uru, Janu, Jangham, Pada,

Prishta

Rogamarga - Madhyama

1) Dosha

According to the texts, Vata is the essential Dosha for the

manifestation of disease „Gridhrasi‟. Kapha is in the

form of Anubandha. It is also well known that the

Prakopa of Vata may occur in two ways - due to

Dhatukshaya and Margavarodha. In case of

Dhatukshaya, continuous ingestion of food materials

which are Ruksha, Laghu, Sheeta, Sushka in nature

Ratrijagarana, Vegavidharana, Pramitasana and all such

causes lead to Dhatukshaya and it leads direct Sanchaya

and Prakopa of Vayu. In the case of Margavarana, Kapha

is an important factor, particularly for producing Vata-

kaphaja type of Gridhrasi.

According to Sushruta, in Gridhrasi Sakthi uthkshepa

Nigrahaniyat is found. The Kshepana, Utkshepana are

the Karma of Prakruta Vyana Vayu. Causes and

Adhisthana of Gridhrasi resemble to causes and

Adhisthana of Apana Dushti. Hence, out of five types of

Vata, Vyana and Apana are the especially vitiated.

2) Dushya

Acharya Sushruta says that, in Gridhrasi the vitiated

Doshas affects the Kandara and thus manifestation of the

disease occurs. According to Charaka, Kandaras are the

Upadhatu of Rakta Dhatu.

Chakrapani mentions that Sthula Snayu may be taken as

Kandara (tendon). Now, according to Charaka,

Mulasthana of Mamsa is Snayu and Snayu is an

Upadhatu of Meda.

Sthana of Vayu has been mentioned as Asthi and there is

an inverse relation between Vayu and Asthi. For

example, increasing Vayu causes Asthikshaya and it

leads to the further Prakopa of Vata.As Gridhrasi Nadi

vitiated in this disease, some Acharyas correlate nervous

tissue with Mastulunga and thus to Majja. So, in disease

Gridhrasi Rakta, Mamsa, Meda, Asthi, Majja, Sira,

Kandara and Snayu may be taken as Dushya.

3) Srotas

As mentioned above, here Rakta, Mamsa, Meda, Asthi

and Majja Dhatus are vitiated. So, their respective Srotas

may also be vitiated in this disease. Hence, the Srotas

involved may be taken as Raktavaha, Mamsavaha,

Medavaha, Asthivaha and Majjavaha Srotas.

4) Agni

Jatharagni and Dhatwagni of Rakta, Mamsa, Meda, Asthi

and Majja Dhatu may be vitiated in this disease.

5) Ama

When the Agni is vitiated automatically respective Ama

is formed. So, in this disease Jatharagnijanya and

Dhatwagnijanya Ama of Rakta, Mamsa, Meda, Asthi and

Majja Dhatu is produced.

6) Udbhavasthana

The main Udbhavasthana of this disease is Pakvashaya

because it is a Nanatmaja Vatavyadhi – Amashaya may

be considered as an Udbhavasthana of Vatakaphaja type

of Gridhrasi.

7) Sanchara Sthana

Here, Sancharasthana of the vitiated Dosha is the

Kandara which is situated in either side of the limb

between Parshni and Anguli as mentioned by Sushruta.

8) Adhisthana

According to Charaka, Kati and Sphika are the initial

sites from where the disease starts and then respectively

affects Uru, Janu, Jangha and Pada. According to

Sushruta, vitiated Dosha affects Kandara of Parshani,

Pada and Anguli. Thus, Sphik, Kati, Uru, Janu, Jangha,

Pada and Kandara of Parshani, Pada and Anguli may be

taken as Adhisthana of the disease Gridhrasi.

Sadhya – asadhyata

Acharya Charaka, in Chikitsa Sthana, has explained that

if Vata vyadhi more than one year or chronic is difficult

to cure or considered as incurable for treatment

(Asadhya) He further explains that, Vata Vyadhi should

be treated if they are in strong patient, newly originated

or less than one year and also free from complications

(Upadrava). They are Sadhya for treatment.[41]

Acharya Sushruta says that if the patient of Vata Vyadhi

develops the complications like Sunam

(edema/inflammation), Suptatvacha (tactile

senselessness), Bhagna (Fracture), Kampa (tremors),

Adhmana (distention of abdomen with tenderness) and

pain in internal organs, then it‟s Asadhya.

According to Acharya Charaka, if Vatavyadhi is

connected with Sandhichuti, Kunjanam, Kubjata, Ardita,

Pakshaghata, Angasamshosha, Pangutva and those which

are Majja and Asthigata are usually cured with difficulty

or even incurable for treatment.

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Vyavachedaka nidana

Every disease is unique and has its own cardinal signs

and symptoms. But certain diseases have resemblance in

their clinical presentation. Hence it is obligatory to rule

out the disease and initiate a correct line of treatment.

Vyavachedaka Nidana is not separately mentioned in

classics. It‟s not a part of Nidana Panchaka. Ancient

scholars did not have confusion regarding diagnosis.

Recent scholars find difficult to diagnosis due to lack of

sound knowledge regarding the symptomatology of

diseases. So they have introduced differential diagnosis.

Therefore, here an attempt has been made for the

differential diagnosis of the disease Gridhrasi.

Few disease are considered here for differential diagnosis

because of presence of similarity and also dissimilarity in

Nidana (dosha-dushya), Purvarupa, Rupa, Samprapti,

Sthana.

Gridhrasi presents with pain in lower limbs radiating

from Sphik, Kati, Prishtha and affecting Uru, Janu,

Jangha and Paada in order. „Sakthiutkshepanigraha‟ is

mentioned as a cardinal sign by Sushruta and Vagbhata.

But other symptoms such as Stambha, Toda, Sphurana,

Ruk. are also found in other diseases like Urustambha,

Khalli, Kalayakhanja and Vatakantaka.

Urustambha[75]

is a disease affecting one or both the legs

with symptoms of pain and coldness of leg associated

with Toda, Sphurana, Stabdhata and systemic

manifestations like Chardi, Jwara are found in

Urustambha which are absent in Gridhrasi. Also, a

patient of Gridhrasi will never have such a strange

feeling that the leg doesn‟t belong to him, which is

common in Urustambha. The typical radiating type of

pain is found in Gridhrasi only.

In Khalli,[76]

pain is in Pada, Jangha, Uru and Hasta.

Charaka has specified the type of pain as Avamotana i.e.

Mardanavat. Harita opines that Gridhrasi and Vishwachi

when originate together is called Khalli, while Vagbhata

gives importance to the severity of pain. But Khalli can

be differentiated from Gridhrasi by the nature of the pain

i.e. originating from Sphik, Kati and then radiating to the

leg.

Khanja is a disorder where vitiated Vayu gets lodged at

Kati affecting the Kandara of one leg, and when it affects

both the legs it is Pangu. In Gridhrasi also, the Kandara

of leg is affected but in Khanja there is no pain instead

there is wasting in leg. Kalayakhanja is caused due to

ingestion of certain kind of peas (Kalaya). In this disease

there is difficulty in walking and trembling gait.

In

Gridhrasi Kampana or Sphurana is present but not

specially related to walking. Also, Sandhi Shaithilya is

seen in Kalayakhanja but absent in Gridhrasi.

Vatakantaka is a disease affecting Gulpha Sandhi and

localised pain is the main symptom. In Gridhrasi, pain

may be present at Gulpha Sandhi but the whole leg is

affected which is not seen in Vatakantaka.

Chikitsa

Chikitsa is not only at the radical removal of the

causative factors of the disease, but also the restoring the

equilibrium of doshas.

General line of management of Vatavyadhi

1. Nidanaparivarjana

2. Samshamana

3. Samshodhana

Nidanaparivarjana: Nidana which are Vata Prakopaka

or causing kapha vitiation leading to Margavarodha

should be strictly prohibited.

Samshamana: Among the Shad Upakramas, Swedana,

Sehana and Brimhana can be adopted accordingly. If the

Dosha Prakopa is very less Langhana Chikitsa is enough,

if the intensity of Dosha Prakopa is moderate Langhana

and Pachana treatment is given. If however Dosha

Prakopa is severe, Shodhana treatment is decided.

Samshodhana: Vamana, Virechana and Basti are

advised in Gridhrasi. Raktamokshana is also indicated in

Gridhrasi.

Gridhrasi being a Vata vyadhi, the general line of

treatment for Vatavyadhi is indicated for Gridhrasi also.

Upakramas such as Snehana, Swedana, Utsadana,

Parisheka, Asthapana and Anuvasana Basti are indicated.

Basti is described as one of the best line of treatment for

Vata Dosha.

Vagbhata prescribes Sneha, Sweda, Mrudusamshodhana

along with Madhura, Amla and Lavana Dravyas,

Veshtana, Trasana, Madhya, Sneha siddha with Deepana

and Pachana drugs, Mamsa Rasa and Anuvasana Basti to

pacify the Vata.

Snehana

Snehana or oleation therapy is used externally and

internally in case of Gridhrasi. Externally Snehana may

be performed in the form Abhyanga, Pizhichhil,

Avagaha, Parisheka.

Swedana

Shoola and Stambha in the lower extremities are the

cardinal symptoms of Gridhrasi and is best treated by the

Swedana Chikitsa. Swedana also helps in the

liquification of the Dosha there by assisting clearing the

Srotas, or else rectifying the Margaavarana. Among the

different forms of Swedana procedures, Avagaha Sweda,

Pizhiccil, Nadisweda, Patrapindasweda, Pindassweda

and Upanaha Sweda, Sankara sweda may be exclusively

performed in patients of Gridhrasi.[81]

But in Vatakaphaja

Gridhrasi, Ruksha Sweda is a better option.

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Gridhrasi being a Vata vyadhi, the general line of

treatment for Vata vyadhi is indicated for Gridhrasi also.

Upakrama such as Snehana, Swedana, Utsadana,

Parisheka, Asthapana and Anuvasana Basti are indicated.

Specific treatment for gridhrasi

Table No 07: Chikitsa According to Different Authors

Acharyas Chikitsa Sutra

Charaka Sira vyadha, Basti, Agni karma

Sushrutha Sira vyadha

Vaghbhata Sira vyadha

Vangasena

Dipana, Pachana, Swedana,

Mardana, Upanaha, Vamana,

Virechana, Asthapana Basti, Sneha

Basti, Agnikarma

Chakradatta Pachana, Shodhana, Basti, Shastra

karma

Yogaratnakara Sira vyadha, Agni karma

Bhava

Prakash Virechana, Vamana, Basti

Charaka Samhita: Acharya Charaka has mentioned the

site of Siravyadha as Antara khandara gulpha and Basti,

Agnikarma is also indicated.

Susruta Samhita: Acharya Susruta has mentioned Vata

vyadhi Chikitsa for Gridhrasi, and if rakta avarana is

present even after the treatment then Sira Vyadhi should

be done. In Gridhrasi Siravyadha is mentioned four

Angula above and four Angula below at the site of knee

joint. It is a general rule that, when the regular treatment

with Shadvidhopakrama fails to give any relief in any

disease, one should consider the involvement of Rakta

Dhatu in the pathogenesis and is best treated by

Raktamokshana. This rule is also applicable in Gridhrasi

Roga.

Vagbhata: Chikitsa sutra for Gridhrasi is not mentioned.

Indu the commentator of Astanga Sangraha explained

Sira vyadha in Gridhrasi is four Angula above and four

Angula below at the site of knee joint.

Chakradatta: He has mentioned Pachana, Shodana,

Basti. Shodhana includes Vamana, and Virechana. The

physician should have proper knowledge regarding the

Nirama Avastha and Agni of the patient before giving

Basti and Virechana Chikitsa.

He has explained Shastra karma as line of treatment of

Gridhrasi ie., a small operation with prior Snehana and

Swedana to remove Granthi in Gridhrasi. Sira vyadha

should be carried out four Angula below IndraBasti

Marma. Agni karma should be done in Pada Kanistika

Anguli (little toe of the affected leg).[42]

Vangasena: He has explained Dipana, Pachana,

Swedana, Mardana, Upanaha, Vamana, Virechana,

Asthapana Basti, Sneha Basti, Agnikarma. He has

clearly mentioned application of warm Taila and Isthika

sweda. He also mentioned Mardana and Upanaha

measures for Gridhrasi. Agni karma should be done in

Pada Kanistika Anguli.

Yogaratnakara: Siravyadha and Agnikarma is

explained.

Bhava Prakasha : Virechana and Basti is explained.

Pathya – apathya

Acharya Charaka has defined Pathya as that type of food

article, drug and regimen which do not affect the body

and mind adversely and that which adversely affects the

body and mind are considered as Apathya. Thus

Ayurveda ascribes the importance of regulations in daily

living to maintain good health ie. Dinacharya, Ritucharya

and Achara Rasayana. Pathya is given equal importance

to that of Chikitsa and it is termed as a synonym for

Chikitsa too.

Gridhrasi, being a Vatavyadhi, the Pathyapathya

mentioned for Vatavyadhi should be followed. Ahara

having the basic quality of Madhura, Amla and Lavana

Rasa, Snigdha, Ushna guna and Brimhana property

should be advised. Chakradatta, Bhaishajya ratnavali and

Yogaratnakara have the description of Pathyapathya in

detail.

It can be presented as:

Anna varga : Rakta shali, Purana Shashtika shali,

Kulatha, Masha,

Godhuma, Lavana.

Dugdha varga : Dugdha, Ghrita, Dadhi,

Matsyandika, Dadhikurchika.

Shaka varga : Patola, Shigru, Vartaka, Lashuna,

Tambula

Phala varga : Dadima,Parushaka, Badara, Draksha,

Jambira

Mamsa varga: Gramya, Anupa, Audaka Mamsa,

Chataka, Kukkuta,

Tittira, Nakra mamsa.

Drava Varga : Taila, VasaMajja, Yusha, Mamsarasa,

Sura, Naladambu

Aushadha : Prasarini, Gokshura, Nimba,

Kshirkakoli.

Pathya Vihara Snigdha swedana, Abhyanga, Basti, ShiroBasti,

Sirahsneha, SnaihikaDhuma, Sneha Nasya, Sneha

Gandusha, Sukhoshna Parisheka, Samvahana are the

upakramas to be followed.

Apathya Ahara Chanaka, Kalaya, Shyamaka, Nivara, Kangu, Mudga,

Rajamashaka, all Trina Dhanyas, Nishpavabija, Bimbi,

Kasheruka etc. should be avoided. Also Tadaga and

Tatini Jala.

Upadrava

Upadravas are produced as a sequel of the disease

proper. Their emergence increases the graveness and

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complexity of treatment. Their description in various

classics is as follows

Sushruta has elaborately described Upadravas of eight

Maharogas including Vatavyadhi in general as well as

that of Vata-vyadhi independently.

Upadravas of Eight Mahavyadhi

1. BalaKshaya

2. Mamsa Kshaya

3. Shosha

4. Trishna

5. Chardi

6. Jwara

7. Atisara

8. Moorcha

9. Hikka

10. Shwasa

Specific Upadrava of Vatavyadhi 1. Shotha

2. Suptata

3. Bhagna

4. Kampa

5. Adhmana

6. Ruja

DISCUSSION

The Ayurvedic treatises in the context of Vata Vyadhi

explain a painful condition afflicting the lower limbs

called ‘Gridhrasi’ wherein the pain along with stiffness,

sensation of pins and needles, gripping and pulsations

start in the Spik or the buttocks [gluteal region] initially

and gradually encroach the regions of the posterior

aspect of Kati (pelvis and lumbo sacral regions), Uru

(thigh), Jaanu (behind the knee), Jangha (leg) and Pada

(foot) in order. This occurs due to the vitiation of Vata.

But when Kapha gets involved with Vata stupor,

heaviness of the body and anorexia are also associated

with the above said complaints.

Gridhrasi can be compared with the ‘Sciatica’ explained

in the modern texts due to a close resemblance in the

manifestations of both the conditions.

Sciatica is a term used to explain a set of symptoms

including pain numbness tingling and weakness starting

from the low back and or buttocks and radiating towards

the foot through the back of the thigh, knee joint and the

leg when one or more of the 5 nerve roots forming the

sciatic nerve or the sciatic nerve itself is either

compressed or irritated.

CONCLUSION

Gridhrasi a Shoola Pradhana Nanatmaja Vata Vyadhi

manifest owing to multiple factors related with changing

lifestyle, which is commonly seen as a prominent

problem. Specific Nidana and Samprapti is not explained

in classics so the general Vata Vyadhi Nidhana

Samprapthi can be considered.

With the Chikitsa part concerned, Sneha, Sweda, Basti,

Siravyadha, and Agni karma is explained. Basti Karma is

Sarvarthakari, superior most in the management of Vata,

and it seems to be the radical treatment of this disease.

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15. Sri Satyapala Bhishagacharya edited Kashyapa

Samhita, Sutra Sthana, Chapter 27, Shloka No. 21,

Edition: Reprint 2006, Pub: Chaukhambha Sanskrit

Sansthan, Varanasi, Page No. 68.

16. Prof. Priyavrat Sharma edited Bhela Samhita,

Chikitsa Sthana, Chapter 24, Shloka no.44

Edition:Reprint 2005, Pub: Chaukambha

Visvabharati, Varanasi (UP), Page No.454.

17. Proff.K.R.Sreekandamurthy Translated Madhava

nidana,Chapter 22, Sloka no.54 Pub: Chaukhamba

Surbharati Prakashan, K.37/117, Gopal Mandir lane,

Post box No.1129, Varanasi (UP), Edition: Reprint

1995, Page No.142.

18. Acharya Chakrapanidatta, Chakradatta, Chapter

Vata Vyadhi Chikitsa, Shloka No.43,44,45,51,53,

Edited by Priyavrat Sharma, Pub:Chaukhambha

Publishers, Varanasi(UP), Edition: Second1998,

Page No.136-137.

19. Sri Vaidhya Sodhala, Gadanigraha edited by Shri

Ganga Sahaya Pandeya, Prayoga Khanda, 4th

Chapter, Shloka no.322,352, Pub: Chaukhambha

Sanskrit Sansthana, Varanasi, Edition: 2003, Page

no.271.

20. Sri Vaidhya Sodhala, Gadanigraha edited by Shri

Ganga Sahaya Pandeya, Kayachikitsa Khanda, 19th

Chapter, Pub: Chaukhambha Sanskrit Sansthana,

Varanasi, Edition: 2003, Page no.505-506.

21. Dr. Rajjev kumar Roy edited Vangasena Samhita,

Chapter Vata vyadhi Adikara, Shloha No.115, 1st

edition 2004, Pub: Chawkhambha Sanskrit Series

office, Varanasi (UP), Page No.267.

22. Pandit Parashurama Shastri Vidyasagar edited,

Sharangadhara Samhita, Deepika commentory by

Adamalla on Poorvakhanda, Chapter 7, Shloka

No.108, 3rd edition 1983, Pub:Chawkambha

Orientalia, P.B.32, K, 37/109, Gopal Mandir lane,

Varanasi (UP), Page No.40.



Adamalla on Poorvakhanda, Chapter 2, Shloka






Adamalla on Madhyama Khanda, Chapter 5, Shloka




25. Vagbhatacharya, Rasa Ratna Sammuchaya, Edited

by, Dr.Kapidev Giri, Chapter 30,Shloka no.71, Pub:

Chaukhambha Sanskrit Sansthana K.37/116, Gopal

Mandir Lane, Varanasi, Edition Reprint, 2009, Page

no.410.

26. Bhavamishra, Bhavaprakasha, Edited by

Dr.Sreekanda Moorthy, Vol 2, Madhyama Khanda,

Chapter 24, Shloka no.129, Pub: Chaukhambha

Krishnadas Academy, Varanasi, Edition, 2009, Page

no. 331.

27. Yogaratnakara, Edited by Dr.Ashakumari and

Dr.Premvathi Tewari, Part 1, Chapter, 25, Shloka

no.68-71, Pub: Chaukhambha Viswabharati,

Varanasi, Edition , 2010, Page no.581.

28. Shri Govinda Dasji, Bhaishajya Ratnavali, Edited by

Bhisagratna Shri Brahma Shankar Mishra, Vol 2,

Chapter 26, Sloka No.37, Pub: Chaukhambha

sankrit samsthan, Edition: Reprint 2009, Page

No.135.

29. 8Vaidya Jamini Pandey, Harita Samhita, Chapter 22,

Shloka No.2-9, Pub: Chaukhambha Viswabharati,

K. 37/109, Gopal Mandir Lane, Varanasi, Edition,

2006, Page no.381.

30. Vrindamadhava or Siddha Yoga,Edited by

Dr.Premvati Tewari, Part one, Chapter, 22, Shlok a

no, 69, Pub: Chaukhambha Viswabharati, K.

37/109, Gopal Mandir Lane, Varanasi, Edition,

2006, Page no.316.

31. Amarakosa sloka no.2015.

32. Prof. P.V Tewari edited Kashyapa Samhita by

Acharya Vruddha Jivaka, Redacted by Vatsya,

Kilasthana, Chapter 8, Sloka-41-45 Reprint 2008,

Pub: Chaukhamba surabharati prakashan, K.37/117,

Gopal Mandir lane, Post box No.1129, Varanasi

(UP), Page No.271-272.

33. Vaidya Jadavaji Trikamji Acharya edited Charaka

Samhita, Revised by Charka and Drdhabala, with

Ayurvedic commentry by Chakrapanidatta on

Siddistana, chapter 1, Sloka No. 7, Edition Reprint

2009, Pub: Chaukhamba surabharati prakashan,

K.37/117, Gopal Mandir lane, Post box No.1129,

Varanasi (UP) page No.678.

34. Vaidya Jadavaji Trikamji Acharya edited susrutha

Samhita with commentary Nibandha sangraha of

Dalhana, Chapter-38, Sloka No. 5, Edition:Reprint

2009. Pub: Chaukhamba Sanskrit sansthan


Varanasi (UP) Page No.540

www.ejpmr.com


266

35. Vaidya Jadavaji Trikamji Acharya edited Susrutha


Dalhana, Chapter-38, Sloka No. 19, Edition:Reprint

2009. Pub: Chaukhamba Sanskrit sansthan


Varanasi (UP) Page No.541.




Siddistana, chapter 1, Sloka No.46, Edition Reprint




37. Vaidya Jadavaji Trikamji Acharya edited Susrutha


Dalhana,Chikitsa Stana, Chapter-37, Sloka No.9,

Edition:Reprint 2009. Pub: Chaukhamba Sanskrit

sansthan K.37/117, Gopal Mandir lane, Post box

No.1129, Varanasi (UP) Page No.541.















40. Pt. Harisadashiva shastri paradakara edited Astanga

Hrudaya of Vagbhata with commentary

Sarvangasundare of Arunadatta and Ayurveda

Rasayanam of Hemadri, chapter No. 19, Sloka

No.51, Reprint 2010, Pub: Chaukhamba surabharati

prakashan, K.37/117, Gopal Mandir lane, Post box

No.1129, Varanasi (UP) page No.81.

41. Prof. Priyavrat Sharma edited Bhela Samhita,

Chikitsa Sthana, Chapter 24, Shloka no.44

Edition:Reprint 2005, Pub: Chaukambha

Visvabharati, Varanasi (UP), Page No.454.

42. Vaidya Jamini Pandey, Harita Samhita, Chapter 22,

Shloka No.2-9, Pub: Chaukhambha Viswabharati,

K. 37/109, Gopal Mandir Lane, Varanasi, Edition,

2006, Page no.381.

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