Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S
Context of Vilambika dysfunction
Vilambika is a gastrointestinal dysfunction. Vilambika has been defined in Sushruta Samhita Uttara Sthana Part, Chapter 56. Grasp Sushruta has quoted a verse of two strains describing this context in a chapter meant for detailed clarification of one other digestive dysfunction Visuchika.
The identical situation has additionally been defined in Madhava Nidana treatise within the context of (chapter of) Agnimadyadi Nidanam i.e. chapter coping with Agnimandya – sluggish digestive fireplace and different ailments. Right here too, the writer has copy pasted the identical references from Sushruta Samhita.
Relation to context
The situation referred to as Vilambika has been defined together with Visuchika and Alasaka instantly after the reason of agnimandya – low digestive fireplace, ajeerna – indigestion and kinds of ajeerna.
Grasp Sushruta says that the ama, vistabdha and vidagdha kinds of ajirna are chargeable for manifestation of gastrointestinal problems like Visuchika, Alasaka and Vilambika.
Briefly – Ajirna vis-à-vis indigestion is the muse (trigger) for vilambika and comparable circumstances.
Nidana: Causative components
Vilambika is brought on by Ajirna – indigestion. So, logically something and every part which causes ajirna would possibly trigger Vilambika. All kinds of ajirna and all causes of all these sorts are additionally the causes of vilambika. The causes of vitiation of annavaha srotas – channels carrying / conveying meals shall even be thought-about.
The causative components of formation of ama additionally ought to be thought-about as causal of vilambika.
Samprapti: Pathogenesis
दुष्टं तु भुक्तं कफमारुताभ्यां प्रवर्तते नोर्ध्वमधश्च यस्य ।।
विलम्बिकां तां भृशदुश्चिकित्स्यामाचक्षते शास्त्रविदः पुराणाः ।। ९ ।।
Meals getting vitiated by kapha and vāta, doesn’t come out both from upward or from downward paths (and stays contained in the stomach for a very long time). This illness, which is troublesome to deal with, is named by the traditional physicians as Vilambikā.
The consumed meals comes into the abdomen whereby there’s irregular enhance of kapha and vata
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Kapha and Pitta would vitiate the consumed meals by getting blended with it
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The meals contaminated by kapha and pitta neither strikes upwards or downwards
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There happens stagnation of meals within the abdomen
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As a consequence of this stagnation and really gradual motion (vilamba) of meals, the situation is named as Vilambika
Lakshana: Signs
The primary symptom of Vilambika is ‘the meals not having the ability to transfer upwards or downwards and getting stagnated within the abdomen’.
The beneath talked about signs are usually not talked about within the treatise however should be assumed primarily based on the character of the illness.
– Ajirna – continual indigestion shall be one other most important grievance within the backdrop. All signs related to indigestion of meals will even be current on this situation.
– Generalized signs of kapha and vata aggravation may additionally be seen.
– Because the meals is stagnated and never digested correctly, ama is shaped and the rasa shouldn’t be shaped. Since ahara rasa shouldn’t be shaped, the tissues are additionally not shaped. This results in depletion of tissues, low power and immunity.
Srotas Affected & Mode of Affliction
We will see that the annavaha srotas – meals conveying channels are primarily concerned on this illness Vilambika. The srotodushti i.e. affliction of srotas shall be of ‘sanga – obstruction’ sort. The obstruction takes place within the amashaya – abdomen and annavahi dhamanis i.e. oesophagus above and duodenum / small gut beneath. Subsequently, the meals can not transfer upwards or downwards. Amashaya and Annavahi Dhamanis are the roots of annavaha srotas.
The stricken factor is ‘anna’ i.e. meals. The doshas which might afflict the meals are kapha and vata, as already talked about.
Extreme consumption of the meals, premature consumption of meals, consumption of unwholesome meals and disturbance or vitiation of agni – digestive fireplace positioned within the abdomen and gut are the chief causes of contamination / vitiation of annavaha srotas. The identical are the causes of Vilambika.
Relationship with Alasaka
By description and pathogenesis, alasaka and vilambika seem like the reason of comparable circumstances. In each circumstances, the meals affected by kapha and vata neither strikes upwards nor downwards. Then what’s the distinction between these two circumstances?
In alasaka it’s stated that the meals being stricken by kapha and vata will get stagnated within the abdomen like a shalya i.e. overseas physique. Although there is no such thing as a diarrhoea or vomiting, this situation is marked by extreme ache within the stomach. Thirst and belching are predominantly current.
The opposite signs of alasaka are distension of stomach, fainting, sounds from stomach, upward motion of vata, and obstruction of faeces and fart / flatus.
The distinction between these two circumstances is that Alasaka is an acute situation whereas Vilambika seems like a continual manifestation and a progressive state of Alasaka.
Grasp Sushruta has specified that vilambika could be very a lot troublesome to deal with whereas dangerous prognosis has not been talked about within the context of alasaka.
Grasp Charaka has not talked about Vilambika. He has talked about extra dreadful and incurable state of alasaka as Dandalasaka. Charaka’s Dandalasaka could be stated to be an identical situation as that of Sushruta’s Vilambika.
Relation to Vidagdhajirna
This situation vilambika is alleged to develop from a state of in all probability a continual indigestion and compromised abdomen and gastrointestinal tract brought about attributable to predominant vitiation of pitta which in all probability has brought about extreme irritation and injury within the intestinal tract i.e. vidagdhajirana.
Prognosis of Vilambika
The phrase ‘dushchikitsyam’ within the description of Vilambika signifies that it is extremely troublesome to deal with vilambika and therefore carries a nasty prognosis.
Instantly after explaining vilambika, Grasp Sushruta Samhita provides two extra fast verses they usually appear to be relevant to vilambika. They’re –
यत्रस्थमामं विरुजेत्तमेव देशं विशेषेण विकारजातैः ।।
दोषेण येनावततं स्वलिङ्गैस्तं लक्षयेदामसमुद्भवैश्च ।। १० ।।
This explains ‘the place within the physique whereby there’s ama will give rise to ache and that place itself ought to be thought-about as a seat of origin of ailments brought on by doshas. This shall be decided by the presence of signs of ama at that place.’ This verse is definitely relevant for all circumstances arising from ama and likewise to vilambika.
This additionally reveals the presence of ama in vilambika and the explanation it is likely to be a painful situation.
यः श्यावदन्तौष्ठनखोऽल्पसंज्ञश्छर्घर्दितोऽभ्यन्तरयातनेत्रः ।।
क्षामस्वरः सर्वविमुक्तसन्धिर्यायान्नरः सोऽपुनरागमाय ।।११।।
The affected person of vilambika walks away by no means to return (i.e. he dies) if he has the beneath talked about indicators (and signs) related to the illness –
– Shyava danta oshta nakha – bluish discoloration of tooth (gums), lips and nails
– Alpa Sanjna – has solely little consciousness
– Chardi – extreme vomiting,
– Abhyantara yata netrah – sunken eyes (eyes gone deep contained in the sockets)
– Kshama svarah – has developed feeble voice
– Sarva vimukta sandhi – looseness / laxity of all of the joints of the physique
These indicators present extreme deficit of oxygen, hydration and diet to the cells and improvement of extreme cyanosis which could result in dying.
These indicators of dangerous prognosis may additionally be relevant for visuchika and alasaka defined by Grasp Sushruta in the identical context, however the dangerous prognosis itself has not been talked about within the description of those circumstances.
So, by default they’re relevant just for vilambika. It additionally is smart as a result of they’re defined instantly after the outline of vilambika.
Therapy Rules of Vilambika
We will see that Grasp Sushruta has not defined the therapy of Vilambika, and neither does different treatises. This clearly explains that the acharyas had severely regarded this situation as incurable. So, you will need to see that this downside doesn’t develop.
Beneath talked about are the essential precautions to be taken in order to maintain vilambika away from manifesting.
Preventive measures –
– Avoiding the etiological components which may trigger agnimandya
– Avoiding the etiological components of pitta aggravation
– Avoiding the etiological components which might trigger ajirna, primarily vidagdhajirna
– Avoiding the etiological components of ama
– Avoiding the etiological components of contamination and vitiation of annavaha srotas – channels of transportation of meals and liquids and purishavaha srotas – channels chargeable for formation and expulsion of faeces – in whole, the gastrointestinal tract together with abdomen, small intestines and colon
Healing measures – Since vilambika can’t be cured, you will need to remedy the ajirna and ama in its backdrop promptly. The beneath talked about rules shall be thought-about –
– Immediate and well timed therapy of agnimandya
– Promptly conserving pitta in a state of stability all the time
– Immediate and well timed therapy of ajirna, primarily vidagdhajirna
– Immediate and well timed therapy of ama – ama pachana measures
– Immediate and well timed therapy of annavaha and purishavaha sroto dushti
– Immediate therapy of different gastrointnestinal ailments like atisara, grahani, pravahika, anaha, adhmana, alasaka and so forth
Additionally, the beneath talked about are additionally the important thing components which ought to be thought-about –
– Following the rules laid by Ayurveda in the direction of taking of wholesome and well timed meals hitting qualitative and quantitative stability, as per the physique’s wants making use of the thoughts and senses i.e. aware consuming habits, like following ahara vidhi vishesha ayatana rules.
– Figuring out the proper and improper diets for oneself in session with Ayurveda or weight loss program specialists and making ready a custom-made dietetic protocol which might go well with oneself.
– Following disciplined etiquettes as associated to meals consumption.
– Maintaining a test on gastrointestinal well being, importantly on continual and cussed subtleties like lack of urge for food, aversion from meals, indigestion, constipation, flatulence, dyspepsia, distension of stomach, noises from stomach, modified patterns of urge for food or bowel evacuation and so forth and taking fast opinions and in search of fast treatments for a similar.
– Maintaining effectively hydrated, taking balanced meals, following correct bowel habits, following time of consuming meals and sleep
– Maintaining away from undue stress and making peace with meals.
– Correctly following the dinacharya and rutucharya as defined in Ayurveda.
