Concept of Aavran

Chikitsa
By Dr.Bhavin Kathiriya

1st year P.G.SCHOLAR Depa. Of Kayachikitsa

 Introduction :

Like Ama the Avarana also an unique concept of disease pathogenesis, especially of Vatavyadhis.

c.c.28/3

urUros urkivUUhq |
uruqS xu mpur Mii ||

Vayu is life, strength, sustainer of the creatures, entire world, master of all activities.
Vata dosha is the chief among Tridosha, because of its Ashukaritwa and its ability to carry on all the life process in association with Pitta, Kapha, Saptadhatus, and TrividhaMalas. It is composed of RajogunaBahulya which is the Pravartaka-Sarvabhavanam and the other two Doshas often described as Pangu or lame without the involvement of Vata Dosha.

Such dynamic factor Vata, naturally causes more number of diseases in the body than the other doshas.

Avarana, the unique concept of Ayurveda explains the abnormal course of activities of Vata due to an impediment resultant of an Avaraka. The clinical understanding of Avarana is necessary for the diagnosis and management of disorders mentioned in the context of Vatavyadhi as well as in other chapters of Ayurvedic classics.

 Derivation :
The word Avarana is originated from the root ug uUh means to

cover and produce obstruction.

Meaning of Avarana :

AuUh = AuUk (x.l 1/85) AuUh=AcNSlq

ua miolkq || c c.c.28/59
Aur Aulkrirj || QsWh

AuUM AcNSM || (uvoSxlS ) AuUh AcNSlq || (voSMsmSq)

 Definitions of Avarana Vata : 1 qauUhl ua miolkSu Mmi puli | (cmh

c.c.28/59)

Margavarodha(occlusion/ obstruction) causes obstruction in the speed of movement of Vata, leads to its aggravation.

2. xipr AlrSwmhpr AuUh mmr

os urUu u Mmri|

(AhS A.W.l. 15/6)

The anya doshas get accumulated in the srotas and produces Avarana to the Vata marga is called as Avarana.

3. uiS Sw qv kil xuXaqu c |

(uxUxXaW)

Auir Mi rxqi ixqSuUh uS ||

The occlusion or obstruction which is produced by Vatadi dosha, Dhatus called as Avarana.

 Terms used in the concept of Avarana Vata :

1 Avarana of Vata : Which denotes obstruction of Vata movement.

The obstruction can be due to Pitta, Kapha, Dhatus, Malas, even by

other Vatas.

2 Samanyavarana : Vata get obstructed by dosha, dhatu, mala etc.

In case of Samanyavarana : ll mMTpr kip qUuUh reri | (QsWh

x.c.5/29)

The Gati Nirodha produced by Pitta, Kapha, Dhatu, Mutra etc

3 Anyonyavarana : Sub type of Vata get obstructed by another type of

Vata.

In case of Anyonyavarana : i Fku acNSl mh umlxrkaql ailUk

MuuUM Circri|

(QsWh x.c.5/29)

 4 Avaraka : The factor which causes the obstruction of Vata is Known as

Avaraka. Eg If Kapha causes Avarana of Vata ,then Kapha is called as Avaraka in this context.

Prana Vata or Udana Vata having upward movements and Apana is having downward movements. That which produce Gati Nirodha to this is called as Avaraka

5. Avruta : Vata movement which is effected by the Avaraka is called as Avruta. MiuUh Aui | (voSMsmSq)

That which get covered is Avruta

In Samanyavarana : Vata and its bheda called as Avruta. In Anyonyavarana : Vata bhedas (Durbala Vata ) as avruta.

rqirUpqZ Apxmi osui Sosppi mirui

xl Aui Circri | (QsWh x.c.5/29)

When two types of Vata move towards each other and the weaker one overcome by the stronger one is called as Avruta

 Types of Avarana Vata :

The Avarana of Vata may be innumerable
urUuUh ci oWpS muri | (A.W.l.16/30)

How ever 42 types of Avarana Vata have been described in the texts,

which can be categorized under the fallowing two major divisions.

1.Murta avarana.(22 types) Pitta dosha, Kapha dosha, Dhatus, malas and Anna are the murta

substances which obstruct the path of Vata and this condition is called as Murta avarana.It can be divided into
a) Dosha avarana(12 types)
i.e. pitta , pitta with panch-vata(5), kapha, kapha with panch-vata(5)

b) Dhatu avarana(7 types)

i.e. rakta,mansa,meda,asthi,majja,shukra, sarvadhatu(1)

c) Mala avarana (2 types)

i.e. mutra,purisha

d)Anna avarana(1 type)

i.e. anna

2.Amurta avarana:(20 types) When the sub type of Vata entraps the functions of another sub type of vata it termed as an Amurta /Anyonya Avarana.

Anyonya-avrana(20 types)
Avarana
Pranavrut udana Pranavrut vyana Pranavrut samana Pranavrut apana Udanavut prana Udanavrut vyana Udanavrut samana Udanavrut apana Samanavrut prana Samanavrut udana

Charaka
+ + + + + + + -

vagbhatta
+ + -

Samanavrut vyana
Samanavrut apana Vyanavrut prana Vyanavrut udana

+
+ + +

Anyonya-avrana(20 types)
Avarana charaka + + vagbhatta -

Vyanavrut samana Vyanavrut udana Apanavrut prana Apanavrut udana Apanavrut samana Apanavrut vyana

 General principle of Symptomatology

: A Aurh osrxuUhi xuMqWlpuli, AuUMxr iixa xuMqupuli, ij AuUhl c Aur mMmi pui iS xuMqh upuii uruxj Alr i AuUhrxr xuMqWl, AuUMxr iixai upuii uruxjqW ||
(cmh c.c.28/206-216 )

If the Avaraka is stronger than Avarya, then the Avarya looses its function and there is increase in the function of Avaraka.
AuUM Aui xuMqu (Eixa) xuMqWl

If the Avaraka is weaker than Avarya, then the Avarya

function get increased and decrease in the function of Avaraka.

AuUM Aui xuMqWl xuMqu

General-line of treatment for Samanyavarana:

1) first treat `avaran with suitable drug/procedure 2) next treat `avruta dosha chikitsa as per text 3) if vata is avarut by pitta and kapha avarana then 1st treat pitta,later kapha. xxwO MTmipr miqS uleri | (c.c.-28/188) 4) mciqMxr uil mil zswqh Am u| pwaeiq xqrM Emsr xqcUi || (c.c.- 28/238) AlpwrSp xlak xix zMUM| MTmiu mb uilsqlq || ( c. c.-28/239) if vata is aavruta in all its locations,than adopt therapies which are not antagonistic of kapha and pita, but which cause vatanulomana (as downward movement of vayu is beneficial),this treatment should be conducted with abhishyandi,which do not cause obstruction to srotas and helps in the cleaning of channels of circulation;drug useful are bhallataka,rasona,guggul,pippali, shilajit etc. 5) yapana vasti prepaired with madhuradrvya followed with anuvasana vasti is useful. 6) all aavruta condition administration of rasayans like shilajatu,rasona,eranda,gokshura and guggulu along with milk is beneficial. 7) if rogi is balvan;samsrana is useful. 8) chyavan-prasha along with milk is also indicated.

 Specific treatment for samanyaavaran:

1) Pitta avruta vata:

miui uzwh ziqwh ij r | urirxi MUri xmeulr c zxri || (c.c.-28/184)

-treat with shitoshna upachara,changing repeatedly i.e. first ushna dan followed by sheetala,again followed by ushna,than by sheetal repeatedly. - e.g. jivaniya ghrut is very useful as explained in vat-shonita chikitsa, milk boiled with panchmoola,balatail,yashthimadhu taila are helpful.

2 ) Kaphavruta vata chikitsa: xuSxih lW uql xuUclq || (c.c.- 28/187) -kaphahar chikitsa like tiksha sweda, niruha vasti,vamana n virechana is to be done followed by vatanuloman. vamana - if kapha in stomach virechna-if kapha in pakvashaya or pita spread in all over body vasti if kapha is dissolved due to swedana in pakvashaya or appearance of pitta feature. -if vata combined with kapha located in head , treat it with shtanik chikitsa i.e. dhumrapan and nasya - if vitiated vata is found in respiratory passages even after eliminating kapha;than pure vatahar chikitsa is done e.g. Hot gomutra yukta niruha--- eliminates vata 1st and kapha is got rid of simillarly.
pitta. - Milk containing niruha eliminates vata combined with pita( madhura tail sidha anuvasan would be useful) ----eliminates vata in association with

3)Raktavruta vata: zhilAui MrSuizhiM rq | (c. c. 28/194) line of treatment for raktavruta vata is vatarakta. 4)Mansavruta vata: xuSpra UxU xlW qxui Wi : | (c, c.-28/195) swedana and abhyanga is benificial here. 5) Medavruta vata: mqW ui qSbl Aquimreri | (c. c.-28/195) here prameha chikitsa,vata shamana measure along with medohar chikitsa is done 6)Asthiavruta vata: mahasneha (combination of ghruta+ tail+ vasa+ majj) should be done. qWxlW Azjqzj | (c. c.- 28/196) 7)Majjavruta vata: Mahasneha is to be used. 8)Shukravruta vata: in shukravruta vata virechna than shukra vardhana and agni dipan is to be done.

9)Annavrut vata:

Aui iSssZ mcl Sml sb || (c. c.-28/196) food is to be vomited,than dipan & pachana is done

10)Mutravruta vata:

ql i xuS xiU oxir | (c. c. -28/197) diuretics,fomentation, n treated with bladder douches

11)Purishavruta vata:

zMi is LUhQ xlakSuiui r| ( c.c._28/197) Erand tail with udavarthar chikitsa is done -- if doshas are located in its own locality should be considered strong and should be overcome with priority of specific treatment like vaman/virechan/vasti etc.

12)Pittavruta panchvata: (all 5 types)

mui i mblqixruUkp | (c.c.28/245) The measures to be adopted are pitghna which should never antagonistic to vata.

13)Kaphavruta panchvata: (all 5 types)

MTui MTblxi qixrlsql || (c.c.28/245) The measure to be emplyoed should be kaphghna,but also vatanulomana. - moreover the association of prana & udana with pitta & kapha should be identified as serious condition,since the life depends on pranvata and strength depends on udanvata. uzwi eui mh ESl xi osq ||( c.c.-28/234)

General line of treatment for panchvidha vata

ESl reri Eku Aml c Alsqri | xql zqri cu k url i reri | mh Ur cipr Am xjl W Axr xji ku | xu xjl aqrSu uilil uqaql || (c.c.-28/219-220) Udana is treated by vamana Apanvat is treated by anuloman(vasti+virechana) Samanvat is treated by shaman Vyanvat is treated by in all the 3 direction treatment Pranvata is to be protected carefully and continuously as its location in its normal position is most essencial. Amllui xu Sml aW pwe | uilsql r mMuzr uzkl | Ci xmi mi Auil cMixi || (c.c.-28/244) When aavran is by apanvata; than chikitsa is followed by dipan,grahi, vatanuloman and pakvashaya shodhana. for other `avaranas the physician himself should use his own yukti-pramana( discetion) to findout the details of treatment and addopt it by keeping the basic rule of chikitsa in mind.

Anyonya avaran and its management:

AVARAN
1)PRANAVRUT UDANA

LAKSHNA
Shirograh,pratishyay (Dyspnoea),hradroga, mukhashosh,nishvasuchchvas sangrahan Sarvendriyani shoonyatva, Loss of intellect,strenght,memory. Dumbness(jad),inertness, Stammering(mukta) Vomiting,dyspnoea (shvasa) Loss of karm-oja-balavarna. Death Stabdhata,alpa-agnita, asweda, loss of activity, nimilan(closing of eyes).

TREATMANT
Urdhjatrugat rogdhna chikitsa

2)PRANAVRUT VYANA

Urdhjatrugat rogdhna chikitsa Chatushprayog sneha i.e. bahya-abhyantar-bastisustaining enema Vasti n vatanuloman Cold water sprinkling slowly, consolation & comfort is provided. Pathya diet n light food.

3) PRANAVRUT SAMANA

4) PRANAVRUT APANA 5) UDANAVRUTA PRANA

6) UDANAVRUTA VYANA

AVARANA
7) UDAVRUTA APANA 8) VYANAVRUT PRANA

LAKSHANA
Vomiting, dyspnoea Swedo atiyarth, lomaharsha,suptagatrata, tvakdosha

TREATMENT
Vasti n vatanuloman Snehan yukta virechana

9) VYANAVRUT APANA

Vomiting, distension of abdomen, hard-tumour, distress cutting pain in abdomen

Murchcha,tandra, pralap, angasad, agninasha, ojokshaya, balakshaya Grahani, stomach pain, parshva-shoola Moha, alpa-agni, atisara Vinmootra-retasam atipravruti

Snigdh anuloman

10) SAMANAVRUT VYANA 11) SAMANAVRUT APANA 12) APANAVRUT PRANA 13) APANAVRUT VYANA

Physical excercise, Light food. Dipan with sarpi Vaman, dipan, grahi (astringent diet) Sangrahanam matam (astringent measure)

Complication of avarana
Emhi Axkr xr Aju SUq |

Sa uSk msW asq AixU Lu c || pui EmSu iw Auil Emhi | ixqS AuUh uk mulxrsri || (c.c.-28/236-237) The ignored avruta condition ;mis-diagnosed or mis managed or allowed to continue for one year would lead to incurability.it may lead to cardiac disorders,abscess,enlarged spleen,hard-tumour, diarrhoea etc.

Prognosis of avaranas Aui zswqmipr mh cSlqu c |

aUrxiul mzrli pwe zxcw | uzwui mh ESl xi osq || xrir mQllUrw osxr c | xu Amri AmUbri: mUxuixUxij | EmhSxkr xrUju Smq: || (c.c.-28/233-235)

experienced physicians should observe the obstruction of prana vayu and udana vayu by both kapha & pitta as a serious condition. If undiagnosed or if not properly treated or neglected treatment for more than a year than all ailments become incurable or difficult to cure. Thus physician should diagnose the specific type of feature produced wether increased or decreased of their function in their own sthana or remote place by proper observation by yukti n oohya(applying reasons).then he should conclude the line of treatment among by snehan,swedan,vaman,virechana,vasti accordingly..