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 known 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 issues like Visuchika, Alasaka and Vilambika.
In brief – Ajirna vis-à-vis indigestion is the muse (trigger) for vilambika and comparable circumstances.
Nidana: Causative elements
Vilambika is attributable to Ajirna – indigestion. So, logically something and every part which causes ajirna may 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 elements of formation of ama additionally must 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 tough to deal with, is known as by the traditional physicians as Vilambikā.
The consumed meals comes into the abdomen whereby there may be irregular improve of kapha and vata
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Kapha and Pitta would vitiate the consumed meals by getting combined 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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On account of this stagnation and really sluggish motion (vilamba) of meals, the situation is known as as Vilambika
Lakshana: Signs
The primary symptom of Vilambika is ‘the food not being able to move upwards or downwards and getting stagnated in the stomach’.
The under talked about signs should not talked about within the treatise however must be assumed based mostly on the character of the illness.
– Ajirna – power indigestion can be one other important grievance within the backdrop. All signs related to indigestion of meals can even be current on this situation.
– Generalized signs of kapha and vata aggravation may be seen.
– Because the meals is stagnated and never digested correctly, ama is fashioned and the rasa shouldn’t be fashioned. Since ahara rasa shouldn’t be fashioned, the tissues are additionally not fashioned. This results in depletion of tissues, low energy 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 can be of ‘sanga – obstruction’ kind. The obstruction takes place within the amashaya – abdomen and annavahi dhamanis i.e. oesophagus above and duodenum / small gut under. Due to this fact, the meals can’t transfer upwards or downwards. Amashaya and Annavahi Dhamanis are the roots of annavaha srotas.
The bothered 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 look 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 bothered by kapha and vata will get stagnated within the abdomen like a shalya i.e. international physique. Although there isn’t any 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 power manifestation and a progressive state of Alasaka.
Grasp Sushruta has specified that vilambika may be very a lot tough 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 may be stated to be the same situation as that of Sushruta’s Vilambika.
Relation to Vidagdhajirna
This situation vilambika is claimed to develop from a state of most likely a power indigestion and compromised abdomen and gastrointestinal tract brought on resulting from predominant vitiation of pitta which most likely has brought on 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 rather tough to deal with vilambika and therefore carries a foul prognosis.
Instantly after explaining vilambika, Grasp Sushruta Samhita provides two extra rapid 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 in the body wherein there is ama will give rise to pain and that place itself should be considered as a seat of origin of diseases caused by doshas. This shall be determined by the presence of symptoms of ama at that place.’ This verse is definitely relevant for all circumstances arising from ama and in addition to vilambika.
This additionally exhibits the presence of ama in vilambika and the explanation it may 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 under talked about indicators (and signs) related to the illness –
– Shyava danta oshta nakha – bluish discoloration of enamel (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 vitamin to the cells and improvement of extreme cyanosis which could result in loss of life.
These indicators of dangerous prognosis may 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 sensible as a result of they’re defined instantly after the outline of vilambika.
Therapy Ideas of Vilambika
We will see that Grasp Sushruta has not defined the remedy of Vilambika, and neither does different treatises. This clearly explains that the acharyas had critically regarded this situation as incurable. So, it is very important see that this downside doesn’t develop.
Beneath talked about are the vital precautions to be taken in order to maintain vilambika away from manifesting.
Preventive measures –
– Avoiding the etiological elements which might trigger agnimandya
– Avoiding the etiological elements of pitta aggravation
– Avoiding the etiological elements which might trigger ajirna, primarily vidagdhajirna
– Avoiding the etiological elements of ama
– Avoiding the etiological elements 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 complete, the gastrointestinal tract together with abdomen, small intestines and colon
Healing measures – Since vilambika can’t be cured, it is very important treatment the ajirna and ama in its backdrop promptly. The under talked about ideas shall be thought-about –
– Immediate and well timed remedy of agnimandya
– Promptly protecting pitta in a state of stability all the time
– Immediate and well timed remedy of ajirna, primarily vidagdhajirna
– Immediate and well timed remedy of ama – ama pachana measures
– Immediate and well timed remedy of annavaha and purishavaha sroto dushti
– Immediate remedy of different gastrointnestinal ailments like atisara, grahani, pravahika, anaha, adhmana, alasaka and many others
Additionally, the under talked about are additionally the important thing elements which must be thought-about –
– Following the ideas 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 ideas.
– Figuring out the fitting and unsuitable diets for oneself in session with Ayurveda or food regimen specialists and making ready a personalized dietetic protocol which might swimsuit oneself.
– Following disciplined etiquettes as associated to meals consumption.
– Preserving a examine on gastrointestinal well being, importantly on power 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 many others and taking fast opinions and searching for fast treatments for a similar.
– Preserving nicely hydrated, taking balanced meals, following correct bowel habits, following time of consuming meals and sleep
– Preserving away from undue stress and making peace with meals.
– Correctly following the dinacharya and rutucharya as defined in Ayurveda.
