Articles On Ayurved · Kaya Chikitsa · Nidan

ANUKTA ĀVARANA

ANUKTA ĀVARANA – my approach ( 8 types of anyonya avarana are not described , just, their name is referred in charak samhita ) , here , explained with modern perspective.. !
Vyāna Āvr̥ta Udāna
Vyāna is associated with gati and prakshepan while udāna is associated with bala prayatna and urjā. Vikrut vyāna has impaired gati which when impedes udāna will reduce the bala, prayatna ādi karma of udāna.
Sympathetic fibres originate in the hypothalamus, pass down the brain stem and cervical spinal cord to emerge at T1 level, return back up to the eye in association with the internal carotid artery and supply the dilator pupillae. Lesion in the sympathetic pathway cause Horner’s syndrome. The reason may be central (at the level of Hypothalamus / brain stem) or at the periphery (at the level of lung apex, carotid artery) or may be idiopathic.
Vyāna āvr̥ta udāna can also be considered in paroxysmal tachycardia. Abnormalities in different portions of the heart including the atria, the Purkinje system, or the ventricles, can occasionally cause rapid rhythmical discharge of impulses that spread in directions throughout the heart. This is believed to be caused most frequently by re-entrant circus movement feedback pathways that set up local repeated self re-excitation. The above process occurs unless considerable ischemic damage and may lead to ventricular fibrillation. Thus there is never a coordinate contraction of all the ventricular muscle at once which is required for cardiac pumping. Patient may complaint of palpitation or symptoms such as dizziness, dyspnoea, fatiguebility i.e. bala, prayatna are reduced.
Apāna Āvr̥ta Samāna ;
Apāna is responsible for srijan karma. Vikrita Apāna increases the nishkraman prakriya. Increase Hustration reflex causes excessive propulsion movement. Excess motility causes reduced absorption. The body in unable to reabsorb bicarbonate ions i.e. Samāna karma is reduced. Loss of bicarbonate causes rise of H+. Body compensates the process by increased ventilation. The PaCO2 is reduced secondarily by hyperventilation which mitigates the rise in H+ leading to metabolic acidosis.
Diarrhea associated with passage of more than 200g of stool with urgency of defaecation and faecal incontinence. This may lead to malabsorption leading to hypoalbuminaemia, hypocalcaemia and vitamin D deficiency, hypomagnesaemia, phosphate, zinc and weight loss.
Prāna Āvr̥ta Apāna
Prāna vāyu function is associated with controlling system of the body, as said by Nyāyachandrikākār. Prāna vāyu helps in assimilation and maintain homeostasis.
Apāna is responsible for elimination. Considering pakvāshaya it may be compared with srijan of purisa mūtra etc. and at cellular level function of apāna is removal of cellular products within the cell. In this particular condition of prāna āvr̥ta apāna the vikrita prāna obstructs the gati of apāna and it is unable to release the cellular products. This can be understood in condition of Brainstem lesion where in the control over CO2 expiration is lost. Depletion of CO2 expiration leads to increase in concentration of CO2 in blood resulting in respiratory failure of Type II origin i.e. severe respiratory acidosis. A simple sleep apnoea / hypopnoea syndrome may also be considered.

Prof. Dr. Satyendra Narayan Ojha ,
MD (KC), Ph.D.
Director , Yashawant ayurveda college , Post graduate teaching and research center ,
Kodoli ,Panhala , Kolhapur..
 drsnojha@rediffmail. com

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