Whatsapp discussion series- 7 : Dhamanigata Vata by Dr. D.C. Katoch Sir and other

[27/03 1:42 PM] Katoch sir: 

A lady of 35 years are, from poor family, was brought to me on 28th February for her paroxysmal excruciating pain and blue-brackish discoloration with slight oedema in the toes on both sides. The onset of the problem dates back to about one year when the allopathic doctor diagnosed her as a case of PVD and prescribed her vasodilators and pain killers. The problem gradually increased and in February 2016 she was advised amputation of big toes. Being reluctant for surgery, may be due to financial constrains the family decided to take her for Ayurvedic treatment. She is non-diabetic, not obese, non-hypertensive, non smoker, physically active working in fields but told me of long history of consuming lot of vegetables, tea. Ayurvedically I considered her to be suffering from Dhamanigat Vaat Janya Kutilata/Sang and intended to improve her peripheral circulation with Triphla Guggul, Chander Prabha Vati, Dashmoolarisht & Ashwagandharisht. All possible elements of the samprapti were kept in mind while prescribing these medicines and patient was advised to consume 20-30 ml of Vastuk (Bathua, Chenopodium ) leaves juice and onion juice with honey, which are good blood thinners and help in developing collateral circulation and capillary perfusion. In one month time she took painkillers only 4-5 times, blue-brackish discoloration and numbness has gone and in her own words she has 30 Paise relief out of 100. Her today's picture is given below. What more than this you expect from Ayurveda to do.

[27/03 1:46 PM] Ankur Sharma Dr Delhi:

 sir

[27/03 1:46 PM] ravi shankar khatri dr:

[27/03 1:53 PM] Ankur Sharma Dr Delhi:

 But i have some doubts why she have pvd/ Burger's disease ??

She is non smoker

First to confirm it ---

Is it ischemic??? If yes then cause of ishemia?
Or is there any vaso spasm as seen in Raynaud's phenomenon.

Any color Doppler study ( arterial & venous) of both lower limbs.

If any clot or space occupying lesion is compressing artery thrn treat accordingly.

Jalauka avcharan can be done st most appropriate site.

[27/03 1:54 PM] Ankur Sharma Dr Delhi:

 Hot fomentation with dashmool kwaath / maharasnadi kwath also

[27/03 1:56 PM] Ankur Sharma Dr Delhi:

 Ginger extract , beet root extract + garlic extract+katu ras dravya have good ability to break down any obstruction ( sang dosh).

[27/03 1:57 PM] Ankur Sharma Dr Delhi:

 Chitrakadi vati may be helpful in such cased

[27/03 2:01 PM] Dr Surendra A. Soni: 

Excellent selection of drugs Katoch sir.... 
Internally
Manjisthadi/ guduchyadi kwath may be added...
Externally
Nimb haridra darvi vasa Manjistha patola kalka pralepa may be considered..

[27/03 2:01 PM] Ankur Sharma Dr Delhi:

 Peripheral pulses of both lower limbs as Poplitial artery tibial artery pulsation should be checked .

[27/03 2:03 PM] Ankur Sharma Dr Delhi:

 Femoral artery also

Is there any wasting of muscles ??

[27/03 2:04 PM] Somraj Kharche Dr. KC:

 वैसे कटोच सर को ट्रीटमेंट बताना मतलब सूर्य को दिया दिखाने जैसा है। पर अब यहाँ बात ही छिड़ी है तो एक केस बताता हु। 2009 में मेरे पास एक 60 + दादाजी आये। दादाजी अमेरिका के रहिवासी थे। वहा उनको बर्जर डायग्नोज़ किया गया और ampute करने की सलाह दी। उसी दरम्यान दादाजी का दैव वशात भारत आना हुआ और चुकी आणंद के रहनेवाले थे सो हमारे यहाँ दिखाने आये। और यकीन मानिए मैंने उन्हें 100℅ ठीक कर दिया। ट्रीटमेंट में सिर्फ 3 दवाये दी। मेरा निदान वातरक्त था। और दवाये थी लघुमंजिष्ठादि क्वाथ, यष्टिमधु घन वटी और सिंहनाद गुग्गुलु

[27/03 2:05 PM] J K Pandey Dr. Lukhnau:

 Beurgers disease can occur to nonsmokers too esp females..

[27/03 2:05 PM] Somraj Kharche Dr. KC:

 हमारे यहाँ का लघुमंजिष्ठादि एकदम बढ़िया क्वालिटी का है। हमारी फार्मेसी खुद बनाती है

[27/03 2:06 PM] J K Pandey Dr. Lukhnau:

 There it is autoimmune mediated

[27/03 2:06 PM] Dr Surendra A. Soni: 

Somraj ji

[27/03 2:06 PM] Somraj Kharche Dr. KC: 🏻🏻🏻🏻

[27/03 2:07 PM] J K Pandey Dr. Lukhnau: 

Plz go for anticardiolipin antibodies test..

[27/03 2:07 PM] J K Pandey Dr. Lukhnau: 

If its positive then prognosis is not good

[27/03 2:07 PM] J K Pandey Dr. Lukhnau:

 Basically it is thromboangitis obliterence

[27/03 2:07 PM] J K Pandey Dr. Lukhnau:

 Somrajji superb..its vaatrakt

[27/03 2:08 PM] Somraj Kharche Dr. KC:

 जी सर

[27/03 2:08 PM] J K Pandey Dr. Lukhnau:

 We can proceed keeping nidaan of vaatrakt in mind

[27/03 2:08 PM] Dr Surendra A. Soni: 

Pandeji
Then
How did patient get improvement...?

[27/03 2:08 PM] J K Pandey Dr. Lukhnau: 

Sir I had treated two,pts of beurgers ..one smoker n other nonsmoker

[27/03 2:09 PM] J K Pandey Dr. Lukhnau:

 Smoker was very obediant ..he followed my instructions n got massive relief

[27/03 2:09 PM] J K Pandey Dr. Lukhnau: 

The nonsmoker lady cudnt follow up n ran away after one month

[27/03 2:10 PM] J K Pandey Dr. Lukhnau:

 Later I came to know that she got amputated n after two months she died

[27/03 2:10 PM] Dr Surendra A. Soni:

 Once please try panchtikta ghrita guggulu in thromboangitis obliterence...
Pandeji

[27/03 2:11 PM] J K Pandey Dr. Lukhnau:

 Absolutly soni sir..I gave panchtiktghrit guggulu
giloy kwath
mahamanjishthadi kwath
sarivadyarishta

[27/03 2:11 PM] J K Pandey Dr. Lukhnau: 

And dressing with jatyadi oil n nirgundi oil

[27/03 2:12 PM] Dr Surendra A. Soni: 

[27/03 2:12 PM] Ankur Sharma Dr Delhi: 

Diseases with which Buerger’s disease may be confused
include atherosclerosis (build-up of cholesterol plaques
in the arteries), endocarditis (an infection of the lining of
the heart), other types of vasculitis, severe Raynaud's
phenomenon associated with connective tissue disorders
(e.g., lupus or scleroderma), clotting disorders of the
blood, and others.

[27/03 2:13 PM] Dr Surendra A. Soni: 

[27/03 2:13 PM] Ankur Sharma Dr Delhi: 

How can it be diagnosed as vaat rakt pandey boss ???

[27/03 2:13 PM] Ankur Sharma Dr Delhi: 

On which symptoms ??

[27/03 2:13 PM] Katoch sir:

 Medicines work if they are given after knowing their action and what is intended to be hit.

[27/03 2:15 PM] Ankur Sharma Dr Delhi:

 There is cynosis & black colour as in gangrenous changes.

Is there any erthyma hotness ????

[27/03 2:16 PM] Ankur Sharma Dr Delhi:

 Manjasthai etc are acting as raktprasadhan in this cases

[27/03 2:16 PM] Ankur Sharma Dr Delhi:

 Tikt ras based medicine

[27/03 2:16 PM] Katoch sir:

 No erythema, no hotness

[27/03 2:16 PM] Ankur Sharma Dr Delhi:

 But katu ras also required if we consider sang dosh

[27/03 2:17 PM] Ankur Sharma Dr Delhi:

 If it is autoimmune origin based then why not start with aampachak
Sanjeevani vati chitrakadi vati

[27/03 2:18 PM] Ankur Sharma Dr Delhi: 

Dinesh sir rule out erytma & hotness

[27/03 2:18 PM] J K Pandey Dr. Lukhnau:

 गम्भीरे श्वयथुः स्तब्धः  कठिनोअन्तर्भृशार्तिमान् ।
श्यावस्ताम्र अथवा दाहो तोद स्फुरण पाकवान् ।

[27/03 2:18 PM] Katoch sir: 

Selection of drugs is always doctor's choice who has seen the patient and understood the disease.

[27/03 2:19 PM] Ankur Sharma Dr Delhi: 

Agree sir
[27/03 2:19 PM] J K Pandey Dr. Lukhnau:

 वातज वातरक्त के लक्षण beurgers se milte h

[27/03 2:19 PM] J K Pandey Dr. Lukhnau:

 Here vaat n rakt both dooshit

[27/03 2:20 PM] J K Pandey Dr. Lukhnau:

 So both shud be kept in mind

[27/03 2:21 PM] Katoch sir:

 Sharing of experiences should not be taken as teaching Ayurveda/Medicine to others.

[27/03 2:22 PM] J K Pandey Dr. Lukhnau:

 Katoch sir ..u keep sharing
we will take it as teaching..

[27/03 2:22 PM] J K Pandey Dr. Lukhnau:

 Ur experiences r a samhita in itself

[27/03 2:22 PM] Ankur Sharma Dr Delhi:

 U r senior sir
Ur guidance is always required

[27/03 2:25 PM] Ankur Sharma Dr Delhi:

 But freedom of expressing of different different views are also part of discussion.

If we all think in same way we never get new thing.

If discussion hurt any Senior, i say sorry for that.

[27/03 2:28 PM] Katoch sir:

 Whole world is teacher for me and I am learner,  being in office dealing with files for the last 16 years I still have kept my clinical and academic interest and that's why I am in this group with all of you.

[27/03 2:29 PM] Daya Shnkrji Sir: 

[27/03 2:29 PM] Ankur Sharma Dr Delhi: Great sir

[27/03 2:30 PM] Katoch sir: 

[27/03 2:33 PM] rupesh bhai dr: ✍🏼🏼🏼🏼 

[27/03 2:41 PM] Katoch sir: Pt was also advised to wash her feet twice daily with Neem Kwath and apply Jatyadi tailam on wounds.

[27/03 2:47 PM] Dr Ranga prsad Ay Pith:

 Abscence of cellulitis and signs of decrease in pedal edema is encouraging result in your above case Katoch Sir.
Simple drugs have given major relief to that patient.

An adorable craftsmanship of vaidya has executed a clean work sir.

Adorations & appreciations in having saved the toe of a rich soul dwelling in poor socio-economic status.

[27/03 2:52 PM] Katoch sir: 

Dr JK Pandey, Dr Ankur and Dr Soni, your brilliant observations I have noted.  My diagnosis was Dhamanigat Vaat and it was managed with the medicines I prescribed. It means clinical hypothesis got proven. Thanks to all for excellent inputs, which somehow I will use of the patient does not show further improvement. I believe in one bullet to one known target, not AK47 approach of many bullets for one target and that too unknown.

[27/03 2:53 PM] Katoch sir: Thanks Dr Ranga too.

[27/03 2:54 PM] Dr Ranga prsad Ay Pith: 

[27/03 2:58 PM] J K Pandey Dr. Lukhnau: 

Thanks,dr katoch..basis is same ..u r saying dhamni gat vaat othere r vaat rakt..
means both r treating rakt n vaat..on same principles..I dont think any difference in basic approach to treat such diseases,,
and most imp thing is pt shud get relief..and u r providing that.,so hats off
best wishes

[27/03 3:15 PM] Dr Surendra A. Soni:

 Thanks Katoch sir 

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Above discussion held on 'Ayurveda Peetha"(initiated by Prof. S.N. Ojha) and 'Kaysampraday'  2 Famous Whatsapp groups of  well known Vaidyas from all over the India. 

Dr. D. C. Katoch

M.D. Ayu.Kayachikitsa (NIA Jaipur)

Senior expert Physician