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 traces 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 hearth and different illnesses. Right here too, the creator 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 hearth, ajeerna – indigestion and kinds of ajeerna.
Grasp Sushruta says that the ama, vistabdha and vidagdha kinds of ajirna are answerable for manifestation of gastrointestinal issues like Visuchika, Alasaka and Vilambika.
Briefly – Ajirna vis-à-vis indigestion is the inspiration (trigger) for vilambika and related circumstances.
Nidana: Causative components
Vilambika is attributable to Ajirna – indigestion. So, logically something and all the pieces which causes ajirna may trigger Vilambika. All kinds of ajirna and all causes of all these varieties 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 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, known as by the traditional physicians as Vilambikā.
The consumed meals comes into the abdomen whereby there’s 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 gradual motion (vilamba) of meals, the situation known as 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 will not be talked about within the treatise however have to be assumed based mostly on the character of the illness.
– Ajirna – persistent indigestion will probably be one other most 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 might also be seen.
– For the reason that meals is stagnated and never digested correctly, ama is fashioned and the rasa will not be fashioned. Since ahara rasa will not be fashioned, the tissues are additionally not fashioned. This results in depletion of tissues, low energy and immunity.
Srotas Affected & Mode of Affliction
We are able to see that the annavaha srotas – meals conveying channels are primarily concerned on this illness Vilambika. The srotodushti i.e. affliction of srotas will probably 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 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 hearth situated 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 mentioned that the meals being 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 persistent manifestation and a progressive state of Alasaka.
Grasp Sushruta has specified that vilambika may be very a lot tough to deal with whereas unhealthy 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 might be mentioned to be an analogous situation as that of Sushruta’s Vilambika.
Relation to Vidagdhajirna
This situation vilambika is claimed to develop from a state of most likely a persistent indigestion and compromised abdomen and gastrointestinal tract triggered as a consequence of predominant vitiation of pitta which most likely has triggered extreme irritation and harm within the intestinal tract i.e. vidagdhajirana.
Prognosis of Vilambika
The phrase ‘dushchikitsyam’ within the description of Vilambika signifies that it is vitally tough to deal with vilambika and therefore carries a nasty prognosis.
Instantly after explaining vilambika, Grasp Sushruta Samhita provides two extra rapid verses and so they 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 must be thought-about as a seat of origin of illnesses attributable to 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 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 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 vitamin to the cells and growth of extreme cyanosis which could result in dying.
These indicators of unhealthy prognosis might also be relevant for visuchika and alasaka defined by Grasp Sushruta in the identical context, however the unhealthy 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.
Remedy Ideas of Vilambika
We are able to see that Grasp Sushruta has not defined the therapy 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.
Under talked about are the necessary 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 answerable 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 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 preserving pitta in a state of steadiness 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 illnesses like atisara, grahani, pravahika, anaha, adhmana, alasaka and so on
Additionally, the beneath talked about are additionally the important thing components which must be thought-about –
– Following the rules laid by Ayurveda in direction of taking of wholesome and well timed meals hitting qualitative and quantitative steadiness, 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 correct and fallacious diets for oneself in session with Ayurveda or weight loss plan specialists and getting ready a custom-made dietetic protocol which might swimsuit oneself.
– Following disciplined etiquettes as associated to meals consumption.
– Protecting a examine on gastrointestinal well being, importantly on persistent 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 on and taking fast opinions and searching for fast treatments for a similar.
– Protecting effectively hydrated, taking balanced meals, following correct bowel habits, following time of consuming meals and sleep
– Protecting away from undue stress and making peace with meals.
– Correctly following the dinacharya and rutucharya as defined in Ayurveda.
