Rajayakshma Chikitsa: Difference between revisions

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|type=article

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<big>'''[[Chikitsa Sthana]] Chapter 8. Management of Rajayakshma (Wasting Diseases)</big>'''

{{Infobox

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|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|label6 = Translator and commentator

|data6 = Sewatkar B.K.,Vaish G., Choudhary P.

|data6 = Sewatkar B.K., Vaish G., Choudhary P.

|label7 = Reviewer

|data7 = Singh R.H., Ghadi R.

|label8 = Editors

|data8 = Baghel M.S., Deole Y.S., Basisht G.

|data8 = Baghel M.S., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]

|label9 = Year of publication

|data9 = 2020

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<big>'''Abstract </big>'''

<~~div~~ style="text-align:justify;">

<p style="text-align:justify;">''Rajayakshma'' is a syndrome consisting of diseases associated with wasting (''kshaya'') of various tissues including ''[[rasa]]'' and ''[[ojas]]'' causing immunodeficiency resulting in opportunistic infections, most common being tuberculosis. The term ''rajayakshma'' has been used interchangeably with tuberculosis. It is potentially fatal wasting disease that "consumes" the body. This chapter describes etio-pathogenesis, signs and symptoms and principles of management. Groups of signs viz. a group of three signs, six signs and eleven signs are enlisted to designate variety of ''srotasa'' (systems) involved with increasing severity of disease. The complications and prognosis are elaborated to categorize the disease as one of the dreadful diseases. Treatment with modern antitubercular medicines reduces mortality in patients with tuberculosis (cure rate 11.42% and the death rate 40.9%) but when combined with Ayurvedic treatment there was significant improvement (cure rate 41.3% and the death rate 3.8%). </p>

''Rajayakshma'' is a syndrome consisting of diseases associated with wasting (''kshaya'') of various tissues including ''[[rasa]]'' and ''[[ojas]]'' causing immunodeficiency resulting in opportunistic infections, most common being tuberculosis. The term ''rajayakshma'' has been used interchangeably with tuberculosis. It is potentially fatal wasting disease that "consumes" the body. This chapter describes etio-pathogenesis, signs and symptoms and principles of management. Groups of signs viz. a group of three signs, six signs and eleven signs are enlisted to designate variety of ''srotasa'' (systems) involved with increasing severity of disease. The complications and prognosis are elaborated to categorize the disease as one of the dreadful diseases. Treatment with modern antitubercular medicines reduces mortality in patients with tuberculosis (cure rate 11.42% and the death rate 40.9%) but when combined with Ayurvedic treatment there was significant improvement (cure rate 41.3% and the death rate 3.8%).

'''Keywords''': ''Rajayakshma, kshaya, shosha,'' tuberculosis, ''vyadhikshamatva, dhatukshaya,'' immunity, depletion of tissues, wasting diseases. ~~</div>~~

'''Keywords''': ''Rajayakshma, kshaya, shosha,'' tuberculosis, ''vyadhikshamatva, dhatukshaya,'' immunity, depletion of tissues, wasting diseases.

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''Rajayakshma'' has been identified since Vedic period (2400 BC). ''Yakshma'',the word, first appeared in the vedas (Rigveda and Atharvaveda), but a detailed description was missing. In the Ayurvedic treatises, or the Samhitas (1000 BC to 500 AD), a detailed description of ''rajayakshma'' can be found. An account of its definition, etiology, pathogenesis, general features, management, and the prognosis is found in [[Charak Samhita]], ''Sushruta Samhita'', and ''Ashtanga Hridaya'' with more extensive description is in [[Charak Samhita]]. Four etiological factors are described, ''sahasa'' (over exertion or working beyond one's capacity), ''samdharana'' (suppression of natural urges), ''kshaya'' (depletion of tissue element) and ''vishamashana'' (irregular diet).

The three chapters viz. [[~~Sosha~~ Nidana]], [[Rajayakshma Chikitsa]] and [[Kshatakshina Chikitsa]] deal with similar clinical presentation of disease and principles of management. ''Dhatukshaya'' is common feature in all. Advancement of ''dhatukshaya'' in ''~~sosha~~'' reaches a stage when immuno-suppression with resulting opportunistic infection occurs and is called ''rajayakshma''. In ''kshatakshina'' or ''urakshata'' there is chest injury due to direct or indirect trauma along with ''dhatukshaya''. ''[[Brimhana]]'' of ''[[dhatu]]'' (nourishment) is the principle line of management.

The three chapters viz. [[Shosha Nidana]], [[Rajayakshma Chikitsa]] and [[Kshatakshina Chikitsa]] deal with similar clinical presentation of disease and principles of management. ''Dhatukshaya'' is common feature in all. Advancement of ''dhatukshaya'' in ''shosha'' reaches a stage when immuno-suppression with resulting opportunistic infection occurs and is called ''rajayakshma''. In ''kshatakshina'' or ''urakshata'' there is chest injury due to direct or indirect trauma along with ''dhatukshaya''. ''[[Brimhana]]'' of ''[[dhatu]]'' (nourishment) is the principle line of management.

Thus ''upsarga''(additional contact or exposure to) may be considered as ''Sannikrishta Nidana'' (recent cause) of ''rajayakshma''. Sushruta was aware of this fact, and he has described its contagious nature by saying that skin diseases, fever, ''rajayakshma'' and conjunctivitis are infectious diseases which spread from one man to another man.

@@ Line 9: / Line 9: @@
 |type=article
 }}
 <big>'''[[Chikitsa Sthana]] Chapter 8. Management of Rajayakshma (Wasting Diseases)</big>'''
 {{Infobox
@@ Line 23: / Line 22: @@
 |data5 = [[Sutra Sthana]], [[Nidana Sthana]],  [[Vimana Sthana]],  [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
 |label6 = Translator and commentator
-|data6 = Sewatkar B.K.,Vaish G., Choudhary P.
+|data6 = Sewatkar B.K., Vaish G., Choudhary P.
 |label7 = Reviewer
 |data7  = Singh R.H., Ghadi R.
 |label8 = Editors
-|data8  = Baghel M.S., Deole Y.S., Basisht G.
+|data8  = Baghel M.S., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]
 |label9 = Year of publication
 |data9 =  2020
@@ Line 37: / Line 36: @@
 <big>'''Abstract </big>'''
-<div style="text-align:justify;">
+<p style="text-align:justify;">''Rajayakshma'' is a syndrome consisting of diseases associated with wasting (''kshaya'') of various tissues including ''[[rasa]]'' and ''[[ojas]]'' causing immunodeficiency resulting in opportunistic infections, most common being tuberculosis. The term ''rajayakshma'' has been used interchangeably with tuberculosis. It is potentially fatal wasting disease that "consumes" the body.  This chapter describes etio-pathogenesis, signs and symptoms and principles of management. Groups of signs viz. a group of three signs, six signs and eleven signs are enlisted to designate variety of ''srotasa'' (systems) involved with increasing severity of disease. The complications and prognosis are elaborated to categorize the disease as one of the dreadful diseases. Treatment with modern antitubercular medicines reduces mortality in patients with tuberculosis (cure rate 11.42% and the death rate 40.9%) but when combined with Ayurvedic treatment there was significant improvement (cure rate 41.3% and the death rate 3.8%). </p>
-''Rajayakshma'' is a syndrome consisting of diseases associated with wasting (''kshaya'') of various tissues including ''[[rasa]]'' and ''[[ojas]]'' causing immunodeficiency resulting in opportunistic infections, most common being tuberculosis. The term ''rajayakshma'' has been used interchangeably with tuberculosis. It is potentially fatal wasting disease that "consumes" the body.  This chapter describes etio-pathogenesis, signs and symptoms and principles of management. Groups of signs viz. a group of three signs, six signs and eleven signs are enlisted to designate variety of ''srotasa'' (systems) involved with increasing severity of disease. The complications and prognosis are elaborated to categorize the disease as one of the dreadful diseases. Treatment with modern antitubercular medicines reduces mortality in patients with tuberculosis (cure rate 11.42% and the death rate 40.9%) but when combined with Ayurvedic treatment there was significant improvement (cure rate 41.3% and the death rate 3.8%).
-'''Keywords''': ''Rajayakshma, kshaya, shosha,'' tuberculosis, ''vyadhikshamatva, dhatukshaya,'' immunity, depletion of tissues, wasting diseases. </div>
+'''Keywords''': ''Rajayakshma, kshaya, shosha,'' tuberculosis, ''vyadhikshamatva, dhatukshaya,'' immunity, depletion of tissues, wasting diseases.
@@ Line 47: / Line 45: @@
 ''Rajayakshma'' has been identified since Vedic period (2400 BC). ''Yakshma'',the word, first appeared in the vedas (Rigveda and Atharvaveda), but a detailed description was missing. In the Ayurvedic treatises, or the Samhitas (1000 BC to 500 AD), a detailed description of ''rajayakshma'' can be found. An account of its definition, etiology, pathogenesis, general features, management, and the prognosis is found in [[Charak Samhita]], ''Sushruta Samhita'', and ''Ashtanga Hridaya'' with more extensive description is in [[Charak Samhita]]. Four etiological factors are described, ''sahasa'' (over exertion or working beyond one's capacity), ''samdharana'' (suppression of natural urges), ''kshaya'' (depletion of tissue element) and ''vishamashana'' (irregular diet).
-The three chapters viz. [[Sosha Nidana]], [[Rajayakshma Chikitsa]] and [[Kshatakshina Chikitsa]] deal with similar clinical presentation of disease and principles of management. ''Dhatukshaya'' is common feature in all. Advancement of ''dhatukshaya'' in ''sosha'' reaches a stage when immuno-suppression with resulting opportunistic infection occurs and is called ''rajayakshma''. In ''kshatakshina'' or ''urakshata'' there is chest injury due to direct or indirect trauma along with ''dhatukshaya''. ''[[Brimhana]]'' of ''[[dhatu]]'' (nourishment) is the principle line of management.
+The three chapters viz. [[Shosha Nidana]], [[Rajayakshma Chikitsa]] and [[Kshatakshina Chikitsa]] deal with similar clinical presentation of disease and principles of management. ''Dhatukshaya'' is common feature in all. Advancement of ''dhatukshaya'' in ''shosha'' reaches a stage when immuno-suppression with resulting opportunistic infection occurs and is called ''rajayakshma''. In ''kshatakshina'' or ''urakshata'' there is chest injury due to direct or indirect trauma along with ''dhatukshaya''. ''[[Brimhana]]'' of ''[[dhatu]]'' (nourishment) is the principle line of management.
 Thus ''upsarga''(additional contact or exposure to) may be considered as ''Sannikrishta Nidana'' (recent cause) of ''rajayakshma''. Sushruta was aware of this fact, and he has described its contagious nature by saying that skin diseases, fever, ''rajayakshma'' and conjunctivitis are infectious diseases which spread from one man to another man.