To study the efficacy of Murchit Til Taila in management of Sandhigata Vata-a single case study

Sandhigatavata is described under vatavyadhi in all ayurvedic classical texts. Sandhigatavata is defined as a disease of sandhi (joint) with symptoms of joint pain, swelling in joints, pain during movement and in the later stage restricted movements of joints. In Allopathic science, the similar condition of joint is explained as osteoarthritis. Treatment provides symptomatic relief, but the underlying pathology remains unchecked due to the absence of effective drugs. In the management of Sandhigata Vata, all the Acharyas have described the employment of Bahya snehana, Swedana, Abhyantara Tikta snehapan Vasti treatment. In this study, a female patient aged 57 years was admitted to the ipd of panchakarma department with complaints of bilateral knee joint pain, crepitus, restricted movement, swelling and general weakness since three years. She was diagnosed as dhatukshaya janya sandhigata vata also known as nirupstambhit sandhigata vata sthansansharya at janu sandhi. Murchit til taila has vatashamak and vedanasthapan & balya property. Hence in this case murchit til tail was used in the patient for matra vasti, sarvang snehan swedan, as well as sthanik vasti for a period 15 days and the patient was assessed on bases of relief in symptoms at end of treatment. Significant result was found symptoms of sandhi shoola(b/l knee joint pain), sandhishotha(swelling in joints) vata purna druti sparsha (crepitus), Graha(restricted movement).

ABSTRACT:-Sandhigatavata is described under vatavyadhi in all ayurvedic classical texts. Sandhigatavata is defined as a disease of sandhi (joint) with symptoms of joint pain, swelling in joints, pain during movement and in the later stage restricted movements of joints. In Allopathic science, the similar condition of joint is explained as osteoarthritis. Treatment provides symptomatic relief, but the underlying pathology remains unchecked due to the absence of effective drugs. In the management of Sandhigata Vata, all the Acharyas have described the employment of Bahya snehana, Swedana, Abhyantara Tikta snehapan Vasti treatment.
In this study, a female patient aged 57 years was admitted to the ipd of panchakarma department with complaints of bilateral knee joint pain, crepitus, restricted movement, swelling and general weakness since three years. She was diagnosed as dhatukshaya janya sandhigata vata also known as nirupstambhit sandhigata vata sthansansharya at janu sandhi. Murchit til taila has vatashamak and vedanasthapan & balya property. Hence in this case murchit til tail was used in the patient for matra vasti, sarvang snehan swedan, as well as sthanik vasti for a period 15 days and the patient was assessed on bases of relief in symptoms at end of treatment. Significant result was found symptoms of sandhi shoola(b/l knee joint pain), sandhishotha(swelling in joints) vata purna druti sparsha (crepitus), Graha(restricted movement).

INTRODUCTION:-
Pain is an unfavorable sensation that brings an individual to the physician due to a halt from his routine works. The condition is more painful when mobile joints such as Janusandhi (knee joint) of the body are involved due to Sandhigata Vata. The disease Sandhigata Vata is more prone to be affected to knee joint because it is most frequently involved joint in daily routine work, weight bearing joint of the body, and more prone to develop in overweight patients. In the pathogenesis of Sandhigata Vata, Vata Dosha dominant with symptoms such as Vedana (pain during joint movement) and Shotha (swelling).
The joint stiffness and crepitus (specific sound during joint movement) are symptoms that may be co-related in modern parlance with osteoarthritis (OA) of the knee joint. OA is the second most common rheumatologic problem and is the most frequent joint disease having prevalence of about 22-39% in India. Among them, 29.8% persons between 45 and 64 years of age group report diagnosed arthritis. [1] OA of the knee joint is seen most common in the clinical practice of elderly population. Below 45 years of age, this disease is common in men and involves one or two joints, while in female, 55 years of age, usually involving multiple joints. [2] OA is the most common form of arthritis and leading cause of chronic disability mostly in all the population. For the management of OA, patients need to take analgesics for daily and lifelong. In OA, surgical therapy-like knee joint replacement is very costly and even after surgery patient has to continue some medicine for a long duration. The use of analgesics and steroids in old age may produce adverse effects such as gastritis, hyperacidity, and sometimes renal failure. [3] In Allopathy science, mainly analgesics, anti inflammatory drugs or surgery are the options for the treatment of osteoarthritis. These do not give satisfactory relief and also cause great adverse effect. Charaka refers to taila as 'marutaghana'. Taila is mentioned to reduce vata without increasing kapha. [6] It also stabilizes the mansa dhatu. Acharya Sushruta mentions snehana (outer/internal) for management of Sandhigatava. Murchit til taila, has til taila as the base content along with drugs like Haritaki bhibitaki amlaki musta lodhra manjistha kevada which has vataghna along with balya properties. All the above factors inspired me to study the effect of murchit til taila matra vasti in sandhigata vata.
Vasti Chikitsa is considered the best management of vitiated vata . The panchkarma procedure of Vasti has been hailed as 'ardha chikitsa' by acharyas that Is, half of the whole treatment. [7] Matra Vasti is a type of Anuvasana Vasti that can be given to almost everybody, in all the seasons, without any strict regime of ahara and vihara and it is nishpariharya i.e, it can be given with maximum ease and has no complication thereafter. [8] CASE REPORT: Single case study.
A female patient aged 57 years came to opd of panchakarma department having complaints of Bilateral knee joint pain, swelling, stiffness, restricted movement, since last 3 years.

MATERIALS AND METHODS:-
The procedure for murchit oil [9] is as follows:- The followings herbs, Haritaki bhibitaki amlaki musta lodhra manjistha ketakipushpa, kumari were taken in powdered form in equal quantity. Four parts of the til oil was taken. The oil was heated on a low flame till it started bubbling and continued till all the bubbles disapppear. After cooling the above powder and 16 parts decotion of same drugs were added. The entire mixture was heated on a low flame till all the water content in it is evaporated. The oil thus prepared was used for various panchkarma procedure.