• Introduction
• Hetu (etiological features)
• Classification & Rupa (clinical features)
• Treatment
• Commonly used drugs

Introduction
This ailment expounded by Ayurveda, VataRakta is a combination of two words Vata & Rakta. In Charak Sanhita, Ashtang Hridaya & Madhav Nidan VataRakta has been elaborated in great details.

Synonyms

• Khuda
  Khuda means small joints. Since in this disease, the small joints are inflicted it is called as Khuda Vata
  
  
• Adhayavata
  Adhaya means the rich class of people & those who are delicate. Since this class of people is generally inflicted with the disease, it is also called as Adhayavata.
  
  
• Vatabalasaka
  The aggravated vata having been obstructed in its passage by aggravated blood, affects the entire blood.

Hetu (causes)

• Intake of diet consisting of an excess of sour, pungent, alkaline, fatty, hot & uncooked articles, moist or dried things, meat of aquatic & marshy animals, oil-cakes, radish, horse gram, black gram, nishpava and other leguminous. Vegetables, seasum paste, sugar cane, curd, sour gruel, sauvira, shukta (vinegars), butter milk, sura are asava also the causative factors
• Incompatible food
• Eating during indigestion
• Anger
• Day-sleep

Poorvarupa (Premonitory symptoms)

• Swedo Atyartham Na Vaa- Excess or absence of perspiration.
• Karshnya- Blackness
• Sparshaagyatvam- Anaesthesia
• Shate Atiruk- Severe pain on injury
• Sandhi Shaithilyam- Laxity in joints
• Aalasyam- Lassitude
• Sadanam- Malaise
• Pidakodgam- Appearance of boils
• Janujangha Uru Katayam Sa hastapada and Sandhishu Nistoda Sfurnam
• Bhedo Gurutvam Supti Kandu - piercing pain, quivering, tearing, heaviness
• Numbness & itching in knee, shanks, thigh, waist, shoulder, hands,, feet & joints of body.
• Sandhishu Rug Bhutva- unstable pain in joints.
• Vaivarnam & Mandalotpatt- abnormal complexion & appearance of patients.

Classification & Rupa (clinical features)

• Based on the seat (root) / location
  
  • Uttana (superficial)
    This is located in the twak (skin) & mamsa (muscle).
    
    
  • Gambhir (deep)
    This is located in the deeper dhatus.
  
  
  
• According to the Doshas involved (predominance)
  
  • Predominance of Vata (Vatadhika)
    Sira aayam shul Sfuran Todanam Shothasya Karshnyam. Raukshyam Shyavata Vruddhi haanaya meaning:
    • Dilatation of vessels
    • Pain
    • Quivering & piercing pain
    • Blackness
    • Roughness
    • Blackishness
    • Aggravation & diminution
    • Dhamanya anguli Sandhinam Sankocha Anggraho Atiruk
      Contraction in Dhamanis (arteries), fingers & joints
      Stiffness in body parts
      Intense pain
      
      
    • Kunchan Stambhane Sheeta Pradvesha
      Contracture & stiffness
      Aversion to cold
    
    
    
  • Predominance of Rakta (Raktadhika)
    • Shwayatu Brusha Ruka Toda Tamrashcha Chim Chimayate
      Swelling with severe distress
      Pierceing pain
      Coppering with pricking sensation
      
      
    • Snigdha Rukshaiya Shaman Na ati Kandu Kledanvito
      Not subsiding by either unctuous or rough applications & associated with itching & moistening.
    
    
    
  • Predominance of Pitta (Paitika)
    • Vidaho Vedana Murchha Swed Trshna Mada Bhrama
      Burning after meals
      Pain
      Fainting
      Sweating
      Thirst
      Narcosis
      Giddiness
      
      
      
    • Raga Pakashcha Bhedascha Shoshashcha
      Redness
      Inflammation
      Tearing
      Dryness
    
    
    
  • Predominance of Kapha
    • Steymityam Gauravam Sneha Supti Manda Ruk
      Feeling of wetness
      Heaviness
      Unctuousness
      Numbness & mild pain

There are certain upadrava (complications) that musty be kept in mind while treating this ailment, which are a follows:

• Asvapna- Sleeplessness
• Arochaka- Anorexia
• Swasa- Dyspnoea
• Mansa kotha- Gangrene
• Shiro graha- Stiffness in head
• Murchhaya- Fainting
• Mada- Narcosis
• Ruk- Distress
• Trushna- Thirst
• Jwara- Fever
• Moha- Mental confusion
• Pravapaka- Trembling
• Hikka- Hiccup
• Pangulya- Lameness
• Visarpa- Erysipalas
• Paka- Inflamation
• Toda- Piercing pain
• Angulivakrata- Crookedness in fuigen
• Sfota- Blisters
• Daha- Burning Sensation
• Marmagraha- Stiffness in Vital parts
• Arbuda- tumour
• Etaivupadrava Vaivarjyam Mohen Ekan Vaa Api Yata - Even on complication, mental confusion is enough to make the disease incurable
• Samprastavi Vivarnam Cha Stabhdham Arbuda Kruchcha Varjayet Cha Eva Sankoch Karmendriya Tapanam
• Akrutsna Upadravam Yapyam Sadhyam Syat Niru padravam - The one having less than all symptoms i.e. least no of symptoms is pallative & that which is free from complications is curable.

Treatment

• The blood of the patient of Vata Rakta (gout) should be let out, in small quantities, at many times after oleation therapy
• Protecting him from (aggravation of) vata
• Bloodletting beingappropriate to the dosha
• When pain, redness, pricking pain and burning sensation are present, blood should be got sucked by jalauka (leeches).
• When tingling sensation, itching, pain and burning sensation are present, the use of srnga-alabu (sucking horn or gourd) is indicated.
• When the disease / lesion is found spreading from place to place, either pracchana (scratching the skin) or siravyadha (venesection) is recommended.
• Blood should not be let out when there is debility of the body, dryness and predominance of vata; vata getting aggravated (increased) by loss of blood (from blood-letting) produces profound swelling, stiffness, tremors, diseases of tendons, and veins, debility and many other disorders of vata origin.
• Purgation therapy should be given oleation therapy first and then administered purgative drugs mixed with fats (medicated ghee / oil).
• In Vatarakta (gout) having predominance of vata, the patient should be made to drink old ghee. Ghrta prepared with decoction of Draksha and
• Madhuka, added with Sitopala (sugar candy) should be consumed; or milk boiled with addition of fresh juice of Guduchi; or drink the mixture of taila (oil), milk and sarkara (sugar) boiled together.
• In Vatarakta caused by pitta, decoction of vari, tikta, patola, triphala and amrta should be consumed. Also ghee or milk boiled with drugs of sweet and bitter tastes (be consumed)
• Eranda taila should be consumed mixed with milk to produce purgations in the patient who has great increase of dosha; after it gets digested (and after purgations) he should eat boiled rice along with milk.
• The malas (doshas) may also be removed by kshirabasti (milk enema) added with grtha (ghee).
• There is nothing equal to basti (enema therapy) in the treatment of vatarakta (gout), especially for those who have pain in the rectum, flanks, thighs, joints, bones and abdomen.
  
  When kapha is predominant, the decoction of musta, dhatri and haridra or of triphala or of guduchi, whichever is suitable, should be consumed mixed with kshaudra (honey)
• After administering the appropriate sneha (fat) to drink, he should be given mild vamana (emetic) drugs and then rukshana (therapy creating dryness inside).
• Decoction of kokilaksha consumed followed by partaking its leaves only as food, cures gout just like the practice of compassion cures anger.
• Medicated oil prepared with madhu ucchista (bee's vax), manjishta, sarjarasa and sariva-known as pinda taila-used for abhyanga (anointing and massage) relieves the pain of vatrakta.
• The Uttana kind of vatrakta (gout) should be treated with lepana (application of pastes), abhyanga (anointing with fats) parisheka (pouring liquids on the body) and avagaha (immersing the body in liquids), the gambhira kind of gout by vireka
• (Purgation), Asthapana (decoction enema) and snehapana (drinking of fats). · When vata and kapha are predominant, warm applications of pastes etc. are beneficial; if cold applications are made, burning sensation, swelling, pain and itching will increase, due to rigidity (caused by cold).
• In gout, when there is predominance of pitta and rakta cold application are beneficial, plosha (blisters, blebs) osha (localised burning sensation) pain, redness, sweating and avadarana (laceration, abrasion) will develop by heat (of warm applications).

Commonly used drugs

• Guggul
  • Gokhshuradi (Sharngdhar Sanhita)
  • Kaishor (Sharngdhar Sanhita)
  • Panch Tikta Ghurta (Bhaisajya Ratnavali)
  • Mahayograj (Sharngdhar Sanhita)
  • Yograj (Bhaisajya Ratnavali)
  • Sinhnad (Bhaisajya Ratnavali)
  
  
  
• Bhasma
  • Shrung (Ras Tarangini)
  • Shankha (Siddha Yog Sangraha)
  • Swarna Makshik (Rasendra Saar Sangraha)
  • Praval (Ayurved Saar Sangraha)
  
  
  
• Arishtha / Asava
  • Dashmularishtha (Bhaisajya Ratnavali)
  • Chandanasava (Bhaisajya Ratnavali)
  • Maha Manjishthadyarishtha (Siddha Yog Snagraha)
  
  
  
• Rasa Kalpa /Vati / Mandur
  • Samshamni (Siddha Yog Sangraha)
  • Gandhak Rasayan (Ayurved Prakash)
  • Punarnavadi Mandur (Ayurved Saar Sangraha)