Respected Vaidyas, Today a rare case came to OPD. Below the details are mentioned. A male patient of Age 65 yrs complaining of - 1. Mild swelling of Bilateral Feet - 20-25 yrs. ( swelling automatically decreases but never come to normal) 2.Tingling sensation and Pricking type of pain in B/L feet since 3 yrs. 3. Stiffness in metatarsal and Tarsal joints 4. Decreases sensation of B/L feet 5. Burning Sensation of B/L feet 6. Discolouration of B/L Lower limbs ( Below knee joint ) 7. Swelling of face -2 yrs. NORMOTENSIVE, NON DIABETIC Occupation - Farmer Personal History - 1. Appetite - Normal 2.Bowel Habit - Regular, Not cleared since 1 yrs. 3. Urinary Habit - Normal 4. Sleeping Habit - Normal 5. Mental status - Stress = ++ ( Familiar, Land related ) Pathological Reports - LFT - WNL RFT- WNL Anti CCP - Negative ANA - Negative HbA1C - 4.51 WNL ESR - 25 ( 1st hour ) ( Increased ) Vitamin B1 and B12 levels are normal. Venous and Arterial Doppler of Both Lower limb - Normal MRI of L.S spine - 1. Diffuse posterior bulges of L1-L2, L2-L3,L3-L4,L5-S1 2. IV discs and Osteophytes causing narrowing of Neural foramina Bilaterally at respective level 3. Disc Osteophyte complex at L4-L5 level is causing indention over anterior Sub- arachnoid space All features in MRI suggestive of Lumbar Canal Stenosis. Nerve Conduction Study ( NCS ) suggestive of Axonal Sensori-Motor Polyneuropathy. Intellect Curofians kindly diagnose the case Acc. to Ayurvedic Parameters and suggest best possible management.

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A case of CIDP i.e. Chronic inflammatory demyelinating neuropathy in absence of any other comorbidity like diabetes... With osteophytic changes and disc bulges.. its a case of lumber spondylysis... Again pedal edema may be of a stasis related due to long standing relaxed tone of arteries and veins due to chronic demyelinating disease or the neurons supplying them... as we find no any other abnormalities in systemic routine investigations e.g RFT,LFT etc.. Now according to AYURVEDIC ASPECTS I think its a Katigat kafavrutta Vaat dosha or say asthi majjagat vaat.. i.e. vitiated vaat dosha with dhatvagni mandyaa... Again its a Yaapya roga as its a chronic, with low bala and sattwa of patient... Aahar, vihar, Pathyapathy plays a distinctive role here... Snehan, swedan, abhyang plays important role in Vaat vyadhis Anuvasan basti Mrudu virechana Kati basti Advise about posture and yogasana like gomukhasana, bhujanhasan, tadasana etc with patients ease also... Here are some remedies Yogaraja guggulu, Maha Yogaraja guggulu,Trayodashang guggulu, Simhanada guggulu, vatari guggulu, Dhanvantara vati – Relieves pain and inflammation. Gandha taila, ksheerabala 101, Dhanwantharam 101, Guggulu tiktaka ghrita – Hydrates and rejuvenates the disc and joints. Rasna saptaka kashayam, Maharasnadi kashayam, Dhanwantharam kashayam, Sahacharadi kashayam, Astavarga kashayam, Dashamoola kashayam – Pacifies the vitiated vata and kapha. Lakshadi guggulu, Kukkutandatvak bhasma, pravala and mukta pishti – Strengthens the bone. Narayana taila, Murivenna, Kottamchukkadi taila, Karpuradi taila, Ksheerabala taila, Dhanvantara taila – Used for abhyanga which improves blood circulation, strengthens the muscles and alleviates the vitiated vata dosha. Ashwagandharishta and Balarishta to strengthen the nerve roots. Ashwagandha, bala, dashamool and lasuna ksheera paka – Rejuvenates the disc, vertebra and joints. Thank you..@Dr. Niranjan Ram @Dr. Hemant Adhikari sir

Thank you so much sir
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Case of NEUROPATHY Due to posterior disc bulge/prolapse causes neurodegenerative changes. Bilateral Doppler of lower limb vessels not perfectly visualized due to edema. May blockage seen in deep vessels ! Wet Beriberi think in mind. Management:--- *Rest. *Vit.B1, Calcium, Cholecalciferol,Methylcobalamin as per advice. *Ref. to neurologist. *Avoid forward bending.

Sir, He has taken allopathic treatments under renouned Neurologists Since 3 yrs but got no markable benefits till now...He is getting bored from Allopath and came to alternative system with great hope.
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Not experienced with such case.... @Dr. Ashish Tiwari @Dr. M V Subramanyam @Dr. Sukrant Sharma @Dr. Yogeshkumar Manani @Dr. Sushant Revadekar @Dr. Aditi Mangsuli please share your clinical experience....

Thanks Sir for showing your kindness.
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We can treat as Vat Vyadhi . Bruhatvatchintamani Vatgajankush Maharasnadi guggulu Triphala guggulu Yogaraj guggulu Mahavatvidwans Ekangveer Sameerpannag Snehan swedan Basti Katibasti Abhyang Taildhara

1 tab tirfala gogal two bd 2 tab punarwadi mandor loh tab two bd 3 tab chanderpirbha vati two bd 4 syp shankhpuspi 10 ml two time daily with water 5 Sahar shaktiprash powder one tea spon two time daily with milk

रोगी वात व्याधि से ग्रस्त है चिकित्सा शुरू करें मूत्राल क्वाथ बनाकर पीएं सुबह शाम। महायोगराज गुगल अन्डी के तेल में मिलाकर सेवन कराएं। वृहत वातचिन्तामणि रस शहद में मिलाकर सेवन कराएं। महारास्नादि क्वाथ को 25 ग्राम सुबह-शाम महानारायण तैल की मालिश करें।अणु तेल का नस्य विधि से करें। निश्चित रूप से लाभ होगा योग परिक्षित है पिछले 40 वर्ष से प्रयोग कर रहा हूं

Shotha... shotha genrally comes because of awrodha and second due to aajirna...see in jwar charak...so should find out these two hetu..if he has ajirna or awrodha.... sir give him strong pachan awshadi...combined with shothhar drwya.. sanjivni wati ,aaraghwadh haritaki wati also useful in saam awastha.. Ask him about d swelling. Wen it comes, about anulomana,ask him about appetite.. then u should plan for shodhan.. either waman or virechan acc to sharir awastha.

Case of degenerative disease of spine Pedal edema is physiological unless otherwise rft and cardiac profile is normal This is pivd L2 to L5 Need complete bed rest and physiotherapy

I think it should be treated on lines of Marga Avran janya vaat vyaadhi...as there is stenosis of spinal canal as well as decreases nerve conduction Kaishora Guggulu Ekangveera rasa Ashwagandharishta with a few course of dashmoola niruh basti can be tried... alternatively Lashunadi rasayana can be also prescribed..

Thanks @Dr. Sukrant Sharma sir
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Mahayograj guggul 1 bd Vaatgajankus10gm + vaatkulantak10gm +kukutandtavk bhasma10gm+Moti pisthi 1gm+shilasindur 5gm+mahavatvidhvansak ras5gm all mix make 41 pudiya take 1tds with honey Ashwagndharista +dashmoolaristha 20 ml bd Dashmool tail+vishgarbha tail + mayanaryan tail+ pyroflex oil all mix for LA

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