Panchakola Siddha Yavagu (Medicated Rice Gruel) in Management of Vatarakta (Gouty Arthritis): A Review  ^†

Abstract

Yavagu or rice gruels are used as daily food items in Kerala and southern part of India. “Panchakola siddha yavagu” is a medicated rice gruel mentioned in classical Ayurveda book Charaka Samhita, in Sutrasthana “Apamarga tanduliya” chapter. Additionally, it is used in inflammatory conditions such as Gout arthritis. It contains drugs such as Pippali (Piper longum), Pippalimoola (Root of Piper nigrum), Nagara (Zingiber officinale), Chavya (Piper chaba) and Chitraka (Plumbago zeylanica) along with six parts of water and one part of rice. In the case of Gouty arthritis, from an Ayurvedic point of view, it is caused by improper digestion of food in the body associated with doshas such as vata and rakta. It causes reddish discolouration, debility, looseness and cutting or pulsating types of pain in the knees, ankles, hips, shoulders, fingers and toes. The drugs mentioned in Panchakola Siddha Yavagu, i.e., Shogaol present in dry ginger (Nagara), Plumbagin present in fire plant (Chitraka), Piperine present in Long pepper (Pippali), Long pepper root (Pippali moola), and Wild pepper (Chavya) were proved to have anti-inflammatory properties. Therefore, it is understood that consuming rice gruel containing these drugs will help to reduce symptoms such as inflammation, looseness and pain present in joints in conditions such as Gouty arthritis.

1. Introduction

Vatarakta (gout) is one of the main articular diseases, which is characterized by severe pain, tenderness, inflammation and a burning sensation in the affected joints. The disease has a prevalence in the population of 2.26 per 1000. These diseases are caused by the sedentary life activities and consumption of fast food. It is mentioned in classical Ayurveda book Charaka Samhita, in Sutrasthana “Apamarga tanduliya” chapter [1]. The pathogenesis of Vata Rakta, according to Ayurveda, progresses as follows, Vata is blocked by Rakta (blood) and Ama (i.e., Srotorodha), which leads to inflammation in the extremities, i.e., Sandhi Shotha. Additionally, it leads to Vata Rakta, i.e., Gouty Arthritis [2]. It causes pain, redness and inflammation in joints. According to Ayurveda, indigestion[agnimandya] is the main cause of almost all diseases, so by correcting the digestion by improving the digestive power the disease can be cured. Therefore, here digestion is corrected by using Panchakola Siddha Yavagu, and the drugs present in this gruel also helps to reduce inflammation and pain in joints (Sandhi Shotha and Sandhi Shoola). Panchakola Siddha Yavagu is a rice gruel which is included under pathya kalpana (dietary products). Usually, these types of gruels are given after Panchakarma procedures such as Vamana (emesis), Virechana (purgation) and Basti (enema) as a Samsarjana krama (diet) to improve the digestion process, as the agni (digestive fire) will be weak due to the purification process. However, it can also be used as medicine for conditions such as “Vata Rakta”. As these disease causes pain, and interrupt the day- today activities of patients, the Panchakola Siddha Yavagu is considered the best option as it can be used on daily basis.

2. Materials and Methods

This was an attempt to review clinical trials regarding the effect of Panchakola Siddha Yavagu in treatment of Vata Rakta in Samavastha. 30 patients with classical symptoms of Vata Rakta of 30–70 years’ age group were selected. Patients were divided into two groups, Group A (the trial group) was given with Panchakola Siddha Yavagu 3 times for 5 days, and for 1 month classical shamana chikitsa were given. Group B was given with classical shamana chikitsa for 35 days, i.e., Virechana was done by using Aragvadha choorna and Kampillak choorna. Rakta Prasadana was conducted using Guduchi and Sariva choorna. For Tiktha Pachana Mahasudarashan, choorna was given with Shadanga Paniya. For dosha pachana and deepana Pippali and Daruharidra, choorna was given [2]. Assessment was conducted by using an S.D.S (simple descriptive scale) and a V.A.S (visual analogue scale) (

Table 1. Gruel Preparation: Panchakola Siddha Yavagu was prepared by adding 1 part of rice (20 gm) with 6 parts (120 mL) of water. After the gruel was prepared 5 g of Panchakola churna was added to it. Ingredients and their quantities are given below.

Ingredients	Quantity
Rakta shaali	20 gm
Pippali	1 gm
Pippali Moola	1 gm
Chavya	1 gm
Chitraka	1 gm
Nagara	1 gm
Water	120 mL

).

3. Results and Discussion

In Group A, the symptoms such as Sandhi Shotha (inflammation) has reduced by 63.41%, Sandhi Ushnata improved by 63.15%, Sandhi Supti improved by 61.53%. Sandhi Shoola (pain) improved by 57.14% and Anga Graha (pain in the body) improved by 54.54%. In Group B, these symptoms improved in less than 30% of patients. Complaints such as Gaurava (heaviness of body), Aruchi (loss of appetite), Klama (weakness), Malasanga (constipation), etc. improved in 95% of patients in Group A. Additionally, in Group B, only 40% of patients improved. Therefore, the patients who were treated with Panchakola Siddha Yavagu showed more improvement rather than patients who were treated with other treatments [2].

The symptoms such as Sandhi shotha (inflammation of joints) and Sandhi Shoola (joint pain) were relieved by the anti-inflammatory action of drugs present in Panchakola Siddha Yavagu such as Pippali, Pippali moola, Maricha, Chavya, Chitraka and Nagara. Anga Graha and Gauravata were relieved by the action of Chitraka, Pippali and Nagara. The Klama was relieved by the Snigdha guna (unctuousness) and Madhura rasa (sweet taste) of Rakta shaali (red rice). Malasanga was relieved by the Dipana—Pachana action of Chitraka and Pachana action of Nagara. Therefore, that we can say that Panchakola Siddha Yavagu is very effective in treatment of Vata Rakta in Samavastha [2].

4. Conclusions

Panchakola Siddha Yavagu is an effective Avasthika Chikitsa for the Vata Rakta Samavastha. For better results, it can be given with other treatments (Shamana Chikitsa). It can be used in patients with digestion problems such as Agnimandhya and Udara shoola. The main actions of Panchakola drugs are deepana (carminative) & pachana (digestive). However, it can also be used in Amavata, Agnimandya, Gulma, Aruchi, etc. conditions. They are also made into dosage forms such as “Panchakola churna and Panchakola phanta”. Panchakola choorna is used in Ajeerna, Adhmana and Aruchi. In the case of Sutika paricharya, churna helps to reduce secondary postpartum haemorrhage. Panchakola Siddha Yavagu can be used daily as a food supplement as it helps to increase digestion and reduces the chances of indigestion and abdominal disturbances.