Paralysis: Ayurveda Understanding

Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S

Paralysis is a condition in which the muscle movements are hampered due to some damage or problem in the nervous system. In simple words, ‘loss of muscle functions in the body’ is paralysis. It can manifest in many forms – localized or generalized, partial or complete, temporary or permanent, spastic or flaccid.

Understanding Paralysis from Ayurveda lens

Paralysis is caused due to vata imbalance

Paralysis is a condition related to ‘movements’. All movements in the body – be it in the limbs or organs or spine – are caused by vata. In other words, vata is responsible for all movements.

Definition of Vata goes as – ‘Va gati gandhanayoh Vata’.

Meaning – ‘That which causes gati – movement or knowledge and gandhana – carrying a message or continued effort, is called as VATA’.

In short – Vata can be defined as ‘that which causes movement, enables obtaining knowledge, makes one reflect enthusiasm and interest, respond to stimulus and make continued effort’

Here we can see that the definition of vata has both ‘sensory and motor component’. The motor component is the response to do any work in response to stimuli. The meaning of vata also covers the physical and mental abilities, sensory and motor responses and all activities happening in the body as conducted by vata.

We also know that paralysis occurs due to disruption of flow of nerve signals to the muscles. This causes inability to move the muscles voluntarily. The overall picture of paralysis reflects on the ‘disturbance of gati and gandhana aspect of vata’ i.e. ‘disruption of nerve impulses’ and hence a state of imbalance of vata.

All components included in the definition of vata i.e. making movement, obtaining knowledge (perception), enthusiasm and interest, response to stimulus and efforts – all are disrupted in paralysis to some extent or greater extent depending on the severity of the disease.

So, paralysis is a vata imbalance disorder.

Apart from gati, ‘chala’ is another word which is related to vata. Chala also means movement. It is one of the qualities of vata.

Vata Subtypes, movement disorders and Paralysis

Intellect, mind, brain and sense organs are controlled by Prana Vata located in the head, the seat of the brain / nervous system. Among many functions of Udana Vata, production of speech, effort, energy, strength and memory are the most important ones. The disturbance in these functions of Prana and Udana Vata are evident in those suffering from paralysis. The other subtypes of vata may get involved in due course of time as the disease progresses.

Paralysis is a Vata Vyadhi

Vata Vyadhi is a group of ‘special or uncommon disorders – asadharana vyadhi’ caused only by ‘severely aggravated vata – vikruta vata’. Separate chapters have been dedicated in Ayurveda treatises to explain Vata Vyadhi.

Pakshavadha or Pakshaghata is one of the vatavyadhis. This condition in which there is loss of movements in one side, one part or one half of the body has been popularly compared to paralysis. The clinical picture of Pakshaghata almost resembles that of different types of paralysis.

With this we can conclude that Paralysis is a ‘Vata Vyadhi’.

Read more: Read more: Charaka Vatavyadhi Chikitsa 28th Chapter

Pakshaghata / Pakshavadha

Pathogenesis of Pakshaghata

‘The aggravated vata gets lodged in and affects one half (any half – right or left) of the body. In that half portion of the body the vata dries up (destroys) the sira – veins and snayu – ligaments, tendons and nerves, causes looseness of the joints and destroys functions / movements and sensations in that side of the body. This condition is called Ekanga Vata or Pakshavadha. When the aggravated vata afflicts the entire body i.e. both sides of the body are equally afflicted, it is called Sarvangavata.’

Here we can see many things in common between paralysis and pakshaghata.

Just like paralysis, pakshaghata too is occurring in half side, a part of or complete body. Sira and Snayu are the words which represent ‘nerves’. Looseness of the joints and destruction of functions or movements and sensation in the affected part, parts or side of the body as explained in Pakshaghata are also evident in the clinical picture of paralysis.

Ekanga Vata and Sarvangavata are synonyms of Pakshavadha.

While ekanga vata represents partial paralysis / localized paralysis, sarvanga vata represents complete paralysis / generalized paralysis.

Ekanga vata is also similar to monoplegia. Pakshavadha explains hemiplegia. Quadriplegia can be included in Sarvanga Vata.

Looseness of joints and destruction of movements indicate flaccid paralysis.

Pakshavadha caused by only vata is difficult to cure. This can be compared to permanent paralysis.

Pakshavadha caused by vata associated with pitta and kapha is curable. This represents temporary paralysis. Pakshavadha caused by destruction of tissues (muscle loss) is also a permanent paralysis which is irreversible.

Ardita

Ardita is yet another vata vyadhi. It only affects the face.

Pathogenesis – ‘The aggravated vata spreads to and occupies the head, nose, lips, chin, forehead and joints of the eyes, affects the face and causes Ardita.’ Symptoms of Ardita include – deviation or crookedness of one half of the face and neck, shaking of the head, obstruction of speech, eye deformities, deformities of nose, neck, jaw and teeth and pain on the affected side.

This can be compared to Bell’s Palsy and Facial Paralysis.

Read more: Facial Paralysis- Ayurvedic Treatment, Medicines, Home Remedies

Causative Factors

Damage to the nervous system, stroke, and spinal cord injuries are the major causes for paralysis. Traumatic injury, injuries, accidents, falls and violence are also the causes.

Among the common etiological factors of Vata Vyadhi – jumping, swimming, extreme physical activities / adventurous activities, trauma, excessively riding elephants, camels or horses and falling during such rides have been mentioned. These can cause injury to the head / brain, nervous system or spinal cord and cause pakshavadha vis-à-vis paralysis.

The other etiological factors causing vata vyadhi or vata increasing etiological factors can be considered to be distant factors, yet contributory or triggers of pakshavadha. Etiological factors of ardita can also be considered as causal of facial paralysis or Bell’s Palsy.

Pakshavadha happens in two patterns –

–         Dhatu kshaya – depletion of tissues in the body
–         Avarana – blockage of the functions of vata

All etiological factors causing dhatu kshaya and avarana shall be considered as causal of paralysis.

Analysis of ‘Symptoms of Paralysis’ through Ayurveda lens

Loss of movements is due to vata imbalance since all movements are controlled by vata.

Loss of sensation is also due to vata imbalance. Sparshanendriya – sense organ of touch or tactile sensation is one of the seats of vata.

Sama mamsa pramana – structural, functional and proportional balance of muscle tissue is one of the features of best health according to Ayurveda. Vata increases, decreases kapha proportions in the body and also the tissues in which kapha are located. Muscle tissue is one among the ‘kapha category tissues’. When vata increases due to trauma or otherwise, there is loss of muscle tissue leading to muscle weakness. This leads to loss of control over the muscles and loss of muscle movements and thereby paralysis. Muscle cramps and atrophy, tingling, pain or numbing sensation in affected muscles also occurs due to the localization of aggravated vata in the muscles.

Likewise the other symptoms of paralysis like loss of sensation, stiffness and involuntary spasms or twitches are also due to vata aggravation.

Prevention of Paralysis / Pakshavadha

Keeping away from the nidanas i.e. etiological factors of vata aggravation as mentioned in cases of vata vriddhi and prakopa, vata vyadhi and ardita is the best way to prevent diseases related to nerves and nervous system including pakshavadha vis-à-vis paralysis.

Vata constitution persons should take extra care.

Abhyanga, mentioned among the dinacharya activities, is said to control vata and keep it in a state of balance in the best possible way. If not daily, Abhyanga or oil therapies taken over the body and head will not only keep one ‘off-stress’ in today’s stressful life but will also rejuvenate the body, relax the mind and senses, and keep one fit and healthy.

For those prone for vata disorders or showing early symptoms of the same, abhyanga, dhara, murdni taila, nasya and vasti are the best therapies to be done periodically, especially so during the acting and stressful part of life and towards and in old age.

One needs to keep away from excessive driving and riding vehicles and venturing into unnecessary adventurous activities especially if he or she is showing vata signs and symptoms in the body.

Diet, lifestyle activities and exercises

Unctuous foods, foods predominant in sweet, sour and salt tastes, meat and meat soup of animals living in marshy areas are good to combat vitiated vata. Hot and fresh foods are preferred. One should avoid spicy, pungent, bitter and astringent foods.

One should avoid excessive indulgence in exercises, fasting, injuries and fractures, awakening at nights, suppression of natural urges, stress and consumption of cold foods.

Treatment Principles of Paralysis in Ayurveda

Treatment principles explained in the context of Pakshavadha and Ardita can be administered skillfully as and when required in the treatment of paralysis. Ayurveda physicians will conduct tests and examinations to find out the dosha involvement and aggravation and plan the treatment principles after having diagnosed the disease.

The treatments include –

–         Snehana – unctuous therapies / oleation – external and internal oil therapies which includes abhyanga, samvahana, kayaseka, sarvanga dhara, shirodhara, avagaha etc

–         Swedana – steaming therapies / sudation including bashpa sweda – steaming, pinda sweda – heat using herbal boluses, Shashtika Shali Pinda Sweda etc

–         Murdni Taila – also included in snehana therapies but mainly done on the head, oil therapies on the head

–         Virechana – purgation with medicated oils / ghee

–         Navana – nasal medications

–         Tarpana – nourishing and vata alleviating foods

–         Vasti – herbal enemas using medicated oils, decoctions or milk prepared with vata alleviating herbs

To make the treatment more comprehensive your Ayurveda doctor will also include –

–         Prescription of dosha specific and disease specific medicines

–         Advices related to dietetic regimens and lifestyle changes

Treatment principles of Pakshavadha

–         Swedana – sudation (after oil application in the form of massage etc)

–         Sneha samyukta virechana – purgation recipes prepared in oil base or mixed with oil

Treatment principles of Ardita

–         Navana / Nasya – instillation of medicines through nasal route

–         Murdni taila – oil therapies done on head includes Shiro Abhyanga, Shiro Pichu, Shiro Dhara and Shiro Vasti

–         Tarpana – nourishing foods

–         Nadi sweda – tube steaming / sudation

–         Upanaha – medicinal poultices

–         Anupa pishita – meat of animals and birds living in marshy regions

Panchakarma for Paralysis

Virechana & Vasti – therapeutic purgation, mainly with unctuous purgatives and Vasti – medicated enemas, of decoction, oil and milk types are extremely beneficial in the treatment of paralysis. Virechana expels morbid pitta and also balances vata since the purgatives are mixed with oil or in oil form. Vasti on the other hand balances vata at its root. Pittadhara Kala – the membranes regulating the functions of the small intestine is said to be the same as Majjadhara Kala – the layers and cells of the brain which manage functions of the nervous system by Master Dalhana. So technically, virechana and vasti, as a combo, work on the gut brain axis and help in rejuvenation and recovery of the nervous system.

Nasya is the best therapy for ardita – vis-à-vis facial paralysis / Bell’s Palsy.

Useful herbs in Paralysis

–         Bala – Sida cordifolia
–         Ashwagandha – Withania somnifera
–         Guduchi Tinospora cordifolia
–         Guggulu – Commiphora mukul
–         Shankapushpi – Convolvulus pluricauli
–         Jatamansi – Nardostachys jatamansi
–         Vacha – Acorus calamus
–         Brahmi – Bacopa monnieri
–         Nirgundi – Vitex negundo
–         Shunti – Zingiber officinale, ginger
–         Rasna – Pluchea lanceolata
–         Rasona – Alium sattivum, garlic

Useful formulations in Paralysis

–         Maharasnadi Kashayam
–         Ashtavargam Kashayam
–         Gandharvahastadi Kashayam
–         Pathyaksha Dhatryadi Kashayam
–         Sahacharadi Kashayam
–         Prasarinyadi Kashayam
–         Mustadi Marma Kashayam
–         Balarishtam
–         Ashwagandharishtam
–         Yogaraja Guggulu
–         Mahayogaraja Guggulu
–         Panchamrita Loha Guggulu
–         Vatagajankusha Rasa
–         Mahavatavidhwamsini Rasa
–         Ekangaveera Rasa
–         Ksheerabala Taila 101
–         Dhanwantaram 101
–         Maharajaprasarini Tailam
–         Valiya Marma Gulika
–         Dhanwantara Gulika
–         Vayu Gulika
–         Guggulutiktaka Ghrta
–         Ashwagandha Ghrta
–         Vidaryadi Ghrtam

Useful formulations for external use

–         Ksheerabala Taila
–         Dhanwantaram Taila
–         Mahanarayana Taila
–         Sahacharadi Taila
–         Balashwagandha Lakshadi Taila
–         Prasarinyadi Taila
–         Mahamasha Taila
–         Saindhavadi Taila

Formulations used in Vasti

–         Erandamuladi Kashaya Vasti
–         Madhutailika Vasti
–         Rajayapana Vasti
–         Dashamula Vasti
–         Dashamula Ksheera Vasti
–         Mustadi Yapana Vasti
–         Ksheerabala Taila
–         Guggulutiktaka Ghrta
–         Vidaryadi Ghrta
–         Eranda Taila
–         Sahacharadi Taila

Formulations used in Virechana

–         Gandharvahastadi Eranda Tailam
–         Nimbamritadi Eranda Tailam
–         Trivrut Lehya
–         Mishraka Taila
–         Eranda Bhrista Haritaki

Formulations used in Nasya

–         Ksheerabala Taila 101
–         Mahamasha Taila
–         Karpasastyadi Tailam
–         Shadbindu Taila
–         Dhanwantaram Taila 101

Beneficial Yoga Postures in Paralysis

–         Utthita Trikonasana – Extended Triangle Pose
–         Supta Padangusthasana – Reclining hand-to-big toe pose
–         Tadasana – Mountain pose
–         Uttanasana – Standing Forward Bend pose
–         Marjariasana – Cat Pose
–         Supta Baddha Konasana – Reclining Bound Angle Pose
–         Virasana – Hero Pose
–         Sarvangasana – Shoulder Stand Pose
–         Sirsasana – Headstand
–         Setu Bandha Sarvangasana – Bridge Pose
–         Siddhasana – Accomplished Pose
–         Mandukasana – Frog Pose
–         Ardhamatsyendrasana – Sitting Half Spinal Twist Pose / Half Lord of the Fishes Pose
–         Ujjayi Pranayama – Ocean Breath / Victorious Breathing

Few Ayurveda Researches / Studies on Paralysis

Ayurvedic Management of Facial Paralysis – A single case study – Dept of Panchakarma, UPGIAS&R, Jodhpur

Sadyovamana – an effective therapy in the management of Bell’s Palsy – A case report

Ayurvedic Management of Pakshaghata (Right Middle Cerebral Artery Hemorrhagic Infarct) – A Case Report

Treatment protocol of Stroke (Pakshaghata) through Ayurveda Medicine – A Case Study

Efficacy of Ayurvedic Shodhana and Shamana in the management of Ardita (Facial Paralysis)