CHAPTER-32 HRDROGA (HEART DISEASES) Introduction- The Mila! of Pranavaha srotas are hrdya and Maha Stotas “Tetafe TTI? the word 'mila’ indicates that the organs Stated as milla of a srotas are capable of bestowing strength and effi cacy 4 or even influence that particular srotas. ox The term 'Hrdya’ is derived from three Sanskrit roots € and(In) which respectively mean Harana, Dapa and Aygng i.e. Recipt, giving away and moving for the continuous activity tg execute the two earlier functions. The word ‘Ayana’ indicates Path, way or through which movement of materials takes place. Hridaya or Thoracic heart which receives and ejects the blood (Rasa- Rakta complex) by continuous contractions and relaxations for the maintenance of the circulation to perform the Preerana and Jeevana Kriyas to the body tissues. And if such vital organ is afflicted with disease pathology, naturally all the life processes are also impaired to a great extent. Hrdroga is basically of two types, Functional disorder and structural disorder, where as functional ‘ problem is treatable while structural problems are to be corrected through surgery or other procedures. Samanya Nidana/Samprapti‘- Suppression of the natural “urges, ingestion of food of hot potency, any dry in nature, use of incompatable foods, consumption of more food than required, uncooked food; Excessive, purgation, emesis and vasti usage; excessive grief, excess fear or psychological stress (Pressure) or AC wa me aa Re ARE Herel | (Ca. Vie. 5/8) 2. Cakrapani on above stanza, 3. Satapada Brahmana 14-8-4-1, A@ Tarkett: | feererrniicatenty ar: | aren we Shr Fe weet Te: Ra we at aah a eR (6.u. 4334) (b) Ca, Ci. 26/77, ; 5 Scanned with CamScannerHrdroga (Heart Diseases) 267 Injury, trauma over cardiac region etc are the three types of factors related to somatic, psychic and external segements. Due to these causes, dosas get aggravated, vitiate the rasa present in the heart and give rise to pain in the heart, it is known as Hrdroga. Hrdroga : Common Signs & Symptoms- -& Ruja (Pain) ©” Kastaswasa (Dyspnoea) Kasa (Cough) Trsna (Thirst) Asyavairasya (Bad taste) - Vaivarnya (Discoloration) Micha (Syncope) Hikka (Hiccough) Kapha Utklesa (Nausea) Pramoha (Stupor) and we Ivara (Fever) oo ° ee These are the common features of heart disease. Types of Hrdroga— ‘The following are the types as described by Caraka and Sushruta. ae: ‘Charaka “Sushruta Xt 1. Vataja Hrdroga * 2. Pittaja Hrdroga 3. Kaphaja Hrdroga ~ 4, Sannipataja Hrdroga. 1, Vataja Hrdroga 2. Pittaja Hrdroga 3. Kaphaja Hrdroga 4, Sannipatija Hrdroga 5. Krimija Hrdroga Note- Vagbhata and Madhavakara also stated the Caraka version. VATAJA HRDROGA- Nidadna & Samprapti- The Vata prakopa factors like Soka (Grief), Upavasa (Fasting), Vyayama, Riksha (Dry) ahara, Alpa bhojana (Eating in sufficient 19 K.C.-I1 4 Scanned with CamScanner268 The Princip! quantity) etc. cause aggray' spreads into Cardiac region area areas Te TET A Je and Practice of Kaya Cikitsa ~ yo) hn ion of Vata, which in turn Swift) fo produce Vataja Hrdroga~ y frieat dea gaicag east a |! (Sushruta Uttara) In hrdroga produced by vata, according to Sushruta the in following are the specific cl haracteristics of pain felt— © The person (affected) feels pain such as expanding, © Pricking; © Twisting; © Tearing and © Exploding or splitting. Thus, 'Hrd sila’ is the important character of Vataja Hrdroga, hence it is described in detail. ‘Hrdsila' (Angina Pectoris)- Angina pectoris is chest pain due to impaired coronary flow, The classical features are - (of stable Angina) © The site of pain is retrosternal (Centre of the sternum), e Character is constricting or crushing. © Pain radiates across the chest, both arms— and shoulders (More commonly left sided) © Neck, jaw, fingers & epigastric © Duration of pain- \Exertional Angina ~ Emotion-induced — region. Any pain which lasts for a few seconds in not Angina. © Precipitating factors/ ~ Exertion ~ Climbing stairs, going uphill. ~ Anger, excitement, ~ Sudden exposure to cold. © It is relieved wi Isosorbide, dinitrate, th rest, Sublingual Nitroglycerine ® Scanned with CamScannerHrdroga (Heart Diseases) 269 unstable : Angina- . e It occurs at any time, even at rest without any precipitating | factor. i e Pain lasts for several minuts. _Atigina Vs Acute Myocardial Infarction- In acute myocardial infarction, the characteristics of pain are the same like that of Angina but- — It lasts longer : It is more severe and | It is accompanied by profuse sweating, breathlessness i = Patients complain of discomfort or heaviness more often than pain. | Approach to Management of Stable Angina I © Antianginals like Rasona Kshira, Arjuna BP control — Sarpagandha, Jatimamsi etc. gement with Guggul therapy /diet management trol + Pranayama. ble Angina— Approach to U: It needs acute medical care in ICCU. Vataja Hrdroga Cikitsa— The following classical medicines 1. Pippalyadi cirna in the dose 1-2 are indicated in Angina. g. thrice a day with Dadima svarasa. _2-Pushkaramiiladi c 3. Haritakyadi curna 4. Sonthi Kvatha added with Ij beneficial. PITTAJA HRDROGA'- In hrdroga caused by Pitta, the person has © Thirst, burning sensation 1. Potereredie: =: Shae Tem: irr a pet a ae: ait Feet aT (S.U, 43/7) firna 1-2 g. twice a day with ghee. 1-2 twice a day with ghee. ittle ghee and Saindhava is Scanned with CamScanner270 The Principle and Practice of Raya Cikitsa_ Vo} ? ¢ Sucking pain ¢ Exhaustion / 4 e Feeling of Hot fumes coming-out. e Fainting Prespiration and dryness of mouth. Treatment— 1. Vamana with water boiled with Sriparni, Madhuka, 4. Hone + ae and Utpala. 2. Sidda ghrtha (From Kakolyadi gana) with milk, . Shadanga Paniya — as drink. . Arjunka kshira (Prepared as per Kshirapaka) . Shitala pralepa/Pariseka is also advised. wee 1. Pravala panchamrt - 250 mg Akikapisti - 250 mg | Single dose- Two such Guduchi satva — lg. doses quantity Kama dugdha — Ig 2. Jawahar mohar pisti — 125 mg. Tabs thrice a day with milk, 3. Driksha avalehya at bed time 20 g. with milk, KAPHAJA HRDROGA'- The following are the symptoms— © Feeling of heavyness, © Kapha srava from mouth/nose © Anorexia/dull digestive fire © Stiffness of the body, © Sweet taste in the mouth, Treatment— __ L After Piirva Karma- 2) with honey, (Rata Pree anphfy assert aerarett Het Scanned with caine eanr ner , Fe is With Vaca + Madanaphala clHrdroga (Heart Diseases) 271 2. For Vi ‘ivrii ; ae ~ Trivrit cima with honey should be given. F tt Prescribed the following Cikitsa Siitra. wanna area art ey amifat | arrestee fore @ ae 01 i paar on dasa emesis with the decoction of Vaca or Nimba (Chakradutta) ippalyadi ciitna indicated in Vatika Hrdroga. Rx- Ie Hrdyamava Tas 200 mg™] 2 doses with anupana of Chintamani ras 250 mg | Pippaliciirna + honey Pravala bhasma 250 mg | twice a day. 2, Nagarjuna abhrak ras 125 mg. Tab with hotwater during afternoon. 3. Pippalyasavam 20 mi Draksharista 10 ml. {| With lukewarm water twice. TRIDOSAJA HRDROGA- All the symptoms indicated under Vataja, Pittaja and Kaphaj Hrdroga, are manifested in Tridosaja variety as per the dosa vrddi. Treatment- 1. Treatment should be on the lines of dosas predominence. 2, Pushkaramiila ciirna. 3g. twice with honey. 3. Nagabala ciirna 3g. twice a day. 4, Mrga shrngibhasma 200 mg € honey twice a day. Rx- _ Sidda Makhara dwaja- 300 mg Yogendra ras — 300 mg | make in to 2 doses Arjuna cirna — lg. Pushkaramila cima—-_ 2g. 2. Arjunarista — 15 ml. ; Amritarista- 15 ml, Twice a day. Scanned with CamScanner272 KRIMIJA HRD The Principle and Practice of Kaya Cikitsa Vol ki ROGA'- he symptoms of Krimija Hrdroga~ The following are it e Nausea (Utklesa) e Spitting (Shtivana) e Pricking pain (Toda) Colic (Sila) e Drowsiness (Tamas) Anorexia (Aruci), Blue colour of eyes and Emaciation. Treatment a, Langana and Pachana line should be followed er giving Tila made sweets 1 2. 3. Vaividanga | g. 1 g.|with 100 ml Gor ‘a twice a day. Akshara twice a day. 4, Pushkara 5. Krimimudgaras 250 mg twice ay 6. Vidangisava 20 ml. Twice a day 1, Krimimudga rasa Ig. Palisabyja cima 4 g. | 2 doses/twice a day with honey: Shrngi bhasma lg. Arjuna cirna 4g. Followed by 2 . Vidangisavam 15 ml. Arjunirista 15 ml.}| Twice a day. Pathya- Patola, Salirice, Karela; Marica, Draksha, old jagse Shonti, ‘Ajvoit : ‘ honti, Ajvoin, Garlic, Haritaki, Dadima, Ginger, Honey et —_— saree: werd ihe: yeh wearer: | eh: aan ee oa Apathya- oe Pathya~ All causative factors as indicated. Scanned with CamScanner