Characteristic feature of Oorustambha is stiff and stable thighs. Oorustambha is a single disease caused by the vitiation of all the three Dosha. It is not divided into types in accordance with the Dosha. In this disease Panchakarma is totally contraindicated.
Stambhayet Sthairya S`haityabhyaam Oorustambhah tatah tu Sah | Ch. Chi. 27.14
(When both the thighs become stiff due to stability and coldness, this is Oorustambha)
Causative factors of Oorustambha are
o Consumption of unctuous, hot, Laghu (easy to digest), cold food when earlier food is undigested.
o Consumption of liquid, dry, curd, milk, meat
o Liquor prepared from Pisht`a (Starchy) material
o Sleep in day time, suppressing natural urges etc.
(These factors aggravate Aama and provoke Dosha, especially Kapha)
- Aamais aggravated due above causative factors.
- Aamaaccumulates in Kosht`ha. It further coats internal organs.
- This Aamagets associated with Meda and obstructs Vaata, Pitta and Kapha.
Due to the heaviness, this Aama with Meda and Tridosha traverse to the thighs (Ooru) quickly through the channels going downward (Adhogaami Siraa) filling the channels in the thigh and leg.
- Kaphawith Meda defeating Vaata and Pitta causes stiffness, stability, and coldness in the thighs.
Lakshan`a (Clinical presentation):
Patient can not lift up the limb or can lift it with difficulty or pain.
Other signs and symptoms are heaviness, stiffness, burning sensation, pain, numbness, and tremors in the thighs.
Status of Sampraapti related factors Oorustambha
|Avayava||Kosht`ha (Aama Upalepana)|
|Asaadhya||Daaha Yukta, Arti Yukta, Toda Yukta, Vepana Yukta|
|Dosha||Vaata Aamasamruddha, Pitta Aamasamruddha, Kapha Aamasamruddha Dosha Meda Bala Utkat`a, Kapha Sameda, Vaata Kaphaavrita, Vaata Medaavrita|
|Dosha & Gun`a||Kapha (Guru, Sthira, S`heeta, Stimita)|
|Dhaatu||Medas Sahita Aama|
|Indriya||Avidheyaparispanda (Asvaadheena) Indriya|
|Effect on other||Aama Sakapha, Aama Samedas, Aama Savaata|
Oosrustambha (Oorugraha) is the disease in which the movement of the thigh muscles is hampered due to severe stiffness. Kapha and Medas along withVaata are the responsible factors.
Oosrustambha (Oorugraha) is the only disease where Panchakarma like Basti, Virechana and Vamana are contraindicated. Poorvakarma like Snehana is also contra-indicated.
The reason for contraindication is that, Snehana (Oleation therapy) and Anuvaasana Basti; both aggravate Kapha. In the pathogenesis of Oosrustambha,Kapha and Medas are the two mainly involved entities. As has been explained by Charaka, Kapha, Aama and Medas are accumulated in the Ooroo andJanghaa (thighs and leg) causing their stiffness due to their Sthira and S`heeta attributes. Therefore, if Snehana and Basti are done in the patients suffering from Oosrustambha, it will again aggravate Kapha, which in turn will boost up the pathogenesis of Oosrustambha. The prognosis will become graver then before in this situation.
Virechana is also contraindicated as Virechana acts on Pitta dominated Dosha. As in the Oosrustambha, Kapha is the main vitiated Dosha, Virechana has got no potency to remove Kapha, which is vitiated and harboured in the thighs.
Vamana and Virechana, both the Karma are potent to root out the vitiated Kapha and Pitta in their own sites (Kosht`ha). But when Dosha are aggravated in the thighs (other than their own sites), they are unable to expel them out making any Panchakarma useless in this disease as it becomes very difficult to get the water from deep well. Therefore, Poorvakarma Snehana and Panchakarma like Basti, Vamana and Virechana are contraindicated in Oosrustambha.
In Oosrustambha, it is necessary to do the Kshapan`a, S`hoshan`a and Sams`hamana continuously, as there is dominance of Kapha.
There should be all the Rooksha Upachaara i.e. use of food and drug having dry attributes.
After doing the Rooksha Upachaara (Apatarpan`a), if it has happened in excess, it is necessary to do the Santarpan`a. It is because while doingApatarpan`a to deplete the Kapha, Vaidya should take care of strength of patient. There should not be the depletion of strength while carrying out the depletion of Kapha. If debility appears, then Charaka has given the food regime to get back the strength.
Aabhyantara and Baahya both are mentioned.
o Associated with excess of Kapha and Aama Dosha Sams`hamana, Ksapan`a , S`hoshan`a and Yuktyapeksha should be the line of treatment
- Yathaa S`hakti Naaree S`heelana(sexual gratification as per Bala)
- A special treatment has been mentioned as jumping, walking etc in sand as these bring about Rookshan`aof Kapha
o Generally, it has been said that Kapha should be depleted (Kapha Kshapan`a) but without aggravation of Vaayu. Anything that can achieve this principle can be done as treatment of Oosrustambha. Digestive capacity (Agni) and physical strength (Bala) should be maintained in the treatment procedure.
o According to Sus`hruta, Kapha Medaavrita Vaayu is the causative factor in Oosrustambha. Sus`hruta has advised to treat Oosrustambha as per Kapha Medaavrita Vaata. He also says to treat it as S`hotha (specifically Apakva S`hotha).
o When Kapha and Meda get depleted in substantial amount, then Karma like Snehana can be done.
o Sus`hruta has advised to use Guggulu in Oosrustambha. The reasons are:-
- Gugguluis Kaphavaataghna due to its Teekshn`a and Ushn`a attribute.
- Guggulupacifies Mala and Pitta due to its Sara attribute.
- It is Sugandhi(having aroma), therefore it cures Pooti Kosht`ha Vaataghna.
- It increases Agniby its Sookshma attribute. (Su. Chi. 5.30)
Rasa- Kat`u, Tikta, Kashaaya, Lavan`a,
S`hooka- Yava, Rakta S`haalee
S`haaka- S`higru, Kaaravellaka, Pat`ola, Vaastuka, Sunnishan`n`aka, S`haalee, Kaakamaachee, Vetraagra, Rasona, Nimba, Haritakee, Arka
S`himbee- Kulattha, S`hyaamaaka, Kodrava
Maamsa- Krita Jaangala Maamsa
Drava- Ushn`odaka, Arisht`a, Gomootra, Kshaara
Other- Saktu, Svedana, Kshaara, Lavan`a Varjita S`haaka, Lekhaneeya Aahaara
Gun`a- Guru, S`heeta, Drava, Snigdha
Other- Viruddhaanna, Asaatmya Bhojana, Virechana, Snehana, Vamana, Raktmokshan`a, Basti