Diagnosis and Treatment of M.S

 

 Knowledge is the shield that ensure s our survival from foes unknown.Knowledge is the campass that guides us through the vast ocean of ignorance.This universal truth is attested by our scholars too. A so-called physician who does so-called treatment without a thorough knowledge is bound to get the capital punishment.There is another twist in the story.One who is an epitome of knowledge but is lacking in its applied aspects means he is similar to a single-winged bird.
The following context is a walkthrough of the practical and clinical aspects of Multiple Sclerosis.
Diagnostic methods
    Diagnosis of Multiple Sclerosis is often difficult.The vague and nonspecific nature or this disease mimics many other diseases.Doctors combine history ,physical examinations,laboratory investigations, and sophisticated medical imaging techniques to arrive at a diagnosis.A complete blood count ,blood chemistry, urine analysis, and often spinal fluid evaluation and all routine laboratory tests are used to rule out  other diagnoses and help confirm the diagnosis of Multiple Sclerosis.An MRI is used to search for changes within the brain or spinal cord that are particular to Multiple Sclerosis.
   Besides taking aid of scientific tools,general data collection can also pave the path to an accurate diagnosis.
   Ayurvedic diagnosis based on pratyaksha (direct observation ), anumana (inference), aptopadesha (authoritative testimony) and yukti (reasoning) is comprehensive enough to determine the symptoms and thereby coming into a definitive diagnosis in the case of Multiple Sclerosis.
   The pratyaksha part can be covered along  with the ‘History of presenting complaints’. One can also infer the brain center involved by examining certain features like gait, region and range of disability etc. involvement of medo dhatu is attained by reasoning. Going through the  patient’s medical history and that of their family, for examble. It may well be that the patient has had symptoms suggestive of multiple Sclerosis or may have relatives with the disease. This makes Multiple Sclerosis a likely diagnosis. Ask the patient to describe their current symptoms. The patient’s description of his/her symptoms is an important indicator. An intensive neurological examination is almost always mandatory. Some of the tests that Shall be included are: Romberg’s sign, Gait and coordination, Heel/Shin test , L ‘ Hermitte’s sign, Babinski’s sign, Chaddock’s Sign, Hoffman’s sign, Doll’s Eye Sign and Sensory tests. Ashtasthaana pareeksha and dashavidha pareeksha is done synchronously with the modern diagnostics. They are: nadi (pulse), mootram (urine), malam (faeces)0, jihwa(toongue), sabda(sound-auscultation),sparsha(palpation),drik(eyes),aakruti(dimension & measurements of the body) The pulse rate, volume and strength would either be elevated or diminished depending on the degree of vata kopa and medo dhatu kshaya. In Multiple Sclerosis,if vata kopa is very high, the urine is theoretically said to be of panduravarna/neelavarna and rooksha in property. It can also be frothy, painful and frequent. In the classic text Yogaratnakara, it is said that, if there is high vata vitiation, a drop of sesame oil put in a cup of urine would spread like a snake. In case of excessive medakshaya, the urine would have visra gandha. The mala would be druta (hard), shushka(dry), and blackish in vata kopa. Faeces with ama(an indicator of metabolic error) would sink if put in water. The tounge will be dry,rough and cold to touch in vata kopa. The eyes/ vision would be dry and cloudy in the beginning of vata kopa. Apart from this examination, the dasha vidhapareeksha or the assessment of the ten factors should also be made.
  Dooshayam (the doshas and dhatus that have vitiated – in this case, vata and medas), Desham (the region of the patient is very important in case of Multiple Sclerosis, since its incidence is very high in the temperature is often very low and that alone can increase vata0 Balam (assessment of physical and mental strength of the patient and the strength of the disease is estimated) Kalam (analysis of seasonal variations of doshas)Analam (the digestive capacity ) Prakruti(the natural doshic constitution and also its vitiation) Vayas (the age factor.Old  age is ,by nature, the time for vata kopa).
Definite Diagnosis
  It is very rare to get a definite diagnosis for Multiple Sclerosis. There are a number of demyelinating conditions of unknown aetiology which are selflimiting and strike only once. In order to diagnose Multiple Sclerosis, there must be at least two episodes separated by at least one month and the location of the lesions must be in the central nervous system.
Diagnostic Diagnosis
 Physicians have developed a checklist to confirm a diagnosis of Multiple Scherosis.These criteria are now largely a clinical record and they form the basis for later revisions. They are also the simplest statement of what M.S. is, clinically. The Schumacher criteria was one of the first such attempts. Later, the poster criteria have updated the Schumacher criteria in recognition of the diagnostic benefits of laboratory data, specifically the MRI. Still more recently, on 4th May 2001, an international panel in collaboration with the NMSS of America has recommended revising the diagnostic criteria for Multiple Sclerosis.
Management
  Ayurvedic treatment for Multiple Sclerosis is highly variable with respect to the condition of the roga,rogi,kaala, and yukti of the vaidya. Though it is considered as a combined condition of vata vyadhi and medokshaya,eminent scholars sees it as sarvanga vata with aavarana (a condition in which one dosha is covered by another and a mixture of symptoms belonging to each dosha is exhibited) and aama association. In such a consideration, a typical treatment is initiated with
1.    Chitrakaadi Kashaya (Susruta) with Vaiswanara or Vidangatanduladi choorna as anupaana in the morning, considering the agnibala and need for sodhana.
2.    Dhanatanayanadi Kashaya with shaddharana gulika as anupana in the evening
3.    Dashamoolarishta mixed with Jeerakarishta is given along with Mahadhantaram gulika and Kasturikalpa Rasayana after meals.
4.    For external application, Sahacharadi tailam mixed with Karpasatyadi tailam is used.
5.    Shiro pichu is done with Sudhabala thaila.
The general line of treatment accepted:
Shodhana Chikitsa:
1.    Snehanam,Acchapaana- with vatahara ghruthas like Sukumara ghrutham, Kalyanaka ghrutham, Indukantham ghrutham can be used.
2.    Swedana-Keraleeya pancha Karma methods like pizhichil,Uzhichil, Elakizhi, Shiro Vasti & pichu are beneficial. Takra Dhara is done to ease the patient.
Procedure:
    Virechana-even thought it shows good result, it is practically difficult to administer in bed ridden conditions. So, maadhu tailika vasthi, with its vata hara abilities, is preferred. Besides, vasti is the rime procedure in curing vata disorders.Nasya with vata hara taila or balya ttaila is done.
Shamana drugs:
   The medications for Multiple Sclerosis that are given internally are mostly vatahara and balya since there isconsiderable fatigue and tiredness along with all complications of vata kopa. The fatigue is mostly due to medo dhatu kshaya. Some of the commonly administered medicines are:
1.    Abhraka bhasam – 125 mg with ghrutha tds after food..
2.    Guggulu tiktakam kashaya – 60 ml bd
3.    Maharasnadi Kashaya – 60 ml bd
4.    Sammira pannaga rasa tablets(does as directed by physician)
5.    Aarogya vardhini rasa tablets.(does as directed by physician)
Rasayana Preparations
 These are given to increase the strength and to speed up recovery. It can considerably improve the functions of mental faculty and helps to regain memory power and other cognitive functions of the brain. Major rasyanas given in Multiple Sclerosis are:
1.    Shilajit 
2.     Lashuna 
3.     Chitraka
Apart from this, Satwavajaya Chikitsa is adviced.