A Comprehensive Guide to Ayurvedic Specialties
The term Abhighata is derived from the Sanskrit root 'han' (to strike or to kill) with the prefix 'abhi' (towards, against). It literally means "a strike," "a blow," or "trauma."
It is defined as any injury to the body caused by a direct, external physical force leading to damage of tissues (Dhatu), organs, or systems. Unlike Agnimandya or Ajirna, which are endogenous diseases, Abhighata is exclusively an exogenous cause of disease (Agantuja Nidana).
Its management is a primary subject of Salya Tantra (Ayurvedic surgery and traumatology).
The causes are all forms of external trauma.
Classical Reference (Concept from Sushruta Samhita, Sutrasthana 25)
Sushruta provides a comprehensive list of sharp instruments and types of trauma, but a direct sloka for Nidana of Abhighata as a whole is not found in a single verse. The causes are enumerated throughout the texts.
अश्मना दारुणा लोहैः शृङ्गेणापि करेणुना |
दंष्ट्रया नखरैश्चापि पादेन मुष्टिनापि च ||
(Based on descriptions of causes of wounds)
Praharana (Weapons/Objects): Trauma from stones (Ashma), wood (Daruna), iron/metal objects (Loha), horns (Shringa), etc.
Pradeshina (Regional): Falls from a height (Patana), crushing injuries, collisions, animal kicks (Padena).
Shastrakrita (Sharp Injuries): Incised wounds, punctures, cuts from knives, swords, arrows, etc.
Damshtra & Nakharaja (Bites and Scratches): Injuries from teeth (Damshtra), nails (Nakhara), or claws of animals, humans, or birds.
Mushṭina (Blunt Force): Fist blows, beating with a blunt object.
Abhighata is an acute, exogenous event. Therefore, it does not have internal Purvaroopa (premonitory symptoms) like a metabolic disease. The "prodrome" is the event itself. However, in a broader sense, the pre-existing condition of the body (Sariratva and Dosha Avastha) can determine the severity of the outcome.
The symptoms are directly related to the site, severity, and type of trauma. They can be immediate and local or delayed and systemic.
Classical Reference (Sushruta Samhita, Sutrasthana 21:6)
This verse describes the general symptoms of a wound (Vrana), which is the primary outcome of Abhighata.
स्रावणं पूतिमांसत्वं शोथो वैवर्ण्यमेव च |
स्पर्शासहिष्णुता चैव षड्विधं व्रणलक्षणम् ||
Sravanam, Putimamsatvam, Shotho, Vaivarnyameva cha |
Sparshasahishnuta chaiva, Shadvidham Vrana Lakshanam ||
Local Symptoms (Vrana Lakshana - signs of a wound):
1. Srava (स्रावः): Discharge (blood, pus, serous fluid).
2. Puya / Pūtimāmsatva (पूय / पूतिमांसत्वं): Suppuration (pus formation) and putrefaction of muscle tissue.
3. Shotha (शोथः): Swelling, inflammation.
4. Vaivarnyata (वैवर्ण्यता): Discoloration (blue, black, red, pale) around the wound.
5. Sparshasahishnutā (स्पर्शासहिष्णुता): Tenderness, intolerance to touch.
6. Vedana (वेदना): Pain (this is implied in all texts).
Systemic Symptoms (Due to Doshic Vitiation):
Jwara (ज्वरः): Fever (sign of infection/toxic absorption).
Daha (दाहः): Burning sensation.
Trushna (तृष्णा): Excessive thirst.
Aruchi (अरुचिः): Anorexia.
Angamarda (अङ्गमर्दः): Body ache.
This involves observing the effect of treatments to understand the nature of the complication.
Upashaya (Relief): Symptoms improve with:
Raktamokshana (Bloodletting): If the pain and swelling are due to vitiated blood.
Seka (Pouring medicated liquids): If inflammation reduces with warm or cold medicated decoctions.
Upanaha (Poultice): If a medicated poultice reduces pain and promotes healing.
Anupashaya (Aggravation): Symptoms worsen with:
Application of wrong therapies (e.g., heating poultice on a Pitta-dominant inflamed wound).
Exposure to etiological factors (further injury, unclean dressings).
E. Samprapti (Pathogenesis - सम्प्राप्ति)
The pathogenesis involves the trauma itself and the body's subsequent response.
1. Nidana Sevana: The body is subjected to a traumatic force (Abhighata).
2. Dosha Prakopa: The impact immediately vitiates all three Doshas at the site of injury:
Vata is aggravated by the rupture, fracture, and tearing, causing severe pain, deformity, and loss of function.
Pitta is aggravated by the heat, inflammation, and bleeding, causing burning sensation, redness, and suppuration.
Kapha is aggravated by the swelling, discharge, and heaviness, causing edema, numbness, and slow healing.
3. Dhatu Kshaya & Strotas Avarodha: The trauma causes direct damage (Kshata) to the tissues (Dhatus) like Rakta (blood), Mamsa (muscle), and Asthi (bone). This damages the channels (Srotas), causing obstruction.
4. Vrana Utpatti (Wound Formation): The combination of tissue damage, Doshic vitiation, and channel blockage manifests as a Vrana (wound) with all its characteristic symptoms.
5. Sopha (Inflammation): The vitiated Doshas spread to the surrounding tissues, causing inflammation and swelling.
6. Systemic Spread: If severe, the vitiated Doshas can spread systemically, causing fever, malaise, and other constitutional symptoms. This can lead to serious complications like Visarpa (erysipelas/sepsis).
Abhighata directly correlates with Traumatology in modern medicine.
Modern Correlations:
Blunt Force Trauma: Contusions, hematomas, concussions, internal organ injuries, fractures from falls, assaults, or accidents.
Penetrating Trauma: Stab wounds, gunshot wounds, puncture wounds from sharp objects.
Orthopedic Injuries: Fractures, dislocations, sprains, strains, ligament tears (e.g., ACL tear).
Soft Tissue Injuries: Lacerations, abrasions, crush injuries, compartment syndrome.
Head Injury (Shiroroga Abhighata): Concussion, traumatic brain injury (TBI), intracranial hemorrhage.
Animal/Insect Bites: Rabies, tetanus, Lyme disease, venomous bites.
Lab Investigations & Diagnostics:
Diagnosis is primarily clinical and radiological, but labs are crucial for monitoring complications.
Imaging:
X-Ray: First-line investigation for suspected fractures.
CT Scan: For head injuries, internal organ damage, and complex fractures.
MRI: For soft tissue injuries (ligaments, tendons, spinal cord), brain contusions.
Ultrasound (FAST Scan): To detect free fluid (blood) in the abdomen after blunt trauma.
Blood Tests:
Complete Blood Count (CBC): To check for anemia due to blood loss and elevated WBC count indicating infection.
Coagulation Profile (PT/INR, PTT): To assess blood clotting ability, especially in head injuries or on anticoagulant therapy.
Serum Electrolytes & Renal Function Tests (RFT): To monitor systemic status, especially in crush injuries that can cause rhabdomyolysis and kidney failure.
Blood Culture and Sensitivity: If signs of systemic infection (sepsis) are present.
Wound Culture: To identify the causative organism in an infected wound and guide antibiotic therapy.
Arterial Blood Gas (ABG): In cases of major trauma to assess respiratory and metabolic status.
KASHAYA KALPANA
1. Marma Kashayam
2.Nadi Kashaya
3.Bhadradi Kashayam
4.Dhanwantharam Kashayam
1. Dhanwantararishta
2.Ashwagandharishta
3.Balarishta
4.Vasharishta
1. Laksha Churna
2.Lakshadi Churna
3.Nagaradi Churna (external)
1. Marma Gulika (big)
2.Dhanwantaram Gulika
3.Vayu Gulika
4.Marma Gulika (small)(external)
5.Karutha Gulika (external)
1. Laksha Guggulu
2.Mahayoraraja Guggulu
3.Rasabhra Guggulu
4.Trayodashanga Guggulu
TAILA KALPANA
1. Marmma Taila
2. Bala Taila
3. Balashwagandhadi Taila
4. Chandana bala lakshadi Taila
5. Dhanwantaram Taila
6. Karpuradi Taila
7. Kuruntotti Taila
8. Lakshadi Taila (big)
9. Lakshadi Taila (small)
10. Mahabala Taila
11. PRasarani Taila (bruhat/big)
12. Vatasini Taila
13. Kayatirumeni Taila (prop.med)
14. Marmmani Taila (prop.med)
15. Ulukkenna (prop.med)
16. Siddha Kayatirumeni (prop.med)
17. Gandha Taila
1.Dhanwantaram Taila
1. Murivenna
2.Lakshadi Kera
1. Bruhat chagaladi Ghrita
2.Guggulu tiktakam Ghrita
3.Panchatiktaka Ghrita
1. Ajashwagandhadi Lehya
2.Kushmanda Rasayana
3.Narasimha Rasayana
4.Shatavari gula
5. Ajashwagandhadi Lehya
6. Kushmanda Rasayana
7. Narasimha Rasayana
8. Shatavari gula
1. Kukkutanda twak Bhasma
2.Pravala Bhasma
3.Varatika Bhasma