Disease and conditions

The disease Rajayakshma is known by dif­ferent names as Kshaya, Rogaraat, Shosha and so on. Rajayakshma is composed of two words viz. Raja and Yakshma.  The word Raja is derived from Dhatu ‘Raj’ meaning ‘Deeptau’ which means the person who rules. Plurality of etiology causes multiple manifestation of Rajayakshma. The plural etiology factor falls under unique 4 catoge­ries, they are Shoshaja ni­dana,Vishamashana,Vegasandharana, Dhatukshayaja nidana.

The clinical presentation of Ra­jayakshma is never the same. The Ra­jayakshma contracted by way of sexual re­lation or by the other means also exhibit the similar nature of multiple clinical presenta­tions. The multiple clinical presentations are described as Triroopi Rajayakshma, Sha­droopi Rajayakshma, Ekadashiroopi Ra­jayakshma and so on. Person suffering from Rajayakshma may have any of the above said clinical presentation or intermediary between any of clinical presentation as Saptharoopi Rajayakshma, Astharoopi Ra­jayakshma Dasharoopi Rajayakshma and so on.

The eventuality of clinical presenta­tion of Rajayakshma depends upon the inte­raction between Vyadhikasmatva and etio­logical factors. The different etiological factors tend to reduce the Vyadhikshamtva ultimately manifests as the disease Ra­jayakshma. This unique pathogenesis of in­teraction between host immune mechanism and the pathogenesis holds good for both Rajayakshma as well as HIV infec­tion/AIDS.

The etiological factors causing mor­bidity of Dosha, morbid Dosha in turn cir­culating in the body gets localized in differ­ent parts. Finally leading to the different symptoms related to Sandhi, Pranavaha, Annavahasrotas and so on. It’s worth men­tioning here that clinical manifestation and severity of illness may vary from patient to patient and is dependent upon the Vyadhik­shamatva interacting with virulence of etio­logical factors. Akin to this HIV infec­tion/AIDS may be present with the multiple clinical manifestations, probably related to opportunistic infection or otherwise.

      The treatment of disorders of Ra­jayakshma should consist of such operations as to give rise to the concordance of Dhatus. Treatment is given with the objective of en­suring that no discordance will arise in the Dhatus and there is continuance of their concordance. In Rajayakshma there is vitia­tion of Doshas that ultimately leads to dep­letion of Dhatus. Therefore, the prime aim of management of Rajayakshma is concor­dance of Doshas and Dhatus. The possibility of Shodhana in a patient suffering from HIV/AIDS adapting the principle of Shod­hana treatment of Ayurveda; it can be ar­gued that the HIV/AIDS is an illness of Ba­hudosavastha, and Shodhana is essential. With the due consideration of the physical strength Mrudu Shodhana may be adapted further, exclusive remedies should be ex­plored to uproot the disease or else the po­tent medicines for effective control over this dreadful disease. Sivagutika is a Shamana treatment/Rasayana, administered orally for a long duration is said to be very effective in combating the multiple system involvement of this disease.

MODE OF ACTION OF THE DRUG SHIVAGUTIKA

Among the different oral medica­tions Shivagutika is unique in its category as it is capable of showing Shaman, Bramhana, and Rasayana effect. Simultaneously Ra­jayakshma is characterized by the depletion of body aliments. The body became lean and this person becomes emaciation this counte­ract that effect. The Shivagutika contains Brahamana drugs like Shatavari, Vidari, Drasksha, Godugdha, Jeevanthi and so on. The present study shows the improvement in the body weight of patient following the treatment of Shivagutika affirms its Braha­mana effects.

            One of the factors related to the dep­letion of the body aliments and emaciation is

Angnimandhya. Agnimandhaya exhibits the progressive biotransformation of body ali­ments from rasa to sukra dhatu. This patho­gensis includes both Jataragnimandhaya and Dhatvagnimandhaya , this Angnimand­haya is best treated by Shivagutika and the formulation contains many Deepana, Pa­chana drugs like Pippali, Marchia, Nagara, Gajapippali etc. once again improvement in ability to consume food followed by the in­creasing the weight, patient treated with Shi­vagutika proves the effect.

Symptoms related to Pranavaha Srotas are common in Rajayakshama. It in­cludes Kasa, Swasha, Prathisaya Peenasa, Parshvashoola and so on, Shivagutika is a unique combination having drugs to counte­ract the symptoms also the drugs like Talsi­patra, Puksharamoola, Pippali. Kantakari, Brathi etc.  The reduction of Kasa   from 5.85 to 2.050 by the drug Shivagutika con­firms this effect.

Atisara is another commonest symptom of Rajayakshma. Medicines like Musta, Kutaja controls the same. The Ati­sara which was seen among the patients treated with Shivagutika and complete re­mission is seen. Contrary to this the patient of Rajayakshma also develops constipation. Drugs like Danti, Triphala are effective in maintain the Anulomana of the Vata.

Jwara is considered as invariable symptoms of Rajayakshma Shivagutika as drug to counteract Jwara also like Musta, Patola, Katuki, Agnimantha this evidence in present study shows that Jwara by reduction from 6.850 to 1.850 by the effect of Shivagutika confirms the efficacy in relation to Jwara. The drugs are also having action on Kusta, Cahrdhi, Angamardha, Kristhangata, and so on.

More than anything the definite sig­nificant increase in CD4 count confirms the efficacy of Shivagutika in Rajayakshma/ HIV infection. From this observation it can be definitely said that Shivagutika can be prescribed as an effective treatment in Ra­jayakshma / HIV infection. This study is carried out in stage I and II of HIV infection with a single dose per day regimen.  There­fore there is ample of scope of continuation of study in the other stages of HIV infection and also in increased dosage for the better response of Rajayakshma/ HIV infection in Stage III and IV.

CONCLUSION

• The etiology of Rajayakshma   me­diates through Dhatu Kshaya and con­sequently reduces the Vyadhikshamtva.
• Sahasa,Vishamasna,Vegasandharana and Dhatukshaya are the unique cate­gories of etiology of Rajayakshma and the patient may have the causes from any or all the categories.
• Etiological factor rendering impaired Vyadhiskshamtva increases the risk of diseases hence the plethora of manife­station, multitude of the disease and plurality of complication marks the ill­ness Rajayakshma.
• Intimate contact, sexual relation takes a major role in transmission of the dis­ease.
• The etiology, the pathology, the clini­cal symptoms, complication and final outcome of disease is similar to tuber­culosis and identical to HIV Infection/ AIDS.
• Shivagutika is effective in controlling the clinical manifestation of Ra­jayakshma AIDS/HIV infection.
• Shivagutika as definite Brahmana ef­fect increase in body weight and BMI.
• Shivagutika is effective in recuperating the depleted Dhatu, increase in Hb% is one among the evidences for the same.
• The important in CD4 count affirms the therapeutic benefit of Shivagutika in HIV infection/AIDS beyond the doubt.