KATIVASTI

          Kativasti is one of the variety of bahya sneha  and comes under the type of bahir parimarjana chikitsa . Normally we can administer this treatment for 3 to 7 days and changes can be made according to the condition of rogi , roga , dosha , kala etc. . The oil should be decided according to the conditionof the patient and roga . It’s a modification of moordha taila chikitsa (siro abhyanga , dhara , pichu , vasti ) . In this treatment both snehana and swedana will take place simultaneously . The biggest benefit of this treatment is that it will give an immediate result because of the action at the site of lesion.

Definition

            Oushdha yuktha taila poured over the kati pradesa is made to stay in a particular temperature in a circular shape of instrument prepaid out of masha (masha pishti).

Nirukthi

            The word vasti is derived from the root word vas+chit . Here in this context we can take vas aaschadane ethi vasti means to cover or wrap

Reference

            The procedure is not mentioned in any of the classical texts but the reference regarding the sirovasti is mentioned in chikitsa manjari (a therapeutic book which is written in malayalam  ) according to the site the name of the treatment changes like siro vasti , kati vasti , greeva vasti , jaanu vasty etc.

Indication

1 , kati soola - according to the gada nigraha and bhava                                                                                                             prakasa it is the condition their vitiated vata alone (kevala) or with other doshas causing pain and stiffness in kati pradesha

2 , gridhrasi

3 , thrika graha – pakvasayasritha vata kopa lakshana

4 , lumbar spondylosis  , spondylolythesis , disc prolapses , ankylosing  spondilitis , rheumatoid arthritis , sacroileitis , lumbar sacral strain .

Site and size

                        With the help of lumbo sacral x-ray, lesion must located for the kati vasti

For prushta vasti generally between c7 to t12 vertebrae and kati vasti t12 to s1 vertebrae

Time           

            Genarally 1000 matrakala (55mts)

         in vataja rogas 10000 matrakala

         in pittaja rogas 80000 matrakala

         in kaphaja rogas 60000 matrakala                                                                                        

                                                         (ref-chikitsa manjari)

 Temperature of the oil

          35° to 45° minimum temperature . Heat of the oil should be felt by physician or therapist  before pouring.

Contraindication

·         Localised skin lesion

·         Fracture in vertebrae

·        Open wounds

Precautions

                      Observe the heat of the oil before pouring , patient have to take complete bed rest , vatatapa is contraindicated , restricted for lifting weight , restrict forward and backward bending .

Oils(taila)

           Commonly tila taila , vishagarbha taila , bala taila , mahamasha taila , dhanwanthara taila , karpasasthyadi taila , dhathoora taila , nirgundi taila are using .

Tila taila

          It is vatahara , thridoha hara , thhekshna , vyavai , and it will not cause kapha aggravation

             twak dosha krith –

                  twak dosha hara - if externally apply

                        twak dosha kara – if internally administering                                                                    (ref – ashtanga hrudaya sutra sthana )

Masha choorna

           It is snigdha , bala sleshma mala pitta kara , guru ushna , anilahara , madhura rasa , sukla vardhaka and sukla vireka krit                                                                                      
 (ref – ashtanga hrudaya sutra sthana )

Requirements

·         masha choorna – 500 gm

·         medicated oil – 300 ml [ 150 ml at a time pouring in kati

region ]

·         facility to heat the oil

·         towel

Procedure

                       Preparation of masha pishti

Poorva karma

                        Preparation of the client – after evacuation of mala , mootra  etc.

                        Before staring the procedure swasthi vachana 

Pradhana karma

                         Patient have to lie down in prone position with low back region exposed the area should be cleaned with the help of a cotton piece after that masha pishti have to fix on that region. The luke warm taila pouring on that region with the help of a cotton swab , when the poured oil becomes cool have to replace it   . Normally 30 – 50 mts of time duration we can keep for this procedure and according to the condition we can administer the gentle massage over that area with the help of fingers .

Paschath karma

                       Remove the oil with the help of a cotton swab , removing the frame , slight massage over the area , swedana [nadi sweda for 5 mts ]

Observation

              Observe the symptoms indicate of proper effect of swedana , if deficient or excessive to be treated accordingly after the procedure the patient have to take rest for 15 mts in supine  position , hot water bath with the help of green gram powder . Patient have to take rest in a flat cot made up of wood without using any type of thick matters.

Probable mode of action

             The seat of vata is – pakvasaya , kati , sakthy , sparsanendriya

Kati pradesa – vertebral coloumn joints with hip bone on either sides , the lumbar , sacral and sacro iliacal joints

Sakthy – both lower limbs – uru

Vitiation of vata in any one of this location leads to shows symptoms like sthambha and ruja

                                   Kati vasti action its local site ,  because of the guna of sneha (yasya kledanae sakthi sa) it creates unctuousness . Their after it undergo paka with the help of bhrajaka pitta (lies in skin) further it will assimilated under the influence of bhoothagni paka and it will pacify the dosha .

Effect of kati vasti in kati soola

                            In case of vata a dosha which causes kati soola supposed to get pacify from its moola , out of the sthanas of vata pakvasaya is given more importance because vata developed from their . Apart from this it is enumerated that vata is placed in asthi dhathu to pacify vata , here the taila will reach in asthi not only by absorption but also through its local action . On the basis of dallana clarification we can tell that the sneha will reach in asthi dhathu with in 800 matrakala (245 seconds) . Thus in practice to use the kati vasti in vata vyadhi especially in kati graha.

Prepared by

Dr.Vishnu Raj. S 

08904747803

v4vishnuraj@gmail.com