Ayurvedic Management of Systemic Lupus Erythematosus with Respect to Vatapradhana Vatarakta: A Case Report

Therapeutic Intervention

      Considering the chronicity of symptoms and the patient’s intolerance to strong Shodhana (purificatory) therapies, a Mridu Shodhana (mild purification) approach was adopted. A classical Virechana Karma followed by Ksheera Basti, as mentioned in the Siddhi Sthana of Charaka Samhita, was implemented.

Table 6: Virechana Karma Protocol

Ksheera Basti Protocol

     Ksheera Basti is considered a Mridu Niruha Basti, suitable for patients where Vamana and other Shodhana therapies are contraindicated. It provides both nutritional and therapeutic benefits and is particularly beneficial in Vata-Rakta conditions.

Table 7 : Ksheera Basti Ingredients

 Follow-Up and Outcomes

     The patient remained hospitalized for 28 days during which Virechana and Ksheera Basti therapies were completed. Notable clinical improvements were observed, particularly in joint pain, stiffness, and swelling, with increased functional mobility. All clinical examinations were repeated post-treatment, showing moderate to marked symptomatic relief.

At discharge, the patient was counselled regarding the chronic and relapsing nature of the disease and was advised to:

• Maintain regular follow-up (every 1 month)
• Avoid dietary and lifestyle factors aggravating Vata and Rakta
• Follow Dinacharya and Ritucharya tailored to her constitution

Table 9. Pain Assessment (VAS Score)

Table 10. Assessment of Joint Stiffness (Grading System)

 Table 11. Assessment of Swelling (Measured in Inches)

 Discussion

   The clinical manifestation of Systemic Lupus Erythematosus (SLE) in this case—including pain, stiffness, joint swelling, intermittent fever, and blackish discoloration—can be appropriately correlated with Vatapradhana Vatarakta in Ayurvedic classics. Symptoms such as Dhamani Anguli Sandhinam Sankocha, Atiruk, Karshnya, Shyava Varna Shotha, Kunchana, and Sthambhana align with the observations in this case[5].

   Given the Vata-Rakta Dushti and chronicity of symptoms, along with a background of long-term steroid use, a Mridu Shodhana [6] approach was warranted. Virechana Karma using Aragvadhadi Avaleha[7] was selected as it is Snigdha and suitable for Sukumara Purusha and Vata-predominant disorders.

Charaka has described Ksheera Basti (milk-based enema) as the prime line of treatment in Vatarakta. The chosen decoctions—Dashamoola and Punarnavashtaka — possess anti-inflammatory (Shothahara) and analgesic (Shulahara) properties. They are also effective in Raktaprasadana and Twakdoshahara.

• Guduchi, known as the Agryadravya in Vatarakta[8], was used both in Ghrita[9] and Kalka forms. It has Tikta Rasa, Rasayana action[10], and helps pacify Tridoshas.
• Madhu and Saindhava, due to their Yogavahi nature, enhance absorption and bioavailability of the Basti Dravyas.
• The combined effect of Basti Karma significantly reduced symptoms by clearing vitiated Vata and nourishing affected tissues.

This integrative approach proved effective in managing autoimmune inflammation by providing subjective relief, improving joint function, and enhancing quality of life.

Patient Perspective

      The patient expressed satisfaction and gratitude with the outcome of the treatment. She was particularly relieved by the rapid reduction in symptoms and regained her ability to perform daily tasks. She acknowledged the seriousness of the illness only after understanding its autoimmune nature post-discharge and appreciated the effectiveness of Ayurveda in managing her chronic condition.