Critical Review on Ellumnishadi Lepa: An Ayurvedic Topical Applicant in Knee Joint Swellings Associated With Rheumatoid Arthritis

Abstract

ABSTRACT'Ellumnishadi lepa' is a poly herbal topical dosage form mentioned in 'Chikitsa Manjari', which is a compilation of clinical observations and simple formulations that were used by traditional Ayurveda practitioners of Kerala. As per the textbook, the lepa (topical applicant) is indicated in knee joint swellings associated with Vatarakta (a disease condition caused due to dangerous amalgamation of vitiated Vata (bio force) and Rakta (blood)). The ingredients of the formulation are to be boiled in milk, made into a paste and applied locally over the afflicted area with q uantity sufficient ghee. Rheumatoid arthritis (RA) is an autoimmune chronic inflammatory disease afflicting majority of synovial joints. Although Rheumatoid arthritis cannot be correlated to a single entity in Ayurveda, clinical protocols and medicaments prescribed for Vatarakta are used by clinicians in different stages of rheumatoid arthritis. Ingredients in the prescribed lepa are having proven anti-inflammatory, anti-rheumatic and antioxidant activities which can combat the pathology in RA. Ellumnishadi lepa application can be used as an effective complimentary treatment along with main stream management strategies in providing satisfactory relief from knee joint swellings associated with degenerative changes in Rheumatoid arthritis.