A Ayurvedic management of Thrombo Angiitis Oblitrerans (T. A. O.) (Buerger’s disease) – A case study

Abstract

T.A.O (Thrombo Angiitis Oblitrerans) also called as buerger’s disease or smoker’s disease.it is due to in response to the inflammation of all three layer of the artery. It is non -atherosclerotic inflammatory disorder involving medium sized and distal arteries.Mainly occurs in young males between ages of 20-40 years  and is common in lower limbs .  The common cause of the disease is smoking or tobacco chewing. Tobacco secretes nicotine which is responsible for vasospas,. In early stage it is unilateral but later involves both the limbs. Causes include hypersensitivity to cigarette, recurrent minor feet injuries, poor hygiene and altered autonomic functions. Sign and symptoms include intermittent claudication, discoloration of the involved limb, decreased local temperature, rest pain, ulceration and, bridded nail,loss of subcutaneous fat ,gangrene,  absence/feeble distal pulses and recurrent superficial thrombophlebitis¹.  Modern management of this disease includes conservative with use of vasodilators, pentoxyfylline,dose aspirin,or platelate aggregation inhibitor drug. Surgical management includes chemical sympathectomy lumbar sympathectomy,, and if gangrenous stage is there then amputation is the choice.These means of treatment are costly, not satisfying and associated with  complications.  In  Ayurveda, the disease is not mentioned as it is but the features can be correlated with gambheera vatarakta.²Hence, because of rakta dusti manjisthadi Kshara basti³ was planned as ekal chikitsa.with the hypothesis that it helps  to improve the collateral formation and increased the micro circulation. All these means gave satisfactory results and the patient was able to do his daily activites without any trouble.