Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S
Kalaya Khanja is a disease condition which has been briefly explained in the context of Vata Vyadhi – specific and special / uncommon disorder caused by severely aggravated vata, only vata.
Reference – Madhava Nidana – Vata Vyadhi Nidanam Chapter 22, verse 60 and Sushruta Samhita Nidana Sthana, Chapter 1.
Meaning / Definition
कलायसेवनात् खञ्जः कलायखञ्जः।
Khanja – means ‘limping’.
Kalaya – is ‘grass pea’. It has other names also – white pea, Indian pea, chickling pea, blue sweet pea, white vetch, chickling vetch or cicerchia. Its botanical name is Lathyrus sativus. It is a legume belonging to the family Fabaceae. Commonly it is grown for human consumption, as food, and livestock feed in Asia and East Africa. Their seeds contain a neurotoxin that causes lathyrism, a neurodegenerative disease when consumed in excess, as a primary source of protein for prolonged periods.
Summing it up,
Kalaya Khanja is khanja – a neurodegenerative disorder / vata vyadhi marked by limping gait, which is caused due to excessive consumption of Kalaya – Lathyrus sativus for prolonged periods. So, this condition is limited to those people who consume Kalaya in excess.
Synonym
कलायखञ्ज इति शास्त्रे रूढा संज्ञा; अयमेवान्यत्र खञ्जवात इत्युक्तः।मधुकोश, मा.नि.२२/६०।
Kalaya Khanja is also called ‘Khanja Vata’.
Why is Kalaya Khanja considered as Vata Vyadhi?
Kalaya has qualities similar to those of vata. So, when Kalaya is consumed in excess and for a longer duration, it will definitely increase vata to abnormal proportions. This vata will affect the nerves and tissues of the lower limb and cause the person to limp. Since Kalaya increases vata and leads to a peculiar and uncommon special vata disorder with vata predominant symptoms – unable to walk, in this case, it is counted amongst vata vyadhi.
Pathogenesis of Kalaya Khanja
Excessive consumption of Kalaya
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Aggravation of vata
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Vata takes sthanasamshraya – lodgement in the kati – pelvis and low back regions, sakti – thighs and pada – lower limbs and the kandaras – tendons and ligaments of the lower limb
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Cause khanjatva – imbalance and shaking (tremors in legs) and weakness in the lower limb at the beginning of walking stance, causing the person to limp
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This is called Kalaya Khanja
As per the definition of Khanja, this condition is called Kalaya Khanja when it affects one lower limb. If it affects both limbs it needs to be termed as Pangu itself. This has not been clarified in the text if Kalaya Khanja would affect one or both lower limbs, but the difference between khanja and pangu has been given. Limp affecting one lower limb is called khanja and if the person finds it difficult to walk with both limbs, it is called pangu – lameness.
Symptoms of Kalaya Khanja
प्रक्रामन् वेपते यस्तु खञ्जन्निव च गच्छति॥
कलायखञ्जं तं विध्यान्मुक्तसन्धिप्रबन्धनम्।सु.नि.१, मा.नि.२२/६०॥
Prakampan Vepate Yastu – the person feels shaky / shivers or trembles or has jerky movements as if the lower limb is having tremors. The commentator of Madhava Nidana has further added that these shaky movements or trembling gait is seen right at the beginning of walking i.e. when the person gets up from resting position – sleeping or sitting position – and tries to walk. This means to tell that the initial steps are themselves uncomfortable and shaky. ‘Gamanarambhe Vepana’ i.e. trembling at the beginning of the walk differentiates this condition from another condition called ‘Khanja’ which also means ‘limping’. But in Khanja, Kalaya need not be an etiological factor.
Khanjan Iva Cha Gachchati – the person will walk as if limping i.e. will have a limping gait. Immediately when we see that person walking, we can sense that he or she is not having an easy time walking and is limping along. The commentator of Madhava Nidana explains Khanjan Iva as ‘Vikalayan Iva’ i.e. the person walks as if disabled by limbs.
Mukta Sandhi Prabandhanam – or ‘Shithilikruta Sandhi Bandhanam’ (Madhava Nidana Commentary) – i.e. laxity or looseness of the joints of the lower limb. So, the joints in the lower limb and pelvis also have started giving way and are not supporting the act of walking. This also shows the immense aggravation of vata in the joints leading to their degeneration and destruction. The joints are not able to bear the weight of the body and the person might fumble while walking. On the other hand, this might be the actual mechanism behind limping gait and may also be the initial process in the pathogenesis of Kalaya Khanja.
These three are the main symptoms and hallmark features of Kalaya Khanja.
Prognosis
Though the sadhyasadhyata – prognosis of Kalaya Khanja has not been explained we can consider it as sadhya i.e. curable in the initial phase of its manifestation, when vata symptoms are seen afresh and can be correlated with consumption of Kalaya as etiological factor.
On the other hand, Kalaya Khanja becomes incurable –
– as the disease progresses
– when the symptoms are severe,
– the disease has caused sufficient damage of muscles and joints of the lower limb,
– if it occurs in old aged people
– if the disease is associated with complications which cannot be reversed and
– if the link between the symptoms and Kalaya as etiological factor cannot be established and
– if the person keeps taking Kalaya
Prevention
Keeping away the etiological factors, Kalaya in this case, is the best way of preventing the disease or progression of the disease.
Treatment of Kalaya Khanja
The mainstays of successful treatment of Kalaya Khanja includes the below mentioned principles –
– early identification of the disease,
– establishing the link between symptoms and consumption of Kalaya,
– isolating the etiological factors and
– promptly treating the disease
Nidana Parivarjana – Giving away the consumption of Kalaya and all other vata increasing foods, activities and behaviours is very important strategy in the treatment of Kalaya Khanja.
Vata Vyadhi Chikitsa – Since Kalaya Khanja is a Vata disorder, the principles of treatment of Vata disorders are applicable for this disease too. This includes medicines, therapies, diet and lifestyle changes.
Panchakarma Therapies – Vasti is the best choice for patients having symptoms of Kalaya Khanja. Brimhana Vastis and Yapana Vastis should be administered to strengthen and nourish the muscles and joints and also to calm the nerves. They are the best and unparalleled in the business of mitigating vata and also will halt the progression of disease and its symptoms.
External Therapies – Along with Vasti, properly planned and executed external therapies are disease modifying in nature and also will help in restoring the movements in the lower limbs and the muscles and joints therein. They are also vata calming in nature. The external therapies should include Abhyanga – herbal oil massages, Swedana – sudation, Taila Dhara – showering of medicated oils and Ksheera Dhara – showering of medicated milk.
Useful medicines
– Maharasnadi Kashayam
– Sahacharadi Kashayam
– Dhanwantaram Kashayam
– Gandharvahastadi Kashayam
– Ksheerabala Taila 101
– Gandharvahastadi Eranda Taila
– Nimbamritadi Eranda Taila
Modern Correlation
Kalaya Khanja is correlated with a condition called Lathyrism. It is a condition caused by excessive consumption of legumes of the genus Lathyrus for prolonged time.
The three types of lathyrism are – Neuro-lathyrism, Osteo-lathyrism and Angio-lathyrism. All these conditions differ in their symptoms and are said to be incurable.
In neuro-lathyrism motor neuron death occurs leading to paralysis and muscle atrophy of the lower limbs. Osteo-lathyrism affects the connective tissues. Angio-lathyrism affects the blood vessels.
Kalaya Khanja is a mixture of these conditions. The symptoms Prakampan Vepate points towards neuro-lathyrism. Mukta sandhi prabandhanam points towards osteo-lathyrism. Khanjan iva gachchati and prakampan vepate yastu may collectively point towards angio-lathyrism.
To sum up,
Lathyrism is caused by consumption of large quantities of lathyrus grain – Lathyrus sativus mainly. Lathyrus sativus is Kalaya in Ayurveda. Excessive Kalaya intake causes Pangu and it is called Kalaya Khanja. Kalaya Khanja is explained in the context of vata vyadhi. Vata vyadhi explains a wide array of neurological, musculoskeletal and neuro-degenerative disorders, all of which are involved in lathyrism. Lathyrism, can be correlated with Kalaya khanja and thus is a vata vyadhi from Ayurveda perspective.
Related Reading – Lathyrism
