Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Kubjata – A Vata Disorder
Kubjata is one of the diseases mentioned amongst 80 Nanatmaja Vikaras of Vata (Ref – Charaka Sutra Sthana Chapter 20).
Nanatmaja Vikaras or Rogas are those disorders which are caused by a specific aggravated dosha and only that dosha is responsible for its causation, like ‘that dosha owns that disease’.
Here Kubjata is one among the eighty ‘specific’ disorders of vata. It is a Vata Vyadhi (special vata disorder) in general and Vata Nanatmaja Vyadhi (specific vata disorder) in specific.
Meaning of Kubja
Kubja is a person whose body is crooked. This is due to the abnormal curve in the back. Due to this curve, the person will have a hump on his back. This condition is called ‘hump back’ or ‘hunchback’.
Kubjata or Kubjatva is a state / condition of being ‘hump backed’ or ‘crooked backed’.
Kubjata – etiological factors
गर्भो वातप्रकोपेण दौहृदे वाऽवमानिते।
भवेत् कुब्जः कुणिः पङ्गुर्मूको मिन्मिन एव वा॥सु.शा.२/५४॥
garbho vātaprakopeṇa dauhṛde vā’vamānite|
bhavet kubjaḥ kuṇiḥ paṅgurmūko minmina eva vā||su.śā.2/54||
Below mentioned are the main causative factors for Kubjata –
1. Dauhrda Avamana – insult or ignoring the longings of pregnancy (wishes of a pregnant woman / mother) –
According to Ayurveda, in the fourth month of pregnancy the mother is said to have two hearts – one of hers and the other of the child. Therefore she is called ‘dauhrda’ – a woman with two hearts.
Ayurveda tells that during this period and henceforth all the wishes of the pregnant woman (mother) i.e. longings of pregnancy, be it small or big, usual or unusual, common or strange should be fulfilled. If these are not fulfilled they may have a bad impact on the physical, mental and emotional health of the mother and may have a similar impact on the fetus (embryo) as well.
If the longings of pregnant women are not fulfilled there will be improper development of the fetus – physically, mentally and emotionally. Master Sushruta tells that the child who will be born to a mother whose wishes have not been fulfilled during pregnancy might be –
– Kubja – humpbacked / hunchbacked – scoliosis
– Kuni – crooked armed / lameness
– Pangu – lame, crippled in legs
– Muka – dumb
– Minmina – stammer
It is interesting to note that kubjata is mentioned amongst these conditions.
2. Vata Prakopa – aggravation of vata
Aggravation of vata causes tissue destruction. When vata aggravation is severe, the destruction of tissues is on a massive scale. In this context, apart from ignoring and insulting the wishes of an expectant mother, kubja, kuni etc conditions mentioned above are also said to be caused by vata aggravation.
Vata aggravation can take place –
– in the mother – leading to deprivation of nutrients to the fetus and subsequent undernourishment of tissues including the bones and improper formation of tissues (bones here) leading to kubjata (and other conditions)
– in the fetus – leading to destruction of tissues including bones
– in both mother and fetus – leading to the same chain of events
– after birth – in infancy, during growth or in adolescence (might happen in adults also)
General aggravation of vata in the body may impact on the bones. On the other hand, vata may also get aggravated in the bones. Both these events can cause disorders like kubjata – vis-à-vis scoliosis.
Vata has ashraya ashrayi sambandha with bone tissue. Bone is one among the abodes of vata wherein bone is ashraya (residence) and vata is ashrayi (resident). So, there is always a chance that the bones will be subjected to damage and destruction by vata, if vata severely gets aggravated in the bones.
3. Snayugata Vata – aggracation of vata in the ligaments (lodgment of aggravated vata in the ligaments)
स बाह्याभ्यन्तरायामं खल्लीं कौब्ज्यमथापि वा॥
सर्वाङ्गैकाङ्गरोगांश्च कुर्यात् स्नायुगतोऽनिलः।च.चि.२८।
sa bāhyābhyantarāyāmaṃ khallīṃ kaubjyamathāpi vā||
sarvāṅgaikāṅgarogāṃśca kuryāt snāyugato’nilaḥ|ca.ci.28|
When aggravated vata gets localized in the ligaments it gives rise to wide array of disorders like bahyayama, antarayama, khalli, kubjata and sarvanga roga – diseases afflicting to the entire body or ekanga roga – many diseases pertaining to small regions (body parts and tissues).
Here it is important to note that kubjata which can be closely compared to scoliosis is one of the symptoms of snayugata vata.
In short
Kubjata, according to Ayurveda can occur due to –
– ignoring / insulting the wishes of expectant mother – causing kubjata (scoliosis) in the child / fetus due to deficit nutrition and consequent mal-formation of spine and its curve
– severe aggravation of vata in expectant mother or fetus
– as a nanatmaja roga of vata
– as a symptom of snayugata vata
Prognosis of Kubjata
Though separate prognosis of kubjata is not mentioned (kubjata itself has not been explained in detail in Ayurveda texts) we can infer from the available references –
Kubjata can be easily treatable / curable if it has manifested due to mild to moderate aggravation of vata, mild aggravation of vata in the snayu (ligaments) and asthi (bones).
Kubjata will have bad prognosis and will become difficult to treat if it is chronic or congenital in nature or with severe symptoms.
Modern correlation of Kubjata
Kubjata is often compared to a modern day condition named ‘scoliosis.
Related Reading – Scoliosis
In kubjata there is a lump / hump on the back. Humpback is a characteristic feature of yet another condition of the back – kyphosis.
Kyphosis and Scoliosis often coexist. This condition is called as ‘Kypho-scoliosis’.
So the disorders of spine included under the umbrella term Kubjata include –
– scoliosis
– kyphosis
– kypho-scoliosis
Treatment of Kubjata
Curable types of Kubjata can be treated by implementing the below mentioned principles.
1. Vata Vyadhi Chikitsa – Since kubjata is a vata nanatmaja roga it can be treated by following the principles of vata vyadhi chikitsa (treatment principles followed generally to treat vata disorders).
Snehana (external and internal oleation), Swedana (sudation) and Vasti (medicated enemas) are the most important interventions.
Diet and lifestyle practices which balance vata too shall be implemented.
When these vata balancing interventions are done early (as and when it gets noticed), vata can be brought into control and further curving of spine can be prevented.
2. Possible correction of bija dushti (genetic remodeling) – If there is family history, parents who are planning conception need to be administered Panchakarma therapies, Rasayanas & or Vajikaranas (aphrodisiacs) to correct the bija dushti before conception.
3. Fulfillment of dauhruda – wishes of the expectant mother should be done.
Other aspects of treatment considering kubjatva in comparison to scoliosis / kypho-scoliosis
4. If neuromuscular conditions like cerebral palsy or muscle dystrophy have caused scoliosis – same treatments which mitigate vata should be done. If the complications have not occurred in scoliosis and if the disease has not progressed to a stage of asadhyata i.e. incurability, the below mentioned interventions should be considered on priority –
– Virechana – therapeutic purgation
– Sneha-dhara – pouring of medicated oils on the body
– Murdni taila – oil therapies done on the head &
– Rasayanas including Ashwagandha etc
Since there would be mamsabala kshaya (deterioration in the strength of muscles) in the backdrop of kubjata vis-à-vis scoliosis (especially in neuromuscular conditions causing kubjata), treatment should be done on the lines of treatment of majjagata vata, asthigata vata and snayugata vata shall be adopted. (Ref – Cha.Chi.28/33, 93).
5. Kubjata / scoliosis caused by injuries to the spine should be managed with bhagna chikitsa (treatment of fractures) or vrana chikitsa (treatment of ulcers and wounds).
6. If kubjata / scoliosis is caused by infections it shall be treated with a combination of krimi chikitsa (treatment of worms) and vata vyadhi chikitsa.
7. Treatment of Asadya Kubja (incurable and complicated scoliosis) – Severe scoliosis is disabling. If complications like breathing problems and back problems (chronic back pain) occur in scoliosis – treatment principles of the below mentioned diseases explained in Ayurveda shall be adopted –
– Shwasa – breathing disorders (Cha.Chi.17) – when breathing problems occur due to scoliosis affecting the lungs and chest organs,
– Sarvanga vata – aggravation of vata in the entire body (Cha.Chi.28/91) – causing painful symptoms all over the body,
– Asthyavrta Vata – Vata obstructed by bones & Majjavruta Vata – Vata obstructed by bone marrow – causes diseases and painful symptoms related to bones and bone marrow (Cha.Chi.28/66, 67 & 93, 196)
– Majjagata vata – vata aggravation in bone marrow and asthigata vata – vata aggravated in the bones (Cha.Chi.28/33, 93)
Vinamana is a symptom of Majjavruta Vata. Vinamana actually means bowing down, but also means crookedness, bend, incline or turn. (Cha.Chi.28/67). This condition too looks like kubjata – scoliosis. Even in this condition, the same treatment principles mentioned for kubjata shall be implemented.
