Dr. G.

A CLINICAL STUDY WITH "R. COMPOUND"

IN THE TREATMENT OF RHEUMATOID ARTHRITIS
AND

OTHER CHRONIC ARTHRITIDES


BY
Dr. G. ETHIRAJULU, M S
Professor of Orthopaedics, Guntur Medical College
&Orthopaedic Surgeon, Government General Hospital, Guntur (A.P.)

And

Dr. J. VENKATA REDDY, M.B.B.S., P.G. in M.S. (Orthopaedics)

Guntur Medical College, Guntur (A.P.)

 

Paper before IV Annual Conference of the Association of Orthopaedic Surgeons of Andhra Pradesh held at Hyderbad during 7th& 8th July 1972

INTRODUCTION:

The term "Rheumatism" refers to a mixed bag of heterogenous conditions which is characterised by pain, stiffness and swelling arising from Musculo-fascial and skeletal systems. This is most common symptom-complex attending the orthopedic department daily.


The aetiology of Rheumatic Disorders is largely obscure, hence the treatment has remained empirical. All the currently used drugs in relieving the complaints are not free from untoward side-effects. SO from centuries it had been an ardous endeavor by Scientists and doctors to find out a suitable, safe and satisfactory remedy against chronic Rheumatism.
The present clinical study is undertaken to observe the clinical effectiveness of the composite Ayurvedic drug "R.Compound" (Alarsin) in chronic Arthritides.
EXPERIMENTAL WORK :(On the ingredients of the "R.Compound"):

1. GUJRAL et al, 1960 – observed all the beneficial effects against Rheumatism in the case of Mahayograj Guggul.

2. KARANDIKAR et al, 1960 – who also observed similar potency of this drug against Rheumatism

3. HERD AND MUNDY -  conducted toxicity test in London, 1952 and found to be quite Non-Toxic

4. Other workers have reported good results, when used especially with other anti-pyretic and analgesic drugs such as Salicylates. Their action seems to be potentiated by this Compound.

COMPOSITION "R.COMPOUND"

R.Compound is composite Ayurvedic drug used for chronic Rheumatism and other painful chronic musculo-skeletal disorders. This compound consists of the following ingredients.

1. Mahayograj Guggul c Gold
   (in Bhasma form)                                                     200.00 mg

2. MaharasnadiQuath :                                             67.00 mg

The various Pharmacological properties of these constituents are :

1. MAHAYOGRAJ GUGGUL: It is prepared by processing 30 different herbal ingredients. The main ingredient is an Oleo-resin-Gum GUGGUL.

PROPERTIES: It is credited to have Anti­rheumatic, analgesic, anti-pyretic, anti-bacte­rial properties. It is broad-spectrum drug hav­ing demulcent, aperient, carminative, anti­spasmodic properties. It is stated to possess diuretic, haematinic, expectorant and ap­hrodisiac properties. It is considered to have some soothing effect on the brain.

It is quite non-toxic and can be used in ex­tremes of age with good-results. It is excreted by the skin, mucous membranes and Kidneys, and in the course of its excretion, it stimulates them and disinfects their secretions. Guggul is said to have used in rheumatism, nervous dis­eases, scrofulous affections, urinary diseases and skin diseases.

It is highly reputed in the treatment of rheumatism.

Latin - BalasmodendronMukuL English - Salai Tree. Gum - Guggul; Indian Bedeilium. Hindi & Marathi-Guggul. Tamil-Gukkulu; MaisatchiKungiliyam. Telugu-MaisakshiGuq- guiu.           

GOLD IN BHASMA FORM:

Gold in the form of Bhasma acts as a "Gen­eral Metabolic stimulant" and activates Reticulo-Endothelial System. It also acts as an antiseptic. It also brings about a sense of well­being. It is a Metabolic - Catalyst and it is Non­Toxic,

In the particular preparation of R. Com­pound, M/s. Alarsin Pharmaceuticals made a successful attempt to present Gold-in-Bhasma form, which is proved to be non-toxic even on prolonged therapy, unlike Gold-Salts.

2. MAHARASNADI GUATH: It is prepared by processing 25 different herbal drugs. Its chief ingredient is "RASNA"

PROPERTIES: It is anti-rheumatic, analgesic, antipyretic, diuretic. The drug is ex­creted through kidney and skin. It is well toler­ated and Non-Toxic. In the opinion of R. N. Singh in scientifically evaluated experimental studies with formaldehyde induced arthritis, croton oil granuloma pouch and freunds adjuvant induced arthritis in albino rats, he found that Rasna, Prasarini, Nirgundi and Bhela effective as anti-inflammatory agents.

Hindi & Marathi-Kulinjan, Tamil – Chittrattai, Telgu- SannaRashtram, Kannada Rasna.

MATERIAL AND METHOD:

A group of 30 patients who attended the Orthopaedic Outpatient Department. Govt. General Hospital, Guntur, was selected with vari­ous chronic arthritides and were tried with R.Compound (Alarsin) drug along with Vitamin C and B Complex. All the patients were ambulat­ory and treated as out patients. Follow up studies were done between 1 -2 weeks, upto 6 weeks. One case was admitted in Orthopaedic ward because of his severe condition for hospi­tal care. But unfortunately, the patient expired duo to heart failure. Most of the cases were previously treated with other types of analgesics and anti-rheumatics including Cor­ticosteroids. Occupation of the patients varied from sedentary work to hard manual labour In fields.

DOSAGE SCHEME:

In all cases the drug was started with one tablet thrice daily after meals with plenty of but­termilk or milk to avoid any gastric irritation and slowly increased to 2 tablet thrice daily until acute symptoms were subsided. After the clin­ical improvement was observed, again the dose was reduced to T tablet thrice daily as maintenance therapy to avoid recurrence. Along with this Vitamin C-500 mg. and B. Com­plex tablets were given. Cases were followed upto 4 to 6 weeks.

>CUBICAL EVALUATION:

The improvements in the various clinical features noticed were;

I.    General:                 1. Feeling of "Sense of wellbeing".

                                    2. Improved Appetite.

                                    3. Subsidence of Pyrexia if any.

                                    4. Gain in body weight.


II. Local:                     1. Relief of Pain.

                                    2. Disappearance of Swelling in the joints.

                                    3. Relief of Stiffness and gain in the range of movements.


III. Investigations:        1. Return of ESR to normal

COMPLAINTS:

1.             Painful stiffness of smaller joints of hands, wrists, ankles, elbows and hips.

2.             Back-ache; Lumbar-Spondylosis with route pains.

3.             Osteoarthritis knee.

4.             Chr. Synovitis knee.

5.             Rheumatoid Arthritis of knee and hip etc.

6.             Periarthritis shoulder.

7.             Senile Osteoporosis with sciatica.

 

CASE ANALYSIS

 

Sr No

Disease Entity

No of cases

1

Rheumatoid Arthritis

19

2

Osteo Arthritis Knee

3

3

Chronic Synovitis

2

4

Periarthritis Shoulder

1

5

Lumbar Spondylosis with Sciatica

5

 

Total

30

AGE INCIDENCES:

Sr No

Age Group

No of Cases

1

0 – 9 years

1

2

10 – 19 years

3

3

20 – 29 years

4

4

30 – 39 years

10

5

40 – 49 years

2

6

50 – 59 years

8

7

60 -69 years

2

 

Total

30

 

 SEX INCIDENCE :

1. Males                                   17

2. FEMALES                          13

            TOTAL                       30

 

MAXIMUM DURATIION OF DISEASE IS 10 Years

MAXIMUM DURATION OF DISEASE IS one month.

 

IMPROVEMENT OBSERVED:

Subjective within 1 to 2 weeks.

Objective 2 to 3 weeks.

RESULTS OBSERVED:

1 No relation to chronicity of the disease,

2.             No relation to the site of disease.

3.             Relief of Pain within 2 weeks.

4.             Subsidence of Stiffness within 2-3 weeks.

5.             Gain in range of movements in joints.

6.             No change in fixed deformitis.

7.         A feeling of sense of well-being in all the cases.        '

8.             No toxic or any untoward symptoms noted.

9.             All the patients were ambulated within 2-3 weeks follow-up.

DISCUSSION:

In this present clinical study all the patients were ambulant and showed good results espe­cially when adjuvant drugs such as Vitamins C & B Complex were given and septic foci if any eliminated by antibiotics. Rapid improvement in relief of pain and subsidence of swelling occurred especially in acute cases.

On the whole treatment with this R. Com­pound showed a sense of well-being and im­provement in general health. Continued treat­ment showed no evidence of toxicity.The cases of rheumatoid arthritis were treated previously with corticosteroids without any effect. Most of them were of long duration ranging from 6 months to 10 years. No im­provement in reducing the fixed deformities was seen. All the cases of Osteo-Arthritis showed gain in the range of movements and relief of pain.

Lumbar Spondylosis with Sciatica, five cases, were treated with "R. Compound" Within 1-week patient noticed less in severity of pain and by 2nd week pain subsided com­pletely with full range of movement. In cases of chronic synovitis pain relief was obtained within 2 weeks and swelling subsided after 4 weeks along with necessary antibiotics treat­ment and aspiration. No further effusion was noted.


One case of Periarthritis shoulder treated with "R. Compound" gave good results within a week with relief of pain and patient had ulti­mately painless range of movement of shoul­der. In all the cases the result varied between the relief of pain to complete remission.


SUMMARY & CONCLUSION

It is always important to remember while treating cases of Chr. Rheumatoid arthritis and other conditions of unknown etiology, with drug of unknown mode of action but a good result ultimately.

However, we want a drug which should act effectively in relieving pain, stiffness and swel­ling and at the same time without having unto­ward and undesirable side effects. The Ayurvedic drug R. Compound is proved clinically by our trial study that it can fulfill the ideal feature needed. This is a well-known Ayurvedic medicine described in our time hon­oured Ancient system of Medicine which has immortal stream of Scientific thought. We have in our ancient systems many drugs whose efficacy is proved beyond doubt in the treatment of Acute and Chronic ailments and it is to be hoped, further trials on scientific lines will yield very goodresults in future. ALL THAT IS "MODERN" IS NOT NEW AND ALL THAT IS OLD IS NOT" ANCIENT" The most important criterion with this drug is it can be used in ambulatory patients without constant medical supervision which is neces­sary in the case of other patent drugs.

ACKNOWLEDGEMENT:

We thank "M/s. Manthan" the research division of "Alarsin Pharmaceuticals" Bombay, for their help and co-operation in conducting these trials. Particular mention is to be made regarding the assistance and help given by Mr. K.M.S. CHETTY, of Alarsin Pharmaceuticals Bombay.