Which means, Signs, Analysis and Differential Analysis, Remedy Ideas and Trendy Views

Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S

Klama is a time period which we encounter many instances in Ayurveda literature. Its that means has been interpreted in numerous methods as per situational utilization of the time period. It’s used to explain states of fatigue, exhaustion or practical debility.

Klama is a state of exhaustion of many varieties – bodily, psychological, sensory or all collectively. Such exhaustion could have its origin from many causes, the principle ones being 0

–        Shrama – exertion,

–        Vyadhi – illness processes,

–        Dhatu kshaya – tissue depletion or

–        Dosha Vaishamya – doshic imbalance

Completely different vary of circumstances to think about underneath the umbrella time period ‘Klama’

Although generally understood as a state of exhaustion or fatigue, the time period KLAMA encompasses broader dimensions and states comparable to

–        lassitude,

–        diminished enthusiasm,

–        lowered physiological effectivity and

–        impaired psychophysical functioning or

–        a mix of 1 or two circumstances talked about above (overlap)

Understanding Klama would give us worthwhile insights into understanding power fatigue, exhaustion associated to ongoing illness pathologies, burnout syndromes and circumstances related to tissue depletion. 

Nirukti – Etymology of Klama

The phrase Klama originates from its root phrase Klam which implies to grow to be weary, exhausted, languid or debilitated.

क्लमः श्रमो ग्लानिर्वा – Klama means Shrama or Glani. Right here, we see that the phrases Klama, Shrama and Glani are interchangeable. This provides completely different meanings for Klama –

–        Fatigue

–        Lassitude

–        Weariness

–        Exhaustion

–        Langour

Definition of Klama

1. Klama is outlined as ‘Anayasa Janya Shrama’.

–        Anayasa = with out bodily exertion

–        Janya = arising from / born out of (has its origin from)

–        Shrama = exhaustion or fatigue

Placing them collectively, Klama may be outlined as – ‘A state of Exhaustion or Fatigue arising with out important exertion’.

Normally bodily exertion causes exhaustion or fatigue. Klama contains all such circumstances of exhaustion or fatigue that are triggered despite the particular person not being bodily exerted.

So Klama is a state which encompasses tiredness, psychological fog, heaviness, weariness or weak point occurring on account of causes aside from bodily exertion.

It could be linked to numerous components that are contributory, comparable to – depletion of ojas, impairment of agni, formation and accumulation of ama within the physique and involvement of Hridaya – coronary heart in a illness course of. It’s distinguished from the conventional post-exertional tiredness.

2. In response to Acharya Sushruta, Klama may be outlined as ‘A lower in bodily capability accompanied by subjective feeling of exhaustion’. Such Klama may be present in Vata problems, states of Kshaya (Dhatu Kshaya) and Abhighata (traumatic circumstances).

3. “कर्मासामर्थ्यम्” – Acharya Chakrapani defines Klama as ‘Incapacity to carry out regular actions’. This definition explains Klama past a state of being drained and places it by way of ‘practical impairment’.

Numerous states of exhaustion or weak point in response to Ayurveda / Differential Analysis of Klama

Beneath talked about phrases outline a state of tiredness or weak point and must be contextually understood. Although every of those might not be an actual state of weak point or tiredness, weak point or tiredness are half and parcel of those circumstances.

Amongst all these, Klama is a multidimensional state whereby the physique, thoughts and senses are concerned within the state of being weak or exhausted.

Nidanas for Klama

Klama could happen on account of a variety of causes. They’re as enlisted under –

Sharirika Nidana – Bodily causes –

–        Ati Vyayama – extreme train

–        Ati Gamana – extreme strolling

–        Ati Maithuna – extreme indulgence in sexual actions

–        Ratri Jagarana – extreme and ordinary awakening at evening instances

–        Upavasa – extreme hunger / fasting

Manasika Nidana – Psychological Causes

–        Chinta – extreme pondering / worries

–        Shoka – extreme grief

–        Bhaya – extreme worry

–        Krodha – extreme anger

Vyadhi Sambandhi Nidana – Illness Associated Causes – Klama is a symptom of sure ailments like –

–        Jwara – fever

–        Rajayakshma – power depletion of tissues, tuberculosis

–        Pandu – anaemia

–        Kshaya problems – depletion of tissues

–        Rasa Kshaya – poor formation and provide of dietary fluids within the abdomen

–        Jwara – numerous sorts of fevers

–        Kshata Kshina – emaciation and tissue loss on account of harm

–        Vata Vyadhi – particular vata problems 

Ahara / Poshana Janya – Dietary Causes

–        Alpa Ahara – consumption of much less meals / insufficient diet

–        Dhatu Kshaya – deterioration / destruction of tissues on account of dietary imbalances

–        Kuposhana / Mithya Ahara – malnutrition

Samprapti of Klama – (Hypothetical) Pathogenesis

The pathway of improvement and manifestation of Klama may be of some ways relying on the completely different causes from which it arises. However we will strive to attract a easy hypothetical pathogenesis which could be the frequent pathway resulting in Klama.

As a consequence of completely different causes, there’s extreme expenditure of vitality from the physique.

↓

In an effort to compensate for this vitality, the agni over-works and therefore would get impaired within the course of. There’s hyperfunctioning of dhatu agnis additionally. There’s an imbalance between provide and demand.

↓

This results in tissue burnouts – dhatu kshaya.

↓

This ultimately results in diminution of ojas, which is a byproduct of dhatus – accountable for vitality and energy.

↓

This might lead to Klama.

Different Pathway of Samprapti

Nidanas result in Vata Aggravation Dhatu Kshaya → Imbalance between provide and demand of diet → Additional discount of tissue nourishment → Manifestation of Klama

Completely different Dimensions of Manifestation of Klama

Klama is one thing which is past a sense of tiredness.

Dimension or Layer of Klama Manifestation	Manifestation / Signs
Bodily	Fatigue, Weak spot
Psychological	Lack of motivation
Sensory system	Decreased responsiveness Altered sensory notion Weak spot of sensory organs
Useful	Decreased work capability, lack of curiosity in doing any work or dedication in the direction of it
Emotional	Feeling drained, Mind fog
Physiological	Decreased Effectivity

By this we perceive that Klama is a mix of subjective exhaustion and goal discount in practical functionality.

Understanding Dosha involvement in Klama

1. Vataja Klama – When Klama is brought on by Vata, there’s generalized weak point, physique pains and tremors. The particular person would get exhausted shortly.

Vataja Klama could also be correlated with power fatigue or cachexia.

2. Pittaja Klama – When Klama is brought on by Pitta, the particular person would expertise fatigue with burning sensation within the physique together with extra thirst and psychological irritability and anger.

Pittaja Klama could also be correlated with fatigue triggered on account of irritation within the physique. Febrile exhaustion may also be included on this class.

3. Kaphaja Klama – When Klama is brought on by Kapha, the particular person would expertise fatigue related to heaviness of the physique, extreme drowsiness and lowered actions and laziness.

Kaphaja Klama could also be correlated with metabolic or obesity-related fatigue.

Understanding Klama from the attitude of Dhatu concerned (brought on by depletion of tissues)

Rasa Kshayaja Klama – When Klama happens on account of Rasa Kshaya, it’s related to thirst and dryness of the physique.

Rakta Kshayaja Klama – When Klama happens on account of Rakta Kshaya, it’s related to pallor.

Mamsa Kshayaja Klama – When Klama happens on account of Mamsa Kshaya, it’s related to muscle weak point and losing.

Ojo Kshayaja Klama – When Klama happens on account of Ojo Kshaya, it’s related to extreme fatigue / weak point, lowered vitality and lack of enthusiasm. Klama is an early expression of Ojas depletion, particularly if klama has persevered for an extended period. This may also predispose the particular person in the direction of many ailments since immunity might be compromised with Oja Kshaya.

Dhatu Kshaya will result in Ojas Kshaya which is able to result in Klama and Daurbalya and within the later interval when this progresses, the particular person would grow to be sufferer of many ailments.

Trendy Biomedical Correlation of Klama

From the data accessible in Ayurveda treatises and the contexts by which Klama has been talked about as a symptom, complication, premonitory symptom or signal of unhealthy prognosis, Klama and its variants embrace most of the trendy circumstances talked about under, underneath their umbrella.

They’re –

–        Fatigue

–        Persistent Fatigue Syndrome

–        Asthenia

–        Lack of energy

–        Bodily exhaustion / fatigue

–        Psychological exhaustion / fatigue

–        Persistent tiredness

–        Lassitude

–        Exhaustion syndrome

–        Decreased capability to carry out work

Fatigue associated to power circumstances like most cancers may also be included underneath Vyadhija Klama.

Different circumstances –

–        Neurophysiological circumstances like vitality deficit, lowered ATP technology, imbalance of neurotransmitters, irritation of nerves, HPA Axis dysregulation and many others. could also be thought-about.

–        Stress induced exhaustion

–        Psychological circumstances – like emotional exhaustion and burnouts, lowered motivation and many others.

Scientific Evaluation of Klama

Beneath talked about domains ought to be thought-about whereas clinically assessing Klama –

1. Bodily situation
2.   Power and endurance
3. Psychological state and stress
4.   Consideration and Motivation
5. Useful – day by day actions
6. Severity and chronicity of ailments if any and related pathology
7. Immunity

Remedy ideas of Klama

Nidana Parivarjana – Remedy of Klama, like several illness, is determined by the causative components. Maintaining away or addressing the causative components is not going to solely assist in treating Klama however may also forestall its recurrence.

Consideration to Agni and Ama, Deepana and Pachana Chikitsa – Agni and its sub-units (dhatvagni) ought to be correctly addressed. The presence of Ama and Sama Doshas / Sama Dhatus and Malas (affiliation of doshas, dhatus and malas with ama) too ought to be accessed and handled accordingly. Medicines which might improve the functioning of Agni (Deepana) and which digest Ama (Pachana) ought to be included.

Substitute and restoration of Dhatus – If dhatu Kshaya is current, Brimhana, Santarpana and Rasayana Chikitsa ought to be thought-about.

Shodhana Chikitsa – If there’s extra morbidity and extreme accumulation of morbid doshas within the physique, Shodhana ought to be thought-about as per dosha or doshas concerned within the pathogenesis of the illness in query which is inflicting Klama.

Brimhana and Rasayana – Persistent and cussed Klama related to any situation or Klama persisting for lengthy period following a illness course of or remedy schedule shall be addressed with Brimhana and Rasayana therapies. This can assist in tissue rejuvenation and would enhance immunity. They won’t solely improve and restore the tissues however may also enhance the standing of Ojus within the physique. Kshira – milk and Ghrita – ghee ought to be used as day by day Rasayanas (Nitya Rasayanas).

Sattvavajaya Chikitsa – For psychological causes of Klama, psychotherapies ought to be included within the remedy.

Others – Dhyana – meditation and Nidra – satisfactory sleep and Yoga ought to be adopted within the remedy schedule.

Scientific point out of Klama in numerous ailments (Madhava Nidana)

Klama as Lakshana (symptom of ailments) is talked about in

–        Amlapitta

–        Udavarta – Adhovata Nirodhaja

–        Tandra

–        Pandu Roga – Sannipataja

–        Pittavruta Udana Vata

–        Pittavruta Vyana Vata

–        Masurika – Vataja

–        Visha – Jangama Visha

Klama as Upadrava (complication of ailments) is talked about in –

–        Vatarakta

–        Hrdroga

Klama as Asadhya Lakshan (symptom indicating unhealthy prognosis of ailments) is talked about in –

–        Kumbha Kamala

Associated AIAPGET Questions

1. Anayasa Janya Shrama is –
2. Tandra
3.   Glani
4. Klama
5.   Alasya

Ans – c. Klama

2. In response to Chakrapani ‘Karma Asamartyam’ is –
3. Glani
4.   Shrama
5. Alasya
6.   Klama

Ans – Klama

3. Klama is a symptom of which kind of Udavarta?
4. Purisha Nirodhaja
5.   Kshut Nirodhaja
6. Adhovata Nirodhaja
7.   Trt Nirodhaja

Ans – c. Adhovata Nirodhaja

4. Klama is a symptom of –
5. Pittavruta Udana
6.   Pittavruta Vyana
7. Each a and b
8.   Pittavruta Samana

Ans – c. Each a and b

5. Klama is a symptom talked about in –
6. Gara Visha
7.   Sthavara Visha
8. Jangama Visha
9.   Luta Visha

Ans – c. Jangama Visha

6. Klama is just not a symptom of
7. Amajirna
8.   Amlapitta
9. Masurika
10.   Tandra

Ans – a. Amajirna

7. Klama is talked about among the many Asadhya Lakshanas of –
8. Mrttikajanya Pandu
9.   Kumbha Kamala
10. Adhoga Raktapitta
11.   Krimi Roga

Ans – Kumbha Kamala

8. Klama is talked about among the many Upadravas of –
9. Amavata
10.   Kroshtushirshaka
11. Vatarakta
12.   Amlapitta

Ans – c. Vatarakta