A text book of

KAYA CHIKITSA
2

Dr. Tajagna Dalsaniya

Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)

INDEX
Sr. No Topic Page no.
Part A 4
1. Chikitsa sutra and Management of the diseases of Pranavaha Srotas 5
such as - Kasa, Shwasa, Hikka, Rajayakshma, Urakshata,
Parshwashoola, Bronchitis, Bronchiectasis, Emphysema and COPDs.
2. Chikitsa sutra and Management of the diseases of Udakavaha Srotas 28
such as- Shotha, Jalodara, Trishna, Water & Electrolyte Imbalance.
3. Chikitsa sutra and Management of the diseases of Annavaha Srotas 34
such as – Agnimandya, Aruchi, Ajirna, Anaha, Atopa, Adhmana,
Alasaka, Vilambika, Visuchika, Chardi, Grahani, Amlapitta, Gulma,
Shoola, Bhasmaka, Acid peptic disorders.
4. Principles of treatment and management of Vata Vyadhi such as - 51
Pakshavadha, Ekangavata, Sarvangavata, Ardita, Avbahuka, Kati
Graha, Manyastambha, Gridhrasi, Vishwachi, Khalli, Khanja, Pangu,
Padaharsha, Padadaha, Vatakantaka, Kroshtukashirsha, Udavarta,
Kampavata, Dhatugata and Ashayagata Avarana Vata, other Vata
Rogas, Parkinsonism.
5. Nidana and Chikitsa of Urusthambha, Gullian Barrie syndrome, 65
Muscular Dystrophy, Myasthenia Gravis, Motor Neuron Diseases and
Neuralgia.

1
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)

INDEX
Sr. No Topic Page no.
Part B 77
1. Chikitsa Sutra and Management of Mamsavaha Srotas and Medovaha 78
Srotas such as- Gandamala, Galaganda, Mamsashosha, Arbuda,
Apachi, Prameha, Sthaulya, Karshya, Diabetes Mellitus,
Dyslipidaemia.
2. Chikitsa Sutra and Management of ‘Asthi and Majjavaha Srotas such 99
as Asthimajja Vidradhi, Asthisoushirya, Asthi kshaya, Sandhigata
Vata, Osteo Arthritis, Osteomyelitis, Osteoporosis, Osteopenia.
3. Chikitsa sutra and management of Shukravaha srotas such as 104
Klaibya, shukralpata, shukradosha, kshina shukra, dhwajabhanga.
4. Chikitsa Sutra and Management of diseases of Mutravaha Srotas such 108
as -Mutrakricha, Mutraghata, Ashmari, Cystitis, Nephritis, Nephrotic
Syndrome, BPH, Renal Failure.
5. Chikitsa Sutra and Management of diseases of Purishavaha Srotas 120
such as – Atisara, Pravahika, Arsha, Purishaj Krimi, IBS and
Ulcerative Colitis.
6. Chikitsa Sutra and Management of Sexually Transmited Diseases 131
such as – Phiranga, Puyameha, Upadamsha, lymphogranuloma
inguinale, Syphilis, Gonorrhoea.
7. Introduction, Definition and Management of Kama, Krodha, Lobha, 136
Moha, Mada, Matsarya, Shoka, Bhaya, Vishada, Dainya, Harsha and
Pragyaparadha.
8. Manas and Manovahasrotas, Nidana and Chikitsa of the following 139
disorders - Unmada-Apasmara-Atattvabhinivesha, Chittodvega,
Vishada, Anxiety disorders, Depression, Somatoform and Mood
disorders, Stress induced disorders, Psychosexual Disorders.
Importance of Daivavyapashraya, Sattwavajaya, Adravyabhuta
Chikitsa. Medhya Rasayana in the management of Manasa Roga.
Bhuta Vidya diagnosis and management of graha disorders.
9. Derivation, definition and synonyms of Rasayana, importance of 153
Rasayana and its benefits. Indications of Rasayana therapy.
Classification of Rasayana. Kutipraveshika and Vatatapika Rasayana.
Indications of Vatatapika Rasayana. Knowledge of Kayakalpa,
Achara Rasayana. Procedures of Kutipraveshika, Poorvakarma and
specific schedules to be followed after Kutipravesha, benefits of
Kutipraveshika Rasayana, duration of process, Rasayana yoga and
directions for their use. Determination of dose of Rasayana according
to age. Rules and regulation after Rasayana therapy, Importance of
Immunomodulators and antioxidants in Rasayana therapy.

2
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
10 Vajikarana- Derivation, definition, synonyms, necessity, benefits, 168
importance of fertility, Symptoms of Shûkra (Semen), Vajikaran
Dravya and Aushadhi. Properties, doses, methods of administration,
ingredients and methods of formation of Rasayana & Vajikarana
formulation. Classification and importance of Vajikarana Dravya

3
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)

KAYA CHIKITSA

PAPER 2

PART A

4
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)

1. Chikitsa sutra and Management of the diseases of Pranavaha Srotas

such as - Kasa, Shwasa, Hikka, Rajayakshma, Urakshata,
Parshwashoola, Bronchitis, Bronchiectasis, Emphysema and COPDs.

KASA
कसनात ् कासः |
‘Kasa’ implies ‘to move’ or ‘to afflict.’
Since kasa involves the movement of vayu and because it also afflicts chest etc. it is called
kasaroga.

Kasa is an attempt by the human system to throw out or expel out excess secretions and other
harmful material from inside the throat and lungs.

Nidana:
Exposure to smoke
Exposure to dust
Excessive exercise
Excessive consumption of dry foods.
Entry of food particles into the respiratory passage.
Forcible stopping the natural urges of the body, especially that of cough and sneeze.

Samprapti:
Dosha: vata dominant kapha
Dushya: rasa
Srotas: pranavaha, rasavaha
Adhisthana: urakantha
Srotovikara: sanga

Due to obstruction in lower region, vayu moves upwards → afflicts the channels of
circulation in the upper part of the body → takes over the functions of udana vayu → and
settles in throat and the chest → produce kasa (cough) which may be dry or with phlegm →
type of kasa depends on the nature of obstruction by kapha etc.

Purvarupa:
Sensation as if the throat and mouth are filled with bristles i.e., a feeling of congestion in
throat शक
ू पर्
ू गण लास्यता
Itching sensation in the throat.
Obstruction to the movement of food in gullet.
The patient is unable to take food properly because of associated anorexia or his inability to
swallow food due to congestion in throat.

5
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Types:
Kasa is of five types viz.
1. Vataja kasa 4. Kshataja kasa
2. Pittaja kasa 5. Kshayaja kasa
3. Kaphaja kasa

Lakshanas:
1. Vataja kasa:
Excruciating pain in the cardiac region, in the sides of the chest, head ache.
Hoarseness of voice
Dryness in chest, throat, mouth
Dry cough
Aggravated after digestion of food.

2. Pittaja kasa:
Yellowish sputum and eyes
Bitterness in the mouth.
Impaired voice
Morbid thirst, burning sensation, anorexia, giddiness, fainting etc.
Phlegm mixed with pitta comes out.

3. Kaphaja kasa:
Suppression of digestive fire.
Anorexia, vomiting, nausea, heaviness of body.
Lomaharsha, swasa, sticky mouth
Thick phlegm in large amount
Feeling of fullness in chest.

4. Kshataja kasa:
Firstly, one coughs without any phlegm output, but later on blood mixed phlegm.
Severe pain in throat, feels as if his chest is cracking.
Pricking pain.
पारावत इवाकूजन ् i.e. while coughing one produces sound like that of a pigeon.

5. Kshayaja kasa:
Sputum foul smelling / greenish or red and which is like pus.
While coughing patient feels as if his heart is displaced.
Hot and cold sensation

Sadhyasadhyata:
Vataja, pittaja, kaphaja kasa → sadhya
Sarva lakshanas yukta Kshataja & kshayaja kasa → asadhya
Vriddha rogi → Krichra sadhya

6
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Chikitsa:
1. Snehana → by ghritapana, basti, peya-yusha-mamsarasa, vatanashaka drava siddha
ghrita-taila.
Swedana → snigdha sweda
In case of mala & Apanavata avarodha → snigdha basti
In case of pittanubandha → ghrita sevana after food
In case of kaphanubandha → snigdha virechana

Formulations →
• Kasantaka rasa • Talisadi churna
• Lakshmivilas rasa • Kantakari ghrita
• Sitopaladi churna • Agatsya haritaki

2. Pittaja kasa:
Virechana
Vamana if associated with kapha
Ghrita prayoga → ghritapaka of mahisha godugdha with Aamalaki swarasa & ghrita.
Madhura rasa anupana prayoga → sarkara + jala / draksha swarasa / ikshurasa /
godugdha etc.

Formulations →
• Chandramruta rasa • Pippalyadi avaleha
• Vasarishta • Kasahara gutika

3. Kaphaja kasa:
Vamana
Yava – katu, ruksha, ushna, kaphaghna ahara vihara

Formulations →
• Ananda bhairava rasa • Kantakari ghrita
• Kasakuthar rasa • Kaphaja Kasahara pippali

4. Kshataja kasa:
Aatyayika chikitsa
Madhura jeevaniya balamamsa vardhaka aushadha prayoga
Pittaja kasavata chikitsa → ghrita & dugdha prayoga
Trinapanchamula siddha ajadugdha prayoga

5. Kshataja kasa:
In nava Kshataja kasa → mrudu shodhana & brimhana
व्यत्यासात चिककत्सा → alternatively dipana – brimhana -shrotoshodhana chikitsa
All the measure which promotes strength
Drakshadi leha & padmakadi leha prayoga

7
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Pathya & apathya:
Pathya → ajakshira is best in all types of kasa, wheat, yava, draksha, kharjura, patola, mamsa
rasa etc.
Apathya → vyavaya, contaminated cold foods, cold climate, dust, smoke, vegavarodha, all
the causative factors
In ardra kasa: foods predominantly prepared with bitter things should be given.
In shushka kasa: lubricating foods and drinks should be given.

SHWASA
श्वासत्वं वेगवदर्ध
ू वणवातत्वं |
In this disease vata moves in upward direction and causes difficulty in breathing.

Nidana:
Vata prakopaka →
Ahara e.g., ruksha anna sevana, vishamasana, shitala jalapana, Atibhojana, adhyasana etc.
Vihara e.g., exposure to smoke, dust, cold air, living in cold environment, excessive exercise,
atimaithuna, bathing with cold water, vamana atiyoga, vegadharana etc.

Kapha prakopaka →
Ahara: masha, tila, vistambhi vidahi anna, guru-atisnigdha bhojana, jaliya & anupa mamsa,
dadhi, abhishyandi bhojana etc.
Vihara: living in cold environment, bathing with cold water, exposure to cold air etc.

Internal causes →
Malavarodha, amavisha, kapha dushita prana vayu, pranavaha sroto vikara, accumulation of
vayu in amashaya and udara, pathology of lungs etc.

External causes →
Injury to chest, throat, exposure to cold, dust or smoke, atimaithuna etc.

Local causes →
Inflammation in upper portion of airway, pathology in accessory muscles of respiration,
tonsilitis etc.

Swasa janak roga →

Pandu, atisara, jvara, chhardi, kshatah kshina, raktapitta, visha, hridroga, shosha, gulma,
agnimandhya etc.

Samprapti:
Dosha → kapha pradhana vata Adhisthana → amashaya
Dushya → rasa Srotodushti → sanga & vimarga gamana
Srotas → prana vata

8
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Kapha vata vardhaka ahara vihara sevana → vitiation of kapha along with vata → obstruction
of pranavaha srotas → generates movement of vayu in all direction in pranavaha srotas and
body → shwasa roga

Poorvarupa:
आनाहः पाश्वणशूलमं ि पीडनं हृदयस्य ि | प्रार्स्य ि ववलोमत्वं श्वासानाम ् पूवल
ण क्षर्म ् ||
• Anaha • Adhmana
• Parshwashula • Mukha vairashya
• Pain in hridaya pradesha • Pricking pain in sankha pradesha

Bheda:
1. Mahashwasa 4. Kshudra shwasa
2. Urdhwa shwasa 5. Tamaka shwasa
3. Chinna shwasa

1. Maha shwasa:
मतर्णभ इवाननशम ् → Breathing with difficulty in a loud sound like a bull.
Loss of consciousness
Random movement of eyes, dilated pupils
Breathes with open mouth
Interrupted speech
Found in terminally ill and the patient who is going to die in near future.

2. Urdhwa shwasa:
दीर्ण श्वसनत → prolonged expiration but inability to inspire
Pranavaha srotas and mouth are full of kapha
Eyes focused upwards and there are random eye movements.
Frequently loses consciousness due to pain
Restlessness

3. Chinna shwasa:
श्वसनत ववच्छिन्नं → interrupted or irregular breathing despite of full effort.
Pain in heart and other marmas cause frequent cessation of breathing.
Burning sensation in vasti pradesha.
Eyes filled with tears and becomes red.
Patients dies soon.

4. Kshudra shwasa:
Dyspnoea, which lives for a short period
Not produce any discomfort in the body parts.
Easily curable and many times doesn’t require any treatment.

9
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
5. Tamaka shwasa:
Kapha pradhana
र्ुर्रुण कं – तीव्रवेगं – प्रार्पीडकं – पीनस – कास – प्रमोह
Patient feels relief in sitting position & attacks get aggravated in cloudy and
conditions
Pratamaka shwasa → associated with jvara murcha
Santamaka shwasa → aggravates in dark (tama) & relieved by sheetopachara (cold
measures)

Sadhyasadhyata:
• Mahashwasa, urdhwa swasa, chinnashwasa → asadhya
• Nava tamaka shwasa → sadhya
• Jirna tamaka shwasa → kricchrasadhya
• Kshudra shwasa → sadhya

Chikitsa:
For abhyanga, lavana taila processed with salt and other medicinal herbs is used.
Following abhyanga, Swedana is administered by one of the below mentioned methods of
Swedana →
Nadi sweda (steam fomentation)
Prastara (slab fomentation)
Sankara sweda (bolus fomentation)

Avoid Swedana in person with increased pitta, or of pittaja prakruti, associated with profuse
haemorrhage, debility and in pregnant women.

Vamana by using pippali + saindhava with madhu. Before vamana, patient is given food
which aggravates kapha dosha.

Dhumapana prayoga → even after snehana, Swedana and vamana, if dosha remains attached
to srotas, then dhumapana should be adopted.

An enlarged varti should be prepared with the paste of haridra, yava, erandamula, laksha,
devadaru, jatamamsi, manahshila and haratala. This varti is smeared with ghrita and used for
dhumapana
Dhumapana to eliminate hidden dosha in srotas
Similarly, yavachurna mixed with ghrita can be used for smoking therapy.

In strong patients → samsodhana chikitsa

In weak patients → brimhana chikitsa (vatahara chikitsa)

10
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Ayurvedic formulations:
• Sauvarchaladi churna
• Bharangyadi kalka
• Satyadi churna
• Dashamuladi kwatha
• Gudavaleha
• Varshamana pippali
• Hingwadi yavagu

Pathyapathya:
• Pathya → vamana, virechana, Swedana, dhumapana, Diwaswapna, rakta shali, yava,
mamsa, aja dugdha, sura, lasuna, ela.
• Apathya → raktamokshana, purva vata, mesha dugdha, matsya, kanda, sarshapa,
ruksha, annapana

Tamaka shwasa:
The term ‘tamaka’ shwasa is composed of two words, ‘tamaka’ means ‘andhakara’ and
second word shwasa is derived from ‘swasa’ means living of life.

Samprapti:
Aggravated vata due to exposure to causative factors leads to its pratiloma gati or reverse
movement.
Vitiated vata runs through channels and reaches head-neck region.
It exaggerates the regional kapha by increasing epithelial secretion and produce pinasa.
These secretions or malarupi kapha obstructs the passage of air and produces ghurghr shabda
or wheezing sound.

Lakshanas:
• Pinasa
• Griva-sirasa sangraha
• Ghurghurkama shabda – wheezing
• Prameha – fainting and shock
• Kanthodhwansa – discomfort in throat
• Dryness of mouth
• Rapid breathing
• Body shakes during breathing
• The person feels better with warm or hot comforts.
• The breathlessness gets severe in cloudy environment (megha), ambu, sheeta, praka
vata and shleshmala avastha.

11
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Types:
1. Pratamak shwasa:
When tamaka shwasa is associated with symptoms like jvara and murcha, it is known as
pratamaka shwasa.
It is caused by udavarta, raja, ajirna, klinna kaya and suppression of natural urges.
According to madhukosha commentary, association of pitta dosha with vata and kapha causes
pratamaka shwasa.
2. Santamaka shwasa:
This subtype of tamaka shwasa increases during night time and is relieved by cold things.
It is known as santamaka shwasa because the patient feels as if he is drowning in the darkness
usually the attacks precipitate early in the morning.

Sadhyasadhyata:
Tamakaswasa in general is described as yapya (palliable) disease. However, in individual
with recent origin of disease person pravara bala or both said to be sadhya.
While mentioning prognosis of any disease following characters are mentioned in case of
yapya disease.
Disease has affected the deep seated dhatus
Disease involving many dhatus
If affects vital organs and joints
Affected patient continuously for longer period.
Disease is caused by two doshas.

In disease tamaka shwasa kapha and vata dosha are involved primarily. Both of them exhibit
opposite qualities. Hence management will be also difficult as factors, which excite vata,
alleviate the kapha dosha and vice versa.
Rasadi dhatu gets involved in tamaka shwasa, which is suggestive of the involvement of
more than one dhatu.

Chikitsa:
If the patients of hikka and shwasa get afflicted with kasa, or swarabheda, they should be
treated with emetic therapy (vamana).
Patients suffering from tamaka shwasa should be treated with purgation therapy. Purgatives
are given to normalize both vata & kapha and to set right the size of vitiation.
Channels of vayu should always be cleared to remove the obstruction.

Vegakalina chikitsa:
the disease tamaka shwasa needs immediate management in the vegakalina – avastha like
sadhya vamana, abhyanga, Swedana and dhumapana or shamana aushadhi.
It should aim at both preventive and curative aspect.
1. Abhyanga → tila taila and lavana on chest region
2. Swedana → nadi, prastara, Sankara
3. Sadhya vamana → salt water, sugarcane juice, decoction of yastimadhu
4. Dhumapana → ardraka arka

12
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
5. Muhurmuhur prayoga of pushkarmulasava
6. Nebulization by ‘amritdhara’ – a mixture of menthol, thymol and campher used as an
aerosol.

Shamana aushadhis:
• Shwasa kuthar rasa • Shatyadi churna
• Maha lakshmivilasa rasa • Manahshiladi ghrita
• Marichyadi vati • Dashmuladi ghrita
• Lavangadi vati • Vyaghri haritaki

Rasayana chikitsa:
Increase in the strength of pranavaha srotas following medication should be used.
• Chyavanaprasha
• Vardhamana pippali
• Chausatha prahari pippali

Pathyapathya:
Pathya:
• Laghu ahara, ushna ahara
• Yusha, jangala mamsarasa, shastika shali
• Ushna vatavarana
• Vishrama

Apathya:
• Shitala annapana • Vegadharana
• Shleshmavardhaka ahara vihara • Shita vatavarana
• Pragvata sevana • Cloudy environment
• Raja – dhuma – hima – atapa
sevana

HIKKA
हहन ् हहनच्स्त इनत हहक्का |
Outcome vata making typical hiccup sound.

Vayu frequently moving upward, by shaking the liver, spleen and intestines with sound and
outcoming of the mouth with a loud sound and causing trouble to life is called hikka.

Nidana:
Aharaja Nidana:
Guru, vidahi, vistambhi, ruksha, abhishyandi and shitala ahara evum jala sevana.
Vishamasana, ajirnasana

13
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Viharaja Nidana:
Shita sthana, rajo – dhuma – atapa – anila sevana, ati vyayama, vegadharana, langhana etc.

Hikka janaka roga:

Pandu, alasaka, urahkshata, kshaya, udavarta, raktapitta, visuchika, atisara, jvara, chhardi,
pratishyaya etc.

Samprapti:
Dosha: kapha, vata (prana, udana)
Dushya: rasa
Adhisthana: pittasthana, swarayantra
Srotas: pranavaha, udakavaha, annavaha

Nidana sevana → vata prakopa → prakupita vata provokes urah sthita kapha → pranavaha,
annavaha & udakavaha srotovarodha → hik-hik Dhwani → hikka

Bheda:
1. Maha hikka
2. Gambhira hikka
3. Vyapata hikka
4. Kshudra hikka
5. Annaja hikka

1. Maha hikka:
Vata along with kapha affects the throat of an individual whose mamsa dhatu, strength, prana
and agni are depleted. It further produces remarkably loud and resonant hiccups.
Maha hikka is mahamula (deep rooted), mahavega (massive attack), mahashabda (very loud
sound), maha bala (very strong).
This can lead to death immediately, hence named as mahahikka.

2. Gambhira hikka:
Excessive aggravation of kapha and vayu in an aged, emaciated and mentally depressed
individual leads to hikka.
In such a patient the hikka is arises from the umbilicus or pakvashaya with pain all over the
body.
Characterised by deep and resonant sound, and affliction of the chest, yawning, contracts and
expands body.

3. Vyapata hikka (Yamaka hikka):

Produced after the intake of chaturvidha annapana. It gets aggravated after digestion of food.
This hikka originates from the root of the neck.
There is yawning, watering of eyes, dryness of mouth, adhmana.

14
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
4. Kshudra hikka:
When the vayu, which is slightly aggravated in the kostha, is pushed up by physical exercise
causes this minor form of hiccup known as kshudra hikka.
The doshas originated from hridaya, kloma, kantha.

5. Annaja hikka:
Aggravate vayu in kostha gets afflicted by food and drinks and move in the upward direction
and get lodged in channels of chest and produce annaja hikka.
Dosha originates from amashaya
It subsides after drinking water or taking food.

Sadhyasadhyata:
Kshudra & annaja hikka → sadhya
Maha hikka, gambhira hikka, vyapata hikka → asadhya
Pralapadi upadrava yukta hikka → asadhya
When during the bout of hiccough, the body becomes stretched and the eyes roll upwards, the
person becomes thin, has an aversion for food and sneezes continuously → asadhya

Chikitsa:
For abhyanga, lavana taila processed with salt and other medicinal herbs is used.
Following abhyanga, Swedana is administered by one of the below mentioned method of
Swedana.
Nadi sweda (steam fomentation)
Prastara (slab fomentation)
Sankara sweda (bolus fomentation)

Hikka vega shamaka upaya:

The time when hikka vega is strong:
1. Sudden sprinkling of cold water on face.
2. To cause frequent distress
3. Creating surprise
4. Fear anger, exhilaration, and separation from dear can stop hiccough.

Nasya yoga:
1. Nasya of lasuna, palandu, or garjara swarasa.
2. Nasya of chandana which grinding in stridugdha
3. Nasya of mixture of sunthi churna & madhu
4. Shwasakuthara rasa nasya

Dhuma:
Haridra, blackgram churna equal parts should be burnt & the smoke should be inhaled.

15
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Formulations:
• Mayurpiccha bhasma • Shankha vati
• Hikkantaka rasa • Trikatu churna
• Shwasakuthar rasa • Manahshiladi dhuma

RAJYAKSHMA
In ancient medical literature, rajyakshma has been described as यक्ष्मार्ां रोगार्ां राजा
राज्यक्ष्मा | i.e it is the king among diseases.
Moon was first affected by this disease; hence it is known as ‘yakshma’.
It is chronic, serious and many times fatal one, which spreads from one person to another one
– aupasargika and sankramaka in nature.

Nidana:
The causative factors of rajyakshma are of 4 categories viz.
1. Sahasa: over exertion
2. Sandharana: suppression of natural urges
3. Kshaya: depletion of tissue elements
4. Vishamashanam: irregular dieting

1. Sahasa:
Means excessive work or fight or exercise beyond one’s own capacity.
These are as follows
• Having the fight with powerful person
• Excessive talking
• Lifting very heavy loads
2. Vega sandharana:
Means suppression of natural urges.
Few examples of social and other conditions where these urges are likely to be suppressed for
long durations leading to the dosha vitiation, which are as follows-
• At travelling
• Because of some phobia or fear
• During sexual intercourse
• Because of shyness
3. Kshaya:
Kshaya means depletion and discretion.
Charaka has mentioned the two possible ways to getting depletion of dhatu.
Anuloma kshaya → in dhatuposhana krama. Classified in two categories viz.
Psychological: due to stressful life
Malnutritional: eating very small quantity of food.
Pratiloma kshaya → opposite direction of dhatuposhana krama.
Due to atimaithuna.

16
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
4. Vishamashana:
Means taking the food without observing the regulations of eating.
Astavidha vishesha ayatanani not followed
1. Prakriti 5. Desha
2. Karana 6. Kala
3. Samyoga 7. Upayoga samstha
4. Rashi 8. Upayokta

Roopa:
The cardinal symptoms of rajayakshma have been grouped under three heading viz., trirupa,
shadrupa and ekadasha rupa of rajyakshama.
1. Trirupa rajyakshma:
a. Burning sensation in costal & scapular region.
b. Burning sensation in palms & soles.
c. Raised bodily temperature

2. Shadrupa rajyakshma:
a. Kasa (cough)
b. Jvara (pyrexia)
c. Parshwashula (chest pain)
d. Swara bheda (hoarseness of voice)
e. Varchogada (diarrhoea)
f. Aruchi (anorexia)

3. Ekadasharupa rajayakshma:
a. Kasa (cough) g. Rakta vamana
b. Amsa tapa h. Shleshma vamana
c. Svara bheda i. Svasa
d. Jvara j. Atisara
e. Parshwashula k. Aruchi
f. Shira shoola

Samprapti:
Vishamashana, vega dharana → aggravated vata leads to kapha pradhana tridosha prakopa →
srotovarodha → poshana abhava → anulomakrama dhatu kshaya → shosha.
↓ ↑
→→→→→→→→→→→→→

Kshaya, sahasa → sukra kshaya / ojokshaya leads to vata pradhana tridosha prakopa →
pratiloma krama dhatukshaya → shosha

17
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Sadhyasadhyata:
Sadhya → aksheena bala mamsa (balavan rogi), pravara satva, kriyasaha, jvaranubandha
rahita
Asadhya → ksheena bala mamsa, atisara pidita, urdhwa shwasa pidita, sukla akshata.

Upadrava:
• Kanthodwansha • Nisthiva
• Uroruja • Agnisada
• Jrimbha • Aasyaputi
• Angamarda

Chikitsa:
All types of rajayakshma are tridoshaja therefore a physician should treat it according to the
prabala & aprabala dosha.

Malaraksha in rajayakshma:
In severe dhatukshaya, the strength of body depends on vit or mala, therefore, mala of the
patient of rajyakshma should not be eliminated

Mamsa prayoga in rajyakshama:

As there is marked weight loss due to mamsa kshaya the physician should advice the patient
to take mamsa rasa, that enhances the agni and mamsa – bala.
Aja, lava, titira, kukkuta, and vartaka mamsa rasa should be used among them aja mamsa rasa
is best.
Jugutsa (gupta) chikitsa: the patient of rajyakshama which the patient would never eat meat,
meat should be fed with deceit for the benefit of the patient.

Nidana parivarjana:
In all types of rajyakshma, the first step in the treatment is to avoid causative factors. It can
be understood as avoiding mithya ahara – vihara and treating the underlying causes as well,
like treating dhatukshaya, or vega sandharana janya vikara etc.

Sanshodhana chikitsa:
1. Vamana & virechana:
Yakshma rogi → excess of dosha → snehana Swedana → snehayukta mridu vamana →
sansarjana karma → punah snehana Swedana → snehayukta mridu virechana → sansarjana
karma
2. Nasya:
Balamoola + vidarigandhadi gana + yashtimadhu siddha ghrita + saindhava lavana → nasya

18
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Sanshamana chikitsa:
1. Brimhana chikitsa:
Aja dugdha, mamsa of jangala animals, Chanaka, mudga, yusha made of moth should be
used.
2. Lakshanika chikitsa:
Symptomatic treatment of jvara, swasa, kasa, pratishyaya, amashula, atisara etc.
3. Ghrita prayoga:
• Kharjuradi ghrita • Pancha panchamoola ghrita
• Dashamoola ghrita • Jeevantyadi ghrita
4. Ksheera prayoga:
• Baladi ksheera • Shruta godugdha
• Aja dugdha
5. Churna prayoga: (3 – 6 gm with madhu)
• Shitopaladi churna • Kapuradhya churna
• Talisadi churna • Eladi churna
6. Vati prayoga: (250 – 500 mg with ushnodaka)
• Chitrakadi vati • Agnitundi vati
• Higvadi vati • Eladi vati
7. Avaleha prayoga: (10 – 20 gm with dugdha)
• Vasavaleha • Kantakari avaleha
• Chyavanprasa avaleha • Agastya avaleha
8. Asava / arista / kwatha:
• Drakshasava • Ashwagandharista
• Dashamularista • Kanakasava
9. Rasa aushadhi prayoga:
• Suvarna malati vasant rasa • Chandrakala rasa
• Shwasa kasa Chintamani rasa • Godanti bhasma
• Lakshmi vilasa rasa

Pathyapathya:
Pathya → shastika shali, ajadugdha, ushnodaka, mamsa rasa, ghrita, draksha, purna visrama,
aja mutra snana, bramhacharya palana, achara rasayana palana etc.
Apathya → ruksha, kaphavardhaka – sheetal ahara, katu, tikta, kashaya, rasayukta ahara,
ativyayama, vyavaya, divaswapna, shitala jala, atisahasa

URAHKSHATA
Also called kshataksheena
Urahkshata refers to injury or excessive exertion such as swimming, cunning, wrestling for
long hours, leading to respiratory symptoms and depletion of body tissues.

19
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Causes:
Injury due to continuous use of bow.
Lifting heavy weight
Fighting with stronger persons
Crossing a big river by swimming.

Samprapti:
Nidana sevana → vatadi doshasya prakopa → vaksha pradesha pravesha → teevra vedana →
parshwa shoola evam rakta mishrita kaphasya pravruti → phupphuse kshata → sukra
ojokshaya → urah kshata

Lakshanas:
• Pain in chest region • Haematuria
• Haematemesis • Stiffness in costal region and back
• Cough • Lumber stiffness

Chikitsa:
Intake of laksha churna with madhu, followed by drinking milk
After digestion of drugs, patient should be made to have food with milk and sugar.
If patient is having pain in flanks and lower abdomen, and diminished agni then he should
take laksha churna mixed with sura.
If patient is having loose stool, he should take laksha churna with musta – ativisha – patha –
kutaja twaka.
Lakshadi ksheera → patient having deeptagni should be given lakshadi ksheera – laksha
ghrita, honeybee wax, jeevaniya gana, sugar & vamshalochana are cooked in the milk.

Shamana aushadhis:
• Raktapittantaka rasa • Ushiradi churna
• Bola parpati • Kharjurasava
• Shankha bhasma • Amrutaprasha ghrita
• Lakshadi churna • Chyavanaprasha

Parshwa shoola:
Parshva → side, flank
Shula → pain, colic
Though parshva means both sides of chest wall and belly, the condition is often considered as
‘urah parshwa shula’ i.e., pain in the sides of the chest region.

Causes:
It is caused by kapha and vata doshas, all the factors that aggravates kapha and vata should be
taken as Nidana factors.

20
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Samprapti:
Nidana sevana → vata & kapha dosha prakopa → prakupita kapha obstructs vata in the
parshwa & vaksha pradesha → prakupita vata causes shoola in parshwa & vaksha pradesha
→ parshwa shula

Lakshanas:
• सूचिभभररव ननस्तोद (pricking pain in flanks)
• Krichhra shwasa (dyspnoea)
• Adhmana
• Aatopa
• Sankocha (kaphadhikya)
• Aayama (vatadhikya)

Chikitsa:
Nidana parivarjana

Sanshodhana chikitsa:
Acharya charaka charts out common treatment principles and formulations for 6 conditions
associated with rajyakshama i.e., rhinitis, headache, cough, hoarseness of voice, dyspnoea,
and pain in sides of chest cavity
Considering these principles, the below mentioned treatments can be considered to combat.
Parshwashoola:

Snehana: dashamuladhya ghrita, bala ghrita, jivantyadi ghrita

Swedana: Upanaha sweda, tapa sweda
Abhyanga with herbal oils: chandanadi taila
Lepa: applied over afflicted part, baladi pradhana, shatapushpadi lepa
Food prepared with barley
Anuvasana basti

Useful formulations:
• Lakshmivilasa rasa • Pushkaramuladi churna
• Trailokya Chintamani rasa • Pippalyadi avaleha
• Dashamoola kwatha

BRONCHITIS
Bronchitis is inflammation or swelling of the bronchial tubes, the air passage between the
nose and the lungs.
More specifically, bronchitis is when the lining of the bronchial tubes becomes inflamed or
infected.
Bronchitis is caused by viruses, bacteria and other particles that irritate the bronchial tubes.

21
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Etiology:
• Smokers
• People who are exposed to a lot of second-hand smoke
• People with weakened immune systems
• The elderly and infants
• People with gastroesophageal reflux disease (GERD)
• People who are exposed to air pollution.

Types:
1. Acute bronchitis:
Acute bronchitis, also known as a chest cold, is short term inflammation of the bronchi of the
lungs.
Coughing up mucus, wheezing, shortness of breath, fever and chest discomfort
Usually lasts a few days or weeks.
2. Chronic bronchitis:
Chronic bronchitis is defined as a productive cough that lasts for three months or more.
Coughing up scanty thin and mucoid frothy expectoration, haemoptysis, wheezing and
shortness of breath.

Sign & symptoms:

• Inflammation or swelling of the bronchi
• Coughing
• Production of clear, white, yellow, grey or green mucus.
• Shortness of breath
• Wheezing
• Fatigue
• Fever and chills
• Chest pain or discomfort

Investigation:
• Physical examination • Pulmonary function test
• Chest X ray • Bronchoscopy
• Sputum cultures

Treatments:
Antibiotics: effective for bacterial infections
Cough medicine: important way to bring up mucus and remove irritants from the lungs.
Bronchodilators: these open the bronchial tubes and clear out mucus.
Mucolytics: these thin or loosen mucus in airways, making it easier to cough up sputum.
Anti-inflammatory medicines and glucocorticoid steroids – for the persistent symptoms.
Pulmonary rehabilitation program
e.g., amoxicillin, cefixime, doxycycline, salbutamol, cetirizine, ambroxol etc.

22
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Ayurvedic management:
bronchitis correlated with kasa i.e., cough and swasa i.e., shortness of breath.

BRONCHIECTASIS
Bronchiectasis is a condition anatomically defined by chronic irreversible dilatation and
distortion of the bronchi caused by inflammatory destruction of the muscular and elastic
components of the bronchial walls.

Etiology:
Past infection → bacterial pneumonia, tuberculosis, pertussis, measles, influenza
Proximal airway obstruction → foreign body aspiration, Benign airway tumours, middle lobe
syndrome
Abnormal host defence
Genetic disorder

Pathology:
Dilation and distortion of the bronchi
Damage of airway epithelium
Dilatation and hyperplasia of blood capillary.

Clinical features:
• The production of large quantities of purulent and often foul-smelling sputum.
• Chronic cough
• Recurrent haemoptysis
• Recurrent bronchitis
• Recurrent pneumonia
• Fever, weight loss

Treatment:
1. Improving the drainage of airway
• Expectorant • Postural drainage
• Bronchodilators • Bronchoscopy
2. Antibiotics:
The choice of antibiotics should be accurately by the results of sputum culture and drug
sensitivity test.
Empirical therapy antipseudomonal antibiotics like amoxicillin, levofloxacin is often given
initially.
3. Surgical management:
Surgery may also be used to treat localized bronchiectasis, removing obstruction that could
cause progression of disease.
Removal of affected portions of lung by surgical removal or bronchial artery embolization.

23
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
4. Steroids:
Inhaled steroids therapy that is consistently adhered to can reduce sputum production and
decrease airway constriction over a period of time, and help prevent progression of
bronchiectasis.
5. Use of inhalers such as salbutamol, fluticasone, ipratropium may help reduce
infection by clearing airways and decreasing inflammations.

EMPHYSEMA
Emphysema is a long-term progressive disease of the lung that primarily cause shortness of
breath.
In people with emphysema, the tissue necessary to support the physical shape and function of
the lungs are destroyed.
It is included in a group of disease called chronic obstructive pulmonary disease (COPD).
Emphysema is called an obstructive lung disease because the destruction of lung tissues
around smaller sacs, called alveoli makes these air sacs unable to hold their functional shape
upon exhalation.

Causes:
• Occupational exposure to chemical irritant.
• Exposure to environmental pollutant.
• Inherited genetic defect
• Most likely cause is smoking

Classification: (4 types)
1. Pan acinar emphysema
2. Centri acinar emphysema
3. Distal acinar emphysema
4. Irregular emphysema

Sign & symptoms:

• Shortness of breath is main symptoms of emphysema
• Wheezing
• Cyanosis → blue or grey lips or finger nails
• Barrel shaped chest
• Constant soughing
• Difficulty concentrating

Treatment:
Smoking cessation and avoid all exposure to cigarette smoke and lung irritants.
Medications are usually prescribed to widen the airways (bronchodilators, steroid,
anticholinergics)
And reduce the swelling in the airways (anti-inflammatory drugs)
Antibiotics (to treat lung infection)

24
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Effective body positioning and supplemental oxygen as required.
Pulmonary rehabilitation can be very helpful to optimize the patient’s quality of life and teach
the patient how to actively manage his or her care.
Lung volume reduction surgery: surgical removal of large area of damages lung.
Lung transplantation: this is the most drastic of emphysema treatments.

Ayurvedic management:
Looking at the pathogenesis and symptoms of emphysema, it falls under the topics of shwasa
and kasa as explained in ayurveda.

In emphysema:
Coexistence of kasa and shwasa
Symptoms like tamaka shwasa
Predominance of vata
Involvement of vata and kapha in varying proportions

Emphysema should be treated on the lines of treating one or more of the below mentioned
conditions.
1. Vataja kasa chikitsa:
Snehana by ghritapana
Intake of yusha, peya, mamsarasa, vatanashaka dravya siddha ghrita
Swedana by snigdha ghrita
Formulations like
Lakshmivilasa rasa
Sitopaladi churna
Talisadi churna
Kantakati ghrita
2. Kaphaja kasa chikitsa: when there is heaviness in chest, plenty of mucus
Vamana
Formulations like
Anandabhairava rasa
Kasakuthara rasa
Kantakari ghrita
3. Kshudra shwasa chikitsa:
Abhyanga – taila processed with lavana & other medicinal drugs
Swedana – nadi sweda, prastara sweda, Sankara sweda
4. Sthaulya and karshya chikitsa:
Excessive weight will cause the symptoms of emphysema to flare up so langhana therapy
should be applied.
Less weight due to destruction of tissues will keep the person in bad state of health and
compromised immunity. In this condition brimhana therapy should be apply.
5. Tamaka shwasa chikitsa:
When there is severe breathlessness along with congestion and expectoration of phlegm;
tamaka shwasa line of treatment should be applied.

25
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Should be treated with purgation therapy. Purgatives are given to normalize both vata &
kapha.
Nebulization by ‘amritadhara’ – a mixture of menthol, thymol and campher used as aerosol.
Formulations like-
• Shwasakuthar rasa • Shatyadi churna • Manahshila ghrita

Rasayana chikitsa like –

• Chyavanprasha • Vardhaman pippali

6. Rajyakshama chikitsa:
In complicated cases of emphysema rajyakshma chikitsa should be applied.
Alternate vamana and virechana
Brimhana chikitsa: aja dugdha, mams rasa sevana
Formulations like –
• Chitrakadi vati • Sitopaladi churna
• Agnitundi vati • Kanakasava etc.
• Eladi churna

COPD / CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Chronic obstructive pulmonary disease is a disease state characterized by airflow limitation
that is not fully reversible.
COPD may include diseases that cause airflow obstruction (e.g., emphysema, chronic
bronchitis) or a combination of these disorders.

Classification:
COPD includes chronic bronchitis and emphysema. Asthma is not considered part of COPD
due to its reversibility
1. Chronic bronchitis (blue bloater) is a chronic inflammation of the lower respiratory
tract characterized by excessive mucous secretion; cough & dyspnoea associated with
recurrent infections of the lower respiratory tract.
2. Emphysema is a complex lung disease characterized by damage to the gas exchanging
surfaces of the lungs.

Causes:
• Tobacco smoking or environmental tobacco smoke
• Environmental pollution with sulphur dioxide etc.
• Frequent respiratory infections
• Genetic factors

26
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Clinical features:
Three primary symptoms:
1. Cough
2. Sputum production
3. Dyspnoea on exertion
Others are chest tightness
Wheezing
Frequent respiratory infections

Treatment:
Risk reducing → i.e., smoking cessation
Antibiotics → azithromycin, doxycycline etc.
Bronchodilators → relieve bronchospasm and reduce airway obstruction by allowing
increased oxygen distribution throughout the lungs
Corticosteroids like prednisolone, beclomethasone
These medications which are central in the management of COPD are delivered through a
metered dose inhaler (MDI) by nebulization.
Oxygen therapy
Pulmonary rehabilitation

Surgical management:
Bullectomy → bullae are enlarged airspaces that do not contribute to ventilation but occupy
space in thorax, these areas may be surgically excised.
Lung volume reduction surgery
Lung transplantation.

27
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)

2. Chikitsa sutra and Management of the diseases of Udakavaha Srotas

such as- Shotha, Jalodara, Trishna, Water & Electrolyte Imbalance.

SHOTHA
Shotha as per ayurveda is swelling or inflammation. It is also known as sopha or shvayathu.

Nidana:
Nija sotha Nidana:
Ati guru – amla – lavana – ushna – tikshana ahara, dadhi, viruddha ahara, nava shooka
dhanya, shami dhanya, aanupa mamsa rasa ati sevana, panchakarma mithya yoga, vega
dharana, kustha, kandu, pidaka, arsha, bhaganadara, chhardi etc.
Aagantuka sotha Nidana:
Aaghata, bhallataka pushpaphala rasa, Kapikachchhu shooka etc.

Samprapti:
Nidana → prakupita vayu enters raktavahini bahya shira → leads to vitiation of kapha-pitta-
rakta → aggravated kapha pitta rakta obstruct the vayu sancharana → obstructed vayu causes
utsedha → sotha

Bheda:
1. Vataja sotha:
Spreads rapidly, unstable, soft
Skin over Edema is dry and blackish
Edema increases during day, reduces in night
Subsides by oily and hot qualities
2. Pittaja shotha:
Oedema is soft, reddish, yellowish in colour
Tenderness, pus formation possibility
Typical unpleasant odour
Red eyes, vertigo, sweating, burning sensation
3. Kaphaja sotha:
Oedema is heavy and stable
Loss of appetite
Too much of salivation
Oedema is non-pitting type, increases in night
4. Agantuja shotha:
It spreads swiftly and may be associated with burning, heat, pain and redness etc. features.

Sadhyasadhyata:
Sadhya: aksheena bala mamsa, balavan rogi, eka doshaja, upadrava rahita, nava sotha
Krichra sadhya: shareera – madhyabhaga gata shotha, sarva shareera gata shotha
Asadhya: balaka, vriddha, durbala rogi, upadrava yukta, kukshi udara gala marmagata shotha

28
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Upadrava:
• Jvara • Aruchi • Kasa
• Chhardi • Trishna • Hikka
• Atisara • Shwasa

Chikitsa:
A physician should treat shotha according to rogi-roga bala, considering its Nidana, dosha
involvement, sama – Nirama condition etc.

If shotha is produced by amadosha → langhana pachana

If dosha are aggravated → Sanshodhana chikitsa
In case of shirogata shotha → nasya
In case of urdhwagata shotha → vamana
In case of adhogata shotha → virechana

If shotha is caused by snigdha padartha or atisnehana → rukshana chikitsa

If sotha is caused by ruksha padartha or ati rukshana → snehana chikitsa

Doshanusara chikitsa:
In vataja shotha → fomentation with dashmoola sveda
Arjuna: effective in this type of shotha
In pittaja shotha →
Virechana with trivrut or aragvadha
Shata dhauta ghrita
In kaphaja shotha →
Vamana with suitable drug
Dashanga lepa should be applied over the area of swelling

Shamanoushadhis:
Churna → Krshnadi churna, punarnavadi churna, triphala churna, haritaki churna
Vati → Punarnavadi guggulu, gokshuradi guggulu
Leha → Kansa haritaki, punarnavadi lepa
Asava / kwatha → Punarnavasava, punarnavastak kwatha, dashamoola kwatha
Ghrita → Chitrakadi ghrita, punarnavadhya ghrita
Rasa aushadhis → Punarnava mandur, chandraprabha vati, shothari lauha, arogyavardhini
vati, lakshmivilasa rasa, shothashardula rasa
Rasayana → Shilajatu rasayana, haritaki rasayana

Pathya:
Shali, mudga, yusha, yava, Shigru, Punarnava, takra, karvellaka etc.
Apathya:
Lavana, jala, anupa mamsa, shushka mamsa, navanna, dadhi, guru, vidahi anna etc.

29
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
JALODARA
Literally ‘udara’ means abdomen, diseases occurring in this are called as udara roga.
Udara roga refers to abdominal distension – either generalized (e.g., jalodara) or localized
(e.g., pleehodara).

Causes of udara roga:

All the disease are basically produced by mandagni udara roga is also produced by mandagni,
and the causative factors are indigestion, intake of food during indigestion, intake of impure
or contaminated food etc. which result in accumulation of excess mala in the body.

Bheda:
8 types of udara roga:
1. Vatodara
2. Pittodara
3. Kaphodara
4. Sannipatodara
5. Plihodara
6. Baddhagudodara
7. Kshatodara
8. Jalodara

Jalodara:
In which disease there is accumulation of fluid in between twacha and mamsa in the udara
pradesha it is called jalodara

Nidana:
Jalodara is caused by mandagni, malina anna sevana, mala sanchaya, excessive intake of
water after snehana karma, excessive intake of salt, pleeha and yakrita dosha, vegavarodha or
advanced stage of remaining seven types of udara rogas.

Lakshanas:
Generalized abdominal distension
Engorgement of veins over abdomen
Everted umbilicus
Anorexia
Dyspnoea
Cough
Weakness

Stages of jalodara:
1. Ajatodaka avastha:
Early stage of jalodara, in which fluid has not yet collected – here the abdomen is red in
colour, with gurgling sounds, and a network of veins is visible on the abdomen
2. Pichchhavastha:

30
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
This is second stage in which serous fluid has started accumulating in abdomen.
3. Jatodaka avastha:
Complete manifestation of jalodara characteristics, by generalised abdominal distension. The
skin over the abdomen is shiny and network of veins can be seen due to engorgement fluid
thrill and shifting dullness positive.

Samprapti:
Dosha → Vatapradhana tridosha
Dushya → rasa, rakta, udaka
Srotas → udakavaha, rasavaha, raktavaha
Srotodusti → sanga, vimargagamana
Udbhava sthana → amashayodbhava
Vyakta sthana → udaka – twak mamsantara

Nidana sevana → agnimandhya → ama + shleshma → pichchhila shleshma → carried by

vayu and take place in udakavaha srotas → udakavaha srotas dushti → vimarga gamana of
udaka in twaka & mamsantara → udara

Chikitsa:
Nidana parivarjana
All the types of udara roga are tridosha → tridosha shamaka chikitsa
The main cause of udara roga is mandagni → dipana & laghu ahara sevana

Udara roga is produced by excessive accumulation of dosha and obstruction to the srotas. To
eliminate excess doshas and to clear srotovarodha, purgative therapy should be given.

After purification by virechana, peyadi samsarjana krama should be given

Dugdha sevana for regaining the strength

To treat jalodara, follow nirjala, nirlavana, nirranna chikitsa

Chikitsa sutra:
Initially all measure to eliminate the effect of fluid should be done in the treatment of
jalodara.
Oral administration of different strong kshara added with cow’s urine should be done.
Foods that alleviate kapha and augments digestion should be given to patient.
Patient should be gradually reducing the intake of fluids.

Sastra karma in jalodara:

The fluid should be aspirated by inserting a cannula into the abdomen just below the
umbilicus on the left side.
While aspiration, compress the abdomen and after the aspiration the abdomen is tightly
wrapped with a cloth.
After the removal of the fluid patient is treated with langhana.

31
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Patient is kept on only milk diet for six months.
For another three months patient is allowed to take peya along with milk
Following this for another three months the patients is given rice prepared with shyamak
added with milk.
By managing the patient in the manner for one year one can get cured of jalodara.

Shamana aushadhis:
Churna: 3 – 6 gm with ushnodaka
Narayana churna
Punarnavadi churna

Vati: 250 – 500 mg with ushnodaka

Katuki vati
Abhaya vati
Kshara vatika

Kwatha / asava /arista: 20 – 40 ml with jala

Punarnavadi kwatha
Punarnavasava
Kumaryasava
Arjunarista

Lepa:
Devdarvadi lepa + gomutra (L.A.)
Rasa aushadhis: 125 – 250 mg with jala
Icchabhedi rasa
Yakrita plihari rasa
Jalodarari rasa
Tamra bhasma

Pathya:
Rakta shali, yava, mudga, takra, ustra kshira, gomutra, adrak, ela, langhana, udaravastrapatta
bandhana

Apathya:
Patrashak, ahishyandi drava, snehapana, lavana, vyayama, ati ambupana, Divasvapna

TRISHNA
सवणदाअम्बुकाभमत्वं
Even after drinking water repeatedly, the thirst does not get pacified, such morbid thirst is
known as trishna roga.
Mukha shosha is the pratyatmaka lakshana.

32
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Causes:
Pitta and vata gets aggravated due to –
Excitement, fear, exertion, grief, anger, fasting
Drinking too much wine
Intake of alkalis
Food which is amla, lavana, katu, ushna, ruksha
Dhatu kshaya
Vamana, virechana atiyoga
Surya santapa

Samprapti:
Nidana sevana → pitta vata prakopa → shoshana of apa dhatu → jihwamula gala talu mukha
shosha → trishna

Lakshanas:
• Dryness of mouth, lips, tongue, and throat
• Hoarseness of voice
• Loss of concentration of mind
• Desire for drinking of water persists.

Bheda (5):
1. Vataja 4. Kshayaja
2. Pittaja 5. Upasargaja
3. Amaja

Chikitsa:
Generally, vatahara & pittahara chikitsa, should be given
Bhaya & abhyantara shitopachara
If the patient is strong → shodhana chikitsa like vamana & virechana should be applied
Person should take bath with cold water after shata dhauta ghrita applying to his whole body.
Nasya with stree dugdha
Anulepana with amalaki lepa or panchamla + pancha valkalla lepa
Endra jala pana
Trina panchamula siddha jala paan
In madhyaja trishna → wine should be given mixed with water
In kshayaja trishna → treat it similar to kshata ksheena and kshayaja kasa

Formulations:
• Chandrakala rasa • Chandanasava
• Pravala pishti • Ushirasava
• Rasadi gutika • Shadangapaniya

33
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)

3. Chikitsa sutra and Management of the diseases of Annavaha Srotas

such as – Agnimandya, Aruchi, Ajirna, Anaha, Atopa, Adhmana,
Alasaka, Vilambika, Visuchika, Chardi, Grahani, Amlapitta, Gulma,
Shoola, Bhasmaka, Acid peptic disorders.

AGNIMANDHYA
Agnimandhya is a condition in which food is not properly digested due to the diminished
power of jatharagni.
Among the 13 types of agni, jatharagni is the most important, therefore, mandagni should be
treated properly in order to prevent the progress of the disease to other disorders of ama.

Nidana:
• Abhojana
• Atibhojana
• Vishamashana
• Ajirnashana
• Astamya, guru, sheeta, atiruksha, sandushta bhojana
• Vamanadi panchakarma mithya yoga
• Kapha prakopaka ahara vihara sevana

Samprapti:
Nidana sevana → kapha pradhana tridosha prakopa → jatharagni dushti → jatharagni
mandata → apoorna aharapaka → amavisha utpatti → agnimandhya

Lakshanas:
1. Vataja agnimandhya:
Udara shula, adhmana, malavrodha, mukha shosha, daurbalya
2. Pittaja agnimandhya:
Amlodgara, bhrama, trishna, daha, swedagamana
3. Kaphaja agnimandhya:
Madhurodgara, Utklesha, chhardi, klama, alashya, gaurava

Chikitsa:
Nidana parivarjana
Laghu & supachya ahara: peya, vilepi, mudga yusha, krishra etc.
Deepana – pachana
Ghritapana – deepaniya dravya siddha ghrita
Vamana – virechanadi shodhana karma

34
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
• Agnitundi rasa • Hingvashtaka churna
• Ajirna kantaka rasa • Lavana bhaskara churna
• Chitrakadi vati • Dashamularishta
• Shankha vati • Saindhava churna
• Trikatu churna • Chitrakadi ghrita
• Ajamodadi churna • Pippalyadi ghrita

ARUCHI
When the taste of food taken in the mouth is not detectable by a person, then the disease is
called arochaka.

Nidana:
Excess intake of guru and snigdha bhojana
Ajirna & agnimandhya
Secondary to pandu, kamala, kaphaja roga etc.
Intake of viruddha ahara
Intake of tridosha prakopaka ahara – vihara
Manasika Nidana like shoka, bhaya, krodha etc.

Lakshanas:
1. Vataja aruchi → hypersensitivity, bitter taste of the mouth
2. Pittaja aruchi → bitter and acidic taste in mouth, foul smell from mouth
3. Kaphaja aruchi → sweet and salty taste in mouth, heaviness
4. Tridoshaja aruchi → mixed features of all doshas
5. Agantuja aruchi → discomfort

Samprapti:
Nidana sevana leading to incomplete digestion of food. This leads to the formation of ama.
This ama with a type of kapha, known as bodhak kapha blocks the annavaha srotas of the
body and thus disturbs the sense of taste.

Chikitsa:
Kavala – gandusha
Dhumapana
Mukhaprakshalana
Harshana (measures to keep with pleasure)
Aashwasana (assurance to boost the self-confidence)
Single herbs like – maricha, draksha, chincha, sunthi, amalaki, vacha etc.

Formulations like -
• Lavanabhaskara churna • Chinchyadi lehya
• Hinguashtaka churna • Chitrakadi vati
• Chyavanaprasha

35
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
AJIRNA
Ajirna is the disease in which food is not properly digested due to low digestive power or
other reason.
It is the root cause of many other diseases and causes many types of pain.

Nidana:
Aharaja:
Atyambupana, atimatra bhojana, ati langhana, vishamasana, asatmya ahara, kaphakara ahara
Viharaja:
Vegadharana, swapna viparyaya, ratri jagarana / Diwaswapna
Manasika:
Dwesha, bhaya, chinta, krodha, moha, lobha
Agantuja:
Virechana – snehabasti vyapada, desha kala vaishmya, vyadhi karshana (due to any illness)

Samprapti:
Intake of aaharaja, viharaja, mansika, agantuja Nidana → vitiation of tridosha specially kapha
dominating → impairs jatharagni → agnimandhya → ajirna

Purvarupa:
• Annabhilasa • Aruchi • Chhardi

Rupa:
• Malavibandha or atipravriti
• Obstruction of apanavayu and udgara
• Shaithilya
• Shirah shula
• Murchha
• Heaviness of body
• Angamarda
• Aruchi & Avipaka

Bheda:
1. Ama ajirna:
Caused due to vitiation of kapha dosha
The feature of this is puffiness of around the eyes & face, frothy and increased salivation in
the mouth, nausea, repeated belching having the smell of food and feeling of heaviness in the
body.

2. Vidagdha ajirna:
Caused due to vitiation of pitta dosha.
It causes burning sensation in the chest & throat region, different kinds of pain, increased
feeling of thirst, sour belching, fainting, giddiness

36
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
3. Vistabdha ajirna:
Caused due to vitiation of vata dosha
It is characterised by pain abdomen, bloated stomach or gaseous distension, pain all over the
body, fatigue, non-elimination of stools & flatus

4. Rasa shesha ajirna:

This is caused due to agnimandhya of rasa dhatu.
It is characterised by dislike for meals, pure belching heaviness and turbidity in heart,
excessive salivation, and heaviness.

5. Dinapaki ajirna:
In this the digestion completes within one day and one night
This occurs due to overeating of food.
It is not harmful

6. Prakrita ajirna:
It is prakrita avastha
It prevails till the consumed food is complete digested.
After the completion of digestion, its manifest symptoms like hunger, thirst, defecation etc.

Chikitsa:
Samanya chikitsa:
The first line of treatment for all types of ajirna is langhana (fasting)
The purpose of langhana treatment is to make the body light by relieving heaviness
In ajirna heaviness is due to kapha dosha, so langhana treatment principle is adopted to
subside kapha.
Dipana pachana:
A dipana is herbal medicine taken before meals with the intension of kindling agni for the
meal.
A pachana is herbal medicine taken after meals with the intention of burning ama, or toxic
waste.
Therefore, in ajirna some dipana pachana herbs like trikatu, hingwastaka churna, chitrakadi
vati, shankha vati taken.
Takra pana: drink after meals to aid digestion. Add jiraka, dhanyak, sunthi, for better
digestion.

Vishesha chikitsa:
In amajirna → langhana
In vistabdhajirna → Swedana repeated on abdomen
In vidagdhajirna → vamana until pitta darshana

In amajirna:
Pippali, dhanyak, shunthi, haritaki, nimbu siddha dhanya panchak kwatha, amapachaka vati,
ajirnakantaka rasa, chitrakadi vati

37
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
In vidagdhajirna:
Avipattikara churna, shankha vati
In vistabdhajirna:
Shivakshara pachana churna, Hingwastak churna, Lavanabhaskar churna
In rasa shesha ajirna:
Diwaswapna, shankha bhasma, lasuna vati, gandhaka vati

Pathya:
• Food should be taken only when previous is completely digested and feel hungry.
• Never suppress the natural urges
• Always prefer to light food in moderate quantity
• Mentioned at least three-to-four-hour (1 yama) gap in between meals.
• Drink water sip by sip along with meal.
• Replace curds with buttermilk
• Regular usage of some ushna, tikshana and laghu dravya like jeerna, maricha, hingu,
lasuna and sunthi for proper digestion of food.

Apathya:
• Guru, vidahi, vishtambhi bhojana
• Asatmya bhojana, viruddha bhojana
• Ati ambupana
• Tikshana virechana
• Adhyasana, samashan, vishamasana
• Raktamokshana

ADHMANA
• Due to obstruction to vata dosha, when severe pain in abdomen along with gurgling
sour and distension occurs, the disease is called as adhmana.
• If vayu sanchaya in pakvashaya called adhmana
• Purishaja anaha chikitsa should be adopted for adhmana
• If vayu sanchaya in amashaya called pratyadhmana
• Aamaja aanaha chikitsa should be adopted for this.

Formulations:
• Lavanabhaskara churna • Agnitundi vati

Anaha
The disease in which mala and vayu get obstructed and not eliminated by their natural route,
is called as anaha.

Bheda:
1. Amaja anaha:
Caused due to accumulation and obstruction of ama in the stomach

38
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
2. Purishaja anaha:
Caused due to accumulation and obstruction of faeces in the intestine & colon.

Lakshanas:
Mala marga avarodha: constipation
Vayu marga avarodha: obstruction of belching & fart.

Chikitsa:
• Nidana parivarjana
• Abhyanga, Swedana
• In amaja anaha → Vamana, dipaniya aushadha siddha peya – vilepi – yavagu pana
• In purishaja anaha → Virechana, niruha basti, vatanulomana, phala varti

Formulations like:
• Ichchhabhedadi rasa • Haritakyadi churna
• Lasunadi vati • Sukha virechana churna

ATOPA
आटोपः गुडगुड शब्दः
Atopa refers to gurgling sound / borborygmi sound of the abdomen.

Lakshanas:
Sound in abdomen
Abdomen distortion
Nausea

Chikitsa:
Snehana, Swedana, dipana pachana
Vatanulomana chikitsa: basti, gudavarti, haritaki
Ajirnavata chikitsa
Formulations like –
Lavanabhaskar churna
Chitrakadi vati
Abhayarista

ALASAKA
आमाशयेअलसीभूत: तेन सोअलसकः स्मत
ृ ः |
In this disease the food remains in the stomach without getting digested for a long time.

Nidana:
Kaphadhikya, durbalagni, vegadharana, adhyasana, vishmasana
Consuming guru ruksha sheeta ahara after indigestion

39
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Samprapti:
Nidana sevana → vata kapha prakopa → margavarodha → leads to aamashaye alaseebhuta
anna → urdhwa & adha marga apravruti → alasaka

Lakshanas:
• Kukshi aadhmana • Vayu malavarodha
• Shula • Murcha

Chikitsa:
• Vamana by saindhava lavana & • Panchakola churna
ushna jala • Vishatinduka vati
• Langhana • Agnitundi vati
• Dipana pachana • Amapachana vati

VILAMBIKA
After kapha-vata type indigestion, if the person continues mithya ahara vihara, he develops
accumulation and adherence of ama in the body.
Vilambika is the chronic disease in which food neither goes upwards nor downwards, it
remains in stomach for a long time and becomes toxic this condition is known as Vilambika.
This is the result of long standing alasaka.

VISHUCHIKA
Vishuchika is a condition in which vitiated agni causes over affection of ama leading to
expulsion of the biological humors through both upper and lower passage.
Because of Ajeerna, vata is vitiated with other doshas which causes pricking pain all over the
body, as through being pricked by needles, hence this disease is called Vishuchika (suchi
means needle)

Lakshanas:
Pricking type of pain all over the body.
Udarshula
Vomiting
Rice water diarrhoea

Chikitsa:
• Langhana (upavasa) • Vishuchikantaka rasa
• Peya -vilepi etc. laghu ahara which • Sanjivani vati
is given after virechana karma. • Mahashankha vati
• Niruha basti • Ajirnakantaka rasa
• Formulations like –

40
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
CHHARDI
Forceful expulsion of the atipravritta doshas through mouth is known as chhardi.

Nidana:
Ati drava, ati snigdha, ati lavana bhojana
Atimatra bhojana
Bhaya, udwega, shoka, Krimi dosha
Garbhakala
Beebhatsa hetu

Samprapti:
Vatadi dosha prakopa → amashayastha dosha Utklesha → anga utpeedana & dosha urdhwa
gamana → chhardi

Purva rupa:
Nausea & uneasiness in cardiac region
Excessive salivation
Aversion towards food

Bheda:
1. Vataja chhardi
2. Pittaja chhardi
3. Kaphaja chhardi
4. Sannipataja chhardi
5. Dwishtartha samyogaja chhardi: vomiting cause due to incompatible, disturbing,
repulsive or awkward foods and things.

Chikitsa:
All chardi are caused by amashaya -utklesha, there langhana & kaphapitta shamaka vamana,
virechana should be adopted.
Formulations:
Mayurpichchha bhasma, manahshiladi yoga

GRAHANI
Grahani (duodenum) which is the site of agni is called so, because of its power to restrain the
downward movement of food. It is located above the umbilical region, and is supported and
nourished by the strength of agni.
Normally, it restrains the downward movement of undigested food and after the digestion it
releases the food through its lumen. In the abnormal condition, when it gets vitiated because
of weakness of agni, it releases the food in undigested form only.
Mandagni brings about vidaha which moves upwards and downwards in gastro intestinal
tract. When the digested and undigested food move downwards, this condition is called
grahani.

41
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Nidana:
Abhojana
Ati bhojana
Ajirna bhojana
Vishamasana
Asatmya guru shita ati ruksha dushta bhojana
Mithyayoga of vamana, virechana, snehapana
Karshyata due to disease
Vega dharana

Bheda:
1. Vatika grahani 3. Kaphaja grahani
2. Paitika grahani 4. Sannipataja grahani

Samprapti:
Nidana sevana → Pittapradhana tridosha prakopa → mandagni → amadosha → shukta paka
→ amavisha → grahani dushti → ama or pakwa muhur baddha muhur drava malapravruti →
grahani.

Lakshanas:
• Irregular bowel habits
• Excess thirst
• Aruchi
• Vairasya – bitter taste in mouth
• Excessive salivation
• Darkness in front of eyes.
• Belching having metabolic smell.

Avastha bheda (according to madhavakara):

Ghati yantra grahani:
There is bubbling sound in the abdomen
Ghatiyantra grahani is the chronic stage of sannipataja grahani which is characterised by pain
in the flanks while sleeping and bubbling sound in the abdomen.
It is incurable.

Sangraha grahani:
There is temporary retention of dosha and mala. Sangraha means collection or retention.
Characterised by antra kunjana, alasya, sadana, diva prakopa & ratri shamana

42
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Sama grahani:
When dosha is in grahani is afflicted by food, which is not fully digested then the signs of
ama are manifested –
Vishtambha – constipation
Shoola – pain
Vidaha – burning sensation

Chikitsa:
Snehana, Swedana, shodhana, langhana, deepana various powder preparation of lavana,
kshara, madhvarishta, surasava, various takra preparation. Deepaniya ghrita are to be
prescribed to the grahanidosha patient.

Grahani dosha should be treated like ajirna. First line of treatment is to administer langhana
and deepaniya dravyas.
If amadosha is situated in pakvashaya then do the virechana by dipana dravya.
If dosha spread in body then use the langhana & pachana.
After shodhana karma use the panchakoladi peya and laghu annapana.

Vataja grahani chikitsa:

Niruha and anuvasana basti
Virechana – Eranda taila mixed with kshara tilvaka ghrita with ghrita
Ghrita prayoga:
Dashamuladi ghrita
Trayushnadi ghrita
Panchamuladi ghrita

Pittaja grahani chikitsa:

Vamana & virechana karma
Tiktadravya sadhita ghrita (tiktak ghrita, maha tiktak ghrita)
Agnideepana by using jangala mamsa rasa.

Kaphaja grahani chikitsa:

Vamana karma, then agnidipana by use of katu, amla, lavana, kshara dravya.

Shamana aushadhi:
• Rasa aushadhi • Panchmrit parpati
• Agnikumara rasa • Shankha bhasma
• Hemagarbha pottali

Vati:
• Agni tundi vati • Chitrakadi vati • Jirakadi vati

43
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Churna:
• Bhunimbadya churna • Jirakadhya churna

Kwatha / arista:
• Dhanyakadi kwatha • Madhvarista
• Dhanyapanchaka kwatha • Takrarista

Kshara prayoga:
• Bhallataka kshara • Kshara gutika
• Bhunimbadi kshara

AMLAPITTA
Amla → sour
Pitta → pitta
The disease in which the normal quality of panchaka pitta changes from katu to amla as a
result of pitta-vidagdha, is called as amlapitta.

Nidana:
• Viruddha anna pana • Vidahi anna pana
• Dushta anna pana • Pitta prakopa anna pana
• Amla anna pana

Samprapti:
Accumulation of pitta in monsoon season & other etiological factors of its own → pitta
developing vidagdhata / sourness → amlibhava pitta → amlodgaradi lakshanas utpati →
amlapitta

Lakshanas:
Classified under 3 groups for better understanding of the disease –
1. Samanya lakshanas
2. Bhedanusara lakshanas
3. Doshanubandhanusara lakshanas

1. Samanya lakshanas:
• Avipaka • Tikta udagara • Hrt daha
• Klama • Amla udagara • Kantha daha
• Utklesha • Gaurav • Aruchi

2. Bhedanusara lakshanas:
Udhwarga amlapitta:
• Harita, pitta, nila, ati amla vamana
• Amlodgara
• Kantho daha

44
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Adhoga amlapitta:
• Harita, pitta, raktavarna, gudasrava
• Trishna
• Daha
• Murchha

3. Doshanubandhanusara lakshanas:
Vatanubandhi:
• Kampa, pralepa, shula, tam pravesha
Kaphanubandhi:
• Kaphasthivana, gaurava, shitata, aruchi, vamana, kandu
Kapha-vatanubandhi:
• Hrita kantha daha
• Tiktamla udgar
• Bhrama, murccha, praseka

Chikitsa:
Vamana:
Patoladi kwatha for vamana
In udhwarga amlapitta

Virechana:
Trivrut yoga for virechana
In adhoga amlapitta

Anuvasana basti
Asthapana basti

Useful formulations:
• Amalaki churna • Patoladi kwatha
• Yastimadhu churna • Yavadi kwatha
• Avipattikara churna • Kushmand avaleha
• Katuki churna • Sutshekhara rasa
• Pathhyadi churna • Shankha bhasma
• Patoladi churna • Shukti bhasma
• Dashanga kwatha • Narikela khanda
• Guduchyadi kwatha

Pathya:
Amla, lavana, tikta ahara
Laja saktu, sheetala jalapana

45
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
GULMA
A palpable lump like swelling in the abdominal region due to vitiated vata is called as gulma.
The important feature of the gulma is that there is always swelling and pain.
Sushruta has said that gulma is deep rooted, fixed and is round in shape.

Gulma sthana:
Both charaka and sushruta have given five places where gulma develops viz.
1. Hridaya 4. Vama parshwa
2. Nabhi 5. Dakshina parshwa
3. Basti

Nidana:
• Excessive elimination or excessive accumulation of purisha - kapha – pitta
• Suppression of natural urges
• External injury
• Excessive intake of ruksha annapana.
• Excessive grief
• Improper administration of panchakarma.

Samprapti:
Nidana sevana → vatadi prakopa → dosha sanchaya (sthana samshraya in mahasrotas) →
obstruction in mahasrotas → paripindita in any part of udara → gulma

Stage of gulma:
1. Apakwa (immature) gulma:
Gulma are heavy, hard, situated beneath the muscles, without change or colour and fixed
firmly.
2. Pachyamana (maturing) gulma:
Gulma are burning, painful, causing agony, loss of sleep, irritation and fever
3. Pakwa (matured) gulma:
Gulma are burning, bluish red in colour palpable like bladder and severe painful in nature.

Specific features:
1. Vataja gulma:
Obstruction of flatus
Aggravates in empty stomach and relieved on ingestion of food.
2. Pittaja gulma:
In this condition fever, thirst, redness of the face, pain, sweating, burning and tenderness are
complained by the patients.
3. Kaphaja gulma:
This produces shivering, fever, body ache, nausea, cough, tastelessness, heaviness, and hard
elevated non inflammatory masses.

46
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
4. Dwidoshaja & sannipataja gulma:
Mixed features
5. Raktaja gulma:
Menstruating women indulging in fasting or using excess of dry food, suppressing the natural
urges, suffering from uterine dysfunction etc. cause the vitiation of menstrual blood. This, in
turn lead to the occurrence of raktaja gulma.
Here pulsating tumours gradually taking the shape of a round mass, with pain an producing
the features of pregnancy (like amenorrhoea, pigmented nipples, morning sickness etc.)

Chikitsa:
All measures are undertaken to control vata. To achieve this –
Snehana, Swedana, Asthapana basti, and sour mixed sweet eatables are recommended
Upavasa, deepana pachana, snigdha – ushna & Vatanulomaka dravya, and brimhana should
be used to treat all types of gulma.

1. Vataja gulma chikitsa:

Snehapana → if gulma is situated above nabhi
Basti → if gulma situated in pakwashaya
Both → if gulma is situated in udara pradhesha.

2. Pittaja gulma chikitsa:

Mridu virechana, raktamokshana
Shastrakarma (in case of pakwa gulma)
Kshirabasti (if pittaja gulma is situated in pakwashaya)

3. Kaphaja gulma chikitsa:

Vamana, virechana, ksharakarma, agnikarma, langhana
After vamana or langhana → katudrava siddha ghritapana

4. Raktaja gulma chikitsa:

Treated only after 10 months
Virechana should be administered after snehana – Swedana
Palashkshara Yamaka is used for gulma bhedana
Yonivishodhana (medicines kept in yoni)
e.g., mamsa khanda mixed with yavakshara, mamsakhanda mixed with snuhi kshara, cotton
piece dipped in bile of pig or fish.
If bleeding occurs after shodhana →
Uttara basti with jeevaniya dravya siddha ghrita
Anuvasana basti with tiktadravaya siddha ghrita

47
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Shamana aushadhi for gulma chikitsa:
• Gulmakuthara rasa • Swarjika kshara
• Agnikumar rasa • Eranda taila
• Pravala panchamrita • Danti haritaki
• Hingwadi churna • Kumaryasava
• Hingwadi vati

SHOOLA
It is a symptom complex in which there is pain as if some sharp pointed object has been
penetrated.

Types:
Shula is of 8 types. They are:
1. Vatika shoola 5. Vata-pittaja shoola
2. Pittaja shoola 6. Vata-kaphaja shoola
3. Kaphaja shoola 7. Pitta-kaphaja shoola
4. Sannipataja shoola 8. Amaja shoola

Parinama shoola and anna drava shoola are special types of shula and its variants. They have
not been included under the 8 types of shoola, because of the unique way of their
presentation.

Chikitsa:
• Depending on dosha involvement • Pachana
and nature of the disease – • Phalavarti
• Vamana • Kshara
• Langhana • Churna
• Swedana • Kshara gutika

Parinama shoola:
Parinama means transformation
The shoola or colic or pain abdomen which occurs due to transformation (digestion) of the
food is called parinama shoola.

Lakshana:
Pain occurs during digestion of food.
Pain in abdomen
Pain in abdominal sides
Navel pain
Pain in region of urinary bladder
Pain in between the breasts
It is correlated with duodenal ulcers.

48
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Annadrava shoola:
Anna means food, drava means liquids, the pain (colic which is associated and aggravates
with food and liquid is called anna drava shula.

BHASHMAKA ROGA
In a person with increased pitta- vata & decreased kapha, ingested food gets digested very
quicky and later the digestive fire digests the dhatu, thus the person becomes weak, suffers
from various diseases, and finally dies.

Lakshanas: trishna, daha, murcha, Kshudha, vruddhi & bala hani

Chikitsa:
Intake of guru, kaphavardhaka, snigdha, shita madhura ahara
Products of jaggery, milk, diwa swapna, virechana karma

ACID PEPTIC DISORDERS

Acid peptic disorders include a number of disease whose etiology can be linked to gastric
secretions
Gastro oesophageal reflux disease, and peptic ulcer disease are two most common and well-
defined disease states.
APD occurs when the acid starts irritating the mucosa of the stomach.
APD mostly affect the oesophagus, stomach and duodenum
Regurgitation of gastric contents into the oesophagus is called GERD.
Peptic ulcer is a lesion in the mucosa of the digestive tract typically in stomach or duodenum

Etiology:
• Infection of helicobacter pylori
• Prolonged use of high dose of NSAIDs
• Excessive use of steroids
• Stress, hereditary

Treatment:
• Avoid use of aspirin & NSAIDs
• Avoid spicy foods
• Antacids (milk of magnesia, gelusil)
• H2 blockers – ranitidine, cimetidine
• Proton pump inhibitors – omeprazole, rabeprazole
• For H. pylori – antibiotics – amoxicillin, tetracycline

49
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Ayurvedic concept & treatment:
GERD can be compared to amlapitta.
The main objective is to get rid of the morbid pitta and protect the stomach and gut from
getting damaged by the action of pitta.
Vamana by decoction of patola, nimba, madanaphala, honey and saindhava lavana.
Virechana by decoction of triphala, trivrut, madhu
Anuvasana basti → after vamana and virechana anuvasana basti should be administered.
Asthapana basti → in chronic cases

Formulations like
Yavadi kwatha
Guduchyadi kwatha
Patoladi kwatha
Lasun ksheerapaka
After the disease gets controlled, rasayanas are administered to eliminate the residual disease
and to provide a long-term immunity towards the disease.
Peptic ulcer can be correlated to parinama shula and annadrava shoola.

50
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)

4. Principles of treatment and management of Vata Vyadhi such as -

Pakshavadha, Ekangavata, Sarvangavata, Ardita, Avbahuka, Kati
Graha, Manyastambha, Gridhrasi, Vishwachi, Khalli, Khanja, Pangu,
Padaharsha, Padadaha, Vatakantaka, Kroshtukashirsha, Udavarta,
Kampavata, Dhatugata and Ashayagata Avarana Vata, other Vata
Rogas, Parkinsonism.

VATAVYADHI
Diseases produced by vata dosha are called as vatavyadhi.
2 types of disease
1. Samanyaja vyadhi: caused by combination of dosha.
2. Nanatmaja vyadhi: caused by a single dosha (there are 80 vataja nanatmaja vyadhi)
There are two major cause.
1. Dhatu kshaya 2. Margavrodha

Samprapti:
Dhatukshaya janya vata vyadhi:
Hetu sevana → vata prakopa → rukshata, kharata, parushata in srotas sthana → vayu purana
in rikta srotas sthana → nirupstambhita vata vyadhi

Srotavarodha janya vata vyadhi:

Hetu sevana → amadoshotpati → srotovarodha → vayu vimarga gamana → sthana samsraya
of sama vayu at srotovaigunya sthana → upastambhit vata vyadhi

Samanya lakshana:
Sandhi stambha, sandhi bheda, asthi bheda, Pralapa, panipristha shirograha, pangutva,
Shosha, sanga, spandana, Nidranasha, gatra suptata, toda

Samanya chikitsa:
If there is absolute vitiation of vata without any kind of association, it should be treated at
first with snehana therapy, such as internal administration of ghee, fat, oil, marrow when
saturated by snehana should again be snehana with snigdha dravyas
Like yusha, mamsarasa with dugdha.

Swedana → regular
Mruduvirechana by Eranda taila, tilvak taila
Vatanulomana by haritaki churna to clear the obstruction.
Anuvasana & niruha basti → basti is the best treatment –
Anuvasana basti with ksheerabala taila / sahacharadi taila
Niruha basti with Erandamuladi basti / ksheera basti.
Nasya → medicated oils to treat urdhwa jatru gata vatavikara by anutaila / shad bindu taila /
dhanvantari taila

51
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Shamshamana:
• Vatanashaka aushadha like –
• Vatari rasa
• Panchakola churna
• Rasnasaptaka kwatha
• Rasona taila
• Dashamularista
• Yogaraja guggulu
• Kaishor guggulu
• Chyavanprasha
• Shilajatu

PAKSHAGHATA / PAKSHAVADHA
When the aggravated vata paralyzes one side of the body either right or left side of the body it
causes immobility of that side along with pain, loss of speech. This condition is called
pakshaghata.

Samprapti:
Due to etiological factors vata is aggravated and it vitiates blood vessels or nerves and
muscles, tendons in the left half or right half of the body and produces their diminution.

Bheda:
1. Based on dosha involvement:
Pittanubandhi → daha, santapa, murccha
Kaphanubandhi → shaitya, shotha, gaurava
Kevala vata → toda, shosha
2. Based on which organs affected
Ekanga vata (monoplegia) → only one part of the body gets affected like one hand or
leg.
Ardhanga vata (hemiplegia) → either left or right half of the body.
Adhanga vata (paraplegia) → both the lower extremities
Sarvanga vata (quadriplegia) → all the body parts get affected or both the arms and
legs get paralyzed.

Chikitsa:
Nidana parivarjana
Snehana karma: massage with medicated oils such as – maha Narayana taila, sahacharadi
taila, dhanvantara taila, ksheerabala taila, etc.

Svedana by shashtika shali pinda sveda

Sarvanga sveda for 7 – 14 days.
Snehayukta virechana should be administered
Virechana by draksha, Aragwadha phala majja, haritaki, katuki with Eranda taila

52
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Basti: matra basti with Narayana taila, kashaya basti with Eranda mula kwatha, ksheera basti
Nasya karma: brimhana nasya with purana ghrita
Shiro basti with medicated oils like Narayana taila, ksheera bala taila
Shirodhara with medicated liquids

Shamana aushadhis
• Ashwagandha churna • Maharasnadi kwatha
• Brahmi svarasa • Brihatvata Chintamani rasa
• Rasana ksheera pala • Vatari guggulu
• Eranda taila • Brahmi vati

EKANGAVATA & SARVANGAVATA

When vata after getting aggravated take ashraya at any of the dhatu, ashaya or kostha and
gets prakupita then it is known as Ekangavata.
If vata gets increased all over the body, there will be tremors (throbbing, twitching, pulsations
etc.) cutting, crushing and other types of pain, feeling of pain in the joints and the person
feels as if there is a blast (bursting) in the joints.

Ekangavata lakshana:
Lakshana of the respective amashaya (dhatu, ashaya or kostha) as shows its own lakshanas.

Sarvanga gata vata lakshana:

• Gatra sphurana • Bhanjana

Chikitsa:
In case of pain → upanaha
In case of Sankocha → abhyanga with the taila cooked with masha and saindhava.
Basti:
Sarvangavata: abhyanga with vatahara taila, anuvasana & niruha basti
Ekangavata: abhyanga, swedana, avagaha, medicines which are good for heart.

ARDITA
When excessively aggravated vata affects the half part of the body, it dries up the rakta dhatu
and causes contraction of the arm, foot and knee of that part. It causes deviation of half of the
face and curvature of the nose, eyeball, forehead, eye and mandible.

Lakshanas:
Deviation of half of the face
Pain in extremities, temple, ear and cheek
Loss of function which are carried with the help of facial muscles and nerves like difficulty in
speaking, difficulty in swallowing, unable to close affected eye etc.
Numbness of skin
Stiffness of the neck muscles & jaw.

53
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Bheda:
1. Vataja:
Nausea, shivering, pulsation, lock jaw, Edema over the lips, pain in specific part of the face
etc.
2. Pittaja:
Yellowish discolouration of the face, fever, thirst, sensation of fumigation etc.
3. Kaphaja:
Edema over the hair margin, cheeks, face and neck. Stiffness of muscle etc.

According to location:
1. Half of the body affected
2. Half of face only

Chikitsa:
Nasya (navan), shirobasti (murdha taila), tarpana, Swedana (nadi sweda, Upanaha sweda),
anupa mamsarasa sevana are general line of treatment of ardita.

Shodhana chikitsa:
• Nasya karma
• Shirobasti
• Mukha abhyanga with ksheerabala taila
• Dhooma with dashamoola kwatha boiled with milk.
• Upanaha sweda
• Karna poorana
• Akshitarpana
• Gandusha with ksheera bala taila with dashamoola kwatha.

Shamana chikitsa:
Single herbs:
1. Lasuna → it stimulates facial nerves by improving blood circulation
2. Nirgundi → it is good to relieve pain of nerve and to improve muscle strength
3. Eranda → balance vata
4. Lavanga → strengthen nerves
5. Rasna → powerful vata balancing herb

Formulations:
• Mahanarayana taila • Rason pinda
• Saindhavadi taila • Rasnadi guggulu
• Mahayogaraja guggulu • Dashamoola rasayana
• Ekangaveera rasa

54
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
AVABAHUKA
The aggravated vata vitiates the nerves in the shoulder region and causes atrophy and
contraction of the muscles in that region. The movement of shoulder become restricted and
painful

Chikitsa:
Vyaghri taila or sheeta jala prayoga for nasya
Mahamasha taila or prasarinee taila prayoga for abhyanga

KATIGRAHA
Due to improper posture, excessive exercise, strenuous work, or injury, aggravated vata gets
localized in kati – pradesha and causes pain and stiffness of the low back.

Chikitsa:
Langhana (in amavastha)
Sthaniya abhyanga
Kati basti with mahanarayana taila
Rasnadi guggulu, Agnitundi vati, Dashamularista

MANYASTAMBHA
Due to improper posture, injury to the neck, or excessive travelling vata gets aggravated and
causes stiffness and pain in the neck.

Chikitsa:
Ruksha Swedana (lavana, pottali / valuka sweda)
Nasya karma & sthanika abhyanga

GRIDHRASI
Gridhrasi is explained as one among 80 types of vataja imbalance disorder.
The word gridhrasi is derived from the root word gridhra, which means the bird vulture.

The patient walks similar to the walk of the vulture. Hence it is known as gridhrasi.

Nidana:
Intake of vata aggravating eatables like masura etc.
Excess intake of dry, light and cold food
Excess intake of pungent, bitter and astringent food.
Heavy weight lifting, long walk, improper lying or sitting positions.
Vegadharana
Mithya yoga of pancha karma
Fall or injury etc.

55
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Rupa:
Pain starting from hip area and radiating to the thigh, back, sacral region, popliteal area, calf
muscles and foot.
Pricking sensation in those parts.
Altered gait
Rarely stiffness or pulsation etc. are mainly found.

Bheda:
Based on dosha imbalance, gridhrasi is of two kinds
1. Vataja gridhrasi
Curved posture due to pain
Severe stiffness
2. Vata kaphaja gridhrasi:
Indigestion, nausea
Drowsiness, anorexia
Heaviness of the leg
Freezing sensation in the lower limbs

Samprapti:

56
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Chikitsa:
Gridhrasi is being a vata vyadhi, general treatment advised for that of vata. The first and
foremost principle to be adopted in treatment is to avoid the nidanas that cause gridhrasi.

Stages of dosha prakopa treatment:

Minimum (vata) → langhana
Moderate → langhana pachana
Maximum (vata kapha) → shodhana

In all stages of gridhrasi, except in amavata oil preparations is suggested by all acharyas both
externally and internally. But in ama and vata kapha gridhrasi sneha prayoga will not give
any positive result. In this, rukshana prayoga should be advised.

Snehana:
Taila is supposed to be the best for vata as vata is ruksha, shita, laghu and khara and taila has
just opposite qualities like snigdha, ushna, guru, pichchila etc.
Sneha is used externally in abhyanga, pariseka, avagaha etc. sparshanendriya is the place of
vata since abhyanga is done on the skin, it alleviates vata.

Swedana:
Gridhrasi is a shoolapradhana vatavyadhi and shulavayuparama is sign of proper Swedana.
Nirgundi patra sweda is effective in gridhrasi as it acts as snehana as well as Swedana.

Mridu virechana:
Trivruta, Eranda, aragvadha etc. are used for this purpose.
Virechana removes the maladravyas, increases agni, purifies srotas, dhatus & destroys the
vyadhi.

Venesection in between the Achilles’ tendon and ankle joint (four angula above the janu)
Basti karma:
Basti is the important karma in treatment of vata vyadhis, especially indicated in the patients
who have disability, stiffness in extremities etc. Majority of the symptoms is present in the
patients of gridhrasi.
Niruha basti is used methodically and skillfully purifies mala.
In anuvasana basti sneha is used. Taila with its snigdha guna destroys rukshata and with its
guru and ushna guna destroys laghu and sheeta guna of vata respectively

Agnikarma:
After siravedhana agnikarma at kanishthika anguli of pada has been suggested.

Shamana chikitsa:
Single herbs:
• Nirgundi • Punarnava • Shigru
• Bala • Eranda
57
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Formulations:
• Yogaraja guggulu • Sahacharadi kashaya
• Gokshuradi guggulu • Punarnavastaka kashaya
• Kaishora guggulu • Ksheerabala taila

VISHWACHI
The aggravated vata affects the nerves in the upper extremity pain starts from the backside of
the shoulder, travels along the hand and palm up to the fingers.
All the movements: flexion, extension, abduction raising the hand are restricted and painful.

Chikitsa:
Sthaniya abhyanga, nadi Swedana, vatanashaka chikitsa

KHALLI
Khalli is characterised by the twisting pain of the feet, calf regions, thighs and wrists

Chikitsa:
Ushna Upanaha prepared of payasa (ksheera) or krushara or mamsa.

KHANJA & PANGU

Nidana:
Ruksha, katu, tikta, kashaya dravya sevana
Ati vyavaya
Ati vyayama
Vata vardhaka ahara vihara
Shoka, bhaya

Samprapti:
Nidana sevana → vata at kati pradesha gets prakupita → produce akshepa (karma heenata) in
kandara of kati to gulfa pradesha → khaja & pangu (If one leg is involved khanja, if both the
legs are involved pangu)

Lakshana:
Limping

Chikitsa:
Virechana
Asthapana basti
Swedana
Use of guggulu cure newly arised khanja or pangu.

58
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
PADAHARSHA
Aggravated vata along with vitiated kapha produces tingling sensation in the feet and
numbness in the legs.

PADADAHA
Aggravated vata along with vitiated pitta and rakta produces burning sensation in the feet and
this condition is called pada daha.

VATA KANTAKA
Due to excessive walking or abnormal positioning of legs, the aggravated vata causes
excessive pain and swelling in the ankle

Chikitsa:
Sthanika abhyanga by maha lakshminarayana taila or dashamoola taila
Nadi Swedana with dashmoola kwatha
Eranda taila pana
Haridra + saindhava lepa

KROSTUKASHIRSHA
The aggravated vata along with vitiated rakta causes swelling and severe pain in knee joint.
The affected joint appears a head of a fox and hence called as kroshtuka-sheersha.

Chikitsa:
Vataraktanashana chikitsa
Abhyanga, ruksha Swedana

UDAVARTA
Udavarta means the upward or backward or reverse movement of vata dosha. Usually,
obstruction to the normal pathway of vata results in reverse movement. Most commonly, this
condition is resulted due to the suppression or obstruction to the natural urges or natural
functioning of vata. Rarely it occurs as a secondary to organic obstruction.

Hetu:
Suppression of vega of adhovata, purisha, mutra, jrimbha, ashru, kshvathu, udagara, chhardi,
Kshudha, uchchvasa, nidra.
Kashaya, tikta, katu, ruksha ahara

Samprapti:
Nidana sevana → vata prakopa → srotovarodha & vimarga gamana of vayu → udavarta

59
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Samanya lakshanas:
• Severe pain in hridaya, kukshi, • Toda
udara, prustha & parshwa • Vipaka
• Adhmana • Basti sotha
• Hrillasa • Mala sanga
• Vikartika

Chikitsa:
First abhyanga should be done with shitajvara nashaka taila i.e., agurvadi tailam. Next
Swedana should be done. Due to these doshas will move to the kostha. After that varti, niruha
basti, sneha virechana, anulomana ahara and anuvasana basti.

Snehana → Swedana → varti → niruha basti → anulomana ahara → sneha virechana →

anuvasana basti

Varti → main important phalavartis are pippalyadi varti and krimighnadi varti

Pradhana churna prayoga:

Done with shyamakadi and rakshoghnadi churna.
These churna filled in nadi yantra and should be inserted inside the guda.

Teekshna niruha basti prayoga:

It should be done with kwatha prepared with virechana and vamana dravyas, gomutra,
vataghna dravyas.

Aushadha prayoga:
• Ichchabhedadi rasa • Panchalavana churna
• Hingwadi churna • Pippalyadi kwatha
• Vachadi churna

Annapana prayoga:
• Vatanulomanaka ahara
• Prasanna
• Guda seedhu (alcohol prepared with guda)
• Trivrut, sudhapatra

KAMPAVATA
Kampa – means tremors and vata means pathological increase or aggravation of vayu.
Thus, Kampavata means a diseases condition in which the tremors are manifested due to a
pathological increase of vata.

60
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Lakshanas:
• Tremors in hands and feet
• Irregular movements of body parts
• Insomnia
• Reduced memory and intelligence

Chikitsa:
Bahya prayoga:
Abhyanga with sahacharadi taila, masha taila, balashwagandha taila, ksheerabala taila
Swedana with baspa sweda, nadi sweda → kwatha of rasna, patrapinda sweda, shashtika shali
pinda sweda
Shirobasti with brahmi ghrita
Shirodhara with medhya kashaya

Abhyantara prayoga
Snehapana → aswagandhadi ghrita, brahmi ghrita, panchagavya ghrita, rasna ghrita
Virechana → Eranda taila, trivrut leha, triphala churna
Anuvasana & niruha basti → Erandamuladi kashaya, dashamoola kashaya

Aushadha yoga:
• Balya & medhya rasayana prayoga
• Kapikacchu churna
• Ashwagandha churna
• Kapikachchu churna ksheerapaka
• Trivanga bhasma
• Vanari gutika

AVARANA
Avarana is a unique concept in ayurveda. It is a condition which has been explained in the
context of vata disorders.
Avarana means covering, enveloping or enclosing.
In this condition the ‘free flowing’ vata is obstructed and enveloped by pitta, kapha, tissues,
food and excrete. This obstructed vata many disorders. These diseases are called avarana
janya vyadhis.

Avaraka → the dosha dushya those are causing avarana.

Aavruta → obstructed vata

Types:
1. Doshavruta vata:
When vata gets obstructed by components body inclusive of pitta, kapha
13 types of avaranas occur.

61
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
2. Dhatu, anna & malavruta vata
Vata gets obstructed by food, urine, faeces tissues
9 types of avaranas occur.
3. Anyonyavarana:
When one sub-type of vata obstructs another sub-type of vata.
20 types of avaranas.

Ashaya gata vata:

Ashayagata vata is a pathological condition of vata wherein the vitiated vata gets lodged in
the tissues and visceral organs, consequently damage the tissues and organs and giving origin
to many diseases.

Twakgata vata:
When vitiated vata gets lodged in skin, the below mentioned symptoms can be seen –
• Ruksha
• Sphutita
• Supta
• Krushna
• Toda

Chikitsa → svedana, avagaha, abhyanga, hridya ahara

Asthi majja gata vata:

When the vitiated vata gets seated in bones and bone marrow, the following symptoms are
seen –
• Asthi bheda → splitting pain in the bones.
• Parva bheda → splitting pain in the joints
• Mamsa kshaya
• Bala kshaya
• Santata ruk → constant pain

Chikitsa → snehapana, snehana like abhyanga, seka, pichu

Amashayagata vata:
When vitiated vata gets lodged in amashaya or stomach, the following symptoms are seen –
• Parshwa ruka
• Udara ruka
• Hrid – nabhi ruk
• Trishna
• Vishuchika

Chikitsa → vamana – virechana with trikatu, Lavanabhaskar, amapachaka vati

62
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Pakwashaya gata vata:
When vitiated vata gets lodged in pakvashaya, the following symptoms are seen –
• Antrakunjana
• Shula – pain in sacral region
• Anaha – abdominal distension
• Atopa – borborygmi of abdomen
• Malavarodha – constipation

Chikitsa: udavarta chikitsa

Guda sthita vata:

Vata aggravated in anus and rectum causes dryness, emaciation and pain in legs, sacral
regions, legs and hands.

Chikitsa: same as udavarta

Mamsa medogata vata:

Presence of throbbing pain in muscles and pain as if beaten with sticks is experienced in
vitiated vata afflicting muscles and fat.

Raktagata vata (hypertension):

Raktagata vata means involvement of rakta by vitiated vayu.
The following symptoms are seen –
Santapa and teevraruja in sarvashareera.
Varna Vivarnata, daurbalya
Acne in the body

Chikitsa:
Sheetapradeha, virechana, raktamokshana

Sandhigata vata:
When vata gets aggravated in joints, it causes destruction and damage to ligaments of joint
swelling over joint feels like air-filled bag. There will be pain and difficulty in movement of
joints.
This condition is compared to osteoarthritis.

Ashayapakarsha vata:
Ashayapakarsha means displacement from original place. In this, the vitiated vata dosha
displace normal pitta or kapha from its place.
This displacement of pitta and kapha from its place causes various disorders due to imbalance
of pitta and kapha.

Chikitsa: vata prashamana, ashayapakrushta dosha sthapana

63
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
PARKINSONISM
Parkinsonism is a clinical syndrome of the nervous system characterized by the cardinal
features of rigidity, bradykinesia, tremor and postural instability. It is found in parkinson’s
disease.
Parkinson’s disease (PD) is a neurodegenerative disorder that affects predominantly
dopamine producing neurons in a specific area of the brain called substantia nigra.

Symptoms:
Generally, come on slowly over time. Early in the disease, the most obvious are shaking,
rigidity, slowness of movement, shuffling gait and flexed posture.
Dementia becomes common in the advanced stages of the disease. Depression and anxiety
are also common.

Treatment:
There is no cure for parkinson’s disease, but medications, surgery and multidisciplinary
management can provide relief from symptoms.
Initial treatment is typically with the antiparkinson medication levodopa (L-Dopa)
When medications are not enough to control symptoms, surgery and deep brain stimulation
can be of use.

Ayurvedic management:
Kampavata is an ayurvedic term given to a condition which closely resembles parkinson’s
disease.
Also, parkinson’s disease can be treated on the lines of treatment protocol of below said
conditions –
• Vata vyadhi • Unmada chikitsa
• Sarvanga vata • Apasmara chikitsa
• Mamsagata vata • Ardita chikitsa
• Majjagata vata

All the above said conditions might be different conditions from parkinson’s disease, but the
principles of the treatment explained in the above said contexts are also useful in PD.

64
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)

5. Nidana and Chikitsa of Urusthambha, Gullian Barrie syndrome,

Muscular Dystrophy, Myasthenia Gravis, Motor Neuron Diseases and
Neuralgia.

URUSTAMBHA
A rather rare medical condition correlated with thigh stiffness or spasticity of thigh

Nidana:
Intake of snigdha, ushna, laghu, sheeta ahara during indigestion
Ati drava, shushka ahara, dugdha, dadhi sevana
Langhana, adhyasana, Diwaswapna, Ratrijagarana
Vega dharana, atisneha, prayoga

Samprapti:
Nidana sevana → ama sanchaya in kostha + meda kapha sangati → avaruddha & prakupita
vata-pitta → sthanasamshraya in uru pradesha → Sakthi – asthi kaphapurnata → urustambha

Lakshana:
Stiffness, continuous pain & burning sensation in the thighs.
Patient feels as if thigh region is broken.
Difficulty in standing and walking
Unable to perceive cold touch.

Chikitsa:
This is the only disease where panchakarma is contraindicated.
Snehana is contraindicated in urustambha → when applied, causes sadana (lassitude), supti
(numbness), difficulty in lifting legs.

Chikitsa sutra:
All the therapeutic measures which alleviate kapha but do not aggravate vata should always
be employed for the treatment of urustambha.

Rukshana therapies with diet, lifestyle and medicines administered to absorb morbid dosha
causing obstruction.

Shamana aushadhis:
Haritaki + pippali + madhu
Vatsakadi lepa,
Swarnakshiryadi yoga,
Urustambhanashak kalka
Urustambhanashaka taila → Kusthadi taila, saindhavadi taila

65
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
GUILLAIN BARRE SYNDROME
Guillain barre syndrome or landry’s paralysis is a disorder in which the body’s immune
system attack on the part of the peripheral nervous system.
It is an acute, progressive, autoimmune, inflammatory demyelination of peripheral sensory
and motor nerves and nerve roots.
This leads to nerve inflammation that causes muscle weakness.
It is also known as acute inflammatory demyelinating polyneuropathy (AIDP).
This syndrome is named after the French physicians George Guillain & jean barre, who
described it.

Causes:
Exact cause is unknown
It is due to immune response to foreign antigens such as infectious agents that the body’s
immune system mistargets.
Immune system mistakenly attacks gangliosides compounds which are naturally present in
nerve cells.
The most common infection which precedes the GBS is

Rarely, recent surgery or immunization can trigger GBS.

Recently, there have been a few cases reported following infection with zika virus.

Pathogenesis:
Infection by pathogens → pathogens have specific antigens in their capsules, that they share
with nerves → the immune system usually response to these components by producing →
antibodies → but, antibodies cross react with the myelin sheath in peripheral nervous system
→ causing demyelination & damage to PNS. → this will lead to defect in the transmission of
electrical nerve impulses → lead to paralysis

66
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Clinical features:
The first symptoms of GBS are numbness tingling and pain, alone or in combination. This is
followed by weakness of the legs and arms that affects both sides equally and worsens over
time.
• Tingling or prickly sensations in the fingers and toes.
• Muscle weakness in the legs that travels to upper body and gets worse over time.
• Difficulty walking steadily
• Difficulty in eye movement, facial movements, facial movement, speaking, chewing,
swallowing
• Severe lower back pain
• Tachycardia
• Difficulty in breathing
• Paralysis
• Parasthesia – loss of sensation
• Diagnosis:
• Medical history
• Physical examination
• Cerebrospinal fluid analysis (typical CSF findings include albuminocytological
dissociation)
• Electromyography
• Nerve conduction studies

Types:

1. Acute inflammatory demyelinating polyneuropathy

It is the most common form of GBS, and the term is often used synonymously with GBS.
It is caused by an autoimmune response directed against schwann cell membrane
2. Miller fisher syndrome (MFS):
Rare variant of GBS
Manifest as a descending paralysis.
It usually affects the eye muscles first and presents with the triad of ophthalmoplegia, ataxia
and areflexia.

67
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
3. Acute motor axonal neuropathy (AMAN):
Known as Chinese paralytic syndrome
Attacks motor nodes of Ranvier & prevalent in china & Mexico.
Auto immune response directed against the axoplasm of peripheral nerves
4. Acute motor sensory axonal neuropathy (AMSAN):
Similar to AMAN
Affects the sensory nerves with severe axonal damage.
5. Acute panautonomic neuropathy:
Most rare variant of GBS, sometimes accompanied by encephalopathy
Associated with high mortality rate.
Symptoms are impaired sweating, lack of tear formation.
6. Bickerstaff’s brainstem encephalitis (BBE)
Characterized by acute onset or ophthalmoplegia, ataxia, disturbance of consciousness etc.

Treatment:
1. Plasmapheresis:
The aim is to deplete the body of blood plasma without depleting of its blood cells.
The aim is to remove the cells that are attacking the nerves.
2. High dose immunoglobin therapy:
Concentrated antibodies are injected straight into a vein. The antibodies are extracted from
healthy donors.
3. Mechanical ventilators:
Supportive care with monitoring of all vital functions is the corner stone of successful
management in the acute patient.
Greatest concern is respiratory failure due to paralysis of the diaphragm.
4. Pain control
5. Supportive care
6. Advice from physiotherapist & occupational therapist.

MUSCULAR DYSTROPHY
Muscular dystrophy is a group of genetic diseases that causes progressive weakness and loss
of muscle mass.
It is a group of muscle diseases that weaken the musculoskeletal system & hamper
locomotion.
It is characterised by progressive skeletal muscle weakness, defects in muscle proteins
(dystrophin) and the death of muscle cell and tissue.

Causes:
Muscular dystrophy is genetically inherited.
The main cause of the disease is due to the lack of muscle proteins like dystrophin and
dystrophin associated protein complex.
However, mutations of dystrophin gene and nutritional deficits are responsible for the
disease.

68
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)

Classification:
There are around 30 types of muscular dystrophies out of below mentioned are common.

1. Duchenne muscular dystrophy (DMD):

Most common form of early childhood muscular dystrophy.
Caused by change of gene that makes a protein called dystrophin.
2. Myotonic muscular dystrophy:
It is the common form of MD diagnosed in adults.
This type of MD causes difficulty with muscle relaxation: weakness in the distal extremities,
such as hands & wrists.
It can also lead to endocrine disturbance.
3. Becker muscular dystrophy:
It is very similar to DMD, but it is progresses much more slowly & less common.
It causes progressive weakness in the muscles of hips, thighs, pelvis & shoulders.
4. Emery – Dreyfus’s muscular dystrophy:
Arise mainly in adolescent boys and young men.
In this muscle strength in the shoulders, upper arms may be affected.
This type of MD progresses slowly.
69
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
5. Limb – girdle muscular dystrophy:
It affects the muscle of the upper arms, upper legs, shoulders & hip.
Complains are – problems with climbing stairs, rising from seating position, walking etc.
6. Fascioscapulo humeral muscular dystrophy:
It affects the muscles of the face.
Affects shoulder blades & upper arms.
Weakness of the muscles around eyes & mouth, shoulders & hip muscles become weak.

Symptoms:
The first symptoms usually appear between 3 to 5 year.
• Fatigue
• Muscle weakness: proximal muscles are affected first, later on distal muscles.
• Difficulty in walking, running, jumping
• Frequent falls
• Trouble in getting up from a lying position.
• Loose of muscle coordination.
• Waddling gait – walking like duck
• Gower’s sign – take support while standing from sitting
• Muscle atrophy – as the muscles are damaged it shrinks
• Pseudo hypertrophy – the muscles is replaced by fat & connective tissue, so it become
larger.
• Breathing difficulties
• Drooping eyelids
• Scoliosis (curvature of the spine & back)

Complication:
• Common complications are • Scoliosis
• Cardiac arrhythmias • Pulmonary infections
• Joint contractures • Mental retardation
• Osteopenia

Treatment:
There is no specific treatment for any of the forms of muscular dystrophy but significant way
is being made with –
Low intensity anabolic steroids, prednisone supplements may help to prevent contractures
and maintain muscle tone.
Physical therapy, aerobic exercise
Occupational therapy – self feeding, self-care activity etc.
Orthoses / orthopaedic appliances used for support. E.g., braces → slowing the progression of
contractures mobility aids like canes, walker and wheel chairs can help maintain mobility and
independence
Myotonia occurring in myotonic MD may treated with medications such as quinine
phenytoin.

70
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Inactivity and body building efforts,
Genetic counselling:
Education about the disorder
Coordination and explanation of genetic testing
Emotional counselling.

Surgery:
Surgery might be needed to correct contractures or a spinal curvature that could eventually
make breathing more difficult.
Heart function may be improved with a pacemaker or other cardiac device

Ayurvedic management:
No disease explained in ayurveda can be directly correlated with muscular dystrophy.
When the pathogenesis and symptoms of MD are translated into ayurveda it can be
understood on the lines of one or more of below mentioned conditions.
Mainly correlated as per symptoms is ‘mamsashosha’ where MD is due to imbalance vata
dosha and sapta dhatu. Vitiation in agni of any of these dhatu leads to improper absorption of
nutrients which result in weakness

Other ayurvedic concepts –

• Aadibala pravrita rogas • Mamsa kshaya
• Mamsa pradoshaja vikara • Mamsa gata vata
• Snayu sira kandara upadhatu • Mamsa dhatu avarana
pradoshaja

Aim of chikitsa:
• Vata shamana
• Kapha vardhana
• Amapachana, deepana
• Mamsa dhatu pushtikara

Abhyanga: mahamasha taila, bala -ashwagandhadi taila

Swedana:
Shastika shali pinda sweda → reduce pain and stiffness and increase muscle strength

Basti: brimhana basti, ajarakta basti, ksheera basti

Nasya: brimhana nasya with ksheerabala taila, dhanwantara taila

In severe condition → rajyakshma chikitsa

Brimhana chikitsa → aja dugdha, mamsa rasa sevana

71
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Useful formulations:
• Dashamoola kashaya • Chyavanaprasha
• Vaiswanara churna • Brahma rasayana
• Shatpala ghrita • Pravala bhasma
• Dashmoola siddha ghrita with peya • Shilajeetwadi vati
/ mamsarasa. • Brimhana Mahakashaya
• Ashwagandhadi leha • Mrit sanjeevani sura

Useful herbs:
• Ashwagandha • Guduchi • Musta
• Bala • Guggulu • Triphala

Preventive aspect:
• Nidana parivarjana
• Masanumasika garbhini charya (5th month)
• Ksheera sarpi
• Shashtika odana with peyas
• Protect agni to cause doshapaka & prevent dhatupaka.
• Ojoskara, rasayana

MYASTHENIA GREVIS
Myasthenia gravis comes from the Greek and latin words meaning grave muscular weakness.
Myasthenia gravis is a chronic autoimmune neuromuscular disorders that affecting the
myoneural junction, is characterised by fluctuating weakness of voluntary muscle groups.

Causes:
By circulating antibody block acetylcholine. It is an autoimmune disorder, in which weakness
is caused by circulating antibodies that block acetylcholine receptors at the post synaptic
neuromuscular junction inhibiting the excitatory effects of the neurotransmitter acetylcholine
throughout neuromuscular junctions.
Idiopathic
Auto antibodies that destroy acetyl choline receptors.
Thymus tumours found in 15% of patients

Symptoms:
Affects any of the muscles that control voluntarily, certain muscle groups are more
commonly affected than others – eye, face, throat, neck, limb muscles
The hallmark of myasthenia gravis is fatigability.
Fluctuating weakness increased by exertion – weakness increases during the day and
improves with rest.

72
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Extraocular muscle weakness:
Ptosis is present initially in 50% of patients and during the course of disease in 90% if
patients.
Head extension and flexion weakness
Weakness may be worse in proximal muscles.
Dysarthria
Dysphagia
Diplopia
Nasal – sounding speech

Diagnosis:
• History
• Physical examination
• Edrophonium test
• Blood analysis
• Repetitive nerve stimulation
• Single fiber electromyography
• Imaging scans

Treatment:
• Non-pharmacological management:
• Eat small meals and snacks 5 – 6 times a day
• Avoid using low fat or diet products
• Avoid eating chewy or dry foods.

Pharmacological management:
• Immunosuppressive therapy • Neostigmine bromine
• Prednisone • Edrophonium chloride
• Azathioprine • Plasmapheresis:
• Acetylcholinesterase inhibitors: • Immunoglobulin therapy
• First line of therapy

Surgical management:
Thymectomy: surgical removal of the thymus gland; can produce antigen specific
immunosuppression and result in clinical improvement.

Ayurvedic management:
Vatavyadhi chikitsa, asthimajjagata vata chikitsa, Ardita chikitsa and avarana concepts were
applied for diagnosis and treatment.
Nasya, basti chikitsa were planned accordingly
Vatakaphahara, dhatwagni vardhana, brimhana and snehana dravyas were used in
management.

73
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
MOTOR NEURON DISEASES
Motor neuron diseases are a group of neuro-degenerative disorders that affects the nerves in
the spine and brain to progressively lose its function.
They are rare but serious and incurable form of progressive neurodegeneration.
It is condition that selectively affects the motor system, the cells which control voluntary
muscles of the body.
It is defined as a progressive disease that involves degeneration of the motor neurons and
wasting of the muscles.

Pathophysiology:
Motor neurons are two kinds of viz.
1. Upper motor neurons (UMN) 2. Lower motor neurons (LMN)
UMN are in the brain. They send message from brain to spinal cord.
LMN are in the spinal cord. They transmit the messages from spinal cord to muscles.
As nerve cell die, when MND occurs, electrical messages can’t get from brain to muscles and
muscles waste away, known as atrophy.
When this happens, it leads to lose control over movements. It gets harder to walk, talk,
swallow and breathe.

When there are the disruptions in the signals between the LMN & muscles → muscles do not
work properly → muscles gradually weaken & may begin wasting away → develop
uncontrolled twitching (called fasciculation)

When there are disruptions in the signals between UMN & LMN → the limb muscles
develop stiffness
Movement become slow & effortful
Tendon reflexes such as knee & ankle jerks become overactive.
The ability to control voluntary movement can be lost.
They are generally progressive in nature, and can cause progressive disability and death.

Classification:
There are five recognized subtypes of motor neurine diseases.
The bulbar region in the table below refers to the mouth, face a throat.
Type UMN degeneration LMN degeneration
ALS (Amyotrophic lateral Yes Yes
sclerosis)
PLS (Primary lateral Yes No
sclerosis)
PMA (progressive muscular No Yes
atrophy)
PBP (progressive bulber No Yes – bulber region
palsy)
Pseudo – bulber palsy Yes- bulber region no

74
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Causes:
Exact 90% MNDs are ‘sporadic’.
Meaning that the patient has no family history of ALS.
Approximately 10% of cases are ‘familial MND’.

Symptoms:
MND can be divided into three stages – early, middle and advanced

1. Early stage:
Symptoms develop slowly and can be confused with symptoms of other neurological
diseases.
Early symptoms depend upon which body system is affected first.
Typical symptoms begin in one of three areas: the arms, legs, mouth or respiratory system.
They include:
A weakening grip, making it hard to pick up and hold things.
Fatigue difficulty swallowing
Muscle pains, camps, twitches
Weakness in the arms & legs
Trouble breathing or shortness of breath.

2. Middle stage:
As condition progresses, symptoms become more severe.
Muscle pain & weakness increase and spasms & twinges worsen
Limbs muscles becomes weaken & starts to shrink, and become abnormally stiff.
Movement is difficult
Eating, drinking & swallowing become harder
Speech problem worsen
Person may show changes in personality and emotional state.
Secondary symptoms include insomnia, anxiety & depression

Advanced stage:
Eventually, the patient will be unable to move, eat or breathe without assistance.
Without supportive care, an individual will pass away.

Diagnosis:
• Blood test, urine test
• MRI
• EMG
• Lumber puncture / spinal tap
• Muscle biopsy
• Transcranial magnetic stimulation

75
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Treatment:
Currently there is no cure for ALS.
Two drugs are currently approved for ALS. Riluzoe or rilutek.
Muscle cramps & stiffness can be treated with physical therapy & medications, such as
botulinum toxin (BTA) inj.; BTA blocks the signals from the brain to stiff muscle.
Speech and language therapy
Occupational therapists, dieticians, respiratory therapists, social workers, palliative care
specialists, psychologists can slow the progress of disease.

NEURALGIA
Neuralgia is a stabbing, burning and often quite severe pain that accounts along a damaged
nerve.
The damaged nerve may be anywhere in the body, but is most common in the face and neck.

Causes:
• Infection like shingles • Diabetes
• Multiple sclerosis • Result of old age
• Pressure on nerves

Types:
1. Postherpetic neuralgia (PHN)
Occurs as complication of shingles
Characterised by painful rash & blisters
2. Trigeminal neuralgia:
Pain from trigeminal nerve
Characterised by pain in face, usually one side
3. Glossopharyngeal neuralgia:
Pain from glossopharyngeal nerve from throat.
Pain in neck & throat.
4. Supraorbital neuralgia / swimmer’s headache:
Damage of supraorbital nerve, severe headache
5. Occupational neuralgia:
Damage of occipital nerve
Pain in upper neck, back of head, behind eyes

Treatments:
• Surgery to relieve the pressure on the nerve.
• Control of blood sugar levels
• Physical therapy
• Nerve block by injection of medicines
• Medications to relieve pain.

76
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)

KAYA CHIKITSA

PAPER 2

PART B

77
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)

1. Chikitsa Sutra and Management of Mamsavaha Srotas and Medovaha

Srotas such as- Gandamala, Galaganda, Mamsashosha, Arbuda,
Apachi, Prameha, Sthaulya, Karshya, Diabetes Mellitus,
Dyslipidaemia.

MAMSAVAHA SROTAS
Nidana:
अभभष्यन्दीनन भोज्यानन स्थल
ू ानन ि गरू
ु णर् ि |
मांसवाहीनन दष्ू यच्न्त भुक्त्वा ि स्वपतां हदवा ||

Lakshanas:
अचिमांसाबुणदं कीलं गलशालूक शुंडडके |
पूनतमांसालजी गण्डगन्डमालोपच्जडिका ||

Chikitsa:
मांसजानां तु संशवु ि शस्त्र क्षाराच्ननकमण ि |

GANDAMALA
Gaṇḍamālā is the condition in which Kapha Doṣa along with association of Vāta and Pitta,
vitiates Meda Dhātu leading to a series of glandular swellings in axillae, shoulders and neck
region.

Nidāna: Divāsvapna, Meda vṛddhikara Āhāra, Duṣṭa Ambupāna

Chikitsā:
Pathya: Vamana, Virechana, Svedana, Vairechanika Dhūmapāna, Sirāvyadha, Agnikarma,
Kṣāra, Pralepa, Laṅghana, Purāṇa Ghṛta pāna, Guggulu, Shilājatu
Rakta Shāli, Yava, Mudga, Paṭola, Rakta Shigru, Rūkṣa Kaṭu Dravya, Dīpana Dravya

Apathya: Kṣīra, Ikṣu, Māṁsa, Piṣṭānna, Amla Madhura Guru Abhiṣyanda Dravya
• Kāñchanāra Guggulu
• Bhallātakādi Lepa
• Gandhakādi Lepa
• Nasya with either one of the following: Nirguṇḍī mūla, Nimba taila, Vachā and
Pippalī with Madhu

CERVICAL LYMPHADENOPATHY
Cervical lymphadenopathy refers to a local form of lymphadenopathy in which only the
lymph nodes in the cervical area are enlarged.
It is an acute condition, common in children.

78
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Causes:
• Staphylococcus infections
• Streptococcal pharyngitis
• Cat scratch diseases: Bartonella henselae bacteria
• Viral respiratory infections; bronchitis, common cold, etc.
• Ear infection, Tonsillitis, Chickenpox, Cancer

Symptoms:
• Swollen lymph nodes, prolonged tenderness and pain
• Fever, Runny nose
• Sore throat
• URT infections
• Weight loss

Diagnosis:
CBC, CT scan, PET, Lymph node biopsy, Chest radiography

Management:
• Antibiotics: Clindamycin, Trimethoprim, Sulfamethoxazole, Amoxicillin
• Antiviral, NSAIDs, Ibuprofen
• Adequate rest
• Symptomatic treatment for pain, fever, etc.
• Warm and wet compress
If the lymph nodes are swellings because of cancerous growth, treatment may include:
• Chemotherapy
• Irradiation therapy
• Lymphadenectomy

GALAGAṆḌA
The swelling which hangs like scrotum in the throat region is called Galagaṇḍa.

Samprapti:
Duṣṭa Kapha Doṣa along with Vāta Doṣa localize at throat region to vitiate Meda Dhātu and
cause Galagaṇḍa.

Bheda:
1. Vātaja
2. Kaphaja
3. Medoja

79
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Lakshana:
1. Vātaja Galagaṇḍa:
• Toda
• Kṛṣṇa-Sirā avanaddha (covered by a network of blackish veins)
• Kṛṣṇa / Aruṇa varṇa
• It may be rough and discharge pus
• Āasya Vairasya
• Tālu-Gala Shosha
• When associated with Medo duṣṭi, it grows slowly but gradually, is painless and
unctuous.

2. Kaphaja Galagaṇḍa:
• Savarṇa (same colour as the surrounding skin)
• Sthira, Alparuk, Kaṇḍū, Shīta
• Mahān (large swelling)
• Chiravṛddhi
• Āsya Mādhurya
• Tālu-Gala Pralepa

3. Medoja Galagaṇḍa:
• Snigdha, Mṛdu, Pāṇḍu varṇa
• Niruja, Atikaṇḍū
• Decrease or increase of Meda Dhātu influence the size of the swelling
• Snigdhāsyatā

Asadhya lakshana:
• Dyspnea
• Flaccid body
• Diseases is associated for more than a year
• If patient suffers from thirst, emaciation, and hoarseness of voice

Chikitsā:
Pathya: Vamana, Virechana, Svedana, Dhūmapāna, Sirāvyadha, Agnikarma, Kṣāra, Pralepa,
Laṅghana, Purāṇa Ghṛta pāna, Guggulu, Shilājatu
Rakta Shāli, Yava, Mudga, Paṭola, Rakta Shigru, Rūkṣa Kaṭu Dravya, Dīpana Dravya

Apathya: Kṣīra, Ikṣu, Māṁsa, Piṣṭānna, Amla Madhura Guru Abhiṣyanda Dravya
• Varuṇa mūlatvak kvātha with Madhu
• Kāñchanāra tvak kvātha with Shuṇṭhī chūrṇa
• Kāñchanāra tvak chūrṇa pounded with Taṇḍulodaka and mixed with Shuṇṭhī.

80
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
1. Vātaja:
Nāḍī Svedana with Vātahara Dravya
Nichulādi Lepa (Nichula, Shigru bīja, Dashamūla, Uṣṇodaka)
2. Kaphaja:
Upanāha Svedana with Kaphahara Dravya
Devadāryādi Lepa (Devadāru & Indravāruṇī)
Vamana, Shirovirechana, Virechana
3. Medoja:
External application of Sneha followed by Sirāvyadha
Kalka from Shyāmā-Trivṛt, Snuhī, Maṇḍūra Bhasma, Dantī, Rasāñjana
Khadira sāra Kvātha with Gomūtra for internal administration

GOITER
Diffuse enlargement of thyroid gland is called as goiter. It is derived from latin word gutter
means throat.

Incidence:
Physiological goiter occurs at puberty, pregnancy and menopause
25-35 years (Primary thyrotoxicosis)
35-45 years (Secondary thyrotoxicosis)
M: F = 8:1 (Thyrotoxicosis)
Toxic goiter is more common in persons working under stress and strain
Himalaya. vindhya, satpuda regions in India are known as goiter belts and porbandar is
iodine deficiency goiter belt.

Classification:
1. Simple goiter
• Puberty goiter (Diffuse hyperplastic)
• Colloid goiter (Iodine deficiency goiter)
• Multinodular goiter

2. Toxic goiter
• Grave’s disease (Diffuse toxic goiter)
• Secondary thyrotoxicosis (Plummers disease)
• Toxic nodule

3. Neoplastic goiter
• Benign tumour (Follicle adenoma) • Malignant tumour

4. Thyroiditis
• Granulomatous thyroiditis • Hashimoto’s autoimmune
• Riedel’s thyroiditis thyroiditis

81
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
➢ Simple goiter:
It is developed as result of increased levels of TSH. It is due to stimulation of thyroid gland
by the anterior pituitary. The main factor is iodine deficiency.

Types:
• Diffuse hypertrophic goiter: The goiter is soft, diffuse and may become large enough
to cause discomfort.
• Nodular goiter: Appear between 20-30 years of age. Usually multiple nodules, or
cellular degeneration. Hemorrhage and subsequent calcification occur. Due to
fluctuation in TSH level, leads to iodine deficiency.

Clinical features:
• Slow progressive disease with many years of history
• Swelling: Firm, nodular, non-tender and moves with deglutition
• Later hardness and irregularity due to calcification

Diagnosis:
• Thyroid function test (T3, T4, TSH) • Ultrasonography neck
• FNAC

Complications:
• Secondary thyrotoxicosis • Tracheal obstruction
• Follicular cancer of thyroid

Treatment:
• Early stage: Hyperplastic goiter may regress if Thyroxine is given daily for few
months
• Nodular stage: Irreversible. Operation is indicated on cosmetic grounds
• Subtotal thyroidectomy: 8 gm of thyroid is retained in each lateral lobe
• Total thyroidectomy: Entire gland is dissected

➢ Toxic goiter (Thyrotoxicosis or Hyperthyroidism):

Thyrotoxicosis: Biochemical and physiological manifestation of excessive thyroid hormone.
Hyperthyroidism: Over production of hormone by thyroid gland.

Types:
• Primary thyrotoxicosis/Diffuse toxic goiter (GRAVE’S DISEASE): Disease with
increased level of specific antibodies in blood (TSH receptor antibodies). A diffuse
vascular goiter usually in young women and frequently associated with eye sign, due
to abnormal thyroid stimulating antibodies.
• Toxic nodular goiter (Secondary thyrotoxicosis): A simple nodular goiter, usually in
middle age or elderly and eye sign absent
• Toxic nodule: A solitary overactive nodule. Thyroid is > 3 cm in size

82
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Clinical features:
• Loss of weight in spite of good appetite
• Tiredness
• Heat intolerance
• Thyroid swelling
• Exophthalmos
• Cardiac arrhythmias
• Unexplained behavioral problems
• Insomnia
• Myopathy
• Unexplained diarrhoea

Diagnosis:
• Sleeping pulse rate: 2 hours before the scheduled time of awakening
• X-ray neck AR, lateral view
• Thyroid hormone assay
• FNAC

Treatment:
• Rest & sedation
• Antithyroid drugs e.g., carbimazole
• Surgery: In diffuse toxic and toxic nodular goiter to reduce the mass of overactive
tissue below a critical level.
• Hemithyroidectomy
• Subtotal thyroidectomy
• Total thyroidectomy

MAMSASHOSHA
Mamsa kshaya and shosha can be considered as wasting of muscles.
Extreme weight loss and unnatural thinness due to a loss of subcutaneous fat and muscle
throughout the body leading to the condition emaciation.
This condition emaciation (wasting of muscles) is explained as a symptom in mamsavaha
srotas vidha lakshana.

CACHEXIA
It is term used to describe the stage of emaciation.
It is a multifactorial syndrome defined by an ongoing loss of skeletal muscle mass (with or
without loss of fat mass) that can be partially but not entirely reversed by conventional
nutritional support.

83
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Unexplained weight loss leading to emaciation, cachexia can be a symptom of a serious
condition or illness such as –
• Addison's disease (adrenal • Diabetes
insufficiency) • Heart failure
• Amyloidosis (build-up of abnormal • HIV/AIDS
proteins in organs) • Hypercalcemia
• Cancer • Hyperthyroidism (overactive
• Celiac disease thyroid)
• Changes in diet or appetite • Hypothyroidism (underactive
• Changes in sense of smell thyroid)
• Changes in sense of taste • Medications
• COPD • Parkinson's disease
• Crohn's disease • Peptic ulcer
• Dementia • Substance abuse (alcohol,
• Dental problems • Tuberculosis
• Depression (major depressive • Ulcerative colitis
disorder)

ARBUDA (TUMOUR)
Nirukti:
• Derived from arb dhatu means cause to death.
• Literally it is used to denote mountain.
• In Rigveda it is used to describe a demon like serpent.

Definition:
When granthi becomes too large, it is called arbuda.
Location, etiology, clinical features, involvement of Doṣa and Dushya, and treatment of
Granthi and Arbuda are identical. Arbuda is larger in size compared to Granthi.

Samprapti: same as granthi

Bheda:
1. Vātaja 3. Kaphaja 5. Māṁsaja
2. Pittaja 4. Raktaja 6. Medoja

Lakṣhana:
• Vṛtta (round) • Analpamūla (deep seated roots)
• Sthira (stable / fixed) • Chiravṛddhi (grows slowly)
• Mandaruja (mild pain) • Apāka (never suppurates)
• Mahānt (large)

Sādhyāsādhyatā:
Sādhya → Vātaja, Pittaja, Kaphaja, Medoja
Asādhya → Raktaja, Māṁsaja, Mahāmūla, Marmasthāna

84
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Adhyarbuda:
When an additional Arbuda grows over a pre-existing one, it is known as Adhyarbuda or
Dvandvaja Arbuda.

Dvirarbuda:
When two Arbuda grow simultaneously or one soon after the other, it is known as
Dvirarbuda.

Treatment: Same as Granthi

1. Vataja arbuda:
Repeated raktamokshana by shrunga
Nadi sweda
2. Pittaja arbuda:
Raktavisravana with jalauka
Mrudu sweda
Upanaha sweda
Virechana
3. Kaphaja arbuda:
Raktamokshana by alabu
Maggot therapy
4. Alpamula arbuda chikitsa:
Base is encircled with sheets of tin, copper, lead or iron
The physician should apply kshara, agni and shastra many times without any hesitation.
avoiding risk to patient's life
Vrana shodhana by decoction of asphota, jati and karvira leaves.
5. Medoja arbuda chikitsa:
Fomented and incised
Drained out blood and cleaned the wound
Sutured
Apply kalka of haridra, lodhra, patanga, haratala and manahshila with plenty of madhu

Krimi chikitsa in Kaphaja arbuda:

Paste of nispava, oil cake and kulattha with plenty of meat, goghrita, and buttermilk should
be applied over the tumour so that flies may be attracted to it and produce worms. After the
worms have consumed most of the tumour, the remnant should be scraped and perform dahan
karma.

85
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
TUMOURS (NEOPLASM)
Definition:
A tumour is a new growth consisting of cells of independent growth arranged atypically and
serves no function. Cells proliferate without relation to the needs of body. The most
important two processes which plays part are abnormal reproduction and abnormal
differentiation.

Types:
1. Benign or Innocent tumours: Growth of mass of cell may be stopped and there is no
tendency to invade surrounding tissue. It is subdivided as follows
• Papilloma • Chordoma • Neuroma
• Lipoma • Fibroma
2. Malignant tumours: Growth of cell mass continuous and proliferation is an atypical
and relentless way. It is subdivided in to Carcinoma and Sarcoma.
Carcinoma Sarcoma
It arises from epithelium-ectodermal (skin It arises from soft tissues or bone and are
cancer), endodermal (Gut cancer) or derived from mesoblast or mesenchymal
mesodermal (Renal cancer) in origin. tissue.

Etiology:
Cancers are caused by abnormalities in the genetic material of the transformed cells.
1. Mutation: Chemical carcinogen
2. Mutation: Ionizing radiation
3. Viral or Bacterial Infection
4. Hormonal imbalances
5. Immune system dysfunction
6. Hereditary
7. Other causes, such as trans-placental from mother to foetus, unhealthy diet

Risk factors:
Tobacco, Overweight, Obesity, Unhealthy diet, Lack of physical activity, Alcohol, Sexual
transmitted infection, Ionizing and non-ionizing radiation, Urban air pollution, Exposure to
indoor smoke from household use of solid fuels

Mode of spread:
• Blood stream
• Lymphatic drainage
• Both
• Direct spread

86
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Signs & Symptoms:
1. Local
Unusual lump / swelling, hemorrhage, pain, ulceration, compression of surrounding tissues
2. Metastatic
Enlarged lymph nodes, cough, haemoptysis, hepatomegaly, bone pain, fracture of affected
bone, neurological defects
3. Systemic
Weight loss, poor appetite, fatigue, night sweats, anemia, etc.

Pathogenesis:
Causes → Cell proliferation: uncontrolled & uncoordinated cell division or replication →
Angiogenesis: new vascular tree grows to supply oxygen & nutrients to neoplastic cells →
Growth: continuous cell proliferation leads to formation of lump / mass → Metastasis →
Growth: cell proliferation of secondary tumour

Investigation:
Biopsy
FNAC (Fine Needle Aspiration Cytology)
Tumour markers
Polymerase Chain Reaction (PCR)

Treatment:
Primary treatment:
The goal of a primary treatment is to completely remove the cancer from the body or kill all
the cancer cells.
Any cancer treatment can be used as a primary treatment, but the most common primary
cancer treatment for the most common types of cancer is surgery. If the cancer is particularly
sensitive to radiation therapy or chemotherapy, one of those therapies may be chosen as
primary treatment.

Adjuvant treatment:
The goal of adjuvant therapy is to kill any cancer cells that may remain after primary
treatment in order to reduce the chance that the cancer will recur.
Any cancer treatment can be used as an adjuvant therapy. Common adjuvant therapies
include chemotherapy, radiation therapy and hormone therapy.

Palliative treatment:
Palliative treatments may help relieve side effects of treatment or signs and symptoms caused
by cancer itself. Surgery, radiation, chemotherapy and hormone therapy can all be used to
relieve symptoms. Other medications may relieve symptoms such as pain and shortness of
breath.

Cancer treatment options include:

Surgery:
The goal of surgery is to remove the cancer or as much of the cancer as possible.

87
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Chemotherapy:
Chemotherapy uses drugs to kill cancer cells.

Bone marrow transplant:

A bone marrow transplant, also known as a stem cell transplant, can use one’s own bone
marrow stem cells or those from a donor. A bone marrow transplant allows the use of higher
doses of chemotherapy to treat cancer. It may also be used to replace diseased bone marrow.

Radiation therapy:
Radiation therapy uses high-powered energy beams, such as X-rays or protons, to kill cancer
cells. Radiation treatment can come from a machine outside the body (external beam
radiation), or it can be placed inside the body (brachytherapy).

Immunotherapy:
Immunotherapy, also known as biological therapy, uses the body's immune system to fight
cancer. Cancer can survive unchecked in the body because the immune system does not
recognize it as an intruder. Immunotherapy can help the immune system "see" the cancer and
attack it.

Hormone therapy:
Some types of cancer are fueled by the body's hormones. Examples include breast cancer and
prostate cancer. Removing those hormones from the body or blocking their effects may cause
the cancer cells to stop growing.

Cryoablation:
This treatment kills cancer cells through extreme coldness. During cryoablation, a thin, wand-
like needle (cryoprobe) is inserted through the skin and directed into the cancerous tumor. A
gas is pumped into the cryoprobe in order to freeze the tissue. Then the tissue is allowed to
thaw. The freezing and thawing process is repeated several times during the same treatment
session in order to kill the cancer cells.

Radiofrequency ablation:
This treatment uses electrical energy to heat cancer cells, causing them to die. During
radiofrequency ablation, a thin needle is guided into the cancer tissue. High-frequency energy
passes through the needle and causes the surrounding tissue to heat up, killing the nearby
cells.

88
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
APACHI
Apachī is the condition in which there is chronic presence of Gaṇḍamālā, glandular swelling
in axillae, shoulders & neck region. It is mainly due to vitiated Kapha and Meda.

Lakṣhaṇa:
• The lumps are Sthira, Vṛtta, Snigdha
• Alparuja, Kaṇḍū
• The swelling grows steadily, but slowly
• When injured, the lumps start suppurating and discharging pus. The swelling
disappears and recurs at another location in the body.

Treatment:
• Agnikarma: By making three linear incisions above the wrist, at a distance of one
angula between each.
• An incision is made in the leg, 12 fingers from heel avoiding the vital part named
indravasti, remove the retinaculum similar to the of fish and apply dahan karma.
• During healing stage, kshara prepared from peacocks, crows, godhas, snakes and
tortoises should be mixed with oil of ingudi is used
• Vairechanik dhuma
• Regular diet of barley and mudga

CERVICAL LYMPHADENITIS
Inflammation of lymph node in cervical region

Source of infection:
Nasal and oral cavity, larynx, pharynx, ear, scalp etc.

Types:
1. Acute
2. Chronic
3. Tuberculous

1. Acute lymphadenitis 2. Chronic lymphadenitis

• Affected lymph nodes are enlarged and • Painless
tender • In children/adults may be tuberculous
• Pyrexia, general malaise • In elderly due to secondary malignant
• Appropriate antibiotics metastasis
• If abscess occurs go for I & D

89
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
3. Tuberculous lymphadenitis:
• Commonly seen in children and young adults
• Deep upper cervical lymph nodes are commonly involved, but due to widespread
lymphadenitis, matting together of numerous lymph nodes is evident
• These caseated lymph nodes enlarged and result in formation of cold abscess
• Gradually pus drains out through skin resulting in chronic discharging sinus called as
collar stud abscess.
• Treated with ATT
• Drainage of abscess and excision of surrounding lymph nodes

PRAMEHA
In ayurvedic texts prameha is defined to be characterised with excessive urination (both in
frequency & quantity) and turbidity. The nature of the turbidity may vary depending upon the
body reaction with the doshas.

Nidana:
आस्यासुखं स्वप्नसुखं दिीनन ग्राम्योदकानूपरसाः पयांभस |
नवान्नपानं गुडवैकृतं ि प्रमेह हे तुः कफ़ेकृछि सवणम ् ||
Addiction to the pleasures of lounging and sleeping.
The excessive use of curds.
Meat juice of domestic, aquatic and wet-land animals.
Milks, new grains, and drinks & products guda and all things that increase kapha are the
causative factors of prameha.

Purvarupa:
• Excessive sweating with foetid odour.
• Flabbiness of body
• Sedentary habits
• Excessive mucosal discharge
• Rapid growth of hairs & nails.
• Sweetness of mouth
• Burning sensation in hands & feet.
• Swarming of ants on the urine.

Bheda:
Etiological classification (sushruta):
1. Sahaja prameha:
Family history
Early onset
2. Apathyanimittaja prameha:
Over nutrition
Sedentary habits
Obese

90
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Clinico-pathological classification:
1. Kaphaja prameha:
There are 10 types of kaphaja prameha.
Early diabetes –
1. Udaka meha → urine resembling water
2. Ikshu meha → urine resembling sugarcane juice
3. Sandra meha → urine having high density
4. Sandra prashada meha → high density in lower layer of urine
5. Shukla meha → urine having white colour
6. Sukra meha → urine containing seminal fluid
7. Sheeta meha → urine with cold touch
8. Sikta meha → urine containing sand like particles
9. Sanaih meha → urine passing out slowly
10. Lalameha → urine containing slimy material like saliva

2. Pittaja prameha:
6 in number
Acute diabetes
1. Kshara meha → urine resembling the solution of alkalies
2. Kala meha → urine having black colour
3. Neela meha → urine having blue colour
4. Haridra meha → urine having yellow colour like haridra
5. Manjistha meha → urine having reddish colour like Manjistha
6. Rakta meha → urine having blood in it

3. Vataja prameha:
4 in number
Chronic diabetes
1. Majja meha → urine mixed with majja or bone marrow
2. Vasa meha → urine mixed with vasa or muscle fat
3. Hasti meha → urinates more in quantity like an elephant
4. Madhu meha → urine mixed with ojas.

Therapeutic classification based on body constitution

1. Sthula pramehi:
Santarpana janya prameha
Manageable with diet control and exercise
Correlated with non-insulin dependent diabetes mellitus (NIDDM)
2. Krisha pramehi:
Apatarpana janya prameha
Not manageable with diet control alone rather requires nutritive treatment (brimhana chikitsa)

Samprapti:
Dasha dushya:
Rasa, rakta, mamsa, meda, majja, sukra, oja, ambu, vasa, lasika

91
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Samanya lakshanas:
General symptoms of all types of prameha are increased quantity of urination with turbid
urine, resulting in excess thirst.

Sadhyasadhyata:
Sadhya (manageable)
Apathyanimittaja prameha (NIDDM)
Kaphaja prameha (early diabetes)
Sthula prameha (obese diabetes)

Yapya (palliative):
Pittaja prameha (acute diabetes)

Asadhya (unmanageable):
Sahaja prameha: (IDDM)
Vataja prameha: (chronic diabetes)
Krisha pramehi (asthenic diabetes)

Chikitsa:
Treatment is based upon the nature of the individuals in obese (sthoola) and lean (krisha). In
obese patients, purification is carried out first and later santarpana is followed. The disease is
controlled by wholesome diets & habits.
In lean patients, brimhana (tissue nourishment) is carried by selective medicines and diet.
Other than this all the pramehas are treated based upon dosha dominance.

Shodhana chikitsa in sthoola & balavana pramehi:

• Nidana parivarjana
• Abhyantara snehana with triphala ghrita or pippali ghrita
• Swedana is contraindicated
• Tikshna vamana & virechana
• Tikshna, ushna, ruksha basti according to dosha e.g., mustadi payanabasti,
madhutailika basti, prameha hara Asthapana basti
• Anuvasana basti is indicated in sthoola pramehi because it is nourishing type of basti.
• Kapha medo hara chikitsa
• Takrarista
• Mustadi kwatha

Shamana chikitsa in krisha & durbala prameha

• Nidana parivarjana
• Santarpana chikitsa: rasayana & vajikarana yoga
• Mantha, kashaya, avaleha, yavanna with madhu
• Salasaradi gana kwatha bhavita shilajatu
• Abhyanga, pradeha, parisheka
• Manasika and sharirika vishrama

92
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Common medicine used in prameha:
• Nyagrodhadi churna • Vidangadi kwatha
• Eladi churna • Phalatrikadi kwatha
• Mustadi kwatha • Vasantasukumar rasa
• Shilajatu • Chandraprabha vati
• Shilajatvadi vati • Madhuka

Doshanusara chikitsa:
1. In kaphaja prameha:
Apatarpana should be done in santarpanajanya prameha and then after vamana, santarpana
should be done.
Mantha, kashaya or leha of yavachurna
Haridra churna and madhu with amalaki swarasa
Kapha pramehanashaka ten kashaya yoga –
1. Parijata kashaya
2. Vaijanti kashaya
3. Nimba kashaya
4. Chitraka kashaya
5. Khadira kashaya
6. Haridra kashaya
7. Daruharidra kashaya
8. Saptaparna kashaya
9. Kasheru kashaya
10. Haritaki kashaya
In meda vriddhi → triphala, guduchi, shilajatu, madhu etc. should be used.

2. In pittaja prameha:
After virechana, santarpana should be done
Pittaja pramehanashaka ushira kashaya, lodhra kashaya

3. Vataja prameha:
Sneha processed with kapha-pitta pramehanashaka medicines

Pathyapathya:
Pathya:
The best foods to eat are those that are not sweet not too oily, have the ability to mitigate
kapha, meda and nourishing.
Ushna diet is recommended since it will ease kapha, normalize vata, and stimulate pitta to
intensify digestion.
In the diet importance should be given to yava.
Other spices with antidiabetic are haridra, dhanyaka, jeeraka, Rasona, methika, ela etc.
Ayurveda recommends use of anupana along with diet and any herbs that are being utilized
like: sarodaka, kushodaka.

93
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Vihara:
Regular exercise, including brisk walk, jogging, sports and so on.
Patients are advised to do yoga, pranayama which highlight the development of positive
attitude and decrease anxiety and stress

Apathya:
Ahara:
Navanna pana, dadhi, ghrita, Sharkara, dugdha, anupa mamsa, adhyasana
Vihara:
Avoid laziness and sedentary lifestyle. Swedana, raktamokshana

Upadrava:
1. Trishna 4. Putimamsa 7. Daurbalya
2. Daha 5. Prameha pidika 8. Ajirna
3. Arochaka 6. Atisara 9. Vidradhi

Prameha pidika:
1. Saravika 4. Sarshipi 7. Vidradhi
2. Kachchapika 5. Alaji
3. Jalini 6. Vinata

DIABETES MELLITUS
Diabetes mellitus is a chronic disorder of carbohydrate, fat and protein metabolism, with a
relative or absolute deficiency in insulin secretory response resulting in hyperglycaemia.

Types:
1. Type 1 DM
It results from the pancreas’ failure to produce enough insulin
Also called ‘insulin dependent diabetes mellitus’ (IDDM) or ‘juvenile diabetes’
2. Type 2 DM
It begins with insulin resistance, a condition in which cells fail to respond to insulin properly.
Also called ‘non-insulin dependent diabetes mellitus’ (NIDDM) or ‘adult-onset diabetes’.
The most common cause is excessive body weight and insufficient exercise.
3. Gestational DM:
When pregnant women without a previous history of diabetes develop high blood sugar
levels.
Clinical features:
Classic hyperglycaemic triad → polyuria, polydipsia, polyphagia
Weight loss
Blurred vision
Genital itching
Delayed wound healing

94
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Treatment:
Diet control
Daily exercise & life style modifications.
Medications:
Insulin injections for type 1 DM
Metformin / insulin for type 2 DM
Mass education / counselling to the patient.
Diabetes mellitus is correlated with an ayurveda disease called madhumeha.

STHAULYA
स्थूल पररबह
ृ र्े the word sthoola donates the meaning of paribrimhana or vriddhi. Hence
sthaulya means over weight (ati sthoola) or excess accumulation of body fat.

Nidana:
Lack of exercise
Sleeping at day time
Intake of foods which increase kapha dosha
Excessive sleep
Hereditary

Samprapti:
Due to above factors the annarasa becomes sweet by not getting digested and thereby results
in accumulation of sneha and meda. The accumulation of meda blocking the other tissue
channels, the successive dhatus (bone, marrow, shukra) do not get nourishment and they fail
to develop properly. It leads to more accumulation of meda.

Lakshanas:
• Short life span
• Inability to work
• Loss of libido
• Weakness
• Foul odour of the body
• Excess sweating
• Excess appetite
• Excess thirst

Complication:
One indulges in continues kapha increasing foods, the agni gets weakened and the resultant
ahara paka becomes madhura, there by resulting in ama. Formed madhura rasa gets adhered
to the inner coatings of the annavaha srotas. Hence, though the annavaha srotas is supposed
to be predominant with the activities of pitta, it starts experiencing vidaha within its channels
and thus starts exhibiting the pathological features of ama.

95
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
This ama causes sthaulyajanya rogas which are –
• Prameha • Kamala • Uccha raktachap
• Arsha • Atisara • Sandhivata
• Bhagandara • Visarpa • Katigraha
• Jvara • Slipada • Apachi etc.

Chikitsa:
• Nidana parivarjana • Karshana
• Guru apatarpana chikitsa

Samshodhana:
• Vamana • Niruha basti
• Virechana • Karshana nasya prayoga

Samshamana:
• Vadavagni rasa • Phalatrikadi kwatha
• Medohara vati • Medohara guggulu
• Bhedani vati • Guggulu rasayana
• Triphala churna • Shilajatu rasayana
• Vidangadi churna • Amalaki rasayana

Swedahara & daurgandha nashaka lepa → shirishadi lepa, haritakyadi lepa

Yogasana: surya namaskara, Sarvangasana, mayurasana, pranayama etc.

Pathya:
Purana shali, mudga, yava, kulattha, patola, Shigru, takra, ela, sarshapa taila, ushnodaka,
langhana, udvartana, vyayama, chankramana, atapa sevana

Apathya:
Nava dhanya, godhuma, masha, dugdha, dadhi, mamsa, matsya, guda, Diwaswapna,
sukhashadhya.

KARSHYA
The word ‘karshya’ is derived from ‘krusha’.
It is a disease characterised by atikrushata that means excess leanness or emaciation.

Nidana:
• Ruksha annapana sevana • Ativyayama
• Langhana • Vamanadi panchakarma atiyoga
• Alpabhojana • Sahaja or kulaja karana
• Vatavardhaka ahara sevana

96
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Lakshana:
• Thinner thighs, abdomen and neck.
• Appearance of vascular network on skin.
• Skinny and skeletal appearance of the body
• Tiredness
• Intolerable to heat and cold
• Always suffering from diseases

Upadrava:
Plihavriddhi, kasa, shwasa, gulma, rajyakshma

Chikitsa:
Nidana parivarjana

Samshodhana:
• Bahya & abhyantara snehana • Brimhana basti
• Anuvasana basti • Brimhana nasya prayoga

Balya & brimhana dravya chikitsa:

Dugdha, ghrita, mamsarasa, bala, atibala, ashwagandha, lasun, amalaki, kharjura

Samshamana drugs:
• Kshudhasagar rasa • Shatavari churna
• Agnitundi vati • Ashwagandha churna
• Chitrakadi vati • Bala taila
• Chandraprabha vati • Chyavanprasha
• Arogyavardhini vati

Pathya:
• Navanna • Dugdha, dadhi, ghrita, ikshu
• Gramya anupa & jangala mamsa • Shastika shali, godhuma
rasa • Rasayana & vajikarana dravya

Apathya:
• Katu tikta kashayarasa pradhana • Yava, chanak, shigaru
dravya • Ativyayama
• Rukshana • Atisanshodhana etc.

DYSLIPIDAEMIA
Dyslipidaemia is an abnormal amount of lipids in the blood.
Lipids, or fat, are building blocks of the life and provide energy to cells.
Lipids include: LDL cholesterol, HDL cholesterol, triglycerides

97
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Types:
Hyperlipidaemia → lipids
Hyperlipoproteinemia → lipoproteins

Symptoms:
Severe or untreated dyslipidaemia can lead to other conditions, including coronary artery
disease (CAD) and peripheral artery disease (PAD).
Common symptoms of these conditions include –
Leg pain, especially when walking or standing
Chest pain, pressure in the chest
Sleep problems and daytime exhaustion
Dizziness
Fainting

Treatment:
Lifestyle changes such as exercising and eating a healthy diet.
Statins
Bile acid binding resins
Cholesterol absorption inhibitors

Ayurvedic management:
In ayurveda, dyslipidaemia denoted as medoroga.

Use of lekhaniya dravya:

The drugs that have a depleting effect on the body are known as lekhaniya dravya.
Medohara dravya is compared with hypolipidemic agents
Drugs having katu vipaka are said to be lekhaniya drugs.

Guggulu → Use of guggulu as treatment of high levels of lipid in the blood.

Arjuna → arjunarista is very effective in reducing high levels of blood cholesterol.
Amalaki → supplementation of the diet with amalaki. It effects on serum cholesterol and its
lipoprotein fractions.
Sarpagandha → reducing blood pressure

98
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)

2. Chikitsa Sutra and Management of ‘Asthi and Majjavaha Srotas such

as Asthimajja Vidradhi, Asthisoushirya, Asthi kshaya, Sandhigata
Vata, Osteo Arthritis, Osteomyelitis, Osteoporosis, Osteopenia.

ASTHI MAJJA VIDRADHI

The aggravated dosha vitiate the tvaka, rakta, mamsa and meda getting sthanasamsraya in
asthi. When there is suppression process in the asthi & majja, the pus fails to find an outlet
and thus results in severe burning pain.

Chikitsa:
It is pratyakhyey that means the physician can treat it without holding any definite hope of
recovery.
In pakwa Vidradhi → incision & drainage of pus
In apakwa Vidradhi → vrana shodhana by tilwaka ghrita or Trivrutadi gana kwatha siddha
ghrita.
Vrana ropana by priyangwadi taila.

Shamana aushadhi:
• Panchatiktaghrita guggulu • Swarna bhasma
• Triphala guggulu • Jatyadi taila
• Sanjivani vati

OSTEOMYELITIS
Osteon → bone
Myelo → marrow
Itis → inflammation
Osteomyelitis is the inflammation of the bone caused by an infecting organism, which spread
to the bone marrow, cortex, periosteum and soft tissue surrounding the bone.

Types:
1. Acute pyogenic osteomyelitis
2. Subacute osteomyelitis → Brodie’s abscess
3. Chronic osteomyelitis → chronic pyogenic osteomyelitis, tuberculous osteomyelitis.

Aetiopathogenesis:
• Staphylococcus aureus is common causative organism. These organisms reach bone
via blood circulation.
• The bacteria as they pass through bone, get lodged in the metaphysis.
• The host bone initiates an inflammatory reaction in response to the bacteria.
• This leads to bone destruction and production of an inflammatory exudate & pus.
• Once sufficient pus forms in the medullary cavity, it spreads to sub periosteally,
muscle, where it can be felt as an abscess.
• Then abscess. If untreated then bursts out of skin forming discharging sinus.

99
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Clinical features:
• Pain & swelling as the end of a bone.
• Painful movements
• Fever with chills
• Dehydration

Treatment:
• Incision and drainage of pus
• Antibiotics
• Analgesics & anti-inflammatory drugs.

ASTHISOUSHIRYA
Asthi soushirya is not mentioned as a separate condition but in majjakshaya symptoms
vagbhata elaborate the term soushirya.
soushirya means ‘with pores’.
Asthi soushirya means ‘porous bones’.

OSTEOPOROSIS
Osteoporosis, which literally means porous bone, is a disease in which the density and quality
of bone are reduced.
It is characterized by thinning of the bones, with reduction in bone mass, due to depletion of
calcium & bone protein.

Etiology:
More common with old age. Bone loss increases after menopause due to lower levels of
estrogen.
Osteoporosis secondary to disease state.
e.g., calcium deficiency, vit D deficiency, malnutrition, scurvy, renal disease, leukemia

Drug induced → thyroid hormones, corticosteroids

Life styles → nutrition, alcohol, smoking, inactivity, excessive caffine

Clinical features:
• Loss of height • Vertebrae collapse
• Back pain • Spine deformities like kyphosis

Treatment:
• Bisphosphonates medicines
• Estrogen
• Weight bearing

Ayurvedic management:
Correlated with asthi soushirya

100
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Management:
Preventive measures like using rasayana and adopting life style modification early in the life.
Snehana: massage with medicated oils such as maharasayana taila, dashamoola taila,
mahamasha taila, chandana bala lakshadi taila etc.
Vata alleviating drugs e.g., dashmoolarishta
Yoga practices
Drugs useful for pain and fractures. E.g., laksha guggulu, mahayogaraj guggulu, pravala
pishti, muktashukti bhasma.
Adequate dietary calcium – masha, tila, milk, milk products, banana, pear, apple, and other
dietary articles rich in calcium.

ASTHIKSHAYA
Kshaya means loss, decline, decay, diminution or warning.
Asthi kshaya means ‘decrease in the bone tissue’.

Lakshana:
Brittleness of teeth and nails
Asthitoda, asthishula
Falling of hairs, body hairs
Laxity of joints.
Roughness of skins

OSTEOPENIA
Osteopenia is decreased bone density but not to the extent of osteoporosis.
This decreased bone density leads to bone fragility and an increased chance of breaking a
bone (fracture).

Ayurvedic management:
Osteopenia is correlated with asthikshaya.

Management:
Basti with kshira, ghrita and tikta dravyas.
Nidana parivarjana → avoid steroids, secondary life style, smoking etc.
Medication → calcium containing drugs: sudha varga dravyas.

Drugs helpful in osteogenesis: ashwagandha, Shatavari, amalaki

Vata shamana with various measures.

Abhyanga
Swedana
Pizhichil
Sashtikashali pinda sweda
Panchatikta ksheera basti

101
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Sudhavarga dravya:
• Pravala pisti
• Mukta sukti
• Godanti bhasma
• Kukuttanda twak bhasma
• Shankha bhasma

SANDHIGATA VATA
Sandhigata vata means a condition in which morbid vata is located in the joints and destroys
the joints.

Nidana:
Since the disease is caused by vitiated vata all the foods, life activities which cause
aggravation of vata are the cause of sandhigata vata.

Lakshana:
Shula
Atopa
Shotha
Painful movement of the joints including extension and flexion.

Chikitsa:
• Daha karma • Sneha karma • Upanaha chikitsa

Bahya chikitsa:
Abhyanga → tila taila, mahamasha taila, ksheerabala taila, sahacharadi taila
Swedana →
Baspa sweda: nadi sweda
Pinda sweda: churna pinda sweda with Rasnadi churna
Shashtika shali pinda sweda
Avagaha
Dhara or seka
Sthanika basti: kati basti, janu basti, prishtha basti
Sandhi lepa → with Rasnadi churna, dashanga lepa

Abhyantara chikitsa:
Snehapana: guggulutiktam ghrita
Bala taila
Rasnadi taila
Mahamasha taila
Virechana → trivruta leha, triphala ghrita, gandharvahastadi Eranda taila
Basti →
Asthapana basti: Erandamuladi kashaya basti, dashamoola kashaya basti, mustadi yapana
basti
Anuvasana / matra basti: guggulutiktaka ghrita, ksheerabala taila, bala taila

102
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Udwartana: with vatahara herbs powder
Shamana yogas:
Dashamoolarishtam
Lakshadi guggulu
Yogaraja guggulu
Medohara vidangadi lauha
Vatagajankush rasa
Mukta sukti bhasma
Shringa bhasma
Ksheerabala taila
Vatavishwanshaka rasa

OSTEOARTHRITIS
Osteoarthritis is the most common form of arthritis that results from breakdown of joints
cartilage and underlying bone.
It is characterized by progressive degenerative changes in the articular cartilages and
commonly affects the hands, feet, spine and the large weight bearing joints, such as the hip &
knees.
Also called degenerative arthritis or degenerative joint disease.

Types:
1. Primary osteoarthritis
2. Secondary osteoarthritis

Etiology:
1. Primary osteoarthritis:
Genetic factors, metabolic disorders, old age, idiopathic avascular necrosis, obesity etc.
2. Secondary osteoarthritis:
Trauma, management, inadequate blood supply, nutritional bone diseases, infection of joints
e.g., pyogenic, tuberculosis etc.

Clinical features:
Pain – it is initial and leading symptoms
Stiffness – it follows pain.
Deformity due to shrinkage of capsule, fibrosis, muscle imbalance.
Limping – due to pain, stiffness and deformity of joint.
Synovial thickening and effusion resulting in swelling of the joints.
Treatment:
Lifestyle medication (such as weight loss & exercise) and analgesics are mainstays of
treatment.
Paracetamol with NSAIDs such as aspirin or diclofenac.
Topical ointments with diclofenac.
If conservative management is ineffective → joint replacement surgery or resurfacing.

103
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)

3. Chikitsa sutra and management of Shukravaha srotas such as Klaibya,

shukralpata, shukradosha, kshina shukra, dhwajabhanga.

KLAIBYA
Klaibya is defined as sexual dysfunction characterized by the inability of a man to perform
the ‘sexual act’ or ‘incomplete performance which leaves the female partner partially or
totally dissatisfied.

Nidana:
• Ati maithuna • Ayoni maithuna
• Ati vyayama • Vriddhavastha
• Viruddha ahara-vihara • Shukravaha srotas dushti
• Akala yonigamana

Bheda:
1. Beejopaghata janya Klaibya:
Due to pathology of spermatogenesis
Patient is weak, depressed, and unhappy with his relation with women.
He can be affected by panduroga, hridroga, tamakashwasa, kasa, jvara etc.
2. Dhwajopaghata janya Klaibya:
Due to pathology of genital (e.g., STD)
Genital organ is having pain, swelling, redness, boils or abscess.
It can discharge like rice – water and undergo necrosis.
3. Jarajanya Klaibya:
Due to old age.
The patient is weak, getting tired without doing any work, affected by various diseases.
4. Shukrakshaya janya Klaibya:
Due to depletion of shukra dhatu.
Symptoms of shukra dhatu kshaya
Pratiloma dhatu kshaya leads to death.

Chikitsa:
Klaibya should be treated with the drugs and therapies useful in shukradosha chikitsa &
kshataksheena chikitsa
Samanya chikitsa:
Samshodhana, basti karma, rasayana & vajikarana prayoga
Daivavyapashraya chikitsa (manidharana, yajna, stuti, homa, brahmacharya

Bhedanusara Klaibya:
1. Beejopaghataja Klaibya → vajikarana prayoga
2. Dhwajopaghata Klaibya chikitsa →
Pradeha → parisheka → raktamokshana
Snehapana → snehayukta virechana
Anuvasana or niruha basti
Vrana chikitsa
104
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
3. Jarajanya & 4. Shukra kshayaja Klaibya chikitsa →
Snehana → Swedana → snehayukta virechana
Yapana basti
Rasayana – vajikarana prayoga
Dugdha and ghrita sevana

Rasayana yoga:
• Shilajatu rasayana • Amalaki rasayana
• Ashwagandha rasayana • Chyavanaprasha
• Bhallataka rasayana • Amrutaprasha ghrita

Vajikarana yoga:
• Vanari gutika • Vajikarana pindarasa
• Brimhana gutika • Ashwagandha ghrita
• Kameswar modaka • Vrushya shatavari ghrita

Balya & brimhana dravya:

Bala, atibala, ashwagandha, shalaparni, lasuna, vidarikanda, draksha, kharjura

SUKRALPATA
It is the diseases produced due to old age or excessive sukra kshaya.

Treatment:
• Ksheera • Rasayana
• Ghrita • Vajikarana
• Basti • Sukra vardhaka medicines

Formulation:
• Pippali rasayana • Bhallataka
• Amalaki rasayana

SHUKRA DOSHA
According to acharya charaka, due to mithya ahara 8 types of shukradosha can be manifested
which can result impotency.
फ़ेननलं तनु रूक्षं ि वववर्ण पनू त वपच्छिलम ् |
अन्यिातप
ू संसष्ट
ृ मवसाहद तथाऽष्तमम ् ||
1. Fenila (frothy)
2. Tanu (thin)
3. Ruksha (rough)
4. Vivarna (abnormal colour)
5. Puti (foul smell)
6. Pichchila (slimy)
7. Anyadhatu upasamsrisht (other dhatu mixed)
8. Avasadi

105
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Chikitsa:
• Nidana parivarjana:
• Raktapitta nashaka chikitsa
• Rasayana vajikarana prayoga

KSHINA SHUKRA
शुक्रे चिरात ् प्रभसछयेत ् शुक्रं शोणर्तमेव ि |
तोदोऽत्यथण वर्
ृ र्योमेढ्रं िूमयतीव ि ||
Kshina shukra is a condition in which the man is unable to do intercourse even in presence of
his partner due to stiffness of the medhra. Even if he intercourses he is not able to complete it
because of it he will find difficulty in ejaculation of the virya and virya will be ejaculated in
small quantity.

Treatment:
• Basti
• Daiva vyapashraya chikitsa
• Use of dugdha, ghrita and rasayana – vajikarana

Formulations:
• Sugandhadi churna
• Kalyanaka ghrita
• Shilajatu rasayana

UPADAMSHA / DHWAJABHANGA
Upadamsha is characterised by peeta srava yukta vranotpatti on genital organs of men and
women.
Nidana:
• Linga abhighata by hasta, mukha, danta, nakha during hasta maithuna or mukha
maithuna
• Linga adhavana (not cleaning the genitalia)
• Rati atisevana
• Yoni pradosha
• Kuyoni gamana

Samprapti:
Nidana → jeevana sankramana → pita pradhana sotha utpatti in jananaga → vranotpatti →
upadamsha roga

Bheda:
1. Vataja
2. Pittaja
3. Kaphaja
4. Raktaja
5. Sannipataja
106
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Lakshana:
1. Vataja → toda, bheda, sphurana, krishna sphota
2. Pittaja → peeta varnata, bahukledi, sadana
3. Kaphaja → kandu, Shopha, mahat, sravayukta
If upadamsha is not treated, or in late stage it causes gangrene of genitalia that is shishnamani
fall out.

Chikitsa:
• Nidana parivarjana
• Snehana, Swedana
• Raktamokshana by siravyadha or jalaukavacharana on genital organ.
• Vamana & virechana
• Anuvasana & niruha basti
• Vrana Prakshalana with grahi, jantughna, visankramana kwatha i.e., panchakshiri
kwatha, triphala kwatha, Bhringaraja swarasa
• Vrana ropana with triphala masi, jatyadi taila, vranarakshasa taila
• Lepana, dhupana, bandhana

Shamana aushadhis:
• Trivanga bhasma • Patoladi kwatha
• Upadamsha gajakesari rasa • Karanjadhya taila
• Gandhaka rasayana • Jatyadi taila
• Kasisa bhasma • Vranarakshasa taila
• Kaishor guggulu • Upadamshahara lepa
• Triphala masi

107
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)

4. Chikitsa Sutra and Management of diseases of Mutravaha Srotas such

as -Mutrakricha, Mutraghata, Ashmari, Cystitis, Nephritis,
Nephrotic Syndrome, BPH, Renal Failure.

MUTRA KRUCHCHRA
Types:
1. Vataja
2. Pittaja
3. Kaphaja
4. Sannipataja
5. Abhighataja
6. Shakruda
7. Ashmari
8. Sharkara

1. Vataja mutra kruchchra:

• Passes urine in small amount with difficulty producing pain
• Tearing sensation in the scrotum, penis, and urinary bladder
Treatment:
Shavadamshtradi taila or ghrita used as orally, anuvasana basti and uttar basti
Oil should be processed with the expressed juice of shvadamshtra, along with jaggery, milk
and ginger; it should be administered as above.

2. Pittaja mutra kruchchra:

• Passes turmeric coloured or bloody urine with scalding sensation
• Feels his scrotum, penis, and urinary bladder as if burning with fire
Treatment:
Ghee or milk processed with trina panchmula, utpala, kakoli and nygrodha gana should be
taken orally and for urethral irrigation.
Fat medicated with above said drugs also administered as basti.
Laxatives with milk along with juices of grapes and sugarcane

3. Kaphaja mutra kruchchra:

• Passes slimy and colourless urine which is not warm
• Horripilation
• Feeling of heaviness in the scrotum, penis and the urinary bladder
Treatment:
Taila and yava processed with surasa, ushaka, musta and varuna.

4. Sannipataja mutra kruchchra:

• Passes urine of various colours again and again with difficulty, pain and either warm
or a cold sensation
• Feels as if sinking into darkness

108
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
5. Abhighataja mutra kruchchra:
• An injury to the urinary system after surgery or trauma produces very painful
obstructive
• uropathy of its channels Clinical features are similar to those of vatabasti.
Treatment:
Sadhyo vrana chikitsa

6. Shakrud pratighata mutra kruchchra:

• When there is faecal retention, movement of apana vayu get reversed
• Produces aadhmana, Shula and mutrasanga
Treatment:
Vatahara treatment
Swedana, avagaha, basti, churna kriya

7. Sharkaraja mutra kruchchra:

• The disintegrated particles of kapha, transformed by pitta and then broken up by vayu
are known as sharkara.
• Precordial pain, rigor, colicky pain in the flanks, impaired digestive power, fainting
and dysuria.
• When sharkara are passed with the flow of urine, pain subsides and this period of
remission lasts as long as another sharkara does not obstruct the urinary passage.

DYSURIA
Dysuria is painful or uncomfortable urination, typically a sharp, burning sensation.

Dysuria results from irritation of the bladder trigone or urethra. Inflammation or stricture of
the urethra causes difficulty in starting urination and burning on urination. Irritation of the
trigone causes bladder contraction, leading to frequent and painful urination.
Dysuria most frequently results from an infection in the lower urinary tract, but it could also
be caused by an upper urinary tract infection (UTI). Impaired renal concentrating ability is
the main reason for frequent urination in upper UTIs.

MUTRAGHATA
Nidana:
• Vegavarodha (suppression of • Excessive intake of ruksha, ushna
urges) and teekshana materials
• Ashmari (Stones) • Vibandha (Constipation)
• Abhighata (trauma)
Types: 12
1. Vatakundalika 7. Mutra kshaya
2. Vatasthila 8. Mutra granthi
3. Vata vasti 9. Mutra shukram
4. Mutratita 10. Ushnavata
5. Mutra jathara 11. Mutrauksada (2 types)
6. Mutra utsanga

109
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
1. Vatakundalika:
Nidana leads to aggravation of vata, which localises in bladder causing severe pain in this
region and passes the urine in drops.

2. Vatashtila:
The aggravated Vata produces an enlargement like a stone, leading to distension of bladder
and rectum, severe pain and obstruction to passage of urine and faeces.

3. Vatavasti:
Vegavarodha etc for long time, aggravate vata, which localising in bladder outlet, blocks the
urinary passage, resulting in retention of urine and pain over region of bladder.

4. Mutratita:
When patient tries to pass urine, he passes it slowly in drops.

5. Mutra jathara:
Vegavarodha makes apana vayu to move upwards, causing distension of abdomen below
region of umbilicus associated with severe pain and inability to pass urine.

6. Mutrotsanga:
Irrespective of site of obstruction, whenever the person tries to pass urine, he has to strain and
when he passes, the urine is mixed with blood and is in small quantities. This may or may not
be associated with pain.

7. Mutra kshaya:
In person who takes dry foods and does excessive physical activity, pitta and vata get
aggravated, localise in bladder, leading to passage of urine in small quantities with pain and
burning sensation.

8. Mutra granthi:
Sudden development of swelling (round) inside the bladder (internal urethral orifice), which
is fixed and produces symptoms like ashmari is termed as mutra granthi.

9. Mutra shukra:
Shukra vegavarodha makes semen to get mixed with urine, making urine appear like water
mixed with ash (chyleuria).

10. Ushnavata:
Excessive physical exercise, exposure to sun etc aggravate pitta. which along with causes
burning sensation in bladder, genitalia and perineum, makes the urine yellow and mixed
blood.

11. Mutrauksada:
a. Pittaja: Burning micturition which is clear and yellow. On drying urine resembles
gorochana powder

110
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
b. Kaphaja: Dysuria, which is slimy, concentrated and whitish. On drying urine
resembles shankha churna

Chikitsa:
• Different forms of medication depend upon their uses (Kashaya, kalka, sarpi, leha,
payasa, kshara, madhu, asava, swedana)
• Snehana and swedana
• Uttar basti
• Virechana
• Kalka of bala, svadamshtra, kraunch asthi, Kokilaksha, devadaru, chitraka with sura –
orally

URINARY RETENTION
Urinary retention is incomplete emptying of the bladder or cessation of urination.
It may be acute or chronic.
Causes include impaired bladder contractility, bladder outlet obstruction, detrusor-sphincter
dyssynergia (lack of coordination between bladder contraction and sphincter relaxation), or a
combination.
Retention is most common among men, in whom prostate abnormalities or urethral strictures
cause outlet obstruction. In either sex, retention may be due to drugs (particularly those with
anticholinergic effects), severe faecal impaction (which increases pressure on the bladder), or
neurogenic bladder in patients with diabetes, multiple sclerosis, Parkinson ‘s disease, or prior
pelvic surgery resulting in bladder denervation.

Symptoms & Complications:

Urinary retention can be asymptomatic or cause urinary frequency, a sense of incomplete
emptying, and urge or overflow incontinence.
It may cause abdominal distention and pain. When retention develops slowly, pain may be
absent.
Long-standing retention predisposes to UTI and can increase bladder pressure, causing
obstructive uropathy.

Diagnosis: Diagnosis is obvious in patients who cannot void. In those who can void,
incomplete bladder emptying is diagnosed by postvoid catheterization or ultrasonography
showing an elevated residual urine volume. A volume < 50 mL is normal; < 100 mL is
usually acceptable in patients > 65 years but abnormal in younger patients. Other tests (e.g.:
urinalysis, blood tests, ultrasonography, urodynamic testing, cystoscopy, cystography) are
done based on clinical findings.

Management: Urethral catheterization and treatment of specific cause

111
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
ASHMARI
Nirukti:
अश्मानं रनत ददनत अश्मरर |
“Ashma” means “stone.”
“Rati” means “to present”
Ashmari means the formation and presentation of a substance like stone.

Nidana:
तत्र असंशोिनशीलस्य अपथ्यकाररर्ाः प्रकुवपतः श्लेष्म मत्र
ु सम्प्रक्तोऽनुप्रववश्य बच्स्त अश्मरी जनयनत |
Those who neglect the Samshodhana of internal channels
Those who are engaged in unwholesome dietary habits become the victim of Ashmari.

Samprapti:
Nidana causes kapha prakopa, which mixes with mutra, entered in basti and formed ashmari.

Similes given by sushruta:

A new pitcher filled with clear water can also show settling down of muddy particles in due
course of time. In the same way the calculi are formed in Basti.
As air & fire of electricity in the sky consolidate water (to form hail storms) similarly Pitta
located in the bladder, along with Vayu consolidates Kapha to form calculi.

Purvarupa:
• Basti peeda (Pain in hypogastric region)
• Aruchi (Anorexia)
• Mutrakricchra (Dysuria)
• Bastishirovedana (Pain in Suprapubic region)
• Mushka Vedana
• Shepha Vedana
• Jwara (fever)
• Avasada
• Bastigandhatwa (Concentrated urine smell like goat's urine)
• Sandra Mutra (Sedimentation of urine)
• Avila Mutra (Turbidity of urine)

Rupa:
• Nabhi Vedana • Dhavan, Plavan • Sarudhira Mutra
• Mutra Dhara etc. • Sevani Vedana
Sanga • Basti Vedana • Mutra Vikirana
• Gomeda Prakasha • Mehana Vedana • Sasiktam
• Atyavilam

Classification of ashmari:
1. Shleshmaja ashmari 3. Vataja ashmari
2. Pittaja ashmari 4. Shukraja ashmari

112
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)

Kaphaja Pittaja Vataja Shukraja

Heavy and cold Burning hot Severe bladder pain, Dysuria
sensation in bladder sensation and umbilical and pain in
area inflammatory the anus
changes in urinary
tract
Cutting, incising, Reddish / yellowish Frequent passage of Scrotal swelling
pricking pain – black or honey like flatus
in colour
White, slimy, big Resembles Urethral burning Lower abdominal
like kukkutanda bhallataka seed pain
Colour – madhuka Dysuria Special
pushpavata characteristic feature
is, it can be crushed
into powder by
pressure
Heavy in weight Difficulty in
defecation. Dusty
coloured, hard,
irregular, rough and
nodular like
kadambapushpa

Sadhyasadhyata:
In our classics Acharyas have described about 'Ashta Mahagadas’ and these mahagadas are
not easy to treat and they are not having good prognosis. As Ashmari is mentioned as one of
them, so it requires attention for its cure.

Ashmari in balaka:
Ashmari in balaka is easily curable because of following reasons.
• Smaller space occupying lesion
• Less fat in subcutaneous and peri-nephric region the prognosis is better
• Can easily catch and remove

Upadrava:
• Daurbalya • Sadana • Pandu
• kukshi Shula • Aruchi • Hruta peeda
• Ushnavata • Trishna
• Vamana • karshya

Chikitsa:
Chikitsa in purva rupa:
1. Snehana 3. Vamana
2. Swedana 4. Virechana etc.

113
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Ayurvedic formulations:
• Varunadi kashaya
• Chandraprabha vati
• Tab crush
• Gokshuradi kashaya
• Tab cystone
• Tab clacurosin

Panchakarma chikitsa:
1. Virechana: Tilvak ghrita etc
2. Basti: Especially Uttara basti
3. Niruha basti
4. Anuvasana basti: Peetadaru siddha taila

CYSTITIS
Definition: Inflammation of the urinary bladder mucosa is called as cystitis.

Causes:
Common .in females, because of short urethra in females may cause ascending infection and
cystitis
Honeymoon cystitis → Initial period of sexual contact in females can cause diffuse form of
cystitis.
Causative organisms → E coli, klebsiellae, pseudomonas, staphylococcus aureus (Acute
cystitis)

Predisposing factors:
• Catheters, instrumentation
• Bladder stone, bladder diverticulum, bladder neck obstruction, bladder tumours

Clinical features:
• Frequency, urgency, and dysuria are hallmark of cystitis
• Low backache
• Fever, chills, and rigors
• Suprapubic pain and tenderness

Investigation:
• Leucocytosis
• Urine Microscopy: More than 5 WBC (females) and 2-3 WBC (Males)
• Culture study to know organism
• Cystoscopy: Bladder inflammation, mucosal changes

114
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Treatment:
• Plenty of water intake to flush the bacteria from bladder
• Urine alkalisers like Neeri, Chitraka
• Local hot and Sitz bath
• Appropriate antibiotics
• Antipyretics, analgesics and antispasmodics

NEPHRITIS
Nephritis is inflammation of the kidneys and may involve the glomeruli, tubules or intestinal
tissue surrounding the glomeruli and tubules.

Types:
1. Glomerulonephritis
It is inflammation of the glomeruli. Glomerulonephritis is often implied when using the term
‘nephritis’ without qualification
2. Interstitial nephritis:
Inflammation of the spaces between renal tubules.

Causes:
• Infections
• Caused by autoimmune disorder that affect the major organs like kidney.
• Pyelonephritis: inflammation that results from urinary act infection by E. coli.
• Lupus nephritis: inflammation of kidney caused by SLE.
• Athletic nephritis: is nephritis resulting from strenuous exercise.

Symptoms:
• Pain in pelvis
• Pain or burning sensation while micturition
• A frequent need to urinate
• Cloudy urine
• Blood or pus in urine
• Vomiting

Treatment:
• Corticosteroids → to reduce inflammation
• Immuno suppressing drugs → if nephritis is due to auto immune disorders.
• IV fluids if electrolyte disturbance
• Intravenous antibiotic
• If condition serious than dialysis.

115
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Ayurvedic management:
According to ayurveda nephritis can be consider as a disease of mutravaha srotas.
The featured of this patient indicates involvement of vata and pitta dosha, the treatment was
planned as per the principle of ayurveda described for ushnavata.
Kidney is root of ‘medovaha srotas’ also applied medovaha srotas dushti chikitsa.
Inflammation of kidneys called vrikka shotha.
The main approach will be strengthening the kidneys with rasayanas like chandraprabha vati,
vanga bhasma and shilajatu, trivanga bhasma, gokshura, dashamoola kashayam

The formulations like –

• Varunadi vati
• Mutrakrichantak churna
• Punarnava mandura
• Gokshuradi guggulu
• Punarnavadi kashayam
• Gokshur churna
• Gokshur kwatha

Supportive enemas in the form of dashamoola kshira basti and mustadi yapana basti and
matra basti with guggulutiktakam ghrita, masha taila, Narayana taila.

NEPHROTIC SYNDROME
Nephrotic syndrome is a non-specific disorder in which the kidney is damaged, causing them
to leak large amounts of protein proteinuria at least 3.5 grams per day 1.73m2 (body surface
area) from the blood into the urine.

Causes:
• Many disease and conditions can cause glomerular damage and lead to nephrotic
syndrome including –
• Diabetic kidney disease
• Membranous nephropathy
• Systemic lupus erythematosus
• Amyloidosis
• Blood clot in a kidney vein

Symptoms:
Nephrotic syndrome is a collection of symptoms due to kidney damage.
This includes –
• Protein in the urine (proteinuria)
• Low blood albumin levels (hypoalbuminemia)
• High blood lipids (hyperlipidaemia)
• Significant swelling (oedema)
• Weight gain, feeling tired, foamy urine

116
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Complications may include thrombosis, sepsis, hypertension

Treatment:
• Blood pressure control • Reduce sodium intake
• ACE inhibitors are drug of choice • Fluid management

BENIGN PROSTATIC HYPERPLASIA / HYPERTROPHY (BPH)

Benign prostatic hyperplasia (BPH) is non-malignant adenomatous overgrowth of the
periurethral prostate gland
Pathophysiology:
Multiple fibroadenomatous nodules develop in the periurethral region of the prostate,
probably originating within the periurethral glands rather than in the true fibromuscular
prostate (surgical capsule), which is displaced peripherally by progressive growth of the
nodules.
As the lumen of the prostatic urethra narrows and lengthens, urine outflow is progressively
obstructed. Increased pressure associated with micturition and bladder distention can progress
to hypertrophy of the bladder detrusor, trabeculation, cellule formation, and diverticula.
Incomplete bladder emptying causes stasis and predisposes to calculus formation and
infection. Prolonged urinary tract obstruction, even if incomplete, can cause hydronephrosis
and compromise renal function.

Clinical features:
1. Frequency: Occurs due to visceral introversion of sensitive prostatic mucus
membrane. Started with day time, later day and night time (5-10 times during night).
It is due to irritability of bladder and amount of residual urine.
2. Urgency: Internal sphincter mechanism is deranged due to invasion of prostate into
bladder. This result in few drops of urine tickling down the post urethra resulting in
urgent desire to pass urine.
3. Hesitancy: Patient must wait due to obstruction of internal urethral orifice by median
lobe
4. Difficulty in micturition with weak stream and dribble
5. Retention of urine (Acute/chronic)
6. Haematuria

Diagnosis:
• Digital rectal examination
• Urinalysis and urine culture
• Prostate-specific antigen level
• Sometimes uroflowmetry and bladder ultrasonography
• Transrectal biopsy is usually done with ultrasound guidance and is usually only
indicated if there is suspicion of prostate cancer. Transrectal ultrasonography is an
accurate way to measure prostate volume.

117
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Treatment:
Conservative management:
• Avoid heavy alcohol consumption
• Patient should void as soon as he feels the urge to do
• Correction of electrolyte, urea, and creatinine
• Catheterisation in acute retention. If fails then suprapubic catheterisation
• Drugs: Finasteride acetate 5mg daily for 6 months (to decrease the size) and Alpha-
• adrenergic blocker to relax internal sphincter for better drainage of bladder.

Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a non-cancerous

increase in size of the prostate.

Ayurveda management:
Description of BPH are closely resembles with the clinical features of the 13 types of
mutraghata.
Aggravated vata dosha which leads to astheela which is a mobile and elevated swelling,
which obstructs the passage of urine.

Samshodhana chikitsa:
Avapeeda snehapana with vastyamayantaka ghrita.
Avgaha sveda (sitz bath) for 15 days with warm water or kwathas like panchavalkal kwatha /
triphala kwatha / dashmoola kwatha.
Basti:
Uttara basti with Varunadi ghrita / shatavaryadi ghrita 30 – 50 ml for 3 days. (Each Uttara
basti is given with gap of 3 days)
Matra basti with Varunadi ghrita / shatavaryadi ghrita 30 – 50 ml for 14 days.

Samshamana chikitsa:
• Gokshura • Varuna
• Pashanabheda • Punarnava
• Haritaki

Formulations:
• Trina panchamula kwatha • Varunadi ghrita
• Brihatyadi kwatha • Punarnavasava
• Gokshuradi kwatha • Chandraprabha vati
• Sveta parpati

RENAL FAILURE
Kidney failure, also known as end – stage kidney disease, is a medical condition in which the
kidney no longer works.
Kidney failure is the stage where kidney stops functioning properly and is not able to remove
waste from the blood and control the fluid level in the body.

118
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Types:
1. Acute kidney failure:
A sudden drop in kidney function is known as a kidney failure.
It can be life threatening and requires immediate treatment.
2. Chronic kidney failure:
The chronic kidney failure develops gradually, and the kidney function get worsens over the
years.

Symptoms:
• Malaise • GI mobility
• Breathlessness • Headache
• Nausea • Pruritis
• Vomiting • Pigmentation

119
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)

5. Chikitsa Sutra and Management of diseases of Purishavaha Srotas

such as – Atisara, Pravahika, Arsha, Purishaj Krimi, IBS and
Ulcerative Colitis.

ATISARA
Loose stools or passing excessive watery stool through guda marma is called atisara.
Atisara is disease of intestinal disturbances, involves water and electrolyte imbalances,
malnutrition or under nutrition.

Nidana:
• Guru, Atisnigdha, ushna, drava, sthula shita ahara
• Ajirna, adhyasana, vishamashana
• Viruddha ahara, dushita jala, madhya, visha
• Bhaya, shoka, vegadharana
• Mithyaviparyaya of panchakarma
• Rutuviparyaya
• Krimi etc.

Samprapti:
Nidana sevana → vata pradhana tridosha prakopa → mandagni & increased apa →
purishvaha, udakavaha srotodushti → dravamala – atipravruti → atisara

Purvarupa:
• Suchibhedanavata peeda at udara
• Gatravasada
• Apanavayu avarodha
• Vit sanga
• Aadhmana

Lakshana:
1. Vataja atisara → aruna, fenila, ruksha, alpamala, saruka, sa shabda
2. Pittaja atisara → peeta, nila, krishna, Durgandhi mala, trishna, daha, murcha, guda
paka
3. Kaphaja atisara → snigdha shweta shleshma yukta mala, gaurava, aalashaya
4. Sannipataja atisara → rakta krishna harita peeta mala, tridosha lakshana
5. Shokaja atisara → vataja atisara lakshana
6. Bhayaja atisara → vataja atisara lakshana

Sadhyasadhyata:
Sukhasadhya → vataja, pittaja, kaphaja
Krrichsadhya → shokaja, bhayaja
Asadhya → sannipataja, upadravayukta.

120
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Upadrava → Shotha, shoola, jwara, trishna, murccha, kasa, shwasa, aruchi, chardi

Chikitsa:
First, find out stage of atisara, whether it is –
1. Amatisara:
Stool in this kind of diarrhoea is picchila with foul smell which sinks in water, is known as
amatisara.
2. Pakwatisara:
Diarrhoea with the feeling of lightness in the body and stool does not sink in water, then this
condition is known as pakvatisara.

Amatisara chikitsa:
Do not try to stop diarrhoea when undigested food is being expelled, i.e., sangrahi &
stambhaka aushadha or kashaya rasa dravya are to be avoided, initially.
If stambhana chikitsa is done when ama is still inside, it can cause various diseases or
complications like dandalasaka, adhmana etc.

Langhana pachana is the best method for amapachana. If needed laghu ahara like manda,
peya etc. can be given.
If ama still remains, administered haritaki or Eranda taila with warm water to expel
remaining dosha.
In alpa dosha avastha → langhana
In madhyama dosha avastha → dipana pachaniya pramathya
In bahu dosha avastha → virechana

Formulations:
• Pippalyadi pramathya • Shunthyadi kwatha
• Hriberadi pramathya • Lavanabhaskar rasa
• Dhanyapanchaka kwatha • Sanjivani vati

Pakwatisara chikitsa:
Stambhana dravya should be used.
i.e., kutaja, bilwa, lodhra, jambu, shalmali, Shallaki, dhataki, ahiphena

Formulations:
• Kutaja ghana vati • Kutajarishta
• Bilwadi kwatha • Gangadhara churna

If gudabhramsa condition occurs then –

Changeri ghrita prayoga
Mushaka taila prayoga
Sneha basti
Pichu prayoga after manual replacement of rectum

121
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Raktatisara chikitsa:
Trishna nigrahana with ajadugdha + madhu
Pittaja atisara vata chikitsa (shadanga paniya)
Shatavari kalka + dugdha
Kutaja kwatha
Piccha basti → green stalks of shalmali are covered with green kusha, and coated with black
mud. This pinda is placed over the cow-dung fire. After the mud is dried up, the stalks of
shalmali are removed. This is triturated in khalva yantra and then 1 pala of shalmali is mixed
with 1 prastha of boiled milk and filtered.
Ghrita, taila & yastimadhu churna are added to this milk in adequate quantity, and this
mixture is used for piccha basti after proper oleation.

ARSHAS
Arshas are protrusions of Māṁsa which obstructs Gudamārga and torture the person.
According to Ā. Charaka, Arshas is formation of Aṅkura (muscular sprouts) in Gudavalli.
Paryāya → Gudāṅkura, Gudakīla, Māṁsakīla, Durnamaka, Anamaka, Payūroga

Nidāna:
• Viruddhāshana
• Adhyashana
• Strīprasaṅga (excessive coitus)
• Utkaṭukāsana (sitting for long time on irregular surfaces)
• Pṛṣṭhayāna (riding/travelling on the back of animals)
• Vegavidhāraṇa

Saṁprāpti: Nidāna sevana → Doṣa prakopa Rakta pradhāna → Gudavali Traya pradesha
duṣṭi → Māṁsāṅkura → Arshas

Vargīkaraṇa:
1. According to Origin
a. Sahaja b. Janmottara kālaja
2. According to General Character
a. Shuṣka (Vāta-Kaphaja) b. Arda (Pitta-Raktaja)
3. According to Site
a. Bāhya (Arshas forming at Bāhyavali → Saṁvariṇī)
b. Abhyantara (Arshas forming at Abhyantaravali → Visarjinī & Pravahinī)
4. According to Doṣa
a. Vātaja d. Dvandvaja
b. Pittaja e. Sannipātaja
c. Kaphaja f. Raktaja

122
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Pūrvarūpa:
Anne ashraddhā, Kṛcchrāt pakti, Amlīkā, Paridāha, Viṣṭambha, Pipāsā, Sakthisadana, Āṭopa,
Kārshya, Udgāra bāhulya, Akṣṇo Shvayathu, Antra kūjana, Guda parikartana, Pāṇḍuroga,
Grahaṇīdoṣa, Shoṣa, Kāsa, Shvāsa, Balahāni, Bhrama, Tandrā, Nidranāsha, Indriya daurbalya

Lakṣhaṇa:
1. Vātaja Arshas
• Aṅkura appears dry and reddish (Rūkṣa Aruṇa)
• Arshas resembles Kadamba puṣpa
• Kaṭhina purīṣa
• Kaṭi-Pṛṣṭha-Pārshva-Vṛṣaṇa-Nābhī shūla
• Blackish discolouration of Nakha, Akṣi, Danta, Mukha, Mutra, Viṭ
• Gulma, Plīhā, Udara
2. Pittaja Arshas
• Aṅkura appears slender, with bluish tips and discharge
• Arshas resembles Jalaukavaktra
• Purīṣa pravṛtti Sarakta Sadāha
• Yellowish discolouration of Nakha, Akṣi, Danta, Mukha, Mutra, Viṭ
• Jvara, Dāha, Pipāsā, Mūrcchā
3. Kaphaja Arshas
• Aṅkura appears pale, broad at the base, rounded and does not discharge any fluid or
blood
• Arshas resembles Gostana
• Whitish discolouration of Nakha, Akṣi, Danta, Mukha, Mutra, Viṭ
• Shopha, Shītajvara, Arochaka, Avipāka, Shirogaurava
4. Raktaja Arshas
• Arshas resembles Nyagrodha / Guñja
• Pittaja Lakṣaṇa
• Hard stool with significant amount of Duṣṭa Rakta
5. Sahaja Arshas
• Duṣṭa Shukra Shoṇita janya
• Durdarshana (difficult to see as it is deeply situated)
• Paruṣa, Pāṅshu (grey), Dāruṇa (severely painful)
• Kṛsha, Alpabhukta, Sirā santata gātra, Svarakṣaya, Āṭopa
• Ghrana-Nāsa-Akṣi-Shiroroga

Sādhyāsādhyatā:
1. Sādhya → Ekadoṣa, Bāhyavali sthita, < 1 year duration
2. Kṛcchrasādhya → Dvidoṣaja, Madhyamavali sthita, > 1 year duration
3. Yāpya → Tridoṣaja (Manda lakṣaṇa)
4. Asādhya → Tridoṣaja, Sahaja, Antarvali sthita, Upadrava

123
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Asādyha Lakṣaṇa:
Tṛṣṇā, Aruchi, Shūla, Atishoṇita srāva, Shotha, Atisāra, Chardi, Jvara, Gudapāka, Sammoha

Upadrava: Udāvarta, Vāta-Viṭ-Mūtra saṅga, Nābhī-Pārshva-Ura shūla

Chikitsā:
Sthānika Chikitsā:
• Svedana & Abhyaṅga
• Avagāha Svedana with Kvātha, Uṣṇodaka, Gomūtra
• Raktamokṣaṇa with Shastra/Jalauka in Kaṭhina Arshas & Duṣṭa Rakta
• Arshoghna Lepa (Snuhī kṣīra and Haridrā chūrṇa)
• Haridrādi Lepa (Haridrā and Jālinī chūrṇa with Sarṣapa taila)

Bheṣaja:
• Guḍa Harītakī, Dashamūla Guḍa, Chaṅgeri Ghṛta
• Harītakī with Gomūtra, Shatāvarī mūla Kalka with Kṣīra
• Dashamūla kvātha, Pippalyādi yoga
• Abhayāriṣṭa, Dhātryariṣṭa, Dantyariṣṭa, Takrāriṣṭa
• Arshakuṭhāra rasa, Vyoṣādya chūrṇa, Chandraprabhā vaṭī,
• Takra, Takra with Pañchakola

Doṣa Chikitsā:
• Vātaja Arshas → Kakkolādya chūrṇa, Hiṅgvādi chūrṇa
• Pittaja Arshas → Dhattūrādi chūrṇa, Bhallātaka modaka,
• Kaphaja Arshas → Ghṛta prepared with Kvātha of Surasādi gaṇa & Dīpanīya
Jalaukāvacharaṇa followed by Lepa with Arkapatra svarasa, Shuṇṭhī kvātha pāna
• Raktaja Arshas → Chirabilvādi chūrṇa, Pittaja Chikitsā, Raktapitta Chikitsā

HEMORRHOIDS / PILES
Hemorrhoids are dilated vessels of the hemorrhoidal plexus in the anal canal.
Increased pressure in the veins of the anorectal area leads to haemorrhoids.
This pressure may result from pregnancy, frequent heavy lifting, or repeated straining during
defecation (e.g.: due to constipation).
Hemorrhoids may be external or internal. In a few people, rectal varices result from increased
blood pressure in the portal vein, and these are distinct from haemorrhoids.

External haemorrhoids are located below the dentate line and are covered by squamous
epithelium.
Internal haemorrhoids are located above the dentate line and are lined by rectal mucosa.
Hemorrhoids typically occur in the right anterior, right posterior, and left lateral zones.

124
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Signs & Symptoms:
• Hemorrhoids are often asymptomatic, or they may simply protrude.
• External haemorrhoids may become thrombosed, resulting in a painful, purplish
swelling.
Rarely, they ulcerate and cause minor bleeding.
Cleansing the anal region may be difficult.

• Internal haemorrhoids typically manifest with bleeding after defecation; blood is

noted on toilet tissue and sometimes in the toilet bowl.
Internal haemorrhoids may be uncomfortable but are not as painful as thrombosed
external haemorrhoids.
Internal haemorrhoids sometimes cause mucus discharge and a sensation of
incomplete evacuation.
Strangulated haemorrhoids occur when protrusion and constriction occlude the blood
supply. They cause pain that is occasionally followed by necrosis and ulceration.

Diagnosis:
• Anoscopy
• Sometimes sigmoidoscopy or colonoscopy
Most painful haemorrhoids, thrombosed, ulcerated or not, are seen on inspection of the anus
and rectum. Anoscopy is essential in evaluating painless or bleeding haemorrhoids.
Rectal bleeding should be attributed to haemorrhoids only after more serious conditions are
excluded (i.e., sigmoidoscopy or colonoscopy).

Classification of Internal Hemorrhoids:

1. Grade I → No prolapse; Prolapse after a Valsalva manoeuvre
2. Grade II → Prolapse reduces spontaneously; Prolapse after Valsalva manoeuvre
3. Grade III → Prolapse needs manual reduction; Chronic prolapse
4. Grade IV→ Manual reduction of prolapse ineffective

Management:
• Symptomatic: Stool softeners, sitz baths, analgesics
• Occasionally excision for thrombosed external haemorrhoids
• Injection sclerotherapy, rubber band ligation, or infrared photocoagulation for internal
haemorrhoids

Symptomatic Treatment:
Symptomatic treatment of haemorrhoids is usually all that is needed. It is accomplished with
stool softeners (e.g.: docusate, psyllium), warm sitz baths (i.e., sitting in a tub of tolerably hot
water for 10-15 minutes) after each bowel movement and as needed, anaesthetic ointments
containing lidocaine, or witch hazel (hamamelis) compresses (which soothe by an unknown
mechanism).

125
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Pain caused by a thrombosed external haemorrhoid can be treated with non-steroidal anti-
inflammatory drugs.
Infrequently, simple excision of the external haemorrhoid is done, which may relieve pain
rapidly; after infiltration with 1% lidocaine, the thrombosed portion of the haemorrhoid is
excised, and the defect is closed with an absorbable suture.

PRAVAHIKA
When less quantity of kaphayukta mala is passed frequently, by pravahana (straining) and
with difficulty, the condition is known as pravahika.
The cardinal symptom is pravaha.

Nidana:
• Sarva atisara Nidana
• Ahita ahara sevana
• Vata-kapha doshavardhaka ahara vihara sevana
• Ati ushna tikshana kala (rutu)
• Tilapishta, misthanna sevana

Samprapti:
Hetu sevana → kledaka kapha dushita + samana vayu dushita + pachaka pitta dushti →
kledaka kapha becomes stickier and sticks to inner layer of pakwashaya → apana vayu dushti
→ pravahana → frequent minimal sticky mucous mixed loose stool → again vata prakopa
due to pravaha shrama → pravahana yukta frequent minimal sticky mucous mixed, blood-
stained loose stool → pravahika

Purvarupa:
• Suchibhedana vata peeda at udara
• Gatra avasada
• Apanavayu avarodha
• Vit sanga
• Adhmana

Samanya lakshana:
Muhur muhur kapha mishrit alpa mala pravruti
Pravahana

Differential diagnosis:
• Raktaja atisara
• Kaphaja atisara
• Kaphaja grahani
• Amaja atisara

126
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Chikitsa:
Pravahika should be treated like atisara, by considering its ama & pakwa avastha
In ama avastha → langhana pachana
In pakwa avastha → stambhana dravya prayoga
Also refer to atisara chikitsa
In raktaja pravahika → raktastambhaka chikitsa & piccha basti

Formulations:
• Ramabana rasa • Kutaja parpati
• Panchamrita parpati • Kutaja ghana vati

ULCERATIVE COLITIS
Ulcerative colitis is a chronic inflammatory and ulcerative disease arising in the colonic
mucosa, characterized most often by bloody diarrhoea.

Pathophysiology:
Lesion in base of crypts of lieberkuhn → Crypt abscess → Pus in lieberkuhn → Abscess
ultimately ruptures to form tiny ulcers → Proctitis and colitis → Multiple, small, irregular,
shallow, superficial Pinpoint ulcer → Inflammation spread into submucosa of colon →
Attempt of healing may produce polyp like structure (Pseudopolyposis) which is surrounded
by heaped of granulation tissue & oedematous mucosa → Gut spasm → Epithelial
hypertrophy healing with fibrosis resulting in narrow, contracted colon (Pipe stem colon) →
Stricture of colon

Toxic Colitis:
Toxic colitis or fulminant colitis occurs when transmural extension of ulceration results in
localized ileus and peritonitis. Within hours to days, the colon loses muscular tone and begins
to dilate. Toxic colitis is a medical emergency that usually occurs spontaneously in the course
of very severe colitis.

Signs & Symptoms:

• Attacks of bloody diarrhoea of varied intensity and duration interspersed with
asymptomatic intervals
• Usually an attack begins insidiously, with increased urgency to defecate, mild lower
abdominal cramps, and blood and mucus in the stools. Some cases develop after an
infection (e.g.: amebiasis, bacillary dysentery).
• When ulceration is confined to the rectosigmoid, the stool may be normal or hard and
dry, but rectal discharges of mucus loaded with red and white blood cells accompany
or occur between bowel movements.
• If ulceration extends proximally, stools become looser and the patient may have
> 10 bowel movements per day, often with severe cramps and distressing rectal
tenesmus, without respite at night. The stools may be watery or contain mucus and
frequently consist almost entirely of blood and pus.

127
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
• Toxic or fulminant colitis manifests initially with sudden violent diarrhoea, fever up
to 40° C, abdominal pain, signs of peritonitis, and profound toxemia.
• Systemic symptoms and signs, more common with extensive ulcerative colitis,
include malaise, fever, anemia, anorexia, and weight loss.

Investigation: Barium enema, Colonoscopy, Plain X-ray abdomen

Management:
Conservative:
1. Hospitalization & bed rest
2. Sedatives and tranquilisers with psychological counselling
3. Anti-diarrhoeal drugs like Lomotil etc.
4. Antibiotics: Salazopyrines 2ml/day. It is anti-microbial drug help in chronic cases
5. Corticosteroids:
Oral prednisolone 60mg/day. Dose is tapered off over 3-4 weeks (they decreases
frequency of stools)
In acute attack IV hydrocortisone 100mg
Prednisolone retention enema, 20mg in 200ml saline. Advice for 7-10 days
6. Cyclosporines: IV 4 mg/kg/day
7. Diet: It should be milk free. Avoid too hot & too cold items. Fruits are helpful.
Vitamin A, B, C, D with supplements of iron and potassium.

Ayurvedic management:
The below mentioned conditions explained in ayurveda describe signs of inflammation of
cold and small bowel.
Pitta atisara & rakta atisara
Pitta causes inflammation of colon rakta vitiated by pitta and cause bleeding diarrhoea, as
happens in IBS & colitis.
Grahani, pittaja grahani:
Episodes of loose stools & diarrhoea.
Pittaja pravahika:
Blood in stools

Treatment:
• Pittaja atisara chikitsa → initially langhana
• Raktaja atisara chikitsa → piccha basti, kutaja kwatha
• Pravahika → langhana, pachana, stambhana dravyas like kutaja, bilwa etc.
• Pittaja grahani chikitsa → ama should be dealt with and pitta alleviating medicines &
diet should be administered, vamana & virechana, tiktadravya sadhita ghrita
• Adhoga raktapitta chikitsa → therapeutic emesis should be given.
• Balya and brimhana chikitsa → bala, atibala, ashwagandha, vidarikanda, kharjura
brimhana chikitsa shall be administered after the inflammation have been cured. This
will enable the patient to gain weight & health

128
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
• Rasayana → for strengthen the small bowel & colon. Shilajatu rasayana, amalaki
rasayana.
• Krimihara chikitsa → If infection is found to be causal of colitis.

Role of panchakarma:
• Vamana in case of bleeding from lower passage i.e., anus as in adhoga raktapitta.
• Virechana → virechana should be given after the disease has been cured, to expel
morbid pitta and prevent recurrence.
• Pittahara basti → pittahara basti to combat vitiated pitta with decoctions and oil / ghee
prepared using pitta alleviating herbs.
• Piccha basti → special forms of basti mead for bleeding disorders, especially IBD &
colitis associated with bleeding.

IRRITABLE BOWEL SYNDROME (IBS)

IBS is not a disease. It is functional disorder, which means that the bowel simply does not
work as it should.
IBS is a common disorder that affects the large intestine.
IBS commonly causes cramping, abdominal pain, bloating, diarrhoea, constipation

Causes:
• Abnormal gastrointestinal tract movements.
• Change in nervous system communication between GI and brain.
• Sensory & motor disorders of colon.
• Dietary allergies & food sensitivities.
• Neurotransmitter imbalance
• Stress

Types:
• Constipation predominant (IBS – C)
• Diarrhoea predominant (IBS – D)
• Mixed (IBD – M)

Treatments:
Dietary modification
Pharmacological medications like antispasmodic & antidepressants medications.
For IBS – C → laxatives
For IBS – D → antidiarrheal drugs.

PURISHAJA KRIMI
Those craving for mamsa are called Krimi.
If these krimis are originated at large intestine called purishaja Krimi. They always move
downwards. If their count is increased significantly, they move towards stomach too.

129
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Bheda:
The worms are bigger, round, thin, bluish black, yellow, white or black in colour.
They are 5 kinds viz.
1. Kakeruka
2. Makeruka
3. Sousurada
4. Sashoolaka
5. Leliha

Nidana:
• Amla and madhura padartha atisevana
• Guda atisevana
• Ajeerna bhojana
• Viruddha anna sevana, snana dwesha, unhygiene

Lakshana:
• Atidrava mala pravruti • Kathorata of udara
• Atisara • Gudapradeshe kandu
• Daurbalya • Sometimes worms are passed out
with stool.

Chikitsa:
Three principles of treatment of Krimi roga.
1. Apakarshana → (extraction or removal of Krimi)
Extracted by hand or with instrument
By samshodhana chikitsa
2. Prakriti vighata → (breaking pathogenesis)
Counteraction of manifestation of Krimi roga by using krimighna dravyas.
Krimighna dravya: Vidanga, kampillaka, puga, nimba etc.
3. Nidana parivarjana → (avoid factors which produces Krimi)
Avoid madhur-amla rasa atisevana, guda sevana

Formulations:
• Krimi mudgara rasa • Palashabija churna
• Krimi kuthara rasa • Vidangarishta
• Krimihara rasa • Parasikadi churna
• Vidanga churna

130
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)

6. Chikitsa Sutra and Management of Sexually Transmitted Diseases

such as – Phiranga, Puyameha, Upadamsha, lymphogranuloma inguinale,
Syphilis, Gonorrhoea.

PHIRANGA
It is a sexually transmitted disease which is spread by foreigners.
As it came in India due to firangi, it is called phiranga.

Samprapti:
Nidana → jeevana sankramana → vranotpatti on prajana indriya → granthi nirmana →
phiranga roga.

Roga avastha:
1. Prathama avastha → vranotpatti on prajanana indriya
2. Dwitiya avastha → after initial vranotpatti, within 3 to 4 weeks second stage
manifests that can last for 2 years. In this stage jeevana visha gets circulated and
spread all over the body producing body lesion on guda, bhagaushtha, that are called
‘condyloma’.
3. Tritiya avastha → this stage manifests after 6 months to 2 years of condyloma stage.
In this stage, granthi are formed in twacha.
4. Chatur avastha → there is involvement of central nervous system.
Nadi samsthaniya phiranga
Phirangajanya khanjata

Chikitsa:
Nidana parivarjana
Raktamokshana (jalaukavacharana)
Vrana Prakshalana with Nimbapatra kwatha, triphala kwatha, sphatika churna
Vrana shodhana ropana with triphala masi, vranaghna malhar, paradadi lepa vati
Rakta shodhaka aushadha prayoga – Manjistha, nimba, amalaki

Formulations:
• Rasamanikya • Laghumanjisthadi kwatha
• Arogyavardhini vati • Khadirarista
• Chopachini churna • Nimbadi churna
• Patoladi kwatha

SYPHILIS
Syphilis is a sexually transmitted disease (STD) caused by the bacterium Treponema
pallidum.
Syphilis is most commonly spread through sexual activity. It may also be transmitted from
mother to baby during pregnancy or at birth, resulting in congenital syphilis.

131
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Stages:
1. Primary syphilis:
Starts as painless erythematous ulcer.
Site: genital, perineal or anal area
2. Secondary syphilis:
2 – 12 weeks of development of primary syphilis. Characterised by low-grade fever, malaise,
sore throat
3. Tertiary syphilis:
Characterised by gumma & appear 3 – 10 years after infection.
Gummatous syphilis
Cardiovascular syphilis

Treatment:
• In early infection: • Ceftriaxone
• Doxycycline & tetracycline

In late infection:
Once weekly IM benzathine penicillin.

PUYAMEHA
There is puyasrava (pus – discharge) from mutra marga (urethra) in this disease, it is called
puya meha.

Nidana:
• Sexual contact
• Sex with a woman who has yoni vyapada
• Indulging in sexual activities by raja swala stree
• Multiple sexual partners
• Not using nirodha.

Lakshana:
• Pus discharge from urethra.
• Redness & swelling of urethra.
• Painful & burning micturition
• Sometimes urinary retention due to dried pus.
• Itching around urethral opening

132
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Chikitsa:
• Nidana parivarjana
• Maithuna tyaga
• Veshyagamana nishedha
• Shothahara aushadha
• Vrana hara aushadha
• Vatanulomana, mutrala, raktashodhaka aushadha
• Shishna / yoni Prakshalana with –
• Sphatika jala
• Nimbapatra kwatha
• Panchavalkala kwatha
• Uttara basti with – triphala + pippali kashaya, triphala + dadhi + tuttha +
mridarashriga kashaya

Shamana aushadhis:
• Trivanga bhasma • Arogyavardhini vati
• Rasa manikya • Manjisthadi kwatha
• Pravala pishti • Vidangarishta
• Gandhaka rasayana • Shilajatwadi vati

GONORRHOEA
Gonorrhoea is a sexually transmitted infection caused by the bacterium Neisseria
gonorrhoeae
Gonorrhoea is spread through sexual contact with an infected person. This includes oral, anal
and vaginal sex.
It can also spread from a mother to a child during birth

Clinical features:
• Burning with urination
• Discharge from the penis
• Testicular pain
• If untreated, gonorrhoea can spread to joints or heart valves

Treatment:
• Injectable ceftriaxone is effective antibiotics.
• Combination of azithromycin or doxycycline.

This condition is correlated in ayurveda with puyameha vyadhi.

UPADAMSHA / DHWAJABHANGA
Upadamsha is characterised by peeta srava yukta vranotpatti on genital organs of men and
women.

133
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Nidana:
• Linga abhighata by hasta, mukha, danta, nakha during hasta maithuna or mukha
maithuna
• Linga adhavana (not cleaning the genitalia)
• Rati atisevana
• Yoni pradosha
• Kuyoni gamana

Samprapti:
Nidana → jeevana sankramana → pita pradhana sotha utpatti in jananaga → vranotpatti →
upadamsha roga

Bheda:
1. Vataja 4. Raktaja
2. Pittaja 5. Sannipataja
3. Kaphaja

Lakshana:
Vataja → toda, bheda, sphurana, krishna sphota
Pittaja → peeta varnata, bahukledi, sadana
Kaphaja → kandu, Shopha, mahat, sravayukta
If upadamsha is not treated, or in late stage it causes gangrene of genitalia that is shishnamani
fall out.

Chikitsa:
• Nidana parivarjana
• Snehana, Swedana
• Raktamokshana by siravyadha or jalaukavacharana on genital organ.
• Vamana & virechana
• Anuvasana & niruha basti
• Vrana Prakshalana with grahi, jantughna, visankramana kwatha i.e., panchakshiri
kwatha, triphala kwatha, Bhringaraja swarasa
• Vrana ropana with triphala masi, jatyadi taila, vranarakshasa taila
• Lepana, dhupana, bandhana

Shamana aushadhis:
• Trivanga bhasma • Patoladi kwatha
• Upadamsha gajakesari rasa • Karanjadhya taila
• Gandhaka rasayana • Jatyadi taila
• Kasisa bhasma • Vranarakshasa taila
• Kaishor guggulu • Upadamshahara lepa
• Triphala masi

134
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
CHANCROID
Also known as soft chancre and ulcer molle.
Chancroid is a bacterial sexually transmitted infection characterized by painful sores on the
genitalia. It is caused by the bacterium called ‘bacillus or Ducrey’
Chancroid spread from one individual to another solely through sexual contact.

Clinical features:
• Small, red bump on genitals.
• The ulcers are frequently painful
• The ulcers may bleed easily if touched.
• Pain may occur during sexual intercourse or while urinating.
• Swelling in the groin may occur.

Treatment:
• An oral dose of azithromycine, ceftriaxone, erythromycin, ciprofloxacin.
• Abscesses are drained
• Aminoglycosides such as gentamicin, streptomycin.

LYMPHOGRANULOMA INGUINALE
Lymphogranuloma inguinale is a sexually transmitted disease caused by the bacterium called
chlamydia trachomatis.

Symptoms:
• Blood or pus from anus
• Pain in anal area when defecation
• Constipation

Laboratory tests for STDs:

• Blood test
• Urine samples
• Fluid samples
• Syphilis serology
• HIV – ELIZA test
• Chlamydia test

135
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)

7. Introduction, Definition and Management of Kama, Krodha, Lobha,

Moha, Mada, Matsarya, Shoka, Bhaya, Vishada, Dainya, Harsha and
Pragyaparadha.

MANO BHAVA
KAMA
Lust / passion
Desire to obtain the objects
Aggravation of vayu caused by kama, shoka & bhaya
Kamaja jvara: due to kama manobhava

KRODHA
Anger
A strong feeling of annoyance, displeasure or enemity to someone.

Assessment of krodha:
• Redness of face and eyes
• Tightened eyebrows
• Tying teeth
• Saying good and bad and finally expressed in form of fights, abuses etc.
• Gradually the person becomes irritable, angry which in the end may generate
psychoses.
• Krodha produce pitta which causes pittaja jwara and other pitta diseases.

Chikitsa:
• Production of kama suppress krodha janya jwara and production of krodha suppress
kamaja jwara
• Brahmi vati
• Shankhapushpi
• Pranayama
• Swasthavritta
• Achara rasayana palana
• Satvika diet should be consumed

LOBHA
Greed
Intense and selfish desire for something, especially wealth, power or food.

MOHA
Delusion
Intense passion, or a mistaken belief that is held with strong conviction even when presented
with superior evidence to the contrary.

136
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
MADA
Neurosis
Madness or intoxication which leads to anxiety or confused state of mind.

MATSARYA
Malice
To desire to harm someone – ill will.

SHOKA
• Grief / sorrow
• Special condition of mind due to –
• Disconnection of wealth
• Destruction of wealth
• Death of loved one
• Failure of some tasks
• Expression of shoka → person cries, sobs, sighs, chest thumps, falls to earth, become
unconscious

Chikitsa:
Counselling, tell him about mortal things, consumption of medhya rasayana, satsang,
pranayama

BHAYA
Fear
The feeling that has when something dangerous, painful or frightening might happen
Occurs due to insecurity, failure

VISHADA
Depression
A state of low mood, feeling of severe dejection and aversion to activity due to failure or
other cause.

Symptoms:
Headache, insomnia, excessive worrying, restlessness, lack of fighting power. If proper care
is not taken, then the patient can take his life as a result of regret.

Chikitsa:
First find the cause of depression
Give ashwasana
Satvika ahara vihara
Ashwagandha, kapikacchu prayoga

137
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
DAINYA
Misery
A state of feeling of great, physical and mental distress or discomfort.
When a person loses patience, the feeling arises is called dainya.

HARSHA
Euphoria / joy
Intense excitement and happiness
On receiving the desired thing, person or news, this condition occurs.

PRAGNAPARADHA
Due to derangement of intellect and memory violating the normal procedures / acts, or doing
unwholesome practice knowingly.
Pragnaparadha has been described as the cause of all diseases.

Chikitsa:
Manoroga chikitsa

Especially sattwavajaya chikitsa →

Increases sattva quality of mind and decreases rajas and tamas.
Main aim is restraining mind from desire of unwholesome objects.

Techniques:
Jyana → knowledge of self
Vijnaja → analytical knowledge
Dhairya → patience and confidence
Smruti → keeping good memories
Samadhi → concentration and meditation

138
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)

8. Manas and Manovahasrotas, Nidana and Chikitsa of the following

disorders - Unmada-Apasmara-Atattvabhinivesha, Chittodvega,
Vishada, Anxiety disorders, Depression, Somatoform and Mood
disorders, Stress induced disorders, Psychosexual Disorders.
Importance of Daivavyapashraya, Sattwavajaya, Adravyabhuta
Chikitsa. Medhya Rasayana in the management of Manasa Roga. Bhuta
Vidya diagnosis and management of graha disorders.

UNMADA
Unmada is the disease in which there is abnormality, contradiction and variation in the
qualities of mind, intellect, knowledge, memory, desire, character and actions
Perversion of mind.

Nidana:
Intake of viruddha, dushta, ashuchi foods and drinks.
Insult to the gods, guru and dvijas (people belonging to the families of brahmanas, vaidhyas
and kshatriyas)
Manoabhighata due to fear and sudden happiness
Unwholesome physical and mental activities

Samprapti:
The excited dosha of the individual with alpa satwa mounting upwards through manovaha
srotas vitiate hridaya which is the seat of buddhi and disturb manas, and occlude
manovahasrotas as a result, chitta is disturbed and this condition is called unmada.

Purva rupa:
• Feeling of emptiness in head
• Loss of appetite
• Irregular behaviour
• Excessive thinking
• Exhausion

Bheda:
1. Vataja unmada
2. Pittaja unmada
3. Kaphaja unmada
4. Sannipataja unmada
5. Agantuja unmada → 8 types of bhutonmada
a. Daivonmada e. Yakshonmada
b. Shaponmada f. Rakshshonmada
c. Pitrugrahaja unmada g. Brahmarakshsonmada
d. Gandhrvonmada h. Pishachonmada

139
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Acharaya sushruta explained 6 types of unmada instead of agantuja unmada.
Manasaja unmada → produced due to mental shock or psychological shock and is
characterized by irrelevant talk and unusual behaviour.
Vishaja unmada → produced due to poisoning and is characterized by blackish discolouration
of face and destruction of bala & indriya

Samanya lakshana:
• Mental disturbance
• Aggressive and unstable mind
• Irrelevant talk
• Emotionlessness
• Feeling of hollowness of heart.

Vishesha lakshana:
1. Vataja unmada →
At inappropriate place or without any cause laughing, smiling, dancing, singing, speaking,
moving limbs.
Body becomes rough, emaciated, and reddish.
2. Pittaja unmada →
Intolerance, over dancing, nakedness, excessive heat & anger
Desire for shade, cold food, cold water
3. Kaphaja unmada →
Sluggishness in speech and activity
Linking for women and lonely places
Excessive sleep, vomiting, salivation
4. Sannipataja unmada →
All three dosha lakshanas present
5. Agantuja unmada →
Also known as bhootonmada
Caused by improper observance of niyama, insult to gods, sages etc. in present life and sinful
acts of past life.
Lakshanas are supernatural speech, supernatural knowledge.

Chikitsa:
1. Daiva vyapashraya:
Chanting of mantras, homas, spiritual healing, religious rituals etc.
2. Yukti vyapashraya:
Nidana parivarjana

140
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Samshodhana chikitsa:
• Snehana, Swedana
• Vamana, virechana
• Anuvasana & niruha basti
• Anjana, avapeeda nasya, pradhamana nasya
• Dhoomapana, dhupana karma

Samshamana chikitsa:
Abhyanga
Pradeha, parisheka, anulepana

Trashana chikitsa:
The patient is tied, and kept confined to a dark room devoid of iron & wooden pieces.
Body is rubbed with kapikacchu or branded with hot iron rods or burnt with hot oil or water
or beaten with hunter etc.
Shouting with anger, threating, terrorizing to the patient bring back the natural state of mind.

Shamana yogas:
• Unmada gajakesari rasa • Saraswata churna
• Unmada gajankusha rasa • Lasunadhya ghrita
• Sarpagandha ghanavati • Kalyanaka ghrita
• Brahmi vati • Siddharthaka ghrita
• Sarpagandha churna • Siddharthaka agada
• Ashwagandha churna • Purana ghrita
• Jatamansi churna

3. Satvavajaya chikitsa → Psychotherapy

Doshanusara chikitsa:
1. Vataja unmada chikitsa:
Snehapana
If vata is obstructed or covered by kapha-pitta then mrudu vamana-virechana.
2. Pittaja & kaphaja unmada chikitsa:
Snehana – Swedana
Vamana for kaphaja
Virechana for pittaja
3. Agantuja unmada chikitsa:
Ghritapana
Mantropachara
Rativishayaka Upahara

141
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Vigata unmada:
Clarity in perception of sense objects, clarity of intelligence, self as well as mind, and
normalcy of body elements are lakshanas of the person free from unmada.

APASMARA
Loss of memory for a while, associated with a feeling of entering into darkness
(unconsciousness), irrelevant body movements, due to derangement of intellect & mind are
the signs of apasmara.

Nidana:
• Habitual intake of unwholesome and unclean food
• Suppression of the sattva by rajas and tamas
• Occlusion of the heart by the aggravated doshas
• Affliction of mind by worry, passion, fear, anger, grief, anxiety etc.

Samprapti:
Nidana sevana → vatadi dosha prakopa, raja tama prakopa → sthanasamshraya at hridaya
(mastishka) → smruti → tama pravesha & bheebhatsa cheshta → apasmara

Purvarupa:
• Visualizing non-existing things
• Falling down
• Twitching of eyes, tongue, eyebrows
• Excessive salivation
• Convulsive movement of hands & feet etc.

Bheda:
1. Vataja apasmara 3. Kaphaja apasmara
2. Pittaja apasmara 4. Sannipataja apasmara

Samanya lakshana:
• Smrutinash • Bhibhatsa chesta
• Lala srava • Irrelevant mental activities
• Tama pravesha • Convulsions

Vishesha lakshana:
1. Vataja apasmara:
Tremors in the body, biting teeth
Seeing things as red & black
2. Pittaja apasmara:
Yellowish discolouration of body & eyes
Seeing things as yellow red.

142
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
3. Kaphaja apasmara:
Pale body & eyes
Seeing things as white
4. Sannipataja apasmara:
All 3 dosha lakshanas are present
It is incurable.

Chikitsa:
First of all, the physician should use samsodhana chikitsa to clear the obstruction of
manovaha srotas and to protect the chetana of the patient.

In vataja apasmara → basti

In pittaja apasmara → virechana
In kaphaja apasmara → vamana

Nasya in apasmara:
Nasya with kapila Gaumutra is best to cure apasmara also use urine of dog, cats etc.
Nasya with bharangi, vacha & naga danti triturated with gomutra.
Nasya with triphaladi taila cures apasmara.

Samshodhana chikitsa:
Nidana parivarjana
Abhyanga with sarshapa taila processed with ajamutra
Dhoopana with pippali, saindhava lavana, chitraka, hingu, sarshapa, chandana & asthi of dog.
Utsadana with tulsi etc. mixed with gomutra.

Shamana yogas:
• Smriti sagara rasa • Panchagavya ghrita
• Saraswata churna • Mahapanchagavya ghrita
• Ashwagandha churna • Brahmi ghrita
• Dashamoola kwatha • Siddharthaka ghrita etc.

Medhya rasayana prayoga →

Apasmara is the chronic disease related to smruti, which should be treated with rasayana like
brahmi, mandukaparni, yastimadhu, guduchi, shankhapushpa, Jyotishmati, vacha, jatamansi
etc.

Agantuja apasmara should be treated similar to unmada chikitsa.

ATATWABHINIVESHA
Atatva means false, non-elementary having no existence.
Abhinivesha means interpretation.
Atatwabhinivesha means attachment to unreality.

143
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Lakshana:
The patient thinks or believes in the things which are not in existence.
He cannot differentiate good things from bad things. He believes the beneficial things as
harmful and harmful things as beneficial.

Samprapti:
Vitiated dosha affects hridaya, channels connected to mind and intellect of a person →
produces confusion → attachment to unreality.

Chikitsa:
• Samshodhana chikitsa
• Snehana, Swedana, vamana etc.
• After shodhana, sansarjana karma should be done.
• The medhya annapana should be given to the patients.

Shamana chikitsa:
Drug which is having teekshna, Srotoshodhana, tridoshahara. Medhya is the ideal for
combating the pathogenesis of atatwabhinivesha.
Medhya rasayana like brahmi, shankhapushpi
Panchagavya ghrita

Aashvasana chikitsa:
Includes reading of religious books, speaking wise thoughts by the aid of patience, memory

Yoga therapy:
• Pranayama
• Meditation
• Deep relaxation techniques

CHITTODVEGA
Chittodvega is an anxious status of mind or anxiety of mind.

Lakshana:
• Illusion
• Easy fatiguability
• Inability to concentrate
• Mind going blank.

In modern science, chittodvega is correlated with anxiety disorders.

ANXIETY DISORDERS
Anxiety disorders are a group of mental disorders characterised by significant feelings of
anxiety and fear.

144
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Anxiety is a worry about future events, and fear is a reaction to current events.
These feelings may cause physical symptoms, such as a fast heart rate and shakiness.

Causes:
• Combination of genetic and environmental factors.
• History of child abuse
• Family history of mental disorders
• Poverty
• Alcohol abuse
• Occur with other mental disorders, particularly major depressive disorder, personality
disorders.

Classification:
• Broadly classified in number of anxiety disorders including –
• Generalized anxiety disorder
• Specific phobia
• Agoraphobia
• Social anxiety disorder
• Post traumatic stress disorder
• Panic disorder
• Obsessive compulsive disorder
• Selective mutism

Generalized anxiety disorder:

Characterised by long-lasting anxiety that is not focused on any one object or situation.
Persistent fear & worry
Restlessness, fatigue
Concentration problems
Sleep disturbances

Specific phobia:
Unreasonable or irrational fear related to exposure to specific objects or situations
i.e., fear of dogs, spiders, snakes
fear of water (aquaphobia)
fear of heights (acrophobia)
fear of darkness (nyctophobia)
fear of blood (hemophobia)

Agoraphobia:
Specific anxiety about being in a place or situation where escape is difficult or embarrassing
or where help may be unavailable.

145
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Social anxiety disorder:
Intense fear and avoidance of negative public scrutiny, public embarrassment, social
interaction
Symptoms like blushing, sweating and difficulty speaking.

Post traumatic stress disorder:

Results from a traumatic experience
Results from extreme situation, such as combat, natural disaster, rape, hostage, situations,
bullying, or even a serious accident.

Panic disorder:
Characterised by reoccurring unexpected panic attacks
Symptoms:
Sudden periods of intense fear, sweating, shaking, shortness of breath

Obsessive compulsive disorder:

OCD is a condition where the person has obsessions (distressing, persistent, intrusive
thoughts or images) and compulsions (urges to repeatedly perform specific acts or rituals)
In this people feel the need to check things repeatedly, perform certain routines repeatedly or
have certain thoughts repeatedly.
In ayurveda this condition correlated with atatwabhinivesha.

Selective mutism:
In which a person who is normally capable of speech does not speak in specific situations or
to specific people.

Ayurvedic management:
• Nidana parivarjana
• Panchakarma therapies followed by shamana chikitsa should be advocated
• Abhyanga
• Snehapana – mahakalyanaka ghrita
• Shiroabhyanga – with medicated liquids
• Shirobasti – with chandanadi taila
• Shirodhara with medicated liquid like chandanadi taila
• Pichu with ksheerabala taila
• Takra dhara daily 45 min for 14 days
• Nasya karma with brahmi swarasa

Drug therapy:
• Ashwagandha churna • Sarpagandhadi vati
• Brahmi churna • Ksheerabala taila
• Kalyanaka ghrita

146
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
DEPRESSION / MOOD DISORDER
Depression is a state of low mood and aversion to activity that can affect a person’s thoughts,
behaviour, tenderness, feelings, and sense of well being

Etiology:
• Genetic cause
• Environmental factors
• Dopaminergic activity: reduced in case of depression. Over activity in mania.
• Studies have shown that those who identify as LGBT are more prone to depression.
• Drug induced depression
• Endocrine factors: hypothyroidism, Cushing’s syndrome

Types:
1. Major depressive disorder:
Recurrence of long episodes of low moods, or one extended episode that seems to be ‘never
ending.’

2. Atypical depression:
Increased appetite
Sensation of heaviness in limbs

3. Post partum depression:

Refers to the intense, sustained and sometimes disabling depression experienced by women
after giving birth.

4. Catatonic depression:
Disturbance of motor behaviour
Also occur in schizophrenia or in manic episodes.

5. Seasonal affective disorder:

Depressive episodes come on in the autumn or winter, and resolve in spring.

6. Melancholic depression:
Loss of pleasure in most or all activities, a failure of reactivity to pleasurable stimuli

7. Manic depression (bipolar disorder)

Alternating periods of mania and depression.
Four episodes of bipolar disorder
Depressive episode
Manic episode
Hypomanic episode
Mixed mood states

147
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
8. Dysthymic depression:
Lasts a long time but involves less severe symptoms.
Lead a normal life, but may not be functioning well or feeling good.

9. Psychotic depression:
Major depressive episode
Symptoms such as delusions or less commonly hallucinations

Symptoms:
• Reduced concentration and attention
• Reduced self-esteem and self confidence
• Ideas of guilt and unworthiness
• Ideas or acts of self-harm or suicide
• Disturbed sleep
• Diminished appetite

Treatment:
• Cognitive behavioural therapy
• Music therapy
• Psychotherapy
• Animal assisted therapy
• Physical exercise
• Medicines such as antidepressants can consists of antipsychotics, mood stabilizers and
lithium.

SOMATOFORM DISORDERS
A somatoform disorder is the manifestation of psychological conflict in physical form, which
can include paralysis, blindness, and physical pain.

PSYCHOSEXUAL DISORDER
Psychosexual disorder is a term which may simply refer to a sexual problem that is
psychological rather than physiological in origin.
Sexual stages like excitement, orgasm and resolution are psychologically determined, are
responsible for various sexual disorders.

Classification:
There are three major group of sexual disorders
1. Dysfunction:
Dyspareunia or experience of more pain during the sexual act.
Decreased desire or sexual aversion is associated with fear, anxiety, and dislike
Impotence, premature ejaculation, inhibited male orgasms and vaginismus (involuntary
contraction of vagina in female) are the visible symptoms of sexual problems.

148
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
2. Paraphilias:
It is the unusual or abnormal sexual behaviour that does not follow the normal standards.
This category of sexual disorder exhibits abnormal preference of sexual objects that include –
Fetishism (preference of sexual inanimate objects)
Fetishistic transvestism (wearing clothes of the opposite sex),
Paedophilia (pre-pubertal children),
Zoophilia (animals),
Necrophilia (dead bodies)
Exhibitionism → usually males expose their genitals usually to unsuspecting strangers and
become sexually excited when doing that.
Voyeurism → a person who gains sexual pleasure from watching others when they are naked
or engaged in sexual activity.
Sexual sadism → it is the condition of experiencing sexual arousal in response to the extreme
pain, suffering or humiliation of others.
3. Gender identity disorders:
It is the feeling of discomfort or distress that might occur in people whose gender identity
differs from their sex assigned at birth or sex related physical characteristics
Transgender and gender diverse people might experience at some point in their lives.
Also known as gender dysphoria.

Treatment:
Psychosexual counselling
Behavioural and cognitive therapy
Group therapy
More serious sexual perversions may be treated with androgen blockers, GnRH modulators,
selective serotonin reuptake inhibitors (SSRIs)
To help restore hormonal and neurochemical balances.

SMRITI BHRAMA
Means loss of memory

Causes:
• Jara sambhava • Madatyaya, meda
• Unmada, apashmar, • Alpa satva
atatwabhinivesha

Lakshana:
• Forgetfulness
• Difficulty to undertake even simple and routine tasks
• Thinking errors
• Often mood elevations / fluctuations
• Lack of motivation
• Communication problems

149
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Chikitsa:
Single herbs
• Haridra • Brahmi • Lasuna
• Ashwagandha • Dhanyaka
• Vacha • Maricha

Ayurvedic formulations:
• Brahmi ghrita • Brahmi vati
• Panchagavya ghrita • Vachadi churna
• Shankhapushpi ghrita • Saraswatarishta
• Medhya ghrita • Swarna vacha
• Manasamitra vati

IMPORTANCE OF DAIVAVYAPASHRAYA, SATTWAVAJAYA, ADRAVYA

BHUTA CHIKITSA
1. Daivavyapashraya chikitsa:
This is to cure diseases caused by agantuja bhutadi, papa, adharma janya purva janmakarma.
a. Mantra
b. Aushadhi dharana / sevana
c. Mani dharana
d. Mangala karma
e. Bali
f. Upahara
g. Homa
h. Niyama
i. Prayashchita
j. Upavasa / vrata
k. Swastika vachana
l. Bow to devata, guru & pujya
m. Visit to tirtha sthana

Purvajanma kurta karma is named as daiva; and the treatment which cures it is known as
daiva-vyapashraya. Effective in almost all diseases.

2. Sattwavajaya chikitsa:
पुनराहहतेभ्योऽथेभ्यो मनोननग्रह:
Sattwavajaya is the treatment where mana is being stopped going towards ahita artha. This is
the main treatment of manasika roga.

150
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
3. Adravya bhuta chikitsa:
Adravyabhuta chikitsa includes all those treatments wherein no drug or pharmacological
approach is involved.
Some examples are –
• Nidana parivarjana
• Achara rasayana
• Langhana
• Vyayama
• Nidra
• Brahmacharya
• Bhayadarshana
• Vismapana
• Harshana
• Bandhana
• Samvahana
• Ekantavasa

MEDHYA RASAYANA IN MANASA ROGA

Medhya rasayana play an essential role in the treatment of psychiatric and psychosomatic
disease.

The mode of this therapy involves the individual to attain sedation, calmness, tranquillity or a
stimulation of activities of brain.

Neurological and psychiatric disorders are generally associated with loss of memory,
cognitive deficiency impaired mental functions etc.

Medhya rasayanas are known to have specific effect on mental performance by promoting the
functions of buddhi and ‘manas’ by correcting the disturbance of rajas and tamas.
These drugs promote the intellect (dhee), retention power (dhruti), and memory (smruti)

Maximum medhya rasayana is concerned having ‘shita virya’ and ‘madhura vipaka’ whereas
some of them are ‘ushna virya’ and ‘tikta rasa’
Ushna virya medhya drugs are helpful mainly in grahana and smaranam functions.
Whereas shita virya medhya drugs are helpful in dharana functions.
i.e., mandukaparni swarasa
yastimadhu churna
guduchi swarasa
shankhapushpi churna
brahmi swarasa
vacha
Jyotishmati
Jatamansi etc.

151
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
BHUTA VIDHYA DIAGNOSIS AND MANAGEMENT OF GRAHA DISORDERS
Bhuta vidhya is a branch of the eight principle branches of astanga ayurveda. It is also called
graha chikitsa and deals with psychology and psychiatry (manasika vikara). In ayurveda, it is
used for the diagnosis and treatment of diseases resulting from unknown reasons.

Different experts have explained the word ‘bhuta’ differently →

• Some experts say that ‘bhuta’ means ghosts and similar evils spirits who cause
abnormal psychological conditions.
• Others say ‘bhuta’ represents microscopic organisms such as virus, bacteria that are
not visible to naked eyes.
• In modern terminology, it can be considered as idiopathic diseases in which the exact
cause of disease is unknown.

Ayurveda also believes in the past karma or deeds as a causative factor of certain diseases.
Bhuta vidhya deals with the cause, which are directly not visible and have no direct
explanation in terms of tridosha.

In most cases illness is caused by the disturbance of mind, where rajas and tamas are
supposed to be the contributing factors. These psychiatric diseases are a result of the
affliction from the deva, asura, gandharva, yaksha, rakshasa, pishacha, naga and other
demons or evil spirit.

The problems and ailments dealt under the Graha chikitsa or Bhut vidhya can be related to
modern psychiatry.

The treatment includes →

Ashwasana or manaso upachara → counselling of patient
Graha vidhya dravya prayoga → use of certain herbal disinfectants as fumigation (dhupana)
or simply keeping the sticks or leaves in the room to disinfect the atmosphere of the patient.
Examples of dhupana dravya: guggulu, agaru, vacha, nimba, mahanimba, sarshapa, pippali,
chitraka, hingu, chandana, karpura etc.
Mantrocchara & anushthana → chanting mantras and performing tantric rituals to pacify the
affliction of evil spirits and demons.
Yoga → use of yogic therapies like dhyana and pranayama to pacify the psychological
disturbance of a patient.

152
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)

9. Derivation, definition and synonyms of Rasayana, importance of

Rasayana and its benefits. Indications of Rasayana therapy.
Classification of Rasayana. Kutipraveshika and Vatatapika Rasayana.
Indications of Vatatapika Rasayana. Knowledge of Kayakalpa, Achara
Rasayana. Procedures of Kutipraveshika, Poorvakarma and specific
schedules to be followed after Kutipravesha, benefits of
Kutipraveshika Rasayana, duration of process, Rasayana yoga and
directions for their use. Determination of dose of Rasayana according
to age. Rules and regulation after Rasayana therapy, Importance of
Immunomodulators and antioxidants in Rasayana therapy.

DEFINITION OF RASAYANA
लाभोपायो हह शस्तानां रसादीनां रसायनं |
That which help in attaining the prashasta rasaraktadi dhatu by nourishing and strengthening
the body, is called as rasayana.

यजरा व्याचिववर्धवांभस वयः स्तम्भकरं तथा |

िक्षुष्यं बह
ृ र्ं वष्ृ यं भेर्जं तद् रसायनम ् ||
According to bhavamishra, rasayana dravya is having following features →
Jara vidhvamsi (jarahara)
Vyadhi vidhvamsi (vyadhi hara)
Vaya stambhakara (vaya sthapana)
Chakshushya (promoting vision)
Brimhana (nourishment of dhatus)
Vrishya (promoting virility)
Bheshaja (acts as quality drug)

BENEFITS (IMPORTANCE OF RASAYANA)

दीर्णमायुः स्मनृ तं मेिामारोनयं तरुर्ं वयः |
प्रभा वर्ण स्वरौदायण दे हेच्न्िय बलं परम ् ||
वाच्क्सविं प्रर्नत काच्न्तं लभते ना रसायनात ् |
लाभोपायो हह शस्तानां रसादीनां रसायनम ् ||
By using of Rasayana, person achieves long life, sharp memory, intelligence, optimum
health, youth, luster and better colour complexion of skin, better voice, optimum strength of
the body and sense organs, vaaksiddhi (what he says becomes true), popularity, brilliance etc.

153
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
TYPES / CLASSIFICATION
in rasayana therapy, the bhesaja (medicine) is divided into two types viz.
1. Swasthasya urjaskar
2. Aaturasya roganut

Swasthasya urjaskar bheshaja is again divided into two types viz.

1. Rasayana
2. Vajikarana

Rasayana can be classified variously, on the basis of following factors.

1. According to mode of administration → 2 types:
Kutipraveshika
Vatatapika
2. According to dravya etc. → 2 types:
Dravyabhuta → amalaki, pippali, bala etc.
Adravyabhuta → achara rasayana, sada vakya, yoga etc.
3. According to modalities → 3 types:
Achara rasayana
Ahara rasayana
Dravya rasayana
4. According to achievable outcomes → 3 types:
Naimitika rasayana
Ajashruka rasayana
Kamya rasayana

Naimitika rasayana:
Nimita means cause. Naimitika rasayana is also known as rogapaharana or curative type of
rasayana. It is used to combat or balance a specific cause responsible for the disease in the
body.
For example
Triphala rasayana for netra roga
Arjuna for hrida roga
Loha bhasma for pandu
Agastya rasayana for shwasa
Shilajatu for prameha
Medhya rasayana for unmada – apasmara

Ajashruka rasayana:
This rasayana is used to maintain good health and improve the quality of life through a
healthy lifestyle, diet or exercise. It is also called as vayasthapana rasayana. Few examples
include – ksheera, ghrita, anna, phala sevana, yoga, pranayama, sadavrutta palana etc.

Kamya rasayana:
It is described as to fulfil a wish or to serve a special purpose (kama means desire).

154
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
It is of three types viz.
1. Prana kamya → to achieve best quality of prana (life energy) in the body. E.g.,
amalaki, haritaki, bibhitaki, nagabala, ashwagandha rasayana etc.
2. Medha kamya → enhancing the memory and intellect e.g., manduka parni,
yashtimadhu, guduchi, shankhapushpi, brahmi, vacha, Jyotishmati rasayana etc.
3. Shree kamya → to promote the complexion and luster of a person. These rasayana
drugs are divine herbs (divya aushadhi)

KUTI PRAVESHIKA RASAYANA VIDHI PRAYOGA

Among the two methods of using rasayana, the kutipraveshika method is considered the best
because this method gives the benefit of rasayana soon.

The meaning of kuti here is from the trigarbha kuti made in a special design. This kuti is
made in such a way that it protects from sun & wind or to assume that the patient does not
have any special effect on the body due to change in the environment.

Construction site of kuti:

The place where the king, doctor, brahmin, kshatriya, vaishya and sage resides and all the
necessary materials are available, get the kuti constructed in the east-north part of the city.

Purva karma:
Patient, free from raja & tama dosha with concentration, faith and patience enters the kuti on
auspicious day in the presence of surya, suklapaksha, shubh nakshatra & muhurta after
offering the pooja & pradakshina to the devata & bramhana.
Sanshodhana i.e., vamana, virechana, niruha basti and nasya should be administered.

Pradhana karma:
During pradhana karma, it is advised to consume rasayana while living in the kuti. Person
taking rasayana should consume rasayana along with bathing, routine as well as meditation,
perception, chanting, self-contemplation and reading of spiritual books. Food should be taken
in short and small quantities during the entire rasayana intake period. Generally, rasayana
should be done by staying in the kuti for 60 – 90 days.

Paschat karma:
One should not come out of the kuti immediately after the rasayana intake period is over,
because many diseases can be caused by immediate contact with the external environment.
Therefore, after staying in the middle of the kuti from inside and then in the outside kuti, then
it should be taken out.

Benefit of kutipravesika rasayana:

In this way, old hair, nails and teeth fall off due to consumption of rasayana and new teeth,
nails and hair start coming. The person becomes beautiful and veeryavana. There is increase
in medha, bala, buddhi, & satwa. This person lives for a thousand years in a niramaya state,
that is he lives a long life.

155
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
VATATAPIKA RASAYANA
When a person consumes rasayana while being in wind & sun, then it is called Vatatapika
rasayana vidhi. This is the external rasayana consumption method, the person who does not
have much time does not have complete control over the mind. Who cannot stay away from
his family for a long time, he can consume rasayana by this method.

Importance of shodhana before administration of rasayana chikitsa:

Acharyas has mentioned that “as dirty clothes cannot be coloured properly, patients without
shodhana cannot get proper result of rasayana & vajeekarana.

KAYAKALPA
Kayakalpa is an ancient system for total body rejuvenation. Originating in India circa 3000
B.C.E., Kayakalpa purifies and nurtures the body, mind, and soul with a series of customized
therapy sessions, herbal and mineral preparations, vital breathing practices, dietary
guidelines, and daily living recommendations.
The name Kayakalpa comes from the Sanskrit kaya (bodies) and kalpa (transmutation).
Kayakalpa brings the physical and energetic, or subtle bodies back into balance through a
process of purification and nourishment. This enables one to transcend any degenerative
conditions and attain an optimal metabolic state for health and recovery.
Kayakalpa’s history reaches back to the Siddha yogis of India, ancient sages renowned for
their youthful longevity and supernatural powers. It is considered to be the precursor to the
Ayurvedic system, and is believed to have been first transferred from the god Shiva to his
wife Parvati, and from her to the Siddhas, who practiced Kayakalpa as a sacred science to
attain Siddhi (mystical powers).

Purification:
A key element of the Kayakalpa medical philosophy is Purification.
The Siddhas chose to purify their physical and subtle bodies, in order to facilitate the flow of
health, consciousness, knowledge, and action.
Mind is the organ of consciousness, where people store their memories and desires. When
these desires are unfulfilled it creates a melancholic state which produces a bio-toxicity
known as Ama, destroying the immunity of the entire system and depleting the quality of its
tissues. Kayakalpa is designed to rid the body of Ama, purifying it to allow the energy and
vitality flow through you as a clear channel.

Nourishment:
The second key element of Kayakalpa philosophy is Nourishment. Your treatments, diet and
herbs are designed to nourish the purified body.
In Kayakalpa, taste is the key to nourishment. There are six tastes: sweet sour, salt, astringent,
pungent, and bitter. Depending on your constitution, the appropriate taste profile is carefully
chosen to nourish your body. With this guiding principle, Kayakalpa classifies all food types
according to their taste, which determines their impact on the biological principles of Air,
Fire and Water.

156
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
An important feature of Kayakalpa is molecular nutrition or applied alchemy— which
consists of herbal-mineral compounds called Kalpas, preparations that bring about balance in
physiology, enhance immunity and slow down the aging process.
Nourishing the subtle body is as important as nurturing our physical body. Subtle nutrition is
the specific use of sound, color, aromas, gems, metals and breath customized for a particular
constitution. It nourishes the mind and senses and awakens, invigorates, and expands the flow
of energy.

INDICATIONS: (RASAYANA YOGYA)

Jitendriya → who can control his sense organs
Hitayu & sukhayu vyakti → who wants to live healthy life
Sadhana sampanna → who can afford the treatment
Savadhana vyakti → cautious
Dharmika
Non addicted
Free from mental stress
Between 16 – 70 years age
Male & female both are eligible
Shodita & snigdha

Contraindications: (rasayana ayogya)

Anatmavana → unstudied person
Aalasi → lazy person
Daridra → poor
Pramadi & vyasani → careless and addicted persons
Papakruta → evil person who indulges in sinful acts
Bheshaja apamani → who do not respect medicine
Patita → characterless
Sushrusha rahita → who do not have care taker

Ideal age for rasayana therapy:

Pariharini avastha i.e., 40 + age is the ideal age for initiation of rasayana chikitsa, as during
this stage all the dhatus reach peak stage (fully matured) and decline is likely to set in, if
rasayana are administered at this critical age, the dhatus may remain intact and sustain the
perfect health further.

AACHARA RASAYANA
Aachara rasayana deals with practice of ethics (achara) and regimen (vihara), collectively
known as ‘behavioural science’ to gain the excellence of satva-buddhi and Chetan (aatma).
Satyavadinam → to be honest / trustworthy
Akrodham → to be free from anger
Nivrutam madhamauthunat → to walk away from wine and women (sex)
Ahinsakam → to be non-violent
Anayasam → never be tired, but be cheerful

157
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Prashanta → to keep cool and calm
Priyavadinam → to speak good / talk sweetly
Japa shaucha karam → to practice mantra – chanting and is cleanliness
Dheeram dananityam → to be courageous and charitable (donates & serves to poor)
Tapasvinam → to practice yoga, meditation etc.
Daiva go brahmana acharya guru vriddha archaneratam → devoted to gods, cows, brahmins,
sages, teachers, elders, and serving them
Nitya karuna vedinam → ever compassionate, merciful
Sama jadarana swapnam → balanced sleep and awakening
Nitya ksheera ghrutashin → using ghee and milk regularly
Desha kala prmanagnam → to be aware of place & time, and act accordingly
Shastacharam asankirnam → to be well behaved and simple (transparent)
Upasitaram vruddhanam → accompanying (experienced) elders.
Aasitkanam →to have faith in God
Jitatmana → to be self-controlled, non-submissive to sensory

Medhya rasayana:
Medhya rasayana promote the intellect (dhee), retention power (dhruti), and memory
(smruti). They provide medha, aarogya, aayu, agnibala, dehabala, varna, and svara. Acharya
charaka has mentioned 4 medhya rasayana viz.
1. Mandukaparni swarasa
2. Yashtimadhu churna with dugdha
3. Guduchi swarasa
4. Shankhapushpi kalka

1. Mandukaparni → act on behaviour besides being neuroprotective brain growth

promoter, inhibits the memory impairment induced by scopolamine through the
inhibition of AChE.
2. Yashtimadhu → it increases the circulation into the CNS system, improves learning
and memory on scopolamine induced dementia.
3. Guduchi → possess learning and memory enhancing, antioxidant, and antistress
action, enhances the cognition in normal and cognition deficits animals in behavioural
test. It is useful for treatment of bhrama (Vertigo), in improving behaviour disorders,
mental deficit and IQ levels.
4. Shankhapushpi → effective in chittodvega (anxiety disorders), reverses the social
isolation stress induced prolongation of onset and decrease in pentobarbitone induced
sleep, increased total motor activity and stress induced antinociception in
experimental model.

The formulations of medhya rasayana drugs are of two types viz.

1. Sheeta virya madhura vipaka → it promotes kapha and enhances ‘dharana karma’ i.e.,
retention and cognition e.g., yashtimadhu, brahmi, shankhapushpi etc.
2. Ushna virya and tikta rasa → it promotes pitta and enhances grahana and smaranam
i.e., grasping power and memory e.g., guduchi, vacha, Jyotishmati etc.

158
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Examples of medhya rasayana:
Manduka parni, yashtimadhu, guduchi, shankhapushpi, Jyotishmati, brahmi, vacha,
jatamansi, ashwagandha rasayana, satata adhyayan, satsanga etc.

Rasayana according to srotas:

For giving strength and increasing immunity of the srotas or channel systems following
herbal, mineral, or metallic preparations can be given.
1. Pranavaha → pippali, maricha etc.
2. Annavaha → sunthi, lasuna, maricha, hingu, shankha bhasma
3. Udakavaha → phala swarasa, narikelodaka
4. Rasavaha → Shatavari, guduchi, kharjura etc.
5. Raktavaha → Manjistha, sariva etc.
6. Mamsavaha → ashwagandha, mamsarasa, swarna bhasma etc.
7. Medovaha → guggulu, shilajatu, vyayama etc.
8. Asthivaha → babbula niryasha, pravala, mukta etc.
9. Majjavaha → yashtimadhu, brahmi, jatamansi, rajat bhasma etc.
10. Sukravaha → kapikacchu, ashwagandha, Shatavari, ghrita, ksheera etc.
11. Mutravaha → gokshura, Punarnava, varuna etc.
12. Purishvaha → bilwa, haritaki, triphala
13. Swedavaha → dhatura, chandana etc.
14. Manovaha → mandukaparni, yashtimadhu, guduchi, brahmi, vacha etc.
15. Aartavavaha → ashoka, lodhra, Shatavari
16. Stanyavaha → Shatavari, methika

Jeevaniya gana dravya → jeevaka, rishbhaka, meda, mahameda, Kakoli, ksheera Kakoli,
mandukaparni, mashaparni, jeevanti, yashtimadhu

Rasayana according to disease:

Eye diseases → triphala, Jyotishmati, yashtimadhu, Dhatri lauha
Tuberculosis → pippali, lasuna, nagabala, shilajatu
Heart diseases → arjuna, shalaparni, pushkarmula, guggulu
Skin diseases → bakuchi, khadira, gandhaka, bhallataka, tuvaraka
Joint diseases → Shallaki, amruta bhallataka, Rasona
Diabetes → shilajatu, haridra, Aamalaki
Anaemia → Aamalaki, Punarnava, lauha bhasma
Grahani & gulma → pippali, bhallataka
Hypertension → kupilu, kasturi
Asthma → haridra, rasna, shireesha, Agastya rasayana
Allergies → haridra
Lipid disorders → guggulu, Rasona, haritaki
Brain & mental disorders → brahmi, shankhapushpi, Jyotishmati

159
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Rasayana & organs:
Brain → medhya rasayana like brahmi, shankhapushpi etc.
Kidneys → gokshura and Punarnava
Small intestine → trikatu & chitraka
Eyes → triphala
Heart → arjuna
Pancreas → mesha shringi, daru haridra
Large intestine → parpati preparations

Rasayana herbs according to prakriti →

Vata prakruti → ghrita, dugdha, ashwagandha, bala, guduchi, shankha pushpi, swarna
bhasma etc.
Pitta prakruti → ghrita, dugdha, Aamalaki, chyavanprasha, Shatavari, Bhringaraja, brahmi,
rajata etc.
Kapha prakruti → madhu, trikatu, triphala, haritaki, brahma rasayana, bakuchi etc.

Rasayana and stages of life:

Age-group Loss of impact / desired Rasayana recommended
in years effect
1 – 10 Balya (childhood) Vacha, swarna bhasma
11 – 20 Vriddhi (growth) Kashmari, bala, Shatavari
21 – 30 Chhavi (complexion) Aamalaki, loha bhasma
31 – 40 Medha (intellect) Medhya rasayana like shankhapushpi, brahmi
40 – 50 Twaka (skin) Jyotishmati, tuvaraka, somaraji, bringaraja
51 – 60 Drishti (vision) Triphala, Jyotishmati, dhatriloha
61 – 70 Shukra (semen) Kapikacchu, ashwagandha, shilajatu
71 – 80 Vikrama (power / courage) Aamalaki, bala, mahabala, ashwagandha
81 – 90 Buddhi (wisdom) Brahmi
90 – 100 Karmendriya (motor func.) Rasayana not effective.

PURPOSE OF RASAYANA
Rasayana should be used for three-fold purpose →
1. Maintaining health,
2. Prevention of diseases and old age and
3. To aid in treatment, and to avoid the recurrence of diseases.
Sharangadhara has advised that in each group of age, every person should take specific
rasayana for keeping healthy and fit.

PATHYA & APATHYA (DURING RASAYANA THERAPY)

Pathya ahara:
Goghrita, go dugdha, aja dugdha, madhu, sheetala jala, shashtika shali, mudga yusha, yava
yavagu, laja, jangala mamsarasa

160
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Pathya vihara:
Satata adhyayana, satsanga, laghu vyayama, abhyanga, utsadana, snana, swachha vastra
dharana, brimhana karma, vishrama, achinta etc.

Apathya ahara:
Ati amla, ati lavana, katu, kshara, shushka shaka, shushka mamsa, tila, tila pishta, masha,
virudha anna (sprouted grains), nava anna, viruddha ahara, asatmya ahara
Apathya vihara:
Vishama vyayama, ati vyayama, ati vyavaya, diva swapna, ratri jagarana, vega dharana, ratri
jagarana, atapa sevana, maruta sevana, krodha, shoka, bhaya etc.

Chyavanaprasha:
Ingredients:
Pradhana dravya → Aamalaki
36 kwatha dravya → bilwa, agnimantha, shyonaka, gambhari, patala, bala, mashaparni,
mudgaparni, prushnaparni, shalaparni, pippali, gokshura, brihati, kantakari, karkata shringi,
bhumyamalaki, draksha, jeevanti, pushkara mula, agaru, haritaki etc.
Prakshepaka dravya → madhu, pippali, twaka, ela, patra, & nagakeshara

Preparation:
All these herbs are taken 1-1 pala each in coarse powdered form and cooked in 1 drona of
water. A pottali of 500 fruits of aamalaki is immersed in this mixture to be cooked. Boil the
water till it is reduced to ¼ then pottali is removed and decoction is filtered.
• Seeds of Amalaki fruits are removed and paste is made. Fibres are removed by
straining it through cloth.
• Fry this paste of Amalaki in the mixture of ghrita & tila taila till the moisture is
evaporated.
• Add sugar (mishree) to decoction and boil to prepare syrup, to this add fried paste of
Amalaki and cook till it becomes avaleha. After cooling add madhu (honey) and
prakshepaka dravya – chaturjata (twaka, ela, tejapatra, nagakesara)

Dose: the quantity that should not alter the food intake.

Indications:
• Rajayakshma • Vruddha • Vatarakta
• Kasa • Bala • Pipasa
• Shwasa • Svara roga • Mutra vikara
• Kshata-ksheena • Hridaroga

Benefits: best rejuvenative and anti-aging medicine.

161
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Prathama brahma rasayana:
Preparations:
This consists of five types of roots (pancha panchamoola)
Laghu panchamoola → gokshura, brihati, kantakari, shalparni, prishni parni
Bruhati panchamoola → bilwa, agnimantha, shyonaka, gambhari, patala
Madhyama panchamoola → bala, Punarnava, Eranda, mudgaparni, mashaparni
Jeevaniya panchamoola → jeevanti, jeevaka, rishbhaka, meda, mahameda
Trina panchamoola → kush, kasha, nala, darbha, kandekshu

Take all 25 drugs, 10 pala (50 gms) each with 1000 fruits of haritaki and 3000 fruits of
aamalaki, add 10 times water. Boil it to prepare decoction. Take the fruits of haritaki &
Aamalaki out and remove seeds then prepare paste of these cooked fruits. Mix decoction and
paste again and add mandukaparni, pippali, shankhapushpi, musta, vidanga, chandana, agaru,
yashtimadhu, haridra, vacha, twaka, ela churna to it (4 pala each). Then add 1100 pala of
mishree (sugar), 2 adhaka of tila taila and 3 adhaka of ghrita. Cook the mixture on low fire till
avaleha (jam) is prepared. After cooling add madhu (honey) to it.

Dose: It should be taken in such quantity that doesn’t alter appetite of the person that means it
should get digested before the time of food.

Benefits: By the administration of this rasayana, the sages (tapashwi) regained their youth
(taruna vaya) and achieved medha, smruti & bala. One, who seeks nirapada deerghayu &
taarunya, should use this rasayana.

Dwitiya brahma rasayana:

Preparation:
Take 1000 fruits of Aamalaki, remove the seeds and cook them well in milk. Then dry the
mixture in sun and triturate it with the Aamalaki swarasa.
Add Punarnava, jeevanti, bala, nagabala, Shatavari, kapikacchu, guduchi, chandana, agaru,
brahmi, mandukaparni, shankhapushpi, pippali, vacha & Vidanga. Triturate the mixture again
with nagabala swarasa. Add double the quantity of mixture of madhu & ghrita to it. Keep the
mixture in jar for 15 days. Then add swarna bhasma, rajata bhasma, tamra bhasma and praval
bhasma.

Dosage: According to agni bala of the person and the quantity that should not alter the food
intake.
After digestion of medicine, the person should take Shastika Shali with milk and ghee.
Indications: it is indicated for Kutipraveshika rasayana.

Medhya rasayana:
Mandukaparni swarasa → 10 – 15 ml with madhu (honey) twice a day
Yashtimadhu churna → 2 – 3 gms with ksheera (milk) twice a day
1. Guduchi swarasa → 10 – 15 ml with equal quantity of madhu twice a day.
2. Shankhapushpi churna → 3 gms with ksheera twice a day

162
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Benefits:
Medhya rasayana promote the intellect (dhee), retention power (dhruti), and memory
(smruti). They provide medha, aarogya, aayu, agnibala, dehabala, varna & svara.

Haritakyadi rasayana:
Preparation:
A decoction is prepared of haritaki, Aamalaki, bibhitaki, pancha panchamula
Add to it paste prepared from the mixture of pippali, yashtimadhu, Kakoli, ksheera Kakoli,
kapikacchu, jeevaka and rushbhaka. Add vidari swarasa, ksheera and ghrita and cook
properly.

Benefits: This is excellent tonic for old age and increases functions of all sense organs and all
systems of the body.

Aamalaka rasayana:
Preparation:
Aamalaki, haritaki & bibhitaki or combination of these, is tied to the bark of palasha. This is
covered with a layer of wet mud. This big ball is fried using cow dung cake fire.
Then the mud and Palasha layers are scrapped, pulp is taken and crushed properly in khalva
yantra.
This paste is administered by adding equal quantities of dadhi, ghrita, madhu, tila, kalka &
mishree.

Use: During administration of this rasayana, person should be restrained from food, if he
feels hunger, should take milk or fruits.
Benefits: By the administration of this rasayana, the sages regained their youth and lived for
many hundreds of years.

Aamalakavaleha:
1000 Amalaki and 1000 Pippali are soaked in Ksharodaka of Palasha. Then these are dried,
powdered, mixed with Ghrita, Madhu & Sharkara and kept in a ghee smeared jar. This jar is
stored underground for 6 months.

Vidangavaleha:
All the ingredients Vidanga churna (1 aadhaka), pippali churna (1 aadhaka), sitopala churna
(1½ aadhaka) and ghrita, taila, madhu (1 aadhaka each) are mixed and then kept in a ghee
smeared jar. This jar should be stored inside a heap of ashes for complete rainy season.

Nagabala rasayana:
Roots of Nagabala should be collected from Jangala desha, the earth of the field should be
snigdha, krishna, madhura or suvarna varna. The field should be free from poison, wild
animals and pavana-salila-agni-dosha., should not be cultivated land, no ant-hill, no
crematorium, no sacred temple, no residential house etc. Roots of Nagabala should be
collected in the month of magha & falguna.
The roots are made to a thin paste or powder and taken with milk or honey in the morning.

163
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Indrokta rasayana: first rasayana told by lord Indra.
Regular use of drugs like endri, brahmi, payasya, ksheerapushpi, Shravani, mahashravani,
Shatavari, vidari, jeevanti, Punarnava, nagabala, vacha, meda, mahameda, with ksheera
(milk) for 6 months improves svara, varna, bala, medha, smruti.

Droni-praveshika rasayana:
The juice (swarasa) of brahma sauvarchala, suryakanta, nari, kasthagodha, sarpa, soma,
padma, aja, neelika should be taken internally and then the person enter the droni made of
palasha, after smearing his body with ghrita.
He stays unconscious for 6 months in the boat and then awakens completely rejuvenated
(achieves ayu-varna-svara-aakruti-bala-kanti).
Aja ksheera should be given to drink.

Kevala aamalak rasayana:

After spending one year on milk-diet and surrounded by cows, one should do fasting for three
days and then enter the forest of amalaki, in the months of pusha, magha, falguna. By
chanting aum, he should consume the fresh fruits of aamalaki.

Lohadi rasayana:
Red hot iron is dipped in triphala kwatha, gomutra & ksharodaka in sequence. Churna is
made and kept in ghrita-smeared earthen pot inside paddy of barley (yava) for one year. After
one year, it should be used with madhu according to agnibala.

Pippali vardhamana rasayana:

Intake of pippali daily with godugdha, start with 10 pippali, then increase it by 10 pippali /
day, every day for 10 days, then from 11the day decrease it by 10 pippali/day till the
consumption of total 1000 pippalis.

Increasing Decreasing
1st day → 10 11th day → 90
2nd day → 20 12th day → 80
3rd day → 30 13th day → 70
4th day → 40 14th day → 60
5th day → 50 15th day → 50
6th day → 60 16th day → 40
7th day → 70 17th day → 30
8th day → 80 18th day → 20
9th day → 90 19th day → 10
10th day → 100
550 450
Total → 1000 pippali

164
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Methods of Pippali Rasayana Prayoga:
1.shreshtha prayoga: Starting with 10 pippali, increasing & decreasing by 10-10 pippali →
1000 pippali prayoga.
2.madhyama prayoga: Starting with 6 pippali, increasing & decreasing by 6-6 pippali → 600
pippali prayoga.
3.laghu prayoga: Starting with 3 pippali, increasing & decreasing by 3-3 pippali → 300
pippali prayoga.

Benefits of pippali rasayana:

Brimhana, svarya, aayushyam, pleehodaranashanam, vayasthapana, medhyam etc.

Shilajatu rasayana:
Rasa → amla rasa yukta kashayarasa pradhana
Virya → na ati ushna sheeta (neither hot nor cold)
Vipaka → katu
Karma → sarvaroganashaka

4 types of shilajatu →
Prakara Varna Rasa Virya Vipaka
Swarna shilajatu Raktabha Madhura tikta Sheeta Katu
Rajata shilajatu Swetabha Katu Sheeta Swadu
Tamra shilajatu Mayurkanthabha Tikta Ushna Katu
Loha shilajatu Krishna Tikta lavana Sheeta katu
Loha shilajatu is the best.

All shilajatus smell like cow’s urine i.e., gomutra Gandhi

Shilajatu rasayana prayoga vidhi:

Shilajatu shodhana → Shilajatu is mixed with dugdha and immersed into triphala kwatha or
hot decoction of the drugs that are prescribed for alleviating the aggravated
doshas. After the decoction is absorbed, decoction should be added again.
• This procedure should be repeated for 7 days.
• Use this processed Shilajatu (suddha shilajatu) mixed with loha bhasma with milk.
• Can be used for 7 or 3 or 1 weeks as para, madhyama and avara prayoga respectively.
• Can be used in dose of 1 pala, ½ pala, and 1 karsha.

Apathya in shilajatu prayoga:

Avoid teekshana guru ahara, and especially kulattha while taking shilajatu, because kulattha
has the quality of ashmano bhedana (cutting & breaking of stone).

165
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Triphala rasayana:
Acharya Charaka has explained following four rasayana prayoga of Triphala:
Triphala rasayana 1:
Along with honey and ghee, a person should take: 1 haritaki after digestion of previous meal;
2 bibhitaki before food; and 4 aamalaki after food.
Triphala rasayana 2:
A new iron vessel should be pasted with the Triphala paste (kalka) for 24 hours.
This paste is administered with honey and water. After its digestion, one should take food
with ghrita and sneha.
If it is administered for one year, the person can live one hundred years free from aging and
diseases.
Triphala rasayana 3:
Using Triphala churna with Yashtimadhu, Vamshalochana, Pippali, Madhu, Ghrita and
Mishri is effective anti-aging rasayana.
Triphala rasayana 4:
Triphala along with Sarva Loha bhasma, Suvarna bhasma, Vacha, Vidanga, Pippali, Lavana,
Madhu, and Ghrita is administered continuously for one year. It provides health, intellect,
strength and longevity.

Other important rasayanas:

• Dhatri rasayana • Arjuna ksheerapaka
• Ashwagandha rasayana • Rasona ksheera
• Amrutaprasha ghrita • Shankhapushpi
• Agastya haritaki • Gandhaka rasayana

ANTIOXIDANT ACTION OF RASAYANA

Rasayana drugs act as anti-oxidants. Antioxidants are the substances that reduce oxidative
damage that caused by free radicals. Well known antioxidants include a number of enzymes
and other substances such as vitamin C, vitamin e and beta-carotene that are capable of
counteracting the damaging effect to oxidation.
A recent study shows that people whose diets had highest level of vitamin-E were 30% less
likely to develop type-2 DM. In addition, researchers found that people who ate a lot of
carotenoids, a type of antioxidant found in colourful fruits and vegetables, also had a lower
risk of developing type-2 DM.
Oxidative damage to cells is also important phenomenon in aging process. So, antioxidants
are also helpful in delaying aging.
Antioxidants may possibly reduce the risk of cancer and age-related macular degeneration.
Many rasayana drugs like Aamalaki, ashwagandha, guduchi etc. act as antioxidants. Main
constituents of amalaki are vitamin C, carotene, and riboflavin. It is having a role in cellular
oxidation reduction. They have also, a role in collagen fibrin synthesis, helps in formation of
fibrin; Absorption of iron. Withanolide in ashwagandha also acts as antioxidant by
increasing levels of three natural antioxidants like – dismutase, catalase, glutathione
peroxidase.

166
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
IMMUNO-MODULARY ACTION OF RASAYANA
Immunomodulator is a chemical agent (as methotrexate or azathioprine) that modifies the
immune response or the functioning of the immune system (as by the stimulation of antibody
formation or the inhibition of white blood cell activity).
Rasayana drugs also act as immunomodulator. Certain rasayana drugs such as guduchi,
haridra, pippali, shilajatu etc. act as immunomodulator; strengthening of immunity is done in
various ways by promoting bodily defence mechanism like increasing the WBC count,
improving immune function.
In an in vitro study on immune competent cells, aqueous extract of the stems of guduchi was
found enhancing T as well as B cells responses and protected mice against experimental
infections. (Sainis et al, 1998).
Administration of brahma rasayana, amrutaprasha rasayana, and Narasimha rasayana were
found to enhance the proliferation of lymphocytes in response to Mitogens.

167
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)

10. Vajikarana- Derivation, definition, synonyms, necessity,

benefits, importance of fertility, Symptoms of Shukra (Semen),
Vajikaran Dravya and Aushadhi. Properties, doses, methods of
administration, ingredients and methods of formation of Rasayana &
Vajikarana formulation. Classification and importance of Vajikarana
Dravya

DERIVATION →
The word ‘Vaji’ is a synonym of horse (which is known for high physical strength and sexual
power) Vaja means shukra, person who is having shukra (semen) is known as ‘vaji’, and who
is not possessing it is called ‘avaji’.

DEFINITION OF VAJIKARANA →
The medicine which makes the man able to have children and continue his generations; the
medicine which induces sexual desire and pleasure; and by using which the man copulate
with woman like a horse is called Vajeekarana.
The drugs and foods which make a man capable of performing sex many times, like a horse,
are called ‘Vajeekarana’.

VAJIKARANA PARYAYA
1. Vajikara → that which makes the man powerful like a horse.
2. Vrushya → increases the quantity and quality of semen.
3. Kamotejaka → sexual stimulant – enhances libido in man or woman.
4. Punsatva prada → enhances sexual competence
5. Sukra bala prada → increases shukra (semen) and bala (strength)

AIM (PRAYOJANA) OF VAJEEKARANA SEVANA / BENEFITS

According to charaka, one should use vajeekarana for –
• Achieving dharma, artha, Preeti, & yasha
• Producing a good progeny

According to sushruta - the three benefits attributed to vajikarana –

Preeti – pleasure, affection to women
Apatya – producing offspring (children)
Bala prada – strength in the body.

IMPORTANCE OF FERTILITY
A person with no progeny (without child) is useless like a tree with no fruits, having one
branch with no shadow. A man without child is like an idol made of grass wearing the grad of
a man, he is like a lamp in sketches (paintings), like gold without any qualities of gold, and
like a dried lake.

168
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
A person, who has many children (bahu prajah), is having bahu murti, bahu mukha, bahu
vyooha, bahu kriya, bahu chakshu, bahu jnana, & bahu aatma. He is mangali (auspicious),
yasha vaan (praise-worthy), dhanya (blessed), viryavaan and bahu shakha yukta.

PRASHASTA PHALAPRADA SUKRAGUNA (qualities of semen that is capable of

reproduction)
बहलं मिुरं च्स्ननिंववस्रं गुरु वपच्छिलं |
शुक्लं बहु ि यत ् शुक्रं फलवतद् असंशयम ् ||
1. Bahala → thick
2. Madhura → sweet (by inference)
3. Snigdha → unctuous
4. Avisra → not having foul smell
5. Guru → heavy
6. Picchila → slimy
7. Sukla → white
8. Bahu → profuse (in sufficient quantity)

CLASSIFICATION OF VAJIKARANA DRAVYAS

Broadly vajikarana dravyas or the vajikarana therapy is of four types viz.
1. Shukra janaka (sukrala) → that increases semen e.g., ashwagandha, musali, Shatavari,
sarkara, shilajatu, kapikacchu etc.
2. Shukra pravartaka → that enables flow of semen e.g., stree sparsha, Sankalpa,
madira, ahiphena
3. Shukra sruti vruddhikara → that increases ejaculation e.g., masha, bhallataka,
kapikacchu, ksheera etc.
4. Shukra stambhaka → that causes prolonged erection of penis e.g., jatiphala, ahiphena,
kesara etc.

Indications:
• Jitendriya (self-controlled, or who can control his sense organs)
• Apatyarthi (who wants good progeny)
• Kama sukharthi
• Upabhoga sukharthi
• Veerya vardhanarthi
• Putrarthi
• Klaibya
• Alpa veerya
• Vilash purush
• Dhanavana
• Rupavana
• Shodhita
• Between 16 – 70 years of age

169
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Contraindications:
• Below 16 years of age
• Above 70 years of age
• Chintita
• Vyadhita (rogi)
• Upavasita
• Ati vyavaya shranta
• Duratma
• Avivahita
• Brahmachari
• Sadhu-santa-tapasvi
• Ashodhita

VAJEEKARANA SEVANA VIDHI (PROCEDURE) →

Shodhana is essential before Vajikarana therapy is administered.
Poorvakarma – Depending upon the strength of the person, Shodhana therapies should be
administered, before the commencement of Vajikarana-chikitsa, like a dirty cloth does not get
properly coloured even if it is dyed, similarly in an uncleaned body the aphrodisiac remedies
do not produce the desired effects.
Pradhana karma – After Shodhana, with consideration of age, strength, prakriti and needs of
the individual person, a suitable vajikarana drug or formulation should be administered with
suitable anupana and pathya for a certain duration.
And the person should be observed carefully for the effects and adverse effects.
Paschat karma – The person, after therapy should be exposed to like beautiful parks, ponds,
mountains, pleasing women, scents, flavours, garlands, friendly companions, body massage,
bathing, wearing clean and perfumed clothes etc., and he should follow pathya-apathya.

Vajikarana aachara vichara:

A person gets vigour, and he becomes fit for sexual intercourse, if he is having following
aachara – vichara:
Consumes ghee and milk regularly
Free from fear (i.e., courageous)
Free from any disease (i.e., healthy)
Youthful
Willing to have sex

Pathya & apathya:

Pathya aahara:
Go ghrita, go dugdha, dugdha vikara, shashtika shali, godhuma, yava, saktu, pakwa phala,
phala swarasa, sushka phala (dry-fruits), kharjura, madhura rasa pradhana dravya, harita
shaka, jangala mamsarasa etc.

170
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Pathya vihara:
Vajeekarana mitra mandali, vajeekara stree sparsha, mano anukula vihara, mano anukula
geeta-vadhya-yantra, abhyanga, snana, svachcha & sugandhita vastra dharana etc.

Apathya aahara:
Ati katu, ati amla, ati lavana, ruksha anna sevana, guda vikara, asatmya, viruddha ahara,
anashana (upavasa) etc.
Apathya vihara:
Ati vyavaya, ayoni maithuna, diva swapna, chinta, shoka, bhaya etc.

Stree sarva pradhana vajikarana:

A beautiful and youthful woman is the best aphrodisiac.

Vrushyatama stree: woman suitable for sexual intercourse

अतुल्यगोत्रां वष्ृ यां ि प्रहृष्टां ननरुपिवाम ् |
शुिस्नातां व्रजेन्नारीमपत्याथी ननरामयः ||
A person who is healthy and who desires to have child should copulate with a woman who is-
Atulyagotra → of a different clan.
Vrushya → sexually attractive
Praharshta → excited
Nirupadrava → free from any disease
Suddha snata → after her menses and / or after taking bath

Lakshana of vrushya (vrushyatama stree):

Surupa → beautiful
Yauvana avastha → youthful
Vashya → attractive or adorable
Shikshita → educated
Nritya sangeeta geetadi kala praveena → expert in dance, music and other arts

Vajikarana dravya (drugs):

Aahara:
Dugdha, ghrita, mamsarasa, shashtika shali, godhuma, saktu, masha, lasuna, palandu,
kushmanda, haridra, dadima, mrudvika, kharjura etc.
Vihara:
Vajikarana mitra mandali, vajikarana aachara vichara, stree sparsha, manoanukula vihara,
mano anukula geeta-vadhya-yantra, abhyanga, snana, svachcha & sugandhita vastra dharana
etc.
Aushadha:
Kapikacchu, ashwagandha, Shatavari, musli, Kokilaksha, gokshura, Punarnava, vidari kanda,
bhallataka, keshara, shuddha shilajatu, swarna bhasma, Abhraka bhasma etc.

171
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
VAJIKARANA YOGA
Brimhana gutika:
Ingredient:
Kvatha dravya:
3 – 3 pala each sharamula – ikshumula – kandekshu – ikshuvalika – Shatavari –
ksheerakakoli – Kakoli – vidarikanda – kantakari – jeevanti – jivaka – rushbhaka – meda –
bala etc. & 1 aadhaka masha & 1 drona jala
Kalka dravya:
2 – 2 pala each yashtimadhu, draksha, atmagupta, Shatavari, pippali, kharjura, amalaki
Prakshepaka dravya:
Sharkara, vanshalochana, pippali, maricha, twaka, ela, nagakeshar

Method of preparation:
The kwatha and kalka are cooked in 1 aadhaka dugdha & 1 drona ghrita as per ghritapaka
vidhi. Then prakshepaka dravya are added and gutika are prepared.

Vajikarana pinda rasa:

Ingredient: Sharkara, masha, vanshalochana churna-godhuma churna-dugdha-ghrita
Method of preparation:
Utkarika is prepared of above ingredients. These are cut into pieces, eladi chaturjata dravya
are sprinkled on these pieces, and then squeezed and mixed with kukkuta madhura
mamsarasa. This is known as vajikarana pinda rasa.

In the same way, other pinda rasa can be prepared with mayur, hansha or titira mamsarasa.

Benefits:
It promotes bala& varna. Man becomes exceedingly excited.

Vajikarana ghrita:
2.56 kg each of newly harvested masha and kapikacchu and 160 gm each of jeevaka,
rushabhaka, veera, meda, ruddhi, Shatavari, madhuka, ashwagandha are added in water and
boiled to prepare decoction.
640 gm ghee – 6.4 litre milk -640 ml juices each of vidari and ikshu are added and the mix is
cooked on mild fire. This ghee preparation should be mixed with 160 gm of each of Sharkara,
madhu, vanshalochan, pippali.
The dose is 40 gm before meal.

Vrushya pippali yoga:

This product is prepared by frying 30 pippali in 40 gm of each of tila taila and ghrita,
pulverizing and then mixing with sugar and honey. The food should consist of shashtika shali
and ghee.

172
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Vrushya payash yoga:
This is good aphrodisiac. The rice cooked with milk is called payasa. The masha and
shashtika shali are cooked in the decoction of gokshura, and vidari with four times milk and
plenty of ghee.

Vrushya madhuka yoga:

One who uses 10 gm madhuka powder mixed with ghrita, madhu and ksheera becomes
continuously impelled with sex urge.

Vrushya rasa:
1. Chataka mamsa cooked in titira mamsa.
2. Titira mamsa cooked in kukkuta mamsa.
3. Kukkuta mamsa cooked in Mayura mamsa.
4. Mayur mamsa cooked in hansa mamsa.
These mamsarasa are again fried with ghrita and amla dravya, madhura dravya, ela, or
Sharkara are added as per taste.

Apatyakari shashtikadi gutika:

The shashtika shali is soaked in milk, then crushed and grounded with milk. The paste is
squeezed in a cloth to collect its juice.
To this juice, godugdha and atmagupta bija churna are added and boiled.
While boiling, the decoction of masha, bala, mudgaparni, mashaparni, jeevanti, jivaka,
ruddhi, rushbhaka, Kakoli, gokshura, yashtimadhu, Shatavari, vidarikanda, draksha and
kharjura are added.
At the end of boiling, powders of vanshalochana, masha, shashtika shali and godhuma are
added to make it semisolid.
Add madhu and Sharkara to make it sweet.
Pills are prepared and fried with ghrita.

Dose: depending upon agnibala.

Benefits: even an old man becomes capable of procreating many children and he does not get
exhausted during sexual intercourse.

Vrushya ksheera:
Ingredients:
Kwatha dravya: 1 – 1 pala each kharjura mastaka, kharjura, ksheerakakoli, Shatavari,
madhuka, mrudwika, kapikacchu & 1 aadhaka jala.
Method of preparation:
Decoction is prepared by boiling above ingredients till 1/4th part is remaining. 1 prastha
ksheera (milk) is added and boiled again till the milk part remails.
Use:
This vrushya ksheera should be taken with shashtika shali mixed with ghrita.

173
Kaya chikitsa paper 2 By: Tajagna Dalsaniya
(9664757178)
Vrushya ghrita:
The kalka of jeevaka, rushbhaka, meda, jivanti, yashtimadhu, kharjura, draksha, pippali,
sunthi, shrungataka, and vidari is cooked with 4 parts of ghrita, 4 parts of dugdha, and 16
parts of jala till only ghrita remains.
This vrushya ghrita is mixed with ¼ part madhu and Sharkara.

Vrushya Shatavari ghrita:

1 kudava Shatavari kalka is cooked with 1 prastha go ghrita and 10 prastha go dugdha till
only ghrita remains. This should be taken with madhu, sharkara and pippali.

Masha:
Black gram is one of the best vajikarana dravya (aphrodisiac drugs). It can either be used
directly, or indirectly, by drinking the milk of the cow fed on black-gram leaves.

Mashadi pupalika:
The flours of masha, godhuma, shali, shashtika shali, and powders of kapikacchu, vidari,
ikshu and Sharkara (mishree) are mixed and kneaded with milk to make dough for making
pancake balls. These pancake balls are rolled in to pancakes and fried in ghee to make
pupalika. These pupalika are to be taken with milk.

Other important vajikarana yogas:

• Vanari gutika → kapikacchu, Sharkara
• Makaradhwaja rasa → parada, gandhaka, swarna
• Ashwagandhadi churna → ashwagandha, vidari, gokshura
• Amruta bhallataka → bhallataka, triphala, Shatavari
• Kesharpaka → keshar, trikatu, gokshura
• Suddha shilajatu (shilajeeta)

174
 1

THANK YOU